Sedaghat Law Group Tel: 424-777-0078
9454 Wilshite Blvd, Ste 830 Fax: 424-467-1662
SEDAGHAT
Beverly Hills, CA 90212 www.sedlawgroup.com
LAW GROUP
August 4, 2026
SENT VIA CERTIFIED MAIL
Rialto City Clerk's Office AUG
150 $ Palm Are.,
Rialto CA, 92376 CITY CLERK CITY OF RIALTO
Certified Mail No: 9589 0710 5270 4044 4084 54
PM 4: 05
RE: Our Clients) : Robert Antonio Campos
Date of Loss: : 02/13/2026
To whom it may concern:
Please be advised that our firm has been retained by the above-mentioned client in order to pursue a bodily injury claim against you in connection with the incident reference above. We ask that you direct all future correspondence regarding this matter to our office.
Enclosed please find the completed Claim for Damages form. Should you have any questions or require additional information, please do not hesitate to contact our office during our business hours of Monday through Friday 8:00am to 6:00pm or via email to [email protected].
Sincerely,
SEDAGHAT LAW GROUP
CITY OF RIALTO CITY CLERK'S DATE STAMP
LIABILITY CITY OF RIALTO
CITY 7026 AUG -7 PM 4: 05
CLAIM FOR DAMAGES
TO PERSON OR PROPERTY RECEIYED
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 occurence (Gov. Code $9112). 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., Rialto, CA 9237( Address: 290 W. Rialto Ave., Rialto, CA 9237
CLAIMANT INFORMATION:
Roberto Antonio Campos
FULL NAME DATE OF BIRTH
-
HOME ADDRESS INCLUDING CITY, STATE & ZIP HOME TELEPHONE NO. 1 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: 02/13/2026 TIME: • AM 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.
See Attachment A
3. HOW DID DAMAGE OR INJURY OCCUR?
See Attachment A
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.
See Attachment A
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 See Attachment A
Item/Date: Amount: $
Item/Date: Amount: $
TOTAL AMOUNT CLAIMED AS OF PRESENTATION OF THIS CLAIM: $.
ESTIMATED PROSPECTIVE DAMAGES, AS FAR AS KNOWN:
Item/Date: Amount: S_
Item/Date: Amount: $_
TOTAL ESTIMATED AMOUNT PROSPECTIVE DAMAGES: $
7. WITNESSES TO DAMAGE OR INJURY List all persons known to have information (atfach additional pages, if necessary) NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: ( TELEPHONE: |) 2026 AUG -7 PM 4: 05
8. IF INJURED, PROVIDE NAME, CONTACT INFORMATION AND DATE/TIME DOCTOR(S) OR HOSPITALS) VISITED: EVERK See Attachment A
NAME: NAME:
ADDRESS: ADDRESS:
TELEPHONE: ( TELEPHONE: )
DATE: TIME: •AM O PM 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 cityltown 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
I HAVE READ THE FOREGOING CLAM AND KNOW THE CONTENTS THEREOF; AND CERTIFY THAT THE SAME IS TRUE OF MY OWN KNOWLEDGE EXCEPT AS T 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
Lillian Sedashat 08/04/2029
TYPE OR PRINT NAME
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
CITY OF RIALTO
Attachment "A" 2026 AUG - 7 PM 4: 05
On February 13, 2026 at approximately 8:00 a.m., Claimant, REeF pio Campos (hereinafter referred to as "Mr. Campos"), was at a complete stop facing south bound on Cedar ave, at or near the intersection with Foothill Blvd, Rialto, California (hereinafter referred to as "Subject Location"), when the West Valley Water District driver suddenly rear ended Mr Campos' vehicle causing him to be pushed forward and whiplash best.
West Valley Water District, and/or their employees, agents, and/or independent contractors are responsible for the dangerous condition found at the motro vehicle accident occured. West Valley Water Company, including the City of Rialto and County of San Bernardino, owned, controlled, operated, maintained, and/or were responsible for driving with caution at the subject location where Claimant was rear ended. West Valley Water District along with the City of Rialto and County of San Bernardino,, owed a duty to persons accessing its public grounds, walkways, sidewalks, streets, and roadways, including Claimant, to proced with caution and reasonable distance such that they maintain roadway free of any dangerous conditions and hazards, including, but not limited to, the dangerous condition at the subject location where the client was rear ended. West Valley Water District, were responsible for conducting all motor vehicles with caution and be aware of any any necessary repairs to ensure the vehicles were safe for persons to use and access, including Claimant.
As a result of this incident. Claimant sustained bodily injuries and other damages including, but not limited to injuries to his neck, upper back, right shoulder and severe emotional distress. Claimant has sustained past and future economic and non-economic damages as a result of this incident and the negligence: of West Valley Water District, the City of Rialto and the County of San Bernardino,. Treatment for Claimant's injuries is ongoing.
No witnesses to this incident are known at this time. Investigation is ongoing.
CERTIFIED MAIL
SEDAGHAT : CA 900 $6.330
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LAW GROUP FIRST-CLASS
063S0001945041
9454 Wilshire Blvd. Ste 830 FROM 90212
Beverly Hills, CA 90212
9589 0710 5270 4044 4084 54
Rialte City Clerk CITY CLERK RECEIVED 2026 AUG - 7 PM 4: 07 150 s. Pilm Ave. CITY OF RIALTO
Rialtc, CA 92376
82375-648799