Claim by Ann ParadisoTHE CITY OF
DUB E
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To:
DATE:
RE:
Claimant
MEMORANDUM
Mayor Roy D. Buol and
Members of the City Council
December 22, 2009
Claim Against the City of Dubuque by Anna Paradiso
Date of Claim
Anna Paradiso
12/21 /09
Date of Loss
12/14/09
Nature of Claim
Vehicle Damage
This is a claim in which claimant alleges that her vehicle which was parked near 687
Needham Place was struck by a City of Dubuque salt truck.
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
John Klostermann, Street & Sewer Maintenance Supervisor
Anna Paradiso
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
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: ~ IVA'Al /~~~I D ISd
2. Address: to 87 `~+Et~~~~lA4'1 C,
3. Telephone Number: ~~3 - Ts~ ~T ~3fl C72 _ ~ S ~" L ~3
4. Date of Incident: ~ Z ~" ~ y" ~~
5. Time of Incident: Y• So ~•M•
6. Location of Incident (Be specific): ~i ~~ ~E~ r~A~
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.)
S4 ~ T "f+rLV G R ~'1 f T ~~ ~. I~ T~ S fef'i O
r~c~ c.4a
8. What were weather conditions like? LSD/" l rt. <<-~. ~ ~,
_ ~
9. Give name and address of any witnesses: /Vc~/Vf°~ ~7 ~~ rO
c7
taa
10. Did police investigate? (If so, give names of officers.) !~: t~. ~
yfs ~ c:
::~ - ----
11. Was an one inured? If so, ive names, addresses, and extent of in'uries. ~'
Y 1 ( 9~ 1 ) (i~ C~R
c.~
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.)
~S
-r
i~
'1
n
~~
~? r
•~ `" ',°~
~ ~
:~ '~ -'~' - S .
. ;, .
,•
.., t ° ~
.. • sets ~ e ~~ . .~ •~ ~ •
s _ • ~ ~sr .
.'y'~4.~.. `''~)`'i
h, .yr• . ~. r.
k
J
• ... .. •
•,~~`
13. What other damages do you claim, if any?
N ~N~
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.)
N.~
15. What amount do you claim from the City of Dubuque?
16. Why do you claim the City of Dubuque is responsible? _ _ ~`I!'Y GAt~L.~
17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and
address. )
~~
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 Z.0 day of Q EC.. , 20~
'~mnw Pww~ae~
(Signature)
Aga Pa~AJ~zo
(Print Name)
Y'.i t ' l
~..
r
.. `
~ - .
.T,/+'~~'~;la`s ~.Y
,~
t
t,~Y.
• ~ ~ "•
..
• , ! .. ,, . i ~ c
., j
HART AUTO BODY & PAINT
800 CEDAR CROSS ROAD DUBUQUE, IOWA 52003
PHONE: (563) 556-8323 FAX: (563) 556-8324
DAMAGE REPORT
PRICES SUBJECT TO CHANGE
Items CIRCLED aro not in the total in
our opinion, are not part of this clam.
V ICLE OWNER ADDRESS 3 S / _ ~ ONE DATE
R M/A~KE MODEL /' LICENSE MILEAGE C LOR SERIAL NO. CONDITION
!l d ~J~ I~10 "I /~` ~r'v7~
1 SURANCE CO ADJUSTER PHONE CAR LOCATED AT DEDUCTIBLE
Byrn. FRONT sublet
Or Psint service;
Or Hours
Parts LEFT
Sym. sublet
Or Paint service;
Or Houn
Parts
sym. RIGHT sublet
Or Paint service;
Or Hours
Part
f Bumper W/Pads /, Fender, Frt. Fender, Frt.
Bumper Abs. Fender Shield Fender Shield
Fender Ext. Fender Ext.
Fender Mldg. Side Fender Mldg. Side
Fender Stripe Fender Stripe
Fender Mldg. Fender Mldg.
Bumper Reinf.
Bumper Brkt. Side Light Asmbly Side Light Asmbly
Bumper Cushion Headlamp Headlamp
Valance Headlamp Door Headlamp Dr.
Bumper Gd. Sealed Beam Sealed Beam
Frt. S tem Park Light Park Light
Frame Cowl Cowl
Cross Member Door, Front Door, Front
Wheel Door Hinge Door Hinge
Hub Cap Disc Door Panel Door Panel
Lr. Cont. Arm Door Stripe Door Stripe
Door Mldgs. Door Mldg.
Up. Cont. Arm
Center Post Center Post
Door Rear (~ Door Rear
Bumper Filler Door Mldg. Door Mldg.
Grille
Grille Panel
Gril! Panel :11dg• Racke: Pane! Rocker Panel
Rocker Midg. Rocker Midg.
Floor Floor
Dog Leg Dog Leg
s quay. Panel ,r guar. Panel
Air Condenser Quar. Ext. guar. Ext.
Recharge System guar. Wheel House guar. Wheel Hourg
Name Plate guar. Mldg. Side guar. Midg. Side
Baffle, Upper guar. Mldg. guar. Mldg.
Lock Plate, Lr. guar. Stripe quay. Stripe
Lock Plate, Up. Side Light Asmbly Side Light Asmbly
Hood Top Tail Light Tail Light
Hood Hinge REAR MISC.
Hood Lock Bumper (. Inst. Panel
Ornament Bumper Abs. Front Seat
Rad. Sup. Bumper Cushion Front Seat Adj.
Rad. Core Bumper Reinf. Top
Anti Freeze Bumper Brkt. Headlining
Rad. Hoses Bumper Gd. Top Vinyl
Fan Blade Bumper Filler Tire % Worn
Fan Shroud Valance Painting a, O
Fan Belt Lower Panel Aerial
S Tl•
J'
30. ae
Water Pump Floor Rust Proof
Water Pump Pulley Trunk Lid Battery
Motor Mts. Trunk Midg.
EPA WASTE DISPOSAL CHARGE r. i ~
Lic. Light PARTS (Prices Subject To Invoice) 0
0
-
SERVICESap.S'HRS. @~S'D HR. _
.
1. 027
Windshield Gas Tank SUBLET OR PAINTING
Frame SUB TOTAL 2"J (e D• 0
wheel TAX 7 6
Hub & Drum PAINT
MAT 3
~
A
l -
RL-HDW. ff
/, O()
- x
e
Spring
GRAND TOTAL / J` j ~. a,
ApProiser X
Symbols: A-Align N-New OP-0pen P-Paint I HEREBY AUTHORIZE THE ABOVE REPAIRS
S-Straighten R-Replace OH-Overhaul
~ TOYS DONE RIGHT
1006 central ave
DUBUQUE, IA, 52001
Te1:563-552-1601 Fax:563-552-2207
Tax ID:26-1404014
Invoice -Preliminary
Estimate Prepared by:
Accident Date:
Date of Loss:
Arrival Date:
Type of Loss:
Policy Number:
Claim Number:
Owner:
Appraised for.
Date: 12/17/2009
Estimate#:
Contact: Anna Paradiso
Address: 563-451-9430
Year Make Model Color Trim
1999 Dodge Neon Highline Sedan
Unit Number License Plate # Mileage Serial#NIN#
1 B3ES47CSXD 125040
Sup Seq Qty Labor Labor Description Part Part List Extended Labor
Type Op Type Number Price Price Units
1 1 Ref Ref Refinish Front Cover Exist 2.1
2 1 Body Repair Cover Assy, Front Exist 1.0#*
Smooth Finish (P)
High Level Trim
3 1 Body Rem/Ins R&I Cover Assy Exist 1.2#
4 1 Ref Ref Refinish Hood Exist 2.3
Outside
5 1 Body Repair Panel, Hood Base, Exist .5
High Level Trim
6 1 Body Align Panel, Hood Base, Exist .5
High Level Trim
7 1 Ref Ref Refmish Fender Exist 1.8
Outside L
8 1 Body Repair Fender L 98-99 Exist .5#
9 1 Ref Ref Refinish Door Exist 2.0
Outside Sedan L
10 1 Body Repair Shell Assy, Door Exist .5
Sedan L
11 1 Ref Ref Refinish Side Exist .4
Moulding L
Version 2.0 P-Page logic not included.
Database Edition CPL 09-11 Page 1 of 3
Sup Seq Qty Labor Labor Description Part Part List Extended Labor
' Type Op Type Number Price Price Units
12 1 Body Repair Moulding, Side Exist •5*
(Adhesive) Jade
Sedan L
13 1 Ref Ref Refinish Door Exist 2.0
Outside L
14 1 Body Repair Shell Assy, Door Exist •5
1999 L
15 1 Ref Ref Refinish Side Exist .4
Moulding L
16 1 Body Repair Moulding, Side Exist •5
(Adhesive) Alpine
Green L 98-99
17 1 Ref Ref Refinish Quarter Exist 1.8
Outside L
18 1 Body Repair Panel, Quarter L Exist 1.01#*
19 1 Body Repair Cover Assy, Rear Exist 1.0*
Smooth Finish (P)
High Level Trim [
reattach Rt side]
20 1 Body Rem/Rep Pinstripe New $15.00 T $15.00 .5*
21 1 Ref Ref Clear coat Exist 2.0*
22 Paint Materials $518.00
* -Judgement Item
# -Labor Note Applies
Labor
Body 8.2 Hrs @ $55.00
Refinish 14.8 Hrs @ $55.00
Labor Total
Parts
$451.00 Parts Subtotal $15.00
$814.00 Less Adjustments
$1,265.00 Parts Total $15.00
Additional Costs and Operations
Addl. Costs/Ops Total $518.00
Taz
Labor Tax @ 7.00% $88.51
Parts Tax @ 7.00% $1.05
Tax Total $89.56
Totals
Sub Total: $1,887.56
Customer Resp. $0.00
Net Total $1,887.56
1999 Dodge Neon Highline
Version 2.0 P-Page logic not included.
Database Edition CPL 09-11 Page 2 of 3