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Claim by Steve CookTHE CITY OF DUB E MEMORANDUM Masterpiece on the BARRY LIND HL CITY ATTORNEY To: Mayor Roy D. Buol and Members of the City Council DATE: January 2, 2008 RE: Claim Against the City of Dubuque by Steve Cook Claimant Date of Claim Date of Loss Nature of Claim Steve Cook 01/02/08 12/20/07 Property Damage This is a claim in which the claimant alleges that a large amount of snow fell from the City Hall Annex roof onto his building, damaging the building's wooden porch, awning, iron railing, window screen, and cement at the base of the railing. This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa Communities Assurance Pool. BAL:tIs cc: Michael C. Van Milligen, City Manager Jeanne Schneider, City Clerk Rich Russell, Building Services Manager Steve Cook OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 3OO MAIN STREET DUBUQUE, IA 52001-6944 TELEPHONE (563) 583-4113 / FAx (563) 583-1040 / EMAIL balesq@cityofdubuque.org CLAIM AGAINST THE CITY ~~~ OF DPJBUQUE, ___ __ .,, i L - ~ ~ ' vi -~ _~ Iowc.~~~~F - This written report constitutes your claim against the City of Dubuque, Iowa. You should complete this form in full and attach any additional informatior~Qi~~1N -2 A~1 ~~' 3Z supports your claim. Ff °, _, r, `~~ ~~ iC~ C-ty' 'vsC, r. ,~ The claim must be filed with the City Clerk at City Hall, 50 West 13th St., (~;~' t,~~u~:, ~~~ Dubuque, IA 52001. It will then be referred to the appropriate department for investigation and to the City Attorney's Office. 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 Dubuctue has the authority to make any representation to you as to whether your claim will or will not be paid. Name of Claimant: ~. L ~ ... 2. Address: // ~ ~ ~ ~ ~1~~~/~~ - 3. Telephone Number 4. Date of Incident: 5. Time of Incident: -s' -3~~~'"'~ 6. Location of Incident (Be specific): I ~ ~ ~ ,7'~ „~ s T~~- r ~~ 'f ~C5:J,1(.Xi.~ 7. Describe the 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.) ~ ~„ _ , , ; r __ .._ . L ,~'/1I /~ i f~az~y Tc~ S % JJ ~CX~~~J, 8. What were weather conditions like? irr it .„ ~ iir.~ ~k /~ u~J /~i7~ 9. Give name and address ~ any witnes es: 1 / ~i - clr~e' f~c'r=',Ci<~.S /~3~~~/~9~.~ -t~ ~ ~ 7'<~//~C~~jI~~T- ~~' ~~_ /,~/9iriJ~ /, ...~_ .~.~, /L'~ ~ /. z-> / ~ ~~ /YI~~ itJ ~ 7 .~ T~O.Sc f~t'iG ~t 1 ~.'~~',O~J.9~Gc:~~` ~ 10. Did police investigate? (If so, give names of officers 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.) r~o.~~~ ~~~ iii , ~~,.~ r ~ .~,%,-~~ ri~r~ ~i~~r.~~ 13. What other damages do you claim, if any? ~~~~~~ ~~, ~~,~ ~- ~,~~ ,~ 5~.5 ~ ~To rte/ ~ ~il.__-a 16. Why do you claim the City, of Dubuque is responsible? ~ 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? / ~~ d a r Dated this y of ~~~ ~/~%'~/~ , 20 ~ 7 (Signature) ~ ~~ ~-L C~~ (Print Name) 14. Have you been compensated for any part or all of your claim by any ,Dec~21~ 2007 6~36PM MERCY SERVICES CORP. Asburyr ~om~ ~mprov~rr~ent 2332 Burr Oak Asbury, Iowa 520Q2 Phone & fax (563) 583.431 owner -Mark A. nEernmers Td: Address: Re: ~sTlNlAT~ -.-- -~ N o. 3 813 P. 1 ~~~~~o~ aa~ Customer 3ignaturo o~~ l~ --27~d pwnei 3ignatura .. .. .~G ~ ~ ,~~ . C~~ ~ dome Irm ro~r~~ne~tt Asbury p 2332 Burr Dak ~'~" Asbury, Iowa 5242 C~ Phone & Fax (563) 583-4431 weer ~ IVlark A. Nemmers To: .2 ~ o o .---~.._-- Address: Phone: ~~,,,~.~ -- Re: ~STI~VIAT~ ~` Unit arr~oun~t Quantity Description price P !// ~ / ~~ R 'C. t1~ k !. a I H L - ~c CJC) ~ / ' ~ VI !~1 G u a 20c~~ a nKTd 'c ~ ta. ~ c~. !.H ~ . k c. 2 ~. i ` ' o ,~, ~ ~ Q CJGI .~ GQ. ' .k - r. ~ ~e fc~ n ~ ~h r • ~ ~ ---) G I ~ ~ a~ ~_ _ ~~ r G .~ ~ ~ ~T- Customer Signature pate Owner Signature °~ Date ~~'~~ ~-.~7 ~~ ~~ .-_. q~1'NiiA•N ~1rld~rY Page # _. of .oases ~r- • ~~v V w N•~• " - .?>.T.rSTAT)ES 17'0 W 11TH ST DUSIIQIIE IA 5200, (563) 513-0599 )563) 543-1472 Proposal Suhmltt?d to; ~~,~ ~ c~n~ ~ Job Name Job sk Adnress Job Location ~~ ~ ~ /~ i N ~ / ~' ~/ ~(.~ I ~' ( bite ~~ ~ ~ C ~ j Date of Plana Phony # Fax & Architect WP hereby submit specitlcatlons and estimates tor' --.---.----..---.- ............ ............__.......-...._..._..............._..--...... ii .................. 0.x-1-- ...................... ... ,~ .~!!1!I_...... c..~~._ _- ._-~.. .. ...............................-...................... ...-..._.........._...................-.......... . ._ ----- -.. .., i ~~%~I ~'" h~/sue We propose hereby tp fiarnish ma#eris~l and labor -complete in accord~lnce with the above specifications for tht~ sum of: $ _~•--.. Dollars with payments tb he made as follbvus~ ~~~~ Gy--w~..~._:_1i orN Any :~Iror.~tllon or dOvihtlan rrom above spedflcetlons Invelvlnp oxtr.+ rxr:.gs wlll no Fie9p6ctfUlly /~/y~~ ex¢cuted only ~ilxrn wrltT!+n ~)I'dgr, iU1d wilt UOC9111rr iin oxrrR chRR~e over rand gubTTlitted ~.~ - y ~•~~"'~7_ above the rrr•,rlmnrR. /111:.1Qrotetnent5 r,0ntlifgonr llpOfl ,tdkR~, RecldRnts, or dRtnye ~- •.- beyond civ rnntrnl, Nalp - Ihla proposal may be wlthdrawm by us it' nOt aCC8pt0tl anthill _~„-,,,., days. --- ~i The abova Ares a Pnlfir.Rlirtns and rnndltlnnR are sattsfbcto and are ~1 F ~' ry Signature , ~-+' hAmby aaC.eptocl, You om autliorizod to db the work as cpgr..ifted. Payment., will bo made Fl., ntttllnPd Abovta. fJati~ of AcceotaneP Signature ~: AV~oc~n