Claim by Roger RichardMasterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
MEMORANDUM
To: Mayor Roy D. Buol and
Members of the City Council
DATE: December 12, 2012
RE:
Claimant
Roger Richard
Claim Against the City of Dubuque by Roger Richard
Date of Claim
12/11/12
Date of Loss
12/02/10
This is a claim in which claimant alleges that a City Housing
contractor to dispose of property which was in claimant's yard.
This claim has been referred to Public Entity Risk Services of Iowa,
Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
Alvin Nash, Housing & Community Development Director
Roger Richard
Nature of Claim
Loss of Property
Inspector ordered a
the agent for the Iowa
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, 501Nest 13th St.,
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:
2. Address: /ref
3. Telephone Number
4. Date of Incident: °" f
5. Time of Incident:
6. Location of Incident (Be ssp cific):
7. Describe the accident or occurrence that caused injury Pr , damage. (Give full
details upon which you base your claim. If a City employee was involved, give
the e ployee's name.)
8. What wpre weather conditions like?
9. Give name and address of any witnesses:
r
10. Did police investigate? (If so, give names of pfficers.)
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11. Was anyone injured? (If so, give.names, addresses, and extent of injuries).
•
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.)
ther damages,do you claim, if any?
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. ill hat amount do you claim from the City of Dubuque?
16. Why do you claim the City of Dubu ue is respo sible?
17. Have you made any claim against anyone else for damages as a result of
this incident? (if yes, give name and address.)
A, /€I
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 I f day of
(Signatu
(Print Name)
,20 t1
January 24, 2012
Hi Mr. Nash! Here is a bill for trespassing and theft concerning my
1513 Washington street property on 12 -2 -10.
1 aluminum storm door 134.00
1 Yardman lawnmower 300.00
1 32 foot wood extension ladder 75.00
1 two person swing and A -frame 50.00
1 air conditioner 300.00
20 wolmanized 32 inch stair treads 63.38
1 10' downspout and gutter 16.50
2 storm combination windows 20.00
1 plastic four milk jug container 6.00
2 exterior electrical lamps 50,00
2 three- quarter sheets %2 inch plywood 23.94
1 rose bush 10.00
73.42
total $1122.24
tax