ST9302-CL000915 (3)LAWSUIT/CLAIMS AGAINST TH~ CITY TRANSMITTAL FORM
DATE:
FROM:
CLAIMANT/PLAINTIFF:
20o b, ~
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
CLAIM NOTICE
PLEASE USE BLACK INK ONLY
(For Office Use)
CL, O q t O00
OFFA~ . TI-nS THE /.~'/~ . OF
.'- . _
City Secretary
City of Coppeil
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 .j~D'-/k day of ~ ,
at approximately ~ ICI0 o"clock
' , in Capi~fl, 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)
Address / 0 ¢2 ./~//~.r, C r-4.~ 7L City/State/Zip ~-P~o~// 7'~' ?~'~I?
I do swear the above is true and corr, eft.
/ I
Signed (,~L.~.~'~ /~~"~'~ Date
NOTE: Article 11, Section 11.09 of the Home Rule Charter - Damage Suits.
The notification sh~ 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.
scoTl'S s~ INVOICE
1825 Ingleside Drive
FLOWER MOUND, TX 75028
(972) 355-0816 14 5 8
FAX (972) 874-0109
Irfi_oation in Texas is regulated
by the Texas Natural Resource
ORIGINAL
:) P.O. B0x 13087
Austi~~Oe~87 :')
'Scott's Sprinklers
Scott Pennington
Licem~d Irrigation Sl~cialist
License f~5504 Office 972-355-0816
1825 Ingleslde Drive Fax 972-874-0109
Flower Mound, TX 75028 E-mail s4penn~att.net ' . ~
' :, i: :, .:
FA)((214) 352-3201
TELEPHONE (214) 358-6581
ED BELL CONSTRUCTION COMPANY
POST OFFICE BOX 540787 10605 HARRY HINES
DALLAS, TEXAS 75354-0787 DALLAS, TEXAS 75220
September 22, 2000
John R. & Cecilia C. Dockery
103 Allencrest
Coppell, TX 75019
Re: Corrected Insurance Information
Dear John & Cecilia:
Ed Bell Construction Company is concerned that the City of Coppell has misinformed
you regarding insurance information for your claim. They did not contact us prior to
referring your claim. We have forwarded your claim to the correct insurance company.
You may contact them at:
Insurancel
Address:
National American Insurance Company
P.O. Box 38
Chandler, OK 74834
Contact: Bettina Patton
Phone # 1-800-822-7802
We regret any delay and inconvenience.
Respectfully,
Nancy Johnston
Administrative Assistant
AN EQUAL OPPORTUNITY EMPLOYER
CCi
Ken Griffin, City Engineer
Clay Phillips, Deputy City Manager
Jim Witt, City Manager
Vickie Boyer, The St. Paul
Bettina Patton, National American
Ricky Main, M-Co