HomeMy WebLinkAboutCC 12 CLAIM #89-28 11-20-89DATE: ~ I
TO:
FROM:
SUBJECT:
HONORABLE MAYOR AND CITY COUNCIL
CITY ATTORNEY
CLAIMANT: DORA KRUG; D/L: 4/28/89; DATE FILED W/CITY:
7/13/89; CLAIM NO: 89-28; CARL WARREN FILE NO: S 59794
NPB
, J
After investigation and review it is recommended that the above-
referenced claim be re3ected and the City Clerk directed to give
proper notice of the re3ection to the claimant and to the
claimant's attorney.
City Attorney
JGR( F4 )
Enclosure: Copy of Claim
CLAIM AGAINST THE CITY or TUSTIN
·
(For Damages to Person~ .i Personal Property)
Received by via ~
U.S. Mail
Inter-office M~il
Over the Counter
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T~e law provides generaily that a claim must be filed with 'the City Clerk~
the City of Tustin within 100 days after which the incident or event occurr
Be sure your claim ~s against the City of Tustin, not another public entity
Where space is insufficient, please use additional paper and identify infor
tion by paragraph number.. Completed claims must be mailed or delivered to
City Clerk, The City of Tustin, 300 Centennial Way, Tustin, California 926B
TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Tustin, California:
The undersigned respectfully submits the following claim and information re
tire to damage to persons and/or personal property:
1. NAME OF CLAIMANT: ~D~ ~
· ~ ~ ~ , ' ·
a. ADDRESS OF CLAIMANT:
~'~' c.- DATE OF BIRTH: ~/ ~. '~' .
SOCIAL -' ' DRIVERS
d. SECURITY NO: ~~-/~-~ / e. LICENSE NO:
2~ Name, telephone and post office address to which claimant desires notic~
to be sent, if other than above:
,
3. This claim is submitted against:
a. y
The City of Tustin only.
The following employee(s)'of the City of Tustin only:
C ·
The City of Tustin and th'e following employee(s) of the
City of Tustin only:
4. Occurrence or event from which the claim arises:
a. DATE: ~,~,/~/~ b. 'TIME: ~'~.~ · c. PLACE~ (Exact
and specific location): /mt~l~ ~],~'. '/'~,s~,'~ ~~ ~. ' ' '
/
d. How and under what circumstances did damage or injury occur? Speci~
th~ particular occurrence, event, act or omission you claim'caused
the injury or damage (Use additional Paper if necessary).
!
e. What particular action by the City, or its employees.,' cause.d.-the.
alleged damage or injury? ..'~ ..
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Give a description oi ,:e injury, property dama_ or loss s6 far as is
known at the time of this claim. If there were no injuries, s'tate. "no
injuries"
'
6. Give the name(s) of.the City employee (.s ) causing the damage or injury:
7. Name and address of any other per. son injured:
8. Name and address of the owner of any damaged property:
9; Damages cZatmed:
a.. ~oun~ cZa~med as of ~hts da~e:
b. Estimated amount of future costs:
c. Total amount claimed:
d. Basis for computation of amounts claimed (include copies of a~l bills,
invoices, estimates, etc.: ~,~,~
10. Names and addresses of all witnesses, hospitals, doctors, etc.:
. Any additional information that might be helpful in considering this claim
·
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WARNING: 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 know the
same to be true of my own knowledge, except as to those matters stated to be
upon information or belief and as to such matters .I believe the same to be tru
I certify under penalty of perjury that the foregoing is TRUE AND CORRECT.
Executed this //
O-f. fice of the City' Clerk,
..tin, California
CLAIM NO:
Revised 8/05/81
JGR:se:R':.'8/5/.81 (A)
· .
·
, 19 , at Tustin, California.
. .
' - ~LA S I GNAT URE
. ~
DATE FILED:
On April 28,1989, my husband~ (driver) and I were traveling toward
Santa Ana on Irvine Blvd. at approximately 40 m. p. h. The signal
at Tustin Ranch Rd.~ located in the center divider, was green.
(The signal since has been moved owerhead) We were nearly through
the intersection, when we saw a gap in the road. The pavement had
been cut out and there was a drop of several inches 12-18 £mcbes wide
and across the number one lane. There was'no warning of any kind.
My husband applied the brakes, but since it was not visible until
the last seconds, was on~ble to avoid the jolt as we went through, it.
At about that time~ we were struck from behind by a car driven by
Shelley 8owman, who also was jolted by the gap and struck from behind
by a rental car.
At the time we all felt little damage had been done to the cars,
excep~ a broken headlight on the rental car.
After exchanging names, insurance companies,etc, we went'on to my
doctor's office wher I was going for a blood pressure check. While
I was in the doctor's office, my husband called ~he City. of Tustin
to report the incident and was told someone would be sent out to
the intersection immediately.
Dr. Badin gave me a thorough check up. 8y then the muscles in roy
right shoulder and neck were beginning to tighten. The following
two days I was very-sore. With rest, aspirin, and heat, I did fairly
well for several days. However, the next weekend I was Having trouble
turning my head and was having a great deal of pain. I went back to
the doctor onMayll and including July 5, have made 13 trips for
tremtment. It is mucl~ better now as long as I aln careful not to
use my armin any way that puts pressure on the involved muscle.
A's we drove home on the day of tho accident, we realized the cot
was pulling to the right, so stopped at Meister Chrysler Plymouth
to have it aligned. Whenthey looked at it, they said it was unsafe
to drive as the k frame and ball joints were cracked and needed to
be replaced. There was also damage under the back bumper. This
left us without a car for five days (til May~) and again May 11-12
for the bumper repair.
Ail this could have been avoided if thecut-out area had been filled,
covered, or a warning posted. Since the work on the street was a
city project, Ifeel the Ci'ty of Tustin was responsible for the accident.