HomeMy WebLinkAboutClaim No. 531 - T.DobrevCITY OF PALM DESERT
COMMUNITY SERVICES DIVISION
CITY CLERK OPERATIONS
STAFF REPORT
REQUEST: CLAIM AGAINST THE CITY (#531) BY TERESA DOBREV IN AN
UNSPECIFIED AMOUNT
DATE: April 8, 2004
CONTENTS: I. Staff Report
II. Claim No. 531
Recommendation:
By Minute Motion, reject the Claim and direct the City Clerk to so notify the
Claimant.
Background:
Based on a review of the subject Claim and the recommendation of the Claims Adjuster,
Risk Manager, City Attorney, and staff, it is recommended that the Claim be rejected.
Discussion of this item should be held in Closed Session pursuant to Government Code Section
54956.9(b), potential litigation.
Submitted by:
CHELLE D. KLASS
CITY CLERK
Approved:
S L. ORTE
ITYYAANAGER
rdk
Attachment (as noted)
,CMC
i
SHEILA R. GILL AN, C
ASST. CITY MANAGE " • R
COMMUNITY SERVIC
H:1WPdatalWPDOCSIC(A(MSclaim-reject-staff report. wpd
CLAIM AGAINST THE CITY OF PALM DESERT
(For Damage(s) to Person(s) or Personal Property)
Received b
via: U.S. Mail
(37) kW;
Interoffice Mail
CITY OF PALM DESERT
ASSIGNED CLAIM NO . 3 i
CITY CLERK'S OFFICE
PAL 2j DESEPT, CA
2004 FEB 26 P11 3: 12
Over -the -Counter
A CLAIM MUST BE FILED WITH THE CITY CLERK OF THE CITY OF PALM DESERT WITHIN SIX
MONTHS AFTER WHICH THE INCIDENT OR EVENT OCCURRED. BE SURE YOUR CLAIM IS
AGAINST THE CITY OF PALM DESERT, NOT ANOTHER PUBLIC ENTITY. WHERE SPACE IS
INSUFFICIENT, PLEASE USE ADDITIONAL PAPER AND IDENTIFY INFORMATION BY
PARAGRAPH NUMBER. COMPLETED CLAIMS MUST BE MAILED OR DELIVERED TO THE CITY
CLERK, CITY OF PALM DESERT, 73-510 FRED WARING DRIVE, PALM DESERT, CA 92260.
TO THE HONORABLE MAYOR AND CITY COUNCIL, City of Palm Desert, California:
The undersigned respectfully submit(s) the following claim and information relative to damage(s) to
person(s) and/or personal property:
1. CLAIMANT INFORMATION:
NAME c'(e C D e) 13 iz.E \I
ADDRESS
PHONE NO. DOF BIR
SOCIAL SECURI Y NO. DRIVER'S LI EN N+
2. Name, telephone number and post office address to which claimant desires notices to be
sent, if other than above:
3. Occurrence or event from which the claim arises:
a. DATE:
location)
b. TIME: c. PLACE (exact and specific
d. How and under what circumstances did damage or injury occur? Specify the particular
occurrence, event, act or ommission you claim caused the injury or damage. (Use
additional paper if necessary.)
e. What particular action by the City, or its employees, caused the alleged damage or
injury?
Page 1 of 2
4. Give a general description of the indebtedness, obligation, injury, damage, or loss incurred
so far as it may be known at the time of presentation of the claim. If there were no
injuries, state "no injuries":
5. Give the name(s) of the City employee(s) causing the damage or injury:
6. Name and address of any other person(s) injured:
7. Name and address of the owner of any damaged property:
8. Damages claimed:
a. Amount claimed as of this date: $ �v
b. Estimated amount of future costs:
c. Total amount claimed: $
d. Basis for computation of amounts claimed (include copies of all bills, invoices,
estimates, etc.):
9. Names and addresses of all witnesses, hospitals, doctors, etc.:
ID. Any additional information, including police reports, which might be helpful in considering
this claim:
WARNING:IT IS A CRIMINAL OFFENSE TO FILE A FALSE CLAIM! (PENAL CODE 72;
INSURANCE CODE 556.1).
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 upon information or belief as to such matters
I believe the same to be true. I certify under penalty of perjury that the foregoing is TRUE AND
CORRECT. 4.
Signed this ZI' day of kl9rZtQ i�., , 20 `)V, at A// } 1 �, Ci�
�
SIGNATURE OF CLAIMAINT SIGNATURE OF CLAIMANT
Office of the City Clerk, Palm Desert, California
Page 2 of 2
DOC. NO. DATE FILED
"v
On December 7, at aproximacely 645pm as I was driving on Highway 111, I
drove over what appered to be a 100 lb., boulder set on the middle line
of the west bound line at the NW corner of Cabrilloand 111.
As a result of
samaritans out
state escorted
secction on to
in progress it
the accident I became ill, terrified, but there are good
there and a couple that was vacationing from out of the
me and I was able to drive the car out of the busy inter-
Potola I turned right and everywhere was construction work
was night time so workers were not around, but red lines
lined the entire first street that I turned on, so I went to the second
street and parked in the corner. Got off and knocked on the door a man
welcomed me into his house I explained to him why I was shaken he aloued
me to use his cel phone and I call the sheriff my tire had been demolished
by the impact, my wheel damaged as well. The next day I called and explained
my ordeal to the city clerk, she told me that she was going to send me a
claim form and that I was to fill it and mailed back to her when a month
went by and I did not get it I called the City Clerk's Office and the lady
was kind enough to mail me a form. I am enclosing a copy of my CSTRS income
I am unable to come up with more than $500 dollars
I did not get any help from the sheriff he told me
Policy he was prevented from helping me to put the
for the expense.
that because of Liability
mini extra tire that I had,
at least to get home. I was very upset because I am more than aware that if
that accident had taken place in Indio they would have helped me, I walked
over to the A M P M Store and asked several men to help me I offered $15.00
and finaly one person went and removed the shreded tire and place the tiny
emergency tire for me. I am certai that the Sheriff (deputy) was correct but
I was very upset I could have been killed with all the trafic at that hour.
It is my personal policy not to give personal information or my SS on a letter
that may get to you or not. Please call me I am a retired teacher. I asked the
tourist couple that drove behind me for their ifromation but they politely declained
v this is a drawing of the place of the accident. The officer that responded was Mexi n.
4'x line#1 W
114 XXXXmycar W i
v
J
s't11
centerline W
1, West
Please reply at your earliest convenience. I am enclosing copies of 3 documents.
My telephons41111111, has been the same for 15 years.
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W&e/ ( 415,6!-- ‘b•t)`‘ a-`14
Teresa Dobrev
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