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Claim McMahon, Kasey . de ;l~ Ii 111 .' fiu CLAIM AGAINST THE CITY OF DUBUQUE,' IOWA ~ '1J;f This written report constitutes your claim against the City of Dubuque, Iowa: tc;u 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 W. 13th St., Dubuque, IA 52001. It will then be referred by the City Council to the appropriate department for investigation. 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. NameofClaimant:J~(AS€j ~m o.ho0 2. Address: 5 3 5 SLA \ II \J O-{\ 'St. 3. Telephone Number: 563 - S 5 7- 10 l 5 4. Date of Incident: 10 - 0 b - 0 5 5. Time of Incident: I) ~ Gj 5 om 6. Locationoflncident(Bespecific): T{\ -front of I 3S0 IF(\ Ad (eu,~ t(\{\J) i(\ ~ ~\ 3~t- \ OJH'_ , 7. DESCRIBE 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 em~yee's name.) . . h . C 4: Wo.s tr-(),\J~ \ 11'\3 N(')rt\... O{\ J f K', Wit (\, n Of\.-t \n Tro{)t 0+ r 0. r a.ch.e fu lof1S vc lor. ~c, onJ. h;+ 0. loi i{.,rcw'\f\ iN. "f-fcn./ltn,\ \~k,\-(. d'\V\"3' iD"II'l'o.I CJ'.H-, (').(\ (r-es+woo& to cJ..,5CO-.Jt[ Jflo-t--tiNS. 8. What were weather conditions like? Ro...'in "f\j '. do [ k 9. Give name and address of any witnesses: OlAV-Ie&- CoL~Rr) gc' ~9 Huf'v<-s+ LV') Wo..$ in 'f-h.., (('~ I"Jd~ mJ2, 10. Did police investigate? (If so, give names of officers.) No 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). No 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.) . -No \ ~<lcle)tk con+ru,ct)Of\ VJ~ ~(~ Wv.S +hu--e. 13. What other damages do you claim, if any? \\l Of\-€. 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.) _Tr;J - 5+<J.te~w'){1Jtow-e~ vY\~ (Wt POj-{J- ~j 'St().+~ FCl{'~ ~'. I 15. What amount do you claim from the City of Dubuque? 5'90 8Lf 16. Why do you claim the City of Dubuque is responsible? Th.erf ~,0C^.S CHl ()V~'5'I?-ert ~,^(YlP wh'lch -Shou./cU-"1- hiAW b--e-ef\Huf\e \ Cdusi{\j tWo -Flcd-fi{.q fa vn:j (0.(. 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) 1\1(') 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? Dated at Dubuque, Iowa this _6 ti, day of ,~ ., ;) " , , }" .,J (Rev. 1/00 & 7/01) Yahoo! Mail - eskc486@yahoo.com http://us.f3II.mai1.yahoo.com/ym/ShowLetter?Msgld~491 0_55417... Yahoo! Mv Vahoo! Mail Make Yahool your home Dace "'~.Ii:HOO' MAIL ~f~~o~~;,e~~~~~unt] t~;~i',;~~~~: r-"--"'"'---'~'-'--"--'-' ._~~~~J ~..2lLHome-Mail Tutorials - Help ilJ.t' ,~IU ()1//~1,1~ GET YOUR DEGREE IN Organizational Psychology & Development Bachelor S In 13 MONTHS' 'f Master 5 In 10 MONTHS LEA~N MORE' . / Mail Addresses Calendar .... Notepad What's New ~ Mail For Mobile - Uoarades - Octions Check M.II J_.compose J Searel W'I rr~> 5'TATe,1.t (A/( W l+k rLAJ<f.r ~ Get VONAGE 8. get 1 month FREEl Previous I Next I Back to Messaoes Delete I ReplV Forward Spam I Move... Fold.... [Add - Edit] This message is not flagged. [ Flag Message - Mark as Unread] Inbox Draft Sent Bulk Trash Date: Wed, 26 Oct 2005 22:02: 19 -0500 From: .Oavid Colyer" <DColyer@dbq.edu> ~J Add to Address Book III AOO IVIUUl1", .....,<:, C To: eskc486@yahoo.com [Empty] [Empty] SubJect: Car Damage Testimonial r What's your . Credit Score? On Oct 6 at around 12:45 Casey McMahon and I were driving on JFK past the road constrution next to Long John Silvers and Burger King. Travelling the speed limit, we crossed the gravel section of the road work. Apparently the rain that night had washed out a section of gravel at the end of the work, exposing a slab of concrete. We hit this exposed area of concrete and were jolted as the tires and rims were crushed. This sent us fishtailing and narrowly averting a serious crash. The result of this event was that Casey McMahon's front right and back right rims and tires were damaged extensively. . Online Degrees! Nursing to MBA . Earn a Degree Online and fast! r?;. Wow! Mortgage ~.~ Rates under 4% -David Colyer Delete I Reply Forward Spam I Mov.... Previous I Next I Back to Messaqes Save Messaqe Text Check Mall I Compose I Search Mall Search the Web I Copyright@1994-2005 Yahoo! Inc. All rights reserved. Terms of Service - CopyrightllP Policy _ Guidelines - Ad Feedback NOTICE: We collect personal infonnation on this site. To leam more about how we use your information, see our Privacy Policy lofl 10/27/2005 I :46 PM LighthEdge Solutions Webmail Page 1 of 1 (bgednals@cityofdubuque.org) - Wed, 10/12/05 13:32:04 +0000 b~\v(i<. .--- SrAT~ ~!-vl f'-,<20/O? '/Mr )J (~ 1-1.-(. Show Full Headers I ~int I Close Printer View From: < bgednals@cityofdubuque.org> Reply-To: bgednals@cityofdubuque.org To: mmcmahaon@cityofdubuque.org Cc: bgednals@cityofdubuque.org Subject: bump in the road Date: Wed 10/12/05 09: 12 AM I WAS ON MY WAY HOME NORTH BOUND ON JOHN F KENNEDY ON OCT 5TH 2005 AT 2315 HRS. AFTER STOPPING AT THE LIGHTS AT WACKER AND JFK I CONTINUED ON NORTHBOUND ON JFK IN THE FURTHEST RIGHT LN BECAUSE OF ORANGE CONES MOVING TRAFFIC TO THAT LANE. I DROVE OVER A PATCH IN THE ROAD (FROM CONSTRUCTION) WHICH CAUSED MY CAR TO BOTTOM OUT AND BOUNCE A COUPLE OF TIMES.IT WAS DARK AND UNABLE TO SEE THAT PATCH.THERE WAS NOT ANY TYPE OF SIGN ADVISING YOU TO SLOW DOWN(MORE), NO BUMP IN ROAD SIGN,OR ANY OTHER TYPE OF WARNING SIGN TO ADVISE YOU OF THAT PATCH IN THE ROAD. THAT BUMP COULD EASILY DAMAGE A CAR IN MY OPINION. SIGNED ROBERT GEDNALSKI (bgednals@cityofdubuque.org) - Wed, 10/12/05 13:32:04 +0000 http://webmail.cityofdubuque .org/email/scripts/view.pl ?fullHeaders=&mid=] 79&folder=... 10/12/2005 ::::t.i:.i:"":; LCC3tlOi 'I (i;'-/!"" I:" ; ]'"~"'o't ;:~1 "-d .;-," '~, 1\-'.. r", :,~' i(\' .i:')\.if (jjTANDfM TIRE & AUTO SERVICE INC ~;t;UI'':" Phn Oat f; 'C'. \' (1\.1\' r' "r: #: (1 '1',' (kef: # I i: j'" 1tI1.~ Y~JJ:,(';i 'i:-::":;.~i';':Y\: ,d<)" T ,\ Qty Bhp BIO Itern Numb.. q '-:;CF. Di!~CT i pt i on 13/1. FEr Pi ,j t.;(~ '-i:, i':-i.'I;' j '::P liL. i"FC" lJL j j 1 'f iLL -j-~,"" i-I ,;: t: L-.\ i,!~ 1..- ;,:'~ :. UHi _ !~\nr,j i",'\,:;;,;:i:::ii'j'-j I, ',~ .1: i J 'ji.C ;'::[I"ikL': .:Lf:i!,,: fPi" ;"r;~:c i,'(JUr t'., i'C'TC'C' r li fr, ')':'lL' nr'!JF'n 1;, ,- , , . ",j .;('1'::' [;1) j-'CiT(':I'!.l ,Ii-j -:--F:,\ i'l':_:,:~'CY f'" '-;- t, LL f~~ Lj 7/((<:.s (;!'!i', , Ui- Ti Ui'::::1 " f',' :il'; i l,; I Ii (. : i . I'" , . : ;':~ ::-:"i':" Q9>end on us! T; mc ")\) i P I,J i;~4 :n ,!, ; 'L .:~< c, Amaunt lnitl.li /i Ct, ", !,;"Ij:-, ,-7:11,_ 1.e, ';}i :0. j~\!D ':',l;' "",J, ,1.>(-1 (:H, (1(.) F.J!<,. .L.r;-d C,t;", ~:);Zl '.' :1'.;""{-i0. Jt. " i;,)Ct:I,'---. f-f t-; :" ',',,' I,ili,'" '~ 1/1, 1..', (' . , ",f; ill .,. ;H A 1',01 <'1\ ": ~ ~ " ,';/1 \ '1,' i r~i :?!}i)1 {, (j)TANDfN TIRE & AUTO SERVICE IN( r;\ ("1',/ f:Yli1' n.)t t,; ., :,UI' '1 ~., nCi..UJ' 1'1('1 C, )t I'm T, 'I L Qh.i Shp n/o Tt~"Ii Ni18!bt;\( 'Ie 'Hi,; I .fhe 'i; 'Ii,!i\; :~: I ,) .; ~:~l'~_jV! ;:"ii:'_lF:(j t'; ~ J .,. ';; ,-~ 'Ti, \,'; I: ," .' '_'iL ---- r)e~cr-ipt i (if! 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"q"\~,,,~ '.l!1Il' ;;;< .<:.l.<>..\ 14\Ju,., ~ !INVOICE I NO: CHECK CHANGE I J 9 ~ 0 M" (oe.... :::IYlt-€-'1'0- CHARGE RESALE RETURN CUSTOMER ORDER NO. SHIP VIA: OTHER CUSTOMER OUR TRUCK c=J c:=J - ['J'seA PRICE 30."" M4duNTX"~~ I ' ~O 0() '^ -:K,,..1 '" \ 00 t.. \-\- H-O.M. \\ f'llt_rV-..jc., *"" I' '-' ~, ~ <t--- \.3 0 ~ . ~ ..::::l <j:. ';) .a ..a ~ -1 (- ~ ~ <:l/. ~ ::> = J ".<2 ~ () ~ ~ ~~-\,. \J ~~ ... ,:: -:> -oJ 4 'I; ")l \J 3 -oJ '-\ "< \J <,l 1- ~ ~ \- :> ...,... VI lil <l:. - ~ . - L C HOLDER & FOR HIRE ca "- ::r: SALES rs,O 00 Icertifythatthepropertypurchased,aslisted,istaxellemptbecausertispurchasl a!. ....J 0 for exclusive use in farmirlg. dairying, agriculture. horticulture or floricultu a... \., TAX (Sec. 77.54.3j. I am authorized 10 execule thecertificale and claim thisexemplic -:::J.. 1 ~ 1. '" .... f;;,o '>-- :\ 0 I:: ~ ..J 3 ~ 0 SIGNATURE <J - .0 OJ ~ ~ ~ ~ ~ \~ \- ~ 0 "- <t c2 ~