Claim by Nancy GourleyCity of Dubuque
ITEM TITLE:
SUMMARY:
SUGGESTED DISPOSITION:
ATTACHMENTS:
Description
Claim by Heather Flohr
Claim by Nancy Gourley
Claim by Jo Ann Witterholt-Weigel
Copyrighted
May 18, 2020
Consent Items # 2.
Notice of Claims and Suits
Heather Flohr for vehicle damage, Nancy Gourley for
property damage, JoAnn Witterholt-Weigel for property
damage.
Suggested Disposition: Receive and File; Refer to City
Attorney
Type
Supporting Documentation
Supporting Documentation
Supporting Documentation
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 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 WI L NOT BE PAID.
1. Name of Claimant:
2. Address:
City: State:
3. Telephone Number: 5-5 3 .3 9 - % 7 3,a
4. Date of Incident: , 3 /r9(
5. Time of Incident: /01 � ,Oni
6. Location of Incident (Be specific):
Zip: 5d60/
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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. Wha were weaconditions like /' I aurvyti
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9. Give name and ddress of any witnesses: ex/Id,
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10. Did police investiga'e? (If so, give names of'4 officers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
No
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 other 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.)
15. What amount do you claim from the City of Dubuque?
16. vyhy do you claim the CI of Dubuque is esponslble? -1
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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.)
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, Iowa this obi bday of Si , 2012„0.
111.
(Signature)
Ahr Cy Goo k / (Print Name)
(Rev. 5/18)
co
co
Copyrighted
May 18, 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: Heather Flohr
for vehicle damage, Nancy Gourley for property damage,
and Jo Ann Witterholt-Weigel 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
Dubuque
All•America City
WCI'�WLCS/K: IFAC :
2007*2012*2013
2017*2019
MEMO
To: Mayor Roy D. Buol and
Members of the City Council
DATE: May 11, 2020
RE: Claim Against the City of Dubuque by Nancy Gourley
Claimant Date of Claim Date of Loss Nature of Claim
Nancy Gourley 05/07/20 02/23/20 Property Damage
This is a claim in which claimant alleges that a clogged city sewer line near 1161 Edina
Street backed up into claimant's basement.
This claim has been referred to the Iowa Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
John Klostermann, Public Works Director
Nancy Gourley
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