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Claim by Ethel & Bill SchneiderTHE CITY OF DUB E MEMORANDUM Masterpiece on the Mississippi BARRY LINDAHL '~ CITY ATTORNEY To: Mayor Roy D. Buol and Members of the City Council DATE: RE: Claimant October 31, 2007 Claim Against the City of Dubuque by Ethel & Bill Schneider Date of Claim Ethel & Bill Schneider 10/23/07 Date of Loss 09/01 /07 Nature of Claim Property Damage This is a claim in which the claimants allege that the basement of their residence located at 710 Duggan Drive sustained water damage due to a sewer backing up on September 1, 2007. This claim has been referred to Public Entity Risk Services of Iowa, the agent for the Iowa Communities Assurance Pool. BAL:tIs cc: Michael C. Van Milligen, City Manager Jeanne Schneider, City Clerk John Klostermann, Street & Sewer Maintenance Supervisor Ethel & Bill Schneider 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 balesq@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 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: Ethel ~ Bill Schneider 2. Address: 71o Duggan Dr., Dubuque, IA 52003 3. Telephone Number (563) 583-4251 4. Date of Incident: september 1, 2007 5. Time of Incident: 11.3D AM +/- 6. Location of Incident (Be specific): 710 Duggan Dr (and neighboring nronerties) ~v~n ~~~ b~~ 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.) The Cites sanitarv sewer 1 „ggPrl and b, ~tipd u~causi~~gP t^ i °rcnnal property. Bill Kelly and Jerry (last name unknown) witnessed the dam4ce after clearing the sewer main 8. What were weather conditions like? Sunny, clear, 80-degrees 9. Give name and address of any witnesses: Mark & Sue Schneider, 2580 Knob Hill • Bill Kelly and .TerryT('.; r3r of Dubuque employees 10. Did police investigate? (If so, give names of officers.) No 11. Was anyone injured? (If so, give names, addresses, and extent of injuries). No 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.) Yes - 16 yards of carpet had to be removed and disposed of due to saturation of the carpet with wastewater. Value $15/vd X 16 yards = $240. 13. What other damages do you claim, if any? _ Cleaning supplies - $10• Labor -Ethel & Sue Schneider 5 hours each @ $15 Mark Schneider 4 hours @ $15. Total $220 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.) No 15. What amount do you claim from the City of Dubuque? $460 16. Why do you claim the City of Dubuque is responsible? The damage was the direct result of the City sanitary sewer back-up 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? NA Dated this 5th day of o~tobe _~ 2g C~! `~,~~~qrl(] (Signature) 61; ~ I Nd ~Z 1~0 LO ,~~-h e (Print Name) ~~f~f~J~~