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Claim by Brian Ward Copyrighted February 6, 2023 City of Dubuque Consent Items # 02. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUM MARY: Tara Behnke for vehicle damage; Dubuque County for personal injury/property damage; Gerardo Flores for property damage; Richard and Julie Hardorff for property damage; Lindsey Hoyne for vehicle damage; Laura Knabel for personal injury/vehicle damage; Kelly Otting for personal injury/property damage; Brian Ward for personal injury. SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney DISPOSITION: ATTACHMENTS: Description Type Claim by Tara Behnke Supporting Documentation Claim by Dubuque County Supporting Documentation Claim by Gerardo Flores Supporting Documentation Claim by Richard and Julie Hardorff Supporting Documentation Claim by Lindsey Hoyne Supporting Documentation Claim by Laura Knabel Supporting Documentation Claim by Kelly Otting Supporting Documentation Claim by Brian Ward Supporting Documentation MVM Legal J. Klosterman CLAIM AGA�NST THE CITY OF DUBUQUE, IOWA A. Swift This written report constitutes your ctaim agains� the City of Dubuque, lowa. You should complete this form in full and attach any additional informatian that supporfs your claim. - The Claim must be fi�ed wi#h the City Clerk at City Hall, 50 W. 13t'' St., Dubuque, IA 52U0'I. It will then be referred by the City Council to fihe appropriate dep�rtment for investigation, Once that in�estigatian 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 AUTHOR�TY TQ MAKE ANY REPRESENTATION TO YOU A5 TO WHETHER YOUR CLAIM WII.L OR WfLL NOT BE PAID. 1. Name of Claimanfi: Brian Luis Ward 2. Address: 1951 S. Grand�iew Avenue _ City:___ Dubuque _ __ State: lowa Zip: 52003 _ . .__ ..._ . .3. _Telephone Number: (563} 231-0285 � 4. Date of Incident: J��y �, �a22 � -- - ---- - -----_ 5. Time of Incident: _12:53 pm � . ,.., � 6. Location of lncident (Be specific). At the intersectian of South Grandview Avenue and � Rackdale Road in Dubuque, lawa � 7. DESCRIBE ACCIDENT OR QCCURRENCE THAT CAUSED INJURY OR DAMAGE. �Give full details upon which you base your claim. If a City employee was in�olved, give the employ��'s name.) Claimant was bikin on S. Grandview Auenue when Justin 5teckel, a cit em lo ee, dri�in a cit owned �ehicle, failed to abey a stop sign and yield the right of way. Steckel hit Claimant, causing injury. 8. What were weather conditions like? Sunny and humid � 9. Give name and address of any witnesses: Nane 90. Did police investigate? {If so, give nam�s of officers,) Yes. Report was made by affic�r Bailey Paulsen and reviewed by Jay Morrissette. See attached. 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). Yes. Claimant suffered inlury to his feft shouider, left chest, left hip, and head, he also experienced bruising in his bifateral lorn+er legs, See attached medica! records. 12. Was any damage dane ta property? (If so, describe properfiy and the extent of ciamages. Aftach estimates of damag�s or describe basis for ascertaining exfent of cfamage.) Yes. The cost of re air the bike was $�45.50. See attached invoice. The helmet was a roximatel $150.Q0 to replace. 13. What other damages do you claim, if any Medical, pain and suffering, lost wages, loss of full mind and body. 14. Ha�e you been compensated for any part or all of your claim by any insurance campany? (If so, give name and address of insurance company and amount paid.) Wellmark Blue Cross Blue Shielc� of lowa, 1331 Grand Ave., Des Moin�s, IA 5Q309. Wellmark has paid $707.74. 5ee attached explanation of benefits. 15. What amount do you claim from the City of Dubuque? The full amount has not yet been determined as #he extent of Claimant's injuries is still unknown. Hawe�er, Claimant currently has paid and outstanding medical �ills totaling $19,420.55. �6. Why do you claim the City of Dubuque is responsible? Justin Steckel was working for the City of Dubuque at the #ime of the accident. H� pled guilty to failure to obey stop sign and yield right of way on July 10, 2022. S�� attached copy of guilty plea. 17. Have you made any claim against anyone else far damages as a result of this incidenfi?(If yes, give name and address.) No. 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in w�at amaunt? No. Dated at Dubuque, I�wa this �� day of �GlvlriUtY�/ , 20�. {Signature) Brian L. Ward {Print Name) Received via email {Re�. 5118) January 13, 2023 4:22 p.m. Copyrighted February 6, 2023 City of Dubuque Consent Items # 03. City Council Meeting ITEM TITLE: Disposition of Claims SUMMARY: CityAttorneyadvising thatthe following claims have been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool: Tara Behnke for vehicle damage; Dubuque County for personal injury/property damage; Gerardo Flores for property damage; Richard and Julie Hardorff for property damage; Lindsey Hoyne for vehicle damage; Laura Knabel for vehicle damage and personal injury; Mark Laird for vehicle damage; Kelly Otting for personal injury/property damage; Brian Ward for personal injury. SUGGESTED Suggested Disposition: Receive and File; Concur DISPOSITION: ATTACHMENTS: Description Type ICAP Referral Supporting Documentation THE CTTY OF DUB E MEMORANDUM Masterpiece on the Mississippi � ONI MEDINGER LEGAL ADMINISTRATIVE ASSISTANT To: Mayor Brad M. Cavanagh and Members of the City Council DATE: 1/18/2023 RE: Claim Against the City of Dubuque by Brian Ward Claimant Date of Claim Date of Incident Nature of Claim Brian Ward 1/12/2023 7/5/2022 Personal Injury This is a claim in which claimant alleges Claimant's was injured after a City vehicle struck Claimant while he was riding his bike. 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 Brian Ward OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 3OO MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)589-4113/Fax (563)583-1040/EMai� jmedinge@cityofdubuque.org