Claim by Jane Thorne and Michael ThorneCity of Dubuque Consent Items # 2.
City Council Meeting
ITEM TITLE: Notice of Claims and Suits
SUMMARY:
SUGGESTED
DISPOSITION:
ATTACHMENTS:
Description
Copyrighted
July 6, 2021
Dustin McGonigle - Section 1983; J.B. Priest for property damage;
Douglas Spyrison for property damage; Jane Thorne and Michael
Thorne for vehicle damage; Settlement Agreement and Mutual Release
of All Claims between HACAP / Operation New View and Gary
Stelpflug/2G2, LLC.
Suggested Disposition: Receive and File; Refer to City Attorney
Claim by Dustin McGonigle
Claim by J.B. Priest
Claim by Douglas Spyrison
Claim by Jane Thorne and Michael Thorne
Settlement with Gary Stepflug and 2G2
Letter and Settlement Agreement Stepf lug and 2G2
Type
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Staff Memo
Supporting Documentation
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 claim.
The Claim must be filed with the City Clerk at City Hall, 50 W. 13th 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.
I. Name of Claimant:
2. Address:
City' �'k' '� State: T2-
ZiP: _LI
3. Telephone Number: �OCf -
4. Date of Incident: U -:w _ -
5. Time of Incident:
6. Location of Incident (Be specific): Pr rv. `+
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
employee's name.)
8. What were weather conditions like? Q Lop), , Q h 1,
9. Give name and address of any witnesses:
10. Did police investigate? (If so, give names of officers.)
it .an.a I _
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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.)
Y
13. What other damages do you claim, if any? _0 t , r)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.)
15. What amount do you claim from the City of Dubuque?
16. Why do you claim the City of Dubuque is responsible?
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) ,
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, Iowa this day of
20
IC, cw 01,n-- lA I o e(Print Name)
(Rev. 5/18)
c;
Driver Information Exchange Report
DUBUQUE POLICE DEPARTMENT
(563) 589-4410
U
IJ
001
Driver's Name - Last
COOK
Address
2472 RADFORD RD
CDL? Driver's License Number
NO
Class
C
First
JENNY
State
IA
City
ASBURY
Endorsements
NONE
Middle
LYNN
Restrictions
Owner Com ame
CITY OF DUBUQUE
Owner's Name - Last
State
IA
Insurance Co Name
(CAP
Insurance Policy #
53
Suffix
Age
45
Gender
FEMALE
Zip Home/Cell Phone Number
52002-0000 (563) 451-3090
Insurance Co. Phone #
(563) 589-4144
First (Middle
Address
50 W 13TH ST
VIN No. IYear
3C6JR7DT1H G675507 12017
License Plate #
107280
State
fA
City
DUBUQUE
Make Model
RAM - RAM 1500ST
Year Most Damaged Area
2099 09 - MIDDLE DRIVER SIDE
State
IA
Suffix
Zip
52001
Style
PK
Vehicle Configuration
02
Color
WHI
Approximate Cost to Repair or Replace
$200.00
U
T
002
Driver's Name - Last
RATCLIFF
Address
201 W 17TH ST APT All
CDL? Driver's License Number
NO
Owner Company Name
First
JOHN
City
DUBUQUE
Middle
CHRISTIAN
Class State Endorsements !Restrictions
C IA NONE (NONE
Owner's Name - Last First
RATCLIFF JOHN
Address
201 W 17TH ST APT All
VIN No.
Year
1FTPW14V59FA60925 2003
License Plate #
2623235E
County
DUBUQUE -31
Literal Description
ALGONA ST N AND LORAS BLVD
IX -Coordinate
00689681
State
IL
Suffix
State Zip
IA 52001-0000
Insurance Co. Name
AMERICAN FAMILY MUTUAL
Insurance Policy#
129209611368FPPAIL
Age Gender
23 MALE
Home/Cell Phone Number
(760) 525-1959
Insurance Co. Phone #
(309) 353-8700
City
DUBUQUE
Make Model
DODGE -DODG RAM
Year
2022
Middle
CHRISTIAN
State
LA
Suffix
Zip
520010000
Style
PK
Vehicle Configuration
02
Color
RED
Most Damaged Area
10 - FRONT DRIVER SIDE
Approximate Cost to Repair or Replace
$500.00
Accident occurred within corporate limits of (city)
DUBUQUE - 2100
If accident occurred outside of city
limits show general vacinity;
On Road, Street, or Highway:
Distance
Dirocion !Nearest City
of
Direction Distance
and
Definable intersection, bridge or railroad crossing
Officer
OFFICER SAMUEL WHITE
Y-Coordinate
04707828
At Intersection with:
Direction
of
Milepost Number
!Badge No. aw Enforc ant Case Number
35 021-00281
Date of Accident
04/26/2021
Or
•
Route (Cardinal)
Travel Direction
Time of Accident
11:22 Hrs. Ij
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Page 1 of 1
MIKE MURPHY FORD INC.
565 WEST JACKSON ST MORTON IL 61550
JANE THORNE
Home:
Mobile:
Work:
Email:
TYPE _..., DESCRIPTION
DOOR MIRROR - Remove & Replace - [DOES
Labor NOT include refinishing (where applicable).] F150
Power Mirror,Each
Jun 26, 2021 07:38 AM
YMMS:
2009 Ford Pickup F150
Engine:
5.41- Eng
License:
VIN:
Odometer:
PART # QTY PRICE LINE TOTAL
Parts DOOR MIRROR - [Contact Dealer with VIN for 9L3Z
proper application and price.l 17683-CB
Customer Signature:
- - $142.50..
1.0 $211.48 $211.48
Labor: $142.50i
Parts: $211.48
Shop Supplies:
$14.25
Hazardous Materials:
$1.00
Labor Taxes:
$0.00
Parts Taxes:
TOTAL:
$14.87
$384.10
https://wwwl .prodemand.com/Print/Index?hideLogo=true&hideModuleTab=true&hideOp... 6/26/2021
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