CITY CLERK'S DATE STAMP
CITY OF RIALTO
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES R0ZZ DEC -5 AM||: 47
TO PERSON OR PROPERTY
• RECEIVED
CITY CLERK
1. Claims for death, injury to person, or to personal property must be filed not later than six (f) months after the occurrence (Gov. Code 59112).
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gov. Code 5911.2). RETURN TO:
3. READ ENTIRE CLAIM FOR BEFORE FILING Rialto City Clerk's Office
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Mail: 150 S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
Kyle Wong 1/3/76
FULL NAME DATE OF BIRTH
HOME TELEPHONE NO.
HONE ADORES INCLUDING CITY, STATE &28 Midwky city, CA 92655 BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE same as above
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above):
1. WHEN DO DAMAGE OR MURY OCCUR DATE: October fober 8, 15 TiE. 1:25 DAM IPM
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 addresses, measurements and landmarks. plato
104 N. Sycamore Avenue
Kiatto • CA 92376 (see letter for more details)
3. HOW DID DAMAGE OR INJURY OCCUR?
see attached letter for detailed
explanation!
4. WERE POLICE AT THE SCENE? DYES ENO WERE PARAMEDICS AT THE SCENE? O YES ENO
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.
see attached letter + photo for details.
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ 12,0000 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
$ 4,000 @x 3 days = 12, 00000
Item/Date: Amount: $
Item/Date: Amount: $
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $12,00050 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: See attached /etter Amount: $
Item/Date: Amount: $
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: 84120070
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: None NAME:
ADDRESS: ADDRESS:
TELEPHONE: () TELEPHONE: | )
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITALS VISITED: Nose NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: | ) TELEPHONE: | )
DATE: TIME: DAM PM DATE: TIME:
9. PLEASE READ THE FOLLOWING CAREFULLY:
For all vehicle accident claims, place on the following diagram, the names of streets, including NORTH, EAST, SOUTH AND WEST directions. Indicate place of accident by "X" and by showing house numbers or distances to street comers.
If 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 yourself or your vehicle vhen you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yourself or your vehicle at the time of th accident by "B-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.
Sycamore Avenue
CURB
PARKWAY
7/1a SIDEWALK
Loy N. Sycamore Are
Rialto, CA 92376
HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS T HOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRUI PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
12/1/2022
TYPE OR PRINT 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 Kyle Wong CITY OF RIALTO
15041 Jackson St Unit 553 2022 DEC -5
Midway City, CA 92655-2028 AMI/: 47
RECEIVED
CITY CLERK
December 1, 2022
RE: 104 N. Sycamore Ave Rialto, CA 92376
Dear City Clerk,
On October 1st, 2022 October 8th, 2022 and October 15th of 2022, I was in my wheelchair going down the sidewalk at the above address and was unable to pass because the sidewalk was inaccessible due to unmaintained pavement issues and cracks. (Photo attached). The sidewalk surface was too rough to get through. I could not navigate past it and had to backtrack to get to the other side of the street, so that I could move forward. Please fix this serious issue immediately.
This a demand letter for statutory damages under the Unruh Act Civil Code 51 and the American Disabilities Act of 1990. I am demanding a payment of $12,000. Under the Unruh Act I am entitled to statutory damages of $4,000 per occurrence. I was unable to pass three times in this area to get to my sick relative's house.
Sincerely,
yle Wong
CITY OF RIALTO
2022 DEC -5 451: 47
RECEN EL
CITY CLERK®
104
Sycamore Avenue
Lialto, CA 92376
. SANTA ANA CA 926
Kyle Wong
3 DEC 2022 PM5 L
Midway City, CA 92655 FOREVER / USA
CITY OF RIALTO 2022 DEC -5 AMII: 48 RECEIVEL CITY CLERK Rialto City Clerk's Office I50 S. Palm Avenue
Rialto, CA 92376
92376-846799