Loading...
HomeMy WebLinkAboutClaim #573 - L.Cendejas�1T C REQUEST: CITY OF PALM DESERT COMMUNITY SERVICES DIVISION CITY CLERK OPERATIONS STAFF REPORT CLAIM AGAINST THE CITY (#5731 BY LORENZO CENDEJAS IN AN UNSPECIFIED AMOUNT DATE: January 25, 2007 CONTENTS: I. II. III. Recommendation: Staff Report Responses to Claim Report Claim No. 573 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: HELLE D. KLSSEN, CMC CITY CLERK Approved: CARLOS L. OEGA CITY MANAGER rd k Attachment (as noted) KHEILA R. GIL I IT, ASST. FOR COMMUNITY SERVIC CITY COUNCIL ACTION: APPROVED f DENIED RECEIVED OTHER MANAGER .1.0. MEETING DATE I-A5-Dr1 AYES: 6ensr, Rerruson) Finer-I/1 Spiejtl) Kali NOES: None. - ABSENT: Mcn� ABSTAIN: 10 one,, VERIFIED BY: Diarcl Original on File with 'City Clerk's Office H:1WPdataIWPDOCSICLAIMS1573 reject staff rept.wpd � • �� � �ECEIVED '' C!T Y CLERK'S OFFICE PALM DESERT, CA 20Q6 OEC 26 PM 12� 37 December 21, 2006 TO: The City of Palm Desert ATTENTION: Rachelle D.Klassen, City Clerk RE: Claim . Cendejas vs. The City of Palm Desert Claimant . Lorenzo Cendejas D/Event : 6/14/2006 Rec'd Y/Office : 12/13/2006 Our File : 5-1443037-PMQ We have received and reviewed the above claim and request that you take the action indicated below: CLAIM REJECTION: Send a standard rejection letter to the claimant. Please provide us with a copy of the notice sent, as requested above. If you have any questions please contact the undersigned. Very truly yours, CARL WARREN & COMPANY Ric d D. Mazque cc: CJPIA w/enc. Attn.: Executive Director CARL WARREN & CO. . CLAIMS MANAGEMENT CLAIMS ADJUSTERS .,� �1'(.J 770 Placentia Avenue,Placentia,CA 92870.6832 �.�PY�T� ` Mail:P.O.Box 25180 •Santa Ana,Ca 92799-51 SO ' Phone:(714)572-5200 •(800)572-G9W•Fax:(714'�9G1-8131 f� �/ —�� :'�ATE � • • �� � CITY Of P� lm DESERT , 73-5�o FxEn Wuttrrc DxcvE � - - �� P�.t�t DESEttr, C�.tFottt�tu gi26o—i578 � � 760 346—o6ii F�x: 760 340-0574 info�palm-daert.org � TO: CJPIA (c/o CARL WARREN & CO.), CITY MANAGER, CITY ATTORNEY,' ,�F, ALM DESERT CHIEF OF POLICE, RISK MANAGER FROM: CITY CLERK DATE: DECEMBER 13, 2006 � SUBJECT: CLAIM N�- CLAIM AGAINST THE CITY BY LORENZO CENDEJAS IN AN UNSPECIFIED AMOUNT � The attached Claim No. 573 is being transmitted to you for the following: �il%���II� or ❑ Review and recommendation to the Claims Review Committee for any action required by the City of Palm Desert. We would appreciate your report, if requested, by January 16� 2007� for timely response to the Claimant. or our reference, attached is a co of th� � J � - �����^' �i�1� Y PY � Services befinreen the County of Riverside an� 2� No. C22010). �� � / ' t `s� � RACHELLE D. KLASSEN, CMC � CITY CLERK � Attachment (as noted) i 2/�� ��swrt�� , . �,. .,, CITY OF P�l �l DESERT ' 73-5�o FttEn W,UurrG DxtvE , - -<t PALM DESERT, C�LiFottNt�g2x6o—ZS78 � �60 346-06�[ F�x: 760 340-0574 info�palm-d«erc.org i TO: CJPIA (c/o CARL WARREN & CO.), CITY MANAGE ACM FOR COMMUN{TY SERVICES, PALM DESERT CHIEF OF POLICE, _ RISK MANAGER FROM: CITY CLERK DATE: DECEMBER 13, 2006 � SUBJECT: CLAIM NO. 573 -CLAIM AGAINST THE CITY BY LORENZO CENDEJAS IN AN UNSPECIFIED AMOUNT � The attached Claim No.�s being transmitted to you for the following: ❑ Information only. or to the Claims Review Committee for any action required by the City of Pafm Desert. We would appreciate your report, if requested, by January 16, 2007,for timely response to the Claimant. or your reference, attached is a copy of the current Contract for Law Enforcement ervices between the County of Riverside and the City of Palm Desert (Contract No. C22010). I���� !� S�'�-r� I� RACHELLE D. KLASSEN, CMC J CITY CLERK Attachment (as noted) ��....m.�. , :ac-OT-08 09:14p� FronrPAtM DESERT CITY CIERK T603400674 T-626 P.02/03 F-610 ��� + v� rtaun ut�kh�{ � , f:�C�[ti`�D , , �� � � �. ,. � ;� ;,;. ,,; '�� ' ��-r:'•',..`.. �`10.�SjG D LAfM NO. " CLRIM AGAIIVST THE CITY O� P�TAII l�,� (?F F I C E ' �J i.r:;�:::�_ �:i;�:�-; �. ��. � ��;--L•�.� . (For Damage(s) to Person(s) or Persdi�����n!f�Y�� C A � G , „ „�:^-�:; �,!� -;.. : � 2�05 QEC I 3 P!� 3� 21 06 OEC i 2 �;� �� 2Q - Receive4 by: via: U.S. Mai! 1�teroffice Mail Over-the-Counter CLAfM MUST BE F L OF MONTHS AFTER WHICH THE WCIDENT OR LYENT OCCURRED. BE SUR� YOUR CLAiM I$ AGAINST TH� CITY OF PALM DESERT, NO'C ANOTHER PUBLIC F.NTCCY. WH�RB $pACE TS INSUFFiCIENT, PLE1lSE USE AO�ITIOtYAI PII�EIt AND IDENTIPY INFORMATION HY PARAGRAPH NUMBER. COMPI.ETEp CLAIMS MUST BE MA[LED OR pLLIVEItEp Tp '�HE C[Ty CLERK, CI7Y OF PALM DF,SL[tT; 73-510 FRED W1�lRING DR[VE, PALM DLSERT, CA 92260. __ TO THE HONORARLE MAYOR AND C[TY COUNC[L, City of Palm Descrt, Caiitocni�: The undtrsigned respectfully submit(s) the Lollowing claim and iniormation relative to damsga(s) to persa,(s)and/or personai property: t. CLAIMANT iNFORMAI'ION: NAME Gv,vO�s.-p �,�/� . AQDR PHONE N . ATE O i : SOCIAI. SECUR - -� DRIYER'S . 2. Name, telephone number an0 post vffice add�ess to which clsimant desires notices to ba '. sent, ii other than abovet . �✓• A. 3. Occurrence vr event f�om whlch the clalm arisas: a. OATE: �_4�� ��L.�/G b. T�ME: :3o A•�. c_ PLAC� (ext►ct and speCific location [) ,t vd 7,�/ 7 2- 4 90 � L As�,_,��.c� d�sL.s,�' ,� 9 ZZ�o . ��d. s�g ��� d. How and u�d�r what ci�cumstances did damage or injury oCcu�? Speclfy Thc particutac occurr�nce, everzt, sct oc ommission you claim caused tht injury or dama�e. (Use additiona! papec it neccssa�y.) SE� A�rT.r�rr�t.v�' 3 �. e. What pa�yitular action b the City, or Its er►�ployees, csus t alleged dumage or Inju�y? �, c�jQ�,. _ __-..,..r-�,._...._... _..�, _...,_.--- Psge � �f z 9Z �E E�d £I �30 900Z V� '��i3S:�0 S�ld�! 3�l�.�0 S.4t���� �111� Q��i�3�c� O�c-Ot-OB 09:14�a Fra�-PAIM DESERT CITY CLERK 16�34005T4 T-6ZA P.03l09 F-810 ' � 5rt 3 � k. Glve a ge�eral des�ciption of the sndebtedness, obitgation, injury� damage, or loss incv�ret . so far as It may be known at the time of p�esentatio� of the claim. If there wece �c injuries, state "no injurtes": � �T,v��,,,,,E,��- � �, � S. Giv� the name(s) �of the City amployee(s)causing �the darr�age or inju�y: _F����.�z f� —�Da�,�j yt. 2 S . 6. Na�me and addcess of sny vther pecsonls) Injured� Lrss tsTs (' ,� ,,..f _ /,y�„� ���t,�. G �seall� Ca,e.:w _ �v�d, Dc1..w_ 7. Name and address of the owner of sny damaged propecty: L y�tE,,v�m �e«�e�a f. �� �„e. 8_ Dam�ga3 claimed L.sr .i �.w.✓i�rJ .v.Tk�•r.J.� .�%✓��. a. Amount claimed ss of this dates $G'��iMq,,� Coti�,,,rc.r,� �cti�e �atarf��. b. Estimated amount oi future costs $1voT ,�,o,�„✓ ,�- ,�•,w.,, r,,,,� c. Total amount daimed: $ Nsr t�..✓•� Tx+�s T��+t• d. Basis ior tomputation of amounts Uaimed an uda coplas o 1 a, invoices, estim�tes, etc.�: � � 9. Nacnes and address+es of all witnesses, hospitats, doctors, etC.: _s,�,� ,p�T,�as-�►.s.� 9 10, Any additlona! information, including pollce reports, which might be help#ul in cv�slde�ing thls c1alm: o%a .��a�- ��rN�rJ JT.fT�✓1INY'l ,y,,*.,,�,r„��L .✓ /`� va . !C , '� . WARNIN .IT LS A CRIMINAC FFNSE O FIi.B A FAI,SE CLAIMI PENAL CODE 7� INSURANCE CODE 556.1}. I have read the matters and statements nnade in the above claim, and t know the samt to be t�ue of my own knowiedge, except as to thos� matters stated upon information oc beiief as to �uch mattecs I believe tht same to be true. I ceetlfy vnder penalty oI perjucy that the fo�egol�g is TRUE AND CORRBCT. Signe Is�'�day ��'cel�ri�er" ,20d� , at L'.4Trs t,��C.IL �• T� ,�. � . 51 CLAI I U CL NT Office o1 tf�e Clty Clerk, Pa1m 4esect, California �JOC. NO. �____� DATE PILEO Page 2 01 2 ,� �� �; . t��`/�/t �n,A . �: . � ':~7 �'�r yi�`�t.�"�j `'�.�V`� � � r•;��.s�r� �,:�{i,`i� t� t,�., /\(/ \/ �rJ • ��r,�,l! .. . . I ".S � ntt �./ fl � , _ _ ,. ���� �, � `�,�s , g: �Q o��- o F ��'�� -��-t, C L�� � �,�e �,� , � , 7 � . � `� ��✓d�d�, �� w�.�e . W�� �.��.��� ��� � � � s Q � � �c -�c,c�/c� �`�'�''{ 3 , a S d`�' " 5 a� �` d"P� ,� n� � �h�+.���,5 Q �S !`f c�k� wt ? �� �'v �e �j � � , `� 5 t 5�t-e,l . o�� � � �s �' b�.�,l� . `� ►�.... . � �� Was � ��-�' I � - �,, , � �es�- � � _ � � ��. � �►t/t��-� � � '�2 fo �:� l � � �- ��. �C�.dr �� --�.t< <���,, � � a � �� . ) � a s � !� 1 a5 !� � ��. Ki �'�-� S c�Je�e l � c��,J _- _ � WA.S i� �-�'i (� a �� ' � ����� a ��5 }�.''`� � W� - ��1.0 -�,t} ✓L (�..� �� S � Qo� � c.� �� � �fe ' ( U 5 � << ��e �.'� tT�'�. c't-Sc•�4. � 1 C. �-s �, W « ��,,G,� � / . �� y ��. ���-�., �(�� _ � �� � � �� �� `�' �R-�" c�,r� �s 5 5�� ti,,,, m��- o �- ��...�- �-� , �S -�.' S� ` �� �r w� s ��d � � �. � 0 n8 5� � G�.o� . �„� r r`^�- s� d � C�- �'�,� .� �.i.� l �e.. � � a cr�� row ��1-c-w`� � ,, ��o��l . �Va�-- � .w � V�fj -,�.� � � r ( �^ , �•�� �,�� � ��L11 �� o �O a '� �- . � � �-�... ��� �� � � �Q c�- �� . . �,�� 5 -�� � d��.� � ��u.�. � `� ,� c,��,,.�— �'-��-d'1�,. �,� � °t„� c�,,. , �J G� re�� � l w� ��,. s�a�. � � o�- �rok�,�, � � � f c�- . � �s � ,� � . -t` �r w� c �t � �`'use" t-�--e�l`�e�. ` ► �- ��.5 �� �w.�-- �l� �„� � , �s � �`� C�,� �''� w� �� �� ��� C� C�.. S . � ��4� . � �� ►� o� � � �1�--- �� � �� o w � � nr� w� � GC� '�n 1--k-_ '�' �U � ,�; `� �� � �� S --�,, -�'° --� s � � � , y � _ � � `� � . �. � ...� s � � � ,_ -� �� . -� ._ -� o � � -� - .� � �� � � �, � .� ,� , �-. � ( ,� --�-o , � -� � - .-.�- -o . --�" ,� --� � � � � �� � � � � �� � � � � � -� . ....� a� ,� �, d �.r ,�-°�'° � ,� � � .. � ��, , iQ , � � . � �� � � � � � `� �� r � � , 1� , � � -� --' a � � � � '3� $ � � � � � -_., � ► � � -� �� � � � � � aa. s� � � �.., e� � -- �' , � � � � � � � �- � . ... � � o �' d � _ ��'� � � � � � d c� �. �� � � -� , � � . � � � � � � � � ��_ �, � � � �' U � n� �, � , �` � `'� � � � � C��'� '�-� � 3 -6 . � o � , v � � �" `n � � � � � a � � � ♦ � (� � .� ..� j � � � � � --�. � � ---a� �y�.\, � ►�� , � O � � � � �I `+ V � Q .� � � � � � ��. _s �n � 3 � �,. � � � � � � � � c� � _ .n � v� o "'��' � � � � _.�- � � ,.. �. �.�. � -� �--� � ..._. 3 � � � �, v� � �� �� � . , � � .� . `� , � �, � ,� � o .� o � � � �� � s � � �-� � ._ � ` � � �� .� � �, ��� � � _ _ ,.� � �' � �. �--� ..G.. . �---,� L„ � r..t' -�- _ � q� . R � O� �' �'� �' '".. V v" � � L, D ?--�' a' C�' � � � - �`" --�° 7' �' C���� � �' , .� � � -- ,� � � -. . � ('� `�.� r � �'_ � 3 3 �' 'V � � ~� � � � � �� Lz� t/1 � � � � �' �"� ,,�°' ,�, _ � � o � �. � � � � �� � � ��� � � � � � � � �- � � , � , �. � � t� -� � � __ �' �- v, ��. � � � � � „� �' , � -� � -. � � .�.- � ..� JS •+ cr ' '�- � � w V � /� �'-..► t,' � h �� .. � �� 'U � � � _.9c' ,,,,, �'� �, +n � '� � `�' '"" � � c.r' � 4 , RJ �S� �� J� � � � �, � V1 � . � `o ��" ` � � �...s � .� ,� `'tl � � ` � � � � C.:� �- ' r �- ,� �..�°' vv�► `� �' � � �. �_ �'� � � �► 3 N� � ,.. `� .:� . �. �� � � � �� ----� � � � - � � � o � � Q � � � �, � -� � �� �� -� .._._�, `� �. � � ,. .� � — -� c..� � � � � �� � � � � --. � e� � .� -� � o —�' � �' t � � � � A�` 4-� �( '� � �" �� _.__ � �� �y ` �' �S: � _....> � �/ � � � � S � � � � � � � ,� a � �. ,� -�._.... � . � .� ---� � , . � .� ,e, �? `� j ►� �� o � � --- � cr c,� . -� '� - � ,p -� a � ,� -�-�-- � s� �`t7 � � �� `' , ..s ,� o � 4 �.,. � " `� ��' � �--� �..� -�".� � .� -� � -� ; � � °� � � � ,_ �� � � a . � ._ �. �. �..�.o � 3 � � � �� � � � � � � � � ..�. � � 3 , � � i �����.v v J � l�� 1��� �`' bl.��lc �.�. ��e �,��1 �. � � � � �/ ��u��5� � � w�. �0� �� � �� �N` �I I ( ( � - JV�. �61��'.�/ ��`v'�'-� . �v �.�,l��, C�d � � � e.a� l��t.. �. ��. , �o�c,1�.- , �.� k� � � a�r � �,,n.c� cz�rn S �'�.-� �Q�t'e �i��v.�- ���� • � � u�C'�- i��- l�i � c�i'�^ ��-� �5 � �i��S �l f �,1 �5 � �cTe� rn��e�. � cu.� a,�ea.s � �9 , �` , � (v �' � �.�co�t �;� r���o�t- (�5��i o✓� � � °�t 1 _ �I� C�`C`�c� 2�,J S �,d w`�- � �- (pc�.�1 I.� C�. ,.� r� F�e, � �►�,b� l. -� �U �sz �G.�► QU/Y.�i •, �.-� � �-S �2alV�.� , �.eQ,�ecn � � d� S �.8- , �bu-�-�. �.�d -��.�.; �L1� �� ��. ��- _ / _ �. � ��l� �✓�- � l , � s��� -��-. � � �� � l �ZI�� ��.� ��-� �� � �11� vC.� ,, �v�,� S ,; � �-- � W �a.5 � � �a � �� � ,�� oMe No. DESERT REG�ONAI� M£D CTR 2 3 PAT1ENi CONTROL N0. PILE #571��F ,, . . - LOS ANGEZE i �A 9t��074 5 FED.TAX N0. IJE ;; D. B N�C D. 8 C-I D. 10 L-A D. 11 760-323-650C� 75-269413 0 ` �f �.0' � �' `' 12 PATIENT NAME 13 PATIENT ADDRESS ' � . , �ErroESAs LORErvzo 1.660 s w 14 81RiHDATE 15 SD(16 MS . 7 �;;-:, .; :i: ` 21 D HR ?2 SU1T 'Li M . (� � i • �• i., . }!.. ....�0,. 31 r�t � �i�o6 oz';: 2: i 3 oi 1 !?'-" � it} �5 061406 � LORENZ(l CENLEJAS :"'; ; � a 4 O1 b c d � 02 REK CD. 13 DESCRIPTION 44 HCPCS/MTES 45 SERV.DATE �8 SERV.UNIiS p TOTAL CHAR9ES 48 NON-COVERED GIIW6ES 18 )259 SELF—ADMIIVISTERED DRUGS 061406 4 '71 ZO . . � � �'�'Q:�. . ,.� _ SI;��''+�;:' ., �.;; ,..;.. b1406 # . � 3�t�: 1S )Z72 TERII,,E SUF'PLI£S 061406 1Z 378 92 ���. .,��iil`�,�+��� . f. -.�f...¢{i` .�� .. -t: J.T�✓Q� � 'i� . i+i�`� �f . .. . � � ' .. )300 CI�TE HEP PANEL 80074 061406 1 44 41 ��►��': �� ,-��,;, . . � . . � . ��.�a�< � s:�s ��r." � )300 YLASE 2150 61406 1 65 00 �•: ��;:� . - _ �� . �. '��� f;14�� �:. �' O`0- . )300 �IPA�£E 690 y� 061406 1 92 0�y0�,, �� . . . 4 1'..- }fi�}_4� . . . '��{,SN �� _ . ,r S: • ':�i': .. � ��'r. .�'}R�( ? . . . . _ . . )300 �ROTHR�M TIME 5610 061406 1 31 00 � � .,1q�"h . �w,*�~ .�;' ' . ..k .'�� ��� .... .� � � . . . . i� . ,c . . �a' wi'`q ti ir` .'i .'�"'^.�N ��' )300 ��IV I AE 6701. 61406 1 6 00 �.` K:��� >•'�'.. �'�;;'`';; �`����,� zi, . �, �' � � :����. .. - ,, .. . � >3Z0 PINE CERV 2VWS 2040 061406 1 6Z9 45 � �.� .l�' ��,.���..,���+��.a'�.,v�i�t"����c `^'F� . ���.i�':;. .��+ .. . . . � �� . .. .�r: 3..,a: .. 132� HOLTI.I�R LIMITED 73020 061406 1 3Z2 65. �.�3«. � p. �'�������"���:��•.`s � _ l?� ��'- 1 i " ��� .� .; ►450 RG PRC SGL/MZ 12013 _ � 61406 1 716 10 , ��i �, r s e� � h +" ; 1;,: �" �'�. ""'�f.�..�.� %� mi�-�'_•`' .. . '��. '.��a�s -�r. .y,�i.µ .J'.:> .- ►454 R VISIT LVL N 9284 614_0�+,6�, 1 1247 65 ��i . .��a..�������1..:��' 1'f�,Vl 4y. :��� . �1V�iF J �r- ,:+(e a.. .. . .. . S ��'�. g YR �1`' '6; j _A _.� <':�. . � . 0 PAYER 51 PROVIDER N0. 64 PRIOR PAYMBITS 55 fSL AMOUIif DUE 58 �ELF PAY/LAVIT�iSL1�EL1 C s =�; � ��::a:; , t�,'Y r�^. r,: » . ' �y ��h :i ''� yiyF��`..p�} +�il"��".�+`.' .��,�. �' �, ia , ' °fi?;n., +. t �d N,¢a:� �:`�, G�i .� . ' �. . 's i . .�:4i:�.�`i.�5-:b�� 'r4.. � . :. �}y t �.r,•�; :.;�r. , -::. +�. � ,�' ..:. �: � 6P48� • . .�•. . ... . . . .. . '.. �. .. _�. .... .;.. , _. .. . . -,s� .�. ) �� •I � 8 INSURED'S NAME 68 P. EO C61T.-SSN•HIC.-ID M0. 618ROUP NAME 82 HISURANCE BROUP N0. !EI�IDEJAS LARENZC� 18 :c� .. ' - : . . ..:•. �.��. }.t�: .'� . . ,+,.r . <,,. . . �. :'�.l ..r';��$f. . _ Y. .'�"`t. x s��.,3Fs:r>. . .. 3 TREATMENT AUT}IOHIZATION CODES 85 EMPLOYER NAME 68 EMPLOYER LOCATION 1 YON SPRINGS 9696 RAMON C�ITHEDRAL CIT CR 9ZZ34 . . . . �?�.�a t �kL:uy� ,t : - - ' �. . . � ' . � � � . >�. �...., ,r :;..$, - .- .,. ,: .. ,.. �s aoM.ous.co. n� �e ��ur.aac.co. �. ;. ,._,. 7340 2303 Q500 8499 O 6 i r.c. ,,,, , s1�rr� t�trs-1� C�A 0 3 5 � 659 6X4p6 ". : : '; -- .,� . f�; , aaoni��io' CAG 0534 5 HOF �� '�� C�JBQ �MUL'fI—Pf3� 06/21/06 3V65 PT3 FC70 000 ' ��;fo 6Z81 P920 e� X ' CA EMER PHYS * DESERT RE�IONAL LORENZO CENDEJAS E78 222853 • PO BOX 582663 STE D-78 �a►rnic�svM,�ar�ec�xoaev�sn.�oure�ow• MODESTO, CA 95358-0046 ����D���4�T �i 0 '' cnrm wun� - Kr �� ADDRESS SERVICE REQUESTED .n� F SBtVICES WERE RENDERED AT TF�HOSPITAL, STATEMBdT QR1TE Y THIS AMOUNT PAS DA THIS Bll.l tS SEPARATE FROM YOUR HOSPITAL B�.l.. 07 07 06 748.00 07 25 06 � � � � 3966 LORENZO CENDEJAS MAKECHECK PAYABLETO CA EMER PHYS � DESERT REGIONAL � PO BOX 582663 KODE3T0, CA 95358-0046 �Pbese � ff address or instxance �formstlon has c�enped. Make c�anpes on reverse side. ■ � � ���■�� �� �■ ■ � � � � � ���M� ����� � � � � ������� � � ��� ������ �� �� ��� �■ ■ � � ■� �� ��� ��■ � • � • • • - • • • •- • • • • PLEASE MAI�COPY OF ENTRE PAGE IF MEED�FOR INSURANCE THEREISA�IO.00SERVICECHARGEFORALL RETURNED CHECgS: BILLING OFFICE HOUR3: 8 AM-5 PM Phone ► soo 34o-i�s� Tax ID.#► 942494000 Pa� ESpA?Sol► 1�00-952-8351 Attending Physician ► HOFFMAN, MARK, M.D. Referting Doctor ► HENDERSON, DEBORAH, P.A Account Number ► E78 222853 Service Provider ► CEP DESERT REGIONAL Patient Name ► LpRENZO CENDEJAS Statement Date . o�/0�/06 piATE POS DIAGN0818 DESCRIPTION OF 3ERVICE3 AMOUNT 06 14 06 23 30500 99284 25 LEVEL 4 EMERGENCY, PHYS 291.00 06/14/06 23 30500 99053 SERVICE 10:00PM & B:OOAM 27.00 06/14/06 23 30500 71010/26 X—RAY INTERP CHEST 1 VW 28.00 06/14/06 23 30500 72040/26 X—RAY INTERP C—SPINE 28.00 06/14/06 23 30500 72170/26 X—RAY INTERP PELVIS 28.00 06/14j06 23 30500 73030/26 X—RAY INTERP SHOULDER CO 28.00 06/14/06 23 30500 12014 LAC/SIMPLE 5.1-7.5 CM 318.00 PAYMEN OF THIS ACCOUN IS YOUR RESPONSIBILITY. IF YOU HAVE INSURANCE, PLEAS CONTACT THIS O FIC . THANK YOU EL PA A STA CUENTA S SU SI UD. TIENE SEGURO MEDICO, POR FAVOR LLAME • � � • - • • � � •� � • ���� INSURANCE ���DATE ADMISSION DATE DISCF�AR(iE DATE BALANCE DUE ** SELF PAY/NO INS 06/14/06 748.00 POS (Place of Service Codes) � - Inpatient Hosptta� 2 - OutPetisnt Hospital S - Doctor's OtBce 4 - Ernergency Roam QASIS RADIOLOGY GROUP PO BOX 5850 LA QUINTA, CA 92248-0000 STATEMENT DATE PAYMENT DUE gy p(;CpUNT Nl�p Phone Number: 760 322-5124 ��31� 08/30/06 18594812 ��T� sHow�ourR $,s�.vo PAID HERE s LORENZO CENDEJAS OASIS RADIOLOGY GROUP PO BOX 5850 LA QUINTA, CA 92248-0000 � �....a,.a�eox n.ad�...w ino«,.oe a w�.�..�o.r,w�ew� w....awa�Mw r.a�m uw.po.non.�nn p.�. n..an.no.a.nd xao.e.on.npK.)on nvws.da.. ACCOUNT NUMBER: 18594812 � 1 -INPATIENT HOSPITAL 2-OUTPATIENT HOPSPITAL 3-DOCTOR'S OFFlCE 4-PATIENTS HOME 5-NURSINO HOME 8-OTHI 06J14/06 1 LORENZO O 70450/26 873.40 CT HEAD/BRAIN W/O CONTRA gp,pp O6/14J06 1 LORENZO O 71010/26 786.50 XRAY CHEST 1 VIEW 20,0p O6/14/06 1 LORENZO O 72040/26 349.9 XRAY C-SPINE 2 OR 3 VIEW 25,pp 06/1M06 1 LORENZO O 72170/26 349.9 XRAY PELVIS 1 OR 2 VIEW 20,pp O6h4/06 1 LORENZO O 73020/26 729.5 XRAY SHOULDER 1 VIEW 20,pp + .00 165.00 .00 .00 .00 7/31/06 �165.00 1 CORD,JASON M.D. YOUR PROMPT PAYMENT IS APPRECIATED.IF YOU HAVE 2 ANY�UESTIONS ABOUT YOUR ACCOUNT,PLEASE 3 CONTACT OUR BILLING OFFICE. THANK YOU. 4 For Blllfng OASIS RADIOLW3Y QROUP Phons NumbK: 760 322-6124 Qusstlons: PO BOX 6860 Tex ID Number: ZO-1928810 LA QUINTA,CA 92248-0000 •���� '��� ..��..�,.w.���.�w . r�nn�n� ���.._ •�n.n�.rv�nnnn 0......�.J� MIA �J�/"'� • vtru� -� 1 �y \ � � �,l � �-a �� � , � � , 06/21/06 09 : 51 PAGE 1 TREATMENT FOR: CENDEJAS,LORENZO PAT NO: 0021680 0 SAFEGUARD CAP 0058 CP CAP ACCOUNT 06/21 50 $0000 TTA DATE DR TR# B DESCRIPTION T# SURF UCF PRIM SEC PATIENT --------- -- ---- -------- -------- -------- -------- 250 50 637 IN-OFFICE BLEACH 550 . 00 295 . 00 260 50 647 COMPOSITE ANT 4+ 10 NIDFLI 320 . 00 270 50 649 PORCELAIN VENEER 10 1000 . 00 800. 00 -------- -------- -------- -------- 1870 . 00 0 . 00 0 . 00 1095. 00 , �; - (�. A ir '�� ��i; � � _ t ... i�i i i . ...., . � (/►" �• � �� � �/�� /� �!. "�' � ''��'� I.. �•1� V ��- vW` r ' .'�. .. . .i j . � � - Q6 DEC I 2 i i't 8' :C� `�1�Q,, -E��55��, ^ r ��f CSZ- p� �� (,�, -_ _ 1 � ��-t , ��� r1b�'� G�p�. � � �'�^fy�� , P�VL S -n✓ �- - `��-- G� f �.Q.. a C�S� � -� �� � � ,� 5 � , o � s t �! �,,/�. I o� Q ��s �, ��, � . �� `�( (�-� �� ��-d ��b a `� v� w�c'`�►,�'�` . �-���ac.� � — � 1 � "��.5 � W Q.5 o ri �.i v,, i � �c,,, � �.. �p .. � �^' � �- �C�o�� -�!�/'e� ��w�� a-�- t�u2 Q. �Q ��. � � . Q �S i e�.� ��c i.�Oi�f ` Q c� �.�. �l�•.e.. � ��� ��nn�. .�,,� uva5 ar � � . i'"�Q.� �C3✓7 �Z?f !J� � � s�-� �i � . � �v'L � r5plrn n I � �� e 'r� . � � 1 ���-s � �.` 6�.�.,Ic, � �..�-- 5� . o --�- d.�. � � �,��n ��e� �o,r � (= . � � � �.� a.�d. !s�-�-�- w�.. s�w� ,�„� - � � . � (�x-�, �C�. � -� s�-, < < �,� C� � ,�. � . }� v �x�o�� c�,CC � � � � � � �d�-s �� co��e�,,� ��-�. �- � �o��,, � � r � 5, � � � �-�, �� �o� � �-� �( gs�� ,�¢,�,�- �,l � , ��s� h�� � �1. � 0� b��(', � ,� � �� �� . � S � � �v�e ,r � ev�a�we� � �- ��� � �-d � �� . Qc�;s , . � �� � � � �� � � � . �� � sC�`o0� U�(�.S w � � -� � �c Q � � -�.w� � �. I�� � C�- ,� �� �� Y � �,�,�r, ,� � co � � � � � �- � �-r�-c r � ��� ��► 5� � �Qs o n. ��-c� � 1� .� / t � �/ - ` �� � �� �� - ��v� , J�n.� l 1�,,� . �,p.w �v 1��5��✓1 - [ Ck� � G- W ► l � ��,5 ��� �`v �• �;� �. o� � -Y l /`� I�r�r . I � 'J _v� � 1�� � J �G.� ��.�. l`���� ��r �J' � � l� r (� � Q o ti�-�- �- d� �5 �e. b. a�. , b�.-� a� I �� ����� 6���� . . � a� t ��,u� �� � �c� ,� �rGbna. ��I s.�� �a;,.e 1.� �-v -�,� ` 1 � �_ . a�-d -�e,�, r� � ^- ��,l��oc�� '(�.� r-�+C_ �j � 1 �J ^�` • C' � �, � 1 � � � � T' - r•...� � � � � � � � � � � � �, � �- � � � , � � � r r� � � o � � — � � � � � � ��- -� ' . �� �� �� � � � � � � , y/�' N ��'\J ,.,.. � � � ' '�w \ � r/ _ F �.. � � , , � � � �-�- � �..� � � : 1 � s� � � � � c� � �. �a � � -- , �, .�� � � � � � � � _...._ , , � � � , � �— .� � - . � � � � �' � . � � � � ' � �, � � � � � � w � � � � � � � � � � � � N � � � � � � � � _ . � � , - �t �C ���� °I G 1 �V Y �D\ ��1 � ' � � �'r C� � � Z23� (�,�. �.�ba.� �' S�. � CG���r� � - / T I C� • �2�3� -� e ' r�-�s S ��.� ����s . �� �,,��,, ,-�� . ���Yi C�� Y v�. kP'l�-Z - �- t� o�-� �� � lv � QI� � c�.l c�� 5 ( �a�1 �C� se� � � �v� s !,� I �,/ C � � � � -•�• ���+�41 � �fi •�(W � r �, C�n�,,/ — F-��'e�I' �-� � ��s S ( r , 5 I p v�.�5 i �,Q� �c�,i�-I` 'C'V� �1 C�c� S " C'��S r� -� � �1�k.� �C�t O � - n��,/ a�-t� � � c� /`e S 5 c.�- av` f� t,t,,eS�" - . . � � . �-�• � � c�a,�� G� � i 1�-� - 9 .� �� C �,� 5 C�- � � � . �� � Q�d�s 5 ��.� ��� �.��.�� �. s�--1 �� �� �1 d � . � �,, l 1 �.C.,�. c�- �t�-�-� ;� � � �e �..�,�s �P � � � he. �,�} C l�.I� Q s� . � �'� c� �-1. � �Q(N,. s�,� �4- . ��c����� °1 �c,�/k �—o i� � �,r�.J �� . �� , r c?� N - _ v�.c�;�-✓► c�-r N a ( � � �; 5 � l � � � . c� 2� . � �� c� ���� ���� � �.� -�v� �. �Q �,, ��, �� �� . $� .� c at c� . q ZZ3 � �r . Q�.dl� � �� - ��r - � � b � _y 7��.1 �1,c� Q�t�.. �s�-�� C� . �'22c�� � c��c,"� �c�.� - �f R 3� �i4��� K-�1ia` �fac�.P I Q�c� '���C S� � ��; wc�,� c�. �zZ�t� �c�� ,��Q�/1 � �f�5c�► ��r �S �l�tg,�- �►�-�e � � � G CC� � `�223`� . ������� �� , , ., December 11, 200C On the day June 13, -(�u6, my fiancee Lorenzo Cendejas and I were out with some friends. We had decided to �o to the club Red 74, to celebrate Lorenzo's birthday. We were all in couples and �����rc having a good time, everything was going well! , It was about 1:30am the cluh ���as �bout to end so we decided to leave. We all headed out towards our cars, whc» a coul�le ol�guys approached Lorenzo and his friends. The crowd started getting bigger; s��me ho��- Lore�i�o �vas able to move away from that area, because I saw him standing by himself'un thc side, when out of nowhere a guy stabbed him on the head. By then evci•ything was happenin� sc� fast. Unknown police of'ficers came into the scene immediately striking I_c�rcnzo and throwing him on the ground, and then they tried to control the crowd. l.issette, I_orcnzo's si�ter and I were pushed by a female off'icer and Lissette was struck numerous times to hcr back. I,orenzo was detained had two officers on his back ancl was still being fiit. He reccived hits to thc head and body. I had noticed Lorenao's pants had bcen pullccl down, exposin�,his buttocks completely. I asked and pleaded for them to st�p heating him and pull his pants up, they did not listen instead told me to step away or I to would �,et �irrestcd. The crowd started to get disturbed by the unnecessary amount of force they were using against Lorenzo. They all also asked to have his pants pulled up, the ot'ficcrs appi•oachecl the crowd and with no warning mazed the entire crowd, we were all forced to leave the scene after that. 1 drove to the neazest gas station with some 1'riends to clean thc maze f'i•om oui•bodies and face, we then returned to the rlubs p,u-king lot about 15-20 minutcs latcr to find Lorenzo on the floor in the same position he had becn. Latcr that morning I was able to see him at the hospital and take him homc injurcd. Yolanda Cruz ���� �� . � � RIVERSIDE COUNTY SHERIFF'S DEPARTMENT ,���N'��''�'f� PQ►4flA DESE�FI','��S�;ATION O NAR��l1/E O� i y?' 'L�REPORT '� � � . - • i- �S {.. . .�4 �.. / . . . . .. __ �� Subject: 242 P.C., 647(fl P.C. ��i �E� ; 7 ��i`� $� ?� Dep. M. Williams#3868 Page �,F �� Case#T06165005 1 Subiect 2- Hisaanic Male Adu1t in his mid 20s, aAArozimatelV 5'10". annroximate�v 2 220 lbs., Iong black hair. He was wEaring a tan shirt and daiic nants. 3 4 Subiect 3- Hisaanic Female Adult in her mid 20s, aAnroximately 5'04"-5'06". 5 approximatelv 1351bs. She had long black hair with light streaks. She was wearing 6 a black shirt and black uants. 7 8 Benitez could not provide any further information. I then spoke to Dante Nunez, 9 a Red 74 security employee, who told me the foliowing: 10 11 During the course of the night inside the club Nunez had observed both GonzaIez 12 and Cendejas. Nunez had spoken to Cendejas inside the club, and Cendejas was there 13 celebrating his birthday with his friends and their girlfriends, approximately ten people in 14 all. Cendejas and his friends were very polite, courteous, and non aggressive. Nunez 15 also notice that they kept to themselves the whole night and did not bother anyone inside 16 of the club. 17 18 Nunez and several other of the security personnel were watching Gonzalez 19 throughout the night. Gonzalez appeared to know one of Cendejas' friends, and appeared 20 very agitated. Gonzalez kept staring at Cendejas' group and appeared to be trying to 21 provoke someone. 22 23 . As the club closed Nunez walked outside to maintain control of the patrons as 24 they walked to their vehicles. He saw Gonzalez walk to a black caz in the north side of 25 the pazking lot in front of the Morgan Stanley building. Gonzalez appeared to have met 26 up with three individual who were waiting for him. The three individuals had not been 27 inside the club that night. 28 ���� � �.�� � R r..� . u� � � t � RIVERSIDE COUNTY SHERIFF'S DEPARTMENT PALM DESERT STATION '� .; NARRATIVE OF INITAL REPORT Subject: 242 P.C., 647(� P.C. Dep. M. Williams#3868 � Page f U G F �� Case#T06165005 1 Cendejas and his friends then exited the club and began to walk to the north side 2 of the parking lot where their vehicles were parked. At approximately 4142 hours he 3 heard a loud commotion to the north of.the club. Nunez looked towards the noise and 4 saw several people fighting. An unknown witness later told Nunez, that Gonzalez and 5 the three individuals he linked up with at the black caz jumped Cendejas. Nunez could 6 not provide any further information. 7 8 During the course of the investigation Deputy Anderson and I were unable to 9 determine if a 245 P.C. (Assault with a Deadly Weapon) had occurred. Since Deputy ' 10 Anderson and I observed Cendejas and Gonzalez fighting each other, we asked them if � � 11 they desired to press chazges against each other with 242 P.C. (Battery). Both Cendejas � 12 and Gonzalez refused to give us a definitive answer, and were extremely uncooperative. ;; 13 Both Cendejas and Gonzalez expressed that they wanted to settle their differences 14 between themselves. Therefore, Cendejas and Gonzalez were arrested for 647(fl P.C. 15 (Public Intoxication). Due to Cendejas' injuries he was transported to Desert Hospital for 16 medical treatment. Deputy Chlazson followed Cendejas' transport to the Hospital due to 17 his combative nature, and later released him and provided him with an 849 form, due to 18 medical reasons. 19 20 Officer Maloney then transported Gonzalez to John F. Kennedy Memorial 21 Hospital in Indio for medical treatment. Officer Maloney then transported Gonzalez to � 22 the Indio Jail, where he was booked for 647(fl P.C. (Public Intoxication), 23 24 Refer to the attached Supplemental Reports for the actions of each Deputy . i 25 involved in this incident. A copy of this report will be forwarded to the District 26 Attorney's Office, seeking prosecution against Cendejas and Gonzalez for 647(� P.C. �I 27 (Public Intoxication). I am also requesting a review in regards to the 242 P.C. (Battery) 28 charges. This case will be closed by arrest. 29 CASE STATUS: ARR �� � yl �� � �� �. � ,��p �; �: