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Business License 38250 Sierra Highway Palmdale, CA 93550 661/247-8384 661/267-5434 [EMAIL REDACTED] [EMAIL REDACTED] Page 1 of 4 Taxicab Company Business Permit Application REV. 10/11/22 TAXICAB BUSINESS PERMIT APPLICATION This Application is for (check one) New Permit Annual Renewal Taxicab Company Name: Business Address: Telephone number and Email: Legal Name of Applicant: (List any other name used by the applicant) Home Address: Home Telephone Number: California Driver’s License Number and Expiration Date: Social Security Number: The name and business address of all directors, officers, shareholders, partners, employees or other individuals who are financially interested in the proposed operation of the taxicab business or who are involved, or proposed to be involved, directly or indirectly, with the management of the business: The number of vehicles for which a permit and license is desired: Describe each vehicle, including the number assigned, the license plate number, vehicle identification number, model, make, year of manufacture and passenger seating capacity: ---PAGE BREAK--- Business License 38250 Sierra Highway Palmdale, CA 93550 661/247-8384 661/267-5434 [EMAIL REDACTED] [EMAIL REDACTED] Page 2 of 4 Taxicab Company Business Permit Application REV. 10/11/22 The make and type of taximeter intended to be installed in each taxicab: The street number and exact location of each taxicab stand which the applicant proposes to use (if applicable): The applicant’s estimate of the need for service, supported by factual data demonstrating that public convenience and necessity require the granting of a permit: Please submit with application the following: 1. The color scheme, name, monogram or other distinguishing insignia proposed to be used on each vehicle. 2. The proposed schedule of rates to be charged which shall not exceed that authorized in Section 5.40.320. 3. The estimate of the need for service, supported by factual data demonstrating that the public convenience and necessity require the granting of a permit. 4. A current financial statement of the applicant. 5. A letter stating the experience of the applicant in the transportation of passengers. The applicant agrees to submit additional information as the City Council or the Director may require or deem necessary. I declare under penalties of perjury that this application is true and correct to the best of my knowledge and belief. Signature of Applicant Date ---PAGE BREAK--- Business License 38250 Sierra Highway Palmdale, CA 93550 661/247-8384 661/267-5434 [EMAIL REDACTED] [EMAIL REDACTED] Page 3 of 4 Taxicab Company Business Permit Application REV. 10/11/22 Checklist: 1. Photographs of each taxicab 2. Copy of County of Los Angeles Weights and Measures Certificate of Inspection for each taxicab 3. Copy of City of Palmdale Vehicle Inspection Report (Midas Inspection) 4. Copy of current registration for each taxicab 5. Original Insurance Certificate listing the City of Palmdale as additional insured and listing each taxicab covered by VIN# 6. Rate chart and map of territory 7. Current financial statement of applicant 8. Copy of Fictitious Name Filing/DBA or Articles of Incorporation Taxicab Drivers must obtain their own driver permit application and license. OFFICE USE ONLY Recommend ( ) Not Recommended ( ) Los Angeles County Sheriff’s Department: Signature Date Planning Manager: Signature Date ---PAGE BREAK--- Business License 38250 Sierra Highway Palmdale, CA 93550 661/247-8384 661/267-5434 [EMAIL REDACTED] [EMAIL REDACTED] Page 4 of 4 Taxicab Company Business Permit Application REV. 10/11/22 INDEMNIFICATION STATEMENT It shall be a condition of this permit issued under the Business Regulation Ordinance that the permittee agrees to indemnify, hold harmless, and defend the City, its City Council, and each member thereof, and every officer, agent and employee of the city, from any and all liability or financial loss resulting from any suits, claims, losses, or actions brought by any person, and from all costs and expenses of litigation, including attorney’s fees, by reason of injury to any person, including, but not limited to, officers and employees of the permittee, performed under and pursuant to this permit, and any and all activities, operations, and conditions in any manner connected therewith or pertaining thereto. Such indemnity shall include, but not be limited to, any and all liabilities, demands, claims, damages, losses, costs and expenses caused or alleged to have been caused by any negligent or other act of this permittee. Print Name (Business Owner/Permittee) Sign Name (Business Owner/Permittee) Business Name Date