Schmidt National Document Center
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Oklahoma City,OK 73126-8994
dai msdocuments @farmc7sinsurance.com
Fax Number: (877)217-1389 N
February 21, 2012 °
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Self Insured N
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310 City Hall �
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Saint Paul,MN 55102 N
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Self Tnsured �
Aitn: Sandra Bodensteiner m
310 Ciry Hall N
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Sa.int Paul,MN 55102
Our Insured: Js►mes Schmidt
Our Claim#: 099 SUB 1018081702-1
Date of Loss: 03/O1/2011
Your Insured: Ciry pf Saint Paul Driver: Officer R.Rantilla
Your Claim#: cc-110329
Tota1 Amount Owed: $727.b9
Dear Sandra Bodensteiner:
We previously received an agreement from your company regarding payment of our subrogation
claim in the amount of$727.69. As of today,we have not received payment.
If you need additional support for our claim,please call me with your FAX number so that the
requested information can be sent to you. If you need anything addicional or woWd like to
discuss this matter further,please call me at 630-9(}7-6933 .
Sincerely,
Illinois Farmers Insurance Company
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Jonathan Allen
Auto Subrogation Representative
630-907-6933
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