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HomeMy WebLinkAboutItem 3.5 Ian Chisholm Deny Claim CITY OF DUBLIN AGENDA STATEMENT MEETING DATE : February 28 , 1983 SUBJECT Claim of Ian E. Chisholm EXHIBITS ATTACHED Claim UV RECOMMENDATION Deny claim and refer to City' s Insurance Carrier FINANCIAL STATEMENT: Claim in the amount of $61. 08 DESCRIPTION The City is in receipt of a claim from Ian t. Chisholm, 7186 Brighton Drive, Dublin, in the amount of $61 . 08 . Mr. Chisholm alleges that he sustained damages to his car as a result of hitting a pothole on a City street. ---------------------------------------------------------------------------- COPIES TO: Ian E. Chisholm Ben Fernandez ITEM NO- �3•.S r'; 3 r 4-----.. February 14,1983 Ian E. Chisholm 7186 Brighton Dr, Dublin,. CA. 9456 ,Q C Dear Mr. Ambrose , s City 9 x983 ' I have been advised to file a reimbursement claim, OF p for damages to my car. Since no actual city claim forms ex- n ist,. as yetythis will have to do. If more information or action is required please notify me.. The accident occured on 'Monday, February 7th at 7130 P.M. My sister and I were returning, home on Amador Valley Boulevard.: The rain was heavy at times, causing pe- - riods of poor visibiliity.. The only warning I had was a large dark. area just in front of the car. The dark. spot turned out to be a large pot-hole:.. The area in question is just under the southbound lane of 680 (Freeway) . The hole was approx- imately 8 to 10 feet long by 2 feet wide .. Fortunately no one was injured.. However my left rear wheel was bent beyond repair. I drive to my Walnut Creek job at least 5 days per week., With my czar out of commission I couldn't "Shop Around" for a used rim. The dealership cost for an 181 Toyota rim is $51:.08. Exchanging rims (old tire to new rim) was an additional $10..00 at a i local service station. Please note copies of cash receipts attached. i Any help from you or your staff, would be greatly appreciated. Please forward any information and/or possible 'i reimbursement to the return address listed above . Sincerely yours, Ian E. Chisholm MFD-201 •NAME DATE 19 87740 0o ADDRESS u '� MDSE. SOLD MOS E R SALESMAN ORDER NO. CODE C Q. a. CASH CHARGE CASH CRCOIT 7i ca cp O V PART NO. DE SCRIPT N UNIT LIST UNIT NET TOTAL NET i V « 1'1 > P ![ 3 oLV. 0 0 ? z a 0 3 m CA TICKET (� REFERENCE KEY .O• TOTAL j NO; _ a NO. ❑I .. J ACCOUNT C KEY ACCT.NO. AMOUNT JKEYJ ACCOUNT C KEYI ACCT,NO. f A OU KEY °J O J PARTS A i PARTS & ACC. ?'' vi N>< PAWS INTERNAL .fc:'v: C 4 0 s iy':�'A:, ❑R T �`p-- C 4 7 4. 0 - Q -zz <�a ;: ©47. 50 ,: � "Z�°� TIRES C 4, .O ,rr; � ❑ WHLSE A C , �ori>°_u� f W C m W W GAS. Il, C O p,..�. i. TIRES: _ C 4 7.7.0 =<z 7 c J z GREASE ❑4. ❑ ❑ ❑ ' •->..f: '`-i,;;: ^f' © '-. + :. ❑ , I j W W GA IL < LL S S GR 0 O El USED CAR INV.` T 4 O O iK+`. � © t ❑ W u]7 w NEW CAR INVENT. .: Z 3 3 O ''�;`,E, '`;�". -f- rAZ 3 1 4`0'..!.,'. I J W 2 C vf a f �¢ O � u Jm22O •� J N BBYC•D. SALESE T 1 O 0 N <Z .. .. SALES L O 4 O .. } i. j. *j; f tt " ` •rt *O: si4 r+�f�Y. � �t,} '� 1 -1 y. r\'•� !^'l ,rLh t yX;t F1 J St �"•: 'f. 4.y F1 t � S+}�F .; , i},t� �� n �t `,^\/ '0 j�1 rf 'it { `� N. tt�rr r{ �,�, „)) t f: ttf .+�p tKf �i f �y+•• � *�t� rh''ti 7 x. lir ) �+,f'• }�1 t dla }i, / 1 � ) + Z�;@s liarf', b -'16ytrfr 't �� �t.a Arm r w {L1 )K. 00]'0,, O H !2j''V,' 'h •O' t ti,