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Home My WebLink About96-18 RESOLUTION113 West Mountain Street Fayetteville, AR 72701 (479) 575-8323 Resolution: 96-18 File Number: 2018-0201 DREW CHRISTIE WATER DAMAGE CLAIM: A RESOLUTION PURSUANT TO §39.10(C)(4) OF THE FAYETTEVILLE CITY CODE TO AUTHORIZE THE MAYOR TO PAY THE AMOUNT OF $13,099.19 TO DREW CHRISTIE FOR A WATER DAMAGE CLAIM ARISING AT 1168 OAKS MANOR DRIVE IN ADDITION TO A PREVIOUS PAYMENT OF $2,581.45 TO SERVICEMASTER FOR WATER DAMAGE MITIGATION SERVICES WHEREAS, pursuant to the §39.10(C)(4) of the City Code, the City Council must approve the payment of water damage claims exceeding $8,000.00. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section 1: That the City Council of the City of Fayetteville, Arkansas, pursuant to § 39.10(C)(4) of the Fayetteville City Code, authorizes the Mayor to pay $13,099.19 to Drew Christie for a water damage claim arising at 1168 Oaks Manor Drive in addition to the previous payment of $2,581.45 to Servicemaster for water damage mitigation services. PASSED and APPROVED on 4/17/2018 Attest: Sondra E. Smith, City Clerk`"T}�rF14F�Q��tt�f OP Ci .Cf Cy r`,;yr 4 'F/1 t t s i rte k'�''��. Page 1 Printed on 4/18118 / - - City of Fayetteville, Arkansas 113 West Mountain Street Fayetteville, AR 72701 (479) 575-8323 Text File "f .r File Number: 2 1 - be 0 8-0201 Agenda Date: 4/17/2018 Version: 1 Status: Passed In Control: City Council Meeting File Type: Resolution Agenda Number: A. 3 DREW CHRISTIE WATER DAMAGE CLAIM: A RESOLUTION PURSUANT TO §39.10(C)(4) OF THE FAYETTEVILLE CITY CODE TO AUTHORIZE THE MAYOR TO PAY THE AMOUNT OF $13,099.19 TO DREW CHRISTIE FOR A WATER DAMAGE CLAIM ARISING AT 1168 OAKS MANOR DRIVE IN ADDITION TO A PREVIOUS PAYMENT OF $2,581.45 TO SERVICEMASTER FOR WATER DAMAGE MITIGATION SERVICES WHEREAS, pursuant to the §39.10(C)(4) of the City Code, the City Council must approve the payment of water damage claims exceeding $8,000.00. NOW, THEREFORE, BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF FAYETTEVILLE, ARKANSAS: Section I: That the City Council of the City of Fayetteville, Arkansas, pursuant to § 39.10(C)(4) of the Fayetteville City Code, authorizes the Mayor to pay $13,099.19 to Drew Christie for a water damage claim arising at 1168 Oaks Manor Drive in addition to the previous payment of $2,581.45 to Servicemaster for water damage mitigation services. City of Fayetteville, Arkansas Page 1 Printed on 411812018 Tim Nyander Submitted By NEWLY REVISED PACKET City of Fayetteville Staff Review Form 2018-0201 Legistar File ID 4/17/2018 City Council Meeting Date - Agenda Item Only N/A for Non -Agenda Item 4/10/2018 Water & Sewer Maintenance / _ Utilities Department Submitted Date Division / Department Action Recommendation: Staff recommends approving a damage claim reimbursement to Drew Christie in the amount of $13,099.19 for damage to his residence located at 1168 Oaks Manor Drive as a result of flooding after a city water main break. Original Contract Number: Approval Date: Comments: Budget Impact: 5400.720.4310.5311.04 Water/Sewer Account Number Fund N/A N/A Project Number Project Title Budgeted Item? Yes Current Budget $ 34,500.00 Funds Obligated $ 6,584.16 Current Balance [ $ 27,915.84 Does item have a cost? Yes Item Cost $ 13,099.19 Budget Adjustment Attached? No Budget Adjustment $ - Remaining Budget $ 14,816.65 V20140710 Previous Ordinance or Resolution # Original Contract Number: Approval Date: Comments: NEWLY REVISED PACKET CITY OF Fayr cAS MEETING OF APRIL 17, 2018 TO: Mayor and City Council THRU: Don Marr, Chief of Staff Water & Sewer Committee FROM: Tim Nyander, Utilities Director DATE: April 10, 2018 CITY COUNCIL AGENDA MEMO SUBJECT: Claim Settlement — Drew Christie, 1168 Oaks Manor Drive RECOMMENDATION: City staff recommends approving a claim settlement for water damage with Drew Christie in the amount of $13,099.19 for damage to his residence located at 1168 Oaks Manor Drive. BACKGROUND: On February 26, 2018, a water main break occurred near 1168 Oaks Manor Drive, which is owned by Drew Christie (claimant). The water flooded the basement of the claimant's residence, which includes a bedroom, bathroom, and hallway. DISCUSSION: Ordinance 5504 identifies the water and wastewater claims process. Drew Christie hired Steamers Carpet Cleaners in the amount of $576.19 to extract the water, apply a microbial agent, and clean an area rug immediately after the incident. ServiceMaster was contacted by the City of Fayetteville to perform mitigation services in the amount of $2,581.45. ServiceMaster's remediation included tearing out the damaged sheet rock and baseboards, as well as providing air movers to dry the residence. ServiceMaster has already been paid by the city. The claimant also incurred restoration expenses, which included the replacement of doors, trim, cabinets, sheet rock, electrical inspection, paint for trim and walls, flooring, stair treads, and labor for the repairs. JD Blagg, LLC will complete these repairs at a cost of $12,523.00. Staff recommends reimbursing Drew Christie in the total amount of $13,099.19 to cover the damage expenses he incurred. BUDGET/STAFF IMPACT: Funds are available in the water maintenance self-insurance account. Attachments: Cost Detail Claim Form and Documentation Photos of Damage Mailing Address: 113 W. Mountain Street www.tayetteville-ar.gov Fayetteville, AR 72701 NEW /DetakKET Water Damage Claim at 1168 Oaks Manor Drive Description Cost Doors (3/0, 2/6 interior, 2/6 exterior) $ 680.00 Trim Materials 220LF $ 400.00 Trim Labor $ 950.00 5' cabinet / countertop $ 750.00 Sheet rock(remove bottom 2' and replace) $ 800.00 Paint trim and Walls $ 1,581.00 Insulation, remove and replace $ 800.00 New Floor 527 SF $ 3,162.00 New stair treads (13 @ 50) $ 800.00 Clean up $ 600.00 JD Blagg LLC (Labor) $ 2,000.00 Steamers Carpet Cleaners $ 576.19 Total $ 13,099.19 Approval Claim Request http://cof-lfforms/Forms/form/aysu bmission?instanceld=22142&routing... NEWLY REVISED PACKET Although the City of Fayetteville is immune from any claim for liability or damages caused by alleged negligence of its employees, the City Council has authorized a very limited property damage claims procedure. INSTRUCTIONS: Please complete this form clearly stating the reason for the claim, amount you are requesting, all contact information, and attach appropriate documentation including receipts, estimates, photos, etc. Three (3) itemized written estimates must be provided prior to repairs being made. Substantive documentation MUST be provided to establish all monetary values. Additional sheets may be added. Failure to provide all information and fully substantiate your claim will result in the claim being denied. Please do not discard any items that are being claimed as damaged. Filing a claim does not imply approval; claims will be investigated before a decision is rendered; claims received more than 30 days after the incident will be denied. Claims containing inaccurate or fraudulent information will be denied. Please mail to or hand -deliver documents to: Mayor's Office — Claims, City of Fayetteville, 113 W. Mountain St., Fayetteville, AR 72701 OR Fax to 479-575-8257 CLAIMANT INFORMATION First Name Last Name Middle Initial Drew Christie M Claim Type What type of claim are you requesting? General Water and Sewer Email grubsbar@gmail.com Address Street Address 4095 N Crossover Address Line 2 City State / Province / Region Fayetteville Arkansas Postal / Zip Code Country 72703 United States 1 of 5 3/27/2018,10:49 AM Approval h ttp://cof-1 fforms/Forms/form/aysu bmission?instance1d=22142&rou tin g... NEWLY REVISED PACKET Daytime Phone Alternate Phone 479-841-9497 501-912-8789 Incident Location Address/Location of Occurence Street Address 1168 Oaks Manor Drive Address Line 2 City Fayetteville Postal / Zip Code 72703 INCIDENT INFORMATION Date of Incident Time of Incident 2/26/2018 11:00 AM Incident Nature Nature of Occurrence Automotive Related other City water pipe burst State / Province / Region Arkansas Country United States of America Amount being Claimed Home Related Personal Insurance Do you have any insurance which covers your damage? Yes No The City cannot pay a claim in an amount exceeding a Claimant's insurance deductible, if covered. The undersigned hereby files a claim against the City of Fayetteville, Arkansas for the following reason(s): Attach additional sheets if necessary 2 of 5 3/27/2018,10:49 AM Approval http://cof-Ifforms/Forms/form/aysubmission?instanceld=22142&routin g... NEWLY REVISED PACKET Incident Description The undersigned hereby files a claim against the City of Fayetteville, Arkansas for the following reason(s): A city water pipe busted on Oaks Manor that morning and flooded the house. There was 8 inches of water in my house. File Upload Upload Attach appropriate documentation including receipts, itemized estimates, photos, etc. If vehicle related, please include proof of insurance if applicable. 3 of 5 3/27/2018, 10:49 AM Approval http://cof-Ifforms/Forms/form/aysu bmission? instanceld=22142&routing... NEWLY REVISED PACKET Agreement I Agree. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. Signature Refer To Department Additional Documentation Memo Letter to Claimant* By signing below, I acknowledge that the above -provided information is true and correct to the best of my knowledge and belief. Water and Sewer Upload Upload 4 of 5 3/27/2018, 10:49 AM Approval Comments http://cof-lfforms/Farms/Form/aysubmiss ion?i nstanceId=22142&routing... NEWLY REVISED PACKET Submit Memo 5 of 5 3/27/2018,10:49 AM NEWLY REVISED PACKET r--� � 5147 E. Maywood Rd. Invoice S,. _ Fayetteville, AR 72703 "Quality Isn't Expensive-It's Priceless" (479)751-1056 5147 Maywood steamerscarpetcleaners@gmail.com Faye11eH0e, AR 727700 3 BILL TO Matt Christie 5212 Sloan Rogers, Ar INVOICE # DATE TOTAL DUE DUE_ DATE TERMS ENCLOSED 11439 03/02/2018 $576.19 04/01/2018 Net 30 DATE ACTIVITY AMOUNT 02/26/2018 Flood Services 425.00T 11689 Oaks Manor, emergency call out, water extraction (3 inches of standing water upon arrival), furniture blocking and removal. Includes water extraction, microban anti bacterial and mold, cleaning and fan rental. Prices are not set and will vary on a case by case basis., 1 @ $425.00 03/02/2018 Area Rug(s) 100.00T ITEM: Oriental/Wool Rug (submerged in water) On Location or Pick Up/Delivery Options Your treatment consists of an inspection, pick up, dye test, vacuum, pre- treatment, forced air cleaning, steam extraction or complete submersion cleaning, a second dry vacuum, a rapid air dry humidity controlled application to ensure quicker drying times and delivery. Basic spot treatment, deodorizer is included FREE of charge. Pet treatments and trip fees are additional. Area rugs differ on a case by case basis and cleaning process times will vary., 1 @ $100.00 Thank you for choosing Steamers Carpet Cleaners! We sincerely appreciate SUBTOTAL 525.00 your business and look forward to serving you again soon! TAX (9.75%) 51.19 www.SteamersCarpetCleanersAR.com TOTAL 576.19 BALANCE DUE $576.19 "Like" us on Facebook to WIN PRIZES & GET DEALS I "Rate/Review" us online for DISCOUNTS I "Rate/Review" us online for DISCOUNTS NEWLY REVISED PACKET JD BLAGG LLC n\/ i V O f C e Attention:Grub Christie JD BLAGG LLC 1635 W Shadowridge Dr Fayetteville, AR 72701 479-530-7267 Date 4/10/18 PROJECT TITLE: Flood damage repair INVOICE NUMBER: 137 TERMS: 30 Days ■• , n Cost 3/0 LH exterior door $ 300.00 2/6 RH interior door $ 80.00 2/6 RH exterior door $ 300.00 220 LF trim materials $ 400.00 trim labor $ 950.00 cabinet in bathroom 5' with countertop $ 750.00 remove the bottom 2' and replace sheetrock $ 800.00 paint trim and walls $ 1,581.00 insulation (remove and replace) $ 800.00 new floor 527 SF $ 3,162.00 new carpet on stairs $ 800.00 clean up $ 600.00 JD BLAGG LLC FEE $ 2,000.00 Subtotal is 12,523.00 Is 0.00 Thank you so much for your business! NEWLY REVISED PACKET ServiceMaster by Quality Restoration (120S .Ums nt Rd Springdal;•, ,SIR 72762) (4 79) 756--l! (3g Insured: City of Fayetteville ?ropeny: ' 168 Oaks Manor Fayetteville. AR 72703 Claim Rep.: Weston Bryant Estiw.ntor: Weston Brvant Claim Number: Policy Number: Ifate:.Comactcd: 212W201S 3:3UP M I7zt;r o` Loss; ?/-10,'-, 0 1 S D.110 In.."pected: 212 0 201 � 4:30 p \ I Price List: ARFA8X FEB 18 Restoration%Service!Rcmolcl Estimate: Cl'I'Y OF PAY 1168 OAK Business (479) 530-6081 E-mail westori.bryantCseryiceuutstcrdr. COW Business: (479) 530-6081 E-iniil. wuston. bryani a servicemastercr coni Type O' Loss: Water Damage Date Receival::7:'2015 3:3V P.N1 Date Entered: 9 -13 AM Thauk you For allowing ScrvicuJvlaster by Quality Restoration to meet your mitigation needs I'Sl' i'';:cie:2, NEWLY REVISED PACKET ServiceAlaster by Quality Restoration 4208 Johnson Rd. Springdale, AR 72762 (479)756-4169 CITY -OF -FAY -1 168 OAK Nfinin Level N iscellaneous DESCRIPTION QTY REMOVE REPLACE TAX TOTAL 20. Emergency service call - during i,00 EA 0.00 112,21 10,94 123.15 business hours 21. Equipment setup, take down, and 4.50 HR 0.00 40,17 17.76 199.88 monitoring (hourly charge) 22. Haul debris - per pickup truck load 1,00 EA 102.89 0.00 10.03 112.92 - including dump fees Totals: >\ kellaneous 38.73 435.95 Basement PlY4issing Wall Dom- Dow- oorDoor DESCRIPTION- DESCRIPTIOiN- Heibllt: 8' 73S.86 738.86 SF Walls 441 .69 SF Ceiling 1,180.55 SF Walls & Ceiling 441.69 SF Floor 49.08 SY Flooring 91.52 LF Floor Pei imcter 96.52 LF Ceil. Permitter 3' 3 11/16" X 8' Omens into STAIRS 2' X 6' 8" Opens into BATHROOM 3' X 6' 8" Opens into Exterior QTY REMOVE REPLACE TAX TOTAL 11. Apply anti -microbial acent to the 441,69 SF 0.00 0.19 8.18 92.10 tloo: 12- Tear cut nen-sahVageable vinyl, cut 441.69 SF 0.97 0.00 41.77 470.21 &C bag for disposal 13. Content Manipulation charge - per 2.00 HR 0,00 28.04 5.47 61.55 hour 15. Tear out baseboard 91.52 LF 0,34 0.00 3.03 34.15 16. Drill holes for wall cavity drying 23.00 EA 0.00 0.38 0.85 9.59 17. Tear out wet drvwnlL cleanup, bag, 1.00 LF 2.52 0.00 0.25 2.77 per LF - up to T tall 18. Air mover (per 24 hour period) - 2!,00 EA 000 26,01 53.26 599.47 No monitoring 7 air mover, 3 days 19. Dehumidifier (per 24 hour period) - 3.00 EA 0.00 77.46 22.66 255,04 Large - No monitoring I dehu, 3 days CITY -OF -FA)'- 1 168 -OAK 3/7/2018 Page: 2 NEWLY REVISED PACKET Se wiceM.Istcr by Quality Restoration 4208 Johnson Rd. Springdale, AR 72762 (479) 756-4169 DESCRIPTION Totals: Basement Bathroom CONTINUED - Basement QTY RE, \10VE REPLACE TAX TOTAL 13547 1,524.88 11ci g h t: 8' B.ithroom 31,38 353 28 (`1'a\\'15pn1'e 302,14 SF 1V ills TAX 62.91 SF Ceiling 9, Apply anti -microbial agent to the 50 00 SF --- 0.00 0.19 0.93 _ 10.43 Su rraec ;1rCa 65 05 SF'Vrills & Ceiling 6191 SF Floor 22.82 256.91 s I 6.99 SY Flooring 15.54 LF Floor Perimeter Totals: Crawlspace 23 75 41.52 LF Ceil. Perimeter Total Main Level 229.33 2,581.45 Door 2' 6" X 6' 8" Opens into Exterior Door 2'X 6' 8" Opens into BASEMENT DESCRIPTION Q"I'1' REMOVE REPLACE TAX TOTAL L Apply anti -microbial agent to the 62.91 SF 0 00 0. t9 1.17 13.12 floor 3. Tear out non -salvageable vinyl, cul 4291 SF U 97 0.00 4,06 45 68 & ba; fol disposal 4. Tear out baseboard 18.54 LF 0.34 0,00 0.61 6,91 5. Tear out toc kick ;Ind bag for 500 LF 220 0100 L07 12.07 disposal 6. "pear out net drywall, cleanup, bac. 5 50 LF 2 52 0.00 1.35 15.21 per LF- tip to2'tall 7. Tcar out and baa wet insulation 5.50 SF 0.56 0,On 6.30 3.38 8. Air mover (per 24 hour period) - No 9.00 EA 0 00 26.01 22.52 256.91 monitoring 3 air movers, 3 days B.ithroom 31,38 353 28 (`1'a\\'15pn1'e DESCRIPTION QTS' RENIOVE REPLACE TAX TOTAL 9, Apply anti -microbial agent to the 50 00 SF --- 0.00 0.19 0.93 _ 10.43 Su rraec ;1rCa 10. Air mover (per 24 hour period) - 9.00 EA 0.00 26,01 22.82 256.91 No monitoring 3 all" Il',ovcrs, 3 day -s Totals: Crawlspace 23 75 267..",'4 Total Main Level 229.33 2,581.45 CITY OF_F,\)'_1168 OAK 3%7/2018 Page:3 NEWLY REVISED PACKET 0:;:' ServiceNlaster by Quality Restoration 4208 Johnson Rd Spi ingdale, AR 72762 (479) 756-4169 I,ine Item Totals: CITY OF FAY 1169 OAIC Grand Total Areas: 1,170.14 SF Walls 525.83 SF Floor 0.00 SF Long Wall 5'_'5.83 Floor Area 1,034.33 Exterior Wall Arca 0.00 Snrfince Area 0 00 Total Ridge length 525.83 SF Ceiling 58.43 SY Flooring 0.00 SF Short Nall 571.64 "Total Area 119.00 Exterior Perimeter o: Walls 0.00 Number of Squares 0.00 Total Hip Length 229.33 1,695.98 SF Walls and Ceiling 126.21 LE Floor Perimeter 154.18 LF Ccil, Perimeter 1,'_'50.28 Interior Wall Arca 0.00 'local Perimeter Length 2,551.45 CITY -0 1FAY 1168 OAK 3/7/2018 Page:4 NEWLY REVISED PACKET ServiceA7aster by Quality Restoration 3208 Johnson Rd. Springdale, AR 72762 (4',9) 7;64169 Summary for Dwelling Line Item Total 2,352.12 Total Sales Ta-, 229.33 Ruplacernent Cost Value Net Claim %Vcston Brvant (Ej52,581.: " 5,2,581.45 CITY _OF FAY I I G5_OAK 3/7/201 S Pace: 5 NEWLY REVISED PACKET NEWLY REVISED PACKET NEWLY REVISED PACKET x NEWLY REVISED PACKET j yi �. S i6w.sv :dgiWdy- z r I 't.14 S4 S r^' i W r y ♦ 6, pi s Mn i• � ` S d rk 't.14 S4 S M,, This packet has been replaced with an updated new agenda packet Please see newly revised packet. Tim Nyander Submitted By City of Fayetteville Staff Review Form 2018-0201 Legistar File ID 4/17/2018 City Council Meeting Date - Agenda Item Only N/A for Non -Agenda Item 3/30/2018 Water & Sewer Maintenance / _ Utilities Department Submitted Date Division / Department Action Recommendation: Staff recommends approving a damage claim reimbursement to Drew Christie in the amount of $14,518.19 for damage to his residence located at 1168 Oaks Manor Drive as a result of flooding after a city water main break. Budget Impact: 5400.720.4310.5311.04 Water/Sewer Account Number Fund N/A N/A Project Number Project Title Budgeted Item? Yes Current Budget $ 34,500.00 Funds Obligated $ 6,584.16 Current Balance $ 27,915.84 Does item have a cost? Yes Item Cost $ 14,518.19 Budget Adjustment Attached? No Budget Adjustment $ - Remaining Budget $ 13,397.65 V20140710 Previous Ordinance or Resolution # Original Contract Number: Approval Date: Comments: This packet has been replaced with an updated new agenda packet Please see newly revised packet MEETING OF APRIL 17, 2018 TO: Mayor and City Council THRU: Don Marr, Chief of Staff Water & Sewer Committee FROM: Tim Nyander, Utilities Director DATE: March 30, 2018 SUBJECT: Claim Settlement — Drew Christie, 1168 Oaks Manor Drive RECOMMENDATION: City staff recommends approving a claim settlement for water damage with Drew Christie in the amount of $14,518.19 for damage to his residence located at 1168 Oaks Manor Drive. BACKGROUND: On February 26, 2018, a water main break occurred near 1168 Oaks Manor Drive, which is owned by Drew Christie (claimant). The water flooded the basement of the claimant's residence, which includes a bedroom, bathroom, and hallway. DISCUSSION: Ordinance 5504 identifies the water and wastewater claims process. Drew Christie hired Steamers Carpet Cleaners in the amount of $576.19 to extract the water, apply a microbial agent, and clean an area rug immediately after the incident. ServiceMaster was contacted by the City of Fayetteville to perform mitigation services in the amount of $2,581.45. ServiceMaster's remediation included tearing out the damaged sheet rock and baseboards, as well as providing air movers to dry the residence. ServiceMaster has already been paid by the city. The claimant also incurred restoration expenses, which included the replacement of doors, trim, cabinets, sheet rock, electrical inspection, paint for trim and walls, flooring, stair treads, and labor for the repairs. JD Blagg, LLC will complete these repairs at a cost of $13,942.00. Staff recommends reimbursing Drew Christie in the total amount of $14,518.19 to cover the damage expenses he incurred. BUDGET/STAFF IMPACT: Funds are available in the water maintenance self-insurance account. Attachments: Cost Detail Claim Form and Documentation Photos of Damage This packet has been replaced with an updQ&A- DatMI packet. Please see newly revised packet Water Damage Claim at 1168 Oaks Manor Drive Description Cost Doors (3/0, 2/0, 2/6) $ 680.00 Trim Materials 220LF $ 450.00 Trim Labor $ 1,400.00 5' cabinet/ countertop $ 1,300.00 Sheet rock(remove bottom 2' and replace) $ 750.00 Replace insulation bottom 2' $ 600.00 Electrician to check plugs $ 300.00 Paint trim and Walls $ 2,100.00 New Floor 527 SF $ 3,162.00 New stair treads (13 @ 50) $ 650.00 Clean up $ 550.00 JD Blagg LLC (Labor) $ 2,000.00 Steamers Carpet Cleaners $ 576.19 Total $ 14,518.19 Approval h ttp://cof-1 ffonns/Forms/form/aysubmi ssion? ins Lan celd=22142&routing... This packet has been replaced with an updated new agenda packet Please see newly revised packet Claim Request Although the City of Fayetteville is immune from any claim for liability or damages caused by alleged negligence of its employees, the City Council has authorized a very limited property damage claims procedure. INSTRUCTIONS: Please complete this form clearly stating the reason for the claim, amount you are requesting, all contact information, and attach appropriate documentation including receipts, estimates, photos, etc. Three (3) itemized written estimates must be provided prior to repairs being made. Substantive documentation MUST be provided to establish all monetary values. Additional sheets may be added. Failure to provide all information and fully substantiate your claim will result in the claim being denied. Please do not discard any items that are being claimed as damaged. Filing a claim does not imply approval; claims will be investigated before a decision is rendered; claims received more than 30 days after the incident will be denied. Claims containing inaccurate or fraudulent information will be denied. Please mail to or hand -deliver documents to: Mayor's Office — Claims, City of Fayetteville, 113 W. Mountain St., Fayetteville, AR 72701 OR Fax to 479-575-8257 CLAIMANT INFORMATION First Name Last Name Middle Initial Drew Christie M Claim Type What type of claim are you requesting? General Water and Sewer Email grubsbar@gmail.com Address Street Address 4095 N Crossover Address Line 2 City State / Province / Region Fayetteville Arkansas Postal / Zip Code Country 72703 United States 1 of 5 3/27/2018, 10:49 AM Approval http:Hcof-lfforms/Forms/form/aysubin ission? ins tanceld=22142&routing... This packet has been replaced with an updated new agenda packet Please see newly revised packet Daytime Phone Alternate Phone 479-841-9497 501-912-8789 Incident Location Address/Location of Occurence Street Address 1168 Oaks Manor Drive Address Line 2 City Fayetteville Postal / Zip Code 72703 INCIDENT INFORMATION Date of Incident Time of Incident 2/26/2018 11:00 AM State / Province / Region Arkansas Country United States of America Amount being Claimed Incident Nature Nature of Occurrence Automotive Related Home Related Personal other City water pipe burst Insurance Do you have any insurance which covers your damage? Yes No The City cannot pay a claim in an amount exceeding a Claimant's insurance deductible, if covered. The undersigned hereby files a claim against the City of Fayetteville, Arkansas for the following reason(s): Attach additional sheets if necessary 2 of 5 3/27/2018, 10:49 AM Approval http://cof-]fforms/Forms/form/aysubmission?instance1d=22142&routing... This packet has been replaced with an updated new agenda packet. Please see newly revised packet. Incident Description The undersigned hereby files a claim against the City of Fayetteville, Arkansas for the following reason(s): A city water pipe busted on Oaks Manor that morning and flooded the house. There was 8 inches of water in my house. File Upload Upload Attach appropriate documentation including receipts, itemized estimates, photos, etc. If vehicle related, please include proof of insurance if applicable. 3 of 5 3/27/2018,10:49 AM Approval 1 hap://cof-]fforms/Forms/form/aysubmission?instanceld=22142&routing... This packet has been replaced with an updated new agenda packet. Please see newly revised packet, Agreement I Agree. By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date. Signature Refer To Department Additional Documentation Memo Letter to Claimant* By signing below, I acknowledge that the above -provided information is true and correct to the best of my knowledge and belief. Shea Fankhouser Water and Sewer Upload Upload 4 of 5 3/27/2018, 10:49 AM Approval Comments http://cof-Ifforms/Forms/form/aysubin ission?instanceId=22142&routing... This packet has been replaced with an updated new agenda packet. Please see newly revised packet. SubmitMemo 5 of 5 3/27/2018, 10:49 AM This packet has been replaced with an updated new agenda packet Please see newly revised packet. r r---' 5147 E. Maywood Rd. Invoice 6— Fayetteville, AR 72703 'Quality Isn't Expensive -It's priceless" (479)751-1056 5147E Maywood Rd. steamerscarpetcleaners@gmail.com Fayetteville, AR 72703 BILL TO Matt Christie 5212 Sloan Rogers, Ar INVOICE # DATE TOTAL DUE DUE DATE TERMS ENCLOSED 11439 03/02/2018 $576.19 04/01/2018 Net 30 DATE ACTIVITY AMOUNT 02/26/2018 Flood Services 425.00T 11689 Oaks Manor, emergency call out, water extraction (3 inches of standing water upon arrival), furniture blocking and removal. Includes water extraction, microban anti bacterial and mold, cleaning and fan rental. Prices are not set and will vary on a case by case basis., 1 @ $425.00 03/02/2018 Area Rug(s) 100.00T ITEM: OrientalMool Rug (submerged in water) On Location or Pick Up/Delivery Options Your treatment consists of an inspection, pick up, dye test, vacuum, pre- treatment, forced air cleaning, steam extraction or complete submersion cleaning, a second dry vacuum, a rapid air dry humidity controlled application to ensure quicker drying times and delivery. Basic spot treatment, deodorizer is included FREE of charge. Pet treatments and trip fees are additional. Area rugs differ on a case by case basis and cleaning process times will vary., 1 @ $100.00 Thank you for choosing Steamers Carpet Cleaners! We sincerely appreciate SUBTOTAL 525.00 your business and look forward to serving you again soon) TAX (9.75%) 51.19 www.SteamersCarpetCleanersAR.com TOTAL 576.19 BALANCE DUE $576.19 "Like" us on Facebook to WIN PRIZES & GET DEALS I "Rate/Review" us online for DISCOUNTS I "Rate/Review" us online for DISCOUNTS This packet has been replaced with an updated new agenda packet, Please see newly revised packet. Scr�`iee1�'I, - b� Quality Restoration 4208 Johnson Rd. Springdale, AR 72762 (479) 7a6=1 ! 69 Insured: City of Fayetteville Properl: 1 168 Oaks Maror Fayetteville, AR 72703 Claim Rep.: Weston Bryant E.stin-.ator. wcslon Bruit, Claim Number: Date Contacted: 2/26/2018 3:30 PM _hate of Loss: 2/26/2018 Date Inspected: 2;26201 h 4:30 P\> Business: (479) 530-6081 E-mail: wcston.bryant@servicemasterth. C0111 Business: (479) 530-6081 E -snail: wcsmn. L-ryant!n',servicet:jast:,rcr.cu=n Police Number: Type of Loss: Water Damage Price List: ARFA8X FEB 18 Restoration,%senvicE/Remodcl Estimate: CITY OP PAY 1168 OAK Date Received: 7:126/2018 3:30 PM Date Er.tercd: 3;7!20; S 9:23 A,M Thank you for allowing SciviccNikistcr by Quality Restoration to :ncetyour mitigation needs. Tax ID. 20-1283784 PSP Code: 2 5592 0 DESCRIPTION This packet has been replaced with an updated new agenda packet. Please see newly revised packet ServiceMaster by Quality Restoration 1208 Johnson Rd. Sptingdale, AR 72762 (479)756-4169 CITY -OF -FAY -1168 -OAK Main Level .Miscellaneous QTY REMOVE REPLACE TAX TOTAL 20. Emergencv service call - durinQ 1.00 EA 0.00 1 l2 21 10.94 123.15 business hours 21. Equipment setup, tike down, and 450 HR 0,00 40.47 17.76 199.88 monitnring (hourly charge) 22. 1I„ul debris - ;icr pickup truck load 1 00 EA 102.89 0.00 10.03 112.92 - including dump fees Totals: I\liscellaneous 38.73 435.95 Basement hfeight: 8' .t•; 1 738.86 SF Walls 441.69 SF Ceiling t^ i��a c - na:,•� roR 1 ... 1,180.55 SF Walls & Ceiling 441.69 SF Floor 1 ,;•,-- ....,,, ;' 49.08 SY Flooring 91 52 LF Floor Perimeter 96 52 LF Ceil. Perimcter Missing Wall 3' 3 11/16" X 8' Opens into STAIRS Door 2' X 6' 8" Opens into BATHROOM Door 3' X 6' 8" Opens into Exterior DESCRIPTION QTY RE MOVE REPLACE TAX TOTAL 11. Apply anti -microbial agent to the 441 69 SF 0.00 0.19 8.18 92.10 floor 12. Tear out nen-sahagcable vinyl, cut 441.69 SF 0,97 0.00 41.77 470.21 & bag for disposal 13. Content Manipulation chaise - pei 2.00 11R 0.00 28.04 5.47 61.55 hour 15. Tear out baseboard 91.52 LF 0,34 0.00 3.03 34.15 16. Drill holes for will cavity drying 23.00 EA 0.00 0.38 0.85 9.59 17. Tear oul wet drywall; Cleanup, big, 1.00 LF 2.52 0.00 0.25 2.77 per LP - up to T tall 18. Air mover (per 24 hour period) - 21.00 EA 0.00 26.01 53.26 599,47 No monitoring 7 ait movers, 3 days 19. Dehumidifier (per 24 hour period) - 3.00 EA 0.00 77.46 22.66 255.04 Large - No monitoring 1 dehu, 3 days CITY -OF -FAY I168_OAK 3/7/2018 Page:2 This packet has been replaced with an updated new agenda packet. Please see newly revised packet. ServiceAlaster by Ouality Resta ortion 1208 Johnson Rd, Springdale, AR 72762 (47 9) 756-4169 DESCRIPTION Totals: Basement Bathroom CONTINUED - Basement QTY REMOVE REPLACE 302.t4 SF \rolls 365.05 SF Walls & Ceiling 6.99 SY Flooring 41.52 LF Ceil. Perimeter TAX TOTAL 135.47 1,524.38 Height: 8' 62.91 SF Ceiling 62 91 SF Floor 18.54 LF Floor Perimeter Door 2' 6" X 6' 8" Opens into Exterior Door 2' X 6' 8" Opens into BASEiNIENT DESCRIPTION Q -n, REMOVE REPLACE TAX TOTAL I. Apply anti -microbial agent to the 6291 SF 0.00 0.19 1.17 13.12 floor 10. Air mover (per 24 hour period) - 9.00 BA 0,00 26.01 22.82 256.91 3, Tear out non -sal ageAlc vinyl, Gut 42.91 S1• 0.97 0.00 4.06 45,68 & bag for disposal 2175 267.34 Total: Main Level 229.33 2,581.45 4. Tear out basebmrd 1854 LF 0.34 0.00 0.61 6.91 5. Tear out toe kick :Ind bag For 5.00 LF 2.20 0.00 1.07 12.07 disposal 6. 'hear out %vet dry„ au, cicenup, boe, 5.50 LF 2.52 0.00 1.35 15.21 Per LF - up to 2' tall 7. Tcar out alid ba wet insulation 5.50 SF o.56 0.00 0.30 3.38 8. Air mover (per 24 hour period) - No .9,00 EA 0.00 26-01 22.52 256.91 monitoring, 3 air movers, 3 cays Tot.:is- Bathroom 31.38 35325 Crn lspace DESCRIPTION QTY REMOVE REPLACE TAX TOTAL 9. Apply anti -microbial agent to the 50.00 SF 0.00 0.19 0.93 10.43 sit Face arca 10. Air mover (per 24 hour period) - 9.00 BA 0,00 26.01 22.82 256.91 No monitoring 3 air movers, 3 days Totals: Crawlspace 2175 267.34 Total: Main Level 229.33 2,581.45 CITY -CF -FAY -1 168 OAK 3!712013 Page: 3 This packet has been replaced with an updated new agenda packet- Please see newly revised packet, Service_Nlaster by Quality Restoration 4204 Johnson Rd Springdale, AR 72762 (479)756-4169 Linc Item Totals: CITY—OF—FAY-1168—OAK Grand Total Areas: 1,170.14 SF Walls 525.83 SF Floor 0.00 SF Long Wall 525.83 Floor .area 1,034.33 Exterior Wall Area 0,00 Surface Area 0.00 Total Ridgc Length 525.83 SF Ceiling 58.43 SY Flooring 0.00 SF Short Nall 57 1,64 To^al Aiea 119.00 Hxterior Peri:-eter o.' `,'falls 0-00 Number of Squares 0.00 "Total Hip Length 229.33 1,695 98 5F Walls and Ceiling 126.21 LF Floor Perimeter 154.18 LF ('61. Perimeter 1,250 28 ]tllerior Wall Arca 0-00 Tolal Perimeter Length 2,55 LAS C1T1'_OP_FAY_l168 OAK 3/7/2018 Pagc:4 This packet has been replaced with an updated new agenda packet Please see newly revised packet. ServiceMaster by Quality Restoration 4208 Johnson Rd. Springdale, AR 72762 (479) 756-4169 Line Item Total Total Sales Tax Replacement Cost Value Not Claim Summary for Dwelling Weston Bryant 2,352.12 221 9.3 3 X2,581. $2,581.45 CITY OF FAY 1168 OAK 3/7/2018 Pane: 5 This packet has been replaced with an updated new agenda packet. Please see newly revised packet. This packet has been replaced with an updated new agenda packet. Please see newly revised packet. This packet has been replaced with an updated new agenda packet. Please see newly revised packet. This packet has been replaced with an updated new agenda packet. Please see newly revised packet. M This packet has been replaced with an updated new agenda packet. Please see newly revised packet. 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