Claim by Zach SchreiberTHE 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
July 23, 2008
Claim Against the City of Dubuque by Zach Schreiber
Date of Claim
Zach Schreiber
07/22/08
Date of Loss
07/10/08
Nature of Claim
Vehicle Damage
This is a claim in which claimant alleges that the driver's side rear quarter panel of his
vehicle was damaged when a City of Dubuque police officer dropped his flashlight
which struck claimant's vehicle.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
BALaIs
cc: Michael C. Van Milligen, City Manager
Kim Wadding, Chief of Police
Zach Schreiber
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 / EnnAIL 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 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.
1. Name of Claimant: ~~ ~~ ~c~ti"r,`lor~/`
2. Address: '~ ~~ ~b ~-~ c ~ ~ 7~~
3. Telephone Number ~ 3 ~ S~~ 2 - ~ ~l
4. Date of Incident: ~ -~ l0 ~ ~
5. Time of Incident: ~~~~i~,rt~~ /~ j~ o~~ ~ ~ys-Z
6. Location of Incident (Be specific):
On C/~~~o~'d ~~t_ bo~~- ~ ~ov ~ s
~_ .~_„ _
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~e~m,~loyee's name.)
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8. What were weather conditions like?
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9. Give name and address of arsy witnesses: _
1 M ~ Uh~2 ~~ ~~ ~ ~ Y_ ~ s,~
10. Did police investigate? (If so, give names of officers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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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
extent of damage.) . , „_ ~ ,
13. What other damages do you claim, if any?
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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.)
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15. What amount do you claim from the City of Dubuque?
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16. Why do you claim the City of Dubuque is responsible?
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17. Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.)
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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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Dated this ~~ d y of ,, c9 ~~/ ~ 20-4~-~~`~,
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(Print Name)
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07/14/2008 15:15 FAX 583 558 8928 TURPIN DODGE
07/14/2008 at 02:49 PM
94524
Jub Number:
TURPIN pODC3E OF DIISVQVE, LLC
9 0 I{EhTNEDY' RD
DUSU4VE, IA 52001
(563)5835781 lFax: (563)556-6928
PRELIMINARY ES'1'IMATL
Written By: TARRY ~'ORTMANN
Adjustex-:
I=ssur®8: ZACH SCHREISER
QwYier: ZACH SCHREIBER
Address:
Day:
Evening:
Inspect
LacatiQa:
Insuraac®
Company:
Days to Repair
X001
1999 DODG BRZ500 4X4 QUAD CAB $-5.2L-FY 4D SHORT Xnt:
VZN: 3B7HF'13'X5XM557423 Lic: Prod O~teteT.
Date:
Intermittent Wipers Dual MlrrarS Console/Storage
Clear Caat Paint Paver Steering Paver Brakes
ANt Radio FM Radio
SeaxchlSeek Stereo
Anti-Lock Stakes (2)
Cassette
priver Air Bag Passenger Air Bag Rear Step Bumper
4 Wheal Drive
i Overdrive
on
5 Speed Transmiss
+'--T----~---pp- '~--~-~l--DESCRIPTXON- QTY EXT. PRICE LABOR PAINT
NO_ ----~-~-----~-___~-___---~-~-- ~___~_-----------------~ ----~--
r -
~---------
1 ---
PICK UP BDX 2
5 2.7
2* Rpr UT Side panel single rear ,
wheel, 6.5 ft bed from 3-95
US; fr 4-10-95 Mex built 1.1
3 Add for Clear Coat
'
5' 00 T
]
4# fS WASTE
Hp,ZAgDOC .
I 5. 0 0 T
5# C,AR CDVER
_- ----^
----~-----~--~-~ ~__--------------subtotals ==~ 10.00 2.5 3.8
a.oa
Parts
Bady Labor
2.5 hrs @ $ 52.00/hr
130.00
paint Laba:r 3.8 hrs @ $ 52.00/hr 197.60
Paint Supplies 3.8 hrs @ $ 32.OOfhr 121.64
10.00
Sublet/Misc. -
---^-r----
_T--------- -----'-
$ 459.20
SUBTOTAL
'
' $ 459.20 @ 7.0000 32.14
3,
ax
Sales
1
Claim #
Pa1,1Cy #
Deductibles
pate of Loss:
K'ype off' Loss:
Paint of Impact:
D7/14/2008 15:15 F~k 563 556 6928 TURPIN DdDGE
01002
. 07/14/200$ at 02:49 PM
94524 Job Number;
PRELIMINARY ESTYMATE
1999 DOUG 8R1500 4X4 Q~1AD CA8 8-5.2L-~'z 4b SHORT Trit:
-W---~-------~-
GRAND TO'Y'AL _
--~___~____-
`
_
$
491 34
ADJUS~'MENT5
Deductible
-_~_ 0.00
CV5'1'OMER PAY _`-----_---
~
ZNSVRANCE PAY $
0 00
$ 491.3Q
Estimate based on ~0'POR CRASH ESTZk~,gTING GVTDE. CTnless otherwise noted all items are derived from
the Guide UR3TA94, CCC Data Date 46/02J20p6, and the parts selected are oEM-parts manufactured by
the vehicles Original Equipment Manufaetuzer. OEM parts are available at of/Vehic~,e dealerships.
OPT' OEM (optional OF,M} er A~,T OEM (Alternative OEM) parts are OEM parts that may be provided by or
through alternate sources other than the OEM vehicle dealerships. OPT pEAi or A,i,`P oEN~ parts may
ref7,ect some specific, special, or unique pricing or discounC. OPT OEM or ALT OEM parts may
include 'Slemished• parts provided by OEMs through oEM vehicle dealerships. Asterisk {*} or
Double Asterisk {**} indicates that the parts and/or labor information provided by MOTOR may have
been mod,i£ied or may have come £zom an alternate data source. Tilde sign (-y items indicate MOTOR
Nut-Included Y,abor operations. Non-Original Equipment Manu£acturez aftermarket parts are described
as AM, Qual Repl Parts or Comp Repl Parts which stands for Competitive RepYacement Parts. Used
parts are described a9 bKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as
Recond. k~ecored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are
provided by National Auto Glass Specifications. Lobar operation times listed on the line with the
NAt~S ?z~formatian 3~e MOTOR suggested labor operation times, NAGS labor aperatien times are not
included. Pound sign {#} items indicate manual entries. Some 2006 vehicles contain minor Changes
Frain the previous year. For those vehicles, prior to receiving updated data from the vehicle
manufacturer, labor and pazts data from the previous year may be used. The Pathways estimator has
a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the
local dealership.
CcC Pathways - A product of CCC In~ormatian Services Inc_
2
y P.O. Box S75
' Dubuque, Iowa 52004-0875
y(!~ (563) 589-4415 dispatch
(563) 589-4497 fax
911 Emergency
Chad Leitzen
Patrol Officer