Claim by Dan and Beth Kennedy Copyrighted
June 15, 2026
City of Dubuque CONSENT ITEMS # 2.
City Council
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Dan and Beth Kennedy for property damage; Nicholas Holzer
for property damage
SUGGUESTED Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
1. Claim by Dan and Beth Kennedy
2. Claim by Nicholas Holzer
Page 79 of 1594
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA �� . �-� r
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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 DECISI�N 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.
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1. Name of Claimant: r�J'(,��`1 �`` ������`"��1 � ir'� � � ���
2. Address: _�-� � t�; ��'`��v�=�:f� =�, ,�-�`����- -'
City: 'V__�` �-"�-=��� 'e��� �J State: ��_� Zi . ��t�d�,' �
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3. Telephone Number: �3�,r � �- , a t � �- ) ��-- � y�
4. Date of Incident: �� � �� � ���.� ���3� �
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5. Time of Incident: �`���� V �� 1 �r ,,�` '�G� '�;�1� ��-����. i�'��' ��� ��� �_','�a'��-1
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6. Location of Incident (Be specific): ,y, �� � `"� �� �� �.��� ", i ��!�
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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 weather conditions like? ,`Q��k�-�
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9. Give name and address of any witnesses: ,- �� �=- , ,�; � � �.5�
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10. Did police investigate? (If so, give names o o %ers.) ��
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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Page 80 of 1594
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 y8u ci�im, if any?
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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. What amount o ou,claim from the City of Dubuque?� �t�,y ,�-
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16. Why do you claim the City of Dubuque is responsible?�",,,� '""'
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17. Have you made any claim against anyone etse for damages as a result of this incident?
(If yes, give name and address.) ��,;1'��`
18. If the answer to Question 17 is yes, have you received any payment from that source, and
if so, in what amount? � � '
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Dated at Dubuque, lowa this �� day of �`��'��'`--- , 20'�'�
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��~ � � Page 81 of 1594
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