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Home My WebLink AboutMINUTES - 07271999 - C16 CLAIM 171my "I Claim Against the County, or district Governed by ft Board of &Wrvisats, Routing Endarsem-its, NOTICE TO CLAIMANT and Board Wom All Section references are to The copy of t €s docLmnt moiled to you is your Califorria GoverrinentComp notice of the action taken on your clam by the Beard of Wiper sass (Paragraph IV befog, Oven pursuant to Governrnent Code SeCtion 913 and 915.4. Please note all " f rr i s", . 1OL'N"I'a $25,000.00 OMAN'. Michael. Gene Jones AT` NE : Barney Berkowil t z DATE RECEIVED; June 29, 1999 ��` �Z V Attorney at La;q ADDRESS, 3811 Bissell Avenue, 2nd e'-Ir. By DE�MRY T CLEO , June 23� 1999 Ricbv-nond CA 94805-2298 BY L POSTMARKED: June 281_:1999 LFRO-ft Clerk of the Board of Supervisors . County Counsel Attached is a copy of the above-prated claim. June 29, X999 PHIL EAS LOIt, Clerk Dated: By: P" '®„�m�; ' ' � °� `s A ✓ '; f Z IL FROA County Counsel Clerk of the Board of Supervisors Y� 77his claim coomplies substantially with Sections 910 and 91002. This claim ETES to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for is days (Section 910.8), Claim is not timely filed. 'be Clerk should return claim on ground that it was filed late and send warning of claimant's rift to apply for leave to present a late claim (Section 911.3). ) Other: of 7 Da ted �£� r` y > y County o?rasei r r� y F Clerk of the Board y�Counsel (1) County Administrator (2 ( ) Claim was returned as untimely with notice to claimant (Section 911.3). � BOARD ORDER.- By unanimous vote of the Supervisors present- This Claim is rejected in full. Other; I certify ftt this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 4_ 4 � p 'L EA Clerk, By � Deputy Clerk WARNING (Gov. code section n 913) �.� IMG 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 attorney, you should do so a immediately. *Por Additional inn See Reverse Side of This Notice. A AWr ' ' I declare under penalty of perjury that I am now, and at ,all tires herein mentioned, have been a citizen of the United States, over age 19; and that today I deposited in the United States postal Service in Mixtinez, California, postage fully prepaid a certified copy of this Board Carder and Notice to Claimant, addressed to the claimant as shown above. Dated. � Y <' ` Ey= PHIL BATCHELOR. By ��' � . � putt' clerk CC; Court/Com.stl County Administrator `Claim tc: BOARD OF SUPERVISORS OF CONTRA.!COSTA COUNTY a MTRUCTIONS TO CLAIM A. Claims relating to causes of action for death or for injury to person or to personal property or growing crags and which accrue on or before December 31, 1987, must be presented not later than the 10&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. (Gov't 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 fine 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 Dif-trict 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 U_W_ RECEIVED Against the County of Contra Costa or ) 91999 - District) CLERK BOARD OF SUPERVISORS (Fill i name} a CONTRACOSTA 20, t f > The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of Sld �d in support of this claim represents as follows: 106L l4� 00" C45 I.i prcq 404 1. Mein did the damage or injury occur?(Give exact nate and hour) 0� � t �� Dr 5 �16n re- I �I INWha :.5 ill m,s � , �� '� �. 1 ,� ` : 2. Where did the damage or injury occur?(Include city and county) fi fX � 1 � ;" n1a., en t ou,Q re'...(I I.rL 0.rl+� a iiq, 3. Ho did<the dama a or in'u occur? Give fall details;use extra r ifr aired g 1 rJ' ( , p required) l l tl` ao �C &�5 `64 Cilet_ C� Trallr,nlfvT�A hc6nnA , artd- +hc C_c�ort dis M"' t*s5nd, ahar�r_5 bU +hc- el"o " 'o r " Ori Ks 6L,3vl b r t,yet.I prwxdo r .. e nit,7 his 4 "4. What.particular act or omission on the part of coup or district officers, servants, or employees caused the Ylu� .injury or damage? � ` fV, �K � toy l l i"o U-cp 0-V411 4-n-A 111 -.0s 41T .. C4 � . 5. What are the names of county or districtcers, srvants, or e�rnp ogees g the d �amage or inlu - hi Po �Prftm 'Piro 6. at ries o you claim resulted?(Give full extent of Injuries or damages claimed, Attach two estimates for auto damage.) r' e4-V�r4AC,55� Calk <Ja � . ,I � , .3 n � �� POI' .. t .t t'lel t. 1 ht 7. How was the amount claimed above computed?(Include the estimated amount of any prospective inluty or damage.) k4 � 06tht- 8. Names and addresses of witnesses, doctors,and hos Stals. id 9. List the expenditures u made on account of this accent or injury' r D,DT'E M TDAE 41 r w� F u X I"""mo ehr for apnje,5 x. Gov. Code Sec. 910.2 provides"The claim must be signed by the claimant or by some pez on on his behalf;" S A Name and Address of Attorney ) rY ) (Claimant'sYi'gnature). r5f { ) ric-t.- -4 a fl.oc> (Address) Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defxaud,presents for allowance or the 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,f ail for a period of not more#lw one year,by a fine of not exceeding one thousand($l,(00l 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 bath such imprisonment and fine. �A y, y � � y F y i s F r m Wit t+ ki Je rN } A } Al .tet tf CLAD. JMNMAMM JTn- 271 l X99 Claim Agimt the County, or Dstrict Governed by ft Board of Supermors, Roilting Endoruments, NOTICE CLAIMANT and Board Acton. All Section reference are to N copy of i s docent ffilled to you is your Califorda Goverrmmt Code, rotiof the action taken on your daim by t Board of S per sors, (Paragraph IV beloM, Oven s€ ant to Govermmnt Code Section 9,113 end :.. ,4, Plow rote all 'Wgrin s"> CLAIMANT. Paul Delbert Moser ATMRN'EY. DAA FIVER: June 25, 1999 ADDRESS P.00220 A-4-115 BY DELIVERY TO CLERK ON: Pe vm Box 3030 Juice 2. , 1999 3ussnv_lle CA 96127 BY MAIL POSTMARKED: L FROM- Clerk of the Board of Supervisors TQ County Counsel Ached is s wpy of the above-noted claim. y ,... PML l3 Clerk Dated. JS:r e rya� p tsnty ler the �osrd of Supervis rs . 'Ibis claim complies substantially with Sections 910 and 910.2° This clsirr: FAILS to comply substantially with Sections 910 and 914.2, and we are so notifying claimant, The Board cannot act for l days (Section 910.9). Claim is not timely filed. e Clerk should return clang on ground that it was filed late and send warning of claimant's right to apply for leave to present s. late claim (Section 911.3). Other Z, f Dated. ♦qJ frfr{ . 0) s ....''tead �i't rs' {b , ut4County pd5t Counsel IM FROH- Clerk of the Board County Counsel I} County Administrator ) Claim was returned as Untimely With notice to claimant (Section 911e3). IV. BOARD ORDER:- By unanimous vote of the Supervisors present: This Claim is rejected in full. Othen I certify that this is s true and Correct copy of theBoard's Order entered in its minutes for this date. tedr PML BATCHELOR, Clerk, By Dept Clerk !� (Gov. e section 9i3 Subject t in exceptions, you have only six S) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government CO& Section 945.6. You may seek the advice of an attorney of your choice in connection with this tnstter� If YOU Want to ns':lt an attorney, you should do so iinniediately. *For Additional Warning See reverse Side of This Notice, AFMAVIT OF MAIMG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been s citizen of the United States, over age 18; and that today I deposited in the united States Postal Service in Martinez, califomia, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. dated ; By: ply BATCHELOR y _ �, � puty Clerk urly camselcoCounty Adr6nistmtor Clakim to: BOARD OF SUPERVISORS of CONTRA COSTA COUNTY A. 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 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. (Gov't 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. EraMd, See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp L RECEIVED Against the County of Contra Costal JUN 2 5 1999 C1.FFtK f7 S�AROF S District) OLRD SUS RVISORS o. (Fill in name) ) The undersigned claimant hereby makes claim against the County of r Contra Costa or the above-named District in the sum of $ , cb. tt and in support of this claim represents as follows: w i . when did, the damage or injury occur_? t 'Give exalt date and hour 1110 C; LL .\ Zlat•,. _ 4 . ` (� 2. Where diad the damage or injury occuF? l(Include city and county) 3 3. How did the damage or injury occur? (give full, details: use extra paper if required) 'aG 15t' ^ g; -t - ct -, -A"' l..f C.: i'e.!' .1 ...<,.. �.�� S*'k'?C..`? `-k�. Vz✓C L.: �, t 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5. ,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 claim d. Attach two estimates for auto tt damage. )tt` - , "L' C_ a-''t"'�v +1"iE, C7 E?::> `a t:'2 k{--rv}C,. f`i'L ti�..."2-a '.,t <::�-^'- j tr..f Y-.. _.i..,#;J#:+•¢ y-£:,�, ..T`s 6,g C•.�;-'t,Y r. a u'G [tx..�:.i'`f`^ ""�'.t vi:�., {;- c..'�^'i V i �� y'Y""i C.�v^-t�.�,. (,`�+r�''Oi/'e'kr`'�'""S L.. f f✓ .�" 'J` ..4,....}5.t?_ �l •4,Y .:e` {3..a'1rc -:>"tom l"' `�'" f v%. ' C:' "'f'" u&y E''i} 'e4-',c'.s'i C:f%,. 7. How was the amount claimed above computed? (Include the estimated {��^^^' amount of any prospective injury or damage. ) , ... - k-00""" �: cXV� }'5 �'` �'- F RC-'3''J r 1. Ea. '}`C;.. C _... -' f iJG'..y'�j L i i E.i.% j U�. - r�� cx j ' / f5 L£ c`k� Gli'i'ar.c r r' fF-'!'' s". r5 {'' � ?% t;'�'r'•. ',t f..r r;_zc,. ,.Yi'i ^.""G t"'G,C�. ��w:t f~:,'fC�,:;�a 8. Names and addresses of witnesses, docto a and hospitals. 9. List the expenditures you made on account of this accident or injury. c' ti'ec� ; f TIME f-MOUNT - '= .. } Gov. Code Sec. 910.2 provides } "The claim must be signed by the claimant or by some person on his SEND NO-TI99S TO: t behalf," Nime an .` d Address of Attorney ) ~ A y ? S`4, .r..`?C'r^ PIC;,5 e � .. ) (Claimant's 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. CLAM JMARDJMM MY 27, 1999 Ulm Against the County, or District Governed by ft Board of 4ervisors, Routing Endarser nts, NOTICE TO CLAIMAN'T and Board Action, All &ction references are to N copy of this docomni rnalled to you is your California Gavermwit Codes, notice el the action taken on your claim by the Board of &pervisors. (Paragraph IV belowl, Oven _ 3 z pursuant to Govennent Codaectiorn 913 and n 915.49 le rote all ' `erings". e� v� /, 47-7 � �,J AMOUNT: $,451 n X49 LIMAN7. Daniel A. .Muller* and 1c._.elle D. Estrada AO : Dan'el A. M�ull.erl, Esq. , DAM RED, June 28, 1999 SBNN 169935 ADDRESS: Meyers, Riback, S".lver &BY DELINERY TO CLERK ON; June 28, 1999 Wilson aye is r ?laza June 26 1999 777 Davis Street-, Suite 300 San Leandro C 94. 77 FROTNE Clary of the. Board of Supervisors . County Counsel Attached is a copy of the above-noted claim. PML BAT Clerk s Dated:_ June Z81 1999 y; Deputy. IL FROM County Counsel M Clerk of the Board of Sup rvis•rs This claim complies substantially with Sections 910 and 910.20 L' This claim FAL S to comply substantially Faith Sections 910 and 910.2, and we are sus notifying claimant. The Board cannot act for 15 days (Section 910.8). Claim: is not timely filed. The Clary 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: -3 Dated; r` s.'` y; ° pasty County Counsel f IMM. l Clerk of the Board aunty Counsel (l) County Administrator (2) Claim was returned as untimely with notice to claimant (Section 911.3). BQARD ORDEYb 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 its its :minutes for this date. Dated:nPML BATCHELOR, Clerk, By pasty Clerk d 13) ' . (Gov. code section 9 Subject to cerin 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:. Sec Government Code Section 945>6. You may sects the advice of ars 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'Dais Notice, AFFIDAVIT OF I declare under penalty of perjury that I am now, and at all tunes herein: mentioned, have been a citizen of the United Stags, over age IS; and Haat today I deposited in the Ignited Stags Postal Service in Martinez, California, postage Bally prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shote above. Bated; : ��f y; Il ii. BATCBELOR y - eputy Clary CC: County comsel Courcy Ad�r,nistrr:or 0, Mtoe BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY MSTRUCTIQNS TO CLAMAINT A. Claims Miating to causes of action for death or for injury to person or to pe mnal property or growing crops and which accrue on or before December 31, 1987, most be presented not later than the 100� dky 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 14 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 agaimt each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Seen 72 at the end of this fqnn. RE: Claim by Ike ed for Clerk's Filing Stamp Daniel A. Muller & Michelle D. Estrada RECEIVED Against the County of Contra Costa ti JUN 2 8 1999 or Contra Costa Co. Fire ProtectionDistrict CIIERK BOAP0 OF 5U,`_"SVMriS �66, (Fill in Name) The undersigned claimant hereby makes claim against the County of Contra Costa or the above named District inthe sine OfS 451.47 -and in support of this claim represents as follows. 1. When did the damage or injury occur? �cive exect Date and Hour) Friday, April 30, 1999, at approximately 1.00 a.m. -------------------------------7- ------------------------------------------------ ----- 2 k y. Where did the damageorinjury occur? ,i�niadz city ans�count ) 1421 SprIngbrook Rd. Walnut Creek, Contra Costa County -------------- ----------------------------------------------------driveway----------------- 3. How did the damage or injury occur� (cine m dtta&-,urmqwredOu se extra ppW� ) r driveway has a bridge across it, ma�e o-Pwoodiously 11 In response to my call to 91-1. for paramedics to assist my wl , W-0 wasser a -fire engine was sent, in front of the paramedics' van. The fire engine's driver saw a sign at our driveway stating that the bridge could handle 10 tons. The driver decided that although the engine weighea, 17 tons, less than 10 tons would be on the bridge ----------the ------ ---------- 4 me$. o he . oceeisd to c-o=.q he ,W which broke rxcqe Veit 4 JUS%�O&% n g. IF IwAt partidn'lar hepor emiWon, an � e p y or cers, servants, or g art of c8at injury or damage? I told the disnatcher during the 911 call, and before the fire engine crossed the bridge, that there is a bridge at the entry to our driveway. The dispatcher told the engine driver this before he proceeded across the bridge, The driver also saw the sign before crossing the bridge. Finally, there was absolutely no need for the firem=en to cross the bridge, because our house is only 40-50 feet up the driveway, and it would have taken only 10-1-5 seconds for the man to reach t. .0ver),o-ase by foist. When I asked the driver why he crossed the bridge, he said he made a mistake, and that the disict would pay for the bridge repair r costs. p �aawuaspdwg qi q�eq 9q job 00011 r iellop pannagi aua ufp axa tau ja gag a kq 'j g a s q� Baa dam jo papal's raj 1pt kjanm;�q; ug �uawaospdwz Sq ng4p ajgegiqund 9� UlIUM.10'.9aP80A m a 'lliq A ja z ajap �j 20 mjvj sai°a la zg j!ams aqt(vd xO tAogp Ol pazpoqlnv a.133WO ja pjvOq;a ojp 10 Sm' anaa A o�as£aaa a io p voq nets Suv a�wa Svd.90J,aea Wa AAajj'6JOJ RjUaS d fipON.Ijap 04�Ua3tll gj�Ai'04A a .-A , map!Aaad apo ivuad ag4jo rL ugpaS 331ioN §8 +� &3 � k% 43 Ya`4 � � �% 24 $4 � k .°A � p$ 56 � 3w. §a X � s3 Yfi � � �j � R4 � 88s3 � sfi � � $� � S° +✓ Re �^ $4 � � sg i� �F �" � •'R � �*" 7 — ZL—f/LZ (GZ6) "OAF JUG0aja ' OOc m S �^� S) -OK. mogda€a , 969:76 W) 'Xaa.aD 4nu'VY1 (ggwv) LL5t,6 V3 'oapuPaU UPS - °p2 NooaqbuTars TZ i 00£ 94TnS 'q.aaaa, SIA2Cs LGL VZ�Mai r�PMG4po 'anaq 'sa9AaW .. � � � °• S£669T Nag 'bs;z 1d79TJnw •V laluva qaq siq UO u0slad mOsSq.a _F - (sa onv) OL muom auras Z-016-32S 3POD'AG9a 66/0£/V Pa' sP ; s.a-rvdaa aog s-raT.aaa-erT pup aagmn i -To,- gd-taoaa pagova 4P aa0 °amp a .aSaarm ja�uappm szgz ja junwav uo apvw naafi saimpuadvo aq�mj °6 m � m --wo.a mvs aogv9nYonxqmoa abap-r- i e pus 'uaddeq rtT Mss uaw axrg eqj -pauadduq aT aagjv 4snr a5pwvp aqa Mles ATgvgoad BAPq a,uop I sa;uau asogM) sogpaUsvaed aqj °epvaas OTTaqOTW 33-,qu raid-oa 'a Tr Aw pup 'p qH 4puV lgsgvd uvl-V saoqu6Tau Aw a.ap aovg aq4 aaajv aha-ewpp auq oa sassa TM s-cgq j asuadxa pup alta-ca PTvs ao; sa6vuzvp aaga.an ,vio oa agBTa aqq an.aasaa I saoaTd ssoao paBsimpp au a ano apaa pum sa apdaa aqa ayvw oa saoggbTau Aw pup am Aq pa.aanouT asuadxe pup ate; aqa apn jou T aou scop puv 's vIaaaew aT4a .aOJ Ajal9W ST V40a aql � a�� r��.aa,�a•��3 s,�ga�a�sc.a��rn;€zs�n��sa awl a�azsgaaaE) sp�� a�$�"�a9.aE�&�r �a�a ��h.�q��$�w<9r� �a�5 "L ---------------------------------------------------------------------- s; as pan n aqa ao; ad:aoaa V °sa i?dea aqa paaaTdwoo I pup s.aoggbTeu Xw °s.aTPdaa aqa .:og Aasssaoeu aaaM saoaTd ssoao p? ;o Teaoa le pup 'BUOT aaa; ZT ATaavuiTxoadda svm aooTd qvp Tj pa4paa4 aanssaad„ZaxZ sr aoaTd gova °paOPTdaa ag oa papaeu Aaga os 'auti6ua aaT4 a' 4 Ag palicaasap aaaM woa d ssoao asp as aqa go cJ ATaavuTxoaddV ,sag saysszpaa OA64 q,-Inuv -Pas ivp".Iu zp 10 sAgamp zvq '9 a5pTaq aqa oa a5vmvp aqa ao; PinoM pup 41na; aP svm 43Ta4s p- aqa 4vg4 pTvs Raga asnaoag 'saamu asaga a95 aou pip I , '', ................ .... .... .........�...� �.'i�.."�i��lE��-, -..-.:.,. �` - " :K "�i a j:jk:::]:i:i,::::i:i:i:i:i:i:i:i:i:]:i,j ....... � . ....... - ........i ......... 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All Section references are to The copy of is docent r4led to you is your California Goverrmnt Codes. wtice of the action taken an your claim by tte Board of risers. IPeregre h IV belowl, given rsent t t Cede Section 1 and =° 915.4. Please note all *Fernings". M0LN, : 1n Excess of $25,000 L : Charles J. Theveny TO NEYe Paul D. Hiles, yy��yypp ��, Esq.. DATE jure 24 �, 999 Sch-ijpp ADDRESS. 540 Lennon} Lane, S de. 250 BY DELIVERY TO CLERK ON: Walnut Creek CA 94598 BY MAIL POSTMARKED. Oft Clerk of the Board of Supervisors TQ. County Counsel Attached is s copy of the above-noted claim. ane 2 .1999 PML Bhp ., Clerk Dated: � By; Deputy ard of Supervisor visor \A 11is claim complies substantially with Sections 910 and 910.2. This cla=m FAILS to comply substantially with Sections 410 and 910.2;and we are so notifying claima to Ile Board cannot act for 15 days (Section 410.8). ( 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 � : 5 r4 ` y, f rA , puty Count c s t Clerk of the Board - qty Counsel (1) County Administrator (2) ( ) Clair: was returned as untimely withz notice to claimant (Section 411.0. 7� BOARD ORDELBy unanimous vote of the Supervisors present. This Chinn is rejected in full. (� ) Othen I certify that this is a true and correct copy of the Board's Order entered in its minutes for his date. Dated: '.' , .111 . - p 1, Clerk �y Deputy Clerk WARNING (Gov. code se, ion 913) Subject to ceruin exceptions, you have only six (5) 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 Set Reverse Side of Ibis Notice. AFFIDAVIT OF WMXNG 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 189 and that today 1 deposited in the [United States postal Service in Martinez, California, postage fully prepaid s certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Date d� - �� y: � 1a �� C�1�� y puty Clerk a : county Counsel County AdrrunRstrator Paul D. Hiles, Esq. SCHaAR`y�Z,oLBER & HILI � Ci, � �mw �._. -_a- ,i's4S.de .yn , Lane, 4:.: .t I ¢ R.ECEVgym R Walnut 'Creek, CA 94598Telephone . (925) 932-4314 � r JUN 2 4 10,99 At—to `ney for 'Clai-m n C' flu SOAALI OF SUPEq.VISCRS .. TP.A COSTA CO. CLAIM AGAINST CCB . COSTA COUINTY/CONTRA COSTA HEALTH SERVICES/CONTRASERVICES/CONTRA COSTA REGIONAL MEDICAL CENTER FOR MEDICAL MALPRACTICE The undersigned hereby presents the follow-ng chin agaiinst Contra Cosh _ ra Costa Alhambra Avenue, Martinez,- California. rtin zCalifornia. Name of Claimant: Charles j. The+Peny Address and telephone number of Claimant: 5125 Concord Boulevard, Concord, Cal-ifornia 9452:1, telephone number (925) 825--6082 . Seed Notices to: Pain, D. Hiles, Esq. Schwartz, S41ber & .-Hziles 540 Lennon Labe, Suite 250 Walnut Creek, CA 94598 Date of the incident: On or about January 25, 1959 Place of the incident: Martinez Health Center/Contra Costa Reg.4onal Medical Center, 2500 Alhambra Avenue, Martinez, California 94553 . Genera; Description of the incident: Claimant was a patient at- said tsaid medical f cil-.ty on January 25, 1999, for a ro'C'ine colonoscoT)y, following which claimant as taken to surgery and forced to undergo an exploratory laparotomy which was unnecessary, pa;_nful, and has resulted in numerous physical complications amore filly described he:�einafter. Act or Omission on the part of Public Employees that Caused the Injury or Damage: Contra Costs. County/Cont—ra Costa. Health ervices/Cont-°a, Costs Regional Medical Center, their agents, employees, who were employed by crosir,,aant 4.o re.--der rofessiona services in the dl'a `%°iosis p treatment and care of claimant, negligently failed to exercise the proper degree of knowledge and skill in examining, diagnosing, treating and oaring for claimant in the performance of a colonoscopy and subsequent 1a aro tomy, such, that claimant was forced to undergo an unnecessary, pa L fel and expensive surgical procedure. The agents and employees of the entities furthermore failed to consult with one another with respect to appropriate care and treatment of alai ant, failed to undertake or investigate the possibml qtyofE :m^re conservative measures prior to surgery and failed to inform claimant of the risks attendant 'poem' the treatment undertaken and failed to eget his consent . As a further result, the agenzs and employees of the geverni ental entities committed a ba-eery Pon cla,S.rdiant. . .Names, if known, of any Public Employees Causing the Injury or Loss m Clal ant is informed and believes and thereon alleges that Drs. Ste-ohen D. Weiss, M.D. , k:ane � . McCormick, M.D. and Mark E. Vukalcic, and possibly others whose identities claimant will assert when ascertained.. Names and Address of Witnesses: ?n addition to the aforementioned agents is and employees, claimant is L-n-formed and believes and thereon alleges that Dr. Paul M. ReLf,, M.D. mas know-Ledge of and may be a witness to facts stated above. Names and address of Doctors and Hospitals Where Treated: See above General Description of the Injuries and Damages Sufferedt. Unnecessary laparotomy with significant abdominal scarring, and other complications, .Lncl •ceding pall, mntest5 nal disfunction, embarrassment, and other injuries and damages claimant will assert when th ey are fully known. Total Amount Claimed: Total damages are unknown at this time, however, they include, but are not limited to, general damages for pa®n and suffering, Dalt and future medical expenses In an amount unknown at this time but according to proof, including, b,�t not linited to, the cost of surgery, surgical recovery, and loss of income, all In an amount in excess of the minlmunm jurisdiction of the Superior C-ourt, i . e. , in excess of $25, 000 . Description of Property Damage: Norge This is not a chain for indemnity. .ATED: jun e 21 , 1-999 PAUL HELES Attorney for Claimant 4 AF LI A `I N' `IMS" LATE CLAIM JULY 27 1999 BO : D Off' �� STA AIS FORMA BOARD ACTION Application to pile ate Claim NOME TO A-MLI ANT Against the County, Eouting "T"he copy of you is your Endorsements, and Board Action.) notice of the action taken on your appli motion by (All Section Raferences are to the Board of Supervisors ( aph 111, law)� CaliforniaGoverment } given pursuant to Gov gat Code Sections 911.8 and 915.4. Pl rote tie " below. Claimant Mic.:nae i Ard At torneyi Cynthia F. Newton Lasa Offices of Walkup, Meiodia, Kelly & E.-heverrie Addresst 650 California Street, 261-1- door San Francisco CA 94108-2702 AM0 un t 83,000,000 By delivery to Clerk on June 2.5, 1999 Date Received® jurne 257, 1999 By mall, postmarked on .dune 24, -1999 icor Mot ° 1 Attache is a copy of the above Noted Application to File Late Claim. DATWt Jun e 25, 1999 PETL EMMM, Clerk, By put Q em t s Clerk of the Board of Supervisors The Board should grant this s Appli ti oar to File We lai mo'tio 911.6). The Board should deny this Application to File eta Claim > s € a A � w k (Check one Orly) s The Application is granted (Section 911.6). This Application to File Late Claim is denied ( eetion 911.6). certify the. this is a true and correct copy of the Boardes Order entered in its minutes for this date, 2 i4 _jPKI BAICi=R, Clerk, By Deputy WARNM Wv. Code 1911.8) If You Wish to file a o=t action on this matter,, you must first Wtition the WrWriat* for An Order relievingthe provislowof Government Code sootion 945.4 (claims entatic t). fte Goverjoent Code Section 946.6. Such titin =At be filed with the court within six (6) wnths fr= the date your application ford talate claim was denied. You MY Seek the advise Of &MY AttOrWy of yow choice in cowAction with this matter. f t to ,t t d i i atel 1 ,a rar Attached are 00piesof the above Application. We notifed tete applicant of the Board's action on this Application bY mailinge copy of this doomeint, and a mwo thereof has ben filed and endorsed on the Boardfa copy of this Claim in accordance th Section 29T03. A Ire � �cft qty FRM. 1 ty 1 County A ttretorTOt lark Received copies of this Application and Board Order. of Supervisors DAA County Counsel 0 By County A nistrat rj, APPILICATIZOIN TO FILE LATE CLAD4 j g �p Law Offices of Q� �i PAU'.V.Nc[.00IA T f g d@�.1 KELLY �dCHEV .s A CYNTHIA F. NEWTON 'AME;j.1.'nELiY MICHAEL 1.R.ECUPERO ,JOHN ECHEVERRIA A Professicna/Corporation DOUGLAS S.SAECTZER RONALr H.WECHT 656'CA,iFORN'A S?REE-,, 26TH FLOOR,SAN FRANCISCO,CALIFORNIA 94108-2702 KHALDcuN 'K.BACSHDAD7 t1A1C14AEl.A.KELLY TELEMHONE(415) 951-7210 FACsimiu(415)39"s-6965 DORIS CHENG tiEvtN 1,DONEEcus E FrREY P,e4ion OF COUNSEL DANIEL D;u'`",JssO foHN D.I iNK REC:iARD I'2.SC:�GEN$ERGER WESLEY SOKOLOSKY,M.D.,1.D. BRUCE WALKUP June 24, 1999 R;cnARD B.CaeT;-IALs,9R. (?g5ff-17�i�} IIIA CERTIFIED MAIL RETURN RECEIPT REQUESTED Board of Supervisors { County of Contra Costa E C E 65�1 Pine Street, #l0 Martinez, CA 94553 JuN s Ike: Claim of Michael Ard E A T�� 3^ Dear Sir orMadam: Enclosed herewith please fi-nd the original and one copy each of Application to File Late Claim and Claim for Personal Injury Damages Against the County of Contra Costa in the above referenced matter. Please acknowledge receipt on the enclosed copy and rets to us in the envelope provided, Thank you for your anticipated cooperation. `fiery truly yours, CYNTHIA F.NEWTON- CPN;sg Enclosures i LAW OFFICES OF WALKUP,x'�d�EL°o3DIA,KELLY&ECHEVERRIA A PROFESSIONAL CORPORATION RECEIVED 550 CALIFORNIA STREET, 26TH FLOOR � 3 SAN FRANCISCO,CALIFORNIA 94308-2702 (41 5)981;-7210 JUN 2 5 1999 4 MICHAEL A. KELLY (State Bar#71460) CYNTHIA F. .NTE TON (State Bar#13 0955) RK B"01MD Cc SUPE-RMORS �. ATTORNEYS FOR CLALMANT f 7 i. 8 IN THE SUPERIOR COURTOF THE S TATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF CONTRA COSTA l I Case No. 2 In the utter of the Claim of Michael Ard APPLICATION TO FILE LATE E CLA Ili I 13 Against Contra Costa County l 14 1 ` ! 16 TOO THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY 17 1. Application is hereby made, pursuant to Government erode sec. 911.4 for leave to 1 present a late claire on a cause of action for negligence and personal injuries which accrued on 19 August 8, 1998, for which claire was not presented within: the six-month period as reauired ley{ 29 Government Code sec. 911.2. This claire arises from an accident which occurred or August 8,I 21 1998. The claimant, Michael Ard, was a patient of Contra Costa County Mental Health Services, 22 I when his psychiatric medication was abruptly discontinued, causing a psychiatric/psychotic i 23 incident in which Ard suffered serious psychosis, causing a fall in which he fractured his r:ec c and 24 back. (See, Proposed Cla;.m attached hereto.) 25 I 26 APPLICATION TO TE E� 1 Z. The claim was not presented within the six month period (ori or before February 8, 2 �j 1999) because claimant was physically and -mentally incapacitated during ail time specified in sec. 3 1911.2 for presentation of the claire and by reason of such disability failed to present a claim during li such time, as provided by Government Code sec. 911.5. Alternatively, the claim was not presented 5 within the six-rmont i period because of mistake, inadvertence, surprise or excusable neglect and 5 Contra Costa County was not prejudiced in its defense of the claim by the fail-are to preser=t the 7 claire vAthim the time specified in sec. 911.2, as provided by Government Code sec. 911.5. (See, 8 Declaration of.,lady Ard attached hereto.) 1 1 9 3. This application is being presented within one year of the accrual of the cause of a 10 ! action as allowed by Goverrment Code sec. 911.4, 1 I certify and declare under penalty of perjury under the laws of the State of California that 3 12 the foregoina is true and correct, 13 DATED: June 999. rt °r 7lre 15 CYNTHIA F.NEWTON 15 17 18 19 �+ I 20 j 21 22 23 � 1 24 25 i 26 i LAW OFFICES OF WALKUP MFLODIA, KFLLY& CHEM11R!A A PROFFSSiONAL CORPORATION -2- 650 CALIFORNIA STREET" f 26TH FLOOR _ SAN FRANCISCO,CALIFORNIA 94108-2702 APPLICATION TO FILE LATE CLAIM (41 5)981-7210 i LAV OFFICES OF A PROFESSIONAL.CORPORAMN 650 CA€FORMA,STREET,26-1 H F. OR 3 SAN FRANCISCO,CALIFORNIA 9411 08-2702 (415)981-7210 4 MICHAEL A. KELLY (State I3ar##71460) CYNTHIA F.NEWTON (State Bar#130955) 5 i ATTORNEYS FOR CLAIMANT 6 ; 7 8 IN THE SUPERIOR COUNT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF CONTRA COSTA 10 11 Case No. ! 12 In the Matter of the Claim of Michael Ard � DECLARATION OF JUDY ARD IN 13 # Against Contra Costa County SUPPORT OF APPLICATION TO FILE 7 LA'Z'E CLAIM 14 � 15 ' 1 � 16 1, Judy Ard, declare as follows; 17 I rnake this declaration: in support ofclaimant Michael Ard's application for presentation oxl f 18 a late claim against the County of Contra Costa. , 19 Michael Ard (date of birth September 10, 1961.) is my son and I have been invol vedl 20 and familiar with his medical care, including his mental health care throughout his lifetime. In 21 j 1992, my son was diagnosed with -manic depression and bipolar disease. These difficulties, added' i 22 to his leaning disabilities with which he has struggled for many years, have made living! 23 independently difficult, and at times impossible for Michael. 24 2. In 1992,he came under care of Dr. Hernandez with the Contra Costa County Mental� 25 Health Services, In or around 1997, Dr. Hernandez left the County and Dr. Champlin tools over 26 DECLARATION OF JUDY ARD i r primary responsibility for racy son's mental health care. As part of that care, Dr. Chas-Taplin 2 managed Michael's medications for his bipolar disease and manic disorder from at least 1996 3 forward. 4 i 2. Since his diagnosis in 1992, based on my observation and:ray conversations with his 5 treating physidans, including psychiatrists, 1 have understood that Michael's psychiatric problems 6 have been moderate to severe, and have interfered with his ability to work and to live? 7 independently. As a consequence, while a conservator or guardian has never been appointed for 8 hien, t-ae has required extensive living assistance. For the period. May 1998 through the August 8, 9 1998 accident described in this clams,he resided at Diablo Valley Ranch. � 10 3. prior to the August 8, 1998 accident, Dr. Champlin directed that my son.discontinue 11 several of his psychiatric medications which were prescribed to control his manic depression and l2 bipolar disorder. Thereafter, any son ceased taking various psychiatric medications. On or about i 3 August 8, 1998, I because aware of Michael's suffering a manic attach or other psychiatric incident, 14 in which he suffered a serious fall, fracturing his neck and back. His doctors diagnosed T6-T7 i 15 Brown-Sequard Syndrome with C2 and`1`6-7 fractures. I 16 ( 4. Following the incident, my sora was taken, to Mt, Diablo Hospital where be was 17 stabilized. Then he was transferred to John Muir Medical Center and subsequently to University of I 18 California San Francisco where Dr. David Bradford performed surgery to stabilize his fractured} } spine and. neck. From there, he was transferred to Santa Clara Valley Medical Center where hel 20 (� remained hospitalized from.August 24, 1998 through October 15, 1998. I 21 5. Following the accident, Michael was completely paralyzed from the waist down.1 22 1 1-iis physicians advised that he would be unable to walk as a result of his spinal fractures. Indeed, 23 Michael remained almost entirely paralyzed during his hospitalization through October, 1998. 24 6. Michael also received psychiatric medical care while hospitalized at Mt. Diablo, 25 John Muir., University of California, and. Santa Clara Valley Medical Centers. As part of this care, 26 he received psychiatric medications which had been discontinued by County physicians before the LAW OFFICES OF j WAS.SSU..z,L�fE.LOMA, KELLY& 'CHEVERR?A A PROFESSIONAL CORPORATION —2- 6SO CALIFORMA STREET 1 26TH FLOOR SAN FRANCISCO,CALIFORNIA — - DECLARATION yg A TION OF JUDY ARD�'S D 941 702 1..1 c_.Lr .t ef�.t�iX �..J'lta @.J .54J 7J Z 1'#SI,tJ (41 5)981-7210 i I i I� I y I i I accident, as well as other psychiatric medications,which provided some assistance in stabilizing, in. 2 1 part, Vichael's manic disorder and bipolar disease. 3 7. After his discharge from Santa Mara Valley Medical Center, Michael wash 4 trannspo ted to my home in Martinez, California, where my husband and I have cared for him., with 5 the assistance of in-home nurses and other medical personnel, since. Michael was initially nearlyl 6 totally ,paralyzed and unable to walk or even to transfer himself from his bed to a chair. It was i 7 necessary to use a spine hoard to move him at all for the first weeks. Eventually, through extensive 8 physical therapy he was able to transfer himself from bed to chair with assistance. Only after 9 weeks of therapy was he able, despite the doctors' grim prognosis to sit in a wheelchair and hobble 10 short distances using a walker. � 11 8. In addition to my son's emotional and physical difficulties, following his accident 12 my husband and I, who are not his official legal guardians but who have assisted him n financial 13 and legal inatters, were consumed with the daily requirensents of caring for our son at home and� 14 transporting horn to multiple medical and therapy appointments. These responsibilities prevented 15 i' my husband and me from attending to any investigation or inquiry into Michael's accident within] 16 � wl-hat A now understand to be the 6-month time frame described in the Dov, Code. 17 9. Based on the facts stated above, I believe this late claim should be accepted based( ?.8 on Michael's physical and mental disability during the entire six months following the August 8,� 19 1998 accident. alternatively, this late claim should be excused due to mistake. fnadverterce ori 20 excusable neglect on Michael's or my part. i 21 I declare under penalty of penury that the foregoing is true and correct and flhat if called as 22 a witness I could and would competently testify thereto. 23 1/I 241f1 i 25 Itl i 26 LAW OFFICES OF W�.AL--Ulm MIEF..ODIA, v� L1EUV&1--CHEVERAZA A PROFESSIONAL CORPORATION -3- 550 CALIFORNIA STREET 25TH FLOOR SAN FRANCISCO CfiORNIA 94C8-XIj3 OF JUDY ARD02 } LClTV {4151981-72-10 if 981-72 i 0 iE f Executed this---l.,= day of Jae, 19991n San Francisco, Cailfola. 3 4 JUDY ARD 5 1 6 7 8 9 10 f� 12 3 i 14 15..1 16 1 18 19 f i i 20 � 21 22 23 II 24 2s I 26 LAW OFFICES OF WALKUP,MEL ODHA, Ts"3�L'Y&nC HEVERRSA. }( A PROFESSIONAL CORPORA?:ON -4- 550 CALIFORNIA STREET 26Th FLOOR SAN FRANCISCO,CALiFORN;A 941108-08-2702 DECLARATION OF JUDY 4157g$1_721 0 157981-7210 CLAIM FOR PERSONAL I��_+JURY�"�'DAMAGES AGAINST THECOUNTY Oma` CONTRA A COSTA TO THE BOARD OF SUPERVISORS OF COUNTY OF CONTRA COSTA You are hereby notified that Michael Ard claims damages from the County of Contra Costa as follows: A. NAME AND ADDRESS OF CLAIMANT: Michael Ard 245 H Street Martinez, CA 94553 Phone: 92.5 228-9090 Age: 37 (date of birth. 9/10/61) B. ADDRESS TO WHICH COMMUNICATIONS CONCERNING THIS CLAIM SHOULD BE SET: Michael .Ard c/o Michael A. Felly, Esq. Cynthia F. Newton, Esq. Walkup, Melodia, Felly & Echeverria 650 California Street, 26''�' Floor San Francisco, CA 94108 Phone: 415 3$1-7210 C. DAMAGE OR INJURY OCCURRED ON THE FOLLOWING DATE IN 'I I HE FOLLOWING MANNER: The incident and injury occurred on or about August 8, 1998, when claimant suffered a psychiatric/psychotic episode as a result of inappropriate and unproper discontinuation of his psychiatric medication. During the episode, claimant suffered a significant fall sustaining back and neck fractures requiring extensive surgery and hospitalization. Claimant was taken to Mt. Diable,Hospital where he was originally treated and received additional treatment at John Muir Medical Center, University of California San Francisco Hospital and Santa Mara Valley Medical Center where he remained hospitalized from August 24 through October 15, 1998. D. ACT OR QMISSIQNTCAUSING INNJURY AND DATMAGE: County mental health care providers including but not limited to physicians Dr. Hernandez and Dr. Champlin managed claimant, Ard's mental health care. Drs. Hernandez and Champlin, and others whose na M. es are currently unknown to claimant, inappropriately and negligently evaluated, examined, treated, diagnosed and cared for claimant Mrd causing him to suffer a psychological or psychiatric event on or about August 8, 1998. During the episode, claimant was unable to properly ambulate, recognize dangers, care for himself and exercise appropriate judgment, such that he suffered a serious fall fracturing his back and neck, requiring extensive medical care and treatment and causing permanent significant disability. Such negligent care included, but was not limited to, discontinuing specific psychiatric medication, without appropriate monitoring and follow up care, such that claimant suffered a psychiatric/psychotic episode during which he fell causing serious injuries. Claimant reserves the right to amend this claim as additional facts supporting or revealing negligence or other culpable conduct become available. As a result of his injuries, plaintiff suffered paralysis and other injuries and damages presently diagnosed, E. AMOUNT OF CLAIM: $3,000,000 including medical expenses, lost income and general damages. Dated: June 2 , 1-999 WALKUT, MELODIA, KELLY & ECHEVERRIA By CY,NLTHI F. NEWTON Attorneys for Claimant 2 a � z � > .a M a, z a v n F t`� Q f n o a � vµ Rt jb ru cm 0 CO act 20 0 r Z 7•:j �,