Claim by Jessica YoungClai
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CLAIM AGAINST THE CITY ~~'B~UQ~ ~ID'WA
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This written report constitutes your daim iGi~ df.~~l6i~ue, Iowa. You should complete this form in
full and attach any additional information that~~p~Q~rts, y~yr ~im.
The daim must be filed with the City Clerk at City Hall, 50 West 13~' 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 Councl. 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 re`presentaction to you as to whether your dai/mw, ill or will not be paid.
1. Name of Claimant:Jessica Young
2. Address: 487 Primrose Street
3. Telephone Number: n ~ V 1 I ~~
4. Date of Incident: ~/~.. ~~~
5. Time of Inddent: `~
6. Location of Inddent Hill Street turning onto West 9th
7. Describe the acddent 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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9. Give namZe and address of any witnesses: w~-T \
10. Dind police investigate? (If so, give names of officers.)
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11. Was anyo//ne~e injured? (If so, give names, addresses, and extent of injuries.)
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12. Was any damage done to property? (If so, describe property and the extent of damages. Attach estimates
of damages or describe basis for ascertaini extent damage.)
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13. What other damages do you daim, if any?
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3/31/2008
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14. Have you been compensated for any part or all of your Gaim by any insurance company? (If so, give
naAme and address of insurance company and amount paid.)
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15. What amount do you Gaim from the City of Dubuque?
16. Why do you Gaim the C' of Dubuque is responsible? ~ '~~
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7 ave you made an laim against anyone el for damages as a result of this incident? (If yes, given e
and addr ss~
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 ~~ day of
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http://www.cityofdubuque.org/printer_friendly.cfin?pageid=155
3/31/2008
March 20, 2008
To Whom it May Concern:
I am writing to inform you that on Saturday night (March 15) while driving on Hill
Street turning on to West 9th in Dubuque I hit a pot hole/crack and blew my tire.
My car is a 2007 so the tires on it were still in very good shape. So, because you
(the city workers) did not fill the massive holes/cracks I had #o spend $146.55 to
get a brand new tire.
I have paid the bill but I believe that I should be reimbursed by you (the city)
because it is your fault the holes and cracks were not filled and were allowed to
get so large.
If it was my sidewalk and someone got hurt while on it I would be responsible.
Therefore since it is your street you are responsible.
Just yesterday (March 19) I was driving on West 9th heading towards University
and noticed that you have filled the holes/cracks. I do acknowledge that
something has been done to fix the problem, but it was done too late.
I have enclosed a copy of my invoice from Vaughn's Automotive.
If you have any other questions please feel free to contact me at 563-599-0082.
Thank you.
Jessica Young
X487 Primrose Street
'Dubuque Iowa 52001
563-599-0082
Lo~~l cz~ c~2~C~~N~- Lelia-I'2 sel'~l-
VAUGHN'S AUTOMOTIVE
315 UNIVERSITY AVENUE
DUBUQUE, IA 52001
563-557-1836
BILL TO
YOUNG JESICA
487 PRIMROSE
DUBUQUE IA 52001
563-599-0082
Invoice
Date Invoice #
3/18/2008 53233
YEAR/MAKE/MODEL
MI
EMP GT
P.O. No. Terms
Item Description Qty Rate Amount
053950 P205/SSR16 EL 400 TURINZA 1 109.20 109.20
BAL COMPUTER WHEEL BALANCE 1 8.00 8.00
DIS TIRE DISPOSAL 1 3.00 3.00
SS SHOP SUPPLIES 1 5.00 5.00
SUBTOTAL 125.20
UPS UPS 1 12.59 12.59
Sales Tax 7.00% 8.76
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It's been a pleasure working with you! Tota I
$ 14(a,Ss