The URL can be used to link to this page

Claim by Bettye Kronstad 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 �� ` � C�A[M AGAINST THE CITY t�F DUBUt�UE� IOWA �t�`1�� This written repc�r� constitutes your claim against the City of �ubuque, Ic�wa, You� �he�uld � complete this form in full and attach any additional informa�ic�n that supperrts your cla`[m. � � The Claim musfi be filed with the Gity Clerk at City Hall, 50 W. 13�" St., Dubuque, IA �2(I01. It � will then be r�ferred hy th� Gity �ouncil to the appropriate department for inv�stigation. � �nce that investigation is completed, a report and r�commendation will be �ubmitted ta the City Coca�cil. You wi11 be provided wi�h a copy af that report and recammeredation. � I � � THE FI�tAL. DLCISIC}N C}N ALL C�.AIM� IS MADE �Y THE CITY CC]UNC(L. N� EMPL.OYEE t}F � THE CITY OF' DUBUQUE HAS TFI� AUTI-�ORITY TO MAKE� ANY REPRE aENTATICIN T�} Y{�U � AS Tt3 WHETHER YC}UR CLAIM WIGL (JR 1tIlILL NOT BE PAID. (i �. Name c�f�[airr�ant; ��1��°� ��5`�'�� 2. Address: �� '�.j �� j �� CiEy: � ��c.a ll � State: 1 �" Zip: ��.�� ; F 3. Te��phone Number: �'� � � �� i N i 4. Da�te of Ir��dent: �� 1'� I �" ' , . N 5. Time of Ir�c�dent: � � �..� �'� �1 h 6. l,ac�tion �f lncident {Be specific}: 9'�t{� f I� a'� �� ,�� '�-- I � ; j � 7. D�S�R(BE ACCIDENT t7R C)GCURRENCE THAT CAtJSED INJURY tJR DAMA�E. {Giue � full details upon which you ba�e yc�ur cl�im. [f a City employee was involved, g�ve the � employee'� r�am�e} 9 J i'�c��n�� .�� t� � � ��--�� 1�� s-l- 6��c�� /��-- ;� � �� .1� -�—�,� ��-C��e�`� � �� c� � c��— r�� c� `� c��c�� 8. What were weather canditit�ns like? ��e+t'" 9. Give name and address of any witnesses: '�`�'° �0. Did pcalice investigate? {If so, gi�re names of officers.� �°�S , ��a,�� .�}e�{"�— '�- `�.�\�' rt�Cl°�.�� C�a �— 'I 1. Was an�cane injured? (If so, �ive names, addresses, and �xtent of injuri�s�. �'1� � � � s a x �i 2. Was any damage done to property? {If so, describe prop�:rty and the extenfi �f � damages. Attach esfiim�tes of clamages or t�escribe basis fc�r ascertaining extent of � damac�e.) � ti �� r r..S S�� t'1U.��'' C�t2� ��c�Yi {'�� C�1C� � �t��'� � w�� J� ��r � � � :� �� 13. What c��her damages do you claim, if any? '��"`��'"�� i u I� '14. Have you b�er� compens�ted for any part or all of your claim by an�r insurance u company? �lf so, give n�me and addr�ss af insurance cc�mpany and amo�nt paid.} � �� '15. What amouri� do you claim from the City of E}ubuque? j tr��a.�" ��.��-�-� � � ��. �"� ;i 1 16� V4/hy dc� you claim the City of Dubuque is respons`rble? ? e � �` i �.��p��-� t�-c�� s �°► ii � � 17. Have yau rnade any claim against anyt�ne �Is�: for damages as a res�lt of this incid�nt? ;� �If yes, give n�me and addre�s,� � � ;� °I8. If �he an�wer to Question 17 is yes, have �+Qu received any payment from that s4urce, � and if so, in whafi amcaunfi? � � ;� � Dated at D�buque, lowa this � � day c�� Y , ZQ� � � � (�igna�ure} �� C �� {Prin# N�me) � � � �� {Rev. 5J�8} �` -�- r�a � � � � � � � � � � � � : � � � � c� "� � ; i }( ( 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 OF .I�UB E MEMORANDUlVI Master�iece an the Mississippi � � TRACEY STECKLEIN � � PARALEGAL � � To: Mayor Roy D. Buol and � Members of the City Council � d DAT�: September 24, 2018 ii, �4;' Re; Claim Against the City of Dubuque by Bettye Kronstad ;; � Claimant Date of Claim Date of Loss Nature of Claim �;�, i! Bettye Kronstad 09/24/18 09/08/18 Vehicle Damage � �, � This is a daim in which claimant alleges that a Health Department employee struck the � driver's side of claimant's vehicle at the intersection of 13t" and Main Streets. �� This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa '�� ti � Communities Assurance PooL � � cc: Michael C. Van Milligen, City Manager � Mary Rose Corrigan, Public Health Specialist Bettye Kronstad � . � OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA , SuITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHorvE (563)583-4113/Fax (563)583-1040/EMAi� tsteckle@cityofdubuque.org