(A) With respect to any claim made hereunder by the city, such claim shall be made on such forms as the City Administrator shall determine appropriate, provided that such forms shall show the following:
(1) Date of accident;
(2) Location of accident;
(3) Owner of vehicle;
(4) Person operating applicable vehicle or having actual physical control thereof;
(5) Violation alleged, if any;
(6) Disposition of violations; if any;
(7) Nature and extent of any emergency services rendered and the costs thereof;
(8) Reference to any presumption upon which the city relies;
(9) The total reimbursement demanded; and
(10) Due date for payment.
(B) Such notice shall bear the signature of the City Administrator or City Clerk and shall be mailed, U.S. mail, first class, postage prepaid, to the person against whom such costs are demanded, at the address shown on the accident report for such person. Such notice shall bear a legend in upper case letters, which shall be substantially in the following form:
THE LAWS OF THE CITY OF PEMBROKE PINES REQUIRE THAT YOU REIMBURSE THE CITY FOR COSTS AND EXPENSES SUFFERED BY THE CITY IN CONNECTION WITH THE ABOVE-DESCRIBED ACCIDENT. THE CITY'S RIGHT TO RECOVER AGAINST YOU MAY BE BASED UPON CERTAIN PRESUMPTIONS, WHICH PRESUMPTIONS MAY BE REBUTTED BY YOU IN AN ACTION INITIATED BY YOU IN THE CIRCUIT COURTS OF BROWARD COUNTY, FLORIDA, PURSUANT TO CHAPTER 86, FLORIDA STATUTES, OR IN ANY MOTION PERTAINING HERETO.
ALL COSTS ARE PAYABLE WITHIN TEN (10) CALENDAR DAYS FROM THE DATE OF THIS NOTICE AND YOUR FAILURE TO PAY SUCH COSTS WITHIN SAID PERIOD IS UNLAWFUL AND MAY GIVE RISE TO THE PENALTIES SET FORTH IN THE APPLICABLE LAWS OF THE CITY.
(Ord. 890, passed 5-3-89)