CM-2014-588 - 11/7/2014City of Round Rock
Tows aorx Agenda Item Summary
Agenda Number:
Title: Consider executing a claim for payment of incidental expenses and a
claim for moving expenses related to a relocation claim on Parcel 1-
Lara/Warner.
Type: City Manager Item
Governing Body:
City Manager Approval
Agenda Date:
11/7/2014
Dept Director:
Steve Sheets/Don Childs
Cost:
$3,355.80
Indexes:
Attachments:
00314842.PDF, 00314843.PDF
Department:
Legal Department
Text of Legislative File CM -2014-588
Consider executing a claim for payment of incidental expenses and a claim for moving
expenses related to a relocation claim on Parcel 1- Lara/Warner.
Staff recommends approval.
ay efeeeeaeoex Paye f Pnmeeon rraama
LEGAL DEPARTMENT APPROVAL FOR CITY COUNCIUCITY MANAGER ACTION
Required for Submission of ALL City Council and City Manager Items
Department Name: Legal
Project Mgr/Resource: Steve Sheets
Project Name: Creek Bend Extension
ContractorNendor: Paul Hornsby 8 Company
Council Action:
ORDINANCE RESOLUTION
QCity Manager Approval
CMA Wording
Consider executing a claim for payment of incidental expenses and a claim for moving expenses related to a relocation claim on
Pard 1- LarruWarner.
Attorney Approval ++ II I
Attorney l -J <h, i�lu.t Date I! 3
O:\wdox\SCClnts\0199\0105-1\MISC\00314842.XLS Updated 6/3/08
Farm ROW -R-118
(Rev. 07111)
Page 101
PROPERTY OWNER'S CLAIM FOR PAYMENT
INCIDENTAL EXPENSES OF PURCHASE OF REPLACEMENT DWELLING
I. Name of Claimant(s)
Parcel No.: 1Couv :Williamson
ROW CSI: Project No.:
Crelyne Warner
2. Occupancy of State -Acquired Property:
3. Controlling Dales
Mo.
Day
Yr,
05
30
2014
From (Date):5/27/2011 To (Date): 10/282014
a. First Offer in Negotiations
b. Property Acquired by State
4. Address of Replacement Property:
10
03
2014
17842 Park Valley Drive
c. Replacemrnr Property Aequired
10
01
2014
Round Rock TX 78681
10
28
2014
d. Occupancy of Replacement
Property
5. Expenses (List below each item included in claim - arbach receipts or closing documents In support cath cost.)
Item Amount
Loan Set up Fee $149.00
Document Preparation $225.00
Title Insurance $125.00
Courier Fees 545.00
E -Recording Fees $12.00
Guaranty Assessment Recoupment Charge $1.80
Recording Fees $90.00
WCID Notice Recording $58.00
Total $705.80
6. Payment of this claim in the amount shown in Block 5 above is requested. 1 certify these incidental expenses were necessary in the
purchase of my replacement dwelling and that I have not and will not accept reimbursement or payment from any other source for these
expenses. I further certify that all information shown above is true and correct, and that the mAacement dwelling I now occupy meets the
standards of decent, safe and sanitary housing to the best of my knowledge and belief,
0— ' maat
Date of Claim
Claimant
Spaces Below to be Completed by State
7. The dwelling at the address under Block 4 above has been inspected and in my opinion
meet, the standards for decent, safe and sanitary housing.
ni
_. August l5 2014 w�/LIQ
Date of Ins etion hiopactedB - Si tore
1 comfy thin I have examined this claim and found it to conform to the ap i able laws and mgulat ns gove ing mineation assistance payments. 1 further
Date the comput& etffy payq:rnt and Be information sh0own here qct, Thjs m s AmmOf ed for ayment.
CjtyofRrundRJA
CNA -Z(314-568
Foon ROW -R-100
(Rev. 07111)
Page 1 W 2
CLAIM FOR FIXED MOVING EXPENSE PAYMENT - INDIVIDUALS AND FAMILIES
L NameofClaimant(s):
Parcel No.:I
County: Williamson
Crelyne Warner
ROW CSJ:
Project No.:
4. Occupancy of Property Acquired by City of Round Rock
From (Date):
To (Date of Move):
5. Controlling Dales Mo. Day Yr.
a. First Offer in Negotiations OS 30 2014
2. Address of Property Acquired by City of Round
b. Date Property Acquired to 13
Rock:
2401 Creek Bend Circle
Round Rock, TX 78681
c. Dale Required to Move
6. Dwelling:(house, apartment, etc.)
House
®Owner -occupied ® Famished
❑Tenant ❑ Unfurnished
Apt. No.:
3. Address Moved To:
(I) Number of Rooms: 13
17842 Park Valley Drive
Round Rock, TX "31.081
(2) Payment Schedule Amount $ 2,650.00
(3) Total Amount of Claim: $2,650.00
Apt. No.:
7. Payment of this claim in the amount shown in Block 6 (3) is requested. I certify that I have not submitted any other claim
for, or received reimbursement or compensation for, any item of expense pmsu o [his claim. 1 further certify that all
information shown above is true and correct. l
Deo OrClai
Claimant
Spam Below to be Conant
led by City of Round Rock
8. Type occupancy and number of rooms verified prior to
9. Vacancy verified on:
move on: 180 -Day Owner Occupant -13 room count
Date; 6/6//99p/22001�4�
Date: ��Uq'�3�U�—�
By: .tv�c= -.. / �(A-G�GI _.. __...
��
By:nv.nr�r/o�u W -1
Si nature
Si eture
I certify that I have examined this claim and found it to conform to the applicable laws and regulations governing relocation
assistance payments. I further certify the computation of the payment and the information as shown herein is correct. This
claim is recommended for payment. This claim is recommended for payment as follows:
Amount
of $2,650
Date
crit' ire FOLKIc, PZCK.