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Claim Welu Printing by D. WrighCLAIM 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 flied with the City Clerk at City Hail, 50 W. 13TM St,, Dubuque, IA 52001. tt 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 COUNC1L. 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:, 2, Address: 3. Telephone Number: 4. Date of Incident: 5. Time of Incident: 6. Location of Incident (Be specific):__ WELU, INC. d/b/a WELU PRINTING CO. 1685~CENTRAL AVE., DUBUQUE IA 52001-3626 · (563) 582-1332 ? BUSINESS OF ~LU, INC. , d~/a ~LU PRI[~NG AT 1685 CENTRAL AVENUE, DUBUQUE IA 52001-3626 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.} ' FLCODING FROM HEAVY RAIN DAMAGED FILMS, EQUIPMENT, AND LIGHT FIXTURE. THE CURBS WHERE THE WATER LEAKED INSIDE THE BUILDING HAD BEEN REDESIGNED AND RECONSTRUCTED BY THE CITY OF DUBUQUE. BECAUSE OF THE DEFECTIVE DESIGN, THE WATER LEAKED INTO THE BUILDING AT WELU PRINTING CO. DAMAGING THESE ITEMS. RAIN 8. What were weather conditions like? 9, Give name and address of any witnesses:__N° ACTUAL EYE WITNESSES EXCEPT FOR THE CITY REPRESENTATIVES WHO ARE FAMILIAR WITH THE REDESIGN AND RECONSTRUCTION OF THE CURB INCLUDING JANE SMITH. 10. Did police investigate? (If so, give names of officers.) NO, BUT THE CITY OF DUBUQUE HAS INVESTIGATED SINCE 6-4-02. 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 TOTAL OF DAMAGES CLAIMED IS $60,381.26. 13. What other damages do you clalm, if any? NONE 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.) YES, CINCINNATI INSURANCE COMPANY HAS PAID THESUM OF $40,000.00 TO WELU, INC. d/b/~ WELU PRINTING, CO. 15. What amount do you claim from the City Of Dubuque? $60,381.26 BECAUSE THE CITY OF DUBUQUE 16, Why do you claim the City of Dubuque is respons b REDESIGNED AND RECONSTRUCTED THE OUTSIDE CURB THAT ALLOWs THE WATER TO DRAIN INTO THE BASEMEN~ OF THE BUILDING WHERE WELU PRINTING CO. OPERATES. 17. Have you made any claim against, anyone else [or damages as a result of thls incident? (If yes, gtve name and address.). ' NO 18. )f the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount7 NO Dated at Dubuque, Iowa this ,~' y~'~ day of ~-:-~~_, 20 02 (Rev. 1100 & 7101) (Signature) DAVID J. WELU, PRESIDENT & CEO OE WELU INC. d/b/a WELU PRINTING CO. (Print Name) E. DAVID WRIGHT ~'' NORMAN, GILLOON, WRIGHT & HAMEL, P.C. 800 MAIN ST., PO BOX 857 DUEUQUE ~IA 52004-0857 (563) 556-6433