CITY OF TACOMA CLAIM FOR DAMAGES FORM General Liability Claim Form ForOiIicial Use Only Pursuant to Chapter 4.96 RCW, this form is for ?ling a claim against the . City of Tacoma. Some of the information requested on this form is required by RCW 4.96.020 and may be subject to public disclosure. Pursuant to the new law, Claim for Damages forms cannot be submitted EC Iv ED electronically (via e?mail or fax). PLEASE TYPE OR PRINT INK FEB 2 1 2017 Mail or deliver original claim to: cmrracoma CITY CLERKS OFFICE Of?ce of the City Clerk 747 Market Street, Room 243 No. Tacoma, WA 98402 Business Hours: Mon. - Fri. 8:00 am. - 5:00 pm. Closed on weekends and holidays. CLAIMANT INFORMATION 1, Claimant's name; See Exhibit A attached hereto. Last name First Middle Date of birth 2. Current residential address: See EXhibil A attached hereto. 3. Mailing address (if different): See Exhibit A attached hereto. 4. Residential address at the time of the incident (if different from current address): 5. Claimant's daytime telephone number ?90 undersigned counsel at (205) 639-2140 Home Business Cell 5_ Claimant?s e?mail address: do undersigned counsel at djurw@helseil.com INCIDENT INFORMATION See Exhibit 8 attached hereto. 7. Date of the incident: Time: Elam. p.m. (mm/Mm!) (check one) 8. if the incident occurred over a period of time, date of ?rst and last occurrences: See Exhibit attached hereto. from Time: am. pm. to Time: am. [3 pm. (check one) (check one) 9_ Location of incident See Exhibit attached hereto. City State Place orAddress where occurred 10. If the incident occurred on a street or highway: See Exhibit attached hereto. Name of street or highway At the intersection with/or Nearest intersecting street 11. City agency or department allegwa responsible for damage?njuM?or and City Council. Department Of PUDHC Utilities TPU Tacoma Power. and Click! Network 12. Names. addresses, and telephone numbers of all persons involved in or witness to this incident See Exhibit attached hereto. 13. Names. addresses and telephone numbers of all City employees having knowledge about this incident See Exhibit attached hereto. - 14. Names, addresses. and telephone numbers of all individuals not already identi?ed in #12 and #13 above that have knowledge regarding the liability issues involved in this incident, or knowledge of the Claimant's resulting damages. Please include a brief description as to the nature and extent of each person's knowledge. Attach additional sheets if necessary. See Exhibit attached hereto. I 15. Describe the cause of the injury or damages. Explain the extent of property loss or medical. physical or mental injuries. Attach additional sheets if necessary. See Exhibit attached hereto. 16. Has this incident been reported to law enforcement. safety or security personnel? If so. when and to whom? It has been reported to the Mayor and City Council. and to the Public Utilities Board. See Exhibit attached hereto. 17. Names, addresses and telephone numbers of heating medical providers. Attach copies of all medical reports and billings. NIA 18. Please attach documents which support the claim?s allegations. See Exhibit attached hereto 19. I claim damages from the City of Tacoma in the sum of See Exhibit attached hereto. This Claim form must be signed by the Claimant. a person holding a written power of attorney from the Claimant. by an attorney admitted to practice in Washington State on the Claimant's behalf, or by a court-approved guardian or guardian ad litem on behalf of the Claimant. I declare under penalty of perjury under the laws of the state of Washington that the foregoing is this and cOrrect. t? the 5? my Medge- and be"ef' Helsell Fetterman LLP, 1001 Fourth Avenue. Suit 420 511% Seattle, WA 93154?1154 (King County) Q0 jeo/ 7 Sign re of Claims Authorized Agent Date and Place (residential address, city and?coun?l) Attorney for Clar identi?ed in Exhibit A attached hereto. The nalnes and addresses of ihe Claimanis are as follows: Edward E. (Ted) Coates Mr. Coates is a former Director of Tacoma Public Utilities and an electric raiepayer ofTacoma Power. Mike Crowley Mr. Crowley is a former Mayor and member of the City Council of the City ofTacoma, and an electric ratepayer of Tacoma Power. ark and Mar arei Bubeniki dba Sieele Manor Aparimenis If Mr. Bubenik is a former Chief Assistant City Attorney for Tacoma Public Utili est He and his wife do business as Steele Manor Apanments, located at 521 South steele Streei, Tacoma, WA 98405, and are ratepayers of Tacoma Powerl Thomas H. Oldfield Mr. Oldfield is an attorney and an electric ratepayer ofTacoma Powerl Industrial Custolners of Northwest Utilities 818 sw 3rd Avenue #266 Portland, OR 97204 ICNU is an incorporated, nonrproflt association of large industrial users of electricity in the Pacific Northwest including industrial electric ratepayers of Tacoma Power. All communications wiih the Claimants about ihis claim should go through their aitorney, whose name, address telephone number and email address are as follows: David Jurca Helsell Fetterman LLP 1001 Founh Avenuei Suiie 4200 Seattle, WA 9815471154 (206) 68972140 djurca@ helsell.com Exhibit B Pursuant to actions and resolutions of the Mayor and City Council of the City of Tacoma, the Tacoma Power electric utility has been unlawfully subsidizing both the capital expenses and the operational and maintenance (O&M) expenses of the commercial telecommunications business of the Click! Network (“Click”) for many years. Further, the Mayor and City Council have proposed that substantial improvements and expansion of the Click telecommunications business be funded in large part by further subsidies from the electric utility. The Claimants are or represent ratepayers of the Tacoma Power electric utility. They seek the following relief: (1) the immediate cessation of all such subsidies and (2) a refund to the Tacoma Power electric utility, from the City’s general fund or from separate funds of Click itself, in the amount of all such unlawful subsidies for the past three years and to the date of cessation of all such subsidies, for the ultimate benefit of all electric ratepayers. The unlawful subsidies include unreimbursed capital expenditures for facilities and equipment benefiting or properly allocable to Click rather than to the electric utility, unreimbursed expenditures for O&M expenses benefiting or properly allocable to Click rather than the electric utility, and the provision of facilities or services for Click without receiving payment therefor at its true and full value (for example, allowing Click wires or equipment to be attached to electric utility power poles without adequate payment therefor, and paying for audits or studies for Click’s benefit without adequate reimbursement therefor). The amount of unlawful subsidies for the past three years is estimated to total more than $21 million. This claim is supported by the documents attached hereto, and by other documents believed to be within the City’s possession, custody or control. City employees and other persons having knowledge about the relevant facts include the following: present and former mayors and members of the City Council and the Public Utilities Board; present and former City Attorneys and Assistant City Attorneys who have dealt with issues relating to electric utility and Click expenses; present and former executives, managers and analysts at Tacoma Public Utilities, Tacoma Power and Click; present and former managers and employees of the City’s Finance Department who have dealt with financial matters for the electric utility or Click; and authors of audits, reports and studies by outside consultants and auditors concerning past and projected capital and O&M expenses of the electric utility and Click, including but not limited to those prepared by Virchow Krause & Company, CCG Consulting LLC, Moss Adams LLP, NewGen Strategies and Solutions LLC, CTC Technology & Energy, and the Washington State Auditor’s Office.