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Item C13 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: Februarv 16, 2000 Bulk Item: Yes X No Division: Man~ement Services Department: Human Resources/Risk Management AGENDA ITEM WORDING: Approval for Mayor to sign title transferring County Vehicle No. 141-009 to insurance company. ITEM BACKGROUND: This vehicle has been declared a total loss by the insurance company due to an accident on 11/28/99. PREVIOUS RELEVANT BOcc ACTION: N/A STAFF RECOMMENDATION: BOCC approval to transfer title. TOTAL COST: $0 COST TO COUNTY: $0 REVENUE PRODUCING: Yes BUDGETED: Yes No X No X AMOUNT PER MONTH YEAR APPROVED BY: County Atty _ OMB/Purchasing _ Risk Management _ DIVISION DIRECTOR APPROVAL: --::T"~ James L. Roberts DOCUMENTATION: Included: l To Follow: _ Not Required: _ DISPOSITION: Agenda Item #: l::U~ .J1 :... 2000 2....: 11 :30 Qf1EP!':A :~iS - '?13CJ5295-CS... ':J. :37: ,02 I ~ ~ , ~L ; TOTAL' LOSS WORKSHEET FOR CLAlM NUMBER b / J 1 tj 7 ~ - INSURED; CLAIMANT: JIIQft.roe ~_ /3r;Q~J c~~,y DATE OF LOSS: /I-~-n Y1lfMAIcrJMODEL: qLf old5 Cvf~55 ~ NlJMBER~ L ~ '3 A YB .lYt1r) ~ tt! ;)dltJO MILEAGE: 7~ 5 ~ /I ' SUBRO: _YES_NO STORAGE. YES _NO TOTAL DVT 1111 quons . AViRAGB QUOrIS . NADA COMmNEl) NADA&QVOTU AVERAGE NADA QUOTES AD1US'noGNTS TOt' AI. · SALES TAX <15...'YfI:Idt./:L8I \ . DEDt1CTIBI..E anDawtOlS COMPANYUTAIIQ . ratIST SALVAGlBID OWNERRETAINI NADA BOOJ( V ALUB: S 677 . txJ NlLEAGE .J+: . -J. ,,~ ~ANDDSDUC'l'IONa '. ....,....- TOTAL NADA VAWE: S LOSS PA"YEE _YES--.JIO PAYES: PHONE: SALVADEWOYED_YES_MO WHERE: . LOCAmN: C'l'MNV': . I I' ) BASIS lOa ANY IXClPlJOlfl to AIOW ADDmONAt. COIIIIDot.. .. DA 1'1; AD.I1JS1'D: . ...- - I, r I I ,:;1 14/2000 2.4: 11 GO Af1ERICf=l !r6 .,. 313052954364 'lO. :571 ';04 ~ ,,-'1Ll '991-9& ..' - "-" a:; ":.' l.. ... ._"'IPf ... UM ,.-~illo.. ,. ,. .--.-r~ - "'f. ;.;, :: :t ,.-.-.. 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