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RESOURCES
*****NOTICE OF CLAIM*****
Date: 06-25-2003
CERTIFIED MAIL, RETURN RECEIPT REQUESTED
To: WELD COUNTY
COUNTY COMMISSIONERS
915 10TH ST
GREELEY, CO 90631
CERTIFIED MAIL# 7003 0500 0002 9503 9212
RE: Damage to QWEST Property
QWEST Claim No.: 233091
Date of Damage: 06-11-03
Location of damage: WCR 32.5 &WCR 21, PLATTEVILLE, CO
Amount of Damage: $725.67
Dear Sir/Madam:
Please be advised that QWEST Facilities sustained damage as a result of the
negligent acts by employees or agents of WELD COUNTY.
Investigation has revealed that on or about 06-11-03 employees or agents of
WELD COUNTY damaged BUIRED CABLE while MOWING in area at WCR
32.5 & WCR 21, PLATTEVILLE, CO.
If there is insurance to cover this matter,kindly advise as to the name of the
insurance company, its address and the claim number assigned.
REQUEST FOR GOVERNMENTAL NOTICE FORM
If your Governmental Entity requires the completion of its own claim form to
complete proper notice,please forward a copy to the address listed above.
If you have any questions, or need additional information,please call me at 1-
800-321-4158 ext 2006 or fax me at 405-605-3401.
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CMR QWEST CLAIMS NOTARY MA
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