CC SR 20160216 C - Claim Against the City - Kalan MavarRANCHO PALOS VERDES CITY COUNCIL MEETING DATE: 02/16/2016
AGENDA REPORT AGENDA HEADING: Consent Calendar
AGENDA DESCRIPTION:
Consideration and possible action regarding a claim against the City by Kalan Mavar
RECOMMENDED COUNCIL ACTION:
1) Reject the claim and direct staff to notify the claimant.
FISCAL IMPACT: None
Amount Budgeted: N/A
Additional Appropriation: N/A
Account Number(s): N/A
ORIGINATED BY: Carla Morreale, City Clerk`�
REVIEWED BY: Same
APPROVED BY: Doug Willmore, City Manager'
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A. Claim (page A-1)
BACKGROUND AND DISCUSSION:
The claimant alleges that, on October 29, 2015, his vehicle was parked at 29 Miraleste
Plaza under a pepper tree. He reported that his vehicle was struck by a tree limb that
fell from the tree.
The City's Claims Administrator, Carl Warren and Company, has reviewed the claim
and advised the City to reject the claim, as the City tree under which the claimant was
parked has been properly maintained and the cause of the tree limb falling was a direct
result of an act of nature (severe winds) on the date of the incident.
1
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.
TO: CITY OF RANCHO PALOS VERDES
mant
Cc % k
Business Address of Claimant City and State
Give address and telephone number to which you desire notices or
RESERVE FOR FILING STAMP
CLAIM NO. oZ O 15 • c?s
Birth
Occupation of Claimant
m
ne Number
Claimant's Social Security
When did DAMAGE or INJURY occur? Names of any city employees involved in INJURY or DAMAGE
Date 10 _ Z I -117 Time 11:lp MA
If claim is for Equitable Indemnity, give date
claimant served with the complaint:
Date
Where did DAMAGE or INJURY occur? Describe fully, and locate ondiagram on Pa a 2. Where appropriate, give
street names and address andmeasurements
A)",. rements from landmarks: M, fCt
``
Describe in detail how the DAMAGE or INJURY occurred.
J we,,+ ice►fd4 •� iipw S voe •4-z yt %kwt- ctod C--h,,.e
C19 LA c,,. c-, n,., pe r (Coat /LPA •4-o tvt-e0--va h k 5 e Am e
Why do you claim the city is responsibl ?
xy
Describe in detail each INJURY, or DAMAGE. � �D � � h� C1sl'�'��Si,�`� (�f g� Kd� ,�
�f� (.061 j y�iii. , �, B G` r �43`►°�- S S
�
/ SS S�f j,, +r�C C C' --i t-� P • �53,� rr 5. G1 c� /t� dL
This Claim Must Be Signed on Page 2
A-1
�sltimated;Vpective
The amount claimed, as of the date of presentation of this cl, is comfollows:Damages incurred to date (exact): damages as far as known:
Damage to property .................... $ G cj Fut r6 expenses for medical and hospital care . $
Expenses for medical and hospital care .. , $ iture loss of earnings ........... I ......... $
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: $
Was damage and/or injury investigated by ole?V If so, what city?_
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 DAM G or INJURY: List all persons and addresses of persons known to have information:
Name "`t r ,.,,k �-) (.,a Address Phone
Name Address Phone
Name Address Phone
DOCTORS and HOSPITALS:
Hospital Address
Doctor Address
Doctor Address
Date Hospitalized_
Date of Treatment
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.
CURB
SIDEWALK
PARKWAY
SIDEWALK
Signature of Claimant or person filing on Typed Name: Date:
his behalf giving relationship to Claimant:
NOTE: CLAIMS MUST BE FILED WITH CITY CLERK (Gov. Code Sec. 915a). Presentation of a false claim is a felony (Pen. Code Sec. 72.)
A-2
Damage Assessed By: MITCHELL MITCHELL
Classification: None
Deductible: UNKNOWN
Date.
Estimate ID:
Estimate Version:
Preliminary
Profile ID:
H&M BODY SHOP
Appraised For: ANTHONY MAVAR
Mitchell Service: 910438
Description: 2008 Toyota Tacoma PreRunner
11/ 2/201510:16 AM
29
0
Mario
Body Style:
4D PkupCrw 6' Bed 141" WB Drive Train:
4.OL Inj 6 Cyl 2WD
VIN:
License:
Mileage:
78,154
OEM/ALT:
O
Search Code:
None
Options:
PASSENGER AIRBAG, POWER LOCK, POWER WINDOW, POWER STEERING, AIR CONDITIONING
TILT STEERING COLUMN, AM/FM STEREO, DRIVER AIRBAG, SKID PLATES
ANTI-LOCK BRAKE SYS.,
TIRE INFLATION/PRESSURE MONITOR, CD PLAYER
POWER ADJUSTABLE EXTERIOR MIRROR, FIRST ROW BUCKET SEAT, CLOTH SEAT
DRIVER SEAT WITH POWER LUMBAR SUPPORT, REAR BENCH SEAT
Line
Entry
Labor
Line Item
PartTypel
Dollar
Labor
Item
Number
Type
Operation
Description
Part Number
Amount
Units
1
002514
BDY
REMOVE/INSTALL
R Front Combination Lamp
1.6 #
2
003577
BDY
REMOVE/INSTALL
Hood Scoop
0.3
3
002537
BDY
REMOVE/INSTALL
R Hood Washer Nozzle
0.2 #
4
002538
BDY
REMOVE/INSTALL
L Hood Washer Nozzle
0.2 #
5
000095
BDY
REPAIR
Hood Panel
Existing
6.0*
6
AUTO
REF
REFINISH
Hood Outside
C
2.6
7
002900
BDY
REPAIR
R Fender Panel
Existing
1.0*#
8
AUTO
REF
REFINISH
R Fender Outside
C
1.6
9
002551
BDY
REMOVE/INSTALL
R Fender Wheel Opening Flare
0.4 #
10
000243
BDY
REMOVEIREPLACE
R Fender Antenna Assy
86300-04070
53.85
1.2 #
11
000244
BDY
REMOVE/REPLACE
R Fender Antenna Bezel
86392-04040
22.81
12
000245
BDY
REMOVE/REPLACE
R Fender Antenna Nut
86396-04040
5.66
13
000246
BDY
REMOVE/REPLACE
R Fender Antenna Mast
86309-04110
36.96
INC
14
002561
GLS
REMOVE/INSTALL
Windshield
3.8 #
15
003516
BDY
REMOVEIREPLACE
Upr W/Shield Moulding
75531-04081
64.79
16
001703
BDY
REPAIR
R Cab Hinge Pillar
Existing
6.0*
17
AUTO
REF
REFINISH
R Cab Hinge Pillar
C
1.0
18
001711
BDY
REPAIR
R Cab Roof Rail
Existing
1.0*
19
AUTO
REF
REFINISH
R Roof Rail
C
1.6
20
001715
BDY
REPAIR
R Cab Corner Panel
Existing
1.0*#
21
AUTO
REF
REFINISH
R Cab Corner Panel
C
1.6
22
001723
BDY
REPAIR
Cab Roof Panel
Existing
2.0*
23
AUTO
REF
REFINISH
Cab Roof Panel
C
2.0
24
004425
BDY
REMOVE/INSTALL
R Roof Drip Moulding
0.2
25
004426
BDY
REMOVE/INSTALL
L Roof Drip Moulding
0.2
26
002106
BDY
REPAIR
R Pickup Bed Side Panel Assy
Existing
1.0*#
27
AUTO
REF
REFINISH
R Bed Side Panel Outside
C
3.1
28
002730
BDY
REMOVE/INSTALL
R Pickup Bed Wheel Opening Flare
0.4 #
29
002736
BDY
REMOVE/INSTALL
R Frt Pickup Bed Moulding
0.2
30
002739
BDY
REMOVE/INSTALL
L Rear Pickup Bed Moulding
0.2
31
003394
BDY
REMOVE/INSTALL
R Pickup Bed Mudguard
INC
ESTIMATE RECALL
NUMBER: 11/02/2015 09:56:23 29
Mitchell Data
Version: OEM: SEP 15-V
SEP -1
Copyright (C) 1994 - 2015 Mitchell International
Page 1
of 3
Software Version:
7.1.186
All Rights Reserved
A-3
32 003192 BDY
33 002745 BDY
34 002746 BDY
35 002749 BDY
36 936013
37 933006 FRM
38 933031 FRM
39 933021 REF
40 AUTO REF
41 933003 REF
42 933005 BDY
43 933007 REF
44 933018 REF
REMOVE/REPLACE
REMOVE/INSTALL
REMOVE/INSTALL
REMOVE/INSTALL
ADD'L COST
ADD'L OPR
ADD'L OPR
ADD'L OPR
ADD'L OPR
ADD'L OPR
ADD'L OPR
ADD'L OPR
ADD'L OPR
R Pickup Bed Wheel Opening Flare
Tailgate Assembly
R Rear Combination Lamp
Rear Bumper Assy
SPCL PAINT MATERIALS
FRAME/RACK SET UP
PULL FOR MASH
DE -NIB AND FINESSE
Clear Coat
TINT COLOR
RESTORE CORROSION PROTECTION
FILL, SAND AND FEATHER
MASK FOR OVERSPRAY
* - Judgment Item
# - Labor Note Applies
C - Included in Clear Coat Calc
vehicle suffered damage to the folloing areas; right front roof and
fender damage due to tree. secondary damage(right rear) due to tree
branch scratches. Also, windshield mpoulding was torn off along witht
he antenna assembly.needs to be replaced. 1
1
1
1
Mr. Mavar, the following repairs need to be completed inorder to bring
your vehicle to the condition it was in before the tree damage. The
sheet metal need to be pulled out and worked. _roof, roof pillar and
hood) the antenna assembly needs to be replaced along with the
windshield moulding. And the rear right corner of the cab and bed
assembly need to be repaired aswell. Approximately 5-7 working days.
I. Labor Subtotals
Body
Refipish
Glass
Frame
Labor Summary
Units Rata
25.6 55.00
19.8 55.00
3.S 45.00
3.0 75.00
Taxable Labor
52.2
III. Additional Costs
Taxable Costs
Total Additional Costs
Estimate Totals
Add'I
Labor
Sublet
Amount
Amount
Totals
10.00
0.00
1,418.00
T
20.00
0.00
1,109.00
T
0.00
Q.00
171.00
T
0.00
0.00
225.00
T
2,923.00
2,923.00
Date: 11/ 2/2015 10:16 AM
Estimate ID: 29
Estimate Version: 0
Preliminary
Profile ID: Mario
75873-04030 422.82 0.3
0.4
0.2
0.6
II. Part Replacement Summary
Taxable Parts
Total Replacement Parts Amount
Amount IV. Adjustments
20.00 Customer Responsibility
20.00
ESTIMATE RECALL NUMBER: 11/02/2015 09:56:23 29
Mitchell Data Version: OEM: SEP -15 V
Copyright (C) 1994 - 2015 Mitchell International
Software Version: 7.1.186 All Rights Reserved
20.00 *
2.0*
1.0*
5.00 * 2.0*
2.7
5.00 * 0.3*
10.00 * 1.0*
5.00 * 1.0*
5.00 * 0.3*
606.89
Page 2 of 3
1 I
Date:
11/ 2/2015 10:16 AM
Estimate ID.
29
Estimate Version:
0
Preliminary
Profile ID:
Mario
I. Total Labor:
2,923.00
II. Total Replacement Parts:
606.89
III. Total Additional Costs:
20.00
Gross Total:
3,549.89
IV. Total Adjustments:
0.00
Net Total:
3,549.89
This is a preliminary estimate.
Additional changes to the estimate may be required for the actual repair.
Point(s) of Impact
2 Right Front Side (P), 3 Right Side (S), 4 Right Rear Side (S), 16 Non -Collision (S)
ESTIMATE RECALL NUMBER: 11/02/2015 09:56:23 29
Mitchell Data Version: OEM: SEP -1 5-V
Copyright (C) 1994 - 2015 Mitchell International Page 3 of 3
Software Version: 7.1.186 All Rights Reserved
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o
A-7
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MLO
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