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Home My WebLink AboutMINUTES - 09111990 - 1.2 (2) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA' 'Claim Against the County, or District-governed by) ", BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT " SEPTEMBER 11, 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 Board of Supervisors (Paragraph IV below), given pursuant to-Government Code Amount: $114,225.87 Section 913 and 915.4. Please note al l "Warrn;ngs'Vr'IVFD CLAIMANT: LANDMARK WEST U G ;; 0, 190 ATTORNEY: Paul F. Adams, Esq. COUNTY COUNSEL Tobin & Tobin Date received MA:lii+ice?, CALIF. ADDRESS: 1676 No.' California Blvd. BY DELIVERY TO CLERK ON August '14, 1990 (hand delivered) Suite 690 Walnut Creek, CA 945.96, BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervis"ors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL BATCHELOR, kZQ4Z�, . DATED: August 17, 1990 BY: Deputy 11. FROM: County Counsel TO: Clerk of the Board of Supervisors J` (� ) 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: �G dC� BY: J - 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 ( his Claim is rejected in full. ( J Other: I certify that this is a true and correct copy of the Board's Order entered'; in its minutes for this dates. Dated: E P 1 3990 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, "you have only six:(6) months from the date this notice was personally served or deposited in the mail to file a. court action on this claim. See Government Code Section 945.6. You may seek..the advice of an attorney of your choice in connection with this matter. �If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid:a certified copy.of this Board. Order and Notice to Claimant, addressed to .the claimant as shown above. Dated: SEP 12 .1yJU BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator TOBIN & TOBIN ATTORNEYS AT LAW MARTIN D. MURPHY JOHN L. HOSACK 1676 NORTH CALIFORNIA BOULEVARD RICHARD TOBIN (1852-(887) EUGENE C. PAYNE 111 PAUL E. GASPAR( SUITE690 ROBERT TOBIN (1875-18891 SCOTT A. SOMMER JOHN A. LAPINSKI CYRIL R. TOBIN (1905-1977) KEITH A. KANDARIAN MARTIN H. ORLICK WALNUT CREEK, CALIFORNIA 94596 EUGENE J. CHIARELLI DENNIS McATEER NANCY L. BRAUN C. DARRELL SOOY FACSIMILE (415) 934-1582 SAN FRANCISCO OFFICE PETER H. KRUSE JAMES H. SAKODA JUDITH ILENE BLOOM BONIFACIO BONNY GARCIA (415) 934-1400 ONE MONTGOMERY STREET ROBERT A. ZADEK JOHN C. CALLAN. JR. FIFTEENTH FLOOR HILARY L. LAMAR LESLIE R. HOROWITZ - SAN FRANCISCO, CALIFORNIA 94104 DANIEL L. CARR JOHN P. CHRISTIAN FACSIMILE (415)433-3883 ROBERT A. HARKNESS STEPHANIE L. KRAFCHAK (415) 433-1400 PAUL F. ADAMS PATRICIA H. LYON LAWRENCE R. JANNUZZI LIZBETH R. GORDON (�(� JOAN M. GRIMES RAJEEV M. TALWANI Augu.Sy, 14, 1770 LOS ANGELES OFFICE TERRY J. MOLLICA EVELYN ANN KRAMER l• LINDA J. BERBERIAN FRANK P. MINORE, JR. 770 WILSHIRE BOULEVARD SCOTT F. LANE ALICIA C. MINANA SIXTH FLOOR LOS ANGELES, CALIFORNIA 90017 FACSIMILE (213) 629-8040 (213) 629-5800 SPECIAL COUNSEL JOHN H. HALL.JR. JOHN R. LIEBMAN RECEIVED OF COUNSEL CHARLES D. SOOY .�`7�5,� Board of Supervisors 7AW GU�1 �I Contra Costa County 4 County Administrative Building Room 106 CLERIC 8W0 OF SUPERVI 651 Pine Street NTRACOSTA CO Martinez, CA 94553 Re: Claim of Landmark West Dear Board of Supervisors: This office represents Landmark West, Inc. ("Landmark") which, pursuant to the provisions of Government Code Section 911.2 presents this claim against the County of Contra Costa (the "County") , the County Building Inspection Department and the County Community Development Department in the Isum of $114,225. 87. A specific breakdown of the damages incurred is attached hereto, marked as Exhibit A and incorporated herein by this reference. This claim arises from the actions of the County Community Development and the County Building Inspection Departments in refusing to perform building inspections requested by Landmark. On August 8 , 1988, the County approved the minor subdivision known as MS 32-88 (the "Approval") , subject to five conditions and reciting nine sub-conditions. The County received the soils report required by the Approval on April 25, 1989. On or about May 23, 1989, an application for a grading permit, accompanied by a grading plan was presented to the County. The County approved the grading plan as complying with the conditions of MS 32-88 and issued grading permit G 154772 on June 8, 1989. Grading : in compliance with the approved plan and in reliance upon the grading permit commenced in June 1989. The County inspected the grading on multiple occasions during the summer and fall of 1989. Landmark substantially completed the grading at a cost of $41, 401.51. On February 22 and 26, . 1990, the County issued building permits R 161316, 161393 and 161392 allowing TOBIN & TOBIN Board of Supervisors August 14, 1990 Page 2 the construction of single family residences on lots B, C and D of MS 32-88. In reliance upon the building permits, the construction of the foundations commenced. Landmark installed approximately 100 foundational piers, up to 10deep and filled with steel reinforced concrete for each house. On or about March 15, 1990, a neighbor complained about the construction. As a result, Karl Wandry, Community Development Department, orally issued an internal directive (the "oral directive") forbidding any further inspections of the work in progress on Lots B, C and D. On March 27, 1990, inspections were permitted for the . work on Lot D. However, despite numerous requests, the County refused to perform any inspections on Lots B and C. Because of the requirements of the County Code, Landmark could not proceed with any further work on Lots B and C until the County inspected the foundational work in place on those lots. On or about March 28, 1990, Landmark filed a Petition for Writ of Mandate, -action number C 90-01394. On March 29, 1990, the court issued an Alternative Writ of Mandate commanding the County to perform the required inspections or show cause why it had not done so: The. County continued to refuse to conduct the inspections and ultimately, three court hearings were conducted to determine if the court would order the County to perform the inspections. On May 22, 1990, the court issued its notice of* intended decision to issue the Writ of Mandate and order the County to perform the required inspections. On May 23, 1990 the County permitted the inspections to occur. The preemptory Writ of Mandate ordering performance of the inspections issued on June 19, 1990, with Judgment for Landmark entered on June 28,1990. There is no dispute that the County issued the permits or that the County refused to perform inspections after a proper request. There is no dispute that the refusal to perform the inspections resulted in damage to Landmark. The County was aware of the potential for damages resulting from delays in the project. The only issue is whether the County and its employees individually are immune from liability for their actions. The only reasonable conclusion is that they are not. Landmark anticipates that the County will contend that Mr. Wandry exercised "discretion" in issuing the directive, thus rendering the County and Mr. Wandry immune from liability because of the provisions of Government Code Section 820.2 . This argument will fail. To be entitled to immunity, the County must demonstrate that Mr. Wandry engaged in a policy making decision, consciously balancing the risks and advantages to each available course of action. First, Mr. Wandry did not choose any of the courses of action available to the County under the provisions of the County TOBIN TOBIN Board of Supervisors August 14, 1990 Page 3 Codes. Second, the neighbor's complaint could not involve important policy decisions if it could be resolved by "working it out with the neighbors" rather than through action by the County. In the court's decision issuing the Writ of Mandate, it specifically found that this matter did not involve serious issues of public policy. Finally, assuming, arguendo that Mr. Wandry exercised discretion in the decision that work must stop on the project, he carried out that decision in a negligent manner. That negligence is a source of liability for both the County and Mr. Wandry. In addition to the lack of immunity, the County is liable on an affirmative showing that it failed to carry out a mandatory duty. Government Code §815. 6 provides that Where a public agency is under a mandatory duty imposed by an enactment that is designed to protect against the risk of a particular kind of injury, the public entity is liable for an injury of that kind proximately caused by its failure to discharge that duty unless the public entity establishes that it exercised reasonable diligence to discharge the duty. County Code Section 716-6. 006 provides that (a) The Building official, upon notification from the permittee or his agent, shall inspect the work at the following stages of the work and shall either approve the portion then completed or shall notify the permittee or his agent wherein it fails to comply with the requirements of this division. (Emphasis added. ) The controlling statute requires that an inspection be performed upon the request of the citizen holding the permit. " Landmark, the holder of a valid permit requested a mandatory inspection and the County intentionally refused to perform the inspection. The permits specifically provide that: work can only proceed upon favorable results of County inspections. The County inspections are intended to ensure that the work complies with the requirements of the permits and applicable codes. Under the current County codes, if no inspections are conducted, a citizen would never be able to complete a project. If inspections were optional at the whim of the County, no building would„occur because of the lack of certainty of completion. The harm suffered by Landmark as a result of the refusal to inspect is the particular kind of injury the County Code is designed to prevent. TOBIN & TOBIN Board of Supervisors August 14, 1990 Page 4 The County cannot establish that it exercised reasonable diligence in this situation. The only reason that the County could refuse to perform an inspection is if it either revoked the permits or issued a valid written stop work order in compliance with the requirements of the pertinent County Codes. The County ignored its codes, and arbitrarily issued the Oral Directive. ' When Landmark questioned the Oral Directive, the County told it to work the problem out with the neighbors. Abdicating the process to Landmark's neighbor is not the exercise of reasonable diligence. Implicit in the Court's issuance of the writ of mandate is a finding that Landmark possessed vested rights inr the building permits. By refusing to inspect the work performed pursuant to those permits, the County inversely condemned those permits and violated Landmark's civil rights. Should the County not settle this claim, Landmark shall assert causes of action for negligence, inverse condemnation and violation of Landmark's civil rights under the 'provisions of 42 USC §1983 against the County and the individual County employees responsible for the damages. Should the County desire any additional information, please do not hesitate to contact the undersigned. I look forward to your prompt response. Very ruly yoyrs, TOB N Paul F Adams Enclosure cc: Landmark West, Inc. Lillian T. Fujii, Esq. PFA\claim.ltr 1613-200 { Lot B, C, & D Date of Flag March 15,,' 1990 12 Days Down Lot D Date Flag Removed March 27, 1990 69 Days Down Lot B & C Date Flag Removed May 23, 1990 Land Loan Balance Period Days Daily Totals Lot D Lot C Lot B Bank of Canton $120,000 3-15 to 5-27 69 Days $40.37 $2,018.50 $161.48 $928.51 $928.51 Construction Loan Balance Period Days Daily Totals Lot D Lot C Lot B Bank of Pleasanton $368,655.94 3-15 to 3-25 10 Days $121.21 $404.03 $404.03 $404.03 $375,415.94 3-26 to 4-6 11 Days $123.42 $82.28 $452.54 $452.54 $379,173.45 4-7 to 4-11 4 Days $124.66 $166.21 $166.21 $416,388.47 4-12 to 5-6 24 Days $136.89 $1,095.12 $1,095.12 $445,975.53 5-7 to 5/27 20 Days $146.62 $977.47 $977.47 $6,677.06 $486.31 $3,095.37 $3,095.37 Lumber 10%Increase on approx.$42,000(Estimate) $4,200.00 $2,100.00 $2,100.00 Foundation Extra for Pump for one House $450.00 $450.00 Extra for Panels on Job for 2+Months $1,730.00 $865.00 $865.00 Interest on Labor Payroll for 60 Days $800.00 $400.00 $400.00 Concrete Flatwork 4%increase on Appros. $9,500 $190.00 $190.00 Roof $13 Per Square(Estimate) $949.00 $481.00 $468.00 Lot C 37 Squares,Lot B 36 Squares Legal Total Fees(Estimate) $30,000.00 Toilet Monthly Rate of$76.72($2.56 Day) $176.64 Storage Shed Monthly Rate of$175($5.83) $402.27 P.G.&E. Monthly Average$12($.40 Day) $27.60 Amwest Suriety Bond for Site Improvements Extension $1,655.00 Road Paving Etc. Old Bid$6350 New Bid$13680 $7,330.00 Fees Water Meter,Sewer Connection& $1,000.00 $500.00 $500.00 Public Works(Estimate) Landscaping For Neighbors $5,000.00 Material 10%increases Approx.$15,000(Estimate) $1,500.00 $750.00 $750.00 Appliances,Lighting fixtures,Shower Doors Hardware,Locks,&Misc. Finish Material Sub-contractors Price increases Approx.$80,000(Estimate) $10,000.00 $5,000,00 $5,000.00 Overhead Based on 1989 total$50,801.83 $6,959.00 $556.72 $3,201.14 $3,201.14 ($139.18 Day) Caning Cost Based on$400,000 per House.Due to delay in $25,000.00 $12,500.00 $12,500.00 completion taking us into the slowest selling season. (12.5%interest rate,90 days). Plus 90 days of additional overhead costs. $8,350.80 $4,175.40 $4,175.40 TOTAL $114,225.87 CLAIM. BOARD OF .SUPERVISORS'OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 11, 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 qFgpc' plaragraph IV below), given pursuant to Government Code Amount: $190:00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: WONG, Natalie 6699 Garden Valley Road' eoury rr rou MARiW CALIFL` SE ATTORNEY:"Suisun, CA 94585 Date received ADDRESS: BY DELIVERY TO CLERK ON August 10, 1990 BY MAIL POSTMARKED: Au ust,' 8, 1990 I. FROM: Clerk of the Board of Supervisors . TO: County•Counsel. Attached is a copy -of the above-noted .claim. ppHH gg DATED: August 13, 1990 BYIL DeputyLOR, Clerk II: FROM: County Counsel TO: Clerk,of the Board of S rvisors �t) This claim complies substantially with Sections 910 and 910.2. ( ) ..This claim FAILS to comply substantially with Sections 910.and 910:2, and we are so notifying claimant. The 'Board cannot act for 15 days (Section.910.8). ( ) Claim is fiot timely filed. The Clerk should return claim, on,ground that -t ,°was filed late and send warning of claimant's right' to apply for leave. to present a late claim (Section 911.3). ( ) Other: Dated: �3gc; BY: _ �. Deputy County Counsel III. FROM: Clerk of 'the Board TO: - County Counsel` ,(1) County Admin'istrator (2) ( ) Claim was returned as untimely with notice to. claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present, ( PT This Claim is `rejected -i'n full. r" ( ) Other: I certify that this is a true and correct copy of the Board's Order .entered'.'in its minutes -for this date. Dated: 'SEP 11 1990 PHIL BATCHELOR,'Clerk, By , Deputy Clerk WARNING (Gov.°code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail, to file a •court action on this claim. See Government.Code Section 945.6. . You may seek the advice of an attorney of your choice in'connection with this matter. ',If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING' I' declare under penalty of perjury that I .am now, and at all times herein mentioned, have been a citizen of the . United States, over age 18; and that today, I deposited in the United States Postal -Service in Martinez, California, postage fully prepaid a certified copy of this Board Order'and Notice to Claimant, addressed to the claimant.as shown above.. Dated:, SEP 12 1990' BY: PHIL BATCHELOR by L _ Deputy Clerk CC: County Counsel County 'Admini'strator 4' 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 claw 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-'=filedagainst 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 or officer, authorized to alloworpay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, is guilty of a felony. " n n'n-ifs J�c iC J.Gi iCi iG iG n�i��i:i n-J•iC iC inn-iii. iC i.X>�iC i�i�i�J- J�•L-ni �i�-nom J J � n-n.J.� n n n c.c c c c c c .. � �4c ;c ;c .cam., ckicki. :c,cic,cxx:'c3c.cJ,c �cic �4c *�c�� is kJcJ.c RE: Claim By Reserved for Clerk's--.f'l* s*� ...,RErEtViED .� AM 1 DOW Against the COUNTY OF CONTRA COSTA r � CLERK 8 D 0� ERVISORS . or _ DISTRICT -- CONTRA COS ACO. (Fill in name) The undersigned claimant hereby makes claim against the County of Contra. Costa or the above-named District in the .sum of $x. 00 and in support of this claim re-- . presents as follows: 1. When did the damage or injury occur? (Give exact. date and hour) - �f 0 g� 1'Y1 t 2 �YY1 2. Where did the damage or injury occur: (Include city and county.) AA 3. How did the dama;e or injury occur? (Give full details;-use extra sheets if required.) 4. What par ' cular act or omission on the part of count or disitri&t officers, servants, or employees caused the injury or damage? over - $, What are the names. or county or district .officers, servants, or employees causing the damage or injury?. 6. 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 ori l �age.) h c� PRAIA It P"hem su�°a �c as t cn 81 r 8. Names and addresses of iAtnesses, doctors, and hospitals: 9. List to expenditures you made on account of this accident or injury: DATE ITEM AMOUNT t60100 RO 40 AX) Govt. Code Se,c. 910.2 provides: "The claim signed by the claimant or by some person on his behalf." SEND NOTICES TO (Attorney) Name and Address ofY AttorneyO Claima s 'gnat u e �N . � 'Address 33 Telephone sNumber ,,, Telephone Number: LO) 4Z7��`� N; i "a { -+n-arz sen^a.r„rsarsusa<x••q- .-�. 5. What are the names. or county or district officers, servants, or employees causing the damage or injury?. 6. 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 ofanyprosypecti�v�/e� .pinpj�ury or lc��age.)) //j/�y�Q/�) �UU t 1 rJ t �U`�j7 PQ t4�l�t�v 8. Names and addresses of A tnesses, doctors, and hospitals: 9. expenditures you made on account of this accident or injury: DATE ITEMAMOUNT - VIU00 M100 RO 94-0 -00 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 0��agr�t,�v�� G� 4 q45 OJ Address Telephone (Number,; _ Telephone Number: ( '7. PROPERTY/CLOTHING. RECEIPT 'CREC NO: ON RA •COSTA`COUNTY 89""867 DATE. -TIME.- NAME: TIME:NAME: BOOKING NBR CASH: $ Q, SHIRT/BLOUSE- El DRESS `COAT/JACKET 0 TIE/SCARF O SHORTS/PANTIES-- - .JEWELRY ED SOCKS(NYLONS: _ J�JG 0 SVSIEATEEiLS101TSHIRT TC�1"w __1_ _ _• ., „�.,_. tEr BELT f PANTS/SKIRT ► .s . . -SHOES/BOOTS r n. a T-SH I RT/BRA:°' L'LETC yZi� d 0• C SHA /PURSE ' : EYS ) KNIFEGLASSES( -!U 0 OTHER AA _ _ L� / X BKG OFC: t� "! . .,, INMATE SIGNATURE have received all-ofmy personal DATE: 'property and clothing. REL OFC: - X INMATE SIGNATURE' : CONTRA COSTA DETENTION FACILITY PROPERTY RECEIPT DATE: Clr'#7C��JLi REC: �J�;3 TIME: 2120 FACILITY: HDF NAME: 'W011G NATAt_IE C D.O.B.: -�• :• BOOKING NBR: 0002' 134:30J ITEM UNDER COUNTER: Y OR N CASH: $ Iwi r` I JEWELRY: N DESC: WATCH: N DESC: LIGHTER: WALLET/PURSE: h! KEYS: U GLASSES: N BELT: N KNIFE: ; OTHER: ONE SEALED BAG BKG OFC: Al 49 41All-M!,AI NATURE RELEASE DATE: I HAVE RECEIVED ALL OF MY PERSONAL PROPERTY. REL OFC: X INMATE SIGNATURE °i 0 CO � r 4 1 � � i r �r CLAIM A do 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 SEPTEMER 11, 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 RO PLr riph IV below), given pursuant to Government Code Amount: $64.50 Section 913 and 915.4. Please note all "Warnings". � CLAIMANT: RAKES, AAUG 13 Ali A.. lingo 1535 ATTORNEY: Martinez, Blvd. CA co 94553 MA?TNF?COUNSEL Date received ADDRESS: BY DELIVERY TO CLERK ON August 8, 1990 (hand delivered) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pPHH gg DATED: August 13, 1990 EY peTutyLOR, P Cler II. FROM: County Counsel TO: Clerk of the Board of rvisors 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: 13 9 ' 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: SEP 1 1 19C)a PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately, AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: S E P 12 1990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator A"- 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 injuryto 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 of 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..,..,k:ccx..,.Jc'.c,..c.............<......;..c�c..3.,.,....J.e:.......,.,..,,.,c....k�;.....�.c;..c:cx;c:c...<..x.<........*.c..�:;t*......�;Y.... RE: Claim By Reserved for Clerk's-.filing stamps EDM .:-Z Against the COUNTY -OF CONTRA COSTA OF SUPERVISOS .;< or _ DISTRTCT- _ CONTRA COSTA CO. .- (Fill in name) I The undersigned claimant hereby makes claim lainst the County of Contra. Costa or the above-named District in the sum of $_ and in support, of this claim re- rese s follows: _ 1. trt _. d! t am in occur?"TbU ' i •e act, date nd hour 2. Wher did dke, damage or injury occur: (Include city and county. ) Mo,,di p_ Ca-1 1-f., rn 3. How did the dama;pfor injury occur? (Give full details : use extra sheets if required.) 4. What particularact or co iss on o the p of county or district officers, servants, or employees caused the injury or damage? _ over - Rv M-w J. What are the names or county or district officers, servants, or employees causing the damage. or injury?, P 11 6. What damage or injuries do you clam resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) f 7. How was the amount aimed above computed? Include the es imated amount of any 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 S.-"e's �,3Q . a-& . CIO r Govt. Code Seb. 9.10.12 rovides: "The claim signed by the claimant or by some person on his behalf." SEND NOTICES TO (Attorney) . Name and Address of Attorney _ — Cla=Wts ignature Addr ss G BVIS � �� Telephony N m e�: Telephone Number: . Y VVV � - 'iq�::fi&f.9ver� CLAIM OO BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board 'of Supervisors, Routing. Endorsements, I�� pp� TICE TO CLAIMANT SEPTEMBER 11 , 1990= and Board Action. All Section references are to ) �Iie py of this document mailed to you is your notice of California Government Codes. 1 the1��jjcQtnnion taken on your claim by the Board of Supervisors (`Para'gQph IV below), given pursuant to Government Code Amount: $2S0 . 00 COUNTY (5g&1Q§jn 913 and 915.4. Please note all "Warnings". MARTINET CALIF. CLAIMANT: TRANT, Vera Irene 2114 Rancho Road ATTORNEY: E1 Sobrante , CA . 94803 Date received ADDRESS: BY DELIVERY TO CLERK ON August, 6 , 1999 CP-O. Rnx) BY MAIL POSTMARKED: JulL2 7, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 8., 1990 , I3y1L Deputy 0R, Clerk I1. 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: bo BY: I Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Admini trator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOA7RD By unanimous vote of the Supervisors present ( 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: S E P 1 HIL BATCHELOR, Clerk, By Deputy Clerk 7. WARNING (Gov. code sect' 3) 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 claimantasshown above. SEP .1 2 WO Deputy Clerk t Dated: BY: PHIL BATCHELOR by r; CC: County Counsel County Administrator 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. " ,,.......cic.c.....c...... ...c...c,.....,.....J.c.c.......c�c,.�.,...,....r.. ..,...,..c:...k�.......'�.c�c:c4:ic'<�c..� 9c* �:c 9c�c�n� � '� RE:. Claim By Reserved for Clerk's..filing stamps Ya_ Ye"re T"Yanf RECEIVED . JQ 71,. P.O. x Alin Against the COUNTY OF CONTRA COSTA lX1v 6MW or > DISTRICT- - q EpK SUPERV (Fill in naive) CONTRA COSTA CO. —L `, —— . L The undersigned claimant hereby makes claim against the County of ra. Costa or the above-named District in t e sum .of SO.0 0 and in support of this claim re presents as follows: 0 Q3 1. When did the dama.g - or, injury, occur? (Give exact. date and hour) 2, where did the damag injur;� occur: (Include city and county.) 3.. How did the dama;e or injury .occur? (Give full details:-use extra sheets irequired.) 01 17 Gt/ w ,fid- ita'•�u t�r.P,�L 4. What particular -act or omission on the part of county or district officers, servants, or employees-caused the injury or damage? O~ over 5. What are the names or county or district-officers, servants, or employees causing the damage or injury?, 6. 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.) 8. Names and addresses of witnes es, doctors, and hospitals: 9. List the expenditures you made on account of this _accident or injury: DATE ITal LMOUNT I l 14— Govt. Code Sec. 910.2 provides: "The claim signed by the claimant or by some person on his behalf." SEND NOTICES 0 (Attorney) Name and Addre of At -r ney �� y Claiman s Signature Address Telephone NU r� ,' 3 Telephone Number: ~� 4 r. 3 P -.,'+�69YM_'.YiJt4Y 't'SjktlL?%}^N4+AA Y.tiaka.-.r barsoc.: •-*—�.-^_..kw.. �.�rsmr:-.';. ' 3C , n7 I 073 { —71 ~ l s{ (;) �pp SH05iA!l3dt1S ?his 009 �1 a3ni333V CLAIM A e;20 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA `v Claim Against the County, or District governed by) - BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 11, 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: Undetermined Section 913 and 915.4. Please note all Qw"W14-SIT. CLAIMANT: CALLAHAN, Sherry Boehme andG HUGHES, Jonathan "Jay" E. ;sNy COUNSEL P.O. Box 2164 Ty rALW, Santa Rose, CA 95405 Date received ADDRESS: BY DELIVERY TO CLERK ON August 6, 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, pHIL BATCHELOR, Cle DATED: August 17, 1990 1I. FROM: County Counsel TO: Clerk of the Board of 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: o BY: Deputy County Counsel a III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: SEP 11 199-0 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code sect' 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: SEP 1 ,�. 1gg BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM T0: She Boehme Callahan and Jonathan "Jay" E. Hughes P.O. Bo 2164 Santa Rosa, A 95405 Re: Claim of SHERRY HME CALLAHAN and JONATHAN "JAY" E. HUGHES Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. x 3 . The claim fails to state the -date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, if known. x 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10, 000) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000) , the claim fails =to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WEST Y oun y Counsel By: Deputy County Counsel CERTIFICATE OF SERVFCE BY MAIL C.C.P_. §§ 1012, 1013a, 2015 .5; Evid. C. §§ 641 , 664 ) My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s ) addressed as shown above (which is/are place(s) having delivery service by U.S. Mail ) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: �' ! (� , at Martinez, California cc: Clerk of the Board of Supervisors ( riginal ) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 21 920 . 4 , 910 . 8) SHERRY BOEHME CALLAHAN 08 JONATHAN "JAY" E. HUGHES - in Pro Per 2 P.O. Box 2164 Santa Rosa, Ca. 95405 4 SUPERIOR COURT, STATE OF CALIFORNIA, COUNTY OF CONTRA COSTA, MARTINEZ SHERRY BOEHME--.,CALLAHAN and CASE NO. C90-01367 I JONATHAN "JAY" E. HUGHES, NOTICE PRIOR TO FILIWCLAIM Plaintiffs, AGAINST THE COUNTY AGAINST JUDGE RICHARD L. PATSY CONCERNB G 8 vs. THE ABOVE ENTITLED CASE gp JUDGE ELLEN S. JAMES; KATY RECEIVED GRONOWSKI, ESQ.; COUNTY OF CONTRA COSTA; MICHEL & MANNING; LAU6G and ATTORNEY DAVID WIGNALL, 619M Z Defendants. 3 CLERK BOARD OF SUPERV S CONTRA COSTA CO. y NOTICE IS HEREBY GIVEN TO THE COUNTY that plaintiffs, SHERRY BOEHME CALLAHAN and 25 JONATHAN "JAY" E. HUGHES, intend to file an action against JUDGE RICHARD L. PATSY 16 concerning the above entitled case. The reasons are as follows; 27 1. JUDGE RICHARD L. PATSY did excuse plaintiff's legitimate default against MICHEL & MANNING and their employee, KATY GRONOWSKI, ESQ. on the grounds 18 that plaintiff's had filed an incomplete service of the Summons and Complaint. 19 However the serving of the Summons and Complaint was in the hands of the 20 Sherriff's office - JUDGE RICHARD L. PATSY was so very considerAte of the Sherriff's office that it didn-0t bother him one bit to leave the Sherriff s 21 office 'open to liable. 'WHY?" Because JUDGE PATSY had that one all figured out - all he had to do, he thought, was to give a bunch of double- talk oubletalk or "gibbleygook" and say that MICHEL & MANNING had accepted service; and somehow those magic words were supposed to get MICHEL & MANNING as., well as the Sherriff's office "off the hook" and plaintiffs on the hook - 23 it didn't work! 24 Plaintiffs subpoenaed Laurie Lind of the Sherriff's office who served MICHEL & MANNING to testify at the hearing on July 18, 1990 to verify a 25 proper service - however JUDGE RICHARD L. PATSY did "flatly" refuse to hear her testimony: Plaintiffs contend, "That JUDGE PATSY doesn't give 26 a 'hoot' about justice - he is only interested in protecting the interest of MICHEL & MANNING! 27 Plaintiffs are knowledgable and aware of the codes in Witkin in which a judge has a 28 right to change judgment prior to the:`_"final judgment, and plaintiffs quoted a case istory to support those codes - JUDGE RICHARD L. PATSY "couldn't have cared less!" 2 It ,doesn't do any good to quote codes and case histories to a judge in Municipal or Superior Court - the only codes which are of interest to them are the ones 4 that happen to confirm their purpose! b 2. JUDGE RICHARD L. PATSY sustained the demurrer of JUDGE ELLEN S. JAMES and THE COUNTY OF CONTRA: COSTA on the basis that plaintiffs: did not file a l 7 claim against the county; however a late claim was filed on June 20, 1990• f Plaintiffs were told so many lies by the clerk's office, and especially by Betty Ann DeBalko that plaintiffs thought the claim had been deliberately withheld; 10 however when JUDGE PATSY refused conclusive evidence against MICHEL & MANNING via 1' Deputy Laurie Lind who served them, - well, "what's one moreK\lie!" 22 3. In addition, plaintiffs were denied a change of venue DESPITE the fact 3 that C.C.P. #394 states that it is "MANDATORY" that a change of venue be granted where a city, county or local agency is involved which is supported by C-C.P # 397 nd #657 in Witkin 3rd edition. 15 Plaintiffs declare that JUDGE RICHARD L. PATSY wanted to retain Case No. C90-01367 16 against JUDGE ELLEN S. JAMES, ET AL for the sole and ony purpose of defrauding 17 plaintiffs - which he did! 1 Plaintiffs declare that none of these justicies or attorneys should worry about 19 being out of a job - they can always get a job on the railroad - they've had PLENTY 20 of experience! 21 Notice is hereby given that plaintiffs are drawing.up the Complaint and Summons 22 against JUDGE RICHARD L. PATSY for the foregoing reasons, and the charges shall be 23 the same as those against JUDGE ELLEN S. JAMES. 24Claimants address and address for mailing is as follows: 25 SHERRY BOEHME CALLAHAN and JONATHAN "JAY" E. HUGHES P.O. Box 2164 Santa Rasa, Ca. 95405 26 27 2S 2. This notice to filefclaim against the county conceng the atrocious 211 conduct of JUDGE RICHARD L. PATSY is being mailed to him as. follows: 3 4 JUDGE RICHARD L. PATSY - Dept. 13 P.O. Box 911 b Martinez, Ca. 94553 A copy is also being mailed certified to County Counsel as follows: i Victor J. Westman, County Counsel ? P.O.Box 69 . 651 Pine St. , 9th Floor Martinez, Ca. 94553 Plaintiffs further state that it is a national disgrace that the backbone of. our 10 society, the judicial system, is so blantly corrupt - it is "disgusting!" 12 13 DATED: OLIA^ HE 'Doham, CALLAHAn \ 41/DATED: Q4,&4 /J ��0 161 y JONATHAN -AY' /19. HUGHES 27 19 20 21 22 23 24 _. 25 26 27 Ian �✓ • 28 3. VICTOR J. WESTMAN TO �,(}�! • CONTRA COSTA COUNTY COUNSEL . 1 �O - P.O. BOX 69, CO. ADMIN. BLDG.. MARTINEZ, CA 94553 DATE SUBJECT RECENED M 141990 CLERK BOARD OF SUPERVI a , CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA flaim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO .CLAIMANT SEPTEMBER 11, 1990 and Board Action. All Section references4 re 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 (Para•graph IV below), given pursuant to Government Code Amount: $139.75 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: KING, Carol M. 4657 Wilson-Lane AUG " a 1990 ATTORNEY: Concord, CA 94521 COUNTY COUtqC Date received NLAXii.,5? C&iF .ADDRESS: BY DELIVERY TO ,CLERK ON August 13, 1990 BY MAIL POSTMARKED: August 11, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a. copy of the above-noted claim. DATED:' August 17',' 1990 laIL DeputyLOR, 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: BY: AI )_ Deputy County Counsel T 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 enteredin its minutes for this date. 1 . Dated:. SEP' 1 1 1999 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sects Fn913) 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: S E P 12 1990 BY: PHIL BATCHELOR 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, 1987.0, must presented .not later- than the 100th day after ,the, accrual of the .cause of action. Cla'i'ms 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 RECEIVE® 4�S-7 I<,, (:ta_,, v Against the County of Contra- Costa . ) EAUG 19gp CLERK BOARD OF SUPE District)-'• CONTRA COSTA CO Fill in name ) The undersigned claimant hereby makes claim against the County of tra Costa or the above-named District in the sum of $ /32 and in support of this claim represents as follows: ----------------------------=-------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) 117 ----- ----------- ----------- -- ----- ----- --------------------=---------------- 2. Where did the damage or injury occur? (Include city and county) ------------- ---------.-------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) . -----------------------------------------------------------------------=------------ 4. What particular act-or omission on the ,part of county or district officers, . servants or employees caused the injury or damage? (over) 5. What are the names of county or district officer_s,,`servants,or employees causing, the damage or injury? _ = . 5. ,_What damage 'or-injuries do you claiWresulted? (Give'fuil extent,of injuries or -damages claimed.' Attach'`two est'i.mates fof auto damage. r 7... How was the:amount. claimed above 'c`omputed? (Include the estimated `amount `of any prospective injury or damage.) ` 8. Names and addresses- '-Of witnesses,"`doctors and hospitals. �'� �..(/` /-.7-.M1-x�0`�-��z.(. �,2.'.�/ t Fly I i• - G.... � .- ._ . 9. List the expenditures.you made on account of ths. accident or injury:,,,.,. DATE ITEM AMOUNT 1 14kA Gov. Code-S"ec: 910.2 provides: r "The claim must be signed by the claimant SEND NOTICES-' TOs. (Attorney) ;; ; or by some. erson on his behalf." Name and Address ofrAttorriey -- (Claimant's Signat ,e ryJ ._ .. - _ _. _. .. . ......._ _., __ /�'� C' ....lily h-G� - _•. .. Ww �? (Address - Telephone No. Telephone No. So-s- - N O T I C E Section 72 of the Penal' Code"providesi M .. "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 'orie 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. y,, 1y V( y S C O �o JU W � U) U6 0 pct Q W c�cc r V 0 0 W mU U Baas -'\ cjo �- r mob• � _ v �