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HomeMy WebLinkAboutEric Morrison - Tort Claim Claim for Property Damage or Bodily Injury NOTE:This form is being provided as a courtesy to assist you in filing your claim.Providing this form to you is not an admission,nor shall it be construed to be an admission,of liability or an acknowledgement of the validity of a claim by the political subdivision.Legal requirements for filing claims can be found in Idaho Code:Title 6.Chapter 9.All claims must be filed promptly. CLAIMANT INFORMATION: First Name:* Last Name: Eric Morrison Physical Address Street* 13453 Hilltop Place City* State* ZIP Code* Valley Center California 92082 Have you lived at this address for at least 6 months prior to the incident date? Yes No My mailing address is different than my physical address Phone Number* Email Address: 208-293-7474 woodym@emorrison.net xxx-xxx-xxxx INCIDENT INFORMATION: ....................................................................................................................................................................................................................................................................................................................................................................................................................................... .. Date of Incident:* 01/21/24 05:00:00 PM Location of Incident:* 863 Elm Street N.Twin Falls ID 83301 DESCRIBE IN DETAIL WHAT DAMAGE OR INJURY OCCURRED: Sewage flowed out of the basement toilet flooding roughly 80%of the basement. Based on conversations with City Employees who resolved the flooding sewage,the backflow check valve for the area was clogged. Sewage has seeped into the walls as well as flooring and furniture. A Flood remediation company"Magic Valley Restoration and Construction"was called to address the flooding. Evaluation of the damage and removal of sewage soaked carpeting and furniture is in process at this time. Additional Files/Pictures: 22543.jpeg 180.09KB 22544.jpeg 301.64KB 22549.jpeg 167.12KB 22574.jpeg 161.72KB 22575.jpeg 244.64KB 22612.jpeg 280.84KB 22613(1).j peg 232.23 KB 22613.jpeg 232.23KB Morrison Repairs Estimate.pdf 2.34MB Morrison Mitigation.pdf 2.16MB Cost of Property Damage or Bodily Injury: $38,317.58 Property Damage or Bodily Injury:* Property Damage Bodily Injury Property Damage and Bodily Injury I hereby make a claim against the City of Twin Falls and I hereby certify that I have read the above information and it is true and correct to the best of my knowledge. Date* Signature* 2/15/2024 Cla t ol We,t ti<lOK Per Idaho Statute Title 41,Chapter 13:41-1331 -Any person who knowingly,and with intent to defraud or deceive any insurance company,files a statement of claim containing any false,incomplete,or misleading information is guilty of a felony."Statement"includes,but is not limited to, any notice,statement,proof of loss,bill of lading,receipt for payment,invoice,account,estimate of property damages,bills for services, diagnosis,prescription,hospital or doctor records,x-ray test results,or other evidence of loss,injury,or expense.