Claim by Mary Coan Copyrighted
January 16, 2018
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Merlyn Atkinson for property damage; Mary Coan for
personal injury; Elizabeth Wallace for vehicle damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City
Attorney
ATTACHMENTS:
Description Type
Atkinson Claim Supporting Documentation
Coan Claim Supporting Documentation
Wallace Claim Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA ��-��" `
This written report constitutes your claim against the City of Dubuque, lowa. 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: I �.'v' CC;G�d�
2. Address: �C� � ��('iGL S S'� �(.-L � c'� � �
3. Telephone Number: '���% � "�v �' � � << � �
4. Date of Incident: �Z-�l�/I �
5. Time of Incident: (> � �U �V�
6. Location of Incident (Be specific): �i�f�Uc��l� ��e�uiee�� �'C�G i�v��/i�E.{,t,l ,� �G�����
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7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your clai If a City em�l ee was involved, give the
employee's name.) �v ���v�c��o y E� ���� .c� � c���� ��
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8. What were weather conditions like? �r�� � C (�' �ir � l/1 �i � ' D� S��L��UGI.��Cs
9. Give name and address of any witnesses: w �����
10. Did police investigate? (If so, give names of officers.)
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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? �U� C C�� `��\ � S �� �M Y'
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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. What amount do you claim from the City of Dubuque?�
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16. Why do you c aim the Cit of Dubuqu�e is re onsible? (^ - l
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17. Have you m�e 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, lowa this � day of ����C�f!� , 20 f�
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Copyrighted
January 16, 2018
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 lowa, the agent
for the lowa Communities Assurance Pool: Merlyn Atkinson
for property damage; Mary Coan for personal injury;
Elizabeth Wallace for vehicle damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Supporting Documentation
THE CITX QF
D�U�� E MEMORANDUM
Masterpiece on tlie Mississippi
�
TRACEY STECKLEIN �
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: January 10, 2018
RE: Claim Against the City of Dubuque by Mary Coan ,
�
Claimant Date of Claim Date of Loss Nature of Claim ;
,i
Mary Coan 01/10/18 12/19/17 Personal Injury/
Property Damage
This is a claim in which claimant alleges that she tripped on a raised portion of the
sidewalk that connects South Grandview and Fremont Avenues, injuring herself and
damaging her glasses.
This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa
Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
Gus Psihoyos, City Engineer
Tom Kopp, Engineering Technician
Mary Coan
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAfN STREET DUBUQUE, IA 52001-6944
TE�EPHONE (563)583-4113/F,vc (563)583-1040/EMai� tsteckle@cityofdubuque.org �
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