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Claim by Craig KowalskiTHE CITY OF DUB E MEMORANDUM Masterpiece on the Mississippi BARRY LINDAHL ~~ I CITY ATTORNEY To: Mayor Roy D. Buol and Members of the City Council DATE: April 14, 2008 RE: Claim Against the City of Dubuque by Craig A. Kowalski Claimant Date of Claim Date of Loss Nature of Claim Craig A. Kowalski 04/07/08 04/01/08 Property Damage This is a claim in which the claimant alleges that the City's retaining wall located on Grove Terrace collapsed and damaged claimant's house at 1106 Grove Terrace. This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa Communities Assurance Pool. BAL:tIs cc: Michael C. Van Milligen, City Manager Jeanne Schneider, City Clerk Gus Psihoyos, City Engineer Craig A. Kowalski OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 30O MAIN STREET DUBUQUE, IA 52001-6944 TELEPHONE (563) 583-4113 / FAx (563) 583-1040 / EnnAIL balesq@cityofdubuque.org C"iaim Fonm Department and Division Links Enter Key ', f ti [ ~; :; -i.. I. I~ ~' b I: ~ t :) '~ I~ i i t' f 1 ~ *~ i ~ ~; I E' Ek ! t_ I F ~. h. 1 . ~ t. C`F~ ~`~ t ti Home Page :Departments :City Clerk :Claims against the City : Clalm Fori'1't City Clerk First floor of City Hall, 50 W. 13th Street Phone: (563) 589-4120 Fax: (563) 589-0890 Hours: 8 a.m. to 5 p.m. Monday through Friday Email: jschneidCa)cityofdubuaue.org a' ~ CLAIM AGAINST THE CITY OF DUBUQUE, IOWA I-l-I ..- J +-~ This written report constitutes your claim against the City of Dubuque, Iowa. You should comple %' n ~,~ ~~ full and attach any additional information that supports your claim. L. ~i ~`-~ ~ The claim must be filed with the City Clerk at City Hall, 50 West 13th St., Dubuque, IA 52001. It -~,; ~ ~ referred to the appropriate department for investigation and to the City Attorney's Office. Once 1 tom[ d~'~, G is completed, a report and recommendation will be submitted to the City Council. You will be prc ~ ~ 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 authority to make any representation to you as to whether your claim will or will not be paid. 1. Name of Claimant: (_ 0. '~~ ~o ~/ ~J .S 1~ 2. Address: 1 ~ [~ ~ L7' Gro, /~ ~ ~ f r ~ C .Q 3. Telephone Number: S~ ~ ~ (7y ~ ,.S , ~~ y~ v~xC~nr. ~„ W v ~ r z ~ °; `' ~~yy 4. Date of Incident: =~ '~1 In m ,p ~ ~ r~+. ~, ~ h~l ~ m w ~ '--' '~ ~ ~ ~ L 1 / J ~ ~ t / ~ lam. ~ / ~, ~ ~ ~ o , , ~ `d ~ 5. Time of Incident: -~p~~~ ~ Y'~ ~1-~- ~/ ~ ~ `w° ~ o ~ z ~ ~ r ~ 6. Location of Incident (Be specific): ~ ~ t T 6 ~ '~ -e- ~ ~ ~ ~ a C e ~-~ ~o~M ~ N rr>y ~~ X wC ~ ~+ ~ ip m v v +. ~, o N ~ n ~ 7. Describe the accident or occurrence that caused injury or damage. (Give full details upon whi trl your claim. If a City employee was involved, give the employee's name.) ~ ~ ~ ~~ + ~ -.~.. N C _/'~ ~ ~J s ~n W1 J ~ ~ 8. What were weather conditions like? ~" ~./-Q-- ~ .>2 +^-~ 9. Give name and address of any witnesses: ~ ~G ~ P 10. Did police investigate/? (If so, give names of officers.) ~~~+~ ~~~~Y~~ __ ___ ~~^ ~~ •n s (~ L. ` ,, ~J~~~^Page 1 of 3 http://www.cityofdubuque.org/index.cfin?pageid=155 4/7/2008 Claim Foram Page 2 of 3 11. Was anyone injured? (If so, give names, addresses, and extent of injuries.) ~~~ 12. Was any damage done to property? (If so, describe property and the extent of damages. Att damages or describe basis~for~ascertaining extent of damage.) ._2 ~ ~ ~ ~f CJ-S (~ ~ S rt ~ ~ ~ c~_S l~ e- ~ tC 0 / / lJ 13. What other damages do you claim, if y? ~ dl r ~ k"f" r ~ ~ ~~ f Q ~ - 14. Have you been compensated for any part or all of your claim by any insurance company? (li and address of insurance company and amount paid.) / -.-J ~ I~ c, f~ -E- ~ ~' ~ e tom, P ~t? ~~c/ ~~ ~ / /' 15. What amount do you claim froom the C-i}ty of Dubuque? ~n 6 ~ .2 ~ -2 (w~ ~ ~ -" .1- ~ w` C o ~ I.~C~.'Z- ~ fCS f.~q -F~--S 16. Why do you claim the City of Dubuque is responsible? 17. Have you made any claim against anyone else for damages as a result of this incident? (If y and address.) 18. If the answer to Question 17 is yes, have you received any payment from that source, and if amount?~ / / v~ Dated this ~ ay of ~' / , 20 d (Signature) (Print Name) Home Page :Departments :City Clerk :Claims against the City : C~a1C11 FOt'll'i http://www.cityofdubuque.org/index.cfim?pageid=155 4/7/2008 ~_> ~~~°Il~1~~ ~~ :. 191 .a~ . t :.:. ._..r._ ^+~ .i~i'~'"S:r/3' +'a ,, s ..