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=d for Record 01/06/2011 03:45:29 PM - Kittitas County, WA Auditor - 201101060029 Page 2 of 4 <br />7. Describe in detail the defect which caused the injury: SC--� e-- ft•-r/—q rr FfEo <br />S. Describe in narrative form and in detail exactly how the incident occurred: SCC <br />ATA <br />9. Was claim investigated by a police officer? J <br />Sheriff State Patrol City Police <br />10. Description of claimant's vehicle: D4 Make Year <br />Model License No. <br />11. Describe what you did after the accident occurred: Nl/4 <br />12. Describe the conversations you had, if any, with County personnel during or after the <br />incident occurred:— 14 / <br />13. Describe the damages or injuries which you sustained as a result of the incident: .!�pyn-o x <br />000 C-0 <br />14. What is the amount of damages claimed? (Include estimates and bills, if available): <br />,:) 0 -FAL 'S T <br />cs of <br />15. How did you identify the County as the party responsible for your damage? <br />Page 2 of 3 <br />