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HomeMy WebLinkAboutMINUTES - 09251984 - 1.15 CLAIM BOARD OF SUPERVISORS OF C WM— COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CIAIMARr September 25, 198 governed by the Board of Supervisors, ) The copy of th s document ma ed to you is your xwLing rAmorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below) , to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: Steve Fleischer 5602 Idlewild Avenue! County Counsel Attorney: Livermore, CA 94550 AUG 2 2 1984 Andress: Martinez, CA 94553 Amount: $1750 . 00 By delivery to clerk on Date Received: August 20, 1984 By mail, postmarked on August 18 , 1984 - 1. 984 -I. FROM: Clerk of the Board ot Supervisors County arose Attached is a copy of the above-noted claim. Dated: August 20, 1984J.R. OLSSON, Clerk, By —ff ,� Deputy Jo ene Edwards II. FROM: County Counsel : Clerk of the Board of Supervisors (Check only one) ( 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. 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) . ( ) Other: Dated: c Bys Deputy County Counsel III. FROM: Clerk of the Board 70: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BMM ORDER By unanimous vote of Supervisors present ( This claim is rejected in full. ( ) Other: I .certify that this is a true and oorrect copy of th rd's Order entered in its mitts for this date. Dated: JJ tt 2 5 1.984 J. R. OLSSON, Clerk, By � Deputy Clerk WNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave present a late claim was mailed Vaimant.DATED: Z 5 1984 J. R. OLSSON, Clerk, y X Deputy Clerk cc: County Administrator (2) County Counsel (1) 00015 I CLAIM I CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions -co Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106 , County Administration Building, 651 Pine Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, .CA) . 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. If 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 end of this form. RE: Claim by ) Rese7Bv_�����. ' fi ing stamps S�-EVE Fi.E15cNER j ED ) ) Against the COUNTY OF CONTRA COSTA) irrNor DISTRICT) PERVISORS(Fill in name) ) CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 171SO. OQ and in support of this claim represents as follows: When a�a the damage or i - -------- 1 injury occur? (Give exact date and hour) S12, 8y IS : 1� ------ ----T--------------------------------------(Include------city--and---------county)----- 2. Where did the damage or injury occur? f WLA N D 7R.JG7' , L n/WC0RP02t%cV -60V-a4 CoS7�3 ------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details, use extra sheets if required.) A CAR, COMtn14 go 17WT (R.0 � POS 78Z SPdM SS,ti pM CAMs To . AN .5 CVKV ON A W —IA/6 , THE 00UV8R w43 VN"0�00 To &d5lr HCS G92 IN 14(j LANE 'SND RAV j R✓i O MY CAR,, ------------------------------------------------------------------------- 4. What particular act or omission on the part .of county or district officers , servants or employees caused the injury or damage? L A,k.- o, SIGN wwji/j& of S c vvt Tuq,— wu ©" RN L"CJ4 v0s �© (over) _S. What are the names of county or district officers, servants or loyees causing the damage or injury? ------------------------------------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) � T REA2- DOOR, 1-0'r Rte. qvgR,—(FJL P,"gL pc-SrROYev 7--. H-----ow--wasth------e-------amount--------claimed--above--------computed?---------------(Include--th--e--est------imated------ amount of any prospective injury or damage.) VE�AGt� C�` �E Z �5ittitA cS Y.�v �{/}✓c lis 17c 8. m Naes and addresses of witnesses, doctors and hospitals. -- - ---- ------------------------------------------------- 9.--L-is-t the---expenditures------ you made on account of this accident or injury----: DATE ITEM AMOUNT ,5 ZL 11t7 i���,,,rN (Vs o 7 do s OL V6*lf �'gaa Govt. Code Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some p erson on his behalf. " Name and Address of Attorney Claimant' s Signature S'(On Z 10LA-Y A 4 Address Telephone No. Telephone No. 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " 00017 C[AZM BOARD OF SUPERVISORS OF CORM COSTA COUNTY, CALIFMTIA BOARD ACTION Claim Against the County, or District ) NCYr CE TO CLAIMANT September 25, 1984 governed by the Board of Supervisors, ) The copy of th s document ma ed to you is your Routing Endursemenrs, ana &-*AL.i Notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below) , to California Goverment Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warm s". Claimant: Beatrice and Harry Krell Couniy0ounsel Attorney: J. Michael Matthews AUG 2 2 1984 650 California St. , :31st Floor Address: San Francisco, . CA 94108 Martinez, CA 94553 Amount: Unspecified By delivery to clerk on Date Received: August 22, 1984 By mail, postmarked on August 21, 1984 I. FROM: Clerk of the Board o upervisors County Counsel Attached is a copy of the above-noted claim. D Dated: August 22, 1984 J.R. OI.SSON, Clerk, By �-[�. ,�c, Deputy ff Jolene Edwards II. FROM: County Counsel 10: Clerk of the Board of Supervisors (Check only one) (X) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to amply 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. 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). ( ) Other: Dated: — _ By: mac. Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2)/County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD ORDER By unanimous vote of Supervisors present X( ) 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 dor this date. {�'le ' {XjDated: Jif' 1 5 1 J. R. OLSSON, Clerk, , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DATED: SEP 2 51984 J. R. OISSON, Clerk, By ?;�i; Deputy Clerk cc: County Administrator (2) County Counsel (1) i5 00018 CLAIM RECEIVED C L A I M AUG as 1934 J. R. OLSSON TO: COUNTY OF CONTRA COSTA CJ4RK BOARD F SUPERVISORS ONT o e .. FROM: BEATRICE RRELL and HARRY RRELL C/o J. MICHAEL MATTHEWS, ESQ. 650 California Street, 31st Floor San Francisco, California 94108 BEATRICE RRELL and HARRY RRELL have been named as defendants in Contra Costa County Superior Court Action No. 256866 entitled LEE v. RRELL, ET AL. The RRELLS were served with the Complaint in that action on approximately May 21 , 1984. Plaintiffs in that action seek to recover for alleged property damage and personal injury suffered when a landslide impacted their real property. That landslide allegedly occurred on March 2 , 1983, and impacted No. 9 Charles Hill Circle in Orinda, California. BEATRICE KRELL and HARRY RRELL claim a right to be defended and indemnified by the County of Contra Costa for any liability imposed upon them in the above-referenced action and by this claim tender their defense. The amount of this claim is not currently known. Public employees involved in this alleged inci- dent are not currently known. DATED: August 15 , 1984 J. MICHAEL MATTHEWS JMM:lgs 00019 CLAIM . BOARD OF SUPERVISORS OF QORMA COSTA COUNTY, CAL11"WIA BOARD AMON Claim Against the County, or District ) NOME Tp CLAIMANT September 25, 1984 governed by the Board of Supervisors, ) The copy of-gFis--d-oc-wie-n-t-`iilled to you is your Routing Endorsements, and Board ' - J -notxc* or r-ne action taxen on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below) , to California Government Codes _) given pursuant to Government Cade Section 913 and 915.4. Please note allCi ,� �iaSei Claimant: Phyllis C. Martinez 2249 Quebec Street Attorney: Concord, CA 94520 AUG 2 1y�4 Address: Martinez, CA 94553 Amount: $214 . 09 By delivery to clerk on August 22, 1984 .Date Received: August 22, 1984 By mail, postmarked on - I. FROM: Cler kr of the Board ot Supervisors County Coxisel Attached is a copy of the above-noted claim. Dated: August 22, 1984 J.R. OLSSON, Clerk, By Deputy o ene war s II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) IV-4) 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. 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) . ( ) Other: Dated: - By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1) Canty Counsel, ( County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD ORDER By unanimous vote of Supervisors present This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of Board's Order entered in its mi Utes for this date. Dated: EP J. R. OLSSON, Cler , ,jv, Deputy Clerk SING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FRCM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. we notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to resent a late claim was mailed to aimant. DATED. S�P 2 5 1984-- J. R. OLSSON, Clerk, , Deputy Clerk cc: County Administrator (2) County Counsel (1) 00020 S CLAIM CLAIM, TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions :o Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 9.11. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553 (.or mail to P.O. Box 911, Martinez, CA) 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. If 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 end of this form. RE: Claim by ) Reserved for Clerk' s filing stamps Alis C. Martinez ) ------ -- ---Against--the-_COUNTY--OF---CONTRA--COSTA ---- - -- ------------- ---- ---- ------------- or DISTRICT) (Fill in name) ) The undersigned claimant hereby r.takes claim against the County of Contra : Costa or the above-named District in the sum of $ 214.09 and in support of this claim represents as follows: 1. When did the damage or injury occur? ' (Give-exact date-and hour) Friday, August 10, 1984 at 5:40 p.m. -' -----------T-----------------------------------------.-.--.-----•------ d -��.�... 2. Where id the damage or injury occur? (Include city and •county) Marsh Drive, Pacheco, California, County of Contra Costa -- --- --- -----d-------------------------------------------- 3. --How—did—the amage or injury occur? (Give full details, use extra rheets if required) I was driving down Marsh Drive, Pacheco, behind a construction (tar truck cCrafco Int' 1 Surfacing, Inc.Phoenix, Ariz.Lic.l0A387?)which kicked off rocks and broke my car windshield. I continuously honked at the truckandfollowed it into the construction sight there (near storage sheds behind the Concord Airport, rear left side c 'Marsh Drive). The driver said to report the incident to the man in the blue truck . O ic. #ISI-3), who told me to report it to the county. --------------------------------—--------------------------------------- 4 . What particular act or omission on the part of county or district . officers , sQrvants or employees caused the injury or damage?. Dye to xtensfve construction work done in this area, the roads have not been kept RLear of debrisr exces ivg r cks. ` amage was caused by roct hitt ng windshield. 000 (over) What are the names of county or district officers , servants or P eRerorve� ocGaoun y,ftCbntdran oaEa�y injury? contractors working for County of Contra Costa. Crafco International Surfacing, Inc. (Tar Truck-Arizona License #lOA3877) #1011 - - -- - ------------------------------------------------- 6 . Wh-at--damage----- or injuries do you claim resulted? (Give full extent - - of injuries or damages claimed. Attach two estimates for auto damage) Broken car windshield (two estimates for auto damage attached) 1983 Escort Wagon --__ ____-------------------------------__-------------------------------- 7. How was the amount claimed above computed? .(Include the estimated amount of any prospective injury or damage. ) Estimates attached. 1 - Al Eames Ford, Antioch $291.41 2 - Concord Auto Glass, Concord $214.09 -----------------------------I-------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. None available at time of auto damage._ -.-- - ---------- --- ------------------------- ---------------------------------- 9. --List the expenditures y---o-u,--m-a- ou made on account of this accident or injury: DATE ITEM AMOUNT None, awaiting claim. Govt. Code Sec. 910. 2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Claimant' s Sign&ture 2249 Quebec Street Address _------ ---- .Con_cord,_ CA 94520 Telephone No. Telephone No. work - 944-3966 home - 825-2690 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, .town, city district, ward or village board or officer, authorized to allow or pay the same if genuine , any false or fraudulent claim, bill, . account, voucher, or writing, is guilty of a felony. " 00022 �. .CONCORD AUTO, GLASS JOHN F.:DUGGAN SERVICE THAT YOU WILL RECOMMEND TO YOUR FRIENDS 1759 Concord Ave. • P. O. Box 681 •Concord. Calif. 94520 Phone 685-3674 Reg. No#13119 CUSTOMER'S ORDER NO. - PHONE DATE NAME ADDRESS SOL CASH C.O.D. CHARGE ON ACCT. MDSE.RETD. PAID OUT C� I3ESCF21PLION P#2tCE I i I . S,TAX I RECEIVED BY TOTAL All claims and returned goods 8899 MUST be accompanied by this bill. PRODUCT 610 00, 23 _ (' _`RT'EI •rte^'::x 'rYb:'.. � J - -_' '�irc`l x_.VghF'°".. ..'... 'a°"r w =1400•W Ofh meet tept>ane 3571771 SUMATE 10F�.� HAIRS _ 4Y�1710CH, AU060 to 9d509 b ^ NAM ADDRESS CITU , STATE'-- s "'ZIP ?t DATE rr 11 T eze r fdAKE OF R YEA PE . :. •- i EN NO. LEAGE MOTOR Np. ANDJOR SERI NO. C iN SD RED By i - :ADJUSTER INSPECTOR PHONE .. .. ,,.' • HOME BUSINESS r FRONT 8. PARTS : i£ET 1b-, PARTS itIGHT PARTS �rtvr fndr fnd r. Bmpr Brkt - " Fndr Skid - Bmpr Od Fndr Shid Fndr Midg Bmpr Bolts & Shims Fndr Mldg Hd ImP Valance Grvl Shid HdImD Door Prk Lite Hdlmp ' Geared Biu^ Frt SVst "•Hdlmp Door Cowl—post Frame - Door (Frt) +4br Sealed Beam Cowl-Post Door Hinge - Wheel -Door (Frt) - Hub Cap - Door Mldg Door Hinge Hub& Drum - Door Lock i D"or Mlrig. . K,,uckie Cir Post _ r Dont Lock Ur. Cont Arm Duo" (REL' I ` Gtr Post - Lt Cc•nt Arm Door Midg , • Door (Ree') Shock ----_-- ----."._ _..__. _—._ ..—__.�_ Rocket PnL ----- --- ------ Door Mldg Rockr Midg Tie Rod Ends Floor Rocker Pni - Qtr.Pnl Grille "Rockr Mldg ' floor Qtr. Pnl Qtr Mldg . 'Qtr Mldg Qtr Ext Qtr Ext Lock Plate Lr - - Whi Hsg- a' - Whl Hag Lock Plate Up MISC. REAR Frt Seat HoodBmpr ear Seat Houd Hinge Bmpr Brktlk ndshld Hood Mldg Bmpr Gd ALIVVndshid Kit Wing _ Red. Sup Back Up Lite Top Red. Core Lwr Body Pnl Tire %Worn Coolant Batt Red Hoses & Clamps Tail Lite Antenna fan Shroud Paint fL Mtl Fan Blade Trnk Lid/Gate AUTHORIZATION FOR REPAIRS Water Pump Trnk lid Hinge You are herebv authorized to make the above repairs. A/C Core Trnk Lid Mldg •Rechrg A/C Sig ad i floor frame +Mbr GROSS PARTS 26f *2 do MtrMts Gas.Tnk - - X DISCOUNT s Tailpipe—.Mfflr ;tana'iinkage ,. Axle ;. . NET PARTS.&`BUMPER 1 " Spring PAINT r Uiub fi Drum SALES TA%77, u ° +</aienoe f T0TA1 3 ( ' s1-Ati. n yrs + : i( ,rsEtC a DE "� aL eherWe�-Nw Hifi y�yerltstrl x$+-$aiat rf < •;? y a 'o s tralpht"on-0-wUied 1iRAND 7l3TAl J M1iala-Are Subiect 7o Price change pt Time fntroice.. Ibie-,Huai se-'Reid Before J"t pill-So ADlsased ?£81875 NDRICK OKL'AHDMA LJT1 CLAIM BOARD OF SUPERVISORS OF COA SA COSTA couR Y, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CIAllyA19p September 25, 1984 governed by the Board of Supervisors, ) The cony of th s document ma ed to you is your xouting rnaorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes _) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings'. Claimant: Paul L. & Lucille H. Phelps County 06sel 317 Polk Way Attorney: Livermore, CA 94550 AUG 2 2 1984 Address: N ifinez. CA 94553 Amount: $297 . 34 By delivery to clerk on Date Received: August 20, 1984 By mail, postmarked on August 18, 1984 - I. 984 -I. FROM: Clerk'o? the Board ot Supervisors County Counsel Attached is a copy of the above-noted claim. Dated: August 20 , 1984 J.R. OLSSON, Clerk, By �G�� Deputy A,'ene � war s II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) 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. 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). ( ) Other: Dated: — 3 By: Mtr Deputy County Counsel III. FROM: Clerk of the Board TO: (1 County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD OR'DIIt By unanimous vote of Supervisors present ( This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of a Board's Order entered in its da Dated inu�,to jt ,s J. R. OLSSON, Clerk, B �llYl��, Deputy Clerk gloom WARNING (Gov. Code Secticn 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FRCM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leavet present a late claim was mailed t% t. ]DATED: 1984 J. R. OLSSON, Clerk, , Deputy Clerk car: County Administrator (2) Canty Counsel (1) 00025 .1`' CLAIM "CLAIM `TO: - BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions -:o Claimant A. Claims relating to causes of action for death or''for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec-. 911•. 2 , Govt. Code) . - B. ode) .B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, _CA) , 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. If 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 end of this form. RE: Claim by ) nese d ' il 'ng stamps Paul L. and Lucille fit. Phelps ' RECEIVED Against the COUNTY OF CONTRA COSTA) J. R. OLSSON or DISTRICT) CLERK OARRD OF SUPERVISORS O (Fill in name) ) g T OSTA CO. e U The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ #2-9 7. 3 tf and in support. of this claim represents as follows: --------=--------=------------------------------------------------------ --__ 1. When did the damage or injury occur? (Give exact date and hour) a_Au .List_-LL_l9d4i_at_J�kx__y _01) P.M. ----------------------------- 2. Where did the damage or injury occur? (Include city and county) On Vasco Road, just inside the Contra Costa County Line , approximately four miles from the Livermore City Limit sign. - - ----------------------------------------- - ----- 3.--How---did----the-----damage------or---injury occur? (Give full details, use extra sheets if required) The entire road was covered with loose gravel (both lanes) , and cars approaching from the opposite direction caused rocks to shatter the front windshield in my IY84 Isuzu automobile. ------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers , . servants or employees caused the injury or damage? Covering the road with loose rocks, causing a hazardous situation from which there was no escape. 00026 (over) 5. - ',What are the names., of, county or district officers, servants pr "employees causing the damage or. njury? Members of the Contra Costa County road repair crew, as supervised by Tom Barcelano and Tom Borman. - --------------------------•------------------------------------------- 6-.--What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) The windshield on our vehicle must be replaced. )Estimate of 4297. 34 attached) . 7. How was the amount claimed above computed? (Include the estimated . amount of any prospective :injury or damage. ) Roadrunner Glass estimate ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Not applicable. ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Total expenditure: . $297.34 to replace windshield. Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) orb,�y some a on on his behalf. " Name and Address of Attorney Claimant's Sig ature None. 317 Polk Way Address LIver.more, .CA 94SSU: . Telephone No. Telephone No. 'A�, -44 7 V4 Z9 NOTICE Section-72 of the Penal Code provides: "Every person who, ' with' intent to defra.ud', . presents for allowance or for payment to any state board or officer, or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or. fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " 0002 ILoadrunner Glass Eddie Camp, Owner 2321 .First Street Cont. Ua.# 457633 Livermore, Calif 94550 �\ 447-0646 Date BGG 19 ESTIMATE TO /L��Xi JOB ADDRESS PHONE OWNER OWNER'S ADDRESS V We agree to furnish the above items for the sum of $ F. 0. B. provided this estimate is accepted within from this date Please examine this estimate carefully as we agree to furnish only the articles named and described hereon. All agreements contingent upon strikes, accidents or other causes of delay beyond our control. Accepted 19 By WADRU NER GLASS By B 00028 CLAIM BOARD OF .SUPERVISORS OF CONTRA COSTA COUNTTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT September 25, 1984 governed by the Board of Supervisors, ) The copy of this document ma ed to you is your Routing Endorsements, and Board ) notice or th@ actiar-�cakefi do yout claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: Leo Saenz 3071 Frandoras Circle Attorney: Oakley, CA 94561 Address: Amount: Unspecified By delivery to clerk on Date Received: August 24, 1984 By mail, postmarked on August 23, 1984 I. FRCM: Clerk of the Board ot Supervisors County Counsel Attached is a copy of the above--noted claim. t Dated: August 24, 1984 J.R. OISSON, Clerk, By Deputy Jolene Edwards II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( ' ) 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. 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) . ( ) Other: Dated: - 771, By: Deputy County Counsel III. FRM: Clerk of the Board TO: (1) County Counsel, (2) ounty Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD OBER By unanimous vote of Supervisors present ( This claim is rejected in full. ( ) Other: I .certify that this is a true and correct copy of t e Board's Order entered in its min s�for this date Dated: �Jtt 5 J.. R. OT SSON, Clerk, Deputy Clerk MINIM (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to esent a late claim was mailed tosimant. DATID: 17251984 J. R• , Clerk, By Deputy Clerk cc: County Administrator (2) County Counsel (1) 00029 I� CLAIM r�-. CLAIM' TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions -.o Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2 , Govt. Code) , B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651• Pine Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, CA) . 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. If 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 end of this form. RE: Claim by ) Reserved rwk-�s cling stamps ) FREEIVED Against the COUNTY OF CONTRA COSTA) or DISTRICT) . OL:SON O. SE1p_RVISORS (Fill in name) CC'�iA CO. u, The undersigned claimant hereby i.Lakes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: ------------------------------------------------------------------------ - 1. When did the damage or injury occur? (Give exact date and our 2. Wher did the damage or injury occur? (Include city and county) o .. ra`� ff 7 ea -----=��_ 0---�--- --- ---�/14 3. How did the damage or injury occr? (Give full details, use extra sheets if required) f�of/e L d u S 6 i n � rice-rs , � lcto�ori� �. ------ ------- ----------•---------------P------------y--------------- 4. Wharticu ar act or omission on the art of count or district of servants or employees caused the injury or damage? t (over) . 00030- 5% What .are the names of -.county or district officers, servant-s. or _. .employees causing the damage or injury? AL.--_ _-�.�°------------------------- --------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) ------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated, amount of any prospective injury or damage. ) _ ___ __ --- .� _- ____ __ 8. Names andy addresses of_wi_tnesses_____, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT � . Govt. Code Sec. 910.2 provides : ` "The claimsigned by 'the claimant SEND NOTICES TOS. (Attorn ) y some per on on his behalf. " Name and Address "of Attorney Cla ant' Sig r �- ress Telephone No. Telephone No. /4 -762/- O&O NOTICE Sectfon 12 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account , voucher, or writing, . is guilty of a felony. " 00031 (1 Z t�4'� ��• 9-ysG� _ �" ti,aE,/ Jccs� �uFc�i�¢seo� �rfe.cv /��y- C�✓ EC��..z-� n of was 9'a i,n9 -fo wo o k S&,4,JAbau4io1 ®h e a :3 o tkl�64n ex arc M 0 r1 Itt , �i-n ttiC w,g S move`-4tC *td Yh"In j 4ppro x . �_� m.. �, ti• ev4 e n . - -w ti `f ? r4vcL l 4V'APiC S-($Rkcal. slawth -dawh� .. .hu bre f l�� .h - r—4 f?. rq, tep.,I 7Lr44 - j411a d4st' 7/ f 6ic n dvi . e _o Z I C jf4ttsf?l knok d4.-n,41 e- mopc ttjok!�Ii?nf ce _ 44 e-c yrI s t c - -- _o 4-A /-o )},nd GUA c e L-_)es/7--.- PCA ke tj 7� Ize S a r--Ai e� - _en._ - k -Scue�- ©_ .__A �?_ weer-S - �►r�4!/ L _.___��1 _ - Szewn.a k4ty 74rfo �'� A-e- l-qS- z .. .!rile : /0r._. 50 _ - �JGdu rc - i�c. _ _ -cs .� -14c _- _--was �" 00032 -,, � � . . I . . � . - � " . . Estimate For-, m . . . . Name ��d V R,el � Date 5 1 _ / " p Address r State Zip Phone f 5 V_- b V G 6) - Year Make C Af � Model f' l c/9mexl e I.D. No. /L/ Color 3 Prod. Date Trim Mileage License No. . �C4 7 1 3 I I 11 Ins. Co. File No. Claim No. Appraiser Lic. No. Phone Written By Line Re- Re- No. pair place_ DESCRIPTION OF DAMAGE PARTS LABOR PAINT , 1 _X 6V��,e-� Fez�- Oa .3 d- ,sa s 3 . 4 .}J 5 //Z-e— . ,.-. .i?klgi5�W��-"..-..-'.*...-...*..X.'.._....."._..."_...,..*1......:..........-...I..:......-.:........:...:....:..,......:...:...,.:.:.....:...:....-:...:..­.-:...:...:.....'v....:...:....-:.:..:..:...:.-.,-:.."..,.�......�...I.,.:...�....­ ..:.....:.:....:_.:-....:".:­...i....�.....!...i...�-........:-...]­...:-........:...�..:...j...:...�...::..i:..::.::. .::..::..::..::..:.-..:._..:'.-,:..:'...:-...:..:..:..:..i:..::.:.:.::.:..::.:­.:...:...:..:...:-...:.­..:. ..:...:.-..:.::::I�:--.,.-.. �­........................."........ ......-....... ...�.,......,,. .....:.-.......",....*... .:­:.I­-.....-..�.., ..:- 1.*....::,�..,.�.......,...*.....:...�I�:....._:.....:.....:..........._..�....:..-..:...*..-..I.........:..--.�._..,.-':_ -*:..­..-__:.._......:':*....,.:...".�...:.....:.-..II*.-._. _.­.-.­-­.. ­..� .­..-.-.-...-.,..,.....-........:_:�,�.:: .*...�1. �.". :.,...,..,........I...­,..-,..�. ... / -� 1 7�-q 3 _.... s .,. ..... .... :::::::.:.. .............................. ..................................................................................................................... ......................................... ...............................................:. ........ 10 . 11 .. . 1z 13 - i a>:;:::»;:::::i::z:::;:';::>::::3::;::::;;::::>::;<:::; ::>:::>:s>::»:<:<>::;>.::::>:<::::::«:::::::< ::_:>:<:::: :6..:>: >::::>:<:::.::::: ............. ...... ................. ...... s::::::: ::::.::::.::. :.......................... ................. ...... ::..:::::::::::::. ::. ................ ........ 14 ........... ..................................................................................................................................,..:................. :-...::::::::.::::::::::::::.::::::::.::::::::::::::. : . ::: . ::::::::::::. ::.: I.... I.:::::::::::.::::::::::::::::::::::::::::::::::...........................................................:::.::....:...: ................................;..... ...:._ :::.......�............. ......................... 15 . 16 .............. .._...... ...._..__.......,........_............................................................................ . ........__ .. ........ ._...... ..... ... _....__.. -.... .. 17 . 18 ''1 19 -. 2 .. 0 . ....4.... ......... ........ . ...4... ....... . . . . 21 .,.— ..:... ................. ::.::::::.:....:.:.:.::....::.... .... . :.:.: '23 24 I :25 2627 27 ::< 2 . . ..;::......;.:;,::: 4i 29 i 3 0 I TOTALS ..... . :.::;..:.: .. :..::X:::;:.:..:.:..<::.;:.::..:.:.:.. ..:::.:.:.;:.;..::.:.:...:::::...::;.::.::..:...:::..::...::.:.:...::..:..:.:.:.:...:.:......... ►�t -, :a ior�:ftp.:(+i r..:::::::....... ..::::::::.......::::::::.::::::::::. ::::::::.: :::.::::::.:::::...:.:::::::. .:::. . :: :.:::.:: .: .... .. ................ ........ ............. :::.:: ......................::............:.:........................................................:.:................... ................ ::::::::::::::::::...:::. :::::::.:.;.:...:::::.... ........ ..................:::..... .....:..#.... .:.::. ...:.... . ......... t -. PARTS Prices subject to invoice I BYER'S AUTO BODY REPAIR, INC. LABOR hrs.@$ $ ' 177 Highway 4 Paint Supplies $ . Shop Supplies $ i . Brentwood,California 94513 0®Q '3 Towing/Storage $ '.- r Phone (415) 634-3198 sublet $. ;... -_ . , - I II I Tax DAMAGE REPORT TOTAII L $ ,. i . CASEY'S CUSTOM PAINT'.& BODY SHOP-- ESTrnnaTE OF REPAIRS ` 1 142 N. Highway 4 - Phone: 634-22.11 BRENTWOOD, CALIFORNIA 94513 CALIF.B.A.R.REG:#AB572.16R NAME �_' ADDRES � � � DATE -. o d1 L MAKE OF VEHICLE ,-. YEAR TYPE ICENSE NO. - MILEAGE SERIAL NO.(VIN NO.) -- INSURED BY ADJUSTER ]INSPECTOR 'PHONE HOME BUSINESS tabor Labor. Labor SCM' Hours PARTS SCM. Hours PARTS SSM. Hours PARTS Bumper IFender Fender Bumper Rail lFender Ornament Fender Ornament Bumper Brkt. I Fender Shield Fender Shield Fender Mldg. Fender Mldg. Bumper Gd. Headlamp Headlamp Frt. System Headlamp Door Headlamp Door Frame Sealed Beam . Sealed Beam Cross Member Cowl Cowl Door,Front Door, Front Wheel Door Lock Door Lock if Hub Cap Door Hinge Door Hinge Hub&Drum Door Glass Door Glass Knuckle Vent Glass Vent Glass Knuckle Sup. Door Mldg. Door Mldg. Lr.Cont. Arm-Shaft Door Handle Door:Handle License Frame-Brkt. Center Post Center Post Up. Cont. Ar%:,S aft Door, Rear Door, Rear \ Shock Door Glass Door Glass Windshiekf &J Door Midg. .. Door Mldg. U. Rocker Panel I Rocker Panel Tie Rod Rocker Mldg. Rocker Mldg. Steering Gear Sill Plate Sill Plate - Steering Wheel Floor Floor" Horn Ring Frame Frame Gravel Shield Dog Leg Dog Leg Park. Ligh / O Quar.Panel Quar. Panel Grills AoF•� Quar.Mldg. Quar. Mldg.. Quar.Glass Quar.Glass Fender,Rear Fender,Rear Fender Mldg. Fender Mldg. Fender Pad Fender Pad Mirror Inst. Panel Horn Bumper Front Seat Baffle,Side Bumper Rail Front Seat Adj. Baffle, Lower Bumper Brkt.. Trim Baffle, Upper Bumper Gd. I Headlining Lock Plate, Lr. Gravel Shield Top Lock Plate, Up. Lower Panel Tire Hood Top - Floor Tube Hood Hinge Trunk Lid Battery Hood Midg. Trunk Lock" Paint Hood Letters Trunk Handle Undercoat Ornament Tail Light Polish Rad. Sup. Tail Pipe Misc. Materials Rad. Core Gas Tank AUTHORIZATION FOR REPAIRS Radio Antenna Frame You are hereby authorized to make the above Rad. HosesWheel specified repairs. Signed Fan Blade Hub&Drum Laborg440A $ Fan Belt Back U lite P Parts Water Pump Wheel Shield " Wrecker Service Motor License Frame—,Brkt. Tax S Q Sublet A—Align N—New OH—Overhaul S—Straighten or Repair EX—Exchange RC—Rechrome U---:Used $ This estim to is based on b est Rossible cost r�gn�isten�4vith qu>flity work, and as such, is TOTAL guaranteed.Items not cover iby this estimate or ► en wI 1 be adt7itlonal. y 'FORM ER-1002-C(4-79) NORICK.OKLAHOMA CITY.LOS ANGELES .SAN FRANCISCO .CHICAGO KINGS MTN..N.C. ... 00. t j „� CLAIM BOARD OF SUPERVISORS OF COMM COSTA COCR rY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) BICE Tp CLAIMW September 25, 1984 governed by the Board of Supervisors, ) The copy of th s document ma ed to you is your Routing Endorsements, and Board ) notice of the action taxei ai Yuur ciaAm uy me Action. All Section references are ) Board of Supervisors (Paragraph IV, below) , to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings'. Claimant: Calfon Construction, Inc. Attorney: James W. McKeehan, Esq. 2450 Peralta Blvd. , Suite 211 Address: Fremont, CA 94536 Amount: Unspecified By delivery to clerk on Date Received: August 24, 1984 By mail, postmarked on August 23, 1984 I. FROM: ClM of the Board ot Supervisors County Counsel Attached is a copy of the above-noted claim. Dated: August 24, 1984 J.R. OESSON, Clerk, By Deputy Jolene Edwards II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) (x) 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. 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) . ( ) Other: Dated: By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) C Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . �as> >•a•s�.r+��sa IV. BOARD ORDER By unanimous vote of Supervisors present X( ) This claim is rejected in full. ( ) her: I certify that this is a true and correct copy of a Board'p Order entered in its minu fK "84 date. / )) Dated: J. R. OISSON, Cl Deputy Cler k MRNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FRCM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave t present a late claim was mailed tot. DATA: S 1984 J. R. OESSON, Clerk, Deputy Clerk cc: County Administrator (2) County Counsel (1) 00035. 5 ' CLAIM TO: BOARD OF SUPERVISORS CE 1 V . Contra Costa County P. 0. Box 911 Martinez, CA 94553 ay Rev CLERKgp R- OLSSON +RU O;- SUPERVISORS g ..........CUhJIRq COSTA CO, IN THE MATTER OF THE CLAIM OF: .---..De ut CALFON CONSTRUCTION, INC. Claimant VS. CONTRA COSTA COUNTY Calfon Construction, Inc. hereby presents this claim for equitable indemnity to Contra Costa County pursuant to Section 910 and 901 of the California Government Code. 1 . The name and address to which all correspondence should be sent is as follows: James W. McKeehan, Esq. 2450 Peralta Boulevard, Suite 211 Fremont, CA 94536 2 . On or about May 17 , 1984 , suit was filed against Calfon Construction, Inc. , et al . , in Contra Costa Superior Court , No. 259635 seeking damages for injuries allegedly received under the following circumstances: a. Several residences of Concord near Monument Boulevard, were flooded during heavy rains occurring on September 30, 1983. b. Calfon Construction, Inc. , was working on a storm system construction project for the Army Corps of Engineers in the nearby area. c. Gallagher & Burk Construction Company was working on a storm system construction project for the Bay Area Rapid Transit District in the nearby area. d. Plaintiff in the ensuing suit , Maryland Casualty Company, made payments to the residents and filed its subrogated 00036 claim against Calfon Construction, Inc. , among others. 4. This claim is being filed for the purpose of seeking equitable indemnity from Contra Costa County in compliance with Section 901 of the California Government Code requiring a filing of claim within 100 days of service of the complaint. There is no proof of service of the complaint in the file but the general appearance of Calfon Construction, Inc. , was made by its answer on July 26, 1984. 5 . At the date of filing this claim, discovery is just commencing and the amount sought for indemnity is unknown. In the complaint , plaintiff seeks not less than $29 ,094. 76. 6. Further , as discovery is just commencing, the name or names of persons responsible for the damage alleged in the complaint are not known by Calfon Construction, Inc. DATED: August 22 , 1984 &4VJL-ct..' ' CYNTHIA A. M. LEE Attorney for CALFON CONSTRUCTION, INC. 0003 PROOF OF SERVICE BY MAIL — CCP 1013a, 2015.5 1 1 declare that: 2 1 am(a resident of/employed in)the county ofAl ajwda. . . . . .. .... .California. . . . .. .. . . . . . . . . . . ... . . . . .. ICOUNTY WHERE MAILING OCCURRED) 3 I am over the age of eighteen years and not a party of the within entitled cause; my (business/residence) address is: 4 2450 Peralta Boulevard, Suite 211 , Fremont, California_ .: 5 On. .August 23, 1984 , 1served the attached..,Claim of Cal fon ,DATE) 6 Contra Costa County 7 Construction, Inc:, , , on the. Bay of Supervisors 8 in said cause, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, In the 9 United States mail at . . . . . . .Fremont , California. . . . . .. . . . . . . . . . . . . . . . . . . . . addressed as follows: 10 11 12 BOARD OF SUPERVISORS Contra Costa County 13 P. 0. Box 911 Martinez, CA 94553 14 15 16 17 18 19 20 21 22 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct,and that 23 this declaration was executed on August 23 , 1984 Fremont 24 . .. . . . . . . . . . . . .. .. . .. ,at . . . . .. .California. (DATE) IPLAGEI 25 26 ROSEMARY ARTMAN ,�_�, 'Y7 �--•` (TYPE OR PRINT NAME) SIGNATURE 00088 SARON PRESS FORM NO.22 REV.AUGUST 1981 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT September 25, 1984 governed by the Board of Supervisors, ) The copy of-UTIRZ-73-3-65m-e--nt­milled to you is your Routing maoL6c%«e,rL5, aiiu tfoaLu notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Goverment Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings'. Claimant: Jackie Stefani County �OUnSeI 166 Pebble Place y Attorney: San Ramon, CA 94583 AUG 2 2 1984 Address: Martinez, CA 94553 Amount: Unspecified By delivery to clerk on Date Received: August 21, 1984 By mail, postmarked on August 20, 1984 - I. FROM: Clerk of the Board ot Supervisors Canty Caunsel Attached is a copy of the above-noted claim. Dated: August 21, 1984 J.R. OLSSON, Clerk, By ,.Ct,„� ,�� Deputy Jolene Edwards II. FROM: County Counsel 70: Clerk of the Board of Supervisors (Check only one) ( ) 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. 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) . ( ) Other: Dated: `� ' By: Deputy County Caansel III. FROM: Clerk of the Board 70: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . a IV. BOARD ORDER By unanimous vote of Supervisors present ( This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of t Board's Order entered in its minutes for is date. Dated: J 4 5198. J. R. OLSSON, Clerk, Deputy Clerk STING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to resent a late claim was mailed to claimant. DATED:to 2 519RAJ. R. OLSSON, Clerk, Deputy Clerk cc: County Administrator (2) County Counsel (1) 00039 1 I� CLAIM t.o _—CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY • Instructions ',:o Claimant A.- Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2 , Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, -CA) . 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. If the claim is against more than one public ent_ty, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. *********************************************** ********** *********** RE: Claim by ) ReserN,io * *filing stamps RECEIVED ) I - Against the COUNTY OF CONTRA COSTA) or DISTRICT) CLEPK SCARo Or SUPERVISORS (Fill in name) ) y c NTR COSTA CO. De U The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: ------------------------------------------------------------------------ l. When did the damage or injury occur? (Give exact date and hour) 2. Where-did the damage/or injury occur? (Include city and county) 3. How did the damage or_ ij nury occur? (Give full details, use extra ; sheets if required) _ �:'.'_ -� .��;-, �,,�cti :.:IV7 r,r ;=� ;�• � . is ;��1 ��c� ^lC+ �iC{ C, �.t{ tt ��`T��_� ,� 1C.�"� `� _,.i.";`� ���- `� �l� <`� � ►E: J�. � Il:�fiCr�� r � I, ('/n.cJ�� (� 4. What particular act or omission on the part of county or district rZ� officers , servants or employees caused the injury or damage? t L.'_1� t.` E'i^ J i C� 1 \� °�h L �� over) j 00040 -L t - ' Y '5 at are the ma nes of county er . 1ISfict l-Wf rs:; servants pYpyees causing .the damage• or na ry? _ eLA w2re Cn� ^ y e rv _�_o� �S __( or:�,n 4:n 6. What damage or injuries do you claim resulted? (,Give full extent. of. . :in�uriesor damages claimed Attach-.awo estimates --for ;auto . damage) r _ Ct�i- r% ir � � ��a� =fhe: w� �,dlow :=has o ha e F 7. How -was the .amount claimecY above computed? (.Include the estimated,. amount of -any prospective injury or_.damage ) ,1 = ---------------------------------- `F ------------------- ------ 8. Names .and addresses of witnesses; doctors and hospitals _. kve Y-\ Rda��� q �P_1 S ' a:��orn 13 9. List the expenditures you made on account 077th1; accident-o-r­7 injury : DATE - .ITEM AMOUNT.:.: , w Govt Code Sec. 910.2 providers: . "" r The claim 'signed by the` claimant ::SEND .NOTICES TO: (Att`orne `) ; - ' "or 'b "some erson on 1a156ialf. " Name and Address of,Aftorney r �. la' a is gn re Addr,"s Telephone No. Telephone No NOTICE ' • Section 72 of the Penal Code provides. "Every--person who, with intent to defraud, presents for allowane c -or for...payment -::to any state .board :or .:officer,.. ,:ot to_ .any :county, .town, ':city:" :. district", -:ward or village 'board' .or officer, , author:ized' to- -allow or';spay '. the same cif genuine, iany -false or `fraudulent claim, bill, -account.; .voiieher, or writing, -°is, guilty:•of a felony. 00.4" 1 3.. J. BOARD /F ORS OF CONTRA COUNTY, /AL IA BOARD ACTION Claim Against the County, or District ) _ NOTICE TO CLAIMANT September 25, 1984 governed by the Board of Supervisors, ) The copy of this document ma ed to you is your Routing-r nctorseffientd, ana Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below) , to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all 'Warnings" Claimant: Steve Shiromizu 2117 Camelia Court County Counsel Attorney: Pittsburg, CA 94565 AUG 2 2 1984 Address: Martinez, CA 94553 Amount: Unspecified By delivery to clerk on Date Received: August 21, 1984 By mail, postmarked on August 18, 1984 - I. FRCM: Clerk of the Board ot Supervisors County Counse Attached is a copy of the re-noted d claim. Dated: August 21, 1984 J.R. OLSSON, Clerk, By Ojl—.c.L, ewl Deputy ohne -Edwards II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) X) 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) . ( j Claim is not timely filed. Clerk should return claim an 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) . ( ) Other: , I Dated: - By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1 County Counsel, (2),04ty Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . _ I IV. BARD By unanimous vote of Supervisors present ( This claim is rejected in full. ( ) Other: I I I certify that this is a true and correct copy of the ard's Order entered in its mins Int--hi s date. Dated: 9 ttSS44 J. R. OLSSON, Clerk, ���- , Deputy Clerk WART NG (Gov. Code Section 3) Subject to certain exceptions, you have only six (6) months from the date of 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. .V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703.. ( ) A warning of claimant's right to apply for leave to resent a late claim was mailed DATED:t� �s84 J. R. OLSSON, Clerk, , Deputy Clerk c�: County Administrator - (2) County Counsel (1) 00042 5 CLAIM l �� ^L,.AIM. TO: BOARD. OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions ---o Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors . at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, _CA) . 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. If 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 end of this form. RE: Claim by ) Reser' C r ' s filing stamps RECEIVED ) Against the COUNTY OF CONTRA COSTA) or DISTRICT) J. R. OLSSON --- CLER. BUARD OF SUPERVISORS (Fill in name) ) C NTRA COSTA CO. By.- ePutv The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named -District in the sum of $ and in support of this claim represents as follows: ------------------------------------------------------------------------ 1. When did the damage or injury occur? (Give exact date and hour) ITUCSIAN 8-7-eq 3L 30 '4'00 PM ___—__----_r_______________.________________________________--_—_—____—_- 2. Where did the damage or injury occur? (Include city and county) 3 MILES IN110 C�oti�A GiniA eouNAN, ON of sco RCA0 -_-__H_- -- ALpmCOiA AN0 ccn, YLA coSTA Cos-INTy_--L 1NC 3. ow-did the damage or injury occur? (Give full details, use extra sheets if required) Thf OAMA6ff dc:[;URED TO THE WIDE.SHIrLD. AS :1 WfS 'TRP4ELiW- A)C RTH ALONG VfASCO, A 6RAVFF. 7R�,ACK 'IR�VCCI�L- S&ITH Rla.CF-ASE0 A ROCK 'Tki iJIT My W\0 '%SH) LD yb� n 4. What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? (over) 5,.1 -. What are the names of county or district officers, servants or 'y�-np1 Syees causing the damage or, injury? no FS NC;f AP41LI ------ - - ------------------------------------------------------ 6. Wh-at-d-amage------or--injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) -EN (Lo.SLO pa C- -TWo eS'T%kmA (FS fcc- W %W05N11:LO Ru66r(z S 1,AAX PNfl LA&)i2 Te RC fLJACC Tc OR%V INAL --- - ---- --- - - - -- -- - - ------------- - ------ ----------- - --------- -- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) by t, i"cN OOPZS ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. NCNtr ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Govt. Code Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) . . or by some person on his behalf. " Name and Address of Attorney Claimant' s dignature 2i11 CSA 4 r--Y . ddress Telephone No. Telephone o. 151 y3q - 1957 X**2.2 - J q 73 wc�IC ************************************************************** ******** 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " Delta Glass 615 "A"STREET ANTIOCH,CALIFORNIA 94509 y° q (415) 757-5300 c T DATE Q ' / 19 �55 --' �I NAME 4 ADDRESS PHONE NO. (' JOB LOCATION PHONE NO. INS. CO. ON, DESCRIPTION AMOUNT 3 �3 —� I t , 4 ` - 76 is 3 Q i I 12� .Kmoii fir' - Vq N , w+ E'-�ST .CDOUNTY GLASS QLI0TAT101V S 2201 A HARBOR S7. PITTSBURG,CA 94565 m 432-1433 TO: DATE u 7I PHONE NAME JOB: Cl vo 341-� L QUOTED BY: \`,.