Claim by Daniel E. VaseyTHE CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
BARRY LINDAHL
CITY ATTORNEY
To: Mayor Roy D. Buol and
Members of the City Council
DATE:
RE:
Claimant
February 26, 2008
Claim Against the City of Dubuque by Daniel E. Vasey
Date of Claim
Daniel E. Vasey
02/2008
Date of Loss
02/14/08
Nature of Claim
Vehicle Damage
This is a claim in which the claimant alleges that a City of Dubuque snow plow truck
struck claimant's vehicle while claimant was stopped on Glen Oak 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
Jeanne Schneider, City Clerk
Paul Schultz, Solid Waste Management Supervisor
Daniel E. Vasey
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 30O MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 583-4113 / FAx (563) 583-1040 / EMAIL balesq@cityofdubuque.org
~~~ ~~~;
,,_
CLAIM AGAINST THE CITY OF DUBUQUE, IOW
L
This written report constitutes your claim against the City of Dubuque, Iowa. ou
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 13th 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.
Name of i
2. Address:
3. Telephone Number SR2= ~ ~~~
4. Date of Incident: ~~~{, ~~ 6
5. Time of Incident: 7 °' ~ ~ /~ .
6. Locat'on of Incident (Be specific):
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) _ _ ~ r
8. What were w ather c nditions like?
9. Give name and address of any witnesses:
1 Q., Did police investigate? (If ~o, give names of1officers.)
i ~i_nx-
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
13. What other damages do you claim, if any?
l1 b ~
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.)
15. I~,Vhat amount do you claim from the City of Dubuque?
16 Why do you laim the City of/Du uq~e is respon~sJible? ~ ~~
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?
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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
r
Estimate Prepared by:
Accident Date:
Date of Loss:
Arrival Date:
Type of Loss:
Policy Number:
Claim Number:
Owner:
Toys Done Right
11941 sherrilt rd
Dubuque, IA, 52002
Te1:563-552-Ib01 Fax:563-552-2207
toysdoneright@yahoo.com
Tax ID:26-1404014
Estimate -Preliminary
Appraised for:
Date: 2/15/2008
Estimate#:
Contact: Daniel Vasey
Address: 582-7842
Year Make Model Color Trim
1999 Saturn SL Sedan
Unit Number License Plate # Mileage Serial#NIN#
1G8ZF5288XZ36929i
Sup Seq Qty Labor Labor Description Part Part List Extended Labor
Type Op Type Number Price Price Units
1 I Ref Ref Refinish Bumper Exist 2.3
Cover
2 1 Body Repair Cover, Bumper Exist 2.0*
1996-99 SL, SL I
Sedan
3 i Body Rem/Ins R&I Bumper Assy Exist 1.0
4 1 Ref Ref Refinish Quarter Exist 2.0
Outside L
5 1 Body Repair Panel, Outer Quarter Exist 2.Oi~
L 00-02
6 1 Ref Ref Refinish Door Exist 1.1*
Outside L [blend for
color match]
7 1 Body Rem/Ins R&I Outer Belt Exist .3
Moulding R
8 1 Body Rem/Ins R&I Outside Handle Exist .2
R
9 1 Body Rem/Rep Pinstripe New $15.00 T $15.00 .5*
10 1 Ref Ref Clear coat Exist 1.0*
11 Paint Materials $204.80
Version 2.0
Database Edition CPL 07-12
P-Page logic not included.
Page 1 of 2
• ~'- judgement Item
# -Labor Note Applies
Labor
Body 6.0 Hrs @ $52.00 $312.00
Refinish b.4 Hrs @ $52.00 $332.80
Labor Total $644.80
e above is an estimate based on our inspection and
oes not cover any additional parts or tabor which may
e required after the work has started. Occasionally,
orn or damaged parts are discovered which may not
e evident on the first inspection. Because of this, the
bove prices are not guaranteed. Quotations on parts
d labor are current and subject to change.
Parts
Parts Subtotal $15.00
Less Adjustments
Parts Total $15.00
Additional Costs and Operations
Addl. Costs/Ops Total $204.80
Taz
Labor Tax @ 7.00% $45.13
Parts Tax @ 7.00% $1.05
Tax Total $46.18
Totals
Sub Total: $910.78
Customer Resp. $0.00
Net Total $91U•78
This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair.
RepairMate does not automatically include items required by many business repair partners. This application
allows the author to manually enter line items such as overlap deductions.
1999 Saturn SL
Version 2.0 P-Page logic not included.
Database Edition CPL 07-12 Page 2 of 2