send claim to: Los Angeles Department of Water & Power PO Box 51111, Room 342 Los Angeles, Ca 90051-0100 THIS IS NOT AN ADMISSION OF LIABILITY OR A GUARANTEE OF PAYMENT BY LADWP 1 NAME: BIRTHDATE: ADDRESS: CITY,STATE & ZIP HOME PHONE NO. MAILING ADDRESS FOR THIS CLAIM: CITY,STATE & ZIP WORK PHONE NO. 2 WHERE DID THE INCIDENT HAPPEN? DATE OF INCIDENT Not applicable -- This is a billing dispute. TIME OF INCIDENT 3 DESCRIBE THE INCIDENT (USE BACK OF FORM AND ADDITIONAL SHEETS IF NECESSARY) You charged me a "bulky item fee," but I own a condo, and the law only allows you to impose that charge on apartments, not condos. You can see this by reviewing the Los Angeles Municipal Code at Article 6.1, Section 66.41(c), which authorizes the charge for apartment buildings and apartment tenants. Condos are not included. In 2008, City Council Members Huizar and LaBonge made a motion to charge condos, too, but the motion was not adopted. Therefore, you cannot charge me for this. DESCRIBE THE DAMAGE/INJURY/LOSS 4 The damage is the amount you have charged me for the "bulky item fee," namely, $15.36, plus interest at the legal rate of 10% per year for the past 12 months' worth of charges, which according to my calculations is another 83 cents, for a total of $16.19. 5 AMOUNT OF CLAIM NOTE: ENCLOSURE SUPPORTING DOCUMENTS: Bills, Estimates, Invoices, Photos, etc. $ 16.19 6 POLICE REPORT TAKEN? POLICE DEPARTMENT REPORT NUMBER YES( ) NO ( ) 7 WITNESS TO THE INCIDENT (USE BACK OF FORM IF NECESSARY) NAME HOME PHONE NO. ADDRESS CITY,STATE & ZIP 8 NAMES OF LADWP EMPLOYEES INVOLVED (IF KNOWN) DWP VEHICLE MAKE COLOR VEHICLE NUMBER LICENSE NUMBER YOUR VEHICLE YEAR MAKE COLOR VEHICLE NUMBER LICENSE NUMBER 9 10 SIGNATURE: DATE: NOTICE: YOU HAVE 6 MONTHS TO FILE A CLAIM FOR DEATH, PERSONAL INJURY, OR DAMAGE TO PERSONAL PROPERTY, AND 1 YEAR TO FILE A CLAIM FOR DAMAGE TO REAL PROPERTY OR FOR ANY OTHER TYPE OF INCIDENT. CLAIMS INFORMATION 1 If applicable contact your insurance company; they are your direct insurer 2 Be specific about the incident; time, date, location. 3 You must be able to substantiate your loss. Be practical and reasonable 4 To document your claim send copies of: bills, cancelled checks, receipts, invoices, etc. This is your own interest.
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