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Claim by Sarah AnthoneyTHE CITY OF DUB E MEMORANDUM Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL -4) To: Mayor Roy D. Buol and Members of the City Council DATE: August 18, 2011 RE: Claim Against the City of Dubuque by Sarah Anthoney Claimant Date of Claim Date of Loss Nature of Claim Sarah Anthoney 08/16/11 07/15/11 Vehicle Damage This is a claim in which claimant that a City of Dubuque bus struck claimant's parked vehicle on Booth 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 Sarah Anthoney 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, I a' Q �EiVED This written report constitutes your claim against the City of Dubuque, 1pyvAint t 53 should complete this form in full and attach any additional information that" supports your claim. City OT OS' °� ��., U: OS' The claim must be filed with the City Glerk at City Hall, 50 West 13th St., Dubu4UO. 'A Dubuque, IA 52001. It will then be referred to the appropriate department for investigation and to the City Attorney'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: 3 r4 k d}` -1-)brt. 2. Address: 57( et1i7Lrt/ 7 5 ..� - LOS: to :z)(/' 3. Telephone Number 4. Date of Incident: 5. Time of Incident: / ;j/ 1, rYY\ 6. Location of Incident (Be specific): �` 6 +k kr) t 1 sees_ o L 1 D hU Gets 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 mpl y 's name.) C,1 CUs tv 1 mi Ivy �c 8. What< ,ere weather cond' ions •like? Jvcnr1. ' 9. Give name and address of any witnesses: 10. Did police investigate? (f so, given es of officers.) dc d