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Claim by Madeline and Paul HaverlandCity of Dubuque City Council CONSENT ITEMS # 2. Copyrighted March 3, 2025 ITEM TITLE: Notice of Claims and Suits SUMMARY: Samantha Duehr for vehicle damage; Alan Feldmann for personal injury; Madeline and Paul Haverland for vehicle damage. SUGGUESTED Receive and File; Refer to City Attorney DISPOSITION: ATTACHMENTS: 1. Claim by Samantha Duehr 2. Claim by Madeline and Paul Haverland 3. Claim by Todd Klapatauskas, Esq on behalf of Alan Feldmann Page 49 of 629 rn\)m CLAIM AGAINST THE CITY OF DUBUQUE, IOWA 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. 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: 2. Address: City: �v. cu c_ State:, u, Zip: S�r,Zo o 3. Telephone Number:6 4. Date of Incident: 5. Time of Incident: 6. Location of Incident (Be specific): 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.) NOW - it , f� • 8. What were weather conditions like? L x 9. Give name and address of any witnesses: 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). Page 52 of 629 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.) 13. What other damages do you claim, if any? 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. What amount do you claim from the City of Dubuque? 16. Why do you cl�T the City of Dubuque is� responsible? Q�v ° - 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, in what amount? "' ../ ILC� Dated at Dubuque, Iowa this 0 day of ��e Nz,c r j , 20A!51. (Rev. 9/24) (Signature) (Print Name) z .COw.. CD MID _ r (D Page 53 of 629 City of Dubuque City Council CONSENT ITEMS # 3. Copyrighted March 3, 2025 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: Gerald Breitbach for vehicle damage; Samantha Duehr for vehicle damage; Alan Feldmann for personal injury; Madeline and Paul Haverland for vehicle damage; Robert Hochrein for vehicle damage. SUGGUESTED Receive and File; Concur DISPOSITION: ATTACHMENTS: 1. ICAP Referral Page 56 of 629 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: 2/19/2025 RE: Claim Against the City of Dubuque by Madeline and Paul Haverland Claimant Date of Claim Date of Incident Nature of Claim Madeline and 2/18/2025 2/14/2025 Vehicle Damage Paul Haverland This is a claim in which Claimant alleges Claimant's vehicle was damaged by a City snowplow. This claim has been referred to the Iowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager Arielle Swift, Public Works Director Madeline and Paul Haverland 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 60 of 629