HomeMy WebLinkAboutC.C. 11 CLAIM 92-07 02-18-92a h
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ATE FEBRUARY 11, 1991
CONSENT CALENDAR NO. 11
2-18-92
T �'
I.): HONORABLE MAYOR AND CITY COUNCIL
I--
QOM: CITY ATTORNEY
'1 -17-92; DATE FILED W/CITY:
AB i E C , T: CLAIMANT: ENTERPRISE FLEETS; D/L: 09
01-27-92; CLAIM NO: 92-07; CARL WARREN FILE NO: S _.- 66949 C . LB
After investigation and review it is recommended that the
above -referenced claim be rejected and the city Clerk directed to
give proper notice of the rejection to the claimant and to the
claimant's attorney.
JAMESL;*frRMRKE, City Attorney
JGR: jab: D:021192(CL-9207jab)
Enclosure: Copy of Claim
cc: Carl Warren & Co.
Finance Director
City Manager
City of Tustin
:M AGAINST THE CITY OF TU' N
(For Da_ _3es to Persons or Personal :operty)
ie law provides generally that a claim must be filed with the city ent occurred. of
Be
..he City of Tustin within 6 months after the
not another public entity.
sure your claim is against the City of ,.
Where space is insufficient, please use additional paper be dma identify
Wh P
information by paragraph number. Completed claims m
delivered to the City Clerk, City of Tustin, 300 Centennial Way, Tustin,
California 92680
WHEN COMPLETING THIS FORM, PLEASE TYPE OR USE BLACK -INK
To THE HONORABLE MkYOR AND CITY COUNCIL, City of Tustin, California:
The
undersigned respectf_uliv submits the following claim and information
relative to damage to person and/or property:
1, a. NAME OF CLAIMANT: E h T W 'Pr �` Let
b. ADDRESS OF CLAIMANT: :
C. CITY/ZIP CODE:
e. DATE OF BIRTH:
f. SOCIAL SECURITY NO:
g. DRIVERS LICENSE NO:
2. Name telephone and post office address to which claimant desires notices
to be sent (if other than above):
3. This cl m is submitted against:
a. The City of Tustin only.
b. The following employee(s) of the City of Tustin only:
C,
The City of Tustin and the following employee(s) of the City
of Tustin only:
4. Occurrence or eve t from which the claim arises:
a. DATE: / 17 g I
b. TIME: -3-
C.
-
PLACE Exact and specific location) : A ►�+ n
%t CA.
161 vs �--; occur?
Specify
d. HOW and under what circumstances did da og omission you claim caused
the particular occurrence event, act
the injury or damage (Use �a�d/d?itio%nal paper if necessary) : Gn
yr '
►moi ✓r/ r uti.
✓5P
the Cit or employees, caused the
e. WHAT particul ction by Y.
alleged damag�r injury? _ �j / /'4
n 71 ye ,,
5. Give a description of the injury, property damage or loss so far known
at the time of this claim. If there were no injuries, state no
injuries". _ wm k C 16, , V 7
�
1 vim,• 1. �f,i �
6. Give the nai e(s) of the City employee(s) causing the damage or injury:
s o f an other person inj ured :
7. Name and addres Y
8. Name and address of the owner or any damaged property:
9. Damages claimed:
a. Amount claimed as of the date:
b. Estimated amount of future costs:
cTotal amount claimed:
d.. Attach basis for computation of
all bills, invoices, estimates,
101. 01-'
O
1671 °'
amounts claimed (include copies of
etc.
1-0. Name and addresses of all witnesses, hospitals, doctors, etc.
m
WARNING: IT IS A CRIMINALOFFENSE TO FILE AFALSE
CLAIM!!
ction 556.0)
(Penal Code Section 72; Insurance Code
I have read the matters and statements made in the above claim s nso
w the
xcept as to those matters to be
same to be true of my own knowledge, e
• tetters I believe. the same to be
upon in or belief and as to such matters
I certify under penalty or perjury that the foregong is TRUE AND
CORRECT.
Executed this day of o2 �6 � 119 J�,, at Tustin, California.
I
DATE FILED: A
CLAIMANT'S SIGNATURE
B1:CLFORM
Revised 10/23/90
ENTERPRISE LEETS INC.
#7 HUNTER AVEN
ST. LOUIS, MO. 63 .
GPCR LAG_-C1IGENT REPORT — FP"'TS — Sr. EE��
.i . _
�./�..f= { {��'�=rr GCS r -RVICE�^ii.{`iT•�i�lyT�lZ=
CLk I
}{ Jr L:4 ^.e:—:'1 L: LrT �+� 11 -t V i y i
&-fA E .. •_riLv TH.FT {_L.rsS RENTAL {1{ -Jt*. eR Wit# {
CCRMO3
L1 1 L: AC
srr% }• s tri JI". = SE S 9 t _HEY i�i�i 2 ra '.ra � /�•�
;�isIIT Jyt _I{*i•i'{Mir.Lr•'{e ADL: f�{T. t
tjS!'' f" �'^Lt'.I =•E*T* �l:LE:={GE s_=-'_ r,^_.LCR
.T # GC_4_ yam:_
DRIVER TA YL0R *E0WA' R 00—w
ADR 3
CONTAC s E I L B ER w -MITCHELL*
r•i{..r t* m
s
r% r%
P�
1-dLi t* G l�
�
t. l-. t lr—r. �. .. AGE Cl�^J RELATIONSHIP E
DR i VE{R• I N OL v EED TA { LOR M I T��-tELL'�'
FACTSCA • THE CL={ I M eNT VEHICLE
OUR DRIVER WAS k�ES''BO� it�C Opti EL O{ -{M I t!O t I t1 FUST _ i� t
EHICLE
WAS #AOR THBOUND ON RED HILL, WHA I T I N 2 ATTR RED � L I Gi- R . ! H THE CLAIMANT � Y � � �8 -&- —
Wi=t= t+ POLs:.tE Ci�R 4t;:�EIREt;E r�� Iiti F��E�..fI { �F A.�+��'�-:cs'�. �Er{3,..►,..
POLICE Ci=tT+' PUL :ECS FOR WWA..R G :=:ND WE STR UC f :
EO THROUGH THE INTERSECTION THE n TRUCK WHICH
STRUCK IT. OUR DRIVER t�EN T IONED THAT TO HIE RIGHT WAS 1-; Q0 �:
BLOCKED THE VIEW OF THE BETWEEN THE POLICE CAR AND US.
January 6, 1992
ENTERPRISE FLEETS INC.
CORPORATE HEAOOUARTERS:
7 HUNTER AVENUE, ST. LOUIS, MISSOURI 63124 • 314-863.1111
City of Tustin
300 Centennial Avenue
Tustin, CA 92680
Attn: Risk Manager
Date of Loss:
Our Client:
Our Claim Number:
Our Driver:
0.:r Unit lyftiber:
Your Insured:
• City Vehicle Number:
�� t'G�
1 A.' rjV 199#2
JAN 2 7 1992
FINANCE DEPT.
09-17-91
GCS Services
04988
Taylor
J01003
Morgulies
807
Madam or Sir:
shed is a copy of the repair bill for the damage our vehicle sustained in the
above referenced loss. The amount of our damage is $1,671.07.
After you have had a chance to review this information, please make your draft
payable as follows:
Enterprise Fleets Inc.
#7 Hunter Avenue
St. Louis, ND 63124
Attn: Claims Department
Thank you for your cooperation in this matter. Should you have any further ques-
tions, please feel free to contact me.
Sincerely,
E NI'ERPRIS� FMS INC.
�L
Paul Coates
National Claims Supervisor .
PC/ko
Enclosure
National Specialists in Vehicle Fleet Management