HomeMy WebLinkAbout20170606 Hardisty-Sfx1 AdvancePayRecpt2 1958591C»~~ ____
CAR1. ~~'A.R.I~EN & COIVIPA~'~1I'
Claims iUlanagement and Solutions
RECEIPT FOR ADVANCE PAYMENT
(THIS IS NOT A RELEASE)
File No. 1958591 —Suffix 1
This is to acknowledge receipt of $941.20 paid to David and Jaimie Hardisty, 219
Seaview Avenue, Pismo Beach, CA 93449 on behalf of the City of San Luis Obispo,
California. This payment represents credit against the total amount of any final
settlement or judgment in your favor for damages resulting from a water main rupture
that occurred on March 17, 2017 that affected the residential property at 1311
Fredericks Street, San Luis Obispo, California 93405.
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Date C imant —Jamie Hardisty
Witness Signature Claimant —David Hardisty
Please Print Name
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Address
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City, State, Zip Code
This Advance Payment Covers The Following:
Description Claim Am't
Meathead Mini Stora e —Reservation Fee — Recei t #62083 $50.00
Meathead Mini Stora e — Recei t #63359 $445.60
Meathead Mini Stora e — Recei t #64407 $445.60
Total Advance Pa ment $941.20
An Employee-Owned Company
P, 0. Box 2411 (Tustin, CA 92781
Tel: 800-444-8714 ~ Direct: 805-544-7963 (Fax: 866-254-4423 ~ www.carlwarr2n,com
CA License No: 2607296