D1804 White — City Clerk CITY O F SAINT PA U E
Pink — Finance Dept.
Canary— Dept.
OFFICE OF THE MAYOR
No:
ADMINISTRATIVE ORDER JAN 2 8 1975
Date:
•
ADMINISTRATIVE ORDER, that pursuant to the Award of the Minnesota
Industrial Commission, dated January 3, 1975, Kalman Govrik,
an employee of the Bureau of Police, be paid from the Workmen' s
Compensation Account of the General Fund, the sum of $8,500.00,
representing approximately 188. 8 weeks of compensation at the
compensation rate of $45.00 per week, subject to the conditions
set forth below; such sum being payable by reason of the injuries
said Kalman Govrik sustained on October 31, 1965; be it
FURTHER GRHPRED, thet out of the aforesaid compensation, 25/ or
$2,125.00 be deducted and paid directly to Robert E. Faricy,
attorney for said Kalman Govrik, in full satisfaction of legal
services rendered and the remaining balance of the aforesaid
compensatz;on, $6,375.00, be paid directly to said Kalman Govrik
in one lump sum without interest deduction and, further, that
the following medical payments be made:
1. Directly to St. Joseph' s Hospital the sum of: $1,974. 72
2. Directly to Blue Cross, reimbursement for
St. Joseph' s Hospital payments, ft sum of: $1,237.69
3. Directly to MII, reimbursement, for sums paid
to the University of Minnesota Hospitals, the
sum of: $ 65.00
4. Directly to Blue Cross, reimbursement sum
paid to U of M Hospitals: $ 42.00
5. To Social Security Administration (medicare
reimbursement for sums paid at U of M Hospitals: $1,240. 61
6. Directly to St. John' s Hospital the sum of: $ 560.63
7. To St. Jospeh' s Hospital for reimbursement
to Social Securtiy Administration: $ 252.50
8. Directly to Richard Tregilgas, M.D. : $ 162.00
APmg;u Approved `� 73
Richard E. Sch roeder
et Director
As istant City Attorney 0 /,J Department Head
By �'1
Date
Adminis rative Assists t to Mayor