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HomeMy WebLinkAboutMINUTES - 09191995 - C9 CLAIM C,9 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 Ci?'T* Ai;-�rst the County, or District governed by) 60ARQ, ACTION `_:'.ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT crjd Sutra Action. All Section references are to ) The copy of this document mailed to you is your notice of Califcrn•ia Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unknown Section 913 and 915.4. Please note all "Warnings ounty Couhsel CLAIMANT: Carmen and Jesus Fausto 'AUG 2 T 105 ATTORNEY: c/o Cameron J. Whitehead 1407 A Street, Ste. D Date received Martinez.CA 94553 ADDRESS: Antioch, CA 94509 BY DELIVERY TO CLERK ON August 21, 1995 BY MAIL POSTMARKED: Mand Delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Au gust 22 1995 HHII ATCHELOR, Clerk DATED: BQQY: Deputy 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: 'Z 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 Superviscrs 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: 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, f For Additional Warning 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 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. c / 9 c/ r BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator X RECEIVE® . .;. Law Offices of Joel A. Harris 2 2 ATTORNEY AT LAW CONTRA COSTA CO. _,, Joel A. Harris ameron J. Whitehead August:..-21, 1995 Clerk of the Board of Supervisors VIA HAND DELIVERY County of Contra Costa, California 651 Pine Street Martinez, CA 94553 Re: Claims of Carmen and Jesus Fausto Accrual date: February 27, 1995 Dear Madam or Sir: This office has been retained to represent the interests of Carmen and Jesus Fausto pertaining to their claim against the County of Contra Costa and certain employees thereof. The instant claims arise from a tubal ligation procedure performed upon Mrs. Fausto at Merrithew Memorial Hospital in or about September 1994. On or about February 27, 1995, Mr. and Mrs. Fausto were advised that Mrs. Fausto was pregnant, alerting them to the negligence of the physicians in the performance of the ligation procedure. . It should be noted that Mrs. Fausto had previously undergone an unsuccessful ligation procedure in Mexico and that the doctors at Merrithew were aware of that fact. Because the Faustos are -morally and religiously opposed to abortion, they have been forced to carry to term, and to care for, an additional child they cannot afford. Consequently, they have no real choice but to proceed -with`-the instant claims, which are premised upon the theories of medical negligence, breach of contract and loss of consortium. The damages claimed are in excess of the jurisdictional limit of the Superior. Court. Please address all official notices or correspondence to the undersigned at the address indicated in below. Should you have any questions, I stand ready to provide whatever information I can. Very truly yours, Cameron J. Whitehead of Counsel 1407 "A"Street, Suite D 2121 S. El Camino Real, Suite 700 Antioch, California 94509 San Mateo, CA 94403-1897 ❑ Tel: (5�0) 757-4605 Tel: (415) 578-8080 Fax: (510) 757-1811 Fax: (415) 578-0148 cd rA O N O r tU v cn o v WO N 0o v ,o G) o ..w G lo v r ons � 5; �a CLAIM 1 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CA_L_IFORNIA September 19, 1995 CIA;m a^?inst the County, or District governed by) BOARD ACTION :`. S.:;,erv.isors, Routing Endorsements, ) NOTICE TO CLAIMANT and ELc,c Action. All Section references are to ) The copy of this document mailed to you is your notice of Califcrnia Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $500,000.00 Section 913 and 915.4. Please note all •Warnings". CLAIMANT: Gary Mosbarger ATTORNEY: Date received ADDRESS: 901 Court Street BY DELIVERY TO CLERK ON August 8. 1995 rlartinez, CA 94553 BY MAIL POSTMARKED: Interoffice Mail I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gg DATED: August 9, 1995 gtlL DeputyLOR, 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). ( oOl Other: sps.,L- Gvv "_& w [L I, Awa tp^A Dated: IA—ti 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 Superviscrs 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. q � Gated: 9 / — g 9s 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 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 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: g—A o _/ 9 9 S" BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator AA Claim-lo:" BOARD OF SIIPERVISORS OF CONTRA`COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims rea'ting to cause's of action for death or for injury.to person or to per- sonal property or growing crops and which accrue on or before December 311 1987, must be,presented not later than the 100th day after the accrual of the cause of action.. Maims 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 cone 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 Clerks filing stamp RECEIVED AUG - 81995 Against the County of Contra Costa ) v • CLERK BOARD OF SUPERVISORS District) CONTRA COSTA CO. Fill in name ) The undersigned claimant hereby makes elai against the County of Contra Costa or the above-named District in the sum of $ 5ap PVV and in support of this claim represents as follows: ----------------NN 1. When did the damage or injury occur? (Give exact date and hour) (VtA Pa, --7 4 COLA ' k N.MNN---�---N------N--MN--N-N-N- �-----M ---N---NN-NNM�N--- 2. Where did the dzmage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper.if required) 7 --~---N-- ---------------------N-w------------------------------N----N---rN�- 4. What particular act or omission on the part of county or district officers," servants or employees caused the injury or damage? ��x� S �®- Cdr 0,C- kA.& tAA- OAf .6 ��ay a,J 6 � V 4-e- �t 0,C (over) 5. What:are the names of 'county or district officers, servants or employees ca ing the damage or injury? � #b ") _" y4 ` - A -------1 -- _ !-_-4---- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attac two estimates for au damage. 7. How was the amount claimed above computed? (Include the estimated amount of any 'Tel,L S44 prospective injury or damage.) PL-)r\ Y\Ik--T t' 8. Names and addresses of witnesses, doctors and hospitals. ..---------------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) orb some Derson on his behalf." Name and Address of Attorney Claimants Signature Address Telephone No. Telephone No. 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. to d � t CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 Clam Ar,""Ft the County, or District governed by) BOARD ACTION -,_;_.'ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and ELo,a Action. All Section references are to } The copy of this document mailed to you is your notice of Califcrn,ia Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $1.75 Million Section 913 and 915.4. Please note all 'Warnings". CLAIMANT: Gary Mosbarger ATTORNEY: Date received ADDRESS: 901 Court Street BY DELIVERY TO CLERK ON August 17, 1995 Martinez, CA 94553 BY MAIL POSTMARKED: August 16, 1995 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 21, 1995 Jy?L BepUtyLOR, Clerk A Ca 11. FROM: ft6unty Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 7i� i 8Y: unty Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Superviscrs present (✓) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: g-/ /—/9 9$' 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 1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 9- BY: PHIL BATCHELOR by puty Clerk CC: County Counsel County Administrator ,..t„ Claim 'to: BOARD OF SUPERVISORS OF OONTRA 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 RECEIVED Against the County of Contra Costa ) AUG 170% or ) 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 $ t , -7 mt11.&-,% 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 in.Jury o`cur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) {- {{�� l �� r 1 6C l��Cr�. �i� .SO r ♦ 4-20 r 1 f 2C�i q..( l/f (ct►t ,o iTtGj� use. r 0.r � R IAB d531bLc 4. What particular actor omission on the part of county or district officers,' servants or employees caused the injury or damage? �C j Chi w (over) 5. What are the names of county or district officers, servants or employees causing ` the damage or injury? 2�.��y �j J V O'k r-,/um ----------------------------------------------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. ,ter e �a Y1--Z"�� d Cv,-V-XLO e S --- ------------ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors and hospitals. ------------------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some p son on his behalf." Name and Address of Attorney 0, Claimants Signature t� ( C0J /- + Address Telephone No. Telephone No. * V 9 1 V T Irs 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. NNJ Q-j J,u .. CLAIM C BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 Ci?4m d^"^St the County, or District governed by) BOARD ACTION Ccs ;ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and 6c,crc Action. All Section references are to ) The copy of this document mailed to you is your notice of Califcrnia Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: 1.5 Million Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Gary Mosbarger ATTORNEY: Date received ADDRESS: 901 Court Street BY DELIVERY TO CLERK ON August 8, 1995 Martinez, CA 94553 BY MAIL POSTMARKED: Interoffice Mail 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ' PPHH gg DATED: August 9, 1995 BYIL DeputyLOR, Clerk 11. FROM: ounty 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: [) — cj► .I� 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 Superviscrs present ( r/) 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: 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 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 1B; 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 (jjj�.;-eputy Clerk CC: County Counsel County Administrator Claim 'to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A., Clams 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 GG vino b� ) M RECEIVE® - 8 19A6 Against th ounty of Contra Costa ) I,u AUGG r ) CLERK BOA D OF SUPERVISQR$ CONTRA COSTA CO. District) Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 1 , Vh;`� h . and in support of this claim represents as follows: J S - ------------------------------- � l`1---� ----------- -- ( ---------- 1. When did the damage or injury occur? (Give exact date and hour) 1 --------------�---------- ---------ww_Y---men-----------.�wr�.S.sa�+mow---�ee—w-----�-...-.._.rfs 2. Where did the dam-age or in j; ry occui,^ 'Include city and county) Mal' 2 Z ----------------------------------------------------------------------------- --- 3. How did the damage or injury occur? (Give full details; use extra paper if required) Cc,P 4- sv\h v F -Kk- S 6./L�r +d 1 d r'e P d r f_rS C GJW kra \vws uiws L Cdc ---- ee / -- is ore ,e- s--- ZjU4-i7i _ 4. What particular act or omission on the part of county or district officers ic servants or employees caused the injury or damage? C��--rc� Cash , s C,�, S e `.v,\ o 4X-qv- Jae.J s A- �� b1`.S Led i v} � P`�S F` OW -d y � , 5 rn.\ \\c7n � ( C,uV�O�-.� �'- (over) 5. What are the names of county or district officers, servants or employees causing , the damage or injury? -� s _-----__--------------________P'_________________ _____________ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated unt of any prospective injury or damage.) 1 ------------------------------------------------------------ -- 8. Names and addresses of witnesses, doctors and hospitals. t4 C Vk S CO r (els `C FIEF►S ------------------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT k e 4 Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by somi person on his behalf." Name and Address of Attorney 0 1 rt w4WAq,� Clai is Signature / a U - (Address) 1M� r 4- YA -PZ G, Telephone No. Telephone No. T V I V V V V V V V Vf. 1t 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. i Lack of Linedical Cale ; Durin a recent 'ail tour a lack of medical care'was the most coin mori-.complaint. One inmate showed a gnarled hand to a reporter,He said he a '° c.0-0�� ��-`" �� �- _`� W �--� •� .;Hued at the jail with a broken:han ° �*CD „, . but:that it had taken 30 days for him --= -. to eta doctor to look at tt TA In C' Z l An inmate with a'visibly swollen n awsaid he had had'a toothache for s� rna� c� ,cu a° . yr J. o. ` ,N'A ? C 1 �-+ 10 days but still hadn t en given M.,Cy $ , Z ly an appointment with a dentist. , ~ o o A ° o N �3 A few inmates have asked the .. .... - � �n�,g CP- M Oy jam, CD �. r .rgn; ;.. >:or el :On of them;.. a � Dale o�r er told'a fudge IIasi wee tlia ;'was being denied"bg; m . :.human. ,necessities" `a dady . `shower, a toothbrush,.soap and an A this"t with a counselor: aPPon3 he ud e-scheduled a hearing- WA: coo + ee . 0 1T - _ o 15arg e�','who.is`char ed with g tm� tq steal•,a,case of beer from.a con zh _ a,� , vemence store;received proper at -V i-tention. . , _..... f r` ►O*� � ;, k re�� c�p'pn:ate.�p�' r x 2�ti ".n�` -;tr-a Smlwaueffri t o s *, :_m� m �, YInmates' ike. Mostsar er •who: n° a @tea o ` V. complain regularly about jail condi -0. Y 1 f ` Noris don't generally get muchsyxp:' w 14. ?" a o VQ, � pathy from fail.administrators. - �, They point out that most of thy" x inmates earnedtheirji ace is jail liy j something the -'did'-04',-the,outside.:'. <Y .'They also sad►that-i unates`see#n to find lots to=wonry abut in jail thet they never worried about on the odt- MWIP1 side > y, `" F. "If youfe out on s YOU can do dope,Y9u can a alcohol, commit.cnfnes,'an thenof aisud- den you tome in here and you.want. s-:to o tolhe doctor and the dentM-~' ti•_ do your exercise and contact your'family,".said Shinn, Contra 4 `' •* Costa jail boss. Despite the crowding, Shinn in sists that the.jail is,meeting i%oblig- ations of blig- ations:of protecting the public''safety and protecting the health aind,legal hts of itimates But he admits that crowding makes life more difficult, for inmates and jailers 4, "My Iegal responsibility is toas- r sume that these people have consti tutional rights,"he said "But.as,1he rt : ernwdine continues:our:abliiro'to. f ti 'n*ZN 4 i i d� C_, 9 APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUN'T'Y, CALIFORNIA September 19, 1995 BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4• Please note the "WARNING" below. Claimant: Gary Mosbarger Attorney: Address: 901 Court Street Martinez, CA 94553 Amount: Unknown By delivery to Clerk on A„g„st � 1995 Date Received: August 9, 1995 By mail, postmarked on Interoffice I. FROM: Clerk of the Board of Supervisors 70: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: August 11, 1995 PHIL BATCHELOR, Clerk, By V Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). {i �The Board should deny this Application to File Late Claim (Section 911.6). DATED: ► ' gS VICTOR WESTMAN, County Counsel, By Deputy III. BOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 91.1.6). (� This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Boardfs Order entered in its minutes for this date. _ P DATE: 9-/9- 9s PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code S911.8) If you wish to file a oourt action on this matter, you must first petition the appropriate court for an order relieving you tram 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 connection with this matter. If you want to consult an attorney, u should do so immediately. IV. FROM: Clerk of the Board T0: 1 County Counsel 2 County Administrator Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: 9 -o?© — / 99SPHIL BATCHELOR, Clerk, By Putt V. FROM: 1 County Counsel 2 County Administrat 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 AUG DECEIVED 1 t�CL c`. YZ'1 aS Y1cc f r 1�t3 r CUFFRI o a° s�aco. AUG t� 3 1995 2 .( v1 �R e� MWINom, 3 � ( �v 4 0.r -4 \ i } Z � �J3 7 s 9 300,4, SG S Y 11 12 13 Ale 14 Cir t: `��\C! 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Cod 9 /. tis G S � vtf'e - c '" ti` 4LQ w ct.s Qt lr a. -U 011 ,54,q)'C6..., 12 E 1 CkC V.Q f- cu►^C- . f S v �" �" i �e- C3 X G v S a�a ,/f/ 'g C T- » . • 13 �.. e 14 fT Yi C '. + .s �j t v X 6-z G f-C14 0 ( tj' $ 0 rs CoAk o if"v "C'.0 vY c s Ll 7 { 17 { 1t ,n 1 L Y c T f�Y r-�' 1 l�?. �J c i C� j�*c._ A.r� GCI e v Y-g oc."t't 1$ 24 Ia,lt �- 0.J VYN �q �t E C 4" a,, 21 r-4e\c+F s v o v t4 V GOdQ- s� 644(a aid 22 23 �. 24 'l t7a.' 26 27 /2 2s '' A- ID cx, 1 CCk ry ' ►r}'toS� f(aX ), c tcL f : 2 4 5 11 S CL--v-t 'A..R C l G �.M av,.T i,v\ A-kk a 6 b v-k Cc,- (-,b- 7 0. Lb- 7 � � Qc �l � 8 9 y ca'C :v 10 G^c, 10 C y 0 '11�"� vl`� ';. , w © t q� �v h c ck re4 r ci 4e 11 c(+ J r-t fi- - wtc .. . . Ovvok k75 u ►tion b k 4-,6 ac4- 12 { 14ts ('�ck i YkA w a S . c� L0. c r- 16 .- 9 Y-\ 'oL c s Po %-I A o-,C- - ,;' 17 . t • r 18 eO"U A�' 20 21 ,�. -E- �r� � a-.�-�� r " y 22 � E �ti (� `C�`��'`'�- �C} f� L)��J I 23 24 25 U Y" ley 26 276 L3- 28 lu\ � ,r TO: Gary Mosbarger and Cynthia Lee Ginn MDF 901 Court Street Martinez, CA 94553 NOTICE T9 CLAIMANT (Of Late-Filed Claim) (Government Code Section 911 .3) The claim you presented to the Board of Supervisors of Contra Costa County, California, as governing body of the County of Contra Costa and/or District, on July 6 , 1995 has been reviewed by County Counsel and is being returned to you herewith because: Your claim for an injury tc person or personal property which arose on or after January 1, 1988 was not presented within six months of the event or occurrence as required by law as to those events occurring between October 15, 1994 and January 6, 1995. (See Government Code sections 901 and 911.2) Because the claim was not presented within the time allowed. by law, no action was taken on that portion of the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code sections 911.4 to 912 .2 and 946 .6) Under some circumstances leave to present a late claim will be granted. (See Government Code section 911.6) NOTICE OF LATE CLAIM You may seek the advice of an attorney of your choke in connection with this matter. If you desire to consult an attorney%, you should do so immediately. PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administrator By: Dty Clerk Dated: l� q95- Enclosure 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 copy of the above Notice to Claimant (of Late Submitted Claim) , addressed to the claimant as shown above. Date: ,I R9� By Phil Batchelor by Deputy Jerk NOTICE OF LATE CLAIM ,J VERIFICATION OF PROOF OF PERSONAL SERVICE 1 2 1 am a citizen of the United States and a resident of the county of 3Co n4 r-rK&N T 4 ; 1 am over the age of eighteen years of age and not a party to 4 the within cause of action ; that my address is : 5 6 cs O C 0 r + 'tiMa i- N 91UC-,1 That I personalty served the within a : VVN , Ck"j, a P��r� cry, �atv_s" s Ca 6 �,� ed Ci r YVSa'f 5 [3eta rel d i— 9 on the �� .,�, e C oCo in-said action by personally 18 delivering same to the aforementioned and/or his/her agent at the address of 11 v F S v jP vs Ir. U CO A--ra 1-LAr,,, 12 ('� ✓lL� �G CV sc G r G ne S ,, Vio r,it or 13 �.� �q!sS -$ -! about the 1 5 day of C v � v S + , 199 � at the approximate time of 14 15 16 17 1 declare under penalty of perjury that the foregoing Is true and correct, except as 18 to matters stated upon Information and belief, and as to those matters I do believe them 19 to be true. Executed this C A-- day of u ,,� 199 at 28 i` -ZCalifornia pursuant to provisions of California Code of 21 22 Civil Procedures, Sections 446 and 2815.5. 23 24 25 DECLARANT 26 7z w.siezi C7 C �= 3 4 6 9 � 10 tCC) 13 vi 14 16 17 18 19 20 21 22 23 yy\ 24 25 26 27 62w 28 . °�` . ,, c� 610 1a mom' 11 �tW{ J Stu'+ (\V�\"`• c. M 4r v" r �v AMENDED CL A I M C Cl BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 Cl?;+r 61?4nst the'County, or District governed by) BOARD ACTION C._ •j .` 5ervisors; Routing Endorsements, ) NOTICE TO CLAIMANT and Sicro Action. All Section references are to ) The copy of this document ma iled to you is your notice of Califcrria Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $328.00 Section 913 and 915.4. Please note all "Warni�p '1. OoAty % CLAIMANT: JoAnne Kelleghan F„ ATTORNEY: Date received martlneX,Cit�1 b� ADDRESS: 4440 Morgan Territory Rd. , 419 BY DELIVERY TO CLERK ON August 10, 1995 Clayton, CA 94517 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: August 28, 1995 JaIL Bep�tYLOR, 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: Z�/ " S BY: puty 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 Superviscrs 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: 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: g — 02 Q /9 9,; BY: PHIL BATCHELOR by' eputy Clerk CC: County Counsel County Administrator CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 clz;rr the' County, or District governed by) BOARD ACTION S:;;ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Bucr6tion. All Section references are to ) The copy of this document mailed to you is your notic of Califc*ria G vernment Codes. ) the action taken on your claim by the Board of Supe visors (Paragraph IV below), given pursuant to Governmen Code Amount: $3 8.00 Section 913 and 915.4. Please note all "Warni s". CLAIMANT: JoAn"Kelleghan ATTORNEY: Unknown Date received ADDRESS: BY DELIVERY TO CLERK ON August 10 1995 4440 Morga Territory Rd. , #19 Clayton, CA 94517 BY MAIL POSTMARKED: Hand Deliv red via: Risk Mgmt. 1. FROM: Clerk of the Board o\Supervisors TO: County Counsel Attached is a copy of he above-noted claim. DATED: August 11, 1995 By1L BATCYELOR, Clerk epu o II. FROM: County Counsel TO: Clerk of the Board of S pervisors ( ) This claim complies substantia ly with Sections 910 and 910.2 ( his claim FAILS to comply substa tially with Sections 910 d 910.2, and we are so notifying claimant. The Board cannot act fo 15 days (Section 910. ( ) Claim is not timely filed. The Clerk hould return cl im on ground that it was filed late and send warning of claimant's right to apply fo leave to pre ent a late claim (Section 911.3). ( ) Other: Dated: i S �G Y: Deputy County Counsel III. FROM: Clerk of the Board TO: C unty Counsel 1) County Administrator (2) ( ) Claim was returned as untimely wit notice to claiman (Section 911.3). IV. BOARD ORDER: By unanimous ote of the Superviscrs present ( ) This Claim is rejected in ful . ( ) Other: I certify that this is a true and correct copy of the Board's 0 der entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain excepti ns, you have only six (6) months from the date this n\Rever personally served or deposited in the mail to ile a court action on this claim. See Government Code945.6. You may seek the advic of an attorney of your choice in connection with this mayou want to consult an attorney, you shou d do so immediately. * For Additional Warning See Side Of This Notice. AFFIDAVIT OF MAILING 1 declare under nasty of perjury that I am now, and at all times herein mentioned, have be a citizen of the United States, ver age 18; and that today I deposited in the United States Postal Service in artinez, California, po age fully prepaid a certified copy of this Board Order and Notice to Claimant, ddressed to the claimant s shown above. Dated: BY: PHIL BATCHELOR by Depu Clerk CC: Coun y Counsel County Administrator OFFICE OF COUNTY COUNSEL DEPUTIES: CONTRA COSTA COUNTY PHILLIP S. ALTHOFF i; SHARON L. ANDERSON ANDREA W. CASSIDY Z COUNTY ADMINISTRATION BUILDING VICKI}.,-, 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 August 11, 1995 VALERIE J. RANCHE DAVID F. SCHMIDT DIANA J. SILVER VICTORIA T. WILLIAMS NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Unknown (Doe) 4440 Morgan Territory Rd. , #19 Clayton, CA 94517 RE: CLAIM OF: Unknown 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: [X] 1 . The claim fails to state the name and post office address of the claimant. [X] 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [ ] 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4 . The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 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. [ J 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: August 11, 1995 at Martinez, California. 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) C.a;-- to: BOARD OF SJPERVISORS 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 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 5911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, 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 R£: Claim By ) Reserved for Clerk's filing stamp RECEIV�® Against the County of Contra Costa ) AUG 10 or 1.ERPoARD OF SUFE& F_' f0t1S. z ,, District) -.; �F. Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 3 g, a and in support of this claim represents as follows: 1. When did the'damage or injury occur? (Give exact date and hour) 3 a 6- 9 S_ 21 LAI 2. Where d the damage or Injury occur? (Inc ude city and county) . .�W�� �a t�S �cenacc a- -.Q�,c:�'�, cPo� ►t.o C..s�.-- �.v;� c�� $�-s-'� '' 3 How did the damage or injury occur? (Give full details; use extra paper if required) 4. What particular act or omission on the part of county or district officers, � servants or employeescaused ma ed the injury or damage? V,0+ repo, i x. o Lu-Ca a t,(. -6' k 5. wnat are the rimes of county or district officers, servants or employees causing t3i ca;age or injury? C1,tK_ ?� �t¢,t y ca s pot 1XZC.-- 5. w What damage or injuries do you claim resulted?- (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount sclaimed above computed? (Include the estimated amount of any prospective injury or da •) (�W °D Loi(, kmsS4zjA* 00 0 3 r00 $. Names and addresses of witnesses, doctors and hospitals, e � #.� 9. List the expenditures you made on ace oun.t 6T this accident or injury: DAM ITEM AMOUNT ,\ 4 nrill, r 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 Cla' 's Si ture Addre . Telephone No. - Telephone No. * * * N0T, ICE Sect in 72 of the Pe al Code provides: "Everypexson?,�aY o; with intent to defraud, presents for allowance or for paym�7t-*to any state board-or officer, or to any county, city or district board or offiee�;,. 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 x both s-ch imppriso.nrjent- and fine. i f , s e n. - . (its- Gvc'2e 1/0 10 IC r- CLAIM n Q BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA l� September 19, 1995 Clp;m n^2'^st the County, or District governed by) BOARD ACTION `_::;ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Eucro 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: $1,636.43 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Barbara L. and Curtis L. Cole ATTORNEY: Date received ADDRESS: 2623 Francisco Way BY DELIVERY TO CLERK ON August 14, 1995 E1 Cerrito, CA 94530 BY MAIL POSTMARKED: August 11, 1995 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, BB DATED: August 21, 1995 ��1L DeputyLOR, Clerk . A o II. FROM. County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 1 Z S 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). 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: g-/9—/q 9s PHIL BATCHELOR, Clerk, B , 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 Earning 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: 0-02C) .—/q g_!e,;— BY: PHIL BATCHELOR by L�eputy Clerk CC: County Counsel County Administrator Clare: to: BOARD OF STRERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMAhrr 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. Ifclaim 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 ) AUG 14 1995 or ) District) CLERK BOARD OF SUPEh"djS`)RS CONTRA CCs sTA rp'n Fill in name The undersigned claimant hereby makes claim against, the County of Contra Costa or the above-named District in the sum of $/ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did 'theAdama or injury occur? (Inelu My, aunty ; ;�� N 3. How did & damage or ini ur? (Gi a full details; use extra paper if required) �,'i , w.ct G'�/�JT � ' ' A�3'S ia Th�'Uc��`� �M96 G t 6� 8/-�X�o G ��U�IJ Com' J T�` � f�/ .0 .�E / LpW7Wc.7J MON n/�S7l, 1.z �S A 7�J, i� E c�2,Owc/ &I-P� ez&e , „� CJS �i �► C'A,�. Nd ;�5 e! del v6e C11$��� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 17 �y A! �. wnat; are the nz.-aes of counLv or district officers, servants or employees causing the image or injury? iV 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach wo est:kmatep for auto e. ii 15.E 1-117 7. How was the amoAt claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors and hospitals. ���� 6! ��J�-<�� �, y iC: "'�ab�i� ��� �/ �C.lt✓ vs^' 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT . , Gov. Code Sec. 910:2 provides: " claim must be igned by the t SEND NOTICES T0: (Attorney) or ome erso is Name and Address of Attorney tis Signature / Address. f 60 1 f � C- Telephone No. Telephone No. N Q 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 imprisonr.}ent and fine. DAMAGE REPORT COLE 08/09/95 at 15 : 41 D.R. 25822-0000207 AA137377 Est: J. LUCERO CONTRA COS '3'A BODY SHOP PARTICULAR WORK FOR PARTICULAR PEOPLE 2323 BARRETT AVENUE RICHMOND, CA 94804- ( 510) 233-8290 Owner: CURTIS COLE Day Phone : ( 510) - - Address: 2623 FRANCISCA WAY Other Ph: ( ) - - EL CERRITO CA 94805 Deductible : $ N/A Insurance Co . : Phone: Claim No. : Adj . . 84 LINC MARK VII LSC 2D SED BLUE 8-5 .OL-FI Vin: 1MRBP98F2EY653114 License : lMDA018 CA Prod Date : 0/ 0 Odometer: 0 Power steering Power brakes Power windows Power locks Power driver seat Power antenna Power mirrors Tinted glass Body side moldings Dual mirrors Air conditioning Rear defogger Tilt wheel Cruise control Auto level Climate control Elec. instrumentation 4 wheel disc brakes Leather seats Recline/lounge seats Aluminum wheels Clear coat paint -------------------------------------------------------------------------------- REPR/ PART NO. REPL DESCRIPTION OF DAMAGE QTY COST LABOR PAINT MISC -------------------------------------------------------------------------------- 1 FENDER 2* Repr LT Fender 1 1 . 0 2 . 8 3 Add for Clear Coat 1 1 . 1 4 R&I LT Whl opng mldg w/o spcl 1 0. 3 5 R&I .LT Side molding 1 0. 3 6 R&I Nameplate Mark VII 1 0. 3 7 DOOR 8* Repr LT Outer panel w/keyless entry 1 1 . 0 2 . 5 9 Overlap Major Adjacent Panel 1 -0. 4 10 Add for Clear Coat 1 0. 4 11 R&I LT Side molding upper 1 0. 3 12 R&I LT Lock 1 0. 3 13 R&I LT Handle , outside chrome 1 0 . 3 14 LT Trim panel R&I 1 0. 5 15 QUARTER PANEL 16* Repr LT Outer panel. 1 1 . 0 2 . 8 17 Overlap .Major Adjacent Panel 1 -0. 4 18 Add for Clear Coat 1 0. 5 19 R&I LT Whl opng mldg w/o spcl 1 0. 3 20 R&I LT Side molding 1. 0. 3 21 TRUNK LID Page : 1 DAMAGE REPORT COLE 08/09/95 at 15: 41 D . R. 25822-0000207 AA137377 Est: J. LUCERO CON'T'RA COS 'T'A BODY SHOP PARTICULAR WORK FOR PARTICULAR PEOPLE 2323 BARRETT AVENUE RICHMOND, CA 94804- ( 510 ) 233-8290 -------------------------------------------------------------------------------- REPR/ PART NO . REPL DESCRIPTION OF DAMAGE QTY COST LABOR PAINT MISC ------------------------------,------------------------------------------------- 22* Repr Lid 1 1 .0 2 . 5 23 Overlap Major Adjacent Panel 1 -0. 4 24 Add for Clear Coat 1 0 . 4 25 R&I Lock w/trunk ajar 1 0. 6 26 R&I Nameplate Mark VII 1 0. 3 27 HOOD 28* Repr Hood 1 3. 5 29 Overlap Major Adjacent Panel 1 -0 . 4 30* Add for Clear Coat 1 0. 6 31* TINT COLOR 1 0. 5 32* PINSTRIPE TAPE 1 0. 5 T 15 . 00 33* COVER CAR 1 0. 3 T 5.00 ---------------------------=---------------------------------------------------- Subtotals =__> 0. 00 9 . 1 15 . 5 20. 00 Page : 2 DAMAGE REPORT COLE 08/09/95 at 15; 41 D . R. 25822-0000207 AA137377 Est: J. LUCERO CONTRA COSTA BODY SMOP PARTICULAR WORK FOR PARTICULAR PEOPLE 2323 BARRETT AVENUE RICHMOND, CA 94804— ( 510) 233-8290 Parts (Subject to Invoice ) 0.00 Labor 9 . 1 units @ $52 .00 473. 20 Paint 15. 5 units @ $52 .00 806.00 Paint/Materials 15. 5 units @ $20.00 310. 00 Sublet/Misc 20. 00 -------------------------------------------- SUBTOTAL $ 1609 . 20 Tax on $ 330. 00 at 8. 25000 27 . 23 -------------------------------------------- GRAND TOTAL $ 1636 . 43 -------------------------------------------- INSURANCE PAYS $ 1636 . 43 Estimate based on ROTOR CRASH ESTIMATING GUIDE, tion-asterisk(') items are derived from the Guide DR2KB84, Database Date 4195 Double asterisk(") items indicate part supplied by a supplier other than the original equipment manufacturer, EZEst - A product of CCC Information Services Inc. Page : 3 DAMAGE REPORT COLE 08/09/95 at 15=39 D .R . 25244-0000536 AL 135822 Est: Not On File . E-=:in%iS-1" E3 E3tDE>'Y' S"CDt:11 WE GUARANTEE CUSTOMER SATISFACTION 251 24TH STREET RICHMOND , CA 94804- ( 510 ) 233-3233 Owner = CURTIS COLE Day Phone: - Address= 2623 FRANCISCO WY. Other Ph: - EL CERRITO CA 94530 Deductible $ N/A Insurance Co . : Phone= Claim No . Adj. 84 LINC MARK VII LSC 2D SED CHARCOLE 8-5-OL-FI Vin= 1MRBP98F2EY653114 License= lMDA018 CA Prod Date: 1/84 Odometer = 0 Power steering Power brakes Power windows Power locks Power driver seat Power antenna Power mirrors Tinted glass Body side moldings Dual mirrors Air conditioning Rear defogger Tilt wheel Cruise control Auto level Climate control Elec_ instrumentation Keyless entry 4 wheel disc brakes Leather seats Recline/lounge seats Aluminum wheels Clear coat paint Metallic paint -------------------------------------------------------------------------------- REPR/ PART NO . REPL DESCRIPTION OF DAMAGE QTY COST LABOR PAINT MISC -=------------------------------------------------------------------------------ 1 HOOD 2* Repr Hood 1 0 .5 3 .5 3 Add for Clear Coat 1 1 .4 4 FRONT PANELS 5* Repr Header panel w/LSC model 1 0.5 1 .8 6 Overlap Major Adjacent Panel 1 -0 .4 7 Add for Clear Coat 1 0 .3 8 R&I Ornament header panel 1 0 .3 9* R&I Nameplate 1 0.3 10 FENDER 11* Repr LT Fender 1 0 .5 2 .8 12 Overlap Major Adjacent Panel 1 -0 .4 13 Add for Clear Coat 1 0 .5 14 Repl LT Whl opng mldg w/o spcl edtn 1 41 .23 0 .3 15 R&I LT Side molding 1 0 .3 16 R&I LT Lwr mldng fr . w/LSC w/o 1 0 .3 17 R&I LT Lwr mldng rr w/LSC w/o 1 0 .3 18 FRONT LAMPS 19 R&I LT Park lamp assy 1 0.3 20* Refin TAPE STRIPE 1 0.3 T 15 .00 21 DOOR Page= 1 DAMAGE REPORT COLE 08/09/95 at 15-39 D .R . 25244-0000536 AL 135522 Est: Not On File . WE GUARANTEE CUSTOMER SATISFACTION 251 24TH STREET RICHMOND , CA 94804- (510) 233-3233 -------------------------------------------------------------------------------- REPR/ PART NO . REPL DESCRIPTION OF DAMAGE QTY COST LABOR PAINT MISC -------------------------------------------------------------------------------- 22* Repr LT Outer panel w/keyless entry 1 2.5 2 .5 23 Overlap Major Adjacent Panel 1 -0 .4 24* Add for Clear Coat 1 0 .4 25* R&I LT Trim panel R&I 1 0 .5 26 R&I LT Blt mldng w/o vnt wndw 1 0 .3 27 R&I LT Side molding upper 1 0.3 28 R&I LT Sd mldng lwr w/LSC w/o 1 0 .3 29* R&I Edge guard 1 0 .2 30 R&I LT Mirror w/heated chrome 1 0 .3 31 R&I LT Cyl & kys w/illm entry 1 0 .5 32 R&I LT Handle , outside chrome 1 0 .3 33* R&I. KEYLESS ENTRY 1 0.3 34* Refin TAPE STRIPE 1 0 .3 T 15.00 35 QUARTER PANEL 36* Repr LT Outer panel 1 2 .5 2 .8 37 Overlap Major Adjacent Panel 1 -0 .4 38* Add for Clear Coat 1 0 .6 39 R&I LT Whl opng mldg w/o spcl 1 0 .3 40 R&I LT Side molding 1 0 .3 41 R&I LT Lwr mldng frnt w/LSC w/ 1 0 .3 42 R&I LT Lwr mldng rr bdy mldng 1 0 .3 43 REAR LAMPS 44 R&I LT T1 lmp assy LSC w/o spc 1 0 .5 45 R&I LT Side marker lamp assy 1 0 .4 46* Refin TAPE STRIPE 1 0 .3 T 15 .00 47* Refin COVER CAR 1 5 .00 0 .2 48* Refin TINT COLOR 1 0 .5 -------------------------------------------------------------------------------- Subtotals =__> 46 .23 15 .3 15 .0 45 .00 Page= 2 . DAMAGE REPORT COLE 08/09/95 at 15=39 D .R . 25244-0000536 AL 135822 Est: Not On File . FEE a^—e!E>- -` 6E3^ )r E3 C7 E>Y !F>- "C3 F=1 WE GUARANTEE CUSTOMER SATISFACTION 251 24TH STREET RICHMOND , CA 94804— (510) 233-3233 Parts (Subject to Invoice) 46 .23 Labor 15 .3 units @ $53 .00 810 .90 Paint 15.0 units @ $53 .00 795.00 Paint/Materials 15 .0 units @ $23 .00 345 .00 Sublet/Mist 45.00 -------------------------------------------- SUBTOTAL $ 2042.13 Tax on $ 436 .23 at 8.25000 35 .99 -------------------------------------------- GRAND TOTAL $ 2078 .12 -------------------------------------------- INSURANCE PAYS $ 2078 .12 FAX #510-233-9761 Estimate based on MOTOR CRASH ESTIMATING GUIDE. Non-asterisk(*) items are derived from the Guide DR2884. Database Date 7/95 Double asterisk(**) items indicate part supplied by a supplier other than the original equipment manufacturer. EZEst - A product of CCC Information Services Inc. Page= 3 „�- �� M } �, ,,: r �� �.,,� `� i U � --`� ~? ���� << � � �� � � � . � �� eJ � '� � � �. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 Cia:rr as?4^s.t the County, or District governed by) BOARD ACTION ;ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Duca 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: $500,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Jeanette Flores ATTORNEY: Michael Train Caldwell, Esq. 100 Van Ness Ave. , 19th Floor Date received ADDRESS: San Francisco, CA 94102 BY DELIVERY TO CLERK ON August 24, 1995 BY MAIL POSTMARKED: August 24, 1995 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. B s DATED: August 24. 1995 g�Il DeputyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.6). ( } 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: Z r 4 S 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). 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: PHIL BATCHELOR, Clerk, By 2Z 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: BY: PHIL BATCHELOR by aL.,-)Deputy Clerk CC: County Counsel County Administrator CLAIM AGAINST THE CONTRA COSTA COUNTY JAIL Government Code sections 910 to 911 .2 require that all claims must. be presented to a governmental entity. within 6 months of the date of incident . TO: CLERK OF THE BOARD OF SUPERVISORSEC EIVED 651 Pine Street N: Martinez, CA 94553 AUG 2 4 1995 CLAIMANT'S NAME: CLERK BOARD OL OORS3a Jeanette Flores CONTRA COSTA Co. CLAIMANT'S ADDRESS: C/0 MICHAEL TRAIN CALDWELL, ESQ. , 100 VAN NESS AVENUE, 19TH FLOOR, SAN FRANCISCO, CALIFORNIA 94102 , (415) 431-3200 . DATE OF INCIDENT: 6/14/95 LOCATION OF ACCIDENT: Contra 'Costa County Jail, 9.01 Court, Martinez, CA 945.53 HOW DID ACCIDENT OCCUR: On June 14, 1995 claimant, went into labor while in custody at the Contra Costa County Jail facility. She was examined by the nurses at the facility whom refused to summon medical assistance. . Some 6 hours later, after continously requesting medical attention, she was finally taken by ambulance and, while in transport, she went into labor and her child, Theresa Marie Burks, was born prematurely and eventually died. DESCRIBE INJURY OR DAMAGE: Wrongful death of her newborn infant, Theresa Marie Burks, intentional infliction of emotional distress . NAME OF PUBLIC EMPLOYEES CAUSING INJURY OR DAMAGE, IF KNOWN: Unknown. a AMOUNT OF CLAIM: $500, 000 . 00 DATED: August 22, 1995 M' ain Caldwell, Esq. Attorne for Claimant JEANETT LORES 1 l � t r t ..r N T J W N Q O d u1c° ZU ' c I Uoc� � CLAIM C , BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 Cl?4r* a^��rst the County, or District governed by) BOARD ACTION :` `_::;ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Sura Action. All Section references are to ) The copy of this document mailed to you is your notice of Ca.lifcrni•a Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $1,500.00 �Zy CckyFlP 913 and 915.4. Please note all 'Warnings". CLAIMANT: John and Irene Hatch AUG 2 ;�, tu��► ATTORNEY; �nez,CA94553 �� �' Date received ADDRESS: 1527 Marshall St. BY DELIVERY TO CLERK ON Auzust 22, 1995 Antioch, CA 94509 BY MAIL POSTMARKED: Lag sit 21 , 1995 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH gg DATED: August 22, 1995 BYII DepuiYLOR, Clerk . JJJA'�Q I A 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 910.6). ( ) 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: 2—'L 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 Superviscrs 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:_ 9'l9' 9 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 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 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: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator a -Clair to. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Cla;L s relating to causes of action for death or for injury to person on 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. R£: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) AUG 2 2 19% or ) District) CLERK BOARD OF SUPERVISORS CONTRA COSTA G0: (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) 2. Where did the damage or injury occur? (Include city and county) 3• How did the damage or injury occur? (Give full details; use extra paper if required) 4. What particular act or omission on the part of county or district officers, se.^vants or employees caused the injury or damage? �. wnaL are the na-mes of county or district officers, servants or employees causing the carnage or injury? 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Vie m4tz�LI - 3. *.games and addresses of witnesses._ doctors and hospitals. �(t+��-4-1-�x-�..�cL•t"=�.�1ut.�' �a/ �--b;�n a. ,L.-e•�i(7 er'�e-�" /617 marsk. -I1 r-f. vA ,dA ,fin-{ oe-A 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 ,�/ V L� Claimants Signature J (Address) Telephone No. Telephone No, 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 #3. Garry Frank Reynolds tried to light a homemade firecracker. When it wouldn't light, he poured out the contents of the firecracker on the ground by our junipers. He then lit it and the junipers burst into flames causing damage to our property. #4. Garry Reynolds was living with Joanne Cecchini (phone- 778-6674) at the time. According to Mrs. Cecchim, nothing was finalized as far as her being his foster parent. I was told by Mrs. Cecchini that Garry had lived with her since April and she had not received anything from the county for the care of Garry, therefore she is not accepting responsibility. If she is not responsible, the county department for foster children would be responsible. #6. Seven full grown juniper bushes were completely destroyed. The fire also scorched the top left part of our house. This part of the damage was covered by our insurance company in the amount of$1,453.11, which did not include the $500 deductible. Also burned in the fire was our 1974 GMC truck which parked along side of the bushes. It burned the passenger side of the truck; melted both tires; burned the electrical wiring and brake lines; all the windows were destroyed;the interior of the passenger door was melted and the car battery was destroyed. We are claiming $1,000 for the truck plus$500 for our insurance deductible. #7. The amount came from the blue book value from Contra Tel Federal Credit Union in Concord. An exact estimate for a 1974 GMC truck was not available so we were given a high blue book amount of$2,575 and low amount of$1,300 for a 1975 GMC truck. We were told there wouldn't be much of a difference between the 1974 and 1975 GMC trucks. W C72 J ,I: c r, CNJo vi _Lin• R� cn U)LL_ co;r c� t CD u 7 �^ 1 �V� Cc) � go Ir ! I a- CLAIM q BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C" I September 19, 1995 Ci?;m an?inst the County, or District governed by) BOARD ACTION S*i"ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT grid SLcrd Action. All Section references are to ) The copy of this document mailed to you is your notice of Califcrria Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unknown Section 913 and 915.4. Please note all `Warnings". CLAIMANT: Cathy Lewer County Counsel ATTORNEY: Steven L. Weiner AU6 21 1995 2355 San Ramon Valley Boulevard Date received Martinez,CA 94553 ADDRESS: Suite 208 BY DELIVERY TO CLERK ON Angi iGr 9.1 1 AQ5 San Ramon, CA 94583 BY MAIL POSTMARKED: August 18, 1995 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, gg DATED: August 22, 1995 JylL DepuiyLOR, Clerk z. II. FROM: County Counsel TO: Clerk of the Board of Supervisors (This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: Z— S ( 8Y: JZ� 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. BOARDS ORDER: By unanimous vote of the Superviscrs 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: PHIL BATCHELOR, Clerk, By L , 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. Or For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING 1 declare under penalty of perjury teat 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 Novice to Claimant, addressed to the claimant as shown above. Dated: 9-- ?-o /9 9S' BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator RECEIVE® AUG 2 11995 ti CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. c CERTIFIED MAIL RETURN RECEIPT REQUESTED To: County of Contra Costa . CLAIM The Law Offices of Steven L. Weiner hereby present this Claim to the County of Contra Costa pursuant to Section 910 of the California Government Code. 1. The name and post office address of the Claimant is: Cathy Lewer c/o Patra Stathis 232 Jewel Terrace Danville, CA 94526 2 . The post office address to which Cathy Lewer desires notice of this Claim to be sent is as follows: c/o The Law Offices of Steven L. Weiner, 2355 San Ramon Valley Boulevard, Suite 208, San Ramon, California 4583 . 3 . On May 10, 1995, Cathy Lewer was attempting to enter her vehicle which was parked on San Ramon Valley Boulevard, in the Town of Danville, Contra Costa County, -State of California, when she tripped and fell over an unmarked asphalt : obstruction. The unmarked asphalt obstruction was dangerously defective constituting an unreasonably high risk of harm to Claimant. The property as described herein was improperly and negligently designed, constructed, repaired, inspected and maintained. Said dangerously defective condition proximately caused Claimant's injuries and damages. 4 . As a result thereof, Claimant was knocked unconscious and suffered a broken elbow, injured ribs and has suffered physical, mental and emotional injuries. 5. So far as is known at the time of filing this Claim, Claimant has incurred general and special damages in an unknown amount. Jurisdiction of this matter will rest in the Superior Court. f � DATED: August 1995 LAW OFFICES OF STEVEN L. WEINER By: SAIEVEN L. WEINER Attorney ;for.-..Claimant 1 2 PROOF OF SERVICE [Pursuant to California Code of Civil Procedure Section 1013 (a) 3 4 I, MARYLOU A. QUAYLE, declare that: 5 I am employed the county of Contra Costa, California. I am over the age of eighteen years and not a party to the within 6 entitled cause; my business address is 2355 San Ramon Valley Boulevard, Suite 208, San Ramon, California 94583 . 7 On August 18, 1995, I caused to be served the attached CLAIM 8 AGAINST COUNTY OF CONTRA COSTA 9 x BY CERTIFIED MAIL - RETURN RECEIPT REQUESTED: I am "readily familiar" with the firm's practice of collection 10 and processing correspondence for mailing. Under that practice, it would be deposited with the US postal W 11 service on that same day with postage thereon fully w10 � prepaid in the ordinary course of business. I am aware 3 YM 12 that on motion of the party served, service is presumed a invalid if the postal cancellation date or postage meter > � 13 date is more than one day after date of deposit for > = mailing in proof of service. I deposited envelope(s) W H -, 00 14 containing the above-referenced documents(s) with postage > ,n thereon fully prepaid, in the United States mail at San 0 0 ° 15 Ramon, California, addressed as follows: 0 a o 16 Clerk of the Board of Supervisors w a 651 Pine Street O M = 17 Martinez, CA 94553 aNm m a j$ BY TELECOPIER: I caused the above-referenced documents) to be transmitted via telecopier to the individual(s) 19 named above at the following telecopier number(s) : 20 BY PERSONAL SERVICE: I caused the above-referenced 21 document(s) to be delivered by hand on this date to the offices of the addressee(s) named above by: 22 23 [Messenger] 24 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and corr t, and that this 25 proof of service was executed of August 18 ,,Ft, a Ramon, California. 26 27 ,L U L 28 _L: =_ EO /�4 (1) w w O M `CS to �4 Ul (o dt O d-) M 4-) U 4-) M W N N O 9 O •rq r_: ae a •�+ 0H r-i LO � u "o ru N _ a :-:.. O1 94•8£8 t0{93 £85V6 VINN031"1V'Zi'NOWV8 NVS 802 3.Lins'02l VA31nos A311VA NOWVU NVS SS£Z .» SalepoSSd V ~~ NaARJLS ;a sa:)tj30,.eel CLAIM (2" 9 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 12, 1995 Cle;m,a^� ^Ct the County, or District governed by) BOARD ACTION - L` 1_::;ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT acid Sero Action. All Section references are to ) The copy of this document mailed to you is your notice of Califcrnia Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: IUriknown Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Pacific Gas and Electric Company c/o Thomas Smaniego ATTORNEY: Claims Representative Date received ADDRESS: PO Box 8329 BY DELIVERY TO CLERK ON Air est 1, lAAS Stockton, CA 95ZOS BY MAIL POSTMARKED: Hand DPl i vPrPd via- Ri Gk Mg=- 1. g=,1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. QQHH gg DATED: August 4, 1995 611L DepuiyLOR, Clerk 1I. 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: C 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 Superviscrs 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: 9-/`)- / 99,,� PHIL BATCHELOR, Clerk, By a 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: 9-90 — 9 5' BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator k OFFICE OF COUNTY COUNSEL DEPUTIES: 1: Y PHI LLI P S. ALTHOFF CONTRA COSTA COUNT ' 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) 646-2041 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 August 11, 1995 VALERIE J. RANCHE DAVID F. SCHMIDT DIANA J. SILVER VICTORIA T. WILLIAMS NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Thomas Samaniego P.O. Box 8329 Stockton, CA 95208 RE: CLAIM OF: PG & E Please Take Notice as Follows : The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910 .2, or is otherwise insufficient for the reasons checked below: [] 1 . The claim fails to state the name and post office address of the claimant. [] 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [] 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [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. [] 6 . The claim is not signed by the claimant or by some person on is behalf . [] 7 . Other: VICTOR J. WESTMAN, County Counsel By: Aul 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: August 11, 1995 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) Pacific Gas and Electric Company Credit and Collection Center P.O.Box 8329 Stockton,CA 95208 August 1 1995 - g RECEIVED County of Contra Costa AUG - 31995 Attn: County Administrator651 Pine Street OARDOFSUPERVISORS r CONTRA COSTA CO. Martinez, Ca 94553 Gentlemen: This refers to an incident on June 15, 1995, when your canopy tent flew into our 21kva electric lines, burning them down at Glacier and Muir Road in Martinez, Ca. The conditions under which this damage occurred indicate you may be legally responsible for the damage to our Company' s property and, in our opinion, we have the right to recover from you the cost of repairs which are presently being determined. If.. you have 'irisizranc6"coverage, please provide the name and address-,of-your in6urance' carrier, as well as your policy number-in .the space"-provided below. We• will then forward our bill for damages to them. If .you do not have insurance, we shall forward our bill to you for payment . Please call me at 800-945-5251, Extension 7470, if you have any questions . S 'ncerely, Thomas Sa a iego Cl ms Re esentative TS. A/R No. : 9507169 D&C No. : UJG 1244888 ------------------------------------------------------------ ( ) Submit _ invoice directly to me for .payment . ( ) Submit invoice .to insurance carrier. Insurance Company:, Agent : Address : City: State,: Zip: Phone : Contact Name: Claim/Policy No. : AR No. : 9507169 County of Contra Costa Owl uj Lo i. Zd LLJ Ul to O 19 1 ::r- ulQ ca (co) CC .en. C:) 1fiAS c0 10 Ira Sp 1tl6S3�� tl }t9 �t f G ens a E a v d v o W oCl Ts r v 1 N O aO R V ` yp o o- .. CLAIM C. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 19, 1995 C,14m cC,0;fIst the County, or District governed by) BOARD ACTION S.:,ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT acid BLcrc Action. All Section references are to ) The copy of this document mailed to you is your notice of Califcrnia Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Goverwent Code Amount: $3,149.76 Section 913 a.pd 915.4 note all 'Warnings". Bounty Co�'6i CLAIMANT: Progressive Adjusting Company Claim # 950313502 fa 1 9 ATTORNEY; �A Date receivMartinez,CA445.53 ADDRESS: PO Box 1418 BY DELIVERY TO CLERK ON August 22, !995 Rancho Cordova, CA 95741-1418 BY MAIL POSTMARKED: August 21, 1995 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH gg < DATED: August 22, 1995 BYIL DeputyLOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( kolrThis 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: 1�7— 2-2 `cT S BY; 1��_,_ 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 Superviscrs 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: ?-/9-/ 9 9S 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 innediately. * 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: 9",,Zr7 —19 9,6- BY: PHIL BATCHELOR by J eputy Clerk CC: County Counsel County Administrator 3 "la; BOARD OF SPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS To CLAIMANT' A. Claim-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 mist be filed against each public entity. E. Fraud. See Penalty for fraudulent claims, Penal, Code Sec. 72 at the end of this for--. RE: Claim By Reserved for Clerk's filing stamp R ECEVED &gamy_ 4u&o ECEIVED AUG7 19 4 Against the County of Contra Costa—) U221995 or F CLERK BOARD"O�SUPE�Rvjsonaj 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 �4q,7L and in support- of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) June i2th 2. Where did the damage or injury occur? (Include city and county) Ad Lat dreeg; Ld, 3. How did the damage or injury occur? (Give full details; use extra paeA required) LZ al rad wume 16tw;--4VWJ._4dd_,�_ oked, -bv -4/-F&A-4- 4. What particular act or omission on the part of 'county or district officers, servants or employees caused.-the injury or damage? W47 a/I. U41uress-ail fi'sk PC6+ preffr Wim'` hvbf t-516 Wnat are the ria-rnes of county or district officers, servants* or employees causing the -da:�--ge or Injury? ___ L,1tW 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages,claimed. Attach two. estimates for auto damage. P-M 'e- -10 -ft, - 1Vtk*-11A pow'- lycAve f1toweAq _r05kVq-S Je do c-k b k 314 9,76, 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) B. Names and addresses of witnesses, doctors and hospitals. A Okw,s 34.0 I/j-O-Fa &CS 20 CA 4 tz-4 46eA 4 #p N#w-- and carof 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) orAm-,*ome person on his behalf." Name and Address of Attorney 7 (Claimant I s,Signature) Fa &vc 1445 Aq qS626- kAddr4ess. ' Telephone NO. Telephone No.. ..._ �2be-3S*3 �I Ss -5 T V W W I I I V W 7 e6n tL 11!i0313-5-021 NOTICE Section 72 of the Penal Code provides: "Every person who, withintent to defraud, presents for allowance or for payor pt 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 su--h imprisonment and fine. 2 8 1995 W n7 cx••a kg t.. . „ L s sw5�.v. t .:cx a, ,.,- .o s '�.,,. : �.'� .fie ., .s. .t..,_.,w,, f st..t. �. + »:S;sy r �'? c'Sih,�r' »`�Y sem„ �•�i.;.t�,. ;�2 Stu ata'",tc zki� ':t rr, � �c.e �3 �,j,Ytit r,.....—��c,� � se tr�r n,+i- ` �'.�°d - i`�. 9 '�'C{` �� -�, �A�'�.a'`.7' �{�t7•'r s. .:c. `# �y� 't ,��.�! 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'`.:*y`N-t'�w'%... _"'hA�. $F-£ = FL�` s- Y%"'•,�-a „r-i.H�-1 fC ,',:��i}s••4v�?�' \J5 :y j -. Y I -Mgg"'d T f s ► en .� r Y l� L f COQ. # cr. Ataoti�t y� Cem F s g a ' LN ei F,y 4 REB. # ` . MA,•w'".y » PR99REIII F CLAIM REP.&PHONE COMPANY CODE ATTACH TAPE S1 UtA 'DO� -L444'T NAMED INSURED - CLAIM NO. POUCV NO. CLAIMANT OWNER LOCATION OF INSPECTION UENHOLDER PHONE NO. ^ 2 DATE OF LOSSG INSP.DATE/&TIME _ REPORT DATE&TIME RESIDENCE: 5 J WORK: [14 dr 02dr ❑PN MC _ ❑sw. ❑Hoc--- ❑Ver,_ ❑RV 5C-EA_600Y�t-4_ou('b�S c�S 3 13 c`t C`f gv< s DET1C1f.S± Z£tEPIUE# PR IDUM, a CI Fare fie8rt i lK0Parts Plags= Pale CONDITION t :t�mod [1 _ Hottrs BSubiet f LaGm ,.- �� ,Y' rfic. 1 f-IZ ri1-lZi r l G 2 !u tAoni-t f` t l 3 )c S 155 4 s s 8 R 1 9K 9 k Ff1 T Kir 10 s►ssy BHS' t� �u: 11 IX CzjPk 17 5 I 12 13 (6 14 15 16 17 _ 18 19 20 21 22 23 24 25 ---- -- -- 26 - — - 27 —- - LOCATION OF LKQ/AFTERMARKET-' TOTALS'-._-, New Parts._.._.._.__.._ Less%. $. LKQ Parts&Sublet $ BET ERMENTIOLDDAMAGE Mechanical USE REVERSE SIDE FOR TOTAL LOSS ANALYSIS -- _ Refinishing Mrs.@$ REPaRFACIUTY Refinishing Material Hrs.@$ $ $ % tax$ ADDRESS -_Towing&.Storage $ PHONE AGREED PRICE'._ --- .._--..__ __Subtotal_; $ _ Less:Deductible $ SHOP MGR:SIGNATURE--- --.._..-..__-._.-_...... . .- ._.-.. .. ._...____...--_..-..-.... .._Betterment $ . Net Total$ FORM 0135 8/94 CA Repair Authorization Must Come From Vehicle Owner You Have The Right To Select The Repair Facilty - - No Supplements Without Reinspection-__-. ~- JUL-05-'95 WED 23: 19 ID:CONCORD KAWASAKI TEL NO:415-609-5770 ##941 P02 ,�LdCf ((ATCtO))) )OWING AND ECOVERY 2653"W'CLOVERDALE AVE 1 Q 1 1 {a« Y: NO CONCOM CA(510)82'1-060 18 �, : L i7 24 HOUR SERVICE CASE NO_.... DATE ,.i NAVE CoU.NG.u:tl ADDRESS v; '_�J%A Q � A(I(s CITY a STATE ... _ ZIP: PHONE: 72 51/ TOW REOESTE,- { TIME YEAR _ MAKE V/41 ,4 �A LIC.N0. COLOR �L:' VAN.NO. OM7.'LR / ..,. CHAnOL I OXACCT, FoRJUNX REPORTED 10 _: TOxe snarl L. RiaJt Q DOLLY l..!'x KEL—r-1 CAAR6YRo 7P-r9 109'f 10-64 /� 10.06 10. JIM 74x #TAJR I.rJi i�M '� 4 AVYAm=D Cms C:-...:1,FFGa: i 9 3 WMIIIAOEt SROM: f TO: TOTAL OA1'6 - i 11ALfAOA OF ¢ P HOHi NO. t / } •• cnveo R1� er ,� � t( � TOTAL R,O. P.O. 1plp f1PIR►Tgr: willm"paw ND,OR ORarERS LE,tq. t: :HARGE 1.5%MONTHLY ON UNPAID BALANCE ;i :z ;t. JUL-05-'95 WED 23:10 ID:CONCORD KAWASAKI TEL NO:415-689-5??O #941 P01 OQ in In O OA � 4r y) 1 11 � N N N � T A O D � j m • _. P' v i ! I � I ci t � rna s Q umt C r L: y r rt iX1 O All i tit o ccr m !91 m t� y c aj (aZ C}i Di Vi Uni Ci rr omR.a;mn. � � � w • ; m� ;f LU T1 >� �Un 0 cny_ /// O m y c iJt O 2 X Z SN 7'Y � CIO Q a 1 m i c: r• � ED In rD I x Q N a . CX? a- m r� i ; - f JUL-05-195 WED 23:19 ID:CONCORD KAWASAKI TEL NO:115-Ge9-57?0 #911 P03 AS LIST r-U�011 1,ABOrl Ar4D NIAl' 'ALS ESTIMATE OF REPAIRSVEnrJAI.AGREENIENTS NOT Bit'ji.) U-h5IIMATLS FREE 6c, (aAc5s- 6pPoEp No. nJSU A NCE c t 1. CG Js-73. PHONE ..... oar,_ MILIC-Qr 05TOR No: Y 2..12 ....... '9 0 33J , 2 c - a G a�/ - -:% -�-�, k„r '� �� - &Z 3L ul, - 6 IU 2L LAJI 7 1'�l A' /A !!t O Or) o CATAt.OG Fi(CICUWAIUP VNICE 1,6 1"SUBJECT 10 CF. WITH(Illf tvfl I ICF.' I--To T Q"' ;All All(I LOCALLY. r r. C u I I-.I C,N i ra 1: r I L. t 10 W: t y V L b U U 10 f I �Wr.C IA I, V,C 1:0 P4 t T E Ni S N, MA-ri '.IIAL -ZZA U1;1 PaT'T I 1 t V U f i'll's Ci,Lt, 11 t !'.t TMAI I_ k1.'-LW ER A r.,I))I I uN!k L, P-IZTS OR, I Vil ilt'l I t;i- tlro,.)l T'!LC: -f I f N 'I I Ir viOltK 11AS vf.'ar el,.Ntl)UP, C)CCA- TO Ttk L.JVIA� L-I I IAt :o' 4L f, , � 1:1()N A�'L Yf, 1 1; N�1% 1 U I A Ft T f,0 wn W N +,n n'j ,.[?C VG', Z'e,'Ol 9 r'C41 V, „SII A R C t40 I t CTIU1!1' ,,:AUSE ()F ;"W.I. tlif CsQ CPAI(7f", AD(: t GVAW\NTtEO. r.s I I MATEI AX f C.:,T;MAYEC1(,Y APPROVEC)BY PAIOOV'T' Ak-ITWORILLD AND AC(',PP-f ED If (i'C') CNT EA!�!L 1H 420 rI;PqEQR0 -74 JUL-05-195 WED 23:20 ID:CONCORD KAWASAKI TEL NO:415-669-5770 #941 PO4 X46 ESTIMATE OF REPAIRSAS L I STEI) FOH LABOR AND MAT. :A L S VEnIsAL.A(j)IL t MENTS NOT BIND-:Li L-z;l IMATU.S FREE --- --—- - 2 - - :--r I Kl (jw fy c R OATC A Doo Ebs PH"61Wi- EST. 140. ........... ............... INSURAW:l: (.0. ORDER NO. gGORfSs PHONELICENSE NVM�kR y C.A R P., F. L N(1, MAOFL Mrd,f,gCG F. moyon r4 LOH -el7l/2 ------ 7- LIZ �z f3m. C.- CIO FS 3 Y -7, Q V D ---A;J Zuliel-.- ........... J/ ' -/Q-L a .--S F PAM IS Nl iCES BASE:1) UN S I AfJ&,Fi 0 CATAJ 06 PROCU PC Y.E NI PHIGL LISTS SUBJECT TO E WIT HOU r NOTICE. 'TOTAL Pnocurii.mrNI ANU UEA IVERY C.11APOES MAY UF AUrA 17 f'Jfi SPECIAL sEnvicE ON LOCALLY. NIATLMAL ()I Ij PAIIT,,,PE EO I"Urli Ck't:V,'I 1.L BE JUNKED UNLr":S Eli 111;!VOISI INST FiUrtf u IN Wr(l'!. Ti4l. A!;Ovt- is AN Ct'TINI;l.T f' rcaSfiU ON (?UP lN:.PL7CT 1C,N AND DOCS NO I I IONAL .7 Q T A L 13 1.; P A I S ()P� I /keop "41,11C.1i BIC..- RE �P-QUIQLA., Ar'l WORK HAS 6C�:X ;':)LNLr) UP. oCCA- Slol 4 A,ct.y '�F-yf.r V,'ORK I A5 'l VARTEU ',VOPN P,4f'7�; ARE. DI�'COVERE'I;j V. ..H ARE NGT CVI- DENT '.,N 1, FiFCAUSE OF -rtf'S Tv< APOVEPRICE-75 APF '-'!T GUAAAN-1 F--E:L). I UTA.L r.I AT E I i I E.s.riMATE I Ax _!�-Ll M A I L L E3 Y APPROVED BY AUTHCI RILED AND ACCEPTED ....... BY()VV N[-.I SLJ(3L.ET REPAII-;:. OR AGENT DATE f 4)4429 rtIEDFORM. iNTRA.6FF'CE ROUTING TICKET _ To'. PROGRESSIVE`�E f r ten. PROGRESSIVE ADJUSTING COMPANY UnWo t._ �7_t._�� 1500 FASHION ISLAND BLVD. SUITE 208 �7 SAN MATEO.CA 84404 FROM:--- rte`jre (415)578-0494 UnitlDeP. . TO: --- _____---———a woav� �---_ COMMENTS: 4377(2-80) Attention: Julie Aumock Claim Number 950313502 Our Insured James Davis Date of Loss June 28, 1995 Dear Ms. Aumock:. This letter will follow up our conversation on July 19, 1995. In this conversation you indicated that you would forward to my attention all the necessary claim forms for Progressive Insurance Company to file a subrogation claim regarding the above loss. It is my understanding that these forms will be sent as soon as possible so that we may resolve this matter within the 6 month Statute of Limitation. By copy of this letter I am notifying our insured that we will present our subrogation claim along with all supporting documme tattion to your attention. Please contact my office if you have any additional questions. I look forward to receiving the forms soon. Sincerely, Stuart J. Poon St. Claims Representative PROGRESSIVE ADJUSTING COMPANY cc: James Davis 3460 Vista Oaks,Apt. 208 Martinez, CA 94553 PROGREMYE Date: to �� Claim Office Location: PROGRESSIVE COMPANIES 1500 Fashion Island Blvd. #1208 San Mateo, CA 9$40A p QaASA_ CW l 4!—�) Re: Policy Number:t� Lt J v S� ()0,�- Date of Loss: qq�5�_3 _ Claim Number: EXPLANATION OF COVERAGES THIS FORM IS FOR INFORMATIONAL PURPOSES ONLY AND IS NOT INTENDED AS CONFIRMATION OF COVERAGES. The paragraph(s) marked with an X' indicate the coverages, deductibles and limits set forth on the declaration page of the above referenced policy. These coverages are subject to the terms, conditions, definitions and exclusions in the policy. 1 Bodily Injury Liability C , Limit: h 15, 000 per person fl :3D:MD per occurrence Property Damage Liability Limit: . , k-01t7C7 per occurrence ❑ Medical Payments Limit: per person (Limited to bills incurred within one year of the injury) Damage to Your Car Comprehensive: .6 350,QD deductible Collision: 1)-PO deductible ❑ Towing and Labor Limit: ❑ Rental Reimbursement Limit: Uninsured/Underinsured Motorists Limit: per person per occurrence ❑ Uninsured Property Damage Limit: ❑ Other The above information is provided to assist you in-understanding the possible coverages that may apply in the above referenced claim. Your Claims Representative will be able to advise if coverages marked with an "X" are available under the specific facts of loss presented by the above referenced claim. Sincerely, --1�TU�✓1 PobAj Title: 167 FORM NO.0095(04/95)CA CLAIMS ai{'4a s ar 'tom'.. .a `'t•' : 3 y c-<� -, .- ����; �, '���.nay_=v�%" �„r .��a ".-': ,"�'�, �:, ',.::_�• .. �`. YK bc ..�" � x y,. � _,.g'P..�,�l�° .�, ` �t�-`•�',�'".'� ,fix.-..,5* ' x �` � e Wt ` .Y 41 Ski t x e. IT { i rxx t 4 01 IV T a M UP fO its as �.. •.`$ �, d t ..iE x �'` ,oar; _' sit �PF } .��� qy� Fax a-�R Y ��r �:..�� '�.��y 3��a{-1• z+'. S`4."{'b �� >a�". dyRT-R tNl- ` An ilpA ' W., ZZ ;�,'. �: aye � ��.- ��. _•`� - � .- � -am -r;� •' - wool, 0 g�g� 1ys F: ?- i' :• ,3 y; a¢av'jy �- - ",:��yY:cx' -L• ~baa N '° _$� `�• �_. � : �, ,gym^ s8' - 1`w 3'�. .,q. '$. ..8` �': � : .asp _ MA x x . w� 5 �` - •swr�a.a�--rte >, _ '44, F' . a Mt >- ai � �� � S - � l^Jw '£e•.y`�,'S 'fie 4' IRK a-it teNK ; ' A, now vw K q� ate'' gw ' m� -y -fib QUM ilk ga 5% Ogg FRO"MRS "w:�ti;i ti AV ifitT'.i I',, Ryffril 'it 'All pp, ggm wpp� AM,iriziffii.:4,3, 'i N Ta---!N i. gg. I'V Al Cii, Rif qj N-5 iANI �Z,W, ?EP- New MUM ..........- MAY IMO I.,rd MI: SO 10 md"i"'I Ril."I N.. O"i own i f. .eG'4 "; .•� � 0-1 C-All p. "./ . O lit , e co co to 0 N co „L :rte O s N oD c � Z �Q o V co O p (5, co, swoo, vow 0 Ir t, -oo) ct (f), co N t 0 CLAIM R BOARD OF SUPERVISORS OF CONTRA A COSTA COUNTY CALIFORNIA ' September 19 1995 Cl?;m anairst the County, or District governed by) BOARD ACTION ;:;:arvisors, Routing Endorsements, ) NOTICE TO CLAIMANT arid 6L�Crd Action, All Section references are to } The copy of this document mailed to you is your notice of Califcr, nia Government Codes. ) the action taken on your claim by the Board of. Supervisors .(Paragraph IV below), given pursuant to Goverrunent Code Amount: Unknown Section 913. and 915.4. Please note all "Warnings ' Couns.- cou CLAIMANT: Redwood Mortgage Investors IV � , Aft ATTORNEY: James M. CAdy , 1676 Forth California Blvd. Date recei@ lne,; .CA, � �. ADDRESS: BY DELIVERY TO CLERK ON A Suite 200 22 1995 Walnut Creek, CA 94596-4137 BY MAIL POSTMARKED: Hand Delivered via Ri sLllot, I. .-FROM Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. f Agy1L BATCHELOR, ClerkDATED. u st 23 1995 . eputy124.4 II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( } This claim complies substantially with Sections 910 and 910.2. (r/'This claim FAILS to comply substantially with Sections 910 and 910.2 and we are so notifying P y y y 9 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. 5s- BY: Deputy County Counsel III. FROM: Clerk of the Burd TO: County Counsel (1) County Administrator (2) ( } Claim was returned as untimely with notice to claimant (Section 91.1.3). 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. 4 Dated: PHIL BATCHELOR, Clerk, BY 9)jhL4 L41, Deputy Clerk . P y 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 immedi ate ly. For Additional Warning See Reverse Side Of This Notice AFFIDAVIT OF MAILING I declare under penalty of perjury ttiat 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 e ut Clerk P y CC: County Counsel County. Administrator i OFFICE OF COUNTY COUNSEL DEPUTIES: - PHILLIP S. ALTHOFF CONTRA COSTA COUNTY SHARON L. ANDERSON BRANDON D. BAUM COUNTY ADMINISTRATION BUILDING ANDREA W. CAS S I DY VICKIE L. DAWES P.O. BOX 69 MARKE S. ESTIS VICTOR J.WESTMAN MARTINEZ, CALIFORNIA MICHAEL D. FARR COUNTY COUNSEL 94553-0116 LILLIAN T. FUJI I DENNIS C. GRAVES SILVANO B.MARCHESI TELEPHONE (510) 646-2041 GREGORY C. HARVEY ARTHUR W.WALENTA,JR. FAX (510) 6,46-1078 KEVIN T. KERR ASSISTANTS EDWARD V.. LANE, JR. MARY ANN M. MASON N PAUL R. MUNIZ August 24 , 1995 VALERIE J RANCHE DAVID F. SCHMIDT DIANA J. SILVER VICTORIA T. WILLIAMS NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: James J. Cady, Esq Morgan, Miller & Blair, 1676 N, California .Blvd. , Ste 200 Walnut Creek, CA 94596 -4137 RE: CLAIM OF Redwood 'Mortgage Investors IV 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: 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 cl aim f ai 1 s 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) 1 the claim fails to state whether jurisdiction over the claim would . rest in municipal or superior court. [] 6 . The claim is not signed by the claimant or by some person on is behalf . C] 7 * Other VICTOR J. WESTMAN, County Counsel By: Deputy County -Coup el 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: ..August 24, 1995 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) z 5 EC Keimeth A4..M11/1'r EIVED M V R V N Kultur G.!;lair 4�� Mnrilt/111�Jcr1-i M I L LE R 2 21995 -� Bruce'l,.Rbi�; , A z Darrill D.Ott & B L A I R /rd lame.;t fart-I.; �'r,(�•::i c�a�c t C r �c�rn t i c�ri CLERK BOARD OF SUP V�S� c f CONTRA CC�STi�'CO. IGaIltic'c•u FCitrl�i'11tc'1 Mii hael K.(�► :r11 AT TORN E YS AT LA tip' �111c`c'trl�.Ri�;1i GC.-or e S.callot Ritllcrtl L.t-ilcltlt'= August 15, 1995 1 at riche�It Cow ti1111t11 Times M.0111111 Pamela A.Lt W1. Ch t,01,11 R.1lc�riter Mr. Elton Rapp Contra Costa County Public Works 845 Brookside car Ct►1111:�'I Richmond CA 94801 �.f,•►t,� ; i1 l'i1111,�l�c'�'c•:o.;;1111 Re Property at 510 Second Avenue Crockrett, California Our File No.: .2361.8 Dear Mr. Rapp: B via of introduction, this firm represents Redwood Mortgage Investors IV, Y Y p the owners of theproperty.referenced above (the,.'.Crockett Property"}. The Crockett Property is located downhill and adjacent to the intersection of Star Street and Second Street in Crockett, California. It is our understanding that Contra.Costa Countydesigned, built and is obli ated to maintain and repair both of these streets g and appurtenant structures. Redwood has recentlylearned that the Crockett,Property has an active landslide. A June, 1995 geotechnical investigation reveals how diversion of water from the street has been seeping into the County's soil and running onto the p g Crockett Pro ert for quite some time now. The seepage is a contributory cause of p Y the landslide. We-believe.the water draining from the street is due to` the County's failure to adequately maintain and repair the streets. At this oint the streets"' air has required Redwood to rent a fence to p p protect against potential personal injury. In the very near future Redwood will have to repair. the landslide. The slide can only be repaired as a joint effort between .the Count and Redwood. In order to full repair the slide, the County will also Y y p have to modifythe streets'" current drainage pattern. This letter, therefore, demands � that the Count participate in repairing the Crockett Property's landslide and that County p p the County correct the streets' poor drainage. 16 6 No wrii CA11F-10 RNIA Bi-vD.. SulTu 00 WALNUT CREEK. CA 94706-4 1 3 7 1^ 4(1 0 t` 0 0.1 Z 1 1 r)t, M Mr. Elton Rapp August 15, 1995 MORGAN Page:.2 MILLER B L A I R I�T��1t'::lt�rltl� (..l�!'�it��'.ei 1�►11 K \ f l A"1 L. :. Please contact the undersigned sometime in the next two weeks to arrange for a meeting to discuss the nature of the problem and joint repair alternatives. Sincerely, MOR AIT, M. E & BLAIR JA ES M. C Y JMC-amb cc: Richard G. Blair, Esq. Ted.Fischer Maintenance Yard //Contra Costa County Public" Vljork Maintenance 2475 Waterbird Way Martinez, CA 94553 Redwood:2361.8;Maintenance Yard.ltr/mL-081093 r, CLAIM , BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September- 19, 1995 CI?4m a^ai^.st the County, or District governed by) BOARD ACTION C•- ;, ervisors, Routing Endorsements, ) NOTICE TO CLAIMANT crid hL�crc Action. All Section references are to } The copy of this document mailed to you is your notice of Califcrria Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to.Government Code Amount: $100,000.00 Section 913 and 915.4. Please note.al.l "Warni ngstl. ' CLAIMANT: Denise and Steven Russell ATTORNEY: John Martin 3100 Oak Rd, Station Plaza Date received ADDRESS: Suite 230 BY DELIVERY TO CLERK ON August 17, 1995 Walnut. Creek, CA 94596 PO Box 5331 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. IL BATCHELOR, ClerkU, DATED. August 2119 5 ��0 eputy AL dd II. FROM: County Counsel TO: Clerk of the Board of Supervisors (A4' This claim complies substantially with Sections 910 and 910.2. ' ( ) This claim FAILS to comply substantially with Sections 910 and 910.29 and .we are so notifying claimant. The Board cannot act for 15 days (Section 910.B). ( } 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: Da tel: _ .. 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 Superviscrs 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: PHIL BATCHELOR, Clerk, By%JjftOey put Clerk _,/LJJWARNING (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 consul, 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: - ., BY: PHIL BATCHELOR byPAA,,_JY_&aDeputy Clerk CC: County Counsel County Administrator 4Z,0: BOAM OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO Ci.A DIANT k. Claims relating to causes of action for death or for inr`Y`u . to person or to per- zonal 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 actio:. 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, mi t be presented not later than six months after the accrual of the cause . of action. Claims relating to any other cause of action Faust be presented not later than one year after the accrual of the cause of action. {Govt, Code §911*2*) Re Clamust be filed with the clerk of the. 'Board of Supervisors at its office in Roots 1.06, County.Administration Building, 651 .Fine Street, Martinez, CA 94553. Ce if claim is against a district governed by the Beard of Supervisors, rather than the County, the name of the District should be f*11ed in. D. If the claim is against more than one public entity, separate cla ms must be filed against each Public entity. Eo - Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this RE Claim BY Reserved for Clerk's filing stamp RECEIVED owitsia�40n L U_;5 S Against the ounty, of Contra Costa ) AUG 1 TIM or CLERK BOAR of S�3PE V� o District.) CONTRA COSTA co. Fill in name). The Undersigned cla t hereby makes claim against the County of Contra Costa or the wave--namar District in the sutra of $ and in support of this claim represents as follOWs 1.0 When dial the die,or injury occur? (Give exact date and hour M011 P P Y-0 X RL/Sse)l 11/" A 2. there did the or injury occur? (Includecity $rad county 3 9 N, ro qcl�.OQ R ve E)a' PO)n o n fra, ' C-1,o s q C L -o u r,+Lf -ef) CL +_ ' Glacier i�f-) M 4a, el-Z- t)s Ou oom _1 ...��.� 3. How did the age or i n jury occur?. (Give full details.; use extra paper f re u reds 16� R �t v� S �es--e co ioLl - ,e S h e r j S'ke ui a.&e n ct 4-4 0.c,k S-�Cve(\ Rus-se" , e4- & Q+ X411 m11�1p_qaI1 �e,t 'k e chi J -n6+ v1 o /a4- . P rolo e C>n • what particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? -°- - Oen- s ' 4- PU01C 0,e-�4zndiej\ OL MCI aAja'^ �j�/ +y�,.r�. �,/"�' - �n.l sZoe 8r1LS-P-r-1<::) In�� RU.5 sem= 1 �.1 c �- e , ON 0, gu Set I - )iD vinat ape-wne of counry or district officers, servants or employees cau3in8 �a'a yeor j j t;I"`�y? I nodKno(.A) TIO 0 Re e._O� ' -Y-P f ` i on,, AG ve n d4ev ir M, e� e,-. �ira�►aw+ww/r�Ir�Ayl wM+r'+��rlr lrr•law+�wrr+ww.�+++.+r+Ir.wa�IMlr�rwM��4i �MrIrMM rM�'+II�MMMr`►.I�.►wr1iM���i+�+eaM+�r�'�'�+• w�•s�rar.wr.r i.+. s . 6.40 What age or injuries do yau. :dla im resul ted' (Give N11 extent. of 'injuries or damages c' la i.med.- Attach two,estimates forte,auto damage. dQ1 , KOSS P .,LAS�(apj CO r)-V-u S1 el Mv..Ao' _�ec& LA, S ., wrrw��ra�ra�+r+rrar'.w.r.�,r.+ww.+�w�++rs+�rr+rsili�M�+w wra+w+r�wrr wr+r.�w How was the t claimed above computed? Clnc •ude the estimated amount of any pros ctiie a�nJury or �e.} ... D � `e +46C ��1 .1 C t CL G( cr)mma-� r ._ i c - t ~ .i .. ar�wwr.+r+rr.rr�r�r+�rrn+raw+��.w'urs+r.iwrlr.r.r�rw+iri+rwr�r�rwr+r+ir+w/rr wrww+I�+r+riIr�►+rM►�wl*�wfwrs�wswaww,.s - , 3 games and'. addresses of witnesses, doctors and hospitals ig_a_C &1, 8 road Cq. Oams 31 %Ir . -. M . r dba4 br; ROU% M, i 1 0 �id's �� � .94 List the +expend ittzres you made on account of this accident or injury DAA �:T� M },i.'`c� s sa? s Gov. Code Sec 9'10:2 provides F A n ed the claimant �e claim must be sign by SFS MM (Attorne ) orb some erson on h,�:s behalf4. Dame fund Address of attorney, 100 OCZK, ocd S,k ai 'n IQ ZO�, C,ia�a�ant.s Signature 9 W04 n ► ! _. �.'W" N- 45,qBO (Address, - "` �- + �.' hone ' 4. OVO Telephone 3�o. T pzn;e. NOT- ICE Section 72 of the Penal' Code provides: t' ve e�rson w 0, "ith ntent :t ' defraud presents for :allowance',or ,for ar'y payment to any state. board or officer, or to any county, c i t' or district board or officer author: zed to alhw or pad the same if Benue, any false rr razed en cam: b3.L account, vauck�er or writing, is punishable either by imprisonment iri the county jail. for iod of not more than. one year, by a fine of. not exceeding one thousane ($l,,,'000,):-,,, ".or by both such impr sonment• and. fine, or by imprisonment in t. e State pry s 7, by a f z ne of not exceeding ten thousand, dollars ($10,000'', or by both %c-3 h i�riso:�m,n and fine.