Claim Farner Bocken Co StevensCLAIM 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 WILL NOT BE PAID.
1. Name of Claimant: Farner Bocken L
2. Address: P.O. Box 368 Hy 30 East Carroll, IA 51401
`
3. Telephone Number: 717 792 7466
4. Date of Incident: 8 20 03
5. Time of Incident: 9:45 A.M.
6. Location of Incident (Be specific): South lane of Grandview Ave. Next to Finley Hospital.
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.)
North lane under construction, all traffic in south lane. Cones separating the lanes. Southbound lane next to curb where parking was normally permitted. Trees were low in that lane. Truck trailer struck large limb from tree, too low. Heavy traffoc from north.
8. What were weather conditions like? Normal
9. Give name and address of any witnesses: None
10. Did police investigate? (If so, give names of officers.)
No
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 right front corner of 2000 Trailmobile .....? $3,96.03
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?
$3,960.03
16. Why do you claim the City of Dubuque is responsible?
Would like to understand any city ordinances or laws governing obstruction i e the height required of object over city streets.
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?
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Dated at Dubuque, Iowa this 27th day of October, 2003.
/s/ Dan Stevens
(Signature)
(Print Name)
(Rev. 1/00 & 7/01)
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 WILL NOT BE PAID.
1. Name of Claimant:
2. Address:
`
3. Telephone Number:
4. Date of Incident:
5. Time of Incident:
6. Location of Incident (Be specific):
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.)
8. What were weather conditions like?
9. Give name and address of any witnesses:
10. Did police investigate? (If so, give names of officers.)
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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?
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. Why do you claim the City of Dubuque is responsible?
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 day of , 20 .
(Signature)
(Print Name)
(Rev. 1/00 & 7/01)
Page 1 o£3~
Home Page: Departments: CiW Clerk: Claims against ~e City: C[~[~ Form
City Clerk
First floor of City Hall, 50 W. 13th Street
Phone: (563) 589-4:120
Fax: (563) 589-0890
Hours: 8 a.m. to 5 p.m. Monday through Friday
Email: jsch neidd~citvofdubuoue.ora
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
This written report constitutes your claim against the City of Dubuque, Iowa. You should compJe
full and attach any additional information that supports your claim. ~
th ,
The claim must be tiled with the City Clerk at City Haql, 50 West 13 St,, Dubuqug~]A 52001. It
referred to the apprepdate department for investigation and to the Legal Dffpa~ent. Once that
completed, a report and recommendation will be sulsmitted to the CityC0~riciL¥og,will.be prove,
of that report and recommendatFdn.
The final decision on all clams is made by the City Council. NO employee of the city of Dubuqm
authority to make any reFresentafii~n~o you as to-wh~th~r yo~WClaim will or wilFnot be paid.
:1. Name of Claimant: ~-I~CZ- ,o (c"~ . .
.... 6f Incident: , ~ ~--~ (~
'- ~7, Descdbe t~e a~ident or ~ccu~ence that caus~ ~nju~ or da~ge. (Give ~11 details upon whi
,, a em,,o , was ,nvo,w .¢w
~8. What were w~er conditions like?
~ e. Give name and address of any ~nesse,: ~¢~.k~ ~ ¢~ /(%e/ ~O ~-
. Did police investigate? (lfso, give nam~ of o~cem.)
http//www.cityo fdubuque.org/index, cfm?pageid= 155 10/23/2003
11. W~S anyone injured? (If so, give names, addresses, and extent Of injuries).
12. Was any damage done to property? (if so, describe property and the extent of damages. Ati
damages or descdbe basis for ascertaining extent of damage.)
13. What other damages do you claim,, if any?
14, Have you been compensated for any part or all of your claim by any insurance company? (1I
and address of insurance company and amount paid.)
15. What amount do you claim from the City of Dubuque?
16, Why do you claim the Cit7 of Dubuque is responsible?
18, if the answer to Question 17 is yes, nave you received any pay~nt from that source, and if
amount?
(Datedthis C~ dayof I:~-~-DB~c~ ,20 O~
(Signature)
{print Name)
http://www.cityo fdubuque.org/index.cfrn?pageid= 155
Home Page~: Departments: City Clerk: Claims aqainst the City: Claim Form
10/23/2003
A. · P.O. BOX 1797 · SIOUX CITY, ]OWA 51102
(712) 277-2364 (S00) 274-2364
RAVENS~'
CDRREF:-i";O~'¢.~ ~R MiRiN~ CF; B':5~: F'DR ~SiDE DDM::'~ L~HTS / REME}VE
Accepted and Received By:_
The terms and conditions on the other side apply to this invoice. Please read carefully,
/cu~w~nT/._e_. ~ ,,o,,,,.,,,,,,o TIlIIILEfl .~ALE.~
~,'m RQ. BOX 1 ?9? · SIOUX CIT%, IOWA 51102
(712) 277-2564 (800) 274~2364
FRRB~ i ALUm% ROOF
RAVENS~'
Accepted and Received By:.
The terms and conditions on the other side apply to this inVoice. Please read carefdlly.
Famer Bocken Ce.
Phofie:7/2-792~7466
FAX: 7/2-792-7375
emai~ dstevens@far~er-bocke~.com
Monday, October 27, 2003
City Clerk
First floor of City Hall
50 W. 13th Street
Dubuque,IA. 52001
To Whom it May Concern
In -closed is a claim form against the city Of Dubuque. Also inclosed are pictures
of the incident.
Farner Bocken Company is a wholesale candy, tobacco and food service
wholesaler located in Carroll,IA. We distribute products to stor~s~n and around the
Dubuque area.
On 8/20/2003 at 9:45 a.m. on Grand view Ave., next to Fi~ey hospital one of our
delivery vehicles was forced to use just one lane of the south bound lane where parking is
normally permitted because of construction in the north bound lane. The south bound
lane was separated by orange cones, designating lanes of traffic. As our truck and trailer
traveled this street it s~ruck a large tree branch that was stick~g out over the street, and
di~ ~n~iderable damage~o the trailer In- closed is also a copy-6fthe re air cost to the
In most cities ariel municipalities there are codes on he~ ht
~g eqmrements for
obstructions for over head clearance. The city of Dubuque wom~lnot give me any of this
information without tiling this claim, so I do not know the cocl~_of the city of Dubuque.
To the best of my knowledge and as you can see by the pictures~the tree being located
between the sidewalk and the curb. In most cases the property dwner owns the property
but the city has rights to this partial of ground.
We would like you to look into this incident and let us know if the city of Dubuque
has any liability in this situation.
On behalf of Farner -Bocken Company we would ask that you look into this
situation and please respond to us.
If you need any additional information please feel free to contact me at the above
phone number and or E- mail
Sincerely,
Dan Stevens