Claim by William and Rebecca GarrMasterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: March 7, 2011
RE: Claim Against the City of Dubuque by William & Rebecca Garr
Claimant Date of Claim Date of Loss Nature of Claim
William & Rebecca Garr 03/04/11
This is a claim in which claimant alleges that a City of Dubuque bus struck claimant's
parked vehicle in front of 435 Glen Oak Street.
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
Barbara Morck, Transit Manager
William & Rebecca Garr
MEMORANDUM
4 P
02/23/11 Vehicle Damage
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
From: Barbara Morck
Sent: Friday, February 25, 2011 9:01 AM
To: HTLD CLMS - AUTOCUST
Subject: 153554578
Attached please find the City of Dubuque's Claim Form. Please call the City Clerk's office at 563 -589-
4120, or myself at 563 - 589 -4341, if you have any questions or concerns.
Barbara J. Morck
Director of Transit Operations
The Jule / ECIA
2401 Central Avenue
Dubuque, IA 52001
(563) 589 -4196
Dubuque
AJ1 Arne 1caCitY
1 111
2007
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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 Attorneys 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: \v ;, Q yn .42 ,CiC,G■_(2p(\
2. Address. C1 S T • 0 ) \
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6. Location of Incident (Be specific): � 5\Z-c\1
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3. Telephone Number: ��C j — � — c\5 C A I
4 Date of Incident ) —33 -.-
5 Time of Incident:
8 What were weather conditions like?
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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.)
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 .amage.)
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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 amoun do you claim from the City of Dubuque?
16. W y do you claim the City of Dubuque is responsible?
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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 this
day of 20
(Print Name)
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