Claim by American MarineCity of Dubuque
City Council Meeting
Consent Items # 02.
Copyrighted
July 15, 2024
ITEM TITLE: Notice of Claims and Suits
SUMMARY: Ross Dolphin for vehicle damage; Felderman Realty for property
damage; Hennessey Fortman for vehicle damage; Olivia Hansen for
property damage; Richard Hess for property damage; American Marine
for vehicle damage; Othman Mokhantar for property damage; Sarah
Weekley for vehicle damage.
SUGGESTED Suggested Disposition: Receive and File; Refer to City Attorney
DISPOSITION:
ATTACHMENTS:
Description
Claim by Felderman Realty
Claim by Ross Dolphin
Claim by Hennessey Fortman
Claim by Olivia Hansen
Claim by Richard Hess
Claim by American Marine
Claim by Othman Mokhantar
Claim by Sarah Weekley
Type
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
Supporting Documentation
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA M
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.
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1. Name of Claimant: A t I
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2. Address: t Oi)h
City: lewuw State: -Je2cDCA, zi P:
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3. Telephone Number: I's (0 a, - �,-_s q 2 Cl , Is 10 q
4. Date of Incident:
5. Time of Incident:
6. Location of Incident (Be specific): AneriCqrl AW i0g, 4n e
fo ras g, bqc, k
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.)
7
8. What were weather conditions like?
9. Give name and address of anywitnesses: -rvler Lco"nel,-s. 50-2-q)-0109
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10. Did police investigate? (if so, give names of officers.)
11. Was anyone injured? (if so, give names, addresses, and extent of injuries).
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.)
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4 AC K,
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13. What other damages do you claim, if any? Au X W1 *1 M J 0 W
14. Have you been compensated for any part or all of your claim by any insuranc.
company? (If so, give name and address of insurance company and amount paid.) 11
16. Why do you claim th City of Dubpque is responsible?
c4v wo r ired %roire, P4 0'r 1W ih ofo W
17. Have you made any claim against anyone else for damages as a result of this incident?
(if yes, give name and address.)
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18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount?
MO
Dated at Dubuque, Iowa this day of UAR 20
(Signature)
(Print Name)
City of Dubuque
City Council Meeting
Consent Items # 03.
Copyrighted
July 15, 2024
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: Ross Dolphin for vehicle damage; Felderman Realty for
property damage; Hennessey Fortman for vehicle damage; Olivia Hansen for
property damage; Richard Hess for property damage; American Marine for
vehicle damage; Othman Mokhantar for property damage; Sarah Weekley for
vehicle damage.
SUGGESTED Suggested Disposition: Receive and File; Concur
DISPOSITION:
ATTACHMENTS:
Description
I CAP Referral
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: 7/2/2024
RE: Claim Against the City of Dubuque by American Marine
Claimant Date of Claim Date of Incident Nature of Claim
American Marine 6/28/2024 5/16/2024 Vehicle Damage
This is a claim in which Claimant alleges Claimant's vehicle was damaged when a rock
was kicked up by a City lawnmower and hit their rear window.
This claim has been referred to the Iowa Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
Arielle Swift, Public Works Director
American Marine
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