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Home My WebLink About14 CLAIM ELAINE HILL 03-20-06 AGENDA REPORT MEETING DATE: MARCH 20, 2006 TO: WilLIAM A. HUSTON, CITY MANAGER FROM: RONALD A. NAULT, FINANCE DIRECTOR SUBJECT: CONSIDERATION OF CLAIM OF ELAINE Hill, CLAIM NO. 06-04 SUMMARY: The claim asserts that there was a height differential in sections of the sidewalk in front of 1152 E. First Street causing the Claimant to trip and fall, resulting in injuries to her lip and mouth. RECOMMENDATION: That the City Council deny Claim Number 06-04, Elaine Hill, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: We are continuing to investigate the facts of this claim. The recommendation to deny is procedural to protect the six-month statute of limitations. Staff may return to the City Council for further authorization dependent upon the completion of the investigation of facts. Ronald A. Nault Finance Director ATTACHMENT: Copy of Claim No. 06-04 I Icot < secon"'" se rs $1 T5ke ff\ C LAI M 51 Can sideretion OICle ImOtE 'e IneH 1/1. doc CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Property) R,.teived Via: IS'[ U.S. Mail 0 Inter-Office Mail 0 Over the Counter Time &t~1,þ: OF TUSTIN )nOh In' 21 P 12' Dc- ClairWNo~'\i1.. '.J Otn-o4 PLEASE NOTE: A. Read entire claim before filing. B. Be sure your claim is against the Citv 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: Elaine Hill Home Address: Home Telephone: ( Work Telephone: 2. Post Office address to which the person presenting the claim desires notices to be sent: (If different from above) NameofAddressee:Kerr & Sheldon Law Corporati<føephone: PostOfficeAddress:16480 Harbor*100 Fnl1nrAin VAllpy, CA C)~ (714) 531-5900 3. The date, place and other circumstances of the occurrence or transaction from which the claim arises. Date of Occurrence: 10/9/2005 Time of Occurrence: apx.' 11:00 am Location: sidpwAlk in front of 1152 E. 1st St. in Tustin Circumstances giving rise to this claim: Claiman t was walking on the sidewalk when she tripped & fell. There was a height differential among sections of the sidewalk that created a tripping hazard. Claimant tripped on that hazardous portion of the sidewalk. 4. General description of the indebtedness, obiigation, injury, damage or loss incurred so far as you now know. C1AimAnr fp11 forwArd injl1ring her liD and mouth. Due to excessive -b..l~g ig her mouth. a b100d "",~~",1 ~r~~ pv",nrl1A11 y rAl1tpri zpd Page 1 of4 5. The name or names of the public employee or employees causing the injury, damage, or ioss, if known. -Llnlu1.o-w n ---- "-- 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 potentiai 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 (inciude copies of all bills, invoices, estimates, etc.) Amount Claimed and basis for computation: If amount claimed exceeds $10,000: If the amount claimed exceeds ten thousand doilars ($10,000), do not provide a dollar amount in the claim. However, your claim must indicate whether it wouid be a iimited civil case. A limited civii case is one where the recovery sought, exclusive of attorney fees, interest and court costs, does not exceed $25,000. An uniimited civil case is one in which the recovery sought is more than $25,000. (See CCP § 86.) D Limited Civil Case :G 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 followin uestions. 7. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim arises: None known at this time 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: Irvinp MpdirFl1 Cpnrpr,~inp, CA Kaiser in Garden Grove (Dr. Lu and Dr. Vu) Kaiser mn Lakeview Gary Winslow, D.D.S., 17th Street, Santa Ana, CA If applicable, please attach any medical bills or reports or similar documents supporting your claim. 9. If the claim relates to an automobile accident: Not applicable Telephone: Claimant(s) Auto Ins. Co.: Address: Insurance Poiicy No.: insurance BrokerlAgent: Address: Teiephone: Claimant's Veh. Lic. No.: Claimant's Drivers Lic. No.: Vehicle MakelYear: Expiration; If applicable, please attach any repair bills, estimates or similar documents supporting your claim. Page2of4 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 CitylAgency 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 ----f:1(/ CURB --.J- f. \ ~t 'S+ft:.et 1~1UL SIDEWALK Y.. PARKWAY SIDEWALK in ñf 7J j¡1 ~ Warning: Pr sentation of a faise claim is a feiony (Penal Code §72). Pursuant to CCP §1 038, 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 in good faith and with reasonable cause. Signature: Date: \ - \'1,-0 l.> 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 appiication 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 iate claim will be granted (Government Code § 911.6). The reason for delay in presenting the claim is: /' / / Date Signature of Claimant Revised 1212004 Page4of4