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Home My WebLink About11 CLAIM GOMEZ 9-19-05 A G END A REPORT Agenda Item 11 Reviewed: -¿wff- City Manager Finance Director MEETING DATE: SEPTEMBER 19, 2005 TO: WilLIAM A. HUSTON, CITY MANAGER FROM: RONALD A. NAULT, FINANCE DIRECTOR CONSIDERATION OF CLAIM OF BOB GOMEZ, CLAIM NO. 05-35 SUBJECT: SUMMARY: The Claimant reported that while entering the parking lot of the Nieuport 17 restaurant on Newport Avenue, the left rear tire of his vehicle was punctured by a large piece of metal. This section of metal appeared to match the construction project caution signs lining the City street. The amount claimed for damages is the charge for replacement of the tire, which could not be repaired. RECOMMENDATION: That the City Council deny Claim Number 05-35, Bob Gomez, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: The City of Tustin has contracts with Sequel Contractors, Inc. for the Irvine Boulevard/Newport Avenue Intersection Enhancement Project ongoing at the time of the above occurrence. Staff has confirmed that the metal segment causing the damage to the Claimant's tire was part of a sign belonging to this Contractor. Investigation regarding this claim also revealed that the City had no notice of a dangerous condition of roadway to have been placed on notice. The City's Claims Administrator has tendered the claim on behalf of the City to Sequel Contractors, Inc. for handling. ATTACHMENT: Copy of Claim No. 05-35 U: \ CLAIMS \ Cons IderaUon OrCla I m OrBob G orne z. do c CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Property) Received Via: 0 U.S. Mail 0 Inter-Office Mail ~ Over the Counter CITY OF TUSTIN Time Stamp: ZO05 AUG 23 P 12: DC) Claim No: 05"-35 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). D. Claims for damages to real property must be filed no later than one year after the occurrence (Government Code § 911.2). E. If additional space is needed to provide your information, please attach sheets, Identifying the paragraph(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 hislher 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 attorney If legal advice is desired. No employee of the Cuy may give legel advice to any claimant relating to privata 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: Social Security No.: Post Office Address: Date of Birth: 2. Post Office address to which the person presenting the claim desires notices to be sent: Name of Addressee: ~ 45 46)(/€:. Post Office Address: Telephone: 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. 4. Page1of4 7. 8. 9. 5. The name or ~mes of the public employee or employees causing the Injury, damage, or loss, if known. Y¡of- ~ 6. If amount claimed totals less than $10,000: Provide the amount claimed if it totals less than ten thousand dollars ($10,OOO) 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 claim, together with the basis of computation of the amount claimed (include copies of all bills, invoices, estimates, etc.) 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 attomey 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 § 86.) 0 limited Civil Case 0 Unlimited Civil Case You are required to provide the information requested above In order to comply with Government Code §910. Additionally, In order to conduct a timely investigation and possible resolution of your claim, the CI of Tustin re uests that ou answer the followln uestlons. Name, address and telephone number of any witnesses to the occunrence or transaction from which the claim ~ M/¿¡Jç/¿- t!:ðl1f¿-2 (; I If the ciaim involves medical treatment for a claimed injury, please provide the name, address and telephone number of any doctors or hospitals providing treatment: -hiffì P . If applicable, please attach any medical bills or reports or similar documents supporting your claim. If the claim relates to an automobile accident: Claimant(s) Au1o Ins. Co.: Address: tJI A- Telephone: insurance Policy No.: Insurance BrokerlAgent: Address: Telephone: Claimant's Veh. Lic. No.: Claimant's Drivers Lic. No.: Vehicle MakelYear: Expiration: Page 2 of4 If applicable, please attach any repair bills, estimates or similar documents supporting your claim. READ CAREFULLY For all accidant claims, place on following diagram name of straets, including North, East, South, and West; indicata place of accident by "J(" and by showing house numbers or distances to street comers. If City/Agency Vehicle was involved, designate by letter "A" location of City/Agency Vehicle when you first sew ~, and by "B" location of yourself or your vehicle when you first saw City/Agency Vehicle; location of CUy/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 beiow do not fit the situation, attach hereto a proper diagram signed by claimant ~(/ 1/ I~ ~ SIDEWALK CURB CURB -.. 7íI $1 PARKWAY In fF- SIDEWALK q Z2 --éxS Date: ¿J Paga30f4 IF LATE CLAIM: 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 ciaim will be granted (Govemment Code § 911.6). The reason for delay in presenting the claim is: Signature of Claimant Date Ravisad 1212004 Page40f4 Customer Invoice 029358 08/05/2005 FIRESTONE TIRE & SERVICE CENTERS SANTA ANA - TUSTIN 2005 N TUSTIN AVE STE A SANTA ANA, CA. 92705 Service Advisor: 06 RICHARD 714.541.7977 CARRY OUT Lic #: Vln #: In: 08/05/05 10:52AM Mileage: 0 Out: 08/05/05 11 :24AM Mileage: 0 RETAIL SALE REG#AG222549, EPA#CALOO0258915 Article Unit Extended Job Description Number ID Q~ Price Price Total tJRlDGESTOJIIEllRe WITIfUNI~, -PACKAGe - - - - - - - - - - - -05 - - - - - - - - - - - - - - ~6-S-:12 RIM DAMAGED BEFORE TIRE REMOVAL 04 056483 POTENZA RE050A BL 245/40R19 94W No 056483 04 Mileage Warranty DOT# VNHLAT3092 DISPOSAL FEE/CA RECYCLE FEE NEW TIRE WHEEL BALANCE PARTS NEW TIRE WHEEL BALANCE LABOR RUBBER VALVE STEM TIRE DISPOSAL FEE (1) TIRE INSTALLATION GOMEZ, MICHELL Store # 023884 349.99 349.99 7046655 04 7018708 04 7018716 04 7015040 04 7075078 04 7015016 04 1.75 2.99 . á:òo 2.99 3.00 N/C 1.75 2.99 . 8.00 2.99 3.00 N/C Technician{s): 04 STEVENTRAN Payment History: Visa 7704 396.55 396.55 670967 Summary: Parts . Labor Sho" Sup.plies Sub-Total Tax (7.75%) Total 355.97 12.75 0.00 368.72 27.83 Total Tendered $396.55 I have received the above goqds and/or services. If this Is a credi.t card purchase, I agree to pay an~comply with my cardholder agreement with the issuer. . . Customer Signature Initial here to indicate you have received the -"ire Maintenance Warranty Book. All parts are new unless otherwise specified. COMMITTfO TO PROVIDING A POSITIVE CUSTOMER EXPERIENCE ",1 DIAIHGHAIIGANO50204 LIMITED WARRANTY f!I!,"JsterCare@ SerVice & PEWU,: a coccant locally- pcovide a cuccent outstanding debt. as parts and labor Nashville. Sequel Contractors, Inc. 13546 Imperial Hwy. Santa Fe Springs, CA 90670 PH: (562) 802-7227 FAX: (562) 802-3419 August 10,2005 Robert D. Gomez Dear Mr. Gomez, With reference to the letter and invoice that you have sent in regards to the replacement of your tire, our investigations reveal that we were not working at the location that you have mentioned (Irvine & Newport Boulevard) on the date in question, so we cannot accept liability for the loss of your tire and trust you understand our obligation is to pay only those claims for which our company is legally responsible. Sincerely, For and on behalf of Sequel Contractors, Inc. v ~ f d.w eM'" cW tc~~' dAf:~, {ð. ¿( r I' ¿; / ? /I )7 & ç /. ~r~ di ð'ðð - .22/- 5?7</ ~( q I 0:5 Îb', jAckQ/ MMJ.er -;;:::.., ~'( købtff D. 6'M\el ~ ~" ~\~-€Ad- -- j;~ W. nAæMff¡ As ptr ()w( Iffillflf ~ ~ ~ I ~ (~ Ì4 ~ ~ Ðf ~ VW(JlC¿ f)r +Irle. ~rJ( eð +tlÍ¿ ~ Dr»< '2»0 ~~'Ytti-ì M 4~ : 1 ~'!fE£i. ~ rf (Y\øh1 c~ h W:,)N r çç6> lð;c cf ~ JØv I J . cf}u5'1UA) f~ncKwJ ()Wl ~e. M I.Ve.- 'ff di +/1¿ þ~ ktf cf ìJ ìwf°rf 17 ~~WtrLWt b-rL g/7-!(JÇ, (C{t{ý){?f ¡ :[rvlne ( ~r+ ~h,tdS). ~~ $~~ ~ ~+f-~~.. ) tv~ Wtl{ ~f);&J~ re,{~ ~td- il1\fV\~, ~btr + J) , ~me/l- ~