Fillable Application-for-taxieditable CITY OF KANKAKEE, ILLINOIS

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Application-for-taxieditable CITY OF KANKAKEE, ILLINOIS

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1
CITY CLERK’S OFFICE
304 SOUTH INDIANA AVENUE
KANKAKEE, ILLINOIS 60901
PHONE 815-933-0480
FAX 815-933-0482
PUBLIC PASSENGER VEHICLES FOR HIRE
DRIVER’S REGISTRATION APPLICATION
DATE:_________________________________________
___________________________________________________________________________________
PERSONAL INFORMATION
___________________________________________________________________________________
NAME OF APPLICANT SOCIAL SECURITY NUMBER
___________________________________________________________________________________
AGE SEX WEIGHT HEIGHT EYE COLOR HAIR COLOR
___________________________________________________________________________________
DRIVER’S LICENSE NUMBER EXPIRATION DATE
___________________________________________________________________________________
RESIDENCE ADDRESS PHONE NUMBER
___________________________________________________________________________________
EMPLOYER INFORMATION (IF APPICABLE)
___________________________________________________________________________________
NAME OF EMPLOYER BUSINESS ADDRESS
___________________________________________________________________________________
NAME OF IMMEDIATE SUPERVISOR PHONE NUMBER
PERSONAL REFERENCES:
___________________________________________________________________________________
NAME ADDRESS (CITY, STATE, ZIP CODE) PHONE NUMBER
___________________________________________________________________________________
NAME ADDRESS (CITY, STATE, ZIP CODE) PHONE NUMBER
2
1. IS YOUR DRIVER’S LICENSE VALID, CURRENT AND PROPERLY
CLASSIFIED BY THE SECRETARY OF STATE? YES NO
___________________________________________________________________________________
(IF NO, PLEASE EXPLAIN)
___________________________________________________________________________________
PLEASE ATTACH A COPY OF YOUR DRIVER’S LICENSE TO THIS APPLICATION.
2. HAVE YOU BEEN CONVICTED OF, OR PLACED ON SUPERVISION FOR
MORE THAN THREE (3) OFFENSES AGAINST THE TRAFFIC
REGULATIONS GOVERNING THE MOVEMENT OF MOTOR VEHICLES
WITHIN TWO (2) YEARS OF THE DATE OF THIS APPLICATION? YES NO
__________________________________________________________________________________
(IF YES, PLEASE EXPLAIN)
___________________________________________________________________________________
3. HAVE YOU BEEN CONVICTED OF, OR PLACED ON SUSPENSION FOR RECKLESS
DRIVING, DRIVING UNDER THE INFLUENCE OF ALCOHOL OR DRUGS, DRAG
RACING, FLEEING OR ATTEMPTING TO ELUDE A POLICE OFFICER, LEAVING
THE SCENE OR FAILURE TO REPORT AN ACCIDENT INVOLVING INJURY OR
DEATH WITHIN FIVE (5) YEARS OF THE DATE OF THIS APPLICATION?
YES NO
_____________________________________________________________________________________
(IF YES, PLEASE EXPLAIN)
_____________________________________________________________________________________
4. HAS YOUR DRIVER’S REGISTRATION, ISSUED UNDER THE PROVISIONS HEREIN,
BEEN REVOKED OR SUSPENDED FOR CAUSE WITHIN THREE (3) YEARS AT THE
DATE OF THIS APPLICATION? YES NO
_____________________________________________________________________________________
(IF YES, PLEASE EXPLAIN)
_____________________________________________________________________________________
3
5. HAVE YOU BEEN CONVICTED OF A FELONY OFFENSE, INCLUDING MURDER,
MANSLAUGHTER, RECKLESS HOMICIDE, RAPE, PROSTITUTION, ARMED
ROBBERY OR VIOLENCE, ILLEGAL MANUFACTURE, POSSESSION OR DELIVERY
OF A CONTROLLED SUBSTANCE OR ANY OFFENSE SIMILAR TO THE
FOREGOING OFFENSES UNDER FEDERAL, STATE, AND LOCAL LAWS OR
ORDINANCES? YES NO
_____________________________________________________________________________________
(IF YES, PLEASE EXPLAIN)
_____________________________________________________________________________________
6. HAVE YOU KNOWINGLY FURNISHED FALSE OR MISLEADING INFORMATION
OR WITHHELD RELEVANT INFORMATION ON ANY REGISTRATION
APPLICATION FOR ANY REGISTRATION REQUIRED ON THE PROVISIONS
HEREIN, OR KNOWINGLY CAUSED OR SUFFERED ANOTHER TO FURNISHED
OR WITHHOLD SUCH INFORMATION ON HIS BEHALF? YES NO
_____________________________________________________________________________________
(IF YES, PLEASE EXPLAIN)
_____________________________________________________________________________________
THIS PERMIT IS VALID FROM MAY 1, __________ THROUGH APRIL 30,_________________.
DRIVER’S ID IS INVALID ON LEAVING EMPLOYMENT OF ____________________________
CAB COMPANY.
I ______________________________________________, DO HEREBY CERTIFY THAT THE
INFORMATION SUBMITTED HEREWITH IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE AND BELIEF AND UNDERSTAND THE CONDITIONS AND LIMITATIONS
SET HERETOFORE.
SIGNATURE OF APPLICANT:_____________________________________ DATE:_____________
4
TAXI DRIVER’S APPLICATION
CRIMINAL BACKGROUND INVESTIGATION AND
LOCAL ALPHA CONTACT REPORT
RELEASE FORM
Applicant: Please read, sign and date the following:
This is to inform you that a criminal background investigation and local alpha contact report will be
conducted as part of your application processing.
I AUTHORIZE the City of Kankakee, Illinois, Police Department, to conduct a criminal history
search, and other background checks required, through the City of Kankakee, Illinois per Chapter
33 of the Municipal Code Book Section 33-33.
I understand that my application approval is contingent upon successful completion of both the
criminal background investigation and local alpha contact report. I acknowledge that if I provide
false, inaccurate, incomplete or misleading information it may result in denial of this application
and all future applications.
I also release City of Kankakee, from any and all claims and liability related to or arising from
background investigation. I further release any and all parties providing information in connection
with my taxi driver’s application background investigation from any and all claims and liability
related to or arising there from, and all such parties are authorized to provide any information
requested by City of Kankakee in connection with the application background investigation and to
rely on this release as if they were a party hereto.
Date__________________
________________________________ __________________________________________________
Applicant's Signature Full Name/Include Maiden Name (Type or Print Legibly)
____________________________ ______________ ___________________________
Race Sex Daytime Phone Number
____________________________ _______________ ___________________________
Social Security Number Date of Birth Driver’s License Number
____________________________________________________________________________
Current Address (Street, Apt. #, City, State, Zip Code)
5
PUBLIC PASSENGER VEHICLES FOR HIRE
OPERATOR’S LICENSE APPLICATION
_____________________________________________________________________________________
PERSONAL INFORMATION
_____________________________________________________________________________________
NAME OF APPLICANT SOCIAL SECURITY NUMBER
_____________________________________________________________________________________
DRIVER’S LICENSE NUMBER EXPIRATION DATE
_____________________________________________________________________________________
RESIDENCE ADDRESS PHONE NUMBER
_____________________________________________________________________________________
BUSINESS INFORMATION
_____________________________________________________________________________________
NAME OF BUSINESS EMPLOYER IDENTIFICATION NUMBER
_____________________________________________________________________________________
BUSINESS ADDRESS PHONE NUMBER
_____________________________________________________________________________________
CHIEF EXECUTIVE OFFICER RESIDENCE ADDRESS
PRINCIPAL SHAREHOLDERS (IF APPLICABLE)
______________________________________________________________________________
NAME ADDRESS (CITY, STATE, ZIP CODE)
_______________________________________________________________________________
NAME ADDRESS (CITY, STATE, ZIP CODE)
_______________________________________________________________________________
NAME ADDRESS (CITY, STATE, ZIP CODE)
6
REFERENCES:
CREDIT
_______________________________________________________________________________
NAME OF BUSINESS ADDRESS (CITY, STATE, ZIP CODE) PHONE NUMBER
_______________________________________________________________________________
NAME OF BUSINESS ADDRESS (CITY, STATE, ZIP CODE) PHONE NUMBER
_______________________________________________________________________________
NAME OF BUSINESS ADDRESS (CITY, STATE, ZIP CODE) PHONE NUMBER
PERSONAL
_______________________________________________________________________________
NAME ADDRESS (CITY, STATE, ZIP CODE) PHONE NUMBER
_______________________________________________________________________________
NAME ADDRESS (CITY STATE, ZIP CODE) PHONE NUMBER
_____________________________________________________________________________________
SCHEDULE OF RATES
METERED RATES
FIRST 1/8 MILES OR FRACTION THEREOF: $ _________________________
EACH ADDITIONAL 1/8 MILE OR FRACTION THEREOF: $ _________________
EACH ADDITIONAL PASSENGER: $ _____________________ (FLAT RATE)
WAITING TIME PER EACH ½ MINUTE OR FRACTION THEREOF: $ ________
OTHER (PLEASE DESCRIBE): ___________________________________________
_________________________________________________________________________
_________________________________________________________________________
7
NON-METERED RATES
FLAT RATE (ONE-WAY PER PERSON): $ _______________________________________
SERVICE AREA: _______________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
OTHER (PLEASE DESCRIBE): _________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
OTHER RATES:
SPECIAL OR DISCOUNT RATES (PLEASE DESCRIBE):___________________________
_______________________________________________________________________________
_______________________________________________________________________________
OTHER (PLEASE DESCRIBE): __________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
8
PUBLIC PASSENGER VEHICLES FOR HIRE
VEHICLE INFORMATION
(1) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
(2) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
(3) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
(4) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
(5) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
9
(6) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
(7) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
(8) _______________________________________________________________________________
MAKE MODEL YEAR OF MANUFACTURE
_______________________________________________________________________________
SEATING CAPACITY VEHICLE IDENTIFICATION NUMBER
_______________________________________________________________________________
LICENSE PLATE NUMBER EXPIRATION DATE
APPLICANT SHALL FURTHER FURNISH, IN ADDITION TO THE ABOVE INFORMATION,
PROOF OF REQUIRED INSURANCE AND VEHICLE INSPECTION REPORTS FOR EACH
VEHICLE TO BE COVERED BY THE LICENSE
_____________________________________________________________________________________
CERTIFICATION
I, _____________________________________________, DO HEREBY CERTIFY THAT ALL OF
THE ABOVE INFORMATION, AND THE INFORMATION CONTAINED IN ANY
DOCUMENTS SUBMITTED HEREWITH IS TRUE AND CORRECT TO THE BEST OF MY
KNOWLEDGE AND BELIEF.
____________________________________________________________________________________
SIGNATURE OF APPLICANT DATE
A FEE OF $25.00 PER EACH PUBLIC VEHICLE TO BE COVERED BY THE LICENSE,
SHALL ACCOMPANY AND BE MADE PART OF THIS APPLICATION UPON ITS FILING
WITH THE CITY CLERK.
OFFICE USE ONLY:
PROCESSED BY: ________
DATE: __________________
APPROVED DENIED
10
Here is a sample of a posting for your records:
Notice of Public Hearing
Notice is hereby given that the City of Kankakee License and Franchise Committee will
hold a public hearing giving all persons interested the right to appear and to be heard
regarding the proposed taxicab application for an operator’s license submitted by
____________________________________ (your name/company). The public hearing
will be held on ___________________________(date) in the City Council Chambers,
Public Safety Building, 385 East Oak Street, Kankakee, Illinois, starting at 5:15 p.m.
Respectfully submitted by: _________________________________ (your name)
This notice needs to be posted not less than five (5) days, nor more than fifteen (15) days
from the date of the public hearing.
11
TAXI CAB REQUIREMENTS:
APPLICATION
COPY OF INSURANCE covered amount sum at least $50,000.00 property damage,
$300,000.00 combined single limit for injuries
COPY OF A VALID AND CURRENT ILLINOIS STATE LICENSE
ILLINOIS STATE SAFETY LANE OR IDOT TEST – MUST PASS
VALID ILLINOIS PLATES
PROOF OF FINANCIAL RESPONSIBILITY
COPY OF SCHEDULED RATES
Changes or modifications to rate must be approved by License & Franchise
and City Council. No new, modified or amended rate shall become effective
or any change shall be effective until on file for 30 days in the Clerk’s Office
and approved by both License & Franchise and City Council.
3 CREDIT AND 2 PERSONAL REFERENCES
METERS ARE TO BE CHECKED BY POLICE CHIEF
FEE
$25.00 for each vehicle that will be reduced by 50% if paid during second half of license
year.
$10.00 for each driver
HEARING
Upon filing of a vehicle-for-hire license application, a hearing notice must be published in
a newspaper of general circulation. The notice shall state that an application for a
operator’s license has been made, giving the applicant’s name, and that a public hearing on
the application will be held by the License & Franchise Committee, designating the place,
date, and hour. The date shall not be less than five (5) days, nor more than 15 (fifteen)
days from the date of publication. Applicant is required to pay the expense of publication
of the notice.
APPROVAL
Licensing subject to Police Chief’s approval. License must be approved by License &
Franchise and City Council.
PENALTY
$50.00 nor more than $500.00 per offense. A separate offense shall be deemed committed
for each day during which violation occurs or continues.
THE MAXIMUM HOURS A DRIVER CAN DRIVE IS TWELVE HOURS IN ONE
TWENTY-FOUR HOUR PERIOD.
12
TAXICAB APPLICATION
CHECKLIST
_____ Completed operator’s license application (including FEIN # and legal
name of the company)
_____ Three (3) credit references and two (2) personal references
_____ Proposed schedule of rates
_____ For each vehicle: make, model, year; seating capacity; VIN #; current
license plate; title #
_____ For each vehicle: proof of required insurance: property damage ($50,000) and public
liability ($300,000).
_____ For each vehicle: a valid vehicle inspection report
_____ Dates of any legal actions involving applicant’s use of public vehicle
_____ Proof of financial responsibility (may be insurance coverage)
_____ Completed driver’s registration application for each driver (including a copy of the
driver’s license and signed release form for background check)
_____ Send each driver’s application to the Police Department for background check.
______ Drivers photographed
FEES
$25 for each public vehicle
$10 for each and every driver covered by the registration of the applicant.
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Application-for-taxieditable CITY OF KANKAKEE, ILLINOIS

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Completed 11 July 2020

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