ST9302-CL001101LAWSUIT/CLAIMS AGAINST THE CITY TRANSMITTAL FORM
CLAIMANT/PLAINTIFF:
DISTRIBUTION LIST:
~Jim witt, City Manager
Peter G.Smith, City Attorney
~Vivyon Bowman, Director of Human
Resources
Texas Municipal League
La~wuit File (original/copy)
COMMENTS:
suit/city.for~
revised 8/19/94
CLAIM NOTICE
PLEASE USE BLACK INK ONLY
City Secretary
City of Coppell
PO Box 478
Coppell TX 75019
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 ~ 0
at approximately ~,_ Z,-Do"c[~ck
dayof
, at the spe6fic location of,
, in Coppell, Texas.
The damage or injury occurred in the following manner:
.... / ~ - . ~ ...... - _ _, ~---,~-- ~=~.
The full extent of my damages and/or injuries are as follows (be specific - attach estimates, bills,
etc., if available):
:bi/~-~,: ,~ ~. ~ ',,~;~- crv. ~ ~ ~, 3 ~c
The amount of damages claimed is $ fi:, ~
(Please Print)
Claimant '~4
Address
I do swear the above is true and correct.
NOTE: Article 1 l, Section I 1.09 of the Home Rule Charter - Damage Suits. The notification shall 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 thne and manner specified shall
exonerate, excuse and exempt the City from any liability whatsoever. No action at law shall be brought
against the City until at least sixty (60) days have elapsed following the date of notification.
November 3, 2000
Ms. Bettina Patton
c/o National American Insurance Company
P.O. Box 38
Chandler, OK 74834
RE: James Chang
Dear Ms. Patton:
Enclosed please find one more claim that has been filed with the City.
Sincerely, t ~
Administrative Support Supervisor
CCi
Encl.
Viyvon V. Bowman, Director of Administration/HR
Jim Witt, City Manager
Clay Phillips, Deputy City Manager
Ken Cn'iffin, City Engineer
255 PARKWAY 1irP.O.80X 478 'JrCOPP£LL TX 75019 it'TEL 972/462 0022 'k FAX 972/304 3673
November 3, 2000
Mr. James Chang
237 Westbury Dr.
Coppell, TX 75019
Dear Mr. Chang:
This letter is to notify you that your claim against the City for the recent water problems
at your residence has been fonvarded to the insurance company of the contractor working
on a project which caused this problem.
The name of the insurance company is:
National American Insurance Company
P.O. Box 38
Chandler, OK 74834
The name of the contact person is: Bettina Patton
Her telephone number is: 1-800-822-7802
Please contact Bettina with any comments/concerns regarding your claim.
Sin~x~. ly, .
Vivy6n V. Bowman
Director of Administration/HR
Bettina Patton
Ken Griffin, City Engineer
Jim Witt, City Manager
Clay Phillips, Deputy City Manager
255 pARKWAY ~ P.O.BOX 478 dr COPP£LL. TX 75019 'k TEL 972/462 0022 ~' FAX 972/304 3673