CC SR 20161004 F - Edwards Claim against the CityRANCHO PALOS VERDES CITY COUNCIL
AGENDA REPORT
AGENDA DESCRIPTION:
MEETING DATE: 10/04/2016
AGENDA HEADING: Consent Calendar
Consideration and possible action regarding a claim against the City by Charles
Edwards.
RECOMMENDED COUNCIL ACTION:
1) Reject the claim and direct Staff to notify the claimant.
FISCAL IMPACT: None
Amount Budgeted: N/A
Additional Appropriation: N/A
Account Number(s): N/A
ORIGINATED BY: Teresa Takaoka, Acting City Clerk Cid
REVIEWED BY: Gabriella Yap, Deputy City Manager
APPROVED BY: Doug Willmore, City Manager AWL
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ATTACHED SUPPORTING DOCUMENTS:
A. Charles Edwards claim (page A-1)
BACKGROUND AND DISCUSSION:
The claimant states that he was walking from the Los Verdes Golf Course Clubhouse to
his car when he slipped on a painted curb, which caused him to fall and sustain injuries.
The alleged incident occurred on March 14, 2016, and the claim was filed on September
8, 2016.
The City's Claims Administrator, Carl Warren and Company, has reviewed the claim
and advised the City to reject it, due to the determination that the incident occurred
outside of the City's jurisdiction (i.e., on County -owned property). Therefore, it does not
appear as though the City has any liability for the accident.
1
17-77,�
PILE VW H.
CITY CLERICS OFFICE
city of Rancho Palos Verdes
3090 Hawtbome Blvd.
Rancho Poles Verdes, CA 90275
1. Cha ms for death, ir"ry to person or to personal property must be filed not
later than six months of +r the accummae. (Gov. Code Sec. 1111.2,)
2. Claims for dents Wo to real pmpefty must be filed not later Man I year aW
the occurrence. (Gov. Cod* See. 911,2j
3. Read entire claim form before filing.
4.84* Pa" 2 for diagram upon which to locate ptice of vW41dent
6. THIS CLAIM FORM MUST %P- SIS14SO ON PA*fi 2 AT SOTTOM.
a. Aftoah sapamte sheeft, it necessary, to give full details. SIGN EACHSHEET.
Suilniss Address at Claimant City and
or
communications to be sent ragarding Oft claim.
-
RESERVE FOR FILING STAMP
CLAIM 140, _2PL�P-�
RECEIVED
CITY OF RANCHO PALOS VERDE
SEP 08 2916
Wei 1 117, 01
When 014 DAWAUX Or INJUKT 00OUrf Names or any any empWyees Involv*0 in IWVKY or EJANIAuft
Date
_3— It)— 14 Time 4,4tt
if claim Is for Equitable Indemnity, give date I
claimant served with #to complaint
Date I
Where did DAMAGE or INJURY oar? Describe fully, and locaft on diagram on PAgo 2. Where appropriate, give
sb*vt names and address and measurements frown landmarks:
--iLooto LO--, VVAW� �Ajoal
Describe In detall how the DA GE or INJURY ocourred,
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5"TTE4Z—t> &&:F -r f5F#4
-no Ae-M(P, 4Aj-b )�Ks45,
by do y*u claim the city Is ;vs ? --- ---
KIRES! Mm' --Eirty, i , I
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ThIS Claim MuStBo Signed WAI-Q*2
A-1
incurredThe amount claimed, as of the date of presentation of this clalm�, is computed as follows.'
Damages to sv ed prospective damages known:
Damage to pa e expenses for medicalAnd hospital care W4K
Expenses .,. medical and hospital care Future lossof €4
Loss *prospectivedamages
estimateSpecial damages for ...... ....... Prospective general dama0es
Total prospective damages.
General damages
Total damages incurred to M
Total amount claimed as of date of presentation of this claim*
•:, 's: x �.:.:. ;..: - -: a .: � s .: x: a � -. �` -.;*. :.:.
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WITNESSES to DAMAGE or INJURY: List all persons and addresses of persons known to have Information-
xs:
Name-- ddross; --Phone-
-Address--
xyr. -..
DOCTORS and HOSPITALS'
Date Hospltaljzed-�-�,,
",#octor -TJ4 -(a 1-0 Date of Treatment
Doctor Address Date of Treatment
READ CAREFULLY
place
for all accident claims place on following diagram names your vehicle when you first saw City vehicle; location of
Of stroets, Including North, Fast, South, and West; indicate City vehicle at time of accident by *A-1" and location of
of accident by x by showing houses a' s yourself or your b ..at ,,, time 6: the accidentby
�rr distances to street corners. If City Vehicle was "84" and the point of impact by "X.* NOTE. It diagrams
Involved,, designate by letter "N' location of City Vehicle below do not fit the situationN attach hereto a proper
when you first saw it, and by "B" location of yourself or diagram signed by the claimant.
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