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Claim by Lindsay KruserTHE CITY OF DUB E Masterpiece on the Mississippi MEMORANDUM TRACEY STECKLEIN PARALEGAL To: Mayor Roy D. Buol and Members of the City Council DATE: RE: Claimant January 22, 2009 Claim Against the City of Dubuque by the Lindsay Kruser Date of Claim Lindsay Kruser 01/20/09 Date of Loss 01/11/09 Nature of Claim Vehicle Damage This is a claim in which claimant alleges that as she was traveling west on 4th Street, a City of Dubuque snowplow truck attempted to switch lanes and struck claimant's vehicle. 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 & Sewer Maintenance Supervisor Lindsay Kruser 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 ~; ~~n 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: ~ a~ld~U.~~ 2. Address: ~. ~~,1~ 3. Telephone Number: ~_j~ , 4. Date of Incident: ~"~ ~- lf~~ 5. Time of Incident: ~ ~~ ~:~""i 6. Location of Incident (Be specific): ~h;(;,~ ~\I~~~ ~~ ~(~~~ t~i~ u ~ I~~~;~1~1~ ~t- l ~ f~ t~C':~ ~i?i t' f r Ir 1 / LI~/ii ~il~l l ~11\~~~+'~~~/ ('~Y~~'1 ~~lli~l ~!\"" ~~JY 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.) ~~ ,~ '~`~J l,~d,~~!~j~~~, "'"~, ~~~~ '+~ l,''~i~U~~ I~'t1 ~~1 r~~ 11 ~~ '~~~~lA~l,"~ ~~ '\.I~ ~~ ~,'vU ~II`,'~,! r ~l~'~il `1~i ~i~"1-~~I~l~i ~,i~l't1 i~-~~11~ ~~lia.1 ~~~~~~i1(~" -~-i~= ~~~~~Ur ~,L~~I .~ 8. What were weather conditions like? ~,~~~ ~ ~ ~~~ l ~~~~1' 1,~~' 9. Give name and address of any witnesses: (v ~~ 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). ~~° ~ . ~~~ i ~ '~ ~fi ~l-~ ~~ ~ ~ ~ ~~~ 1~1. I ~~~~~ J ~ ~ ~ U~,~ ~ ~~'~,~," ~ ~ ~~ I~~<<~~ y t~ [`~;I~ ~ Diu I i ~ ~" i~ ~ (~ ,~~r ~ ~`~-~ ~~ ~~~ ~ ~ t`~-~~~~~ ~ ~ ~ ~ n ~ _!~T ~ u~ ~ ~ ~ ~~ 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.) ~~~ '~~ilr`. ~~"`~~ 13. What other damages do you claim, if any? 1~~ 14. Have you been compensated for any part or all of your claim by any insurance cod~ (mpany? (If so, give name and address of insurance company and amount paid.) 1~~. 15. Wh t unt do you aim from the City of Dubuque? ~--~~~.~~ _ ups -~ ~r1t~a ~ l~;~ 1.6. 1Nhy do,you claim the City of Dubuque is responsible? 17. Have you made any claim against anyone else for damages as a result of this incident? (I~ yes, give name and address.) 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 U" . 11,5 ~u ~.~' ~ ~ ~-~~ ignature) rint Name) (Rev. 1100 8~ 7/01) 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.) ~'~~~ ~~~~.1 13. What other damages do you claim, if any? ~\~ti 14. Have you been compensated for any part or all of your claim by any insurance co~(m'~pany? (If so, give name and address of insurance company and amount paid.) l~U. 15. the City of Dubuque? 6. I~Vhy do,you claim the City of Dubuque is responsible? 17. Have you made any claim against anyone else for damages as a result of this incident? (I# yes, give name and address.) 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 \~('~11~,1(~.l~l 20~. r~ds~u Kr~,s~r (Rev. 1 /00 & 7/01) Print Name) C~ ~ ~`~'~ ~ ~ C - ~ ~~~ ! ~ ~J. ' - ~ N _~_. ~ ~' ~ ' cd ~ N HABERKORN AUTO CENTER OWNER .~C ~LB~ I~1~ ADDRESS ~~2 ~y~-423 DATEl~~3-19C~~~ MAKE Y©R~ M L ~ CO IDENTIFICATION NO. MILEAGE LICENS~ .~~~~ FRONT OF CAR KEV HRS. SUBLET 8 MATERIAL PARTS LEFT SIDE KEV HRS. SUBLET 8 MATERIAL PARTS RIGHT SIDE KEV HRS. SUBLET 8 MATERIAL PARTS BUMPER HEADLIGHT HEADLIGHT BUMPER BRKT. COMPOSITE COMPOSITE BUMPER GUARD GRILL PARKING, LIGHT PARKING, LIGHT GRILL FENDER, FRONT FENDER, FRONT GRILL MLDG. FENDER, APRON FENDER, APRON FENDER MLDG. FENDER MLDG. GRAVEL SHIELD FENDER MLDG. FENDER MLDG. WINDSHIELD FENDER MLDG. FENDER MLDG. HEADER PANEL FENDER MLDG. FENDER MLDG. DOOR, FRONT DOOR, FRONT ~/ r~ CrC ~ ~ ~f COWL DOOR, MLDG. DOOR, MLDG. tf ~ e Q ~ (~ d C RAD. SUPPORT DOOR GLASS DOOR GLASS RAD. CORE VENT GLASS VENT GLASS ! i " ~ C . .~ ANTIFREEZE CENTER POST CENT POST , ' i FAN BLADE ( , S" ~ O FAN SHROUD DOOR, REAR DOO ,REAR / ~ S 3. Z ~ Q I DOOR, MLDG. DOOR, MLDG. DOOR GLASS DOOR GLASS HOOD ~ ~ ~ Q HOOD HINGES HOOD MLDG. ROCKER PANEL ROCKER PANEL ROCKER MLDG. ROCKER MLDG. FLOOR FLOOR ORNAMENT 1/4 PANEL 1/4 PANEL NAME PLATE 1/4 PANEL 1/4 PANEL LOCK PLATE, LR. 1/4 PANEL 1/4 PANEL LOCK SUPT. WHEEL HOUSE WHEEL HOUSE 1/4 MLDG. 1/4 MLDG. REAR OF CAR BUMPER BUMPER BRKT. BUMPER GUARD TAILLIGHT TAILLIGHT TAILLIGHT TAILLIGHT TAILLIGHT TAILLIGHT GRAVEL SHIELD TAILLIGHT TAILLIGHT LOWER PANEL BACK-UP LIGHT BACK-UP LIGHT FLOOR BACK-UP LIGHT BACK-UP LIGHT TRUNK LID CLEAR COAT ~ TRUNK HINGE CLEAN-UP TRUNK MLDG. LABOR HRS. C~ ~° M ISC . ITE MS PARTS ~ n TOP IDENTIFICATION PAINTING ~ ~) LICENSE LIGHT FRAME KEY TOWING TIRES MATERIAL ~Q HUBS CAPS N NEW R REPAIR HAZARDOUS wnsrE ~ n / C, 1. WHEEL DISC. OH OVERHAUL A ALIGN P PAINT TAX G S SUBLET TOTAL / ~ { The above is an estimate based openetl up, we discover worn, b on our roken o Inspectio r tlamage n and does n tl parts not ot cover ad evident in th ditional parts or labor which may be required e first inspection. Quotations on parts antl la after w bor are ork has current begun. Occa and subject t sionally, whe o change. n work is ~ ) / ,, ~V (j.! ~ / 602 PERU ROAD DUBUQUE, IOWA 52001 PHONE (319) 556-8872 ESTIMATED BV WORK AUTHORIZED BV ESTIMATE .~ ,--~ ~--,-- S -~ ~5~~ ` G~I~ ~~ ~- ~ ~ 4 ~~~t~: ~~~`~ 1 ~~,U~~~t. ~~b~ fio~~~rJ -~~. ~~~ ~ `' _. ~ i ~ c S___ .~=`~ C ~~ J~- ~ir~ ~IG~~~S ~~~~~ ~~~~ ~~ Driver Information Exchange Report '~ Dubuque Police Department 563-589-4410 Drivers Name -Last First Middle Suffix Date of Birth l1 LATTNER TIMOTHY JOHN 07/14/1965 N Address City State Zip Phone I 929 MT LORETTA DUBUQUE IA 52003 (563) 582-7733 x T Gender Drivers License Number Class State Endorsements Restrictions Insurance Co. Name Insurance Co. Phone # Male 018AA6863 B IA N-L NONE SELF INSURED (563) 5894120 x ~~~ Owner Company Name Insurance Policy # CITY OF DUBUQUE Owners Name -Last First Middle Suffuc Address City State Zip 50 W. 13TH STREET DUBUQUE IA 52001- VIN No. Year Make Model Style Vehicle Configuration 1HTWGAAT19J131842 2009 INTL 7000 PLOW 12 License Plate # State Year Most Damaged Area Approximate Cost to Repair or Replace IA 2009 ~ Driver's Name -Last First Middle Suffix Date of Birth U KRUSER LINDSAY JO 03!07/1986 N Address City State Zip Phone I 392 BLUFF ST #2 DUBUQUE IA 52001 (563) 513-8281 x ~ T Gender Drivers License Number Class State Endorsements Restrictions Insurance Co. Name Insurance Co. Phone # Female 945AA8194 C IA NONE B STATE FARM MUTUAL {563) 588-1491 x 002 Owner Company Name Insurance Policy # 080487662615 Ovvner's Name -Last First Middle Suffix KRUSER LINDSAY JO Address Ciry State Zip 392 BLUFF ST #2 DUBUQUE IA 52001- 1 VIN No. Year Make Model Style Vehicle Configuration 1J4GW58N9YC157556 2000 JEEP GRAND CHEROKEE LL 04 License Plate # State Year Most Damaged Area Approximate Cost to Repair or Replace 026WBL IA 2009 07 -Left Side $1,000.00 i County Accident occurzed within corporate limits of (city) Dubuque - 31 Dubuque - 2100 Literal Description W 4TH ST X-Coordinate Y-Coordinate 00691730 04707621 If accident occurrad outside of city Direction Nearest City Route (Cardinal) i limits show general vacinity: "N/A" "N/A" of "N/A" Travel Direction "N/A" On Road, Street, or Highway: At Intersection with: !"14TH STREET "N/A" Distance Direction Distance Cirection Milepcst Number 50 Ft 7-W and "N/A" "NIA" of "N/A" Or I Deflnabte intersection, bridge, or railroad crossing W 4TH ST/ LOCUST ST Officer Badge No. Lava Enforcement Case Number Date of Accident Time of Accident BOWERS, JAMIE 4 01-09-07447 01/11(2009 03:33 Hrs. Printed At• Dubuaue Police Department G~i'~~2009 03:45 AM Page 1 Form #: 01-09-01447