HomeMy WebLinkAboutAGENDA - 11042008 - C.14 (13) i r CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
BOARD ACTION: NOVEMBER 04, 2008
Claim Against the County, or District Governed by
the Board of Supervisors, Routing Endorsements, 0 I NOTICE TO CLAIMANT
and Board Action. All Section references are to The copy of this document mailed to
California Government Codes. D 6gB�� you is your notice of the action taken
(!v on your claim by the Board of
OCT 0 6 2008 Supervisors. (Paragraph IV below);
given Pursuant to Government Code
AMOUNT: $1,000,000.00 COUNTY COUNSEL Section 913 and 915.4. Please note all
MARTINEZ CALIF. "Warnings",
CLAIMANT: APRIL WILSON, DAVID WARREN
ATTORNEY: DAVID C. ANDERSON DATE RECEIVED: OCTOBER 06, 2008
LAW OFFICES OF DAVID C. ANDERSON OCTOBER 06, 2008
ADDRESS: 50 FRANCISCO ST. , 46450 BY DELIVERY TO CLERK ON: .
SAN FRANCISCO, CA 94133 HAND DELIVERED
BY MAIL POSTMARKED:
FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DAVID TWA, Cler
Dated: OCTOBER 06, 2008 By: Deputy
II, FROM: County Counsel TO: Clerk of the Board of Sup rvisors
This claim complies substantially with Sections 910 and 910.2.
( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so
notifying claimant. The Board,cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and
send warning of claimant's right to apply for leave to present a late claim(Section 911.3).
O Other:..
Dated: o12 a lu Cou unsel
III. FROM: Clerk of the Board T0: Co my Counsel (1) County Administrator(2)
( ). Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present:
(� This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this
date.
DateS/DAVID TWA, CLERK, By eputy Clerk
WARNING (Gov. code section 913)
Subject to certain exceptions,you have only sir(6)months from the date this notice was personally served
or deposited in the mail to file a court action on this claim.See Government Code Section 945.6.You may
seek the advice of an attorney of your choice in connection with this matter. If you want to consult an
attorney,you should do so immediately. *For Additional Warning See Reverse Side of This Notice.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have
been a citizen of the United States, over age 18; and that today I deposited in the United
States Postal Service in Martinez, California, postage fully prepaid a certified copy of this
Board Order and Notice to Claimant, addressed to the claimant as shown above.
Dated:A/Pd, 0s .&4 JDAVID TWA, CLERK, By uty Clerk
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This warning does•not.apply to claims which
are not subject to the California Tort Claims
Act such as actions in::myerse condemnation,
actions for specific,relief such as mandamus or
,;rrr
injunction, or Federall'Civil'Rights'claims. The
above list is not ezhaustive.and legal
consultation is essential`-to:niiderstand all the
separate limitations periods that may apply.
The limitations period within which suit must
be filed may be shorter or longer depending on
the nature of the claim. Consult the specific
statutes and cases applicable to your particular
claim.
The County of Contra Costa does not waive any
of its rights under California 'tort Claims Act
inor:•does it waive rights under the statutes of
11 ns applicable to actionsnotsubject to
the California Tort Claims Act
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10/01/2008 13:38 CONTRA COSTA COUNTY CLERK OF THE 3 914151&9839 NO.GeO 1?01
BOARD•SUPERVISORS OF CONTRA COST UNTY
INSTRUCTIONS TO CLAIMANT
A. A claim relating to a cause of action for death or for injury to person or to personal property or
growing crops sball be presented not later than six months after the accrual of the cause of
action. A claim relating to any other cause of action sball be presented not later than one year
after the accrual of the cause of action.
(Gov. Code §911.2.)
B, Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106,
County Adminislralian Building, 651 Pine Street,Martinez,CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than the County, the
name of the District should be filled in.
D. 1f the claim is against more than one public entity, separate claims must be filed against each
public entity.
E. Fraud. See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form.
YYY Y YYYYY poor Y •ommo•Ron mangoes was 0 M we a of
RE: Claim By: Reserved for Clerk's filing stamp
April Wilson, David Warren
RECEIVE®
Against the County of Contra Costa or ) OCT 6-6 Z00
Contra Costa County Public Works )
Dept. Dis'tr'ict) CLERK BOARD OF ;;S qS
(Fill in the name) ) CONTRA
The undersigned claimant bereby makes claim against the County of Contra Costa or the above-named
district in the sum of$ I, 0 0 0 , 0 0 Oand in support of this claim represents as follows:
I. When did the damage or injury occur? (Give exact date and hour)
4/10/08
2. Where did the damage or injury occur? (Include city and county)
San Pablo Dam Road nearmarons Lane
3. How did the damage or injury occur? (Give full details;use extra paper if required)
Decedent Alexandria Warren, 15 years old, was struck and killed by automobile.,
while crossing San Pablo Dam Road.
4. What particular act or omission on the part of county or district officers, servants, or employees
ca=1411, Acc de t site lack d suff ' ci nt i htin oste
rspeed ��_mit o� 4 eli was IZig�i given exis�ence o� c�iurclZes, sc�bo�s,
resi(JeiDces, bus sto s in proxim t here wer n cr ss al1ks in a
proximity. The CounEy was on no i e rom resiedenots aoou dangerousiccos4it-
5 What are the names of county or district officers,servants,or employees causing the
damage or injury?
ContraCosta County Building/Public Works Dept. I
10/01/2008 13:38 CONTRA COSTA COUNTY CLERK OF THE 4 914153 59839 NO.Geo D02
6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages
claimed. Attach two estimates for auto damage.)
Death, funeral and burial expenses .
7. How was the amount claimed above comparted? (Include the estimated amount of any
prospective injury or damage.)
Loss of society, comfort, companionship, care, affection,
and assistance.
9, Names and addresses of witnesses,doctors,and hospitals:
See C.H.P. Report No. 4-110 , Mantinez Office, and John Muir
Medical Center records
9. List the expenditures you wade on account of this accident or injury:
PAM TME �1
Medical bills and fun.;.eral expenses .
.Asa..aaam aago@as@so aa66.so a...ago am Nowaa.a as as a•.a.r.Ora goo pupas as as a a..one for
) Gov.Code Sec. 910,2 provides"The claim shall be
) signed by the claimant or by some person on his
behalf."
SEND NOT.[CFS_TD! (Attorney) )
Name and address of Attorney )
David C. Anderson, Esq. )
Law Office of David C. Anderson (C1 °sSignature)
50 Francisco St. , #450 )
San Francisco, CA 94133 ) 50 Francisco Street, Suite 450
(Address)
San Francisco, CA 94133
Telephone No.415 395-98()8 )Telephone No. 415 395-9898
•.. 4..0 0.80900 9660.01101aa06110 9..0aa6 a a r a■■•u....a.a.a a a a■a a aa.a 4.I
PUBLIC RECORDS NOTICE:
Please be advised that this claim form,or any claim filed with the County under the Tort Claims Act, is subject to
public disclosure under the California Public Records Act, (Gov. Code, §§ 6500 et seq.) Furthermore, any
attachments,addendums,or supplements attached to the claim form,including medical records,are also subject to
public disclosure,
.............................................■.newsBass lassos.:.....mean gas a...a..el
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NOTICE:
Section 72 of the Penal Code provides:
Every person who,with intent to defraud, presents for allowance or for payment to any state board or officer,or
to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or
fraudulent claim, bill,account voucher, or waiting, is punishable either by imprisonment in the County jail for a
period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), or by both such i
imprisonment and fine, or by imprisonment in the state prison, by a floe of not exceeding ten thousand dollars
($10,000), or by both such imprisonment and fine.
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