Claim by Susan HarrisCity of Dubuque
City Council Meeting
Consent Items # 02.
Copyrighted
April 3, 2023
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Rebecca Ambrosy for vehicle damage; Connie Carroll for property
damage; Tony Cross for property damage; Susan Harris for vehicle
damage; James Hauber for property damage; Ruth McEnany for
property damage; Alex Pfeiffer for vehicle damage.
SUGGESTED Suggested Disposition: Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
Description
Claim by Rebecca Ambrosy
Claim by Connie Carroll
Claim by Tony Cross
Claim by Susan Harris
Claim by James Hauber
Claim by Ruth Mcenany (Claim No. 1)
Claim by Ruth Mcenany (Claim No. 2)
Claim by Alex Pfeiffer
Type
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
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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. 131h 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.
CS r> U 1 ..
1. Name of Claimant:
2. • • 1%2j1f i�
i
3. Telephone Number:
4. Date of Incident: 1
5. Time of Incident:
State: Ll) (l Zip:4
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.)
9. Give name and address of any witnesses:
ii[;
11
Did police investigate? (If so, give names of officers.)
Was anyone injured? (If so, give names, addresses, and extent of injuries).
12. Was
damages.
damage.)
any damage done to property? (If so, describe property and the extent of
Attach estimates of damages or describe basis for ascertaining extent of
13. What other damages do you claim, if any?
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
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 ^C1 C",, ,lJ 20 1
W
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(Rev.5/18)
City of Dubuque
City Council Meeting
Consent Items # 03.
Copyrighted
April 3, 2023
ITEM TITLE: Disposition of Claims
SUMMARY: City Attorney advising that the following claims have been referred to
Public Entity Risk Services of Iowa, the agent for the Iowa Communities
Assurance Pool: Rebecca Ambrosy for vehicle damage; Connie Carroll
for property damage; Tony Cross for property damage; Susan Harris for
vehicle damage; James Hauber for property damage; Ruth WEnany for
property damage; Alex Pfeiffer for vehicle damage.
SUGGESTED Suggested Disposition: Receive and File; Concur
DISPOSITION:
ATTACHMENTS:
Description
I CAP Referral
Type
Supporting Documentation
THE CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
JONI MEDINGER
LEGAL ADMINISTRATIVE ASSISTANT
To: Mayor Brad M. Cavanagh and
Members of the City Council
DATE: 3/29/2023
RE
Claimant
Susan Harris
Claim Against the City of Dubuque by Susan Harris
Date of Claim Date of Incident Nature of Claim
3/24/2023 3/14/2023 Vehicle Damage
This is a claim in which claimant alleges Claimant's vehicle was damaged due to an
alleged defective condition of the intersection of Holliday Drive and NW Arterial.
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
John Klostermann, Public Works Director
Susan Harris
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 589-4113 / FAx (563) 583-1040 / EMAIL jmedinge@cityofdubuque.org