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It�i�� ��e�tr s�����l�l�n�?ciical trtattucnt'' �'r:�, N<� T'1��t�r,i���l��ti�el, 'Trr..a�.�r»c.t�t t�,sr�.l�) 1� I�,�i? iti�i ����tt��cc�i��c�. t.ic�:���r�i�r�E? .(��t�:j�it�� �Iatr•{�:j> ___ ...... ,_.._..._ . .._..._ . __ .--_._ ._..,__ ___ �.:tIR��V� �`if'l�IC4lI .I7k'il�iC�tid��5.�:_._..______ . . _. __�.._� __..__._..__._.� . ._...._.._« _..... ._,...... ,._,_... .... __. �.ci�1r�_�s _.____� l+:�l:.��h<xi�:__._._. . .----- ___ — .. _....�_______.___._ ___.T.__�_�....____._ I�sci yn�t nti-:�: «s>r�:���, i r�sult��t'��3i�r i�'tjtir�': 1'i:, `vca ti�l�en.�iid ��ai.f nriss 4+�c�t�:? ._ . . . __,..__.. ,._._ .__.__. . _...,...._.__. .. __.._ :�_.______.__.(t�rt�tiici�ci�stc:(s}) _ __._� —.--- �i�1r<<� i,( �°c>ur I?tx���iaEr t . . . _ __. _ _ ... . . : :liic3r�.ss__._..._ ._:.._ _.�._�__..__... .._ __.., --.._ ._- _ felt��►y�rt�x°- .._ ._._. ___._. ... .___.. .-----r f ._._:. .... ...... _ C�] ("hrck lx��t��•i!°�nu �srL�tt.�CI1131n ttau��e�aa��s tn fi�ix ci<�iru farr�t. ;vu�r�h�r r�#a�t3itis:,i�a��ja„,=es __ _..._ i�s �i�;rri�tt rlris%orvr�. f•e>ir ar?.crutir.��tJevt�tl!itr fi�rirr,�rirtti,)•rru 9r.yv�'p��ovid���l,i.s J,•r1�:rrrttl e•r,rr��,.i 1��rlu!l,e-.vr�f�Yt�rr kn�ns li>rl;re. f%n�i�ie�r/ )";nn:.rnln•itr�t AE•j�rr�rr�sr:/. .S'uhmlti7�t�tt/islt?rlrrim r,`ufr re^iu�l it��rrt3�t`s`uti�Rir. I'1�)tfi t�1t.. ;4i1lIlG Of 1�iC �rCT'S{}t) Y1�➢i7 C�C1Tti(l�t�it� �liiw t�'�fr• t ..,� `.�..... _..��l_�__ , � \J _.._ ....w----.__. Si�;ns�ture ui' Pt��•st��� 1�.ikin�; ttie (""t�in�. � �,,,� __.__.__.._.�.. k3.tle ft�t'cll �+'.i:ti c{►tri��[et�cl,_�;M�"_.5.1�.. _ Rt:��_?:1rr:i'�t()G `1 l;"" CMR CLAIMS DEPARTMENT � � PO. BOX 60770 �I,� OKLAHOMACITY OK 73146-0770 1-866-887-4066 CenturyLinkrM *X**xNt�'TICE OF CLAIM*Xx** - REC , n -:�� Date: 1 I-22-20]3 �;EC L'� 70�3 CERTIFIED MAIL, RETLTRN RECEIPT REQUESTED To: CITY OF ST PAL'L ClT�' ��.��K C[TY CLERK 310 CITY HALL I� W. KELLOGG BLVD ST PAUL, MN 55102 C.'ERTIFIED MAIL# 9171 9690 0935 0036 8141 l 1 tYE: 1)amage io Century i.i�i��?S��zrta� Century I ink Claim Num: 556603 Damage/Discovery Date: 11-2U-2013 Damage Location: 665 SELBY .4VE,ST. PAUL, MN Damage County: RAMSEY Damage Amount: UNDF.TERMINED Dear Sir/�ladar.�: Please be advised that Centur� Link Facilities sustained damage as a result of the negligent acts or omissions b��employces or agents af CITY OF S I'PAIJL . Imesti�ation has revealed ±hut on ��r about I 1-20-2013 employees or agents of CITI' OF S'T PAUL, C17�Y OF S"f. PAUL V4'ATER DA1viAGFD A 1500 PAIR BUR[ED CENTURY LINK CAL�LE DUR[NG WA"I'ER EXCAVA"r1.ON in the area of N65 SGLBY AVE, ST. PAUL, MN. This letter is the written presentment of Century Link's claim pursuant to Minnesota Statute 466.05 . RE(�I`E�T F(JiK GOVERNMENTAL NOTICE FORM It your Governmental Entity requires the completion of its own form to complete proper notice. please forward a copy to the addres; listed above. Every good faith effort has been made to identify the proper office and address ta perfec[ our notice. Pfease forward to �:our attornev, if misc�ir�c±e�, to :ontact �zs. Matters herein stated are alieged on information and belief this pleader believes to be true. If there is insurance.to cover this mafter, kindl,� advise as to the name of tlte insurance company, its address and the claim number assigned. lf you I�ave any questions, or need additional information, please contact me az 1-800-321-4158 ext 8232. -- ---------------------------- � ; .�"TA�`.. JAMIE WINTERS � � t+`' "' i Sincerely, ; ; ��M� � Notary Public � Holly Finiey � '�'�,��,.•�' State of Oklahoma ; �Cominission#09001748_Expires 03/03117 ; r � � .��. �` . . i`f . � , � .. � . "� �. NOTAR __ — CMR Claims UEPT Commis i Expii•es_��J�� ( _