Claim by Luke Potnick THE CITY OF
DUBUQUE MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: January 7, 2016
RE: Claim Against the City of Dubuque by Luke Potnick
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Claimant Date of Claim Date of Loss Nature of Claim
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Luke Potnick 01/06/16 01/05/16 Vehicle Damage
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This is a claim in which claimant alleges that a City of Dubuque Jule bus sideswiped
claimant's vehicle which was parked at 1195 Vernon Street.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
Candace Eudaley, Transit Manager
Luke Potnick
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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 tsteckle@cityofdubuque.org
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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 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.
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1. Name of Claimant: L�-t V,e- A ®th 1(,)-,4)
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2. Address: 12 f +Ck- 0` 5 11 IA Q )
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3. Telephone Number: �
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4. Date of Incident: 5
5. Time of Incident: 'M
6. Location of Incident Be specific): t ` _`5 *VV on V�
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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.) (30cli J 0614 OYN Wou�- on S(,tM) -�q Ci+,�uT -1Xn1bu"v-t-vJb4cAr-
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8. What were weather conditions like? CA 0.yA C 1'0 Lc>w 3 os' �V11
l9. Give name and address of any witnesses: �10. flY1'Yl d�krva ( ��,,deyl✓'��
10. Did police investigate? (If so, give names of officers.)
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.)
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13. What other damages do you claim, if any? N 0
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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 claim from the City of Dubuque? O O CI9
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16. Wh do you claim the City of Dubuq a is respo sible?
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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.)
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 tulk& day of 20 .
(Signature)
L Bpi ® I C�� (Print Name)
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(Rev. 7112) !�
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Name: Luke August Potnick {
Address: 1751 Alta Vista St. Dubuque IA, 52001
Phone Number: (847) 764-9695
Email: Luke.r)otnick@loras.edu
License: (Illinois) No.: P352-5219-4338 DOB: 11-28-94 Expires: 2-28-16 Issued: 10-23-13
I wanted to add a detailed page about the incident to further clarify any questions.
On January 5th, 2016 1 (Luke Potnick),was walking back from class at Loras College. I had
received a phone call at approximately 12:36 pm from Lizzy McWhinney, a renter of the location of the
incident (1195 Vernon St),telling me that my parked car had been hit by the Jule bus of the city of j
Dubuque, IA. She further explained that my car had been side swiped by the bus.The driver of the bus
(Rita Ann Parking),the officer(Karen Smith) and a worker for the city of Dubuque (Jodi Johnson)were
awaiting my arrival. When I had arrived on scene there were visible scratches, paint chips, scuff marks as
well as a minor dent on the back left rear of the vehicle where it had been struck.The driver of the bus
(Rita Ann Parkin), admitted to fault and received a ticket from Karen Smith,the officer who was on i
scene.Jodi Johnson (Transit Operations Supervisor, Phone: 563-589-4198), a worker from the city of
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Dubuque, walked me through process of filing a claim through Dubuque.org. She explained I have to
obtain two estimates from auto body repair shops and/or dealerships to send in to the city to be
compensated for the damages to my vehicle. After leaving the incident, I went to Brimeyer Auto Body
(10709 Collision Dr, Dubuque IA 52001),to receive an estimate at approximately 1:31 pm. Brimeyer's !ll
estimate for the damage totaled out to be approximately$1,009.97.After leaving Brimeyer I then drove
to Richardson's Motors(1475 J.F.K Rd, Dubuque IA, 52002), and received another estimate totaling
$1,108.95 at approximately 2:41pm. Both copies of each estimate are attached to the rest of the
documentation provided.
Everyone who I dealt with on scene was very nice and helpful.The driver admitted to complete
fault and was very apologetic.They all answered the questions I had, and gave me clear direction as to
what my next steps had to be. I currently am a student at Loras College and rent out a house in Dubuque
(1751 Alta Vista St, Dubuque IA, 52001.). Even though I reside in Arlington Heights IL, due to my
schooling,the vehicle must be repaired in Dubuque. Furthermore, I would greatly appreciate all contact I
including phone calls or letters sent to my Dubuque address, so I can get my vehicle repaired as quickly
as possible, NOT the (3014 N Dryden Place AH, IL 60004) address that it says on my license, where I live
with my mother Kim Erickson. Contacting me directly will be a lot easier for my family and I can take
care of the car being fixed myself. Attached to the claim documents is the driver information exchange
report, both invoices for the estimates on the total damage, and lastly this detailed letter explaining
what all had occurred.All of my contact information is available at the top of this page. For any
questions or concerns anyone may have, feel free to call or email me at any time.
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Luke Potnick
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Confidential
This communication and any attachments may contain information which is confidential
and privileged by law and is for the use of the designated recipient. If you are not the
intended recipient, you are hereby notified that you have received this communication in
error, and that any review, disclosure, dissemination, distribution or copying of its contents
is prohibited. Please notify City of Dubuque immediately by telephone at (563)-589-4120 of y
your receipt of these items and destroy the communication and any attachments i
immediately. Further disclosure of this information may violate state and federal a
restrictions.
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Confidential information may include the following:
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1) Social Security Number(s)
2) Medical/Health Information 3
3) Personnel/Disciplinary Information
4) Bank Account Information
5) Financial Information t
6) Credit Card Numbers-
If any documentation you desire to submit to the City of Dubuque contains any of the items above,
this cover sheet must be attached directly to the confidential information. Please indicate below the
type of inform atio that is included.
hereby certify that the attached documents h
include the following protected information: a
Social Security Number(s) Bank Account Information
Medical/Health Information Financial Information
Personnel/Disciplinary Information Credit Card Number(s)
understand that this information may be distributed within the City organization or to agents of the
City for processing and I hereby authorize the City to act accordingly taking all precautions to
protect my information from unnecessary distribution.
Sig ure Date
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have read the information above and do not have any confidential documentation to submit to the
.City of Dubuque as part of this Claim Against the City. {
Signat a Date A
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