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Claim by Eagle Window & Door Copyrighted February 4, 2019 City of Dubuque Consent Items # 3. ITEM TITLE: Notice of Claims and Suits SUMMARY: Paula Beecher for vehicle damage, Robert Decker for vehicle damage, Eagle Window& Door, Inc. for property damage, Patricia and Lyle Galliart for property damage, John Kirk for vehicle damage, Kelly Keenan O'Rourke for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Refer to City Attorney ATTACHMENTS: Description Type Beecher Claim Supporting Documentation Decker Claim Supporting Documentation Eagle Window& Door Claim Supporting Documentation Galliart Claim Supporting Documentation Kirk Claim Supporting Documentation O'Rourke Claim Supporting Documentation _ � V � �-a�i C��:�' - CLAI�V1 AGAIN�T TH� CITY (�F DUBUC�UE, IOWA � ��.P��`j �..�,� � � T�is written repor� constitutes your c�aim,againsfi the City of Dubuque, lawa. You shouId complete this form in fuil ar�d a#ta�h any additic�n�l inforrr�ation �ha#supports your+c�aim. The Claim rnust be fi{ed with the City C1erk afi City Ha�l, 50 V11. '13xn ��., Du�ugue, IA 52001. lt � � wi11 tl�en be referr�d by the Ci�y Council to the apprc�priate d�par-�ment fc�r investigafia�n. � Once that investigafiion is comp��ted, a repor� and recommenda�ior� will be submi�ted to the , Gi�y Council. Yc�u wi11 be provided with a copy of that repart and re�omm�ndatic�n, � � THE F[NAL D�CISIQN C}N ALL CLA€]VIS 1S MADE BY THE GITY CUUNCIL: NQ EMPLUYEE C1F TNE CITY CtF' DUBtJQUE HAS THE AUTHOIRITY TC} MA�{E ANY I�EPRESENTATION TC3 Y011 '� AS TO WNETHER Y�UR CLAIM W1L.L OR WIL� NOT BE PAID. _ � . . � 1. , Name of Claimant: ��--� ��,�-- � � � �- - ; � Z. Addr�ss: �� .:,��. �t�l�I� � City: ��,,�� tate: �� Zip: �C� � � � 3. Telephone Numb�r: � �c�� 'f �� `� �� _ _ �� , ; 4. Date of �ncident: ��! � � �� `�' �;�5��:�� , � ; 5. Tim� of lnciden�: `..�.' ��, ; , ,� , , . ( p } �`�� '� �- _��.�� -�� 6. Locat�on �# lncident Be s ecific : �'(�.��,� ��j 11� , � ��t-.� �,�.;�1��d �'��;`�. � 7. DESCRIBE A�C[DENT C}Ft �C�URRENCE TI�AT CAUSED 1NJUR'Y OR DAMA�E, {Giv� full details tapon which you ba�e y�ur claim. If a Ci�y employee was involved, g9ve the employee's name.� � �.��- ��'� ��...:- .� �� ' ' �,1��4�.,,,. �--- i c��.�c.��'�r� �. �.jr, ��t ��" c� l��-�-�. �' � ��f� ��1�.��`�--�,�,,' `� C�o,�� i�y�try� �'� . �' a� tl`�f�'1 � �C3C`�' 1`�3f�� Cli"'.� �yl��T'�t`� `� �itY�.- Cf6}�#i�'4 , . �(.��'. . �,,.,...- 8. 1Nhat w�re wea�h�r con�at�ons��? ��.�' i �� 9. Give nam� an�l ad�r�s� o# ar�y wi�nesses. �,,l�� 1Q. Did police invesfi�ate? {1f so, giv� names of c�fficers.} � �-f `�" °�'�`l t�F��' V'"� ��i �� "'t��'�tl�� ' �i� �CC� C.��t`�c�4r�`-�' . � ��c� ��"�i,a"� � '�'�. Was anyone injur�d"? {If s�►, c�ive names, addresses, and ex�ent of injuriesj, . � � C� �� -- �12. Was any .d�mage done to property? -{If so, d�scribe praperty ar�d the extent of damages. Attach estimates of damages or describe basis for asc�rt�ining �xfent flf � damage.} � s _ r �-�.� ��.�.1'�� '�;� �C K�.� t1 �- C�;{ t'�t �a.c� � �3 ��G��... ��, � ' � � � '13.��tl�hat c�ther damages do you ciaim, if�ny? � ��C�� ..��,�'� �-c��-`f�s�i� r � 1� � ; . � �:��' �� , � ��.� �� t�c.�c,.��'�'� �� _ � 7 �[4. Have yc�u b�e� compen�ated for any par� or �ll of �rQur claim by any insurance � compan�r? �If�o, giv� namie and a�dress of i�s�trance compa�y and arnount paid.) � � � � � � � 4 15. What �mou� c�c� Yo�u��irn��om fihe �ity of �ubuc�ue? � � � . • � 16. V11h�� do you +cl,aim the City c�f Dubuque�is re�s�po�r�sibl�� M1 � � ��.. � � `��- � �.�.1°�t �t�v�cf.. . i � " ��, . � .s=' ,� ��6` ��, �t.�.J f�'�i��'0� , � '�7. Have yota made any claim aga��s� �nyone else fc�r damages as a result of this incident? �u (If yes, give n�me and address.} � � � � � 18. 1� �� answer to Questicrn '17 is yes, �ave you received at�y paymen� frorn thafi source, � an�1 if so, in whafi amount? � , � �a�et� a� i�u3�uque, lawa this day of , Z�i . �Sic�nature} �� .�t-- � 64��..�� prin� Name} � � � � � � � -�� -� � �a..$ � ��- `�' �� (�ev. 51`98� � �' � � C,; �'s� � � � �s� � � � Confid+�ntial Tt�is carnmunication anc{ any attachments rnay cant�in information_ wh'rch is confidentiai and privileged by law and is for the use of the designated recipient, If yau are not the intend�d recipient, yora are hereby nfltified that yau I�ave received this c�,m'municatia�n in error, and that any review, disclosure, clissemination, r�istribu#ion or copying of ifis contents is prohibited. Piease natify City of Dubuque immediately by telephflne at �563}-58�-4'120 of your receipt o# these ifiems and des�roy the communicatian and any attachments immedia#ely. �urther disclosure of this it�formatian may vicilate state and federal restrictions. � ' � � Canfid�t�tial informatian may include �he €ol�owing: � � � � 1} SociaJ Security Number(s) !� 2) M�dicallHeafth Informatian ;; 3) Pers�nneliDisciplinary Inf�rrnatic�n � � � � � � 4) Bank Account lnformatian ;i 5j Financia( Inf�rmation ; 6) Credit Card Numbers ; �d I If any document�ti�n yau d�sire to submit to the City of Dubuque contains any �f the ifiems abave � this cover sheefi musfi be attached directly to the confidential infarmation and indicate the type af informatian tha# is included. � l h h l � 1, , her�by certify that the �tt�ched dacuments � ;, include the folf wi protected information: ; �, � � Social Securifiy Nut�ber(s) Bank Account fnformation � � Medical/Nealth lnfarmation Financial lnformatic�n � Personnel/Disciplinary lnforma#ion Credit Card Number{s) � , ! understand that this information may be distributed within the City organization or to agents of the � Cifiy for processing �nci I hereby authorize the City to act accordingly fiaking all precautions to . protect my ir�formation from unnecess�ry distribution. � � � _ ��--- /��- �� s��t aat� � , � � � I � � 3 Ea�le Winda►w and Doc�r Sew�r I.ine Back Up t _ _ f � R�einnbursement Request � � a 12J11-Sewer line backed up into the building,sewage coming up thraugh the floor drains in office � restrc�oms,quality lab,and plant restrooms.�ity was called,said leveis were low at the time, but � � showed higher readings fram their meter the night before. � Mr. Roater called to come clear the line from our plant to the city m�in.They said there was a blockage ; the last few feet right aff the city m�in, {$631.19} ` � i Service Master of Key City was called to clean all restrooms and quality lab floors where backed up � occurred.{$84.8.59) � � � i Carpet tiles r�placed in affice haflway,from backup that had oceurred (1 box-$304) i Eagle Window and Door Labar: Problem reso(ution anc!clean up,7 hrs @$45 per hr{$315) � a , � I 12f 19-Sewer line 6acked up again into the building,sewage coming up through the flaor drains in afifi�e and plant restrooms.City was call�d,said levels were low at the time, but showed higher readings ; from their meter the night befiore again. �� j Mr. Roc�ter calEed to come clear liroe from plant to city main.They again said there was a blackage the last few feet right off the city main. {$667.31} Service Master ofi Key City was called to clean all bathroorn floors that backed up. {$321.77� '? '1 � Eagle Windaw and Door Labor:4hrs�a �45 per hr($180} i ; ij ,, � We are rec�uestin�reimbursement from t�e City of Dula�que for the�ollcawin�exqenses: � � 4 Mr. Roater: {631.19+667.31}=Tota11,2985 � Service Mast�r�f Key City: ($848.59+321.77)=Total$1,170.36 � i 1 Box of Carpet TiEes:$300 { t Andersen Window Labor Reimbursement R�quest: 11Nr� ��5 per hr.=Tatal$4.95 � � Total Reimbursement Request:��y2G3.$'�r � � � � , � i � � Copyrighted February 4, 2019 City of Dubuque Consent Items # 2. ITEM TITLE: Disposition of Claims SUMMARY: City Attorney advising that the following claims have been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool: Paula Beecher for vehicle damage, Robert Decker for vehicle damage, Eagle Window& Door, Inc. for property damage, Patricia and Lyle Galliart for property damage, John Kirk for vehicle damage, Kelly Keenan O'Rourke for vehicle damage. SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur ATTACHMENTS: Description Type ICAP Referrals Staff Memo THE CITY C7F , � E MEMORANDUlVI Masterpiece on the Mississippi � I 1 RACEY jTECKLEIN � � PARALEGAL � � � To: Ma or Ro D. Buol and �� Y Y � Members of the City Council DATE: January 24, 2019 !i RE: Claim Against the City of Dubuque by Eagle Window & Door � Claimant Date of Claim Date of Loss Nature of Claim � Eagle Window & Door 01/18/19 12/11/18 & 12/19/18 Property Damage �'�� This is a claim in which claimant alleges that the sewer backed up onto claimant's i�j - property. ;; � This claim has been referred to Public Entity Risk Services of lowa, the agent for the lowa � Communities Assurance Pool. � � cc: Michael C. Van fVlilligen, City Manager ; John Klostermann, Public Works Director �' Brandon Schardt, Eagle Window& Door �� OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, HARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/F,vc (563)583-1040/EMAi� tsteckle@cityofdubuque.org