Claim by Shelley Atchison Copyrighted
January 4, 2021
City of Dubuque Consent Items # 2.
City Council Meeting
ITEM TITLE: Notice of Claims and Suits
SUM MARY: ShelleyAtchison for personal injury; John Davis for vehicle damage;
Keith Dolan J r. for vehicle damage; Jeffrey Last for personal injury; Kevin
and Sue Leute for property damage.
SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney
DISPOSITION:
ATTACHMENTS:
Description Type
Claim by Shelley Atchison Supporting Documentation
Claim by John Davis Supporting Documentation
Claim by Keith Dolan Jr. Supporting Documentation
Claim by Jeffrey Last Supporting Documentation
Claim by Kevin and Sue Leute Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA '�� `��''��
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. 13tn 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.
1. Name of Claimant: SHELLEY ATCHISON
2. Address: 2888 WILDWOOD DRIVE
�ityo Dl1�UC�lJE �tate: IA zip: 52002
3. Telephone Number: _563-599-0149
4. Date of Incident: July_19_, 2020
5. Time of Incident: 2:30 pm
6. Location of Incident (Be specific): In the sidewalk right-of-way in front of my residence
at 2888 Wildwood Drive in Dubuque.
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.)
On July_19_, 2020 at approximately_2:30 �_.m., I was trimming my front lawn and
stepped onto a manhole cover within the sidewalk right-of-way near the curb along
Wildwood Drive. This manhole cover is intended to be walked on. When I stepped onto it,
the manhole cover gave way, and i fell down into the recess below the cover.
8. What were weather conditions like? Sunny, clear. See enclosed video.
9. Give narne and address of any witnesses: A car passed by just before I fell, but I do not
know the identity of the driver or whether the driver saw the incident. I have video footage
from my doorbell, which is submitted with this claim. Immediately following the incident,
I went to my neighbor's house, Dave Smith, to get assistance.
10. Did police investigate? (If so, give names of officers.) No. Dave (my neighbor) called
the non-emergency number. He told them what had happened and asked for help closing
the manhole. They told him he needed to call the public works number. I then dialed the
number they gave us and got a recording stating they were closed, as this happened on a
Sunday afternoon.
11. Was anyone injured? (If so, give names, addresses, and extent of injuries). Yes. I was
injured: Shelley Atchison, 3888 Wildwood Drive, Dubuque, IA 52002. My injuries required
pain relief inedication and chiropractic visits. Attached are receipts totaling$106.84,which
were all necessary for pain treatment. I paid for one chiropractic visit ($20.00) over the
phone and do not have a receipt for it, which results in a sum total of $106.84 in past
rr�edical expenses. My total claim includes the following:
Past medical expenses: $106.84
Future medical expenses: $ 0.00
Past pain and suffering: $250.00
Future pain and suffering: 250.00
TOTAL: 606. 4
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.) There
was no damage to my personal property; city staff arrived the next day and welded the
manhole shut.
13. What other damages do you claim, if any? I claim no other monetary damages, but the
lack of concern by city staff when I called to report the incident, both to the non-emergency
(following the incident) and Public Works(the next day) was very disappointing,especially
considering that I have complained about this manhole in the past and the city knew that
it was problematic.
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.) No. My
insurance paid directly to Medical Provider: Medical Associates - $187.00, ChiroCare Plus
- $235.00 Receipts attached.
15. What amount do you claim from the City of Dubuque? $606.84
16. Why do you claim the City of Dubuque is responsible? This occurred within the right-
of-way on property that is maintained by the City of Dubuque.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) No.
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount? n/a
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Dated at Dabuque. lowa this day_16t"_of December, 2020. -_;� � �;
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