Claim Qwest - Perry, Lloyd
2915 N CI'5ee' Selle 400 Oklahoma C,ly OK 73106 (800)421-2153 (405)290-2040 la, 200-2015 WWW¡;'CI"';r;.~ / () <{
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*****NOTICE OF CLAIM*****
CERTIFIED MAIL. RETURN RECEIPT REOUESTED
Date: 07/06/2004
To:
CITY OF DUBUQUE
CITY CLERK, JEANNE SCHNEIDER
50 W. 13TH ST. 1ST. FLR.
DUBUQUE, IA. 52001
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CERTIFIED MAIL# 91 71082133393097498205
RE: Damage to QWEST Property
QWEST Claim No.: 288867
Date of Damage: 04/05/2004, 1:11 PM
Location of damage: N. GRANDVIEW & LORAS BL YD., DUBUQUE, lA.
Amount of Damage: $ 3,563.01
Dear Sir/Madam:
Please be advised that QWEST Facilities sustained damage as a result of the negligent
acts by employees or agents ofthe CITY OF DUBUQUE, IA. (ENGINEERING
DEPARTMENT).
Investigation has revealed that on or about 04/05/2004 employees or agents of the CITY
OF DUBUQUE, IA. (ENGINEERING DEPARTMENT) damaged 900 PAIR BURIED
CABLE while LANDSCAPING with an AUGER in area at N. GRANDVIEW &
LORAS BLVD., DUBUQUE, IA.
If there is insurance to cover this matter, kindly advise as to the name of the insurance
company, its address and the claim number assigned.
REQUEST FOR GOVERNMENTAL NOTICE FORM
If your Governmental Entity requires the completion of its own claim form to complete
proper notice, please forward a copy to the address listed above. Every good faith effort
has been made to identify the proper office and address to perfect our notice. Please
forward to your attorney, if misdirected, to contact us. Matters herein stated are alleged
on information and belief this pleader believes to bed true. \\\,\111111111//11/1
If you have any questions, or need additional information, please call me at ~,'~'v;~...'!:!..r?!:~ó;;"',~
1-800-321-4158 ext 8361 or fax me at 405-605-3401. f }'ó<,Þ-RY pus;;..,? \
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