Claim by Joan OverhouseTHE CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
BARRY LINDAHL
CITY ATTORNEY
To: Mayor Roy D. Buol and
Members of the City Council
DATE: July 13, 2007
RE: Claim against the City of Dubuque by Joan M. Overhouse
Claimant Date of Claim Date of Loss Nature of Claim
Joan M. Overhouse 07/05/07 07/05/07 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
Joan M. Overhouse
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 3OO MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 583-4113 / FAx (563) 583-1040 / EMAIL balesq@cityofdubuque.org
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'~ * ~~ a. You shoo ete this form in
ld comet
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~` a ainst the City
stitutes your claim 9 orts your claim.
rt con .. tion that supp ue IA 52p01. 4t will then tie
This written repo ad~t+onat informa ~, ~., putwq s Once. Cnce that
full and attach anY Hatl, 50 West 13 AttomeY
Clerk at City to the City ~ to the GdY Counat. You will be
filed with the City anon ~ wiN be subm+tt
The claim must be artrnent for +n msrnendation
opriate clap
referrer to the aPPr a report and re ~mgndation. +,1e has the
is co+rPteted, ee of the City of Dubuq
~~ ~~ a copy of that mport and reco
a+d.
- ion on aN datms is made by the City Councit• No em oY-
eqs lion to you as to whether Your da+m w+tl or w+ll not be p
The final i an fepresenta ~ v e `
to make Y
authority ~_, ri N ~n .~ ~ i J _._-
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1, Name of Claimant: _ ~
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2. Address:. ~ ~_ ~ '-" _ -= - C
5. T+me of lnctdent: ~ _ ------'-'""-
6. location of Incident (Be speafic)~ 1
which you base
rr¢nce that caused injury ~' damage. (Give full details upon
ant er eECU +ve the employee s name.)
?: p~ribe the a~mptoY~ was involved, g .) ._
your da+m. If a City ' i ~ J ~ _ ' /
g. What were weather conditions like? r
~~
9. Give name and address of any witnesses: , ~
1p, Did police investigate? (If so, give names of officers.)
11. Was anyone injured? (If so, give names, addresses, and extent of injuries.)
12. Was any damage done to property? (tf so, describe property
of damages or describe basis for ascertairnng extent of damage.;
and the extent of damages. Attach estimates
13. What other damages do you claim, if any?
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1~_ Have you been compensated for any part or aft of your claim by any insurance company? (lf so, give
name and address of insurance company and amount paid.)
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15. Wha# amoun# do you claim from the City of Dubuque? ~ ~~ .
t6. Why do you Gaim the City of pubuque is responsible?
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Page 2 0 ~ 2
17. Have you made any claim against anyone else for damages as a result of this incident? (if yes, give name
and address.)
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18. ff 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~
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~~/1 ~'v'el° ~OvS-c~
(Print Name)
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