CC - Item IV.CC-E - Authorization To Reject Claim Against City From Inez Martinezl
staf epor
TO: HONORABLE MAYOR
AND MEMBERS
ROSEMEAD CITY COUNCIL
FROM: NANCY VALDERRAMA, CITY CLERK, CMC
DATE: SEPTEMBER 7, 2000
RE: AUTHORIZATION TO REJECT CLAIM AGAINST CITY FROM INEZ
MARTINEZ
The attached claim was received in this office on June 12, 2000. A copy was sent to the City's
claims adjuster, Carl Warren & Company on the same day.
Carl Warren & Company sent a notice on August 7, 2000, recommending that the aforementioned
claim be rejected by the City.
Recommendation:
It is recommended that the City Council approve the rejection of this claim and authorize a letter
of rejection be sent to the claimant.
Attch.
COUNCIL AGENDA
S E P 12 2000
ITEM No. Z.14-E
LANtOFF/CES OF
OFCOUNSEL
Cda,io Cadero
kh/ and w Ne )W
Patrick Longhi
Cilbert.Sigala
Adrnimdin LnlJornio
RAU L G. ILOMAS*
80 South Lake Avenue
Suite 823
Pasade Ca lif o rnia 91101
Tel (626) 792 -9666
Fax (626) 405 -0952
June 8, 2000
CITY CLERK'S OFFICE
8838 E. Valley Boulevard
Rosemead, CA 91770
Re: Our Client: Inez Martinez (Minor)
Date of Loss: 2/8/00
I�'��f7 /TiF.fi
Leo a
CiC�e r
JUN I ru0
CITY 10:EiiI'. 0
' Admitted in
Florida &California
Please be advise that this firm has been retained by the above - mentioned client in order to
pursue her claim for personal injury against the City of Rosemead arising out of the above
captioned matter.
Enclosed please find an Original plus 3 copies of the Claim for Damages, referenced to
the above to matter. Please, file and conform a copy and return to our office in the self - addressed
stamped envelope we have provided for your convenience.
Should you have any questions, please do not hesitate to contact this office.
Thank you for your courtesy and cooperation in this matter.
`very truly yours,
LAW OFFICES OF RAUL G. LOMAS
t
1
' �
DELIA FLORES
Secretary to Raul G. Lomas
Enclosures
JUN. -05' 001SUINI 11 :22 CITY OF ROSEMEAD TEL:626 -007 -9218 P. 002
- FIL.E WITH CLAIM FOR DAMAGES RESERVE FOR FILING STAMP
CITY CLERK'S OFFICE CLAIM NO.
8838 E. Valley Boulevard TO PERSON OR PROPERTY
Rosemead, CA 91770
t Claims for death, injury to person or to personal property must be tied not later than six
months after the occurrence. (Gm. Code Sec 911.2)
2 Claims for damages to real Property must be filed not later than t year after the occurrence
(Gw. Coda Sec 911211
a Read entire claim form before filing.
a- See page 2 for diagram upon which to 10=10 place of accider=-
S This claim form must be signed on page 2 at boom-
E_ Attach separate sheets. If necessary. to give full details. SIGN EACH SHEET
T0: CITy OF ROSEFE.AD, 8638 E. ,Valley Blvd., Rosemead 91770
n„ n el
Name of Claimant minor ny a t- tt�""y" -• -- - - - --
Inez Martinez, Litem, Alfonso Martinez CITY and ather)
A90�- s of Claimant
3618 Vane Avenue, Rosemead, CA 91770 Cayandstate
Business Address of Claimant
vi.�
G dd re s an d telephone number to which you desire polices or communications to sent
F -
JUN ' z ZOuO
CITY C1. KIS O
of Birth of Claimant
9/13/84
upation of Claimant
Student
>me Telephone Number
(626) 443-4
.cin Te le bmber
N/A
Social Security No.
Ve a
regarding ails claim: Law Offices of Rau G. oma
80 S. Lake Avenue, Ste. 823, Pasadena,
cryem91105 wolvedinlTJURYorDAMAGEO
When did DAMAGE or INJURY ==r? N ames
2-8 -00 T ime 3:00 P•m-
If clam is for Equitable indemnity, give date Claimant served
with the complaint
Date riate, gwe Street
Where did DAMAGE or INJURY D=e-; Des cribe Tully. and locale on diagram on reverse sitle o1 this sheet Where appropriate,
nachos and addrt�nd m ph R oSemead i H gn
Parking lot o TT
Describe in derail how the DAMAGE or INJURY occurred• .
Claimant was opening the parking lot gate of Rosemead High School when the
gate fell on claimant's head and back.
Why do you claim the city is responsible?
Failure to inspect, manage and maintain gate in safe and operating condition.
DesorlDe in detail each INJURY or DAMAGE
spine and bump on the right side of head
Fractured Vertebrae in lumbar
2 (OVER)
CLAIM MUST BE SIGNED ON REVERSE SIDE
dUN . 05'001SUA'I 11 23 CITY OF ROSEMEAD TEL 626 - 501-9218 P. 005
The amount claimed, as of the date of presentation
of this claim, is computed a5 follows: as tar as known!
Estimated prospective damag
Damages incurred to date (exact):
Future expenses for medirat and hospital cam ....S
n n k n nwn
Damage to property . ........................S
Expenses for medical and hospital Cam .........S
Future loss of earnings- - - ... • ' ' ' •
special damages .......... .
. s
Loss of earnings. .... - . ....................
.y
5
other pmspsclve
..........
p .s
Special damages for .......................
. .
Total eslirnate prtsspeaive damages ....... . ..S
i,,e prspectwe damages
General damages ............ . . . ..- S 200 r 00 . 0.00 .
Total damages incurred to Cate .............. S
Total amount claimed as of date of presentation of this Claim: 5 200
M edical specials may change
Was damage and/or injury invesligatad by police? NO if so. what dry? N/A
Were paramedics or ambulance called? Yes It so. name city or ambulance A
If injured, state date, time, name and address of doclorolyomfi= visit Februar
Gabriel Valley Medical Center, 438 W. Las Tunas Dr. a
WETNESSEESIC DAMArr,�E or INJURY= Lisa all persons and ad 2l Dea C Clale a know STe anon: Phone
Name M. MOritoya - Address y Phone
Name — Address -- - Phone- �
Name "s
DOCTDRS and HOSPITALS:
Hospital San Gabriel Valley - Address 438 W. Las Tunas Dr. San Said Blized
O Matthew Lin, M.D. Address S Gar ie A ham r DateofTreatment
O �—
Date of Treatment
Doctor Address
READt
For all accident claims place on following diagram names of sueem
inctuding North, East. South, and West: indicate place Of accident by
"X" and by showing house numbers or distances to super tamers
If Ctry Vehicle was involved, designate by letter 'W' location 01 City
Vehicle when you first saw it, and by 8" location of yourself
yaREFULLY
or your vehicle when you first saw City vehicle: location of Olty vehicle
at time of accident by "A -V and location of yourself or your vehicle at
the time of the accident by "B-t and the point of impact by "7C
.NOTE: It diagrams below do not fit the situation, attach hereto a proper
dtagrem signed by claimant.
L��J L
SIDEWALK
CURBS _ LJRB ,
V��
Signature of Claimant or person filing on
his behalf giving relationship to Claimant:
NOTE:
C 1
FILED WITH CITY
Typed Name:
I
J () AJ 7 -
Date:
1 11 C 6 P16
Code Sec 915a). Presentation of a false Claim is a felony (Pen. Code Sec n•
MAYOR:
MARGARET CLARK
MAYOR PRO TEM'.
JAY 7 IMPERIAL
COUNCILMEMBERS:
ROBERT W. BRUESCH
GARY A. TAYLOR
JOE VASOUEZ
June 12, 2000
osmcad
B838 E- VALLEY BOULEVARD • P.O. BOX 399
ROSEMEAD, CALIFORNIA 91770
TELEPHONE (626) 569 -2100
FAX (626) 307 -9218
DwiEht J. Kunz
Senior Account Manager
Carl Warren R Company
750 The City Drive, Suite 400
Orange, CA 92665
- Re: Inez Martinez (Minor) Claim
Dear Mr. Kunz:
The attached Claim was received in my office today. The City does not have any prior -
information on this claim. Please note that this incident occurred at Rosemead High School.
Please advise as to the steps you wish to take in this matter.
Sincerely,
- - - - - -- - - -- - -
N.A2',ICY VAL.DERR_AMA
City Clerk
Citv or Rosemead -
cc: City Attorney
JUN. - 95 00(SUN) 11 - CITY OF ROSEMEAD TEL:626 -30j -9218 P. 002
FILE WITH:
CrrY CLERK'S OFFICE
883B E. Valley Boulevard
Rosemead, CA 91770
CLAIM FOR DAMAGES
TO PERSON OR PROPERTY
1NSTRUGTIoNs
1_ Cliamss for death, injury to person or to personal property must be Ned not later than six
months after the occurrence. (Gov. Code See 9112.)
2 Claims tar damages to real Property must be riled not later than 1 year tither the occurrance
(GOY. Code Sec. 911m) -
3 Read entire claim form before filing.
4- See Page 2 for diagram upon which to locate Place of actade d
S This claim font must be signed on page 2 ffi btroom.
c t» i, eanarate sheets. It necessary. to give full detals SIGN
'EACH SHEET.
TO: Clry OF ROSEIII0, 883E E. ,Valley Blvd., Rosemead 91770
Minor by & t roug er Guar lan A
Name of Claimant
Tr Martinez, Li tem, Alfonso Martinez (Father
Home Add�s of Claimant CA 9 17 7 0
1c10 rr -no noanve. Rosemead,
City and State
Business Address of Claimant
Wry ano amw
RESERVE FOR FILING STAMP
CLAIM N0.
`I NN, ( r
r
O f BirLR of Ctaiman
9/13/84
p
:uahon ofCla Claimant
Studen
ielephone Number
(626; 443 - 4 315__.___
mass Telephone Number
N/N
s Social Security N
Give address and telephone number s orLOmas 55 recardingthisclaim: Law Off 8 -99 -38
80 S. Lake Avenue, Nines OfMy me plpye�ln„o lvedinlNJURYorDAMA GE
When did DAMAGE or INJURY Occur? 3 0 0 m
Date 2 -8 -00 Time�' -
if claim is for Equitable indemnity, give daze claimant served
with the complaint ive SLMet
Date ere ropriate, g
Where did DAMAGE or INJURY occur'? Describe Tully. �and locale on diagram on reverse side of this sneeL Wh ere app
nParking l do €�Ros H gti'School
Describe in detail how the DAMAGE or INJURY occurr lot gate of Rosemead High School when the
Claimant was opening the parkin
g
gate fell on claimant's head and back.
Why do you claim The city is responsible? in safe and operating condition
Failure to inspect, manag e and maintain gate
I
�soritie in detail each INJURY or DAMAGE p ht side of head
Fractured Vertebrae in lumbar spine and bum p on the rig
BE SIGNED ON
SEE PAGE 2
JUN. -05 00(SU, I1 :'3 CITY OF ROSENIEAO TEL :6 26 a0 "r 9 ?18 P. 005
The amount claimed, as of the date of presentation of this claim, is computed as follows: es as far as "Own:
Damaqes incurred to date (exact):
Estimated prospective damages S n n - k n nwn
Damage w property .....................
S-
Expenses for medical and hospital care .........S
Loss of eamings--- - - -- ------ - - - - *,
.......
special damages for
..S
y 200,00
General damages .............. ...........
Total damages incurred to date .. . ...........
S
TOW amount claimed as of date of preserrm on
of this claim:
Future expenses for medical and tImPlral care :. - . S
Enure loss of earnings ................... . S
Other prospective special dam30es ... s
Prospective general damages ............. .
ctive damages S
. .. ... .. ..
Total estimate Prospect"
11
200,980.15
M edical specials ma Chan 1 s st
Was damaoe andlor injury investigated by police? No It so. what cry7 N A
Were paramedics or ambulance called? Yes It sa, name city or ambulan. Am
If injured, state date, time, name and noomm of doctor of your first visit F e b r ll a r
Gabriel Valley Medical Center, 438 W. Las Tunas Dr. Sa
WITNESS to DAMA or IhUUR1': List all persons and �add es of pe known to nave information:
.Tohn M. Montoya Address y21 De adal�ena ST. Rosemea Pnone
Phone
Name
DOCTORS and HOSPrrALS: 438 W. Las Tunas Dr. San pydJJospsuuz�+.�-�++--^�—
HasPital San Gabriel Va11e Address S ar le A hambra of Treatment _.2,8 --
Doctor Matt h Lin, M.D. Address pateotTreatment__�
Doctor Address
READ CAREFULLY . location of Chy vehicle
names of sweets or your vehicle when you first saw ty X"
including North, East. South, and We= indi= a Place of acdidem by at time of accident by "A•t" an - ov
8.1 and th pn of l imPact by hicie a:
For all accident claims place on following diagram
..X.. and by showing house numbers or distances to stmet corners, the lime of the acci do notfrtthesaumbon. 3nadt hereto a proper diagnarru; below
If City Vehicle was irrvolved. designate try letter 'W' Iomtion of City NUM - i I dia nt Signed ra Clamant.
Vehicle when you first saw it, and by °B•' location 01 yourself 9
CURB
Signature of Claimant or person filing on
his behalf f giving relationship / t to oClaimant:
.�nr rr iuc ,.atrC'r 9F FILEJ WffH
Typed Name:
(Gov. Code sec 9153).
Date:
r
of a false claim is a felony ( ?en. Code Sec
June 14, 2000
CITY c
JUN 19 2000
CITY CLERK'S OFFICE
TO: City of Rosemead
ATTENTION: Nancy Valderrama, City Clerk
RE: Claim Martinez v. City of Rosemead
Claimant Inez Martinez
D/Event 08- Feb -00
Rec'd Y /Office 12- Jun -00
Our File S- 108)07-GMQ
We have reviewed the above captioned claim and request that you take the action indicated
below:
• TAKE NO ACTION: Defer any written response to the claimant pending our
further advice.
If you have any questions please contact the undersigned.
Very truly yours,
CARL WARREN & COMPANY
S
Dwight J. Kunz
cc: CJPIA
Attn: Executive Director
CARL WARREN & CO,
CLAIMS MANAGEMENT-CLAIMS ADJUSTERS
750 The City Drive • Ste 400 • Orange, CA 92868
Mail: P.O. Box 25180 • Santa Ana, Ca 92799 -5180
RECEIVEL,
_.. ;....:' CITY OF r�OSE.'F D
. JON 21 200
CITY CLERK'S OFFICE
TO: Carl Warren & Company DATE: 06/16/00
7 The City Drive, Suite 400 CLAIMANT Inez Martinez
Orange, CA 92868 FILE NO: S 108307 GMQ
D/EVENT: 2 -8 -00 FILING DATE 6 -12 -00 SIX MOS. YES
PRINCIPAL /CITY CJPIA /City of Rosemead
RECOMMENDED ACTION ON CLAIM Take No Action.
FACTS Parking lot gate at Rosemead High School fell upon claimant while she was
opening the gate.
POSSIBLE CO- DEFENDANTS School District.
EVALUATION Deferred pending investigation.
RESERVES TYPE OF CLAIM AMOUNT
1. Inez Martinez(Loss) LBI $100.000.00
2. Inez Martinez(Expense) LBI 525.000.00
COMMENT/WORK TO BE COMPLETED Secure statement from claimant and scene
inspection. Tender to school district? Our further report will follow shortly.
Very truly yours,
CARL'WARREN & COMPANY
George J. Mankiewicz
c: City of Rosemead, Attention:. Nancy Valderrama
cc: CJPIA - Attn.: Executive Director
CARL WARREN & CO.
CLAIMS MANAGEMENT•CLAIMS ADJUSTERS
750 The City Drive • Ste 400 • Orange, CA 92868
Mail: P.O. Box 25180 • Santa Ana, Ca 92799 -5180
Phone: (714) 740 -7999 • (800) 572 -6900 • Fay: (714) 740 -9412
July 31. 2000
Nancy Valderrama
Citv of Rosemead
8835 East Valley Boulevard
Rosemead, CA 91770 -1787
RE: Principal
Member City_
D /Event
Claimant
Our File
Dear Ms. Valderrama:
CJPIA
City of Rosemead
2 -8 -00
Inez Martinez
S 108307 GMQ
Cl
AUG
CITY CLE-RK'S OFFICE
Enclosed is a draft of the non - ownership declaration to be signed by Donald Wagner. If
there are no corrections or additions, please have this typed on City stationery and signed by
Mr. Wagner. Please return the original declaration to me.
Please call if you wish to mane significant changes or if you have any questions. Thank you
for your help.
Very truly yours,
T
CARL WARREN & CO.
CLAIMS MANAGEMENT - CLAIMS ADJUSTERS
750 The City Drive - Ste 400 - Orange, CA 92868
Mail: P.O. Box 25180 - Santa Ana, Ca 92799 -5180
Phone: (714) 740 -7999 Ext. 140 - (800) 572 -6900 - Fax: (714) 740 -9412
I. Donald Wagner, declare`.
1. I am over the age of 18 vears. If called upon to testify I could and would competently testify to the following:
2. I am the Assistant rt Mager for the City of Rosemead. I have been employed by the City of Rosemead
since an .
3. As the Assistant City Manager, I have knowledge of the particular streets sidewalks, roadways boundaries
structures and.proper[ies that are within the City of Rosemead's jurisdiction ownership control and
maintenance responsibility. 1 also have knowledge of any and all crntracts and agreements that the City of
Rosemead may have, if at all, .with other entities regarding street, sidewalk, roadway, structure or highway
maintenance.
4. I have reviewed the Claim For Damages presented by Inez Martinez which was received by the City of
Rosemead on .tune 12, 2000. This claim states Ms. Martinez was injured by a parking lot gate at Rosemead
High School Rosemead, California, on February S. 2000. Rosemead High School is owned and operated by
the El Monte Union High School District. The premises described in Ms. Martinez' claim are owned and
controlled by the El Monte Union High School District. "
The Citv of Rosemead did not have any responsibility whatsoever for the Rosemead High School property on
or before February 8, 2000.
The El Monte Union High School District is a wholly separate and distinct. entity from the City of Rosemead.
The City of Rosemead has no ownership interest in, control of or maintenance responsibility for any of the El
Monte Union High School District's properties.
The El Monte Union High School District was at all times pertinent to this matter responsible for the
ownership, maintenance, and supervision for the Rosemead High School property.
8. The City of Rosemead did not design, maintain supervise control or construct any of the structures at the
Rosemead High School property.
I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
Executed this day of 2000, at Rosemead, California.
y ;_Next Report Due: 9/5/00
AUG - 7 2000
i CITYC:EM" )F` lj
E -= M
REPORT #2 INVESTIGATION - AUTHORITY
Carl War en and Company
750 Th City Drive
Suite XOO
Ora7ntion: CA 92868
Att Richard Marque
Re: O /Principal: CJPIA
Member City: Rosemead
Claimant: Inez Martinez
D /Event: 2 -8 -00
Our File No.: S 108307 GMQ
August 4, 2000
PREVIEW: Student parking lot gate at Rosemead High School
fell upon claimant while she was opening the gate.
MEMBER CITY: City of Rosemead.
OTHER INSURANCE: Unknown.
DATE, TIME. AND PLACE: February 8, 2000; 3:00 p.m.;
Rosemead High School, Rosemead, CA.
GOVERNMENT CODE REQUIREMENTS:
1. Date Required Claim Filed: The claim was timely filed
on June 12, 2000.
2. Action by Public Entity: No action has been taken.
3. Statute of Limitations: The claim was denied by
operation of law on July 27, 2000. An action must be
filed no later than February 8, 2002.
PREMISES: Rosemead High School is located on the northeast
corner of Rosemead Boulevard and Mission Boulevard in the
City of Rosemead. Rosemead High School is located on a
large block that is bordered on the west by Rosemead
Boulevard, on the north by Lower Azusa Road, on the east
Encinitas, and on the south by Mission Boulevard. Rosemead
CARL WARREN & CO.
CLAIMS MANAGEMENT • CLAIMS ADJUSTERS
750 The City Drive - Suite 400 - Orange, CA 92868
Mail: P.O. Box 25180 - Santa Ana, CA 92799 -5180
Phone: (714) 740 -7999 - (800) 572 -6900 - Fax: (714) 740 -7992
Page 2
S 108307 GMQ
High School occupies the western portion of this parcel from
Lower Azusa Road all the way down to Mission Boulevard. The
smallest section is in the northeast corner of this parcel
which is Encinitas Elementary School. The southeast portion
of this parcel is occupied by Rosemead Park.: Rosemead Park
is a public park owned and controlled by the City of
Rosemead.
The student parking lot is the largest parking lot at
Rosemead High School. It is located on the west side of the
campus with 2 entrances /exits onto Rosemead Boulevard.
Along Mission Boulevard are 2 smaller parking lots, one for
visitors and another for faculty.
OWNERSHIP /CONTROL: Rosemead High School is owned and
controlled by the E1 Monte Union High School District. We
drove completely around the large parcel containing Rosemead
High School, Encinitas Elementary School, and Rosemead Park.
We saw no signs or other indications that the City of
Rosemead had any involvement with the high school property.
We walked into the high school parking lot and inspected
both gates as well as the perimeter fences on the north and
west side of the high school. We saw nothing to connect the
high school with the City.
CO-DEFENDANT:
1. E1 Monte Union High School District, 9063 E.. Mission
Dr., Rosemead, CA 91770.
Carl Warren and Company handles the liability claims for the
high school district. Michael Hedtke is the adjuster
handling this claim for the school district.
2. General Fence and Iron, 11235 Garfield Ave., Southgate,
CA 90280, (800) 449 -6666, (310) 923 -6799.
This is the name on a plate found on the chain link fence at
2 different places. We called the phone number and verified
the business is still ongoing.
SC Gury Corporation, Anaheim, CA, license number 679302.
This name was also on the plate on the chain link fence. We
have not contacted this corporation to determine its
involvement in the construction of the fence.
Page 3
S 108307 GMQ
ACCIDENT DESCRIPTION /FACTS IN BRIEF• The claimant was
opening one of the parking lot gates for the student parking
lot when she was injured.
CITY VERSION: The City has no information about the
accident details.
CLAIMANT VERSION: The claimant's attorney declined to make
the claimant available for a statement. The attorney is not
clear whether the injury occurred while the gate was being
opened or closed.
DIAGRAM: A diagram of the parcel containing the 3 public
facilities is enclosed.
PHOTOGRAPHS: 2 photographs were obtained. One is of the
southern gate to the student parking lot through the wrought
iron fence. The second photograph is of the subject gate in
the chain link fence.
WITNESS: John M. Montoya, 9212 Deadalena St., Rosemead, CA,
(626) 288 -0171.
This witness has not yet been interviewed.
INJURY:
A. Type of Injury: Fractured vertebrae in the lumbar
spine and a contusion to the right side of the head.
B. Health Care Provider:
1. Matthew Lin, M.D., 911 S. Garfield, Alhambra. She
was seen by Dr. Lin on February 10.
2. San Gabriel Valley Hospital, 438 W. Las Tunas Dr.,
San Gabriel, CA. The claimant was seen here on
the day of the accident.
C. Damages: $980.15 for medical specials.
D. Demand /Offer: None.
E. Attorney: Raul G. Lomas, 80 S. Lake Avenue, Suite
823, Pasadena, CA 91101, (626) 792 -9666.
INDEX BUREAU: An Information Sheet has not yet been
submitted.
Page 4
S 108307 GMQ
LIABILITY: The property where the claimant was injured is
owned and controlled by the high school district. The City
has no involvement. There is no liability to the City.
SETTLEMENT NEGOTIATIONS: None.
EVALUATION AND AUTHORITY REQUEST: We have sent a draft of
a Non - Ownership Declaration to the City.
We recommend the claim be rejected now:
WORK TO BE COMPLETED:
1. Secure return of Non - Ownership Declaration and forward
to claimant attorney with 1038 letter.
2. Secure statement from witness Montoya.
CLAIM STATUS /RESERVES:
1. LBI - Inez Martinez - Open.
ENCLOSURES:
1. Diagram.
2. Scene photographs.
3. Letter to City with Non - Ownership Declaration draft.
4. E -mail from Mike Hedtke.
5. Representation from claimant attorney.
COMMENT: Our further reports will follow.
Very truly yours,
CARL WARREN AND COMPANY
GJM:ck Georg J. ankiewicz
cc: CJPIA
. �' c: City of Rosemead
.August 4, 2000
C' j T':
AUG - 7 2GOD
CiTy CLEF X I -1 1
TO: City of Rosemead
ATTENTION: Nancy Valderrama, City Clerk
RE: Claim Martinez v. City of Rosemead
Claimant Inez Martinez
D/Event a 2/3/00
Recd Y /Office 6/12/00
Our File S 108307 GMQ
We have reviewed the above captioned claim and request that you -take the action indicated
below:
• CLAIM REJECTION: Send a standard rejection letter to the claimant.
Please Provide us with a copy of the notice sent, as requested above. If you have any
questions please contact the Undersigned.
Very truly yours
CARL WARREN & COMPANY
2 Ec hGt,t''dl 1 0. M cwq u4p/
Richard D. Marque
cc: CJI'IA
Attn: Executive Director
CARL WARREN & CO.
CLAIMS MANAGEMENT• CLAIMS ADJUSTERS
750 The City Drive • Ste 400 - Orange. CA 92868
Mail: P.O. Box 25180 • Santa Ana, Ca (12799 -5180
Phone: (714) 740 -7999 - (800) 572 -6S,0o • Paz: (714) 740 -9412