Claim by Krystie LorenzTHE CITY OF
DUB E
Masterpiece on the Misszrssippi
BARRY LINDA
CITY ATTORN Y
To:
DATE:
RE:
Claimant
MEMORANDUM
Mayor toy D. Buol and
Members of the City Council
August 1, 2007
Claim against the City of Dubuque by Krystie Lorenz
Date of Claim
Krystie Lorenz
07/30/07
Date of Loss
07/30/07
Nature of Claim
Property Damage
This is a claim in which the claimant alleges damage to her swimsuit resulting from
uncured paint at Flora Pool.
According to Gil Spence, Leisure Services Manager for the City of Dubuque, this claim
pertains to the City of Dubuque Flora Pool Painting Project. Fred Jackson Tuckpointing
was retained by the City of Dubuque Leisure Services Department to provide painting
services for the Flora Pool Painting Project. The contract required the standard form of
contracts and bonds to be filed with the City, which requires Fred Jackson Tuckpointing
to hold the City harmless from any claims of damage resulting from the work.
It is therefore the recommendation of Gil Spence to forward this claim to Tricor
Insurance and Financial Services, insurer for Fred Jackson Tuckpointing, for its
consideration. The City Attorney's Office concurs with this recommendation.
BAL:tIs
cc: Michael C. Van Milligen, City Manager
Jeanne Schneider, City Clerk
Gil Spence, Leisure Services Manager
Krystie Lorenz
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 r•~aim will nr will not hP naid_
Name of
2. Address:
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3. Telephone Number ~ ~~=~G ~J ~ ~~~1~/
4. Date of Incident:
5. Time of Incident:
6. Location of.lncident (Be specific):
8. What were weather conditions like?
9. Give name and address,gf any witnesses:
10. Did police investigate? (If so, give names of officers.)
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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
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
extent of damage.) ~~ t ~,~ ~ ^ ~~
13. What other damages do you claim, if any?
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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.)
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15. What amount do you clam from the City of Dubuque?
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16. Why do you claim the City of Dubuque responsible?
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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. 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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