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HomeMy WebLinkAboutMINUTES - 08171993 - 93-511 uouniy t uun5el • JUL 201993 /• 2z CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CAL IFORNIAAVIal111iez, CA 945b�5 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 Ane BnarA Acr.inn. 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: $1,302.62 Section 913 and 915.4. Please note all 'Warnings". CLAIMANT: BUMGARNER, Carl P. ATTORNEY: Date received ADDRESS: 199 San Luis Ct. BY DELIVERY TO CLERK ON July 16, 1993 Vacaville, CA 95688 via Risk Management BY MAIL POSTMARKED: g 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. p1� gg DATED: July 19, 1993 IV DepuLyLOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: I-- 20 /�/ BY: ` Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (!/) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1993 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sect on 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. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR 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 of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after .the accrual of the cause of .action. Claims relating to causes of action for.death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity,' separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE: Claim By j Reser v d for Clgrk's filing S=PC`a ) RECEIVED Against the County of Contra Costa ) JUL 16 W3 or ) - District) CLER CONTRA COSTA CO.'SORS Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ f 3 o :1 , 9 and in support of this claim represents as follows: _� Q;, .FNM ���/1/�/�(/. ��/,�j`✓'(u/-,,.�� 1. When did the damage or injury occur? (Give exact date and hour) - 3 -----------------'�--Q -------- !.S u o • ------------------------------ 2. Where did the damage or injury occur?.� (Include city and county) 3. How did the ge or injury occur. (Give full details, use extra paper if required) d tom, Rp4L&tUA, .v Ag,,t dam, �-Qa oln )0-tL. $A 1160�j k -1 . b%�/10�- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5. Wnat are tne names of. county or district officers, servants or employees causing the damage or injury? ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto da le A- _T ------------------------- 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. &XLA, 7 ril -—----------------------—----- -—------------ ----- ---- ,- ?J 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 'Tb:',' tt6ineD_` orb some person on his behalf." Name and Addre-s-b'of-Att6rhey- Z&i-, (CYaima­ftt IsKitnature) (Address) "A IZZ Telephone No. TelepQ40. V V V V V V NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such- imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. 1, 1 't A e O4O^R pFTVOID AFTER 30 DAYS.. REPAIR 150 bepot Street ESTIMATE Vacaville,CA 95688 (70-n"9-9358 . 0 0 013.23 Date w Car Owneer. �(/�\Pe7-C1Q P� , Address � In ts,,y l� Home Phone 4AC) Year r'� Make�T. Model I' � ��� • Type .O(AID Lic.# Mileage Business Phone s VIN# Adjuster Phone , Insurance Co. Inspector CODE_ A-ALIGN N-NEW OH-OVERHAULi' S-STRAIGHTEN OR REPAIR EX-EXCHANGE RC-RECHROME U-FOR USED PARTS B-REBUILT Code -tl Labor PARTS I Code ,;^ ` Labor' PARTS Code ��...3„, g,.. Labor PARTS -FRONT; Hours LEFT%RIGHT L R Hours RE_ARk. ,. Hours Bumper I' Fender, Front Bumper.w Bumper Brkt. j Fender Shield Bumper Rail Bumper Impact Cyl. Fender Mldg. Bumper Brkt. Headlamp Bumper Gd. Bumper Gd. IHeadlamp Door Gravel Shield Frt. System Sealed Beam Lower Panel Frame Halogen Lamp Floor Cross Member I Cowl Trunk Lid Door, Front. Trunk Lock Wheel Door Hinge Trunk Handle Hub Cap Door Glass Tail Light & Assy. Hub & Drum !' Vent Glass Tail Pipe Knuckle Door Midg. Gas Tank Knuckle Sup. Door Handle Frame Lr. Cont. Arm-Shaft Center Post Wheel License Frame-Brkt. !i; .. . Door, Rear. Hub 8 Drum Up. Cont. Arm-Shaft Door Glass Back Up Light Shock,- . { Door Mldg.,' License Frame—Brkt. Windshield Rocker Pandl.. Stop Light Assy: Front Cowl l' Rocker Mldg. Rear Wind ow.Def. Tie Rod Sill Plate- Fuel Door &'.Assy. Steering Gear �,. Floor " Steering Wheel Frame Steering,Columnj Dog Leg La or Horn Quar. Panel �. . ALIGNMENT Hours' PARTS Horn Ring Quar. Mldg. Front Wheel Drive Gravel ShieldQuar. Glass 4 Wheel Align ,. ParkingAight 1. Fender, Rear Rear Wheel Drive ;. Grille j;. Fender.Mldg. 2 Wheel Align Shock Absorbers' I Fender Pad Wheel Balance Gas;;: I' Corner Lamp Assy.. H dr(ulic it ? Labor f. Labor Code :�:4,?;` M'�S� x,';y%`:: PARTS FINISH ;;. .... F.,: :. Hours :..�. ;; Hours :: , Baffle, Side I Inst. Panel . Prepare Baffle, Lower I' Front Seat Prime41 92 Baffle, Upper Front Seat Adj. Paint. Lock Plate, Lr. Electric Seat Mechanism Materials Lock Plate, Up. Trim I Paint Sealant Hood To 1 Headlining Clear Coat Hood Hine !' Sun Visors Hood Midg. ICarriage & Landau Top Ornament ITOPAUTHORIZATION FOR REPAIRS Rad. Sup. J Tire Rad. Core Battery. You are hereby authorized to make the above Radio Antenna ;. .. Restraint Systems specified repairs. Rad. Hoses Undercoat Fan Blade r Polish .; r Signed Fan Belt J` Replacement Floor Mats Water Pump Misc. Materials Labor 1 Hrs. $' Motor Mts. ;` Interior Protectant Parts $`� L� 2 3 �� Trans. Linkages J' Rust roofing G Wrecker Service $ To This estimate is based on lowest possible cost consistent with quality work, and-as such, is Sublet $ guaranteed. Items not covered by this .estimate .or hidden will, be additional. - $ '• TOTAL $ RE-661-3 Rev.90 PRINTED IN U.S.A. Lf PIIA11J1J�81,!/ i OF CAUPDW#, AFFI GOL.LISION REPORT _. :::._.::._ r-7—' :AOS /C.... . 'ALCONOITIONB NmfaO NRANUN CITY. JUOICRALOIST10CT LOCAL ARPORTNUMBER NJr FELE 4o0X,-,p/c*-7�6- NUMBER NRA NUN COUNTY NO NKPORTOISTIELT BEAT 10 off . o3-iffr,Qi� � - 320.. ...., zs/i .. OL WION OCCURRED ON Owr YEAR TIME(x00) IIC'N: O.RCa11 t 27 9 /So ---- =-?`-�---F---6---------------------------------- 18 13 a 9320 6� MILEPOST INFORMATION DAY OF W99K TOW AWAY NOTOOKA.IA BY: OQ 1-0 S M T WQF S Ons CgNo jAT INTERSECTION WITH STATE NMT REL ON: DO FEET,4rBas G o/ Gr V�/ff.�/ iffrn ONq �NONa Ty D/SLIC. 11AIRTY ��� iv,��s Li NEM NAME(FIRST,MIDDLE.LAST) I 5Corr C.Eg- _ AN 3 STREET ADDRESS 949 V/� •_V 49I r r� eA �/V m O KID CITY IRATEILe��j'Z C.� Qf�SS3 /f�0/ S�YEL4�✓��OWN9WS ADOIMG III AS �'0, :t• SSI MMR BYES NSIONR WIDOWrRTNDATE VACS COPOWnCM OF VO4CLS ON ORD OIS or P"CtR DINNER OTNEII HIrT r IT � � ism "OMR/.NOME 1 SUNNIS.►,MONS /�/� PRIOR YfCNANICAL DEFECTS: NOW APPARENT® REM TO NARRATIVE J (SZO) 3• Z7OO \SIO/ �! � ✓✓ C"rUSEVINICLE TYNIY DESCRIBE VEHICLE!OAYAOE MACKN DAMMED MG INSURANCE ' CARRIER POLICY NUMBaR 1/SC Nowd �MIN�ON ^ AL aG. ION STREET r�eNOWAY ,PEE er Z�3SO%lV �� ' PTY ONVEM7 MINES NUMBER STATE j CLASS SAFETY V YEAR YAj KS K COL ST KNfI NwtfR ATE z 3 ZZ9� c �• �3 yo»9lv dey NKR HANN("ART,MIOOLE ) I. Oat• TREAT ADORES. OWNERS NAYS ®SAME AS DRIVERAN . 1 3ZD l�Ir190 /Z KID CITY I STATE,L► OWNER'S MORRIS ANI AS DRIVER KSGB !l/LL� C�' g EP l/a :V. sal M A NOONf WEKNT .I• rRT11D�TE RACE oISIOr11ON OF Va"CLe ON ORDERS or: 13 (3OI" [� CER (NDRrvIR OWNER 7 NKR /NONE PNON/ NA ESS.110M 10� //7/I�- ���� PRIOR MECHANICAL DaFEen: TRINE APPARENT 93 REFER ro wIRRAmI �10)' 3s �3 . CN..USE ONLY pESCRIBE VENSCL�011YAot MADE N DAMAGED AREA VEHICLE TYPE INSURANCICARRIaR J' POLICY NLSISaM UML OMON! YNOM 2t ! - — ❑rAJ011 TOTAL om o1 lo"sirmitaloaNOWINA! .PEES PC. lee p ' PTY 0—am'S LICR91sa NUMBER STATE CLASS SAFETY VEIL TEAR MAKE I MODEL I COLOR LICOON"mom STATE 3 KOUIP. VIM NAME(MMST.MIDOLII.LAST) • • • 0Ei STREET ADDRESS OWNitme WANT OSAM9 AS DRIVER AN KOO CITY I STATE I ZIP OWNER"ADORES. OtAMa AS DRIVER CLE --• J :Y. f[I MAIM EYES Na10NT WOONT MO )SIRD SATE YEAR OISPOSITON OF VENCLK ON ORDERS OF: ❑OIRCKM ❑DRIvNI OOTNOI IRA NOME P/ION\/S BUSINESS PHONE .AOM WKCKAIACAL DEPICTS: NOW APPARENT REFER TO NMRAmECHIP O J VEHICLE�B DESCRIBE'VENCLB OAYAOE MADE IN DAMAGED AREA INSURANCE CARRIER POLICY NUMBER UNIL ❑NONE YNOM . .. 0II00. OMAIOR DOTAL aRIOP oN STARIM OR HIGHWAY BPfaD PCF ICCQ , TRAVEL uMR CHP El O Cf1. `RE •Iw" yAN. 1y� (�/ OISPATCH NOTIFIEp MKVIaVVEM s NAME JDATC R WIIIC T WA E3 YE3 C3 NO SSS PAGE/ (Rev 148) OPI 042 88 49567 tTA'M OF CAUFORMA „ TRAFFIC COLLISION CODING '+.. . �• DATE OF SPIN /�� �'/ '!>O !K!C �2a t NUYt[II MO. DAY YRAR 4!J t Ovmmmis NANtf AOD11Rft NDT�F1ED PROPERTY ;,/ ❑T ONO DAMAGE DRscmprnoNOFou"Ot SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE OccupAm L-AIR BAG DEPLOYED We C MCLS•ISO Ism A-NONE IN VEHICLE M-AIR BAG NOT DEPLOYED DITIVEN 4-NOT EJECTED . 9-UNKNOWN N:OTHER . 1•FULLY EJECTED C-LAP BELT USED P-NOT REOUIRED W•NO S 2-PARTIALLY EJECTED 1•DRIVER D-LAP BELT NOT USED w•YES -UNKNOWN 1 2 3 2 TO t-PAS5FIITTER$ E-SHOULDER HARNESS USEDPASSENGER 4 5 6 7-STATION WAGON REAR F•sHOUtDER HARNESS NOT USED S�Ht DS? X-NO 8-REAR OCC.TRIG OR VAN (1,LAP I SHOULDER HARNESS USED O-IH VEHICLE USED ,,„ Y-YES t-POSITION UNKNOWN H-LAP 1 SHOULDER HARNESS NOT USED R-IN VEHICLE NOT USED. T 0-OTHER -PASSIVE RESTRAINT USED S•IN VEHICLE USE UNKNOWN K•PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U-NONE IN VEIDCLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(')SHOULD BE EXPLAINED IN THE NARRATIVE. PRIMARY UST NUMBER (tCOLLISION PARTY AT FAULT TRAFFIC CONTROL DEVICES 1 �j ;{ TYPE OF VEHICLE 1 2 3 �COWPRECEDING A .: C ON VIOLATED: C 80ya JACONTROLS FUNCTIONING APASSENGER CAR I STATION wAqO X lAsTpPPw SGS v G CONTROLS NOT FUNCTIONING• SPASSENGFR CAR W I TRAILER IS PROCEEDING STRAIGHT • S OTHER IMPROPER DRIVING•: CONT ROLE OBSCURED MOTORCYCLE I SCOOTER RAN OFF ROAD 10"0 CONTROLS PRESENT 1 FACTOR-. D PICKUP OR PANEL TRUCK MAKING RIGHT TURN C OTHER THAN DRIVER' TYPE OF COLLISION E PICKUP 1 PANEL TRUCK W 1 fRAILER MAKING LEFT TURN D UNKNOWN• HEAD-ON F TRUCK OR TRUCK TRAC MAKING U TURN t E 4BROADSIVE SIDESWIPE TRUCK I TRUCK TRA R W I TRLR, BACKING REAR END SCHOOL BUS SLOWINGISTOPPING WEATHER( MARK I TO 2IT MSy OTHER BUS (PASSING OTHER VEHICLE ACLEAR E HT OBJECT EMERGENCYWHICLE J CHANGING LANES S CLOUDY IF OVERTURNED KHIGHWAY ONSL EQUIPMENT PARKING MANEUVER C RAINING VEHICLE/PEDESTRIAN BICY ENTERING TRAFFIC SNOWING OTHER`: OT VEHICLE OTHER UNSAFE TURNING FOG r VISINUTY FT. MOTOR VEHICLE INVOLVED WITH ESTRIAN XING INTO OPPOSING LANE F OTHER•: ANON-COLUSION ED PARKED G WINO PEDESTRIAN MERGING LIGHTING . _ OTHER MOTOR VEHICLE -.. _. TRAVELING WRONG WAY NADAYLIGHT MOTOR VEHICLE ON OTHER ROADWAY OTHER ASSOCIATED FACTORS) OTHER,: B DUSK-DAWN PARKED MOTOR VEHICLE 2 3 {,MARK 1 TO2ITEMS) C DARK-STREET LIGHTS TRAIN Averw TMW: Ara D DARK-NO STREET LIGHTS SICYCLE [O�r ND BARK-STREET UGHTS NOT ANIMAL: Bve icrONVIquTION: CTrto FUNCTIONING• QYtB ROADWAY SURFACE TI SOBWETY•DRUQ A oar I RTxED OBJECT: D 1 2 3 (DKK I TO 2ITEMS) ! S SHOWY-ICY WETOTHER OBJECT: D ONO ' HAD NOT BEEN DRINKING ()SLIPPERY(MUDDY,OILY,ETC,) VisiON OBSCUREMENT: S HBO-UNDER DERINFLINFLUENCE'ENCS MBD-NOTUNDEA iPtATTEltitON•3 ROADWAY CONDITION(5) G.STOP a HBO•IMPAIRMENT UNKNOWN (MARK I TO 2ITEMS) PEDESTRIAN'S INVOLVED ENTERING/00 TR LEAVING RAMP UNDER DRUG INFLUENCE NO PEDESTRIAN INVOLVED IMPAIRMENT-PHYSICAL HOLES.DEEP RUT• CRO"n IN CROSSWALK PREVIOUS COLLISION UNFAMILIAR WITH ROAD , IMPAIRMENT/Gi KNOWN B LOOSE MATERIAL ON ROADWAY• ATINTERSECTION DEFECTIVE VEK OUIP.: qnD NOT APPUCASLE C OBSTRUCTION ON ROADWAY• CROSSING IN CROSSWALK-NOT t3Tp 1 SLEEPY FATIGUED D CONSTRUCTION-REPAIR ZONE AT INTERSECTION Ung SPECIAL INFORMATION E REDUCED ROADWAY WIDTH D CROSSING-NOT IN CROSSWALK (,UNINVOLVED VEHICLE AHAZARDOUS MATERIAL FLOODED• IN ROAD-INCLUDES SHOULDER OTHER OTHER-: NOT IN ROAD NONE APPARENT I{NO UNUSUAL CONDITIONS APPROACK90 I LEAVING SCHOOL BUS RUNAWAY VEHICLE SKETCH1-6-1MISCELLANEOUS T-C-1- ESre—V �s DOT VZ� � � trxAn NDRTN _cR CRNR �� EIp —._ 19C CHP _DA P[3jS0 OTHER CHP$SS PAGE 2 1 Rev lit)OPI042 j RATE OPCI ORTpA INJU"E WITNESSES / PASSENGER6'-' PAGE OA OF ONn'�;� TIME�JEyDj„rO� NCIC T?: zo OfRC NUMBER EXTENT OF INJURY("X" ONE) INJURED WAS( "X" ONE ) PARTY BEAT SAFETY WITNESS PASSENGER AGE SEX ONLY ONLY FATAL SEVER[ OTHERVISIBLS COMPLAINT NWBER POS. [QUIP. EJECTED INJURY IWUnr INJURY Of PAIN DRIVER PASS.t1tt ❑F / ❑ ❑ ❑ ❑ rs NAYi I D.O.L I ADDnES{ ATNG �K ,G 41-1.0- 72 -707- f� ENURED ONLr)TRMISPORTtD BY: !y / TAKEN TO: AWV DESCRIBE INJURIES 4% VICTIM OF VIOLENT CRIME NOTIFIED ❑* ❑ ❑ ❑ 1 ❑ 1 ❑ 11110 101 ❑ I ❑ NAME I O.O.S.I ADDRESS TELEPHONE INJURED ONLY)TRANSPORTED IT: TAKEN TO: DESCRIBE NJURIL{ I VICTIM OF VIOLENT CRIME NOTIRED ❑� ❑ o ❑ ❑ ❑ ❑ o ❑ ❑ D NAME IO.OA I ADDRESS TELEPHONE ONJUREO ONLY)TRANSPORTED BY: TAKEN TO: DESC)MBE INJURIES VICTIM Of VIOLENT CRIME NOTIFIEO D� ❑ ❑ D ❑ 1 Cl 10 1.0 10 1 ❑ 10 1 1 1 ` NAME I O.O.B.I ADDRESS TELEPHONE ONJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE BIJumn VICTIM OF VIOLENT CRIME NOTIFIED ❑" ❑ ❑ o I ❑ O 1010101 O lo NAME I O.O.S.I ADDRESS TELEPHONE (INJURED OILY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES VICTIM OF VIOLENT CRIME NOTIRED D" ❑ ❑ 17 ❑ ❑ ❑ ❑ ❑ ❑ ❑ NAME I O.O.L I ADDRESS TELEPHONE ONJURSO ONLY)TRANSPORTED{Y: TAKEN TO: DESCNBE INJURIES ClVICTIM OF VIOLENT CRIME NOTIRED PnE ll��i G'N 57� 1.07 MO. Q F ��fAp niV1EWEn7 NAM{ MO. 0 rtA H 555-Page 3(Rev.7.87)OPI 042 `j/� 117 43631 • I om U42 Page DATE OF I CID T/OCCURRENCE TIME(2400) NCIC NUMBER 7;,Yffr BEji NUMBER3 /soo 3 Zo170',X�',O 'X'ONE TYPE SUPPLEMENTAL('X'APPL)CABLE) Icl Narrative Collision report ❑BA update ❑Fatal ❑Hit and run update ❑Supplemental ❑Other: ❑Hazardous materials ❑School bus ❑Other: CITY/COUNITYIJUEYCIAL DISTRICT REPORTING DI TRICT/BEAT CITATION NUMBER LOCATIIOOWSLIJECT p STATE HIGHWAY RELATED c 5 - 1 � �G G awerw 114 40& Yes ❑No 1. o 4 ti : 2. 5 3. 4. JrUrt//1�' �% D E !t/E. ` T�'�r/✓E�/.y6 E/ S/1 2f� 5. s. sn 1 c .� r.✓ FyLo ' o` 7. oe 8. �/s err io,✓ ,�-/ S,,?•v 9. /�,flT L Gr/i/S ro�i� -/ W .f �t/�r fGF a o�v i..) 10. 11. / W �1 r o.✓l' �G'iiv�" of ,ZE3T TG G1.�:7� 12. �/E .o�lJ6!/ • 13. 14. A,0/A/1- 10,11' 1W,"6 , &�q. r/.S -14 .S 15. L G E� �7 �• Q� / G �G Gl/ Q/L� 0 16. / N E Gr`/ S/O 18. 19. C 20. = /J- �So�! �3 ,9r cr i.�v Ty%5 N, 21. IAI L1110 .v 401-or 22350 &Ie. - erzzq T Iw 22. it .✓ oa 23. 24. i 25. 26. C 27. 28. ozx 29. 30. 31. PREPARER'S NAME AND I.D.NUMBERDAT REVIEWER'S NAME DATE Use previous editions until depleted. 90 57541 JJ arty Comns, . CLAIM JUL 2 0 1993 1, 22- BOARD . 2ZBOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 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: $2,290.46 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: California State Automobile Association Kent Rundles, Claim Representative ATTORNEY: 2055 Meridian Park Blvd. Concord, CA 94520 Date received , ADDRESS: Claim No. 01-5A3259-3 BY DELIVERY TO CLERK ON July 15; 1993 BY MAIL POSTMARKED: via Risk Management I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH gg DATED: July 19, 1993 81IL DepuLyLOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of S visors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: `� 2� OY 3 BY: - ' Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (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. Dated: AUG 1'� 1993 PHIL BATCHELOR, Clerk, 8y . Deputy Clerk WARNING (Gov, code secton 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. *For additional warnino see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a .certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR Deputy Clerk CC: County Counsel County Administrator � California State Automobile Association Untee-InsuranceB0reau ^ CONCORD (5lO ) 67l-27O8 2O55 �ERID�AN PHRK BLVD COMCORD CH 94520 JUI Y 4 , l993 RISK MANAGEMENT 0IVISlON INSD : PIERC�,LlNVA 651 PlNE S1'1-41 E. 6} 14 FLOUR CLM-NO: 01-5*3259-3 MARTIN�Z CA 945�3 D0L : O5-ll-93 DEAR RISK MAwHGEM��T DIVISIUN : THIS IS NOTlCE OF OUH' SUBROGAlION INlER�ST ARISING FROM THLUSS. WF HHVF HRRANGED SE| [LEM�NT W�IlH UUR {NSURED. PL�ASE MHKE YUUR PAYMENT DIREC [LY /O THE CALIFORNIA STAlE 'AU |�UMOBILE HSSOCIATIUN INl �R-INSURANC� BUR�AU ( CS�A-IIB) . ATTACHEU ARE: R�PAIR BILL $ 2198.5O REN[AL BILL $ 91 .9� lOTAL $ 229o.�6 LL YUUR INSURED: CCC FIRE DISlRlCT YUU� CLAIM : N/A ' LJLUL I 519M93j OTHER: A [/N: JULIE AUMACCONTRA COSTA CO.K CLERK BOARD OF SUPERVISORS SINCEKELY ~�--- ^-~ KENT W RUNDLES C� �IM kE�KESENlATIVE � Clair to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or,growing crops and which- accrue on.or -before December 31, 1987, must be presented 'not later than the 100th day. after .the accrual of the cause of action. Claims relating to causes of action for.death or for injury to person or to personal property or growing-crops and which, accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed.by. the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal, Code Sec. 72 at the'end of this form. RE: Claim By ) "Reserved for Clerk's filing stamp &4 /i/ll 5 �1 Q!ti oZnld��Gib ) 3oua*a e �gECEIV � Against the County of Contra Costa ) or ) JUL 15 /� /� Pia k�oh (�d/ILa 6431 � w Arr District) C�R�BOAR AO OSA V ISORS Fill in name] COMM The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ ,� 9Q, and in support of this claim represents 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) 3. How did the ge or injury occur? (Give full details; use extra paper if required) ile4iV o We4 ari eS ba✓ um r'/ Ulf, , l0 r n ScM j4 t- C-0 �L ------------------- ------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) D. wriat ;IrA tne names of county or district officers, servants or employees causing the dxkwgl�- or injury? -- -----------r ----- -- 6. What damage or inj I uries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 1110440 le 01X7 741 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury. or damage.) C5 914 1.5 4 ,0,,�&Ac-C MW Iled C 41' 441 - ----------- 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 See. 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-At,t6rney (Claimant's Signature) de r Melfi al"a, kAddress) Telephone No. Telephone No. 467;71-2 26 T I V WIT I V I W I I F -V T I I I IF I NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if .genuinep any false or fraudulent claim, bill, account, youcher, or writing, is punishable either by imprisonment in the county jail for a -period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment. and fine. i California StateAutomobile.Association Inter-Insurance Bureau 030 $4 4 �y 030 L846��F-6—R DATE OF LOSS CLAIM INSURED'S NAME DATE 05-11=93 .- O1-5A3259-3 '' ''. P.IERCE, LINDA -.- 05-26-93 POLICY—TYPE KIND OF LOSS SUFFIX CUIMAN ' PAY m AUT D LU 03F ` RCE, LINDA x/75. 00 0 0 _ a D.O. ADJUSTER NO. IN PAYMENT OF' Thmuph m CON 18798 INVBICE # 11-33249 BankolAmericaNTBSA 11-35 0 Global Payments 01233 1210 oz ' 1850 Gateway BNd. � PAY *SEVENTY FIVE 00/100* Concord.CA 44520 Sa m m M STANDARD RENT A CAR INC 1n a 1945 N FINE ST STE 116 m TO ,FRESNO � CA ',93727 AUTHORIZED SIGNATURE � (' r ', THE FRESNO��VV ORDER OF NOT NEGOTIABLE M.O. COPY a°0 308446 74o' is i 2 1000 3 581: 1 2 3 30ilvi9094t3ip . _ . . .. 3 ..«1.1...+.95-.,_ -f.-+.rte.-....1� .3+�..� s.•.aC' r'.".:-VnT•.;.�.::: :...ti'. [;;7i •..Y V:.�,: _ �4:: _ _ .L, f. t........___.t 4 ,Eater. jo-'�:y :�: ::jtr: - - -r:.:;. :y..;•.:. B LL.I .RA# t1' 3249 -Cam *Y , 1800 MONUMENT BLVD. 2001 MARKET ST. { ❑ CONCORD,C^i. 94sk E] CONCORD,CA 94521 CA!" :F:;• FED.I.D.:#94-1717107 (510)sae-saga (510)798.2372 01. ...,. ENTFE '. E Ou, UT Aj Af 4 V EX R.`D llSN'Sq. CURDa Im Date ' Tlme RESI34 ® ,;;. I IQA: OUT OUT STATE•' ' .. .. cc' :'PH Dat c' Ilme Date Time 7 - - COMMENTS? SUGGESTIONS? ' REFERRED BY PLEASE CALL R S/i €fl�fRVICE VOICE MAIL g CONTACT/P.O.N 0 0 4=1575 EXT. 1100 JJ INS. k rW• ..w.,.�. r.. s .sy. �,,.. CONFIRMED CA AT/TYPE r $1 01 " r' RATE DATE METHOD.. ' PER DAY ✓Y' FREE MILES DAILY ' 'PER MILE AFTER F PER WEEKFREE MILES WEEKLY PERMILEAFTER DATE HOD -PER � E- ES. PER MILE AFTER -- - .�• :.. k "¢ RENTAL DISCOUNTS' j, S ALENDAR DAY❑ 24�iOUR DAY�DD'L .OURS® k " � . '. .: ri ' ..:: cr..� '. VEHICLE DUST BE RETURNED BY` N DATE METHOD IN ORDER TO QUALIFY FOR THIS SPECIAL RATE-LOTHERWISE IT REVERTS TO THE SLJBTO rJ ,ts V. :REGULAR DAILY RATE FROM DAY ONE.:: :. :.. - _ _ DATE O METHOD �j - e BILLING INFORMATION Ins.Co. : Ad•. �-�'L f Bilied. 3=F Ins. r1 �L� 1 _�'' (� # r, IS!i -% _ l Due from Renter.. Conf. Maxs I 1 � � DOL. 1 Re fund Renter`::;:= ( ) .f rt .:. - NOTES PIMP PAY.EF�OM ST�N�� THIS_INVOICE-NO Rent-m-cam 'STATEMENT WILL. FORM#101 BE SENT. . I hereby assign to Standard Rent-A-Car,Inc.the sum of for car - = rental services,and authorize Standard Rent-A-Car,Inc.as my agent with a power of attorney to sign or endorse any checks and/or drafts,and any releases,made payable 1'945 N. FINE # 116 to me,for said car rental services. FRESNO, CA 93727 I also acknowledge that I have read the rental agreement and this explanation of insurance (209) 454. company and renter responsibilities and agree to comply with the provisions and conditions Ca? 1555 FAX (209) 41555 5 r thereof. 75i-00 Date RENTER l_� / 5 4 .•.. M. '. California State Automobile'Association Inter-Insurance Bureau 030 A `.. .� 030- L,84^3 : 4> v DATE OF LOSS CLAIM INSURED'S NAME -' 05-1-1-93 01 5A3259--3 PIE CE,'L I NDA 05 DAA�-93 POLICY—TYPE KIND OF LOSS $UFFr-IK 5 AME PAY rs AUTO CCL 1 F �G� '_5G 2 c DO.CON 1' 163RND. CMITdREPAIRS Through rt Bank of America NTdSA 11-35 C Global Payments#1233 1210 Z 1850 Gateway Bh d. PAY 'ONE THOUSAND NINE HUNDRED, FORTY EIGHT 50I 1f,`b�nOVA!4520 m m m JIM 'S CALIF AUTO BODY INC m 2520 MONUMENT BLVD m To THECONCORD CA 94520 AUTHOWZEJEURbj OF NOT NEGOTIABLE M.O. COPY , 00308439970 to L 2 X000 3 5E11d 1 2 3 30vm90946um F r� �a -,1 •1 9 :3 -rUE 1 5 44 T I MS CAL I F AUTO :B0D 'Y' I MC P _ •� 1 .TQM • C:2Z&L X%.LJ'TC) nC)TDO X 2520 MONUMENT ROUT,FVARD CONCORr), CA 94:520 ( 5101 689-6117 Fax: ( 5 0 ) 689-7836 'V'.i s z k} P Q1:ac>t,t a:<>n. #6 8 by ANNA on 05-11-93 3966 S'MNEkTLKGF TJR AFT 7 Style 4 DR SFT)AN Tlnsurer : CAT.Tr.. STATE 11UJO. AS Lic. Plate: 1.PT,S482 Acdjlister : 5'I'FWE Cu'1`rPI P1Z 5AN'J'c)N, CA 94.988 Paint Code.- X11?6 Appraiser: Ph<5nP: 372-20.1.5/462--761.8 Prod. Date: 1.2/85 Cai.mant 86 70TYT'A CA%9RY Profi le : A&,IF InSUrC-d VIN: ,Ti128VI.2r.5 40421.1.1,2 Dar3.uc ti,blP: 250.00 CJ l my# # . O1-5A:32593 Ma IC+age: 35 3 3 25 crpt ions: Ali tr.hel 1 service- 935747 Line, Entry r,abar Line Item Part Typel Dollar Labor CEG Item HuIyer_Tyke . Operation Ueacr ption Part hurber Annunt Unit hit . )0f; Wl1 ( lIrIL, I, dun l; T1 ;Tt h6lltJ IIT-" ^ n1'PLtsCK L JUARTER OUT1,R PANYL 61602-32030 286.99 IAC 13.OT 2� 5197703 A-1no REFTN RaFTNISH L DARTBR PA-1W, OUTSIDE C0.52.44 AUTO XVF1H RKFiN;S3 L OCK PILLAR 5 521330 ROOM REPAIR LUGCACR LID PANEL 3X4TING R 2.01 0.7 6 AUTO RE,F1N RItFINIS11 LUGGAGE LID 00"SiD8 C 2,0 2.4 7., 521.580 RCDP R A I LDGGr1GE LTD NA:PPt,ATE EXiSTTNG ' 0,2' 0.2 8. 52!;90 BODY R 6 I L,,JCCACB LID NA.I"PLATR FXTSTilC 0.2" 0.2 :? .9 524000 BODY R,PAIR REAR BODY PANE, RkTsT1f+C C 1.7� 5. 2.1 10 AUTO RITIN, REPIHTSH REAR BODY PANEL, I1 524:70 R;PT,ACR T, CC;I6INATION LAE1P AS.�RRVI 81560-32121 !96,14 INC 0.5T 12. 525520 ROOY RHPLACH L VCFISR LAMP ASST f98LY 81690-32061 55.83 0.3 0.3T 13 526050 - R?PLACS r, MARKFIR T,1110 ASS:.RBLY 81750-14050 18.30 INC 1, 3T 14 526300 BODY OVRRHAUL RIFAR CCVFR ASSY1. 15 526360 P,F.P1,r1CR REAR 90'9PRR COVRR $2159-32060 2A.19 InC 1.311 16 526410 REPLACK L RRAR. BUMPER COVER EXTFISION 52153-32040 32.48 INC = 0.4T 17 A:,T0 R3FIN P"FINiS11 L REAR COVER BXTRVSIOli 0.5 0.5 18 526470 R1,PLACR L k",AR BUMPER BR,ICXFT 52158-32010 16.73 INC T 19. 526510 REPLACE L REAR;HMHR COVER EXT ERXT 52168-32010 5.62 INC T 20 526550 RXPLACE Rigla RuNP^k SEAL 52591-32010 4.21 1'IC T 11 933002 RBPT.N' AN, OPER CLEAR COAT 117 22 933003 311F-H ADL OPRR TtiT COLOR 0.31 23 111011 1"F I I AAL CP%R S RIPE 0.2' 24' 935007 AifL COSTSHP RATFRIAT.S 15.00 T 25 936008 AN, COST PAIHT MA%RIAT,S 85.87, T Judgement ttep C Tnc103ed in Clear Coat Calc I. Labor subtotals Unita Rate Totals TT. Part Replace©Ent sumary Anount _ ROM iu:7 4 r,H NI-M Taxable Parts; BIE:D9 RIFOTV 9.3 48.00 446.40 Parte Adjrtatmr;nt 40.90- Nontaxable Labor 1248.00 SalEa Tax 1 8.2501 64.12 Labor 511mary Totals: 26.0 1248.00 Total Replaresar:nt Parts hount: 841.31 PstiMate CX is a trade ark of Mitchell International Copyritrht 1991, 1992 All Rights Reserved i X68 Po TOYOTA CANRY P)OU Page 2 M. AJaitional Costs Anount 1, Total ►,abort 12;9.00 Taxable Costa N M IT. Total Neolaccaent Parts; 841.31 Sales Tax @ 9,2591 .9,32 M. 'Dotal Adaitional Costs: 109.19 Nantaxah':e Coats 0,00 Total Additional Costs, 109.19 O"ru,s Total: 2198,54 Custo�er A11os+.,nee: 0,00 C;istorer Responsibility: 250,40 Net Total: 1918.50 01 � O1L 4, FstiMate C }s atradem rk of i tcnell Iaterna`ional Copp get 1991, 19 2 Al Rights Reserve ImageMate Est# : 245 Page : 1 Name : PIERCE l : 2 : 3 : .. :.::.....::::::.::.:.:.: ........ ... ..... :.:.,:.,. v .:. ...:......... . . ...... . :..:..::.. die...;..-r..: .. 4 : ImageMate Name: PIERCE Slide Slide k � v n_ / zz AUG 31EMMM CLAIM + BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim A; ounty, o District governed by) BOARD ACTION the oard of Supervisors, outing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT: FINKS, Floyd and HICKS, Linda ATTORNEY: Date received ADDRESS: 1913 Calaveras Drive BY DELIVERY TO CLERK ON July 30, 1993 West Pittsburg, CA 94565 BY MAIL POSTMARKED: hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. QQ 8g DATED: August 3, 1993 B�1L DeputylOR, C1er 001- I1. FROM: County Counsel TO: Clerk of the Board of visors ( ✓) 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: Ll 19 q 3 BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1), County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( ) 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. AUG 17 1993 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sec on 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. *For additional warnina see reverse side of this notice. 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: rAUG 2 0 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLAIM AGAINST COUNTY OF CONTRA COSTA AND ITS AGENTS AND EMPLOYEES Floyd Finks and Linda Hicks hereby present a claim for damages against the County of Contra Costa and its agents and employees. ADDRESS OF CLAIMANTS Floyd Finks 1913 Calaveras Drive West Pittsburg, CA 94565 Linda Hicks Address as above RECEIVE® ADDRESS TO WHICH NOTICES SHOULD BE SENT: AL 30 M Floyd Finks Address as above CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Linda Hicks Address as above DATE, PLACE AND CIRCUMSTANCES OF OCCURRENCE: On January 31, 1993 at approximately 2 : 30 a.m. , Claimant Floyd Finks was returning to his home from a gathering at a friend' s house. He was driving a vehicle owned by and registered to Claimant Linda Hicks, his girlfriend, with whom he lives. Near the intersection of Willow Pass Road and Poinsettia Drive in W. Pittsburg, not far from his house, Claimant noted a vehicle behind him flashing its bright headlights at him. He recognized the vehicle as a police unit, so he pulled over to the side of the road and got out of the vehicle. Deputy Weikel approached him, baton out, saying "You're under arrest. You have a warrant. " No details of the warrant were given. After saying this, he pushed Claimant against the car so that his back was towards the officer, saying at the same time "Don't make me fuck you up. " While Claimant ' s back was to him, Deputy Weikel struck Claimant in the back of the head with the baton. Claimant asked why he was being hit, but the only response was more baton blows by Deputy Weikel . After several of these blows, Claimant began defending himself, and attempted to take the baton from Deputy Weikel . He was unsuccessful, however. By the time back-up arrived, Claimant was face down on the ground, mostly trying to ward of the baton blows Deputy Weikel was continuing to apply. Another Deputy held him down and cuffed him. The blows from Deputy Weikel were still falling. Claimant estimates total baton blows between 15 and 20. A few minutes later, more Sheriff' s Deputies arrived, together with some officers of the Pittsburg Police Department. By this time, Claimant was cuffed and bent over the trunk of a police vehicle. Claimant was searched, during which all items were removed from his pockets. He was then placed in handcuffs and placed in the back of one of the Sheriff 's Department vehicles. Deputy Weikel told them they would be towing the car despite Claimant' s protests that his house and girlfriend were very close and that she could come and retrieve the car, which was registered to her anyway. Claimant had been seated for approximately 10 minutes when another Sheriff' s Department car arrived and a Sergeant got out. He said to Claimant, "Have you been fighting my deputies?" Claimant responded, "Your deputies jumped on me" The Sergeant directed the deputies to pull Claimant out of the car and to "double cuff" him. While other deputies were attain searching Claimant, the double cuffing was done mercilessly by the Sergeant himself, who bent Claimant ' s hands backwards to an extreme degree, causing severe pain. Claimant complained that he thought his wrist was broken. The Sergeant said "I don't give a fuck. If you fuck with my men, I ' ll take you somewhere and beat the fuck out of you. " Claimant responded that "you've already done that. " Shortly thereafter, Claimant ' s girlfriend, Claimant Linda Hicks, showed up at the scene and spoke with a Sergeant Dunlap. She explained that the car was registered to her. and that she could drive it from the scene. Sergeant Dunlap told Claimant Linda Hicks that she could not have the car. "Your car is going to car jail and Floyd is going to people jail . " Claimant Hicks left the scene very disappointed and returned later asking to see "the Sergeant" in charge, and the same person she 'd spoken with before told her he was in charge and that she should "leave and leave now. " Claimant Linda Hicks left the scene and the car was towed. Claimant Linda Hicks was compelled to pay $107 . 00 to get the car out of impound after it was wrongfully seized. After a few minutes, Claimant Floyd Finks was again taken from the police car. This time, a Sergeant produced a polaroid camera, and several photos were taken of Claimant Floyd Finks. He was then taken into custody and transported to the Martinez Detention Facility. While in the custody of County of Contra Costa at the Martinez Detention Facility, Claimant Floyd Finks asked for an evaluation of his existing cardiac condition and for his medication for that aliment. This was refused. PARTIES RESPONSIBLE: The County of Contra Costa, Deputy Weikel, Sergeant Dunlap and other of the County ' s agents and employees, whose identities are presently unknown. AMOUNT OF CLAIM: Punitive damages against Deputy Weikel and other individual agents and employees of the County of Contra Costa; compensatory damages against County of Contra Costa all in an amount within the jurisdiction of the Superior Court. GENERAL DESCRIPTION OF INJURIES AND BASIS OF COMPUTATION OF DAMAGES: Compensatory damages are based upon the special and general damage suffered by Claimants by reason of the wrongful acts of the responsible parties. Special damages include, but are not limited to, the cost of retrieving the car from improper impounding. General damages include, but are not limited to, the pain, suffering, inconvenience, embarrassment, humiliation and anxiety which occurred when Claimant Floyd Finks was wrongfully stopped, beaten, arrested , photographed, double cuffed, intentionally injured in the double cuffing procedure, deprived of his rights to medical care and vital cardiac medications. Punitive damages are based upon the outrageous, malicious nature of the agents and employees ' acts. The above-described acts of these agents and employees were willful , wanton, malicious, oppressive and fraudulent and done with the intent to deprive Claimant of his civil and constitutional rights. Dated: July , 1993 - aNDA D F NKS HICKS - C /. 2 .2, ` CLAIM 2 T 19 OF SUPERVISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim tri governed by) BOARD ACTION the Boa rsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Boa ection 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 Supervi!�crs (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT: HWANG, Chung Ying ATTORNEY: Joel Gumbiner, Esq. Rudy and Gumbiner Date received ADDRESS: 100 Spear Street, Ste. 1850 BY DELIVERY TO CLERK ON July 26, 1993 San Francisco, CA 94105 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. ppHH 8g DATED: July 27, 1993 BILL DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors i ( 67 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: y �/ Y-5 BY: 6Deputy 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 (V1 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 dat AUG 17 1993 Dated: 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. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 V 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator RECEIVED r2JUL 61993 Claim for Wrongful Deathr��r , jState of California, Contra Costa County, CLERK BOARD OF SUPERVISORS City of Richmond Alameda-Contra Costa Transit Distr c CONTRA COSTA CO. (Government Code§910, 911.2) Name/Address of Claimants: 1. Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 2. Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo,4400 Wesley Way, El Sobrante, CA 94803 3. Ching Sheng Hwang, 5028 Santa Rita Road, Richmond, CA 4. Shio-Min Hwang, 4400 Wesley Way, El Sobrante, CA 94803 5. Pei Shan Hwang Sun c/o Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 Address to which Notice to Claimant Should be Sent: Joel Gumbiner Rudy & Gumbiner 100 Spear Street, Suite 1850 San Francisco, CA 94105 Date, place and circumstances of the occurence giving rise to the claim: On January 26, 1993, 68-year old Tuli Tu Hwang was killed when struck in a crosswalk in the uncontrolled intersection of San Pablo Dam and Clark Roads in Contra Costa County (Richmond). Claimants are the husband and surviving children (and grandchildren) of Tuli Tu Hwang. The grandchildren, Alvin Lo and Elaine Lo, are minor children who were present and witnessed the incident and the gruesome death of their grandmother at the scene from a broken neck, head and internal injuries. The crosswalk and intersection in which Mrs. Hwang was killed were in a dangerous condition in that the intersection was uncontrolled (no signs or traffic signals), the crosswalk was difficult (and at times virtually impossible) for drivers to see, traffic speed was too fast for conditions present, and the placement of a public bus stop and/or the crosswalk at this portion of San Pablo Dam Road encouraged pedestrians (especially elderly pedestrians) to cross this busy road at this location. On information and belief, this intersection had been the scene of other accidents and near misses previous to this fatality, a situation which had been discussed at public meetings. These and other conditions at the scene, and the failure of the government entities to better control traffic at the intersection and around this crosswalk, created a dangerous condition of public property, negligence in the maintenance, control, operation and protection of pedestrians and bus patrons at this location, and/or were the result of ministerial acts of public employees, and/or violation of statutes which caused the death of Mrs. Hwang. The entities in charge of this crosswalk and this intersection also failed to warn pedestrians, and particularly elderly pedestrians utilizing the crosswalk to reach the bus stop that at certain times of the day that traffic is heavy, that drivers are blinded by the sun, that the intersection and crosswalk are dangerous as set out in the previous paragraph. This claim is made against the entities responsible for controlling, signaling, maintaining and operating the intersection at San Pablo Dam and Clark Roads and crosswalk at that intersection, as well as those entities responsible for placement of crosswalks and bus stops on this portion of San Pablo Dam Road, as well as those entities responsible for controlling traffic speed and warning pedestrians about drivers and drivers about pedestrians on San Pablo Dam Road, as well as those entities employing persons to do all of the above and keep this area safe for pedestrian traffic. General description of injury/damage Claimants are making claims for Wrongful death pursuant to CCP§377 et sec- -Grandchildren Alvin and Elaine Lo are also making claims for emotional distress from witnessing the awful death of their grandmother. [Dillon v. Lgy'& (1968) 68 Cal.2d 7281. Name of public employee(s) causing injury, if known: Unknown at the present time. Amount of claim (or jurisdictional limits): Jurisdiction over the claims of each claimant rests in Superior Court. Dated: July 23, 1993 JJ L Joel tumbiner Rudy &Gumbiner, PC Attorney for Claimants Chung Ying Hwang, Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo, Ching Sheng Hwang,Shio-Min Hwang, Pei Shan Hwang Sun 1 PROOF OF SERVICE 2 3 I, the undersigned,.declare: 4 1 am over the age of eighteen years and not a party to the above- 5 entitled action. My business address is 100 Spear Street, Suite 1850, San 6 Francisco, California, 94105. On this date, I served the foregoing CLAIM 7 FOR WRONGFUL DEATH on all parties by placing a true and correct copy 8 thereof enclosed in a sealed envelope and causing it to be hand-delivered to 9 the following: 10 County of Contra Costa (Also served: Form Claim Against Clerk of the Board the City of Richmond) 11 651 Pine Street, Room 106 City of Richmond Martinez, California 94553 City Clerk's Office i2 2600 Barrett Avenue, 3rd Floor 13 Richmond, California 94804 14 AC Transit State of California Claims Department Board of Control is 1600 Franklin Street, 6th Floor Government Claims Division Oakland, California 94612 630 "K" Street, 4th Floor i6 Sacramento, California 94814 17 18 19 1 declare under penalty of perjury under the laws of the State of 20 California that the foregoing is true and correct. 21 Executed this 26th day of July, 1993. 22 23 effrey . Tiet ens 24 25 26 Rudy&Gumbiner Professional Corporation • ' u CLAIM JUL 2 7 D PERVISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim Against he ove ned by) BOARD ACTION the Board of perviso 11iF. ndors nts, ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Board Acti - on references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all 'Warnings". CLAIMANT: HWANG, Ching Sheng ATTORNEY: Joel Gumbiner, Esq. Rudy and Gumbiner Date received ADDRESS: 100 Spear Street, Ste. 1850 BY DELIVERY TO CLERK ON July 26, 1993 San Francisco, CA 94105 BY MAIL POSTMARKED: hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, eeH BATCHELOR. DATED: July 27, 1993 BtII Clerk I1. FROM: County Counsel TO: Clerk of the Board of Supervisors (✓f 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: Z �/ /�/ y BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1993 PHIL BATCHELOR, Clerk, Sy , Deputy Clerk WARNING (Gov. code sec n 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator • RECEIVED JUL 2 61993 Claim for Wrongful Death '2.'*rte H . IState of California, Contra Costa County, CLERK BOARD OF SUPERVISORS City of Richmond Alameda-Contra Costa Transit Distr CONTRA COSTA CO. (Government Code§910,911.2) Name/Address of Claimants: 1. Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 2. Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo,4400 Wesley Way, El Sobrante, CA 94803 3. Ching Sheng Hwang, 5028 Santa Rita Road, Richmond, CA 4. Shio-Min Hwang,4400 Wesley Way, El Sobrante, CA 94803 5. Pei Shan Hwang Sun c/o Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 Address to which Notice to Claimant Should be Sent: Joel Gumbiner Rudy & Gumbiner 100 Spear Street, Suite 1850 San Francisco,CA 94105 Date, place and circumstances of the occurence giving rise to the claim: On January 26, 1993,68-year old Tuli Tu Hwang was killed when struck in a crosswalk in the uncontrolled intersection of San Pablo Dam and Clark Roads in Contra Costa County (Richmond). Claimants are the husband and surviving children (and grandchildren) of Tuli Tu Hwang. The grandchildren, Alvin Lo and Elaine Lo, are minor children who were present and witnessed the incident and the gruesome death of their grandmother at the scene from a broken neck, head and internal injuries. The crosswalk and intersection in which Mrs. Hwang was killed were in a dangerous condition in that the intersection was uncontrolled (no signs or traffic signals), the crosswalk was difficult (and at times virtually impossible) for drivers to see, traffic speed was too fast for conditions present, and the placement of a public bus stop and/or the crosswalk at this portion of San Pablo Dam Road encouraged pedestrians (especially elderly pedestrians) to cross this busy road at this location. On information and belief, this intersection had been the scene of other accidents and near misses previous to this fatality, a situation which had been discussed at public meetings. These and other conditions at the scene, and the failure of the government entities to better control traffic at the intersection and around this crosswalk, created a dangerous condition of public property, negligence in the maintenance, control, operation and protection of pedestrians and bus patrons at this location, and/or were the result of ministerial acts of public employees, and/or violation of statutes which caused the death of Mrs. Hwang. The entities in charge of this crosswalk and this intersection also failed to warn pedestrians, and particularly elderly pedestrians utilizing the crosswalk to reach the bus stop that at certain times of the day that traffic is heavy, that drivers are blinded by the sun, that the intersection and crosswalk are dangerous as set out in the previous paragraph. This claim is made against the entities responsible for controlling, signaling, maintaining and operating the intersection at San Pablo Dam and Clark Roads and crosswalk at that intersection, as well as those entities responsible for placement of crosswalks and bus stops on this portion of San Pablo Dam Road, as well as those entities responsible for controlling traffic speed and warning pedestrians about drivers and drivers about pedestrians on San Pablo Dam Road, as well as those entities employing persons to do all of the above and keep this area safe for pedestrian traffic. General description of injury/damage Claimants are making claims for Wrongful death pursuant to CCP§377 et s� Grandchildren Alvin and Elaine Lo are also making claims for emotional distress from witnessing the awful death of their grandmother. [Dillon v. Legg, (1968) 68 Cal.2d 7281. Name of public employee(s) causing_injury, if known: Unknown at the present time. Amount of claim (or jurisdictional limits): Jurisdiction over the claims of each claimant rests in Superior Court. Dated: July 23, 1993 J.j L oel umbiner Rudy &Gumbiner, PC Attorney for Claimants Chung Ying Hwang, Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo, Ching Sheng Hwang,Shio-Min Hwang, Pei Shan Hwang Sun PROOF OF SERVICE 2 3 I, the undersigned, declare: 4 I am over the age of eighteen years and not a party to the above- 5 entitled action. My business address is 100 Spear Street, Suite 1850, San 6 Francisco, California, 94105. On this date, I served the foregoing CLAIM 7 FOR WRONGFUL DEATH on all parties by placing a true and correct copy 8 thereof enclosed in a sealed envelope and causing it to be hand-delivered to 9 the following: 10 County of Contra Costa (Also served: Form Claim Against Clerk of the Board the City of Richmond) i1 651 Pine Street, Room 106 City of Richmond Martinez, California 94553 City Clerk's Office 12 2600 Barrett Avenue, 3rd Floor 13 Richmond, California 94804 14 AC Transit State of California Claims Department Board of Control 15 1600 Franklin Street, 6th Floor Government Claims Division Oakland, California 94612 630 "K" Street, 4th Floor 16 Sacramento, California 94814 17 18 19 I declare under penalty of perjury under the laws of the State of 20 California that the foregoing is true and correct. 21 Executed this 26th day of July, 1993. . zz 23 effrey Tie ens 24 25 26 Rudy&Gumbiner PmfeUMMI Cmyor&UCM CLAIM JUL 2 87 RD O 0AF E VISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim Against th County,C0tl1NWVS1 governe by) BOARD ACTION the Board of Supe v' n s, ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all •Warnings". CLAIMANT: HWANG, Shio—Min ATTORNEY: Joel Gumbiner, Esq. Rudy and Gumbiner Date received ADDRESS: 100 Spear Street, Ste. 1850 BY DELIVERY TO CLERK ON July 26, 1993 San Francisco, CA 94105 hand delivered BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH BB DATED: July 27, 1993 81IL DepuLyLOR, Clerk I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( A) 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: c, Zu r �? 3 BY: �.-� Deputy County Counsel II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ((�) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1999 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING {Gov. code secton 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. *For additional warnino see reverse side of this notice. 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 16; 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. AUG 2 0 1999 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator RECEIVED JUL 2 61993 Claim for Wrongful Death 7"*. �+ . IState of California, Contra Costa County, CLERK BOARD OF SUPERVISORS City of Richmond Alameda-Contra Costa Transit Distri 8 CONTRA COSTA CO. (Government Code§910, 911.2) Name/Address of Claimants: 1. Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito,CA 94530 2. Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo,4400 Wesley Way, El Sobrante,CA 94803 3. Ching Sheng Hwang, 5028 Santa Rita Road, Richmond, CA 4. Shio-Min Hwang,4400 Wesley Way, El Sobrante, CA 94803 5. Pei Shan Hwang Sun c/o Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 Address to which Notice to Claimant Should be Sent: Joel Gumbiner Rudy & Gumbiner 100 Spear Street, Suite 1850 San Francisco, CA 94105 Date,place and circumstances of the occurence giving;rise to the claim: On January 26, 1993, 68-year old Tuli Tu Hwang was killed when struck in a crosswalk in the uncontrolled intersection of San Pablo Dam and Clark Roads in Contra Costa County (Richmond). Claimants are the husband and surviving children (and grandchildren) of Tuli Tu Hwang. The grandchildren,Alvin Lo and Elaine Lo, are minor children who were present and witnessed the incident and the gruesome death of their grandmother at the scene from a broken neck, head and internal injuries. The crosswalk and intersection in which Mrs. Hwang was killed were in a dangerous condition in that the intersection was uncontrolled (no signs or traffic signals), the crosswalk was difficult (and at times virtually impossible) for drivers to see, traffic speed was too fast for conditions present, and the placement of a public bus stop and/or the crosswalk at this portion of San Pablo Dam Road encouraged pedestrians (especially elderly pedestrians) to cross this busy road at this location. On information and belief, this intersection had been the scene of other accidents and near misses previous to this fatality, a situation which had been discussed at public meetings. These and other conditions at the scene, and the failure of the government entities to better control traffic at the intersection and around this crosswalk, created a dangerous condition of public property, negligence in the maintenance, control,operation and protection of pedestrians and bus patrons at this location, and/or were the result of ministerial acts of public employees, and/or violation of statutes which caused the death of Mrs. Hwang. The entities in charge of this crosswalk and this intersection also failed to warn pedestrians, and particularly elderly pedestrians utilizing the crosswalk to reach the bus stop that at certain times of the day that traffic is heavy, that drivers are blinded by the sun, that the intersection and crosswalk are dangerous as set out in the previous paragraph. This claim is made against the entities responsible for controlling, signaling, maintaining and operating the intersection at San Pablo Dam and Clark Roads and crosswalk at that intersection, as well as those entities responsible for placement of crosswalks and bus stops on this portion of San Pablo Dam Road, as well as those entities responsible for controlling traffic speed and warning pedestrians about drivers and drivers about pedestrians on San L Pablo Dam.Road, as well as those entities employing persons to do all of the above and keep this area safe for pedestrian traffic. General description of injury/damage Claimants are making claims for Wrongful death pursuant to CCP§377 et gq. Grandchildren Alvin and Elaine Lo are also making claims for emotional distress from witnessing the awful death of their grandmother. [Dillon v. Leg,& (1968) 68 Cal.2d 7281. Name of public employee(s) causing injury, if known: Unknown at the present time. Amount of claim (or jurisdictional limits): Jurisdiction over the claims of each claimant rests in Superior Court. Dated: July 23, 1993 J-j L oel tumbiner Rudy &Gumbiner, PC Attorney for Claimants Chung Ying Hwang, Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo,Ching Sheng Hwang,Shio-Min Hwang, Pei Shan Hwang Sun PROOF OF SERVICE 2 3 I, the undersigned, declare: 4 I am over the age of eighteen years and not a party to the above- 5 entitled action. My business address is 100 Spear Street, Suite 1850, San 6 Francisco, California, 94105. On this date, I served the foregoing CLAIM 7 FOR WRONGFUL DEATH on all parties by placing a true and correct copy 8 thereof enclosed in a sealed envelope and causing it to be hand-delivered to 9 the following: 10 County of Contra Costa (Also served: Form Claim Against Clerk of the Board the City of Richmond) 11 651 Pine Street, Room 106 City of Richmond Martinez, California 94553 City Clerk's Office 12 2600 Barrett Avenue, 3rd Floor 13 Richmond, California 94804 14 AC Transit State of California Claims Department Board of Control 1s 1600 Franklin Street, 6th Floor Government Claims Division Oakland, California 94612 630 "K" Street, 4th Floor 16 Sacramento, California 94814 17 18 19 I declare under penalty of perjury under the laws of the State of 20 California that the foregoing is true and correct. 21 Executed this 26th day of July, 1993. 22 23 effrey . Tie ens 24 25 26 Rudy R Gumbiner Pmfunmal Carpm man D � • i. P ,JMI 2 T CLAIM so 11 VISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim Against t j0ff_]g:6r44�nJd by) BOARD ACTION the Board of Supervisors, Routing n s, ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all •Warnings". CLAIMANT: LO, Shirley Wong, individually and for Elaine Lo and Alvin Lo ATTORNEY: Joel Gumbiner, Esq. Rudy and Gumbiner Date received ADDRESS: 100 Spear Street, Ste. 1850 BY DELIVERY TO CLERK ON July 26, 1993 San Francisco, CA 94105 BY MAIL POSTMARKED: hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 27, 1993 Iqll �eputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Sup—errlTors (d) 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: / `!'f,� BY: 'C - Deputy County Counsel 1I1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (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. Dated: AUG 17 1993 PHIL BATCHELOR, Clerk. By . Deputy Clerk or 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. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator • RECEIVED ME!Claim for Wrongful Death IState of California, Contra Costa County, CLERK BOARD OF SUPERVISORS Cit of Richmond Alameda-Contra Costa Transit Distr CONTRA COSTA CO. (Government Code§910, 911.2) Name/Address of Claimants: 1. Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 2. Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo,4400 Wesley Way, El Sobrante, CA 94803 3. Ching Sheng Hwang, 5028 Santa Rita Road, Richmond, CA 4. Shio-Min Hwang,4400 Wesley Way, El Sobrante, CA 94803 5. Pei Shan Hwang Sun c/o Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 Address to which Notice to Claimant Should be Sent: Joel Gumbiner Rudy & Gumbiner 100 Spear Street, Suite 1850 San Francisco, CA 94105 Date, place and circumstances of the occurence giving rise to the claim: On January 26, 1993, 68-year old Tuli Tu Hwang was killed when struck in a crosswalk in the uncontrolled intersection of San Pablo Dam and Clark Roads in Contra Costa County (Richmond). Claimants are the husband and surviving children (and grandchildren) of Tuli Tu Hwang. The grandchildren,Alvin Lo and Elaine Lo, are minor children who were present and witnessed the incident and the gruesome death of their grandmother at the scene from a broken neck, head and internal injuries. The crosswalk and intersection in which Mrs. Hwang was killed were in a dangerous condition in that the intersection was uncontrolled (no signs or traffic signals), the crosswalk was difficult (and at times virtually impossible) for drivers to see, traffic speed was too fast for conditions present, and the placement of a public bus stop and/or the crosswalk at this portion of San Pablo Dam Road encouraged pedestrians (especially elderly pedestrians) to cross this busy road at this location. On information and belief, this intersection had been the scene of other accidents and near misses previous to this fatality, a situation which had been discussed at public meetings. These and other conditions at the scene, and the failure of the government entities to better control traffic at the intersection and around this crosswalk, created a dangerous condition of public property, negligence in the maintenance, control, operation and protection of pedestrians and bus patrons at this location, and/or were the result of ministerial acts of public employees, and/or violation of statutes which caused the death of Mrs. Hwang. The entities in charge of this crosswalk and this intersection also failed to warn pedestrians, and particularly elderly pedestrians utilizing the crosswalk to reach the bus stop that at certain times of the day that traffic is heavy, that drivers are blinded by the sun, that the intersection and crosswalk are dangerous as set out in the previous paragraph. This claim is made against the entities responsible for controlling, signaling, maintaining and operating the intersection at San Pablo Dam and Clark Roads and crosswalk at that intersection, as well as those entities responsible for placement of crosswalks and bus stops on this portion of San Pablo Dam Road, as well as those entities responsible for controlling traffic speed and warning pedestrians about drivers and drivers about pedestrians on San Pablo Dam Road, as well as those entities employing persons to do all of the above and keep this'area safe for pedestrian traffic. General description of injury/damage Claimants are making claims for Wrongful death pursuant to CCP§377 et s� Grandchildren Alvin and Elaine Lo are also making claims for emotional distress from witnessing the awful death of their grandmother. [Dillon v. Legg; (1968) 68 Cal.2d 7281. Name of public employee(s) causing injury, if known: Unknown at the present time. Amount of claim (or jurisdictional limits): Jurisdiction over the claims of each claimant rests in Superior Court. Dated: July 23, 1993 Joel tumbiner Rudy &Gumbiner, PC Attorney for Claimants Chung Ying Hwang, Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo, Ching Sheng Hwang,Shio-Min Hwang, Pei Shan Hwang Sun 1 PROOF OF SERVICE 2 , 3 I, the undersigned, declare: 4 I am over the age of eighteen years and not a party to the above- 5 entitled action. My business address is 100 Spear Street, Suite 1850, San 6 Francisco, California, 94105. On this date, I served the foregoing CLAIM 7 FOR WRONGFUL DEATH on all parties by placing a true and correct copy 8 thereof.enclosed in a sealed envelope and causing it to be hand-delivered to 9 the following: 10 County of Contra Costa (Also served: Form Claim Against Clerk of the Board the City of Richmond) 11 651 Pine Street, Room 106 City of Richmond Martinez, California 94553 City Clerk's Office 1z 2600 Barrett Avenue, 3rd Floor 13 Richmond, California 94804 14 AC Transit State of California Claims Department Board of Control 1s 1600 Franklin Street, 6th Floor Government Claims Division Oakland, California 94612 630 "K" Street, 4th Floor 16 Sacramento, California 94814 17 18 19 I declare under penalty of perjury under the laws of the State of 20 California that the foregoing is true and correct. 21 Executed this 26th day of July, 1993. 22 23 effrey Tie ens 24 25 zb Rudy&Gumbiner Prdeum=l Corporetleo JUL 41A CLAIM d ISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim Against the Counoverned by) BOAR_ D ACTION the Board of Supe ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SUN, Pei Shan Hwang c/o Chung Ying Hwang ATTORNEY: Joel Gumbiner, Esq. Rudy and Gumbiner Date received ADDRESS: 100 Spear Street, Ste. 1850 BY DELIVERY TO CLERK ON July 26, 1993 San Francisco, CA 94105 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. DATED: July 27, 1993 IVIL Depuiy OR, Clerk II. FROM: County Counsel TO: Clerk of the Board of visors ( e�) 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: Z BY: C., Deputy County Counsel I1I. FROM: Clerk of the Board TO: County Counsel (1) County Admi 'istrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present W1 This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1993 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. *For additional warning see reverse side of this notice. 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 16; and that today I deposited in the United States Postai Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator • RECEIVED JUL 2 61993 Claim for Wrongful Death IState of California, Contra Costa County, CLERK BOARD OF SUPERVISORS Ci of Richmond Alameda-Contra Costa Transit Distr CONTRA COSTA CO. (Government Code§910, 911-2) Name/Address of Claimants: 1. Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito,CA 94530 2. Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo,4400 Wesley Way, El Sobrante, CA 94803 3. Ching Sheng Hwang, 5028 Santa Rita Road, Richmond, CA 4. Shio-Min Hwang,4400 Wesley Way, El Sobrante, CA 94803 5. Pei Shan Hwang Sun c/o Chung Ying Hwang, 11025 San Pablo Ave., Apt 412, El Cerrito, CA 94530 Address to which Notice to Claimant Should be Sent: Joel Gumbiner Rudy & Gumbiner 100 Spear Street, Suite 1850 San Francisco, CA 94105 Date, place and circumstances of the occurence giving rise to the claim: On January 26, 1993, 68-year old Tuli Tu Hwang was killed when struck in a crosswalk in the uncontrolled intersection of San Pablo Dam and Clark Roads in Contra Costa County (Richmond). Claimants are the husband and surviving children (and grandchildren) of Tuli Tu Hwang. The grandchildren, Alvin Lo and Elaine Lo, are minor children who were present and witnessed the incident and the gruesome death of their grandmother at the scene from a broken neck, head and internal injuries. The crosswalk and intersection in which Mrs. Hwang was killed were in a dangerous condition in that the intersection was uncontrolled (no signs or traffic signals), the crosswalk was difficult (and at times virtually impossible) for drivers to see, traffic speed was too fast for conditions present, and the placement of a public bus stop and/or the crosswalk at this portion of San Pablo Dam Road encouraged pedestrians (especially elderly pedestrians) to cross this busy road at this location. On information and belief, this intersection had been the scene of other accidents and near misses previous to this fatality, a situation which had been discussed at public meetings. These and other conditions at the scene, and the failure of the government entities to better control traffic at the intersection and around this crosswalk, created a dangerous condition of public property, negligence in the maintenance, control, operation and protection of pedestrians and bus patrons at this location, and/or were the result of ministerial acts of public employees, and/or violation of statutes which caused the death of Mrs. Hwang. The entities in charge of this crosswalk and this intersection also failed to warn pedestrians, and particularly elderly pedestrians utilizing the crosswalk to reach the bus stop that at certain times of the day that traffic is heavy, that drivers are blinded by the sun, that the intersection and crosswalk are dangerous as set out in the previous paragraph. This claim is made against the entities responsible for controlling, signaling, maintaining and operating the intersection at San Pablo Dam and Clark Roads and crosswalk at that intersection, as well as those entities responsible for placement of crosswalks and bus stops on this portion of San Pablo Dam Road, as well as those entities responsible for controlling traffic speed and warning pedestrians about drivers and drivers about pedestrians on San k Pablo Dam Road, as well as those entities employing persons to do all of the above and keep this area safe for pedestrian traffic. General description of injury/damage Claimants are making claims for Wrongful death pursuant to CCP§377 et s� Grandchildren Alvin and Elaine Lo are also making claims for emotional distress from witnessing the awful death of their grandmother. [Dillon v. Leg& (1968) 68 Cal.2d 7281. Name of public employee(s) causingiinnjury. if known: Unknown at the present time. Amount of claim (or jurisdictional limits): Jurisdiction over the claims of each claimant rests in Superior Court. Dated: July 23, 1993 Joel tumbiner Rudy &Gumbiner,PC Attorney for Claimants Chung Ying Hwang,Shirley Wong Lo, individually, and as guardian ad litem for Elaine Lo and Alvin Lo,Ching Sheng Hwang,Shio-Min Hwang, Pei Shan Hwang Sun 1 PROOF OF SERVICE 1 3 I, the undersigned, declare: 4 I am over the age of eighteen years and not a party to the above- .5 entitled action. My business address is 100 Spear Street, Suite 1850, San 6 Francisco, California, 94105. On this date, I served the foregoing CLAIM 7 FOR WRONGFUL DEATH on all parties by placing a true and correct copy 8 thereof enclosed in a sealed envelope and causing it to be hand-delivered to 9 the following: 10 County of Contra Costa (Also served: Form Claim Against Clerk of the Board the City of Richmond) 11 651 Pine Street, Room 106 City of Richmond Martinez, California 94553 City Clerk's Office 12 2600 Barrett Avenue, 3rd Floor 13 Richmond, California 94804 14 AC.Transit State of California Claims Department Board of Control 1s 1600 Franklin Street, 6th Floor Government Claims Division Oakland, California 94612 630 "K" Street, 4th Floor 16 Sacramento, California 94814 17 18 19 I declare under penalty of perjury under the laws of the State of 20 California that the foregoing is true and correct. it Executed this 26th day of July, 1993. 22 23 effrey . Tie ens 2 is 2 Rudy&Gumbiner Pfdessmml Corporation ' :tjUflL Ci(DIIf1Sa CLAIM J U L z 0 1993 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 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: $260,000 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JOE FOSTER EXCAVATING, INC. ATTORNEY: Kathleen T. McShane McShane &: Felson Date received ADDRESS: 2175 No. California Blvd. , #900 BY DELIVERY TO CLERK ON July 16, 1993 Walnut. Creek, CA 94596-3500 BY MAIL POSTMARKED: July 15, 1993 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, ppHH Bg DATED: July 19, 1993 BYIL DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Su rvisors ( ✓) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: bpi" /i Y3 BY: /cam Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( �) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. 1;4Dated: AUG 17 1993 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, *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified Copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR Deputy Clerk CC: County Counsel County Administrator Claim -to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp Joe Foster Excavating, Inc. ) ) RECEIVE® Against the County of Contra Costa ) or I JUL 1 619M District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 260,000 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) February 12, 1993 ------------------------------------------------------------------------------------ 2. Where did the damage or injury occur? (Include city and county) ------------------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details; use extra paper if required) County Public Works Department wrongfully rejected a portion of construction performed by claimant, and required removal and replacement, resulting in damages to claimant. ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? See #3. (over) �. What are the names o*unty or district officers, sets or employees causing the damage or injury? J. Michael Walford, Public Works Director ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Total , as presently calculated: $246,261.46 ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Addition of: liquidated damages withheld under contract with County, plus,: cost of removing and replacing paving work, additional lab and testing costs ------and_�S�S114Ds31_DYErbEdil--------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Antioch Building Materials Co. Kleinfelder Engineers Consolidated Laboratories ------------------------------------------------------------------------------------- 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 Kathleen T. McShane Claimant's Signature McSHANE & FELSON 2175 No. California Blvd. , Suite 900 Address Walnut Creek, CA 94596-3500 Telephone No. Telephone No. (510) 943-6111 N O T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. i V., vY'd'f ad ixt (.)77( uj Fir r - if " CC CO U Ne LU ." .r4 ,: -rl O co :3 T-4 44 ° r.o °° r� -H PG U) - p41 LO cd (f Nr ° p -P rn - m4J ° - M a� - GNU 444 4) N ° >4-ri r E i ,h4 4J a -P t r♦ O u7 0 (} U %o I� h 1.9 k-r tr 0 Z 0 m w iO W r m W a 3 n a a J LL o ~ o cr a - O } Q J W o Z ¢U Z 4 ¢O LLO Y w W r � o r a Q U U C J a, County Counsel / CLAIM JUL 2 7 1993 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Martinez, CA 94553 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 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 clam by the 8na.rd of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $250,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: LANCASTER, Donald ATTORNEY: Jeff Cunan, Esq. Taylor & Cunan Date received ADDRESS: 2121 No. California Blvd. BY DELIVERY TO CLERK ON July 23, 1993 Suite 680 Walnut Creek, CA 94596 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. DATED: July 26, 1993 IVIL �ep�LyLOR, Cler I1. FROM: County Counsel TO: Clerk of the Board of Supervisors (�) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �Iw�. Z 7 8Y: �• Deputy County Counsel 11I. 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 ( kf This Claim is rejected in full. ( ) Other: 1 certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1993 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sect on 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. *For additional warnina see reverse side of this notice. 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. AUG 2 0 1993 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator "Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 1069 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 . _.. :sic, Zi . S�dYs% c.ili public en .ty: E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp Donald Lancaster ) '?ECEIVE® Against the County of Contra Costa ) JUL 2 31993 or ) CLERK BOARD District) CONTRA�ps A Cp ISORS Fill in name ) cQ The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 250 , 000 . 00 and in support of this claim represents as ,follows: ------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) Februaryi 19 1993 ------------- -------_�� ------------- 2. Where did the damage or injury occur? (Include city and county) _ _Marsh Creek Detentioa��,��±�,��,nntra Costa 3. How did the damage or injury occur? (Give full details; use extra paper if required) Claimant ' s jaw was severly broken by a length of pipe thrown by a fellow inmate . Though surgery to repair the damaged jaw was scheduled for 2-23-93, jail personnel. refused to transport Claimant until 3-4-93, resulting in disfiguring and agonizing development of the injury. --��------------------- --- ------ -------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Refused to take Claimant to the hospital for necessary surgery and negligent failure to provide a safe environment. (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? ,,. Unknown at this time ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. See attached medical records ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Jury awards for injuries of similar severity ------------------------------------------------------ ------------------------------ 8. Names and addresses of witnesses, doctors and hospitals. See - medical records ------- ---------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT l• q i.r: U9 •)E $ �E �E 9F $ lF 3f * 3F * $ 9F �E �F $ $ 3F dE 9E $ 9E � $ $ $ jE � * * 9F * * $ * $ 9E �F � iE * # Gov. Code Sec. 910.2 provides: t "The claim must be sig d by the claimant SEND NOTICES TO: (Attorney) or some erson on s behalf." Name and Address of Attorney JEFF CUNAN, ESQ. TAYLOR & CUNAN Claimant's Signature 2121 N. California Blvd. I Suite 680 I(A7/ 61,11LWIV 7,11 �3 Walnut Creek, CA 94596 Address Telephone No. (510) 988-9800 ` Telephone No. ( N O T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district •board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable 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. CLAIM INI Al IG X99110 SUPERVISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim Agaist the R Fstrict gtements, verned by) BOARD ACTION the Board ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: LATHAN, James and FLETCHER, James ATTORNEY: Date received ADDRESS: 49 Breaker Drive BY DELIVERY TO CLERK ON August 2, 1993 West Pittsburg, CA 94565 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. JyIL ATCHELOR, Clerk DATED: August 3, 1993 eputy I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( v1 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: !d 3 f 9 3 BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This 'Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:AU D 17 1993 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. *For additional warnino see reverse side of this notice. 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 16; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR Deputy Clerk CC: County Counsel County Administrator OFFICE OF COUNTY COUNSEL DEPUTIES: CONTRA COSTA COUNTY PHILLIP S. ALTHOFF -` SHARON L. ANDERSON COUNTY ADMINISTRATION BUILDING ANDREA W. CASSIDYVICKIE L. DAWES P.O. BOX 69 MARKE S. ESTIS MICHAEL D. FARR VICTOR J. WESTMAN MARTINEZ, CALIFORNIA LILLIAN T. FUJII COUNTY COUNSEL 94553-0116 DENNIS C. GRAVES GREGORY C. HARVEY SILVANO B. MARCHESI TELEPHONE (510) 646-2074 KEVIN T. KERR ARTHUR W. WALENTA, JR. FAX (510) 646-1078 EDWARD V. LANE, JR. ASSISTANTS MARY ANN M. MASON PAUL R. MUNIZ VALERIE J. RANCHE DAVID F. SCHMIDT DIANA J. SILVER August 4, 1993 VICTORIA T. WILLIAMS NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: James Lathan and James Fletcher 49 Breaker Drive West Pittsburg, CA 94565 RE: CLAIM OF: LATHAN and FLETCHER 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. [XX] 3. The claim fails to state the circumstances of the occurrence or transaction which gave rise to the claim asserted. [XX] 4 .The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [XX] 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 J 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 ($10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. [XX] 6 .The claim is not signed by the claimant or by some person on his behalf. VICTOR J. WESTMAN, County Counsel By: d. &, Depu ounty CouoTsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. S§ 1012, 1013a, 2015.5; Evidence Code §$ 641, 664) I declare that my business address is the County Counsel's Office of Contra Costa County, 651 Pine Street, Martinez, California 94553; 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 addressed as shown above, sealed and postage fully prepaid thereon, and thereafter was, deposited this day in the U.S. Mail at Martinez, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: August 4, 1993 at Martinez, California. J cc: Clerk of the Board of Supervisors (original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE SS 910, 910.2, 920.4, 910.8) Page 2 ' R • Clair,: to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th dayafter -the accrual of the cause of action. Claims relating to causes of action for-death or for injury to person or to personal property or growing-crops and which.accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of .the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at. the end of this form. RE: Claim By 0. �1e�C�, Reserved for C erk's filing stamp RECEIVED Against the County of Contra Costa ) AUS - 2 1993or ) District) CLERK BOARD OF SUPERVISORS Fill in name CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) A ------------------------ 2. Where did thA ' ��- damage or injury occur. (Include city and county) UL 3. How did the damage or injury occur? (Give full details; extra paper if required) +,bus WC01 J1^tVn�S 4. What particular act -or omission on the part of county or district officers, servants or employees caused the injury or damage? LA (over) 7. wnat are tne names of county or district officers, servants or employees causing the damage or injury? A ---------------------------------------w------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injurieWor. damages claimed. Attach two estimates or auto damage. N\ ss LPhLS I ht- S EP 9I7 t� s --q- LLELV 7. How was the amount claimed above computg?. (Include the estimated amount of any prospective injury or damage.) ----------------------------- ------------ 8. Names and addresses of witnesses doctors and hospitals. bo&afs,,& Los Me-ao-nos- L ov Rx-ceXqz W. PvA4S�6.1,^e, dA- _�e.nTiS .�J ?_yRiep i 1565 -3blz Rgifir.o1q.0 Ap&t P&A-3.1 a. 9. List the expenditures you made on`'account of this accident or injury: DATE ITEM AMOUNT 4 V* GoV Code See. 910.2 provides; "The claim must be signed by the claimant SEND NOTICES ,TO: (AttorneiV orb some person on his behalf." Name and Address of Attorney (Claimant's Signature) Address Telephone No. Telephone No. ..510 Ji69 -1 6 V 1 9 V I V W 4 T-T NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to .defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000),, or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. ae), County Counsel CLAIM JUL 2 7 1993 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA --. Martinez. CA 94553 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 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: $159.29 Section 913 and 915.4. Please note all •Warnings". CLAIMANT: MAZZTA, Carmen ATTORNEY: Date received ADDRESS: 2244 Reef Court BY DELIVERY TO CLERK ON July 23,199"1 Byron, CA 94514 via Risk Management. BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 26, 1993 JyIL DeputyLOR, Cle I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( WThis claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: '2�' // � BYDeputy County Counsel J 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 &. true and correct copy of the Board's Order entered in its minutes for this date. g Dated: AUG 17 1993 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 notici'i as.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. *For additional warning see reverse side of this notice. 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 aLove. Dated: AUG 2 ® 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COMM INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for-death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year -after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * IF * * * * * RE: Claim By ) Reserved for Clerk's filing stamp � RECEIVED Against the County of Contra Costa ) JUL 2 3 1993 or I I:co v. q , CLERK BOARD OF SUPERVISORS 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 this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) �S�c-L ''1rr1__���''✓((////����,,-C �i� vv (\ Cl-1y^v�(J\\�/,/'�TT\\���\���///////yyyJJJ��.���� ��_a..----------------- 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) u. Wha particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? lover) �. wnat are the naves of cou.::ty or district officers, servants or employees causing the ca.-...age or injury? l t ---------------------_________________----------- —______-_---- 5. What damage or injuries do you claim resulted? (Give full extent of. injuries or damages claimed. Attach two estimates for auto damage. 4ea A- a -o �. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 3. Names and addresses of witnesses, doctors and hospitals. __--------------------------------�..�.__�..,.___.._..__.._�____�..__._.._____�___� 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMDRT 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 Signa`tv Address Telephone No. Telephone Ndti _ NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. ADDENDUM TO THE CLAIM OF (f VA (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 alt- ,rnate, route available? Yes ( �) No ( ) ( 4) Did you read about the impending resurfacing in the local newspaper? Yes ( ) No (�) ( 5) Did you see warning signs advising . of loos gravel and a ��–mi lepe- houraA ise �– gam- - —r-?bw�P� Yes ( X No ( ) A�Su �oa3e �wv e� W a S em o t �re u6C �";t S °`-A k A� 0�. ( 6) Did the damage result from another vehicle e�ceeding the 25 mile per hour advisory? Yes ( ) No N ( 7) Did a vehicle traveling in the same direction and exceeding the 25 mile per hour advisory sign attempt to pass you? Yes ( ) No (�) ( 8) Did a vehicle coming from the opposite direction cause gravel to be thrown onto your car? Yes ( ) No (X) ( 9) Was the vehicle located directly in front of you exceeding the speed advisory? Yes ( ) No ( X) ( 10) Did -you travel the -roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( ) No ( ( 11) Did you obtain the identity of the car relating to questions 6 thru 9? Yes ( ) No �) 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. pp IN 0.S M \�� vj�ne n �e s . C�sn-erg, 1 ( 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. ( Signature,T/1'°' (Da e) __.��—_.• __,—_ __..�._.vC-'-�y.""�.1*J_c_.__1__l�_�"""":_�_ Ci. ..:, 17!I"f"Vl-Ll f' I 1 i._H f',H'-,I t i_1 L I -K`I ` To A2-7 - i A J STREET + 1 MIa CITY ST. 21P Dear CLIstomer: It was necessary for us to SPECIAL, ORDER the Item(s) below for you_ As soon as they a,rive you will be notified. Thank You DATE 1"i -t 80 Phone No. Ordered By `�rJ Paid Invoice a YEAR _ _MAKE JmotSERIAL NUMBER TRIM NUMBER (-C M 11OTY. PART NUMBER DESCRIPTION R C'D ?3 �3 ^M Ao3 Perts Received Date — -- Pack.Slip •• Parts Back Ordered Date Pack.Slip • Customer Notified 1st 2nd Part Returned to Stock Parts 06pt, Special Order Location. • Farm r 107 (-;UU1lty 000sel CLAIM JUL 2 7 1993 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA �y►�rlirie�, CA 94553 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUQpUST 17, 1993 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: $252.10 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MAZZIA, Kent ATTORNEY: Date received ADDRESS: 2244 Reef Court BY DELIVERY TO CLERK ON July 26, 1993 Byron, CA 94514 BY MAIL POSTMARKED: via Risk Management 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 26, 1993 IVIL BAATTCHELOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( �t�} This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is 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�� BY: Deputy County Counsel 67 II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( P1This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1993 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sect 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. ' For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California. postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claimz relating to causes of action for death or for injury. to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day- after .the accrual of the cause of action. Claims relating to causes of action for.death or for injury to person or to personal property or growing-crops and which- accrue on or after January 1, 1988, must be presented not later than six months after the accrual of .the cause of action. Claims relating to any other cause of.action must be presented not later than one year after the accrual of .the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity,' separate claims must be filed against each public entity.. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp �e MA Z-Z RECEIVE® Against the County. of Contra Costa .2- or ) -JUL 1993 District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ ZS 2.1a and in support of this claim represents as follows: -------------- 1. When did the damage or injury occur? (Give exact date and hour) co eAk OfrM �T heic� _ 6U4ve \aA c� °�' ---6-.50Po�1_ 2. Where did the damage or injury occur? (Include city and county) sem-- _nye - -71 3. How did the damage or injury occur? (Give full details; use extra paper if required) E�rxq-�—c)c 60\\J ON\C� _ 4. What particular act or omission on the part of unty or district officers, M servants or employees caused the injury or damage? / yr A (Over) • , �. W nat a.^e the t .+nes of county or district officers, servants or employees causing the darn-ge or inju' ? ----------_________.._________ ____________. ______. ____--------____---____---_----- 5. What damage or injuries do you claim resulted? . (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 0�,1�� 1� Gfic, a 0o��Ci 7. How was the amount claimed above computed? (Include the estimated amoun�of any+ prospective injury or damage.) ------------ $. Names and addresses of witnesses, doctors and hospitals. -___------------------------------- - ---------r..--------____,r__ 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: (Attorne ). or, by some person. on,his. behalf." Name and Address of Attorney"." . . Claimant's Signature Address Telephone No. Telephone No. r T.I C E r - . 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 orldistrict board or officer, authorized •to allow or pay the same if-genuine,. any false or:fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such Imprisonwnt and fine. ADDENDUM TO THE CLAIM OF Kevv C '`AAs- t A (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 (x,) ( 3) Was an alternate route available? Yes (x ) No ( ) ( 4) Did you read about the impending resurfacing in the local newspaper? Yes ( ) No (x) (5) Did you see warning signs advising of loose gravel and a -4 -.m' - . w a.S see",\ Yes ( X) No ( ) ka- no P1v\��inCE'_. off' S+gree Q . ( 6) Did the damage result from another vehicle exceeding the 25 mile per hour advisory? Yes ( ) No (�) (7) Did a vehicle traveling .in the same direction and exceeding the 25 mile per hour advisory sign attempt to pass you? Yes ( ) No (X ( 8) Did a vehicle coming from the opposite direction cause gravel to be thrown onto your car?�/ Yes ( ) No ( ) (9) Was the�:Yehicle located_ directly in front .of you ;exceeding the`' speed advi'sary?` Yes ( ) No ( } ( 10) -Did you travel the roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( ) 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: Lure ►,,.��1 rvrnvh\'vaV\_ ( 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. �vv\ 4 LSootk6ouv\� o11 .&)Cly al _ CAbc,,,tk 5 5o QN\ A- car �r (K rNrlKCIS h mei VJ���5� E D CX QbS NA 0,-\ e urn w\ fie: ����� e o-�- s ep r—oo c.h CA ( 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. ( Signature) -7 � 22-1 8 3 (Date) - Auto �,:�,a .• Glass Corp.i yx� Customer Service Center 1-800-835-2257 VJ....... .'�"'�•!�. ��%.. r_ 1_.li, �='j.l.li{rte . i1 I. :'1. Fol F '. ;i:.�41 {..:1.:ii'..: i!� i•:- �,'`, .., t`�1.:. i i..i...l.�.:'r rr : Y: ._ I „ .,1 jF•.c. M,0 F1 �. M I I A:-.WA-- LA i:!. 4'. CC L l...L ID I. .. 1E EF? l:I.�.1 i.(1rl.)F .f f h1ATE_i� ri:�L.. i:;!..frJ .IfJr'I t... ' ; IF..iI_ ..;1 I,J.I +.dli•`: FIIE I.,):? C C v 35. C 3 rr 2 C C Z 01)1.11 E_ 0I`11..Y. �:�.) � ;i.i i i'!•iY I h'i 1 Fi.'t:s !.)I_. ..1 j r*i;..:i•� ; I...' ,I::t,)i; ' ,I_!l.t ! 0 F TOTAL ESTIMATE 52. 10 _. _I� f. '! :iI1 �1..,� , :: I'z 1... Oi_1.::.,1.I`I!. H!" ..)... { F ._ I cI � ... ...E 1;' ' _.:._ _-7 as F F'•!F-j'.!f.,r_;,}:.l'+ :1.1..,1•.. ....._.. ..... ...... ....._._ .... ....... .. .. ... l. ...r-:.!f•;1..;!..., _...._..._......._...._.._. PIr PP)T.R 1='0G T 431....1::. `v'F: �.i.i`.:, ' tf'•il: . ,. ... .. {'i':!::.�-` I'i::;:� �:'I:: 1:;1.. 1.1'•11.::+i V 41187399509 RA I NESCHUB/SHOP 07/22/93 10.( 8 K.)1 ESTIMATE OF REPAIRS RAINES CHEVROLET CO. c►IEYao:tT 666 El Camino Real • Telephone 736.3496 SUNNYVALE, CALIFORNIA 94087 r SHEET _.. OF SHEETS NAME- /I,f ... 2-74 4-- -- - DATE 7 -'�I ADD RES 5 - - md / Nk `'1 Y-V r PHONE' ZQ �y E7 7� -4 INSURLD 9Y__ --.-•.--__-- ADJUSTEI4—.- fin/,,,', PHONE EELOW IS OUR ESTIMATE To REPAIR YOUR VEHICLE._- _.. YEAR/1001" EAR 1/� MAKE� •�� Q1 V .-- ---. .. �y _MODEL LICENSE NO. —� $ERtAL NO. WIN NO.) MILEAGE 73A/1 VOb-S� PARTS NECESSARY AND ESTI"rATE OF LABOR AEOUIRED P A R T S LABORC.oST 1_..-...._,..___._..._.—__—._...... _ _ ...NUMSFR AN10uNT ESTIMATE -r,Jr ^ ._ -- - -- 9 YSupA+!:k NSVRArvCf A 0 — �AvS CO CArj M NUDER Inc an— 'x ..toi,..t.lr�••.� .. .. -- /I $, on au, an"nr,:x,.,t TOTALS Ian,; w r a; oa rt,v •e 1 WRECKER after the Acrr,ha:beer.n rnrrl SERVICE "`�= ':��:r.•:" SIGNED n# Oct aE-0'la... al... 5.,, , n1x L[irlFJ tlargeSeJ or DroF cn TAX �.�''.,• (,(a//V�7- / parts ere tlfscnrcretl wh.01. ale 6Y not W.1"r,x tnr r:. ..y+rt, . TOTAL MATL. AUTHORIZATION FOR REPAIRS - AND TAX Y mak:are hereby authorized Tr>mAkr. the Sbovu spur:trod repairsJA-- GRAND TOTAL I!J s:3tiko nnrE . . .. .. ,.,..... 11!! FI;�*67$ervUl BIZCLAIM UG 3 199 0 SUPERVISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim Agai .� t g verned by) BOARD ACTION the Board !, I- Endor ements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 and BoardAZTTW. All bection re erences 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: $55.83 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SNYDER, Shellie and Mark ATTORNEY: Date received ADDRESS: 2136 Morello Avenue BY DELIVERY TO CLERK ON July 30, 1993 Pleasant Hill, CA 94523 BY MAIL POSTMARKED: hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH g DATED: August 3, 1993 Bl tl Deputy OR, Clerk 6 / - I1. FROM: County Counsel TO: Clerk of the Board of S visors ( kl')' 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: y 113 BY: Deputy County Counsel 11I. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 1V. BOARD ORDER: By unanimous vote of the Supervisors present (Y) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1993 PHIL BATCHELOR, Clerk, By b Deputy Clerk WARNING (Gov. code sects 13) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 20 1993 BY: PHIL BATCHELOR Deputy Clerk CC: County Counsel County Administrator Claim -to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk'* filin stamp inaQ) Against the County of Contra Costa ) JUL 3 0 1993 or /- u!1' i r �" ` District) CLERK BOARD OF SUPERVISOR ty- (d �.yfa� LTA„ CONTRA COSTA CO. Fill in name) / tfe..ruiG2,.S ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ j� �.aAY and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ----- - �_1� °'3----- ' - ---- __cZ.7ra-m--------------- 2. Where did the damage TOr injury occur? (Include city and county) el IR 41 /11110 FF PL.. la C-0 GD C U vv1 1 � �rnG IlC --------1--�------------ L - -----�---- ------------ - - --y- ---�� �� 3. How did the damage or injury occur? (Give full details; use extra paper if required) Wv-haA �t ���s vJAW(_ on/ A 5-->ye cLd k7ZA /< C.rx _el� ` kC v v�o W/t s sv posed 7 0 ,C-ld f u6 o,.r f.k,e d,,V IA-e- h e 4/}tee- f#v� ii b le -1 fl�/l�� n v (?A 1-e d, L',ke,, e �v�R� fa ld. W*P- W A'P I-r- The Ceot m e, o �ls� lips Fi�e s T-eh o�ce eJ^/7� ��LTL /d'(' cA/i„�/ 01 a A-Lso S1W r e�Igs q M,aLeoq_r77 /- d 4. What particular act or omission on the part of county or district officers, owze,,ep or employees caused the in jury or damage? ms s 480V-e,wAo , .���T' � S/��0 �y w®vLd call Us c^) 02 7/AL-7A.3 w k-w ?7�.� bed;/�me i�cJA rL/ keJ1)A)'C_/ 3� (over) 5. What are the names of county or district officers, servants or employees causing •� I the damage or injury.o L T' ORR ED ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. c.Je W f-4 /T-�-Q-d-T O v Q, d,-- yR . d `d.. VJr45 VAP -7-irk Tf1rt j1 /�l on�� w i�"h o�ji 9.�+�vY�i• oLdq --------------------------------------------------v-- - -------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any 4:1-- prospective injgy or damage.) t,Je ;�* � o .r�_ 13(p .5 k-04✓ 3 O 2 JAS``� ` i�2 �J-d% f'-' �•ewl �G�$- ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. ��i3 �vr-I..r�.y �.r3to �o�E1(a �lve• �vlw-+'�� S/��y1,G:P— vZ l �(o Mo 2•e 1�� /�"� ------------------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT )1a9/?3 �r,�s n E�o� Pavw� ::c> 7,1361 ��3 a� -�/�! qq3 Tb c>0-rro POV V 0 3, 00 7 311 G3 �R rce i:-Op- �- � 3 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 Signa e Address TD" I Telephone No. Telephone No.(5-/d GKO NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district. board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. r f .r.,i rrlty COLI S l CLAIM JUL 19 1993 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 'v1d"I'lez, CA 94553 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 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: $3,712.96 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SPIRIT ROAD OILS ATTORNEY: Leslie E. Beemer, Esq. Sims & Layton Date received July 15, 1993 ADDRESS: 84 W. Santa Clara St. , #660 BY DELIVERY TO CLERK ON San Jose, CA 95113 certitiect BY MAIL POSTMARKED: July 14, 1993 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: July 16, 1993 BppH yIL BITCYELOR, Clerk epuII.. FROM: County Counsel TO: Clerk of the Board of erv' rs (✓) 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: �,�.Ly zo , 1 4 S 3 BY: / ar Deputy County Counsel 11I. 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 (VThis 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: AU G 17 1993 PHIL BATCHELOR, Clerk, 8y , 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. *For additional warnina see reverse side of this notice. 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. AUG 2 0 1Z3 Dated: BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator SIMS & LAYTON ATTORNEYS AT LAW TELEPHONE 84 WEST SANTA CI— R e.,SUITE 880 FACSIMILE (408)998-3400 SAN JOSE,CALIFORNIA 95113 (408)297-1104 July 14 , 1993 " RECEI V�� � JUL 1 51993 CERTIFIED MAIL/RETURN RECEIPT REQUESTED Clerk of the Board CLERK BOARD OF SUPGRVIS 'r-1c y Contra Costa County CONTRA COSTFi Cf . 651 Pine, 1st Floor '` Martinez , CA 94553 Re: Spirit Road Oils Dear Sir or Madam, Enclosed please find a Notice of Claim which I am filing with your offices on behalf of my above referenced client. Kindly keep me informed of all actions taken on this claim. Thank you for your courtesy and cooperation in this matter. Verytruly yours, 66LI�EE. =EEMER LEB/amw J134 R14 cc: Janet Simas 1 Phillip M. Sims, Esq. Leslie E. Beemer, Esq. 2 SIMS & LAYTON 84 W. Santa Clara St. , n 660 RECEIVED San Jose, CA 95113 (408) 998-3400 4 JUL 15193 Attorneys for Claimant 5 SPIRIT ROAD OILS CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. 6 7 SPIRIT ROAD OILS , ) 8 Claimant, ) CLAIM AGAINST CONTRA V. ) COSTA COUNTY, DEPT. OF 9 ) PUBLIC WORKS CONTRA COSTA COUNTY, ) 10 ) Respondent. ) 11 ) 12 13 TO: Contra Costa County, Department of Public Works 14 15 Spirit Road Oils hereby makes claim against Contra 16 Costa County, Department of Public Works for the sum of $3 , 712 . 96 17 and makes the following statements in support of the claim: 18 1 . Claimant ' s post office address is as follows: 19 Spirit Road Oils GtJUG S . 10t11 Street 20 San Jose, CA 95112 21 2 . Notices concerning the claim should be sent to: 22 Leslie E. Beemer, Esq. SIMS & LAYTON 23 84 W. Santa Clara St. , 1#660 San Jose, CA 95113 24 3 . The date and place of the transaction giving rise 25 to this claim are the 1.992 contract between Contra 26 Costa County Department of Public Works and Joe 27 Foster Excavating for grading and surfacing of 28 1 1 Highway 4 and Live Oak in Oakley. 2 4 . The circumstances giving rise to this claim are as 3 follows: Joe Foster Excavating orally 4 subcontracted part of the grading and surfacing 5 contract to Spirit Road Oils. Officers and 6 employees of Joe Foster represented to officers 7 and employees of Spirit Road Oils that a payment 8 bond had been obtained for the project as required 9 by state law. The true facts were that a payment 10 bond had not been obtained by Joe Foster and that 11 no Contra Costa County representative, agent or 12 employee had ensured that Joe Foster Excavating 13 had indeed obtained such a valid payment bond. By 14 failing to make such an investigation, the County 15 did not comply with the requirements of the Public 16 Contract law of the State of California. A valid 17 payment bond had not been obtained by Joe Foster 18 Excavating. Joe Foster failed to pay Spirit Road 19 Oils for the labor and materials as provided under 20 the oral subcontract. As no valid payment bond 21 exists, Spirit Road Oils has been damaged in the 22 principal sum of $3 , 712 . 96 . 23 5. Claimant ' s damages as set forth above are 24 $3 , 712 . 96 in principal , interest at the legal rate 25 from March 9 , 1993 attorneys fees and other 26 related costs. 27 6 . The names of the public employees causing the 28 claimant injuries are unknown. 2 1 7 . The claim, as of the date of this claim, is in an 2 amount that would place it within the jurisdiction 3 of the municipal court. The claim is based on 4 damages in a total amount to be proved later. 5 6 Dated: 1 ESE. BEEMER, Attorneys 7 for Claimant Spirit Road Oils 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 1 PROOF OF SERVICE BY MAIL 2 3 I, the undersigned, declare: 4 5 That I am a citizen of the United States, over the age of eighteen years, a resident of Santa Clara County, California, 6 and not a party to the within action or cause; that my business address is 84 W. Santa Clara Street, Suite 660, San Jose, 7 California; that I served a copy of the attached: 8 Claim Against Contra Costa County, Dept. of Public Works 9 10 by placing said copy in an envelope addressed to: 11 Clerk of the Board 12 Contra Costa County 651 Pine, 1st Floor 13 Martinez , CA 94553 14 which envelope was then sealed and, with -postage fully prepaid 15 thereon, was on July 14 , 1993 deposited in 1-he United States mail at San Jose, California ; that there is delivery service by United 16 States mail at the place so addressed. 17 I declare under penalty of perjury that -he foregoing is true and correct. 18 Executed on July 14 , 1993 at San Jose, California. 19 20 ; 21 ANGELA M. WILSON 22 23 24 25 26 27 28 1 \try ��./r✓;�-�•� ��` } 1014 A N � -A cid +v U � s C o co r' r r- a co o co LU 3r �� m Ll LO r J � uj d T11 of i Uutinty Counsel • CLAIM JUL 2 7 1953 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARd'WfJUVZ, GA 94553 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 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 yc_r :Ia4- `; ` - Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $150,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: TAYLOR, David ATTORNEY: Jeff Cunan, Esq. 2121 No. California Blvd. Date received ADDRESS: Suite 680 BY DELIVERY TO CLERK ON July 23, 1993 Walnut Creek, CA 94596 BY MAIL POSTMARKED: hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. BATCHELOR, DATED: July 26, 1993 ��ll Cler II. FROM: County Counsel TO: Clerk of the Board of S sors ( v1 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: 7-71 / 9 7 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 OR ER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AUG 17 1993 PHIL BATCHELOR, Clerk, By . Deputy Clerk WARNING (Gov. code sec 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 O 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator M \1 "glairD•to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp David Taylor ) � NED Against the County of Contra Costa ) ' or ) AL 2 31993 District) c Fill in name) WAD OF SUPER' .U* RA COSTA CO. The undersigned claimant hereby makes claim against he County of Contra Costa or the above-named District in the sum of $ 1.50 . 000 . 00 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) February 27 , 1993 _ approximately 11 : 30 p.m. to February 28 , 1993 2. Where did the damage or injury occur? (Include city and county) Martinez County Jail_ 3. How did the damage or injury occur? (Give full details; use extra paper if required) Claimant fell in his jail cell resulting in severe head injuries and paralysis due to his not being discovered or treated for over six hours . 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Negligence (over) 5. What are the names of county or district officers, servants or employees causing ,,'., the damage or injury? --unlilawn-;3 t_t b i S ------—------!"-------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Extensive personal injury, pain and suffering. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) — Jury awards for similar- cases - -------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Robert Smith: Martinez County Jail Albert Johnson : Martinez County Jail Dr. McDonald: Merrithew Hospital ---------------------------------------------------------------------------- -- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Code Sec. 910.2 provides: "Gov.The claim must be signed by the claimant SEND NOTICES TO: ,,(Attorney) orb some person on his behalf." Name and Address ,,of Attorney'-., JEFF CUNAN, ESQ. 2121 N. California Boulevard (Claimant's qignature) Suite 680 Walnut Creek, CA 94596 (Address) Telephone No. (510) 988-9800 Telephone No. 9 IT V NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board. or officer, or to any county, city or district -board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. t A CZ CLAIM JUL 2 0 119. BOARC OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA CA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 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: $121.60 Section 913 and 915.4. Please note all 'Warnings". CLAIMANT: WILSON, R6sina T. ATTORNEY: Date received ADDRESS: 81 Norwood Avenue BY DELIVERY TO CLERK ON July 16, 1993 Kensington, CA 94707 BY MAIL POSTMARKED: (via Risk mqn;-�mPnt-) I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ee Bg DATED: July 19, 1993 BIL DepuLylOR, Clerk Il. FROM: County Counsel TO: Clerk of the Board of Su ors ( 1/f This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.6). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: _c Dated: ` `" �9 0 93 BY: Deputy County Counsel 111. FRDM: 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: AUG 17 1993 PHIL BATCHELOR, Clerk, By . Deputy Clerk WARNING (Gov. code sect on 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. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that I am now. and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant. addressed to the Claimant GZ2 Ov 19above. Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Clain: to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to Person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day. after the accrual of the cause of action. Claims relating to causes of action' for .death or for injury to person or to personal property or growing crops and which accrue on or after January lo 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of -the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District,should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE: Claim By Reserved. for Clerk's filing stamp U1 /L PX /04- 77'd AA� U) I :D RECEIVE Against the County of Contra Costa—) JUL 1 6 1993 or District) CLERK BOAONTRA CRD OFOSTA CO.SUPERVI ORS C (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 this claim represents as follows: —---------- 1. When did the damage or in.jury occur? (Give exact date and hour) L__L4.&LP ------------------------------------- 2. Where did the damage or injury occur? (Include city and county) VP_(UWA,q1 9'1 3. How did the damage or injury occur? (Give full details; use extra paper if required) NaRW .00 ojw,'61 M y ce A- "R5 R4*.K CO M Y 10 pt I V V,L.Jq Y Fj4elAl& 41r 06ttj( W C44 40,4.).r A.,1VAn4-,SoJ7H - k/,qs_gW W tfLu 0#0 0 1 0 Oft Arc-(6 to,46 17-- U. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 174-C &AP W0,44166A1 wt*F Q1VAt-'A_fl-6 )70+7" j*,o C - t,)A-J CO-M ,0 A-C_CtL=.,Vr- 1�tV— Aca 0 ez�J7 - 17 (over) 7. Wnat are the names of county or district officers, servants or employees causing the damage or injury? 1 Oa,v� j3�L��✓c f�-r�1C o,.�� ��QSo,� !S 7a ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. PASSU6EP-s' .SePC wlNDaW o F 4;o� C,:5mQGE relyJ'6W-7T CA O_ ---------------------------------------_--___ ----------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) - ------------ -- --- -------------- -- -- ------ -=------------- ----- ---- $. Names and addresses of witnesses, doctors and hospitals. R-�Y f AW1 -.US Avie. P�.s W.4,( D WA)'�- StF� /7- OAP,46�a, 450r kfF� W,C- P TiE- "OSS _w----------------------------- _____ w -------------___-_________-__ 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: . (Attorne ) , or by some person on his behalf." Name and Address-of Attorney `, T . (Claimant's Signature (Address) . . Telephone No. Telephone No.5l0I.)- ' «C� NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any .state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisorLment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. L': �', Ii ;, Y, _5 :(: .' :r. r' :.ti t" �. VV l ori::.:`. :-. : . -�Ros a �I:` F 1 (';: 1.1. ri: lt' bite ��C o su ant Wr r: ,'V '; ' '...I. .' ' t: ., . . �. ... ..' .. — - - . 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Yes ( } No ( ) ( 2) Were you aware that construction would be commencing on the roadway? Yes '( } No ( ) ( 3) Was an alternate route available? Yes ( ) No ( ) (4) Did you read about- the impending resurfacing in the local ' newspaper? Yes ( ) No ( ) ( 5) Did you see warning signs advising of loose gravel and a 25 mile per- hour advisory sign? - Yes ( 6) Did the damage result from another vehicle exceeding the 25 mile per hour advisory? �Yes (. } No ( ) (7) Did a vehicle traveling in the same direction and exceeding the 25 mile per hour advisory sign attempt to pass you? Yes ( ) No ( ) ( 8) Did a vehicle coming from the opposite direction cause gravel..to be thrown-onto your car? Yes ( ) No ( ) ( 9) Was the vehicle located directly in front. of you exceeding the speed advisory? Yes ( ) No ( ) (10).--..Did yau:°•travell the-roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( ) No . ( ) ( 11) Did you obtain the identity. of' the car relating to questions 6 thru 9? Yes ( ) No ( } 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. ( 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. (Signature) (Date) 07 s CIOAP a, Cl. sm � ¢ A AUTO' INVOICE Alarm • Stereo 15185 Glass • Upholstery Resldentlal • Commercial • Industrial T-Tops -- Sunroofs Cellular Phone <. WHOLE &RETAIL • MOBILE SERVICE • INSURANCE CLAIM • REPAIR AND INSTALLATION Guaranteed Worlananship 3906 Adeline Stree 3800 San Pablo Ave. 450 8th Street 2711 EI Camino Real Vallejo dr Benicia Fremont 8r Hayward Emeryville,CA 94608 Emeryville,CA 94608 San Francisco,CA 94103 :Redwood City,CA 94081 California California. 510-654-0761 510-428-3950 415-626-4474 415-366-0999 707-642-2200 510-481-8300 ...<.F: ................. ... ...:::.. ...:::.::. :::::::::::.:: :::::.. .:: :::::::..:::::.::::::.::::::::.:::.:::::::::::::.:.:::::::::.::..............:..::.:.:::.:,:::.::. ESTIMATE :.::::::::::::::::::::::::.::.:::...:::::.:: :.r:.: .:: . ::.:. :: . : . :..: ....:....................................... ::. . ..: :::.:.::::: : : . $3AEE7.AOnA $S...:.:.:::::........... ..........:.:..:.::::::::::.::::::::::::.: ::...:::.:. ................. .:.;:.;;;; :::::::::.::,::::::E.. .:.::::::.:::::::.:,.:::. :.:.:::::::::::. : �r ................ .... .. .... ::::::::: : ...; �y f..:::::::: :. ..� x �':...::. ..::: ::::.:: . : . ..:: ::...:............. ... ... ...... ........................... +Tax YEAR.:.::.:. ...:::.:::..:::.. .....:........ MAKE:: M.ODEL........................,:.:::::::::::::. ::. ..: ::> ::. ::.. .......;..:..: ........... ;:. :::: : ..... ..::::::.:::::::::::::......:.:::,:::....:::.:::::..:.:........:.,..................................................:.:..::::: . .:..:::. :::::::.:..;,.:,::;;::::::::.:.::..:.:.::::.::::::.::.:...:::.::........ , '' ... ........................... .. ....... .. HOW DID YOU HEAR ABOUT US ? f. 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D E S C R I P T 10 N LABOR MATERIAL C' V M.A.Z.CENTER Is authorized to perform the above work TOTAL With terms and conditions on reverse side. MATERIAL S L T j SALES TAX SIGNATURE DATE LABOR 1 I hereby authorize and empovnr the above-named Insurance company to pay this invoice in fullsetusmsrd satldaction and dseharge of all TOTAL D U E loss under the above policy. Upon such payment,all rights I may have for Wim and demand for los and damage described above against the above named insurance company staff be thereby forever discharged. In the event that the above famed imurance company does not make timely and/or toil payment of this invoice according to its terms.I hereby accept responsibility for such payment and agree to pay all. INSURANCE charges reflected an this invoice to the above named glace company subject to and according to all terms and eon6ttone on this invoice.. DEDUCTIBLE NONREFUNDABLE DEPOSIT County Counsel CLAIM JUL 19 1993 A2 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MaruneZ, CA 94553 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT AUGUST 17, 1993 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Undetermined Section 913 and 915.4. Please note all "Warnings". CLAIMANT: WOLTZ, Grant � �Ivd �y e� ATTORNEY: � f` ���= Date received . ADDRESS: P.O. Box804 ( BY DELIVERY TO CLERK ON July 16, 1993 Martnez, CA 94553 BY MAIL POSTMARKED: hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. p gg DATED: July 16, 1993 e�Il DepuLyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( Poo') 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: � 20 9 9 3 BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (✓) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: AU G 17 1993 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. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: AUG 2 0 1993 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator �I RECEIVED I GRANT WOLTZ JUL 1 6 M P.O. BOX 804 2 MARTINEZ, CALIFORNIA CLERK BOARD OF SUPERVISORS 3 (510) 427-1771 CONTRA COSTA CO. 4 5 Claimant. 6 In the Matter of the 7 Claim of GRANT WOLTZ 8 Claimant, CLAIEK FOR 9 DAMAGES 10 vs. 11 DR. WALTER CARR; CONTRA COSTA COUNTY JAIL; MARSH CREEK 12 DETENTION FACILITY; AND DOES I 13 through 10, inclusive, 14 Respondents. 15 1, 16 GRANT WOLTZ, hereby presents this claim to the DR. 17 WALTER CARR, CONTRA COSTA COUNTY JAIL, MARSH CREEK DETENTION 18 FACILITY, and DOES I through 10, inclusive, pursuant to 19 Goverrment Code S 910, et seq. 20 11. 21 The name and address of Claimant are as follows: 22 GRANT WOLTZ 1450 Pacheco Blvd. 23 Martinez, CA 94553 24 111. 25 At all times herein mentioned, the DR. WALTER CARR, 26 CONTRA COSTA COUNTY JAIL, and MARSH CREEK DETENTION FACILITY, 27 were public entities and at all times herein mentioned 28 defendants CARR and DOES I through 10, were employees and/or -1- 1 agents of the above-named public entity and were acting in 2 the course and scope of their employment and or agency. 3 IV. 4 On or about January 24, 1993, at the Marsh Creek Deten- 5 tion Facility, Claimant, an inmate broke his right leg 6 playing volleyball at the facility. Claimant was caused to 7 be injured further and his medical condition aggravated by 8 the defendants' failure to provide medical care to claimant 9 despite actual knowledge of his injuries. 10 Vi. 11 Amongst other acts and omissions, defendants and each of 12 them, failed to provide reasonable medical care to claimant, 13 treated claimant's medical condition with such deliberate 14 indifference as to constitute infliction of cruel and unusual 15 punishment on claimant, thereby violating his State and 16 Federal Civil rights; violating the Eight Amendment of the 17 United States Constitution, and violating California Govern- 18 ment Code §845.6. 19 At all times herein mentioned the defendants negligently 20 failed to provide proper and reasonable medical care to 21 Claimant GRANT WOLTZ. 22 V. 23 As a result of the aforementioned acts and omissions of 24 defendants, and each of them, Claimant has suffered great 25 emotional damage, physical damage, loss of earnings, medical 26 bills, general damages, and special damages. The amount of 27 these damages has not yet been ascertained, due to the ex- 28 -2- 1 treme severity of Claimant's injuries. 2 VI. 3 Claimant is unaware at this time of the true and correct 4 name of the male nurse who participated in the aforementioned 5 acts and omissions, and prays leave to amend this claim when 6 such true name is ascertained. 7 VII. 8 Therefore, Claimant, GRANT WOLTZ, seeks relief for the 9 damages he has sustained as a result of the aforementioned 10 acts and omissions of defendants, and each of them. 11 Dated: July 16, 1993 12 13 GRANT WOLTZ 14 Claimant 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -3- 1 2 PROOF OF SERVICE 3 I reside in the County of Contra Costa, California. I am 4 over the age of eighteen (18) years. My residence address is 5 1450 Pacheco Blvd. , Martinez, CA 94553 . 6 On the date shown below, a copy of the attached docu- 7 ment(s) : 8 CLAIM FOR DAMAGES 9 was served on the interested parties in this action as fol- 10 lows: 11 SEE ATTACHED LIST 12 [X] (BY PERSONAL SERVICE) By causing each such envelope to be delivered by hand, as addressed, with instructions that it 13 be personally served. 14 [ ] (BY MAIL) By placing said envelope, with postage thereon fully prepaid for first-class mail, for collection and mailing 15 at my place of business following ordinary business practice. I am readily familiar with the ordinary business practice for 16 collection and processing of mail. In the ordinary course of business, mail is deposited with the United States Postal 17 Service on the same day as it is placed for collection. i8 [ ] (BY FACSIMILE) By causing said documents to be trans- mittedby facsimile machine to the number indicated after 19 each address listed. 20 I declare under penalty of perjury under the laws of the 21 United States that the foregoing is true and correct. 22 Executed July 16, 1993 , at Martinez, California. 23 24 25 GRANT WOLTZ 26 27 28 THE BOARD OF SUPERVISORS County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 ZuY'' ' n1 O "a �✓t W r� a� O co 5- o cs 0 f C Lin CD N N N aO N � G t0 00 JUL [1APPLICATION TO FILE LATE CLAIM VISORS OF .CONTRA COSTA COUNTY CALIFORNIA BOARD ACTION Appliction a Cl ) NOTICE TO APPLICANT AUGUST 17, 1993 Again , nvuttng ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Section 911.8 and 915.4. Please note the "WARNING" below. Claimant: ORTEGA, Jesus Franco Attorney: Larry E. Cook, Esq. Casper, Meadows & Schwartz Address: One Corporate Centre 1320 Willow Pass Road, Suite 500 Concord, CA 94520 By delivery to Clerk on July 27, 1993 Amount: Undetermined By mail, postmarked on hand delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: July 27, 1993 PHIL BATCHELOR, Clerk, By Deputy II. FROM: County Counsel : Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). ( ✓ The Board should deny this Application to File Late Claii(Section 9 1.6). _ DATED: f!3 VICTOR WESTMAN, County Counsel, WDeputy ` I - III. BOARD ORDER By unanimous vote of Supervisors pre en (Check one only) ( ) This Application is granted (Section 911.6). ( ✓f This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATE: /7 99 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code $911.8) If you wish to file a oourt action on this matter, you must first petition the appropriate court for-an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of any attorney of your choice in oonnection with this matter. If you want to consult an attorney, u should do so immediately. _ IV. FROM: Clerk of the Board T0: 1 County Counsel 2 County Administrator Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof' has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: AUG 2 0 1993 PHIL BATCHELOR, Clerk, By Deputy V. FROM: 1 County Counsel 2 County Admi for TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM RECEIVED JUL 2 71993 1 LARRY E. COOK /; 3 s a M CASPER, MEADOWS & SCHWARTZ CLERK BOARD OF SUPERVISORS 2 A Professional Corporation CONTRA COSTA CO._ One Corporate Centre V 3 1320 Willow Pass Road, Suite 500 Concord, California 94520 4 Telephone: (510) 827-0556 5 Attorneys for Claimant, JESUS FRANCO ORTEGA 6 7 8 9 10 JESUS FRANCO ORTEGA, APPLICATION FOR LEAVE TO PRESENT LATE CLAIM ON 11 Claimant, BEHALF OF CLAIMANT (GOVERNMENT CODE S 911.4 . ) 12 VS . 13 SANITARY DISTRICT NO. 3, 14 Respondent. 15 16 To: Sanitary District No. 3: 17 1. Application is hereby made, pursuant to Government 18 Code Section 911.4 for leave to present a late claim founded on 19 a cause of action for personal injuries which accrued from 20 January 10, 1993, for which a claim was not presented within 21 the six month period provided by Government Code Section 911.2 . 22 For additional circumstances relating to the cause of action, �3 reference is made to the proposed claim attached to this 24 application. 25 2 . The reason that no claim was presented during the 26 period of time provided by Section 911.2 of the Government Code 27 is that the claimant, Jesus Franco Ortega, was, until May 1993, 28 hospitalized and otherwise incapacitated from gunshot wounds CASPER,MEADOWS &SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE — 1 — 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)827.0556 I sustained in the incident. of January 10, 1993, which gives rise 2 to the cause of actions set out in the proposed claim attached 3 to this application. Claimant is a paraplegic as a result of 4 injuries sustained in the incident giving rise to the cause of 5 action. From the time of his release from the hospital on 6 May 19, 19:93, to the present day, claimant has been confined 7 to bed and requires 24 hour a day care. Claimant is unable to 8 care for himself. He relies on family members, and health care 9 professionals to attend to his physical needs as well as his 10 personal affairs. This claim is presented well within one year 11 of the incident giving rise to the cause of action and the 12 Contra Costa County Sanitary District has not been prejudiced 13 by this late claim application. 14 3 . This application is being presented within a 15 reasonable time after the accrual of this cause of action, and 16 less than one year subsequent to the incident. 17 18 19 20 21 22 23 24 25 26 27 28 CASPER,MEADOWS &SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE _ 2 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)827-0556 I WHEREFORE, it is respectfully requested that this 2 application be granted and that the attached proposed claim be 3 received and acted on in accordance with Sections 912 .4-913 of 4 the Government Code. 5 DATED July 27, 1993 CASPER, MEAD S & SCHWARTZ 6 A Profes Corporation 7 8 BY: IVARRY E. COOK 9 Atto eys for Claimant 10 11 The address to which notices relating to this application are to be sent is: 12 13 Larry E. Cook Casper, Meadows & Schwartz 14 A Professional Corporation 1320 Willow Pass Road, Suite 500 15 Concord, CA 94520 16 17 18 19 20 21 22 23 24 25 26 27 28 CASPER,MEADOWS &SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE — 3 — 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)827-0556 .� . • • RECEIVE® JUL 2 7 1993 1 LARRY E. COOK /:a 5 M . CASPER, MEADOWS & SCHWARTZ CLERK BOARD OF SUPERVISORS 2 A Professional Corporation CONTRA COSTA CO. One Corporate Centre 3 1320 Willow Pass Road, Suite 500 Concord, California 94520 4 Telephone: (510) . 827-0556 5 Attorneys for Claimant, JESUS FRANCO ORTEGA 6 7 8 9 10 JESUS FRANCO ORTEGA, CLAIM FOR PERSONAL INJURIES 11 (Government .Code §910 . ) Claimant, 12 VS . 13 SANITARY DISTRICT NO. 3, 14 Respondent. 15 / 16 TO: Sanitary District No. 3: 17 YOU ARE HEREBY NOTIFIED that Jesus Franco Ortega, whose 18 address is c/o 1320 Willow Pass Road, Suite 500, Concord, 19 California 94520, claims damages from Sanitary District No. 3 20 in an amount within the jurisdiction of the Superior Court. 21 This claim is based on personal injuries sustained by 22 claimant on January 10, 1993, at the Montero Bay Center, San 23 Pablo. On or about January 10, 1993, claimant, Jesus Franco 24 Ortega, was chaperoning a birthday party at the Montero Bay 25 Center. During the course of the party, uninvited individuals 26 entered the center and would not leave. When asked to leave, 27 the uninvited individuals left the Center briefly and returned 28 with a gun. During this period of time, members of the CASPER,MEADOWS &SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)627-0556 I birthday party attempted to use the pay phone which was located 2 at the Center and were unable to do so because the telephone 3 was not operating properly. The uninvited individuals returned 4 to the Center and fired a gun at the guests . Claimant Jesus 5 Franco Ortega sustained gunshot wounds and now is a paraplegic 6 and confined to bed as a result of the injuries sustained in 7 the incident. 8 Claimant sustained the above-mentioned injuries because 9 the Sanitary District No. 3 was negligent in maintaining the 10 property on which the Montero Bay Center is located and the 11 Center itself. Specifically, they negligently failed to 12 provide any type of security for the Center, or means for 13 securing emergency help. 14 The injuries sustained by claimant, as far as known, as 15 of date of presentation of this claim, consist of paraplegia. 16 The ;amount claimed as of the date of presentation of 17 this claim is computed as follows: 18 A. . General damages and potential future medical 19 expenses that fall within the jurisdiction of the Superior 20 Court. 21 22 �3 24 25 26 27 28 CASPER,MEADOWS &SCH WART L A Professional Corporation ONE CORPORATE CENTRE — 2 — 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)627-0556 a 1 Jurisdiction over the claim would rest in the Superior 2 Court of Contra Costa County, California. 3 DATED July 27, 1993 CASPER, MEAD SCHWARTZ } A Profess 'o al C rporation 5 6 BY: TIARY COOK 7 Attorn for Claimant 8 All notices or other communications with regard to this claim 9 should be sent to the claimant at the following address: 10 Larry E. Cook 11 Casper, Meadows & Schwartz 1320 Willow Pass Road, Suite 500 12 Concord, California 94520 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 8 CASPER,MEADOWS &SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE _ 3 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)827-0556