HomeMy WebLinkAbout1992-09-01; City Council; 11862; WORKERS COMPENSATION CLAIM SETTLEMENT PROPOSAL FOR JOSEPH PIMENTALAB# //,8b%
MTG. 9/1/92
DEPT. RM
DEP
SETTLEMENT PROPOSAL FOR JOSEPH CITY
CITY PIMENTAL
TITLE: WORKERS COMPENSATION CLAIM
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RESOLUTION NO. 9 2 - 2 6 8
A RESOLUTION OF THE CITY COUNCIL OF THE
CITY OF CARLSBAD, CALIFORNIA,
AUTHORIZING THE EXPENDITURE OF FUNDS
FOR SETTLEMENT OF THE WORKERS
COMPENSATION CLAIM OF JOSEPH PIMENTAL
WHEREAS, HCM Claim Management Corp., the Third Party Administra
for the City of Carlsbad, has recommended a settlement in the Workers Compensation ca
of Joseph Pimental; and
WHEREAS, there are sufficient funds available in the Workers
Compensation Self-Insurance Fund to pay the settlement,
NOW, THEREFORE, BE IT RESOLVED by the City Council of the Cii
of Carlsbad, California, as follows:
1.
2.
That the above recitations are true and correct.
That the expenditure of $10,920 from the Workers Compensation
Self-Insurance Fund is authorized for the settlement of said case.
That the Council accept the Stipulations with Request for Award,
attached hereto as Exhibit 2.
3.
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PASSED, APPROVED AND ADOPTED at a Regular Meeting of the Ci
Council of the City of Carlsbad on the
vote, to wit:
1st day of &pt&L 1992, by the follorring
AYES: Council Members Lewis, Larson, Stanton, Nygaard
NOES: None
ABSENT: Council Member Kulchin
ATTEST
Meiid&smZ2E$zi)
I
Joseph Pimental
SS# 554-06-1926 Stipulations
W
STATE OF CALIFORNIA
WORKE R d COMPENSATION APP~ALS BOARD
5. Medical-legal expenses are payable by defendant as follows: All paid. No liens c
q2 $
6. Applicant’s attorney request a fee of $ (3 / 0
7. Liens against compensation are payable as follows: None
8. Other stipulations: None
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Datd 1
Fybt \&iLJc u jos+?Pimental &A.Y
1200 Carlsbad Village Drive 554-06-1926 Carlsbad, CA 92008
Social Security Number of Applicant 1694 Harbor Drive 3954 Murphy Canyon Rd., #D-
Vista, CA 92083 San Dieso, CA 92193 ;r::y;y/7- Address of Insurance Company
Ki Attorney or Authorized Representative for E 2646 ison Street 3954 Murphy Canyon Rd., #D-
Carlsbad, CA 92008 San Diego. CIA 97193
Address of Attorney for Applicant Address of Att6mey or Auth@q’-Represen
Address of Employer
pliant Thomas Gniatkowski
DL?ARTYCNT Of INDOS~
DIVISlON OF 1NDUSTR DIA WCAB FORM 3 (REV 9-75) (Pace 2)