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Claim by Horsfield Materials, Inc. Copyrighted June 4, 2018 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUMMARY: Sarah Cassella for property damage; and Horsfield Materials, Inc., for vehicle damage; City of Dubuque vs. Gary Bernhard et al.; City of Dubuque vs. Frederick J. Kammiller I I I, et al. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City Attorney ATTACHMENTS: Description Type Cassela Claim Supporting Documentation Horsfield Materials, Inc. Claim Supporting Documentation City vs. Bernhard Suit Supporting Documentation City vs. Kammiller Suit Supporting Documentation ��� � CLAIM AtaA1�+1�T T�-IE CITY t?F DUBUQUE, IQ1NA ���b� �`����-� ° � This wr'rtfi�n report constitufes yQur claim agair��t th� City of Dub�q�ae, Ic�wa. You should � cample�e this form in futl and attach any additivnal infc�rmation th�t suppc�rts your claim. The �laim must be fii�ed wifh the Ci�y Cl�rk �t City Hall, 50 W. '13t� �t., Dubuque, IA 52Qt}�. It will then be referred by the City Council ta the appropriate department fior inve�tigation. i �D�c� #h�# 6��r���cg��6a�r: �� ^��ple��ds � r�przr� �nd r�ct����r�d��or�� ��6E '�� �o�bam6t�t�d t� #h� � Gity Council. You wil! be provided with a copy of that repc�r� and recommendatian. � THE FINA� D�CI�It�N ON ALL CL.AIM� !S M,�DE BY THE GITY COUNCII.. Nt� EMPLC?YEE UF � THE CITY QF E�UBU(�UE HAS THE AUTHf)RITY TO MAKE ANY REPRESENTATt(}N TO YOU � AS TO WNETHER YOUR CL.AIM WILL C3R W[LL. NC}T BE PAID. ;; � 1. Name c�f Claimanfi: �°���,������ ,����°,�� ��, �� c. - ', � � .�.. � , � �. Address; ��� � r ����� � ¢ � � � ��� ��� ' � f y; � � .��- Z��; �c�c'�5�f'��" n Cit �� � State' t �I 3. Telephc�n� Nu€m�er: ��':� � ���� �--���� � i 4. Date af Inc�dent: `����. B � �° � �� '�I 5, Tim� vf Incident: �� ��� �� p �-�,�P�.���� �'��f�t� � . ,..� i 6. Lecati�n of Incident (Be specific}: ��A�t � ���i ��� � ��' � �� �� ��.. � � � � � 7. DESCRIBE /���IDENT t}R C3CCURRENCE THAT CAUSED INJURY aR C}AMACE. (Give g full detai{s upon which you base ycaur claim. If a City employee was involved, give the � employee's name.) ��.c.�'' ���!`�'� "9�'"��� �uc�,�` �,s'��� ��' �� �� �,�°� �_�� �� �t� � �'�r �C����... ��p�`�� ��r2�� ��7���'�� ��u�°°� `���. �,..� �A`m""'�*°. ���:a�' �A"a° �� °°J.�(f a.��� ��,.+� � c`���"' �. �� �S��a,`G� �L, ua�r c�`r�� �a� �fy� � ����f� ���� c��r,� ��`,'.at,�� `�y`�e� °'� ���� 8. What were wea�h�r conditions like? � � 9. Give name and address of an� witnesses. m� � ��� ��r��`�%���� �� ��. '[Q. Did police investigate? {If sQ, �ive names ofi o�icers.} �� � , �1. Was anyone in�ured? (If sa, give nam�s, addresses, and e��ent of i�juries}. �� ' � � � �� � � � , ; 0 � 12, Was any damage dane to prc�perty? {If sv, descr"rfae prvperty ar�c� fihe extenfi of damages. Attach e�timates of damag�s or describe basis for �scer~taining extent af damage.) � �~ s /' 3 „1` ��:t�� „S""��'cx' �� t.�'�`"� �''.��{� a"�°'t��f�cr�' �..� ��e�^'- .✓�e i,A� ��"'° ` � � � � � rG ' ���"�'t 6uC ����-m�'t� , a � 13. What other damages do yvu claim, if any? �`'.��. '14. Have you been comp�nsated for any part c�r a[1 of your claim by any insurance company? 41f so, give name and address of insurance compar�y and amount paid.} � �f} k Ld' � � 3 e 15. Wha# amot�nt dc� you claim from the City of Dubuque? ;; 8.✓'r.�n p'`I � t��, � t" �° w�e��,�n,'�, �`�c,�/ �c�a'@�" �t�r�` ,�"3�'s��°'c��`.. � � 1fi. W�y do yau cla�im the ity +�f Dubuque is respvnsible? �e !' ���" �3� .���..a �'� � :�� ��...r- �r:,�,t't�' ������' ?� s � � � �17. Ha�re yau made any claim against anyane else fc�r damage� as a re�ult of this inci+den�t? u (If yes, give name and addres�.} ; � a � ; � '18. If fihe answ�r tc� t�u�stian 17 is yes, hav� you received any paymenfi from t�at source, ; � and if so, in what amc�unt? i ��-..�...- � � Da�ed at Dubuque, lowa th�s � day 4f , 2��� . � x � � .� ,� � � �`��,� � � C���'�r.����i- ���s�,��'���`� (Signature� ��.��.- ���°!�� � {Print Namej � �� � �':°'� �� �� f i r ���i� Rv� � . �..�„�.� �»�}a°; q a t �fF�F �R � �J G�.3 �" � �� {� U7� � �R�V. �/'��? w'�' �� �.--; ��;:.7 ``� �' '� �..,..� � � � � � , "d Copyrighted June 4, 2018 City of Dubuque 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 lowa, the agent for the lowa Communities Assurance Pool: Sarah Cassella for property damage; SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Staff Memo THE CITY OF DUB E MEMORANDUM Masterpiece on the Mississippi TRACEY STECKLEIN � PARALEGAL To: Mayor Roy D. Buol and Members of the City Council DATE: May 30, 2018 RE: Claim Against the City of Dubuque by Horsfield Materials, Inc. Claimant Date of Claim Date of Loss Nature of Claim � Horsfield Materials, Inc. 05/29/18 05/22/18 Vehicle Damage This is a claim in which claimant alleges that while claimant's truck was parked at 3371 Kimberly Drive, a City of Dubuque Public Works truck passed by and scraped the mirror on claimant's truck. � This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager John Klostermann, Public Works Director Steve Stoffel, Horsfield Materials, Inc. OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/FAx (563)583-1040/EMAi� tsteckle@cityofdubuque.org