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MINUTES - 09241991 - 1.14
A CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Clain Against the County, or District governed by) BOARD"UTJOB the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT S ep tem)A"1 244? @qwk and Board Action. All Section references are to ) The copy of this document mailed to you is o�f California Government Codes. ) the action taken on your claim by the Boardr, Ars (Paragraph IV below), given pursuant to Government Code Amount: $3,000,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ANSON, Wanda I ATTORNEY: STAN CASPER Casper, Lowenstein & Schwartz Date received j ADDRESS: 1320 Willow Pass Road, Suite 500 BY DELIVERY TO CLERK ON August 30, 1991 Concord,, CA 94520 BY MAIL POSTMARKED: August 29, 1991 Certified P 377 749 013 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 30, 1991 PpHHIL BATCHELOR, Clerk DATED: g BY: Deputy I AI'm 0 1 A A,. 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 no tifying 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 filedilate and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: I I i I Dated: BY: _ Deputy County Counsel I 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 � � I (�C) 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 2 4 1991 PHIL BATCHELOR Clerk By Cj� 0 � , Deputy Clerk i 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. i , You may seek the advice of an attorney of your choice in connection with this matter. If you walnt 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. I Dated: SEP 2 5 1991 BY: PHIL BATCHELOR by . Deputy Clerk I CC: County Counsel County Administrator j I I STAN CASPER CASPER, LOEWENSTEIN & SCHWARTZ 2 A Professional Corporation RECEI�iED One Corporate Centre 3 1320 Willow Pass Road, Suite 500 Concord, California 94520 3 0 1991 4 Telephone: (415)827-0556 5 Attorneys for Claimant, CLERK BOARD OF SUPERVISORS WANDA ANSON CONTRA COSTA CO. 6 " 7 8 CLAIM AGAINST COUNTY OF CONTRA COSTA I 9 TO: Clerk. of the Board of Supervisors County of Contra Costa 10 651 Pine Street Martinez, CA 94553 11 CLAIMANT'S NAME WANDA ANSON 12 13 CLAIMANT'S ADDRESS 2425 Church Lane, No. 49 San Pablo, CA 94806 14 15 CLAIMANT'S TELEPHONE (415) 237-5142 16 AMOUNT OF CLAIM $3,000,000 . 00 17 ADDRESS TO WHICH NOTICES ARE TO BE SENT: STAN CASPER 18 CASPER, LOEWENSTEIN & SCHWARTZ 1320 Willow Pass Road, Suite 500 19 Concord, CA 94520 20 DATE OF OCCURRENCE March 12, 1991 I 21 PLACE OF OCCURRENCE Martinez, California i 22 HOW DID CLAIM ARISE This claim is based uponithe medical 23 negligence of Dr. John Bringhurst and other staffimembers of 24 the Merrithew Memorial Hospital in failing to completely and I 25 properly perform an appendectomy on January 8, 1988, and I 26 conduct necessary post-operatie procedures. Notwithstanding 27 their failure to successfully complete the aforementioned 1 28 appendectomy, Dr. Bringhurst and other staff informed the CASPER,LOEWENSTEIN AND SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 Concord.California 94620 I claimant that the appendectomy was complete and that she no 2 longer had an appendix. 3 Claimant continued to experience abdominal pain and 4 difficulties over the next months . Merrithew staff assured her 5 that her appendix had been removed. 6 After suffering continuing abdominal distress in late 7 1990 and early 1991, claimant underwent exploratory surgery at 8 the Kaiser Hospital in Vallejo. She learned for the first time 9 in discussing the matter with the staff members of the Kaiser 10 facility that her continuing abdominal pains were the result, 11 in large part, from an infected appendix which had, in fact, 12 never been removed in 1988. i3 The injuries sustained by the claimant as far as known 14 as of the date of the presentation of this claim, consists of 15 loss of earnings, the costs of additional surgeries and 16 hospitalization, anxiety, severe emotional distress,) and fear. 17 Jurisdiction over the claim would rest in the Superior 18 Court. 19 ITEMIZATION OF CLAIM Loss of earning capacity, $500,000 . 20 Incursion of medical bills and surgeries, including future 21 surgeries, $500,000. 22 General damages including emotional distress, trauma, 23 humiliation, pain and suffering, $2,000,000 . 24 Dated: August 29, 1991. 25 CASPER, LOEWENSTEIN & SCHWARTZ A Professional Corporation 26 27 STAN CASPER By 28 STAN CASPER CASPER,LOEWENSTEIN Attorneys for Claimant AND SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE — 2 — 1320 Willow Pass Road Suite 500 Concord,California 94520 1A1F1 A97-M--A n Y �d 7d r (� D �0r1 Z N ° 0 O O m m SSC m m o ° CMaz Dm O O r- (/) OT r m F a r C�I_77! T N D n n m o D m O �-4 0 D y m 0 -n 0 A ]D p m --i ^ O Z x H � rt sn H. I'd rt x v 0 H.14 m0 0 w N fD O F-h -J I-h ,] 0rrtt 0 � � m 0 (D fD rt bd t�ortn0 � PD n ca `— W O Cl) O rt r-h m Q0 Co o K \ a n t� Lo Ln G.� C. I °' m I l 1,54 CLAIM R&%OFl V/ELF BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA AUG 3 0 1991 Claim Against the County, or District governed by) BOARIDLWI UNSEL the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT September R!lq%fXIF. 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: $4,430.26 + interest Section 913 and 915.4. Please note all "Wart ings". CLAIMANT: COMBS, Earl ATTORNEY: Date received ADDRESS: 420 Pebble Drive, Suite A BY DELIVERY TO CLERK ON August 30, 19,,91 E1 Sobrante, CA 94808 BY MAIL POSTMARKED: August 29, 1991 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. l August 30, 1991 PpHHIL BATCHtELOR, Clerk DATED: epuy (1, — I 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: 9 3 I _ BY: I Deputy County Counsel I I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) I ( ) Claim was returned as untimely with notice to claimant (Section 911.3). ' IV. BOARD ORDER: By unanimous vote of the Supervisors present (� 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 mIinutes for this date. � 0 Dated:—SEP 2 4 1991 PHIL BATCHELOR, Clerk, By L I Deputy Clerk I WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personallyserved or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. I You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. I AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been I 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 SEP shown above. Dated: SGP 2 5 10 BY: PHIL BATCHELOR by O Deputy Clerk CC: County Counsel County Administrator I I claire 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�.De.ember.:�-31,. 1987, must be. presented= not later.'than the- 100th,'day after the;accrual of :the- cause of action. Claims relating.`ta.'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.of1the 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. (Qovt.;Gode §911.2.) B. Claims must be filed with the Clerk of the Board of`-Supervisors at itsloffice 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 of7,the-D'istrict'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 e(d' of this . form. ` -w RE: Claim By ) Reserved for Clerk's filing stamp Earl Combs- ,�' ) RECEIVED Against the .County-of Contra Costa } 3 1991 Cor, ) .0 41 District) ''x CLERK BOARD OF SUPERVISOr., Fill in name ___ ).. . CONTRA COSTA CO. The undersigned claimant hereby makes claim against therfCounty of Contra Costa or the above-named 'District in the sum of $41430:26+Interest _ and in support of this 'cla3.m represents as foilows`:- f 1., When-did, the damage _or injury occur.? (Give exact date and hour) February..,(.exact..day",and- hour,cannot be determined) _ ....r. .-...._..__:------------------------------------_---- -___- 2. Where did the damage or injury occur? (Include city and county) 4739 Appian Way , El Sobrante, Ca. Contra ,Costa; 3. How did the damage or injury occur? (Give full details; ,use extra. per.,if. s required),�f puring 'thecourse��'of widening arid new'-oonstruction of, ,, p ian Way, damage ,was<done to the sewer l ne 'in�the, street at "4739 Appian 'Way: r� 4739 Appian Way, El Sobrahte 4. ...What particular.°act,:or .omission on° 'the part of county` or district offficers, servants or.employees�caused"aloe `injuryor-=damage? Contractors doing the widening of Appian Way were respsonsible+"to the county for work completed. Since the county ordered the work completed and their contractors did damage to the sewer line at 4739 Appian Way I feel the county should be responsible for damages to my property. (over) o. what. are the names of county or- district officers, servants or employees causing the damage or injury? .. -----------------—w —r--------------------irr+ii���s��a.r�Yrw�rrrr:+mow 5. 'What'"damage--or*' it juries do you claim resulted (Give.,Mull, extent: of,- injuries or damages",claimed. Attach two estimates for .auto,-daWe-. See number # 4 P 4 rr swrW.wrwsyslieWwWWrw.irwNMwMrwrr+�rN.11�erWWWwWWra�Wat�.wWrwwWY Wr W w.IMW�rr�rWWWw��r wwW.ar 7. How_was`the amount elaimecl` above'eomputed? (Include ;the. estimated ,amount-of any prospective,` njury or damage`.): See #'3'1. _ - rM---------------------r.srrWWw�IrWwr.wWMWW�wWWrriwW-WY�-wMWrWrw.----------- war WrW—Ww.w Names and addresses `of witnesses` doctors and •hT osp.itals. ----------------------------------------Wr-------w--WNWw�r Wrw—�iWw�4��rswrWWw rWw ' �WWww •. 9. Listthe expenditures'°you made ori account of this accident or injury: v DATE ITEM AMOUNT - See. Attached Gov.` Code':Sec. ,910.2' provides- 4 "The claim must be signed -by the claimant SEND NOTICES TO: (Attorn ° ) _ orb some erson on his ))ehalf." Name and Address of Attorney Claimant's Signature Address) Reciito+ - Broker' Pebble'Dr.j'Suite A" M Sobran, Cdliiorni[i 04808 Telephone No. Telephone No. �NfQ 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 districtboard 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, rby.a fine. of -not exceeding "m one thousand ($1 '000')`;.'or by' both such imprisonment:and r,-fine, -,or, by ,imprisonment- in ` the state p'rison; by a fine`of not' exceeding,ten thousand .dollara..($10,000 °or by both such imprisonment and fine. Clerk of the Board of Supervisors County Administration Building , Room 106 651 Pine Street Martinez , California 94553 Re : Sewer Repair 4739 Appian Way E1 Sobrante , California 94803 August 26 , 1991 To whom it may concern : The sewer line at 4739 Appian Way , El Sobrante , California has been broken. As per item #9 of the county claim form the following is an accounting of the costs: Roto-Rooter 110 .63 February 5 , 1991 Rescue Rooter 250.00 117 , 1991 " " 125 .00 March 14 , 1991 Levy/Attn at Law 881 .00 May 7-June 27 , 1991 Lisbon Backhoe 3 ,050 .00 July 8 & 11 , 1991 Photos 11 .83 July , 1991 Postage 1 .80 February-August , 1991 ------------------------------------------------------------- Total cost outlay : $4 ,430 . 26 + interest on this amount from July 9 , 1991 to settlement date. My claim includes interest until payment is received Sincerely , ��aromb'se4' E/3 : CCC4739 . let ro d N p �• O V1 O n Q r4• N rn CHM A Ld f 1j t "zr \ 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 Septem ear I24, 1991 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 more Or less Section 913 and 915.4. Please note all "Warnings". CLAIMANT: COYNE, Brian D. ,,,. I -�• ATTORNEY: Au u 3 0 19J1 Date received ADDRESS: 763 Slater Avenue BY DELIVERY TO CLERK ON August 2,NJ!N►I!99QuNSEL Pleasant Hill , CA 94523 1—MINCE, %Jp%L1rr. BY MAIL POSTMARKED: August 27, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. AU ust 30, 1991 PpHHIL BDATCHELOR, Clerk Na DATED: 9 BY: eputy 1 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: 1 1 Dated: 99 BY: / Iputy County Counsel III. FROM; Clerk of the Board TO: County Counsel (1) County Administrato (12) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (t� 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 2 4 1991 PHIL BATCHELOR, Clerk, B OAAA OLA4 o , .Deputy Clerk WARNING (Gov. code section 913) f 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 25 1991 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 onto per sonal property.or,growing-crops and'which ac' cr'ue:on or before December 31; 1987, must be presented not later than the 100th day after the'aecruai 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 11 1988, must be presented not later than six months after, the,accrual. of.,the-cause of action. Claims relating to any other"cadge of action must,b'e 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"1*.the Board .of Supervisors, rather =than the County, the name of.-'the District should be filled in. I D. If the claim is against more than'orie public entity, separate claims must be filed against each public entity. See.-penalty for fraudulent. claims, Penal, Code 'See. ?2� at the,end of this RE: Claim By ) Reserved for Clerk's filing stamp n r ; } RECEIVED AW:•. .: .< . } �� � � 2 8 1991 Against the .County of; Contra Costa ) ' ------------ -------- ------ CLERK BOARD QfSUPERUt 4P.. District) CONTRA coSra 1 Fill in name )... . The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $2 0 Q ..more or less and in support of this claim represents as' follows: , _---- --------------.u----_M--M-----_ --------M-------n.__------- 1. When did the damage or injury occur?.-(.Give exact date and hour) Monday July 22 1991 at 8. 30 ;am app-rox. . 2. Where-did the damage or injury occur? (Include .city and county) Taylor Blvd in Contra Costa County near Withers Ave . --------------------m.---------------------_M.Y_M_'�-M--A_i-M-_-_+r-�Y-,�-----_---_ - 3.. How did the damage or injury occur? (Give full details;,,use extra .paper.,if, .. required); A gre,a.t number of .small stones= were sprayedtyonto my windshield , app,arently -1-yi.ng on the road surface "after re-surfacing ,,of T,ay16r Blvd . , w,hen_I--was driving in : a sourtherly'F'dlrect_ion, 4. What-particular-act .or.omission,on'the part' of county or`-district officers: . , servants or employees. caused the,injury. or 'damage! Complete lack of elementary safety precautions such as a Blot vehicle to lead and control traffic while the road was being re-surfaced , no early warnings of the road work so that drivers entering at Alhambra or Grayson are into the work area with no way to get off, no traffic control personnel visible at any time . (over) �i- What are the names of county ordistrict officers, servants or employees causing the damage or injury? . 40 Contra Costa County'.B bard of Supervisors and their employees/agen 5. What damage or -injuries,do you claim resulted? (Give full:extent- of. injuries or damageb�'claimed*.` Attach two estimates for auto damage. ' My' car windshieldf is 'soseverely.: marked -that for:..sacfe.t'y>..purp"ores it must be re`placed;' at an e st'imate.d cost of;..$.200 .. Estimatis attached 7. 'How-was the,amount'-claimed above computed? :,.(Include,,the..estimated amount of any prospective injury or `damage.) Actual q.uo,tes show `,$198. 41 and $137,..27 .', '' �. M -----------------------------------.. -------------------- ----------= --- 8. Names and addresses' of witnesses; 'doctors and -hospitalsi: NONE µ �..�---- .. -----_----..-----.--N----r.------.. --------- 9. List th expenditures you made on acepunt of this accident or injury: � DATE ITEMAMOUNT - NONE � !F •iF �F �E � � � � .� �F � �E � � * if iF-�E it.!t *' * � iF !! i! � � � !t !F 1t �F � � # * 1k it � � Gov..,Code Sec': 910:2 provides; "The' claim must be signed :by the claimant SEND NOTICES TO; (Attorney) orb o e person on Ws behalf." Name and Address of Attorney C UMM i s Signa e 63 Slater- Ave : . � ..: .. .. _ .. . . . . - (Address)---... ....,_.. .. a.. � o. ,.... ,. Pleasant Hill --Ga °94.523 . Telephone No. - Telephone No. 938-9070 . V 1 9 W V V V W I W I V I I I VW * .... NOTICE i Section 72 of the Penal Code provides: _............._._ "Every person' wha, with intent to defraud, presents for allowance orifor 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 ($10,10106, ,' 6r by both such imprisonment and fine. i I ADDENDUM TO THE CLAIM OF Brian D . Coyne . - (Print your full name) ( 1) Do you use the roadway as part of. .a. daily commute? Yes ( x ) No ( ) ( 2) Were you aware that construction would be commencing on the roadway? Yes ( ) No ( x ) ( 3) Was an alternate route available? No really , Reliez used to be an alternative but a sign has been errected at Withers directing traffic Yes ( ) No ( ) l onto Withers and n of trhough Reliez , and no alternative r.q to was, indicated on Taylor. ' ( 4) Dial you read' about. the impending .resurfacing in the local newspaper? Yes ( ) No ( x) I -ha•d only just returned to California. - ( 5) Did you see warning signs advising of loose .gravel and a 25 mile per hour advisory sign? There were no signs visible from Grayson or Pleasant Oaks onto Taylor. Yes (x ) No ( ) but please, n_ote only.-after I .enter,-ed. Taylor from Grayson and witl no 1 ce to turn . ( 6) Did th& amage result from another v_ ehicle .exceeding the 25 mile per hour advisory? I do not know for sure what Yes ( ) No ( ) speed .the pas_sing, vehicle was doing.. (7) Did a vehicle traveling in the same direction and exceeding the 2'5 mile per hour -advisory signIattempt to pass you? Yes ( } No .Another )Ume Another vehicle did pass .me. and travelled in t me direction but as I noted it ,passing I slowed down so cannot state what (8) Did a vehicle coming from the opposite direction caVS(9 he was at . gravel to be thrown onto your car? Yes ( ) No ( x ) (9) Was the vehicle located directly in front of you exceeding the speed advisory? I ._ Yes ( ) No ( x ) No vehicle was in front of me . I ' h ( 10) Did you travel the roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( x) No ( ) ( 11) Did you obtain the identity of the car relating to questions 6 thru 9? Yes ( ) No ( x) If yes, please provide identification below: ( 12) Please describe in your own words how the gravel caused damage to your vehicle and the angle the gravel was thrown onto the car,..along with the specific damaged parts on your vehicle. It caused damage to my windshield by hitting it,` I can only guess at the angle or angles because the holes are from 25 t035 1de rees . However—as th-e holes .are not all , at the. same level it would require an expert in this field to state the angles . I' I ( 13) Were you aware that using the road during the chip seal process might result in damage to your car.? , 4... Yes '{ ) No' ' { X) Certainly not such damage to the windshield. I declare that the above information is true and correct under the penalty of perjury. ('Signature) August 25 . 1.991 . (Date) / • it DAN'S CONTRA COSTA GLASS - MAIN OFFICE- ANTIOCH LAFAYETTE CONCORD 1013 WEST 10TH STREET (415)256-644 w, 1140 ERICKSON ROAD ANTIOCH,CA 94509 CONCORD, CA 94520 (415)754-0799 (415) 827-4173 NAME INSURANCE AGENT PHONE - DATE ► g- 3-� ADDRESS q F.O.B. COD E] INVOICE SOLD C �^" �-� CHARGE ❑ CITY I CUSTOMER ORDER NO. POLICY NO. VE BVI KE I TYPE&MODEL- SERIAL NO. SPEEDOMETER NO. LICENCE NO. �JKNISH & FU NISH LABOR D P OMISE TIME A.M. AUTHORIZED BY CJ INSTALL ❑ ONLY ❑ ONLY P.M. 4TY , PART OFt,S12E31V0 D,ESCRIPT,IOIULABO#i°r 0 "A 4 la- 47-56114111 ' i i DELIVER TO: =TOTaL aPARTS,, / JOB NAME ❑ WILL CALL ❑ DELIVERY � TOTAi�?,, LA /1✓©/ SO�i_,. 7l ADDRESS HOME PHONE /Q & TAX e;•' �`Y� / CITY WORK PHONE SUBa., Guaranty against water leaks for the life of the car (except for rust or prior damage to glass area). Dan's Contra Costa Glass is not respon- sible for any damage to vehicle resulting from any water leak before or after glass work has been completed. This includes carpets, dash . , area, seats, etc. TOTAL SIGNATURE. 176P.1C-3-T'F-:E SAFEL 1 TE AU TOGLASS OUOTE vee 1(--)8(:)2 ORG DATE: 08--2 BARhL--AC 1.:33972 o9;;06:24 BD 2049 CONTRA COST" DVLD PLEASANT HILL, CA. 94523 INSURED BRIAN COYNE I 4:).:a 887--7200 ) 783 SLATER PLEASANTH I LL, CA 94523 PHONE 1 a 4 1.5-938-9i y71" f-tHONE2 e CASH SALES — LOC 493 POLICY # 2249 CONTRA t_.OST"A BLVD CLAIM #: PLEASANT HILL, C!I 9b,523 f_St"'si 0 RUTH!VER> ! PO4/REF: LOSS LOC2 415 687--7200 LOSS DATE/CAUSE.- 5019898-000502-599898 ATE!CAUSEv;~;`1` 898-0f")t=},G."02—a99898 PAGE 1 —I— YEAR MAKE MODEL MILEAGE LICENSE STATE VEHICLE ID NUMBER 1988 CHEVROLET CAPRICE i 4D STATION WAGON (L=ULL_. SI STOCK �e QTY FART #k LIST SELLING LABOR KIT MATERIAL EXTENSION 1 W1006--s 69.. 95 94. 48 35. 00 0 129.. 48 SHADED WINDSHIELD e � P � a 9 � J C J_ c i t THIS I5 A QUOTE ONLY. PART SUB TOTAL 94. 48 DO NOT PAY FROM THIS DOCUMENT-. LABOR SUB TOTAL_ 35. 00 SUB TOTAL 129. 48 SALES -rAX 7. 79 TOTAL ESTIMATE 137.27 THANK YOU FOR CHOOSING SAFELITE FOR YOUR AUTOGLASS NEEDS ! =============INSTALLER INFORMATION!========_===== 1 ===========CL_A I MANT===_—======= I N•—S'T'ORE NOT SCHEDULED ADDRESS u 1. CITY o ) WINDSHIELD REPAIR POSSIBLE YES —_. NO __ 1 COST INITIALS u PCCEPTED DECLINED ---------_ ---_.—__--------------__—__ o o . m M, LA AGO CP 0- o 0 ,0 ct H* Ct 0 Li N (D ID, cn 5 C-r C-t V'- Ori A K� En 0 i CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA RWEIVED 4 Claim Against the County, or District governed by) BOARD&W 1991 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT S ep tembe6 24, 1991 UNTY and Board Action. All Section references are to ) The copy of this document mailed to you is!y �wf ftp- California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Uns pec'ified Section 913 and 915.4. Please note all 'Warnings". CLAIMANT: DUFFY, Gloria S. ATTORNEY: Alfred C. Cavagnaro 582 Market Street Suite 708 Date received ADDRESS: San Francisco, CA 94104 BY DELIVERY TO CLERK ON August 26, 1991 i BY MAIL POSTMARKED: Hand delivered I I I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 27, 1991 ppHHIL ATCHELOR, Clerk DATED: BY: Deputy Lh II. FROM: County Counsel TO: Clerk of the Board of Supervisors � ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). i ( ) Claim is not timely filed. The Clerk should return claim on ground that it was find late and send warning of claimant's right to apply for leave to present a late claim (Section 9111.3). ( ) Other: I Dated: U 2 �� BY: I / ' 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. BOARDD ORDER: By unanimous vote of the Supervisors present I (V) This Claim is rejected in full. i ( ) 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 2 4 1991 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 2 5 1991 BY: PHIL BATCHELOR by o ( Deputy Clerk CC: County Counsel County Administrator I Cie to:. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT n A. Claims relating to causes of action for death or for injury to person or to per- �� 4'�,�� conal property or, growing crops and which accrue on or before December'-31 19$7, must be presented not. later than the 100th day after the accrual the cause of action. Claims relating to-causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 0 1988, must be presented not later than six months after the Accrual of the ciuse'- of action. Claims relating to, any other cause of action must be.presented not c,)_ � later than one :year,after, the' accrual of the cause af.action. (Govt. Code 011.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its ,office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. yw� C. If claim is against a district governed'by the-Board of Supervisors, rather than ��� the County, the name of the District should-be"fill ed in. 0 Q;N D. If the claim is against more than one public entity, separate claims must be yt� filed against each public entity. E. Fraud. See penalty. for-fraudulent claims, Penal. Code Sec. 72;at the end of his form. -ti * * * * * * * * * * * *. * * * * Is Is Iswiv * * 0101 US,RE: Claim By ) Reserved for Clerk's filing stamp RKEIVEQ. Against the County of Contra Costa ) AUG 2 610 CLERK BOARD OF SUPERVIS 'RS w� L t ` ' r District) CONTRA COSTA CO. Fill in name )_.. �^ The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum_of.$ and in support of as this claim represents follows: 4 tJ N�fit7` ToZ LnTiAu 11s{fr9 LAtkD —iwt—a14i4+www.wwMiMwr—rwwiw.riiwarYNUMrMrrwrwwNi .Yswiilr.er.Yw�ryarwwAlrwYarwsw+�i+.w.aiYrsws�lriYis.s 1. When did the damage or injury occur?, .(Give exact date and hour) � "' '` �� Q tst) U1¢t_,tt iNiNirriw..rrwrwi. iiwriwN Nww�Ywwl�Nr4N.ir'I�wrrrwrMi�liiwwMir4�+r/.r r�Yriwwwww*i— 2. Where did the r e or in = /I4//�wKll 3� r` damag jury occur? (Include city and county) o� w..�lYi4w�Iri.YrqlrrMril.iNrMMFiwirM.wtilNlYrr,Il.rr+�NwwN'rMNwirYNiwrwirori.Viwwwtl.rii.Yis 3. How did the damage or injury occur? (Give full, details; use extra paper if - A required), ww 4. What particular act or omission on thdL part of county or district officersi ` servants or employees caused the injury ore? ,t ,,, - -�} 5~, $U ,j � ulda J� f cad .0C cl 10S&r �. �ZeA� 1'�'•'-�..7� t'1� �f�1-.S �.iaz�' �- S"t2RY"" d� i9- Y�, E-sr _ mac � �.0,5 fr A)-tnosfi T,1)- 14, k- �P7- 0 o7 OF AZe ��� :s(over Yf-o" x b R,4�J ew - To 0 -D S I TL- 5��z>e- o f ll�fl�t C�� r..b �" �' ,��' 1 dre cne names of county or district officers, servants or employee causing the damage or injury? •_M -----------------r_--------------------------------------- -__-_-,� l` --------------- 5. _ What damage or, injuries do you claim resulted,?: (Give full extent of injuries or damages claimed. . Attach -two estimates for auto damage. i iT-. t D kms( 0,0[ - -----------rrr�.rrr_ren.r_r—�--.�+ww.•�.��..•r.._.�..a.:.� 7. How was the amount claimed above computed?, (Include the..estitat d amount of any prospective -injury or damage.) > _Ma.�s�sr_—M�_—•IDLY---.i__------r—_—•srr—_----_—r—_-------i--_--------r-----.. r—r--r------ 8. , Names,-and addresses' of witnesses, doctors and hospitals. ----------- ---------r------r..r.. —------ �r.------sem---- 9. ,List theexpenditures you made on account of this accident or injury: DATE ITEM AMOUNT -- Gov. Code Sec':, 910:2 provides: 20 J IiN "The claim must be signed .by the claimant SEND NOTICES TO: (Attorney) or by some erson on his behalf-�" Name and Address ofi,Attorney :,. ... .. .. t - T" . .. . Claimant's ture f2� "C'l�Cr� •-gr��. - Address . Tele hone No. -S (/ 77a Telephone No. Tl,` * * a NOTICE Section 72 of the Penal Code.provides: : ...... "Every person who `with.i'. ent 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. suoh imprisonment.and �fine, or by imprisonment in the state prison, by(�a fine of not•exceeding ten thousand dollars ($1000001 or by both such imprisonment and fine. ` ti 14 Ih a ADDENDUM TO 'THE CLAIM -OF G),m,f, (Print your full nami) ( 1) Do you use the roadway as part of a daily commute? Yes No ( ) ( 2) Were you aware that construction would be commencing on the roadway? 4- Yes No ( ) ( 3 ) Was an alternate- route available? Yes ( No ( ) ( 4) Did you read about the impending resurfacing in the local newspaper? Yes ( ) No 0,� ( 5.) Did you _see..warning signs advising of loose gravel and, a 25 mile per hour advisory sign? _. . . ... _ . . Yes No ( ) ( 6) Did the damage result .from another vehicle exceeding the 25 mile per hour advisory? Yes (V ) No ( ) (7) Did a vehicle traveling—in the same direction and exceeding the 25 mile per hour advisory sign attempt to pass you?I� Yes No ( ) ( 8) Did a vehicle coming from the opposite direction cause gravelto be thrown onto your car? Yes (✓) No ( ) I I ( 9) Was the vehicle located directly in front of you exceeding the speed advisory? No Yes ( � ( ) i I i I I A ( 10) Did you travel the roadway more than once. dur ng the resurfacing prior to the damage sustained to your car? Yes (!,-T No ( ) ( 11) Did you obtain the identity of the car relating to questions 6 thru 9? Yes ( ) No (!/� . 1 R If yes, pleas provide identification below: . . . /L�. ?tea. � �-•,J e c-� ( 12) Please describe in your own words how the gravel cal sed damage to your vehicle and the angle the gravel was thrown onto the car., .along with the specific damaged parts on your vehicle. .sc�v�R L CRs . yr .c�G-' , s ' WrWs 4> U)*%q `.b oP=� l#L)1A9>0#f,- L ',v SL)C-* A9- /)94A1/kt ff D �LSo �i`�.a s�� f broil-r a _. .c f ria �Ju 0,6 ICS IV/.uDsf1 �� t lF/s P°ps 3 g RPAt;, �A4_y Bsj.,v� R .4 RCP �Z k7"tCrJL�i_L -14JO ,.b #oal ,SRI.)G- By M� �. vc ���,� &k,' R t`7t 27` Rte»-res ,�rri� 'o s Lc3 -Ae ,s�°� 461el—s— ( 13} Were you aware that using the road during the chip seal process might result in damage to your car? Yes (�' ). No ( ) I declare that the -above information is true and correct under the penalty of perjury. - - (Signatu e) (Date) ` 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 24, 1991 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 if Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: FIORILLO, Daniel H. ''' r'`_'Y� ATTORNEY: AUG 2 8 1001 COUNTY COAlf received ADDRESS: 995 Howard Street MARTINEZ, CAMFpELIVERY TO CLERK ON August 27, 1991, San Francisco, CA 94103 BY MAIL POSTMARKED: August 26, 1991 I I. FROM: Clerk of the Board of Supervisors TO: County Counsel I Attached is a copy of the above-noted claim. August 28, 1991 PpHHIL 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). i { ) Other: Dated: A 7 BY: i Deputy County Counsel i 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 2 4 1q91 PHIL BATCHELOR, Clerk B4 . Y Q 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 945.6.1 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 beenia 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 2 5 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator I ii f I i I I NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Daniel Fiorillo 995 Howard Street I San Francisco, California Re: Claim of FIORILLO, Daniel 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. X 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. X 4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, lif 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 I 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. WESTMAN, County Counsel By: 1 S. Deputy Co) Counsel �yy CERTIFICATE OF SERVICE BY MAIL C.C .P. 1012, 1013a, 2015 . 5 ; Evid. C. SS 641 , 6641 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, andthereafter 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: 9 , at Martinez, Califor a. I i cc: Clerk of the Board of Supervisors ( /iginal) Risk Management i (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 4, 910 . 8 ) i i i i August 20, 1991 DANIEL H. FIORILLO RECEIVED �� ��� � - 995 HOWARD STREET SAN FRANCISCOi CA 94103 tel : 1 -415-495-4082 'AUG 2 7 1991 Board President CLERK BOARD OF SUPERVISORS Board of Supervisors Contra Costa County CONTRA COSTA'CO. 651 Pine St 11th Floor j Martinez CA 91+553 j Attached is a six (6) pages motorized Notice of Intent to Sule as � required by Law. i You have ninety days to correct the illegal activities . Each violation can easily be redone and made legal. All it takes is doing his or her duties properly, most of it administrativelii y. Under no circumstances, will I allow one (1 ) single activity, to be left in place which is illegal, wheither it be a violation of United States Law or State of California Law. If it becomes necessary to name the President of the United States in a lawsuiteach person that falls under ,the Notice of Intent to Sue (attachedj , I will sue in Small claim Courts for $5,000.00 and Court Costs for each time I have been injured. Each Tuesday, Wednesday, Friday and Saturday California State Lotto Game is a separate and distinct activity to defraud me which I will sue each person separately and individually. It is your choice if I have to- take a lawsuit. I can only act for myself and not for anyone else, even though everyone is also being injured massively. Sincerely, i Daniel H. Fiorillo I I i i August 2a 1901 - Page 1 of. 6 Pages - Notice of Intent to Sue I, Daniel Yo Fiorillo, 995 Howard Street, San Francisco, California 94103 do hereby give NOTICE of INTENT that on completion of a ninety (90) days starting on receit of this Notice of Intent, I will start action to take a lawsuit naming the President of the United States as allowing United States Constitut::onal and Cival Rights violations with intent to defraud me and allowing activies which has caused me to be a victem of fraud; further, This is Notice of Intent that I will name the United States Justice Department as a � p party to activities to crimiially defraud me ; further, this i is Notice of Intent that I will sue the Attorney General of the United States and each person,within the United States Justice Depart i ment,separately and individually$ as a direct party,to causing me personal injury by fraudulent activities ; further, this is Notice of Intent that I will name The Federal Bureau of Investigation as a direct party to activities to criminally defraud me ; further, this is Notice of Intent that I will sue the Director of the Federal Bureau of Investigation amd each person,within the Federal Bureau of Investigation, separately and individually, for activities causing me direct personal injury as a victem of criminal fraud; further, this is notice of intent that I will name the Internal Revenue Service as a party to activities to defraud me; further, this is Notice oflIntent to sue the Director of the Internal Revenue Service and each person, ;within the Internal Revenue Service, separately and individually, as a direct party to activities to criminally defraud me ; further, this is Notice of Intent that I will name the United States Treasury Department as a direct party to activities to defraud me ; further, this is Notice of Intent ti sue the Secretary of the Treasury and each person, within the United States Treasury Department, separately and individually, as a direct party to criminally defrauding me ; further, this is Notice of Intent to name the United States Postal Service and the Postal Inspector Service as party to aI ctivities to defraud me; further, this is Notice of Intent to sue the Postmaster General and each person, within the United States Postal Service and Postal Inspector i August 20, 1991 - Page 2 of 6 Pages - Notice of Intent to Sue Service, separately and individually, as a direct party to criminally defrauding me; Further, this is Notice of Intent, that on the completion of ninety (90) days ,after receiveing this Notice of Intent to Sue, I will start action to sue the City and County of San Francisco, and the State of California, and every political subdivision of the State of California, and every agency, department and commission_ of the State of California and of every political subdivision of the State of California ; further, this is Notice of Intent to sue every Elected Official of the State of California, and every Elected Official of every political subdivision of the State of California, separately and individually, for activities as a direct party to criminally defraud me ; further, this is Notice of Intent to sue every Appointed Officlial of the State of California and ever A Official of ever Y Appointed PP y political sub- division of the State of California, separately and individually, as a direct party to activities to defraud me ; further, this is notice of intent that I will sue .every employee of the State of California and every employee of every subdivision of the State of California, separately and individually, as party to activities to defraud me ; Further, this is Notice of Intent, that on the completion of iinety (90) days I will start action to sue the California State Lottery !for activities I to defraud me ; further, this is notice of intent to sue each person, separa- tely and individually, who in any manner or form had or have received any i form of compensation, of any sort, from California State Lottery Accounts , with the only exemption being those persons who had received their prize winnings from a selection g process in which they had selected their own winning numbers in a particular lottery game; j I Further, this is notice of intent to sue every School District in the State i of California for participation in activities to defraud me; Further this is Notice of Intent to sue every person, group, organization or business, wheither governmental in organizational structure or not, separately or individually, who receives compensation or benefits where the icompensation August 1 20,1991 - Page 3 of 6 Pages - Notice of Intent to Sue or benefit was derived from monies initially derived from California State Lottery Accounts, for activities to defraud me; Further, this is Notice of Intent to sue each Student and Parent, separate- I lir and individually, who receive any financial Benefit, of a financial nature, in any form, where the Benefit, in whole or part, was derived from funds of the California State Lottery Accounts, for activities which caused me to be defrauded; Furtherg this is Notice of Intent to sue each property owner i!h the State Of California, separately and individually, who received Benefits of .a financial nature, in any form, which caused me to be defrauded{; Further, this is Notice of Intent to sue each Attorney, in goJernmentl separately and individually, for activities which caused me to be defrauded; further, this is Notice of Intent to sue each Attorney, separately and individually, who has received a Compensation and/or Benefitfor their services as an attorney or not, in any manner or form, in any dealings with the California State Lottery or who has represented any person/business, governmental in structure or notl, having dealings with the California State Lottery or not, or who represents anyone who receiced any form of Benefit or Compensation derived from the California State Lottery Accounts or not, for activities that caused me to be defrauded and whose activities have violated my constitutical and c5f.val rights that caused me to be defrauded; Further, this is Notice of Intent to sue each media, wheither print mediat audio media or audio-visual media, separately and individually, wheither compensation was obtained from the California State Lottery Ace.r. or not, for activities that caused me to be defrauded; further, this is notice of intent to sue each person, separately and individuallyt who receives any compensation or benefit from any print mediag audio media or audio visual media, for activities that caused me to be defrauded; further,, this is notice of intent to sue any person/business/organization, wheither g I overnmental or not, who participated in causing me to be defrauded, or who 'aided others I August 20, 1991 - Page 4 of 6 Pages - Notice of Intent to Sue in activities that caused me to be defrauded, or who should have acted and did not act to stop activities that caused me to be defrauded or who have performed actions which caused activities to cause me to be defrauded, or who cowered up unconstitutional) illegal and criminal activities which caused me to be defrauded on an ongoing basis. grounds for Suits : 1 . Violation of Commercial equal treatment to gain illegal appropiations. 2. to gain financial compensation or benefits and to gain greatier benefits i or compensation. 3. To gain monies for pension reasons. 4. Commercial discriminations monopoly and anti-trust activities by and with the approval and cooperation of the California State Lotter,% 5. Political, Bureaucratic and business commercial discrimination aidence to obtain money and other financial considerations. 6. Specific violations of specific Federal and State Cival and Criminal Laws knowing laws were being violated. 7• Illegal use of the Internal Revenue Laws of the United States and cover up of illegal use of the Internal Laws of the United States. 8. Illegal Appropiations of monies derived from illegal use of the Internal Revenue Laws of the United States and Cover-UP of illegal appropiations. 9. Making Winning .Lotto Result Machines for the intent to manipulate and rig the winning results. 10 Setting of the Winning Lotto Result Machines each drawing to manipulate the winning machine results. i 11 . Using a substance (powder) some of the Lotto machine ball's and not on other balls to directly allow certain balls. te be picked for the Official Winning Results, 12. Cover up of the manipulating and rigging of the Lotto Result Draw Machine 13. Rigging the selling of Quick Pick Tickets for lotto gamesi. I I August '20, 1991 - Notice of Intent to Sue - Page 5 of 6 Pages 14. Interstate transportation of machines with participation of the FBI. 15, Interstate Activity to set up certain lotto games with participation from the F.B.I. and with cooperation amongst other State LoItery personnel to defraud the players and gain monies illegally for themselves . 16. Discrimination against the disabled, with intent to defraud, 17. Thief of lotto prize monies by the Retailers with direct palrticipation by the California State Lottery and State of California Officials, 18,, Allowance of activities of fraud and cover-upb * the prosecuting and 3 P g I police powers of the State of California, i 19. Direct participating activities by State Legislators$ Conroller, State Superintendent of Public Instruction and State Attorney General, on their own activities to aid in defrauding lottery players to obtain money. 20, False advertising with fraud. of advertisers . 21 . Mail fraud against advertisors, direct aid by U.S. Postal Authorities 22. Racketeering activity by the US Justice Department, FBI and Postal Service to aid individuals involved with federal felony violationsI I 23, Failing to take action on illegal activities and allowing illegal acts to continue and in return allowing fraud so property tax will not increase 24. Helping defraud a lottery player so expenses as a student it parent will not to increase or not to increase more than if not defraui ding a lottery player, i 25. Setting up a prize structure with intent not to pay all th'e prize monies, 26, taking money knowing the money ezizzza from illegal activities & covering up. 27. Deliberate interference in playing a lotto game to defraud the player. 28. Deliberate making it hard to cash a winning ticket and expensive to make for unclaimed prizes so monies are illegally gained, 28. To steal interest monies from California State Lottery Accounts, i 29. To steal unclaimed prizes from the California State Lottery Accounts , i 30, to willfully disregard the wishes of the people of the State of Cali- . i fornia and obtain financial considerations for themselves, i 31 , Malfeasance by the State Attorney General amd State Legislature to obey August '20} 1991 - Page 6 of 6 pages - Notice of Intent to Sue written Laws and failure to perform their Official Duties . 32. Use of credit cards to play the lottery with interest rates above Law. 33- Interst rates violations and activity to defraud by the State Legisla- ture and every employee of the State of California to gain compensa- tion and benefits for themselves. 34. False statements by the media to gain revenue for themselves. 35. Direct personal activity by individuals to interfere in my playing the lottery and to interfere with others playing with me. 1 36. Lottery -retailers helping setting up games of the California Lottery with intent to obtain monies for themselves. 37. Direct activities by the companies that do business with thle California State Lottery participating to set up games to cheat the California players to protect thier other State and Foreign commerciall interests. I CIA C5 H cc 0 OFFICIAL S&A.L STATE OF CALIFORNIA ss. My Comm.ExDiris!uric 25 1992 COUNTY OF SAN FRANCISCO On this 201-b day of August in the.year 1991 before me, - B. JOAN DEEPE a Notary Public, State of California, duly commissioned and sworn, personally a eared T)AN T FT. T4- VTQ11TT,T.Q proved to me on the basis of satisfactory evidence) to be the person— whose name is subscribed to this instrument, and acknowledged that he executed it.. IN WITNESS WHEREOF I have hereunto set my hand and affixed my official seal in the City and County of San Francisco on the date set forth above in this certificate, Notary Pub Vi c, State of Califorrfia t L�. r' � r r„ v zY_ co N Id V-Sp ;0 p / doffs p b O a �is of �. A CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARDIACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT September 24, 1991 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 Boardlof Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $250.00 Section.913 and 915.4. Please rote all "Warnings". • I CLAIMANT: MINEMOTO, Vicki L. Mrs. ATTORNEY: AUG Z 7 1� 1 Date received ADDRESS: 146 Blue Canyon Way BY DELIVERY TO CLERK ON August 26�,0e, � coUNSEI Martinez, CA 94553 �' BY MAIL POSTMARKED: August 23, 1991 j Certified P 338 900 932 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. AU gust 27, 1991 PpHHIL BATCHELOR, Clerk DATED: g BY: Deputy (14W J I AM La II. FROM: County Counsel TO: Clerk of the Board of Supervisors I This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3) i i ( ) Other: Dated: BY: Deputy County Counsel Ki 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 I ('X) This Claim is rejected in full. ! ( ) Other: j I I certify that this is a true and correct copy of the Board's Order entered in its mintes for this date. Dated: SEP 2 4 1991 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 wantlto consult an attorney, you should do so immediately. i 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. Gated: SEP 2 5 1991 BY: PHIL BATCHELOR byLeputy Clerk CC: County Counsel County Administrator Claim"tov BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAMANT ". 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 oflthe 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 accruallof the cause of action. Claims relating to any other cause ofaction 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,i 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 thel end of this form. RE: Claim By ) Reserved for Clerk's filing stamp s Mrs. Vicki L. Minemoto RECEIVED County of Contra Costa ) Against the County of Contra Costa ) IM 2 61991 or ) CLERK BOARD OF SUPERVISORS'; District) CONTRA COSTAcn Fill in name ) The undersigned claimant hereby makes claim against the County of ContraI lCosta or the above-named District in the sum of $ 25()_00 and in support of this claim represents as follows: ---------------------------7-7------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) Thursday June 27 1991 at 5:30 2. Where did the damage or injury occur? (Include city and county) ------ vl o r Blvd• 1------y------�4�42�_G.Q�a ss�_�s� _----=----- At Ta for Blvd Lafa ette _ �—_________ 3. How did the damage or injury occur? (Give full details; use extra paper if required) I was driving on Taylor Blvd. , in the slow lane at the posted mileage, when some loose gravel -hit my windshield. - I N _ I 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury -or damage? The dumping of gravel on a public road without the intention of tarring or even removing loose gravel caused my damage. �I (over) I 5. What are the names of county or district officers, servants or employees',causing the damage or injury? Contra Costa I , -------------------------------------------------------------------------'---------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Two holes----in-- wmy indshield --------------- ----------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) i I called for estimates and lislowest i _ ------------------------------------ ---te--d- -hg---------� ..-- ------ ----------- 8. Names and addresses of witnesses, doctors and hospitals. i --- N/A ------------ 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT .. rho.,'!•p} H None .. . -u; S Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf."I Name and Address of Attorney Claimant's Signature i 146 Blue Canyon WaVq Martinez CA 94553 Address i (Work) 415-254-4313 Telephone No. Telephone No. NOTICE a Section 72 of the Penal Code provides: i "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, oz 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)9 or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,0009 or by both such imprisonment and fine. j i I i I I On August' 20, 1991, after the road work was completed, I called for estimates to replace my windshield for a 1984 Nissan 200SX with tinted windows: Harmon Glass, Concord (827-4520) $278. 03 Beeline, Walnut Creek (932-8442) $359. 06 I Costlite Auto Glass, Martinez (372-4167) $250. 00 Should you have any questions regarding the above :information, please do not hesitate to call me at work. Sincerely, Vicki Minemoto 146 Blue Canyon Way Martinez, CA 94563 Work - 254-4313 i i i i I i i I OJD ,6 s� �'• C�.S b ^^ co 0 c a +-> O E b b -C� cn vl C7 D Lr) O J, 4--) -,t C 41 fU N O m -c-, u +� y ' Q. +j Un 4a \,O N N O O C N O •li C T, a In, • I S E +-J 43 O O --1 �-4 m --1 O crn ca m Ux �o CL 1 co M 3 cn C �t O O ON -W �>, O C -4 E ca U N U C •ri N N C O r1 C .H = •r1 14 J-.1 U ',O t-i •r-1 -, CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Sep tem eb rZ4, 99 1 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: $260.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ROBBINS, Richard ATTORNEY: AUG a 8 19, Date received ADDRESS: P•0. BOX 183 BY DELIVERY TO CLERK ON eOF.1991 Martinez, CA 94553 j BY MAIL POSTMARKED: Hand delivered j i I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. I I DATED: August 28, 1991 PpHHIL BATCHELOR, Clerk BY: Deputy i a44 4-1 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 no 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). I i ( ) Other: I 1 s Dated: BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator. (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present I w/) This Claim is rejected in full. I ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. I Dated: � P 2 '� Q� PHIL BATCHELOR, Clerk, B a amb; Deputy Clerk I i WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was persohally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you Want to consult an attorney, you should do so immediately. i i i 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. i Dated: S E P 2 5 1991 BY: PHIL BATCHELOR by CLIVA eputy Clerk CC: County Counsel County Administrator i 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. lCode) I 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 clam is against a district governed by the Board of Super Ivisors, rather than the county, the name of. the district should be fulled in. D. If the claim is against more than one public entity,' separate, claims must be--filed against each public entity, j 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, I s ,guilty of a felony." _ RE: Claim By Reserved for Clerk's-:.filing stamps Against the COUNTY OF CONTRA COSTA '= '-AIN 2 71991 7 r. 3 5_p. "4or . -1 ' DISTRTCT' (Fill in name) CLERK BOARD OFSUPERVISORS COSTA CO. The undersigned claimant hereby makes claim aoainst the .County of Contra. Costa or the above-named District in the sum of $__;�74�9() and in support; of this claim re resents as follows: _ 1. When did the damage or injury occur? (Give exact. date and hour) - 2. Where did the damage or injury occur: (Include city and county.) L -A- L - - 3. How did the dama;y or injury occur? (Give full details: use extra sheets if required.) 1\E(JS (i(jALtoz—1 0tOo rT/4n�C' mad- tc�� — Su/J 4. What particular act or om ssion on the part of county or district officers, servants, or employees caused the injury or damage? P - over - 5. 111dhat are the names of 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 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 NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney Claimant's Signature �1 , rdsC) p Address /M 2. Telephone No. Telephone No. N 0 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 ($1,000)9 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. J PROPERTY/CLOTHING. RECEIPT A CONT49- A,COSTA COUNTY REC. NO. J®�38 • E1 o DATE: " _` RACKMDF I, OLHBOX MCD`F'1 _ TIME: PROP.BOX W F C NAME:— d34iwS'r �tcLtrrrr �o-7,e�ro�r? WCJC BOOKING NBR: _ OTHER, CASH: $ ❑ SHIRT/BLOUSE ❑ DRESS ❑ COAT/JACKET ❑ TIE/SCARF ❑. SHORTS/PANTIES ❑ JEWELRY t. ❑ SOCKS/NYLONS. ❑-SWEATER/SWT.SHIRT- ❑ WATCH - ❑ BELT El PANTS/SKIRT ❑ SHOES/BOOTS. ❑ T-SHIRT/BRA ALLET } ❑...HAT/PURSE >2EYS ❑ KNIFE ❑ GLASSES OTHER c LtgG.-�eP , Ii_! fok pen E b neo r�. Pc:c k G4' C;doss C 15 cv P'fes -... All 4( Y BKG OFC: ;`INMATE SIGNATURE have received all of my per DATE: . sonal'. property and clothing. REL OFC: X .. INMATE SIGNATURE 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 24, 1991 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: $265.22 Section 913 and 915:4. Please note all "Warnings". CLAIMANT: ROUNTREE, Tim ATTORNEY: IAU G N 7 1991 Date received 19 August 26, ADDRESS: 156 Southwind Drive BY DELIVERY TO CLERK ON 9duNrY COUNSEL Pleasant Hill , CA 94523 BY MAIL POSTMARKED: Hand delivered 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 27, 1991 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: BY: �. Z)A Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Admin trator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (V) 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. 0 Dated:_ 2 1991 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 2 5 1991 BY: PHIL BATCHELOR by b Deputy Clerk CC: County Counsel County Administrator Claim to BOARD OF SUPERVISORS'OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes ,ofr action for path or for injury to person or. to- per - sonal property or growing erops�and-which accrue on or, before Decembe'r, 31, 1987,. must be presented not later.than the: 100th day after .the accrual of the cause of action. . Claims relatingi to causes of aation �for death or for inSury 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 fo any other cause 'of action .must be presented. not , later than one,year after thdiaccrual -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-o€ this f orm. ., . _ RE: Claim.By ) Reserved for Clerk's filing stamp Ji''1 RECEIVED Against the .County of Contra Costa or2.6,1991 District) CLERK BOARD OF SUPERVISORS Fill in name i` 7:' )' ry CONTRA COSTA CO. The undersigned claimant hereby makes claim,against the County of Contra Costa or the above-named District,in the,.,sum of:$, Vit'��, ,2 and in support of this claim re resents as follows: , p � .:��F t7T1'1iC'tt,EO 1. When;.did�the dargage or, injury,_ocggr,? .,(G ve exact date and hour) ���4 25 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur (Give full details;wus .extra paper if , required)- ,5 d, 4. What particular act or-,,omission on< the 'pant of county or d'istriet'officers, servants or employees caused the injury,"'or 'damage?' v (over) i r I 5. What are the .names of county or district officers, servants or employees causing the damage or injury? 5. ' Wha ,damage or injuries do;you elaiin,•resulted? (Give., full+extent- of linjuries or damages claimed, Attaeh;:tiao estimates for.auto damage.:;.. 190: oyoT 1 !9xX .l,�tN,�;S�l G�? 7. How was the amount claimed above Computed?. .(Incluft,the estimated amount,-of any prospective` injury or, damage,} L,>„��NS 8« -. Names and addresses of`witriesses, doctors, and hospitals. _ _________ _ ----- 9. List he' expenditures you made on accountofthis accident or injury: DATE ., ITEM AMOUNT W * �E k,iF A *.A iF, �k � $ *ki °IE 1t tGov.�'Code,::Sec«. 8142 provides: . ��,q 3. The claim mus be signed,,by the claimant SEND NOTICES TO: (ittor-ne ')V or some erson hib behalf."� Name and Address of Attorney NO j _ la ignature y (Address) 44 561 Telephone No. Telephone-No, xj �t� e2 ll N O T I C E . Section 72%of the Penal Code provides: �.. W.. >. _ .,_. v � "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 boarrd,'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.__. eart-•by,a fine of not exdeeding' one thousand:($1;000),,.,or by .both .such imprisonment and fine- or' ” by-impirisonment in the state prison, by 'a-fine of not exceeding ten: thousand ,doliars ($10,QOIj or by both such imprisonment and fine. i ADDENDUM TO THE CLAIM OF (Print your full name) (1) Do you use the roadway as part of a daily commute? Yes ( ) No ( ) ( 2) Were you aware that construction would- be commencing on the roadway?. Yes ( ) No ( } ( 3) Was an alternate route available? Yes ( ) No ._� )_... i ( 4) .Did you read about the impending resurfacing in the local newspaper? Yes ( ) No (. ) ��( 5) tD d you,see warning ;signsi adv singh�bf;-looseOgravel and a 25 mile per hour 'advisory sign? es E s� (w6-} Did the damage r�esult�from another vehicle 'exceeding the x a •a_- 25 mile ger hour advisory? Yes { x). No { ) �>> s d �d., t (T)� fD:i d ,4a ,veh c'le,,traveling yin th6,\s,Ame rection a1R�. nd eXceec3i ng*' the 2`5 mile per hour advisory.-sign attempt +fio-pass you? z.��°� - r Yes (X } No { ) ( 8) Did a vehicle coming from the opposite direction cause gravel to be thrown onto your car? Yes { ) No (9) Was the v6hicle located directly in front of you exceeding 'the,speed\advisory? w. v- ... Yes 06 No ( ) ( 10) Did you travel .the ,roadway more than once during thle resurfacing prior to the damage sustained to your c1ar? Yes ( ) No ( ) I "r ( 11) Did you obtain the identity of the car relating to questions 6 thru . 9? Yes (� ), No ( ) -If yes, please provide identification below: CJ O�✓bREQ ( 12) Please describe in your own words how the gravel caused damage to your vehicle and the angle the gravel was thrown onto the car, along with the specificdamaged parts on your vehicle. Z WAS `ki �t�v'F-ULt,36 AT A?F-OV, 0"20 MPH (S4oL,.1 �OdT ry �RRNQ /lJ�y✓ IUEHZr�LL' 1 .i LvikS 1/✓ if�F G�l�i A�' hR/U� [�lff N A T Ty /17AL'KF� �!1 f1�1� 0 ke c i -OoRoy, 5 -3y .�►�ti �'�yr 09 O_UT Li NGT1IS. AWiV7 Oi /I7z5: 1n/ ,(3FTr, c—Gf/ �1�� Tnl Tirf ,dy1�c=DQLF ,SUSiFizi+/i-f� lrJUr�.�rPv�s �,�.5 %� �tj�= �,eG/vT �F �Y �2�/U/-G� . :}=,�oy-T Cr✓o k/.x/`iy4" ( 13) Were you aware that using the road during the chip seal �- process might result in damage to your car? Yes ( ) No X I declare that the above information is true and rrect under the penalty of perjury. 'i atu e) (Date) r 1 f • ' V I SAFEL I TE AUTOGLA SS QUOTE #: 10797 ORG DATE: 8-22--91 • DAR#—AG 133972 08--22--91 12:21 :40 BDOw 2049 CONTRA COST BVLD . ' PLEASANT HILL, CA. 9452 sINSURED TI.hI ROUNTREE i X415 687-7200 158 SOUTHW I ND DR PLEASANT HILL, CA 94523 Y; PHONE 1 : 372-84907 PHONE2: CASH SALES LDC 493 POLICY #I D15T1: D V,D': L ! • { -� ,. _... CLAIM kl� .. _ !"'LEASANT HI'LL:, CA 945,23 raooc,l : � AlJ'TH/V�'�a, r �1 PO#/REFa ' - LOSS LOC B 4.15 687--7200 LOSS DATE/CAUSEa 599898-000502-599898 a0502--599898 PAGE 1 _ w•W_�:_::�:=c______ -.::.-.:.^: ________.____aw.w•wr_..:'-s...._..._.-:^cm.=.=^a.=c.^^w.-.'^^a�^�^.�-.•:•��.Y�.=�.=.=-:z-.-.::.�za^z:» "� . YEAR MAKE MODEL MILEAGE LICENSE STATE VEHICLE ID NUMBER 199Ci .TOYOTA SR5 2D PICKUP STOCK a QTY PART # LISTSELLING LABOR KIT MATERIAL.. EXTENSION 1. FCW598—SP 480. 75 192 0 30. 00 222. 30 WINDSHIELD O 1 M I SCl+10L.D -N 25 Urfa 25. 0o M I SC MOLDING 5 '; . r THIS IS A QUOTE ONLY. PARI' SUB TOTAL 217. 30 i DO NOT PAY FROM THIS DOCUMENT. LABOR SUB TOTAL 30. 00 SUB TOTAL 247. 30 i SALES TAX 17. 92 T :f L r C T ESTIMATE •_ 265,.22_ THANK YOU FOR CHOOSING SAFELITE FOR YOUR AUTOGLASS NEEDS ! Y - _ ---_--- ====INSTALLER I NFORMAT I DN=========-—==I===:=---======C LAI MANT==_ IN—STORE NOT SCHEDULED I ADDRESS e ! o. CITY w WINDSHIELD. REPAIR POSSIBLE YES NO 1 COST INITIALS . ACCEPTED _._ DECLINEA f w .:i. CMT. W zt LJ 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 PeAtember 24. 1?91 and Board Action. All Section references are to ) The copy of this document mai ls "�I�You is 'your notice o California Government Codes. ) the action taken on your�'�'��im a Board of Supervisors (Paragraph IV below), g'ver�4 unsuan M47 Government Code Amount: $142 . 95 Section 913 and 915.4. ] ase Qo#� all "Warnings". CLAIMANT: TAMURA, Tim T. tiQ J ATTORNEY: Date received ADDRESS: 223 Village Place BY DELIVERY TO CLERK ON August 30, 1991 Martinez , CA 94553 1 BY MAIL POSTMARKED: August 29 , 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gH DATED: Auirust 30. 1991 JdILATCELOR, 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: Dated: 9 r 5 BY: I on , A Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (f✓) 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. 0 Dated: SEP 2 4 199 1 PHIL BATCHELOR, Clerk, By t Deputy Clerk WARNING (Gov. code section 913) 4 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 2 5 1991 BY: PHIL BATCHELOR by 1 Deputy Clerk CC: County Counsel County Administrator I Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY t INSTRUCTIONS TO CLAIMANT A. Claims, relating to causes of action for death or for`injury.to' 'person Or to per • •sohal •propertyor gr6wing cropsand `which accrue .ori 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.:,3anuary 1, .1988, must be presented snot:-,later than six,.,-months. after the accr,`u of ihe' cause *of action.-••-Claims relatin'g'to`any other ,cause of aetion.must ?be presented not later than 'one:year after 'the `'accrual ,of'the cause,of action. (Govt..jCode. 5911.2.) 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, 1S rtinez, CA 94553., G. If claim is against a district'governed by the Board ;of,Superv_isors, 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 See,. 72 at the end of this form. „ RE: Claim By ) Reserved,f, er " ling s amp' } RRECEIVED Against the .County -of Contra Costa } X99` or ?. 3 d ,.. CLERK BOARD OF SUP • District} �avisoRs ��µ Fill irn - } CONTRA COSTA CO. ° The undersigned claimant hereby makes claim ins unty of Contra Costa or the above namedDistriet:;in;-,the :sum of 2� and in support of .this claim represents 'as follows: �G:Y / , � __iM.--___.!i_______ _______nR__M►__f_i� _ r,_�, ___—fes—_ 1. When did -the damage, or injury occur? '. (Give exact date and hour) 2. Where -did the:• damage •or- J rywoccur? (Include city and county) r NIM I - __/ 3. How did the damage or injury occur? (G ve,full details; use extra paper. if required)., .. 4, What :particular act.-or -omission ori the 'pant of'coupty,or' distriet officers, servants or ,employees':caused the.`in jury"or�de? (over) �. wnat are .the names of county or district officers, servants or employees causing y the damage or injury? - .t_ 1/11,14 14 5. What`.damage �br injuries da you'claim :resulted? : (Give full extent., ofinjuries or� damages`'claimed. Attach .Wo estimates for auto damage. _ S t 7. :How.was the amount claimed"above computed? {Include the estimated amount of any prospective injury or damage.`] 2- �n 8.. : Names' and addresses of witnesses, doctors..and.hospitals. 00,9. . List the expenditures you made-on account of thip accident or injury:, DATE ITEM AMOUNT _ ..- yy j, y, f]]1, �I+�/ (M' ,y�/ v('-Y• �i Y ,y�y, J v ( jY y Y [ ,( ( ] y J( ] ( * Gov,` C de Sde ee.' 0:2 provis:' . ; n10e, i ed -by the claimant SEND NOTICES 'TO: '(At"tbrne ) Drab' Name and Address of Attorney /AMMY TM Cl ' Signature) Address ... _ Telephone No: Telephone No,, ,' +' . * V V V I W I IF * 71 >, 79 d n P 72 of the Penal.,Code provides: e d � "Every, person,4h6, 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 .frauduient 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..exceedirig ten, thousand ,dollars ($10,QOQ, or by bath such imprisonment,and. firie. 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IV� n' r o _ ti i ;° m ' I c - m m «l c v .a a �0 M i t z a,' �� -i m rm c a s . - . �ry n i r 3 0 - � amED m cmrl o,� ce IllN (� ow m m „ o m -a . •i I. C m '` -v r m m �' r �� r o m - , lu r -n 13 m �m-I m Z 3 ., = -1 m m n - Y m i 0 [�0. - N O W,, z tel. o ma` n �'m<f £, D 13 - m rn-,-+ mg t m �ii �^ a.1 IN N' yr ® ` _ s =' cn c`n °� r 1 I z m: ' to [ j a r U - v Q Y Q U � Q � i Z U G Q6 N ...♦ a4 ~° CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT September 91 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to GoveI rnment Code Amount: Unspecified Section 913 and 915.4. Please qq4eF*,0V(fiafnings". CLAIMANT: THOMPSON, James 0. AU Q ATTORNEY: cgpNTy C-01N54 Date received WCOINE$, CALIF. ADDRESS: 3080 Berkley Drive BY DELIVERY TO CLERK ON August 27, 1;991 Richmond, CA 94806 BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 28, 1991 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy Um OJ 1 0 6)� 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 filedilate and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 2 91 BY: I S_ An-h Deputy County Counsel V1 0- 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. BOARDD ORDER: By unanimous vote of the Supervisors present (1/) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Sill v Dated: S E P 2 4 l 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. 0 Dated: SEP 2 5 1991 BY: PHIL BATCHELOR b4 00'z- Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: James Thompson 3080 Berkley Drive Richmond, California Re: Claim of THOMPSON, James 0. 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. 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, lif 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. WESTMAN, ounty Counsel 'aj 0 By: Deputy11�T . y ty Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. 9§ 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 I certify under penalty of perjury that the foregoing is true and correct. ; I Dated: 9 1 99l , at Martinez, California cc: Clerk of the Board of Supervisorsinal) ig Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 .2, 920. 4, 910 . 8) sheriff=Coroner Contra „ Richard K. Rainey SHERIFF-CORONER COS}� Duayne J. Dillon P.O. Box 391 ( Assistant Sheriff Martinez, California 94553 (415) 372- 4494COunty I Warren E. Rup1 County Assistant Sheriff RECEIVED AUG 2 7 1991 CLERK BOARD OF St1'ER`dISORS CONTRA COSTA COI Enclosed, is a County Claim Form., Please list the missing articles and their value, along with any documentsyou may have, i .e. , receipts etc. Be sure you have included pertinent dates that tie in with your loss. These dates should show when you were brought here and when you left. Then you..must 5 return this =form to Contra Costa County, Clerk of.tithe, Board, P.O. Box 911, Martinez, Ca. 94553 ,. J C. Ludwig Support Services Dept. AN EOUAL OPPORTUNITY EMPLOYER J % TO BOARD OF SUPERVISORS OF CONTRA COQ ( c 'mv <' r ne2ur indl apDllcatlon t0: Instructions to Claimant Clerk of the Board a P.O. Brox 911 A. Claims relating .to causes of action for death or =or�lingurynto4[33 "person .or to personal property or growing crops must be presented hot '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 off the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be- filed led with `the Clerk of the Board of Si Dervisors at its office in Room 106 , Coun�y _Administration Building, 651 Pine Street, Martinez , California 94553: C. If claim is against a district governed by the Board of Suo_ ervisors , 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 , Pe.-,41 CodelSec. 72 at end oz this form. RE: Clain by ) Reserved for Clerk' s filing stamos RECEIVED 9'1. 6'41 019 J: Against the'�COUNTY OF CONTRA COSTA} AUG 21 1991 or IV,#gfw,4�t4e ,(}'gr"f QA) Ali,DISTRICT) - CLERK EM-RD of SUPERVI ORS (F ill 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 $ and in support of this claim represents as follows : ---------------------------- -----------------------------------�_--______ 1. When did the damage or injury occur? (Give exact date and hour) (9-11 -411 _10z00 - A-M ..--------------------------------.-----s-------------------------_-______ 2. Where did the damage or injury occur? (Include city and county) .. How-did-the-damage-or injury occur?_ (Givefulldetails, use extra sheets if required) 4Jo4.k. rU4 16/ UAIXjee.t4,+/ Xiv 9 . What particular-act or omission-on the part-of-county or district' officers , servants or employees caused the injury or damage? - - Al S- amage? - `AG£ J-.E&Wf_E.- 0.F S SIC& W-04,kIEW, OF (over) '.:5..:.:•� zat-. ar.e.•.the..names of county or district officers , servants or I employeescausing 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) ,�, +'� ..• 1-0 7 . How was the-amount claimed- above- computed? - (Include-the _estimated amount of any prospective injury or damage. ) ____________ ______________________________________________-----____-- 8. Names and addresses of witnesses , aoc-ors and hoscitals 1���,c+ m. rhe 11.. r •v,,ti - ------- - -------- - 9 . List�the expenaitures you made on account of this accident or injury. I T ,. � �' EI 1 ; , AMOUNT 4jeciSk DRTc,, DATE x� 45 -o jVe°-e b -kc, Se's �)eov itr 4C, De4emr»a _ Govt. Code Sec. ;910.2 provides : "The claim signed by the claiman SEND NOTICES TO: (Attorne.YY or by some oersbn on his behalf. Name and Address of •Attorney -x Claimant' s Signature •` $ ) Address Telephone No. Telephone No. NOTICE i Section 72 of the Penal Code provides: "Every person who , with insert . 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 torallow or a the same if genuine , any false or fraudulent claim, bill, accouizt, 'voucher or writing , is guilty of a felony. "