CC SR 20210706 E - Claim Against the City - David Martin
RANCHO PALOS VERDES CITY COUNCIL MEETING DATE: 07/06/2021
AGENDA REPORT AGENDA HEADING: Consent Calendar
AGENDA TITLE:
Consideration and possible action regarding a claim against the City by David R. Martin.
RECOMMENDED COUNCIL ACTION:
1) Reject the claim and direct Staff to notify the claimant, David R. Martin.
FISCAL IMPACT: None
Amount Budgeted: N/A
Additional Appropriation: N/A
Account Number(s): N/A
ORIGINATED BY: Teresa Takaoka, City Clerk
REVIEWED BY: Karina Bañales, Deputy City Manager
APPROVED BY: Ara Mihranian, City Manager
ATTACHED SUPPORTING DOCUMENTS:
A. David R. Martin claim (page A-1)
BACKGROUND AND DISCUSSION:
The City of Rancho Palos Verdes (City) is a member of the California Joint Powers
Insurance Authority (Authority), which provides risk management services and handles
any liability claims received by the City. Under the current practice, claims presented to
the City Clerk are forwarded by the Authority to a third-party claims administrator, Carl
Warren and Company (Carl Warren) for adjusting.
Carl Warren’s staff reviews each claim on its merits and contacts the City with any
requested action pertaining to the disposition of the claim. The City Clerk and the City
Attorney review each claim when received and work closely with Carl Warren throughout
the claims process.
Claimant:
1
On May 26, 2021, the City received a claim for damages from David R. Martin. The claim
was referred to Carl Warren for review and investigation. The claimant states that on
January 25, 2021, a city tree fell and damaged the insured’s vehicle. The claim alleges
the City is at fault due to a lack of maintenance of the tree.
Deposition:
Carl Warren has reviewed the claim and found that there is no liability for the City as the
tree was adequately maintained, tree standards for trimming were met, and the records
established proved the tree to be in good health. Carl Warren recommends denying the
claim for damages.
2
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 pf 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.
Horne Address pf Claimant City and State
Business Addre ss of Claimant
RESERVE FOR~cY~ED
CLAIM NO. CITY 0-F-R-AN_CH_O_PALOS VERDES
MAY 2 6 2021
CITY CLERK'S OFFIC E
Date of Birth of Claimant
Occupation of Claimant
Home Telephone Number
Business Telephone Number
When d . MM AGE or INJ~RY Pee??, A....., Names pf any city employees irwPlved in INJURY or DAMAGE
Date ·-"L--,me b_ .(b .,..,,, 1
If claim is for Equitable In emnity, give date
claimant served with the complaint:
Date
Where did DAMAGE or INJURY occur? Describe fully, and locate Pn diagram on Page 2. Where appropriate, give
street names and address and measureme nts from landmarks:
/<dndio ~ hs V&-'IE:r, Cl4 902 7~-
Why do you cla im th e city Is resp o ns ible?
711..e-,-free u.xi..s Q. ~J OvJ _, ,-, tLff"eco;_v-t'Ov.5
/IJl:7+ mat vi+a I 11-eJ t V] G1 -l-; 111-e._y VYICt VI )J--er~
I _--r ..L l.J..Ja c._ Cov1d ;17 'ov1 , ..l-1 · _,,.
Describe in det ail each INJ~~y o},°AMAGE.
"711.Q_ . .fn::,,e ~ 0 f'O :>S -f/..e_ ffooc/ o+
This Cl aim Must Be Signed on Page 2
A-1
The amount claimed, as of the date of presentation of this claim, is computed as follows;
Damage,; incurred to date (exact); /' --O Estimated prospective damages as far as known ;
1_.... ~-Damage to property ..••......••.•...... $1t2{2 fl Future expen,;es for medical and hospital care.$$ C,C.U-Aj' .. f"l>-8e,_. Expenses for medical and hospital care ... $:I_ Future loss of earnings ....•...•............ $
0'6-• Loss of earnings ...••...•...••..•..•.. $ Other prospective special damages •.•..•.... $
Special damages for •..••...•.•......•• $ Prospective general damages ..•..•....•.... $
Total estimate prospective damages ....... $ ___ _
General damages ........•......•...•.• $ . ~ n . _, ,/ I I'..,.._ ...
Totaldamagesin·curredtodate .....••. $____ 2 ~ -aE?(;Lu.c:.:,::ptJ ~ TJY1'1"
Total amount claimed as of date of presentation of this claim; $ 5
Was damage arid/or injury investigateil by police? Iv O 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 __________________ _
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
of streets, in cluding 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
CURBJ
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
CURB
I
Typed Name;
Soc. 915a). Presentation of a false claim is a felony (Pen. Code Sec. 72.)
THIS DOCUMENT IS A PUBLIC RECORD AND MAY BE PROVIDED TO A REQUESTOR UPON DEMAND.
A-2
Y & S AUTO BODY SHOP -San Pedro
1441 N GAFFEY ST, SAN PEDRO, CA 90731
Phone: (310) 548-1120
FAX: (310) 519-8120
Final Bill
Workfile ID:
PartsShare:
State ID:
BAR:
aa5b29S
67dl.2
ARD001499E
RO Number: 96529
Customer: Insurance: Adjuster: JENNIFER LINCOLN Estimator: Jerry Safar
Martin, David SAFECO INSURANCE COMPANY Phone: (800) 225-2467 Create Date: 1/25/2021
Business
PO BOX 515097 Claim:
tos 1:1:ngeies, CA '9trcJ'51-:i097 loss Date:
Deductible: 250.00
2017 BENZ GLE 350 4D UTV 6-3.5L Gasoline Gasoline Direct Injection GRAY
VIN: Interior Color: Mileage In: 53,808 Vehicle Out: 2/12/2021
License: Exterior Color: GRAY Mileage Out:
State: C4 Prado'Ct:km Date: 9/2016 Cono\uon~ Joo#: SALAINAS
Line Ver Operation Description Qty Extended Part Labor Type
Price$ Type
1 E0l INFORMATION LABELS
2 S01 Remove/Replace Emission label 3.5 liter w/o E85 OEM 0.2 Body
3 E01 FRONT BUMPER & GRILLE
4 E01 Remove/Install R&I grille assv fl .13 6,;yj.'f
5 E0l Remove/Install R&I bumper cover 1.9 Body
6 E0l FRONT LAMPS
7 S01 Remove/Replace LT Headlamp assy 1 425.00T RCY 0.8 Body
8 E01 Remove/Replace Aim headlamps 0.5 Body
9 E0l RADIATOR SUPPORT
10 S0l Remove/Replace Radiator support 1 600.00T RCY 5.8 Body
11 E0l Remove/Install RT H'lam,o bracket D.D Boot'
12 E01 Remove/Install LT H'lamp bracket 0.0 Body
13 E0l Remove/Install Sight shield 0.0 Body
14 E01 Remove/Install Front shield 3.0, 3.5 liter w/o off road 0.0 Body
pkg
15 E01 COOLING
16 E01 Remove/Install Reservoir tank 0.4 Body
17 E0l HOOD
18 S01 Remove/Replace hood 1 900.00T RCY 0.8 Body
19 E01 Add for Clear Coat
20 E01 Refn underside
21 E01 Remove/Install Emblem 0.1 Body
22 S0l Remove/Replace RT Spring 1 39.0ST OEM 0.1 Body
23 S01 Remove/Replace LT Spring 1 39.08T OEM 0.1 Body
T = Taxable Item, RPD = Related Prior Damage, AA = Appearance Allowance, UPD = Unrelated Prior Damage, PDR = Palntless Dent Repair, A/M = Aftermarket, Rechr = Rechromed, Reman =
Remanufactured, OEM = New Original Equipment Manufacturer, Recor = Re-cored, RECOND = Reconditioned, LKQ = Like Kind Quality or Used, Dlag = Diagnostic, Elec = Electrical, Mech =
Mechanical, Ref = Refinish, Struc = Structural
2/11/2021 9:53:06 AM
Paint
3.
1.
1.
'Page A-3
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
Final Bill
Aer: 96529
,~Z GLE 350 4D UTV 6·3.5 L Gasoline Gasoline Direct Injection GRAY
E01 Refinish
E01 Remove/Install
E01 Remove/Install
E01 Remove/Install
E01 Remove/Install
E01 Remove/Install
E0l
E0l Repair
E01 Repair
E0l
E01 Remove/Replace
E01 Remove/Replace
E01 Repair
E01 Sublet
E01 Repair
E01 Repair
Estimate Totals
Parts
Sublet/Miscellaneous
Labor, Body
Labor, Refinish
· Labo r,· Methanical
Material, Paint
Towing
Subtotal
Bottomline Discount
Sa les Tax
Grand Total
Deductible
Net Total
(BASE COAT REDUCTION ON PANEL)
LT Belt molding chrome
LT Lower w'strip
LT R&I mirror
LT Handle, outside w/o key!ess-go
cardinal red
LT R&I trim panel
VEHICLE DIAGNOSTICS
Pre -repair scan
Post-repair scan
MISCELLANEOUS OPERATIONS
Cover car
Corrosion protection
Reset electrical components
Hazardous Waste Removal
Mask Exterior
Mask Jamb
1
1
1
5.00T
8.00T
3.50T
Discount$ Markup$ Rate$
606.25
52.00
52;00
1113.00
Estimate Version
Origina l
Supplement 501
Insurance Total $:
Received from Insurance$:
0.3 Body
0.3 Body
0.4 Body
0.6 Body
0.8 Body
0.5 Mech
o.s Mec'n
Non OEM 0.3 Body
Non OEM 0.2 Body
0.3 Mech
Other
0.2 Body
O.Z Body rt,
Total Hours
31.4
12.0
1.3
Balance due from Insurance $:
Customer Total $:
(0.6)
Total$
3,257.41
3.50
1,632.80
624.00
153.40
432.00
299.00
6,402.11
(192.06)
340.30
6,550.35
(250.00)
6,300.35
Total$
6,156.66
393.69
6,300.35
0.0(
6,300.35
250.0C
T = Taxa.ble Item, RPO = Related Prtor Damage, AA = Appearance Allowance, UPD = Unrelated Prior Damage, PDR = Pa intless Dent Repair, NM = Aftermarket, Rechr = Rechromed, Reman =
Remanufactured, OEM = New Original Equipment Manufacturer, Recor = Re-cored, RECOND = Reconditioned, LKQ = Like Kind Quality or Used , Diag = Diagnostic, Elec = Electrical, Mech =
Mechanical, Ref = Refinish, Struc = Structural
2/11/2021 9:53:06 AM Paae ~ A-4
A-5
A-6
A-7
May 21, 2021
Claim for Damages
Enclosed:
Form for 'Claim for Damages'
Bill from auto repair indicating $250 deductible
Photos of damaged car.
Submitted by:
Dr. David Martin
A-8