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Filed for Record 05/07/2019 03:51: 11 PM -Kittitas County, WA Auditor -201905070021 Page 2 of 4 <br />7. Describe in detail the defect which caused the injury: <br />8. Describe in narrative form and in detail exactly how the incident occurred: <br />se(:_ o,,-\toj(bad <br />9. List the names of all persons involved and contact information, if known. <br />10. Was claim investigated by a police officer? _N~O _____ _ <br />Sheriff ___ State Patrol __ City Police <br />11. Description of claimant's V(}hiclc: f\/ / A Make. __ . ____ Year <br />Model: __________ _ License No .. _____ _ <br />12. Describe what you did after the accident occurred: <br />NIA <br />13. Describe the conversations you had, if any, with County personnel during or after the <br />incident occurred: . <br />c c:<:m'O\ 1ed kD c a c 1< \'[\ \/io.. ernau_0 4 p'ooa L <br />10 ;:-ee \f xe,v(dQ 'O.::pra ere~ 'cad \xro ~~cl. <br />2 of3 <br />Kittitas County Claim ror Damages Fonn <br />Revised 9/2012