COLOR SCHEME CHANGE APPLICATION SFMTA Taxi Services

Change Of Color Scheme - From: ___________________________ To: ____________________________

The following MUST be submitted with this application to the SFMTA: Proof of Auto Liability Insurance; Vehicle Registration Card; Vehicle Introduction Forms; and the Questionnaire on the back of this application.

Medallion Holder’s Name (First, Middle, Last)

Phone ( )

Residence Address (Street Address, City, State, Zip)

Second Medallion Holder’s Name (First, Middle, Last) Phone

( ) Residence Address (Street Address, City, State, Zip)

Is this a Corporate permit? □ No □ Yes, If Yes, Name of Corporation:

Color Scheme Information: Print the requested information for the color scheme you want to change to: Color Scheme Name

Address (Street Address, City, State, Zip)

Color Scheme Phone ( )

Medallion #(s) □ Owner / Operator □ Gas & Gate □ Long Term Lease

Please describe why you would like to change to the above named taxi company (attach additional pages if necessary): ________________________________________________________________________________________________ ________________________________________________________________________________________________ I (We) certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on ______________________________, 20______ at San Francisco, California.

______________________________________________________________________________________ Signature of Applicant

******TO BE COMPLETED BY ACCEPTING COLOR SCHEME ONLY****** Name of person authorized to sign for Color Scheme Holder:

Title:

I, the Color Scheme Holder / person authorized to sign for the Color Scheme Holder for ______________________________________, Taxicab Color Scheme

hereby give consent to the applicant named to use my color scheme. I certify (or declare) under penalty of perjury under the laws of the State of California that the foregoing is true and correct. ____________________________________________________________ ___________________________________________ Signature of Color Scheme Holder / person authorized to sign for Color Scheme Holder Date

**********************OFFICE USE ONLY********************** Notice Date: SFMTA DTAS Decision: □Approved □Denied Effective Date:

Received By: Insurance: □Yes □No VIF: □Yes □No Registration: □Yes □No Received Date:

Amount: Receipt #: Notice Letter Sent: □Yes □No

COLOR SCHEME CHANGE QUESTIONNAIRE

1. Why are you requesting this color scheme change?

2. How will you operate your medallion at the new color scheme? Circle one:

a. Gas and Gates

b. Color Scheme Only

c. Single shift operated

3. Will you sign any leases with your new color scheme or with any drivers associated with that color scheme?

□ Yes □ No

If yes, you must provide a copy to SFMTA Taxi Section upon request. 4. For Post-K medallion holders only: What shifts will you be driving your taxicab vehicle in order to comply

fulfill the full-time driving requirement?

I acknowledge that in making this color scheme transfer to ____________________________, I will operate my medallion # ________ in compliance with the following stipulations (initial after each statement below): 1. The taxicab will begin and end all shifts at the company property and all waybills, reports and found property

will be turned in at the company premises at the conclusion of each shift. _____

2. All lease arrangements will be limited to a maximum of three layers (e.g. Owner/Color Scheme/Driver). ____

3. The vehicle used for this taxicab will contain at least my name or that of the Color Scheme Holder and may

also contain the name of a driver holding a lease which complies with the three layer rule. _____

4. I will not permit anyone to drive or operate the taxicab vehicle unless that person (1) holds a valid driver’s

permit issued by the City and County of San Francisco, (2) has a lease for the vehicle or is a gas and gates

driver, (3) is listed on the driver’s roster for the taxicab company with which I am associated, and (4)

complies with all applicable driver training requirements established by the City and County of San

Francisco and the SF Paratransit Broker. _____

5. The vehicle will be operated in accordance with all provisions of the SFMTA Transportation Code and the

SFMTA DTAS Rules and Regulations, and I have taken time to educate myself about those provisions so

that I fully understand and comprehend them. _____

6. If I received my permit after 1978, I will comply with the 800 hours or 156 four-hour shift full-time driving

requirement contained in Article 16 of the Municipal Police Code. _____

7. I will comply with the provisions of the Charter, Transportation Code, Planning Code and Traffic Code of the

City and County of San Francisco, the California Vehicle Code, California Worker’s Compensation Laws and

SFMTA Taxi Section Rules and Regulations. _____

I have read and understood all of the above. I declare that I will operate my taxicab medallion permit # _______ in full compliance with the above stipulations.

Signature: _______________________________________ Date: __________________________

Department Witness: ______________________________ Date: __________________________

1 South Van Ness Avenue 7th Floor, San Francisco, CA 94103 415.701.4500 www.sfmta.com

SF Paratransit/Transdev Requirements for Color Scheme Change Before a medallion holder may submit a Color Scheme Change application to the SFMTA Taxi Division, he/she must have the Vehicle Introduction Form (VIF) signed off by SF Paratransit/Transdev. No Color Scheme Change Application can be reviewed by the SFMTA prior to the Paratransit/Transdev sign-off on the VIF. In order to obtain the sign-off from SF Paratransit, the medallion holder must submit to SF Paratransit:

1. A properly completed Color Scheme Change Application; 2. A complete VIF (including signatures from both deleting and receiving companies);

3. Printed proof of a successful ITE Post-Installation Test. Such proof should be

in the form of a receipt from a test transaction displaying the proper medallion number and color scheme. You must use your Color Scheme’s SF Paratransit-issued PIT card to complete this test transaction. This will show Transdev that the accepting color scheme has the designated In-Taxi Equipment (ITE) properly programmed and ready to install; and

4. An Agreement by the medallion holder of a complete understanding of all of the paratransit operating requirements promulgated by the SFMTA for all drivers of that medallion.

Once Transdev has signed the VIF, the medallion holder can bring it, and the color scheme change application form, to the SFMTA with a valid ACORD Certificate of Liability Insurance showing appropriate auto-liability insurance coverage for the medallion in accordance with the City’s and Paratransit requirements.

For related questions or further information regarding Transdev’s requirements, please

contact:

SF Paratransit Contracts Administrator Transdev Services, Inc. 68 12th Street, Suite 100 San Francisco, CA 94103 (415) 351-7000

us.sfcontractadmin@transdev.com

SAN FRANCISCO PARATRANSIT ITE Post Installation Test

Test Name:

ITE-PIT001 – Driver Login/Logout, Balance Inquiry, & Fare Transaction

Purpose: To verify that the ITE initiates connectivity with the DCCS during the driver logon process and transmits the 8-digit (1-letter, 7-number) of the California Driver’s License (CDL).

Starting Condition: The ITE shall be fully installed in the taxi vehicle and connected to a functioning taxi meter.

Resources Requirement: 1. Permanent power to the ITE. 2. California Driver’s License containing a magnetic stripe and a unique ID number on Track 2. 3. Fully installed set of ITE as proposed.

Procedure: 1. With the ITE powered on but in Meter OFF mode, swipe the swipe the Post Installation Test

paratransit debit card. 2. Observe that no communication with the DCCS occurs and that a balance inquiry or fare transaction

is initiated. 3. With the ITE still in Meter OFF mode, swipe the CDL in the magnetic card reader to Login. 4. Observe that the ITE initiates communication with the DCCS and achieves Login. 5. With the meter still in the Meter OFF mode swipe the Post Installation Test paratransit debit card to

perform a Balance Inquiry. Select the option for NO red flag. 6. Observe that the ITE initiates communication with the DCCS and receives the required response from

the DCCS in return. 7. Select the Meter ON position to simulate the start of a trip. 8. Select the Meter OFF position to simulate the end of a trip and swipe the Post Installation Test

paratransit debit card to generate a trip transaction. Select the option to NOT include a Tip. Select the option for NO red flag.

9. Observe that the ITE initiates communication with the DCCS and receives the required response from the DCCS in return.

10. With the meter still powered on but in Meter OFF mode, swipe the CDL in the magnetic card reader to Logout.

11. Observe that the ITE initiates communication with the DCCS to transmit the 8-digit CDL number logout information.

12. Following logout, swipe the Post Installation Test paratransit debit card in the magnetic card reader and observe that no transaction is created and transmitted

Expected Result

1. In Step #2, observe that the ITE does not accept card swipe and that no communication with the DCCS occurs.

2. In Step #6, observe that the printed receipt contains the following information (it is desirable to also have the “account balance” information displayed on the user interface and to print the information only if desired by the patron).

The printed receipt shall contain the following: 1. the words "Balance Inquiry” 2. date & time of inquiry 3. fleet & cab ID number 4. transaction ID (value = ‘1’) 5. card number truncated to all but the last four digits 6. account balance - If the remaining debit card balance is greater than $75.00, the receipt will

show “$75.00+”. If the balance is less than $75.00, then the true balance will be shown. 7. a printed receipt message

3. In Step #9, observe that the printed receipt is in duplicate and contains the following information (it is desirable to also have the option to display Total Amount and Balance):

1. the words "Ride Receipt” 2. date & time of transaction 3. fleet & vehicle ID number 4. the word "sale", transaction amount (in US currency) 5. tip amount (value = $0.00) 6. approval code and ID number 7. card number truncated to all but the last four digits 8. customer signature field. 9. remaining account balance - If the remaining debit card balance is greater than $75.00,

the receipt will show “$75.00+”. If the balance is less than $75.00, then the true balance will be shown.

10. Any text transmitted from the DCCS in the ‘Message’ field. 4. In Step #11, observe that the ITE initiates communication with the DCCS and achieves Logout. 5. In Step #12, observe that the ITE does not accept the card swipe and that no communication with the

DCCS occurs. THE TEST CARD NUMBERS FROM ALL TEST CARDS USED SHALL BE INCLUDED AS PART OF THE TEST RECORD THAT IS SUBMITTED TO TRANSDEV FOR REVIEW AND APPROVAL. ALL PRINTED RECEIPTS SHALL BE RETAINED AS PART OF THE TEST RECORD AND SUBMITTED TO TRANSDEV FOR REVIEW AND APPROVAL.

Complete the following fields after successfully completing the post-installation test. Attach the receipt printed by the in-taxi equipment. Failure to submit acceptable documentation of a completed test may be grounds for denial of the request to change color schemes. Vehicle No. : ITE Serial No. : Test Card No. : SIGNATURE: DATE:

Vehicle Introduction Form (VIF)_____________________________________ Manager’s First and Last Name

__________________________________ Date Field:

____________________________________________________Color Scheme Company Name

______________________________________

Phone Number

Reason for Request: Delete Medallion Color Scheme Change(CSC )

ADDING A VEHICLE

_____________________________________________________ VIN # Vehicle # (Medallion #) License Plate #

Vehicle: ___________________ __________________________

Make Model Year

CNG Hybrid Gas Other

Vehicle Mileage _____________________________________________

Effective Date: __________________________________ Registered Owner: _________________________________

DELETING A VEHICLE

_____________________________________________________ VIN # Vehicle # (Medallion #)

______________________License Plate #

Vehicle: ____________________ ___________________ ______________ Make Model Year

__________Mileage

Effective Date: __________________________ Put on hold:

For Color Scheme Change Only (signature from manager of company deleting a medallion):

________________ _______________________________________________________ Print Manager’s First & Last Name

_____________________________________ Signature Date

CHANGING VEHICLE NUMBERS (Medallion #) ONLY

Vin # License Plate #

Vehicle: ____________________ ___________________ Make Model Year

Mileage

Old Vehicle # (Medallion #) New Vehicle # (Medallion #)

Revised April 30, 2018

*****Office Use Only *****

SFMTA: Approved Denied GTU: Approved Denied

Approved by: Date: Approved by: Date:

Delete/Hold: Must return Airport decals

This vehicle will be operated as: Gas & Gate Other

CSC is only when VIN is moving from another company and Airport decals must be returned. Write name of previous company:_______________

Change of vehicle is only applicable within same taxi cab company. If movement is vehicle or medallion, on the VIF Form mark Existing Medallion, then fill in this section

Decals #

San Francisco Municipal Transportation AgencySan Francisco Municipal Railway - Department of Parking & Traffic - Taxi ServicesOne S. Van Ness Avenue, Seventh Floor, San Francisco, CA 94103 - Tel: 415.701.4400 Fax: 415.701.5437 www.sfmta.com

______________

VIN #

Effective Date:

Vehicle: Make Model Year Mileage

License Plate #

______________ ______________

Old Vehicle # (Medallion #) New Vehicle # (Medallion #)

YES NOCSC Deletion Absolute Deletion

Existing Medallion

New vehicle added to fleetNew Medallion

Approved by: Date:

Paratransit: Approved Denied

SF PARATRANSIT APPROVAL (CSC only):

_______________________________________ Paratransit Representative First & Last Name

_________________________________ Signature

____________________ Date

Vehicle Re-Introduction