Loading...
Claim by Rosalie MorganDUB MEMORANDUM Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL To: Mayor Roy D. Buol and Members of the City Council DATE: February 6, 2013 RE: Claim Against the City of Dubuque by Rosalie Morgan Claimant Date of Claim Date of Loss Nature of Claim Rosalie Morgan 02/04/13 01/22/13 Vehicle Damage This is a claim in which claimant alleges that while she was parallel parking near the intersection of 13th & Main Streets, her right rear tire was slashed by a sharp piece of metal protruding from the curb. 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 Gus Psihoyos, City Engineer Rosalie Morgan 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, 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: Address: f S� 3. Telephone Number: 4. Date of Incident: 5. Time of Incident: 6. Location of Incident (Be specific): VAA I a Z' 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.) . What were weather conditions like? 9. Give name and address of any witnesses: 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). /4.1 02/04/2013 12:00 16087942194 SCHLIRMANS WI CHEESE PAGE 01/01 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, f tfv'r~ 12- i44• t-1 r Ac o 71 I s gt t r A.)02 1) AA Or 13E / , * SEE 14..71446-(eo 1112 n 13. What other damages do you claim, if any? Ji 0 N 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.) U 16. What amount do you claim from the City of Dubuque? l..r + 9t+ ik/at Why do you claim the City of Dubuque is responsible? A- (1.2E- U v N w- iA L v-) H 1 L e P4461 t`i l O 61/41 it? ' l CJ-4. 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) N 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 it day v } (Signature) (Print Name) , 20 13. Rost - 04' (Rev, 7112) n Rosalie E Morgan 1255 Sunset Drive Platteville, WI 53818 January 28, 2013 City Clerk Dubuque City Hall 50 W. 13th Street Dubuque IA 52001 To Whom It May Concern: I am writing this letter to formally submit this claim for damages that my car sustained as a result of parking on 13th street on January 22, 2013. I was so upset because of the flat tire I forgot to put extra money in the parking meter and the time expired and subsequently received a parking ticket. I am enclosing a copy of the parking ticket as it confirms the date and time for this claim as well. I have enclosed pictures of the damage to the tire and the curb with the exposed sharp metal pipe that slashed my right rear tire. I have also enclosed a copy of the estimate to replace my tire. The cost of the tire is all I am looking to be reimbursed for. I had my husband leave work and drive from Beetown Wisconsin to Dubuque a distance of approximately 34 miles to put my spare tire on for me. Please review this claim and reimburse me as soon as you are able. You can call me if you have questions or need additional information. Thank you for your help in this matter. Sincerely, Rosalie Morgan 608/348 -6102 home 608/778 -6902 cell