Loading...
HomeMy WebLinkAbout09 CLAIM 09-17, KANAHELE 07-21-09Agenda Item 9 r RT Reviewed: R AGENDA REO City Manager Finance Director N/A MEETING DATE: JULY 21, 2009 TO: WILLIAM A. HUSTON, CITY MANAGER FROM: KRISTI RECCHIA, DIRECTOR OF HUMAN RESOURCES SUBJECT: CONSIDERATION OF CLAIM OF AARON KANAHELE, CLAIM NO. 09-17 SUMMARY: The Claimant alleges that a dip in the road at Irvine Blvd. and Brittany Woods Drive created an unsafe condition that caused his car to "bottom out", breaking the oil pan. The claimant alleges damages to his vehicle of $701.41. RECOMMENDATION: That the City Council deny Claim Number 09-17, Aaron Kanahele, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: The Public Works Department has advised the City's Claims Administrator that the intersection of Irvine Blvd. and Brittany Woods Drive is 100% in the County of Orange unincorporated territory. There is, therefore, no liability attributable to the City of Tustin. Staff is recommending denial of the claim. X/V�(j & 6 //& A Kristi Recchia Director of Human Resources ATTACHMENT: Copy of Claim No. 09-17 I. CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Pers perty) CITY OF T� Received Via: Time Stamp: ❑ U.S. Mail�(j: 3b ❑ Inter -Office Mail INN JUN 18 A Over the Counter Claim No:y 2-17 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 (Government 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. 1. Name and Post Office address of the Claimant: Name of Claimant: Aaron Kanahele Home Address: Home Telephone: ?iii Work Telephone: 2. Post Office address to which the person presenting the claim desires notices to be sent: (if different from above) Name of Addressee: Same as above Telephone: Post Office Address: 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. Date of Occurrence: 12-21-08 Time of Occurrence: 4:45 PM Location: Irvine Blvd and Brittany Woods Circumstances giving rise to this claim: 110K WPd C P N jj.tvtib �0 %1 C�4�M1'y\i�'1�%! . T��ik` '( Ili iN'�N$1f1,�,b S�1r2N S (� ukl; �ISI.(��i �f�l�t'�l� U'- �y t�tl� U-' i Fk�t 0 � w AVA � OE Ake- %-,K VV 2;� < < Ate, SN � JJk9 c Arf- -co gtzm& f)uy- AAQ V��W� o} L VAN • z W -M twG &/y M qtr► -kW Sfftq ahNT Q! LV C " i k f.l, -t4V JOE AITA�, Nk l O `3 L S 4. General description of the indebtedness, obligation, injury, damage or loss incurred so far as you now know. 'rte nl lv -'�4 A-0 \ 1A* Af.1 AJ n:M W -r 4 b t,�) WA -S a -NQ \h( M A -W 1QV, CW1 `� -h,�r�c�sa`c tOt� , -cam s Iry v.►,61;S .CetTk Nip LA -t VtVT`ftJc 14ff Nb �, %�� S�1 (rf✓riY1 Q�`� 'h t%sy Pagel of 4 TA --V �C�tc, � �c -t-- � rL. tv � � � � �' F r. a=� e� (r►� c.� � ,� � rJ'� .�A� 5. The name or names of the public employee or employees causing the injury, damage, or loss, if known. AVII n t J17 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, 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 claim, together with the basis of computation of the amount claimed (include copies of all bills, invoices, estimates, etc.) Amount Claimed and basis for computation: $701.41 (Total Charges w/ actual receipt attached) If amount claimed exceeds $10,000: 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 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 following questions. 7. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim arises: Amanda Fritsch 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: If 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 Ins. Co.: Did not submit claim to Insurance Telephone: Address: Insurance Policy No.: Insurance Broker/Agent: Telephone: Address: Claimant's Veh. Lic. No.: Vehicle Make/Year: 2000 Audi A6 2.7T Claimant's Drivers Lic. No.: �I&iill Expiration: 10-26-13 If applicable, please attach any repair bills, estimates or similar documents supporting your claim. Page 2 of 4 READ CAREFULLY For all accident claims, place on following diagram name of City/Agency Vehicle; location of City/Agency vehicle at time of streets, including North, East, South, and West; indicate place of accident by "A-1" and location of yourself or your vehicle at the accident by "X" and by showing house numbers or distances to time of the accident by "B-1" and the point of impact by "X." street comers. If City/Agency Vehicle was involved, designate by letter "A" location of City/Agency Vehicle when you first saw it, NOTE: If diagrams below do not ft the situation, attach hereto a and by "B" location of yourself or your vehicle when you first saw proper diagram signed by claimant. CURB SIDEWALK / PARKWAY SIDEWALK e, ZS rrif CURB —� Warning: Presenotion of a fatsclaim i4 felony (Penal Code §72). Pursuant to CCP §1038, the City/Agency may seek to recover all ofd i the ev' an action is filed which is later determined not to have been brought in good faith and with r>dasonabl us Signature: /; - Date: V 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 circumstances, leave to present a late claim will be granted (Government Code § 911.6). The reason for delay in presenting the claim is: Date Revised 12/2004 Signature of Claimant Page 4 of 4 OPTIONS: ENG:2.7_Liter 22DEC08 1 22DEC08 LABOR AMOUNT LINE OPCODE TECH.T PF :OURS LIST NET TOTAL ...; ; .WNE...`..:HE.7.<. N...:k�AJ:'A`:.: :::.:..::..;:.......::.:......:.....:.:...:,...., LEAKING OIL. TCWED IN pur ose of testing and/or inspection. SL bject to AND ORAL Two:': _;::: . cc( litions on reverse side of this contract. \PPROVAL OF AN SUBLET AMOUNT 2562, .. - CA I ALSO ACKNOWLEDGE RECEIPT OF 375.E:�::.�, MISC. CHARGES : ..... :.:. ....:........::..<:::.;.> . :::::.::: s>:::.: ..:::;'i>:;:><:<'>:'.;:::::;;:;:,:;,;:>, '�.........3:.:6".[}�::.:�A:.;;���.:;:.S�.7M�.:...:.:....:.;:::::;:.:::.::;.:.;:;:_..;.;:;.;�.;_2{7.9,:.12::;:::»;>���;Q�::::�:2, .:.::.;. :::<»:.>>;>;:;:x::<2::>::;: ;::.:. ;.::...;;:- ,: .>:..-:.3:�.:'.:�:>�:�:...:.."<::. 1 0787,11S-56-1-.0 OIL FILTER 15..68 15.68 15 68 WF iRANTY. LESS ADJUSTMENT 1 D -176-404-P_2 SEALANT 27.24 27.24 27.24 :.:<.: :; tVW....2. 4:..:<'.<:: PLEASE PAY 1 N,-013-849-2 VASHER. 0.74 0.74 0.74 3 c7....08. LiECy 3..7..5.4Q.:....a?THBR .: , .: 0 .:0.0 'DOTAL :L7 NE A:.::. 6.76=:'fl 8 . ; .:.. PARTS & SERVICE HOURS: ;:. TOTALS Ilotice to Consumer: Please read mportant information on back. rTTQrrAARWV rnnur I h. eby authorize the repair work to be dcne along LABOR AMOUNT wit . the necessary material and hereby grant your em loyees permission to operate the vehicle I ACKNOWLEDGE PARTS AMOUNT MONDAY -FRIDAY 7:00 A.M. TO 6:00 P.M. des ribed on streets, highways or eisewher: for the NOTICE GAS, OIL, LUBE SATURDAY 8:00 A.M. TO 5:00 P.M. pur ose of testing and/or inspection. SL bject to AND ORAL cc( litions on reverse side of this contract. \PPROVAL OF AN SUBLET AMOUNT I ALSO ACKNOWLEDGE RECEIPT OF NCREASE IN THE MISC. CHARGES 50 G -BEVERLY WARRANTY ACT PLEASE READ ORIGINAL RE' ERSE SIDE. SEE REVERSE SIDE FOR :IMITED _STIMATED PRICE TOTAL CHARGES WF iRANTY. LESS ADJUSTMENT SALES TAX SIG a X PLEASE PAY Cu rOMER ACKNOWLEDGE RECEIPT OF A COPY HEREOF SI iN X THIS AMOUNT Ilotice to Consumer: Please read mportant information on back. rTTQrrAARWV rnnur _ �� . � y d 2 � ©� \\ � \ � .vim . z: «..« 2» y®» , ~§ � d - ?r«� ?»<«y <�� . � . ._� »z� : . a, �� : _ . . :a.y.. { ay:s\y w ?m �� . � .� : : .. . � w- � �� �� � .. w . . � 2 2 , .:� «w: . � .-� .:.� ^«� .�. ~°q...; #d� . y\2�.y � � : %< \\»»\:2 \�< �: �� \y. � � . � y ,<. /««/- :. ;\� y . \%�� ����/\�\\/ \��d\�K� . � � � � � � � � � § �.l \. \\\\� / � 3� . © . -x 2 2 °� t °� � «� � %� � © � � � ^ c�. � ° � 2 �\� ?. > /§ \ � . .y ? a.. � : � :y: . . . .. w.�. »} < » zzv: .:<: #\� � � / «< 6 «� . � . � §,y,/,: � � � . . « «� - , . w. . . .� ,e,� � � � w- ._ � . a� y< . . . :«� :\<2% 66 � z � \ \\K� � � � � � §2 � � � � \ �� \ \ � � _ ��'/, 1 �i'�C�" Iv P�s Y00 c k/,� s i�--C� "y A)OMO')��t::S 3�� -�t v M. :J�-NA