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Home My WebLink About08 CLAIM 08-46, GUILLEN 04-07-09.ai... MEETING DATE: TO: FROM: SUBJECT: SUMMARY: AGENDA REPORT APRIL 7, 2009 WILLIAM A. HUSTON, CITY MANAGER KRISTI RECCHIA, DIRECTOR OF HUMAN RESOURCES Agenda Item 8 Reviewed: City Manager Finance Director NIA CONSIDERATION OF CLAIM OF SIRLEY GUILLEN, CLAIM NO. 08-46 The Claimant reported that a tree branch from a City tree on West 6th Street fell on to the roof of her car, causing a dent and scratches. RECOMMENDATION: That the City Council deny Claim Number 08-46, Sirley Guillen, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: Following investigation by the City's Claims Administrator, there appears to be no liability on the part of the City of Tustin, as it appears that wind was the cause of the tree limb falling; a cause that could not have been foreseen or prevented by the City. The City had not received any prior complaints pertaining to the specific tree involved. Staff is recommending denial of the claim. ~~~~~ ~C ~ Kristi Recchia Director of Human Resources ATTACHMENT: Copy of Claim No. 08-46 Guillen, Sirley -Agenda Report - GL Claim Rejection 3.18.09 ( CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Property) Received Via: ^ U.S. Mail ^ Inter-Office Mail -Over the Counter -~ ~~r~e~~s~mpT ~ ' -- i f ; , ?~~IaR-~~-d:u P 2~ ~ o o~ y~ PLEASE NOTE: A. Read entire claim before filing. B. Be sure your claim is against the Citv 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 (Govemment Code § 911.2). D. Claims for damages to real property must be filed no later than one year after the occurrence (Government 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 prescribed by the Government Code of the State of California, by the claimant or a person acting on his/her behalf and shall provide the information shown below and must be signed by the claimant or a person on his behalf (Government Code § 910.2). G. This form is for the convenience 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. 2. 3. 4. Name and Post Office address of the Claimant: 1 ~ Name of Claimant: ~~ Y" 1 G Home Address: ~ _ ome Telephone: Work Telephone: -_~ _ _. Post Office address to which the person presenting the claim desires notices to be sent: (If different from above) Name of Addressee: Telephone: Post Office Address: The date, place and other circumstances of the occurrence or transaction from which the Gaim arises. Date of Occurrence: ~ ~; ~ ~ ~~ Location: . ~ t ~ ~ , , -~-i, S; Time of Occurrence: ~I lit;%G t~ j1 P!r- Page 1 of 4 Circumstances Giving rise to this Gaim: 5. The name or names of the public employee or employees causing the injury, damage, or loss, if known. 6. If amount claimed totals less than $10,000: Provide the amount claimed if it totals less than ten thousand dollars ($10,000) as of the date of your claim, induding the estimated amount of any related potential future injury, damage, or loss, insofar as it may be known as of the date of your daim, together with the basis of computation of the amount daimed (indude copies of all bills, invoices, estimates, etc.) Amount Claimed and basis for computation: If amount claimed exceeds x10,000: If the amount daimed exceeds ten thousand dollars ($10,000), do not provide a dollar amount in the daim. However, your daim must indicate whether it would be a limited dvil case. A limited dvil case is one where the recovery sought, exdusive of attorney fees, interest and court costs, does not exceed $25,000. An unlimited dvil case is one in which the recovery sought is more than $25,000. (See CCP § 86. ) ^ Limited Civil Case ^ Unlimited 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 daim arises: 8. If the claim involves medical treatment for a daimed injury, please provide the name, address and telephone number of any doctors or hospitals providing treatment: \~ V '~~}(~U Ug if applicable, please attach any medical bills or reports or similar documents supporting your claim. If the daim relates to an automobile accident: Claimant(s) Auto Ins. Co.: ~'~-~ ~ n ~ ~ Telephone i -~j(~(1 - ~(~ 2- ~~ G~ Address. Insurance Policy No.: _Insurance Broker/Agent: W~~~ C~~-i- ~~ th~iAYtAn~ ('~ Telephone: Address: Claimant's Veh. Lic. No.: Vehicle Make/Year: ('hP~~~-rte IQ Claimant's Drivers Lic. No.: Expiration: If applicable, please attach any repair bills, estimates or similar documents supporting your claim. Page 2 of 4 READ CAREFULLY For all acddent claims, place on following diagram name of streets, including North, East, South, and West; indicate 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 Vehicle when you first saw it, and by "B' location of yourself or your vehicle when you first saw ~_. ~ :~ .. ~ ..~ .~~' ~, '~~`' CURB City/Agency Vehicle; location of City/Agency vehicle at time of accident by "A-1" and location of yourself or your vehicle 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. ~~>~ SIDEWALK t~ ~-~--_ PARKWAY ~,°r ~-= SIDEWALK L~u~~ ~~' ~ `~ 4 __. ~- ir~~ __._ L1uI?,. ~- -~ 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 costs 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: I~ . 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 Gaim will be granted (Government Code § 911.6). The reason for delay in presenting the Gaim is: Date Revised 12!2004 Signature of Claimant Page 4 of 4 11/.07/2008 at 12:34 PM 3644 INFINITY INSURANCE COMPANY SANTA ANA 17542 E 17th St STE 175 TUSTIN, CA 92780 (866)206-0115x5169 Fax: (714)371-2665 ESTIMATE OF RECORD ICS10000630577_178817 02t800sa Written By: anthony welsh 11/07/2008 12:34 PM Adjuster: ANTHONY WALSH (866)206-0115x5169 Insured: SIRLEY GUILLEN Claim #ICS10000630577 178817 OMnar: SIRLEY GUILLFrT Policy # Address: Date of Loss: 10/11/2008 at 12:00 AM Point of Impact: 13. Rollover Evening: Inspect Business: (714)679-5063 Location: TUSTIN , CA 92780-8533 HOME Repair 5 Days to Repair Facility: License # 2008 CHEV MALIBU LT 4-2.4L-FI 4D SED BLACK I nt:TAN VIN: :,ic: CA Prod Date: 05/2008 Odometer: 6312 Condition: Excel lent Air Conditioning Rear Defogger Tilt Wheel Cruise Control Telescopic Wheel Intermittent Wipers Keyless Entry Theft Deterrent/Alarm Steering Wheel Controls Message Center Dual Mirrors Console/Storage Traction Control Stability Control Clear Coat Paint Metallic Paint Power Steering Power Brakes Power Windows Power Locks Power Mirrors Power Trunk/Tailgate AM Radio FM Radio Stereo Search/Seek CD Player Anti-Lock Brakes (4) Driver Air Bag Passenger Air Bag Head/Curtain Air Bags Front Side Impact Air Bag 4 Wheel Disc Brakes Communications System Cloth Seats Bucket Seats Automatic Transmission Overdrive ------------- Aluminum/Alloy Wheels NO. OP. ------- DESCRIPTION -- ---------------------------------- QTY EXT. PRICE LABOR PAINT 1 -------- ROOF ---------------------------------- 2* Rpr Roof panel w/o sunroof 12.0 3 0 3 Add for Clear Coat . 1 2 4 R&I RT Roof molding 0 6 5 R&I LT Roof molding . 0 6 6 R&I Headliner w/o dual reading . 2,g lmp, w/o G.P.S. titanium 7 QUARTER PANEL 8* Rpr RT Quarter panel 1.0 2.8 1 11/07/2008 at 12:34 PM 3644 • LSTII~ATE OF RECORD 2008 CHEV MALIBU LT 4-2.4L-FI 4D SED BLACK Int:TAN N0. OP. ---- DESCRIPTION --------------- QTY EXT. PRICE LABOR PAINT 9 ---------------- Overlap Major Non-Adj. Panel ----- ------- -- --------- --------- -0.2 10 Add for Clear Coat 0.5 11 FRONT LAMPS 12 R&I RT Repeater lamp 0.1 13 FRONT DOOR 14* Rpr RT Door shell (HSS) 1.0 2.4 15 Overlap Major Non-Adj. Panel _0,2 16 Add for Clear Coat 0.4 17 R&I RT Belt w'strip 1st design 0,2 18 Repl RT Emblem 1 4.75 0.2 19 R&I RT Mirror assy w/o heated 0.3 black 20 R&I RT Handle, outside primed 0.4 21 R&I RT R&I trim panel 0.4 22 Repl RT Body side mldg 1 38.78 0.3 0 6 23 Repl RT Upper molding 2nd design 1 111.24 0.6 . 24 REAR DOOR 25 R&I RT Belt molding 0 2 26 Repl RT Body side mldg 1 34.22 . 0.3 0 6 27 R&I RT Handle, outside primed 0.4 . 28 R&I RT R&I trim panel 0 4 29# Match Tint 1 . 0 5 30# Subl Hazardous Waste 1 5.00 X . 31# Subl COVER VEH FOR OVERSPRAY 1 12.00 32# max blend time/RT FENDER/RT 1 1.5 REAR DOOR LT SAIL PANEL 33# Buff and Polish (.5 per 3 1.5 panel) / MAX 3 PANELS ---- ----------- Subtotals =_> ------ ------- 205.99 -- --------- 23.8 -------- 12.6 Parts 200.99 Body Labor 23.8 hrs @ $ 34.00/hr 809.20 Paint Labor 12.6 hrs @ $ 34.00/hr 428.40 Paint Supplies 12.6 hrs @ $ 24.00/hr 302.40 Sublet/Misc . 5.00 SUBTOTAL $ 1745.99 Sales Tax $ 503.39 @ 7.75008 39.01 ---------------------------------------- TOTAL COST OF REPAIRS $ 1785.00 ADJUSTMENTS: Deductible 1000.00 ------------------------------------------ TOTAL ADJUSTMENTS $ 1000.00 NET COST OF REPAIRS $ 785.00 ICS10000630577_178817 02t800sq 2 11/07/2008 at 12:34 PM 3644 ' ICS10000630577_178817 OZt800sq ESTI1rII~TE OF RECORD 2008 CHEV MALIBU LT 4-2.4L-FI 4D SED BLACK Int:TAN This is only an appraisal. This is not an authorization to repair. The vehicle owner is the only person that can authorize repairs to his/her vehicle. Please call the claim file Adjuster to confirm coverage prior to starting repairs. No supplements will be honored without prior approval from Infinity/Leader Any supplement charges must be pre-approved or it will not be honored. Requirements to repair RSVP covered vehicles prior to payment, policy states "no payment is due under this policy until evidence of satisfactory repairs has been submitted to us. We shall then have the right, to our option, to inspect the repairs prior to our making payment." Please notify the adjuster at least three (3) days prior to completion of repairs. This estimate may have been changed based on the supplied by a source other than the manufacturer warranties applicable to these replacement parts manufacturer or distributor of the parts rather manufac t~rer of ,u vehicle. ~ ~L ~~~ I ~ ~(;°~\ use of aftermarket parts of your motor vehicle. Any are provided by the then by the original as a representative of, ' ~- do understand and agree that the above repairer will complete the above repairs a`t the price of $~__~)p~~.~cluding charges incidental there o. ~ ~ ~~ ~, ~ ~~ Signature: ~ti9ate: 3 11/07/2008 at 12:34 PM 3644 ESTIMATE OF RECORD 2008 CHEV MALIBU LT 4-2.4L-FI 4D SED BLACK Int:TAN FOR YOUR PROTECTION CALIFORNIA LAW REQUIRES THE FOLLOWING TO APPEAR ON THIS FORM: ANY PERSON WHO KNOWINGLY PRESENTS FALSE OR FRAUDULENT CLAIM FOR THE PAYMENT OF A LOSS IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN STATE PRISON. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES: B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS: ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT O/H=OVERHAUL OP=OPERATION NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY REPLACEMENT PART COMP REPL PARTS=COMPETITIVE REPLACEMENT PARTS RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE AND REPLACE APR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT W/_=WITH/_ SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE..MOTORS DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NOTES ATTACHED TO LINE. MQVP=MANUFACTURER'S QUALIFICATION AND VALIDATION PROGRAM. OPT OEM=ORIGINAL EQUIPMENT MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR OTHERWISE PROVIDED WITH SOME UNIQUE PRICING OR DISCOUNT. NWCPP=NATIONWIDE CRASH PARTS PROGRAM. Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide DR1CP08, CCC Data Date 09/01/2008, and the parts selected are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at OE/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts that may be provided by or through alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle dealerships. Asterisk (*) or Double Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have been modified or may have come from an alternate data source. Tilde sign (~) items indicate MOTOR Not-Included Labor operations. Non-Original Equipment Manufacturer aftermarket parts are described as AM, Qual Repl Parts or Comp Repl Parts which stands for Competitive Replacement Parts. Used parts are described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pound sign (#) items indicate manual entries. Some 2006 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The Pathways estimator has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. CCC Pathways - A product of CCC Information Services Inc. ICS10000630577_178817 02t800sq 4