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Claim by Tina CantuTHE CITY OF DUB E Masterpiece on the Mi~ issippi 1I < BARRY LINDA CITY ATTORN To: DATE: RE: Claimant MEMORANDUM Mayor`Roy D. Buol and Members of the City Council October 8, 2007 Claim against the City of Dubuque by Tina Cantu Date of Claim Date of Loss Nature of Claim Tina Cantu 10/02/07 09/19/07 Vehicle Damage This is a claim in which the claimant alleges that while her vehicle was parked in front of her residence of 2040 St. John Drive, a City employee driving a refuse truck struck and broke the driver's side mirror of her vehicle. According to Paul Schultz, Solid Waste Management Supervisor for the City of Dubuque, the truck driver of the referenced refuse truck reported the accident to the claimant immediately after it occurred, and also contacted his supervisor, Dave Sitzmann. The truck was malfunctioning, causing the rear of the truck to sway back and forth. Mr. Sitzmann investigated the accident, took photos and sent the truck in for repairs. It is therefore the recommendation of Paul Schultz to approve this claim for the amount of the submitted invoice of $195.33. The City Attorney's Office concurs with this recommendation. BAL:tIs cc: Michael C. Van Milligen, City Manager Jeanne Schneider, City Clerk Paul Schultz, Solid Waste Management Supervisor Tina Cantu OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 3O0 MAIN STREET DUBUQUE, IA 52001-6944 TELEPHONE (563) 583-4113 ! FAx (563) 583-1040 / EMAIL balesq@cityofdubuque.org THE CTTY OF DUB E MEMORANDUM Masterpiece on the Mississippi October 8, 2007 TO: Barry A. Lindahl, Esq., Corporation Council FROM: Paul F. Schultz, Solid Waste Management Supervisor SUBJECT: Claim of Tina L. Cantu The claim and estimate is recommended to be approved as filed for $195.33. Tina L. Cantu submitted a claim alleging that on September 19, 1970, our recycling truck damaged the mirror on her 2006 Jeep Liberty in front of 2040 St. John Drive. The recycling truck driver reported the accident to the claimant immediately after it occurred. His truck was malfunctioning, the truck rear end was "dog-tracking" badly, causing the damage to the mirror. Lead Sanitation Driver Dave Sitzmann investigated the accident, took photos and sent the truck in for repairs. ,+~ n f\ CLAIM AGAINST THE CITY OF DUBUQUE, IOWA YfWV; t}~-~ 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 W. 13t" St., Dubuque, IA 52001. It will then be referred by the City Council to the appropriate department for investigation. 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: ~ i ~'1 a-- L- ~ L ~-t- tl~} u 2. Address: a~ ~ ~ S`t` ~'c~1r`n l~~- i~U b~~~y~, ~ A r~ -dO~ a 3. Telephone Number: ~ "~ 5 ~ 3-__. ~ ~ a - 13 ~i `~ ~~)~ ~~ c~wo~~- 4. Date of Incident: _ _ __ ___ ,~~~ C~ r~c~cl!.~q 9 - I ~1- ~~ ~' f a' ~ c.~rY 5. Time of Incident: ~ ~ ~~ ~ ~ ~~-~~ 6. Location of Incident (Be specific): ~~ ~~ ~ \ S~ ~~~ ~~~re~~ - ~ ~'- ~u ~C'e51 c~e.~~ ~ ~~- ~.~Li~ St So~,n 'ter 7. DESCRIBE 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.) ~~ 8. What were weather conditions like? ~J~C~.` ~~ \ ~~_~ 9. Give name and address of any witnesses: Tr`n Cc~nn~l ltn , c~0~'J ~S~ ~p~, ~r 10. Did police investigate? (If so, give names of officers.) w~~-Ue ~~ ~°~~~ ~~~ 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). ~~ 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.) 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.) Igo 15. What amount do you claim from the City of Dubuque? ~~DD - DO 16. Why do you claim the City of Dubuque is responsible? -~ ke, c; -~ ~ ern~1 ouP P o-F -~hc..S_r,l ~ ~) ~,vasf~ r~e~ 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) ~~ 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? IV~O Dated at Dubuque, Iowa this~l'ic~~ day of ~~-~°~bel~-' 20~. ~~~'~~ (Signature) _---° 1 t v~1Gl, ~~ ~ (~~'1~ \„~ (Print Name) (Rev. 1 /00 & 7/01) C7 0 '' rn o~ ~ ~ c r 6 ~~ Ctd ' ~n '2 ! il CG 'C ~ ~'~ '" n cp . d ~ -r 13. What other damages do you claim, if any? i~f~lU'~ _ • ~: o ~~ . ~ - _ -_ _ - --- - ~~~ ~r~v~~,~ f rn ~~e~ 1.~ bed- ,-{~.r1~c1- 1-~_ a~_ _ _-~"' --~-- C~r_ZC~ ~~ ~:~ sfr~ e.~- _R bra k~ ~~_ __ --- _ -- --------- -----~+~=~~r~ ~ ~~? ~ L~?%~._i~~~~'~ _~-~- -fie (1 -~o ~f~~r~~r_?c1_ _ - - ~ _ -- _ __ _-_ - -_- ro -_~~ ~1 ~ ~ of ~ ~~~-k- --~h.~_ ~-c sf_~-- -___. - --- - - - -~ ~- ~ ~_!~-e-r~- ~ __a i s~-- ~ s~ r~-~ ~ ~ o ~ -~j~. ~ c~-~s~c~ _- ------- _ ------~'-- _~ ~h~ ' nor rr~r ~ -~s ~ ~ , I !mot e. Cc t _ - __- _ ---------.--. ~~-e_~ _ Cry - _-f-~ ~tl2e~ _~oa -~' -- - - - ---- ---_ - - -._- --~'~---- -~Y~C~? ~-rJv~ ~G~ ~. o ~ m fro u ~-- _-- __ __ _---- o - _ ----- -_ __ _ _ -------- --~~ rn-~-1~s?- hc~l___ _C~t I,e~___ ~..~j ---_ _ __ .- ~ ~~~; - - _-- --- - _ ---1~- ~ ~' - _ e ~-~1~- ~ c~-~~ rn ~r-n~~r--rte' ~ - __ _ ,, - - _ --- --- ~- S~ ~, - - ~ __- --1 ~- _ _~_~~ _ _ _ _ ~ C6,I~T'U, TINA 2046 ~T .iOH~I DR Dubuque, I.A 52001 Home: 5635811349 C1fTice: Ema>>: ~'~~ ~Fi=T ~U~~I~F ~i~lf~d~o~R ¢gy _~ Part No Unit Price Subtotal 1.00 121.00 121.00 Labor „~'~:~1-L LFFT ~t~7~Il7E 52.50 ! ~MIFdl2C~Ft ~+Jarksheet Suglslies Hazmat Tax Subtotal Part $ x.73.00 9.l;~$ 8.47 139.15 --s~nr ~~ 52.50 0.00 3.58 56.18 Grand Total 195.33 Tuesday, actober 02, 2007 1:32 53 P141 °age 1 j~~© 2005 MRIC, LLC and Snap-on Technologies, Inc. ~laote for 20U6 Jeep Liberty Sport -Mileage: 25,565 Mike Finnin Ford 3500 Dodge st Dubuque, la 52001 Phone: 563-556-1010 Email: service@finninautos.com