HomeMy WebLinkAbout1991-08-20; City Council; Resolution 91-263x
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RESOLUTION NO. 9 I - 2 6 3
A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF CARLSBAD, CALJFORNIA,
AUTHORIZING THE EXPENDITURE OF FUNDS
FOR SETTLEMENT OF THE WORKERS
COMPENSATION CLAIM OF JAMES CONTINO
WHEREAS, HCM Claim Management Corp., the Third Party Administrator for the
City of Carlsbad, has recommended a settlement in the Workers Compensation case of
James Contino; and
WHEREAS, there are sufficient funds available in the Workers Compensation Self-
Insurance Fund to pay the settlement,
NOW, THEREFORE7 BE IT RESOLVED by the City Council of the City of
Carlsbad, California, as follows:
1. That the above recitations are true and correct.
2. That the expenditure of $8,715 from the Workers Compensation Self-
Insurance Fund is authorized for the settlement of said case.
That the Council accept the Stipulations with Request for Award, attached
hereto as Exhibit 2.
3.
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PASSED, APPROVED AND ADOPTED at a Regular Meeting of the City
Council of the City of Carlsbad on the 20th day of August . 1991, by the following
vote, to wit:
AYES: Council Members Lewis, Kulchin, Larson, Stanton and Nq
NOES: None
ABSENT None
A'ITEST
LlLt2L-P. 6L- ALETHA L. RAUTENKRANZ, City Cler
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Exhibit 2 1- 0 0
b WO-RKERS' COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
Applkunt Case No. Unassigned \
James Contino Stipulations
with Request
vs. for Award
City of Carlsbad
Defendanis
The parties hereto stipulate to the issuance of an Award and/or Order, based upon the following facts,
waive the requirements of Labor Code Section 5313:
,' 1. James Contino ,born 09-25-55
( Emelom )
10-25-90
(Date of Injury) employed within the State of California as Street MaintenanCe Wkr Ibn (Occupation)
-- whose compensation insurance carriel
sustained injury arising out of and in the course of employment t!Zi&"er ba
City of Carlsbad
( Ewbw 1 by
HCM Claim Mqmt.
(Pa& of body injure
2. The injury caused temporary disability for the period ___ 10-29-90 - fully
through - 0 1-21-9 1 -- for which indemnity is payable at $-compenS aM
week, less credit for such payments previously made.
3. The injury caused permanent disability of I-* R, for which indemnity is payable at $ 140.00
, less credit for per week beginning - 0 1-2 5-9 1 , in the sum of $8 t 715* O0
payments previously made. e&?$
f&i& t sui An informal rating has hmt been previously issued.
(Select one )
4, nere*xkmR may be need for medical treatment to cure or relieve from the effects of said in
( Sekd ooe 1
Upon demand, limited to injury herein mentioned, defendant has 5 da:
authorize or show good cause for denial. Failure to do so shall givc
tacid authority to secure whatever treatment is necessary to cure 0: DLPARTM NT OF INDUSTRIAL RCLl the effects of injury. DIVISION OF INDUSTRIAL ACCl
% 0 e . WORKERS’ COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
5. Medical-legal expenses are payable by defendant as follows: None
6. Applicant’s attorney request a fee of $ N/A
7. Liens against compensation are payable as foIbws: None
8. Other stipulations: None
1200 Carlsbad Village Dr.
a 5 6 2-9 8-8 432 . -2~: ? k ’Carlsbad; Ca Sr2Dm8G1 .d
q&$ Social Security Number of Applicant
Address of Applicant Address of Insurance Company $
Address of Employer 155 Madison St. . 3954 Murphy Canyon Rd.
Oceanside, Ca 92056 San Dieso. Ca 92123
N/A Karen Church
N/A San Diego, Ca 92123
Attorney for Applicant Attorney or Authorized Representative for Defend( 3954 Murphy Canyon Rd, #D-20!
Address of Attorney or Authorized Representative Address of Attorney for Applicant