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Claim by American Family Insurance a/s/o Johnny HillCity of Dubuque City Council ITEM TITLE: SUMMARY: SUGGUESTED DISPOSITION: ATTACHMENTS: Copyrighted November 17, 2025 CONSENT ITEMS # 2. Notice of Claims and Suits Johnny Hill for vehicle damage; Mark Stender for vehicle damage. Receive and File; Refer to City Attorney 1. Claim by American Family Insurance aso Johnny Hill 2. Claim by Mark Stender Page 101 of 750 MVM Legal Jeremy Jensen CLAIM AGAINST THE CITY OF DUBUQQUE, 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. 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 prodded 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 DE PAID. 1. Name of Claimant: American Family Insurance a/s/o Johnny Hill ( insured ) 2 Address: 6000 American Parkway City: Madison State: WI Zip: 53783 3. Telephone Number: 800-692-6326 4. Date of Incident: October 15, 2025 5. Time of Incident: 3:15 pm 6; Location of Incident (Be specific): 700 Block of Main Street Dubuque IA 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.) Police officer Joel Cross was pulling into street parking in front of the parked unoccu ied American Family_vehicle Office Cross miss judged space and struck the parked vehicle 8. What were weather conditions like? not a factor 9. Give name and address of any witnesses: n/a 10. Did police investigate? (If so, give names of officers.) office invoilved and filed report: Joel Christopher Cross 11. Was anyone injured? (if so, give names, addresses, and extent of injuries). no phyiscal injuries Page 102 of 750 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 photos and estiamte included in packet. Point of impact Driver Side Front Bumper Corder 13. What other damages do you claim, if any? no 14. Have you been compensated for any part or ali of your claim by any Insurance company? (if so, give name and address of insurance company and amount paid.) yes, insured paid estimate of damages less the isnured collision deductible (per auto polciy) listed on letter 15. What amount do you claim from the City of Dubuque? all damage = $ 1,335.36 16. Why do you claim the City of Dubuque Is responsible? The pollee office was pulling into a street parking space and struck teh parked unoccupied Insured vehicle owned by Johnny Hill 17. Have you made any claim against anyone else for damages as a result of this incident? (if yes, give name and address.) only filed damages under auto insurance policy American Family Insurance 6000 American Parkwy Madison UVI 53783 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, In what amount? Insured chosen repair shop was paid $832.36 , inusred paid $500.00 which needs to be reimbrused Dated at Dubuque, Iowa this 6 day of November 1 2025 igpature) Eileen Janssen Subrogation Adjuster (Print (dame) (Rev. 9/24) Page 103 of 750