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Hannig (2) . 1 ' . � � _ �� ���. �� I � . � ��� �� ,����� ��, ��� ���� � �� ���� � � 1 � � __. � � � �U����� ��,���� G� C�G1 � l� �1� ����s � � �'���������� (�{ �S � � � � � � � � � i , �� _s � � NOTICE OF CLAIlI�I �'QRM ta �e Citt� of Saint Paul, lYlinnesota _bli7?PFSt7f(ISKIftSffi181P�{!�(L�$Skttt'StI!(11 "_..dYFI'►�.5!rSOM_..H•koc/tri�NSlI(f71RiQ2.f!lY71FCN:)IRd71IClE.1C7I1f}__,CI717I,CQlISAfOI7ep!'t'St'P.121If01Ji!' � �n:rrail.+g Gek�p nj rl�r rAwiecipxiliry wirGiu 180 cfin5•ir{rer rhe a!lrged lnss or i�rjan•is Jiscu�resd a nn�ire sar�i�rg i11r riipr,pfacr,nrd rirc��ms/rtr.ees zhere��:and�hr aixnu�tr of cn�uyenstrfinn.o�otirer reite}tlemrrr�ed.' { Pks�se rnrnptete tt�is forru fin Its etaEir�y bycl�H}t�pingor printinr roor�answer toeach c�uestion. If[xore sp�are is -�,I neecled,Accach ac#cbi�onaf st�eets. Ple�se note thst�ou�i11 rx�t be ecjnracted bp telephot�e�o ctarii��nsvvers,so provicie as � rut�ch infora�+tfon as[�eeessnry to esplain}our claim.z�1 t�ansoiu;t of compeasatkx�be3aa mqaestec3. You r�f0 rece�ice a ti�titten a�cE:noti�lerl�ecnent once yvur fo�n ts receivec7. The process ca�n tai;e up to ten weeks or ioneer tlepe�x3ing t�n the � � r�ature of your etc�su. 3his form fnn.st be si�netJ,and both p�es corupietad. If sometliing does not ap�ly,ivrlte°NI.4'. SEND Cfllt-�PLETF� FUR11rI �iND OTHER DOCU112ENTS TU: CI'I`Y CLERK, 15 Vt�S'I'KELLOGG BI,VB, 31i3 CITY HALL,SAINT P�LTL, h3N 5�1�2 FirstNarnz ,�-�J�.^. hticfdletr�itial i JLa�tNarne �'�3:�:�: . EIVF� Cot�tpanyorBu�ine�5l�Tamz ` pr i�a�4� �p'�,�Cfi{(��5 � .�rY You an In�ur<irac�Corr3gany'? Yrs N�i li'Ye:_C13Fit1 NtttT1��C� �Or � � ���� r Street A.ddrecc ��(C � . � ,� � Y �.tl.,..,W c `�a Cit} `��,�. t�:?.�\ Stnte q---�t..l Zip t'ode !-�`���=�^ Daytime Phone( `�^1 �ISS�Ccit Phon� '1r51�LI,$����I ZC�Evenine Tele�hone( Z�$��'3 1 c��-`� D<�ce of Accidei�ti Injury or Date Qixov�r�d �� Tii�ie am/pm Pleasz�tate,in d�cail,r►�hat accurrzd{h;spp�nzd);and�vt�y you are suhmitti��g a ciaim,Pl�ase indicace why or haw���u fz tii Ci[y of Saint Ptxat or i�s e�x►ploye ;• e inva r• ct and/or - n,ib F�r ya r�ia�n��es. �; r�e r���� .� v � v� o a � ,�. v� •a : �c ,� � \ < < � � � i 1r t �?4 r _ 'v1 i��.����, Pte�t�ct�eck che box(e�)chat eno�clos,e!)°repre�nt the ret�so�� for coinptetiii�this fi�rm: �A�iy t�ehictw�vcu daa�ecl in an acciJent �h�}° vahicle�vas darmaQed durin�a ra 0 My��ehicfe�sa,dama�ed by a pothc�te of•co�iciicion of the street O h1}� vehicle�vas r3artraQed hy�i plo«� aa ❑ �ti1; F�ehi�te w��i wTOngfutly towed andlor ticketed Q [«�as� �ured on C�ty propert� �1 ���, i�� �a h v r E W�e Q f F.m g c n}�i l a m a��-p S e�:;e s c t p � d �l � /Cl Chherty�o�injvcy- �le�i�specify-`�� a ` Y1��G�l� \ � [n arder ca process your ct�um�oo neecl to inclade conies of ait at�r�lirable documents. F�r ihe etaim.�tg'�eS IIS(2'(f bCI4R, piL'c1'aE L��tt1E C9 IF1CIl1(�C[tl�{IOl'.UR�tlt�7f3fI1C�C(1 i)f IC t3�lII(jelZ�IItC IliiDdlt11�4 Q� your elaim. Docuinent�1�[Ll.t�iOT be retnrned anc�beco�ne thz�roperty of the City. You ar��neourc.ged tc�keep a copy f�c yourseif heF�re submittin�your�lain�Forn�. O Pro�rty damage ciaim�to��vehit';lz:two e�i�ces for fhe r�pair�to yaur vehicle'rF fha damage exeze�, �504,00:flr the<xx�.+af bili�andlor receipts For the nepain � �ow•in�et<tims:le�ibte copies of any tiet�zt issu�d and :a cc�py o[ilie irttpcwnd tot �ceipt O Otder property clanra�e claicn�;:��vo re�uir estin�►tes if the danr.�g�exceeds�S40.DU:ar the acn,�E bills a�dlor rec;�ipts fur the repaii3_detaitec!iist�f dam�ged iten� O Injury ctaim�: ��kdicul bill�,receipts - O Photc�raphs ar�RJur=a��ti�etcome ta dociiment and aip�otc y�ir ciaim but�viii not be ren+med_ Page 1 aP2-PlQase cor�piete aud return bot6 pages of tRaim�orm � � �� � �. �� � � � � . _ �, �� G ����� � l � � � a � � ������ ��� } \i �1(_J r` �� \J �� �",�`�� ���� � � � _ �<< ►: _ � 0 ` C�� 6�-� �� �, 1 �r ��s �`� �� � � � � S 5 � w � �S � � � .� � � ��� , , � P � --- - - � � � (Retum this portion with your payment- DUE NOVEMBER 15,2013) Make check payable to:City of Saint Paul property Address• 716 MENDOTA ST � Property ID Number: 33-29-22-22-0011 ! Mail to: City of Saint Paul PO Boz 64015 Assessment Number: 130032 Saint Paul,MN 55164-0015 AMOUNT DUE: $678.79--- � �i Q�� � � (Please use the self-addressed envelope) � � 0� - �` � Returned checks are subject to a 530.00 Jee `� � 1��r �� (DO NOT WRITE BELOW THIS LINE-TO SO WILL DELAY YOUR PAYMENT PR�SSING) (� ��� i 33�92222001113�0320000067879? �ESTOw►noN i Restoration Professionals o�ssrowus; 505 Minnehaha Ave.W. Saint Paul,MN 55103 Phone:(651)379-1990 � Fax:(651)379-1991 License#BC396147 SPRINGER# SPRINGER# DESCRIPTION QNTY REMOVE REPLACE TOTAL 1. Emergency service call-during business 1.00 EA 0.00 126.91 126.91 hours 2. Water extraction from hard surface floor 200.00 SF 0.00 0.22 44.00 3. Clean floor 2U0.00 SF 0.00 0.30 60.00 4. Apply anti-microbial agent 200.00$F 0.00 0.18 36.00 5. Dehumidifier(per 24 hour period)- 12.00 EA 0.00 101.25 1,215.00 XLarge-No monitoring Two extra large dehumifiers for six days to dry Class 4 materials(plaster) 6. Air mover(per 24 hour period)-No 12.00 EA 0.00 25.00 300.00 monitoring Two air movers for six days to dry class 4 materials(piaster) 7. Equipment setup,take down,and 10.00 HR 0.00 44.29 442.90 monitoring(hourly charge) Total: SPRINGER# 2,224.81 Line Item Totals:SPRINGER# 2,224.81 II SPRINGER# 7/18/2013 Page:2 �TOF��S i Restoration Professionals 505 Minnehaha Ave.W. Saint Paul,MN 55103 Phone:(651)379-1990 Fax:(651)379-1991 License#BC396147 Summary Line Item Tota] 2,224.81 Cleaning Sales Tax @ 7.625% 169.66 Replacement Cost Value $2��•47 Net Claim $2,394.47 Rich Hilmanowski SPRINGER# 7/18/2013 Page:3 �.� ���i ' � �� ��� � �� l 1 cr�rs cusro�con►sr�ucr�oN iwc. l.tC:#BC173484 Date 7M7M3 B!D Job Loca�on: 87S east 7'"street ST. Paul MN.55106 C�r. Sprin9er coHec�iorts 81ct Suasmary: -Repalr wails a�tf ceilin9s in 6aseme�t -Reptace 2 new bath ven�e in batArooms. -Repaldr+eplace tile in haHway : � -tnstalf new vanity in mer�s bathroom ; -Pair�#hallway and bathrooms ; a Totai $1�.500 $8,250 Dawn$8250 due oper�comptetion Price inciudes materiai and labor AH mal�riai and labov is warranted#o ma�ufacture spec�cations: Aut[torized siSnature af Acceptance� Date: Custom Cuts Covtstruction: pa�; � Joe Howa�t1659 29Q-0f93 Kelly Naugle 512-�98-4558 , . .. . . .. . . -- - , . . ... . _.._ .. , .._ - - � - � - _ - - ..-- - - . �.t - - � - - - _ -- - _ - .. - _ - __ - � - - - -. - - � - --- -- �a :. - - _ _ _ _ - - - - __ _ - - .._ _ _ _ _ _ �-i . . � _ _ - - .- - -� - _ _ _ ' _.. - - , . 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'�� `,..; <,. -. - . •�.. . _-' . ' : _. _ _ ;: - ...... -.8'7.6 E,°7.TH-ST'RE��';;�., ST.='pAL3L;TlIt�1NESOTA.55.1. .. 5 - _ Ax_ , i . � ' • i i ; ; j conscience and do the right tbing and take responsibility for the city's error. � Please contact me to discuss a resolution to the matter prior to any attomey i involvement � ; i_ � Regards, � � � � � � } Steve Hannig ± P�Box 876 ` � Pelican Rapids, MN 56572 i 651-485-9920 i ; i t t t � f � i � �_ 4 F E � i f j i l } � i f # f � i . t � � ; j � � 3 f . t�oC;olZaHS - C:ommuruty C;ollaborahve Kain, Hail� �now Network Ya,ge 1 ot 1 �S COMMUNI7Y COLLASORA7IVE RAIN� HAIL Sc SNOW NFTWORK Go�a __ �Because eve�y rlrop �ounts" __�� � �y �p ome � States � View Data �Maps My Data Entry � Login f a View Data : List Multi-Day Precipitation Reports View Data Search Muitiple Day Accumulation Reports Station Fields: ❑Station Number�Station Name • DaiN Predo ReooAs . DaiN Cortunents Reoorts LOCBtiOtl: USA Minnesota RM-Ramsey • Rianificarrt Weather pa�Ran e: � • MutUde Dav Reoorts Start Date�,6izzizoi3 _ End Date' 6/24/2013 - - • Drouaht Imuact Reports •._. __ _ �_ • ._ _' . Davs with Hail Pt�Clp VelUe: A��PrepP Values Operator � • Search Hail Reoorts Search . Station Hail Reports . ���„P�;o s,,,,�„ Searched:Stations in Ramsey, Minnesota. Report start or end date between 6/22/2013 and . Station Snow Summerv 6/2412013. • Raim Davs Report Showing 2 Records. e Total Precip Summarv . List Stations TOt�i Total � Start Date Station FROST Data ♦ End Date Number Qrecip Snow State County View in. . Frosc 6/22/2013 6/24/2013 7:00 AM MN-RM-20 0.50 0.00 MN Ramsey � . o°ea • Snowflake 6/22/2013 6/24/2013 7:00 AM MN-RM-22 .14 NA MN Ramsey �_ . 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