Claim by Lisa BowersTHE CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
BARRY LINDAHL I~
CITY ATTORNEY
To: Mayor Roy D. Buol and
Members of the City Council
DATE: July 13, 2007
RE
Claimant
Lisa Bowers
Claim against the City of Dubuque by Lisa Bowers
Date of Claim
Date of Loss
Nature of Claim
06/28/07
06/25/07 Property Damage
This is a claim in which the claimant alleges damage to her swimsuit resulting from
uncured paint at Flora Pool.
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
Gil Spence, Leisure Services Manager
Lisa Bowers
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
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This written report constitutes your daim against the City of Dubuque, Iowa. You should complete this form in
full and attach any additional information that supports your claim.
The daim must be filed with the City Clerk at City Hall, 50 West 13~' 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 Coundl. No employee of the City of Dubuque has the
authority to make any re jpreisenta/t~ion to you as to wh~et(he~r your daim will or will not be paid.
1. Name of ClCaimant: H~ A ~ (~ ~ ~- -~~'~ ~(~
2. Address: 1~~ `J ~ ~~"~'E ~-2~~ K`t
6. Location of Inddent (Be specific): ~ l ~'~'~~ `~\~i;1( V`,~ IY \ "~ Its L ~1 ~
3. Telephone Number: _~;Ze , ~ ~~~~ ~ ~~~
4. Date of Incident: ~ ~ ~~' ~~
5. Time of Inddent: ~ (~~ ~ ~1~~~~„~T -, r, ,r-7-,. r-~1 n,~~ ~(~Q~
7. tribe the acct nt or oncelhat catJSt3d mt~lry' old mage. (~iSe fu~ e i s upon whi you b~se
your daim. If a City employee was involved, give the employee's name.) I~G~S ~~ `~ 6th
~ S ~t ~~
8. at wer wea er co ditions I e? r l
9. Give name and address of any witnesses: \`` 1 t~ G l ~~G'~ ~C ~ ~~
10. Did police investigate? (If so, give names of officers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries.)
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12. Was any damage done to property? (ff so, describe property and the extent of damages. Attach estimates
of damages or describe basis for ascertaining extent of damage.)
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13. What other damages do you claim, if any?
14. Have you been compensated for any part or all of your daim by any insurance company? (If so, give
name and address of insurance company and amount paid.)
~~
http://www.cityofdubuque.org/printer_friendly.cfm?pageid=155 6/26/2007
15. What amount do you claim from the City of Dubuque? ~ 5 ~ . ~--~ -1
_(~1`Ig`~ C~P~ # I~~~y C(dc~cm~.~ i2`~~ ~~utn~s~ + -~a:x> o~`s
16. Why do you daim the City of Dubuque is responsible? \ ~~ ~ e. ~~ (~ I~CJI i`~~
_~~~:~ b~~y1 ~~~ i1~.-~1~-~-- 111 ~ ~ ~~,~,~~ 1 C
lT. ~P r~ ~,L^,\-~1C~ t/L~- ~ Cat Ills' .
15 ~?~"~bQ~ ~ic;~{oM
~~n~ r,g 5~~t1.c(~tl~Cc~,
ti,ri1~s ~c~'u~t ~/ a~ircc~laSo l¢ .
17. Have you made any claim against anyone else for damages as a result of this inddent? (If yes, give name
and address.)
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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 day of , 20
{Signature) ,
Lt~ ~~~
(Print Name)
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http://www.cityofdubuque.org/printer_friendly.cfin?pageid=155 6/26/2007
TARGET'
pUBUQUE MALL - 563-557-9800
06/13/2007 10 99 RM
RECEIPT EXPIRES UN 09/11/07
III IIIINI l i llllnl l l Iii 11111 NII IN
H receipt dated within 90 days is
required far RLL returns & ex~hanyes.
Giving a gift? Include a gift rer.eipt! !
239250559 WATER BALLS T 1.00
030000898 BRIM HRT T 5.99
077100069 TG BrACHSOCK T 9.99
234230554 PUFFY BHLL T 1.00
238021730 ME CODER T 17.99
238012650 MDSSIMD SWIM T 19.99jF
238011913 MOS5IMO SWIM 1 9.48
238012659 MOS5IMO SWIM T 17.99
007090038 HUGGIES T 8.99
536000160760 MFR COUPON 1.00-
086050111 DISNEYTERPOT T 13.99
007070015 HUGGIES T 7.77 `
536000700829 MFR COUPON 2,00-
007090693 HUGGIES T 19.99
536000110789 MFR CDUPUN 1.50-
SUBTOTAL 119.b7
T = IR THX 7,0000% on 1TOTRL 128.36
X8765 (FIHNKS! THRGFT UISR 128.36
Rki:EIPT ID# 2-169-0086*00~685817 1
UCO# 752--257-033 TM#
T1,rtTf'A?Eri SALE °RICE
Save RLl RecerNi~ I
Give u;ft Rer_eipt5 :~ Giftt:ard~~ ~
Hsk shout Receip LnokuP
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