CITY OF RIALTO CITY CLERK'S DATE STAMP
LIABILITY
CITY OF RIALTO
CLAIM FOR DAMAGES
TO PERSON OR PROPERTY 200% FEB-7 AMII: 25
RECALLED
1. Clalms for death, injury to person, or to personal property must be filled not later than six (6) months after the occumence (Gov. Code 59112). CLERK
2. Claims for damages to real property must be filled not later than one (1) year after the occumence (Gov. Code 59112). RETURN TO:
3. READ ENTIRE CLAIM FOR BEFORE FILING
Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mall: 150 S. Palm Ave., Rlaito, CA 92376 Address: 290 W. Rlalto Ave., Alalto, CA 92376
CLAIMANT INFORMATION:
The Devi Enterprise Trust -
FULL NAME DATE OF BIRTH
-
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO.
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE 3679 Hawkwood Road
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above): Diamond Bar, CA, 91765
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: January 25, 2024 TIME: 08:00 X AM • PM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (it appicable) locate on dlagram on reverse side of this sheet.
Where appropriate, give street names and addresses, measurements and landmarks.
On January 25, 2024, our tenants discovered a significant water leak on the above-mentioned property.
It was determined that the leak originated from the city's water main, specifically from the city's water main to the meter box.
This leak was caused by the encroachment of tree roots from a city-planted tree located on an easement along Riverside Avenue.
3. HOW DID DAMAGE OR INJURY OCCUR?
This leak was caused by the encroachment of tree roots from a city-planted tree located on an easement along Riverside Avenue.
4. WERE POLICE AT THE SCENE? • YES IX NO WERE PARAMEDICS AT THE SCENE? • YES I NO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CAUSED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known.
The encroachment of tree roots from a city-planted tree located on an easement along Riverside Avenue caused the water line's damage to the property's premises and subsequent increase in water bill, along with inconvenience.
6. GIVE TOTAL AMOUNT OF CLAIM Include estlmate of amount of any prospective injury or damage $_3,054.89 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repalr estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: Plumber's Invoice for Assessment and Repairs Amount: $ 1.000.00 Item/Date: Water Bill for Billing Period and Tenant Inconvenience Amount: $_2.054.89 TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $- ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Amount: $.
Item/Date: Amount: $_
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have Information (attach additional pages, If necessary) NAME: Alejandra Martinez (Tenant) NAME: Naisel Martinez (Tenant) ADDRESS: 2930 North Riverside Avenue ADDRESS: 2930 North Riverside Avenue TELEPHONE: ( 909) 913 - 9660 TELEPHONE: (909 ) 913-9860
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: L TELEPHONE: | 1
DATE: TIME: •AM • PM DATE: TIME: •AM PM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following dlagram, the names of streets, Including NORTH, EAST, SOUTH AND WEST directions. Indicate place of accident by "X" and by showing house numbers or distances to street corners.
If a city/town vehlcle was Involved, designate by letter "A" location of the City/Town vehicle when you tiest saw it, and by "B" location of yourself or your vehicle when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and locatlon of yourself or your vehtcle at the time of the accident by "B-1" and the point of impact by "X".
→ NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT.
CURB
PARKWAY
/ SIDEWALK
I HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS TO THOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRUE.
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
Pawan Anand
SIGNATURE OF CLAIMANT OR AGENT
The Devi Enterprise Trust (C/O Pawan Anand) January 26, 2024
TYPE OR PRINT NAME DATE
RELATIONSHIP TO CLAIMANT
NOTE: PRESENTATION OF A FALSE CLAIM IS A FELONY (CA PENAL CODE 72) RETURN CLAIM TO: RIALTO CITY CLERK'S OFFICE - 150 S. PALM AVE., RIALTO, CA 92376 The Devi Enterprise Trust
951-515-2090 3679 Hawkwood Road, Diamond Bar, CA, 91765 January 26, 2024
Rialto City Clerk's Office
150 South Palm Avenue
Rialto, CA, 92376
Subject: Reimbursement/Claim - Water Main Leak Repair Expenses at 2930 North Riverside Avenue, Rialto, CA, 92376
To Whom It May Concern:
I am writing to formally request reimbursement for the repair expenses and water bill charges I incurred due to a water main leak originating from the city's water line on the property located at 2930 North Riverside Avenue, Rialto, CA, 92376.
Details of the Incident:
On January 25, 2024, our tenants discovered a significant water leak on the above-mentioned property. Upon further investigation, it was determined that the leak originated from the city's water main, specifically from the city's water main to the meter box. This leak was caused by the encroachment of tree roots from a city-planted tree located on an easement along Riverside Avenue.
This root cause was noted on the plumber's invoice (Appendix "B").
Actions Taken:
To mitigate the damage and prevent further water loss and property damage, I promptly contacted a licensed plumber, Steve's 5-Star Service, who performed the necessary repairs on January 25, 2024.
The repairs included a thorough repair assessment, necessary digging to reach the failure, and repairs of all piping and peripherals. I have attached a copy of the plumber's invoice for your reference, which details the cost of the repairs, totaling $1,000.00.
Photographs of the damage inflicted and repair efforts are detailed in Appendix "A." Financial Impact:
In addition to the repair costs, the leak resulted in a significant increase in our tenants' water bill for the billing period of December 14, 2023 to January 23, 2024. The total water bill charges associated with the leak amount to $1,304.89. 1 have attached a copy of the water bill as supporting documentation. 1 of 5
Claim for Reimbursement:
The City of Rialto is responsible for the water main leak, the resulting damage, and expenses due to the leak being caused by the encroachment of tree roots from a city-planted tree.
Therefore, please remit full reimbursement for the following expenses incurred:
Repair costs: $1,000.00 (invoice attached)
Water bill charges: $1,304.89 (water bill copy attached) Tenant inconvenience: $750.00
Total: $3,054.89
Additional Actions (Required by City):
In addition to the reimbursement to the claim described above, we are requesting the City of Rialto to remove the tree from the property's premises to avoid future water leaks and substantive inconvenience to the property's residents.
Supporting Documentation:
I have attached the following documents to support the claim:
• Photographic evidence of the leak and repair work (Appendix "A") • Plumber's invoice (Appendix "B")
• Copy of water bill (Appendix "C")
Please feel free to contact me at 951-515-2090 if you require any further information. Thank you for your prompt attention to this matter.
Sincerely,
Pawan K. Anand
The Devi Enterprise Trust
3679 Hawkwood Road, Diamond Bar, CA, 91765
Tel: 951-515-2090
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Appendix A - Photographs of Repair and Damage
Plumber Repair - Water Box City Planted Tree Proximity to Water Line Detail of Leak Failure and Tree Repairs to Impacted Leak Area Roots
3 of 5
Appendix B - Plumber's Invoice
INVOICE #2413
STEVE'S SERVICE DATE Jan 25, 2024
DUE Upon completion
E STAR SERVICE
COOLING BEATING PLUMBING of work
I AMOUNT DUE $0.00
Steve's 5 Star Service
Devi Trust CONTACT US
665 N Central Ave
Upland, CA 91786
(951) 515-2090 (909) 985-5254
ec [email protected]
Service completed by: James Kessler
INVOICE
Plumbers report 1.0 $0.00 $0.00
esponded to leak on the Watermain. Upon arrival found meter box to be full of water and water pouring down th treet. Meter is turning very fast. Electrical and tiber optics from the city has already been on site and marked fo ilities. Existing main water service is installed in PVC pipe. Very large tree growing a couple feet away from t ater meter, which will make digging much more difficult. Will provide options for replacement and spot repa - after performing spot repair, found that the cause of the brake on the Watermain was the tree roots from the city tree next to the water meter.
Digging For Water Line To Diagnosis Problem 1.0 $360.50 $360.50 Digging for water line to diagnosis problem
Spot repair 1.O $1,129.00 $1,129.00
Once excavation is complete and leak is exposed, will cut out compromise section of domestic waterline. (Up to 2 feet)
- necessary pipe and fittings to make repair.
- Turn the water back on and test for leaks.
6 month warranty
Subtotal $1,489.50
Discount - $489.50
Total $1,000.00
Steve's 5 Star Service | 960861 http://www.stevesair.com 1 of 2 4 of 5
Appendix "C" - Water Bill - West Valley Water District
WEST VALLEY WATER DISTRICT • OFFICE HOURS
Mon - Wed - Thu • Fn 8:00 am - 5:30 pm.
855 West Base Lihe Road Tai Tue
9:00 am - 5:30 pm
wwwd.org
Customer Service/After Hours (909) 875-1804 • [email protected]
ACCOUNT INFORMATION
ALEJANDRA & NASIEL MARTINEZ CUSTOMER NAME: ALEJANDRA & NASIEL MARTINEZ SERVICE ADDRESS:
CITY: RIALTO
ACCOUNT NUMBER:
BILLING INFORMATION YOUR ACCOUNT SUMMARY
SERVICE PERIOD: 12/14/23 10 01/23/24 PREVIOUS BALANCE 91.70 BILL DATE: 01/30/24 PAYMENTS 91.70
CURRENT BILL DUE DATE 02/20/24 LATE FEE/ADJUSTMENTS 0.00 PRIOR BALANCE - 0.00
CONSUMPTION HISTORY CURRENT ACCOUNT DETAIL
CURRENT CHARGES UNITS RATE TOTAL
Last Year This Year MONTHLY SERVICE CHG 22.21
500 TIER 1 CONSUMPTION 10 $2.13 21.30
400 TIER 2 CONSUMPTION 40 $2.30 92.00
TIER 3 CONSUMPTION 424 $2.53 1,072.72
300
RIALTO TAX 820-2546 96.66
200
TOTAL CURRENT CHARGES 1,304.89
--
Mar May Sep Nav Jan
1 Unit = 748 Gallons
SPECIAL MESSAGE FROM WWD
delinquent bill processing in accordance
with Senate Bill 998 (Discontinuation of Residential Water Service). Ratepayers must pay cutstanding balances to avoid possible disconnections. WWD understands that some
atepayers may be experiencing hardships and our goal is to Piease contact the Customer Service Team al
(909) 875-1804 to assist you in managing your bill and
avolding disruption of service
TOTAL BALANCE DUE 1,304.89
SERVICE PERIOD METER NUMBER SERVICE TYPE PREVIOUS READ CURRENT READ UNITS USED GALLONS USED 12/14/23 to 01/23/24 14139593 WA 2892 3366 474 354,577
PLEASE RETURN THIS PORTION WITH YOUR PAYMENT AND MAKE YOUR CHECK PAYABLE TO WEST VALLEY WATER DISTRICT PAYMENT COUPON FOR 2930 N RIVERSIDE
Wear Dariet ACCOUNT NUMBER:
PRIOR BALANCE: DUE IMMEDIATELY 0.00
https://www.municipalonlinspayments.com/westvalleywdca CURRENT CHARGES DUE BY: 02/20124 1,304.89 TOTAL AMOUNT DUE: 1,304.89
AMOUNT PAID: s.
WEST VALLEY WATER DISTRICT
P.O. BOX 102060
PASADENA, CA 91189-2060
102060091616203000304894
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