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HomeMy WebLinkAbout10 CLAIM OF MARK GAUGHAN 06-05-07Agenda Item 10 'Reviewed: AGNDA REPORT City Manager w . Finance Director MEETING DATE: JUNE 51 2007 TO: WILLIAM A. HUSTON, CITY MANAGER FROM: RONALD A. NAULT, FINANCE DIRECTOR SUBJECT: CONSIDERATION OF CLAIM OF MARK S. GAUGHAN, CLAIM NO. 07-04 SUMMARY: The Claimant reported he was driving on Edinger Avenue and his vehicle hit a lateral trench that was not properly covered or repaired. He is requesting reimbursement in the amount of $1,745.81, which was the cost to fix the damage to the front end of his car. RECOMMENDATION: That the City Council deny Claim Number 07-04, Mark S. Gaughan, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: The City's Claims Administrator has found no fault attributable to the City of Tustin in this case. It has been confirmed that FCI Constructors, Inc. was the contractor working on a street widening project in the area at the time the Claimant's vehicle was damaged. Staff is recommending denial and the Claim has been referred to FCI Constructors, Inc. for review and handling. Ron A. Nault Finance Director ATTACHMENT: Copy of Claim No. 07-04 Consideration OfClaim OfMarkGaughan. doc *AIM AGAINST THE CITY OF TU& (For Damages to Person or Personal Property) Tu ived Via: .S. Mail ter-0ffice Mail ❑ Over the Counter , Time Stamp: CITY 0F US'l ! 'H Claim No: 2[01 f1AR — 8 PLEASE NOTE: A. Read entire claim before filing. B. Be sure your claim is against the City of Tustin, not another public entity. C. Claims for death, injury to person or to personal property must be filed no later than 6 months after the occurrence (Government Code § 911.2). must be filed n for dams to real property o later than one year after the occurrence (Government Code § 911.2). es D. Claims g p P ' ' nal space is needed to provide your information, please attach sheets, identifying the paragraph(s) being answered. E. If additio p P F. A claim must beP resented, as prescribed by the Government Code of the State of California, by the claimant or a person actingon 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 § 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 ay g 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: "ZS A" Home Address: UAf Home Telephone: - - Work Telephone: 2. Post Office address to which the person presenting the claim desires notices to be sent: (If different from above) of Addressee: Telephone: Name � Post Office Address: 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. . Date of Occurrence: Time of Occurrence: /J d Location: - 0 ^:--. Chic maim. P 4. General descri tion of the indebtedness, obligation, injury, damage or loss incurred so far as you now know. 6 Page 1 of 4 5. The name or names of the is employee or employees causing the inj , damage, or loss, if known. -,141co Al e- 6. If amount claimed totals fess than$ $10,000: Provide the amount claimed if it totals less than ten thousand y dollars ($10,000) as of the date of our claim, including the estimated amount of any related potential future injury, s insofar as it may be known as of the date of your claim, together with the basis of computation of damage,. or loss, Y the amount claimed (include copies of all bills, invoices, estimates, etc.) Q� Amount Claimed and basis for computation: 11 lReO4VI; 7 If amount clamed exceeds$ $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 000. An unlimited civil case is one in which the recovery sought is more than $25,000. (See CCP § exceed $25, s� 86.) 24�% a `l 81Y F-1 Limited Civil Case ❑ Unlimited Civil Case 17 You are req required to provide the information requested above in order to comply with Government Code §910. Addy, itionall in order to conduct a timely investigation and possible resolution of your claim, the ,City of Tustin requests that you answer the following uestions. p 7. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim arises: gzvovkJa 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: /0-1 411 lease attach an medical bills or reports or similar documents supporting your claim. If applicable, p Y . 9. If the claim relates to an automobile accident: Claimant(s) Auto Ins. Co.: Telephone: Address: Insurance Policy No.: Insurance Broker/Agent: Telephone: Address: Claimant's Veh. Lic. No.: Vehicle Make/Year: Claimant's Drivers Lic. No.: Expiration: y re If applicable, please attach an air bills, estimates or similar documents supporting your claim. p Page 2 of 4 READ CAREFULLY For all accident claims, p 9 lace on followingdiagram name of City/Agency Vehicle; location of City/Agency vehicle at time of streets, including "X" and b North,East South, and West; indicate place of accident by "A-1" and location of yourself or your vehicle at the accident by Y showinghouse numbers or distances to time of the accident by B-1 and the point of impact by X. " �� street corners. If City/Agency Vehicle was involved, designate by not fit the situation, attach hereto a letter "A" Location of City/Agency Vehicle when you first saw it, NOTE: If diagrams below do and by "B" location of yourself or your vehicle when you first saw proper diagram signed by claimant. CURB 777 Ole le�1�/r SIDEJWALK PARKWAY SIDEWALK r", e CURB --7, Warning: Presentation of a false claim is a felony (Penal Code §72). 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: ? el Page 3 of 4 Date: �ljeecr1 4C. .Zoo ne 7-00" VOLVO. � TOYOTA • NISSAN Indepent Specialist Since 1980 "Quality Service That Gives You Peace Of Mind"