CITY CLERK'S DATE STAMP
CITY OF RIALTO
•
LIABILITY
СТТУ
CLAIM FOR DAMAGES
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. Carla $911.2).
2. Claims for damages to real property must be filed not later than one (1) year after the occurrence (Gor. Code §811.2) 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., Riato, CA 92376 Address: 290 W. Rialto Ave., Riatto, CA 92376
CLAIMANT INFORMATION:
Eric Porfirio Martinez
FULL NAME DATE OF BIRTH
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 Forrester Lopez APC NOTICES OR COMMUNICATIONSREGARDING THIS CLAIM 260 Newport Center Dr. Ste 100, Newport Beach, CA 92660 (if different from home address provided above):
1. WHEN DID DAMAGE OR INJURY OCCUR? DATE: - April 20, 2026 TIME: 8:29 AM CAMO PM
2. PLACE OF ACCIDENT (OCCURRENCE) BE SPECIFIC - Describe fully and (if applicable) locate on diagram on reverse side of this shoot.
Where appropriate, give street names and addresses, measurements and landmarks.
Riverside Ave. and Agua Mansa Road in Rialto, County of San Bernardino, California.
3. HOW DID DAMAGE OR INJURY OCCUR?
Claimant was stopped at a red light, going north on Riverside Drive and was struck from behind by City of Rialto employee/vehicle, Paul Elweed Truffa.
4. WERE POLICE AT THE SCENE? YES • NO WERE PARAMEDICS AT THE SCENE? DYES 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.
Motor vehicle negligence. City of Rialto employee, Paul Elwood Truffa, rear ended Claimant's vehicle with a City of Rialto vehicle, a 2024 Ford F-150, License Plate No.: 1696589, causing property damage and bodily injuries to Claimant.
6. GIVE TOTAL AMOUNT OF CLAIM Include estimate of amount of any prospective injury or damage $ Approx $500,000.00 HOW WAS THE ABOVE AMOUNT COMPUTED? Be specific, list doctor bills, repair estimates, efc. Please attach 2 estimates.
DAMAGES INCURRED TO DATE:
Item/Date: Property damage Amount: $_$10,000.00
Item/Date: Medical Treatment Amount: $ $50,00.00
ano woula de an unmitea civil case.
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: The total amount Clammed exceeds 510,000 ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN: and would be an unlimited civil case.
Item/Date: Enomic Damages Amount: $_$150,000.00
Item/Date: _ Non-Ecomonic Damages Amount: $ $300,000.00 TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (attach additional pages, if necessary) Paul Elwood Truffa NAME:
NAME:
ADDRESS: ADDRESS:
TELEPHONE: (909 820-2501 TELEPHONE: ()
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTORS) OR HOSPITAL(S) VISITED:
NAME: Riverside Community Emergency Department NAME:
4445 Magnolia Ave, Riverside, CA 92501 ADDRESS:
ADDRESS:
TELEPHONE: L TELEPHONE:
DATE: TIME: L AM • PM DATE: TIME: AM 0PM:
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. 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 vehi en 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 t 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
Mansa Rd CURB S. Riverside Ave
PARKWAY
Agua SIDEWALK
I CERTIFY (OR DECLARE) UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT.
SIGNATURE OF CLAIMANT OR AGENT
6-01-26
Kingsley Forrester
TYPE OR PRINT NAME DATE
Attorney
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 1 PROOF OF SERVICE
2 I am employed in the county of Orange, State of California. I am over the age of 18 and not a party to the within action. My business address is 260 Newport Center Dr., Suite 100, Newport 3 Beach, CA 92660.
4 On June 10, 2026, I caused the documents) described as CITY OF RIALTO LIABILITY 5 CLAIM FOR DAMAGES TO PERSON OR PROPERTY to be served on the parties on the attached mailing list as follows:
6 7 XBy United States Mail
I placed the envelope for collection and mailing following our ordinary business practices. I am 8 readily familiar with this business's practice for collecting and processing correspondence for mailing.
On the same day that correspondence is placed for collection and mailing, it is deposited in the ordinary 9 course of business with the United States Postal Service, in a sealed envelope with postage fully prepaid.
The envelope or package was placed in the mail at Lake Forest, California. 10 Rialto City Clerk's Office
12 Mail: 150 S. Palm Ave., Rialto, CA 92376
Address: 290 W. Rialto Ave., Rialto, CA 92376
13 14
•By electronic mail
15 I transmitted the documents) via email to the email addresses listed on the attached mailing list.
16 17 For this case and unless notice to the alternative, please include the following persons on your email service list:
18 Oscar Lopez ([email protected])
19 Kingsley Forrester ([email protected])
Paralegal - Megan Stanford ([email protected])
20 21 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
22 Executed on June 10, 2026, at Lake Forest, California 23 Kingelay Forrester
24 Kinglsey Forrester
25 26
27 28
PROOF OF SERVICE - U.S. MAIL
FORRESTER LOPEZ
ATTORNEYS AT LAW SANTA ANA CA 926
260 Newport Beach, A Site 100 12 JUN 2026 PM k
Riaho Cay Cerk's Offire
150 s. Palm Ave
Rialto, CA 92376
ES:
FL
92376-646799