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S � <br />Y <br />7. Describe in detail the defect which caused the injury: <br />A <br />LI <br />Describe in narrative form and in detail exactly how the incident occurred: <br />List the names of all persons involved and contact information, if known. <br />MI <br />10. Was claim investigated by a police officer? 0 <br />Sheriff State Patrol City Police <br />11. Description of claimant's vehicle:' Make O Year <br />Model: �% _ i� License No. Ukcd. /S 4101' e % <br />AV 615 6-0y- <br />12. Describe what you did after the accident occurred: <br />4v- i-vAie z At e;�-mic4�7 /31 wri <br />13. 'Describe the conversati <br />6 r cz GS cj& 45 &- 4kJt6I <br />you had, if any, with County personnel during or after the <br />2 of 3 <br />Kittitas County Claim for Damages Form <br />Revised 9/1012 <br />