Claim by Judd BillmeyerTHE CITY OF DUBUQUE
Masterpiece on the Mississippi
MEMORANDUM
BARRY LINDAHL
TO: Mayor Roy D. Buol and
Members of the City Council
DATE: January 11, 2009
RE: Claim Against the City of Dubuque by the Judd Billmeyer
Claimant Date of Claim Date of Loss Nature of Claim
Judd Billmeyer 01/07/09 12/27/08 Vehicle Damage
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
John Klostermann, Street & Maintenance Supervisor
Judd Billmeyer
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 1=lled 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 alJ 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 Claiman
2. Address:
3. Telephone Number 'SCE
4. Date of Incident:
5. Time of Incident:
6. Location of Incident (Be s ecific):
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 em loyee's na e.) ii
11 ~ as 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.) f)/)
13. What other damages do you claim, if any?
flyae
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
ar~74unt paid.)
11 c~
1.5. What amount do you claim from the City of Dubuque?
'
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
17. Have you made any claim against anyone else for damages as a result of
this,~ncident? (If yes, give name and address.)
Date: 1/ 5/2009 01:32 PM
Estimate ID: E8962
Estimate Version: 0
Preliminary
Profile ID: Mitchell
KRUSE-WARTHAN Nissan, Pontiac, BMW
600 Century Drive, Dubuque, IA 52002
(563)583-7345
Fax: (563)588-3874
Tax ID: 420655341
Damage Assessed By: GAYLE PURMAN
Deductible: 0.00
Claim Number: DRIVE UP
Insured: JUDD BILLMEYER
Telephone: Home Phone: (563) 495-5814
Description: 1998 Mercury Grand Marquis LS
Body Style: 4D Sed
VIN: 2MEFM75W3WX621570
Line Entry Labor
Item Number Type Operation
1 001185 BDY OVERHAUL
2 001187 BDY REMOVEIREPLACE
3 AUTO REF REFINISH
4 001189 BDY REMOVE/REPLACE
5 001316 BDY REMOVE/REPLACE
6 001192 BDY REMOVE/REPLACE
7 AUTO REF ADD'L OPR
8 AUTO ADD'L COST
9 AUTO ADD'L COST
Mitchell Service: 910624
Drive Train: 4.8L Inj 8 Cyl 4A
Line Item
Description Part Type/
Part Number
REAR BUMPER COVER ASSY
REAR BUMPER COVER YW3Z 17K835 BA
REAR BUMPER COVER
R REAR BUMPER COVER MOULDING F8MZ 17C830 AA
L REAR BUMPER COVER MOULDING F8MZ 17C830 AA
R REAR BUMPER COVER SUPPORT F8MZ 17D995 AA
CLEAR COAT
PAINT/MATERIALS
HAZARDOUS WASTE DISPOSAL
* -Judgment Item
C -Included in Clear Coat Calc
Estimate Totals
Dollar Labor
Amount Units
2.0
564.83 INC
C 2.8
36.23 INC
36.23 INC
26.33 INC
1.1*
124.80 *
3.50 '
Add'I
Labor Sublet
I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount
Body 2.0 52.00 0.00 0.00 104.00 T Taxable Parts 663
62
Refinish 3.9 52.00 0.00 0.00 202.80 T Sales Tax @ .
7.000% 46.45
Taxable Labor 306.80 Total Replacement Parts Amount 710.07
Labor Tax @ 7.000 % 21.48
Labor Summary 5.9 328,48
ESTIMATE RECALL NUMBER: 01/05/200913:32:49 E8962
Mitchell Data Version: DEC_08_A UltraMate is a Trademark of Mitchell International
Copyright (C) 1994 - 2008 Mitchell International Page 1 of 2
UltraMate Version: 6.7.018 All Rights Reserved
Date: 1/5/2009 01:32 PM
Estimate ID: E8962
Estimate Version: 0
Preliminary
Profile ID: Mitchell
III. Additional Costs
Non-Taxable Costs
Total Additional Costs
Amount IV. Adjustments
128.30 Insurance Deductible
128.30 Customer Responsibility
I. Total Labor:
II. Total Replacement Parts:
III. Total Additional Costs:
Gross Total:
IV. Total Adjustments:
Net Total:
Amount
0.00
0.00
328.28
710.07
128.30
1,166.65
0.00
1,166.65
This is a preliminary estimate.
Additional changes to the estimate may be required for the actual repair.
THIS DAMAGE REPORT IS BASED ON OUR INSPECTION AND DOES NOT
COVER ANY ADDIONAL PARTS OR LABOR WHICH MAY BE REQUIRED AFTER
THE WORK HAS BEEN OPENED UP. THE INSURANCE COMPANY WILL BE NOTIFIED.
WE GUARANTEE OUR COLLISION REPAIR WORKMANSHIP FOR AS LONG AS YOU OWN
YOUR VEHICLE.
ACCIDENTS ARE A PAIN BUT WE MARE THE REPAIR A PLEASURE!!!
ESTIMATE RECALL NUMBER: 01/05/2009 13:32:49 E8962
Mitchell Data Version: DEC_08_A UltraMate is a Trademark of Mitchell International
Copyright (C) 1994 - 2008 Mitchell International
UltraMate Version: 6.7.018 All Rights Reserved
Page 2 of 2
Date: 1! 5/2009 01:00 PM
Estimate ID: 8278
Estimate Version: 0
Preliminary
Profile ID: Mitchell
Mike Finnin Ford
3600 Dodge Street, Dubuque, IA 52003
(563) 556-1010
Fax: (563)690-1086
Tax ID: 14-1862673
Damage Assessed By: Rick Stumpf
Deductible: 0.00
Claim Number: 8278
Insured: JUDD BILLMEYER
Address: 1267 THOMAS PLACE, DUBUQUE, IA 52001
Telephone: Home Phone: (563) 495-5814
Mitchell Service: 910624
Description: 1998 Mercury Grand Marquis GS
Body Style: 4D Sed
VIN: 2MEFM75W3WX621520
Color: GREEN
Line Entry Labor Line Item Part Typel
Item Number Type Operation Description Part Number
1 001187 BDY REMOVE/REPLACE REAR BUMPER COVER YW3Z 17K835 BA
2 AUTO REF REFINISH REAR BUMPER COVER
3 001189 BDY REMOVE/REPLACE R REAR BUMPER COVER MOULDING F8MZ 17C830 AA
4 001316 BDY REMOVE/REPLACE L REAR BUMPER COVER MOULDING F8MZ 17C830 AA
5 AUTO REF ADD'L OPR CLEAR COAT
8 AUTO ADD'L COST PAINT/MATERIALS
7 AUTO ADD'L COST HAZARDOUS WASTE DISPOSAL
Drive Train: 4.6L Inj 8 Cyl 4A
* -Judgment Item
C -Included in Clear Coat Calc
ESTIMATE RECALL NUMBER: 01/05/2009 13:00:48 8278
Mitchell Data Version: DEC_08_A UltraMate is a Trademark of Mitchell International
Copyright (C) 1994 - 2008 Mitchell International
UltraMate Version: 6.7.018 All Rights Reserved
Dollar Labor
Amount Units
564.83 1.5
C 2.8
36.23 INC
36.23 INC
1.1*
128.70 *
5.00 *
Page 1 of 2
Date: 1/ 5/2009 01:00 PM
" Estimate ID: 8278
Estimate Version: 0
Preliminary
Profile ID: Mitchell
Estimate Totals
Add'I
Labor Sublet
I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount
Body 1.5 53.00 0.00 0.00 79.50 T Taxable Parts 637.29
Refinish 3.9 53.00 0.00 0.00 206.70 T Sales Tax @ 7.000% 44.61
Taxable Labor 286.20 Total Replacement Parts Amount 681.90
Labor Tax @ 7.000 % 20.03
Labor Summary 5.4 306.23
III. Additional Costs Amount IV. Adjustments Amount
Non-Taxable Costs 133.70 Insurance Deductible 0.00
Total Additional Costs 133.70 Customer Responsibility 0.00
I. Total Labor: 306.23
II. Total Replacement Parts: 681.90
III. Total Additional Costs: 133.70
Gross Total: 1,121.83
IV. Total Adjustments: 0.00
Net Total: 1,121.83
This is a preliminary estimate.
Additional changes to the estimate may be required for the actual repair.
ESTIMATE RECALL NUMBER: 011051200913:00:48 8278
Mitchell Data Version: DEC_08_A UltraMate is a Trademark of Mitchell International
Copyright (C) 1994 - 2008 Mitchell International
UltraMate Version: 6.7.018 All Rights Reserved
Page 2 of 2