HomeMy WebLinkAboutCC 3 CLAIM #91-39 12-02-91CONSENT CALENDAR NO. 3
E12-2-91
N DA
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DATE: NOVEMBER 18, 1991
TO- HONORABLE MAYOR AND CITY COUNCIL
FROIA: CITY ATTORNEY
SUBJEC-11-: CLAIMANT: DONALD ROBBINS; D/L: 07-22-91; DATE FILED W/CITY:
08-16-91; CLAIM NO: 91-39; CARL WARREN FILE NO: S 66590 PRL
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. ^_ 'A
JAMS G. ROURKE, City Attorney
]GR: jab: I I 1591(CL-9139.jab)
Enclosure: Copy of Claim
cc: Carl Warren & Co.
Finance Director
City Manager
CITY OF TUSTIN
Office of the City Clerk
RECEIPT OF CLAIM
CLAIM NO.
A L C NO.
Pet. NO.
9/- 3q
THE ATTACHED DOCUMENT WAS RECEIVED ON:
Date: � I& , 19 -I i ; Time:
BY:
Personal service upon the undersigned
V Regular Mail
Certified/Registered Mail
Copy on g-19 -9
Carl Warren & Company
City Attorney
Department Head
Finance Department
Formbw - Receipt
5/13/88
to the following:
0.1 as .M.
Signature
B. White
Print Name
Deputy City Clerk
Position
City of Tustin
X AGAINST THE CITY OF TU N
(For Da Jes to Persons or Personai zoperty)
The law provides
generally that a claim must be filed with the City
Clerk of
'-'-e City of Tustin within 6 months after the incident or
event occurred. Be
_e your claim
is against the City of Tustin, not another public
entity.
"dere 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 INR
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 CLAIMANT: Donald E. Robbins Jr.
b.
ADDRESS OF CLAIMANT:
C.
CITY/ZIP CODE:
e.
DATE OF BIRTH:
f .
SOCIAL SECURITY 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. XX 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 event from which the claim arises:
a. DATE: 7/22/91 (approx.)
b. TIME: 1 lam (approx.)
C. PLACE (Exact and specific location):
13502 Falmouth Dr. Tustin Ca 92680
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):
See attached details
e. WHAT particul?" action by the City, or employees, caused the
alleged damag injury?
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".
no injuries see attached details
6. Give the name(s) of the City employee(s) causing the damage or injury:
N/A
7. Name and address of any other person injured:
N /A
8. Name and address of the owner or any damaged property:
Same as above
9. Damages claimed:
a. Amount claimed as of the date: unknown
b. Estimated amount of future costs: none
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.
N/A
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 9t4S ,19 ` 1* , at Tustin, California.
DATE FILED:
CLAIMANT'S SIdNATURE
.CLFORM
Revised 4/29/91
During the installation of Stop lights at the intersection of Bryan Ave and Farmington Dr.
the construction crew dug -up portions of the side walk on the south side of Bryan Ave.
This was accomplished by Jack -hammers and Heavy equipment. Adjacent to the same
sidewalk is my property line and a two foot high block wall. Upon returning home from
work one afternoon, I found an eight foot long section of the wall had fallen down onto my
lawn. I talked to the supervisor of the construction crew who said that they had seen the
damage, but claimed that they had not caused it. I don't believe that the crew did
intentionally knock down the wall, however, the operation of Jack Hammers and heavy
equipment directly adjacent to the wall did cause the damage. At this time, I don't have an
estimate of the cost to repair the damage.
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