HomeMy WebLinkAbout08 CLAIM 09-29 - MILLER 09-15-09„_, Agenda Item _ $ /
• Reviewed:
- AGENDA REPORT City Manager
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Finance Director N/A
MEETING DATE: SEPTEMBER 15, 2009
TO: WILLIAM A. HUSTON, CITY MANAGER
FROM: KRISTI RECCHIA, DIRECTOR OF HUMAN RESOURCES
SUBJECT: CONSIDERATION OF CLAIM OF BERNARD MILLER, CLAIM NO. 09-29
SUMMARY:
The Claimant alleges that he sustained damage to his tire and alloy wheel as a result of road work
near Redhill and Walnut.
RECOMMENDATION:
That the City Council deny Claim Number 09-29 Bernard Miller, and direct Staff to send notice
thereof to the Claimant.
FISCAL IMPACT:
None.
DISCUSSION:
The City's Claims Administrator, NovaPro, has completed their investigation and concludes that
there is no liability on the part of the City. Industry standards were followed with regard to the
road work; as such during the construction, the `pit' that the claimant alleges to have created
damage to his tire/wheel was 3/4 of an inch in depth, which is the same depth as a driveway
approach. Additionally, the road work was completed on August 20, 2009, which is one day prior
to the date the claimant alleges the damage to have occurred. Staff is recommending denial of the
claim.
~hvll~~i1 ~'C C•(~la ~~
Kristi Recchia
Director of Human Resources
ATTACHMENT: Copy of Claim No. 09-29
s:\general liability\claims\miller, bernard 09-29\miller, bernard -agenda report - gl claim denial 09.04.09.doc
CLAIM AGAINST THE CITY OF TU~~r1N
(For Damages to Person or Personal Property)
Received via: CITY ~f TUSjCN Time Stamp:
^ U.S. Mail
^ Inter-Office Mail
Over the Counter 1ppq ~tlG 2b P 1~ 3U Claim No: D ~-~- ~
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
(Government 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 prescribed by the Govemment 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.
Name and Post Office address of the Claimant: 1
Name of Claimant: ~ ~v.-o~~- c~.. j~1 > l t~-r-
Home Address:
Use ~J l~Nr/~x~
Home Telephone: 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: Telephone:
Post Office Address:
3. The date, place and other circumstances of the occurrence or transaction from which the claim arises.
Rate of Occurrence: ~~ f ~ u (~ , 2 r` 7.6d 9 Tima.of Occurrence: / / `3~ q
Location: ~ /-a t-. r\1 v ~,~ ~ : - G. ILIa~. - u/~
Circumstances giving rise to this claim: ~~~'J~p (~ ~/ ,,/Cc ; N~"". G ~ p~J
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Ae~,(a yf2 `~ ,r?t 6-/-~ ~ ~'~~-b ~ ~ " "vt1 l~ ~ ~l ~Dl~-®~I°P ~2~ ~l rr~ 8 "xn-' A~Pr-~x ~~-~A2 r~ Lei "
E„~ o~ - ~ 1,l € ~'~ ,~~~ :./~ ~ . f~ ~.av~ ~~ n.~ ~ 7_la ~ T~2~ ?NFL ~N/~
zt" General des ri ton of the in edness, obligation, intury, damage or loss incurred so far as you now know. I~
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5. The name or names of the p'`ublic 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, 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: T/~ ~' ~ C.(J N AEG- ~'-r L- ! ~A-n/ ~r1 ~~._/~~--• /~~f
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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.
Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim
arises:
~~ ;~
8. 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:
6
If applicable, please attach any medical bills or reports or similar documents supporting your claim.
9. If the claim relates to an automobile accident:
Claimant(s) Auto Ins. Co.: Telephone:
Address:
~~ ~ Insurance Policy No.:
Insurance Broker/Agent: Telephone:
Address:
Claimant's Veh. Lic. No.: Vehicle Make/Year:
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 accident 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 corners. 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
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.
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SIDEWALK
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PARKWAY
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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 reasonably cause. -~
Signature:
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Date: ~~`"~ ~ ~~
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Page 3 of 4
TIRFS WAREHOUSE INC p06
18283 MT BALDY CIRCLE
FOUNTAIN VALLEY CA 92708
719-432-d851
Merchant ID: 00000391318'6
Tara ID: 00982872 Ref U: 0008
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RMEX Entrv Method; Swiped
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08i26i09 12.41.49
Inv q. 800006 Appr Code; 529782
Apprvd; Online 8atch~: 000128
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ol, Coale Mesa, CA 92828
x12+0 EPA/: CAL000178129
FAIN VALLEY (714) 432-8861
ddy Cr., Fountain Valey, CA 92708
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FAX (951)808.9083
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FAX (818) 792-4129
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'.,t~f~A~ ~iAZ~RD PQLI~`Y='CL15~`CR DECLYt~ l: id~r f~. Ott! @. 4~D idr ~` ~ .
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NOTICE: For till Wheel purchases, lug. rwt9 mast be,ra-tort~ed . at 50 miles.
Tt>is seadca is FREE of charge. Customer understands:
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Rll Utrti~'it ~ lilt. Qi@ .
SUBTOTAL f 177r 41
TAX TOTAL ~ ~- ~ +
T AMOUNT DUE 184~r ~~
I ACKNOWLEDGE NOTICE AND ORAL E
APPROVAL OF AN INCREASE IN THE R
ORIGINAL ESTIMATED PRICE. INITIAL_ M
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1 Hereby auCtotize the above repett work b be none, are agree to aiow your empbyees to operate my velude for Cte purpose a testing arxilor inspection. An express meeF,erap ien is Hereby acWtowledgi
Caa above vefilde m seaxe Cie anx>'sa d repab8 thereb. t agree to buy etl a ate goods and persorief property des«ited kt tiie forgokip Nlvoice at the prbe and leans herein staled. The flea ro sale property
remit wiC- TMek Warehouse Iris. aril the full purcCiaee prbe k paid, but i shah be responsible for any bas, damage a ~+Y to saki propeAy, whether by fire or olfierwlse. M the event a a suit, ~ costa, irtd
a retismi~le attorney's tee and Cie lapel rate a irRerest wit be paid by said cusronier. 1 '!x°/.per month interest will be charged w1 p~ ~ accounts. This agreerneM stra8 be interpreted In aocoMance xrd
laws a C1e Smte a Calibrrfla. C for any reason, arty senlerx~, louse or provisbn a Cie foregoing b tied urva8d or inappicaWe, tip remehikig provtsione wit be held to be in hti force and elect.
i HAVE READ THIS AGREEMENT, I~N'~ ITS PROVISipNS,
. 'i Qtr (~{~ QI„ Q}~ ~ r $4 91 r /~~ i{„ fs5 AND ILY ASSENT TO IT A, I, ~I~GED`B)Y~Y SIGNpTU~