BROTHERHOOD OF MAINTENANCE OF WAY EMPLOYES

and

NORTHEAST ILLINOIS REGIONAL COMMUTER RAILROAD CORPORATION

(Metra)

NMB Case No. 19


This dispute involves Mr. Richard Sparks employed by Metra as a B&B Mechanic.

Mr. Sparks was hand delivered a letter dated April 19, 2002, instructing him to attend a formal investigation on Thursday, April 25, 2002, for the purpose of developing facts, determining the cause and assess responsibility, if any, in connection with an accident with Metra Vehicle #90810 on Friday, April 12, 2002. It was alleged that an unsecured load of pipe shifted when Mr. Sparks was driving the vehicle causing damage to the rear window.

Mr. Sparks was charged with alleged violation of Metra's Employee Conduct Rule "N", Paragraph #3, Items #2 and #3 and Safety Rule 107.2, #8 and #9.

The letter of April 19, 2002, calling for the investigation and the specific charges against Mr. Sparks is attached to this Award.



Following the investigation, Mr. Sparks received a Notice of Discipline letter dated May 17, 2002, assessing discipline of Three (3) days deferred

suspension for violation of Metra Employee Conduct Rule "N", Paragraph #3, Items #2 and #3 and Safety Rule 107.2, #8 and #9.

The transcript of the investigation held on May 1, 2002, provides the basis for this Board's adjudication of this dispute.

This dispute is before this Special Board of Adjustment established by agreement between the Brotherhood of Maintenance of Way Employes and the Northeast Illinois Regional Commuter Railroad Corporation (Metra) dated November 12, 1999. SBA No. 1122.


FINDINGS:

This dispute involves an incident occurring on Friday, April 12, 2002, when the rear window on Metra Vehicle #90810 was damaged.



The transcript testimony reveals that Mr. Sparks was working under the supervision and direction of Mr. Martin DeVito, B&B Foreman on the day of the incident.

Mr. DeVito testified that Mr. Sparks was told to drive the truck to the 51s` Street Yard where there was a fence project underway.

Mr. DeVito testified that he had received a call from his Assistant Foreman, Mr. Phil Rodriquez, on the day of the incident advising Mr. DeVito that the back window of the truck was broken while they were unloading the fence poles from the truck.




Mr. DeVito testified that the truck was loaded with fence poles on the day before the incident.

Mr. DeVito testified that he personally inspected the loading of the truck on the day before the incident and the load was very secure.

At issue in this dispute is whether the damage to the rear window of the truck occurred during the trip between job sites or did the damage occur during the unloading process.

The Carrier has based their position on the accident report of Mr. Joseph Gbur, Metra Police Officer, Carrier Exhibit No. 2, wherein Mr. Sparks stated that he believed that while en route from Blue Island to 47`h Street that a load of pipe shifted and struck the protective gate on the truck which in turn struck the rear window of the truck and cracked the glass.

The police report also stated that Mr. Sparks said that he was unaware of when the glass actually broke.

The property damage personal injury report prepared by Mr. Joseph Gbur, Officer of the Metra Police Department, Carrier Exhibit No. 5, stated "Was carrying pipe from Blue Island Yard to 47 `h St. Yard White Truck #90810. I believe that the pipe bump the gate in the back of the cab, and broke the window of the truck, once we stop at 47`" St the window was broken." Both Carrier Exhibits No. 2 and No. 5 are attached to this Award.


3

It is quite evident from both Carrier Exhibits No. 2 and No. 5 that the accused Mr. Sparks was not positive as to whether the damage occurred while en route from job site to job site while he was driving the truck.

It seems highly unlikely that a rear window of a truck could be damaged while traveling from job site to job site without attracting the attention of the driver and passenger in the cab with the driver.

There is no evidence in the record to show that is what occurred. There are positive statements in the record to show that the damage occurred when the pipe was being unloaded. The testimony of Foreman DeVito, B&B Mechanics Larry Harper and Trenidale Evans clearly point out that Mr. Sparks was not negligent or responsible for the window damage to the truck. Based on the testimony in the record, there is no basis or support for the assessment of any discipline against Mr. Sparks.

Accordingly, it is our decision that the Notice of Discipline letter of May 17, 2002, to Mr. Sparks be rescinded and Mr. Sparks record be cleared of the charge. Additionally, Mr. Sparks should be compensated for any time lost as a result of this incident.


AWARD: Claim sustained in accordance with the above findings.

                      Charles J. khamberlain

                      Neutral Member


Date ~7 ~'~dL

                        4

e ra

A
 SBA 111
 Rwd ~q

 NOTICE OF INVESTIGATION

 April 19, 2002

 HAND DELIVERED

 Mr. Richard Sparks
 15210 S. Ewers
 Dolton, IL 60409

 Dear Mr. Sparks:

 You are hereby instructed to attend a formal investigation which will be held on Thursday, April 25, 2002 at 10:00 a.m. in the Office of Director of Engineering, 2067 West 123rd Street, Blue Island, Illinois 60406.

 The purpose of this investigation is to develop the facts, determine the cause and assess responsibility, if any, in connection with your alleged involvement with an accident with Metra Vehicle #90810 on Friday, April 12, 2002. It is alleged that an unsecured load of pipe shifted while you were driving this vehicle causing damage to the rear window. Therefore you are hereby charged with alleged violation of Metra's Employee Conduct Rule "N", Paragraph #3, Items #2 and #3 and Safety Rule 107.2, #8 and #9. Your work record, a copy of which is attached, will be reviewed at this investigation.

 You may be represented at the subject investigation, as provided for in your Labor Agreement, and you will be afforded the opportunity to present evidence and testimony in your behalf and to cross-examine any witnesses testifying.

 Sincerely,

 AfficO'on, sDirector
 Rock Island Engineering

 MRldm

 cc: V. L. Stoner
 W. K. Tupper
 G. Washington
 H. Thomas
 J. Barton
 C. Cary
 M. S. Wimmer, G/C
 A. F. Scott, L/C
 J. Gbur - Please appear as Corporate Witness
 M. DeVito - Please appear as Corporate Witness

 I hereby acknowledge receipt of the original of this letter.

 Matra is the registered service mark for the Northeast Illinois Regional Commuter Railroad Corporation.
OS · ~ Z O Sdv <<
"IaH 1109111-_
                                                        Salk 11 Q1. ALOd i9


              NORTHEAST ILLINOIS COMMUTER RAILROAD CORPORATION PgI,%G ~o

              NOTICE OF DISCIPLINE


_;,.=.:._r:.:~-- Name & address of supervisor assessing discipline:

      W.K. Tupper

      Chief Engineering Officer

      547 W. Jackson Boulevard

      Chicago, Illinois 60661

      May 17, 2002


      Mr. Richard Sparks 15210 S. Evers Dolton, IL 60419


      The result of the investigation of May 1, 2002, has revealed your responsibility in connection with the violation of Metra Employee Conduct Rule "N", Paragraph #3, Item #2 and Safety Rule 107.2, #8 and #9. Therefore you are hereby assessed the following discipline which will also be entered on your personal record:


      ( ) 1. Formal reprimand (letter of particular attached).


          (X) 2. Three (3) days deferred suspension (with waiver one (1) day deferred) which will remain in effect for two (2) years and must be served as actual suspension if additional discipline is assessed during those years.


          ( ) 3. Five (5) work days actual suspension (with waiver three (3) days plus deferred from Step 2).


          (X)3a. Your record indicates a deferred suspension of 3 days which was assessed on 9/13/01 and must be served in conjunction with discipline outlined above.


          Suspension will begin Monday, May 20, 2002 and end Wednesday, May 22, 2002. You must return to work on Thursday, May 23, 2002. Failure to return to work on that date will be treated as an unauthorized absence.


      ( ) 4. Ten (10) work days actual suspension (with waiver seven (7) days).


          Suspension will begin and end . You must return to work on

          Failure to return to work on that date will be treated as an unauthorized absence.


      ( ) 5. Dismissal. a


                      Signature & Title bf`Supervisor assessing discipline

                          SBA 1IQ1 Awd 19 P0.esG


    .P SE.; S p pL.r a,_,.~c UETHCC )EMS PROPEAT· I PECOVERY SrOLEN RECWEREO


/O,> J J

 METRA POLICE DEPARTMENT OFFENSE/INCIDENT REPORT

      T 2 STArufco of OCCUAIENCE

      OF NCQE~T

      'PCII

      of

      F/4~/7

6 C' --~ C).;L la~'5 7
 c
        CL.E~E iAOCRESS NAME I APPROPRIATE) AXALMY"

        wc.roow. I

13 1-717a-5~ a lC C.o , h~7TN 5.`. SI1010 l -lob-aa. o9.S7
                  lCOMPL,LINANTIL:LST.f~ST.MI00Lfl 15EA (RACE I0 Cos 1.-0-11

                  ~~s

                  ~~in~c~.

                  l

IS 462 708 ayg-i oz
 ~i 9
m d
. L) . !p/c.:.reL)
CITY
    17Rf5.A00Rf55 IP°TI I7BU$ PNONf O IIEMT

    STATE

                        ~ ' a 9,j-~16:~bi6~

                        c (/c25 ~TJ~ 1L ~D~J

    ISVRCYIMSNPALEILJST.FIRST-MIOOLEI19uSINES51 165EA 17RPCE IIAGf 190GBIM.Or1 70RESPHOnf

    ,ylG~.r~P0~,;,E-FJ ~~ - - - - - - -

    STATE 72 Bus PNONf 77 EAT

    " Is AOORf55 IAPTI CITY

          _ 3~J-69V~

          sh7 w' -~/~c~SJr~/3/--ills C.~-/crcU 1- L

-il aSEA 76RACE 7700BIM-Orl 29-ES PHONE
 7f RES AWnf53 IARTI CITY STATE W Bus PFONE 71 EST
 W
 h
 A
 W
 VWITI1fSEP71LPST FIRST MIOOLE1 17 SEA LRACE 75pOBIM.0.11 76Rf5RHONf
 H
    7/RES AOORIESS 'APT, CITY STATE mBu5 PHONE IS SAY

    WPI ILASTiuST.MI00LE1 .I SEA 17RACEIVOOBIM.0"1 v9 HT OWY AIEYIS IIIYAlR

    ORES ACORESS IA.P11 CITY STATE YSNIC·IIAVEIAAA SORES MMOME

f 51 P7 ILMSTSAST.M10pLEj SISE1 f7 RACE SAW91M.O.Yl 537. 56 WT. $7EYIS SIN AIR
    fERES.A00NE55 IPITI CITY STATE WNIC7tMAMFUAAA IIRESPMONE

    NSFI. Tome EA NAIRSrTLE,UP to 31 VSCARSIMARAS~TATTOOSI pfAPPEARANCEIUPT071 67 CAUTIONS IVPTOII 5ESPEECNPATTERN

W I 7 PERSON I 7 PERSON DEFORM PUP T071 1 7 PERSON I 7 PERSON 1 7 PERSON
    071LI LIGHT 701UNRI UIIRNONN 7 PERSON _=IC~1 CASUAL=IALCI ALCONOLUSE -=IACCI ACCENT

    OOIM) MfOIUM ~CIBMLI BALOIPARTBALO OOYES IOESCRl9E1 =CIDIS) DISGUISE _-IPRMIAAMEp _=IONAIOOESNOTUPLY

    cc I9I OFRR d0ICURI CURLY/AFRO 0OIOTHI OTMfRRWA _=IAPRI RESISTING ==IRMPI IMPEDIMENT/

              OOILOMI LONGUgNGTH 0711RSJ TRANSVESTITE ==IORUI OPUGUSE L15PSISTUTTERS

    V FACIPL HPNI O O IIAEOI MEDIUM LENGTH 7 = IUIIII UNIFORM _ IESCI ATTEMPT ESCAPE = MROI RA/IWTALIIATIYE

    -

              OCISNOI SHGMTLENGTH Ca~wGMIYWELLGROOME0 _ -ISLRI SLURREW

              =(ILIUM IMPERSONATES

    I 7 RERSON 701ST.) STRAIGHT =~ IWRNI WORK CLOTMES OPPOSITE SEA MUMBLES

    OOIWYYMI UOFMGww _ == IOTMI OTHER

    = IMECI ME11ICIALCOMO )DESCRIBE)

    =WEN) MIST pFAOM15

    OOINFIII NOFAOIPLNAIRT

    O 0 1lUGI MASS) NEALEN FPPCIL

y O o ILCSI IFMSAGHf -= IS", ATTEMPT SUICof
 e 00 SCSI vawRINS
 ~= Iv101 VIOLENT
 0
    IS Ap0ITERSAIDESCRIPTORSIOLI SOC F ARAnas.GLASSFS.EYC.I 70.WrIONOLSUSPECTSIETC

                                _ DYES ONO

                                _ CAN / R-.c.,t-- *~- 'QO? O Rc"~ReF/L4fz _ Fv

                                L il)g-s '7l ~`3~

    11 YEAR 7 MA E 73 MODEL 74 BOOT STYLE 75 TOP COLOR IOTTOM 761MPOUNOEO 77 vEHICLE USAGE

                              01071 ~5G09 APFESAff7EEG OTHER

                              C/7`G J /,+x I li~l` LLIIY'T LV~l 1071=rf50 1011 REG0@1RAEOAFnfSlff

                                                      OWNS. SEA 16 LICENSE NUMBER t 79 YO IR 10 STATE II ~EYYCLE IOENTIFIGTION NUMBER I~IMl OI071 FASSENNGER IN vf.CLE

J IMP
 COMVMEI5H5CWLfN/POfPRRSAOFH
 V _
ECSE
 OIBNI MoW
I G :3 N P F P J_ OIOn WrOLWAO Pp 0-EITTR fflf
 I O~' I DL y C- J I I p S_
                                                        Ol t ff~lC TOi

                                                        I)RGfT

B=7 IIYENIGLE OESCRIRT~N COOfS IOPT~ALIIUP TO 71 OYail
 OF
                    CRY*, IEATtR - r

                    CKu11 CUSIOMIOUIPrtMT JC~I~GL1MLI ~DOYOAV~f _Lw01 FOVFWwffL011NE ATT.pCA

                    IC;lRJNCS~v

                    SEA- 5

                                    ~Ir01

                                    fNAO

                                    OPARPY A17RAI F00YPFRIs A _Irr1Rl IMPAIM ON NYEIIICLf~SS _ITTII TOPHVNAW( all,, SUSPECT vt

    ORCR EXCESSIVE No." -IRV51 .. ST ON VENCLl

    0" V ITEM IYPE 15 BMNO1MOOEL ! S~P~AL NO ST MISG OESC E G OWNER 101 V VALUE tl

        ~P2 - a

11-~ a u ~. \ .i~Ll - .W T
 W
 4
    IS °sEE~MPRbPERTYLIST EXHIBIT

VLEAOS NO 11 GATE E T ME EHIEPEO 970P )HIT 9.OP Iwlr
 CZ
 CC,
 W f'
                                                    95.OOIrIONPL ENTRIES=SUSPCOUSZ

                              5 6 A I I ;?a Awd Iq '"Pa se

                                                          g


                                001·PGET DSECURI


    ON* _tJ O.· On· ~,·P On! _ DNA

    UHSMONM - UNSNCWN UHRNONM _ UHKNGWN _ UNRNDWn

    OTHER _ OTHER _ OTHER _ OTIfR _ CIT . EP

    LNG EN~Gn TOOL NON.PESIOENCE =IAI CH·INIBOL7

y5MNt000P = =I· I opt. _IAI PRVICPOwBAP .1·I CASH PFGI57EP -IBIOEAOBOIT
    B·$uN7 vnHOOw = =IBI UNLOCKED =IBI SCPEwOaWEp =IBI $AGEIUpNEY BOF -ICI CYLINDER pa lOO4

    FRONT DOOR! - -ICI rnIEO -ICI PIPE waENCH =ICI COI. OPM·CNINF =101 P·OlOG4

    1fAa DOOR = =101 - SMASHED =101 LOCK PULLER =101 SALES AREA =LEI CHARLIE EAp~SUpInG


-~(1 SIDE DOOR = :AI GORGED =LEI PUNCH =LEI OISIUr
 [11) ClOOPI
 GAG OR CV-01 = =:F, S~.eo ED : ~11 KEYX PICX _~lj OPPICE LOCKS
 nGI GAG CIA IOT. I Z DISMENTI. : III OC Z G1 TOOL RDCMW IG, EAR&OFATE
 Cc:1.1 PULL 0 Z (.1 ALARIN-OUTSICE
 IN) OrM Ov"O ON -IN, SLI. JIM - IN) STORAGE PMAAEA
 PAMIOX 00 (11 PICKED 1.1 DRILL - (1 ) CLASSROOM FINGER$I,
 rDI GRAD F,DOawO = =IJI GRILLED =IJI TORCH .=IJI SHOP =111 ALAPM.1DSEC.
 =IRI up ROOPwO = =IRI TORCHED ::PI SAw =I41 MULTI LOG1pN5
 =ILL SCAM/STRY ON - =IU SAWED =ILL BOLT CUTTEP COMPANY
 =IYI SCpN157pu W0 = =IAR CUT =fMl °LIER/YISEGal1 RESIDENCE =IJI :URM-TOPOLDEPT
 MINI TRANSOM = =INI PEELED =INI NAMYEa =IMI
                                ZILJ vENICIERPORT -IRI I·VDIB EtOOIRIERI


u101 `NAIL _ _ MA OeJER =INI BASEMENT -ILL CAMERA
 =I/I SRriIGHt - 101 BE/PELLETDAUAGE
 -101 SPRAT PAINT =GI BEDROOM =IMI PENCE
 1101 ROOF - =III SMASHED =IPI SHARP OBJER =111 LIVING POOY -INI
 YfNIQLE =COG
 101 SUSHEOI1UNCfUaED 101 BIUNTIN$TRUI =101 PAM p4/DEN _IDI WATOnufNIGVAPD
 IaI FRONT DOOR - =IRI SCR·7CHE0 SLUGGED. =lal RIT[HEN =IPI °P^' SEC PATROL
 .x.15) pEAA DOOR - =I51 PAINTED -lal FA. l10U10 =151 BATNPOOM 102 LIGHTING
 =,17j N·TCNB·GRRA0.WTf^ =ITI BURNED .CSI COMBUSTIBLE =ItI DINING ROOM
 PEAK DOOR _ -lul CORRODED =171 Ek1LOSNE =IUI AMC =_ ONA
 aul SIQf vnnOpv _ =IVY B·"ERE0 =IUI PROJECTILE =IVY STOP PMIS.EO UNRNpvN
 =M wINOSNIELO =IVR BIOwNV1 =IVI CAUSTIC SV037 -Iwl MULTI lOCA71ON$ ~,~

 ^IWI FEAR wINOON -IYI MULTIPLE MEANS -IWI SOO, il^I DAYLIGHT
 Clil 101.CONVERIR.701 C =1k1 CREDIT CARD -fN 11DAWN
    -_ =YI CHECK =1YI GLOVE BOC0YPa7 =ICl Ou$R

    _ 1 =IOI DARK-UNLIGHTED

    TRUNK WE· N =177 CONSOLE =IE] OR-INTER LIGHT


                      _El =101 ENGINE COYIpTM _Ifl OK -fkTEa-UGMT

                      =101 °EVJIYfPI$ILVEPI :III BOGY '-101 OK -IHT6EYTlGt

                      = III AV70MAT IBIVIDRI =171 wHEELS/TRES

                      =Itl AU70MAl ISIlYER1 =I]7 UT14ITYICOMMER WEN

                      =1]I RIFLE $70a AREA

                      =I·1 SHOTGUN =nl RECREA7 VIE" LIVING

                      =151 KNIFE AREA

                      =LEI MARTIAL AIRwE·PON =151 MULTI LOCATIONS

                      =In MN DEVICE

                      =LEI CHEMICAL DEVICE

                      =191 BB/PELLE7GUN


ICA fTpE0UE57E0 If61YVE571G·TORJOREOUE57ED ID6TIUERE0uE5TE0 0nE711NVE5TIGw70Ry0·551GNE0
 YE3 ./j10 'E$ ~O

 Id

 ~.1T IL~2o hLICS Rig n'1 ~;- 1-.~ ~ P~ 1=I~R=~nsvN 2. SPARKS CCi^A4~6~1-W C: ~1- (2=-r,=-IR-NCC hc~-WCJ T1.4L ~.~cc i o CVi(1P.~,v7~ %K`i[K
 ~ c'1 O F~ I O . I

 F,:~ JL-Yr.AY.D SP4R-KS "Zc.ALh./ i ~ Tlh~^ r4- (3'~-' v r- 1%`l kWvr+

 ~ IJ ~ J `c ~ I< _g I_ _ _- S c- lk ~ so 4 7 Z=-+ -rt-L.4'i- W . ~ · ~ c F

    P F_ s.+, r r E ~ a- sa A-c. K -rl+~ per.,-f e-

                                      r I ~ ~ c ~-- o:~ ; I+~


~R..rCIC t~W lG~ SI-.5_T 2N S-~R.~cIC T1-1-~_ R~AX
                                          WINI~U LFu C,= I ~-c


                  1<.-=.5~ TI-~= Ci_A $ 5 . i=~2.=.Ta^~ SPh~KS S.F-i


n01N15[

    O~

    UNRVQNN

= OTHER
 'All
    _AG·I c Q 0IN IRENIS

-IBI P·N$·CREO
 =ICI Of CECA7Ep
 FLUIDS
 -.IDI USED M·i[NEa
 -LEI VANDALIC,,
 -ICl Him ePp[EED$In
    ·Pf·


QPIME$ ·GN57 PEPSON
 _IGI BUNOipL w
 =INI ISOUNDIGAGOEDVICT
 =III INJURED v RIM
 =ul COMYInE05Ek
 OFFENSE ON vIR
 =IRI TNRE·T$-WE·10N
 =IU TNpfATS·YEpBAI
 =IYI OEMANDNptE

 GENERA
 -INI MAO1
 =101 USED MONITOR
 =IVl USED CB MAGIC,
 =101 VEHICLE NEEDED TO
 aEYW E 1RD1Ea7Y
 in, DISABLED IMO.1
 =151 DISABLED ALARM
 =In 015ABLEDCAMERA
 =IVI DISABLED U7KITY
 =IVl USED GLEvZ5

 _14-t_ w.4_S mJ A n~,.p_= o = c~LJ ~~.w -'I+c G~.h5S h-cT .a~-y 4.ccuc-7 . i H E

 b A r-,Pc~- w.v,S ~ KS i NJ~ICE,~ Po~J /k-2RIy.h L. h-i S'7Tn 5~ .2.=`= i .
 N C rut-L ' yQ Sr _J2A1it, 1J.V J~,41N_.t-3c.c
 ~l~ p=JZ--i ~~1-pve..Ca~ ~ro~sW PC
                              yZ~oS ~i-,a.e-IJ^=


STAR· IIISUIERW50a I Ci II7PEVIEwOGRCEP

 am UNFOUNDED -1]I CLEARED B7 ADULT ARREST IPEDUIRES ARREST REPORT
 CIII PECEpPE0TOO7HEPJUP1501C710N =I·1 CLEARED BYJUVEHILEARRESTIPEOUIPES·PPES7REPOR7
 Cal vENaINDINVESTIGATION =151 E71CEI71pnALCLEARANCE-·puL7
 NO fUptNEpAR10N -161 EXCEPTIONAL CLEARANCE-JUVENILE

 I 10 PEPOFf LNG OFfI[EPI 1

 -j- I 'Q UL-
                        S 8A I12 Z Awd IQ

~Ollpptv,~a,~ yIAI·71VI1V WIC! VIW WW

 HO /5 PERTY DAMAGEI~ONAL INJURY REPORT ?d4 t

 DATE OF OCCURREYCE V
 TIME OF CUR~E7NICE
 S l AM A ; PM
 TRAIN NO ENGINE NO DIRECTION OF TRAVEL
 TIMETABLE COMPASS
 NEAREST RR STATION MILE Pp5T LOCATION
    S/=T 5 £~% F~ S?~P. S

    UNTY CI?·ROWNSHI

    clo K

INITIALS S NOS OF EN~INES A CARS OMECTLY INVOLVED
        N c

    TYPE OF OCCURRENCE WITH TYPE OF TRAIN

    PASSENGER KAURV Z: VANDALISM = PASSENOER-FARE PAYING ' TRESPASSER PASSENGER f(OMER ONAnE

- EMPLOYEE BVMNY _~ OTHER = PASSENGER-ON PASS MOTOR VEHICLE = WORK -Tje uG~
    ROPE RTYDAMIOE _ EMPLOYEE _ OTHER = $vATNwG

    - PEDESTRIAN

NAME OF INJURED PERSON ADDRESS. CITY HOME PH~IE
    N 13 T

GATE OF BIRTH AGE SOCIAL SECURITY NO SEX MARITAL STATUS
 1
 EMr%aYER OCCUPATION I
 IF NIRO EMPLOTEC ORIGINAL EMPLOYEE ADP
 NIRC SENIORITY DATE SENIORITY DATE
 IF PUUREO. TAKEN TO -. TAKEN BY
 NATURE OF INIURIES OR PROPERTY' DAMAGE
 WEATHER LIGHT PLATFORMIGRGUND ACTIONS OF III PARTY
 - CLEAR DAYLIGHT = 06h' = BOARDING _ CROSSING TRACKS
    CLDLADY _ GAMIN WET = ALIGHTING = PLAYING ONINEARTRAW

    RAIN = DUSK = $Ao1YRCE = CAUGHT IN DOORS ~~/1'J = WAITING ON PLATFORM

    SHOW = DARKNESS = UNDER REPAIR = SEATED ~f~ ,7 = PERFORMING ASSKNED DUTIES

= REST = ARTIFICIAL = QINEP = IN VOfdN wrf~w VEHICLE
    Fm

WIERE POLICE PRESENT? OFFICERS NAME BADGE NO NAME OF FORCE
 YES '~
 ROLCE AC7nN
    TICKET TO - ARREST OF Z OTHER

    \SSENGERFUURY WHERE BOARDING: DESTINATION

DESCRIBE EXACTLY WHAT HABPENEO. V
 rsLx,V5 /Rel`TD /7f y/-20 il°f`E 'NmtC
    S Cy~r~ flp n .4i~E.E

    AVA

r behcua Y~#f-- -Ac Plpe btt4 'Art, Bs~f /# fk bhak OF .fl, E C*g, +A.Db 6&pkE
 "TG4E WYAaou] px -~FE `y'p,.~.GGL, Owc~ we STAID A~ '~7l'f' YfiE. .v~R~ :~A-S-
 bRqKt r~ A
      OF INJURED PERSON DATE OF REPORT

      dY,,D S 4:l- 2-2

LIST WITNESSES TO ACCIDENT ADDRESS. CITY HOME ONE
 7.
 ADDRESS, CITY HOME PMCF49
 2
 SIGNATURE OF ENGINEERCONOUCTORSUPERVISON PRE ER' NATURE IIF DIFFERENT)
                    NORTHEAST ILLINOIS RAILROAD CORPORATION


I AUTHORIZE ANY DOCTOR. HOSPITAL EMPLOYER. OR OTHER PERSON. TO WHOM A SIGNED OR PHOTOCOPY OF THIS AUTHORIZATION IS DELIVERED TO FURNISH ANY INFORMATpN REPORTS. MEDICA: REPORTS. OR COPIES OF RECORDS WHICH Mar BE REQUESTED BY THE NORTHEAST ILLINOIS "ILROAD C40RPORATCK

                    EXHIBIT NIA -_


    $ATWESTUACICSON ;.I:._ ADDRESS


    CH "" ILLINOIS 0",

    'CAG


                                CITY-STATE


RCAODS IREV6E0 70.131

                                                      TOTAL P.01


                                        Co., p pi