HomeMy WebLinkAboutClaim 741 - A.Meyerhoffi
CITY OF PALM DESERT _ �
CITY CLERK DEPARTMENT
STAFF REPORT
REQUEST: CLAIM AGAINST THE CITY (#741) BY ALEX MEYERHOFF IN THE
AMOUNT OF $13,819.76
SUBMITTED BY: Rachelle Klassen, City Clerk
DATE: April 10, 2014
CONTENTS: • Staff Report
• Recommendations of Claims Adjusters and Staff
• Claim No. 741
Recommendation
By Minute Motion, reject the Claim and direct the City Clerk to so notify the
Claimant.
Background
Based on a review of the subject Claim and the recommendation of the Claims Adjuster,
Risk Manager, City Attorney, and staff, it is recommended that the Claim be rejected.
Discussion of this item should be held in Closed Session pursuant to Government Code Section
54956.9(b), potential litigation.
Fiscal Analysis
City of Palm Desert participates in the self-insurance pool of the California Joint Powers Insurance
Authority (CJPIA). Action to reject the subject Claim does not have a fiscal impact on the City at
this time.
Submitted by: Approved:
�r �"�
Ra helle . Klassen, MM , City Clerk n M. Wohlmuth, City Manager
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C( Y COUNCIL ACTION
Attachments (as noted) AYPROVI�.D r/
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ItECEIVED t)THrR
MEETINGDATE�_ `/-/D•-�C/�
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AI3SENT: _lJ�n c
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VCI21F[ED BY: /�"
Original on File with City Clerk's ftice
Klassen, Rachelle
From: Greenwood, Mark
Sent: Tuesday, February 25, 2014 3:09 PM
To: Klassen, Rachelle
Subject: Claim No. 741
Rachelle,
It is recommended that Claim No. 741 be denied as the drain in question was properly maintained prior to the storm.
Debris from the storm clogged the drain and we had no notice that it needed attention.
Mark Greenwood, P.E,
Director of Public Works
City of Palm Desert
�
� IIY 0 � Pfl � M DESERT
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TeL: �60 346-06��
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TO: CJPfA (c/o CARL WARREN & CO.), CITY MANAGER,
DIRECTOR OF PUBLIC WORKS, RISK MANAGER
FROM: CITY CLERK
DATE: FEBRUARY 21, 2014
SUBJECT: CLAIM N �:� ' - CLAIM AGAINST THE CITY BY ALEX MEYERHOFF IN
THE AMOUNT OF $13,819.76
The attached Claim No. 741 is being transmitted to you for the following:
❑ Information only.
or
� `� '"`' f��iv�ii��i��j�:t��t '�o the Claims Review Committee for any action
required by the City of Palm Desert.
We would appreciate your report, if requested, by March 24, 2014, for timely response to
the Claimant.
+�:•':�fyou have any additional information regarding the incident giving rise to the subject
claim that would assist in its processing, please forward to me so that I may transmit it to
the City's third-party Claims Administrators, Carl Warren & Company.
— - > _ c, / ;�/
_���- �
- -��� .
J ! c'4�` ..
RACHELLE D. KLASSEN, MMC ��,
CITY CLERK 1���;,
/
Attachment (as noted)
o.�vu o o�r nm�r�•u
--- �
L�JJJ � C i T Y C�>;>;� :E
�� �. ��. , F
CAR1.. WARF�EN & COMPANY ?014 �i�4� _'3 ��� �n; S��
� I�,nn�, M�,iiri�:�����i.�,iit �in�i S�;i�lt,��i���
l�ebruary 26, 2014
'I'O: City of Palm Desert
n"("I"f;N"1'ION: Rachelle D. Klassen, MMC, City Clerk
RE: Claim : Meyerhoff v. Palm Desert
Claimant : Alex Meyerhoff
Member : City of Palm Desert
Date Rec'd by Mbr : 2/2I/14
Date of Event : 8/25/13
CW File Number : 1880998 LMQ
I'lease allow this correspondence to acknowledge receipt o('the captioncd claim. Please take the
(ollowin� aclion:
• CI.AIM REJECTION: Send a stxndard re,jection letter to the claimant.
Nlcasc i�1cluJc a 1'rool�of Mailing with your rejec:tion noticc to the claimanl. �1n excmplar copy
ol�a I'roc�l�ui�Mailing is attached. Please providc us with a cc�E�y of�the Notice ot'Rejcction and
copy ot�thc I'rooCofMailing. If you havc any qucsti��ns (ccl lrcc to contact thc assi�ncd adjustcr
c�r thc uncl�rsi�ncd supervisor.
Vcry truly yours
CARL WARREN & COMPANY
�;chard A. MArc�u.e
Richard D. Marque
Supervisor
CUPY TO ��- - t r.v ��'� --
-� , �r ������ --
Gi;�E , � - 3 -���.�`��
AN EMPLOYEE-OWNED COMPANY
770 S Pfacentia Avenue � Placentia, CA 92870
P. Q. Box 25180 i Santa Ana, CA 92799-5180
www.carlwarren.com i Tel: 7i4-572-5200 i 800-572-6900 i Fax: 866-254-4423
CA L�cense No 2607296
� ��
. RE.: i • �
' ' CiT Y C� �:-��r �
Pt ( r� ;, _r ^�,.
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2014 hAR -7 �,,, �?: 5?.
Mazch 4, 2014
GOVERNMENTAL ENTITY PRELIMINARY REPORT
TO: R' hard Marque CLAIMANT: Alex Meyerhoff
Carl arren & Company FILE NO: S 1880998 -LMQ
700 S. P centia Ave.
Placentia, CA 92870
This report and our investigation are done in anticipation of litigation for the ultimate
transmittal to defense counsel and with the intent that it remains confidential.
D/EVENT: 8-25-2013 FILING DATE: 2 -21-2014 ONE YEAR: Yes
PRINCIPAL: CJPIA
MEMBER CITY—City of Palm Desert
RECOMMENDED ACTION ON CLAIM: This claim was recommended for rejection on 2-26-
2014
FACTS: The claimant alleges the City's storm drains became b{ocked during a period of
heavy rainfall causing a back up of water that flooded his property. The claimant believes
the City is liable because bars placed across the storm drains caused debris to block the
storm drain opening creating the flood condition.
POSSIBLE CO-DEFENDANTS: We have identified no co-defendants to date.
EVALUATION: Our evaluation is pending completion of our investigation.
RESERVES TYPE OF CLAIM AMOUNT
1. Alex Meyerhoff Property Damage $15,000.00
COMMENT/WORK TO BE COMPLETED: Our further report will follow within 30 days.
!�i�U -� : �;. �- � � �- � CARL WAI�:REN & C O.
-�-, J
T� i.� 't 1
- ? /` ;;} An Employee-OumedComparry
_ CLAIMS MANAGEMENT • CLAIMS ADJUSTERS
770 P{acentia Avenue,Placentia,CA 92870-6832
Mail: P.O. Box 25180,Santa Ana, CA 92799-5180
Phone: (714)572-5200.(800)572-6900•Fax: (714)961-8131
�.��� �
Very Truly Yours,
� ����_
'� Larry Muilen
Carl Warren � Company
� CC: Rachelle D. Klassen, MMC, City Clerk, City of Paim Desert
—2 -- Carl Warren & Co.
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C I T Y C I.� �. ; IA:E C(T Y C!_� CtTY OF RA�I�I�II�SERT
Pf�IM i;: . ., r��� r . r
A�f�NED CLAIM N0.�
CLAIM AGAINST THE C[TY OF PALM D �'� .,,, �;. � �. ��,,
(For Damage(s) to Person(s) or Personal P�e t� ? � 2U14 FE(� ?. I ��= I f�
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Received by: . �----_ _.�
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via: U.S. Mail Interoffice Mail Over-the-Counter�f"� �
A CLAIM MUST BE FILED WITH THE CITY CLERK OF THE CITY OF ALM D SER WITHIN SIX
MONTHS AFTER WHICH THE INCIDENT OR EYEN? OCCURRED. BE SURE YOUR CLAIM IS
AGAINST THE CITY OF PALM DESERT, NOT ANOTHER PUBLIC ENTITY. WHERE SPACE LS
INSUFFICIENT, PLEASE USE ADDITIONAL PAPER AND [DEN?IFY INFORMAT[ON BY
PARr4GRAPH NUMBER. COMPLETED CLAIMS MUST BE iV�A[LED OR DEtIVERED TO THE CITY
CLERK, CITY OF PALM DESERT, 73-510 FRED WARING DRIVE, PALM DESERT, CA 92260.
TO 'fHE HON4RABLE MP►YOR AND CITY COUNCiL, City of Palm Desert, California:
The undersigned respectfully submit(s) the following claim and information relative to damage(s) to
person{s)and/or personal property:
1. CLAIMANT INFORMATION:
NAME Alex Meverhoff
ADDRESS
PHONE NO.( ) DATE OF BIRTHc
SOCIAL SECURITY NO. xxx -xx - ORIVER'S LICENSE IVQ.
2. Name, telephone number and post office address to which rlaimant desires notices to be
sent, if other than above:
Same as above
3. Occurrence or event from which the claim arises:
a. DATE: Aug 2 5, 2 013 b. TIM E: 3 Am c. PLACE (exact and specific
location
74-682 Yucca �Qe Drive. Pal� De�ert, CA 92260
d. How and under what circumstances did damage or Injury occur? Sp�cify the particular
occurrence, event, act or ommission you claim caused the injury or damage. (Use
additionai paper if necessary.)
Followina a stroncs summer rainstorm, the stormdrain next
to mv drivewaY was blocked by d�bris. As a result
stromwater flooded IDy res� dence
e. What particular action by the City, or its employees, caused the alleged damage or
injury? The stormdrain design caused the stormwater to flood my
residence. Specificallv, the bars covering the drain
opening created a place to debris to collect.
The C� t,y has s�.nce r�constructed the drain o�enin�and
built a new drainage basin.
Page 1 of 2
4. Give a general description of the indebtedness, obligation, injury, damage, or loss incurred
so far as it may be known at the time of presentation of the ciaim. If there were no
injuries, state "no injuries":
The floorina �n mv residence waG d ,�an�pd and ; G no� ut,a�P�
The floorincr and underlayment must be reFlaced. lso, as a
result of the flooding, my _residence haG_ cubterranean t rQ mitPs.
No injuries �to any person.
5. Give the name(s) of the City employee(s) causing the damage or injury:
n/a
6. Name and address of any other person(s) injured:
7. Name and address of the owner of any damaged property:
Alex Meyerhoff is the owner of the residence.
8. Damages claimed:
a. Amount claimed as of this date: $ 13, 819. 76
b. Estimated amount of future costs: $
c. Total amount claimed: $ 13, 819.76
d. Basis for �omputation of amounts claimed include copies of a 1 bills, invoices,
estimates, etc.): DKI Invoice, Construct3on Cost Es�j��e,
Edison bills
9. Names and addresses of all witnesses, hospitats, doctors, etc.:
n/a
10. Any additional information, including police reports, which might be helpful in considering
this ciaim: _ Drainaae has been a recurring �roblem a thi G eGidence.
CitY staff has been involved in work at this citP nrav;c,_v,���
includin��� 'ettin �� the drain and construction of the debris uard.
�IARNING:IT LS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM! PENAL CODE 72;
INSURANCE CODE 556.!).
I have read the matters and statements made in the above claim, and I {mow the same to be true of
my own knowledge� except as to those matters stated upon information or belief as to such matters
I believe the same to be true. J certify under penalty of perjury that the foregoing is TRUE AND
CORRECT.
Signed this 20 day of February �20 14� �t Palm Desert, CA
�, �� �� � L�..��',
IG A UR O CLA IN SIGNA URE O� CLAIMf1NT
Office of the City Clerk, Palm Desert, California DOC. NO. -�"�l � DATE FILED �� j
�,
Page 2 of 2
City of Palm Desert, California
73-510 Fred Waring Drive
Palm Desert,CA92260
Risk Manager,
RE: Meyerhoff Flood Damage Claim,7Q682 Yucca Tree Drive, Palm Desert, CA 92260
January 27, 2014
On August 25, 2013, I returned to my residence to find my
street and driveway flooded. The flood waters had run over the curb and down my driveway and across
my side yard. When I entered my residence there was water throughout the residence.
As a result of the flood, I am seeking reimbursement for removal, replacement and installation of the
damaged flooring and underlayment, reimbursement of Edison electric utility expenses of 1021 KW of
electricity used to power multiple drying fans, DKI clean up expenses of the remediation contractor and
treatment of subterranean termites which resulted from the additional wall moisture associated with
drywall"wicking"of mo+sture.
On several occasions in the past, I had made the City aware of a persistent drainage issue at the
property. I had met on multiple occasions with the Public Works staff regarding the drain adjacent to my
driveway. I had also spoken to Mr. Ortega regarding this issue on multiple occasions.
f apoiogize for the delay in fiiing this claim. I initiaily fiied the claim with Mercury Insurance.The claim
was rejected.The insurance adjuster subsequently suggested that I file a cfaim with the City.
1 am requesting that the City of Palm Desert cover the following expenses which resulted as a direct
result to the flood. These include:
1. Immediate Clean up Expenses of DKI $2,389.20
2. Electricity for One Week of Multiple High Powered Drying Fans(24/7) $234,47
3. Replacement of Flooring Damaged by Flood $8,736.00
4. Treatment for Subterranean Termites 2 460.00
Total $13,819.76
I am available to discuss this matter by phone at 760-910-3289.
R g�rd�, �
� l., �
, �• .� � � � • '�l'-��
Alex Me rhoff
Apmeyerhoff@hot il.com
DANIEL�S Unniel's DKI Statement
�D� 73950 Dinah Shorc
Drive#302
Palm Desert,CA 92211- statement Uate
�83� 11/13/13
(760)320-2128
Account Of: Meyerhoff.Alex
Account No.
ralm Desert,CA' MEYERHOFF,ALEX
ite Invoice# Order Type Job# Policy Policy Holder Status Invoice Total Amount Due�
'03/13 SI-12390 Invoice 13-0825-WTR MEYERHOFF,ALEX 31 -60 2,389.20 2,389.20
,. .
F'/i�i;?U� r''...FP,Sf: PFY;'{:UPI='1", '!'
Activity after 11/13/13 will be reflected on your next statement.
Cunent Days Past Due� 1-30 31-60 61-90 Over 90 days Balance Due
0.00 0.00 2,389.20 0.00 0.00 2,369.20
To avoid additional finance charges,pay by 12/13N 3
Page 1
N���� . LilI��CI J ill\�
73950 Dinah S6ore Drive#302
Palm Desert,CA 92211-0830
(760)320-2128
Date: 09/03/13 [Invoice#: SI-12390��
Invoice
Care of: Bill To:
Meverhoff.Alex MEYERHOFF,ALEX
Palm Desert, CA . Palm Desert,CA
USA USA
Estimator Job# FilelCiaitin# Tertms
Wili Eads i3-0825-W71t Net 30
Descriptlon Total
Water Damage $2,389.20
WALK THROUGH
��
Q
5�
4 �
State Lic 5811�9 Subtotal $2,389.20
Thank you,we do appieclate yoarBWs�e�s
danie/sdkLco�n NO TAX $0.00
Totul: $2,389.Z0
Amouat Due:52,389.20
i
! �y� Daniel's DKI �
� 73950 Dinah Shore Dr.Ste 302
Palm Desert,CA.92211
(760)320-2128(760)324-1714
Client: Meverhoff Home:
Property:
Palm Desert,CA
Operator Info:
Operator: CMAGANA
Estimator: Daniel M.Eads Business: (760)320-2128 x 2
Position: Estimator E-mail: danielC�danielsdki.com
rompany: Daniel's DKI
Business: 73950 Dinah Shore Dr.Ste. 302
Yalm Desert,CA 92211
Reference: Business: (760)320-2128
Company: Daniel's DKI E-mail: Restorenow@danielsdki.com
Business: 73950 Dinah Shore Drive Ste.#302
Palm Desert,CA 9221 I
Type of Fstimate:
Date Entered: 9/5/2013 Date Assigned: 8/25/2013
Date Est.Comptetecl: 9/10/2013 Date Job Completed: 9/2/2013
Price List: CAVI7X AUG13
Labor Efficiency: Restoration/Service/Remodel
Fs[imate: 13-0825-WTR
Emergency 5ervices
��y�,y;; Daniel's DKI
�� 73950 Dinah Shore Dr.Ste 302
Palm Desen,CA.92211
(760)320-2128(760)324-1714
13-0825-WTR
Main Level
Geaeral Items
DESCRIPTION QNTY REMOVE REPLACE TOTAL
1. Emergency service cal!-after business 1.00 EA 0.00 251.72 251.72
hours
Emergency service call Sunday 08/25/2013
2. Equip.setup,take dawn&rnonitoring- 1.()0 HR t).��0 89.98 89.98
after hrs
Set up of drying equipment on initial day Sunday 08/25/2013
3. Equipment setup,take down,and 8.00 HR 0.00 59.93 479.44
monitoring(hourly chazge)
Daily Monitor:OS/26/13,08/27/13,08/29/13.Monitor/Remove Drying Equipment:09/02/13 - 4 Trips C� 1.5 Hours per trip(portal
�P Portal)
Totals: GeneralItems 821.14
��o-�. ��-�
�----•---��-����- .�. Living Room Height:8'
� � ~--T�
7 j �+.• 47933 SF Walls 356.46 3F Ceiling
t t �•- ! 835.80 SF Walls&Ceiling 356.46 SF Floor
° = � 39.b I SY Flooring 59.42 LF Floor Perimeter
1 ' ,r � 62.42 LF Ceil.Perimeter
��-m• -.-, r•
Missing Wali-Goes to Fioor 3'X 6'S" Opeas into HALLWAY
Missing i�Vali �'3"X o' ��r�intu K�'T'�HEN
Missing Wall 11'6"X 8' Opens into DINING_ROOM
DESCRIPTION QNTY REMOVE REPLACE TOTAL
4. Appty anti-microbial agent-after hours 356.46 SF 0.00 034 121.20
5. Air mover(per 24 hour period)-No 8.00 EA 0.00 27.00 216.00
monitoring
Totals: Living Room 337.20
13-0825-WTR 9/]0/2013 Page: 2
�� �y�,l,;� Daniel's DKI �
��' 73950 Dinah Shore Dr. Ste 3�2
Paim Deserc,CA.92211
(760)320-2128(760)324-1714
��- •,-, 4„- e•�-, Hal►way Heighh 8'
��rr r�sr-,-Qr T •
�,�..� . r�h b b 308.00 SF Wa11s 91.28 SF Ceiiing
°•-'r'� 399.28 SF Walls&Ceiling 91.28 SF Floor
t
10.14 SY Flooring 38.00 LF Floor Perimeter
�"` "` 41.00 I.F Ceil. Perimeter
Missing Wall 6' 11"X 8' Opens into HALL_CLOSET
Missing Wall-Goes to Fioor 3'X 6' S" Opens into LNING�._ROOM
Missing Wall 2'S"X 8' Up�ns into KITCHEN
DESCRIPTION QNTY REMOVE REPLACE TOTAL
6. Apply anti-microbial agent-after hours 9128 SF 0.00 034 31.04
7. Air mover(per 24 honr period)-No 4.00 EA 0.00 27.OQ 108.Q0
monitoring �
8. Dehumidifier(per 24 hour period)- 4.00 EA 0.00 83.00 332.00
Large-No monitoring
Totals: Hallway 47I.04
�
- -- �r,.,�, Bedroom 1 Height:S'
'�'�� `� 352.00 SF Walls 121.00 SF Ceiling
� � � ~ j 473.00 SF Walls&Ceiling 1 Z I.00 SF Floor
13.44 5Y Flooring 44.00 LF Fioor Pcrimeter
,,, � 44.00 LF Ceil.Perimeter
I N'4----i
s i �_ Subroom: CloBet 1(1) Height:8'
� � 196.00 SF Walls 22.50 SF Ceiling
� 218.50 SF Walls&Ceiling 22.50 SF Floor
I 2.50 SY Flooring 24.50 LF Floor Perimeter
24.50 LF Ceil.Perimeter
�xr�
DESCRIPTION QNTY REMOVE REPLACE TOTAL
9. Apply anti-microbial agent-after hours 143.50 SF 0.00 0,34 48.79
i0. Air mover(per 24 hour period)-No 4.00 EA 0.00 27.00 1 Q8.00
monitoring
t 3-0825-WTR 9/10/2013 Page: 3
o M I E ' D��CI�S DKI __,
73950 Dinah Shore Dr.Ste 302
Palm Desert,CA92211
(760)320-2128{760)324-1714
CONTINLTED-Bedroom 1
DESCRIPTION QNTY REMOVE REPLACE TOTAL
Totals: Bedroom 1 156.79
r4� ,a,m----� Bedroom 2 Height:8'
� nr-,ae^ T 377.33 SF Walls 135.83 SF Ceiling
� St3,1'] SF Wails&Ceiling 135.83 ST�Floor
h� !l�C3 b G
15.09 SY Flooritig 4?.17 LF Floor Perimeter
,3�r• 1 47.17 LF Ceil.Perimeter
h---t 4'1"
i r r{ Subroom: Closet 2(1) Height:S'
2� 196.OU SF Walls 22.50 SF Ceiling
�� 218.50 SF Walls&Ceiling 22.50 SF Floor
I 2.50 5Y Flooring 24.50 LF Floor Perimeter
1 24.50 LF Cei1.Perimeter
� -
DESCRIPTION QNTY REMOVE REPI.ACE TOTAL
I 1. Apply anti-microbial agent-after hours 158.33 SF O.pO 0.34 53.83
12. Air mover(per 24 hour period)-No 4.00 EA 0.00 27.00 108.00
monitoring
13. Dehumidifier(per 24 hour period)- 4.00 EA 0.00 83.00 332.U0
Large-No monitoring
'T„�:!s• Rc:dreom 2 4>'.��
Garage
DESCRIPTION QNTY REMOVE REPLACE TOTAL
14. Air mover(per 24 hovr period)-No 4.00 F,A �.00 27.00 108.00
rn�nitoring
T`otals: Garage 108.(}Q
.�_._
Total:Main Level 2,388.00
Line Item Totals: 13-OS25-WTR 2,388.00
l3-0825-WTR 9/i0/2013 Page�a
o N F � Daniel's DKI ___
73950 Dinah Shore Dr. Ste 30'l
Palm Desert,CA.9221]
(760)320-2128(760)324-1714
Grand Total Areas:
2,963.00 SF Walls 1,100.6i SF Ceiling 4,063.61 SP Walls and Ceiling
1,100.61 SF Floor 122.29 SY Flooring 369.37 LF Floor Perimeter
0.00 SF Long Wall 0.00 SF Short Wall 375.37 LF Ceil.Perimeter
1,100.61 Floor Area 1,190.4� Total Area 3,019.33 lnterior Wall Area
1,435.50 Exterior Wall Area 159.50 Exterior Perimeter of
Walls
0.00 Surface Area 0.0"� Number of Squares O.OU Tfltai P�rimer�r I_ength
0.00 Totai�idge Length O.OU Total Hip Length
i3-0825-W1'R 9/10/20.3 Pagc• `
� Daniel's DKI '
73950 Dinah Shore Dr, Ste 302
Palm Desert,CA.92211
(760)320-2128(760)3241714
Summary for Dwelling
T ine Item Total 2,388.00
Material Sales Tau @ 8.00(.�3'0 120
Replacement Cost Value $2,389.z0
Net Claim $2,389.20
Daniel M.Eads �
Estimator
13-0825-WTR 9/10/2013 Page: G
� o►M�� �� Daniel's DKI
� 73950 Dinah Shore Dr.Ste 302
Palm Desett,CA.92211
(760)320-2128(760}324-1714
Recap by Category
Items Total °Io
WATER EXTRACTION&REMEDIATION 2�388.00 99.95%
Subtotal 2,388.00 99.95%
Material Sales Tax @ S.OUO% 1.20 0.05%
1'at�t 2,389.20 100.00%
t 3-0825-WTR 9/IO/2013 Pa�e: "'
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Uanicl's Uki DANIEL'S
13950 Uinah Shorc Drivc,Suitc 302 .loh#:-_----� ---
Palm Descrt,Ca 9221 1
Te1: 760-320-212H Lic. 11581149 L)atc: • • �
CA MECHANIC'S LIEN LAW AND CSLB INFORMATION SHEET
The Statc of CaliFornia rcc�uires us to providc you with this informaUon in thc intcrest of your protection.
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Customer(s): � ' ' �% � � ^� � ____ Property Address: _ _
MECHAN[C'S LI�N WARNING
Anyone who hel}�s improve your property, but who is not p�id, may record what is called a mechanics lien on your property. A
mechAnics lien is a claim, like a mortgage or home equity loan, made against your property 1nd recorded with the county recorder.
Even iF you pay your contractor in tull, unpaid suhcontraccors, suppliers, �nd laborers who helped to improve your property may
record mechanics liens and sue you in court to foreclose the lien. If a court finds the lien is valid,you could be forced to pay twice or
have a court officer sell your home to pay the lien. Licns can also affect your credit. To preserve their right to record a lien, each
subconu�actor and material supplier must provide you with a document called a " Preliminary Notice." This notice is not a lien. Tlie
purpose of the notice is to let you know that the person who sends you the notice has the right to record a lien on your property if he or
she is not paid.
BE CAREFUL. The Preliminary Notice can be sent up to 20 days after the subcontractor starts work or the supplier provides material.
This can be a big problem if you pay your contractor before you have received the Preliminary Notices. You will not get Preliminary
Notices from your prime contractor or fi•om laborers who work on your projecl. The law assumes diat you already know they are
improving your property.
PROTECT YOURSELF FROM LIENS. You can protect yourself from liens by getting a list from your contractor of all the
subconVactors and material suppliers that work on your project. Find out from your contractor when these subcontractors started work
and when these suppliers delivered goods or materials.Then wait 20 days,paying attention to the Preliminary No[ices you receive.
PAY WITH JOINT CHECKS. One way to protect yourself is to pay with a joint check. When your contractor tells you it is time to
pay for the work of a subcontractor or supplier who has provided you with a Preliminary Notice,write a joint check payable to both
the contractor and the subcontractor or material supplier. For other ways to prevent liens,visit CSLB's Web site at www.eslb.ca.gov
or call CSLB at 800-321-CSLB(2752).
REMEMBER, IF YOU DO NOTHING, YOU RISK HAVING A LIEN PLACED ON YOUR HOME. This can mean that you may
have to pay twice,or face the forced sale of your home to pay what you owe.
INFORMATION ABOUT THE CONTRACTOR'S STATE LICENSE BOARD (CSLB)
CSLB is the state consumer protection agency t�at licenses and regulates const�-uction contractors.
Contact CSLB for information about the licensed contractor you are considering, including information
about disclosable complaints, disciplinary actions and civil judgments that are reported to CSLB. Use
only licensed contractors. If you file a complaint against a licensed contractor within the legal deadline
(asuaUy four years), CSLB has authority to investigate the complaint. If you use an unlicensed contractor,
CSLB may not be able to help you resolve your complaint. Your only remedy may be in civil court, and
you may be liable for damages arising out of any injuries to the unlicensed contractor or the unlicensed
contractor's employees.
For more information: Visit CSLB's Internet Web site at http://www.cslb.ca.gov, call CSLB at,800:321-
CSLB (2752) or write CSLB at P.O. Box 26000,Sacramento,CA 95826. -
I acknowledge receipt of a copy of this form on the date set forth above. Customer initials:
� t)anicl's [�KI DANIEL�S
73950 Dinah Shorc [)rivc. Suitc 302 Job 1�:---------------------
Palm Desert,CA 9221 I
'T'c1:7G0-320-212H [)atc: �
Licensc�! 581 149
TERMS AND CONDITIONS
Custo�ncr(c): �'f� '� _ _��;,�.� `., . . Property Address:
L. . , �
1. Release for 'Third Partv Professionals; lndemnitv: If the properly has sustained significant water damage, Customer
is advised to retain the services ol'independent environmental consultant lo inspect, and if appropriate, prepare remedial protocols.
Customer shall indemnify and hold Contractor harrnless for injury or damage arising fi•om or relatcd to: (a)Customer's failure to hire
environmental consultants or design professionals;or(b) the crro�:�or omissions oFany such third pacty professional.
2. Personal Liabilitv: Payment to Contractor is not conlingent upon Contractor's invoice being fully or plrtially approved
by Cus[omer's insurance company. All charges shall Ue invoiced directly to Customer. Contractor will submit a copy of the invoice
�0 CUSlO111C1''s insurance carrier(s) as a courtesy only. Cuscomcr has been inPormed of, and agrees: a) Custonier is personally
responsible for any �nd all deductible(s), depreciaticm, and charges not paid by insurance; and b) Invoices not paid by insurance arc
due within fifteen(15)clays of the invoice date.
3. Down Pavment and Schedale of Progress Pavments: The schedule of progress payments must
specifically describe each phase of work, including the type and amount of work or services scheduled to
be su lied in each hase, alon with the amount of each ro osed ro ress a ment.
Description of Phase Amount Uescription of Phase Amount
Pa able Pa able
� $
$ $
$ $
$ g
4. Pavment: Contractor will invoice Customer, describing the work performed and the charges. Payment is due fifteen
(15) days of the invoice date, unless the table of Progress Payments above is completed, in which case payment will be due as set
forth in the table. Contractor has the right, in Contractor's sole discretion, to suspend Work until past due invoices are paid. In
addition to the Finance Charges set forth below, Customer agrees to pay Administration Fees of one and on�half percent(1.5%) per
month on any unpaid balance after thirty(30)days of the invoice date,plus all actual collection costs,collection agency commissions,
actual attorneys' fees,expert fees,and court costs.
5. Finance Charees: Customer will pay interest at the rate of ten percent(L O%)per year on any unpaid balance after thirty
(30)days of the date of invoice(interest is separate from,and in addition to the Administration Fees set forth above).
6. Partial Lien Releases: Upon satisfactory payment being made for any portion of the work performed,Contractor shall,
prior to any further payment being made, furnish to Customer a full and unconditional release from any claim or mechanic's lien for
that portion of the work for which payment has been made.
7. Extra Work and Chaage Orders: Extra Work and Change Orders become part of the contract once the order is
prepared in writing and signed by the parties prior to commencement of work covered by the new Change Order. A Change Order is
not enforceable against the Customer unless it describes the scope of the extra work or change,the cost to be added or subtracted from
the contract, and the effect the order will have on the schedule of progress payments and completion date. However, by California
law,the contractor's failure to comply with these requirements does not prevent the contractor from the recovery of compensation for
the reasonable value of change order work in the absence of a written change order. Customer agrees to execute Change Orders to
increase the price to address conditions not reasonably anticipated by Contractor.
8. Limit of Liabilitv and Indemnitv: Contractor is not liable for claims arising from acts of Customer or Customer's
agents. Contractor's liability is limited to an amount equal to two times the Contract Price. All claims in excess of this amount are
waived. Customer shall pay for the defense and indemnify Contractor for all third party cfaims against Contractor that are not the
result of the sole negligence of Contractor. Contractor will select counsel of its choice and control the litigation. Commereial
General Liabilitv Insurance (CGL): Contractor carries commercial general liability insurance written by
Westchester Surptus Lines Insurance Company. Tel. 760-360-4700. You may call to check the contractor's
insurance coverage.
9.Workers Comaensation Insurance: Contractor carries workers' compensation insurance for all employees�
/�/IhITD A!"�Tl1D (hiTTi n�O. .(^t iCTfl�,fAD TAI7Tf AT C•
' ���,��i's l�ki DANIEL'S
7395U Uintih Shorc Drivc,Suilc 302 Job#:
Palm Dcscrt,CA 9221 1 ------�--
Tel: 760-320-2 I 2R I.iccnsc11581 149 Daie: s . /%'�!_' `'�_
WORK AUTHORIIATION - HOME IMPROVEMENT CONTRACT
CAncellation: The Notice of Cancellation referred to below may be sent to the add►•ess above.
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Customer(s): � ,%� �
Dute of Loss: � / � ' / " '
Property
Address: _ City/State/'Lip: r ( .� �.+ r %
Cuslomer hereby engages Daniel's DKf ("Contracior") to perform the work set forth below : to address da�nage caused by
❑Wind; ❑Fire/Smoke; G�WAter; ❑Mold; �Accident; ❑Other: whicl�occurred on tlie
date of loss statcd above ("tl�e F,veiit") or; ❑Remodei/Renovation;
1. Contract Documents: The lisl of documents actachcd and hereby incorpor�ted into the conteact is:
�Terms and Conditions; [] Estii��aie;�]Notice of Cancellation andj�]Other:
Customer acknowledges receipt of the following disclosures:�CA ivlechanic's Lien Law and CSLB Information Sheet;
❑ Mold Notice;Q EPA Renovale Right Lead Notice;and Other:
2. Scope of Work: A description of the project and description of the significunt materials to be used and equipment to be
installed is as follows: Customer hereby a��thorizes and directs Contractor to furnish all labpr,equipment and material to perfonn work
at the Property as generaliy described beiow(the"Work"),or i�l the attached Estimate dated:_/_/_:
�Emergency Services ❑ Reconstruction ❑ Restoration and Cleaning of Contents[] Packing and Storage of Contents
Remodel/Renovation and ❑Other
Affected areas: []�n�e Interior Structure�Living Room; ❑Dining Room; �.�`Hall �Kitchen; [] Family Room; �] Garage;
QMaster Bedroom; � Mastec Batliroom;�. Guest Bedroom ; []Guest Bathroom; Q,Bedroom 3; ❑Bathroom 3; []Laundry;
❑Other: i- i'. f ; 1 !, _
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Contract Price: Customer hereby agrees to pay Contractor the cost of the Work (the "Contract Price"):
'[]Insurance Replacement Cost Value or ❑At the price presently estimated at
Dollars ($ ).
The price sfated is an approximation made in good faith based on currently available information and an initial visual observation,and
is subject to change.Reasonable value will be based on Xactimate�pricing for the date of loss and zone of the property address.
3. Approximate Start Date: :_ / ," / . , ;Approximate CompleNon Date: ` / /
4. Substantial Commencement of Work Shall Consist of: Move on of personnel,equipment or material
5. Personal Liabilitv: Customer understands that Contractor is hired by Cnstomer and NOT Customer's insi�rance company.
Customer Initials:�
'�.
RESIDENTIAL CU$TOMERS: (1) YOU ARE ENTITLED TO A COMPLETELY FILLED-IN COPY OF THIS
AGREEMENT,SiGNED BY YOU AND TAE CONTRACTOR,BEFORE ANY WORK MAY BE STARTED; (2)YOU MAY
CANCEL THIS TRANSACTION AT ANY TIME PRIOR TO MIDNIGAT OF THE THIRD BUSINESS DAY AFTER THE
DATE OF THIS TRANSACTION,OR THE SEVENTH DAY IF A STATE OF EMERGENCY HAS BEEN DECLARED; (3)
THE LAW REQUIRES THE CONTRACTOR TO GNE YOU A NOTICE EXPLAINING YOUR RIGHT TO CANCEL.
YOU AAVE THE RIGHT TO REQUIRE THE CONTRACTOR TO HAVE A PERFORMANCE AND PAYMENT BOND.
6. NOTICE TO INSURANCE COMPANY—ASSIGNMENT OF CLAIM—DIRECTION TO PAY:
Cnstomer ere y trans ers an assigns to ontractor a ega rig t an bt e to t e procee s o a insurance policies which
cover the damage to the property that Contractor is to repair pursuant to this contract, Customer hereby authorizes and
instructs ali inserance carriers who ntay be liable to Customer for thls loss in whole or in part to pay directly to Contraetor the
amounts due or to become due in connection with the Work hereby authorize�'or, in the alternative, to include the ualne of
Contractor as an additionai payee on all drafts issaed fn payment of this loss. ' ' �
Customer Si�n�irfe:__� =; ' �
"Customer(s)"(I have read this contrac�and understand it) Contractor
� � � - � �--,,, '�y�, �i'�}�
. Signature. Iheck one: Cu�tqmer; Cysto er's Agent Signature
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Print Nam�and TitTe � Print Name,Title and Registration#
Notice of Cuncellation
Date of Transaction
You may cancel this transaction, without any penalty or obligation, within three business days from the
above date.
If you cancel, Any property traded in, any payments made by you under the contract or sale, and any
negotiable instrument executed by yau will be returned within 10 days following receipt by the seller of
your cancellation notice, and any security interest arising out of the transaction will be cancelled.
If you cancel, yau must make available to the seller at your residence, in substantially as good condition
as when received, any goods delivered to you under this contract or sale, or you may, if you wish, comply
with the instructions of the seller regarding the retui•n shipment of the goods at the selter's expense and
risk.
If you do make the goods available to the seller and the seller does not pick them up within 20 days of the
date of your notice of cancellation, you may retain or dispose of the goods without any further obligation.
If you fail to make the goods available to the seller, or if you agree to return the goods to the seller and
fail to do so, then you remain liable for performance of all obligations under the contract.
To cancel this transaction, mail or deliver a signed and dated copy of this cancellation notice, or any
other written notice, to: (Danie!'s DKI, 73950 Dinah Shore Dn Ste. 302, Palm Desert CA 92211) or email
ta: restorenow@danielsdki.com or send a fax to: (760) 324-0690:
not later than midnight of Date / /
I hereby cancel this transaction Date / /
Signature of Buyer
WAIVER OF RIGHT TO CANCEL
I, the Customer, hereby certify that this contract was initiated by me or my agent or insurance
representative. This contract is executed in connection with making emergency or immediately necessary
repairs that are necessary for the immediate protection of persons or real or personal property.
The following emergency situation exist requiring immediate remedy:
Flood ❑Fire ❑ Wind ❑Government Declared Natural Disaster with 7 days right to cancel.
Other
Pursuant to Section 1689.13 of the California Civil Code, I acknowledge and WANE THE RIGHT TO
CANCEL THIS AGREEMENT within three or seJ�en business days, whichever applies.
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Signature of Customer: . %� ' � �� � � • ' �`-'� Date: , • ' `;
�
I received two completed copies of this form on (date): / . /
—check one: ❑Customer; ❑AuthoriZed Agent �
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Signature Print Name
Address•
City: State: Zip: