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Home My WebLink About08 CLAIM STRICH 09-16-02AGENDA REPORT NO. 8 09-16-02 MEETING DATE: SEPTEMBER 16, 2002 180-10 TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL FROM: CITY ATTORNEY SUBJECT: CLAIM OF SHIRLEY STRICH- CLAIM NO. 02-23 SUMMARY: This is a Claim that should be denied by the City. The Claimant alleges damage to her automobile when she struck a police vehicle after running a stop sign. RECOMMENDATION: After investigation and review by this office and the City's Claims Administrator, it is recommended that the City Council deny the Claim and send notice thereof to the Claimant and to the Claimant's insurance company, State Farm Mutual Automobile Insurance Company (attention: Nancy Westerholt). FISCAL IMPACT: There is no fiscal impact with this action. BACKGROUND: A claim on behalf of Shirley Strich has been filed by Nancy Westerholt for State Farm Insurance. The amount claimed is One Thousand Six Hundred and Ten Dollars and Sixty-three cents ($1,610.63) for damage to Shirley Strich's automobile. However, in this case, the responsibility for this damage is solely that of Ms. Strich. She ran a stop sign and struck a police vehicle. There is no City liability. ATTACHMENT: Copy of Claim Internet :State Fa rm August 15, 2002 ~00DRUFF SPR~DLIN SMART Insurance Companies 714 835 7787 P.02/12 L' South Coast Auto C[airn Central Post Offk~e Box 5010 Thousand Oaks. CA. 9135S-S01 1 1888) 888-0457 HONORABLE MAYOR AND CITY COUNCIL CITY CLERK, CITY OF TUSTIN 300 CENTENNIAL WAY TUSTIN, CA 92780 RE: Insured: Shirley Strich Claim Number: 75-A484-558 Date of Loss: March 12, 2002 Total Amount of Loss: $1610.63 Our Payment: $1244.43 Insured's Payment: $366.20 Your File Number: Policy Number: UNIT #3, LIC # 1011701 Your Insured: TUSTIN POLICE/COLTON KIRWAN Dea~ SIR:: We have been informed you are the insurance carrier for the party designated as your insured in the caption of this letter. Our investigation establishes your insured was responsible for the damage to our policyholder's property as a result of the accident on the date indicated. In order to assist you in evaluating and processing the subrogation claim we are asserting, we may provide nonpublic personal information about our customer. We are sharin~ this information to effect, administer, or enforce a ~ransaction authorized by the consumer. However, you are neither authorized nor permitted to: (1) use the customer information we provide for any purpose other than to evaluate and process the' subrogation claim, or (2) disclose or share the customer information we provide for any purpose other than to evaluate and process the subrogation claim. HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001 SEP-10-2002 11:58 714 835 7787 977. P.02 5EP-10-~00~ 11:58 WOODRUFF 5PR~DLIN SMART 914 8~5 9989 P.0~/1~ Shirley Strich Page 2 Augus~ 15, 2002 Please accept this letter with supporting documents as a notice of our subrogation rights and communicate with us in regard to your position in this matter. Sincerely, Nancy Westerholt Claim Specialist (888) 888-0457 State Farm Mutual Automobile Insurance Company Enclosures SEP-10-2002 11:59 714 835 9987 96z P. 03 SEP-10-2002 11:58 WOODRUFF SPRRDLIN SMRRT 7i4 835 7787 P.04/12 "'- CITY OF TUSTIN . , CLAIM AGAINST THE CITY OF TUSl'"IN · ' (For Damages to Persons or Personal Property) The law provides generally that a claim n~ust be filed with the City Clerk of the City of Tustin ~ months after the incident or event occurred. Be sum your claim is against the City of Tustin, not another public entity. Where sp.ace is insufficient, please use additional paper and identify information by paragraph number. Completed claims must be mailed or delivered to the City Clerk, City of Tastin, 300 Centennial Way, Tustin, California 92780. WHEN COMPLETING THIS FORM, PLEASE TYPE OR USE BLACK INK To the Honorable Mayor and City council,, city of Tustin, California: . ' The undersigned respectfully submits the following claim and 'information relative to damage t;3 person and/or property: Name of Claimant: c~/, _//~./~. ~-/ ~ ,~,-~-~ b. C. ._ ?'-__-" .~,~- . ../ e. Date of Birth: f. Social Security Number: ..... · g. Driver License Number: /'~' ~;_)~ ~ ~ -- ' · · 2. Name, telephone, and post office address to Which claimant desires notices to be sent (if other than · above):_ ~ .~.__~ .. .3. This claim is submitted against: a.. The City of Tustin only. b. ~ The following employee(s) of the City of Tustin only: , . Citygf Tustin. an.d the fc~llo~.'ng employee(s) of the City of Tustin only: · __ · Occurrence or event from which ~e claim arises: a. b. d, Time: J,-2; .~0~ ,~//, . .... ~'-- - /' ~ ' Place (Ex~tct and,SIpeCifi~lJ-Ac~t'on~:-. d'~p~ A)~. 'J- (..)Y~ C~/. '-'~~/', ' ~_-J I ~ ,~_')'-t- / m. (,t--!.. ' ' .. i-:iow a~l under what cirCUmstances did damage or injury occur?. Specify the Particula, occurrence, event, act or omission you claim caused the injury or damage (use additibnal . SEP-10-2802 11:59 714 835 7787 96% P.04 11:58 LdOODRUPP SPRRDL. IN SMRRT 714 835 7787 -- ~ pa~riTnece sa~: . ' --,' ~? · - · - - ' ' 1 G~ e. What particular action by the Cit~, or its employees, caused the' alleged damage or injury? 5. Give a description of the injury, property damage or loss so far known at the time of thisldaim. If ~ ere o' 'uries, state"noini,,ries". - ~ -- ~' -'~/'-'""L~,~ 6. Give the name(s) of the City employee(s) causing the damage or i.njury: 7. Name and address of any other person injured: .... · · . Name and address of the owner of any damaged property: J ; ;, 9. Damages Claimed: b. Estimated amount of future costs.: '~ ~, c. Total amount claimed: ' ~_~_/_/) ~- ,'~ :~ d. Attach basis for 'comp'u'tation of amounts claimed (include copies of ail bills, estimates, etc.) 10, Names and addresses of all witnesses, hospitals, doctors, etc. .invoices, · ,, ii Executed this WARNING: IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM (Penal Code Section 72; Insurance Code Section 556.0) ' : I I~ave read the matters and .s~atements made'in the above ciaim and ! know the same to be true of my own knowledge, except as to those matters stated to be upon information or belief and as to such 'matters I b~lieve the same to be true. '1 certify under penal~l~ of perjury th, at,, the foregoing is true and correct. _ dayof -, - - Date flied this ~:CLAIM (1/00) SEP-10-2002 12:00 714 835 ?78? P. 05 SEP-10-~002 11:~ WOODRUFF SP~DL. IN SMART 71~ 835 7787 RBZ0003H · date: 08-15-02 ! ' ~.~ ~-:' ' '9' ~i,"~59.~:~ ' STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY AUTO PAYMENTS named insured STRI CH, SHIRLEY P.06/12 page: 1 po 1 icy numb er date of loss O3--12--O2 C cleno~es consolidated payment p denotes previous data E denotes EFT payment pa~tnumber E 123164910K E 123161679K payee ENTERPRISE RENT A CAR TOP FINISH COLLISION CEN ~ota [ amount 113.75 1,130.68 05-03-02 PAID 04-24 -02 PAID SEP-10-2002 12:00 714 835 7787 967. P.06 SEP-10-2002 11:59 WOODRUFF SPRADLIN SMART 714 835 9989 P.07/12 04/22/2002 AT 05:45 PM 49466 INSURED: SHIRLEY STRICH OWNER: SHIRLEY STRICE ADDRESS: EVENING: ( JOB NUMBER: 4017 TOP FINISH COLLISION CENTER LICENSE #:AF200353 WE MEET THE NICEST PEOPLE BY ACCIDENT 626 W. 17TH STREET SANTA ANA, CA 92706 (714)543-9713 FAX: (714)543-6050 SUPPLEMENT OF RECORD 1 WITH SUMMARY WRITTEN BY: BUCIO TONY #49466 04/22/2002 05:45 PM ADJUSTER: NELSON COVARRUBIAS # CLAIM ~75-A484-55801 POLICY # DEDUCTIBLE: 250.00 DATE OF LOSS: 03/12/2002 AT 12-30 PM TYPE OF LOSS: COLLISION POINT OF IMPACT: 5. RIGHT REAR INSPECT TOP FINISH COLLISION CENTER LOCATION: 626 W. 17TH STREET SANTA ANA, CA 92706 INSURANCE STATE FARM INSURANCE COMPANIES COMPANY: 3333 HYLAND AV. COSTA MESA, CA 92626 BUSINESS: (714) 543-9713 BUSINESS: (888) 888-0457 DAYS TO REPAIR 1999 VOLV V70 5-2.4L-FI 4D WGN SILVER INT:BLACK VIN: LIC: CA PROD DATE: 01/1999 ODOMETER: 29250 TILT WHEEL KEYLESS ENTRY CALIFORNIA EMISSIONS METALLIC PAINT POWER WINDOWS ANTI - LOCK BRAKES (4) FRONT SIDE IMPACT AIR BAG BUCKET SEATS AIR CONDITIONING CRUISE COhVfROL BODY SIDE MOLDINGS FOG LAMPS POWER STEERING POWER LOCKS DRIVER AIRBAG 4 WHEEL DISC BRAKES AUTOMATIC TRANSMISSION REAR DEFOGGER TELESCOPIC WHEEL DUAL MIRRORS CLEAR COAT PAINT POWER BRAY~ES POWER MIRRORS PASSENGER AIRBAG CLOTH SEATS NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT 1 2 3 4*' 5 6 7 8* 9* 10 11 ROOF R&I RT DRIP MOLDING W/O RAILS QUARTER PANEL RPR RT OUTER PANEL ADD FOR CLEAR COAT REPL RT WHEELHOUSE LINER R&I FUEL DOOR REPL RT STONE DEFLECTOR SUBL RT QTR GLASS VOLVO W/O ANTENNA t20% REFN FUEL DOOR ADD FOR CLEAR COAT 0.3 12.0' 1 36.88 0.3 1 22.89* 0.3 1 78.00' X 2.4 1.0 0.3 0.1 SEP-10-2082 12:00 714 835 ?78? 96Z SEP-10-~00~ 12:00 WOODRUFF SPRADLIN SMART 714 855 9989 P.08/1~ 04/22/2002 AT 05:45 PM JOB All/MB~R: 4017 49466 SUPPLEMENT OF RECORD 1 WITH SUMMARY 1999 VOLV V70 5-2.4L-FI 4D WGN SILVER INT:BLACK NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT . 12 13 14 15 16 17 18' 19 2O 21 22 23 24 25* 26* 27% 28# 29# 30~ 31% 32# 33~ 34 35# REAR LAMPS RPL CORNER LAMP ASSY R R&I RT TAIL LAMP ASSY UPPER R&I RT LENS & HOUSING LOWER REAR BUMPER O/H BUMPER ASSY RPR COVER 2WD PRIMED ADD FOR CLEAR COAT REAR DOOR BLND RT OUTER PANEL REPL RT BODY SIDE MLDG WAGON W/O V70 XC R&I RT BELT MOLDING R&I RT HANDLE, OUTSIDE R&I RT DOOR TRIM PANEL R&I RT RUN CHANNEL MISCELLANEOUS COVER CAR FOR OVER SPRAY COLOR SAND A1TD"BUFF.PER PANEL MASK JAMBS FLEX ADDITIVE COLOR MATC~ ADD TO DETAIL VEHICLE OTHER CHARGES E.P.C. I 29.66 .! I 5.00 1 10.00 X ! 5.00 1 8.00 T I X 1 5.00 SUBTOTALS ==> 0.6 INCL. INCL. 1.5 2.0* 0.2 0.3 0.2 0.5* 0.5* 0.3 1.0 0.5 1.0 0.5 2.6 1.0 1.0 200.43 22.0 8.4 PARTS 177.43 BODY LABOR 22.0 HRS @$ 32.00/HR 704.00 PAINT LABOR 8.4 HRS ~$ 32.00/HR 268.80 PAINT SUPPLIES 8.4 I-IRS @$ 22.00/HR 184.80 SUBLET/MISC. 18.00 OTHER CHARGES 5.00 ~ -- m m m m -- ~m - ................ m m m m m m m m -- ~ .... mm m m m GRAND TOTAL ~ 1380.68 ADJUSTMENTS: DEDUCTIBLE CUSTOMER PAY INSURANCE PAY 250.OO 250.00 ~o. ~ SEP-10-2082 12:00 714 835 ??8? 977. P.08 $EP-10-200~ 12:00 WOODRUFF SPRADLIN SMART 914 835 9989 P.0~/12 04/22/2002 AT 05'45 PM JOB NUMBER: 4017 49466 SUPPLEMENT OF RECORD 1WITK SUMi~RY 1999 VOLV VT0 5-2o4L-FI 4D WGN SILVER INT:BLACK THIS ESTIMATE IS BASED ON OUR INSPECTION AND DOES NOT COVER ADDITIONAL PARTS OR LABOR WI{ICH MAY BE REQUIRED AFTER THE WORK ~AS BEEN STARTED. AFTER WORK PIAS STARTED, WORN OR DAMAGED PARTS WHICK WERE NOT EVIDENT ON FIRST INSPECTION MAY BE DISCOVERED. NATURALLY, THIS ESTIMATE CANNOT COVER SUCH CONTINGENCIES. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS TI-IAT 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=MECI-IANICAL 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/~=OVERIEAUL OP=OPERATION NO=LINE NUMBER QTY~QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY REPLACEMENT PART RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT~RIGHT SECT~SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT W/ =WIT~/ SYMBOLS: #=MANUAL LINE ENTRY *=OT~ER [IE..MOTORS DATABASE INFOR~J%TION WAS CHANGED] **=DATABASE LINE WITK AFTERMARKET N=NOTES ATTACMED TO LINE. ESTIMATE BASED ON MOTOR CRASH ESTIMATING GUIDE. UNLESS OTHERWISE NOTED ALL ITEMS ARE DERIVED FROM TEE GUIDE ERN9711 DATABASE DATE 5/2001 AND TEE PARTS SELECTED ARE OEM-PARTS MANUFACTURED BY THE VEHICLES ORIGINAL EQUIPMENT MANTJFACT~R. ASTERISK (*) OR DOUBLE ASTERISK (**) INDICATES TF_AT T~E PARTS AND/OR LABOR INFORMATION P~OVIDED BY MOTOR MAY F~AVE BEEN MODIFIED OR MAY HAVE COME FROM A~ ALTERNATE DATA SOURCE. NON-ORIGINAL EQUIPMENT MANUFACTURER AFTERMARKET PARTS ARE DESCRIBED AS AM OR QUAL REPL PARTS. USED PARTS ARE DESCRIBED AS LKQ, QUAL RECY PARTS, RCY, OR USED. RECONDITIONED PARTS ARE DESCRIBED AS RECON. RECORED PARTS ARE DESCRIBED AS RECORE. NAGS PA3~T NUMBERS AND PRICES ARE PROVIDED FROM NATIONAL AUTO GLASS SPECIFICATIONS, INC. POUND SIGN (#) ITEMS INDICATE MANUAL ENTRIES. PATHWAYS - A PRODUCT OF CCC INFORMATION SERVICES INC. $EP-10-2802 12:01 714 835 7787 P.09 SEP-10-2802 12:00 WOODRUFF SPRADLIN SMART 714 835 ??8? P.10/12 04/22/2002 AT 05:45 PM JOB NI/MBER: 4017 49466 SUPPLEMENT OF RECORD 1 WITH SUM¥~kRY 1999 VOLV V70 5-2.4L-FI 4D WGN SILVER INT:BLACK PARTS 0. 0 0 -- SUBTOTAL $ 0.00 ESTIMATE . 1380.68 SERGIO NUNES SUPBT,EMENT Sl 0.00 BUCIO TONY CUSTOMER PAY $ 250. O0 JOB TOTAL $ 1380.68 INSURANCE PAY $ 1130.68 THIS ESTIMATE IS BASED ON OUR INSPECTION AND DOES NOT COVER ADDITION~L PARTS OR LABOR WHICH MAY BE REQUIRED AFTER THE WORK HAS BEEN STARTED. AFTER WORK HAS STARTED, WORN OR DAMAGED PARTS WHICH WERE NOT EVIDENT ON FIRST INSPECTION MAY BE DISCOVERED. NATURALLY, THIS ESTIMATE CANNOT COVER SUCH CONTINGENCIES. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS TF~AT 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: A/DJ=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 OF--OPERATION NO=LINE NIIMBER QTY--QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY REPLACEMENT PART RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I-REMOVE AArD INSTALL R&R=REMOVE AND REPL~CE RPR=REPAIR RT--RIGh"r SECT=SECTION SUBL-SUBLET LT=LEFT W/O=WITHOUT W/_=WITH/ SYMBOLS: ~=MANUAL LINE ENTRY *=OTHER [IE..MOTORS DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WIT}{ AFTERMARKET N=NOTES ATTACMED TO LINE. ESTIMATE RASED ON MOTOR CRASH ESTIMATING 'GUIDE. UNLESS OTHERWISE NOTED ALL ITEMS ARE DERIVED FROM THE GUIDE ERN9711 DATABASE DATE 5/2001 AND THE PARTS SELECTED ARE OEM-PARTS MANUFACTURED BY THE VEHICLES ORIGINAL EQUIPMENT MANUFACTURER. ASTERISK (*) OR DOUBLE ASTERISK (**) INDICATES THAT THE PARTS AND/OR LABOR INFORMATION PROVIDED BY MOTOR MAY F[AVE BEEN MODIFIED OR MAY HAVE COME FROM AN ALTERNATE DATA SOURCE. NON-ORIGINAL EQUIPMENT MANUFACTURER AFTERMARKET PARTS ARE DESCRIBED AS AM OR QUAL REPT, PARTS. USED PARTS ARE DESCRIBED AS LKQ, QUAL RECY PARTS, RCY, OR USED. RECONDITIONED PARTS ARE DESCRIBED AS RECON. RECORED PARTS ARE DESCRIBED AS RECORE. NAGS PART NUMBERS AND PRICES ARE PROVIDED FROM NATIONAL AUTO GLASS SPECIFICATIONS, INC. POUND SIGN (#) ITEMS INDICATE MANUAL ENTRIES. PATHWAYS - A PRODUCT OF CCC INFORMATION SERVICES INC. SEP-10-2002 12:02 714 835 7787 97Z P.10 5EP-10-2802 1Z:01 WOODRUFF SPRADLIN SMART 714 835 7?87 P.11/12 / %. ~ .. 04/22/2002 AT 05:45 BM JOB NUMBER: 4017 49466 SUPPLEMENT OF RECORD I WITH SUMMARY 1999 VOLV V70 5-2.4L-FI 4D WGN SILVER INT:BLACK ALTERNATE PARTS USAGE AFTERMARKET PARTS AFTERMARKET SELECTION METHOD: MANU~LY LIST NO. OF TIMES USER WAS NOTIFIED THAT AN AFTERMARKET PART WAS AVAILABLE' 0 NO. OF AFTERMAKKET PARTS THAT APPEAR IN THE FINAL ESTIMATE: 0 SEP-10-2082 12:02 714 835 7?87 96Z P. 11 WOODRU~ SPRADLIN SMART -- 714 855 7787 12675 WESTMINSTER AVE SANTA ANA CA g2705-213S Bill TO: STATE FARM-COSTA M;SA ACC ATTN: Processor-TeamS* P.O. BOX 5010 THOUSAND OAKS ,CA 91359-5010 Rental Agreement )e~cription 4 DAYS 4 DAYS DW 4 DAYS PA! SLP SALES T~X% Dele Out Date In 4/15/02 4/19/02 Renter SHIRLEY STRICH Address City State Dr~er Llce~e State Home Phone Office Phone Expires 5/07/03 Naive NO OTHER DR~VER PE'RM!TTEO Age Ikivef License. :Stale Expires r0TAL CHARGES .ESS AMOUNT RECEZVEO D787557 - 3282 Rate Amount 32.99 iai.g6 8.99 85.96 3,00 12.OO 39.80 7.75 10.28 229,9( 116.2C 113.75 Color BRONZE Model 02 ]MPA License No. Claim #/Poliw #IP.O, # 4SLX224 ' 75A484558 Unit # Insured KE6533 STRICH' SHTRLEY* O~le of Loss Type of Loss 3/12/02 INSURED Type of Car Repair Shop VOLW?O TOP FIN[SH Billing Inquiries Call 14-554o6640 Illllng Information Fad Tax ID # 95-3475810 Thank You For Choosing Enterprise O0 YOU KNOW WE RENT SPECIALTY VEH[CLES? *. PICK'UPS ~a 4X4'S ua -* PASSENGER VANS "* LUXURY CA~S ** I I · t · · I I · I · · · · I I · I · I' I I / I Please Retum This Portion with Remittance AMOUNT DUE ........... ."' ~ · I I 113,75 Remit ENTERPRISE RENT-A-CAR ATTN: ACCTS RECEIVABLE 18151 BEACH BLVD. HUNTINGTON BEACH CA g2646-1306 Paid by:. STATE FARM-COSTA MESA ACC ATTI~ Processor. TeemS. P.O. BOX 5010 THOUSAND OAKS CA 9135g-501D ~/23 stomer#Re__n~t_aI.A. gteement Amount GPBR F32KG U7aTlt b/ 113.75 3282 SEP-10-2 4 835 ??8? II II TOTAL P, 12