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Filed for kigtmd 0'02/2019 02 59:52 PM - Kittitas County, WA Auditor - 201908120064 Page 2 of 4 <br />7. Describe in detail the defect which caused the injury: _ <br />N /%k <br />8. Describe in narrative form and in detail exactly how the incident occurred: <br />I WAkdrilil ll on 'L-40 nr nulepo 6$ ty(le a Ki i+acC U144 frock <br />(*16hiir <br />e4s_ulA �y$ir1C IM@r8e� nrcto Y -9Z in-Protl-i•arme ! no%Iced 46 <br />sl ro TUM -f-CU L 4446,4 pOI4+f <br />(%9 vta irl@ X105 , p p� " wr h 0., number 4 'J �hn� (�i k Qnd brake +y► <br />windsi,t eld % L P I�,cr°S , JbiS aecurrecl on RurJq 7uly 8, 2otq at 4Spal <br />9. List the names of all persons involved and contact information, if kn wn. <br />10. Was claim investigated by a police officer? N Q <br />Sheriff State Patrol City Police <br />11. Description of claimant's vehicle: 06VRDLLT Make995Year <br />Model: !�2 0 VA O License No. A f)3$ q 4 <br />12. Describe what you did after the accident <br />truck <br />13. Describe the conversations y u d 'f �ny� w, ith Co�pty personne unng or a er h9 <br />ntoccurred: Z r" P KNi'r%ffl lAl7Mk i 1p. 0A A_lQ Sa <br />w h r enri� In Ae-4 i i e� e eMC,iie�! <br />-t4titS -l' m 4 rne- anal rn rvcl me 4o coll 461P.�oeN and <br />�e4Ur(e `ren 1Sp06 WA Suetlham oh Ji ly q,2o19 <br />14. Describe the damages or injuries which you sustained as a result of the incident: <br />2of3 <br />Kitdtu County Claim for Damages Form <br />Revised 9/2012 <br />