HomeMy WebLinkAboutCC 3 CLAIM #84-23 11-05-84CONSENT CALENDAR
NO. 3
11-5-84
Inter -Corn
~~R~LE '
TO: MAYOR AND CITY COUNCIL
F~0M: JAMES G. ROURKE, CITY ATTORNEY
SUBJI~CT: CLAIMANT: YOUNG, JAMES P.; D/L: 7/11/84;
DATE FILED W/CITY: '10/8/84: CLAIM NO: 84-
23; CARL WARREN FILE NO: S 39730 GH
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.
JGR (F4. se)
Enclosure:
Copy of Claim
cc: OCCRMA
dLAIM AGAINST THE CIT~' TUSTIN
('For Damages to Persons or Personal Property)
Received by ~(7%~ ~_ tJ via
U.S. Mail K/ ~_
Inter-office Mail~
Over ~he Counter ~
The ia~ provides generally that a claXm must De ~iled witt% the City Clerk
the City of Tustin within 100 days after which the inciden~ or event
Be sure you= claim is a~ainst the City of Tustin, not another public entity-
Where space is insufficient, please use additional paper and idenCiEy inEo~a-
~ion by paragraph n~ber. Completed claims must be mailed 0r delivered-to ~he
~ Clerk, The Cit~of Tustin, 300 Centennial W~ Tustin, California 92680
TO T~E aONO~LE ~OR ~D CITY CO~CIL, City of Tustin, California:
The undersigned re~pectf.ully submits ~e following claim and info,etlon ~la-
~ive to damage ~o persons and/or personal prope~y:
b. PHONE NO: ( ,~ x c. DATE OF ~IRTH: ~-~ ~
SOCI~ ~ . DRI~
d. SZ~RZ~ NO: ~ e. L~C~SZ NO:
2. Name, ~elephone and pos~ offic~ address to which claiman~ desires no,ices
~o be sen=, if other than above:
This claim is submitted against:
a. ~ The City of Tustin only.
b. The following employee(s) of the City of Tustin only:
The City of Tustin and the following employee(s) of the
City of Tustin only:
arLseS
Occurrence or event from which the claim ' :
a. DA=E: 7'11' b. c. PLACE (Exact
and specific location):
d. How and under what circumstances did damage or injury occur? Specify
the particular occurrence, event, act or omission you claim caused
the injury 9r damage (Use additional paper if necessary).
What particular action by the City, or its employees, caused the
alleged dame e or injury?
"'w. Give a des=rip=ion of the'injury, proper=y damage or loss so far as is
· known a= the =ime of ~his claim, if :here were no injuries, s%a=e "no
injuries".
6. Give =he name(s) of the City employee(~) causing the damage or injury:
7. Name a~cl address of any other person injured: ~'~'6
8. Name and address of' =he owner of any damaged property:
e
Damages claimed:
a. Amount claimed as of this da=e: ~ 50(; ~
D. Es=ima=ed amoun= of future cos=s: --
c. To:al amount claimed: .~Qoo ~
d. Basis for computation of amoun=s claimed (include copies o~ all Dills,
invoices, esCima=es, e=c.: f~ z~/.
10. Names and addresses of all witnesses, hospi=als, doc=ors, eec.:
11. ~y additiona~ info~ation that might be help~l in considering ~is cla~rr/~ '~
WARNING: IT IS A CR/MINAL OFFENSE TO FILE A FALSE CLAI]{! (Penal. Code
Sec=ion 72; Insurance Code Sec=ion 556.0)
I have read ~he mac=ers and s=atemen=s made in the above claim and I know =he
same =o be =rue of my own knowledge, excep= as =o ~hose mat=ers sCa=ed =o be
upon info=ma=ion or belief and as =o such maC=ers I believe the same to be =rue.
I cer=ify under penalty of perjury th'a= =he foregoing is TRUE AND CORRECt.
~ecuted =his ~23 day of OCTa~'A' , 19_~9= , ac Tus=in, California.
Office of the City Clerk,
Tus=in, California
Revised 8/05/81
~GR: se :R: 8/5/81 (A)
This is a list of the expenses incurred aa a result cf the accident
The Medical expenses as are:
The replacement value of a restored 72 Datsun
(see below)
Other expenses directly resulting from accident:
Including; Travel expenses to and from doctor,
temporary vehicle expenses,towin~
and expences inccured seeking council.
TOTAL CLAIM
$325.00
$~5o0.oo
. $17~.00
$5000.00
Replacment price of Datsun is based on a restored 1972 2~O-Z
(The 1972 only,2~O-Z is a special intreat vehicle.)
Recent parts include;
~ nitrogen ~as shocks (for Mac?herson struta).& instalatiOn
Olutch and hydralic system rebuild
~omplete engine rebuild including balancing and machining
Custom interior including padding and carpet
Recbromed bumper including added trim
Brake & hydralic system rebuild (including new lines)
£xahst system
· New hoses throughout car
Battery
Tires (Z radials)
Sespenslon bushings (rack & pinion)
Air conditioning compressor,drier & service
The sutible replacment vehicles I have examined have all been in
excess of $5000.00 however I have made some allowence as my car
was in need of paint. My vehicle was not in need of body work
only paint.
'i
- '
' ,,o~
TUSTIN-IRVINE MEDICAL GROUP. INC.
James P. Young
EXPLANATION OF CHARGES
12072
.2815
NO.. 6579'
8310 C£RRrros AVILNLJE t STANTON CAUFORNIA 90&RO,~ (7141X~g-RR65
UNIT OR
O~. DE~CRI~ON MATERIAL AMOUNT
MOTOR VEHICLE REPAIR
~IS.TT~AT]O N NO..
AUTO SERVICE
CALIFORNIA
841057'
87'6,4/J ~ 96109
2/4/83
CUSTOMER COPY
SERVICE BY EXJ'f, IITS
TUSTIN' POLICE DEPARTMENT
-'"RAFFlC COLLISION REPORT -- '"' '-/ .....
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