Claim by Julie Fry1' vrn
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA �tca(cFchrzt
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. ITT 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: Julie Fry
2. Address: 2080 Roosevelt
City: Dubuque
3. Telephone Number:
4. Date of Incident:
5. Time of Incident:
Iowa
State:
608-436-9371
October 12, 2022
approximately 6:00 PM
6. Location of Incident (Be specific):
The deck on side of house
Zip: 52001
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.)
A large tree branch snapped off of tree and fell on my patio. I was not at my home when this happened.
8. What were weather conditions like? windy
9. Give name and address of any witnesses:
George Kapparos, 2026 Lincoln
10. Did police investigate? (If so, give names of officers.)
Yes. Officers' last names are Yeo and Hoover. Park Officer's last name is Blosch.
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
No
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.)
Yes, parts of the patio wood is cracked, gutters are bent, gazebo is destroyed, grill cover ripped and damaged
13. What other damages do you claim, if any?
Please see insurance report.
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.)
No
15, What amount do you claim from the City of Dubuque? 42976,11
/
16. Why do you claim the City of Dubuque is responsible?
The tree belongs to the city. Also, the tree was rotted.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) No
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 14 day of November 20 22
Julie . -
(Signature)
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Julie Fry (Print Name) 3
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(Rev. 5118) °