HomeMy WebLinkAboutMINUTES - 07211987 - 1.2 (2) CLAIM
' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA as Ex-Officio as
the Governing Board of the Consolidate Fire District
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT July 21, 1987
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $100,000. 00 Section 913 and 915.4. Please note all -warn
coun yptbUt15E1
CLAIMANT: CARL & ANNE MILLER
c/o Maryanne Britten JUN 2 9 1987
ATTORNEY: 2151 Salvio St. #299
Concord, CA 94520 Date received Martinez, CA 9455
ADDRESS: BY DELIVERY TO CLERK ON June 22 , 1987 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.
June 29, 1987 PpHHIL 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: BY: Deputy County Counsel
-Allf
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:J U L 2 1 1987PHIL BATCHELOR, Clerk, 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 immediatelys
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and thai today I deposited in the United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated: J U L 2 2 1987 BY: PHIL BATCHELOR byfivl�uty Clerk
CC: County Counsel County Administrator
CLAD TGz BOAi?D OF SUPERVISORS' OF CONTRA COSTA COUNTY
Instructions to Claimant Return original application to
Clerk of the Board
651 Pine St., Room 106
Martinez, CA 94553
A. Claims relating to causes of action for death orafcir 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 tRis form.
RE: Claim by )Reserved for Clerk's filing stamps
-
Against the COUNTY OF CONTRA COSTA) - JUN ooft"Tomo"
or O p r tel' DISTRICT) - CLOW DoAft IN ft
irf-IF� n name ) `r ;;_ . ► _
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District in the sum of $�lda tp01!_ yo
and in support of this claim represents as follows:
I. Khen �i�`the`�amage'os'�njury occur? ZGive exact date an�'hourj
�"""iThere"di�tFie'aaCna e'oiiln'u`r'"occuz3"�Inclu�e'cit"'and`couiYt`S`ii"
• 9 � Y y Y
i tou1,fJ�..h� �.�Al. _''`��.f�f 6;---
K UK-
i w w.�..-�fs+„.- r.si�a�s ��Yii ii
3. How aid the damage or in3ury occur? Give uii etai s, use extra
sheets
�{if !required)
71- rd /C` t, Q ,� Aa.r j//el 8•'_90/'�,,l ,3�,3f,�? �., y'/
JrR.iK /f.G r'"� ''"C- /+'a-f !/i.�' /T.l� �INC�„✓G�",�� �r�'L IIl'JO/p/L/": � /�G � 4"- /O /ISG
js�aa .r�1A.Ma/. fJ7�/�:�d'/9/ry`. ,�/�bP7 .�i'dJ- !✓Grp �'t /eo�/�' h `.7s 13c
..�.?�,�e, /f//',�� yr,� J�.�.s r ,�p,G'a:,i,���QE3/TTa. filon
Tise�7,1'L„". _e ���i./ r_�_i_.r_.r_ �i___r.____r .viii ..I�i1. What part cuiar ac ar om son the part o� county or dxstr�ct
officers, servants or employees caused the
/�injury
/ or damage? �t e
//tG /ire'.. Gi�irr, �i�ice ./�j�G ,.�f�f��!f-/o/3 .7�� lift /ilt"�a fYizd �G. ,l�+C
� /�/� /�'r,�,�re .,��.��/3 1'�,�.w. �' �x�e.-- T�. /,f'` _ . �e
,4elo,�x/2.,X r,1e Svc /Ge rms y-G
?Zer .fie7a/ 41v/' Jcrc-! 7AC- 4A? 0,:;;,e .esur-,�.oe (over)
5. What are the names of county or district officers, servants or'
employees causing t,be damage or /1;Ia
?
cbA'Je�1,-/J ( )
rie- / ,s�r'�ieer/� Ix l+�_//_
i_ �___ _ii__ i6. Wiat damage r-injuriestloyou cesu teeul� extenof injpries or damages claimedd. h two estimates for auto
damage) �1t rwie Goss t974
r �
7.--Howlwas the amount claimed sbove�computed? (Include the estimated
amount of any prospective injury or damage. )
41'-0-r-r 4��4 00"41// 4�r-04-"/ Aew'ol
6. -Names-and-addresses of-witnesses,-dodoes and hospital-siiii__-ii_i_-_
4-1 191 1141AI-II.X �;VA
Llst the expenditures you made on account of this accident or injury:
ITEM AMOUNT
Jk
Govt. Code Sec. 910.2 provides:
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) or by s e person on his behalf, "
Name and Address of Attorney
-;,4 C a ants Signature
Add
ZOAOo�� 11
TelephoneNo�tfr,�T z,s=Qyy� 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 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 July 1987
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $295 . 00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: RANDY DUANE NICHOLS
130 3rd Street
ATTORNEY: Ripon, CA 95366
Date received June 23 , 1987
ADDRESS: BY DELIVERY TO CLERK ON
BY MAIL POSTMARKED: June 22 , 1987
I. FROM: Clerk of the J3oard of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED. June 29 , 1987 EqIL Deputy oR, Clerk
L. Hall
II. FROM: County Counsel To: Clerk of the Board of Supervisors
(�Q
( )
This claim complies substantially with Sections 910 and 910.2 a4 Qv
cM-/FomSto
comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
(�Q 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). 7P GJ� '
Moy � / u>� � 42d G/l, rj� 5 /oss er ZAIi1 CIL,
Dated: � � w LL& BY: �� .(/ , , Deputy County Counsel
III. FX
ROOM: 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.
( YJ Other: Portion of original claim not previously returned as untimely
is 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.
Dated: J U L 2 11987 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 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.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant; addressed to
the claimant as shown above.
JUL 2 2 1987
Dated: BY: PHIL BATCHELOR by �� Deputy Clerk
CC: County Counsel County Administrator
j
BOARD OF SUPERVISORS OF CONTRA C
��c}�[R �'appiicstion to:
' 1
. ,
Instructions to ClaimantGeri 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. Maims 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 this form.
RE: Claim by Mese w"� ' i_ing stamps
JUN 98? -
Against the COUNTY OF CONTRA COSTA)
}
or DISTRICT}
(Fillin name )
The undersigned claimant hereby makes claim against the Coi ty of Contra
Costa or the above-named District in the sum ofSusi..
and in support of this claim represents as follows:
i. When did the-damage or injury occur? (Gi.ve exact date and hourT
j
sl 46,S 0-f prop' Appeaw, 12_ ►9+- tf 6 %o 0 P"I
Mass o4 Cti Ih;h - 3 -2 r/- 8'7 6'0 b rr\
�. Where did the damage or snooty occur? {Include city and county}
/ f bass �a5 a 1 NQhe✓ 44,1m CA CQv►\Yc` C o Icy, Cry
r
r7 J01 D •�'
37-How did-thedama a or�injury occur? Give tu�S etiai��s�; Gs;-extra
s.beets if required)
/ t 1,055 e,\7 1ii�► 4 �z �eq,4r rrlr Pr°P' wag �c►g/ an� fb� �- "
Li
1. What particular act or omission an the p t of county or district
officers, servants or employees caused the injury or damage?
�At rc�.bli ly G�� RcsPrcl -pow G01h cr M4tiS
ana Cts , 1rj
(over)
e ,
5. What are the names of county or district officers, servants or ='F'
employees causing the damage or injury? prtwu. C 4'14,
}eParlmcrt't
6. -Whatlaamage orilnjuriesrao you claim-resulted?r ZGive-full-extexit-
of injuries of damages claimed, Attach two estimates for auto
damage) 7Az 4,055 a /n eGrSkialG�kr1'c�
- - - - -
Q t,�st Ic�"` j�? /11 � Dcrn _.t' ✓N �Z_=
rrr�sr rrrrrrrrr wrrrrrrr:rrrr rr r
7. How was the amount claimed above computed (Include the estimates
amount of any prospective injury or damage.)
a / F ,4 } p 5 WcVc A)cc.J So .l !ol� �c� �- %h z Cas '
1 ,. !•c
v1A so
rrrrr r•wir r � �rrwr rrr rr_•�rr
8. Names and addresses of witnesses, doctors and hospitals.
�'
aAM
!2- 1 -- G !j� z Sgt o M {}i.�,
amtl w % �Yy\c,, iaay 7AJ1 yons Th r-
f F Ica rl,"e s
rrrr ,,�..,�t��•.� �•y�.rrr�rr:rwr rrrrr�r�.�.r..r�r rr rr+rrr rrrrrrrTrrT+�rrr
�ttiblekp"d ou made on account of t"hl; accident or in3ury:
DATE ITEM AMOUNT
11 W—
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 L � �\ Jz,,
s
Clant s Sina ur
dr SS ,
Telephone No. Telephone No.
P1 c5mi N (*,Iri r.4{ ��
NOTICE P1
r aJw) _
. �tUl C.o�'✓1 5 i
Section 72 of the Penal Code provides:
RV I! tz Cyt ^3+
vEveryr.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.*
a
esS dos -�5�- cf 7 - --- -
/C v1,c S Coo I Ck 14 .41 5w s-
/a C �o�j jo h kt I v . /0
11 cj
�/- Ql � �c. Short 5lrevc `� a � ''
N4D(Lss Ail
/ po,Ie. 1L1 t socr5
BOY
/ G
PIT- 0
Grv1
ii r- r= tcgscJ (3t,,T 1 . ast<� ;®y
0�.Ay pant.Jct' T Asir I'm iqz5rGv ; k
7"� s IA, /7c-
i
I Thr✓z S a m jk rpe 7�/t h
4'4 t s !J' )i s z fe c/
tv L
� b �
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 July 21, 1987
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $1,000, 000. 00 Section 913 and 915.4. Please note all "WarQagsr).tZ CoL'7S�!
CLAIMANT: JACK LEE PAICH JUN 2
c/o James- C. Glassford ` 1987
ATTORNEY: 2033 -No. Main Street #750fv9a rt r ll ez, C �
Walnut Creek, CA 94596 Date received
June 19, 1987
ADDRESS: BY DELIVERY TO CLERK ON
BY MAIL POSTMARKED: June 18, 1987
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PPHIL BATCHELOR, Clerk
DATED: June 29, 1987 Bd: 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: i � BY: �l`► .(.�.17`� 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.
JUL 21 1987
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 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.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated:
-JUL..2 2 1987 11
BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
1 BEFORE BOARD OF SUPERVISORS
COUNTY OF CONTRA COSTA
2 -
In the Matter of the Claim of "CEIVED`
3 Jack Lee Paich
Claimant, UN ?1 87
4 =
VS. BA
5 The County of Contra Costa and
6 The Sheriff ' s Department
7
8
9 CLAIM AGAINST A PUBLIC ENTITY
10 JAMES C. GLASSFORD, a Professional Corporation, hereby presents
11 this claim to the COUNTY OF CONTRA COSTA and THE SHERIFF' S
12 DEPARTMENT, pursuant to Section 910 of the California Government
Code:
13
14
15 1 . The names and post-office addresses of the claimant is as
16 follows: Jack Lee Paich, 1209 Simmons Street, Antioch,
California 94509 .
17
18
2 . The post-office address to which JAMES C. GLASSFORD, a
19
Professional Corporation desires notice of this claim to be sent
20
is as follows : 2033 No. Main Street , Suite 750, Walnut Creek,
21
Ca. 94596.
22
23
3 . On or about May 27 ,1987, Claimant received personal
24
injuries under the following circumstances: an automobile
25
accident occurred in the westbound lanes of Pacheco Blvd. ,
26
Martinez, California, approximately 200 feet east of Shell Road;
27
28 JAMES C. GLASSFORD
A PROFESSIONAL CORPORATION Page 1
2033 NO. MAIN ST. STE. #750 WALNUT CREEK, CA 94596 (415) 977-4078
1 said accident occurred when an employee of the Sheriff ' s
2 Department of the County of Contra Costa, while driving an
3 automobile owned by said County, lost control of said
4 vehicle due to negligence, causing said vehicle to collide with
5 the read end of the Claimant ' s vehicle; further said public
6 entity was negligent in the maintenance, inspection and repair
7 of the vehicle and the training and selection of the employee
8 driver.
9
10 4 . That as a direct and proximate result of the
11 carelessness and negligence of said public entity and its
12 employees, Claimant sustained personal injuries consisting of
13 injuries to his neck and back; loss of time from his employment;
14 total loss of his 1976 Honda automobile; and loss of use of said
automobile.
15
16
17 5 . The true names and capacities of the public employees
responsible for the accident referenced above, with the
18
exception of the driver of the vehicle owned by said public
19
entity, Thomas Nathaniel Webb, are unknown to the claimant and
20
JAMES C. GLASSFORD, a Professional Corporation, who therefore
21
claim that Does 1 through 100 are in some way responsible for
22
the damages of the claimant.
23
24
6 . So far as it is known to JAMES C. GLASSFORD, a Professional
25
Corporation, at the date of filing this claim, claimant has
26
incurred damages in the amount of One Million Dollars
27
28 JAMES C. GLASSFORD
A PROFESSIONAL CORPORATION Page 2
2033 NO. MAIN ST. STE. #750 WALNUT CREEK, CA 94596 (415) 977-4078
1
P
1 ($1,000,000.00) due to the following injuries: the medical
2 expenses for his treatment and general damages now and in the
3 future; destruction of his automobile and the loss of use
4 thereof; loss of wages while off work recovering from his
5 injuries now and in the future.
6 Dated: June 17, 1987
7 Respectfully submitted by
8 JAMES C. GLASSFORD
a Professional Corporation
9
10
r
11 by
J es C. G ass
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28 JAMES C. GLASSFORD
A PROFESSIONAL CORPORATION Page 3
2033 NO. MAIN ST. STE. 4750 WALNUT CREEK, CA 94596 (415) 977-4078
r , CLAIM oC�/
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 July 21, 1987
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: Unspecified Section 913 and 915.4. Please note all "W �ingsiY Counsel',
CLAIMANT: ELIZABETH SILVERIA
1024 5th Ave. JUN 2 9 1987
ATTORNEY: Crockett, CA 94525 treceived Pvlartinez
ADDRESS: BY DELIVERY June
TO CLERK ON 24C� 0�S
, 1987
BY MAIL POSTMARKED: June 23 , 1987
1. FROM: Clerk of the Board of Supervisors TO: , County Counsel
Attached is a copy of the above-noted claim, ppHH gg
DATED: June 29, 1987 BYIL DeputyLOR, Clerk
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: Deputy County Counsel
l
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:
JUL 2 1 1987 PHIL BATCHELOR, Clerk, By VAL 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,
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated: J U L 2 2 1987 BY: PHIL BATCHELOR byputy Clerk
CC: County Counsel County Administrator
OWLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
r 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 , 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 this form.
RE: Claim by ) Reserved for Clerk' s filing stamps
RECEIVED
Against the COUNTY OF CONTRA COSTA) N ��1987
JU
or DISTRICT) a�
(Fill in name) ) A
r
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:
------------------------------------------------------------------------
d
1. When did the amage or injury occur? (Give exact date and hour)
11,A m �- 1 ,Vo '1
Where did the damage or injury occur? (Include city and county)
------------------------------------------------------------------------
3. How did the damage or injury occur? (Give full details, use extra
sheets if quired)CL
� v
--------- -------------------------------------------------------------
4. What particular act or omission on the part of county or district
officers ,
pservants or emplo7ees caused the injury or dam gel
(over)
5. What are the names ,of county or district officers, servants or
employees causing the damage or injury?
--------------------------------------------------------------
6. What damage or injuries do you claim resulted? (Give full -extent
off injuries or damages claimed.
4Ae.�
.1
7-.--How----w-as the amount claimed above computed? (Include the estimated
amount of any prospective injury or damage. )
---------------------------/- -----------------------P-------------------
8. Names and addresses of�sse��octors and hos itals
7�' ,, -, , C� .. �w�%/-33 0 1
rnAOo�
--------- ----------------------- ----------------------
---
9. List the expenditures you made o-n-account--------of----th-is accident or injury:
DAT
MV,
ITEM AMOUNT
�'G�-u-t l.�Ce�l'� i�%�G�.c
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
Cla mant s Signature
cldres
Telephone No. Telephone No. 'Y(C-? 7-
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. "
101
CLAIM All
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 July 21, 1987
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: Unspecified Section 913 and 915.4. Please note all "Warnings".
County Coups;;!
CLAIMANT: FLORENCE ARBUCKLE
2320 Mahan Way JUN 2 9 1987
ATTORNEY: Sari Pablo, CA 94306
Date received -.rt,EZ
ADDRESS: BY DELIVERY TO CLERK ON June 19, l�tS �ha i7:`'
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.
June 29 , 1987 PpHHIL 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: 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
(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: J U L 2 11987 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 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.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated: JUL 2 2 1981 BY: PHIL BATCHELOR by uty Clerk
CC: County Counsel County Administrator
CLAIM TO: BOARD OF: SUPERVISORS OF CONTRA COSTA COUNTY
L
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 f;o , ling stamps
Against the COUNTY OF CONTRA COSTA) JUN
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:
----Wh-e-n-d-id-th-e-d-am-a-g-e--o-r--in--j-u-r-y--o-c-c-u-r-?---(G--i-ve---e-x-a-c-t--da--t-e--a-n-d--ho--u-r)-
----
is �`"`_-'"z--a—•�j•!✓' -z+—r r�C�-S..L_,s�, --C—r... .�-fr-at.sr,.r4 3�- �G-:-.�r._,v:,i/ "� K�2. Where didthedamageorin}u-ryoccur?. ( include city
and_county)
v1. i••(C�•- -s, _{_::..e-..-.'`.f",I /s•e "-t"�!'��-.-y1•• --sK--.--u .1v-7'u-_4-fi-�-
.,'t'Y�•--ft--R.�a'.��' •'e""y__f .�:.�c.,._�t_.s�..• .A!/-•ve-••G...�)�'�t-a.,.�� .y, a�—/eG�,/�"Z' '+vi"'z-'������� Ga''''
VP-`x % �1
r HOW�dld the damage or 'injury occur? `-Give full details use
+----�-' j'--
3 ---- (" extra
sheets if required)
4. What partic far act kir omission on the part of county or district
officers , s1rvants or employees caused the injury or damage?
(over)
1
~ S
5. What are the names of county or district officers, serv✓ant:&eos>: :.,
1 employees causing the damage or injury?
--------------------------------------------- -------------�+---------
6. What damage or injuries do you claim resulted? (Give full ex-tent
of injuries or damages claimed. Attach two estimates for au o
damage) -
---------------------------------------------------------------=---------
7. How was the amount claimed above computed? (Include the estimated
amount of any prospective injury or damage. )
-------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
------ -------'-----------------------------------------------------
9. Li t tai ------- —ures you made on account of this accident or injury:
• , ITEM AMOUNT
t ,
r=,
**41** *************************************************
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':,,p Signature
3�Zv 2 .
ddre
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. "
' � s
r
.�
�r►it
'44�03 -
Ilk
Sr"%N PABLO. CA ;)46UV
AS LISTED FOR LAOR 23y_ 2
TERIALS
No.
ESTIMATE OF REPAIRS VERBAL'AGREEMENTS NOTBINDINGMAESTIMATES FREE
-- d--
Owner f 1l rl�Ort 1. Odour. -le Date 1'
Address 2,52.O rn1ynpkr% UL1►-+1/� �1��r Phone 23'2-"W Est. No.
�Iygal�
Order No.
YEAR MAKE MODEL LICENSE NO. SPEEDOMETER
/� �j/? Retain DestParts ye�P
I g� I�r&u r t1. T�O>g� L_�� Cl t Z Ports �-�--- Parts 'L7—
—01
1
QUAN. DESCRIPTION OF LABOR OR MATERIAL * PART NO. MATERIAL LABOR
mo rd marQ rn bra, ,1C}p-{.ern fi
� �hvt- Cir D4,nh
it C, RSey (4Act rethore
LL)AY
U l4
I
i
i
t
I
ar
o
TOTAL
MATERIAL -
Old parts removed from cors will be junked unless atherwise instructed. Total Labor 25
The above is an estimate based on our insppection arequired nd does not cover additional parts orlaborwhich may be reLter
the work hos been opened up. Occasionallyafter work hos started worn parts are disco eredwhicharenotevident on first Total Material
inspection. Because o is rhe above prices are not guaranteed.
Estimate
Estimated B _ Approved By Tax
AUTHORIZE AND ACCEPTED You are hereby authorized to R e above specified repairs. Paid Out-Tow$Storage
Sublet Repairs
By Ov�nar �—
or Agent --- Date L` TOTAL ( <j
4K 42
CODE N•NEW U-USED R-RE IlT
1440 23rd SrLrT.. E".
SAN PABLO, cry 94806
AS LISTED R23ti_4�y2
TERIALS
No, ESTIMATE OF REPAIRS VERBAL AGREEMEN ONOTBOR BINDINGMA ESTIMATES FREE ,
Owner !I n1�Qn �• �(' LI �� Date Id—
Address :Z-� A`'1an I 'r - fYMab0 (..fit Phone 232-"9D&S Est. No.
9y8o�
Order No.
YEAR IMAKE r� /' MODEL LICENSE NO. SPEEDOMETER Retain Destroy
QAlg� t�/�a 1 C/�rJ�LZN ZParts --� PartsKi
'00—
QUAN. DESCRIPTION OF LABOR OR MATERIAL * PART NO. MATERIAL LABOR
ooep rid 4'Ar 41" o m ire ,bo+ r'
u»IV btxxnr�n*)
LI La ca ie-j-�. •� b .
i I
IJ I
� I
i
I .
i
i
F
i .
TOTAL
MATERIAL MUM
Old parts removed from cars will be junked unless otherwise instructed. Total Labor 25
The above is an estimate based on our tnsppectionand does not cover additional parts orloborwhich maybe required rter
the work has been opened up. Occosionallyafter work has started worn parts ore disco eredwhichorenotevident on first Total Material 15 •
inspection. Because o is the_nbove prices are not guaranteed.
Estimate
Estimated B C,/,_ Approved By v — `� Tax
AUTHORIZE AND ACCEPTED You ore hereby authorized to a above speciFied repo i.:. Paid Out-Tow&Storage
Sublet Repairs
By Owner "
-- or Agent Date C` TOTAL 2 < <j -�
4K 42 M® *CODEN•NEW U•USED R-REB41LT
A
a
x
0
a
i�
H a n
3
til
mo T - r
c �
r .t
6
Lo
` CLAIM
BOAR) 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 July 21, 1987
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $100,000- 00 Section 913 and 915.4. Please note all rnings".
ClAIMAN,T:
ED BRASSFIELD uurqy Ccu,��__
,.�
1864 Jacqueline Way JUPd
ATTORNEY: Concord, CA 94521 2 9 j98�
n
Date received PvjGrti
ADDRESS: BY DELIVERY TO CLERK ON June 24, 198f,7,, CA
BY MAIL POSTMARKED: not legible
Certified P 075 963 737
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: June 29, 1987 PpHHIL BATCHELOR, Clerk
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: 7ZQ BY: ' Deputy County Counsel
II1. 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.
JUL 21 1981
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 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.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
W
Dated: JUL 22 1987 BY: PHIL BATCHELOR byW_deputy Clerk
CC: County Counsel County Administrator
i,
MWAR
RECEIVED
ED BRASSFIELD
1 1864 Jacqueline Way .SUN
2 Concord, California 94521
!1917
3
4 CLAIM AGAINST PUBLIC ENTITY
(Government Code §905 et seq)
5
6
7 TO: CITY OF ORINDA, STATE OF CALIFORNIA, AND TO THHE
COUNTY OF CONTRA COSTA, STATE OF CALIFORNIA.
8
9
10 ED BRASSFIELD hereby makes claim against the CITY OF
11 ORINDA, STATE OF CALIFORNIA, AND COUNTY OF CONTRA COSTA, STATE
12 OF CALIFORNIA, for the sum of $1001000. 00, jointly and/or
13 severally, and in support of said claims makes the following
14 statements:
15 1 . Claimant' s post office address is 1864 Jacqueline Way,
16 Concord, California 94521.
17 2. Notices concerning the claim should be sent to 1864
18 Jacqueline Way, Concord, California 94521.
19 3 • The date and place of occurrence giving rise to thi=
20 claim are:
21 (a) March 16, 1987 at 2: 50 P.M.
22 (b) Location was on Monte Vista Road (at first turn from
23 San Pablo Dam Road) , Orinda, Contra Costa County, California.
24 4. The circumstances giving rise to this claim are as
25 follows:
26 At approximately 2: 50 P.M. on said date of
27 March 16 , 1987 , claimant was proceeding to
28 a work site off upper Monte Vista in
Orinda , Contra Costa County, California.
4
4,
1 Just after claimant had turned off San
2 Pablo Dam Road onto Monte Vista at the
3 first curve, a motorcyclist in rounding the
4 curve drifted into the moving lane of
5 traffic opposite to his direction. To
6 avoid hitting claimant, the motorcyclist
7 "laid-down" his motorcycle.
8
9 A call for police was made and OFFICER L.
10 GREGG appeared at the scene. OFFICER GREGG
arrested claimant for violation of §23102
11
of the California Vehicle Code. He then
12
13 transported claimant, handcuffed, to the
14 Police facility in the City of Orinda.
15
16 At said facility, claimant took one of
17 three required tests (breathalizer)
18 required by the Vehicle Code which revealed
19 a reading of . 01 and . 02 alcohol. In spite
20 of said minimal reading, which did not
21
create a presumption of being under the
22 influence, OFFICER GREGG and OFFICER DOE
ONE insisted that claimant was "under the
23
24 influence" and had claimant transported to
the Contra Costa County Detention Facility,
25 Martinez , California . Said claimant was
26
27 transported in handcuffs by Officer DOE
28
TWO.
'
1
1 At said detention facility, said claimant
2 was required to take a blood test for
alcohol content. Said test revealed there
3
was 00. 00 alcohol in claimant' s blood.
4
5
6 After each test, both in Orinda and
7 Martinez , claimant demanded to be released
8 from custody, but each demand was refused.
Claimant was not released from custody
9
10 until approximately 1:45 A.M. on March 17,
1987. OFFICERS DOES TWO through TEN
11
retained claimant in custody against
12
claimant' s will.
13
14
Claimant alleges that OFFICER L. GREGG and
15
OFFICERS DOES ONE through TEN were Deputy .
16
Sheriffs and were acting in the course and
17
18 scope of their employment and or agency at
all times mentioned herein for the CITY OF
19
ORINDA and/or CONTRA COSTA COUNTY.
20
21
22 Claimant alleges that OFFICERS L. GREGG and
OFFICERS DOES ONE through THREE were Deputy
23
Sheriffs of CONTRA COSTA COUNTY acting as
24
police enforcement officers for the CITY OF
25 _
ORINDA at all times mentioned herein.
26
Claimant alleges that said OFFICER L. GREGG
27
28 and OFFICERS DOES ONE through TEN, acting
in the course and scope of their employment
6
and or agency with the CITY OF ORINDA
2 and/or the COUNTY OF CONTRA COSTA, falsely
3 arrested, falsely imprisoned and
4 negligently inflicted emotional ,distress on
said claimant. Claimant further.. alleges
5
that the CITY OF ORINDA and or the COUNTY
6
OF CONTRA COSTA negligently trained and/or
7
8 supervised the conduct of OFFICER L. GREGG
and OFFICERS DOES ONE through TEN in the
9
performance of their duties.
10
5. Claimants injuries are:
11
(a) Deprivation of liberty.
12
(b) Battery and physical injuries.
13
(c) Emotional distress.
14
6. The names of the public employees causing claimant's
15
injuries are OFFICER L. GREGG and the true names of OFFICERS
16 DOES ONE through TEN are unknown to claimant.
17 7. My claim as of the date of this claim is $100,000-00.
18 8 . The basis of computation of the above amount is as
19
follows:
20 (a) Estimated future medical expenses. . . . .UNKNOWN
21 (b) Loss of earnings. . . . . . . . . . . . . . . . . . . . . .UNKNOWN
22 (c) General damages. . . . . . . . . . . . . . . . . . . . . . .$100 ,000.00
23 TOTAL. . . . . . . . . . . . . . . . . . . . . . . . .$100,000.00
24
25
DATED: June �, 1987.
26
27 ED BRA MHENf' C-Taim`aAV
28
V E R I F I C A T 1 0 N
2
I ED BRASSFIELD, am the claimant in the
above-entitled action. I have read the foregoing CLAIM
4
AGAINST PUBLIC ENTITY and know the contents thereof. The
5
6 same is true of my own knowledge, except as to those
matters which are therein stated on information and
7
8 belief, and as to those matters I believe it to be true.
I declare under penalty of perjury under the laws of
9
the State of California, that the foregoing is true and
10
correct and that this declaration was executed on this
11
12 �2,,J day of June, 1987 , at Yuba City, California.
13
14 ED ECR468YIE_25
15
16
17
18
19
20
21
22
23
24
25
26
27
28
PROOF O`F' 'S'ERVICE BY 14AIL - CCP 1013a, 2015.5
I declare that : I am employed in the county of Contra Costa;
California.
I am over the age of eighteen years and not a party to• the within
residence2900 Esperanza Drive, Concord,
entitled cause; my IMENUNIM address isxugxKXxi(xiiiXgXNNNX4X]glilXgXlg:64X
=Xxtt1x(?xmmU California, 94596. On June 1987
I served the attached CLAIM AGAINST PUBLIC ENTITY (Government
Code Section 905 et seq)
on the interested parties in said cause, by placing a
true copy thereof enclosed in a sealed envelope with postage thereon
fully prepaid, in the .United States mail at wa l nt,t rrAPk r
California, addressed as follows:
CITY CLERK
CITY OF ORINDA
26 Orinda Way
Orinda; California 94563
BOARD OF SUPERVISORS CLERK
651 Pine Street
Martinez., California. 94553
I declare under penalty of perjury that the foregoing is ,true and
correct, and that this declaration was executed on. June A2, , 1987 ,
Concord
at wa3wx1KxMxeEmk , California.
JUANITA GIBSON DYE"
/
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 July 21, 1987
and Board Action. All Section references are to } The copy of this document mailed to you is your notice of
California Government Codes. } the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $1, 000,000. 00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: WILLIAM BODINE County Counsel
c/o Charles F. Bourdon JUN 2 9 19$7
ATTORNEY: Colman, Reisman & Bourdon
861 Bryant Street Date received Mar-tine�, C �
�
ADDRESS: San Francisco, CA 94103 BY DELIVERY TO CLERK ON June 23, 198 ` hand t1 .
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.
DATED: June 29, 1987 JVIL BAAputyLOR, Clerk
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: uty 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. t o
Dated: J U L 2 1 1987 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 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.
AFFIDAVIT OF MAILING
[ declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
lnited States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
:alifornia, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
)ated: JUL.2 2 1987 BY: PHIL BATCHELOR by uty Clerk
:C: County Counsel County Administrator
BOARD OF SUPERVISORS`'OF` CONTRA COSTA 'COUNTY
Instructions to Claimant . .Return original application to
Clerk 'of the Board
651 Fine St., Room 106
J Martinez, CA 94553
A. Claimi:> 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) ;
S. 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. & 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 entitye separate claims
must be filed against each public entity.
E. Fraud. . See penalty ,for fraudulent claims, Penal Code Sec. 72 at end
or-t-Fiis form.
RE: Claim by .Reserved for Cler' k's fit ng stamps
WILLIAM BODINE }. .: _ •••� �* ,4z
UN 1981
Against ,the COUNTY OF CONTRA COSTA} �
or :DISTRICT)'<;.
AFill in name - )
The*undersigned claimant`'hereby makes-'claim against the County of Contra
Costa or the above-named District--in -the. ,sum,,of $ -1,00o1000.00
and in support of this claim represents as follows:
I.`" i'en"did`the"Damage ozr" n ury occur?~`�G ve"ex`act oa"te`&R. fiou`rF�'�`"
. 3/16/87, approximately :2 :37- P.m..
`&mage`o=" n3ury-oc"cu`r7""�Znclu a"citty"ani"countyS"-__
26 Orinda' Way," 'Orirrida Gommtinity Park
Orinda, CA- ,.-,Contra .-,Costa Count
3:
low"d1d`ithe damage"or` nury occur3 `ZGive� ulllaetas;"use"extra`
sheets if required)
On March 13 , 1987, -he was placed ander,. citizens arrest for indecent
exposure and imprisoned for approximately 'seven hours before being
released,
v a
-a par`ticuia"z`ao`t`orFomIe'aIon`on"iBe'part'o1"coun"ty'or'oi,"stract-`
officers, servants or employees'' cause the injury or damage?,
Complete information is unavailable at= this" time; investigation i's
continuing. Based on information -presently known Claiman contends `
that Deputy Rock and unknown Orinda. Police Officers failed to properly
investigate and substantiate the arresting citizen's allegations.
Claimant was arrested without probable cause and he was falsely (over)
imprisoned.
5.- wh' t-Uie the names of, county or district officers, servants or' '
employee's causing the damage or injury?
Deputy John Rock, Employee # 37929
6. FAKE damage or �n�uries do you cla m resulted? 7G ve u�� extent
of injuries ,or .damages claimed. Attach :two: estimates .for..auto
damageClaimant_ was detained for"several. ;hours,-sand was unable to- contact
his family due to hi's--inabil ty to-,ruse :.the ;telephone because of is,
physical hardship. As a result he �-suffered ,extreme .emotional distress.
�. How was the amount claimed above .eomputed?. ZInclude the estlmate�
amount of any prospective injury, or, damage. ):`He continues- to be fearful
of police officers and suffers re-occuring nightmares, extreme anxiety and
depression. Additionally, within 1 week -of'"his arrest `Mr. iBodine ,suffered
his first attack of :Bell's Palsey.
B. Names and addresses of witnesses, doctors and .hospltals,.:
"13otten 2. Mar Sears, M.D.
• "Mary.,
Orinda Senior Village 12' Cam no 'Minas
Orinda, CA Orinda; CA 94'563
�. List tie expenditures .you made on account of this accl�ent or In ur
ATE;E ITEM AMOUNT
Cmp -teoinfo4'�S ITunavailable at ,'this time. Medical and psychiatricoe ses a . pot exceed .$5, 000. at this, time.
Govt. Code
1Xlraiari�sA •,:jam,• -
- -
- Sec. 0-= 1 ,2 provides:
The claim signed by the claimant
SEND.-NOTICES T0: (Attorney) - or by 'some person on his behalf. "
Name and Address of _Attorney .
CHARLES F. BOURDON - - ,.0 a hts nat e
COLMAN, REISMAN & BOURDON Addrear
.
- --
San'.Francisco., CA 94103
Telephone No. (415) 626-5134 `Telephone No.
NOTICE
Section 72 of the Penal-: Code provides:
'Every person who,`vith intent. bo 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 .off icer, authorized to allow or pay
the same if ,genuine, any '.fai.se or raudulent, claim, bill, account,=voucher,
or writing, is guilty of..a :felony. "
j
CLAIM
r
BOARD*Or 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 July 21 , 1987
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: Unspecified Section 913 and 915.4. Please note allarni.rEQ�"�+
�+'4..ii Ily Ulil,. a13 1
CLAIMANT: ROBBIE CR1JM
64 Tracy Court JUN 2 9 1987
ATTORNEY: Alamo, CA 94507 _
Date received 5
ADDRESS: BY DELIVERY TO CLERK ON .June 26, 19$1
BY MAIL POSTMARKED: June 25 , 1987
I. FROM: Clerk of the Board of Supervisors TO: County Counsel -
Attached is a copy of the above-noted claim. iflf�
IL aATCHELOR, Clerk
DATED: June' 29, 19$7 ��: 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: UTv, _ — BY: M.4 c2W_ eputy 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
O 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. 1
Dated: JUL 21 1987 PHIL BATCHELOR, Clerk, By �/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.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
JUL 2 21987
Dated: BY: PHIL BATCHELOR by &6&�ty Clerk
CC: County Counsel County Administrator
e1 - CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
s:
_t 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 ends
of this form.
RE: Cl 'm by ) Reseryad gnr Clerk' s filing stamps
X%JQ
15T21MIVED
Against the COUNTY OF CONTRA COSTA)
- JUN 1987
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:
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour) j
;.--W-hr--e-ir_e-e-ifa the damage or injury o�cc�ur? Include cit and count )
s, use extra,--,
7
dama a or injury occur. (Give f� de il +
alit-
3. How did the g Y
sheetq if required)
---------P-------------=`�--------------- -- -7-----------
4. What articular act or omission on t pa t of county or district
officers , servants or employees caused the injury or damage?
P7
� - _ (over)
5. What are the nares o county or district officers, exuantsu r'- _
I employees causing the damage or injury?
-------------------------------------------------------------------------
6. What damage or injuries do you claim resulted? (Give full extent
damagejries. or damages claimed. Attach two estimates for auto )
-IP-
---------------------------------- y
7. How was the amount claimed above computed? (Include the estimated
amount of any prospective injury or damage. )
-------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
-------------------------------------------------------------------------
9. _s you made on account of this accident or injury:
ITEM AMOUNT
i 5 c,
J* ISM** ► JEr * **************************************************
Govt. Code Sec. 910.2 provides :
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) . . . or bV some person on his behalf. "
Name and Address of Attorney
Cla 'mant' s Signature
Address
Telephone No Telephone No. 7
**************************************************************************
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 July 2 1,l 9 8 7
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $92. 25 Section 913 and 915.4. Please note all "W860 81 CGLIi�S�f
CLAIMANT: LISA BETLAN
1019 Camino Verde Circle JUN 2 9 1987
ATTORNEY: Walnut Creek, CA 94596 91157n
Date received Martinez, Grp 04 :.,
ADDRESS: BY DELIVERY TO CLERK ON June 22 , 1987
BY MAIL POSTMARKED: June 190 1987
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: June 29, 1957 PpHHIL ATCHELOR, Clerk
8Y: Deputy
L. Hall
I1. FROM: County Counsel TO: Clerk of the Board of Supervisors
(}t/ 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 910.6).
( } 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
111. 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: JUL 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 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.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the.United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order an Notice to Claimant, addressed to
the claimant as shown above.
JUL 22 1987
Dated: BY: PHIL BATCHELOR by //"eputy Clerk
CC: 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 (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 ) ReserPrklg filing stamps
RECEIVED
Against the COUNTY OF CONTRA COSTA)
JUN 981
or DISTRICT)
J4
-
Fill in name) ) -
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District in the sum of $ CN , 96
and in support of this claim represents as follows:
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
Maw__h 2C_Q , KR-7 a-+ a-Opynx�y ly 1 'copvvt
-----------T------------------------------------------------------------
2. Where did the damage or injury occur. (Include city and county)
c>f`FY-e + _Rl Va -':;;-►-1 tea -I ren
VJ_ Int Cve� , c n`{-1
--------------------------------------;-------------- ----------------
3. How did the damage or injury occur. (Give full details, use extra
sheets if required) WV)r%n aP�► �,�i'�� �V���-�i S Y'E�'rl Z ?)r
6DO_�--` -h iC9 �,n �-{- V z C� CI.S h l Cl/t -�Ur r►�-� Z�1`� `�b c� ak a
u��� a. ► C 'e etch )
------------------------------------------------------------------------
4 . What particular act or omission on the part of county or district
officers , servants or employees caused the injury or damage?
71-VDk�� -pri or 4,Go U,�broi01n wCth '�'v, o-KICAa4 } e.+Ll C� W�I kiufi
5`,� had -b 16k We -+ i -tie Wort wean un -the area weve_
aDL" C�1�jtYl�C DY1 .
(over)
5.1-;,,What are the names of county or district officer ,:ae van.ts �a . �::=gip:
I ,'ein4loyees causing the damage or injury?
T C,�cc5lrt'� hG�-t Gi-�� Ir1LZ i7Le_5 ScXI Csz, -�(n2 C'-ti'l�� S u Y► MaA,�k'& .
-------------------------------------------------------------------------
6. What damage or injuries do you claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage)
my i ire. - 1-+- arm T h��6 -t� �+ O. scat 6YU
-------------------------------------------------------------------------
7. How was the amount claimed above computed? (Include the estimated
amount of any prospective in'ury or damage
� ava- .
YAd A�-1-� - Lae-{ o -�-t i� (us
l�
-------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
9------------------------------------------------------------------------
- -s you made on account of this accident or injury:
:..3
_ DIF (f ITEM AMOUNT
P(1V_41 2�1 .. ./A
Y_
t4.1 y�1J►ni:.i!tYr
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
fb�QjJair6aAf_ s ,Signature
IrLi4lbAddress �/
Q
Telephone No. Telephone No. (� q�p
**************************************************************************
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. "
�t TIRE — WHEEL BATTERY
• 1 WORK ORDER
AUDIT Wg2�• 08
NUMBER 55
GRAND AUTO, .INC.' _ 2077 WtrtRA COSTA BL.
E
7200 EDGEWATER DRIVE OAKLAND,CA 94621 PLEASANT HILL, CA 9458
4t5� tf86-59�
t5T04�U ER s,t NAME,
$.AAL No.AC 9048
CASH CHECK G;C P 3 BOTHER
MR.
MS. QTY ?1D IRE`S S
INITIALS_ T-LAST N ME
�t
ADDRESS
i
CITY STATE ZIP
ME PHON9, DESCRIPTIO EMCLE:..
C YR. M MODEL
„s;tFAcnRs'. E:; n{ ==rte
MILEAGE LICENSE NO - STATE' -�—
+ TO$E MASLE6810N PQ$TCARD CUST•' ,GRAND
AUTO
• • • • :• MDSE.
s _
MAX.TIRE WARRANTY PERIOD MAX.BATTERY WARRANTY PERIOD =TIRE NEW' BLEM L "'- E.
PECiFIE M S. SPECIFIED IN MILES SPECIFIED IN MOS. SPECIFIED IN MILES y ,
MI. MO. mi. _FE DERAL£XCISETAX � ; t 950009
TIRE NEW BLEM r�
�.i4iK LED6MfrIFT'x z - _
FEDERAL EXCISE TAX { 9
� s
_taEtluERfp9vs� „ TIRE
TRADE-IN VALUE _ 004
TUBE
-
Mo N TIME VALVE STEM METAL * 323721
INSTAL -NOTICE TO CUSTOMER: =VALVE STEM CHgR�ME � £ 393509
IN PLEASE READ IMPORTANT,
INFORMATION ON BACK VALVE STEM,.RUBBERgz <I: ,079892 ,I
.gw
,OUT... .
MOUNTING 940038
STATIC x r m r z
IN IMPORTANT WHEEL BALANCE 940046
PLEASE KEEP THIS RECEIPT FOR COMPUTERIZED �
YOUR INFORMATION AND PRO- WHEEL BALANCE _ "x �54
�
OUT '' TECTION.CLAIMS FOR REFUND, FRONT
EXCHANGE, OR "ADJUSTMENT s
WILL BE CONSIDERED ONLY WHEEL ALIGNMENT ` a 940062 ; ,
IN UPON ITS PRESENTATION. FRONT AND REARS
140062
3 WHEEL ALIGNMENT _
OUT BATTERY NEW RECON.
TRADE-NBATTEVALUE �RY 960012 I T
FREE! .� •TOP POST '
r ' -, ANTI-CORROSION KIT .286672 -
TIRE ROTATION SIDE POST
AND '- ANTICORROSION KIT ` 5301665 , *
+a F. fib. ,.k.. ,..,.
WHEEL BALANCE CHECK ANTI-CORROSIONS
--970034
SERVICE �'�.� .� � _;:
Uj EVERY 5000 MILES �, t
WITH PURCHASE OF-,.,.,-,, WHEEL
LL
FOUR COMPUTERIZED WHEEL LUGS �.
WHFEL'BALANCES
/PKG.
LOCK NUTS
+
/PKG.
3 NTIFICATION •'
TAXABLE,
CUSTOMER AUTHORIZATION TOTAL ^1
I hereby authorize Grand Auto to perforni the repair or Installation work - SALES
itemized hereon,including the cost of replacement materials.You and your TAXCY
j
1
employees may operate the vehicledescribedhereon for purpose of testing,
- or inspection at my risk.An express mechanic'slien'is acknowledged on TOTAL r 3• C-
this vehicle to secure the amount of costs indicated hereon.I understand
-that storage fortfie,veh cle may be charged to commencing 48 hours TOTAL
�.k
after repairs are completed CREDIT 4' l 1
,�� I 1 will not hold.Grand Auto Inc responsible for loss or,damage to the .
vehicle or ds contents In case of fire,theft accident,or ny other cause ` `' TOTAL
Wd 99:Zr i . .W6 . - beyond Grand Auto s
CEJVED A1J CE•COPY:OFiT EST ATE i'.TOTAL'
6.
LABOR
LITH AIZED AND D S ATEb MfERtON
•
1001G 4 PT.
REGISTRY GR.NO.418072(9--
`