Claim by CEI ASO Mediacom Communications CorporationCopyrighted
December 19, 2022
City of Dubuque Consent Items # 02.
City Council Meeting
ITEM TITLE: Notice of Claims and Suits
SUMMARY: C E I AS Mediacom Communications Corporation for vehicle damage;
Jackson Rahman for vehicle damage.
SUGGESTED Suggested Disposition: Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
Description Type
Claim by CEI ASO Mediacom Communications Supporting Documentation
Corporation
Claim by Jackson Rahman Supporting Documentation
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
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This written report constitutes your claim against the City of Dubuque, Iowa. 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
THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO YOU
AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAID.
1. Name of Claimant:
2. Address:
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CEI ASO Mediacom Communications Corporation
4850 East Street Road
City: Trevose
Telephone Number: 267-989-3279
Date of Incident:
Time of Incident:
11/16/22
7:18 PM
State: PA
6. Location of Incident (Be specific): 4507 49th Street Moline, IL 61265
Zip:
19053
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
employee's name.)
Our driver's vehicle was parked near their home when the bus, driven by Michael Felttes, sideswiped our vehicle
8. What were weather conditions like?
Dry and clear
9. Give name and address of any witnesses: Unkn own
10. Did police investigate? (If so, give names of officers.)
Debuque PD, Officer Allison Bailey, Report # 2022-007967
11. Was anyone injured? (If 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 estimates of damages or describe basis for ascertaining extent of
damage.)
Damage to our vehicle: driver side front fender, bumper and hubcap
13. What other damages do you claim, if any? None
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 company and amount paid.)
No
15. What amount do you claim from the City of Dubuque?
Amount pending completion of repairs
16. Why do you claim the City of Dubuque is responsible?
Our vehicle was parked and unoccupied when struck.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.)
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18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount?
Dated at Dubuque, Iowa this
7th day of December 2p 22
Mary Ammon, CEI Representative
(Rev. 5/18)
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rint Name)
City of Dubuque
City Council Meeting
Consent Items # 03.
Copyrighted
December 19, 2022
ITEM TITLE: Disposition of Claims
SUMMARY: City Attorney advising that the following claims have been referred to
Public Entity Risk Services of Iowa, the agent for the Iowa Communities
Assurance Pool: CEI ASO for vehicle damage; Julie Fry for property
damage; Jackson Rahman for vehicle damage; Beth Whisler for vehicle
damage.
SUGGESTED Suggested Disposition: Receive and File; Concur
DISPOSITION:
ATTACHMENTS:
Description
I CAP Referral
Type
Supporting Documentation
THE CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
JONI MEDINGER
LEGAL ADMINISTRATIVE ASSISTANT
To: Mayor Brad M. Cavanagh and
Members of the City Council
DATE: 12/13/2022
RE: Claim Against the City of Dubuque by CEI ASO Mediacom
Communication Corporation
Claimant Date of Claim Date of Incident Nature of Claim
CEI ASO 12/7/2022 11/16/2022 Vehicle Damage
This is a claim in which claimant alleges Claimant's vehicle was damaged due to being
struck by a City bus.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
Ryan Knuckey, Director of Transportation Services
CEI ASO Mediacom Communications Corporation
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563) 589-4113 / FAx (563) 583-1040 / EMAIL jmedinge@cityofdubuque.org