Claim by John MoranTHE CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi '
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE:
RE:
Claimant
John Moran
January 28, 2009
Claim Against the City of Dubuque by the John F. Moran
Date of Claim
Date of Loss
Nature of Claim
01 /23/09
01 /04/09
Vehicle Damage
This is a claim in which claimant alleges that a City of Dubuque snowplow truck lost
control and slid down Samuel Street, striking claimant's vehicle which was legally
parked in a private driveway on Samuel 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
John Klostermann, Street & Sewer Maintenance Supervisor
John Moran
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
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA ,~,~ ~
. This written report constitutes your claim against the City of Dubuque, Iowa. Yo
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: ~o ~ "o' , / ~ D r ~ ~
1 2. Address: ~ U ~ ~o ~l e f ~- ~ tJ -
3. Telephone Number So ~ S ~~ ~ Ll c~~ 7
4. Date of Incident: ~~~~/~~_
5. Time of Incident: ~-' /~ ~f~
6. Location of .Incident (Be spgcific);
~'t S; ~ n e ,at ~U.S ~~~rn fii~~ ~ ~
7. Describe the accident or occurrence that caused injury or damage. (Give full
details upon which you bash your claim. If a City employee was involved, give
the employee's name.) _ ,~
8. What were weather conditions like?
.Lc N rd2~< /'/JV(~i''e~ w~~f'lc_ ~_~~ ~~~ _s'rr a ~
9. Give name and address of any witnesses:
10. Did police investigate? If so, give names of officers.)
yv ~ Tc. wi ~ P ~ ~ u~2,r ~; _
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.) ~1
1 k-~' ~ ~-
13. What other damages do you claim, if a y?
k o ' ~ ~ 2S 1 ~~rrytac .~.~
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
amo nt paid.)
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?
`T stow ~lo~ .b /obzse ~`o ~ c~'fN
17. Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.)
0
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 f~ day of -~' - - r _ ~~~;
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(Print Name)
Date: 1!15/2009 02:02 PM
Estimate ID: 8306
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: 8306
Insured: JOHN MORAN
Address: 405 SOUTHERN AVE, DUB, IA 52003
Telephone: Home Phone: (563) 543-4287
Description: 1999 Ford Crown Victoria
Body Style: 4D Sed
VIN: 2FAFP73W3XX140186
Options: CRUISE CONTROL
Line Entry Labor
Item Number Type Operation
1 001018 BDY REPAIR
2 AUTO REF REFINISH
3 002544 BDY REMOVE/REPLACE
4 001185 BDY OVERHAUL
5 001186 BDY REPAIR
6 AUTO REF REFINISH
7 AUTO REF ADD'L OPR
8 933018 REF ADD'L OPR
9 AUTO ADD'L COST
10 AUTO ADD'L COST
Mitchell Service: 910624
Drive Train: 4.6L Inj 8 Cyl 4A
Line Item
Description
L QUARTER OUTER PANEL
L QUARTER PANEL OUTSIDE
L REAR COMBINATION LAMP ASSEMBLY
REAR BUMPER COVER ASSY
REAR BUMPER COVER
REAR BUMPER COVER
CLEAR COAT
MASK FOR OVERSPRAY
PAINT/MATERIALS
HAZARDOUS WASTE DISPOSAL
* -Judgment Item
# -Labor Note Applies
C -Included in Clear Coat Calc
Part Type!
Part Number
Existing
3W7Z 13405 CA
Existing
Dollar Labor
Amount Units
0.5* #
C 2.4
107.62 0.4
2.0
4.0*
C 2.8
1.5*
10.00 *
221.10
5.00
ESTIMATE RECALL NUMBER: 01/15/009 14:02:41 8306
Mitchell Data Version: DEC O~ 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: 1/15!2009 02:02 PM
Estimate ID: 8306
Estimate Version: 0
Preliminary
Profile ID: Mitchell
Estimate Totals
Add'1
Labor Sublet
I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount
Body 6.9 53.00 0.00 0.00 365.70 T Taxable Parts 107.62
Refinish 6.7 53.00 10.00 0.00 365.10 T Sales Tax @ 7.000% 7.53
Taxable Labor 730.80 Totai Replacement Parts Amount 115.15
Labor Tax @ 7.000 % 51.16
Labor Summary 13.6 781.96
III. Additional Costs Amount IV. Adjustments Amount
Non-Taxable Costs 226.10 Insurance Deductible 0.00
Total Additio nal Costs 226.10 Customer Responsibility 0.00
I. Total Labor: 781.96
II. Total Replacement Parts: 115.15
III. Total Additional Costs: 226.10
Gross Total: 1,123.21
IV. Total Adjustments: 0.00
Net Total: 1,123.21
This is a preliminary estimate.
Additional changes to the estimate may be required for the actual repair.
ESTIMATE RECALL NUMBER: 01115/2009 14:02:41 8306
Mitchell Data Version: DEC_~S_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
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Nn. 7779 P. 1
MAILREPORTgTO: I
De artment of Trans OI't81~lOB Law EnforcementtaseNOmoer.
OWA
o~ laws Department of TranspoAauon P Q ,
01-09-D0463
office vt DAVer Servtces ~ INVESTIGATING OFFICERS REPORT
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Dea Molnea, Iowa 5030fi-8204 OF MOTOR VEHICLE ACCIDENT cgal ovate
Intervenlion~~ Property?
Dale of Accldanl Timo of Accident County Accident oocuned within torporale IImIIB of (city) Location Lilera(DaecrlDllon
01fUdl09 06:12 Hrs. Dubu Ue - 31 Dubuque - 210D SAMUEL ST and 8oU7HERN
Ir sccldent occurred outside of dry tlmlle AVE
;.hrnr genarsl vldnlly. "NIA" orneareal red "N/A"
On Rosd, Slreal; or Highwsy; Al In(etsed'an wrih:
SAMUEL ST SOUTHERN AVE
Note: Unless aCCidenl ocourrad 5l en interseclioh which la comDlelely desclibed above, use the space bstow Id ghra the exact
Iecalion riom a mlleposl or derinsWa Inlereaclion, bridge, of railroad crossing, using two tlielenceB and dVezlions rrnece~~ary. x-Coefdlnete: 00691830
Dlelence Olradlon Dlelence Dlrecuon Y-Cootdinalo:04706811
"NIA" "N1A" end "NIA" "N/A" d I(Dividetl Highway, Plovlde Rattle
MileDosl Number bahnable inlersedion, Drldge, or railroad crossing (Cardinal) Travel Direction
"N1A" or "NIA" "NfA"
betters Name - Lssl Flrsl Middle 3uffDr
POWERS JAMES ROBERT Phone
51l~ 689.0102 X
Address Cily Stele ZP~
1266GLEYELAND AVENUE DU6UOUE IA 62001
Date of Binh DAVere ucenee Number C ilauon Charge Code 1 Cllal[on Charge 1
09/06/1963 4SBWVY5644
C3ender Slate Class Entlorsemenl e Reslricliens C lleuon Charge Code 2 Citation Charge 2
Male IA t3 N-L NONE C ilallon Charge Code 3 Citation Charge 3
alcohol Teat Drug Teel
t3lven? Teel Reeulls: Given9 Tael Aeaults: C jlalion Charge Code 4 Cilallon Charge 4
1-None 1-Nona
Sealing Position0l Inluty Slalus 6 Ou:upanl Proladlon9 Airbag Deployment 6 Airbag Switch Status 9 Ejection 1 F.leclion path 1 Trapped 1
Transports lo: TrenapoAed bY. .
Ovmef3Name-Lest Flral Middb Suffu< oCvlr7YrOCFmDU9UgUE
Address Cily Slab Zlp
50 W 13TH STREET DUBUQUE IA 52001
Insurance Co. Name Insurance Pdicy>h Licanee Plsle R S`talo Ytar
SELP INSURED IA 2009
VIN No. Year Make Modal Style Tow tl Approximate Gest to
1HTwbAAN59Je4a4e0 2009 International - INTL 7400 SFA PLOW NO Repslror RaDiace
Initial Trsvel Vehido Spaetl Point d Mosl Oamagad l-xlenf of Undarrlde! PYivale7 ((~-~
Direction 1 Aellon 01 Limit 26 InRlal fmpaU 02 Area Damage 1 Override 1 1^J SQ.00
Tolsl TrarPic Vehido Cargo Body vehicle Driver Vision Conlrrbuling Cfrcumelancos,
Occupants 1 Conlmis 01 Conflg. OS Type 11 Defad 01 CordWon 1 Obsrured D1 Delver (up (o hvo} 28
3EOUENGE OF EVENTS FUsI Event 29 3ecdnd Event 7hlyd Event Fourth t=venl Moat Harmhal Event (by vehide) 23
Commercial Troller Attached Lp slate Year Attar-7~ed le State tear Emergery Emergency
St
t
a
ue 3
Llcanse Plare k Power Unil: Treller Unil: Vehicle ape 1
Carrier Name Addreee Clty ~ stale 21D
US 007 p ar MC # Number or Gross Vehlde Placard # Hazardous Materials
Axles Weight Rachg Relesaed7
DrLera Name - Lasl First Middle Suffix Pflona
Address Cily Slate Zfp
IA
Oslo of Birth Drlvera Licensa Number Cilauon CharOa Cade 1 Cjlalion Charge 1
ti
ch
2
C
G~cndcr Slats Class Endorsemen ts Rostridiona on
arge
ita
Chellon Charge code 2
NONE NONE Cilallon Charge Code 3 Cjlalion Charge 3
AlcahclTBSI Drug Teal '
Divan? Teal ReauIIB: Glen? Tell Results; ( ',jlarion Charge Code 9 Cilallon CharOO 4
SeallAg Position InJunr Status Occupant Protection Airbag Depoymenl Airbag switch $IafUS E(edran Eledlon Pslh Trepped
Tranaportedlo: ~ TrenaportedbY•
Owne~e Nama -Last First Middle Sulfa Owner Company Name
SEELING GINA ANN
Addl6ss
23078 CENTERVILLE Clly
LA MOT7E Stale
IA 2iP
620fid
Insurance Co. Name Insurance PoI~Y # Llcanse Plate tl stele Year
STATE FARM MUTUAL 079919980616 B03TKX IA 2009
VIN No Year Make Mader style Tow# ApproximateCosl to
.
1HGCMB9446417gd51 2006 Honda-HOND ACCORD dDR NO tiepairorReplace
Inlllel Travel venida Speed Point or Most Damaged Gxlenl df Underride/ PAvale9
^
0
5900
Direction A~lion 12 Llmll 25 Initial Impact 06 Area 06 Damage 2 Overrde 1 .0
ToIBI Tremc Vehido Cet+Oo Body Vehlde Driver Vlaton CanUlbuling Circumstances,
Occupants 0 Controls 01 Confld. 01 Type 01 oefatl 01 Condlion Obscured Driver (up Lo Iwo) 2$
SEQUENCE OF EvENT3 Flrsl Event 21 Second Event 7hlyd Event FauM Event Moel Harmful Event (Dy vehlde) 21
Commercial Treller Allarhetl to Slate Yaer AHaehed to State Year Emergency Emorgency
d
T
Sl
l
o
ype 1
a
us 3
License Plate S Paver UniL• Trailer Unil: Vehi
Carrier Name AddleBe Cily 31a1e Zip
Us DOT # or MC o Number or Grass Vaflide Placard # He28rdoua Mareriars
axles Welphl Reline Releaeed9
Printed :~i; Dubuque Police Department 01/05!2049 12;50.AM Page 1 Form #,: 01.09.OOdfi3
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5. 2009 2:1~PM
No. 2279_P. 2,
Di:rersNeme-Lass Firal Middle Sulfa Phone
Address Ciry Stale Llp
IA
Dffia of 9iM1h Dnve(9 Ltnsanae Number CiLalJon Charge Code 1 Cltello0 Charge 1
Cer:der slsla Cleas Endorsements Roslriraians Citation Charge Code 2 citation Charge 2
NONE NONE Challon Charge Codes Citation Chargo3
Alcohol Teal Drug Test
Given? Tasl Raaulla: GNen7 Teel ReauHs: Challon Charge Codo 4 Challon charge a
LI Sealing Poallion InJUry SfaW a Occupant Pmlaclicn rUrbag Doploymanl AifDflg SWIIch $talU9 EleGllon EIeGIIOn Path Trapped
N
I Tranaponed to: 'renaportad bY.
Otvne(s Nema :Lest Fircl Middle Sufi iv lTrner Company Nama
T MORAN JOHN FRANCIS
003 Addmss
dOS SOUTHERN AVE City
DUBUQUE Slala
IA Zip
62001
Ineuranca Co. Name In3ur~nca Policy ri Liccna~ Plata # Stale Yesr
STATE FARM MUTUAL 0921385gE1715 7d2AYG 1A 2009
VIN NO. Yaer Make Model Styla ToW# ApproxlmalaCosllo
2FAPp73W3XX1a11186 1998 Ford -FORD GROVffN VICTORIA 4 DR NO ~ Aepairor Replace
Initial Travat vertlcle Speed Point of Moat Damaged Exlanl of undemlde! Private?
Din-coon Action 12 Llmlt 25 Inillallmpaet 05 Area 06 Damage 2 Override 1 ^ $500.00
Tolsl 1'reffic Vahi4e cargo body vehlGe Drlver vialon Contributing Gimumalancea,
OCCUpsn16 0 Conlrole 01 Config. 01 type 01 Defect QI Condhlon obecuted Ddver(uplotwo) 28
3EUUENCE OF EV6NT5 Fiw.l Event 21 Sewntl Event Third Event Fourth Evanl Moal HarmNl Event (byvehicle) 21
Convnercisl Trailer Allechetl to Stale Year Attached to Slab Year Emergency Emergency
Liccnsa PIaIcJt Powai Unil: TrailerUnil: Vehicle Type 1 Slaluc 3
CairiarNsme Atltlraea City Slate Zip
U3 DOT # or MC # NumDar of Gmea vehicle _ placard # ~ Hszartloua Melerlals
Axles Welghl Reling Released?
ACCIDENT ENVIRONMENT ROAOWAYCHARACTERISTICS WORK20NE RELATED? SEQUENCE OE EVENYS
MsjorCOnlribulingClrcunJSlences: No
Location of FiraL Hsrmrul Event 4 Weslhar Condilians Environment 2 Locallon Flrat HarmGal Evanl of Crach
Manner of CreshlGollision ~ (up to two) OS Roedwey p2 Typa (use codes 11-42 only) 2y
Light Condiliona d Sur(aca Condili~ns 9 Type of RoarAvay JunclloNFealure 01' Wol%era Present?
SAMUEL ST
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P IVATE DRIVEWAY
3a
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SOUTHERN AVE
NARRATIVE
DelscHbe what happened (refer to vehicles by numbeh
A SNOW PLOW, WAS TRAVELING NORTHBOUND ON SAMUEL STREET FROM THE INTERSECTION WITH
UNIT 1
,
SOUTHERN AVENUE WHEN IT 5lID BACKWARDS ON THE ICE AND COLLIDED WITH UNITS 2 AND 3 WH[CH WERE
PARKED LEGALLY IN A PRIVATE DRIVEWAY,
Ofllcer eedga No. 7'me Officer NotNod of 4ccidenl Tlme Oficer ArrNed Al Scene
BOWERS JAMIE a 06:16 Hra: 05:22 Hrs.
Name of Agency Dale of Report Inveslipalion T.I, #
DubuquePnllceDe arlment 01!04/2009 made alacene7
R ev ed BY. vie
D Agency Specific OlherTed,niwt Invesligauon Agency
~1~~ ~
P(il;tad At: Dubuque Po(Ice Department 01105!2009 12:56 AM Page Z Form #: 01-09-o0d6J