Claim by Mark HoppmannTHE CITY OF
1.~UB E MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: September 28, 2009
RE: Claim Against the City of Dubuque by Mark Hoppmann
Claimant Date of Claim Date of Loss Nature of Claim
Mark Hoppmann 09/22/09 09/22/09 Vehicle Damage
This is a claim in which claimant alleges that his vehicle was struck by a City of
Dubuque bus while the vehicle was parked at the corner of Keyway and Keystone.
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
Jon Rodocker, Transit Manager
Mark Hoppmann
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
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 daim.
the daim must be filed with the City Clerk at City Hall, 50 West 13'" St., Dubuque, IA 52001. k 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 Coundl. 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 daim will or will not be paid.
1. Name of Claimant: ~'~RJC.. ~a~nn.Rnn ~1.
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2. Address: ,~ ~ Cl 9 P1-~(~Gt:W
3. Telephone Number. .~ $ oZ ~~ ~ ~
4. Date of Incdent: ~ ~ as - c ~
5. Time of Incident: "? : ,~-~ i4-tA
6. t.ocation of Inddent (13e specific): ~~~p ~'~[~e-1 r. r.~~ '4~i hoYll.c_ .
t'' ~~ r' ter G F L'{w ~.c~u-lu i~ 2.. ~'~ ~C ~ S'~tli1 ~- l~ R
7. Describe the accident or occurrence that caused injury or damage. (Give full details upon which you base your
daim~._H a City emplofyee was involved, givee the employee's name.) \ ~.
~•~ v $ inS CX i^: a-a_ n \C~,~lw 1~t.J ~ ~~~1~ `(~'` `' `(~1~~ 4>c,.r~F.q~
~~r ~-..~' ~~... C r c~g,i~`i: 1~' ~-t~a W c:. ,. a..,.~. C~Chr~ . \
8. What were weather conditions like? `~ a
9. Give name and address of any witnesses: ~ ~ ~5 r~ ~ : nc u,. C .~~y
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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? (ff so, describe property and the :,.t_.a of damages. Attach estimates of
damages or describe basis for ascertaining exte\nt of damay`~~ge.) ~ ~
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ALL PARTS INSTALLED ARE NEW UNLESS SPECIFIED OTHERWISE ` ~T ~
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ADDRE ~ „~..-~~..~~`~ m ~' - I TIME RECEIVED
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SPECIAL REPAIRS
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RETAIN PARTS ^
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TOTAL PARTS I I HEREBY AUTHORIZE THE ABOVE REPAIR WORK TO BE DONE, ALONG TOTAL LABOR
WITH NECESSARY MATERIALS. YOU AND YOUR EMPLOYEES MAY OPER-
PARTS -
ATE ABOVE VEHICLE FOR PURPOSES OF TESTING, INSPECTION OR DELIV-
'
ESTIMATE AMOUNT ERY AT MY RISK. AN EXPRESS MECHANIC
S LIEN IS ACKNOWLEDGED ON
LABOR ABOVE VEHICLE TO SECURE THE AMOUNT OF REPAIRS THERETO. YOU
TIME ev
WILL NOT BE HELD RESPONSIBLE FOR LOSS OR DAMAGE TO VEHICLE _
ADO'L AUTH AMT OR ARTICLES LEFT IN VEa18tE IN ASE OF FI ,THEFT, ACCIDENT OR TOTAL PARTS
ANY OTHER CAUSE BE`~OKID YOUJR NTROL. -
ADD'L AUTH. AMT - '~ J/•
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~ GAS, OIL, GREASE
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AUTHORIZED BY ~~
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ADD'L AUTH. AMT. RECEIVED BY _ SPECIAL REPAIRS
~ ~ • GAL. GASOLINE @ CHARGOES ENTAL
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QTS. OIL @
~ Unless otherwise provided by law, the seller (above named dealership) hereby -
O z expressly disclaims all warranties, either express or implied, including any implied
~ ~ warranty of merchantability or fitness for a particular purpose, and neither LBS. GREASE @ STATE TAX
a a assumes nor authorizes any other person to assume for it any liability in connection - -
with the sale of said products. TOTAL GAS -OIL -GREASE • ~ I ~ •
Used Car Value -Chrysler Cirrus-V6 Sedan 4D LX
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Bodv Stvle > Make > Year > Mode18: Trim > NFleaae & ODtions > Value Report
1995 Chrysler Cirrus-V6 Sedan 4D LX
~~ Driver Information Exchange Report
Dubuque Police Department
563-589-4410
I Driver's Name -Last First ~ Middle Suffix Date of Birth ~
I~, U OUGH STEVEN EDWARD I 01/30/1945 j
N Address
1 City
I State Zip Phone
2237 WASHINGTON ST DUBUQUE IA 52001-0000 (563) 589195 x i
T Gender Driver's License Nu mber Class State Endorsements Restrictions Insurance Co. Name Insurance Co Phone # ~
Male 800ZZ2517 B IA P B IOWA ASSURANCE POOL (563) 589120 x
~Di Ovaner Company Name Insurance Policy #
~ CITY OF DUBUQUE KEYLI NE 8US SERV CITY OF DUBUQUE
Ovmer's Name -Last I First Middle Suffix
~ Address City State Zip
2401 CENTRAL AVE. DUBUQUE IA 52001- ~
VIN No. Year ~ Make Model Style Vehicle Configuration
I T6H4523A1967 1976 ~ GMC BUS 18
License Plate # State Year Mosl Damaged Area Approximata Cost to Repair or Replace
64507 IA 2009 02 -Right Front $50.00
Driver's Name -Last _ First Middle Suffix Date of Birth ~
U ~ '
N I Address City State Zip Phone
i (563) 582-7795 x
T Gender ~ Driver's License N~_r
~ mber Class ~ State
L 1 Endorsements Restrictions
NONE NONE I Insurance Co. Name
LIBERTY Insurance Ce Phone #
(800) 225-2467 x ,
002 Owner Company Name Insurance Policy # ~,
A02-243-600185-70 9 ',
Owners Name -Last First Middle ~ Suffix
HOPPMANN ~ MARK FRANCIS
Address City State Zip
1899 KEYWAY DR DUBUQUE IA 1 52002-
VIN No. Year Make Model St le Vehicle Confi~u~_3t,on
I1C3EJ56HXSN513618 1 1995 CHRY CIR 4D 01
License Plate # I State Year Most Damaged Area Approxim ate Cost to Repair or Replace i
842MYC IA 2009 01 -Front $1,500. 00
County Accident occurred within corporate limits of (city)
' Dubuque - 31 Dubuque - 2100
I
Literal Description
~ KEY WAY and KEYSTONE DR
X-Coordinate
100686869
~ If accident occurred outside of city
limits show general vacinity: "N/A"
On Road, Street, or Highvray:
KEYSTONE DR
Distance Direction
I "N/A" "NIA" and
I Definable intersection, briuye, er railroad crossing
("N!A"
Officer
BASTEN, DANIELLE
Y-Coordinate
04708331
Direction ~ Nearest City 'Route (Cardinal]
"NIA" of "N(A" Travel Direction "NiA" I
At Intersection with:
KEYWAY DR I
Distance Direction Milepost Number ',
"N/A" "N/A" of "NIA" Or
Badge N Law Enforcement Case Number I ate of Accident I Time of Accii:en}
23A 01/094698\ ~ 9/22/2009 ~~, 07:28 Hrs. ,
Printed At: Dubuque Police Department 09/22/2009 08:16 AM
Page 1 Form #: 01109-446981