Claim by David JansenCLP,Pli AGAINST THE CITY OF DUBUQUE, KMA
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 VVest 13m St, Dubuque, IA 52001. It will then be referred to
the appropriate department for investigation and to the City Attorney's Office. 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: Address: eg`711:r.le;'7,-/
3. Telephone Number: (37-i) —5?
4. Date of Incident: „//1/6/1. ei)
5. Time of Incident,
6. Location of Incident (Be specific): /:;7"
7. Describe the accident or occurrence that caused injury or damage. (Give full details upon which you base your
claim, Ha City employee was involved, give the employee's name.)
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8. What were weather conditions like?
9. Give name and address of any witnesses:
10. Did police investigate? (If so, give names of officers.)
11, Was anyone injured? (If so, give names, addresses, and e>ctent of injuries,)
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 ?
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 do you claim from the City of Dubuque? 700, 0 0
16. Why do you claim the City of Dubuque is responsible? Pe Ir7,}-c. 'd �Efr/ct"
17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and
address.)
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18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount?
Dated this
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(Signature)
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(Print Name)
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Re: Case # 12 -2396
On January 15th, the police were called to my rental unit on 1297 Belmont for loud
music. 3 hours later they showed up. Then they proceeded to kick the door in. This cost
me approximately $150 for a new door and $250 for installing.
I should have been contacted first. I could have been there within 5 minutes. The police
made no attempt to even call me. They just destroyed my property without using any
common sense.
I spoke with the tenants next door who called the police because of loud music. They
told me that the police finally arrived 2 hours later. My tenants also informed me that
they gave the police my phone number when they called in the complaint. Hence the
police can not use the excuse that they did not know how to contact me.
#1) Why did it take so long for them to respond?
#2) Why didn't they just call me to take care of the situation? I could have been there in
5 minutes to open the door for them.
I also spoke to neighbors directly across the street who were sleeping. They were only
awakened by the police pounding on the front door.
Please direct further questions to me at 563 -599 -1759.
Sincerely,
Dave Jansen