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Claim by Karen L. CandeeCLAIM AGAINST THE CITY OF DUBUQUE, IOWA t - / / uk� 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 13 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: Karen L. Candee 2. Address: 188 Ward St. Dubuque, IA 52001 5. Time of Incident: t1�e rf• ( 1 L. s+ Th 1 9L ) 3. Telephone Number c )D7- ) f ( C C 4. Date of Incident: 03 [361 i` oocr r.tcfki4- 6 onil 6. Location of IncideniBe specific): VdRi 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 - employee's name.) 66 (tle(? / ti) tit -1ht it ) • j _ .. n I/ h- 8. What were weather conditions like? >etr'P 6i )ern17r-1 ;"fr, 'm 9. Give name and address of any witnesses: I -1-11 - , we a k tnEs * i «4 r) r 17 rf /')F l , ;rr N, I Le/ m`( 10. Did police investigate? (If so, give names of officers.) 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). n 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.) - rc ( hc EC� Li U e ,r re-) (7e k r, 13. What other damages do you claim, if any? acne, 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.) n� 15 .W hat amount do you claim from the City of Dubuque? 415 . /() 16. Why do you claim the City of Dubuque is responsible? i s ill r 0.1 ' 5 - I ec h rk oo In - -I in (0 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) h n 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 ,--9,6 6" day of P nature) -(R i��� 1, (kft/ee, (Print Name) ,201 (U . 0 ill 0 p BIECHIER ELECTRIC, INC. 7762 Wildnest Lane • Dubuque, IA 52003 • (563) 583 -5366 • Fax (563) 556 -4466 July 13, 2010 Neil & Karen Candee 1188 Wood St. Dubuque, IA 52001 Phone: 563 -556 -1196 RE: Storm Damage ((~` Dear Karen and Neil, Thank you for the opportunity to repair your electrical service after it was damaged by the storm to include: • Secure Permit & Inspection from the City of Dubuque. • 1 - 200 Amp Meter Socket. • 1 — Milbank 2" Hub. • 2 — Crimp Connectors. • 1 — Tape. • 4 —'/4 x 20 A.J. Anchors. • 4 —'/4 x 20 x Bolts. • 4 —'/4 x 1 Fender Washers. • 1 — Service Call. • 1 — Temporary Repairs / • 4 hours Labor. • Permit $39.50 • ivlateriai 129.23 • Labor 216.00 • Service Call 75.00 • Tool & Truck 15.00 • Tax 20.37 $495.10 All Wiring to be Per National Electrical Code and in Compliance With All Local and State Codes.