[HISTORY: Adopted by the Town Council of the Town of Phillipsburg as indicated in article histories. Amendments noted where applicable.]
[Adopted 3-1-1994 by Ord. No. O:94-9 (Ch. 17, Art. I of the 1969 Code)]
No action shall be brought against the Town of Phillipsburg unless the claim upon which it is based shall have been presented in strict compliance with the requirements of the Tort Claims Act, N.J.S.A. 59:1-1 et seq., and as may be amended. Such notice of claim shall be filed on other form hereinafter established in the Office of the Clerk of the Town of Phillipsburg, and in the manner and time as established by the Tort Claims Act.
There is hereby adopted as a regulation/rule of the Town of Phillipsburg for the presentation of claims against the municipality under the Tort Claims Act, N.J.S.A. 59:1-1 et seq., the following form:
NOTICE OF CLAIM UNDER TORT CLAIMS ACT AGAINST THE TOWN OF PHILLIPSBURG, NEW JERSEY
(1)
Name and post office address of the claimant;
(2)
Post office address to which the person presenting the claim, desires notices to be sent;
(3)
The date, place and other circumstances of the occurrence or transaction which gave rise to the claim asserted;
(4)
A general description of the injury, damage or loss incurred so far as it may be known at the time of presentation of the claim;
(5)
The name or names of the public entity, employee or employees causing the injury, damage or loss, if known; and
(6)
The amount claimed as of the date of presentation of the claim, including the estimated amount of any prospective injury, damage or loss, insofar as it may be known at the time of the presentation of the claim, together with the basis of computation of the amount claimed.
PURSUANT TO N.J.S.A. 59:8-6, DEMAND IS HEREBY MADE THAT THE CLAIMANT PROVIDE ADDITIONAL INFORMATION OF EVIDENCE AS FOLLOWS:
(1)
Written reports of claimant's attending physicians setting forth the nature and extent of injury and treatment, any degree of temporary or permanent disability, the prognosis, period of hospitalization and any diminished earning capacities;
(2)
A list of claimant's expert witnesses and any of their reports or statements relating to the claims;
(3)
Itemized bills for medical, dental and hospital expenses incurred or itemized receipts of payment for such expenses;
(4)
Documentary evidence showing amounts of income lost; and
(5)
If future treatment is necessary, a statement of anticipated expenses for each treatment.
NOTICE IS FURTHER GIVEN that the claimant may be required to submit to a physical or mental examination by a physician employed by the Town of Phillipsburg, and the claimant may be required to permit the Town of Phillipsburg to inspect all appropriate records relating to his claim for liability and damages, including but not limited to income tax returns, hospital records, medical records and employment records.