Claim by Elijah CallahanCity of Dubuque
City Council
CONSENT ITEMS # 2.
Copyrighted
January 6, 2025
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Elijah Callahan for vehicle damage; Daniel Dunne for vehicle
damage; Elizabeth Gonner for vehicle damage; Amy Smith
for vehicle damage.
SUGGUESTED Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
1. Claim by Elijah Callahan
2. Claim by Daniel Dunne
3. Claim by Elizabeth Gonner
4. Claim by Amy Smith
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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. 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: _LA
2. Address: Z33� AcC1111011>1-tX1Q_ LN
City: 0LA_10J~-,_
State: �1�
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3. Telephone Number:
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4. Date of Incident:
5. Time of Incident: 07LO
6. Location of Incident (Be specific): Via. GrmAJLv,,L> Av.,,- ``zct Dk�
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 weather2onditions like? .
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9. Give name and address of any witnesses: A)-,6LL
10. Did police investigate? (If so, give names of officers.)
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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? /V'O^t-
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?
16. Why do you claim the City of Dubuque i responsible?
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17. Zve you made any claim` ainst 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 A day of 20, -i .
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C'. It'X.,,,X (Print Name)
(Rev. 9124)
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Page 53 of 366