Loading...
Claim by Austin Bodenhofer 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 rmv m ��� CLAIM AGAINST THE CITY �F DUBUQUE, IOWA ��- ���� LL� :Jc����r�c�"�c.� This written report constitutes your claim against the City of Dubuque, lowa. You should complete this form in fulf and attach any additional informa#ion tha# supports your claim. The Claim must be filed with the City Cterk at City Hall, 5Q W, 13t'' St., Dubuque, IA 52001. !t 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, Yau will be provided with a copy of tha# report and recommendation. THE FINAL DECISION ON ALL GLAIMS IS MADE BY THE CITY �Ol7NClL. NO EMPLOYEE OF THE CITY OF DUBUQUE HAS THE AUTHORiTY TO MAKE ANY REPRESENTATION TQ YOU AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAtD. 1. Name of Claimant: ��,y1��ti� ���'>��4�`� 2. Addrsss: _I�� U.'>c:_:�� ;�3�c,� 5�-6��� Ci#y; ��`�1:-��-t�tAe State: �� Zip: `"��rsc, 1 3. Telephone Number: �L�3-������ �d��� 4. Date of Incident: ,.�����a� 5. Time of lncident. � ��1 6, Lacation o# lr�cident (Be specifc): �t��t��. 7. DES�RIBE ACCIDENT OR OCCURREN�E THAT C�4llSEfl lNJURY OR DAM:4�E. �G`tve full detaits upon which you base your cfaim, If a �ity employee was involved, give the employee's name.) 1 1�� ��1C� i,��S t`����1� C-+. '��.�� c�rti �s�� ���1,(��°� I a��.S�� c�.�� �� M�l c�.�' ��� �-�c1t:e� ��� y�,�. `����. c:��� r,� 'C�� oE 3�1� C�.�' � ,ct�<��,� i������(11� 8, What were weather canditions 4ike'? C�i �1;��-a- 9, Give name and address of any witnesses; _iti�� �;�.���e 10. Did police investigate� �lf s�, �ive names of officers.) �1�;.,cv� � ��a'7(�� --i�� 3 H C��{ 1'�. i►Vas anyone injured� (If so, give names, addresses, and exten# of injuriesj. �(J Page 75 of 1000 12. Was any damage done to pro�erty? (t#so, describe property and the extent of damages. Attach estimates o#damages or describe basis for ascertaining extent o#damage,} ��1~1 �;�� T��ttc ��� c�.�� �`��.�C1� ��-i- c.�l� :�c���C,1���� t�.�i� � c�:�� C5�°t- cL �i�c��-c� c��c� c.c +Mfie,� t����c� r� Tl��+v� c,�� �-�n�� I�`�i t�,`rr , 13. V1lhat other damages do you ctaim, if any? :�ti��1,�� '14. Ha�� yfl� been compensated #or any part or a1I of�our claim by any insurance com�any`� {If so, �iv� n�me ar�d address of insurance compar�y an�3 ar�ount paid,) v'1r'�".-�% '15. What am�unt do you claim from the �ity �f t�ubuque'? ����°��`� �S�'�, w\�r� z '16, Why do you c1a9m the �ity of ��buq�e is r�sponsibie� `E+�( �5 . �� c�.� w►t ��. c� � i�' 37. Have y�u made any claim against a�yone �lse for dama��s as a resu�t o#this incici�nt? (lf yes, give ��m� and ad�tress,) uN`�,: �8, lf the ans�nrer t� t�ues#ion '17 �s yes, ha�e you recei�r�� any paym�nt#rom that so�rce, and �f sa, in what amoun#? �a#e� at Dubuque, lowa this �i W ��y of ���/ , 2� �(.�. . __ _ _.._....._._.�. � ._.__--=_----- , ���"��� ��i��at�re) , ���.�;t� ��-�g��i�K,�g� �Print N�me} ,m.,P �, I dry :,� �n �R�V. �i2�j ; � :� Page 76 of 1000