Claim by Bill and Kathy Miller MVM
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Pub1 ic �oYKs
CLAIM AGAINST THE qN OF �UBU�UE, IOWA Wa�f./' R�(✓�'
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This written report constiW[es your claim against [he City of Dubuque, lowa. Vou shoultl
comple[e ihis form in full and attach any atltlicional information [M1at supports your claim.
The Claim mus[ be filed wilM1 tM1e City Clerk a� City Hall, 50 W. 1]�^ SL, Oubuque, IA 53001. It
will then be referretl by [he City Council ro [he appropria[e tlepartmen[ for imestigation. I
Once Ihac investigation is completetl, a report antl recommentlation will be submitted to the
CityCoun<il. Vouwillbeprovidedwithacopyoftha[ repor[ andrecommendation.
THE FINAL DECISION ON ALL CLAIMS IS MA�E BY THE LITY COUNCIL. NO EMPLOVEE OF
THE CITV OF DUBUQUE HAS THE AUTHORITV TO MAKE ANY REPRESENTATION TO YOU
AS TO WHETHER VOUR CLqAIM WILI OR WILL NOT BE PAI�. �
1. NameofClaimant: 1J.[G ' �HrNU /Y/� GC.cti'
2. Atltlress: 39S OiVE��L STKEEY
� ciry:�L�iRa/; ut state: SA zip: S�tOG/
]. TelephoneNumber: S�3 -,$57-$/oy8
6. Da[e of IncitlenL c��r�U a - �ut y 3
v
5. Timeoflncitlent ��Q9Am �duC.��� — �(/cnr� �du��,4�
6. Locationoflncitlen[ (Bespedfic): /n�rEP. secrio<J (viE:tt ' RlZuusu�icL'
]. DESCRIBE ACCIOENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give
full details upon which you base your claim. If a City employee was involvetl, give the
employee's name.�
5FE AT�Ru/ED
8. Wha[werewea[hercondiHonslike? Hor ' f�pnlU�
9. GivenameandatldressofanywiMesses: J�E �TrRCNE
10. Did police investiga[e? Qf so, give names of officers.)
11. Was anyone injured? pf so, give names, atltlresses, antl extenl of injuries).
tiU
1]. Was any tlamage tlone to propertyi (If so, tlescribe property and [he extent of
damages. Attach es[imates oi damages or tlescribe basis for ascertaining exten[ of
tlamage.) �
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13. Whatotherdamagestloyoudaim, ifany? �e,.nnu2seme�.�'r Fo2 HnrE[ .
_$E2vi�e /✓nsrE¢. GieSF s ifcmz rNarmerzc d;isameT
14. Have you been compensatetl (or any part or all of your claim by any insurance
company? Qf so, give name and address of Insurance company and amount paid.)
No
15. WM1atamomttloyouclaimfromtheCityofOubuque?
Sfc an:w��F \
16. Why tlo you claim [he Ciry of Dubuque is responsible?
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1]. HaveyoumadeanydaimagainstanyoneelsefortlamagesasaresWlofihisin Idnt?
Qf yes, give name antl atltlress.)
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19. If [he answer ro Oues[ion 1] is yes, have you received any paymen[ from iha[ somce,
antl if so, in what amomt?
Da[etl at �ubuque, lowa this �e{h tley of �b!us�r , 20fQ.
__'f/L7fif�/ ���� ISi9namre� 'F�
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Tj/�rNi/ �- ��tLE2 �printName� - �' �
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D ? C,
2d v
(Rev. 5118) .
Claim against the City of Dubuque �
July 10, 2019
Date of event: Julv 2, 2019
7:00 a.m. —Workers began working at the intersection of O'Neill & Brunswick to replace man-hole cover
1:00 p.m. — Severe vibration coming from compactor—whole house was shaking. The contractor was �
using a large compactor and a large excavator.
2:00 p.m. —Water shut off
3:00 p.m. —Water main break—was informed that we might have water in our basement—which we did.
(Sewage)
3:30 p.m. — Second water break
4:45 p.m. - Service Master was already in the area cleaning other homes—started cleaning our
basement.
5:30 p.m. —Air conditioner quit working —called Giese
5:30 p.m. — Informed that there was now a gas line leak
7:00 p.m. — Giese arrived to repair our air conditioner
7:15—Told to evacuate due to gas leak— Giese had to leave also — repair was not done at this time.
8:30 p.m. —Waited in our neighborhood until 8:30— Gas Company had no idea when the leak would be
fixed —so since a storm was about to hit Dubuque we checked into a hotel. The hotel was booked for 3
adults, an elderly family member who was visiting from out of town and our pets.
(At this point we had no water, no air conditioning, no gas and told to evacuate)
Julv 3, 2019
Was able to re-enter our home.
Service Master was back to check on dehumidifier and measure the area and complete their paperwork.
Giese also came back and was able to fix our air conditioner
Called Gas Company to have our gas turned back on.
This was all completed by noon
Amoun[fo be cleimetl from iM1e Ciry of Oubuque:
2 Holel rooms -$ 126.�0 & $i66 00 = $ 492.00 (we paitl) - requesting reimbursemeM
Ilems tlisposetl of due to sewage:
Lea�hercoat - $ iW.00
Win�er ma� -$ ]5.00
vacuom ciezoer- E eo.00
Sleeping Bag - $ 56�0
Chrislmas W reath -$ 25 00
Towels - $ 20.00
Hemstlisposetl: 5600.U0 - requeslingpaymerit
Service Mas[er $ 1,6365]- bill enclosed -we have not paid this
Giese - $ 21935- bill encbsed -we have not paid ihis
Witnesses'
Robert (Smiley) Schmi�z
3085 Brunswick Street, 52001
Chns Reed
3105 Bmnswick Stree�, 52001
Jon & Amy Shireman
3020 O'Neill Shee�, 52001
Jim AMofer
3]5 O'Neill Shee�, 52001
aataaaaataaaiii�iaaaaaataaa+++aatiaaa+aaaaaaitaaaiittaaa�aatat+++a+++++++++++
It ehould be mted that the mutcactoc dfdnY do the cuatomary s[reet signa to notify Mat [he
street wes boaically cloarA. There wue vchicles tlriving [hrou� Ihe work azra.
Wih ou� whole house shalm�g-we IookeA outside m eee what the wnhacto�s were usng -
they wae usvg e lerge wmpactor a�d en ezwvator. b�ev too exceasive for Ne avra
inGastrucmre.
l, why weav't the gas initislly shut o1i in such Goae pmbmiLyP
2. When Ne iuitiel watec bceak happeued why waenY Ne erea reloea� eiuce Me hole was
enlarged.
Confidential
This rommuniwtion and any attachments may confain information wM1ich is confitlential
antl privilegetl by law antl is for the use of the tlesignatetl recipienc. If you are no[ [he
in[entled recipient, you are hereby m[ifietl tha[ you have received ihis communication in
error, antl that any review, tliscbsure, tlissemination, tlistribution or copying of its contenis
is prohibi[ed. Please notify City olDubuque immetliately by telephone a[ (S6J)-589-4120 of
your receipt of these items antl tles[roy the communication antl any atfachmenis
immedia[ely. Fur[her disclosure of tM1is informacion may violate state and federal
reshictions.
Confitlentialinformation mayinduCelhefollowing:
i) SocialSecurityNumber(s)
2) MetlioeUHealtM1 Information
3) PersonneVDisciplinarylntormation
4) Bank Accomtlntormation
5) Financiallnformation
6) GredilGardNumbers
If any documentation you desire to submit lo the City of Dubuque rontains any of ihe items above
this covar sheet must be atlachetl directly �o the conPitlential 'mforma�ion and Intlicate Me type of
information ihat is includea.
I, t nue �B�n � ' 6arH4/n�<<E,� , hereby certiy Ihat ihe atlached tlacumenfs
inclutle [he following'protectetl i �ormatio�
SodalSecudtyNumber(s) _BankAccountlnforma9on
Medical/Health Inlormation Financiallnformation
ParsonnallDisdplinary Intormatton _Credlt CaN Numba�(s)
I understantlthatthisinformation may be dls�ributetl withinthe City organization orro agenis ofthe
City for pmcessing and I hereby au[horire the City to act acmrdingly laking all precautions to
protect my informa[ion from unnecessary dishibution.
�1'���rr��PP , , R/�/�y
gnalur - �ate
Copyrighted
August 19, 2019
City of Dubuque Consent Items # 3.
ITEM TITLE: Disposition of Claims
SUMMARY: CityAttorney advising that the following claims have been
referred to Public Entity Risk Services of lowa, the agent
for the lowa Communities Assurance Pool: Susan
Beckman for property damage, Mike and Jeanne Duggan
for property damage, Brian Feldman for property damage,
Bill and Kathy Miller for property damage
SUGGESTED DISPOSITION: Suggested Disposition: Receive and File; Concur
ATTACHMENTS:
Description Type
ICAP Referrals Staff Memo
"THE CTTY QF
�U� � � � E MEMOI� AleTDUM
Mc�sterpiece on the Mississippi
;
TRACEY STECKLEIN �`�
PARALEGAL
'I
iI
To: Mayor Roy D. Buol and ��
Members of the City Council �
i
DATE: August 7, 201 J ���
��
i
R�: Claim Against the City of Dubuque by Bill & Kathy Miller ;
,;
Cl�imant Da�e of Cla�m Date ofi Loss Na#ure of C�aim '�'�
I;
Bill & Kathy Miller 08/06/19 07/01 & 07/02/19 Property Damage �I
�
_ �
This is a claim in which claimant alleges that a City sewer line backed up into claimant's ��,;
basement at 395 O'Neill Street.
�
This daim has been referred #o Public Entity Risk Services of lowa, the agent for the lowa �
Communities Assurance PooL �
I;
cc: Michael C. Van Milligen, City Manager
Denise Ihrig, Water Department Manager �h�
Arielle Swift, Assistant Public Works Director �,
Bill & Kathy Miller ��
�
i
�
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/EMai� tsteckle@cityofdubuque.org �
�