CITY CLERK'S DATE STAMP
CITY OF RIALTO
CITY OF RIALTO
LIABILITY
CLAIM FOR DAMAGES 2025 FEB 20 PM12:40
TO PERSON OR PROPERTY RECEIVEL
CITY CLERA
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 lail: 150 S. Palm Ave., Rialto, CA 9237 ddress: 290 W. Rialto Ave., Rialto, CA 9237
CLAIMANT INFORMATION:
Ramrad Senior Housing Inc. NIA
DATE OF BIRTH
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO. 1010 Terrace Rd., San Bernardino, Ca 909 384-9855
92410
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 DID DAMAGE OR INJURY OCCUR? DATE: October 11, 2024 TIME: 9:55 • AM &I 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.
Please see attached (page 1, 2)
3. HOW DID DAMAGE OR INJURY OCCUR?
Please see attached (pagel, 3)
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.
City of Rialto Emergary Services- Station 202 (name of emerjany driver not given on City of Riato Police report #932411233. (see attachment A
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ 3,000 +8 5800 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, etc. Please attach 2 estimates DAMAGES INCURRED TO DATE:
Item/Date: RLC WElDING NOV. 4, 2024 Amount: $ 3,000.°°
Item/Date: Quintero's Iron works NOV 4,202Y Amount: $ 5,900, 0º (sce attainments, page 243. 285"0
Additiinal propasal: mr. Alarm 1125/24 Amont$
services Paid: mr, Alarm 10-21-24 Amout#1950° PAID
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $6,380,00 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN: Mr. Alcum 10-21-24 (Pard -
Item/Date: Quinitero's Iren Works 11-4-24. Amount: $ -5900.
Mr Alarm 11-25-24 Amount: $ 285.00
Item/Date:
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $
7. WITNESSES TO DAMAGE OR INJURY List all persons known to Rave information (attach additional pages, if necessary) NAME:-- NAME: 1
ADDRESS: 1010 Terrace Rd ADDRESS: 010 Terrace Kd.
San Bernardino, Ca 92410 San Bernardino, Ca 72410
TELEPHONE: TELEPHONE: | )
(see Jaciarity r2p0rt-10"11-24)
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITALS) VISITED:
NIA NAME:
NAME:
ADDRESS: ADDRESS: _
TELEPHONE: L ) TELEPHONE: |)
DATE: TIME: LIAM LIPM 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 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.
CURB
PARKWAY
SIDEWALK
(see attachment B)
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
oreNa Trevino - Office Manager 2/20/2025
TYPE OR PRINT NAME DATE
office manager
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
2) PLACE ON ACCIDENT (OCCURRENCE) BE SPECIFIC-
The accident happened at the north exit gate as the City of Rialto emergency vehicle was leaving the Ramrod property at approximately 9:55 pm on October 11, 2024. Exit and entrance to the Ramrod Senior Housing Inc. is located at 1010 Terrace Rd. San Bernardino, Ca 92410. 3) HOW DID DAMAGE OR INJURY OCCUR?
According to Ramrod's volunteer security this information was viewed on Ramrod's security camara 2_MG_FULL as he was scanning our camara's he noticed that there were police and ambulance from the City of Rialto at the north gate. He then went to the North gate and saw the damage to our north exit gate facing Terrace Rd. He explained that the supervisor of the fire department of City of Rialto was present as well as the City of Rialto Police Department. Mr. reviewed the playback of the security camaras the following day. He stated that the camaras reveled that the Paramedic driver exited through the North exit gate at Ramrod Senior Housing at approximately 9:55 pm on October 11, 2024. He then witnessed the driver of the emergency vehicle pull to the left towards the guest parking directly outside of the exit gate. It was then that the exit gate began to close hitting the passenger side of the emergency vehicle and again closing on the back of the emergency vehicle in which stated that the gate caught on the back of the emergency vehicle dragging the gate off the track. witnessed the driver of the emergency vehicle call someone which he later found out was his supervisor.
A report was filed by the City of Rialto Police Department by Officer S. Barajas badge #342.
Report DR#932411233.
Security footage is attached, unfortunately we were only able to obtain footage after indecent occurred due to technical difficulties.
ATTACHMENTA
SAN
CAD Operations Report PRETD
Call Number: 241011-0329 Printed: 1/9/2025 1:22:43 PM
Call Detail Information Jurisdiction: RIALTO
Call Number Taker Pos Call Owner Status Date - Time Received Inj 241011-0329 SBONDY 3 C 10/11/2024 22:17:02 0
Complaint Ten Code Priority Fire Grade Class Alarm How Received 1182 3 T
Incident Location Apart/Suite Fir Incident City State ZIP 1010 N TERRACE RD RIALTO CA
Caller Name Telephone Alt Telephone Tower ID
CAPTAIN BENDER//RFD --
Caller Location Apart/Suite Fir Caller City State ZIP
Landmark Weapons
RAMROD SENIOR MHP
IRA Grid Disp Zone Fire Run Zn EMS Run Zn ]ESN Tract
117 2
Contacts Fire Plan Hazard Images Medical Traffic x Previous BOLO Warrant RMS CH RMS Al InProg Rot Rea [Sub Rea
Ali Time Call Rec'd Xmit Dispatch Enroute OnScene Departed Arrived 22:17:02 22:18:41 22:19:44 22:19:44 22:19:49 22:19:49
Comp Unit x:
23:02:26 P20G
Lwr: 7 Upr:
SAN BERNARDINO CITY SHAMROCK ST
CONTROLLED COPY
CONFIDENTIAL COPY
RESTRICTED PC 11142-1114
REL TO: ARNOLD TORRES
WALK IN REQ
BY: JLM
•
CAD Operations Report
Call Number: 241011-0329 Printed: 1/9/2025 1:22:43 PM
Narrative...
[10/11/2024 23:02:26: pos4: YWRIGHT]
[Cleared with unit P20G]
[10/11/2024 22:52:41 : pos4: YWRIGHT]
[10/11/2024 22:52:17: pos4: YWRIGHT]
4BNMM.ID
DATE:10-11-24 *TIME:22:52*
DMV RECORD FOR LAW ENFORCEMENT USE ONLY
ONTROLLED COPY
PONFIDENTIAL COPY
' NƠT FOR THIRD PARTY RELEAS
REL TO: ARNOLD TORRES
WALK IN REQ
BY: JLM
CAD Operations Report
Call Number: 241011-0329 Printed: 1/9/2025 1:22:43 PM
[10/11/2024 22:43:37 : pos4 : YWRIGHT]
932411233
[10/11/2024 22:43:18: MOB : P20G]
$5-6,000 to repair gate
[10/11/2024 22:35:33 : pos3: SBONDY]
SUPERVISOR /ISEC NRT TO THE FRONT GATE
[10/11/2024 22:34:07 : pos4: YWRIGHT]
* GATE *
[10/11/2024 22:34:02 : pos4: YWRIGHT]
Unit : P20G
HAVE RESP 87 FRONT GARE
[10/11/2024 22:19:21 : pos4: YWRIGHT]
S14 ADV
[10/11/2024 22:18:41 : pos3: SBONDY]
Landmark: RAMROD SENIOR MHP
Cross streets: SAN BERNARDINO CITY//SHAMROCK ST
GATE WAS STRUCK BY FIRE ENGINE AND ENGINE IS DAMAGED
MEDIC AMBULANCE 202
RP IS STANDING BY AT STATION 202
CONTROLLED COPY
CONFIDENTIAL COPY
_ RESTRICTED PC 11142-1114
REL TO: ARNOLD TORRES
WALK IN REQ
BY: JLM
.. •
CAD Operations Report
Call Number: 241011-0329 Printed: 1/9/2025 1:22:43 PM
Department Numbers Department OCA Numbers
Department Dept Number Unit Id Department TOCA Number TRMS Juris 3609 241011-00223 P10G 3609 932411233 CA0360900
Call Dispositions
Date Time Disposition Unit ID
10/11/2024 23:02:26 RTF P20G
Call Log
Unit Status Date Time Dept Type Comments officers Todo
P20G 10/11/2024 22:43:49 3609 POL Primary Unit 02672/01734 0 P20G 10/11/2024 22:43:48 3609 POL Primary Unit 02672/01734 P20G ONS 10/11/2024 22:30:05 3609 POL T1010 N TERRACE RD, RIALTO 02672/01734 P20G COM 10/11/2024 23:02:26 3609 POL COM 02672/01734
P10G REM 10/11/2024 22:20:19 3609 POL REM 02458
P10G ENR 10/11/2024 22:20:11 3609 POL FIRE STATION 202, RIALTO 02458 0 P20G ENR 10/11/2024 22:20:07 3609 POL 1010 N TERRACE RD, RIALTO 02672/01734 P10G LEF 10/11/2024 22:19:49 3609 POL RIALTONe, FIRE STATION 202. 02458 P10G ENR 10/11/2024 22:19:44 3609 POL 1010 N TERRACE RD, RIALTO 02458 Unit Dept DIS ENR ONS LEF ARR [BUS TREM COM
P10G 3609 22:19:44 22:19:49 22:20:19
P20G 3609 22:20:07 22:30:05 23:02:26
Call Persons
Category Last Name First Name Middle Name Suffix Crim Hist RMS Alerts Race Sex Ethnic Height Weight DOB OLN
Clothing Demeanor
Relationship Hair Color Eye Cir Complexion
Business Name Description
Location Apt/Ste Fir/Bl City ST ZIP Phone
CF1535791
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= =
CAD Operations Report
Call Number: 241011-0329 Printed: 1/9/2025 1:22:43 PM
Call Vehicles
Year Make Model VIN Plate ] Color ] Towed BOLO
Role Body Style
Comments Owner
C 1608202
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page z
• 12/18/24, 1:16 PM Gmail - Ramrod Senior Housing, Inc. - Need updated proposal
SPECIALIZED IN COSTOR DESTERS NOVATION AID HARD STELE
P 590 Maple Ct. Suite B Colton, Ca 92324
Office (909)329 0695
www.quinteresironworks.com
RAM ROD SENIOR H. (909) 384-9855 12/15/24
1010 N. TERRACE RO S. BeRNardo 92410
CA
Spechications H Open Side
SINGLE GATE
(int)(L/R)
SINGLE DOOR
DOUBLE GATE REMOVE THE OLD GATE
DOUBLE DOOR AND INSTALL NEW GATE
PANELS
FENCES
SLIDING GATE ONE NEW 18'× 6' Aprox. Dim.
FOLDING GATE
SAM TYPE THE MATERIALS EXIST.
WINDOWS PROTECTION
MOTOR FOR GATE
TH OTHE GATE
HAND RAILS
STAIR CASES
REPAIR NEW HADWARE INCLUID.
Designs on top Floor
ARC NOTE:
I SEMI ARC 1.- Total will change if any alterations are made from this inveice.
2.- Not responsible for broken lines, sprinkles, power, gas, not STRAIT
identified by customer.
SPEARS 3.- Although powder coating oil base and water base enamel CASTING provide protection; there is hever guarantee against rust, TOP proper maintenance by owner is required to control corrosion.
MEDIUM
Ornamentals Color BLACK
WOOD STAIN
SCREEN (METALIZE
POWDER COAT TOTAL $ 5900°°
SHEET SOLID
GATE LATCH REGULAR PAINT
SLIDING BOLT DEPOSIT $ 2900
CANE BOLT
BALANCE $ 3000
SPRING
SINGLE LOCK (BOX)
DOUBLE LOCK (BOX)
HANGER BOLT
LOCKS
RODOLFO QUINTERO CUSTOMER
[Quoted text hiddenl
nann AIn
NOV - 4 2024
000000000000000000
1066 vasar st Phone-909-626-7978
Pomona ca Fax-909-626-7978
951-285-5183 91767 Email: [email protected]
Cell-951-285-5133
"PABLE TIE PORNO RLC WELDING
909-626-1978
TOTAL PAGES, INCLUDING
COVER:
PLEASE PLEASE FOR YOUR
L URGENT REPLY ASAP COMMENT REVIEW INFORMATION
Send to: From:
Attention: Office POMONA CA.
Location:
Office 1010 TERRACE RD Date: 11/1/24
location: SN BERNARDINO CA
92410
Fax number: Phone
number:
***BUILD ENTRY GATE US SAME EXISTING ONE,US WE SPOKE,
BUILD AND INSTALL TOTAL PRICE, $3,000
THIS QUOTE IS A C,O,D
NOTE, THE ENTRANCE GATE NEEDS TO BE ALL WAYS OPEN FOR TENANTS,ANY INTERRUPTED TIME WILL BE EXTRA CHARGE OF $195,00 PER HR...
THANK YOU,
• - JAN 1 3 REC'D
Mr. Alarm Proposal
P.O BOX 4501
Ontario, CA 91761 Date of Proposal: 11/25/24
Proposal Number:
Customer Number: 1235
Ramrod Senior Housing Inc
1010 Terrace Road
San Bernardino, CA 92410
The terms of this proposal are valid
for 30 days from the date shown above.
Mr. Alarm
Hereby Submits Specification and Estimate for:
1235 Ramrod Senior Housing Inc @ 1010 Terrace Road
Quantity Description Amount
1 Disconnect gate damaged by emergency vehicle and
reconnect new gate. 285.00
Complete in accordance with above specifications for: $285.00 If you have any questions regarding this proposal please call us at (909)854-5530 Pages
Invoice
Mr. Alarm avoice Dat 10/21/24
ustomer Numbe 1235
P.O BOX 4501 Invoice Number: 01121757
Ontario, CA 91761 Monitoring No:
• Due Date: 10/21/24
Amount Due: $195.00
Ramrod Senior Housing Inc Mr. Alarm
1010 Terrace Road P.O BOX 4501
San Bernardino, CA 92410 Ontario, CA 91761
Please detach and return this coupon with your payment.
Mr. Alarm
Invoice Date: 10/21/24
Invoice Number: 01121757
1235 Ramrod Senior Housing Inc @ 1010 Terrace Road
Quantity Description Amount
Inspect gate after being struck by emergency vehicle.
1 Reset start stop limits as gate has ben bent changing adjustments.
1 Adjusted chain as needed after incident.
* Advised customer gate is bent and can not be properly straightend, the gate will need to be replaced
11353
CK. NO. 11/1/024
DATE
* Total amount due for labor. 195.00
All charges are due upon receipt. $195.00
For billing questions please call customer service at (909)854-5530 10-11-24
On 10/11/24 a ambulance leaving the park hit
the gate approximate time after 9:55pm. Instead of
pulling straight out the gate he truns to the right to
park lenght ways in visitors parking hitting the gate
twice with the side of the ambulance, knocking the
gate off the track and got stuck in open position. I
think the gate was allso bent.
The ambulance driver must have called his
supervisor, he came to look at the gate.
I saw him inspecting the gate thur the cameras,
and then the police showed up, I called
to tell him something going on at the frort gate, I
met cliff at the front gate. called (Mr. Alarm)
because the gate wouldn't close. I got the gate to
close and operate correctly.
The Fire department supervisior will come to
the park Saturday morning around 7:am and will
also be here to check the gate.
report by Lonnie, Head of security
doni Felt 10=11=24
Attachment B
N. Terrace Road
Property Address:
1010 Terrace Road
San Bernardino, CA 92410
Guest Parking Guest Parking
MAIN ENTRANCE
MAIN EXIT
GATE
E
X is point of contact
W•