Claim Lopez, Andrew T.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 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. Name of Claimant: Andrew T. Lopez
2. Address: 1310 4th St. SW Dyersville, IA 52040
3. Telephone Number: 563 875 6165
4. Date of Incident: 9/11/05
5. Time of Incident: 8:15 P.M.
6. Location of Incident (Be specific): In front of Mary Frances REsidence Hall - Dubuque, City Street
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 employee’s name.)
Curb in front of Res. Hall - See Photo was "cut" to facilitate Storm Sewer Repair (See Photo)
The Curb was not repaired properly - sharp edge of curb punctured tire.
8. What were weather conditions like? Summer, not a factor.
9. Give name and address of any witnesses: Clarke Security stopped as I was talking to ___ truck driver.
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.)
Yes, See Attached $183.77 - Towing paid by my Triple AAA (Tire Repair)
13. What other damages do you claim, if any?
See Letter
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, Clarke ____ has broken _____ off curb.
15. What amount do you claim from the City of Dubuque?
$183.77
16. Why do you claim the City of Dubuque is responsible?
Curb not repaired adequately - broke piece of curb that worked loose, punchtred my tire.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) No
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 25 day of November, 2005. , 20 .
/s/ Andrew D.Lopez
(Signature)
(Print Name)
(Rev. 1/00 & 7/01)
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.... CLAIM AGAINST THE CITY OF DUBUQUE,.IOWA _2;!:P:t" 'U";
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. r
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.
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3. Telephone Number:
4. Date of Incident:
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6. Location of Inc~drnt $Be specific): /IV /) <;- IrlJ
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7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your cla.im. If a City empl?lee was involved, give the
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8. What were weather conditions like?
10. Did police investigate? (If so, give names of officers.) N ()
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.)
13. What other damages do you claim, if any? s: / ~
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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?--it
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16. Why do youclaim the City of Dubuqu,:~ res,~onsible?
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17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.) Iv D
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
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(Print Name)
(Rev. 1/00 & 7/01)
. ~ ' September 20, 2005
City of Dubuque
City Clerk Department
1300 Main Street
Dubuque, IA 52001
RE: Defective storm sewer repair
Date of accident: 9-11-05
Attn: City Clerk
On Sunday evening, September 11, 2005, I experienced property damage to my
2002 Chevrolet Tahoe. Enclosed with this letter is an invoice in the amount of
$183.77, reflecting the cost of a new tire.
On that evening, as I was attempting to park my vehicle in front of Mary Frances
residence hall, Clarke College, a piece of defective curbing that obviously had
been "cut" to facilitate storm sewer replacement, punctured the sidewall of my
new tire. Because I have AAA, I simply contacted McCann's Towing to change
my flat tire, as this happened at night time. The security department at Clarke
College was notified of this incident that same evening.
On Monday, September 12th, I followed-up with Bob Nelson of the Maintenance
Department at Clarke College. The broken piece of curb that punctured my tire
was removed and is currently in the possession of the maintenance department
at Clarke College.
I was advised that the City of Dubuque was responsible for the curb in question,
as a storm sewer was recently installed in front of this residence hall. It was
obvious after I realized what had happened to my tire that whoever "cut" the curb
to allow for the storm sewer installation did not properly repair / replace the curb.
The "repaired curb" eventually broke loose and fell into the street, where on a
dark Sunday night, the broken curb got wedged between the existing curb and
my tire, which resulted in a punctured tire.
On teday's date, I spoke with Deron Muehring of your engineering department
and he suggested that I follow-up with your department regarding this incident.
In summary, I feel that if the City of DUbuque had properly repaired and/or
replaced the curb in question, this incident would not have occurred. I do not feel
that I should incur the expense of a new tire, as this incident was not caused by
actions that I had control of. Thank you for your consideration.
Sincerely,
Andrew T. Lopez
1310 4th Street SW
Dyersville, IA 52040
(563) 875-6165
III a . *
CHAPMAN AUTO Et: TIRE
117 11TH ST. S.E.
DYERSVILLE, IA 52040-1904
81
I 9120/2005 I I
Invoice
Invoic.' I
111853 I
I BII/To
LOPEZ ANDY
1.3104THSTS.W.
DYERSVILLE. IA 52040
~tr3 ql1-31~
P.O. No. Term. Due D.,. Rop
NET DUE FOLLIN... 10/1 0/2005 JGC
"om Qty Ducr/pllon Rote Amount
L 1'2657016 I 265/70R 16 Fireston Wilderness LE P. WL 123.88 123.881'
WHEEL BALAN... 4 COMPUTER SPIN BALANCE 6.50 26.ilOT
UNLUG. LUG 4 SWITCH 2.00 8.00T
VALVE STEM 2 RUBBER VALVE STEM 2.00 4JJOT
DISPOSAL I DISPOSAL OF OLD TIRES 2.00 2.00
MOUNT DISMO... I DISMOUNT & MOUNTSPAIR TIRE PUT AWAY 8.00 8.:IOT
MILAGE 41.857
IF YOUR FUEL FILTER HAS NOT BEEN REPLACE IN THE LAST 25.000 MILES Subtotal
YOU. SHOULD IlEPLACE WITH NEW. $171.88
r Sales Tax (7.0%)
I Total
$11.89
$183.77
.
Oty Clerk's Office
50 West 13th Street
Dubuque, Iowa 52001-4864
(563) 589-4120 Office
(563) 589-0890 Pax
(563) 690-6678 TDD
www.cityofdubuque.org
THE CITY OF L...~
.1-).. ....----.--;--~
. UBUQUE
~~~
September 21, 2005
Andrew Lopez
13104th Street SW
Dyersville IA 52040
RE: Claim Against the City of Dubuque
Dear Mr. Lopez:
If you wish to file a claim against the City of Dubuque regarding an incident that occurred
on September 12, 2005, I would request that you fill out the enclosed claim form and mail
it to the City Clerk's Office at the following address:
Ms. Jeanne Schneider, City Clerk
City Hall - City Clerk's Office
50 West 13th Street
Dubuque, IA 52001
Once the City Clerk has stamped the claim in, it will be forwarded to the Legal
Department for investigation. Enclosed is an addressed envelope for your convenience.
Very sincerely,
([,4:r~64:rc~;))
~;:nne F. Schneider
City Clerk
Enclosure
cc: Tracey Stecklein, Legal Secretary
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