Claim by Julie Rupert Copyrighted
November4, 2019
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Jerome Ehlers for property damage, John Koenig for
property damage, George Langas for personal injury, Julie
Rupert for vehicle damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Referto City
Attorney
ATTACHMENTS:
Description Type
Ehlers Claim Supporting Documentation
Koenig Claim Supporting Documentation
Langas Claim Supporting Documentation
Rupert Claim Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA � �
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This written report constitutes your claim against the City of Dubuque, lowa. 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 W. 13t" St., Dubuque, 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 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.
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1. Name of Claimant: �.�► ��t� �� � �
2. �+►ddress: � �C�J I N�� �6�`�(�t�( �.1�C
City: �(��{�L,��l��� State: �,�- Zip: ��-���
3. Telephone Number: �,�c,(�.� �-�j�'� .�L�,`�j�-�
4. Date of Incident: (i�-����� �� �� , ��-���
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5. Time of Incident: ��� e� �� �l�
6. Location of Incident Be s ecific : � r
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7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim. If a City employee was involved, give the
employee's name.)
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8. What v�er� �re�ther conditior�s like� �� �„
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9. Give name and address of any witnesses: �f�: / rt �i� ���` ��-"
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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? (If so, describe property and the extent of
damages. Attach estimates of damages or describe basis for ascertaining extent of
damage.)
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13. What othe� 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? ��` �
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16. Why do you claim the Ci of Dubuque is res onsible?
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17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) ���3
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount?
Dated at Dubuque, lowa this �� day of (��. l c.--�' ���I`� , 20 �� .
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Copyrighted
November4, 2019
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Claims
SUMMARY: CityAttorney advising that the following claims have been
referred to Public Entity Risk Services of lowa, the agent
forthe IowaCommunitiesAssurance Pool: Jerome Ehlers
for property damage, John Koenig for property damage,
George Langas for personal injury, Julie Rupert for vehicle
damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Staff Memo
Dubuque
THE CITY OF
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TRACEY STECKLEIN � �
PARALEGAL �
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MEMO �
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To: Mayor Roy D. Buol and �j
Members o#the City Council � �
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DATE: October 28, 2019 ��
RE: Claim Against the City of Dubuque by Julie Rupert ;;I
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Clairnant Date of Clairai Date of Loss (Vature of Claim
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Julie Rupert 10/28/19 10/15/19 Vehicle Damage i
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This is a claim in which claimant alleges fihat as she was firaveling northwest on JFK near �
Turin Motors, she drove over a sharp pointed object protruding out of a crack in the road
which punctured both the front and back passenger side tires of claimant's vehicle. �
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This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa �,
Gornmunities Assurance Pool. ;
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cc: Michael C. Van Milligen, City Manager �,
John Klostermann, Public Works Director
Julie Rupert �
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OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 �
TE�EPHONE (563)583-4113/F� (563)583-1040/EMai� tsteckle@cityofdubuque.org