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Claim by Kyle Christina Copyrighted September 3, 2019 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUM MARY: Kyle and Shelby Christina for property damage, Kathy Jansen for vehicle damage, Gail Miller for property damage, Suit by Timothy McKenzie vs. City of Dubuque et al. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Referto City Attorney ATTACHMENTS: Description Type Christina Claim Supporting Documentation Jansen Claim Supporting Documentation Miller Claim Supporting Documentation McKenzie vs. City of Dubuque Suit Supporting Documentation _ �� V� ' �� CLA�M AGA�NST THE �1TY C}F DUBUQU�, 1C}WA r This written report con�titutes your ciaim against the Gity of Dubuque, lowa. You shou[d � cornple#e this form in full �nd attach any addifiional information that suppor�s your ctaim. � � � ;; The Glaim mu�fi be filed with the Ci�y Clerk at Ci�y Hall, 50 W. '!3#h St., Dubuque, IA 52001. It � will then be referred by the Ci#y Council to the apprapriate department for investigation. C}nce that investigation is campleted, a report and recommendatian will be submi#ted to fihe � City Council. You will be provided with a copy ofi that report and recammendation. � , � THE FINAL DECISI�N ON AL.E. CLAIMS IS MADE BY THE CITY CtJUNGIL, Na EMPLOYEE flF � THE CITY O�' DUBUQUE HAS THE AUTHCJRITY TQ N[AKE ANY REPRESENTATION TCl YC�tJ � AS TC� WHETHER YOUR CLA1M Vill�� t}R W1C.L NOT BE PAID. � �� f�` o'�'?�:....-. � '1. Name of G1a�rnant: �� "��` �"' �" ; ii �. .�{�C�l'�SS: �� ItY: �E� � � St�t@. � �1�: ;�� F 3, Telephone Number. � �� 4. Date of incident: �� t � �5. T'rme of Incident: ��'_ .°�` '��' ��°�� . 6. LocafiAor� of Incident {Be speeifie�; ,�'�� } � � � � � ` � � ��' - � � �'�"' ��,.- ,,; �� . 7. DESCRIBE ACClDENT �l� C?��1JFtf�E[�GE �'I�AIf ��,!l�EL� l�J.3URV d7F� DAMA�E. �C�iv� : full details upan which you k�ase your clairra. lf a Cifiy employee was involvad, give the` ' employee's name.} ��,�t LL� '�� " �r,��`:� �,�? �� %Y1 ��+�` ,�'�, 7�,�j�` � � L.�3��y� �S��, � ��.,�".-C�C.� ��+" ��/�r��.7,� ��l' ��a`�'`z �,. �'T`e:� L��..t' �.a�. �, a.�.�',�('. "�"�� 'µ�-� �� ,�,�'�r�-- ��-��.��`. 8. What were weather conditions iitce? �� 9, Give name and address of any witnesses: ��'� I[��1� T'r`'��"��T �i�1�f�,� t�n� .� �p�&��-� �f a�"��s �'r:w,c�;�..� 10. Did potice investigate? (lf sr�, give names a�o�`icers��`��`'��° �'� ��1�" ��f��. �� . �� ? � '11. Was anyon� in�ured. (1f so, g�v� names, addresses, and extent of �r��ur�es}, � � � � �� , � s ` I � 12. Was any darnage done to property? (If sc�, describe prc�perty and the extent c�f � damages. Attach estimates of damages or descril�e basis for ascertaining extent of " damage.} � � �T` C.��` �t��►r"�� a ��►�,:+��r` d�`T ��a�.c�- 1 C7' ��,.. ��("�,��l`�`` ��r��.�- , G�°�'2r�-- 1v�t��I�� (�t�C ��•�.�`J L-- � , � a�1?�- f=idt`h�'��...- �,,�.:�,.1`.�..�..;� � . c��. � -- � 9�r`��t't�[��,,.� �,��- ��7 i�a�a��l��a�� w�� 1-��°7 t��' 1�d?�' � � 13. What other damages do you claim, if any r� o � ,i 14. Have you been �ompensated fc�r any part or al� of yaur claim by any insurance � company'� {If so, give name and address of insurance company and amount paid.) 4' �� 5,,�';� �'��t�� i c��t" ��c�c�,�.�t-��. �'��Y 1�� 1�J � � , � '15. 1Nhat amount do you claim from the Gity of Dubuque? � �.��m �`� ��' ��`�5 ��-�'��,�' � 1 '16. Why dc� yau cfaim the City of D�buque is responsible? � � ��a� ��-��.f" �� - �'� �5 r`� ��, ��,, ��y.r� �� cc�,�� I , 17. Have you made any claim agair�st anyon� e�se for damages as a result of this incider�t? (If yes, give name and adctr�ss.} �� W � 18. If the answer to Question 17 is yes, have you r�ceived any payment from that source, � and if so, in what amoun�t? � I � � �}�t�d at D�buqaa�, ��a th�s �� iay s�f ��",��n. , �fl� � � �°�� 9 ^�rd� � �..,.�„�.... � .� _ .....�—�..�. t.�"'.rl�Il�tUi'G'� � ..�, �� F f �� --�^�'7�'t ��'i �Print Name� -�� :,.�: ,,=� �, �,.� �a_{ :�.' �} �s �--, � � � !i1 � cr;�� -a.3 :w`= � _ �, �_� 4y-�.. � � � �� ., E'� (Rev. 5118} `�' �, . � I "" P , ' � Confadential This communication and ar�y attachments may cantain information_ which is confidential and privileged by law and is far the use of the designaf�d recipient. (f you are not the � intended recipient, you are hereby notified that you have received this communication in { error, and tMat any review, disctasure, di�semination, distribution or copy�ng af its contents � is prohibited. Please notify City of Dubuque immediately by telephone at (563�-589a4'IZO of � your receipt af these items and destroy the communicatitrn and any attachments � immediately. . Further disclosure af this information may violate state anc! federa! � restrictions. . � � a 4 �Confident�al �nformat�on may include the fallowing: z 1 SociaC �ecurit Number s � } Y � ) i 2) Med�callNe�lth Informatian 3} Personnel/Disciplinary Informatior� � 4) Bank Accaunt informa�ian 5) Financiallnformation 6} Credit Card Numbers � ff any documentation you desir� to submit to the City �f Dubuque contains any of the ifiems abave � this cover shee� must be att�ched directly ta the confidential information and indicafie ti�e type af a infarmation that is included. � , � i, �� ,� �,� . 0. , hereby certify thafi the afitached dacuments include the following protected infc�rmation: � �acial Securifiy Number(s) Bank Account Information � i , MedicallHea�th Information Financial lnform�tian ; Personnel/Disciplinary lnfarmation Credifi Card Number(s) � � � understand that this irrformafiiort may b� disfiributed wifihin the City arganization or ta agents of the City for proeessir�g and ! hereby aufihori�e the City ta act ��eordingly taking a!I precautit�ns to prot�ct my informafiian from unnecessary distribution. �-� . ��,��'`�.��'� StC�Clr��t�r�' C}�t� THE C.7.'I'Y C7I' ""' ��b'�� A��-Attler�r�G�y , M..r.ast�rpiece c�rt tFz� Mississi��7 � �� xular�.vitSa.��u�a�..aai:� � June 28; 2019 i Mr. Brett Meye�s � � lowa Departmenfi of Natural Resources 909 West Main, Suite 4 M�nchester, lowa 52057 i� Dear Mr. Meyers �i �� The purpos� of this letter is to provide you with additional information concernir�g th� �;i sar�itary sewer ba�ement back-up vvhich occurred at 565 Pri:mrose Ct in the �ifiy of � Dubuque an VUednesday, June 2'6, 20�9. The basement back-up was reparted to yau �1 around 08:20 a.m. Thursday, June 27, 2Q19. � � The basem�nfi back-up at 5�5 Primrose Ct was reported fio th� Public Work� Ij Depar�ment around 10:00 p.m. on Wednesday, June 26,, ZQ�9. A maintenance crew 1 was dispatched to the loc�tion and found a blockage in our line due to roats. The line I'I was jetted open in a �hort period of tirne. Our mainten�nc� cr�w took a root cutter to � fu11y clear the Iine on June �7, 2Q19. VVe wi{'I evaCuate the need provide addi�ional maintenance jetting and root cutting a(ong with adding the line to our ann:ual root I foaming prograrn, � i We are estimati�ig that 1 Q0 ga0lons of ur�treated wastewafier backed into the hame � based on what we were told by others. � Included with this letter is fh� basement back-up report for your r�cords, � If you need any additional information, please feel free contacf ine, �ince ely, � a � Ari�l[e Swift �� Assistant Public Works Direcfor Copyrighted September 3, 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: Kyle and Shelby Christina for property damage, Kathy Jansen for vehicle damage, and Gail M. Miller for property damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Staff Memo � Dubuque THE CITY OF �,,,, ��a.,, — Alhq�eriea Ci� 4.�J i.� � w�r��a�cu=�;��; e'� �m r � I � Maste iece on the Mississi i zoo7.zo�Z.zo13 il YP pp Zoi7*zoi9 a �� i TRAGEY STECKLEIN Ij PARALEGAL �� IVIEMO ' I; To: Mayor Roy D. Buol and Itl Members of the City Council DATE: August 26, 2019 ��;� ;� � � RE: Claim Against the City of Dubuque by Kyle & Shelby Christina I�, Claarr�ant Dat� of Ciaim Da#e of Loss Nature o�' Clairn ';� Kyle & Shelby Christina 08/23/19 06/26/19 Property Damage Ili� ii This is a claim in which claimant alleges that a City sewer back2d up into claimant's ; basement at 565 Primrose Court on June 26, 2019. ,I �� This ciaim has been referred to Public Entity Risk Services of lowa, the agent for the lowa I� Communities Assurance Pool. j � cc: Michael C. Van Milligen, City Manager ,� John Klostermann, Public Works Director ; Kyle & Shelby Christina � OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/F,� (563)583-1040/Ennai� tsteckle@cityofdubuque.org