Claim by Janet RhombergMasterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
MEMORANDUM
DATE: July 6, 2011
RE: Claim Against the City of Dubuque by Janet Rhomberg
Claimant Date of Claim Date of Loss Nature of Claim
Janet Rhomberg 07/06/11 06/22/11 Property Damage
This is a claim in which claimant alleges that the rain gutter on claimant's garage was
damaged while City of Dubuque Public Works employees were repairing the alley next
to claimant's home.
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
John Klostermann, Street & Sewer Maintenance Supervisor
Janet Rhomberg
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 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: e.,-)6 i' Qom} /� _ir\ or t "
2. Address: r- Fl�,m 6V∎' IVC I O►.-b i.C 1k 5a 003
3. Telephone Number: (5(5) 5$ 2- p 5 � 5 U
4. Date of Incident: I.(A5 i (e-TV re pD4 006t1(144 Dt5R.
5. Time of Incident:
6. Location of Incident (Be specific): by
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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.)
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8. What were weather conditions like? tkiti((I w
9. Give name and address of any witnesses:
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10. Did police investigate? (If so, give names of officers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries.)
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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.)
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13. What other damages do you claim, if any? no
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.)
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15. What amount do you claim from the City of Dubuque? 23 Io b f ) ( hQ pa,{r...5
16. Why do you claim the City of Dubuque is responsible? , eirid Us2 d le,fer '
17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and
address.)
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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 this day of � 20
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(Print Name)
Masterpiece on the Mississippi
Mr. Roger Rhomberg
245 Fremont Avenue
Dubuque, Iowa 52003
Dear Mr. Rhomberg
June 22, 2011
The purpose of this letter is to make you aware of damage that occurred to your garage
rain gutter during the recent repair of the alley next to your home. Your gutter was
damaged by the City of Dubuque Public Works crew making the asphalt repair in the
alley.
In order to be reimbursed for the damage to your property a Claim Against the City
Form must be completed and returned to the City Clerk at City Hall, 50 West 13 Street,
Dubuque, IA 52001. Once the claim form has been received a report and
recommendation will be sent to the City Council. I have also included a picture of the
damaged gutter that you could attach to the claim form.
I apologize for the damage to your property. If you have any questions concerning this
issue feel free to contact me at 563/589 -4348.
erely
Jdhn Klosthrmann
St�-eet/Sewer Maintenance Supervisor