Claim by Dane Schrobilgen 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
c�AiM a�A�NST THE cr-�r o� oue;uQuE, io�rA
This written repart car�stitut�s your claim against the City of Dubuque, lowa. You should
complete this form in full and attach any additi�nai information that seapports your claim.
The Claim mus� be filed with the City Clerk at�City Hall, 5t�W. 13t'' St., Dubuque, lA 52001. It ' 'I
will then be referred hy the City Council to�#he appropriate depar#ment #or 9nvestigation. ;
Once that investigation is completed, a report and recommendatian will be submitted to the
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�ity Council. Yau w�ll be provided with a copy of that report and recommendation. �
THE F�lVAL DEGISlUIV ON ALL CL.AIMS IS MADE BY THE CtTY �flUNC1L. NO EMPLt'�YEE OF '�
THE CI'P'Y OF DUBUQUE HAS THE AUTHURITY TQ MAKE ANY REPRESENTATIt?N TD YOU �
AS TO WHETHER YQUR CLAlM V1tILL OR 11VlL NOT BE PAID.
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1. Na��ne of Clairnant: ; ti � � i
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4. �ate af incident: �1� �� ��� �
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l. DESCRIBE ACCiDENT OR Oc�CURRENGE THAT CAUSEI� IhlJl4RY C!R DAMAGE. (Give ''
ful� detaifs upan which you base yo�r claim. if a City employee was involr►ed, give the
employee's name.) I,
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9. Give narr�� and addr�ss of any witnesses: ___ ��? �
10. Did polic� investigate? (If so, give names caf officers.'
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11. Was anyone injured? (If so, give names, addresses, and extent of inauri�s).
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12. Was any damage done to prDperty? (If so, describe prope�ty and the extent of ;
damages. Attach estimates of damages or describe basis for ascertaining extent of �
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13. What ot�eer damages do you claim, if any? 9��� �$,� � Yt�
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14. �iave you been compensated for any part or all of your claim by any insurartce ''i
corropany? (If so, give nam� and address o�insurance company and amount paid.)
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15. Whafi am�unt do ou �rlaim frorn the Cit of Dubu ue? � a ;� �� ���� .
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16. h do you claim #he City of Dubuque is r sponsib�e? !i
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17. Have you rnade any claim against anyon� else for damage� �s a r�saalt af this incid�nt?
�If y+�s, g�ve name and address.)
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`l8. I# th� ansuver to Questfon 17 is yes, have you receiVed any payment from that source, 'i
and if so, in what amo�ar�t? �� 'I'
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Dated at Dubuque, lowa this �� day of �'t,�! � �, 2�� '
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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
D�buque ;
THE CITY OF �
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N�VA.A'W.tNN:1.l=".YJF: ��
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Masterpiece on the Mississippi 2oi�*2oi� �
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� TRACEY STECKLEI �N �
PARALEGAL �
MEn�o � ��
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To: Mayor Roy D. Buol and �'
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� � Members flf the City Council � �, ��
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DaTE: June 26, 2020 �
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RE: Claim Against the City of Dubuque by Dane Schrobilgen i�
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Claimant Date of Claim Date of Loss Nature of Claim �'
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Dane Schrobilgen 06/25/20 06/15/20 Vehicle Damage ��
This is a claim in which claimant alleges that as his vehicle was eastbound and stopped �
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on Pennsylvania Avenue waiting to turn left onto Chaney, he was rear-ended by a City of ?I'
Dubuque police squad car.
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This claim has been referred to the lowa Communities Assurance Pool. i
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cc: Michael C. Van Milligen, City Manager C
Mark Dalsing, Chief of Police �
Dane Schrobilgen �'
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OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA �
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TE�EPHONE (563)583-4113/F,vc (563)583-1040/EMA�� tsteckle@cityofdubuque.org `
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