CC SR 20190416 G - Claim against the City WarnerRANCHO PALOS VERDES CITY COUNCIL MEETING DATE: 04/16/2019
AGENDA REPORT AGENDA HEADING: Consent Calendar
AGENDA DESCRIPTION:
Consideration and possible action regarding a claim against the City by Christopher
Warner
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: Emily Colborn, City Clerk
REVIEWED BY: Gabriella Yap, Deputy City Manager
APPROVED BY: Doug Willmore, City Manager
ATTACHED SUPPORTING DOCUMENTS:
A. Christopher Warner claim (page A-1)
BACKGROUND AND DISCUSSION:
The claimant alleges that a tree branch fell in front of his vehicle as he was driving on
the roadway and he drove over it, causing damage to the undercarriage of the vehicle.
The alleged incident occurred on January 25, 2019, at 5:50 p.m. at Montemalaga Road
near Grays Lake. The claim was filed on February 15, 2019.
The City’s Claims Administrator, Carl Warren and Company, has reviewed the claim
and advised the City to reject it due to the determination that the branch fell due to an
act of nature. The tree is in good health and this is the first notice to the City.
1
FILE WITH:
CITY CLERK'S OFFICE
City of Rancho Palos Verdes
30940 Hawthorne Blvd.
Rancho Palos Verdes, CA 90275
CLAIM FOR DAMAG ES
TO PERSON OR PROPERTY
e Jo s oo.{NSTRUCTIONS
1. Claims for death, inj..rtY~£p~r'§oh or to personal property must be filedtnbt>ln
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.
RANC PALOS VERDES
M.
Jll> ~ lephone number to which you
. \.......:ommunications to be sent regarding this claim:
RESERVE FOR FILING STAMP
CLAIM NO.------
FEB 15 2019
did DAMAGE or INJURY on diagram on Page 2. Where
street names and address and measurements from landmarks: )+ (.c:o,.&,. t"\ E ~ S -,-OV\
tv' OV"\ T"'-~ -..\ """J ~ ~oJ. ot... fa"'-""'-l1 oo ~ ~ 2.-~.e. .f-o ..I'L (:> flJ+ 'f 5 l...-14-K r-I
c.~~er o~ ::;..k_ R..oo--£2 1 Oo..rrK.... ~V"~Co\.. o..f!-..ST~.
A-1
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 .................... $ P~) Future expenses for medical and hospital care . $._=-=-=-
Expenses for medical and hospital care ... $ Future loss of earnings ..................... $ g 0 5. o o
Loss of earni ngs ...................... $ ~~ 1 {). oo Other prospective special damages .......... $ $00 • oo
Special damages for ................... $ Prospective general damages ............... $ ~ Y 0 • 0 0
Total estimate prospective damages ....... $ I 1 $1..( $. O"D
General damages ...................... $.___,.---
Total damages incurred to date ........ $ ?.."!!I 0 . Ob
Total amount claimed as of date of presentation of this claim: $ oo
Was damage and/or injury investigated by police? \( -e.5 If so, what city? Lorn i -r ""-S ~ fZ-tr v;, C:..s D ~ •
Were paramedics or ambulance called? ~0 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 c laims 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
CuRB j
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.
S JE\'Jt..U\
Typed Name : Date :
THIS DOCUMENT IS A PUBLIC RECORD AND MAY BE PROVIDED TO A REQUESTOR UPON DEMAND.
A-2
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A-3
Chris Warner-Claim Details
1/25/19 DATE OF INCIDENT Time: 5:50pm
1/25/19 Lomita Sherrifs Report I 919-00299-1730-472
1/25/19 Mercury lnsurace Adjuster/ Rep
Christian Canales 800-521-9693 ext. 21888
Claim #: CAPA -01060388
1/28/19 Enterprise Rental RA#: 4PNX2G
Torrance South Lomita (31 0) 539-1939
Item : Info: $$$ Notes
Vehicle Repairs/Body Work Pending Pending
Earnings Lost Earnings to date $2,310.00 Current
Earnings Future Earnings $ 805.00 Estimated
Deposit Mercury Insurance $ 500.00 Pending/Firm
Rental Enterprise Car Rental $ 240.00 Additional Costs
!Total 1 s 3,855.oo 1
DATE
A-4
Wa r ner -Lost Wages Mercury Ins: CAPA-01060388
1/25/19 DATE OF INCIDENT (5:50pm)
1/26/19 $ 175.00 Uber/Lyft Saturday
1/27/19 $ -Off Sunday
1/28/19 $ -Off Monday
1/29/19 $ 140.00 Uber/Lyft Tuesday
1/30/19 $ 140.00 Uber/Lyft Wednesday
1/31/19 $ 140.00 Uber/Lyft Thursday
2/1/19 $ 175.00 Uber/Lyft Friday
2/2/19 $ 175.00 Uber/Lyft Saturday
2/3/19 $ -Uber/Lyft Sunday
2/4/19 $ -Uber/Lyft Monday
2/5/19 $ 140.00 Uber/Lyft Tuesday
2/6/19 $ 140.00 Uber/Lyft Wednesday
2/7/19 $ 140.00 Uber/Lyft Thursday
2/8/19 $ 175.00 Uber/Lyft Friday
2/9/19 $ 175.00 Off Saturday
2/10/19 $ -Off Sunday
2/11/19 $ -Off Monday
2/12/19 $ 140.00 Uber/Lyft Tuesday
2/13/19 $ 140.00 Uber/Lyft Wednesday
2/14/19 $ 140.00 Uber/Lyft Thursday
2/15/19 $ 175.00 Uber/Lyft Friday
2,310.00 Total Lost Wages
Christopher M. Warner DATE
A-5
Warner-Lost Wages Future Mercury Ins: CAPA-01060388
1/25/19 DATE OF INCIDENT (5:50pm)
2/16/19 $ 175.00 Uber/Lyft Saturday
2/17/19 $ -Off Monday
2/18/19 Off Tuesday
2/19/19 $ 140.00 Uber/Lyft Wednesday
2/20/19 $ 140.00 Uber/Lyft Thursday
2/21/19 $ 175.00 Uber/Lyft Friday
2/22/19 $ 175.00 Uber/Lyft Saturday
Total Lost Wages Future
A-6