CC SR 20230919 G - Claim against the City Ashley Ibarra
CITY COUNCIL MEETING DATE: 09/19/2023
AGENDA REPORT AGENDA HEADING: Consent Calendar
AGENDA TITLE:
Consideration and possible action regarding a claim against the City by Ashley Ibarra.
RECOMMENDED COUNCIL ACTION:
1) Reject the claim and direct Staff to notify the claimant, Ashley Ibarra.
FISCAL IMPACT: None
Amount Budgeted: N/A
Additional Appropriation: N/A
Account Number(s): N/A
ORIGINATED BY: Enyssa Sisson, Administrative Analyst
REVIEWED BY: Teresa Takaoka, City Clerk
APPROVED BY: Ara Mihranian, AICP, City Manager
ATTACHED SUPPORTING DOCUMENTS:
A. Ashley Ibarra claim (page A-1)
BACKGROUND AND DISCUSSION:
The City of Rancho Palos Verdes (City) is a member of the California Joint Powers
Insurance Authority (Authority), which provides risk management services and handles
any liability claims received by the City. Under the current practice, claims presented to
the City Clerk are forwarded by the Authority to a third-party claims administrator, Carl
Warren and Company (Carl Warren) for adjusting.
Carl Warren’s staff reviews each claim on its merits and contacts the City with any
requested action pertaining to the disposition of the claim. The City Clerk and the City
Attorney review each claim when received and work closely with Carl Warren throughout
the claims process.
1
RANCHO PALOS VERDES
Claimant:
On September 7, 2023, the City received a claim for damages from Ashley Ibarra. The
claim was referred to Carl Warren for review and investigation. The claimant states that
on September 6, 2023, her vehicle suffered damages to her front windshield. The
claimant alleges the City is at fault due to City tree causing damages to her vehicle.
Deposition:
Carl Warren has reviewed the claim and found there is no liability for the City as the
incident did not occur in the City of Rancho Palos Verdes. Carl Warren recommends
denying the claim for damages.
2
A-1
FILE WITH:
CITY CLERK'S OFFICE
City of Rancho Palos Verdes
30940 Hawthorne Blvd.
Rancho Palos Verdes, CA 90275
CLAIM FOR DAMAGES
TO PERSON OR PROPERTY
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 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.
Business Address of Claimant City and State
Give address and telephone number to which you desire notices or
communications to be sent regarding this claim:
RESERVE FOR FILING STAMP
CLAIM NO . _____ _
•-~•=··· ....
-----
Claimant's Social Security No.
When id A
Date . Time //: IJIJ ttm
Names of any city employees involved in INJURY or DAMAGE
If c!aim is for quitable Indemnity, give date
claimant served with the complaint:
Date 7 -z.,:3
Where did AM GE or INJURY occur? Describe fully, and locate on diagram on Page 2. Where appropriate, give
street names and address and measurements from landmarks: 7M aaidt/11-ffefJlkn C?2 #f_1/ern I J,«,t/1?1~/ j/aM 1,4rdLJ
Je,ifAI-a~~ /4 //9.A/-.
Describe in detail each INJURY or DAMAGE.
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This Claim Must Be Signed on Page 2
A-2
The amount claimed, as of the date of presentation of this clalm , Is computed as follows:
Damages incurred to date (exact): Estimated prospective damages as far as known:
Damage to property .......•............ $ </zc.--Future expenses for medical and hospital care . $ ___ _
Expenses for medical and hospital care ... $±: Future loss of earnings ...•.... , ... , ......•. $
Loss of earnings ...................... $ Other prospective special damages ...•...... $--~-
Special damages for ................... $ Prospective general damages •...........•.. $T....,...,_ __
General damages ...................... $ t{z< --Total estimate prospective damages •...... ..,, ____ _
Total damages incurred to date .....•.. $ /
Total amount claimed as of date of presentation ofthls claim: $ '-/ !Jr, //I)
Was damage and/or injury investigated by police? _____ If so, what city? _________________ _
Were paramedics or ambulance called? _____ If so, name city or ambulance _______________ _
If injured, state date, time, name and address of doctor of your first visit ___________________ _
WITNESSES to DAMAGE or INJURY: List all persons and addresses of persons known to have information :
Name ______________ ,Address _________________ Phone ________ _
Name _____________ Address _________________ Phone, ________ _
Name _____________ Address _________________ Phone ________ _
DOCTORS and HOSPITALS:
Hospital Address Date Hospitalized, _______ _
Doctor ____________ A,ddress ______________ Date of Treatment _______ _
Doctor Address Date of Treatment _______ _
READ CAREFULLY
For all accident claims place on following diagram names yo,1J r 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
Signature of Claimant_ or person filing on
his behalf givin rel I nship to Claimant;
SIDEWALK
Typed Namo :
CURB"'""'l
Date :
NOTE· CLAIMS MUST BE FILED WITH CITY CLERK (Gov, Code Sec. 915a). Presentation of a false claim Is a felony (Pen . Code Sec. 72.)
. THIS DOCUMENT IS A PUBLIC RECORD AND MAY BE PROVIDED TO A REQUESTOR UPON DEMAND.
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' used Auto Glass Installed WORK ORDER
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