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Claim by Jeff Kintzle
Copyrighted February 19, 2018 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUMMARY: Bard Materials for property damage, Kendall Coulson for vehicle damage, and Jeff Kintzle for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City Attorney ATTACHMENTS: Description Type Claim by Bard Materials Supporting Documentation Claim by Kendall Coulson Supporting Documentation Claim by Jeff Kintzle Supporting Documentation DBQ Fa� 2f712Q18 9:24 :29 AM PAGE �t��5 �ax �erver �� �� ����� �� �L.}�►IM A�A���T T�iE �1TY OF DUBUQUE, �fJWA ` This vwritten r�pc�rE constitu#es ye�ur clainn a�ain�t the City c�f D�u&�uque, ivwa. Yc►u sh��ald coce�plet�#his for� in fu11 artd�t4ach any addi�i�rr�al inforrrtatec�n that supports y�ur claisn. The Claim mus�b�e�led with#he Gity Clerlc z�� �i#y Ha1#, ��VV. '13��` a�., Guba�q�re, IA ?52�{��. I� will then �e r�eferred by th�e City �aun�il to the apprc��riat�e departcra��# for investiga�ic�n. Or���#�tat investigation is campA+�ted,a v�p�rrt artd recomm�ndatir�n v�rilt be submitte�to tl�e City Cc��n�oi. Y+�u�i1� be pr�vi�#�d wi#h a�c�py c�f fihat repvrt anc! recommendation. TI-�E �t1UAL C}ECf�K}!4t C}N AL�,C�.A1�1� IS MAt�E BY THE CtTY Gt��4NCIL.. N� E�E��.+CJY�� t�F � TN� C!T'9�' Q� [?t1BUQU� HAS �HE AUT'HQRlTY TG� MAKE A�l� REPRESENTAT1t'�N TC?YC�kJ � AS TC�WMETl�E��fC�UR CLA��t� WFLL ClF�WI�.L Nt}T B�P'AIC?. " q � �. fV�rn� �f G1��t�nt: ���� �� t ����,, �,,..� � 2. Acidr�ss: ��� M l. 1...,����"'T`� � ��`►.-�C��� � � i 3. T��ephr�ne Nunr�k�er: ��'� �" ��'� -y � �' � �' � � 4. C�ate caf tnci�+�rat. � 1 ��'�T' t��= ���� `��� �C� C� s j ,�,. �.. �� �� iI �, Tim� +�flra�id�n#; �e= `�"'� �,:�� � �v! .w," �� �' ;E h � � 6. Lac�tie�n c�f Incidl�rrt(Be��ci��)a r� ��'�� ��`�.�.'�� � ��i'' ��.c:�� C�� ��1�. '�C���.�. �o, ���c�r�� �����E���a ��������c� rN��c�us�c� ������ c�� o�n�ac��. ����� ful� e�eta�i�s c��aon v�rhi�h ye�u ba�� }��u� �lair�, tf a Ci�y ern�a�c�y�� wr�s inv�lv�d, giv� the emplc�yee's r��a��.} � ��..� -� ��`'�:.a d� ��...�C,.� � �� �h1� ���i.���� .��-� ` i � x � �'F� t1.�J�. ���-'� C..�4� C1 t.a �— �..,��.... � 8, What were�weat3��r c�ndition� �ik+�? 9�t`�t�� 1�� � �' � 9. Giv�nam�an�i acidress of ar�y witn��s�:s: 1�. Did poi�ce inuestigate? {If s�,giv�narr�es c�f afficer�.) $�� � 14. Was�ny�rne injuied� �If sc►, giv�names, acfdresses, �a��f extenf caf in�uries). � �� I , . � � � 5 D�Q ��� �/712��� �: 24 :�� A� PAGE 3l��5 Eax Server 12. Was �ny �iama�e dc�ne t+� prc�pe�ty? (if so, describ� property antf #he exter�t c�f � dama�es. At#ach esfimat�� of damages �ar de.�criE�� basis far ascer��inong extent e�f � darr►ac��,� �i�� . � t��..� t� °` ��,� � '!3. What oth�r da�na�ges d�yv�cla6m, if any? �C�t�� 14. Ma�ue yc�u been cc�rr�p�en�ated for ar�y part �ae ali af yo�r �lai� by aa�y in�uran�e company? (If sa, �irr�narne anc� a�dress of i�s�r�nc�cc+mpar���nd amaunt pai+�.} �� 1�. '�#3����nnc�aarat d� �c��a �laieva frczs�o tf���6ty cs�l�a���aq�ae? ,,,�, ° Nt.���i � ��Jct2. �� �s�.. � c� ��� ���� �6. Why c!o yau cl��r�tt�e Ci#�t�f Dubuqu�is respon��bl�? .� ��,J���. , � —' �}�= �.� �C..��:= �S-`'c.. C,a,3� � !,� ���i�'��' �V la�"�-�.'�a 9"�. Fiave you rr��cle ar�y�lairn agaa��#an�one el�e�ar damag��a� a m�esult cr�tl�i� incident? {Ef yes, give r��m� �nd adclr�.��.� �� 18. 1f#he a�tswer t� t�t�+es4ion 17 i� yes, have y�€� re�eir�ed any pay�nt frorrz that sc�urce, anc��f sa�, irt v�hh�t a�nc�a�nt`? � g � Dat�at C�utauq�ae, lo�nra�this ��day of ����'��`'�'`'� 2t} �� , � � (Sigr�at�ure} ���� � ) t�3�`�,t,,,,,� �Print Narne� � �.,� : (Rev. 7192� �`�� � � �- � �� _ � � � �; ��, .� . .� �� � ��� r;: , �.n� :�-n ,� `� -,�` ��� � � � � � f f � � � � � � � �- �� ��� ���� � ..�.,�. _ :_��—� � �� ���� � � ���� �It����� ���� �.,�,� � .�._u ����. ���. � _ _ � �» L�J l�� -� t� ��� t �, �� � � (...� �..t �.1� �, ,� �`1"� ��� � � �. �--- —_�-� -- --- _—�__� .�.,..,,W, ... ��y:�__ -.� ,.�.���_T_ �.�o�_.�.. — — /-�-�'" ��� I�.e1,�", �....-� ,� ��"� i �J ��� ���� -- �.� _ � ��, _— _ � _ — —�, s�.��.� � --�� ��-��� �a� �� � hS� _� �—�13 � �3 z� �.�-�"��..c _ _� � ���'��,��� °���-; ���-�,�� t.��-� t��r���:;� �7�� � �-�. �;��-�,,1� ��` �•? ��:, c�� �T 1�-� �};t���: .. - �— - - � � �����. ,�� � �:�..,�..� /�-�_��et�C's��_� � �� �3�� ��.� t�,� ��� �� � �'� �� � � ; ��� -.��` ��"�-t�.�`� �!���G 1�.�� �� �-�-i�k�'/.��i�� � _���_ __—�� �� �i� ��'—�a f�� � � �' �. ��� � �� �%�`��.r�� �.a�-� ' �;�� ��� �i"��s c�3 �r.� '�1 ���2�a� �� "�` �" ' ' �� ���� �� � �� ��� ������� ���`� .� � � �i� �7 ����I��� �-1�C��X�'� �c�-� ��3�..�' � 7� �.�� �� ������ !� �— ' ° � — _ �. __..��.� - ---�°.'`�-�.._ , �.��� t.���� �� � �--�` �"��� �tt � § . �� �..��� � 1�� �:� � � �� �. � �� � ����� � i�-�� ������ �� ���� � — - ; � � ��— �#�� �-. �, �=��. c�,�,���.r�. -- � �`� ���, `�=� � �-� �� ������ ��� � _ _ - - - -- _ _ �� A \ �''j y/p{ �,_ /� q/�V J f � � J 4r h✓ J .j♦ �G ..r'' ( �.��n��1 �-�� '��` """ � ,. f _ � � t�C.� � ��.���. c�9,�►� �t��,r�t����► . ; - - — - A_ - — � -- � �.���.`o ��� � 1�� ,� �r���� �� �� . 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ITEM TITLE: Disposition of Claims SUMMARY: City Attorney advising that the following claims have been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool: Bard Materials for property damage, Kendal Lee Coulson for vehicle damage, and Jeff Kintzle for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Supporting Documentation � THE CTTY QF D�.T� E MEMORANDUM Mc�ster�iece on the Mississippi TRACEY STECKLEIN PARALEGAL d {� � To: Mayor Roy D. Buol and � Members of the City Council � DATE: February 12, 2018 � , RE: Claim Against the City of Dubuque by Jeff Kintzle �� 7 Claimant Date of Claim Date of Loss Nature of Claim % Jeff Kintzle 02/12/18 02/05/18 Vehicle Damage � I This is a claimt�in which claimant alleges that during the late evening/early morning of � February 5 /6 , the blade from a City of Dubuque snow plow truck struck and damaged � the rear driver side of claimant's parked vehicle. B This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa � Communities Assurance Pool. ' � � cc: Micha�l C. Van N!illig�n, City Manager � John Klostermann, Public Works Director Jeff Kintzle � � � � � � OFFICE OF THE CITY ATTORNEY DUBUQUE, (OWA � SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 � TE�EPHONE (563)583-4113/Fax (563)583-1040/Ennai� tsteckle@cityofdubuque.org g � � � i