Claim by Nicholas ViertelBARRY A. LINDAHL, ESQ. ~~
CITY ATTORNEY
MEMO
To:
DATE:
RE:
Claimant
Mayor Roy D. Buol and
Members of the City Council
February 22, 2007
Claim against the City of Dubuque by Steven Nicholas Viertel
Date of Claim
Steven Viertel
02/20/07
Date of Loss
02/20/07
Nature of Claim
Vehicle Damage
This is a claim in which the claimant alleges that as he turned right onto Asbury Road
from Clarke Drive, he ran over a pothole in the road, damaging his vehicle.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
BAL:tIs
cc: Michael C. Van Milligen, City Manager
Jeanne Schneider, City Clerk
John Klostermann, Street & Sewer Maintenance Supervisor
Steven Viertel
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 balesq@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 West 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.
Name of Claimant: Steven Nicholas Viertel
8. What were weatl~,er conditions 'ke?Clear/Sunny
2. Address: 170 West 24th
3. Telephone Number (563) 583-8214
4. Date of Incident: 2/20/07
5. Time of Incident: 2:00 PM
6. Location of Incident (Be specific Clarke Dr. / Asbury Rd.
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.)
Driving on Clarke Dr. Came to stop sign at end turned right on to Asbury Rd.
I heard a clunk sound then pulled over to check damage. Then called City Hall.
9. Give name and address of any witnesses:
None
10. Did police investigate? (If so, give names of officers.)
None
11. Was anyo~i~ured? (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.)
13. What other darrtages 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. What amount do you claim from the City of Dubuque? ~' , ,
16. Why do you claim the City of Dubuque is ,responsible?
17. Have you made any claim against anyone else for damages as a result of
this incident? If yes, give name and address.}
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 20th Day of February 2007
(Signature)
4
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(Print Name)