Claim by Donna Stecher Copyrighted
July 2, 2018
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Sherry Saunders for vehicle damage, Allan Simms for
vehicle damage, Donna Stecher for personal injury.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City
Attorney
ATTACHMENTS:
Description Type
Saunders Claim Supporting Documentation
Simms Claim Supporting Documentation
Stecher Claim Supporting Documentation
�"t�� �
, • ���
C�,�IM AGAINST TI�E CITY t�F DU�UQU�, I(�VIdA ����.`�v�.��
I
This wri#ten reporfi constitutes your ctaim agains# the City of Dubtaque, lowa. You should
complete this fQrm in f�atl and attach any addi�ionat informat�c�n that supports your claim.
� � �
The Claim must be filed with the City �lerk afi City Hail, 5� W. '13th 5�., Dubuque, �A 52001. It
will then be refi�rred by the City Cauncil fio the appro�riate depar�ment for investigatior�. �
Once that investigation is cflmpleted, a report and r�commendafiion w.ill be submitted �o the ;',
�
Gity Council. You will be prov�ded with a copy of th�t repart and recommend�tion. E
THE FINAL DECISIC}N UN ALL C�AIMS IS MADE BY THE CtTY COUNGIL.. NC? EMPLOYEE C3F
THE C1TY C}F DUBUQUE HA� THE AUTHORITY TO MAKE ARIY REPRESENTATIaN TO YC?U
AS Tt7 WHETNER YOUR. GLA1M WlLL. t.�R WI�� IV�7` BE PAI[�.
'1. Name of Claimant. � C� �� c.,.� i
,
2. Address: � �` �. � �. ��''� �"��ic� � ���t '
Gity: ��,�i.C. �tate: $��e� Zip: ..� ��, .
�
3. T�leph�ne IVumber:_ ,;� .�"�� � �� { �� ��t�i ��'��' -�c����' i
�� ���.�.��� ��~���.�����. ,� ��
4. Date of tr�cide�nt: � �' M'�— �'" �
�
5. Time af Incident: �, � �
6. Lo�atic�n of ltn�ident (Be �pecific): � �° � � � ' �-- �����- ��
7. DESGRIBE ACCIDENT CJR t,3CGIJRRENGE THAT CA1JSEi� INJllRY C)R DAMAGE. (Giv�
futl de#ails upon which you base your cDaim. If a Gity employee was involved, give the
empl�yee's name.}
�r �U�`�`'' �'a� c�6�� �`'' �' �'?l �. � ��'� � e°"��" ,h �'" ��"'"
r "
���r �� r�f �°" � � �a' �s'�.� -�,� � � �..
�-� ��- � ' ,� � �� �ea..%�
8. Vl/hat were w�ather conditians like? �'r����,�.�_
9. f�ive nam� ar�d addr�ss of ar�y witness��: ~°-� ���� ;�;�'r -- �c��l�� �� �1���`
�
'10. D�d palice inv�stigate� {If sa, give names �«f officers.)
���'( ��'G'' `,1 �'� �'�� � �°' ,s
'11. Was anyone injured? {lf sa, give names, �ddresses, and exter�t of in�uries}.
/��cr�,t.1 � c �' �-- � � �, d,�,�t��'���`a �' ��.�� ' c� �.L-� ,�ac�a,�.
� -�c� f�Lr ce�
{ � � � �
12. Was any dlamage done �c� property? {�f sa, des�ribe property and fihe exter�t of
damagesA A�t�ch estimates of damages ar descr�be basis for as�er�aining exten� of
damage,}
��� � �
�
�
�
'13. What ofih�r damages do yc�u claim, if ar�y? i�i,/��J�1 �_
'14. Hav� yc��a be�r� compensated for �ny part �r all c►f yo�ar ctaim by �ny insurance
company? {�f so, g9v� name and a�ldress of insur��ce company and amcaunt pa�d.j
� t ��s� —p---a
�� c� -� ���c�.c. c�.,r � �.�c�e
�5, What �mc�un# c�c� you clai�n firom fihe City of Dub�aque?
�'- � � ~ � -~ �'r+,a. c s�cr/� � /,.�r Ckr�cc.
�c:�+� �-�ter --�'t! �iat tau,�ua� . �'lk f
16. U11hy d+a yau +claim the City of�?ubuque is r�spor�sibl�'? �edt c.a.�--r c��c, �,
,���:s ,�'� �� ��� S�'� :��
� �7. Hav� yc�u r��c8e ar�y cEairn �gainst a�yone else fo�r dam�ges �s a result of this i�cider�t?
�If yes, girre n�me and addr��s.�
��
�8. 1� th� an�wer fio Quesfiion '17 is gres, Iha�e you received ar�y paym�a�t �rom th�t �ource,
and if sca, in whafi amo�nt?
Dated at Dubuque, iowa thi� ,� day �f ,/ � , �� ��'.' ',
,�'� {�ignature�
�t.J� a^� � �'` �r- � ��=�� ,�. (Pr'rn� Nam�) .�. '
� �.
.�:
E�� � �
� � �
� � � �� '
�. �
c`� �'' � �°
(Reve 511�3} � '��. � �
� ,�"
�
�an�'ide�tial
This communicatitan and any attachments may con�ain ir�farmatic�n which is con�F3dent�al
and privileged by law ar�d is far the use af the desi�r�at�� recipient. If yc�u are nc�t fihe
intended reeipient, yau are hereby nc�tified tha�: yc�u have received this cc�mmunicafii�n in
err�r, and tha� any review, disclo�+ure, dissemi�ati�n, di�tribution or copying ofits contents
is prc�hibit�d. Please nc�tify �ifiy of Dubuque immediately by telephon� at {563}-58�-4120 of
yo�� �-��e6�� r�� ±�a��� a���� ��d ���#��y� �h� �r��~iu���.a��c� a��� a�y ��t��9�rr�e���
immedia�te�y. Fa�rther disclosure of this irtformat�on m�y vialate state and fed�ral
restr�ctior��. .
Confiden�ial infc�rmation may inc(�de the followit�g:
�} Sacial Securify Rtumber(s}
�) Medical/Nealfih lnformation
3) Personnel/D�sciplinary Infflrmation
4} Bank Accc�unt Informatian
5� �inancial Infiormation
6) Credit Card Numbers
Ifi any doeumentati�n you desire to sUbmit tc� the City of Dubuque contains any of the items abnve
this cover sheet must be attached directly #o the confidenti�l information and indicate the �ype of
informatian that is included.
1, , hereby certi�y thafi the attach�d documenfis
include fihe foilowing pratected infiormation;
S�cial Security �lumber(s} Bank Account Inf�rrnation
Medic�l/Hea[th Informafiian Financial Ir�fc�rmatiora
Perst�r�nellC�isciplinary Infiormafiion Gredifi �ard Nur���r��)
I ur�derstand �h�t thfs information may be distributed within the City t�rganizatidn or t� age�ts c�f the
City for processing and 1 hereby �utht�rize the City to act accordingly taking all precautior�s to
prafiect my informa�ic�n from �annecessary distrik�ution.
�
���� r� ����
� ignat�re Date
Copyrighted
July 2, 2018
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Suits
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: Rainbo Oil
Company for property damage, Sherry Saunders for
vehicle damage, Allan Simms for vehicle damage, Donna
Stecherfor personal injury,
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Supporting Documentation
THE CTTY OF
�UB E MEMORANDUM '
� Masterp�iece on the MisszssippT � �
i
�
TRACEY STECKLEIN �
PARALEGAL �
i''
To: Mayor Roy D. Buol and � � � � �
Members� of the City Council ��
�
DATE: June 18, 2018 �
�
RE: Claim Against the City of Dubuque by Donna Stecher �
,
�i
Claimant Date of Claim Date of Loss Nature of Claim �,
��
;
Donna Stecher 06/18/18 06/07/18 Personal Injury Ih
��I
This is a claim in which claimant alleges that while riding a City of Dubuque Jule bus, the i
driver of another vehide ran a red fight at which time the City bus driver applied the
�
brakes, causing claimant to be ejected from her seat. '�
�
�
This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa �
Corr�munities Assurance Pool. �
�
,
cc: Michael C. Van Milligen, City Manager ;i
Candace Eudaley, Transit Manager I'
Jodi Johnson, Operations Supervisor �i
Russ Stecklein, Field Supervisor �)
Donna Stecher
�
�
� �
��
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA �
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 �
TE�EPHONE (563)583-4113/Fax (563)583-1040/EMai� tsteckle@cityofdubuque.org
a