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Claim by Halanier HolmesCity of Dubuque City Council ITEM TITLE: SUMMARY: SUGGUESTED DISPOSITION: ATTACHMENTS: Copyrighted November 18, 2024 CONSENT ITEMS # 2. Notice of Claims and Suits Halanier Holmes for vehicle damage; Jamie Joe Doyle for vehicle damage; Keon Killins for vehicle damage, Receive and File; Refer to City Attorney 1. Claim by Halanier Holmes 2. Claim by Jamie Joe Doyle 3. Claim by Keon Killins Page 97 of 1454 M V VIn L;e)- O-A CLAIM AGAINST THE CITY OF DUBUQUE, IOWA V,�`',`r- w"f-c" �Vt T415�N4 lk�zl Sw�� 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. 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: p% L rl A 1 cr t 2. Address: City: State: 17 L Zip: 5� 0 0 3. Telephone Number: 319 - q (o I - 7d 4 0 4. Date of Incident: 0 Zr v t� 5. Time of Incident: A rovnJ TJS P!vi 6. Location of Incident (Be specific): Pe, r (i a NP.a r t � c Q U 4-0 '�L oil 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.) T w rr S O A my W, °l � o m c 0 /1 rid ck l r k s Z- U l' I V' 15 q 1 oc M ,vl y vuu ( GIB 8. What were weather conditions like? M V t i41,14V 9. Give name and address of any witnesses: D I Q M 0 11uv,� A d n 3 (o 7 Pt4 ,1 Avc UG 4 u c A 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). N 0 Page 98 of 1454 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.) CufallO 13. What other damages do you claim, if any? .b 0, M ite-� r� (� .� d U ��✓� T 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.) 15. Ahat amount do you claim from the City of Dubuque? }, you , 16. Why do you claim the City of Dubuque is responsible? T � ,, +-rus 1'r,C e � C -i�i n S `� 0 r A uc `MC, , tv ' � , u rM �LA 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) ' 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so,' what amount? Dated at Dubuque, Iowa this 3 i� day of 0 C f L ✓ 20�Li. ignature) �, �1 !1 t✓�' �� I P>o►I (Print Name) (Rev. 9124) Page 99 of 1454 Copyrighted November 18, 2024 City of Dubuque City Council CONSENT ITEMS # 3. 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: Halanier Holmes for vehicle damage. SUGGUESTED Receive and File; Concur DISPOSITION: ATTACHMENTS: 1. ICAP Referral Page 104 of 1454 THE CITY OF DUB UE MEMORANDUM Masterpiece on the Mississippi JONI MEDINGER LEGAL ADMINISTRATIVE ASSISTANT To: Mayor Brad M. Cavanagh and Members of the City Council DATE: 11 /6/2024 RE: Claim Against the City of Dubuque by Halanier Holmes Claimant Date of Claim Date of Incident Nature of Claim Halanier Holmes 10/31/2024 10/30/2024 Vehicle Damage This is a claim in which Claimant alleges Claimant's vehicle was damaged due to a fallen tree. This claim has been referred to the Iowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager Steve Fehsal, Park Division Manager Halanier Holmes 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 Page 105 of 1454