Claim by William/Racquel McClellan and Ramone Bowen, Jr. THE CM OF
DUB11ticruE MEMORANDUM
Masterpiece on tete Mississippi
TRACEY STECKLEIN
PARALEGAL
To: Mayor Roy D. Buol and
Members of the City Council
DATE: March 8, 2016
RE: Claim Against the City of Dubuque by William McClellan, Racquel
McClellan, and Ramone Bowen, Jr., filed by Attorney Marvin Gray
Claimant Date of Claim Date of Loss Nature of Claim
William McClellan 03/07/16 02/03/16 Personal Injury/
Racquel McClellan Vehicle Damage
Ramone Bowen, Jr. I
This is a claim in which claimants allege that a City of Dubuque police officer made a
left turn into the left side of the vehicle occupied by claimants, causing personal injury
and property damage.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool
cc. Michael . Van Milli en City Manager
Mark Dalsing, Chief of Police
Attorney Marvin Gray
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 9
TELEPHONE (563)5834113/FAx (563)583-1040/EMAIL tsteckle@cityofdubuque.org
AMENDED
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
(to be supplemented subsequently)
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 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:S: William McClellan, Racquel E. McClellan and Ramone Bowen, Jr.
2. Address: 729 1/2 Lincoln Avenue, Dubuque, IA 52001
3. Telephone Number: 815 708 3033
4: Date of Incident: February 28, 2016 �
S. Time of Incident: Approximately 10:12 a.m.
& Location of Incident(Be specific): At the intersection of Garfield Street
and Johnson Street in the City of Dubuque, Iowa
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.)
Officer Ramirez made a left turn into the left side of the vehicle
occupied by the claimants, causing personal injury and property damage.
8. What were weather conditions like? Clear and dry
9. Give name and address of any witnesses; to be provided subsequently
10. Did police investigate? (If so, give names of officers.)
Yes. Their names are presently unknown; to be provided.
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
Briefly: William--injury to entire body; Racquel--injury to neck, breast,
ribs, knees and ankles; Ramone--cut at left eyebrow.
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.)
Yes. The claimants' 2003 Dodge Neon was totally destroyed.
13. What other damages do you claim, if any? Undetermined at this time; to be
supplemented
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.)
No.
15. What amount do you claim from the City of Dubuque?
Undetermined at this time;to be supplemented
16. Why do you claim the City of Dubuque is responsible?
Officer Rodrigupz raused thp motUryeh'c1p,aCcident and ad ':Ued tba mg at the scene.
17. Have you made any claim against anyone else for damages as a result of this incident?
(if yes, give name and address.)
Not at this time.
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount? Does Not Apply
Dated at 9KX this�t day of
Chic L
(Signature)
(Attorney Marvin "ra (Print Name)
:U
(Rev. 7/12)
C M
(D
0
CD
LAW OFFICES OF
MARVIN W. GRAY
ATTORNEY AT LAW
405 E. OAKVOOD BOULEVARD March 10, 2016 SUITE 2L
CHICAGO, ILLINOIS 60653-92.303 TELEPHONE: 773 268 0900
EMAIL: MARVINGRAY(2S)AOL.COM FACSIMILE: 773 268 0901
Officer Pablo Ramirez, and the City Clerk's Office
Dubuque Police Department City Hall
770 Iowa Street 50 W. 13th Street
Dubuque, IA 52001 Dubuque, IA 52001
REGULAR MAIL REGULAR MAIL
Re: Date of Occurrence: February 28, 2016
Place of Occurrence: At the intersection of Garfield and Johnson
Streets in Dubuque, Iowa
AMENDMENT OF LETTER SENT ON MARCH 8, 2016 TO SHOW THE COR-
RECT NAME OF THE POLICE OFFICER: PABLO RAMIREZ, IN ACCORD-
ANCE WITH THE ENCLOSED DRIVER INFORMATION EXCHANGE REPORT
Dear Addressees:
Enclosed please find a copy of an Amended Notice of Attorney's Lien. If you were covered by a
policy of insurance at the time of this occurrence, you should turn these materials over to that
insurance carrier, immediately. If you were not insured, you should contact me as quickly as
possible, for the purpose, perhaps, of avoiding the expense and inconvenience of being sued. I
thank you for your time and attention.
Please find the enclosed completed Amended Initial Claim Form Submitted by Claimant's
Attorney and Amended Claim Against the City of Dubuque, Iowa.
ply
Marvin W.,.'
MW G:bm
Enc.
C7
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E5 M
AMENDED*
NOTICE OF ATTORNEY'S LIEN
Officer Pablo Ramirez, and the City Clerk's Office
Dubuque Police Department City Hall
770 Iowa Street 50 W. 13th Street
Dubuque, IA 52001 Dubuque, IA 52001
Certified Mail; Return Receipt Certified Mail; Return Receipt
Requested 97012 3460 0002 4332 4522 Requested#7012 3460 0002 4332 4539
Dear Addressees:.
You are hereby notified, pursuant to Iowa Code § 602.10116 (Attorney's lien — notice),
that Racquel E.McClellan and William McClellan,in behalf of themselves and as Foster Parents
and Next Friends of Ramone Bowen, Jr., A Minor, have placed in our hands as their attorney, a
claim, demand or cause of action against Officer Pablo Ramirez*, the Dubuque Iowa Police
Department and the City of Dubuque, Iowa, for prosecution, suit or collection, growing out of the
negligence of Police Officer Pablo Rodriguez at the intersection of Garfield and Johnson Street in
the City of Dubuque, Iowa on or about the 28th day of February, 2016, and have agreed to pay to
this law firm,for such services as a fee, a sum equal to thirty-three and one-third percent(33-1/3%)
of whatever amount may be recovered therefrom by settlement without suit, and that we claim a
lien upon such claim, demand or cause of action for such fee.
Law Office of Marvin W. Gray
by Marvin W. Gray
STATE OF ILLINOIS )
) SS.
COUNTY OF C O O K )
MARVIN W. GRAY, the attorney, states that the above Notice of Attorney's Lien was
served by Certified Mail, Return Receipt requested by enclosing a copy of said Notice in a sealed,
postage prepaid envelope, addressed to each party to whom the Notice is directed and mailing said
envelope and contents in a U.S. Mail Box on March 8, 2016.
SUBSCRIBED and SWORN TO be-
fore me this 8th day of March, 2016
*This amended Notice of Attorney's Lien, showing
the correct name of the police officer, Pablo Ra-
mirez, was sent by regular mail on March 10,
NOTARY PUBLIC 2016
M Vr1
AMENDED
INITIAL CLAIM FORM SUBMITTED BY CLAIMANTS' ATTORNEY
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
your receipt of these items and destroy the communication and any attachments
immediately. Further disclosure of this information may violate state and federal
restrictions.
Confidential information may include the following:
1) Social Security Number(s)
2) Medical/Health Information
3) Personnel/Disciplinary Information
4) Bank Account Information
5) Financial Information
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 information that is included.
AttorneyMin W. Gray*
1, ary , hereby certify that the attached documents
include the following protected information:
Social Security Number(s) Bank Account Information
Medical/Health Information Financial Information
Personnel/Disciplinary Information Credit Card Number(s)
*counsel for William McClellan, Racquel E. McClellan and Ramone Bowen, A Minor
I understand that this information may be distributed within the City organization or to agents of the
City fo
.,rpmqessing and I hereby authorize the City to act accordingly taking all precautions to
pr ct my in rmation from unnecessary distribution.
Signature Date
*counsel for illia MCC, Ilan, Racquel E. McClellan and Ramone Bowen, A Minor
I have ad the nformation above and do not have any confidential documentation to submit to the
City f Dubu as part of this Claim Against the City.
Signature Date
MVtA
i e,�
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
(to be supplemented subsequently)
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, 60 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:S: William McClellan, Racquel E. McClellan and Ramone Bowen, Jr.
2. Address: 729 1/2 Lincoln Avenue, Dubuque, IA 52001
3. Telephone Number: 815 708 3033
Date of Incident-
February 28, 2016
4.'
6. Time of Incident: Approximately 10:12 a.m.
6. Location of Incident(Be specific): At the intersection of Garfield Street
and Johnson Street in the City of Dubuque, Iowa
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.)
Officer Rodriguez made a left turn into the left side of the vehicle
occupied by the claimants, causing personal injury and property damage.
Clear and dry
8. What were weather conditions like?
9. Give name and address of any witnesses: to be provided subsequently
10. Did police investigate? (if so, give names of officers.)
Yes. Their names are presently unknown; to be provided.
11. Was anyone injured? (if so, give names, addresses, and extent of injuries).
Briefly: William—injury to entire body; Racquel--injury to neck, breast,
ribs, knees and ankles; Ramone--cut at left eyebrow.
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.)
Yes. The claimants' 2003 Dodge Neon was totally destroyed.
13. What other damages do you claim, if any? ,Undetermined at this time; to be
supplemented
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.)
No.
II
15. What amount do you claim from the City of Dubuque? 1
Undetermined at this time; to be supplemented
I
16. Why do you claim the City of Dubuque is responsible?
officer Rodri6uez caused the motor vehicle accident and admitted the same at the scene.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, gave name and address.)
Not at this time.
18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount? Does Not Apply
Dated at ' this day of 110 v� , 20 KC
i
(Signature)
(Attorney Marvi W. Gra (Print Name)
(Rev.7112)
c�
P
r.
INITIAL CLAIM FORM SUBMITTED BY CLAIMANTS' ATTORNEY
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 (663)-589-4120 of
your receipt of these items and destroy the communication and any attachments
immediately. Further disclosure of this information may violate state and federal
restrictions.
Confidential information may include the following:
1) Social Security Number(s)
2) Medical/Health Information
3) Personnel/Discipli nary Information
4) Bank Account Information
5) Financial Information
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 information that is included.
I, Attorney Marvin W. Gray* hereby certify that the attached documents
include the following protected information:
Social Security Number(s) -Bank Account Information
Medical/Health Information -Financial Information
Person nel/Disciplinary Information Credit Card Number(s)
*counsel for William McClellan, Racquel E. McClellan and Ramone Bowen, A Minor
I 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
prot7y,,n_) malion from unnecessary distribution,
_ ;><�' 11(2(rdn '8` 2c---A4
Signature Date
*counsel fo Willi-4 cclln, Racquel E. McClellan and Ramone Bowen, A Minor
I have read:�e information above and do not have any confidential documentation to submit to the
city �ubuq e as part of this Claim Against the City.
Signature Date
LAW OFFICES OF
MARVIN V. CRAY
ATTORNEY AT LAW
405 E. OARWOOD BOULEVARD March 8, 201.6 SUITE 21.,
CHICAGO, ILLINOIS 60653--2303 TELEPHONE: 773 268 0900
EMAIL: MARVINGRAYOA AOL.COM FACSIMILE: 773 268 0901
Officer Pablo Rodriguez, and the City Clerk's Office
Dubuque Police Department City Hall
770 Iowa Street 50 W. 13th Street
Dubuque, IA 52001 Dubuque, IA 52001
Certified Mail; Return Receipt Certified Mail; Return Receipt
Requested #7012 3460 0002 4332 4522 Requested-#7012 3460 0002.4332 4-539
Re Date of Occurrence: February 28, 2016
Place of Occurrence: At the intersection of Garfield and Johnson
Streets in Dubuque, Iowa
Dear Addressees:
Enclosed please find a copy of a Notice of Attorney's Lien. If you were covered by a policy of
insurance at the time of this occurrence, you should turn these materials over to that insurance
carrier, immediately. If you were not insured, you should contact me as quickly as possible, for
the purpose, perhaps, of avoiding the expense and inconvenience of being sued. I thank you for
your time and attention.
Please the enclosed completed Initial Claim Form Submitted by Claimant's Attorney and Claim
Against the City of Dubuque, Iowa.
Circerc�
Marvi . Gr
MW -bm
Enc. C3
c l
I ; M
cD
NOTICE OF ATTORNEY'S LIEN
Officer Pablo Rodriguez, and the City Clerk's Office
Dubuque Police Department City Hall
770 Iowa Street 50 W. 13th Street
Dubuque, IA 52001 Dubuque, IA 52001
Certified Mail; Return Receipt Certified Mail; Return Receipt
Requested #7012 3460 0002 4332 4522 Requested #7012 3460 0002 4332 4539
Dear Addressees:
You are hereby notified, pursuant to Iowa Code § 602.10116 (Attorney's lien — notice),
that Racquel E.McClellan and William McClellan,in behalf of themselves and as Foster Parents
and Next Friends of Ramone Bowen, Jr., A Minor, have placed in our hands as their attorney, a
claim, demand or cause of action against Officer Pablo Rodriguez, the Dubuque Iowa Police
Department and the City of Dubuque, Iowa, for prosecution, suit or collection, growing out of the
negligence of Police Officer Pablo Rodriguez at the intersection of Garfield and Johnson Street in
the City of Dubuque, Iowa on or about the 281h day of February, 2016, and have agreed to pay to
this law firm,for such services as a fee,a sum equal to thirty-three and one-third percent(33-1/3%)
of whatever amount may be recovered therefrom by settlement without suit, and that we claim a
lien upon such claim, demand or cause of action for such fee.
Law Office of Marvin W. Gray
by Marvin W. Gray
STATE OF ILLINOIS )
) SS.
COUNTY OF C 0 0 K )
MARVIN W. GRAY, the attorney, states that the above Notice of Attorney's Lien was
served by Certified Mail, Return Receipt requested by enclosing a copy of said Notice in a sealed,
postage prepaid envelope, addressed to each party to whom the Notice is directed and mailing said
envelope and contents in a U.S. Mail Box on March 8, 2016.
SUBSCRIBED and SWORN TO be-
fore me this 81h day of March, 2016
NOTARY PUBLIC