HomeMy WebLinkAboutCC 4 CLAIM #90-35 03-04-913-V-yi
DATE: FEBRUARY 19, 1991
TO: HONORABLE MAYOR AND CITY COUNCIL
FROM: CITY ATTORNEY
CONSENT CALENDAR NO. 4
3-4-91
Inter - Com
SUBJECT: CLAIMANT: JOHN HUTCHERSON; D/L: 8/13/90; DATE FILED W/CITY:
10/11/90; CLAIM NO: 90-35; CARL WARREN FILE NO: S63730PRL
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.
3PARME G. ROURKE
City Attorney
JGR:kbg(claim.frm)
Enclosure: Copy of Claim
'(For Damages to Persons ^r Personal Property)
Received by
U.S. Maily-
Inter-office Mail
Over the Counter
via
f e law provides generally that a claim must be filed with the City Clerk o
the City of Tustin within 100 days after which the incident or event occurre<
Be sure your claim is against the City of Tustin, not another public entity.
Where space is insufficient, please use additional paper and identify inform( -
tion by paragraph number. Completed claims must be mailed or delivered to tl
City Clerk, The City of Tustin, 300 Centennial Way, Tustin, California 92680
TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Tustin, California:
The undersigned respectfully submits the following claim and information relc-
tive to damage to persons and/or personal property:
1. NAME OF CLAIMANT:
a. ADDRESS OF CLAIMANT:
b. PHONE NO: ( c._ DATE OF BIRTH:
SOCIAL 'DRIVERS
d. SECURITY NO: e. LICENSE NO:
2. Name, telephone and post office address to which claimant desires notice;
to be sent, if other than above:
SAME
3. This claim is submitted against:
a. X 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: 8-13-90 b. 'TIME: 5:00 P.M. C. PLACE (Exact
and specific location): Intersection of Tustin Ranch and Irvine Blvd.
d. flow and under what circumstances did damage or injury occur? Specif%
the particular occurrence, event, act or omission you claim caused
the injury or damage (Use additional paper_ if necessary).
I WdS drlylnS,, wesLbound on Irvine Blvd. and hit an open water valve
71-3r, holCnv('r_ '1'lle cover was turned sideways in hole. 1 hit Lhe _
rnvrr Mid r:�v 1-1re and
e. What particular action by the City, or its employees, caused the
alleged damage or injury?
Someone d i_d not secure the cover ,)roi)crl y.
5. Give a description of ',e injury, property damage r loss so far as is
known at the time of 3 claim. If there were i injuries, state "no
injuries".
_ Destroyed tire- A two inch gash in the sidewall and the rin was
severely bent.
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 of any damaged property:
9. Damages claimed:
a. Amount claimed as of this date: $329.00
b. Estimated amount of future costs: 0.00
C. Total amount claimed: $329.00
d. Basis for computation of amounts claimed (include copies of all bi'l'ls,
invoices, estimates, etc.: Estimate from the Wheel Warehouse
10. Names and addresses of all witnesses, hospitals, doctors, etc.:
a. -
b.
C.
d.
11. Any additional information that might be helpful in considering this claim:
I called police when I got home (approximately 6:00 P.M.). They
supposedly sent someone out but they were looking for a full size
manhole cover, not the smaller water valve manhole cover.
Sgt. Fisher took report and took pictures of damage.
WARNING: IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIPI! (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 of perjury that the foregoing is TRUE AND CORRECT.
Executed this 4TH day of October , 1990 , at Tustin, California.
Of L ice or the City Clerk,
Tustin, California
--' LA I I'l N0 :
°v ised 8/05/81
JGR: se : R: 8/5/81 (A)
CLAIfIANT ' S SIGNAT URE
DATE
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