Claim by Linda Wessels Copyrighted
April 3, 2017
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Mark Laird for property damage; Marvin and Mary Ritt for
vehicle damage; Teamsters Local 120 for property
damage, Rachel Wedewer for vehicle damage and
personal injury; Linda Wessels for personal injury
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City
Attorney
ATTACHMENTS:
Description Type
Laird Claim Supporting Documentation
Ritt Claim Supporting Documentation
Teamsters Local 120 Claim Supporting Documentation
Wedewer Claim Supporting Documentation
Wessels Claim Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOC
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 Claimant: LjNzf--s We- &,se-' S
2. Address: a,-ACklppeweL, b 2: w I
3. Telephone Number 5(o3 45\ ct '31sl
4. Date of Incident: L -1
5. Time of Incident: q ry-N
6. Location of Incident (Be specific):
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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
the employee's name.)
Eca ed
8. What were weather conditions like?
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9. Give name and address of any witnesses:
10. Did police investigate? (if so, give names of officers.)
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11. Was anyone injured? (if so, give names, addresses, and extent of injuries).
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12. Was any damage done to property? (I€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?
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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.)
15. What amount do you claim from the City of Dubuque?
16. Why do you claim the City of Dubuque ise responsible?
t X 04 �t I# S *10
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?
IA-
Dated this day of roAr , 20
C;iJ ature)
LIML)—a (D
(Print Name)
Confidential
This communication and any attachments may contain information which is confidential
and privileged by law and is for the use of the designated recipient. If you are not the
intended recipient, you are hereby notified that you have received this communication in
error, and that any review, disclosure, dissemination, distribution or copying of its contents
is prohibited. Please notify City of Dubuque immediately by telephone at (563)-589-4120 of
your receipt of these items and destroy the communication and any attachments
immediately. Further disclosure of this information may violate state and federal
restrictions.
I
Confidential information may include the following:
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1) Social Security Number(s)
2) Medical/Health Information
3) Personnel/Disciplinary Information h'
4) Bank Account Information
5) Financial Information
6) Credit Card Numbers
If an documentation you desire to submit to the Cit of Dubuque contains an of the items above
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this cover sheet must be attached directly to the confidential information and indicate the type of
information that is included.
1, -I WOA W' essejs , hereby certify that the attached documents
include the following protected information:
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6
Social Security Number(s) Bank Account Information
Medical/Health Information Financial Information
Personnel/Disciplinary Information Credit Card Number(s)
I understand that this information may be distributed within the City organization or to agents of the
City for processing and I hereby authorize the City to act accordingly taking all precautions to
protect my information from unnecessary distribution.
'gnfiat ure Date
I have read the information above and do not have any confidential documenta n to submit to the
City of Dubuque as part of this Claim ainst the City
S gn t re
Date
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On Thursday February 9th, 2017 I was walking from the 5th street parking ramp to my
employment in the Roshek Building. The sun was out and there was not any snow or ice
on the sidewalk. There is an empty lot next to the Iowa Workforce building on the 600
block of Main St. The sidewalk at the corner of this building has a raised area that my
shoe caught and I tripped and landed on my face. The area is closer to the street side of
the sidewalk next to the dark colored concreate square, When I hit the pavement I could
hear my glasses scratch on the cement and my 2 front teeth felt like they were pushed
back. I got up and touched my nose and noticed blood on my finger. I continued
walking into work to let them know what happened. My lip and nose were swelling up H
so I put some ice on them. I left work for the day and proceeded to my dentist (Dr.
Kilburg) to have my teeth checked out. The 2 front teeth had a couple a chips in them so
the dentist was able to smooth them out. He stated from what he could see they did not it
moved but are badly bruised. I could only eat soft foods until this got better over a few
weeks. He didn't think that they would die in the future but could not promise this. He
noticed that my nose was swollen and suggested that I see a doctor to make sure it was
not broken. I tools his advice and went to the acute care clinic to have my nose checked
out. Dr. Townsend had a skull x-ray done which came back negative. I was told to put
on an antibiotic cream on my nose so that it did not get infected. I then proceeded to
Vision Health to order a new pair of glasses. Fortunately the glasses were still under
warranty until the end of February. They were able to order them at no cost to me. I
received the new glasses on 02/25/17. My leg also had a bruise on it.I also stayed home
from work on Friday 02/10/17 due to the headache still and my face and teeth still being
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sore.
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I have enclosed pictures of the sidewalk, my face, my lip on the inside showing the bruise h
and a phone of my leg with the bruise. N
I am looping at getting compensated for the following;
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Dr. Invoice to Medical Associates: $20.00
Dentist Invoice to Dubuque Dental: $56.00
2 days off work: $29.81 x 16 hours= $476.92 (I had use a vacation
day and sick day that I was not planning on using.)
Pain and Suffering: $500.00
New glasses: $0S 00 (these were still under warranty)
Total of$1,052.92
Linda Wessels
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Copyrighted
April 3, 2017
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Claims
SUMMARY: City Attorney advising that the following claims have been
referred to Public Entity Risk Services of Iowa, the agent
for the Iowa Communities Assurance Pool: Kaitlyn Birch for
personal injury and vehicle damage; Mark Laird for property
damage; Marvin and Mary Ritt for vehicle damage;
Teamsters Local 120 for property damage; Rachel
Wedewer for personal injury and vehicle damage; Linda
Wessels for personal injury.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Supporting Documentation
THE CTFY OF
QCT LTE MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: March 20, 2017
RE: Claim Against the City of Dubuque by Linda Wessels
Claimant Date of Claim Date of Loss Nature of Claim
Linda Wessels 03/17/17 02/09/17 Personal Injury
This is a claim in which claimant alleges that she was injured after tripping on a raised r
portion of sidewalk located in front of the empty lot next to the Iowa Workforce
Development Office at 680 Main Street.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool
cc: Michael C. Van Milligen, City Manager
Gus Psihoyos, City Engineer
Linda Wessels
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)583-1040/EMAIL tsteckle@cityofdubuque.org