CLAIM FOR DAMAGES
TO PERSON OR PROPERTY
INSTRUCTIONS
1. Clairns tor dealh, injury b pe.son or to peBonal property must be fled not later lhan six (6) months afrer the occuEence. (Gov. Code S€c- 9112)
2. Cl8ims for damages lo realproperty m(rst befiled nd laterlhan one (1) year af,er the occunence. (Gov. Code Sec.gr 1.2)
3. Read entire claim before fitrng. 4 See page 2 for diagram upon which to locate place of accident
5. This claim form must be signed on page 2 at bofiom. 6 Attach segaratB she*, lf nece&sary, to give tdl details. slGN EACH SHEET
7. Claim musl be filed wilh City Clerk. (Gov.Code Sec. 915a)
RESERVE FOR FILING STAMP
CLAIM No.
iuN 27 ?02{
ITY CLERK DIPARTMENT
TO: CITY OF VERNON CITY GOUNCIL
Name of lairnant n fa pe
Sareen LLC
Bqsiness Address ot CbirrEnt v62 Iillson Street, Los Angeles, 90040 Arsiness Tdephoae Nurber
323-286-5382
and
Give address to whach you desire notbes or communicaliofls to be sent regarding this daim:
2262 E 37th Street, Vernon, CA 90058
a
How did DAMAGE or INJURY occur? Give full particulars.
Sareen LLC purchased the building 2024 and discovered that the lateral pipe was damaged. After communicating with the City of Vernon, they found out that the Gas Department is responsible for the damage.
Wlen did OAMAGE or ll{JURY occuf Give full particulars, date, time of day, etc.:
According to the Gas Department of the City of Vernon, the lateral pipe was damaged when they installed the gas piDe sometime around 1998.
tMere did DAMAGE oTINJURY occur? Oescribefully, and localeon diagram on reverse side ofthissheet, where appmximate, give street names and address and measurements from landmarks:
The damage was located at the road of 2262 E 37th Street, at the joint ofthe lateral pipe about 5 feet below ground level, right at the drop to the main sewer pipe.
What particula.AcTorOMlSSlON doyou claim causedthe injury ordamage? Givenamesof Cityemployees, if any, causingthe iniury or damag€, if kno n:
According to the Gas Department ofthe City ofVernon, the lateral pipe was damaged when they installed the gas pipe sometime around 1998.
mat oAMAGE or INJURIES do you claim resulted? Gi\re full extent of iniuries or damages claimed.
The lateral pipe was broken near thejunction ofthe main sewer pipe, resulting in possible contamination ofthe soil, soil loss, or the creation of a sinkhole.
WhatAMOUNTdo youdaimof each item of injury ordamagE asof date of presentation of thbclaim, giving baisof compulelion :
$34,000.00
ECEIVED
G
basisof computation:
$34,000.00
Were you insured al the time of the incident? lf so, provide narne of insurance company, policy numbers and amount of insurance payments received
Expenditures made on account of accident or lnjury: (Date - ltem) (Amount) Name and address of Witnesses, Doctors and Hospitals
REAOCAREFULLY
For all accident claims place on following diagram names of streets, including Norlh, East. South, and West: indicate place of accident by'X" and by showing house numbers or disiances to street comers. lf City Vehicle was lnvolved, designate by letter'A" location of City vehicle when you first saw it,and by "B" location ofyourself oryour vehicle when you frst saw Cily vehicle; location of City vehicle at time of accident by'A-1"and location of yourself or your vehicle at the time of accident by "8 1" and he point of lmpact by "X." NOTE:lf diagrams do not fit the situatioo, attach herelo a proper diagram signed by claimant.
FOR AUTOMOBILE ACCIDENTS
FOR OTHER ACCIDENTS
SIDEWALK
cuno
I declare, under nal of u , that the
CUIBl
includin a attachments is true and correct.
Typed/Printed Name: Date:
1c .t (^" L
e /zt/ztr
YBER UESTED TO SE EXAMINEOAS TO THEIR CLAIM UNDER OATH, PRESE}TATION OFA FALSE CLAIM IS A FELONY (CAL.
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Signature of Claimant or person filing on his/her behaf, giving relatonshiprto Claimant;
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PEN. CODE SEC, 72), CLAIMS MUST 8E FILEDWTH CITY CLERK (GOVCODE SEC 915A) STATE LAW PROVIDES THAT IF YOU ARE NOT T.IOTIFIED OF ANY ACTION BY THE CITY OF THIS CLAIM WTTHIN 45 DAYS OF FILING THEN THE CLAIM IS DEEMED DENIEO (SEE GOV CODE SEC 911 6 & 912,4) __l
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High Speed Rooter & Plumbin8
3831Arden Drive, El Monte, California 91731 United States (2t3) 949-4202
BILL TO
Kit Kwok
2262 East 37th Street
Vernon, CA 90058 UsA
JOB ADDR ESS
Kit Kwok
2262 East 37th Street
Vernon. CA 90058 USA
Home lmprovement Contract
License #1017796
completed Date:
Te€hnlcian: Santiago
Payment ierm: Due Upon Receipt
DESCRIPTION OF IHE PROJECT & DESCRIPTION OF THE SIGNIFICANT MATERIALS TO BE USED & EQUIPMENT TO BE INSTALI.ED
Upon arrival, technician encountered a main sewer line lateralthat has been impacted by a city gas line. Technician recommends opening up street area as a means to redirect sewer line below existinS gas line, based on the close proximity i.u aiiy iirjin s€wEr iiriE ieaiiiii..ii re.uriirrrrrerids upEriiriB uu SireEl drEd irorii .iiy i"iaiii io ciiy cur b. iecirtriciarr wiii puii perm'rts to begin work immediately once approvd by property owner.
Progress payments are as scheduled
1. $100O.0O down payment due upon signing contract
2. $33OO0.OO no more than 8 weeks after completion ofjob Cost to open up street area, utilizing machinery.
Technician will contast dig alert to mark street are for all existing utilitys.
Technician will pull all necessary permits.
Technician will sawcut existing asphalt.
Technician wiiiexcavate by hand around exising 6" gas iine.
Technician Will open area accordingto local city standards.
Technician will b€ responsible for removing alldebris.
Technician will be responsible for setting traffic grade plates in place untiljob passes final inspection.
ITWOICE DATE
Feb 21.2024
tNvotcE
17829473
lnvoice #17829473 Page 1 of 5
Technician will have to regrade drainline to go underneath existing gas line. Technican will also have to reconnect properly to existing city main.
Technician will back fill area according to local city inspectors request and local city standards Technician will be responsible for traffic control.
Technkian will also be respoosible to adhere to all local city ordinarrces in coniunction with the above mentioned scope of work
HSR will not be responsible for cost of permits.
Any change orders necessary will first be discuss€d with property owner and local city inspectors.
Progress payments are as scheduled:
1. 3100O.m down payment due upon signinB contract
2. l33mo.m no more than 8 weeks after comphtion of job.
TA5K DESCR IPT IO N OF MATE R IAI.S A N D
EQUIPM ENTS QTY PRICE TOTAI
CPR1.m,0000
Lateral repair underneath public street
TYPE
1.m $34,000.00 134,000.m
PAID ON MEMO AMOUNT
4/26/2024 Online Payments $ 1.000.00
POIENTIAI. SAVINGS
SU&TOTAL
TAX
$0.00
s34,000.00
$0.m
CONIRACI PRICE
PAYMENT
$34,000.00
31,000.00
BATANCE DUE t33,000.00
Thank you for choosing High Speed Rooter & Plumbing
CONTRACT P R ICE: $34,m0.m
A PPROXIMATE SfARr DAfEt2/27/2o24
APPROXI MArE COM P LETE D Af Et2/21/2o24
PERMITS, FEES, AND INSPECfIONS Unless otherwise agreed to in writing, CUSTOMER shall secure and pay for all permits, fees, and inspections necessaryfor prosecution of the work described herein. lacknowledge that it is my responsibility for securing and paying allpermG, fees, and inspection.
HIGH SPEED ROOTER & PLUMBING is not responsibl€ for any breakage of walls, floor, concrete, landscaping or any other items removed in conjunction with any work done or diagnosint attempted. we are also not responsible for any water damage that occurs while working on the plumbing system or any damage occurring from drains lines backing up after being cleared. we are also not responsible for pre-€xisting conditions in the plumbing system that can not tolerate attempted repairs made to same.
AUTHORIZATION TO PROCEED W]TH ABOVE SOTUTION
lnvoice #17829473 Page 2 of 5
I, the undersigned, am owner/authorized representative/tenant of the premises at which the work mentioned above is to be done. I hereby authorize you to perform Solution, and to use ruch labor and materials as you deem advisable. A month\ service charge of 1 1/2% will be added after 10 days. I agree to pay reasonable attorney's fees and court costs in the event of legal action. lf my check does not clear, I realize that I could be liable fo. 3 times the amount of the check, in no case more than S500 and in no case less than t10O a5 set forth in California civil code Section 1719, plus the face value of the check and court costs. I have read this contract, imluding the terms and conditions on the reverse side hereof and agree to the bound by all terms contained herein. I have received a copy of this contract and Notice to Owner. All parts will be removed from premises and discarded unless otherwise specified herein.
DOWNPAYMENT
THE DOWN PAYMENT MAY NOT EXCEED $1,(x)0 OR 10 PERCENT OF THE CONTRACT PRICE, WHICHEVER IS TESS.
IHE SCHEDULE OF PROGRESS PAYMENTS MUST SPECIFICALLY DESCRIBE EACH PHASE OF WORK, INCLUDING THE WPE AND AMOUNT OF WORK OR SERVICES SCHEDUTED TO BE SUPPTIED IN EACH PHASE. ALONG WTH IHE AMOUNI OF EACH PROPOSED PROGRESS PAYMENT. IT IS AGAINST THE LAW FOR A CONTRACTOR TO COLLECT PAYMENT FOR WORI( NOT YET COMPLETED. OR FOR MATERIALS NOT YET DELIVERED. HOWEVER. A CONTRACTOR MAY REQUIRE A DOWN PAYMENT.
YOU, THE HOMEOWNER (BUYER} OR TENANT HAVE THE RIGHT TO REQUIRE THE CONTRACIOR TO
FURNISH YOU WITH A PERFORMANCE AND PAYMENT BOND, HOWEVER THE CONTRACTOR CAN REQUIRE YOU TO PAY FOR THAT BOND.
INFORMATION ABOUT THE CONIRACTORS STAIT IICENSE BOARD (CST8) CSLB is the state consumer protection agency that licenses and regulates construction contractors. Contact CSLB for information about the licens€d contractor you are considering, including intormation about disclosable complaints, disciplinary actions and civiljudtments that are reported to CS|B. Use only licensed contractors. lf you file a complaint against a licensed contractor within the leSaldeadline (usuallyfour years), CSLB has authority to invedi&te the complaint. ll you use an unlicensed contractor, CSLB may not b€ able to help you resolve your complaint. Your onv remedy may be in civil court, and you may be liable for damates arising out of any injuries to the unlicensed contractor or the unlicensed contractor's employees.
For more informatlon:
vlslT csLB's website at www.cslb.ca.gov
CALL csLs at 1-80G32L<5LB 127521
WRITE CSLB at p.O. Box 26000. Sacramento, cA 95826
NOTE: ABOUT CHANGE ORDERS
You, the buyer, may not require a contractor to perform extra or chan8e-order wo* without providing written authorization prior to the commencement of any work covered by the new charge order. Extra work or a change order is not enforceable aSainst a buyer unless the change order also identifies allofthe following in writing prior the commencement of anywork covered by the new change order:
(i) The scope of work encompassed by the order.
(ii) The amount to be added or subtracted from the contract. liii) The effect the order will make in the progress payments or the comdetion dateThe contractor'5 failure to comply with the requirements of this paragraph does not preclude the recovery of compensation forwork performed based upon legalor equitable remedies designed to prevent unjust enrichment..
MECHANICS' LIEN WARNING
MECHANICS LIEN WARNING: Anyone who helps improve your property but who is not paid may record what is called a Mechanics' Lien on your property. A Mechanics' Lien is a claim, like a mortgate or home equity loan, made againd your property and recorded with the County Recorder.
Even ifyou pay your contractor in full, unpaid subcontractors, supdiers, and laborers who helped to improve your propertt may record Mechanics'Liens and sue you in court to foreclose the lien. lf a court finds the lien is vatid, you could be torced to pay twice or have a court officer sell your home to pay the lien. Liens can also affect your credit. To preserve their riSht lnvoice #17829473 Page 3 of 5
to record a lien, each subcontractor and material supplier must provide you with a document called a "2Hay Preliminary Notice." This notice is not a lien. The purpose ofthe notice is to let you know 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 P.eliminary Notices. You will not get Preliminary Notices from your prime contractor or laborers who work on your proiect. The law assumes thatyou 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 subcontractors and material suppliers that worl on your project. Find out from your contractorwhen these subcontractors started work and when these suppliers delivered goods or materials- Then wait 20 days, paying attention to the Preliminary Notkes you receive.
PAY wlTH JOINT CHECKS. One way to protect yourself is to pay with a jointcheck. when your contractor tells you 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 otherways to prevent liens'visit CSLB'S Web site at www.csib.ca.gov or call CSLB at 80G321-CSLB {2752).
REMEMBER, lF YOU DO NOTHING YOU R|SK HAVING A tlEN PI,ACED ON YOUR HOME. This can mean you may have to pay twice or face the forced sale of your home to pay what you owe.
You are entitled to a completely filled in copy of this agreement, signed by both you and the contractor, before any work may be started.
CUSIOMER AUTHORIZATION
Thlr invoice ls agreed and acknowled8ed. Payment ir due upon recelpt. A servlce fee wlll be charted for any retumed checks, and a financinS charge of 1% per month shall be applled for overdue amounts.
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THIS lS AN ESTIMAIE, NOT A CONTRACT FOR SERV|CES. Th€ summary above is furnlshed by HlSh Speed Roote. & Plumbing a5 a good faith esumate of work to be performed at the location descriH above and ls based on our evaluation and does not include material price increases or addhlonal labor and materials whlch may be requlred should unforese€n problems arise after the t/york has started. I understand that the fiml cost of the work may differ from the estlmate, perhaps materially.IHIS ls t{oT A GUARAMrEE OF THE FINAL PRrcE oF WoRK TO BE PERFORMED. I agree and authorize the work as summarizcd on thes€ estlmated terms, and I agree to pay the fullamount lor allworl performed.
Acknowiedgement
I find and agree that all work performed by Hitt Speed Rooter & Plumbing has been completed in a satisfactory and workmanlike manner. I have been dven the opportunity to addresr concerns and/or discrepancics in the work provided, and I either have no such concems or have found no discrepancies or they have been addressed to my satisfaction. My signature here signines my tull and final acceptance of all wor* performed by the contractor.
THREE DAY RIGHI TO CANCET NONCE.
You have the right to cancelthe contract withing three days after signint. kit kwok
Sign here
Date 4/26/2024
lnvoice #17829473 Page 4 of 5
THREE DAY RI6HT TO CANCET
kit kwok
Sign here
Date 4/26/2024
The "Notice of Cancellation" may be sent to:
High Speed Rooter & Plumbin8
3831Arden Drive, El Monte, California 91731 United States .273],949-4202
lnvoice #17829473 Page 5 of 5
TERMS AND CONDITIONS
1. DEFINITIONS
A. The term 'CONTRACTOR" herein refers to High-Speed Rooter & Plumbing and its associates.
B. The term "CUSTOTUER' herein refers to the person/agent to whom the CONTRACTOR is rendering its service.
2. SrTE CONDTTTONS
A. lf CONTRACTOR rnust obtain access tr) other properties in the course of work, CUSTOMER shall secure permission for such and hold harmless and indemnify CONTRACTOR and its employees and agents against all actions and consequences aris ng or relating to the use of said properties, including but not limited to damage done in normal course of work, exc;luding negligence, aLnd for securing said property and its contents during and after work.
B. CUSTOMER shall riecure, remove and protect all properties and its contents, including but not limited to adults, children, animals, cabinets, fixtures, flooring, walls, tiling, carpets, drapes, furniture, and vegetation cluring and upon completion of work, and shall hold harmless and indemnify TSONTRACTOR, its employees and agents against all claims arising out c,f CUSTOMERS failure to do so.
3. LIMITED WARRANTY
A. CONTRACTOR wurrrants its materials and workmanship to be free from defects for one year after performance unless otherwise specified in writing. This warranty does not cover faults caused by misuse; negligence; or damage caused by acts of God, including but not limited to earthquakes. ln the event that the manufacturer offers a warranty, said warranty shall negate and supersede CONTRACTORS warranty. This warranty is the only warranty by CONTRACTOR to CUSTOMER and is the lieu of all other warranties, expressed or implied.
B. CUSTOMER shall telephone CONTRACTOR within twenty-four (24) hours of the discovery of any warranty claim.
CONTRACTOR will respond with reasonable promptness between the hours of 8:30 a.m. to 4:30 p.m. Monday through Friday, excluding holidays.
C. CONTRACTOR shall not be liable for electrical or other damages relating to drywall, stucco, roof, carpet, tile, floor, windows, fixtures, plumbing, furniture, and personal property from any defect or delay in responding to said warranty.
D. CONTRACTOR shall not be liable for lost profits, incidental, special, exemplary, indirect, or consequential damages resulting from any work performed or any problem, whether or not covered by this limited warranty. 4, UNFORESEEN CONDITIONS
A. lf conditions and/or circumstances are encountered at the job site which are concealed physical conditions, or unknown physical conditions of an unusual nature, which differ materially from that which is visually ascertained, CUSTOMER agrees to accept responsibility for such conditions and those circumstances outside the control of CONTRACTOR and further agrees to pay for any labor or materials, including repair to damaged equipment of CONTRACTOR caused by such conditions and/or circumstirnces.
B. lt is the intent of this provision to make ,GUSTOMER responsible for all (1 ) unforL.seen and concealed conditions and (2) for that which CONTRACTOR cannot control. Accordingly, CUSTOMER further agrees to hold C{)NTRACTOR harmless and shall indemnify and defend CONTRACTOR and all its agents and employees from and against all claims, damages, losses, and expenses, including but not limited to attomey fees, consequential damages, arising out or as a result from the performance of CONTRACTOR work involving, affecting, or relaling to such unforeseen or concealed conditions regardless of whether such damages are caused in part by CONTRACTOR.
C. Asbestos or other tlazardous Materials Remediation Work - CONTRACTOR has no information whatsoever with respect to asbestosi or other hazardous materials or substances in any portion of the CUSTOMERS property and has not conducted any investigation in connection herewith, CONTRACTOR does not perform asbestos or other hazardous materials or substance removal and CONTRACTOR shall have no responsibility whatsoever and CUSTOMER expressly releases CONTRACTOR from any liability whatsc'ever and for any claims arising out of its presence, release, remediation or removal and for any costs, losses or damages CUSTOMER may suffer or sustain if it is found to exist on the CUSTOMERS property or if, in order to obtain a buikling permit for the work to be performed by CONTRACTOR as set forth herein, any remediation action or work obtain an investigation is required to be performe,l on the CUSTOMER hs, at CUSTOMER sole expense, caused said asbestos or hazardous materials or substances to be removed in compliance with all applicable laws relating ther'3to.
D. Mold or lvlold Spores - CONTRACTOR recommends that you hire a professional water restoration company to clean and treat an area that has water damage or as a result of wcrk performed. CONTRACTOR is not responsible for any damages or ill health caused by mold. CUSTOMER agrees to waive all claims against CONTRACTOR that may be related to such work.
E. lf, for any reason, a maintenance visit is not performed either because of the contractor or because of the maintenance agreement customer, the monetary value does not exceed the cost of the maintonance agreement.
5. SOI-UTIONS NOT PERFORMED
lf suggested options are not chosen by the CUSTOMER, and a failure is experienced, the CONTRACTOR is held harmless.
6. STOPPAGES
A. CONTRACTOR will not clean any drain line or sewer lines through a roof vent if deemed unsafe.
B. Any drain cleaning cable which becomes stuck in the sewer lines is the responsibility of the CUSTOMER for removal and/or additional repairs.
C. lf a sewage spill is deemed hazardous material, the cost of cleanup is the responsibility of the CUSTOMER.
7. LtCENSE, PERMITS, AND FEES
A. CUSTOMER shall furnish and pay for at their own expense, all taxes, permits, and license fees required to legally perform the repair rvork in accordance lvith this Agreement.
B. Access to the property for an agent of administrative authority must be provided within a reasonable time. Should reasonable access not be provided, it may result.in additional charges to the CUSTOMER.
C. lf at any time the administrative asks for additional work not related to our originrrl contract, the work is the responsibility of the CUSTOMER. CONTRACTOR will provide an additional COIITRACT PRICE for that work.
D. All notices related to work performed by the CONTRACTOR which are sent to the property owner mrJst be forwarded to the CONTRACTOR, and a reasonable amount of time allowed for the process.
8. PAYMENT
A. All work done on a fixed CONTRACT PRICE. The price includes MATERIALS, Tax, and Labor. NO BREAKDOWN WILL BE PROVIDED.
B. Payment for the work described herein this Agreemenl shall be immediately due upon completion of work unless othenrise specified in writing.
C. No deduction shall be made from payments due CONTRACTOR or account of penalty, liquidated damages, back charges for alleged defective work, or other sums withheld rrom payments to other CONTRACTORS, or on account of the cost of charges or defects in work. Furthermore, CUSTOMER agrees and recognizes that payment for services rendered by CONTRACTOR when due is an express condition precedent to CONTRACTOR continuing work as herein described in the Agreement. CUSTOMER recognizes that the failure to pay for services when due shall entitle CONTRACTOR to terminate work immediately. ln the event that CONTRACTOR terminates work for non-payment as herein described, C;ONTRACTOR shall be entitled to all of itts reasonable expenses, including but not limited to the cost of labor, matetials, a reasonable allowance for overhead and profit, and other compensation as allowed by law. All warranties will be void.
9. RIGHT TO TERMINATEI IN EVENT OF DISPUTE
ln the event of a dispute betvveen CONTRACTOR and CUSTOMER, CONTRACITOR and CUSTOMER agree that the CONTRACTOR immediately terminate the work described herein. ln the event of such termination, OONTRACTOR shall be entitled to payment for all services rendered, including costs of all labor, materials, reasonable proflt, and overhead. ln the event of cancellation by CUSTOMER after a contract has been signed, CONTRACTOR is entitled to a minimum fee of 101/o or $1000, whichever is less. ln the event of cancellation by CUSTOMER after work has commenced, CON'rRACTOR is entitled to 10% of payment for work performed, whichever is more.
IO. NOTIGE OF DEFECTIVE WORK
Upon completion of the work, CUSTOMER agrees to exercise due to diligence in inspecting the work for defective workmanship and rnaterials. CUSTOMER agrees to notify CONTRACTOR within forty-eight (48) hours of completion of work described hereunder of all defective work if any, CUSTOMER agrees that upon discovery of any allegedly defective work, CUSTOMER shall immediately call CONTRACTOR, who shall have the first opportunity to repair the allegedly warranties, express and implied hereunder. CUSTOMER agrees and recognizes that they shall not withhold any payments for allegedly defective work. CONTRACTOR is not responsible for reimbursemenl for work performed by any other company or individual.
12. SCOPE OF AGREEMENT
This Agreement represents the entire and integrated agreernent between CUSTOMER and CONTRACTOR and supersedes all prior negotiations, representations, or agreements, either oral or written, this agreement may be amended or only by written instrument offered by CONTRACTOR and accepted by CUSTOMER.
13. NOTTCE
Contractors are required by law to be licensed and regulated by the Contractors' State License Board, which has jurisdiction to investigate complaints against contractors if a complaint regarding a patent act of omission is filed within four years of the date of alleged violation. A Complaint regarding a latent act or omission pertaining to any violation.
Any questions concerning a contractor may be referred to the Registrar, Contractors' State License Board, P.o. Box 26000, Sacramento, Califomia 95826