HomeMy WebLinkAboutCC 8 CLAIM #82-16 06-07-82OATE:
TO:
SUBJECT:
May 12, 1982
CONSENT C~T.RNDAR
NO. 8
6-7v82
Inter-Corn
,/~N~RABLE MAYOR AND CITY COUNCIL
JAMES G. ROURKE, CITY ATTORNEY
CLAIMANT: FRAIM, Barbara L. D/L: 4/14/82
FILED W/CITY: 4/30/82 CLAIM NO: 82-16
CARL WARREN FILE NO: 31772 AB
After investigation and review it is recommended
that the above-referenced claim be denied and the City Clerk
directed to give proper notice of the denial to the claimant
and to the claimant's attorney.
JGR:se
Enclosure
1. Copy of Claim
cc: OCCRMA
OLAIM AGAINST THE CITY ~' TUSTIN
(Fo'~.Damages to Person~'~'r ~ersonal Property)
'qeceived by ~ ~. ~ia
.S. Mail
Inter-office Mail
Over the Counter ~ 4' ~'S'-~/~
The law provides generally that a claim must be filed with the City Clerk of
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 informa-
tion by paragraph number. Completed claims must be mailed or delivered to the
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. NAME OF CLAIMANT: Barbara L Fraim
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 sen~, if ot~r than a~ove: -~
3. This claim is submitted against: Road Department
a. ~
b.
The City of Tustin only.
The following employee(s) of the City of Tustin only:
Ce
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. DAT~: 4/14 Or 4/lgm. 'TIME: Approx Noon c. PLACE (Exact
and specific location): Second & Pacmfmc St (East Intersection)
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).
Turning the corner from Second to head North on Pacific, there was
thick wet tar (approximately two feet wide) and not noticeable.
My tires on riqht side thickly coated causinq me to shimmy badly.
Tires had to be cleaned and rebalanced - Invoice attached.
e. What particular action by the City, or its employees, caused the
alleged damage or injury?
d ~ with a warn~ng
Gi~d a description of 'the injury, property damage loss so far as is
known at the time of this claim. If there were no injuries, state "no
injuries"
No in3ur~es
Give the name(s) of the City employee(s causing the damage or injury:
Name and address of any other person injured:
Name and address of the owner of any damaged property:
Damages claimed:
a. Amount claimed as of this date: $91.59
b. Estimated amount of future costs: Unknown (May have to be rebalancs
c. Total amount claimed: Unknown
d. Basis for computation of amounts claimed (include copies of all bills,
invoices, estimates, etc.: Invoice Included
~0. Names and addresses of all witnesses, hospitals, doctors, etc.:
a. Unknown
b.
c.
d.
Any additional information that might be helpful in considering this claim:
WARNING: IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM! (Penal Code
Section 72; Insurance Code Section 556.0)
~ 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 info~mation or belief and as to such matters I believe the same to be true.
~ certify under penalty of perjury that the foregoing is TRUE AND CORRECT.
Executed this 30 day of April
Office of the City Clerk,
Tustin, California
r'~IM NO: ~- /A
82 , at Tustin, California.
CLAIMANT ' S SIGNATURE /
DATE FILED:
Revised 8/05/81
jGR: se :R:8/5/81 (A)