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Trudeau, Emily NOTICE OF CLAIM FORM to the City of Saint Paul, Minnesota Minnesota State Statute 466.05 states that “…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 of compensation or other relief demanded.” Please complete this form in its entirety by clearly typing or printing your answers to each question. If you have additional documentation, you may add those documents to your submission. You will not be contacted by telephone unless clarification is needed. The claim process for investigations can take upwards of four (4) weeks. This form must be signed, dated with all applicable sections completed. Submission this completed form to the mailto:Saint%20Paul%20City%20Clerk’s%20OfficeSaint Paul City Clerk’s Office by email (cityclerk@ci.stpaul.mn.us), fax (651-266-8574) or mail addressed to “Saint Paul City Clerk, 15 West Kellogg Blvd., Suite 310, Saint Paul, MN 55102”. Claimant: First Name: Emily___________________________ Last Name: Trudeau________________________________________ Please Indicate Your Pronouns: ☐ She/Her/Hers, ☐ He/Him/His, ☐ They/ Them/Theirs Company or Business Name: Epstein Enterprises LLC ______________________________________________________________ Is this claim being made by an Insurance Company? NO If yes, what is your Claim/File Number? <_________________________ Is this claim being made by an Attorney? NO If yes, what is your File Number? I have consulted with a lawyer.______________ If yes, provide your Insured’s/ Client’s Name: Epstein Enterprises LLC__________________________________________________ </ Street Address: PO Box 18004___________________________________________________________________________________ City: Saint Paul___________________________________ State: MN____________________ Zip Code: 55118 Daytime/Work Phone: 651-307-2038______________________ Cell Phone: 651-210-1343________________________________ Date of Incident or Date Discovered (Must Complete): 10/1/2025 Time: 5:25 AM-9:39 AM________________________ Please state, in detail, what happened that prompted you to file a Notice of Claim Form: A tenant in my rental property had a standoff with police on 10/1 that resulted in windows being broken, the door kicked in, the lock system damaged, cracks to the new siding, and multiple canisters of tear gas dispatched into the apartment. The apartment is now uninhabitable until tear gas remediation takes place. Please state why or how you feel the City of Saint Paul is responsible for your Damages? The police did not make any effort to notify me or my company that they had a search warrant and needed to get into the property. If they had, I would have met them there or provided them with a lockbox code for the lockbox on site so that they could enter the building and apprehend their suspect without causing damage to my property. There is a statute that protects innocent third parties from police damage. In this case, the owner of the building is a third party and not responsible for the behavior that caused the police investigation. Here is the statute: 626.74 COMPENSATION FOR DAMAGE CAUSED BY PEACE OFFICERS IN PERFORMING LAW ENFORCEMENT DUTIES.Subdivision 1.Definitions. As used in this section:(1) "just compensation" means the compensation owed to an innocent third party under the state constitution by a Minnesota local government unit due to property damage caused by a peace officer in the course of executing a search warrant or apprehending a criminal suspect; and (2) "peace officer" has the meaning given in section 626.84.___________________________________ Please check the reason that most closely describes the reason for your submitting a claim. Please note the documents that will need to be provided with your completed form.< Photographs will be accepted. All documents submitted become the property of the City of Saint Paul and shall not be returned.< ☐ Automobile damage from a motor vehicle accident: please provide two estimates for repairs or actual bill that has been paid. ☐ Automobile damage from a street defect or pothole: please provide two estimates for repairs or actual bill that has been paid. ☐ Automobile was towed and may or may not have sustained damage: please provide copy of towing ticket (if available), receipt from Impound Lot, and two estimates for repairs or actual bill that has been paid. ☐ Snow Emergency: please provide copy of towing ticket (if available), receipt from Impound Lot, and two estimates for repairs or actual bill that has been paid. ☒ Property damage: please provide two estimates for repairs or actual bill that has been paid. ☐ You were injured during a motor vehicle accident: please provide police report number, details about injury. ☐ You were injured in the City of Saint Paul: please provide police report number, witnesses, and details about injury. Continue to page 2 of Notice of Claim Form. Failure to complete and return both pages will result in delays. This section must be completed for all claims. Is there a police report for this incident? YES If yes, please provide the police report case number: 25181157___________________________ If yes, what law enforcement agency responded? Saint Paul Police Department__________________________________ Where did the incident take place? Please provide a street address, intersection or name of city park or facility: 41 Atwater St W, Unit 2, Saint Paul, MN 55117_____________________________________________________________________ What would you like to see happen to resolve this claim to your satisfaction? We would like to be reimbursed for the money spent to resecure the property, fix all resulting damage, and remediate the tear gas. _______________________ Were there witnesses to this incident? Please provide names and contact phone numbers: </w:t></w:r></w:sdtContent></w:sdt><w:r w:rsidR="0031571E" w:rsidRPr="00 Yes, the tenants who live downstairs witnessed the standoff. I am not sure if they witnessed the entire event. Alexis Teague 906-352-1327 ____________________________________________________________________________________________________________ For property damage claims, including vehicle accidents. Your vehicle’s information: Year: _________ Make: _________________ Model: __________________ Color: __________________ License Plate #: _________________________ State vehicle is registered in: ___________________________ Registered owner of vehicle: _____________________________ Driver: __________________________________________ Area(s) damaged:______________________________________________________________________________________ If a City vehicle was involved, License Plate #: _________________________________ Color: _______________________________ Was there City insignia on the vehicle? YES / NO Driver’s Name</w: ______________________________________________________ Other property damaged: _______________________________________________________________________________________ For injury claims of any type. What part of your body was injured? _____________________________________________________________________________ Did you go to the emergency room or urgent care? YES / NO Where? ___________________________________________________ Was medical treatment received? YES / NO Where? </________________________________________________________________ First day of medical treatment? _____________ Are you still receiving medical treatment? YES / NO Did you miss any work as result of this incident? YES / NO < Employer(s): _________________________________________________________________________________________________ How much time have you missed from work? _____________________________________________________________________ If you are submitting other documents, please state what you are attaching and how many pages: 7 photos of damages, 1 invoice (paid) for repairs to windows, door, and lock mechanism, bid to repair the siding where the tear gas canisters hit it (not paid yet), and 2 bids for tear gas remediation (not paid yet)____________________ By signing this form, you agree that all information provided is true and correct to the best of your knowledge. Please NOTE that submitting a false or misleading claim can and will result in prosecution under Minnesota Statutes. Name of Person completing form: _____________________________________________________________ < Signature of Person submitting this form: _______________________________________________________ Relationship of person signing to Party making the claim: __________________________________________ Date document is being signed: _____________________ Revised March 2023