ST9302-CL001005LAWSUIT/CLAIMS AGAINST THE CITY TRANSMITTAL FORM
DATE:
FROM:
DISTRIBUTION LIST:
Jim witt, city Manager
Peter G.Smith, City Attorney
Vivyon Bowman, Director of Human
Resources
Texas Municipal League
Lawsuit File (original/copy)
COMMENTS:
suit/city.form
revised 8/19/94
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CLAIM NOTICE
PLEASE USE BLACK INK ONLY
(For Office Use)
~.,,~v~ ~o. /0 0~,~_~3~0 .l F~ ~ M'~'
OFF~%'I;~S ~ ~ DAY OF
City Secretary
City of Coppell
PO Box 47~
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 ~__[J ~' .day of ~.~ ~-/~OO
at approximately 7t~: OO. o"clock , at the specifi'~location of,
~t~ ~i~_.~4/oo~ /.-d-r~e_., , in Coppell, Texas.
o
(Please Print)
Claimant
Address
The damage or injury occurr,ed in the following m. _aaner: --
Vd[ s C
The ~ ~ent of my d~ages ~or bj~es ~e ~ ~ows ~ sp~e - ~h ~t~ b~
etc., · a~le):
q, oo
I do swear the above is true and correct.
NOTE: Article 11, Section 11.09 of the Home Rule Charter - Damage Suits. The notifiC~ion shah be
filed within forty-five (45) days of the date of injury or damage or, in the case of death, within forty-live
(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 shah be brought
against the City until at least sixty (60) days have elapsed following the date of notitication.
INVOICE
ROBBINS SPRINKLER REPAY,'
P.O. BOX 1772
McKINNEY, TX 75070
2144H".-9735
NO.
SHIP TO:
,,..., SALESPERSON SHIPPED VIA ,~,; TERMS ] F.O.B. ] ...
Octobor 6, 2000
Ms. Bettina Patton
c/o National American Insurance Company
P.O. Box 38
Chandler, OK 74834
Dear Ms. Patton:
Enclosed please find two more claims that have been filed with the City.
Sincerelv,
Administrative Support Supervisor
CC.'
Encl.
Viyvon V. Bowman, Director of Administration/HR
Jim Witt, City Manager
Clay Phillips, Deputy City Manager
Ken Griffin, City Engineer
255 PARKWAY' 1~ P.O BOX 478 ~r COPPE:I./ TX 75OI9 ~ TEL 9'72/462 0022 'A'FAX 972/304 3673
October 6, 2000
Mr. & Mrs. Paul Salvie
309 Beechwood Lane
Coppell, TX 75019
Dear Mr. & Mrs. Salvie:
This letter is to notify you that your claim against the City for the recent water problems
at your residence has been forwarded 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.
Sincerely,
Director of Administration/HR
CC:
Bettina Patton
Ken Griffin, City Engineer
Jim Witt, City Manager
Clay Phillips, Deputy City Manager
255 PARKWAY 'k P.O.BOX 478 lk' COPPELL TX 75019 'k TEL 972/462 0022 "k FAX 972/304 3673
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