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Claim by Colin Hollenback Copyrighted March 6, 2023 City of Dubuque Consent Items # 02. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUM MARY: Brenda Atkinson for property damage; Jacqueline Budde for vehicle damage; Colin Hollenback for vehicle damage; Victor Mowery for vehicle damage; Tonia Nicholson for vehicle damage; Wayne Ramaker for vehicle damage. SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney DISPOSITION: ATTACHMENTS: Description Type Claim by Brenda Atkinson Supporting Documentation Claim by Jacqueline Budde Supporting Documentation Claim by Colin Hollenback Supporting Documentation Claim by Victor Mowery Supporting Documentation Claim by Tonia Nicholson Supporting Documentation Claim by Wayne Ramaker Supporting Documentation rn� ���.i CLAIM AGAINST THE CITY OF DUBUQUE, IOWA C��r�S' �S'fr.� This written report constitutes your claim against the City of Dubuque, lowa. 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. 13t" 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: Colin Hollenback 2. Address: Mailing Address: 155 E 12th Street Address: 988 Indian Ridge Cit Dubuque IA Y� State: Zip: 52003 3. Telephone Number: 563-451-6221 4. Date of Incident: 02/24/23 5. Time of Incident: 10:41 6. Location of Incident (Be specific): Parking lot to the South of 2617 University Ave Dubuque, lA 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.) City Employee- Jason Patrick Ellis, drove into private parking lot and struck 2001 Dodge pickup Vehicle registration was in process. All sale and registration documents attached. 8. What were weather conditions like? ICE 9. Give name and address of any witnesses: 10. Did police investigate? (If so, give names of officers.) Police were called, filed report 2023-001342 Officer Bradley Hesselbacher 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). No 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.) Yes- Passenger side door, window, front wheel/tire. Pictures attached. 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.) None 15. What amount do you claim from the City of Dubuque? $2 g50.00 16. Why do you claim the City of Dubuque is responsible? City employee struck parked vehicle in private lot. Police report attached 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) None 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, lowa this 27 day of February 2023 . , _ �/ ������ (Signature) ��l�� � `�'���%���� (Print Name) � �� � � -r. � ;i' r� J __ I'T (Rev. S/18) �' -= - l._.' r; �� Copyrighted March 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: Brenda Atkinson for property damage; Jacqueline Budde for vehicle damage; Steven Grutzmacher for property damage; Colin Hollenback for vehicle damage; Michael Lange for vehicle damage; John Lockwood for vehicle damage; Victor Mowery for vehicle damage; Tonia Nicholson for vehicle damage; Wayne Ramaker for vehicle damage. 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: 3/1/2023 RE: Claim Against the City of Dubuque by Colin Hollenback Claimant Date of Claim Date of Incident Nature of Claim Colin Hollenback 2/27/2023 2/24/2023 Vehicle Damage This is a claim in which claimant alleges Claimant's vehicle was damaged when it was struck by a City vehicle. 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 Christopher Lester, Water Department Manager Colin Hollenback 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