HomeMy WebLinkAbout11 CLAIM 06-14 JOHANSSON 09-05-06AGENDA REPORT
MEETING DATE: SEPTEMBER 5, 2006
TO: WILLIAM A. HUSTON, CITY MANAGER
FROM: RONALD A. NAULT, FINANCE DIRECTOR
SUBJECT: CONSIDERATION OF CLAIM OF BRITT JOHANSSON, CLAIM NO. 06-14
SUMMARY:
The Claimant reported that the windshield of her vehicle was shattered due to being hit by a ball
from a Tustin Softball league game. She is asking the City to reimburse her for the cost to replace
the windshield.
RECOMMENDATION:
That the City Council deny Claim Number 06-14, Britt Johansson, and direct Staff to send notice
thereof to the Claimant.
FISCAL IMPACT:
None.
DISCUSSION:
Staff and the City's Claims Administrator have determined that the damage to the Claimant's vehicle
was the result of an accident, and a case of no liability on the part of the City of Tustin. The ball
field at Columbus Tustin Park where the game was played has protective facilities which include a
backstop with a half dome canopy and high screen netting between the field and the adjacent
streets. These structures were renovated in 2004 and appear adequate - there have been no prior
reported incidents of balls leaving the field and flying into the street. As the City is not responsible
for this accident, Staff is recommending denial of the claim at this time.
ATTACHMENT: Copy of Claim No. 06-14
ConsiderationOfClaimOfBrittJohansson.doc
CLAIM AGAINST THE CITY OF TUSTIN
(For Damages to Person or Personal Property)
Received Via:
o U.S. Mail
Q)nter-Office Mail
0' Over the Counter
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. TimeStBrnpi
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:Cfaim NO:: j {'yO - t ~
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 !i 911.2).
D. Claims for damages to real property must be filed no later than one year after the occurrence (Government Code !i 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 Govemment Code of the Stale of Califomia, 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 (Govemment Code!i 910.2).
G. This form is for the convenience of those desiring to present claims against the city. Claimant is advised to consutt 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: \V C
Home Address:
r\-+ JJhClns.:xYL
Work Telephone: .
~
2. Post Office address to which the person presenting the claim desires notices to be sent:
(If different from above)
Name of Addressee:
Post Office Address:
5~tJ\ G
Telephone:
3. The date, place and other circumst nces of the occurrence or transaction from which the claim arises.
Date of Occurrence: 4 l- '5 0 (0 Time of Occurrence: c\ (2p 'if: j <:; fJ\^^-
Location: I . ! G
Circumstances giving rise to this claim:
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4.
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5.
/:rLZ51L-nth~bliC
using the injury, damage, or loss, if known.
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6. If amount claimed totals 1888 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, involr'" estimates, etc ) .
Amount Claimed and basis for computation: 4~ (e c.J2A p-f--
/tZft ~ --t ~
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 attorney 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 !i
86.)
D Limited Civil Case
o Unlimited Civil Case
You are required to provide the infonnation requested above In order to comply with Government Code
1910. Additionally, in order to conduct a timely investigation and possible resolution of your claim, the
el of Tustin uests that ou answer the followin uestions.
7.
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:
If applicable, please attach any medical bills or reports or similar documents supporting your claim.
9.
If the claim relates to an automobile accident:
Claimant(s) Auto Ins. Co.:
Address:
. CD-==R& ~ 13
Telephone: j i'S ,. t
olicy No.: (p Z21~'0
Insurance BrokerlAgent:
Address:
Telephone:
Claimant'sVeh. Li.c. NO.:_~ '.
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Vehicle MakeNear: .
p--------- .,
Expiration:
If applicable, please attach any repair bills, estimates or similar documents supporting your claim.
Page 2 014
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 comers. If City/Agency Vehicle was involved, designate by
ietter "A" location oi 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.
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CURB ~
CURB -"
PARKWAY
SIDEWALK
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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 detenmined not to have been brought in good
faith and with reasonable cause.
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Page3of4
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 (Govemment Code ~ 911.6). The reason for delay in presenting the claim is:
5-rz~) 007
Date
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Revised 12/2004
Page 4 of 4
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