SCMTD Board of Directors Agenda of February 8, 2008 - Santa Cruz ...
SCMTD Board of Directors Agenda of February 8, 2008 - Santa Cruz ...
SCMTD Board of Directors Agenda of February 8, 2008 - Santa Cruz ...
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I__-<br />
CLAIM AGAINST THE SANTA CRUZ METROPOLITAN TRANSIT DISTRICT<br />
(Pursuant to Section 910 et Seq., Government Code)<br />
Claim# (3 @cxmb<br />
TO:<br />
ATTN:<br />
1.<br />
2.<br />
3.<br />
BOARD OF DIRECTORS, <strong>Santa</strong> <strong>Cruz</strong> Metropolitan Transit District<br />
Secretary to the <strong>Board</strong> <strong>of</strong> <strong>Directors</strong><br />
370 Encinal Street, Suite 100<br />
<strong>Santa</strong> <strong>Cruz</strong>, CA 95060<br />
- - --<br />
Clainxmt's Ad&ess/Fost Office Box: -<br />
--<br />
~-- -<br />
Claimant's Phone Number: ___-<br />
Address to which notices are to be sent: -<br />
--<br />
Occurrence:<br />
--<br />
Date: ?%&e:l)ylK%W<br />
__.-<br />
---_<br />
Place: -\~2Oc) ki\J.r'n/ 5-ke+<br />
-<br />
c<br />
--<br />
4.<br />
~-<br />
General description <strong>of</strong> indebtedness, obligation, injury, damage, or loss incurred so far as<br />
-c<br />
isborn: 6s /-TZ&J~ SS/~AZ 5<br />
5.<br />
6.<br />
7.<br />
Name or names <strong>of</strong> public employees or employees causing injury, damage, or loss, if<br />
known: 11 io kh~n/\<br />
-____ ___- -<br />
____<br />
Amount claimed now ..........<br />
Estimated amount <strong>of</strong> future loss, if known ........................ $<br />
TOTAL ................................................... $--<br />
Basis <strong>of</strong> above computations: --<br />
5EZ. .#.T=@F.<br />
efiex2.. . $-<br />
- /-s-%F ___--<br />
DATE<br />
- - - -<br />
Note: Claim must be presented to the Secretary to th<br />
Metropolitan Transit District<br />
F~UeganCases+Forms\Taylor SC 11-07-25ipot claim03 claim Ih english doc
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