Claim by Gregory DoserMasterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
MEMORANDUM
ilAJ\
To: Mayor Roy D. Buol and
Members of the City Council
DATE: October 4, 2010
RE: Claim Against the City of Dubuque by Gregory Doser
Claimant Date of Claim Date of Loss Nature of Claim
Gregory Doser 10/01/10 09/28/10 Vehicle Damage
This is a claim in which claimant alleges that a City police squad car struck claimant's
vehicle which was legally parked in front of 1799 Clarke 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
Mark Dalsing, Chief of Police
Gregory Doser
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: C a - / ? 6 ( ' / v
2. Address: / 9'9 �2._/4/4/- 0z .D aid9&,/
3. Telephone Number :/a - 6 - 363L/
4. Date of Incident: 9/a 2/1O
5. Time of Incident: 0- : 3 7 f ,
6. Location of Incident (Be specific :
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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.)
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8. What were weather conditions like?
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9. Give name and address of any witnesses:
10. Did police investigate? (If so, 9ive names of officers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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.)
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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.)
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15. What amount do you claim from the City of Dubuque?
16. Why do you claim the City of Dubuque is responsible?
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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 .3C day of Jto 7 - Et'/3r:'
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(Signature)
(Print Name)
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YAGER AUTO BODY INC
4488 DODGE ST
DUBUQUE, IA 52003 -2600
PHN: 563 557 7376 FAX: 563 557 1709
*** PRELIMINARY ESTIMATE ***
Owner
Inspection
Repairer
Vehicle
1998 Ford Explorer Eddie Bauer 4 DR Wagon
8cyl Gasoline 5.0
5 Speed Automatic
Damages
Line Op
Totals
Parts
Paint Materials
Body Labor
Refinish Labor
Sublet Repairs
Tax
Estimate Total
Insurance Pay:
09/28/2010 02:34 PM
Owner: GREG DOSER
Address: 1799 CLARKE DR.
City State Zip: Dubuque, IA 52001
Inspection Date: 09/28/2010 02:26 PM
Driveable: Yes
Appraiser Name: CJ YAGER
Lic.Plate: 407 NMH
Mileage: 122,000
Ext. Color: MAROON
Ext. Refinish: Two -Stage
1 Replace OEM Stripe Assembly LT
2 Replace Recycled Panel,Quarter LT
3 Refinish Panel,Quarter LT
4 R & I Assembly Door,Fuel Filler LT
5 Sublet Repair Glass,Quarter Tinted LT
6 Replace Recycled Flare,Wheel Opening LT
7 Refinish Flare,Wheel Opening LT
8 Replace Recycled Taillamp Assembly LT
9 Replace Recycled Bumper Assembly,Rear
10 Repair LT REAR DOOR FLARE
11 Refinish LT REAR DOOR FLARE
11 Items
Description
Cell: (563)543 -3034
FAX:
Rental Assisted:
Repairer YAGER AUTO BODY Contact: YAGER AUTO BODY
Address: 4488 DODGE ST Work/Day: (563)557 -7376
City State Zip: Dubuque, IA 52003 Work/Day:
Email: bodyshop @yagerauto.com
VIN: 1 FMZU35P6WZA53515
Mileage Type: Actual
Int. Color:
Int. Refinish: Two -Stage
ADJ% B% Price Labor
+25.00
+25.00
+25.00
+25.00
$868.25
$208.00
$905.00
$325.00
$90.00
$153.18
$2,549.43
$2,549.43
$80.75
$275.00
09/28/2010 02:26 PM
$35.00
$845.00
$245.00
INC
$90.00
$75.00 INC
$30.00
$30.00 INC
$250.00 INC
$25.00
$50.00
Page 1 of 2
-
Damage Assessed By: Robert Hanley
Deductible: UNKNOWN
Owner: Greg Doser
Address: 1799 Clarke Drive, Dubuque, IA 52001
Telephone: Home Phone: (563) 543 -4256
Description:
Body Style:
VIN:
Mileage:
OEM /ALT:
Color:
Options:
Line Entry Labor
Item Number Type Operation
1998 Ford Explorer Eddie Bauer Vehicle Production Date: 11/97
4D Ut 112" WB Drive Train: 5.0L Inj 8 Cyl AWD
1FMZU35P6WZA53515 License: 407 NMH IA
122,199
0 Search Code: None
Red / Silver
VEHICLE ANTI - THEFT, PASSENGER AIRBAG, DRIVER SIDE AIRBAG, POWER DRIVER SEAT
POWER LOCK, POWER WINDOW, POWER STEERING, REAR WINDOW DEFOGGER
MANUAL AIR CONDITION, CRUISE CONTROL, TILT STEERING COLUMN, ANTI -LOCK BRAKE SYS.
ALUM /ALLOY WHEELS, LEATHER STEERING WHEEL, V8 ENGINE, CD PLAYER
POWER ADJUSTABLE EXTERIOR MIRROR, 4WD OR AWD, TINTED GLASS, TRIP COMPUTER
FIRST ROW BUCKET SEAT, SECOND ROW BENCH SEAT
REAR HEATING, VENTILATION & AIR CONDITIONING, CLOTH SEAT, TACHOMETER
1 400185 BDY REMOVE/REPLACE
2 AUTO REF REFINISH
3 AUTO REF REFINISH
4 400206 BDY REMOVE/REPLACE
5
6 800154 BDY REMOVE/REPLACE
7 801054 BDY REMOVE/REPLACE
8 AUTO REF REFINISH
9 804449 GLS REMOVE /INSTALL
10 AUTO BDY OVERHAUL
11 803729 BDY REMOVE /REPLACE
12 AUTO REF ADD'L OPR
13 AUTO ADD'L COST
14 AUTO ADD'L COST
Hanley Auto Body Inc.
1030 Century Circle, Dubuque, IA 52002
(563) 583-7220
Fax: (563) 583 -8355
Mitchell Service: 918622
Line Item
Description
L Replace Quarter Panel
L Quarter Panel
L Add For Edges & Pillar
L Replace Tail Lamp
* ** END OF ATG SECTION * **
Stripe Tape Liftgate
L Quarter Wheel Opening MIdg
L Quarter Wheel Opening Mldg
L Quarter Glass
Rear Bumper Assy
Rear Bumper Face Bar
Clear Coat
Paint/Materials
Hazardous Waste Disposal
* - Judgment Item
# - Labor Note Applies
d - Discontinued by the Manufacturer
C - Included in Clear Coat Calc
r - CEG R &R Time Used For This Labor Operation
ESTIMATE RECALL NUMBER: 09/30/2010 08:18:36 36
Mitchell Data Version: OEM: SEP_10_V UltraMate is a Trademark of Mitchell International
Copyright (C) 1994 - 2010 Mitchell International
UltraMate Version: 7.0.223 All Rights Reserved
Date: 9/30/2010 08:18 AM
Estimate ID: 36
Estimate Version: 0
Preliminary
Profile ID: Hanley
Cell Phone: (563) 543 -3034
Part Type/
Part Number
Qual Recycled Part
Qual Recycled Part
F5TZ 7842604 BJ
Qual Recycled Part
Qual Recycled Part
Dollar Labor
Amount Units
250.00 * 17.0*
C 3.5
C 1.0
25.00 * 0.2
d75.73 0.2
75.00 * 0.5 r
C 1.0
2.6 #
1.5
250.00 * INC
2.0
225.00 *
5.00 *
Page 1 of 2
Estimate Totals
Add'I
Labor Sublet
I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount
Body 19.4 48.00 0.00 0.00 931.20 T Taxable Parts 675.73
Refinish 7.5 48.00 0.00 0.00 360.00 T Sales Tax @ 7.000% 47.30
Glass 2.6 48.00 0.00 0.00 124.80 T
Total Replacement Parts Amount 723.03
Taxable Labor 1,416.00
Labor Tax @ 7.000 % 99.12
Labor Summary 29.5 1,515.12
111. Additional Costs Amount IV. Adjustments Amount
Taxable Costs 5.00 Customer Responsibility 0.00
Sales Tax @ 7.000% 0.35
Non - Taxable Costs 225.00
Total Additional Costs 230.35
Paint Material Method: Rates
Init Rate = 30.00 , Init Max Hours = 99.9, Addl Rate = 0.00
I. Total Labor: 1,515.12
II. Total Replacement Parts: 723.03
III. Total Additional Costs: 230.35
Gross Total: 2,468.50
IV. Total Adjustments: 0.00
Net Total: 2,468.50
This is a preliminary estimate.
Additional changes to the estimate may be required for the actual repair.
ESTIMATE RECALL NUMBER: 09/30/2010 08:18:36 36
Mitchell Data Version: OEM: SEP_10_V UltraMate is a Trademark of Mitchell International
Copyright (C) 1994 - 2010 Mitchell International
UltraMate Version: 7.0.223 All Rights Reserved
Date: 9/30/2010 08:18 AM
Estimate ID: 36
Estimate Version: 0
Preliminary
Profile ID: Hanley
Page 2 of 2
u
Driver's Name - Last I First TMiddle
DEUTSCH BRUCE I I WILLIAM
Suffx
N
I
T
001
rAddress .ity
770 IOWA STREET DUBUQUE
State
IA
Z'p 7 Home CE.: ! Dr,_: ,
52002 1 (563) 588.4410 x
Gender
Male
1
Class
C
State
IA
Endorsements
NONE
Restrictions
NONE
Insurance Co. Name Insurance : o Pnc :.
.n.
CITY OF DUBUQUE (563) 589.4120 x
Insurance Policy #
Owner Company Name
Owner's Name - Last
CITY OF DUBUQUE
First
Middle
Suffix
Address
50 EAST 13TH STREET
City
DUBUQUE
State
IA
Zip
52001 -
VIN No.
Year
2009
Make Model i Style T ✓rh • -
1 85468 1 4D I 01
License Plate #
85468
State
IA
Year
19
Most Damaged Area Approximate Cost to Repan c r Rc; .!a
02 - Right Front I $3,000.00
u
N
I
T
002
Driver's Name - Last
DOSER
First
JACQUELINE
Middle
ANN
Suffix
Address
1799 CLARKE DRIVE
City
DUBUQUE
State
IA
Z'p
52001
I Home'Cel' ?h ,,
(563) 543 4:56 x
Gender
Female
Class
C
State
IA
Endorsements
NONE
Restrictions
NONE
Insurance Co. Name Insure ice �, Ph-_. 4
ALLIED (563) 556 x
Owner Company Name
Insurance Policy #
PPGM00171497348
Owner's Name - Last
DOSER
First I Middle
JACQUELINE IANN
Suffix
Address
1799 CLARKE DRIVE
City
DUBUQUE
State
IA
Zip
52001 -
VIN No.
1FMZU35P6WZA53515
Year I
1998 I
Make
FORD
Model
EXPLORER
Style \fen _ !a "
LL i 04
License Plate #
407NMH
State
IA
Year
2011
Most Damaged Area
05 - Rear
Approximate Cost to Repe r , i kr_I, -
$2,000.00
County
Dubuque - 31
Accident occurred within corporate limits of (city)
Dubuque - 2100
Literal Description
CLARKE DR
X Coordinate
00689337
Y Coordinate
04708470
If accident occurred outside of city
limits show general vacinity: "N /A"
Direction
"N /A" of
Nearest City
"N /A"
Route (Cardi••e
Travel Direction We
On Road, Street, or Highway:
CLARKE DR
At Intersection with:
WEST LOCUST
Distance
"N /A"
'Direction I Distance
N /A" and " NIA "
Direction
"N /A' of
Milepost Number
"N /A" Or
Definable intersection, bridge, or railroad crossing
"N /A"
Officer
PAPENTHIEN, ROBERT W
Badge No.
39
Law Enforcement Case Number
01-10-47522
Date of Accident — -
09/28/2010 , 02:37
Driver Information Exchange Report
Dubuque Police Department
563 -589 -4410