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Xiong, Soua & Mailee Kong AMERICAN FAMILY � 6131 Blue Circle Drive I Eden Prairie MN 55343-9130 I amfam.com Mailing Address:PO Box 1246 I Minneapolis,MN 55440-1246 I Phone:(952)933-4884 June 10, 2014 ���i�� V �� JUN 1.3 2014 39-PMZ001 CITY CLERK CITY CLERK CITY OF ST PAUL 15 WEST KELLOGG BLVD 310 CITY HALL ST PAUL MN 55102 RE: Your Insured Name: St Paul Police Department Your File Number: Unknown Our Claim Number: 00-345-072902 3905 Our Insured: Soua& Mailee Kong Xiong Date of Accident: May 17, 2014 Total Claim: $11,242.57 Company Portion: $10,742.57 Insured's Deductible: $500.00 Dear City Clerk: We are notifying you that American Family Mutual Insurance Company has now made payment on the above referenced claim and our supporting documentation and proof of payment is enclosed. The facts support that this incident was caused by your police officer's negligence. Our subrogation claim is pending salvage at this time. We are requesting that you set up a claim for our damages and we will be submitting our claim using your Notice of Claim form as soon as the salvage has been completed. Thank you for your attention to this matter. When sending correspondence, please include 'Attn: Subrogation DepY. Respectfully, ����� Pat Zoerb Subrogation Senior Adjuster American Family Mutual Insurance Company 1-800-MYAMFAM (1-800-692-6326) X 66303 pzoerb @ amfam.com ' Fax: (866) 833-5599 www.amfam.com/claims Enc: (Page 1 0£ -�) . Acc�dent Report ���07���� Page 1 of 2 I AI�AG{!IO ��tl0 .�'f•1 � S. �� l .C�'�-• p 19095615 Rf tka''��`'�,� �, ��2�'f3Ytt�t''''�c��,�t, s � .iu+o.� �oru, ,4uo tw ' wa. 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' ' •�'' '�i+� 3:�.vj� '�1.� � ?'•"�'7 . : e 14095615 7 .. � �2�•$� - �'i.%'• � v �+inaw wenio. w�aas ia�m sw ,�� •��1 �.-�;���+• Q � � # # # ? � � °�` :� o�� « ._�eR e: e:�� � '� � ��„ �..� �.� �..�, .��.��.�..��,��,�,. o ��. +_ u, �, ..-- �.:- ._.� .. � r � ra�cx ua�a�maaKru.� aon a�u e�m�aa rorna� oro+a�irauMw�oe.� ~ swe aua a�uns �ra� 3 � 01 S599103766923 t`III D � n�cra: ,w�owcrencwn uaca�.m Mw�caw.c�u.wn o�oam� w.,oR, � SENG CHRISTOPHER XIONG OS 23 93 O iwi.a .oeise a� au+a N il 143f Selby AVenue t3� y v wqy we s a nnsu Ol St Paul Park 55071 m►o � wrr .��r �w.a �ar wav .� Q �vr �•erorr �...o rsr ww ra�a 01 � M 4 04 06 OS N ? raa mr n.n ,er ,nioe nui.o�a i..u,waw�a .nw�x ,ux ,..a uw n.. m�m mrxre�r W...ria.sau .,tw�ew � 98 �` 98 l�j Oo�n.. �? ?T �o�nse aocv one�w�. �rw�� �aro�wi � �e aoou. 0@ XIONG SOUA�. �T ? # .m�m ,wm- +mm - � � �w.., � .c.�m� 03 840 JODY I�N S Y� � w�w arcaaca n�un o�rcr an.�arca► wan weT �we Ol COTTAGE GROVE MN 55016 '19� Oi "'� eouee � �ma ,uw awo� '�ws rma .w mu. vo� 11 CADI ESC 200 BLK wowv iwu n�m swaa ,� '�sj°°`:� ... n�n� mwo rw�ea „�, ,M, �ortww mar 04 VXT43B i� 9 02 02 wua.Q .a,ci�..e� • rr�urriaMra raw.w� American Family Mutu 1376620376FPPAt�IIQ wwo w�u�r .v.m ...m,o�. .rrooe. .M,Ym �u.�. .n. tae FAECOltR NVdXW ACOYIIfRA�1.Mb1CR VEWCtB,iCM001.6W.ORlIEM aTARTlW �n+ � ? 11�11lEAlONOTrt1t7NElUi6M7R0l.�QUlhduaAU1t61NJp�nd1WlH►. 4 � m�oou�elQ[rYat.�oeatwame+we amrYa m�6oRxlCCr�a�ett.uam�rJlMne1W� oOrMlwut MYSqOY/lYrtltal0 uR GKO� Ns IYM YI! /A�C rJlCT Wltv fiM�Ir LMIVIVOIR 7 Qy� AI�tB1v�Lf 1Y�y��l � COp ` Q� M�1(IIYp IRfI1�A � Qea° .. � fly� u�mrvet �wr� �• � 0� � aruaror�awaYwo[or�vs�rrNeoowme.are�r�ms�erprr�wwTeio.mw�am uv��ecor�a,aim�mra�e� ^ V ' �aenr - � . . ,-�....... . . �� ( eeNs ,� � .. { I' �oa�a ' � . ' °,� —� _ � ° .i "' � � '_'� �....� naieaa �°a'u ! ,.. .�— _-_. _ �f _ _'*' � ,� wwoor : .�. y�_ ., _ _ �.. xr�a •t• .' � ;. 7 ' ' ` mao �" � tr 'r � , .9 - �,..�a, ± M ' � , '�• ��PfM[11i � � t ImOW `�. ( �� ] 1 o _ `. .. v uort ro�r � y -' '`' "� i . �, ow�ur ioavw o���wtww1uowa�• " mc� w�m+a p sw��.na p wua Sergeant Pat=icia Enqlund 2fi2 St Paul PD a�+. O� hi#ps.//dvscrash.x.state.mn.us/dvsinfo/acc�dentrecords 2008/Includes LE/PrintReportIndiv 5/17/2014