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Claim by James NormanTHE CITY OF DUB TE MEMORANDUM Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL To: Mayor Roy D. Buol and Members of the City Council DATE: September 27, 2010 RE: Claim Against the City of Dubuque by James Norman Claimant Date of Claim Date of Loss Nature of Claim James Norman 09/27/10 09/24/10 Property Damage This is a claim in which claimant alleges that his refuse can was damaged during refuse collection. This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager Paul Schultz, Resource Management Coordinator James Norman 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 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 West 13 St., Dubuque, IA 52001. It will then be referred to the appropriate department for investigation and to the City Attomey's Office. 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 James Norman 2. Address: 2560 Knob Hill Drive, Dubuque, IA 52003 3. Telephone Number: (5 6 3) 583 4. Date of Incident: September 24th 2010 5. Time of Incident: approximately 8:00 a . m . 6. Location of Incident (Be specific): Beacon Hill - south curb at 7. Describe the 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.) At approximately 9:00 a.m. I went outside to collect I my garbage can. It was in the middle of Beacon Hill drive, and the hinged lid was gone. 8. What were weather conditions like? 9. Give name and address of any witnesses: none Knob Hill Drive 10. Did police investigate? (If so, give names of officers.) No Overcast, slight breeze. 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.) Yes - my 35 gallon trash can, which had been used approximately 4 times now has no lid and needs to be replaced. f. 13. What other damages do you claim, if any? None 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 15. What amount do you claim from the City of Dubuque? $25.00 approximate replacement cost 16. Why do you claim the City of Dubuque is responsible? Pretty clear sign of negligence by the trash collector. Hinged lid was no where. I'm sure it went with the truck. 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) (Print Name) No 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? NA Dated this 24 day of September 20 1 0. (Signature) James Norman