Claim by Carol Klinkhammer Copyrighted
January 6, 2020
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUM MARY: Sara Burke for property damage; John Herrig for property
damage; Carol Klinkhammer for property damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Referto City
Attorney
ATTACHMENTS:
Description Type
Claim by Sara Burke Supporting Documentation
Claim by John Herrig Supporting Documentation
Claim by Carol Klinkhammer Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA ,� �
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This written report constitutes your claim against the City of Dubuque, lowa. You should
complete this form in full and attach any additional information that supports your claim.
The Claim must be filed with the City Clerk at City Hall, 50 W. 13t'' St., Dubuque, IA 52001. It
will then be referred by the City Council to the appropriate department for investigation.
Once that investigation is completed, a report and recommendation will be submitted to the
City Council. 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 CLAIM WILL OR WILL NOT BE PAID.
1. Name of Claimant: ��t.n,v�._ � ��.,��n�
2. Address: � �Z�;� .��,�s� ��--
City: �����.� State: ���''�`� Zip: S`�--�'���
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3. Telephone Number: ,5�'��- �.��'.-�--- �s°�«-�'
4. Date of Incident: �,,,��,,�^�- / `�--
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5. Time of Incident: �, �u ?�`�'l.
6. Location of Incident (Be specific): '�� .���- ��'�`� t; ,,�,�� �.� .���
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7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim. If a City employee was involved, give the
ernpioyee's name.)
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8. What were weather conditions like? ��C����'
9. Give narne and address of any witnesses: �� ��
' 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? (If so, describe property and the extent of
damages. Attach estimates of damages or describe basis for ascertaining extent of
damage.)
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13. What other damages do you claim, if any? ?��Z:Y=.�..'`
14. Have you been compensated for any part or all of your claim by any insurance
company? (If so, give name and address of insurance company and amount paid.)
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15. What amount do you claim from the City of Dubuque?� F ,.; �<%
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16. Why do you claim the City of Dubuque is responsible?
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17. Have you made any claim against anyon� else for damages as a resul# of this incident?
(If yes, give name and address.) �
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18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount?
Dated at Dubuque, lowa this �� day of '`-� ��-ti��-F '-��-�� , 20�,
(��� � ��'��`��'� (Signature) s._,;
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(Rev. 5/18)
Copyrighted
January 6, 2020
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Claims
SUMMARY: CityAttorney advising that the following claims have been
referred to Public Entity Risk Services of lowa, the agent
for the lowa Communities Assurance Pool: Sara Burke for
property damage, John Herrig for property damage, and
Carol Klinkhammer for property damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Staff Memo
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�ubuque
THE�ITY OF
A(I•A�erica Ci� �
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TRACEY STECKLEIN �,�j�
PARALEGAL jJ`" I
iVIEMO �
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To: Mayor Roy D. Buol and
Members of the City Councif I
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DATE: December 17, 2019 �
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RE: Claim Against the City of Dubuque by Carol Klinkhammer ;�
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Claimant Date af Clairn Date of Loss Nature of Claim �
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Carol Klinkhammer 12/17/19 09/12/19 Property Damage/ �
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This is a claim in which claimant alleges that during a storm that occurred on September j
12, 2019, a limb from a City tree fell onto claimant's house damaging the gutters, and '�
damaged claimant's smoke tree. i�
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This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa i
Communities Assurance PooL ;�
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cc: Michael C. Van Milligen, City Manager ;I
Marie Ware, Leisure Services Manager �
Stephen Fehsal, Park Services Manager
Carol Klinkhammer
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OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TE�EPHONE (563)583-4113/FEvc (563)583-1040/EMai� tsteckle@cityofdubuque.org