CITY CLERK'S DATE STAMP
CITY OF RIALTO
SALTO, CATAPO CITY OF RIALTO
LIABILITY
CLAIM FOR DAMAGES 2024 DEC -3 AM 9: 08
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). 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: 150S. Palm Ave., Rialto, CA 92376 Address: 290 W. Rialto Ave., Ratto, CA 92376
CLAIMANT INFORMATION:
Alexis Rose Sanchez
FULL NAME DATE OF BIRTH
-
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO.
BUSINESS ADDRESS INCLUDING CITY, STATE & ZIP
The Simon Law Group, LLP
ADDRESS AT WHICH CLAIMANT DESIRES TO RECEIVE
NOTICES OR COMMUNICATIONS REGARDING THIS CLAIM
(if different from home address provided above): 2916 W. 164th St., Torrance, CA 90504, (310) 914-5400
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: June 17, 2024 TIME: 9:41 p.m. • AM X 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.
The crosswalk at the intersection of Sycamore Ave, and Baseline Rd. in Rialto, CA
3. HOW DID DAMAGE OR INJURY OCCUR?
On the date of the Incident, Claimant's husband was walking southbound on Sycamore Ave. in the marked crosswalk when the signal light turned green. While Claimant's husband was walking through the crosswalk, a vehicle traveling northbound on Sycamore Ave. attempted to turn left at the intersection and travel westbound on Baseline Rd. When the driver attempted his turn, he struck claimant in the crosswalk.
4. WERE POLICE AT THE SCENE? IX YES • NO WERE PARAMEDICS AT THE SCENE? X 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.
Upon information and belief, Claimant alleges the City of Rialto knew there had been numerous vehicular collisions that occurred at the Subject Intersection, including vehicle vs. pedestrian collisions, which gave ample notice to the City that the subject intersection, and particularly the crosswalk where this collision occurred, was in a dangerous condition. Furthermore, upon information and belief, Claimant alleges that the crosswalk in question did not have a leading pedestrian interval installed, which is not in compliance with AB 2284 and Catifornia Vehicte Code 9 21450.5, that created a dangerous 15,000,000.00
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage 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 bills according to proof Amount: $
Item/Date: Amount: $.
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: cp $500,000.00 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN: OF RIALTO AmdantlEr
Item/Date:
Item/Date: Amount: AM 9:08
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: C/$ E 65,000.000.00 CLERK
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) NAME: Jonathan Albert Escobar NAME: Officer Carina Magallanes, CHP ADDRESS: ADDRESS:
TELEPHONE: =....... TELEPHONE: (
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITALS) VISITED:
NAME: Arrowhead Regional Medical Center NAME: Ballard Rehabilitation Hospital ADDRESS: 400 N Pepper Ave, Colton, CA 92324 ADDRESS: 1760W 16th St, San Bernardino, CA 92411 TELEPHONE: ) (909) 580-1000 TELEPHONE: | ) (909) 473-1200 DATE: June 17,2024 TIME: DATE: July 9, 2024 TIME: DAM OPM
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 yourself 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.
NORTH
WEST Baseline Rd x EAST
CURB
PARKWAY
SOUTH Sycamore Ave.
7/F SIDEWALK
HAVE READ THE FOREGOING CLAIM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS 1 HOSE MATTERS WHICH ARE HEREIN STATED UPON MY INFORMATION AND BELIEF; AND AS TO THOSE MATTERS I BELIEVE THEM TO BE TRU I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OR CLAIMANT OR APENT
Thomas J. Conroy, Esq. 11/26/2024
TYPE OR PRINT NAME DATE
Attorney of Behalf of Claimant
RELATIONSHIP TO CLAIMANT
CERTIFIED MAIL
The Simon Law Group
2916 W. 164th Street ELES CA 900
Torrance, CA 90504 US POSTAGE PITNE: BOWES
1024PM 326
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S
ZIP 90504 009.64°
9589 0710 5270 1145 1767 25 02|
0006194092 NOV 26 2024
Rialto City Clerk's Office
150 S. Palm Ave 2024 DEC -3 AM 9: 08 CITY OF RIA! *
Rialto, CA 92376 CITY CLERK RECEIVED
S2376-848793