Claim by Tracey HayesCLAIM 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:
2. Address: 1
3. Telephone Number
4. Date of Incident:
5. Time of Incident:
6. Location of Incident (Be specific):
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.)
8. What were weather conditions like?
9. Give name and address of any witnesses:
10. Did police investigate? (If so, give names of officers.)
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.)
13;.What other damages do you claim, if any?
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14. Have you been compensated for any part or all of your claim by any
insurance company? (Ifso, 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.)
18. If the answer to Question 17 is yes, have you received any payment from that
sou ce, and if so, in what amount?
Da ed this
(Signature)
(Print Nam4)
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The day the Water main broke
It all began when my son Brandon called me a little after 3pm on Jan 31st, to tell me he could
hear water running in the basement. I asked him to open the door and check and he could see water
like a raging fountain coming up through the toilet, shower and sink drains. I left work immediately and
raced home. By the time I arrived the basement had at least a foot of water or more. We tried getting
a hold of the city immediately and called the landlord to tell him. The water kept coming in and by the
time a half hour had passed the washer /dryer were floating.
It took approx. /2 hour for the city sewage division to arrive, but we were told it was a water
main break and they could not shut it off. So they called the water division to come and investigate,
which took another /2 hr. By this time the water was almost to the window in the basement and
covered the bottom two stairs. They had to find where the break was, and turned off the water. The
weather was very cold that day and was not pleasant to the workers. After the water was shut off, the
landlord arrived to access the damages and called a local company to start pumping out the basement.
He was told that they could not do it because it was too deep and that the fire dept. would need to be
called.
Shortly after 5pm, the fire dept. showed up and accessed the damages in the basement. They
had to have the gas and electric turned off for safety. Unfortunately the landlord left and had to travel
an hour away on personal business, so I had to stay as the firemen came in and out of the house. The
temperature in the house dropped right away as the doors were held open. To a normal person sitting
in the cold for 3 hours might not be a problem, but as you will see on the attached documents, I am also
partially handicapped due to a sickness / nerve condition. This was not comfortable for me and I had to
finally go sit in my car to get warm. The fire chief was very gracious and called my landlord to tell him I
couldn't stay there anymore because I was in so much pain and freezing. I was grateful for that. I had to
find a place to stay for the night, and had to farm the kids out to different places.
The next day came the news from the landlord that the water heater, furnace, washer and
dryer, and everything in the basement were ruined. You will see on page 2 the list of damaged items I
lost. I have severe allergies and was not able to be present while they were cleaning out the basement
but attached you will see pictures of the damage and the pile. The landlord said because of there being
no heat and water, it was obviously uninhabitable and therefore the kids and I needed to move out. He
requested we be out within week, and so it began
On Monday Feb 3rd it had snowed and was very windy, especially up on the hill. My son and I had
bundled up, put our gloves on and dug in. We started packing. 20 minutes later we were running to the
car to warm up. This week was one of the coldest weeks of the year, with temperatures dipping from
zero to -20 degrees. We worked in this kind of weather from Mon — Thurs 3 -4 hours a night. On Friday
the landlord had the heat on and it was more comfortable to continue packing. Saturday was one of the
worst days to move. I have a Chevy Trailblazer which has some room for boxes in the back. As you can
see from the pictures, we did not leave with much, but what we did have took us 8 trips from Dubuque
to East Dubuque, where my best friend was gracious enough to let me store my stuff and keep me up till
I am able to find another place. We also had a friend help us with a truck to help move. It was blizzard
type weather on Feb. 8th, when we finally got all of our belongings that were salvageable out. It was
depressing and disheartening to see all the stuff that I worked so hard for destroyed. I was also sick and
exhausted by the end of the week. With an already low immune system because of my sickness, it has
been very hard to stay healthy through all of this. It also resulted in my son having some behavior issues
because of depression at school. This was not something little to a single mom and her three teenagers.
We may not have had all the things most people do, but what we did have, I worked hard for and the
kids took care of. To have to start over has been very hard on all of them.
On Sunday Feb 9th, we came back to the place we called home for 3 years and put all the stuff that
smelled like sewage or had a musty smell from coming up from the basement, on the curb. My floral
couch almost brand new and 5 mattresses were on the curb as you can tell. The rest of it was what we
felt we could not hold on to considering where we were going, and the storage capacity we would have.
Tracey Hayes (Ti)
2/20/14
Damaged and non - salvageable items
• All Spring and Summer clothes for myself, my 18yr old daughter, my 14 & 16 year old son.
Ali — 8 pairs of shorts, 10 t- shirts, 8 dresses
Bryan — 9 pairs of shorts, 12 t- shirts, 4 pairs of pants
Brandon — 7 pairs of shorts, 10 t- shirts, 6 pairs of pants
Tracey (TJ) — 4 pairs of shorts, 12 shirts, 8 dresses
Total estimate: $500
• 18 yrs. worth of Christmas ornaments. Every year I would buy my kids each an expensive
ornament to hang on the tree. New ornaments cost on average $4 -10, we also lost our
Christmas tree, which on average and on sale costs $50_
48 ornaments x $2 = $96. New Tree $50
• New and used purses, 5 purses ranging from $15- $200. Total estimate lost $100
• Washer & Dryer - Lowest prices $449 for the cheaper Roper Electric Washer and Dryer
Total price $898
• Emergency Evacuation enforced by the Dubuque Fire Dept.
I am asking for first month's rent and deposit and the inconvenience to move in a week . I
found a 3 bedroom apt / house $ 800. I was only paying $690 a month for the house I was
living in. Total displacement for finding a new place $1380
• Displacement of my family
A Hotel would cost on average $80 a night. FEB (28 days) and MARCH (31 days) and APRIL (30
days) $80 x 89 days = $7120, but since the place that I have found is not available till MAY.
I am asking for 1 month of Rent for emergency living costs $690
Emergency Food costs, as everything had to be thrown away due to the Electricity being shut
off. Asking for $300
Emergency utility displacement costs. Asking for $180
• Storing of household items at friend's house till we are able to move ...
Average storage costs in Dubuque $90 a month, asking for 3 months through April= $270
• Pain and suffering - $2000 for Emergency evacuation / working 4 days with no heat / and loss
of pay from missing hours at work to take care of things.
• TOTAL EMERGENCY DISPLACEMENT FUNDS REQUESTED: $6364.00
Family Signatures :
Ali Evans 1 ?7 � ����,�^=— Bryan Evans
Brandon Evans
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Witnesses:
Melissa Knuckel
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Nicole Hante|mann(/vL~6
Nikki Fran
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