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Claim by Gregory DoserMasterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL MEMORANDUM ilAJ\ To: Mayor Roy D. Buol and Members of the City Council DATE: October 4, 2010 RE: Claim Against the City of Dubuque by Gregory Doser Claimant Date of Claim Date of Loss Nature of Claim Gregory Doser 10/01/10 09/28/10 Vehicle Damage This is a claim in which claimant alleges that a City police squad car struck claimant's vehicle which was legally parked in front of 1799 Clarke Drive. This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager Mark Dalsing, Chief of Police Gregory Doser OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001 -6944 TELEPHONE (563) 583 -4113 / FAx (563) 583 -1040 / EMAIL tsteckle @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 West 13 St., Dubuque, IA 52001. It will then be referred to the appropriate department for investigation and to the City Attorney's Office. 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: C a - / ? 6 ( ' / v 2. Address: / 9'9 �2._/4/4/- 0z .D aid9&,/ 3. Telephone Number :/a - 6 - 363L/ 4. Date of Incident: 9/a 2/1O 5. Time of Incident: 0- : 3 7 f , 6. Location of Incident (Be specific : / 7 g 9 c7,1- /,?rk. 1/ 7. Describe the 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.) f -rc? E /7'/ ')W AXi/9n'L 2 t'xT ' /N t i2n, A '11" ) / -/ wJi a// /d /1.S .G GiS?LG y A4/fim B u. C_E D1:7( -.TSC K ( o - O F-p [ci R 8. What were weather conditions like? (12-E ai . r►�.� 9. Give name and address of any witnesses: 10. Did police investigate? (If so, 9ive names of officers.) y5 - hors -.T / NrH/E /J 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.) - OUR. CiJ /1 s Y)AMR/ E17 oAJ 7WE ASS ,AJD - PEAR 13. What other damages do you claim, if any? 14. Have you been compensated for any part or all of your claim by any insurance company? (If so, give name and address of insurance company and amount paid.) 1UD 15. What amount do you claim from the City of Dubuque? 16. Why do you claim the City of Dubuque is responsible? � F I EI'L >? Alv / /JTz )9R .4; e l'./9R_ l?/i /,J j ZJ15 14R/ To /4 i — Arc 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? Dated this .3C day of Jto 7 - Et'/3r:' i / - (Signature) (Print Name) 0 —4 Mar CJI m rn D YAGER AUTO BODY INC 4488 DODGE ST DUBUQUE, IA 52003 -2600 PHN: 563 557 7376 FAX: 563 557 1709 *** PRELIMINARY ESTIMATE *** Owner Inspection Repairer Vehicle 1998 Ford Explorer Eddie Bauer 4 DR Wagon 8cyl Gasoline 5.0 5 Speed Automatic Damages Line Op Totals Parts Paint Materials Body Labor Refinish Labor Sublet Repairs Tax Estimate Total Insurance Pay: 09/28/2010 02:34 PM Owner: GREG DOSER Address: 1799 CLARKE DR. City State Zip: Dubuque, IA 52001 Inspection Date: 09/28/2010 02:26 PM Driveable: Yes Appraiser Name: CJ YAGER Lic.Plate: 407 NMH Mileage: 122,000 Ext. Color: MAROON Ext. Refinish: Two -Stage 1 Replace OEM Stripe Assembly LT 2 Replace Recycled Panel,Quarter LT 3 Refinish Panel,Quarter LT 4 R & I Assembly Door,Fuel Filler LT 5 Sublet Repair Glass,Quarter Tinted LT 6 Replace Recycled Flare,Wheel Opening LT 7 Refinish Flare,Wheel Opening LT 8 Replace Recycled Taillamp Assembly LT 9 Replace Recycled Bumper Assembly,Rear 10 Repair LT REAR DOOR FLARE 11 Refinish LT REAR DOOR FLARE 11 Items Description Cell: (563)543 -3034 FAX: Rental Assisted: Repairer YAGER AUTO BODY Contact: YAGER AUTO BODY Address: 4488 DODGE ST Work/Day: (563)557 -7376 City State Zip: Dubuque, IA 52003 Work/Day: Email: bodyshop @yagerauto.com VIN: 1 FMZU35P6WZA53515 Mileage Type: Actual Int. Color: Int. Refinish: Two -Stage ADJ% B% Price Labor +25.00 +25.00 +25.00 +25.00 $868.25 $208.00 $905.00 $325.00 $90.00 $153.18 $2,549.43 $2,549.43 $80.75 $275.00 09/28/2010 02:26 PM $35.00 $845.00 $245.00 INC $90.00 $75.00 INC $30.00 $30.00 INC $250.00 INC $25.00 $50.00 Page 1 of 2 - Damage Assessed By: Robert Hanley Deductible: UNKNOWN Owner: Greg Doser Address: 1799 Clarke Drive, Dubuque, IA 52001 Telephone: Home Phone: (563) 543 -4256 Description: Body Style: VIN: Mileage: OEM /ALT: Color: Options: Line Entry Labor Item Number Type Operation 1998 Ford Explorer Eddie Bauer Vehicle Production Date: 11/97 4D Ut 112" WB Drive Train: 5.0L Inj 8 Cyl AWD 1FMZU35P6WZA53515 License: 407 NMH IA 122,199 0 Search Code: None Red / Silver VEHICLE ANTI - THEFT, PASSENGER AIRBAG, DRIVER SIDE AIRBAG, POWER DRIVER SEAT POWER LOCK, POWER WINDOW, POWER STEERING, REAR WINDOW DEFOGGER MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN, ANTI -LOCK BRAKE SYS. ALUM /ALLOY WHEELS, LEATHER STEERING WHEEL, V8 ENGINE, CD PLAYER POWER ADJUSTABLE EXTERIOR MIRROR, 4WD OR AWD, TINTED GLASS, TRIP COMPUTER FIRST ROW BUCKET SEAT, SECOND ROW BENCH SEAT REAR HEATING, VENTILATION & AIR CONDITIONING, CLOTH SEAT, TACHOMETER 1 400185 BDY REMOVE/REPLACE 2 AUTO REF REFINISH 3 AUTO REF REFINISH 4 400206 BDY REMOVE/REPLACE 5 6 800154 BDY REMOVE/REPLACE 7 801054 BDY REMOVE/REPLACE 8 AUTO REF REFINISH 9 804449 GLS REMOVE /INSTALL 10 AUTO BDY OVERHAUL 11 803729 BDY REMOVE /REPLACE 12 AUTO REF ADD'L OPR 13 AUTO ADD'L COST 14 AUTO ADD'L COST Hanley Auto Body Inc. 1030 Century Circle, Dubuque, IA 52002 (563) 583-7220 Fax: (563) 583 -8355 Mitchell Service: 918622 Line Item Description L Replace Quarter Panel L Quarter Panel L Add For Edges & Pillar L Replace Tail Lamp * ** END OF ATG SECTION * ** Stripe Tape Liftgate L Quarter Wheel Opening MIdg L Quarter Wheel Opening Mldg L Quarter Glass Rear Bumper Assy Rear Bumper Face Bar Clear Coat Paint/Materials Hazardous Waste Disposal * - Judgment Item # - Labor Note Applies d - Discontinued by the Manufacturer C - Included in Clear Coat Calc r - CEG R &R Time Used For This Labor Operation ESTIMATE RECALL NUMBER: 09/30/2010 08:18:36 36 Mitchell Data Version: OEM: SEP_10_V UltraMate is a Trademark of Mitchell International Copyright (C) 1994 - 2010 Mitchell International UltraMate Version: 7.0.223 All Rights Reserved Date: 9/30/2010 08:18 AM Estimate ID: 36 Estimate Version: 0 Preliminary Profile ID: Hanley Cell Phone: (563) 543 -3034 Part Type/ Part Number Qual Recycled Part Qual Recycled Part F5TZ 7842604 BJ Qual Recycled Part Qual Recycled Part Dollar Labor Amount Units 250.00 * 17.0* C 3.5 C 1.0 25.00 * 0.2 d75.73 0.2 75.00 * 0.5 r C 1.0 2.6 # 1.5 250.00 * INC 2.0 225.00 * 5.00 * Page 1 of 2 Estimate Totals Add'I Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 19.4 48.00 0.00 0.00 931.20 T Taxable Parts 675.73 Refinish 7.5 48.00 0.00 0.00 360.00 T Sales Tax @ 7.000% 47.30 Glass 2.6 48.00 0.00 0.00 124.80 T Total Replacement Parts Amount 723.03 Taxable Labor 1,416.00 Labor Tax @ 7.000 % 99.12 Labor Summary 29.5 1,515.12 111. Additional Costs Amount IV. Adjustments Amount Taxable Costs 5.00 Customer Responsibility 0.00 Sales Tax @ 7.000% 0.35 Non - Taxable Costs 225.00 Total Additional Costs 230.35 Paint Material Method: Rates Init Rate = 30.00 , Init Max Hours = 99.9, Addl Rate = 0.00 I. Total Labor: 1,515.12 II. Total Replacement Parts: 723.03 III. Total Additional Costs: 230.35 Gross Total: 2,468.50 IV. Total Adjustments: 0.00 Net Total: 2,468.50 This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair. ESTIMATE RECALL NUMBER: 09/30/2010 08:18:36 36 Mitchell Data Version: OEM: SEP_10_V UltraMate is a Trademark of Mitchell International Copyright (C) 1994 - 2010 Mitchell International UltraMate Version: 7.0.223 All Rights Reserved Date: 9/30/2010 08:18 AM Estimate ID: 36 Estimate Version: 0 Preliminary Profile ID: Hanley Page 2 of 2 �1 Driver Information Exchange Report Dubuque Police Department 563-589-4410 I I u Driver's Name - Last First TMiddle DEUTSCH JBRUCE 1 WILLIAM Sufnx Date of Birth 1 N 1 _ Add ress 7Hy 1 State 770 IOWA STREET j9UBUQUE IA Z p 7 Home C.:1 fir, _ i.,- 52002 1 (563) 58e -+4 is x T Gender a Number Male I� Class C Slate IA Endorsements NONE Restrictions NONE Insurance Co. Name CITY OF DUBUQUE Insurance ::o P,iLrr.• (563) 589-4124 x 001 Owner Company !Name Insurance Policy a Owner's Name - Last CITY OF DUBUQUE First Middle Suffix Address 50 EAST 13TH STREET City DUBUQUE State LA Zip 52001- VIN No. ' Year 2009 r Make Model 1 85468 1 Style T Jrh^ 4DR 1 01 License Plate # 85468 Stale IA Year 19 Most Damaged Area 02 - Right Front Approximate Cost to Repair c r Re1A3 or 33,000.00 u Driver's Name - Last DOSER First JACQUELINE Middle ANN Surfer Date of Borth 11111.1.1 N 1 Address 1799 CLARKE DRIVE City DUBUQUE State IA Zip 52001 liomeoCal �r. .r (563) 543 .4736 A T Gander Female Driver's License Number Class LC State IA Endorsements NONE Restrictions NONE Insurance Co. Name ALLIED looser nce 7, Ph_. - 4 (563) 556-6$6 t x 002 Owner Company Name Insurance Policy u PPGM00171497348 Owner's Name - Lasl DOSER First JACQUELINE I Middle 1ANN Suffix Address 1799 CLARKE DRIVE C ty DUBUQUE Stale IA Zip 62001- VIN No- 1FM2U35P6W2A53516 Year I Make 1998 I FORD Model EXPLORER Style Vah _Ea 7 7 LL 1 04 License Plate # 407NMH State IA Year 2011 Most Damaged Area 05 - Rear Approximate Coo to Repa : cr P-..i- - 52,000.00 County Dubuque - 31 Accident occurred within corporate limits of (city) Dubuque - 2100 Literal Description CLARKE DR X-Coordinate 00689337 Y-Coordinate 04708470 If accident occurred outside of city limits show general vacinity: "NIA" Direction "NIA" of Nearest City "NIA" I Route rCardi..e r ! Travel D.rectron We. On Road, Street, or Highway: CLARKE DR At Intersection with: WEST LOCUST Distance 1 DireolFon I Dislanae 1 Direction "NIA" 1 "NIA" and I 'NIA" "NIA" of Milepost Number "NIA" Cr Definable intersection, bridge, or railroad crossing NIA" Officer PAPENTHIEN, ROBERT W Badge No. 39 Law Enforcement Case Number 01-10-47522 Date of AL -rider -NI - 09/28/2010 ; 02:37