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Claim by David Prince 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 � � � � � ������� ��;� CL.1lIM ACAINST TNE CITY QF C�l16UQUE, It�1�VA ���r�.�,� Ti�is written report con�titutesy ouc�r claim against the City of Dubuque, lowa. Yc�u should complete this form in fut! and attach �ny additoonai information that supports your claim. The Cla�m must be filed }rvi�h the City Clerk at City Ha11, 5q W. 'i3tn St., Dubuque, !A 5200`I. �t w�ll th�n be referred by the City Council to th,e apprapriate depa�rtmen� for investigation, C?nce t�at invesfiigation is compl�ted, � report ar�d recommendation wi11 be submi�t�ed to �he Ci�y Council. You w%11 be pravided wi�h a copy of that report and recommendation. THE FINA� DECISION ON AL� C�AIMS 1S MADE BY THE CITY �OU�JCIL. �1�3 EMPLCIYE� CJF THE CITY C3F QUBUQIJE HAS THE AUTH{JRITY TO MAKE ANY REPRESENTAT1CtN TC? YOU Aa TO WHETHER YOUR CLAIM INILL t3R W1L�. NUT BE PA1�. _ i .� �: Name flf Cfaimant: �� r�� ��4' .,v��:f►t� -,�.. , 2. Address: _��,�2.� r"`'� ���..� ,�i��fe� �� : � , � City � r ��°����, State: g _,� _ Zip. �'� � � � ,_..�. �. _ � A, . ���.uua , ��� �� � �� ' 3. ?e1e �one Numbe�: � ' � ' � 4. Date vf l�cident: ,�-� �� �� ' �_ 5. Time of Incident: ����:`—'��.��-`'��� �� _ �' �" � 6. �ocation c�f Incid�ra� {Be specifi��: ..''�,r��.i.��'.��.� ���.�" �� ��-� � � � � � � � � � � �. 7. DE�CRIBE ACCIDEINT 4R OCCURRENCE THAT CAUSED INJURY C3R �AMAGE. (Give ful� details upc�n which you base your claim. If a City employee was inv�lved, e�ive the employee's name.� � � .. ,Y.�.. ,� � � � r � m ` �i s i,���t �� " � ��'� �� �.�+�: � � �.�� � '�-- �°"•� � �� � ���-� i.�. ' �-�; 8. What w�re weather cc�nditions like'� &��' � °��-�.� �,����,e� 9. Give n�me and address of�ny wit�esses. ��� '10. Did police investig�te? {If s�, give n�mes c�f officers.} ��, j , ��f `"� Gt,. "...._.. ° ,�,�G�SI,�9 �- i "'�'mr�� cdC� �"�'" �i�.��« '1'1. Was anyone injured� (If so, give names, address�s, and extent �af injuries�. �� _ �� �- ����-�,���..� �� ��� �. ��.��.,� .:�— ,� r� �-. l��.c� , � r� ��-� C �~?'�-� ���/�Co�'�t J���d c �-�°', ��@-8�d. ���' "�� � �� �C . ���.--- � �.� ��� ���� �� �� ��� � �� ���� . �� �t� ���� �� �� �� �� � �� ��� ���� A �. a��`��.. ��,,.� �����.� c�� %���-- ,�`��i �` � � ��� � r- `���.�,- � �d� ��c��'- �� � �.. ��-� �� �� � ���� ��� �� � � � � �� ��� ��� �� ���� �� �������. � ��� �'� � � � �' ,� ���.c�t�',�c��. ��`' ��``�" � .,�-� ��� �� �'�. � ��� �� � �� ' � �" ;�, f �'�-` �� `� � c�'�� t�.�� �" ��"�+�� � ���. �� � �' � , � .�- --�....- � �� � ��� �f� ���. ���¢� ,� � � C��'� .%� ,�� �� �° '' � �, �: � � � ,�,�'����.��.�- /�-� �- ��c:-�� �� � � � � � �. � ���.�- �- �.�- �-�- ��.� ��.�. �`�'��� � �� �"��� �.�.� ��..� .�...� ��,��...�.�.� �'� . ��� �''���.- ��.��� .�� ��.��.�-��� � �.�.�✓,� �.�- �. �� �� /� ���� � � ��-�.,, ��� �� �� ��—� �¢�..�. �� �� a ,��!�r �,,,,�y� ,�y ,{ f a.�- +�� � p � d�-�C�, b.��-� �. ��/�'t'� tj��.^���'�� �!''Vg �,."'. '�'"'"_ ��`-,.�7 r� V k*� ��' `�� �'`�� �� .� ��� ���..� �� ��' �'"���..� �'�" e_ �� � �� `������_ �""'e...��:� ���- f!�l i ,`�`�t ,��z. f . a°�� �l �-�`�" � � ' �.._ � � �, c��-��� �'� �. ����' � %� `���`�—��. ������ ��.;�-- ,�� �.—�--- �,��,.� � �.:�,.� Gt.�'�..� �- � �o r��`�-� !� !�-��a.�r �t,,,. � �:�� � � i � , � � 12. Was any tiamage dor�e fo property'? {1f so, describe property and the e���nt of � damages. Attach estimates c�f +damag�s or describe basis for ascertaindng exfient of � damag�.} �(,�+[h.�� � � • S++ q,,.. . . � , � . . . .. . � . .. . � I, 9 . . ... . �. . _ . ... _ . . - . ( . . . °+ ,� .�.wq � �;... { 3 13. Wh�t ather d�mages dc� you �laim, if any� ��.�e�,.�-- � ��� .��� � t � �1 C^ � 'f i.�l�C �4. Have you been eompensat�d for any part or all af your claim by any insurar�ce company? �[f sc�, giv� r��me and ��#c1r��s af insuranc� c�m�+�n� ar�d amaun� p�id.) �� `! I�dVhat amount dv you cEaim frorr� the City of Dubt�qt�e? ; �- � '� ���.' ��i'�"`���..�"` 16. Why dc� yc�u claim the �ity af Du��q�a is r�spc�ns`sble? ,� , �1 ,� � � �,� ; ��-�- �.�.:� ���s i � 17. Have yc►u made ar�y clait� ag�inst any�ane else fc��d�r�n�ges as a r�su�t o#�his �ncident? � (If es, give n�me and address.� � � � �� 18. If fihe answer ta Qu�stion �7 i� ye�, have you re�ei��d �ny payrner�� from that soc��-ce, and if so; in what �r�nc�unt? �(� I Dated at Dubuq�ae, towa �his �� d�y of t���c�°'7'"'" , 20�,. � . � � ��`l��.-..~°-�-�-- �Sigr�a�ure) � �j � �(�c..�a� �,�o Y'�-��?�__ �Prin� Name) � � ' �� � � ,�' C� "�' � � � � � � i � ��' -� �� � � I � � ,.�' � (Rev. 5/`��) � � ,..; C� � C+�nf�d�n�ial Thi� comm�nication and any attachmenfs may corttain information which is confidential and privileged by law and is far the use of the designated recipient. If you are no� the intended recipient, you are hereby notified tha� you have received this cammunication in errc�r, and that any revievtr, disclosure, disseminatic�n, di�tributic�n or copying af its contents �is prQhibifed. Please nc�tify City of Dubuque immediately by fielephone a� {563)-�89-4'120 of your receipt of these ttems and destroy th� cor•nmunica�ion and any attacktments immediately. Furfiher disclosure vf th�� i�forrnatio� may violate state and federat restrictic�ns. . ConfidentiaC information may include the fallowing; 1) Socia( �ecurity Numb�r�s) 2} Medical/Health Infarmation 3} PersonnellDiscip[in�ry Information 4} Bank Accaunt Enformation 5} Financial Infarmatic�n 6} Credit G�rd Numbers (f ar�y documentation you desire ficr submit ta the City of Dubuque contains any af the items above this cover sh�et must be attached directly to the confidential inf�rmation and indicate the type of ir�formation that is included. I, � f -c�o���,��`*� , h�reby certify that the a�ta�hed documents include_fihe ft�llowing protecfied inftarmation: � Social Securi�y Number(s} Bank Account Infarmation Medical/Health �nformatiar� Financial lnfarmation PersannellDisciplinary Informatian Credit Gard Number(s) I understand that this informatic�r� m�y be distrib�fied within the City r�rganization or to agents of the City for processing and I hereby authorize the Cifiy to act �ccflrdingly takin� �!I precautior�s to prc�tect my infarmation frc�m unnecessary distribution. � , �. �.P � � Si�nafure �ate � 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: September 12, 2018 RE: Claim Against the City of Dubuque by David Prince Claimant Date of Claim Date of Loss Nature of Claim David Prince 09/11/18 08/28/18 Vehicle Damage This is a claim in which claimant alleges that he scraped and damaged the roof of his truck on a support beam in the lowa Street Parking Ramp. This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa i Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager Russ Stecklein, Transportation Services Field Manager David Prince OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 33�, HARBOR�/IEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TELEPHONE (563)583-4113/Fax (563)583-1040/EnnAi� tsteck�e@cityofdubuque.org i 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