| | | 20,000+ Fresh Resumes Monthly | |
|
|
| |
Click here or scroll down to respond to this candidateCompliance and Safety-Interlock Installation UnitStreet Address Street Address
Trenton, New Jersey Street Address -0174Fax to PHONE NUMBER AVAILABLECERTIFICATION OF INTERLOCK COMPLIANCE-BASED REMOVAL OR NON-COMPLIANCE PRINT OR TYPE Driver Name (Last, First, Middle Initial) Brown,KenyaNew Jersey Driver License NumberNJ BPHONE NUMBER AVAILABLEMailing Address251 Meeker AveCityNewarkCountyESSEXStateNJZip Code07112Vehicle Make/ModelHONDA AccordYear2013Vehicle Identification Number (VIN)1HGCR2F33DA255162License Plate NumberNJ B74HUCOffense Date:12/26/2021Court-Ordered Installation Period:3 MonthsDate of Installation:10/20/2022Total Number of Days Installed:129Last Day of Court-Ordered Installation Period:1/21/2023Compliant (All three boxes below MUST be checked for Interlock Compliance) During the final 30 days of the court-ordered installation period, there has been no more than one failure to take a test; and During the final 30 days of the court-ordered installation period, there has been no more than one failure to pass a test with a breath alcohol concentration (BAC) of 0.08% or higher (unless a re-test conducted within five minutes of the initial test indicated a BAC of less than 0.08%); andDuring the court-ordered installation period, the person has complied with all maintenance, repair, calibration, monitoring, and inspection requirements of the device.Court Order Compliance achieved after previous review of non-compliance. (Attach Court Order with signature of the Judge) Non-Compliance: For NJ offenses: This form must be sent to the NJ sentencing court and the New Jersey Motor Vehicle Commission. For Out-of-State offenses: This form must be sent to the New Jersey Motor Vehicle Commission ONLY. Non-CompliantDuring the final 30 days of the court-ordered installation period, there has been more than one failure to take a test; or During the final 30 days of the court-ordered installation period, there has been more than one failure to pass a test with a breath alcohol concentration (BAC) of lower than 0.08% (and there was no re-test conducted within five minutes of the initial test indicating a BAC of less than 0.08%); orDuring the court-ordered installation period, the person has failed to appear at the ignition interlock provider when required for maintenance, repair, calibration, monitoring, or inspection of the device. INTERLOCK PROVIDER MUST ATTACH REPORT OF NON-COMPLIANCE WITH THIS FORM. Court NamePassaic County Superior Court- NJAddress77 Hamilton StCity and Zip CodePaterson, NJ 07505Provider/InstallerI certify that the information provided on this form is true and correct. I am aware that if any of the information provided on this form is false, I am subject to penalty pursuant to N.J.S.A. 2C:21-3, 2C:21-4, N.J.A.C. 13:19-6.1 et seq.Best Labs 1A Smart Start, Inc. LifeSaferGuardian Interlock Systems Alcohol Detection Systems IntoxalockLow Cost Interlock, Inc. Draeger, Inc. Simple Interlock PRINT OR TYPE Ignition Interlock Service CenterNJ Interlock Mobil ServiceNew Jersey Business License Number000168Device Serial Number1C485654Name of Company Representative Authorized to Complete This Form (Area Code) Telephone NumberPHONE NUMBER AVAILABLEMailing Address111035 Aurora AvenueCityUrbandaleStateIowaZip Code50322Signature Date of Compliance ReviewRevised 2/20Drey Blevins |
