Claim by Jordan Lyons Copyrighted
May 20, 2019
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Shannon Katka for personal injury/vehicle damage, Jordan
Lyons for vehicle damage, Sherrie Moriarity for vehicle
damage, Linda Rauen for vehicle damage, Kimberly
Sampson for vehicle damage
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Referto City
Attorney
ATTACHMENTS:
Description Type
Claim by Shannon Ketka Supporting Documentation
Claim by Jordan Lyons Supporting Documentation
Claim by Sherrie Moriarity Supporting Documentation
Claim by Linda Rauen Supporting Documentation
Claim by Kimberly Sampson Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA Y. r
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This written report constitutes your claim against the City of Dubuque, lowa. 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 i
THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE APJY REFRESENTATION TO YOU
AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE FAID.
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1. Name of Claimanto C�i'A'�liy ,c�✓�,�/ �
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2. Address: /D/.l'/l�sr�' �i�� �f.�.!� j
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City: � ,.,��rf State: Issrs Zip: .�ZZt�/ �;
� � �3. Telephone Number: .�,G��'—l�'1"'�—S"8�1
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4. Date of Incident: �T�//9 ii
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5. Time of Incident: �. .;'�
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6. Location of Incident (Be specific): �`G//` �f�' �j`.�iA'.�''� �i� �
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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 y
employee's name.) �
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8. What were weather conditions li�lfe? f l:� �/' � ,��
9. Give name and address of any witnesses: ��
10. Did police investigate? (If so, give names of officers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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'12, Was any damage done to pr�aperty? �If so, describe property and the e�ctent af
damages: Attach estimates of damages or describe basis for ascertaining extent af
damage.�
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13. What other damages do yau claim, if any? �,�''.� �:
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14. Have you been cornpensated for any part or all af your claim by any insurance '3
cc�mpany? {If sa, give narne and address of insuranc� �orn�a�r�y �nd �m��ant paid.� {
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1�, What�mounfi do you claim from the City of Dubuque? ��
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16. Why do youu ciairn the City �f Dubuque is respon `ble? u
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17. Have ou made any claim against a yn on�lse far damages as a result of this incident? �
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1�. If the answ�r t� C�uest��ra 1'� is yes, have you received any payment from �hat s�urce, �
and if so, in what �mount? ;�
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Copyrighted
May 20, 2019
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Claims
SUMMARY: CityAttorney advising that the following claims have been
referred to Public Entity Risk Services of lowa, the agent
for the lowa Communities Assurance Pool: Shannon Katka
for personal injury/vehicle damage, Jordan Lyons for
vehicle damage, Sherrie Moriarity for vehicle damage,
Linda Rauen for vehicle damage, Kimberly Sampson for
vehicle damage
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Supporting Documentation
THE CITY OF �
L�� E MEMORANDUM
Mc�sEerpiecP on the Mississippi "
TRACEY STECKLEIN '�
PARALEGAL �
,
To: Mayor Roy D. Buol and
Members of the City Council
DATE: May 9, 2019
I
RE: Claim Against the City of Dubuque by Jordan Lyons �
Claimant Date of Claim Date of Loss Nature of Claim
Jordan Lyons 05/08/19 02/24/19 Vehicle Damage �
This is a claim in which claimant alleges that his vehicle which was parked near 1015 ;
North Booth Street was struck by a City of Dubuque snow plow truck. u'
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
John Klostermann, Public Works Director
Jordan Lyons
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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/EMai� tsteckle@cityofdubuque.org