Claim by Ken DuffyTHE CTTY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE:
RE:
Claimant
Ken Duffy
January 22, 2009
Claim Against the City of Dubuque by the Ken Duffy
Date of Claim
Date of Loss
Nature of Claim
01 /19/09
01 /16/09
Vehicle Damage
This is a claim in which claimant alleges that a City of Dubuque police squad car backed
into his vehicle which was parked in the parking lot of 1550/1600 Butterfield.
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
Kim Wadding, Chief of Police
Ken Duffy
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
r~Y~, n~~y, ,G~
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 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:
2. Address: ~5~~ ~S >~~~iO.O~ ~~ / ~
3. Telephone Number ~ ~ ~ ~- S ~ ~ ~ ~ ~ S ~r
4. Date of Incident: / ~ /~ .. ~?
5. Time of Incident: ~% ?~ ~'' J' ~
6. Location of Incident (Be specific):
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.)
n `~
8. What were weather conditions like? ;~-- .__~ -- `~~
~= < , t, -~
. ; - _~
k... 3
`~J ~~ i T~ '.~
9. Give name and address of any witnesses.: __ '_ C~,~, =~ ~~
_~ N '~
CP
10. Did police investigate? (If so, give names of officers.)
A/l~, 'U//`~~ ~~~5 %7t° ~~/2z~ f~Z~P~ ~Tf ft //ice,
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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.)
15. What amount do you claim from the City of Dubuque?
y
16. Why do you claim the City of Dubuque is responsible?
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 ___~~ day of ~[/~~ , , 20~ _
(Signature)
(Print Name)
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.)
17. Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.) ~ ~ ,.~
nrn Inl-QS.~.
` ~ DUOU4Uf POLICE DEPAREIiEHT Cil{ ~ INCIUEITT CASE ND
I HGJ f2EtiLRf P~II l ~]C r'1Z a `~ - a 3 f~~
rEOESTRIAH INJURY ~r11YSICAL AGtLiEY EYEGLASSES TYPE FOU[SiEAR IYPE YICEIM - FIRfi R/SlOUB
UIlRER ABUTERTG PROPERTY ADDRESS VIC![H'S ADDRESS C[[9 PIIUNE 110.
• 7 7 t] ~~u.lr4 S^ f)l.TRr.~C~tiF S~'i2 ~ 4~`~ 15~`
OCLUPAr1T ADUIEING PRUPERIY NA5 VICTIM fAtklLIAR NI IN LOCAf1011 - HU'd LOLAIIUN [)F IHC[OENI~ ~ ~ ~ RUSClTf55 PIIUNE HU.
tlEAll[ER COHDITIUHS SURFACE fDN01TlUN5 ~ L[GIiT11TC CONDIi[ONS YICIEM OCCUPAfIOfI ~ ~ EMPLOYER-SCIIODL A[TEHDED I11UUR5
ADUII]OIIAL UESCR[Pi1011 Qf AREA uAIE AHU I[ME OCCURRENCE OATE ANU I[ME REPOREEO f
1 ! t Co Jc~4 .s_317 t ~l r± lu `t ~,3 J 7
~~COFIPLAI HAIT [ R/5!90/6
~,r-1 ~L.~~ , 0J41.}'Z~ r3 . Lf fd~
YICIIN'S ACTIPIiEES fiU[11G FRUH TU ADURfSS CITY PIIUNE Nu.
_ ~ 71J ~.1r ryt• (~ 1-a;$LiI.SJc~~ S~~- 4rf~lS
ALL [H.1URIfS IIAIUAE OF [HJURY ATiEI{DING P11Y5[CIAN OEATEI REPORT' LUL'A110[I OF DOOM
TAKEN 1U TRAHSPORIEO BY NEUICAL E1IAMIITER NOTIFIED If11iE NOTIFIED iiHE ARHIYED
COHOI[ION ( ~ 1140 { } [HE411CAIEU ALCOSENSOR TIME AHD DAFE
f 1 C~F_ R f 1 1 Nf I t} ~11~,5
GEIY PROPERLY DAMAGED. .ESIIMAlEU !:UST
DAMAGE CI fY PROPER•[ Y p1~,f,1~~ ~ ~ ~ J ~ y~ I ~ - ~ ode
DESCRIPLIOH OF OAMAGf ~ - -+ _
~Z="VC.2 SS101r 12~~le. f.s I-J~~ r< ZS E Lc.. cs 1~ CA- {~ .
RESPONSIBLE PERSON ~ ~ ..~ RlSIDOB .
~;~L.S~r 014V~T4 13 ~~ t..L1 t`''l
AOURE55 - ~ ~ C[ 1'Y.
~ 7 ~ ~[,~~ s i : I~I.tBt~ c'~ L.u~
RESPDHS[B[LTTY {• } ~YES'~ -DESCRIBE ••
ADMITTED ( I NO `
.. t
OUDY REMOVED DY
APPAREITf CAUSE OF DEAIJI
ANfMAI COMPLAINT ~ NAIURE OF CUtil'LA1NIfI11JURY
REIERAEO T0. 'OISPOSII1011
[YPE ANIMAL 1 CDLURIMARKIITG$ I SEIL J AGE NAME
: ONNER'S•NAME rF I. _ OHNER'S ADDRESS
• • YEl11CLf IHFORFIAT9DR MAKE ~ MODEL
I r-c~+~ j=U C.UlS
YEAR •. YCO. T _ B LfCENSE 1JU.
~c~~ i 13~tu~~ ~ Quiff - o,~-?w 13k
INSURANCE CARRIER - ~ ~ - ~ 41~i 101fE0 BY
l , ~ `' ~1= Ql~l~ ~i u+~ - ~ ~I~ A-- ~t~' ~' '~ ~3 ci ~tJ 1~~3Jd 4-
1rI~ HCE CARRIER DDRESS ~ . . UPERAIDR/PERSQN ,IN CONTROL. [TAp}E AOURE55
~~ !~ ~3 - DLtB'V1Da~-~ ~4 ~~D~~
EIRE Of REMOYAI
AD0111UIIAL I 1
INYESTIGATION
FABIES 1AG 11U.
STYLE
~~
t1CEH5E 51AIE
1
ARREST-C1IARGE ~ -~ UNHER NAME ~ ADDRESS
U N ~ • ~}u Fes`!' . ~F 1-f NC ~- l SSA t~ r^~'!Zr ~€~D ?did +3 •
DESCRIBE AClIUH DF RE5PUHSIBLE PERSON CAUSING UAMAfiE PEIUTDGRAPIiS 1 NAM BADGE IIME AiID DAIE
~~1=;`f~/2 L,rFts~ o-J~a-"a ~AC~c. t-t-r~ Y~f1~L LFI~ I ~~' ~.1~ I o~oZl~ ~1~/~~~°/
a~-~>7 5. arwcx ~ t~ ~~SSF-~.~GE~ S.~i~i a2~2 ~~'-vRl:2 ~ [- Try ~o[u5'.
PpRfING ~f{ICER(S~
DAD~GE,I~~r ~ oiEE,~EP?ORT~LEO ! SUPERY[SUCR!1F`~G
0
r
r
m
0
0
m
°z
r
c
y
en
G
to
00
m
y
C7
trJ
r
m
b
O
r
C]
a
0
N
~/
DUAUQUE POLICE 6EPARiHEN1
}NCIDENT RErDRr PROP ~
tLIJM' y UtS1.HlY111rN Uf Iryl:IDtNI IUSE FJk51 rEA50N - ER14MPlE~: I ifAS '41AUCIAB, ... EIC. }
I R 1 !lAYE READ { } 1{AU AfAD TO HE ilfE FOREGOING YfR51fl}! OF illE .Ir{CIDENI Aq0 I CERiIFV ifiAT 1T i5 TflE 1RUTIi 16 11iE 9E5T OF HY KtinuLEAGE.
urrittx'y sr~N~luRt _ v~~lln'y slUNp+unt
Ni1Nt5S NAIiE xllJ~f55 ADDRESS RlS/t-U$ P![DI~E HU.
1
!r[1HE55 NAME f11 iIlE55 A08RF55 R/SJOUB NNUHE ND.
2
M11 it DS LUMMlNf3 - UIISENVAl1Ur{S~UfFJLEH'S 6DJiNENIS - UHStkVAIlUHS
c~ b 1 ~ J {~c~ q ~4 l ,4 ,P#~17d ~.'~ J ~ ~ 2f5 o t ~.1- [,~ J~ l~.!'F L51~ [,.~ /¢-5 .~'N f-1 TS ~~~~ ~ ~ A lL / f~ 3f 1..,FL Sf~ r~>~1
nl ~ P~-R~='~~ Lo i ' a~ J,s'S~] / fCat~ o f3~ .~;_'_ "y'~ .
~ ~ 1..~~r:~t/~ - Gv,~'~S/~ IPRcY~Q rl ~,*PA,'fvL GfFf~ ~~ (~Y...~.ra
~ LLC{-~?trL.~ PlAl2XJ~l~ ~L~,tE Icu{~} ~Ce~3_ AA-~aR{6 :a ~-~~ Pte; /~Z c~2. r,..fFS o~•- ~ DRz'vi~-1~-5;-~~- /~~}2
Z.i~ 1E£ L Ls L `L CW.s s i ~ .~ C . r~ r !~ D ~ r A~-s ~p ~C IL4~'CL~ a J~ 31s i J°I l=lt t.Ki ~~ r~ f~Gk o F' T1~~ L.t~E ~ 1.1'~Z-L..
TJ~E DA~'1 A Cr£ i ~ TAE .tai ~O ~,~r ra S Pro S~ ~.1 rsE2 2T.4,fL t~ I,t ~ P~1Z cur-s ~ x' ~ ~.,.~ ~f~ Gr k ~3'E A~.~ i TY~4~~ ~~iL.
A+SD Sc~; ~t~'ES . ~' ;u~,~ -Plea ~~ r~F' 130; ~ ~R,2s R~rf~D ~.1~i ~.~F'/3 /!w.ri~lr~ s-h+ Qu~~Fi ~h~~crr-+~"~/Z.orC
C 19IZ . Ou~'~' +' /,VAu E r~ ~} ,~'LLS, A-! F yssu r2.4,.[c~ c~2rJ c,~~,~ Po L~: < v ~' a 9S~ a ~7 ~, a r'1 ~C~ {~~yc- ~-~a~
~,~5- ?`r3~~ . D~-~rY s ,~ur~ ~s ~~lex f ~r~ .awQ Pax.. ~s ~~-1r~'~' ~ ra.~; ~aci ~~ ~1. ~3~ ~c; ~2 ~.6~
~1G7
~ FrfJ Tl ~ r_rt~Ct.~. ~l~l~ 14.rt i 1t~~.Ii', Q¢IM/~~ ~O ~/-P Z~'~ ~ t ~~~~C. ~1D~ "' ,A~iD 1~c2~ ~ 5 A~~71 1s
(dc}.. C.~~F~C~L, 1.. ~~ S!~ C~LCI.JC} ~ /a- I'L,""F"~2 ;-~] e N~ 'CI'F..
0
r
r
m
N
0
0
co
O
z
r
0
ao
Kyy7
~d
m
m
y
d
o~
ro
0
r
Cn
0
0
w
01/19/2009 at 12:51 PM
24443
ABRA - DUBUQUE
Federal ID #:420782245
DBA: ANDERSON-WEBER INC
3400 CENTER GROVE DR
DUBUQUE, IA 52003
(563)556-0696 Fax: (563)556-1899
PRELIMINARY ESTIMATE
Written By: RICK KELLY
Adjuster:
Insured: KEN DUFFY
Owner: KEN DUFFY
Address: 1550 BUTTERFIELD
APT 108
DUBUQUE, IA 52001
Evening: (563)583-1155
Inspect ABRA - DUBUQUE
Location: 3400 CENTER GROVE DR
DUBUQUE, IA 52003
Insurance
Company:
Claim #
Policy #
Deductible:
Date of LOSS:
Type Of Loss:
Point of I~act
~;~ c~,e~a's .
~~0
Job Number : ~'$ q - ~ ~~
6. Rear
Business: (563)556-0696
Days to Repair
2000 FORD FOCUS SE 4-2.OL-FI 4D SED BLUE Int:GREY
VIN: 1FAFP3430YW133366 Lic: IA Prod Date: Odometer: 76000
Air Conditioning Rear Defogger Intermittent Wiper s
Keyless Entry Body Side Moldings Dual Mirrors
Console/Storage Clear Coat Paint Power Steering
Power Brakes Power Locks Power Mirrors
AM Radio FM Radio Stereo
Cassette Search/Seek Driver Air Bag
Passenger Air Bag Cloth Seats Bucket Seats
5 Speed Transmiss ion Aluminum/Alloy Wheels
-
-----------------
NO. OP. -------------------------------
DESCRIPTION ----
QTY --------
EXT. PRI ------------
CE LABOR P ------
AINT
-----------------
1 -------------------------------
REAR BUMPER ---- -------- ------------ -------
2* Rpr Bumper cover 0 0.00 1.5 2.8
3 Add for Clear Coat 0 0.00 0.0 1.1
4# Refn DEDUCT FOR BLEND WITHIN BUMPER 0 0.00 0.0 -0.2
5 O/H bumper assy 0 0.00 1.9 0.0
6# Subl HAZARDOUS WASTE DISPOSAL 1 4.00 T 0.0 0.0
----------------- -------------------------------
Subtotals =_> ---- --------
4.00 ------------
3.4 -------
3.7
1
01/19/2009 at 12:51 PM
24443
Job Number:
PRELIMINARY ESTIMATE
2000 FORD FOCUS SE 4-2.OL-FI 4D SED BLUE Int:GREY
Parts 0.00
Body Labor 3.4 hrs @ $ 52.00/hr 176.80
Paint Labor 3.7 hrs @ $ 52.00/hr 192.40
Paint Supplies 3.7 hrs C~ $ 33.00/hr 122.10
Sublet/Misc. 4.00
-------------------
SUBTOTAL ------- --------- ----------
$ -------
495.30
Sales Tax $ 373.20 @ 7.0000 26.12
-------------------
GRAND TOTAL ------- --------- ----------
$ -------
521.42
ADJUSTMENTS:
Deductible 0.00
-------------------
CUSTOMER PAY ------- --------- ----------
$ -------
0.00
INSURANCE PAY $ 521.42
WARRANTY VALID ONLY WITH ORIGIONAL COPY OF YOUR RECEIPT PARTS SUBJECT TO
INVOICE NO GUARANTEE ON RUST ALL PARTS NEW, UNLESS OTHERWISE NOTED
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived
from the Guide DF,2JK00, CCC Data Date Oi/02/2009, aild the parts selected are OEM-parts
manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at
OE/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts
that may be provided by or through alternate sources other than the OEM vehicle dealerships.
OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT
OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle
dealerships. Asterisk (*) or Double Asterisk (**) indicates that the parts and/or labor
information provided by MOTOR may have been modified or may have come from an alternate data
source. Tilde sign (-) items indicate MOTOR Not-Included Labor operations. Non-Original
Equipment Manufacturer aftermarket parts are described as AM, Qual Repl Parts or Comp Repl Parts
which stands for Competitive Replacement Parts. Used parts are described as LKQ, Qual Recy
Parts, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described
as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass
Specifications. Labor operation times listed on the line with the NAGS information are MOTOR
suggested labor operation times. NAGS labor operation times are not included. Pound sign (#)
items indicate manual entries. Some 2009 vehicles contain minor changes from the previous year.
For those vehicles, prior to receiving updateu data from the vehicle manufacturer, labor and
parts data from the previous year may be used. The Pathways estimator has a complete list of
applicable vehicles. Parts numbers and prices should be confirmed with the local dealership.
CCC Pathways - A product of CCC Information Services Inc.
2
7HE CTIY OF -l~
DUB. ~ E
Dubuque Police Department
Law Enforcement Center
P.O. Box 875
Dubuque, Iowa 520040875
(563) 589-4415 dispatch
(563) 589-4497 fax
911 Emergency
Scott Koch
Patrol Officer