HomeMy WebLinkAbout07 CLAIM 95-37 02-05-96A PROFF$$1ONAL CORPORATION
NO. 7
2-5-96
MEMORANDUM
TO:
Honorable Mayor and .Members of the City Council
City of Tustin
FROM: City Attorney
DATE:
RE:
January 24, 1996
Claim of Harry F. Smith; Claim No. 95-37 '
RECOMMENDATION:
After investigation and review it is recommended that the above-referenced claim
be rejected and that the City Clerk be directed to give proper notice of the rejection to the
claimant and to the claimant's attorney.
DISCUSSION:
Claimant alleges that he incurred damages due to a sewage stoppage traceable to
a break in his sewer lateral, located under a newly installed City water wain. The amount
claimed is $1,660. If, in fact, the claimant's sewer lateral was damaged in the process of
installing the City's water main, this was the responsibility of Steve Casada Construction,
the City's contractor. The City has notified Mr. Casada of this claim and of his potential
responsibility.
LOIS E. JEFFI~EY~/ u
Enclosure
cc: William A. Huston, City Manager
Pamela Stoker, City Clerk
1102-O9537
23748_1
(For
city of Tustin --
~ .IH AGAINST THE CITY Ov ~U iN
lages to Persons or Per: .1 Property)
The law provides generally that a claim must be filed with the City Cler~' of
the city of Tustin within 6 months after the incident or event occurred ~e
sure your claim is against the City of Tustin, not another public entity.
Where space 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 Tustin, 15222 Del Amo Avenue, Tustin,
California 92680
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 to person and/or property:
so
Ce
f. SOCIAL SECURITY NO:
g. DRIVERS LICENSE NO:
ADDRESS OF CLAIMA~T".'i~//fl
CITY/ZIP CODE:
TELEPHONE NO:
DATE OF BIRTH:
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. 9( TJ~e following employee~sJ of th~ City_of Tustin onlyx:
Ce
The City of Tustin and the following employee(s) of the City
of Tustin only:
4. Occurrence or event from which the claim arises:
a. DATE: IOI~LI
b. TIME: /.'/.~ ~
c. PLACE (Exact and specific location):
d. HOW and under what circumstances did damage .or inju~ occur? Specify
the particular occurrence, event, act or omission you claim caused
the injury or damage (Use additional paper if necessary):
ee
WHAT particula~' action by the City, or i~-~ employees, caused the
a~leged damag,' ': injur ~ '
5. Give a description of the injury, property damage or loss so far known at
the time of tb/is claim. If there were no injuries, state "no injuries".
6. Give the name(s) o.f the city employee(s) causing the damage or injury:
/
7. Name and address of any other person injured: ~/./~
8. Name and address of the owner or any damaged property:
9. Damages.claimed: ~~0~
a. Amount claimed as of the date:
b. Estimated amount of future costs: ~O~~-~
c. Total amount claimed: /~0. ~
d. Attach basis for computation of amounts claimed (include copies of
all bills, invoices, estimates, etc.
10. Na,_~_.s and a~dresses of ~11 witn_~esses., h. qspital~ doctors, etc. '
WARNING:
IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM!!
(Penal'Code Section 72; Insurance Code Section 556.0)
...
I have read the matters and statements made in the above claim and I 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 believe the same to be
true. I certify under penalty or perjury that the foregoing is TRUE AND
CORRECT.
Executed. this day of
DATE FILED: /~/~'/~"
,19
, at Tustin, California.
BI:CLFORM
Revised 4/29/91