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HomeMy WebLinkAboutMINUTES - 08191986 - 1.8 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA airi� Agaii!stethe County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT August 19, 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), Amount: $500, 000. 00 given pursuant to Government Code Section 913 and 915.4. Please note all "WARNINGS". County Counsel CLAIMANT: DAVID DURKIN ON BEHALF OF HIS MINOR SON RICHARD DURKIN ATTORNEY: c/o. Peter C. Pappas JUL 21 1986 Attorney At Law Martinez, CA 94553 ADDRESS: 2400 Sycamore Dr: ,,-Ste. 40 Date received Antioch, CA 9.4509 BY DELIVERY TO CLERK,ON: July 18 , 1986 hand del . BY MAIL POSTMARKED: no envelope 1. FROM: Clerk of the Board of Supervisors TO: County Counsel F Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK DATED: July 18 , 1986 BY: Deputy L. Hall I1. FROM: County Counsel TO: Clerk of the Board of Supervisors (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. 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). ( ) Other: Dated. cv2s //T<S By: L puty County Counsel III. FROM: Clerk of the Board TO: County 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 (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 for this date. Dated: AUG 19 1986 PHIL BATCHELOR, Clerk, By � Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally'�erved 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. CC: Claimant County Counsel County Administrator d Y © V ol t (� X 66 v � d 'j N � GL. 5 � V 1 } l t l t a � J d 1 PETER C. PAPPAS RECEIVED ATTORNEY AT LAW -/ 2 2400 SYCAMORE DRIVE, SUITE 2840 ANTIOCH, CALIFORNIA 94509 V lJ 1 3 TELEPHONE:(415) 754-0772 pHil BATCHELOR CLFRIK BOARD OF SUPE VISORS - COM A COSTA 4 5 ATTORNEY FOR 6 CLAIM AGAINST GOVERNMENTAL AGENCY 7 8 TO.: COUNTY OF CONTRA COSTA 9 Board of Supervisors 651 Pine Street 10 Martinez , CA 94553 11 1 . DAVID DURKIN, hereinafter "the claimant" , on behalf of his minor son, RICHARD DURKIN, hereby makes claim against the COUNTY 12 OF CONTRA COSTA, for the sum of Five Hundred Thousand Dollars .( $500 , 000 . 00) and makes the following statements in support 13 thereof: 14 2 . . On or about April 20, 1986, the claimant' s son Richard Durkin, was playing on a rope swing on public land, located 15 parallel to Gallagher Drive, Antioch, California, at approximately the 3600 block, and perpendicular to Chichibu Park. 16 While playing, Richard Durkin slipped and fell and thereby sustaining serious personal injury; severe contusions , damage to 17 arm and a broken hip. The swing constituted both a dangerous condition and an attractive nuisance. 18 3 . Claimant' s post office address is David Durkin, c/o PETER C. 19 PAPPAS , Attorney at Law, 2400 Sycamore Drive, Suite 40 , Antioch, California 94509 . 20 4 . Notices concerning this claim should be sent to the address 21 above. 22 5 . Claimant makes claim for the personal injuries sustained by his minor son . 23 6 . The names of public employee g the jurie re 24 unknown to he plaintiff. 25 Dated: ER C. PAPPAS 26 Attorney for Claim 27 Dated: DAVID RKIN, Claimant 28 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C1•aim Against the County, or District governed by) BOARD ACTION the erard of Supervisors, Routing Endorsements, . ) NOTICE TO CLAIMANT August 19, 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), Amount: $4, 500• 00 given pursuant to Government Code Section 913 and 915.4. Please note all "WARNINGS". County Counsel CLAIMANT: MR. & MRS. D.H. ROLSTON JUL 2 11986 ATTORNEY: Martinet, CA 9063 ADDRESS: 4100 Whispering Oaks Lane Date received Danville, CA 94526 BY DELIVERY TO CLERK ON: July 16 , 1986 BY MAIL POSTMARKED: July 12 , 1986 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. July 18, 1986 PHIL BATCHELOR, CLERK DATED: BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( 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). ( ) Other: Dated �K c J� / / � By: �— / Q yeputy County Counsel III. FROM: Clerk of. the Board TO: County 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 (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 for this date. Dated: AUG 19 1986 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally`3erved 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. CC: Claimant County Counsel County Administrator .CL'AIM TO: + BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY 0 i Instructions to 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 ) Resery stamps Alz G rad ) w,wsoV,e•� � ; R:CEIVED c c. ) Against the COUNTY OF CONTRA COSTA) � 196 NEL RRor DISTRICT) CLSU E VISORS. (Fill in name) ) er . w�,► 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) -7,92 ��8b ------------------------------------------------------------------------ 2. Where did the damage or injury occur? (Include city and county) cc - ----------------------------------------- 3. How did the damage or injury occur? (Give full details, use extra sheets if required) (} l 4 . What particular act or omission on the part of county or-district officers , servants or employees caused the injury or damage? (over) a !In7' BRIAN RUICK ESTOF [Rj -71 REP• 2008 MT. DIABLO BLVD. E IRS PHONE (41 5) 939-0500 Date U WALNUT CREEK, CA 94596 /1 R. 0. No. 4 Name I Phone No. / AddressWL)o Wfl(�h '''7 City StateLA Zip Insurance Co. Phone No. Address City State Zip Adjuster OD L I ENSE NO. i IM9TOR NO. SERIAL NO. MILEAGE r C QUANTITY ESTIMATE OF REPAIR COSTS LABOR PARTS LABOR HRS. i eti G'. :f l P• TOTALS THE ABOVE IS AN ESTIMATE BASED ON OUR INSPECTION AND DOES NOT Labor, LHrs. at 3�00 COVER ANY ADDITIONAL PARTS OR LABOR WHICH MAY BE REQUIRED AFTER $ � THE WORK HAS BEEN OPENED UP. OCCASIONALLY AFTER THE WORK HAS Parts Gross STARTED DAMAGED OR BROKEN PARTS ARE DISCOVERED WHICH ARE NOT EVIDENT ON THE FIRST INSPECTION. Less % on $ Net $ PRICES SUBJECT TO CHANGE TO CORRECT PRICE AT TIME OF INVOICE. PARTS PRICES BASED ON STANDARD CATALOGUE PROCUREMENT Tax on $ $ PRICE LISTS SUBJECT TO CHANGE WITHOUT NOTICE. PROCUREMENT AND DELIVERY CHARGES MAY BE ADDED FOR SPECIAL SERVICE ON ITEMS NOT Sublet and Advance Charges AVAILABLE LOCALLY. SuI -total $ Less: Deductible $ AUTHORIZED BY TOTAL $ 53-33817 NORICK OKLAHOMA CITY CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION :the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu S t 1 9 , 1 9 8 6 . and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the"action taken on your claim by the Board of Supervisors (Paragraph IV below), Amount: Unspecified given pursuant to Government Code Section 913 and 915.4. Please note all "WARNINGS". County Counsel CLAIMANT: KELLY C . WHITNEY JUL 21 1986 ATTORNEY: Martinez, CA 94583 ADDRESS: 4623 Elmwood Road nate received Jul 16, 1986 E1 Sobrante, CA 94803 BY DELIVERY TO CLERK ON: Y BY MAIL POSTMARKED: July 15 , 1986 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK / DATED: July 18, 1986 BY: Deputy L. Hal II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( 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). ( ) Other: Date �C By: �`"� LrZ- -LC�LJ�- y County Counsel 4Z a III. FROM: Cle—rl of the Board TO: County 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 itsminutes for this date. Dated: AVG 1 9 1988 PHIL BATCHELOR, Clerk, By KW,4�r_ � Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (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. CC: Claimant County Counsel County Administrator CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to 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 Cor 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 Against the COUNTY OF CONTRA COSTA) ED or DISTRICT) 111L /,9 1986 (Fill in name) The undersigned claimant hereby makes claim ay L o /URLy f Contra Costa or the above-named District in the sum of $ ,� and in support of this claim represents as follows: ------------------------------------------------------------------------ d 1. When did the amage or injury occur? (Give exact date and hour) �I MOLY 90 1 8(0 NTN . --- -- - -------------------------------------------- 2-.--Whe-re--did the--d-amage------or--injury occur? (Include city and county) L4c0a3 ��'JFCA4'[te- Ca ���'b� C � �-- _ -- --- ------- ----------------------------------------- - --- 3. How did the damage or inury occur? (Give full details, use extr sheets if required) AY'04 C_mtu ) c-o y-e- TC ,rvw5 +�,z 54-r- e+ 4 . What particular act or omission on the part of cunty or districtG � officers , servants or employees causedithe injury or damage? 5 (over) 5. What are the names of county or district officers;. :servants:!or-� :t;_ -� ! } employees causing the damage or injury? ---�A'" ., CC)� --------------------------------------- 6. What damage or infuries do you claim resulted. (Give full extent of injuries or damages claimed. Attach two estimates for auto d�amoa�gse Qt0,K­ ---P-----`-----i r-`- �--�-w--e-v�--.�--�---�--0-�---c-,c-�-c----�--0.--,r----o--va--c-.a--�-�-�-- -- -- How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) �.,.�.0. G DSt �0. W/A LVww V,_ OL ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. ck -------------------------------------=----------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT -74 Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND 100TICES TO: (Attorney) or' by some person on his behalf. " Name and Address of Attorney aimant' s Si ature Address L(&03 Telephone No. Telephone No.(,-�/S) 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. " r WRITE ITL - DON'T SAY IT! - - _==M 103 -0_ .' CONTRA COSTA COUNTY TO Kelly Whitney DATE Tune 5 T Sf6 FROM Administrator's SUBJECT r1 A i m R,qrm Office Enclosed is a formTor your convenience in filing a claim. Please return the completed form to the office of the Clerk of Board of Supervisors for processing. i SIGN (� PLEASE REPLY HE DATE - j�-( r ve- '1 w cis +Mc o (� V r\ Cb CQrl Il Q- v.aq CGv,&- 5Lt eyM r SIGNED ' INSTRUCTI01145 FILL IN TOP PORTION,REMOIDUPTE(YELLOW)AND FORWARD REMAINING PARTS WITH CARBONS. TO REPLY, FILL IN LN AND SNAP OUT CARBONS. RETAIN TRIPLICATE IPINKI AND RETURN ORIGINAL, FORM A103 ©s s f e -� Old soh #-(ow a- was Cly--,c 7 i 0 i x a � t A, i o�f CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District governed by) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu s t 19, 1936 and Board Action, All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below) Amount: $15 000. 00 given pursuant to Government Code Sectionr,,.'�to Chun 915.4. Please note all "WAFtNINGS". JUL@/ CLAIMANT: WANDE GUTHRIE M4 L 2 1986 ATTORNEY:VoAngelo J. Costanza, Esq. of net CA 94$53 77 Bray, Egan, Breitwieser & Costanza ADDRESS: 736 Ferry St. Date received Martinez , CA 94553 BY DELIVERY TO CLERK ON: July 17, 1986 hand del, BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. July 18 1986 PHIL BATCHELOR, CLERK / DATED: , BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors �() 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). ( ) Other: Dated �ounty Counsel III. FROM: Clerk of the Board TO: County 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 (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 for this date. Dated: AUG 19 1456 PHIL BATCHELOR, Clerk, By � �� Deputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally`terved 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. CC: Claimant County Counsel County Administrator .CLAIM TO: BOARD OF SUPERVISORS OF CONTRA CO§T_�OTc9Xapplicationto: Instructions. to ClaimantC!erk of the Board Martinez,California 94553 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, California 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. 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 his form. RE: Claim by )Reserves stamps WAMA GUMIE ) RECEIV' ]D , Against the COUNTY OF CONTRA COSTA) �� � Y'Re TCMELOR o► , gVI or DISTRICT) c 1; Fill in name a .. �.... The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 15,000.00 plus medical costs and in support of this claim represents as follows: according to proof ---------------------------T--------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour] May 8, 1986 at 11:30 a.m. �. W�iere did the damage or in3ury occur? 7Include city and county Outside of entrance to Merrithew Mamrial Hospital, 2500 Alhambra Avenue, Martinez, CA 94553 3. -!---H-ow--di--d---the---------------Z------------------ -- - ---T -------------- damage or injury occur? (Give �ul� $etai�s, use extra sheets if required) As I was walking on the sidewalk after exiting the hospital, I tripped on a rise in the sidewalk and fell. ------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? The county did not maintain safe premises around the hospital. The rise in the sidewalk represented an unsafe condition. (over) 5•. What are the names of county or district officers, servants or- employees causing the damage or injury? Contra Costa County - personnel in charge of maintaining sidewalk adjacent to entrance to. Merrithew Memorial Hospital 6. What damage or injuries do you claim resulted? Give full extent of injuries or damages claimed. Attach two estimates for auto damage) I traumatized my right knee which resulted in water on the knee I pulled mMcleT candtsigaments in the my left shoulder. $15,000.00 general damages plus -------------o----------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) Actual medical bills (unknown at this time) according to proof and $15,000.00 general damages. 6. -----N--ames------and---------addresses----of-wit---nesses--------doctors---and----hospitals---------------------- , . Cheri Lopez, 4022 Pacheco Blvd. , #2, Martinez, CA 94553 Dr. Hammrstrom, 2500 Alhambra Avenue, Martinez, CA 94553 Dr. Slawson, 2500 Alhambra Avenue, Martinez, CA 94553 Unknown staff at Merrithew Memorial Hospital, 2500 Alhambra Avenue, Martinez, CA 94553 ----- ------------:----=----------------------------------------------- 9. List the. Vxpenditure; you made on account of this accident or injury:. DATE' ITEM AMOUNT Unknown at this time. 'iMedical care at Merrithew Memorial Hospital covered Eby my Contra Costa County Hospital Plan. Future medical costs unknown. t G 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 ANGELO J. COSM7A, ESQ. 0 a ' s Slgfhature BRAY, EGAN, BREITWIESER & COSTANZA 736 Ferry Street Address ,Martinez, CA 94553 - Telephone No. (415) 228-2550 Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person sx•ho, 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." CLAIM t BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT August 19, 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph 1V below), Amount: $159 - 75 given pursuant to Government Code Section 913 and 915.4. Please note all "WARNINGS". CLAIMANT: RUBY L. HOWARD County Counsel ATTORNEY: JUL 23 1986 ADDRESS: 635 6th Street Date received Martinez, CA 94553 Richmond, CA 94801 BY DELIVERY TO CLERK ON: July 22 , 1986 BY MAIL POSTMARKED: July 21 , 1986 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK DATED: July 23 , 1986 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� 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). ( ) Other: Dated. �� �'� By: c- County Counsel III. FROM: Clerk of the Board TO: County 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 ntered in its minutes for this date. Dated: AUG 19 1986 PHIL BATCHELOR, Clerk,.By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you.have only six (6) months from the date this notice was personally'3erved 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. CC: Claimant County Counsel County Administrator July 2, 1986 Board of Supervisors County Administration Bldg. 651 Pine Street Martinez, CA 94553 Dear Gentle Person: Thank you for mailing me the attached Claims Form. I completed the form to the best my ability being that I was not at the County Jail on the date April 27, 1986.. On April 27th the first claim was filed and completed at the county jail by Tamela R. Miller (my daugther) and Andre (Tony) Miller. Question #9 ask for names of persons/or officers on duty at the time my daugther's Leather Jacket was taken, she cann't remember the names but she stated that it was a female officer at the desk when she entered the visitor area with her jacket on and who told her that she couldn't wear the jacket inside. She also stated that a male officer fill out the claim form when she exit the visitor area. I will contact my attorney if there are no results. I can be contacted at (415) 843-0220 Monday thru Friday during the hours 8:00 a.m to 4:45 p.m. Thanking you in advance Ms.�•Ruby' L. Howard �ECJnu TN7 ED 7TD JULoTo�19g� iCLAIM TO: BOARD OF SUPERVISORS OF CONTRA COA_XOIQ�pplicaUon to; • Instructions to ClaimantVerk of the Board 01 &J,/000"'t 5?'./ M rtinez,Califomia 44553 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, California 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. 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 cs t is form. RE: Fla, �m by )Reserved for Clerk's filing stamps RECEIVED Against the COUNTY OF CONTRA COSTA) JUL X21986 ) j or DISTRICT) , AT N R Fi n name ) �" ;�o,� s °Ea By .i. The undersigned claimant hereby makes claim aga County-or-Contra Costa or the above-named District in the sum of and in support of this claim represents as follows: ------- ---------------- -------------- -------------- - -- ---- �. When did the damage or Injury occur? Give exact date and hour] --- -- -------- ----------------- ------------------ ---- �:--i+l�ieze did-tie damage or injury occur? (Include city and county T-------------- ---- - ----T-------- -----T--- T -------------- G1 -- - ----- 3. How did the damage or in3ury occu ? (Giveul� det ids, use extra sheets if required) /)IS/ ���1�7j� '��jY��/� 1,72, Zfer A�l5 �/iS�Tiit `i�`.e � ��2 �il/�2iPErr/ � tel•%/�2 �-�2 ��Y�1a�- �v�c�� y � -- --------T--------- r--z------ ---- ----------T---�r----- S� 4. what particular act or omission on the part of county or district officers, servants or employees caused the !injury or damage? Z A#9 44 ode- bel tea/ 171- 1<,04,f /d ere 5. What are the names of county or district officers, servants or— employees causing the damage or injury? b. What damage or injuries do you claim resu�te�? Give dull extent of injuries or damages claimed. Attach two estimates for auto damage) --------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimate�� amount of -any prospective injury or damage. ) ------------- DATE - ------------ ditures 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 IF Cla a s gnat re 5 ddre s s Talephoale No. Telepho a lv « «««t « «« « 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. " '? CLAIM Der BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District governed by) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu s t 19, 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), Amount: unspecified given pursuant to Government Code Section 913 and 915.4. Please note all "WARNINGS". COUn CLAIMANT: GARY LEE ROY HARTMAN JR. County ATTORNEY: C/o Jack Funk Ju` 2 3 1986 610 Court Street �artir%ei, 9453 ADDRESS: Martinez , CA 94553 Date received BY DELIVERY TO CLERK ON: July 21 , 1986 BY MAIL POSTMARKED: July 18 , 1986 I. FROM: Clerk of the Board of Supervisors TO: County.Counsel'. ' Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK DATED: July 23, 1986 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� 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). ( ) Other: Dated: v;?-� By: 1- ty County Counsel III. FROM: Clerk of the Board TO: County 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 (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 for this date. PHIL BATCHELOR Clerk Dated: AUG 1 9 1986 , B y .����,��f� deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally'terved 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. CC: Claimant County Counsel County Administrator •CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COp;,L01rRyappiication to: Instructions to ClaimantVerk of the Board P.O.Box 911 Martinez,California 94353 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. 911.28 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, California 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the Distript 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 • , RECEIVED Against the COUNTY OF CONTRA COSTA) JULY/ 1986 ) or DISTRICT) CL SAT ELOR (Fill in name sT �y .r. The undersigned claimant hereby makes claim against the County o Contra Costa or the above-named District in the sum of $= , q 4l- Or Ne.� 156 - ( rvt,kDe and in support of this claim represents ,,sents as follows:Z Jo NoT vj" rO-T— MONS�l �. -When did the dama a oz in ur occur? Give exact date and hour �. W�iere di3 tFie damage or in3ury occur? (Include city and county) f Z A y VON c 14-/, C©,J�,e,g Co 6 rrt c a Id A.) 3. How did the damage or in0ury occur? Give ZU1_ U11!, use extra sheets if required) Z uJ A 5 T1ZA�S �'� -d F�Lo M FA AM j`o f �19�P /�4�' /��/�7-41F (0;rt9/se . I-O 5 % 4. What particular act or .omission on the part of-county or district officers, servants or employees caused the injury or damage? T-- d /Ze,e. 41L SIU = GIFT t,J001C! S eN h T 7-0v �� ;�ey 1-//C w e c� rte. v . 7 (over) cJoL�lc% ,T , ,'S2a� 5. What are the names of county or district officers, servants or employees causing the damage or injury? 5.6+?- 11V2 047 2 6. What damage or �n�uries do you claim zesulte�? ZG�ve dull extent of injuries of damages claimed. - Attach two estimates for auto damage) M , x'c%�7Q�?- �vD •r �f} �P� y w /+ 7- MIS 5/N'� ------==-----------------------.--Bow-w-a---t-h-e amount claimed above computed-----n--c-l-u-d-p--the es-t-m--a-t-es -- amount of any prospective injury or damage. ) s &-OAJ 'T L4., ,FAJT tf)L)i A - ,N,e L.� . q ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors ,and hospitals. - ---- T -------------------------------T-----Tom•-------T-T---- S. -LIst-' the---exp--e�-nditures you made on account of this accident or injury: DATE ,. ITEM AMOUNT ..:._.:. .. ... . .._...... . . .. . . ....E Govt. rode 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 f� K tvf� Cla ant s Signature 3 G 6 Address MgRiNe. e C .,4 Telephone No. 3 7� ' a �� $ Telephone No. `SSS' ' $q3( 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. " CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu s t 19 , 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below). Amount: 50, 000. 00 + given pursuant to'Government Code Section 913 and 915.4. Please note all "WARNINGS". CLAIMANT: DANNY LOPEZ (MINOR) County Counse! ATTORNEY: VdAngelo J. Costanza, Esq. JUL 2 11986 Bray., Egan, Breitwieser & Costanza ADDRESS: 736 Ferry Street Date received 17 nz' CA 94553 Jul Martinez , CA 94553 BY DELIVERY TO CLERK ON: Y iand del. BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel, Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK Y V DATED: July 18 , 1986 BY: Deputy Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors �() 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). ( ) Other: Date ,L /23 � By:-?�az County Counsel III. FROM: Clerk of the Board TO: County 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 (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 for this date. Dated: AUG 19 1986 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov..code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally'terved 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. CC: Claimant County Counsel County Administrator CLAIM .TO: BOARD OF SUPERVISORS OF CONTRA CON* Q9Wxapplication to: Instructions to ClaimantC!erk of the Board (.5/Pn e A0 6 Martinez,Caiifomia 94553 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, California 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. 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 o this form. RE: Claim by )Resery d lerk's fill g stamps DANNY LOPEZ ) ]EIVED j JUL /71986 Against the COUNTY OF CONTRA COSTA) @ IL®ATQNLIOR OL ` A OFF 6UP RVISOR$ or DISTRICTBy Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $50,000.00 plus medical costs and in support of this claim represents as follows: according to proof 1. -When did the damage or injury occur? (Give exact date and hourT May 8, 1986 at 11:30 a.m. --- --- r+ - ------------T-------- -•�---- ---� ---------------------- . W�iere did the damage or injury occur. Inc(Include city and county) Outside of entrance to Merrithew Memorial Hospital, 2500 Alhambra Avenue, Martinez,. California -'r------ --------------------------------------- -----T -------------- 3. How did the damage or injury occur? (Giv1 ;11 1details, use extra sheets if required) Danny's grandmother, Wanda Guthrie, was carrying him as she walked on the sidewalk after exiting the hospital and she tripped on a rise in the sidewalk causing her and Danny to fall to the pavement. 4. What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? The County did not maintain safe premises amurid'the: hospita1. The rise in the sidewalk represented an unsafe condition. (over) R 5: What are the names of county or district officers, servants or" employees causing the damage or injury? Contra Costa County personnel in charge of maintaining sidewalk adjacent to entrance to Merrithew Memorial Hospital. ---------------------------------------------------- -------------------- 6. What damage or injuries do you claim resulted? Give full extent of injuries or damages claimed. Attach two estimates for auto damage) Danny sustained a subdural hematoma, (skull fracture) as a result of the incident. $50,000.00 general damages plus medical costs. . ------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) Actual medical bills (unknown at this time) according to proof and $50,000.00 general damages. ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Wanda Guthrie, 3821 Alhambra Way, Martinez, CA 94553 Cheri Lopez, 4022 Pacheco Blvd. #2, Martinez, CA 94553 Dr. Hamnerstrom, 2500 Alhambra Avenue, Martinez, CA 94553 Unknown staff at Merrithew Memrial Hospital, 2500 Alhambra Avenue, Martinez, CA 94553 9. List the expendittires you made on account of this accident or injury: DATE ITEM AMOUNT Costs are unknown at this time. Bills have not been received. Future medical costs unknown. Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " m o mer Name and Address of Attorney cis ANGELI) J. COSTANZA,. ESQ. Clai ant s S natur BRAY, EGAN, BREITWIESER & COS`1ANZA 7�(`Z2� :h pca ���! a_ 736 Ferry Street Address Martinez, CA 94553L7 '! F " Telephone No. (415) 228-2550 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. " CLAIM X0 a BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA • Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu S t 19 , 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), Amount: Unspecified given pursuant to Government Code Section 913 and 915.4. Please note all "WARNINGS". County Counsel CLAIMANT: LESLIE, B. DAVIS ATTORNEY: JUL 2 3 1986 Martinez, CA 94553 ADDRESS: 2310 Camelback Drive Date received Antioch, CA 94509 BY DELIVERY TO CLERK ON: July 21 , 1986 hand del. BY MAIL POSTMARKED: no envelope 1. FROM: Clerk of the Board of Supervisors TO: -Count Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK DATED: July 23, 1986 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� 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). ( ) Other: Dated. as 195_6o r_6 By L �puty County Counsel III. FROM: Clerk of the Board TO: County 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 (,k) This Claim is rejected in full. ( ) Other: 1 certify that this is a true and correct copy of the Board's Order_entikred in its minutes for this date. AUG 191986 Dated: PHIL BATCHELOR, Clerk, By . -� Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally'3erved 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. CC: Claimant County Counsel County Administrator CLAIM v BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District governed by) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Au gu S t 19 , 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Section 913 a n d Amount: Unspecified 915.4. Please note all "WARNINGS". CLAIMANT: LESLIE B. DAVIS ATTORNEY: ADDRESS: 2310 Camelback Drive Date received Antioch, CA 94509 BY DELIVERY TO CLERK ON: July 21 ,- 1986 hand del . BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK DATED: July 23, 1986 BY: Deputy L. Hall 1I. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) 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). ( ) Other: Dated: By: Deputy County Counsel III. FROM: Clerk of the Board TO: County 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. Dated: PHIL BATCHELOR, Clerk, By. Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally'terved 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. CC: Claimant County Counsel County Administrator — .i ' ` ' CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to 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 9.111 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 ing stamps RECEIVED Against the COUNTY OF CONTRA COSTA) or DISTRICT) (Fill in name) ) 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. Whe a did the damage or injury occur? (Include city a d county Lout 1'�P�Q w�:� 1� e J�w�cc� c � �c C� +� -- ---- ---- ----- --- ---- -------------------------- 3. How did tie damage or injury occur? (Give full details, use extra sheets if required) (� r I -C.941' cC&'r c�JeLi the pPP�Sc cllra� [d�� C [ �� rcc a t� �u s CA CC u tA-,K �.Q C( —e /t occ C( L4J r� ---------------------------------------------- ----------------------- What particular act or omission on the part of county or district officers servantsor employees caused the injury or dam ge? l V Y L Cc.4 `t R o c,G Cj 1 0 c a rn10 cJ F e. >Z- ctrck.LitL Rocks lJ4 OOrA �L41( (reS(���5�6fQ �o r ��•-2 �ct �, cc p ( (over) 5. "What are the names of county or district officers; se vants;ao=-,y 1 employees causing the damage or injury? ------------------------------------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or d mages cl(imed. Attach two estimate for autp damage) �� e c w .,.�`d�J tiJ 1 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) 8. -----N--ames-----and----------addresses----of----witnesses------,-----doctors-----and-----hosP- -itals---- ------------- ------------------------------------------------------------------------- 9. Ls.t the expenditures you made on account of this accident or injury: DATE 'TEM AMOUNT t 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 Attorneys Claimant' s Signature ddre�s 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. " ,e AL NORVILLE GLASS CO. 5032 Blum Read #2 PACHECO, CALIFORNIA 94553 (415) 228-1777 NAME !J1 ADDRESS PHONE - DATE PROMISED JOB NAME/LOCATION ORDER TAKEN BY DESCRIPTION OF WORK L/ �. i" DAY WORK CONTRACT EXTRA . OTY. DESCRIPTION: PRICE AMOUNT �.. 67 - ---- - 1 - 1 i LABOR HOURS RATE AMOUNT TOTAL MATERIALS TOTAL LABOR WORK ORDERED BY TOTAL I - LABOR TAX , DATE COMPLETED 'Th ank`You T 13 ' �70Q[�OG3DCG3 /� '%'3 SIGNATURE it hereby acknowledge the satisfactory co. on of the above described work.) LA 4 PRODUCT 621-2 I✓Inc.,Groton,Mass.01471. l Bay Glass 686 Escobar Street tinez, C-1. 9455 228-9441. J C� t, CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT August 19 , 1 9 3 6 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Section 913 a n d Amount: $3 7 9 . 5 6 915.4. Please note all "WARNINGS". CLAIMANT: ROBERT D. SAUNDERS County COunW ATTORNEY: JUL 21 1986 ADDRESS: 2290 Hickory Drive Date received Martinez, CA 846$3 Concord, CA 94520 BY DELIVERY TO CLERK ON: July 16', 1986 BY MAIL POSTMARKED: July 15 , 1986 I. FROM: Clerk of the Board of Supervisors TO: County Counsel . Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK DATED: July 18, 1986 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( 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). ( ) Other: Dated: O 57Z �'� By:l Deputy County Counsel III. FROM: Clerk of the Board TO: County 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 nter in its minutes for this date. AUG 19 1986 PHIL BATCHELOR, Clerk, By Deputy Clerk Dated: WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (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. CC: Claimant County Counsel County Administrator — to CLAIM TO: BOARD OF SUPERVISORS OF CONTRA C0A*rF4?WQWapp1icat1on to: Instructions to ClaimantC!erk of the Board &5i Martinez,California 94553 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, California 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. 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 o this form. , RE: Claim by Rolp�t Q . ' d.0-vJ )Reserved ' s filing stamps �a�r° �'�"° ,.= -�,.• RECEIVED Against the COUNTY OF CONTRA COSTA) JUL * 1985 ) or DISTRICT) CL RSUP R qg Fill in name ) ° rey .. ....r. Deputy The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ -37F,5-6 and in support of this claim represents as follows: ---------------------------T--------------------------------------- ---- 1. When did the damage or injury occur? (Give exact date and hour] �pr, I a3 � 19 �� qts A.M '�. W�iere did the damage or injury occur? (Include city and county) —T--------------------------------- =''1TrC Co s cel�Z ------------ ta 3. How did the damage or injury occur? (Give full details, use extra sheets if required) Sls� cA ---- ------------------------------------------------------------------- 4. W-hat particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5.-- - -what are the names of county or district officers, servants or, employees causing the damage or injury? 0- c� OPJr o c�J�-S ----------=-------------a--------------------------- --------------- 6. What damage or injuries do you claim resulted? laive full extent of injuries or damages claimed. Attach two estimates for auto damage) 1 _3 V) ell c �v,� ld ksePIzs Sak i,,,,ae-e--A , 1�e-Ks twrckQ-%k w.a�cG�d 'dual 7 the-amount claimedamount----------------above--------computed?--------------(Include----the-----------estimated--- . How was amount of any prospective injury or damage. ) S a,.,\A tocksc� - Re4,e C- rec5..,.s c\"A v�a5�ic -Z�i Q,•,ce- s�d.�..clo.rcl 3rcv�,as c�l� .� !l�1t ^t�,,.5�� 1(n`� ��-� o-� C( C_ -r � r�4 e iv�l� _M 8.__ m Naes and addresses of witnesses, doc�eors acid hosptals. ---------------------------------- -expen-dittres;.ist the expernditures you made on account of this accident or injury: . .DATE ITEM ,AMOUNT -a.3-STC i �._ 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 Signature Address Telephone :"J'o. Telephone No. 5'379 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. " S h e ri ff-CoronerCentra Richard K.Rainey SHERIFF-CORONER P.O. Box 391 Costa Warren E. Rupf Martinez, California 94553-0039 Assistant Sheriff (415) 372- County Gerald T.Mitosinka Assistant Sheriff July 2, 1986 Mr. Robert Saunders - 2290 Hickory Drive Concord, CA 94520 Dear Mr. Saunders: Your letter regarding the service of a search warrant at 2290 Hickory Drive, was received. You are absolutely correct when you talk about the "fine-line" between legal, moral, ethical and good judgement. " In this case the. officers had a legal search warrant. After service of the warrant the search was greatly decreased in scope after hearing that your son may have been untruthful in listing your address as his own, which in my opinion was good judgement. Our intent is never to frighten anyone but unfortunately we at times do. Should you feel compensation is due you for repair of the doors we do have a claim form that takes but minutes to fill out and return to us. Please feel free to do so. By your letter it seems that you are a sensitive, responsible person who views the Department as a "bureaucratic machinery While we are a Governmental Bureaucracy, please feel assured that your concerns are heard and I truly regret any inconvience suffered by -you or your daughter. Very truly yours, /- RICHARD K. RAINEY, Sheriff-Coroner Warren £. . 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C,&\-N CdA CkAk\f-�;«3 fie. v%�\sseA wcxb 4�N e-r e w o u i A k e rt o vt ee d 45-r CL VILA 1 e - . w As ca, 0. Sec` eve ob.servex , ! cc�a,. ovity 00ytc�ud� ���ivt a.�..c� S�U.•P� e e 6 e-ff(t v- • 1 �c r e. t s vto Os cx 1ne�- at,. 4 c v r c,.r s GL e im u s-V �,av e - eta cid +tle ex t GA&Se c .c� wte ltv\.vclvcA "in +0 r e c©v e.Y- a cX\AAo 3e!, i s P r e-\A:I o i`k i v e . 1►/c3 r do .i eXpec o, r- �+P�y �tcwt Ci-,.Y©vl.(a recekvlvl s � e `ems `fie �ur�:o.uCo-c�`�1c VACLCAntY�ev y bE 1vR3 1-0IA �+ t 'C tS • 1 T. .Cc�vt �u��y �1.cs�l° 't`1r�a'� ��vv�ec3J�ere ti �� ���c�3Ke stn kA 4c, *t,e 5 UL �-- k 4 s o t-- t� T�,e �:%Vx o' m o )rcx l "� �,e` *, ca �ooc� .! �r3 e � • l`�(a-��a S e�ti,�e�•�•e e t s e us M Le Spore '41,e Scx wi,e exPerle-uxce cr y ., CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District governed by) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Auu ist 19, 1986 and Board Action. All Section references are to ) The copy of this document mailed to s your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Section 913 and Amount: $1, 500, 000. 00 915.4. Please note all "WARNINGS". County Couns, CLAIMANT: ST, TIMOTHY LUTHERAN CHURCH JUL Z 519�t� c/o Robert A. Nellessen, Esq. ATTORNEY: Ericksen, Arbuthnot, Walsh, Paynter & Brown, Inc. 'AartlneZ. Chatt3- Pier 12i The Embarcadero ADDRESS: San Francisco, CA 94111 Date received BY DELIVERY TO CLERK ON: July 14, 1986 BY MAIL POSTMARKED: July 11, 1986 I. FROM: Clerk of the Board of Supervisors TO: County Counsel. Attached is a copy of the above-noted claim. July 15PHIL BATCHELOR, CLERK DATED: , 1986 BY: Deputy S(j/ L. Hall II. FROM: County Counsel TO: Clerk of the Boa d of/S-pe_ rviso��) (jV This claim complies substantially with Sections 910 and 910.2 M and �L--This claim FAILS to comply substantially with Sections 910 and 910.2, e are so notifying la'ma%t. The Board cannot ac,foar �1�5a (Sgctions Claim isnott4lnely�jiled Theerkshould ret claim on ground that it was filed late and sen warning of claimant's right to apply for leave to present a late claim (Section 911.3).,G� C � (�() Other: C4 J �. '� tom' DateGa By: � C'Lct Deg6ty County Counsel III. FROM: Cler of the Board TO: County Counsel (1) County Administrator (2) Qo21i sa (>) Claim was returned asi 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: Portion of original ' r1 Air„ not previously returned As untimely i-' s rejected in full. I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. AUG 19 1986Ir BATCHELOR, Clerk, By Deputy Clerk Dated: WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally'terved 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. CC: Claimant County Counsel County Administrator ROBERT A. NELLESSEN, ESQ. R�,CEiltj� ERICKSEN, ARBUTHNOT, WALSH, 1 YY D PAYNTER & BROWN, INC. 151 Union Street, Suite 301 JUL 11986 San Francisco, CA 94111 «8� Telephone: (415) 362-7126 By ci A FSE�ogISoft Attorneys for Claimant +b CLAIM AGAINST PUBLIC ENTITY Government Code, Sections 905 , 910, 910. 2 TO: COUNTY OF CONTRA COSTA c/o Clerk of Board of Supervisors 651 Pine Street Martinez , CA 94553 RE: ST. TIMOTHY LUTHERAN CHURCH San Pablo, CA ST. TIMOTHY LUTHERAN CHURCH, a California non-profit corporation, hereby makes Claim against the COUNTY OF CONTRA COSTA for the minimum sum of $1 ,500 , 000; and makes the following statements in support of that Claim: 1 . Notices concerning the Claim should be sent to Ericksen, Arbuthnot, Walsh, Paynter & Brown, Inc. , Pier 1j , The Embarcadero, San Francisco, CA 94111 . 2. The date and place of occurrence giving rise to this Calim are as follows: The occurrence or incident is of a con- tinuing nature, and the occurrence or incident and resulting damage have occurred for three years prior to the date of this Claim. The occurrence and incident is of a continuing nature and, until remedied, will continue indefinitely into the fu- -1- ture. The place of occurrence is real property and improve- ments at and about St. Timothy' s Church, located at San Pablo Road, San Pablo, County of Contra Costa. 3. The circumstances giving rise to this claim are as follows: Several public entities, including but not limited to the City of San Pablo, San Pablo Redevelopment Agency and County of Contra Costa participated in the development of residential structures, roads, utilities, and other man-made alterations to the terrain in the hillside elevations above and adjacent to St. Timothy' s Lutheran Church. Public entities including but not limited to the City of San Pablo, San Pablo Redevelopment Agency, and County of Contra Costa further participated in the funding and construction of residential developments and other manmade alterations to the natural terrain and drainage system above and adjacent to St. Timothy' s Lutheran Church. As the result of the several public . entities individual and joint development efforts ' the natural contours of the property were altered, lateral support removed, surface and subsurface drainage patterns redirected and other activities undertaken to cause and contribute to the massive earth movement manifesting itself in or about January and February of 1983 and .all times thereafter. This earth movement has greatly and irreparable damaged St. Timothy' s Lutheran Church and adjacent parking and road structures. -2- 4. Claimant is informed and believes, and thereon alleges that the conditions described above have been created and aggravated by the acitivities of public entities City of San Pablo, San Pablo Redevelopment Agency and County of Contra Costa and other public, agencies and employees, in their negligent and intentional acquisition, funding, site development, development approval and other actions presently unknown regarding uphill and adjacent property. 5 . Claimant became aware of the responsibility of the City of San Pablo, San Pablo Redevelopment Agency, County of Contra Costa and their agents and employees on or about January 24 , 1986 following investigation by a geologist and soils engineer. Claimant' s right and ability to file a cross-complaint for indeminty arose on or about January 1 , 1986 when it was served with a copy of Casas del Sol Homeowners ' Association Complaint, as a Doe. This claim is being made within one year of the date of discovery of such claim, and the accrual of said cause of action, as mandated by the California Government Code Sections. 6. Claimant' s injuries exceed $1 ,500 ,000 for property damage and diminution in property value as well as prior and continuing efforts to reduce the earth movement to which St. Timothy' s has been subjected. 7. In addition, Claimant is informed that the earth movement which has now been identified as having been caused or aggravated by Municipal entities, including but not limited to -3- the City of San Pablo, San Pablo Redevelopment Agency and Contra Costa County will result in other damages, including further damage to the church structure and. diminution of pro- perty value. 8 . In addition to the above monetary damages, claimant is entitled to full and complete indemnity from the municipal entities including but not limited to City of San Pablo, San Pablo Redevelopment Agency and County of Contra Costa for any and all sums assessed against it by virtue of the several law- suits pending in Contra Costa County Superior Court, including but not limited to the claim of Casas del Sol, being action number 254559 . Claimant further requests that the City of San Pablo, San Pablo Redevelopment Agency and County of Contra Costa cease and desist all activities tending to further aggravate the earth movement, and to repair and stabilize the property condi- tions heretofore altered by those municipal agencies, and to return the uphill and adjacent property owned or controlled by said municipal entities to the condition existing in or about 1953 at the time of the church' s construction. -4- ASI • ' 9 . The names of the public employees causing the clai- mant' s injuries are unknown at the present time. TOTAL ESTIMATED CLAIM: in excess of $1 ,500,000. 00 and full rights of indemnity. Dated: July 10 , 1986 ERICKSEN, ARBUTHNOT, WALSH, PAYNTER & BROWN y• Robert A. Nellessen on behalf of claimant St. Timothy' s Lutheran Church 0-543-OOb/RAN4 -5- Ire CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District governed by) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu S t 19, 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), Amount: $1, 000, 000. 00 given pursuant to Government Code Section 913 and 915.4. Please note all "WARNINGS".County Counsel CLAIMANT: RONNIE LOUIS PURDUE ET AL JUL 2 3 1986 ATTORNEY: c/o Steven Kazan Martinez, CA 94553 A Law Corporation ADDRESS: 171 — 12th Street, Ste. 300 Date received Oakland, CA 94607 BY DELIVERY TO CLERK ON: July 22, 1986 BY MAIL POSTMARKED: July 21 , 1936 1. FROM: Clerk of the Board of Supervisors TO: County Courts Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERKC'/?+' � DATED: July 23, 1936 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors �r%'%Il 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). ( ) Other: Dated C.2-j: /O/L6 By: y County Counsel III. FROM: Clerk of the Board TO: County 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 (x) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order nt ed in its minutes for this date. Dated: A U G 1 9 ,19p PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally terved 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. CC: Claimant County'Counsel County Administrator J . CLAIM AGAINST THE COUNTY OF CONTRA COSTA AND MERRITHEW MEMORIAL HOSPITAL Board of Supervisors T0: County of Contra Costa R v 651 Pine Street Martinez, California 94553 JUL Administrator LOA ops/ !' Merrithew Memorial Hospital fCL 0 A rt I 2500 Alhambra Ave. er . . Martinez, California 94553 i CLAIMANT'S NAME: / Ronnie Louis Purdue as Guardian Ad Litem for Ronnie Louis Purdue, Jr. CLAIMANT' S ADDRESS : ' 1164 Heavenly Drive Martinez, 'California 94553 CLAIMANT' S TELEPHONE: (415) 372-7173 AMOUNT OF CLAIM: $1 , 000, 000. 00 ADDRESS OT WHICH NOTICES ARE TO BE SENT: STEVEN KAZAN A Law Corporation 171 - 12th Street, Suite 300 Oakland, California 94607 DATE OF OCCURRENCE: April 13, 1986 PLACE OF OCCURRENCE: Merrithew Memorial Hospital 2500 Alhambra Ave. Martinez , California 94553 HOW DID ACCIDENT OCCUR: Claimant entered Merrithew Hospital for treatment of ,a fractured kneecap. Because of the failure of Drs . Ware and Gross , hospital employees and agents and others to adhere to the standard of care required by their professions , Ronnie L. Purdue, Jr. suffered amd sustained injuries which have required and may require further medical care and treatment. ITEMIZATION OF CLAIM: Medical and hospital expenses , pain and suffering, severe emotional distress and other damages the extent of which is presently unknown. Amount of said itemization: $1, 000, 000. 00. DATED: July 1986 S EVEN KAZ Attorney for Claimant CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION . Claim Against the County, or District governed by) -the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu s t 19 , 1986 and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors (Paragraph IV below), 000. 00 given pursuant to Government Code Section 913 and Amount: 1, 000 915.4. Please note all "WARNINGS". CLAIMANT: R011NIE LOUIS PURDUE ET AL .ounty Counsel c/o Steven Kazan AUG ATTORNEY: A Law Corporation 1986 171 - 12th Street, Ste. 300 in►net ADDRESS: Oakland, CA 94607 Date received CA 9455 BY DELIVERY TO CLERK ON: July 29 , 1986 BY MAIL POSTMARKED: July 25, 1986 Certified #194098509 -I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, CLERK DATED: July 31, 1986 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors 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). ( ) Other: Dated:_ 6 19T6 By �-� L'��-� C./(-sL�-�Deputy County Counsel III. FROM: Clerk of the Board TO: County 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. Dated: AUG 19 1986 PHIL BATCHELOR, Clerk, By �jL'f`GC�.(C �/ Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (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. CC: Claimant County Counsel County Administrator l;r i C";,;qty Ccun ej CONTRA COSTA COUNTY _ HEALTH SERVICES DEPARTMENT JUL 240 3 198- Martinez., CA 84553 To: Office of County Counsel Date: July 28, 1986 From: Mark Finucane ��/w %'ice- rc� 1 Subject: CLAIM Health Services CDirector Ronnie Louis Purdue, Jr. Record No: 280854-1 Enclosed is a claim regarding the above named patient which was received by Merrithew Memorial Hospital . SP Enclosure cc: County Adm. Office A-41 3/81 CLAIM AGAINST THE COUNTY OF CONTRA COSTA O AND MERRITHEW MEMORIAL HOSPITAL J UL 1986 C^NTRA COSTA COUNTY TO: . Board of Supervisors HEALTH SERVICES ADMINISTRATION County of Contra Costa 651 Pine Street Martinez, California 94553 A inistrator errithew Memorial Hospital 2500 Alhambra Ave. Martinez, California 94553 CLAIMANT' S NAME: Ronnie Louis Purdue as Guardian Ad Litem for Ronnie Louis Purdue, Jr. CLAIMANT' S ADDRESS : 1164 Heavenly Drive Martinez, California 94 3 CLAIMANT' S TELEPHONE: (415) 372-7173 AMOUNT OF CLAIM: $1 , 000, 000. 00 1/4/ ADDRESS OT WHICH NOTICES e Q ARE TO BE SENT: STEVEN KAZAN y• qr OOFCyf�O A Law Corporation ERv 171 - 12th Street, Suite qs Oakland, California 94607 q ti /y DATE OF OCCURRENCE: April 13, 1986 PLACE OF OCCURRENCE: Merrithew Memorial Hospital 2500 Alhambra Ave. Martinez, California 94553 HOW DID ACCIDENT OCCUR: Claimant entered Merrithew Hospital for treatment of a fractured kneecap. Because of the failure of Drs . Ware and Gross , hospital employees and agents and others to adhere to the standard of care required by their -professions, Ronnie L. Purdue, Jr. suffered amd sustained injuries which have required and may require further medical care and treatment. ITEMIZATION OF CLAIM: Medical and hospital expenses , pain and suffering, severe emotional distress and other damages the extent of which is presently unknown. Amount of said itemization: $1, 000,000. 00 . DATED: July 21 , 1986 STEVEN Attorney for Claimant 1 PROOF OF SERVICE BY MAIL - CCP 1013a, 2015.5 2 3 I declare that: 4 I am employed in the County of Alameda, State of 5 California. I am over the age of 18 years and not a party to 6 this action. My business address is 171 12th Street, Suite 300 , 7 Oakland, California 94607 . On July 21 , 1986 I served the 8 following document (s) : Claim against the County of Contra 9 Costa and Merrithew Memorial Hospital 10 on the parties in said cause, by placing a true copy thereof in a 11 sealed envelope with postage fully prepaid thereon, in the United 12 States mail at Oakland, California, addressed as follows: 13 14 Board of Supervisors County of Contra Costa 15 651 Pine Street Martinez, California 94553 16 Administrator 17 Merrithew Memorial Hospital 2500 Alhambra Ave. 18 Martinez , California 94553 19 20 21 I declare under penalty of perjury that the foregoing is 22 true and correct. 23 DATED: July 21 , 1986 24 25 26 Gl�izi Hansen / STEVEN KAZAN A LAW CORPORATION 171 TWELFTH STREET SUITE]00 OAKLAND,CALIF.94807 (415)48&7728 (41S)8917211