Claim by Geraldine GoodmanTHE CITY OF
DUB E
Masterpiece on the Mississippi
MEMORANDUM
TRACEY STECKLEIN !~'
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE:
RE:
Claimant
November 9, 2009
Claim Against the City of Dubuque by Geraldine Goodman
Date of Claim
Geraldine Goodman
11 /09/09
Date of Loss
09/08/09
Nature of Claim
Personal Injury
This is a claim in which claimant alleges that that as she was walking near the northeast
corner of the Highway 20 Grandview Overpass, claimant tripped on a raised portion of
sidewalk and injured herself.
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
Gus Psihoyos, City Engineer
Geraldine Goodman
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
L I I 1° T ITY , I
This written reporl: constitutes your claim against the City of ®ubuque, 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 . 13t" St., ®ubuque, 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 ®ECISION ON ALL CLAIMS IS iVIA~E Y THE CITY COUNCIL. O EMPLOY E OF
THE CITY OF ®U UQUE HAS THE AUTHORITY TO MAKE ANY REPR SENTATION TO YOU
AS TO WHETHER YOUR CLAIM WILL OR WILL NOT E PAID.
1. Name ®f Claimant: Geraldine M. Goodman
2. Address: 535 English Lane, Dubuque, IA 52p03®8755
563 (582) 6950
3. Telephone Number:
4. Date of Incident: September, 8, 2009
to catch myself, Concrete wall on right hand side. Fell about ten feet from point
where I trinnPr3_ ~Ap ~h~tn~ ~f vita with ri~lPr t.c-~ mak- bad a mane.
6. Location of Incident (Be specific) NE corner of Highwya #20 Grandview Overpass
8. What were weather conditions like? Fair, sunny day
9. Caive name and address of any witnesses: Rebecca Ann Tully. _1509 Prescott, Di~buaue._
Doukt if witness could see attempt to stop myself because of concrete wall. Hand Injuries.
10. ®id police investigate? (If so, give names of officers.)
Yes . Leo Jobgen
11. Was anyone injured? (If so,
I was injured. Fell on face,
incisors. Severe bruising to
Transported to Mercy Hosgzital
over all injuries.
give names, addres i3~ d extent of injuries).
chipped right upper x~~~s~enaff, cracked both upper
right side of face (see picture of face taken Sept. 9 and 10)
by city ambulance. Quite a bit of bleeding. Still not
°12. V1las any damage done to property? (If ~®, deseribe property and the extent of
damages. Attaeh estimates of damages or describe basis for ascertaining extent ®f
damage.
No damage to any property owned b Cit or State. Glasses broken. Replacement $138,70
after warantee allowance. Tooth repair $324. If incisors turn black, there will be
expensive orthodontic work. Wi11 know in six months to a year (see dentist's letter).
9 ~. If the ans~nrer to Question 17 is yes, have you received any payment from that s®urce,
and if so, in what amount'?
'~`'~l
Dated at ®ubuque, lovva this ~ day of ! ~1c., ~;' ~' jyt~:~ ~-r 20C `~ .
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