Claim Rooney, Michael & Tansy JoCLAIM 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 W. 13th St., Dubuque, IA 52001. It will then be referred by the City Council to the appropriate department for investigation. 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: Michael V. & Tansy Jo Rooney
2. Address: 2815 Oakcrest Dr
`
3. Telephone Number: 563 556 3454
4. Date of Incident: 6 30 06
5. Time of Incident: 4:15 P.M.
6. Location of Incident (Be specific): 2815 Oak Crest Dr.
7. DESCRIBE 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.)
A surgery of water from floor drain came up and flooded basement in a few min. and kept coming til they
got up here to stop water.
8. What were weather conditions like? Very nice day; sunny around 80
9. Give name and address of any witnesses: Most of houses on both sides of Oak Crest had same
problem.
10. Did police investigate? (If so, give names of officers.)
John Klostermann, Street/Sewer Mainteannce Supervisors - he took pictures.
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, Water & Sewer Mud came up through the drain the basement was full in a matter of minutes.
13. What other damages do you claim, if any?
The Ins. only gave $5000.00 and the damages lost came to a total
of $8,804.00.
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.)
Ins. Adjuster was here - haven't got the check yet but it should be $5000.00. NOT anymore than $5000.00
15. What amount do you claim from the City of Dubuque?
$3,804.00 plus we still have lots more to clean.
16. Why do you claim the City of Dubuque is responsible?
The Street on the corner of Oakcrest, Berkey - water main broke causing the Sewer line to cave in.
17. Have you made any claim against anyone else for damages as a result of this incident?
(If yes, give name and address.)
No
18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount?
Dated at Dubuque, Iowa this 10th day of July, 2006.
/s/ Michael V. Rooney & Tansy Jo Rooney
(Signature)
(Print Name)
(Rev. 1/00 & 7/01)
/,V) (i/1I1l t
\.. \.' ~ ( "/1/\...
'" b~
CLAIM AGAINST THE CITY OF DUBUQUE, IO~t1. /~
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: /1 i C ), II -R J V y -r:4 /VS~/I .j () f0, n If ..e'l
2. Address: d J' 1<'1 /J If f( f?, If e 5 -I () /I .
3. Telephone Number 5 ~ 3 !J/l/~ ~ L/!:7-Lj
4. Date of Incident: t - 30- () In
5. Time of Incident: )j,'/ S- P fit
6. Location of Incident (Be specific):
.2 f' I:J /JA.R {}" t'., f IJ~
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.)
..(,} t]of
8. What were weather conditions like?
JI/>~!f j1!,'c.e D.If;J SUfl'AlJ Il,f~u/V"d jd
9. Give name and address of any witnesses: . n
t;s:('~}<~ "Ul~) S~~ e ~Roott; u!:e<; n -P
u
10. Did ~ investigate? (If so, give names of _fn__. ~
~A:~ ,I 1 /:t~: {',( It ~ :-~-h.# jJ A/ (' ~
l~ Tao If ?iclu~T'.5
Sa d....~ r-/..so/(
/
11. Was nyone injured? (If so, give names, addresses, and extent of injuries).
t'
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:)
9~5 1:;;~~ >J -/L~).~~,;,..P}~/ w~~ J1t1:u /t'f'N +; ~v;, ;1.;' 01
(11tH
13. What other damages do you claim, if any? ()o
"-(.he >#8. /)11I1'1 ffA-V-l dI{J~()~--j
'Ln d (! A />t ~ h I'l-f 0"1',4 I '" -f
-p~~;
ct/1 p( Ill~./ l'--
8:,9/)f ~
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.)
_~~ ;1kZsf~t.1 ,Iilh h~u.~' IIAI'O!Jd;7- I-},~ -C2A-utv
_ + _ 1.<_ I_~ ~ j,~___".l B", f{_o~ ,1Y4-r 11_ ~
ftl (j ~ P T.! "'" $' Ii; t'~lLJ -~ =-
15. What amount do you claim fT)jlm the City of Dubuque?
#' ,~f?OtJ.~ ,e.A.uS!AlP '1+,' If
/J1/J/{.p ~ . (! /~ A JV
.
h "r~ 10 is
-
16. Why ~o you claim the City of Dubuque is responsible? : /) +
i.: fl-;&+ ~~) ~'~ ; () ~~,u ~ + 9~ L~~ ~
.~ Ji -" -_ I J i-l' A-i . 0 ke (!rw.s' ~
$-" uJ P R.. i-/ 11/ r? -r I? (! If tI.e / /1/.
17. Have you made any claim against anyone else for damages as a result of
thisif>~ent? (If yes, give name and address.)
18. If the answer to Question 17 is yes, have you received any payment from that
source, and if so, in what amount?
Dated thi~ It) day of Tu. I y ,20~.:-,
~ u'frJ~ ~ fL/4~5JZ7f~ -.
17"c.1I~~1- t/. RQolV€-Y \J VPS iL --J~ ~();t/-er
(Print Name) (J
.
,
---
-1tuf/e 3d- cJ(p
'-I e/iSt!fi (!.dl(<t!
J. [:1 Pi<. '7 'f
~ N.J uJ f 1I(l..e ~ S Jt )(<.Q.E'Jt.s
3 tv..t. vJ W ~ J eo II'/-e f't It is
,
1 S~rJ+ft *'u6 3'3" x II ZPe.f1~f..ef
~ /!f?,f/ef;If.v "/;""'/5
9 f~h.6 a..,""T J-'jAfs tV~w ..J - .j t".{'.
/ )...11M.1II",11fj' ,d;fsKef
/ (} 4.J-I; t<Jg t!hU ~
/ It! ;5~/f,<t:I
J L /. .x I'1tfS II( e~
:/. ;J/lfj,fh,N If",!
/ 15ft! ;J/ps
/.! LAlliI' ll/lfA hwels
~ ,lYphe lJA Moe /.''''1 "J;fe,,fef..s
let> II f I- L !jOIll * [e1ll!tJr.
I S II tlf If i tI /'1 U 5; C " / ;f'~ e)< e IC-
tI LW f;p~,e tf/;f-SS Sf!. te<-f'#
/ Tflb/~ ~{rfh
'1 Shi ds
u. 'fII J.. ~e... we", L
S f' c./<
Lt>f #..p ~".k 1/A..J
fill f fA. ~y()S e Ot> tla. i ~f
I 1.2 PI< '0/1.. foe r p..e. /C.
3 J...i~ f /26K-t..
/ CA5-e f.gf5i
(). (1 R II .5 S /11(. /(s
.J L/I ~;e~ ShOltis
., 025" 00
fJ.oo
'71) ~
30 00
rUw IdS o~
~'I~
.r eJd
/0 -
dO
/
4>". f!-6
s-. "d
dO
/ .AS:-
:lt1 ,,0
/ .dO
.1-
ttJ ~
d6"'oo
;'5"0"0
36":.3
~C!!E
'" d"
<<.S -
I 'I ~ o..=!
t'D~
lIP 0..2
llc:l
I()a -
s.~
3.5'0
IO~
'7- all
Ft! dO
%3 de>
.J L If,d i es 'hIs
'I ('1.~N5 5~ids
J ('l .# IJ :r.P II 1".s
I L 11 J ;.e 5 altod"..! Q It "'oS L-e ~
} :B~ l.~. ':g "C-e
'7 f fI;-( s h ,6e~
J. ~ 0 I ~ 13 1\ ~5
I ~D~.e !<.:t
I tpb/e e '"fir
3 (1ftfS
J.I H il f w i .1J +- ~ /l.- /..." ;, ,'e s
I BaI'H~'
J :J.r;~e."t!!
/ -f h f6 W t!... \.<..~
3 J....lffVJ.. SCttO'
150x +U-il. 'N i ee
J f1~"s ~;rqdIJ
I SA 0 1AJ-t.Ji!. Q. ""I< t / IV'
(;tt It 11 A-6'-l2 ,<3 11 ~ s
.1. '1Ks + " " /.e+
3 71upw IfW/1j' e/1IH.,,<<,;1S
/ 5/'1, S/?I/I'f/l e/,/?,-,s tfu,j
WI!?/) b4d+
I Wf/S
Y"teN,s
'ShoR,+ OlA.fS;..-f
FlfhR.ic.
~ ,. I f~ L
,f ~ ,.{'~
d~O
//1/" j1! / k... ~
Ii'
~ 'I x /~
01'1
.; A ~ .:::f, f.-e/
:T
=O{~()~
I I//!l" 7-/; /1,
,r ( .
. /
7b~
1f)t:J
lilt:> -
L) dO
,,()-
~ 00
() 6 -
t;, f!{
3d~
:L St> dO
b- 0,,2
3&' <:} 0
L./ 5d"
/ ,,0
(JtJ -
:zS- "'~
1!r!!
J 5' !-'"
/6-~
IS d..5!
elf)
4tJ -
tiC>
30 -
8~
S~o
11 ~
d"
It:) -
~
I t I ". f
I ; (" ;I If /t'r' )
.) /1- ,.,_n '/ /1 i' p/
SERVPRO OF DUBUQUE
FIRE RESTORATION, MOLD MITIGATION, & WATER MITIGATION
Client: ROONEY TANSEY
Property: 2815 OAK CREST DRIVE
DUBUQUE, IA 52001
Operator Info:
Operator: OWNER
Estimator: Terry Lenstra
Business: (563) 582-7776
Business: 1044 Iowa street
Dubuque, IA 52001
Type of Estimate: Water Damage
Dates:
Date Entered: 07/03/2006
Date Assigned: 06/30/2006
Price List: IADU4B6B
RestorationlServicelRemodel
Estimate: 2006-07-03-1209
SERVPRO OF DUBUQUE
FIRE RESTORATION, MOLD MITIGATION, & WATER MITIGATION
2006-07-03-1209
Room: DRYING
Dehumidifier (per 24 hour period) - XLarge - No monitoring
The above entry is for I Phoenix dehus for 4 days
Dehumidifier (per 24 hour period) - Large - No monitoring
The above entry is for 1 Triton dehus for 4 days
Air mover (per 24 hour period) - No monitoring
The above entry is for 7 fans for 4 days
4.00 EA
4.00 EA
28.00 EA
Room: SERVICE CALL
Emergency service call - after business hours
Water Extraction & Remediation Technician - after hours
The above entry is for a tech to squeegee the floor
Haul debris - per pickup truck load - including dump fees
1.00 EA
1.00 HR
1.50 EA
Main Level
Room: MAIN ROOM
Ceiling Height: 8'
Apply anti-microbial agent - after hours
Clean floor
Remove Refrigerator - 22 cf
R&R Paneling
Framing repair - Minimum charge
The above entry is to build a wall where the refrigerator was
627.71 SF
627.71 SF
1.00 EA
623.00 SF
1.00 EA
Room: LAUNDRY
Ceiling Height: 8'
Apply anti-microbial agent - after hours
Clean floor
R&R Paneling
135.33 SF
135.33 SF
398.67 SF
Room: BATHROOM
Ceiling Height: 8'
Apply anti-microbial agent - after hours
Clean floor
R&R Tile floor covering - Premium grade
R&R 1/4" Cement board
2006-07-03-1209
52.31 SF
52.31 SF
52.3] SF
52.31 SF
07/0512006 Page: 2
SERVPRO OF DUBUQUE
FIRE RESTORATION, MOLD MITIGATION, & WATER MITIGATION
CONTINUED - BATHROOM
R&R Paneling
232.00 SF
Grand Total
5,484.21
Terry Lenstra
Grand Total Areas:
1,461.33 SF Walls 815.35 SF Ceiling 2,276.69 SF Walls and Ceiling
815.35 SF Floor 90.59 SY Flooring 182.67 LF Floor Perimeter
0.00 SF Long Wall 0.00 SF Short Wall 182.67 LF Ceil. Perimeter
815.35 Floor Area 877.58 Total Area 1,461.33 Interior Wall Area
1,525.33 Exterior Wall Area 190.67 Exterior Perimeter of
Walls
0.00 Surface Area 0.00 Number of Squares 0.00 Total Perimeter Length
0.00 Total Ridge Length 0.00 Total Hip Length
2006-07-03-1209
07/0512006 Page: 3
s
~
"
~
,...
58
~
~
,...
~
o(l
:i'
o
i=:
<(
"
~
,...
"'" 58
~ Q
0' ....l
~ 0
= :E
~ z^
Q 8
~ ~
~ ~
~ ~
"'" gj
'" <:;;
Ol
>
"
....l
"
-a
:E
.0\.61
.Z.6(
~ .
7 ~
I
loLl
I
I
.11,91
I
I
I
-::;, "-
,;0..,::-::-'
.'/.a
.6,l
.
I
~
.
~
-
~
....
OJ
OIl
'"
p..
'"
g
N
~
on
'2
t-
o
a,
o
N
-
,.;,
o
~
o
,
::g
o
N
RDTD-
(It~~!~.
_ SEII.ICI
" And A""'"f 00 'ltou6teg 'Z:\o""n tht 'Z:\ttlln .. "
P.O. Box 1533. Dubuque, Iowa 52004. Phone 563-552-1828
Locally Owned and Operated
DARRYL HORKHEIMER
D.B.A. ROTO-ROOTER
. TV Camera Inspection & Video Recording
. High Pressure Water Sewer Cleaning. Electric Sewer Cleaning
CUSTOMER'S
ORDER NO.
NAME fV'\ '
ADDRESS 2'3 1
~,;;;<,
oCJfLi:
'..31.J5L{2
5200 I "
.0,,",,,
.J;>
CHARGES " "c",
sink......................:...............~ ./'. pc:) .
tUb..................:X...............~O, "',\
toil.t....................................$' .' 04"'~
floordrain......;'>.s:................$15<r, ,...'
\;t
, .
HERE'S THE PROBLEM I FOUND AND FIXED.
~~re~~ED BY:, f\ C "II
Olood :\ V
o paper or sanitary prod~, '
Ohair /' J./ 1t"'
o lint L-r..-, lh
o tree roots \0 It-
o )oreign objects
".a sludge . \
,0 soap r.sidu<rb t.J ~
~oth.r \U~
TOTAL FOOTAGE CLEANED' h 0 ' KNIVEs usf['si r
YOUR:
CJ;ink
~ tub or shower
Oloil.t
o laundry I washer Iin.s
"a'floordrain
o septic tank Iin.
o main sewer line
o oth.r
JOB DESCRIPTION AND REMARKS:
laundry............................... $
septic Iin............................ $
_. .":'~,.
CO'),"
""'-:)7 R /J
/1U--l.e / ( VU'lrV&(
r
CUSlOMER SIGNATURE
,,,,,:::'~~
, -';..,'<'-',<'?'
..
A service charge of 1112% per month (18% per annum) wiii'~"c::liarged to all accounts past
30 days. COsts plus reasonable attorney fees to be added in caS.e of-suit for collection.
y",;"
..
".,,,,-..
",;,:>,,<~:j