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1 • to enter. Casino lto�d whcn his vehicle str.uck Che <br /> �����n rlit.r,h and/or holc, causin�) 1:lic injur. ic� �;�++ <br /> � liereinaftur eel Cu���h. '1'hat Chc Cf.ty oE Gvcrett <br /> knew, or should havc known, of Che hazardous con- <br /> � 3 � dition caused by the unmarked consCruction work <br /> upon Che roadwaY as herein set [orCh a��� W�s <br /> q negligenC in the perfottmance of its duty to users I <br /> of the public streets in Chc City of Gverer.t. ' <br /> 5 v.� <br /> � Injuries or d�mages compl��ined of ate: <br /> 7 Claimant has rec:eived injurics to his hcad , body <br /> 8 and limbs and in particular to his neck and back, <br /> which is believ��d to include a compression frac- <br /> c� ture , and has further suftered damayes to his <br /> persona] properCy . <br /> 10 VI. <br /> 11 Current expenses are : <br /> 12 �roximatel 5150 . 00 to date , and <br /> a) 14edical: npF Y <br /> 13 fu*urc me�cal expenses to be incurred. <br /> 19 b) Lost Wdyes_ 7'o dale, five weeks loss of earn- <br /> ings ai S 60. U0 per. weck, totalling $2 , 300 . 00. <br /> 15 <br /> c) Proper. ty Damages: Damage to 1980 t4ustanq . <br /> lg automobile , approximately $680 .00. <br /> 17 VII. <br /> 1� Your affiant secks general damayes, future medical expenses <br /> ]�J and loss of earnings in an amount in excess of 510 ,000 . 00. <br /> 2� VIII . <br /> 21 Other parties to the incidenC complained of, if known, are: <br /> 22 ldone known to claimant at this time. <br /> • 23 <br /> QQ Dated this �3 day of Uecember, ].980. <br /> 25 ,/ <br /> 'LG s�rev �i u� snNoi:as <br /> Q7 STA1'L•' OP WASf1ING1'ON) <br /> `�8 COUNTY OP SNOlIOD1IS11) <br /> QJ S9'6Vf:N U. SAT7DLRS, I�einy first duly sworn on oath, deposes <br /> � <br /> 30 and says: � <br /> 31 <br /> 3Q Claim I <br /> P a g e z ;('.x/'y,;Y�g/ ' <br /> c//a�.!N��v,f��.,,r/,n.d?'cJ <br /> �Y//1/�v/.•i�✓rr��{'(�i./iI� <br /> %urinl, %/'riiiwy/.��.y�_�O/ <br /> /rvwA'�fXj:Q9QT17 �i�m`.S.�M�J�YLilO <br /> .�..� . . . . . <br /> . I . . . . . . � , <br /> . ' � . , . . . . . . .. <br />