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HomeMy WebLinkAboutMINUTES - 09151987 - 1.14 CLAIM li`jL 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 September 15 , 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 6QW46-poLlnsel CLAIMANT: DUKE VICTOR JENNER AUG 2 1* 1987 901 Court Street ATTORNEY: Martinez, CA 94553 Martinez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON August 13 , 1987 transmittal BY MAIL POSTMARKED: no date I. FROM: Clerk of the,Roard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 21, 1987 fidIL ELOR, Clerk gATCH : 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: Lk�z ' BY:�` Deputy County Counsel l III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (�() This Claim is rejected in full. (� �) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. SEP 15 1987 Dated: PHIL BATCHELOR, Clerk, By ,�2 4��C� Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. 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. SEP 16 1987 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLAIM TO: BOARD OF SUPERVISORS OF CONTRA CO@*rF0Yapplication to: Instructions to ClaimantVerk of the Board &5i P, e Martinez,Califomia 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors, ::4tthu r 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 'Ifraudulent claims , Penal Code Sec. 72 at end o —this form. RE: Claim by ) Reser -- r1l"VVIC fil .ng stamps CC V/ ) ' C 4J 1 7 r"' �i�l\� 1 , RECEIVED ) Against the COUNTY OF CONTRA COSTA) &1& 113 Is or DISTRICT) WARPS 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. i7hen did the damage or injury occur? (Give exact date and hourF 00 2. W/,nere did the :damaCgeor in3ury occur? (In-c}—ludeMcityy and county)�j Ic r,- ,."L l� ��•.,T,OTI l G: .1,ry ���1 L,J;I 'T J l i ' lGr ! �r Z �Ct —.. ...---.... — .—. --..----...�---?—T--------------T--�.—. — -----T— --••------ --.� 3. How dsd the damage or 1nJury occur? (Give fu13 details, use extra sheets if required) T`aci, --------------------------------------------------------------z--------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? r, C' JT W r C, IGSer Uu�1 V✓Il W S ClLsfrC' LSC�'� ) ��� �WU S `�� -•T _ t / I j,.,.. `' (over) o,�C� i rT ' 4Ju ux l 5. What are the names of county or district officers, servants or employees causing( the Dep or injury? 1 y- , T✓cp- * ,/ T,0C sOA `-Lj(c)�9t LJC�` it,/ �, WriGhT �L�1���� �6C�f l WUJfG c� : 36666 LT ` _ U� Fr ( �E \J rQe�,or, pC , � 0.�ti.glij d�LI7aU 6. What damage or in�ura.es do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) = my f '��tT � r.,i;a recc vf<l Puv\ ct�rc �. Sn "• E Q�oc .,. r y rrFvc .; 1.,:'i ��� �;�„�o J c,l c�u�M <. JrS, �ar aJtS 7D r�c V1jrrVOc; y }. 7----------------------••--------------------t---------------_ _e_s---------- . How was the amount claimed above computed? (Include theeestimated amount of any prospective injury or damage. ) yet ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. ---- —e --- ---- -- ------- -- ---- -------- ----.--List--h---expe.nd—tu—res—you—made—onaccountofthisaccidentor—i—n—'jru—r—y-- : D1TE ITEM AMOUNT x Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney �• la ante Signature t Address Z 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 br 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 fe4uny. " On TJY 1311187 AT- OUS8 hours (1,ronrcporf) T wets S/7�In9..o►'t-._—_-__.___. 2 . M.y -bE�_ '1 V) CEP DIC 08,4 Whe-v) Tw.o je�uf yS_rit.. . 3 , ntcre� . ;rv\y C-ot , DF.Puty TgC-� SonlPy/067 Depof We;J1 T- 30"3e3 0"3 f,-,T r,T Woola 'r3146g , under 1-1,e. D;recrIOh eF - -- _ S . 4T LaW,be rt '0ea4780 x T wa s in h eqr u[ loud ly ` ,,.Ylv► whtn 6 They Ehter�c\ rY,y CEII x SrooS up anti crsljFtl w` fs c5o; oh 7 . W� cn "Dfpvty1 7ALIJSvr,(�' ��1U69 i O,nd Deputy , �11r1y�,T/�++ ill�1v8� rorcetl $ me TO T�C Iced or,d For cal l,/ �lacec� rhe `tn {')ant CuFrs 6G1-);,\ rv„I q 6t,dj, I The Sqt up on rr\Y 6fcl + ggo'�n retuESte� AT; y0;„9 ? ” T f-n Ur enT W ( .a #ULts I� . 0y) ? " n . I not;ce� S 9 0o a , Sorn2 �, . Type c,F �Ic,sltl�5\,r at +�rtt 2 was ih Ftgr d k ;YNI STJrJ � 9 1. . Me wit ;T So I Stood up x . Sargent Wooliara 7V,cn T v.�e 13 :w;t� sor-ne- ty pe o 5urt K O4ter l Jest PP e� q s q Tu,ser Gunll So w,eth�� k;t me- in rn\1 Stornac.� `- T 1001 1j down And Notiecd Sor+ie Wil h 0, W;YC 11anQ'�r4 rrJv� r�\\j Now y� %n CCgr Or w\y Ii PF So I I��c��FdJ JdePuty 37 ",c\isor, InTke PaceK Deptf-y - 1� 1ac�so,^ TL,rrnet chid 6'r- /het, -Deput/ Wr,57 Tien tore CA n1e To r�ny pur�l� whtre 10.y P E Uowrt +' h1 $TomaC� Cctusihr5 Pq;v� i n Tl1aT aneq „ W�tC n Oki of q Suciclen Yr\y V,,le 6,� V-,u.-rsr (►,,ter r F,J o.f r was sl,oc4,4) ;o 71,cr, I F�[re S CAA^e* Doa x S4r yenT WoolarA t_irec� one m 0r t P ro�el' Ir, my 6ulrox + S� adj et1 rv,e 4g�,;h >< .NF Tl cj aj tnrorvrec\ rnt our gortnq C_rtcJ V 9e4d Ir y0v 4eGphO %;r a4 up IDePuty's Tacl�son + Vr;y�T Tl,c n s� Gc`jjcS ort ------ �5 _FeeTX I wwS Te ES(Ortea down Stairs To G'\,Aper 1 \ _ a6 ws{e_.. P S evcvca j hours --- a) r WaS � -h-en 1rarC Ported �o �o�n VY1v�rcw�Or ;ul hoSpiTul A 8 T-o CA, l 1,c Prot �S re�ove� IT t Wrh {'pcyr Cd UGtC(� t U E re The /rul79ec r*L) rev�� 2cl av 4 p c•({ to i t�t1��C S - Dulj V; TT-`£h ,e rr ct-65ec41TE' uric e. Pcnalry � at' per ! vf�I t A 7-t3 t hT C 6 et S my )�nawlej9C 4 !0 � ,te. TI,i$ �� �a,y Jt1a vS� 1Y$7 oT � 4artinCZ it �3 II �$ ?/E tS€ tVOfF o = T3�1�� ZErY,er ctv„^ u aymar, at 14w �� ►"ur Su- ,T r -lu 7- � , Se-c-to ' IaS�$ ! ! �1�rt ��rE re Vk:S 17 . Cuurl orc,�erwc� ckssiStu�'�c`£ �v C'u�uv,Sd = ca�,rn t =+, c�;9ne x J� �s tr1 �t1St c.\� SO ,L c�� hot Ty `P ' �1 CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COpT. Instructions to ClaimantC'erk of the Board i!':, a .5�.� pio G Martinez,California 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors . ' at its office in Room 106 , County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors, ::tither 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 fortfraudulent claims , Penal Code Sec. 72 at end of—this form. RE: Claim `b/y ) Reserved for Clerk's filing stamps j� 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 $ Ur)- l7ere_rrvN;„ eco and in support of this claim represents as follows: _ --..--..-..--- --..----------T- ..------------------------------------ --- 1. When did the damage or in3ury occur? (Give exact date and hour] TU �y � 3, � �8� 00 S 8 hours 2. Where did the damage or in3ury occur? (Include city and county) ti4rrenT7 Y, lac;I;ry `101 Cort Sr Mar1';�eZ Ca �L15-S73 Coni'« Cost Cuvnr-Y 3. How did the damage or injury occur? (Give full details, use ext=a . sheets if required) A tac_t)ca S )) r s dee .. . 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? T w c% S S but W; ra Ta Ser Guy). fin/IlI I Z w as R� Stra;htc�” �a n caS �1.�4^fit �e�..Jj 6c j / �n I wo S ,p erNl_e- oCG S.on s UY"Ce in Tl.e (over) srorY,a��, + or�� ;%M T1 e b.m-k' ,, 5. What are the names of county or district officers, servants or employees causing the damage or injury? �ep��-y Tvc��Sor1.'��IIOG4 � Dep-t l Wri 91.r 4`,L11L108 Sar9e"T ln/vv�ara 36668 Udder 1�e 7:recd;on of LX a•�l'78U 6. What damage or injuries do you-claim resulted? Give full extent of injuries or damages claimed. Attach two estimates for auto damage) _T %, . �ucntd o� My $rv..^ac� �q1u � G�SJ reCt'ved .Pvv�CtvrC Wo�nt}i IY� I~}�c Sav„�e Plat<s � 2rrever541�1c P1..�c�.��.o9�e41 UAvwa'J 'sx17a...a,cs To r��-- N,c Voc)S SYSTCM 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) Y Z -------------------------------------------------------------------------- 8. A/ Names and addresses of wi{tnyesses, doc_yt_ors and hospitals. lyc►r'les u� V;i it ne5F,5 are navu `a�1�'gt ���S t '+ro1ln ���� .of;a� hvsp;lG E __ Y_l. _a - .. r 9. List the expenditures you made on account of this accident or injury: DATE 1 ` ITEM AMOUNT /V Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and 'Address of Attorney f � , yD T�� -t-- Address �7 gnature ",/7t z CA. rill Telephone No. Telephone No. _ NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, ,presents for allowknce or for payment to any state board or officer, or to any county, town, city district, ward br 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 felfbny. " i On . T-1y 13, 1987 AT ovS8 hors was S;-#;•,9 2 My 6td to Ce11 D/C o8A Whe-v) 7-w.o eC'uf-y 's . 4. 1 Sr9'f,, -- --- ._. y106 'F 3 �nte-regt\ vv,y CL11 X ��p�fiY T4c�Son , �puy ------ y 414 o8 I .Saf'9erT WoolckfA `4'31468 , under Te s .CT Lawrbert' �478v x ! was In Fear of tl.')od,1y v-,carwl - b They Enterf.J my Cet x I STooA up and a 0l eej wl,ctY s go;r9 oh 7 wl,cn Dep.ty Tc r-lJS-n1-110 1 qr,d -Deputy PZX Wr;g>,T tll t1o�31 1'ercee� .- - 8 rnt. To The bed and PorcaU\1 place-t\ e,^e ',n 1-1ar�c� cuR�'s. 6elz;hcl q e ci �f- bac��x I TL,t SG'� upon mygga;*1 retuestej WhgTs Ie on . T�Cn = noticed S g ov A pa, Som2 _ l� Type of Elas�+l;gl,t at' .,nt 2 was ;n Fegr n( h ;.vl 5Tri1t%►19 _. . . .. ........_... 11 •Y,e. W ;T ti ;T So = sTood up K I. Sar9enT WoolArd 7',ey% 13 w f A " (^ l �t� SOrne rt'yPe O r. gUr1 K l '4Yt� Idt+ntiPYec' q S q �aS�r Cun Jo�,� ►li+rj.._._----------. --_ ly � ►,;t v+ae- in Ynr/ . $tornaL� nrotieed Sorme -. IS TMir,q W"T' 1 a, W,rG rnr/ stor✓ A, X Now- .S.rn _„n -- i6, of ray �� f1 . so Pate , Deptty ----- 17. .IJaC�saKs Turned elrlcl Carne qt wnt 1 _�./l,et, �G}�u` ! �/r�g�,r l� eh Fore CA .w\e. 10 m./ bvh`� W�tfc. � ��y.. f'aCown ';.._._ .. — ..._.. .._ If o„ my Stomo,r Ca Wusihy paiv\ t h TI,aT o,ceo, x V�c h col 01= �o Sur-lAer, Wry idle 6oay 4,vrrS,, (/.gter( r r r;n) ovt I Wos S�OC4'4) . .. —...... _.._ _ + r` Al 7�c„ TF�er e it another pot?i r K SarS ehT Vcolorc` r.rec� one �2 1rn-3v-e r CL %t rhy u1rdA + S�►ocliec\ r.,r- gycr;h x Y Trcn. __ ._..__.. or vv,a c\ rv,c_ n u r g a v,rl q Incl tip j e c, c1 � 1� y o v Beep 1 hqt %',T- up -bEQut7's Tacl�san + Wr.sT -T %f-n plo teA shaclj�es on — --- -- _�S_.. Fet�Y-X wo,Se SCOftta el owr� Sfiaina��r�� s To ter room�1 . aG W�}Cre. 1 rCr.,a:rree� �o,r��1 CJ�t,c` I' S�acl��ec� For S�Veval _hours avr�e� To y— �o h n Vh vi r' �cv,n or; re..n„oved ;o, 1 _wAL ! �c►1 -...( ra�SpOrfie� UCIG l� i U i ►1 e J u�.� �' P'GCCC'_�—..______.. .... ... Tke . rub�er---roomDelie,:-( . ",1 019erl w;'r WaS UP . - G _ �� { �- C of . TFnner asses✓aTe: , uhc�cr:..Per)ulTy-- - ---- -` urs T'I,AT. -. .rte -- The h es o� my �_ For£ 0 i v\5 ..�V �J C True COYYGCT-;. --�0 'D T k i S clay of l } lyes . AT'_. i3 i4 -- -=- IS �IEOtsF rvote o = D�IjE 7ErV'\0-r am a ayMa� C%t StGt0y' T_►,ere --_f'7 Cnurfi 0i'c\er£� _ . casSiS�a��c� .._._�o 1-Cuuv�td - _..re do r = aW1 _� ;qr`�f, .AISo in Custocky. h _ .. so-- T J0• ot-..---ha.vcpf'Ttr_, _�_ - - - Iq aCCs . ru. C0rf'S X .a3 a6 a� a8 CLAIM TO: BOARD OF SUPERVISORS OF CONTRA CONrroWXappffcatfon to: Instructions to ClaimantC!erk of the Board Martinez.Cafffomfa 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim isagainst 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 for1fraudulent claims , Penal Code Sec. 72 at end of this form. RE: Claim by )Reserved for Clerk' s filing stamps ) ) Against the COUNTY OF CONTRA COSTA) ) 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 $ Un- De�'errn Y,CA and in support of this claim represents as follow—s.- ------------- ollows: _ ------ --------- -----------T------------------------ --------- - --- 1. Whenldid the Gdammage or injury occur? (Give exact date and hour] J O ) ' � .1987 U7 00 S 8 kovrS Y 2. Where did tie .damage or injury occur? (Include city and county) Mar �;^ez erehron bac;1;1'y 901 Co0rrt- $T' Mar 1';heZ C ca �LI5' Cont C.osfi Cuvyl\,ry 3. How did the damage or in3ury occur? (Giveul� details, use extra sheets if required) A lhcA)cA SI fis dee K--------- r-------- - - T--v----------------------- '-----v; ----- ------T---------------T--T-----------------------------T---T----- 4. What particular act or omission on the part of county or district officers, servants or .employees caused the injury or damage? T wgs ; S of w;r� CA Trier Gun w1,111L �n Seper,`TE oC4s;ons once- 'in Tl,e (over) one F_ 5. What are the' 'names of county'•or district officers, servants or employees ,causing the damage or injury? Dep.'ty .To�l�soo s`Nlo�9� l7epvty i , Wv 9ti,r 4V-LJIL108 S4�g�hT Wool�,r�i 36GG8 onde, T� C; 7�retT;on of �.T. '� ,,�nbcrT— '�2.�f '78U ---•�-----^—'"--�—•�--T�..7--T—...�--..n--••--�•—Tom•--••------�.-- —..—..---�—�.------- 6. What damage or injuries do you claim resulted? Give full extent of injuries or damages claimed. Attach two estimates for auto damage) I 41 So re�4�vcd .p,,rct,.rc wo�,}c In p(ae',<.3 S ��eYcrSa�lt C�il"o ;c41 e�gvn ue c To T-1, rvcr Voss Sys7g r►, ------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) ----------------------------- 6. Names-and addresses of-kitnesses, doctors and hospitals. I►.Q►+�CS ur( V;Ane$,LS Gre nbt ava; IccOUCJ i r 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO': (Attorney) or by some person on his behalf. " Name and Address of Attorney yO l�� a r�tSignature Address 0/7t z C.a ef/-I SS3 Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person ivho, with intent to defraud, presents for allowance or for payment to any state board or officer, ' or to any county, town,, city district, ward b'r 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 foSlony. " On T tY 13, 1987 A7- UUS8 ho.,rs (1; eo^ rtp,,rf) T was . si7fin�j o►� ----- ---- 2 my 6td ,'�v5 CEII - D/C c e A Whe-v) Two Je�vfly S � .� $r91�, -- 3 e ntere.cl vv%y . C.01 x !D. r.pv-t T,,t� son `1106y + DePuf y k 1.,/r;9�T-._. --- ---- - y OD ,f SQr4�Y1� WOoIQra -t31468 , une, I e. Direc-tiQh of s kr Le-rt z,478o x ! wu s i n dear �� l�od;►y Inar� w►,ch .. ._ _ _.-__..._ _. . ` They f"V Cell x T SrOOA vp anal atljE� W�-),,T's CAO, .9 oh 7 w1�tn �eP�ty 7acliSuh �1U69 r qr,c� �epui'y - $ r^t T. TT1 e hed and Po.cab\j placeA n.,e 'tr, t1ana r-uFpj (Deh;rtt Y'ry. _ ._..... ... . .... . . Q 1'wcl�,, 1 TQC SAS up on my 6ecl + qgu„� re�uestec� �• Wl�wTs a�oi�� _._. - ►o on? T1tieh. I nott'tta Sar•9tv\T Wcolaal #UU2 po'l-'\th9 some _- - . .-_.. . li Type o!; �lashl�gl,t Tal' "\P, 2 was ;virr-okr 1 or h ir+�t STr1,l�i%r►9 W ' 1 �T so J. S100A up x .'"Qrge-nTWVJtgrc, 1'1ty\ � J 13 w,t� Some Ty Pe. o gun . lster Tjenfi;Pyeck a s a Taxer G�„„ SornG tit++� �y 1k.'t me. inj mStorno,L� -- 2 Ioolf I clowtj unci +v�t'iced So�+c �S , ^^r W'�I-l; A W,re t\ar��1r�9 F�Jvh rn\l SlOr^at.� Now lrn ,n year_. '^^Y �i �F, So Ffact , .Depul"y - ... �'. V ACkSOY,\ •'I.nnc . qnd C.'C” are e- To M'I 6unli Lv�trc- I4\/ PQG�- �04/vl 'f'_ ---- - -.. .__. IY nr\. vh�1 Sf'I omac� C.aus;h5 po jvN in T4T ogreq x Wkc n all 0 q Zo Suclder\ V-^ ole 6,J i-1ur•t'sr eater hj ovt T v✓a5 s�oc4ed� al eh herd_ � t aho�'r�ev pop �1 rn�re Probe . ►r\ my iJuTra?( + ShotljeA vhC Ayu'yl n torwm .ecl-- P_ u gonna LY%J vp clea 4 , l� you et� a{ Shit" up _-DEpu�y's TAcl�son + vr;51 T -Ti,\ar, p,acec\ s� acjjjes on . - --- -- _�S_ w\\/ FeeT, . x. was Tie d _ tlown Sta��s To ..eNru�per roow`�►.'_ _ _ -- abSgacljicck �Of Seveval �ourc - �• ii por.}_ted t ter- Tot n Ynuir twNOr;a� �j'toI a8 �U _ � o�vC . t �,c Pro eS `f'e.•�ove� �, • 7^ L 1 C _J C., `- P�GC�G'T�-- -- - - I }. -- --- -2- onee__.CA5ck _ _, � Tl.e rA� ec_. roor ,� ue�ies av,-._- d��errt. r J . -Duli �. ViC 1 �t �Enrer aSSEr✓4Te_ . urc�tr ' �G►�u�Ty — -- - - -- . - ----_ 7 Clf 7-..PP ury. , .T�,AT T—o T-he h es T o my _ I�n�WIe�Iye _.. _.__._-g . �e . . �or1�t�D� rS ru �� C. �ru� '�- COYYeC•t; k;S .— �la�� of .. f 987 ar M4rtl hc2 ,_. _._------_--__-_---�-- i . lS 'P/EASI ;IVO tee z WJE 'TILYV-lt•r ate, a IAyMa� CAt- law SectorN ►a5-8 , r��r� r--orE T re�VesT._-__ __-__.---__ t7 CourT orc,,ertc` cess StawrcE V-, -� r in Custoc y S'O _ Z J... hot VC pfOPtr-- - a� a3 ab a8 i CLAIM TO: BOARD OF SUPERVISORS OF CONTRA C rF0Xapplication to: Instructions to ClaimantC!erk of the Board Martinez,California 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of r 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. . I E. Fraud. See penalty for /fraudulent claims , Penal Code Sec. 72 at end o his form;,. RE: Claim by )Reserved for Clerk's filing stamps Against theICOUNTY OF CONTRA COSTA) or DISTRICT) Fi 1; in name ) The• undersigned claimant hereby makes claim against the County of Contra Costa or the above-named Districtin the sum of $ Url- Deter Y,-, recd and in support of this claim represents as follows: _ -——--————————-—— --————--——T--——————————--— ————————�—— --——---- --— 1. �1hen did the'; damage or in3ury occur? (Give exact date and hours i l.- Where did t�ie :damage or 1n3cou ury occur? (Include city and nty} ria�t ^ez erenron �"c;1;1'y 901 Co��r-C S� Ma. Y';�eZ C a CIy S�3 Contr-a Cosf Cuvr��y 3. How dzd the damage or injury occur? (Give full details, use extra sheets if required) /� �£ Aacr��e c� S )) e e s ------ ------T-----------"--"T------------------••---••---�.—�.—..---••— ---- 4. What particular act or omission on the part of county or district : officers, servants or employees caused the injury or damage?. -.1_ W4 S Aot W;r� SCA IGSer Guv) WAS �1a n Cv t't s 4��s �ehS eer��E oC4 v1 S� n U►�Ce i7,e P s (over) S�OvrAC� � Ov1C� Ih �e- �V�Ox ��lidL are the names of,county or district officers, servants or employees "causing the damage or injury? Deputy Svc1�$on;'��i069� l7ePuty 1 . Is/ri9IT -w-LO408 Scryev►T 1n/o�{arc 36bb8 U(Iec1':o4N of LT, X:.;,Il 78v_ -__-_--___--- ------------------------------- ---------------- 6. What damage or injuries do you claim resulted? Give full extent of injuries or damages claimed. Attach two estimates foi auto damage) 2 ;,,wS �juYntd on My Sro*�ac� �' hu h 4�SJ reCg�vcd .�✓v�C�`vr� WOv�a1i I►1 1�c 54we pMa'e<s � 2rrevc{S�bic P�.1C�i�.o9�ca1 e{ay.�ti � eS� 17a...a,cs ' TU T �,� h/{rVOUS SyS7 7. How was the amount claimed above-computed? (Include the estimated amount of any prospective injury or damage. ) ------------------------------------------------------------ ------------- 8. Namets� and addresses of k•itne-sses, docctors and hospitals. lyarnC5 J 01)' £5 Are not CVO; �a6�t_ C,t iS t� * e 9.w List the expenditures you made on account of this accident-or injury: DATE ITEM AMOUNT Govt. Code Sec. 914.2 provides : "The claim signed by the claimant SEND NOTICES TO (Attorney) or by some person on his behalf. " Name ' and 'Address of Attorney la ant Signature yo c - t Z Address q y SS3 1 Telephone No. Telephone No. tktt*ti tic sett+&si>t•it*>t*Mitt#**�r�k*�'k11'�*�t**'�"****�R*�***1t*A'*******�ik�t�llRtit�k*1t��k�'�*tk*�****�k NOTICE Section 72 of the Penal Code provides: "Every person v•ho, with intent to defraud, presents for allowance or for payment to any state board or officer, • or to any county, town, city district, ward br 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 fe4bny. " i i I 1 1 __.._ .� On';. . Tul 13� 1187 AT' OD58 Tours (7�—Ir0Ar4poff) 2 My beck1ih CSI D C.-deA Whev)----Tw.o Je ufi s 4 3 �ntcre-A r•, C_Ll X Dr-p vfi Tqsoh - , DF_ y ... i408 Sq� eI, 9 � n's'. WoolgiA - 5 47- La,berl ?.1.1780x waS in pear GF lood ly -�'►a�-rn __ _ T1,ey- E.httl' 8.1 My Ce,11 ,c I SToOA Up Ancl as1J£� \w`et's cSoi•.y eh ••---..r_.__.. .___ _._..._..-._ 7 w1�en DePuy 7Ac1�Svrt 11-4109 1 gv,ck -Dep.fi7 �xWrigl,T £IlLl�81 t'orctc� Pi 8 rat To 1- i, q ed MC' tiv) t-),J CuPi -- bacl up �n my bEc1 * ggu;r� retuesteJ `, Wh4Ts 9oi.,g C J �o on 7� en = noticta Sex r.5ev,T WoAq«1 UU2 1 po',htih9 some- 7'\/ p ome._.TypwaS i n rtcgr of STril 'vn9 (� tae. wit k' T So StOOC uP x�"G�rgCni Wv01Q,A 1 %t-A Sh"T �3 Witl, sow,e . rt`y pe O r gVn R l 14Tlf TcltntiPYea Q S q Tasl�r UvM SOMt1rl�� i �y l ►,�t rne. ink, m,/ Stornac�^t 4 T IooliFcl Juwn an,a rvoticca sovv+c _._. tl; 01 wife. r+r­%\'/ Sfow.ae�, K Now I,•n .in ----- 1b, of rv\y Fate. , Dep„1"y TTT 11 ` &(c k5cwN .lTT urin4d . Avl1j C4�t: Q*. w1t G,pvt `V wrr�5�� .- - -. Ig �e:h ForN�ecl _. me. To rn,1 but\'j w�cre, � �Ay 1'4CC cYowvl '�”'---_ 11 , �Y car, m�! $ omQC� CauSit,y Pqi� in TI _T, areq x W�c n q`1 of q I 1 { {� (l C 1 T `- 10 SuJaeyl W,y, ,,O�e �Oc1y �urlsr \�QtQr l ihd ovt .L WO% S�IOt��V,.. - - eZ) 7,en I �erCt It Af1^er �O SAIr f AT Wo01ArG` r;%ICrA Or, 11 rnor`c ,,Pf O;bG', in my b�7ta�c + S�oc��e� w,e 5 ,h ' 1 a �,' N e T, 713 i n �orv+neC\ ri,t Yuvr goh,n4 tYtc1 d1� c!e a c� 1� you I�etp 1� -1,, 'T' 1 1 1 a(1 u�� "._- yEpu17,S Jatl�so ) + `•/r.51 `tom T 1 hpfatees 0r1 .T,e PE rTe.A .. Ao,,, r`s To . ,a rAter AG were re r.,a;r,ea} �1ov,G` G ,�fc.� 4- S�acilcck �Or Sevevad �Ourc ;l X was T�,eh._ �rar.c port4 ro To n ►Muir e-vv%orao"'�ifial __---- a8 , WAS ._ / htn �ra�S�}or�e.cl GGLI� t o t C. .� eta Q�GCCC'��_ ---- I ht �U69er rooYYnh 'D eec( ._ oerl.uV��.l 3 r� �t't p w-As UP Q► — L s V'I C of TEhntr e►SSer✓GTE._ .. Uheftr pA-rYA i _7 _op :- Pe1-77�aT ro T-�e h es F cP my M 10@`� ar IarfiihtZ r3 4 ►s ?/t*IS F 'I ►votP- 0. L �uliF 7Eh�cr ate, a l0, MCM A1'. StC-t;o,r i�5-S i I �erc 1Iolrz 17 Court 0rcNersA aSSi Star*rcF 7v CuuV-1S1-1 _fig =n di r\ A o t n CUstock V So � J0 1'1ot �a`Yt 9 i OlUtss T—, ! Cur�"S K ^^ll \1 ^O 1 PIS j 1 a8 ', i � - � Lk edU GLJvtn a A\ r �.w I i I i I .. { I 1 I I � I 1 I 1 I 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 September 15 , 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: $592 . 91 Section 913 and 915.4. Please note all "Wa nin s'.'y. Counsel CLAIMANT: CALIFORNIA STATE AUTOMOBILE ASSOCIATION INTER-INSURANCE BUREAII 1580 Chabot Ct. AUG 2 1 1987 ATTORNEY: Hayward, CA 94545 Date received Martinez, CA 94553 ADDRESS: BY DELIVERY TO CLERK ON August 14, 1987 BY MAIL POSTMARKED: August 12, 1987 Certified P 069 523 233 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 21, 1987 gbIL ELOR, Clerk gATCH: 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: u ��•�-�z /�1�� p ty County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( ) 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: SEP 1 5 1987 PHIL BATCHELOR, Clerk, By V_ 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: SEP 16 1987 BY: PHIL BATCHELOR by i ./ Deputy Clerk CC: County Counsel County Administrator Claim For Damages In accordance with Section 910 of the California Government Code, this is to formally place you on notice of our subrogated claim for the loss described below. Date: ' ' , 198- ft County of Contra Costa •651 Pine St. ' Martinez, Ca; 94553 Hayward , California Claim is hereby made and filed against the County of Contra Costa, Sheriffs Dept. as follows: Name of Claimant: California State Automobile Association Inter-Insurance Bureau Address of Claimant: (Send notices to this address) 1580 Chabot Ct. Haymard, Ca Q4545 Date of Occurrence: June 130 1987 41,_-W Place of Occurrence: 747 Wiliox Take rA. _07. ni stnoysbry Ray OF Nature and Amount of,Damages 04 r t Items Making up said Amount: 1 Name of Public Employee(s) causing said Damage(if known): Timnthy Allen rnrona Facts & Details: Our insureds vehicle was parked and unattended when it was struck in the left rear a panel area by an on-duty Contra Costa County Sheriffs Dept. emz 1nyPA_ Cop,/ of police report attached. California State Automobile Association Inter-Insurance Bureau By: ?,)A;" F1688 (REV.5-78) s, assi nment of claim and :. <*>� '�'���� subrogation agreement In consideration of the payment to the undersigned of 50 the sum of a sum estimated to be Five hundred ninety-two & 91/100 Dollars, being the full amount of loss and damage insured against under an automobile insurance policy, number 4792479 issued to the undersigned by the CALIFORNIA STATE AUTOMOBILE ASSOCIATION INTER-INSURANCE BUREAU, said loss and damage having occurred on or about the 13th day of June 1987, the said undersigned hereby assigns and transfers to said Bureau my said claim in the above amount plus additional claim for damage resulting from said accident, not covered under said policy of insurance, in the amount of$ constituting EX® a total a total estimated claim in the amount of $ 592.91 Said Bureau is hereby subrogated in MY place and stead to the extent of the above amount of the said total claim and is hereby authorized and empowered to sue, compromise or settle in _may name or other- wise to the extent of said total claim for loss and damage, and to endorse in my name any check made payable to me therefor, and collect and receive any money payable thereby. The undersigned covenants that I ha ve not released or discharged any such claim or demand against such party or parties and that T will furnish to said Bureau any and all papers and information in �r possession, necessary for the proper prosecution of such claim. q ' Dated at Hayx=d this day of 19�. Y pc-��Jl. WITNESS F1433 (REV.7-77) 903 Williams Street • San Leandro, CA 94577 (415) 357-5250 Foreign • Domestic NAME OF OWNER o� Estimate of Repairs HOME ADDRESS HOME PHONE BUSINESS PHONE INSURANCE CO 8/ Y AR MAKE OF CAR MODEL BODY STYLE 1 D. NUMBER LICENSE MILEAGE DATE DESCRIPTION OF DAMAGE PAINT SUBLET PARTS LABOR Lri t � I ggre ea epa �3 /lam/ � �� /`l• �� • �y� �l,.�;:• I i � G � - I i /•D •9 I I I I I I I I 1 i I I I I I � � I � j I !PARTS LESS 9 SUBL=7 'ADV C-GS I TOTAL 10397 i / C I STATE OF t;AL1IORNIA i • C TRAFFIC COLLISION REPORT PAGE DF SPECIAL CONDITIONS NO.INJURED N 6 R CITY JUDICIAL DISTRICT NUMEER Z C FELONY � V.Y�I•L/�' � \ NO./KILLED N S` R COUNTY REIORTiNG DtfTRI CT •/KA'yyl / /R� ' W`` ( MI{D. G COLLISION OCCURRED ON MO. DAY TRIP TIM[ (ZA00( NCIC MUME[R O/PICK" I.D. 1 i � -------- - F MILK►OST INP OR NATION • INJURY,FATAL OR TOW AWAY STAT[ MIGNWAY RELATED V FEET OF "I1E10iT YES 'NO ❑�•[f NO O IN OT06RAINf r J AT INTEw S[CTION WITN 1� 1r71... ^ �^ (` FEET/MNl3 ',f``'�//!I"-� OF IG r._�}.1.l.C�L �.� ❑VES NO PARTY NAME (FIRST, MIDDLE, LAST) I\!�r*(_.' � != f�, I ��_ 1�/ IOWR NCR'S NAM[ I SAME AS DIVER r--t Chu--tom:: DRIVER STREET ADD./SS NOME INONE OWNER'S AOO.EiS SAME AS ORIVER FG170IS- CITY:iTATC�21I O..,.ZSS PHONE DIS IOSIT.0 OF VEN. ON ORDERS OF TwIAN f V� .�r11♦ -Gy. !L^ \ t'`��� l �U I IOFr10ER +•S-'�RI�ER L—:OTHER I PAPKED DRIVER'S LICENSE NUMECR STATE I 211—DATEYR. Sr. ACE I 'DIRECTION OF�ON!YR�fi (i TREET OR IMIG. AY) !S-[EO LIMIT VEN, I MO. DAY I IP ! TRJ.YEL 1 VA. f.CY- VCN. V.(Sl MAKE(i)/MODEL(S)!COLD.(5) LI CC NSE NO.(S) STATF_(SI I CNP USE i V—ICLE GAMACE—EXTKNT:LOCATION CLIST I _ /-. 1 ONLY r— r fi��.l. � L •/ � L _Q Mr :? +- IVENICLE TY w� '�' M,NOR MODCR ATE MAJOR L_TOTAL —�T k. 4. } FP RT SME !RST, MIDDLE, LAST) OWNER•S NAME SAME AS C.IVE. O..C.'s A.'+D IyE 9] `- -n ME AS`•RIVER -anal- It::T y nTA+-i CI• Y�S,NE ^-+ONE :OIs ICSITIC'v f va— Oh ORDEF- OFFICER .J OR!ViR -- OTNRR r AKKCC a.V415 LILENfE I. ,.NEF STATE SIF-;NCATC� eEY--ACE IDrRE CT!'UN GF!)N:A•!rL:4i r SPE ET VP MIGNWAY) SPCEC n VE M-. DAv vR. +I- ) TRAVEL : II SIC - (``Va— vrw(SI{M . 1— I . ---- STC!S) 'I :HP lI VCCLr D/.V_—f ST ONLY %rL.NTr:rO_CLIC AT•ON IC :C4E Ty—, MrN. :_ Mo _F A-E N .GR—j'AME(F!PST, MIC—L. 'LAST) 'OWNER'S NAME ` SAME AS OPIVEP 3 ) I ' I DRIVC��-•-PEEr ADD.E SS - ..•L --.+NG OWMCP 5 ♦�D='c S! SAME AS""ER I .. '�CITv rSTATI IZIP J'LSr!�E 55 "TONE OISICSITION OF VEN, Oh ORDERS OF -RLN � ; i _ r.. OFFICER R V!w OTNER A.KE p1OPrV[R S LICENSE NVMOCR STATE I IIFTy LATE SEX ;RAGE nIRECT'—OF!Dl' ROSS (STPECT OF •-r,G_,a�AY) ;SPEED LIMIT DAV vR. i TRAVEL MAKa(S I!MDOELIf r!^OLOR 15) (LICENSE 10.(5) rSTATE(S) CHP !:SE �VEN,CLE 04 MADE—EX TENT:LOGATION CL FLT ( ONLT _ MI - - VENTCLE TY PEI NOP MODERATE TOTAL LRID—"-E PARTY NAM[ (FIRST,MIDDLE,LAST! Dw NEe s tiAME SAME AS DRIVER A DRIVER —FEET.00.491111 ADDRESS SAME AS DRIVER I ) PED[S- CITY JfT ATE/SIISU S!h GEE PMON6 !DIS IOSITIOh OF VEN. ICN ORDQRII OF — TwIAN _ I OFFICEP C DR l'+!P OT.CR YARK[D Ow!Vaw'S LICENSE XVMEtP 1 STATE *.—aA-a SEX PACE DIRECTION OF f DN.A GROSS (STFGET OR NIGH wAv! SPCEn LIMIT I yEN. MO. DAY YR. TRAVEL I . . . . EICY- VEN.YR(S{ MA w[(S)iMODlL(S(/COLOR(s) LICENSE NO.(i) STATE(SI CNP USE VCNICLE DAMAGE—KXTENTJLOCA-- CLIST ONLY JJJ� ^ _ — 1 �V[NIGLE TY►� I MINOR ��I MOOERAT[ i .—C. TOTAL I STATE OF CALIFORNIA I ' TRAFFIC COLLISION CODING PAGE Z DAT[ OP COLLISION TIME ("*a) NCIC NUMBER OFFIC[R I.D. NUMB R �� MC. O DAV Yw PROPERTY DAMAGE DESCRIPTION OP DAMAGE OMNER'f NAYE/ADORE{S N DTII ISD I VES NO VIOLATION(S) PARTY I PARTY 2 PARTY 3 PARTY A CHARGED PRIMARY COLLISION FACTOR TRAFFIC CONTROL DEVICES 1 2 3 t TYPE OF VEHICLE 1 2 3 a MOVEMENT PRECEDING (LIST NUMBER (IF)OF PARTY AT FAULT) A CONTROLS FUNCTIONING A PASSENGER CAR/STA. WAGON COLLISION IS, A SECTION VIOLATED: /(/l B CONTROLS OLi NOT PUN CTIONINGt B PA ff[NGER CAR W/TRArL[q A sTO►►[D 1 ZrLI Vt - C CONTROLS OBSCURED' C MOTORCYCLE/SCOOTER B PROCEEDING LTRAIG.T W B OTHER IMPRO►[R DRIVING• D CONTROLS NOT PRESENT/FACTOR D PICKUP OR PANEL TRUCK c RAN OPF ROAD E PICKUP/IAM �TIPK W/TRLP D MAKING RIGHT TURN C OTHER THAN DRIVER• TYPE OF COLLISION I F TRUCK TRUCK TRACTOR i E MAKING LEFT TURN D UNKNOWN' A HEAD-ON G TRK RK TRACTOR W/TRLR F MwKING U TURN WEATHER (MAP. 1 TD 2 iTe MS) B SIDE SWIPE H NOOL BUS G Bw EKING i�d- CLEAR rC REAR END I ..... BUS H SLOwIFIG-STDPPING B CLOUDY D BROAD5IDE I J EMERGENCY VEHICLE I I PASSING OTNCR VEHICLE C RAINING E IT OB]e CT }K .-Y C.N.T.EOUIPME NT J C ANGING LANES D iNO WING F OV HR TU RHCD IL BICYCLE K PARKING MANEUVER E POGG VeHICLE�P60ESTRtAH ' M OTHER YEMICLE i IL EM1'TERIM1G TRAFFIC F OTHER': H OTHER`: iN PE OE STRIA. I IM OT.ER UNSAFE --- G WIND .O MOPED -�i N xING INTJ OPPO 51'+x•i ,_ AM1'H LIGHTING MOTOR VEHICLE IN*,OLVED WITH I IC . KED A DAYLIGHT JA NON-COLLISION 1 ( 2 3 r4 (OTHER ASSOCIATEC FACTOR :P MERGINI B DUSK-DAWN -B PEDC STRIAN I I (M RK f TC ]ITEMS} NG W C OAR.-)TRC ET LIGHT) iC .ER MOTOR VBrIt IH A VC SECTION VIOL AT:O H: OT�EF'' ;D OAgK-NO STREET LIG.TS _-F VEr. ON O-NEP qo ACN AY --_ ---- T' I STREET uc.Ts rrcT -.Ec MpTca vE.ICLE E .'c :c CT-N .In_Ar1DN: If D.P.- --r------ ------ --- -- FUNCTroNING' I F -RA•�r I ! 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NUYRE YD. o� DAT 122 Tq:.�''"► 0315 37-U tf3 ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE ONLESS STATED (SCALE ` • NOwTN I 4 I I f � i 1 � 1 ! 07 ` • � o v-� � I � ca-•G:zu--E �.:�Ev.:�lc i 1 i tdt�l i DwAw ' N RT � �� jl.O. NUYREw f YO. DAv Tq, IpEv1[wEPS NYE I YO. DAv Tq. CHP 555-Page 4 (Re, 11.85) Ari C42 38569 i � � I ETA T9 OF CALIFDMM1A NAR RATI V E/SUPPL EM ENTAL PAGE DATE O. ORIGINAL INCIDENT TIME (USG) MCI. NUMBEw O/wICEw 1-D. MUM■ER 1 1 1 MO• �+ DAY { !✓-w Yw. ^ L/ ,�• ✓,�^ Ln�46:, —( - + ONE "X"ONE TYPE SUPPLEMENTAL ("X"APPLICABLE) 1 ARRATIVE COLLISION REPORT � � BA UPDATE ElFATALE—JNIT& RUN UPDATE 111111 1 Jr SUPPLEMENTAL LJ OTHER: MAZ. MATERIALS L--+ SCHOOL BUS n OTHER: CITY/COUNTY/JUDICIAL DISTRICT RR. DIST-.CT/BEAT CITATION NUMBER I LOCATION/iUiFJ[c '• L STATE NIGH WAY RELATED � r I C YES NO I 6 C� � — i�t-� �'_ t I. I i 17. 16. 20. I – "- �13 I ' I 117. I gyp, 23. 14 j 2 �2c 1 I t2� i 27. 26. I (2o f 30. iRE PAAfl nelw! 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DESL AIPTION(tmPourbed;Aetro.end.Found.Lost Stolen(Item No Art-cle Ousfaft.61end/Maie/Manufactures Model Number.S W NumtMr.MncNlenear Oescnpttdn.LdcAtton eefwe team,vatuv.Include total Loos--GST IN FOLLWPdG ORDER AI Cunencl,Notes S!:e..ery,C)Ciotn.ng,Fun.DI venrNes E)Obits Eouo•rH Fl Raoso.TVs.@K.G)Fueam+s P11 Nousenow Goods 11 Consumsole Nems JI L"sto[k R1 Mot 5 n/ W1,,O 4412-�' On/ A0i44J A.4,4;�E /Fd ;r7- 015C,-- D EI� .� S So a/ T .� S b/1 f�/`o�.✓ I 4" I A/! .� .L Cmc:/ is A' E. ,L_ r � I I i i I I i i I I I I I - I I I 190.Distribution-8—DE—DA L_0_SA_Y Coroner—Marcotics_lnvestigation—Juv. 191,RlPort n 7ep Pnntl Emp a 1 . P93Disposition _ailigence rice Ccaolaint 01c._FOi n T 11 192. Patrol GPress eti Salt. Qt4er t✓� � / r CJ -- 9a.App•or-g Sow IPnnt1 119j,EmP Is 196.Cate Pago I , [TAT[ OF 2ALIFORNIA NARRATIVE/SUPPLEMENTAL PAGE 8 0. .,OF ORIGINAL INCIDENT ITS.. (3A00) MCIC NUM[fR OFPIG[w I.D. NUM[[. MOP C& PAY COSI IL>.!'L✓1 ••X••ONE -X••ON[ TY►[ SUPPL[M[NTAL (••X••APPLICAMIL[) Lj>I�NA R R ATIYE Lp1. COLLISION REPORT LJ BA UPDATE i_I FATAL MIT & RUN UPDATE JI SUPPLEMENTAL �..OTH E R: r HAZ. MATERIALS L- SCHOOL BUS OTHER: CITY/COUNTY/JUDICIAL DISTRICT RFT. DISTPICT/ EAT CITATION NUMY[R LOCATION/SiirSSP. j TTATf NIGN WAY Rf LA TEO r- J YES �VNO 1. NL c>4 3. SL i 6. � 1 1 ; 7. � �B. � �f�!L•i�f"�--.-._� �1` �'r-` �-IC.►\ �'�r� Vim, IJ '1�— �l_►I' 14. . I I - moi-- _ ( I ` ` .- ;•, ,.�,.s. ,i 16. ^1 7. �^`r c J n.T r'�' —��� v(:�� f��►�-�Z_ :—rte 115, ------ 1 16. i� �^�`� �•'� '^�.:_�' �=ter- ! !{ ^^, �C (, ^it .^:.., ,.�✓�_ /.,�. -- i ,1a I 1�0 121. I 26. 27. 28. ti I 29. 30. I 31. ►R[►A.[. S NAM[ I,D. MUM[[. SMO. DAY YR• IR[VIEWEP'S NAM[ 1M0. DAY YR, R.X. CONTRERAS JR. �- CHP 55E IRe. 12-3C', OPi 042 Use arev!ous ea tions uni,m depleted. '"" t + { s Am Zr x ae4` cr, 140CDH� ^T .rte cr 1'. C. . s o C I I � � C i r' Y trir -cn - m In ., `T ,..r m S M . O iw � C'1 I CD i c I � l Oygz�� or O i o,;� s � j + cn 301S 3S83A3tl 3Hl NO 03S8OCN3 kIU3dOUd 3e ismN ijvuc SWL I I _. CLAIM. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, lor District governed by) BOARD ACTION the Board of Supervisors, ;Routing Endorsements, ) NOTICE TO CLAIMANT September 15 , 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 500 000. 00 Counsel Amount: Section 913 and 915.4. Please note all "M�a�pylll�}. CLAIMANT: DERRELL W.1 WALDECKER 2 1987 c/o ,lane Elliot AUG 453 ATTORNEY: Attorney at Law eZ, CA 9 P. O. Box 214 Martin Martinez 'CA 94553 nate received August 14, 1987 hand del . ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Joard of Supervisors TO: County Counsel Attached is a clpy of the above-noted claim. August t 21, 1987 pH IL BATCHELOR, Clerk DATED: g BY: Deputy L. Hail II. FROM: County Counsel; TO: Clerk of the Board of Supervisors This claim comp ilies 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). i ( ) 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: I i I Dated: BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (` This Claim is ;rejected in full. (l )�Other: i i I certify that:this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: SEP 1 5 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 fide a court action on this claim. See Government Code Section 945.6. You may seek the advice of 4n 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: SEP 1 6 1987' BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ' hug• 12, 198? 1 I In the Tia.tter of the Claim of 'ter Derrell W. Waldecker Claimant Vs, i ,047 K � Merritthew Hospital (Contra Costa County Hospital) , ;and DOES 1-20 inclusive, Claimant, Derrell1W. Waldecker, hereby presents this claim to the Board of Super- visors of Contra Costa County, pursuant to Section 910 Goverment Code. 1. The name and post office address of Derrell W. Waldecker is as follows; Derrell W. Waldecker 901 Court St. Martinez, Ca. 94553 2. The post office addros:s to which Derrell W. Waldecker desires notice of this claim to be sent as follows; j Derrell W. Waldecker C/0 Jane Elliot Attorney at Law P.O. Box 214 Martinez, Ca. 94553 3. On or about May 4, -1867 at the Contra. Costa County Hosnit .l, Alhambra avenue , Martinez, Cay , Claimant received personal injuries under the following circumstances; While claim-Int a. patient at the above-named hospital, said hospital by, and throughiit's employee physicians and medical staff, herein referred to as DOES 1-20, inclusive, so negligently provided medical care to claimant, that claimant has sustained serious injury to his left hand and arm. Further said hospital by and through it's above-described employees failed to pro- vide certain neces<-;ary medical treatment to claimant, also resulting in serious injury to his left hand and arm. 4. So far as it is known to claimant Derrell W. Waldecker, at the date of filling this claim, Claimant has incurred dama.-es in an amount inknown at this time, due tb the following injuries; 1. Loss of strength in the ring finger and little finger of claimant's left hand. 2. Frequent inability of said fingers to close into a fist posittion on the left arm. 3. Loss of sensation extending from the tip of little finger of left hand down the right sideiof the l6ft hand, and extending to a point on the left arm approx- imately half way between the hand and elbow. 4. There is a!lump in left wrist at the approximate location of a laceration for observation and treatment of which Clammant was admitted to Contra Costa County Hospital I i (2) 5. The names and/or identities of the public employees physicians and medical staff herein referred to as DOES 1-20 inclusive, are not known to Claimant at this time. 6. At the time of presentation of tris claim Derrell W. Waldecker claims damages in the amount of $500,000, computed on the basis of rehabilitation costs, loss of future income, costs of future medical expenses, and physical and emotional pair. and suffering. Dated; August 12, 1987 /, 1 Signed Derrell W. Waldecker Claimant i 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 September 15 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to y6u 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: $500, 000 . 00 Section 913 and 915.4. Please note all r " Counsel CLAIMANT: DERRELL W WALDECKER c/o Jane Elliot AUG 21 1987 ATTORNEY: Attorney at Law P. O. Box 214 Date received Martinez, CA 94553 ADDRESS: Martinez, ! CA 94553BY DELIVERY TO CLERK ON August 14, 1987 BY MAIL POSTMARKED: August 13, 1987 i I. FROM: Clerk of the juard of Supervisors TO: County Counsel Attached is a ,copy of the above-noted claim. IL gATCHELOR, Clerk DATED: August '21 �a , 1987 : 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). I ( ) 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). i ( ) Other: i i I Dated: ��, � � 1 � BY: '%�ra� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) I ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present O This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: SEP 15 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. I r 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: SEP 16 1981 BY: PHIL BATCHELOR by —Deputy Clerk CC: County Counsel County Administrator i Aug_ L,+, 3.987 i In the Matter of, the Claiin of Cyt Derrell W. Waldecker Claimant' idly Vs, I Merritthew Hospital (Contra Costa County Hospital)i, and DOES 1-20 inclusive, I Claimant, Derrell W. Waldecker, hereby presents this claim to the Board of Super- visors of Contra' Costa County, pursuant to Section 910 Government Code. 1. The name and post office address of Derrell W. Waldecker is as follows; Derrell W. Waldecker 901 Court St. Martinez, Ca. 94553 2. The post office address to which Derrell W. Waldecker desires notice of this claim to be sent as follows; Derrell W. Waldecker j C/0 j J ane Elliot Attorney at Law P.O. B ox 214 Martinez, Ca. 94553 3. On or about !May 4, 1987 at the Contra Costa County Hospital, Alhambra avenue, Martinez, Ca., Claimant received personal injuries under the following circumatances; While Claimant was a patient at the above-mentioned hospital, said hospital by, and througY it's employee physicians and medical staff, herein referred to as DOLS 1-20, inc usive, so negligently provided medical care to Claimant, that Claimant has sustained serious injury to his left hand and arm. Further said hospital by and through it's above-described employees failed to pro- vide certain necessary rr.edidal treatment to Claimant, also resulting in serious injury to hie left hand and arm. 4. So far as it is known to Claimant Derrell W. Waldecker, at the date of filling this claim, Claimanti has incurred damages in an amount unknown at this time, due to the following injuries: I 1. Loss of strength in the ring finger and little finger of Claimant's left hand. 2. Frequent inability of said fingers to close into a fist position on the left hand. 3. Loss of sensation extending from the tip of little finger of left hand down the right side of the left hand, and extending to a point on the left arm approx- imately half way between the hand and elbow. 4. There is a lump in left wrist at the approximateU location of a laceration for observation and treatment of which Claimant was admitted to Contra Costa County Hospital. i i (2) 5. The names and/or identities of the public employee physicians and Medical staff herein referred to as DOES 1-20 inclusive, are not known to Claimant at this time. 6. At the time of presentation of this claim Derrell W. Waldecker claims damages in the amount of $500,000, computed on the basis of rehabilitation costs, loss of future income-, costs of future medical expenses, and physical and emotional pain and suffering. Dated; August 12, 1987 Signed, Derrell W. Waldecker Claimant i I i 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 September 15 , 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 ,Counsel CLAIMANT: NANETTE WEEMS AUG 21 1987 c/o John J. Hartford ATTORNEY: Attorney At Law Martinez, CA 94553 51 James Avenue Date received 1987 ADDRESS: Redwood City, CA 94064 BY DELIVERY TO CLERK ON August 14, BY MAIL POSTMARKED: August 13 , 1987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 21, 1987 gyIL BAATTCVELOR, Clerk epuL. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. �144J ( ) This claim FAILS ti�lcomply 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 Jerk 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��� GL�Jl �;5` ��j`�S� BY: �.� / Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) VC ) 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. ( X) other: Portion of original clair-1 not previously returned as untimel �L is rejected in full . I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. SEP 15 1987 Dated: PHIL BATCHELOR, Clerk, By L, 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. SEP 16 1987 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator JOHN J. HARTFORD Attorney at Law 2 51 James 'Avenue ncE .FD Post Office Box 1207 3 Redwood, City , CA 94064 4 Telephone ( 415) 366-7000 &zz j #4987 f Attorney for Plaintiff GA 01"R 5 K [:K C. IV, 6 8 COURT OF' 'i'llf'] STATE OF CAL T.17 9 IN AND FOR THE COUNTY OF CONTRA COSTA 10' 11 NANETTE WEEMS , CLAIM FOR DAMAGES 12 a i i ii a j i t , 13 vs . 14 COUNTY Oul CONTRA COSTA, OFFICE OF THE DISTRICT 15 ATTORNEY 'FOR THE COUNTY OF CONTRA COSTA, AND 16 RELATED PERSONS AND ENTITIES , 17 Izcspondents . 19 INANETTE WEEMS makes claim the 20 1 COUP111.1V NR11�OF" CUTCOSTA arid thr, OFFICI OF HD]�STRY 2- TE TC' 11TTORNIsy 1Vi11ll , 21 ']'11 F-; 0 U OF CONTI-1,2, COSTA for Lhe :�Ljiii of $100 , 000 r--ii-icl 22 ill suppol-t of t-his clailil : 23 1. . The �iddres�, of Claimant is 6103 Safi Jose 2,1 1?ichmoncl ,i C a JAI f o.rini c-,, 941304 . 25 i 2 . Al]_ rintices recardinc this Claim should j-)r-- s,-,-?.iit to 26 (.)11'N' J . IIARTFORD', Attorney at Lcivv, 51 James Avenue , P . O . Box 1207 , 27 R,...d o(D d dit:\," C�I1AA`01-11.ia 94064 . -i e - -2nces giving rise t-� this c.c 28 dates of tl o c c,u).i:c i Ob i 1 Claim arejvarious but relate to the assertion by" Respondents of an i 2 invalid claim to certain Social Security payments in the amount of 3 $340 . 00 monthly and certain child support payments in the amount of 4 $239 . 0& monthly as per the letters from Respondents dated July 9 , i 5 1987 , June il, 1987 , and April 3 , 1987 , true copies of which are 6 attached Oereto as Exhibits A, B, and C, respectively, and incor- 7 porated h rein by reference . In short , Respondents have unlawfully, 8 arbitrarily, and capriciously made said assertions in willful , I 9 intentional. , oppressive , fraudulent, and malicious derogation of 10 the rights of Claimant as announced by the Supreme Court of the Stat i 11 of California in In re Jerald C. , 36 Cal . 3d 1 (1984) . These rights I 12 were recently summarized in County of San Mateo v. Jensen, 87 Daily i 13 Journal DJA. R. 452.4 ( 7/28/87) , a true copy of which is attached I 14 hereto aslExhibit D and incorporated herein by reference . I 15 l4 . The damages suffered by Claimant consist of severe 16 emotional bstress and mental anguish with .regard to which Claimant i 17 has required and will require the services of health care providers , i 18 the expen e for which is: included in the damages sought herein. 19 The damages suffered by Claimant are those damages which would 20 naturally ; flow from the unlawful taking of support payments other- 2.1 wise payadle to an impoverished person such as Claimant but also ! 22 include the support payments referred to in Exhibits A, B, and C . i 23 i5 . The names of the public employees causing the injuries I � � 24 and damages to Claimant are unknown to Claimant other than the 25 persons signing the originals of Exhibits A, B, and C. i 26 ;6 . The Claim as of this date is in the total amount of 27 $100 , 000 . 00 calculated as follows : I 28 I j -2- 1 :a. Severe emotional distress and related injuries in the 2 amount of '$90 , 000 . 00 ; 3 b. Support payments in the monthly total of $579 . 00 ; and 4 c. The balance to $100 , 000 . 00 for punitive damages and i 5 other special and general damages . 6 .7 . The basis for computation set forth above is tentativ only and Olai_mant r-cse.r. ves the right to, in the event that this 8 Claim i_s rejected , seek such other and additional amounts as are 9 appropriate including punitive damages based on such other and 10 , further legal theories as are appropriate under the facts and 11 circumstances . The foregoing description of the Claim is absolutel 12 without prejudice to the right of Claimant to amend this Claim as 13 appropriate under the facts and circumstances . 14 15 Dated : August 2 , 1987 JOHN J . HARTFORD 16 Attorney for Claimant 17 18 19 20 21 22 23 24 25 - i 26 27 28 i I ii -3- MContra Muir Road 1..1 JIIIG%C UI 151(ICl HjtUr��/, � 4lartinez,Citli(o:nia9a553 (•iis)3'!2.4883 Ory T. Yancey Costa ( J ADMINISTRATION tismcl Attorney j (X ] COLLECTIONS aniily Support Division Uoun`y ( J LEGAL. ( J WELFARE FnAUi Douglas Pipes m enior Deputy DOW Atiomey lirector July 9, 19Q7 {Y Mrs. Nanette Kew; 6103 San Jose Avenue i I Lit r:'p.I.'. in 1v0p.. 10 . raC, ka __ l .iC`. .'t. .-Y i.l_I ...'.f�:-ll!(:� :i:. :'ll�ll.i. •.11 is :!It:l.`, io plavr :uE'nt . ',Ite C<:)llnty .L1.': Pa`inn ' 2, 045.0" por mothi foc Me (:C11-1N's care Wnilo ill ' i..lcement. .Lha Sucial S:11:1.1,. Lt:.y 1., L)i'u._ _'Ul` cendinq 0340. 00 to +:i: I `i,fllhurnumu .. .: U 1.1_ns. tho 07 ,040.1% }.eH 1111"Q i:hL.. ".l :I,?N _U of jQ , yUK. wP ....ich .l.t ..li,r('..L[Ut,lm .'r.l. V-1'3LL.•.i i n knr, the _ I i i LOU I 40 Muir Road )ffice of District Attornk Martinez, California 94553 y Contra (415)372- 4883 mh 3ry T. Yancey Costa I J ADMINISTRATION strict*Attorney ( COLLECTIONS ,nlily Support Division County K)q LEGAL WELFARE FRAUD Douglas Pipes -nior [)eptity District Attorney rector IjUlle 1.1, 1987 'Y I I.i. 017 yom-.' hand-delivered letter of June 8, tis 1 J :-loons i0lis ('0de §11):77(a) , your child, l4onica support frum, her father , David C . Weems , were' assigned Custo, 'r)ulitly �1.s �t matter of law when Nonica received public r.� o U 11 L w . cost-LI Thu�; , all Of 1.111 . Vleems ' child dnLe h,­ci'�:, • Cusla. s O'L' support obligates h.un to pay $239.00 child support Sinc'e November of 19t9)6, lie has paid the full. the he District Att-,,Drtiey of Contra Costa Yr.:;[,:: I's i I I r IL he 1011 Of not,; more LhaI-i U1' L11e -Lixe ev:`.ously received. disagree Our int e'rpret-.aLion of the la.w. If you e 1-111 i Ti�.Lt'ic.�)I-t -his j_sslle' lrou should obt,­,in ail! I�J ji., L 1 11 o f' j: 10. At"Goj-ne", L aU Afinr I1oad Jffice. of District Mumma Contra � �tarit mcaliiomWU553 I•tlst V. 1083 Lary:T. Yancey Costa ( ( ADMINISTRATION )Islricl AnornL!yCO�1r�t\ ' ( ( COLLECTIONS �/ (X( LEGAL amily Supporl Owlsion ( ( WELFARE FRAUD _. Douglas Pipes iCluur 0.';n,l/ Ult lri,;l AllorltPy r Samar April I I I u lt;:'.r 'i'i L' . i; I'i! ,'/c:lll' ! utter ,Ifl ed I. nrc:ll At , I y8 , 1 have enclosed nit ' :•' 'Ii,I inn" I.,i i.11c.: uiil Iri al.11)i.,rL our _,I C !cc has col.QCLed on your l,t:ll:!tl . is Iir I. . i.! Illi inced in rl I: I!nl.;; Ciu• il. iLy nn Oct.nber 1 1OKA .�..•'1:!.1 c 111 Ii :;,! i I' t.i.i 1'i:1111 t)11r:;t' t.il,: IIII•'I:: ,�. � I�'I ! I il:,' 1 II',: t:<'llil!,?rr i�.)I' ;,'(,;11' i.:ll! i�l :1.i ��I �I;tllllill'v II%i�•( , 'I'I, :Ili I,! :;'I,i ,�,!•L i.:l;/�Rttll t. (.�[ a;;_''y'.i,l_;U 1„:I' 7C.i111,1, I•I'�illl t):tv.l�l 'i��:ca�l:: :I'•.J .. .)i uij t,l l.n (' )IInL,; nll :;Ilnr!I. ti) t.h Cc,l_n'L (:Wdur I,!' .•''tllVHgL 7 1986, '.:i.i :it Ir:; iir l.`.:ttn:; i, ]r. ; ullt'r,rnt. Chi Id r',Ill' port, ol, :1i:'_.;l).(!I'' !.c:l' !itmiLli i'nl' , � I :!IS I. -� ..�.." , it il.l '.'•'1 i•:.;1'i• ,I:I�I 1"Si. l I.I11. 5110 ClIde 91111 �'( I 1 ..,;li'i, PM)— . I�I .• 1 ;111, 1' :ttll•I, t:i 111 i.1�'I II' „!I!±I :l l,t111C c.. �iln_I'71 I.t'.� il.:, Ylfl it l,.i 1;.11111"1;1, , lli ltl , .0 „ )I ly ..,i.,l ir,lt,,t:d t.;. .inI, orL m"ni, .. . 1. ! f' rnil:i, :r!, !' ! �) , I;rl I,�:, n!�n,',il i ., I i ::t��l V ., 1:..11� � :r :cl,•1 1,poI'I. ti! t voI ' I r ,. . •iii I „ .,.;;.!...I ,. I:n;,;l•...!I l: . il:� i,l ..ill' r,ll !.I..: ,,:�. I . :.,,. ., I .i i' !.i'. i•,. .:li.l<:it ct•.i. .� �.li �I•._, ,,i i.,X111 t;iI I.L L.ill'c,lti'.I1 ;I: .. _ .. 11 i C 1il:, 41h,j 4!!.'•.''1 lil'::'/ Im:.ily ll t'I.-1'I:c) As T was cc., qy . .. . .• I ! ! , I ilr!!!. !c. :'I y;'lll' t:�..ri;t:rJt'll I��)I" it ';lil[!i? ;1C;:iLt`nllll;)Ilt, AL i.li'` tll:tl' :!y', rrl AqVwAL ( , 1,49 ) , Eho ,llkau .lit! ImA c rdur the paymeril.0 LY wage "snir —5L . . 'I ­,•c.: , t-i:' 1•iitri_Illt'., !:UI'lilll,i.tl;iii Lllt'' 1"rl' ..'•/ 1�:)Il:, L!!L;� it:. .�.1,'1'llll(".•Ill. , Mrs-. Weems 2 � April 3, 1987 WO apoloirj ;e f& any inconvenience this situation may have caused you. IC you have further questions, please feel free to contact Kim CoUngn , Lhe ('o1.lections OrAcer asoi.gned to your case. Very Lru l.y.-your" , r,r,M T. YANCEY MORL Attorney I i pnilg Mellute Depart All Tuesday, July 28, 19 when the affected party'volunt�appears after acceptance of thedLssolutionofthemarrfageorthele I separation of the parties,...no modifica service of notice by his attorney whereas Gortner suggests"sets of such Judgment,birder,or decree,and no subsequent order in such proceedings s be valid unless any prior notice otherwise required to be given to a party to al notice"is sufficient if combined with only"technical failure"to proceeding be served,in such manner as such notice is otherwise permitted by law t( comply with section 4809. We readily concur with Ruszovan and served,upon the party himself.For such purpose,service upon the attorney of rec, Askren,that a voluntaryappearance b the affected art consti- that not)x sufficient."I"(Emphasis added.) ppe Y party Unless otherwise indicated,all further statutory references are to the Civil Co, tutes a waiver of service on him,when his attorney has previously The letter contains no reference to the accepted service of an adequate notice as well. There hardly can 5. January 27 hearing date, be any doubt that the party has received sufficient"actual notice" 8.Th)s determination makes unnecessary our review of the record as to evidence "actual notice" and "technical" failure, we note, however, that there is dispute of the pending proceeding. evidence of an initial direction to serve Mathews;there is no proof of service of notice t We have difficulty, however, concurring with Gortner's sug- appellant;there Is no indication that Mathews forwarded the notice served toappellan estion Gortner does not,;for example,Indicate the content of the the notice served on Mathews specified a January a hearing date; and, there is r B p Indication that either Mathews or appellant knew In advance of the January 27 hearin actual notice to which a pprty is entitled.It is,perhaps,trite for date, This tack of facts showing actual notice, coupled with Gottschalk's apparer us to hold,as we now do,that any such notice should be adequate:. concession of defective service In his January 22 letter to appellant, leave the tris It should be sufficiently in advance of the hearing date and should court's finding of waiver without evidentlary,support,in any event. include that date and the time,place, and purpose of the hearing. In addition, Gortner does not specify what type of "failure" to Trial Court: comply with section 4809 is so"technical" as not to invalidate an Superior Court, County of Humboldt order. That dictum cites as authorities Lewis v. Lewis (1957) 49 Trial Judge: 011.2d 389, 3X, and Leverett v. Superior Court (1963) 222 Ca- Charles M. Thomas, Jr. 1 App.2d 126, 134. Both of these opinions hold that"(a)etual notice Attorney for Appellant: is sufficient" (Lewis at p. 3% and Leverett at p. 1`34), and cited Francis E. Mathews several constitutional law decisions. Neither opinion, however, considers the requirements of section 4809, for the good reason Box. 1325 Eur that both decisiot>_s preceded enactment of predecessor statute Eureka, CA 95501 (section 147) in 1%3. Attorneys for Respondent: In view of recurrent uncertainty of what constitutes adequate Gottschalk & Sanders "actual notice" and similar uncertainty as to what failure to 417 Second Street, Suite 5 comply with section 4809 is only a"technical"failure,we arrive at Eureka, CA 95501 what the Legislature could hardly have expressed more clearly when It enacted section 4809; No subsequent order is valid unless the requisite notice is served "upon the party himself" and that "service upon the attorney of record shall not be sufficient." GOVERNMENT We now apply these principles to the facts of the present case. Although section 4809 provides for no waiver, or other exception, Cite aS 87 Daily Journal D.A.R. 4524 we have accepted the holdings of ituszovan and Askren that a party's voluntary appearance, in combination with previous ac- COUNTY OF SAN MATEO, ceptance of service of an adequate notice by his attorney, consti- Plaintiff-Respondent, lutes a waiver. In the present case, however, appellant did not v appear and there is no Ruszovan waiver. DELL WARD JENSE;N, et it., We are left,therefore,with the precise problem which section Defendants-Appellants. 4&19 was intended to solve. The statutory language could not be more clear in providing that a party must be served a notice of a No. A032125 modification proceeding. We decline to create or uphcUd excep- Super. Ct. No. 269050 tions to the statute which olwn the door to factual disputes over California Court of Appeal oral communications between counsel and often hostile•parties. First Appellate District Respondent's clearly appropriate course of action here was to Division One have served aplxllant. If-,r attorney's failure to comply with the Filed July 23, 1987 statute left appellant without the statutory notice of the hearing to T'he County of San Mateo (hereafter respondent or the COL111- which he is entided.s We are compelled to invalidate file resulting ty) filed an action against appellants,parents of it minor declared order. a ward of the juvenile court (Wolf. & Inst. Code, § 602) and 'I'llc order of March 26, 1986, is t•eversed; and,the trial court is committed tp a group home,seeking;child suplx)rt and reinlburst�- directed to slake its order granting appellalit's motion to vacate. inent of Aid to Families of Dependent Children (hereafter AFDC) Appellant is untitled to costs oil this appeal. funds used to support the minor child. (Welt. & Inst. Code, § HOUTDAIII-,, J. 11350.)1 We concur: On August 20, 1984, the superior court was requested to take EL,KJN(;T0N, Acting P.J. judicial notice of the pleadings in both the juvenile court case NIaWSOM, J. which had resulted in the couunitmertt of the minor to the Stockton 1.The notice of ahikal alsospcciIi s the.court's order—del viug itoden's Code Of Civd Children's Hoene and the present action for reimbursement. On Procedure section 17x.6 inotion to disqualify the judge.'rhis order is not discussed in the September 23, 1984, appellants moved for judgment (Code Civ. appellant's briefs on a{{,peal:thus,we Achne to contiider this Iwint.(Younger v.state of Proc., §631.8), and asked that certain matters be deemed admit- California (1�, rr7 C•al.App.:kl 11W,812013.) ted due to the County's alleged failure to adequately respond to 2.The mcord contaimi no indication that Gottschalk told Mathews isWut the i1nuary 27 hearing date. requests for admission. '('he court refused to deem the matters __� admitted, but granted appellants'motion to have the requests for 3. The mord contaliis no indication that Gottschalk told apiwilant alwut the admissions, the County's responses thereto, and subsequently January�7 hearing;dale, _ _ filed notices of default made part of the record. :Jia^ 1:; 1I'•, idr< ui rc , lr.:ant pail "A(ti•r the entry 4)(:1jum dgcnl dve:rc•ing;� The court declined to render judgment.. oQL all evidence lmi! i i ,,tgy, July 28, 1987 Pllifu Appellate Fepart � 4525 been presented.At the close of the County's case in chief,the court while here the County seeks to recover AFDC benefits under ordered submission of further written points and authorities,and authority of section 11350—and second, the fact that appellants' took appellants' motion for judgment under submission, child was placed in a nonsecure,private group home rather than On November 19,1984,the superior court rendered its decision confined in juvenile hall, a secure facility like Jerald C. Respon- denying appellants'motion and awarding judgment to respondent dent stresses that under the current statutory scheme AFDC for$2,511 in arrearages and$93 per month current support as long funds cannot be used to support juveniles confined in secure as the child continues in his current placement. The County's institutions,and thus the placement of appellants'minor in group request for a wage assignment was denied without prejudice. homes was not for the benefit.of society as in Jerald C. Commencing November 1, 1985, appellants were ordered to pay The focus of our inquiry must be upon whether the purposes of the sum of $125 per month ($93 current support plus $32 the minor's confinement include the protection of society. (Jerald arrearages.) IC.,supra,36 Cal.3d 1,7.)"As we noted in Terminal Plaza Corp.v. Appellants' minor child was declared a ward of the juvenile City and County of San Francisco (1986) 177 Cal.App.3d 892, 910: court on August 11, 1982, pursuant to Penal Code section 602. 'The basis for the equal protection violation is that society as a Custody of the minor child was removed from appellant and he whole benefits from the incarceration; ...' 'It is a denial of equal was placed with a juvenile probation officer. The child was not protection when the government seeks to charge the cost of opera- confined ton juvenile detention facility, however. instead,he was tion of a state function,conducted for the benefit of the public, to a phcc�l in the ('hil6ren's llome (if Stockton, and then the EE particular class of persons. (Norwood v.Baker(1898) 172 U.S.269, Residential Group lloine, both norisecure facilities, State AFDC 279 et seq. (43 L.Ed. 443, 447 et seq., 19 S.Ct. 187); In re Jerald C. funds were used to support the child. (1984) 36 Ca1.3d 1, 6; (201 Cal.Rptr. 342, 678 P.2d 917); Dept. of The trial court awarded respondent reimbursement for the Mental Hygiene v. Kirchner(1964) 60 Cal.2d 716,723 (36 Cal.Rptr. co6ts of care of the child pursuant;to section 11350,2 which man- 488, 388, P.2d 720, 20 A.L.R. 3d 353) (remanded 380 U.S. 194 (13 dates compulsory reimbursement,from "the family" of AFDC L.Ed.2d 753,85 S.Ct. 870); sub.opn. 62 (Cal.2d) 586 (43 Cal.Rptr. funds paid to a foster care facility. (County of Ventura v. Stark 329, 400 F.2d 321, 20 A.L.R. 3d 361).) "To charge the cost of (1984) 158 Cal.App.3d 1112, 1117; County of San Mateo v. Booth operation of state functions is conducted for public benefit to one (1982) 135 Cal.App.3d 388,397,) The,central issue presented in this class of society is arbitrary and violates the basic constitutional appeal is whether collection from appellants of the'AFDC funds guarantee of equal protection of law. (Citation.)" In re Jerald C., used to support their minor child would constitute a violation of supra, 36 Cal.3d at p,6.)' (Cunningham v. Superior Court (1986) the equal protection clause under the principles announced by our 177 Cal.App.3d 336,348 (222 Cal,Rptr.854).)" (County of Marin v. state high court in In re Jerald C. (1984) 36 Cal.3d 1 (hereafter Pezok (1987) 190 Cal.App.3d 1441, 1445.) Jerald C.). Although the reasons underlying placement of appellants' In Jerald C.,supra,the minor cliild was declared a ward of the minor child were the subject of some controversy at the trial, the juvenile court pursuant to section G02, placed in custody at juve- legal basis for the commitment is undisputed. The minor was rule hall, aril subsequently committed to the California Youth initially referred to the juvenile court because of emotional distur- Authority. (36 Cal.3d at p. 4.) The County of Santa Clara sought Bance and his sexual molestation of a sibling. He subsequently reimbursement pursuant to section;903 (prior to its amendment), committed a violation of Vehicle Code section 10852 (unlawful While acknowledging that "(s)tatufes requiring responsible rela- taking of a vehicle without consent of the owner),which led to his tives to reimburse governmental agencies for support have been becoming a ward of the Court,.."The commitment was pursuant sustained against claims of denial of equal protection" (id.at p.5; to section 602 and, according to the probation officer in charge of citing Swoap v. Superlor Court (1973) 10 Cal.3d 490, and.ln re placement, was for three reasons: protection of the public; rcha Iticky IL (19"70) 2 Cal.3d 513), the, court observed: ".however, bilitation of the minor, and protection of the family. relative responsibility statutes have been invalidated when the Thus, among the obvious objectives served by the placement government charges were riot for; support which the relative was the protection of society from possible future criminal acts by refused but for the cost of maintaining public institutions for the minor. His rehabilitation also benefits society, even as it public benefit... (Paras.) The cases have reasoned that when indirectly promotes the protection of his family. A second critical incarceration or commitment is forlthe protection of society, it is factor is the involuntary nature of the placement, which resulted arbitrary to assess the relatives fair the expense." (Jerald C., directly from juvenile proceedings rather than voluntary or con- supra, 36 Cal,3d at p. G.) sensual actiows on the part of the parents. Nor was it due, as far as Relying un its earlier decision ill 1)ept. of Mental hygiene v. Nye can tell from the record, to any failure or-refusal by appellants Kirchner (L'Ni4) 60 Cal.2d 716, 720, the court concluded that the to provide support for their child. purposes of confinement and treatment or care in commitnrenls pursuant to section r,02 encom tss!" 'the protection of society The fact that reslxpndent seeks reimbursement of AFDC funds Iron► the confined p Bison.... Henceithecost of maintaining the pursuant to section 11350 is no basis for distinguishing; Jerald t'. state irzstilution, including provision of adequate care for its in— mates,cannot be arbitrarily charged to one class of society, such v. Pezok, supra, 190 Cal.App.3d 1441, 1445-1446, "it is the purpose assessment violates the equal protection clause.' " (in re,Jerald and derivation of the commitment rather than the source of [lie C., supra, 36 Cal.:Id at p. 8; see also Pennell v. City of San Jose funds used to pay for it which is dispositive in an equal protection (1966) 42 Cal.3d 365, 372.) Additionally, the court recognized that analysis." Here, as in Pezok, the commitment restUted from "Vic common law duty to support minor children does not autho commission of criminal acts and was imposed under section 602 rite the state to recover the costs of confinement imposed for the for the benefit of the public. (Ibid; see also County of Merced v. protection of society and the minor and his rehabilitation." (In ►•e Dominguez (1986) 186 Cal.App.3d 1513, 1517.) And the fact th;it Jerald C., supra, 36 Cal.3d at p. 10; see also County of Ventura v. Children's home of Stockton and EE Residential Group Home are Stark (1981) 158 Cal.App.3d 1112, 1118.) not secure facilities does not alter the essential purpose of the detention to protect the public. (1d.at pp. 1517-1511;.) Accordingly, Respondent seeks to distinf;uish;Jerald C. from the case at under the compulsion of Jerald C., we conclude.that the County is bench on two grounds: first, the statutory basis for rein►burse- precluded from obtaining reimbursement from apl'_�llants for th� ment — in J r-Ad C;., section (N)3 wa:s declared unconstitutional, AFDC; funds used to care for their minor child. ilbid.)` Nuel; ppeawlc eport Tuesday, July 28, 19 Appellants also request an awardtorney's fees and costs V. pursuant to Code of Civil procedure section 1021.5. Without sup SUPERIOR COURT OF 50LANO COUNTY, • porting argument,they merely offer the summary argument that . ' Respondent, their action has conferred a "significant benefit, both pecuniary JEROME RAPOZA et at., and nonpecuniary," on the general public. Real Parties In Interest. We disagree. All benefits conferred by this litigation were No. A038342 private rather than public. Appellants have merely furthered Super. Ct, No. 92671 their own pecuniary interests by successfully challenging the California Court of Appeal County's right to reimbursement. Lack of a significant public First Appellate District benefit thus defeats appellants' claim to attorney's fees under Division Four Terminal Plaza Corp.v.-City and County of San Francisco,supra, Filed July 23, 1987 177 Cal.App.3d 892, 914; Jutkowitz v. Bourns, supra, 118 Ca- l.App.3d 102 113, Petitioner Campos Food Fair has filed a timely challcnl The judgment is reversed; Appellants' request for attorney's to an order denying its motion for summary judgment (Co( fees is denied. Costs on appeal are awarded to appellants, Civ. Proc., § 437c, subd. (b).) We agree that the motif should be granted. j NEWSON, J. Jerome Rapoza and Jennifer Rapoza, real parties We concur: interest herein, filed an action against petitioner arising n RACANELLI, P.J. of an injury to Mr. Rapoza which occurred when 'he w, HOLMllA1iL J. servicing refrigeration equipment on the roof of petitioner 1.All further statutory references nie to the weifare and lristihrtior>.9 Code unlcxs premises. Real parties allege that petitioner maintain otherwise indicated, unsafe premises and petitioner takes the position that 5 3.In pertineni part,section 11350 states:"in any case of separation...of a parent or Rapoza's negligence was the sole cause of his injury. parents from a child...which results in aid under this chapter(Chapter 2)being granted Petitioner noticed a motion for summary judgment on f to such famlly,.the noncustodial parent or parents shall be obliged to the county for an amount equal to: ... (b) The amount of aid paid to the family during such period of ground that real parties' exclusive remedy is under worker separstloo...limped by such parent's reasonable ability to pay during that period in compensation. In support of the motion, petitioner offer w�� gUon Inannted;....'I%edistrict%ti(orneyshall take appropriate action pursuant evidence that at the time of the injury Mr. Rapom w periorcourt oftlrecounty which provided aid under tlrisct,»pier." employed by Jerry's Refrigeration and that neither N .Inlight ofthisconclusion,wencednotaddress appellants'contenllonthat the War Rapoza nor Jerry's Refrigeration had a contractor's liceiv court erred by denying their request to have certain matters deemed admitted. Petitioner cited Blew v. Ilorner (1986) 187 Cal.App.3d Milo which the court held that an unlincensed contractor cannot Thal an independent contractor for purposes of workers' comfy San Mateo Superior- Court sation but he and his employees are employees as a mat! Trial Judge: of law of the person hiring the work done. They cane Honorable James L. Browr;iing maintain a civil action for' damages at the workplace I Attorneys for Plaintiff/ must resort to the exclusive remedy of worke Respondent: compensation. John K. Van de Kamp 1 In response to the motion for summary judgment, r( Attorney General parties pointed out that at the time the complaint was fil- Steve White the case of Blew N. 1101'ner' had not been decided. Tf Chief Assistant requested permission to amend the complaint to allege Attorney General cause of action pursuant to section 37M of the Lxibor Cox Gloria Deliart This section provides that in injured employee niay bring Supervising Deputy -action at law against his employer if the "employer fails Attorney General secure the payment of conipensation." Furthermore, sec( Mary A. Roth 3708 provides that in such an action, negligence of Deputy Attorney General employer is presumed and usual defenses to a negligee GOW State Building action are riot available. &w 1''renci:;co, CA !).1102In reply, petitioner argued that even if real parties + 1>rr•nlitted to amend their complaint, it was entitled Attorney for Defendants/ Apf>rllllnts: sulliniary judgment becallse it had a �iurkers' conlixvrsil, ) (Y __ (r u policy ill full force and effect Ott the. time Mr. John J. Hartford, Esq, injured. A declaration to that effect attached to /M James Avenue 7 reply, P.O. Box 12W < 1 > c, Redwo<xl City, CA JLQCrt ) At the hearing, real parties argued that to ai 1 L vv t ` application of section 3736, petitioner would have to stn C� \� actual payment of compensation and not merely insure 4 v coverage. On March 31, 1987, an order was filed providinf part: "The Court does not agree tliat the phrase 'secure i rr?g�7��JJ� H�JJTT ��TT�`��SA �T payment of compensation' is satisfied merely by Yd OALKLR'� COMPE1 V�7.`�9.T IO V maintenance of insurance in the abstract as opposed to Cite as 87 Daily .rp1.1r'nal U.A.R. 452(i maintenance of insurance specifically covering plaintiff this action. Only the latter would satisfy the statute." 0:1»11'.1 l''OU1) )':hilt court, citing Mew V. Iforner, went oil til% gi-mit the edit iw.. Petitioircr, the extent that plaintiff was found to tx, all errplo��ec i 1 PROOF OF SERVICE BY MAIL [C .C . P . Sections 1013a, 2015 . 5] 2 3 I at a resident of the County of San Mateo and over the age 4 of eigh-teern years . I am not a party to the within action . My 5 business address is 51 James Avenue , Post Office Box 1207 , I 6 Redwood City , California 94064 . 7 On 'I August 3 , 1987 1 served the pywced-i.nd I 8 CLAIM FOR ;DAMAGES 9 i 10' i 11 �, I I 12 I 13 on the I parties in said action by placing a true 14 copy thereof enclosed in a sealed envelope , with postage thereon 15 fully prep�,��-i.d , in the Uni Led Stites mail- at Redwood City , I i 16 California, l addressed as follows : I I ' I 17 Office of the County Clerk. � County of Contra Costa 18 40 Muir_ Road Martinez , CA 94553 19 1 Mr. L. Douglas Pipes 201 Office of the District Attorney County of. Contra Costa :'1 I 40 M,.i_ir RoAd Martinez , CA 94553 Board of Supervisors "1;, County of: Contua Costa40 Muir Road J4,, , Martin -z , 945' „ �. , J4, ,l . hTR F RD , declare under penn I Ly of perjury undo- 25 1 t-he laws of I the SLate of Cal.:i-fornia that the forego:i-ng is true and I 1 _ 26 correct , and that this Proof was uxecuted oil Auynst- 3 , 1987 27 at Redwood Q v ; Califofww . 1. HARTFORD 2 JOIII`------ J--------------- - - - -- - — - - .' . IIAR'a'1:'Ul;n I I r i i • i 1 PROOF OF SERVICE BY MAIL i [C.C.P. Sections 1013a, 2015 . 5]' 2 3 I am a resident of the County of San Mateo and over the age 4 of eighteen years . I am not a party to the within action. My 5 business address is 51 James Avenue , Post Office Box 1207, 6 Redwood City, California 94064 . 7 On August 12, 1987 I served the preceding 8 CLAIM FORIDAMAGES i 9 10' 11 I 12 i 13 on the PARTIES in said action by placing a true i i 14 copy thereof enclosed in a sealed envelope , with postage thereon 15 fully prepaid, in the United States mail at Redwood City, 16 California , addressed as follows : 17 Office of ;the Clerk BOARD OF SUPERVISORS 18 County of ,Contra Costa 651 Pine Street 19 Martinez, 'CA 94553 20 21 i 22 I j 23 I 24 I , ;JOHN J . HARTFORD, declare under penalty of perjury under I 25 the laws of .the State of California that the foregoing is true and 26 correct, and that this Proof was executed on August 12, 1987 27 at Redwood City, California . I 28 JOHN J . HARTFORD I I� - CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Clam Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT September 15 , 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 a9cm.'., v—= nse1 Amount: $50, 000- 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: RODNEY CHRISTOPHER MIELK AUG 2 1, 1987 c/o Marcua R. Peppard Martinez, CA 94553 ATTORNEY: Attorney at Law 3615 Bissell Avenue Date received ADDRESS: Richmond, , CA 94805 BY DELIVERY TO CLERK ON August 13 , 1987 BY MAIL POSTMARKED: August 12 , 1987 I. FROM: Clerk of the.Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. EVIL BATCHELOR, Clerk DATED: August 21, 1987 Br: Deputy ' L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) T11)Acla compli s substantially with Sections 910 a c�,910.2. LSC /� ( TKis claim FAILS�oy substan is"days Sec�i�6nsT�91�0 and 910.2; and�we/7alrle so notifying claimant. The Board cannot act for 1ection 910.8). /2& z 9�17? Azq 1151 Claim is not timely filed. The Cl 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: A 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. ( x) Other: Portion of original claim not previously returned as untimely is rejected in full. I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: SEP 15 1987 PHIL BATCHELOR, Clerk, By /"s� �L '/. Deputy Clerk L ' .Y 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. r 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. SEP 16 1987 Dated: BY: PHIL BATCHELOR by - % Deputy Clerk CC: County Counsel County Administrator CLAIM TO: BOARD. OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant Return original application t_ • Clerk of the Board 651 Pine St.. Room 106 Martinez. CA 94553 A. Claims relating to causes of action for death or"for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. - Claims relating to any other cause of action must be presented not later than one year after the accrual of the -cause of action.-- (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. , E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by )Reserved fo r n stamps RODNEY CHRISTOPHER MIELK ) ) RECEIVED Against the COUNTY OF CONTRA COSTA) 1987 and the BAY MUNICIPAL COURT 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 $ 50,000 00 and in support of this claim represents as follows: -- ----------- -------- -------------- ----------------- ---- ---- S. hThen did the damage or injury occur? ZGive exact date and hour] began 4-8-87, time unknown, not discovered until 6-11-87 �. idFiere did thie � damage or InOury occur? Zln�lude city and county] Pinole (Antler's parking lot) ; City of Pinole jail; Martinez Detention Facility; Bay Municipal Court 3. How did the damage or injury occur? (Give lull details, use extra sheets if required) Claimant arrested, jailed and prosecuted in violation of State laws and State and Federal Constitutions 4. Khat particular act or omission on the part of county or district Officers , servants or employees caused the injury or damage? Claimant arrested, jailed and prosecuted in violation of State laws and State and Federal Constitutions (over) r 5.^ -.Whet are the names of county or district officers , servants or' employees causing the damage or injury? David McArthur, Pinole Police Department, Does I thru XX 6. what damage or sn3uries do you claim resu�te�? ZGive dull extent of injuries or damages claimed. Attach two estimates for auto damage) missed work, attorney's fees, mental and emotional distress --------------------------------- ------------------------------------- -- 7. How was the amount claimed above computed? (Include the estimate amount of any prospective injury or damage. ) estimated - presently not known in full 8. Names and addresses of witnesses, doctors and --------------- presently presently unknown List the expenditures you made on account of this accident or injury: DATE - ITEM AMOUNT not prlesently available - -•�� _ Govt. Code Sec. 910.2 provides : "The claim signed _b the claimant SEND NOTICES TO: (Attorney) or b e z his beh f. " Name and Address of Attorney MARCUS R. PEPPARD Claimant' i- ature Attorney at Law c/o 3615 Bissell Aver(r 3615 Bissell Avenue Address Richmond, CA 94805 Richmond, CA 94805 Telephone No. (415) 233-8688 Telephone No. c/o (415) 233-8688 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. " APPLICATION TO FILE LATE CLAIM BOARD' OF SUPERVISORS OF CANTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File La,'te Claim ) NOTICE TO APPLICANT September 15, 1987 Against- the-:,County Ro,'uting ) 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" bejW ounty Counsel Claimant: DONNA RENEE STEINBERG AUG 2 1 1987 c/o Ms. Ge.'raldine Gilleran Attorney: Law Offices of William J. Hooy Martinez, CA 94553 3125 Clayton Road 2nd Floor Address: Concord, CA 94519 Amount: $4, 030, 000. 00 By delivery to Clerk on August 13 , 1987 hand del . Date Received: August 13, 1987 By mail, postmarked on no envelope a I. FROM: Clerk of the Board of Supervisors TO: County Counsel i Attached is a copy of the above noted Application to ile Late Claim. i DATED:August 21, 19.87 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). Q� The Board should deny this Application to File Late Claim (Section 911.6). DATED: CTOR WESTMAN, County Counsel, By Deputy III. BARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 911.6). ( ) 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. SEP 15 1987 PHIL BATCHELOR Clerk '' :. De DATE: BY � k .-- P ut Y WARNING (Gov. Code 1911.8) If you Wish tofile a court action on this matter, you must first petition the appropriate court foran 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. It you Want to consult an attorney, u should do so immediately. IV. FROM: Clerk of the Board T0: 1 County Counsel 2 County Administrator 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: SEP 16 1987 PHIL BATCHELOR, Clerk, B r 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 REC09ED ' 15 ,181 Ai P V IN THE MATTER OF THE ) APPLICATION FOR PERMISSION ) TO FILE LATE CLAIM OF DONNA ) APPLICATION TO FILE RENEE STEINBERG ) LATE CLAIM AGAINST PUBLIC ENTITY VS. ) MERRITHEW MEMORIAL HOSPITAL ) 1. Claimant DONNA RENEE STEINBERG by and through her guardian ad litem, GERALDINE GILLERAN ("Claimant" ) hereby applies to the MERRITHEW MEMORIAL HOSPITAL ("MERRITHEW" ) for leave to present a claim against that entity pursuant to Section 911. 4 of the Government Code . 2. The cause of action of claimant as set forth in her proposed Verified Claim attached hereto accrued on or about December 15 , 1986 , when Claimant ' s natural guardian learned for the first, time of the possibility that she might have a claim against the various entities involved despite having signed a release prior to surgery which the hospital said released Claimant ' s legal rights if anything went wrong in the delivery, a period within one (1) year from the filing of this Application. 3;. Claimant ' s reasons for the delay in presenting her claim to the Public Entity is as follows : (a) Claimant was a minor during all the time specified in Government Code , Section 911. 2 for the presentation of this claim. Thus , pursuant to Government Code , Section 911 . 6 (b) ( 2) , Claimant is entitled to the requested relief as a matter of right . (b) Claimant was also incapacitated for the entire time specified -in Government Code , Section 911.2 as she suffers from cerebral palsy and because of her minority and incapacity , she failed to ' file a claim during such time . (c) Neither claimant , her parents , or guardians had any reason to' believe that the doctors and nurses involved here negligently acted or failed to act prior to July 24 , 1987 . From the time claimant and her guardian first learned of the possibility of a valid' suit until the above date , claimant ' s attorneys were involved with obtaining the necessary medical records (this took numerous attempts) , finding expert consultants and waiting while said experts rendered their opinion. On July 24 , 1987 , claimant finally learned of the possible malpractice of the hospital personnel ., Executed at Concord , California on August 12 , 1987 . I declare under penalty of perjury that the foregoing is true and correct . ,,/ GERALDINE G—IRAN -2- IN THE MATTER OF THE CLAIM ) OF DONNA RENEE STEINBERG, BY ) AND THROUGH HER GUARDIAN AD ) CLAIM AGAINST LITEM GERALDINE GILLERAN ) PUBLIC ENTITY VS. ) MERRITHEW MEMORIAL HOSPITAL ) DONNA RENEE STEINBERG, by and through her guardian ad litem, GERALDINE GILLERAN ("Claimant" ) presents this claim to MERRITHEW MEMORIAL HOSPITAL ( "MERRITHEW" ) pursuant to Section 910 of the California Government Code . 1. The name and Post Office address of Claimant is as follows : DONNA RENEE STEINBERG, 3155 Mt . Diablo Street , Concord , California 94518 . 2: The Post Office address to which Claimant desires notice regarding this claim to be sent is as follows : Ms . GERALDINE ,GILLERAN c/o Law Offices of WILLIAM J. HOOY, 3125 Clayton Road, Second Floor , Concord , California 94519. 3 . On February 15 , 1984 , at MERRITHEW in Martinez, California Claimant received personal injuries under the following circumstances : Claimant ' s mother , JEANETTE STEINBERG, entered MERRITHEW at approximately 5: 00 p.m. on February 15, 1984 , pregnant . with Claimant , and experiencing severe labor contractions . She had attempted to gain admission to the hospital since early that morning but was told that she had not progressed sufficiently. At approximately 5: 00 p.m. on February 15 , 1984 , Claimant was admitted to the hospital. Despite indications that Claimant was in severe distress the hospital , through its employees , failed to heed said indications and take appropriate action. At said time Claimant was physically under the complete control of the doctors , nurses and other health care professionals employed by the hospital and was totally dependent upon them for her care and safety. At least as early at 10 : 00 p.m. , claimant ' s heart rate fell precipitously low and , thereafter , Claimant 's mother was offered the option of Caesarean section or continued natural labor . Claimant ' s mother chose surgery which was performed and Claimant was birthed at approximately 11 : 00 p.m. , February 15, 1984 . r; 1� As a result of the hospital and its employee ' s failure to heed the indications of fetal distress and failure to take into account various prenatal information in their possession , Claimant was born with brain damage due to lack of oxygen. Claimant ,now suffers from cerebral palsy and will continue to do so for the rest of her natural life . These injuries were the direct result of inattention and negligence of the hospital ' s health care professionals and other staff employees , in that said individuals failed to properly respond to that which Claimant is informed and believes were clear signs of fetal distress which should have caused a reasonably prudent doctor , and attending nurse practicing within the community standard of care to take immediate steps to avoid the injuries which , in fact , resulted . 4. A general description of the injury, damage or loss received , so far as it is known at the time of presentation of this claim: Claimant suffers from cerebral palsy and other maladies associated with hypoxia suffered at birth . She has partial loss of use of the right side of her body and runs a significant risk of future seizures . Specifically, the damages known presently include the following : (a) MEDICAL EXPENSES - Claimant has employed physicians and incurred hospital and medical expenses , the exact amount of which are unknown . However , Claimant estimates the expenses incurred at the hospital alone exceed $10 , 000 and may run as high as $25 , 000 to $30 , 000 . (b) FUTURE MEDICAL EXPENSES - Claimant expects to incur further expenses for treatment of her condition which , as stated before , will exist for the rest of her natural life . The amount and nature of such expenses are unknown at this point , however , Claimant estimates they may run in excess of .Two Million Dollars . (c) PERMANENT DISABILITY - Claimant ' s condition should not completely bar her from obtaining some meaningful employment , however , her options and earning capacity will undoubtedly be sharply curtailed . Claimant estimates her probable earnings loss over her lifetime to be in excess of One Million Dollars . (d) GENERAL DAMAGES - Claimant has sustained mental and physical pain, anguish, stress , depression, embarrassment , fatigue and related injuries connected with her injuries and will continue to do so for the rest of her life . Claimant estimates this aspect of damages to be in excess of One Million Dollars . 5. The name or names of the public employee or employees causing the injury, damage or loss : Other than Dr . MITCHELL NEWMAN these are unknown to Claimant at present. They would , however , be the hospital ' s personnel on duty on February 15 , 1984 , when Claimant first went to the hospital until after the delivery -2- at approximately 11 : 00 p.m. There may be others whose action or inaction contributed to the problem. These are , however , best known to the hospital. 6. The amount claimed as of the date of presentation of this Claim, including the amount of any prospective injury and the basis for its calculation : Claimant claims damages of $4 , 030 , 000 . 00 based on the damage estimates given above . This amount is'necessarially an estimate as exact figures cannot now be obtained. The above estimate is based on what Claimant presently knows . I'f further medical expenses are discovered and/or additional disabilities/or more general damages arise , then, obviously,, this amount would be increased . Executed on August 12 , 1987 , at Concord , California. I declare under penalty of perjury that the foregoing is true and correct. :.GERALDINE GILLERAN i -3- APPLICATION TO FILE LATE CLAIM / BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE 70 APPLICANT September 15 , 1987 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 NWARNING" below. Claimant: DONNA RENEE STEINBERG County Counsel c/o T1s . Geraldine Gilleran Attorney: Law Offices of William J. Hooy AUG 21 1987 3125 Clayton Road 2nd Floor Address: Concord, CA 94519 Martinez, CA 94553 Amount: $4, 030, 000'. 00 By delivery to Clerk on August 13, 1987 hand del . Date Received: August 13 , 1987 By mail, postmarked on no envelope I. FROM: Clerk of the Board of Supervisors 70: County Counsel Attached is a copy of the above noted Application to r1c to Claim. DATED: Angust 21, 1987 PHIL BATCHELOR, Clerk, By . / ; Deputy 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, By46—pul III. BOARD ORDER By unanimous vote of Supervisors sent (Check one only) ( ) This Application is granted (Section 911.6). ( ) 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. P SEP 15 1981 DATE: HIL BATCHELOR, Clerk, By �.C. 'C 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 attorne_y, rF should do so immediately. IV. FROM: Clerk of the Board TO: 1 County Counsel 2 County Administrator 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 Boardfs copy of this Claim in accordance with Section 29703. SEP 16 1987 DATED. PHIL BATCHELOR, Clerk, Byy �G�–t �_--� 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 REV IVrD ..0 G 45 1987 0!L T ¢app C sT r S IN THE MATTER OF THE ) APPLICATION FOR PERMISSION ) TO FILE LATE CLAIM OF DONNA ) APPLICATION TO FILE RENEE STEINBERG ) LATE CLAIM AGAINST PUBLIC ENTITY VS. ) CONTRA COSTA COUNTY BOARD ) OF SUPERVISORS ) ) 1. Claimant DONNA RENEE STEINBERG by and through her guardian ad litem, GERALDINE GILLERAN ("Claimant" ) hereby applies to the CONTRA COSTA COUNTY BOARD OF SUPERVISORS (the "COUNTY" ) for leave to present a claim against that entity pursuant to Section 911. 4 of the Government Code . 2: The cause of action of claimant as set forth in her proposed Verified Claim attached hereto accrued on or about December 15 , 1986 , when Claimant ' s natural guardian learned for the first time of the possibility that she might have a claim against the various entities involved despite having signed a release prior to surgery which the hospital said released Claimant ' s legal rights if anything went wrong in the delivery, a period within one (1) year from the filing of this Application. 3 . Claimant ' s reasons for the delay in presenting her claim to the Public Entity is as follows: (a) Claimant was a minor during all the time specified in Government Code , Section 911. 2 for the presentation of this claim. Thus , pursuant to Government Code , Section 911. 6 (b) (2) , Claimant is entitled to the requested relief as a matter of right . (b;) Claimant was also incapacitated for the entire time specified in Government Code , Section 911. 2 as she suffers from cerebral palsy and because of her minority and incapacity, she failed to file a claim during such time . (c) Neither claimant , her parents , or guardians had any reason to , believe that the doctors and nurses involved here negligently acted or failed to act prior to July 24 , 1987 . From the time claimant and her guardian first learned of the possibility of a valid suit until the above date , claimant ' s attorneys were involved with obtaining the necessary medical records (this took numerous attempts) , finding expert consultants and waiting while said experts rendered their opinion. On July 24 , 1987 , claimant finally learned of the possible malpractice of the hospital I ' I personnel : Executed at Concord , California on August 12, 1987 . I declare under penalty of perjury that the foregoing is true and correct . -'GERALD INEGRAN i i i i i i I i i I -2- i IN THE MATTER OF THE CLAIM ) OF DONNA RENEE STEINBERG, BY ) AND THROUGH HER GUARDIAN AD ) CLAIM AGAINST LITEM GERALDINE GILLERAN ) PUBLIC ENTITY VS. ) CONTRA COSTA COUNTY BOARD ) OF SUPERVISORS ) DONNA RENEE STEINBERG, by and through her guardian ad litem, GERALDINE GILLERAN ("Claimant" ) presents this claim to the CONTRA COSTA COUNTY BOARD OF SUPERVISORS (the "COUNTY" ) pursuant to Section 910 of the California Government Code . 1.; The name and Post Office address of Claimant is as follows : DONNA RENEE STEINBERG, 3155 Mt . Diablo Street , Concord , California 94518 . 2 .: The Post Office address to which Claimant desires notice regarding this claim to be sent is as follows: Ms . GERALDINE GILLERAN c/o Law Offices of WILLIAM J. HOOY, 3125 Clayton Road, Second Floor , Concord , California 94519 . 3 . ' On February 15 , 1984 , at MERRITHEW HOSPITAL in Martinez, 'California ( "MERRITHEW) Claimant received personal injuries under the following circumstances : Claimant ' s mother , JEANETTE STEINBERG, entered MERRITHEW at approximately 5: 00 p.m. on February 15, 1984 , pregnant with Claimant , and experiencing severe labor contractions . She had attempted to gain admission to the hospital since early that morning but was told that she had not progressed , sufficiently. At ',approximately 5: 00 p.m. on February 15, 1984 , Claimant was admitted to the hospital. Despite indications that Claimant was in severe distress the hospital , through its employees , failed to heed said indications and take appropriate action. At said time Claimant was physically under the complete control of the doctors , nurses and other health care professionals employed by the hospital and was totally dependent upon them for her care and safety. At ;least as early at 10 : 00 p.m. , claimant ' s heart rate fell precipitously low and , thereafter , Claimant ' s mother was offered .the option; of Caesarean section or continued natural labor . Claimant ' s mother chose surgery which was performed and Claimant was birthed at approximately 11 : 00 p.m. , February 15 , 1984 . �l r' As a result of the hospital and its employee ' s failure to heed the indications of fetal distress and failure to take into account various prenatal information in their possession, Claimant was born with brain damage due to lack of oxygen . Claimant now suffers from cerebral palsy and will continue to do so for the rest of her natural life . These injuries were the direct result of inattention and negligence of the hospital ' s health care professionals and other staff employees , in that said individuals failed to properly respond to, that which Claimant is informed and believes were clear signs of fetal distress which should have caused a reasonably prudent doctor , and attending nurse practicing within the community :standard of care to take immediate steps to avoid the injuries which , in fact , resulted . 4., A general description of the injury, damage or loss received , so far as it is known at the time of presentation of this claim: Claimant suffers from cerebral palsy and other maladies associated with hypoxia suffered at birth . She has partial loss of use of the right side of her body and runs a significant risk of future seizures . Specifically, the damages known presently include the following : (a) MEDICAL EXPENSES - Claimant has employed physicians and incurred hospital and medical expenses, the exact amount of which are unknown. However , Claimant estimates the expenses incurred at the hospital alone exceed $10 , 000 and may run as high as $25 , 000 to� $30 , 000 . (b) FUTURE MEDICAL EXPENSES - Claimant expects to incur further expenses for treatment of her condition which , as stated before , will exist for the rest of her natural life . The amount and nature ;of such expenses are unknown at this point , however , Claimant estimates they may run in excess of Two Million Dollars . (c) PERMANENT DISABILITY - Claimant ' s condition should not completely bar her from obtaining some meaningful employment , however , her options and earning capacity will undoubtedly be sharply curtailed . Claimant estimates her probable earnings loss over her lifetime to be in excess of One Million Dollars . (d) GENERAL DAMAGES - Claimant has sustained mental and physical pain, anguish , stress , depression, embarrassment , fatigue and related injuries connected with her injuries and will continue to do so for the rest of her life . Claimant estimates this aspect of damages to be in excess of One Million Dollars . 5. ' The name or names of the public employee or employees causing the injury, damage or loss : Other than Dr . MITCHELL NEWMAN these are unknown to Claimant at present. They would , however , be: the hospital ' s personnel on duty on February 15 , 1984 , -2- when Claimant first went to the hospital until after the delivery at approximately 11 : 00 p.m. There may be others whose action or inaction contributed to the problem. These are , however , best known to the hospital . 6. The amount claimed as of the date of presentation of this Claim, including the amount of any prospective injury and the basis for its calculation : Claimant claims damages of $4 , 030 , 000 . 00 based on the damage estimates given above. This amount is necessarially an estimate as exact figures cannot now be obtained . The above estimate is based on what Claimant presently knows . If further medical expenses are discovered and/or additional disabilities/or more general damages arise, then, . obviously, this amount would be increased . Executed on August 12 , 1987, at Concord, California. I declare under penalty of perjury that the foregoing is true and correct . GERA D1NE GIE2E N -3- APPLICATION TO FILE LATE CLAIM B0ARD ,0F SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT September 15 , 198' 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. CourAy Counsel Claimant: DONNA RENEE STEINBERG c/o Ms . Geraldine Gilleran AUG 2 1" 1987 Attorney: Law Offices of William J. Hooy 3125 Clayton Road 2nd Floor Martinez, CA 94553 Address: Concord, CA 94519 Amount: $4, 030, 000., 00 By delivery to Clerk on August 13, 1987 hand del . Date Received: August 13, 1987 By mail, postmarked on no envelope I. FROM: Clerk of,the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: Augu s t 21, 19 8 7 PHIL BATCHELOR, Clerk, By ✓ _Deputy L. Hall II. FROM: County Counsel T0: 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. BOARD ORDER By unanimous vote of Supervisors pr sent (Check one only) ( ) This Application is granted (Section 911.6). (X) 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. / f DATE: SEP 15 19$7 PHIL BATCHELOR Clerk By Deputy s WARNING (Gov. Code 3911.8) 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 oourt 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 oonnection with this matter. If nu want to consult an attorneX, u should do so immediately. IV. FROM: - Clerk o , the Board TO: 1 County Counsel (2T County A nis ra or 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. SEP 16 1987 DATED. PHIL BATCHELOR, Clerk, By � C _ 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 r IN THE MATTER OF THE CLAIM ) OF DONNA . RENEE STEINBERG, BY ) AND THROUGH HER GUARDIAN AD ) CLAIM AGAINST LITEM GERALDINE GILLERAN ) PUBLIC ENTITY VS. ) CONTRA COSTA COUNTY HEALTH ) SERVICES , ) DONNA RENEE STEINBERG, by and through her guardian ad litem, GERALDINE GILLERAN ("Claimant" ) presents this claim to the CONTRA COSTA COUNTY HEALTH SERVICES ("HEALTH" ) pursuant to Section 910 of the California Government Code . 1. The name and Post Office address of Claimant is as follows : DONNA RENEE STEINBERG, 3155 Mt . Diablo Street , Concord , Californi.'a 94518. 2. The Post Office address to which Claimant desires notice regarding this claim to be sent is as follows : Ms . GERALDINE GILLERAN c/o Law Offices of WILLIAM J. HOOY, 3125 Clayton Road, Second Floor , Concord, California 94519. 3 . On February 15 , 1984 , at MERRITHEW HOSPITAL in Martinez, California ("MERRITHEW) Claimant received personal injuries under the following circumstances : Claimant ' s mother , JEANETTE STEINBERG, entered MERRITHEW at approximately 5: 00 p.m. on February 15, 1984 , pregnant with Claimant , and experiencing severe labor contractions. She had attempted to gain admission to the hospital since early that morning but was told that she had not progressed sufficiently. At approximately 5: 00 p.m. on February 15, 1984 , Claimant was admitted to the hospital. Despite indications that Claimant was in severe distress the hospital , through its employees , failed to heed said indications and take appropriate action. At said time Claimant was physically under the complete control of the doctors , nurses and other health care professionals employed by the hospital and was totally dependent upon them for her care and safety. At least as early at 10 : 00 p.m. , claimant ' s heart rate fell precipitously low and , thereafter , Claimant ' s mother was offered the option of Caesarean section or continued natural labor . Claimant ' s mother chose surgery which was performed and Claimant was birthed at approximately 11 : 00 p.m. , February 15, 1984 . As a result of the hospital and its employee ' s failure to heed the indications of fetal distress and failure to take into account various prenatal information in their possession , Claimant was born with brain damage due to lack of oxygen . Claimant now suffers from cerebral palsy and will continue to do so for the rest of her natural life . These injuries were the direct result of inattention and negligence of the hospital ' s health care professionals and other staff employees, in that said individuals failed to properly respond to that which Claimant is informed and believes were clear signs of fetal distress which should have caused a reasonably prudent doctor , and attending nurse practicing within the community standard of care to take immediate steps to avoid the injuries which , in fact , resulted . 4. A general description of the injury, damage or loss received ,, so far as it is known at the time of presentation of this claim: Claimant suffers from cerebral palsy and other maladies associated with hypoxia suffered at birth . She has partial loss of use of the right side of her body and runs a significant risk of future seizures . Specifically, the damages known presently include the following : (a) MEDICAL EXPENSES - Claimant has employed physicians and incurred hospital and medical expenses, the exact amount of which are unknown. However , Claimant estimates the expenses incurred at the hospital alone exceed $10, 000 and may run as high as $25,000 to $30, 000 . (b) FUTURE MEDICAL EXPENSES - Claimant expects to incur further expenses for treatment of her condition which , as stated before , will exist for the rest of her natural life . The amount and nature of such expenses are unknown at this point, however , Claimant estimates they may run in excess of Two Million Dollars . (c) PERMANENT DISABILITY - Claimant' s condition should not completely bar her from obtaining some meaningful employment , however , her options and earning capacity will undoubtedly be sharply curtailed . Claimant estimates her probable earnings loss over her lifetime to be in excess of One Million Dollars . (d) GENERAL DAMAGES - Claimant has sustained mental and physical pain, anguish, stress, depression, embarrassment, fatigue and related injuries connected with her injuries and will continue to do so for the rest of her life. Claimant estimates this aspect of damages to be in excess of One Million Dollars . 5.' The name or names of the public employee or employees causing the injury, damage or loss : Other than Dr . MITCHELL NEWMAN these are unknown to Claimant at present . They would , however , be the hospital ' s personnel on duty on February 15, 1984 , -2- when Claimant first went to the hospital until after the delivery at approximately 11 : 00 p.m. There may be others whose action or inaction contributed to the problem. These are , however , best known to the hospital . 6 . The amount claimed as of the date of presentation of this Claim, including the amount of any prospective injury and the basis for its calculation : Claimant claims damages of $4, 030, 000 . 00 based on the damage estimates given above . This amount is necessarially an estimate as exact figures cannot now be obtained. The above estimate is based on what Claimant presently knows . If further medical expenses are discovered and/or additional disabilities/or more general damages arise, then, obviously, this amount would be increased . Executed on August 12, 1987, at Concord , California. I declare under penalty of perjury that the foregoing is true and correct . Allo A J"� :E - 4MA�NEGILL*tRAN -3- i1 a RE ND 3�P�-cc� x,31987 SUP R #ORS f CLIA t IN THE MATTER OF THE ) APPLICATION FOR PERMISSION ) TO FILE LATE CLAIM OF DONNA ) APPLICATION TO FILE RENEE STEINBERG ) LATE CLAIM AGAINST PUBLIC ENTITY VS. ) CONTRA COSTA COUNTY HEALTH ) SERVICES ) 1: Claimant DONNA RENEE STEINBERG by and through her guardian ad litem, GERALDINE GILLERAN ("Claimant" ) hereby applies to the CONTRA COSTA COUNTY HEALTH SERVICES ("HEALTH" ) for leave to present a claim against that entity pursuant to Section 911.4 of the Government Code . 2. The cause of action of claimant as set forth in her proposed Verified Claim attached hereto accrued on or about December 15, 1986 , when Claimant ' s natural guardian learned for the firsttime of the possibility that she might have a claim against the various entities involved despite having signed a release prior to surgery which the hospital said released Claimant ' s legal rights if anything went wrong in the delivery, a period within one (1) year from the filing of this Application. 3 . Claimant ' s reasons for the delay in presenting her claim to the Public Entity is as follows : (a) Claimant was a minor during all the time specified in Government; Code , Section 911. 2 for the presentation of this claim. Thus , pursuant to Government Code , Section 911 . 6 (b) (2) , Claimant is entitled to the requested relief as a matter of right . (b) Claimant was also incapacitated for the entire time specified 'in Government Code , Section 911.2 as she suffers from cerebral palsy and because of her minority and incapacity , she failed to ;file a claim during such time . (c) Neither claimant , her parents , or guardians had any reason to ; believe that the doctors and nurses involved here negligently acted or failed to act prior to July 24 , 1987 . From the time claimant and her guardian first learned of the possibility of a valid suit until the above date , claimant ' s attorneys were involved with obtaining the necessary medical records (this took numerous attempts) , finding expert consultants and waiting while said experts rendered their opinion. On July 24 , 1987, claimant finally learned of the possible malpractice of the hospital 1 personnel;. Executed at Concord , California on August 12 , 1987 . I; declare under penalty of perjury that the foregoing is true and 'correct . ERALDINE GILLERAN I w i -2- IN THE MATTER OF THE CLAIM ) OF DONNA RENEE STEINBERG, BY ) AND THROUGH HER GUARDIAN AD ) CLAIM AGAINST LITEM GERALDINE GILLERAN ) PUBLIC ENTITY VS. ) CONTRA COSTA COUNTY HEALTH ) SERVICES ) DONNA RENEE STEINBERG, by and through her guardian ad litem, GERALDINE GILLERAN ("Claimant" ) presents this claim to the CONTRA COSTA COUNTY HEALTH SERVICES ("HEALTH" ) pursuant to Section 910 of the California Government Code . 1. The name and Post Office address of Claimant is as follows : DONNA RENEE STEINBERG, 3155 Mt . Diablo Street , Concord , California 94518. 2 . The Post Office address to which Claimant desires notice regarding this claim to be sent is as follows : Ms . GERALDINE GILLERAN c/o Law Offices of WILLIAM J . HOOY, 3125 Clayton Road , Second Floor , Concord , California 94519. 3 . On February 15, 1984 , at MERRITHEW HOSPITAL in Martinez, California ("MERRITHEW) Claimant received personal injuries under the following circumstances : Claimant ' s mother , JEANETTE STEINBERG, entered MERRITHEW at approximately 5: 00 p.m. on February 15, 1984 , pregnant with Claimant , and experiencing severe labor contractions. She had attempted to gain admission to the hospital since early that morning but was told that she had not progressed, sufficiently. At. approximately 5: 00 p.m. on February 15 , 1984 , Claimant was admitted to the hospital. Despite indications that Claimant was in severe distress the hospital , through its employees , failed to heed said indications and take appropriate action. At said time Claimant was physically under the complete control of the doctors , nurses and other health care professionals employed by the hospital and was totally dependent upon them for her care and safety. At least as early at 10 : 00 p.m. , claimant ' s heart rate fell precipitously low and , thereafter , Claimant ' s mother was offered the option of Caesarean section or continued natural labor . Claimant 's mother chose surgery which was performed and Claimant was birthed at approximately 11 : 00 p.m. , February 15, 1984 . -1- (n) J As a result of the hospital and its employee ' s failure to heed the indications of fetal distress and failure to take into account various prenatal information in their possession , Claimant was born with brain damage due to lack of oxygen . Claimant now suffers from cerebral palsy and will continue to do so for the rest of her natural life . These injuries were the direct result of inattention and negligence of the hospital ' s health care professionals and other staff employees, in that said individuals failed to properly respond to that which Claimant is informed and believes were clear signs of fetal distress which should have caused a reasonably prudent doctor , and attending nurse practicing within the community standard of care to take immediate steps to avoid the injuries which , in fact , resulted . 4. A general description of the injury, damage or loss received , so far as it is known at the time of presentation of this claim: Claimant suffers from cerebral palsy and other maladies associated with hypoxia suffered at birth . She has partial loss of use of the right side of her body and runs a significant risk of future seizures . Specifically, the damages known presently include the following : (a) MEDICAL EXPENSES - Claimant has employed physicians and incurred hospital and medical expenses , the exact amount of which are unknown. However , Claimant estimates the expenses incurred at the hospital alone exceed $10, 000 and may run as high as $25 , 000 to $30 , 000 . (b) FUTURE MEDICAL EXPENSES - Claimant expects to incur further expenses for treatment of her condition which , as stated before , will exist for the rest of her natural life . The amount and nature of such expenses are unknown at this point , however , Claimant estimates they may run in excess of Two Million Dollars . (c) PERMANENT DISABILITY - Claimant ' s condition should not completely bar her from obtaining some meaningful employment , however , her options and earning capacity will undoubtedly be sharply curtailed . Claimant estimates her probable earnings loss over her lifetime to be in excess of One Million Dollars . (d) GENERAL DAMAGES - Claimant has sustained mental and physical pain, anguish, stress, depression, embarrassment , fatigue and related injuries connected with her injuries and will continue to do so for the rest of her life. Claimant estimates this aspect of damages to be in excess of One Million Dollars . 5. 1 The name or names of the public employee or employees causing the injury, damage or loss : Other than Dr . MITCHELL NEWMAN these are unknown to Claimant at present . They would , however , be the hospital ' s personnel on duty on February 15, 1984 , -2- when Claimant first went to the hospital until after the delivery at approximately 11 : 00 p.m. There may be others whose action or inaction contributed to the problem. These are, however , best known to the hospital . 6. The amount claimed as of the date of presentation of this Claim, including the amount of any prospective injury and the basis for its calculation : Claimant claims damages of $4 , 030, 000 . 00 based on the damage estimates given above . This amount is necessarially an estimate as exact figures cannot now be obtained. The above estimate is based on what Claimant presently knows . If further medical expenses are discovered and/or additional disabilities/or more general damages arise, then, obviously, this amount would be increased . Executed on August 12 , 1987, at Concord , California . I :declare under penalty of perjury that the foregoing is true and correct . LDINE GIL RAN -3-