HomeMy WebLinkAboutClaim No. 550 - Karen Wilkinson1L E
CITY OF PALM DESERT
COMMUNITY SERVICES DIVISION
CITY CLERK OPERATIONS
STAFF REPORT
REQUEST: CLAIM AGAINST THE CITY (#550) BY KAREN WILKINSON IN AN
UNSPECIFIED AMOUNT
DATE: June 23, 2005
CONTENTS: I. Staff Report
II. Claim No. 550
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:
RA HE LE D. KLASSE
CITY CLERK
Approved:
CARLOS L. OR
CITY MANAGER
rd k
Attachment (as noted)
, CMC
(
/SHEILA'. r fL�(GA , ASST. CITY MANAGER
FOR COMMUNIT S RVICES/P.I.O.
H:IWPdataIWPDOCSICLAIMS1550 reject staff rpt.wpd
May-08-05 12:44pa From -PALM DESERT CITY CLERK
T6034005T4
T-388 P.OI/02 F-082
CLAIM AGAINST THE CITY OF PALM DESERT
(For Damage(s) to Person(s) or Personal Property)
Received by: ✓224 Vafdne0._
U.S. Mail Interoffice Mail
• CITY OF PALM DESERT
.unJiv
RECEIVED
CFI T AS5LS14E AIWISIOF
-/ipd. PALM DESERT, CA
Z1105 MAY 17 AM 8: 36
Over -the -Counter ✓ .
A CLAIM MIDST BE FILED WIT Tip CJCY CLIERK U THE elTY 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-SIO 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 i Y
ADDRES
PHONE NO. {,� DA • F BIRTH:
SOCIAL SECU I O. DRIVER'S LICENSE NO.
2. Name, telephone number and post office address to which claimant desires notices to be
sent, if other than above:
S6 - �S 4boVe, Q4o, (Lim U/vr kAt-
760— 771
3.
Occurrence or event from which the claim arises:
DATE: VAC1 V -/, fit b. TIME: 4- t� i5 . PLACE (exact specific
locati l s; ) S(a j' t, P.;GS� -� •\--r tO
a.
�. 1..:. C A -A, rope ial)
t Al fit14.7 P Y SArt- d h\ - U . k' I. _ rip r S c` (Gi b•
What particular action by the City or its employees caused the alleged damage or
injury? I -'Z '- 1S E.' ' : Go1�1 kCA►N rS; -f-J -teev SXc'Al4
•r p t- k N set \ �, (Gt* c 2p. S' Sr. Oo r-S �` aA,A *- irtB i✓ ,
�-� -�l o 4 r i. r r t ri fidni v - O"
N Ajx .�i tN ;NC Y i
cie - Cat, tairal-' G 0i J
How and under what circumstances did damage or injury occur? Specify the particular
occurrence, event, act or ommission you claim caused the injury or da age. (Use
additional papeq,r, if necessary.) (' y tY t.L G k., (A/as. 'Q4 i X@-d ci dI t ive,
SA yy )Ci 4 C, /t/ t 9 4"2'V L I Cirriei tar,
Page 1 of 2 E
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iveduPY
bit ¥fW Ar hear
May-09-05 12:44pm From -PALM DESERT CITY CLERK
T6034005T4 T-368 P.02/02 F-092
t-
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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 he claim. If there were no
injuries, state "no injuries": �¢�i Atin.-r ' a\Al+ i S-
S C� Yes k .be Ci—ldzv o Q _� 7V t S APPI r nil ym
psi . VLkie62 �� 4At
11►'its � �- 1hj�S GVO i �1�P
5. Give the name(s) of the City employee(s) causing the damage or injury:
.f. . C t i-'y C'3 ► ally/ ?-y1gill t
6. Name and address of any other person(s) injured:
. %1J 'j`ei
Aio eadplovC,e
7. Name and address of the owner of any damaged property: jLiA) (j,+l 1 i /1/. .i1)
3 e4&
8. Damages claimed:
a. Amount claimed as of this date:
b. Estimated amount of future costs:
c. Total amount claimed:
d. Basis for computation of amounts
estimates, etc.):
claimed (include copies of all bills, invoices,
9. Names and addresses of all witnesses, hospitals, doctors, etc.:
ihii ►e.SS
<An8(ij;Wi/ riv
10. 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
CORRSignedEth s. % '•day of , May, 204� at \ t^ ) C .
SIGNAT RtE OF CLAIMANT
Office of the City Clerk, Palm Desert, California
Page 2 of 2
SIGNATURE OF CLAIMANT
DOC, NO. DATE FILED