RPVCCA_CC_SR_2012_06_19_F_Claim_Against_City_ShullCITY OF RANCHO PALOS VERDES
TO:
FROM:
DATE:
SUBJECT:
REVIEWED:
HONORABLE MAYOR &CITY COUNCIL MEMBERS
CARLA MORREALE,CITY CLERK~
JUNE 19,2012
CLAIM AGAINST THE CITY BY J.ROBERT SHULL
CAROLYN LEHR,CITY MANAGER oSl
RECOMMENDATION
Reject the claim and direct staff to notify the claimant.
BACKGROUND
The claimant alleges that he was walking uphill from the asphalt path when he slipped
on dry pine needles which resulted in him falling and injuring himself.
The City's Claims Administrator,Carl Warren and Company,has reviewed the claim
and advised the City to reject the claim.
Attachment:
Claim
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~~~~t1':K'S OFFICE CLAIM FOR DAMAGES
City of Rancho Palos Verdes TO PERSON OR PROPERTY30940HawthorneBlvd.
Rancho Palos Verdes,CA 90275
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.)
2.Claims for damages to real property must billled 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 CHO PALOS VERDES
J.~.sA4(
Name of Claimant
GE or INJURY occur?
Time I lCJ 1M
If clal,.;.m"-l15.ols....fooo-lru.-.qf.=lita~blJ..e.L..lndemnity,dlve d-ate
claimant served with the complaint:
Date
RESERVE FOR FILING STAMP
CLAIM NO.a.0Lo\'"ol
RECEIVED
CITY OF RANCHO PALOS VERDES
MAR 05 2012
CITY CLERK'S OFFICE
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:
H<..~~e.-Pt.tvJ(.·-To t-1'1 kt of'v.::a.f kw~~0"1
H-",~e.s.0
Describe in detail how the DAMAGE or INJURY occurred•
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o ..."_d b 'r ---E r-t..Et..f\~c..J {e.s ..po.({,..:.,
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General damages •...••••..••...•.••.•.$:.....-_
Total damages incurred to date •.••••.•$I\,)!1::>00
Total amount claimed as of date of presentation of this claim:
The amount claimed,as of the date of presentation of this claim,Is computed as follows:"'S
Damages Incurred to date (exact):Estimated prospective damages as far as known:~
Damage to property ••••••••••••••.•••••$Future expenses for medical and hospital care.$,..:,:...-__
Expenses for medical and hospital care ..•$Future loss of earnings ••...•......•..•...••$'_
Loss ofearnings $Other prospective special damages $,_
Special damages for $Prospective general damages $,_
Total estimate prospective damages $ _
WITNE~!tto ~AGE or INJURY:List all persons and addresses of persons known to have Info
Name ~~!I'r Address Phone
Name Address Phone,_
Name Address Phone,_
DOCTORS an~H()SPITAI;~_,.'f',.,j,~::r~~al~it1nLtt;'fb~X(J :::~:::'------------~g::~;~~~=~:~tY'J*(W)W ({
Doctor Address Date 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 "B·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..
CURBJ
SIDEWALK
CURBT
Signature of Claimant or person filing on
his behalf giving relationship to Claimant:
PARKWAY
SIDEWALK
Typed Name:
.-
\..
\
Date:
NOTE:~LAIMS MUST .BE FILED WITH errv CLERK (Gov.Code Sec.915a).Presentation of a false claim Is a felony (Pen.Code Sec.72.)
'Patricia .JlL snuff
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'Patricia J\.sliuff
ThIs facility Is operated under franchise agreamsnt wllh Ramada FnmchlsG Sy&tema,Ino.
RAMADA INN FOOTHILLS •6944 East Tanque Verde Rd.•Tucson,Arizona 85715
(520)886-9595.Fax:(520)721-8466·E-mail:ramadafoothills@juno.com
Patricia A.Shull
Yours truly,
I have spoken with Nancy Silvers and hopeful~y,this matter
will be resolved abbording to an agre~ment.of the above
matter.
:fuile E~we have Medicare and supplemental insurance,the on
going costs for his recovery and rehabilitation will be consider-
able,and I am requesting that the City reimburse us for this
ongoing expense when he comes home which our insaranee will not
cover.
To :iJ,om It }!..ay Comrern
FOal:years I have complained to City Hall about the
lack of maintenance in the strip of park property between the
street of Verde Ridge and the park entrance on Hawthorne.
Each year the weeds in that area"create a fire hazard because
they are not cut down until July.
This year they were cut down in April after my yearly complaint •
..,I ~1:fThispastSunday,December my husband,J.Robert Shu.ll,
fell on dry pine needles,crack~g his pelvis.A report was filed
by Yel,the park emplyee,paramedics 'Sere called and he was
taken to emergncy at Torrance Memorial Hospital.
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