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Home My WebLink About15 DENY CLAIM 12-5-05 AGENDA REPORT Agenda Item Reviewed: 1t City Manager Finance Director 15 MEETING DATE: DECEMBER 5, 2005 TO: WILLIAM A. HUSTON, CITY MANAGER FROM: RONALD A. NAULT, FINANCE DIRECTOR SUBJECT: CONSIDERATION OF CLAiM OF STEPHANIE LEUPOLD, CLAIM NO. 05-45 SUMMARY: Ms. Leupold's claim alleges that an electrical cover left askew on Old Irvine Blvd. caused damage to the bottom of her vehicle. RECOMMENDATION: That the City Council deny Claim Number 05-45, Stephanie Leupoid, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: The City's Claims Administrator has reviewed Ms. Leupold's claim and has determined that work was being done on Old Irvine Blvd. by a City Contractor. The claim was submitted to the Contractor in accordance with their obligation under the terms of their contract with the City. We have been notified by the Contractor that they will accept the claim. It is appropriate to deny the claim maintain the status of the statute of limitations under the Government Code. ATTACHMENT: Copy of Claim No. 05-45 I Icot -secondluse fS $1 T Skaff! CLAIM 51 Con side faUon OICla 1m OISt e ph a n Ie Leupold. doc 8 ~ Office the C;¡ty Clerk .--------------..--------.- -, ~ . ~'"""_. - ~aa...' , November 8, 2005 f ...... .' 0, I usnn Alex Barrios Ward North America, Inc. P.O. Box 2422 Tustin, CA 92781-2422 300 Centennial Way Tustin. C.t>, 92ï80 7¡~.5ï3.30.:>6 FAX 714.832.0825 Re: Transmittal of Document(s) Claimant: Stephanie Lewpold City Claim No: 05-45 Filed With City: 11/8/05 L By: Receipt of Claim/Summons/Complaint Over the counter The enclosed records were presented to this office as indicated above and have been referred to the appropriate City department for investigation and also to the offices of Woodruff, Spradlin and Smart, Attn: Lois E. Jeffrey, City Attorney. By this letter, you are authorized to commence the necessary investigation of this claim on behalf of the City. We request that you give such notices as may be appropriate to the City's insurance carrier(s) and further request that you submit your preliminary and all subsequent reports to the City, with a copy to the City Attorney and to the insurance carrier(s) if they so request. Upon receipt of advice from the City Attorney, we will plan to present this matter to the City Council and/or take such other steps as are directed by the City Attorney. A copy of this letter and enclosures were sent on November 8, 2005 to the City Attorney and Department Head, and the original was forwarded to the Finance Department. ~. Sincerel..Y, . ~'\ \ , .' '\ 'fl.,)L JCJie Dahlke City Clerk's Office ~. Enclosures: (as above) C: City Attorney Department Finance Department (orig copies) CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Property) Received Via: 0 U.SMail OT')~(f~'II.\\'\" '~l 0 Inter-Office Mail ill'\( ~ U ~ \j 1\'/' ~Over the Counter Ti~m~ TUSTIN o¡l!IIIIl-V A P 2: 20 U~J I'" - (~-45 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 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 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: Social Security No.: Post Office Address: L 0 rjZI!CF, Date of Birth: 2. Post Office address to which the person presenting the claim desires notices to be sent: Name of Addressee: Post Office Address: 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. 4. "'---"" 5. The name or the i1ury, damage, or loss, if known. 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 claim, together with the basis of computation of the amount claimed (include copies of all bills, invoices, estimates, etc.) Amount Claimed and basis for co pula 'on: l,J ," k ^ Il-D ¿ ÐV1 . 0""".)-jC '~ 'Ai It) (} . ¿' e- If amount claimed exceeds $10,000: If the amount claimed exceeds ten thousand dollars ($10,000), do n provide a dollar amount in the claim. However, your claim must indicate whether it would be a lim~ed civil case. 14 t", A lim~ed civil case is one where the recovery sought, exciusive of attorney fees, interest and court costs, does not ~1 ::J:"X exceed $25,000. An unlimited civil case is one in which the recovery sought is more than $25,000. (See CCP § ,- 86.) wi I æl?{)\ 0 Lim~ed 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 r uests that ou answer the followin uestions. 7. Name, address and telephone number of any w~nesses to the occurrence or transaction from which the claim ~i3~AI ry' e- '12v ~ f: O-V~.àLTu<;h;1 - } D 11:- to 2.3 8. If the claim involves medical treatment for a claimed injury, please provide the name. address and telephone number of any doctors or hosp~als providing treatment: fJ=k If applicable. please attach any medical bills or reports or similar documents supporting your claim. 9. If the claim relates to an automobile accident: Page 2 of 4 Ciaimant(s) Auto Ins. Co.: Address: If applicable, please attach any repair bills, estimates or similar documents supporting your ciaim. READ CAREFULLY CitylAgency Vehicle: location of CitylAgency vehicle at time of accident by "A-1" and location of yourse~ 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 pro par diagram signed by claimant L i~l nf Warning: Presentation of a false claim is a felony (Penal Code §72). Pursuant to CCP §1038, the City/Agency may seek ", ~, 0"" of defens~' ..~"' '" "'oo' "'" ""'" ¡, "'" ,..","'" """ "~ '"'" """'" '" ,.. ,,~,.,"'" .'00"'", æ", . '."""~ ~ Á{~ """ 14~lzh I Page30f4 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 claim will be granted (Government Code § 911.6). The reason for delay in presenting the claim is: ~ Revised 12/2004 Page 4 of 4