3. Goodwill Sewer and Water PolicyCity of Kalispell Public Works Department
Post Office Box 1997, Kalispell, Montana 59903-1997 -Telephone (406)758-7720, Fax (406)758-7831
REPORT TO: Mayor and City Council
FROM: James C. Hansz, P.E., Director of Public
SUBJECT: Review and Consider Possible Water/
MEETING DATE: Work Session December 11, 2006
Every so often there is a blockage in one of the City sewer mains. In most cases the
blockage is quickly cleared by City maintenance crews and there is no lingering problem..
However, there are times when maintenance crews are unable to clear the block in time to
prevent sewage from backing up in the main and into a house or business. On less frequent
occasions a City water line problem might cause similar flooding into a basement or crawl space.
Water and sewer back-ups do not happen often, but when they do it can be a serious
problem for the customer. The City's sewer and water systems are very well maintained. As a
result, claims by customers for damage reimbursement or cleaning costs are routinely denied by
the City's insurance carrier, MMIA. No policy mechanism currently exists for the City to deal
with these situations in any other way.
Several months ago, the City Council asked PWD staff to research options for dealing
with losses to City utility customers due to problems with the City's main lines. Terri
Loudermilk prepared the attached report which outlines the ways other Montana cities have
addressed this issue in their communities.
December 11, 2006 Water -Sewer Goodwill Poticy.doc
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City of Kalispell Public Works Department
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°��..... .. . � � � � `�''" °� post Ot�ice Box 1997, Kalispell, Montana 59903-1997 -Telephone (406)758-7720, Fax (406)758-7831
I�pl��fl'��I�19�i
V' III �
MEMORANDUM
Date: November 27, 2006
To: Jirn Hansz, public Works Director
From: Terri Loudermilk, Budget Resource Manager `
Re: Water/Sewer Goodwill Policy
In response to the City Council's question as to whether or not other Montana communities offer
compensation to residents or businesses that have experienced property damage caused from a
City water or sewer main incident, I researched and assembled the following information.
Current City folic
Whenever a home owner or business experiences property damage due to a sewer main backup
or grater main brew, the affected party submits a claim to the City's insurance carrier (MMIA).
MMIA conducts an investigation of the incident. If the incident was caused by an Act of God,
such as extreme weather, or by a third party, such as a contractor damaging the City's main, the
City is generally found not liable and the claim is denied. Also, because the City has a well
documented utility maintenance program in place the claim will most likely be denied. In all
recent cases this has been MMIA's decision. There are approximately 2 to 5 cases each year and
most are related to sewer back-ups.
Homeowner's Insurance
Water and sewer backups are excluded on standard homeowner's policies. An endorsement
must be separately purchased that covers water and severer backups. Most policies and
endorsements are subjected to a $1,000 deductible. Most homeowners are not aware that they
are not covered for these types of incidents. In order to be covered they must purchase an
additional endorsement. A local insurance company stated that adding a 'water and Sewer
backup endorsement with a $1,000 deductible adds approximately $60.00 to a standard policy. It
is an endorsement they automatically apply to any policy they write. The company I spore with
did not know if other insurance companies followed the same procedure.
Other Montana Cities
The City of Whitefish recently adopted a Goodwill policy that recommends a maximum of
$51,000 per claim and anticipates 2 to 4 claims per year. The City Manager may authorize
payments over $5,000. Annual funding comes from the water &. Wastewater Fund. All claims
are initially sent to MMIA for payment or denial of payment. A committee consisting of the
Public Works Director, Public Works Utility Supervisor, and Finance Director review claims
Water sewer Goodwill Policy Memo (2).doc
following the City's established policy guidelines. Whitefish's policy guidelines state that
compensation may be denied or limited, particularly in cases involving third party liability or
"`Acts of God". The claimant must sign a waiver releasing the City from any further claim or
action. If the damage is only for cleaning costs the maximum reimbursement is $11000.
The City of Billings has had a Goodwill Policy in place for many years. The policy covers only
sewer backups. Claims are reviewed by the Distribution & Collection Superintendent and are
limited to a maximum of $11,000. The annual budget is $12,5 00 in the sanitary sewer fund.
The City of Great Falls Goodwill Policy is similar to Whitefish and Billings. The difference is
Cheat Falls' policy guidelines specifically state that claims will not be paid in cases of "Acts of
God" or clear liability on a third party. Also, Great Falls does not have a $1,000 limit on
cleanup. The funds come directly out of the water and sanitary sewer funds. The annual budget
for water is $12,000 and $15,000 in sewer. Very seldom is a water claim received. They receive
approximately 10 sewer claims each year.
The City of Missoula has a goodwill policy in place for sewer main backups. Missoula's
Goodwill Policy will compensate for damage after MMIA has determined that the city is not
liable. Missoula has a step program in place. For example, if the amount requested is less than
$2M00 the Public Works Director may approve it. Up to $5,000 the City Administrator approves
the claim and for claims over $5,000 the City Council must approve. The funds come directly
out of the Sanitary Sewer fund. The annual budget is $70,000.
The City of Helena does not have a Goodwill Policy.
The City of Bozeman —received no response.
City of Columbia Falls does not have a Goodwill Policy.
Similar Characteristics
The Cities with established Goodwill Policies included the following attributes in their programs:
• Goodwill Policy reimbursement is not an option until after MMIA has concluded its
investigation.
• A board or individual is appointed to review claims.
* The reviewer follows written guidelines.
* A maximum payout amount is usually established.
• Individuals must sign a waiver releasing the City from any further claims or action.
• Funding comes from the water & Sanitary Sewer funds.
It is important to remember that a Goodwill Policy is only for damage caused from a City utility
i.e., water or sewer main), and not for damage that may have been caused from problems with
an individual's private service line.
Water Sewer Goodwill Policy Memo (2).doe
NUVIIA Recommendation
Bob Worthington, MMIA CEO recommends Kalispell implem_cnt a Goodwill Policy. From an
insurance standpoint MMIA doesn't believe that it opens the City up to further liability. In fact,
there is the possibility that it could alleviate further challenges or lawsuits against the City.
However, it is very important that the City wait to reimburse an expense until after MMIA has
concluded its investigation of a claim. The cities that have Goodwill policies have had minimal
payouts, and from a public relations standpoint the feedback has been very positive.
Fundin a Goodwill. Pro m
Possible funding options:
1. Add a surcharge to the bi-monthly utility bill, similar to the existing meter
replacement fee. For example, adding a $0.25 charge to the bi-monthly water bill
would generate approximately $11,000 in revenue annually to fund damage
reimbursements due to water amain breaks; adding a similar charge to the sewer bill
also generates approximately $11,000 annually for sewer back-ups.
2. Increase the rate per 1,000 gallons: adding $0.01 to the rate for every 1,000 gallons of
use would generate approximately $7,500 for each fund.
3. Place no surcharges on the utility bill; fund the program from current rates. Set aside
an annually budgeted amount each fiscal year in the water and Sanitary Severer funds.
This option would reduce the fund reserve until such time that a general rate increase
becomes necessary. In effect, this merely delays the rate increase to a future more
convenient date when the full spectrum of utility costs can be analyzed at one time.
Canchmian
A water/sewer Goodwill program can be a beneficial addition to the City's utility systems. Other
cities with these programs in place have found them to be manageable and cost-effective
methods to provide much needed financial assistance to utility customers who, through no fault
of their own, have experienced property damage or clean-up costs as a result of water/sewer
flooding due to a problem. with City owned and maintained facilities. Some of these lases might
be reimbursable to the customer via a modified homeowner "insurance policy, but there is usually
a significant deductible amount to be paid by the homeowner.
Experience has shown that these situations arise between 2 and 5 times a year in Kalispell. while
annual costs would vary, over time the average annual Goodwill cost to the City to reimburse its
utility customers when damage occurs from a problem with our water/sewer mains would be
about $151,000. The majority of these costs would be related to sewer backups. water related
problems are much less common. The potential impact of this on the current rates is
approximately $0.021 1,000 gallons for sewer and water.
The City' s insurance carrier, MMIA, has indicated support for such a program and has further
stated that the community goodwill fostered by such a program can also help reduce future
claims for damage whenever unfortunate problems With City utilities cause damages to a utility
customer's property.
Water Sewer Goodwill Policy Memo (2).doc
Recommendation
Based on the above informmation and MMIA's endorsement, I recommend that the City Council
develop a water and sewer Goodwill policy for the City of Kalispell. The policy should include
the following:
* Written procedure/policy/guideline
• An appointed committee to review claims
• Claims only acted upon after MMIA's has responded to a claim investigation
Committee can authorize payment up to $5,000 per claim
• City Manager has the authority to authorize payment over $5,000
• Claimant must provide original receipts or written estimates for cleanup costs or damage
• Claimant mint sign a form waiving related claims or actions against the City as a
condition of payment
Attachments
Attached for your information are copies of data provided by Whitefish, Billings, Great Falls,
and Missoula related to their existing water/sewer Goodwill programs.
Water Sewer Goodwill Policy Memo (2),doc
city
Of
Whitefish
July 27, 2006
Mayor Feury and City Councilors
City of Whitefish
Whitefish, Montana
Mayor Feury and Councilors
Recommendation to Adopt a Goodwill Policy in Regards to property Damage
Caused by water and wastewater Accidents
Introduction/Hi t
The City's water distribution and wastewater collection systems are occasionally
subject to mechanical problems, such as pump failures and broken or clogged pipes.
Some of these incidents result in damage to private property. The following policy is
proposed as a means to offer limited financial assistance to affected property
owners, under certain conditions.
Current Re ort
Two recent instances involving damage from broken water mains were flooding in th
the lower level of the Downtowner Motel and basement flooding at a residence on 7
Street. Clogged City sewers have also caused wastewater to accumulate in crawl
spaces and basements on rare occasions.
The owner of the Downtowner Motel has submitted the attached information
regarding a water main incident that occurred last December, including a request for
compensation. We offer this to illustrate some of the problems our customers may
face. If adopted, the process recommended below will be used to review the
Downtowner's request.
Some accidents, such as the Downtowner's flooding, involve third party contractors
whose insurance may come into play and almost all accidents involve a claim to our
insurance carrier. Although our insurance may pay a claim if the City has been
negligent, they will often deny the claim if the incident was caused by an "act of god"
such as extreme weather, or if the City can document reasonable maintenance prior
to the accident. When a third party contractor is involved, our insurance carrier may
pass the claim on to the contractor's insurance company.
ECtJ'e believe it is appropriate, in some instances, for the City to offer limited
compensation, beyond our insurance coverage. If raw sewage accumulates in
someone's basement because a well maintained sewer clogs up for some odd
reason or if a hard winter freeze breaks a water main and it floods a nearby building,
it isn't the property owner's fault but the consequences can be very unpleasant and
very expensive. Although we may not be legally liable, it only seems right to offer
some help.
We contacted other Montana communities and found that Billings, Great Falls and
Butte have some form of "goodwill policy". We propose to work from Great Falls'
example with a program as outlined in the following policy statement.
WATERIwASTEWA TER DAMAGE CLAIM REVIEW COMMMITTEE
POLICY& GUIDELINES
t) The Committee shall meet on an as needed basis and include the
following three members:
Public Works Director
Public Works Utility Supervisor
Finance Director
2) All claims shall first be submitted to the City's insurance carrier and
appropriate third party insurance carriers. The Committee shall
consider the claim after the City's insurance carrier has responded.
3) The claimant's submittal to the Committee shall include invoices for
labor and materials. If the claim includes cleanup or repair work
performed by parties other than an established service provider the
claimant shall provide written estimates prepared by established
service providers to confirm the value of the work.
4) The Committee shall review claims on a case-bya-case basis and
compensation shalt be considered in light of the facts surrounding that
particular incident. Compensation may be denied or limited,
particularly in cases involving third party liability or "Acts of God' ;
such as extreme weather, earthquakes, etc.
5) The Committee may authorize payments up to $5,000 per claim and will
make recommendations to the city Manager regarding larger requests.
5} The City Manager may authorize payments over $5, 000 per claim.
7] The City Manager's decision is final.
8) The claimant shall sign a form waiving related claims or actions
against the City as a condition of payment.
Financial Re uirement
We recommend a maximum payment of $5,000 per claim and anticipate no more
than 2 to 4 claims per year. Annual funding for this program would be through the
Wastewater and Water Funds.
Recommendation
We respectfully recommend the City Council adopt the policy described above and
thereby establish a goodwill program to compensate customers, under certain
conditions, for damage attributed to City water and wastewater utilities.
Sincerely,
John C. Wilson
Public Works
WATER/WASTEWATER DAMAGE CLAIM REVIEW COMMMITTEE
POLICY d GUIDELINES
1) The Committee shall meet an an as needed basis and
include the following three members:
Public Works Director
Public Works Utility Supervisor
Finance Director
2) All claims shall first be submitted to the City's insurance
carrier and appropriate third party insurance carriers. The
Committee shall consider the claim after the City's
insurance carrier has responded.
3) The claimant's submittal to the Committee shall include
invoices for labor and materials. If the claim includes
cleanup or repair work performed by parties other than an
established service provider the claimant shall provide
written estimates prepared by established service
providers to confirm the value of the work.
4) The Committee shalt review claims on a case -by -case
basis and compensation shall be considered in light of the
facts surrounding that particular incident. Compensation
may be denied or limited
, particularly in cases involving
third party liability or "Acts of God'; such as extreme
weather, earthquakes, etc.
5) The Committee may authorize payments up to $5., 000 per
claim and will make recommendations to the City Manager
regarding larger requests.
6) The City Manager may authorize payments over $5,000 per
claim.
7) the claimant shall sign a form waiving related claims or
actions against the City as a condition of payment.
Adapted August 7, 2006
city
Of
Billings
{date}
Dear Public Utilities Customer:
Below is the procedure to follow after you have experienced a wastewater backup that
occurred as a result of stoppage in the ClMs sewer line.
For health and safety reasons, we recommend that you have the affected
area professionally cleaned as soon as possible. Retain your receipts for
cleaning work, as these expenses may be reimbursed.
2. To file a damage claim with the City, please call JoLynn Yerger,
Safety/Risk officer at 657--3061. Your claim will immediately be filed with
the Montana Municipal Insurance Authority (MMIA), the Dity's liability
insurance provider. Normally, an adjuster will contact you and a
determination regarding City liability will be made within 7-10 days.
3. If MMIA denies your claim, please contact , at
, to file your cleaning casts. The public Utilities
Department will reimburse you up to a maximum of 1,000.00 for
documented cleaning costs associated with a backup caused by stoppage
in the City's sanitary sewer line.
Sincerely,
Superintendent, Distribution & Collection
Public Utilities Department
ACKNOWLEDGMENT
I/We, the owner(s) of property located at
Billings, Montana, hereby acknowledge receipt of the sum of $
, paid to
me/us by the City of Billings. IMe further acknowledge that payment of said sum is made for
cleanup costs incurred as a result of a sanitary sewer backup; that said payment is made
voluntarily by the City; and that said payment is not an acknowledgment or admission of any
liability or fault by the City.
DATED THIS DAY OF , 20
OWNER
OWNER
OWNER
OWNER
{date}
Name
Address
City, state Zip
SUJ ECT: Sanitary Sewer Complaint — address of backupl--
Dear
The city Of. Billings' public Works Department currently has a reimbursement program
for damages incurred by a City sanitary sewer backup. The program will pay up to
$1,000.00 in cleaning costs.
In order to be reimbursed for the casts you recently incurred, please complete the
attached acknowledgment form and return it, along with the cleaning receipts. We will
then process the payment.
If you have any questions, please contact me at
Sincerely,
[distribution & collection Superintendent
Attachment
City
Of
Great Falls
WATER/SEWER COMMITTEE
POLIO" Y & GUIDELINES
1) The Committee shall consist of three members as follows:
• Utility Systems Supervisor
• Utility Systems Foreman
• Risk Manager
2} The Committee shall meet on an as needed basis.
3) All claims are initially sent to the MMIA for payment or denial of payment.
4) Only those who contact the City, after the MMIA.'s denial are acted on.
S) Staff can authorize up to $5,000 per claim.
6} The City Manager has the authority to authorize payment over $5,000.
7) Program is administered by the water/Severer Committee.
8) Claimants must sign a waiver form.
9) Program is initially funded as follows:
• $71P00 Sewer Administration Budget
• $31000 — water Administration Budget
10) Payments will not based on an across-the-board figure. Each claim will be reviewed
with a maximum dollar amount set at $5,000. Clauns gill not be paid in cases of
"Acts of God" or clear liability on a third party.
11 ) Before paying any claim, bills must be submitted by the claimant and reviewed by the
Committee. If claimant chooses to do cleanup themselves, they must provide a
written estimate by a cleaning company as to the hours and costs to do the cleaning.
July 19, 2004
RE: Sewer Back Up
Date of Loss: une 23, 2004
Dear:
The City of Great Falls Water/Sewer Committee has met regarding your claim for the above
referenced incident. After careful consideration of the items you asked us to consider we are
willing to offer you a final good will settlement of I have attached a copy of the
breakdown for your reference.
The Committee feels this is a fair offer. The Committee also reviewed the Montana Municipal
Insurance Authorities decision. The City of great Falls has been reasonable in their inspections
and maintenance of this line as well as in their response to the problems of the back up. The
Montana Municipal Insurance Authority has determined the City of Great Falls was not
negligent in their actions concerning this claim. We are willing to offer this goodwill settlement
given the fact that it was the City's line.
I have enclosed a copy of a Release Form that we are asking you to sign if you should accept our
final offer. You may mail this foam to me or bring it in personally, whichever is more
convenient for you. When we receive this release Farm, the City will issue you a check.
Should you wish to discuss this further I can be reached at (406)455-8440.
Sincerely,
Kelly Audet
Disk Management Specialist
* RELEASE
That for and in consideration of the sum of $ paid by the City of Great Falls,
Montana, receipt of which is hereby acknowledged, do hereby
release and discharge the City of Great Falls, a municipal corporation, all of its officers,
employees and agents from any and all actions and causes of action, demands, claims of every
kind and nature whatsoever arising out of the alleged water line repair causing damage to
claimant's property located at . This Agreement shall be binding
upon the heirs, successors and assigns of the -parties hereto.
IN WITNESS WHEREOF,
this
Day of
Claimant
, 2006.
Claimant
has hereunto set their hands
SUBSCRIBED AND SWORN to before me, the undersigned, a Notary Public for the State of
Montana this - - - - - day of -- - -- -- - -- -- 12006.
Signature
Printed Name
Notary Public for the State of Montana
Residing at , Montana
My Commission Expires:
(NOTARY SEAL)
City
Of
Missoula
*+tam#r ++
ru
Eligible Expenses
To be coaddared, Umm cquam a" be ne -
T` essW, reasonable and mentaw as
al Contracting of a cleaning service
b j Emergency e)penses. such as rental of heat -
OD ers to prevent freezing if the heating systern is
Go affected.
c) Emergency housing and meads for owner(s)
or tenant(s). ;f required because the savtary
concidon of the sbrxture is unhealthy .for oc
M man as a residence.
od) Disposal of any contaminated material in an
approved landfill site.
el Actual cash value of the damaged personal
property that must be replaced because it
Cannot be repaired or leaned
. - Estimates
ao if the claimant chooses to perform cleanup
and claim personal labor and materials costs, the
claimant must provide a written es&nate from a
c6 ni cleang company as to the work hours and
ni costs to complete the job. This estimate will be
used to substantiate the -necessary and reason-
able- requirement ofthe Goodwill Policy.
Reimbursements
All claims for reimbursement must be acCorn-
parced by original receipts and/or cost estimates.
Actual cash value equals replacement cost of
items of We kdnd and quality, less depreciation.
for use, wear, age -and other applicable factors.
Q Non-ligible Expenses
Nor eligible for financial assistance: purport-
0 ed personal labor cosh pain and suffering, emo-
CO
co tional or mental distress, incor enience, air fare
or travel expenses, lost wages{ lost business rev-
enues. lost business profits,, or similar items.
M WaiYer Agreement
Claimants must sign an agreement waiving,
any further calms against the City in order to re-
(u ceive financial assistance -
CD
T1ds peNcy supwwdss my and A prkw resatudoas
P4 to to" VM polikia an satyr bachJUP&
The UdbrotieP In /fc kvcdure is outlined i t
CU
� CW Rem*Alop 3R30 r
rI adopted Uwch 1996.
i
D
Q
Z
Questioln'soo,
Calf the offices listed below
fbr further information,
Wmtewater Treatment Plant
523-4880
523.4SS6
city of Missoula
Finance O ftce
523-4929
�Clty of Missoula
Public Works Departnnent
523-4520
i
I&Iastewater
D a, gd e I
from
City Sewer Backups?
****4*.;* + ,+..;*.**.
Voluntary
Goodwill
Policy
If you've ever had wastewater
backed up in your residence from
City sewer facilities, you know
whd (rush afien is ...
�
'he City of Missoula has a thorough sewer
� one maintenance program. However, from
irne to time, under unusual circumstances,
O@Aissoula residents experience a backup of
opwastewater into property they own or rent
F- The City of Missoula has a Voluntary Goad-
CD nnll Policy designed to help you receive assis--
cr ,ance if you qualify for it. This could occur if,
(5 he wastewater problems originate in City
~ )wned or maintained facilities, such as in
;ewer mains, S.T.E.P. systems or pump sta-
ions. Limited financial help with cleanup is
available from the City in certain instances.
0 Why does the
' City of Missoula have a
U) Voluntary Goodwill Policy?
the City of Missoula wants to help citizens
CD
'T naintain a healthy, safe and pleasant way of
ife. Offering voluntary assistance to help
Mth sewer backups in City sewer facilities is
)ur way of helping you handle the incohve-
Vence and cleanup as well as some of the
-osts which may not be covered' by your own
CE nsurance or the 013(s insurance:
I
B By following a few simple steps,
LO
you can avoid delays in determining
what type of helpual for.
]� R d `Y
w(ou may qualify for some assistance even if
cr four insurance or the City's insurance does
bi }ot cover the damage. We encourage you
c p ask about possible assistance and submit
i claim, even if you"re informed that the City
W s not liable. Probiems in the sewer system
an occur even though proper operation
r� end maintenance has been performed.
0
Z
Missoula's Voluntary Goodwill Policy
is based on the following considerations:
4, Blockages in the 0Vs system of wastewa-
ter main collection tines occur occasionally,.
for a variety of reasons (such as foreign ob-
:jests, grease, roots and other sources).
a.. In many cases, .such blockages are not a
result of any actions, inactions, negli-
gence or fault of the City.
*:- ' City sewer main backups may cause dam-
age and inconvenience to owners or ten-
ants of an affected structure.
i The City wants to lessen the hardship resi-
dents experience by providing some fi-
nancial assistance, even though the City
may not be responsible for the damage
or the inconvenience.
*:- The City wants to respond promptly to
your questions; however, the City cannot
provide assistance until after the Cityys ire
surer has determined whether the City is
liable for cleanup or damage_
r+i#� #*i#*! e4 lee
Here's what you should do if you need assistance.
l . Report -the problem to the Wastewater TreatrTrent
Plantat 523-4880 or 5234885.
2 Waswwater crews w411 locate. the blockage_ if it is
In the 'servrce lateral. line (the connection from
your structure to the city main), the City will a&
vise you to call a plumber to dear the blockage.
Such: blockages are the homeowners flnandal
responsibility.
a if the blockage is In the CiVs main Um or is caused
by a malfunction of City -owned or maintained
facilities such as S,T.E.P. systems, the City mainte-
nance crew wail resolve the problem. The crew
Will provide the occupant. with a copy of this bro-
chure and advice on how to file a claim.
4. To be considered for financial 'assistance, you
must submit a. claim form to the City_ fail the- Fi-
nance Cffiee at 5234929 for claims information.
5 The City will provide assistance only if the CiVs
insurer has denied the claim. In that case, the City
will be authorized to approve some goodWitas-
sistance to the property owner and/or tenant for
cleanup.
T. Cleanup expenses are limited to chose considered
necessary, reasonable, and documentable. Esti-
mates and original receipts are required. It will
be the property owner's or tenant's responsibil-
ity to perform the cleanup or hire a cleaning corr)-
pany. (See "Eligible Expenses" for detail.j-
B. The City will reimburse the claimant only to the
extent that expenses exceed or are not covered
by a homeowner, renter, or business insurance
policy. No payment will be made of damages due
to "Acts of God` or where there is clear liability by
a property owner or a third partyPayment will
not be made fbr indirect costs. (See `Eligible Ex-
penses" for additional detail.)
TIPS ON FIRING CLEANING AND
RENOVATION SERVICES
Read, the City's Voluntary Goodwill brochure
thoroughly.
You should always get three estimates
before any contract work is to be done. The
City requires three estimates for
renovation work done after the initial
clean- up for payment to be made.
Before reimbursement can be made, you or
the contractors you've hired must provide
documentation of damaged items 'or the
actual items for- Inspection by, the City
before they are disposed of.
The C ty's Voluntary Goodwill RQ-licy may
not cover all services offered or
recommended 'by a cleaningL or renovation
company. You will be responsible for any
costs not covered in the voluntary i
Goodwill Policy.
Most cleaning and renovation companies
are repo#able, but don't be taken. advantage'
of during a stressful time by any contractor. -
The C 's voluntary Goodwill Policy does
not necessarily cover replacement value of
.items that cannot be, cleaped or repaired,
The pollcy pays only the actual cash value
or depreciated value of a da- maged' item.
1
All claims must be submitted within 90 days
of the sewage , back up to receive
reins bu rserri ent. '
If you have any questions or concerns,
please call- the Wastewater . Uivislo n at 523-
17
4880
g
I " d I 006 112aBS L90t? 16.0l 6t7- 8S2 - 90t,
dIMM u-1noss I w : woaj u92 : eo 9002 - 2 - nON
WAIVER AND RELEASE OF ALL
CLAIMS TO RECEIVE VOLUNTARY GOODWILL
POLICY PAYMENT FOR SANITARY SEWER BACKUP
Ilvve,
Name(s) Address
Missoula MT 59$ , in order to participate in and receive some City voluntary
goodwill policy money to assist with recovery involving the city sanitary sewer system and a
backup at , Missoula, Montana, on
Address of sanitary sewer backup Date of backup
do hereby for ourselves and our heirs, executors, administrators, successors and assigns in
exchange for receiving a City voluntary goodwill policy payment of $ do hereby
Amount
in exchange for receipt of this money, release, acquit and forever discharge the City of
Missoula and its agents, officers and employees from all manner of legal actions, claims,
cause of action, demands, rights, damages, costs, etc., in law or equity, which we may have
now or in the future, against said City of Missoula and their agents, officers and employees by
reason of the sanitary sewer backup identified herein including the processing of this voluntary
goodvAH policy claim. We further state that we understand that the City of Missoula does not
consider itself negligent in this matter but that pursuant to the city of Missoula's voluntary
goodwill policy for assisting individuals in my/our circumstances who have experienced
sanitary sewer main backup damage the City is voluntarily offering to assist me/ us with this
payment.
The undersigned further declare and represent that no promise, inducement or
agreement not herein expressed has been made to the undersigned, that this Release is
voluntarily made and that the terms of this Release are contractually binding.
SIGNED this day of , 200
State of Montana }
)ss.
County of Missoula
This instrument was acknowledged before me on this day of
Zoo , by
Kinfory Pi jhlir- few tha Rtata of RAnntnna