CITY OF
TAXICAB
REGISTRATION APPLICATION
COMPANY NAME: _____________________________________________________
MAKE: ____________________MODEL: _________________COLOR:
___________
YEAR: ______________________VIN: _____________________________________
==================================================================
INSURANCE CERTIFICATION
(attach
copy of insurance certificate)
INSURANCE POLICY # ___________________________________
AMOUNT OF COVERAGES ________________________________
(personal injury, bodily
injury, & property damage)
EXPIRATION DATE: _________________
__________________________________Insurance
Agent's Signature
==================================================================
MECHANIC'S
CERTIFICATION
I HEREBY CERTIFY THAT I HAVE EXAMINED AND
INSPECTED THE ABOVE VEHICLE AND THAT IT CAN BE SAFELY OPERATED, IT IS EQUIPPED
WITH ALL REQUIRED SAFETY DEVICES, AND IT IS IN A CLEAN AND SANITARY CONDITION.
______________________ ______________________________
Date Signature
______________________ ______________________________
State License Number Name
of Employer
==================================================================
POLICE
DEPARTMENT APPROVAL
I AUTHORIZE ISSUANCE OF A TAXICAB REGISTRATION
CERTIFICATE FOR THE ABOVE DESCRIBED VEHICLE.
_____________________________ __________________________________
DATE
MARQUETTE CITY POLICE DEPT.