HomeMy WebLinkAboutCC 9 CLAIM #88-39 07-18-88 CONSENT CALENDAR
· '~ ~ ~,~'~A 7-'18-88
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~TE: JULY 5, 1988 ~ ............ J
~O~LE ~YOR ~ CITY COUNCIL
FRO~:
CI~ A~O~EY
S USJ ECT:
C~I~: ~THERINE M~RE~ D/L: 1/13/88~ DATE FILED
W/CITY: 6/22/88; CLAIM NO: 88-39; CARL WARREN FILE
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 reject'ion to the claimant and to the
claimant's attorney.
~,/
City Attorney
JGR (F4. se)
Enclosure:
Copy of Claim
mv
AGAINST THE CI,_
(For ·Damages to Persons or Personal Proper'~y)
'.eceived by ~ ~,.~. ~- ~, ~-- via
'~ , ,,,
J.g..Mail ,.) ~ <~ .
In~r-office ~ai!
Over' ~he Counter
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The law provides generally ~ha't'a ciaim must De flied with uno city Ciern o=
.~e. which the incident o. event occurred
the City of Tustin within 100 days a~ - ~ ·
Be sure your claim is against 'tn~ City of Tustin, not another public entity.
Where space is insufficient, please use additional paper and identify informa-
tion by paragraph number. Completed claims must be mailed or delivered to =he
City Clerk, The City of Tustin, 300 Centennial Way; Tustin, California 92680
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.TO THE HONORABLP. MAYOR AND CITY COUNCIL, City 0'~ Tus%in, Cailfornia:
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The undersigned respectfully submits the ~o!iowing claim and info,-ma=ion rolo:
tire 'to damace, to persons and/or personal prope~'..y:
1. NAME OF CLAIMANT: Ka%h~rine Moore .....
a. '-ADDRESS OF CLAZMA/~T-:
b. PHONE NO: ( c. DATE OF BERTH: /~$
SOCI~.L DKIVEP~
~,~, ~ NO' ~$
d ' SECURITY NO: e~ L''~'''c"
o
2 . ' c-=iman= des =
~, Name, tole:hone and pos res: uc which ~-
· ,res notices
=o be sent, if other than aDOre:
_ .. ~7~9~ Ir~ine Blvd. ~u=tin c~ a9680
__~av~d M. Nisson~ Attorney at Law, _... _ . ., ~ ~ ,. ~ ._
., Th~.s claim is submi,,ed against:
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a. X ."~e City of Tustin only. '
b. The ~o!lowing employee(s) of the City cf Tus=in on!y:
.The City o~ Tt, suln and =ne fallowing employee(s) c~ uno
City of Tustin only:
i i i ,
Occurrence or event fram whict th-: claix a-:sos:
a DATE: ~-~ 88 ~ 'TIME- ~ :0.C a m c. PLACE (Exact
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and specific ioca=i0n): . 1222 17vi. ne Blvd., Tus~in. CA 99'90
d. How and under who= circumstances did damage or injury occur? Spec: fy
=he -~*icular occurrence, even=, ac'. c- omission you claim caused
'.he injury cr damage (Use addit_ona= DADO, i= necessary)
. .im~rooe. r me~uenanqe of oub!i~ sidewalks Create, nc hazards tc
What particular ac'.ion b.v thc City, or iUs employees, caused the
alleged damage or' injury'..
Fa~iure ~9. kee~ p%~b~ ..... ~ sidew~~_k,? free .frpm h~?.~'~.=.
Give a description ~f the injury, property, damage or loss so far as is
known at the time of this claim. If 'there were no injuries, sta~e "no
injuries" ·
Sprained ankle, X-~ay~ ~nd thereby
6. Give the name(s) of the City employee(s) causing the damage or injury:
,.
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Name and address of any other person injured:
Name. and address of the owner of any damaged property:
;
Damages claimed:
a. 'Amount claimed as of this date: S41!.25 waqe loss/ $814.00 med. ical:
b. Es=imated amount of future cos=s: $5_,000.00 General Damaqes
c. To:al amount, claimed: $6e225.25
d. Basis for computation Of amounts ¢:~,aimed (Inc'iude copies of =-.~ Dills,
invoices, estimates, e%¢.: wii~ be Drovide¢ uDon rec. u. est
IC~ Names and addresses of all witnesses~ hospi'&als, doctors, etc.:
.
a ~onnie Henne
.
.
~i, ~y addi:ional info~a:ion ~ha~ might ~,': be.!p~u! in considering :~is claim.:
See attached Dho%oqraDh.~
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WA_Pd~ING: IT IS A CRIMINAl5 OFFENSE T.C, Fi-LL L. FALSE CLAI.~i!
Sec=ion 72; Insurance Code Sec%ion 556.0)
(Penal Code
' :" the above claim and ' know ~he
i have read the matters and s=atemen'a~ m~.cc ~,,.
same :o De '-- e cf my own know~dc¢~ .~. ~
_~ cer='~, under penai~y of ~erju~..'. , :~a.~ ~,,.: ~--~.~cinc= , `~ ~=U~.,. -. ~D ~'===~
Executed this 21st day c'" · June
, -~a., in Ca_, ifornia
David M. Nisson,
Attorney for Katherine Momre
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Reviseg 8/05/81 -
JGP, :-sA :A:8/5/8~
. (A)