HomeMy WebLinkAboutCC 8 CLAIM #82-4 03-15-82DATE:
TO:
F~OM:
SUBJECT:
3/1/82
CONSENT CALENDAR
NO, 8
3-15-82
Inter-Corn
~ORABLE MAYOR AND CITY COUNCIL
JAMES G. ROURKE, CITY ATTORNEY
CLAIMANT: KEELER, SCOTT: D/L: 12/6/81; FILED W/CITY:
2/11/82; CLAIM NO: 82-4; CARL WARREN FILE NO: 31201 RR
After investigation and review it is recommended
that the above-referenced claim be denied and the City Clerk
directed to give proper notice of the denial to the claimant
and to the claimant's attorney.
JGR: se
Enclosure
1. Copy of Claim
· '.~AIM AGAINST THE CITY ~F TUSTIN
(For Damages to Persons or Personal Property)
Received by
u.s. Mail
Inter-office Hail
Over the Counter
via
FEB t ! 1982
The law provides generally that a claim must De tiled wltn the C~ty Clerk or
the City of Tustin within 100 days after which the incident 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 ~YOR AND CITY COUNCIL~ City of Tustin, California:
The undersigned respectfully submits the following claim and information rela-
tive to damage to persons and/or personal property:
NAME OF CLAImaNT: SCOTT KEELER
a. ADDRESS OF CLAImaNT:
b. PHONE NO: ( 714 ) 534-325~ c. DATE OF BIRTH: ±-
SOCIAL DRIVERS
d. SECURITY NO: e. LICENSE NO:
Name, telephone and post office address to which claimant desires notices
to be sent, if other than above:
GERALD H. NELSON, , Suite 1200, Orange,
3. This claim is submitted against:
a. XX
b.
The City of Tustin only.-
The following employee(s) of the City of Tustin only:
The City of Tustin and the following employee(s) of the
City of Tustin only:
4. Occurrence or event from which the claim arises:
a. DATE: Dec. 6, 1981 b. TIME: 3:42 ~.m. c. PLACE Exact
and specific location): Intersection of Svcamore& New-oort Avenue
How and under what circumstances did damage or injury occur? Specify
the particular occurrence, event, act or omission you claim caused
the injury or damage (Use additional paper if necessary).
improper maintenance of stop si qn'notice~ on-the street.
What particular action by the City, or its employees, caused the
alleged damage or injury?
· h~ n~l~g~n~ly d~ig~ ~nt~r~c~on, improperly olaced StOD si cns
~ ne~ligontly maintainod ~to~ zi~n noticm~ on paver~n~
.Give a description of the injury, property damage or loss so far as is
k~own at the time of this claim. If there were no injuries, state "no
injuries".
Fractured neck and hackl
6. Give the name(s) of the City employee(s) causing the damage or injur%;:
,. Name and address of any other person injured: Pearl Murray,
Name and address of the owner of any damaged property:
Jesus Arroyo,
Ca.
Damages claimed:
a. Amount claimed as of this date: $200,000.00
b. Estimated amount of future costs: 20,000.00
c. Total amount claimed: 220,000.00
d. Basis for computation of amounts claimed (include copies of all bills,
invoices, estimates, etc.: Injuries to neck and back.
0. Names and addresses of all witnesses, hospitals, doctors, etc.:
a. PEARL MURRAY,
c. Robert Seidlinger, Ca.
d. Luis Arroyo, Ca.
Tustin Community 14662 ~;ewport Ave., Tustin, Ca. 92680
Any additional information that might be helpful in considering this claim:
1ARNING: IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM! (Penal Code
Section 72; Insurance Code Section 556.0)
£ 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
pon information or belief and as to such matters I believe the same to be true.
~ certify under penalty of perjury that the foregoing is TRUE AND CORRECt.
~,xecuted this /(; day of ~
, 19 F~ , at Tustin, California.
Office of the City Clerk,
-"ustin, California
C IM NO: ~.~ -- ~
CLAIMANT ' S SIGNATURE
Revised 8/05/81
JGR:se :
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