Notice of Appeal of Claim by Jim Hauber Copyrighted
October 16, 2023
City of Dubuque Consent Items # 04.
City Council Meeting
ITEM TITLE: Notice ofAppeal of Claim
SUMMARY: Jim Hauberfor property damage, Clayton and Nicole Ketchum for
property damage
SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney
DISPOSITION:
ATTACHMENTS:
Description Type
Appeal of Claim by Jim Hauber Supporting Documentation
Appeal of Claim by Clayton and Nicole Ketchum Supporting Documentation
APPEAL TO THE C4UNCIL
City Clerk
50 W 13�h Street
DubuqueIA 5z001
9�11/23
Dear Ciiy Clerk,
I am writing to submit a request ta appear on a council agenda to appeal to the council
regarding reimbursement of $2113.25 fior services rendered due to a sewer bloc{�age in
manhole SANS01991 0� public right of way.
Enclosed are supporting documer�ts and pictures showing tF�e blackage within the
manhole. Digital copies have �een emailed to Katyr Wethal 9/7/23,hlere is the timeline of
events and a brief descri��ian of the incident.
5/28/22 - 6�Z9/2Z SEWER BACKUP
8/2/22 ]AEGER INVOICE
3/ZO/23 GSAV CITY OF DBQ CLAIM
6�12/23 ICAP DENIAL OF CLAIM LETTER
b/23 CALL TO JOHN KLbSTERMAN
gl�I Z3 EMAiI.TO KATY WETHAL
{,}n F,17R (:�pll PYReI'IPf'1f'Pf�I � �Ati,hinr �,iarki ir �,hihj�h r�i;r���tar� tho a�i�iti�r ±n r�,ir� ��,��1��55.
r
Rob Kilcoyne (Technician) Jaeger Plumbing verified the sewer pipe outlet from GSAV to
highway was clear via camera inspectian. Jaeger determined that the main ci�y sewer
line was fully clogged @ manhole SANSD1991, Jaeger cleared blockage within the
manhole. Befor� and after pictures enclosed.
Best regards,
Jim Hauber
� � 3349 Daykin Ct
DubuqueIA 52002
� � 5635560135
� �
James@greatsoundsa�.com
�L�IM ��A�N��' `T�� C[�Y 0� ���U��J�, I�ll�IA
�his wrif�en repor� canstitu�es y�ur claim against t1�e �ity of �ubuque, iowa. You sh�uld
c�mple#e �his farm in full and attach any addific�nai inft�rmaYi�n thafi �upports your claim.
7'he �laim must be filed wi�h the �ity Clerk at City Hail, 50 ►lV, 13t� �t., Dubuque, I�+ 5200'l. I�
will fihen be referred by the City Council fo the apprapriate deparfimenf �or inve�tig�tinn.
Once fha� in�estigation is compkefed, a report and recommenda�ivr� will be submitted 40 �he
�ify Council. You wiil be �r�vided wi�h a co�y �fi that report and r�commendation.
�HE FINAL [3ECISION 0{� ALL CLAIIVI� IS fVi,4DE BY TH� C11'Y C�UNCIL. NO ENiF'LOYE� O�
�HE Cf�Y C]F DU�UCIUE HAS TH� AUTF��FtlTY �� MAK� Ai�V ���RE�EN7�4TI�N T� Y�tJ
A►S TO I�IHE7HI�Et Yt�UR CLAI[V1 lIUILL OR WILL NOT �� �l�.I�.
�. Name of Claimant: �cn�1 - �t
n
2. ,�;ddr�ss: �� ci. ��N L.�
City: U�i�ti,)q f��_ _ S�ate: �� ��p: .�v��i�
� � �
3. Yelephone Number: �p_ cJGJ Q � '�-
�. �}ate o�f lncidenf: 'a�i� -- � �. ��
�. �ime of lncid�nt: ����N� '" � — `��OOA�� �'�O��N�
6. Location of Incider�Y (Be specific): �`� � ��� �. �ew�.s �u.
C:1p Lac�-� �u,� �'1�ill+�v �� � }`�°l� � I�v�,�.'�r `�.�-� �-r� �- N�
� ,
7. DESCRIBE ACCID�NT OR t�CCtJRRE�lGE �"HA,T CAUS�D iIVJIlRY �R D�4�iAGE. (Gi�e
full details upon whi�h ynu base your �laim. lf a City ern�loyee was irt��lved, give �he
ernployee's name.)
$. What were weather co�ndi�inns fike? ��`��- ��U �unf�
t
9, C3ive name and address of any witnesses: Rv� ki(e.4 i�� -�i�E e+" ��u'�.h�n� `��� ��o���Q�_e��
+ �b35� ('v6�`� � ��S�i �t,p6�
1i�. Diti poiice in�es�iga4e? �lf so, gi�e names og o�fiicers.)
�U U
1'1. �lias anyone injured? �If so, g�ve names, addresses, antf extent a� injuries).
f
vu
R�. UVa� any damage d�n� t� pro�erty? (I� so, de�eribe praperty a�d ��e �x�en� [��
damages. Af�ach estimates a� damage� or describe basis f�r ascertaining ex�en� t�f
damage.)
� ���
13. 11Vh�t other darr�ag�s do you claim, if any? _�, �� u:n�n n-
�
�
'14. Ha�e you been corr�p�nsat�d for any part or all of your claim by any insurance
c�mpa�y'? �I� s�, giyc r�an�e ar�d a�dre�3 �t in��ra�ce icsr�pany a�� am��nt ��ic�.j
Nu
�5. Vllhat arr�ount do yv claim from fihe Ci�y af Dubt�que?
� � 1C>
, , -�,�_.�-
16. Wh do you claim �he City o� �3u�auque i� respc�nsibie?
` loa.�.,��s�'��r U1��,�. c�r���r�+�n�c�-�-�����_c,i�v_t- ���1��_c�� ��� �1 � 5�1`�`1l
� ��
17. Flave you made any claim again�t anyone else for damages as a result of this incidenY?
�lf yes, gi�e name ancE addr�ss.)
�-� ------ � -
�8. If the answer to Question 1� i� y�s, ha�e you received any payment frt�rr� that sourc�,
and if so, in what amount?
Dated at Dt�buque, I�wa this �,� day of �`�,c„`C,�--- -- , �0�,
� (�ignature)
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' Fi�9nr� a �1�1m
wn�„�n���a 1 �t�e a cie�m�
If ynu I7�ve su�tained�n in)ury or damage tor whioA you belir�v«ihe Clty or ona of(ia employc�ne I�rqsponeibin,you
� mAy fll�a clalm ay7�inst ihe City.
liaw l�m 1 FEeques4 a CIaIm 1=orm'�
It�arder tc�ohtaln a�IpLC�aCalb nlease cc�nfaci or vtsfi ono of thca inilowing City ofifiaes:
S+�Lk�7.[(I�P. S�11Y1�11uW9v'�.�itice
City Hall I-ierbor Vi�3w Piscc�,8io.330
60 W.131h 6i. 30C3 Moln at. I
� i�ul�ut{uo,lA 5;�001 l3Ul�uy�io,IA 5'?Y101 ;
G63.��9.A120 aB3.Gk13.41'I3 '
Gan 1 Sc�nd It�Addi81ana11nYorma4lan uvlth the Ci�im �r,rm?
Yes. It is recammondsd th�i ynu sond�n es+nuclt inCormailon as poes3Uto wiih your claim torm In order tn expedite I,
ihe InvesllpeUon nf ilre alaim.71i1s inoluti�s,but is noi limi4�d to,e�stlnmat�s, renelpis,mmdint�l b]Iis, picturaa and any 'i
other infarmation you Toei me�y Ua relevant ta your ci�rlm. 1!Cs qlso recommencied iI7a1 you sene3 In copir�s of ihese �
Itame and kaep it7e orlginele ior your records, j
What Happons Attor 1 Fllo MY Gielm9 I
Once�clatm}�as bee�recelved and flla-eiarnped by iha Giry Clerk, It tzc fnrwarded to Ihe Cily Altorney`e t7tfico Tor ����
investl�atian.ClQimn Involvin�poraon�l inJury ar suusi�rntlai prnpnrly damegs wlli bm(onuarde�to ilr��ity's claims
agenoy Por investig�tton.You wili rea�ive�leii�r irom the Gity Atinrn�y'�C)itices Ind9aating ihsC your�lalrn 17ae benri
�
�. forw�rcio<I to ihe oiaitna agenoy.Thia letier wlll alao oontain the ciaime agency s cnntt�ci fnfiormailor�. �.
- A ciatm�udJusier wiU ihr�n cc�niacl you regarding your ol�lm.At ihat polni,any ryuestinns regnrding your nlaim ��..
shauld be addressed in the claim�adJustor.Ail aiher al�fms will we forwarde�3 4a llie apprapri�te Gity denertmeni tar
Invsatipation.Afier sp�aking witlr empioyeee and aonsuiiing dep�rtmc�nt recorcis,lhe clonartrrtent manager!
superolsar wili m[�i<�a recornme�nc3aUon as to whethse 1he cia(m shauld be anprovec3 or clanled,
B�eesi on lhat InPnrmetfon,iir�City Alicrrn�y wlll ihan meice a rocnmmendaiion to 9ho Clty Counoil As io wtreihor Ihe
alaim�ahou3d bo a�r�rrovec3 or denl�d.IC the City Aitorney r000mmends 9het ihm claln7 be d�nied,ynu w1il reaeive a
capy oP ihs ciepsflment manager 1 st3{aervisar's report alzrng wiih iho Ciiy Att�+mey's repnri io the Clty Cuuitcll.
If the Cliy Attornoy recan7monds tliet 4ha clalm be�ipprovad,yraa witl receive the C31y AUornay's ronort tu ths City
C+aunait as well ag�a role�iso form to�ar�signad and returnecl io iho C9ty Aitomcay's l7�tice.7hoso are only
reaomrnendatlans. tt 1�lmportt�nt tn nntc�iiiet 10m tln�ai deoislon on aD nIa(mm is made Uy the Clly Gouncii,
No employea+�P the GRy has tho a�Nhority in rnalce any re��rosentation io you as to whc+thsr your claalm wlll or wili not
be paid,If tha�lty Councti apprav�a iha cteim tor payment si Ita City Councii mersting,a at�eck will bs mel��d ia you
pravided ihe Otty Attorney'e t��'ice hme recel�nd your aigned rateas�fnrm.
Whafi i�My Glalni is Danled hy the Gity Cnu»c117
'fhe Gi4y Caunnii m�kee ite doterroinatinn s�i Oliy Gouncll me��ings,wriicia are hetd ihe Tirst and third Monciay of
� - eech monih.We renomrn�snd writina a t�iter io ihe Glly Councli indicating why your clatm shoulU not be danted rand
�. any edditionat infarmation that You h�ave to�upp�arl yowr ei�im,
!t Is not ndcnssary 8a�p��eai the CSty Aitnrney's recommendaiton for danial oY your aiatm hetore U5e Gity Gzaunnit
m�kes its ei�terrnina#lon,howevar,yeu r�iay do so.You are Invited to attand{he City Council meeiing wh�n you3•
olaim will b�decided;how+�ver,your aitarulc�nce ts not mandaiary and you�iill have the rlgYli to eppeAl the Gliy
Counoil's de�islon any iime�fier Ct has be��i made.
IY yaur claim or appeui is de�rl�d,you have ihzs nptlan ofi tl8nq a IAwsult In�court of appropri�te Jurlsdictior�.
How Long I�o 1 Heve ta Walt BeYore my Claim 3s iYesolved7
7he length oY tb7��3t l�Res to investigate mnd r�so�ve a cletm depends lnrgely an tl�e nature of ih�ala+lm end 1he
amount nT damepos invnlvod.Sorne ololms may take a few weaics to resniva,whlle others�n�ay iakm longor. If yau
wleh to ol�eck on tho�t�tus of your eslmim or if you havo any yuestlons nr oonaerns sbnut iha procesa,canta�l ihe
�� Clly Atiomay'�Y7fflce at Sti3.B8�.�4113.
���, r,1 w�v�to rt���l�aLm7 --.
You may flle e c�alm et any ilma,I-inwavor,if your claim is denl�ei by 1h�City Cauncll and Yn�'wiah to fila a tawculi,
you mhauid be awaro ihok ffitaie law may IImR ihe fiime In which to Tlle a lawe�iit.
��n�iden�i�l
Yhis communicatinn and any attachment� may eantain ir��o�r�ation which is confidential
and pri�ileged by iaw and is for the use of the designa�ed r�cipien4. I� you are nof �he
intended recipien�, yt�u are hereby nofified fihat you have rec�i��d this communication it�
error, ar�d �hafi ar�y re�iew, disclosure, dissemination, dis4ribution or copying af its content�
i� proh9bi�ed. �lease notify �ity of dubuqu� immediately hy teiephone at (563]�5$9-4�12U of
your recei�t ofi the�e it�ms and desfroy the communication and any att�chm�nts
imrr�ediately, �ur�her disclosure o� �his infor�7iation may violate sfate and federal
re�frictions.
Cor�fidential infarmation may include the following:
�) 5acia� SecurityNumbei(s)
2) Medicalll�ealth Information
3) PersonnellDisciplinary lnformation
4) 8ank P,ccount Informa�ian
5} Financia� lnformation
6� Credit Card N��mbers
If ar�y documentation you desire to submit to t�e City �f Dubuque contains any ofi the items above
this cover sheet must �e at�ached directly ta th� canfident�al informatio� and indicate the type of
inforrnation tl�at is included.
�, _,ct�l�e � �c�._U��<. � , hereby c�r�ify that �he attached documents
inc4ud� the foll�wing pr�tected information:
Social Security Nurnber(s) Bank Account Informatio€�
MedicallHealt� Informatior� Financial I�formation
Personnel]Disciplinary Information Credit Card Number(s)
I uncierstand �hak this information may be distri�uted within the City organization ar to agents of the
Gity far processing and I here�y authorize the City to act accardingly taking al! precautians to
protect my information from unnecessary distrib�tion.
=�,�.�1�----� � �.�
'�ig t're Date
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�� 17500 S John D�er� Rd ����i��
���;��� Dubuc�ue, IA 52001-8244
563-583-6677 Date Invoice# �
VWMOIMO 6 pU�iPr INO.
8/2/2022 4A576
Bill To
Gxeat Sounds Audio
3345 Daykin Ct
Dubuqire, TA 52001
p.0. No. Terms Project
06J29/�022 Due nn receipC
�ty Description Rate Amnunt
Cleaned sewer line frorn builcling to City sewer rnain, Pluggeci
200' fi•om house
300 Sewer Mttchine 150.00 150,00
Pressixre Jetter 250.00 250.00
���OT 1,575,00 1,575.00
Sa10s Tax 7.00% 138,25
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Provide us your email acldress and we can esnail future invoices.
Payment due upon receipt. 1 1/2%service chaege on all past due ����) $�,113?5
balances. MCIVISA accepted by phone with convenience fee
��yrr+�n�lCr�clits $0,00
����((i�� ��� $2,113.25 i
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� 12951 University Avenue,Surie 120 � Clioe,IA 50325
� Underwrkfng/Local AdininietreNom(SOtl)383-0116
Clalms:(888)52tl-4674
� www.iu�N��wa.com
June 12,2023
James Hauber
3349 Daykin Court
- Dubuque,IA 520tl2
RE: (�ur Member; CICy Of Dubuque
�� . � Our Clalm No,; . 4A2303L10RVG0001 .
Date of I.oss: 06J28J2022
Claimant: 3ames Hau6er
Dear James,
� We are hendling the above captioned matter on 6ehalf of City Of Dubuque, who is a Memher of the lowa
Commun`rties A5surance Ppol-ICAP.
As part nf our analysis, we consider whether our Member Is legal Ilable for your loss. If the Member is not
__ .. .Iegally 1ia61e,the.n.there is.naJegal obUgation_to.pay ypur 2�laim, 1Ne havecomplated_nurJnuestigatlon ofthe. _. _ I
clalm referenced ebove.We believe that we have obTeined alI the facts concemir�g this claim and are able to I
adv(se ynu of our declslon. !�
Following enalysts of the relevant fects,please be adv�aed that our Member Is rrot at fault for your loss and, ,
kherefore,we mwst deny this claim. '�.
If you have additipnal intormation regardingthis matter thatyou would Iike us to consider,pleasa contacC me �i�
at the number Iisted beiow. ,
Sincerely, �I�
5hannon Killam
� Clalms Examiner-MuRi-Line �
. (515)639-3117
sha nnon @ ica p iowa.com
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