HomeMy WebLinkAboutCC 6 CLAIM #93-29 08-02-93CG EN
CONSENT CALENDAR NO.-6 - --o
- =
8-2-93
Inter-Oom .....
DATE:
JULY 19, 1993
TO'
FROM'
SUBJECT:
HONORABLE MAYOR AND CITY COUNCIL
CITY ATTORNEY
CLAIMANT: BHAVANA AMIN; CLAIM NO: 93-29; D/L: 01-09-93; DATE
FILED W/CITY: 06-30-93; CAI~L WARREN FILE NO: S 74266 CLB
After investigation and review it is recommended that the
above-referenced claim be rejected and the City Clerk directed to
give proper notice of the rejection to the claimant and to the
claimant's attorney.
/ ?
/.' . // i /;?
JAMES G. ROURKE, City Attorney
J G R :jab: ~ 1693 (CL- 9329 .jab)
Enclosure: Copy of Claim
cc: Carl Warren & Co.
Finance Director
City Manager
City of Tustin ~ ~
C~ ~, AGAINST THE CITY OF TU& ,~
(For Damages to Persons or Personal Property)
The law provides generally that a claim must be filed with the City Clerk of
~he City of ~h/stin within 6 months after the incident or event occu.~-red. Be
sure your claim is against the City of Rhastin, not another public entity.
~here space is insufficient, please use additional paper and identify
information by paragraph number. Completed claims must be mailed or
~elivered to the City Clerk, City of Tustin, 15222 Del .A~o Avenue, Tustin,
2alifornia 92680
WHEN COMPLETING THIS FORM, PLEASE TYPE OR USE BLACK INK
THE HONORABLE MAYOR AND CITY COUNCIL, City of Tustin, California'
7he undersigned respectfully submits the following claim and information
-elative to damage to person and/or property:
a. NA/~E OF CLAI~T: BHAVANA AMIN
b. ADDRESS OF CI~tIMANT: !
c. CITY/ZIP CODE:
e. DATE OF BIRTH:
f. SOCIAL SECURITY NO:
2. Name, telephone.and post office address to which claimant desires notices
to be sent (if other than above):
Pal A. 'Len_~yel-Leabu. .55Q W. ~th Street, Suite 1237 Tustin, CA 92680
3. This claim is submitted against:
a. ~y~ The City of Tustin only.
b. The following employee(s) of the City of Tustin only'
C~
The City of Tustin .and the following employee(s) of the City
of TUstin only:
Occurrence or event from which the claim arises:
a. DATE: 3AN 9, 1993
b. TITLE: 1600-1630
c. PI2%CE (Exact and specific location) ' Intersection of Prospect and irvine
d. HOW and under wha~ circuunstances did damage or inju~-y occur? Specify
the particular occurrence, event, act or omission you claim caused
the injury or damage (Use additional paper if necessary)'
Due to a defective traffic siznal, claimant was involved in an automobile
accident.
e. ~qiAT par~icula ~ction by the City, or employees, caused the
alleged damage-or injury? --~
The traffic si.~nal in question was improperly maintained. The timinK
mechanism did not meet with traffic safety standards and thereby contributed
to the accident.
5. Give a description of the injury, property damage or loss so far known at
.the time of this claim. If there were n,o injuries, state "no injuries".
multiple rib fractures, broken pelvis, injurea coccyx, neck and back trauma,
venlc±e tota±le~.
6. Give the name(s) of the City employee(s) causing the damage or injury:
unknown
7. Name and address of any other person injured:
8. Name and address of the owner or any damaged property'
BHAVANA and PRADEEP kMIN
9. Damages claimed:
a. Amount claimed as of the date: $250,000.00 '
b. Estimated amount of future costs: $50,'000.00
c. Total amount claimed: $300,000.00
d. Attach basis for computation of amounts claimed (include copies of
all bills, invoices, estimates, etc. Unavailable at the present time,
treatment is continuing.
10. Names and addresses of all witnesses, hospitals, doctors, etc.
-- WESTERN MEDICAL CENTER, TUSTIN
MARTIN LUTHER HOSPITAL, ANAHEIM
GATEWAY MEDICAL CENTER, ANAHEIM
WAP~ING: IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM!!
(Penal Code Section 72; Insurance Code Section 556.0)
I have read the matters and statements made in the above claim and I ¥~ow the
same to be true of my own }~owledge, except as to those matters s~ated to be
upon information or belief and as to such matters I believe the same to be
true. I certify under penalty or perjury that the foregoing is TRUE AND
CORRECT.
Executed this 30th day of JUNE
,19 93 , at Tustin, California.
DATE FILED'
CLAIMA2{T' S SIGNATURE
E!' CLFORM
Revised 4/'29/91