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HomeMy WebLinkAbout02-04-2004MINUTES OF THE BOARD OF PUBLIC WORKS AND SAFETY OF THE CITY OF JEFFERSONVILLE, INDIANA FEBRUARY 4, 2004 Mayor Waiz called the meeting to order at 9:30 a.m. and on call of the r011 those members present were: City Engineer Miller and Councilperson Sellers. Also present were: Wastewater Treatment Employee Wright, Administrator Rich Davis, Fire Chief Miles, Building Commissioner Seagraves, Vehicle Maintenance Director Drury, Street Commissioner Ellis, Planning and Zoning Director Padgett, Police Chief Ashabrarmer, Personnel Director Calabro, Redevelopment Director Becket, Asst. Police Chief Lovan, Youth Coordinator Knight, City Attorney Merkley, Parks Director Poff, and Deputy Clerk Lynne Mayfield. Engineer Miller made the motion to approve the payroll as presented, seconded by Councilperson Sellers and carried unanimously. HANDICAPPED PARKING Inspector Steve Hardin told the Board that Thelma Lovans of 719 Meigs Avenue is requesting handicapped parking sign in front of her house. The police department will look at the location and report back to the Board. POLICE SIGNS Assistant Police Chief Lovan said addi~tional Signs need to be posted on Meigs Avenue for police officer parking. The signs will be marked "Police Uniform Division". Police Chief Ashabrarmer said he is working with the Greater Clark County Schools on acquiring additional parking. PERSONNEL MATTER Fire Chief Miles asked the Board to approve promoting Dennis Dierking from Lieutenant to Captain. Engineer Miller made the motion to approve the promotion, seconded by Councilperson Sellers and carried unanimously. STREET CLOSURE Engineer Miller made the motion to close Penn Street between Ninth and Tenth Streets sometime in March approximately two days for grade work, seconded by Councilperson Sellers and carried unanimously. PLAN COMMISSION APPOINTMENT Conncilperson Sellers made the motion to approve appointing Dennis Dierking to the Plan Commission, seconded by Engineer Miller and carried unanimously. CITATION Building Commissioner Seagraves said he received a complaint on 12-22-03 on Marilyn Werblo of 1502 Nina Road for open storage and garbage on her property. A citation was sent to her by certified letter, which was not picked up, and by registered letter, which was returned. Building Commissioner Seagraves asked what could be done next. Engineer Miller said she can be fined or the Street Department can clean it up and bill her property taxes. City Attorney Merkley said she would need to be notified again to appear before the Board. Mayor Waiz asked that it be done as quickly as possible. WATER MAIN BREAK Street Commissioner Ellis said a water main broke on Spring Street Tuesday night north of Magnolia Avenue. That portion of Spring Street will be closed Wednesday. Some concrete broke up as a result of the water main break. NEXTEL CONTRACT Street Commissioner Ellis asked the status of getting phone service from Nextel. The Nextel representative was present to answer any questions. The Police and Fire Departments use Nextel and are pleased with the service. GREEN MACHINE Street Commissioner Ellis said people would be coming on 3-3-04 at 10:00 a.m. to demonstrate the sweeper called the Green Machine. DEPARTMENT HEAD MEETING Animal Shelter Director Wilder said the shelter would be open on Saturdays from 8 a.m. to 4 p.m. starting in March. Street Commissioner Ellis said he doesn't have any CDL drivers to lend to EMC. He said his driver's could only drive 10 hours. Mayor Waiz said that EMC should have one of their employees get their Class A CDL license. Councilperson Sellers said that when we got the snow almost two weeks ago that the Meadow's Subdivision was not cleared by the Street Department. She took pictures of several surrounding subdivisions and they looked pretty clear. Street Commissioner Ellis said the snow plows have rubber blades that just slide over ice, which was under the snow. He said he concentrated mostly on the main roadways. Councilperson Sellers said her streets had never looked this way before. Personnel Director Calabro passed out new workman's compensation forms for Department Heads. Personnel Director Calabro said she has ordered a training video from Midwest Toxicology for the Street Department. She said they have not been trained properly. ~'iPersonnel Director Calabro said she would be going over job descriptions with the Police and Fire Departments. Personnel Director Calabro reported that the Dare To Care boxes are here. She will be collecting the donations to turn in. Vehicle Maintenance Director Drury asked if there would be an auction in April. Mayor Waiz said there would be. There was discussion on possibly doing it on E-Bay or doing it the conventional way. There being no further discussion to come before the Board the motion was made by Engineer Miller to adj~.m., seconded by Councilperson Sellers and carried unanimously. M~OR ' ATTEST: CLEf~ASURER Date: February 3, 2004 To: Department Directors From2 Klm Calabro, ~luman Resources Director Re: ~47orkers Compensatio~ Claims Attachedplease findclean copies of allforms relatedto the filing of a workers compensation report. Severaloftheseforms have been revised so please discard any old forms you currently have on file. An instruction sheet has also been attached for you convenience. All of these forms can be located and down~oaded from the Downey Insurance Inc. website at www.downeyins.com~ I plan to complete and file the reports via the Internet. Please visit the site and familiarize yourself with the information required for reporting, as this will expedite the reporting jrrocess and keep me --llsu~ervisors or additional informatio~ The from having to c~ w f~ Supervisor's Incident Investigation Report is a new document. It is imperative that the immediate supervisor accurately completes · this section andbe very specific when descr~b~ g the incident. Additionally, the Authorization For Release of:Medical Information is also a new fornu :Make sure that the employee signs this document as this will allow for the sharing of medical information related to the injury. If you have any questions regarding the attached forms please let me knc~v. I willbe meeting with representatives from Do~vney Insurance Company to discuss %Torkers Compensation reports and claims on Thursday February 26, 2o04 at I~:30 a~m~ If you would like to attend the meeting let me know. Thanks for your support! INSTRUCTIONS General Instructions: l. plea.se enter information into all of the shaded areas of the First Report form, except the boxes at the top right comer of the form which ii for Office use only. 2. Enter all dates in MM/DDPfY format. 3. Ple~e ~ completed forms m: 4. For answers to questions, please call Indiana Worker's Compensation l~ard 402 W. Washla~on St., Room W196 Indianapolis, IN 462042753 Definitions:, AGENT NAME & CODE NUMBER: Entcr the name of your insurance agent and his/her code number if known. This infatuation can be found on your insutanc~ policy. ALL EQUIPMENT, MATERIALS OR CHEbI[ICAI~ EMPLOYEE WAS USING WHEN ACCIDEI¢I' OR EXPOSURE oCC1JR~,ED: Lis~ ~nythi~$ the empl°yee was u'sing' applylng' handlin$ °r °perad=g whtm the injury or exp°sure °courted' ' If the injur~ involws a fall, indicaIe any surfaces and/or obi ~'~s the claimant fell on and where theft fell from. Enter'HA" if no eqorpmen[, marerial$ or ch~mlcals wer~ being'used (e.g. Ac~ylene cutting toech, meal plate, e~c.). AVG WG/WK: Claimant's average wcekty wage, calculated by totalling the latest 52 w~Ics of wages (incinding overtime, tips, eto.) and dividing by ~. CLAIMS ADMINISTRATOR: Enter the name of the carrier, li~rd-part,ff adminisu'ator, stem fund, or self-lnsured ~-ponsible for administering thc claim. cONTACT NAME/~tlONE NUMBER: l:~-the r~me of the individual at thc employer's premises ~o be contac~l for a~iduna! information (Lo. Supurv[sor, HR P~soa, Nurse, DAT£ DISABILITY ~EGAN: 'the ffa~ day un which the claimant originally Iosx dine flora work. due to the occ~oaa~ hju~. or ...... ,-...,, tho fo.o ,boil: EM]PLOYEE STATUS: indicate tan empm~ . -. -- - -- ,,,~--- t~ .~-ac~ Disabled, I~i~d, I~ot ~.~p~oy~ T~ra~, Appr~ . .e, -- . ..~ ,~- ,t-r ant vt~ SW. PW OS, DL RE, lie or (you may aiso abbt~'~'.at~ lllo a~ovc as. r l, r~,,z'~ l · uenc¢ of cvcata leading to the injury or (e.g. Wod(~ OW INJURYflLLNESS OCCUIIRED. Desan'be the seq bruxhed ' ~he h~t m~ H . ~ some me,al. As woflc~r f~lL he , ~ · ' fall of the scaffolding, lost balance and fell slx te~t to me con~,, ,,,~-....e __ NCCI CLASS CODE: A four-digit cod= claaaifyin§ the occupation of the claimant. OCCU PATIONIJOB '11 it LE:' Enter h~ p~mary occupation of the claimant at the time of the accid~at or expusu~. pART OF BODY AFFEt. ~ ED: Indicale the part of body affec~d by the injury£dlness (e.g. Right forearm, Low Back, etc.). REPORT pURI'OSE CODE: 00 = Original Fkat P,~o ~ of Iajtn3", 02=updatod or Amended F'u~t Report. RTW DATE [Kalum to Work Da~): ~utm' th~ da~ following the mo.~ recant dlaab ~t~ period un which the ~nployee r~arned to SIC CODE: This ia the code which ropr~unts lhe nacre of the employor's lousiness which a aontained in the Sumdard Indusuial Classification Manual publish~'d by the F~derai Office of Manage'hoot and Budget. pr~For:ation for painting)." TYPE OF INJUP, Y/ILL4NE~g: Briefly describe file n~mre of the mju~ or Lliness (e.g.: Conats~on, Lacel~un, Fr'~mre, otc Enter "NA" if Indiana Worker's Compensation First Report of Employee Injury/Illness PLEASE TYPE or PRINT IN INK EMPLOYEE INFORPt~'RON 3CCUPA~ONJJOE TITLE NCCI CLAES CODE PHONE · OF DEPENO~S $ OyR 'O0~ ~PLOYER INACTION SELF INSU~CE ~CU~THE~ INACTION MIN~ BY EMPLOYER DOWNEY INSURANCE Downey Insurance Inc. P.O Box 1247 Kokomo, 1N 46903-1247 Toll free: 1-800-382-8837 Local: 1-765-45%9161 Claims fax: 1-765-868-3310 Adjuster: Claim No: AUTHORIZATION FOR RELEASE OF MEDICAL, MILITARY, EDUCATION AND WAGE INFORMATION To any physician, dentist, hospital, health care practioner, military authority, education authority, employer or insurance carrier: The requested information is needed to accurately evaluate, adjust and pay the patient's insurance claim. I hereby authorize any health care professional (including health care physicians, medical practinners or other health care providers, hospitals, medical attendants, narsas~ x-ray technicians, or any other person), military authority, education authority, employer or insurance cartier, to furnish to the insurance company named above or its authorized vendors and representatives, wage toss and individually identifiable health information regarding my injuries, payment, treatment rendered, or health care received or provided. I understand that this authorization is voluntary. I agree that a photocopy or fax of the original authorization shall have the same force and effect as the original. I understand that my health care records may contain information regarding the diagnosis or treatment of HIV (AIDS virus), other sexually transmitted diseases, drug and/or alcohol abuse, mental iliness, or psychiatric treatment. I give my specific authorization for these records to be released. I understand that 1 may revoke this authorization at any time by notifying the health care professional(s) in ~vriting, but if [ do it will not have any affect on any actions taken before receipt of the revocation. I understand that once disclosed, the information and documentation released may be re-disclosed and may no longer he subject to the HI, AA Privacy Rule. This disclosure is made at the request of the individual named below for the purposes of evaluation, adjusting and paying an insurance claim. Unless other,vise required by law, this authorization shall expire upon the final resolution of the insurance claim. By signing below, the patient acknowledges that he/she has read the fraud statement printed below. PATIENT OR REP SIGNATURi~ PATIEN'r NAME OR REP (PLEASE pRINT) REPRESENTATIVE'S RELATIONSHIP TO PATIENT PATIENT ADDRESS CITY. STATE, ZIP PATIENT PHONE NUMBER SOC SEC NUMBER DATE OF BIRTH ANY PERSON ~,VHO KNOWINGLY AND WITH INTENT TO DEFRAUD AN INSURER, FILES A STATEMENT OF CLAIM CONTAINING ANY FALSE, INCOMPLETE. OR MISLEADING INFORMATION COMMITS A FELONY. 12/03 1. Company or Location INDIANA PUBLIC EMPLOYERS' P~_AN, INC. SUPERVISOR'S INCIDENT INVESTIGATION REPORT (Please Complete All Sections~ 2. Department 3. Date of IncidentJDay of Week 4. Exact Location of Incident 5. Time of Occurrence {am/pm) 6. Date RepoAed 7. Name of Injured 8. Occupation 9. Body PaA Affe~ed 10. Nature of Injury or illness 11 Item Inflicting Injury/Illness 12. Type of Accident 13. Person With Most Control of Item 11. 14. Description of the Incident 15. Direct Causes of Incident 16. Why Each Cause Exists 17. Actions Taken or Needed to Prevent Recurrence 18. Date Completed 19. Investigated By 20. Date 21. Reviewed By 22. Date Please mail form to: IPEP P.O. Box 690 Kokomo, Indiana 46903-0690 Toll ffee: ClaimsF~x: Loc~: [-800-382-8837 1-765-868-33 I0 t-765-457-9161 Type of Accident. Bite by Animal Bite by Human Bite by InsectJSting Body Reaction Burn Caught in/Between/On Contacted Harmful Substance Contagious Disease Exposure Electrical Contact Fail From Fall Level Fell Through Foreign Body Gunshot Motor Vehicle Other Overexertion Pierced/Punctured By Public Transportation Repetitive Action/Motion Slipped (Not Fall) Smoke inhalation Stepped In/On Stress Struck Against Struck By Struggle/Resistive Subject Nature of Iniury Abrasion Amputation Asphyxia Avulsion Bruise, Contusion Burn Caused by Chem. Burn Caused by Heat Carpal Tunnel Syndrome Concussion Cut, Laceration Crush Death Dermatitis Dislocation Electrical Shock Fracture Frostbite/Freezing Hearing Loss Heart Attack Heat Stroke Hernia Infection inflammationlSwelling Multiple Injudes Other No Injuries Poisoning Puncture Radiation Soreness/Pain Sprain/Strain Stress Tendonitis Part of Body Abdomen Arm - Lower Arm - Upper Back/Spinal, Back/Non-spinal Buttocks Chest Ears, External Ears, Internal Elbow Eyes Face Fingers Foot Groin Hand Head Hips Jaw Knee Leg - Lower Leg - Upper Mouth Multiple Parts Neck/Spinal, Neck/Non-spinal Nervous System Nose Other Respiratory System Shoulder Teeth Thigh Thumb Toes Trunk/Non-spinal Wrist