CC SR 20150721 E - Claim Against City Jeremy DivonaCITY OF NCHO PALOS VERDES
MEMORANDUM
TO: HONORABLE MAYOR AND CITY COUNCIL MEMBERS
FROM: CARLA MORREALE, CITY CLER<O,
DATE: JULY 21, 2015
SUBJECT: CLAIM AGAINST THE CITY BY JEREMY DIVONA
REVIEWED: DOUG WILLMORE, CITY MANAGER Wt -J
RECOMMENDATION
Reject the claim and direct staff to notify the claimant.
DISCUSSION
The claimant alleges that on December 9, 2014, his vehicle (motorcycle) was traveling
northbound on Palos Verdes Drive West at the intersection of Rue Beaupre, and
another vehicle was traveling west on Rue Beaupre and failed to yield to the claimant's
vehicle, causing a traffic accident which resulted in injuries and property damage.
The City's Claims Administrator, Carl Warren and Company, has reviewed the claim
and advised the City to reject the claim. Liability appears to rest with the claimant
and/or the driver of the other vehicle; the City's liability is doubtful.
Attachment:
Claim (page 2)
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FILE WITH: CLAIM FOR DAMAGES
RESERVE FOR FILING STAMP
CITY CLERK'S OFFICE
City of Rancho Palos Verdes
CLAIM NO. '2015 _21
30940 Hawthorne Blvd. TO PERSON OR PROPERTY
Rancho Palos Verdes, CA 90275
RECEIVED
CITY OF RANCHO PALOS VERT
TM
INSTRUCTIONS
1. Claims for death, injury to person or to personal property must be filed not
later than six months after the occurrence. (Gov. Code Sec. 911.2.)
JUN 0 S 2015
2. Claims for damages to real property must be filed not later than 1 year after
the occurrence. (Gov. Code Sec. 911.2.)
3. Read entire claim form before filing.
4. See Page 2 for diagram upon which to locate place of accident.
5. THIS CLAIM FORM MUST BE SIGNED ON PAGE 2 AT BOTTOM.
6. Attach separate sheets, if necessary, to give full details. SIGN EACH SHEET.
TO: CITY OF RANCHO PALOS VERDES
Gate of Birth of Claimant
Name of Claimant _
Occupation of Claimant
Jeremy Divona
Home Address of Claimant City and State
Home Telephone Number
BE+sines Address of Claimant City and State _
Business Telephone Number
Same Same
Same
Give address and telephone number to which you desire notices or
Claimant's Social Security No.
communications to be sent regarding this claim:
Cohen & Marzaban Law Corporation 16000 Ventura Blvd.#701 Encino, CA 91436
When did DAMAGE or INJURY occur?
Names of any city employees involved in INJURY or DAMAGE
Date 12/9/2014 Time 3:20 p.m,
Pending Investigation
If claim is for Equitable Indemnity, give date
claimant served with the complaint:
Date
Where did DAMAGE or INJURY occur? Describe fully, and locate on diagram on Page 2. Where appropriate, give
street names and address and measurements from landmarks:
Palos Verdes Drive West and Rue Beaupre in Rancho Palos Verdes, CA 90272
Describe in detail how the DAMAGE or INJURY occurred.
Claimant vehicle traveling north on Palos Verdes Drive West at the intersection of Rue Beaupre.
Other vehicle traveling west on Rue Beaupre failed to yield to the Claimant Vehicle, causing a traffic
accident which resulted in Claimant's Injuries and Claimant's Property Damages.
Why do you claim the city is responsible?
Due to the negligence of the City of Rancho Palos Verdes, City of Rancho Palos Verdes Department
of Transportation, City of Rancho Palos Verdes Public Works, and its employees for failing to post
proper markings and signs on Rue Beaupre & Palos Verdes Drive West which caused a traffic
accident and resulted in claimant's injuries and claimant's property damages.
Describe in detail each INJURY or DAMAGE.
Injuries include but are not limited to fractured pelvis requiring surgery/hardware, right knee requiring
surgery/hardware, fractured left leg requiring surgery/hardware, neck, shoulders, arms.
This Claim Must Be Signed on Page 2
2
)ES
The amount claimed, as of the date of presentation of this claim, is computed as follows:
Damages incurred to date (exact):
Estimated prospective damages as far as known:
Damage to property ............. ..... .
$ Pending
Future expenses for medical and hospital care,
$ Pendky
Expenses for medical and hospital care ...
$ Pundiny
Future loss of earnings ............... . ... . .
$ rtes -d -o
Loss of earnings ............ . ... . .....
$ ('ending
Other prospective special damages ........
$ Pending
Special damages for ................ . . .
$ Pending
Prospective general damages ...............
$ Rtvx Q
Total estimate prospective damages.......
$ Panding
Generaldamages ....... ........... . .
$ Pending
Total damages incurred to date ........
$ Pending
Total amount claimed as of date of presentation of this claim:
$ Greater than $10,000.00, Unlimited Civil Case. Govt. Code Section 910 (t)
and Cahfomia Code of Sections 85 and 86.
Was damage and/or injury investigated by police? Yes If so, what City? Los Angeles Counly Shefiff Department
Were paramedics or ambulance called? Yes if so, name city or ambulance Los AAngales County Plre Department Paramedlcs
If injured, state date, time, name and address of doctor of your first visit 12/g/14,4:00 p.m., Hafbor U C.I. A Hospital 1000 W. Carson Sl, Torrance, CA 90502_
WITNESSES to DAMAGE or INJURY: List all persons and addresses of persons known to have information:
Name Pending Investigation Address Phone
Name P -di np rrwanrlgcraa,:a Address Phone
Name Pending investigation Address Phone
DOCTORS and HOSPITALS:
HospitalHarborU,CLA Hpspllal Address 1000 W Carson Sl. Torance,CA90502 _Date Hospitalized 1219/14
Doctor Pending _ Address Date of Treatment
Doctor Pending AddressDate of Treatment
READ CAREFULLY
For all accident claims place on following diagram names your vehicle when you first saw City vehicle; location of
of streets, including North, East, South, and West; indicate City vehicle at time of accident by "A-1" and location of
place of accident by "X" and by showing house numbers yourself or your vehicle at the time of the accident by
or distances to street corners. If City Vehicle was "13-1" and the point of impact by "X." NOTE: If diagrams
involved, designate by letter "A" location of City Vehicle below do not fit the situation, attach hereto a proper
when you first saw it, and by "B" location of yourself or diagram signed by the claimant.
SIDEWALK
CURB,,.., CURC3—+
G�PARKWAY M...e...�.._._
SIDEWALK
Signature of Claimant or person filing on Typed Name: Date:
his behalf giving relationship to Claimant: Bob M. Cohen Attorney for 06/08/2015
Claimant, Jeremy Divona
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