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Claim by Ann Marie Schroeder Copyrighted June 1, 2026 City of Dubuque CONSENT ITEMS # 2. City Council ITEM TITLE: Notice of Claims and Suits SUMMARY: Shannon Brenner for Vehicle Damage; Ann Marie Schroeder for Personal Injury; J&R Rental LLC for Property Damage; Austin Bodenhofer for Property Damage SUGGUESTED Receive and File; Refer to City Attorney DISPOSITION: ATTACHMENTS: 1. Claim by Shannon Brenner 2. Claim by Ann Marie Schroeder 3. Claim by J&R Rental Inc Nicholas Kluesner 4. Claim by Austin Bodenhofer Page 64 of 1000 MVM Legal Gus Psihoyos � CLAIM AGAINST THE CITY OF DUBUQUE, IOWA j � This written report constitutes your claim against the City of Dubuque, lowa. 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. 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 I THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO YOU i AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAID. � ! 1. Name of Claimant: Ann Marie Schroeder ; ; 2. Address: 5186 Fagan Road ; i City: Zwingle State: lowa Zip; 52079 1 3. Telephone Number: 563-543-8083 � I 4. Date of Incident: November 7, 2024 � 5. Time of Incident: Approximately 6:45 AM � ! I 6. Location of Incident (Be specific): 2408 WinsorAve, Dubuque j � 1 , ; ; 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.) ; See attached. 8. What were weather conditions like? Clear 9. Give name and address of any witnesses: Wendy Lyons, 1320 Rhomberg Ave, Dubuque 10. Did police investigate? (If so, give names of officers.) N/A 11. Was anyone injured? (If�so, give names, addresses, and extent of injuries). Yes. See attached. Page 68 of 1000 i � � � 12. Was any damage done to property? (lf so, describe property and the extent of damages. � Attach estimates of damages or describe basis for ascerfiaining extent ofi damage.) ; i N/A � { � 13. What ofiher damages do you claim, if any? See attached. � � . � 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.) i s Some of my medical bills have been paid by BCBS. ; 15. Whafi amount do you claim fram the City of Dubuque? See attachsd. ; 16. Why do you claim the City of �ubuque is responsible? ' See attached. 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) Only to the extent of my medical insurance. See attached. 18. If the answer to Question '[7 is yes, have you received any payment from thafi source, and if so, in what amount? See attached. Dated at Dubuque, lowa this day of , 20 Ann chroeder(May 12,2026 12:2A:23 COT) �SIg1�afUrE� Ann Marie Schroeder (Print Name} (Rev. 9/24) i � � Page 69 of 1000 Copyrighted June 1, 2026 City of Dubuque CONSENT ITEMS # 3. City Council ITEM TITLE: Disposition of Claims SUMMARY: City Attorney advising that the following claims have been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool: Ann Marie Schroeder for Personal Injury; J&R Rentals LLC for Property Damage. SUGGUESTED Receive and File; Concur DISPOSITION: ATTACHMENTS: 1. Schroeder_PERS Report 2. J&R Rentals_PERS Report Page 80 of 1000 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: 5/19/2026 RE: Claim Against the City of Dubuque by Ann Marie Schroeder Claimant Date of Claim Date of Incident Nature of Claim Ann Marie 5/13/2026 11/7/2024 Personal Injury Schroeder This is a claim in which Claimant alleges Claimant sustained injuries as a result of a fall caused by a "dangerous and defective public sidewalk within the City of Dubuque This claim has been referred to the lowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager Gus Psihoyos, City Engineer Jeremy Gallagher, Esq. OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)589-4113/Fax (563)583-1040/Ennai� jmedinge@cityofdubuque.org Page 81 of 1000