ST9301-CL060410
THE.CITY.OF
COPPELL
Date:
April 1 0, 2006
To:
Robert Caudill, VP
Tiseo Paving Company
From:
Garreth Campbell, Construction Inspector
RE:
East Sandy Lake Road Project #ST 93-01
On Thursday, February 16, 2006 at approximately 10:30 p.m., a Coppell resident entered onto the
new pavement at the East end of the project and traveled West where she drove into a block out for
a manhole. As a result her car was severely damaged. She called me Friday morning, February 17
and I personally checked the location where I found access to the new pavement was not
barricaded. Under the contract, Tiseo paving is obligated to protect "Persons and Property",
NCTCOG Item 1-24-2. You failed to do so in this instance. Furthermore, Tiseo Paving did not
meet the requirements of the approved barricading plan.
Under the terms of the contract, the City of Coppell has the right to withhold payment to protect its
own interest against claims filed against the contractor. Because of the issues mentioned above you
have fair warning that it is my intention to withhold any payments due Tiseo Paving until this claim
is favorably resolved.
Please call me at your earliest convenience at 469-576-7708.
255 PARKWAY * P.O BOX 9478 * COPPELL TX 75019 * TEL 972/462 0022 * FAX 972/304 3673
'pr 10 06 03: 46p
Tiseo Pavin~ Co
9722165637
p.2
PAVING COMPANY
--::
419 East Highway 80
P.O. Box 270040
Dallas. Texas 75227-0040
Tel (972) 289-0723
Fax (972) 216-5637
~lonJay, ApClIIU. 200(1
\~_V f' ~~
ell]' or CoppcH
P.O. l:3u:\; ').17:-)
Coppc1J TX 75019
s~ I.~
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Attn: (,anLlh Campb,-'l1. Cun,lrullio!\ 1[1~pI,;ClUr
Ro;'. ClJIJl1 for O::lI1lJ.gcs IOchruar{ ] (,11'.2006
'1'I~tO P~lvlng Co. h:ls through it contr;lct wah ThL CHy ol'Coppdl imkmnii'ILllthc Clly, ib Orficers (lncl El11ployees
from arl;-' ciJillls ilrlSlllg out of the construction ofthc Sandy Lake project hlrlher, in ;lccol'cl:1nce witll tlw conlract
documents T1SCO PLiving Co. has addi11011all>; in~urcd. lhwugh jl~ plOvidl:r Zunch ;..r~)rth ;\ll1clic::lll, the OWller.
Upon Icccipl urlhe cbun made by 1\15, Peggy HUl1",l'ove for cl;Jma~e to her VChlclc on or nt:af h:brll;lry 1(/',2006,
11~~e(l I'ZlV;I1~~ Co. forwarded this claim to the: In,uunc~ carner prOV)(JIJI~ covcraSl: fur bulb rj,~.o PJVll\r~ Co. :wd th~
CltV of COjJpclL T~lbrcpolt iAcluded lhe inforrnation obta,n",d by Tht,;' City of C'ol\pdl dtlrin~ their il1v~~\iga~I". It
l~, the st~lncc or Ollr in~UI'Jllc,; cJni.;-1' IhJt (11.;- wornin~ sign<(includinz but not Ilrnitcd to a b;mTII<lpcL me:;,afl:
hoard. ;md right lane, clo~;~J ~lhcad ,Isn:;) wen: ,u1'11citnllo guide !VIs, 1-J<ll'g[O\'.;' 10 th~ 3ppropri:ltc 1:\Ilcs of lraffic.
Conslruclion an:JS ,10 not relIeve motorists orth<:ir responsibility to appropnatcly IIltcrprct si<;.ns Linu barm;aucs allo
tl'.lvr:l ;n J ler,.1ll';lte of speed.
Addiliolhllly. plC'~tse.: be adns<.'d llwt :Vb, I1;lrgIOvt' has rl.'ct,;'lv.,;d compcilsiltioll for lhi~ claim from her own II1surLil1Ce
policy, It IS llkg::d and consllnlles lllsurance froud for !'vIs, Hmgrove to make a second C1:1I111 for damages Tn shon,
\<1<,. Hargrove 110 longer has a ehllll. Her pre,cnt Illsurance c;.!rrJCT nlJY chuosc lo subrus;,rk lllls cbWl.l11d 11.1s .ill
nccC';sary ml'on1nlion to du ~u
Allhough, it IS Wllhlll thL City ofCOflPcll's rir,hts to \vlthholct payment for claIms fllcd hy or agall1slthl' contraclur
undcr Itcm I 52 of the ContDct Doeunll'nts, this applies only to sllllatlOl1S in whJCh IllS "nl'c,;~<,ary tu pnlte.:ct llle.:
()\Vller'~ Lnter~sf'. 'l'lS~O I'a\,int'. Co has III accordance WIth the la\\! f!l~d thl, clall11 with irs in';urancl' canleT This
c!::1l1l11;dls withrn the lImils o( S;llJ polley. 1 ur\hermore, this polley lndc-mniftes and holds harmless Ibe City of
Coppdl. Therelott, tbe City I)rCoppell It"s no exposll1(' ullckt' tl1is CL:lJlll and it,; riShlS 11,1'<: b,'en cOlllrld~lv
protected bv T1S('O T'avmg Co.
Sllotdd you need Jny further InJorlilJtion regJrdlllg tbis maller, please fed frce (() conlact Ill";,
Slllcerely L',
'-y /J n /~O ('~
r lJ Qy.,Q;\<:-~V_ bcc:~(f21/\,~
Vlt-bnl, T;Lylor - (j
Oflicl'Mgr.
~ 1974
'.:>r 10 06 03:45p
9722165637
Tiseo PClvin~ Co
9722165637
p. 1
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PA.".~~ CCJIVIPAI'-I'V
M..ilin~ Address: P.O.Box 2700.10 DalIu.TX 7522'7
P h y , i cHI A Ii u r " S s: 4 I 9 E. H w Y 1\ (I M c s qui le. T X 7:; 1 5 0
Tel (~1;2) 289.C7)3 Fux: (972) 216-5637
FACSIMILE TRANSMITTAL SHEET
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(-1D1A~_._} ~rO"J~ n (;0 JOOJ
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FAX 1'L'tvml=:R: TOTAL NO. OF PAGES INCLUDING
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INTERGOVERNMENTAL RISK POOL
~ -
TML
March 22, 2006
MargaretIIargrove
309 E. Bethel School Road
Coppell, TX 75019
RE:
TML-IRP Fund Member:
Claimant:
Date of Loss:
TML-IRP Claim #:
City of Coppell
Margaret Hargrove
02-16-06
0600125721
Dear Ms. IIargrove:
This letter is in regard to the claim that you have made against the City of Coppell .for the
above-referenced matter.
Based on the facts revealed in our investigation of this claim, it appears that the City of
Coppell has no legal liability in this matter. The City is legally immune from liability for the
property damage claim being brought against it as afforded the City by common law of
Texas. Although the Texas Tort Claims Act waives this immunity under certain
circumstances, the facts of your case and the damages which you seek do not fall under any
of the waivers set forth in this Act. For this reason, we must respectfully deny this claim in
its entirety.
You may refer your claim to the City's contracted construction company, 1. T. Dresner, 2101
E. Shady Grove Road, Irving, Texas 75060. Their phone number is (972) 421-0930.
Should you have any questions concerning this matter, please do not hesitate to contact me.
Sincerely,
Ginny Larvin
Fast Track Claims Specialist
TML Intergovernmental Risk Pool
GLide
cc: City of Coppell
Attn: Vivyon Bowman
P.O. Box 9478
Coppell, TX 75019-9478
TExAs MUNICIPAL LEAGUE INTERGOVERNMENTAL RIsK POOL
1821 Rutherford Lane, First Floor . Austin, Texas 78754 · (512) 491-2300 · (800) 537-6655 Texas Only
PO Rnx 14Ql94 . Austin. Texas 78714-9194
02/27/2005 17:41 3723043533
Ft,-I? - 2005 11 ; 5,3 HDl)H~-,JCEPC5
F mA~~CE
PAGE 02/02
F.tJl'01
CLAIM NOTICE
City Secretary
"' ~
City of CoppeH
P.O. Box 9478
Copp~ll, TX 75019
(972) 304-3673 (FAX)
(For Office Use Only)
!CLAIM NO. 0:)1 uC'IH .~, / FILED IN 1\.JY
OFFICE THIS THE /7rA DAY OF
-~'~~:~A..:;z . ,206Jc;..
~ _~ 'L~-A~
ADMINlSTRA T1VE SECRETARY,
"1, '..11... . L.i.:..d..ll
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TIllS 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 _16_ day of _Februarv' ,2006, at
approximately ~10:20 o'clock _PM-1 at the specific location of Sandy Lake Road
going west bern'een I35E and MacArthur Blvd. in Coppelt Texas.
2, The damage or injury occurred in the following manner:
Goi.n...,g ",est on ~'!Dcty Lake RO<:ld at constructiC'}T'l ~ite. there wele no barrier.$. to going ~traight in the right
D.<1ncl.lilne. I haven't traveled SandY~Lal<~ Road In more than a month and was unsure of the 5t~e oJ
construction. As then' were no barriers to me continun::1.,g.straight onto the new road, I did so. Once
.again} ttwre were no He:h..ts QI barriers - lust yellow tape around a 6'x8' (approxintatel g.ap in tlH~
pavement By tne time.] was able to see the 2" t.@.€...5_urroundmg the gap ill tb~ to~dwav, I could not <;tcp
in tiOle tv keep my vehicl~J.r:OD:l gohg into the hole
3. The full extent of my damages and,! or injuries are as follows (be specific ~ attach
estimates, bills, etc. if available):
My car has bEte.,n towed to tl repair store irl. Coppell and I am havinJ:. a(l estimate done at this time:. So f8or,
I know there was extensjve ~amage done to the und~.!.~iq~ of my car, the wheel ,Is Q~nt} t\,,"O tires are
busted, th~ axle seal Or axle is busted (not determined WhIch as yet) broken reck and pinion seals and
pos5ibl.x ctacked hq"using.. transmission housmg. At this time we don't )mow if it is iust bustecls..esls or
busted nardware, I will fax the estimate to you aU.QO(1 ~s 1 have It.
4,
The amount of damages claimed is S
Do nQt know at this time. Do not know
at this time. I ,,,,,ill fax estimate to the City of Coppell as soon as I have it.
Claimant Margaret Hargrove_ Phone (_972-304-0932 Home (214-354-0727 -cell)
Area Cod",
Address 309 E. B~thel School Road. Coppell Ix. 75019
(Also hst previous address if less than 6 months)
~.*~..~.~~>>.~..*.**.**..*.**.~
I do swear the above 15 true ar.d cprrect.
'! ~: I
Signed'" ,I '. f. Date ~~ 17~ Db
The !".0 tiflca tio t: be ed wit In 311< (6) mont\... f the date of injury Or damage or., tn the CU.'ie of de~ th, within 5;:0; (6)
IT.O:1tns of thl" date of di>ath. The fail'Jr" t" so noti~.- the CIty w\tl'l:n the time and manrler spl!'cified sl.\l~ll eJ(onerat!'. eXCUSE and
(!xempt the Ci ~ from <in)' lia bill ty whal:5ot2'...,r. (Ar:idc 1] SeCtlofl 11,09 of lh~ Home R ..Ie Ch,utcr - D<lJll<lge Suits)
R.;:vi$l::c. ()Coi Q3 / O~
TOTQL i=',0~
'3723043693
02/27/2006 17:41 9723043693
F IHA~jCE
PAGE 01/02
THE.CIl'Y.OF
COPPELL
s
FAX COVER SHEET
PLEASE DELIVER THE FOLLOWING PAGES TO:
To: ~ ~~
Company:
From: Yd!Y'~ ~~
Department:
Phone # :
Phone #:
Fax #: tl/".o/' of) 1/ -- 3570
Transmitted by: ~AAA~
Date: d-/;)-"7 /0(" Time:
.
Number of Pages (including cover sheet):
Remarks:
v:itiZ/XA<..../ Jzdn ~~1t~ d..M-~A It> ..,{ef/tilu ~
/fM.L/)(-(J'-/J0ff M-.d/.-in d/YJd ~/JkJ~CV ~:J'00.
'T/nL- uhAL) liJLfJ'-J .~~A 4 tl.qo~.
/1f~1 !r'A~
IF YOU DO NOT RECEIVE ALL OF THE PAGES, PLEASE CALL THE
NUMBER LISTED ABOVE. THANK YOU.
LAWSUIT/CLAIMS AGAINST THE CITY TRANSMITTAL FORM
DATE:: (),;J.-17-(J~
d /J/J J /) L/
FROM: t:t ,L"'IA/I/{/iv (lJff!.f~4~
CLAIMANT IPLAINTIFF: C;;rC't/~d ,Ik~~~
DISTRIBUTION LIST:
-t
Jim Witt, City Manager
Bob Hager, City Attorney
L
Vivyan Bowman, Director of HR
Texas Municipal League
Lawsuit File (original/copy)
COMMENTS:
\ \ TWN_CTR\USERS\Kwilkers\Claim Forms\Suit Transmittal Form.doc
Revised 8/19/94
~
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PHONE ~bq - 52-Lt - Lt l 7 g
AREA CODE NUMBER EXTENSION
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AREA CODE
NUMBER
TIME TO CALL
T~~E~~~~ED_.. ~ .J:~.~~:~S: ~_~:.Lu......_ ._-J~~
CAME TO SEE YOU i WILL CALL AGAIN i i
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ED
~ FORM 4009
'W'~. MADE IN U.SA
M~R-06-2006 14:14
HDUHt'-lCEPC::,
P.01
Margaret W. Hargrove
309 E. Bethel School Road
Coppell, Texas 75019
11 Y car Resident
Ms. Natalie Wilson
Clajm Case :vIanager for TIseo Paving Company
Zurich N.A.
P.O. Box 619507
Dallas, TX 75261-9507
Re: Claim #C\720029747-001
Copy Fax to: Mr. Ken Griffith, Engineering
City of Coppell
972-304-3570/972-304-7041/ 972-304-3673
Mr. Doug Stover
Dear Ms. Wjlson:
In reference to your letter of 2/24/06 (copy attached) denying any claim obligation. Your
letter states that "the right lane was closed to traffic" _ That was absolutely not the case on
the night in question. For whatever reason the right lane was WIDE open and there was
indeed negligence on behalf of Tiseo. I \vould suggest that you and Tiseo review this
with Ken Griffith and Larry Davis with the City ofCoppell Engineering and Inspection.
It does not interest me whether you/Tiseo admit liability or not. My request is that Tiseo
reimburse me for the amounts I am out of pocket due to their negligence In addition to
the deductible, I was forced to pay a salvage fee in order to retain my vehicle.
My deductible is $500.and the salvage fee was 5600. Tiseo \vas negligent.. ...my
automobile suffered the damage and I should not have to be out of pocket any funds. I
am simply requesting that I be made whole
Thank you for your attention and please address this matter as soon as possible.
r'1HF'-05-2005 14: 14
Zunch North AmeriUl
Claims
PO.60~619507
Dallas. TX
75261.9507
Telelir'Qne (866) 828.6816
F3) (214) 866-16i6
I"ttp:!/wwV', ,eJnChn3. CO ,"1
HDUHtKEF'C'3
P.02
@
ZURICH
February 24,2006
Peggy Hargrove
309 E. Bethel School Rd.
Coppell, TX 75019
RE:
9720029747-001
Tiseo Paving Company
02/16/06
Peggy Hargrove
Claim #:
In~W'~-,i.:_.
Date of Loss:
Claimant:
Dear Peggy Hargrove:
We have completed our investigation into this incident. The basic facts as we
know them are that you were traveling west on Sandy Lake. You indicated that
your whicle went into a ditch in the roadway. Our insured indicated that they
did have parts of the roadway dug out with yellow tape around it, which was
located in the right lane. Our insured indicated that the right lane was closed to
traffic. Based on the pictures taken, our insured had adequate lane closure signs
up.
Our obligation as an insurer is to pay for claims when our insured is legally
liable. It 1S our goal to fairly and accurately assess potential liability, and
promptly process claims on behalf of our insured when appropriate.
Based on the information we have, there appears to be no negligence: on the part
of our insured, and therefore no liability. We must therefore respectfully deny
your claim for payment.
If you have any additional information you would like us to consider, or if you
have any questions, please contact me. Please include our claim number on all
forms of communicat1on.
v cry truly yours,
Zurich American Insurance Company
f)a:1:a..u.'~ u.J~bI\
Natalie Wilson
CLAIM CASE YlA."\JAGER
(214) 866-1656
TOTHL P. 02
FEB-22-2006 10:47
RDIJRNCEPCS
P.01
Margaret W. Hargrove
309 E. Bethel School Road
Coppell, Texas 75019
11 year resident of Coppell
February 22, 2006
Mr. Doug Stover, Mayor
jMr. Larry Davis, City Inspector
V ~~en Griffith, Engineering
255 Parkway Blvd.
Coppel1~ Texas 75019
FilX: 972.304.3570 1972-304-7041/972-304~3673
email~
Enalneerdici.coDDell.tx. us
"To the City ofCoppell Representatives:
This is to advise that the contractor you have working on West Sandy Lake Road (Tiseo)
in the city of Coppell has an unsafe jobsite. The incident with my vehicle only involved
damage to my car, I am wondering when their negligence will cause injury to a person.
On Thursday, February 16th-at approximately lO:30pm I was going west on Sandy Lake
Road from Hwy. 3SE. The newly poured section of Sandy Lake was wide open with no
barricades. Not only where there no barriers, but no directional lights to direct the night
time driver. As I do not travel that way often, I assumed this new section was open to
traffic. About Y:z. block down. there was a 6'x 8' section of concrete that was not poured.
By the time my headlights showed this, I was too close to totally miss it. My car has
undercarriage damage along with left side tire and wheel damage. I personally was not
injured. My husband drove to the sight, changed my tire, turned the car arOlmd and drove
out on the same wide-open stretch of road. We drove the car to the Kroger parking lot
before we realized the wheel was broken. We left the car there overnight.
On Friday, February 17th in the morning, I contacted the City ofCoppell and ultimately
was given the phone number of Garreth Campbell, Inspector. I spoke with him and
described the incident and the issue of no barriers. I suggested that he do something
promptly to correct this problem before others drove onto that section of road. Mr.
Campbell has since told me he called the contractor, but did not inspect the area until the
following Monday.
I can tell you that my husband and I drove by on Friday night, February 17th to check out
the situation. There were approximately 8 barrels deterring entrance to that section of
roadway. As a side note, at that time, we saw a vehicle heading east on what is supposed
to be the closed section of road.
1
FEB-22-2006 10:46
ADI)ANCEPCS
P.01
,"-"
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:Y1argaret W. Hargrove
309 E. Bethel School Road
Coppell, Texas 75019
11 year resident of Coppell
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February 22, 2006
Mr. Doug Stover, Mayor
Mr. Larry Davis, City Inspector
Ken Griffith, Engineering
255 Parkway Blvd.
Coppell, Texas 75019
Fax: 972.304-3570/972.304-7041 ! 972.304-3673
email:
Enaineer(ii)cI.CODPell. tx. us
~ I re o+-k~ c, '1 ~ ~9t~ 07?~
-7 Ca." ~\)~ 4410 - 04102.-
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To the City ofCoppell Representatives:
This is to advise that the contractor you have working on West Sandy Lake Road (Tiseo)
in the city of Coppell has an unsafe jobsite. The incident with my vehicle only involved
damage to my car. I am wondering when their negligence will cause inj ury to a person.
On Thursday, February 16th at approximately lO:3Opm I was going west on Sandy Lake
Road from Hwy. 35E. The newly poured section of Sandy Lake was wide open with no
barricades. Not only where there no barriers, but no directional lights to direct the night
time driver. As I do not travel that way often, I assumed this new section \vas open to
tramc. About Y2 block down, there was a 6'x 8' section of concrete that was not poured.
By the time my headlights showed this, I was too close to totally miss it. My car has
undercarriage damage along with left side tire and wheel damage. I personally was not
inJ ured. My husband drove to the sight, changed my tire, turned the car around and drove
out on the same wide-open stretch of road. We drove the car to the Kroger parking lot
before we realized the wheel was broken. We left the car there overnight.
On Friday, February 17th in the morning, I contacted the City ofCoppell and ultimately
was given the phone number of Garreth Campbell, Inspector. I spoke with him and
described the incident and the issue of no barriers. I suggested that he do something
promptly to correct this problem before others drove onto that section ofroad. Mr.
Campbell has SInce told me he called the contractor, but did not inspect the area until the
following :\1onday.
c h -'Ct efl
r:: rv, 'Jie" t
I can tell you that my husband and I drove by on Friday night, February 17th to check out
the situation. There were approximately 8 barrels detemng entrance to that section of
roadway. As a side note, at that time, we saw a vehicle heading east on what is supposed
to be the closed section of road.
1
FEB-22-2006 10:47
RDlJRNCEPCS
P.02
Where are our city inspectors? What are the safety procedures outlined by our city
engineers? Who is watching thIS contractor to make sure the citizens ofCoppell don't
get injured?
I have heard from the claim's adjuster for the contractor. The contractor is denying the
claim. Not only was Tiseo negligent, I feel like the City ofCoppell was negligent in not
inspecting the site promptly on Friday morning. The City should intervene on behalf of
its citizens and take steps to ensure that Tiseo pays for the damages incurred, This in
itself might be a deterrent for further negligence on their part. (How many other claims
have they denied?)
The damages to IllY vehicle are repairable at $2.140. This is what I would like the City of
Coppell or the contractor to cover.
Thank you for your time and attention to this matter. I would appreciate a response from
the City on how I can move forward with this claim.
Regards.
~argaretf.[argrove
(469) 524-4178
214-354-0727 (cell)
2
TOTRL P.02
HP LaserJ et 3330
HP LASERJET 3200
Jan-9-2007
12:37PM
Fax Call Report
Job
Date
16
1/ 9/2007
1 dVf-..
: "i:O
Identification
Duration
Time Type
4695244859
0:59
12:36:16PM Send
THE CITY OF
COPPELL
.~.
> .,
< ,
.r >\ ~ \ to
Date: April 10, 2006
To: Robert Caudill, VP
Tiseo Pa.ving Company
From: Garreth Campbell, Construction Inspector
RE: East Sandy Lake Road Project #ST 93-01
On Thursday, February 16,2006 at approximately 10:30 p.m., a Coppell resident entered onto the
new pavement at the East end of the project and traveled West where she drove into a block. out for
a manhole. As a result her car was severely damaged She called me Friday morning, February 17
and I personally checked the location where I found access to the new pa.vement was Dot
barricaded. Under the contract, Tiseo paving is obligated to protect "Persons and Property",
NCTCOG Item }-24-2. You failed to do so in this instance. Furthennore, Tiseo Paving did Dot
meet the requirements of the approved blllricading plan.
Under the terms of the contract, the City of Coppell has the right to ",ithhold pa)'ment to protect its
own interest against claims filed against the contractor. Because of the issues mentioned above you
have fair warning that it is my intention [0 withhold any payments due Tiseo Paving until this claim
is favorably resolved.
Please call me at your earliest convenience at 469--576-7708.
_.~~---_.._--------_.~-
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Pages
Result
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31/29/2008 15:19
9722165637
TISEO
PAGE 01/03
M aUhlg Acldreu: P.O. Box 270040 D aUa3, TX 75227
PFq'~iClB.l Addresl: 419 B.E:wy. 80 Masquita, 'I'X 7S1S0
Tel: (97.2) 289.0723 F~:I:,: (972) 216.-5637
FACSIMILE TRANSMITTAL SHEET
TO: . L1 FRO},!, ~ ~
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c~~ (iJ '(J.'1f- DAm / 129;(28
FAX NU 1 ~ TOTAL NO' OF iAGES INCLUDlNG
COVER:
.9 /~IJ'I-L3~70 ' ~~'.,
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-
o URGENT 0 POll.. REVIEW 0 PLE.A.SB COMllr.SNT 0 PIJ3.AS~ :U:PLY r:J PLEASE RECYCLE
NO'I'ES/COMMBNTS:
l-b.....
P.O. ':!lOX 2700-+0 o.u.:t..A.S, 'I':t 7S~27
0L/29/2008 15:19
9722155537
TISEO
PAGE 02/03
IO.'P' UI
~ DAI.LAS, TEiXAS 70ee7-0()o!O ':"0..
DATE f.JvorcE NO. DESCRIPTION INVOICE AMOUNT DeDUCtiON BALANCE
12/31/0 7 ~ 11608 Margaret Hargrove 1100.00 1100.00
~.J
CHECI< ) jCHECK ~ 626061 TOTALS)
DATE 1/16/0 8 NUM$ER 1100.00 1100.00
PLEASE; IJ~ I ACH THIS PUH mm AND R~ I "'IN FOfl YOUR RIfWHD8.
P A VIN(~ COMP:Am;
. .\ . ~j .., ~
.. $T~EEt; 11g EAST HIGHWAY B.9 ME~OUITE.'t~iI:s~lS0
Mllll.It-lG: P.O. BOX ~70040~I"LA~. -ro<Ag"i5~7.o040
AN F!QUAL OP"MFiTrJ/1irY IEM~LdYI$A
.cOME;l'IteA SA!ilK - tGXA13
,.., . eSl Q IlBflAMS RD.
.. . . ~t)y-At;rx ~~U,
.~.GeN~Ai~;ACCOUNT
$2-7~
1110
6'2:6::0.6,
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Pay~. **,*'\-*******",*H,***:;t.**~**~**bne thou~;l'al'\d one hundred dollars and no cents
DAnt
. January 16, 2008
,.
~.. ,': ":
,CKECK NO. AMOUNT
.62,606 $**.****1,100.00
VOIO AFTeR 60 o~ YS . . . .~
~U.:._..L~:':~
.;.:..:~:L__._.~: .:.., .:.,:,i,>....}~
PAY
TO TI1IO
OFlDEn
OF
~argaretHargrove
30 9.E..:Bethel Sc~o(1)l~Oa~
Cop'p~ll , TX 75019' .
Signature
Date
Witness
Date
E4t4/P.1.l8d 1914
01/29/2008 15:19 9722155537
TISEO
PAGE 03/03
PAVING COMPANY
P.O. 80x 270040 Dallas, Texas 75227-0040
Telephone (972) 289-072:3 Fax (972) 216-5637
RECEIPT AND RELEASE
Received of Tiseo Paving Co. this _ day of January, 2008, the sum of
Eleven Hundred Dollars and 00 Cents (1100.00) in full satisfaction and
extinguishment of all claims and causes of action arising out of any damage
or loss, direct or indirect, or bodily injuries known or unknown sustained by
me in consequences of an incident during the Construction of East Sandy
Lake Road in the City of Coppel!.
This payment is made without prejudice to any and all rights and defenses of
the payor who expressly denies any liability, contractual or otherwise, to any
and all parties involved in, or interested in, the said accident.
Signature
Date
Witness
Date
~ 1974
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