ST9302-CL000925LAWSUIT/CLAIMS AGAINST TH~. CITY TRANSMITTAL FORM
DATE:
FROM:
CLAIMANT/PLAINTIFF:
DISTRIBUTION LIST:
Jim Witt, City Manager
Peter G.Smith, City Attorney
Vivyon Bowman, Director of Human
Resources
Texas M~nicipal heague
naws~t File (original/coPY)
COMMENTS:
suit/city.form
revised 8/19/94
CLAIM NOTICE
PLEASE USE BI,ACK INK ONLy
(For Office Use) ,
ICLAIMNO. f)9~..~'~1/900 · I _F~LED~
OFFICE TI~S' -TI~ ~ ,~ ~ DAY OF
~O ~s~:~,~clsl~ ~ECRETARY
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 ~ I'/d: .day of ,
at approximately o"clock , at the sp~ific lo,tmon of /
' ,tin Coppell, Term.
(Please Print)
Claimant
Address
The damag~ or injury occurred in the foll~owing, manner:
The full extent of my damages and/or injuries are as follows (be specific - attach estimates, bilh,
Themoumotd~agescl~is$ ~:~ k~
"Is'v~?
I do swear the above is true and correct. ,
Signed (, ! / ~ ~
NOTE: Article~l, S~9 Iof thl Home Rule Charter- I)a~. ag.~ $~its. ~Th, e .n, otifi.c~.,t!on~ .~mll,.be
filed within forty-five (4~)x~ay~e_d~te of injury _or damage o.r: .m ~e ..case_ ox ,aeam,
(4S) days of thc date of de.~. ~u~e to so nofififf the City within me rune sn~ manner sp~'m~
exonerate, excus~ ~nd exempt'x~ City'ti'om any [ability whatsoever, fro a~on ~ hw shall I~ brougl~
against the City until at least sixty (60) days have elapsed following the date of notification.
i
Customer Address:
c~ty, ap
~Cu~omer Wor~
IN~:OICE# 0022308
Time Promised: I.Z~
J Time Arrived:
Control #
Customer Mobil#
Customer Fax~ [
Customer Pa er~
Work Date: "~/gh~-~ iservice Foreman:
~`~;~:~:~.~:~:~¥~;`~7~:~¥~[~~¥~~-~7.~¥-r~`~:~r~:~:`:c~:~r~:~:~:~:~:~:~;~-~J~:~:~:~:~:~:`:`~:~:~:~:~:`:~;`;~:~:~;+.:c->;+:.2-J+..:c+:.:.2
~:~:~;;;~;;`~;~;~;~;;;~;~,:~`~:~,~;~,~:;~`:;:~;;~;:~;;;~:~:;;;;~;:;~:;;~;;;;~;~;~;:~;~:;;;~;;;;~;:;~;~;::;;:;;;:~
Work Description: [Work Notes:
' .... Dues
Payable Upon Compie~ion
Lump Sum Contract
Customer Signature: X
I hereby acknowledge the satisfactory completion of the above-mentioned work.
Card # Expiration Date:
DFW Sprinkler Systems, Inc. Po ~x 59s2os Dallas, TX 753~59-0205
IE'MAII' Islaffedfw'$prinkler'c°m I IhflP://dfw'~sPrinkler'cOm --I
(214) 343-8433 Metro (972) 445-59~7 Tarrant Metro (817) 261-1001 Fax# (214) 824-6630
i TX L.I. #12141 "Leave The Watering To Usl"
~..I I .~TI'II~I !:: I:1
~om;~" Name: JULIE TREGONING
ICustomer Address: 143 TENYSON PLACE
]City, Zip COPPELL 75019
CuStomer Home~ 972-304-0410 Customer Mobil#
Customer Worl~
TIME PROMISEDIA_M
Time Arrived:
Customer Fax~
0022756
~ustomer Page~
!
Work Date: 9/9/00 ~Service Foreman: ~ARTIN ROBLES
~`~:~:~:::::::::::::::::::i::::1ii::~:i:i::E::i:i:~.E!~.:i~:~:.~...:~?::::iii:~::::::::::::::::::::::::::::::::::::::::::::::::
................................................................
......................................................... . ............ ..,,,..,,,. ............. ..,.,...,..,.. ........
::::::::::::::::::::::::::::::::::::::::::::::::::::::::::
Nork Description: Work Notes:
DO T]]~ ~'ORI~ TIL~T CUSTO~fF-R
[ Customer Signature:X ~'~ ~,~--~1 \
L'-'-' ......... --'-' .............. ' .................... :~.:.hereby acknowled.e th~ry comtletl~n of the above-menflone__d work. __ __ __ _
~.:::::::::: ::::::::::::::::::::::::::::::::::::::
,:,:.:-:-:-:-; .................................................. ...-.-.-.- ;...-,-.-.-.-.- ..... ....,.,.,..-,-.-..,..........-.-,....-.-...-.-.-.-, ......-.-.-.-.-.-...-.-..,-.-.-.-.-.-.-,-.-.-.-.-.-,-.-.-.-...-, ...,-.-.-;. ;-:-:. :. :.;. :-:-;-:. :-:. :-.'. ;. :-:.:
:':-D:';':';'.-.'.-.-.'.'.'.'.-.-.- : .................. - .......
) DFW Sprinkler Systems, Inc. PO Box 595205 Dullm, TX 75359-0205
IE'MAIL Ist~edfw'sprinkler'c°m I ViSIt Our Web ate
(214) 343-84&~ Meko (972) 445-5~7 Tarrant Meko (817) 261-1001 Fax# (214) 824-6630
i [TX LI. #1214 "Leave The Watering. To Us1"
Copydg~t I999 DFW Sprl~)kler Syatem=, inc. ALL RIGHT3 RESERVED. This i= not e~ Ip~¥oic~ (u~a for IrWommtlo~l t~rposes only.
]' f T [ It T
September 28, 2000
T H E: C I T Y 0 F
COPPELL
Ms. Bettina Patton
c/o National American Insurance Company
P.O. Box 38
Chandler, OK 74834
Dear Ms. Patton:
Your name was given to me as a contact person by Nancy Johnston of Ed Bell
Construction in Dallas, Texas.
Enclosed please find two claims that have been filed with the City. I was directed to
forward these claims to you.
Sirtc..~ly, ""x ' / )
Administrative Support Supervisor
CCi
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 COPPELI.. TX 75019 ~lrTEL 972/4,62 0022 I~ FAX 972/30~t :3673
September 28, 2000
Ms. Julie Treguning
143 Tennyson Pl.
Coppell, TX 75019
Dear Ms. Treguning:
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.
S~ely, ~
DV'].~~tration/HR~
ecl
Bettina Patton
Ken Griffin, City Engineer
Jim Witt, City Manager
Clay Phillips, Deputy City Manager
235 PARKWAY 1IrP.O.BOX 478 ~k COPPELL TX 75OI9 'k TEL. 972/462 0022 1~ FAX 972/304 3673
Corporate Office:
Omaha, Nebraska
October 30, 2000
Ms. Julie Treguning
143 Tennyson Pl.
Coppell, TX 75019
, NATIONAL
AMERICAN ClaimDepartment:
Chandler, Oklahoma
. OMPANY '
N0~' 0 4 ~000
Insured:
Claim #:
DOL:
Claimant:
M-Co Construction, City of Coppell & Ed Bell Construction
GL-00-0971
8-30-00
Julie Treguning
Dear Ms. Treguning:
By way of this correspondence, we acknowledge receipt of the claim you filed against the City of
Coppell for damage reportedly sustained as a result of the City purging the water lines.
Please be advised we have reviewed your claim, as presented. We have verified and secured
copies of the invoices you submitted as documentation of your claim against the City of Coppell.
It was concluded only one invoice related to the above loss, invoice 0022308 in the amount of
$100. The second invoice, in the amount of $200, appears to be for work you specifically
requested of DFW Sprinklers and is in no way related to this water problem. Enclosed, please
find our company's check, in the amount of $100 which is issued as full and final settlement of
this claim.
Should you have any questions, please do not hesitate to contact our office.
Sincerely,
Extension 4645
Encl: Settlement Check
1010 Manvel Avenue CI P.O. Box 38 CI Chandler, Oklahoma 74834
405-258-0804 CI WATS 1-800-332-2210 El Casualty FAX 405-258-1329 VI Worker's Compensation FAX 405-258-3005
Ms. Julie TreguningtGL-00-0971
Page Two
October 30, 2000
b¢¢:
Viyvon Bowman
Director of Administration/HR
City of Coppell
P.O. Box 478
Coppell, TX 75019
Nancy Johnston
Ed Bell Construction Company
P.O. Box 540787
Dallas, TX 75234
M-Co Construction, Inc.
6816 Harmonson Rd
Ft. Worth, TX 76180