RPVCCA_CC_SR_2013_06_18_H_Claim_RandolphTO:
FROM:
DATE:
SUBJECT:
REVIEWED:
CITY OF
HONORABLE MAYOR & CITY CO~L ~EMBERS
CARLA MORREALE, CITY CLER~
JUNE 18, 2013
CLAIM AGAINST THE CITY BYSHAWN N. RANDOLPH
CAROLYN LEHR, CITY MANAGER o..Q__
RECOMMENDATION
Reject the claim and direct staff to notify the claimant.
BACKGROUND
The claimant alleges that on December 8, 2012, a city sewer line backed up in multiple
locations along Via Nivel (in the City of Palos Verdes Estates) causing a flood of raw
sewage into her home. She states that the Los Angeles County Department of Public
Works Sewer Maintenance Division took 5 hours to respond; and that the City of
Rancho Palos Verdes is adjacent to the City of Palos Verdes Estates.
The City's Claims Administrator, Carl Warren and Company, has reviewed the claim
and advised the City to reject the claim because the sewer line is owned by the City of
Palos Verdes Estates and is maintained by the County of Los Angeles on behalf of
Palos Verdes Estates. The City of Rancho Palos Verdes has no jurisdiction over this
matter.
Attachment:
Claim
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• ~11~ ~L1r~K'S OFFICE CLAIM FOR DAMAGES
City of Rancho Palos Verdes
30940 Hawthorne Blvd. TO 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 flied 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
RESERVE FOR FILING STAMP
CLAIM NO. OlO\ ~ -0 3
J/iLfj1B
~~:
CAllA..
eo.~l RECEIVED \..(/)
CITY OF RANCHO PALOS VERDES 91,....
MAR 14 2013 ~
Cf
CITY CLERK'S OFFICE-~a...
Date of Birth of Claimant
Give address and telephone number to which you desire notices or Claimant's Social Security No.
communications to be sent regarding this claim: ..s ti l""Yl..t 4.J /);. .. ,Jo 0 V"t!..-
When did DAMAGE or INJURY occ!'r? Names of any city employees involved in INJURY or DAMAGE
Date fl-/ fl/ / "3-Time '-· /J"Yv->
If claim Is for Equitable Indemnity, give date
claimant served with the complaint:
Date
Describe in detail how the DAMAGE or INJURY occurred.
~l fy 6 f. p l1l Io s. V C/1 c/...uJ -c ;.~ ~ e1A..<"/J I I 1'1-e b aal:!-eol 40 lfl-i
0 6l Ali v -d i n rn u .. 1-fip /--t: pl 4 U4 and f7 blJ ell d l"n y h crvvw_ iA1 /
y-Ct w sew tt~. ~A. (run !-vi /Hpr. Of f'ublt'<-µJn I!:.-& ~ew-vi._
fY1~ -fe.-,va tu--u:_, clivl sf y-v-, M r:-" h YS . -A r-e. ...! p """r ~ '
t.--'4-{d. Cl4}rv-a ./}: /2-JI02-°J1./76d
Why do you claim the city is responsible?
Ct tj of R · ,0. v. l r.. d ir--el'-flv , rt-AJ Aten1 -ro c; f; 1Jf fJ, v<~t. pau / t::J I 11 .e YY]t':l/ri kn&Jn ~ -
Describe in detail each INJURY or DAMAGE.
Gx/en s; ve cla VVJ~e.. -fo i "<S'"i l:lt of h 1JYYU ar.tl cru h 'ck ·'6
hJVYUl . ejfcvt S; v< /o.s;. s-/J f va / lA_l -ff, h iJYVl.,1-. ~kn sf ve
f-f/ r;Jj .t::J r;::h,. !::? I o S~ . ( AfV1 U// n fn VY<Rd / ~ ; ,.-,j ""'j
This Claim Must Be Signed on Page 2
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-kl e t:> 1'7)VI h • .., t· WITNESSES to DAMAGE or INJURY: List all persons and' ad resse~ of persons known to ave m.orma ion:
Name Address, _________________ Phone.~-------~
Name Address Phone. ________ _
Name Address Phone. ________ _
DOCTORS and HOSPITALS: Address -N ~ t::J'n.)vfrf..tt ,j
Hospital -------------' I Date Hospitalized ______ _
Doctor Address. ______________ Date of Treatment-------
Doctor Adcg.,ss 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.
SIDEWALK
CURBJ
CURBy
PARKWAY
Sl[}EWALK
Typed Name: Date:
NOTE: CLAIMS MUST BE FILED WITH CITY CLERK (Gov. Code Sec. 915a). Presentation of a false claim is a felony (Pen. Code Sec. 72.)
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