RPVCCA_CC_SR_2015_01_20_D_Claim_Paul_RandCITY OF RANCHO PALOS VERDES
TO: HONORABLE MAYOR &CITY COUNCIL MEMBERS
FROM: CARLA MORREALE, CITY CLER i�
DATE: JANUARY 20, 2015
SUBJECT: CLAIM AGAINST THE CITY BY MERCURY INSURANCE
AS SUBROGEE OF PAUL RAND
REVIEWED: CAROLYNN PETRU, ACTING CITY MANAGER` 4
RECOMMENDATION
Reject the claim and direct staff to notify the claimant.
BACKGROUND
The claimant alleges that a branch from a City owned and maintained tree fell on his
property causing damage. His property is located on Via Colusa, which is located in the
City of Palos Verdes Estates. The alleged incident occurred on July 28, 2014 at 4:00
p.m.
The City's Claims Administrator, Carl Warren and Company, has reviewed the claim
and advised the City to reject the claim. The City does not have any liability for the
accident, as the incident occurred on Via Colusa, which is in the jurisdiction of the City
of Palos Verdes Estates, and is not within the jurisdiction of the City of Rancho Palos
Verdes.
Attachment:
Claim
D-1
Alk
MERCURY
INSURANCE GROUP
January 6, 2015
City Clerk's Office
30940 Hawthorne Blvd.
Rancho Palos Verdes, Ca 90275
RE: YOUR FILE:
YOUR INSURED:
DATE OF LOSS:
OUR CLAIM NUMBER
OUR INSURED:
OUR CLAIM AMOUNT
Dear City Clerk's Office:
NOT YET KNOWN
Name
July 28, 2014
10Y1119
Paul Rand
$9,085.00
P.O. Box 4600
Rancho Cucamonga, CA 91729
(888) 917-6372
RECEIVED
CITY OF RANCHO PALOS VERDES
JAM 0 8 2015
CITY CLEERKS
We have obtained information regarding the above date of loss suggesting that
damages incurred were caused by your insured's negligence.
Enclosed for your review please find copies of our supporting documentation.
Our insured's version of the loss is as follows: A Rancho Palos Verdes City tree branch
fell and caused damage to our insured's property. The above amount includes our
insured's unpaid deductible of $1,000.00.
Please return a copy of this form with your payment, to ensure proper credit. If we
receive a payment that is less than the amount shown above, that payment will be
processed and applied as a partial payment only. This will not indicate any acceptance
of liability or agreement to compromise the claim amount. Full or final settlement or
similar wording, whether on the payment itself or on accompanying correspondence,
does not function as a release.
Should you have any questions or need additional information, please contact me.
Thank you for your cooperation.
Sincerely,
MERCURY CASUALTY COMPANY
RICHARD LEE
Property Subrogation Specialist
(888) 917-6372, ext. 21771
Enclosures
D-2
FILE WITH: CLAIM FOR DAMAGES
CITY CLERK'S OFFICE
City of Rancho Palos Verdes T
30940 Hawthorne Blvd. O PERSON OR PROPERTY
Rancho Palos Verdes, CA 90275
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 T
Paul Rand _
Name of Claimant
Palos Verdes Estates, Ca 90274-1041
Home Address of Claimant City and State
Business Address of Claimant City and
RESERVE FOR FILING STAMP
CLAIM NO. a.ot5--fl(
DECEIVED
d:ITY OF IIIANCHO PALOS VERDES
JAN 0 8 2015
1 T r,L�' K' S 0", L-� IF
Date of Birth of Claimant
Occupation of Claimant
Home Telephone Number
Business Telephone Number
Give address and telephone iunnlx r to which you desire notices or Claimant's Social Security No.
communications to be sent regarding this claim:
P.O. Box 4600 Rancho Cucamonga, Ca
When did DAMAGE or INJURY occur? Names of any city employees involved in INJURY or DAMAGE
Date 071x61a014 Time 4:,ypm
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 to home, address listed above.
Describe in detail how the DAMAGE or INJURY occurred.
City Tree Branch fell caused damages to our insured's property.
Why do you claim the city is responsible?
For improper maintenance.
Describe in detail each INJURY or DAMAGE.
All supporting documentation enclosed.
This Claim Must Be Signed on Page 2
D-3
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 ....................
$ 9.o-oo
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: $ 9,085.00
Was damage and/or injury investigated by police? Yes If so, What city? Palos Verdes Estates PD
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 persons known to have information:
Name Address Phone
Name 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 "13-1" 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.
�ij SIDEWALK
CURB
CURB
PARKWAY
SIDEWALK
Signature of Claimant or person filing on Typed Name: Date:
his behalf ivin rel tionshi to Claimant:
e
NOTE: CLAIMS MUST BE FILED WITH CITY CLERK (Gov. !:ode Sec. 915a). Presentation of a false claim is a felony (Pen. Code Sec. 72.)
ITEM DESCRIPTION
Evolution Construction
ESTIMATE
REPLACEMNET OF EXISTING CONCRETE SLAB IN FRONT YARD
License # 974037
FRONT YARD
1 DATE ESTIMATE
2455 190th Street Ste. A
DESCRIPTION BELOW:
110/20/20141 135
.
Redondo Beach, CA 90278
$ 700.00
2-
Concrete hauling & dump
Phone (310) 469-3141
3
New 5" concrete slab with 5" of class A base approx. 280 sq. ft
$ 3,360.00
Office(310) 379-9747
( )�„
Repair Sprinklers that were damaged
CLIENT
5 •
Landscape Allowance for repair do to branch falling plus the work that
NAME/ADDRESS
Job Site
$ 760.00
OCT 2 4 20tH
Rand Residence
Rand Residence
7-
Stucco damage to wall, new cracks were observed different from existing
$ 940.00
old cracks.
n.
Palos Verdes states, CA 90274
PVE, CA 90274
$ 1,950.00
replacement of broken tiles & any underlayment necessary,
ITEM DESCRIPTION
TOTAL
REPLACEMNET OF EXISTING CONCRETE SLAB IN FRONT YARD
FRONT YARD
DUE TO FALLING BRANCH, OTHER AREAS DAMAGED, SEE
DESCRIPTION BELOW:
1 _
Demolition of front concrete slab approx. 280 sq. ft
$ 700.00
2-
Concrete hauling & dump
$ 595.00
3
New 5" concrete slab with 5" of class A base approx. 280 sq. ft
$ 3,360.00
4-
Repair Sprinklers that were damaged
$ 220.00
5 •
Landscape Allowance for repair do to branch falling plus the work that
will be done to replace the existing concrete slab.
$ 760.00
6-
Scaffold set up for stucco/gutter/roofing repair
$ 560.00
7-
Stucco damage to wall, new cracks were observed different from existing
$ 940.00
old cracks.
8-
Rain gutter replacement plus the two adjacent 10' runs including
$ 1,950.00
replacement of broken tiles & any underlayment necessary,
INSURANCE &
Once contracted :Liablllty Insurance certificates will be provided plus Home owner will
CERTIFICATES
be added on as additional insured, workman's Comp Certificate can be provided upon
request.
EVOLUTION CONSTRUCTION- "revolutionizing the construction experience"
TOTAL
$ 9,085.00
Thank you for your business!
L,
PALOS VERDES ESTATES
POLICE DEPARTMENT
Officer Report for Incident 14-07445
Nature: INCIDENT REPORT
Location: 703
Offense Codes:
Received By: B. Hernandez
Responding Officers:
Responsible Officers: R. Venegas
When Reported: 17:10:48 07/28/14
Assigned To:
Status:
Complainant: 39961
Last: RAND
DOB:
Race; Sex: M
Alert Codes:
Offense Codes
How Received: T
Address:
PLS VRD EST CA 90274
Agency: PVEP
Disposition: NOT 07/29/14
Occurred Between: 17:10:48 07/28/14 and 17:10:48 07/28/14
Detail: Date Assigned:
Status Date: **/**/** Due Date:
First: PAUL
Dr Lie;
Phone:
Reported:
Additional Offense: INFO Information Only
Circumstances
LT20 Residence or Home
Responding Officers:
Unit:
R. Venegas
71,12
A. Gonzales
7L11
Responsible Officer:
R. Venegas
Received By:.
B. Hernandez
How Received:
T Telephone
When Reported:
17:10:48 07/28/14
Judicial Status:
Misc pantry:
Mid: ALAN
Address:
City: PLS VRD EST, CA 90274
Observed: 911C Meet the citizen
Agency:
PVEP
Last Radio Log:
17:30:53 07/28/14 CMPI,T
Clearance:
ICO Investigation Completed
Disposition:
NOT Date: 07/29/14
Occurred between:
17:10:48 07/28/14
and:
17:10:48 07/28/14
D-6
Officer Report for Incident 94-07445
Modus Operandi:
Time of Day
Involvements
Date
Type
07/28/14
Name
07/28/14
Cad Call
07/28/14
Property
Description : Method:
Time of Day Afternoon
Description
RAND, PAUL ALAN Complainant
17:10:48 07/28/14 PROPERTY REPORT Initiating Call
Flash Disk SANDISK 2GB 0 Flash Disk
Page 2 of 6
D-7
07/29/14
Officer Report for Incident 14-07445 Page 3 of 6
Narrative
Palos Verdes Estates Police Department
Investigation Narrative
On 07/28/14, I (Officer Venegas / #733) was dispatched to in
reference to a large branch that fell from a city tree an caused damage to the
property.
Upon my arrival, I noticed a large tree branch on the walkway of
Upon examination, it was determined that the large tree branch fell from a city
tree, just east of the residence (see attached photos). I spoke with the owner
of the property, Paul Rand. Rand told me that the branch caused damage to the
concrete walkway in addition to breaking a few lights along the walkway. He was
unable to see any further damage with the branch on his yard. A small portion of
the branch fell onto his top balcony as well though there was no apparent damage
in this area_
Prior to my departure, I provided Rand with a PVEPD Incident Card and this
report number. I informed Rand that Streets and Parks would be able to remove
the branch tomorrow, 07/29/14.
V ENJ zk!�
Responsible LEO:
Qz�-►3 r 0�'4 --
Approved by:
-7-zS-11
Date
07/29/14
Officer Report for Incident 94-07445
Supplement
CAD Call info/comments
--------------------------------
--------------------------------
LARGE LIMB FROM A CITY TREE HAS FALLEN ON THE RP'S HOME - STATES THERE IS DAMAGE
- UNIT WILL ADVISE IF S&P CALLOUT IS NECESSARY WHEN 97
17:26:45 07/28/2014 - B. Hernandez - From: A. Gonzales
UNITS ARE CODE 4
17:30:44 07/28/2014 - B. Hernandez - From: R. Venegas
LARGE TREE BRANCH HAS CAUSED DAMAGE AT LOCATION - IT IS NOT A HAZARD AND THE
HOMEOWNER IS OK WITH STREETS AND PARKS DOING CLEAN UP AT LOCATION IN THE MORNING
Page 4 of 6
D-9
07/29/14
Officer Report for Incident 14-07445
Property
Property Number: 11200
Item: Flash Disk
Brand:
SANDISK
Year:
0
Meas:
Total Value:
$0.00
Owner:
PALOS VERDES ESTATES PD 480
Agency:
PVEP PALOS VERDES ESTATES PD
Accum Amt Recov:
$0.00
UCR:
**:**:** **/**/**
Local Status:
III
Crime Lab Number:
Date Released:
Released By:
Released To:
Reason:
Comments:
Owner Applied Nmbr:
Model: 2G$
Quantity:
Serial Nmbr:
Color:
Tag Number:
Officer:
R. Venegas
UCR Status:
Storage Location:
26
Status Date:
07/28/14
Date Recov/Rcvd:
**/**/**
Amt Recovered:
$0.00
Custody:
**:**:** **/**/**
D-10
Page 5 of 6
07/29/14
Officer Report for Incident 14-07445
Name Involvements:
Page 6 of 6
Complainant: 39961
Last: RAND First: PAUL Mid: ALAN
DOB: r Dr Lic: Address:
Race: Sex: M Phone: I& City: PLS VRD EST, CA 90274
D-11
07/29/14
%;A5.Uftv4
I
MIS(ILLANEOUS CASH RECEIPT
At
City of Pal®s Verdes Estates
w"I.I.MM 1;A CALIFORNIA
'4 Z I F 00"�'
�CHIVED FROM -
M IS Lim
)R
No- 56456
DOLLARS!
Cash El Check d'
20
MUNT
D-12
ARMERCURY
INSURANCE GROUP
Mail PAULA. RAND
TO
ALOS VERDES ESTATES CA 90274-1041
925 - Brea - Greenbriar - Property
INSURED:
Paul A. Rand
POLICY NUMBER:
POLICY NUMBER:
CLAIMANT:
Paul A. Rand
DATE OF LOSS:
OCCURRENCE NUMBER: 1 OY1119-1
PA'.'EE:
Paul A. Rand
CLAIMANT:
Paul A. Rand
INVOICE NUMBER:
DATE OF LOSS:
Jul 28, 2014
PAYMENT FOR:
In Partial settlement of All Other Perils Claim(s)
CHECK AMOUNT:00..i.mis
PAYMENTTYPE:
Loss
CHECKNUMBER:
COVERAGE:
Building
ISSUED BY:
ext 22941
VENDOR CODE:
REPRESENTATIVE:
Antonio Morris ext 22941
COMMENT: PAYMENT FOR HOME REPAIRS.
C. CC28'20
NELY
OCT
C 0 P y CLAIMS
THIS IS A COPY OF THE ORIGINAL CHECK
ARMERCURY
INSURANCE GROUP
Pay To The Paul A. Rand
Order Of
PAY Eight Thousand Eighty Five and 001100 Dollars
In Partial settlement of All Other Perils Claim(s)
arising out of incident on 07128/2014
DATE ISSUED:
Oct 24, 2014
POLICY NUMBER:
OCCURENCE NUMBER:
10Y1119-1
DATE OF LOSS:
Jul 28, 2014
INSURED:
Paul A. Rand
CLAIMANT:
Paul A. Rand
Mercury Casualty Company
NC]l�T—hTEC�;C:)T:E
SIGNATURE
$ **'`8,085.00
(NOT VALID AFTER 6 MONTHS)
D-13
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet
001
Date Taken: 10/8/2014
Taken By: Antonio Morris
FRONT OF RISK
"i EL' E[fI RC,33A8
OCT 0 o mi,
002
Date Taken: 10/8/2014
Taken By: Antonio Morris
EUCALYPTUS TREE WHERE
BRANCH BROK OFF
10/8/2014
D-14
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 1 0Y1 119
Policy #:
Photo Sheet
-2-
003
Date Taken: 10/8/2014
Taken By: Antonio Morris
BROKEN BRANCH
004
Date Taken: 10/8/2014
Taken By: Antonio Morris
TREE THAT HAD BRANCH BREAK
OFF
10/8/2014
D-15
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet
-3-
005
Date Taken: 10/8/2014
Taken By: Antonio Morris
FRONT WALK WAY
006
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT WHERE BRANCH FELL ON
10/8/2014
D-16
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 1 0Y1 119
Policy #:
Photo Sheet
-4-
007
Date Taken: 10/8/2014
Taken By: Antonio Morris
DAMAGED CEMENT
INDENTATION FROM TREE
BRANCH
008
Date Taken: 10/8/2014
Taken By: Antonio Morris
INDENTATION OF CEMENT
10/8/2014
D-17
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet - 5 -
009
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT INDENTATION FROM
TREE BRANCH
010
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT DAMAGED AREA
10/8/2014
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet 6 -
025
Date Taken: 10/8/2014
Taken By: Antonio Morris
AFFECTED CEMENT AREA
026
Date Taken: 10/8/2014
Taken By: Antonio Morris
AFFECTED CEMENT AREA
10/8/2014
D-19
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet
027
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT LENGTH
028
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT WIDTH MEASUREMENT
10/8/2014
D-20
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet
-8-
029
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT WIDTH MEASUREMENT
030
Date Taken: 10/8/2014
Taken By: Antonio Morris
CRACKS IN CEMENT AREA
10/8/2014
D-21
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 1 OY1119
Policy #:
Photo Sheet
9-
031
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT HAS CRACKS IN IT
032
Date Taken: 10/8/2014
Taken By: Antonio Morris
CRACKS IN CEMENT
10/8/2014
D-22
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet - 10 -
033
Date Taken: 10/8/2014
Taken By: Antonio Morris
CEMENT HAS CRACKS
011
Date Taken: 10/8/2014
Taken By: Antonio Morris
FRONT WALK WAY TO SIDE OF
HOUSE
10/8/2014
D-23
Photo Sheet Insured: PAUL RAND
Claim #: 10Y1 119
Mercury Casualty Company
Policy #:
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
012
Date Taken: 10/8/2014
f " i Taken B Antonio Morris
- . SIDE OF HOME
4
6.1 i
Photo Sheet
-11-
013
Date Taken: 10/8/2014
Taken By: Antonio Morris
DAMAGED LAMP
10/8/2014
D-24
Photo Sheet Insured: PAUL RAND
Claim #: 10Y1119
Mercury Casualty Company Policy #:
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
6'r
014
Date Taken: 10/8/2014
Taken By: Antonio Morris
TOP OF DAMAGED LAMP
015
Date Taken: 10/8/2014
Taken By: Antonio Morris
ELECTRIC BOX
Photo Sheet -12- 10/8/2014
D-25
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
4
p'?
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet
-13-
016
Date Taken: 10/8/2014
Taken By: Antonio Morris
ELECTRIC BOX WAS PUT BACK ON
017
Date Taken: 10/8/2014
Taken By: Antonio Morris
10/8/2014
D-26
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet
-14-
018
Date Taken: 10/8/2014
Taken By: Antonio Morris
STREAK ON SIDE OF THE HOUSE
019
Date Taken: 10/8/2014
Taken By: Antonio Morris
POWER OUTLET COVER BROKE
OFF
10/8/2014
D-27
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet - 15 -
020
Date Taken: 10/8/2014
Taken By: Antonio Morris
POWER OUTLET COVER BROKE
OFF
021
Date Taken: 10/8/2014
Taken By: Antonio Morris
RAIN GUTTER ON TOP FLOOR
10/8/2014
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 10Y1119
Policy #:
Photo Sheet - 16 -
022
Date Taken: 10/8/2014
Taken By: Antonio Morris
RAIN GUTTER ON TOP FLOOR
023
Date Taken: 10/8/2014
Taken By: Antonio Morris
DAMAGED RAIN GUTTER
10/8/2014
D-29
Photo Sheet Insured: PAUL RAND
Claim #: 10Y1119
Mercury Casualty Company Policy #:
P.O. Box 1150
Brea, CA 92822
(714)255-5001
024
Date Taken: 10/8/2014
Taken By: Antonio Morris
RAIN GUTTER IS BENT
034
Date Taken: 10/8/2014
j Taken By: Antonio Morris
i DAMAGED RAIN GUTTER. PIECE
�1 OF TILE IS CRACKED
Photo Sheet - 17- 10/8/2014
D-30
Photo Sheet
Mercury Casualty Company
F.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 1 0Y1 119
Policy #:
Photo Sheet
-18-
035
Date Taken: 10/8/2014
Taken By: Antonio Morris
LENGTH OF AFFECTED RAIN
GUTTER ON THE RIGHT
036
Date Taken: 10/8/2014
Taken By: Antonio Morris
DAMAGED RAIN GUTTER
10/8/2014
D-31
Photo Sheet Insured: PAUL RAND
Claim #: 1 0Y1 119
Mercury Casualty Company Policy #:
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
'2 aL .W
Photo Sheet
-19-
037
Date Taken: 10/8/2014
Taken By: Antonio Morris
RAIN GUTTER IS BENT
038
Date Taken: 10/8/2014
Taken By: Antonio Morris
RAIN GUTTER IS BENT
10/8/2014
D-32
Photo Sheet
Mercury Casualty Company
P.O. Box 1150
Brea, CA 92822
(714) 255-5001
Insured: PAUL RAND
Claim #: 1 0Y1 119
Policy #:
Photo Sheet
. 20 -:
039
Date Taken: 10/8/2014
Taken By: Antonio Morris
RAIN GUTTER IS BENT
10/8/2014
D-33