The URL can be used to link to this page

Claim by Edward J. EhrlichTHE CITY OF DUB TE MEMORANDUM Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL oP To: Mayor Roy D. Buol and Members of the City Council DATE: August 6, 2010 RE: Claim Against the City of Dubuque by Edward J. Ehrlich Claimant Date of Claim Date of Loss Nature of Claim Edward J. Ehrlich 08/05/10 07/19/10 Vehicle Damage This is a claim in which claimant alleges that his vehicle was damaged after being struck by a rock which was thrown from a lawn mower being operated by a City employee on North Grandview Avenue near Aspen Drive. 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 Marie Ware, Leisure Services Manager Edward J. Ehrlich 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 i")/ �,/ • CLAIM AGAINST THE CITY OF DUBUQUE, IOWA ( 1 / 1 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: E. -w R a - � . t fi ( ' c H 2. Address: 3o o ± 6. Location of Incident (Be specific): 6 N 6- /✓6 A ,e /Ts Pty✓ D G J / v c - l ;€ s T 3. Telephone Number 56 3 -- S ? 3 - d 3 - 7 4 4. Date of Incident: - 7 - i 9 - moo' C' 5. Time of Incident: f /.00 /4A1 8. What were weather conditions like? &Goa p y 9. Give name and address of any witnesses: Nr y J/LAI /�E C /r,ec. /c_N >R. 10. Did police investigate? (If so, give names of officers.) A/o k At! ''A.i.g,t/ , 4 o_ , u Ase Ai P 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.) 4 e cr - Y Lc:_mP ' g ec,7-T /A)6 6;4 A Lv.vv THE K co) 11.' 6/1A) DLil (4 1 /7 4- 12 /0/Nf L✓et//'7 1 -1/ 4s 7 Die y Tf/� L. g ivNAi TAJ cr7 /9 /Pock S / k/.0c- 7 /(t. GNT s//,/_", e% /+/t/ a ' 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). N0 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.) M y vg-y e c 0 (-1 1 s - Fn/TIe f 4.1E- 13. What other damages do you claim, if any? 4)' A/- 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? 7 16. Why do you claim the City of Dubuque is responsible? £. G ne4S -7/it DA 4-7.96 E /PCsNL -Teo /Rd:'-i 72 , .4 C ? le,,.JS 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) c) 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? 0 0 Dated this S day of 4u 6. i.s , 20 0 C:7"< c ci Ems,..- a - c' m saz' 0 (Signature) @ n. TI 3_ m ...z.)1._41.1 RU �Hrc G/�/ D =743 9 0 (Print Name) x' RICHARDSON MOTORS 1475 J.F.K. ROAD DUBUQUE, IA 52002 PHONE: (563) 582 -5411 FAX: (563) 582 -4129 FEDERAL ID: 42 -0813744 *** PRELIMINARY ESTIMATE*** Owner Inspection Repairer Vehicle 2000 Oldsmobile Intrigue GLS 4 DR Sedan 6cyl Gasoline 3.5 4 Speed Automatic Options Air Conditioning Automatic Dimming Mirror Compact Disc W/Tape Dual Airbags Heated Front Seats Keyless Entry System Lighted Entry System Power Steering Rem Trunk -UGate Release Tachometer Damages 3 N 08/03/2010 10:46 AM Owner: ED ehrlich Address: 3005 oak crest City State Zip: Dubuque, IA 52001 Inspection Date: 08/03/2010 10:24 AM Appraiser Name: Jason Charley Address: Repairer: Richardsonmotors Address: 1475 JFK RD City State Zip: Dubuque, IA 52002 Email: jcharley ©richardsonmotors.com Lic Expire: Veh Insp# : Condition: Ext. Refinish: Two-Stage Line Op Guide MC Description 1 I 288 Door Shell,Rear RT 2 L 288 # Door Shell,Rear RT # =10,13 » paint below mid Corrosion Protection Aluminum/Alloy Wheels Center Console Cruise Control Dual Power Seats Heated Power Mirrors Leather Seats Power Brakes Power Windows Split Folding Rear Seat Tilt Steering Wheel MFR.Part No. Repair Refinish 1.0 Surface 0.6 Two -stage setup 0.4 Two-stage Additional Labor Work/Day: (563)583-0378 FAX: Inspection Type: Appraiser License # Work/Day: (563)582 -5411 Price $8.00* Contact: Jason Charley Work/Day: (563)582 -5411 Work/Day: VIN: 1 G3WX52H9YF318567 Mileage Type: Actual Code: V3303C Int. Refinish: Two -Stage Anti -lock Brakes Climate Control For A/C Digital Clock Fog Lights Intermittent Wipers Leather Steering Wheel Power Door Locks Rear Window Defroster Strg Wheel Radio Control Traction Control System ADJ% B% 08/03/2010 10:24 AM Hours R 1.0* SM 2.0* RF 0.2* SM Page 1 of 2 2000 Oldsmobile Intrigue GLS 4 DR Sedan Claim # : 4 N 4 Items Estimate Total & Entries Other Parts Paint Materials Parts & Material Total Tax On Parts Only Labor Sheet Metal (SM) Mech /Elec (ME) Frame (FR) Refinish (RF) Paint Materials Labor Total Tax on Labor Gross Total Net Total Op Codes * = User - Entered Value EC = Replace Economy ET = Partial Replace Labor TE = Partial Replace Price L = Refinish TT = Two -Tone BR = Blend Refinish CG= Chipguard AA = Appearance Allowance 08/03/2010 10:46 AM MC Cover Car Exterior Additional Labor $6.00* Message 10 INCLUDES AUDATEX TIME TO CLEAR ENTIRE PANEL 13 INCLUDES 0.6 HOURS FIRST PANEL TWO -STAGE ALLOWANCE $55.00 $64.00 $59.00 $55.00 $35.00 Q 7.000% Rate Replace Hrs Repair Hrs Total Hrs 1.4 1.4 2.0 2.0 7.000% Alternate Parts Y /00 /00 /00 /00 /00 CUM 00 /00 /00 /00 /00 Zip Code: 52002 Default E = Replace OEM OE= Replace PXN OE Srpls EP = Replace PXN PM= Replace PXN Reman /Rebit PC = Replace PXN Reconditioned SB = Sublet Repair I = Repair RI = R & I Assembly RP = Related Prior Damage 3.4 Hours $77.00 $110.00 $14.00 $70.00 Audatex Estimating 6.0.353 ES 08/03/2010 10:46 AM REL 6.0.353 DT 07/01/2010 DB 08/01/2010 Copyright (C) 2009 Audatex North America, Inc. 1.0 HRS WERE ADDED TO THIS ESTIMATE BASED ON AUDATEX'S TWO -STAGE REFINISH FORMULA. $187.00 $13.09 $285.07 $285.07 $84.00 $0.98 NG = Replace NAGS UE = Replace OE Surplus EU = Replace Recycled UM= Replace Reman/Rebuilt UC = Replace Reconditioned N = Additional Labor IT = Partial Repair P = Check 08 3/2010 1 0:24 AM 0.2* SM Audatex This report contains proprietary information of Audatex and may not be disclosed to any third party (other than the insured, claimant and others on a need to know basis in order to effectuate the claims process) without Audatex's prior written consent. Copyright (C) 2009 Audatex North America, Inc. Audatex Estimating is a trademark of Audatex North America, Inc. Page 2 oft R iChardSoh Buick Cadillac GMC Truck Honda Business 563 - 582 -5411 Toll Free 888 - 806 -5411 Fax 563 -582 -4129 Jason Charley DuPont PE RFORMANCE ALLIANCE Drop off. Relax. Pickup. Body Shop Manager Body Shop Hours: 8 a.m. - 5 p.m. Mon. -Fri 1475 John F. Kennedy Rd. Dubuque, Iowa 52002 jcharley@richardsonmotors.com