Coppess _ �C��ev��
NOV 1 J 2012
CtT'� ��-���
NOTICE OF CLAIM FORM to the City of Saint Paul, Minnesota
Minnesotu State Stanete 466.05 states tluat "...every person...who claims damages from any municipality...shall cause to be presented to the
governing body of the municipality within 180 days after the alleged loss or injury is discovered a notice stating the time,place,and
circumstances thereof,and the amount ojcompensation or other relief demanded."
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 claun,and the amount of compensation being requested. You will receive a
written aclrnowledgement 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 sfgned,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 •�
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First Name �C�v� _�S Middle Initial � �' ���'' . .� .���
�Last Name� �
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Company or Business Name c � , -s_C' � � �' � � ' �"'� '
Are You an Insurance Company? Yes P�o ff Yes,Claim Number?
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Street Address V����
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City S / ��/ ��� Zip Code � —�C��
�3c��eae�--�---_— Cell Phone(Cc� ��- �', i EvP,,;.,,.•re��r}����---
Date of Accident/Injury or Date Discovered ��/c��<L Time l����./�pm
Please state,in detail,what occurred(happened),and why you are submitting a claim.Please indicate why or how you
feel the City of Saint Paul or its employees are involved and/or responsible for your damages.
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Please check the box(es)that most closely represent the reason for completing this form:
❑ My vehicle was damaged in an accident ❑My vehicle was damaged during a tow
❑My vehicle was damaged by a pothole or condition of the street 0 My vehicle was damaged by a plow
— - -- -f3-My vehicl�vva�wra�fuily towed�dforticketed -- --_� �-@_�-���}-e�.Y�� _ __�- - ,
❑ Other type of property damage–please s 'fy • �� ��'� �'t- -
,�Other type of injury–rlease srecify � i ;— . — ' °� '��'T%'z L►�� c%�-�/f f��
In order to process your claim you need to include copies of all applicable documents.
For the claims types listed below,please be sure to include the documents indicated or it will delay the handling of
your claim. Documents WII.L NOT be returned and b�come the property of the City. You are encouraged to keep a
copy for yourself before submitting your claim form.
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
and/or receipts for the repairs;detailed list of damaged items
O Injury claims: medical bills,receipts
O Photographs are always welcome to document and support your claim but will not be returned.
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Page 1 of Z–Please complete and return both pages of Claim Form
Failure to complete and return both pages will result in delay in the handling of yonr claim.
All Claims-nlease complete this section
Were there witnesses to the incident? �'`-��' No Unl�own (circle)
Provide their names,addresses and te ephone numbers: � � � � ������
,�� �� —�L �,;��J `" `—'�— �" —�!�--�
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Were the police or law enforcement cailed? Yes No Unlmown (circle) �
If yes,what department or agency? " � ' Case#or report# �J
Where did the accident or injury take place? Provide street address,cross street,intersection,name of park or facility,
closest land ark,etc. Please be as detailed as possible. If necessary attach a diagram.
�'/C/,��/�i S i ��'rJ 7Z' l-�¢� ��i�`l.�// s�-�rl S`� /'� , ��1�
Please indicate the amo are seekin in compensa'on or what you would like the City to do to resolve this m� �¢—
to your satisfaction. �. �Z° i���
Vehicle Claims-please comnlete this section ❑chee x if this section does not applv
Your Vehicle: Year Make Model /�
License Plate Number State�Color
Registered Owner -!
Driver of Vehicle � �
Area Damaged '
City Vehicle: Year Iy�e� Model
License Plate�+lumber State Color
Driver.o€Vehicle(City Employee's Name)
�rea Damaged
In'ur Claims- lease com lete this section O check box if this sec 'on d not a 1
How were you i ured? � ��-�'� �rv ` � ' .� ^ '"� C" ' " '
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What part(s)of your body were injured?
Have you sought medical treatment? Yes Planning to Seek Treatment(circle)
When did you receive treatment? - (provide date(s))
Name of Medical Provider(s): "
Address � ���,elephone
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 pag��:�����
���
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. ate form was completed � :�
�', �
Print the Name of the Person who Completed this Fo ��` . S '� 1 - �a �
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Signature of Person Making the Claim: C' -
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Revised February 2011
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"Assist and Advise" Call
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Thursday 10/18/12 @10:56am /
Pla.intiff Holiday Gas Station
1345 Marshall Avenue, St Paul,MN 55104
Defendanr pougla.s J Coppess
SPPD Internal Affairs,
This correspondence is in regard to an inquirp I ma.de and the "paperwork" I received back
from pour department in response to mp complaint in "general" about the group of
officers involved. More s�ecificall�mp complaint is in regards to the actions of
officer Lo ehn. The other FNE cops involved were: Teff, Boone, Murph�, Lesedi,a.nd
BravQ. :
This is a true and accurate description of the events that occurred that day, as I recall them.
On said date and time I had gone into the Holida.y Sta.rion:store located at the
aforemenrioned address. I set down with my portfolio and related work papers on a 1of the
3 high top ta.bles that sit in their l�osk. This area is a bump out" egtension of the front
facade and is located immediaxelp adjacent to the right of the stores front entrance.
I then proceeded to pour myself a 20 ounce cup of coffee. Next I "immecliatelv"
proceeded to the front counter area. to Uav�i I then recognized a clerk named "Victor"
and approached him first to pap. I know this gentleman from being a fairlp regular
customer. As well from time to time I have bumped into him around this local
neighborhood of St Paul. It appeared to me that he was busy (perhaps getting his till ready
to open), so he "waved" me over to another clerk "Evan," who was stationed at the resister
immediately adjacent to the front exit dooL I think this clerk was a new emplopee since I _ _
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"overkill" to say the least It was obvious to me that it was their goal to try to
"intimidate" me. T'hey were putting forth their best concerted effort!
When I first noticed Longbehn "chazg�ng" the front entrance my "Honest to God" first
thoughts that raced through my mind were: (1) Is there.a robbery going on, or{2) They
must to be coming to perha.ps to serve a warrant or arrest like an employee, or someone
else,who was in the store. That's how "serious" this cops demeanor was not including the
overwhetining response ta a "alleged" coffee theft....utterly ridiculous!!
So (Longbehn) comes right over a.n up to me and out of the blue, as I recall, asks me for
mp drivers license. To say the lea.st I was a little more then surprised a.nd totallp clueless as
to what was going on without him even providing a simple explanation of whp he needed
it He was neither courteous nor eaplanatory. Thus, I didn't immed�atelp surrender it
When I asked him why he needed it the officer stated "the manager called and said that
you'd stolen a cup of of their coffee!" For a second there I was speechless! Huh...Say
What??
I then replied, NO I DID NOTtI! He may, at that'time, again asked me for my license.I
don't remember. Regardless...AGAIN I attempted to reiterate my previous sta.tement...."I
didn't do anpthing wrong, and I certainly didn't steal anpthing". At this point the officers
demeanor continued to be sour, dema.nding, angry, and unvvilling to bend. I asked him to
sim�lv �o over to the clerk at the counter to "veri , 'fy' m� stor3r. He refused and continued to
"glare" at me. At this point I started to get upset.......... and 'r�htfullX so. Because by this
time 6 officers ha.d me "cornered." DID I FAIL TO MENTION 6 COPS? Upon beign
wimess to this fact I counted out loud from left to right with mp right index finger 1,2, 3,
4, 5, 6. So why are sig of pou guys here. Is it because "I'm a pretiy big guy or what?" the
reply was something to the effect that it was a "normal" response...ya, sure it wasi
Since there was an "obvious" friction between Longbehn and I.Officer Bra.vo (playing to
role of the good cog}, stepped in aud interjected himself into the conoersation: AGA1N I
sta.ted my innocence in regards to the ma.jor felony accusarion of the 0.42 cent coffee
theft...hey, this is '"serious" stuff here! NOT ONCE did ANY of the officers, as I ha.d
requested; even "feign" a make any feeble attempt to talk to the employee in question. Nor
did any cops attemgt to get the manager to come over to "discuss" what happened and if
she was telling the truth, and justified,in callin�the police. I was under the impression that
making a "false report" to a police officer is a misdemeanor crime. Certaanlp that store
manager DEB, shoutd be charged with this offensei. Tha.t being said I guess the officers felt
it necessary to "hold the line" like a wall of linebackers just in ca:se the accused criminal was
going to trp to bull rush them and make a mad dash for his highly valued freedom�
So fram here I was basically "forced" to hand over my license which I surrendered to
Officer Bravo. At this time Longbehn was more then happy to "quicklp snatch" the license
from Bravo's hand so he could start filling out the "you cant bring pour thieving coffee
`�, �
ass...no Holdiay trespass, for one yea.�" paperwork. He then filled it out and gave it back to
Bravo. I refused to sign thax document The whole
rime Longbehn was unwieldp and menacing in his nature and approach.He continued to
totally transfi� his eyes directlp upon, and "mug me" from his perch at the ne.�ct table over
(approximately 4 feet away).
Bravo then proceeded to read aloud the "charges" against me in regards to the no trespass.
After he ftnished I asked the cops (did i fail to menrion that therre were 6 of them?), their
permission(s� if it was "okap for me to leave now?" After I heard a yes. I got up from my
stooL At no time during this inciden� did I leave my seat,move forward, or make any
threatening movements or gestures towards any of the cops during this hightp important
matter of national securitp.
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This was a very stressful situarion for anp wrongly accused person to have had to be put
subjected too! As I got up l unintentionally let out a sort of sigh,like a stress reducing
"whew".....blowing out a breath of air sort of li.ke......wheeeew..like tha.t,just as I walked
by Longbehn. You know wha.t he did then. He "mimicked" me. Making the same
sound/noise/gesture, as I walked right past him. Then he immediately took up the FIRST
position as the "line of officers" proceeded�to escort me out of the demilitaxized zone.
As I was walking out past the manager l did ma.ke the comrnent to her something to the
effect of "You know I paid for that cup of coffee." Deb did not reply. However as soon as
I got out of the store Longbehn was still direcdy behind me. I guess he just couldn't resist
being a.� asshole to me on my depaxture. So he then states..."see Xou later...buddy!" Can
you believe that I had already been subjected to a very unsettling and stressful situation.
And here was this 20+ pear veteran of the SPPD acting in such a childish and
unprofessional manner. His comment was totally uncalled forl. At this time I did stop for a
brief moment, turn, and address him and the other officers there. I said...."how daxe you
mock me behind my back as I walk out of here. Its cops like YOU that give all cops a bad
name. At least the other officers here have acted in a decent manner!"
None of the officers said anything, or replied to my comments even though it was more
then obvious the� all heard what I had just said. At that moment I turned back around,
proceeded to get into my car, and calmly drove away. I just wanted to let the SPPD Internal
Affaixs dept be fiilly aware that I atso recorded video and audio of this "situaridn"
on my cell phone. Those smartphone apps are just great!. So it would be well advised and
prudent that the officers involved tell the truth the first time when they are questioned as to
the "events" that occurred.
Even now, nearly a month after the fact, I'm very nervous and shaking as I've composed
and written this letter. I think this alone attests to the fact of what an "unsettl'tng" "event"
this was for me.
�
I feel the Saint Paul, MN police department (SPPD) was woefully ne ' ent in their civic
duty and responsibility to me. I'm au honest, ta.x paying, hard wor_kiag, citizen of this
community. One who has no "record" of trouble or run-ins with the law
The actions, and the la.ck thereo� of the SPPD were inappropriate and unprofessional. No
onip were thep negligent in their duties but thep attempted to intimidate me through using
the ta.cric of egcessive force (number of officers present). Longbehn subjected me to
intimida,rion and repeatedly mocked me. This resulted in subjecting me to unnecessaty and
serious levels of stress, anxiety, and anguish;not onlp at that time,but currendp as well.
Thoughts of wha,t happened still continue to upset me. As I've composed this letter I've
been totally nervous, jittery, and shaking!
The officers also used very poor judgment, ha.d improper motives, and failed to even
attempt to verify the authenticity of my claims of innocence. Thev, s��lv di.dn't care. The
only thing the Most Senior cop on the scene,Longbehn was concerned with; was to harass,
intimidate, and embarrass me!. Not only in the view of the public, but in front of the
younger and less experienced officers present I was defazned as well as slandered by both
the SPPD and the management o£ Holiday Sta.rion Stores: It also has had an indirect effect
on my business. I have been a fairly regular customer there and I've had a "routine" of
stopping in 4-5 times per week to work on some of mypaperwork. So much for ti.ying to
relax to a nice hot, and hopefully peaeeful, cup of Joe. Instead this is what.happened to me
and I cant even go back into tha.t store,which is only a '/4 mile from my house, for another
yeari
Douglas J Coppess
1018 Iglehart Ave
St Paul, MN
55104 � -
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Douglas J Coppess '•
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