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ST9302-CL010112January 12, 2001 Ms. Bonnie Whitted 600 Deforest Rd. Coppell, TX 75019 Dear Ms. Whitted: This letter is to notify you that your claim against the City has been forwarded to the insurance company of the contractor working on a project in this area at the time of your claim. The name of the insurance company is: Ed Bell Construction P.O. Box 540787 Dallas, TX 75354-0787 The name of the contact person is: Nancy Johnson Her telephone number is: 214-358o6581 Please contact Nancy with any comments/concerns regarding your claim. Sincerely, VivT'on V. Bowman -- Director of Administration/HR CC: Nancy Johnson, Ed Bell Construction Ken Griffin, City Engineer Jim Witt, City Manager Clay Phillips, Deputy City Manager 255 PARKWAY ~r P.O BOX 478 'k COPPELL TX 75019 lit TEL 9'72/462 0022 'Jr FAX 972/304 3673 CLAIM NOTICE City Secretary City of Coppell PO Box 478 Coppell TX 75019 This is my notice of claim against the City of Coppell. The circtunstanc~ giving rise to this claim are as follows: 1. The injury or damage occurred on the /~ ~ day of .,/Vo{,/~ ~ ~e, , ~ at approximately .~.'_go o"clock ~ at the specific location of ~-~. ~/~, ~.a~: ~, *- ,/97~C .,~,'~.. ~ ; /._'n_ ~e_~,.,,-r.~/'~'~J ',in'Coppell, Texas. The damage or injury oc~'urred in the following manner: ~e ~ e~em of my d~es ~or bj~ ~e ~ fo~ows ~e sp~c - a~ch ~t~ b~ etc., · av~le): / The amount of damages claimed is $ c_~ ~?, ~7 q (Please Print) I do swear the above is true and correct. Signed .?~ ~ Date NOTE: Article 11, Section 11.09 of the Home Rule Charter - Damage Suits. The notification shah be filed within forty-five (45) days of the date of injury or damage or, in the case of death, within forty-five (45) days of the date of death. The failure to so notify the City within the time and manner specified shall exonerate, excuse and exempt the City from any liability whatsoever. No action at law shah be brought against the City until at least sixty (60) days have elapsed following the date of notification. METRO INC. 2400 N. STORY ROAD IRVING, TEXAS 75062 972-659-9999 METRO 972-256-5561 metrovwtx.com CUSTOMER NO. ADVISOR TAG NO. INVOICE DATE INVOICE NO. ,'t ,~;?'7 . IA P.k' ?N.q 189 11 I1 ~lnn vwc..~ ~.I.'t 1A ..... [.~b'R-'F~ATE STOCK NO. --[~CENSE NO MILEAGE COLOR ' BONNIE WHITTED ;. nn-[ Ti:UP lelr;;I .ell vi:Ri YEAR r' MAKE /"'M'~Ot~[ ........... D'~FCV~:~"'~-[~ATE DELZVERY MILES 600 DEFOREST nn/Vnl I~.~WaC. FNIRFFTI F VET~i-CL~E.'~IO - ............ SEL,.:NG DEALER NO. PRODUCTION DATE q U',B P & '*J 1 f~,q V IUI.A ~ "7 St A ~ F ~ '~. IqC)- .............. P.'O"RO R O DATE COPPELL, TX '75019 1 RESIDENCE PHONE BUSINESS PHONE COMMENTS g72.,!.B2.!_065 ANY WARRANTIES ON THE PRODUCT SOLD HEREBY ARE THOSE MADE BY THE MANUFAC- ,]0~ ! CHAJ~S ................................................................................. TURER. THE SELLER, METRO VOLKSWAGEN INC. HEREBY EXPRESSLY D;SCLA;MS ALL ......... .... ................ WARRANTIES E THER EXPRESS OR ,MPUED 170.00 INCLUDING ANY IMPLIED WARRANTY OF MER- 0IL PAN LEAKING CHANT ABILITY OR FITNESS FOR A PARTICULAR REPLACE 0IL PAN AFTER BOTroN[N6 OUT PURPOSE. AND THE SELLER NEITHER ASSUMES NOR AUTHORIZES ANY OTHER PERSON TO PARTS ...... QTY---FP-NUNBER ............... DESCR[FrION ......... L]'ST PRiCE-UNiT PRICE- ASSUME FOR IT ANY LIABILITY IN CONNECTION I 038'103'601'NA 0[L PJ~ ~-11,60 111.60 111.60 WITH THE SALE OF SAID PRODUCTS, 1 D-176-404-A2 SEALANT 21.69 21.69 21.69 ~ HEREBY AUTHORIZE THE REPAIR WORK HERE- TOTAL - PARTS 133.29 INAFTER SET FORTH TO BE DONE ALONG WITH THE NECESSARY MATERIAL AND AGREE THAT JOB# ! TOTALS ............................................................ YOU ARE NOT RESPONSIBLE FOR LOSS OR LAJ~R 170.00 DAMAGE TO VEHICLE OR ARTICLES LEFT IN PARTS 133.29 VEHICLE IN CASE OF FIRE, THEFT OR ANY OTHER i CAUSE BEYOND YOUR CONTROL OR FOR ANY J01~ I JOURNAL PREF[X V~S J01~ I TOTAL DELAYS CAUSED BY UNAVAILABILITY OF PARTS OR DELAYS IN PARTS SHIPMENTS BY THE SUP- J01~ 2 CHARGES ................................................................................. PLIER OR TRANSPORTER. I HEREBY GRANT YOU STREETS, HIGHWAYS OR ELSEWHERE FOR THE DRIVERS W[NI)0W S~[CH [~P PURPOSE OF TESTING AND OR INSPECTION. AN REPLACED WIND0~ swrIcH EXPRESS MECHANIC'S LIEN IS HEREBY 01300002,.35TU I)IA6NOSIS ACKNOWLEDGED ON ABOVE VEHICLE TO 7059].900..40TU P-&[ TP,[N PANEL SECURE THE AMOUNT OF REPAIRS THERETO. 64581950..20TU REPLACE SIll'[CH 645840HE1_2 NOT RESPONSIBLE FOR LOSS OR DAMAGE TO PARTS ...... QTY;--FP-NUI~ER ............... DESCRIPT[0N ......... L[ST PRZCE-UN[T PR[CE- CARS OR ARTICLES LEFT IN CARS IN CASE OF lC0'959'85].' '01C SWITCH ~ FIRE THEFT OR ANY OTHER CAUSE BEYOND J. TOTAL - PARTS 0.00 OUR CONTROL. CLIENT'S OR OWNER'S SIGNA- TURE. CASH ;i; CHK. ~ CHG. J01~ 2 TOTALS ............................................................ Notice Pursuant to §70,001, Texas Property Code J01~ 2 JOURNAL PREFZX VWCS ,]01~ 2 TOTAL 0.00 AM THE PERSON OR AN AGENT ACTING ON BEHALF OF THE PERSON. WHO IS OBLI- RISC ...... C01)E ........ DESCRIPTION ............................... CONTROL NO ......... GATED TO PAY FOR THE REPAIR OF THE J0~ # A SS SHOP SUPPLIES 6.07 MOTOR VEHICLE SUBJECT TO THE REPAIR CONTRACT, I UNDERSTAND THAT THIS VEHI- TOTAL - N[SC 6.07 CLE IS SUBJECT TO REPOSSESSION IN ACCORDANCE WITH {,9.503, TEXAS BUSI- NESS AND COMMERCE CODE, IF A CHECK OR MONEY ORDER FOR PAYMENT FOR REPAIR ON THE VEHICLE IS STOPPED, DISHONORED BECAUSE OF INSUFFICIENT FUNDS, NO FUNDS, OR BECAUSE THE DRAWER OR MAKER OF THE ORDER HAS NO ACCOUNT OR THE ACCOUNT ON WHICH IT IS DRAWN HAS BEEN CLOSED. X Signatura of Person Responsible o~ Age~l tot Pe~son ALL PARTS REMOVED WILL BE DISCARDED UNLESS INSTRUCTED OTHERWISE, ALL PARTS INSTALLED ARE NEW UNLESS SPECIFIED OTHERWISE. METRO INC. 2400 N. STORY ROAD IRVING, TEXAS 75062 972-659-9999 METRO 972-256-5561 metrovwtx.com PAGE i OF 2 CUSTOMER COPY [CONTINUED ON NEXT PAGE] 10:30:14