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Claim by Eric Mueller Copyrighted February 18, 2019 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUMMARY: Trever Allen for vehicle damage, Brian and Dee Collins for property damage, Robert Krohmer for vehicle damage, Eric Mueller for property damage; lawsuit by Jerry Brandenburg for personal injury. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City Attorney ATTACHMENTS: Description Type Allen Claim Supporting Documentation Brandenburg Suit Supporting Documentation Collins Claim Supporting Documentation Krohmer Claim Supporting Documentation Mueller Claim Supporting Documentation t�C�� �� � A .�-���- ; � GLRII�I AGAINST THE CI�Y OF D�JBUQU�, 1�DWA � � ; This writt�n r�port canstitutes your ciaim ag�inst th� City of pubuque, ic�wa. You st�auld � �c►mplete t�is form irr full ar�d a�ttach a�ry additional information that supports yaur claim. � Th� CMaim rnus� �re fil�d wit�► the Ci�y Cterk at City Ha�l, �0 W. 1���' St., Dubuque, NA 520��1. Mt '! will then be referr�d by the City Council to the appropriate department far inv+estigation. � Or►ce #hat investigation is completed, a report and r�cc�mr�nendatior� witl be submitfect �o the City Cou�cif. Yau wi�N b� �rovided r�rith a ca�py of th�t r�par�anc� recc►mmend�tion. � ;i u� THE FI�AL DECI��C1N QtV ALL. CLAIMS 1� MADE BY THE C[TY CQUNCiL. Nf3 �MP1mtJY E t�F � TME CITY C�F I�U�MJt�I,ME HA� THE ,AUTHt�F�.ITY 1"C) MA1�CE ANY I�;Ei�REaENTATIC�N TU�YUU �) AS TtJ WHETHEi�Y(7�UR C[.�INI VId1LL QR WILL NOT BE PAlD, fl 1. N�rn�caf Claim�nt. �-�� �� ��`� �dµ�� � � � � � � i' .� a 2. �.ddress: � �� ,�° �,;t ; � u City: _ ���.�:���-�,�� Sfiate: �r�" Zip: .�f��.ai: ! i ; 3. Tel�phor�e Number: �` .°- � � "� -� �� ��,j �"• � . � , � � 4. [��fie a#�r��i�`er�t� ,�, 1 �, � � � � `�" � 5. Time af Incident: ' il , � $ �i +�. �c��a�ior� af In�ident (�� sp���ific): � '��� �°�.`� � � s�� . � ; � ����� ; 4 � h !; 7. DESCRI�E AGCIDENT dR OG�U�RENCE THAT �AUSED INJURY OR DAMAGE. �Give � full details tap+an which you k�ase ycaur claim. !f a �ity �mplaye� uv�s invo�ved, giv� the i� �mplaye�'s n�ir�ne.� � °� 1�' ' II'{ G t�. �'.r� � � o.�.- e r�.,Y'�. �.. Y�<t���. 1�µ � � ��'' N � � j � � P � �.� ° � �" „��„x $- � �'�' ��t'.� ' � � 8. 1d�►hat were w�ather conc�itic�ns like? 9. Give narne a�nd address of�ny w�tnesses; � I 1f1. Qid palice irtvesfigate? (!f so, give name� of offcer�.) ��� �11. Was a�yane injur�d? (If s�o, give n,�mes, addresse�, and extent of injuries). �G i � i � i 1 � 'f 2. Was any da�mage c�one t� ro ert °� � d�mag�s. Attach estimates of damag s orr descr be b s�isf or�asc rtair�ing exte t of damage.) , � ,� n ��.5 �~ �`�� � , � �°� �1��� ��� � � �� �� � � i 't3. What ather c�amages do you claim, if any? ��� ..� � il i � 14. �lave ycru been campen�ated for a�r�y par� o�r all of yaur +�l�irn b an � , campany? �If so, give name and address of insurar�ce company and amo nt p wa����ur(rrce ; � ;, � 7 15. What amount do you ctaim from th� Gity�,f t�ubuqu�'� . � I � � � � � � il f 16, Why do you claim the City af Dubuc�u� is re�portsible? ' li ;! 17. Haue you made any ciaim again�st anyon� e(se for dar�na�es a� a �e�ul�o�thi� incid��t? II (if yes, ��ve ,n�me and adclre�s.� i �� i� � � 1�. If th� araswer tca Qu�st�c�r� �7 i� yes, �ave you rec+�ived an �� and if sa, in what amount? Y p�Yment from tha� sou�ce, � � i 1 p r � � � � Qated afi Dubuque, lowa th�s __��+��Y of G�..�`� , 2t3�A P ; � 0 �� ��`� �. ` �� 1� _...._..�.._._.,� �~�-�-�—� ts���,a�ur�� � �f � � � ��,• V�1.�� , '� (�f I11� Nr�Ct1�� � � ',�,,'��' C„�l ��"4 �� (� � � .�� i� .�° � � � � � {Rev. 5/18} � � 4 `�,�- � :: � � � ; r�.� � I ._.__..._._ � i ��"���"��3�� � � � 3 ) �Qtlfld��ttl�� I �"hi� cammu�icatia�n �nd any �fitachmer�fis may c�!r���in rnfarmafiion which �s ��pn�Md�nti�l and �riviCeged by law and is for fihe use of the designated recipr�nf, !f you �re nafi the infiended r�cipient, you �re h�rek�y n�tifie� thafi you ha�e rec�ived this �ommun�cati�n in errr�r, ancd tha� any r�view, cfisctosure, diss�min�tiorr, distrit��t�an or copying af its co��en�k� is �rohibited. pfease notify Cifiy of Dub�aque immedi�tely by tElephcane at (563)_5$9.�12E} of yaur receipt of �hese ifems and d�stroy the cvrnmunication and any atta�hr�ents imrr��diatety. Further disc�asur� of this i�formafiiar� may �ric�l�te st�►te and �ec�+�r�l � restr'rctions. I � i Canfid�ntial infiarmatian may include the fallowing. � i � 1 j �oci�l Security Number(s) � � 2) Medical/Heafth Infarmation � �) P�rsonnellD[sciplinary Infarmation � � 'tl 4) B�nk Account Informatian � 5) Firranciaf Infarmation i 6j Credit ��rd Nurra��rs � � I � � � lf�any documenta�i�r� you�d�sire �ra submit tr� th�e �ity of Du�buq�ae confiai�►s any +af the ifisrn� �bc�ve �i �his cover sh�et must be atta�h�d dir�c�ly to th� c�n�Fid�ntiaN infc�rmation �nd indicate the fiy,pe c�f !;� inforrraation �ha� i� includ�d. � � � II i I ; � ��� � � � � ' � �} � , hereby certify fihat the a�tach�d documents E inc(ud�the follcawing protecfied infcarm�t��an: � �I �____Social Security Number(s) Bank Account Infarmation I! @ M�dical/Health Infiorm�ti�n Financial Infiormation ��' i 3 � �MI�4.�/�1 14IIDIr.3�1���1 ICA� �1 l�VI A I IS'.d��\,7� �.....,..,.�„I'1 5.l4.11� V�!� ��F�t 1}.A4;74��) � � N I un�erstand that this infarmation r�ay bc distributed within the Gity argan�z,atian or ta agents 'f the � City ficar processing �nd N hereby �uthcariz� th� City tca ac� �cccardingly t�kir�g �II pr�c�uii��s to � pratect my infc�rmatian from unnecessary distributian. �° ��,�,����.._ i �.-� ,� �igr�ature Date i � � � i 1 1 Copyrighted February 18, 2019 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: Trever Allen for vehicle damage; Brian and Dee Collins for property damage; Robert Krohmer for vehicle damage; and Eric Mueller for property damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Supporting Documentation THE CITY OF DUB E MEMORANDUM Mnsterpiece on the Mississippi TRACEY STECKLEIN �[ J�J-� �.. PARALEGAL To: Mayor Roy D. Buol and Members of the City Council DATE: February 14, 2019 RE: Claim Against the City of Dubuque by Eric Mueller Claimant Date of Claim Date of Loss Nature of Claim Eric Mueller 02/14/19 01/18/19 Property Damage This is a claim in which claimant alleges that as a City of Dubuque Housing Inspector opened a window during a rental inspection at claimant's rental unit located at 2061 Fengler, the window fell down and cracked. 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 Alexis Steger, Housing & Community Development Director Eric Mueller OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 �/IAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/Fax (563)583-1040/Ennai� tsteckle@cityofdubuque.org