ST9302-CL010327 COPPELL
March 27, 2001
Ms. Nancy Johnson
C:o Ed Bell Construction Company
P.O. Box 540787
Dallas. TX 75354-0787
Dear Ms. Johnson:
Enclosed please find a claim for Ms. Mary Ayad.
If you have any questions, please don't hesitate to contact me directly at 972-304-3648.
Sincerely.
Vivyo~ V. Bowman
Director of AdministratiowHR
cc: Ken Griffin, City Engineer
Cia3' Phillips, Deputy' City Manager
Mary Ayad
\-'VB td
C!.AF~ NOTICR (For Office Use Only)
CLAIM NO.~ ~ ~OI- ~ FILED IN
~OFFtC~TmST~E ~ ~O~
~k ,20 o/
DEPUTY C~EC~T~Y
Ci~ of Co~R (972) 3~3673 ~ ~m
P.O. BO~ 478
CO~, ~ 75019
~ is my no6ce ofcia~ a~st ~e CiW ofCop~R. ~e c~mstances ~v~g ~e to ~is claim
~e as foRows:
-
1. ~e ~j~ or ~mage oozed on ~e ~y of
. ap~ox~t~. [ ~ ' o'clock 'gi~ , at ~e s~cffic location
~ ~~ ~ ~ ~3 ~ , m Cop~, Texas.
2. ~edamageor~ju~oc~ed~efo~o~gmanner: ~le~s~ kt
~, e~. ifava~able):
4. The amount of damages claimed is $ ~gUU. ~3~ $2~(~c~37,2~7.33
~a Co~
938
(~so l~t pre~ous ad.ss ffless ~an 6 monks)
I ~ swe~.~eabove is ~e~nd coge~
T~ n~fic~d~ ~h~ ~ ~ed~ ~ ~_ m~n~ ef t~ d~te of mju%, et d~m~ ¢, ~ the ca~e of ~ath. ~t~m ~ (6) mon~ o
t~ d~u of de~. ~e f~ure b ~o n~ the Ct~ wtt~n the t~ and ma~er s~dfied sha~ exonerate, excuse a~ ex.pt ~he C~
from lny habdiW w~a~ver (~le 1 ~, Scion 11 09 of :~ Rome Rule Chan~ - D~mage Su~u)
CLAIM NOTICE (For Otfice Use Only)
CL.MM NO. Oa;l$ gCOl.] FILED
.%Df OFFICE THIS THE ;lard DAY OF
FY~ c..f c.k ,20 O/
City Secretary
Cit' of Coppell (972) 304-3673 (TAX)
P.O. Box 478
Coppell, TX 75019
This is my notice of claim against the Cit' of Coppell. The circumstances giving rise to this claim
are as follows:
1. The injury or damage occurred on the (~.-r~ day of k'i , -dM9-," i, at
approximately { i o'clock , at the specific location of C:~q~'~ If-~O'--
lc~3;,,-~a ~A- ~,'~,%'r<_ o( ~ovv~k&,-t 'o-i ~ , in CopCell, Texas.
2. The damage or injuw occurred in the following manner: {21 e~,se- Lc o,o r,~ :~ ire ~.~
"- (~ -C,~ '"
3. The full extent of my damages and/or injuries are as follows (be specific - at~ach estimates,
bills, etc. if available):
4. The amount of damages c!aimed is $ .-.-99"/.
(Please Print)
Claimant 2 i~ ~ ~-~"{ 'X .4
Area Code
Address Q~
I Ou~Cttr'~ ~rtU-~ CiD'/State/Zip :.', .
(.~so list previous address ffless than 6 months)
I do swear~thg above ts =uel~nd co~ect/i
Si~ed ~ Date
The 2cuficatio% shaE be filed~'itbin
:he date eF death. TEe failure ~ so nctiN' :he C:P¢ wi:bm :Ee :!me and ma~er ~=ee:fied fkail exonerate, excuse and ex,m== :he Ci~¢
fra~ ]~y~ k'" · .... ¢- "¢' ,
aa..nt] ,~ ha=s~e.~. ~Amcle i 1. Section ! 1 09 ;~ :he Name Rule CEa~er - Damage Suks~
Page 1
GOODSON. ACUI~A
1750 E.. ~TRimD]~r.'FR~EEW-AY
IRVING, TEXAS 75062
972-721-6502 FAX: 972-554-1374
CD LOG NO 0004010 DATE 03/21/01
SHOP CONTACT: LARRY ~SP DATE 03/21/01
OWNER ,MARY AYAD
LIC# 0 VIN JH4DC4459TS022320
BODY COLOR RED MILEAGE 0
E=NEW PART EC=ECONOMY PART EU=SALVAGE PART-
EP=SEE PX REPORT P=CHECK I=REPAIR/ALIGN/SUBLET
L=REFINISH N=ADDN'L LABOR OPERATION TE=PART/PARTIAL REPLACE
ET=LABOR/PARTIAL REPLACE IT=LABOR/PARTIA~ REPAIR . AA=APPEARANCE ALLOWANCE
RP=RELATED PRIOR DAMAGE UP=UNRELATED PRIOR DAMAGE ~=USER ENTERED VALUE
1996 ACURA iNTEGRA LS/LS-SPL/GS 2DR H/B 81422B/C OPTNS A/34
OPTIONS: TWO-STAGE - EXTERIOR SURFACES TWO-STAGE - INTERIOR SURFACES
OP GDE MC DESCRIPTION MFG. PART NO. PRICE AJ% HOURS R
E 037 D~"FLECTOR,~-q{T ~ ~ D471~'S~7010ZZ 119.67 .5 1
L 037 09 DEFLECTOR, FRT END PNL REFINISH 2.0 4
L M03 FLEX ADDITIVE REFINISH 10.0C* 4
3 ITEMS
~4CMESSAGE
09 INCLUDES 0.6 HOURS MAJOR P~NEL TWO-STAGE ALLOWANCE
FINAL CALCULATIONS & ENTRIES
GROSS PARTS 119.67
OTHER~>~TS 10.00
PAINT_ MATERIAL 48.00
PARTS TOTAL 177.67
TAX ON PARTS & :~TERIAL ~ 8.250% 14.66
LABOR RATE REPLACE HRS REPAIR HRS
1-SHEET METAL 34.00 .5 17.00
2-MECH/ELEC 6'5.50
3-FRA~ME 34.00
4-REFINISH 34.00 2.0 68.00
5-PAIN~ MATERIAL 24.00
T.a~ TOTAL B5.~0
TAX CN LABOR D .000%
ACURA INTEGP~A LS/LS-SPL/GS 2DR H/B Page 2
CD LOG NO 0004010 Date 03/21/01
SUBLET REPAIRS
TOWING
STORAGE
GROSS TOTAL 277.33
NET TOTAL 277.33
~kDP SHOPLINK U4743 ES LOG 0004010 DATE 03/21/01 13:50:11 R4.2 CD 03/01
PXN:N-N/00/00/00/00 CUM:00/00/00/00
Copyright, 2~01 Automatic Data Processir~
0.8 HOURS WERE ADDED TO THIS ESTIMATE BASED ON ADP'S TWO-STAGE REFINISH
FORMULA: 20% OF REFINISH HOURS, AFTER OVERLAP, PLUS 0.6 HOURS FOR THE FIRST
MAJOR PA/qEL, WHERE NOTED.
THIS ESTIMATE FOR IMMEDIATE ACCEPTANCE ONLY. AN kDDITIONAL CF~ARGE WILL BE
ASSESSED FOR ANY ADDITIONAL REPAIRS NOT LISTED IN THIS APPRAISAL. PARTS
PRICES ARE~{~BJECT'~ C~L~E~k~I~R ~mv~iC~"15qE"X~ OF I~EP~TR.
LABOR AND MATERI~_L RATES WILL BE HONORED FOR UP TO NINETY DAYS FROM THE DATE
OF THIS APPRAISAL.