Claim by Kathy OstranderTHE 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
June 30, 2009
Claim Against the City of Dubuque by the Kathy Ostrander
Date of Claim
Kathy Ostrander 06/26/09
Date of Loss Nature of Claim
06/19/09 Property Damage
This is a claim in which claimant alleges that during a storm that occurred on June 19,
2009, a City tree fell on the gutters of her residence, as well as her shed, clubhouse and
fence, located at 2908 Brunswick.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
Gil Spence, Leisure Services Manager
Kathy Ostrander
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
~%
~~u _~
CLAIM AGAINST THE CITY OF dUBUQUE, fOWA
Ji~~~~.
l his written report constitutes vour Gaim against the Crty or uuououe. Iowa. rou snoura comorete trns roan m ruu ano
attach any additional rntormation that supports your crarm.
I he claim must be filed with the Citv Clerk at Citv 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 Citv Council. You will be provided with a coov of that report and
recommendation.
The final derision on all claims is made by the City Councl. 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: L" l L
3. Telephone Number:
4. Date of Incdent: _
5. Time of Inddent:
6. Location of Incident
(Be
~,~
JZOL ~
7. Describe the acadent or occurrence that caused injury or damage. (Give full details upon which you base your
9. Give name and address of any witnesses:
11. ,Wnas anyone injured? (If so, give names, addresses, and extent of injuries.)
C 1~
~~S , a~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 ascertainin extent of damage.)
51~.~I - ~~~~ ~~ ~~C~.. ~ S~ c~.~ bYc k~
VY
10. Did police investigate? (If so, give names of officers.)
~L
+"!+,~+ ^ttio~ ,~=maces do you daim. if anv? ~L'
~-. ,~~N vr!+ ripen compensarea ror any part or air or your aa~m oy any insurance company's (if so, give name and
address of insurance comoanv and amount oaid.l
~V ~ -
15. What amount do you daim from the Citv of Dubuque? ~~ ~ ~ . DU
16.rW~hy~d~o you daim th~`e Ci o~f pDubuq(ule,is respponsible? C.~-
l ~.l~.If~ ~~ ~ J 1 V`= 1.,~ ~ l.~
17. Have you made any daim against anyone else for damages as a result of this incident? (If yes, give name and
address.) (( ''
~v
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 ~/~-~ V . 20~
(i Hats)
u~~~ ~S~ c~tX
(Print Name)
n O
~
"'
~ ("-. L..
~ ~,
....
c'
~. ~
N
°'~-~
~` ,
ZD t~v