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ST9302-CL001127November 27, 2000 Paul & Kathryn B. Salvie 309 Beechwood Lane Coppell, TX 75019 Dear Paul & Kathryn 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, · Vivy66 V. Bowman Director of Administration/HR CC~ Bettina Patton Ken Griffin, City Engineer Jim Witt, City Manager Clay Phillips, Deputy City Manager 255 PARKWAY 3IrP.O,BOX 478 1~ COPPELL TX 75019 1IrTEL 972/462 0022 'k FAX 972/304 3673 LAWSUIT/CLAIMS AGAINST THE CITY TRANSMITTAL FORM FROM: CLAIMANT/PLAINTIFF: DISTRIBUTION LIST: Jim Witt, City Manager Bob Hager, City Attorney Vivyon Bowman, Director of HR Texas Municipal League Lawsuit File (original/copy) COMMENTS: \\TWN_CTR\USERS\Kwilkers\Claim FormsXSuit Transmittal Form.doc Revised 8/19/94 CLAIM NOTICE City Secretary City of Coppell P.O. Box 478 Coppell, TX 75019 (972) 304-3673 flAX) (For Office Use Only) CrArM NO. l i ~,2. ~:~0. ~ FILMY ~N MY OFFICE THIS THE ,~ ~ t~ DAY OF Nlo ~~ r. - ,20 b/~e'uT~t ~ SEC~Z~Y This is my notice of claim against the City of Coppell. are as follows: 1. The injury or damage occurred on the approx~nnately "] A o~clock The circumstances giving rise to this claim __ day of J~%'r ,20 ~, at , at the specific 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): The amount of damages claimed is $ (Please Print) Claimant ~/L~ Area Code Address ']"~0~ ~p..g~/~t.O-v~-~'~--- ~ City/State/Zip (Also list previous address if less than 6 months) I do swear the above is true and correct. The notification shall be filed within six (6) months of the date of injury or damage or, in the case of death, within six (6) months 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. (AnScle 1 I, Section 11.09 of the Home Rule Charter - Damage Suits) Revised I 1/00 1I 7I