Claim by Jessica LangCity of Dubuque
ITEM TITLE:
SUMMARY:
SUGGESTED DISPOSITION:
ATTACHMENTS:
Description
Claim by Tamika Carr
Claim by Jessica Lang
Claim by Ashley Moore
Claim by Brad Reicherts
Copyrighted
March 2, 2020
Consent Items # 2.
Notice of Claims and Suits
Tamika Carr for personal injury, Jessica Lang for personal
injury, Ashley Moore for vehicle damage, Brad Reicherts for
vehicle damage.
Suggested Disposition: Receive and File; Refer to City
Attorney
Type
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
GUI EVICV-12-W V-49
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 W. 13th 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 B PAID.
1. Name of Claimant: J -e S S 1 co, a a_ h
2. Address: t C X5 3unro Tr ) \�
City: a/ JOU- tA-e_ State: 61A-)cZ. Zip
: Sabc��
3. Telephone Number: . 3— a. 3 1- ) 1 9
4. Date of Incident: I"2i0 r ltiGl r 1014,1 2 0 Z
5. Time of Incident: 1 • AA-
6. Location of Incident (Be specific): r-) l<,Q A.J be l p f Qi S \ prp Jtia,/ `C
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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 were weather conditions like? CA) l d , 5 hRik/ 5"1A-leCi t L ht
9. Give name and address of any witnesses: Gr(Li S ►'1 O Ms '1, ,gads 9
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Legg'
low - `io\► C WDAKS
10. Did p
lice investigate? (If so, give names of officers.)
6
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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e'r e.ir\ u �W rn rn e_rs cr, Yik_r -� Jyss-�ls �
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? rneAicL
wckys 1:QY\s u*irV
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.)
a ;, hrc Grd Ir4,6 cl m i41,49\1-98q
15. What amount do you claim from the City of Dubuque? IT
6. Why do you claim the City of Dubuque is re ponsible?
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17. Have yowhade any claim against anyone erse for damages as a result of this incident?
(If es, give naRe and a dress.
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, (Y1
in what amount? •�� w) T� /fin ���
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Dated at Dubuque, Iowa this Z'Sfday of re,torkal`%
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5 c--7 Val' v; d ie s h eW i r• 1- kAo J�
(Rev.5/18) )
Copyrighted
March 2, 2020
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Claims
SUMMARY: City Attorney advising that the following claims have been
referred to Public Entity Risk Services of Iowa, the agent
for the Iowa Communities Assurance Pool: Tamika Carr for
personal injury, Jessica Lange for personal injury, Ashley
Moore for vehicle damage, Brad Reicherts for vehicle
damage, and Emily Treanor for property damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
I CAP Referrals Staff Memo
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
MEMO
To: Mayor Roy D. Buol and
Members of the City Council
DATE: February 24, 2020
RE: Claim Against the City of Dubuque by Jessica M. Lang
Claimant Date of Claim Date of Loss Nature of Claim
Jessica M. Lang 02/21/20 02/10/20 Personal Injury
This is a claim in which claimant alleges that she slipped and injured herself on a snow-
covered icy driveway at 3110 Cedar Cross Court.
This claim has been referred to the Iowa Communities Assurance Pool.
Dubuque
AIFAueriea City
111111
2007.2012*2013
2017*2019
cc: Michael C. Van Milligen, City Manager
John Klostermann, Public Works Director
Jessica M. Lang
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 / EMAIL tsteckle@cityofdubuque.org