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Claim by Brendan QuannTHE CITY OF DUB MEMORANDUM Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL To: Mayor Roy D. Buol and Members of the City Council DATE: October 7, 2011 RE: Claim Against the City of Dubuque by Brendan T. Quann Claimants Date of Claim Date of Loss Nature of Claim Brendan T. Quann 10/05/11 07/28/11 Property Damage This is a claim in which claimant alleges that the City sewer located in the median of South Grandview Avenue backed up during the July 28, 2011 rain event, causing claimant's lateral line to clog, resulting in sewage backing up into claimant's basement. This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa Communities Assurance Pool. cc: Michael C. Van Milligen, City Manager John Klostermann, Street & Sewer Maintenance Supervisor Brendan T. Quann 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 / EMAIL tsteckle @cityofdubuque.org (). CLAIM AGAINST THE CITY OF DUBUQUE, IOWA 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 13th 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: Brendan T. Quann 2. Address: 175 South Grandview Avenue, Dubuque, IA 52003 1; ✓V 3. Telephone Number 563 - 583 -4457 4. Date of Incident: July 27 -28, 2011 5. Time of Incident: 8 p.m. on July 27 to 6 a.m. on July 28, 2011 6. Location of Incident (Be specific): Basement of home at 175 South Grandview Avenue, Dubuque, IA 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 the employee's name.) Rain caused City sewer to clog which caused our lateral sewer line under the roadway (S. Grandview) to clog, which caused sewage in our basement. We had to leave our home for 7 days. Photos of damages are available. 8. What were weather conditions like? 10+ inches of rain fell in a 10 -hour period 9. Give name and address of any witnesses: Jeanne P. Quann and Brendan T. Quann 175 South Grandview Avenue, Dubuque, IA 52003 10. Did police investigate? (If so, give names of officers.) No 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). No 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.) Yes - see attachments 13. What other damages do you claim, if any? None 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.) No, but we are filing a claim with USAA (our insurance carrier)for damages done to our home -- renediation and repair are not covered under our home- owners insurance policy. 15. What amount do you claim from the City of Dubuque? $16,726.70 - see attached 16. Why do you claim the City of Dubuque is responsible? The City sewer in the median of South Grandview Avenue backed up approximately 30 meters to our south, causing our lateral line under the street to clog, causing sewage in the basement. 17. Have you made any claim against anyone else for damages as a result of this incident? (if yes, give name and address.) SPe answer to No. 14 above. 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? No Bren1an T. r uann (Print Name) Exhibit A Exhibit B DAMAGES Hotel Julien - hotel expense for two nights (remainder of time we could not live in our house we were able to live with our daughter) Danner Plumbing & Heating Service (bill includes excavation and repair of South Grandview) (page 2 of bill ($723.00) is for work done inside of our home, and that amount is included in the total on page 1) $ 244.16 6,771.70 Exhibit C Dubuque Area Steamatic, Inc. 4,618.84 Sewer Mitigation Exhibit D Listing of destroyed contents 4,829.00 Exhibit E Pregler Electric, Inc. 118.00 Water damage to electrical system Exhibit F Darrell Zmolek 145.00 Removal of destroyed items to landfill TOTAL DAMAGES: $16,726.70