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Claim by Joan Reimer Copyrig hted J uly 6, 2020 City of Dubuque Consent Items # 2. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUM MARY: Darlene Hughes for property damage, Joan Reimer for property damage, Dane Schrobilgen for vehicle damage; Suit by Eunice Meyer v. Dubuque Hotel Partners, LLC, Kinseth Hotel Corporation, and City of Dubuque. SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney DISPOSITION: ATTACHMENTS: Description Type Claim by Darlene Hughes Supporting Documentation Claim by Joan Reimer Supporting Documentation Claim by Dane Schrobilgen Supporting Documentation Suit by Eunice Meyer Supporting Documentation ,�`r�s� CLAIM AGAINST THE CITY OF DUBUQUE, IOWA T'�� i This written report constitutes your claim against the City of Dubuque, lowa. You should i complete this form in full and attach any additional information that supports your claim. � i 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 recommendatiore will be submitted to the � City Council. You will be provided with a copy of that report and recommendation. I� THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF j 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: ,a�� r� � � ��° ,�1 � �,P`� ��i 'I 2. Adclress: �� ,� �� e ,��a� ,� ,,- .�.�-- City: �� °� State: ,�'1 �_�) C� Zip: �,� C?C� j � � � ` �^ �� : �Q�p��lp �aE??har: �/�,-,_ `7' �,� � / tr� � A � li 4. Date of Incident: , .� , �- c - fi � > � �� 1 t ; 5. Time of Incident: � � ; I�� 6. Location of Incident (Be specific): ��,�` �� ` r f` �� •� ��.�i ��° � ' � � � -�-" a � � �L: �G. , �`�' � � �� J � G 7. DESCRI�E ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give ; full details upon which you base your claim. If a City ernployee was involved, give the 4 employee's name.) ; � � , a , s��.. f � f f �� F' � � � � ��.� I � l � � ,(� ° � j. _<" I � � � � �> � � '� � 8. What were weather conditions like? °�' � � � 9. Give name and address of any witnesses: I � � 10. Did police investigate? (If so, give names of officers.) � � �a�� a � i f i 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). � n � � e� e E � � � � � t � � � � �� 12. Was any damage done to property? (If so, describe property and the extent of 'i damages. Attach estimates of damages or describe basis for ascertaining extent of � damage.) �� ... ,,...... f li � � c� �: � � �{ - � � � ��er� � f`�;� �� J li 13. What other damages do you claim, if any? � �h � �� 14. Have you been compensated for any part or all of your claim by any insurance ,i company? (If so, give name and address of insurance company and amount paid.) '� � �� `I � ; 15. What amount do you claim from the City of Dubuque?4 / /� � —'�� r� ! t s�a � � � �-�C.�4'� 7 ��r� S �a n rl � f c� � ��J� %Il 1 16. Why do you claim the City of Dubuque is responsible? , g I � �` 5 � �. - �' � � l �,c� � i�" � �� s`�1 � �t ��`� �'�� .� ' c��. �1 y� ��f�l,7�� -� �r°d� ��f!�`�. .,�fi� �C�s�.�� T�t1�.�� ` 17. Have you made any claim against anyone else for damages as a result of this incident? (,��, j (If yes, give name and address.) '�j �V�� ,,�� 1 18. If the answer to Question 17 is yes, have you received any payment from that source, �' and if so, in whaf amounf? '! ��.� � �� i �, I Dated at Dubuque, lowa this� clay of '��,,�a..� , 20 ,��.,, � 6 � �4 �. �px„,..�� (Signature) , _ � � fi I �p"� � :� � �. Print Name � ) C�:� � ,-=�- ,.�� r�.a � � � � � � � ,..� . �� (Rev. 5/18) � �� "� �. =� „ � m � `� � G v � � � �, � Confidential i 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 'i error, and that any review, disclosure, dissemination, distribution or copying of its contents � is prohibited. Please notify City of Dubuque immediately by telephone at (563j-589-4120 of I,I your receipt of these items and destroy the communication and any attachments immediately. Further disclosure of this information may violate state and federal ''i restrictions. � i � i ! Confidential information may include the following: � �� 1) Social Security Number(s) III 2) Medical/Health Information y 3) PersonneUDisciplinary Information I; 4) Bank Account Information i � 5) Financiallnformation 6) Credit Card Numbers �i , � If any documentation you desire to submit to the City of Dubuque contains any of the items above this cover sheet must be attached directly to the confidential information and indicate the type of i f rma ion that is included. no t ;�; I, , hereby certify that the attached documents include the following protected information: ' � Social Security Number(s) Bank Account Information �� Medical/Health Information Financial Information ii � iI PersonneUDisciplinary Information Credit Card Number(s) � q I understand that this information may be distributed within the City organization or to agents ofi the ��, City for processing and I hereby authorize the City to act accordingly taking all precaufiions to !' protect my information from unnecessary distribution. � � �i � �. � � ��, � �� ,��;>�� z...�.^— ��'~ t'� �e G� �(L�1 �� a. Si�gnat�re Date � � � � a � � ;; N � � �� Copyrig hted J uly 6, 2020 City of Dubuque Consent Items # 3. City Council Meeting ITEM TITLE: Disposition of Claims SUMMARY: CityAttorneyadvising thatthe following claims have been referred to Public Entity Risk Services of lowa, the agent forthe lowa Communities Assurance Pool: Darlene Hughes for property damage, Joan Reimer for property damage, Dane Schrobilgen for vehicle damage. SUGGESTED Suggested Disposition: Receive and File; Concur DISPOSITION: ATTACHMENTS: Description Type I CAP Referrals Staff Memo . �""" �u�UqU� THE CITY OF ""�� All•A�eeica Ci� � � �.✓ i.d .Ll . w�rvxw.avicuxAn; J ' � � �'��o� �i� � Maste iece on the Mississi i 2°°'*z°12'Zo13 p' �P pp 2a��,��o�� ; ;; � ,� TRACEY STECKLEIN � PARALEGAL �''�� " �� MEMO � � I I� ;I To: Mayor Roy D: Buol and '�+ Members of the City Council �' ; � I� DATE: June 26, 2020 ', `� 'i � RE: Claim Against the City of Dubuque by Joan Reimer { � Claimant Date of Claim Date of Loss Nature of Claim Joan Reimer 06/22/20 ? Property Damage �I:. i; This is a claim in which claimant alleges that the steps and sidewalk at her residence of ��' 945 Oak Street sustain water damage after every rain event. Ili ;! This claim has been referred to the lowa Communities Assurance PooL � ;I cc: Michael C. Van Milligen, City Manager ; John Klostermann, Public Works Director ;� Gus Psihoyos, City Engineer " Joan Reimer � �� 'd ;� � . � � � 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 � , �