01-468� ! \ � � � ( �f�L
Presented By
Referred To
Committee: Date
1 Resolved, that upon execution and delivery oP a release in full to the Ciry of Saint Paul, the
2 proper City officers are hereby authorized and directed to pay from the Tort Liability Fund,
3 09081-0511, to Wendy Severin and her attomey 3effrey A. Jones, the sum of $14,500, in fuli
4 setflement of any and a11 claims for damages sustained on May 4, 200Q as a result of an
5 accident at or near the intersection of St. Peter and 5�' Street in Saint Paul, Minnesota.
APPROVED
DATED:
4�-���
Adopted by Council: Date _ 1'� C> , a p�
Adoption Certified by Council Secretary
�
Approved by Mayor: Date
�
�
Council File # G 1�� L�
Green Sheet # ���d ��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
��
Requested by Department of:
Apptoval Recommended by Financial Services D'uector:
By: �..'�/� ��7 !l''�i![ivL--
Form Ap soved by Ci t ey� ��
i/JA
By: �.tUi. 'Y'Va7/a
� ��
Appr d by yoi for Submis io to Council:
BS'� ���i�v��t� ��T�GI�-rTV�
�
GREEN SHEET
�,L:,� �z-�_��.:,
5/2l01
sort
TOTAL # OF SIGNATURE PAGES
No 1 � s0U4
�-�r :.�=�
� ��� �
an�noiuer arvc�K
❑ wuwdata¢axcci__ iae� ❑ wwKw.mivrnxra _
❑3 w ���� ❑6 Risk Management
(CL1P ALL LOCATIONS FOR SIGNATURE)
Approval of resolution settling aii claims of Wendy Severin against the City of Saint Paul in the amount of 514,500.00.
PLANNING COMMISSION
CIB CAMMITTEE
CML SERVICE COMMISSION
Has mie ce�soNfirm ever NnrkeG under a contrau torthis tlepertmerA?
YES NO
tf�tlxa peieoNF`m e+er eeen a cay anMovee9
YES NO
Do� this persaNfiim 7�seas a sluN not nameliyP�seE bY m�Y arreM city emPbyee4
YES NQ
Is Mie pe�sonlfirtn a tefpetetl vendof!
YES ND
On May 4, 2000, a City of Saint Paul squad car rear ended a vehicle driven by Wendy Severin. Ms. Severin sustained injuries as a
result of the collision. A final settlement of all claims has been reached in the amou�t of S 14,500.00.
IFAPPROVED
SOURCE
INFORM1NTON (IXPWN}
GL 001 Tort
COE7IREVEHUE BUDQETEC (CIRCLE ONEI YES NO
AcirvITYMUMBER -. D9081 �
4/Ut� C:�'���t'vSf 4FR?%?$a�
✓
Re(ease of All Claims
File Number C-000322
o�-4�Y
In sole considera#ion of the payment of fouReen thousand five hundred doliars and no cems
{514,500.0�), to me paid in hand. ! do hereby release and forever discharge the City of Saint Paui, the
Saint Paut Potice Department, Gnia Kong, their representatives, suCCessors, essigns and alt ather
persons, f+rms and corporations from any liability, claims, actions, causes of action, and demands of any
kind, known ar unknown, existing now or to arise in the future, resulting from or related to any damage,
foss or injury sustained by me arising from an incident which took p{aca an or about 4th day of Fe6ruary,
2001 at or near the intersection of St. Peter and 5th Street, Saini Paul, MN.
i understand that my injury may be permanent and prograssive, and that recovery may 6e
uncertain. 1 rety oniy on my own judgment in making this release and do noi rely on any othar person in
any way. By s+gning this document, I understand that 1 am responsihle for any and all bilis, liens, rights
ofi action or causes of action relating to or stemming from any treatment rece+ved, service rendered or
product provided, whether paid or unpaid, know� or unknown, in connection with or reiating to any
damage, injury or 4oss from the above date, inc{uding, hut not limited to: P,rvidson Grand Avenue
Chiropractic, Centrai Neurology, Dr. Raphaei Magana, Advanced Imaging, United Hospiiai, Sister Kenney
Physical Therapy, St. Paui Radiology, City of Saini Pau� EMS, Jeffrey A. Jones and Associates, and
American Family Insurance Compa�y.
l�he payment of this money is not to be construed as an admission of liability. it represents onfy
the campromise of a doubtfut and disputed ciaim.
Regarding the parties hereby released, this document, and the payment made pursuant to it, are
not to be construed as a waiver of the right to prosecute, or an estoppei p�ohibiting the prosecution of a
ciaim or cause of action against any other person, firm or corporation for damages resu�ting from the
incident referred to above. 7his re�ease is not to be construed as prohibiting any parties hereby released
from denying fiabitity to anyone, or from defending against any c(aim or action 6rought by any person,
firm or r,orporation as a resuit of the incident referred to above.
This release contains the entire agreement Between the parties hereto, and Yhe terms of this
reiease are contractuai and not a mere reci4al.
THE UNDERSIGNED HAS flEAD THE FOREGOING AND FULLY UNDERSTANQS IT. i here6y state that 1
have read this release, know the content ther of, and have signed the same, and of my own free wii{
and accord dated this �day of ��p�,� � , 20�.
i�.e.,v� � <�,� %c,�L—_
Wendy Severin
Subscribed and sworn to before me
this �?�day nf _ !�� 1 � .
C
Notary P�b{ic
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� ! \ � � � ( �f�L
Presented By
Referred To
Committee: Date
1 Resolved, that upon execution and delivery oP a release in full to the Ciry of Saint Paul, the
2 proper City officers are hereby authorized and directed to pay from the Tort Liability Fund,
3 09081-0511, to Wendy Severin and her attomey 3effrey A. Jones, the sum of $14,500, in fuli
4 setflement of any and a11 claims for damages sustained on May 4, 200Q as a result of an
5 accident at or near the intersection of St. Peter and 5�' Street in Saint Paul, Minnesota.
APPROVED
DATED:
4�-���
Adopted by Council: Date _ 1'� C> , a p�
Adoption Certified by Council Secretary
�
Approved by Mayor: Date
�
�
Council File # G 1�� L�
Green Sheet # ���d ��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
��
Requested by Department of:
Apptoval Recommended by Financial Services D'uector:
By: �..'�/� ��7 !l''�i![ivL--
Form Ap soved by Ci t ey� ��
i/JA
By: �.tUi. 'Y'Va7/a
� ��
Appr d by yoi for Submis io to Council:
BS'� ���i�v��t� ��T�GI�-rTV�
�
GREEN SHEET
�,L:,� �z-�_��.:,
5/2l01
sort
TOTAL # OF SIGNATURE PAGES
No 1 � s0U4
�-�r :.�=�
� ��� �
an�noiuer arvc�K
❑ wuwdata¢axcci__ iae� ❑ wwKw.mivrnxra _
❑3 w ���� ❑6 Risk Management
(CL1P ALL LOCATIONS FOR SIGNATURE)
Approval of resolution settling aii claims of Wendy Severin against the City of Saint Paul in the amount of 514,500.00.
PLANNING COMMISSION
CIB CAMMITTEE
CML SERVICE COMMISSION
Has mie ce�soNfirm ever NnrkeG under a contrau torthis tlepertmerA?
YES NO
tf�tlxa peieoNF`m e+er eeen a cay anMovee9
YES NO
Do� this persaNfiim 7�seas a sluN not nameliyP�seE bY m�Y arreM city emPbyee4
YES NQ
Is Mie pe�sonlfirtn a tefpetetl vendof!
YES ND
On May 4, 2000, a City of Saint Paul squad car rear ended a vehicle driven by Wendy Severin. Ms. Severin sustained injuries as a
result of the collision. A final settlement of all claims has been reached in the amou�t of S 14,500.00.
IFAPPROVED
SOURCE
INFORM1NTON (IXPWN}
GL 001 Tort
COE7IREVEHUE BUDQETEC (CIRCLE ONEI YES NO
AcirvITYMUMBER -. D9081 �
4/Ut� C:�'���t'vSf 4FR?%?$a�
✓
Re(ease of All Claims
File Number C-000322
o�-4�Y
In sole considera#ion of the payment of fouReen thousand five hundred doliars and no cems
{514,500.0�), to me paid in hand. ! do hereby release and forever discharge the City of Saint Paui, the
Saint Paut Potice Department, Gnia Kong, their representatives, suCCessors, essigns and alt ather
persons, f+rms and corporations from any liability, claims, actions, causes of action, and demands of any
kind, known ar unknown, existing now or to arise in the future, resulting from or related to any damage,
foss or injury sustained by me arising from an incident which took p{aca an or about 4th day of Fe6ruary,
2001 at or near the intersection of St. Peter and 5th Street, Saini Paul, MN.
i understand that my injury may be permanent and prograssive, and that recovery may 6e
uncertain. 1 rety oniy on my own judgment in making this release and do noi rely on any othar person in
any way. By s+gning this document, I understand that 1 am responsihle for any and all bilis, liens, rights
ofi action or causes of action relating to or stemming from any treatment rece+ved, service rendered or
product provided, whether paid or unpaid, know� or unknown, in connection with or reiating to any
damage, injury or 4oss from the above date, inc{uding, hut not limited to: P,rvidson Grand Avenue
Chiropractic, Centrai Neurology, Dr. Raphaei Magana, Advanced Imaging, United Hospiiai, Sister Kenney
Physical Therapy, St. Paui Radiology, City of Saini Pau� EMS, Jeffrey A. Jones and Associates, and
American Family Insurance Compa�y.
l�he payment of this money is not to be construed as an admission of liability. it represents onfy
the campromise of a doubtfut and disputed ciaim.
Regarding the parties hereby released, this document, and the payment made pursuant to it, are
not to be construed as a waiver of the right to prosecute, or an estoppei p�ohibiting the prosecution of a
ciaim or cause of action against any other person, firm or corporation for damages resu�ting from the
incident referred to above. 7his re�ease is not to be construed as prohibiting any parties hereby released
from denying fiabitity to anyone, or from defending against any c(aim or action 6rought by any person,
firm or r,orporation as a resuit of the incident referred to above.
This release contains the entire agreement Between the parties hereto, and Yhe terms of this
reiease are contractuai and not a mere reci4al.
THE UNDERSIGNED HAS flEAD THE FOREGOING AND FULLY UNDERSTANQS IT. i here6y state that 1
have read this release, know the content ther of, and have signed the same, and of my own free wii{
and accord dated this �day of ��p�,� � , 20�.
i�.e.,v� � <�,� %c,�L—_
Wendy Severin
Subscribed and sworn to before me
this �?�day nf _ !�� 1 � .
C
Notary P�b{ic
�!l-j��_-:i.^J/_ Ifllf_ lllllJ l!l/'..(
� ..,.,,, ti
1 �.�,,: . , ;. �
` :�, ..�: . . . : , . 1
` '!'=' T . _. , :.: , �� 1
1 '` , >',
✓rr.�i.i-r�rr.i.r.rrr-�i.�.-.�v��- .iiti
� ! \ � � � ( �f�L
Presented By
Referred To
Committee: Date
1 Resolved, that upon execution and delivery oP a release in full to the Ciry of Saint Paul, the
2 proper City officers are hereby authorized and directed to pay from the Tort Liability Fund,
3 09081-0511, to Wendy Severin and her attomey 3effrey A. Jones, the sum of $14,500, in fuli
4 setflement of any and a11 claims for damages sustained on May 4, 200Q as a result of an
5 accident at or near the intersection of St. Peter and 5�' Street in Saint Paul, Minnesota.
APPROVED
DATED:
4�-���
Adopted by Council: Date _ 1'� C> , a p�
Adoption Certified by Council Secretary
�
Approved by Mayor: Date
�
�
Council File # G 1�� L�
Green Sheet # ���d ��
RESOLUTION
CITY OF SAINT PAUL, MINNESOTA
��
Requested by Department of:
Apptoval Recommended by Financial Services D'uector:
By: �..'�/� ��7 !l''�i![ivL--
Form Ap soved by Ci t ey� ��
i/JA
By: �.tUi. 'Y'Va7/a
� ��
Appr d by yoi for Submis io to Council:
BS'� ���i�v��t� ��T�GI�-rTV�
�
GREEN SHEET
�,L:,� �z-�_��.:,
5/2l01
sort
TOTAL # OF SIGNATURE PAGES
No 1 � s0U4
�-�r :.�=�
� ��� �
an�noiuer arvc�K
❑ wuwdata¢axcci__ iae� ❑ wwKw.mivrnxra _
❑3 w ���� ❑6 Risk Management
(CL1P ALL LOCATIONS FOR SIGNATURE)
Approval of resolution settling aii claims of Wendy Severin against the City of Saint Paul in the amount of 514,500.00.
PLANNING COMMISSION
CIB CAMMITTEE
CML SERVICE COMMISSION
Has mie ce�soNfirm ever NnrkeG under a contrau torthis tlepertmerA?
YES NO
tf�tlxa peieoNF`m e+er eeen a cay anMovee9
YES NO
Do� this persaNfiim 7�seas a sluN not nameliyP�seE bY m�Y arreM city emPbyee4
YES NQ
Is Mie pe�sonlfirtn a tefpetetl vendof!
YES ND
On May 4, 2000, a City of Saint Paul squad car rear ended a vehicle driven by Wendy Severin. Ms. Severin sustained injuries as a
result of the collision. A final settlement of all claims has been reached in the amou�t of S 14,500.00.
IFAPPROVED
SOURCE
INFORM1NTON (IXPWN}
GL 001 Tort
COE7IREVEHUE BUDQETEC (CIRCLE ONEI YES NO
AcirvITYMUMBER -. D9081 �
4/Ut� C:�'���t'vSf 4FR?%?$a�
✓
Re(ease of All Claims
File Number C-000322
o�-4�Y
In sole considera#ion of the payment of fouReen thousand five hundred doliars and no cems
{514,500.0�), to me paid in hand. ! do hereby release and forever discharge the City of Saint Paui, the
Saint Paut Potice Department, Gnia Kong, their representatives, suCCessors, essigns and alt ather
persons, f+rms and corporations from any liability, claims, actions, causes of action, and demands of any
kind, known ar unknown, existing now or to arise in the future, resulting from or related to any damage,
foss or injury sustained by me arising from an incident which took p{aca an or about 4th day of Fe6ruary,
2001 at or near the intersection of St. Peter and 5th Street, Saini Paul, MN.
i understand that my injury may be permanent and prograssive, and that recovery may 6e
uncertain. 1 rety oniy on my own judgment in making this release and do noi rely on any othar person in
any way. By s+gning this document, I understand that 1 am responsihle for any and all bilis, liens, rights
ofi action or causes of action relating to or stemming from any treatment rece+ved, service rendered or
product provided, whether paid or unpaid, know� or unknown, in connection with or reiating to any
damage, injury or 4oss from the above date, inc{uding, hut not limited to: P,rvidson Grand Avenue
Chiropractic, Centrai Neurology, Dr. Raphaei Magana, Advanced Imaging, United Hospiiai, Sister Kenney
Physical Therapy, St. Paui Radiology, City of Saini Pau� EMS, Jeffrey A. Jones and Associates, and
American Family Insurance Compa�y.
l�he payment of this money is not to be construed as an admission of liability. it represents onfy
the campromise of a doubtfut and disputed ciaim.
Regarding the parties hereby released, this document, and the payment made pursuant to it, are
not to be construed as a waiver of the right to prosecute, or an estoppei p�ohibiting the prosecution of a
ciaim or cause of action against any other person, firm or corporation for damages resu�ting from the
incident referred to above. 7his re�ease is not to be construed as prohibiting any parties hereby released
from denying fiabitity to anyone, or from defending against any c(aim or action 6rought by any person,
firm or r,orporation as a resuit of the incident referred to above.
This release contains the entire agreement Between the parties hereto, and Yhe terms of this
reiease are contractuai and not a mere reci4al.
THE UNDERSIGNED HAS flEAD THE FOREGOING AND FULLY UNDERSTANQS IT. i here6y state that 1
have read this release, know the content ther of, and have signed the same, and of my own free wii{
and accord dated this �day of ��p�,� � , 20�.
i�.e.,v� � <�,� %c,�L—_
Wendy Severin
Subscribed and sworn to before me
this �?�day nf _ !�� 1 � .
C
Notary P�b{ic
�!l-j��_-:i.^J/_ Ifllf_ lllllJ l!l/'..(
� ..,.,,, ti
1 �.�,,: . , ;. �
` :�, ..�: . . . : , . 1
` '!'=' T . _. , :.: , �� 1
1 '` , >',
✓rr.�i.i-r�rr.i.r.rrr-�i.�.-.�v��- .iiti