HomeMy WebLinkAboutMINUTES - 09271994 - 1.16 CLAIM (p
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
September 27, 1994
Claim Against the County, or District governed by) . BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
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 Gower
Amounts $1695.94 Section 913 and 915.4. Please note all rn�g�s � .
CLAIMANT: Brassfield, Sarah Joy SEP
ATTORNEY: 0UNTY COUNSEL
MARTINEZ CALIF.
Date received
ADDRESS: 11440 Marsh Creek Rd. BY DELIVERY TO CLERK ON September 2. 1994
Clayton, CA 94517
BY MAIL POSTMARKED: August 26. 1994
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim. p ��
DATED: i�IL DepuLyLOR, Clerk
11. IFROM: 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 I
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: rc.)_� P.w _ Cc, l Ct L/ BYDeputy 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).
1V. BOARD ORDER: By unanimous vote of the Supervisors present
(,4 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: ,oT D., IL BATCHELOR, Clerk, By _ �Q a`OlJ..., . 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 Rail 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
3 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 1n 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: j U /941 BY: PHIL BATCHELOR by �1 ��., Deputy Clerk
CC: County counsel County Administrator
Cla to. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for deaJth 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
C- "o 0) 1`-1 Mr,
Against the County of Contra Costa )
or ) o _28N
District) CLERK BOARD OF SUNJORS
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 $ j(Qq S ,Q and in support of
this claim represents as follows: 0� ' Via, l
1. When did the damage or injury occur? (Give exact date and hour)
7 15,51v , (0a, /0.'00
2. Where did the damage or injury occur? (Include city and county)
3. How did the damage or injury occur? (Give full details; use extra paper if
required) - C e 4d b"Ia" C', i'a c(G.
O,i, 4 - evn ��^Q Q n Q� hid aur-�u NJe�I /
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage? C�U
�..ee�a_.� Gt.�z.� .�Le-cam �'.th�� •�Z�-2�� ee..�B-�" �j' �u�t�a�
� C � ,�,,� �(,t,�> e'er -� `' ✓ oma,
✓�� vd
D. wnat are the names of county or district officers, servants or employees causing
the da.-.-ge or iri jL:ry?
__----__.�--------- ------------------------
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.0 /14✓�
)e ly�� .,
7. How was the amount claimed above computed? (Include the estl.mated amount of any
prospective injury or damage.)
8. NameAnd addresses of witnesses, doctors and hospitals.
-
-------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNTWs -
Gov. Code Sec. 910:2 provides:
�_' "The claim must be signed by the claimant
SEND NOTICES T0: (Ator0e` orb some person on his behalf."-_
Name and Address of Attorney .
(Clairrfants Signatur
(Address)
Telephone No. Telephone No. 4-ID- 7Z
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 S(� �a h J O / ( `���
(Print yodr full name)
(1) Do you use the roadway as part of a daily commute?
1� \ C-0
C-0 Cl n >.0 <2r Yes ( No ( )
( 2) Were you aware that construction would be commencing on
the roadway?
Yes (X) 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?
Cvv�i adlvi �, 25 rnph ��, o h wF c ., Yes ( No ( )
(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?
-,6�& Yes ( ) No NA
(8) Did a vehicle coming from the opposite direction cause
gravel to be thrown onto your car?
Yes ( ) No (I)
( 9) Was the vehicle located directly' in front of you exceeding
the speed advisory?
�2 Yes ( ) No ( )
( 10) Did you travel the roadway more than once during the
resurfacing prior to the damage sustained to your car?
Ilk &01ydocJ LA-ICcS On
cr,e f''`� `-te, (,..e v Oak ---I� Yes ( No ( )
LOOS y ry�-b61 o O-e-v -• C%-Oa -1 0' '5( 11) Di you obtain the identity of the car relating to
questions 6 thru 9?
Yes W) No ( )
If yes, please provide identification below:
?) tom � C )
( 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.
W cOL d, 1n e,�G ►int �o�-�,nn 'i7o�'�tc�
C)YN
y�-�-'� tae��-, ��'y � G�Cu.�►S �r2.(��o� �, cc.;l..-e.-�.
( 13) Were you aware that using the road during the chip seal
process might result in damage to your car?
0.m C-\-JoL 2-.j ' Yes ( ) No ( )
\ � iS � I declare that the above information is true and correct
under the penalty of perjury.
( si nature)
(Date)
Gz- ' 0b)
EVNEOR
NI SSA N-vS
1290 CONCORD AVE
CONCORD, CA 94520
(510) 676-4400
)ATE ENT 19ED YOUR ORDER NO. DATE SHIPPED INVOICE DATE INVOICE
10 A'eG 94
110 AUG 94 NUMBER 1486
**QUOTE**
ACCOUNT NO . 86 PAGE 1 OF 1
O H/ n ��
L GASH RETAIL P ����%SRN E
T T
O 0
SHIP VIA SLSM. B/L NO. TERMS F.O.S.POINT
8 CASH CONCORD, CA
QUANTITY - '
0801_ . .,SHIe,:_ ._.eo:,.,•. ,.PART NUMBER 'DESCRIPTION LIST NET AMOUNT_
1 1 0 72712-41F20 01_ASS FR-ON 826 .5 826 .5 826.50
****** I N V O I C E 0 U 0 TE *******
**CONCORD NISSAN'S FARTS DEPARTMENT**
-
IS OPEN ON SATURDAYS FROM 9AM TO 3PM ! PARTS 8 Vb •� .'
-OUR MON-FRI HOURS ARE 8AM TO 5 2 30F'M-- SUBLET
00 WITH A WINNING COMBINATION* FREIGHT 0 .00;
**GENUINE FARTS AT CONCORD NISSAN** SALES TAX
CUSTOMER'S SIGNATURE IJ
XV
NOTICE:All prices are subject to change without notice.20%handling charge on all returned merchandise.Parts not returnable
after 30 days. No refunds on carburetor parts or smog parts. No refunds on electrical parts. No refunds on special order parts.
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FAINT MATERIALS 0; k!0
TOTALS 4 1826. 10 1 001 oicl 1 0 1 c" o 1 0 0
Fed.ID#68-0133657
Unibody&Frame Paint&Body EST111ATE
Specialists Work
SUMCCT
PARTS T. 8-26. 50
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PAINT/MISC . 11710
SUBLET . 00
M&T AUTOBODY&PMTVr, INC. BODY LABOR 9� 0 0 w s 53.00
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(510) 685-2294 STORAGE .DETAIL • 00
FAX(510) 685-7T295 TAXX
69
TOTAL
OTAL EST.
2291 Via deMercados Mark Cusack DED
UCTIBLE
Concord, CA 94520 Owner-�perator INS.PAYS
CUST PAYS
ALL CRAFTSMANSHIP 100% GUARANTEED BAR#AM 136519 EPA#CAD 981640238
SikknCAR REFINISHES (510) 6495-2294
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CLAIM
' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
September 27, 1994
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
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: $224.50 Section 913 and 915.4. Please note all warnings".
CLAIMANT: CARPIO, Tina '
ATTORNEY: SEP 14 1994
COUNTYCCUNSEL, ate received
ADDRESS: 5083 Fernwood MARTINEZCAL.IF. BY DELIVERY TO CLERK ON September 14. 1994
• Oakley, CA 94561
BY MAIL POSTMARKED: Hand Delivered via: Risk Mint.
3. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim. H ��pp
DATED: �aIl DepuLyLOR, Clerk
11. FROM: County Counsel TO: Clerk of the Board of Supervisors
(_,KYhis claim complies substantially with Sections 910 and 910.2. ,
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: — BY: Deputy County Counsel
311. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( Claim was returned as untimely with notice to claimant (Section 911.3).
3V. BOARDD 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. '/
Oated:�l,w 7,� '�9`t PHIL BATCHELOR, Clerk, ByT_( '/�
A_4 �Q Q,.„� Deputy Clerk
WARNING (Gov. code section 913)
Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or
deposited in the mail to file a court action on this claim. See 6overnment Code Section 945.6.
You may seek the advice of an attorney of your choice in connection with this setter. 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 1n the United States Postal Service in Martinez.
Lalifornia, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the Llaifaant as shown above.
.29 1445 BY: PHIL BATCHELOR by Deputy Clerk
cc: County Counsel County Administrator
.j
September 7, 1994
RECEIVED
Ms. Diane Iwasa SEP 1 4 N4
Director, Animal Services , 0
CLERK BOARD OF SUPERN No
4849 Imhoff Place CONTRA COSTA CO
Martinez, CA 94553
Dear Ms. Iwasa:
This is in follow-up to numerous telephone conversations that I have had with
Ted Brasier and Dan Berrett of your office regarding the death of my dog, Lacey
Carpio.
Let me begin by sharing with you what happened on the day Lacey was hit by a
car and died.
It was about 8:30 a.m. on August 19, 1994, when I-suddenly heard my other dog,
Buck, barking ferociously at my front door, which was open. I ran out of my 14-
month old son's bedroom into the front room to found the "dog catcher"
approaching my home, screaming to my sister (who was visiting), "Is this your
dog?"
I responded to him, "Yes." I immediately sensed his obvious "upset emotional
state" and asked, "What's going on?" He just continued to yell at me the same
thing something like, "I want to see your license and your dog's license - and the
other dog's license." I was feeling very overwhelmed and confused about what
the heck was going on -where was Lacey I was asking myself?
Finally I continued to ask him, "where is Lacey - did she get hit by a car??" He
finally (and very rudely) responded, "Yes, now just bring me the licenses." and
continued on his return to his truck parked at the curb in front of my home." I
remember feeling very shocked at his escalated, rude emotional state; it felt very
inappropriate and callous.
I ran to get the licenses he requested and ran out to his truck, and immediately
requested to see Lacey. He first told me no. I then asked why not and
requested again to see my dog. He at last opened the door for me to just barely
seetacey, kept.his•arm across:it_(for precautiom l guess).and.then.slammed-the-
door immediately. He seemed very anxious to get my citation written out to me!
I asked what he thought was wrong with Lacey - if he thought she was OK and
he said, "Maybe her hip." (Bad guess)
Ms. Diane Iwasa
September 7, 1994
Page 2
I asked, "What happened, did someone call you??"
He responded, "No." I continued to feel confused and asked, "Did you see who
hit our dog?"
He responded, "Yes, I saw it." And I said, "Did they stop - did you talk to them?"
He said, "Yes." (At this point my husband recalls him also saying, "...and they
were very sorry.")
His emotional state, from our point of view, continued to be very distraught, rude,
and cold. He kept asking if we were on some particular street (name I cant'
remember); we kept telling him that we were no where near this street and we
hadn't even heard of it - it was very peculiar (come to find out he had been
called out for a loose dog on that street -that was NOT our dog that the call was
about!)
He suggested that he drive Lacey to the vet as dogs can bite when they are hurt.
We agreed and my husband followed him to vet.
To make an already long story a bit shorter, it was very, very sad morning for us
at the vet. Lacey's hips and pelvis had been shattered, she had no feeling in her
legs, her intestines had been pressed out of her stomach, and her bladder had
been crushed. The prognosis was very bad and the recommendation from the
vet was to put her to sleep; we eventually, very sadly and reluctantly agreed.
We returned home very upset.
Immediately upon our return home, the neighbors came over and told us, 'The
two houses on the corner just one street away (where we were to learn Lacey
had been hit) had both seen it and it was their consensus that the dog catcher
had hit Lacey. 1 was totally shocked.
I walked right over to the house and spoke with one of the women who
witnessed.it. She:•had-beemom-her-porch-with-hernewbonrout-or #wlawn-when-
she heard it and immediately turned that second; she saw was the dog catcher's
truck rolling away to the curb; she was VERY clear and adamant that their were
NO other cars around!
e
Ms. Diane Iwasa
September 7, 1994
Page 3
I then contacted your office right away, and thus began the investigation in your
office. When he called me back the next day, he informed me (amongst other
things) that the driver said NOW that he had seen Lacey in his side view mirror, I
believe. That is an outright contradiction to what he very clearly stated to me
and my husband. Other then the death of my dog, Lacey, who was only three,
this is the most upsetting thing to us!
In closing I am writing to ask you to conduct whatever type of an investigation is
appropriate for your office in a case like this and let me know what the outcome
is. I am specifically interested in knowing why his story changed; why he was so
rude and cold to my husband and I - his behavior was highly inappropriate for
the nature of the incident - he acted as though we had just killed someone! I'd
also like to know why he was so rough to Lacey -throwing her in the truck as
was witnessed by the neighbors. Also, will you consider excusing the citation
written to us? My sister inadvertently let our dogs out. We are very
conscientious people about our animals - they are NEVER out without their
leash, as our neighbors told your office
I am also carbon copying the Risk Management Division, as I am hereby
respectfully requesting that they consider this claim to pay the $ 224.50 for
Lacey's veterinarian bill and respond back to me regarding this.
Thank you for your consideration. Please feel free to contact me at 246-6267 if
you have any questions or concerns.
Sincerely,
Tina M. Carpio
cc: Risk Management Division
�
'
. SEP 04 9'i 1
EAKLEY YETE9INPRY AND BIPD HOSPITAL
3607 Pain Street
Conley , Co . 04561
510-6W-167G 510-625-8511
MONTHLY STATEMENT
Louis/TiAa Carpio CLIENT ID :
______________________________________________________________________
FREVIOUS SALONC7 : 10 . ��
�[ j P4Y�ENT — [HECK
AW l�WD [CE 02 A+5U, !LA ' Z�
QUG 22 04 lNQQI[H # : 64GG0 A&'I 5 :
AW 14 ?4 l". 1171 &*857 c ��
- --- ---
TUBT]TAL :
_________
BALA%CE [UE : $ 224 .&�i
C47PEHT 30 FAY3 60 DAYS 90 DAYS
EEO . CC 0C 0.00
PLEAS! �OTT On;j HOAR3 4RNI : KC/ 0AY-7RIDAY : 8 :00an On 8 : 00p�
S4TL'R]AY ; G : 3Cam to 5: 00.0m SUN[Av : 9:002o to 2 :00pn
1VT 0AHE a�ned to eU snu:m unpa�o i�t�` 3. days. LATE CHARGE Cooput�d by a Yer�o�ic
ra�a of 1.75 1 per nonth` Quo is ��e anka: ;rcmnags rate of 21.VV X hinmum Charp WN)
CLAIM
_BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
September 27, 1994
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Board Action. All Section references are to ) The copy of this document exiled 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: Unkknown Section 913 and 915.4. Please note allT?&argmn
CLAIMANT: HEINEMANN, Marvin �}}SE�P0 8 1994
COUNTY COUNSEL
ATTORNEY: Date received MARTINEZ CALIF.
ADDRESS: 901 Court St. BY DELIVERY TO CLERK ON ContomhAr 71 192A
Martinez, CA 94553 August 27, 1994
BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors 70: County Counsel
Attached is a copy of the above-noted claim.
� paIL ATCHELOR, Clerk ,(
DATED: , .°A Ze.,,. ?ye t. 4� it 61(1 B : puty �A pVA
ll. FROM: County Counsel TO: Clerk of the Board of Supervisors
( ) This claim complies substantially with Sections 910 and 910.2.
( wOr 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).
1V. 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 tntered in its minutes for
this date.
Dated:"'J'4, '171 9VPHIL BATCHELOR, Clerk, By—,j 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 RAILING
3 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 Is; and that today I deposited 1n the United States Postal Service in Martinez,
California, postage fully prepaid a certified Copy of this Board Order and Notice to Claimant, addressed to
She claimant as shown above.
Dated: �g BY: PHIL BATCHELOR by ( tet po.") Deputy Clerk
CC: County Counsel County Administrator
OFFICE OF COUNTY COUNSEL DEPUTIES:
�)._.. !.
CONTRA COSTA COUNTY PHILLIP S. ALTHOFF
SHARON L. ANDERSON
BRANDON D. BAUM
COUNTY ADMINISTRATION BUILDING ANDREA W. CASSIDY
`•.b = VICKIE L. DAWES
P.O. BOX 69 MARKE S. ESTIS
VICTOR J.WESTMAN MARTINEZ, CALIFORNIA MICHAEL D. FARR
COUNTY COUNSEL 94553-0116 LILLIAN T. FUJII
DENNIS C. GRAVES
SILVANO B.MARCHESI TELEPHONE (510) 646-2074 GREGORY C. HARVEY
ARTHUR W.WALENTA,JR. FAX (510) 646-1078 KEVIN T. KERR
ASSISTANTS EDWARD V. LANE, JR.
MARY ANN M. MASON
PAUL R. MUNIZ
September 16, 1994 VALERIE J. RANCHE
DAVID F. SCHMIDT
DIANA J. SILVER
VICTORIA T. WILLIAMS
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Melvin Heinemann
Martinez Detention Facility
901 Court Street
Martinez, CA 94553
RE: CLAIM OF: Melvin Heinemann
Please Take Notice as Follows :
The claim you presented against the County of Contra Costa or District
governed by the Board of Supervisors fails to comply substantially with
the requirements of California Government Code Section 910 and 910 .2 ,
or is otherwise insufficient for the reasons checked below:
[] 1 . The claim fails to state the name and post office address of
the claimant.
[] 2 . The claim fails to state the post office address to which the
person presenting the claim desires notices to be sent.
[X] 3 . The claim fails to state the date, place or other
circumstances of the occurrence or transaction which gave rise
to the claim asserted.
[X] 4 . The claim fails to state the name (s) of the public employee (s)
causing the injury, damage, or loss, if known.
[X] 5 . The claim fails to state whether the amount claimed exceeds
ten thousand dollars ($10, 000) . If the claim totals less than
ten thousand dollars ($10, 000) , the claim fails to state the
f amount claimed as of the date of presentation, the estimated
amount of any prospective injury, damage or loss so far as
known, or the basis of computation of the amount claimed. If
the amount claimed exceeds ten thousand dollars ($10, 000) , the
claim fails to state whether jurisdiction over the claim would
rest in municipal or superior court.
[X] 6 . The claim is not signed by the claimant or by some person on
is behalf .
[] 7 . Other:
VICTOR J. WESTMAN, County Counsel
By:
Deputy
y: Deputy County Counsel
CERTIFICATE OF SERVICE BY MAIL
(C.C.P. §§ 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: September 16, 1994 at Martinez, California.
cc: Clerk of the Board of Supervisors (original)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE H 910, 910.2, 920.4, 910.8)
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OFFICE OF COUNTY COUNSEL DEPUTIES:
�` CONTRA COSTA COUNTY PHILLIP S. ALTHOFF
SHARON L. ANDERSON
4 BRANDON D. BAUM
COUNTY ADMINISTRATION BUILDING ANDREA W. CASSIDY
VICKIE L. DAWES
P.O. BOX 69 MARKE S. ESTIS
VICTOR J.WESTMAN MARTINEZ, CALIFORNIA MICHAEL D. FARR
COUNTY COUNSEL 94553-0116 LILLIAN T. FUJII
DENNIS C. GRAVES
SILVANO B.MARCHESI TELEPHONE (510) 646-2074 GREGORY C. HARVEY
ARTHUR W.WALENTA,JR. FAX (510) 646-1078 KEVIN T. KERR
ASSISTANTS EDWARD V. LANE, JR.
MARY ANN M. MASON
PAUL R. MUNIZ
September 12, 1994 VALERIE J. RANCHE
DAVID F. SCHMIDT
DIANA J. SILVER
VICTORIA T. WILLIAMS
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO:
Marvin Heinemann
901 Court Street
Martinez, CA 94553
RE: CLAIM OF: Marvin Heinemann
Please Take Notice as Follows :
The claim you presented against the County of Contra Costa or District
governed by the Board of Supervisors fails to comply substantially with
the requirements of California Government Code Section 910 and 910 . 2 ,
or is otherwise insufficient for the reasons checked below:
[] 1 . The claim fails to state the name and post office address of
the claimant.
[] 2 . The claim fails to state the post office address to which the
person presenting the claim desires notices to be sent.
[X] 3 . The claim fails to state the date, place or other
circumstances of the occurrence or transaction which gave rise
to the claim asserted.
[X] 4 . The claim fails to state the name (s) of the public employee (s)
causing the injury, damage, or loss, if known.
[X] 5 . The claim fails to state whether the amount claimed exceeds
ten thousand dollars ($10, 000) . If the claim totals less than
ten thousand dollars ($10, 000) , the claim fails to state the
amount claimed as of the date of presentation, the estimated
amount of any prospective injury, damage or loss so far as
known, or the basis of computation of the amount claimed. If
the amount claimed exceeds ten thousand dollars ($10, 000) , the
claim fails to state whether jurisdiction over the claim would
rest in municipal or superior court.
[X] 6 . The claim is not signed by the claimant or by some person on
is behalf .
[] 7 . Other:
VICTOR J. WESTMAN, County Counsel
By:
Deputy County Counsel
CERTIFICATE OF SERVICE BY MAIL
(C.C.P. §§ 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: September 12, 1994 at Martinez, California.
cc: Clerk of the Board of Supervisors (original)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE §§ 910, 910.2, 920.4, 910.8)
CONFIDENTIAL
COUNTY COUNSEL'S OFFICE
CONTRA COSTA COUNTY
MARTINEZ, CALIFORNIA
MEMORANDUM
Date: September 1, 1994
TO: Jeanne Maglio, Clerk of the Board of upervisors
FROM: Victor J. Westman, County Counsel /- ./
By: Gregory C. Harvey, Deputy County sel
RE: Heinemann v. Knox (/
Pleased treat the document attached to the memorandum
from Gary Yancey as a claim by Mr. Heinemann.
cc: Gary Yancey, District Attorney
Mary Elizabeth Knox, Assistant District Attorney
Julie Aumock, Risk Management
(With Attachments)
RECEIVED
SP - 7V
CLERK C O
001RE)O STA CO ISORS
3i CLAIM ' &
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
September 27, 1994
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, clouting Endorsements, ) NOTICE TO CLAIMANT
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: Unkknown Section 913 and 915.4. Please note al l%tar
CLAIMANT: HEINEMANN, Marvin }SEP 0 8 1994
COUNTY COUNSEL
ATTORNEY:
Date received MARTINEZ CALIF.
ADDRESS: 901 Court St. BY DELIVERY TO CLERK ONgQ tnh=7T 129
Martinez, CA 94553
8Y MAIL POSTMARKED: August 27, 1994
1. FROM: Clerk of the Board of Supervisors 70: County Counsel
Attached is a Copy of the above-noted claim.
` Q pHll BATCHELOR. Clerk
DATED:
B1: Deputy
JI. FROM: County Counsel TO: Clerk of the Board of Supervisors
( ) This claim complies substantially with Sections 910 and 910.2.
( Vr This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying I
claimant. The Board cannot act for 15 days (Section 910.8).
i
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: ` ` Z t4 BY: 1•Z 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).
JV. 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 D17JJ7VPHIL BATCHELOR. Clerk, By ( �1�� •�� 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
Aeposited 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 iazaediately. *For additional warning see reverse side of this notice.
AFFIDAVIT OF MAILING
3 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 cartified copy of this Board Order and Notice to Claimant, addressed to
the claimant as Shown above. p /�
BY: PHIL BATCHELOR by Deputy Clerk
tC: County Counsel County Administrator
OFFICE OF COUNTY COUNSEL DEPUTIES:
CONTRA COSTA COUNTY PHILLIP S. ALTHOFF
i; SHARON L. ANDERSON
BRANDON D. BAUM
COUNTY ADMINISTRATION BUILDING ANDREA W. CASSIDY
VICKIE L. DAWES
P.O. BOX 69 MARKE S. ESTIS
VICTOR J.WESTMAN MARTINEZ, CALIFORNIA MICHAEL D. FARR
COUNTY COUNSEL 94553-0116 LILLIAN T. FUJII
DENNIS C. GRAVES
SILVANO B.MARCHESI TELEPHONE (510) 646-2074 GREGORY C. HARVEY
ARTHUR W.WALENTA,JR. FAX (510) 646-1078 KEVIN T. KERR
ASSISTANTS EDWARD V. LANE, JR.
MARY ANN M. MASON
PAUL R. MUNIZ
September 16 , 1994 VALERIE J. RANCHE
DAVID F. SCHMIDT
DIANA J. SILVER
VICTORIA T. WILLIAMS
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Melvin Heinemann
Martinez Detention Facility
901 Court Street
Martinez, CA 94553
RE: CLAIM OF: Melvin Heinemann
Please Take Notice as Follows :
The claim you presented against the County of Contra Costa or District
governed by the Board of Supervisors fails to comply substantially with
the requirements of California Government Code Section 910 and 910 .2,
or is otherwise insufficient for the reasons checked below:
[] 1 . The claim fails to state the name and post office address of
the claimant.
[] 2 . The claim fails to state the post office address to which the
person presenting the claim desires notices to be sent.
[X] 3 . The claim fails to state the date, place or other
circumstances of the occurrence or transaction which gave rise
to the claim asserted.
[X] 4 . The claim fails to state the name (s) of the public employee (s)
causing the injury, damage, or loss, if known.
[X] 5 . The claim fails to state whether the amount claimed exceeds
ten thousand dollars ($10, 000) . If the claim totals less than
ten thousand dollars ($10, 000) , the claim fails to state the
f amount claimed as of the date of presentation, the estimated
amount of any prospective injury, damage or loss so far as
known, or the basis of computation of the amount claimed. If
the amount claimed exceeds ten thousand dollars ($10, 000) , the
claim fails to state whether jurisdiction over the claim would
rest in municipal or superior court.
[X] 6 . The claim is not signed by the claimant or by some person on
is behalf .
[] 7 . Other:
VICTOR J. WESTMAN, County Counsel
By: A_
Deputy County Counsel
CERTIFICATE OF SERVICE BY MAIL
(C.C.P. §§ 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: September 16, 1994 at Martinez, California.
CC: Clerk of the Board of Supervisors (original)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE §§ 910, 910.2, 920.4, 910.8)
TM;
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OFFICE OF COUNTY COUNSEL DEPUTIES:
PHILLIP S. ALTHOFF
CONTRA COSTA COUNTY
SHARON L. ANDERSON
BRANDON D. BAUM
COUNTY ADMINISTRATION BUILDING ANDREA W. CASSIDY
�6- VICKIE L. DAWES
P.O. BOX 69 MARKE S. ESTIS
VICTOR J.WESTMAN MARTINEZ, CALIFORNIA MICHAEL D. FARR
COUNTY COUNSEL 94553-0116 LILLIAN T. FUJII
DENNIS C. GRAVES
SILVANO B.MARCHESI TELEPHONE (510) 646-2074 GREGORY C. HARVEY
ARTHUR W.WALENTA,JR. FAX (510) 646-1078 KEVIN T. KERR
ASSISTANTS EDWARD V. LANE, JR.
MARY ANN M. MASON
PAUL R. MUNIZ
September 12 , 1994 VALERIE J. RANCHE
DAVID F. SCHMIDT
DIANA J. SILVER
VICTORIA T. WILLIAMS
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO:
Marvin Heinemann
901 Court Street
Martinez, CA 94553
RE: CLAIM OF: Marvin Heinemann
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:
[]
I . The claim fails to state the name and post office address of
the claimant.
[l 2 . The claim fails to state the post office address to which the
person presenting the claim desires notices to be sent.
[X] 3 . The claim fails to state the date, place or other
circumstances of the occurrence or transaction which gave rise
to the claim asserted.
[X] 4 . The claim fails to state the name (s) of the public employee (s)
causing the injury, damage, or loss, if known.
[X] 5 . The claim fails to state whether the amount claimed exceeds
ten thousand dollars ($10, 000) . If the claim totals less than
ten thousand dollars ($10, 000) , the claim fails to state the
amount claimed as of the date of presentation, the estimated
amount of any prospective injury, damage or loss so far as
known, or the basis of computation of the amount claimed. If
the amount claimed exceeds ten thousand dollars ($10, 000) , the
claim fails to state whether jurisdiction over the claim would
rest in municipal or superior court.
[X] 6 . The claim is not signed by the claimant or by some person on
is behalf .
[] 7 . Other:
VICTOR J. WESTMAN, County Counsel
By: 3L�
Deputy County Counsel
CERTIFICATE OF SERVICE BY MAIL
(C.C.P. §§ 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: September 12, 1994 at Martinez, California.
CC: Clerk of the Board of Supervisors (original)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE §§ 910, 910.2, 920.4, 910.8)
y .•
CONFIDENTIAL
COUNTY COUNSEL'S OFFICE
CONTRA COSTA COUNTY
MARTINEZ, CALIFORNIA
MEMORANDUM
Date: September 1, 1994
To: Jeanne Maglio, Clerk of the Board of upervisors
FROM: Victor J. Westman, County Counsel
By: Gregory C. Harvey, Deputy County-' u sel
RE: Heinemann v. Knox ((//
Pleased treat the document attached to the memorandum
from Gary Yancey as a claim by Mr. Heinemann.
cc: Gary Yancey, District Attorney
Mary Elizabeth Knox, Assistant District Attorney
Julie Aumock, Risk Management
(With Attachments)
RECEIVED
P " 7
CLERKCON7RAOOS A Co.{SORB
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RECEIVED
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NOYL
CLERK BOARD OF SUPERVISORS
CONTRA COSTA CO.
L( Novi --riiE tJO—Fir--'eLS —rjjL-1
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WlNoe(?-,� Put-Mly 0Q Pora-AOa 7/7
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Gary T.Yancey
Pistrict Attorney
OFFICE OF THE
CONTRA COSTA COUNTY
DISTRICT ATTORNEY ��
725 Court Street, Fourth Floor 4
Martinez, California 94553 AUG 3 1 1994
Cou'' Y CJUlVSs�L
MARTIh'cZ CALif-
TO: Victor J. Westman
County Counsel
FROM: Gary T. Yancey
District Attorney
DATE: August 30, 1994
SUBJECT: People v. Bruton, Heinemann, et al.,
Contra Costa County Superior Court Docket No. 940549-9;
United States District Court No. C94-2704 MHP
Deputy District Attorney Mary Elizabeth Knox received the attached document yesterday. She is
requesting your assistance and representation in this matter in federal court.
Thank you.
GTY:pd
WESTVI.DOC/AUG94
Attachments RECEIVED
C"'I - 7 1994
OF SOPF-RVISORS
CLERK BOARD C1'
CONTRA C(ISTA CO.
rPro4111 Y r
_
2T AUG
AUG 9 1994 /s � M
CONTR' COSTA COUNTY CALIF.
DISTRICT ATTORNEY'S OFFICE
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CO,,-J71&A C;c f� -A �
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fill 1111 if 11.111 Jill 113h111113.1 SM
CLAIM j p
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
September 27, 1994
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Board Action. All Section references are to The copy of this document Baited 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
Mount: Unknown Section 913 and 915.4. Please note a -Y
CLAIMANT: HOLLAND, Jeff J
SEP 0 8 9954
ATTORNEY: :�OUNTtY�COU VSEL,
Date received Se tember ,�AAR,W f ZCAUF.
ADDRESS: 802 First Street BY DELIVERY TO CLERK ON p
Rodeo, CA 94572 September 7, 1994
BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
/ JVIL BATCHELOR, Clerk
DATED: �vr Q&2Jl� F. �l9`f : Deputy ` d,
11. FROM: County Counsel TO: Clerk of the Board of Supervisors
( his 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:
Dated: ( ' 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).
JV. BOARD ORDER: By unanimous vote of the Supervisors present
(✓1 This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
00
Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk
YARNING (Gov. code section 913)
Subject t0 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 any seek the advice of an attorney of your choice in connection with this matter. if you want to consult
an attorneyq you should do so immediately. *For additional warning see reverse side of this notice.
AFFIDAVIT OF MAILING
3 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: - BY: PHIL BATCHELOR by ill„ r Deputy Clerk
CC: County Counsel County Administrator
Clai- 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 146, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this
form
RE: Claim By ) Reserved for Clerk's filing stamp
RECEIVED
Against the County of Contra Costa )
or )
District')
Fill In name ) CLERK BOARD OF SUPERVISORS
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)
5_ e7 M/ F 9 z
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)
E
��----------------------- ------------------=- ------------------------ -
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
�. wnat are the names of county or district officers, servants or employees causing
the damage or injury?
313
----�a ��i�cam--------------=-•���=7000
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
daylages claimed. Attach two estimates for auto e. /q 7';?,
rq - fie'/-1 ��0C .ice-oma �c/L�' 7e,
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
01
$. games and addresses of witnesses, doctors and hospitals.
-------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
iF 9F iE 9F wF .* 4-4 i,# :
r� Gov. Code Sec. 910:2 provides:
"The claim must be signed by t claimant
SEND NOTICES TO: (Attorne ) or by some erson on his beh ."
Name and Address of Attorney
(ClaiJ2-`fft's S gnature
r(Address)
Telephone No. Telephone No.—d&Llft� .
a Sys 79V,01
N 0 T I C E
Section 72 of the Penal Code provides: -
"Every person who, with intentP 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 imprisommnt and fine.
4
ADDENDUM TO CLAIM
3. FIRST STREET HAD BEEN TARRED ANG GRAVELLED DURING THE DAY, HOWEVER
THE TAR APPARENTLY NEVER HARDENED AND BY MORNING MY CAR HAD SLID SIX TO
EIGHT INCHES IN THE SOFT TAR AND PINNED ONE TIRE BETWEEN THE RIM AND THE
CURB AND IMBEDDED TAR AND GRAVEL IN THE TIRES. WHEN I MANAGED TO GET THE
CAR UNSTUCK AND MOVING, THE GRAVEL STUCK IN THE TIRES WAS THROWN UNDER
THE FENDERS CAUSING DENTS FROM UNDERNEATH AND EXTERNAL BODY AND PAINT
DAMAGE AS WELL AND DAMAGING TWO TIRES. THIS VEHICLE, A 1972 OLDSMOBILE
CUTLESS HAD BEEN PAINTED ONE MONTH EARLIER.
4. THIS CONDITION SHOULD NEVER HAVE BEEN ALLOWED IN THE FIRST PLACE, BUT
SINCE IT HAPPENED, SOME WARNING SIGNS, ETC. SHOULD HAVE BEEN PUT UP OR
THE STREET BLOCKED UNTIL THE PROBLEM WAS CORRECTED. THIS CONDITION WAS
NOT CORRECTED FOR OVER A WEEK.
1712 San Pablo Ave. diIMATE
Berkeley, CA 94702
`510)5265-1262 Dat0000184
e i��
Car Owne f Home Phone
ZX-
Year oriel C. Business Phone
VIN# Adjuster Phone
Insurance Co. Inspector
CODE: A-ALIGN N-NEW OH-OVERHAUL S-STRAIGHTEN OR REPAIR EX-EXCHANGE RC-RECHROME U-FOR USED PARTS B•REBUILT
FRONT
Labor LE L R Labor tiprREAR Labor
Code PARTS C PARTS Code
'' Hours PARTS
Bumper I Fender, Fro Bumper
Bumper Brkt. Fender Shie-M Bumper Rail
Bumper Impact Cyl. Fender Mldg. Bumper Brkt.
lHeadlamp Bumper Gd.
Bumper Gd. Headlomp Door Gravel Shield
Frt. System Sealed Beam Lower Panel
Frame Halogen Lamp Floor
Cross Member Cowl Trunk Lid
Door, Fron Trunk Lock
Wheel Door Hinge Trunk Handle
Hub Cap Door Glass Tail Light & Assy.
Hub & Drum Vent Glass Tail Pipe
Knuckle Door Mldg. Gas Tank
Knuckle Sup. Door Handle Frame
Lr. Cont. Arm-Shaft Center Post Wheel
License Frame-Brkt. Door, Rear Hub & Drum
Up. Cont. Arm-Shaft Door Glass Back Up Light
Shock Door Midg, License Frame—Brkt.
Windshield Rocker Panel Stop Light Assy.
Front Cowl Rocker Mldg. Rear Window Def.
Tie Rod ISM Plate Fuel Door & Assy.
Steering Gear Floor
Steering Wheel Frame
Steering Column Dog Lem ,," Labor
Horn Quar.Panel 'ALIGNMENT Hours PARTS
Horn Ring Front Wheel.Drive
Gravel Shield Quar. Glass 4 Wheel Ali n
Parking Light Fender„Rear, Rear Wheel Drive „
Grille Fender M 9. 2 Wheel Align
Shock Absorbers oder pad Wheel Balance
Gas Comer Lamp Assy.
Hydraulic i
Labor Labor .
Code MSC• a Hours PARTS FI SH; , Hours
., rA
Baffle, Side In nel
Baffle, Lower n t Prime
Baffle, Upper ont Ad'. Paint
Lock Plate, Lr. lectric Seat Me m Materials
Lock Plate, Trim Paint Se t
Hood To Headlinin
Hood Hin Sun Visors
Hood M Carriage da To
Ornament To AUTHORIZATION FOR REPAIRS
Rad. Sup. Tire
Rad. Corea You are hereby authorized to make the above
Radio A enna Re int Systems specified repairs.
Rad. Hos s I Wercoat
Fan Bla lisp Signed
Fan Belt Replacement Floor Mats
Water P mp Misc. Materials
Motor j Interior Protectant
Trans. Link s Rust roofing Parts $
f Wrecker Service $
Tax $ l
This estimate is based on lowest passib a cdst. consistent with quality work, and as such, is S $
guaranteed. Items not covered by this a ti�ate'or hidden will be additional.
TOTAL $
RE-661-3 Rev.90 - -
PRINTED IN U.SA.
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CLAIM J `o
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
September 27, 1994
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
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: $75.00 Section 913 and 915.4. Please note all `Warnings".
CLAIMANT: VALDEZ, Anthony _ ' !
ATTORNEY: SES' 1 1994
COUNTY COUNSEL ate received
ADDRESS: P.O. Box 153 MARTINEZ CALIF. BY DELIVERY TO CLERK ON SPp tPmher 13, 19A4
Oakley, CA 94561
BY MAIL POSTMARKED: Hand D 1 i verPd via- Ri Gk Ms t_
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
ppN De
ll ATCHELOR, Clerk
DATED: 81: puty
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 I
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:
Dated: T 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).
JV. 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: 1994PHIL BATCHELOR. Clerk. By , �na�llll„ 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 an this claim. See Government Code Section 945.6.
Tau =y seek the advice of an attorney of your choice in connection with this utter. If you want to consult
an attorney. you should do so immediately. *For additional warning see reverse side of this notice.
AFFIDAVIT OF MAILING
3 declare under penalty of perjury that I as now, and at all times herein mentioned, have been a citizen of the
Wited States. over age 18; and that today I deposited to the United States Postal Service in Martinez.
California. postage fully prepaid a certified copy Of this Board Order and Notice to Claimant, addressed to
Zhe claimant as shown above. d 1
I i 9 q BY: PHIL BATCHELOR by �e� . ��a , fL�Le m� Deputy Clerk
CC: County Counsel County Administrator
I
l
C=a' to: BOAFM OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Clai�:s 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
RECEIVED
Against the County of Contra Costa j SEp 13
WA
District) CLERK BOARD OF SUPERVISORS
Fill in name ) _ CONTRA COSTA CO.
The undersigned claimant hereby makes claim against the County of gntra Costa or
the above-named District in the sum of $ '�, eo 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.oceur? (Include city and county)
3• How did the damage or injury occ ? (Give ful details; use extra paper if ^
required) `�,� �t he�� m CW26 C'� C ► �U I
nab-
-
4. Wha„ particular act or omission on the part of coon or district officers, Qo
servants or employees caused the incur or damage? ho,?i _�D a
I-Z04_C1D0,7/5 76u); a* e, tjak�
Comm CbM
M M VJ&r 4t Id rale,.� q-0 67� (,A)0 U_(6
waod 46
prcabl �� cook. � �'.G% �/
D. wnat are the naves of county or district officers, servants or employees causing
the da asage or ir,jury?
5. at damage or injurie do you claim resulted? (Give full e ent of injuries or
damages claimed. Attach two estimates for auto damage.
_416 (), ftulhlp"
7. How was the amount claimed abovemp uted? Include t estimatWaamount of any
prospective injury or damage.)
$. Names and addresses of witnesses, doc rs and idspitals.
9. List the expenditures you made on ac t of this ac dent or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910:2 provides:
I,_ "The claim must be signed by the claimant
SEND NOTICES TO: ::`>(Attorne ) or by some pers_oQ on his behalf."
Name and Address of Attorney
a' tis ignature
ftv
� . x 3 n
Address
Telephone No. Telephone No.
N0•TI CE
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 _r
' both such• imprison,. nt and fine.
'3 4 ;RR_?t S{trt r is t d r 4
'ii`(-flrtt. "5 r s'aXi Sar.v<.`r+i, -•n. j.r ..'s' a r„IkSYc. '
I S Tp'`
GQNy�
��2 pIZ � zN�
6877 Brentwood Boulevard' 1105 Somersville Road s
t • Brentwood,CA 94513 Antioch,CA 94509' • r
Somersvtlle Road (510)6341444 (510)754-8686
s Antioch;CA 94509• ("�
t a {510)7541550: t, 13 0 _1
Date Tim s/ AM vn, Call# Drmrer. ,, A r ,
`VEHI LE '. l f LOCATION
l TOWED F
sJ, AbDRE -4IK j �.. {TOWE TO'' ' '
CITY ZIP. f / /' PHONE i•CASH 'CRE IT CHARGE OTHER
CARD
YEAR ` MAKE MODEL f LOR LICENSE# STATE i z
YIN#' I ODOMETER
AR0 r/
RIGHT. •FRONT STARyTq✓ IME f ENDTIME TOTAL TIME CALL j
MIK i
+ PDIRELEASE DRIVEABLE 180 KEYS i
HEAR _- LEFT (]res Ort+—o� ves D{no ❑urix ❑ CI
CARRIER
TOW ❑REAR TOW ❑DOLLY TOW ❑DRIVESHAFrtAXLEPLILL uCARRIER
RIVER REMA I S 8 ADDITIONAL,INFO:V.
� TOWING � $
tyc .• I
•ROAD SERVICE
(' STORAGE DAYS O ER DqY ,•
A { M A•t! IN OUT -.; 1 _ ... ...•....__
r LABOR - HRS
r LEIN SALE $
DRIVESHAFT'OR
AXLE PULLING64
DULLIES;I % $ }
-VEHICLE INVENTORY: 0.
E CHARGES $
•
r �t � l f
2 CERTIRCATlON: IED UNDERSIGN ED DO
HEREBY CERTIFY.THAT I AM LEGALLY
AUTHORIZED AND ENTITLED TO TAKE
POSSESSION OF VEHICLE DESCRIBED
ABOVE AND ALL PROPERTY THEREIN.I HAVE
t r; ,..,... • RECEIVED ABOVE VEHICLE_ i:IN :,
y k�"`j
SATISFACTORY CONDITION RE —�
lN
l
i .TOWAUTFlORIZEQ BY X SIGNATu
AQV{4NC
l
y ,�