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Claim by CenturyLink Copyrighted October 5, 2020 City of Dubuque Consent Items # 2. City Council Meeting ITEM TITLE: Notice of Claims and Suits SUM MARY: CenturyLink for property damage, and Stacey Dudgeon for vehicle damage. SUGGESTED Suggested Disposition: Receive and File; Referto CityAttorney DISPOSITION: ATTACHMENTS: Description Type Claim by CenturyLink Supporting Documentation Claim by Stacey Dudgeon Supporting Documentation � � �� CLAIM AGAINST THE CITY OF DUBUQUE, IOWA %�� This written report constitutes your claim against the City af Dubuque, lowa. You should ` cora�plete this form in fr�ll and attach a�ny additional infiormation that supports your claim. The Claim must be filed with the City Clerk at City Hall, 50 W. 13t" St., Dubuque, IA 52001. It ', will then be referred by the City Council to the appropriate department for investigation. ', Once that investigation is complefied, a report and recommendation will be submitted to the Gity CounciL You will b� provided with a copy of that report and recommendatian. THE FINAL DECISION iDN ALL CLAIMS IS MADE BY THE CITY COUNCfL. NO EMPLOYEE OF ' TH� CITY QF aUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO YOU AS TO WHETHER YOUR CLAIM WILL OR UVILL NOT BE PAID. 1. Name of Claimant: Centuryzink 2. Add1'ess: ��o J'NR Adjustrnent Company, Inc. P.O. Box 27070 �', Cit�/: Minneapolis $tafg: MN 7�,ip; 55427 3. Telephone Number: 800-279-2567 JNR 4. Date of Incident: 06 04/2020 , 5. 7ime of Inciden#: __ a�,nrnx �i n • nn a .m ' Asbury Road & St Ambrase Stxeet ' 6. Location of Incident (Be specific): Dubuque, IA 7. DESCRIBE ACCIDENT OR OCCURRENCE THAT CAUSED INJURY OR DAMAGE. (Give full details upon which you ba�e your cla6m. If a Gity �:mployee was �nvolved, give the , employee's name.) CenturyLink' s 600-pair buried cable was damaged by the City of Dubuque while dig�ing out an a1d concrete base for a stop light. Fqr further _ in�ormation contact JNR Adiustmen.t, include �ile# 1MN28444 . 8. What were wea#her conditions like? unknown � 9. Give name and address of any witnesses: �� ,1' � 10. Did police investigate? (If so, give names of officers.) �� No � ; � 11. Was anyone injured? (If so, give names, addresses, and e�ent of injuries). � , No � � i � ��q I G x � NI j1 � 12, Was any damage done to properky? (If so, describe property and the extent of I'� damages. Attach estima�es of damages or descr�be basis �or ascertaining extent of �, � damage.) � CenturyLink' s 600-pair buried cable 13. What other damages do you claim, if any2 14. Have you been compensated for any part or all of your claim by any insurance company? (If so, give name and address af insurance company and amount paid.) '� N/A - Self I 15, What amount do you claim from the City of Dubuque? $ 2, 550 . �� 16. Why do you claim the City of Dubuque is responsible? ��e � . above ' 17. Mave you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) 18. �f the answer to Question 17 is yes, have you received any payment from that source, I, and if so, in what amount? ' �ated at �ubuque, lowa this 1� day of ��Pternber ' 20 2 0 ! � r�. //"i i�� s^a � A /'V 1 `O ��. °v:-'(✓+i°vUa-c.,�-�ir°��,��°�_.L r �--�-� (5igna�rurej Santana Sanchez - JNR Adjustment Company �prirlt Nam�) ' ; � r C-� � � �� ! � � � �� I � �";; -°v �-� , (Rev. 5/18) .� �,y ' -� � ; �.- [i'1 ; � cn . m, 4�i � t �, �," � � '� � � � � � I � � � PAGE 1 OF 2 IA ACCOUNT NO: IA 8F654620 INVOICE NO: A460024- iNVOICE DATE: 06-13-�2Q20 PREVIpU5 - PAYMENTS + CLIRRENT + LA�'E = NEW AMOUNT PAYMENT BAI,ANCE CHARGES CHARGE HALANCE DVE DUE DATE 0.00 O.pO 255p.B6 0.00 2550.56 2550.56 UPON RECEIPT DAbIAGE DETAII, : 600 PAIR BVRTED CASI,E - TRAFEIC SIGN ' DATE OF DAMAGE: 06/04J20 CASLE LOCATE WAS ACCURATE LOCATION : SAINT AMBROSE & A$BURY, DUSUQUE TA Damage Claim #: 0654620 Claim ID: 7307089 Mai]. aarxespondence Co: CENTURYLINK/DAMAGE CLASMS P.O. 80X Q541 MQNROE, LA 71211 -------------^__....-----------�---"------------------_"----^--^_.._----- To pay via check by phone, pZease aall 1-844-2tl8-3636 Rnow What's Below, Always CALL SEE4RE YOV DIG!!! Call Bli or visit ca11811.cam for more information. .._____________...._----- Detail of Current Charg�s -------------------__ Labor Hours: 19.50 Labor Hours 94.45/HR 1,841.77 Material Costs: ' 20.00 CABLE - 600 PAIR 8.42/FT 168.40 , 2.00 ENCP CI.OSURE MAT 3,8.49/EA 36.94 Miseellaneaus Costs: ' M/C 221 0823 3M U'�10-SD1-25H MODULE3 3'7.92 ! XAGA 165084 CLOSURE M/C 219 0520 192.26 CONTINUED ON NEXT PAGP]... Return this portion with yowr payment - please mri�e the invoice # on your check. ACCOUNT NQ: IA SE654620 INVQTCE NO: A460024- INV�ICE DAmE: D8-13-2020 624211 11906008 I NEW AMOUNT PAYMENT BALANCE DUE DLIE DA.TE AMOUNT ENCLOSED: 2550.58 2550.56 URON RECEIPT I I� RE7.'URN PAYMENT TO: � ATTN: BAUL bAVIS Ii CENTURYLINK CITY OF DUBUQUE '{ F.O. SOX ^�348 925 KERPER COURT � SEATTLE, WA 98111 2348 DUSUQUE, SA 52001-0000 { � 1 �� i 9 92824211IA/SF654620A4600240813202040000025505603T600/ � I G � 1 � �� i ; � � � ,i � I 1 1 � PAGE 2 OF 2 IA i I ACCOUNT Np: IA BF654620 INVOICE NO: A460024- � INVOICE DATE: 08-13-2020 � DIRECT ADMINISTRATIVE COST 273.27 S[JMh1ARY QE CORRENT CBARGE$ I � CHARGES � % MISCEI�LANEOUS COSTS $ 503.45 MATERIAL 205.34 LABqR - REGULAR HOURS 1,841.77 TOTAT, CURRENT CHARGES $ 2,550.56 :I i, i IF YOU HAVE ANY QUESTION$, PLEASE CALL (B44) 2p$-3636 i I i i 'i I i i 7 ; , � i � � 3j 1 � i ; i j _ 9 ; i � P.O.Box 27070, Minneapolis,Minnesota 55427-0070 { 33Q0 Fernbrook Lane N,Ste.225,plymouth,MN 55447 i � 800-279-2567�763-519-2710�Fax 763-744-14$0 ADJU STMEbtT Ct? i# RA �lY 09J10/202Q ', City of Dubuque Attn: Risk Managemen# 50 W. 13th Streete Dubuque, IA 52001 Dear: CITY OF DUBUQIJE � ; JNR Adjustment Company, Inc. is a third party claims administrator for CenturyLink, which has ;, assigned aur firm �� i�nvestiga�te and resoive claims fior damages to CenturyLink faciiities. This letter should serve as official notice of tart claim filing with the CITY OF DUBUQUE. tf additional information is required to affect official notice of claim, please respond to include , any necessary forms, or specific procedure mandated by statute. ', Enclosed is a demand far property damage.These damages were discovered or repaired on or about 06/04/2020 at the location of SAlNT AMBROSE STREET&ASBURY ROAD in DU6UQUE, IA. If you need additional information or have any questions please call 800-2�9-2567 ext. 116. Please include our reference nurnber 1MN28444 when responding to this letter. ,� Thank you, �!!, �CN��,�� '� �� ; Public Relatians JNR Adjustment Ca ;i P(7 Box 27070 Minneapalis, MN 55427 �' Fax: 763-744-�.480 �� Santanasanchez�a jnrcollects.com p � � � � , � a I u' �� ; , !i �� 9 ; 1 � � w adjustment company, inc. P.O. Box 27070 Minneapolis, Minnesota 55427-0070 " filtwittr Custom 1: 1 mn28444 11 USPS CERTIFIED MA I I . 1, ,t cm 1 1,,, 9214 8901 9403 8320 8520 77 • ' • ' ,••• • ' 71P 55441 041MI 1460962 .11 j I- His] 1)111i iji ij • Copyrighted October 5, 2020 City of Dubuque Consent Items # 3. City Council Meeting ITEM TITLE: Disposition of Claims SUMMARY: CityAttorneyadvising thatthe following claims have been referred to Public Entity Risk Services of lowa, the agent for the lowa Communities Assurance Pool: CenturyLink for property damage, Stacey Dudgeon for vehicle damage. SUGGESTED Suggested Disposition: Receive and File; Concur DISPOSITION: ATTACHMENTS: Description Type I CAP Referral Staff Memo Dubuque THE CITY OF � Ali-A�triCa City DuB E .,��,,�r�.. 1 ' ��I I � Maste iece on the Mississi i �oo�.zo�z�2013 �P pp zoi�*zoi9 TRACEY STECKLEIN �� PARALEGAL � MEMO To: Mayor Roy D. Buol and Members of the City Council DATE: September 18, 2020 RE: Claim Against the City of Dubuque by CenturyLink Claimant Date of Claim Date of Loss Nature of Claim CenturyLink 09/18/20 06/04/20 Property Damage This is a claim in which claimant alleges that cable owned by CenturyLink was damaged during the construction/installation of a new stop light at Asbury Road and St. Ambrose Street. This claim has been referred to the lowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager John Klostermann, Public Works Director CenturyLink OFFICE OF THE CITY ATTORNEY DUBUQUE, IOWA SUITE 330, �-IARBOR VIEW PLACE, 300 MAIN STREET DUBUQUE, IA 52001-6944 TE�EPHONE (563)583-4113/F,vc (563)583-1040/EMai� tsteckle@cityofdubuque.org