CITY OF RIALTO CITY CLERK'S DATE STAMP
LIABILITY CITY OF RIALTO
CLAIM FOR DAMAGES 2023 FEB 14 AM 9: 00
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 (6) months after the occurrence (Gov. Code §911.2).
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gov. Code §911.2).
3. READ ENTIRE CLAIM FOR BEFORE FILING RETURN TO:
4. ATTACH SEPARATE SHEETS, IF NECESSARY, TO GIVE FULL DETAILS Rialto City Clerk's Office Mail: 150 S. Palm Ave., Rialto, CA 92376
Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
QUINCy RonCE CARLISLE
FULL NAME
DATE OF BIRTH
REALTO CA 92376
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO.
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE 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 INJURY OCCUR? DATE: NOV523 - 24 TIME:
DAM O PM
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.
ORIGINALTERES LOCATE AT DUR E FOOTHILL BLUR REALTO CA 72326
WHEN YOU ENTER THE GATES MY TRUCK WAS TO THE LEFT BY
ITSELE WITH NO ONER VEHICLES NEAR,
3. HOW DID DAMAGE OR INJURY OCCUR?
SaMSONE BROBE AT THE PASSENGER CARP OCCA WINDOW STOLE THE BLUETOCTTA JOUCHSCREE RADIO ALONE WITH THAT "IS SPEAKIAS AND SEVERAL OTHER.
4. WERE POLICE AT THE SCENE? • YES NO WERE PARAMEDICS AT THE SCENE? •YES 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.
REMOVAL OF THE ITEMS CAUSEO PANAGE TO PASMGOALD IC/ HEATER UNET AND BaTA FRONT DOES, THE WINDONWA THE WAY TO FUTER THE VEHICLE
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ 000, 49 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates DAMAGES INCURRED TO DATE:
Item/Date: Lipow / DEC 14, La Amount: $1141. 47
Item/Date: MAnNESs/ DECI4 | ta Amount: $ 1S39.00
PLEASE SEEATACHMENi DEN
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $3516.49 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: PANA. DEL 14,23 Amount: 54f,5d
Item/Date: PAwEr SCORD DEs MiLt Amount: $ 477. 2s
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $ 896, 77
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:
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: NAME: _
ADDRESS: ADDRESS: _
TELEPHONE: ( TELEPHONE: L 1
DATE: _ TIME: 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 corners.
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 when you first saw City/Town vehicle; location of City/Town vehicle at time of accident by "A-1" and location of yoursetf or your vehicle at the time of the 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.
CURB
PARKWAY
SIDEWALK
I HAVE 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 (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
FEB 14,2045
TYPE OR PRINT NAME DATE
SELE
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
CITY OF RIALTO
LETTER OF INTENT TO SUE 2023 FEB 14 AM 9:00
RECEIVED
CITY CLERK
Quincy Carlisle
rialto, California, 92376
Effective Date: december 5 2022
RE: NOTICE OF INTENT TO FILE LAWSUIT
Dear Original Tires,
This letter of intent to sue shall serve as a formal notice that Quincy Carlisle intends to commence a lawsuit against you due to the following: My truck was at original tires from november 23 2022 til november 24 2022, during that time my trucks right side cargo door window was broken out and several items were taken. When i called on nov. 24 to inform them i was on the way to pick up my truck they told me my truck had been broken into and items were stolen. the police came and viewed the cameras which i was told they did not see anyone breaking in or out of the premises so i asked the employees for my items and they gave me attitude and wrote the insurance company information for me to file a claim on the back of they business card.I tried to file a claim however i was informed by the insurance company that they are not and have never been a client of farmers insurance. I attempted to get the owners information from employees and they respond with we cant get ahold of him ,and they refuse to give me the contact number they have for him.
I. THE PLAINTIFF. Quincy Carlisle (the "Plaintiff").
II. THE DEFENDANT. Original Tires (the "Defendant").
III. SETTLEMENT DEMAND. As a result of your actions, the Plaintiff is willing to resolve the matter for a payment of $3,658.00. This offer to cure and/or settle this matter outside of court and avoid a lawsuit is valid for 5 days from the Effective Date.
IV. GOVERNING LAW. This Letter of Intent shall be governed under the laws of the State of California.
Sincerely,
Aninav Calida
DASH
K
909-355-5222 Fax 909-355-5225
17338 Foothill Blvd Fontana, CA 92335
Alarm •C
Vidco • Motor Sports • Navigation • Rims & Tires •Tinting
SOLD BY DATE
NAME MAKE
MODEL
STREET YEAR
COLOR
CITY LICENSE NO
(PHONE
OTY PART DESCRIPTION
PRICE AMOUNT
SHOP SUPPLIES #2700
TAX 224
LABOR 300
INSTALLED BY TOTAL
3424
All sales are final - No Refunds ACKNOWLEDGMENT:
I have read and understand tho
Layaways Not refundable or Transferable above estimate and terms and authorize the removal for the GUARANTEE: DASH provides warranty for one year on all above described equipment for the purpose stated. I aiso products purchased and installed at DASH and 90 days on all understand when authorized repairs along with necessary items sold over repair only. No warranty on blown speakers, no materials are completed and expross repairman lien is hereby acknowledged on abave tom lo secure the amount of renair warranty on physical damaged equipment. Layaways, deposits thereto terms C.O.D. No vstrenty on items installed by DASH, are not returnable on f *at purchased form DASH is not responsible for any eme may have in my car even if it didn't appear
Customer's man's of DASH.
Signature x
DATE
ompanied with this recoupt
DASH Copy (Fite) Customer Copy (Filo)
*DIAMOND CITY OF RIALTO
DriveADiamond.com 2023 FEB 14 AM 9:00
DIAMOND CHEVROLET RECEIVED
909 W. 21st CITY CLERK
San Bernardino, CA 92405
Phone: (909) 883-8833
www.DiamondChevroletofSanBernardino.com
RETURN/REFUND POLICY: ALL RETURNS MUST BE ACCOMPANIED BY THIS INVOICE AND ARE SUBJECT TO A 20% HANDLING CHARGE. RETURNED ITEMS MUST BE IN THE ORIGINAL UNOPENED BOX OR CONTAINER. PLEASE NOTE THAT THE DEALERSHIP WILL NOT ACCEPT RETURNS OR MAKE REFUNDS AFTER 30 DAYS. NO REFUNDS OR RETURNS ON SPECIAL ORDER PARTS OR ELECTRICAL PARTS.
DISCLAIMER OF WARRANTY: ALL PARTS AND ACCESSORIES ARE SOLD BY OUR DEALERSHIP AS IS. OUR DEALERSHIP DISCLAIMS ALL WARRANTIES, EXPRESS AND IN CONNECTION WITH THE SALE OF PARTS AND
IMPLIED, INCLUDING IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE, THE ENTIRE RISK AS TO THE QUALITY AND PERFORMANCES OF THE VEHICLE AND PARTS AND ACCESSORIES IS WITH THE CUSTOMER AND, IF ACCESSORIES.
APPLICABLE, THE MANUFACTURER. IF THE VEHICLE OR ANY INSTALLED PARTS OR ACCESSORIES SHOULD PROVE DEFECTIVE FOLLOWING THEIR PURCHASE, THE CUSTOMER AND POSSIBLY THE MANUFACTURER AND NOT THE DEALERSHIP ASSUME THE ENTIRE COST OF ANY NECESSARY SERVICING OR REPAIR. CUSTOMER
SHALL NOT BE ENTITLED TO RECOVER FROM THE DEALERSHIP ANY CONSEQUENTIAL DAMAGES, DAMAGES TO PROPERTY, DAMAGES FOR LOSS OF USE, LOSS OF TIME, LOSS OF PROFITS OR INCOME, OR ANY OTHER INCIDENTAL DAMAGES.
DATE ENTERED YOUR ORDER NO. DATE SHIPPED INVOICE DATE INVOICE 14 DEC 22 NUMBER 026137 16:55
14 / DEC 22
**QUOTE**
ACCOUNT NO. 15914 PAGE 1 OF 1
H
QUINCY CARLIESLE
RIALTO, CA 92376
SHIP VIA SLSM. B/L NO TERMS F.O.B. POINT
A3012 CASH SAN BERNARDINO,
PART NO. DESCRIPTION LIST NET AMOUNT
SHE B.O.
15762696 window 1141.471141.47 1,141.47
1 15176084 PANEL SPORD 477.25 477.25 477.25
0 PANEL SPORD 442.91 442.91 442.91
15766640
PANEL 419.52 419.52 419.52
1 15766641
15163886 HARNESS 1539.021539.02 1,539.02
1 (S) CONNECTSPORD 118.82 118.82 118.82
1 0 88862291
DO NOT PAY ****
**** INVOICE QUOTE
PARTS 4,138.99
SUBLET
FREIGHT 0.00
SALES TAX 362.16
CUSTOMER'S SIGNATURE METHOD OF PYMT
TOTAL $4, 501.15
NOTICE TO CONSUMER: PLEASE READ IMPORTANT INFORMATION ON REVERSE SIDE.
DealerAP 2014 COK Gabel, LL 101/67 PARO INVOICE 1LP • PIC 1 . "AS-IS* • CALIFORNIA • 9696592 CUSTOMER COPY ITEM:
9:44 d 00 NO SUC A 0
CITY OF RIALTO
bolt cutters
2023 FEB 14 AM 9: 00
• Deliver to samuel - Rialto 92376 v
CITY CLERK RECEIVED
Shop holiday gift cards
Visit che KSEIBI Store ***** 771
KEIBI 14159G Bolt Lock Cutler Hand Jaws Blades Chain Wire Fence Cable Rebar Wire (30 Inch-750MMl
• 0.0 C 0 ° O
30 Inch-750MM ^
Size:
30 Inch-750MM 14 Inch-350MM 18 Inch •БОМ
*17* $34"
9:40 NO SGUC AR
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2023 FEB 14 AM 9:00
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