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Claim by Lori Meyer Copyrighted October 16, 2023 City of Dubuque Consent Items # 02. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUM MARY: Jill Boge for vehicle damage; Mary Burke for vehicle damage; Linda I rish for vehicle damage; J P Gasway Co I nc for vehicle damage; Lori Meyer for property damage; Mercy One Medical Center for property damage; Erica Nelson for vehicle damage SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney DISPOSITION: ATTACHMENTS: Description Type Claim by Jill Boge Supporting Documentation Claim by Mary Burke Supporting Documentation Claim by Linda Irish Supporting Documentation Clim by Mercy One Medical Center Supporting Documentation Claim by Lori Meyer Supporting Documentation Claim by Erica Nelson Supporting Documentation Claim by J P Gasway Co Inc Supporting Documentation (����l �f 5 �c_..�j�i :� ;.� �� ., ��,. CLAIM AGAINST THE CiTY OF DUBUQUE, IOWA This written report constitutes your claim against the City of Dubuque, lowa. You should complete this farm in full and attach any additianal information tha# s�pparts yaur claim. The Clairti must be filed with the City Cl�rk at City Hall, 50 W. 13t'' St., Dubuque, lA 52001. It wili ther� be referred by th� City Council to the appropr9ate department for investigation. Once that investigation is completed, a report and recommendation will be submitted to fhe City Councif. You will be provided with a copy of tha� repart and recommendation. THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE C{TY COIJNCIL. NO EMPL�YEE OF THE CITY �F DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO YOU AS T� WHETH�R Y�UR CLAIM WILL OR WIl�L NQT BE PAID. '�. N�m� of Claiman#� �_bf� � ��L��I� � ,_�r" 4 2, Address: " �'� � � C c- City: ���� ��uf' State: ,`; ,.��L, Zip: �SvZ(��i3� 3. Telephone Number: r5�,-3 `p y S ' `�(����� 4. Date of Inciden�: ���f �J , �� .3 5. Time of Incident: � ,��� U�-�--, �..f[�` 3(� ��r�v� ---- —� 6. Location of Incid�nt (Be specific}: L-z � �1,-�c`,� �,�^- � � ;�G '�-• �, � �� �;� 4: ���f.! 67�.\--��� �> >Y1 V\Yt1lC r(,i J 7. DESCRIBE ACCIDEN7 OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Gi�e full details upon which you base your claim. If a City ernployee was in�olved, gi�e the employee's name.) �. Q` - ��� � � �'� �� � � U � � C�� f?r: ,� �'. ,r ��-l`j��v, �L--� �`V� �'.n�n lfti i t"` ' �`��^'r"� C���'� �1�u����_ ��w� ��' C �� " v <: �`� ' t� " _ , , �a J�_C. U. �' � ' t 1 C' W^E'.� � 8. What were weather condi�ions like? N; c.rz. c`��v�. ,�`��S ���l�r �Y�!,,.,�-���� 9. Gi�e name and address af any witnesses: d�� J,= +U`�1'1 (� � 10. Did police in�estigate? (If so, give names of officers.} �L�.� ��.`� ��'�� Y��! �C`W��. 11. Was anyone injured? {If so, gi�e names, addresses, and extent of injuries). ��� 12. Was any darnage done ta property? (If so, describe property and the extent of damages. Attach estimates of dama�es or describe basis for ascertaining extent of damage.} l� � �_ � � ` ` '�. �(�S � �� r'��r� ��l�i� r--�C:_� �i��i�n �c�.`it.� CT'10 (�'��' � { c�v'l'�-c 1��.��v�� . -., �i� C�'� e � r��,��?c'� � ��� �_�.���f�'�,C.�f����,.�: 1� �S 1�..��.-�v-� � L�, ��- ' 1�,��j[;�C�-- �v� �� '' � � 13. What other darnages d ou claim, if any? _ �'�� _..._. .. - - .. - 14. Ha�e you been compensated for any part or all of your claim by any insurance compar�y? (l�so, give name and address of ia�surance com�any and arnount paid.) �,, 1�. Wha� amount do you claim from th� City af Dubuque? ' r ` v L -�'•� ' � � ' V'�C-� S�l,��c� ' �� 1 Ft:� ����<<���{-h:�.��-11��+�--� 16. W�y do you claim �he City of Dubu ue is respo sible? �� r " � r , ��� � '�� t.��4CC E' : r'1' 3l..iL�C;� t ~ �i��� � �� c�. --, r'C°�v� .�,� C?;-L 5'�a . �c-� �'�v�,r r� c.��c��.1 c� tri v---��3c�, �7 c�t�., ` �•-'ti� ' , V� �`� 17. Ha�e you made any cfaim against anyone else for damages as a resu7� -o�h�is inciden�?C��-� (If yes, give name and address.) �2`� 18. I� the answer to Question 17 is yes, have yau recei�ed any payment from that source, and if so, in what amaunt? Dated at Dubuque, lowa this day of , 20 r � ��- � (Signature} ` ��rr {Print Name) � �. s i _ �,_ ', - . ��:_..`: _ = y. � . `� __�.i �� (Re�. 5118) ., �,- � Copyrighted October 16, 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: J ill Boge for vehicle damage; Mary Burke for vehicle damage; Linda I rish for vehicle damage; Lori Meyer for property damage; Erica Nelson for vehicle damage; J P Gasway Co I nc for vehicle damage SUGGESTED Suggested Disposition: Receive and File; Concur DISPOSITION: ATTACHMENTS: Description Type PERS Jill Boge Supporting Documentation PERS Mary Burke Supporting Documentation PERS Linda Irish Supporting Documentation PERS Lori Meyer Supporting Documentation PERS Erica Nelson Supporting Documentation PERS- P J Gasway Supporting Documentation THE CTTY OF DUB E MEMORANDUM MasterpTece on the Mississippi � ONI MEDINGER LEGAL ADMINISTRATIVE ASSISTANT To: Mayor Brad M. Cavanagh and Members of the City Council DATE: 10/4/2023 RE: Claim Against the City of Dubuque by Lori Meyer Claimant Date of Claim Date of Incident Nature of Claim Lori Meyer 10/3/2023 9/25/2023 Property Damage This is a claim in which claimant alleges Claimant's property was flooded after a City watermain break causing water to flow around Claimant's property. 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 Lori Meyer 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