Claim by Qwest_West 5th StreetTHE CITY (JF
DUB E MEMORANDUM
Masterpiece on the Mississippi
BARRY LINDAHL `~
CITY ATTORNEY 1
To: Mayor Roy D. Buol and
Members of the City Council
DATE: October 31, 2007
RE: Claims Against the City of Dubuque by Qwest, CMR Claims, TPA
Claimant Date of Claim Date of Loss Nature of Claim
Qwest, CMR Claims, 10/26/07 08/27/07 Property Damage
TPA
Qwest, CMR Claim, TPA has filed five (5) separate claims regarding damage to Qwest
buried service cables located at the following addresses:
1. 896 West 5t" Street
2. 986 West 5t" Street
3. 995 West 5t" Street
4. 996 West 5t" Street
5. 999 West 5t" Street
According to Gus Psihoyos, City Engineer for the City of Dubuque, Horsfield
Construction, Inc. has been retained by the City of Dubuque Engineering Department to
complete the 5t" Street Reconstruction Project. The contract called for the standard
form of contracts and bonds with the City, which require the contractor to hold the City
harmless from any claims of damage resulting from the work.
It is therefore the recommendation of Gus Psihoyos to refer these claims to Horsfield
Construction, Inc. for its consideration. The City Attorney's Office concurs with this
recommendation.
BAL:tIs
cc: Michael C. Van Milligen, City Manager
Jeanne Schneider, City Clerk
Gus Psihoyos, City Engineer
Holly Finley, Qwest, CMR Claim, TPA
Horsfield Construction, Inc.
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
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~-;ep, 1$. 2007 5.14PM CITY OP DBQ LEGAL DEPT .~'1,'~U~~ i ' ~ ~"~ ''~ No. 1862 P. 3
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CLAiM pGAiN~T THE CITY Ot= DUBUQUE, IOWA
This written report constitutes your claim against the City of Dubuque, Iowa. You should
complete this form 'in full and attach any additional information that supports your claim.
The Claim must be flied with the City Clerk at City Haii, 50 W.13m St., Dubuque;. IA 5001.
It will then be referred by the City Council to the appropriate department for investigation.
Once that investigation is completed, a report and recommendation wilt be submitted to the
City Council. You wlil be provided with a copy of that report and reGOmme.ndation.
THE FINAL DECISION ON A!_L CLAIMS.IS MADE i3Y THE CITY COUNCIL. NO EMPLpYEE
OF THE CITY QF I]UBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATIQN TO
YOU AS T!~ WHETHER YOUR CLAIM WILL OR WILL NOT BE rs.A1D. .
7. Name of Claimant: -~S L
2. Address: ~O ~ ~~ N ~ (~~C~~~e n ~ ~C~ ~% ~ 1 ~ ~ ~ Ub
3. Telephone Number: ~ ~ ~~ ~~ ~ " ~ ~ ~ ~ ~X-~ g~~' --
4. Date of incident; ~ ~ 2~ - d 1 -----
5. Time of Incident; ~
6. location of Incident (Be specific): ~ ~ ~ `~~' __ -
7. DESCRIBE ACCIDENT OR' OCCURRENCE THAT CAUSED 'INJURY OR DAMAGE. (Give
full. details :upon which you bash your claim. If .a City employee was .involved;. giye,the
em I, ee's a e) ..~ 1„ ~ n
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8. What were weather conditions like?. - .
9. Give name and address of any
70. Did police,,~nNestigate? (If so, give names of o#ficers,)
71. Was anyone injured? (If so, give names, addresses, and extent of injuries).
~l1
,~Sep,1$..2007 5.14PM CITY OF DBC LEGAL DEPT No, 1$62 P, 4
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, Have you been compensated for any part 'or ail of your ciaim by eny insurance
company? (.If so, give name and address of insurance company and amount paid.)
15. What amount do you ciaim from the City of Dubuque? ~~ ~ _° 2" ~`~ ° ~ . .
16. Why do you claim the City of Dubuque is responsible?
~ ~~n-~-~r~n~-1-~,v~ .~1~ u~,oa.(~ .v 1 ~ (~,hv~ C~Y~ a ~;[-- ~~ ~n ~. I~C~ ~,; . ~~,Vl/1 C~ Q~PI~
78.. tf the answer to Question i7 is yes, have you received .any payment from that source,
and ff so, in what amount?
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Dated at ~ this - ° ` da of O ~ 20
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(Rev. 1/UO & 7/Q1)
17. `Have you made any claim against anyone else for damages .as a result ofthis incident?
(if yes, give name and address.) ~ /,
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Jct. 22. 2007 12:34FM CITY OP DBQ LEGAL DEPT C~~~2 '~ ~ ~ ~-~C~No~2077 P. 2
CLAIM AGAINST ThiE CITY ~~ DUBUQUE, i0'WA
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. 73a' 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 provid®d 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: ~ ~~..^Q ~~ - GI~~I~ ~~~-I~ I~ S ~ A-
2. Address: N • Cla l K~ , ~-
3. Telephone Number: ~ - ~~ - ~~ ~ - ~ ~ ~ X-+ ~~~~-
4. Date of Incident: Ci "~~ ` ~~
5. Time of Incident: n- ~ ~
6. Location of Incident (Be specific): ~~~ W ~~'~
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.)
`~ ~~~ e ~~ ~,~n~k~ U r,~ i ~n ~ t~~ 1~,~vr~i r~ r~ r~ (~v~ ~ ~t b u.~ l ~d
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8. What were weather conditions like? v
9. Give name and address of any witnesses: ~'
hw~,~ /~+r~~t ~xcc~~a-hur~.
1 D. Did police invetsti ate? (I# sa, give names of officers.)
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11. Was anyone injured?A (If so, give names, addresses, and extent of injuries).
~I~
~:~ct.22, 2007 12:34PM CITY OF DBQ LEGAL DEPT
No. 2077 F. 3
12. Was any damage done to property? (lf 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?
GU
14. Have you been compensated for any part or ail of your claim by any insurance
company? (If sno, ' ive name and address of :insurance company and amount paid.)
Y~
15. What amount do you,c..l.~im from the City of Dubuque?
1.7. Have you made any claim a(c
(If yes; give Hems and address.)
result of this incident?
18. If the answer to Question 17 is yes, have ,you received any payment from that source,
and if so, in what amount? r'
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Dated at, this 22'~ day of ~c~~Dl~-~ 20 D~.
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(Signature)
(Print Name)
(Rev. 1/00 & 7/01.)
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Oct. 22. 2007 12:34PM CITY OF DBQ LEGAL DEPT "~'!'~ `'1`-', ',U~N~? 20-1~ P. ~~~`~`~
~ _/
CLAIM AGAINST TWE CITY O~ DUBUQUE, i0'WA /~~~
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 Ciaim must be filed with the City Clerk at City Hall, 50 W. 73«' 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 provid®d 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 Ta WHETHER YOUR CLAIM WIRL OR WILL NOT f3f~ PAID.
1. Name of Claimant:
~`, _.
2. Address: ~ ~ ~ • ~ ~~ ~-
3. Telephone Number: •` ~ ~~a
4, pate of Incident: ~ ~~~ -~~
5. Time of Incident:
~; //y~j , n I
6. Location of Incident (Be specific): ~"L~ U ~' ~~~
7. DESGRIBE 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.
' L ~~u~~ l C' Vl..~ I~ G~,~ G~. ~ S
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8. What were weather conditions like?
9. Give name and address of any witnesses: ~- i
70. Did police investigate? (If orr,, give names of officers.)
U~-
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
~~
Oct. 22. 2C07 12:34PM CITY OF DBQ LEGAL DEPT
No, 2077 P. 3
13. What other damages do you claim, if any?
14. Have you been carnpensated far any part ar 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? ~ ~~ ~ U~
.(If yes, give name and address.)
Dated at .this ~~L day of ~~ r/-~C~ 20 ~.
U~~ ISO ~ (-Iti1
' L (Signature)
~'~!, (Print Name)
(Rev. 1100 & 7101.)
dl 'an~n~na
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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.)
18. If the answer to Question 17 ys yes, have you received any payment from that source,
and if se, in what amount? ,n I ~~ ,
()ct. 22. 2007 12:34FM CITY OF DBQ LEGAL DEPT C'I V V~- ~d, ~P?7 P. 2
CLAIM AGAINST TWE CITY OE DUBUQUE, IOWA
This writ#en 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. 73"' St., Dubuque, IA 52001.
It will then be referred by the City Gouncil 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.
~r
1. Name of Claimant: ~ C ~ ~ ~~.~, ~~~
2. Address: : " ~ C r
3. Telephone Number: ~ -~~~~_~~ `- ~ ~ ~~ ~~~ ~ ~ JoZ
4. Date of Incident: ~' ~ I
5. Time of Incident: ~ ~'
6. Location of Incident (Be specific): ~I~ l!/ 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.)
8. What were weather cb~d~ifiWs~k~+? ~ ~ f 1 l T~ ~x ~/~ ~~~ ~~
9. Give name and address of any witnesses: ~~,1 I (J~-
10. Did police investigate? {If sa, giv names of officers.)
U~
11. Was anyone injured? (lf so, give names, addresses, and extent of injuries).
r~
Oct,22. 2007 12:34PM CITY OF DBQ LEGAL DEPT
No. 2077 P, 3
12. Was any damage done to property? (tf so, describe property and the extent of damages.
Attach estimates of damages or describe basis fora certaining extent of damage.) o
73. What other damages do you claim, if any?
14. Have you been compensated for any part or atl of your claim by any insurance
company? (If so, give name and address of :insurance company and amount paid.)
15. What amQUnt do you claim from the City of Dubuque? ~ n ~~ X11
17. Have youVnade any claim a~
(If yes, give Hems and address.)
for damages as a result of this incident?
bK- ~
Dated at this ~~ day of ~iC/~ 20 V ~.
Signa#ure)
Prin# Name)
(Rev. 1104 & 7/01.)
dl 'a~~,n~r~~
I~~IIN~"9Z 100 L0
18. if the answer to Question 17 is yes, have ,you received any payment from that source,
and if so, 'in what amount?
~, ~ 1
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Oct. 22. 2007 12:34PM CITY OF DBQ LEGAL DEPT ~I ~' ~I~-- ' f~ ~ , 1 ~
No. ~'~7 -~ P, 2
CLAIM AGAINST ThIE CITY t]E DUBUQUE, IQWA
This written report constitutes your claim against the City of Dubuque, lawa. 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 Gity Hail, 50 W. 13t~' 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 provid®d with a copy of that report and recommendation,
THE FINAL DECISION ON ALL CLAIMS tS MADE BY THE ,CITY COUNCIL. NO EMPLOYEE
OF THE CITY OF DUBUQUE HAS THE AUTHORITY TO MAKE ANY REPRESENTATION TO
YOU AS 70 WHETHER YOUR CLAIM WIRL OR WILL NOT BE PAID.
1. Name of Claimant:
2. Address: ~Qt~ ~~'G ~ ~~ Y L~ V IBC V
3. Telephone Number: ~" 3~ ~ - ~ ~~ a
4. Date of Incident: ~ `cam
5. Time of Incident: r l
6. Location of Incident (Be specific): ~~I ~ ~~ ~~ I V '
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.)
9. Give name and address of any witnesses:
11. Was anyone injured? (If so, give names, addresses, and extent of injuries).
10. Did police investigate? (if sa, give names of officers.)
C:~c}.2~. <<~0/ 12:34FM CITY OF DBQ LEGAL DEPT
No. 2077 P. 3
12. Was any damage done to property? (!f sa, describe properly 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. Have you been compensated far 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 amoun# do you claim from the City of Dubuq.ue~
~? v ~_
17. '~fi~ yialf made ariy Claim ac
{If yes, give name and address.)
for damages as a result of this incident?
' ~
Dated at this day of
(Rev. 1IQ0 & 7/01.)
nature)
nt Name)
t/! 'G~ nGnCJ
a~i~~C~ ~;;';~c ~,~ I~~-~
Z~~ l l ~iti 9 Z 130 ~.0
Cl~/~1~;..~~~
18. If the answer to Question 17 is yes, have ou received any payment from that source,
and if so, in what amount?