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Home My WebLink About25-9885 IT si " II IIIII III IIIII II IIII IIIII I . 27c REPORT NO EG54757OLCERA COLLISION REPORT 1591971 CASE# 25-9885 2 INTERSTATE CITY STREET FIRE ❑ RESULTED 1 STOLEN STATE ROUTE ❑ OTHER ❑ VEHICLE ❑ LECCO A`NG 4200 3[--� COUNTY RD NVOLVED CONING 2❑ TOTAL 1 PRIVATE WAY TRIBAL UNITS#OF 03 SO BJECT TRUCK 1 8 28 RESERVATION 2 3� M M D D Y Y Y Y TIME(2400) COUNTY# MILES CITY# DATE OF'. N E coLLISION' 11 - 14 - 2025 0831 17 =.= S 8 W E IN OF M 1070 a 4❑ ON (PRIMARY TRAFFIC WAY) INTERSECTION �✓ NON INTERSECTION ❑ BLOCK NO. e .� 4a NE 3RD ST MILE POST ❑ ❑ DISTANCE OF(REFERENCE OR CROSS STREET) 5 FEET e S 8 W e BRONSONWAYN 0 4 29 MOTtlR PEDAL- DAM AG THRESHOLD MET PHONE UNIT 01 VEHICLE ❑ CYCLE' ❑ YES ✓NO Q 1 30 5 LAST NAME VERG FIRST NAME MATTHEW MIDDLE 1 2 31 INITIAL STREET ❑ 1902 S UNION AVE APT 29 CITY TACOMA ST WA ZIP 984051020 2 NEW ADDRESS 7 CDL .IGNITION REQUIRED IGNITION PRESENT MEDICAL TRANSPORTED3 INTERLOCKYEs NL INTERLOCKYEs NO YES D NC 8❑ LCEENSE# STATE WA SEX M MMDCSYY' 08 1 2 32 9[�] ON DUTY STATUS AIRBAG 2 RESTR 4 EJECT 1 N USEET INJURY CLASS 1 NAruRE of INJURIES 2 LICENSE, CTE0369 STATE WA VN# JH4KA9657WO01679 3 10 PI ATP tt TRAILER STATE TRAILER ,STATE 11 3 5 PLATE# PLATE# ROM TO TRLR TRLR 7 1 33 1 3 5 VIN# vN# FROM TO 2 VEH.YEAR MAKE MODEL STYLE VEHICLE TOWED TO BLIN �tpyEV�I GOVT VEHICLE 13 2 199$ ACUR 3.0 CL DAMAGE YES�NO� �"-"'"'�RS 3 7 34 YE NO REGISTERED OWNER INFO MATTHEWVERG 1902 S UNIONAVEAPT29 TACOMA WA 984051020 VEHICLE NO. 1 ❑ SHADE IN DAMAGED AREA 35 3 4 14❑ LIABILITY INSURANCE❑ NSURANCE CO IN EFFECT &POLICY# 4TOP LTA LNG ❑ ❑ CHARGE FAIL YIELD LEFT TURN MOTOR s o ooTrom z 36 Yes NO CITATION# 15 III MOTOR PEDAL- PEDESTRIAN PROPERTY DAM THR OLD MET PHONE UNIT VEHICLE CYCLE nWNFR YES 1/ NO D:2066985742 16� LAST NAME HERMSEN FIRST NAME JEFFERY MIDDLE C INITIAL 37 ❑ 17 STREET'❑ 21600 94TH PL S CITY KENT ST, Wq ZIP 980311902 NEW ADDRESS 18❑ CDL IGNITION REQUIRED IGNITION PRESENT MEDIGALTRANSV'CSRTED. 38 INTERLOCKYEs No INTERLOCK YES NO YEs ND 19 DRIVER'S STATE WA IIJ SEX M E.O.B. 10 11 1963 ❑ 39 LICENSE# MMEDYY - HELMET INJURY' NATURE OF INJURIES 4p 20❑ ON DUTY❑ STATUS' AIRBAG 2 RESTR 4 EJECT 1 USE CLASS 1 ❑ 21 LICENSED09083F TATE I WA vIN# 1GCUYDEDlMZ271678 41 PLATE# 22❑ [TILER TRAILER PLATE# STATE PATE# STATE ❑ 42 23 TRLR kRLR 43 UIN#. 'IN#. VEH.YEAR 2Q21 24= MAKE CHEV MODEL SILVERA STYLE VEHICLE TOWED TO BLIN TOWED BY GOV HI 44 DAMAGE YES NO YES NO REGISTERED OWNER INFO JEFFERYHERMSEN 2160094TH PL S KENT WA 980311902 D:2066985742 VEHICLE NO.2 SHADEDAMAGEDAREA 3 4 LIABILITY INSURANCE INSURANCE CO GEICO 6055-36.41.83 IN EFFECT &POLICY# 9TOP veeiae ❑ ,J—I CITATION# CHARGE 1060TTOM LecnLLr YES N`[ 2rO 8 6 --J OFFICER'S NAME(PRINT) OFFICER PHONE BADGE OR ID# AGENCY 26 M.LEVERTON 2517 WA0171300 PAGE 01 OF PART A 3000-345-159(R 11/18) POLIICFETRAFFICN CORRECTION REPORT NO. EG54757 COLLISION REPORT III III III III III 111 1591972 CASE# 25-9885 ADDITIONAL PERSONS INVOLVED(PASSENGERS AND/OR WITNESSES ONLY) 'NAME (LAST,FIRST MIDDLE INTTIAL) ADDRESS&PHONE# SEX' D.O.B. - [----------� MMDDYYYY PASSENGER F-1 WITNESS Ej UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES--� POS. USE CLASS 'NAME (LAST FIRS,MIDDLE INITIAL) ADDRESS&PHONE# SEX' D.O.B. - L----------� MMDDYYYY PASSENGER DWITNESSD UNIT# SEAT AIRBAG RESTR. EJECT HELMET NJURY NATURE OF INJURIES POS. : USE CLASS ----� '.NAME (LAST,FIRST,MIDDLE INITIAL) ADDRESS&PHONE# SEX D.O.B. - L----------� MMDDYYYY PASSENGER WITNESS UNIT# SEAT AIRBAG RESTR. EJECT HELMET INJURY NATURE OF INJURIES ❑ Q POS. USE CLASS �____ ----j NARRATIVE Please see subsequent narrative pages I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 11-14-25 04:05 PM INVESTIGATING OFFICER'S SIGNATURE UNIT OR DIST.DET DATED PLACE SIGNED APPROVED BY DATE C.JACOBS 1953 1 121312025 7.57:36 AM BADGE OR ID# 2517 ORI# ( WA0171300 TIME POLICE DISPATCHED'; 8:37 AM TIME POLICE ARRIVED 8:43 AM PART B 3 Do-3mx-,ao(Rtrras) PAGE 27 OF 57 REPORT NO.` EG54757 CASE# 25-9885 O COLLI COLLISION TIME OF 11/14/25 08:31 COLLI NARRATIVE unit 1 It/wht unit 2 wht/ln2 wb unit 3/wht lane 1 CC Within the city limits of Renton/King/Wa I responded to a 3 vehicle crash at the intersection of NE 3rd St at Bronson Way N. When I arrived unit 1 was on Bronson partially blocking southbound lane facing the wrong direction and also over the sidewalk, unit 2 and 3 were pulled off the roadway over the sidewalk on NE 3rd facing west. I contacted the driver of unit 3 who told me he was in lane 1 when unit 1 turned left across his lane while he was on his green light. Unit 3 said he was contacted by unit 1 as unit 1 was crossing in front of him. He did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 2 who told me he was on his green light in lane 2 westbound when unit 1 turned left across his path with no room to avoid contact. He told me unit 1 just cut in front of him when the crash happened. He did not complain of injury and damages did not require a tow truck. I contacted the driver of unit 1 ID'd by his picture WADL. He told me he did not have insurance for his vehicle. He told me he slid out on the wet roadway on his doughnut mini spare tire and couldn't get stopped. He said he was contacted by unit 2 and 3 in the side of his car. The rear passenger tire was folded over and required a tow truck. cited unit 1 Ref RCW 46.61.185 FTYROW Left Turn 3 car crash and Ref RCW 46.30.020 No valid proof of insurance via complaint. I certify (declare) under penalty of perjury under the laws of the State of Washington that the foregoing is true and correct. M.Leverton/2517 City of Renton/King/Wa 11/14/2025 PAGE 3 OF 5 SUPPLEMENTAL REPORT No. EG54757 POLICE TRAFFIC 1 1 8 27 µ ^'� COLLISION REPORT CASE#+ 25-9885 1 COMMERCIAL MOTOR CARRIER INTERSTATE INTRASTATE UNIT# USDOT ICC# VEHICLE TYPE CARGO BODY TYPE 2 ❑ 1 28 CARRIER NAME 3 CARRIER L ADDRESS CITY ST ZIP 4 ❑ NAME # PLACARD GWVR NO NUMBER SOURCE AXLES1:1 + NAME IF 4a ❑ ADDITIONAL UNITS MOTOR PEDAL- PROPERTY DAMAGE THRESHOLD MET PHONE UNIT : 3 �✓ PEDESTRIAN ❑', YEs� No D:4252822576 5 VEHICLE CYCLE OWNER 0 1 29 I NITIAL E LAST NAME ZUBKO FIRST NAME IVAN-VOLODYMYR I ; N ITCA STREET 30 NFW ADDRGS.p; 268 GRAHAM AVE NE CITY RENTON ST WA ZIP980595068 6 ❑ PRESENT MEDICALTANSPORTED, 1 1 2 31 CDL IGNITIt7N REQUIRED 1GNi710N INTERLOCK YES NO INTERLOCK YES NO YES[:]N DRIVER'S D.O,B 7 LICENSE WA SEXM MMDDYYY 07 - O6 - 1996 ON DUTY STATUS: AIRBAG 2 RESTR. 4 EJECT g HELMET INJURY 1 NAruREofINJURIEs USE GLASS 8 ❑ 1 32 LICENSE 541QHP TAT OR VIN# 2C4RDGBG9HR567680 PLATE# 9 TRAILER TRAILER 2 PLATE#i STATE PLATE# STATE 10 ❑ TRLR TRLR VIN.#. VIN.#. 11 3 5 VEH.YEAR2017 MAKE DODG MODEL GRAND STYLE VEHICLE TOWE E T ABLIN TOWED BY GOVT VFHICI F FROM To DAMAGE YES NO ✓ YES NO REGISTERED OWNER INFO.V&K TOW INC 268 GRAHAM AVE NE RENTONWA98059 3 7 33 12 � SHADE IN DAMAGED AREA 4 FROM TO INSURANCE CO LIABILITY INSURANCE ST FARM 582 9799-E28-47 IN EFFECT � &POLICY# <DQ 34 13 vewcEe YES❑ NO❑ CITATION# CHARGE s rnNolNc MOTOR PEDAL_ ' PROPERTY DAMAGE THRESHOLD MET PHONE ❑ 35 14 ❑ UNIT# VEHICLE CYCLE PEDESTRIAN OWNER YES NO 15 LAST NAME FIRST NAME INITIAL E ❑ 36 16 ❑ STREET CITY ST! ZIP NEW ADDRESS" GDL IGNITIC7N RE(]UIRED IGNITION PRESENT MEDICAL TANSPORTED INTERLOCK YES NO INTERLOCK YES NO YES NO 17 37 LDRIVERS ICENSE STATE SEX M�oflYBYY' 18 ❑ ❑ HELMET INJURY NATURE OF INJURIES 38 ON DUTY STATUS AIRBAG RESTR. EJECT USE CLASS 19 ❑ LICENSE TAT viN ❑ 39 PLATE# # 20 ❑ TRAILER TRAILER ❑ 40 PLATE#. STATE PLATE# STATE 21 ❑ TRLR. TRLR 41 VIN#�. VIN#+. 42 22 VEH.YEAR MAKE I MODEL I STYLE VEHICLE TOWED DUE T SABLIN TOWED BY GOVT.VEHICLE DAMAGE YES NO YES NO 23 REGISTERED OWNER INFO. SHADE IN DAMAGED AREA 43 2 3 4 LIABILITY INSURANCE INSURANCE CO IN EFFECT I &POLICY# tK-99 5 44 vewcEe ❑ ❑ CITATION# CHARGE 24 IEGALLY VES NO3 3 6 I CERTIFY(DECLARE)UNDER PENALTY OF PERJURY UNDER THE LAWS OF THE STATE OF WASHINGTON THAT THE FOREGOING IS TRUE AND CORRECT. M.LEVERTON 11-14-25 04:05 PM 25 INVESTIGATING OFFICER'S SIGNATURE OFFICER'S PHONE UNIT OR DIST DET DATED: PLACE SIGNED BADGE 1 APPROVED 2 �ORIWA0171300 A 1312025PAGE26 2517 OF ORID# # 3000-345-013(R 11l18) REPORT NO. EG54757 CASE# 25-9885 DATE AND TIME i 11/14/25 08:31 OF COLLISION I U; �4 1 1 SL � M1M1 JJ ut� Y ,3z �s a� { n, 0 e , �4 yy 4411 t �2 � i t { r j 5 PAGE 5 OF 5