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Home My WebLink About07 CLAIM #04-03 04-05-04Agenda Item 7 AGENDA REPORT Reviewed City Manager Finance Director MEETING DATE: APRIL 5. 2004 TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL FROM: LOIS JEFFREY, CITY ATTORNEY SUBJECT: CLAIM OF JENNIFER LE; CLAIM NO. 04-03 SUMMARY: Claimant alleges approximately $166.97 in property damage due to a piece of metal located on Jamboree between Tustin Ranch Road and Pioneer Way. The piece of metal punctured the right front tire and chipped the alloy rim. The City was not doing any work in this area, nor were any City contractors. The work being performed in that area was being done on behalf of the Irvine Ranch Water District. Claimant has been informed of these facts by the City's Claims Administrator. RECOMMENDATION: After investigation and review by this office and by the City's Claims Administrator, it is recommended that the City Council deny the claim and direct the City Clerk to send notice thereof to the claimant and the claimant's attorneys. ATTACHMENTS: Claim CC.. William A. Huston, City Manager 187697.1 FEB -23-2004 10:23 CITY OF TUSTIN 714 B32 6382 P.04 .. i RECEIVED CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Property) FEB 212004 frolshred via: .S. Mali �YICLERKS OFFICE u ten.Oifice Mail ver the Counter Claim No:� A claim must be presented, as prescribed by the Government Code of the State of California, by the claimant or a person acting on his/her behalf and shall provide the information shown below. Be sure your claim is against the City of Tustin, not another public entity. Completed claims must be presented to the City of Tustin, City Clerk's Office, 300 Centennial Way, Tustin, California 92790. If additional space is needed to provide your information, please attach sheets, Identifying the paragraph(s) being answered. 1. Name and Post Office address of the Claimant: _Name of Claimant: LE T nli P eR 2. Post Office address to which the person presenting the claim desires notices to be sent: Name of Addressee: CeMA ovbove. _, Telephone: ( Post Office Address: �a bow, .. 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. 4. Date of Occurrence: d 1401 Ina The of Occurrence: Circumstances giving 1188 to this claim: general descriodon of the Indebtedness, obligation, injury, damage or loss incurred so for as you now know, S. The name or names of the public employee or employees causing the injury, damage, or lose. If known. No owd& 6ff,o�N1t{ Ar &k fir, ftOeti- _ i L.nt. �k Page i of 3 FEB -23-2004 10:24 CITY OF TUST I N 714 832 6382 P.05 g. it amount claimed totals less than $10,000: Provide the amount chimed if it totals less than ten thousand dollars (;10,000) as of the data of your deim, including the estimated amount of any related potentlal future injury, damage, or loss, Insofar as it may be known as of the date of your claim, together with the basis of computation of the amount claimed (inolude copies of all bills, invoices, estimates, etc.) Amount Claimed and basis for if amount claimed "cosde $10,000' If the amount claimed exceeds ten thousand dollars (510,000), do not provide a dollar amount in the claim. However, your claim must indicate whether it would be a lira ited civil case. Alimited chru one is one where ts. does not exceed $25,0000. n unlimited a� ease Is o one to which h the recovery sought Iclusive of attorney s amore than $26nterest and ,000.rt (Sao CCP § g8.) ❑ Limited Civil Case Unlimited Civil Case You aro required to provide the Information requested above In order to comply with meat Code ;910: AtIdltlonaliy, In ober to wnduct a timely investigation and possible re9blUtion'of your claim, the CIS of XX requests that you answwthe following cues0ons. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim arises: AAA tswN Zara H:caa —Vna+&lot ww wi+M&@+ 0. If the claim involves medical treatment for a claimed injury, please provide the name, address and telephone number of any doctors or hospitals providing treatment: if applicable, please attach any medloal bills or reports orsWor documents supporting your claim. 9. If the claim relates to an automobile acoidertC N fv%A- Auto Ina. Co.: Insurance Policy No.: Insurance Broker/Agent Telephone: Address_ Chimantle Vsh. Lia No.: Vehicle Make/Year. Cialmeni's Drivers Lic. No.: _^ _ Expiration: Happlicable, please attach anyrepeir bills, eseme(se orsimilar documents supporting yourClalm. Page 2 or 3 FEB -23-2004 10'24 CITY OF TUSTIN r READ CAREFULLY 714 832 6382 P.06 For all accident claims. piece on following diagram name of CItyNgenoy Vehicle; location of City/Agency vehicle at time of streets, Including North. East. South. and West; indicate place or accident by "A-10 and iocadon of yourself or your vehicle at the accident by IT and by showing house numbers or distances to time of the accident by'&1" and the point of impact by "X" street comers. if Chy/Agency Vetdrte was Imrohred, designate by hereto a Mer •A" location of City/Agency Vehicle when you first saw k. NOTE: If diagrams below do not fit the situation, attaeh and by "B" location or yourself or your vehicle when you first law proper diagram signed by claimant. �d� N / R1 SIDEWALK a^ 7a Dices. PARKWAY ' x ; giYoy. ttn�x acu:da,.k e"WK CURB Warning: Presentation of a false daim is a felony (Penal Code 572). Pursuant to CCP §1038, the City/Agency may seek to recover all costs of defense In the event an action is filed Which is later determined not to have been brought In good faith and with reasonable cause. Signature:.... Date: . 1,104 Rwtsed it•19A3 Page 3 of 3 11 M-23-2004 10:24 CITY OF TUSTIN 714 832 6382 P.07 1 IL14 Polish Aim Aiepair'- Polithin6 Supplies. HZZL Ewa i A L FEB -23-2004 10-'26 CITY OF TUSTIN JUST TYRES 410 N. TUSTIN AVE ORRMS, G 93867 (714)639-4311, BAR REGMJ1555942,IDO T.D. 981407786 FEDERALj6NVO„ E5E 01/10/04 01/10/04 rzs-i 1102 02 AN 1107 Ali! TERR: 4820 PAGE: 01 NC/NSIG: 904620 HILL TO: RICHARD VU 714 832 6382 P.08 .( _ .-_ ... _. _VVSgH� YRAR NA88. 9,9 TOYOTA ,lPHO!U �2..:..... VIN.L L> ."ZSAI41L7-•CE"'--- — mRBCD� 01/10/04 VEHSCLB COLOR. GOLD R8C�8 LIC SS/6TATB. / CA RETURN PARTS „ NO ODONHI'R IN/OUT 057268 / 57268 SAI,N81gA1Q...... 025 / 025 �o000005 COB TC M 0 PE/$STATE AA11�21ZATION CRREEDIT CARD NO, 7597 SLSM TECH PRODUCT CODE BC OTY DESCRIPTION CORE PARTS LBR/EXCISE LINE TOTAL 025 827-047.0 P195/70R14 90S S1 INTEGRITY VSBRPTL 59.00 .00 59.01 Q2- M6RWC9FR4203 025 069 041.263 R 1 NEW VALVE STEM 2.99 00, •' ' 2.9! 025 069 044-263 R 1 WHEEL BALANCE - COMMUTER SPIN 2.95.' -:4-40, ' 10.9! 025 071 R 1 SCRAP TIRE DISPOSAL AUTO 3.00 O0. 3,0( — — TIRE BLOWOUT AND ROAD HAZARD PROTECTION DECLINED, T UNDERSTAND THAT ALL CUSTOM WHEEL LUG NUTS MUST BE RE•TOROUEO AFTER 25 MILES AND CHECKED PERIODICALLY. N pp _ qna ure ' Z F YOU ARE M K 1 KE 0 LAN S F= E d CA L, THE STORE MA AOMR... AT ZT 9 4 b39 - 432' •PARTS TOTAL:......:. 67.94 CHARGED AMOUNT 81.97 LABOR TOTAL........ 8.00 STATE TIRE FEE 1.00 SUB TOTAL.......... 76.94 x--------------- ---- TAXAl1L KID 64.94 SALES Tg . ... 03 CUSTOMER AUTHORIZATION FOR TOTAL I NVO I C E *4pTAL— 11 .. V TREAD L/F..... 10/322 �ATREAD R/F ..... 10/32 TREAD RA..... 4132 TREAD L/R..... 4/3 SE�ADpETYR�N pp 32qM^%./FgWARRANTX--0 Ou&gy brands, TOTAL P.08