Claim by Dennis Day Copyrig hted
February 15, 2021
City of Dubuque Consent Items # 2.
City Council Meeting
ITEM TITLE: Notice of Claims and Suits
SUM MARY: Jennifer Connolly for property damage; Dennis Day for property
damage;Ashley Johnson for property damage; Biniv Maskay for
personal/property damage.
SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney
DISPOSITION:
ATTACHMENTS:
Description Type
Claim by Jennifer Connolly Supporting Documentation
Claim by Dennis Day Supporting Documentation
Claim by Ashley Johnson Supporting Documentation
Claim by Biniv Maskay Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA � ��o���r���
This writ#en report cans#itutes yaur claim against the City of Dubuque, lowa. Yau shouid �. Swi�!
complete this form in full and attach any additional information that suppQrts your claim.
The Claim must be filed with the City Clerk at City Hall, 50 W. 13t" St., Dubuque, IA 52001.
It will then be referred by the City Council to the apprapriate deparEment far investigation. �
Qnce 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 DECtSION ON ALL CLAIMS tS MADE BY THE CITY COUNCIL. NO EMPL4YEE
O� THE ClTY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO
YOU AS TQ WHETHER YOUR CLAIM WILL OR WILL [VOT BE PAID.
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1. Name of Claimant: CG 1n►��l � �
2. Address: ��J �b',E�-� r Y. .�,1V�'v ��� � �j ZCX7 _
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3. Telephone Number. ���� s�'� -�$�3
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4. Date of Incident: t�Z.'-f j2021
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5. Time of Incident: ��d� Qt�. �
6. Location of Incident(Be specific): ��2-� �51t�v►'�-! 1�-CX � �v��� :,�. ✓T �
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7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim. If a Gity employee was invalved, give the
employee's name.)
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8. What were weafiher conditians like? 4'�
9. Give name and address of any witnesses: �'Q-S��`-�' (��o`� �'r'cv-�-i�`� �a-'�t.�w
C.�� �� �ti..��� dl��.� �Gw �-� � -���. ��� � �.���,
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10. Did police investigate� (If so, ive names of officers.j
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11. Was anyone injured? ([f so, give names, addresses, and extent of injuries).
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'12. Was any damage done to property? (If so, describe property and the extent of damages.
Attach e$timates of damages or describe basis far a�certaining extent af damage.)
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13. What other damages da you cl�im, if any?__ �bhL, �K�-� -�v� -�..
t�� Q,v��.�-e ka �4�e. �arx� ��r� ����.�►� ,
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 cornpany and amount paid.)
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15. What arnount do you claim from the City of Dubuque?�l �-1,T�C�,o0
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'!6. Wh do ou ctaim the Cit of Dubu ue is res onsible? �
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�17. Have yau made any c0aim against anyone else for damages as a result of this incident? �
(1#yes, give name and address.) n r
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18. If the answer to Questien 17 is yes, have you received any payment from that saurce,
and if so, in what amount?
Dated at Dubuque, lawa this �� day of �L..v�.vr.�� 20�,
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Copyrig hted
February 15, 2021
City of Dubuque Consent Items # 3.
City Council Meeting
ITEM TITLE: Disposition of Claims
SUM MARY: Dennis Day for property damage and Biniv Maskay for personal/property
damage.
SUGGESTED Suggested Disposition: Receive and File; Concur
DISPOSITION:
ATTACHMENTS:
Description Type
I CAP Referral Staff Memo
THE CITY OF
I���B � MEMORANDUM
Masterpiece on fhe Mississippi
JENNYMESSERIG�
PARALEGAL 1
To: Mayor Roy D. Buol and
Members of the City Council
DATE: January 29, 2021
RE: Claim Against the City of Dubuque by Dennis Day
Claimant Date of Claim Date of Loss Nature of Claim
Dennis Day 01/25/2021 01/24/2021 Property Damage
This is a claim in which claimant alleges that his vehicle was struck by a City snow plow.
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
Dennis Day
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW Pu�,CE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TE�EpHONE (563)589-4381 /FFvc (563) 583-1040/EMni� jemesser@cityofdubuque.org