Claim by John TschiggfrieTHE CTTY OF
DUB E
Masterpiece on the
BARRY LiNo
CITY ATTOR
MEMORANDUM
To: Mayor Roy D. Buol and
Members of the City Council
DATE: December 12, 2007
RE: Claim Against the City of Dubuque by John Tschiggfrie
Claimant Date of Claim Date of Loss Nature of Claim
John Tschiggfrie 12/03/07 11/09/07 Property Damage
This is a claim in which the claimant alleges that a City of Dubuque refuse truck struck
and damaged claimant's mailbox and post.
According to the report of Paul Schultz, Solid Waste Management Supervisor, the
sanitation driver operating the truck and causing the damage reported the accident to
the Solid Waste Management Supervisor immediately after it occurred. Lead Sanitation
Driver Dave Sitzmann investigated the accident, took photos and determined that the
damage was caused by the sanitation driver.
It is therefore the recommendation of Paul Schultz to approve this claim for the amount
of the submitted invoice of $77.37. 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
John Tschiggfrie
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
THE CTTY OF Dubuque
DUB E
1 1
Masterpiece on the Mississippi
s
2007
TO: Barry Lindahl, Esq., Corporation Council
FROM: Paul F. Schultz, Solid Waste Management Supervisor ~``
:;
SUBJECT: Claim of John Tschiggfrie
r
DATE: December 11, 2007
The claim and estimate is recommended to be approved as filed for $77.37.
John R Tschiggfrie submitted a claim alleging that on October 9, 2007,. our refuse
truck #3401 backed into and destroyed the mailbox and supporting post in front of 421
Banak Court. The location of the mailbox was in a tight cul-de-sac.
The Sanitation Driver operating the truck and causing the damage reported the
accident to the Solid Waste Management Supervisor immediately after it occurred. Lead
Sanitation Driver Dave Sitzmann investigated the accident, took photos and left information
at the claimant's residence on how to file a claim.
7_
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA' ~ l/ G~
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. 13th 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 wilt 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: -~ ~ !'1 ~'y ~. ~ ~ ~ ~~ J ~ J Fr ~~
2. Address: "~- ~ ~ ~ A ~/ ~ I~ ~~ u ~r
r 3- ~ S6
3. Telephone Number: ~ 6 ~ ~ ~~
4. Date of Incident: ~ j_ ~ ~~' ~ ,~
5. Time of Incident: 1 J ~ 3 ~ ~~ , ~'~ f
6. Location of Incident (Be specific): ~= IZ a N ~ J ~' ~{~ ~ ~ ~ ltl,~ /C C o'~ V~ T
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.) ~ ~ ,~ o ~
CITY G1~213~/~' Ty2kCjs p2r~rN Qy Q~ G~c r~j~Tno S ~k~9' T1,1~ ~c'kx2 F.~,-
~~ 'Tllr 7RU,cK /~ ~,~ ~-~~~d~~: ~ 1tiY M~ir~ i~ vX f ti~ ~~~ ~ !~~"fil:v'y ~ti~ T ~iN
8. What were weather conditions like? ~ r `'
9. Give name and address of any witnesses: N ~ ~ ~
10. Did police investigate? (If so, give names of officers.)
/V U
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
IV
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.)
~'1~1L ~~X ~ti~ ~u„f'T' ~ff~atG'zY
13. What other damages do you claim, if any? ~V aN~
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.)
~'~
15. What amount do you claim from the City of Dubuque?
~~~.3~
16. Why do you claim the Ci~ of Dubuque is responsible?
~ T7 c A+E'uASr 'Frtuc~ ~~ TNk ~~ r~r;~ ~o nY MI~~z Is~x ~ ^,~ ~arT
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.)
/V U
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount?
Dated at Dubuque, Iowa this a ~ day of ,~/ ~° y~~ atC? 20 0 ~ .
f ~"~.~~ir~~
(Signature)
~'~v l~!y ~, ~f c ~ 15 5 F n I~ (Print Name)
(Rev. 1 /00 & 7/01)
VI ';~n~nur~Q
a~r~~ v ~,~r~~ ~I+~
~ 0 ~~ bid ~- 030 LO
U.~itl:~~~cl
_ _ ___
;, ~,~~t
VEHICLE ACCIDENT INFORMATION ,>>~~~~ ~,
DATE: ~ ~' ~ TIME: I L • ~ ~ f AM~PM
When exchanging information for vehicle accidents under $1,000 and the Police
Department is not called, the following information is needed to complete Vehicle
Accident Reports.
City Vehicle Description:
Vehicle # ~ ~ ~ ~ ~ Name of Driver ~') ~ ~*-~ ~ ~' ~~~ r C.i
Description of the Accident ~ ~~~r ~; ~ ~ S G~c: c k. ~ ~n.~ ~~ r u ~ ~ ~t c
..1 U ~~ C ~ lCl l t~ ~ \ ~' : L'l ] ~ ` ~r L1 ~ ~~i t~ C i` ~ . ~ l o`~(r .~-..
~ - ~ _ C ~,
Estimate of Damage $ ~~ ~ ~ ~ ~'
Other Vehicle Description:
Year Make
VIN #
Name ~ Address of Driver
Model
License Plate
Name & Address of Owner
Driver License Number
Insurance Carrier
Is the Vehicle Drivable
Description of Damage to Vehicle
Estimate of Damage $ (over)
**If this accident or damage IS NOT investigated by the Police Department**
The City vehicle driver's Supervisor or Manager MUST complete this page
North
Use arrow to
Indicate direction
ACCIDENT DIAGRAM
**Position vehicles or objects in the diagram at the point of collision
I /
4Ws
Y T -Intersection V S Lt / No Intersection
t~S VeLicle
Intersection Y - Intersection
/ Symlwl
~ City Vehicle labeled #1
tither Vehicle labeled #2
Contributing f7~eckApplicaLtcBares
CireumstanCes Briefly Describe Circumstance (s)
Yes No
Road Surface Conditions
Road Defect
Weather Conditions
Driver's vision Obscured
Fixed Ob'ect Struck
Pedestrian Involved
ACCIDENT /DAMAGE PHOTOS ATTACHED: YES _ NO _ (If not, reason: )
NOTL: ALL ACCIDENTS AND DAMAGE MUST BE Pr1GTOGRAPffED
NARRATIVE:
Completed By: Job 'Title:
VVV vv ^ . ~-~ --
MA Kx 1'~M pu1Zl~2~ RkPA~r~s ro /~zc~t~~
ran r ~. A ~~~ ~ ~, o ~~~~R>;~
MA 1L ~,ox ~,,iiH 1~1ou~~~N9 pvs~', ~ ~. 9~
CU M j~1FT~ K 11 ~.h-' ~~~ ~L U w~'S)
RzM.i,4,~ ~ N~ ~I sP~~.~ o~p ('ulr ANO r~~~ .
4t 3 Nkw Nv,r;~ , /~ISFM811" Atio In~si~'r~
N~ w M >11 L /3~X K ti.
N(,IMQt~s FAR /Ltf71L ~J1! ~. ~ ~
~o?RL `?7.3?