ST9302-CL000127LAWSUIT/CLAIMS AOAINST THE CITY TRANSMITTAL FORM
DATE:
FROM:
DISTRIBUTION LIST:
CiTY MANAGER
CiTY OF COPPELL
COMMI :
Jim Witt, City Manager
Peter G.Smith, City Attorney
Vivyon Bowman, Director of Human
Resources
Texas Municipal League
Lawsuit File (original/sol-f)
suit/city.form
revised 8/19/94
CLAIM NOTICE
PLEASE USE BLACK INK ONLY
(For Offic~ Use)
CLAIMNO. ()l- ~}-q- i?-00~) FILED INMY
OmCE T~S ~m ~TH.. DAY OF
City Secretary
City of Coppell
PO Box 478
Coppell TX 75019
This is my notice of claim against the City of CoppeH. The circumstances giving rise to this claim are as
follows:
The injury or damage occurred on the
at approximately cl o"clock
, at the ~ecific location of -~k.~ c~=,sso-~e~-
, in Coppell, Texas.
The damage or injury occurred in the following manner:
J
The full extent of my damages and/or injuries are as follows (be specific - attach estimates, bills,
etc., if available):
4. The amount of damages claimed is $
~zz .?.°r
(Please PrinO
Claimant
Address ~1~ I~. ~ c~ ~C~o~'Z.
Phone
· City/State/Zip (..oc~ec.~-,'T~ ~')~:'~1
I do swear the above is true and correct.
NOTE: Arti¢~H,~ 11.09 of the Home Rule Clnu'ter - Damage Suits. The notification fla~ll I~
filed within forty-five (45) days of the date of injury or d~n~e or, in the ~ of d~.h, within forty-five
(45) days of the date of death. The fidlure to ~o notify tl~ City within the ti~e ~1 manner Slx~:ifled ~dl
exonerate, excu~ and ~xempt the City from any liability ~~. No ~ion ~I law ~ b~ brought
against the City until at least sixty (60) days have elapsed following the date of notification.
JohnMahalik
215N. Moore Rd
#8032
CoppeR, TX75019
I have originally called the city about the poor road conditions at the
crossover at Sandy Lake and Moore. The group in charge has made, as you
should be aware of, a "make shift" dirt ramp which is way too steep and
terribly constructed, especially the first couple days before cars had chance
to smooth it over. Due to this half-way job, my front end spoiler on my
Nissan 240SX was damaged.
When I had originally called, I was given the number for the
Company doing the work and the names Mike Martin and Kent Collins at
972-304-3679. I talked to Allison at that number and was then given the
number, 972-304-3685 for Gan'is Campbell who was in charge of the
project. After leaving a message with no reply after 4 days, I re-called
Allison and was told to call the City Secretary for a Claim Form and the
appropriate measure will be taken to correct this problem.
Included is the completed claim form. I am not looking for any money
in this case, just to have my plastic front end piece replaced.
I called Banston Nissan in Lewisville (972-420-9500), and talked with
Jason in the parts department. Upon checking, the cost of this piece is
290.24 plus 32.00 for labor. If any other additional information is needed,
please feel free to contact me at the address above.
John Mahalik
215 N. Moore Rd
#8032
Coppell, TX 75019
I have originally called the city about the poor road conditions at the
crossover at Sandy Lake and Moore. The group in charge has made, as you
should be aware of, a "make shiW' dirt ramp which is way too steep and
terribly constructed, especially the first couple days before cars had chance
to smooth it over. Due to this half-way job, my front end spoiler on my
Nissan 240SX was damaged.
When I had originally called, I was given the number for the
Company doing the work and the names Mike Martin and Kent Collins at
972-304-3679. I talked to Allison at that number and was then given the
number, 972-304-3685 for Garris Campbell who was in charge of the
project. After leaving a message with no reply after 4 days, I re-called
Allison and was told to call the City Secretary for a Claim Form and the
appropriate measure will be taken to correct this problem.
Included is the completed claim form. I am not looking for any money
in this case, just to have my plastic front end piece replaced.
I called Banston Nissan in Lewisville (972-420-9500), and talked with
Jason in the parts department. Upon checking, the cost of this piece is
290.24 plus 32.00 for labor. If any other additional information is needed,
please feel free to contact me at the address above.