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2022 FEB-2 PM 3: 34
RECEIVED
CITY CLERK
CITY CLERK'S DATE STAMP
MALIO CITY OF RIALTO
LIABILITY
CLAIM FOR DAMAGES
TO PERSON OR PROPERTY
1. Clains for dealt, inary lo person, or to personal property must be fled not later than sir (6) montis after the occumence (Gov. Code 5911.2).
2. Claims loe damages to real property must be lied not later than one (1) yere alter the occumence (Gov. Code §911.2). RETURN TO:
3.READ ENTIRE CLAIM FOR BEFORE FILING Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mal: 150 S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
arenda Lee. Stringer
-
DATE OF BIRTH
Rialto, CA 92376-3400
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO.
N/A
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP CEETELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above):
1. WHEN DID DAMAGE OR MAURY OCCUR? DATE Sep 3,2021 TIME: 8:00
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (If applicable) locate on diagram on reverse side of this sheet.
Where appropriate, give street names and addrosses, measi Approximately 20' East of Alice /Walnut intersection - entrance to Meadows Estate.
3. HOW DID DAMAGE OR INJURY OCCUR?
Tripped on un level Sidewalk
4. WERE POLICE AT THE SCENE? DYES>NO WERE PARAMEDICS AT THE SCENE? LIVES NO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CAUSED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known
lipped on uneven sidewalk -City of Rialto
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury of damage $6600.00 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repal estimates, efc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: et Stacked Amount: $.
Set
Item/Date: Amount: $
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Item/Date: Amount: $
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES:
T. WITNESSES TO DAMAGE OR INJURY List al persons known to have information (altach adional pages, l necessary) ADDRESS: Haut No Contact Into
TELEPHONE: ( TELEPHONE: (
& yourrialto.com
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CITY CLERK RECEIVED 2022 FEB -2 PM 3: 34 CITY OF RIALTO 3 of 5 12/12/2021,9:03 AM
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2022 FEB PM PM 34
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: _ TIME: CAM O.PM KECEIVE (*'applicable) locate on diagram on reverse side of this sheet. • (OCCURRENCE) BE SPECIFIC - C and india
vet names and addresses, measureme
2 of 2
3. HOW DID DAMAGE OR INJURY OCCUR?
4. WERE POLICE AT THE SCENE? I YES I NO WÈRE PARAMEDICS AT THE SCENE? YES I NO
5. WHAT PARTICULAR ACT OR OMISSION DO YOU CLAIM CASED THE INJURY OR DAMAGES? Give the name of the city/town employee causing the injury or damage, if known.
6. GIVE TOTAL AMOUNT OF CLA Include estimate of amount of any prospective injury of damage HOW WAS THE ABOVEAMOUNT COMPUTED? Be speclic, list doctor blls, repar estimates, etc. Please ch 2 estimates.
DAMAGES INCUBATED TO DATE:
Item Date: Amount: $.
tem/Date: Amount: $
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: = 6l00.00
ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN
Item/Date: Midical Amount $ 371.00 - So far
Item/Date: Turmoil to my Life Amount: $ 622900
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $ 6600.00
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: L TELEPHONE: )
NAME: VA Hospital- Jerry tPettis Memorial NAME:
ADDRESS: 1/20i Benton Strent at
Loma Linda CA 12357-1000 JA
TELEPHONE: 909, 825-7084 for other Care
TELEPHONE: L 1
DATE: SIP 3,2021 TME: 10:00 JAMIN CAM CIPM
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of steets, including NORTH, EAST, SOUTH AND WEST directions. Indicate place of accident by "X* and by showing house numbers of distances to street comers.
Il a city/town vehicle was involved, designate by letter "A" location of the City/Town vehicle when you first saw it, and by "B" location of yoursell of your vehicle when you first saw Cly/Town vehicle; location of CRy/Town vehicle at time of accident by "A-1" and location of yourselt of your vehicle at the time of the accident by "8-1" and the point of impact by "X.
• NOTE: IF THE DIAGRAM BELOW DOES NOT FIT THE SITUATION, PLEASE ATTACH A PROPER DIAGRAM SIGNED BY THE CLAIMANT. 4 of 5 12/12/2021, 9:03 AM
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THAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF, AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS TO THOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF, AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRUE.
I CERTIFY (QR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
URE OF CLAIMANT OR AGENT /
Brenda k. Stringur 30 Jan 22
TYPE OR IT NAME DATE
RELATIONSHIP TO CLAIMANT
NOTE: PRESENTATION OF A FALSE CLAIM IS A FELONY (CA PENAL CODE 72) RETURN CLAIM TO: RIALTO CITY CLERK'S OFFICE - 150 S. PALM AVE., RIALTO, CA 92376 @ yourrialto.com
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CITY CLERK RECEIVED 2022 FEB-2 PM 3: 34 CITY OF RIALTO
5 of 5 12/12/2021, 9:03 AM
CITY OF RIALTO
30Jan22
2022 FEB-2 PM 3: 34
Dear Madam or Sir: RECEIVED
CITY CLERK
On September 3rd 2021 while on my daily 2-mile walk, I tripped over uneven sidewalk, on Walnut Ave between Riverside and Willow. When I fell I broke my knee and chipped a piece out of my knee (pictures enclosed). I have been walking almost 2 miles a day for over 10 years, on the same path and have watched the sidewalks get worse and worse every year. When they really buckle than Rialto will finally sends someone out to repair/replace it. Yes, Rialto did come out and replace a small section of the sidewalk on Walnut between Willow and Alice but not the whole sidewalk on that street, and not the section that I fell on. If they had I would not have tripped. After I fell, I couldn't get up on my own, a guy on a skateboard had to help me up off the ground and a teenage girl waiting for her school bus rushed over to assist me. I am a very independent person and I wasn't even able to get up off the ground by myself. Beside the broken knee I also ended up with bruised ribs on my left side, leaving me needing hourly breathing treatments for a month to avoid an infection setting in. I was in a total leg mobilizer for two (2) months, then I spent two (2) weeks in a leg brace with 30% mobility and another two (2) weeks in the brace at 90% mobility. I can still not get back to doing my aerobics until March 1, 2022, at the earliest. I am a United States Army Vet and thankfully I have insurance through the VA. My doctors have told me it could be a year before I can ride my bike again, which is something my grandson and I really enjoyed doing together. I'm afraid by the time I'll be able start riding again my grandson won't want to ride with me, what 14-year-old boy wants to go biking riding with his 64-year-old grandma, we used to love to go riding together. If I hadn't had insurance through the VA this would have crippled me financially. I have included a copy of my FitBit tracking info from last year to demonstrate how much different my life was before and after the fall. All the numbers at the bottoms are averages.
I could not drive until the leg braces came off. Thank God for my wonderful boss who, for three (3) months came to my house at least twice a week to deliver all my work to me so I was able to keep doing my job. That's two (2) trips a week for 12 weeks that he accommodated me, going completely out of his way, for something that was neither his nor my fault. My daughter also had to take time off from work to keep taking me to the Orthopedics specialist appointments. She also had to take my grandson to his Orthodontists appointments, which is something I always did as well as all the grocery shopping and errands. (We were trying very hard to keep the exposure to Covid-19 to a bare minimum.) As you can see my life and my family's life was turned into turmoil because of an uneven sidewalk, that I pay taxes to be maintained and they weren't. My knee is still swollen and bruised almost 6 months later and I am not comfortable taking my dogs for walks yet as I'm afraid that any pulling may cause a misstep that could set me back, I have a beagle and a chihuahua, they aren't big dogs. I am not looking to get rich here. I am looking for fair compensation for what has been taken away from me for the last five (5) months and the struggles I will continue to go through, possibly for the rest of my life.
Sincerely,
'Brenda L. Stringer