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Ledesma RE�EIi�ED MAR 14 2012 NOTICE OF CLAIM FORM to the City 6��u1, Minnesota Minnesota State Stutaue 466.05 stutes that "...every person...who claims damuges from any municipality...shaR cause to be presented to the governing body of the municipality within 180 days after the alleged loss or injury is discoverecl a notice stating the time,place,and circumstunces thereof,and the amount of compensation or other relief demancled." Please complete this form in its entirety by clearly typing or printing your answer to each question If more space is needed,attach additional sheets. Please note that you will not be contacted by telephone to clarify answers,so provide as much information as necessary to explain your claim,and the amount of compensation being requested. You will receive a written acknowledgement once your form is received. The process can take up to ten weeks or longer depending on the nature of your claim. This form must be signed,and both pages completed. If something does not apply,write`N/A'. SEND COMPLETED FORM AND OTHER DOCUMENTS TO: CITY CLERK, 15 WEST KELLOGG BLVD, 310 CITY HALL, SAINT PAUL, MN 55102 First Name �I � �� Middle Initial�Last Name L�!��.� Company or Business Name Are You an Insurance Company? Yes No If Yes,Claim Number? Street Address� � � �,,��A(��1 � S /I�G (�rC�l �� City �Q��.W State 1 r r � Zip Code ,� .S� � Daytime Phone ( �i�)�-�Sd 3 Cell Phone(�)a�" �Evening Telephone(6S�)��f� Date of Accidend Injury or Date Discovered Time�_am/� ,� r �-d f 7-� Please state,in detail, what occurred(happened),and hy you are submitting a claim.Please indicate why or how you feel the City of Saint Paul or its employees are involved and/or responsibl.e for yoar dama es. i ' �riC t� a �c � ZC7 ` u/ S� � S / t � o ��t `(f f2cz cn1�` ` S— Z o -. �'e� r �z i ��}7/{' , /1 Cc " l� S ' r�t /t� .�.. ' i` S YV! Z�1 Z l� � , �a �e Z 2 r .� ti wa.S �/�� '] Ca�' �.�i. a f—a-F�ir✓l�-y� �vt(��u�vV� i rW.Q. w �lQ .�-V�! ,.. c�-�' Please check t�e box(es)that most closely represent the reason for completmg this form: 't,v�(� Q� �at ��'„`�r'', ❑ My vehicle was damaged in an accident ❑ My vehicle was damaged during a tow Cp� , ❑ My vehicle was damaged by a pothole or condition of the street ❑ My vehicle was damaged by a p1owZ� ,�J� �My vehicle was wrongfully towed and/or ticketed ❑ I was injured on City property �� f� ❑ Other type of property damage—please specify � � ❑ Other type of injury—please specify 5' r�'a w a.s a c�.� In order to process your claim you need to include copies of atl applicable documents. p l0� ��,�;.�� For the claims types listed below,please be sure to include the documents indicated or it will delay the handling of�� your claim. Documents WILL NOT be returned and become the property of the City. You are encouraged to keep a V�D t�� copy for yourself before submitting your claim form. �1�CWt✓L� O Property damage claims to a vehicle: two estimates for the repairs to your vehicle if the damage exceeds �� $500.00; or the actual bills and/or receipts for the repairs O Towing claims: legible copies of any ticket issued and a copy of the impound lot receipt ��/ �"�� O Other property damage claims: two repair estimates if the damage exceeds $500.00; or the actual bills J 1�'� ° �5 and/or receipts for the repairs;detailed list of damaged items l.��"� O Injury claims: medical bills,receipts �,�i�� Q S O Photographs are always welcome to document and support your claim but will not be returned. � � ;��.� �C� Page 1 of 2—Please complete and return both pages of Claim Form `�'(,�.�'p� v�1 Q S �� ^ i�, A� �e-�� p t �� . �3 �� (� � �� ,��-�— ��,.✓�;� r s .s ta��- � �� . Cjl►� C.Q. �- tz-� Failure to complete and return both pages will result in delay in the handling of your cl i • C a� All Claims— lease com lete this section �.� U U�'�Q" �a W�%��} U p � �I� Were there witnesses to the incident? Yes N�� Unknown (circle) �ovide th•e;r qames,addresses aqd t le hot�,e numbers: LL��,� N 2 l SO Yl �.l%ti1,�'d ��1'��t '�'��ra� '�Lt�Sl;t� ct.c 47'1 L( il�t( . -°�- �(��(- !6 ._ Were the police or law enfarcement called? Yes No Unknown (circle) � If yes,what department or agency? Case#or report# �� Where did the accident or injury take place? Provide street address,cross street,intersection, name of park or facility, closest landmark,etc. Ple be as detailed asp�ssible. If�neces�,attach a d'a ram�,4_�.�__��. , � �c� ��b � L� � S�l Vvi,vwt�f� '`�1/P. I �4�' -' �r � �� Please indicate the amo t y are seekin in compensation r what you woul like the Cit�do o resolve this claim to your satisfaction. 1°��► � �' � t �— Vehicle Claims— lease com lete this section ❑ check box if this section does not a 1 Your Vehicle: Year Make Model `� `C/ License Plate Number � O C'_- � State �Colo Registered Owner , ` S 1'L Driver of Vehicle 1�� Area Damaged City Vehicle: Year Make Model License Plate Number State Color Driver of Vehicle(City Employee's Name) Area Damaged I� Iniurv Claims—please complete this section ❑ check box if this section does not a�plv How were you injured? What part(s)of your body were injured? Have you sought medical treatment? Yes No Planning to Seek Treatment(circle) When did you receive treatment? (provide date(s)) Name of Medical Provider(s): Address Telephone Did you miss work as a result of your injury? Yes No When did you miss work? (provide date(s)) Name of your Employer: Address Telephone _ �Check here if you are attaching more pages to this claim form. Number of additional pages � By signing this form,you are stating that all information you have provided is true and correct to the best of your knowledge. Unsigned forms will not be processed. Submitting a false claim can result in prosecution. Date form was completed �� / �Z� ��. Print the Name of the Person who Completed this Form: �r I'C Q � � �� fiZ . � Signature of Person Making the Claim: '�f C--� G�_ Revised February 2011 I �i Statement regarding towing on 2/29/2012 A snow emergency was called for St. Paul at 9 p.m. on 2/29/2012. St Paul City website claims that night plow routes will be cleared within 8-12 hours, depending on the amount of snow. I was parked on Summit Ave. (South side; 1600 block) near the corner of Grand and Summit. The Summit Ave. side street, on the morning of 3/1/2012, appeared clean. I was parked there 12 hours after the snow emergency was called. My car was towed later that afternoon (unknown time) while I was at work at Macalester College. If the Summit Ave. side road is a day plow route,there was no way of knowing this. Summit Ave. is clearly marked as a night plow route. There was no indication that the street had not been plowed on 3/1/2012 at 9 a.m. since night plowing is stated to take 8-12 hours. Thank you for your time and consideration of this statement. Sincerely, /rI. II 9/ �� .� �-�J � II�� V � �� Erica L. Ledesma 1600 Grand Ave, Saint Paul,MN 55105 Directions,Location and Ma... http://www.mapquest.com/print?a=app.core.e0d3236fU24fn2f21fa1a172 �C��V�� otes Map of: C Q r� ��,V ��t2�C � 1600 Grand Ave ��,��=r ,��/.2 C Saint Paul, MN 55105-1801 �� /� /� ��.-- ��' � a- tM • ��t �� .-f- r s _ L �-e.�� V�t a�"lGe� � �s �- ��t` ��' �'� ,1� � �� -° �- � ,,., �,r+xrr�,a��-. ... ... _.. _ 5�"'''a'�� '��a ►,�^s�-_ � -� 5ummitAvc— _ l� -� -* � _ . �.-. � . .. ��. i t � t f F ..._. .�� . . . „:.�.. ._.,.. _ .+ Q � L^. � I i� � �` � � � . � � { - � . . i � ��. � �.,,.... �:..� L . .. .. , � t� ( � �, . � � � �� v. � ' . �. r� _ �n_ v_ �� -- � -- --- . _r _ .. : . _ _.,_ ��' � �_._ Gfarxf/#V� __ ____ _ ,. �.� �_ __... __a,. ,. _ � __ __ ,,._ _. _ _ , � , _ � t � tr�q�u� � } � �� r � ; _ . ' "� " 002012 MapQuest �;Portions 002012 N�1Y�'�t�,Intermap�7erms 002011 MapQuest,Inc.Use of directions and maps is subject to the MapQuest Terms of Use.We make no guarantee of the accuracy of their content, road conditions or route usabitity.You assume ali risk of use.�ev.:Te�M�s of,Use 1 of 1 3/13/2012 8:55 AM City of St. Paul,MN-Official Website-Snow Piowing http://stpaul.gov/index.aspx?NID=905 SA I N T PAU L� � �� The most{ivable ciry in America, � �; 4 a�,:�-�-� . � .�. z _ . .-- - . . . , You are here:Home>Govemment>Public Works>Street Maintenance>Snow Plowing Parking fG F �r6`�sl:y .Cin3�J a.��k . Ticket,Towing 8 Storage Fees Select Language Sidewalk Snow Shoveling powered by��le�Trenslate Information Snow Plowing Information ...._ .,.....,, . ......... ................ ............ ................. ... .............. .................... ............. .................. .......... .......... ........ ............ Alleys Friday March 2,2012 Multi-lingual Snow Emergency Today we are out doing pushbacks and pretreating streets with salt ahead of tonights predicted snow. � Information Snow-Related PAQs """""""""""""""""""""�""""""""""""""""""""""""""""""""""' GENERAL INFORMATION FOR SNOW EMERGENCIES � ��' ��'� All snow emergencies start with NighC Plow Routes at 9:00 P.M.on the day of the declared snow �E�l�uu�t �.; emergency. ��G �' �Owing begina on NigM Plow Routes et 9:0�P.M.and continues tlu0uyh the niyht into the mominy until thp.��ow is Rlowed to Espanai• HR14QEi g��. parking is banned on these routes until snow is plowed all the way to the curb '7?Ji�ptOVWog o,p@retion takee 8: �Somali• � ��httiurs to Complete in on the amount of stt +-Night Plow Routes are typically the busy streets--marked with � signs that say"NIGFIT PLOWft -p Us one side of north-south residential streets with signs that say"NIGHT PLOW � ^„�� /}1/� ROUTE THIS SIDE OF STREET." All downtown streets are on the night plow route. �� ' 1 / �� /� ` �ookForthesesiyns: �yn"'� ��c� j..�� a �,� ` ��y�,,`1/1 l �' �� _ � Q ��-_iy-"�1/1 I��.�� tt�,ft1 O � NIGHT p�Q�r p�Q�y ROUTE S�. � ROUTE oFStn�eeT �—�(,_ !� Day Plow Routes begin the following morning. There are no signs on Day Plow Routes. Plowing starts after the night � ��—� routes are plowed,which is typically around 8:00 A.M. Parking is banned on these routes until snow is plowed all the way �� r , � I to the curb. The Day Plow Routes are the east-west residential streets PLUS one side of north-south residential streets--the S ��'�U� � side WITHOUT the plowing signs. There are some exceptions to these rules but they are all well marked. �� The tagging and towing continues for 96 hours after the snow emergency has begun. � t � � For 24-hour Snow Emergency information call(651)266-PLOW(7569)for an up-to-date recording of current snow emergency �nl� l�� conditions or(651)266-9700 to talk to Street Maintenance personnel. �� `� ��"'" Sign Up for Snow Emergency Notification-SnowAlert L �y_ � y If you would iike to get an email notification or text message alert of the next Snow Emergency,sign for SnowA..l.e....rt. _��,�r_ n ��;� L� You can also follow us on �� ,� } r u.s �� I� V 1-� s� _� �� Snow Emergency Brochure "� V V�' �� If you're going acr ss the river,you may want to check Minneaoolis to see if there's a Snow Emergency in effect. C ��:�`� ( � ��` �� Home � Conlact � Trenslate � Site Mao � Accessibilitv � DisabiliN Access � Policies 8 Praclices � Policies 8 Practices � Copvripht Notices � Poweretl by CivicPlus 1 of 1 3/7/2012 8:21 AM U.S. Bank Internet Banking https://www4.usbank.com/internetBanking/RequestRouter?request... ��. GustamerServt�e CarEaet Ue Lorat#ana � Erica L Ledesma � YOUR PROFILE TUeSday,MarCh 13,2012 Your Accounts» • Checking , ,,, � Funds Transfer Account ending in 8832 Make a Payment » Account 8�Card Info Make_.a._Deposit(New} » View Online Statements -��cure,5impfa&Green Cash Advance » ATM and Check Card Overdraft Coveraqe Download Transaction Data ��,11 Download transaction ACCOUM BALANCE � AUAILABLE BALANCE � Online.Statements U data for this account Alerts» $1,507.36 $1,474.22 Bill Pay(Free) CHECK CARD AU7HORIZATIONS $33.14 Mobile Bankinq � Pay Bilis Now �i Request Checking Account Advance � Overdraft Protection-NEW Recent Transactions� Click on column headings to re-sort. Previous�Next MESSAGE.CENTER (3 new) DATE #HECK DESCRIPTION DEPOSIT WITHDRAWAL ACCOUNT >View your messages BALANCE REWARDS CENTER Visa Purchase(Non-pin)Redbox 03/05/12 � $2.57� 3 0 9.13 >View and redeem your *dvd Rentoakbrkterracil rewards 03/05/12 Visa Purchase(Non-pin)Don $27.�5� 3 101.70 SECURITY CENTER Pablo's-50roseville Mn >View or change your 03/05/12 �sa Purchase(Non-pin) $2.00 3 128.85 � Personat ID,Password or Shoreview Parks Shoreview Mn other security cptions 03/02/12 � Visa Purchase(Non-pin)Cub $4.48� 3 130.85 �� Foods Arden Arden Hills Mn CUSTOMER SERVIC__E VIgB PU�t� S�PaUI •, ° - CENTER ``�'.�'lI'��' ,.,ti.,'.a� �. ,w � s . �.�-... ...;�a,�m+,� ,.-�': x�,� ta�.';?v' � ��e,�, au � u� �,�°r�-- >Order checks,maintain Visa Pu�Chase(Non-pin) ' accounts,report issues or get 03/02/12 � Minnesota Youth ��1 -�"i $300.00� 3 4 7.83 � � heip 952-933-2384mn y.,� APPLICATI.ON_CE.NTER. ViSa PUfChase(NOn-pin) < < �� - -- -- 03/02/12 $32.11 3 707.83 � >Apply online for additional Exxonmobil 47shoreview Mn accounts and�oans •03/01/12 1099 Check view • $25.00• 3 739.94 �'� � 03/01/12 Atm Withdrawal Us Bank $40.00 3 764.94 � Special Offers Rosevillroseville Mnus1 >Valuable products for Internet 03/01/12 �sa Purchase(Non-pin) $34.26� 3 804.94 � eanking Customers Rainbow Foods OOshoreview Mn �03l01/12� Visa Purchase(Non-pin) . $43.54• 3 839.20 � E�oconmobil 47shoreview Mn OZ�29��2 Electronic Deposit Mn Dept Of $2g0.00 � 3 882.74 � Deed I �2�29��2 Electronic Deposit Macalester $2 258.80 3 592.74 � � Colle Visa Purchase(Non-pin)Target i� 02/28/12 �OOshoreview Mn $39.43� 1 333.94 � 02/28/12 Visa Purchase(Non-pin) $2.10 1 3$ • 73.37 � Augsburg Collegeminneapolis Mn 02�28��2 Visa Purchase(Non-pin)Rampb . $5.00 1 375.47 � Mplsparkinminneapolis Mn �02/27/12 1097 Check view $89.00• 1 380.47 � 02/27/12 1088 -Electronic Check Scholastic $26.00� 1 469.47 � 02/27/12 �sa Purchase(Non-pin)Target $55.67 1 495.47 � OOshoreview Mn �2�2��2 Visa Purchase(Non-pin) , $16.07- 1 551.14 � Shoreview Exxon Shoreview Mn �2�2��2 Visa Purchase(Non-pin)Redbox $1.29 1 567.21 *dvd Rentoakbrkterracil �02/27/12 Visa Purchase(Non-pin)Shish $7.00� 1 568.50 Mediterranst Paul Mn 1 of 2 3/13/2012 8:52 AM U.S. Bank Internet Banking https://www4.usbank.com/internetBanking/RequestRouter?request... 02/27/12 Visa Purchase(Non-pin) $30.99 1 5$ , 75.50 � Frattallones Grast Paul Mn -02/27/12 Visa Purchase(Non-pin) $1.00� 1 606.49 Shoreview Parks Shoreview Mn 02/27/12 � Deposit view • $1,000.00� • 1 607.49 " •02/24/12 • Visa Purchase(Non-pin) , $44.02� 607.49 � • E�oconmobil 47shoreview Mn 02/24/12 Visa Purchase(Non-pin) $1.60 6$ 51.51 Breadsmith St Pasaint Paul Mn 02/24/12 Electronic Deposit Mn Dept Of $2g0.00 653.11 Deed 02/23/12 �1098 Check view • $25.00 3$ 63.11 �� 02/23/12 Visa Purchase(Non-pin)Cub $36.85 388.11 � Foods Arden Arden Hills Mn Printer-friendly Format Return to Too Previous�Next Recent Statements �' ;� View Online Statements ��'�°6�� If you need transactional history beyond what is available here, check your past statements or Contact Us. Your Accounts� Funds Transfer� Make a Payment� Make a Deposit� Cash Advance Download Transaction Data � Online Statements� Alerts� Bill Pay � Mobile Bankinq MESSAGE CENTER I REWARDS CENTER� SECURITY CENTER I CUSTOMER SERVICE CENTER I APPIICATION CENTER �4OtttJleCtitM SBCtt�Bd RAamt�rt Ft71C Privacy Pledge�Security Standards �2012 U.S.Bancorp USB Column:OBC 9 , 2 of 2 3/13/2012 8:52 AM Move cars! St. Paul calls 9 p.m. snow emergency� The Big Story Blo... http://minnesota.publicradio.org/collections/speciaUcolumns/bigstory... NEWS THE CURRENT Ct_ASSICAL Archive Events Member info Support Shop About us Search MPR I GO I�� ,II�� Wednesday,March 7.2012 Mobile 50°in 7win Cities, Newsletters (nrt�re cifies) RSS Feeds r• � Member Supported•Join Now> Nreatner�epo.t> Podcasts � T'ra9'f'ic Report� r ' y � • ! • � � . � I / i I r <'�iR closes:�itkin,Pine,Carlton,tiL Lcxiis.Lake offices�A4ain�Centr:il Mti rood conditions impro�ing,J1nD(Yf sxys> Move cars! St.Paul calls 9 p.m.snow emergency � ��- _ � �.�r� �. , � � �: rwaea sc�:os�t os FeD�riy aq,4oia bp rant'l�ta ��' ._-�, � / Filed under WeaYher . . . � :,9t.Pa►�city offiaats ltiave deids�^ed a e�ow emergen �artinB 9 P.m.ttr�ight� �y `-� � 4l/ � � . � St Paul Public Works Fonow �� ' , @stpaulpublicw � St.Paul has declared a snow emergency,�2sit stpaul.gov/snow for i � 'I � more information. � 1 ��-� �1 d�'- � � 29 Feb 12 Reply Relweet Favorite l�' �n,,�t�� Plowing begins then on night plow routes and continues into the morning until the snow is plowed to the curb,the city jy�announced^ �.i�h , ,^ it� �� {��(' (/l y � � � Parldng is banned on these routes unHl snow is plowed all the way to the curb.This plowing operation takes 8 to i2 hours to L�omplete depending on the amount off,, �o snow. � I �� "�,'V"�`'�� Night Plow Routes are typically the busy streets--marked with signs that say"TIIGHT PLOW RO171'E"--plus one side of north-south residenrial streets with signs that say"NIGHT PIAW ROU'PE THIS SIDE OF STREET."All downtown streets are on the night plow route. �„ A ,�p p � _ Q Q,-� (�Jll,V'L v:��..... Click here for more information. ,�� ,V� , Recommend Be the first of your fnends to recommend this. C, , ,�-�.� .Add a comment... ..... ..... ...... .. ... ..... ..��. J ��'lrl�� _ _ . _ j e -y` 1 Comment usinq... _: \�C/A /3 s�,�` � � � . �J �� Shannon Watson•Marketing and Membership Coordinator at LifeScience Alley � \ � �� (``'J,�,V`�,/I /�� 1 � � / This is why I pay for an off-street parking space.Seriously.:) U Q-'� `� ` . ....... Repiy•Like•February 29 at 1023am ..... ... ..... ...... A �n 'n .�� `� �t �.'� [.n.. JL- v v f. Facehook wcel p�gn � y��l,/1.r'�,�� SPONSORS � su � '�,(e� r�� ,.,�r r�d ��Kr � St. Paul Police Department for Ramsey District Court RECEIPT f Date/Time: 03/01/2012 23:00 Invoice #: 17083 i Vehicle Plate: 5106CR/MN Payor: OWNER Location Paid: Impound Snow Lot Citation: Amount: 888744992 $ 53.00 Total Amount Paid: $ 53.00 Paid by: CREDIT CARD KEEP THIS COPY FOR YOUR RECORDS Saint Paul Police Impound Lot, 830 Barge Channel Road, Vehicle Release Form Make: 00 HONDA License#: ,10BCR CN: 12047044 Invoice#: 17083 Date/Time Released: 03/01/2012 22:54 Tow Charge: $ 123.95 Released to: TOTO Storage Charge: $ 0.00 Paid by: CREDIT CARD Admin Charge: $ 80.00 Released by: ELISE Tax: (7.625°/a) $ 15.55 I,the undersigned,have recovered the vehicle described above. Subtotal: $ 219.50 I will check the vehicle for damage or any other problems that may have occurred while this vehicle was in the custody of the Service Charge: $ 0.00 `�4 , Saint Paul Police Department. I acknowledge I will report �- `: damage and/or any other problems to the Impound Lot staff Total Charges: $ 219.50 \� L on this form prior to leaving the impound lot. Damage and/or other problem: Police Report made: Yes_No_ IF Yes, CN , If NO, Why? TO PROTECT YOUR RIG TS EP T ANY PROBLEMS/DAMAGE BEFORE LEAVING THE LOT . � , .-' , , � / 5/2000 Signature % �__� , ,