Claim by Kelsey BhatiaCity of Dubuque
City Council
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Copyrighted
October 6, 2025
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Kelsey Bhatia for property damage; Joseph Jenkins for
property damage; Mik Kalloway for vehicle damage; Lillian
and Jacob Ludlow for vehicle damage; Martin Wing for
property and vehicle damage.
SUGGUESTED Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
1. Claim by Kelsey Bhatia
2. Claim by Joseph Jenkins
3. Claim by Mik Kalloway
4. Claim by Lillian and Jacob Ludlow
5. Claim by Martin Wing
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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:
2. Address:
City: U ua I Zf? State: -1--oyd (,, Zip: � C�
3. Telephone Number:�����" 1
4. Date of Incident:
5. Time of Incident:
6. Location of Incident (Be specific): t t-C�Oe(3 A Q0 JE-i�lM pi/j j-
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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9. Give name and address of any witnesses: --9d I J
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? ialna,l 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.)
15. What amount do you i
16. Why do you clgjm the
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from the City of Dubuque?
ity of Dubuque is responsible?
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 wh amount?
Dated at Dubuque, Iowa this day of �5a M , 20 Z.
(Rev. 9/24)
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