Claim by Azariah MartinCity of Dubuque Consent Items # 02.
City Council Meeting
ITEM TITLE: Notice of Claims and Suits
SUMMARY:
SUGGESTED
DISPOSITION:
ATTACHMENTS:
Description
Copyrighted
March 18, 2024
Latoya Eubanks for property damage; Ronald Lindblom and Catherine
Dunning for property damage; Azariah Martin for vehicle damage; Kirtland
Thayer for vehicle damage.
Suggested Disposition: Receive and File; Refer to City Attorney
Claim by Ronald Lindblom and Catherine Dunning
Claim by Latoya Eubanks
Claim by Azariah Martin
Claim by Kirtland Thayer
Type
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
(N o'A
A,y4e,t
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.
1. Name of Claimant: A 2.c,- r i Q h M ct`r-- 1 n
2. Address: IcIHO f,n_therint S#
City: b U hero u L State: Zip: 520o 1
3. Telephone Number: (boa) 3 " U - UHW b
4. Date of Incident: )- I to -LA
5. Time of Incident: owo v nc1 1 '. OO p rcM
6. Location of Incident (Be specific): of 191-1 Q C,&-t he Y i flt -�t , Cl t J h t, d f. Q d
in of -thy s-tr c e;A
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.)
rntrtvec� o worK ��� e �cdoY0 �Nanal
o� c4 my roomuAC, ;f Ah\ t-ar taw he, moved• o hrn tj ►mri kt(As wi-kh Mt tvilut n0+
of 1ow►1• too"\m,%c, totd -them thq-t Ctnd -they Sind lA gJ01S okay Una They to nAinv(ol on
8. What were weather conditions like? sunsh i nc baa,)
9. Give name and address of any witnesses: 1140 GQAhertnt S� -
d►d hot Wttvt 'th1. WDVluV4 tc1IV,(.d tD V�tm
10. Did police investigate? (If so, give names of officers.)chbovt MVUNy the, cat Und tt betny uk..
N jA
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
N/A
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.)
a►c-t�scc0.3t0,check•
13. What other damages do you claim, if any? N i A
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.)
N jP\
15. What amount do you claim from the City of Dubuque?
� 1, i'tb. ZVO C, from erlmeye.r, Rvto body IS a'ttacheel)
16. Why do you claim the City of Dubuque is responsible?
GI+u 01 Dubuaoe, ; mi(VfrS wtyl LnIorybinq ga +hr atoll end r\ut A() my car
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.)
NIA ,
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount?
NIA
Dated at Dubuque, Iowa this r�-) day of Mg r C h , 20 2-4 .
(Signature)
N)
Pa a Y► a h Martin (Print Name)
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(Rev. 5/18)