Claim by Gerald BreitbachCopyrighted
February 17, 2025
City of Dubuque CONSENT ITEMS # 2.
City Council
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Gerald Breitbach for vehicle damage; Robert Hochrein for
vehicle damage; Kathryn Luher for vehicle damage.
SUGGUESTED Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
1. Claim by Gerald Breitbach
2. Claim by Robert Hochrein
3. Claim by Kathryn Luher
Page 67 of 797
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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. 13t" St., Dubuque, IA 52001. 11
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:
2. Address: I `i nr/U-U#!r "
City:
3. Telephone Number:
4. Date of Incident:
5. Time of Incident:
6. Location of Incident (Be specific):
State: :+--t7►t� Zip: 5z ,.
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25
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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What were weather conditions li
9. Give name and address of any witnesses: ( .-
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10. Did police investigate? (If so, give names of officers.)
. f*tie 7I V. (;"e- Ht4 INFO .
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
Page 68 of 797
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? �Ww oj- —ffKE a � - rM14
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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. Wnaquint do�rou claim from the Cit of Dubuq e? YAwAt milm' ne 1� I w� +t" I�r'I �- nT. ,I+M 15
16. Why do you claim the City of Dubuque is responsi e?
17. Have you made any claim against anyone else for dama es as a result of
(If yes, give name and address.)
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is incident?
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18. If the answer to Question 17 is yes, have you received any payment from tf�at source, and
if so, in what amount?
NO PMKAE7q-_ d" r-j-" A- U*V^ TOCV VUE-70
Dated at Dubuque, Iowa this day of •��� 20 75
nature)
Vl°li� I� (Print Name)
(Rev. 9/24)
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Page 69 of 797