Item 11 - Rejection of Claim for Damages
..GENDA REPORT ~ -
CITY OF POW A Y
This report is included on the ConSent Calendar. There will be no separate discussion of the report prior to approval by the
City Council unless members of the Council, staff or public request it to be removed from the Consent CalendllT and
discussed separately. If you wish to have this report pulled for discussion. please fill out a slip indicating the report number
and give it to the City Clerk prior to the beginning of the City Council meeting.
TO: Honorable Mayor and Members of the City Council
FROM: James L. Bowersox, City Man~
INITIATED BY: Peggy Stewart, Director of Administrative ~~
Douglas A. Milton, General Services Manager.
DATE: April g, 1991
SUBJ ECT: Denial of Claim for Damages - Cheryle Garcia
ABSTRACT:
On March 7, 1991 a claim for damages was received from Ms. Chery1e Garcia.
The amount of the claim is not known, at this time. It is recommended
that the City Council deny this claim.
BACKGROUND:
Ms. Garcia claims that while driving on Poway Road, she unavoidably
struck a wooden crate that was lying in the left lane. The impact caused
damage to her vehicle.
FISCAL IMPACT: Unknown
RECo...ENDATION:
It is recommended that the City Council deny this claim.
JLB:PS:DAM:bs
Attachments
ACTION:
L
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AI'R !J 1991 Ilt.M 1 1
City Of Poway
CLAIM AGAINST THE CITY OF POWAY
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ofatrh must be filed with the Clty °Clerk or'Rlsk Manager of the CIty,of „Poway within 6 months after which hehe
ident or event occurred. Be sure your dS:a1 is.against the. City of Poway,- not,another public entity.
Iace is insufficient, please use additional paper and identify inforrnation'by paragraph number. Completed
aims must be mailed or "delivered to The City of Poway, 13325 Civic Center Drive Poway CA. 92064 ( P.O.
)x 769 )• Attn: Risk,Manager
D THE HONORABLE MAYOR AND CiTY COUNCIL, THE CITY OF POWAY CALIFORNIA
he undersigned respectfully submits the following dig" and information relative to damage to persons
ndlor personal property:
Name of claimant
a• Address of
b. Phone No.
d• Social Security No. e, Driver's Uc. No..
!. Name, telephone and post office address to which claimant desires notices to be sent if other
than above:
NA
3. Occurrence or event from which the din arises:
a. Date 1 q/ b• Time �U c. Place ( exact and specific location)
d• occurrence, event, act for omission-you ��cllaimacaused the injury or damage (se articular
additional paper if necessary).
I f��r° oil c�Ru R�� , �2Ft;C�ne b P rze Dl�il/ cl/iUr
G1 � VA f?<< ii t a ►rlcvClien el)�c% a�ys l'n t�2_L
�nc� rcac� %�s7v��v�lu �h�rDby�c- Jr), iuRfC /1�a��
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t((yelry GR�.N'L;1CT / i(!( r . /(�C�W /TJh /!YC.�.'w.�,i��.�,.. •- - -•- . --
e. What particular.action:by the City, or its employees, caused`the aileged'damage or
injury?
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Give a descriptiornof the-in jury; property damage or loss, so far as is know, at the time of this
claim. If there were nolinjurles, state "No Injuries."
Give naffie(s) of the City: employee(s) causing the damage or injury:
Name and address of 'any other person injured:
Name and�addresa ot;the owner of any damaged property:
v_
Damages claimed:
a. Amount - claimed as of this date $
b. Estimated_ amount of future costs: $
a Total amount claimed:' $
d. Basis for computation of,amounts claimed ( include:copies.of all biils,invoices, estimates, etc)
Names and addresses of all
I v�
b.
C.
CL _
Any
'NARNING: IT' IS A.
insurance_ Code, §
, etc.
helpful in considering this claim:
OFFENSE TO FILE A FALSE CLAIMI
(penal Code §72
have read the: matters °and':statements made_ in the above claim:and I know the same to be true of, my own' knowledge,
axcepfias.- those mattersistated uponinfornWion or beljef,as to suchshatters l believe the same to be true. I certify under
?enalfy otperjury that,the foregoing is TRUE and CORRECT.
Signed4his day of Y 19_,L_, at
Claimant's Signa re
OfOe of the; City Clerk
'E ay, Califomia
DOCUMENT NO, FILED
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APR y 1991 11'" 11