Loading...
Tanning , NOTICE OF CLAIM FORM to the City of Saint Paul, Minnesota Minnesnru State Slatuse 4C6.05 states rhnt` ...every penson...►rho claims dnmages fmm nny muniripaliry...shntt cause tu be preseiued tn the governPnR balp uf the municiputity within/�0 cta��s aFter the ulleged loss c�r injury is discovered a ncrtice stafing the ti►ne,place,arul cirr.umctance.s therenf,and the mm�unt of cnmpensatinn nr nther relief demanded.` Please c�impiete this f��rm in it�entircty t�y clearly typing or prin#in�your<�nswer t��cach yucstion. If mon spac�Lti needed,uttuch addili�m:i[sheets. Yiease note that you�vitl nnt be contacted by tefephone to clarify answers,so provide as much inCocmatlon as�tecessar►�to c�xpl��In your ctaim,und the amount of cuinpen�ation beinK rct�uested. You wiU ri.�ceive a �vriccen ackaifwledKement once your fE�rm is received. The pr<>cess cf�n take up to ten weelts or loager depending E�n the nxture of your elaim. This farm must be s[gned,and buth pages cumpleted. If sumething d+xs not apply,write`N/A'. SEND COMPLETEll FORM ANll OTHER llOCUMENTS TO: CITY CLERK, 15 WEST KELLUGG �3LVll, 31U C1TY HALL, SAiNT PAUL, MN SS1U2 First Name � � G�� Middle initiat I`� Last Name�✓��� E I V E D . Company or Business Name i�► � ��� � 6 20�4 Are You an Insurance Campany? Yes/IV� If Yes,Claim Numbc:r? Street Address 3 � � _ / �,`� �hr-c S�J LERK City o � 15✓'�s �� Stc�te m I v Zip Code �S I 1 Z � Daytime Fhe�ne(�) - Cell Phone(�}��E�ening Telephone(���7� C� 1�� . . � �c Date of Accident/Injt►ry o� Date Discovered /�1� /3 Time 7 3 U am/pm � 1'leasc:slale,in detait,what occurn:d(happened),and why you are submitting a claim.Please indicate why on c��w you feel thi City of Saint Fat3 or its employees are i volved and/or res�nsible for your damages. p� �� �'i l�i(ti C�� ' t�c� t 5 �r� ' A �'1 L,� "I—� fi � I�' A c�. LO� r Sti � � � � . Avi 0 S a. � o L i�5f ' asS �i'ti -C t�J � � o- � � , t'lc>asc chc:ck thc hax(cs}thal m<�st closcly represcixt thc rcasan f<�r cczm�lcting lhis form: �I� 0 My vehicte was damaged in an accictenl � My vehicle was damaged during a taw � My vehicle was damaged by a�othole or condition of the street ❑ My vehicle was damaged by a p[ow C] My vehic{e was wrongfully towcd and/c�r ticke[ed � T was injured on City gro�:rcy 0 Other type of property damage—please speciCy ❑ Other t,�e of injnry—p�ease s�ec�fy In order to process your clairn you need to inctudi copics of all applicable document,s. Fc�r thc c;laims lyfx:s listed t�elow,ple<�.5e bc:sure lo include the document�indicated or it will delay the hand[ing c�f your claim. Documents WILL NOT be returned and become the praperty of the City. Y�u are encouraged to keep a ct�py fc�r yoursell'bclore submiEting your claim fc�rm. Q prope:rty d�unage claims tc�a vehicle: two estimates i:ar the repairs to your vehicle if�the damage exceeds , $500.00; or the aclual bills and/or receipts for th�repairs I, O Towing claims: Icgibl�;capies of any cickec issued and a cc�py c�f the impound !oc n;c;eipt O t)lher property damage claims: twc�ct;�air estimales iC the damage exceeds$StX).(�; cx the actual billti ';� and/or receipts for the repairs;detailed list of damaged items O lnjury clairns: tnedicl! bitls,recc;ipts i ,. O �'hatographs are aiways wcicc�mc to�locumcnt and supporc your claim but will nc�t be rcturncd, ' � Pa�e 1 of 2—Please compiete and return both pa�es of Claim Form Failure to complete and return both pages will result in delay in the handling of your claim. All Claims-qlease complete this section Were there witnesses to the incident? Yes No Un own (circle) Pro de the' names,addresses and telephone numbers: J' ' � �-�l$3=C�g� T..��fw �G�o I{��i �.t-c� �7p-q a 3 - (0 3 Fs� Were the police or law enforcement called? Yes No Unknown (circle) If yes,what department or agency? �J'�-� I�o w Case#or report# /V� Where did the accident or injury take place? Provide street address,cross street,intersection,name of park or facility, closest landmark,etc. Please be as detailed as possible. If necessary,attach a diagram. Please indicate the amount ou are seeking�n com,�jensation o,�r w��hnat y u would like the City o do to res1olv�e this claim to your satisfaction. .��7 Ud 0�"�' ��.! c: •"�i'� ���.C`l s� DIVi'� "f'a rt"►v��it1"'L T���� Vehicle Claims-please complete this section ' v ❑ check box if this section does not anvlv Your Vehicle: Yeaz Make Model License Plate Number State Color Registered Owner Driver of Vehicle Area Damaged City Vehicle: Year Make Model License Plate Number State Color Driver of Vehicle(City Employee's Name) Area Damaged Iniurv Claims-Alease comulete this section t� � ❑ check box if this section does not avplv How were you injured? What part(s)of your body were injured? Have you sought medical treatment? Yes No Pianning �o Seek Treatment(circle) When did you receive treatment? (provide date(s)) Name of Medical Provider(s): Address Telephone Did you miss work as a result of your injury? Yes No When did you miss work? (provide date(s)) Name of your Employer: Address Telephone '�Check here if you are attaching more pages to this claim form. Number of additional pages�. By signing this fornt,you are stating that all inforntation you have provided is true and correct to the best of your knowledge. Unsigned forms will not be processed. Submitting cz false claim can result in prosecution. Date form was completed � � � a ' �� Print the Name of the Person who Completed this Fo /�� ��-�� '" � ' ti��� ' Signature of Person Making the Claim: Revised February 20ll .� , , 324 16th Ave SW New Brighton, MN 55112 1/10/14 Dear City of St. Paul, I'm writing this letter on behalf of my son, Micah Tanning, a freshman at Macalester College in St. Paul. On December 8'h, 2013, he discovered that his car was missing from a street near his dormitory. As young students, barely out of high school, neither he nor his friends at Macalester were aware of the snow emergency nor the rules surrounding it, so this came as a quite a shock. It was the beginning of finals week at Macalester, and he was in a panic. Eventually he would learn that his car had been towed three days earlier. � One of his friends called the St. Paul Police department, who told him that the car had been towed to the Impound Lot at 830 Barge Channel Rd. Because Micah needed to complete a course requirement in ' Calambia He;ghts that even;rg, ! dreve to Macale�ter t� bring him to Columu�a Heights. The raads were vzry slippery and dangerous, so I asked my husband to drive Micah to the St. Paul impound lot. Because Barge Channel Road is all the way across town from here, they called the impound lot first to make sure his car was there, and were told that indeed his car was there at 830 Barge Channel Rd. It took 40 minutes to get to the impound lot, only to be told that his car was NOT there at all. In fact, it had been towed to the Snow Lot by the State Fairgrounds, which is only 3 miles from Macalester College!! Why did your people send him all the way across town, without even mentioning the snow lot only three miles away--adding insult to injury in an already terrible situation? Misinformation supplied by both the St. Paul Police Department and the St. Paul Impound lot meant that my family was unnecessarily out on snow and ice-covered roads in zero degree temperature for nearly ' two hours instead of the half hour it should have taken. This was time that our son should have been in his dorm room finishing papers and studying for upcoming final exams. � Based on this experience, this is what I am requesting: � 1)That the St. Paul Police Department work with local college campuses to ensure that students are being informed of Snow Emergencies and what that entails. For many students, this is a new experience, and it seems a bit predatory to target the young and uninformed without due process. 2)That personnel answering phones at the Police Department and the Impound Lot be trained to , inform callers of the Snow Lot by the State Fairgrounds as an optional towing place so that people don't drive unnecessarily across town in bad weather on bad roads to avoid additional storage charges. 3) My son paid $320.50 for all the charges associated with this incident(see attached). I request , that all of this be refunded except the$124 towing charge plus tax. The city should not be rewarded for misleading the public and putting students at unnecessary risk on bad roads. At the same time, the city should not be stuck with the towing charge, and it is fair for my son to have to pay something for his mistake. Therefore,we request a refund of$187.00 to Micah Tanning. I believe these are all very reasonable requests. Thank you for your consideration.We look forward to your reply. � S�ncerely, � �:. � na Tanning r 51-246-6872 � � St. Paul Police Department for Ramsey District Court RECEIPT DatelTime: 12/08/2013 19:39 Invoice #: 22127 Vehicle Plate: XRP150/MN Payor: OWNER Location Paid: Impound Snow Lot Citation: Amount: � 0900174894 $ 56.00 � Total Amount Paid: r��� 56.00 Paid by: CREDIT CARD KEEP THIS COPY FOR YOUR RECORDS Saint Paul Police Impound Lot, 830 Barge Channel Road, Vehicle Release Form Make: 97 TOYOTA License#:XRP150 CN: 13258617 Invoice#: 22127 Date/Time Released: 12/08/2013 19:39 Tow Charge: $ 123.95 Released to: TOTO ' Storage Charge: $ 45.00 Paid by: CREDIT CARD Admin Charge: $ 80.00 Released by: STACY Tax: (7.625%) $ 15.55 I,the undersigned,have recovered the vehicle described above. Subtotal: $ 264.50 //�� (, I will check the vehicle for damage or any other problems that � may have occurred while this vehicle was in the custody of the Service Charge: $ 0.00 Saint Paul Police Department. I acknowledge I will report damage and/or any other problems to the Impound Lot staff Total Charges: $ 264.50 on this form prior to leaving the impound lot. Damage and/or other problem: Police Report made: Yes_No_IF Yes, CN , If NO, Why? TO PROTECT YOUR RIGHTS REPORT ANY PROBLEMS/DAMAGE BEFORE LEAVING THE LOT 5/2000 Signature ST PNUL IMPOUNG LOT 830 BARGE CHANNEL k0 SAINT PRUL, I'W. 55107-245t3 651-266-5642 Merchant ID: NUk16380149 Term ID: 0Ea17340k700860638G14405 Sale zzzzzxzxz:�xz12?4 ,,------�-�_. VISp Er�ri�ethod. Saiped iotal: i�� $ ��� \ 12/��i3 19,37,85 , Inv p; �4 `Aapr-�Cvde'--�453�- .- � ��rud; Onl�`'�E � CuStcm�ef COPY fHANk i'UUt