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Claim by Alliant Energy_1 of 2Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL M F MORAN DUM To: Mayor Roy D. Buol and Members of the City Council DATE: April 1, 2014 RE: Claim Against the City of Dubuque by Interstate Power Company/Alliant Energy Claimant Date of Claim Date of Loss Nature of Claim Interstate Power Co/ 04/01/14 01/08/14 Property Damage Alliant Energy This is a claim in which claimant alleges that snow plow truck struck and damaged claimant's guy wires at 11th and Bluff Streets on January 8, 2014. 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 Terry Dempewolf, Interstate Power Company/Alliant Energy 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 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: 2. Address: po c)).... 3 Coc-f7 c.:ccoor 3. Telephone Number: C5 -1c., 5- (67 63 .2 4. Date of Incident: ffr • LicC, coc, 5. Time of Incident: 6. Location of Incident (Be specific): 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.) PlUt h G 3 -k) 11 8. What were weather conditions like? 9. Give name and address of any witnesses: See. n 10. Did police investigate? (If so, give names of officers.) qe-`) fit )-11 ),‘ 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? 14 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? 535, 3 5- 16. Why do you claim the City of Dubuque is responsible? I- 17. Have you made any claim against anyone else for damages as a result of this incident? (If yes, give name and address.) 214 18. If the answer to Question 17 is yes, have you received any payment from that source, and if so, in what amount? p/14 Dated at Dubuque, Iowa this day of Mose-IA , 20 )I. vvk (Rev. 7/12) (Signature) (Print Name) a 0 _o 0 > CD 4-- 73 1/49 c,A.) cn 13 ni 0 rn rn ALLIANT ENERGY. Interstate Power and Light, an Alliant Energy Company QUESTIONS CALL 1-800-255-4268 CITY OF DUBUQUE 925 KERPER BLVD DUBUQUE IA 52001 Invoice Number: Invoice Date: 521839 01/08/2014 Account Number 3006236220001 111596 - WR 3922530 NON UTILITY BILLING FOR TIME AND LABOR TO REPAIR DAMAGE THAT WAS DONE WHEN A PLOW HIT GUY WIRES, THAT ' BROKE GUYS AND BURNT DOWN ONE PHASE AT 11TH AND BLUFF, DUBUQUE IA, ON 1/2/14 Description INVOICE TOTAL' Amount :$1,535.35 ® ALLIANT ENERGY Page 1 of 1 Interstate Power & Light Miscellaneous Service Billing ACCOUNT NUMBER 3006236220001 SP 01 000008 945798 A"SNGLP IIIIIi1III""lhl ILII„ihilllgl'Ihlllitl"1"1111ln CITY OF DUBUQUE 925 KERPER BLVD DUBUQUE IA 52001.2338 Keep this portion for your records • Return this portion with your payment 6 PAY THIS AMOUNT ON OR BEFORE 01/28/2014 $1,535.35 AMOUNT ENCLOSED (IF DIFFERENT FROM ABOVE) IiII'IIII'l'I'IIII't"JIJIiIllilld1111111llnnilill'Ii"I°uiIII ALLIANT ENERGY P.0, BOX 3006 CEDAR RAPIDS IA 52406-3066 300623132 20001111153535U015353519 In Case of Errors or Inquiries About your Bill Send your inquiry in writing on a separate sheet so that Alliant Energy receives It within sixty (60) days after the bill was mailed to you.. Your written inquiry must include: 1. Your name and account number; 2; A description of the error and why (to the extent you can explain) you believe it is an error; and 3. The dollar amount of the suspected error. You remain obligated to pay the parts of your bill not in dispute, but you do not have to pay any amount in dispute duringthe time Alliant Energy is resolving the dispute. During that same time, Alliant Energy may not take any action to collect disputed amounts or report disputed amounts as delinquent. This is a summary of your rights: a full statement of your rights and Alliant Energy's responsibilities under the Federal Fair Credit Reporting Act will be sent to you both upon request and In response to a biting error notice. Send inquiries to Billing Department Alliant Energy P.O, Box 351 Cedar Rapids, IA 52406-0351 The detail CD code values on the front of this bill are as follows: B - Balance Forward O - Credit Applied F - Finance Charge Applied - invoice Charge Applied P - Payment Applied ELECTRONIC FUNDS NOTICE Alliant Energy processes check payments electronically. The amount of your check may be withdrawn the same day we receive your check.