Claim by Zachery GriesCLAIM AGAINST THE CITY OF DUBUQUE, IOWA
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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.
Name of Claimant: '?0 07 V. n ( h C'.5
2. Address: 1 10 '►
3. Telephone Number:
4. Date of Incident:
5. Time of Incident:
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6. Location of Incident (Be specific): l-13) use ( I� vT� inn e.
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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.)
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8. What were weather conditions like? e 01 net °'(J 7J \'r (o no knot, -) (1 -1 1r,
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10. Did police investigate? (If so, give names of officers.) c 4 N Ix p Po v:
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11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
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? in
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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.)
15. What amount do you claim from the City of Dubuque?
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16. Why do you claim the City of Dubuque is responsible?
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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.)
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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 I day of (W41 , 20
(Rev. 7/12)
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(Signature)
(Print Name)
To the City Council or to whom this may concern:
On the 315t of January, when I arrived home at 4:15PM, I was greeted by my neighbor from 1110
Althauser Ave. She indicated that a water line, or pipe, had burst near our houses. She suggested that I
check my basement for flooding because hers had filled with water following the pipe- break. As soon as
I got inside my house, I checked my basement, and at that point it had over a foot of brown, cloudy
water covering the entire space (pictures included).
I immediately called my insurance company to file a claim. As I talked with my insurance company, my
furnace began emitting a burning smell. My furnace is also located in the basement, which at that point
was completely flooded. When I turned my furnace off, the smell was no longer noticeable...so I
assumed that the furnace may be malfunctioning or broken due to the flooding taking place.
That evening, I had to purchase five space heaters to heat my home and prevent the pipes from freezing
inside my home. I am seeking reimbursement from the city for the cost of the space heaters from Wal
Mart, totaling $220. The receipt for the space heater purchase is attached. I also purchased water
bottles because I had no running water while the city pipe was undergoing repairs, the expense for
which is also on the receipt from Wal -Mart. I am also seeking reimbursement for this expense. The total
of which is: $2.97. (Item: 1)
The company, Steamatic, was assigned by insurance to clean my home that night, but they were unable
to begin work because the street was cluttered with city workers. They agreed to start cleaning Saturday
morning when the city had completed work on the pipe.
Saturday February 15t I awoke to more work outside my home... the city crew was doing more work on
the streets or pipes, this time a few hundred feet up the street from where the initial pipe had burst. I
do not know what was receiving repairs this time, but the street was blocked off again. Because of the
ongoing repairs, Steamatic was not able to clean my basement Saturday morning either, due to the
work being done on the Althauser Ave. I did not turn my furnace on at all on Saturday either, due to the
possible danger and uncertainty how to proceed given the situation and potential damage.
On Monday, the crew began cleaning my basement, removing mud and water, from my finished
basement. By Tuesday, most of the water /mud was removed, so I called All Seasons Heating and Cooling
to schedule an appointment to have someone look at my furnace. I also wanted to have my water
heater inspected, because I had lost all hot water in my house. On Tuesday, I was also informed that
insurance would only cover up to $5,000 for the incident if I utilized my insurance company during this
crisis. I also received a quote for water /mud removal which was over $5,000. I am seeking
reimbursement for the expenses I incurred for the water removal /mud removal and the removal of
damaged property. That total for this expense is $5,247.94 (Item: 2) and the receipt is included.
Later in the week, an All Seasons Heating and Cooling representative visited my house. I've attached the
receipt for his visit, which totaled about $97.00 (Item 3). As indicated on the invoice, ".....furnace needs
to be cleaned very well or replaced." Additionally it was concluded ".... water heater needs to be
replaced due to water." I am seeking $97.11 from the city for reimbursement to cover my expenses to
hire a heating and cooling representative. I am also seeking reimbursement for a new water heater and
a thorough furnace cleaning, or a new unit. I do not have a quote for a furnace cleaning. So — included in
my documentation and request for reimbursement is:
Receipt for $97.11 to have a representative from All Heating and Cooling examine my water
heater and furnace. (Item 3)
Quotes for a new water heater and furnace. (Item 4) In the reimbursements, I am seeking
reimbursement for the Lennox SLP high efficiency unit ($3,300) a new water heater ($775). You
will see notes below indicating that a chimney liner may be necessary, but I am not seeking
reimbursement for that cost as it is not needed due to the flood damage.
My washer and dryer were both located in the basement, and were also ruined in the flood. I am
seeking reimbursement for both units from the city as well. I called General Electric to confirm price, and
they said that because my units were a few years old, they would need to supply me with the
information on equivalent models. General Electric confirmed that the models in the documentation
would be equivalents (my washer /dryer, which were destroyed, are model no:WCVH6600HWW. The
replacement washer is model number GFWS2600FWW and dryer: GFDS260GFWW). Therefore, I am
seeking $2,698 for a replacement washer and dryer ($1,399 for the dryer and $1,299 for the washer).
(Item 5 and 6)
Additional reimbursements /compensation I am seeking are noted below:
- Custom canoe bookshelf made by my grandfather before he passed away
Log futon frame, futon mattress, and futon mattress cover
- Chaise lounge
Bar stools (six wood and three metal /fabric)
- College level books /notes /work saved on printed material that was ruined
Home decor for fall /winter seasons
I welcome any city representatives to visit my home and provide estimates on these losses, but by my
calculations re: fair reimbursement is $3,000. I do not have documentation of the price for these items
but would welcome inspection to confirm the worth of these items and the replacement costs. I will
include these as item 8 below for total claim purposes.
The final reimbursement I am seeking is for the expense required to fix my basement to pre -flood
condition. Steamatic provided a quote for those repairs as well, which total: $8,789.47. The detail for
this repair can be seen in the estimate included (item 7).
I have also included a couple photos from January 315T when I arrived home and saw the flooding that
had taken place in my basement. I included a set of photos to show the aftermath of the cleaning efforts
by Steamatic so that you can see the extent of the damage. If you need a before -flood photo or
documentation, I can furnish that upon request. I have a video on my iPad from about two months ago,
walking through the basement which will show the exact pre -flood condition and I also have other
photos of the basement that I could provide.
In total, I am seeking the following reimbursements from the city with all documentation to support
these claims:
Item
Price
Notes
1
$222.97
Wal Mart Purchases /Receipt
2
$5,247.94
Steamatic Receipt
3
$97.11
All Seasons Heating /Cooling
Receipt
4
$4,075
Quote from All Seasons
Heating and Cooling
5
$1,399
Front load gas dryer GE
printout (MSRP)
6
$1,299
Front load washer (MSRP)
7
$8,789.47
Quote from Steamatic
8
$3,000
MISC Items that were
destroyed /damaged (see
photos for indication of some
possessions. Or video can be
provided to show all items in
basement before flood.
Total of claim against city:
$24,130.49
I am seeking claims from the city rather than insurance for multiple reasons. By leveraging my insurance,
I will receive higher premiums and they will be tasked with funding repairs and incurring expense for this
damage. This does not seem right or fair given that the cause of all the damage was city property that
mal functioned or broke. Additionally — the insurance coverage is only $5,000 and as documented
above, that amount is but a small fraction of the total damage done.
Confidential
This communication and any attachments may contain information which is confidential
and privileged by law and is for the use of the designated recipient. If you are not the
intended recipient, you are hereby notified that you have received this communication in
error, and that any review, disclosure, dissemination, distribution or copying of its contents
is prohibited. Please notify City of Dubuque immediately by telephone at (563)- 589 -4120 of
your receipt of these items and destroy the communication and any attachments
immediately. Further disclosure of this information may violate state and federal
restrictions.
Confidential information may include the following:
1) Social Security Number(s)
2) Medical /Health Information
3) Personnel /Disciplinary Information
4) Bank Account Information
5) Financial lnformation
6) Credit Card Numbers
If any documentation you desire to submit to the City of Dubuque contains any of the items above,
this cover sheet must be attached directly to the confidential information, Please indicate below the
type of information that is included.
I, Gz d'') .e ✓ru (C ' . , hereby certify that the attached documents
rotected information:
include the following
Social Security Number(s) Bank Account Information
Medical /Health Information Financial Information
Personnel /Disciplinary Information Credit Card Number(s)
I understand that this information may be distributed within the City organization or to agents of the
City for processing and I hereby authorize the City to act accordingly taking all precautions to
protect my information from unnecessary distribution.
i „% 6 %01-/
0 Date
Sign re `�,
I have read the information above and do not have any confidential documentation to submit to the
City of Dubuque as part of this Claim Against the City.
Signature ! Date