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O'Brien, Shane, P Inj. Claim seBarry A. Lindahl, Esq. Corporation Counsel Su/te 330, Harbor V~ew Place 300 Main Street Dubuque, Iowa 52001-6944 (563) 583-~113 office (563) 583-1040 £ax balesq@mwci.net July 14, 2003 Mayor Terrance Duggan and Members of the City Council City Hall - City Clerk's Office 50 West 13th Street Dubuque, IA 52001 RE: Settlement of Shane O'Brien Personal Injury Claim Dear Mayor and Council Members: City of Dubuque Police Officer Shane O'Brien was injured on the job on December 14, 2001. Officer O'Brien's leg was broken when the person he was arresting allegedly assaulted him. Officer O'Brien was on injury leave for 11 workdays and the City was responsible for paying medical expenses related to the injury. The value of the lost workdays is $1,625.29 and the City paid $1,093.87 in medical claims. Officer O'Brien made a claim against the person allegedly responsible for his injuries. Officer O'Brien's attorney, Steve Juergens, represents Officer O'Brien. Mr. Juergens has negotiated a settlement in the amount of $3,000.00. Officer O'Brien has agreed to reimburse the City $1,000.00 for benefits paid to him. In consideration for the $1,000.00 payment to the City, Officer O'Brien is asking the City to waive any further claim against him for reimbursement for expenses incurred by the City as a result of the injury. I would recommend acceptance of the settlement of $1,000.00 and would further request authority to execute the Release on behalf of the City. Corporation Counsel BAL:tls Attachment CC; Michael Van Milligen, City Manager Randy Peck, Personnel Manager Service People Integrity Respomibtlity Innovation Temnwork RELEASE FOR THE SOLE CONSIDERATION OF One Thousand Dollars ($1,000.00), the receipt and sufficiency whereof is hereby acknowledged THE CITY OF DUBUQUE, IOWA does hereby release and forever discharge SHANE K. O'BRIEN, his heirs, executors, administrators, agents and assigns, and all other persons, firms or corporations liable, or who might be claimed to be liable, none of whom admit any liability to THE CITY OF DUBUQUE, IOWA, but all expressly deny any liability, from any and all claims, demands, damages, actions, causes of action or suits of any kind or nature whatsoever, particularly on account of all payments made by THE CITY OF DUBUQUE, IOWA for (a) medical or hospital services or expense on behalf of SHANE K. O'BRIEN, and (b) worker's compensation benefits paid to SHANE K. O'BRIEN, up to and including the date of this Release and relating to injuries received by said SHANE K. O~BRIEN in an incident which occurred on December 14, 2001 ir~ Dubuque County, Iowa. Without limiting the generality of the foregoing, this Release is intended to and does fully release and discharge, said SHANE K. O'BRIEN from any and all liability relating to the claimed subrogation of THE CITY OF DUBUQUE, IOWA to the rights or interests of said SHANE K. O'BRIEN arising out of the aforesaid payments for medical and hospital expense and worker's compensation benefits of said SHANE K. O'BRIEN. THE CiTY OF DUBUQUE, IOWA hereby declares that the terms of this settlement have been completely read and are fully understood and voluntarily accepted for the purpose of making a full and final compromise adjustment and settlement of any and all claims, disputed or otherwise, on account of the matters above mentioned. CAUTION! This is a Release, read before signing. IN WITNESS WHEREOF, this Release has been executed this of , A.D. 2003. __ day THE CITY OF DUBUQUE, IOWA BY: