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HomeMy WebLinkAboutMINUTES - 09171996 - C17 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 17, 1996 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. .All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $50,000.00 Section 913 and 915.4. Please note al V CRUW113) CLAIMANT: Andrew Davis, Jr. AUG 13 1996 ATTORNEY: Andrew Davis as Es COUNTY COUNSEL c/o Peter C. Pappas,, q• Date received MARTINEZ CALIF. ADDRESS: 2400 Sycamore Dr. , Ste. 40 BY DELIVERY TO CLERK ON August 13, 1996 Antioch, CA 94509 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. Au st 13 1996 �aIL BATCHELOR, Clerk GATED: � � eputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ✓) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ✓) Other: 1 L. C%OL*I�t (200.>Te-rq COSTA 1 (2AJJS1T oqurtioelTY is NoT- A !aa_rt of � Qu. Qc��nc��w. ,n(` Con-tQocLX-0) Cif- Co•l/r', CASi� �Duwir} r Dated: �� /S /99� BY: �, Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (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• l7 /n&PHIL BATCHELOR, Clerk, B�j�eif.,<_�� 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: �/"z �U! /9ry� BY: PHIL BATCHELOR bite J Deputy Clerk CC: County Coursel County Administrator • , t 1 PETER C. PAPPAS RECEIVE® ATTORNEY AT LAW 2 2400 SYCAMORE DRIVE,SUTIB 4001 � ANTIOCH,CALIFORNIA 94509 li1996 3 TELEPHONE (510)754-M2 CLERK BOARD 0-SUPERVISORS `1 CONT,COSTA CO. 5 ATTORNEY FOR 6 7 BOARD OF SUPERVISORS OR CONTRA COSTA COUNTY 8 CLAIM 9 10 ANDREW DAVIS, JR. , Claimant, GOVERNMENTAL CLAIM 11 CODE SECTION 911 . 2 12 V. 13 COUNTY OF CONTRA COSTA, EASTERN CONTRA COSTA 14 TRANSIT AUTHORITY, TRI DELTA TRANSIT, LAIDLAW 15 TRANSIT INC. 16 Defendants , 17 The undersigned claimant hereby makes a claim against the 18 County of Contra Costa or the above mentioned Defendants in the 19 sum of $50, 000 and in support of this claim represents the 20 following: 21 1 . The damage is a result of an accident involving a bus 22 driven by TONI L. MILLER for EAST CONTRA COSTA TRANSIT AUTHORITY 23 on February 14, 1996 at approximately 3: 45 p. m. 24 2. The Claimant was injuried when the bus collided with 25 26 vehicle driven by JOHN LEE NORD. The Claimant suffered injuries 27 to his mind, body- and nervous system including but not limited to 28 his back, neck and arms . 3. The damage and injuries occurred on School Street, 1 Pittsburg, Contra Costa County, California. 2 4. The individual responsible for the damages is believed 3 to be TONI L. MILLER whose address is 218 West Madill Street, 4 Antioch, Contra Costa County, California. The Claimant is 5 informed and believes that TONI L. MILLER made an unsafe left 6 hand turn in violation of CVC 21801 (A) of the California Vehicle 7 Code. 8 5 . Any and all responses to this claim should be made in 9 writing to and directed to: 10 Anrew Davis 11 c/o PETER C. PAPPAS, ESQ. 2400 Sycamore Drive, Suite 40 12 Antioch, CA 94509 510 754-0772 13 Additional details wil be provided upon request. 14 15 Dated August 13 , 1996 ANDREW DAVIS 16 Claimant 17 18 Dated August 13, 1996 19 ETER C. PA S Attorney for the Claimant 20 21 22 23 24 25 26 27 28 2 z to t7 - CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 17, 1996 Claim Against the County, or District governed by) BOARD ACTION the Bbard of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Su ervisors via (Paragraph IV below), given pursuant Amount: $1,42 5.00 Section 913 and 915.4. Please note "Warnings". CLAIMANT: Murray C. Wilson and AUG 15 1996 Mabel E. Wilson COUNTY COUNSEL ATTORNEY: MARTINEZ CALIF. Date received ADDRESS: 1520 Manning Lane BY DELIVERY TO CLERK ON August 14, 1996 Alamo, CA 94507-9834 BY MAIL POSTMARKED: Hand Delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 15, 1996 B IL DepputyLOR, 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 910.8). ( ) 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: L'� BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (Y ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:J42-,��/7j /'�96'PHIL BATCHELOR, Clerk, B ,ye�n��/',�� 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 1 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: 20 , q`SCO BY: PHIL BATCHELOR b �_ "�,�-- " Deputy Clerk CC: County Counsel County Administrator Claim ',o: BOARD OF SUPERVISORS OF CONTRA COSTA OOUNTY INSTRIICTIONS 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 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 fi-TiF0 aQairmt P.Sc+.l, oublim entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this Tom—. RE: Claim By ) Res ved f r� l s iling stamp MURRAY C. WILSON and ) RECE W E® I MABEL E. WILSON ) Against the County of Contra Costa ) Qp or ) CLERK BOARD OF SUPERVISORS District) CONTRA COSTA cow, Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 1,425.00 and in support of this claim represents as follows: _���-------------------- --- ----------_----------------- -- 1. When did the damage or injury occur? (Give exact date and hour) DECEMBER 1995 - APPROXIMATE 2. Where did the damage or injury occur? (Include city and county) 1520 MANNING LANE, ALAMO, CA CONTRA COSTA COUNTY 3. How did the damage or injury occur? (Give full details; use extra paper if required) CULVERT IN DRAINAGE DITCH, DANVILLE BLVD. AND MANNING LN (West side) WAS STOPPED UP WITH LEAVES AND BRANCHES WHICH CAUSED WATER TO OVERFLOW ACROSS FRONT YARD OF RESIDENCE. 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? THE DRAINAGE DITCH IN QUESTION IS NOT ONLY DEEP AND DANGEROUS, BUT FAILURE TO KEEP DITCH FREE OF LEAVES AND DEBRIS FOR SEVERAL BLOCKS WILL CAUSE DURTHER DAMAGE. ACROSS THE STEET (East side of Danville Blvd.) , PUBLIC WORKS HAD THE TREES TRIMMED IN ORDER TO PROTECT NEWLY PLANTED TREES. WHO IS SUPPOSED TO KEEP THESE NEW TREE LEAVES FROM BLOWING INTO THE DRAINAGE DITCH? WHY WEREN'T THE TREES ON THE W�ST S DE BY THE DRAINAGE DITCH TRIMMED? THIS DITCH IS AN EYESORE PLUS BEING OVer DANGEROUS! 5. What are the names of county or district officers, servants or employees causing .,., ' the damage or injury? PUBLIC WORKS DEPARTMENT 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. WATER OVERFLOWED OVER YARD, WASHING BARK, RETAINER BOARDS OVER YARD. ALSO WASHED SAND AND SECTION OF 4 X 4 RETAINER AWAY FROM WALK. WATER WAS SWIFT AND DEEP ENOUGH TO WASH THE 4 X 4 (6ft long) COMPLETELY ACROSS YBRD (ESTTMATF. AT AC:H .D)�_ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) LANDSCAPE COMPANY ESTIMATE. 8. Names and addresses of witnesses, doctors and hospitals. RON & KAY NELSON 2851 DANVILLE BLVD. ALAMO, CA 94507 PHONE: (510) 934-6629 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT WE RAKED SOME OY THE WASHED OUT BARK FROM GRASS IN YARD. AWAITING YOUR PAYMENT TO COMPLETE REPAIRS. r , :<= Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some pers2.n on his behalf." Name and Address of Attorney c. Claimants Signature 1520 MANNING LN Address ALAMO, CA 94507-1028 Telephone No. Telephone No. (510) 256-9834 -.;-4 to"xT 1F" # !F 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. Telephone- l(510) 676-0985 Date 7-Z1, (510) 685-2729 VALLEY TREE & GARDEN SERVICE FIREWOOD 1839 McNorth Drive • Concord, California 94519 Customer ��s �//d°n Telephone AddressQhh/h ��''U 2 �O 7 JOB DESCRIPTION PRICE i etc c / I DEPOSIT 500, 00 STUMP REMOVAL ❑ YES K'NO REMOVE BRUSH AND CLEAN UP TRIMMINGS ❑ YES ANO Will VALLEY TREE&GARDEN SERVICE cut wood 18"-24"lengths ❑ YES ❑ NO TOTAL .L asp CD We do not cut any wood with foreign materials or objects within. VALLEY TREE & GARDEN SERVICE will perform the work described above. The customer agrees to pay the total charges indicated.This sum is payable in full upon completion of the work. VALLEY TREE & GARDEN SERVICE will furnish all labor, materials and equipment for proper completion of the job.VALLEY TREE&GARDEN SERVICE does not assume responsibility for small plants,shrubs,etc.directly beneath HOUSE the tree,underground water,electrical or foreign objects.There will be no work done other than that described under Job Description.On completion of the job payment is due in full. THE UNDERSIGNED AGREES&ACCEPTS THE TERMS SET FORTH ABOVE. STREET SIGNATUREE SIGNATURE CANCELLATIONS MUST BE MADE 24 HOURS PRIOR TO JOB. A FEE OF $50.00 WILL BE CHARGED WITHOUT PROPER NOTICE OF CANCELLATION. 3 APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 17, 1996 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: Diane Daubenspeck Attorney: Burnstein & Trimbur AUG 13 1996 Address: 1816 Fifth Street COUNTY COUNSEL Berkeley, CA 94710 MARTINEZCALIF. Amount: $100,000.00 By delivery to Clerk on August 12, 1996 Date Received: August 12, 1996 By mail, postmarked on August 9, 1996 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 13, 1996 per, BATCHELOR, Clerk, By ld,�pig, ��, R_�_Deputy II. FROM: County Counsel 70: Clerk of the Board of Supervisors ( /) The Board should grant this Application to File Late Clai (Section 911.6). ( �) The Board should deny this Application to File Late C1 (Sectio 911.6). DATED: VICTOR WESTMAN, County Counsel, , / Deputy III. BOARD ORDER By unanimous vote of Supervisors peestnt, (Check one only) ( ) This Application is granted (Section 911.6). ( ✓) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATE: Z44� i. 1'7) PHIL BATCHELOR, Clerk, BSL.Ji4.Q _(` acts Deputy WARNING (Gov. Code 5911.8) If you Wish to file a court action an this matter, you must first petition the appropriate court for an order relieving you frcm the provisions of Government Code Section 945.4 (claims presentation requirement). See Goverrment 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. V. FROM: Clerk of the Boar TO: 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• 2a,MOML BATCHEMR, Clerk, Deputy V. FROM: 1 County Counsel 2 County Administrator ZOO: 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 BURN STEIN & TRIMBUR A T T O R N E Y S A T L A W R August 9, 1996 Isoi*, Clerk Board of Supervisors Contra Costa County 651 Pine Street Martinez, CA 94553 Re: Claim of Diane Daubenspeck Our File No. 362.01 Dear Clerk: Please present the enclosed document, Application for Leave to Present Late Claim on Behalf of Diane Daubenspeck—Claimant to the Board of Supervisors for action. I have enclosed an original plus one copy of each document. Please stamp "received" on the copies and return them to us in the enclosed self addressed stamped envelope. Thank you for your attention to this matter. Very truly yours, BURNSTEIN & TRIMBUR Joanne Wolf Legal Assistant /jmw Enclosures MALCOLM BURNSTEIN• CATHERINE TRIMBUR 1816 FIFTH STREET• BERKELEY, CALIFORNIA 94710• 510 548-5075 FAX 510 548-5074 Malcolm Burnstein Catherine Trimbur W•., R EC E NED .BURNSTEIN & TRIMBUR 1816 Fifth Street Berkeley, CA 94710 2 X996 (510) 548-5075 11 Attorneys for DIANE DAUBENSPECK CLERKCOTRABOARDOCOS A CO SUPERV`SOBS Claim of DIANE DAUBENSPECK APPLICATION FOR LEAVE TO PRESENT LATE CLAIM V. ON BEHALF OF DIANE DAUBENSPECK, CONTRA COSTA COUNTY CLAIMANT TO: BOARD OF SUPERVISORS, CONTRA COSTA COUNTY 1. Claimant presented a claim to Contra Costa County on August 5, 1996, which was rejected as not having been "presented within six months of the event or occurrence as required by law." Claimant believes the claim was timely because (1) it was presented within one year of the accrual of the cause of action, and/or (2) the time for presentation was tolled while Claimant, in good faith, pursued her administrative union remedies. Without waiving any rights nor electing any remedies, and at the direction of the Clerk of the Board of Supervisors, Claimant makes application, pursuant to Government Code §911.4 of the Government Code for leave to present a late claim founded on a cause of action for violation of statute which accrued on September 1, 1995. For additional circumstances relating to the cause of action, reference is made to the proposed claim attached to this application. 2. The failure to present this claim within a six-month period of the Application to File Late Claim Claimant: Diane Daubenspeck Page 2 accrual of the cause of action was through surprise, mistake, inadvertence and excusable neglect. Contra Costa County will not be prejudiced by this failure. Particularities are shown in the attached declaration of Malcolm Burnstein. 3. This application is being presented within a reasonable time and within a year of the accrual of the cause of action, as more particularly shown by the attached declaration of Malcolm Burnstein. Wherefore, Claimant respectfully request that this application be granted and that the attached proposed claim be received and acted on in accordance with relevant provisions of the Government Code. Date: August 9, 1996 /5✓ Malcolm Burnstein BURNSTEIN & TRIMBUR Attorneys for Claimant Note: Notices relating to this application should be sent to: Malcolm Burnstein BURNSTEIN & TRIMBUR 1816 Fifth Street Berkeley, CA 94710 Malcolm Burnstein Catherine Trimbur BURNSTEIN & TRIMBUR 1816 Fifth Street Berkeley, CA 94710 (510) 548-5075 Attorneys for DIANE DAUBENSPECK Claim of DIANE DAUBENSPECK DECLARATION OF MALCOLM BURNSTEIN IN SUPPORT OF V. APPLICATION TO PRESENT A LATE CLAIM ON BEHALF OF CONTRA COSTA COUNTY DIANE DAUBENSPECK I, Malcolm Burnstein, declare: 1. I am an attorney licensed to practice in the State of California. The facts stated herein are stated of my own knowledge and, if called as a witness, I could and would competently testify thereto. 2. Diane Daubenspeck first consulted this firm on June 25, 1996, more than six months after the accrual of the cause of action at issue in this claim. She retained the firm to represent her in connection with the wrongful demotion to which she had been subjected as of September 1, 1995. The demotion was, inter alia, in violation of Government Code §§ 26625.3 and 26625.5(e). 3. Ms. Daubenspeck began fighting the wrongful demotion through the grievance process established in the Memorandum of Understanding between AFSCME Local 512 and the County on July 18, 1995, shortly after the Sheriff recommended the reorganization that caused her demotion. She protested the demotion through Steps I to 4 of the grievance process. By letter dated July 24, 1996, the Union Business Agent informed Ms. Daubenspeck that the Union would not advance the grievance to Step 5. Declaration of Malcolm Burnstein In Support of Application to File a Late Claim Claimant: Diane Daubenspeck Page 2 (A true copy of the letter from Jim Hicks to Diane Daubenspeck dated July 24, 1996 is attached hereto.) 4. Our legal research convinced us that the statutory violation at issue in this claim was subject to a one-year claim presentation period. The claim is not based on a cause of action for injury to the person or personal property. By Notice to Claimant, which we received on August 9, 1996, we were notified that Phil Batchelor, Clerk of the Board of Supervisors, disagreed and that, in his view, the claim was subject to a six- month presentation period. (A true and correct copy of the Notice to Claimant is attached hereto.) He informed us that our only recourse was to apply for leave to present a late claim. 5. Contra Costa County will suffer no prejudice by granting Ms. Daubenspeck leave to present a late claim. Since July 1995, even before Ms. Daubenspeck received the Notice of Lay-off, the County has been on notice that Ms. Daubenspeck contested the validity of the demotion and it has had the ability to conduct any investigation that it deemed advisable. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Date: August 9, 1996 Malcolm Burnstein Malcolm Burnstein Catherine Trimbur BURNSTEIN & TRIMBUR 1816 Fifth Street Berkeley, CA 94710 (510) 548-5075 Attorneys for DIANE DAUBENSPECK TO: BOARD OF SUPERVISORS, CONTRA COSTA COUNTY DIANE DAUBENSPECK makes claim against Contra Costa County and makes the following statements in support of the claim: 1. Claimant's post office address is 903 Vista Del Diablo, Martinez, California 94553. 2. Notices concerning this claim should be sent to claimant in care of Burnstein & Trimbur, 1816 Fifth Street, Berkeley, California 94710. 3. The occurrences giving rise to the claim began in July 1995 and continued at least until September 1, 1995 and took place in the Contra Costa County Board of Supervisors chambers and at other locations unknown to claimant. 4. The circumstances giving rise to the claim are as follows: Claimant held the management position of Process Supervisor in the Court Security Bureau (formerly Court Services Division) of the Contra Costa County Sheriff's Department from on or about November 1, 1987 until September 1, 1995, at which time she was wrongfully laid off from the position. Initially, claimant held the Process Supervisor position in the Contra Costa County Marshal's Department, but in 1988 the Contra Costa County Sheriff's and Marshal's Departments were consolidated into the Sheriff's Department pursuant to California Government Code §§26625, et seq. On or about August 8, 1995, the Board of Supervisors approved the elimination of four management positions, including Process Supervisor. Claimant received a Notice of Layoff on or about August 17, 1995, effective September 1, 1995, which resulted in her transfer out of the Court Security Bureau. Daubenspeck Claim Page 2 The actions of the Contra Costa Board of Supervisors violated provisions of the Contra Costa County Marshal/Sheriff Consolidation Legislation, Government Code §§26625, et seq. in that: (1) Section 26625.5(e) provides that no employees of the Marshal's Office who were assigned to court services as of August 20, 1988, the operative date of the legislation, would be demoted or otherwise adversely affected by the consolidation of the Marshal's and Sheriff's Departments. But for the consolidation, claimant would not have been laid off and transferred; and (2) Section 26625.3 requires that all transfers out of the Court Security Bureau be approved by the Court Security Oversight Committee. Claimant is informed and believes and thereon alleges that no such approval was given before her transfer. As a result of the lay off, claimant was transferred to the position of Senior Clerk for the East Contra Costa Narcotic Enforcement Team. This constituted a demotion to a non- management position and involved a monthly pay cut of$767 and loss of management benefits. 5. Claimant's damages are as follows: an ongoing loss of salary in the amount of$767 per month, loss of pension benefits upon her retirement, loss of management benefits and other damages the amount of which are as yet unknown. In addition, claimant has incurred, and will continue to incur, attorney's fees in an amount as yet unknown. 6. The names of the public employees causing claimant's damages are (insofar as the same are known): the Contra Costa County Board of Supervisors. 7. The amount of the claim as of the date of presentation exceeds $100,000 and jurisdiction of any suit brought over the claim would rest in the Superior Court of the State of California or in the United States District Court. Date: August 2, 1996 MALCOLM BURNSTEIN Attorney for Claimant . ••08/07/1996 18:12 5102101638 ELENI BOATWRIGHT PAGE 02 �FOFq Dhstt ct Council 51 S e o d Martinez Offwe a = 1000 Court Street IMA 141r.1 L Martinez,CalHornia 94553.1733 �4'�tov ty AFS-CIO Tel: (510)22&4400 Fax: (510)228.4472 Diane Daubenspcck July 24, 1996 903 Vista Del Diablo Martinez, Ca. 94553 Re: Grievance-Discrimination/Harassment dtd July 18, 1995 Dear Ms.Daubenspeck, As per our discussion and as a result of that discussion this letter is hereby issued to confirm that AFSCME Local 512 will not advance the above grievance to Step 5 of the grievance procedure. As we discussed the grievance procedure does not offer the desired results in your situation. As you know this grievance was regarding the disparent treatment you received from the Contra Costa Sheriffs department in 1995 when management of that department made comments about your future with the department and then took action to eliminate your management position. The department then provided accommodations to the four(4) male Managers whose positions that were also cut at that time and nothing to you. The one manager who remained with the department as you did was provided a$750.00 Differential that represented the same money loss by the demotion. However you were forced to demote to a clerical position at a loss of approximately$650.00 a month plus other management benefits. If we can be of any further assistance please give me a call. im Hicks Business Agent AFSCM$Local 512 American A'ederation of State, County and Municipal Employees . -ow- TO: Diane Daubenspeck c/o Burnstein & Trimbur 1816 Fifth Street Berkeley, California 94710 NOTICE TO 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 on August 6, 1996 has been reviewed by County Counsel and is being returned to you herewith because: _ Your claim for an injury to person or personal property which arose on or before December 31, 1987 was not presented within 100 days after the event or occurrence as required by law. (See Government Code sections 901 and 911.2) XX Your claim for an injury to person or personal property which arose on or after January 1, 1988 was not presented within six months of the event or occurrence as required by law. (See Government Code sections 901 and 911.2) Your claim relating to a cause of action other than injury to person, personal property or growing crops was not presented within one year after the event or occurrence as required by law. (See Government Code sections 901 and 911.2) Because the claim was not presented within the time allowed by law, no action was taken on the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code sections 911.4 to 912.2 and 946.6) Under some - circumstances leave to present a late claim will be granted. (See Government Code section 911.6) You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administrator t By: Deput5itlerk Dated: August 7, 1996 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: g4�L�7LZfJ By Phil Batchelor by aJ Deputy Clerk 5'�6t z �h• ,&vn. fir. "s..',.,!r s« r -x ,.�`:'a i�,"�C r , � r 4 ,�.s� 7 �+' t''k.r rc ""'�,,,� -�� r � .�, z vsw,xz�, ?r xv'<f . ".'"`,,,s Mlfa , ,,:.�- a'. q kk s,. ='{'c 3r c'+zy r i'+* c �S1n t Yk"�„�a"A r�t - .�, 7 - r'- '7` '� -:' �.,e� "f'�Y Ke i �.,L.}eyh�au. �+ ,yM'4� i 4�JnL•"�,6Y 'C4�' i F'*- 1� hn -Ing .':'w ,:� v+v Y� ...r y„ �i�5� �**�.5 •.�... 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"tr:ry s .!.i5' 'Y . .a-1y.7. •'`.y i. dy :�d'v'.S`'*r 6 ,'.'�;tc wi ysiY,.-�� e`"`d ae s Z's :'-a..�r -�,'c u, f S� n�.. � �1`:i�� 1-.�� � � y�.�''u�. n e'#'* SkE4a",�t .�'YV`^' �.` � -51",,,s y ar�✓�k::,� ;<�*:.?;7 @���:Kmdhafx^sI < a4'4 Fa5a, 1-*'' e.tP.",rr'S t •sir'S..'r?.`3°-*?.i'a`r„'L�,,-1s-a;.{:. t _•'�.;�, }r,r,c. ����;;``�x1.-.., `�'' p..:m . +�,.�..::. �`.r... v ro ix�� f�'1�' ~a.�r,. �hs"Izy�� 't�y'.Y:�µ. ��,r' a �;t,. .� a S'��4`: ��''�,V i y � ;`�'4 � ""adrs t'�'.*�Rr G� �-z���'•- �-'� �":, +'Y%v�t �''7 t�s"f -a�� ._ x"x ,,.a.*r sit;. �ry�.. s., x "'`e�'`,�d .�,.'.�= a�n �+.:"�".. -:4` :3`._..., q,-� k,.+,' .>.'."' 's'�i�?'bE�+"y�'1s,�¢�„a.^aY-ti :�"ii' a};b�`� .� :<•s^ z�f^H' ;:,""� .;�. 3�'ft.� i�+'y'�'S^:'$': 'g�u� I `a' ,�r.,r^e. a"��� � n � '�?,y�`.;�«N"' �.. � _ � �I�i.'r5:�d..��'; r3'.�';.:�i�.:r^�% ,- ��" s4��-�',i��.-�" s���`sV« �dk���'�,r' �s„ : -•��"� ?�l*� }"a�." �%�����..��t��i. �<4' �`iss�,�--.�� '�"tr .::fis �'�+�� ,...�`�""r,c:k z3 ,a_ .,rte-._„F *" },e.Gt4.•.x.... aax k :-: '�u- ? ....a�..... �°r K^...�' l,.•� rs��"-'� �_.�* 3 .Kx � � -_�""'�''r v*�. -r 0. ,k 3i WN, H'.. ?if+r Y ,f..,, �.�u.�t 3 H.g.ve ai''sr`�:-�. r�,�s .#' ,✓... *-7 0,,. -iyla 3''^"�.s C_, -� ;s' ',k.'? 'v+a ..':3r+` r'H`;,.,+., f> �.t` .m' :' •a°,.� v�M W...; y CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 17, 1996 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $250.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Lorie Moore ATTORNEY: Date received ADDRESS: 163 Cardinal Way BY DELIVERY TO CLERK ON August 26, 1996 Hercules, CA 94547 BY MAIL POSTMARKED: August 23, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 26, 1996 IaIl Bep�HtyLOR, 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 910.8). ( ) 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: 44-71?4 BY: dA4 1A Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (✓ ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: /7, /"79C0 PHIL BATCHELOR, Clerk, B�jS•��e�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 r� /`� 9� BY: PHIL BATCHELOR bJiLlii�G-C � 1 Deputy Clerk CC: County Counsel County Administrator JUN 1 0 1YV4 Claim -to: BOARD OF SUPERVISORS OP CONTRA COSTA OOUN7Y 30 MUIR ROAD INSTRUCTIONS TO CLAIMANT (APJAI CFRIII(' UAnT1WQ_r% A. Claims relating to causes of action for death or for injury -�•o person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 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 Cinty, 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 RECE1� l63 C ) Ag"they of Co tra Costa ^� 6 (� ?p. �.KBOARDOF SUPEkti+w,`( District) CoA� Fill in name ) The undersigned claimant hereby makes clam against the County of Contra Costa or the above-named District in the sum of $ ®-0 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 damag --or in ury 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, ssion on the part of county or strict officers, servants or employees caused the. injury or damage? CL... � -,� (over) �. What are the names of county or district officers, servants or employees causing the damage or injury? 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed aboV4 computed? (Include the estimated amount of any prospective injury or damage.) (2-0 8. Names and addresses of witnes§es, doctors and hospitals. ------ ----------------------------------.__��._�.�� --- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT b s Lco . 06 Gov. Code Sec. 910.2 provides: ! K ro "The claim must be signed by the claimant SEND NOTICES T0: (Attsrnor s on on his behalf." Name and Address 6f-Attbrn6y'==�r.,." . > Claimant's Si KT t 6 s W���� Address Telephone No. Telephone N . �� 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. -0 15 Q>0 .0 0 CG cy) -0 L) e , 0 0 IC— .0 % -S,�- 0 co �o 0 0- G) tp 4) Po 711 0) lw cd 7-1 'A 01 0 55 3 as (3; ©� d of O 0 q 43) (16 CD Zu: loop- o z I �i,. 0)4 ' p S CD 4r AM 0 th 7s 0cis O' 0 �& —U) 0 0 e -15-n m 1 m L N'Sul Md. m c LUI o .� Yao V -VC- 0 N a cn d o sibCD 42 Y C� 4 N13 1us m cR co 2 @w0 m � �p 7 1` Q ��_ N Otca 0 't vs $$ yW (1) V; c c cm ? }�Z -V W tCO [� �' w Nv+ � wcn0 p Q J ; M U1 oN�p¢ 0 4 JuiCC tL UA t R cr °co Cwt "0 a 0 N t �� �1 a CG a p Q �ti w 1 N a u+ w 1. wa'U'fi cc py �� cr 0 CC cr m G. N ,� fro k;4 CCn.U,us CC Y 3 Q O w t tyt� , Oho G cb � � � 'V CA IL V"' IF } r1. • ZIH ® �` a ee • • ' WINDSHIELDS AMERICA : . U.S. AUTO GLASS sem. r'.>>. . ,. r jNVQICE�QA,, �� • • NELSON VASCC/ALLSTATE tOVIE MOCRE •/ 5370@? E �` s 525 E--i-UDILLO AVE2igD t=LR 163 CARDINAL WAY Pt7RGHASf ORDER NO PAGE NO u CAN LEA�i1'. RO CA 94"'577 HERCULES CA 9 ,i N CUSTOMER�,NQ 7,2CUSTCMEflNO 2 3 USA ELAS .NETWOR}; "r`77?7 N LA SALLE ST ORDER:�'^ATE DATE OF,LOSSw. L ► _fTl:i=0 :L 6iIr"h2:'i.J_t—Ft -i7 �Cj lq 6 T CAt7S,E''OF,LOSS> , STATE �.A s POLICY;NQ „: ... EXP.,DATE „: ,. ,CLAIMS/C(ONTROL NO, OtC D BY, y, . „DEDUCTIBLE m m,...: r„�T t)?00'7988. 1 v^•L' s`ir l�{t'i"7; 1250.`714=t /a6 VIN, "P TE'NO�._.. YEAR, MAKEMODEL„ ,a,.r: =—STYLE'. '.ODOMETER=e ll';S-4 LtNI_, 17 0Wi'•1 I_i:F, DESCRIPTION • NO. :•' • L tA mot E_R"'L.lR E.I HA f4i L_.,,.�,. 7, , gm— _ d°'0 22 -?t,;~ SUB TOTALS► SALES TAX _. a GROSS TOTAL PAYMENT RECEIVED TE t FOR OFFICE REFERRED BY USE ONLY • STATEMENT OF FINAL AND SATISFACTORY COMPLETION AND AUTHORIZATION TO PAY THE UNDERSIGNED ACKNOWLEDGES RECEIPT OF THE ABOVE REFERENCED GOODS AND SERVICES ANC Primary ACKNOWLEDGES HE/SHE HAS INSPECTED SAME AND IS SATISFIED THERE WITH. THE UNDERSIGNED FURTHEF. Vision REPAIR COMPLETED? ACKNOWLEDGES ALL SERVICES WERE PERFORMED IN A WORKMANLIKE MANNER TO HIS/HER SATISFACTION ANC Area AUTHORIZES THE INSURANCE COMPANY TO PAY WINDSHIELDS AMERICA/U.S.AUTO GLASS DIRECTLY FOR PAYMENT OF ❑ YES ❑ NO THIS CLAIM.THE UNDERSIGNED AGREES THAT HE/SHE IS PERSONALLY RESPONSIBLE FOR PAYMENT OF THIS INVOICE IRRESPECTIVE OF ANY INSURANCE COVERAGE WHICH MAY PERTAIN HERETO. GLASS INSPECTION SIZE&DESCRIPTION OF DAMAGE ' NOTE:THERE IS A CHANCE THAT THE WINDSHIELD MAY FURTHER BREAK O SIGNATURE. . DATE DURING THE REPAIR PROCESS, WINDSHIELDS AMERICA/U.S. AUTO GLASS WILL NOT BE RESPONSIBLE IF THE WINDSHIELD SHOULD BREAK FURTHER WHILE ATTEMPTING THE REPAIR.YOU WILL NOT BE g CHARGED FOR THE REPAIR. e ',LL ,; ,,;;, _ - CSR P V B i Y c SERVICE TECH.SIGNATURE o SERVICE TECH. CUSTOMER SIGNATURE MOBILE SERVICE LOCATION INSTRUCTIONS: -, 1 - o TERMS: PAYABLE UPON RECEIPT s d7 7:3 i :A � t 1 f d >� c 0 4,C7 ►'i d a c N �0 w�NNVt cr Z 'Z s2Ucc 4 ,V; mOO-2M d CLAIM e. t� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA September 17, 1996 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $5,000,000.00 Section 913 and 915.4. Please note allWOMMILViR CLAIMANT: Barbara Murphy, Denise Culver, and Ethel Shifflet AUG 2 2 1996 ATTORNEY: COUNTY COUNSEL Date received MARTINEZ CALIF. ADDRESS: 1157 Jensen Circle BY DELIVERY TO CLERK ON August 21, 1996 Pittsburg, CA 94565 BY MAIL POSTMARKED: Hand Delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 22, 1996 gaIL BATTCUELOR, Clerk eputty II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( V) 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: _T Z 3, 11 4 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: ORDER: By unanimous vote of the Supervisors present (V) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated-,,Q /'1'7(OPHIL BATCHELOR, Clerk, B�iLer.e_ it ate' 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: g0, /99C-v BY: PHIL BATCHELOR bDeputy Clerk CC: County Cou^sel County Administrator E r?-aim 'to: BOARD OF SUPERVISOR'S OF CONTRA COSTA COMM IrISTRDCTIONS M 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 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 Tom. f * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RE: Claim By Reserved for Clerk's filing stamp RECOVED Against the County of Contra Costa ) AUG 2 11996 't or ) ` District) -CLERK BOARD OF SUPERVISORS_I (Fill in nam ) cor��RA COSTA CO.-e) 9 The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of _r, ,coc2 . axe and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. mere did the damage or injury occur? (Include city and ootmty) �ra_ 5�� Com% 3. Row did the damage or injury occur? (Give ful de�silaf use extra pa if required)�.,�, C�.�P �oS Sv �se.� �° a��.o V e,5�\ � c� n.9.a\Q_' . ��.p�a,.�, c.�o,,.rt , o. %� m q b. � fir\ �� � 1 SG.�� e,��- � v\® ,r.d.►�s �o - .sz., crorti c��,�t{ w�.,e,�\ tr - G� 4. What particular act or omission on the part of oounty or district officers, servants or employees caused the injury or damage? i ,T)", (\. 11\- rev.csz. -, t k`Q- �-t-e.,�2, f r�'�t C J S S ( 0.,/A. WO-S MY) 0-- � t s�-- C'Onv iG-�'owe s t t�e�2, -`�S CL.VId _�kQ_--e,5- 60 we_�_j 4�, C04r� _S4;50,4Qc4. (over) 1 r. 5. What are the names of county or district officers, servants or employees causing the damage or injury? o D\ — 4C�----' -r 15 ons_ �- -4��..�}�_� ---------- S. 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.) and addresses of witnesses, docto sand bospitals. CoS` Ccs\ �Nr 9. List the expenditures you made on account of this accident or injury: DATE ITEM • a � ! ! ! � a # • � ! • • • a � a • a • � ! • � � * ! � � a � � � 4 a a a a � • IF Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or ome person on s behalf." ame and Address of Attorney Claimants Si M5- 7 Te-n Y Cir d Address Telephone No. Telephone Nor -) qy'a- 3 aaaaaaa aaaaaaaa1'i'9 a * Iry a' oaf NOTICE Section 72 of the Penal Code provides: nvery person who, with intent to defraud, presents for alloaanee or for payment to any state board or officer, or to any oounty, 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 oounty 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 exoeeding ten thousand dollars ($10,000, or by both such imprisonment and fine. 6, CLAIM 0-117 BOARD OF SUPERVISORS OF,CONTRA. COSTA COUNTY, CALIFORNIA September 17, 1996 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unknown Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Clarence Jeffries A.K.A. ATTORNEY: Jeffrie Miller/D22264 Date received ADDRESS: P.O. Box 5002 BY DELIVERY TO CLERK ON August 19, 1996 . Calipatria, CA 92233-5002 8Y MAIL POSTMARKED: August 15, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 19, 1996 IVIL �ep�HtyLOR, Clerk ' H. 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: ck 4=:,,!=T ZO 1 '9-?C BY: -_- �r Deputy County Counsel c- III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (� This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: /7,/14(UPHIL BATCHELOR, Clerk, Deputy Clerk NARNING (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: X dl �9 9C° BY: PHIL BATCHELOR Deputy Clerk CC: County Counsel County Administrator i4 d3aim to: BOARD OF SUPERPISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO` CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this RE: Claim By CIAR45,oGE Reserved for Clerk's filing stamp RECEIVED ) Against the County of Contra Costa ) AUG 19 or ) District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim Against the County of Contra Costa or the above-named District in the sum of $ #W ,0,6-e- .03-3 and in support of this claim represents as follows: FED 42.U.S.C.1983 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, servants or employees caused the injury or damage? �W ^,rdD o" of e"Y-"4 XAqs 0"4 k/p . 1/,S c 3. xCFSsi�!F jis."CAI FC,rW f . 6/. s, e. A- c%•�s� .��mE�� �. 1/J. /Du� GOV. �'o� �j�5�� c (over) / ro;Z �F_ VA42 O4vs,niF HARM 5. What are the names of county or district oftieers, servants or employees causing the damage or injury? f ��r_a,�F ��4, m� �� ,(� },74 F 4,4WX6 JC— 6. What damage or injuries do you claim resulted? (Give full extent of injuries or es claimed. Attach two estimates for auto damage. �,,,� or N � C", j�ov,`G /�c RriB/E/�►s. �; a� 4X 3 ���r -s . �„ .413, 14AV1.1? ��.f�r4 Al� neK . 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) eo,xl��Nl��elc� ftSPr-6'Fk 4A S. Names and addresses of witnesses, doctors and hospitals. O� CH�Gv jN,E�or?;,oh /�a.SP, h1/3r7�.��d.R.cA 6? i3A,S5�`� < Saatis �livE,✓F;,.�� ��Scn> 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT U1lJh/F���1 m4ugf✓ A7r i3 %irh6 i S ' ti GW�F� yG aJC Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some p/erson on his behalf." Name and Address. of Attorney e/ J X•k dd (Claimant's Signature �' �• %�X- s toy 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. ATTACH SHEET" 176-e SS ate U bl!-> Ii. e!/AJ/ A)l 14A Yh . elVI"A C'G��7� �Ic�SF_. / 7,�S C'ccJR7� 5�- P/ll?.31ini �. .' 104�, S A6r.s�,C4ZI, SSA um' ��F4j, �v t/ F AAWREACF ��0113 LdiF�TF .,v �//_ CEr�iFn�� Q �,¢42„i� �1'1Ai�9 /GGA (rlJllS GtJffFn� /�U ��lW/�rNCF_ \�?!U�rAl¢i�aiu/1�,. r� % r p F G/lJ 4,sr 5FR,GUS 7U •(I7[_ C-- 86-CAOS � C'u ,(,U;�l-1 9'►`° A 1113 � :.1� C.�l���r�•.-i S. �/1!�F fair ����/+ F/-1k CA/-& � ��i4i°iiS Gf/i �/F_ ��� �%� h+� �f,(Jn-P 114."I'D S - P1r�S CXR- En6(,t,r,�,�.uCJ� ` Ls /vc �,'..� Ln� ///F_ f��C�s�! ✓ 7- k 5,{ b5 7/?N4,/� cF F_YCF.SS i vF /�✓�. r¢r/I% Fo;:�Cr - U -S . A-f�-f�/ ✓ "�i� f�F!'�°IAir.��F_� Of icy/ �pia-Z. - 1 Gv,�s ��G'l-.-�/-�� �F-T,� Gi F-int'7`/61,-.wQ /✓i��E5S �/i`Gif��"ila�1 e Gov, Coot alb C rPubli'c F/�1 Ff S ci l j i /CFS 4 r Giga lJ�-�_f�G �•-( C/= M.4644zIa . /S� AIV Ih,Q �!✓,¢ �Gr $' QJbJ�,6( i � CUyFlt9 7NF` ��.S�G � ZNIYiJ� /_ 7 � �Fr�%tt��. �77�r`s I..JU ->!+ ” liU�.� �1�i�f�C t�� /'S' 'Ti`l� /✓U��j�lyf�.`.�� /� F/ jU /,j Or PR/-,.S6%,i`FCr � iv� �/-✓ G Cry /� /_f1�� /�/ i _ r+ r �1 J M .. ON Ci) tJl M N P f {t1 Sb k:r ' 1 Ncli 1 CM1 A -4 W d - � Qa � o� � CLAIM `' V7 BOARD OF SUPERVISORS OF,CONTRA• COSTA COUNTY, CALIFORNIA September 17, 1996 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant Amount: $10,000.00+ Section 913 and 915.4. Please note a arnings". CLAIMANT: Leonard Jacobs AUG 1 5 1996 COUNTY• James B. Chanin, Julie M. Houk MARTIN COUNSEL ATTORNEY: MARTINEZ CALIF. Law Offices of James B. Chanin Date received ADDRESS: 3050 Shattuck Ave. BY DELIVERY TO CLERK ON August 14, 1996 Berkeley, CA 95705 . BY MAIL POSTMARKED: August 12, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. I ` August 15 IL gATCHELOR, Clerk p� GATED: 1996 EVIL�: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ✓) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: Awqllt_t BY: e Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARDD ORDER: By unanimous vote of the Supervisors present ( 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:A�/`7,/99G PHIL BATCHELOR, Clerk, BDeputy 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: 6 y �1� 9L° BY: PHIL BATCHELOR b�y—� �Go4'-- Deputy Clerk CC: County Counsel County Administrator LAW OFFICES OF JAMESf B. CHANIN 3050 SHATTUCK AVENUE BERKELEY,CALIFORNIA 94705 (510)848-4752 FAX(510)848-5819 JAMES B.CHANIN JULIE M.HOUK August 12, 1996 VIA CERTIFIED MAIL/RETURN RECEIPT REQUESTED Clerk of the, Contra Costa County Board of Supervisors 651 Pine Street Martinez, CA. 94553 Re: Tort Claim of Leonard Jacobs Dear Madam/Sir: Enclosed please find an original and one copy of a Tort Claim which this office is filing on behalf of the above-mentioned individual . Please stamp the enclosed copy with the date it was received by your office and return it to our office in the enclosed, self- addressed, stamped envelope. Thank you for your attention in this matter. Very truly yours, LAWFICES OF JAMES B. CHANIN J IE M. HOUK Enclosures RECEIVED , l/3 - JAMES B. CHANIN (SBN# 76043 ) JULIE M. HOUK (SBN# 114968 ) KW 14 W6 Law Offices of James B. Chanin { 3050 Shattuck Avenue CLERK BOARD OF SUPERVISORS Berkeley, California 94705 510/848-4752 CONTRA COSTA Co. Attorneys for Claimant CLAIM AGAINST THE COUNTY OF CONTRA COSTA LEONARD JACOBS, ) Claimant, ) TORT CLAIM VS . ) COUNTY OF CONTRA COSTA ) 1 CLAIMANT'S NAME: LEONARD JACOBS CLAIMANT'S ADDRESS: 2300 Foothill, Richmond, CA. 94806 CLAIMANT'S TELEPHONE NUMBER: C/O Law Offices of James B. Chanin: (510 ) 848-4752 . ADDRESS TO WHICH NOTICES ARE TO BE SENT: JAMES B. CHANIN, JULIE M. HOUK, LAW OFFICES OF JAMES B. CHANIN, 3050 SHATTUCK AVENUE, BERKELEY, CALIFORNIA 95705 . DATE OF THE INCIDENT: On or -about July 2, 1996 LOCATION OF ACCIDENT OR INCIDENT: At or about the West County Detention Facility, 5555 Giant Highway, Richmond, California, the Martinez Detention Facility, 1000 Ward Street, Martinez, CA. , Merrithew Memorial Hospital, 2500 Alhambra Avenue, Martinez, CA. Discovery continuing. HOW DID THE ACCIDENT OR INCIDENT OCCUR: On or about July 2, 1996, the Claimant was in the custody of the West County Detention Facility. The Claimant was ordered to clean a bathroom at said Facility by Deputy Kelly and/or Doe 1 . Claimant is informed and believes and thereon states that said order was inappropriate and made for the purpose . of subjecting the Claimant to unwarranted, excessive punishment and/or cruel and unusual punishment. Discovery continuing. Thereafter, while the Claimant was in the process of Cleaning the bathroom, Claimant received electric shock(s ) and 4 F • suffered serious injuries . Claimant fell to the floor when he received the electric shock(s ) and suffered additional injuries and damages in the fall . Discovery continuing. Claimant has not yet completed discovery in this matter and does not currently have documents in his possession, custody or control specifying the exact reasons why he was electrocuted and does not have access to the facility to conduct any independent inspection at this time to ascertain the precise reasons why he was electrocuted. Therefore, Claimant is unable to state with certainty in this claim at this time the precise nature of the dangerous or hazardous condition(s ) at the premises which resulted in his electrocution. Discovery continuing. Claimant is, however, informed and believes and thereon alleges that the County of Contra Costa knew, or reasonably should have known, about defects or dangerous conditions at the premises, including, but not limited to, hazards or defects which could foreseeably result in electric shocks at the premises . Claimant is further informed and believes and thereon alleges that despite notice of said dangerous or hazardous conditions at the premises, the County of Contra Costa and/or its employees, negligently, with deliberate indifference and/or intentionally failed to take appropriate remedial action prior to this incident. As a result, the premises was in a dangerous and defective condition prior to and at the time of the subject incident. Discovery continuing. After the Claimant was electrocuted and sustained serious injuries to his body, Claimant was unreasonably, with deliberate indifference, and/or intentionally denied any or appropriate medical treatment at the West County Detention Facility. Eventually, the Claimant was informed that he would be taken to. the Merrithew Memorial Hospital in Martinez for medical treatment. Discovery continuing. Despite his serious injuries, the Claimant was walked to a car and was then driven to the Martinez Detention Facility, rather than to the Merrithew Memorial Hospital . The Claimant was then detained in the Martinez Detention Facility and negligently, with deliberate indifference and/or intentionally denied any or appropriate medical treatment for his serious injuries . Discovery continuing. Eventually, the Claimant was taken to the Merrithew Memorial Hospital where he was seen in the emergency department. The Claimant is informed and believes and thereon states that negligently, with deliberate indifference and/or in violation of the standards of care, he was denied appropriate medical treatment' for his serious injuries . The Claimant was then returned to the Martinez Detention Facility without adequate or appropriate provisions being made for any y • • or appropriate continuing medical care and treatment for his serious injuries . The Claimant served the remainder of his sentence at the Martinez Detention Facility. While completing his sentence in the Martinez Detention Facility, the Claimant was negligently, with deliberate indifference and/or intentionally not provided with adequate or appropriate treatment for his serious injuries . Discovery continuing. Claimant is informed and believes and thereon alleges that he sustained injuries and damages in the aforesaid incident as a result of customs, policies or practices of the County of Contra Costa, including, but not limited to, customs, policies or practices involving the failure to provide appropriate and adequate medical treatment to persons injured in custody; the failure to provide a reasonably safe custodial environment, free from foreseeable electrical dangers and/or hazards, the failure to adequate train, supervise or discipline jail staff, the use of cruel and unusual punishment, deliberate indifference to foreseeable hazards, deliberate indifference to the medical needs of prisoners and/or other customs, policies and/or practices subject to further discovery. DESCRIBE INJURY OR DAMAGE: Claimant sustained multiple injuries to his body and person, including, but not limited to, pain, suffering and. emotional distress . Claimant suffered injuries to his central nervous system as a result of the electric shock(s ) and/or fall . Claimant suffered injuries which included, but are not limited to, damage to his vision, deterioration of his hearing, injuries to his right . side, including right arm and hand, limitations on movement in his toes, foot drop, incontinency, headaches, sharp pains in his temple, numbness and tingling on the right side, neck and back injuries and other injuries subject to further discovery. Claimant is informed and believes and thereon alleges that he may have sustained permanent injuries due to the incident. Claimant has and will continue to incur medical and related expenses due to the incident. Claimant may incur damages for lost income or damage to earning capacity in amounts to be determined according to proof. Claimant claims statutory damages for the violation of his civil rights under State and Federal law, including, but not limited to, California Civil Code §§51 . 7, 52, 52 . 1 and/or 42 U.S.C. §1983 . Claimant also claims attorney' s fees and costs . Claimant is informed. and believes and thereon states that all and/or some of the conduct alleged in this complaint was intentional, malicious, reckless, oppressive, and/or done with a conscious or deliberate indifference to the Claimant's rights . Accordingly, Claimant also claims punitive and exemplary damages in amounts to be determined according to proof . Discovery continuing. Claimant alleges that he is entitled to recovery damages under theories of liability which may include, but are not limited to, negligence, battery, cruel and unusual punishment, violation of California and/or United States Constitutions, infliction of emotional distress, deliberate indifference to Claimant' s rights, including, but not limited to, the need for adequate or appropriate medical treatment, deliberate or reckless indifference to dangerous and/or defective conditions, dangerous condition of public property, negligent or reckless supervision, training, and/or discipline, negligent or reckless maintenance, management and/or operation of the premises, violation of civil rights under 42 U.S .C. §1983 and/or California Civil Code §§51 . 7 , 52 and/or 52 . 1 . " Discovery continuing. NAME OF PUBLIC EMPLOYEE(S) BELIEVED TO HAVE CAUSED INJURY OR DAMAGE: Claimant is unaware at this time of the exact identities of all of the persons who may have been responsible for causing the damages and injuries alleged in this Claim. Claimant is informed and believes and thereon alleges that a "Deputy Kelly" ordered him to clean the bathroom and may have knowledge of facts relevant to this Claim. Discovery continuing. DEMAND FOR PRESERVATION OF EVIDENCE: Claimant does hereby demand that the COUNTY OF CONTRA COSTA, including its employees, agents, servants and/or attorneys, maintain and preserve all evidence, documents and tangible materials which is and/or may be relevant to the subject matter of this Claim during the pendency of this matter, including until the completion of any and all civil and/or criminal litigation arising from the events which are the subject matter of this Claim. This demand for preservation of evidence includes, but is not limited to, a demand that all law enforcement and/or other public safety communications tapes be preserved until the completion of any and all civil and criminal litigation arising from the subject matter of the events which are, the subject matter of this Claim. AMOUNT OF CLAIM: Claim is in excess of $10, 000 . 00 . Jurisdiction is in the Superior Court of the State of California for the County of Contra Costa and/or United States District Court for the Northern District of California . DATED:• August 12, 1996 LAW OFFICES OF JAMES B. CHANIN +ULIE M. HOUK Attorneys for Claimant 1 PROOF OF SERVICE BY MAIL 2 I am a citizen of the United States and employed in the 3 County of Alameda, California. I am over the age of 18 years 4 and not a party to this action. My business address is the LAW 5 OFFICES OF JAMES 'B. CHANIN, 3050 Shattuck Avenue, Berkeley, CA 6 94705 ., 7 On the date set forth below, I caused the within 8 TORT CLAIM 9 to be served by placing a true copy thereof enclosed in a 10 sealed envelope, with postage thereon fully prepaid, in the 11 United States Post Office mail at Berkeley, California, 12 addressed as follows : 13 Clerk of the Contra Costa County Board of Supervisors 14 651 Pine Street Martinez, CA. 94553 15 I certify under penalty of perjury that the foregoing is 16 true and correct. 17 Executed on August 12, 1996 , at Berkeley, California . 18 19 LIE M. HOUK 20 21 22 23 24 25 26 27 28 � � f\ � y \« � £ 2 0A \ # « � & « 0 ® A � A . O 0 c ƒ � . � a . � . . \ ~ . �y \ CLAIM BOARD OF.,SUPERVISORS OF,.00NTRA,.::COSTA COUNTY, CALIFORNIA September 17, 1996 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE; TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors 2739.18 (Pa r�t��,g��given pursuant to Government Code Amount: $ Sec �'gq��pp'hcrr►► tease note all "Warnings". CLAIMANT: Monica Holmes AUG 2 2 1996 COUNTY COUNSEL ATTORNEY: MARTINEZ CALIF. Date received ADDRESS: 1844 Giaramita St. #652 BY DELIVERY TO CLERK ON August 20, 1996 North Richmond, CA 94801 BY MAIL POSTMARKED: August 19, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. g DATED: August 22, 1996 p BAIL pepuHtyLOR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( V) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY: �, Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( 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: D 9-/7- / 9 9(o PHIL BATCHELOR, Clerk, By , Deputy Clerk YARNING (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. DatedIQ BY: PHIL BATCHELOR by� Deputy Clerk CC: County Counsel County Administrator r~� ''aaiay *to: BOAM& SUPERVISORS OF CONTRA COSTA OM 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, 19879 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 6911.2.) 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 MONICA HOLMES RECEaVE:® - Housing Authority I�96 Against the County of Contra Costa AUG 0 or CLERK BOAR®OF SUPERVISORS District) CONTRA COSTA Co. Fill in name ) The undersigned claimant hereby makes clai inst th 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) ta Ca rn, 3. How did the damage or injury occur? (Give full details; use extra paper if required) _TN__ 4. What particular act or omission on the part of county or dis iot officers, servants or employees caused the injury or damage? f r (over) 5.. What are the names of aMty or `district officers, serval or employees causing the damage or injury? Mr 6. What damage or injuries do you claimulted? (Give full extent of injuries or damages claimed. Attac"twoimaestfor auto damage 7. How waZ the amoi TnU claimed alove computed? (Incl de the estimated amount of any prospective injury or damage.) B. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures ou made on account of this accident or injury: DATE ITEM AMOUNT �Q e l Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) orIx some person Pa hip behalf." Name and Address of Attorney 1 IMM isSignature) (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 010,000, or by both such imprisonment and fine. r n n S t � a N O 'q 4 l` y � 1 s v� i ,