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Claim by Michael Lenstra Copyrighted December 2, 2019 City of Dubuque Consent Items # 2. ITEM TITLE: Notice of Claims and Suits SUMMARY: Michael Lenstraforvehicle damage and Ethel Schneider for property damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Referto City Attorney ATTACHMENTS: Description Type ClaimAgainstthe City - Michael Lenstra Supporting Documentation ClaimAgainstthe City - Ethel Schneider Supporting Documentation ��� � � � � �I�G '�fV C37�'�KS ; ���� � ����� �� ���� �� ��� ��, '� � 1 i Thi� written repc�r� constitutes your claim again�t fh� City of Dubuque, 9owa. You should I c4mpl�t� thi� fe�rm in full �rad atfia�h any �ddi�imnal i�f�rrraat6�r� tha�k suppmrts �our claim, - �n - � �h� �laim must b� fii�d wt�th the �i�y �I�rk a� City H�II, �01fV. 13 �t., �u�uque, I� �2�01. i� ,i uvill t�en b� r�ferred by the �ity C�uncel to the �pprc�priate d�partm�nt f�r r�vestigativn. ! Once fihat ��v�.sfiig�t9�n i� corr�plet�d, a rep�rt �nd re�c�mm�ndat6or� witl b� s�kamitfied t� the li �ify �ot�ncil. You will be provid�d wifih � �c�p� of that report ar�d recomm��d�tic�n. j i T�E FINAL �E�ISIOt� C)N ALl� CLAIIV�� I� MAt3� �lf TH� GITY GOUIVCIL.. NO EIlIIPLOYE� t�F !I TH� ��T'1( QF �U�IJQtJ� MA� TH� AUT'Fi�F��T� °TC� �AAK� aANl° R�Rf��S��1��4`T��N T4 YQU i �� �'� ���T��R�S�rJFt �L�IIVH !s!� taFt�!�L.� [��1' �� p41�o �j � 1. fVarne of�lairr�ar��: Mi�h��[ J. Lenstra 'I 'V �: 2. �ddr���e �E�'1 Amv �t. ii Ci�y; G��a�uqu� �t�t�: !A Zipp 52002 ��'I � °�, `�°r�����nn� ��!s����': �t������-9932 j ,, � 4, C��t� �f in�ident: N�vemb�r 11, 2�19 �� ; S� °�o�,� �f I�c�s��n�: ��rly morning ho�rs '� 6. Lo��tic�r� of Ira�iden�k (B� �pe�i#ic�: 1�1� Amy Ct., G�Q Ii !� i,. 7. Q��CRI�E o4GGIC2ENT iJFt �GG�IRRENG� T�#AT' �AU��D INJURI( (�R DA.M�iCE. 4��v� '� f�l8 ci�t�i�s �por� �sh�ch ��� b��� yo�at claar�. �f � Gity �r�pl+�y�� wr�� inv�alvedq g�v� �h� pr����a�p'� n��'!��) � � There w�s a late r�ightfearly morning snawf�ll. We n�ted �n the rrRc�rning �f 1�I/�i 1/��th�fi fh��treet had be�n piow�d � � � � C}ra�of aur vehi�les was arked alon side the curb�nd w� noted �n �Icai� ated dentin and scra in c�n tt�e drivers ? side dae�r consi�tant with that caf a snc�w pl�w ade -- ,1 $. h�t�er� w�ath�r cc�nditions fike? sr7avv and ice-�nd anoth�r v�hicie was arked directl acro�s the �I street ram c�urs ma ing i a narrcaw passage, u �. �'sjrsp ��!'!'Z� �!�d ��d�'�5� f►'���1►,� !N9'�Ct�����s I'� G 10. Did poli�e inve��igat�? (Ifi so, g�ve n�rnes c�f afficers.� � No � � � ��. 16V�s �nyar�e inj�red? (I��c�, give n�rr���, addr�����, and ��ten� �f ir�juri�s)o � � No � � P � � � ; � 9 � � �� � , � °�2. UVas any damage d�n� ta propert,y? (If �c�, des�rib� pr�perty and th� �xter�t of ; dam�ges. Attach esfisrna�es of damag�s �r describe ba��s far a�c�rtaining ��tent of d�m�g�.� � �amag� cor�tain�d tcr the vehicle qu�rt�r p�nel, re�r and front drivers �ide d��r. I, a � � ; � �13, Wh�t other darnages do �o� cBaim, if any? n�ne ''I � ,'i � _ � , �A�. Fi�ve y+a� b��n cc�rr�p�n���ed �F�r �ny part �r �II af your cl�ir� by �r�y ir�s�ar�r��e c�rnp�ny'? (�f so, give n��e and �tidr�s� of insur�nce ��rrop�ray �nd arr�o�r�t p�Bd.� �� 15. h�fi amoun� do you �lair� fr�rn the �i#y afi Q�b�que? '; ����5.�0 i � � 'i6tl VNt�g� do you ciairn the City of D�buque i� r�sp�r�s6b1�°? '•'; Because�f the weather conditions the fi�ct#h�t the street inras lawed anc�the Ic��ation and char�teristics of the damag� '°; e� ��pecr�late th�t the am���was c��s� y�he uppc�r rpg t carnpr�f t .��n�e±�p.�o„� ';i ,,i '17. H�v� y�u m�de any clairn against �nyo�e �Is� f�r d�r�ages z�� a result of thi� ir�cid�n�'� '; 41f y��, giv� r��me aa�d add�°�s�.� ; r�� ���i ,� � 1�. If �he a��w�r #o t�ues�ion 17 i.� y��, hav� y�La r�ceiv�d any p�y�me�t frcarr� that �ourc�, ''; and i���, i� wh�t�rnount? ',i 'i,;ll Dat�d at Dub�aqt��, It�w� �h6� 1�th day af Nc�vemb�r , 20 �9 , i . ii � � (Sig�atur�) ' � � � y � � � � �� �a �������-- �rir�t Nam� . �. � � ( ) ,�� � ' � , ���k � �� � `� ` ,� � � � �� � � �- e�.� (R�v. 511�) =� � � =�. � ��, ��� :;;� � c� , � ,; t._,! ;i � � � � � � � n � , illl �O�fadGn�lal �� This cammunicatior� a�d any att�chments may contain informatian which is confidential �i �r�d priviieged by law and i� for the us� af th� desBg�at�d recipient. If you ar� �r�t fih� � rr�t�nded r�c�pient, you are h�reby notified fih�t you h�v� receiv�d t�his ��mmuni��tion in I �rror, and that any revi�w, disclosure, dissemination, distributi�r� or copying �f its contents i 6� proh�ta�t�d. �l���� r���6�y �i��' �f �u��q�� �r�rr��ds�t�ly b� t�l��h�r�� �t ��63)�S�9a4�1�g of �!I yc�ur r�c�ipt �f �h��e i�,enn� �r�d d�stroy th� �omrnunica�i�n and any afit�cl�rr����� i irr�mediat�ly. F�rth�r discla�ur� of this ir�farmation rnay �riolate state �nd federal ; �� resfiri�tio��. It ;{ � ;� i C�nfid�ntial infarmatir�n m�y include the fallowing: ; I 1) S��ial ���.urity Psu����(s} ��' 2} Medical/�iealth �nfarm�tion li 3) f'�rsann�U[7isciplinary Inf�rmation �'p 4) ��nk Accourrt Informatian '; �) �wnanciallnfarmation '; �} �r�dit Card Numb�rs �! I' !f �ny d�curr�entafiion you d�sire �n submit tc� ti�e �ity af D�buque �ontains� �ny afi th� items ab�v� � thi� �aver sh��t mtast b� att��h�d dir��tl� tc� the �anfid�ntial inf�rm�tion �nd ':ndicat� th� type af � inforrr�atior� th�t is included� � i � :; � ; i 0, Micha�l J. l.�nstra , her�by �ertify that �he ��fiached d�eumenfis ;I ar��lude the f�llowir�g protected inforrn�tian� '� !J ,�Sr�ciaf 5�curi�y Nr�mka�r(s) �______���k A�cour�t fnf�rma�ion i ;i �; ��M�dic�ll:��al�h Inform�fio�i �_____�Fir�anci�l Informafii�n � � - Persor�nell�?isciplinary Inf�rmat��n _�__�_Cr�dit C�rd Nur�b�r(s) 'J 1 understand fihat this inf�rmatiarr may b� distributed within fihe �ifiy organization �r to ager�ts a�the � �ity far pr�c�ssing �nd I h�reby �uthoriz� the Cifi� to a�t ��cordingly t�king all precauti�n� ta a prcat�ct my i arrr��tir�n from unnecess�ry di�tribufiinn. � � � � �,°': � � Nov�:mber 13, 2019 �ign t Date �� �� � � Copyrighted December 2, 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: Nancy Fett for vehicle damage; Michael Lenstra for vehicle damage; Ethel Schneider for property damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Staff Memo Dubuque � THE CITY OF ►�..�,�,� � �" All•Am� � �.�/ � � w»�u.awcirxxxi: �� r' II '°r 2007■2012�2013 Masterpiece on the Mississippi 2oi�*zoi9 ' ; � � TRACEY STECKLEIN � PARALEGAL � � MEMO j� ,� To: Mayor Roy D. Buol and ' Members of the City Council DATE: November 22, 2019 RE: Glaim Against the City of Dubuque by Michael Lenstra ;j Claimant Date of Claim Date of Loss Nature of Clairn Michael Lenstra 11/15/19 11/11/19 Vehicle Damage j '1 This is a claim in which claimant alleges that his vehicle which was parked near 1611 { Amy Court was struck by a City of Dubuque snow plow truck. ;j il I This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa J Communities Assurance Pool. � , cc: Michael C. Van Milligen, City Manager John Klostermann, Public Works Director Michael Lenstra � � , � � � � OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/Ffvc (563)583-1040/EMai� tsteckle@cityofdubuque.org