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Claim by Tim NemmersTHE CITY OF DUB E MEMORANDUM Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL ~~~1"`""' To: Mayor Roy D. Buol and Members of the City Council DATE: RE: Claimant March 26, 2009 Claim Against the City of Dubuque by the Tim Nemmers Date of Claim Tim Nemmers 03/24/09 Date of Loss 03/18/09 Nature of Claim Vehicle Damage This is a claim in which claimant alleges that the stop box lid located on claimant's property at 3695 Keystone Drive was damaged when a City of Dubuque Operations & Maintenance endloader struck the stop box lid during snow removal operations. 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 Tim Nemmers 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 CLAIM AGAINST THE CITY OF DUBUQUE, IOWA ~ti~ i~~.~~' P.'~~~ lam, _~. 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 13~' 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: ~ V r [71 ~ e.'f'fl fYl P.i' 2.Address:~~t~ Kc.yStc)nN, Dt'-V~ 3. Telephone Number: cJ $ ~ - a ~ ~ ~ 4. Date of Incident: ~ O TTC E D O n .3 ~ ~ 3 ~~ ~~ 5. Time of Incident: ~ OTrC CQ CLt ~' ~ ~"~' J~ D.>'~. 6. Location of Incident (lie specific): ~ ~ %_ 1 n C h C:_~ ~ f') (,i 1 ~'1 P. Q ~'~ 1 my i7lailbox 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.) 9. Give name and address of any witnesses: Q C) n t"1(~ h 3t~~5 K ~ ~tua~z p~-~r~ The. 5 n n t,il t' ,ten c~ v c.,. l c r ,.,,' c ct. u,~ ht the ~ c~ fi e ~ S to la b c X l i c~, u,~ ~~ -t h .~' h e encl Ic~r.c~ec' oc- tracfia, - b~.trlS~~c;~ka,'hi le e'l cLni i1c~ t:X~.ESS SnLw. I1' occu,rf~c~ ~n (~nt°. c;f t,R~e , i-ha~' th v c• Leaned ~t~~t„; ~~ ~~ ~; a5s ~n the cul asc~c,• I 8. What were weather conditions like? ~XG e ~ `~ i V ~ .`? tl C t.tJ b u 1 ~ (~ - Li.1J c~ 1. (' t R (~ c,..n ~... O tA; C,. ~ t R t E d'. 10. Did police investigate? (If so, give names of officers.) iV' 11. Was anyone injured? (If so, give names, addresses, and extent of injuries.) V C; 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.) ?~hP. ;,,~r;_teV' Sfi?D bc~X Wq,S pu(~~c`~. ~~LlC1h~~v r'r'©rin the ut'vu.n ~ anr~ c,>i- a K~t~ T ,.~c7u 1r~ e~~'~m `~ the. cyst fio -~~ X afi ~ VDU to .~ i 5i:c? 'i ~ th e. r i s maw e inte~~'luI c~amcL~u unca~~ the ~c•~+~nr~. 13. What other damages do you daim, if any? N 0 n P. 14. Have you been compensated for any part or all of your daim by any insurance company? (If so, give name and address of insurance company and amount paid.) ~i f") 15. What amount do you daim from the City of Dubuque? .~ C ~ Ci, i (Y1 'T ~ L k Y'r1(~ lL fZ 1 f 1540 fo -~r,~~ prc~Dt',~('ly end fht' unt~~aDtcdn ~n~~,rncil c;~.amayL Uurie un er e ~'ou~ 16. Why do you daim the City of Dubuque is responsible? ~ ~~/ e S C e ~ + h ~ ~ c~, m U.y e, c~ U ~'1 ~ ~" U j" h l: 5 ~' U r Y-"i 5~~i„l',.f' by +h~ p~ULL' n~c~1- my hoase 1~' wa~-~-k~ -l anc~ na{ by rne,The '~ ~ ~~~~. cr ~ cI La stomp pc~,( Ilc. • it's fhc, r;~i ' ~h,r,qq thci-h coa d p~.tl i ll,q -tly from grvu.r~a and, 17. Have you made any claim against anyone else for damages as a result of this incident? (If s, giver name and address.) C era, L (~ ~ U ~Yl ~',~" ~'1 ~ .~~ No +h~.~~ sty-~r,9. 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 ~_a m~ " I (.2~rr n ~ nn (Signature) C7 ~ ~~ I i fY1 N P, rn m ~~' S -- -- ~ ~ T ;1, ~; (Print Name) {-7 ~ r ~U' •~~ ~ ~ ~^ ^ r ~ ~~ '^ V ,