Claim by Tina PfeilerMasterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
M ORANDUM
To: Mayor Roy D. Buol and
Members of the City Council
DATE: June 25, 2012
RE: Claim Against the City of Dubuque by Tina Pfeiler
Claimant Date of Claim Date of Loss Nature of Claim
Tina Pfeiler 06/21/12 06/18/12 Vehicle Damage
This is a claim in which claimant alleges that a limb from a City tree fell onto and
damaged claimant's parked vehicle.
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
Marie Ware, Leisure Services Manager
Tina Pfeiler
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
RECEIVED
12 JUN 2 I PM 1 : 55
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. City CIei k S Office
The claim must be filed with the City Clerk at City Hall, 50 West 13th St., Dubuque, IA 52001. It latilietiVe.hiferrd 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: 1-6-10‘ N. P4 e i C r
2. Address: 5(0 I a GT.
3. Telephone Number: ((3) 5614-04-1
4. Date of Incident: C 1,i t"' j 8 ,
5. Time of Incident: tUV e. F r ) ? i\ r n — 1 ".30 pfn
6. Location of Incident (Be specific): Pay- Ke d dtr ec`-} -Ki ay, fir V-ver 1•) $ht hoti se_ Q}.
1t i ;ldtiAce its \MAI, Y_ live...3Iu_ `°>�nt rt�t�S C iFc ctly In t =tc 04' "h-1e_ Ftu c
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.)
Z: tcf oce c work_ at S Am, i. went tfrxn e cirri vN en+ -lam Led
\Nib. a+ (. , (coked Duf my % re&1 W I ndfw o - - d seen
- hr.. +ree or) c rr c — L -1 mK- p(c k a r ec� Ord -+-hen
8. What were weather conditions like? \ ir3Ci y
9. Give name and address of any witnesses: - - t lo fit' t AIM nyna. C.Orn .-
tu -b )e roi e. rand SftYl a6r1 ��ch;rrc , WG tc,ILeci lx rmnt,)-ft, c3r'd he_ 16-#:
#.
He 61),-A- rrcvcd Pty -_I dc- k-r)thi his hcime- �(e -+•
10. Did police investigate? (If so, give names of officers.)
No
11. Was anyone injured? (If so, give names, addresses, and extent of injuries.)
1\10.
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.)
Tile fret- Ea vex( in imp b Ili Car = bree.e, nc1
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��� Cct�I>vc� 'The Ltl-ys
buntrx 6E1 nurnY'er rind asked -1-hej
(Lcu (d Come_ Cand c we— -4-he it -Free- D DC mn car. _t
hrr, -Hits vVcCS 1ze I,i'► cf -Ft-e on 1-i\\/
v'icss r- e- Perrecd To Tr)Sh (2;s1- t -t(-.t and She_ 0(d am
hbvv Ti r;d -4+1'%5 C i c .i rr Verm .
13. What other damages do you claim, if any? ne 09- yPhtr
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? .3)1 C1 g pe,r r5t1 rn' ate
pn-• Es-n mcd-e-
16. Why do you claim the City of Dubuque is responsible? Th5 v\IhDle.. Ire:Cc --Cf:( )eci
helon5 C-t1 (Intl 0, 10- ON: he .tre,t, are, Lima. 171:e- Crowned
besoct, t5 The- ?prIO +ree . fp fcill on fry r.or in to \I rs
17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and
address.)
Na
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 (?)111) day of 1u
(Signature)
1-11-)o, Pe-
, 20 17-,
(Print Name)
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