Loading...
HomeMy WebLinkAboutMINUTES - 09251990 - 1.18 t CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 25, 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: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT• CORDLE, Ian (a minor through Norm Cordle) ATTORNEY• Steven L. Weiner, Esq. Law Offices Date received ADDRESS• 2333 San Ramon Valley Blvd. BY DELIVERY TO CLERK ON August 23, 1990 Suite 250 San Ramon, CA 94583 BY MAIL POSTMARKED• August' 22,;:::1990 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 27, 1990 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy 11. FROM: County Counsel TO: Clerk of the Board of Sup sors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: u/90 BY:� Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( X) This Claim is rejected in full.. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: S e p t . 2 5 , 19 9 0 PHIL BATCHELOR, Cl erk, 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: September 28 , 1990 BY: PHIL BATCHELOR by Clerk CC: County Counsel County Administrator RECEIVED CERTIFIED MAIL RETURN RECEIPT REQUESTED % 2390 To: County of: Contra Costa Clerk of the Board of Supervisors CLERK 60AVO OF SUPEFMASM 651 Pine Street, Room 106 CONT ACOSTACO.` Martinez, CA 94553OT The Law. Offices of Steven L. Weiner, on- behalf of ' Ian Cordle, a minor, hereby present this Claim to the County of Contra Costa pursuant to Section 910 of the California Government Code. 1.. . The name and postal address of the Claimant is : Ian Cordle, minor, through his Guardian' Ad Litem, No Cordle 302 Ilo' Lane Danville, CA 94526 ' 2 . The postal address to which Ian Cordle desires notice of this Claim to be sent is , as follows : c/o The Law Offices of Steven L. Weiner, ' 2333 San Ramon Valley, Boulevard, Suite 250, San Ramon, California 94583 . 3 . On July 11, 1990,, Ian Cordle was riding` his' motorcycle south on Avenida Nueva approaching LaCadena wherein Jeffrey Michael Scaletti' s motor vehicle struck Ian Cordle' s motorcycle. The accident occured at Diablo Country Club, County of Contra Costa, State of California. The area was dangerously defective constituting an unreasonably; high risk of harm to Ian Cordle. The property as described herein was improperly and negligently designed, constructed, repaired, - inspected and maintained. I Said dangerously 'defective condition proximately caused ' Ian CordleIs injuries and damages when he was struck by the motor vehicle. 4 . As a ' result thereof, Claimant suffered injuries to his left wrist, neck and back and has suffered physical, . mental and emotional injuries . ,. Claimant has incurred property damage in approximately the sum of $5, 000 : 00 . 5 . So far as is known at the time of filing this .,Claim, Claimant' has incurred damages in excess of $150, 000 . 00 general and special damages . Jurisdiction of this matter will rest in the Superior Court. DATED: August 22;, 1990 . LAW OFFICES OF STEVEN L. _WEINER .STEVEN L. WEINER Attorneys for Claimant " 1 t �\ O O w U MX• � �Y . �W Cr) yO Q Q 0 C 2L �d � W W Pd ` U t � r C 0 o qp IAIOAO le o Cep Oc,Z av n5�p�cxioD I��ocssa3okl� Well 10 Sa���30 a a J CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim 'Against the County, or. District governed by) I BOARD ACTION the Board of Supervisors, Routing-Endorsements, ) NOTICE TO CLAIMANT V' SEPTEMBER 25, 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), givenpursuant to Government Code Amount: $200.00 Section 913 and 915.4. Please note all "Warnings". i CLAIMANT: EDWARDS, Eric ` 2409 Lancaster ATTORNEY: Richmond, CA 94806 Date received ADDRESS: BY DELIVERY TO CLERK ON August 23, 1990 (via P.O. Box) BY MAIL POSTMARKED: 1 August 18, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 27, 1990 pH IL BATCHELOR, Clerk DATED: BY: Deputy 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: 2 BY:ja, Deputy County Counsel IIL. FROM: Clerk of .the Board TO: County Counsel (1) County Adminlistrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present i ( X) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order .entered' in its minutes for this date. Dated: Sept . 25 , 1-990HIL BATCHELOR, Clerk, By U- 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 Cfalimant, addressed to the claimant as shown above. Dated: Sept . 28 , 1990 BY: PHIL BATCHELOR by 1P. '' Deputy Clerk CC: County Counsel County Administrator �_�;, LOST PROPERTY CLAI.M = 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 c `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 claitu 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 o3=fes c• , oz to any coun-:y, town, City distrl:.t, ward, or village board or officer, aulhdri7<ed. to alla?i p y the same" if genuine, any_faJs_ .�{ f adusent" c1aLa, bill, account, voucher, or writing, s=-gui.lty ,of a felony, � �c:r•�:c'c•�-�•�•�kck•�:c:c;c:c'c:c;r;c9c%:c;c:c•�;::c��'csc9c;c:c'c;c:c•�•�:c4c•k;c;;•�:'c•�:ck�;.6. '-�:c9::c:c:c4c3cdc�c,;ck:c:c::°.c�k'c:c4c4c�;;-'.d.'-k-'.�: RE: Claim By . Reserved for Cl,erk's.`.'Tiling stamps RECEIVED iffln Against the COUNTY OF CONTRA COSTA W -W 2 3. or DISTRICT-' - CLERK0OAA R0QF'SUpERVISQaS NTRA"COSTA CQ, (Fill in na CO ) , The undersigned claimant hereby makes cic ..m "against the County of Contra. Costa or the above-named District in the sum of$_ 00 and in support' of this claim re presents as follows: L When did the damage or injury occur? (Give exact. date and hour) q Q -� 2, Whert did the damaglflpr injury occur: (T_nclude city and county. ) 3. How did the dama;e or injury occ ? (Give Lull d tai use' extra sheets if required...) 4. What particular act or omission In the part of county or district o fivers, . servants, or employees caused the injury or damage? ,r s - over - V What are the names or county or district°.officers, servants, or employees causing the, damage or .injury? 6. What damage or injuriga do you claim re ulted7 (Give .full extent 16f injuries. or damages claimed. Attach two estimates for auto damage.) OtA 1-4t 001A AN-c- _AX4 cnw 7. How was the a ount claimed above cef,tpl,-t ? (Include the .estimated Pm unt, of anyprospective injury or damage.,?le:ru 0— (A> Anft . c2l� u' 0 C) 8. Names and addresses of witnesses, doctors, and hospitals: 9. List the expenditures you made on account of this accident or injury: �'�'tJ� DATE ` `{ITDIAMOUNT X90 1 Oa 00 t 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 laimants Si � nature44O r Y►�,� Ytid.c1'h.e.. �}ddr eSS Address .CyplY+kaT'•ktib{%.-1YCT:YN ( � G Telephone Number K c —1 0 . Telephone Number: CUP , • a ' a CONTRA COSTA DETENTION FACILITY L .1I812 CLOTHING RECEIPT 'DATE .1.2/10/89 RM' II80264 r F TIlv1E OG p 3 FACILITY MDF NAME (l, F, M}r '". EDWARDS ERIC• TERRELL D.O.B ' • s Y .fir BOOKING NBR 890298 GJ ANTS KIRT817H�—IR!iiLOUSE COAT/JACKET HOE BOOTS §_ , s SHORTS/PANTIES ; ,.' •, T-SHIRT/BRA SOCKSjNYLONS }, "' AT URSE ` SWEATER SWT. SHIRT DRESS * u' OTHER • " '' s. 'j�?� +' 4::v, s ' `, y; tµ ilii f _.e' ,Sgvxa�. ' ci.•u �.,rr yr�iyF' ,� ;w i,': v 1 T-#;, "�' a��4a m,."'�C..N der ��.. ;� � .y 3.3a ;1.i9 v i 1' • Y �GSa,'Fti5 r r� t �S i F c r� z ° �.t[�S y���',z��y 1 .EtKu p n FC: 7 1-, �4 v Ea+,}as ° kir r ,Y,.�.. �/r 6,. «I� a "-Q{"'"`rte.'?a-�`.►,�' r, ., • .. .., 4 !t 4 }. F t��g{��f��-�p�'� � �" '.1 41! T �n H' vg,v"' 4x 7 7� i(Ai.F �tfi ,�t��f � >\j {,"yKy #„''�'yy^1t � t-• � INMATE SIGNATURE »'wf � rrr �Y � 4 f ?7 t tv�Y f r ,a,� {dur i F s4r x.e%sh� t '�{• Y t DATE ,a� y ''� o ': yxt` I HAVE RECEIVED AL`L OF�tMY "µ i a s , 4 : si *J3'��.ss „t �,.CLOTHiNG dv REL OM !. f „� rr�,`�" 3 t�'£ � }��Jr �" �f ��"�1y4<�4•��v�+��� � X av%'x ,�� n-� �A fv qi vG��'�rit^ ��x}ih'��A ��1� 7yr �i�tt� '«K�. `�Lvdi�si }��tJ {��„�d• �� t ..Y ,l-, i ' � tE n P �''!� r fl '4•t;1''' r . P ' GINMAT�E,p}S�.I�NATURE '�af�k:;di,} ,. ..��:` fj�fs.,�`>;. .�rx�•'�+•tT� k :;I:�-i �,.T�'e�st�"1� s u� t ' 4 Y �_, 5��# F {••�� X R � r � jai*' y.' L Y M`� �yj '�,• f�'�a+.r rb°t`l`- K"Y i..�,e5 x",r. a"� � _ dr , G -. ...gin..:' .. -�_=vim...._ s �,.I•;Y� .Sp'Z «..- .�;�- {, t f REC EU 1 AUG 2 3 19W CLERK BOARD OF CONTRA C� Q � c y s .J 01`I'ad�u'4intPC)y`t t 6 r tD CIV � O G O O COCC 1100 �. C G N ri� R 0 �L r 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 25, 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: $200.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: EDWARDS, Eric 2409 Lancaster ATTORNEY: Richmond, CA 94806 Date received ADDRESS: BY DELIVERY TO CLERK ON August 23, 1990 (via P.O. Box) BY MAIL POSTMARKED: August 18, 1990 1. FROM: Clerk of the Board of Supervisors TO: County -Counsel Attached is a copy of the above-noted claim. H BATCHELOR. DATED: August 27, 1990 IVIL Deputy OR, Clerk I1. FROM: County Counsel TO: Clerk of the Board of Supervisors C � ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: J ��in BY:� i_Deputy County Counsel � VV II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( X) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: Sept . 25 , 1990HIL BATCHELOR, Clerk, By. Q.le• 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: Sept . 28 , 1990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator „f CLAIM i BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorseme=nts, ) NOTICE TO CLAIMANT September 25, 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: $200.00 Section 913 and 915.4. Please note all "Warnings” CLAIMANT: FARROKHI, Sohail r$ � 24.8 Thorp Drive �� 1F; ATTORNEY: Moraga, CA 94556 � TY ce F Date received ADDRESS: BY DELIVERY TO CLERK ON August 29, 1990 (.via Sheriff) BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. BY: DATED: August 30, 1990 IpVHIL BATCHELOR, Clerk Deputy 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: IDDated: ) BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( X) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: Sept . 25 , 1990 PHIL BATCHELOR, Clerk, By. zz,� , 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: Sept . 281 1990 BY: PHIL BATCHELOR by LIP. Deputy Clerk CC: County Counsel County Administrator • v s CLAIM T0: BOARD OF SUPERVISORS OF CONTRA COA;F6TrF4yapplication to• .Instructions to ClaimantC!erk of the Board . O.Box 911 Martinez,California 94553 A. Claims relating to causes 'cf 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 Supers at its office in Room 106, ,County Administration Building 651 Pine Street, Martinez, California 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District--should- be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. . E. Fraud.--See-penalty for fraudulent claims, Penal Co3eec:-'72 at end of his form. ' ***############*##**####*#####*** t*######*#*#'#**##***#pit*########*###*### •?fir=;_; RE: Claim by )Reserved for Clerk's .filing stamps RECEIVED Against the COUNTY OF CONTRA COSTA) AUG 2 9 or AOt,i 6� T 7, DISTRICT) OM BOARD OF SUPE (Fill in name ) mriA z co. - The undersigned Costa ortheabove-named Districtainsa thesumof $st thei County of Contra Y al, and in support of this claim represents as follows: ------------------------- -z----------------------_.._-- - -- - =_:�. When did the damage or injury occur? (Give exact date and_hour] ^� Y: -WEiere did tie damage-or injury occur? (Include city and county] _ �/j R.. �•6I.L.-...•. cit •�-. r �"'� Y 3_7-How did the damage or in3ury occur? (Give lull details, use extra _ sheets if required) 0 1h� 0-YVI VOL- Crl c oag': �' a '� t,�S 1,�'�1 4 � Y J Cs►°iTt c4. 'e p�f� �i�'• ��,�� SCA'C) 04 hO be M��� 4. What particular act or omission on the part of county or district' officers, servants or employees caused the injury or" damage? 0 - �sj'� (over) x S. What are the names of county or district officers, servants or employees causing the damage or injury? 6. What �amags os injuries doryos claim resulted? Give-full extent of injuries of damages claimed. - Attach two estimates for .auto damage) g - �oSS �f Corgi G&f. Le�se 7. How was the amount claimed above computed? (Include the estimated amount L�of1/)any prospective �•injury or damage. ) ,X#������� ���,A.�e- • /d r•✓!, !"0404 01s—�-¢ fort !7 �""I!1`�(h������ d � Ovid- Gu/UAV G ------------- " 8. Names and addresses of witnesses, doctors and hospitals. _; ° 'ykq See ( YhIICJr6l AHaVvq)_IIA � --�---.. .� — ---------T��..��TT����...��T�.��..��.•ori:. List the expenditures you made on account of this accident or injury: -�; DATE ITEM AMOUNT Govt. Code Sec. 910.2 provides: 'The claim signed by the claimant ' SEND NOTICES TO: (Attorney) or by some person on his behalf. ",: Name and Address of Attorney • ✓� �� `4 C aimant s Signaturd ... .. . ...._ _....... .... ;.::;:. _Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code .provides: .2 "Every,person who, With intent to defraud, presents for .all<>wance 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 s. the same if genuine, any false or fraudulent claim, bill, account, voucher, .y or -writing,. is guilty of a felony. " —.nN..... - .. .w£_.1/S..�ns1►i..i�.���2�I-�. - w.r....v.....ev.+— 'r �� f� �. � � 6� �- �`' �' � �. �� _� � �� � ``L � � x 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 25, 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: $140.75 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: GARDERE, Kevin AUG 3 .11990 ATTORNEY.- Mr- and Mrs. McGowan iuuNrY COUNSEL Diocese of Oakland Date received MARTINEZ, CALIF. ADDRESS: 3014 Lakeshore Avenue BY DELIVERY TO CLERK ON August 28, 1990 Oakland, 'CA 94610 BY MAIL POSTMARKED: August 27, 1990 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED August 30, 1990 IVIL BATCHELOR, Clerk p y2aV92� 11. FROM: County Counsel TO: Clerk of the Board of Supervisors N ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY: J /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 (X ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct .copy of the Board's. Order entered in its minutes for this date. Dated: Sept . 25 , 199OPHIL BATCHELOR, Clerk, By �Q. 7Le . 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: Sept . 28 , 1990 BY: PHIL BATCHELOR by �:/. ,A- 5� Deputy Clerk CC: County Counsel County Administrator DIOCESE OF OAKLAND 3014 LAI 'SHORE AVENUE OAKLAND, CALIFORNIA 94610 15/763-0301 8/27/90 Dear Lt. Moore, Sorry that it has taken me so long to get this form to you, but I had to do some comparitive .shopping for_.;these articles . What a mess ! Thanks for your help. �•:_ i 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. " J.J.J.J.J J.J.....4 J.J.J....J.✓.J J. J.J.J.iG n-iiC iC n.�iC iC It iC T iC•••'•J.J.4 J.J.J..t-J..1.J.J J.. 4.V J..V J J .J. J.J J. J J..L J.J.. V V 4.1. .{. ....,...,c.....................c..;'c...... ......,c..........,.....,ck,.kT.......c.co:k ...4c9r...c..x.c........k:cJ,r4c .o.s...>:�k..:c RE: Claim By Reserved for Clerk's-.,.filing stamps s. Thoams McGowan RECEIVED Against the COUNTY OF .CONTRA COSTA 2 8 or _ DISTRICT- CLERK BOARD OF SUPERVISORS (Fill in naive) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra. Costa or the above-named District in the .sum .of $ 140.75 and in support of this claim re- ' -presents as follows: _ 1. When did the damage or injury occur? (Give-exact.-date and hour) SEE ATTACHED 2. Where did the damage or injury occur: (Include city and county.) SEE ATTACHED 3. How did the damage or injury occur? (Give full details; use extra sheets if required.) SEE ATTACHED 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? - .over - PROPERTY/CLOTHING RE(/ CONTRA COSTA COUNTY REC. No.74272 :DATE: ' Z t " �7C� eacK�a MDF:�� . TIME: cLHabx.: MCDF. _ 7 w PRQP: #� WFC 't f ( 2E NAME:_ �G �tGlJ l i' WCJC BOOKING NBR: , 160C)Q� 1 OTHER CASH: $ $�LRTBLOUSE— ❑DRESS 7 l ` OAT/JACKET CARF . �O TVPANTIES ❑ JEWELRY OCf YLONS ❑ W /SWT. SHIRT ❑ WATCH tv SAN IRT rr OT S�yL r 'w*�'' ❑ T-SHIRT/BRA ❑ WALLET T' ` ❑ HAT/PURSE ❑ KEYS j �` f ❑ KNIFE ❑GLASSES _ I , ,. OTHER- lei THER - 'C tf BKG OFC: X + ; 1NM T-E"SIGNATURE i I have received all-of my per DATE: sonal property .and :clothing :; REL OFC: X i r , INMATES IGN/0URE ; . c L47 � RE: , Claim by: Mr. & Mrs. Thomas McGowan 139 Pinto Drive Vallejo, CA 94591( (415)763-0301 -work) 1. The realization that the clothing of former inmate, Kevin Gardere, was lost occurred when his parents attempted to retreive the clothes in Augs. after Mr. Gardere left for RCR.- (it 'was the week of Aug 6, 1990) 2 . . The attempt tb retrieve the clothes was made ,at Contra Costa County Detention .Facility, Martinez, California. 3 . The clothing was furnished to Kevin by his parents for his court appearance on or. about July 2, 1990. After his trial he was sent to San Quentin, with his final destination, CRC, Norco California. He was not permitted to take the clothes in question with him. After he was in SQ, we received a box with his "belt and wallet" and that was all 4. Failure, seemingly, on the part . of county or district officers to properly inventory the clothing is to blame . Wrong clothing had been offered to Mr. & Mrs . McGowan,. from -Rack 475 in a brown paper bag. 5. Who was responsible for the care of Kevin's clothing is not known us, the parents, but the matter has been assigned to Lieutenant Gregg W. Moore . 6. The damage suffered is the lost of: 1) dress shirt (new) 2) tie 3) blue:"jeans (new) 4) a sport coat 5) new pair of socks 6) dress "boots" (ankle 7) underware 7 . The amount claimed for the damage .pointed out, is #6 above was arrived at by comparative shopping. 8. N/A 9. o .The expenditures made on -account of this matter are: . 50 postage 3.00 transportation �n O ,I }; O co to O O H � A-D G) �a Vv0 °to a4 SYN 11YY co ei l OHO z w i CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA , Clam Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 25, 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: $600.00 Section 913 and 915.4. Please note all "Warni rwls_ CLAIMANT: LOVIG, Kathleen P. 1416 Buchanan. Road AU G 3 11,990 ATTORNEY: Antioch, CA 94509 COUNTY COUNSEL Date received MARTINEZ, CALIF. ADDRESS: BY DELIVERY TO CLERK ON August 27, 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. PpHHIL BATCHELOR, Clerk DATED: August 30, 1990 BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Sup sors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late .claim (Section 911.3). ( ) Other: Dated: go BY: 1 /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 (X ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: Sept . 25 , 199OPHIL BATCHELOR, Clerk, By. .��� =�,G / 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: Sept . 28 , 1990 BY: PHIL BATCHELOR by ,72L Deputy Clerk CC: County Counsel County Administrator Claimto: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board, of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than. one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this. form. RE: Claim By ) Reserved for Cler 's filing stamp i nl P. Lo V167 ) RECEIVED Against the County of Contra Costa ) ) AUG2 71990 or District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra. Costa or the above-named District in the sum of $ Q Q and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) �rzorn a9do In/� /90 ----- ------------�--�------------------------------------------------- ------- 2. Where a d he ge or Pi �}ry occur? (Include city and county) 1�/� �U�,�Q.12 Q' ---- ivi1 o c --01q =--h ow zt2 _�aS� 0o U"''y ------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) c roS7eje eAj_::7 196e c l 6106LIFICA" y ,6E1IEPU Y posm5k ' 674LCv ME IV /W/0 /-7-PPIL ,� Rs r-ED Inc 73 7P��.� Intl ff� CII LD FR -7y�i 0N� �57k6,C vc y Ars i���� / wouL� ----UQ-1T O ti 2-YE SPECIFIC- c©ti0177,01V---7AhTl- 1 U_v_Ag----- 4. What particular act or omission on the part" of county or district officers, I ervants or employees caused the injury or damage? leER6,QL 7Z) (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? B&VG4Z(- ( POSMEP-J D4RLA -10- WLM TILEEM .t3P-0100 . --------------------------------------------------! What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. ��j�OX� � ------------------------------------------------------------------------------------- .7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 13%e l) ©M CT.E.-�LD OR-Q& W 0 U kYTS Vpk Fps R CO[D�--1 PLUS -NWDStftP 6UPPLEM6AIT, ------------------------------------------------------------------------------------- 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 Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICESTO. (A` torn y) �3' ` or by some person on his behalf." Name and Addressof Attorney . .- Claimans Si e lCom gigh, 12R� Address Telephone No. Telephone No. /3 779- NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or.district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or ;by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. MaeK-Tc 729-6E div :7fr_S -77) 6J-VE- -NoTcs 7Dink— , /YIOST ���NT /�7?�KES ��/�'Ro77fE,� ehUD — GD FOP- Six _ -r–OS_T_EQ C_l 1LD�`t_.d,cl�1_7��cJ.�r_rr_r�Z{, G�ouc.� PO — _/_12� rn_y_L-L A��D �D_�'�`QN_� _�YN_L7_}� X72/—a SLK_lcJ��K.s_, �� Ft � SVP-160k7 f�K /—Gv_,�S6�G_ZCLC��T 7_#f� Q M C_v.S-T_� fflPULP_C�6-M�/1T 49VMZC 0-6-t AA- LICEivsOD Fo9`rC-KAV-j57 PetCE 6P MT. 6502� 76 -NE—C'tl_� 12_ 0-6N_C�-5!Ml,�i-/_Y_1t_�� _ -- Pi20iyllSES�__ �yJU�D�l07� -77 /A(_��SE_NC��icaNC� --- veS� P, s�s L ��,�-oma Cou Av�i�C�cv_ca���._ITs�c���- �3t�,� r b� CLAIM t= 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 25, 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: $285.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MONTGOMERY, Lois 725 South 40th Street; #1 ATTORNEY: Richmond, CA 94804 Date received ADDRESS: BY DELIVERY TO CLERK ON Aucrus 22. 1990 (hand (Ji-livered: BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, BHIL. D eputOR, Clerk DATED: August 27, 1990 y 2� 11. FROM: County Counsel T0: Clerk of the Board of Supe ors N ) .This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we'are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 21 /qo BY: ! Deputy County Counsel III. FROM: Clerk of the�Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( X) This Claim is rejected in full. ( ) Other: I certify that this is a true and .correct copy of the Board's Order entered in its minutes for this date. D , Dated:Sept . 25 , 1990 PHIL BATCHELOR, Clerk, By _�,r� , 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: Sept . 28 , 1990 BY: PHIL BATCHELOR by Deputy Clerk' . 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,. " �k.....c.c.c .c....k....,c.c...c............:c.c..,.,..c�'c.,4c,...,....c:....c.c....,....c;...kr..,...4c.c�..c..�.4c�c...c...c;4...,....k.c'c�cx�.sC..�'csck..dc RE: Claim By Reserved for Clerk's-filing stamps &0#767,C RECEIVED K21902 _ 90 Against the COUNTY OF CONTRA COSTA CLM GOMD Of SUPERVISORS or _ DISTRICT- CONTRA COSTA CO. (Fill in name) The undersigned claimant hereby makes claim -again t the County of Contra. Costa or the above-named District in the sum of $_ and in support of this claim re- presents as foll_o_ws.- _ 1. When did the damage or injury occur? (Give exact. date and hour) 2. Where- did the damage/or injur;r occurs (Include city and county.) 3. How did th dama;e or injury occur? (Give full details ; use extra sheets if required.,) ,O 4. What particular act or omiss on on the part of county •or district officers, servants, or employees caused the injury or damage? A—lq C/[ �.- over .5. What are the names or county or district officers, servants, or employees cau"sing 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.) o L 7. H was the amount claimed above computed? Include the estimated amount of any prospective injury or .damage.)�i 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 C� Z—ic� 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 `µ _ Claimants gn t r �17V ► Telephone Number:: "^ 7 Telephone Numberc �`�`—� �� � R no r- * INCIDENT REPORT CONTRA COSTA COUNTY SHERIFFS DEPARTMENT r>1 ��c r� z9 INCIDENT INCIDENT: LOST P!?-OPEt27y FACILITY : MOF ''',REPORT # : DATE/TIME 'DATE/TIME LOCATION; TZECE/a5,9_ 2oRpJOCCURRED: ��50 ,REPORTED: SAM E MUSING INMATE:mooTGO>tiCF' , LoO1S MA?-11�­ BOOKING #: 90-/ 8-7? OSASS IGNMENT: +-' A Last First Middle WITNESSES) -- LIST -- Name - Address If an inmate, give booking #: A7TACk1MtjJT.S COPy Q1~ 9t)041nlc, SHEF 7 CUPY_ of MAQt,AAL PR6PCYZ1y Si1P ('oPy OF C 6 scCl SYNOPSIS: A 5GAIL.CH WAS C-nlJ Oto C7 E0 FO2 Al 0ilT'60ME 'Zy`S CL07/44,06 A Q0 S SALE 19 9A0 ® E- P1ZJPE 2T y , L-)17-14 M E7C ATlklE 1ZE7SU0-S . NARRATIVE: INMATE NlOo7c-� oMjFfZy ciAS r•)ZoM CU,( cOy n >J Ll y- 0 A 5EA17-SH EEO R- UEIZ CL-0Tl4 AJC, AN0 ACy of PR.0PEJ1T`/ W AJ GO►.iy u c Y E V 1,.)i %1-1 S L G/A—r i L/E- 1Z tSUt7 ;i C011AWG, MISSING : P1 NK �. �1C,UESSra TFANS _ S►�E S — CoO, °p 2E1D/u+H1TE ��'A01 0A�' 7- S1411Z'T .S1-IC LG. ,l/wHT .Cn0 PlN1C ' SOIL - — �I' Soo r'nl'S51No PR,0?-Ep_T1 13RoLjr.4 , LCA7HC )7__ uz5 C ptf3 C_ LT y0 , ae 13LACIL � SPAY-GS KJO � wALUE T L/ 0 C 0 YY\ 5c cr r►-►s % ("s) KtY , PA?E>ZSfmAYC- U /p ov -To TAL1 VALLA :`rz$5 ACTION TAKEN/RE69PIME4BED: rno,J-1ME2y Ljgs 61 67.0 T;4 e A�PP2.OPIZiA7C 6IAlwl F02-m A LZ N Ci w 17A 11J S T F U C 7l DA)S REPORTING EMPLOYEE # SUPERVISOR # OPERATIONS DIRECT7R # O.D. ROUTING INSTRUCTIONS: White -to Facility Manager - Yellow to Booking File - .Goldenrod. to Inmate By: Pink to Lineup Board. , Page one of J Rev. 3/85 CLAIM ` - BOARD OF :SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or Dis.t"rict governed by) BOARD ACTION ' the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 25, 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 pursuan�f to' Government Code Amount: $32.5.01 Section 913 and 915.4. Please note all "Warnings�j-. CLAIMANT: NAUTON, Autar A.0 G 3 1990901 Court Street, C Moaule,. ATTORNEY: Matinez, 'CA .94553 COUNTY.COUNSEL Date received MARTINEZ,.CAi IF, ' ADDRESS: BY DELIVERY TO CLERK ON August- 27, 1990 J, BY MAIL POSTMARKED:- August` 26, 1990 L. FROM: Clerk of the Board of Supervisors` TO: County Counsel i Attached is a copy of the above-noted claim. Au ust, 30 1990 PpHIL BATCHELOR, Cler2ke,,�I" t DATED: g B�: Deputy II. FROM: County Counsel TO: Clerk of the Board of.1bVeWisors This claim complies substantially-with Sections 910 and .910.2. ( j This claim FAILS to :comply substantially-with Sections 910 and 910.2, and we ''a 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 c,laimant'.s right to apply for leave.to present a late claim (Section 911.3). ( ) Other i Dated: 9( BY: ) Deputy County Counsel 111. FROM: Clerk of the Board TO: :County Counsel (1) County Admi,ni,strator. (2) ( ) Claim was returned as' untimely with notice to claimant (Section 911.3). ' IV,: BOARD ORDER: By'unan.imous'yote of the Supervisors present (X ) This Claim is rejected in'full. ( ) Other: I certify that,this-is a true and correct copy of ..the Board's Order entered 'in its minutes. for ' this date. ' Dated: Sept 2 5 1990 PHIL BATCHELOR, Clerk, By ��, `2xad Deputy Clerk WARNING (Gov.' code section 9131) , 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 &. 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: Sept 281 1990 BY: PHIL 'BATCHELOR by'- le Deputy Clerk CC: County Counsel County Administrator r, 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. " i�"n.�i:�f if n"':C'n:f:f if:f iC:f if:f iC iC::n'n':Cif;Cif'n::if:f.+�C:C�C iC.�iC if iC•�iC iC iC�if'r"'r'r'4 J.J �J..r.J. J r.J J.4J r J J.J J J r..4 J. J. r.J.J. RE: Claim By Reserved for Clerk's .filing stamps RECEIVED _ AS 27 Against the COUNTY OF CONTRA COSTA ` CLERK 60ARD Of SUPERV or _ DISTRTCT- CONTRA COSTA CO (Fill in name) The undersigned claimant hereby makes claim against the County of Contra. Costa or the above-named District in the sum of $ 3 and in support of this claim re presents as follows: _ 1. When did the damage or injury occur? (Give exact. date and hour) 8^- 5 -26 2. Where did the damage or injury occur: (Include city and county. ) �Q,t"f�a,�2. fJ �er���ea �aerslt�v N/1ar+�r+e.�- CoH�rra.. Gos���A�_ 3. How did the dama;e or injury /occur? (Give full details : use e5ctra sheets if required.). 6144, A nt a aw f o f 0 r6 Loe rty- Q FP,eP_yJ1A6.;-+ w►,v ,aw ft r� 4. What particular aqt or omissidn on the p-Art 3f cadnty or district 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?. Pm,+Y .Oia me, L Yr rU- SHFF^,ffs �Aude. D1ctrA6 Gow=a,Lves 6. What damrage or injuries do you claim resulted? (Give .f.ull extent of injuries or daZ, 154— mages claimed. Attach two estimates for auto damage.) G a 5 Irya", + 7. How was the amount .claimed -above computed? (Include theestimated amount of any prospective injury or damage. ) 8. Names and addresses of wi nesses, doctors, and hospitals: r / ArhA.,rw_(1'a 3/9/,3 ;0;,ew+v. 66,hg4w 61a ti Q Z vAMW T 9. List e expenditures you mads on account of this accident or injury: DATE ITal AMOUNT VQ•2 �(Z �b �ye�lerv�- r�oar-� Govt. Code Sec. 910. 2 provides: "The claim signed by the claimant or by some person on his behalf." SEND NOTICES TO (Attorney) . Name and Address of Attorney Claimants Signature Address MOt Telephone Number: `""""" Telephone Number: T yy - r �e•.:c'=a+.vewhw r s�:171f1�f( Ft =?:.RT ID TS343 REPOP T DATE : 10/04/89, FAGE N0: . 1 CALIFORNIA DEPARTMENT OF CORRECTIONS R CALIFORNIA CORRECTIONAL CENTER - ---... -- ._.... .. _.._..... _. .._................. --------------.. ......... --_.- INMATE TRUST ACCOUNTING SYSTEM INMATE TRUST `ACCOUNT STATEMENT' -- - -__.. _. - _ -- -- - -=- FOR THE...PER.IOD....._1UN 01 .�8�J THRU,OCT.__. 04_,--- 19t.7LL - ----- ---..._._----- . - ...... __ ..... _ _ ..._. ..__. _.... _.. ... _....._.. . . QC ::UNT NUMBER...:.:. C30739 _ .. : .. . .. ._ BED/CELL NUMBER CB150000000024 A . 'UN 1 _ NAME_ _ NAUTON, AUTAR ACCOUNT TYPE I _..___.. .. __. . . ..... ........ Pr I VIL..EGE GROUP ' A TRUST ACCOUNT ACTIVITY L'" t51 . TRANS DESCRIPTION COMMENT DEPOSITS WITHDRAWALS BALANCE __..._ --------7-7-7....-...-....... ...._ . . .............. - ..... . . .. .... ... . _ p r.t�.1._ _ ' BEGINNING BALANCE -- __...... . ..: �0.:`..0�� ----- 07/24 D300 CASH DEPOSIT. 22271SQ :7 7- _ $3, 2257 . 54 $3,25? 54 ---- PIJA f'_E...D!S54 .: _.I.NMATE ..P,AYROLL.::PR . .. :. . . ..._.'!. ._..: . 2 7G...' ._... . .:`._ , _ .: $3'.2b0 30 ------ 08/47 ._ _ - 0.5r_47W100 CANTEEN.:._DRAW.. . ...000 ..... ........_........- _..... . ._. .-.-. ........__.._.._...--_..._.....-$60 . 00 $3,200 . 30 (18/30 ::.W700 IWF. `..SP..:SURCHAR 13957GPEINN ::: $7 00.':.. ...... : $3 193. 30 . .. OO!{.0_-_4!350 8PECIAL PURCHA 139576PENN $77 iaa $3, 115 . 68 0SE4 INMATiE_ PAYROLL .::PR, ... -` X33 . 96 `.._._. . 3, 149 ,.ra:.. .. 06 D554 INMATE PAYROLL JULY $^c . 76 $3, 152 . 40 .. . . - t'`•`f`('.7;:W502 POSTAGE/COPIES $3, 151 . i5 _. -- �1 - - - 0''11-1 :-w.1.00.......,_CANTEEN....DRAW CCC -.... __.___.. .._ ..... $60 . X10- $3,_091 . 15 . _._._ -- t-3 r.. 3.:..:W905.._..- REVERSE...I WF.. SP.. 22517PENNY 051.' :.:..$3: 092 . 6G .. i),,,'� 3___D300 CASH DEPOSIT. 22517PENNY.__._._ $15 . 08 $3, 107 . 74 --. .;_5 _ _ . .. $3 : 1106 _4 7 05/t5 WS02 POSTAGE%COPIES POSTAGE $2 . 92 $3, 103 .S2 _--_W ..C,'+,•_-`�--W70t.._:.: '.USE.::TAX::: � .:_ 1.40E-70MUSI_ __.. _»_ -- 1�2 4J- �3 .1.01�.. �P: ._ --_ -- nS; : 9_ W700_.--_-_ IWF SP_ SURCHAR 140270MUSI $4 . 00 $3 097. 12 _.........._. __. . - - ._.,_._....._.-.... . ._. _..__._.__.._ __.................... .. ._.. _ ._ ... .. --......_ 4'.`+ 9,:W.350_._::_ .SPECLAL PURGHA .1 4070MUSI $42- 50 $3,054 G2 . ......... _...._ ....... 09i'100 W700 IWF SP SURCHAR 1 40269WALK _,.-....._._._. ._._._.. .`_� $1 0 . 99 $3 043 . 53 _.. W350 SPECIAL_ .SPECIAL PURCHA 140269WAL1. : :_.: . _:. :.. $12.03 $P-, 923 . 10 S?9/129 W502 POSTAGE/COPIES- POSTAGE $3 .-62 $2 919 . 4$ C9'.,E9:...W512 I...EGAL POSTAGE COPIES- _. ...: '2 t 9. ._ . ...__. `$2,917 38 ... - -----.-_1.�_ 03 D_554 . . INMATE PAYROLL PR_ .._...__ ..._,._. _.. . . __. $34 . 80 $2, 952 . 18 -- -._ TRUST ACCOUNT SUMMARY ..._ - - _.... .... .. :.._..__ _.,:..._._ . _........ .. CURRENT rK :...... .... ...... . . .. ._.... ... .... ...:_ ... L, ..._.w....._..._. _... ... .. _......._.__._._::..__c_GI_NNING_.........__.............TOTAL -_._._....... .......TOTAL CURRENT HOLDS AVAILABLE ..... .... SALANCE ... DEPOSITS ...:... WITHDRAWALS . :.:.. : .: BALANCE BAl.ANt1- :BALANCE'. .. -_ . . ..... _._ ._ ,.. __._.._... ...... ........_ ..__-:.x.0.__0.0__..:.:._..$3, 346 . 9.0.. $394 .72._., $2:1-952 . 18 $0 . 00. ,. . . . . :. :`�'t',.952 :.f 8... -- -- ...-....... - - --�. --- __- -- -- -- - - ---- — - * INCIDENT REPORT \� (, CONTRA. COSTA. 000NTY SHERIFF'S DEPARTMENT 1 INCIDENT INCIDENT:_ L-(af_ pylopl;Z-1= FACILITY: J� )'- REPORT #: 2M DATE/TIME s qD DATE/TIME LOCATION: �hyi� �7�C�y�°�'r�C� ✓� D�� I _ OCCURRED:±� REPORTED: \ Q�jqq n -HOUSING INMATE: J���,`i��J )� `2- 8O0KING #:CSI -0'Co S�IASSIGNMENT:Q19 3 Last First Middle WITNESS(ES) -- LIST -- Name - Address If an inmate, give booking #: i SYNOPSIS: t `-yo NARRATIVE: A)A L ly>J1 LL P-)-�='�) r)-C) f�)TS �►t�J: Goo 2AZ-y1� LOX • �� �'//fir-- �y►�� �� ����>J , ��-�=� DN�7 �3�= � /0 C) lj�� �vJ7V c y 7D l3 ACTION TAKEN/RECOMMENDED: :.1.�.Jr��-'�• �Z/was '� .�i; Gi�� C�n ,.,oyo� ! REPORTING EMPLOYEE # SUPERVISOR -j-. —OPERATIONS DIRECTOR O.D.. ROUTING INSTRUCTIONS: White to Facility Manager - Yellow .to Booking File - Goldenrod to Inmate By: Pink- to Lineup Board - Page one of �_ * INCIDENT REPORT SUPPLEMENT • C( A COSTA COUNTY SHERIFF'S DEPAR7rrENT . DATE OFINCIDENT may/ DATE: ORIGINAL: INCIDENT:,G(-2,S) ) VLDPJ�?`J REPORT #-4 —HOUSING INMATE: �f1v�3J� l� V: ) BOOKING # �� �GS�SLiJ ASSIGNMENT: Last First Middle CONTINUATION Q SUPPLEMENT Q STATEMENT Q DISCIPLINARY INVESTIGATION NARRATIVE/INVESTIGATION: rh op-1 J7��7 l X�=►��1J ML 121_C 1,,,�) � � 23DY u)� f3nw�t� .�- J3o�c �'t q���-�yJ 1�5 �i��22�2/..� �l���T-/►� RR COMMENTS & CONCLUSIONS: ACTION TAKEN: PORTING EMPLOYEE-7— SUPERVISOR # OPERATIONS DIRECTOR # O.D. ROUTING INSTRUCTIONS: White to Facility Manaqer - Yellow to Booking File - Pink to Inmate - Gold to _B.A.S. Rev. 8/80 Page off__. * INCIDENT REPORT SUPPLEMENT CO A COSTA COUNTY SHERIFF'S DEPARINT DATE OF INCIDENT /d DATE: ORIGINAL: INCIDENT: Z_� ) � � REPORT #&e" ZI�O d —HOUSING INMATE: NAV��), BOOKING #: ��� `�'��SV �ASSIGNMENT: Last First Middle CONTINUATION Q SUPPLEMENT Q STATEMENT Q DISCIPLINARY INVESTIGATION NARRATIVE/INVESTIGATION: ►SSj�(� Pn o 2� JO Q/�,D f ci) 01 j�e_— COMMENTS & CONCLUSIONS: ACTION TAKEN: REP RTING EMPLOYEE E—# SUP�ERV�ISOR # OPERATIONS DIRECTOR, # O.D. ROUTING INSTRUCTIONS: White to Facility Manager - Yellow to. Booking File - Pink to Inmate -, Gold to B.A..S. Rev. 8/80 Page 3 . of� ' r v � a a� �J 0 sa u1 N �Y a CD 0 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA RECEIVED Claim Against the County, or District governed by) BOARD AC46N G u 7 1990 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBMUQ-,�,rcdi and Board Action. All Section references are to ) The copy of this document mailed to you is yourAk6t61ce7_,afq� California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SPIESS, Pam 222 Loveridge Circle ATTORNEY: Pittsburg, CA 94565 Date received ADDRESS: BY DELIVERY.TO CLERK ON August 23, 1990 (via Risk Mgmt) BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 27, 1990 ppHH11 BATCHELOR, Clerk DATED: BY: eputy 14" 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). ( ) Others ' c Dated: 110 BY: � )- AQJA Deputy County Counsel _T 1I1. FROM Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( X) This Claim is rejected .in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: S e p t . 2 5 , 19 9 0 PHIL BATCHELOR, Cl erk, 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 1 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: Sept . 28 , 1990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator `—� Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A.- Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before, December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death-or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must. be presented not- later than one, year after the accrual of the cause, of action.:, (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of.Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of. Supervisors, rather than the County, the name' of the District should be filled in. . , - D. If the claim is against more than one. public entity, separate-claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec-, 72, at the end of this form. RE.: Claim By ) Reserved for Clerk's filing stamp smt5s ) RECEIVED Against the County of Contra _Costa ) or > AUG 2 319 District) RS Fill in name ) CLER CoA CSO CO. 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: ------------------------------------------------------ When did the damage or injury occur? (Give exact date and hour) ------ ------- -----= . -------------------- ---------------------------------- 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) Z VLM _ bQ 1l ;Q a fo -- ---` ------- -------- ------------ -- --------- --- --- -- --- 4. What'particular. act or omission on the.part_of county or district officers, servants or employees"caused the injury`or, damage? .. k . --Anp_ n fir row �. ?.� 5. What are the names of county or district offi ers servants or, employees. causing ' t the damage or injury? �j - �k r rcov's qOSh -C) __- 5. What damage or* iri juries do you- claim`resulted? (Give' full. extent of injuries or damages c aimed.', A tach,two estmatesr for auto damage j- -How was the 'amount-claimed above computed? ' (Include the estimated amount of any rospective injury or damagCXA . . e.) A0lis -------------- - - --- - -- --- - --------------- ----------- 8. --- - ------ - ^ -- - 8. Names and addresses 'of-witnesses, doctors 'and hospitals. ------- ------------- 9 List the. exp pnditures.you.made on account of this accident or.•injury: DATE ITEM - AMOUNT WA a-h¢ U � I1ek A �e \acs � � Gov. Code 'Sec. 910.2 'provides: - "The 'claim must be signed by the claimant p SEND NOTICE SO; p(Attorney) or some Person ,on his behalf." Name and A'ddrewAttorne�y, .. •. _ Clai t's; Signature - _. . ddress Telephone No. Telephone No. N O T I C E Section"72 of 'the^Penal. Code provides: - "Every'person who, ,with intent to defraud, presents for allowance or for payment to any state board. or officer, or to any county, city or, district board or officer, authorized to allow or pay' the same if genuine', any false. or fraudulent claim, bill; account, voucher, or writing, is punishable -ei•ther. by. imprisonment in the county' jail ,for a period of not.Tor ,,;han. one year, by,.a fine of not exceeding one thousand ($T,000)', or by both such imprisonment. and.'fine,, or. .by, .imprisonmentyin the state prison, by a fine of hot 'exceeding''ten thousand'dollars' ($10,000, or by both such imprisonment and fine. N, 4 ' COMPLETE GLASS SERVICE W + 'EAST COUNTY GLASS , State License #494305 S 600 RAILROAD AVENUE 700 HARVEST PARK DR.STE.G Auto Home Commercial PITTSBURG,CA 94565 BRENTWOOD,CA 94513 Auto REF. (415)432-1433 (415)634-0708 Home NO. FAX(415)432-8935 _ Commercial 'ACCOUNT AGENT'" PURCHASE' NO::' NO:: ORDER NO. e,. DATE a CUSTOMER STATE TAX OR•EXEMPT N0. CUSTOMER FEDERAL TAX I:D.N0, IADV.CODE SALESMAN I.D JORIJER TAKEN BY. INSTALLED BY. FEDERAL TAX I .N0. LORI 1p BILL TO* SOLD TO: SPIES S RT. 2 BOX 1813 B �u a BRENTWOOD, Cry. 94513 ,Heti:x+34-1.449 c INSURANCE P30OF OF • ._:... w.n�-r-. :'vac.. :n--v:v. .a._....a :...a. m:•_ �...uu � ,1#?c - '�. _.� .. ...,.x. _c - _ ....... ....- .. �r»�. - INSURANCE CO POLICY N0. INSURANCE CO. PHONE NO. 777 CLAIM NO. CAUSE& POLICY NAME LOSS LOCATION spa AG&TNAME, %VERIFIED BY AGENT PHONE � y,:. DATE OF LOSS DEDUCTIBLE VEHICLE INFORMATION MAKE :,. ayQtaCel iill 198T MODEL YEAR DOORS ` ODOMETER'° LICENSE VEHICLE 1D NO r , Quan Part .� Color Kit Lal.bIll List Sell Net 1 FCW 18 Shaded 8. 95 4. 3 Hr s: 118. 25 576. 75 x.'42. 23 369. 43 7 1 RECEIVED BY t All material is guaranteed to be as specified.,All work to be completed in a workmanlike manner accortllto standard practices. All agreements contingent upon strikes,accidents or delays beyond our control.. ,. All goods arl services ordered or received by the above named party,or their principals,are subject to`the following conditions which are hereby accepted and agreed to by the person ordering or receiving said goods or services. %ill claims and returned goods must be accompanied by this"receipt.Terms of payment are ten(10)days netfrdm invoice date.All ac- 'S!„t bt of al 2,69, 43 counts are commercial accounts and not open accounts:All delinquent accounts shall bear interest,service,and carrying charges at 7. ?,5% Tom' x 18. 21 maA"um allowable legal Yate.In ll e event legal action Is commenced on this account,the prevailing patty shall be entitled to his costs and reasonable attorney fees'.' . TERMS CUSTOMER'S - 387. 64 z,. s 06,' IY fi c2 DAN'S CONTRA COSTA GLASS MOBILE GLASS SER VICE Specializing in Auto Glass Residential& Commercial Vim- (415) 827-4173 Pitts./Ant.'754-0799 3 vno 'Contra`t;0'osta Ia,mDAN t MA ZZONCINI • CONCORD ANTIOCH )340 ERICKSON RD. 1013 W.10th CONCORD,CR 94520 RNTIOCH,CR 94509 827-4173 —- 754-0799 r i < APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT September 25, 1990 Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARM" below. Claimant: ARIAS, Karen RKEIVED Attorney: _ AUG 3 11990 COUNTY COUNSEL Address: P.O. Box 392 MARTINET CALIF. Rodeo.,. CA 94572 Amount: $850.00 By delivery to Clerk on August 27, 1990 Date Received: 8/27/90 By mail, postmarked on August 24, 1990 I. . FROM: Clerk of the. Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: August 30, 1990 PHIL BATCHELOR, Clerk, By Deputy II. FROM: County Counsel TO: erk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). �(� ) The Board should deny this Application to File Late Claim (Section 911 0. DATED rf VICTOR WESTMAN, County Counsel, By I JA )- Deputy ;. III. BOARD ORDER By unanimousvote of.Supervisors present • (Check one only) ( ) This Application is granted (Section 911.6). ( X ) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its --Ej , minutes for this date. DATE: Sept . 25 , 1990 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code 3911.8) If you wish to file a court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Goverrment Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such . .: petition must be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of any attorney of your choice in connection with this matter. If you want to consult an attorney, u should do so immediately. .IV.. . FROM: Clerk of the Board T0: 1 County Counsel 2 County Administrator , --, Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed rand endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: 9/,28/9 0 PHIL BATCHELOR, Clerk, By ® Deputy V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS, CONTRA COSTA COUNTY, CALIFORNIA AFFIDAVIT OF MAILING In the Matter of: Application to File Late Claim 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: a Board Order denying the Application to File a Late Claim to the following: Karen Arias P O. Box 392 Rodeo , CA 94572 I declare under penalty- of perjury that the foregoing is true and correct. Dated Sept . 2s , 1990 at Martinez, California OF Deput C ler _ nw f C) � � d a/14- 1 co AA P RECEIVE® r -11K G 27 C— vii K Qi' :.RD OF SUPE �Sc� CC ORA COSTA CO. Ev\ (/1.f' a-j CCS VLX LGA ---- —�— 3, 1.���D�•-�:-c�..0� -- C��_c�....._ - _-Sc7 �- �(h..._ .�_�� 5 s _ �\ Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims. relating to causes-of action for death or for injury to' person or to per- sonal property_or growing crops and which accrue on or before December 31, 1987? . must be presented not later than the 100th day after the accrual of the cause of action.. Claims relating to--causes of action for death or for injury to person' ' . or to personal property or-growing crops and which accrue on or after January- 1, 1988, .must be presented not later than six, months-after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one-,, year afterthe 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 RECEIVED Against the County of Contra Costa ) A B 190 or ) District) CLERK BOARD OF SUPERVISO Fill in name ) CONTRA COSTA CO. _ The undersigned claimant hereby makes claimeVs' t 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) %-A CLJO �� )60Q 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) ----- -- -- - ---------� c—---=)--=5 L. 1�- 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 officers, servants or employees causing the damage or injury1 Oar r � '_What damage or,injuries do you_claim°resulted? (Give full extent of injuries or damages claimed.- 'Attadh two estimates for auto damage. rvv- - T---- -_ �_ =- - -- _� �_- + -�==--s- === = ----- ---- How was;the-amount.;elaiimed,:above.computed?' ,(Include the estimated 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 ..' :.fwCIDSq�IDY4^a:W.V'a+LM's'R9hNStiF�.M''W4+ Wel ` Gov. Code Seca 910.2 provides: "The claim must be signed' by the claimant SEND NOTICES TOa,;. (A•ttorney).^ or b ome person on his behalf." Name and Address'of A`ttor,'ney" Claimant's. Signature O E� C/ L Address Telephone No. Telephone No. * * * W IF V IF V V * ' N O T I C E Section- 72 of- the-Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for' payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand: ($1,OOO), or• by" both such"'imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten "thousand dollars -($1O,OOO, or by both such imprisonment and fine. `L Phil Batchelor -The Board of Supervisors Contra Clerk of the Board • Costa and County Administration Building 1 oS LC.t County Administrator `.J (415)646-2371 651 Pine St., Room 106 County Martinez, California 94553 Tom Powers,1st District Nanc;C.Fanden,2nd District Robert 1.Schroder,3rd District - `\ Sunne Wright McPeak 4th District AP Tom Torlakson,5th District July 24, 1990 Karen Arias RECEIVED P.O. Box 392 Rodeo, CA 94572 AUG . 61990 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Dear Ms: Arias: NOTICE TO CLAIMANT (Of Late-Filed Claim) The claim you presented to the Board of Supervisors of Contra Costa County, California as governing board of the X County of Contra Costa and/or District, on July 13, 1990 has been reviewed by County Counsel and . is being returned to you herewith because: or —an L:nj i,r j person or psrconA 7 "r—rcr{;J arose on or before December 31, 1987 was not presented within 100 days after the event or occurrence as required by law. (See Government .Code Sections 901 and 911.2 . ) XX Your claim for an injury to person or personal property which arose on or after January 1, 1988 was not presented within six months of the event or occurrence as required by law. (See Government code Sections 901 and 911. 2 . ) Your claim relating to a cause of action other than injury .to person, personal property or growing crops was not presented within one year after the event or occurrences as required by law. (See Government Code Sections 901 and 911.2 . ) Because the claim was not presented within the time allowed by law, no action was taken on the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code Sections 911.4 to 912 .2 and 946. 6. ) _ under some circumstances leave to present a late claim will be granted. (See Government Code Section 911.6. ) You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. PHIL BATCHELOR, Clerk of the Board of Supervisors and Enclosure County Administrator 47 By: Deputy Clerk e f n to t � 1 t . S