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HomeMy WebLinkAboutMINUTES - 08141990 - 1.18 R Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS'TO CLAIMANT A. Claims relating to causes of action for death or for injury to person 'or to per- sonal• property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months 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. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. 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 the end of this form. — RE: Claim By ) Reserved for Clerk's filing stamp Nakmv u > qga RECEIVED VII-} �C(51C Against the.County of Contra Costa ) ;� ( 3 /T' or ) District) KOOFSUPERVISORS COMM COSTA CO. Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ G,3, 5 �] and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give .exact date and hour) fr1 uh _ 29 1990 LSSA M ------d9 �- --- -----1------------?-----=j_i=--------------------------------- 2. Where did the damn ee or injury ocgur. (Include cit ar�d county) Of t-17� Guab ehl�l-►h5 thl drill LWIV: o� fackr� -7171 ,$uX o� t ht GOri„e+ o S M to l0 0&k- hoar akd i Sire¢ uclrac2n To App14n way 11a..7�1Q.G�j. o*_��Q�ltQ4Yl��}_�Q�L�rYL_�.Q�� j --------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) As -1 , 7-to- ed im-to -tAk'.d1/1v2waY, Aln -i0mw,2ly 5A"1P xdjm curb pu,"cTu►_ed ,imy rjykt "i^ear y7 v¢, 6Qyokd repalN. ------------------------------------------------------------------------------------ 4. What particular act or omission on the .part of county or district officers, servants or employees caused the injury or damage? T 1:s <e xrtrew,el y �i iq ti cab is evev a utrzr arab . I� Aas 6- SA p v►+e 4,! .edl4 , -rAt V�� at IA-e ,G4.s �tafi ov. a cvoSs �ti e ,Street Sard `� cr�aa ; 101`"x` PLVS0" wko AQ.4 coR42 i,H witl: a FcLhc ed 7iry fit- +A&h " s a tite_ culejo. -It S,eem,s t MJ_ -fh,a t 7h.c c& s A&UQ Yn6d j t2 Cun Sm �tia Az /lrts o1 eitljQ.,I�s oav— Iia¢ (over) L(,&,%4 V4 5. What are the names of county or district officers,. servants or employees causing the damage or injury? , ---------- ----------------------------------------------------------- 6. -----=-------- ------ ----------------------- --- ----------- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage: 7. How was the amount claimed -above computed? (Include the estimated 'amount of any prospective injury or damage.) -- et)016se . is TAA _._in_Erol'e 8. Names and addresses of witnesses, doctors and hospitals. -1 h e U•, at _,Q/ivev C A Pvi-ov% Sevu1 ee 57a'!'iDn --�ia��-_ha __c(��- -- l._SQ�r_�.►�t� �'� 94 X03-----=---=-------=' 9. List the expenditures you made on account of this accident or injury: DATE ITEM' ' AMOUNT JU4� e 29, 1 WO a f Gov. Code Sec. 910:2 provides: 7M "The claim must be signed by the claimant SEND NOTICES T0; FAttorney),,,, ;v orb some erson on his behalf." Name and Address'bfwAttormey?'�^sit? _ C1n( imant's Si nature OOt4jPpya.,--d Way (Address) h SCP-&JCC Telephone No. Telephone No. yl S— `/,(. - rj 7 y 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, city or district board or officer, authorized to allow''(orltra pay, the same if genuine, any false or fraudulent i . .. ,, . claim, bill, account, voucher, or ie,1t1ng.,,�is punishable either by imprisonment in the county jail "for a'-period of ,not,{mone)then one year, by a fine of. not exceeding one thousand ($1,000), or by both, such imprisonment and fine, or by imprisonment in the state prison, by a fine of not �i cel P ten. thousand dollars ($10,000, or by both such imprisonment andRfne: '�anageme't } mo ; ZJ cn y D 00 _ p0 m . ➢ Or an m Q !"f ...� Fa3 A rn 34 pp M t m z real Z 7n Az --t.Hca r r c,a^ ( N o-a A .'�; ` i f CA cn 971. 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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: $71.84 Section 913 and 915.4. Please note all "Warnings".ON;FKAD CLAIMANT: CLAYTON, Philip JUL 17 1990 CQUNTY COUNS9, ATTORNEY: MOTINPJy CAUF# Date received ADDRESS: 124 Terranova Drive BY DELIVERY TO CLERK ON -n,ly 12 1990 (hand derive ed) Antioch, CA 94509 BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL BATCHELOR, Clerk DATED: July 17, 1990 BY: Deputy 11. FROM: County Counsel TO: Clerk of the Board of kEe_pv1isors 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: 1 BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: Ali G 1 4 19 90 PHIL BATCHELOR, Clerk, B Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 15 1990 BY: PHIL BATCHELOR Deputy Clerk CC: County Counsel County Administrator 5. What are the names or county or districtofficers, servants, or employees causing the. damage or injury?- r 6. What damage or injuries do you claim resulted? (Give fu l extent of injuries or damages claimed. Attach two estimates for auto damage.) y � 7. How was the amount claimed above computed? (In"clude the estimated amount of any prospective injury or damage.) 8. Names and Nddresses of witnesses; doctors, and hospitals: wIJ t�JG n ,'\ek�Z,d ist the expenditures you made on account of this accident or injury: DATE IMI AMOUNT Govt. Code Sec. 910. 2 provides: "The claim signed by the claimant or by some person on his behalf." SEND NOTICES TO (Attorney) Name and Address of Attorney Claimants Sig ature — y/ s� - �._l �dddress (Rwzu Telephone Number: Telephone Number: 0 J LOST PROPERTY CLAIM Return original application to: Clerk of the Board PO Box 911 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 it's office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 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 - 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 of officer, authorized to allow or pay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, is guilty of a felony. " 'c'k•'••O Jc°•%x4c•F:c:c;cx x& :c:c�'c'c do:c;:k:<x o:4c 4c;ci<:c::;::c k '•'••'.k:c:c xic of dr�k'c�x'.c::;cic:c kic:c'.c:coY;c'.c n:�`�kx�4rok;°•�;:;:9ck�& RE: C aim By Reserved for Clerk' -.filing stamps RECEIVED Against the COUNTY OF CONTRA COSTTAA 12W A CLERK BOARD OF SUPERVISOP- or _ DISTRICT 4 CONT RA COWWA cr' (rill in name) The undersigned claimant hereby makes claim -agaist the County of Contra. Costa or the above-named District in the sum of $ '�ol . � ' and in support of this claim re presents as follows: 1 When did the injury or in damage ' (Give and d hour) Y occur.� 2. Where id the damage or injury occur: (Include city and county.) 3. How did the dama;e or injury occur? (Give full details : use extra sheets if required.) i `Loss a ; tf A C`o�\_N ro_' S 4. What particular act oA omission on the part of county or district officers, servants, or employees caused the injury .or damage? over - / Thank You SALES CNECk: 1010•' '1 4091/1515 ' 3514, �`43.1� ih7 MENSWEAR JPQns 1x.99 4276940?3 MENS +��f'mA,n�39.95 TAS --------------------77------------------ --- REDI TOTAL 6'1. 19 NW-CREDIT 89193`12y APPROVAL-N0. 99930000' ' 1 •1218 89 •12:45 lc- 'Je Gtr n 5' ,_..' zza . . ; o '.'­IJr.IV �..x'.Lc To -�e- •ITh A.[ u wE1eR b IN,avu al mY rill, a tl a .prwba'MM you.Yw MIA nub.PIMCIIAY 1 wW A-A b NII,izl"bw r.IaAw flman tA.,pw. UA mu mw•.m.ffmmom.ry w.,e aer set .� .. •. Mab . w.wlty Intra wt.N. fa.EAOm Mit,Ow /( J l..All..n,«.In el 000e. "Ie' wrvka b tlr XY% / '°"" "' '"° `°`m'°b°" '°^'°'°` `""" Customer Si nature . Plmse Wesent tAis sales check'in caw of error,3700-3eAcchope o,,eturn. Mo^ Ward l ,� 37200-3X �,�,....�. 11 - . Thank You \ :ALES CHECK '1061/1 .1 4091f1515 3533 ORIGINAL CLERK ' .35.14 REFUND .T`rPE' :,: ;.; ,R,ETURN DATE OF'PURCHASE: ''12/18%89 "' WRONG COLOR,. STYLE SIZE _ 769403. .=- - P1EtJS �e f wLs.o ---39.9'I 1. r�G11 MENSTA 4 ---------------'------- �c ---- ---r��73 -- MW-CREdIT`EXCHANGE' •' 5' . 7,2 •10.73 TOTAL . ' ;.'. ..: 10.73 MW-CREDIT 891935129 APPROVAL-N0. " ' 13220000 12/18/89 - 16: 18 ..x,19..,. ..... Zlnmt�4 ` l Ims i ('-0"$r`Tll.' At ...frog • . v 17 l -I ... y 5]nR,er is wbN m w Wme a.,p fi, .l ,i you 1 with .You.11 g%CUIUYY rt ,olein.PURCIU66 ' r . 1' .li, u[a NII.Ncipainp relemG(msaw wipe.. ] rote¢wIv]a MontgomeryWW Gar of • ) .. s:wr,,.lry a]tare.t,w waalar ,eca w, of Oootle eM/ar rryleu la w W.m prlann w oblgeuom •n. m w mrGbnme]. wrraemt .nm w Cosy met Signature, ,. a present this sales check id mse of re[u]n. *py� ] ,;aclmn0a or Mm � You zoo-sx. G�7 tomer uh- /' CONTRA COSTA DETENTION FACILITY CLOTHING RECEIPT LJIS11 DATE: q1/2fJ/30 S REC: 183260 TIME: 0021 15 FACILITY: NUF NAME (L, F, M): W-AY,rON POILIf' OA A AW D.0.B.: e : • BOOKING NBR: C40002147J INTAKE SHIRT/BLOUSEPANTS/SKIRT y COAT/JACKET Ib \ SHORTS/PANTIES ��SHOES/BOOTS HIRT/BRA n� a SOCKS/NYLONS DHAT/PURSE ' 0 SWEATER/SWT. SHIRT QDRESS 0 4 OTHER BKG OFC: INM ESIGNATURE RELEASE DATE: I HAVE RECEIVED ALL OF MY CLOTHING. REL OFC: X INMATE SIGNATURE z. rti Coroner COntrd Richard K. Rainey SHERIFF-CORONER 1 Duayne J. Dillon alifornia 94553COS�a Assistant Sheritl (415) 3724495 County Warren E. Assistant Sheriff _r Enclosed, is a County Claim Form.. Please list the missing articles and their value, along with any documents you may have, i .e. , receipts etc. Be sure you have included oertinent dates that tie in with your loss. These dates should show when you were brought here and when you left. Then you must return this form to Contra Costa County, Clerk of the Board, 651 Pine .St. , Room 106, Martinez, CA 94553, _ (1 Y • I i 1i r I [ . I I AN EQUAL OPPORTUNITY EMPLOYER i � CLAIM I� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA nst the County, or District governed by) BOARD ACTION rd of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 14, 1990 oard Action. All Section references are to ) The copy of this document mailed to you is your notice of lifornia Government Codes. ) the action taken on your claim by the Board of SupiftyR$B (Paragraph IV below), given pursuant to Government o�`e Amount: $55.00 Section 913 and 915.4. Please note all "Warnin CLAIMANT: ESPEN, Anthony Joseph GgHMTY G(gU(4SA ApnRT!! KBUFr ATTORNEY: Date received ADDRESS: 369 Linda Drive BY DELIVERY 10 CLERK ON July 13, 1990 (hand delivered) San Pablo, CA 94806 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH BATCHELOR, DATED: July 17, 1990 BYIL Clerk 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: t ' �� 190 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 (1, This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 14 WO PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sec ' 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 15 1990BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator /R ~ LOST PROPERTY CLAIM Return original application' to: . Clerk o'f 'the Board 'PO Box 911 ` '.Martinez, CA 94553 •A. Claims relating to causes of" action for death or for injury to person or to personal 'property or groaiirig 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'.�ac"tion 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 it's office in•Room- 106; Couhty Administration Building, 651 Pine Street, ' Martinez, CA 94553. C. If clai-ta 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 6ach 'public entity. ' E. Fraud - 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 of fradulent claim, bill, account, voucher, or writing, is guilty of a felony. " ;'c'.c'c:::r t:cx�`:'< k�:cx:c�'c'c:c R'c t-;ckkR- 'c�c:c�;c 'c',c::•,'c;c:c>�.',ck�'.c•:.::k* 'c�'.cir>c;c�:�:'xic:c'.c.'c'x',<:c::*:c'.c',c�ic*�c�`�•lct�ic� RE: ; Claim B "� Reserve ifor 1 k'st.filin stamps o 17, RECEIVED Against the COUNTY OF CONTRA COSTA jL ! 3 � I,o or _ DISTRICT- - CLERKB OOFSUpERVISORS (Fill in name) CONTRA COSTA CO.A-14-1/ 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 re presents as follows: 1. When did the damage or injury occur? (Give exact. date and hour) u ©� -- 2. Where did th amag or in Jury occur: (Include city and county.) G6%1A ft Gos rq Peq'et oft 1% lL -- /11etd1,462- C,�)e*- 3. How did the daea,•e or injury occur? (Give full deta Is ; use extra sheets if required.) � C %Jover - C-toarAM9 tee4AP � I s3 nln -�R1n'l GGo4. What particular act or omission onthe part of couWty or district servants, .or employees caused they ' jury or damage? Pep,50j,B//;�G[,oThnf©©m lo! i J► ,c M What are the names or county or district`.off.icers, servants, or employees c j Causing the damage or injury?. CDd&( COS7�4 0,0YWA ' SIG!\ �1l -� 6. What damage or injuries do ou claim resulted? (Give ful extent of injuries or damages cl d. &ttich two estimates for auto damage.) �4fe kPahtrf ®i?',C/(/3'Lut wov�/f�/7/N�W�`�►uovr�nrc 1'cri/' ®� ,�! ��I �? .�' �uJi1�s� L_A1isSle, 7 How was the amount claimed above computed,? (Include the estimated argount -D of any prospective injury or damage.) h V 0( f S P/�j i MC4_fe au 9 h ,�/Cr.��( ' 1/` -el(. 8. Names and addressEM of witnesses, doctors, and hospitals: f! $G7: R(D&ERS Wlra CO-5-0 Per`eeion Pati iifYJ rhAf1'1i�2�� 9. List the expenditures you made on account of this accident or injury: _ DATE ITalAMOU ©� �7103�Qd _ � pr. 1YJKe,s -nnots hoe- 5� p �Nn-r work unix 0�'M �. � Nay � �� p0 !. work unik Vel sh1r�-�/n . Govt. Code Sec. 910.2 provides: "The claim signed by the claimant or by some person on his behalf. " SEND NOTICES TO (Attorney) . Ad Name and Address of Attorney s S ' na r __ �Te::-S Telephone Numb'es..w . ,, Tele hone Numb `Y ; OWE IAIWY4410 i3- W. P y � 8 • i t .. I� � ply , 4',- . � , I V, 1 1 . . ZCON.TRA.COSTAZETENTION.FACILITY_ `._;`L"'JIsII - ?-CLOTHING RECEIPT '"----"' " ' ... . .. . DATE 07/0390 ..,.::.:, _-:. RECi•c''a-'19E310 '. . ",,TIME:........1212 _..... .... - FACILITY-.- MDF ANTHONY JOSEPH : J 3 ^ � _ 1 Sheriff-Coroner /y/ nT4lA� Richard K. Rainey �n COI ILI Ct g• /� SHERIFF-CORONER P.O. Box 391 Cost Duayne J. Dillon Martinez. California 94553 Assistant Sheriff (415) 372- 4495COurty Warren E. Rupf Assistant Sheriff -d Enclosed, is a County Claim Form. Please list the missing articles and their value, along with any documents you may have, i .e. , receipts etc. Be sure you have included pertinent dates that tie in with your loss. These dates should show when you were brought here and when you left. Then you must return this form to Contra Costa County, Clerk of the Board, 651 Pine .St. , Room 106; Martinez, CA 94553. AN EOUAL OPPORTUNITY EMPLOYER 1 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA • Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 14, 1990 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: $736.50 Section 913 and 915.4. Please note all "Warnings".RECEIVED CLAIMANT: SALO, Donald ATTORNEY: Date received ADDRESS: 2107 Cypress Avenue BY DELIVERY TO CLERK ON July 11, 1990 San pablo, CA 94806 BY MAIL POSTMARKED: July 10, 1990 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 17, 1990 PPH I:L BATCHELOR, Clerk eputy 11. FROM: County Counsel TO: Clerk of the Board of Su isors 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: 1 ). /J A Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER.: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: A U G 14 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code secti 13) Subject to certain exceptions, you have only six (6) months from the'date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 15 1990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY. INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months 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. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. 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 the end of this form. * * * * * * * i * * * * * * * * * * * * * *' * * * * * * * * * * * * * * * * * * * * * RE: Claim By ) Reserved for Clerk's filing stamp klm %tiW SQ21r) RECEIVED Against the County of Contra Costa ) or ) FCLERK6W;J0F SUPERVISORS EDistrict) CONTRA COSTA CO. Fill in name ) The undersigned claimant hereby makes claimainst the County of Contra Costa or the above-named District in the sum of $ 736. 6^0 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ----6-_-d--6-- 2. Where did the damage or injury occur. (Include city and county) 3. How did the damage � or i�nj/u�ry oc �iv full details; use,ex ra p�.per if required) � 7 C9�C gcX �1� 3 .,ouc --- ---��.e_.--------------- ---------------------------- -------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused theinjury orge? S�� ,,,,� � �•�-L "'I/-��`�^'"✓ (over) • r • 5. What are the names of county or district officers, servants or employees causing the damage or injury? ------------=--=------------------=-=-----=-----------------=-=--------------------- 5. ' What damage or injuries do. you claim resulted?. (Give full extent of injuries or damages. claimed. Attach two- estimates for auto damage. 7. How was the amount claimed above computed? (Include the amount of any prospective .i d y or d ) , //JJ •s�,c/v _ �.. 'r /I/P�'c.c e7 g.Ti.� :, i / X36- 5-0 ------------------ -- ---- =-----------=--------- ----------,----�`- --- 8. Names and add re ses of witnesses, doctors and hospitals: 9. List the expenditures you made on account of this accident or injury: DATE. ITEM AMOUNT Q Gov. Code Sec. 910:2 provides: "Thee i must be sig d byt imant SEND NOTICESrTDI Ir(cAttorny:) - or so e er. on s beh Name and Address jof A:,t-toriiey -.c (Claimant's Signature to Add essss) Telephone No. Telephone No. Z�e -7 — -5 O J NOTICE Section 72 of- the Penal Code provides; "Every person who, with intent to defraud, presents for allowance or for paSment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a per,iod.of not more than one year, by a fine of, not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. 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'('sky��"�4 � tF- i `' z r �, � yr,� .:� ` „� , .�,,. g`�'Ei Ste" l 1J..���� ,.�,����f�. ;;;jj%lllj �i� ,,f Ys' � ,-- ` . �, e � r `i ter' 1ti� r ,1 •x J !�1 N60 N s u ® \ V 1 r 1 �b O a Sri o � 4 v CLAIM O ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 14, 1990 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: $150,000.00 Section 913 and 915.4. Please note all "Warnings" CLAIMANT: WILLIAMS, Edward L. JUL 17 1990 ATTORNEY: Law Offices of COUNTY COUNSEL Karlstrom & Krebs Date received MARTINS CALIF. ADDRESS: 1970 Holmes Street BY DELIVERY TO CLERK ON July 12, 1990 Livermore, CA 94550 Cert. P 774-390-520 BY MAIL POSTMARKED: July 11, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, ppHH gg DATED: July 17, 1990 BYIL DeputyLOR, Clerk I1. FROM: County Counsel TO: Clerk of the Board of S sors � ) 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: / /go BY: I Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Adminis ator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 14 1990 PHIL BATCHELOR, Clerk, By Z2tib 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. :ted:_ A�iG 1 5 19Q� BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 6 /' 0�.�` `O�l?i �G ✓L/ Gly/ 970 -Fa�rze� cfti eeb eS -& iveimo�� 0a01v,(4qv94660 ���� // �>6J 4�9 9o98 R. ✓raW& WWZ'* ✓Uwdle l lo-1°.raclice i2 ✓E;,� X 9F-e& of lun a RECEIVED �J90 July 11 , 1990 JUL 12 CLERK 80ARD F SUPERVI CONTRA COSTA CO. Clerk of the Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez , CA 94553 Re: Edward L . Williams bear Clerk: Please find enclosed the original and a copy of the face sheet of a claim form against the County of Contra Costa, in the above named case . Please file the original. claim form and attachments and returned the stamped face sheet to our office in the enclosed self- addressed stamped envelope . Thank you for your cooperation in this matter . Very truly yours, Lynda Adams Secretary to Karlstrom & Krebs enc. SENT CERTIFIED Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months 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. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building,. 651 Pine Street, Martinez, CA 94553. 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 the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp EDWARD L . WILLIAMS RECEIVED Against the County of Contra Costa ) or & 2 1990 ) �( District) CLERK BOARD OFSUPERVIS Fill in name ) coNrRA COSTA co. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 150 ,000 .00 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) -- January 19 , 1990 , approximate) 7 :00 a .m. 2. Where did the damage or injury occur? (Include city and county) Bear Creek Road , Orinda , CA ------------------------------------------------------------------------------------ 3. How, did the damage or injury occur? (Give full details; use extra paper if required 2 car collision (claimant was a passenger in one of the vehicles) , impact left both cars heavily damaged and one car split in two parts . ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Factors proximately contributing to accident include the inherent dangerous condition of the city and county road (Bear Creek Road) , e . g . , road is narrow , windy , with unimproved shoulders and no controls . (over) r .5. What are the names of county or district officers, servants or employees causing the damage or injury? UNASCERTAINED AT THIS TIME ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Extensive injury to hip , ribs , chest , knees and face ; permanent residual damage . ---------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Medical costs to date exceed $17 ,000 .00 and ongoing Wage loss to date totalling $8 ,000 .00 and ongoing ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Edward Williams , 5444 E . 14th Street , Oakland , CA Thomas Bean , 1101 Carey Dr . , #39 , Concord , CA Kenneth Przymierski , 3018 Gratton Way , Concord , CA Other witnesses currently unascertained it �� ----As to_doctors_ and_hospitals ,_s e e Attachment -_A--------------------------- ------ ----------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT See Attachment "B" Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney /� / � Law Offices of Karlstrom & Krebs /C (� /J — 1970 Holmes Street Claimant's Signature Gfa-w-a ^ Livermore , CA 94550 5444 E . 14th Street , #A Address Oakland , CA Telephone No. (415) 449-9093 Telephone No. N 0 T I C E 21 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, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. NOTICE OF CLAIM AGAINST THE CITY OF ORINDA , CALIFORNIA Edward L . Williams ATTACHMENT "A" 1 . John Muir Medical Center 1601 Ygnacio Valley Road Walnut Creek , CA 94598 (415 ) 938-2400 2 . Arthur J . Garry , Jr . , M. D. , Inc . 122 La Casa Via, Suite 218 Walnut Creek , CA 94598 ( 415 ) 935-6907 3 . Neuroscan 115 La Casa Via, Suite 202 Walnut Creek , CA 94598 ( 415 ) 933-9440 4 . Webster Orthopaedic Medical Group 3300 Webster Street , Suite 1200 Oakland , CA 94609 (415 ) 452-0329 5 . Regional Ambulance Inc . 41300 Christy Street Fremont , CA 94538 (415 ) 657-9999 6 . Medical Center Magnetic Imag . P.O. Box 23250 (MCMI ) Oakland , CA 94623-0250 (415 ) 283-9300 7 . Bay Area Physical Therapy, 295 27th Street Oakland , CA 94612 ( 415 ) 451 -2040 8 . East Bay Medical Imaging Assoc . P . O. Box 24970 Oakland , CA 94623-4970 ( 415 ) 283-9300 NOTICE OF CLAIM AGAINST THE CITY OF ORINDA, CALIFORNIA Edward L. Williams ATTACHMENT "B" John Muir Hospital $12 , 204. 52 Arthur Garry , Jr. , M. D. $ 556 . 60 Neuroscan $ 500 . 00 John Muir Hospital $ 555 . 60 John Muir Hospital $ 264. 00 Webster Orthopaedic Group $ 266 . 90 Regional Ambulance $ 557 . 40 Medical Center Magnetic Imag . $ 450 .00 John Muir Hospital $ 111 . 12 John Muir Hospital $ 300 .00 John Muir Hospital $ 157 . 00 Bay Area Physical Therapy $ 195 . 00 Webster Orthopaedic Group $ 70 . 00 John Muir Hospital $ 52 . 80 John Muir Hospital $ 60 . 00 John Muir Hospital $ 31 . 40 East Bay Medical Assoc. $ 100 . 00 Webster Orthopaedic Group $ 65 . 00 TOTAL TO DATE $16 ,497 . 34 2nd AMENDED CLAIM • ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA .Y Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 14 , 1990 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 Gisumgttode Amount: ANDERSON, Rodney L . Section 913 and 915.4. Please note all "Warnings". P .O. Box C 68698 jut- 17 1990 CLAIMANT: Tamal , CA 94964 NTY COUNSEL ATTORNEY: (WRTINV, CALIF, Date received ADDRESS: BY DELIVERY TO CLERK ON July 16 , 1990 (via P . O. Box) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pp gB DATED: Jniy 17 � I000 BAIL DeputyLOR, C1e 11. FROM: County Counsel TO: Clerk of the Board of Supervisors N ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). { ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �I� /In BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:A U G 1.4 1990 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code se ' n 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 aboAvee. Dated: AUG 15 19`° BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator of � � JO . 9' 0 � � ■ � , ul rg % o f 2/ \ � � ■ C-t 9 \ �� % \ y ® � r ® \/ID \ 9 . � t0 . 0 ® a . JP- . � $ \�~ 0 V k � . . �. o A0 ƒi � / . $ ? � ` % \: \ RECEIVED z JUL 10 1990 U 41ARiINEZ, G4GF. .•�� xv Ja - � - a .a 00,.�•',.�-° 000 ij, 3��:z lv�- �r I � Tri,° ��' �"��` � , 4,.�� 3°°ii tl r^� � ice'` � - tG tea" e'"�/� d. � l�y d' �' , ��'''"'������rrrrrr • •VICTOR J. WESTMAN CONTRA COSTA COUNTY COUNSEL TO O P.O. BOX 69. CO. ADMIN. BLDG.. MARTINEZ, CA 94553 DATE SUBJECT SUBJECT CLERK BOARD OF SRUPERViSO CONTRA COSTA M � a } r 1 � i y I �t F� •z N « pa N v'cn •\ � r 6 my g°2 ,AMS ENDE, , CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors,• Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST. 14 , 1990 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 GgjgL4W Mode Amount: ANDERSON, Rodney L.. Section 913 and.915.4. Please note all "Warnings". P.O. Box• C 68698 AUL 17 1990 CLAIMANT: Tamal,.' CA 9496.4 ; WX��. ATTORNEY:. . �. . Date received ADDRESS: BY DELIVERY- TO CLERK ON' July 16, 1990 (via P.O. Box) BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: faunt' Counse; Attached is a copy of the above-noted claim. DATED: .Tuly- 17'9 1000 `VIL Beep�HtyLOR, C1e 11. 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 910.6). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: Ii '9(► BY: nRJ' 'Deputy County Counsel --rr I11. 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:A U G 14 1990 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code se 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney.of your choice in connection with this matter. If you. want to consult an attorney, you should do so immediately:. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service. in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 15 19% BY: PHIL BATCHELOR by Q5Deputy Clerk CC: County Counsel County Administrator