Claim, Link, Leo & PatCLAIM 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: Leo & Pat Link
2. Address: 2820 Oakcrest Drive
`
3. Telephone Number: 563 583 0785
4. Date of Incident: June 31, 2006
5. Time of Incident: 4:15 P.M.
6. Location of Incident (Be specific): Complete lower level of home
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.)
City street caved in and broke water main and blocked sewer
and the water and mud backed up.
8. What were weather conditions like? Good
9. Give name and address of any witnesses: Other 12 houses
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, all 5 rooms were covered with mud and water
13. What other damages do you claim, if any?
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.)
I am not covered for anything. I did not have rideron policy Friedman Ins.
15. What amount do you claim from the City of Dubuque?
$6,135.49
16. Why do you claim the City of Dubuque is responsible?
City street that caused all damage.
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 24th day of July, 2006. , 20 .
/s/ Leo A. Link
(Signature)
(Print Name)
(Rev. 1/00 & 7/01)
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA ~ -
This written report constitutes your claim against the City of Dubuque, Iowa. You Z/YI
supports your claim. . / :->ft .
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.
4. Date of Incident:
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: ~ g.o--'& P~;1I . ~ ;, ",,,'1)
2. Address: d--?3;:) (j ()(L~ru2;;>)-- \Ju;v-..Q..
t((q 'j s<?! 3- CJ 7 g,r
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3. Telephone Number
5. Time of Incident:
6. Location of InC&+t (Be s~eCifiC):
C A'fYY\1f- ," n-1.~ ,
eJ.4~~
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~~'78~ .~.~. .
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t.~. . ~ ""-'c.~ '"
8. What were weather conditions like? ~
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9. G~me and addY;ss of any witnesses:
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10. Did police investigate? (If so, give names of officers.)
,I C,
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
";0
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.~
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13. What other damages do you claim, if any?
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
'mo~''';d) \ =;~. .~
0\\, AJ~r;:~? -,-.;=-::";;:' ~W ~
17. Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.)
,va
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 d.. ...:\ d~y of 0 t ,Q ~
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CLAIM AGAINST THE CITY OF DUBUQUE, IOWA bit-trC'
</ Ie
This written report constitutes your claim against the City of Dubuque, Iowa. You c../Y' I
should complete this form in full and attach any additional information that / It) I /<)
supports your claim. (1/ .' -f ~ 0'.-
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.
4. Date of Incident:
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: ~~o~'& f~,'lI . ~\ ~J''\Av',
2. Address: ,:1 53 ,) (7 (') CC 9r.Lcu~)r- \.2 " v,J<-O.
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o kVtU., ~ L)
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3. Telephone Number
5. Time of Incident:
6. Lo<:.ation of Incod~t (Be s~eC~iC): e Q.
l--<TY~ ." f! L.U'A. '.... R..-'-^~.
,1- ~ o~'-~
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 e.!]ployee:s name., '-.:! '-t .
. \[,,: .' - .\.HC vt '17' .\..TC\.. ..'])" \IlILc
8. What were weather conditions like? S I
CJ <,,,,<'\.
9. G~ame and add~ss of ~ny witnesses:
..... ( ;) C!---<J,,;q).--
10. Did police investigate? (If so, give names of officers.)
~)' (',
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
";0
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 O~damage.~) . ,
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( ~ ,', ~ '_"" ~. hl~~
13. What other damages do you claim, if any?
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
'mo~.I. 1 ~~ ~ ,~
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o YOL! glaim from the City of Dubuque?
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17. Have you made any claim against anyone else for damages as a result of
this incident? (If yes, give name and address.)
tv' ()
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 J.. L.\ day of
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CARPET OUTLET
To
o
Behind J&J Pool. 3120 Cedar Cross Ct. . Ph. 582-5775
1I10n. 10 am to 8 pm . Tues. ~. Fri. 10 am to 6 pm . Sat. B am to 12 pm . Sun. By Appt.
Superstore
SOLD TO
Invoice
DATE
INSTAll DATE
ITEM
COWR
SY/SF
ROOM'S
TOTAL
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The term 'seUer" re1ers to Met's Carpet Outlet, the term "buyer" refers \0 all who sign this contract as a buyer. 1I1here is more than one buyer, each is jointly and severally liable lor \he amollnts due 10 the seller under this
contract Unpaid balanCe is due at time 01 delivery. Title to all merchandise sold Ul'Iderlhis contrad remains with the seI\ef untillhe balance has been paid in full. 11 paym&nl is not received as stated above. then unless othel'wise
agre9d between seller and buyer{s) in writing. Buyer{s) agree to pay Inl8rest on the unpaid balance due al the rate of 1'h% pel' monlh, compounded monthly, plus Seller's reasonable attorney fees and cosls in the event
sull to collect. The buyer(s) acknowledge and accept the conditions 01 this contract and acknowledge rec8iplolampyof it. Pel'formanceof \tIiScontJactis suIJt9c1:to cIelaydue to strike andforothe'r-~beyondtha r's
control. -"-----:::::-'"-
It is unclersloocl that by the acceptance of this proposal you authorize seller to contract wilh a subcontractor on buy&r(sj b&haIf to make the installation. You aulhorize seller 10 issue to said subcontractor onbU19rfsl behaII an
installatlon work order with lhese specifieations. You agree to pay seller the amount spacIfied herain whictl shall include the prial of all materials and the installetlon charges wtlIch are payable 10 subcontractof on your behan.
Buyer acknowledges that no express or implied warranties have been made by seller and seller hereby disclaims all such warran1les.
There will be 20% restocking charge on all caflC9lled sales contracts for special or cul order materials thaI the manulaclurer will accept relum 01 merchandise. Merchandse menufactu.er will not accept for .elurn cannol be
canc9lled after three (3) days 01 dale ot this Iorm. By signing the buyer agrees to the tenns and conditions as stated on this form.
IIIT1D-
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_ SElIlIlCE
. A"d Away 00 CVtou/,{eg 'ZIow" the 'ZItai" . "
P,O. Box 1533 . Dubuque, Iowa 52004 . Phone 563-552-1828
Locally Owned and Operated
DARRYL HORKHEIMER
D.B.A. ROTa-ROOTER
. TV Camera Inspection & Video Recording
. High Pressure Water Sewer Cleaning. Electric Sewer Cleaning
CUSTOMER'S
ORDER ~O.
NAME
ADDRESS
j
20\ ' .
, ,./,
~"
DATE
,,,./'\ )
,..,,-,'
....
HERE'S THE PROBlEM I FOUND AND FIXED. '
,&-
YOUR:
O~nk
o tub or shower
Oloilel
o laundry I wash.r lines
Ofloordraill
o seplic tank line
o main sewer line
Ooth.r
TOTAL FOOTAGE CLEANED' ..
JOB DESCRIPTION AND REMARKS:
CUSTOMER SIGNATURE
WAS CLOGGED BY:
o grease ,.
o food 1-..1 l
o paper or sanitary produl>ts
Ohair
Olinl
o tree roots
o foreign objecls
o sludge
o soap residue
o other
CHARGES
sink......................................$
lub.......................................$
loilol....................................$
t:
,
floordrain............................$ \ .
laundry ................................ $
septic lin.............................$
main sewer..........................l
ri,-' It
"
$ !
KNIVES USED
$
$:
$
TOTAL '. ! .
PlEASEPAYFIO.llHSt<MJKE
,
\
OPERATOR SIGNATURE
\',
A service charge of 11/294 per month (18% per annum) wiD be charged to all accounts past
30 days. Costs plus reasonable attorney fees to be added in case of suit for collection.
FLOORING
9640 Kemp Road I Dubuque, Iowa 52003
Jason Burkart Josh Burkart
(563) 590-1117 (563) 542-3728
".Vood
Caq.H.:t ~ r, u;dnatc ." THe
STEVE'S ACE HARDWARE
2013 CENTRAL AVENUE
(:'563) 588-9755
20534
23629
BLADE UTLTYKMIFE 51
KNIFE UIILITYtSTRIN
1.99
5.99
SUBTOTAL
TAX01
TOTAL
CASH
7.98
.56
8...54
10.00
CHAMGE
1,46
THANK YOU FOR SHOPPING AT STEVE'S ACE!
BE B7/01/B6 11,02AN "BIBB3773 20
'.-.---
Marshalls.
Greer "'oy Station Plaza
1 hiO Oem i ng Way
Middleton, WI 53562
~/~ (~~~;:034~
60 - DOMESTICS 005600885 12.99 T
60 - DOMESTICSji ;004343903 4.99 T
SUBTOTAL ~ ~:(jf! L::.- $17.98
WI SALES TAX 5.50% $0.99
TOTAL $18.97
CASH $20.00
CHANGE $1. 03
5300 DOdge Street
DUbuque. IA 52003
111111111111 111111 1HWJJ11111 1111 111111111
Sale Transaction
1111/1111111111111111111111111111111111111111111111111 1111111
902 3 3 0 2 3 1 3 e J 3 0 4 4 3
ITEMS 2
0158
07/15/06 13:4B:43
CELLULOSE SQUEEZE MO
648Q064 2 @6.96 _ I
FLEX SCRUB BRUS( ;") L~1 Ie:')
6480705 2 @2.2 I ,/, 0 .'
MR CLEAN MAGIC E~/ I
6480838 J, I _
SQUEEZE MOP REFI~.L. I,. ,,'Kitv)
6480077 2 @4.37 \ \ i,\)Lh 1_
10" SQUEEGEE '-/
6480763
FEBREZE OIL WARMER .
6470916
HANOI-GRIP SPONG~(:.-, \,. {\ "1\1)
6482787 4 @0.96(.yiU1:7\ \
1-1/2 X 1-1/2 FLEX C I
6895727
PENCIL BOX
6450QDl 2 @0.96
100 PACK VINYL GLOVE .
5613544 2 @3.49
32 OZ GREASEO LIGHTN
6471020 2 @2.36
USA T-SHIRT ASST SIZ
6609013
COUPON 49132400000
USA T-SHIRT ASST SIZ
6609013
CL33 02 0023 3138
,:,JUNDS WITHIN 30 DAYS WITH RECEIPT
Brand Names For Less. Every Day.
TOTAL
TAX AT 7%
TOTAL SALE
CASH
OEBIT CARD 3617
EFT DEBIT
NETWORK 10 0028
REF# 0701S3420001
13.92
4.58
2.42
8.74
3.87
5.98
3.84
2.94
1.92
6.98
4.72
4.44
4.44-
4.44
64.35
4.50
68.85
50.00
18.85
07/01/06 18:54:21
APP CODE 006537
PRIM.~RY ACCT
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1/ /fLWAVS LOW PRICES. /16~
f{eo~V ~'
WE SELL FOR LESS
"ANAGER ROBERT HARDING
( 563 l 682 - 1003
STI 2004 OPI 00002872 TEl 09 TRI 06694
THE"EBOOK 002622977076
FOR 0.10 1.10 X
SHOWER "AT 007636326310 8.8~ X
TO 00DOOODO~072KF
2.0B Ib I 1 Ib /0.68
FOLGERS 002660080268 F
BV QN OLIVES 007874236976 F
ICBIN SPRAY D0106003~122 F
B 001708200008 F
ILEX "ILDEW ~~60001196
003600060900
TOOTHPASTE 003600060900
POPCORN 007616022211 F
COUPON 36000 063600061033
SUBTOTAL
TAX 1 7.~OO X
TOTAL
CASH TEND
CHANGE DUE
I ITEMS SOLD 21
-...j
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se our r;;'~.. \ 4fl
BIG CARD\'fr:;::"~ RE~A TE
(RI
. -. ~ {j '1:>9
31
5300 Dodge Street
Dubuque. IA 52003
11111111111111111111111111111111111111111111
Sale Transaction
23W SPIRAL DAYLIGHT
3530940
23W SPIRAL OAYlIGHT
35309 0
EASY TRIM WALLBASE B
I 7116405
I, EASY TRIM liAllBASE B
l2116405 _
TOT AL
TAX AT 7%
TOT Al SALE
CASH
CHANGE
4.97
4.97
:'"(/ ,- ~ ;.~
r' OQ,y
15.98
./
---..:::
41.90
2.93
44.83
60.00
15.17-
TOTAL NUMBER OF ITEMS' 4
1.~1 0
2.B~ N
2.18 0
1 .~8 0
0.78 N
2.98 X
1.88 X
1.88 X
2.60 N
1.00-0
26.87
1.17
28.0~
~O.O~
12.00
Summer Seasonal Merchandise vil1 oe
refunded at the register price on the day
of the return or the price i isted on your
receipt - vhichever is lOWER. Returns of
Sumn,er Seasonal Merchandi sa wi 11 on1 y be
accept~d if the product is unused and in
the or;s;nal packaging. Returns of
Summer Seasonal Merchandise will not be
accepted at all after September 1st.
THANK YOU, YOUR CASHIER, HEIDI
8343 10 9447 07/19/06 09:03AM 3057
TCI 7966 1006 3617 6711 0601
IIII~II~IIII~IIIIIIIIIIIIIIIIIIIII~I~I~IIIIIIIII
Fill your ""dlclr" prlscrlptlons hlrl
Wel-Hart PhlrRlcw ICCIPts oil pions.
07/12/06 10:11,61
LDWE"S
U Y -;;;I~. " 0,
se our:",,:~.";, L_,/~
BIG CARD_,,'_ RE1:,A TE
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LOIE'S HOME CENTERS. INC.
4100 OOOGE SI.
4100 OOOGE SI.
OUBUOUE. IR 52003
(563)5BB-8008
-SRLE-
SRLES .: S0117KFl 23929 07-03-08
5300 DOdge Street
Dubuque~ IA 52003
111111111111111111111111 11111 III III! II 111111
Sale Transacticn
180582 ORK BRSE L632 3/8 X 2 3/4
11 I 10.44
34897 ORK BRSE 634 2 3/5 X 3/8
114.84
11.98
3-PK ELEC TAPE 3/4" .
3646004 --.-- - 1. 00
.PLEATEO FlL TEN 16X25 -. ~_ .
6331074 ~ (.:>,2_59')
PLEATEO FILTER 16X20 !-.. j ()::2Y '.1
' ( ! '"'
6Jm61___.____..-.:..______2.59..../
60W 3 3/4" GLOBE BUL -
3535860 4 @2.39 9_56
SUBTOTRL:
TRX 32165:
INUOICE 56263 TOTRL:
126.82
8.88
135.70
BRLRNCE OUE:
135.70
TOT AL
TAX AT 7%
TOTAL SALE
CASH
CHANGE
15.74
1.10
10.84
20.00
3.16-
CASH :
CHRNGE :
150.00
14.30
0117 TERMIMAL: 56 07/03/06 15:13:39
TOTAL NUMBER OF ITENS . 7
Sumlller Seasonal t'lercnandise\.Ji 11 b,~
refunded at the register prieto: on th8: ddJ
of the return or the pric.; l~~h~d un .'lOUr'
receipt - whichever is lC~JER. Ret~rns>of
Summer Setl_sonal ~lerchandi se .....-; 11 .:;rl1}' be
accepted 1 f the product is unused a.nd in
the original packaging. Ret~rns wf
Summer Seasonal Merchandise \,111 neot be
accepted at all after Septdllber :.st.
THANK VOU, YOUR CASHIER, REBE.AH
LDWE"S
89713 12 5918 07/02/06 02; S] PN 3CS7
LOIE'S HOME CENTERS. INC.
4100 OOOGE SI.
4100 OOOGE SI.
OUBUQUE. IA 52003
(563)588-8008
-SALE-
SALES .: S0117KFl 23929 07-03-06
105696 3 PK POLY BRUSH SET L6S
117128 9Xll MULTT-SURFACE 220G-R
45B62 OT SRTlN POLYURETHRNE HIN
5.68
1.98
8.97
SUBTOTRL:
TRX 32165:
INUOICE 56265 TOTAL:
16.63
1.16
17 .79
1044 IOWA STREET . DUBUQUE, IOWA 52001
Dubuque: 319-584-2242 Manchester: 319-927-2196
Fax: 319-584-2373
INVOICE
July 5, 2006
Leo & Patricia Link
2820 Oak Crest Drive
Dubuque, IA 52001
Services Rendered for Water Damage:
$ 2,178.31
Less 15% (Previous Customer) if paid within 5 days
326.74
TOTAL
$ 1,851.57
SERVPRO OF DUBUQUE
FIRE RESTORATION, MOLD MITIGATION, & WATER MITIGATION
Client: LINK P AT
Home: (563) 583-0785
Property: 2820 OAK CREST DRIVE
DUBUQUE, IA 52001
Operator Info:
Operator: OWNER
Estimator: Teny Lenstra
Business: (563) 582-7776
Business: 1044 Iowa street
Dubuque, IA 52001
Type of Estimate: Water Damage
Dates:
Date Entered: 06/30/2006
Date Assigned: 06/30/2006
Price List: IADU4B6B
RestorationlService/Remodel
Estimate: 2006-06-30-2343
SERVPRO OF DUBUQUE
FIRE RESTORATION, MOLD MITIGATION, & WATER MITIGATION
200fHl6-30-2343
Room: DRYING
Dehumidifier (per 24 hour period) - XLarge - No monitoring
The above entry is for I dehus for 4 days
Air mover (per 24 hour period) - No monitoring
The above entry is for 8 fans for 4 days
4.00 EA
32.00 EA
Room: SERVICE CALL
Emergency service call - after business hours
Haul debris - per pickup truck load - including dump fees
1.00 EA
1.00 EA
Main Level
Room: REC ROOM
Ceiling Height: 8'
Apply anti-microbial agent - after hours
Water extract from floor - Gray water - after business hrs
Block and pad furniture in room - after hours
367.71 SF
367.71 SF
1.00 EA
Room: BEDROOM
Celling Height: 8'
Apply anti-microbial agent - after hours
Water extract from floor - Gray water - after business hrs
Block and pad furniture in room - after hours
220.00 SF
220.00 SF
1.00 EA
Room: STORAGE
Ceiling Height: S'
Apply anti-microbial agent - after hours
121.15 SF
Room: LAUNDRY
Ceiling Height: S'
Apply anti-microbial agent - after hours
90.26 SF
Room: BATHROOM
2006-06-30-2343
Celling Height: 8'
07/05/2006 Page: 2
SERVPRO OF DUBUQUE
FIRE RESTORATION, MOLD MITIGATION, & WATER MITIGATION
Apply anti-microbial agent - after hours
Grand Total
Terry Lenstra
Grand Total Areas:
2,196.00 SF Walls
876.13 SF Floor
0.00 SF Long Wall
876.13 SF Ceiling
97.3 5 SY Flooring
0.00 SF Short Wall
876.13 Floor Area
2,302.67 Exterior Wall Area
969.85 Total Area
287.83 Exterior Perimeter of
Walls
0.00 Surface Area
0.00 Total Ridge Length
0.00 Number of Squares
0.00 Total Hip Length
2006-06-30-2343
77.00 SF
2,178.31
IS,%
37..C,.7i
IZSi .57
3,072.13 SF Walls and Ceiling
274.50 LF Floor Perimeter
274.50 LF Ceil. Perimeter
2,196.00 Interior Wall Area
0.00 Total Perimeter Length
l s o~
'p (" '( \l cC\V\. S Cv.S..\.cW'.....;-
cd ,<;. tov, h.l..
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07/05/2006 Page: 3
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