Claim by Cathleen Clausen Copyrighted
June 5, 2017
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Cathleen Clausen for vehicle damage, Richard Kaufman for
vehicle damage, Mathew Kowalske for vehicle damage,
Kathryn Oleson for personal injury, Robert Mootz for vehicle
damage, Corrine Morris for vehicle damage, Carol Moyer
for property damage, Courtney Schminkey for vehicle
damage, suit by Kathleen McCarthy for the estate of
Thomas McCarthy for wrongful death.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City
Attorney
ATTACHMENTS:
Description Type
Clausen Claim Supporting Documentation
Kaufman Claim Supporting Documentation
Kowalske Claim Supporting Documentation
Mootz Claim Supporting Documentation
Morris Claim Supporting Documentation
Moyer Claim Supporting Documentation
Oleson Claim Supporting Documentation
Schminkey Claim Supporting Documentation
McCarthy Suit Supporting Documentation
CLAIM 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.
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The claim must be filed with the City Clerk at City Hall, 50 West 131h ,
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:
2. Address:
3. Telephone Number
4. Date of Incident:
5. Time of Incident: �,����/� zrr
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.)
8. What were weather conditions like?
9. Give ame and address of any witnesses: ®
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10. Did police inv stigate? (If so, give naPnes o 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? (If 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?
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.)
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15. What amount do you claim from the City of Dubuque?
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16. Why do you claim the City of Dubuque is responsible?
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17, Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.)
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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 gt� day of .5222U CT
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Copyrighted
June 5, 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: Cathleen
Clausen for vehicle damage; Richard Kaufman for vehicle
damage; Mathew Kowalske for vehicle damage; Robert
Mootz for vehicle damage; Corrine Morris for vehicle
damage; Carol Moyer for property damage; Kathryn Oleson
for personal property; Courtney Schminkey for vehicle
damage; Kyle Stoffel for vehicle damage
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Staff Memo
THE CITY OF DUBUQUE MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN JJ''J"
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: May 18, 2017
RE: Claim Against the City of Dubuque by Cathleen Claussen
Claimant Date of Claim Date of Loss Nature of Claim
Cathleen Claussen 05/16/17 05/16/17 Vehicle Damage
This is a claim in which claimant alleges that her vehicle was struck by a City of
Dubuque front loader while claimant was at the Dubuque Metropolitan Area Solid Waste
Agency.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool I
cc: Michael C. Van Milligen, City Manager
John Klostermann, Public Works Director
Cathleen Claussen
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