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Claim by Dubuque Co. Sheriff's Office Copyrighted October 1, 2018 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUMMARY: Dubuque County Sheriff's Office for property damage, Bettye Kronstad for vehicle damage, Mark Topf for property damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City Attorney ATTACHMENTS: Description Type Dbq. County Sheriff's Office Claim Supporting Documentation Kronstad Claim Supporting Documentation Topf Claim Supporting Documentation �� 3 � �.{�l�F�"�,,�,� CLAIM ACAINST THE CITY OF DUBUC�UE, IOWA ��5o1,a�� ; . ; This written report constitutes your claim against the City of Dubuque, lowa. You should I� complete this form in full and attach any additional information that supports your claim. ! The Claim must be filed with the City Cierk 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. TFiE 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 iVOT BE PAID. i 1. Name of Claimant: DUBUQUE COUNTY SHERIFF OFFICE � � 2. AddYeSS: 77'0 IOWA STREET � � � P,� ;i DUBUQUE � IOWA 52001 '1 City: State: Zip: i� 563-589-7844 �'' 3. Telephone Number: Ij 4. Date of Incident: 07/23/2018 � 5. Time of Incident: APPROXIMATELY 4:30 p.m. �% i I 6. Location of Incident (Be specific): APPROXIMATELY 50 FEET NORTH OF THE ENTANCE OF THE ' DUBUQUE LAW ENFORCEMENT CENTER 7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give �,i full details upon which you base your claim. If a City employee was involved, give the 'i employee's name.) li� � WATER MAIN BREAK CAUSING FL�ODING INTO THE ELECTRICAL SWITCH GEAR LQCATED IN � THE DUBUQUE LAW ENFORCEMENT CENTER. ADDITIONAL DAMAGE TO SIDEWALK AND DRIVEWAY. A n 8. What were weather conditions like? SUNNY �N� cLEAx 9. Give name and addres� of any witnesses: �911 DIRECTOR MARK MURPHY 10. Did police investigate? (If so, give names of officers.) POLICE AND FIRE WAS DISPATCH T� THE SCENE. 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). NO INJURY WAS REPORTED i � � •I 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.) � I YES, EROSION HAPPEN UNDER SIDEWALKS, DRIVEWAY FROM THE WATER BREAK AND WATER � ENTERED OUR MAIN ELECTRICAL SWITCH GEAR LOCATED IN OUR BASEMENT AT THE 770 IOWA STREET. 7 ELECTRICAL COMPANY WESTPAHL WAS CONTRACTED 13. What other damages do you claim, if any. EMERGENCY TO DRY OUT THE ELECTRICALSWITCH GEAR. � 14. Have you been compensated for any part or all of your claim by any insurance I company? (If so, give name and adciress of insurance company and amount paid:) � � � NONE ;i ; ,; 15. What amount do you claim from the City of Dubuque? '� WESTPAHL INVOICE�F� 7803 $1.012.50 III 16. Why do you claim the City of Dubuque is responsible? �� CITY OF DUBUQUE WATER MAIN � I 17. Have you made any clairn against anyone else for damages as a result of this incident? (If yes, give name and address.) NONE 18. If the answer to Question 17 is yes, have you received any payment from that source, �� and if so, in what amount? !I NONE � il Dated af Dubuque, lowa �his �� day of� � �, , Zp� a i � ��..�.�_... � � (Signature) � ��, \�. �� .�� ~� �'"`� (Print Name) f_„�,� � � �„ � �- �-"�, � �`.�' �a �� : � � � � � � � �' -> � � � (Rev. 5/18) ' ' � � � . i � �� i Conficlential i� This communication and any attachments may contain information which is confidential � and privileged by law and is #or the use of the designated reaipient. 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 isprohibited. Please notify City of Dubuque immediately by telephone at (563)-589-4120 of �j your receipt of these items and destroy the communication and any attachments �� immediately. Further disclosure of this .information ._may violate state and federal I restrictions. � y � Confidenfiial information ma include the followin : � Y J r� � ,� 1) Social Security Number(s) 'i1 2) MedicaUHealth Information �, 3) Personnel/Discipfinary Information , . ,; 4) Bank Account Information�� 41 5) Financial lnformation, '� _ ; 6) Credit Card Numbers If any documentation you desire to submit to the City of Dubuque contains any of the items above 'i � this cover sheet must be attached directl to the confidential information and indicate the t e' of ,, y Yp information that is included. i ii �i �� , hereby certify that the attached documents i include the following protected information: i� i �Social Security Number(s) ��- Bank Account lnformation ;� ��Medical/Health Information �Financial Information � `��Personnel/Disciplinary Information ��Credit Card Number(s) � , , I understand that this information may be distributed within the City organization or to agents of the � City far processing and i fiereby authorize the City to act accordingly taking all precautions to protect my information from unnecessary distribution. � � � � � . �, �_� � � � � �� -��1 Signatura Date . � ; 5 7 � Copyrighted October 1, 2018 City of Dubuque Consent Items # 3. ITEM TITLE: Disposition of Claims SUMMARY: City Attorney advising that the following claims have been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool: Kelsey Caspersen for vehicle damage, Dubuque County Sheriff's Office for property damage, Bettye Kronstad for vehicle damage, Mark Topf for property damage, Brock Tyner for vehicle damage, Doug Winner for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Supporting Documentation THE CITY QF �U E MEMORANDUM Masterpiece on tl�e Mississippi TRACEY STECKLEIN '� PARALEGAL �� y �i, To: Mayor Roy D. Buol and � Members of the City Council � � � DaTE: September 26, 2018 RE: Claim Against the City of Dubuque by Dubuque County Sheriff Office Ii ;, Claimant Date ofi Claim Date of Loss Nature of Claim � �� , Dubuque County 09/25/18 07/23/18 Property Damage �';1 Sheriff Office ; ,� '�� This is a daim in which claimant alleges that a water main break caused flooding into the ,I� electrical switch gear located in the Dubuque Law Enforcement Center, as well as !�{ additional damage to the sidewalk and driveway outside of the Center. '` i'1 � This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa � Communities Assurance Pool. � cc: Michael C. Van Milligen, City Manager Gus Psihoyos, City Engineer �� Denise Ihrig, Water Department Manager ji Steve Hahlen, Dubuque County Sheriff Office � � � � � - OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/Fax (563)583-1040/EMa,i� tsteckle@cityofdubuque.org