Claim by Richard_Linda CathmanTHE CTTY OF
DUB E
Masterpiece on the Mississippi
BARRY LIND
CITY ATTORI
To:
DATE:
RE:
Claimant
MEMORANDUM
Mayor Roy D. Buol and
Members of the City Council
July 25, 2007
Claim against the City of Dubuque by Richard & Linda Cathman
Date of Claim
Richard & Linda
Cathman
07/19/07
Date of Loss
07/18/07
Nature of Claim
Property Damage
This is a claim in which the claimants allege that due to a rainstorm that occurred on
July 18, 2007, a sewer backed up causing water damage in claimants' basement
located at 591 West Locust Street.
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
Richard & Linda Cathman
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 / EnnAIL balesq@cityofdubuque.org
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AGAINST THE CITY OF DUBU UE IOWA -y~ j ~
CLAIM Q ~ ~ 3 ~~
This written report constitutes your claim against the City of Dubuque, Iowa. You ~G
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.
1. Name of Claimant: /~l e /~I ~ /~ ~ ~" ~ /~'!/C~~1 ~i9 7?/`~/j'l ~ ~
2. Address: .S"9'/ W• ~ o Cu,S,T
3. Telephone Number~Slo 3 ~ •.5 ~8 '"/oZ 9 9
4. Date of Incident: Uu~.u /X , olO ~"
5. Time of Incident: _~/3D ~ m -' ~ : ~ ~ /~ ~
6. Location of Incident (Be specific):
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.) ~ ~ ~~ ,e
8. What were weather conditions like?
9. Give name and address of any witnesses:
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? (If so, describe property and the extent
of damages. Attach estimates of damages or describe basis for ascertaining
Pxtent of damaae_1
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
18. If the answer to Question 17 is yes, have you received any payment from that
source, and if so, in what amount?
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Dated this -1~ day of
(signature) I
(Print Name)
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13. What other damages do you claim, if any? _
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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