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Claim by South End Tap Copyrighted May 20, 2024 City of Dubuque Consent Items # 02. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUMMARY: Paul and Paula Herrig forvehicle damage; Southend Tap LLC for property damage; Stacey Humke for vehicle damage. SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney DISPOSITION: ATTACHMENTS: Description Type Paul and Paula Herrig Supporting Documentation Claim by Southend Tap LLC Supporting Documentation Claim by Stacey Humke Supporting Documentation (1�1�YY� f� CLAIM AGAINST THE CITY OF DUBUQUE, IOWA c���,►� �,� ����.ii�,S�;�, 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. 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: ��linois Casualty Company as subrogee of Southend Tap LLC DBA Southend Tap S 2. Address: 225 20th Street C�{�; Rock Island State: Illinois Zip; 61201 3. Telephone Number: 309-732-0121; email: Recovery@ilcasco.com 4. Date of Incident: 02/16/2024 5. Time of Incident: 2:00 PM 6. Location of Incident (Be specific): 55 Locust Street, Dubuque, IA 52001 (Southend Tap) 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 of Dubuque was making repairs to the sidewalk outside the insured building when an object flew up from the sidewalk and hit the front exterior window causing damage, break/crack in front window 8. What were weather conditions like? Clear 9. Give name and address of any witnesses: Justin Rainey (Insured) 10. Did police investigate? (If so, give names of officers.) No 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, damage to exterior glass of building Damages: $1,790.63 13. What other damages do you claim, if any? None - property only 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.) Presenting claim as insurance company - Claim BP49188 15. What amount do you claim from the City of Dubuque? $1,790.63 (including insured's $1,000.00 deductible) 16. Why do you claim the City of Dubuque is responsible? Citv of Dubuaue was makinq the repairs to the sidewalk- resaonsible for anv debris and/or damaqe from the work 17. Have you made any claim against anyone else for damages as a result of this incident? (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 what amount? Dated at Dubuque, lowa this � day of May � 2024 _Cs��¢O-� �/4��'�� (Signature) Elyssa Springer (Print Namg� i �u� ' ,.-..._ ..,. _. � . � � ' �� �-_, _! �+� r3'� -- � �_ ,. _,>.. _. �.�_� � , ('+,? , , (Rev. 5/18) � , '��' ;� ��, Copyrighted May 20, 2024 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: Paul Herrig for vehicle damage; Southend Tap LLC for property damage; Stacey Humke for vehicle damage. SUGGESTED Suggested Disposition: Receive and File; Concur DISPOSITION: ATTACHMENTS: Description Type ICAP Referral 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: 5/9/2024 RE: Claim Against the City of Dubuque by Southend Tap LLC Claimant Date of Claim Date of Incident Nature of Claim Southend Tap LLC 5/1/2024 2/16/2024 Property Damage This is a claim in which claimant alleges that a window on claimant's business property was cracked and broken when an object from the sidewalk flew up and hit the window during City repairs to the sidewalk. This claim has been referred to the lowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager Gus Psihoyos, City Engineer Arielle Swift, Public Works Director Southend Tap LLC 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