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
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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�.
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�: Name flf Cfaimant: �� r�� ��4' .,v��:f►t� -,�.. ,
2. Address: _��,�2.� r"`'� ���..� ,�i��fe� �� :
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4. Date vf l�cident: ,�-� �� �� '
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5. Time of Incident: ����:`—'��.��-`'��� ��
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6. �ocation c�f Incid�ra� {Be specifi��: ..''�,r��.i.��'.��.� ���.�" �� ��-� �
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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.�
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9. Give n�me and address of�ny wit�esses. ���
'10. Did police investig�te? {If s�, give n�mes c�f officers.}
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'1'1. Was anyone injured� (If so, give names, address�s, and extent �af injuries�.
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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�.}
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13. Wh�t ather d�mages dc� you �laim, if any� ��.�e�,.�-- � ��� .��� �
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�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.)
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`! I�dVhat amount dv you cEaim frorr� the City of Dubt�qt�e? ;
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16. Why dc� yc�u claim the �ity af Du��q�a is r�spc�ns`sble?
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� 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.� �
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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?
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Dated at Dubuq�ae, towa �his �� d�y of t���c�°'7'"'" , 20�,.
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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.
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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
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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