07-431Council File # 0 - 3
Green Sheet # �Q3
RESOLUTION �
OF SAINT PAUL, MINNESOTA
Presented by
1 Be it resolved, that upon proper execurion and delivery of a release in full to the City of Saint Paul, the proper City officials are
2 hereby authorized and duected to pay for the 5aint Paul Public Works DepattmenYs Sheet Tort Liability Fund, GL 225-42310-
3 0511, to American Family Insurance Company, as subro�ee of Teaance Sobolewski, the sum of nine thousand three hundied
4 two dollazs and seventy four cents ($9,302J4) in full settlement of any and all claims for damages sustained on or about the I�`
5 day of December, 2006, at or neaz the intersecrion of Territorial and Eusrist, Saint Paul, Minnesota.
Requested by Deparunent of:
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By:
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Adopted by Council: Date G1
Adoption Certified by Council Secret
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Approve a i: Date 5 � ¢�
By:
Form A rove b ay f ubmi ion to Council
By:
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� Green Sheet Green Sheet Green Sheet Green Sheet Green Sheet Green Sheet �
0 7- �31
HU - HnmanReso�¢ces
Contact Person 8 Phone:
Sandra Bode'uteiner
6512668887
mus[ oe on
16MAY-07
Doc. Type: RESOLUTION W/$ TR4NSAC
E-0ocument Required: Y
pceument Conqct Sandra Bodensiein
CoMact PM1one: 6542668887
Z�.�R-0� I Green Sheet NO: 3039050
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Assign
Num6er
Por
Routify
Order
ToWI # of Signature Pages _(Clip All Locations for Signature)
1 �nmanResonrces ; D¢➢ermientDirec[or i Q i�rv _
2 mam�ialServices pfficeFivancialServicesl
3 Attornec Ctiri AStoruev ', �
4 avor•s O�"ice MawNAssistaut
5 wncd Cit� Co�cl j
6 �Citv Clerk CiN Clerk
Approval of settlennen[ of a pmper[y damage claim from American Family Insurance Company in the amount of $9,302.74.
�aauons: Approve (.a) or R
Planning Commission
CIB Committee
Civii Service Commission
1. Has ihis personffum ever worked under a conVaU for this depactment?
Yes No
2. Has this perso�rm ever been a city employee?
Yes No
3. Does this perso�rm possess a skill rrot normally possessed by any
current ciry employee?
Yes No
F�cplain all yes answers on separate sheet and attach to green sheet
[nitiatfng Problem, Issues, Opportunity (Who, What, When, Where, Why):
A City of Saint Paul Pubiic Works satt spreader made an illegal u-tum and struck a vehicle driven by TerranceSobolewski, who is
insured with American Family Insurance Company. A settlement has been reached for property damage in the acnount of $9302.74.
Advartages {f Approvecf:
An outstanding claim against the Ciry will be settlemd.
����������
Disadvantages If Approved:
None.
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l Disadvantages ff NM Approved:
i An outstanding claim against the Ciry wiFl need to be Iitigated resulting in higher costs.
Trensaction: $ 9 . 302 . 74
Funding Sovrce: GL 225-42310-051 �
Financial information:
(Exp�ainj
Cost/Revenue Budgeted: Y
ncttv�ry Numner. pubiic Works Streets Tort Liability Ac ount !
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April 26, 2007 11:42 AM Page 1
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Property Damage Release
File Number C-070010
For the sole consideration of nine thousand three hundred two dollars and
seventy four cents ($9,302.74), the recaipt and sufficiency whereof is hereby
acknowledged, the undersigned hereby releases and forever discharges the City of
Saint Pau{, the Department of Public Works, John Jotblad, their heirs, executors,
administrators, agents, and assigns, and all other persons, firms or corporations liable,
or who might be liable, none of whom admit any liabilifij, from any and all claims,
demands, damages, actions, causes of action or suits of any kind or nature whatsoever,
to property which has resulted, or may develop in the future from an incident which
occurred on or about the 1 day of December, 2006, at or near, Territorial and
Eustist, Saint Paul, MN.
The undersigned hereby deciares that the terms of this settlement are fully
understood and voluntarily accepted for the purpose of making a full and final
compromise adjustment and settlement of any and all claims, disputed or otherwise, on
account of the property damage mentioned above.
1 hereby state that 1 have read this release, know the contents thereof, and have
signed the same, relying on my own jud ent and on representations of others, and
of my own free will and accord this I�7� day of , 20�.
In the presence of:
Witness
W itness
.
Signature of thorized
Representative of American Family
Insurance Company as subrogee of
Terrance Sobolewski, Ciaim # 00-241-
4'12266-0424
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Printed Na e of Person Signing
Above
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Federal Tax Identification Number
Subscribed and worn to before me on
this �2�-dayof �1 p�(_ , 20p�.
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Notary ubiic
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