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VonDeLinde DARRELI.A.JFNSEN STEVEN G,THORSON )EFFREY S,JOHNSON B�IZABE7H A,SCHADING RUSSELL H,CROWDER JON I'.ERICKSON WLLUAM P.HUEFNER THOMAS(�MA[ANE ��l��!'�Ce.J DOUOLAS J.EHN CFIF.R MICHAELFHUALEY ' � a, Guz & Steffen, Ltd. ���R.RILEY nOU0LA9 0,SAUTER wILL1AM D.S1EC3EL HERMAN L TA1.LB t;;qN � Y TIMOTHY D,ERB CHARL&5 M.SBYKpRA �3 ATTORNEYS AT LAW KAREN K.KUtt'�'tt DANIEL D,CANTPR,�x, f, 400 Northcown Financial Plaza ANOELA M.W06SSNeR HEVERLY K.DOL�E y.�T�E�'`I J��r?� p ADRIP.L B.VLLLARI�fiAL ��MSS o.Ho�'r ' - Z00 Coon Ra ida Boulevard TAMMY J.SCHEMMBL •�onN M,Qunne Mlnneapolis,MN 55433-5894 )OEM.WEARMOUTH *SCpTT MBLEPAK^N (763) 780-85� FAX(763) ?80•�77� SHB4PON M,CLARK 1-800•422•3486 www.bgs,com W�voc�,�a •Alui Llcenea�In Wua�wn �' ' Writer's Direct Line: (763) 783-5137 �/A -�� E-Mail Address: mjakacki@bgs.co»� ;�0,� f January 16,2013 •-���- Bv 1'acsimile(651)266-8574�nd U.S.Ma�l City of St, Paul ATTN: SANDRA, RISK MGMT. 15 West Kellogg Boulevard 310 City Hall St. �'aul,MN 55102 RE; Our Client: Tyler VonDeLinde Our File No. 64068-001 Police Case No. 12-291-362 Date of Loss: 12-12-2012 Dear Sandxa: Please be advised th�t Attotney Russell H. Crowder with this office has bcen retained to represent Tyler VonDeLinde in regard to the collecdon of damages arising from an automobile collision with a City of St, Paul plow truck. This collision was handled by the St. Paul police Department,case no. 12-291-362. Please provide our office with information regazding the investigation into this claim. I have attached copies of the information submitted to you by our client on December 14, 2012. Sincerely, BARNA, ZY STEFFEN, LTD, , �, t f M ` ly . cki Paraleg 1 Enc, Ae fl�EJAA 8mnk,,�� wd�o �z� ��o z �9� ��E r � d 6 0 9 8 0 N (`�•I,•I�r.uln�:75 Yr:v��,I 1�y::�l tirn i:r i � � q�c�iv�o �OS� ZG(o �'o�� pEc � � 2at� � '�''�° NOTICE QF CLAIM FO� e C��a'�a�nt Panl,Minnesota �����V A(fnAe�Dfa Sfa1e StaAW�Q6�05 dhqw fliat"...evtr��pe•rton...who cialme � klpolry...ahAA cmRre fo bepnsenf�ed M fhe lo��d�'41'tAe nuaWC4a/Ny wlthGi 1 d0 drq�4f Pw�he aUegM Ido Jln���(�'r�dl�a eoqlu t�albig t1�e 1irn�plaa.mid clrtwnutancsa rantqf,�nhs anarru o�(ca�yenmMon w oeher nitef deona�ded° Pla�e camplete tA�fo�m In Me eatireq b7 d�'b�7➢�!�1�d�8 7a�r pasa�r to aeb qaeelios. �mot��1� naded,attacb�ddttto�l eheeb. Pleaw avto tMt�oa wW not be coatscted Uy EeltphoAe b alar�eneaeey,to provlde as moc6 mL'ornutbn as�.caeary to e�plaGn�aa�ddm�aM tLe w0000nt af oompeee�don be�eeqaated. You wW i�cehe a vr�lttm qCIcpONledsemmt aa�ce yoar form V e�eed�ed. Tha piocea csa talc!np to ten aeelo�or bayer d�p�odfog�tLe naturo o[�r c�a�. Thie torm aawt bs�Igoed,and botbi p�es completed It eoometWo�das noe sypl�,welh'IV/A'. SEND COMPLETED FORl1�AND OTHER DOCUIV�NT5 TO: CITY CLERK, 1S WEST KELLOGG BLVD,310 CITY HALL,SAINT PAUL,MN SS102 Piret Narne I M�ddle�d�l��st Na�ne 1/cN �.�K.1G Compeqy or B 'neae Neme �� Are You ea Ine�aence Company? Yee 1� If Xes�peim Nurnbar? se�c A,aa� Zo6 7 ..�:,��,, ,� . City Se:.r�' �...1 ,...,`_stam T�p Cod�� '��. n.ytime�wne�j��cen Phone�S�'�Ev�eoang ro�op�c►ae�.,�'__.Z`��v Dau ot A�ocidead In�ury at Date Diecoverod .��Z • lZ. �L T,Ume Z'�� am'�."'� Pkaee atate,ln det�il�whst oxumd(bappened�and why you are aubmitting a claim.Pleeee indicate wby or tlow you feal�GSty o�Sa�Paul ar�employcoe are iavolved ena�or responsib�a for your dan�oa. ,� ..._L� ' Please check cho box(es)taac moec cloeety rep�euc tbe reeson for coompledug thi,,fo�m,: �My vebicle wes dameged in aa aocident O My VO�C�C WBY d0me$ed duilA$8 tdw 0 My vebicl�was Qemaged by e pothole or conQitlon of the moot �1.My vehicle w�e damaeed by a plow �My vehicle was wrongfully oowed and/or dcloettd �I wae ft�urtd on C�ty P�P�Y �I Other type of property dan�ge-ples�se speciPy �Ot�er type°f�nj`tty—pleas°epec�fy ° -E� � Ia order to procese your claim For tbie claime typee liste�below,please be eure to include dte docun�eub indicatod or it wUl delay tl►e 6aodling of your claim. Docuanoa�ts$�.L.�T�.T bo retutaed and becem�a tbe p�oporty of the City, You ate cncotuaged ro keep a copy fo!yourself befom eubmiaiag ywr claim fona �Property d�rnage claima co a vehide:two esdmetea for repaits�q your le if t�e dan�e exceeds SS00.00;�the actual bill�and/or receipts for t4e repalrs �iir�. •ll'��� 1 O Towing c]eima:legible caples of aay delcet ieauod and a copy of the impaiad lot z�eceipe �,I'�t�,lo►�G� r O Other p�ope�cy dsmage elaime:hvo repair esdmatea if d,e dnmage exoceds SS00,00;a actual bills and/or neeipta�oc tho sepurs;detailed lis o�.dema�ed itat� , � ��o+�� P O It�ury clsims:medicel bille,receipts •tl�,sSL 4Ya D�CO�, O P�ocogapha Ata�lways w�lcamoe t� t aad support yow claim but will�ot be returnod. ! Poge�o��—Pleeee campk�e aad nWrn botlt pa�ee ot(5eim Form z �d 6098 '°N wdtio �i� ��oi �9� ���r Feflnre to cmnplete and teturn both pegea�rill reenit in ddp in the handdn�a[your cJ�n. All(aabn�nl� ele�e t�t oecdon Were thare witneaees w tve�ncideat7 o No Unlg►owa (circle) tbeir aemee,pddnasee and aumbera; C�� � .wrC ' �.. ' �''�'�f Were the po�lice or law emfarcAmeat d? �To Udmown (cftck) If yea,what deps�tma�t ur egency? �Ca�e N or mpo�t# (,� � z�j f• 362 Whae�d t�e accid�at a iqj�a�y telae plece7 Provide ett�et,ddr�ess,croes atreet,i�ection,name of park or faciliry, cloeest 1 etc. P9eeee bc s decqiled as po�s e, If �et�ech a d�i ram. G�a; �Q�l ��s.,� .....� C��ti�� — �►�'t , .... Please indicata Ihe amaiu►t you aro eeeldng in compensadon ot what y would]iloe the(�ty co do to tesal,ve tl�is elsim �0 yolt[BAt�.1�ACt{Oq • : � rJ � ' . U�4:•�, L1G� s ' N� !� �� Your vabicle: Year Meke • M � �J ' " � Licenee Numbaz S te Colo: � Ae�isteted Ownes � Driver o�f Vebicle ' Area D -- City Vehicle; Year Make � Model Licenee P1ete Numbec �s Staoa Color Drlva of Vehiclo(City�loyee'e Name) ;••. �'% sL � Aree Dam��ed„ 1 HQw,wore yo iq�ured? �' ' � i .�s� : u� . What (S)OPyvutbody ? � �F I -�o . . . �� �v . . Have you eo �ca]ueatraent? e� No Pla�oaing to Seek Tieatment(circle) W6en did you receive��nent? �� y •'� z vide date(e)) Naac of Medicil Ftovi ): • • ' � e+ � • �. LL• :v � Addt�C98�.r��•11.••. e/ 1 • �, w '�' n�a you��� a�wc o�yo,����� Ye xo 1sy- when 4�a you miee wa�k? ` (provide date(e)) Nan4e oE yout Emplo L,•► ' .. � Addc+es � Telophoae �J. Z z. O Check l�ere If yoni oro Utad� pa+�ges to tlde detio form. N�b�or aaalelonal�gee . Bjr�igiti�g thia forn�,you ars imdng eliat all3�jon�ohton yoa bavs provldsd is tr�e and cotrect�o ths bu� of your�owltdg�. Uiw�gned jori�a wlll not be�roce8s6d Sxbrnitling a falae c�atrri can re�u/t i�r prosecr�io�. Date form aa'compla�ed r L • ��. Za J?..� ,-1 Prin!the Name of the Peroon who Co� e�+� �••� f 5l.6�;, g o`� . N�F Si�notnre d Pe�an MakWg the q�trtt: � ItM�ed Febcuery?Al I . � �d 6098 '�N wdtio �z� ��oz �9� ��p� _ - � . 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'r i a r� l r�� 11'�4���^i`�'vir,�.���?ci i}}�yyi°�ilry��F'�`�k���; , d K"�i`�����'��„��j�flw a"�^�SF�.� dF ' � ��� ��'.F� �';c,�k' � 5 ��. - / � � ���. � (� � � � ���������������� �/ �� � - � V� �i� �. � � 1 — � f*��i I �� • -�. `��, ���!:=�/ – � -.: - - � �� � � �1': ' � I 1 ' Attachment to Notice of Claim Form—'Tyler J,VonDeLinde The reason for my claim against the City of Saint Paul is due to a vehicle accident caused by an employee of tha City of Saint Paul Public Works Depertment on the day of 12-12-12. 1 have suffered from multiple injuries, my dog (who wes in the vehicle) was traumatized and taken to a veterinarian, my vehicle was damaged,and there wa9 damage to personal property caused by the accidant, I was driving home from my parents' houso in Eagan with my dog and got onto White Bear Ave northbound from I-94 east. I was traveling north on White Bear Avenue and approached the intersoction of Case Street. As I entered the intersection, a City of Saint Paul plow truck, coming from the opposite direction, turned directly in front of ine. I had the right of way; the truck driver did not. I locked up the b�akes on my vehicle and skidded epproximately 20 foot before colliding with the front of the plow truck. The light at the intersection was green. l was wearing my seat belt and it was a very hard impact and my head hit tho steering wheel. My dog was thrown forward into the dashboard. The accident happened at approximately 2;50 p.m, I called 91 l and a City Police vehicle arrived on the scene about one minute later. The police officer talked to the ptow truck driver and to a garbage truck driver who witnessed the incident. Those discussions went on for about 10 minutes before the police officer even spoke to mo. While he was talking to the plow truck driver,and one of the witnesses,a pazamedic arrived and esked if I was ok. I to(d him my head and neck huR. I then spoke with the officer end told him what had happened. There were two other witnassas from the vehicle behind me who were telling tha officer what happened. But�the officer did not take a report from them. I then askad the officer if the paramedics were pulling around the bloek to get out of the road or if he could call another Qmbulance. Another ambulance arrived about 5 minutes later and I explained to them how my head,nack,back, and teeth hurt from the impact.They said my adrenaline was wearing off and that I probably he,d whiplash,Thay asked if I needed a ride to the hospital and I asked them what their opinion was. They didn't think an ambulance transport was necessary. They did not offer or make an effort to plaee a brace on my neck. I told them I would get a ride&om my parants when they arrived, My psrents, brother and girlfriand arrived shortly theroaftor and I was driven to Woodwinds hospital in Maplewood. I was admitted as an outpatient in the Emargency Room at Woodwinds at approximately 5:00 p.m. I was examined by an ER physician,x-rays were taken,and I was raleased with a prescription for medications. On 12-13-12 I took my dog to a veterinarian for an evaluation. On the same day I also had my vehicle towed to Doherty's Auto Hody Repair for an estimate of damages. That same efternoon I went to the dentist and had repairs done to my permanent retainer and x-rays of my teeth at the Northwood Dental Clinic in Eagan.On 12-14-2012 i want to a family physician and ophthalmologist at the Woodbury Atlina Clinic for an examination. This report was submitted as an attachment to my Notice of Claim form detivered to the City of Saint Paul,City Clerk on 12-14-2012. 9 �d 6098 �°N wd90�Z1 �IOZ �9l ��pr