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HomeMy WebLinkAboutMINUTES - 08181987 - 1.15 1,15- CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA F LClaim Against the County,"or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Au gu s t 18 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 "Warnings". County C0unsel CLAIMANT: MARY SEWELL AND RUSSELL SEV ELL c/o Richard H. DuBois JUL 2 1. 1987 ATTORNEY: Attorney At Law 702 Marshall Street #400 Date received 10art11ne-7fy� 5 5,,987 Redwood Cit CA 94063 rte ADDRESS: S'� BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: July 14, 1987 I. FROM: Clerk of the Joard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. July 23 , 1987 PpHHIL ATCHELOR, Clerk / GATED: Y BY: Deputy G / L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. (VX 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: /"P,(� i���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 18 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 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 a d Notice to Claimant, addressed to the claimant as shown above. AUG 20 1987 Dated: BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator 1 RICHARD H. DUBOIS, ESQ. First Interstate Bank Building {(� 2 7U2 Marshall Street, Suite 400 �� v Redwood City, CA 94063 3 ( 415 ) 367-6222 4 Attorney for Plaintiff ,. 5 6 7 8 BOARD OF SUPERVISORS, COUNTY OF CONTRA COSTA 9 In the Matter of the Claim of 10 MARY SEWELL and RUSSELL SEWELL, CLAIM AGAINST PUBLIC ENTITY 11 Claimants, 12 -vs.- 13 COUNTY OF CONTRA COSTA / 14 Claimants, MARY SEWELL and RUSSELL SEWELL, hereby make claim 15 against COUNTY OF CONTRA COSTA for the sum of $100 ,000. 00 and 16 makes the following statements in support of the claim. 17 1. Claimants home address is 6636 Arlington Boulevard, 18 Richmond, California. 19 2. Notices concerning the claim should be sent to 20 Richard H. DuBois, Attorney at Law, 702 Marsnall Street, 21 Suite 40(x , Redwood City, CA 94063 . 22 3 . The date and place of occurrence giving rise to this 23 claim are April 21 , 1987, on the public sidewalk fronting 5701 24 Barrett Street, in the County of Contra Costa. 25 4 . The circumstances giving rise to this claim are as 26 follows: On the above date and place, claimant, MARY SEWELL, was 27 walking on the public sidewalk which was in a dangerous condition NUDELMAN 28 due to lack of maintenance and repair. The dangerous condition & DuBois ATTORNEYS FIRST INTERSTATE BANK BUILDING 702 MARSHALL ST. SUITE 400 REDWOOD CITY, :ALIFORNIA 9406$ (415) 567-6222 r . 1 constituted several breaks in the -sidewalk so that it was not 2 level and in fact had ridges of approximately 1 inch in height. 3 Due to the dangerous condition., -claimant, MARY SEWELL, tripped and 4 fell causing her serious injuries. 5 - 5 . Claimant' s injuries consist of a broken wrist, residual 6 disability, and other bruises. Claimant, RUSSELL SEWELL, claims 7 damages for loss of consortium due to his wife's injuries. 8 6 . The names of the public employees causing the claimant' s 9 injuries are currently unknown. 10 7. The claims of each claimant as of this date is 11 $100 ,000. 00 . 12 8. The basis of computation of the above amounts are based 13 on estimated medical expenses and general damages. The exact 14 amounts of either of these items are at this time. 15 Dated: July 8, 1987 16 R CHARD H. DUBOIS 17 Attorney for Claimants 18 19 20 21 22 23 24 25 26 27 28 NUDELMAN 81 DUBOIS ATTORNEYS FIRST INTERSTATE BANK BUILDING 702 MARSHALL ST. SUITE 400 ��_ REDWOOD CITY. -ALIFORNIA 9406$ (415) 867-6222 YS ] VERIFICATION 2 3 We, MARY SEWELL and RUSSELL SEWELL , declare that: 4 -We are the Plaintiffs in the above-entitled action; We have 5 read the foregoing Claim Against Public Entity and know the 6 contents thereof; the same is true of our own knowledge, except as 7 to those matters which are therein stated upon our information or 8 belief , and as to those matters we believe it to be true. 9 We declare under penalty of perjury that the foregoing is true 10 and correct and that this verification as executed on 11 at , v 12 Calif45Tnia. 13 14 15 MARY SE 16 ITIUSSELL SEWEELL 17 18 19 20 21 22 23 24 25 26 27 28 NUDELMAN & DUBOIS ATTORNEYS FIRST INTERSTATE BANK BUILDING V02 MARSKALL ST. SUITE 400 REDWOOD CITY,. :ALIFORNIA 94063 (413) 367-6222 r CLAIM c 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 18 , 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". CLAIMANT: BONNIE LEE TURLEY 112 E. 6th St . #6 ATTORNEY: Antioch, CA 94509 Date received ADDRESS: BY DELIVERY TO CLERK ON July 15 , 1987 BY MAIL POSTMARKED: July 14, 1987 1. FROM: Clerk of the Joard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: July 22 , 1987 �b: Deputy1 /e�,iv 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: �cv! � � _ BY: ��_ / 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 X) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's rder entered in its minutes for this date. Dated: AUG 18 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 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: AUG 2 0 1987 BY: PHIL BATCHELOR by puty Clerk CC: County Counsel County Administrator CLA-1M 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 9.11, 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 RE s � ' stamps d,00VN/e Z e e ) JUL 1,51g87 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: ------------------------------------------------------------------------ 1. When did the damage or injury occur? (Give exact date and hour) ea, — Icy— F7 ---------------------- ------------------ ----Whe-r-e-di-d--he-d-a-m-a-ge---o-r--i-njury occur? (Include city and county) /-7/a/ yS0`e-"-" /_ C hoc // ---------------------------------------------- --------- 3. How did---the----damage-------o-r- injury occur? (Give full details, use extra sheets if required) iu o 6 JrcT 1'Lec✓ o , % e-,f- 7-;KC_ e-0 a 7/_ d sTr u c IL -7—A c- s A;C �! a �' /v� � -T—v c/L -------- ------------------------------------------------------------- 4 . What-particular-- act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) t. 5. - Whqt are the names of county or district offiaers,:!..servants I employees causing the damage or injury? P/' � / �;Z G� Y7" �/gM � NoT /� /'o v/ OleI 0r/v/N7 -77 uc/C �o `/ 7c ----------------------------------------I -------------------------------- 6. Whatdamage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) 1k ,, / 7--Ac- w�.✓ a 4, A (J SJi /4�o e e r.o c lL. i �✓ m.`' _ -7-;-(-.,c% ----- --°--�-- - ------------------------------------------- 7. How was the afnount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Av o Al e -- -------- - ------------------------------------------ 9. i t es you made on account of this accident or injury: .;.�� ITEM AMOUNT Al �2ti3Y�VN'1VJ;•!Lt;1 a a71F'::) Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person ori his behalf. " Name and Address of Attorney ' Claimant' s Signature Address Telephone No. Telephone No. ************************************************************************** NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or .-for payment to any state board or officer, or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 1 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Augu s t 18 , 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: $30- 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JOYCE A. TAYLORunt ' Y�L;;1S�J 2127 Crestview Lane #B ATTORNEY: Pittsburg, CA 94565 JUL 21 ! JOR Date received ADDRESS: BY DELIVERY TO CLERK ON Ju�' ! �fi�`�� � �; BY MAIL POSTMARKED: July 15 , 1987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 22 1987 PpHHI:L BATCHELOR, Clerk epu 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: �� /�j,� BY: 1 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 18 1987 PHIL BATCHELOR, Clerk, ByC/MLx_ _, 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: AUG 2 0 1987 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator :AZM T0: BOARD OF SUPERVISORS OF CONTRA CORA W}'appiicationto:``. J. Ynstructi $_ to ClaimantVerk of the Board p,0 Box 911 vartinez.Califomta 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 rection. 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, 551 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 penaltyfor fraudulent claims, Penal Code Sec. 72 at end f' o his form. ` RE: Claim by )Reserved for Clerk's filing stamps Qc L. A ' A J/6i2 ) • i RECEIVED ) Agai st the COUNTY OF CONTRA COSTA) Attic Z ��t�rlfra� ) Ut. `� or fiRC; +* _ TRICT) Fill in Mame ) T A T: The undersigned clai}nant hereby makes claim agar of Contra Costa or the above-reed District in the sum of and in support of this claim represents as follow0: . ------------ ` --,--/---------h---1. 'Wh-en-d-id-th--d-a-ma-g-e-orin3ury. occur (Give Tmact date and )ftqu- / � '� • ' �;_�� /,� ,mss o---^�.---T^-------------- yti.-----------------..-��� �: W�iere`did tie, damage or .injury ocr? (Inc fide .city and c14,fi— ounty) 3. How did the damage or in3ury occur? Give ::ill^details, use extra . sheets if requited) _ i r;:l x A rr�e:s� � 2 T• r ` • ire cJ�u /'1� '���G�f�� �U�'s�-- 4. -What particular act..or. . omission on the partf county or district officers, sery nts or .employees caused th;e9injury or damage? (over) What are the names of county or district officers, servants or employees causing the damage or injury? -:6. What ZIamage or i�uries do you claim resulted? ZGlve-full extent ;bf injuries of damages claimed. Attach two estimates for auto r I damage) r i ; ` d �, M 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ? .:.. 6. Names and addresses of witnesses, doctors and hospitals. _ 37-List the-- ----- ------••---------T-----T--------T—T---- pd �7tres...yoa ade on account of this accident or ITI, y. DA E ,. , ,.. ITEM AMOUNT I - Govt. Code Sec. 910.2 provides: ."The claim signed by the claimant SEND NOTICES TO: (Attoine ) or by some person on his behalf." Name and 'Address of Attorney Gt [A' dr�es/^s_ /7 Telephone No. Telephone No. !! - w��*:***:•****���**�f*tr#�t�t*:+r��**���**��rt:rr*:*�r�t*�**�r*:max::#*t*��r�*w��* 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, surd 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. " .i .. ...... .: i.a:Yi .:'. •. :- ::.:, :. a.:...:..s.'.l.,i..Sar=sem.• a-S4`YJ.. .�..pbTi.,Mf. ..+.`. - 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 Au gu s t 18 , 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, 500. 00 Section 913 and 915.4. PleGC1dd <a(DDtWudPgs". CLAIMANT: DOUGLAS R. ANDERSON JUL 21. 1987 1320 Santa Clara St . ATTORNEY: Richmond, CA 94804 Martinez, CA 945:0 Date received ADDRESS: BY DELIVERY TO CLERK ON July 22 , 1987 transmittal BY MAIL POSTMARKED: no date I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 23 , 1987 ppHHIL ATCHELOR, Clerk 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: 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 (�) 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. - A U G 18 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. AUG 2 We��Zr_0 1987 BY: PHIL BATCHELOR byDeputy Clerk Dated: CC: County Counsel County Administrator Ci:AZ2�! jy BOARD OF SUPERVISORS OF CONTRA CCW*AWYappiieationto; 3 Clerk of the Board _-' - Instructions to Claimant .W.Box 911 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 104th day after the accrual of the cause of 4action. "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. -Claimsmust be filed with the Clerk of the Board of Supervisors = at its office in Doom 106, County Administration Building, 551 Pine Street, Martinez, California 94553. C. if claim is against a district governed by the Board of Supervisors, gather than the County, -the name of the DistriVt should be filled in. D. If the claim is against imore+than one public.entity, separate claims _ trust be filed against each public entity. . E. Fraud. See penaltyfor fraudulent claims, Penal Code Sec. 72 at end o his form. 1tt,t*��*:��wt�re•��rc��***�rtr*�r�*�r�e*�r***Kt�+e,r�*�****�*��**��rrt**��*�**tr�r*#*w* - RE: Claim by )Reserve r Ti n stamps Against the COUNTY OF CONTRA COSTA) or DISTRICT) (Fill in name ) N. . . The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ o a 0 and in support of this claim represents as follows: When did the damage or iniury occur? (Give exact date and hourT Where did tnie damage or sn3ury occur: (Include city and county 3. Haw didr_the damag; 4o-rinjury occur? Giveu2I oetails, use extra . sheets if required) -tm . 4. Wnat particular- ct or omission on the -art of c -- - T--part of county or district officers, servants or employees caused the injury or damage? ofw.s� � • • (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? 6. -j fiat damage or 1n3uries do you claim resulted? ZGfve full extent ,of injuries of damages claimed. - Attach two estimates for auto Z .damage) i b343 a ' - 4�C3 SLID 7. Bow was the amount claimed 'hbve-computed? (Include the est1M d amount of any prospective injury or damage. - / — .:-L!{fI:•.:.. :J....e+r.'- - •I'•• � '��;:•T.• e•M: `-VY-`. • � .•Iiy,.. .•• _ .Ai..-•: - - 6. Names and addresses of witnesses, doctors and hospitals. �. I,j haSL41h you made on ac-count of this accident Or Zn3ury: __ -- '� ITEM AMOUNT Govt. Code Sec. 910.2 provides: The claim signed by the claimant SEND NOTICES TO: (Attorney) os by some person on his behalf." Name and •Address of Attorney Claimant s Signature • ' : . ._.... Address . r.. Telephone No. Va-k,`k 'J s�,.�.-�4r-J\L Telephone No. �-6 - R!#R***##**#R#***#R####*#######R#*#*R!#RR#*##**##RBBB###!###!!R#!##***#R#* NOTICE - - Section 72 of the Penal Code provides: "Every person who, with intent to defraud. }resents 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 sane if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony.' ....... ,...a ii^w.�..+.'•• .�.. ._.....-.. _.�...,.a„_-.-.... .,.-+u•;n•uVc.ci'i7J.ieilsiwia6GIVGtiO:STw -. �aiw-•+:+� CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIF m}1 my Cou, Claim Against the County, or District governed by) J U BOARD MON the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT L 21u 1$ 1987 and Board Action. All Section references are to ) The copy of this document/*M6 oto you is your notice of California Government Codes. ) the action taken on your claim by �hc a M g upervisors (Paragraph IV below), given pursuant to Goverwnt Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PACIFIC BELL, A CALIFORNIA CORPORATION 140 New Plontgornery Street ATTORNEY: Sari Francisco, CA 94105 Date received ADDRESS: BY DELIVERY TO CLERK ON July 20, 1987 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. Jul 23, 1987 pH IL BATCHELOR, Clerk DATED: Y 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 XThis 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. AUG 18 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. (� i Dated: AUG 2 0 1987 BY: PHIL BATCHELOR by /// eputy Clerk CC: County Counsel County Administrator Legal,Department 140 New Montgomery Street,Eleventh Floor PACIFIC "'BELL,. San Francisco,California 94105 A Pacific Telesis Company Writer'sDirect Number 415-542-2572 17 July 1987 Clerk of the Board of Supervisors County Administration Building, Room 106 651 Pine Street, Martinez, CA 94553 Re: Claim for Indemnification/Contribution Pacific Bell, a California corporation, presents a claim for damages against the County of Contra Costa as provided in Government Code Section 900 et sea. Date of Claim: July 17, 1987 Claimant 's Address: Pacific Bell 140 New Montgomery Street San Francisco, California 94105 All notices or correspondence concerning this claim should be sent to counsel for claimaint: Margaret E. Garber, Esq. Pac-ific Bell Legal Department Suite 1126 140 New Montgomery Street San Francisco, California 94105 I 1 Clerk o_f the Board of Supervisors Claim by Pacific Bell, a Californ " t-'orporation Re: Hagman v. County of Contra Costa, et al 17 July 1987 ,VLb19� Page Two Claim: On or about April 9, 1987, Claimant has been served with with the Second Amended Complaint in the case of Linda Hagman. Administrator of the Estate of James Lea Hagman v. County of Contra Costa. et al, filed in the Superior Court of California for Contra Costa County, Case No. 294965 (see attached copy of Complaint which is hereby incorporated as an integral part of this claim) . The complaint alleges that on or about May 3, 1986, the plaintiff 's decedent was involved in a single vehicle accident while driving a motorcycle in a westerly direction on Marsh Creek Road, approximately 1 .4 miles est of its intersection with Deer Creek Road. Claimant has been named as a defendant in said Superior court action. The complaint alleges, inter alis• that the road was improperly constructed and maintained, thereby resulting in the decedent loosing control of his vehicle. Plaintiff further alleges that the County improperly permitted the claimant, Pacific Bell, to maintain a telephone pole in close proximity to the road. Claimant contends that the County of Contra Costa is wholly or partially responsible for the injuries complained of in 2 • ' i . 1 Clerk of the Board of Supervisors Claim by Pacific Bell, a Californ W-torporation Re: Hagman v. County of Contra Costa, et al 17 July 1987 Page Three that plaintiff alleges that the County negligently constructed, repaired and/or maintained the road. Claimant contends that in the event it is found in some manner responsible to plaintiff or to anyone in said Superior Court complaint, that this claimant 's liability would solely be based upon a derivative form of liability not resulting from the conduct of the claimant but only an obligation imposed upon it by law and therefore said claimant would be entitled to total and complete indemnity from the County of Contra Costa. As a result of the above set forth claim, the County of Contra Costa is obligated to indemnify claimant wholly or on a comparative fault basis, for all sums claimant may be compelled to pay as a•result of any damages, judgment or other awards recovered in said Superior Court action, and to reimburse claimant for necessary and reasonable attorney's fees and costs 3 Clerk of the Board of Supervisors Claim by Pacific Bell, a Californ,;a. i6orporation Re: Hagman v. County of Contra Costa, et al 17 July 1987 incurred and paid by claimant in defending said Superior court action. The claim against the County of Contra Costa by claimant is a demand by claimant upon County of Contra Costa to affirmatively assume said obligations. The precise dollar amount attributable to the assumption of said obligations is unknown at the present time. By Mar et Ef G rber, Attorney fo laimant Pacific Bell 415-542-2237 4 G j h I WILLARD E. STONE Attorney at Law 2 1211 Newell Avenue Suite 124 *= 3 Walnut Creek, CA. 94596 4 (415) 935-1711 5 Attorney for Plaintiff 6 7 6 SUPERIOR COURT OF CALFIORNIA 9 COUNTY OF CONTRA COSTA 10 LINDA LIND HAGMAN, Administrator ) for the Estate of JAMES LEA HAGMAN, ) CASE NO. 294965 11 Deceased, ) Plaintiff ) SECOND AMENDMENT 12 )TO COMPLAINT i3 v ) 14 COUNTY OF CONTRA COSTA, PACIFIC ) BELL COMPANY, A CALIFORNIA ) 15 CORPORATION, PACIFIC GAS & ELECTRIC, ) A CALIFORNIA CORPORATION, ROBERT ) 16 SUTTON, HOLLY SUTTON, RICHARD K. ) SHORES, and DOES I through XX; ) 17 Defendants ) 18 ) 19 Comes now, the Plaintiff, LINDA LIND HAGMAN, as Administrator 20 of the Estate of JAMES LEA HAGMAN, Deceased, and as a Second 21 Amendment to the Complaint previously filed herein, amends 22 paragraph 4 thereof to read as follows : 23 IV. The heirs at law of the Decedent pursuant to the 24 provisions of Code of Civil Procedure § 377 and their relation- 25 ship to the Decedent are : 26 WIU ARO E.STONE ' Attorney At Law SUITE 124 1211 NEWELL AVENUE WALNUT CREEK CALIF.94596 -1- 'alapnona;14151935.1711 1 NAME -`RELATIONSHIP TO DECEDENT 2 Virginia L. Hagman Daughter 3 Nicholas C. HagmanSon 4 Johnathan W. Hagman Son 5 Robert C. Hagman Father 6 Lois L. Hagman Mother 7 8 9 Dated: April 9, 1987 10 W- w WILLARD E. STONE, Attorney 11 for Plaintiff 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 WILLARD E.STONE Attorney Al Law SUITE 12. 1211 NEWELL AVENUE WALNUT CREEK —2— CALIF. 2— CALIi.94596 Tottpnone:14151975.1711 VERIFICATION 2 I , the undersigned, declare : ja 3+� _ That I am a party to th " fore oinS Proceeding that I have read the foregoing document and know the contents 5 thereof; that the same is true .of my own knowledge , except 6 for the matters set forth upon my information or belief, and •. 7 as to such matters that I believe to be true. " " 8 I declare under penalty of perjury that the foregoing 9 is true and correct. '.; 10 Executed on April 9, 1987 at Walnut Creek 11 California 12 13 14 15 Linda Lind Ha n ... - 16 F 17 �; 18 19 20 21 22 ' 23 24 :r.: . 25 26 M.RA ARD E$TONE- SURE/2a 1211'NEWELL AVENUE WALNUT GREEK i CALIF.9691 �•�•o�wir:�.1a�99s1�n - MAR 6 - 1987 1 WILLARD E. STONE Attorney at Law 2 1211- Newell Avenue Suite 124 3 Walnut Creek, CA. 94596 ' 4 (415) 935-1711 FEB 21487 5 Attorney for Plaintiff �. R OLSSON, •^,Dung Cle;k 6 aONM C=A Cd#= 7 K. HARTZ B SUPERIOR COURT OF CALIFORNIA 9 COUNTY OF CONTRA COSTA 10 LT NDA LIND HAGMAN, Administrator ) of the Estate of JAMES LEA HAGMAN, ) CASE NO. 294965 11 Deceased ) Plaintiff ) AMENDMENT TO COMPLAINT 12 ) 13 v ) 14 COUNTY OF CONTRA COSTA, PACIFIC ) BELL COMPANY, a CALIFORNIA CORP- ) 15 ORATION, PACIFIC GAS & ELECTRIC ) COMPANY, a CALIFORNIA CORPORATION, ) 16 ROBERT SUTTON, HOLLY SUTTON, ) RICHARD K. SHORES , and DOES I ) 17 through Defendants ) 18 ) 19 Comes now the Plaintiff, LINDA LIND HAGMAN and amends the 20 Complaint on file herein, by inserting in paragraph3 , page7 , line 17 21 DOES VI and VII in place of DOES I through III ; in paragraph 4 , 22 page 7 , lines 20-21 , DOES VI and VII in place of DOES IV through 23 V; in paragraph 5 , page 7 , line 25 , DOES VI and VII in place of 24 DOES IV and V; also in paragraph 5 , on page 8 , line 6 , DOES VI 25 and VII in place of DOES I through V; in paragraph 2 , on page 9 , 26 line 9 , DOES VI and VII in place of DOES I through V; in paragraph WIU ARO E.STONE Auo,nw Al law SUITE 124 1211 NEWELL AVENUE WALNUT CREEK CALIF.94596 -1- T*1p11one:14151 975.1)1 t 1 2, on page 9 , line 20, DOES VI and VII in place of DOES I through 2 V. 3 - Plaintiff further amends he Complaint herein by deleting 4 the existing line 26-1, pages 9 and 10 , and in place thereof 5 adding new paragraphs as follows : 6 WHEREFORE, Plaintiff prays judgment against the Defendants , 7 and each of them, as hereinafter set forth. 8 SIXTH CAUSE OF ACTION 9 (Strict Liability in Tort) 10 1. Plaintiff repleads , realleges and incorporates herein by 11 reference all of the allegations contained in the Fifth Cause of 12 Action as if the same were set forth in full. 13 2. Plaintiff is informed and believes , and based thereon 14 alleges that DOE X, is and at all times herein mentioned was , a ... 15 Corporation. Plaintiff will amend this Complaint_ when said 16 Defendants place of organization, existance and principal place 17 of business in this State is ascertained. 18 3 . Defendant DOE X , is and at all times herein mentioned 19 was , engaged in the business of designing , manufacturing and 20 assembling motor cycle helmets for sale to and use by members of 21 the general public, and as a part of its business , Defendant 22 designed, manufactured, and assembled the specific motorcycle �3 helmet hereinafter referred to . 24 4 . Defendant DOE XI is , and at all times herein mentioned 25 was , engaged in the business of selling at retail to members of 26 the general public the hereinabove described motorcyle helmet WILLARD E.STONES Attorney At Law SUITE 124 121,1 NEWELL AVENUE —2— WALNUT 2—WALNUT CREEK CALIF.94596 Telephone:141St 935.1111 I manufactured designed and assembled- by Defendant DOE X. 2 5. Defendant DOE X . intended that the motorcycle helmet 3 manufactured, designed and assembled by it be used as protective 4 head gear in the event of a motorcycle accident . . 5 - 6. At all times herein mentioned, the Defendant knew and 6 intended that its motorcycle helmet would be purchased by members 7 of the public and used by the purchasers and others without in- 8 spection for defects . 9 7 . Plaintiff is informed and believes and thereon alleges 10 that Defendants RICHARD K. SHORES , ROBERT R. SUTTON, HOLLY SUTTON 11 and DOES VI and VII purchased the defective motorcycle helmet 12 as described herein from DOE XI at his place of business herein- 13 above described. 14 8. The motorcycle helmet was , at the time purchased as herein 15 alleged, defective and unsafe for its intended purpose in that 16 said motorcycle helmet failed to protect the Decedent, JAMES LEA 17 HAGMAN, from receiving serious head injuries . 18 9 . On or about May 3 , 1986, the Decedent was using the 19 motorcycle helmet while riding the above described motorcycle on 20 Marsh Creek Road for the purpose of protective head gear. During 21 the course of this use and as a proximate result of the defects 22. hereinabove described, the helmet shattered upon impact when the 23 Decedent was thrown from his motorcycle as described hereinabove. 24 10. Plaintiff is informed .and believes and thereon alleges 25 that the Defendant knew that the motorcycle helmet manufactured, 26 designed and assembled by it was defective and dangerous in the W HAMD E.STONE Atlomey At Law ' SUITE 124 1211 NEWELL AVENUE —3— WALNUT CAECK 3— WALNUTCAEEK CALIF.94596 T*§"hoM:14151936-17 11 1 manner alleged hereinabove; that Defendant knew that because of 2 the defects , the motorcycle helmet could not safely be used for 3 the- purpose for which it was Mended; that Defendant , knowing ten.}:.._. . 4 that the motorcycle helmets were defective and dangerous , in S conscious disregard of the safety of the public placed them on 6 the market (without warning customers or the unknowing public of 7 the defect) , and knew when it did so that they would be sold to 8 and used by the general public without inspection for defects ; 9 that Defendant , by placing the defective motorcycle helmets on 10 the market , impliedly represented that they were safe for the 11 purpose for which they were intended; and that Defendant , by placi 12 them on the market and otherwise representing them as able to per- 13 form safely, intended that customers and the unknowing public 14 should rely on its representations . The Decedent , in using the 15 Idefective motorcycle helmet as herein alleged, did rely on the 16 Defendants representations , all to his damage as hereinabove 17 alleged. In doing the things aforementioned, Defendant was guilty 18 of malice, oppression, and fraud and Plaintiff is therefore en- 19 titled to recovery exemplary or punitive damages in an amount in 20 excess of the minimum jurisdiction of this court . 21 WHEREFORE, Plaintiff prays judgment against the Defendants , 22 and each of them, as follows : 23 1 . For general damages in an amount in excess of the 24 minimum jurisdiction of this court ; 1 25 2. For medical and incidental expenses according to proof; 26 .. 3 . For loss of income according to proof; MALLARD E.STONE. Attorn"Al Low , SUITE 124 1211 NEWELL AVENUE —4— WALNUT 4—WALNUT GREEK CALIF.94595 Te"hone:IA 1 SI 973.1711 1 4 . For funeral and burial expenses for LINDA LIND HAGMAN, 2 Decedent ' s Personal Representative, in an amount according to 3 Proof; 4 5. . As against Defendants RICHARD K. SHORES , ROBERT R. SUTTON, 5 HOLLY J. SUTTON and DOES VI and VII, punitive and exemplary 6 damages in the sum of Two Hundred Fifty Thousand ($250 , 000) 7 Dollars ; 8 6. As against Defendants DOES X and XI, punitive and 9 exemplary damages in an amount in excess of the minimum jurisdicti n 10 of this court ; 11 7 . For costs of suit herein incurred; and 12 8. For such other and further relief as the court may deem 13 proper. 14 15 Dated: January 7 , 1987 . 16 17 ILLARD E. STONE, Attorney 18 for Plaintiff 19 20 21 22 23 24 25 26 WIU AND E.STONE Afloo"At Law SUITE 124 1211 NEWELL AVENUE WALNUT GREEK CALIF.94596 rvpnone:(4151935.1 "1 I VERIFICATION 2 I , the undersigned, declare : 3 That I am a party to the foregoing proceeding ; that 4 I have read the foregoing document and know the contents 5 thereof; that the same is true of my own knowledge , except 6 for the matters set forth upon my information or belief , and 7 as to such matters that I believe to be true . 8 I declare under penalty of perjury that the foregoing 9 is true and correct. 10 Executed on January 28 , 1987 at Walnut Creek 11 California 12 13 14 15 LINDA LIND HAGMA�) 16 17 18 19 20 21 22 23 24 25 26 WILLARD E.STONE• ANomay At Law ' SUITE 121 1211 NEWELL AVENUE WALNUT CREEK CALIF.91596 TNpnoM:11151975 1711 1 WILLARD E. STONE MAR 6 - 1987 Attorney at Law LFCAL ; 2 1211 Newell Avenue Suite-.124 3 Walnut Creek, CA. 94596 - " 4 (415) 935-1711 5 Attorney for Plaintiff 6 7 8 SUPERIOR COURT OF CALIFORNIA 9 COUNTY OF CONTRA COSTA 10 LINDA LIND HAGMAN, ) 2 94 J Administrator of ) CASE NO . 11 the Estate of ) JAMES LEA HAGMAN, ) 12 Deceased, ) COMPLAINT FOR DAMAGES FOR Plaintiff, ) WRONGFUL DEATH AND FOR 13 ) PERSONAL INJURIES 14 v ) 15 COUNTY OF CONTRA COSTA, ) PACIFIC. BELL COMPANY, a ) 16 CALIFORNIA CORPORATION, ) PACIFIC GAS & ELECTRIC ) 17 COMPANY, a CALIFORNIA ) CORPORATION, ROBERT SUTTON, ) 18 HOLLY SUTTON, RICHARD K. SHORES , ) and DOES I through XX, ) 19 Defendants ) 20 ) 21 Plaintiff complains , of Defendants , and each of them, and 22 alleges as follows : 23 FIRST CAUSE OF ACTION 24 (WRONGFUL DEATH) 25 1. On or about November 2-0, 1986, Plaintiff was issued 26 Letters of Administration of the Estate of JAMES LEA HAGMAN, WARD E.STONE Alloway Al law SUITE 124 III NEWELL AVENUE —1— WALNUT GREEK CALIF.94596 gnoM;441S)935.1711 I Deceased, by the Superior Court of California, County of Contra 2 Costa. 3 2. Plaintiff is the duly afVc�inted, qualified, and acting 4 Personal Representative of the Estate of JAMES LEA HAGMAN, Deceasec . 5 3. Plaintiff brings this action as specified in §377 (b) of 6 the Code of Civil Procedure on behalf of the surviving heirs of 7 JAMES LEA HAGMAN, Deceased (hereinafter referred to as "Decedent") 8 4 . The heirs at law of the Decedent and their relationships 9 to the Decedent are : 10 NAME RELATIONSHIP TO DECEDENT 11 Virginia L. Hagman Daughter 12 Nicholas C. Hagman Son 13 Johnathan W. Hagman Son 14 Robert C. Hagman Father 15 Lois L. Hagman Mother 16 Jeanine Cormany Sister 17 Daunine Vining Sister 18 Gerald Hagman Brother 19 Nancy Hagman Sister 20 5 . The Plaintiff does not know the true names or capacities 21 of the Defendants sued herein as DOES I through XX; that said 22 names are fictitious names and Plaintiff will amend this Complaint 23 to show their true names when ascertained. Plaintiff is informed 24 and believes and on information and belief alleges that each of 25 the Defendants named herein as DOES I through XX, inclusive , is 26 an agent and employee of the other named Defendants ; that in doing iLLARO E.STONE Attorney At Low SUITE Q4 III NEWELL AVENUE —2- WALNUT CAEEK 2- WALNUTCAEEK CALIF.94596 peons:H t SI 935.1711 I the things mentioned hereinafter in this Complaint each was acting 2 within the scope of his employment as agent and employee ; that 3 each is responsible in some manner for the occurances hereinafter 4 alleged; that Plaintiff' s damages as hereinafter alleged were 5 proximately caused by the negligence or actions of each of said 6 Defendants . 7 6. That at all times herein mentioned, the Defendant , COUNTY 8 OF CONTRA COSTA, was a County and political subdivision of the 9 State of California, duly organized and existing under the laws 10 of the State of California. 11 7 . Defendant , PACIFIC BELL COMPANY, is and at all times here- 12 in mentioned was , a Corporation, organized and existing under the 13 laws of the State of California and doing business in the County IJ 14 of Contra Costa. 15 8. Defendant, PACIFIC GAS & ELECTRIC COMPANY, is and at all 16 times herein mentioned was , a Corporation, organized and existing r 17 under the laws of the State of California and doing business 18 in the County of Contra Costa. 19 9. On May 3 , 1986, and prior thereto, Defendants CONTRA 20 COSTA COUNTY and DOES I through V, designed, constructed, owned, 21 maintained and controlled Marsh Creek Road, 1 . 4 miles west of 22 Deer Valley Road in the County of Contra Costa. 231 10. On the above mentioned date , and prior thereo, the 241 Defendants , PACIFIC BELL COMPANY ( PAC BELL) and PACIFIC GAS & 25 ELECTRIC COMPANY (PG&E) constructed, owned_ , maintained and ` 26 controlled a telephone and power utility pole immediately adjacent TAU ARO E.STONE. �+ -- Att9rMT At Low SUITE 124 1211 NEWELL AVENUE -3- WALNUT 3-WALNUT CREEK CALIF.94596 UMWIOM:(41S193S1)11 1 to the roadway on Marsh Creek Road as described above . 2 11. On May 3, 1986, and prior thereto, the above described 3 roadway, owned, maintained ank- trolled by CONTRA COSTA COUNTY, 4 was in an unsafe and dangerous condition, that created a sub- 5 stantial risk of the type of injury hereinafter alleged when said t, . 6 roadway and curve there upon, was used with due care in a manner 7 that it was reasonably foreseeable that it would be used in that 8 said roadway and curve was unsafe and improperly designed and 9 constructed. Further, Defendant , CONTRA COSTA COUNTY, allowed 10 to be erected in dangerous proximity to said roadway by Defendants 11 PAC BELL and P G & E; a telephone and power utility pole so close U121 to the roadway as to constitute a hazardous and dangerous ,13 condition to motorists attempting to negotiate said roadway and 14 curve at the speed limit posted just before said roadway and curve 15 12. The Defendants had actual knowledge of the existance of 16 the above described conditions and knew or should have known 17 of their dangerous character a sufficient time prior to May 3 , V t 18 1986, to have taken measures to protect against the dangerous 19 conditions . 20 �- 13 . On May 3, 1986, Decedent was driving a motorcycle in 21 a westerly direction on Marsh Creek Road, approximately 1 . 4 22 miles west of its intersection with Deer Creek Road. As a 23 proximate result of the dangerous condition of the roadway and Decedent 24 curve, and placement of said utility pole , when the/ entered the - 25 turn, his motorcycle went off the roadway and turn, part of the 26 motorcycle foot peg striking said utility pole , causing the W"RP E.STONE Attomay At Law SUITE 1=4 ttI NEWELL AVENUE —(— WALNUT GREEK CALIF.94596 opnoet:14151935-17 11 1 Decedent and motorcycle to fall down the nearby enbankment , 2 causing the death of the Decedent, on June 25 , 1986 . 3 14 . Prior to the death of.r-tie Decedent, the heirs were 1 � 4 dependent on him for their support and maintenance. and Decedent 5 was a faithful and dutiful father, son and brother to the heirs . 6 15. As a proximate result of the dangerous condition of 7 Defendant ' s property, and the death of the Decedent , Plaintiff 8 Las sustained pecuniary loss resulting from the loss of the . 9 society, comfort, attention, services and suport of Decedent in 10 an amount in excess of the minimum jurisdictional requirement of 11 this court. 12 16. As a further proximate result of the dangerous condition �3 of Defendant ' s property, and the death of Decedent, Plaintiff 14 LINDA LIND HAGMAN, has incurred funeral and burial expenses in 15 an amount unknown at this time . Leave of court will be sought 16 to amend this Complaint according to proof. 17 17 . That on or about August 22, 1986 , prior to the commence- 18 Iment of this action, Plaintiff caused to be presented to the 19 Defendant, COUNTY OF CONTRA COSTA, a claim for damages sought in 20 this action in the amount of Five Hundred Thousand ($500, 000) 21 Dollars . ' A true and correct copy of the claim is attached hereto , 22 marked Exhibit "A" and incorporated herein by reference . 23 18. That on or about August 25 , 1986 , the Board of Supervisors 24 of Contra Costa County rejected said claim in full . 25 WHEREFORE, Plaintiff prays judgment against the Defendants 26 WW ARD E.ST0NE A1to.Aory At Law SUITE 174 5— 1211 NEWELL AVENUE WALNUT GREEK CALIF.94596 telWoM:14151975.1711 1 and each of them, as hereinafter set. forth. 2 SECOND CAUSE OF ACTION 3 (PERSONAL diJRY) 4 1. Plaintiff repleads , realleges and incorporates herein by ( 5 reference all of the allegations contained in the First Cause of ` 6 Action as if the same were set forth ' in full. l 7 2. On June 25 , 1986, after the foregoing cause of action 8 arose in his favor on May 3, 1986, JAMES LEA HAGMAN, Decedent who 1 I 9 would have been the Plaintiff in this action if he lived, died. 10 1 . 3 . As a proximate result of the negligence of the Defendants 11 and each of them, the Decedent was required to and did employ 12 physicians and surgeons to examine,treat and care for him, and 'y' _ 13 did incur medical and incidental expenses in an amount unknown at 14 this time but in excess of the minimum jurisdiction of this 15 court. 16 4. At the time of the events described herein, Decedent was 17 gainfully employed as a traffic signal electrician for the City 18 of Concord. As a further proximate result of the negligence of + 19 the Defendants , and each of them, the Decedent was prevented from 20 attending to his usual occupation for the period of time from 21 May 3 , 1.986, until his death on June 25 , 1986, all to his damage 22 in loss of earnings in an amount unknown to the Plaintiff at this 23 time, to be ascertained according to proof. 24 5. That on or about June 5 , 1986 , prior to the commencement 25 of this action, Plaintiff caused to be presented to the Defendant , r- 26 COUNTY OF CONTRA COSTA, a claim for damages sought in this action vnU ARD E.STONE Attam"At Law SUITE 124 1211 NEWELL AVENUE —6- WALNUT 6WALNUT CREEK CALIF.94596 Tatapnona:l4 t S19]S•t l t t 1 in the amount of Five Hundred Thousand ($500, 000) Dollars . A true 2 and correct copy of the claim is attached hereto marked Exhibit 3 "B11 ---and incorporated herein by,�eference. 4 6. That on or about July 8, 1986, the Board of Supervisors 5 of Contra Costa County rejected said claim in full. 6 WHEREFORE, Plaintiff prays judgment against the Defendants , 7 and each of them, as hereinafter set forth. 8 THIRD CAUSE OF ACTION 9 (WRONGFUL DEATH AS TO DEFENDANT RICHARD K. SHORES , 10 ROBERT R. SUTTON AND HOLLY SUTTON) 11 1. Plaintiff repleads , realleges and incorporates herein by 12 reference all of the allegations contained in the First Cause of 13 Action as though set forth in full. 14 1 2. At all times herein mentioned, the Defendants RICHARD K. 15 SHORES and DOES I through III, were and now are the owners of the 16 motorcycle hereinafter described. 17 3. Defendants RICHARD K. SHORES and DOES I through III , gave, 18 loaned or sold to Defendants ROBERT R. SUTTON and HOLLY J. SUTTON, 19 said motorcycle. 20 4. Defendants ROBERT R. SUTTON, HOLLY J. SUTTON and DOES IV 21 through V are the agents , servants and employess of the Defendant 22 RICHARD K. SHORES, and at all times herein mentioned were acting 23 within the scope and purpose of their agency and employment . 24 5. On or about May 3 , 1986, Defendants ROBERT R. SUTTON, 25 HOLLY J. SUTTON and DOES IV through V, did loan, rent, sell or 26 give to Decedent JAMES LEA RAGMAN, a certain 1975 360 motorcycle , . WIU ARO E.STONE Allom"At Low ' SUITE 124 1211 NEWELL AVENUE WALNUT CREEK CALIF.INS% Te6whow.01 S193S•1?11 I California license number 3M2705, for. the purpose of operating 2 said motorcycle on the public streets and highways of California, 3 and thereafter the Decedent, JAS - LEA HAGMAN, did operate that 4 motorcycle with the knowledge, consent and permission of the 5 Defendants , RICHARD K. SHORES, ROBERT R. SUTTON, HOLLY J. SUTTON 6 and DOES I through V. 7 6. Said Defendants knew that the motorcycle was in a 8 dangerous and defective condition and unfit to be operated on 9 the public streets and highways in that the front tire was bald 10 and the front brake was defective, and Defendants knowlingly 11 permitted the motorcycle so equipped to be placed and operated on 12 the public streets and highways of California and including 13 Marsh Creek, Road, as herein mentioned. 14 7 . On May 3, 1986, the Decedent was driving said motorcycle 15 in a westerly direction on Marsh Creek Road, approximately 1. 4 16 miles west of its intersection with Deer Creek Road. As a proximat 17 result of the dangerous and defective condition of the motor- 18 cycle as aforesaid and the negligence of the Defendants , and 19 each of them, the motorcycle went off the roadway and the foot 20 peg struck the described utility pole , causing the Decedent and 21 motorcycle to overturn and to proceed down an embankment , causing 22 severe injury and brain damage, which resulted in the death of 23 the Decedent on June 25 , 1986. 24 WHEREFORE, Plaintiff prays judgment against the Defendants , 25 and each of them, as hereinafter set forth. 26 VIVA ARO E.STONE - Mos wV At Law SUITE 124 1211 NEWELL AVENUE WALNUT CAEEK CAUF.94596 ~*no'14151935.1711 1 FOURTH CAUSE OF ACTION 2 (PERSONAL INJURY AS TO- DEFENDANTS 3 RICHARD K. SHORES , ROBERT R.r--`S9UTTON AND HOLLY SUTTON) 4 1. The Plaintiff repleads , realleges and incorporates herein 5 by reference paragraphs one through four of the Second Cause of 6 Action and all of the allegations contained in the Third Cause 7 of Action as if the same were set forth in full. g 2. On or about May 3, 1986, Defendants RICHARD K. SHORES , 9 ROBERT R. SUTTON, HOLLY J. SUTTON and DOES I through V owned, 10 maintained, controlled and managed said above described motorcycl . 11 WHEREFORE, Plaintiff prays judgment against the Defendants , 12 and each of them, as hereinafter set forth. 13 FIFTH CAUSE OF ACTION 14 (EXEMPLARY DAMAGES AS TO DEFENDANTS 15 RICHARD K. SHORES , ROBBERT R. SUTTON AND HOLLY J. SUTTON) 16 1. Plaintiff repleads , realleges and incorporates herein 17 by reference all of the allegations contained in the Fourth Cause 1S of Action as though set forth in full. 19 2. That in doing .the acts herein alleged, Defendants RICHARD 20 K. SHORES , ROBERT R. SUTTON, HOLLY J. SUTTON and DOES I through V 21 and each of them, acted with oppression, fraud, malice and in 22 conscious disregard of the rights and safety of the Decedent, 23 JAMES LEA HAGMAN, and based thereon the Plaintiff is entitled to 24 1punitive and exemplary damages in the sum of Two Hundred Fifty 25 Thousand ($250, 000) Dollars . 26 WHEREFORE, Plaintiff prays judgment against the Defendants U"00 E.STONE Altainey Al law SUM 124 !11 NEWELL AVENUE WALNUT GREEK CAL0.945W -9- IOItOM:Nt S19]S•t l t 1 I and each of them, as follows : 2 1. For general damages in an amount in excess of the 3 minimum jurisdiction of this cdVrt; 4 2. For medical and incidental expenses according to proof; 5 3. For loss of income according to proof; 6 4. For funeral and burial expenses for LINDA LINDA HAGMAN, 7 Decedent' s Personal Representative , in an amount according to 8 proof; 9 5. As against Defendants RICHARD K. SHORES , ROBERT R. SUTTON, 10 MOLLY J. SUTTON and DOES I through V, punitive and exemplary 11 damages in the sum of Two Hundred Fifty Thousand ($250, 000)Dollars 12 6. For costs of suit herein incurred; and 13 7 . For such other and further relief as the court may deem 14 proper. 15 16 Dated: December 1986 17 4 18 WILLARD E. STONE, Attorney 19 Plaintiff 20 21 22 23 24 25 26 VALL,ARD E.STONE- A110moy At Low StNTE 124 1211 NEWELL AVENUE WALNUT CREEK CALIF.94596 T~One: -10- I VERIFICATION 2 1 , the undersigned, declare:' 3 That I- am a party to th .foregoing proceeding ; that I have read the foregoing document and know the contents 5 thereof; that the same is true of my own knowledge , except 6 for the matters set forth upon my information or belief , and 7 as to such matters that I believe to be true. 8 I declare under penalty of perjury that the foregoing 9 is true and correct . 10 Executed on December 16 1986 at Walnut Creek 11 California 12 13 14 15 LINDA LIND HAIL 16 17 18 19 20 21 22 23 24 25 26 WILLARD E.STONE AUOM*y Al law SURE 124 1211 NEWELL AVENUE WALNUT CREEK CALIF.M596 'alaynotia:1s16192517 t7 e M ru Cal9fomla 94553 A. Claimg relating tL, causes of action for deat._ or or-Irn jury 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 his form. RE: by LINDA LIND HAGMAN on )Reserve i in stamps behaIT-of VIRGINIA L.HAGMAN, NI&HOLAST , C. HAGMAN and JONATHAN W. HAGMAN min o s gF'CEIVra and a ami y members an heirs o S L. HAGMAN, Deceased. jand on behalf of t) e o% 1SE� est AU G Against the COUNTY OF CONTRA COSTA) LeLOR�LSOi1S or DISTRICT) a AR S •Dow" (Fillin name ) dy . The• undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 500, 000 and in support of this claim represents as follows: r��e e�e e e e—e e e e e------ee e -----e ee e ee e ee e e e e ee e e ee e e�eee e e e ee I. When did the damage or Injury occur? JGive e exact date and hour] The injury to James Hagman occurred on May 3, 1986, at approximately . 6:50 p.m. Mr. Hagman died from the injuries on .June 25, 1986. r..e e.. Te a .e.eee.s.eeTeTeee�eeeeee..eeeeeeeeereeeeeeee�ee�e�e�.e.ee �. W�iere aid the damage or in3ury occur? (Include city and county) On Marsh Creek Road, 1. 4 miles west of Deer Valley Road, an un- incorporated area of Contra Costa County. �T���e�e�e a ee eee --------ee.s------------..e�e�e e e T• e e��e��e ee a ee 3. Bow did the damage or injury occur? (Giveul� details, use extra sheets if required) As Mr. Hagman made a turn on Marsh Creek on a motor- cycle, he went off of the roadway onto the gravel shoulder where his motorcycle foot peg struck a utility pole causing the motorcycle to flip over, injuring Mr. Hagman so as to cause his death. 4. ----=--------------------�--��-------------------------T---a----- iilhat particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? The place of the utility pole was so close to the roadway so as to constitute a danger .and hazard to the motorists and motorcyclists travelling said road and making the left turn in a west bound direction. (over) EXHIBIT " A" Unknown at this tir- �. W�iat 8amage or �n�uries do you clam resu�te�? ZGive full extent of injuries or damages claimed. Attach two estimates fo a damage) Mr. Hagman suffered from massive brain injury including brain contusion, basilar skull fracture and brainstem damage. He died on J e 225, 19 6. Claim is a serted for da�mages o behalf of the Decedent and or r o su ort comort and soc-iet to t e heirs • __ ----------291-----�---L------------------Y------------------------ 7. Now was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) Unknown at this time. ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Doctor: Glenn Lee, M.D. Witnesses : Robert & Holly Sutton Kaiser Hospital 1825 Manzanita Dr. 1425 Main Street Concord, CA. 94519 Walnut Creek, CA. 94596 �. L�sttt�ie expenditures you made on account of this accident or injury: ':DATE ' _ ` : ITEM _ AMOUNT May 3, 1986 Delta Memori4� Hospital - unknown May 3;, 1986 Emergency Medical Care to May 14, 1986 John Muir Hospital unknown May 14, 1986 . ongoing Kaiser Hospital medical care until June 25 , 1986 Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorne ) or by some rson n his behalf. " .dame and Address of Attorney WILLARD E. STONE Claimant Sig tune 1211 Newell Ave, Suite 124 1166 Santa Lucia Drive Walnut Creek, CA. 94596 Address Pleasant Hill, CA. 94523 Telephone No. (415) 935-1711 Telephone No. (415) 686-2711 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. • 1 LILA a"LL%il Vlla LV ..Lai 'L`�""'^••• •••o••••••••• > Mrtinez Calitomla 944 Claims A. relating .,o causes of action for dea.,.h or for injury to person or to personal property orgrowing 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-tKiis form. s:t*+t�f:,rift•:�*�*r��r::s*t:::*�t::��t,r:*������ee�,rf:*�:*�*:t:*::�*:�:.•*::: RE: Claim by )Reserved.4or 1 ;r 's fi] 'ng stamps LINDA LIND HAGMAN ) ' DECEIVED Conservator of JAMES LEA HAGM* Against the COUNTY OF CONTRA COSTA)) JUN 4 19M I,cup /v%. or DISTRICT) FM/ATCM0: _Fi n name IUK. .n of!IT- :'C ttiCO G .. , The' undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 500 , 000. 00 and in support of this claim represents as follows: �. When did the damage orn3ury occur? Give exact date and hour] May 3, 1986 at approximately 6: 50 p.m. -- --� T- - -�.- -- ----T-T---• ------ -------- -------- ----------- W�iere did tie damage or injury occur? (Include city and county) On Marsh Creek Road, 1. 4 miles west of Deer Valley Road, an unincorporated area of Contra Costa County -+--------------------------.r------------ ---- - --T -------------- 3. How did the damage or in ury occur? Give ul�-details us extra sheets if required) As Mr. Hagman made a turn on Mari treet on a motorcycle, he went off of the roadway onto the gravel shoulder where his motorcycle foot peg struck a utility pole causing the motorcycle to flip over, injuring Mr. Hagman severely. 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? The placement of the utility pole was so close to the roadwav , so as to constitute a danger and hazard to' motorists and motor- cyclists travelling said road and making the left turn in a west bound direction (over) EXHIBIT " B " S. . .wnat are the nameS,-�I county or alstricL ui tL-L%- ,.L b, a C l vcu'L A-A, A. employees causing ie damage or injury? • Unknown at this time �. Wiat damage or �n3uries do you claim resulted? Give full extent of injuries or damages claimed. Attach two estimates fc'ram+-n damage) Mr. Hagman suffers from maspi' a brain injury including brain contusion, basilar skull fracture'" d brain stem damage. He has been in a coma since the date of the accident. ------------L-------------------------------------------------------- 7. Eow was the amount claimed above computed? (Include the estimate amount of any prospective injury or damage. ) Unknown at this time �. Names-and addresses of witnesses, doctors and --------------- Doctor: - Doctor: Dr. Glenn Lee, M.D. Witnesses : Robert & Holly Sutton Kaiser Hospital 1825 ,Manzanita Dr. 1425 Main St Concord, CA. 94519 Walnut Creek, CA. 94596 �. Lit .the-.expencla,tures you made on account of this accident or ink ury s r DATE ITEM AMOUNT May. t,=86 = Delta Memoriaf ospital unTcnown May 3, 1986, Emergency Medical Care to May14 , 1986 John Muir Hospital unknown Medical Care Kay 14 , 1986 ongoing Kaiser Hospital Medical Care unknown Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or/-by- some -persoA on his behalf. " Name and Address of Attorney WILLARD E. STONE Claimant s Si nature Santa Tucl- 1211 Newell Ave, Suite 124 Address Walnut Creek, CA. 94596 .Pleasant Hill . CA. 94523 Telephone No. (415) 935-1711 Telephone No. (415) 686-2711 NOTICE Section 72 of the Penal Code provides: 'Every person who, with intent to defraud, presents f'or 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 County Counsel Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT JUL40M718 , 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 cla imigzp" 6Krvisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PACIFIC BELL, A CALIFORNIA COPORATION 140 New Montgomery Street ATTORNEY: San Francisco, CA 94105 Date received July 20, 1987 ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED:July 17 , 1987 Certified P 453 589 719 I. FROM: Clerk of the JIoard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 23 , 1987 EVIL BATCHELOR, Clerk 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: 74' BY: eput'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 entered in its minutes for this date. AUG 181997 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: AUG 2 0 1987 BY: PHIL BATCHELOR by � De ut Clerk Deputy CC: County Counsel County Administrator Legal De Mliarn 140 New Montgomery Street,Eleventh Floor PACIFICI:IBELL. San Francisco,California 94105 Writer's Direct Number 415-542-2572 A Pacific Telesis Company 17 July 1987 Clerk of the Board of Supervisors County Administration Building, Room 106 651 Pine Street, Martinez, CA 94553 Re: Claim for Indemnification/Contribution Pacific Bell, a California corporation, presents a claim for damages against the County of Contra Costa as provided in Government Code Section 900 et seg. Date of Claim: July 17, 1987 Claimant 's Address: Pacific Bell 140 New Montgomery Street San Francisco, California 94105 All notices or correspondence concerning this claim should be sent to counsel for claimaint: Margaret E. Garber, Esq. Pacific Bell Legal Department Suite 1126 140 New Montgomery Street San Francisco, California 94105 Clerk of the Board of Supervisors:' Claim by Pacific Bell, a California corporation V 190 Re: Hagman v. County of Contra Costa, et al 17 July 1987 o� Page Two Asim: On or about April 9, 1987 , Claimant has been served with with the Second Amended Complaint in the case of Linda Hagman, Administrator of the Estate of James Lea Hagman v. County of Contra Costa, et al, filed in the Superior Court of California for Contra Costa County, Case No. 294965 (see attached copy of Complaint which is hereby incorporated as an integral part of this claim) . The complaint alleges that on or about May 3, 1986, the plaintiff 's decedent was involved in a single vehicle accident while driving a motorcycle in a westerly direction on Marsh Creek Road, approximately 1 .4 miles est of its intersection with Deer Creek Road. Claimant has been named as a defendant in said Superior court action. The complaint alleges, inter alia. that the road was improperly constructed and maintained, thereby resulting in the decedent loosing control of his vehicle. Plaintiff further alleges that the County improperly permitted the claimant, Pacific Bell, to maintain a telephone pole in close proximity to the road. Claimant contends that the County of Contra Costa is wholly or partially responsible for the injuries complained of in 2 Clerk of the Board of Supervisorsr!! ::- Claim by Pacific Bell, a CalifornIA corporation Re: Hagman v. County of Contra Costa, et al 17 July 1987 Page Three that plaintiff alleges that the County negligently constructed, repaired and/or maintained the road. Claimant contends that in the event it is found in some manner responsible to plaintiff or to anyone in said Superior Court complaint, that this claimant 's liability would solely be based upon a derivative form of liability not resulting from the conduct of the claimant but only an obligation imposed upon it by law and therefore said claimant would be entitled to total and complete indemnity from the County of Contra Costa. As a result of the above set forth claim, the County of Contra Costa is obligated to indemnify claimant wholly or on a comparative fault basis, for all sums claimant may be compelled to pay as .a' result of any damages, judgment or other awards recovered in said Superior Court action, and to reimburse claimant for necessary and reasonable attorney's fees and costs 3 r Y Clerk of the Board of Supervisors,--r:. Claim by Pacific Bell, a California corporation Re: Hagman v. County of Contra Costa, et al 17 July 1987 incurred and paid by claimant in defending said Superior court action. The claim against the County of Contra Costa by claimant is a demand by claimant upon County of Contra Costa to affirmatively assume said obligations. The precise dollar amount attributable to the assumption of said obligations is unknown at the present time. By Mar et E G rber , Attorney fo laimant Pacific Bell 415-542-2237 4 1 WILLARD E. STONE Attorney at Law 2 1211 Newell Avenue Suite 124 - 3 Walnut Creek, CA. 94596 4 (415) 935-1711 5 Attorney for Plaintiff 6 7 8 SUPERIOR COURT OF CALFIORNIA 9 COUNTY OF CONTRA COSTA 10 LINDA LIND HAGMAN, Administrator ) for the Estate of JAMES LEA HAGMAN, ) CASE NO. 294965 11 Deceased, ) Plaintiff ) SECOND AMENDMENT 12 )TO COMPLAINT 13 v ) 14 COUNTY OF CONTRA COSTA, PACIFIC ) BELL COMPANY, A CALIFORNIA ) 15 CORPORATION, PACIFIC GAS & ELECTRIC, ) A CALIFORNIA CORPORATION, ROBERT ) 16 SUTTON, HOLLY SUTTON, RICHARD K. ) SHORES , and DOES I through XX, ) 17 Defendants ) 18 ) 19 Comes now, the Plaintiff, LINDA LIND HAGMAN, as Administrator 20 of the Estate of JAMES LEA HAGMAN, Deceased, and as a Second •21 Amendment to the Complaint previously filed herein, amends 22 paragraph 4 thereof to read as follows : 23 IV. The heirs at law of the Decedent pursuant to the 24 provisions of Code of Civil Procedure § 377 and their relation- 25 ship to the Decedent are : 26 WI`LARO E.STONE ' Attorney At Law SUITE 124 1211 NEWELL AVENUE WALNUT CREEK CALIF.94596 -1- Talapnona:IK1SI935.1711 i 1 NAME ' RELATIONSHIP TO DECEDENT 2 Virginia L. Hagman Daughter 3 Nicholas C. Hagman Son 4 Johnathan W. Hagman Son 5 Robert C. Hagman Father 6 Lois L. Hagman Mother 7 8 9 Dated: April 9, 1987 , 10 19ILLARD E. STONE, Attorney 11 for Plaintiff 12 13 - 14 15 16 17 18 19 20 21 22 23 24 25 26 WM AND E.STONE Attorney At Law SUITE 120 1211 NEWELL AVENUE WALNUT CREEL( —2— CALIF. 2— CALIi.94596 yet"hane:4415193S.1711 'VERIFICATION �-` 2 1 , the undersigned, declare : . That I am a party to the: foregoing proceeding; that 3 3 4 I have read the foregoing document and know the contents 5 thereof; that the same is true .of my own knowledge , except 6 for the matters set forth upon my information or belief, and ��.i... 7 as to such matters that I believe. to be true. 8 I declare under penalty of perjury that the foregoing 9 is true and correct. ,. 10 Executed on April 9, 1987 at Walnut Creek 11 California 12 13 14 . 15 Linda Lind Hagian 16 17 t: 19 [+. .., 20 21 22 23 24 25 26 ilOi.i. M E.NOME- A060"AS Law tuffs 124 , 1211 Nt*UL AVENUE WAUWf CREEK C/Wf.NSM M+IIOIU: 1'111 -- 1 CCE/ .: MAR g - 1981 1 WILLARD E. STONE l.EygL Attorney at Law . 2 1211 Newell Avenue Suite 124 3 Walnut Creek, CA. 94596 1 L E 4 (415) 935-1711 F E R 2 14R7 S Attorney for Plaintiff 7 K. HARTZ 8 SUPERIOR COURT OF CALIFORNIA 9 COUNTY OF CONTRA COSTA 10 ILIINDA LIND HAGMAN, Administrator ) of the Estate of JAMES LEA HAGMAN, ) CASE NO. 294965 11 Deceased ) Plaintiff ) AMENDMENT TO COMPLAINT 12 ) 13 v ) 14 COUNTY OF CONTRA COSTA, PACIFIC ) BELL COMPANY, a CALIFORNIA CORP- ) 15 ORATION, PACIFIC GAS & ELECTRIC ) COMPANY, a CALIFORNIA CORPORATION, ) 16 ROBERT SUTTON, HOLLY SUTTON, ) RICHARD K. SHORES , and DOES I ) 17 through Defendants ) 18 ) 19 Comes now the Plaintiff, LINDA LIPID HAGMAN and amends the 20 Complaint on file herein, by inserting in paragraph3 , page7 , line 17 21 DOES VI and VII in place of DOES I through III ; in paragraph 4 , 22 page 7, lines 20-21, DOES VI and VII in place of DOES IV through 23 V; in paragraph 5 , page 7 , line 25, DOES VI and VII in place of 24 DOES IV and V; also in paragraph 5 , on page 8 , line 6, DOES VI 25 and VIZ in place of DOES I through V; in paragraph 2 , on page 9 , 26 line 9, DOES VI and VII in place of DOES I through V; in paragraph WH"RO E.STONE AIIOeAIV At La- SUITE 124 1211 NEWELL AVENUE WALNUT CREEK CALIi.945% -1- 1~one:1N151975.1711 1 2, on page 9 , line 20 , DOES VI and. 'VII in place of DOES I through 2 V. 3 Plaintiff further amends,.. e Complaint herein by deleting 4 the existing line 26-1, pages 9 and 10, and in place thereof 5 adding new paragraphs as follows : 6 WHEREFORE, Plaintiff prays judgment against the Defendants , 7 and each of them, as hereinafter set forth. 8 SIXTH CAUSE OF ACTION 9 (Strict Liability in Tort) 10 1. Plaintiff repleads , realleges and incorporates herein by 11 reference all of the allegations contained in the Fifth Cause of 12 Action as if the same were set forth in full. 13 1 2. Plaintiff is informed and believes , and based thereon 14 alleges that DOE X, is and at all times herein mentioned was , a _.. 15 Corporation. Plaintiff will amend this Complaint when said 16 Defendants place of organization, existance and principal place 17 of business in this State is ascertained. 18 3 . Defendant DOE X , is and at all times herein mentioned 19 was , engaged in the business of designing , manufacturing and 20• assembling motor cycle helmets for sale to and use by members of 21 the general public, and as a part of its business , Defendant 22 designed, manufactured, and assembled the specific motorcycle �3 helmet hereinafter referred to . 24 4 . Defendant DOE XI is , and at all times herein mentioned 25 was , engaged in the business of selling at retail to members of 26 the general public the hereinabove described motorcyle helmet MALLARD E.STONE- AllOrnay At Law ' SUITE 124 1211 NEWELL AVENUE —2— WALNUT CREEK CALIF.94596 T414plrone:141 S1 935.1 l l t 1 manufactured designed and assembled" by Defendant DOE X. 2 5. Defendant DOE X . intended that the motorcycle helmet 3 manufactured, designed and assembled by it be used as protective 4 head gear in the event of a motorcycle accident . 5 6 . At all times herein mentioned, the Defendant knew and 6 intended that its motorcycle helmet would be purchased by members 7 of the public and used by the purchasers and others without in- 8 spection for defects . 9 7 . Plaintiff is informed and believes and thereon alleges 10 that Defendants RICHARD K. SHORES, ROBERT R. SUTTON, HOLLY SUTTON 11 and DOES VI and VII purchased the defective motorcycle helmet 12 as described herein from DOE XI at his place of business herein- 13 above described. 14 8 . The motorcycle helmet was , at the time purchased as herein 15 alleged, defective and unsafe for its intended purpose in that 16 said motorcycle helmet failed to protect the Decedent, JAMES LEA 17 HAGMAN, from receiving serious head injuries . 18 9 . On or about May 3 , 1986 , the Decedent was using the 19 motorcycle helmet while riding the above described motorcycle on 20 Marsh Creek Road for the purpose of protective head gear. During 21 the course of this use and as a proximate result of the defects 22 hereinabove described, the helmet shattered upon impact when the �3 Decedent was thrown from his motorcycle as described hereinabove . 24 10 . Plaintiff is informed .and believes and thereon alleges 25 that the Defendant knew that the motorcycle helmet manufactured, 26 designed and assembled by it was defective and dangerous in the WILLApO E.STONE AtIo/My At Lew SUITE 124 1211 NEWELL AVENUE —3— WALNUT CREEK CALIF.94596 TeN1p11one:14151 M-17 i I 1 manner alleged hereinabove; that-.-Defendant knew that because of 2 the defects , the motorcycle helmet could not safely be used for 3 the purpose for which it waste`-intended; that Defendant , knowing 4 that the motorcycle helmets were defective and dangerous , in 5 conscious disregard of the safety of the public placed them on 6 the market (without warning customers or the unknowing public of 7 the defect) , and knew when it did so that they would be sold to 8 and used by the general public without inspection for defects ; 9 that Defendant , by placing the defective motorcycle helmets on 10 the market , impliedly represented that they were safe for the 11 purpose for which they were intended; and that Defendant , by placi 12 them on the market and otherwise representing them as able to per- 13 form safely, intended that customers and the unknowing public 14 should rely on its representations . The Decedent , in using the 15 defective motorcycle helmet as herein alleged, did rely on the 16 Defendants representations , all to his damage as hereinabove 17 alleged. In doing the things aforementioned, Defendant was guilty 18 of malice , oppression, and fraud and Plaintiff is therefore en- 19 titled to recovery exemplary or punitive damages in an amount in 20 excess of the minimum jurisdiction of this court . 21 WHEREFORE, Plaintiff prays judgment against the Defendants , 22 land each of them, as follows : 23 1. For general damages in an amount in excess of the 24 minimum jurisdiction of this court ; 25 2. For medical and incidental expenses according to proof; 26 � 3. For loss of income according to proof ; tlO KA ARO E.STONE. Allorney Al Law SUITE 124 1211 NEWELL AVENUE _(F WALNUT CREEK CALIF.94596 Tal a one:14151935-1711 1 4. For funeral and burial expenses for LINDA LIND HAGMAN, 2 Decedent ' s Personal Representative, in an amount according to 3 proof; 4 5. As against Defendants RICHARD K. SHORES , ROBERT R. SUTTON, 5 HOLLY J. SUTTON and DOES VI and VII , punitive and exemplary 6 damages in the sum of Two Hundred Fifty Thousand ($250, 000) 7 Dollars ; 8 6. As against Defendants DOES X and XI, punitive and 9 exemplary damages in an amount in excess of the minimum jurisdicti n 10 of this court ; 11 7. For costs of suit herein incurred; and 12 8. For such other and further relief as the court may deem 13 proper. 14 15 Dated: January 7 , 1987. 16 17 ILLARD E. STONE, Attorney 18 for Plaintiff 19 20 21 22 23 24 25 26 WIU AIIO E.STONE AIIOro"At Low SUITE 124 1211 NEWELL AVENUE WALNUT CAEEX CALIF.0596 NppOw ;N1S19�S•1n 1 VERIFICATION . 2 I , the undersigned, declare : ' That I am a party to the-_fore oin roceedin 3 g g proceeding ; that 4 I have read the foregoing document and know the contents r 5 thereof; that the same is true of my own knowledge , except 6 for the matters set forth upon my information or belief , and 7 as to such matters that I believe to be true. 8 I declare under penalty of perjury that the foregoing 9 is true and correct. 10 Executed on January 28 , 1987 at Walnut Creek 11 California I 12 I 13 14 15 LINDA LIND HAGMA�) 16 17 18 19 I 20 21 22 �3 24 25 26 WIWRD E.STONE- ' At10rn"At Law SUITE 124 1211 NEWELL AVENUE WALNUT CREEK CALIF.94596 TM One:111SI93S•1711 MAR 6 . l9$7 1 WILLARD E. STONE Attorney at Law �EGq�. 2 1211 Newell Avenue "- Suite---124 Xt. 3 Walnut Creek, CA. 94596 4 (415) 935-1711 5 Attorney for Plaintiff 6 7 8 SUPERIOR COURT OF CALIFORNIA 9 COUNTY OF CONTRA COSTA 10 LINDA LIND HAGMAN, ) 294965 Administrator of ) CASE NO. 11 the Estate of ) JAMES LEA HAGMAN, ) 12 Deceased, ) COMPLAINT FOR DAMAGES FOR Plaintiff, ) WRONGFUL DEATH AND FOR 13 ) PERSONAL INJURIES 14 v ) 15 COUNTY OF CONTRA COSTA, ) PACIFIC. BELL COMPANY, a ) 16 CALIFORNIA CORPORATION, ) PACIFIC GAS & ELECTRIC ) 17 COMPANY, a CALIFORNIA ) CORPORATION, ROBERT SUTTON, ) 18 HOLLY SUTTON, RICHARD K. SHORES , ) and DOES I through XX, ) 19 Defendants ) 20 ) 21 Plaintiff complains , of Defendants , and each of them, and 22 alleges as follows : 23 FIRST CAUSE OF ACTION 24 (WRONGFUL DEATH) 25 1. On or about November 2-0, 1986, Plaintiff was issued 26 Letters of Administration of the Estate of JAMES LEA HAGMAN, ALARO E.STONE Aumn"At Law SWTE Itd I l NEWELL AVENUE —1— WALNUT CREEK CALIF.94596 gAOti:N 1!I 975 1711 Deceased, by the Superior Court of C-alifornia, County of Contra 2 Costa. 3 2. Plaintiff is the duly appbinted, qualified, and acting 4 Personal Representative of the Estate of JAMES LEA ..HAGMAN, Deceasec . 5 3 . Plaintiff brings this action as specified in §377 (b) of 6 the Code of Civil Procedure on behalf of the surviving heirs of 7 JAMES LEA HAGMAN, Deceased (hereinafter referred to as "Decedent") 8 4 . The heirs at law of the Decedent and their relationships 9 to the Decedent are : 10 NAME RELATIONSHIP TO DECEDENT 11 Virginia L. Hagman Daughter 12 Nicholas C. Hagman Son 13 Johnathan W. Hagman Son 14 Robert C. Hagman Father 15 Lois L. Hagman Mother 16 Jeanine Cormany Sister 17 Daunine Vining Sister 18 Gerald Hagman Brother 19 Nancy Hagman Sister 20 5 . The Plaintiff does not know the true names or capacities 21 of the Defendants sued herein as DOES I through XX; that said 22 names are fictitious names and Plaintiff will amend this Complaint �3 to show their true names when ascertained. Plaintiff is informed 24 and believes and on information and belief alleges that each of 25 the Defendants named herein as DOES I through XX, inclusive , is 26 an agent and employee of the other named Defendants ; that in doing U ARO E.STONE Attorney At Law SUITE 124 11 NEWELL AVENUE —2- WALNUT 2WALNUT CREEK CALIF.94696 ,hone:tat S!935•Irl t I the things mentioned hereinafter ..-,in this Complaint each was acting 2 within the scope of his employment as agent and employee ; that 3 each is responsible in some runner for the occurances hereinafter 4 alleged; that Plaintiff' s damages as hereinafter_. alleged were 5 proximately caused by the negligence or actions of each of said 6 Defendants . 7 6. That at all times herein mentioned, the Defendant, COUNTY 8 OF CONTRA COSTA, was a County and political subdivision of the . 9 State of California, duly organized and existing under the laws 10 of the State of California. 11 7 . Defendant , PACIFIC BELL COMPANY, is and at all times here- 12 in mentioned was , a Corporation, organized and existing under the 13 laws of the State of California and doing business in the County 14 of Contra Costa. 15 8. Defendant , PACIFIC GAS & ELECTRIC COMPANY, is and at all 16 times herein mentioned was , a Corporation, organized and existing 17 1 under the laws of the State of California and doing business 18 in the County of Contra Costa. 19 9. On May 3 , 1986, and prior thereto , Defendants CONTRA 20 COSTA COUNTY and DOES I through V, designed, constructed, owned, 21 maintained and controlled Marsh Creek Road, 1 . 4 miles west of 22 Deer Valley Road in the County of Contra Costa. 23 10. On the above mentioned date , and prior thereo , the 24 Defendants , PACIFIC BELL COMPANY ( PAC BELL) and PACIFIC GAS 25 ELECTRIC COMPANY (PG&E) constructed, owned, maintained and ' 26 controlled a telephone and power utility pole immediately adjacent M1RA ARO E.STONE . _.�. ApO/MV At L&w SUITE 124 1211 NEWELL AVENUE -3- WALNUT 3-WALNUT GREEK CALIF.94595 Tppryp,y;14IS19]S•I11I i 1 to the roadway on Marsh Creek Road as described above. 2 11. On May 3, 1986, and pl r. thereto , the above described 3 roadway, owned, maintained and controlled by CONTRA COSTA COUNTY, 4 was in an unsafe and dangerous condition, that created a sub- 5 stantial risk of the type of injury hereinafter alleged when said 6 roadway and curve there upon, was used with due care in a manner 7 that it was reasonably foreseeable that it would be used in that 8 said roadway and curve was unsafe and improperly designed and 9 constructed. Further, Defendant , CONTRA COSTA COUNTY, allowed 10 to be erected in dangerous proximity to said roadway by Defendants 11 PAC BELL and P G & E; a telephone and power utility pole so close ` 12 to the roadway as to constitute a hazardous and dangerous ..13 condition to motorists attempting to negotiate said roadway and 14 curve at the speed limit posted just before said roadway and curve 15 12. The Defendants had actual knowledge of the existance of 16 the above described conditions and knew or should have known 17 of their dangerous character a sufficient time prior to May 3 , i 18 1986 , to have taken measures to protect against the dangerous 19 conditions . 20 13. On May 3, 1986, Decedent was driving a motorcycle in 21 a westerly direction on Marsh Creek Road, approximately 1. 4 22 miles west of its intersection with Deer Creek Road. As a 23 proximate result of the dangerous condition of the roadway and Decedent ' 24 curve, and placement of said utility pole, when the/ entered the - 25 turn, his motorcycle went off the roadway and turn, part of the 26 motorcycle foot peg striking said utility pole, causing the IU ARO E.STONE AIIWMT At Law SUITE 124 11 NEWELL AVENUE —4— WALNUT CAEEK [4— WALNUTCAEEK CALIF.94596 F'—:1415193S-1711 1 Decedent and motorcycle to fall down the nearby embankment , 2 causing the death of the Decedent., on June 25 , 1986 . 3 14. Prior to the death of�`the Decedent, the heirs were .. 4 dependent on him for their support and maintenance and Decedent 5 was a faithful and dutiful father, son and brother to the heirs . 6 15. As a proximate result of the dangerous condition of 7 Defendant' s property, and the death of the Decedent , Plaintiff 8 Las sustained pecuniary loss resulting from the loss of the 9 society, comfort, attention, services and suport of Decedent in J 10 an amount in excess of the minimum jurisdictional requirement of 11 this court. 12 16. As a further proximate result of the dangerous condition �3 of Defendant ' s property, and the . death of Decedent , Plaintiff 14 LINDA LIND HAGMAN, has incurred funeral and burial expenses in 15 an amount unknown at this time . Leave of court will be sought 16 to amend this Complaint according to proof. 17 17 . That on or about August 22, 1986 , prior to the commence- 18 ment of this action, Plaintiff caused to be presented to the 19 Defendant, COUNTY OF CONTRA COSTA, a claim for damages sought in 20 this action in the amount of Five Hundred Thousand ($500, 000) 21 Dollars-. ' A true and correct copy of the claim is attached hereto, 22 marked Exhibit "A" and incorporated herein by reference . 23 18. That on or about August 25 , 1986 , the Board of Supervisors 24 of Contra Costa County rejected said claim in full . 25 WHEREFORE, Plaintiff prays judgment against the Defendants 26 WILLARO L STONE - Altomft At Law ' SUITE 124 —C 1211 NEWELL AVENUE J WALNUT CREEK CALIF.94596 '~0nr N1SI935-1711 M1'N. 1 and each of them, as hereinafter set forth. 2 SECOND CAUSE OF ACTION 3 (PERSONAL INJURY) 4 1. Plaintiff repleads , realleges and incorporates herein by 5 reference all of the allegations contained in the First Cause of 6 Action as if the same were set forth ' in full. 7 2. On June 25 , 1986, after the foregoing cause of action 8 arose in his favor on May 3, 1986, JAMES LEA HAGMAN, Decedent who 9 would have been the Plaintiff in this action if he lived, died. 10 3. As a proximate result of the negligence of the Defendants 11 and each of them, the Decedent was required to and did employ 12 physicians and surgeons to examine,treat and care for him, and . 13 did incur medical and incidental expenses in an amount unknown at 14 this time but in excess of the minimum jurisdiction of this 15 court. 16 4. At the time of the events described herein, Decedent was 17 gainfully employed as a traffic signal electrician for the City 18 of Concord. As a further proximate result of the negligence of 19 the Defendants , and each of them, the Decedent was prevented from 20 attending to his usual occupation for the period of time from 21 May .3 ,. 1986, until his death on June 25 , 1986 , all to his damage 22 in loss of earnings in an amount unknown to the Plaintiff at this 23 time, to be ascertained according to proof. 24 5. That on or about June 5, 1986, prior to the commencement 25 of this action, Plaintiff caused to be presented to the Defendant , 26 COUNTY OF CONTRA COSTA, a claim for damages sought in this action VIILJ RO L STONE A1101 ay At Law SURE 124 1211 NEWELL AVENUE 6 WALNUT CREEK GAUP.94596 Talpnotr:14 i S1 l3S.1 T 1 t I in the amount of Five Hundred Thousand ($500, 000) Dollars . A true 2 and correct copy of the claim is attached hereto marked Exhibit 3 "B" and incorporated herein by-freference. 4 6. That on or about July 8, 1986, the Board of Supervisors 5 of- Contra Costa County rejected said claim in full. 6 WHEREFORE, Plaintiff prays judgment against the Defendants , 7 and each of them, as hereinafter set forth. 8 THIRD CAUSE OF ACTION 9 (WRONGFUL DEATH AS TO DEFENDANT RICHARD K. SHORES, 10 ROBERT R. SUTTON AND HOLLY SUTTON) 11 1. Plaintiff repleads , realleges and incorporates herein by 12 reference all of the allegations contained in the First Cause of 13 Action as though set forth in full. 14 2. At all times herein mentioned, the Defendants RICHARD K. 15 SHORES and DOES I through III, were and now are the owners of the 16 motorcycle hereinafter described. 17 3. Defendants RICHARD K. SHORES and DOES I through III, gave, 18 loaned or sold to Defendants ROBERT R. SUTTON and HOLLY J. SUTTON, 19 said motorcycle. 20 4. Defendants ROBERT R. SUTTON, HOLLY J. SUTTON and DOES IV 21 through V are the agents , servants and employess of the Defendant 22 RICHARD K. SHORES, and at all times herein mentioned were acting 23 within the scope and purpose of their agency and employment . 24 5. On or about May 3 , 1986, Defendants ROBERT R. SUTTON, 25 HOLLY J. SUTTON and DOES IV through V, did loan, rent, sell or 26 give to Decedent JAMES LEA HAGMAN, a certain 1975 360 motorcycle, SntARD E.STONE - A4tOonN M Law SLATE 124 1211 NEWELL AVENUE WALNUT CAM( CALIF.NSii TewVbone:141 St 13s.t 7 11 . ' 1 California license number 3M2705, for- the purpose of operating 2 said motorcycle on the public streets and highways of California, 3 and thereafter the Decedent, JAiES LEA HAGMAN, did operate that 4 motorcycle with the knowledge, consent and permission of the 5 Defendants , RICHARD K. SHORES, ROBERT R. SUTTON, HOLLY J. SUTTON 6 and DOES I through V. 7 6. Said Defendants knew that the motorcycle was in a 8 dangerous and defective condition and unfit to be operated on 9 the public streets and highways in that the front tire was bald 10 and the front brake was defective, and Defendants knowlingly 11 permitted the motorcycle so equipped to be placed and operated on 12 the public streets and highways of California and including 13 Marsh Creek, Road, as herein mentioned. 14 7 . On May 3, 1986, the Decedent was driving said motorcycle 15 in a westerly direction on Marsh Creek Road, approximately 1. 4 16 miles west of its intersection with Deer Creek Road. As a proximate 17 result of the dangerous and defective condition of the motor- 18 cycle as aforesaid and the negligence of the Defendants , and 19 each of them, the motorcycle went off the roadway and the foot 20 peg struck the described utility pole , causing the Decedent and 21 motorcycle to overturn and to proceed down an embankment, causing 22 severe injury and brain damage, which resulted in the death of 23 the Decedent on June 25 , 1986. 24 WHEREFORE, Plaintiff prays judgment against the Defendants , 25 and each of them, as hereinafter set forth. 26 RLLAXO E.STONE AttOHNT At Law SWTE 124 III NEWELL AVENUE WALNUT C LEtt CALIF.US% -8- Ipllfltt�:N t so 97S.1)11 1 FOURTH CAUSE OF ACTION 2 (PERSONAL INJURY AS ,TO DEFENDANTS 3 RICHARD K. SHORES , ROBERT R `f:SUTTON AND HOLLY SUTTON) 4 1. The Plaintiff repleads , realleges and incorporates herein 5 by reference paragraphs one through four of the Second Cause of 6 Action and all of the allegations contained in the Third Cause 7 of Action as if the same were set forth in full. 8 2. On or about May 3, 1986, Defendants RICHARD K. SHORES, 9 ROBERT R. SUTTON, HOLLY J. SUTTON and DOES I through V owned, to maintained, controlled and managed said above described motorcycl . 11 WHEREFORE, Plaintiff prays judgment against the Defendants , 12 and each of them, as hereinafter set forth. 13 FIFTH CAUSE OF ACTION 14 (EXEMPLARY DAMAGES AS TO DEFENDANTS 15 RICHARD K. SHORES , ROBBERT R. SUTTON AND HOLLY J. SUTTON) 16 1. Plaintiff repleads , realleges and incorporates herein 17 by reference all of the allegations contained in the Fourth Cause 18 of Action as though set forth in full. 19 2. That in doing the acts herein alleged, Defendants RICHARD 20 K. SHORES, ROBERT R. SUTTON, HOLLY J. SUTTON and DOES I through V 21 and each of them, acted with oppression, fraud, malice and in 22 conscious disregard of the rights and safety of the Decedent, 23 JAMES LEA HAGMAN, and based thereon the Plaintiff is entitled to 24 punitive and exemplary damages in the sum of Two Hundred Fifty 25 Thousand ($25.0, 000) Dollars . 26 WHEREFORE, Plaintiff prays judgment against the Defendants LLARD E.STONE AUom"At Low Sulu 124 11 NEWELL AVENUE WALNUT CAM CAUL.94MG -9- Miens:14151935-1?11 1 and each of them, as follows : 2 1. For general damages in•.an amount in excess of the 3 minimum jurisdiction of this court; 4 2. For medical and incidental expenses according to proof; 5 3. For loss of income according to proof; 6 4 . For funeral and burial expenses for LINDA LINDA HAGMAN, 7 Decedent ' s Personal Representative, in an amount according to 8 proof; 9 5 . As against Defendants RICHARD K. SHORES, ROBERT R. SUTTON, 10 MOLLY J. SUTTON and DOES I through V, punitive and exemplary 11 damages in the sum of Two Hundred Fifty Thousand ($250, 000)Dollars 12 6. For costs of suit herein incurred; and 13 7. For such other and further relief as the court may deem 14 proper. 15 16 Dated: December �� , 1986 17 18oto � u WILLARD E. STONE, Attorney 19 Plaintiff 20 21 22 23 24 25 26 WILURO E.STONE- Attorney At low SUITE 124 1211 NEWELL AVENUE WALNUT CAM CALtf.94S% T~om:14151935.17 11 -10- 1 VERIFICATION 2 1 , the undersigned, declare : 3 That I- am a party to tl�i foregoing proceeding ; that 4 I have read the foregoing document and know, the contents 5 thereof; that the same is true of my own knowledge , except 6 for the matters set forth upon my information or belief, and 7 as to such matters that I believe to be true. 8 I declare under penalty of perjury that the foregoing 9 is true and correct . 10 Executed on December 16 1986 at Walnut Creek 11 California 12 13 14 15 LINDA LIND HAC 16 17 18 19 20 21 22 23 24 25 26 , NIU ARD E.STONE MOM"Al Lair SWTE 124 1211 NEWELL AVENUE WALMJT GREEK GAUF.94M .MP Do V14151935-1711 ' - 11tl Lt VC t.lulitl LV .iCla►wl �•..•.••. .. _ . �—.— M ttl CAW 94553 A. Claims relating tc, causes of action for deat._ or form 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. Codg); 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 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— Fis form. •:��:ts:::t:i��•�►#��*f*•�+r*��tttt*��*tt*st*t*t�ttr:t•::�:tie*t:rrt:�:••t::t • Claim by LINDA LIND HAGMAN on )Reserve i in stamps RE: of VIRGINIA L.HAGMAN, NI&HOLAST�V , C. HAGMAN and JONATHAN W. HAGMAN wino s CEii�/ and a ami y mem ers an heirs o fl S -E L. HAGMAN, Deceased. find on behalf of the c 1g�6 est Against the COUNTY OF CONTRA COSTA) aU G LSAT �Op or DISTRICT) (Fillin name The• undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 500, 000 and in support of this claim represents as follows: -------------------------- -------------- ------------------------ ---- �. When did the damage or injury occur? ZGive exact date and hour] The injury to James Hagman occurred on May 3, 1986, at approximately . 6:50 p.m. Mr. Hagman died from the injuries on June 25, 1986. �. Where did-the damage or a.n3ury occur? (Include city and county) On Marsh Creek Road, 1. 4 miles west of Deer Valley Road, an un- incorporated area of Contra Costa County. 3. How did the damage or in�ury occur? (Give �ul� details,-use extra . sheets if required) As Mr. Hagman made a turn on Marsh Creek on a motor- cycle, he went off of the roadway onto the gravel shoulder where his motorcycle foot peg struck a utility pole causing the motorcycle to flip over, injuring Mr. Hagman so as to cause his death. -----------———----———--——---———•�———1-------------------------------------- What —--—— 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? The place of the utility pole was so close to the roadway so as to constitute a danger .and hazard to the motorists and motorcyclists travelling said road and making the left turn in a west bound direction. (over) EXHIBIT "All (Jnknown at this tits" $: ts5at damage or �n3uries o you clam resintea? I 617,rF full extent of injuries or damages claimed. Attach two estimates fo damage) Mr. Hagman suffered from massive brain injury including brain contusion, -basilar skull fracture and--btain stem damage. He died on June 5 19186. Claim is ate., serted for damages o b half of the Decedent and _____or, Q�$o_support. co _ ort and society_to_Re-�ieirs--+-�--_--- --- am _ _!. $ow was the amount claimed above computed? (Include the estimated - amount of any prospective injury or damage. ) Unknown at this time. ----------------------------------------------------------------------- �. Names and addresses of witnesses, doctors and hospitals. Doctor: Glenn Lee, M.D. Witnesses : Robert & Holly Sutton Kaiser Hospital 1825 Manzanita Dr. 1425 Main Street Concord, CA. 94519 Walnut Creek, CA. 94596 �. L�stfthe expenditures you made on account of thie accident or 3. 3ury: 'DATE ' : ITEM _ AMOUNT May V, 1986 Delta Memori4� Hospital - unknown May 3, 1986 Emergency Medical Care to May 14, 1986 Jdhn Muir Hospital unknown May 14, 1986 . ongoing Kaiser Hospital medical care until June 25 , 1986 _ Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorne ) or by some person- n his behalf. " Name and Address of Attorney P.. 0- WILLARD E. STONE Claimant Si ture 1211 Newell Ave, Suite 124 1166 Santa Lucia Drive Walnut Creek, CA. 94596 Address Pleasant Hill, CA. 94523 Telephone No. (415) 935-1711 Telephone No. (415) 686-2711 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. " 4&b cructlons zo CIAXIL, . .. •; - �Sj P,„ a 5�.� bio 6 MyUne C jalito��► to 5W A. Claims relating uo causes of action for death or or �n 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. 911.21 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 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. •eee�:ee:eeeeeeeeeeeeeeee*eee::*ee*eeeeeee**:�*:::Beet*�*:eeeee:ee:tee:: RE: Claim by )ReserverJUN..-) l ,r 's fi ng stamps LINDA LIND HAGMAN ) ' CEIVED Conservator of JAMES LEA HAGM* Against the COUNTY OF CONTRA COSTA) 1986 S,cc)P iv%. or DISTRICT) • BATCM= _ _ (Filln name ) `mac f SW - " The' undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of S 500, 000. 00 and in support of this claim represents as follows: - --- - ---- - ve-----------------an- When did the damage or injury occur? Giexact date d hour] May 3, 1986 at approximately 6: 50 p.m. �:--wfiere-did-tFie-�-ama-e or'g ijury _ ------------- ---- --- ----- - ---- noccur? (Include city and county] On Marsh Creek Road, 1. 4 miles west of Deer Valley Road, an unincorporated area of Contra Costa County --- ------ -- 3. How did the damage or inuryH occur? (GiveuII dtais�reec on as sheets if required) As agman made a turn on ar motorcycle, he went off of the roadway onto the gravel shoulder where his motorcycle foot peg struck a utility pole causing the motorcycle to flip over, injuring Mr. Hagman severely. �. i�lhat particular act or omission on the part of county or district officers, servants or employees caused. the injury or damage? The placement of the utility pole was so close to the roadwav , so as to constitute a danger and hazard to' motorists and motor- cyclists travelling said road and making the left turn in a west bound direction (over) EXHIBIT „ B „ 5. . .What are the names,,--f county or aistricL V111L.�,tib, bCi va .Ja v� employees causing ie damage or injury? Unknown at this time, , �: WFiat damage or injuries do you claim resulted? ZGive full extent of injuries or damages claimed. Attach two estimates fcr viutn damage) Mr. Hagman suffers from mass.-IV'- brain injury including brain contusion, basilar skull fracture and brain stem damage. He has been in a coma since the date of the accident. ------------=-------------------------------------------------------- -- 7. Eow was the amount claimed above computed? (Include the estimate amount of any prospective injury or damage. ) Unknown at this time �. Names and addresses of witnesses, doctors and hospitals. Doctor: Dr. Glenn Lee, M.D. Witnesses : Robert & Holly Sutton Kaiser Hospital 1825 ,Manzanita Dr. 1425 Main St Concord, CA. 94519 Walnut Creek, CA. 94596 �. I.isx .the• ®xpenda,tures you made on account of this accident or in3ury: . DATES ITEM AMOUNT Delta Memoriaf ospitalun cZnown May 3, 1986, Emergency Medical Care to Mayl4 , 19.86 John Muir Hospital unknown Medical Care Iay 14, 1986 ongoing Kaiser Hospital Medical Care unknown J ' Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or some rs on his behalf. " Name and Address of Attorney -) WILLARD E. STONE Claimant s Si nature 1211 Newell Ave, Suite 124 Address Walnut Creek, CA. 94596 Pleasant Hill . CA. 94523 Telephone No. (415) 935-1711 Telephone No. (415) 686-2711 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 P 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 18 , 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: $25 , 000 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: KAREN AUSTEN COunty �ounS�l c/o Case , Ford, Atkinson, Burland JUL 21' 1987 ATTORNEY: Attorney at Law 550 California St. #1000 Date received f aVjne� ADDRESS: San Francisco , CA 94104 BY DELIVERY TO CLERK ON �u y , BY MAIL POSTMARKED: July 17 , 1987 I. FROM: Clerk of the Joard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Jul 23 , 1987 PpHHIL BATCHELOR, Clerk DATED: 3' BY: Deputy /�_Z L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( )) This claim complies substantially with Sections 910 and 910.2. (/V 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: AUG 18 19817 PHIL BATCHELOR, Clerk, By �1Deputy 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. AUG 20 1987 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 1 as these damages become known. 2 DATED-:' July 15 , 1987 CASE, FORD, ATKINSON & BURLAND 3 4 By: LYNN . ALTSHULER 5 Attorneys for Above-Named. 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -Page Two of Two- PROOF OF SERVICE BY MAIL = CCP 1013a, 2015.5 1 I declare that: 2 1 am employed in the county of San Francisco, California. I am over the age of eighteen years and not a 3 party to the within cause; my business address is 550 California Street, Suite 1000, San Francisco, 4 California, 94104. Julx 16 1987 I served the within S On ............. ! ....................................., _ IDATEI 6 CLAIM AGAINST THE CITY OF WALNUT CREEK, CALIFORNIA ................................................................................................................................................................................................................._ 7 ................................................................................................................................................................................................................_ 8 ................................................................................................................................................................................................................._ 9 by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the 10 United States mail at San Francisco addressed as follows: 11 Board of Supervisors 671 Pine 12 artinez , CA 94553 13 14 15 16 17 18 19 20 21 22 23 1 declare under penalty of perjury that the foregoing is true and correct, and that this declaration was July 16 , 1987 24 executed on .............. ................................................................ at San Francisco, California. (DATE) 25 1' Maud Rendon 26 .................................................................................................... TYPE OR PRINT NAMEI $IGNATUP.E y 28 A A/6� ,4 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 18 , 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: HENRY L. PHILLIPS County Couns�{ 1531 17th Avenue JUL 2 1- 1987 ATTORNEY: Oakland, CA Date received Martie- ADDRESS: c"l. rtie- ,� c ADDRESS: BY DELIVERY TO CLERK ON Ju1ly 2�', �*5ur�--"' BY MAIL POSTMARKED: July 17 , 1987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 23 , 1987 ppHHIL BATCHELOR, Clerk , 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: '�':'�. t Y . �.!% 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. AUG 18 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. AUG 2 0 1987 �, IeWDeputy Clerk Dated: BY: PHIL BATCHELOR by CC: County Counsel County Administrator oRpeo ✓ r CIC P co l 5 bse� -9 Qos `p oS I v'" X51 cop- 09, o b��o � I -ko y �f. •�ilr�l/R 0..ATF7, Ah1W1;: d 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 Au gu s t 18 , 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), givesi pursuant to GovernmQ0 6j , CO Amount: $33 , 000 - 00 Section 913 and 915.4. Please note all "Warnings". UnSe) CLAIMANT: JONI WALTERS AUG n 1, 1987 c/o Carpeneti & Carpeneti Martin 53 ATTORNEY: 1255 Post Street #1025 e2' CA 945 San Francisco , CA 94109 Date received ADDRESS: BY DELIVERY TO CLERK ON July 31 , 1987 CC 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. August 3 , 1987 BHHIL DATCHyELOR, Clerk DATED: epu L. Hall II. FROM: County Cou sel- 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: / L / �� 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 ,46 s1�i��/O,ED 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 18 1987 PHIL BATCHELOR, Clerk, By If 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. AUG 2 0 1987 W1641�Deputy Dated: BY: PHIL BATCHELOR by • Clerk CC: County Counsel County Administrator l t 1.(00� M LAW OFFICES County Counsel CARPENETI & CARPEN ETOL 2 9 1987 OF COUNSEL RICHARD CARPENETI SUITE 1025 WALTER 1.CARPENETI HERBERT F. MILLER 1255 POST STREET Martinez,,CA 94553 SAN FRANCISCO 94109 (415) 441-8000 July 28 , 1987 RECEIVED Mary Ann McNett JUL 31987 Deputy County Counsel County Counsel' s Office of Contra Costa TM County Administrative Building T P.O. Box 69 Martinez, CA 94553 RE: Our Client Joni Walters Date of Claim July 14 , 1987 Date of Injury: April 8, 1987 Dear Pis. McNett: This letter is to acknowledge your Notice regarding our claim. It is the supplemental information you requested. Joni Walters ' minor daughter Twyla Walters suffered injuries on or about April 8, 1987 when she fell climbing into a hot tub and injured her toe. She was treated that day at the Contra Costa County Health Services and released. The patient was not treated and properly diagnosed, thus causing her greater injury. Twyla Walters even- tually required surgery and one month at Petaluma Valley Hospital. As Twyla Walters ' guardian, Joni Walters incurred over $33, 000 . 00 in medical expenses to date. I have attached the fo.11o;a_.r.9 ir.edi- cal bills : Petaluma Valley Hosvital -- $32, 757. 85 Jerry L. Roberts , M.D. -- 360. 00 Contra Costa County Health Services -- 211. 00 Please contact me if you have further questions or wish to discuss this matter. Thank you for your courtesy and cooperation. Very truly yours, CARPENETI & CARPENETI HFM/jh BY Enclosure. Herert Mil er • ' _ 110'..1111 AL 1 1 U•IIAL IDC 14.1.1 1:::•11I1I IIUMUI 11 _..cd County Counsel PETALIJMA VALLEY HOSPITAL JUL 2 g 1987 400 NOk1H McDOWELL BLVD. MartiZ, CA 94553 — P[TALUMA, CALIFOkNIA 94952-0621 WHEN REFERRING TO THIS ACCOUNT 707-778-1111 PLEASE USE ADMISSION N0, JOANIE WALTERS 7-21181 -6 06/15/ 87 755 G O S S A G E AVE ADMISSION 140. ( DISCHARGE DATE PETALUMA CA 94952 WALTERS TWYLA M 7211816 REGULAR 06/ 18/87 PAGE 1 I:II:I1foR wALTLRS TWYLA ,h AGE 10 PHY 109 39 REV E DATE, "14.4.'°"`C NUMM4.1, cu&4.'Ixnlrllur, SERVICE UESCf11P110N uuANtllT P1110E DATE OF ADMISSION 05/13 / 87 SALANCE FORWARD 22268. 5 ! ** * 01 ROOM AND 90ARD AREA TOTAL ** * 5 1/650.0( ** A 16 CENTRAL SERVICES AREA TOTAL *** 175 .01 AAA 19 CENTRAL SERVICES AREA TOTAL ** * 60.0( **R 22 CENTRAL SERVICES AREA TOTAL ** * 3t045 .10*" ** * 28 LA40RATORY AREA TOTAL *** 384 .0( **� 50 PHARMACY AREA TOTAL * ** 43 .3 *** 51 PHARMACY AREA TOTAL *** 4024 .6 ** * 53 - PHARMACY AREA TOTAL *** 1 .194 .0 BALANCE DUE 32.757 . 8 1 • CONTRA COSTA COUNTY '''ALTH SERVICES PA,._E r 1 '� t OF DATE OF BILL 2500 ALHAMBRA �.. MARTINEZ, CALIFORNIA 94553 COt1 r)t (415 372-4405 y COU�Sel PATIENT NAME PATIENT NUMBER_ SCX AGE ADMISSIOW DATE 1. DISCHARGE DATE DAYS AZ8?10,EIt rt'r CA INSURANCE COMPANY NAME GROUP NO. POLICY N11M3ER .-CANTOR _C. I b ./ L L LAME I: J L 1' AND i 1: 1 DI:E55 , PLEASE RETURN TOP PORTION WITH YOUR PAYMENT k r L OF I OTY OFSCRIPTION•OF SERVICE TOTAL EST COVERAGE EST.COVERAGE [v..:_^`fFfl:it PATIENT RVICE f HOSW TAL SERVICr ^'TDE CHARGL3 INS.CO.NO.1 INS.CO.NO.2 INS,CO NO.7 AMOUNT r • Ti T.;L L. :. 'tT:�IL :, ,L7 1 ' • " r_ ? 1. 4141 -1 r. 1 TT.,l_ i.- 1•. .; 1 L :t, 2 :,_.. : 2111 . 1 l i 1 . : L : 'T 1. 11 . 1 i %AND cU J - -1•AT1,r� H PLEASE REFFR TO PATIENT • ADUITIONAL PA/Ir NT BILLING MAY BI NF CISSAIIY I0/1(iN+ r '/ MUY6IR ONALL INOVI ItS CHARGES NOT POSTED WIZEN THIS Ula WAS"EPA14LU O AND CORRESI•pNULNCE. IF INSURANCE CARRIERS DO NOT PAY ANY PART OF THEn PLEASE PAY THIS AMOUNT PAUN 05 t2 091 AMOUN TS;;HOWN UNOF,.i.;T IMATEU INSLINANCI COVI IIA6I __ 2_ �_)CONTRA COSTA COUNTY HEALTH SERVICES • •A,k�checks payable to County Auditor-Controller. 625 Court Street,Room 2( AA-.,.--- .... - _ -.. , -�-..�- jai ..-.r r. �• ��\�\ County Counsel JUL 2 a 1987 9;THOPEUC Martinez C �,. .A 945.5,3 1115 LC C'' C VEE' vf4Y VF ;u:!j l".il,i :cuu {....:.,.:n; r PET4LU- s9 C. V49r%2 1 „ , I Z$uyU-2 CJS 1 S1 1C-YYYU'%21 5Y RIONI:: ( 707)-763-263A �: v 0913310ZSr, 65-31 -;t7 311j , ,)to T r LTE :?S/ 7C'+1 !:I-LTE'-'L; 755 S?SS,'GE n V;-;Jr PETA LU`A. CA 043n T+°YLL1;T5 3 71r PCi:iT-'1F' SmJE k.7,, 2 ll .t 3 0430 (►i• i'�IT f V 5 F 30. 11; 05014 T•'YL:. f':P+E!:T3 3 Q0i 41) Uv BRIEF •73g2 2�r. �'� 0505 PATIc1l1 CHECK 2�1,�G. 0505 PATIF.fiT CHLCN 4t . n3- 0503 T tiYLi ►s Ei 3 7V b ARAY TUES K7302 2y , �,, 0509 T ' YLr i='.1':Ei;T3 3 r)(11;U1-1 UV B';IEF I,7 t 2t. 11(, 0511 P47IL'•tT CHECK 20. P(,- 0513 T YLIF T n12d EXC, FJR DST') K73(1! 1.? 13r 1 i .5:) I , ., i V ,il:. lel fclu;r: .._ ,.• . 115.31-� rl.cclHr.ti Z k n ..._ ... ..,.: . 3xi4, 1)i) DRTri'­PE,DIf' S1;;-;6E1`Y IIS • NOTICE OF INSUFFICIENCY \ County Counsel TVD/OR NON-ACCEPTANCE OF CLAIM JUL 2 y 1987 Martinez, CA 94553 TO: Joni Walters c/o Carpencti & Carpeneti 1255 Post Street #1025 San Francisco CA 94109 1`o: Claim o f _ JON .I_MALTEIiS P1,•asr 'Fake Notice •1s follows : The claim you presented against the County of Contra Cosa or District cloverned by the Board of Supervisors fails to comply substantially with the regui.rr.mcnts of California Government Code Section 910 and 910 . 2, or is otherwise 6isufficent for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimaint . 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to 1,e sent . X 3 . The claim fails to state the1dxftN*"?P;Fx>9rx>o:tbii•x circum- stances of the occurrence or transaction which gave rise to the claim asserted . 4 . The claim fails to state the name (s) of the public employees causing the injury, damage, or loss, if known. i. The claim fails to state the amount claimed as of the date of present.ation, the estimated amount of any ;prospective injury, damage, or loss so far as known , or the basis of computation of the amount claimed. 6 . The claim is not signed by the claimant or by some person on his behalf. X 7 . Other : The claim fails to state the manner in which �thc' allea( occurred _ —__--• VIMR J. ttiTSTI`SAN, County Counsel By: epi Uut County ounsel CERTIFICATE OF SERVICE BY MAIL (C.C. P. 551012 , 1013a, 2015. 5; Evid.C. §§641 , 664) My business address is the County Counsel ' s Office of Contra Costa County, Co.Admin-Bldg. , P.O. Box 69, Martinez, California 94553, and I am a citizen of the United . S'I-ates, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non-Acceptance of Claim by placing it in an envelope (s) addressed as shown above (which is/.are place (s) having delivery service by U.S. !-la-; 1) , which envelope (5 was then sealod and postage fully pre; aid thereon, and thereafter was, on this day dep,)>;ited in the U.S. Mail, at Martinez/Conoord, Contra Cc!;ta County, California . I certify under penalty of perjury that the foregoing is true and correct. Dated :_ July 27, 1987 at Martinez , California . c.c: Clerk of the Board of Supervisor (original) Risk Management (NOTICI OP T14'; -FICTENCY OF CLAIM: GOVT. C. §5410, 910. 2 , 910. 4 , 910. 8) 1 TO: CONTRA COSTA COUNTY BOARD OF_S[ipE.13k.I.S_ORS --651 Pine Street, Room 106 2 Martinez, California 94553 3 _ JONI WALTERS hereby makes the following against , 4 THE CONTRA COSTA COUNTY HEALTH SERVICES : 5 6 1. Claimant's post office address is 755 Gossage 7 Avenue, Petaluma, California 94952. 8 2. Notices concerning the claims should be sent to 9 Carpeneti & Carpeneti, 1255 Post Street, Suite 1025, San 10 Francisco, California 94109. 11 3. The date and the place of the occurrences giving 12 rise to this claim are April 8, 1987 at Contra Costa County 13 Health Services 2500 Alhambra Avenue, Martinez 94553. 14 4. The circumstances giving rise to this claim are 15 as follows: Claimant's minor child was negligently rendered 16 medical attention at Contra Costa Health Services. Claimant 17 had been responsible for medical bills and other expenses as 18 mentioned below. 19 5: The names of the public employees causing the 20 injuries are unknown at this time. 21 6. The amount of the claim to date is as follou-s: 22 Medical expenses: $33,710.39 Future Medical Expenses: Unknown 23 Other Special Damages: Unknown General Damages: Unknown 24 25 DATED: CARPENETI & CARPENETI 26 By ttorneys for laiman PENETI CARPENETI SUITE 1025 255 POST STREET J FRANCISCO 94109 \ 10151 101.9000 t.w e ' 1 PROOF OF SERVILE 2 3 I am over the age of 18 and not a party to this cause. 4 I am employed in the county where the mailing occurred. My 5 business address is: Carpeneti & Carpeneti, 1255 Post Street, 6 Suite 1025, San Francisco, CA 94109. 7 I served the attached CLAIM AGAINST THE CONTRA COSTA 8 COUNTY HEALTH SERVICES by enclosing true copies in a sealed 9 envelope addressed to each person whose name and address is given 10 below and depositing the envelope in the United States mail with 11 the postage fully prepaid on July 14 , 1987 at San Francisco, 12 California. 13 NAME AND ADDRESS OF EACH PERSON TO WHOM NOTICE WAS MAILED 14 Contra Costa County Board of Supervisors 651 Pine Street, Room 106 15 Martinez, CA 94553 16 I declare under penalty of perjury under the laws of the 17 State of California that the foregoing is true and correct. lg Dated: July 14, 1987 19 Gina ' lson 20 21 22 23 24 25 26 PENETI i CARPENETI SUITE 1025 ?55 POST STREET 4 FRANCISCO 94109. 1415)i41•5000 RECEIVED JUL �198� 1 TO: CONTRA COSTA COUNTY BOARD OF SUPERVISORS 651 Pine Street, Room 106 ► s OR 2 Martinez , California 94553 s R 3 JONI WALTERS hereby makes the following Claim agains 4 THE CONTRA COSTA COUNTY HEALTH SERVICES : 5 6 1 . Claimant' s post office address is 755 Gossage 7 Avenue , Petaluma, California 94952 . 8 2 . Notices concerning the claims should be sent to 9 Carpeneti & Carpeneti , 1255 Post Street, Suite 1025, San 10 Francisco, California 94109. 11 3 . The date and the place of the occurrences giving 12 rise to this claim are April 8 , 1987 at Contra Costa County 13 Health Services 2500 Alhambra Avenue, Martinez 94553. 14 4. The circumstances giving rise to this claim are 15 as follows: Claimant' s minor child was negligently rendered 16 medical attention at Contra Costa Health Services . Claimant 17 had been responsible for medical bills and other expenses as 18 mentioned below. 19 5 . The names of the public employees causing the 20 injuries are unknown at this time. 21 6 . The amount of the claim to date is as follows: 22 Medical expenses: $33 ,710 .39 Future Medical Expenses: Unknown 23 Other Special Damages: Unknown General Damages: Unknown 24 25 DATED : A '7 CARPENETI & CARPENETI 26Z; By Attorneys for Claimant IPENETI 8 CARPENETI SUITE 1025 1255 Pp ST STREET ,N FRANCISCO 9,1", (415)441,8000 1 PROOF OF SERVICE 2 3 I am over the age of 18 and not a party to this cause. 4 I am employed in the county where the mailing occurred. My 5 business address is: Carpeneti & Carpeneti, 1255 Post Street , 6 Suite 1025, San Francisco, CA 94109. 7 I served the attached CLAIM AGAINST THE CONTRA COSTA 8 COUNTY HEALTH SERVICES by enclosing true copies in a sealed 9 envelope addressed to each person whose name and address is given 10 below and depositing the envelope in the United States mail with 11 the postage fully prepaid on July 16 , 1987 at San Francisco, 12 California. 13 NAME AND ADDRESS OF EACH PERSON TO WHOM NOTICE WAS MAILED 14 Contra Costa County Board of Supervisors 651 Pine Street, Room 106 15 Martinez, CA 94553 16 I declare under penalty of perjury under- the laws of the 17 State of California that the foregoing is true and correct. 18 Dated: July 16 , 1987 ;_�: � ! C� : • -/ 19 Gtda Wilson 20 21 22 23 24 25 26 .RPENETI 8 CARPENETI SUITE 1025 1255 POST STREET AN FRANCISCO 94109 14151 441-8000 / ID County Counsel APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA J U L�UiACTION Marti negugA04fg,,, 1987 Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. Claimant: JERRY BROOKS c/o Richard Bridgman, Esq. Attorney: 3 Embarcadero Center #1685 San Francisco, CA 94111 Address: Amount: $200, 000. 00 By delivery to Clerk on July 23 , 1987 Date Received: July 23 , 1987 By mail, postmarked on July 22 , 1987 I. FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above noted Application t File Late Claim. DATED: July 23 , 1987 PHIL BATCHELOR, Clerk, By - � Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). (} The Board should deny this Application to File Late Claim (Section 911.6). DATED: VICTOR WESTMAN, County Counsel, By . puty III. vBOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 911.6). Q?� This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. AUG 18 1987 DATE: PHIL BATCHELOR, Clerk, By - -eL, Deputy WARNING (Gov. Code 5911.8) If you Wish to file a court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed With the court Within six (6) months from the date your application for leave to present a late claim Was denied. • You may seek the advise of any attorney of your choice in connection With this matter. If you Want to consult an attorney, u should do so immediately. V. FROM: Clerk of the Board T0: 1 County Counsel 2 County A 'nis rator Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof. has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: QUG 2 0 1987 PHIL BATCHELOR, Clerk, By Deputy V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM I HADFIELD, JORGENSEN & BRIDGMAN An Association of Lawyers 2 Three Embarcadero Center, Suite San Francisco, CA 94111 3 (415) 956-6090 4 Attorneys for Claimant 5 RECEIVED s Jug;V �98� 7 8 9 10 JERRY BROOKS, 11 Claimant, 12 v. 13 COUNTY OF CONTRA COSTA. APPLICATION FOR PERMISSION / TO FILE LATE CLAIM 14 15 1. Application is hereby made for leave to present a late claim 16 founded on a cause of action for legal malpractice which accured on 17 April 17, 1987 and for which claimant presented a claim within the 100-day 18 period specified by California Government Code 6911.2. For additional 19 circumstances relating to the cause of action, reference is made to the 20 proposed claimattached to this application and marked Exhibit 21 2. The said claim was timely presented on March 6, 1987, within 22 the 100-day period specified in California Government Code §911.2 and 6901 23 based upon the date of discovery of the within cause of action and the 24 doctrine of postponed accurel applicable thereto. A copy of said claim 25 and proof of service thereto is attached and marked Exhibit "B", the same 26 being incorporated herein by reference. 27 3. The reason for this Application is that claimant's claim was 28 returned by the Clerk of Contra Costa County with a Notice to claimant of 1. I Late-Filed Claim attached thereto pursuant to California Government Code 2 4911.3 on April 3, 1987, a copy of is attached and marked Exhibit "C", 3 the same being incorporated herein by reference. Although the County is 4 clearly erroneous in rejecting the claim, claimant files this application 5 out of an abundance of caution. 6 4. This application is being presented within one year from the 7 accrual of this cause of action and Contra Costa County is not prejudiced by 8 this failure in presentation, but in fact, the said County has had timely 9 notice as required by law. i0 WHEREFORE, it is respectfully requested that this application be 11 granted and that the attached proposed claim (Exhibit "A") be received and 12 acted on in accordance with California Government Code H912.4, 912.8. 13 DATED: July , 1987. 14 HADFIELD, JORGENS IDGMAN 15 An Associatio hof awye s 16 By: ,. 17I HARD D. GM DAN Attorney for Claimant 18 19 20 21 ` . 22 23 24 25 26 27 28 2. ivnvj-jj%.irnL, L.vum I Ur %.uN 1 KA GUS I A L.UUNTY — BAY JUDICIAL D15 1 KIL (PaU uanx to Go ve Umen t Code$ 9101, et a eq.) CLAIMANT: JERRY BROOKS Name J.ERRY BROOKS Tei .c/o 956-6090 Address c16' RICHARD BRIDGMAN, Esq. J-. Embarcadero Center, Suite 1685, San .Francis( PERSON TO WHOM ANY NOTICES CONCERNING CLAIM SHOULD BE SENT: Name RICHARD BRIDGMAN, Esq-. Tel . 956-6090 Address 3 Embarcadero Center, Suite 4:685, San Francisco, CA, 94111 Approximately WHEN DID DAMAGE/INJURY OCCUR? Date July to Nov. 1986 ' Time a.m. p.rr LOCATION OF OCCURRENCE: a prroximate y 11-26-87, because with further)omissions by county ork Furlough Jail, San Pablo employees) CIRCUMSTANCES OF OCCURRENCE: Claimant unlawfully and wrongfully incarcerated in excess of his lawful and proper sentence DESCRIPTION OF LOSS, DAMAGE OR INJURY: Physical harm, mental and emotional distress, financial loss NAME(S) OF = EMPLOYEE(S) CAUSING LOSS, DAMAGE OR INJURY, IF KNOWN: Unknown AMOUNT CLAIMED, INCLUDING ESTIMATED AMOUNT OF ANY FUTURE LOSS: $ 200,000.00 NAMES AND ADDRESSES OF ANY WITNESSES, DOCTORS AND/OR HOSPITALS: DATE March 6, 1987 Signature of claimant or person acting on his behalf RICHARD BRIDGMAN CLAIM MUST BE SIGNED BY CLAIAIANT OR PERSON ACTING ON CLAIMANT'S BEHALF MIBIT A,I I VI' %.viv 1 RH t-va 1 r% %�VUIN 1 Y - bAY JUUIUJAL LJIJ I .' w, (Puha uan t .to Go ve)ument Code 5 910, et A eq.) CLAIMANT: JERRY BROOKS Name JERRY BROOKS Tel .c/ti 956-6090 Address c/o--RICHARD BRIDGMAN, Esq. 3.16barcadero Center, Suite 1685, San Francis PERSON TO WHOM ANY NOTICES CONCERNING CLAIM SHOULD BE SENT: Name RICHARD BRIDGMAN, Esq. Tel . 956-6090 Address 3 Embarcadero Center, Suite 1685, San Francisco, CA, 94111 Approximately WHEN DID DAMAGE/INJURY OCCUR? Date July to Nov. 1986 - Time a.m. p.r LOCATION OF OCCURRENCE: (rp ox mately 11-26-87, becauselof further)omissions by county ork Furlough Jail, San Pablo employees) CIRCUMSTANCES OF OCCURRENCE: Claimant unlawfully and wrongfully incarcerated in excess of his lawful and proper sentence DESCRIPTION OF LOSS, DAMAGE OR INJURY: Physical harm, mental and emotional distress, financial loss - NAME(S) OF = EMPLOYEE(S) CAUSING LOSS, DAMAGE OR INJURY, IF KNOWN: Unknown AMOUNT CLAIMED, INCLUDING ESTIMATED AMOUNT OF ANY FUTURE LOSS: $ 200,000.00 NAMES AND ADDRESSES OF ANY WITNESSES, DOCTORS AND/OR HOSPITALS: DATE March 6, 1987 ' Signature of claimant or person acting on his behal'. RICHARD BRIDGMAN CLAIM MUST BE SIGNED By CLATMANT OR PERSON ACTING ON CLAIMANT'S BEHALF r EXHIBIT B r PROOF OF SERVICE. I served the attached Claim against the County of Contra Costa and the Municipal Court of Contra Costa �C-pppty, Bay Judicial District, as follows: y ...r 1 . By personally delivering the original to the Deputy County Clerk in the Richmond Branch office of the County Clerk's Office, 100 - 37th Street,- Richmond, California, at or about 4:00 p.m. on March 6, 1987 (see upper left corner of attached copy). 2. By placing a copy marked "Duplicate Original" in an envelope addressed to: "Clerk-Administrator, Bay Municipal Court" and personally delivering said envelope to Deputy Clerk Susan Hoffman who was working in Department 4 of said Court at 100 - 37th Street, Richmond, California, at or about 4:43 p.m. on March 6, 1987. Said Department 4 was still open whereas the downstairs office of the Clerk-Administrator was locked. Deputy Clerk Hoffman indicated to me that she would deliver the envelope when she went downstairs after closing Department 4. At the time of the above service, I was at least 18 years of age and not a party to this Claim. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: March 1987 MARCUS R. PEPPAR e Board of Supervisors COtrd h P Cow" aunty AdminiatroW tion Building Va m �. Box 911 I,1,Mz, Cgtifomia 94553 COAY . ,was,tat Dw"' +c!C IFOOM VW Dealt, nM VeyNt dtl4ss.d"DMtnCt TG: Jerry Brooks c/o Richard Bridgman, Esq. 3 Embarcadero Center, #1685 San Francisco, CA 94111 NMCE TO CLXDPtTI' PT Late-Y,1�m) (Gmmrn mt Code Section .3) quadrupiet �g e claim you presrntedA Olt* the Board of Supervisors of Contra OWt.a Oounty, California, as gDnrning body of the County of Contra Costa and/or oistrict, en March 18 & 20, 1987 is being retmmad to You herewith beta se—TLvas not p:ew.t.ocin 100 days after the am t or cocurrenoe as required by law. (See Sections 901 and 911.2 of the Government Code.) Bacause the claim was not presented within the time allowed by law, no action was taken on the claim. Tour only recourse at this time is to apply without S=lay to the Board of Supervisors (in its capacity noted above) for leave to present a late claim. (See Sections 911.6 to 912.2, inclusive, and Section 946.6 of the Government Cade.) Uder some circumstanoes, leave to present a late claim will be granted. (See Section 911.6 of the Ommrrment Cade.) You may seek the advice of an attorney of your choice in connection with this matter. If ym desire to consult an attor- ney, you shoctld do so immediately. 20 N PMM IN BY WE CEM Cr' TO DOM OW IF APPLTCME: ( ) Bine a portion of yota claim is not untimely, we are retaining a copy of your claim for Board action an that portion of Yea c'Iaim which is not untimely. Phil Batchelor,Ciek of the Boatd of &*rjisw%rd CCou ft Administrator (✓ r ( By: e'�< Mputy Clerk Date: April 3,. 1987 EXHIBIT C `-= PROOF OF SERVICE BY MAIL — CCP 1013a, 2015.5 I declare that: I am OCULdIQD(M/employed in) the county of....................San..Francisca.............................,California. (COUNTY WHERE MAILING OCCURRED) - I am over the age.of eighteen years and not a party to the within entitled cause;my (business XMIDIDES4 address is: ............................Thraa...Embarcade•ro•••Center.,...Suite...1685.,...Sau..Franc1s co......CA......9:4111.................................. On Jul • .. 1.9$7............................... I served the attached...Application For Permission To (DATE) File Late Claim on interested parties .........--............. .............................................................................. ........................................................................... .. in said cause, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the San Francisco, California addressed as follows: United States mail at.................................................................................................... Clerk Of The Board Of Supervisors Contra Costa County Administration Building Martinez, CA 94553 I declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on July o)l , 1987 San Francisco ....................... ........................................................................at..........................................................................................................California. (DATE) (PLACE) ......CarolG. Bettencourt........................................ r� �-� � &'tt'AZZU rt. (TYPE OR PRINT NAME) SIGNATURE ATTORNEYS PRINTING SUPPLY FORM NO.11 REV.JANUARY 1973 r CLAIM AGAINST THE COUNTY OF CONTRA COSTA 1, Claimant's Name `'iYJ Telephone 2. Claimant"s Address 3. Address where Notices are to be Sent � �7/ /rte �/ � . A4/ t!i�A 4. Annunt of Chun $& Date of Accident - 7- 5. Place of Accident (or event) /�' c � / � �f�),0 r 6. Haw did accident or event occur ,d/ x) 7. Inscribe Injury or damage ' � 1 r , 8. Nave of public EWloyee(s) Causing Injury or IEumge, if Itnou, r 9. LTSI' O 6ES OR MM IDMS OF YOUR C[AIM: - s SICNA OF CLAIMANT RECEIVED Ju 199 R we 6 eovZ 0�1 r #; A144 J3 t AlC:O-,•Ah!WN :i tau d