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CC SR 20160119 D - Kerry Schiappa Claim Against the Citykl,R CITYOF RANCHO PALOS VERDES TO: HONORABLE MAYOR &CITY COUNCIL MEMBERS FROM: CARLA MORREALE, CIN CLERK DATE: JANUARY 19, 2016 SUBJECT: CLAIM AGAINST THE CITY BY INTERINSURANCE EXCHANGE OF THE AUTOMOBILE CLUB, AS SUBROGEE OF KERRY SCHIAPPA; CLAIM AGAINST THE CITY BY KERRY SCHIAPPA REVIEWED: DOUG WILLMORE, CITY MANAGER RECOMMENDATION Reject the claims and direct Staff to notify the Auto Club, as Subrogee of Kerry Schiappa and claimant. BACKGROUND On October 29, 2015, the City received a claim from the Interinsurance Exchange of the Automobile Club ("Auto Club"), as Subrogee of Kerry Schiappa. The Auto Club states in the claim that damage occurred to the claimant's vehicle on Montemalaga Drive between Silver Spur Road and Basswood Avenue when one of the City's trees "lost a branch that fell across the street from the house located at 5420 Montemalaga Drive. The tree branch fell directly in the path of the moving vehicle associated with this claim." The alleged incident occurred on July 3, 2015, at approximately 1:10 A.M. On January 4, 2016, the City received a separate claim from Kerry Schiappa for the incident that occurred on July 3, 2015, for damage to her vehicle, the $1,000 deductible, and the cost of renting a car while searching for a replacement vehicle. The City's Claims Administrator, Carl Warren and Company, has reviewed the two claims and advised the City to reject the claims, as the City received no prior notices or complaints regarding the condition of the tree. Attachments Claim from Auto Club (page 2) Claim from Kerry Schiappa (page 33) 1 Interinsurance Exchange of the A RECEIVED ��t'�I��,��F-��,�7S VERDES o 1225 Freeport Pkwy, Coppell, TX 75019 We 4o�s OCT 29 2015 October 23, 2015 CITY CLER6'�IE CITY OF RANCHO PALOS VERDES C/O CITY CLERK 30940 HAWTHORNE BLVD RANCHO PALOS VERDES CA 90275 Attention: CLAIMS RE: Insured Claim Number Date of Loss Type of Loss Kerry Dolan Schiappa 011958590 07/03/2015 Auto INITIAL REQUEST The Interinsurance Exchange of the Automobile Club has a claim against City of Rancho Palos Verdes as a result of the accident that has occurred on the above date. The claim consists of: AUTO / PROPERTY 6,050.54 DEDUCTIBLE 1,000.00 RENTAL 0.00 TOTAL $ 7,050.54 Enclosed are the necessary documents to support our subrogation claim, as follows: Claim form, estimate, photos, proof of payment, scene photos, total loss eval and summary and salvage. Please note our CLAIM NUMBER and DATE of Loss on your payment, and forward same to: Interinsurance Exchange of the Automobile Club Corporate Cashiering, Mail Stop A118, PO Box 25024 Santa Ana, CA 92799 Ltr No CC0104 2 Rev* Ed 10/13/2010 October 23, 2015 Page 2 of 2 Claim Number: 011958590 information regarding this matter, do not hesitate to Ltr No CC0104 3 Rev: Ed 10/13/2010 FILE WITH: CITY CLERK'S OFFICE City of Rancho Palos Verdes 30940 Hawthorne Blvd. Rancho Palos Verdes, CA 90275 CLAIM FOR DAMAGES TO PERSON OR PROPERTY INSTRUCTIONS 1. Claims for death, injury to person or to personal property must be filed not later than six months after the occurrence. (Gov. Code Sec. 911.2.) 2. Claims for damages to real property must be filed not later than 1 year after the occurrence. (Gov. Code Sec. 911.2.) 3. Read entire claim form before filing. 4. See Page 2 for diagram upon which to locate place of accident. 5. THIS CLAIM FORM MUST BE SIGNED ON PAGE 2 AT BOTTOM. 6. Attach separate sheets, if necessary, to give full details. SIGN EACH SHEET. RESERVE FOR FILING STAMP CLAIM NO. TO: CITY OF RANCHO PALOS VERDES Date of Birth of Claimant t Name of Claimant Occupation of Cl; 110~nCeWange of the Automobile Club As aC, Home Address of Claimant City and State I Home ephone Business Address or claimant 1225 Freeport Parkwa)PIty and State Business Tele hl r'nnnell. TX 75019 Give address and telephone number to which you communications to be sent regarding this claim: or Cl`aimant's Social Securit* No. When did DAMAGE or INJURY occur? Names of any city employees involved in INJURY or DAMAUt Date 7/3115 Time 1:10AMApproximalely If claim is for Equitable Indemnity, give date claimant served with the complaint: Date Where did DAMAGE or INJURY occur? Describe fully, and locate on diagram on Page 2. Where appropriate, give street names and address and measurements from landmarks: Damage occurred on Montemalaga Drive, RPV on the city street. This section of Montemalaga Drive between Silverspur and Basswood has a parkland area separating the opposing directions of traffic. On this parkland there are several trees. One of the City trees lost a branch that fell across the street from the house located at 5420 Montemalaga Drive. The tree branch fell directly in the path of the moving vehicle associated with this claim Describe in detail how the DAMAGE or INJURY occurred. City tree branch fell directly in front of the car. There was no option to miss the branch(es) as they crossed the entire width of the street and the timing for the branch dropping was precisely at the same time the car was passing the site. The branches hit the car at the left driver side, as well as the right hand side. Witnesses state that they had driven by the location 10 minutes earlier and saw no branch or indication of breaking branch at the site. Another witness heard the crack of the breaking branch from his bedroom (house is adjacent to the street). Witnesses indicated that there have been other falling branches in this same section of the road. Why do you claim the city is responsible? Upon inspection of the branches and tree, it is obvious that there was significant rot to the limb which caused it to be weak and break due to the weight. One of the branches was approximately 16 inches or more in diameter. As stated above, the tree in this case was clearly damaged. An inspection and pruning of the same tree would have prevented this incident. Based on the diameter of the branch, as seen in the attached photos, this could have resulted in serious injury or death if the branch had fallen directly on top of the car. There was zero wind factor at the time of the incident and during the prior 24 hours. There have been at least two other instances of fallen tree branches in the roadway in the past year. The trees in this section should be cut back and pruned to ensure that the rotted sections/branches are not a hazard to pedestrians or autos that pass by. This continues to pose a serious threat to life and property. As can be seen in the accompanying photos, there is obvious rot at the point where the branch was attached to the tree and the surrounding surface. As a prevention measure, the tree should have been inspected. Especially given the size of the branch overhanging the roadway. An inspection would ensure that the damaged tree branch was removed prior to this incident. Describe in detail each INJURY or DAMAGE. Significant damage to the vehicle body, airbag deployment and engine. Auto frame was damaged. Leaking oil, brake fluid and antifreeze indicate serious damage to the engine. The body was tweaked to the point that the back seat was out of position and unmovable. The front hood was unable to be opened. The car was a total loss. Additionally, I have had to rent a car while looking to replace this vehicle. This Claim Must Be Signed on Page 2 al The amount claimed, as of the date of presentation of this claim, is computed as follows: Damages incurred to date (exact): // Estimated prospective damages as far as known: Damage to property .................... $10,1 Future expenses for medical and hospital care . $ Expenses for medical and hospital care ... $ Future loss of earnings ..................... $ Loss of earnings ...................... $ Other prospective special damages .......... $-'.,,.. Special damages for ................... $ Prospective general damages ............... $ Total estimate prospective damages....... $ General damages ...................... $ Total damages incurred to date ........ $ Total amount claimed as of date of presentation of this claim:3�-( w4l Ali 000 da " Rental Car - estimated expense Was damage and/or injury investigated by police? Nu If so, what city?_ Were paramedics or ambulance called? No If so, name city or ambulance If injured, state date, time, name and address of doctor of your first visit WITNESSES to DAMAGE or INJURY: List all persons and addresses of ersons known to have information: Name Ruga and Nick Kordant Address Phone Name Kevin and Isabel Bradley Address Phone Name Address Phone DOCTORS and HOSPITALS: Hospital Doctor Doctor Address Date Hospitalized Address Date of Treatment Address Date of Treatment READ CAREFULLY For all accident claims place on following diagram names 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 Vehicle was involved, designate by letter "A" location of City Vehicle when you first saw it, and by "B" location of yourself or your vehicle when you first saw City vehicle; location of City 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 the claimant. l Basqood :!JSIDEWALK CURB his NOTE: Montemalaga Drive X Incident Location SIDEWALK 5420 Montemalaga Drive Typed Name: er Spu Date: (Pen. ad 1o1z3,1,5 5 Claim: 011958590 III 11 Pol: CAA070923840 I Form: PPA I Ins: KERRY DOLAN SCHIAPPA I I DoL: 07/03/20151 St: Open I Adj: Clayton Ryan (Long Beach ER1) I Claim: 011958590 I Financials (Total Incurred: $6,050.54): Checks Check Number Pay To Net Amount Issue Date Scheduled Status Bulk Invoice Send Date 30087479 KERRY E DOLANSCHIAPPA $6,116.34 07/21/2015 Cleared <none> OR ARMAND SCHIAPPA User: Tracey Lovett Page 1 10/23/2015 10:34 AM X SALVAGE Payer COPART Receipt Type Cashiering Receipt Number Receipt Date Exposure Recovery Adjuster Coverage Cost Type Cost Category Type of Recovery Recovery Category Comments Amount Cashiering Receipt 100-08-001-006 09/17/2015 (1) 1st Party Vehicle - KERRY DOLAN SCHIAPPA Sylvia Gutierrez OTC - Comprehensive - Other than Collision Claim Cost Other Claim Cost Salvage Salvage $65.80 7 TOTAL LOSS SUMMARY Salvage Retained No Valuation Request # 36238472 Valuation Amount $6,426.00 Salvage Bid - Sales Tax $578.34 Unused Registration $112.00 Title transfer fee - Deductible $1,000.00 SubTotal $6,116.34 Amount to Lien Holder - Other Adjustments - Other Deductions - Net $6,116.34 0 • Date: Estimate ID: Estimate Version: Committed Profile ID: **NO SUPPLEMENTS WILL BE PAID WITHOUT PRIOR APPROVAL** Automobile Club of Southern California PO BOX 91839, LONG BEACH, CA 91839 (562) 355-2931 Fax: (714) 754-2158 Email: montes.david@aaa-calif.com Damage Appraised By: David Montes Classification: Other Type of Loss: Comprehensive Date of Loss: 07/03/2015 Date Veh Avail 07/1012015 Deductible: 1,000.00 Policy No: Item Insured: KERRY DOLAN SCHIAPPA Owner: KERRY DOLAN SCHIAPPA Address: Amount Telephone: Unit Description: 2004 Volvo S60 Appraised For: Cla ton R an Mitchell Service: 917373 Claim Number: Home Phone: Contact Phone: 07/10/2015 02:47 PM 011958590-1-9984 0 * 40/30 Body Style: 4D Sed Drive Train: 2.4L Inj 5 Cyl 5A FWD VIN: License: OEM/ALT: A Search Code: ACSCNO Options: PASSENGER AIRBAG, POWER LOCK, POWER WINDOW, POWER STEERING, REAR WINDOW DEFOGGER AIR CONDITIONING, CRUISE CONTROL, TILT STEERING COLUMN, AM/FM STEREO DRIVER AIRBAG, HEATED EXTERIOR MIRROR, REAR (DUAL -ZONE) AC FRONT SIDE AIRBAG WITH HEAD PROTECTION, ANTI-LOCK BRAKE SYS., TRACTION CONTROL ALUM/ALLOY WHEELS, ANTI -THEFT SYSTEM, LEATHER STEERING WHEEL, CD PLAYER POWER ADJUSTABLE EXTERIOR MIRROR, SUNROORMOONROOF, CASSETTE PLAYER FIRST ROW BUCKET SEAT, CLOTH SEAT, SIDE AIRBAGS SECOND ROW SIDE AIRBAG WITH HEAD PROTECTION, DAYTIME RUNNING LIGHTS DRIVER SEAT WITH POWER LUMBAR SUPPORT, KEYLESS ENTRY SYSTEM, REAR BENCH SEAT STEERING WHEEL AUDIO CONTROLS **ALL PARTS LISTED ARE NEW OEM UNLESS OTHERWISE INDICATED** **THIS IS NOT AN AUTHRORIZATION FOR REPAIRS** Line Entry Labor Line Item Part Type/ Dollar Labor CEG Item Number Type Operation Description Part Number Amount Units Unit Front Bumper 1 BDY OVERHAUL Frt Bumper Cover Assy 2.2 # 2.2 2 700045 BDY REMOVE/REPLACE Frt Bumper Cover 39963811-3 844.55 INC # 2.2T 3 700063 BDY REMOVE/REPLACE L Frt Bumper Bracket 9484362-0 26.22 INC T 4 700070 BDY REMOVE/REPLACE R Frt Otr Bumper Cover Moulding 9484011-3 48.13 INC 0.2T 5 700071 BDY REMOVE/REPLACE L Frt Otr Bumper Cover Moulding 9484010-5 48.13 INC 0.2T 6 700072 BDY REMOVE/REPLACE Frt Ctr Bumper Cover Moulding 9484229-1 34.80 INC 0.2T 7 704258 BDY REMOVE/REPLACE Frt Bumper Energy Absorber 9178213-6 125.32 INC T 8 700078 BDY REMOVE/REPLACE Frt Bumper Reinforcement 31253240-1 379.02 1.0 # 1.OT 9 BDY REMOVE/INSTALL Frt Bumper Assy INC 1.2 Grille 10 700097 BDY REMOVE/REPLACE Grille 9151881-1 279.67 INC 0.3T Front Lamps ESTIMATE RECALL NUMBER: 07/10/2015 14:46:59 011958590-1-9984 Mitchell Data Version: OEM: MAY 15 V MAPP:MAY_15_V Copyright (C) 1994 - 2015 Mitchell International Page 1 of 3 Software Version: 7.1.177 All Rights Reserved 9 11 700103 BDY 12 BDY 13 700155 BDY 14 REF 15 REF 16 700266 BDY 17 REF 18 REF 19 700317 MCH 20 703370 MCH 21 700361 MCH 22 704307 MCH 23 MCH 24 702529 MCH 25 BDY 26 936014 27 REF 28 REF 29 933003 REF 30 933018 REF 31 32 REMOVE/REPLACE CHECK/ADJUST REMOVE/REPLACE REFINISH REFINISH REMOVE/REPLACE REFINISH REFINISH REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REMOVE/REPLACE REMOVE/INSTALL REMOVE/REPLACE REMOVE/INSTALL ADD'L COST ADD'L OPR ADD'L OPR ADD'L OPR ADD'L OPR ADD'L COST ADD'L COST L Frt Combination Lamp Assembly Headlamps Hoo Hood Panel Hood Outside Add For Hood Underside Front Fender L Fender Panel L Fender Outside L Add To Edge Fender Front Inner Structure Sub -Frame Assy -M Air Bag System Air Bag Module -Driver Front -M Air Bag Contact -M Air Bag Module -Passenger Front -M Instrument Panel Assy -M Air Bag Sensor -M Console ADDITIONAL COSTS & MATERIALS FLEX ADDITIVE ADDITIONAL OPERATIONS DE -NIB AND FINESSE Clear Coat TINT COLOR MASK FOR OVERSPRAY Additional Costs & Materials Paint/Materials Hazardous Waste Disposal * - Judgment Item # - Labor Note Applies ** Aftermarket - Aftermarket C - Included in Clear Coat Calc PARTSCHANNEL LA ACE 8905 REX RD. TMT GROUP PICO RIVERA CA 90660 (800)637-2898 11 ** V3782A/N 375.00 Remarks **TOTAL LOSS PER ESTIMATE -COLLECT ALL FROM OWNER**** Estimate Totals Date: 07/10/2015 02:47 PM Add'I Estimate ID: 011958590-1-9984 Estimate Version: 0 Labor Sublet Committed 1. Labor Subtotals Units Rate Profile ID: * 40/30 Totals Il. Part Replacement Summary ** Aftermarket 375.00 INC # 1.6T 294.80 Taxable Parts 0.4 0.4 30796490-8 894.72 1.0 1.0T Mechanical C 2.8 2.8 864.50 C 1.4 1.4 30796492-4 382.25 1.3 # 2.5T C 1.7 2.1 1,621.30 C 0.5 0.5 30793297-0 1,163.55 6.8 6.8T 31332814-8 821.96 INC 0.5T 8622186-8 309.41 1.1 1.1T 30754337-1 1,043.54 0,5 # 0.5T Software Version: 7.1.177 4.5 4.5 30658912-8 620.05 0.4 # OAT 0.8 0.8 5.00 * T 1.0 2.1 10.00 * 0.5* 12.00 * 289.00 * T 5.00 * 9.000% Amount 7,396.32 665.67 8,061.99 Page 2 of 3 10 Add'I Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals Il. Part Replacement Summary Body 6.7 44.00 0.00 0.00 294.80 Taxable Parts Refinish 10.0 44.00 22.00 0.00 462.00 Sales Tax @ Mechanical 13.3 65.00 0.00 0.00 864.50 Total Replacement Parts Amount Non -Taxable Labor 1,621.30 Labor Summary 30.0 1,621.30 ESTIMATE RECALL NUMBER: 07/10/2015 14:46:59 011958590-1-9984 Mitchell Data Version: OEM: MAY 15-V MAPP:MAY_15_V Copyright (C) 1994 - 2015 Mitchell International Software Version: 7.1.177 All Rights Reserved 1.0 2.1 10.00 * 0.5* 12.00 * 289.00 * T 5.00 * 9.000% Amount 7,396.32 665.67 8,061.99 Page 2 of 3 10 THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. ANY WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE PARTS, RATHER THAN BY THE ORIGINAL MANUFACTURER OF YOUR VEHICLE. Point(s) of Impact 15 Total Loss (P) Insurance Co: AAA California Inspection Site: Insured's Address Address: Inspection Date: 07/10/2015 THANK YOU FOR ALLOWING US TO BE OF SERVICE. FOR MORE INFORMATION ABOUT ALL THE PRODUCTS AND SERVICES THE AUTO CLUB OFFERS, PLEASE CALL 1-877-428-2277, VISIT YOUR LOCAL AUTO CLUB OFFICE OR VISIT OUR WEB SITE WWW.AAA-CALIF.COM. ESTIMATE RECALL NUMBER: 07/10/2015 14:46:59 011958590-1-9984 Mitchell Data Version: OEM: MAY 15 V MAPRMAY 15_V Copyright(C)1994-2015 Mitchell International Page 3 of 3 Software Version: 7.1.177 v All Rights Reserved 11 Date: 07/10/2015 02:47 PM Estimate ID: 011958590-1-9984 Estimate Version: 0 Committed Profile ID: "40/30 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 294.00 Insurance Deductible 1,000.00 - Sales Tax @ 9.000% 26.46 Customer Responsibility 1,000.00 - Non -Taxable Costs 5.00 Total Additional Costs 325.46 Paint Material Method: Rates Init Rate = 34.00 , Init Max Hours = 99.9, Addl Rate = 0.00 I. Total Labor: 1,621.30 II, Total Replacement Parts: 8,061.99 III. Total Additional Costs: 325.46 Gross Total: 10,008.75 IV, Total Adjustments: 1,000.00 - Net Total: 9,008.75 TOTAL LOSS THIS ESTIMATE HAS BEEN PREPARED BASED ON THE USE OF CRASH PARTS SUPPLIED BY A SOURCE OTHER THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. ANY WARRANTIES APPLICABLE TO THESE REPLACEMENT PARTS ARE PROVIDED BY THE MANUFACTURER OR DISTRIBUTOR OF THE PARTS, RATHER THAN BY THE ORIGINAL MANUFACTURER OF YOUR VEHICLE. Point(s) of Impact 15 Total Loss (P) Insurance Co: AAA California Inspection Site: Insured's Address Address: Inspection Date: 07/10/2015 THANK YOU FOR ALLOWING US TO BE OF SERVICE. FOR MORE INFORMATION ABOUT ALL THE PRODUCTS AND SERVICES THE AUTO CLUB OFFERS, PLEASE CALL 1-877-428-2277, VISIT YOUR LOCAL AUTO CLUB OFFICE OR VISIT OUR WEB SITE WWW.AAA-CALIF.COM. ESTIMATE RECALL NUMBER: 07/10/2015 14:46:59 011958590-1-9984 Mitchell Data Version: OEM: MAY 15 V MAPRMAY 15_V Copyright(C)1994-2015 Mitchell International Page 3 of 3 Software Version: 7.1.177 v All Rights Reserved 11 Itemized Totals I. Labor Subtotals Units Rate Totals Body 6.7 44.00 294.80 Remove/Replace 3.3 Total Replacement Parts Amount 145.20 Remove/Install 0,8 35.20 Overhaul 2.2 96.80 Check Adjust 0,4 1760 Refinish 10.0 44.00 462.00' Refinish Only 6.4 " 281.60 Additional Operation ($) 0.0 N/A 22.00 Additional Operation 3.6 158.40 Mechanical 13.3 65.00 864.50 Remove/Replace 8,8 572.00 Remove/Install 4.5 292.50 Non -Taxable Labor 1,621.30 Labor Summary 30.0 1,621.30 III. Additional Costs Taxable Costs Sales Tax @ 9.000% Non -Taxable Costs Total Additional Costs Paint Material Method: Rates Init Rate = 34.00 , Init Max Hours = 99.9, Add] Rate = 0.00 Date: 07/10/2015 02:47 PM Estimate ID: 011958590-1-9984 Estimate Version: 0 Committed 375.00 Profile ID: .40/30 II. Part Replacement Summary Amount Taxable Parts 7,396.32 New 7,021.32 '"Qual Repl Part 375.00 Sales Tax @ 9.000% 665.67 Total Replacement Parts Amount 8,061.99 Amount IV. Adjustments Amount 294.00 Insurance Deductible 1,000.00- 26.46 Customer Responsibility 1,000.00- 5.00 325.46 I. Total Labor: 1,621.30 II. Total Replacement Parts: 8,061.99 III. Total Additional Costs: 325.46 Gross Total: 10,008.75 IV. Total Adjustments: 1,000.00 - Net Total: 9,008.75 TOTAL LOSS Total includes Additional Labor ($) dollar amounts as shown within the group ESTIMATE RECALL NUMBER: 07/10/2015 14:46:59 011958590-1-9984 Mitchell Data Version: OEM: MAY _15_V MAPP:MAY_15_V Copyright (C) 1994 - 2015 Mitchell International Software Version: 7.1.177 All Rights Reserved Page 1 of 1 12 Claim: 011958590-I-9984 01 Claim: 011958590-I-9984 01 Page 1 of 1 KERRY DOLAN SCHIAPPA I M G_2946.jpg Jul -10-2015 02:37p IMG_2955.jpg Jul -10-2015 02:37p I MG_2945.jpg Jul -10-2015 02:37p https://www.mymitchell.com/ClaimIClaimFileV iewerlPhotoPrint.aspx?CID=36054765 &... 10/23/21 AuggKv1ore,, Autoso u rce Market -Driven Valuation T"^ Administrative Data David Montes Claimant Auto Club of Southern Calif. Insured Schiappa APD South Team 1 Branch Claim 011958590 3333 Fairview Road Costa Mesa CA 92626 VINSOURCE Analysis VIN NICB Report Loss Date 07/03/2015 Loss Type Collision Policy Other Decodes as 2004 Volvo S60 2.4 4D Sedan Accuracy Decodes Correctly History No activity was reported AudaVIN Yes NICB/ISO T014 TRAVELERS INDEMNITY COMPANY Member Claim HIH7961001 Loss Date 09/19/11 Type of Loss ESTIMATE Phone 00000000000 Point of Impact Right Rear Side NICB/ISO T014 TRAVELERS INDEMNITY COMPANY Member Claim HIH7961001 Loss Date 09/19/11 Type of Loss PROPERTY/CASUALTY Phone 8007273995 NICB/ISO 1012 INTERINS EXCHANGE OF THE AUTO CLUB OF Member SOUTHERN CA Claim 011958590-1-9984 Loss Date 07/03/15 Type of Loss ASSIGNMENT Phone Point of Impact Left And Right NICB/ISO 1012 INTERINS EXCHANGE OF THE AUTO CLUB OF Member SOUTHERN CA Claim 011958590EXP1 Loss Date 07/03/15 Type of Loss PROPERTY/CASUALTY Phone 7148852621 Vehicle Salvage Title Summary No Branded title history found for this VIN. 14 2004 Volvo S60 2.4 4D Sedan Processed on 07/10/15 2:45 PM. Title History is powered by Experian AutoCheck. The Experian data contained in this report involves the conveyance of information provided to Experian by other AutoCheek sources. Accordingly, neither Experian nor AudaExplore can, or will, be an insurer or guarantor of the accuracy or reliability of the Experian data. Recall Bulletins Nat'l. Highway Traffic Safety Admin (US) has issued a total of 3 recall bulletins that may apply to this vehicle. JkWL2@J= 04VO29 Date Issued 01/01/04 Quantity Affected 29,986 Dates Of Manufacture March - October 2003 Defect On certain passenger vehicles, the front control arms may not have been manufactured correctly and, as a result, the stud and nut that secure the arm to the spindle may lose their initial axial tension. Under certain driving conditions, the steering may become less responsive and the driver may experience steering wheel play. This driving condition could eventually lead to separation between the front control arm and the spindle, which could result in a crash. Remedy Dealers will install a new type of nut. The manufacturer has not yet provided NHTSA with an owner notification schedule for this campaign. Owners may contact Volvo at 1-800-458-1552. NHTSA ID Number 07V226000 Date Issued 05/24/07 Quantity Affected 38,700 Defect On certain passenger vehicles, the fuel pressure sensor located on the left end of the fuel rail may, at times, transmit incorrect signal regarding the fuel pressure to the engine control module. If the signal is outside of the pre-programmed allowable limits, a diagnostic trouble code may be set and the check engine light will come on. The soldered joints on the circuit board of the fuel pressure sensor may crack due to temperature changes and excessive vibrations. Misfire may occur during driving that, in turn, will reduce the engine torque and in the worst case scenario, the engine may stall without warning. In certain traffic situations this could cause an unsafe situation and possibly a crash. Remedy Dealers will replace the fuel pressure sensor free of charge. The manufacturer has not yet provided an owner notification schedule for this campaign. Owners may contact Volvo at 1-800- 458-1552. 09V483000 Date Issued 12/17/09 Quantity Affected 136,100 Defect Volvo is recalling certain model year 2001-2005 S80, model year 2001- 2004 V70, S60, XC70 and model year 2003-2005 XC90 vehicles sold in or registered in the states of Alabama, Arizona, Arkansas, California, Florida, Georgia, Hawaii, Kentucky, Louisiana, Mississippi, Nevada, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia and the U.S. Territories. When exposed to certain environmental conditions (hot climate and temperature cycling) over time and in combination with varying fuel quality, the fuel pump can develop cracks in the fuel pump flange. If the condition occurs vehicle owners may notice fuel smell and/or fuel leak which, in the presence of an ignition source, could result in a fire. Remedy Dealers will inspect the fuel pump installed in the vehicle, and if necessary replace the fuel pump with a part of a modified design. This service will be performed free of charge. The safety recall is expected to begin during January 2010. Owners may contact Volvo at 1-800-458-1552. Volvo Safety Recall No. R220. (PLEASE SEE NEXT PAGE) Owners May Also Contact The Owners may also contact the National Highway Traffic Safety Administration's Vehicle Safety National Highway Traffic Safety Hotline at 1-888-327-4236 (TTY 1-800-424-9153), or go to http://www.safercar.gov. Administration's Valuation Detail Typical Vehicle Your Vehicle Adjustment Vehicle Base Price Rancho Palos Verdes Market $5,661 Claim 011958590 Request 36238472 Page 2 15 Odometer 138,885 Mi(Typical) 103,254 Mi(Actual) Other Optional Equipment Xenon Headlamps Vehicle Description Vire: 2004 Volvo S60 2.4 4D Sedan 103,254 Miles 5cyl Gasoline 2.4 5 Speed Automatic Interior Air Conditioning Cruise Control Lighted Entry System Power Drivers Seat Leather Steering Wheel Telescopic Steering Whl Exterior Mechanical Safety Entertainment Packages Trim Levels Rear Window Defroster Heated Power Mirrors Power Moonroof Power Brakes Dual Airbags Head Airbags Compact Disc W(Tape 2004 Volvo S60 2.4 4D Sedan 715 50 Market Driven Value $6,426 Alarm System Center Console Power Door Locks Split Folding Rear Seat Tachometer Tilt Steering Wheel Xenon Headlamps Metallic Paint Tinted Glass Power Steering Anti -Lock Brakes Side Airbags Strg Wheel Radio Control Dual Zone Auto A/C Intermittent Wipers Power Windows Leather Seats Trip Computer Wood Interior Trim Keyless Entry System Rem Trunk-L/Gate Release Aluminum/Alloy Wheels Stability Cntr/ Suspensn Fog Lights Traction Control System Climate Package, Headlight Washers, Heated Front Seats, Rain -Sensing W/S Wipers *2.4 * Indicates your trim level A detailed description of your vehicle was provided to Autosource by a trained appraiser. Through a partnership with Volvo, AudaExplore AudaVIN retrieves the individual vehicle specifications to identify the vehicle specifications including equipment, packages, engine and transmission. Contact your Claims Service Representative if revisions are necessary. The bold/italic font indicates options reported by the manufacturer. Vehicle Condition Seats Minor Wear Carpets Minor Wear Int Trim Minor Damage Glass Good Headliner Good Body Minor Damage Paint Moderate Damage Claim 011958590 Request 36238472 Page 3 16 2004 Volvo S60 2.4 4D Sedan Ext Trim Engine Transmission Front Tires Rear Tires Valuation Notes Minor Damage Minor Wear Minor Wear Good Good o Loss vehicle description was provided by Auto Club of Southern Calif. o Adjustments of Special Note o A mileage adjustment of 2.00 cents per mile/kilometer has been applied. This adjustment is based on the vehicle year, vehicle category and market area. Mileage adjustments are capped at 40% of the vehicle's starting value. o Typical mileage for this 2004 Volvo S60 in California is 138,885. o No special adjustments were made for this vehicle. o All values are in U.S. dollars. o Autosource Valuation Process o Over 5,000,000 vehicles are entered weekly into the database used for researching this value. This database includes dealer inspected, dealer inventory, dealer advertised, phone verified and advertised private party vehicles. o The originating search area for this valuation was Rancho Palos Verdes, California. Comparable Vehicle Details The Autosource database contains inspected dealer inventories, dealer advertisements, phone verified vehicles, and private party advertisements from thousands of sources including automotive publications, newspapers and Web sites. Autosource uses vehicles comparable in year, make and model within the specified market area, expanding as necessary, to determine the loss vehicle's local market value. This valuation includes a representative sample of the vehicles used to calculate the typical starting price. The market search originated from Zip Code 90275, as determined by the vehicle owner's principally garaged area. Autosource located 17, 2004 Volvo S60 vehicles which were used to determine the typical vehicle price. Adjustments have been made to the comparable vehicles for value differences in vehicle description as indicated in the "Veh Adj" field. The sum of the 17 comparable vehicles is $96,239 for an average price of $5,661. The asking or actual sale price is displayed for each vehicle, If a vehicle has been sold, the sold price is displayed with an (S) indicator. The selling price may be substantially less than the asking price. Additional adjustments have been made to the typical vehicle price taking into consideration the loss vehicle's mileage, equipment and condition. All adjustments are vehicle specific and reflect driving habits and condition for the vehicle's market. A mileage adjustment of 2.00 cents per mile has been applied. Taking into consideration the vehicle specifics, the fair market value is $6,426. The following comparables represent a sample of the vehicles used to calculate the Vehicle Base Price. The complete list of vehicles is available upon request. These vehicles have been recently offered for sale in the market place. 1 2004 Volvo S60 2.4 2WD 4D Sedan $5,495 Stock# X51002. 99,150 Miles. 5 Cylinder 2.4 Engine, Automatic Transmission, Air Conditioning, Dual Airbags, Alarm System, Anti - Lock Brakes, Dual Zone Auto A/C, Cruise Control, Center Console, Rear Window Defroster, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Heated Power Mirrors, Power Brakes, Power Door Locks, Power Steering, Power Windows, Compact Disc W/Tape, Split Folding Rear Seat, Rem Trunk-L/Gate Release, Side Airbags, Velour/Cloth Seats, Strg Wheel Radio Control, Leather Steering Wheel, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Aluminum/Alloy Wheels, Audio System Security, Center Armrest. Offered for sale by Cars 911 in Los Angeles, CA, (323)222-2400. Vehicle information by Cars.com on 07/09/15 2 2004 Volvo S60 2.4 2WD 4D Sedan $3,999 154,179 Miles. 5 Speed Automatic, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Leather Seats, Claim 011958590 Request 36238472 Page 4 17 2004 Volvo S60 2.4 4D Sedan Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel. Offered for sale by Dealer in Van Nuys, CA, (818)618-6561. Vehicle information by Cars.com on 07/06/15. 3 2004 Volvo S60 2.4 2WD 4D Sedan $4,975 Stock# 405032. 89,028 Miles. 5 Cylinder 2.4 Engine, Automatic Transmission, Air Conditioning, Dual Airbags, Alarm System, Anti - Lock Brakes, Dual Zone Auto A/C, Cruise Control, Center Console, Rear Window Defroster, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Heated Power Mirrors, Power Brakes, Power Door Locks, Power Steering, Power Windows, Compact Disc W/Tape, Split Folding Rear Seat, Rem Trunk-L/Gate Release, Side Airbags, Velour/Cloth Seats, Strg Wheel Radio Control, Leather Steering Wheel, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Aluminum/Alloy Wheels, Under Warranty. Offered for sale by City Cars Warehouse in Van Nuys, CA, (818)261-4407. Vehicle information by Cars.com on 06/29/15 4 2004 Volvo S60 2.4 2WD 4D Sedan $4,750 136,350 Miles. 5 Speed Automatic, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Power Drivers Seat, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Leather Seats, Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Overdrive, Owner Non -Smoker, New Tires. Offered for sale by Dealer in Anaheim, CA, (714)396-1553. Vehicle information by Autotrader.com on 07/04/15. 5 2004 Volvo S60 2.4 2WD 4D Sedan $5,980 Stock# C6241953. 90,730 Miles. 5 Speed Automatic, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Velour/Cloth Seats, Well Equipped, Second Owner of Vehicle, Automatic Transmission. Offered for sale by Starfire Auto in Saugus, CA, (661)513-4240. Vehicle information by Cars.com on 07/06/15. 6 2004 Volvo S60 2.4 2WD 411) Sedan $4,999 Stock# 10006. 135,547 Miles. 5 Speed Automatic, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Leather Seats, Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Overdrive, Shift Knob. Offered for sale by New To You Auto Sales Inc. in Fontana, CA, (909)200-2555. Vehicle information by Autotrader.com on 05/03/15. 7 2004 Volvo S60 2.4 2WD 4D Sedan $4,995 104,000 Miles. 5 Speed Automatic, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Fog Lights, Head Airbags, Heated Front Seats, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Leather Seats, Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Excellent Condition. Offered for sale by Bargain Automart in San Diego, CA, (619)325-1880. Vehicle information by Autotrader com on 05/31/15 8 2004 Volvo S60 2.4 2WD 4D Sedan $4,291 Stock# 57209A. 86,961 Miles. 5 Speed Manual, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Claim 011958590 Request 36238472 Page 5 • 2004 Volvo S60 2.4 4D Sedan Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Velour/Cloth Seats, Child Safety Locks, Floor Mats, Reading Lamps, Power Outlet, Security System. Offered for sale by Direct Auto Plaza in EI Centro, CA, (760)353-8000. Vehicle information by Autotrader.com on 04/19/15. 9 2004 Volvo S60 2.4 2WD 4D Sedan $4,888 Stock# 0183. 108,450 Miles. 5 Speed Automatic, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Fog Lights, Head Airbags, Heated Front Seats, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Leather Seats, Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Overdrive, Premium Wheels, Security System. Offered for sale by Pacific Motors in Fremont - Newark, CA, (510)453-2924. Vehicle information by Autotrader.com on 07/05/15 10 2004 Volvo S60 2.4 2WD 4D Sedan $5,998 Stock# 251797693. 93,050 Miles. 5 Speed Automatic, Anti -Lock Brakes, Air Conditioning, Alarm System, Aluminum/Alloy Wheels, Cruise Control, Compact Disc W/Tape, Center Console, Dual Airbags, Rear Window Defroster, Heated Power Mirrors, Dual Zone Auto A/C, Fog Lights, Head Airbags, Intermittent Wipers, Keyless Entry System, Lighted Entry System, Leather Steering Wheel, Power Brakes, Power Door Locks, Power Steering, Power Windows, Rem Trunk-L/Gate Release, Side Airbags, Split Folding Rear Seat, Strg Wheel Radio Control, Tachometer, Traction Control System, Telescopic Steering Whl, Tinted Glass, Tilt Steering Wheel, Velour/Cloth Seats, Audio System Security, Center Armrest. Offered for sale by a dealer in Hayward, CA, (888)449-6491. Vehicle information by Cars.com on 07/06/15 Claim 011958590 Request 36238472 Page 6 19 Original Equipment Guide Engine Options Transmission Options * 5 Cylinder 2.4 Engine STD 5 Speed Manual STD * 5 Speed Automatic $1,000 Other Optional Equipment Convenience Options * Anti -Lock Brakes STD * Air Conditioning STD ' Center Console STD Automatic Dimming Mirror ' Dual Airbags STD * Cruise Control STD ' Fog Lights STD * Rear Window Defroster STD ' Head Airbags STD * Dual Zone Auto A/C STD * Headlight Washers TYP Garage Door Opener ' Intermittent Wipers STD * Rain -Sensing W/S Wipers TYP * Keyless Entry System STD * Rem Trunk-L/Gate Release STD ' Lighted Entry System STD * Strg Wheel Radio Control STD * Leather Steering Wheel STD * Telescopic Steering Whl STD ' Metallic Paint $450 * Tilt Steering Wheel STD Navigation System $1,995 Power Accessories ' Side Airbags STD * Heated Power Mirrors STD * Stability Cntrl Suspensn $695 * Power Drivers Seat TYP Emergency S.O.S. System $835 * Power Brakes STD ' Tachometer STD * Power Door Locks STD ' Trip Computer TYP * Power Steering STD ' Traction Control System STD * Power Windows STD ' Tinted Glass STD Seat Options * Wood Interior Trim TYP Driver Seat Memory TYP Wood Steering Wheel $250 * Heated Front Seats TYP * Xenon Headlamps $500 * Leather Seats $1,400 Claim 011958590 Request 36238472 Page 6 19 2004 `Joivo S60 2 4 4E) Sedan Radio/Phone/Alarm Options * Split Folding Rear Seat STD Alarm System STD Velour/Cloth Seats STD Compact Disc W/Tape STD Roof Options Wheel Options * Power Moonroof $1,200 Aluminum/Alloy Wheels STD Option Packages Climate Package $550 Includes Headlight Washers, Heated Front Seats, Rain - Sensing W/S Wipers Premium Package $2,995 Includes Power Glass Moonroof; Leather Seat Trim; Dual 8 Way Power Seat Adjusters; Leather Wrapped Steering Wheel; am/fm Stereo W/Cd And Cassette; Simulated Wood Trim. Sport Package $795 Includes Front Fog Lights; 16 Inch Ursa Alloy Wheels. Touring Package $595 Includes Inside Automatic Day/Night Mirror; Security Laminated Side Glass; Garage Door Opener; Power Folding Rear Headrest; One Additional Cup Holder. priceBase retail $27,645 ii Loss Vehicle manufacturer's suggested retail price as reported �I Editions available for the same body style (in order of original cost, increasing): *2.4 * Indicates loss vehicle equipment. California Regulatory Statement T �� For your protection California law requires the following to appear on this form: Any person who knowingly presents false or fraudulent claim for the payment of a loss is guilty of a crime and may be subject to fines and confinement in state prison. False representations made on a signed auto theft claim form subject the insured to a penalty of perjury. About Your Valuation This report contains proprietary information of AudaExplore and shall not be disclosed to any third party (other than the insured or claimant) without AudaExplore's prior written consent. If you are the insured or claimant and have questions regarding the description of your vehicle, please contact the insurance company that is handling your claim. Information within VINsource/NICB is provided solely to identify potential duplicative claims activity. User agrees to use such information solely for lawful purposes. Tax rates contained herein are based on general sales tax data provided by Vertex Inc. Excise, use, registration, licensing and other taxes and fees that may be applicable are not included. AudaExplore makes no representations or warranties concerning the applicability or accuracy of such tax data. Report Generated by AudaExplore, a Solera Company US Pat. No 7912740132 US Pat. No 8200513132 US Pat. No 8468038132 US Pat. No 8725544 © 2015 AudaExplore North America, Inc. All Rights Reserved, Claim 011058590 Request 36238472 Page 7 20 L,:+vett.Tracey From: Kerry Schiappa Sent: Tuesday, September 01, 2015 1:28 AM To: Lovett.Tracey Subject: Claim 011958590 Attachments: Claim for Damages Form (PDF)_201501051445176201 Volvo-signed.pdf 21 Hi Tracey, K It was nice speaking with you today. As I mentioned, attached is the claim form. I did not include a value for the auto. Let me know if anything needs to be changed or added. Thank you for your assistance. If this claim is denied, I plan to file in small claims court. Kind regards, Kerry E. Dolan 22 L®vett.Tracey From: Kerry Schiappa Sent: Tuesday, July 07, 2015 1:06 AM To: Ryan.Clayton Subject: Photos File 1 - Claim 011958590 Hi Ryan, Here is second group of photos. Kerry Schiappa 23 1104 Ac . IN or 4, t f lei y<• adi 1' a _ f (x'i I x: _< r � r� � i1r 1. ��1'� ♦ '� i. 5� y�'' • +4S - _ - ecru r'• - a s �`�" � — -•lir: `,r ' W'�I f AI 7 r Lovett.Tracey From: Kerry Schiappa Sent: Tuesday, July 07, 2015 1:10 AM To: Ryan.Clayton Subject: Photos File 1 - Claim 011958590 Hi Ryan, Fourth group of photos. 27 1l' woo,r i s 1, r iv s .tet �:?/ cl 1`r ,! �r..a ` � A a _� �y *�a yt %,�,�.. r *� � ♦♦����./! .�1�V �1 4?: f�q, �;�i�„i a�� _.i1G W, •. `• Pt it a4 `' E I.r. d�'h'� .,.. a•� }„ T �, illa'.y �^k.. '.�.�i t ! .� l`S a �..i-• '�i�'I.' s.• r4'� {4 a;;"k�".'.��S kyi�:.'" y` _g Lovett.Tracey From: Kerry Schiappa Sent: Tuesday, July 07, 2015 1:13 AM To: Ryan.Clayton Subject: Photos File 1 - Claim 011958590 Hi Ryan, Fifth group of photos. 29 Kerry 30 44 ��� \ �� ^� \ y w E ����•� r� ���yff �.i` .�3i !�i.�,l' ia�,�a n 2 _'., r�.� � w FILE WITH: CITY CLERK'S OFFICE City of Rancho Palos Verdes 30940 Hawthorne Blvd. Rancho Palos Verdes, CA 90275 16"1 16 1 w'"' N ,. 11011U - " 41011141:1111=161U4014 INSTRUCTIONS 1. Claims for death, injury to person or to personal property must be filed not later than six months after the occurrence. (Gov. Code Sec. 911.2.) 2. Claims for damages to real property must be filed not later than 1 year after the occurrence. (Gov. Code Sec. 911.2.) 3. Read entire claim form before filing. 4. See Page 2 for diagram upon which to locate place of accident. 5. THIS CLAIM FORM MUST BE SIGNED ON PAGE 2 AT BOTTOM. 6. Attach separate sheets, If necessary, to give full details. SIGN EACH SHEET. k INi"11 CK612:1i► [Q061 Name of Claimant Kerry Schiappa Home Address of Claimant cess Give address and telephone number to which you communications to be sent reclardina this claim: Ki Date July 3, 2015 Time 1:10 AM If claim is for Equitable Indemnity, give date claimant served with the complaint: Date City and Stat City and Stat ire notices or Names of any city PPF RESERVE FOR FILING STAMP M "t" � NIcoLe CLAIM NO. 2�01 b_ — 0 1 L, RECEIVEDOe b C -- CITY OF RANCHO PALOS VERGES JAN 0 4 2010 CITY CLEW OFFICE Date of Birth of Claimant Occupation of Claimant Sales Executive Home Telephone Number ousmess i elepnone Numner PlaoimapntsPociRanecurRyo. NA Involved In INJURY or DAMAGE Where did DAMAGE or INJURY occur? Describe fully, and locate on diagram on Page 2. Where appropriate, give street names and address and measurements from landmarks: Damage occured on Montemalaga Drive, RPV. The tree that lost its limb is directly across from the house located at 5420 Montemalaga Drive. The tree is located in a city parkway that separates traffic in opposing directions. Describe in detail how the DAMAGE or INJURY occurred. The damage occurfed when a city tree branch fell directly in front of the car as it was in motion driving at the speed of approximately 33 MPH. There was no option to avoid the branches as they crossed the entire width of the street and the timing for the branch dropping was precisely at the same time the car was passing the site. The branches hit the car at the left driver side, as well as the right hand side. Witnesses, Mr./Mrs. Nick & Roya Kordani, stated that they drove by the location 10 minutes earlier (returning from a late dinner) and saw no branch or indication of breaking branch at the site. Another witness, Mr. Kevin Bradley, heard the crack of the breaking branch from his bedroom (house adjacent to the street). Damage to the automobile, VOLVO S60, was severe. The insurance company, AAA, rendered the vehicle a total loss. Why do you claim the city is responsible? Upon inspection of the branches and tree (see attached photos from just after the incident and the early morning with daylight), it is obvious that there was significant limb rot which caused it to be weak and break due to the weight. The primary branch was approx. 16 inches in diameter. In addtion, the condition of the wood appeared dried out. There was no wind factor the evening prior or at the time of the incident. The daytime temperature was 75 degrees. The city is responsible for maintaining the trees in a manner that would avoid serious damage and personal injury. If the tree limb had fallen a split second later, there could have been a fatality based on the size and weight of the limb. The city employee worked for quite a while to cut and move the branches wth the assistance of others onsite. The road was not cleared until after 4 AM. During that time, the road was closed to traffic by law enforcement. Describe in detail each INJURY or DAMAGE. Significant damage was sustained to the vehicle body, airbag deployment, engine, wheels and undercarriage. The car frame was twisted. There was a 6 -inch diameter branch of 3 feet in length lodged into the undercarriage. There appears to have been major damage to the front right wheel well with branch material lodged in the area and break fluid soaked into the asphalt. Antifreeze and oil also soaked into the asphalt under the engine compartment. The hood could not be opened due to damage and therefore was not inspected. See attached photos. The LA Sheriffs department was onsite but did not write a report because the incident was deemed not to be an accident (driver not at fault). There was no way to prevent the incident other than the city taking care of the damaged tree in advance. SignedThis Claim Must Be on Page The amount claimed, as of the date of presentation of this claim, is computed as follows: Damages incurred to date (exact): Estimated prospective damages as far as known: Damage to property .................... $1,000.00 Future expenses for medical and hospital care. $0.00 Expenses for medical and hospital care ... $ Future loss of earnings ..................... $0.00 Loss of earnings ...................... $ Other prospective special damages .......... $0.00 Special damages for ................... $ Prospective general damages ............... $0.00 Total estimate prospective damages....... $0.00 General damages ...................... $871.37 Total damages incurred to date........ $1,871.37 Total amount claimed as of date of presentation of this claim: $ 1,871.37 Was damage and/or injury investigated by police? res If so, what City? LA County Sheriff was on scene Were paramedics or ambulance called? If so, name city or ambulance If injured, state date, time, name and address of doctor of your first visit WITNESSES to DAMAGE or INJURY: List all persons and addresses of persons known to have information: Name Roya and Nick Kordanf Address Phone( Name Kevin and Isabel Bradley Address Phone Name Address Phone DOCTORS and HOSPITALS: Hospital Address Date Hospitalized Doctor Address Date of Treatment Doctor Address Date of Treatment READ CAREFULLY For all accident claims place on following diagram names your vehicle when you first saw City vehicle; location of of streets, including North, East, South, and West; indicate City vehicle at time of accident by "A-1" and location of place of accident by "X" and by showing house numbers yourself or your vehicle at the time of the accident by or distances to street corners. If City Vehicle was "B-1" and the point of impact by "X." NOTE: If diagrams involved, designate by letter "A" location of City Vehicle below do not fit the situation, attach hereto a proper when you first saw it, and by "B" location of yourself or diagram signed by the claimant. CURBS t/J� �l MytffEf"A& 6A PARKWAY SIDEWALK °-- is rC1kw "NO �f Signature of Claimant or person filing on his behalf giving relptionship to Claimant: CLAIMS MUST BE FILED WITH CITY CLERK (Gov. 5YJo M? rr-rCM A0 DAA t/6 Kerry Schiappa is a c:t CURB 12/20/15 34 SCO14PPA Photos of scene taken on 7/3/15 approximately 1:45 AM Weather for July 2 and 3, 2015 had a high of 75 degrees and NO WIND. Backend of Volvo with branches Close up of fungus/rot Volvo on Monte Malaga Point of breakage of branch from tree View of Monte Malaga Street w/branches strewn & Volvo Volvo with Airbag Deployment 35 7 -� �.�•+, ZT �� X16 � • �' `'�.�. � i���i'f,. _ .rIVlh T HIA fPA Another tree limb fell in the same parkway (different tree but same type of tree) on September 12, 2015 — these photos taken at approximately 5:45 PM. This along with other fallen limbs earlier in the year show that there is a recurring issue with the trees in this area. This is a recurring danger to life and property. 37 Page I of 1 ENTERPRISE RENT -A -CAR COMPANY OF LOS ANGELES, 2230 PAt.:.z=IC COAST HWY, LOMITA, CA 907172505 (310) 539- 1939 RENTAL AGREEMENT REF# 682710 2347R8 RENTER SCHIAPPA, KERRY DATE & TIME OUT 08/22/2015 11;57 AM DATE & TIME IN 09/10/2015 08:09 AM BILLING CYCLE 24-HOUR VEH #2 2015 VOLK JETT SEV VIN# LIC# MILES DRIVEN 541 VEH #12015 FORD FOCU SSE VIN# LIC# MILES DRIVEN 50 SUMMARY OF CHARGES Charge Description Date Quantity Per Rate Total TIME & DISTANCE 08/22 - 09/10 3 WEEK $176.00 $528.00 REFUELING CHARGE 08/22 - 09/10 1 GALLON $5.99 $5.99 Subtotal: $533.99 Adjustments 0531 - DR CUSTOMER SATISFACTION ($5.99) Taxes & Surcharges SALES TAX 08/22 -09/10 9% $47.52 Total Charges: $575.52 Total Amount Due PAYMENT INFORMATION AMOUNT PAID TYPE CREDIT CARD NUMBER $575.52 Visa PENDING C A P, P, e -?CITfI L- ROf' E I F'i- >1++r•iio��.�� -,- Prate �.,,,,�rPnr��/�1��PT;�.kPtPr;nt isn?doNotPrintRateslndicator=false $0.00 39 9/10/2015 Page 1 of 1 ENTERPRISE RENT -A -CAR COMPANY OF LOS ANGELES, 2230 PACIFIC COAST HWY, LOMITA, CA 907172505 (310) 539- 1939 RENTAL AGREEMENT REF# 680149 1N9863 RENTER SCHIAPPA, KERRY DATE & TIME OUT 07/07/2015 11:40 AM DATE & TIME IN 07/23/2015 10:48 AM BILLING CYCLE 24-HOUR VEH #1 2015 NISN SENT 4DSV VIN# LIC# MILES DRIVEN 579 OAR SUMMARY OF CHARGES Charge Description Date Quantity Per Rate Total TIME & DISTANCE 07/07 - 07/21 2 WEEK $113.00 $226.00 TIME & DISTANCE 07/21 - 07/23 2 DAY $22.71 $45.42 REFUELING CHARGE 07/07 - 07/23 $0.00 Subtotal: $271.42 Taxes & Surcharges SALES TAX 07/07 - 07/23 9% $24.43 Total Charges: $295.85 Total Amount Due PAYMENT INFORMATION AMOUNT PAID TYPE $295.85 Visa CREDIT CARD NUMBER PENDING $0.00 httD://ecarsI.com.erac.com/rental/closeTicketPrint._isp?doNotPrintRateslndicator=false 7/23/2010 Gutierrez.Sylvia to Kerry Schiappa Mon, Jul 13 9:55 AM Ins: KERRY DOLAN SCHIAPPA I D©L: 07/03/2015 1 St: Open Claim: 011958590 1 file attached value schiappa .pelf 111 KB Dear Mrs. Schiappa, My name is Sylvia Gutierrez and I am the total loss adjuster. I have attached a copy of the total loss evaluation that was completed for your 2004 Volvo S60 If you have any questions regarding the report, please contact me so that we can review the report together. Once the value was determined, the following adjustments were made to determine the settlement amount: Not Retaining $6,426.00 Actual cash value $578.34 Sales tax 9.000% $112.00 Registration/title fees $(1,000.00) Deductible $6,116.34 Total Settlement $6,116.34 Payable to owner: Retaining $6,426.00 Actual cash value $(565.60) Salvage bid $527.44 Sales tax 9.00% $20.00 Transfer fee $(1,000.00) Deductible $5,407.84 Total Settlement $5,407.84 Payable to owner: rancho palos verdes KERRY E DOLANSCHIAPPA OR ARMAND SCHIAPPA rancho Palos verdes KERRY E DOLANSCHIAPPA OR ARMAND SCHIAPPA Please note that if you are unable to replace the vehicle with a comparable vehicle for the gross settlement amount within thirty-five (35) calendar days after receiving the final settlement check, you may contact the undersigned to request the file be reopened. Please advise of where the vehicle is located, since AAA will pay vehicle storages through Thursday July 231. If you should require assistance in locating a replacement vehicle, we have a free service available, exclusively to our members. If you would like more information, or have any questions, please just let me know. Sincerley, Sylvia Gutierrez Claims Service Representative Office 310-217-5248 I Fax 714-668-3579 Manager: Paul Bennett I Phone Number 310 217-5244 1Bennett. Paul��aaa-calif.com 41