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					                    AUTOMOBILE LIABILITY
                              &
                AUTOMOBILE PHYSICAL DAMAGE
                   (Damage to Your Vehicles)



Automobile Liability
The JIF will pay for bodily injury and property damage liability claims arising out of
the use of your vehicles in accordance with the coverage described in the Plan of
Risk Management and Coverage Documents provided by the Fund.

Automobile Physical Damage
The JIF will pay for damage to your vehicle as a result of a collision or other
covered event subject to a $1,000 deductible.


Types of losses to be reported on this form:

             Any motor vehicle accident involving an insured vehicle which results
              in bodily injury or property damage to others.

             Damage to any owned vehicle (Automobile Physical Damage).




The purpose of this manual is to highlight the major coverages, limits, sub-limits, and extensions
as afforded through the Joint Insurance Fund. This manual is not a policy of insurance and in no
way modifies, restricts, expands or in any way changes the coverages afforded through the JIF.
For actual coverage determination, reference must be made to applicable coverage documents.



                                                 D:\Docstoc\Working\pdf\d49a48d8-5ab2-48ab-b521-e87f7de38cbe.doc
AUTOMOBILE LIABILITY – Reporting Instructions

                       AUTOMOBILE LIABILITY
                      REPORTING INSTRUCTIONS

1.     You will receive some type of notice of claim from either the claimant or his/her
       attorney. In some instances, the injured party will report the claim by telephone or
       letter, which obviously will not contain sufficient information to meet New Jersey
       State Statute (See Section 9, Tort Claims Notice Procedures). However, you may
       take the information from the injured party and utilize the ACORD Automobile Loss
       Notice (sample attached) to report the claim to our office. Although the ACORD
       Automobile Loss Notice does not contain a sufficient amount of information to
       adhere to New Jersey Statute, we will obtain additional information once we have
       received the claim from you. The information you submit, however, should contain
       the following:
              A.      Name of injured party or party by whom damages are claimed.
              B.      Address and telephone number of above party.
              C.      Social Security Number, if possible.
              D.      Date, time and place of accident.
              E.      Brief facts of accident.
              F.      Extent of injuries/damages.
              G.      Witnesses, if any.
2.     Once you have obtained the above information, please utilize the Claim Transmittal
       Form (sample attached), which will be completed by your office. You will note that
       the Transmittal Form includes information as to which department was involved, the
       name of the claimant, the date of loss and the date you are transmitting the
       information to us. Information also includes whether this is a new claim or
       additional information being forwarded to us on an existing claim.
3.     Once we have received this information, we will assign an adjuster and an
       Acknowledgement Letter will be forwarded to you. The Acknowledgement will
       indicate the adjuster assigned, as well as our claim number, which you will use when
       transmitting additional documents to us if they are received by your office.
4.     It is important that you forward any official reports you may have completed with
       reference to the incident. Please do not hold up the claim until the official reports
       are completed, but you should forward the reports to us once they are received in
       your office.

REFER ALL SUBSEQUENT CORRESPONDENCE AND INQUIRIES BY CLAIMANTS
OR THEIR ATTORNEYS TO SCIBAL FOR HANDLING.
AUTOMOBILE LIABILITY – Reporting Instructions



                 AUTOMOBILE PHYSICAL DAMAGE
                   REPORTING INSTRUCTIONS
                                 (Damage to your Vehicles)


1.     Please complete ACORD Form (Automobile Loss Notice) to report any
       damage to your vehicles. Please advise on the Loss Notice what type of
       physical damage is involved, i.e. collision, fire, theft, etc. (sample attached).
       Be sure to identify a contact person with the authority to make decisions
       and who knows where the vehicle can be seen.
2.     Complete the Claim Transmittal Form, which will advise us as to the claim
       type, the date of loss, etc. Again, this should be attached to the ACORD Loss
       Notice when forwarding it to our office. This will also tell us whether this is
       a new report or additional information on an existing claim.
3.     Immediately forward (fax or mail) completed forms to our office for
       continued handling. (Attach a copy of the repair estimate, if available.)




In the event of a serious loss, please contact your Scibal representative by
telephone to report the claim so that an adjustment can commence immediately.
However, we ask that you follow up with a written notice for further documentation.



NOTE:
There is a $1,000.00 deductible for losses of this type. If information available to you
indicates that the damages are less than that amount, there is no need to report the claim
to us. If other injuries or damages have occurred, however, the claim should be
immediately reported.
AUTOMOBILE LIABILITY – Helpful Hints



                              HELPFUL HINTS

Below are some helpful hints that will assist you in processing your automobile
loss claims.
             If attorney letter (see attached sample) is first notice of claim you
              receive, fill in the ACORD Notice with as much information as you
              know about the loss. Attach a copy of the attorney letter to the
              ACORD Notice and immediately fax or mail to Scibal.

             Be sure to keep a copy of all information you send to Scibal.



             Identify the location of the damaged vehicle if it has been moved.



             Always do what is necessary to maintain a safe environment and
              mitigate further loss to damaged property until repairs can be
              completed.



             If you have a motor vehicle accident and there are injuries to an insured
              employee, be sure that separate workers compensation paper work is
              filed for the loss.



             Identify a contact person with authority to make decisions on your
              behalf.
AUTOMOBILE LIABILITY – Common Errors



                          COMMON ERRORS


These are some common errors that people make when completing Automobile Loss
Notices.



            No date of loss on the paper work.

            No vehicle information (insured vehicle).



            Location of damaged vehicle not disclosed.



            No description of the type of damage.



            No enclosure of prepared estimates (when available).



            Placing insured vehicle information under the “Property Damaged”
             portion of the claim form. “Property Damaged” is for damage to
             property other than your own property or vehicle.



            Failure to identify a contact person with telephone number at
             member municipality with authority to make decisions regarding
             the vehicle.
AUTOMOBILE LIABILITY – Sample Claim Transmittal Form


                   CLAIM TRANSMITTAL FORM
              TO:                                Scibal Associates, Inc.
                                                 P.O. Box 500
                                                 Somers Point, NJ 08244-0500
              PHONE:                             609-653-8400
              FAX:                               609-926-9270

              FROM:                              Claims Coordinator
                                                 Borough of Sunnytowne

              PHONE:                             609-555-1234
              FAX:                               609-555-5678
              TODAY’S DATE:                      7/22/02
This is a:             New Claim
                       Additional Information on Existing Claim



                                                                                         S
                                       Claim Number, if known
Date of Loss:  7/21/02
Claimant Name: Borough of Sunnytowne
Claim Type:    Auto Liability                                   Auto Physical Damage
                       General Liability
                       Workers’ Compensation
              Department:
                                                                 Property

                                                                NCCI Code:
                                                                                         A
                                                                                         M
                    Street Maintenance                                  5509
                    Water Department                                    7520
                    Electric Department                                 7539
                    Sewage Disposal                                     7580



                                                                                         P
                    Paid Fire Department                                7711
                    Paid First Sid/Rescue Squad                         7715
                   Police                                              7720
                    Crossing Guards                                     7727
                    Off Duty Police                                     7728


                                                                                         L
                    Clerical                                            8810
                    Library                                             8838
                    Buildings Department                                9015
                    Lifeguards                                          9053



                                                                                         E
                    Parks Department                                    9102
                    Street Cleaning                                     9402
                    Garbage Collection                                  9403
                    Municipal Employees NOC                             9410
                    Volunteer First Aid/Rescue Squad                    9420
                    Volunteer Firefighter                               9430

Always complete this form whenever transmitting claim information to Scibal Associates
AUTOMOBILE LIABILITY – Sample ACORD Form


ACORD                        AUTOMOBILE LOSS NOTICE                                                                                                           DATE (mm/dd/yy)
                                                                                                                                                              7/22/02
PRODUCER                                                    PRODUCER PHONE (A/C. No., Ext.)                              MISCELLANEOUS INFORMATION (Site & Location Code)
            SCIBAL ASSOCIATES
            PO BOX 500                                      COMPANY                                                      POLICY NUMBER                                    CAT.#
            SOMERS POINT, NJ 08244-0500                                                                                   SELF-INSURED
                                               POLICY EFF. DATE (MM/DD/YY)          POLICY EXP. DATE (MM/DD/YY)                  DATE (MM/DD/YY) & TIME OF LOSS           PREVIOUSLY
CODE                   SUB CODE                                                                                                                                            REPORTED
                                                            1/1/02                                 12/31/02                         7/21/02          6:00       A.M.                YES
                                                                                                                                                                P.M.            X    NO


INSURED
NAME AND ADDRESS                                            INSURED’S RESIDENCE PHONE (A/C.No)                           INSUREDS BUSINESS PHONE (A/C. No., Ext.)
                                                                                                                         *       555-1234         x12
            SCIBAL ASSOCIATES                               PERSON TO CONTACT                                                                     WHERE TO CONTACT
            123 STATE STREET
            SUNNYTOWNE, NJ 08000                            JAIME C. COORDINATOR                                                                  WHEN

                                                            CONTACT’S RESIDENCE PHONE (A/C.No)                           CONTACT’S BUSINESS PHONE (A/C. No., Ext.)
                                                                                                                         *       555-1234         x12
LOSS
LOCATION OF ACCIDENT                                                                              POLICE OR FIRE DEPARTMENT TO WHICH REPORTED              VIOLATIONS/CITATIONS

  SE Corner of Elm Street and Maple Avenue                                                        Sunnytowne Police Department                             94-1234

  DESCRIPTION OF ACCIDENT




                                                                                                                                                            S
  OV was stopped at red light and insured vehicle slid on ice and rear-ended other vehicle


POLICY INFORMATION
BODILY INJURY       PROPERTY DAMAGE            SINGLE LIMIT         MED.PAY         OTC DED.                OTHER COVERAGES AND DEDUCTIBLES (UM, no-fault, towing, etc.)



LOSS PAYEE


INSURED VEHICLE
 NO. YEAR, MAKE, MODEL

10     98    Chev. Caprice
                                                                       V.I.N. (Vehicle identification)

                                                                       55052
                                                                                    COLLISION DED.



                                                                                                                                                  PLATE NO.

                                                                                                                                                  MG 6324
                                                                                                                                                            A
                                                                                                                                                            M
OWNER’S NAME AND ADDRESS                                                                                                                          PHONE (AC, no., ext.)

Sunnytowne Borough                                                                                                                                555-1234
DRIVER’S NAME AND ADDRESS (Check if same as owner)                                                          RESIDENCE PHONE (AC, no.)             BUSINESS PHONE (AC, no., ext)

Sgt. G. Hart                                                                                                                                      555-1111




                                                                                                                                                            P
RELATION TO INSURED (Employee, family, etc.)                DATE OF BIRTH           DRIVER’S LICENSE NUMBER                      PURPOSE OF USE         USED WITH PERMISSION

Employee                                                    4/2/58                  118642 15000 94682                           Patrol Unit               X   YES     X     NO
DESCRIBE DAMAGE                                             ESTIMATE AMOUNT         WHERE CAN VEHICLE BE SEEN?                         WHEN?      OTHER INSURANCE ON VEHICLE

Front End Damage                                            $2,000+                 A & B Auto, 300 Madison Ave., Sunnytowne                             555-3434
PROPERTY DAMAGED (Other Vehicle)



                                                                                                                                                            L
DESCRIBE PROPERTY (If auto, year, make, model, plate no.)                                         OTHER VEH/PROP. INS?           COMPANY OR AGENCY NAME & POLICY NO.

93 Toyota Camry                2TL438                                                             X      YES        NO           State Farm,        P346289SK056
OWNER’S NAME AND ADDRESS                                                                                    BUSINESS PHONE (AC, no., ext.)        RESIDENCE PHONE (AC, no.)

Judy Wright, 14 Waverly Way, Sunnytowne, NJ 08000                                                                                                 555-6438
OWNER’S NAME AND ADDRESS                                                                                    BUSINESS PHONE (AC, no., ext.)        RESIDENCE PHONE (AC, no.)


DESCRIBE DAMAGE

Rear Damage
INJURED
                       NAME & ADDRESS
                                                            ESTIMATE AMOUNT

                                                            Unknown
                                                                                    WHERE CAN VEHICLE BE SEEN?                         WHEN?

                                                                                    Driven away from scene by claimant - contact Mrs. Wright


                                                                       PHONE (A/C. No.)                          PED.
                                                                                                                             INS OTHER
                                                                                                                             VEH. VEH. AGE
                                                                                                                                                            E
                                                                                                                                                  OTHER INSURANCE ON VEHICLE




                                                                                                                                                              EXTENT OF INJURY

Sgt. G. Hart                                                                                                                 x             35                 Back/neck
Judy Wright                                                                                                                        x       28                 Back Injury
REMARKS

REPORTED BY                                                            REPORTED TO                                       SIGNATURE OF PRODUCER INSURED
       Officer C. Hart                                                        Police Chief Smith

ACORD 1 (2/88)                                                                                                                                       ACORD CORPORATION 1988
AUTOMOBILE PHYSICAL DAMAGE – Sample Claim Transmittal Form


                  CLAIM TRANSMITTAL FORM
             TO:                                Scibal Associates, Inc.
                                                P.O. Box 500
                                                Somers Point, NJ 08244-0500
             PHONE:                             609-653-8400
             FAX:                               609-926-9270

             FROM:                              Claims Coordinator
                                                Borough of Sunnytowne

             PHONE:                             609-555-1234
             FAX:                               609-555-5678
             TODAY’S DATE:                      11/22/02
This is a:            New Claim
                      Additional Information on Existing Claim



                                                                                        S
                                      Claim Number, if known
Date of Loss:  11/21/02
Claimant Name: Borough of Sunnytowne
Claim Type:    Auto Liability                                  Auto Physical Damage
                      General Liability
                      Workers’ Compensation
             Department:
                                                                Property

                                                               NCCI Code:
                                                                                        A
                                                                                        M
                   Street Maintenance                                  5509
                   Water Department                                    7520
                   Electric Department                                 7539
                   Sewage Disposal                                     7580



                                                                                        P
                   Paid Fire Department                                7711
                   Paid First Sid/Rescue Squad                         7715
                  Police                                              7720
                   Crossing Guards                                     7727
                   Off Duty Police                                     7728


                                                                                        L
                   Clerical                                            8810
                   Library                                             8838
                   Buildings Department                                9015
                   Lifeguards                                          9053



                                                                                        E
                   Parks Department                                    9102
                   Street Cleaning                                     9402
                   Garbage Collection                                  9403
                   Municipal Employees NOC                             9410
                   Volunteer First Aid/Rescue Squad                    9420
                   Volunteer Firefighter                               9430

Always complete this form whenever transmitting claim information to Scibal Associates
AUTOMOBILE PHYSICAL DAMAGE – Sample ACORD Form


ACORD                        AUTOMOBILE LOSS NOTICE                                                                                                           DATE (mm/dd/yy)
                                                                                                                                                              11/22/02
PRODUCER                                                    PRODUCER PHONE (A/C. No., Ext.)                              MISCELLANEOUS INFORMATION (Site & Location Code)
            SCIBAL ASSOCIATES
            PO BOX 500                                      COMPANY                                                      POLICY NUMBER                                    CAT.#
            SOMERS POINT, NJ 08244-0500                                                                                   SELF-INSURED
                                               POLICY EFF. DATE (MM/DD/YY)          POLICY EXP. DATE (MM/DD/YY)                  DATE (MM/DD/YY) & TIME OF LOSS           PREVIOUSLY
CODE                   SUB CODE                                                                                                                                            REPORTED
                                                            1/1/02                                 12/31/02                       11/21/02           11:00 A.M.                     YES
                                                                                                                                                                P.M.            X    NO


INSURED
NAME AND ADDRESS                                            INSURED’S RESIDENCE PHONE (A/C.No)                           INSUREDS BUSINESS PHONE (A/C. No., Ext.)
                                                                                                                         *       555-1234         x12
            SCIBAL ASSOCIATES                               PERSON TO CONTACT                                                                     WHERE TO CONTACT
            123 STATE STREET
            SUNNYTOWNE, NJ 08000                            JAIME C. COORDINATOR                                                                  WHEN

                                                            CONTACT’S RESIDENCE PHONE (A/C.No)                           CONTACT’S BUSINESS PHONE (A/C. No., Ext.)
                                                                                                                         *       555-1234         x12
LOSS
LOCATION OF ACCIDENT                                                                              POLICE OR FIRE DEPARTMENT TO WHICH REPORTED              VIOLATIONS/CITATIONS

  NE Corner of Main Street and Union Avenue                                                       Sunnytowne Police Department                             94-1234

  DESCRIPTION OF ACCIDENT




                                                                                                                                                            S
  Insured Vehicle slid on ice and struck tree


POLICY INFORMATION
BODILY INJURY       PROPERTY DAMAGE            SINGLE LIMIT         MED.PAY         OTC DED.                OTHER COVERAGES AND DEDUCTIBLES (UM, no-fault, towing, etc.)



LOSS PAYEE


INSURED VEHICLE
 NO. YEAR, MAKE, MODEL

10     98    Chev. Caprice
                                                                       V.I.N. (Vehicle identification)

                                                                       55052
                                                                                    COLLISION DED.



                                                                                                                                                  PLATE NO.

                                                                                                                                                  MG 6324
                                                                                                                                                            A
                                                                                                                                                            M
OWNER’S NAME AND ADDRESS                                                                                                                          PHONE (AC, no., ext.)

Sunnytowne Borough                                                                                                                                555-1234
DRIVER’S NAME AND ADDRESS (Check if same as owner)                                                          RESIDENCE PHONE (AC, no.)             BUSINESS PHONE (AC, no., ext)

Sgt. G. Hart                                                                                                                                      555-1111




                                                                                                                                                            P
RELATION TO INSURED (Employee, family, etc.)                DATE OF BIRTH           DRIVER’S LICENSE NUMBER                      PURPOSE OF USE         USED WITH PERMISSION

Employee                                                    4/2/58                  118642 15000 94682                           Patrol Unit               X   YES     X     NO
DESCRIBE DAMAGE                                             ESTIMATE AMOUNT         WHERE CAN VEHICLE BE SEEN?                         WHEN?      OTHER INSURANCE ON VEHICLE

Front End Damage                                            $2,000+                 A & B Auto, 300 Madison Ave., Sunnytowne                             555-3434
PROPERTY DAMAGED (Other Vehicle)



                                                                                                                                                            L
DESCRIBE PROPERTY (If auto, year, make, model, plate no.)                                         OTHER VEH/PROP. INS?           COMPANY OR AGENCY NAME & POLICY NO.

86 Toyota Camry                2TL438                                                             X      YES        NO           State Farm,        P346289SK056
OWNER’S NAME AND ADDRESS                                                                                    BUSINESS PHONE (AC, no., ext.)        RESIDENCE PHONE (AC, no.)

Judy Wright, 14 Waverly Way, Sunnytowne, NJ 08000                                                                                                 555-6438
OWNER’S NAME AND ADDRESS                                                                                    BUSINESS PHONE (AC, no., ext.)        RESIDENCE PHONE (AC, no.)


DESCRIBE DAMAGE

Rear Damage
INJURED
                       NAME & ADDRESS
                                                            ESTIMATE AMOUNT

                                                            Unknown
                                                                                    WHERE CAN VEHICLE BE SEEN?                         WHEN?

                                                                                    Driven away from scene by claimant - contact Mrs. Wright


                                                                       PHONE (A/C. No.)                          PED.
                                                                                                                             INS OTHER
                                                                                                                             VEH. VEH. AGE
                                                                                                                                                            E
                                                                                                                                                  OTHER INSURANCE ON VEHICLE




                                                                                                                                                              EXTENT OF INJURY

Sgt. G. Hart                                                                                                                 x             35                 Back/neck
Judy Wright                                                                                                                        x       28                 Back Injury
REMARKS

REPORTED BY                                                            REPORTED TO                                       SIGNATURE OF PRODUCER INSURED
       Officer C. Hart                                                        Police Chief Smith

ACORD 1 (2/88)                                                                                                                                       ACORD CORPORATION 1988
   AUTOMOBILE LIABILITY – Accident Investigation


         AUTOMOBILE ACCIDENT INVESTIGATION

   Accident investigation is more than filling out the proper forms, as important as they are.
   It is a system of collecting and documenting factual evidence.
   The accident investigation itself is prefaced by the training of drivers in the correct
   conduct to assume at the scene of an accident, and the following procedures: notifying
   the authorities and the municipality, obtaining witness statements, marking the accident
   site, protecting the vehicle and its cargo, and yes, doing the necessary paperwork.
   For the safety specialist, accident investigation is all this, and more: accurate field
   investigation; evidence gathering; witness statement recording; site and vehicle
   diagramming; and training, interviewing, and retraining drivers.

   Driver Conduct at the Scene of an Accident
   If involved in an accident, the driver must do a number of things immediately, because
   he/she is usually the only representative of the municipality there at the time. Because
   this is so important, all drivers should be trained in the correct procedure to follow in the
   event of an accident.
   Experts generally agree on the things to be done at the scene of an accident:
   FIRST:
         Stop immediately and determine damage. Avoid obstructing traffic if possible.
         Place emergency reflectors, flares, lanterns or flags.
         Aid the injured and see to it that they receive medical attention as soon as possible
         Report the accident to the police and to your supervisor
   SECOND:
         Obtain names, telephone numbers and addresses of witnesses
         Record information at the scene of the accident
              Name, address, telephone of driver(s) and passengers
              Name, address, telephone of vehicle owner(s)
              Year, make, model, license number and state of other vehicle(s)
              Draw a diagram of the accident scene

   IMPORTANT:
       Make no statement to anyone except:
              An officer of the law.
              A representative from your municipality.
              A representative from the JIF claims office.


Make no admission of liability. Make no settlements. Do not argue about the accident.
AUTOMOBILE LIABILITY – Accident Investigation


                   INCIDENT INVESTIGATIONS

                  (Other than Workers Compensation)
Accidents don’t just happen; they are caused. After incidents or accidents
involving employees, injuries or property damage, someone in authority should
investigate to determine what happened. All accidents, including those occurring
to volunteers or citizens, should be investigated by the supervisor responsible for
the area in which the incident occurred. “Near misses” are accidents also, and
even if they do not cause injury or damage, they should be investigated as
thoroughly as an accident that results in injury or property damage. We have
developed a Supervisor’s Incident Investigation Report form which you can use to
investigate accidents. Attach a copy to your Scibal claims transmittal and forward
copies to your Safety Coordinator and the JIF Safety Director (Commerce National
Risk Control Services). The Incident Investigation Report can be reproduced in
your office or additional supplies can be ordered from the Fund Administrator, the
Fund Safety Director, or the Claims Administrator.

Remember:       The purpose of investigating accidents is not to
determine who was at fault, but to determine the cause so that
similar accidents can be prevented in the future.
When an employee is involved in an accident or causes any damage, the
supervisor or someone in authority should make a detailed report about the
incident and should document what happened. Too often, supervisors and
managers focus on a symptom of the problem, such as frequent accidents or
employee injuries, when the actual problem may be a failure to perform proper
inspections for hazards, supervise employees, provide proper instructions and
training, or enforce work rules.

Investigations provide:
    Documentation that can be used in analyzing whether claims are justified.
    A basis for understanding what causes an incident--whether or not a loss
      occurred.
    Clues to determine what the actual problem is.
    Formation of actions that can be take to address the problem.
    Information on incidents and losses that help identify trends and potential
      losses.
AUTOMOBILE LIABILITY – Accident Investigation



After acquiring necessary medical aid for injured persons, supervisors should
follow these steps for investigating accidents:
    If possible, ask the person or persons involved to describe what happened.
     Do not fix blame or find fault; just get the facts.
    Survey the accident scene for information. Collect any objects that might
     have contributed to the accident.
    Determine if there were any witnesses to the accident and get their accounts
     of the incident.
    Take whatever steps are necessary to prevent recurrences until the condition
     can be permanently corrected.
    Complete an Incident Investigation Form.
    If the police were called, attach a copy of the police report to the Incident
     Investigation Form. This is most common for vehicle accidents.

Most accidents occur because of a combination of an unsafe act and an unsafe
physical condition. Look for both, and then draw a conclusion as to why the
unsafe act was committed or why the condition existed.

Once an accident occurs, immediate action must be taken to prevent a recurrence.
Indicate what needs to be done and who is going to do it.
AUTOMOBILE LIABILITY – Sample Claim Transmittal Form


                   CLAIM TRANSMITTAL FORM
              TO:                                Scibal Associates, Inc.
                                                 P.O. Box 500
                                                 Somers Point, NJ 08244-0500
              PHONE:                             609-653-8400
              FAX:                               609-926-9270

              FROM:                              Claims Coordinator
                                                 Borough of Sunnytowne

              PHONE:                             609-555-1234
              FAX:                               609-555-5678
              TODAY’S DATE:                      10/2/02
This is a:             New Claim
                      Additional Information on Existing Claim



                                                                                         S
                                       Claim Number, if known
Date of Loss:  7/21/02
Claimant Name: Borough of Sunnytowne
Claim Type:    Auto Liability                                   Auto Physical Damage
                       General Liability
                       Workers’ Compensation
              Department:
                                                                 Property

                                                                NCCI Code:
                                                                                         A
                                                                                         M
                    Street Maintenance                                  5509
                    Water Department                                    7520
                    Electric Department                                 7539
                    Sewage Disposal                                     7580



                                                                                         P
                    Paid Fire Department                                7711
                    Paid First Sid/Rescue Squad                         7715
                   Police                                              7720
                    Crossing Guards                                     7727
                    Off Duty Police                                     7728


                                                                                         L
                    Clerical                                            8810
                    Library                                             8838
                    Buildings Department                                9015
                    Lifeguards                                          9053



                                                                                         E
                    Parks Department                                    9102
                    Street Cleaning                                     9402
                    Garbage Collection                                  9403
                    Municipal Employees NOC                             9410
                    Volunteer First Aid/Rescue Squad                    9420
                    Volunteer Firefighter                               9430

Always complete this form whenever transmitting claim information to Scibal Associates
DUIE, FLEECUM & HOWE
                         Attorneys at Law
                     Nole Casio Sub Nostrum Est!
                          (No Case is Beneath Us!)




September 30, 2002


Borough of Sunnytowne                                Certified - Return
Receipt Requested
123 State Street
Sunnytowne, New Jersey      08000

Attn:      Borough Clerk


Re:   Sue Mieh v Borough of Sunnytowne
      Date of Accident:   July 21, 2002
      Place of Accident: State Highway 11 and Gypsy Lane


Dear Sir/Madam:

Please be advised that as a result of our client’s collision
with your police car my client has suffered damages. These
arise out of the negligent operation of your vehicle.

Kindly forward this letter to your insurance carrier and
have them contact me immediately. If you are not insured,
you should have your attorney contact me immediately.


Sincerely,




Huey Duie, Esquire

cc:   I. Fleecum, Esquire
      N. Howe, Esquire

				
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