Claim Response - Grove ToolCLAIM 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: Grove Tool inc (Robert Smith)
2. Address: 3230 Dodge St City
3. Telephone Number: 319 588 0536
4. Date of Incident: 01-02-01
5. Time of Incident: 1:13 PM
6. Location of Incident (Be specific): 400 BLK W. Locust
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.)
My vehicle was parked bus hit my right mirror bus driver was john a reno
8. What were weather conditions like? clear
9. Give name and address of any witnesses:
10. Did police investigate? (If so, give names of officers.) Yes, Flannery
11. Was anyone injured? (If so, give names, addresses, and extent of injuries). No
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.) yes, Right Mirror $209 Estimate attached
13. What other damages do you claim, if any? None
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.) No
15. What amount do you claim from the City of Dubuque? $209
16. Why do you claim the City of Dubuque is responsible? The Bus hit my vehicle
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) No
18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount?
Dated at Dubuque, Iowa this 8 day of Jan , 2001 .
(Signature)
(Print Name)
(Rev. 1/00 & 7/01)
BAERY Ao LINDAHL~ ]~
MEMO
To:
Date:
Mayor Terrance M. Duggan
and m~m~ers of the City Council
January 25, 2001
Claim of Gro~ Tool, Inc.
Clai~-~t Date o__~_fClaim Date of Los___~s Nature of Claim
Grove Tool, I~c. 1/11/01 1/2/0~ vehicle damage
This is a claim for damages the claimant's Suburban sustained
when a City bus knocked its mirror off.
According to the report of Transit Manager Mark.'Munson, this
claim is correct as filed, and he recon~ends that it be paid.
It is therefore the recommendation' of the Legal Department
that this claim, ~n the amount of $209.00, be paid by the Finance
· Director a~d subm. itted to ICAP .for reimbursement.
cc - Mr. Mark Munson
cc - Mr. Robert Smith
Grove Tool, Inc.
2~101 Ce.u'~'~l Avenue
Dubu~e, Iowa
January 4, 2001
TO:
FR:
RE:
Mr. Barry Lindahl, Corporation Counsel
Mark Munson, Transit Division Manager
Accident 01/02/01 on W. Locust
Robert Smith
On January 2, 2001 KeyLine driver John Reno. was traveling SE on
W. Locust. Due to Snow piled and cars parked on both sides, Reno
thought he had enough room to clear vehicle, but clipped the left
side mirror of vehicle owned by Robert Smith.
John Reno admits responsibility for the damage done to the vehicle
owned by RObert Smith.
I recommend payment of this claim.