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Claim by Alliant Energy_2 of 2Masterpiece on the Mississippi TRACEY STECKLEIN PARALEGAL M IH,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 01/29/14 Property Damage Alliant Energy This is a claim in which claimant alleges that when a City bus attempted to take a left turn on to White Street from the right lane on 11th Street, the bus collided with another vehicle, forcing the vehicle into claimant's utility pole on January 29, 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 Candace Eudaley, Transit Manager 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: leiv ocw, 2. Address: po 6c'.. Pu.24.94, -e.4„ 3. Telephone Number: (5(c) 2)) 4. Date of Incident: OA/ Vt/i4-1 5. Time of Incident: 7- 3 6. Location of Incident (Be specific): .1i,,A-e:5ec cp 4-- 1 1 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.) rstv. occ...ece CA:4) it \-iev 4.4A- rPL - 8. What were weather conditions like? 9. Give name and address of any witnesses: c_. -_-e_ r' i` G ( • if`' 10. Did police investigate? (If so, give names of officers.) cc) e'-.7 g gAr 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? 44') 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.) 1110 15. What amount do you claim from the City of Dubuque? -4)) 5m c `7 16. Why do you claim the City of Dubuque is responsible? �qq�� 5.' pc)i,`L.e ' /p 4- ,r 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 source, and if so, in what amount? Dated at Dubuque, Iowa this day of Pler. \ , 20 ) ) be (Rev. 7/12) (Signature) (Print Name) O C =I m `7 m Q C CD ALLIANT. ENERGY..interstate Power and Light, an Alliant Energy Company • QUESTIONS CALL 1-800-255-4268 • • OITY OF DUBUQUE • Invoice Number: 522493 50 W 13TH ST • . Invoice Date: 02/17/2014, DUBUQUE IA 62001 Account Number . 3006292132062 . - ...• . COLLIDING WITH ANOTHER VEHICLE CAUSING THAT itEHICLETO HITA POLE ON 1/29/14 AT l'ITH AND WHITEST.; DUBUQUE IA52001 . 111795- WR 3922532 NON UTILITY BILLING TO REPLACE POLE THAT DAMAGED WHEN CIN BUS DRIVEN BY GARRY LUCAS, CHANGED LANES • Amount $2,518.97 Description INVOICE TOTAL • . • • ALLIANT •' ENERGY. •• ACCOUNT NUMBER. • 3006292132002 • • A ' $2,518.97 Sem ©jr\ct t ' 61 \1 +0 '-oa i on z-zi- ly • Pagel of 1 Interstate Power & Light Mlscellaneous Service Billing SP b1 000002 13515E 1 A* SNGLP ' • 11411101011111111"11"1111t111111114"1 "1111111111111'111 CITY OF DUBUQUE 50 W 13TH ST DUBUQUE IA 52Q01-4845 M • Keep this portion for your. records Returnthis portion with yourpayment 6 PAY THIS AMOUNT ON OR BEFORE 03/09/2014 • $2,618.97 AMOUNT ENCLOSED (IF DIFFERENT FROM ABOVE) " I !hl"'li'I'til'faithHuiiiiIilillildlt'II'�hti'ii'Ililit4h ALLIANT ENERGY ' P.O.' BOX 30p6 CEDAR RAPIDS IA 52406-3066 . 3006292132002002518.970025189717 * In Case of Errors or Inquiries About your Bill Send your Inquiry in writing on a separate sheet so that Alllant 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 bit not iri dispute, but you do not have to pay any amount in dispute during the time Alllant Energy Is resolving'the dispute; During that same tlme,'Alliant Energy may not take any action to collect disputed amounts or report disputed amounts as delinquent: Thlsls a summary of your -rights: a.full statement of your rights and Alllant Energy's responsibilities under the Federal Fair Credit Reporting •Act will be sent to you both upon request and In response to a billing 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 Ware as follows: B - Balance Forward C -.Credit Applied . F . - Finance Charge Applied •1 - Invoice Charge Applied P - Payment Applied • • ELECTRONIC FUNDS NOTICE Alllant Energy processes check payments electronically, The amount of your check may be withdrawn the same day we receive your check. '