Claim by Marjorie MeyerTHE CITY OF
DUB E
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
MEMORANDUM
To: Mayor Roy D. Buol and
Members of the City Council
DATE: July 15, 2009
RE: Claim Against the City of Dubuque by the Marjorie Meyer
Claimant Date of Claim Date of Loss Nature of Claim
Marjorie Meyer 07/14/09 06/14/09 Property Damage
This is a claim in which claimant alleges that a tree located in the alley behind
claimant's residence of 1800 Adair Street fell during a storm and pulled the power box
from claimant's house.
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
Marjorie Meyer
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 / EnnAIL tsteckle@cityofdubuque.org
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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
2. Address: ~ sJ ~ ~ ( ~
3. Telephone Number: _~
4. Date of Incident: _Z3~~
5. Time of Incident: _~
6. Location of Incident (Be specific):
7. Describe the accident or occurrence that caused injury
claim. If a City employee was involved, give the employeE
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da age. (Give full details upon hic~b(i h you base your G~~~ ,~SLS2_
name.) _ _ ~
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8. What were weather conditions like? C~J ~ ~~
9. Give name and address of any witnesses: ZC~"CQ/LJ ' ~~~ ~t~t-~L~
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10. Did police investigates? (If so, give names of officers.)
11. Was anyone injured? (If so, give names, addresse ,and eaten of injuries.)
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.)
13. What other damages do you claim, if any? ~~~ ~- ~ '~'~~ ~' - "
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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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15, What amount do you claim from the City of Dubuque?
16. Why do you claim the City of Dubuque is responsible?
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17. Have you made any claim against anyone else for damages as a resu t of this incident? (If yes, give name d ~'2"~rY~2
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address.) r
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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 this ~ day of ~ , 20 L' .9
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American Tree Service
Fully Insured
Dubuque, Iowa 3148 Killarney Ct (563) 556-5740
CONTRACT
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American Tree Service has the right to come on the property
with trucks and equipment to cut trees an lob§. `-~
Total Price .~/ ~ ~ ~ ~
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Signed this ~~~ day of ~ ~~'~ 20
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Customer's Signature '~. ; ncan Tre ervi~
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