Claim by Lisa Bowers
THE CITY OF
DUB E
Masterpiece on the Mississippi
MEMORANDUM
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 Lisa Bowers
Claimant Date of Claim Date of Loss Nature of Claim
Lisa Bowers 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
This written report constitutes your Gaim 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 deasion on all claims is made by the City Council. 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 claim will or will not be paid.
1. Name of Claimant: 1-~~ A , c~ C~ ~ ~-- t~~
2. Address:
Telephon
4. Date of Incident: ~ ~ ~~' ~n~^
5. Time of Incdent: ~ ~ ~ ~ r 1 , ~ ~ ~ „ ~~...-,1 r~ r~ r .,
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your claim. If a City employee was involved, give the employee's name.)
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base
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10. Did police investigate? (If so, give names of officers.)
~y
11. Was anyone injured? (If so, give names, addresses, and extent of injuries.)
Y\ ~
12. Was any damage done to properly? (If 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 Gaim 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
6. Location of Incident (Be specific): ~L'4~'~~ ~~~ Y u'„~ 1 Y \ 'TY 1(~ ~.C i ~
~,. ~ 15. What amount do you claim from the Ciiy of Dubuque? ~ 5 ~ . S-1
(~1~~a C-~P~ #~~~`~Cc~~tcm~_~i2`~~ ii~uv~ks~ +-~x> o~`
16. Why do you claim the City of Dubuque is responsible? ~~~ ~ Q ~~ j~~,~
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~ ~? f ' ~bQ °L bc~ c~ rvt
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vy-tit~S d'~c~:~{pfi cl/a~acla~t¢
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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?
Dated this day of
(Signature) ,
~c~~ ~~e~
(Print Name)
20
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http://www.cityofdubuque.org/printer_friendly.cfm?pageid=155 6/26/2007
1. •:
~TA~GEY'
DUBUQUE MRLL -.563-557-9800
06/13!2007 1099 RM
RECEIPT EXPIRES UN 09/11/07
IIIIIIIhINIIIIhiIII IIIIIIU IIIIIN
A receipt dated within 90 days is
re9uired far ALL returns & exchanges.
Giving a 9ifi? Include a gift receipt!
239230559 WRTER BALLS T 1.00
030000898 $RIM HRT T 5.99
077100069 TG BERCH5DCK T .4.99
234`130559 PUFFY $HLL T 1.00
238021730 ME CODER T 17.99 ~'
238012650 M055IM0 5WIM T 19.99 ~
238011913 MOS5IM0 SWIM T 9.48
238012659 MOS5IM0 SWTM T 17.99
007090038 HUGGIE5 T 8.99
536000160760 MFR COUPON 1.00-
086050111 DISNEYTEAPOT T 13.99
007070015 HUGGIES T 7.77
536000700829 MFR COUPON 2.00-
007090693 HUGGIES T 19.99
536000110789 MFR COUPON 1.50-
SUBTOTRL 119.6?
T IR THX '1.00001 an 1TOTRL 128.36
*8765 fflRNl(5! THRGET UISR 128.36
RkCEIPT TD# 2-7169-OOil6*+Oc~~685817 1
UCD# 752-257-033 TM#
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