HomeMy WebLinkAboutCC 6 CLAIM #88-29 08-01-88, :, ',~ '""~ i~ ] -~ "':""'~ ~ONSENT CALENDAR
HO. 6
-- 8-.1,88
~ -,
~,,7'F' July 18, 1988
~ONORABLE MAYOR AND CI?f COUNCI~~'
CIT!I ATTORNEY
$ U5J £C7:
CLAIMAA'T: PACIFIC BELL ; D/L: 2/5/88 DATE FILED
W/CITY: 5/2/88 ; CLAIM NO: 88-29 ; CARL WARREN FILE NO:
54708CS
After investication and review it
' '- . .nc. the above-
referenced claim be rejec=ed and the Ci:y Clerk direc=ed to give
proper no~ice of the rejection ~o the c~aimant and
a..o-ney.
City A;~crnev
JGR (F4. se)
?'.'n cZ osur e:
Copy cf Claim
' rASE ~O ~F$46-0133
·
CLAIM AGAINST THE C~ ' TUS'~
(For Damages uo Pe~ ,s or Personal Property)
Received by . via
o
U.S. Mail
Inter-office'Mail
Over the Counter
The law provides generally that a claim must.De filed with the City Clerk
the City of Tustin within 100 days after which the incident or event occurred
Be sure your claim is against the City of Tustin, not another public entity.
Where space is insufficient, please use additional paper and identify informs
tion by paragraph number. Completed claims must be mailed or delivered to
City Clerk, The City of Tustin, 300 Centennia~ Way, Tustin, California 9268~
TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Tustin, California:
The undersigned respectfully submits the following claim and information re!a.
tire to damage,'to persons and/or personal property:
1. NAME OF CLAIMANT: PACTFTC B~LL (ATTENTION: ~. A. Roach
. ,.
a. ADDRESS OF CLAIMANT: 10!0 w~c~ ~.! . =~ (n~ _ T~_ :...
- -- h~ OF BIRTH:
b. PHONE NO: ( 213) 975-3305 c .... ~-
SOCIAL DRIERS
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: (Attention: H. A. Roach, JF$46-0!33)
10~ W~H~ R~vmrd. ~onm ~2!. Lo~ ~e!e~. California 90017 _
This claim is submitted against:
a .
= ........ -The-City of-'Tustin only.
~ The following employee(s) of the City of Tustin on~y:
,,,
C ·
The Cit-y of Tustin and :ne f¢iiow~ng employee(s) o~ the
City of Tustin only:
,,
Occurrence or event from which' the claim arises:
a DATE: 2-5-88 b 'TIME- ~-~.~,~ - PLACE (Exact
and specific ioca~ion): South side of Edin~er, 19,~ feet west o~
.~,%H !980 (west of Redhi!!) , Tustin.
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).
bur under~r~[~ m-~h~ 'wm~'dm~cm~ 'Wbe~ ~re~t light posts were
e. What particular action by the ~City, or its employees, caused the
alleged damage or injury? ' ~
Give a description of the inju~f, DroDer:y. . damage or loss so far as is
known at the time of this claim. If there were no injuries, s%a~e "no
injuries".
~r ,~nd~rqround cable w~ d~maged.
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 of any damaged property:
..
,
Pacific Bell
Damages claimed:
a. Amount claimed as of this date: $729.12
b. Estimated amount of future
c. To~a! amount claimed: .$729.12
d. Basis for computation of amounts claimed (include copies of =~.-~ '~ Di'~s,
invoices, estimates, e~c.: . .
10c Names and addresses of all witnesses, hospitals, doctors, etc.:
ao
o
do
Any addit-iona! information that migh~ be helpful in Considering this claim:
WARNING: .%T IS A CRIMINAL OFFENSE TO FILE A FALSE CLAI~.!: (Penal Code
Section 72; Insurance Code Section 556.0)
~ have read =he-ma,:ers and ~ ~ ~ '
s.a~emen~s made in the above claim and I know the
same to be =.--ue of my own knowledge, except as to those ma~ters sta~ed to be
upon information or belief and as %0 such ma~.=ers I believe ~he same to De true.
i certify, under pena!~y cf.perju.~".~ ~ha~. ~he ~oregcing ~: TRUE AND CORRECT.
Executed this ~=~ day of
Office_ of the City Clerk,
Tustin, California
ZLAiM NO:
Aoril , 19 .3.3 , at Tus~in, California.
,,
PACIFIC BELL
?
/ CLA%MANT
J' W' /Jones,'" P. eciona~. _ ~aims i, lanager
/
.
.
"'
DATE FILED:
Revised 8/05/81
JGR:se:R:8/5/81 (A)
_ .