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Notice of Claims and SuitsCopyrighted April 4, 2022 City of Dubuque Consent Items # 2. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUMMARY: BNK Properties / Dubuque Dental Associates for property damage; Dubuque Orthodontic Associates for property damage; Lynn Lampe for vehicle damage; Frank O'Connor for vehicle damage; Ron Vaughn for property damage. SUGGESTED Suggested Disposition: Receive and File; Refer to City Attorney DISPOSITION: ATTACHMENTS: Description Type Claim by BNK Properties / Dubuque Dental Associates Supporting Documentation Claim by Dubuque Orthodontic Associates Supporting Documentation Claim by Lynn Lampe Supporting Documentation Claim by Frank O'Connor Supporting Documentation Claim by Ron Vaughn Supporting Documentation CLAIM AGAINST THE CITY OF DUBUQUE, IOWA This written report constitutes your claim against the City of Dubuque, Iowa. You should complete this form in full and attach any additional information that supports your claim. The Claim must be filed with the City Clerk at City Hall, 50 W. 13'h 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 recommendation will be submitted to the City Council. You will be provided with a copy of that report and recommendation. THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF 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: BNK Properties / Dubuque Dental Associates, PC 2. Address: 1890 John F Kennedy Rd City: Dubuque 3. Telephone Number: (563) 556-4234 State: IA 4. Date of Incident: Tuesday, March 8, 2022 / Wednesday, March 9, 2022 Zip: 52002-3810 5. Time of Incident: Undetermined: it was between hours of 5 PM (Wed) and 7 AM (Thurs) 6. Location of Incident (Be specific): The 2639 SF basement of Dubuque Dental Assoc, PC 7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give full details upon which you base your claim. If a City employee was involved, give the employee's name.) Owners and employees of both Dubuque Dental and (neighbor) Dubuque Orthodonitcs came to work Wed. March 9th to discover 6+ inches of water in their basements caused by a city water/sewer backup. 8. What were weather conditions like? 30+ percent sunshine/36-46 degrees thru the day 9. Give name and address of any witnesses: All employee of DBQ Dental & Ortho. See attached. 10. Did police investigate? (If so, give names of officers.) No 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). N/A 12. Was any damage done to property? (If so, describe property and the extent of damages. Attach estimates of damages or describe basis for ascertaining extent of damage.) Extensive loss of dental materials and supplies, furninshings, flooring, drywall, computer equipment, two furnaces, air purifiers, refrigerators, and employee -personal property. Total loss of anything 13. What other damages do you claim, if any? touched by sewage. See attached spreadsheet. 14. Have you been compensated for any part or all of your claim by any insurance company? (If so, give name and address of insurance company and amount paid.) PENDING %CC tjj7406eA 15. What amount do you claim from the City of Dubuque? TBA 16. Why do you claim the City of Dubuque is responsible? Both 1890 and 1920 JFK had sewage backup into bldgs and once the city unclo ged via manhole across the street water receeded. 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) No 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? Dated at Dubuque, Iowa this 24 day of March 2022 (Signature) Brett N Kilburg, DDS / Owner (Print Name) N IV S _ t^1 70 F_ 6 � (Rev. 5/18) F7'I m n o M o n cn CLAIM AGAINST THE CITY OF DUBUQUE, IOWA This written report constitutes your claim against the City of Dubuque, Iowa. You should complete this form in full and attach any additional information that supports your claim. The Claim must be filed with the City Clerk at City Hall, 50 W. 13th 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 recommendation will be submitted to the City Council. You will be provided with a copy of that report and recommendation. THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF 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: ZW3 L( MTµo pq (O5 D F} SSnG(rf Th" < 2. Address: 0 R ol= & C Ntv U y R h Sr(= f� City: 6kL0LA. 62 Lt r State: s Zip: 3. Telephone Number: SS—(; ;� 4. Date of Incident:1y1 5. Time of Incident: 467 Drsc v;: a Ufhprt (Pe u uLwiy& TKf rul (b � 6. Location of Incident (Be specific): l qa o Sotto K Nlj b� SZC LQoc-k LGUc=L- 7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give full details upon which you base your claim. If a City employee was involved, give the employee's name.) SG-Wef- aYi Y Ue L/i! L-Ld,-�L LL=ULL Lgu-47-ia)-, EriZe16Sto¢ r)aratr46r- (kn9(,Li4tNi10L �R�CETSI. 9kk LJO-L(. q(-It> �i ruS 8. What were weather conditions like? SLLJL#Ql p 9. Give name and address of any witnesses: 10. Did police investigate? (If so, give names of officers.) !v o 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). 12. Was any damage done to property? (If so, describe property and the extent of damages. Attach estimates of damages or describe basis for ascertaining extent of damage.) VEC4 E(.oaX.1t)6 WAs VAMIJ t,eD �, �p La<r �� � ��'�f��L �a< nrm�AGFn ��•� SI/u9ter( j rL A-) C�P_C C407-#MkfvoTe> hwo Loss -._. 13. What other damages do you claim, if any? fiFa:y,�,to . G,-£J{ a uP wk6 (BIZ 6CO OUT(-( S� idt �i}lr'R t�t�Ydwith7ri'TinnJ �CCrt�c t✓c tNGIU(>En CI��i! i �riyl•JRL 2eln t��iPDS L. 14. Have you been compensated for any part or all of your claim by any insurance company? (If so, give name and address of insurance company and amount paid.) wo 15. What amount do you claim from the City of Dubuque? `mrd}t c°aT u�r Y�r i>L- uMiN&o co -sr or x,(- FL--vaukLt pot twl�Gt, XtPr�rt),, cry&O aP&D ltiNi�> Dom 4aeih s6tPfLies 16. Why do you claim the City of Dubuque is responsible? 'liG ctiY S lduR L(O(:F 3t&t,-et, 4 &16 4 NL F1ejj� wt@( 1=ose0b 101 ii su(v UN� 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) W_ c G & o u)n Tinic i, n �..9r' ._ _ /— i7 n a ,: n,l.. i..r n 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? Dated at Dubuque, Iowa this as rh day of hb R1Zc,!+ 20- a'ir- re) ft V l D l,. Mtr V� P (Print Name) (Rev. 5/18) n N N 3 n, CT C 0 ^� 0 n w r� CD r CLAIM AGAINST THE CITY OF DUBUQUE, IOWA This written report constitutes your claim against the City of Dubuque, Iowa. You should complete this form in full and attach any additional information that supports your claim. The Claim must be filed with the City Clerk at City Hall, 50 W. 131h 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 recommendation will be submitted to the City Council. You will be provided with a copy of that report and recommendation. THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF 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: V6?/r p GYJ c / 2. Address: / I ��/ , a R City: State: Zip:5 Apo f 3. Telephone Number: 4. Date of Incident: _,�- 5. Time of Incident: 6. Location of Incident (Be specific): 7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give full details upon which you base your claim. If a City employee was involved, give the employee's name.) u. wnat were weatner conamons uKe e r !F,-A I- 9. Give name and address of any witnesses: 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). V� 00 12. Was any damage done to property? (If so, describe property and the extent of damages. Attach estimates of damages or describe basis for ascertaining extent of damage.) 13. What other damages do you claim, if any? F#2Z. LLCIS.. rl E'er, :-L' i 14. Have you been compensated for any part or all of your claim by any insurance company? (If so, give name and address of insurance company and amount paid.) 15. What amount do you claim from the City of Dubuque? 16. Why do you claim the City of Dubuque is 7 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) 0 I 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? Dated at Dubuque, Iowa this 2Vday of 611c'&6^C (Rev. 5/18) 20 !Z,-- nature) nt Name) N N , CS C C1 CDCO N n s < n iT CD r Co,( CLAIM AGAINST THE CITY OF DUBUQUE, IOWA J This written report constitutes your claim against the City of Dubuque, Iowa. You shou complete this form in full and attach any additional information that supports your claim. The Claim must be filed with the City Clerk at City Hall, 50 W. 131h 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 recommendation will be submitted to the City Council. You will be provided with a copy of that report and recommendation. THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF 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 1. Name of Claimant: / Vwx 1r\ V_ l 0 Q A)r 2. Address: City: State: 3. Telephone Number: 4. Date of Incident: J4� 5. Time of Incident: 6. Location of Incident (Be specific): 1, 00 avy-) 7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give full details upon which you base your claim. If a City employee was involved, give the employee's name.) 8. What were weather conditions like? UMC 9. Give name and address of any witnesses: 10,1 Did police investigate? (If so, give names of officers.) I���a� av3a-Dl1�c�l 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). 12. Was any damage done to property? (If so, describe property and the extent of damages. Attach estimates of damages or describe basis for ascertaining extent of damage.) 13. What other damages do you claim, if any? 14. Have you been compensated for any part or all of your claim by any insurance coMpan„y? (If so, give name and aiddress of insurance company and amount paid.) 15. What amount do you claim from the City of Dubuque? b tI � 16. Why do you claim the City of Dubuque is responsible? �fi l'— 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? M(V�'h Dated at Dubuque, Iowa this day of , 20 (Signature) (�t N) (Print Name) C > C CL ) (Rev. 5118) r r t� CD rJ'1 lac cl AGAINST THE CITY OF DUBU UE A, r CLAIM A{a Q , IOWA VV This written report constitutes your claim against the City of Dubuque, Iowa. You should complete this form in full and attach any additional information that supports your claim. The Claim must be filed with the City Clerk at City Hall, 50 W. 131h 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 recommendation will be submitted to the City Council. You will be provided with a copy of that report and recommendation. THE FINAL DECISION ON ALL CLAIMS IS MADE BY THE CITY COUNCIL. NO EMPLOYEE OF 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: 2. Address: 73 3. Telephone Number: 4. Date of Incident: 5. Time of Incident: 6. Location of Incident (Be specific): 7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give full details upon which you base your claim. If a City employee was involved, give the employee's name.) i 1a-0JCW14-r 1 V 391r ? 8. What were weather conditions like? 9. Give name and address of any witnesses: 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). ,1za - 12. Was any damage done to property? (If so, describe property and the extent of damages. Attach estimates of damages or describe basis for ascertaining extent of damage.) .1(,,,4 Sh e2 -S.-ale 4,141, 13. What other damages do you claim, if any? L .5 ,�e- &Ja//c 14. Have you been compensated for any part or all of your claim by any insurance company? (If so, give name and address of insurance company and amount paid.) 15. rat amount do you claim fr'o_r� the City of Dubuque? 16. Why do you claim the City of Dubuque is re o ible? 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, g p name and address.) 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? Dated at Dubuque, Iowa this ST• day oU- 20�- -> IWI/ (Rev. 7112) Signature) (Print Name) r,l iv 5- C CJ r N CD