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Claim by Denise TrierweilerCopyrighted January 17, 2023 City of Dubuque Consent Items # 02. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUMMARY: Mark Laird for vehicle damage; Ashley Moore for vehicle damage; Denise Trierweiler for property damage. SUGGESTED Suggested Disposition: Receive and File; Refer to City Attorney DISPOSITION: ATTACHMENTS: Description Type Claim by Mark Laird Supporting Documentation Claim by Ashely Moore Supporting Documentation Claim by Denise Trierweiler Supporting Documentation r o vrn CLAIM AGAINST THE CITY OF DUBUQUE, IOWA Ron, kt,11C_ Sw,-AV- 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: Yl I So -fir 1 in ,� I , 1,- 2. Address: City:�l �[51�p State: -T660 a— Zip: 52,20 J 3. Telephone Number: 570,3 4. Date of Incident: ) 2- — 30 - 2022 5. Time of Incident: 1411 dcLt4 1 2 _ .--Pr-3 - 6. Location of Incident (Be specific): 2-8110 —Rh rJ 5L ee+ 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.) 8. What were weather conditions like? _�i l r C�x�G) Rn ,4)s (I �n1,ri U 9. Give name and address of any witnesses: n h 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). Iq �9 c.l c J � ova ; 1 e SerV`ItIen LL Gut icy S�-ee-+ cued 2g s-} a Pi na�-d S+, ✓� e�-��C:i, i o r� a real cal s , sl-r-ee-+ nepL-�r mL, V)bLAS vw�s�de_ �►- cuv�lex �I+ Sli-eP-A wQs e-Io °Je�l, e prDLeede _.T- d I'd hate ~I-o P" M r, P,,,,4-e.-t- A)r `Iron- 2se-r u if c.es - -ke- ro u i d ec z ha_ue c !osect rn y h �' I o� col a c-OPH 0-'P ml e��c�I)e�l chec_I� , 5eruice to e.Ye- pcu C !)h r� I i 6,-7 SLtYY � (� Q y Ocs S e r U 1 CE % (, LU e_ %1Gi tJ� tqo4 had an � el S met 4. 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.) 13. What other damages do you claim, if any? N /,q 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.) NC) 15. What atnount do you claim from the City of Dubuque? i14012—,38 16. Why do you claim the City of Dubuque is responsible? 17. Have you made any claim against anyone else for damages as a result of this incident? (if yes, give name and address.) 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 day of I-R-ri t l I az- 20 (Signature) ISc 1 i^i 22- LUG'_; IP,b^ (Print Name) (Rev. 5118) City of Dubuque City Council Meeting Consent Items # 03. Copyrighted January 17, 2023 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: Ashley Moore for vehicle damage; Denise Trieweiler for property damage. SUGGESTED Suggested Disposition: Receive and File; Concur DISPOSITION: ATTACHMENTS: Description I CAP Referrals 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: 1 /11 /2023 RE: Claim Against the City of Dubuque by Denise Trierweiler Claimant Date of Claim Date of Incident Nature of Claim Denise Trierweiler 1/10/2023 12/30/2022 Property Damage This is a claim in which claimant alleges Claimant's property was damaged due to a sewer line backing up into the Claimant's basement. 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 John Klostermann, Public Works Director Denise Trierweiler 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