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Home My WebLink About05 CLAIM NO. 06-35-SUZIE FIGUEROA 01-15-07 AGENDA REPORT Agenda Item 5 Reviewed: City Manager Finance Director MEETING DATE: JANUARY 15, 2007 FROM: WILLIAM A. HUSTON, CITY MANAGER RONALD A. NAULT, FINANCE DIRECTOR CONSIDERATION OF CLAIM OF SUZIE FIGUEROA, CLAIM NUMBER 06-35 TO: SUBJECT: SUMMARY: The Claimant reported that the windshield of her 1995 Astro Van was broken when it was hit by a foul ball from a City softball league game at Columbus Tustin Park. She is asking the City to pay $250.00 for the damaged windshield. RECOMMENDATION: That the City Council deny Claim Number 06-35, Suzie Figueroa, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: The City's Claims Administrator has completed the investigation of this incident and found no fault attributable to the City of Tustin. There is protective netting and sixty-eight foot fencing between the field where the softball game was being played and the street where the Claimant's vehicle was located. There was nothing the City could have done to prevent the fly ball. Staff is recommending denial of the claim at this time. ATTACHMENT: Copy of Claim No. 06-35 ConsiderationOfClaimOfSuzieFigeroa. doc CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Property) Claim No: 06-35 PLEASE NOTE: A. Read entire claim before filing. B. Be sure your claim is against the Citv of Tustin, not another pubIic entity. C. Claims for death, injury to person or to personal property must be filed1 :s ~r'h~n~~,ia Tonths after the occurrence (Government Code 9 911.2). D. Claims for damages to real property must be filed no later than one year after the occurrenc~j~8vernment Code 9 911.2). E. If additional space is needed to provide your information, please attach sheets, identifying the pa'ragraph(s) being answered. F. 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 and must be signed by the claimant or a person on his behalf (Government Code 9 910.2). G. This form is for the convenience of those desiring to present claims against the city. Claimant is advised to consult a private attorney if legal advice is desired. No employee of the City may give legal advice to any claimant relating to private claims. H. Completed claims must be mailed or delivered to the City of Tustin, City Clerk's Office, 300 Centennial Way, Tustin, California 92780. 1. Name and Post Office address of the Claimant: Name of Claimant: Suzie Figueroa Home Address: 1005 N. Concord St. S.A., CA 92704 Work Telephone: 714-726-4143 2. Post Office address to which the person presenting the claim desires notices to be sent: (If different from above) Name of Addressee: Telephone: Post Office Address: 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. Date of Occurrence: Location: Corner of Prospect & Irvine Blvd. Circumstances giving rise to this claim: Columbus School 4. General description of the indebtedness, obligation, injury, damage or loss incurred so far as you now know Broken windshield of my 95 Astro Van Page 1 of 4 . 5. The name or names of the public employee or employees causing the injury, damage, or loss, if known. Umpire - Dan rodriguez 714-9679-5652 6. If amount claimed totals less than $10,000: Provide the amount claimed if it totals less than ten thousand dollars ($10,000) as of the date of your claim, including the estimated amount of any related potential future injury, damage, or loss, insofar as it may be known as of the date of your c'laim, together with the basis of computation of the amount claimed (include copies of all bills, invoices, estimates, etc.) Amount Claimed and basis for computation: $250.00 If amount claimed exceeds $10,000: If the amount claimed exceeds ten thousand dollars ($10,000), do not provide a dollar amount in the claim. However, your claim must indicate whether it would be a limited civil case. A limited civil case is one where the recovery sought, exclusive of attorney fees, interest and court costs, does not exceed $25,000. An unlimited civil case is one in which the recovery sought is more than $25,000. (See CCP 9 86.) Limited Civil Case Unlimited Civil Case You are required to provide the information requested above in order to comply with Government Code S910. Additionally, in order to conduct a timely investigation and possible resolution of your claim, the Cit of Tustin re uests that ou answer the followin questions. 7. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim arises: 8. 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 medical bills or reports or similar documents supporting your claim. 9. If the claim relates to an automobile accident: Claimant(s) Auto Ins. Co.: Address: Telephone: Insurance Policy No.: Insurance Broker/Agent: Address: Telephone: Claimant's Veh. Lic. No.: Claimant's Drivers Lic. No.: Vehicle Make/Year: Expiration: If applicable, please attach any repair bills, estimates or similar documents supporting your claim. Page 2 of 4 READ CAREFULLY For all accident claims, place on following diagram name of streets, including North, East, South, and West; indicate place of accident by "X" and by showing house numbers or distances to street corners. If City/Agency Vehicle was involved, designate by letter "A" location of City/Agency Vehicle when you first saw it, and by "B" location of yourself or your vehicle when you first saw City/Agency Vehicle; location of City/Agency vehicle at time of accident by "A-1" and location of yourself or. your vehicle at the time of the accident by "B-1" and the point of impact by "X." NOTE: If diagrams below do not fit the situation, attach hereto a proper diagram signed by claimant. SIDEWALK CURB ~ c'"i' V v' l' ~ € <3> l\Jd.- PARKWAY SIDEWALK fC CURB .... G..- ~ G\.S~ \::A.. \ \ Cb<1.M ~ _W CLS St) t ~ r- ~ ~ V\- SO~ -CLYx:d',V\\ +- ~ ~0\-~cd\- h\&mi Warning: Presentation of a false claim is a felony (Penal Code 972). Pursuant to CCP 91-038, 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 i~g~pd \d faith and with reasonable cause. ~ \ V\ ~'1\Ct., . .,.--- ~ () \Jl~ r ~ 00 0 /V Signature: Date: \ \- a-"6-0h Page 3 of 4 IF LATE LLAIM: COMPLETE ITEMS 1- 9 AND THIS APPLICATION. SIGN BOTH FORMS. APPLICATION FOR LEAVE TO PRESENT A LATE CLAIM TO THE CITY OF TUSTIN The undersigned hereby applies for leave to present a late claim to the City of Tustin. This application is being made within a reasonable time, not exceeding one (1) year, after the accrual of the cause of action. Under some circumstances, leave to present a late claim will be granted (Government Code ~ 911.6). The reason for delay in presenting the claim is: Date Revised 12/2004 Page 4 of 4 1) IncideDl Type A 0 Non-1Dj Accident B 0 Jqjury Accident C 0 SearchIRescue D 0 Disturbance E 0 Other F 0 Crime G 0 Fire H 0 ~cal I lilJDfo CODBS: V-Viet W-Wlt R-Rpta 8-SUIp C>-Otmer D=I>river H-BibrJPed B-Bika' J-logerP-PiCDicbr IzlJi. PIty X=Otbr on on o FORMAT: Mditioaal Jaformation (Name,.Vehi~ ~). .$yDop8is, Namative (Footwear, Ey....... ClothiD& etc.) .'Stat........." '_ A1taduuents' . e I z , ...... " o ROUIlNG: Reporting Leader, SU]Xnisor, Director, and Filiug .~ ~ ClMydocalFormslIDcident ReportDoc