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Claim by Andrew Topping Copyrighted October 15, 2018 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUM MARY: Jeffrey Kostein for property damage, Lindsay Lannen for vehicle damage, and Andrew Topping for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Referto City Attorney ATTACHMENTS: Description Type Costein Claim Supporting Documentation Lannen Claim Supporting Documentation Topping Claim Supporting Documentation �i�� CLAIM ACA[NST THE CITY t3F DUBUQUE, 1QINA �� This written repc�rC constitutes yc�ur claim agains# #he City of Dubuque, lovbra. You should complete this farm in full and attach any additian�l 'rr►formatic�n t�at supporfis yQur claim, � � � The Glaim mtast be filed wifh the City Clerk at Ci#y Hall, 5fl W. 13{" �t., Dubuqcae, tA 520Q1. 1t �; will ther� be referr�d by fihe City CQuncil to the appropriate department for investigation. � Once that investigation is completed, a report and recommendation wil! be submitfied to the �, City Cauncil< Yc�u will be provided wrth a copy of fihat report and recommendation. �, r � THE FINAL DEGIS[t}N ON A�� C�AIMS IS MADE BY THE C1TY COUNCIL. RItJ EMPLt�YEE t�F � THE CITY OF C}UBUQUE HAS TNE AUTHC}RITY 7t7 MAKE ANIf REPRESENTATI(JN TC} YOU � AS Tfl WHETHER YOUR CLAINI WI�� CJR WILL NQT BE PAID. 'l. Name of Claimant: Andrew Topping 2, Address; 333 Eas� � Oth :�tree�, U n it �� ' Dubuque IA 52�� r Gity: State: zip: �. ��e hone Number: 319-541-�132 Email: ar�dy�oppingwork��gmail.com � �' 9 4. a�t� of��,��a��t: Saturday, �epfi. 29th, 2U19 j 5. Time of Incident: ��C}X. �:�J��?C11 6. Locatior� c�f lncident {�e specifici: `��J� E. ��r`1 ��. �UbU�l.l£i �l� Intermodal Parking Facility - �ntry g�fie ta parking r�mp �WashingtQn S�. entrance) ; 7. DE�GRIBE ACGIDENT OR C}CCURRENGE THAT CAUSED INJURY t}1� �AMAGE. {G�ve � full details upon which you base your claim. If a City employee was ir�vc�lved, give the employee'� name.) �� The crossing gate arm lowered and sfiruck tY�e top c�f my vehic]e before the vehic3e had completely passed thraugh the aate area causinq damaqe tc�the car. No estimates of re�airs for the vehicle damaae have been obtained„yet. u . � � 8. What were weather candi�ic��s I�ke? Slight Drizzle � RIo material witnesses that i am aware of,but city parking ramp camera 9. Give r�ame and address of any witnesses: fQatage should be available that shows incident. � 1@. C�id pc�lic� investigate? (If s4, give names of afFicerse) Na � 11. Was anyc�ne ir�jured? (If so, give nam�s, addresses, and extent af injuriesj. � Na � � 3 ; � e 12. Was any damage done tc� praperty? {lf so, des�ribe property and the extent of damages. Atta�h estimates of damages or describe b�sis for ascer�taining extent of dam�g�.} Yes. Personal Motor Vehicle. 2023�tudi A4. There is a dent at the point of impact and scratches fo fhe paint on the top of the roof of the � vehicle caused by the the gate arm which lowered prerr�aturely and struck my vehicle as I was proceeding though the gate enfirar�ce. i; � u r 9 3. What other d�mages do yc�u ctaim, if any? �°sts to rep�ir to vehicle and any casts � � ass�ciated with alfernative transpc�rt�tic�n while the vehicle is beir�g repaired. '14. Have you been compensat�d �or any part ar all of your claim by any insurance � compar�y'� {1f so, give name ancl addr�ss of insurar�ce company anci amount paid.� � � No � � � 1 a 15. What amc��ant do you claim from the Gity c�f Dubuqu�? � Costs tn repair vehicle damage and any casts associated with any alternative transportation while vehicle is being repaired. � 16. Why do you claim the City of D�buque is responsibl�? �� Crossing arm of gate�ntranee to parking ramp worked impropedy.The gate crosaing atm{owered onto the top of my car before I ha�passed thmugh khe gate,stnking the top of the esr and caustng demage to the vehicle. 'I 3� a '17. Have you made any clairn against ar�yone else for dam�ges as a result of thi� incident? � �If yes, give raame and addre�s.) ` �fl 18. If the answer to Question 1T is yes, have you receiv�d any paymer�t frr�m tha� source, � and if so, in what amc�unt? � � � Dated at C}ubc�que, lowa fihis �� y �� October } 2�18 Andrew Topping Dgial'yslgnedbyAndrewT9pp3ng -, ON:cn=A�drstiv Toppi�g,o,ou,emaN=a�dytoppi�gworkQgma'.'I.com, 'c US Date:2+�i9.10.C212:35;28 c5'p0� {Signature} Andr�w R.. Topping �. (Prir�t Name) � _ �=�` :�`�- �°a � �� ' � � --4 .��"° C� t..- �� .-� � � � {Rev. 51'18) � � .. � � ,�. `� .�.a � Confidential This communication and any attachments may contain information which is confidential and privileged by law and is for the use of the designated recipient. If you are not the intended recipient, you are hereby notified that you have received this communication in error, and that any review, disclosure, dissemination, distribution or copying of its contents is prohibited. Please notify City of Dubuque immediately by telephone at (563)-589-4120 of 'I your receipt of these items and destroy the communication and any attachments immediately. Further disclosure of this information may violate state and federal restrictions. I �;�; Confidential information may include the following: 1) Social Security Number(s) 2) Medical/Health Information 3) PersonneUDisciplinary Information 4) Bank Account Information 5) Financiallnformation 6) Credit Card Numbers If any documentation you desire to submit to the City of Dubuque contains any of the items above i, this cover sheet must be attached directly to the confidential information and indicate the type of I� information that is included. �; � �� 'I I, , hereby certify that the attached documents include the following protected information: � Social Security Number(s) Bank Account Information � i Medical/Health Information Financial Information � Personnel/Disciplinary lnformation Credit Card Number(s) � � I understand that this information may be distributed within the City organization or to agents of the City for processing and I hereby authorize the City to act accordingly taking all precautions to ; protect my information from unnecessary distribution. $ Signature Date Copyrighted October 15, 2018 City of Dubuque Consent Items # 3. ITEM TITLE: Notice of Claims and Suits SUMMARY: CityAttorney advising that the following claims have been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool: Jeffrey Kostein for property damage and Andrew Topping for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Staff Memo THE CTTY OF �T.��3 �� MEMORANDUM Mctste�piece on the Mississi�api � � TRACEY STECKLEIN �� PARALEGAL � � To: Ma or Ro D. Buol and � Y Y � Members of the City Council � DAr�: October 4, 2018 !� ii RE: Claim Against the City of Dubuque by Andrew Toppong �' �!! Claimant Date of Claim _ __ Date.of Loss Nature of Claim � II Andrew Topping 10/04/18 09/29/18 Vehicle Damage 4! �; w ii This is a clairn in which daimant alleges that the crossing gate arm at the Intermodal i, Parking Facility malfunctioned when it lowered and struck claimant's vehicle, ';; �, ,� This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa � Comrr�unities Assurance Pool. { � cc: Michael C. Van Milligen, City Manager Russ Stecklein, Transportation Services Field Supervisor � Andrew Topping � �� , � � � OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAW STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/F,v� (563)583-1040/EMai� tsteckle@cityofdubuque.org