The URL can be used to link to this page

Home My WebLink About10 CLAIM CHRIS CONFER 06-25 09-18-06AGENDA REPORT Agenda Item Reviewed: City Manager Finance Director MEETING DATE: SEPTEMBER 18, 2006 TO: WILLIAM A. HUSTON, CITY MANAGER FROM: RONALD A. NAULT, FINANCE DIRECTOR SUBJECT: CONSIDERATION OF CLAIM OF CHRIS CONFER, CLAIM NO. 06-25 SUMMARY: The Claimant reported that while driving on Valencia Avenue he made a U-turn because of construction and, when crossing the railroad tracks, his "car bottomed out". Because of huge holes around the tracks, damage was done to the vehicle requiring repairs in the amount of $1 ,661.01. RECOMMENDATION: That the City Council deny Claim Number 06-25, Chris Confer, and direct Staff to send notice thereof to the Claimant. FISCAL IMPACT: None. DISCUSSION: The City's Claims Administrator has verified that the City of Tustin contracted with FCI Constructors for the project work on Valencia Avenue. The City is an additional insured under this Contractor's general liability insurance policy, therefore, the claim was tendered to FCI Constructors, Inc. Staff is recommending a letter of denial be sent at this time. ATTACHMENT: Copy of Claim No. 06-25 ConsiderationOfClaimOfChrisConfer06-25. doc CLAIM AGAINST THE CITY OF TUSTIN (For Damages to Person or Personal Property) iceived Via: U.S. Mail , Inter-Office Mail o Over the Counter Tiro'e Stamp:. Claim i.Jb: r . n 0I1-;l5 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 9 911.2). D. Claims for damages to real property must be filed no later than one year after the occurrence (Government Code 9 911.2). E. If additional space is needed to provide your infonnation, 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 infonnation shown below and must be signed by the claimant or a person on his behalf (Government Code g 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: C1."Ri':J C.on -re K 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) Name of Addressee: t-\ ~ ~ Telephone: Post Office Address: \ 3. The date, place and other circumstances of the occurrence or transaction from which the daim arises. Date of Occurrence: ~ (\ a 00 tp Location: VA \ e f\t\ ~ A-u ~ ~ u.....~ -\-'\ ", ~ l>- - Circumstances giving rise to :hiS claim:. f ~ 10 - -\:\,,\,;'-7' ~ Vh~~ ~ ~J\. R W 0....'>.. t) "to. Lf' So, ~(LX\':15 m ~ h $)" U1 l' 1'0 'Z> CO. ~lj ~ l ~a o-ci ~~~ c..~S - :3::'n.!. $..R~ ~~ Qrl - ~ ~ Lo~~ kJOit~ - ~I~ 8\~~ o{. ~~f tlrOpp~c LowU'''' ~{CPO~~- Q~~ ~r ~ -t~~K . ~Os- wI\':. -W\AX.6. 4D ~GI'!\l\'$}l\ We.~l ~ vb I ~ uJCl...~ 011 i ^ ~-f< I'\. . Time of Occurrence: /(,.OOAYr\ . f~~ 4. - 5. The name or names of the public employee or employees causing the injury, 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 computation: $1 tr ~, ., () ( -:::t" f\$ C '\ (. ~ e ,,~.\~ ~ ~~ ~ r ~ ~ ~'Q. C) f C O--lt. ~'N\l\...~ ~ \ · If amount claimed exceeds $10,000: If the amount claimed exceeds ten thousand dollars ($10,000), do not prOvide a dollar am'ount 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 ~ 86.) o Limited Civil Case o Unlimited Civil Case You are required to provide the information 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 C 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 rises: {\ U-... Q O\\\t - \~ ~. 'o~~'" ~\?~~~~ <\ 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: Telephone: Insurance Policy No.: Insurance Broker/Agent: Address: Telephone: Claimant's Veh. Lie. No.: Claimanfs Drivers Lie. No,: Vehicle MakelY ear: 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 comers. If City/Agency Vehicle was involved, designate by letter "A" location of City/Agency Vehicle when you first saw it, and by "S" 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 "8-1" and the point of impact by "X." NOTE: If diagrams below do not fit the situation, attach hereto a proper diagram signed by claimant ~ . O~~~ _((/b~ f:Y_-o' ~ ^1! L ~~ \J (f> .-- CURB ~ ~ CURB -,. PARKWAY SIDEWALK V~\E(\C'\~ AVb r- 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 determined not to have been brought in good faith and with reasonable cause. Signature: ~ -- Date: '4tr/o~ I I " " If ,. '1 " , , ~ \W~ We:) ~-k.~~-f- ~~~ \ ~C:l~ ~o.L\'\S · 1(e-~ \ Page 30f4 358759 6t29"1 *INVOlCE* COMMONWEALTH VOLKSWAGEN AUDI 1450 AUTO MALL DRIVE SANTA ANA, CA 92705-4732 BUS. (714) 565-7500 FAX (714) 836-8457 E.P.A.# CALOOOO55210 CHRI~ HOME: BUS: DUPLICATE 1 PAGE 1 CP 19JUN06 B .. . .. PARTS & SERVICE HOURS: . .. . .. **************************************************** O~$.Q~o'f. . ':. LABOR AMOUNT PARTS AMOUNT GAS, OIL, LUBE SUBLET AMOUNT MISC. CHARGES TOTAL CHARGES LESS ADJUSTMENT SALES TAX SERVICE I hereby authorize the repair work to be done along with the necessary material and hereby grant your employees permission to operate the vehicle described on streets. highways or elsewhere for the purpose of testing and/or inspection. subject to conditions on reverse side of this contract. MONDAY 7:00 A.M. TO 7:00 P.M. TUESDAY-FRIDAY 7:00 A.M. TO 6:00 P.M. SATURDAY 8:00 A.M. TO 3:00 P.M. I ACKNOWLEDGE NOTICE AND/OR APPROVAL OFAN INCREASE IN THE ORIGINAL ESTIMATED PRICE I ALSO ACKNOWLEDGE RECEIPT OF SONG-BEVERLY WARRANTY ACT PLEASE READ REVERSE SIDE. SEE REVERSE SIDE FOR LIMITED WARRANTY. 7~ ~ SIGNX CUSTOMER ACKNOWLEDGE RECEIPT OF A COPY HEREOF SIGN X PLEASE PAY THIS AMOUNT WARNING MOlor vehlclet conlaln chemicals nown 10 Ihe late of a' ornl8 to cause cancer and birth defects or other reprodUC1lVeharm. h_ chemicals are contained In many vehICle component. and replacemenl pan.. vehICle fluid.. and paWlI. and malerials used to ma,ntaWl vehicles. IncIUdWl9. but nol Hmited 10. luel. oM. batter.... brakes. and wheel balancing wetghts. When you service. clean or maintain your car. you will be exposed to ilIted chemocall contained Wl used oM. weste and replacemenl fluid.. fumes. grease. 9rome. louch-up paWlI. cerlaln replacement part.. and panlculates from component wear When we service your car. we wiD return used componentslo you upon request. Used pant and componentsconlaln chemicals kno~~~~~o.. ~.?ltlh delect. or olher rep =:m~=. :~~h.~-:O:'Io':rirl-C-: ~~:, "r=":'C=.125~;e =~:':~r~~ro:"m::~ab-:~Pr~~ih'1i.~~g1~~d--'ltCtut..natructlon,perUk\nllto prop 358759 64291 *INVOICE* COMMONWEALTH VOLKSWAGEN AUDI 1450 AUTO MALL DRIVE SANTA ANA, CA 92705-4732 BUS. (714) 565-7500 FAX (714) 836-8457 E.P.A.# CAL000055210 CHRIS C0NFER HOME: BUS: DUPLICATE 2 PAGE 2 18:00 09JUN06 :::~~;.:;:{)j(\}t\{/ OPTIONS: 1) BLACK JETTA CP 19JtJN06 PARTS & SERVICE HOURS: SERVICE I hereby authorize the repair work to be done along with the necessary material and hereby grant your employees permission to operate the vehicle described on streets, highways or elsewhere for the purpose of testing and/or inspection. subject to conditions on reverse side of this contract. I ACKNOWLEDGE NOTICE AND/OR APPROVAL OF AN INCREASE IN THE ORIGINAL ESTIMATED PRICE PE$Qr#fthQ.~:.... .. . LABOR AMOUNT PARTS AMOUNT GAS, OIL, LUBE SUBLET AMOUNT MISC. CHARGES TOTAL CHARGES LESS ADJUSTMENT SALES TAX MONDAY 7:00 A.M. TO 7:00 P.M. TUESDAY-FRIDAY 7:00 A.M. TO 6:00 P.M. SATURDAY 8:00 A.M. TO 3:00 P.M. 7~~ I ALSO ACKNOWLEDGE RECEIPT OF SONG-BEVERLY WARRANTY ACT PLEASE READ REVERSE SIDE. SEE REVERSE SIDE FOR LIMITED WARRANTY. SIGN X CUSTOMER ACKNOWLEDGE RECEIPT OF A COPY HEREOF SIGN X PLEASE PAY THIS AMOUNT