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ST8502-CL 860930GINN, INC. September 30, 1986 Mr. Dan Mill Ashlar Contracting Co. P.O. Box 713 Lewisville, TX 75067 Re:~oad Improvements~'~ Dear Mr. Mill: CONSULTING ENGINEERS Enclosed is a claim notice filed by Ms. Lillian Inanaki citing personal damages the week of September 7 - September 13, 1986, on the above referenced project. In accordance with paragraph 3.17, INDEMNIFICATION, of the contract documents, it is requested that you hold the City of Coppell harmless for this claim. Please advise this office of determination in this matter. Sincerely, Kevin Peiffer Enclosure cc: Ed Powell Ms. Lillian Inanaki Dorothy Timmons Larry Jackson Wayne Ginn Butch Ellison RECEtV,.-J SEP 2. z, 1981S CLAIM NO. O~ ~(ZD' I THE'" FILED IN M~f OFFICE, THIS (Above spaces for office use only) City Secretary, City of Coppell P.O. Box 478 Coppell, Texas 75019 Dear Sir: This is my notice of claim against the City of Coppell. The circumstances giving rise to this claim are as follows: 1. The injury or damage occurred on the // day of~ 19 _f~ at approximately 7 ~o0 o'c~ockf~ . at th, ,p.ctfic in Coppell, Texas. 2. The damage or injury occurred in the following manner: PAGE ONE OF CLAIM NOTICE 3. The full extent of my damages and/or injuries are as follows: (be specific; attach estimates, bills, etc., if a. vailable) _ , The above statement NOTE: ARTICLE 6252-19, SECTION 16, V.A.T.S. - NOTICE OF DEATH OR INJUE~ "Sec. 16. NOTICE REQUIRED - Except where there is actual notice on the part of' the governmental unit that death has occurred or that the claimant bas received some injury, any person making a claim hereunder shall give notice of the same to the governmental unit against which such claim is made, reasonably describing the injury claimed and the time, manner and place of the incident from which it arose, within six (6) months from the date of the incident."