HomeMy WebLinkAboutMINUTES - 12201983 - 1.21 • CLAIM
BOARD OF SUPERVISQRS OF CaUPA COSTA Mtt=, CALTFM NIA BOAM ACTI0N
December 20 , 1983
Claim Against the County, ) WM TO C E AVWU
Routing Endorsements, and ) 7he copy of this document mailed to you is your
Board Action. (All Section ) notice of the action taken on your claim by the
references are to California ) Board of SgXrvisors (Paragraph III, below) ,
Gmmrnnent Code.) ) given pursuant to Government Code Sections 913
915.4. Please note the "Warning" below.
Claimant: Eva Dellartini County Counsel
Attorney: Gordon & Rees DEC Q 11983
601 Montgomery St , 4th Flr
Address: San Francisco, CA 94111 Maltinli. CA 94553
Amount: Undetermined Hand delivered
By delivery to Clerk on 11/30/83
Date'Received: Novenber 30, 1983 By mail, postmarked on
I. FROM: Clerk of the Board of Supervisors T0: County Counsel
Attached is a copy of the above-noted Claim.
DATED: 11/30/83 J.R. MBSON, Clerk, . Deputy
e IR Calhoun
II. FROM: County Cb T0: Clerk of 139 Board of Supervisors
(Check one only)
( This Claim complies substantially with Sections 910 and 910.2.
( ) This Claim FA318 to amply substantially with Sections 910 and 910.2, and we
are so notifying cL Lu+a*+t. The Board cannot act for 15 days (Section 910.8) .
( ) Claim is not timely filed. Board should reject claim on growd that it was
filed late. (5911.2)
DATED: �,/ JOHN Be aAUSM, County COUYSel, By,� . Deputy .
III. BOARD OREt By unanimous vote of Supervisors present
(� ) This claim is rejected in full.
( ) This claim is rejected in full because it was not presented within the time
allowed by law.
I certify that this is a true and correct copy of the Board's Order entered
in its minutes for this date.
DAM: DEC 2 J.R. OLSSON, Clerk, by �
Deputy
NNMM (Gov't. C. 5913)
Subject to certain saxpticns, you home only six (6) months from
the date this notice was persopally delivered 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 any attorney of your choice in connection
with this matter. If you want to consult an attorney, you should do so
f mmediately.
IV. PTM: -of the Board 70: County Omvmal, 2 County strator
Attached are copies of the above Claim. We notified the claimant of the
Board's action an this Claim by mailing a copy of this document, and a
mom thereof has been filed and endorsed an the Board's copy of this
Claim in accordance with Section 29703. 1"
DATEDt 1 t �_ 'N 0 I�� J. R. CLSS0N, Clerk,
by , Deputy
• I
088
CLAIM TO:' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
Instructions t:o Claimant
A. Claims relating to causes of action for death or for injury to
person or to personal property or growing crops must be presented
not later than the 10.Oth day after the accrual of the cause of
action. Claims relating to any other cause of action must be
presented not later than one year after the accrual of the cause
of action. (Sec. 911.2, Govt. Code)
B. Claims must be filed with the Clerk of the Board of Supervisors
at its office in Room 106, County Administration Building, 651 Pine
Street, Martinez, CA 94553 (or mail to P.O. Box 911, Martinez, _CA) .
C. If claim is against a district governed by the Board of Supervisors ,
rather than the County, the name of the District should be filled in.
D. If the claim is against more than one public ent_ty, separate claims
must be filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end
of this form.
RE: Claim by ) Resery for Clerk' s filing stamps
Eva DeMartini ) F '
)
E D
Against the COUNTY OF CONTRA COSTA)
N0V_3_ 3
R. OLSSON
or DISTRICT) R ARD OF SUPERVISORS
Fill in name ) e r ,O
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District JXXXthfXXX 4cX)&Akfor indemnity, apportion-
and in support of this claim represents as follows: ment and contribution
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
Claimant was served with Cross-complaint for indemnity on Aug. 21, 1983 in
Cork Harbour v. J. Arthur White Corp. Action #2249222 in Contra Costa
Superior Court.
-----------T------------------------------------------------------------
injury
----------------------------------------
injury occur? (Include city and county)
This litigation involves two landslides on certain real property known
as subdivision 4747 in the City of Lafayette, Contra Costa County,
State of California.
- - - --------------------------- ------------------
3-.--How---did-----the----d-amage-----o-r-injury occur. (Give full details, use extra
sheets if required)
See #2.
------------------------------------------------------------------------
4. What particular act or omission on the part of county or district
officers, servants or employees caused the injury or damage?
Claimant is informed and believes that County of Contra Costa negli-
gently and carelessly approved, inspected and otherwise condoned the
construction, design, soil testing, installation of drainage materials
and other construction materials to real property within subdivision
4747. ( v=
5. What ,dre t:,e names of county or district officers, servants or
employees causing the damage or injury?
Unknown 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) The claimant makes this claim against the County of Contra
Costa to assert its right to equitable indemnity, and contribution
from the County of Contra Costa on account of negligence of its employees
__Loing_acts_stated_above-_The-amount-at-the_claim_cannnt ye...Jag--de.texmined.
7. How was the amount claimed above computed? (Include the estimated
amount oflany prospective injury or damage. )
-------------------
-------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
----------------------
-------------------------------------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Claimant is informed and.believes that over $310 ,000 have been spent to
date to stabilize the slide areas.
Govt. Code Sec. 910.2 provides:
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) or by someperson on his behalf. "
Name and Address of Attorney /a
GORDON & REES William J, Peters9 -6,cSignature
601 Montgomery St. , 4th Flr. on behalf of Eva DeMartini
San Francisco, CA 94111 Address
l0 Toledo Drive, Lafayette, CA 94544
Telephone No. (415) 986-8041 Telephone No. 284-2071
**************************************************************************
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. "
090,
CLAIM
BOAF9 OF SUPERVOF CONTRA COSTA COU.TY, CALIFaVIA BOAARU ACTION
December 20.1, 1983
Claim Against the County, ) fVM TO CZADVW -
Routing Endorsements, and ) The copy of this document mailed to you is your
Board Action. (All Section ) Mice of the action taken on your claim by the
references are to California ) Board of Supervisors (Paragraph III, below) ,
Government Code.) ) given pursuant to Wvenvent Code Sections 913
i 915.4. Please note the "Warning" below.
Claimant: Bdtty Jackson, 1860 Oakmead Drive #5 , Concord, CA 94520
Attorney:
Address: -
Amount: $445 . 00
By delivery to Clerk on
Date'rived: December 1, 1983 By mail, postmarked on
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted Claim
DATED: 12/2/83 J.R. O1.SSON, Clerk, By Deputy
Kelly/R. Calhoun
II. FROM: County Gb 70: Clerk of the Board of Supervisors
(Check one only)
(�) This Claim complies substantially with Sections 910 and 910.2.
( ) This Clain) 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. Board should reject claim on ground that it was
filed late. (5911.2)
DATED: /,2 JOHN B. aAUSQ1, County Counsel, By • qty
IV I
III. BOARD By unanizrou,1zsvote of supervisors presen
( X) This claim is rejected in full.
( ) This claim is rejected in full because it was not presented within the time
allowed by law.
I certify that this is a true and correct copy of the Board's Order entered
in its minutes for this date.
DATED; DEC 2 0 1883 J.R. a LSSON, Clerk, Deputy
i4Nr1 = (Gov't. C. 5913)
Subject to certain excepticns, you have only six (6) months from
the date this notice was persopally delivered or deposited in the mail to
file-a court action an this claim. See Gbwerrment Code Section 945.6.
You may seek the advice of any attorney of your choice in connection
with this matter. If you want to consult an attorney, you should do so
immediately.
FTM: Clerk of 99 Board TO: County Counsel, 2 County strator
Attached are copies of the above ClaimWe notified the claimant of the
Board's action on this Claim by mailing a copy of this docament, and a
mpsm thereof has been filed and endorsed an the Board's copy of this
Claim in accordance with Section 29703. {� �/
G E 10 21u I�u.� J. R. MS9CIJ, Clerk, byIL Deputy
091
CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
Instructions to Claimant
' A. Claims relating 'to causes of action for death or for injury to
person or to personal property or growing crops must be presented
not later than the 100th day after the accrual of the cause of
action. Claims relating to any other cause of action must be
presented not later than one year after the accrual of the cause
of action. (Sec. 911. 2, Govt. Code)
B. Claims must be filed with the Clerk of the Board of Supervisors
at its office in Room 106, County Administration Building, 651 Pine
Street; Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, _CA) ,
C. If claim is against a district governed by the Board of Supervisors,
rather than the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims
must be filed against each public entity.
E. Fraud. See penalty for fraudulent claims , Penal Code Sec. 72 at end
of this form.
RE: Claim by )Reserver L' E'D
stamps
Betty Jackson )
DEC / 1983
Against the COUNTY OF CONTRA COSTA)
) �OkADssorrOr DISTRICT) CLERK P RViSORS
(Fill in name) ByA
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District in the sum of $ $445.50 plus cost of
and in support of this claim represents as follows: furniture repair
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
September 30, 1983 at 4:00 pm
-----•_-----T_---�'------__---T-------------------------------------------
2 Where did the damage or injury occur? (Include city and county)
/S 6 O O,k..,eQ/ Pi- {ks'
C o h C_er,e(, Cft- fy -Q O 11
�Q5[l -.y --------------------------- -------
3. How did the damage or ijt ury occur? (Give full details, use extra
sheets if required)
Muddy water rushed through the apartment complex, flooding
the above apartment throughout. When the water receded, the
entire floor area of the above apartment was covered with
- WydfUnI� M11 the articles laying on the floor and the bases
-- ------- -- - ------------------------------------------------
4. What particular act or omission on the part of county or district
officers, servants or employees caused the injury or damage?
It is unknown to claimant what the chain of events were that led
to the flooding. What is known is that the flooding was not .
�rRlffluA�8&sjgrobul OAUMgRTet� dconnected with the construction
(over)
092
5. Whet Are the names of county or district officers, servants or 1
employees causing the damage or injury?
' The parties known to have been involved are:
Calfon Construction Inc. ; Army Corp of Engineers ; County Flood Control;
Gallagher-and Burke Construction Co. ; BART
--- - --- ------------------------------------------------------
6. What damage or injuries do you claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage) -
Please see attached list
7. How-was the amount claimed above computed?- (Include the estimated
amount of any prospective injury or damage. )
Actual repair and replacement costs as well as expenses.
8. Names and addresses of witnesses, doctors and hospitals. - -
Belva Tabor, 1860 Oakmead Drive, #14, Concord, California - Manager
George Perry, Walnut Creek Project Office, Army Corp of Engineers
-------------------------------------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Please see attached list
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
Claim t' Signature
1860 Oakmead Dr #5
Address
Concord, California 94520
Telephone No. Telephone No.
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or
for payment to any state board or officer, or to any county, town, city
district, ward or village board or officer, authorized to allow or pay
the same if genuine, any false or fraudulent claim, bill, account, voucher,
or writing, is guilty of a felony. "
093
a
l
BETTY JACKSON
01860 Oakmead Drive #5
Concord, California 94520
ITEMIZED LIST OF DAhUGES : TOTALS
Actual Repairs - Replacement
Remat and reframe 2 watercolors $90.00
Penny's catalog $ 2.00
Ii'iagazines $ 5.00
Paperback books $ 5.00
Stuffed toy animals $10.00
2 china barrels (paper) 10.00
Child's boardgame $$ 5.00 $137.00
Living and Cleanup Expenses
2 hours lost at work Sept. 30, 1983 $ 8.00
Deals (dinner, lunch) 8.50
Mileage to and from alternate lodging 4.00
Laundry I 6.00
Gas and electricity $ 5.00
Cleaning supplies $12.00
Cleaning hours worked 35 @ $5.00 $165.00
$208.50
Other Losses : (Estimate to fallow)
Casters on all furniture rusted
Veneer on maple dresser, chest of
drawers loosened
Veneer on oak chest of drawers loosened
Mattress water stained
094
CLAIM
BOARD OF SUPERVI90R.S OF MtMA COSTA OO-:TY, GUXM TIA BUM ACTION
Claim Against the County, ) "WE TO CLAIrAW December 20, 19 8 3
Aouting Endorsements, and ) 7he copy of this document mailed to you is your
Board Action. (All Section ) notice of the action taken on your claim by the
references are to California ) Board of Supervisors (Paragraph III, below) ,
Government Code.) ) given pursuant to Government Code Sections 913
i 915.4. Please robe the "Warning" below.
Claimant: Jay R. Schnitzer, 1035A Mohr Lane, Concord, CA 94518
Attorney:
Address:
Amount: $2 , 000 . 00
By delivery to Clerk on
Date•Reoeived: December 2 , 1983 By mail, postmarked on_ 11/30/83
I. F m: Clerk of the Board of Supervisors TO: County Oounsel
Attached is a Dopy of the above-noted Claim.
DATED: 12/2/83 J.R. OISSON, Clerk, By , Deputy
R. Calhoun
II. FROM: County Wunsel TO: Clerk of the Board of Supervisors
(Check one only)
,A;< ) This Claim complies substantially with Sections 910 and 910.2.
( ) This Clain) FAILS to comply substantially with Sections 910 and 910.2, and we
are so notifying claimant. The Board cw=t act for 15 days (Section 910.8) .
( ) Claim is not timely filed. Board should reject claim on ground that it was
filed late. (5911.2)
DATED: a`Z JOHN B. C[msw, County Counsel, By c Deputy
I.
BOARD OFXM By uranin= vote of Supervisors present
(X ) This claim is rejected in full.
( ) This claim is rejected in full because it was not presented within the time
allowed by law.
I certify that this is a true and correct copy of the Board's Order entered
in its minutes for this date.
DATED: DEC *R* CLS". ClerkDeputy
MANUM (Gov't. C. 5913)
Subject to certain exceptions, you have only six (6) months from
the date this notice was persopally delivered or deposited in the mail to
file-a court action on this claim. See Goverment Code Section 945.6.
You may seek the advice of any attorney of your choice in connection
with this matter. If you want to consult an attorney, you should do so
immediately.
IV. FMX: Milk of the Board 70: County Counselt 2 County A&dxdstrator
Attached are copies of the above Claim. We notified the claimant of the
Board's action an this Claim by mailing a oapy of this docunent, and a
mem thereof has been filed and endorsed on the Board's copy of this
Claim in accordance with Section 29703.
DATED: �tG (1 1� J. R. CQ.SSot�t, Clerk, by
�)�� Deputy
095
F I L998 D
In the Matter of the Claim of :
JAY R. SCI�II�iITZER,
Dec
Claimant, R.LC1fRK ARD 5
vs.
NT
IAS MEDANOS COMMUNITY COLLEGE
Jay Be Schnitzer hereby presents this claim to the Board of
Supervisors of Contra Costa County pursuant to the provisions of Section 910
of the California Government Code.
1. The rime and post office address of Jay Be Schnitzer is as follows:
10351 Mohr Lane, Concord, California 94518.
2. The post office address to which Jay R. Schnitzer desires notice of
this claim to be sent is 1035A Mohr Lane, Concord, California 94518.
3. On August 25, 1983 at the Bookstore at Los Medanos Community College
claimant received personal injuries under the following circumstancess
. Claimant purchased a package of Carefree chewing gum. Claimant then
inserted a piece of chewing gum in his Routh and upon biting down broke
his tooth.
4. Los Medanos Community College was negligent for the following reasons:
a Selling a product that was defective;
b Not keeping a current check on their inventory;
c Selling a product that was not fit for human consumption.
5• So far as it is known to Jay Be Schnitzer at the date of the filing of
this claim Jay Be Schnitzer has incurred damages in the amount of
$527.00 due to the capping of the tooth, and lost wages.
6. At the time of the presentation of this claim Jay Be Schnitzer claims
damages in the amount of $2,000.00 computed on the basis of the followings
$310.00 - dental bill
1473.00 - pain and suffering and loss of tooth
217.00 - lost wages
Dateds November 29, 1983 '
Jay R.05chnitser
096
i f
1
d� G}flrrrn �o L'frJ1mJr�n�"
D 1�2 r3
097
..� £556 V3 '
t0uniti,
0n
CLAIM
►,:
BOARD CF SUPERVISORS OF Cmmh COSTA comm, cALIFaWA BOARD AMON
December 20, 1983
Claim Against the County, ) lum TO CLAa'gM
Routing Endorsements, and ) The copy of this doctment mailed to you is your
Board Action. (All Section ) notice of the action taken on your claim by the
references are to California ) Board of Supervisors (Paragraph III, below) ,
Government Code.) ) given pursuant to Government Code Sections 913
915.4. Please note the "Warning" below.
Claimant: Erik Moore, 632 Poirier Street, Oakland, CA 94609
Attorney:
Address:
Amount; $650. 93
By delivery to Clerk on
Date'Raoeived: November 29 , 1983 By mail,, postmarked on 11 2 2 8 3
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted Claim.
DATED: 11129/83 J.R. CISSCN, Clerk, X41 , Deputy
e Calhoun
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
(Check one only)
This Claim complies substantially with Sections 910 and 910.2.
( ) This Claim FAILS to eamply 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. Board should reject claim on ground that it was
filed late. (§911.2)
DATED: /Q -JOHN B. C[AUSEN# County Counsel, By Deputy
III. BOARD By unanimous vote of Superviso6ts present
(� ) This claim is rejected in full.
( ) This claim is rejected in full because it was not presented within the time
allowed by law.
I certify that this is a true and correct copy of the Board's Order entered
in its minutes for this date.
DATED: D E C 2. °'.83 J.R. as sscN, clerk, b& Deputy
MNG (Gov't. C. 6913)
Subject to certain exceptions, you have only six (6) months from
the date this notice was personally delivered or deposited in the mail to
file'a court action; an this claim. See Government Code Section 945.6.
You may seek the advice of any attorrney of your choice in connection
with this matter. If you want to consult an attorney, you should do so
immediately.
IV. M: EDER o County Counsel, 2 County AdMxdiUaitor
Attached are copies of the above Claim. We notified the claimant of the
Board's action on this Claim by mailing a copy of this document, and a
memo thereof has been filed and endorsed on the Board's copy of this
Claim in accordance with Sections 29703.
D c C `? 0 198 3 J. Re a¢.SSON, clerk A� �heti
DATED:. , by . Deputy
098
CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
Instructions ',:o Claimant
A. Claims relating to causes of action for death or for injury to
person or to personal property or growing crops must be presented
not later than the 100th day after the accrual of the cause of
action. Claims relating to any other cause of action must be
presented not later than one year after the accrual of the cause
of action. (Sec. 911. 2, Govt. Code)
B. Claims must be filed with the Clerk of the Board of Supervisors
at its office in Room 106, County Administration Building, 651 Pine
Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, _CA) .
C. If claim is against a district governed by the Board of Supervisors ,
rather than the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims
must be filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72' at end
of this form.
RE: Claim by n„ ) Reseryems' g stamps
CALK F
,= Lnll
Against the COUNTY OF CONTRA COSTA) V 143
/J�,, Q ) J. R. OLSSON
Or T� IUQL�I DISTRICT) CLLR BO D OF SUPERVISORS
(Fill in name) ) B O COSTA CO. pvty
The undersigned claimant hereby makes claim against the .County of Contra
Costa or the above-named District in the sum of $ t? 5
and in support of this claim represents as . follows:
---------------------------------------
d ---------------------------------
1. When did the amage or injury occur? (Give exact date and hour)
---dc�,w X11 1y nQ s ._l�- -------------------------------
2. Where did the damage or injury occur? (Include city and county)
- ------------=-
3. How did t damage or injury occur? (Give full det ls, use extra
sheets if equired)
I
i
-----------------------------T------------------------------------------
4. What particular act or omission on the part of county or district
officers , servants or employees caused the injury
_oJ^�r damage?
(over)
��.R'1''�► J""""am- �
099
5. What are the names of county or district officers , servants or
ew..ployi�,,es causing the damage or injury?
----- _ �__ �,Q9 5--
6. What d
damage or injuries o you claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage)
- - - - --- -- -- -------5---------------------------
7-.--H-ow-was-- --the----amount--- claimed�e computed. (Include the estimated
amount of any prospective injury or damage. )
CSG_0 . q3_- _ Q _ _�- - at L(= -----
8. Names_ and addresses of witnesses, doctors and hospitals.
-----
------------------------------------on--account of th------------------------ -
9. List the expenditures you made is accident or i--nj---
ury.
DATE ITEM AMOUNT
i� 14$35a ,ao
Govt. Code Sec. 910.2 provides :
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) or by someerson on his behalf. "
Name and Address of Attorney
,Claim ntSign ture
ell
Address
Telephone No. Telephone No.
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or
for payment to any state board or officer, or to any county, town, city
district, ward or village board or officer, authorized to allow or pay
the same if genuine, any false or fraudulent claim, bill, account, voucher,
or writing, is guilty of a felony. "
100
BREMEN; AUTO BODY & PAINT Estimate Report
5427 TELEGRAPH AVENUE • OAKLAND, CA 94609 - (415) 428-9886
Customer's Name d o )^ e Phone Date 11 -2143
Address City State Zip
Auto Year `7/ Make��` � Model ���pf / I.D.No.
Color Trim Mileage License No.,Pi a C ( ,4
Re- Re- DESCRIPTION OF DAMAGE PARTS LABOR PAINT OTHER
pair place
25 G 2-
76 67 2
i
17p v
Labor Rate J 7 X O O Total Labor
Total Paint Materials
Total Parts 72 , 00
Sublet
Tax 793
GRAND TOTAL
101
DEALER4PAC68066R 011aLLUTA. 17ULU UC11LC1 , .Lllt-. NO.' n \A m
3207 SHATTUCK AVE,.,BERKELEY,CA.94705 (415)848-6281 6618 SHA TTUCK AVE.,OAKLAND,CA.94609 p
FRONT,• Lbr. PARTS LEFT Lbr. PARTS RIGHT Lbr. PARTS
Hrs. H rs. H rs.
Bmpr Fndr Fndr N m
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Bm r Brkt Fndr Shld Fndr Shld
Bm r Gd �N
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Grvl Shld Hdl-mo Hdlm
Prk Lite _ _ 4 3
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Hdlmp Door Hdimp Door �
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Fr st
Frame - -- - Sealed Beam Sealed Beam (d�\
+Mbr _ � Cow l--...Post
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Wheel CF-rt- - Door iFrt " oma
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"b Can _-D-o9r_H _-Door_H ince ----- D
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Lr Cont Arm o r- ear r ear
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Floor -. . Floor
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o k...Plate-41p _.v _ REAR —.. MISC.. _— ....—...�.-._ r
-mod -_ -...-_._ -.._BtnPrBr.k.t __. . - - -- - ..- - ---------- V\
-Ho-o.d_Mlls19_..-----. -._ ___._--BmRr Gd_--_�_. . _ — -___Wndshld.--... _-- — m00'vim 3
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Rad Hoses GlamPs- _.___ _Tail Lite..._- ------ ...
Fan hr.o_uai.-_-...__ ... _ -----
-- Trnk...Lid- - Bait.- - -- 2 O
-. -_........ ..Srn k Li�._H1nge. -. - .- - -antenna -_-.- / � 0 n
nrC•C9ie_. _._- ._._ - _ --_Trnk_LdlVlidg-_._.-_- _ _.. - _-__._..._ _-.aini._&-MSL_---_.._-__... .,� f,®'(a__ I 1
_..._--------___-_.__ _----
--_-- g j
(A
-- __.._Frame-_+Mbr._-____
-- --- .__......
-
Mtr Mts
LABOR
HRS @$ v $ �Q oy
— PARTS $ /fi pw
—_.--- - ---- —-----.__....--—- - TAX $
TOW&STG. $ j
TOTAL NET PRICE $ Y 4 :2
Operations not listed hereon are additional to the Total Net Price.Selection of materials,methods and parts used for repairs and
testing will be made by repairer only. All agreements and also the final sale price of labor,parts and materials are shown only on
Repair Orders of Shattuck Auto Center,Inc.All sales are based on the Total Net Price;each component itemized price is only for
the use and convenience of repairer in computing Total Net Price-not for defining the final sale price of each component item.
Total Net Price is subject to correction to the extent of:any difference between dealers'retail price and the price listed herein for O
parts,computation errors and other latent mistakes.
CODE: A-Align-Ex& X-Exchange-N-New-OH-Overhaul-P-Paint-R-Repair-S-Straighten-U-Used
S . '
• CLAIM
BOARD OF SUPRRVI90RS OF C0tVRA OO6TA COLD-11Y, CMZFUMIA BOARD ACTION
Claim Against the County, ) =E TO CLAIMANTD e c emb er 20, 19 8 3
Routing Endorsements, and ) The copy of this document mailed to you is your
Board Action. (All Section ) notice of the action taken on your claim by the
references are to California ) Board of Supervisors (Paragraph III, below) ,
Government Code.) ) given pursuant to Gavvx hent Code Sections 913
i 915.4. Please note the "Warning" below.
Wit: Michael McAuliffe .and Dathy McAuliffe
Attorney: Richard T. Bowles
Bronson, Bronson & McKinnon
Address: 100 Pringle Avenue, Suite 550
Walnut Creek, CA 94596- 3587
pmxrnt: Unspecified
By delivery to Clerk on
Date,Reoeived: November 28 , 1983 By mail, postmarked on ll/21/83
I. FROM: Clerk of the Board of Supervisors 70: County Counsel
Attached is a copy of the above-noted Claim.
DATA: 11/28/83 J.R. C1SSCN, Clerk, By . Deputy
Ke Calhoun
II. FROM: County Wunsel TO: Clerk of the Board of Supervisors
(Check one only)
( ) This Claim complies substantially with Sections 910 and 910.2.
This Claim FADS to amply 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. Board should reject claim on ground that it was
filed late. (5911.2)
DATED: JOHN B. CZ VJM, County Oounsel, By Y
III. BOA CFFt By unanimous vote of Supervisors present
(l( ) This claim is rejected in full.
( ) This claim is rejected in full because it was not presented within the time
allowed by law.
I certify that this is a true and correct copy of the Board's Order entered
in its minutes for this date. �Jy�
DATED:ATDATED: DEC' ' J.R. CLSSCN, Clerk, byy �" ✓IClil�t�.c.o. Deputy
MAIN= (Gov't. C. 5913)
Subject to certain oceptions, you have only six (6) months from
the date this notice was persorsally delivered 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 any attorney of your choice in a--ioction
with this matter. If you want to consult an attorney, you atould do so
immediately.
IV. Fri: Clerk af the Board 70: CDunty Counsel, 2 County AftiniiUaitor
Attached are copies of the above Claim. We notified the claimant of the
Board's action on this Claim by mailing a copy of this document, and a
memo thereof has been filed and endorsed on the Board's copy of this 103
Claim in accordance with Section 29703.
E AMID: DEC 2 0 1.qR 3__ J. R. CLS.90N, Clerk, by . Deputy
I RICHARD T. BOWLES D
N. KATHLEEN STRICKLAND F I L
2 BRONSON, BRONSON & McKINNON
100 Pringle Avenue, Suite 550 N0�/� 9�J
3 Post Office Box 8071
Walnut Creek, California 94596-3587 J. R. OLSSON
4 CLER C OARD OFPERV SORS
Attorneys for Claimant e
5
BEFORE THE CITY OF LAFAYETTE
6
IN AND FOR THE COUNTY OF CONTRA COSTA
7
In the Matter of the Claim of
8 MICHAEL McAULIFFE and KATHY McAULIFFE,
9 Claimants, CLAIM ON GOVERNMENTAL
ENTITY PURSUANT TO
10 vs. GOVERNMENT CODE § 901
et seq.
11 BOARD OF SUPERVISORS, COUNTY OF
CONTRA COSTA
12 /
13 TO THE CITY MANAGER OF THE CITY OF LAFAYETTE:
14 On behalf of MICHAEL McAULIFFE and KATHY McAULIFFE,
15 claimants, make this claim for equitable indemnification and
16 contribution against the City of Lafayette in an unspecified sum,
17 to be amended at a later time when said damages accrue, and make
18 the following statement in support of said claim:
19 1 . Claimants address is 36 Toledo
20 Drive, Lafayette, California.
21 2. Notices concerning the claim should
22 be sent to Richard T. Bowles, c/o: Bronson,
23 Bronson & McKinnon, 100 Pringle Avenue, Suite
24 550, Post Office Box 8071, Walnut Creek,
25 California 94596-3587, attorneys for and
26 acting on behalf of claimants .
27
28
LAW OFFICES OF
BRONSON.BRONSON
MCKINNON
104
100 PRINGLE AVENUE
WALNUT CREEK 94596
(415) 945.6660
1 3 . The date upon which this cause of
2 action for equitable indemnity or partial
3 equitable indemnity accrues was on the date
4 defendant is served with a complaint giving
5 rise to said claim which in this instance was
6 September 1, 1983 .
7 4 . This claim arises from a lawsuit
8 filed in Superior Court of Contra Costa
9 County, No. 224922 alleging damage to certain
10 real property located within or near
11 Subdivision 4747 in the City of Lafayette,
12 County of Contra Costa occurring on or about
13 April of 1980 said damage being discovered or
14 June 27, 1980. Subsequently, on April 7,
15 1982, more property was damaged within the
16 Subdivision. The damage sustained is alleged
17 to be the result of earth slippage, to wit, a
18 landslide, caused by inadequate and defective
19 development and construction of said .
20 Subdivision.
21 5. Claimants seek equitable indemnity
22 from the County of Contra Costa because
23 claimants are informed and believe that the
24 County of Contra Costa through its employees
25 negligently and carelessly approved,
26 certified, inspected and otherwise condoned
27 the construction, design, soil tests,
28 installation of drainage materials, and other
LAW OFFICES OF
BRONSON.BRONSON '►'
MCKINNON
100 PRINGLE AVENUE
WALNUT CREEK 94596
(4 15) 945-6660
I construction to said real property within
2 Subdivision 4747, and that as a result of said
3 conduct, caused and contributed to the
4 property_ damage and losses alleged in the
5 lawsuit filed herein.
6 6. At this time the names of the public
7 employees causing the injury, damage and loss
8 referred to above in paragraphs 4 and 5, are
9 unknown.
10 7 . Since this claim is based on
11 equitable indemnification principles, the
12 amount of damages sustained is unknown at this
13 time. Claimants have already been damaged to
14 the extent they have been brought into the
15 lawsuit as Cross-Defendants, thereby incurring
16 at this time resultant legal fees and
17 expenses. Claimants may be further damaged if
18 they are found liable to the plaintiff or any
19 other Cross-Complainant in this action.
20 Claimant may also be further damaged in the
21 event the earth slippage continues and causes
22 actual damage to their home.
23 DATED: November lz�, 1983 BRONSON, BRONSON & McKINNON
24
25 By
ICH T BOWLES
26
Attorneys for Claimants
27
28
LAW OFFICES OF
BRONSON,BRONSON
-3- 106
MCKINNON
100 PRINGLE AVENUE
WALNUT CREEK 94596
1-1 oea_a
. CLAIM TO-.* BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
Instructions to Claimant
A. Claims relating to causes of action for death or for injury to
person or to personal property or growing crops must be presented
not later than the 100th day after the accrual of the cause of
action. Claims relating to any other cause of action must be
presented not later than one year after the accrual of the cause
of action. (Sec. 911. 2, Govt. Code)
B. Claims must be filed with the Clerk of the Board of Supervisors
at its office in Room 106, County Administration Building, 651 Pine
Street, Martinez, CA 94553 (or mail to P.O. Box 911, Martinez, CA) ,
C. If claim is against a district governed by the Board of Supervisors,
rather than the County, the name of the District should be filled in.
D. If the claim is against more than one public ent_ty, 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 )Reserve ' ' lin stamps
MICHAEL McAULIFFE and KATHY* ) '
McAULIFFE throughtheir attorney. ) E D
RICHARD T. BOWLES )
) N0Vo7/ga
Against the COUNTY OF CONTRA COSTA)
OLN
or DISTRICT) CLER ARD OFSUPERVISORS
T O.
(Fill in name) )
ev
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District in the sum of $ unspecified at this time
and in support of this claim represents as follows:
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
April, 1980 discovered June 27 , 1980 and April 7 , 1982
2. Where did the d--mage or injury occur? (Include city and county)
City of Lafayette, Contra Costa County
3. How did the damage-or injury occur? (Give full details, use extra
sheets if required)
The damage sustained is alleged to be the result of earth slippage, to
wit, a landslide, caused by inadequate and defective development and
construction of the Subdivision
4. What particular act or omission on the part of county or district
officers, servants or employees caused the injury or damage?
Claimants seek equitable indemnity from the County of Contra Costa because
Claimants are informed and believe that the County of Contra Costa
through its employees negligently and carelessly approved, certified,
inspected and otherwise condoned the construction, design, soil tests,
installation of .drainage materials and other construction to said (over)
real property within Subdivision 4747, City of Lafayette, County of 0'7
Contra Costa.
5. What are the names of county or district officers, servants or
employees causing the damage or injury?
unknown
6. What damage or injuri.es do you claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage)
Since this is a claim for equitable indemnification, the damages
are unspecified at this time.
- --H
- - - - - - - --- - -
------ --- ------ ------- ----- --------- -------- --- ---------
7. ow was the amount claimed above computed? (Include the estimated---
amount of any prospective injury or damage. )
(see attached claim)
-------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
Unknown at this time. This claim arises from a lawsuit filed in
Superior Court of Contra Costa County, No. 224922 alleging damage to
real property located within Subdivision 4747, City of Lafayette, County
of Contra Costa.
9. List the expenditures you made on account of this accident or injury.
DATE ITEM AMOUNT
Claimants have already been damaged to the extent they have been
brought into the lawsuit as Cross-Defendants, thereby incurring at this
time resultant legal fees and expenses.
Govt. Code Sec. 910.2 provides:
"The cl signed by the claimant
SEND NOTICES TO: (Attorney)' or b s e pers on his behalf. "
Name and Address of Attorney
Richard T. Bowles C 1 pfm ' s Signature
Bronson, Bronson & McKinnon -�
Post Office Box 8071
Walnut Creek, California 94596-3587
Telephone No. 415/945-6660. . . . . Telephone No.
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or
for payment to any state board or officer, or to any county, town, city
district, ward or village board or officer, authorized to allow or pay
the same if genuine, any false or fraudulent claim, bill, account, voucher,
or writing, is guilty of a felony. "
104
e
6 =
• CLAIM
BOARD CF SUPERVISORS OF CONTRA COSTA WMVY, CALIFOR M BOARD ACTION
Claim the.C►ou n ) 110TE 70 CLAIl�� December 20, 1983
Against ty,
Routing Endorsements, and ) 'Jhe copy of this document mailed to you is your
Board Action. (All Section ) notice of the action taken on your claim by the
references are to California ) Board of Supervisors (Paragraph III, below) ,
Goverment Code.) ) given pursuant to Government Code Sections 913
i 915.4. Please note the "Warning" below.
Claimant: Janette '14, Williams, 1860 Oakmead Drive #1, Concord, CA 94520
Attorney:
Address: -
Amount: Undetermined
By delivery to Clerk on
Date'Received:Received: 12/1/83 By mail, postmarked on 1 13-0/8 3
I. FROM: Clerk of the Board of Supervisors 70: County Counsel
Attached is a copy of the above-notZ;e*llR.
im
DATED: 12/1/83 J.R. MSSON, Clerk, , Deputy
Calhoun
II. FROM: County Courisel TO: Clerk of the Board of Supervisors
(Check one only)
( ) This Claim acsnplies substantially with Sections 910 and 910.2.
( ) This Claim FAILS to oemply 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. Board should reject claim on ground that it was
filed late. (5911.2)
[DATED: JOHN B. CZAUM, County Counsel, By Deputy
III. BOARD CFMR By unanimous vote of Supervisors present
(� ) This claim is rejected in full.
( ) This claim is rejected in full because it was not presented within the time
allowed by law.
I certify that this is a true and correct copy of the Board's order entered
in its minutes for this date.
DATED: DEC J.R. CLSSON, Clerk, by1 "aAc- Deputy
VNeMC (Gov't. C. 5913)
Subject to certain swepti,ons, you have only six (6) months from
the date this notice was personally delivered 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 any attorney of your choice in connection
with this matter. If you want to coaisult an attorney, you should do so
iimredi ately.
FTM: Clerk of the Board 70: County Counsel, 2 County AdininiiUaitor
Attached are copies of the above Claim. We notified the claimant of the
Board's action an this Claim by mailing a copy of this docatnent, and a
nam thereof has been filed and endorsed on the Board's copy of this 1 Q
Claim in accordance with Section 29703.
DATED: DEC 2 n ;Qo J. R. 431& r Clerk, bytDeputy
CLAIM ;"0: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
Instructions to Claimant
A. Claims relating to causes of action for 'death or for injury to
person or to personal property or growing crops must be presented
not later than the 100th day after the accrual of the cause of
action. Claims relating to any other cause of action must be
presented not later than one year after the accrual of the cause
of action. (Sec. 911. 2, Govt. Code)
B. Claims must be filed with the Clerk of the Board of Supervisors
at its office in Room 106, County Administration Building, 651 Pine
Street,. Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, .CA) ,
C. If claim is against a district governed by the Board of Supervisors,
rather than the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims
must be filed against each 'public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end
of this form.
RE: Claim by )Reserved for Clerk's filing stamps
Janette P;:. Williams )
F I L E D
Against the COUNTY OF CONTRA COSTA) pE C al 1983
or DISTRICT) R. OLSSON
Fill in name ) CLERK AR O SUPERVISORS
Co.
B
The undersigned claimant hereby makes claim aga nof Contra
Costa or the above-named District in the sum of $
C aim o ��ilow under
and in support of this claim represents as follows:
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
September 30, 1983 at 4:00 pm
-------------------------------------------------------
d
2. Where did the amage or injury occur? (Include city and county)
1860 Oakmead Drive, Apartment 1, Concord, California, Contra Costa
County
------__r-----------------------------------------------4---------------
3. How did the damage or injury occur? (Give full details, use extra
sheets if required)
I+uddy water rushed through the apartment complex, flooding the above
apartment throughout. When the water receded, the entire floor of the
apartment was covered with mud as well as other items laying on the
floor and furniture basest
-----------------------------_
---------------------------- -- T---------
4. What particular act or omission on the part of county or district
officers , servants or employees caused the injury or damage?
The chain of events are unknown to the claimant except that the
flooding was not a natural disaster but related in some way to
the construction projects on Irionument Blvd.
(over)
110
5. What are the names of county or district officers, servants or
employees'-causing the damage or injury?
The parties known to have been involved are: Calfon "Construction, Inc. ;
Army corps of Engineers ; County Flood Control; Gallagher and Burke
Construction Co. ; and Bart
-------------------------------------------------------------------------
6. What damage or injuries do you claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage)
Estimates of repair and repair costs incomplete, to be sent under
separate cover.
-------------------------------------------------------------------------
7. How was the amount claimed above computed? (Include the estimated
amount of: any prospective injury or damage. )
Actual repair and replacement costs as well as expenses .
8.
-----N--------and---------addresses----of----------�----- --doctors---------------_-------------
ames witnesses and hospitals
George Perry, Walnut Creek Project Office , Army Corp of Engineers
Belva Tabler, 1860 Uakmead Drive, #14, Concord, CA 94520
-------------------------------------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
To be sent under separate cover
**************************************************************************
Govt. Code Sec. 910.2 provides:
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) or by some erson on his behalf. "
Name and Address of Attorney
laimant's Signature
1860 Oakmead Drive #1
Address
Concord, CA 94520
Telephone No. , Telephone No. 689-4183
**************************************************************************
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. "
11�.
3,.
CLAIM
BOAFa OF SUPERVISORS OF CERA COSTA ODIJ:TY, CALIFO RM BOARD ACMON
December 20, 1983
Claim Against the City, ) NOM TO CZAUPM
Routing Endorsements, and ) The copy of this doaum:nt mailed to you is your
Board Action. (All Section ) notice of the action taken on your claim by the
references are to California ) Board of Supervisors (Paragraph III, below) ,
Oovernnent Code.) ) given pursuant to Goverment Code Sections 913
a 915.4. Please note the "Warning" below.
Claimant: Belva Tiay Tabler, 1860 Oakmead Drive #14, Concord, CA 94520-
Attorney:
Address:
fit: Undetermined
By delivery to Clerk on
Date•Received: D e c enb e r 1 , 1983 By mail, postmarked on II/Z24&1_
I. FRAM: Clerk of the Board of Supervisors T0: County Counsel
Attached is a copy of the above-noted Claim.
DAM: 12/1/83 J.R. O 1 SSON, Clerk, By . Deputy
Ke ly Calhoun
II. FFCM: County Counsel 70: Clerk of the Board of Supervisors
(Check one only)
( ) This Claim omplies substantially with Sections 910 and 910.2.
Y�) 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. Board should reject claim on ground that it was
filed late. (S911.2)
L1ATID: joHN B. C msw, County Counsel, By ' zew Deputy
III. BOAM OF R By wwd nous vote of Supervisors present
( X This claim is rejected in full.
( ) This claim is rejected in full because it was not presented within the time
allowed by law.
I certify that this is a true and correct copy of the Board's Order entered
in its minutes for this date.
mm: DEC 201983 J.R. OLMM, Clerk, by Deputy
VLTNM (Gov't. C. 5913)
Subject to certain mss, you have only six (6) months from
the date this notice was persopally delivered or deposited in the mail to
file-a court action an this claim. See Qavernnent Code Section 945.6.
You may seek the advice of any attorney of your choice in connection
with this matter. If you want to consult an attorney, you should do so
immediately.
FROM: Clerk of W Board T0: County , 2 County AddniiUaitor
Attached are copies of the above Claim. We notified the claimant of the
Board's action on this Claim by mailing a copy of this docuiment, and a
memo thereof has been filed and endorsed an the Board's copy of this
Claim in accordance with Section 29703.
DATIDz J. R. CL6.SON, Clerk, by ate , duty
CLAIM tr0: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
Instructions to Claimant
A. Claims relating to causes of action for death or for injury to
person or to personal property or growing crops must be presented
not later than the 100th day after the accrual of the cause of
action. Claims relating to any other cause of action must be
presented not later than one year after the accrual of the cause
of action. (Sec. 911. 2, Govt. Code)
B. Claims must be filed with the Clerk of the Board of Supervisors
at its office in Room 106, County Administration Building, 651 Pine
Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, .CA) .
C. If claim is against a district governed by the Board of Supervisors ,
rather than the County, the name of the District should be filled in.
D. If the claim is against more than one public ent-'_ty, 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 ) Reser i g stamps
Belva May Tabler )
DEC / 1983
Against the COUNTY OF CONTRA COSTA)
J. R. SSON
or DISTRICT) RK so OF SUP RVISORS
T
(Fill in name) ) a .... .....
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District in the sum of $
and in support of this claim represents as follows:
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
September 30, 1983 at 4:00 pm
------ •-- -r----------------..-------------------------------------------
2. Where did the damage or injury occur? (Include city and county)
1860 Oakmead Drive #�14
Coon roadCostazCoun y 94520
---------------- -------------------------------------
3_.__R___ow did the damage or injury occur? (Give full details, use extra
sheets if required)
Muddy water rushed through the apartment complex, flooding
the above apartment throughout. When the water receded, the
ertre floor area of the above apartment was covered with mud
---------- as were all items laying onthe 'floor, including bases of
ftzrni_tUre- ---------------------------------------------------
4. What particular act or omission on the part of county or district
officers, servants or employees caused the injury or damage?
The chain of events are unknown to the claimant except that the
flooding was mt a natural disaster but related in some way to the
construction projects on Monument Blvd.
(over)
113
5. Whaf- are the names of county or district officers, servants or
employees causing thPdam a oz i
The parties knowrf to have �en inv l d' are
-'alfcn Construction Inc. ; Army Corp of Engineers ; County Flood Control;
Gallagher and Burke Construction Co. ; Bart
6.- What damage-or-injuries do you claim resulted? (Give full extent -
of injuries or damages claimed. Attach two estimates for auto
damage)
' To be sent by separate cover when estimates are completed.
-------------------------------------------------------------------------
9. How was the amount claimed above computed? (Include the estimated
amount of any prospective injury or damage. )
Actual repair and replacement costs as well as expenses .
------- --- --------
--. N-----------and-------------of-----------,- - -
doctorsandho ---------------
8ames addresses witnessesital
George Perry, Walnut Creek Project Office, Army C(5rp of 'Engineers
Janette Williams , 1860 Oakmead Drive #1, Concord, CA 94520
-------------------------------------------------------------------------
9. List the .expenditures you made on account of this accident or injury:
.DATE ITEM AMOUNT
To be sent under separate cover
Govt. Code Sec. 910.2 provides :
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) or by some person on his behalf. "
Name and Address of Attorney
Claimant' s ignature
1860 Oakmead Drive #14
Address
Concord, 'CA 94520
Telephone No. Telephone No. 685-8588
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, vouche
or writing, is guilty of a felony. "
11.4