Claim by Deneen MiltonTHE CITY pF ~•
DUB E MEMORANDUM
Masterpiece on the Mississippi
BARRY LINDAHL ~ (~
CITY ATTORNEY
To: Mayor Roy D. Buol and
Members of the City Council
DATE: May 14, 2008
RE: Claim Against the City of Dubuque by Deneen Milton
Claimant Date of Claim Date of Loss Nature of Claim
Deneen Milton 05/09/08 04/12/08 Property Damage
This is a claim in which the claimant alleges that the doors of her rental property located
at 1364'/2 Jackson Street were damaged after police obtained a search warrant and
forced entry into the residence.
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
Kim Wadding, Chief of Police
Deneen Milton
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 583-4113 / FAx (563) 583-10401 EMAIL balesq@cityofdubuque.org
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CLAIM AGAINST THE CITY OF DUBU UE IOWA ~~~
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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 West 13th 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 CI
2. Address: n~C~/~ 1~~~~j
3. Telephone Number D~~~- .~ _~ ~ ~S_S~
4. Date of Incident: `~- - /a~ ~ D
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5. Time of Incident: /`-- (`! `~ ? ~ ~ ~- ~ ~ ~~`~,
6. Location f I,n~ident (B~e ific): II
7. Describe the accident or occurrence that caused injury or damage. (Give full
details upon which you base your claim. If a City employee was involved, give
9.,Cwe name and address of any witnesses:
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10. Did police investigate? (If so, give names of officers.)
8. What were weather conditions like?
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. Attach estimates of damages or describe basis for ascertaining
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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
amqupt paid.)
15. What amount do you claim from the City of Dubuque?
16.,.1~Vhy do you clai .the City of Du uq~ae is espgnsibl~? /
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17. Have you made any claim against anyone else for damages as a result of
this~n~C~ nt? (If yes, give name and address.)
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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Use Your ;;y;ap!, 2
BAG CARD'`. '~.' REBATE
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MEhJARDS - DUBUQUE
5300 Oodge Street
Dubuque, IA 52003
KEEP YOUR RECEIPT
RETURN POLICY VARIES BY PRODUCT TYPE
Allowable returns for items on this
receipt will be in the form of an in
store credit voucher if the return
is done after 07/14/08
Sale Transaction
PINE TAPERED SNIMS 1
4334222 0.99
ALMOND SUPREME 6 OZ. NR
2737711 1.66
DOOR PROTECTOR
2210166 10.47
C-4 9-LITE TRAD 2-PN
4143345 119.00
TOTAL 132.12
TAX AT 7s 9.25
TOTAL SALE 141.37
VISA 1398 141.37
00539C ... G~~~l~~o
TOTAL NUMBER OF ITENS 4 ~f,~ /. ~~
GUEST COPY
The Cardholder acknowledges receipt of
goods/services in the total amount shown
hereon and agrees to pay the card issuer
according to its current terms.
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- ~p~ - ~ O THIS IS YOUR CREDIT CARD SALES SLIP
PLEASE RETAIN FOR YOUR RECORDS.
/ CT
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NR = The following items, if opened or
defective, are only available for an
even exchange on the identical product:
computer software, DUD or UHS videos,
sewer augers, paint sprayers, custom
tinted paint, and consumable items such
as food and drink. Delivery andlor
installation services are not.
returnable.