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Claim Gross, Christine M.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. 13th 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: Christine M. Gross 2. Address: 1640 Ashton Place 3. Telephone Number: 582 8932 h (589 1078w) 4. Date of Incident: January 19, 2002 5. Time of Incident: 8:50 a.m. 6. Location of Incident (Be specific): at the interesection of Asbury and Cherry 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.) My daughter Sara was drivng (she is 17, so I am filing on her behalf), she was stopped at a stop sign heading west on Cherry. Her vision was obstructed by illegally parked cars on Asbury, so she had to pull out into the intersection to see and was struck by Patrick Hancock, traveling south on Asbury. 8. What were weather conditions like? Clear day 9. Give name and address of any witnesses: 10. Did police investigate? (If so, give names of officers.) Officer Schmeichel 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). Yes, the driver of the otehr vehicle: Patrick Hancock. 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.) There was $2,059 in damage done to our car (see attached estimate) 13. What other damages do you claim, if any? None 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.) No, we had liability insurance but not collission. 15. What amount do you claim from the City of Dubuque? $2,059 16. Why do you claim the City of Dubuque is responsible? the City of Dbq. was negligent in not having the no parking area clearly marked, and for not ticketing/towing illegally parked cars. This caused the view of Sara as on-coming vehicles to be obstructed. 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) No 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 18 day of February , 2002. /s/ Chrstine M. Gross (Signature) (Print Name) (Rev. 1/00 & 7/01) CLAIM AGAINST F 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. 13th 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: 2. Address: 3. Telephone Number: ~(~ ~-- c~ ~ 4. Date of lncident: ~)-P~V~tXt~Ic~.~ Itel ~_.~)~__ 5. Time of Incident: 6. Location of Incident (Be specific): 0~Jc- 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.) 8. What were weather conditions like? 9. Give name and address of any witnesses: 10.~Di~p~olice investigate? (If so, giv.e names of officers.) 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.) 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.) 15. What amount do you claim from the City of Dubuque? ~; c~ ! 0~ 16. Why do you claim the City of Dubuque is responsible? ~ 17, Havad-ybu made any claim against anyone el~e fo~ damages (If yes, give name and address.) as a result of this incident? 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? Dated a~-~Du .b~oque, Iowa this 1 ~ day of ~..~ ~ C~' ~) ~Z ~D ~ (Signature) ~ 0 (Print Name) 2002. (Rev. 1/00 & 7/01) February 18, 2002 Christine M. Gross 1640 Ashton Place Dubuque. IA 52001 563-582-8932 Dear Council Members, This is a request for reimbursement of damages to our car due to an accident that was caused through negligence on the part of the city of Dubuque. My daughter, Sarah C. Gross, was ddving our car at the time. She is 17 yrs. old, so I am filing this claim on her behalf. The accident occurred on January 19, 2002 at 8:50 a.m. It was a very clear day. It happened at the intersection of Asbury and Cherry Streets. Sarah was stopped at a stop sign heading west on Cherry. Her vision waS obstructed by illegally parked cars on her dght at the comer of Asbury and Cherry (the cars were on Asbury), and she had to pull out into the intersection before she could see if any cars were coming, and was hit by a van traveling south on Asbury. T~e ddver of the van was Patrick Hancock. Police were called to the scene, and one of the officers said that the cars parked at the comer of Asbury and Cherry would be ticketed because it is a no parking zone. There is some yellow paint on that curb, but it hard to see, also absent is a no parking sign on that comer. It was through negligence on the part of the city of Dubuque that this acci- dent happened. The area is not clearly marked as a no parking zone through the use of highly visible paint or a no parking sign. Also, the police dept. should have been ticketing cars when they park on that comer. The driver of the other vehicle was taken to t~e hospital with injuries and released. Sarah did not incur any injuries. Fortunately, no one was kill~d in this accident, but cars continue to park on that corner. I have never seen any of them ticketed. It is an extremely dangerous situation that needs to be remedied before someone iS killed. We are requesting $2,059.74 for the damages to our car. Enclosed is the repair estimate and photos of where the cars were parked. Chr'~ine M. Gross Date: 1/31.r02 04:06 PM Estimate ID: 2783 0 Pral~n~nary Profile iD: Mitchell Hanley Auto Body Inc. 1030 Century Circle Dubuque, IA 52002 (~s3) ~3-7220 Fax: (563) 583-8355 Damage Assessed By: Robert Hanley Deductible: UNKNOWN Owner Sarah Gross Address: 1640 Ashton Pi. Telephone: Home Phone: (563) 582-8932 Mitchell Service: Description: 1991 Chevrolet Cavalier VL Body Style: 40 Sed 918490 Drive Train: 2.2L Inj 4 Cyl SM Line Entry Labor Line item part Ty~pe/ Item Numbe; Type Operation Description Part Number Dollar Labor Amount Units I 806820 REF BLEND 2 810420 MCH ALIGN 3 827540 BDY REMOVE/REpLACE 4 AUTO REF REFINISH 5 830300 BDY REMOVE/REPLACE 6 AUTO REF REFINISH 7 AUTO REF REFINISH 5 836470 BDY REMOVE/REPLACE g AUTO REF REFINISH 10 AUTO REF REFINISH 11 839600 REF BLEND 12 847580 BDY REPAIR t3 AUTO REF REFINISH 14 936001 ADDI. COST 15 AUTO REF ADD'L OPR 16 AUTO ADD'L COST 17 AUTO ADD'L COST R FENDER OUTSIDE FRONT SUSPENSION -M R ROCKER PANEL W/HINGE & CTR PLR R LWR ROCKER/HINGE pLR/CTR PLR R FRT DOOR SHELL R FRT DOOR OUTSIDE R FRT ADD FOR JAMBS & INSIDE R REAR DOOR SHELL R REAR DOOR OUTSIDE R REAR ADD FOR JAMBS & INSIDE ROOF PANEL R QUARTER OUTER PANEL R QUARTER PANEL OUTSIDE TOWING CLEAR COAT PAINT/MATERiALS HAZARDOUS WASTE DISPOSAL -S Qual Recycled Prat Qual Recycled Part Qual Recycled Part Existing C 0.5 t.3 100.00 * 0.0'# C 1.6 150.00' 5~5 # c 2.t C 1.0 125.00' 5.5 # C 1.7 C 1.0 C 1.4 3.0'# C 1.7 65.00 * 2.6 347.50 * 5.00 * * - Judgement Item # - Labor Note Applies C - Included in Clear Coat Calc ESTIMATE RECALL NUMBER: 1131/02 16:01:19 2783 UitraMate is a Trademark of Mitchell International Mitchell Data Version: FEB_02_A Copyright (C) 1994 - 2000 Mitchell IntemaUonal 4.7.007 All Rights Resewed Page I of 2 Date: 1/31t02 04:06 PM Estimate ID: 2783 0 Preliminary Profile ID: Mitchell Add'l Labor Sublet Labor Subtotals Units Rate Amount Amount Totals Body 14.0 40.00 0.00 0.00 560.00 T Refinish 13.9 40.00 0.00 0.00 556.00 T Mechanical 1.3 42.00 0.00 0.00 54.60 T Taxable Labor 1,170.60 Labor Tax ~ 6.000 % 70.24 Labor~m~ ~.2 01. Additional Costs Amount Taxable Costa 65.00 Sales Tax ~ 6.000% 3.90 Non-Taxable Costs 352.50 Totsl Additional Costs 421.40 II. Part Replacement Summary Taxable Parts Sales Tax ~ Total Replacement Paris Amount IV. Adjustments Customer ResponsibilK'y I. Total Labor:. II. Total Replacement Parts: III. Total Additional Costs: Gross Total: 6.000% Amount 375,00 22.50 397.50 Amount 0.00 1,240.84 397.50 421.40 2,O59.74 IV. Total Adjustments: Net Total: 0.00 2,059.74 This is a preliminary esflnmte. Additional chanqes to the estimate may be required for the actual repair. ESTIMATE RECALL NUMBER: 1/31/02 16:01:19 2783 UltraMate is a Trade.hark of Mitchell international Mitche0 Data Version: FEB_02_A Copyright (C) 1994 - 2000 Mitchell IhtemaUonal 4.7.007 All Rights Reserved Page 2 of