Claim by Smokestack Susan PriceCopyrighted
November 6, 2023
City of Dubuque Consent Items # 02.
City Council Meeting
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Arius Burns and Hayle Johnson for property damage; Laufenberg and
Larson Properties LLC for property damage; Smokestack - Susan Price
for property damage.
SUGGESTED Suggested Disposition: Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
Description Type
Claim by Arius Burns and Hayle Johnson Supporting Documentation
Claim by Laufenberg and Larson Properties LLC Supporting Documentation
Claim by Smokestack Susan Price 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. 13"' 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: .S/I'1 n Iry J, T��---
2. Address: _(„ Z 7
City: d3 t)Qt/� State: L�/� Zip: 2-0
3. Telephone Number: l % - Lf % y —
4. Date of Incident: G� -3 ?� 3
5. Time of Incident: "W/VJ
6. Location of Incident (Be specific):
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.)(
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8. What were weather conditions like? _ % To C,,b W' &G1— Gl ^7
9. Give name and address of any witnesses:_
10. ,Did police investigate? (If so, give names of officers.)
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?
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? q
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16. Why do you claim the City of Dubuque is responsible?� C
17. Have you made any claim against anyone else for
(If yes, give name and address.) damages as a resin of this incident?
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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, Iowa this 1 day of CJ IC 20
(Signature)
(Print Name)
(Rev. 5/18)
City of Dubuque
City Council Meeting
Consent Items # 03.
Copyrighted
November 6, 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: Laufenberg and Larsen Properties for property
damage; Mercy One Medical Center for property damage; Smokestack
Susan Price for property 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: 10/20/2023
RE: Claim Against the City of Dubuque by Smokestack — Susan Price
Claimant Date of Claim Date of Incident Nature of Claim
Smokestack 10/17/2023 9/30/2023 Property Damage
Susan Price
This is a claim in which claimant alleges Claimant's property was damaged due to a sewer
line backing up into the Claimant's bathroom.
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
Arielle Swift, Public Works Director
Smokestack — Susan Price
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