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Home My WebLink About08-11-09 CC Item 04CITY OF LADE LSIHOKE DREAM EXTREME TM REPORT TO CITY COUNCIL TO: HONORABLE MAYOR AND MEMBERS OF THE CITY COUNCIL FROM: ROBERT A. BRADY CITY MANAGER DATE: AUGUST 11, 2009 SUBJECT: CLAIMS AGAINST THE CITY Background Claims filed against the City of Lake Elsinore are reviewed and handled by Carl Warren & Company, Claims Administrators. When received, each claim is logged in the City Clerk's Office and forwarded to this company for investigation. After initial review and investigation, direction is issued to the City to take one of several actions such as rejection, notification of late claim or reservation of action until further information is obtained. Discussion The following claims have been recommended for rejection by Carl Warren & Company: CL# 2009-11 - Gennady Massovich 2009-12 - Barbara Buchanan Fiscal Impact None. Recommendation Reject the claims listed above and direct the City Clerk's Office to send a letter informing the claimants of the decision. CC August 11, 2009 Item No. 4 Page 1 of 12 Claims Against the City August 11, 2009 Page 2 Prepared by: Jessica Guzman Office Specialist Reviewed by: Debora Thomsen City Clerk Approved by: Robert A. Brady City Manager CC August 11, 2009 Item No. 4 Page 2 of 12 July 29, 2009 TO: The City of Lake Elsinore ATTENTION: Jessica Guzman, Office Specialist RE: Claim Buchanan vs. City of Lake Elsinore Claimant Barbara Buchanan D/Event 5-1-09 Rec'd Y/Office 7-13-09 Our File 1500030-RWQ We have reviewed the above captioned claim and request that you take the action indicated below: • CLAIM REJECTION: Send a standard rejection letter to the claimant. Please provide us with a copy of the notice sent, as requested above. If you have any questions please contact the undersigned. Very truly yours, & COMPANY ,Roy Whang cc: CJPIA Attn: Paul Zeglovitch, Liability Claims Manager CARL WARREN & CO. CLAIMS MANAGEMENT•CLAIMS ADJUSTERS 770 S. Placentia Ave., Placentia, CA 92870 Mail: P.O. Box 25180 • Santa Ana, Ca 92799-5180 CC August 11, 2009 Item No. 4 Phone: (714) 572-5200 9 (800) 572-6900 • Fax: (714) 961-8131 Page 3 of 12 July 14, 2009 Dwight Kunz Carl Warren & Company P.O. Box 25180 Santa Ana CA 92799-5180 Dear Mr. Kunz: Enclosed for your handling is a claim received on July 13, 2009 from Barbara Buchanan (CL #2009-11). Please keep me advised of appropriate City Council Action. at (951) 674-3124 ext. 269. T Enclosure 951.674.3124 130 5. MAIN STREET LAKE ELSINORE. CA 92530 W W W. LAKE-E LSI NORE.OI2G CC August 11, 2009 Item No. 4 Page 4 of 12 CITY OF. LAKE LSII`1 DRUAtvt EXTkt ME. CLAIM AGAINST THE CITY OF LAKE ELSINORE (For Damages to Persons or Personal Property) f l7> t 7 Received by: T City Representative A claim must be filed with the City Clerk of the City of Lake Elsinore within six (6) months after the incident or event occurred. Be sure your claim is agatnst the City of Lake cTsinore, not anottrer-public entity. Wheie-space is insufficient, please use additional paper and. identify information by paragraph number. Completed claims must be mailed or delivered to the City Clerk, City of Lake Elsinore, 130 South Main Street, Lake Elsinore, Time/Date Received: IL,, ,J1 Li rd The undersigned respectfully submits the following claim and information relative to damage to persons and/or personal property: 1. Name of Claimant a. Address of b. Phone No. d. Social Security No. 2. 3. c. Date of Birth e. Drivers Lic. No. Name; post office address and telephone to which claimant desires notices to be sent, if other than the above: Occurrence or event from which this claim arises: a. -Date: _S t (09- c. Place (JExact and specific location) l~ d. How many and paper if necessary). what circumstances did damage or injury occur? Specify the particular Cvr\e I ~GIJ hCQ%'l &I n-vco" e. What particular action by the City of its I.} rac k, ITvm-/NS Ltl 1 t t od64 re( caused the alleged damage or inj ry? 1A)QS M+-) P lQ-?O- u( . V Page 5 of 12 occurrences, event, act or omission you claim caused the injury or damage (use additional 4. Were there any injuries at the time of this accident? If not, state "No Injuries." 6. Give the name(s) of the public employee(s) causing the injury, damage, or loss, if known. Nama and address of anv nerson iniured: 9. Damages claimed: a. Amount claimed as of this date: $,o 'non_ b. Estimated amount of future casts: $ Lin knal i 1 c. Total amount claimed: $ 1 V l~. d. Basis for computation of amounts claimed (include copies of all bills, invoices, estimates, etc.): Warning: It is a criminal offense to file a false claim] (Penal Code 72/Insurance Code 556.1) 6 have read the matters and statements made in the above claim and I know the same to be true of my own knowledge, except as to those matters state upon information or belief as to such matters, I believe the same to be true. I certify under penalty of perjury that the foregoing is true and correct. Claimant's Signature CC August TF t2009 Item No. 4 Page 6 of 12 Name pnd address of the owner of any damaged property: United Therapy Network, Inc. 802 Magnolia Avenue, #107 Corona, CA 92879 (951) 340-0070 (951) 340-9188 FAX Barbara Buchanan Re: Physical Therapy Treatment Sessions To Whom It May Concern: Mrs. Barbara Buchanan was referred to our office by Dr Bovetas to treat patient for Hip Pain and Sprain (719:45, 843.0). Therapist recommended patient to following a therapeutic exercise plan to: decrease pain, decrease swelling, increase range of motion (ROM), and increase active function. Therapy plan consists of: manual therapy, therapeutic exercise, ultra-sound, electrical stimulation, and hot packs. Patient was treated on the following dates: 06/09/2009, 06/15/2009, 06/17/2009, 06/23/2009, 06/24/2009, and 07/07/2009 If our office can be of further assistance please call. R 7Ze,,'h ctfully EvaI - UTR, -lne: Billing Department CC August 11, 2009 Item No. 4 Page 7 of 12 July 21, 2009 TO: The City of Lake Elsinore ATTENTION: Jessica Guzman, Office Specialist RE: Claim Massovich vs. The City of Lake Elsinore --Clalmarft Gennady Massovicfi D/Event 7/3/2009 Recd Y/Office 7/13/2009 Our File S-1500031-RWQ We have received and reviewed the above claim and request that you take the action indicated below: CLAIM REJECTION: Send a standard rejection letter to the claimant. Please provide us with a copy of the notice sent, as requested above. I f you have any questions please contact the undersigned. Very truly yours, CARL WARREN & COMPANY O Ric d D. Marque cc: C~PIA w/enc. A n-: Executive Director CARL WARREN & CO. CLAIMS MANAGEMENT CLAIMS ADJUSTERS 770 Placentia Avenue,. Placentia, CA 92870-6832 Mail: P.O. Box 25180 - Santa Ana, Ca 92799-5180 CC August 11, 2009 Item No. 4 Phone: (714) 572-5200 • (800) 572-6900 -Fax: (714) 961-8131 Page 8 of 12 CITY OF ~n~ LADE I LLSIHOIZE ~u DREAM EXTREME July 14, 2009 Dwight Kunz Carl Warren & Company P.O. Box 25180 Santa Ana CA 92799-5180 Dear Mr. Kunz: Enclosed for your handling is a claim received on July 13, 2009 from Law Offices of Robert Haralambopoulos on behalf of Gennady Massovich (CL #2009-12). Please keep me advised of appropriate City Council Action. (951) 674-3124 ext. 269. Enclosure 951.674.3124 130 S. MAIN STREET LAKE ELSINORE, CA 92530 WWW. LAKE- E L S I N O RE.O RG CC August 11, 2009 Item No. 4 Page 9 of 12 v vv., cvva~.+v c. cx r.an CITY OF LSII` O . DREAM EXTREME,. CLAIM AOAINwr THE CITY Of LAKE ELSINORE (For Damages to Persons or Personal Property) Recei ed d. y A claim must be filed with the City Clerk of the City of t *e Elsinore within , six (6) months after the incident or event oocurred, B.- sure your claim is JUL i 3 RE N against the City of Lake Elsinore, not another public e114ty. Wherespace is insufficient, please use additional paper and idemify mformatioh by paragraph, number. Completed claims must be made" ~'i' deliysfert: to the CITY CLERKS OFFICE City Clerk, City of Lake Elsinore, 130 South Main S ~iA;akn£IStnoJe, WJVV./VVC The undersigned respectfully submits th ; following claim and information relative to damage to persons and/or personal property: 1. Name of Claimant a. Address of Claimant: _ b: Phone d. Social Security 2. Name, post office address and telephone to which claimant desires notices to be sent, if other than the above:.. 3. Occurrence or event from whxt:h this claim. arises: a. Date: / b. Time: lQ ?o c. Place (Exact and specific 'doaflop) Zrke t1f~hare Mps,nt, - Z01 317 d. How many and under whit circumstances did damage or injury occur? Specify the particular occurrences, event, act of omission you Claim caused the injury or damage (use additio/n I paper if necessary), by, rtoT p,c ar~ G, fb% F,,R / /_d y/L 1 /L I 1 / i nn 11 e. What particular action by ho City of its 0 orite ~n14? 4 WJ002/002 4, Were there any injuries at the time of. this accident? If not, state "No Injuries. 7CJ 5. Give the name(s). of the pubfic employee(s) causing the injury, damage, or loss, if known. 6. Name and address of any person injured: 7. Name and address of the oat ier of any damaged property: 8. Damages claimed: a. Amount claimed as of thi. date: $o / ~~of b. Estimated amount of future costs: $ c. Total amount claimed $ d. Basis for computation of amountsclaimed (include copies-of all bills, invoices, estimates, etc.): 9. Names and-addresses of alkMOnesses, hospital, doctors, etc: a. b. G 10. Any additional information that might be helpful in considering this claim: Warning: It is a criminal offem .to file a false claim! (Penal Code 72/insurance Code 556.1) l have read the matters and stat-°.-nents made in the above claim and I know the same to be true of my own knowledge, except as to thc°=a matters state upon information or belief as to such matters. I believe the same to be true. I certify undl.r penalty of perjury that the foregoing is true and correct. uVJ,1009 Item No. 4 Claima t nature Date Rage 14 of 1 ROCKY MOUNTAIN RECREATION COMPANY RESERxYATlWii Campground: LAKE ELSITORE Name Address; City, State, &-Zip: Mona: Date Reservation Made: Credit Carta qs~~ £xp: Camping Fees aQ Reservsbon Fees, Total Charge ALL RESERVATION FEES ARE NON=REFUNDABLEIII Cancellations: Gartrping fees may be refdridabie if a reservation agent is contacted between. tha'liours of gam - 4pm P.C.T. three days before day of arrival. Comments: There wilt ba a Host/Hostess at the campground who will do a <COmpllance check and determine any additional 'Fees that will be,reyuired from your party. Reservation recorded on reservation calendar WEI OPE YOU`ENJOYYOUR STAY AND WILL VISIT US AGAIN SOON! Roaky_'Mt1t-R0croaH0n Company 26374 .Ryr Canyon Rd -#B 'Viijohcia, CA.94355 1.800-416-6992 CC August 11, 2009 Item No. 4 Page 12 of 12