Claim by Michael Vondal Copyrig hted
November 16, 2020
City of Dubuque Consent Items # 2.
City Council Meeting
ITEM TITLE: Notice of Claims and Suits
SUM MARY: Black Hills Energy for property damage; Mackenzie Weber for vehicle
damage; Michael J. Vondal forvehicle damage.
SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney
DISPOSITION:
ATTACHMENTS:
Description Type
Claim by Black Hills Energy Supporting Documentation
Claim by Mackenzie Weber Supporting Documentation
Claim by Michael J. Vondal Staff Memo
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CLA{AA AGAINST THE CITY OF DUBUQUE, IOWA i� , M�1��
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'This written reporfi consfiitutes your claim against the City ef Dubuque, lowa. You should
�omplete this form in fiull and attach any addi�9ona1 inforrriation that supporfis your claim.
The Claim must b� filed with the �ity Clerk at Ciky Hall, 50 W. 13t" St,, Dubuque, IA 52001. It
vviil then be referred by th� City Council to the appropria#e department for investigation.
Once that investigation is completed, a report and recorr+mendation woll be submi#ted to the
City Co�an�il. You wii! be pravided wit� � copy of that report and rscommendafiion.
1'fiE FiN,4L DECIS6�N OIV ALL CLAIMS !S MAt?E BY THE CITY COUNCIL. NO EMPLOYEE C3�
TFBE CIT`Y OF DU�QIQ6�E H�►S THE A'JTHORi�'Y TC� IVtAKE At�Y R�PRESENTATION TO Y�U
R►S 'TO VIfHETHEFt YB3UR CLAINi V1fILL OR iti/iLL, NOT BE PAtD.
1. Nam� of�laira�a�t: ��il�'y{f���- � t/�i(��,��,
2. Addr�ss: � �- �7"� �''
�i#y: � !��LQ�` Sta#e: --�� Zip:_S"' d4 �
3, Telephone Number: ��p 3 r �',�-- .3���
4. i3ate of Incident: 1� �� c���C�
5. T'ime of(ncident: �,,lT �P�? � 8:a�0 �m
6. Location of Incident (Be specific): ��Cl� il'1�7"1�o�dL/T!<I�J i4.e�
.S�G I� ��'�'�, 1� / �'1!R°'���1� •P..�> �c/�UQtt�, fi�7 .5�204 3
7. DESCRIBE ACCIDENT OR OCCURRENCE T'iiAl' CAUSE� BNJEJRY OR DAMAGE. (Give
full details upon vvhich yo€a base y�ur claim. If a City �ro�pioyee was involved, give t6�e
employee's r�ame.)
C��-y�.�r��G� `�� �t'���('� e,�ert L�o z�,� ��.,,� ��v� �y .�e.��n�
l�/�i� uJ�'�c�� �' r�5 T"cl��,/��/� /�rn �n�T � �i✓GoA n
8. What were weather conditions like? GL�i1� � �-�2�.1
9. Give name and address of any witnesses: �h'1 COGSai� �� �u��� g�
.d�r�j6�r�l�,�.Z'Z'�l .�oa/
10. Did police investigate? (If so, give name� of ofFicers.)
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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12. Was any damage done to property? (!f so, describe property and the extent of
damages. Attach estimates of damages or describe basis for ascertaining extent of
damage.)
��5. 1'D rr�y ,lS.u.�!� T�ig�t�,2 , S'��' �rT�'-�{�A �"�i9�� �elo�
13. What other damages do you claim, if any? Nd
14. Have you been compensated for any part or all of your claim by any insurance
corr�pany? (!f so, give name and address of insurance company and amount paid.)
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15. 1tVhat arrnount c!o yoa� ciairr�from the Cit� of Dubuc{ue?���C����
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16. Wh do you claim the City of Dubu ue is responsible? c�° l ���`-���
� /1��7 f./7�,�`%al1LG�d� ���`'� fitll� /l'ICJIJt/�i°rr??��/LE�
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17. 9iave you made any claim against anyone else for damages as a result of this incident?
{If yes, give name and address.) ,/�
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18. If the answer to Question 17 is yes, have you received any payment from that source,
and if so, in what amount? ,`�
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Dated a# Dubuque, towa this �� day of,��If�//3�8,�. , 20�
`i��� �'! (Signature)
�/�'f�� JB ����,Jt�� (Print Name)
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Copyrig hted
November 16, 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: Black Hills Energy for property damage, MacKenzie
Weber for Vehicle Damage, Michael J. Vondal for Vehicle Damage.
SUGGESTED Suggested Disposition: Receive and File; Concur
DISPOSITION:
ATTACHMENTS:
Description Type
I CAP Referral Staff Memo
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TRACEY STECKLEIN j'
PARA_L.EGAL i�
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To: Mayor Ray D. Bual and �
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Members of the Cifiy �ouncil : �;{
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DA�r�: Navember 13, 2020 ;�
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R�: C1aim Against the Gity af Dubuque by Michael J. Vc�r�dal
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Claimant Date o�Claim Date of Loss Nature ofi Claim �;
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Michael J. Vondal 11/�2J2� 10/16J20 Vehicle L}amage I�
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This�is a claim in which claimant alleges that as he was abaut to unlaad his trailer at the I�!
Dubuque Mefiropolitan Area Solid V1/aste Agency, a City emplayee operating a bulldozer II,
backed into claimant's trailer.
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This claim has been referred to the lowa Communities Assurance Pool, w
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cc; Michael C. Van Milligen, City Manager jl
John Klostermann, Publie Works�Director � j;
Ken Miller, DMASWA Administrator �
Michael Vondal i;
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QFFICE OF THE CITY ATTORNEY QUBUQUE, IOWA �
SUITE 330,}-�ARBOR VIEW PLACE,3Q0 IV�AIN STREET DUBUQUE, IA 52001-6944
TE�EPHONE (563}583-41�3/F,vc (563}583-104Q/EMa« tsteckle@cityofdubuqua.org �
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