Claim by Brandy Breitsprecker (Corey Hillard) THE CITY OF
DUBUME MEMORANDUM
I
Masterpiece on the Mississippi
I
ii
TRACEY STECKLEIN
PARALEGALa
i
i
i�
To: Mayor Roy D. Buol and
Members of the City Council
ii
DATE: August 6, 2015
!i
RE: Claim Against the City of Dubuque by Brandy Breitsprecker
Claimant Date of Claim Date of Loss Nature of Claim
Brandy Breitsprecker 08/05/15 06/11/15 Property Damage
This is a claim in which claimant alleges that a City sewer backed up into claimant's
basement at 2630 Fulton Street causing property damage.
This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa
Communities Assurance Pool.
cc: Michael C. Van Milligen, City Manager
John Klostermann, Street & Sewer Maintenance Supervisor I
Brandy Breitsprecker
0
OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA
SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944
TELEPHONE (563)583-4113/FAx (563)583-1040/EMAIL tsteckle@cityofdubuque.org
CLAIM AGAINST THE CITY OF DUBUQUE, IOWA
5
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: Brandy Breitsprecker / Corey Hillard
2. Address: 2630 Fulton St.
3. Telephone Number: 563-581-4802
4. Date of Incident: June 11th, 2015
5. Time of Incident: Between 8AM -5 PM
i
6. Location of Incident (Be specific):
2630 Fulton Street. Dubuque, IA 52001 - Basement/laundry room /storage room
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.)
Sewage back-up from drain into basement causing property damage. Called city at 7:15PM to verify of any on-going issues in
the area. Ron Uglyash and Bill from the city arrived over an hour later and said it was indeed on the city's end. They said that
this certain area of the sewer had an ongoing issue and needed maintenance every 3 months to prevent back-up. Ron Uglyash
and John Kloste rmann(Street and Sewer maintenance supervisor)put a request in to the city to update sewer man hole to fix the
on-going sewage issue.
8. What were weather conditions like? Rain, but the city said was not the
9. Give name and address of any witnesses: Ken Koerperich 563-451-8502
10. Did police investigate? (If so, give names of officers.) i
No
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
No
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.)
Yes,the back-up resulted in sewage expanding into 2 separate rooms. The sewage water came up through the drain
in the laundry room, made its way under the wall and into the storage room thus causing damage to walls,trim, floor,-
and personal property.
13. What other damages do you claim, if any? $600.00 for discomfort, stress, and inconvenience.
II14. 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.)
No
15. What amount do you claim from the City of Dubuque?
Incidental damages include: Personal property-$1,881.75, Servicemaster-$537.26, Spawn and Rose-$804.18
Speculative Damage include: Backwater valve installation-$3,400.00. Total amount claimed -$7,223.19
16. Why do you claim the City of Dubuque is responsible?
We were told that the sewer is out of date, and defective. John Klosterman, the Street and Sewer Maintenance Supervisor,
has a s submission into the city to get it replaced.
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?
No
Dated at Dubuque, Iowa this day of <Z 20
(Signature)
a V1 V e !" (Print Name)
C7 Ln
C_—
3 C' c-) 171-1
(Rev. 7/12) cn rn
,D U�
D N idyl
C�
m c"
Confidential
This communication and any attachments may contain information which is confidential
and privileged by law and is for the use of the designated recipient. If you are not the
intended recipient, you are hereby notified that you have received this communication in
error, and that any review, disclosure, dissemination, distribution or copying of its contents
is prohibited. Please notify City of Dubuque immediately by telephone at (563)-589-4120 of
your receipt of these items and destroy the communication and any attachments
immediately. Further disclosure of this information may violate state and federal
restrictions.
Confidential information may include the following:
1) Social Security Number(s)
2) Medical/Health Information
3) Personnel/Disciplinary Information
4) Bank Account Information
5) Financial Information
6) Credit Card Numbers
If any documentation you desire to submit to the City of Dubuque contains any of the items above,
this cover sheet must be attached directly to the confidential information. Please indicate below the
type of information that is included.
I, , hereby certify that the attached documents
include the following protected information:
Social Security Number(s) Bank Account Information
Medical/Health Information Financial Information
Personnel/Disciplinary Information Credit Card Number(s)
I understand that this information may be distributed within the City organization or to agents of the
City for processing and I hereby authorize the City to act accordingly taking all precautions to
protect my information from unnecessary distribution.
Signature Date
I have read the information above and do not have any confidential documentation to submit to the
City of Dubuque as part of this Claim Against the City.
V� I -& --- ' YI 11Jr
Signature f Date
ii