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Claim by Thomas Duccini Copyrighted September 8, 2020 City of Dubuque Consent Items # 2. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUMMARY: Thomas Duccini for property damage, Joseph Michael Ironside for property damage, Sharon Stratton for property damage. SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney DISPOSITION: ATTACHMENTS: Description Type Claim by Thomas Duccini Supporting Documentation Claim by Joseph Michael Ironside Supporting Documentation Claim by Sharon Stratton Supporting Documentation i ��� � �� � CLAlM AGAINST THE CITY OF DUBUQUE, IOWA ��� � � � ,; This written report consti#utes your claim agains# the City of Dubuque, lowa. You shduld � complete this form in #ull and attach any additional information that supports your claim. th II The Glaim must be filed with the City Clerk at City Nall, 5fl W. 13 St., Dubuque, IA 52001. �t will t�en be referred by the City Council to the appropriate depar�men# for investigatic�n. i 4nce t�at investigation is completed, a report and r�commendation wiil be submit#ed to the !i City Council. You will be provided with a copy of that report and recommer�dation. 'I, THE FINA� DECISION ON J�L.L CLAIMS IS MA�E BY THE CITY COUNCIL. NO EMPLOY�E OF Ij THE CITY �F DUBUQ�E HAS THE AUTHflRITY TO MAKE ANY REPRESENTATION TO YIJJU li AS TO WHETHER YOUR CLA1M W1LL OR WILL NflT BE P�11D. I '1. I�ame of �laimant: �110.��,s ,� Dv c c a.+ � II� �� i. � ����-����: /3 S' f3�o .S"�r-�(•e.+c�. c 7'. I�� � Gity: �tJ�v�v� Stat�: �`o w,� Zip; S'��o Z, I, 3. i'�l�ph�r�� N�rrmber: _- �5"��� S�o - �'i4� � I'!;'', 4. �ate of Incident: _���c // �`` � o��� /2 �`• a .,o•►► . ;v a � 5. Time of Ir�ciden#: // II �. �o��t��� �f �r�c�de�t ��e ���c��f�c): os 6��, ,�d'�eP o,;��. �v6�, Ve �'�k,� �' '�'2 u c� �' � 8 I' �i 7v DESCRlBE �#CCIDENT t�R flCCURREN�E TFiAT CAUSED INJURY OR DAMAGE. {Give fu11 details upon whici� �a� base your claim. If a C�ty empioyee wa� invoived, give the empioyee's name.) ,-�;�"l.v�C2 Z.//L/� L�✓.9�5 I�'!IS?".�/Ctrv/ �,L�/��'Dorv'r"I' C�uiLt.n.6 -•� �,r y , i C' �'C/'v7o Va. � � ea�+�,r'e.dw ,��►c/G�� o� �etRrRd'-+e 7`b rY+,'a /��'c,/,,,��cr�`� . i 8. V1lhat were r�veather condi#ions like? Su.aa�„v � � �� 9. Give name and address of any witnesses: �d��` � � � 10. �id police investigate? (If so, give names of officers.) " � r n � � /V� " �� P 11. V1/as anyone injured? {1f so, give names, addresses, and �xtent of injuries). 'r, fv o ,� % ; �� � � 12. Vi/as �ny damage done to property? (If so, describe property and the extent of !I damages. A#tach es#imates of damages or describe basis for ascer#ainir�g extent of i damage.) I � i �1� ���$Cn� �'�S �D/V� . �x,�'Je.s✓cS GvC/'c /^ Gu,i'/��.� 7�'b ,�Ji^e6��r. l i ..�'o,af C 7`�i G /�/S�%A 9c� • .S^E'� .�'TTi�C d7�1£ O C�� <<-a.M c�T � � '13. INha# other damages do you claim, if any? /'I�o�o,�' , I { 1�. Have you been cornp�nsated for any part or all of your claim by any insurarace � compar�y'? {If so, giv� name and addrs�ss of insurance company ar�d amount paid.) i �i , �'V O j � °15. V1lhat am�ur�t do you claim from the City of Du3�uque? ; f�3e7� � '16. Why do �au cl�im #he City of Dubuque is respor�sible? f'°J l�. ry7 e T�'3/G ,� C i J� ,E /c c G m �*.t'.Sar.in lic. „S'C wcr G„inc w��4 S �vd 7' �cfi/'�c . .Old �7- �o�C. �D/�f�ctc v� � �t tev. °l7, Have you m�de any �laim against anyone �Ise fior dama��s as a result c�f t�is inc�dent? {!f�,�es, ��ve ���� Wrad a�E�re��.� �j /V O � '�ti ; '18. If #�� �nsrrver to Questior� 17 is yes, have yo� r�ceived �ny payment from that source, � �nd if so, in eruhat amount? ''i i � ; '� Dated at �ubuque, I�wa this /��'" day of e�l�. ����' , 2�D Z o . I y� '� ; �}''� fi+� �� � {Signa#ure) i I , � � I, ___. �f�`'��'o�P`1 ,�• �v�c ►n R (Print Namej 7 I y 3 a �� � � :�;� � � '� � �, ' {Rev. 5/18) � � � � '� s� � � '� ;� �' �° .;� ; �, � �? CTi a i�' � � � ca� i I � i i a � � � Confidential '� �, T�is cornmunication ar�d ar�y a#tachments may cc�ntain information which is confidential ; and privileged by law and is for the use of the designated recip�ent. If you are not the ; �nt�nded recipient, you are hereby notified that you have received this communication in li error, and that any review, disclosure, dissemina#ior�, distribution or copying of its contents � is prohibited. Please notify City of Dubuque immediately by telephone at (5S3)-589-4120 of ;! �our receip# of these items and destroy the communication and any attachments i� immediately. Further disclosure of this information may violate state and federal i; i; restrictior�s, ; I! ; Confider�tial information may include the following: i, I! 1) Social S�c�rity N�rr�ber(s) ; 2j Medical/Heal#h Infc�rmatior� ,h 3� P�rs�nnellDisciplin�r_y I�forrr�atic�n !; 4) Bank Acco�nt Information �f 5) Fin�r�cial in�Format�on 6j �redit Card Rlumbers Ifi any �oc�mentation you dssire to st�bmit t� tl�e �ity of Dubuque contain� ar�y c�f the items above this cs�ver �heet must be attached drr�ctly to th� �or�fNdential information and ind�cate the typ� �f infc�rm�#ion that is included. 1, f�c�•�a s /� �vcc.i-. ; , hereby certify that �he attacl��d �ocumen�s �� i�clud� the follt�wir�g protected infic�rm�tic�n: �� I� �Social Sec�rity Number{s) Bank Account Inform�#i�n I, �; MedicaUHe�lth lnf+�rmation �Financial lr�form��ion �'' Persor�r�el/Disciplin,�ry l�formatiflr� Credit Card Number�sj � i� �, ! ur�derst��d that #his in�ormation may be distribu#ed wit�in the City r�rganization or to agents of the R Ci#y f�r pro�essing �nd I h�reby author�ze the Cifiy to act accordingly taking ali precautions to !� prot�ct my informatian fro� ur�necessary distribution. � � � /��� ah• e.�.�:...,� D3/�7/�o z o Signature Date � li� �� � , � p � Copyrighted September 8, 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 for the lowa Communities Assurance Pool: Thomas Duccini for property damage, Joseph Michael I ronside for property damage, Michelle Scott for vehicle damage, Sharon Stratton for property damage, Donald Weig for vehicle damage. SUGGESTED Suggested Disposition: Receive and File; Concur DISPOSITION: ATTACHMENTS: Description Type ICAP Referrals Supporting Documentation Dubuque THE CITY OF � All•Aetrica Cit) DuB E ,,xn���r,:. ;� �:; II 2007•2012•2013 Masterpiece on the Mississippi zoi�*Zoi9 TRACEY STECKLEIN '�" PARALEGAL MEMO To: Mayor Roy D. Buol and Members of the City Council DATE: August 20, 2020 RE: Claim Against the City of Dubuque by Thomas F. Duccini Claimant Date of Claim Date of Loss Nature of Claim Thomas F. Duccini 08/20/20 08/11 & 08/12/20 Property Damage This is a claim in which claimant alleges that the City mistakenly abandoned a sewer line, causing a sewer backup onto claimant's property at 2705 Rhomberg Avenue. This claim has been referred to the lowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager John Klostermann, Public Works Director Thomas F. Duccini ; � OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 33�, HARBOR VIEW PLACE, 3O0 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHotvE (563)583-4113/F,vc (563)583-1040/EM,4i� tsteckle@cityofdubuque.org