Claim by Kevin & Heather SargentTHE CTTY OF
DuB E
Masterpiece on the Mississippi
BARRY LINDA
CITY ATTORNE
To:
DATE:
RE:
Claimant
MEMORANDUM
Mayor Roy D. Buol and
Members of the City Council
October 13, 2008
Claim Against the City of Dubuque by Kevin & Heather Sargent
Date of Claim
Kevin & Heather
Sargent
10/06/08
Date of Loss
09/24/08
Nature of Claim
Vehicle Damage
This is a claim in which claimants allege that their parked vehicle was struck by a City of
Dubuque Sanitation truck on 16th Street, just west of Catherine Street.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
BAL:tIs
cc: Michael C. Van Milligen, City Manager
Paul Schultz, Solid Waste Management Supervisor
Kevin & Heather Sargent
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 3OO MAIN STREET DUBUQUE, IA 52001-6944
TEt_EPHONE (563) 583-4113 / FAx (563) 583-1040 / EMAIL balesq@cityofdubuque.org
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
This written report constitutes your claim against the City of Dubuque, Iowa. You should
complete this form in full and attach any additional information that supports your claim.
The Claim must be filed with the City Clerk at City Hall, 50 W. 13th St., Dubuque, IA 52001. It
will then be referred by the City Council to the appropriate department for investigation.
Once that investigation is completed, a report and recommendation will be submitted to the
City Council. You will be provided with a copy of that report and recommendation.
THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF
THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO YOU
AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAID.
1. Name of Claimant:
2. Address: CoCv ~ ~~ ~f ~ (~~ ~.
- ~
3. Telephone Number: ~~~~ `~ ~,J7-~ ~ `~ c f ~5 ~3-~~7- ~~~~
4. Date of Incident: ~'~~~ ~~r~ ~~
5. Time of Incident: l~~ ~~ l~.l"~'~,
6. Location of Incident (Be specific): ~l1 ~ ~~ ~. >~ ~~~ ~
7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim. If a City employee was involved, give the
employee's name.)
v~ ~~~~~fi l~en~~
8. What were weather conditions like?
k
9. Give name and address of any witnesses: ~ ~
i,
10. Did police investigate? (If so, give names of officers.) ~~i~~- jy t~~~;U~,
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
12. Was any damage done to property? (If so, describe property and the extent of damages.
Attach estimates of damages or describe basis for ascertaining extent of damage.)
..- ~,
13. What other damages do you claim, if any? ~ D/'1~_
10/02/2006 at 11:13 AM
30799
Job Number:
BRIMEYER AUTO BODY
License #:30799 Federal ID #:421438980
10709 COLLISION DR.
DUBUQUE, IA 52001
(563)583-4956 Fax: (563)583-1838
PRELIMINARY ESTIMATE
Written By: KEVIN SMITH
Adjuster:
Insured: HEATHER SARGENT
Owner: HEATHER SARGENT
Address: 669 WEST 16 TH ST
DUBUQUE, IA 52001
Evening: (563)357-8561
Claim #
Policy #
Deductible:
Date of Loss:
Type of Loss:
Point of Impact:
Inspect
Location:
Insurance
Company:
Days to Repair
1999 PONT GRAND PRIX GT 6-3.4L-FI 4D SED WHITE Int:
VIN: 1G2WJ52M9RF 315172 Lic: Prod Date: Odometer:
Air Conditioning Rear Defogger Tilt Wheel
Cruise Control Intermittent Wipers Tinted Glass
Dual Mirrors Fog Lamps Clear Coat Paint
Power Steering Power Brakes Power Windows
Power Locks Power Mirrors AM Radio
FM Radio Stereo Cassette
Search/Seek Driver Air Bag Passenger Air Bag
4 Wheel Disc Bra kes Cloth Seats Bucket Seats
Recline/Lounge S eats Automatic Transmissi on Overdrive
Aluminum/Alloy W
----------------- heels
----
N0. OP. ---------------------------
DESCRIPTION -----
QTY E --------------------------
XT. PRICE LABOR PAINT
1 FRONT BUMPER
2 0/H Front Bumper 3.0
3** 0 Repl A/M Bumper cover 1 182.00 Incl. 2.4
4 Add for Clear Coat 1.0
5 Repl Molding white 1 69.78 Incl.
6 FRONT LAMPS
7** Repl A/M LT Headlamp assy all 1 183.00 Incl.
8 Aim headlamps 0.6
9** Repl A/M LT Side marker lamp 1 38.00 Incl.
10 FENDER
11* Rpr LT Fender sedan 0.5 2.0
12 Add for Clear Coat 0.8
13# Repl
----------------- TAPE STRIPE
-------
- 1 12.00 0.2
--
---------------------
Subtotals =_> ----- -------------------
979.78 4.3 -------
6.2
Parts 979.78
Body Labor 4.3 hrs @ $ 53.00/hr 227.90
Paint Labor 6.2 hrs @ $ 53.00/hr 328.60
Paint Supplies
--------------------- 6.2
----- hrs @ $ 32.00/hr
-- 198.40
SUBTOTAL -----------------
$ -------
1234.68
Sales Tax $ 1036.28 @ 7.000Oo 72.59
GRAND TOTAL $ 1307.22
ADJUSTMENTS:
Deductible 0.00
----------------------------------------------------
CUSTOMER PAY $ 0.00
INSURANCE PAY $ 1307.22
1
JIMMY B'S AUTO BODY
1760 Radford Rd #2
DUBUQUE, IA 52002
Name /Address
Heater Sargent
669 West 16th Street
Dubuque, IA 52001
Estimate
Date Estimate #
10/3/2008 235
Terms
Description Qty Cost Total
1994 Pontiac Grand Prix GT vin# 1G2WJ52M9RF315172 white
OH front bumper 3 53.00 159.OOT
Replace front bumper 1 182.00 182.OOT
Replace Molding white 1 64.78 64.78T
Replace LT headlamp assy 1 183.00 183.OOT
Replace LT Side marker lamp 1 38.00 38.OOT
Repair LT fender 0.5 53.00 26.SOT
Replace Tape Stripe 1 12.00 12.OOT
Paint and materials 6.2 32.00 198.40
Paint labor 6.2 53.00 328.60T
Subtotal $1,192.28
Sales Tax (7.0°~) $69.57
Total x1,261.85
Phone #
563-542-1570
Ba ~ A. Li.. ai:', Esq.
Cir Attorney'
Su.., 3"~'~ bor View Place
30u Main ~~reet
Dubuque, Io~~~a 52001-6944
(563) 583-4113 office
(563) 583-1')40 fax
balesq alcityofdubuque.org
Beverly Bettcher
6R~ ~ W. 16t' Street
C '-~uque, I,~ 52001
R C!~~~~t~ Agair~~~t the city of '?ubuque
C .~r Ms. L~ettcher:
Dt: ~.I~u
`~
Apt: ~.~iC2Gi
~,
. :u7
T'HE C1TY OF `r_ --~~__
SUB C~E~UF
~~ U ~
Sep~i: ember :.';:~, ~. 3
If you wise ~o file a claim against th~~~ City o )ubugr a regal+:inc alleged damage to your
vehicle, w_ ,vould request that you I'll out th attachE-d claim forl~I and return it to the City
Clerk's Office a~ the ,~Ilowing address:
Ms. Jeanie ~' :hneider, City Clerk
City Hall - City ':ler': s Office
50 West 13t" ~.: reet
Dubuque, IA ~~2001
Once the claim has been stamped in by ti City Clerk, vi!I ~~ forwar~Ad to thE~ City
Attorney's Office for investigation.
Very since -ply;
Tracey Sfe .'.ei~
Paralegal
Enclc pure
~ ~ S e ~` ~~~_ ~
~~ ~.~-_
~~Y1 ~'Q ~-Yt '
~ ~ 1~Z <
~) ~~
Drib:er information Exchange Report
Driver's Name - Last
KENNEDY
Address
806 EUCLID ST
Gender
Male
Drivers License Number
t7fi1 Owner Company Name
CITY OF DUBUQUE
Owners Name - Last
55�-F5:.•- M
'irst Middle :x, r-. Data of Birth
ryLVY ERNEST
I City - ' Stale zip
f DUBUQUE IA 152091.0000
Class Slate f Er-lrarse,rir:ii•S Pt:;,,. :::rs I u ance vo- Narne
B i IA IL I NONE IA COMM. ASSURANCE POOL
Insurance Policy 4
11CAP 0300 (7198)
Address
50 W. 13TH ST.
VIN No Year Make
1HTSHAAR6WH526036 1998 IN 1 L
License Plate # 1 Ste e 1 Year
64491 IA 2008
U
N
T
002
Driver's Name - Last
Address
• Middle
T city
�DUBUQUE
Model
4900 6X4
Mos', Damaged =•e-r
04 - Right Rear
-first
1
Geiide, Driver's License Number Ias-
D. Clay Company Name
❑varer's Name - Lest
SARGENT
Address
669 W 16TH ST
No.
1G2WJ52M9RF315172
License Plate #
816TXB
rv:l�rlle
1City
Slab 1 Er:vc•rser:iEri'ts1 Rie•ti':k, ions
I NONE NONE
Middle
SCOTT
•
ICity
DUBUQUE
reap fv-e!ce•
1994 PONT I GRA
TFirst --
j KEVIN
Sla:e Year Darnu•j.-u Oreii
I IA 2008 08 - Lett Front
County
Dubuque - 31
Literal Descripti
W 16TH ST
rx-Coordinate
00690812
I if accident occuhey.loutsiir -f city
limits show general vacinity:
rAc idenl occurred cJirhin corporate ;ity]
Dubuque - 2100
State
i IA
Phone
(563) 583-5384 x
Insurance Co. Phone #
Vehicle Configuration
GARBAGE TRUCK 21
App:ex i,:iale Cost to Repair cr Replace
30.00
Suffix ! E lee of Birth
State�
hrsuren Cc Narne
insurance F••icy
Suffix
State
IA
Phone
Insurance Co. Phone
5.:001-
Siyle
4D
'vehicle Configuration j
01
Approximate Cost to Repair or Replace
$800.00
"N/A"
Direction INeatest City
"N/A" of "NIA"
On Road, Street, or Highway:
16Tf'I ST.
Zoordinate
I94708502
At lnterseclion with:
"N/A"
loute (Cardinal}
j Travel Direction "N/A"
D = ice I Direction I Distance
300 F! • 7-W and j NIA"
Definabic intersection bridj.i rai1ic ud iacasiny
CATH ERIN E ST.
Officer
I STAIR, JUSTIN
Direction
{ "NIA"
Milepost Number
of "NIA"
Or
Badge Na Enforceinent Case Number 11 Dale of Accident Tirne of Accident
54A JUR,01-08-44616 09/24/2008 106:34
Printed At: Dubuque Police Department 0812412003 0i :06 AM
Page 1 Form #:01-08-44615