Claim by State Farm Insurance_PizzimentiTHE CITY OF
DUI1 t LJE MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
4
To: Mayor Roy D. Buol and
Members of the City Council
DATE: March 30, 2010
RE: Claim Against the City of Dubuque by State Farm Insurance, subrogating
for Marco Pizzimenti
Claimant Date of Claim Date of Loss Nature of Claim
State Farm Insurance 03/12/10 01/23/10 Personal Injury/
Vehicle Damage
This is a claim in which claimant alleges that its insured's vehicle was involved in an
accident at the intersection of Central Avenue and 5 Street. At the time of this
accident, the stop lights were non - functioning and a portable stop sign was temporarily
being used on 5 Street, but was obscured from view due to a parked 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
Mark Dalsing, Chief of Police
State Farm Insurance
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 13` 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: �et. e fares h sur4n C d
2. Address:
Po Igo x 1 3J0‘ L:`n g.o /.7 , -/l/E (50/
3. Telephone Number: ++ / S - 94 , ‘ .Z-
4. Date of Incident: I O3 —/Q
5. Time of Incident: 7 ( V7 4z/
6. Location of Incident (Be specific): C e ri Y a / v C g
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 e employee's name.)
5 e . 1° ol,�"et chi -e give
po. a
8. What were weather conditions like? /1 a k rr i, /
9. Give name and address of any witnesses: 5 e-e- rki
10. Did police investigate? (If so, give names of officers.)
e
11. Was anyone injured? (If so, give names, addresses, and extent of injuries.)
ye- � , / lf ► c.e r 546N e r /
Ao iIlc j�✓ur ?t Lrr!i kP "Ailed/
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.)
5b; Chev Ue n d-u r e
clod l l'py o)'q /?A. if
F n 41 oa m.41e 4 mbai.✓►.t
13. What other damages do you claim, if any?
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.)
'Vq
15. What amount do you claim from the City of Dubuque? /ob Po V etli
16. Why do you claim the City of Dubuque is responsible? 5 / dP 5 I (f
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 Jo)" day of Mar c/1
,It&
(Signature)
R D n X./ e ;
(Print Name)
SJ'a e_ Farms
,20
Imo` 35o 5
LIARS
5103
L
0
C
A
T
O
N
N
T
001
MAIL REPORTS TO:
Owe a of e Dr S r i Transportation
Office a Driver Services /p
P.O. Box 92
04
Moines, , I owa 50300.9204
Data of Accident
0112312010
Time of Accident
09:47 Firs.
If accident occurred outside of city limits
0iOw penal vicinity "NIA"
of nearest city "WA"
On Road, Street, ix Highway,
CENTRAL AVE
Nat Unless accident occurred a1 en intersection which Is completely described above, use the space below to give the exact
location from a milepost or definable intersection, bridge, r railroad crossing, using Iwo distances and directions if necessary.
Distance
"N/A"
Oiedbn
"WA"
Distance
end "WA"
Direction
"WA"
of
Milepost Nicobar Womble YYerssctbrt bridge, or railroad crossing
"NIA" Or "NIA"
e•s■a11111er
Drivers Name - Last
RIVARO
Address 8
4 6 ELM AVE
City
WINDSOR
State
ON
210
N9A6H-3
Sues
ON
Class bbasem RestRestrictions la
G INONE NONE
Tat Results:
THE RESA
Dug Test
Given?
1 - Nora
Tel Results:
Seating Posilbn01 I Y4uy Stet= 5 I Ocapw8 Prat.Gim2 'Airbag Deployment 5 I Airbag bath SAWS 3 Ejection 1 Election Path 1 I Trapped 1
'Transported lo:
I I Ttn>t�b by
Owners Name • Lest
PIZZIMENTI
I MARCO
I ANTHONY
Address
6 JENSEN CT
nwee E FARM Name
V01 No. Yew
1060X030210220241 I 2001
title! Travel
l
Vehicle
Direction 4 Action 01 L 1 26
Iowa Department of Transportation
INVESTIGATING OFFICERS REPORT OF
MOTOR VEHICLE ACCIDENT
County
Dubuque - 31
Accident occurred within corporate (mils slab)
Dubuque - 2100
Al intersection wet
5TH ST
MWdlis
MARIE
Citation Charge Cadet
321.322
Citation Chwgs Code 2
Citation Charlie Coda 3
Citation Charge Cod 4
Citation Charge 1
STOP SIGN VIOLATION
Citation Charge 2
Cit Ctlrge 3
Carrion Charge 4
6ulrw
IO CITY
I I S A tate f2246
2145341D11150
Mdse
Chevrolet • CHEV
ModN
VEN
Most Dam
Urdenide!
va
OMde 1
Extort of
Point of b111el Area hnp.d 02 �ed 02 I Damage 4
Total Traffic VahVehicle 03 1 X I Defect 01 I Ddvw Vision Vehicle
Doagrss 3 Carob 04 Can11a Type 01 Condition 1 ( Obscured 07
Carrier Nwns
US DOTI or MC IA
Number of
Ands
Dross Vehicle
Weight Rating
I Retard 8
Cevr Eryacement Casa Number
01 -10 -3256
Lego Finale
lreerventOMO Property?
Location Literal Description
W 5TH ST and CENTRAL AVE
XCoordinela 00891968
YCoardnete: 04707629
5 IM MO Highway. Provide Routs
(Canaria) Travel Otwlbn
"WA"
SLOP Horne/Cell Phone
(5191 251.1505 X
Chimer Company Name
License Plate A Slate Year
41SJJA I IA I 2010
Tow e
YES
Private? ❑
Commercial Traier ASac ad
License Plata 5 Poser Unit
Stele Year ARaUad lo
Trailer Link
Stele Year I Emergency
Vehicle Type 1
Apprwdmre Cost to
Repair or Replace
84,000.00
Contributing tUrc msances,
Oriver(up to two) 02
SEQUENCE OF EVENTS I First Event 21 Second Event
Third Evert
Farah Evert Map Hrmkt Event (by velicte) 21
Emergency
Status 3
City
Stste Dv
tazardts Materiels
Released?
V
N
002
Drivers Name - Last
KENNEDY
First
NICOLE
Midis
AMBER
Sullbr HanelCa6 Phone
(910) 3(11 -7474 x
Address
2905 JACKSON ST
City
DUBUQUE
State
IA
Lp
62001.0000
Sled
IA
Case
C
Test Results:
Vet No. I Year
JTEHH2OVIICO2$223 2001
dorsem Restrictions
NONE NONE
Drag GYRO Give TIP
1 - None
Ted Rams.
Sealing Position 01 Hurt Status 4 Occupant ProleclIon2
Traapoasd a
Mime
2905 JACKSON 5T
Insurance Co. Name
UNITED SERVICES AUTO
o M
US DOTC
I Number a
Axles
Citation Charge Cale 1
CtMrm Charge Cod 2
Citation Charge Cod 3
Citation Charge Code 4
Citation Charge 1
Citation 2
Citation Charge 3
Clutron Charge 4
Airbag Deployment Airbag Switch Status 3 Eledion 1 I flotilla' flotilla' Path 1
Transported by
°wises Name - Last
KENNEDY
ANT HONY
I GI ED ON
I
I Owner Company Name
city DUBUQUE
I I A s 1 62001
Insurance Porky e
01872 7617U
Make
Toyota • TOYT
Model
RAV4
151ate
4005
Mal l Travel 1 Vehicle Speed Paint a M ost Damaged Extent d Underrate'
Direction 3 Action 01 roped 25 I tares tnknow 0, Area 01 I Damage 4 Override 1
Taal Traffic Vehicle I Cargo Body I Vehicle 1 Draw
Ono/pants 2 Controls 01
U so
Con lip. 04 Type 01 Defect 01 Condition 1
SEQUENCE OF EVENTS I First Event 21 Second Event
Third Event
Fourth Event Most Hermk4 Event (by vehicle) 21
Commercial Troika Attached b
License Plate a Pow Unit
Sate Year Attached to
Trailer LMT
State Year I Emergency
Vehicle Type 1
Carrier Name
City State
2"0
Gross Vehicle
Weight Rettig
VWert
Obsaxed 01
I Placard
U. keno Plate
761SLC
Tow
YES
Private? ❑
Trapped 1
Sure 1 Yew
IA 2010
Approximate Cod to
Repair or Replace
51,00010
Contnbutirg atarncss
Driver (up two) 26
Hazardous Materiels
Released?
Emergency
Stec 3
Printed At Dubuque Ponce Department 011241201011:13 AM
Page 1
Forma: 01.10.268
ACCIDENT ENVIRONMENT
Location ol Fke1 Harmful Event 1 Weather Cenadons
Manner of CredYCo/sion S Ito to taro) 03
UV Conditions 1 Suisse Conditions 2
ROADYJAYCHARACTERISTICS
Mates Cofltbulhg Cira+mstances:
Environment 1
Rosoway 08
Type of Roadway AaxyionfFesere 11
WORKZONERELATED/
No
Location
Type
Workers Present?
SEQUENCE OF EVENTS
Fist Harmful Event cf Cram
(use codes 1142 only) 21
5TH ST
jV1
2
LEGALLYIARKED
VENICIE
CENTRAL AVE
,'
1
NARRATIVE
Owns what happened (rata to vehicles by munber)
UNIT #2 WAS SIB ON CENTRAL AVE AT THE INTERSECTION WITH 5TH ST. UNIT #1 WAS WB ON 5TH ST AT THE
INTERSECTION WITH CENTRAL AVE. DRIVER OF UNIT #1 DID NOT SEE THE STOP SIGN AND ENTERED THE
INTERSECTION WITHOUT STOPPING AND STRUCK UNIT #2 BROADSIDE.
THIS INTERSECTION IS NORMALLY A 4 -WAY STOP CONTROLED BY STOP LIGHTS IN ALL DIRECTIONS, THE STOP
LIGHTS WERE NON- FUNCTIONING AT THIS TIME DUE TO BEING REPLACED. BECAUSE OF THESE CIRCUMSTANCES,
THERE WERE PORTABLE STOP SIGNS IN PLACE FOR E/B AND WB TRAFFIC ON 5TH ST BUT NO TRAFFIC CONTROL
DEVICES FOR SIB TRAFFIC ON CENTRAL AVE.
DRIVER OF UNIT #1 STATED THAT SHE DID NOT SEE THE STOP SIGN DUE TO A TRUCK BEING PARKED IN FRONT OF IT
AND BLOCKING IT FROM HER VIEW. R/0 DID OBSERVE THIS AND DETERMINED THAT THE TRUCK WAS LEGALLY
PARKED BUT DID OBSCURE THE STOP SIGN FROM VIEW OF WB TRAFFIC. THE STOP SIGN WAS ALSO PROPERLY
PLACED FACING WB TRAFFIC AND WAS SITTING AGAINST THE CURB LINE. IT APPEARS THAT THE STOP SIGN BEING
OBSCURED WAS MAINLY DUE TO THE SIZE OF THE TRUCK (FULL SIZE TOYOTA TUNDRA) AND THE HEIGTH OF THE
STOP SIGN.
WlesaName - last Fist WM.
8uYu
SANNER JOHN
Address
Ciy 5Iate Zip Cede
3814 CORA
DUBUQUE IA 62001
Horne/Cell Phone 11
Work Phone •
(563) 543 x
Officer
Badge No.
Time Maw Notified of Accident Time Weer Arrived AI Scans
HOERNER JASON
51
08;47 Hre 09:50 We.
Name of Agency
Otte of Report
knahgetion
T.I.1
Dubuque Pollee a Dope
0112312010
mode et sane? Yee
Report Reviewed By: � s1/ l C #
O
l ipar
Deter ToarIk Investigation Agency
Printed At Dubuque Police Department 01124/201011:13 AM
Page 2 Form it 01-10-3256
State Farm Insurance Companies
March 10, 2010
City Of Dubuque -City Clerk
City Hall 50 West 13th St
Dubuque, IA 52001
RE:
Claim Number: 15- 3504 -580
Date of Loss: January 23, 2010
Our Insured: Marco Pizzimenti
Dear City Clerk /Claims:
Enclosed is a claim form against the city of Dubuque and
a corresponding police report. A temporary stop sign
was placed at the intersection of Central Avenue and
5th Street, however the sign was not visible due to a
legally parked truck. The city failed to put the sign
where it was visible in the intersection or block off
the parking spot the truck occupied so the sign could be
seen.
At this point, we do not know the extent of the claims
but will advise you when we have this information.
Please look into this matter and advise me on your
position of liability.
Thank you for your cooperation in this matter.
Sincerely,
�-d ► l
Ron Klein
Claim Representative
(515) 223 -9162
Toll Free: 1- 800 - 658 -3731 Ext: 2239162
State Farm Mutual Automobile Insurance Company
HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001
State Farm Insurance
PO Box 83106
Lincoln, NE 68501 -3106
Phone: (800) 658 -3731
Fax: (800) 423 0474