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Claim by Todd WesselsTHE CITY OF DUBUQUE MEMORANDUM Masterpfece on the Mississippi BARRY LINDAHL I I CITY ATTORNEY To: Mayor Roy D. Buol and Members of the City Council DATE: May 22, 2008 Re: Claim Against the City of Dubuque by Todd Wessels Claimant Date of Claim Date of Loss Nature of Claim Todd Wessels 05/19/08 05/17/08 Property Damage This is a claim in which the claimant alleges that the City sewer in front of his residence located at 1330 Belmont, was blocked, resulting in water backing up into claimant's basement. 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 John Klostermann, Street & Sewer Maintenance Supervisor Todd Wessels 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 balesq@cityofdubuque.org 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 Clertc at City Hall, 50 West 13th St., 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 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: Todd Wessels 2. Address: 1330 Belmont, Dubuque, IA 52001 3. Telephone Number.563-556-2186 4. Date of Incident: 5/17/08 5. Time of Incident: 9:00 am 6. Location of Incident (Be specific)1330 Belmont St. 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.) The City sewer in front of our house was blocked forcing sewer water into our basement there was approx 2 in of water 8. What were weather conditions like? sunny 9. Givne name and address of any witnesses: Mr. Rooter plumbing responded and contacted the city works department on our behalfs 10.wwD//id police investigate? (ff so, give names of officers.) 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 ersttimates off damages or describe basis for ascertaining extent of damage.) Floor tile came loose, a load of laundry was thrown out, the washer, dryer, deep freezer, refrigrator and furnace all http:/lwww.cityofdubuque.org/printer friendly.cfm?Page1D=155 Page 1 of 2 had 2" of sewer water on them 13. What other damages do you claim, if any? We spent 6 hours cleaning up the water 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?100% 16. Why do you claim the City of Dubuque inns responsible? It was the City sewer that was blocked in the street 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? 5/19/08 8:17 AM Dated this 19th day of May 2008 (Signature) RECEIVED 08 MAY 19 PM 12:01 City Clerk's Office Dubuque, IA http://vwvw.cityofdubuque.org/printer friendly.cfm?Page1D=155 Page 2 of 2