Claim by Matthew HurmCity Counsel members,
Concerning my claim for damages to my car on October 29th , 2009, I have only one
car and I've been borrowing vehicles since 10/29/09.
1 was told by police officer Alex Scott that he thought someone from the city would
be up to look at the damage. I was then told by city hall that nothing could be done
about my car until the next city counsel meeting which is Monday 11/16/2009.
I haven't moved the car since the incident because it is not drivable due to the
fender being driven into the front left tire.
ESTIMATES:
Hanley Auto Body Inc. gave me an estimate based on the year, make, model, etc.
and the pictures I took of the damage.
Valentine Bros. Body Shop looked at the pictures and stated that I should pry bar
the car until it's drivable enough to get it to his shop.
Brimeyer Auto Body stated by phone that the year, make, model, etc. and the
description of the damage would most likely make it a totaled car.
I am concerned that my car has been on the street and not driven since the incident.
I am aware that I would have twenty four hours after the tires are marked and an
additional twenty four hours after the car is tagged to move it, but as you can see I'm
in a situation where this may cost me money I do not have, and I am not the one at
fault.
My insurance company is not involved because it is a city vehicle that struck my car.
I need a car badly, but do not want to void any settlement because I altered the car
in some way to move it either for a parking violation or to move it for repairs.
I do not have the money to gamble on a rental carat my expense only to find out
later that I would not be reimbursed.
I really need an authorization to rent a car until this is resolved, or have someone
from the city verify that the city will take care of this, so that I can move forward
with the repairs needed. I will have been without a vehicle for nineteen days by the
time of the city council meeting, and as I said before, I only have one vehicle.
Officer Alex Scott was very helpful, and the city workers on the truck that day were
professional and friendly. I'm hoping someone from the city contacts me with the
details I need in order to resolve this and bring it to closure without costing either of
us any more time or money.
Sincerely, rr~~c 1 ' 1
Matt Hurm P ~"~ VJ l~ ~ (lam ~~ ~C.:~
727 Alta Vista St.
Dubuque, IA. 52001 ~,~Q 1 V ~~~ ~ ~~.
563-663-5690
//7Yhi, ~tirny~ ~,,, D~,6
CIJAIM AGAINS'~ TI-IE CI'~~ ®F DUBUQUE, I®~VA
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 13t" 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 ar will not be paid.
1. Name of Claimant: /~ ~T"~T' h. ~_t.zv !~~- ~ l~ to f'` ~
2. Address: ~ ~~ •~ /~"L:.~l~ ~l ~ ~f~- ~~`~r ~~=~
3. Telephone Number ~~~'~ •- ~'~ ~ ~~" ~~,~~-
4. Date of Incident: ~(~ •- ~ ~" U Cf
5. Time of Incident: ~ ' ~ C~ ~ , E'~~
6. Location of Incident (Be specific):
'7 c~.`7 j~ L.~i'~i 111 S-~`/~ ~~"1•~'~"f`
8. What were weather conditions like?
rr}~~ ~~~
9. Give name and address of any witnesses:
K ,
10. Did police investigate? (If so, give names of officers.)
~ ~ ~~~ (~ L k S C ~
L, g~v >=,u#orL mr~~~ ~k~-S L l~+'U h~[~~r ®l ` ~I ~ • 5 0 ~~'~
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 pmnlnvPe'S name_1
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
gyn.
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 _ ~.~-+ ~ ~ o L~ n-I/ l' ~--~. L, f'~f C~~it~ c~~', l r~~ n r_~ ~> r~
13. What other damages do
u claim, if anv?
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. What amount do you claim from the City of Dubuque?
16. Why do
claim the City of Dubuque is responsible?
17. Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.)
IU O
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 ~ '~ ~' ~~' day of
(Sig~nnature) I
(Print Name)
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~~ Driver Informafiion Exchange Reporfi
Dubuque Police Department
563-589-4410
Driver's Name -Last ~ First _ Middle ~ Suffix Date of Birth
~ DAMS ~ CLEMENT JAMES 11124/1949
N Address City State Zip Phone
I 1480 MILLER ROAD DUBUQUE i IA 52003.0000 (563) 580-5759 x
T Gender Driver's License Number Class State ~ Endorsements Restrictions Insurance Co. Name Insurance Co. Phone #
Male 962225883 A IA NONE NONE CITY OF DUBUQE (563) 589-4120 x
001 Owner Company Name Insurance Policy #
CITY OF DUBUQUE
Owner's Name -Last First Middle Suffix
Address 'City State I Zip
925 KERPER BLVD DUBUQUE IA 52001-
VIN No. Year Make Model Style Vehicle Configuration
1 HTSHAAR3TH280302 1996 INTL 4900 6X4 GARBAGE TRK 21
License Plate # State Year ~ Most Damaged Area Approximate Cost to Repair or Replace
72029 IA Oa -Right Rear $0.00
Driver's Name • Last First Middle Suffix Date of Birth
~ HURM I MATTHEW GERARD 04/24/1956
N Address City State Zlp Phone
727 ALTA VI5TA ST DUBUQUE IA 52001-0000 {563) 583-6012 x
I Gender Driver's License Number Class I State ~ Endorsements Restrictions Insurance Co. Name Insurance Co. Phone #
T Male 767229476 C ~ IA NONE NONE MERIDIAN SECURITY (563) 556-3232 x
002 Owner Company Name Insurance policy #
AIA0033881
Oa.ner's Name -Last First Middle Suffix
HURM MATTHEW GERARD
Address City State Zip
727 ALTA VISTA ST ,DUBUQUE IA 52001-0000
VIN No. Year Make Model Style Vehicle Configuration
1G1LA55M(iSY254058 1995 CHfeV ~ CRS i 4D C1
License Plate # State Year Most Damaged Area Approximate Cost to Repair or Replace
792TXC IA ~ 2010 07 • Left Side $900,00
County Accident occurred within corporate limits of (city)
Dubuque - 31 Dubuque - 2100
Literal Description
CARLOTTA ST and ALTA VISTA ST
X-Coordinate Y-Coordinate
00690755 04707666
If accident occurred outside of city Direction Nearest City Route (Cardinal)
limits show general vacinity: "NIA" ~ "N/A" of "N/A" Travel Direction "NIA"
On Road, Street, or Highway: At Intersection with:
ALTA VISTA CARLOTTA
Distance Direction Distance Direction Milepost Number
"N!A" "N1A" and ' "NIA" "NIA" of "N!A" Or
Definable intersection, bridge, or railroad crossing
"N!A"
Officer Badge No. Law Enforcement Case Number Date of Accident Time oFAccident
SCOTT, ALEX 32 01-09-50844 10!2912009 06:30 Hrs.
Printed At; Dubuque Police Department 1012912009 07:11 AM Page 1 Form #: 01.09.50844
Date:
Estimate ID:
Estimate Version:
Preliminary
Profile ID:
Hanley Auto Body Inc.
1030 Century Circle, Dubuque, IA 52002
(563) 683-7220
Fax: (663) 583-8355
Damage Assessed By: ttobert Hanley
Deductible: UNKNOWN
Owner: Matthew Hurm
Address: 727 Alta Vista Street, Dubuque, IA 52001
Telephone: Home Phone: (563) 583-6012 Cell Phone: (563) 663-5690
Mitchell Service: 811482
Description: 1995 Chevrolet Corsica
Body Style: 4D Sed Drive Train: 3.1L tnj 6 Cyl 3A
VIN: 1G1 LD56M6SY254058
Options: DRIVER SIDE AIRBAG, POWER LOCK, POWER STEERING, MANUAL AIR CONDITION
ANTI-LOCK BRAKE SYS., V6 ENGINE, AUTOMATIC TRANSMISSION
11/ 212009 11:28 AM
2918
0
Mitchell
Line Entry Labor Line Item Part Type/ Dollar Labor
Item Number Type Operation Description Part Number Amount Units
1 100030 BDY REMOVEIREPLACE L Replace Fender Qual Recycled Part 45.00 * 1.8
2 AUTO REF REFINISH L Fender Assy C 2,4
3 AUTO REF REFINISH L Add To Edge Fender C 0.5
4 100102 BDY REMOVEIREPLACE L Frt Replace Door Assy Quai Recycled Part 150.00 * 1.5
5 AUTO REF REFINISH L Frt Door C 1.8
8 AUTO REF REFINISH L Frt Add For Jambs & Interior C 1.0
7 **" END OF ATG SECTION ***
8 110430 REF BLEND Hood Outside C 1.2
8 100108 BDY REMOV~IREPLACE L Fender Liner Qual Recycled Part INC* 0.4
10 113980 MCH ALtON Front Suspension -M 1.3
11 900500 BDY * REMOVEIREPLACE NEW TIRE New 55.00 * 0.3*
12 126910 REF REFINISH L Rear Door Outside C 1.7
13 AUTO REF ADb'L OPR Clear Coat 2.4
14 AUTO ADD'L COST PaintlMaterials 333.00 *
15 AUTO ADD'L COST Hazardous Waste Disposal 5.00
* -Judgment Item
C -Included in Clear Coat Calc
ESTIMATE RECALL NUMBER: 11!021200911:28;23 2818
Mitchell Data Version: OEM: OCT 09_V UltraMate is a Trademark of Mitchell Internafional
Copyright (C) 1894 - 2009 Mitchell International Page 1 of 2
UltraMate Version: 7.0.012 All Rights Reserved
Date: 1112!2009 11:28 AM
Estimate ID: 2919
Estimate Version: 0
Preliminary
Profile ID: Mitchell
Estimate Totals
Add'I
Labor Sublet
Amount
Totals
ll• Part Replacement Summary
I. Labor Subtotals Units Rate Amount 00
0 _
192.00 T Taxable Parts
Body 4.0 48.00
00
48 0.00
0.00 .
0.00 532.80 T Sales Tax
Refinish
Mechanical .
11.1
1.3 48.00 0.00 0.00 62.40 T Total Replacement Parts Amount
787.20
Taxable Labor
Labor Tax ~ 7. 000 % 66.10
842.30
Labor Summary
16.4
III, Additional Costs
Non Taxable Costs
Total Additional Costs
Paint Material Method: Rates
Init Rate = 30.00 , snit Max Hours = 99.9, Addl Rate = 0.00
Amount IV. Adjustments
338.00 Customer Responsibility
338.00
I. Total Labor:
11. Total Replacement Parts:
III. Total Additional Costs:
Gross Total:
IV. Total Adjustments:
Net Total:
This is a preliminary estimate,
Additional chanaes to the estimate may be required for_the actual repair.
ESTIMATE RECALL NUMBER: 111021200911:28:23 2819
Mitchell Data Version: OEM: OCT_08 V UCupyright (C)1994m2009 Mitchell International I
All Rights Reserved
UltraMate Version: 7.0.012
Amount
250.00
7.000% 17.60
267.60
Amount
0.00
842.30
267.60
338.00
1,447.80
0.0(
1,447.8(
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