HomeMy WebLinkAboutCC 5 CLAIM #88-37 08-15-888/4/88
CONSENT CALENDAR
NOo 5
8-15-88
*Inter-Corn
TO:
FRON:
$ USJ ECT:
BONORABLE MAYOR AND CITY COUNCIL
CITY ATTORNEY
CLAIM NO: 88-37; CLAIMANT: LOUISE BOESSRICB; D/L:
3/15/88; D/FILED W/CITY: 6/15/88; CW FILE NO:
S54788NPB
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.
City Attorney
JGR (F4. se)
Enclosure:
Copy of Claim
CLAIM AGAINST THE CITY TUSTI~;
(For Damages to Pers¢ or Personal Property)
ReceiVed by ~~ ~ via
$. Mail ' '
;er-office Mail
~ver the Counter
The'law prov-ides generally that a claim must be filed with the Cit:y Clerk cf
the City of Tustin within 100 days after which the incident or event occurred.
Be sure your claim is against th~ 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 the
City Clerk, The City of Tustin, 300 Centennial Way, Tustin, California 92680
TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Tustin, California:
The undersigned respectfully submits the following claim and information rela~
tire to damage to persons and/or personal property:
1. NAME OF CLAIMANT: LOUISE HOESSRICH
a. ADDRESS OF CLAIMANT-.
b. PHONE NO: ( c. DATE OF BIRTH: ]]
SOCIAL DRIVERS '
d. SECURITY NO: e. LICENSE NO: None
2. Name, telephone and post office address tO which claimant desires notices
to be sent, if other than above:.
This claim is submitted against:
a. X
b.
The City of Tustin only.
The following employee(s) of the City of Tustin only:
_
C ·
, ,
The City of Tustin and the foliowing employee(s) of the
City of Tustin only:
4. Occurrence or event from which the claim arises:
a. .DATE: 03/15/88 b. 'TIME: 9'30 A.M. c. PLACE (Exact
and specific location): 404 First Street 0n the sidwa]k in front Qf
G0dfathem's Bar.
d. How and under what circumstances did damage or injury occur? Specify
the particular occurrence, event, act or omiss
r damage (Use additional p ry).
Claimant tripped over crack in pav and stumbled into empty hole. presumabl~
where a tree was to be planted on sidewalk.
e. What particular action by the City, or its emplo d the
alleged damage or injury? --
Failure to make sidewalE safe for pedestrians b,V. leavin~, a hole in sidewalk
- anO/or failure to warn. '
5. Give a description the
known at %ne time of this c!a~m. If there were no in]ur~es, state "no
injuries".
Four (4) broken ribs~ cracked shoulder, broken ~rm; nin~ (q/ ~f~tnh~ in chin~
damaged jaw bon~.
6. Give the name(s) of ~he City employee(s) causing the damage or injury:
Unknown.
7. Name and address of any other person injured: None_
8. Name and address of the owner of any damaged property: None.
9. Damages claimed:
a. Amount claimed as of this date: Unknown~ still healinq.
b. Estimated amount of future costs: Unknown.
c. Total amount claimed:
d. Basis for computation of amounts claimed (include copies of ali Dills,
invoices, estimates, etc.:
10. Names and addresses of all witnesses, hospitals, doctors, etc.:
a. Tustin Community Hospital, 14662 Newport Avenue. Tustin_
b. Dr. W. Robert Crumpton, 14642 Newport Avenue. ~2(l(l~.
c. Dr. Roger Wilson.. 1101 East Bryan. T~t~n, ~,A
do -
I1 ay additional information that might be helpful in' considering this claim:
WARNING: IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM.' (Penal Code
Section 72; Insurance Code Section 556.'0)
Executed this
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 :he same to be true.
I certify under penalty of perjury that the foregoing is TRUE AND CORRECT.
, 19 .:-~ , at xfa]q~&~. California.
San:a AH'~,
Office of the City Clerk,
Tus:_in, California
CLAIMANT ' S. SiGNATURE
DALE ELSBERRY, Attorney for Claimant
CLA NO:
DATE FILED:
Revised 8/05/81
JGR:se :R:8/5/81 (A)