Claim by John ErvolinoTHE CITY OF
DUB E MEMORANDUM
Masterpiece on the Mississippi
TRACEY STECKLEIN ~ r,
PARALEGAL ~`
To: Mayor Roy D. Buol and
Members of the City Council
DATE:
RE:
Claimant
October 22, 2009
Claim Against the City of Dubuque by John Ervolino
Date of Claim
John Ervolino
Date of Loss
10/19/09 07/23/09
Nature of Claim
Property Damage
This is a claim in which the claimant alleges that the basement of his residence
sustained water damage due to a leaky water meter.
According to the report of Ken TeKippe, Finance Director, it was determined a Water
Meter Service Worker replaced a water meter since because it was not registering. After
the water meter was replaced, the new meter leaked for a short period of time, but the
problem was corrected. .
It is therefore the recommendation of Ken TeKippe to approve the claim for $184.80 as
filed. The City Attorney's Office concurs with this recommendation.
cc: Michael C. Van Milligen, City Manager
Ken TeKippe, Finance Director
John Ervolino
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 / EnnAIL tsteckle@cityofdubuque.org
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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 Clerk 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: John Ervolino
2. Address: 928 Spires Dr. DBQ 52001
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3. Telephone Number ~ ~ 5 - `~ ~ ~.-~~~'
4. Date of Incident: ( ~?~`~- ~ ~~ ~ 2~
5. Time of incident: `d ~~
6. Location of Incident: Basement of ranch home in furnance room,
family room, office
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8. Wha we Bathe conditi~ke?~ /°' ,
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9. Give name and address of any witnesses:
10. Did police investigate? (If so, give names of officers.)
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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
thg employee's naJne.) _ n ~ ~,
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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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 o~ damage.)
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13. Wh othe~ damage doyou aim~f any~~ ~ ~~' ~~
15. W t amount do ou claim from the Cit of Dubuque?
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18. If the answer to Question 17 is yes, have you received any payment from that
source, and if so, in what amount?
Dated this l.~ day of v ~Pi2/ , 20~. ~
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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,,p~J~.)
17. Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.)
Don Dietz
14200 Starr Pass
Dub~lA 52002
~~~etCleanin9www.nea~rensn~cbht 83~ 1
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CITY, STATE, ZIP i _i. "'~ TECHNICIAN
CUSTOMER'S EROAIl. ADDRESS ~ Estimate
1Ce J Anticipated Frequency
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TAX ' ' C%s
Carpet ~ t~
Upholstery TOTAL
CONDITION ODOR INSPECTION
Excellent ^ Pets r! Permanent Stains ^ Missing Buttons
Good ~ Smoke ',1 Tears ~ Sun Fading
Fair ~ Mildew ^ Discolorations J Other __
.~ Suggest Replacement ~.! Other ~1 Seams J Other
Charge
Cash ~~an z (/ u
Check # for callin s Best Please tell
Other Wends about us. We look
forward to leaning for you again. X ___----- -
Balances over 30 days are subject to a
O $25 per month late fee and a 1 1!2°o per
month FINANCE CHARGE, or an annual
percentage rate of 780. Customer pays
collection expenses.
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i~l'~Imart :~:w
Save money. Live better.
WE SELL FOR LESS
MANAGER ROBERT HARDING
( 563 ) 582 - 1003
S1tt 2004 OPt 00005253 TE1t 07 TR8 01032
GUN CASE 002650918862 20.00 X ~ ~_
SUBTOTAL 20.00
TAX 1 7.000 % 1.40
TOTAL 21.40
VISA TEND 21.40
pC%OUNT 110420
R°1'ROVAL 1t03929G
it2pNS IO -0089223036911081
vH~lUATION -LVVP
PAYMENT SERVICE - E
CHANGE DUE 0.00
# ITEMS SOLD 1
TCIt 8888 9689 8794 5994 1879
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