HomeMy WebLinkAbout20230912_Amended Claim_Lloyd 24-013Office of the City Clerk
990 Palm Street; San Luis Obispo, CA 93401 3218
805.781.7100
PLEASE READ THE INSTRUCTIONS ON THE BACK BEFORE COMPLETING.
1 Claimant's Name (please print)
Lisa Ann Lloyd
Address
Day Phone Evening Phone
Claim No.
2 When did the damage or injury occur? Date and time
3/4/23 Approximately 2:00 am
3 Where did the damage or injury occur? San Luis Obispo N aPoliceReportNumber
Approximately at or near the De Vaul Park Playground along Maddona Road, San Luis Obispo, CA 93405
4 What happened and why do you think the City is responsible?
See Attachment A
If applicable, identify the name and position of responsible City employee(s), if known.
See Attachment A
5 What damage or injury occurred?
See Attachment A
6 Claim Amount If the amount exceeds $10,000, please check the court of
appropriate jurisdiction
only if less Municipal Court (claims up to $25,000)
than $10,000 Exceeds $1,000,000.00 Superior Court (claims over $25,000)
7 How did you arrive at amount claimed? Please attach documentation.
See Attachment A
8 1 declare under penalty of perjury under the laws of the State of California that the
following information is true and correct, and that this declaration was executed on:
j6, 09/12/2023L, - Los Angeles , California
Signature of Claimant or Repres tative Date Place
OFFICIAL NOTICE AND CORRESPONDENCE
f represented by an insurance company or an attorney, please provide the information requested below_
Name and Capacity (please print)
Shervin Ghanoongooi, Esq., SBN: 333103, William White, Esq., SBN: 346251
Address
3055 Wilshire Blvd, 12th Floor, Los Angeles, CA 90010
Day Phone Evening Phone
213) 381-9988
PLEASE TYPE OR PRINT CLEARLY ALL THE INFORMATION REQUESTED ON T H E CLAIM FORM. YOU MUST
COMPLETE EACH SECTION OR YOUR CLAIM MAY BE RETURNED AS INSUFFICIENT. THE FOLLOWING PROVIDES
SPECIFIC INSTRUCTIONS FOR COMPLETING EACH SECTION OF THE CLAIM FORM:
1 NAME AND MAILING ADDRESS OF CLAIMANT - State the full name and mailing address of the person/persons
claiming damage or injury. Please include a daytime and evening telephone number.
2 WHEN DID THE DAMAGE OR INJURY OCCUR? - State the exact month, date, and year, and approximate time (if
known)
of the incident that caused the alleged damage/injury.
Under State law, claims relating to causes of action for personal injury, wrongful death, property damage, and crop damage
must be presented to the City of San Luis Obispo no later than six months after the incident date. Please note that evidence
of "presentation" includes a clear postmark date on an envelope or a certification of personal service.
When filing a claim beyond the six-month period, you must explain the reason the claim was not filed within the six-month
period. This explanation is called an "application for leave to present a late claim" In considering your claim, the City will
first decide whether the late claim application should be granted or denied. (See Government Code Section 911.4 for the
legally acceptable reasons a claim may be filed late.) Only if your late claim application is granted will the City then consider the
merits of your claim.
Claims relating to any cause of action other than personal injury, wrongful death, property damage, and crop damage must
be presented no later than one-year after the incident date. (See Government Code Section 911.2.)
3 IN WHICH LOCATION DID THE DAMAGE OR INJURY OCCUR? - Please include street address, city, county,
intersection, etc. If possible, also include the Police Report number.
4 WHAT HAPPENED AND WHY DO YOU THINK THE CITY IS RESPONSIBLE? - Please explain the circumstances
that led to the alleged damage or injury. State all facts that support your claim with the City of San Luis Obispo, and why you
believe the City is responsible for the alleged damage or injury. If known, identify the name of the City Department(s)
and/or City employee(s) that allegedly caused the damage or injury.
5 WHAT DAMAGE OR INJURY OCCURRED? - Provide in full detail a description of the damage/injury that allegedly
resulted from the incident. (What specific damage or injury do you claim resulted from the alleged actions?)
6 CLAIM AMOUNT - State the specific total dollar amount you are claiming as a result of the alleged damage/injury. If
damage/ injury is continuing or is anticipated in the future, indicate with a "+" following the dollar figure if $10,000 or
under. If the total dollar amount is unspecified or exceeds $10,000, designate the appropriate court jurisdiction for the
claim.
7 HOW DID YOU ARRIVE AT AMOUNTCLAIMED? - Provide a breakdown of how the total amount that you are claiming
was computed. You may declare expenses incurred and/or future, anticipated expenses. If you have supporting
documentation (ie: bills, payment receipts, cost estimates), please attach copies of them to your claim.
8 SIGNATURE - The claim must be signed by the claimant or by the attorney/representative of the claimant. The City will
not accept the claim without a proper signature. Government Code Section 910.2 provides: "The claim shall be signed by the
claimant or by the person on his/her behalf."
9 OFFICIAL NOTICES AND CORRESPONDENCE - Provide the name and mailing address of the person to whom all
official notices and other correspondence from the City should be sent, only if other than claimant. Please provide telephone
numbers for the representative, if applicable.
SUBMIT COMPLETED CLAIMS AND RELATED DOCUMENTATION TO: City of San Luis Obispo, City Clerk's Office,
990 Palm Street, San Luis Obispo, CA 93401-3249. Personal service of claims can be accomplished during regular City
business hours, 8:00 a.m. to 5:00 p.m., Monday -Friday (excluding City holidays).
If you wish to receive a stamped copy of the claim, return the form to the City Clerk of San Luis
Obispo with a cover letter, along with a stamped, self-addressed envelope, informing the City of
your request.
If, after reading these instructions, you have questions or need additional information regarding the filing of a claim with
the City of San Luis Obispo, please contact the City Clerk's Office at (805) 781-7114.
Once you have filed your claim, you will receive a letter from the City's Claims Administrator (Carl Warren & Company) indicating your
claim has been received and is being investigated. You will receive an explanation of the investigation results within 45 days
in most instances. If you have questions about the status of a filed claim, please contact Carl Warren & Company at (805)
544 — 7963.
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ATTACHMENT A
Claimant LISA ANN LLOYD, hereby presents the following information in
support of his claims against CITY OF SAN LUIS OBISPO:
I. BACKGROUND
On March 4, 2023, at approximately 2:00 am, Claimant was lawfully walking on
the public sidewalk along Spooner Drive, between Foreman Ct and Welsh Ct, near the
De Vaul Park basketball court and playground, San Luis Obispo, CA 93405. Claimant
was walking along the sidewalk, on the side of the street closest to DeVaul Park. As
claimant was walking along the public sidewalk, she slipped/tripped/fell on a messy
and wet portion of the sidewalk that dipped below the level of the surrounding
sidewalk. Lighting in the immediate vicinity was poor and unmaintained and as such,
Claimant was unaware of any dangerous conditions that existed on the
aforementioned sidewalk, as illumination in the area fell below standards.
II. LIABILITY
Claimant contends that the physical condition of the area where the Subject
Incident occurred and the surrounding area played a substantial role in causing the
Subject Incident. Claimant further contends that the STATE OF CALIFORNIA, its
employees, agents and contractors improperly and negligently controlled, designed,
constructed, repaired, and maintained the area where the subject incident occurred,
including the area surrounding the location where the subject incident occurred, and
any and all lighting devices, or lack thereof. This failure to properly control, design,
construct, repair, and maintain said area led to the existence of dangerous conditions
for individuals such as the Claimant using the subject area with due care and in a
reasonably foreseeable manner. These defects included but were not limited to a lack
of adequate lighting, illumination and an uneven portion of pavement on the sidewalk
which allowed for the accumulation of liquid and debris. Claimant also contends that
the CITY OF SAN LUIS OBISPO was aware and had notice that said subject area was
dangerous and in a defective condition and failed to do anything to improve and
1
ATTACHMENT TO GOVERNMENT CLAIM
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remedy said dangerous conditions, or to warn those using the subject area of such
dangers.
Illo A AGES:
As a direct result of the SUBJECT INCIDENT, Claimant has incurred damages
including but not limited to past and future medical expenses, current and future loss
of earnings, past and future economic damages, loss of property damages, and cost of
suit which combined are expected to be in excess of $1,000,000.00. Treatment is still
ongoing, and an exact amount is still to be determined to this date.
Treatment is still ongoing however Claimant has visited the following providers
to date:
a. Rio Grande Dignity Health Hospital, 715 Tank Farm Rd Ste B, San Luis Obispo,
CA 93401
b. Primary Care Partners, SLO, 84 Santa Rosa St, San Luis Obispo, CA 93405
c. The Spine and Orthopedic Center, 401 East Carrillo Street, Santa Barbara, CA
93101
d. Yuvraj Grewal, MD., 23861 McBean Pkwy Suite C 14, Valencia, CA 91355
e. Alta Orthopaedics, 2027 Village Ln Suite 101, Solvang, CA 93463
f. Mesa Pharmacy IV, 7218 Van Nuys Blvd, Van Nuys, CA 91405
DATED: August 28, 2023 WILSHIRE LAW FIRM
By:
Shervin Ghanoongooi, Es .
William White, Esq.
Attorneys for Claimant
I
ATTACHMENT TO GOVERNMENT CLAIM
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