CITY OF RIALTO
CITY OF RIALTO 2023 OCT KIY CLERKSDATE STAY
LIABILITY RECEIVED
CLAIM FOR DAMAGES CITY CLERK
TO PERSON OR PROPERTY
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). 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., Rallo, CA 92376 Address: 290 W. Rialto Ave., Rialto, CA 92376
CLAIMANT INFORMATION:
PAUL NUNEZ
-
FULL NAME DATE OF BIRTH
San Bernardino, CA 92408
-
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO. - L
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP BUSINESS TELEPHONE NO.
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE 3576 Arlington Ave. Suite 304, Riverside, CA 92506
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: 04/13/2023 TIME: _ 3:20 XAM • 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.
STATE ROUTE 210 EASTBOUND AT480 FEET WEST OF STATE STREET, RIALTO CA
3. HOW DID DAMAGE OR INJURY OCCUR?
Mr. Nunez was in the right rear seat of the patrol vehicle that was crashed into by a third party. Mr. Nunez was not taken to receive medical attention after vehicle collision while they had custody of Mr. Nunez.
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.
A city of Rialto Police Officer failed to provide medical attention to Mr.Nunez after the vehicle collision.
Failure to watn claimant of danger of no medical treatment.
6. GIVE TOTAL AMOUNT OF CLAIM Include estimale of amount of any prospective injury or damage $7,638.00 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: Medical Expenses Amount: $7,638.00
Item/Date: Wages Amount: $980.00
CITY OF RIALTO
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THISZCLAÎM: 12 PN 3: 09$8,618.00 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
RECEIVE
Item/Date: Medical Expenses citY cle Amount: $ 100,000.00 Item/Date: Pain and Suffering Amount: $250,000.00
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $350,000.00
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: Officer Vallez NAME: Daniel Cornell Stewart
ADDRESS: ADDRESS:
RANCHO CUCAMONGA, CA 91737
TELEPHONE: L) TELEPHONE:
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITALS) VISITED:
NAME: COMMUNITY HOSPITAL OF SAN BERNARDINO NAME: Robert M. DeLuca DC QME ADDRESS: 1805 Medical Center Drive ADDRESS: 1881 Commercenter E. #114 SAN BERNARDINO, CA 92411 San Bernardino, CA 92408
TELEPHONE: (909) 887-6333 TELEPHONE: L|
DATE: 4/13/2023 _ TIME: — 12:34 •AM 2PM 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. 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 vehid hen you first saw City/Town vehicle; location of Cily/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.
CURB
PARKWAY
7 SIDEWALK
ALDENTIFY OR AREHINDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
PAUL NUNEZ 10/12/2023
TYPE OR PRINT NAME DATE
Self
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
2023 OCT 12 PM 3: 09
RECEIVED
Attachment CITY CLERK
This claim is brought forth by Paul Nunez. It is submitted by his attorney, William C. Kennedy, Esq. of the Law Office of Kennedy & Associates, Inc.
On April 13, 2023, at 3:20 AM, Mr. Nunez was in the custody of Rialto City Police being held in the back of a police vehicle when Daniel Cornell Stewart struck the police vehicle with his own vehicle. Mr. Nunez suffered injuries as a result of that collision, but he did not receive medical attention until he was released from police custody.
1. The City of Rialto employees had custody of Mr. Nunez;
2. Mr. Nunez experienced a vehicle collision while in the custody of Rialto employees and suffered injuries;
3. Mr. Nunez was unable to seek medical treatment on his own due to the restraint of the custody:
4. City of Rialto employees owed a duty to Mr. Nunez to take him to receive medical treatment for the injuries suffered while in their custody;
5. City of Rialto employees failed to meet that duty and Mr. Nunez did not receive medical treatment while in custody;
6. The delay in treatment aggravated the intensity and severity of the injuries Mr.
Nunez suffered.
Dated: October 12, 2023
UM Chines
William C. Kennedy, Esq.
Attorney for Paul Nunez
CITY OF RIALTO
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
TRAFFIC CRASH REPORT 2023 OCTad 2 of 3: 09
CHP 555 Page 1 (Rev. 2-22) OPI 060
SPECIAL CONDITIONS HAT & RUZI CITY JUDICIAL DISTRICT LOCAL REPORT NUMBER FELONY
UNINCORPORATED SAY BEKYARDINO SUPKKOK COURT FONTANA 9860-2023-01369E/V
COURTHOUSE
NUMBER HIT 4 RUI COUNTY REPORTING DISTRICT BEAT DAY OF WEEK TOWNER A
NUEO LASDENEALOR
SAN BERNARDINO 201 5 MT WTF S •YES EX NO
CRASH TIME (2400) NOTIF. TILE (2400) NCIC • OFFICER ID
CRASH OCCURRED ON CRASHA EAR
04/13/2023 0305 04/13/2023 0315 9860 014777
STATE ROUTE 210 EASTBOUND
STATE HIVY REL DIGITAL MEDIA
AT INTERSECTION WITH
X OR 480 FEET WEST of STATE STREET A YES NO ONO EMBEDDED GPS COORDINATES FOR LOCATION (LOC.) AND ARE(S) OF IMPACT (AOD ACT UT SAME AS LOCATION LONG
LONG NO LAY CREFER TO MARRATME
LOC. UT. -117.337193
34.134397
LONG AO1 LAT. LONG LONG
ROT LAT
PARTY DRIVER'S LICENSE NUMBER STATE CLASS AIR BAG SAFETY ECUIP. VEH. YEAR MAKE MODEUCOLOR LICENSE NUMBER STATE CA M G 2015 HIYUN SONATA GRY CA
DRIVER NAME (FIRST, MIDOLE. LAST)
DANIEL CORNELL STEWART OWNER'S NAME L SAME AS DRIVER
PEDEST STREET ADDRESS TORRANCE BRUMFIELD
TRAN
OWNER'S ADDRESS [SAME AS DRIVER
PARKED CITY/STATE/OP ALTADENA CA 91001
VEHICLE
RANCHO CUCAMONGA CA 91737 DISPOSITION OF VEHICLE ON ORDERS OF OFFICER X DRIVER OTHER
SEX THAIR EYES HEIGHT TWEIGHT RAGE DRIVEN AWAY
Osy
CLIST
xxx BRN 5'11" 225 B PRIOR MECHANICAL DEFECTS X NONE APPARENT REFER TO NARRATIVE
OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER
NONE VEHICLE TYPE DESCRIBE VEHICLE DAMAGE
UNK. NONE X MINOR
OPER INSURANCE CARRIER POLICY NUMBER
01 ATOR MOD. I MAJOR
ROLLOVER
TRISURA
DIR OF ON STREET OR HIGHIKAY LANE THRU SPEED
LANES LANES CA
TRAVEL STATE ROUTE 210
4 65 CAL-T TCP.PSC
STATE CLASS AIR BAG SAFETY EQUIP. VEH. YEAR MAKE/MODEL/COLOR LICENSE NUMBER STATE
PARTY DRIVERS LICENSE NUMBER
M 2013 FORD TAURUS BLK/WHI CA
2 DRIVER NAME (FIRST, MIDOLE LAST)
OWNER'S NAME SAMEAS DRIVER
PEDES. STREET ADDRESS CITY OF RIALTO
TRIAN
OVINER S ADORESS SAME AS DRIVER
PARKED! CITYSTATE/RIP 150 SOUTH PALM AVENUE RIALTO CA 92376
VEHICLE
DISPOSITION OF VEHICLE ON ORDERS OF OFFICER DRIVER X OTHER SEX THAIR EYES [HEIGHT WEIGHT RACE
DRIVEN AWAY
PRIOR MECHANICAL DEFECTS X NONE APPARENT REFER TO NARRATIVE OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER:
NONE (909) 820-2550 VEHICLE TYPE DESCRIBE VEHICLE DANAGE X
POLICY NUMBER •UNK. • NONE IN MINOR
INSURANCE CARRIER
CITY OF RIALTO SELF INSURED 48 ROLL.OVER
LANE THRU TOTAL | SPEED
TRAVEL ONSTREET OR HIGHWAY LANES LANES LIMIT CA. DOT.
I STATE ROUTE 210 4 65 CAL-T _ - TCP.PSC
STATE CLASS AIR BAG SAFETY EQUIP. VEH YEAR NHKEMODELCOLOR LICENSE NUMBER [STATE
PARTY DRIVER'S LICENSE NUMBER
3 DRIVER MANE (FIRST, MODLE, LAST
OWNERS NAME •SAME AS DRIVER
PEDES- STREET ADDRESS
THAN OHNER S ACORESS MOSAME ASDRIVER
DISPOSITION OF VEHICLE ON ORDERS OF OFFICER [DRIVER •OTHER BICY. SEX HAIR TEYES THEIGHT WEIGHT RACE
PRIOR MECHANICAL DEFECTE I NONE APPARENT •REFER TO NARRATIVE
OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER • VEHICLE TPE DESCRIBE VEHICLE DAILAGE
OPER. INSURANCE CARRIER POUCY NUNBER •UNK NONE MINOR
ATOR NOO MAJOR ROLL-OVER
DIR OF ON STREET OR HIGHIVAY LINE THRU SPEED
TANES LANES UNIT CA. COT
TRAVEL
CAL.I - VOMI
DISPATCH NOTIFIED EVIEWERS NAME DATE REVIENEO
PREPARER'S MANE 04/30/2023
CURTIS E DANE, 01777 •YES • NO X NIA J. NORFOLK, 02059
An Internationally Accredited Agency Destroy Previous Editions
CITY OF RIALTO
ATE OF CALIFORNI
EPARTMENT OF CALIFORNIA HIGHWAY PATRO
PHOTOS
2023 OCT 12 PM 2009г
CHP 555 OPI 060
DATE OF CRASH (MO. DAY YEAR) TIME (2300) NCIC S OFFICER ID HUMBER
04/13/2023 0305 9860 014777 SiT 9860-2023-01309
041323 1 041323 2
PREPARED BY SID NUMBER IMO. DAY YEAR I REVIEWERS NAME TWO DAY YEAR CURTIS E DANE 014777 04/13/2023 J. NORFOLK, 020595 04/30/2023 An Internationally Accredited Agency
STATE OF CALIFORNIA CITY OF RIALTO
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
TRAFFIC CRASH CODING
CHP 555 Page 2 (Rev. 2-22) OPI 060 2U23 OCT / 2Pae,
CRASH DATE (MO DAY YEAR) CRASH TIME (2400) NCIC • OFFICER ID NUMBER 0/13/2023 0305 9860 01-4777 9860-2023-01309
PROPERTY TOWNER'S NAME OWNER'S ADDRESS
DAMAGE CITY CLERA
PERSON NOTIFIED LI SAME AS OWNER TELEPHONE NUMBER METHOD OF NOTIFICATION (MARK ALL THAT APPLY) LOG / INCIDENT NUMBER TIN PERSON •PHONE DISPATCH CHP 42:
DESCRIPTION OF DAMAGE
SEATING POSITION SAFETY EQUIPMENT AIR BAG INATTENTION CODES
OCCUPANTS CHILD RESTRAINI B - UNKNOWN
A - NONE IN VEHICLE L - AIR BAG DEPLOYED 4 - CELLPHONE HANDHELI 1 TO 9 - STANDARD SEATING B - UNKNOWN Q - IN VEHICLE USED M - AIR BAG NOT DEPLOYED 1- CELLPHONE HANDSFREE
POSITION C - LAP BELT USED R - IN VEHICLE NOT USED N - OTHER C - ELECTRONIC EQUIPMENT
S - IN VEHICLE USE UNKNOWN D - RADIO / CD
D - LAP BELT NOT USED P • NOT REQUIRED
10 - REAR OCC. TRK, VAN E - SHOULDER HARNESS USED T - IN VEHICLE IMPROPER USE € - SMOKING 1 2 3 U - NONE IN VEHICLE F - EATING
STATION WAGON. ETC • F - SHOULDER HARNESS NOT USEO EJECTED FROM VEHICLE 4 5 6 G - LAP/SHOULDER HARNESS USED G- CHILDREN
M/G BICYCLE- HELMET 0 - NOT EJECTED H- ANIMALS
11 - POSITION UNKNOWN• [H - LAP/SHOULDER HARNESS NOT USEO 1 • FULLY EJECTED 7 8 9 PASSENGER I - PERSONAL HYGIENE
J - PASSIVE RESTRAINT USED V - NO X - NO - PARTIALLY EJECTEC 10 0 - OTHER* K - PASSIVE RESTRAINT NOT USED - UNKNOWN J- READING W. YES Y. YES K - OTHER
P • NOT REQUIREO
ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK (*) SHOULD BE EXPLAINED IN THE NARRATIVE.
PRIMARY CRASH FACTOR 1 2 2
LIST NUMBER (E) OF PARTY AT FAULT TRAFFIC CONTROL DEVICES VEHICLE AUTOMATION LEVEL MOVEMENT PRECEDING CRASH cnes A CONTROLS FUNCTIONING
A SAE LEVEL - 0 A STOPPED
B CONTROLS NOT FUNCTIONING• B SAE LEVEL - 1 B PROCEEDING STRAIGHT B OTHER IMPROPER DRIVING Ç CONTROLS OBSCURED C SAE LEVEL - 2 Ç RAN OFF ROAD XID NO CONTROLS PRESENT / FACTOR* D SAE LEVEL - 3 D MAKING RIGHT TURN C OTHER THAN DRIVER• TYPE OF CRASH E SAE LEVEL •4 E MAKING LEFT TURN D UNKNOWN• A HEAD - ON F. SAE LEVEL - 5 F MAKING U TURN IB SIDE SPE G UNKNOWN" G BACKING
C REAR END H SLOWING / STOPPING
WEATHER (MARK 1 TO 2 ITEMS) D BROADSIDE VEHICLE AUTOMATION ENGAGED
PASSING OTHER VEHICLE
A CLEAR E HIT OBJECT X A NO AUTOMATION J CHANGING LANES
X B CLOUDY F OVERTURNED B DRIVER ASSISTANCE K PARKING MANEUVER
X C RAINING G VEHICLE / PEDESTRIAN C PARTIAL AUTOMATION ENTERING TRAFFIC D SNOWING H OTHER• D CONDITIONAL AUTOMATION M OTHER UNSAFE TURNING
E FOG / VISIBILITY FT MOTOR VEHICLE INVOLVED WITH E HIGH AUTOMATION N XING INTO OPPOSING LANE F OTHER: (MARK 1 TO 2 ITEMS) F FULL AUTOMATION O PARKED G WND A NONCOLLISION G UNKNOWN* P MERGING
LIGHTING B PEDESTRIAN Q TRAVELING WRONG WAY
A DAYLIGHT C OTHER MOTOR VEHICLE OTHER ASSOCIATED FACTOR(S) R OTHER • 2 3
B DUSK - DAWN D MOTOR VEHICLE ON OTHER ROADWAY (MARK 1 TO 2 ITEMS) S LANE SPLITTING
C DARK - STREET LIGHTS E PARKED MOTOR VEHICLE A CYC SECTION VICTATION SOBRIETY • DRUG • PHYSICAI
XID DARK - NO STREET LIGHTS F TRAIN MARK ALL THAT APPLY
E DARK - STREET LIGHTS NOT G BICYCLE A HAD NOT BEEN DRINKING FUNCTIONING• H ANIMAL HYES
J NO B HBO - UNDER INFLUENCE
ROADWAY SURFACE FIXED OBJECT C GIE HECTION VIOLATION C HBO - NOT UNDER INFLUENCE
A DRY D HBD - IMPAIRMENT UNKNOWN
X B WET J OTHER OBJECT D E UNDER DRUG INFLUENCE*
C SNOWN - ICY E VISION OBSCUREMENT DRE EXAM. CONDUCTED
D SLIPPERY (MUDDY, OILY, ETC) K ADDITIONAL OBJECTS) STRUCK E INATTENTION• STIMULANT
ROADWAY CONDITION(S) PEDESTRIAN'S ACTIONS G STOP & GO TRAFFIC HALLUCINOGEN (MARK 1 TO 2 ITEMS) X A NO PEDESTRIANS INVOLVED H ENTERING / LEAVING RAMP DISSOCIATIVE ANESTHETI
B CROSSING IN CROSSWALK PREVIOUS CRASH NARCOTIC ANALGE SIC
AT INTERSECTION J UNFAMILIAR WITH ROAD INHALANT
C CROSSING IN CROSSWALK - NOT K DEFECTIVE VEH. EQUIP. SIO] YES CANNABIS D CONSTRUCTION - REPAIR ZONE AT INTERSECTION •NO DEPRESSANT LE REDUCED ROADWAY WIDTH CROSSING - NOT IN CROSSWAL L UNINVOLVED VEHICLE F IMPAIRMENT - PHYSICAL• IN ROAD - INCLUDES SHOULD M OTHER• G IMPAIRMENT NOT KNOWN [G AOPROACHING LEAVING SCHOOL BUS IN NONE APPARENT X H NOT APPLICABLE
NIH NO UNUSUAL CONDITION MISCELLANEO RUNAWAY VEHICLE SLEEPY / FATIGUED KETCH
12 3 SPECIAL INFORMATION
REFER TO SKETCH PAGE(S) A HAZARDOUS MATERIAL
INDICATE NORTH B CELL PHONE HANDHELD IN U!
COSE PHONE HANOSFREE N
D CELL PHONE NOT IN USE
E CELL PHONE USE UNKNOWN
F SCHOOL BUS RELATED
1 2 3 BIKEWAY FACILITY
A SHARED ROADWAY
B CLASS 1- BIKE PATH
CLASS I - BIKE LAN
CLASS III - BIKE ROU
E CLASS - SEPARATED
REFER TO NARRATIVE FOR AQDITIONAL FORMATION
An Intemationally Accredited Agency
CITY OF RIALTO
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATROL
INJURED / WITNESS / PASSENGERS 2023 OCT ( 2903, *?
CHP 555 Page 3 (Rev. 2-22) OPI 060
CRASH DATE (MO. DAY YEAR CRASHTIME (240C) NCIC B OFFICER ID NUMBER 04/13/2023 0305 9860 014777 9860-2023-01309
EXTENT OF INJURY ("X" ONE) INJURED WAS ("X" ONE) PARTY SEAT AIR SAFETY EJECTE
WITNESS PASSENGER
ONLY ONLY POSSIBLE NUMBER POS EQUIP
DRIVER PASS. PED. | BICYCUST OTHER OPER
INJURY
24 M 2 6 P
NAME /D. O. B. /ADDRESS TELEPHONE
PAUL NUNEZ SAN BERNARDINO CA 92410 UNKNOWN
(INJURED ONLY) TRANSPORTED BY EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
X*1 • 28 F
NAME /D. O. B. /ADDRESS TELEPHONE
MELISSA VALLEZ RIALTO CA 92376 (909) 820-2350
(INJURED ONLY) TRANSPORTEO BY: EMS RUN NUMBER: TAKENTE
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
NAME / D.O. B.IADDRESS TELEPHONE
(INJUREDONLY) TRANSPORTED BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
NAME / D. O. 8. / ADDRESS
(INJURED ONLY) TRANSPORTED BY: EMS RUN NUMBER:
DESCRIBE INJURIES
NAME / D. O. 6. /ADDRESS TELEPHONE
(INJURED ONLY) TRANSPORTED BY: TAKEN TO:
DESCRIBE INJURIES
VICTIM OF VIOLENT CRIME NOTIFIED
•*
NANE / D. O.B./ ADDRESS TELEPHONE
(INJUREO ONLY) TRANSPORTEO BY: EMS RUN NUMBER: TAKEN TO
DESCRIBE INJURIES
• VICTIMOF VIOLENT CRIME NOTIFIED
PREPARER SNAME TID NUMBER NO. DAY YEAR REVEWERS NAME A DAY YEAR CURTIS E DANE 014777 04/13/2023 J. NORFOLK, 020595 04/30/2023 An Internationally Accredited Agency
CITY OF RIALTO
STATE OF CALIFORNIA
DEPARTMENT OF CALIFORNIA HIGHWAY PATRO
SKETCH DIAGRAM 2023 OCT 12 P.M. 3: 09
CHP 555 Page 4 (Rev. 2-28) OPI 060 Page 4
(CRASH DATE MO DAY YEAR) CRASH TIME (2400) KCIC • OFFICER ID AMBER L CEIVEL 04/13/2023 0305 9860 014777 9860-2023-01309
N
DATE PREPARER CAPTURED IMAGE: 04/20/2023
PROPRIETOR OF IMAGE: E
COPYRIGHT YEAR OF IMAGE:
+
-
Google
Imagery ©2023 Google, Map data C2023 Unice S Send Feedhach 5m l THIS OVERHEAD IMAGE IS PROVIDED TO DEPICT THE CRASH SCENE ENVIRONMENT ONLY. ANY VEHICLES,
PEDESTRIANS, OR OTHER ROAD USERS CAPTURED IN THE OVERHEAD IMAGE NOT DEPICTED IN THE SUMMARY/CAUSE WERE NOT ASSOCIATED WITH THIS CRASH.
ALL VEHICLE DIMENSIONS AND MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED.
PREPARED BY IO NUMBER MO DAY YEAR REVIEWER S NAME MO DAY YEAR CURTIS E DANE 014777 04/13/2023 J. NORFOLK, 020595 04/30/2023 An Internationally Accredited Agency
CITY OF RIALTO
2023 OCT 12 PH 3:09
STATE OF CALIFORNIA
NARRATIVEISUPPLEMENTAL PAGE 5 COF 7
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
04/13/2023 0305 9860 014777 9860-2023-01309
1 All times, speeds, and measurements throughout this report are approximate. Measurements were 2 obtained using visual estimation and GPS unless otherwise stated. All opinions and conclusions were 3 based on evidence and/or statements.
4 5 STATEMENTS
6 7 Party #1 (Stewart) stated, in essence, the following: Party #1 was traveling eastbound on State Route 210, 8 west of State Street, within the number 3 lane at approximately 65-70 miles per hour. Party #1 stated he 9 was driving in light rain conditions. As a result of the rain, visibility from Vehicle #1's (gray Hyundai Sonata) 10 windshield was blurry from the rain and the windshield wiper. As Party #1 continued to travel in an easterly 11 direction, he noticed he was approaching a police car (Vehicle #2). As Party #1 was near Vehicle #2, he 12 noticed that he was rapidly approaching the vehicle. Party #1 turned the steering wheel to the left to avoid 13 crashing into Vehicle #2, but was unable to react in time as the right front corner of Vehicle #1 crashed into 14 Vehicle #2.
15 16 Witness #1 (Vallez) stated, in essence, the following: Witness #1 was engaged in her duty as a Rialto 17 Police Officer. When Witness #1 arrived on-scene at State Route 210 eastbound, west of State Street, she 18 parked Vehicle #2 on the right shoulder and partially into the number 3 lane. Witness #1 parked Vehicle #2 19 at a slight angle to provide protection for herself and her partner at the scene. Witness #1 had just 20 completed conducting a DUl investigation and placed the arrestee (Passenger Nunez) in the right rear seat 21 of Vehicle #2. Witness #1 walked around the front of Vehicle #2, toward the driver's door when she 22 observed Vehicle #1 approaching the location of Vehicle #2 at a high rate of speed. Witness #1 stepped 23 back near the right headlight of Vehicle #2 and observed Vehicle #1 crash into the left front corner of 24 Vehicle #2.
25 26
27 28
29 30
31 PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
CURTIS E DANE 014777 04/13/2023 J. NORFOLK, 020595 04/30/2023
CITY OF RIALTO
2023 OCT 12
STATE OF CALIFORNIA PM 3: 09
NARRATIVE/SUPPLEMENTAL PAGE 6 OF 7
DATE OF INCIDENT TIME NCIC NUMBER OFFICER DCIT Y NUMBER 04/13/2023 0305 014777 9860-2023-01309
1 OPINIONS AND CONCLUSIONS
2 3 Summary/Cause:
4 5 Party #1 was driving Vehicle #1 eastbound on State Route 210, west of State Street, within the number 3 6 lane at approximately 65-70 miles per hour. Vehicle #2 was stopped on the shoulder and partially within 7 the number 3 lane, facing in a northeasterly direction. Vehicle #2's rear red, blue, and amber lights were 8 activated.
9 10 Party #1 was in violation of section 22350VC- Unsafe Speed for the Prevailing Conditions, when he failed 11 to notice that Vehicle #2 was stopped ahead of Vehicle #1. When Party #1 noticed that Vehicle #1 was 12 rapidly approaching Vehicle #2, he turned the vehicle to the left, into the number 2 lane to avoid crashing 13 into Vehicle #2. Party #1 was unable to react in time before the right front corner of Vehicle #1 crashed 14 into the left front corner of Vehicle #2 (Area of impact #1). Party #1 moved Vehicle #1 onto the right 15 shoulder of State Route 210, ahead of Vehicle #2. Vehicle #2 remained at rest on the right shoulder and 16 partially within the number 3 lane.
PREPARED BY T.D. NUMBER DATE REVIEWER'S NAME DATE
014777 04/13/2023 J. NORFOLK, 020595 04/30/2023
CURTIS E DANE
CITY OF RIALTO
2023 OCT 12 statement Bet
COMM HOSP OF SAN BERNARDI NO
SE Dignity Health. 1805 MEDICAL CENTER DR
5 / 04/23
SAN BERNARDINO, CA 924111217C0/9Y887.6333
In case of eror on your bill, please inquire in writing to the above address within 60 days. CITY CLERK Patient Admission No. Admitted Discharged Page
NUNEZ, PAUL J 82007130782 4 / 28/2023 4128/2023 1
MR#: 3800759121 PT TYPE E
Guarantor:
PAUL JIMMY ACOSTA NUNEZ
SAN BERNARDINO, CA 92408
Ins. Code : Insurance Company Insurance I.D. Number
1. 2134 LEHP DIRECT MCAL
2. 3.
4. Charge # Service Date CPT4/SMA • Mod. Bill / Rev aty. Service Description Hospital Charge Code Codo
0250 PHARMACY
6000854 4 / 28 / 23 27610 0250 1 CYCLOBENZAPRINE 10 MG
•• SUBTOTAL •• 1.0
0301 LABI CHEMISTRY
30 00 43 7 4 / 28 / 23 6 0 307 0301 DRG PRES TCL NONCH N 818.00 3000061 4 / 28 / 23 80053 TC 0301 : COMP METABOLIC PANEL 872. 00 3000133 4 / 28/23 83690 TC 10301 LI PASE 59.00
•• SUBTOTAL •• 1. 749.00
0305 LABI HEMOT OLOGY
3000207 4 / 28 / 23 85025 TC 0305 1 CBC W/ AUTO DIFF 77.00 • • SUBTOTAL •• 77.00
0 3 07 LAB/ UROLOGY
3000 29 9 4 / 28 / 23 81001 TC 0307 1 UA AUTO W MI CRO 181.00 SUBTOTAL • • 181.00
0352 CT SCAN/ BODY
3500108 4 / 28 / 23 74176 TC 0352 1 CT ABDOMEN PELVIS WO 1,006. 00 •• SUBTOTAL •• 1,006.00
0450 EMERGENCY ROOM
45 00 01 2 8128/23 27502 10450 ER LEVEL 4 WI PROCEDU 3, 593.00 4128/23 86372 0450 - -
4500110 INJ TX/ DX/ PROPH SUBO 938.00
•• SUBTOTAL • • 4,531.00
0636 PHARMACY W HCPCS
6001851 4128/23 11885 0636 KETOROLAC 30 MG/ ML 1 M 64.00 6000995 4 / 28/23 11100 0636 I N 26.00
SUBT OT AL 90.00
... TOTAL CHARGES --> 7. 638.00
ALL BILLS DUE AND PAYABLE UPON RECEIPT. PATIENT AMOUNT DUE IS SUBJECT TO REVISION BASED ON ACTUAL COVERAGE WHEN PAID. CHARGES OR CREDITS NOT IN THE BUSINESS OFFICE AT TIME OF THIS Thank You! 7, 638.00 STATEMENT WILL BE BILLED TO YOU AT A LATER DATE.
PAY THIS AMOUNT
CITY OF RIALTO
2023 O stard mant pate 3: 09
COMM HOSP OF SAN BERNARDINO
* Dignity Health. 1805 MEDICAL CENTER DR
SAN BERNARDI NO, CA 924111217 10616333
in case of error on your bill, please inquire in writing to the above address within 60 days. CITY CLERK Admission No. Admitted Discharged Page
NUNEZ. PAUL J 82007130782 4 / 28/2023 4 / 28 / 2023
MR#: 3800759121 PT TYPE E
Guarantor:
PAUL JIMMY ACOSTA NUNEZ
SAN BERNARDINO, CA 92408
Ins. Code ; Insurance Company Insurance I.D. Number
1. 2134 I EHP DI RECT MCAL
2. 3.
4. Charge # Service Date CPT4/SMA Mod. Bul/ Rev Qty. Sarvice Description Hospital Charge Code Codo
SUMMARY OF CHARGES
250 PHARMACY 4.00
301 LABI CHEMISTRY 1.749.00
305 LABI HEMOTOLOGY 77.00
307 LABI UROLOGY 181.00
352 CT SCAN/ BODY 1, 006.00
4 5 0 2 EMERGENCY ROOM 4, 531.00
6 3 6 12 PHARMACY W HCPCS 90.00
Thank You! 7, 638.00
STATEMENT WILL BE BILLED TO YOU AT A LATER DATE.
PAY THIS AMOUNT
CITY OF RIALTO
COMM HOSP OF SAN BERNARDINOCT 12 Pstatenem Date
* Dignity Health. 1805 MEDICAL CENTER DR
SAN BERNARDINO, CA 924111217C809 887-6333
in case of error on your bill, please inquire in writing to the above address within 60 days. CITY CLERK Patient Admission No. Admitted
Page
NUNEZ. PAUL J 82007094053 4 / 13/2023 /13/202
MR#: 3800759121 PT TYPE
Guarantor:
PAUL JIMMY ACOSTA NUNEZ
BAN BERNARDINO, CA 92408
Ins. Code i Insurance Company Insurance I.D. Number
1. 2134 IEHP DIRECT MCAL
2. Charge # Service Date CPT4/SMA : Mod. Bill / Rev Qty. Service Descrption Hospital Charge Code Codo
0250 PHARMACY
6000031 4 / 13/23 27610 0250 ACETAMI NOPHEN 500 MG
2. 00
6001707 4 / 13/23 27610 0250 ..' SUPROFEN 600MG TAB
SUBTOTAL
0320 RADI OLOGY • DI AGNOSTIC
3200149 4 / 13 / 23 72100 TC | 0320 XR LUMBAR SPINE 2 OR 813.00 •• SUBTOTAL •• 815.00
0450 EMERGENCY ROOM
45 00012 4 / 13/23 27502 0450 1 ER LEVEL 4 WI PROCEDU • 593.0 • • SUBTOTAL •• ,593.0
... TOTAL CHARGES ..
4,414.00
ALL BILLS DUE AND PAYABLE UPON RECEIPT. PATIENT AMOUNT DUE IS SUBJECT TO REVISION BASED ON ACTUAL COVERAGE WHEN PAID. CHARGES OR CREDITS NOT IN THE BUSINESS OFFICE AT TIME OF THIS Thank Youl 4,414.00 STATEMENT WILL BE BILLED TO YOU AT A LATER DATE.
PAY THIS AMOUNT
CITY OF RIALTO
Se Dignity Health. COMM HOSP OF SAN BERNARDI 23 OCT 12
1805 MEDICAL CENTER DR
SAN BEADIN, CA 9241112172E8081897-6333
In case of error on your bill, please inquire in writing to the above address within 60 days. CITY CLERK Patient Admission No.
NUNEZ, PAUL J 8 2 0 07 09 40 53 4 / 13 / 2023
4 / 13 / 2023
MR#: 3800759121 PT TYPE E
Guarantor:
PAUL JIMMY ACOSTA NUNEZ
SAN BERNARDINO, CA 92408
Ins. Code ; insurance Company
Insurance I.D. Number
1. 2134 I EHP DIRECT MIC AL
2. 3.
4. Charge # Service Date CPT4/SMA Mod. Bill / Rev Oty.
Service Description Hospital Charge
Code Codo
SUMMARY OF CHARGES
250 PHARMACY 6.00
320 1 RADI OLOGY • DI AGNOSTIC 815.00
450 1 EMERGENCY ROOM 3. 593.00
ALL BILLS DUE AND PAYABLE UPON RECEIPT. PATIENT AMOUNT DUE IS SUBJECT TO REVISION BASED ON ACTUAL COVERAGE WHEN PAID. CHARGES OR CREDITS NOT IN THE BUSINESS OFFICE AT TIME OF THIS Thank You! 4,414.00 STATEMENT WILL BE BILLED TO YOU AT A LATER DATE.
PAY THIS AMOUNT