HomeMy WebLinkAbout04 CLAIM #95-8 04-17-95A PRc)trlr$SION/~,. COR'II~TION
MEMORANDUM
NO. 4
4-17-95
TO:
Honorable Mayor and Members of the City Council
City of Tustin
FROM: City Attomey
DATE: April 5, 1995
Claimant: Gregory Vaughan; Claim No.- 95-8; D/L: 3/11/95;
Date Filed w/City: 3/17/95; Carl Warren File No.: S 84062 PRL
Recommendation:
After investigation and review it is recommended that the above-referenced claim be
rejected and the City Clerk be directed to give proper notice of the rejection to the claimant and
to the claimant's attorney.
Background:
A City tree uprooted during a violent storm and struck Mr. Vaughan's car. There is no
evidence of City negligence. Rather, the damage was due to "an act of God." Mr. Vaughan
has submitted an estimate only for the windshield repair ($327.58), but no information has been
provided on the repair of the dents and scratches. Carl Warren estimates that the total damage
claimed could be $1500 or more.
Lois E. Jeffrey
Enclosure: Copy of Claim
CC:
Carl Warren & Co.
Finance Director
City Manager
11000O022
11262_1
Office of the City Clerk
March 17, 1995
Carl Warren & Co.
P. O. Box 25180
Santa Ana, CA 92799-5180
g 0 1995
300 Centennial Way
Tustin, CA 92680
(714) 573-3026
FAX (714) 832-0825
Re-
Transmittal of Document(s)
C1 aimant: Gregory Vaughan
Claim No.- 95-8
Filed With City- 3-17-95
Receipt of Claim/Summons and Complaint by the City Clerk's Office on-
Date- 3-17-95
Time- 2:45 p.m.
By: ,, X
Personal Service upon the undersigned
Regular Mail
Cert i fi ed/Regi stered Ma i 1
The enclosed Claim (or Application to File Late Claim) was presented to
this office as indicated above and has been referred to the appropriate
City department for its investigation amd also to the offices of Rourke,
Woodruff & Spradlin, Attn: Lois E. Jeffrey, Interim City Attorney. By
this letter, you are authorized to commence the necessary investigation of
this claim on behalf of the City.
We request that you give such'notices as may be appropriate to the City's
insurance carrier{s) and further request that you submit your preliminary
and all subsequent reports to the City, with a copy to the City Attorney
and to the insurance carrier{s) if they so request. Upon receipt of
advice from the City Attorney, we will plan to present this matter to the
City Council and/or take such other steps as are directed by the City
Attorney.
Other-
A copy of this letter and enclosures were sent on 3-20-95
City Attorney, Department Head, and Finance Department.
Sincerely,
Deputy City Clerk
to the
Enclosures
City of Tustin
AIM AGAINST T~R CITY OF = fin
(For Damages to Persons or Personal Property)
The law provides generally that a claim must be filed with the City Clerk of
the City of'Tustin ~ith~n 6 months after the incident or event occurred. Be
sure your claim is against the C~ty 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, 300 Centennial Way Tustin
California 92680 ' ,
WHEN COMPLETING THIS FORM, PLEASE TYPE OR USE BL~CK 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:
1. a. NAME OF CLAIMAN'~: ~ ~ ~ G O ~ Y V ~'~ G ~ ~ ~ .
b ADDRESS OF CLAIMANT.
' -- _
c. CITY/ZIP CODE: ~/-~
d. TELEPHONE NO: {-
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 claim is submitted against:
a. ~ The City of Tustin only.
b. '
The following employee(s) of the City of Tustin only:
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: ~ - ~-~
c. PLACE (Exact and specific location): ~(~p0~
d. HOW and under what circumstances did damage or injury oCcur? Specify
the particular occurrence; event, act or omission you claim caused
the injury or damage (Use additional paper if necessary)-
e. s employees, caused the
._
WHAT particv' action by the City, o'
alleged dam&~ ~r injury?
' iqEEE 'EL.L
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-.
6. Give the name(s) of 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:
a. Amount claimed as of the date:
b. Estimated amount of future costs:
c. Total amount claimed:"
d. Attach basis for computation of. amounts claimed (include copies of
all bills, invoices, estimates, etc.
10. Names and addresses of all witnesses hospitals '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 ~s 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 177"-H day of_ ~'~ R PO~
,19 ~~, at Tustin, California.
DATE FILED:
~ATURE
B1 - CLFORM
Revised 4/29/91
MAR j 1995
Office of the City Clerk R[)LII~K,~. WOODRUFF ~; SPRADLiff
March 20, 1995
Carl Warren & Co.
P. O. Box 25]80
Santa Ana, CA 92799-5]80
Re-
Transmittal of Documentls)
C
ity of Tustin
300 Centennial Way
Tustin, CA 92680
(714) 573-3026
FAX (714) 832-0825
Claimant- Gregory Vaughan
Claim No. ' 95-8
Filed With City- 3-20-95
Receipt of Claim/Summons and Complaint by the City Clerk's Office on'
Date' 3-20-95
Time' 2'20 p.m.
By- X
Personal Service upon the undersigned
Regular Mail
Certified/Registered Mail
The enclosed Claim (or Application to File Late Claim) was presented to
this office as indicated above and has been referred to the appropriate
City department for its investigation-and also to the offices of Rourke,
Woodruff & Spradlin, Attn: Lois.E. Jeffrey, Interim City Attorney. By
this letter, you are authorized to commence the necessary investigation of
this claim on behalf of the City.
We request that you give such notices as may be appropriate to the City's
insurance carrier(s) and further request that you submit your preliminary
and all subsequent reports to the City, with a copy to the City Attorney
and to the insurance carrier(s) if they so request. Upon receipt of
advice from the City Attorney, we will plan to present this matter to the
City Council and/or take such other steps as are directed by the City
Attorney.
X Other'
. ,
Estimate for vehicle repair
A copy of this letter and enclosures were sent on 3-20-95
City Attorney, Department Head, and Finance Department.
Si/p~erely,
Beverley White:J
Deputy City Clerk
to the
Enclosures
INS CO
ADDRESS
' 'ALL STAR GLASS
CO. TIME IN SHOP __
TIME - MOBILE .,
GLASS REP. AIR WORK ORDER · O~',ESTIMATE //
CITY
/"t'~ { 1'- ~ ' -- __ ~HONE NO. _
ADDRESS', ,.,. , [ /'1,
CITY .......... .. --' _ RIFLED BY _
NAME OF INSURED liES. PHONE
ADDRESS
·
CiTY
' ____ BUS. PHONE
POLIC,Y NO ' , CLAIM NO.
~ NY e CENTRALIZE 131LLINb ~
Yea¢
Make
Moctet
WINDSHIELD
BACK GLASS
V'IO -
DATE OF LOSS
CAUSE
DOOR GLASS R O
LD
VENT GLASS R El L D
QUARTER GLASS R [3 L D
Installation Supplies Used
Gasket
Number of Tape Kils
Number of Urethane Tubes
Number of Clips
Number of Rivets
Number of Epoxy Cups
Moldings Used
Cowl Plugs
Rollers
Window Guides
Miscellaneous
3mer's Signature
DATE REPORT RECEIVED-
Or- FICE CLERK
Installer's Signature
ESTIMATES SUBJECT TO C'-iANC, E w~THC)L/T NOTICE