Claim by Mary M. Kisting Copyrighted
October 7, 2019
City of Dubuque Consent Items # 2.
ITEM TITLE: Notice of Claims and Suits
SUM MARY: Nick Helgerson for property damage, William Hickson for
property damage, Mary Kisting for vehicle damage, LJ R
Investments, LLC c/o LinsyAdamsforpropertydamage,
Jayantibhai Patel for property damage, Jhony Edgordo
Ramirez for property damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Referto City
Attorney
ATTACHMENTS:
Description Type
Helgerson Claim Supporting Documentation
Hickson Claim Supporting Documentation
Kisting Claim Supporting Documentation
LJR Investments, LLC Claim Supporting Documentation
Patel Claim Supporting Documentation
Ramirez Claim Supporting Documentation
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA �'K�`����
This written report constitutes your claim against the City of Dubuque, lowa. You should
complete this form in full and attach any additional information that supports your claim.
The Claim must be filed with the City Clerk at City Hall, 50 W. 13t'' St., Dubuque, IA 52001. It
will then be referred by the City Council to the appropriate department for investigation.
Once that investigation is completed, a report and recommendation will be submitted to the
City Council. You will be provided with a copy of that report and recommendation.
THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF
THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO YOU
AS TO WHETHER YOUR CLAIM WILL OR WILL NOT BE PAID.
1. Name of Claimant: Mary M. KistinQ
2. Address: 8484 Hidden Valley Rd.
Clty: Dubuque State: I� ZIp: 52003
3. Telephone Number: 563 542-4150
4. Date of Incident: Sept. 10, 2019
5. Time of Incident: 10:30 am
6. Location of Incident (Be specific): North side of 9th street, �ust west of
9th & Main streets, adjacent Fisher Bldg entry on 9th.
7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim. If a City employee was involved, give the
empioyee's name.)
Approached parking spot parallel to the curb, and felt impact
against my right front tire. A large chuck of concrete curb was jutting out from
the curb and it had made a puncture/tear in the sidewall of my right front tire.
8. What were weather conditions like? clear/warm
called my husband to come
9. Give na�ne and address of any witnesses: none known and change my tire to spare
10. Did police investigate? (If so, give names of officers.) No
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
No
12. Was any damage dnne to property? (If so, describe property and the extent of
damages. Attach estim�tes of damages or describe basis for ascertaining extent of
damage.)
No damage to "property" The conc curb was previously fractured in
two large chunks and prev�ous repair attempts were
obvious.
Photos att�ached
13. What other damag�s �do you claim, if any? Jnst my right front tire.
14. Have you been c�mpensated for any part or all of your claim by any insurance
company? (If so, give nanne and address of insurance company and amount paid.)
No / not filed
15. What amount do you claim fr�m the City of Dubuque? Receipt attached
$156.59 tire replacement incl tax
Broken hazardous curb condition
16. Why do you claim the �ity of IDubuque is responsible? was existing, and obvious previous
repairs had failed.
17. Have you rnade any cl�im against anyone else for damages as a result of this incident?
(If yes, give name and add�es�.)
No
18. If the answer to �u�s�ion 17 is yes, have you received any payment from that source,
and if so, in what amour�t?
Dated at Dubuque, lovva this 13tr� day of Sept. � Zp 19 r-} �
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(Signature) � �; �, �
Mary M. Kistin � � � �'
g (Print Name) cn �
9/10/2019 spoke briefly w/Mr Paul Davis via phone and was
assigned this �CW165G82-0�1019 pursuant to my husband decribing this incident
online with the City af DBQ Street Dept.
(Rev. 5/18)
Copyrighted
October 7, 2019
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Claims
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: Nick Helgerson
for property damage; William Hickson for property damage;
Mary M. Kisting for vehicle damage; LJ R I nvestments,
LLC c/o LinsyAdams for property damage; Jayantibhai
Patel for property damage; Jhony Edgordo Ramirez for
property damage.
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Staff Memo
Dubuque
THE CITY OF � �
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Masterpiece on the Mississippi 2oi�*2oi� �
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TRACEY $TECKLEIN � �
PARALEGAL ��
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1lVI E M O �
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T�: Mayor Roy D. Buoi and �
Members of the City Council C
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Daz�: September 15, 2019 ;
R�: Claim Against the City of Dubuque by IVlary M. Kisting i
Cl�amant Date of ClaAm Da#e o� Loss dVatur� �f Clai�ri '
f
Mary M. Kisting 09/13/19 09/10/19 Vehicle Damage ��
This is a ciaim in which claimant alleges that as she was attempting to paralEel park on
the north side 9th Street, west of Main Street, a large chunk of concrete protruding from
the curb punctured claimant's raght front tire.
This claim has been referred to Public Et�tity Risk Services of lowa, t9�e agent for the lowa �
Communeties Assurance Pool.
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cc: Michael C. Van Mi6logen, City Manager �
John Klostermar�n, Publoc Works �irect�r �
Mary Kis#ing
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TE�EPHONE (563)583-4113/Fax (563)583-1040/EMai� tsteckle@cityofdubuque.org