210027ORIGINAL TO CITY CLERIC
24. oo�
k% CITY OF ST. PAUL FILE
NO. _
OFFICE OF THE CITY CLERK
jQOUNCIL RESOLUTION — GENERAL FORM
PRESENTED BY
COMMISSIONER DATE
RESOLVED, That out of the Workmen's Compensation
Account of the General Fund, Katherine Conroy, widow of
William Conroy, employe of the Department of Public Safety,
Bureau of Fire, who sustained an occupational disease leading
to his death on May 27, 1962, be paid the sum of $45.00 per
week, payable every four weeks, commencing May 28, 1962, and
continuing during dependency, until the sum of $17,500.00 shall
have been paid, together with $550.00 for funeral expenses in-
curred; that $1125 for compensation from May 28 to and including
November 16, 1962 is now due and payable.
COUNCILMEN
Yeas Nays
Dalglish
Holland
Loss
Mortinson
Peterson
Reseii
Mr. President, el is—
10M 6-62
Council File No. 210027 —By Robert F.
Peterson —
Resolved, That out of the Workmen's
Compensation Account of the General
Fund, Katherine Conroy, widow of
William Conroy, employe of the De-
partment of Public Safety, Bureau of
Fire, who sustained -an occupational
disease leading to his death on May
27, 1962, be paid the sum of $45.00 per
(week, payable every four weeks, com-
mencing May 28, 1962, and continuing
during dependency, until the sum of
!$17,500.00 shall have been paid, together
(with $550.00 for funeral expenses in-
curred; that $1125 for compensation
from May 28' to and including Novem-
' her 16, 1962 is now due and payable.
Adopted by the Council November
20, 1962.
t Approved November 20, 1962.
r (November 24, 1962)
Nov 2 01962
Adopted by the Council 19—
�ov2�1
Approv d —19—
Tn Favor
1 01 ABt�� Mayor
gainst
PUPLICATE TO PRINTER 21-0027
CITY OF ST. PAUL FILE NO. NO.
OFFICE OF THE CITY CLERK
COUNCIL RESOLUTION — GENERAL FORM
PRESENTED BY
COMMISSIONER DATE
RESOLVED, That out of the Workmen's Compensation
Account of the General Fund, Katherine Conroy, widow of
William Conroy, employe of the Department of Public Safety,
Bureau of Fibs, who sustained an occupational disease leading
to his death on May 27, 1962, be paid the sum of $45.00 per
week, payable every four weeks, commencing May 28, 1962, and
continuing during dependency, until the sum of $17,500.00 shall
have been paid, together with $550.00 for funeral expenses in-
curred; that $1125 for compensation from May 28 to and including
November 16, 1962 is now due and payable.
COUNCILMEN
Yeas Nays
Dalglish
Holland
Loss
Mortinson
Peterson
Rosen
10A1 8-82
Cr In Favor
Against
01 % t 1.S51
Adopted by the Council 19—
Approved 19—
Mayor
c -19A - STATE OF MINNESOTA 7
, nbustxi�Y Cummtostan of I mints
STATE OFFICE BUILDING. ST. PAUL
P$' MON AND AGREEMENT FOR
File No. 3108" P *MYNDENCY OOMPENSATION
In the Matter of
- -- ° �illia� C�eoY - - - - - - -- -- - - - - - -- ---, �pbye•
vs.
City Of Saul Paul, • w- de'"_ I, Employer,
fif i�UR and - - -- - -
_ - -_ _ - -- son- —, Insurer.
TO THE INDUffRIAL COIIWIMON OF MMNR8 rA:
The undersignA being the only parties having any interest in for above- entitbd matter, hereby petition
for an award therein, and for that purpose stipulate and agree to the following facets:
That they are subject to the Workmen's Compensaga the above -named
Employe on— _ -?r!Y_ - - - --, 19: 62 sustainedy at or near--
S lat Pwtl —
Minnch arose out of and in the course of his employment with the above -named Employer, who was
then 121'red for liability in such casesX443r; that said injury resulted in the death
of said Employe on_— . My - n 1942; that said Employe at the time of his said injury was
receiving wages of $_ 7T.40 -per week; that the following naw4 persons, and no others, were said
Employe's dependents at the time of his said injury and death:
NAME I DATE OF BIRTH I RELATIONSHIP
Kathe ; - - - - - -- —
1r1uLM IL I_J�! 194
Katia
ADDREN
too F161*9 St. ftel 6
(This paragraph to be used for partial dependency only.) 'lint the above -named parsons were said Em-
pioye's partial dependents, and that at and for a reumabie time pdw to his rid injury his regular average
contributions to them were of the value of >Z
f* 11402 (OVDR)
%lim -afore it is hereby agreed that said dependent X/are entitled to receive, and the Industrial Com-
mission may award, compensation for the injury and death of said Employe at the rate of $45•
per week, beginning on _ may 19 and continuing during dependency, but not
to exceed t2t! - ' , subject to the limitations of the Workmen's Compensation Law of Minnesota,
payable in installments of $ 1".00 at intervals as follows.- 6WWY few 10M>f
to dependent wi 'A ^w on behalf of herself and dependbt children.
together with payment of $_ _.__ ____ ___fin medical and hospital expense and ; ' to apply on
burial expense.
It is further agreed that said dependents shall give proper receipts for each payment made to than here-
under; that this agreement is substantially in accord with the provisions of the Workmen's Compensation
Law, and contains the whole agreement between the parties.
DNted!� _ll-- - -_ --, 19_6
Witnessed by - -- - - - -- -- - --
— -- - -- — Dependents of Deceased Employe. J-
-- - - ---- - - -- -- - -- -- - -- -- -- - -- - -- --
- — CM OF SAlhfi - PAUL -
Employer!TMI�!
lNOTa— Signature of any party signing
by mark must be witnessed by two ss sub- –
scribing witnees.) -
A6f . d6ft CVM66 1� _ -
Br_ - ---- - - - - -- - - For Employer and /or insurer.
AWARD OF COMPENSATION UPON FOREGOING AGREEMENT
The Industrial Commission halving examined the foregoing petition and agreement, and the files and
records herein, and being fully advised in the premises, and it appearing that the facts stated in said petition
are true and that said agreement is in substantial accord with the provisions of the Workmen's Compensa-
tion Law bf Minnesota;
NOW, THEREFORE, IT IS CONSIDERED AND DV RI"'ED, That said dependetC-15- WFare en-
titled to and Ware hereby awarded compensation at the rate of f� • 04 _per week, payable in the manner
and amounts set out in said agreement, together with burial benefits and medical and hospital expenses in
the amounts stated in said agreement.
Dated: St. Paul, Minn.
Nivember 16 t2
/s/ J$mes Pomush
/s/ E. P. Robevts
/s/ A. E. Ramberg
Commissioners.
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