HomeMy WebLinkAbout06 CLAIM DIANE WENDLAND 06-19-06AGENDA REPORT
MEETING DATE: JUNE 19, 2006
TO: WILLIAM A. HUSTON, CITY MANAGER
FROM: RONALD A. NAULT, FINANCE DIRECTOR
SUBJECT: CONSIDERATION OF CLAIM OF DIANE WENDLAND, CLAIM NO. 06-12
SUMMARY:
The Claimant reported that she was driving on Red Hill Avenue near Edinger and there was a
man using a weedeater on the center divider at the time. The front windshield of the Claimant's
car was pitted when the weed eater hit rocks and cement - and rocks then hit her vehicle.
RECOMMENDATION:
That the City Council deny Claim Number 06-12, Diane Wendland, and direct Staff to send notice
thereof to the Claimant.
FISCAL IMPACT:
None.
DISCUSSION:
The City of Tustin contracts with TruGreen LandCare for annual landscape maintenance services.
No City employee was working at the above location on the day of this incident. The City's Claims
Administrator has tendered the claim to TruGreen Landcare for handling, as the City of Tustin is
an additional insured on their policy.
Ronald A. Nault
Finance Director
ATTACHMENT' Copy of Claim No. 06-12
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CLAIM AGAINST THE CITY OF TUSTIN
(For Damages to Person or Personal Property)
;,eceived Via:
~ U.S. Mail
o Inter-Office Mail
o Over the Counter
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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 fann is for the convenience of those desiring to present claims against the city. Claimant is advised to consult a private
attomey 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::t IA il.eJ li)/7 nJl.aaJ
Home Address: -
Home Telephone: '
2.
Post Office address to which the person presenting the claim desires notices to be sent:
(If different from above)
Work Telephone:
Name of Addressee:
Post Office Address:
Telephone:
3. The date, place and other circumstances of the occurrence or transaction from which the claim arises.
~Ib'.
Date of Occurrence: Time of Occurrence: 8~ \)
4. General description of the indebtedness, obligation, injury, damage or loss Incurred so far as you no'l" know. .
.lC'Vck I ,\ ,~:<14 ~-rt.. \\.kI.Lil~ (Y-I"l-- <; f:.\:ViI u.l1~A4.h~. o.P00t!r-1 ~~~
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Page 1 of4
5. The name or names of the public emplo ee or employees causing the injury, damage, or loss, if known.
~ I ,.
u.. &
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 computation:
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 !j
86.)
D Limited Civil Case
o Unlimited Civii Case
You are required to provide the information requested above in order to comply with Government Code
!j910. Additionally, In order to conduct a timely investigation and possible resolution of your claim, the
Cit of Tustin re uests that au answer the followin uestions.
7. Name, address and telephone number of any witnesses to the occurrence or transaction from which the claim
t~~: hA- J . ~_
~~~~\~"Cit;1~ ~ ~
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() ~ ~
If applicable, please attach any medical bills or reports or similar documents supporting your claim.
9. If the claim relates to an automobile accident: C'l1:> PI c...L...~
Ciaimant(s) Auto Ins. Co.:
Address:
Telephone:
Insurance Policy No.:
Insurance BrokerlAgent:
Address:
Telephone:
Claimant's Veh. Lie. No.:
Claimant's Drivers Lie. No.:
Vehicle MakelYear:
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.
CURB -A'
L
SIDEWALK
CURB -..
PARKWAY
SIDEWALK
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~~t. ~ liTu 151')):5
Spv~ -\P PM- ffiAds~- ~~()"L- -\1.~iY)
Warning: Presentation of a false claim is a felony (Penal Code !F2). Pursuant to CCP !i1038, 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:
;j ftjotD
Page 3 of 4
84/18/288& 1&:21
714898843&
t-EW VIEW GLASS
PAGE 81
NEW VIEW AUTO GtA..", INC.
15142 Beach Blvd
Suite #liD
Midway City, CA 9165!-1474
(714) 890 - 1347 FlU: (714) 890 - 0436
... lOICV., NUMBER
OATF. 4/1 812006
RIlFERENCH ~ Quo: 7~90.
TAX 10 NllM9F.R 33-0947133
4:17PM
ACCOUNT I CllSTOMER TAX In NUMBER I PO NI.I"lIll!R lIlStALL D4 TF.:
I J 1N!IT At;.!!D BY:
SilI.elJIW': Tl'..RMS:
BILL TO: SOLD TO:
COo CullOm.. Attn: Diane Wendland
'.....e. '.-....110.
AGENT: _lFIEDBY: DJSPA TOt I:
POUCY NtJloI1IER:
CLAIM NUMBER:
CAUSE Of LOllS:
OJ. TE Of lJ)SS: Dl!DucnaLE:
V.lel. '.fonII.atJaa
MAKE': OLDSMOBILE r.<<lDllL: EIGHTY .F.IGIlT YEAR: 1996
BODY: 4 DOOR SEDAN VTH: ODOMETER:
STOcK.: R.O.'1: UNIT_: l./CENSE':
QIItJ PIIrt N.m_ Houn Lllbor Adhlltv. Lilt Prioo Not "lee t.Iaol'otal
Loo DWOIIOSOBNN 2.80 Sloo,OO $0.00 S/~7.3S S "7,34 $297,34
WincIohield (Sollr) (M.y need Mldp)
1.00 IlAHOOOOO4.20 0,00 $0.00 $9.95 $0,00 SO.OO $9.95
Adhesi.e Adhesive (Urolhano.DIIll,Primer)
1.00 HMLOO9II7I 0.00 $0,00 $0,00 S7US S74.25 $74.2S
OEM. - WKT IJIl06C MOUldi.!! Moulding (ChfOll1C) (Mlofa A Rdlolner)
AII..illdshi.... ..'I.e......... MUST..".. I'or .lIdai..... of 4 HOllRS prior \0 <lrMal \0 _r. '.0. .I'ely.
Do IIOt loUh ,.or nIllcle 'or <II .......
I * THIS IS A OUOTE I DO NOTl'AY . I
TCIlIII Lobot $100.00
Tolo! Kit $9.95
Total Pattl' $171.59
SubtDlal 5381.54
Than. you fur ch_ing NEW VJEW AUTO GLASS for your 811'., repslr noods, Tim lWos Tax@ 7,7500 % $21,82
C.__r 8I1nat.r.: A_.nt Due: 5403.36 Invol.. Total $403.36
0... ......w.......,....... elM iI. 121ftM1t1..,., .._lillIllIlllc:hlrt........ .....-..ftI) __titr I: WIler..... ...V,"", GItft.,. ""'..lTIIlly...... ...........lrNII
-=-~fot_,.bcrlC1~-ilj.~_wIIIM_ 1"mtimclwt"'MMh~-.fIII..III"_Ul,,,*-"''''''''IIr.CIIl,itW..JIIrI'IClItIofr-weItlomly...Ntw'............ ~
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