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Claim by Abby McGrane-Ralston 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 � � � � � CLAIM AGAIN�T TNE CITY OF DUBUQU�, ItJWA E �� ` l.�-��u°� �'��tc.�� This written repor� constitutes yaur claim against the City of Dubuque, lowa. You shauid � � complet� this form ira full and attach any additional informatic�ri that suppc�rts yo�r claim. �: The Cla�m must be filed with the City Cierk at City Hall, 50 W. '13t�' St., Dubuque, IA 5�00'I. It � wifl then be referred by #he City Council to #he appropriat� cl.epartmen�E for investigation. � Once that investigation is cc►mpleted, a report and rec+ammendation will be �ubmitted to the I City GounciC. You will be provided with a copy o€that re�ort and recorrimendat'ran. ; THE FINAL DECiS1QN ON ALL, G�Al1VIS 1S MADE BY THE CITY COUNCIL. NtJ EMPLC}YEE t�F � TNE C1TY OF DUBUQUE HAS THE AUTHORITY Tt? MAKE ANY REPRESENTATION TC� Yt3U �� AS TC7 WHETHER Y(�UR �CLAIM INI�L UR 1NI1�L NC?T BE PAID. " � � 1. Name of Claimant: � � i r , � 2. Address: �-��i�.�' �� . � City: ��G�� Sta�e: � � Zip: ,�. 'a ;3 3. Telephone Numb�r: �� -- `�� `� �� : � �, � � � ; 4. Date of ir�cidenfi: � � � ---�--r- • ,� 5. Time of Incidenfi: ��_� � � � � � F. � - � � � � °� . �,��°� ` h 6, Lacation of Incident {Be specific}: _�-��,�+��1� ��"��, �_�� t��i��- ;� � � E! � 7. DESCRIBE ACCIDENT OFF. OCCURF�ENCE THAT CAUS�D INJURY fJR DAMAGE. {Give t� fu11 details upon whieh you base your claim. �f a City employe� was invvlv�d, give th� � emplc�ye�'s r�ame.} � � � .� � ` ° --�� . � � � � � � � ��D � � � 8. Wh�t were weather condition� like'? � ��1 C.��e��- � 9. G�ve name and addres�. of any wifinesses; ' � � ° �2�� 90. D�d police �nvestigate? {If so, give narr�es of off'i+cers.} � ; �- � 1 { �: � ' � '�1. Was anyone injured? (I�so, give r�am�s, address�s, and extent of injuries}. � �, � � � � � � ; 92. Was any damac�e dvne tc� property? {�f sa, describe prc�perty �nd the extent of damages. A�tach estimates of damages c�r describe basis for ascertaxning extent of damage.} ` a ��C� �� ° .� � , � � YP ' .. � . . 4 . - . . . ry p f � � ¢ � 13, What other damages do you claim, if any? � � �� '14. Have �tou been compensate�l far �ny part or a[1 af your cl�im by any insurance � compan�? (If��a, give narne and address af ir�surance company at�d aimc�un� �aid.) � P f 9t � �� 4 A � ^ y � Y V ��W id' � . . . . . . . . ' � 15. Wh�t amount do y�u cta�m from the City of Dubuque'? � ��,�r�' ��1�,� �. � '.�� = � � � �:�;�.C�� ; ;; � 16, Why dc� you claim tf�e City of �ut�uq�ue is responsible? � � � - �,��° ��.�� F� �.�� ",�.� �� ° ��i��r��-� � � � � � '17. Have yau made any cE�im against anyone else far dam�ges as a re�ul# of this incident? � � {If yes give nara�e a�d address.} � � � 1�. If the answer to Question 17 i� yes, have you received any �aymen� frc�m that source, and if so, in what amoun�? � ,, � �afied afi Dubuc�ue, �t�wa this _��.�, da� c�f , �0�,. � �, {Signature) � �� -;:� �Print Name} �,� �; �; .� � `Y� ;�; � �- �� ,� a� � ��, �� -� �_ - �"" ,:� � �� (Rev. S/'18} ��' s� � � � Cc�r�fiden�iaN This comme�nication and any att�chments may contain informatic�n which is confidential � and privileged by law and is for �he use of the designat�d recipient. [f yo�a are not the � infien+ded recipient, you are hereby no�ified that yc�u haue received this communication ir� '� error, and that ar�y review, disclasure, diss�mination, distributian or copyeng of i�s contents F is prohibited. Pleas� r�otify City of Dubuque immedia�ely by telephone at �563}-�89-4'1�0 of � yc�ur rece�pt of th�se item� and destroy the communication and any atfiachments � immediately. �'ur�her disclosure raf this information ma�r violate s�at� and federal � restrictions. � e � � � � Gt�rtfidential infarmatic�n may includ� the fallc�wing: i' � 1} Socia3 Sec�ri�y Num�er�s} �� 2} Medical/Health In�ormation � 3) PersonnellDisciplinary Infarrnation � 4) Bank Accoun� Ir�formation �� i� �} Financiallnf4rmafii�n � 6) Credit Card Numbers � � If any dacumer�tatic�r� you desire to submit fic� the Cifiy of Dubuq�e c�ntains any af the ifiems abave '� this cover �heet musfi be attached direct€y to the eanfidential infarmatian arrd indicate the type �f , infarmation �hafi is included. � � ;; � , 1, �� " , hereby cer�ify that the at�ached d�cuments , include th� f Ilov�ring �rotected ir�fc�rmation: � � Sc�cial Security �1umb�r{s) � Bar�k Accounfi Informatic�n f� h; � Medical/Heal#h lnfc�rmatiar� Financ"sal Infarmation � � � � ,. Persnnnel/Discip[inary Information Credit Gard Number{s} � � I understand that th�s infarrnatiar� may be distributed w�thin the City organCzatiQn or fio agents c�f the � City for proces�ir�g ar�d 1 hereby authcarize the Gity to act accc�rdingly taking all precauti�ns t� � protect my informafiic�n fram unnecessary distributic�n. � � � � _.... { ignature {�at� �. Q � � � 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 C?F � °-�-� ...'%' UB E MEMORANDUM �y Masterpiece on the Mississippi � , ; TRACEY STECKLEIN (l�' i PARALEGAL �� I� To: Mayor Roy D. Buol and 'I� Members of the City Council II DATE: September 6, 2018 � ii RE: Claim Against the City of Dubuque by Abby McGrane-Ralston li i ;, Claimant Date of Clairr� Date of Loss Nature of Claim �; '; Abby McGrane-Ralston 09/06/18 09/02/18 Vehicle Damage I �i This is a claim in which claimant alleges that a City tree fell onto claimant's vehicles at ,� 2306 Queen Street. � Id �i � This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa Cornmunities Assurance PooL � � cc: Michael C. Van Milligen, City Manager � Steve Fehsal, Park Division Manager � Tom Kramer, Urban Forester � Abby McGrane-Ralston � � OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-41 1 3 1 Fax (563)583-1040/Ennai� tsteckle@cityofdubuque.org