Loading...
HomeMy WebLinkAboutCC 4 CLAIM #90-37 11-19-90DATE: NOVEMBER 5, 1990 �.�-f- yC.110. TO: HONORABLE MAYOR AND CITY COUNCIL CONO-''T CALENDAR NO. 4 1- 0 Inter - Com FROM: CITY ATTORNEY SUBJECT: CLAIMANT: VANESSA BEATTY-DULEBOHN; D/L: 9/29/90; DATE FILED W/CITY: 10/18/90; CLAIM NO: 90-37; CARL WARREN FILE NO: s 63749 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. 1. JAMES G. ROURKE City Attorney JGR:kbg(claim.frm) Enclosure: Copy of Claim Received by via U.S. Mail Inter -office Mail Over the Counter e aw provides generally that a claim must be filed with the City Clerk o City of Tustin within 100 days after which the incident or event occurrec Be sure your claim is against the City of Tustin, not another public entity. Where space is insufficient, please use additional paper and identify informa tion by paragraph number. Completed claims must be mailed or delivered to th 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 rela tive to damage to persons and/or personal property: 1. NA11E OF CLAIMANT: Vanessa Beatty-Dulebohn 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 notices to be sent, if other than above: 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: 9-29-90 b. TIME: approx. 5:30 pm c. PLACE (Exact and specific location): Prospect Blvd.(front of Columbus Tustin Intermediate School's softball field) d. Flow 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). Was driving North on Prospect when a softball hit my front windshield on the driver's side of my '79 GLC Mazda resulting in a shattered windshield. The softball was being used during an organized adult softball game. It was hit over the fence and into Prospect Blvd. e. What particular action by the City, or its employees, caused the alleged damage or injury? The fence posted around the field is obviously nom hig_11_enough for an adult softball game to be played there. 'I'hc_Ci_t_y_'_E Park and I:ecreation gives these adult sotl��.I >—P�-s ��'Lnl1ss1-on to p ay i�1� this field. _ — 5: Give a description of the injury, property damage or loss so Ear as is known at the time of s claim. If there were injuries, state "no injuries". No injury. Property damage = shattered car windshield 6 - Give the name(s) of . the City employee(s) causing the damage or injury: Columbus Tustin Intermediate School's softball field 7. Name and address of any other person injured: 8. Name and address of the owner of any damaged property: Vanessa Beatty- Dulebohn, 11862 McPherson Rd., Orange, CA 92669 9. Damages claimed: a. Amount claimed as of this date: $180.00 b. Estimated amount of future costs: 0 C. Total amount claimed: $180.00 d. Basis for computation of amounts claimed (include copies of all bills, invoices, estimates, etc.: Estimate from Rabun's Auto Glass 10. Names and addresses of all witnesses, hospitals, doctors, etc.: a. Carlos Becerra (Fairway Ford) (714) 579-3874 b, C. d. 11. Any additional information that might be helpful in considering this claim: I was told by the softball players that I was the second car to be hit that day. I feel that the City of Tustin is responsible for this claim because it was from your field that the ball that hit my. car came fron and you gave the organized teams permission -to play in that field. :qARNING : IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM ( Penal Code Section 72; Insurance Code Section 556.0) 1. 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 ipon information or belief and as to such matters I believe the same to be true I certify Ender penalty of perjury that the foregoing is TRUE AND CORRECT. Executed this 16th day of October 19 90 at Tustin, California. Jf f ice of the City Clerk, Austin, California LA I I1 N O :� ped 8/05/81 7�_ _ se : P.: 8/ 5/ 81 ( A ) CLAIMANT'. SIGNATURE DATE FILED: abun's a'".Vto Glass Co.. 302 East First Street • Santa Ana, CA 92701 (714) 550-959+ IST:' 15'77 0 (714) 537=0194 ."Zit16 16� NAME __r•�. �`�`� �'�� �iG�7J !'c/YL.r.� ADDRESS CITY SOLD 8Y CASH C.O.D. I CHARGE ON ACCT MDSE. RETU. PAID OUT DUAN. DESCRIPIION PRICE AMOUNT 3 4 S 7 j 8 �- 9 10 II 12 i3