Claim by Mark HoppmannTHE CITY OF
1.~UB E MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: September 28, 2009
RE: Claim Against the City of Dubuque by Mark Hoppmann
Claimant Date of Claim Date of Loss Nature of Claim
Mark Hoppmann 09/22/09 09/22/09 Vehicle Damage
This is a claim in which claimant alleges that his vehicle was struck by a City of
Dubuque bus while the vehicle was parked at the corner of Keyway and Keystone.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
Jon Rodocker, Transit Manager
Mark Hoppmann
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 583-4113 / FAx (563) 583-1040 / EnnAIL tsteckle@cityofdubuque.org
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
This written report constitutes your claim against the City of Dubuque, Iowa. You should complete this form in full and
attach any additional information that supports your daim.
the daim must be filed with the City Clerk at City Hall, 50 West 13'" St., Dubuque, IA 52001. k will then be referred to
the appropriate department for investigation and to the City Attorney's Office. Once that investigation is completed, a
report and recommendation will be submitted to the City Coundl. You will be provided with a copy of that report and
recommendation.
The final decision on all claims is made by the City Council. No employee of the City of Dubuque has the authority to
make any representation to you``as to whether your daim will or will not be paid.
1. Name of Claimant: ~'~RJC.. ~a~nn.Rnn ~1.
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2. Address: ,~ ~ Cl 9 P1-~(~Gt:W
3. Telephone Number. .~ $ oZ ~~ ~ ~
4. Date of Incdent: ~ ~ as - c ~
5. Time of Incident: "? : ,~-~ i4-tA
6. t.ocation of Inddent (13e specific): ~~~p ~'~[~e-1 r. r.~~ '4~i hoYll.c_ .
t'' ~~ r' ter G F L'{w ~.c~u-lu i~ 2.. ~'~ ~C ~ S'~tli1 ~- l~ R
7. Describe the accident or occurrence that caused injury or damage. (Give full details upon which you base your
daim~._H a City emplofyee was involved, givee the employee's name.) \ ~.
~•~ v $ inS CX i^: a-a_ n \C~,~lw 1~t.J ~ ~~~1~ `(~'` `' `(~1~~ 4>c,.r~F.q~
~~r ~-..~' ~~... C r c~g,i~`i: 1~' ~-t~a W c:. ,. a..,.~. C~Chr~ . \
8. What were weather conditions like? `~ a
9. Give name and address of any witnesses: ~ ~ ~5 r~ ~ : nc u,. C .~~y
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10. Did police investigate? (If so, give names of officers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries.}
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12. Was any damage done to property? (ff so, describe property and the :,.t_.a of damages. Attach estimates of
damages or describe basis for ascertaining exte\nt of damay`~~ge.) ~ ~
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ALL PARTS INSTALLED ARE NEW UNLESS SPECIFIED OTHERWISE ` ~T ~
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ADDRE ~ „~..-~~..~~`~ m ~' - I TIME RECEIVED
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SPECIAL REPAIRS
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RETAIN PARTS ^
DESTROY PARTS ^
TOTAL PARTS I I HEREBY AUTHORIZE THE ABOVE REPAIR WORK TO BE DONE, ALONG TOTAL LABOR
WITH NECESSARY MATERIALS. YOU AND YOUR EMPLOYEES MAY OPER-
PARTS -
ATE ABOVE VEHICLE FOR PURPOSES OF TESTING, INSPECTION OR DELIV-
'
ESTIMATE AMOUNT ERY AT MY RISK. AN EXPRESS MECHANIC
S LIEN IS ACKNOWLEDGED ON
LABOR ABOVE VEHICLE TO SECURE THE AMOUNT OF REPAIRS THERETO. YOU
TIME ev
WILL NOT BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO VEHICLE _
ADO'L AUTH AMT OR ARTICLES LEFT IN VEa18tE IN ASE OF FI ,THEFT, ACCIDENT OR TOTAL PARTS
ANY OTHER CAUSE BE`~OKID YOUJR NTROL. -
ADD'L AUTH. AMT - '~ J/•
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~ GAS, OIL, GREASE
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AUTHORIZED BY ~~
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ADD'L AUTH. AMT. RECEIVED BY _ SPECIAL REPAIRS
~ ~ • GAL. GASOLINE @ CHARGOES ENTAL
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QTS. OIL @
~ Unless otherwise provided by law, the seller (above named dealership) hereby -
O z expressly disclaims all warranties, either express or implied, including any implied
~ ~ warranty of merchantability or fitness for a particular purpose, and neither LBS. GREASE @ STATE TAX
a a assumes nor authorizes any other person to assume for it any liability in connection - -
with the sale of said products. TOTAL GAS -OIL -GREASE • ~ I ~ •
Used Car Value -Chrysler Cirrus-V6 Sedan 4D LX
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Bodv Stvle > Make > Year > Mode18: Trim > NFleaae & ODtions > Value Report
1995 Chrysler Cirrus-V6 Sedan 4D LX
Driver Information Exchange Report
N
T
001
Driver's Name - Last
OUGH
Address
2237 WASHINGTON ST
First
STEVEN
Dubuque Police Department
563-589-4410
City
DUBUQUE
I Middle
IEDWARD
Siff x Date of birth
State
IA
Zp
52001-0000
Phone
(563) 689 4196 x
Gender f Driver's License Number
Male I—
a Class
B
r Stale
IA
Endorsements
P
Restrictions
B
Insurance Co. Name Insurance Co Phone #
IOWA ASSURANCE POOL (563) 589-4120 x
Insurance Policy #
CITY OF DUBUQUE
Owner Company Name
CITY OF DUBUQUE KEYLINE BUS SERV
Ormer's Name - Last I First
Middle
Suffix
Address
2401 CENTRAL AVE.
DUBUQUE
State Zip
IA 62001-
VIN No.
T6H4523A1967
Year Make
1976 GMC
Model
Style
BUS
[Vehicle Configuration
18
License Plate
64507
T
002
Driver's Name • Last
State
IA
Year
2009
Most Damaged Area
02 - Right Front
Approximate Coss to Repair or Replace
$50.00
First
Middle
Suffix
Date of Birth
Address
City
State
Zip
Phone
(563) 582-7795 x
Gender i Driver's License Number Class
Owner Company Name'State
Endorsements Restrictions
NONE NONE
—Insurance Co. Name
Insurance Co Phone #
LIBERTY (800) 225-2467 x
Insurance Policy #
A02.243.600185-70 9
Owner's Name - Last
HOPPMANN
Address
1899 KEYWAY DR
First
MARK
City
DUBUQUE
Middle
FRANCIS
I Suffix
State
IA
Zip
52002-
VlN No.
1C3EJ68HXSN513618
Year ! Make
1996 C}IRY
Model
CIR
Style
4D
Vehicle ConFit;urair.;n
01
License Plate #
842 MYC
State
IA
Yeas Most Damaged Area
2009 01 - Front
Approximate Cost to Repair or Replace i
$ 1,500.00 j
County
Accident occurred within corporals limits of (city)
.
Literal Description j
KEY WAY and KEYSTONE DR
X-Coordinate
00686869
Y-Coordinate
04708331
if accident occurred outside of city
limits show general vacinity: "N/A"
Direction
"NIA" of
Nearest City Route
"NIA"
(Cardinal) i
I Travel Direction "N/A"
On Road, Street, or Highway:
KEYSTONE DR
At Intersection with:
KEYWAY DR
Distance
"NIA"
Direction iDistance
"NIA" and E"NIA"
Direction
"NIA' of
Milepost Number
"NIA" Or
Definable intersection, bnx;ye. or railroad crossing
"NIA"
Officer
BASTEN, DANIELLE
Badge N
23A
Law Enforcement Case Number ate of Accident
01/09-446981 9i22/2009
Time of Avuidr
en
07:28 Hrs.
Printed At: Dubuque Police Department 09/22/2009 08:16 AM Paget Form*: 01/09-44898k