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Claim by Jerald Kinsella Copyrighted September 17, 2018 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUMMARY: Kelly Casperson for vehicle damage, Jerald Kinsella for property damage, Gerald Klein for property damage, Abby McGrane-Ralston for vehicle damage, David Prince for vehicle damage, Steve Ruden for property damage, Daniel Scott for property damage, Sisters of the Presentation for property damage, Brock Tyner for vehicle damage, Morgan Weaver for vehicle damage, Doug Winner for vehicle damage, Suit by Michael and Jacqueline Wood for vehicle damage/personal injury. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City Attorney ATTACHMENTS: Description Type Casperson Claim Supporting Documentation Kinsella Claim Supporting Documentation Klein Claim Supporting Documentation McGrane-Ralston Claim Supporting Documentation Prince Claim Supporting Documentation Ruden Claim Supporting Documentation ScottClaim Supporting Documentation Sisters of the Presentation Claim Supporting Documentation Tyner Claim Supporting Documentation Weaver Claim Supporting Documentation Winner Claim Supporting Documentation Wood Lawsuit Supporting Documentation ��r�p C�� CLAIM AGAINST THE CITY OF DUBUQUE IOWA � :�i��c � � �"�-`u�`�!G, 1n,��'"�S � This written report constitutes your claim against the City of Dubuque, lowa. 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 recomrr�enda#ion will be subrnitted to the 'i City Council. You will be provided with a copy of that report and recommendation. ,; � ii THE FlNAL DECISION ON ALL CLAIMS iS MADf BY TFiE CITY COIJNCIL. 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. �I �� ,a 1. Name ofi Claimant: � �► ��r� ��-��i�' ;; �; `�'�3 �' � �� ;i 2o Adc�res�: � �� City: �'� State: �� Zip: �� ; �: I 3. T�lephone Nu�abe�: ��`� �tll- C�"�� ,: r 4. Date of Incident: �'� �� '� � /�� 5. Time of Incident: /¢�� -�'1 ��$�`� i 6. Location of Incident Be s ecific : ��j� ��'�`��°`� � � p ) I'� ��r��,�',�� ,��. P---- i�'1 r:�d�`�� c� �- S"(,r�.��: E E 7. DESCRI�E ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give f full details upon which you base your claim. If a City employee was involved, give the employee's name.) _.. � ; �i�,-�l��p�' .;'�t.ecr�.. ��,-�� I � 8. What were weather conditions like? ��vvr��f «— �� 9. Give name and address of any witnesses: �i�.-�►a�� "`��e�� 10. Did police investigate? (If so, give names of officers.) , �1� " i I 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). � � i �a I � i 4 �i � �, 12. Was any damage done to property? (If so, describe property and the extent of i damages. Attach estimates of damages or describe basis for ascertaining extent of � damage.) i` ,/� � ��I� tr� fi1J�l��r- cV �e ��-.��n e�..�� 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.) �� I'� � � i 15. What amount do ou claim from the City of Dubuque? `� � �'�i�. P �-� ��. `� �..� ��-� �� '7� �C> � � 16. VVhy do you claim the City of Dubuque is responsible? ;.�„� .� � , ��. r�� ,; �,�l��- �`YYI�d�° F W ��, r� 1 f�''e:��~_-�� % , 1 � �� '-�r�� -d�- ��/< i�� -� `�-�'l; �%��l �t't-1, L ��. t�l�.��°-r'��" -w L�ra-��Pq��l� : 17. Have you made any claim against anyone else for damages as a result of this incident? ""� (If yes, give name and address.) �`��' ' 1�. If the ansvver to Question 17 is yes, have you receiveci any payment from that source, anci if so, in what amount? �r� Da#ed at Dubuque, lowa this � day of `�'`� �' �� , 20 i� a � �� `� ..-�� (Signature) �;� �� ! �'f� ...�� -__ �..j —s'� S""�"s V � �'A'""L� U f C e+ �G 1�a�F'�� } LE� ��. r�`1 (Print Name) �-� �-" '�� ;-;3 tr� :r�� :. �., �.� ".� ��.:, :V� .�' ,� . �� _f� �� (Rev. 5/18) Copyrighted September 17, 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: William Baum for vehicle damage, Jerald Kinsella for property damage, Gerald Klein for property damage, Lynn McCormick/Partners Mutual Insurance for vehicle damage, Abby McGrane-Ralston for vehicle damage, David Prince for vehicle damage, Steve Ruden for property damage, Daniel Scott for personal injury/property damage, Sisters of the Presentation for property damage, Morgan Weaver for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Staff Memo THE CITY OF ��,✓ LJ L M L � o � A 1 \ � tJ � Masterpiece on the Miss�issippi TRACEY STECKLEIN � PARALEGAL � To: Mayor Roy D. Buol and Members of the City Council DATE: September 5, 2018 q � RE: Claim Against the City of Dubuque by Jerald Kinsella � Claimant Date of Claim Date of Loss Nature of Claim " Jerald Kinsella 09/04/18 07/27/18 Property Damage I�;i �; �l This is a claim in which claimant alleges that work perFormed on a City water main on II, Pinard Street in early February 2018 caused water to back up into claimant's basement �� at 2914 Pinard Street. i 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 Denise Ihrig, Water Department Gus Psihoyos, City Engineer �'+ Jerald Kinsella � � � I OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SuITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHorvE (563)583-4113/Fax (563)583-1040/EMai� tsteckle@cityofdubuque.org , �