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Claim by Enterprise Car RentalMasterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL DATE: May 28, 2010 MEMORANDUM To: Mayor Roy D. Buol and Members of the City Council RE: Claim Against the City of Dubuque by Enterprise Claimant Enterprise Date of Claim Date of Loss Nature of Claim 05/2710 01/13/10 Vehicle Damage This is a claim in which claimant alleges that a City of Dubuque refuse truck struck claimant's vehicle which was parked in the 1500 block of Montrose Terrace. 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 Paul Schultz, Resource Management Coordinator Tracey Westbrooks, Enterprise 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 W. 13 St., Dubuque, IA 52001. It will then be referred by the City Council to the appropriate department for investigation. 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: .‘rY 2. Address: F AX 1 - 1 JG c 3. Telephone Number: "11C 8 ris 4. Date of Incident: 5. Time of Incident: 6. Location of Incident (Be specific): 1 SCE'.'' ICC. -K Pi `10 3E. \ P a- 4 (E 7. DESCRIBE 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.) s -D2,0 c.k V . 8. What were weather conditions like? uy\V-v1x 111 9. Give name and address of any witnesses: 14 \ F' 10. Did police investigate? (If so, give names of officers.) V'- - c. F .. `'`\x" ' Lv t \ V' `f 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). Ok - 3\\D 3ci Pan ∎97 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.) Jc-c\r-- '(< viva ciN °Q. k r\ tC) ( fol EC 13. What other damages do you claim, if any? -_ _- a.4r L ,, ,- ( Imo s 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.) j \) 15. What amount do you claim from the City of Dubuque? 16 Why do you c aim the City of Dubuque is res onsible? bEe At) se _ (Dt y 2 k t ( \`SU (eC' 17. Have you made any claim against anyone else for damages as a result of this incident? (If ye, 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 at Dubuque, Iowa this 1 day of &Ek.,tic,a ,-e, 7 6- '( �C a \I\r ES-1- .6(aLic k,S (Rev. 1/00 & 7/01) ni7 , 20 10. (Signature) (Print Name) CD � J m -0 a 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.) ES ) ` le i' n'r Cs-E (`e ct V \ o CY t( �-nJ citcoV ,cb,nQA ..20\0 Poia(- 13. What other damages do you claim, if any? 5- G o c) tC S 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.) 0 15. What amount do you claim from the City of Dubuque? 16 Why do you claim the City of Dubuque is res onsible? 6 r�� GJh ( ----11()( 1< c , I I 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes,3ive 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 at Dubuque, Iowa this I day of \ , 20 10. .c7r )6'7 (9-20 t Y 1 V\) E S-T as2t,o )L.S (Rev. 1/00 & 7/01) (Signature) (Print Name) Q O 0- N 0 C x "' rn cn MP "...- 0 3C 0 0 W w nterprise PO B()X 842442 Dallas, TX 75284 -2442 A1TN: DAMAGE RECOVERY UNIT Carrier: Attention: Re: Enterprise Claim Number: DX6246E54 Your Insured: DAVID CASTRO Your Claim Number: Date of Loss: 01 /13/10 Amount Due: $1242.62 Dear Sir /Madam: CITY CLERK OFFC 50 W 13TH STREET DUBUQUE, IA 52001 JEANNE SCHNEIDER,CITY CLERK May 14, 2010 Our investigation indicates that your insured is responsible for the damages to our vehicle. Please find the enclosed documentation to support our damages as a result of the above captioned loss. Please be aware that any parts and /or labor discounts afforded to Enterprise Rent -A -Car have been passed on to you. If you are in agreement with our position, please remit payment in full to the address above referencing our claim number on your draft. If you would like to discuss this matter further, please contact us at the number below. Respectfully, Tracey Westbrooks Recovery Specialist TRACEY.C.WESTBROOKS(a_ )EHI.COM Damage Recovery Unit DIRECT: 970 - 226 -8378 TOLL FREE: 866 - 300 -3238 FAX: 888 - 874 -8937 Image Motorsportz (Admin Data Owner Insured * JJ7T27 Address Address Home Phone Home Phone 111- 111 -1111 Work Phone Work Phone Insurance Company Adjuster Enterprise Adjuster Address Phone Email Phone Inspection Location Fax Address Phone Fax Repair Facility Estimator Information Repair Facility Name Image Motorsportz Estimator TOM PORTZ Address 3250 Portz Drive Office Bettendorf, IA 52722 Address Phone Fax Email Federal Tax ID Phone State Fax BAR Estimate Information Claim Information File ID 1623 Sup No. 0 Claim # DX6246E54 Policy Number Platform M UM7.0 Transmit Date 1/22/2010 Deductible $0.00 Deductible Paid Unknown Loss Assignment Date 1/22/2010 Inspection Date Loss Type (Vehicle Data I Year 08 Make Chevrolet Model Aveo 5 BodyStyle 4D HB Color VIN KL1TD66628B094633 Engine Type Car Odometer 36564 Production Date Primary Point Of Impactl4 License Secondary Point Of Impactl4 License State 'Line Items Line Operation Description Price QTY Labor Paint Lbr TTL Other 1 Repair L Quarter Outer Panel 4* B $100.00 2 Refinish L Quarter Panel Outside 2 R $50.00 3 Remove /Install L Rear Combination Lamp 0.3 B $7.50 4 Remove /Replace L Rear Marker Lamp Assembly $64.30 1 5 Blank Line Discount %25.00 6 Overhaul Rear Bumper Cover Assy 1.8 B $45.00 7 Remove /Replace Rear Bumper Cover Assy $497.59 1 8 Refinish Rear Bumper Cover 2.5 R $62.50 9 Blank Line Discount %25.00 10 Additional Operations Clear Coat 1.3 R $32.50 11 Additional Operations Restore Corrosion Protection $3.00* 1 0.2* B $5.00 12 Additional Operations Finish Sand And Buff 1* R $25.00 DisplayEstimate r 7 https: / /www.getclaim.com/ claim / displayestimate .aspx ?eeid= 30010244&cid =8812 Page 1of2 2/8/2010 13 Additional Operations Mask For Overspray 14 Additional Costs Paint/Materials 15 Additional Costs Shop Materials 16 Additional Costs Hazardous Waste Disposal $116.00` 1 $4.00* 1 $5.00* 1 1* R $25.00 Totals 'Parts 'Part IISub Total 11Adj % IIAdj $ II Total' 1New Parts 118561.89 11 -25.00 % 11(8140.48) 11 $421.411 1Parts Total II $421.411 'Labor I 'Type 11AdditionalLabor liRate I Hours I R•H II Sub Total' 'Body 1180.00 1825.00 16.3 1 $157.50 11 $157.501 1Paint 1180.00 1825.00 1 7.8 18195.00 11 $195.001 'Labor Total II $352.501 I I 'Materials 'Paint Materials 1 $116.00 'Shop Materials 1 $4.00 'Hazardous Wastes 1 $5.00 'Materials Total 11 $125.00 I 'Miscellaneous 'Other 11 $3.00 'Miscellaneous Total II $3.00 I 'Adjustments 'Deductible 11 $0.00 'Sales Tax 11 $55.02 1Orig Total 11 $956.93 'Final Total II $956.93 • DisplayEstimate 7 ry? 7 Page 2 of 2 https: / /www.getclaim.com/ claim /displayestimate.aspx ?eeid= 30010244&cid =8812 2/8/2010 Print EMS Estimate and Images Page 1 of 1 https: / /www.getclaim.com/ claim /PrintEMSDoc .aspx ?eid = &cid= &roid= 4878507 &imids =74... 2/8/2010 - enterprise 1UEI LEP I' I•h,;;;,11 i I. 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