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Claim by Joan MillerTHE CITY OF DUBUQUE Masterpiece on the Mississippi MEMORANDUM BARRY LINDAHL CITY ATTORNEY TO: Mayor Roy D. Buol and Members off the City Council DATE: January 11, 2009 RE: Claim Against the City of Dubuque by the Joan Miller Claimant Date of Claim Date of Loss Nature of Claim Joan Miller 01/05/09 06/09/08 Personal Injury This is a claim in which claimant alleges that she broke her right ankle and tore cartilage in her right knee after stepping into a pothole in the street at the intersection of Hillcrest Road and Grant Street. 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 John Klostermann, Street & Maintenance Supervisor Joan Miller OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 3OO MAIN STREET DUBUQUE, IA 52001-6944 TELEPHONE (563) 583-4113 / FAx (563) 583-1040 / EnnAIL balesq@cityofdubuque.org 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. 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. Name of Claimant: JOAN M. MILLER 2. Address: 2098 ROSEMONT ST. DUBUQUE, IA 52002 3. Telephone Number: (563) 556-7981 4. Date of Incident: 6-9-2008 5. Time of Incident: Approx. 6:15 A.M. 6. Location of Incident (Be specific): INTERSECTION OF HILLCREST RD. & GRANT ST. 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.) See Attachment 8. What were weather conditions like? Normal-Sunny morning 9. Give name and address of any witnesses:GARY MILLER 2098 Rosemont St. Dubuque, Ia 52002 10. Did police investigate? (If so, give names of officers.) YES--OFFICER P.FRIEDMAN WAS AT FINLEY ER AND ALSO AT SCENE OF ACCIDENT 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). YES-JOAN MILLER 2098 ROSEMONT ST. DUBUQUE, IA 52002 BROKEN RIGHT ANKLE AND TORN CARTILEDGE IN RIGHT KNEE 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.) N/A 13. What other damages do you claim, if any? N/A 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.) YES--WELLMARK BLUE CROSS/BLUE SHIELD OF IOWA----$2,031.13 15. What amount do you claim from the City of Dubuque? $4,088.50 (uncovered medical, loss of part-time wages, loss of companionship, pain etc) 16. Why do you claim the City of Dubuque is responsible? A oot-hole SHAT DEEP in an intersection, should have been fixed or had barriers uo to warn people 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? Dated at Dubuque, Iowa this 29th day of December, 2008 # 7 My husband and I were out for an early morning walk heading east on Hillcrest Road on the south side of the street. Due to a storm the night before (tornado sirens blew), a large tree branch had fallen down on the sidewalk in front of us-so we had to cross over to the north side of the street. We crossed at the intersection of Hillcrest & Grant St. Since there are no stoplights or crosswalks located there, we began crossing with caution, being careful for on-coming vehicles. With our primary attention being on the traffic, we did not realize there was a huge "pot hole" in the middle of the street. I stepped into it and rolled my ankle and fell down. I suffered a broken right ankle and torn cartilage in my right knee. With a hole that big and deep, we could not believe the city hadn't fixed it, or at least had some type of barricade up warning people. RECEIVED 09 JAN -5 AM 8:45 City Clerk's Office Dubuque, IA