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HomeMy WebLinkAboutClaim No. 540 - Linda Grant\1L CITY OF PALM DESERT COMMUNITY SERVICES DIVISION CITY CLERK OPERATIONS STAFF REPORT REQUEST: CLAIM AGAINST THE CITY (#540) BY LINDA GRANT IN THE AMOUNT OF $1,000 DATE: June 23, 2005 CONTENTS: I. Staff Report II. Claim No. 540 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: RACHELLE D. KL SEN, CMC -" SHEILAR. G LIGA ST. CITY MANAGER CITY CLERK Approved: CARLOS L. ORT.•' A CITY MANAGER rdk Attachment (as noted) FOR COMMUNITY 'VICES/P.I.O. H:1WPdata'WPOOCStCLAIMS'540 reject staff rpt.wpd CITY OF PALM DESERT ASSIGNED CLAIM NO. CLAIM AGAINST THE CITY OF PALM DESERT (For Damage(s) to Person(s) or Personal Property) RECEIVED CITYCLERK'S DES FLDESERT, CA Received by: 2 fOy NOV 16 PM 12: 35 via: U.S. Mail Interoffice Mail Over -the -Counter A CLAIM MUST BE FILED WITH THE CITY CY.ti(K Or' i rlt CITY OF PALM DESERT WITHIN SIX MONTHS AFTER WHICH THE INCIDENT OR EVENT OCCURRED. BE SURE YOUR CLAIM LS 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 /_!NDI4 6-f-f itJr ADDRESS ImbilmEr PHONE NO. DATE OF BIRTH: SOCIAL SECURIT . DRIVER'S LIC N E NO. 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: CI 1X- iok/ b. TIME: e, t c. PLACE (exact and specific location) (3.2loc,. oU±-12 1221C9Pr't7.a C' AL. 6E'rwt- ! S loAsc,0^re- C' ery p' qa t 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 nece sary.) l�► GKini Cr-1-0 PPv2 K Derr. 1-4-ariE, 132., Q 6 c . 'Fo o ► /1 of ,J nv Loop p' f\--A C.Aus i M E' -ro T2Y To (,., f it N mY ,, Nz-RNc c F0 2 em 4,cct- -� t - ST1z( D e`S A-7 /b l,U4-ttii !,I iv;i Le -a)E N 4 2,b�g-A��ti -rec. . G {r , S £'O LA) Al O11/4?1D 5 i P c1,cl�Yt.- K, FAA -cm, . 2tAr G- e. What particular action by the City, or its employees, caused the alleged damage or injury? UNSc i Lt.KSRi OBE age 1 of 2 L �1T $ 4-1--0U t- D o'Z, tSk•U L S i Av Cr 4- SGe faarv1 L E-Pr N.O, A 1G1T ttit) R 1(rt4-T I ND. 4. Give a general description of the indebtedness, obligation, injury, damage, or loss incur so far as it may be known at the time of presentation of the claim. If there were injuries, state "no injuries": Situ L tl oc. rkpe-RA g G- ; t,D S s erp1t1 calyx e t u t 01/4.4t I C, i TO wore 1C , C'.9c7-5 t✓o12 n1 C;�701CA-f. 4 PN-yc [GR2, -r4e-72, rr°`f 21A (set K'a! cs . 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: $ i a1, cf'c! b. Estimated amount of future costs: S --`1 a. 1 ! c. Total amount claimed: S 1 C90 O Do d. Basis for computation of amounts claimed (include copies of all bills, invoices, estimates, etc.): S Et A r nke L (-L-13 9. Names and addresses of all witnesses, hospitals, doctors, etc.: ill Art.k C-reserk si rnc.C��,L q 1,04/-1 f oitrb A A11 jo, NAft.rrr J3 zT P.�} G....f,0 S-r IA At.-- ()Ar .r 13Ali D2 1'p1 -s, b0 C—R i �z� n►�r+v: rwD, er g 1 bA.CAILIZEDAI iu at 0, CA 'I aa: v/ 10. Any additional information, including police reports, which might be helpful in considering this claim: WARNING:IT LS A CRIMINAL OFFENS[ 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. ,1 Signed this 14 day of % / o1 6 c �2. , 20 v 9, at �/,}c�y,, E! ES , SIGNATURE OF CLAIMAINT SIGNATURE OF CLAIMANT Office of the City Clerk, Palm Desert, California Page 2 of 2 DOC. NO. DATE FILED