Claim by Heather Splinter Copyrighted
September 5, 2017
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Robert& Sharon Bradley for property damage, Anthony
Hemmer for property damage, Heather Splinter for vehicle
damage
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City
Attorney
ATTACHMENTS:
Description Type
Bradley Claim Supporting Documentation
Hemmer Claim Supporting Documentation
Splinter Claim Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA KIS ^
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 W. 13th St., Dubuque, IA 52001. It
will then be referred by the City Council to the appropriate department for investigation.
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. Naze of Claimant:1A
2. Address: g
3. Telephone Number:
4. Date of Incident:
5. Time of Incident:
6. Location of Incident (Be spec'fic):
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7. DESCRIBE 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.)
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6. What were weather conditions like?
9. Give name and address of any witnesses: /V ICIL�4d��'��'
10. Did police investigate? (If so, give names of officers.) l 7 0
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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? , / /lam �
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?
16. Why do you claim the City of pubuqueis responsible?
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 at Dubuque, Iowa this day of 20/-).
(Signature)
--A�rz,4�er let- (Print Name)
(Rev. 7/12) rte-.
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Copyrighted
September 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: Robert and
Sharon Bradley for property damage, Michael Elliott for
property damage, Anthony Hemmer for property damage,
Heather Splinter for vehicle damage
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Supporting Documentation
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THE CITY OF
LTB MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN *P
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: August 22, 2017
RE: Claim Against the City of Dubuque by Heather Splinter
Claimant Date of Claim Date of Loss Nature of Claim
Heather Splinter 08/21/17 07/28/17 Vehicle Damage
This is a claim in which claimant alleges that as she was pulling in front of 2165 Avalon,
the settled curb and gutter punctured a hole in her right front tire. Claimant alleges that
she could not find a tire to match the remaining three and therefore purchased four new
tires.
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
John Klostermann, Public Works Director
Heather Splinter
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 p
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