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Home My WebLink About2023-12-15 Messett, Kerry - 9101 Gloria Sanchez From:Tim Varon <TVaron@carlwarren.com> Sent:Wednesday, November 6, 2024 10:30 AM To:Gloria Sanchez Cc:Damian Olivares; Kissa Thompson Subject:RE: CJP-3050321 - Kerry Messett v City of Palm Desert - Diary review Hi Gloria, Shannon is no longer with Carl Warren and Company. Ms. Kissa Thompson is handling this file on the City’s behalf. We have received the subrogation demand and have extended a Property Damage Release to them. At this point we are simply awaiting the signed PD release to issue payment and close our file. Have a great day! Tim Tim Varon Claims Supervisor TVaron@carlwarren.com Tel: (657) 622-4287 | Fax: (866) 254-4423 Carl Warren & Company, LLC CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the in tended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. 2 From: Gloria Sanchez <gsanchez@palmdesert.gov> Sent: Tuesday, November 5, 2024 2:06 PM To: zz Shannon Williams <swilliams@carlwarren.com>; Tim Varon <TVaron@carlwarren.com> Cc: Damian Olivares <dolivares@palmdesert.gov> Subject: RE: CJP-3050321 - Kerry Messett v City of Palm Desert - Diary review Hi, Shannon: I hope you are well and the week was off to a great start. Did you ever receive the subrogation demand from Safeo? Is this claim now closed? Please and thank you. M. Gloria Sanchez Records Coordinator City of Palm Desert 73510 Fred Waring Drive, Palm Desert, CA 92260 gsanchez@palmdesert.gov | 760.776.6354 | www.palmdesert.gov From: Shannon Williams <swilliams@carlwarren.com> Sent: Monday, March 18, 2024 10:25 AM To: Tim Varon <TVaron@carlwarren.com> Cc: Gloria Sanchez <gsanchez@palmdesert.gov> Subject: CJP-3050321 - Kerry Messett v City of Palm Desert - Diary review Hi all,No major utes. I am just waiting for the subrogation demand from Safeo now. DIARY REVIEW Event: City employee - Brad Chuck, r/e clmt vehicle.Statute of Limitations: 10/23/2026 – PDAction plan items from last review and status:Vehicles photos received from city and Hi all, No major updates. I am just waiting for the subrogation demand from Safeo now. DIARY REVIEW Event: City employee - Brad Chuck, r/e clmt vehicle. 3 Statute of Limitations: 10/23/2026 – PD Action plan items from last review and status: 1. Vehicles photos received from city and clmt 2. 1 estimate received from clmt 3. Statement received from clmt driver 4. Confirmation received from city that driver is city employee driving with permission 5. TCR received confirming all info Coverage: Yes under the MOC Liability Review: City employee Brad Chuck is liable for r/e ax Damages Review – Submitted Medical Bills: none Considered: none Residuals: none Loss of Earnings Alleged: none Reserve Review: $7k – sufficient for now Updated Action Plan: 1. Clmt adv she will go through her policy for repairs 2. Obtain sub demand and reimburse clmt carrier, deductible and any OOP/rental Subrogation Referral: n/a Shannon Williams Sr Claims Examiner swilliams@carlwarren.com Tel: (657) 622-4234 | Fax: (866) 254-4423 Carl Warren & Company, LLC CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, 4 proprietary, non-public and/or privileged. If you are not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. 1 Gloria Sanchez From:Shannon Williams <swilliams@carlwarren.com> Sent:Monday, March 18, 2024 10:25 AM To:Tim Varon Cc:Gloria Sanchez Subject:CJP-3050321 - Kerry Messett v City of Palm Desert - Diary review Hi all, No major updates. I am just waiting for the subrogation demand from Safeo now. DIARY REVIEW Event: City employee - Brad Chuck, r/e clmt vehicle. Statute of Limitations: 10/23/2026 – PD Action plan items from last review and status: 1. Vehicles photos received from city and clmt 2. 1 estimate received from clmt 3. Statement received from clmt driver 4. Confirmation received from city that driver is city employee driving with permission 5. TCR received confirming all info Coverage: Yes under the MOC Liability Review: City employee Brad Chuck is liable for r/e ax Damages Review – Submitted Medical Bills: none Considered: none Residuals: none Loss of Earnings Alleged: none Reserve Review: $7k – sufficient for now Updated Action Plan: 1. Clmt adv she will go through her policy for repairs 2 2. Obtain sub demand and reimburse clmt carrier, deductible and any OOP/rental Subrogation Referral: n/a Shannon Williams Sr Claims Examiner swilliams@carlwarren.com Tel: (657) 622-4234 | Fax: (866) 254-4423 Carl Warren & Company, LLC CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the in tended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. 1 Gloria Sanchez From:Shannon Williams <swilliams@carlwarren.com> Sent:Thursday, January 18, 2024 9:24 AM To:Tim Varon Cc:Gloria Sanchez Subject:CJP-3050321 - Kerry Messett v City of Palm Desert - Diary review DIARY REVIEW Event: City employee - Brad Chuck, r/e clmt vehicle. Statute of Limitations: 10/23/2026 – PD Action plan items from last review and status: 1. Vehicles photos received from city and clmt 2. 1 estimate received from clmt 3. Statement received from clmt driver 4. Confirmation received from city that driver is city employee driving with permission 5. TCR received confirming all info Coverage: Yes under the MOC Liability Review: City employee Brad Chuck is liable for r/e ax Damages Review – Submitted Medical Bills: none Considered: none Residuals: none Loss of Earnings Alleged: none Reserve Review: $7k – sufficient for now Updated Action Plan: 1. Clmt adv she will go through her policy for repairs 2. Obtain sub demand and reimburse clmt carrier, deductible and any OOP/rental Subrogation Referral: n/a 2 Shannon Williams Sr Claims Examiner swilliams@carlwarren.com Tel: (657) 622-4234 | Fax: (866) 254-4423 Carl Warren & Company, LLC CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the in tended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. 1 Gloria Sanchez From:Gloria Sanchez Sent:Friday, January 5, 2024 5:37 PM To:Shannon Williams Subject:CJP-3050321 - City of Palm Desert - 910 - Kerry Messett Attachments:T--232960057 INITIAL #6309 PALENCIA.pdf Hi, Shannon: As requested, aƩached is traffic accident report #T232960057. Have a nice weekend. 1 Gloria Sanchez From:Gloria Sanchez Sent:Thursday, January 4, 2024 1:48 PM To:Shannon Williams Subject:RE: CJP-3050321 - City of Palm Desert - 910 - Kerry Messett Good afternoon, Shannon: Please see the City’s response to your questions below. I will provide you a copy of the police report as soon as I receive it from the Sheriff’s office. Thank you. From: Shannon Williams <swilliams@carlwarren.com> Sent: Thursday, January 4, 2024 10:05 AM To: Gloria Sanchez <gsanchez@palmdesert.gov> Cc: Andrea Staehle <astaehle@palmdesert.gov>; Amber Molina <amolina@palmdesert.gov> Subject: FW: CJP-3050321 - City of Palm Desert - 910 - Kerry Messett Good morning, Following up on the question below. Please let me know. Shannon WilliamsSr Claims Examinerswilliams@carlwarren.comTel: (657) 622-4234 | Fax: (866) 254-4423Carl Warren & Company LLC | A Venbrook CompanyCA Entity License No: 2607296www.carlwarren.comPO Box 2411, T Good morning, Following up on the question below. Please let me know. Shannon Williams Sr Claims Examiner swilliams@carlwarren.com Tel: (657) 622-4234 | Fax: (866) 254-4423 Carl Warren & Company LLC | A Venbrook Company CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the in tended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. From: Shannon Williams <swilliams@carlwarren.com> Sent: Tuesday, December 19, 2023 3:30 PM To: Gloria Sanchez (gsanchez@palmdesert.gov) <gsanchez@palmdesert.gov> 2 Cc: Andrea Staehle - City of Palm Desert (astaehle@cityofpalmdesert.org) <astaehle@cityofpalmdesert.org>; Amber Molina Nunez (amolinanunez@cityofpalmdesert.org) <amolinanunez@cityofpalmdesert.org> Subject: RE: CJP-3050321 - City of Palm Desert - 910 - Kerry Messett Hi Gloria, A few questions on this one while I try to get in contact with the claimant. - It appears a city employee (Brad Chuck) was driving a city vehicle at the time of the loss. Does the city own, maintain, and control of the vehicle being driven by the City driver? YES - Is Brad Chuck in fact a city employee? Yes If so, was he in the course and scope of employment at the time of the loss? YES - Did Mr. Chuck have permission to drive the vehicle when the loss occurred? YES - Can I have the contact information for Mr. Chuck so that I may obtain a statement? Landscape Supervisor Brad Chuck may be reached at bchuck@palmdesert.gov or (760) 346-0611 ext. 482. However, the majority of his assignments are out in the field. Currently he is out of the office and is due to be back to work on 1/8/2024. - Do you have a the police report for this loss? Have requested and pending receipt from the Riverside County Sheriff’s Office (Palm Desert Police). - Do you have photos of the city vehicle involved and the damage it sustained along with any estimates? NO. WE SECURE. Thank you for your assistance on this matter. Shannon Williams Sr Claims Examiner swilliams@carlwarren.com Tel: (657) 622-4234 | Fax: (866) 254-4423 Carl Warren & Company, LLC CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. From: Tim Varon <TVaron@carlwarren.com> Sent: Tuesday, December 19, 2023 11:16 AM To: Gloria Sanchez (gsanchez@palmdesert.gov) <gsanchez@palmdesert.gov> Cc: Shannon Williams <swilliams@carlwarren.com>; Andrea Staehle - City of Palm Desert 1 Gloria Sanchez From:Shannon Williams <swilliams@carlwarren.com> Sent:Tuesday, December 19, 2023 3:30 PM To:Gloria Sanchez Cc:Andrea Staehle; Amber Molina Subject:RE: CJP-3050321 - City of Palm Desert - 910 - Kerry Messett Hi Gloria, A few questions on this one while I try to get in contact with the claimant. - It appears a city employee (Brad Chuck) was driving a city vehicle at the time of the loss. Does the city own, maintain, and control of the vehicle being driven by the City driver? - Is Brad Chuck in fact a city employee? If so, was he in the course and scope of employment at the time of the loss? - Did Mr. Chuck have permission to drive the vehicle when the loss occurred? - Can I have the contact information for Mr. Chuck so that I may obtain a statement? - Do you have a the police report for this loss? - Do you have photos of the city vehicle involved and the damage it sustained along with any estimates? Thank you for your assistance on this matter. Shannon Williams Sr Claims Examiner swilliams@carlwarren.com Tel: (657) 622-4234 | Fax: (866) 254-4423 Carl Warren & Company, LLC CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the in tended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. 1 Gloria Sanchez From:Tim Varon <TVaron@carlwarren.com> Sent:Tuesday, December 19, 2023 11:16 AM To:Gloria Sanchez Cc:Shannon Williams; Andrea Staehle; Amber Molina Subject:FW: CJP-3050321 - City of Palm Desert - 910 - Kerry Messett Attachments:Claim Against the City of Palm Desert For Damage(s.pdf; 20231219 Massett Palm Desert NOTIFICATION LETTER 3050321.pdf Hi Gloria, Please find attached a copy of our Notification Letter for your records. Have a great day! Tim Tim Varon Claims Supervisor TVaron@carlwarren.com Tel: (657) 622-4287 | Fax: (866) 254-4423 Carl Warren & Company, LLC CA Entity License No: 2607296 www.carlwarren.com PO Box 2411, Tustin, CA, 92781 Because Quality and Integrity Matter... please EMAIL my Supervisor about the service you received. Important Notice: This email (including any attachments) is intended solely for the use of the individual or entity to which it is addressed, and may contain information that is confidential, proprietary, non-public and/or privileged. If you are not the intended recipient, you are hereby notified that any use, dissemination, distribution, or copying of this communication is strictly prohibited. If you have received this email in error, please delete it from your system and advise the sender immediately. Please be advised that we are unable to 2 bind, endorse or amend coverage via voicemail, email, or facsimile until confirmed in writing by an authorized representative of this office. We accept no liability for any damage caused by any virus transmitted by this email. It is your responsibility to check this email (including any attachments) for viruses. From: gsanchez@palmdesert.gov <gsanchez@palmdesert.gov> Sent: Monday, December 18, 2023 12:54 PM To: thileman@palmdesert.gov; Isra.Shah@bbklaw.com; cjpia Claims <cjpia@carlwarren.com> Cc: cescobedo@palmdesert.gov; amejia@palmdesert.gov; astaehle@palmdesert.gov; Tim Varon <TVaron@carlwarren.com> Subject: CJP-3050321 - City of Palm Desert - 910 - Kerry Messett Attached for your review and appropriate action is Claim No. 910 submitted by Kerry Messett. I will contact Palm Desert Police (Riverside Sheriff's Office) and forward to your office a copy of traffic accident report T232960057 as soon as possible. If you have questions or need additional information, please do not hesitate to contact me. Kind regards, City of Palm Desert Clerk's Office Some people who received this message don't often get email from gsanchez@palmdesert.gov. Learn why this is important PO Box 2411, Tustin, CA 92781 T: 657-622-4200 | F: 866-254-4423 | www.carlwarren.com CA License #2607296 December 19, 2023 Kerry Messett 11150 Mointain Vista Cir NW Silverdale, WA 98383 RE: Claimant : Kerry Messett Date of Loss : 10/23/23 Claim Filing Date : 12/15/23 Our File Number : 3050321 SWV Carl Warren & Company is the claims management company for the City of Palm Desert. The above-captioned claim has been assigned to Shannon Williams for handling. Ms. Williams may be reached at 657-622-4234. When our investigation is complete, we will advise you as to whether or not we can recommend settlement. Very Truly Yours, CARL WARREN & CO. Timothy M. Varon Timothy M. Varon Claims Supervisor cc: Member Agency: City of Palm Desert, attn:Gloria Sanchez 1 Gloria Sanchez From:gsanchez@palmdesert.gov Sent:Monday, December 18, 2023 12:54 PM To:Todd Hileman; Isra Shah; cjpia@carlwarren.com Cc:Chris Escobedo; Anthony Mejia; Andrea Staehle; tvaron@carlwarren.com Subject:Claim Against the City of Palm Desert - 910 - Kerry Messett Attachments:Claim Against the City of Palm Desert For Damage(s.pdf Attached for your review and appropriate action is Claim No. 910 submitted by Kerry Messett. I will contact Palm Desert Police (Riverside Sheriff's Office) and forward to your office a copy of traffic accident report T232960057 as soon as possible. If you have questions or need additional information, please do not hesitate to contact me. Kind regards, City of Palm Desert Clerk's Office Claim Against the City of Palm Desert For Damage(s) to Person(s) or Personal Property PALM DESERT CALIFORNIA Instructions: Please fill out this form completely. Failure to provide sufficient information may result in delays in claim processing. If you need an accommodation to complete or submit this form, please contact the City Clerk's Office Claims Coordinator at cityclerk@palmdesert.gov or (760) 346-0611. Important Information: 1. Claims for death, injury to person or to personal property must be fi led no later than six(6) months after the occurrence. 2. Claims for damages to real property must be fi led no later than one (1) year after theoccurrence. See California Government Code §911.2. 3. Be sure claim is against the City of Palm Desert, not another public entity. 4. Claimant is advised to consult a private attorney if legal advice is desired. No employeeof the City may give legal advice to any claimant relating to private claims. Instrucciones: Complete este formulario en su totalidad. Si no brinda informacionsufi ciente, pueden producirse demoras en el procesamiento del reclamo. Si necesita algunaacomodacion para completar o enviar este formulario, comuniquese con el Coordinador deADA a la direction de correo electronico cityclerk@palmdesert.gov o al telefono (760) 346-0611. Information importante: 1. Los reclamos por muerte, lesiones personales o danos a la propiedad debenpresentarse a mas tardar seis (6) meses despues de haberse producido el hecho. 2. Los reclamos por danos a bienes inmuebles deben presentarse a mas tardar un (1) anodespues de haberse producido el hecho. (Consulte §911.2 del Codigo de Gobierno). 3. Asegurese de dirigir su reclamo a la ciudad de Palm Springs, no a otro organismopublico. 4. Se aconseja a los reclamantes consultar con un abogado privado si asi to desean.Ningun empleado de la ciudad puede. Claimant First Name Kerry Home Address / Domicilio Street Address 11150 Mountain Vista Circle NW Address Line 2 Claimant Last Name Messett City State/Province/Region Silverdale WA Postal/Zip Code Country 98383 USA Preferred Phone Number / Numero de telefono preferido Email / Correo electronico 206-595-0520 kmsstt@aol.com Are you currently represented by an attorney? / zEsta actualmenterepresentado por un abogado? 0Yes Di No Date and time of damage/injury/loss - Fecha y hora deldano/lesion/perdida 10/23/2023 03:00:00 PM QQ Yes No Did any other person experience an injury/damage/loss? - LAIguna otrapersona experimento una lesion/dano/perdida? D Yes O No Are there any witnesses? - zHay algun testigo? DYes ®No Location of damage/injury/loss (if known, include specific address) - Lugar donde se produjo el dano, la lesion o la perdida (si conoce el domicilio especffico, indiquelo) Intersection of San Pablo and Highway 111 Provide a general description of the damage/injury/loss as the time of this claim - Describa el dano, la lesion o la perdida al momento de este reclamo Rear bumper, license plate and door sustained multiple dents, paint damage and scratches. This may require removal, repair and/or replacement. Specify how the damage/injury/loss occurred - Especifique como se produjo el dano, la lesion o la perdida My son-in-law, authorized to drive the vehicle and driving with valid WA DI (#WDL5PRR9033B) was stopped with other cars at a red light, waiting to cross Highway 111 at San Pablo. City Employee Brad Chuck saw the light turn green for the right hand lane, and thinking it was for all lanes drove forward and rear ended my car, causing the damage. Both vehicles then pulled off to a parking lot. Were paramedics/ambulance called? / llama a los paramedicos/ambulancia? DYes @No Did you seek medical treatment? / Buscaste tratamiento medico? D Yes O No What particular action/omission by the City, or its employee(s) caused the damage/injury/loss? - zQue accion u omision especffica de la ciudad o sus empleados ocasionaron el dano, la lesion o la perdida? Inattentive driving: looking at the wrong lane's light and not looking at vehicles in front of him, including my stopped vehicle in front of him. Provide the name of the City employee involved in the damage/injury/loss, if known - Si to conoce, indique el nombre de los empleados de la ciudad involucrados en el dano, la lesion o la perdida Brad Chuck Was a police report filed? / zSe presento un informe policial? Provide the police report number / Proporcione el numero de informe policial T232960057 Any additional information that might be helpful in considering claim / Cualquier informacion adicional que pueda ser util al considerar el reclamo: City employee was very professional, admitting to causing the accident and checking that driver was alright and then calling the police to make a report. Please cc: m.c.salanga@gmail.com for communications regarding this incident. DAMAGES CLAIMED - If the amount claimed exceeds $10,000, it is not required that a dollar amount be provided. However, your claim must indicate whether it would be a Limited Civil Case. A Limited Civil Case is one where the recovery sought, exclusive of attorney fees, interest, and court costs, does not exceed $25,000. An Unlimited Civil Case is one in which the recovery sought is more than $25,000. / Si el monto reclamado supera los $10.000, no es necesario indicar el importe en dolares. Sin embargo, el reclamo debe indicar si se trataria de una Accion civil limitada. Una accion civil limitada es una accion en la que el resarcimiento pretendido no supera los $25.000, sin incluir honorarios de abogados, intereses y costas del tribunal. En una accion civil sin limite, el resarcimiento pretendido supera los $25.000. 0 Limited Civil Case (damages between $10,000 to $25,000) - Accion civil limitada (los danos ascienden a $10.000 - $25.000) 0 Unlimited Civil Case (damages exceed $25,000) - Accion civil sin limite (los danos superan los $25.000) C) Claimed totals less than $10,000 / Total reclamado menos de $10,000 If the amount claimed is under $10,000, state amount claimed / Si el monto reclamado es inferior a $10,000, indique el monto reclamado $6,616.60 Basis for Computation of amount claimed (include estimate/bills as an attachment, if possible) - Base para el calculo del monto reclamado (incluya estimaciones/facturas como anexo, si es posible) Platinum Auto Repair & Collision checked out the damage and evaluated the necessary work Document Uploads Picture Uploads WARNING: IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM. (CALIFORNIA PENAL CODE 72 AND CALIFORNIA INSURANCE CODE) I hereby certify under penalty of perjury that the facts hereinabove set forth are true and correct to the best of my knowledge. / ADVERTENCIA: ES UN DELITO PENAL PRESENTAR UNA RECLAMACION FALSA. (CODIGO PENAL DE CALIFORNIA 72 Y CODIGO DE SEGUROS DE CALIFORNIA) Por la presente certifico bajo pena de perjurio que los hechos establecidos anteriormente son verdaderos y correctos a mi leal saber y entender. Signature �ive y Weadett Assigned Claim Number 910 Signee Date 12/15/2023 Signature Date 12/18/2023 Additional Information (If Necessary) I will contact Palm Desert Police (Riverside Sheriff's Office) and forward to your office a copy of traffic accident report T232960057 as soon as possible. Action History (UTC-08:00) Submit Submit by Anonymous User 2023-12-15 07:55:54 AM (Start) by Gloria Sanchez 2023-12-18 12:53:34 PM (User Task) • The task was assigned to Monique Lomeli, Gloria Sanchez. The due date is: December 19, 2023 5:00 PM. The priority is: Urgent 12/15/2023 7:56:05 AM • Gloria Sanchez assigned the task to Gloria Sanchez 12/18/2023 12:49:39 PM