HomeMy WebLinkAbout08 CLAIM 08-16, MANNASON 08-05-08
AGENDA REPORT
MEETING DATE: AUGUST 5, 2008
TO: WILLIAM A. HUSTON, CITY MANAGER
FROM: RONALD A. NAULT, FINANCE DIRECTOR
SUBJECT: CONSIDERATION OF CLAIM OF ALAN A. MANNASON, CLAIM NO. 08-16
SUMMARY:
The Attorney for the Claimant has filed this Claim with the statement, "This claim is for indemnity
and contribution for personal injury claim of Sean Whiteley". This pertains to an auto versus
pedestrian accident in which the Claimant's vehicle struck a City of Tustin Police Officer.
RECOMMENDATION:
That the City Council deny Claim Number 08-16, Alan A. Mannason, and direct Staff to send
notice thereof to the Claimant's Attorney.
FISCAL IMPACT:
None.
DISCUSSION:
The City's Claims Administrator has evaluated this claim and determined that it was timely filed. It
would appear that a Workers' Compensation subrogation claim had been filed against the
Claimant, and the Claimant subsequently filed this claim for indemnity against the City. The City
has no liability in this accident and Staff recommends the claim be denied at this time.
Ronald A. Nault
Finance Director
ATTACHMENT: Copy of Claim No. 08-16
ConsiderationOfClaimOfAlanMannasonNo08-l6.doc
CLAIM AGAINST THE CITY OF TUSTIN
(For Damages to Person or Personal Property)
CITY OF TUSTIN
Received Via: Time Stamp:
^ U.S. Mail
Inter-Office Mail '(^~~ ~,!~~ - I P 2~_ S 0
Over the Counter Claim No: -
PLEASE NOTE:
A. Read entire claim before filing.
B. Be sure your claim is against the City of Tustin, not another public entity.
C. Claims for death, injury to person or to personal property must be filed no later than 6 months after the occurrence
(Grnemment Code § 911.2).
D. Claims for damages to real property must be filed no later than one year after the occurrence (Govemment Code § 911.2).
E. If additional space is needed to provide your information, please attach sheets, identifying the paragraph(s) being answered.
F. A claim must be presented, as presa-ibed by the Government Code of the State of California, by the claimant or a person
acting on hisfier behalf and shall provide the information shown below and must be signed by the claimant or a person on
his behalf (Govemment Code § 910.2).
G. This form is for the comrenience of those desiring to present claims against the city. Claimant is advised to consult a private
attorney if legal advice is desired. No employee of the City may give legal advice to any claimant relating to private claims.
H. Completed claims must be mailed or delivered to the City of Tustin, City Clerk's Office, 300 Centennial Way, Tustin,
California 92780.
1. Name and Post Office address of the Claimant:
Name of Claimant: Alan A. Mannason
Home Address:
Home Telephone: Work Telephone: N/ A
2. Post Office address to which the person presenting the claim desires notices to be sent:
(If different from shave)
Name of Addressee: 17n , g l a c D_ L 1 1; n G Telephone: 9 4 9- 4 5 4- 2 5 0 0
Post Office Address: Cullins & Grandy
23141 Verdugo Dr. #205
Laguna Hills, CA 92653
3. The date, place and other dreumstances of the occurrence or transaction from which the claim arises.
Date of Occurrence: Apr i 1 5, 2 0 0 7 Time of Occurrence: 8: 3 3 p. m.
Location: Southbound Jamboree Rd, 1704 ft. South of Edinger
Circumstances giving rise to this claim:
Police officer Sean Whiteley was working a
Auto v. Pedestrian accident
4. General description of the indebtedness, obligation, injury, damage or loss incurred so far as you now know.
This claim is for indemnity and contribution for personal
injury c aim o can W i e ey.
Page 1 of 4
5. The name or names of the public employee or employees causing the injury, damage, or loss, if known.
Unknown at this time.
6. H amount claimed totals less than 510,000: Provide the amount claimed if it totals less than ten thousand
dollars ($10,000) as of the date of your claim, including the estimated amount of any related potential future injury,
damage, or loss, insofar as it may be known as of the date of your Gaim, together with the basis of computation of
the amount claimed (include copies of all bills, invoices, estimates, etc.)
Amount Claimed and basis for computation:
ff amount claimed exceeds 510,000: If the amount claimed exceeds ten thousand dollars ($10,000), do not
provide a dollar amount in the claim. However, your claim must indicate whether it would be a limited civil case.
A limited civil case is one where the recovery sought, exclusive of attorney fees, interest and court costs, does not
exceed $25,000. An unlimited civil case is one in which the n~covery sought is more than $25,000. (See CCP §
86.)
^ Limited Civil Case ®Uniimited Civil Case
You are required to provide the information requested above in order to comply with Government Code
§910. Additionally, in order to conduct a timely investigation and possible resolution of your claim, the
City of Tustin requests that you answer the followin questions
7. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim
arises:
8.
9.
Please see attached Traffic Collision Report for
witnesses.
If the claim involves medical treatment for a claimed injury, please provide the name, address and telephone
number of any doctors or hospitals providing treatment:
Western Medical Center, Tustin, CA.
ff applicable, please attach any medical bills or reports or similar documents supporting your claim.
If the claim relates to an automobile accident
Claimant(s) Auto fns. Co.: State Farm Telephone: 9 4 9- 5 5 3- 5 8 2 0
Address: 3345 Michelson Dr. # 400
Irvine, CA 9261 2 Insurance Policy No.:
Insurance Broker/Agent: Telephone:
Address:
Claimant's Veh. Lic. No.: Vehicle Make/Year.
Claimant's Drivers Lic. No.: F~cpiration:
If applicable, please attach any repair bills, estimates or similar documents supporting your claim.
Page 2 of 4
READ CAREFULLY
For all accident daims, place on following diagram name of
streets, induding North, East, South,. and West; indipte place of
accident by 'X' and by showing house numbers or distances to
street comers. If City/Agency Vehicle was involved, designate by
letter 'A' location of City/Agency Vehide when you first saw it,
and by "B' location of yourself or your vehicle when you first saw
City/Agency Vehide; location of City/Agency vehide at time of
accident by "A-1" and location of yourself or your vehide at the
time of the accident by "B-1" and the point of impact by'X.'
NOTE: If diagrams below do not fit the situation, attach hereto a
proper diagram signed by claimant.
Please see. attached Traffic Collision Report
SIDEWALK
CURB -~
PARKWAY
SIDEWALK
CURB
Warning: Presentation of a false claim is a felony (Penal Code §72). Pursuant to CCP §1038, the City/Agency may seek
to recover all cysts of defense in the event an action is filed which is later determined not to have been brought in good
faith and with reasonable cause.
Signature:
Date:
Page 3 of 4
IF LATE CLAIM: COMPLETE ITEMS 1- 9 AND THIS APPLICATION.
SIGN BOTH FORMS.
APPLICATION FOR LEAVE TO PRESENT A
LATE CLAIM TO THE CITY OF TUSTIN
The undersigned hereby applies for leave to present a late claim to the City of Tustin. This application is being made
within a reasonable time, not exceeding one (1) year, after the accrual of the cause of action. Under some arcumstances,
leave to present a late claim will be granted (Government Code § 911.6). The reason for delay in presenting the claim is:
Pursuant to Government Code § 901, this claim for equitable
indemnity or artial indemnity occured on October 5, 2007,
which is the date of service of the complaint that forms the
basis for the indeminty claim. Thus, this claim is within
the six month period of time allowed by Government Code § 911.2
April 1, 2008
Date
Revised 1212004
~-
Signature of Claimant
Page 4 of 4