HomeMy WebLinkAboutCC 6 CLAIM #88-52 11-07-88.CONSENT CALENDAR
NO. 6
11-7-88
DATE:
TO:
FROM:
SUBJECT:
o/ o/88
Inter-Corn
.~/-HONORABLE ~AYOR AND CITY COUNCIL
,- ,
CITY ATTORNEY
CLAIMANT: DeMEYER, JOAN; D/L: 8/26/88; DATE FILED
W/CITY: 9/26/88; CLAIM NO: 88-52 CARL WARREN FILE NO:/
~55n_ q_ 8?re_R, ,,
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.
..
.
,ty Attorney
JGR (F4.se)
Encl osur e:
Copy of Claim
CLKIM AGAINST THE .CITY ' TUSTIN
(For Damages to Person_ or Personal Property)
-Received by
via
.S. Mail ..
.nter-office Mail
Over the Counter
The law provides generally that a claim must De filed with ~he City Clerk
the City of Tustin within 100 days after which the inciden.t or event, occurred.
Be sure your claim is against the 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 61aim and information rela£
tire to damage to persons and/or personal property:
1. NAME OF CLAIMANT: Joan De Meyer
a. ADDRESS OF CLAIMANT-. £
b. PHONE NO: ( cl DATE OF BIRTH:
DRIVERS
SOCIAL
d. SECURITY NO: e. LICENSE NO:
2. Name, telephone and post office address to which claimant desires notices
to be sent, if other than above: ·
Nancy J. Swanson, Attorney at Law., 1215 N. Boss St., Santa Aha, CA 92701
·
,.
. This claim is submitted against:
ao
The City of Tustin only.
The following employee(s) of the City of Tustin only:
C.
The City of Tustin and the following' employee(s) of the
City of Tus~in only:
4. Occurrence or event from which the claim arises:
a. DATE: 8/26/88 b. 'TIME: 8:15 p.m..., c. PLACE (Exact
and specific location): $ogt-heastcorner of Brcwning~d Irvine. City of
Tustin
d. How and under what circumstances did damage or i
particular occurrence, eve ion you claim caused
the injury or damage (U onal paper if necessary).
OauGht foot on raisedblackt0Da~ea on street, ~n$i~e crosswalk ~nes.
_
e. What partic Y the City, or its employees, cause~ the
alRa ~e or inju.ry? . .
~sea D£ac~top area ~n street
·
· Give a description of the injury, property damage or loss so far as is
~. known at the time of this claim. If there were no injuries, state "no
in_juries"..
u~Dncusslon, black eye swo'llen shut, bump on head, neck and back
inj'uri%s, headac'he-~; han~ h,~
i. G~.v9 the name(s) of the City employee(s) causing the damage or injury:
unknown
'. Name and address of any other person injured: . Unknow1%
Name and address of the owner of any damaged property:
None
Damages claimed:
a. Amount claimed as of this date: $25,Q00.00
b. Estimated amount of future costs: $ 1,500.00
c. Total amount claimed: $26.500.00 -
d. Basis for computation of amounts claimed (include copies of all Dills,
invoices, estimates, etc.: Pain and m~ffm~'img.- m,=rl~r, ml h~lls
Names and addresses of all witnesses, hospitals, doctors, etc.:
a. Norman DeMeye.~r
b. Dr. Bianco, ChaPman Med~qal Gr~D'. Oran~_. CA
C. Dr. Injerd, ~874 N. Plac~_nt~'.a A~m.. D]am~ne~- r"A
Any additional information that might be helpful in considering this claim
~ARNING: IT IS A CRIMINAL OFFENSE T.O 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 ~o be =rue.
I certify under penalty of perju_ry that-the foregoing is TRUE AND CORRECT.-
. '~j.~ Santm Ana
Executed this /~ day of ~. , 19_~., at T~s~&a, California.
Office of the City Clerk,
Tustin, California
--
~M NO: -.,~-- ,~ ,
DATE FILED:
Revised 8/05/81
JGR:se :R:8/5/81 (A)