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Claim by Pamela SchmittTHE 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 September 1, 2009 Claim Against the City of Dubuque by Pamela Schmitt Date of Claim Pamela Schmitt 08/24/09 Date of Loss 08/20/09 Nature of Claim Vehicle Damage This is a claim in which claimant alleges that while she was attempting to exit the Stn Street ramp at the south exit, the exit arm came down prematurely and scraped the driver's side of claimant's vehicle. 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 Tim Horsfield, Parking Systems Supervisor Pamela Schmitt OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 3OO 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~h 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: Pamlea Linn Schmitt 2. Address: 101 1st Street SE, APt#1, Farley, IA 52046 3. Telephone Number: 563-585-6904(w) 563-744-8037(h) 563-599-3387(c) 4. Date of Incident: 08/20/2009 5. Time of Incident: 3:40 p.m. 6. Location of Incident (Be specific): 5th & Iowa Parking Ramp by Prudential 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.) Driving out of ramp on 5th & Iowa, Holiday Inn side, swiped card and arm went up. Proceeded out of the ramp and the arm came down on top of my vehicle as I drove forward. 8. What were weather conditions like? Dry & Clear 9. Give name and address of any witnesses: Tim Brockling 563-585-6218 (w) 14674 North Cascade Rd #117, Dubuque, IA 52003 10. Did police investigate? (If so, give names of officers.) Officer Tuegel Case#09-38967 11. Was anyone injured? (If so, give names, addresses, and extent of injuries.) No 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.) Yes, top of driver and passanger doors on the drivers side paint is scuffed. Luggage rack rail is scuffed on drivers side as well as the rear tinted glass window. See attac~d estimates. Providing two for comparison of damage. n u~ ~~~ i:_ ~- ~' - rv = _ c ~ -• ~= -y , -,-~ a ~ = - ~ ~_ ~__ :_n ~- ~= ~ ,--~, ~. 13. What other damages do you claim, if any? None 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.) No 15. What amount do you claim from the City of Dubuque? Full amount 16. Why do you claim the City of Dubuque is responsible? No fault of mine, Damage was caused by city property that was disfunctional and caused the damage to the vehicle. 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) No 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 21 day of August, 2009. i r ~ ~li(.C- -/~ a nature) ~l~ L ~Sc~,~~~, l-~ (Print Name) 08/21/2009 at 01:12 PM Job Number: ~ 30799 BRIMEYER AUTO BODY License #:30799 Federal ID #:421438480 10709 COLLISION DR. DUBUQUE, IA 52001 (563)583 4456 Fax: (563)583-1838 PRELIMINARY ESTIMATE Written By: BOB COOK Adjuster: Insured: PAM SCHMITT Claim # Owner: PAM SCHMITT Policy # Address: 101 1 ST SE APT1 Deductible: FARLEY, IA 52046 Date of Loss: Day: Type of Loss: Evening: Point of Impact: Inspect Location: Insurance Company: Days to Repair 2005 BUIC RENDEZVOUS 4X2 CX 6-3.4L-FI 4D UTV Int: VIN: 3G5DA03E75S5 08267 Lic: Prod Date: Odometer: Air Conditioning Rear Defogger Cruise Control Intermittent Wipers Keyless Entry Rear Window Wiper Message Center Tinted Glass Dual Mirrors Console/Storage Overhead Console Luggage/Roof Rack Fog Lamps Clear Coat Paint Power Steering Power Brakes Power Windows Power Locks Power Mirrors AM Radio FM Radio Stereo Search/Seek CD Player Driver Air Bag Passenger Air Bag 4 Wheel Disc Brakes Cloth Seats Bucket Seats Automatic Transmission Overdrive -- - Styled Steel Wheels -- -------- N0. OP. ------------- - ---------------------------- DESCRIPTION ----------------------------- QTY EXT. PRICE LABOR PAINT 1 --------------------------- QUARTER PANEL ------------------------------- 2* Repl LT Quarter glass NAGS w/o 1 990.28 1.8 Onstar 3 ROOF 4 Repl LT Side rail 1 199.46 0.4 5# BUFF LT SIDE UPPER DOORS & 1 1.0 ------- GATE ------- ----------- ----------------- Subtotals =_> - ------------------------- 1189.74 3.2 0.0 Parts 1189.74 Body Labor ------ 3.2 hrs @ $ 55.00/hr 176.00 --------- ---- SUBTOTAL --------------- ------------- $ 1365.74 Sales Tax $ 1365.74 Q 7.0000 ~ 95.60 GRAND TOTAL $ 1461.34 ADJUSTMENTS: Deductible 0.00 ------------------- -------------------- CUSTOMER PAY $ 0.00 INSURANCE PAY $ 1461.34 1 RICHARDSON MOTORS .~• 1475 J.F.K. ROAD ` DUBUQUE, IA 52002 PHONE: (563) 582-5411 FAX: (563) 582-4129 FEDERAL ID: 42-0813744 CD LOG NO 6270-1 DATE 08/21/09 SHOP: RICHARDSON MOTORS ADDRESS: 1475 JOHN F. KENNEDY RD CITY STATE: DUBUQUE, IA ZIP: 52002- OWNER: ADDRESS: CITY STATE: ZIP: POINT OF IM LIC#: BODY COLOR: CONDITION: SCHMITT, PAM 101 1ST S SE APT 1 FARLEY, IA 52046 PACT: 0 STATE: TWO TONE *=USER-ENTERED VALUE EC=REPLACE ECONOMY UM=REMAN/REBUILT PRT OE=REPLACE PXN OE SRPLS TE=PARTL REPL PRICE I=REPAIR TT=TWO-TONE N=ADDITIONAL LABOR AA=APPEAR ALLOWANCE INSP DATE: 08/21/09 PHONE 1: (563)582-5411 FAX: (563}582-4129 WORK PHONE: (563)585-6904 CELL PHONE: (563)599-3387 VIN: 3G5DA03E75S508267 MILEAGE: ACCTNG CTL#: E=REPLACE OEM UE=REPLACE OE SURPLUS EU=REPLACE SALVAGE PC=PXN RECONDITIONED ET=PARTL REPL LABOR L=REFINISH CG=CHIPGUARD RI=R&I ASSEMBLY RP=RELATED PRIOR 2005 BUICK RENDEZVOUS CX 4DOOR WAGON CODE: 57103A/D OPTNS E/24FNR OPTIONS: TWO-STAGE - EXTERIOR SURFACES LUGGAGE RACK OVERHEAD CONSOLE NG=REPLACE NAGS UC=RECONDITIONED PRT EP=REPLACE PXN PM=PXN REMAN/REBUILT IT=PARTIAL REPAIR BR=BLEND REFINISH SB=SUBLET P=CHECK UP=UNRELATED PRIOR 6CYL GASOLINE 3.4 TWO-STAGE - INTERIOR SURFACES ALARM SYSTEM OP GDE MC DESCRIPTION MFG.PART N0. E 1116 RAIL, LUGGAGE RACK LT 10313546 GM PART E 0358 GLASS,BODYSIDE TINT RT 10320750 GM PART N sand and buff ADDNL LABOR OPERA left side upper doors and liftgate 3 ITEMS PRICE AJ% B~ HOURS R ----- --- -- ----- - 201.24 0.4 1 990.28 1.9 1 INC* 1.0*1* FINAL CALCULATIONS & ENTRIES 2005 BUICK RENDEZVOUS CX 4DOOR WAGON CD LOQ~ NO 6270-1 GROSS PARTS 1,191.52 PARTS & MATERIAL TOTAL 1,191.52 TAX ON PARTS @ 7.000 83.41 LABOR RATE REPLACE HRS REPAIR HRS 1-SHEET METAL 55.00 2.3 1.0 181.50 2-MECH/ELEC 64.00 3-FRAME 59.00 4-REFINISH 55.00 5-PAINT MATERIAL 35.00 LABOR TOTAL 181.50 TAX ON LABOR @ 7.000 12.71 SUBLET REPAIRS TOWING STORAGE GROSS TOTAL 1,469.14 NET TOTAL 1,469.14 SHOPLINK UN189 ES CD LOG 6270-1 DATE 08/21/09 11:52:48AM R6.37 CD 07/09 PXN: Y/00/00/00/00/00 CUM 00/00/00/00/00 GEOCODE 52002 EDU: 0808 HOST LOG {C) 1998 - 2008 AUDATEX NORTH AMERICA, INC.