HomeMy WebLinkAbout13 CLAIM 06-18 PERRONE 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 DIANNA LYNN PERRONE, CLAIM NO. 06-18
SUMMARY:
The Claimant reported that two Officers of the Tustin Police Department knocked on her door,
demanded to come in, and accused her of having an argument with someone who was not there.
She said the Officers refused to identify themselves and there are no known report numbers - she
is claiming this is a case of police harassment.
RECOMMENDATION:
That the City Council deny Claim Number 06-18, Dianna Lynn Perrone, and direct Staff to send
notice thereof to the Claimant.
FISCAL IMPACT:
None.
DISCUSSION:
Tustin Police Officers responded to a famiiy disturbance call. A neighbor had reported a verbal
disturbance between the Claimant and her mother at 239 Preble Drive. After determining that
there was no physical altercation and no injuries, the Officers left. The City's Claims Administrator
has evaluated the facts of this claim and recommends it be denied for lack of liability on the part of
the City. Staff supports the recommendation.
Ronald A. Nault
Finance Director
ATTACHMENT: Copy of Claim No. 06-18
GonsiderationOfClaimOfDiannaLynnPerroneSecond.doc
CLAIM AGAINST THE CITY OF TUSTIN
(For Damages to Person or Personal Propert0i :
Received Via:
o U.S. Mail
D Inter-Office Mail
~ Over the Counter
7C1\ .;U:Ti~~ St~~i :
Claim No: ~ -I q,
PLEASE NOTE:
A. Read entire claim before filing.
S. Be sure your claim is against the City of Tustin,
C. Claims for death, injury to person or to pers st be filed no later than 6 months after the occurrence
(Government Code S 911.2). ".
D. Claims for damages to real property must be filed no later t '#.~"rlhe occurrence (Government Code S 911.2).
E. If additional space is needed to provide your information, please attach In s entilyin9 the paragraph(s) being answered.
F. A claim must be presented, as prescribed by the Government Code of th. te of California, by the claimant or a person
acting on his/her behalf and shail provide the information ~own below and t be signed by the claimant or a person on
his behalf (Government Code S 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
attomey if legal advice is desired. No employee of the CltytTlily 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:
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Home
Work T e;ephone:
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:
3.
4.
The date, place and other circumstances of the occurrence or transaction from which the claim aris~.
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Date of Occurrence: . ) (\ e. SJ ~vO Time of Occurrence:" - - '1 0
Location: r I I . c.: 'f'" 71'::/) H-:.-'7.c~/
Circumstances giving rise to this claim: "
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The name or names of the public employee or employees causing the injury, damage, or loss, if known.
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If amount c aImed 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: it r; '10, (")(::::>
6.
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 uniimited civil case is one in which the recovery sought is more than $25,000, (See CCP ~
86.)
D limited Civil Case
~mlted Civii Case
You are required to provide the information requested above in order to comply with Government Code
!i9l0. Additionally, in order to conduct a timely' investigation and possible resolution of your claim, the
Cit 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: I
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8.
9. If the claim relates to an automobile accid
Claimant(s) Auto Ins. C :
Address:
Telephone:
Insurance Policy No.:
Insurance BrokerlAgent:
Address:
Teiephone:
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Vehicle MakelYear:' ( .
Expiration: ,r) (, f)l~, Y'/\ _
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If applicable, please attach any repair bills, estimates or similar documents supporting your claim.
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Claimant's Veh. Lie. No.:
Claimant's Drivers Lie. No.:
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 Vehicie; 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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Warning; Presentation of a faise claim is a felony (Penal Code !F2). 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 determined not to have been brought in good
faith and with reasonable cause.
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Signatu?;' .
,., Date:
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Page 3 014
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,
ieave to present a late claim will be granted (Government Code ~ 911.6). The reason for deiay in presenting the claim is:
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Date
Revised 12/2004
Page 4 of4
TAX 10: 33-0299365
BILLING STATEMENT
See instructions on the attachment regarding
~... ---,....
ACCOUNT NO.' I STATEMENT DATE)
3790566 " . 5/11/2006
insurance or to make payments by credit card,
o Check here for credit card payment or address change.
Amount Paid
.'MIlKE'C~K PAYABLE TO:
/:" UCI DEF>AftrMENT OF PATHOLOGY
\
UCI DEPARTMENT OF PATHOLOGY
PO BOX 513377
LOS ANGELES
(714) 456-8835
CA 900513377
FAX (714) 456-6248
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PERRONE, DIANNA
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STATEMENT NO. STATEME PATIENT PHONE NO. ~ENT /
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0330386 3790566 05/11'/06 ' I) ( PERRONE. DIANNA
DATE PROCEDURE CODE'- u..---' DESCRIPTION AMOUNT
04/17/06 81025 HCG. QUAL PREG - URINE 9135295 $8.00
04/17/06 81001 URINALYSIS 9135296 $6.00
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REFERRING PHYSICIAN RENDERING PHYSICIAN .~.~ uUE ..-
FOX, JOHN C EMERSON MD, JANE F. $KOO
THE REMAINING BALANCE,ON THIS ACCOUNT IS YOUR RESPONSIBILITY.
PLACE UCI MEDICAL CENTER These charqes are the professional services
OF 101 THE CITY DRIVE of the pathologist. The services rendered are
~~ERVICE:
ORANGE, CA 9281,8 separate from your physician or hospital bill.
002002099568
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