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Claim by Northeast Iowa Community CollegeCLAIM 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~' 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: Northeast Iowa Community College 2. Address: 10250 Sundown Road, Peosta IA 52068 3. Telephone Number: 563-556-5110 4. Date of Incident: 3/6/07 5. Time of Incident: 11:30 a.m. 6. Location of Incident (Be specific): .680 Main, Dubuque, IA 52001 Northeast Iowa Community College 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.) Main sewer line located in alley behind 680 main was clogged. Sewer backed up into Northeast Iowa Town Clock Center at 680 Main. 8. What were weather conditions like? sunny 9. Give name and address of any witnesses: Laurie Kotz (employee) of Northeast Iowa Community College. 10. Did police investigate? (If so, give names of officers.) NO 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). NO ` r 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.) Carpet and VCT the was damaged. It needs to be removed and Professionally cleaned. 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 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? $5215.02 16. Why do you claim the City of Dubuque is responsible? T e main sewer line that clogged belongs to the City of Dubuoue not NICC 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 None. Dated at Dubuque, Iowa this 1 day of April 20 os , T S <lZU ~Cc D~ 2FcTar2_ Signature) Ron McClain ~L~Nr 5 F 2 U~~ ~ c !z-(-~I-O Q {Print Name) (Rev. 1 /00 8 7/01) tti '~~~n ;~ ~ . ~. Z+i :Z ~d Z- ddb 80 Cl~l~l~~~~f 03/202008 TH[115;12 FAQ 563 582 1727 Commercial Flooring f~002/002 ~ FAG Box 3218. 1042b Stonewood Dr. • Dubr~que, IA 52003 • (563) 582-497b • Fax (Sb3) 582-1727 March 20, 2008 l?`A Northeast Iowa Community College 10250 Sundown Rd. Peosta, IA 52068 Attn: Ron McClain Re' Downtown Dubuque Campus. NORTHEAST IOWA COMMUNITY COLLEGE ~~~~<<s Below, you Will bnd the price t0 iurnls ph: 888.nicc.edu www.nicc.edu Also included, is the price to put carpe treads and tiles on landings and vinyl ti.., ...._.~...~....- ............ ..-:-- -- _----- ---~ Mohawk Surreal, it is comparable, due to the backing, with the carpet that 'o'1es damaged. Total bid carpet damaged from water ..................... 53,800.00. Total bid for vinyl file ............................... 5360.00_ Total bid far carpet in corridors on lower level ............ ..... X4,250.00. Total bid for stair' treads and landing in both stairwells ...... . . ........ $9,750.00. Thank you for giving me the opportunity to bid this project. Yf you have any questions or wncerns, please feel free tv call me at 563-582-4976. Sincerely, Rick Jochum Contract Sales Commercial Carpet • Sheet Vinyl • Ceramic Tile ~r SERVICEMASTER by BANFIELD SEVEN HILLS O. BOX 832 ~UBUQUE, IA. 52004-0832 Bill To NICC ATTN.: RON McClain 700 Main Street Dubuque, Iowa 52001 Invoice Date Invoice # 3/21/2008 4722 Ship To P.O. No. Terms Due Date Account # Project 3/21/2008 Description Qty Rate Amount EMERGENCY CLEANUP DUE TO SEWER BACKUP AT O.OOT DOWNTOWN CENTER MARCH 13 EXTRACTION /REMOVAL OF SEWER BACKUP IN 1 325.00 325.OOT AFFECTED AREAS MOVAL OF WET DAMAGED BOXES & REPACKING INTO 1 87.00 87.OOT ERMANENT STORAGE CONTAINERS STORAGE CONTAINERS 1 88.00 88.OOT REMOVAL OF AFFECTED CARPETED AREAS 1 236.00 236.OOT FLOOR SERVICES --- ROTARY SURFACE CLEANING AND 1 250.00 250.OOT DISINFECTION/DEODORIZATION OF HARD FLOORS, INCLUDING CERAMIC BATHROOMS AND CONCRETE ROOMS Sales Tax (7 0%) . $69.02 Total s>r,a~2 Payments/Credits $o.oo Balance Due s]l,rakss ~ Phone # Fax # 563-557-7459 563-557-9508