Claim Oberfoell, Dona1. Name of Claimant: Dona Oberfoell
2. Address: 2939 Jackson, Dubuque, IA 52001
3. Telephone number: 582-8222
4. Date of incident: 10/25/04
5. Time of Incident: Between 5:30pm and 7:30pm
6. Location of Incident (Be specific): 17th Street same side of
Street as Hoffman/Synder Funeral Home by alley
7. DESCRIBE ACCIDENT OR OCCURENCE 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.)
My car was parked on 17th Street
My group was in the Halloween Parade. When I
got back to my car ther was a note of
admission of guilt by Officer Jason Coble
8. What were the weather conditions like? Clear
9. Give name and address of any witnessess: None I know of
10. Did police investigate? (If so, give names of officers.)
Jason Coble
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
No
12. Was any damage doen to property? (If so, describe property and the extent of damages.
Attach estimates of damages or describe basis for ascertaining extent of damage.)
My car has a dent in the back
bumper plus paint scratch on my
car.
13. What other damages do you claim, if any? Paint and rear
bumper need to be repaired.
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 your officer was
responsible and needs to pay
15. What amount do you claim from the City of Dubuque? $326.56
16. Why do you claim the City of Dubuque is responsible? Jason Coble
admitted he hit my car when he left
the note attached to my car.
17. No
18. No
Dated at Dubuque, Iowa this 28 day of October, 2004.
Dona Oberfoell
To whom it may concern:
Your vehicle was involved
in an accident. Could you please
call 589-4425 to receive the
information of the driver of
the offending vehicle.
Thank you,
Officer Jeff Stewart 64C