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Claim by Lori Ziegenfuss 3 26 07Claim Form Home Page :Departments :City Attorney's office : Claims; Claim Form City Attorney's Office Suite 330, Harbor View Place, 300 Main Street Phone: (563) 583-4113 Fax: (563) 583-1040 Hours: 8 a.m. to 5 p.m. Monday through Friday CLAIM AGAINST THE CITY OF DUBUQUE, IOWA Page 1 of 3 This written report constitutes your claim against the City of Dubuque, Iowa. You should comple 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 referred to the appropriate department for investigation and to the City Attorney's Office. Once 1 is completed, a report and recommendation will be submitted to the City Council. You will be prc 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 authority to make any representation to you as to whether' your claim will or will not be paid. 1. Name of Claimant: L~ ~' c L i 2. Address: ~ i ~ (o ~ ruv~S~ ~ ~-~ , ~ v.~ u ct ~ Q., ~ l~ S~.t~ ~ 1 3. Telephone Number: ~alP ~~ `j\ '3 °~.~4 L ~ ~\\', Si, p~-, - `jgD - c~ ~j(p c~ 4. Date of Incident: ~'~ Q~\~~+~^`'~ ~ ~~~~~ ~ ~~~ ~ ~~~~1 -.>~3Zritn~x 5. Time of Incident: Ci_ pr, ro X~ w~~~,:~ U ~ U ~" ~ ~ { ~ ~~ lY~ 1~ ~"1'~ j~ - 6. Location of Incident (Be specific):~0.,~r `(`cY~- h ~Y~(,l~ bf\ a n~ 7. Describe the accident or occurrence that caused injury or damage. (Give full details upon whi your claim. If a City employee was involved, give the employee's name.) ~' ~ ~~ A~X- hrY.t ~ v~ ~ ~. ~(_ ~ ~ rr~~~t p YY1 ~ (7Y~ O~ ~~1~ ~1' vPQ 8. What were weather conditions like? ~UCf~-y ~ l~ ~~~ 9. Give name and address of any witnesses:517Cxr, - ~.Y 1C ~L ~~ I 1 ~i r1G~ ~(,~, ~~ ~~A~~i ~c.~JC-~.C~..~~ 1(C~ d.~~ 1 -~ NDrhrv~ ~`nLQ:~ l~--til,r ~,wiL `~ ~~ ~~5~. 10. Did police investigate? (If so, give names of officers.) N~ http://www.cityofdubuque.org/index.cfm?pageid=294 3/16/2007 Claim Form 11. Was anyone injured? ({f so, give names, addresses, and extent of injuries.) Page 2 of 3 J ~`J YV ~r. 13. What other damages do you claim, if any? A~^~'~ ~ °~ ~ ~ ~ ~L -Cp-~*~~~ ~DY l~ ~ ~.PSl `~i~,~~ ~ Y1t~9rr~~- [~ -~r~il ~l ~~'~1y`'C~ t ~~; ~~ ~~` 14. Have you been compensated for any part or all of your claim by any insurance company? (N and address of insurance company and amount paid.) __ i 15. What amount~Md~~og4you claim from the City of Dubuque? ~c'9n t~ \Y1C.1.'~rY 1~1~ _ _ _ 16. Why do you claim the City of Dubuqule is responsible? ~~ ~~-~~-`~- ~ ~ ~t ~' -~ 4-s.a ~' G~~.a' YY~GL{h fC~y"~~~ `~-~~ ~ c~ht,~-~.Q ~ c~w~.a c 17. Have you made any claim against anyone else for damages as a result of this incident? (If y and address.) . 'i~ ~._ .~ ,.. ... c. :. r..,.. ~. ~~ !a .vim n L i U~\n ."c~C1..~,. \ _. ~ l.S.+V~. o 18. If the answer to Question 17 is yes, have you received any payment from that source, and if amount? ,, ~,_,, a - ~~ ~ ~ 6~~~ ~~~ i\ S rb ~ dl1~J~l C.w Aa Y~t~ C~ILi~]iy1~ Dated this ~ day of ~rv,~ }"1 , 200`. t1~ lam, (Signature) ~ ~.J 12.,i Z,2u 2,r~sS (Print Name) Home Page :Departments : Ci~Attorney's Office :Claims : CI111'Tl FOr•m http://www.cityofdubuque.org/index.cfm?pageid=294 3/16/2007 12. Was any damage done to property? (If so, describe property and the extent of damages. Att damages or describe basis for ascertaining extent of damage.) -. ~ .r. ~ ~ . ~, Lori J. Ziegenfuss 3106 Brunswick Dubuque, IA 52001 March 26, 2007 Enclosed is my claim against the City of Dubuque for damages received to my home caused by the water problems the city encountered on the evening of Wednesday, March 7, 2007 at O'Neil Street in Dubuque, IA. I noticed it at approximately l Opm that evening. I heard what sounded like my washing machine running and went to the basement to check out the noise and found my basement flooded with city water and raw sewage, at that time it was ankle deep, with a geyser of 4-6" spouting from my floor drain. I immediately called the city emergency number and was told they would send someone. Some time passed and I called again and was told the same thing. More time passed and I was given a number to call direct. I was told again that the city guys were on their way. Not once was I told what was going on over on O'Neil Street or why this was happening (water problems on O'Neil Street). O'Neil Street is one street over from me. I live on the corner of Brunswick and Edith. I ended up with over 14" of water/raw sewage in my basement. It was disgusting...I even had floaters. The fire department pumped out my basement that evening, which left me with 3-4 inches of solid "stuff' to attend to. During all this, I called Steamatic emergency number and they came and assessed the situation. I was told I could not stay the night in my house due to the contamination/bacteria. Ilost my furnace and water heater too, so I wouldn't have stayed anyway. This was a horrendous mess as I am sure it was for all the' other homes in the area that also received damage due to the city water problem on O'Neil Street that evening. Steamatic did the cleanup and after a week, I replaced the furnace and water heater - an expense which I am now trying to figure out how to pay. I have lost just about everything in my basement. It was a finished basement and because I have no outlet in my basement we had to go through the main floor to get everything out of the basement. This caused damage to my main floor carpets. Because of health risks, no insurance company will allow carpeting and property that has been soaked in raw sewage to remain in a home. Cleaning and disinfecting processes are also required -hence Steamatic. I can not even begin to express to you the amount of stress and disruption to my life this has been. I am in my busiest time at work and have had to miss work because of this incident. I am currently without a shower (though I have enclosed pictures of the make-due shower I made) and currently without a washer and dryer as well. The burden of my loss should be the responsibility of the city, as I was not negligent in any way. I have been and will continue to keep track of all expenses and time incurred due to this circumstance. n o ~ _ Thank you, ©~~ ~ ~ ~ N ~ A 1 S3 ;z." 4ti VV- ~ ~ ~ Lori Ziegenfu C, ~ ~~ n cn o Enclosure: Steamatic - $2,245.00 Geisler Brothers Co. - $2,150.00 $4,395.00 I have enclosed, only, two of the many expenses I have and will incur due to the City Water problem on O'Neil Street, as these two bills are coming due and will need to be paid soon. I will continue to obtain estimates for redoing my basement and I need to get costs of replacing the personal items I lost, as well the time it has cost me due to this incident. Thank you, Lori Ziegenfuss 3106 Brunswick Dubuque, IA 52001 563-580-7369 Cell 563-513-2618 Home Dubuque Area Steamatic, Inc. ~~ R;TEAMATIC. _..,~.c ~" -' "- BILL TO Loi9 7,icgenfuss 311)6 Brunswick Dubuque,lA.52001 P.O. NO. TERMS Nct: 10 Days ITEM DESGRIPTION 301RS-1WA"TF,R R EmcrgencyService 30185-Wit'TER R Labor 3019, Anti-microbial application 30184 Equipment. Rental - dehumidifier 30184 Equipment Rental -heaters 30190-MISC' Misc -PPG, Equipment decontamination 500 Huff St. P.O. Box 1164 Dubuque, lA 52004-1.1.64 563-556-5821 Invoice DATE INVOICE # 3/15/2007 14894 DUE DATE TECH REP 3/26/2007 CL, SERVICE DATE AMOUNT 3/R/2007 125AO 3/ 14/2007 1,100.00 3/9/2007 (00.00 3/14/2007 450.00 3/ 14/2007 200.00 3/ 14/2007 270.00 We appr~.~aatc your business. Thank you. Tota I $2.245.00 ~~ ,~ ~`~~~~ tiPq `rQ~ \~ Un _ ~~ GEISLER BROTHERS CO. Established 1892 ~~ 340 E. 12th Street • Dubuque, Iowa 52001 Phone 563-583-7363 • F1~X 563-583-7365 Lori Ziegenfuss 3106 Brunswick Dubuque, IA 52001. INVOICE March 16, 2007 Job # 7701.4 Invoice # 43685 Acct Number 31.06 For Installation of a New Lennox 80% Efficient Natural Gas Fun~ace and a New Rheem Natural C~as I-ht Water Heater as Per Quote. TOTAL INVOICE AlVIOiJNT Net Due 15 Days $2,1.50.00 HEATING • AIR CONDITIONING • ROOFING • SHEET METAL ~~~~~~tiP4 GEISLER BROTHERS CO. ~.h Established 1892 9\~ c~cA ~~~ 340 E. 12th Street • Dubuque, Iowa 52001 ~~~n ,o°a Phone 563-583-7363 • FAX 563-583-7365 ~POSAL SUBMITTED TO Lori Ziegenfuss - 3106 Brunswick Dubuque, IA 52001 PHONE 580-7369 JOB NAME JOB LOCATION ARCHITECT DATE OF PLANS JOB PHONE DATE March 9, 2007 JOB INFO We hereby submit specifications and estimates for: We propose to furnish all labor and material necessary for installation of a New Lennox G50 - 80% Efficient Natural Gas Furnace with a New Rheem 40 Gallon Natural Gas Water Heater, sheet metal ductwork revisions, gas piping, power and control wiring, water piping for water heater, venting to existing chimney, testing and start-up, includes New Condensate Pump, all labor, material and permits. LUMP SUM $2,150.00 We propose hereby to furnish material and labor- completion accordance with above specifications, for the sum of: Payment to be made as follows: Net 30 days All material is quazanteed to be as specified. All work to be completed in a workmanlike manner according to standard practices. Any alterations or deviation from above specifica- Authorized tions involving extra costs will be executed only upon written orders, and will become an Signature extra charge over and above the estimate. All agreements contingent upon strikes, accidents Mark Palmer or delays beyond our control. Owner to carry fire, tornado and other necessary insurance. Note: This proposal may be Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accented within 30 davs. Acceptance of Proposal -The above prices, specifications and conditions aze satisfactory and are hereby accepted. Your are authorized to do the work as specifie Payment will be made as outlined abov~ ) / Date of Acceptanc : ti__,.~ L~-~ ~ U HEATING • AIR CONDITIONING • ROOFING • SHEET METAL • • • City Dubuque, IA Water Main Break on O'Neil Street on Wednesday March 7, 2007 LOSS OF PERSONAL ITEMS LIST Furnace Condensation Pump Mater Heater - 44 Gallon Luggage set Entertainment Center Home Theater System Games -three -Life, Pictionary, Tabu 7'reaam~ll -Sears Ankle weights (DP brand) Running Shoes Foot Massager Gas Fireplace Washing Machine Utility Cart -wood, cloth Wood cabinet for towels Old Spice soap/shampoo Bathroom floor rug -large ~iug - rzrr~r~er size i~ front of ai~asher/dryer Rug at bottom of basement steps Shower Curtain -cloth -mildew resistant Dryer Sheets Swiffer used for the floors Sponge map Duster Bottle of Woolite Bottle of Floor Wax Large bottle of Conditioner -from Beauty Supply house Box of ~14r. C1ear~ sponges Package of Soap Dryer -gas Electric Stove Carpet -Two room size pieces mug -One room size Oscillating Floor Fan Small box Fan Wood Bar Stool -One from set of two w/swivel seat Foam Mattress -Double bed size Down Mattress -Double berg size Quilt -Double bed size Electric Blanket -Queen size, dual controls Electric Roaster - (Three compartment roaster) Karaoke Machine - w/monitor Karaoke CB's - Quantity: 24 Framed Art Work -Quantity: 2, with double mats, approx. size 2 '/z-3" x 3 '/z - 4" Dehumidifier Floor Lamp -Brass -Goes with set of lamps from living room Wood Desk w/ file drawer ~'wo legal pads Two leather legal cases -one legal tablet size, one steno tablet size Round side table -antique -was my grandmothers Kitchen table -antique -was m_y grandmothers Linen Tablecloth -red -rectangle shape Summer Clothes: One Sleeveless Button down blouse One pair white denim shorts Four white cotton tops Two sleeveless summer dresses ~,arge Coffee Pot {percolator kind) Camping Box: Plates, napkins, plastic forks, spoons, knives, Citronella Candles -the bucket kind (4), Battery Camping Lanterns (2), Flashlights (2), Batteries -pack of 4 C cell and 4 D cell, box matches, 6 bug repellent spray cans, box of garbage bags, 2 table clothes 15 Can coolers (Koozies) Cedar Chest -Lane brand -was my mothers Two boquetts of silk flowers from Home Interior Cosmetic Case -cloth S Placemats 4 Hand Towels Bridal Pen Set Hand Carved Wood serving tray wlglass top 4 Christmas Ornaments that were my grandmothers 2 Oil Paintings from Korea 1 China tea pot and lid 1 small Crystal Bowl -Princess House brand Patio Umbrella Toys - Sit n Spin, Doll House, doll furniture, 3 dolls Drapes from JC Per~r~y -for tivo windows from ~llaster Ber~room -style b-100 B One set of burgundy sheers -from K-Mart fiwo sets of appliance gliders -one small set and one medium set Four Christmas Stockings Four Santa Hats Six rolls of Christmas Wrap • Halloween Decorations: ~ddood Scarecrow v,;all hanging 2 sets of Halloween lights Halloween FIag Chicken Statue 1 Bag of Poly Fill 3 Stuffed Halloween figures. ~Nitch, Frankenstein, Scarecrow 7 Inflatable Pumpkins 4 Halloween Candles Pumpkin Carving Kit Black Cat Statue Bag of Hal~owe~en Balloons - (qty 151 S Pumpkin Table ornaments -made of paper 2 packs of spiders and webbing 5 packs of rubber spiders and webbing Ceramic light-up Pumpkin • • O'Neil Street Caused damage to: Water Main Break Lori Ziegenfuss March 7, 2007 3106 Brunswick Dubuque, IA 52001 ~'4 q2. 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