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HomeMy WebLinkAboutMINUTES - 08142001 - C.27 UW JUL 202001 CLAB1 COUNTY COUNSEL .BOARD OF SUPERVISOR OF CONTRA COSTA COUNTY, CALIFORiS'—F NICE—,r'ALIF. BOARD A 0 0 August: 14, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to I The copy of this document mailed to you is your California Government Codes. ► notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $25,000 CLAIMANT: James E Morrison ATTORNEY: Jason Pollack DATE RECEIVED: July 19, 2001 ADDRESS: 10940 Wilshire Blvd #1400 BY DELIVERY TO CLERK ON: July 19, 2001 Los Angeles, CA 90024 BY MAIL POSTMARKED: July 17, 2001 I. FRONL• Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JO _ lF-TE i, ler Dated: July 19, 2001 BY: Deputy H. FROM County Counsel TO: Clerk of the Board of Supervisors ( his claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ~?�3a/ By: Deputy County Counsel M. 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 tered in its minutes for this date. Dated (' a� JOIN SWEETEN Clerk, By �•' G/W�.` Deputy Clerk WARMING (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. J` Dated: a(,(C G(;,Gt����;�(I�� Bv: JOHN SWE]rTEN, CLERK I This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to un'derstand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I RECD : 'ED LAW OFFICES OF JUL 1 9 2001 Jason A. Pollack CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. ✓ Respond To: 10940 Wilshire Boulevard • Suite 1400 580 California Street Suite 500 Los Angeles, CA • 90024 San Francisco, CA 94104 Tel 310•824• 8733 Fax 310-824 •9606 Tel 415 •283 •3244 Fax 415 •283 •3314 July 17, 2001 CLAIM OF JAMES E. MOR.RISON AGAINST THE STATE OF CALIFORNIA; THE CALIFORNIA DEPARTMENT OF MENTAL HEALTH; NAPA STATE HOSPITAL; LAURA RAY; EMPLOYEES, AGENTS, DOCTORS AND NURSES OF THE STATE OF CALIFORNIA, THE CALIFORNIA DEPARTMENT OF MENTAL HEALTH AND NAPA STATE HOSPITAL; CONTRA COSTA COUNTY; CONTRA COSTA COUNTY FORENSIC MENTAL HEALTH CONDITIONAL RELEASE PROGRAM 1. Claimant : Name: James E. Morrison Institution: Napa State Hospital Date of Release: February 9, 2001 Patient Number: NA2033561 Attorney: Jason A. Pollack(SBN 173173) 2. Contact: Attorney: Jason A. Pollack (SBN 173173) LAW OFFICES OF JASON A. POLLACK 10940 Wilshire Blvd. Suite 1400 Los Angeles, California, 900024 (p) 310-824-8733 (f) 310-824-9606 Claim of James E. Morrison July 17, 2001 Page 2 of 6 3. Date Place and Circumstances of Claim: A. False Imprisonment/Wrongful Confinement/Intentional Infliction of Emotional Distress/Negligent Infliction of Emotional Distress/ Negligence/Gross Negligence/Interference With Right To Obtain Review Of Confinement/Assault/Battery/Medical Malpractice/Defamation and Related Claims and Causes of Action. Mr. Morrison was wrongly confined in facilities of the California Department of Mental Health, and specifically, Napa State Hospital for approximately 10 months beyond the proper confinement date. Mr. Morrison was committed to the Department of Mental Health on or about March 2, 1999. He was sent to Atascadero State Hospital first on or about June 8t', 1999, and then sent to Napa State Hospital on or about August 12a' 1999. He was released from Napa State Hospital on or about to February 9, 2001. If his confinement period had been properly applied, Mr. Morrison should have been released from Napa State Hospital in April or May of 2000. The State of California, The California Department of Mental Health,Napa State Hospital, Laura Ray, Employees, Agents,Doctors and Nurses Of The State of California, The California Department Of Mental Health and Napa State Hospital; Contra Costa County and The Contra Costa County Forensic Mental Health Conditional Release Program knew and or should have known that Mr. Morrison was incarcerated beyond his maximum release date. Mr. Morrison, while incarcerated, complained, petitioned, appealed and otherwise made every effort to notify the above named public entities that he was incarcerated beyond his maximum release date. Not only did these public agencies fail and refuse to properly investigate or review Mr. Morrison's confinement, but they further accused him of being delusional and mentally ill for bringing this matter to their attention. This conduct contributed to his prolonged and illegal confinement. In addition, the public entities fabricated and made false statements to the Courts concerning Mr. Morrison's mental health and eligibility to participate in a conditional release program. (February 8, 2000 letter from Jeffrey Zweren to Master Calendar Judge Contra Costa County). By order of The Honorable Michael R. Coleman on February 7, 2001 in Department 21 of the Contra Costa Superior Court(Action Numbers S01098670-3 and SO]-098864-2) it was confirmed and judicially decreed that Mr. Morrison was confined in excess of the maximum confinement period. Claim of James E.Morrison July 17, 2001 Page 3 of 6 Mr. Morrison was processed for release on or about February 9, 2001. At that time, while still at the Napa State Hospital, the above named public agencies presented Mr. Morrison with a proposed release which offered Mr. Morrison the total sum of$5,000.00 in exchange for a release of claims against the above named public entities. B. Intentional Infliction of Emotional Distress/Negligent Infliction of Emotional Distress/Negligence/Gross Negligence/Sexual Assault/Battery/Medical Malpractice/Unlawful and Prohibited Contact Between Patient and Therapist/ Unlawful and Prohibited Contact Between Patient and Employee of Napa State Hospital/Respondeat Superior/Negligent Hiring/Negligent Employment Practices/Related Claims and Causes of Action. Beginning on or about December of 2000, Laura Ray, a nurse, mental health practitioner, and employee and agent of the above names public entities began and continued a prohited sexual relationship with James E. Morrison. The relationship included inappropriate sexual touching, conversations and sexual contact. Beginning on or about February 9, 2001, Laura Ray contacted James Morrison and began a prohibited sexual and personal relationship with him. The relationship included periods.of cohabitation and sexual relations. Laura Ray also, taking advantage of her relationship with James E. Morrison, induced him to expend monies on her behalf, in the total amount of approximately $3,000.00-$5,000.00. Laura Ray took Mr. Morrison's credit card (and or the credit card of his Mother) and used to it purchase personal items of clothing and lingerie. Laura Ray also induced Mr. Morrison to rent an apartment for their cohabitation in Marin County California, inducing Mr. Morrison to pay a security deposit of approximately $3,800.00 and monthly rent of approximately $1,800.00 per month for eight months which Mr. Morrison would not have incurred had it not been for this relationship and Laura Ray's conduct. Mr. Morrison is informed and believes that the above named public entities, including but not limited to The State of California, The California Department of Mental Health, Napa State Hospital, Employees, Agents, Doctors and Nurses Of The State of California, The California Department Of Mental Health and Napa State Hospital; Contra Costa County and The Contra Costa County Forensic Mental Health Conditional Release Program had knowledge that Laura Ray had perpetrated similar acts and conduct against other patients of its facilities and failed to warn Mr. Morrison, failed to terminate Laura Ray's employment and failed to take other actions to prevent this from occurring to his detriment. Claim of James E. Morrison July 17,2001 Page 4 of 6 4. General Description of Indebtedness, Injury and Damage: Because Mr. Morrison's damages are in excess of$10,000.00, an exact claim amount is not stated. However, the claim would be in excess of the Jurisdictional Limits of The Superior Court Unlimited Jurisdiction. (In excess of$25,000.000). This is also a claim where punitive/exemplary damages are appropriate. Mr. Morrison was injured by virtue of being incarcerated in a State Mental Hospital for approximately 10 months too long. He was deprived of his freedom, life and capacity to enjoy basic human rights. In addition, Mr. Morrison was confined in an oppressive environment for this period. This situation was compounded by the fact that when he complained of his wrongful incarceration, he was accused of being delusional and mentally ill. Mr. Morrison suffered personal injuries, emotional injuries, and general damages associated with this incarceration. With regards to special damages, Mr. Morrison lost significant business opportunities by virtue of his incarceration in the estimated amount of$150,000.00. He was also advised that he was required to hire legal counsel in order to address his excessive confinement, and therefore incurred attorney's fees in the amount of approximately $25,000.00. Mr. Morrison also makes a claim for attorney's fees for the bringing and prosecution of this instant action. Mr. Morrison was further injured by virtue of the illegal relationship with Laura Ray. He was deprived on money and bills in the total amount of approximately $18,200.00 for rental payments and deposits and approximately $5,000.00 by virtue of the monies expended by Ms. Ray or on her behalf at her insistence. Mr. Morrison was also personally, physically and emotionally injured by virtue of the inappropriate relationship with this Employee of Napa State Hospital and was further personally emotionally and physically injured by virtue of the inappropriate sexual relationship. All of these injuries were compounded by the fact that Mr. Morrison had a history of Mental Illness and was therefore particularly susceptible to further emotional and psychological injury. The entities as listed above, took advantage of their special relationship with Mr. Morrison, further causing and contributing to these devastating injuries. Punitive and Exemplary damages are sought herein. 5. Names Of The Public Employees CausingThe Injury Damage or Loss: Mr. Morrison does not fully know the names of all of the individuals but lists these in an attempt to comply with the Claims Statutes as substantially as possible. Of course, named again are The State of California, The California Department of Mental Health,Napa State Hospital, Laura Ray,Employees, Agents, Doctors and Nurses Of The State of California, The California Department Of Mental Health and Claim of James E. Morrison July 17, 2001 Page 5 of 6 Napa State Hospital, Contra Costa County, Contra Costa County Forensic Mental Health Conditional Release Program . In addition, Mr. Morrison is informed and believes that the following public employees caused or contributed to the injuries, damages and losses. Robin Coleman-Medical Records Management Director: Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Dr. George R. Splane-Treating Psychiatrist: who impeded release, not only based on release date but also on the conditional release program. Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Sara Isadore- LCSW: Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Janusz Mermel- Conditional Release Program Representative. Refused to investigate release and refused to consider conditional release based on Mr. Morrison's complaints and based on the incorrect release date. Dr. Helen Steenman: Psychologist under Doctor Splane. Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Christina Barasch=Forensic Mental Health Coordinator: Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Ms. Susan Kessler- Office of Patients Right: Failure to report claims of Mr. Morrison, failure to process complaints and appeals. Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Failed to produce records of Mr. Morrison upon his request and request of counsel following Mr. Morrison's release, which impeded the filing of this claim. Dave Graziani -Director of Hospital. Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Jeffrey Zwerin- Medical Director. Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Fred M. Hollander-Program 10 Assistance: Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Participants in Assessments/Conferences Evaluations/Reports: S. Isadore, LCSW, • o Claim of James E. Morrison July 17, 2001 Page 6 of 6 R. Dorsey, RN, B. Johnson, RT.; V. Gunnal, MS; G. Splane, M.D., H Steenman, Ph.D.,. Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Debra Frye: CRS Legal Determinant Sentence Law Sections: Health Information Management Department, Atascadero State Mental Hospital . Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Robert S. Knapp MD Medical Director for Atascadero State Mental Hospital. Refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. Reggie Ott and Suzanne Schiff, Program Director and Assistant Program Director of Program III, both of whom were made aware of Mr. Morrison's complaints and refused to recalculate dates or investigate claims of prolonged incarceration after being notified of complaint. 6. Amount Claimed: Because Mr. Morrison's damages are in excess of$10,000.00, an exact claim amount is not stated. However, the claim would be in excess of the Jurisdictional Limits of The Superior Court Unlimited Jurisdiction. (In excess of$25,000.000). This is also a claim where punitive/exemplary damages are appropriate. A PROOF OF SERVICE SHOWING SERVICE OF THIS CLAIM ISWATTACDRETO Dated: 7 asonA. P , 7�/ Attorney for James E. Morrison 1 PROOF OF SERVICE BY MAIL 2 3 I am employed in the County of Los Angeles, State of California. I am over the age of eighteen 4 (18) years and not a party to the within action; my business address is 10940 Wilshire Blvd. .Suite 1400, Los Angles, CA 90024 5 I am readily familiar with the practice for collection and processing of documents for mailing 6 with the United States Postal Service of the Law Offices of Jason A. Pollack, and that practice is that the documents are deposited with the United States Postal Service the same day as the day of collection in the 7 ordinary course of business. 8 On July 17, 20011 served the foregoing document(s)described as: 9 10 CLAIM OF JAMES E. MORRISON AGAINST THE STATE OF CALIFORNIA; THE CALIFORNI DEPARTMENT OF MENTAL HEALTH; NAPA STATE HOSPITAL; LAURA RAY; EMPLOYEES 11 AGENTS, DOCTORS, NURSES OF THE STATE OF CALIFORNIA, THE CALIFORNI DEPARTMENT OF MENTAL HEALTH AND NAPA STATE HOSPITAL; CONTRA COST 12 COUNTY; CONTRA COSTA COUNTY FORENSIC MENTAL HEALTH CONDITIONAL RELEASE PROGRAM 13 14 on the persons listed below by placing the document(s)for deposit in the United States Postal Service through the 15 regular mail collection process at the Law Offices Jason A. Pollack, 10940 Wilshire Blvd. Suite 1400,Los Angeles, California,to be served by U.S. mail addressed as follows: 16 17 State Board of Control Clerk of the Board of Supervisors Government Claims Branch Contra Costa County 18 PO Box 3035 County Administration Building 19 Sacramento, CA 95812-3035 651 Pine Street ORIGINAL+4 COPIES Martinez, CA 94553 20 ORIGINAL+4 COPIES 21 22 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true 23 and correct. Executed at Los Angeles,California on July 17,2001. 24 25 26 J on A.Poll k 27 28 CQ Ilk tt on S C) 0 0 j.A 450 04 QO '. CLAIM JUL 31 2001 BOARD OF SUPERN'ISORS OF CONTRA COSTA COUNTY, CALIFQRCOUNSEL MARTINEZ,CALIF. 130 0 ACTION: August 14, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, I NOTICE TO CLAIMANT and Board Action. All Section references are to I The copy of this document mailed to you is your California Government Codes. I notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below►, given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $50,000 CLAIMANT: TBf Bodl ein eeer t. Antioch, CA 9 509 ATTORNEY: PDresnick DATE RECEIVED: July 30, 2001 2W West Winton Ave,#125 ADDRESS: Hayward, CA 94544 BY DELIVERY TO CLERK ON: July 30, 2001 BY MAIL POSTMARKED: I. FROIAL Clerk of the Board of.Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOIN EN, GJw Dated: July 30, 2001 By: Deputy U. 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). I ( } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 7-31 O t By; ar Deputy County Counsel III. FROM Clerk. of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. ( ) Other: I certify tha t this is a /true and correct copy of the Board's Order entered in its minutes for this date. Dated: l /, JODI JOHN SWEETEN Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited .n the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an ittorney of your choice in connection with this matter. If you want to consult an attorney, you should do so mmediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF NikMViG f 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 )repaid a certified copy of this Board Order and Notice to ClaimaWaddressed to he laimant as shown above. dated: JOHN SWEETEN, CLERK r,Pniry rip. �l/ � This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to un'derstand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I CLAIM AGAINST PUBLIC ENTITY (Gov C H 905, 905 .2 , 910, 910 . 2) RECEIVED TO: General Manager JUL 3 0 2001 ALAMEDA-CONTRA COSTA TRANSIT DISTRICT JULERK80ARDOFSUPERVISORS 1600 Franklin Street CONTRA COSTA CO. Oakland, California 94612 Clerk, Board of Supervisors COUNTY OF ALAMEDA 1221 Oak Street, Suite 536 Oakland, CA 94612 Clerk, Board of Supervisors COUNTY OF CONTRA COSTA 651 Pine Street, Rm. 106 Martinez, CA 94553 ------------------------------------------------------------ - - - --- TAWAYNE COLE hereby makes claim against ALAMEDA-CONTRA COSTA COUNTY TRANSIT DISTRICT, COUNTY OF ALAMEDA AND COUNTY OF CONTRA COSTA for the sum of $50, 000 . 00 and makes the following statements in support of the claim: 1 . Claimant ' s post office address is 2304 Reindeer Court, Antioch, CA 94509 2 . Notices concerning the claim should be sent to claimant ' s attorney, Paul Dresnick, Esq. , 225 West Winton Avenue, Suite 125, Hayward, California 94544 . 3 . The date and place of the occurrence giving rise to this claim are : March 15, 2001, at Center Street at its intersection with Shattuck Avenue, Berkeley, Alameda County, California . 4 . The circumstances giving rise to this claim are as follows : GLENN S . MORRIS, employed by the ALAMEDA-CONTRA COSTA TRANSIT DISTRICT, parked that certain 1998 ALAMEDA-CONTRA COSTA COUNTY DISTRIT bus, license number E994293 on Center St . east of Shattuck Avenue but he failed to effectively set the brakes before he left it unattended. The bus subsequently rolled from its parked position and rearended the vehicle driven by Claimant Cole causing severe injuries and damages to said Claimant . 5 . Claimant sustained injuries as follows : lumbosacral strain. 6 . The name of the public employee causing the claimant ' s injuries are: GLENN S . MORRIS . 7 . As of this date, claimant ' s claim is $35, 000 . 00 8 . The basis of computation of the above amount is as follows : Estimated figure based only on information submitted to date . DATED: July 25, 2001 ; PAUL DRESNIC _ Attorney for TAWAYNE COLE, Claimant CLAIM JUL..31 2001 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY CALIP® QCOUNSEL CALIF. BOARD ACTIO August 14, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to I The copy of this document mailed to you is your California Government Codes. 1 notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $25,000 CLAIMANT: Robert Tillery ATTORNEY: Michael Kelly DATE RECEIVED: July 30, 2001 ADDRESS: 1912 I St BY DELIVERY TO CLERK ON: July 30, 2001 Sacramento, CA 95814 BY MAIL POSTMARKED: July 27, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN E Cl rk Dated: July 30, 2001 By: Deputy , : II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( his claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: At Dated: �' -3�' By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its mi nu es for this date. Dated:rl`'��1 I i�� JOHN SWEETEN Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant ddressed to the cl 'mant as shown above. Ucl", I1gv. JUIN SWEETEN, CLERK n Dated: , l u, This warning does not apply to claims which are not subject .to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to un'derstand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I I Michael Kelly, Esq. (SBN 176085) MASTAGNI, HOLSTEDT, CHIURAZZI & AMICK 2 A Professional Corporation 1912 "I" Street 3 Sacramento, California 95814 RECEIVED 4 Telephone: (916) 446-4692 5 Facsimile: (916) 447-4614 JUL 3 0 2001 Attorneys for Claimant CLERK BOARD OF SUPERVISORS 6 Robert Tillery CONTRA COSTA,CO. 7 8 GOVERNMENT CLAIM 9 10 I 1 ROBERT TILLERY, CLAIM AGAINST A PUBLIC ENTITY [CALIFORNIA GOVERNMENT CODE §910] 12 Claimant, V. 13 CONTRA COSTA COUNTY, and DOES 1 14 through 100, Inclusive, 15 , . 16 Respondents. 17 TO CONTRA COSTA COUNTY: 18 19 ROBERT TILLERY hereby makes this claim against CONTRA COSTA COUNTY, 20 pursuant to Section 910 of the California Government Code, and makes the following statements in 21 support of the claim. 22 1. Claimant's name is ROBERT TILLERY. His mailing address is 6275 Jacinto Drive,, 23 Apt#135, Sacramento, California 95823. 24 2. Notices concerning this claim should be sent to MASTAGNI, HOLSTEDT, 25. CHIURAZZI, & AMICK, 19121 Street, Sacramento, California 95814. 26 3. The date, place and other circumstances of the occurrence which gave rise to the 27 claim asserted are as follows: 28 A. The date of the incident is 1 April 2001. ;i , ri . . , ., ` • , i I B. The place where the incident occurred was at or near the center of the 2 Carquinez Bridge, in the East bound lane, In CONTRA COSTA COUNTY, 3 State of California. 4 C. On or about the date in question, at or about the location noted above, 5 Claimant, ROBERT TILLERY, was injured when he struck a cable, air hose 6 or some other object hanging from the bridge and protruding down into the 7 lane of traffic that claimant was driving on, causing claimant and his vehicle 8 to be injured. 9 D. Claimant, ROBERT TILLERY, received serious injuries from this accident, 10 including but not limited to injuries to his back and neck. I 1 E. As of this date, the full extent of the Claimant's injuries are not known. 12 F. The name or names of the public employees or employers involved causing 13 this injury, damage or loss are not fully known. However, the Claimant 14 believes that among those involved are CONTRA COSTA COUNTY. This is 15 based on the fact that the injury occurred on property that may have been 16 maintained at the time of this incident, by CONTRA COSTA COUNTY. 17 G. Jurisdiction over this claim would rest in the Superior Court since the 18 estimated amount of any perspective injury, damage or loss in so far as it may 19 be known at this time, including general and special damages, exceeds 20 $25,000.00. 21 H. Claimant has auto insurance through GEICO Insurance, policy number is 22 2555978. 23 24 Dated: 26 July 2001 MASTAGNI, HOLSTEDT, CHIURAZZI & AMICK 25 26 27 28 By. ICHAEL KELLY Attorney for Claimant . � ..,.. i �� _ j 11: .....��I. I I I. •' I PROOF OF SERVICE (C.C.P. SECTION 1013a, 2915) 2 SHORT TITLE: Government Claim COURT NAME: Government Claims Board 3 CASE NUMBER: 4 1 am a citizen of the United States and a resident of the County of Sacramento. I am over the age of eighteen years and not a party to the above-entitled action; my business address is 19121 Street, Suite 5 102, Sacramento, California 95814. 6 On the date below, I served the following document(s): 7 ROBERT TILLERY'S CLAIM AGAINST A PUBLIC ENTITY. 8 9 addressed as follows: 10 CALTRANS City of Vallejo 1120 N Street City Clerk I 1 Sacramento, Ca 95814 555 Santa Clara Street Vallejo, Ca 94590 12 13 Contra Costa County Solano County Clerk of the Board Clerk of the Board 14 651 Pine Street 580 Texas Street Martinez, Ca 94553 Fairfield, Ca 94533 15 16 XX BY MAIL. I caused such envelope, with First class mail and Certified mail fully prepaid to be placed in the United States Mail at Sacramento, California. 17 BY PERSONAL SERVICE. I caused such envelope to be delivered by hand 18 to the offices of the person(s) listed above. 19 BY FACSIMILE TRANSMISSION. I transmitted such document(s) by facsimile machine to the telephone number listed above. 20 I declare under penalty of perjury that the foregoing is true and correct. 21. Executed on July , 2001, at Sacramento, Californi 22 23 24 LXURA JESTE 25 26 27 28 MASTACNI,HOLSTEDT, CHIURA7.Z1&AMICK A PROFESSIONAL CORPORATI N 1412 I STREET SACRAMENTO,CALIFORNIA 4: 14 26 cy-5 C::D fi, LL" r- 4v 73 CEI 'a = " ru 0 M 0 U C) C) m r— u (1) 4v Ln 0 ni G u N vA U 0-4 en u 00 LO Z 0) C) < Z Ir C) C) 0 a. H: cc -j C) < L) z —i < F-0 r M C)0 W W�-- Z cr w (n LL < C) —cr CL < < --,. E - �.. S i � 1 { � j...� t i _ .. c n_.:„ t =. -�� .1 � - . , _ . __ _. _�. _ _._ � __ _. __ .__�. _ �� _.,_ Y i r I lv__—--�._ �.--- ---_ — --�- } • Y_ CLALM BOARD OF SUPE VISORS OF CONTRA COSTA COUNTY, CAL:IFORNLA BOARD ACT10tlt August 14, 2001 Claim Against the County, or District Governed by ) 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 California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV belowl, given RMCM1117TED pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $250.35 J U L 2 3 2001 COUNTY COUNSEL CLAIMANT: James Springfield MARTINEZ CALIF. ATTORNEY: None DATE RECEIVED: July 20, 2001 ADDRESS: BY DELIVERY TO CLERK ON: July 20, 2001 BY MAIL POSTMARKED: I. FROI�Z Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. J01-N—S-VEET Nl . C er • , Dated: July 23, 2001 By: Deputy 1 II. FROM County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( t, f his 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: / 5--O By: `'�8� 66�. Deputy County Counsel M. 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: (k) This Claim is rejected in full. ( ) Other: I certify dd that this is/a true and correct copy of the Board's Order entered in its Z��eputy itfhis date. Dated�'ll�� `1 �� JOHN SWEETEN Clerk B �JClerk 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 MA LING 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: Bv: JOHN SWEETEN, CLERK R„ �:/G'16�1�Pr,llr�, ('Inrli t This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific-relief such as mandamus or injunction, or Federal Civil_,Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I • "Office of the County Counsel Contra Costa County 651 Pine Street, 9th Floor Phone: 335.1800 Martinez, CA 94553 Fax: 646-1078 Date: July 30, 2001 To: Clerk of the Board From: Silvano B. Marchesi, County Counsel By Monika L. Cooper, Deputy County Counsel fK( L(kAp Subj: Claim of James Springfield Mr. Springfield has not provided a return address for this Notice of Insufficiency. Please keep this Notice in your files. Should Mr. Springfield come in to the office or call in with an address, or just wants a response to his claim, please provide this Notice to Mr. Spingfield and then complete a Proof of Service with the date, time and manner of service noted. Please then provide a copy of that Proof to our office. Should you have any questions, do not hesitate to call. Thank you. CONFIDENTIAL ATTORNEY CLIENT COMMUNICATION SILVANO B.MARCHESI DEPUTIES: PHILLIP S.ALTHOFF COUNTY COUNSEL SE L JANICE L.AMENTA _:f \\` NORA G.BARLOW B.REBECCA BYRNES SHARON L. ANDERSON a,-%r;'' ANDREAW.CASSIDY ASSISTANT COUNTY COUNSEL ' �' C .NTRA C0STA EoU11 Y MONIKAL.000PER 'i -.tv-,':\� .11 VICKIE L.DAWES GREGORY C.HARVEY OFFICE•OF,�THE,C,O.UNT?YjQ-' EL MARKES.ESTIS ASSISTANTCOUNTY COUNSEL (7iCOUNTYyADMINISTRATIOIJ�BUILDiNG1.41 LILLIAN T.FUJII I T .DMINI T ION ILDING� JANET L.HOLMES DENNIS C.GRAVES 651 PINE-STREET 9th.FLOORIf KEVIN T.KERR H, e. �i snnit_� 7+�t��,.y+r BERNARD L.KNAPP SENIOR FINANCIAL COUNSEL MA TINEZ. CALIFORNI`A�94:55s 1229 .r EDWARD V.LANE,JR. BEATRICE LIU GAYLE MUGGLI MARY ANN MASON OFFICE MANAGER Oq7 ?% PAUL R.MUNIZ VALERIE J.RANCHE PHONE (925) 335-1800 NOTICE OP,NSUFFICIENCY STEVEN P.DAVID RETTIG IDT HM FAX (925) 646-1078 D ANAAJ.SILVERDT AND/OR JACOUELINE Y.WOODS NON-ACCEPTANCE OF CLAIM PAMELA J.ZAID TO: James Springfield Unknown Address Hand delivered claim RE: CLAIM OF: James Springfield Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: [XX] 1. The claim.fails to state the name and post office address of the claimant. [XX] 2. The clainn fails to state the post office address to which the person presenting the claim desires notices to be sent. 3. The claimn fails to state the date, place or other circumstances of the occurrence or transactiomm which gave rise to the claim asserted. 4. The claim fails to state the mname(s) of the public employee(s) causing the injury, damage, or loss, if known. ] 5. The clawm fails to state whether the amnount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claimll fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or•superior court. [XX] 6. The clainn is not signed by the claimant or by some person on his or tier behalf. ] 7. Other: Page 1 SILVANO B. MARCHESI COUNTY COUNSEL By: 6t— Deputy dounty Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5;Evidence Code§§641,664) I declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California 94553;1 am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. 1 served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S. Mail at Martinez,California. 1 certify under penalty of perjury that the foregoing is true and correct. Dated: July­2001,at Martinez,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CLALM:GOVT.CODE§§910,910.2,920.4,91().8) . Page 2 Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be-presented not later than the 1001h 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, Pera! Code Sec_ 72 at the end of this form. RE: Claim by. ) Reserved for Clerk's Filing Stamp RECEIVED Against the County of Contra Costa JUL 2. 0 2001 or CLERK BOARD OF SUPERVISORS . CONTRA COSTA CO. o�iv7- (, y District) - (Fill in Name) The undersicrned claimant herebv makes claim against the County of Contra Costa or the above named District in the surn of S 2 and in support of this claim represents as follows: 1. When did the damage or injury occur:' (Give exact Date and Hour) f y -- --------------------------------------------------- 2. Where did the damage or injury occur:' (Include City and County) �/�� � Ouej ce•s�f /fL�/u7" l_—�___ 3. How did the dam/age or injury occur' (Give furl details;use extra paper if required) �V�'1o10itCs/CLE �/EU`���INiCf/ GJAS �ZR,up NElv�f�flD j6 �iN�vc1G�/f if/E .SC'A.v, A�P�-�//C ,�'•�•�J ��E.t/t fJ>E1�,BoCE�OB� 7b ow-✓?Hg �1c'i.4 e (�90,-o d y'We /3EG e AVO (?AAS tF f�G�fl i,•i5T j t/c �E2� G✓/1CC T�/t' `/ELHe✓7. StK9/��. /J f? �Cu•� 5�`o j �E�a/.�fl i/ �Q.aSEr� i2AC;e,G. / AUD 5eAQV c 5 'b iNE EXiFei.,� 4. What particular act or omission on the part of county.or district officers, servants, or employees caused the injury or damage? ���f��. Er`19�E.-Uif�CE,C�/.v C4fIALW 4' if�c' SCQ% iAiL�/j iv Side /4f , f�F[�`1F� 4JNE� -Tt�c ft16,11AL Foe_ (,44A(;C 14-, A fl/tt,o.- 'flAf" �12��-rye iNA.c� # �A� 62- J CKer"�f�6� �QoCecO�� tt. c�rc�e/ Kl�K6�P5 . CJN 5NE t�,�ac�.Y Jil/J Vince T B6cii.•�� * �'Lii51i/Ny. (Over) •aug pur luamuostldmt Bans gloq iq to `( 000`OTS ) sirllop pursnogl aal Lutpaaaxa IOU jo aug r ,{q luosud alrls ;)q} ut wamuosudun :iq [o°aug pur luamuosudmi gans gloq Sq 10. °( 000`lS S?E11QJ}��,,u� oql auo Dutpaaaxa IOU jo aag r :►q °.irae auo arp aaoui IOU JO pouad. r .1oj l!rf.iluno� agl(ui%luaaiuos.,`d` �(f�� a algrgstund sl tuilu.�ao °iaganon °lunoaar `ll!q `m!ria. lualnpnr.lj.io aslr3 .aur auinuao j! avers aqj-► lV .Molar o1 pazuoglnr °iaag;o ao psroq laulsip io .ijp °.iiunoa :pur 01.10 •la:)gio ao p.rroq alrls Sur of luatuSrd ioj a0 aaur.Moiir.1o;sluasa rd 4pnr ijap of lualul gl!,b.4oge+ uos iad ,uan'J„ 2001 JUL. 18: P 3' 10 :sapteoid apo lruad aql jo ZL aotlaaS RISK [%AANAGEJ�yj o N. � � MM � MM � M � � MMMMMMMMM � � MMM � M � � M � � M � MM � M � � MMMMMMMMMMMMMMM -ON auogdalaZ •orj auogdalas (;mnlru„!S s,lurwlrlo ) iatuonVjo ssa.ippV pur amrh� «•jlugaq siq uo uosiad amos:iq 10 (:iauaou v) :o L sa:)iioh Q!i3s lueuitrla agl Sq paints;)q 1sn1u maria ay1„ :sapteojd Z'OT6 aas apo :�o� wai i 3.Lv(i :.i.lnfut.10 luappm sigl jo lunoaar uo aprm non salnl!puadxa aql 1si-I (, ----------------------------------------•-------------------------------------------- •sirl!dsoq pur 's.lolaop`sassault.M 3o sassalppr pur sauip.r4 •g ------------------------------------------------------------------------------------- '�s e�i v .�N 4��vis ,,oi✓ao./dG✓r/1S air/1���� ��,s9 �Q� (•a2eutep to.ixnfin aAipadsoad Sue jo mnouie paiewpsa atp apnraul) ;palnduloa lunoalr pamtrja anogr•agl sP..M'.Mog - .. _ ... •.�c'7jvi j<.LS'ns aa'�,7 S?HZ.V�vYj ani i5�ro rydJ•..i ajl� 'i�li!��'/`/-✓A a'oia�_U''�. 4� `�hi��� 3�'�SS� W�(�j`7l. .(;aSeump olne soj snuumsa o&4,pend -pautrera saoetump ao sarinrm jo ivaua llnl aA19).Lpallnsa 1 ultrl�noxi,op saunfui io saxirmr '9 -----=-------------------------------------------------------------------------------- ,�o/� ,��•�J •,7 rat//c>9�_.�t4J5 !7 ��S �:unfui 10 a%rmrp aql 2utsnra saaeoidma so`slur•uas's iaoWo laulstp io.ilunoa jo samru aql aju,lr>iAi s CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARRDACT10111: August 14, 2001 Claim Against the County, or District Governed by ) 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 California Government Codes. 47notice of the action taken on your claim by the JRIF0211 �� Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and J U L Z 7 2001 915.4. Please note all "Warnings". AMOUNT: Unknown MARTIN COUNSEL ALIFL CLAIMANT: Carol & Erasimo Covarrubias ATTORNTEY: Thomas McLaughlin DATE RECEIVED: July 26, 2001 ADDRESS: 3105 Lone Tree Way D BY DELIVERY TO CLERK ON: July 26, 2001 Antioch, Ca 94509 BY MAIL POSTMARKED: I. FRO.IVL Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHNETEN, C e/ Dated: July 27, 2001 . By: Deputy 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 91,1.3). ( ) Other: Dated: J��' By: Deputy County Counsel — L M. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) Claim was returned as untimely with notice to claimant (Section 911.3). W. BOARD ORDER: By unanimous vote of the Supervisors present: k) 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; , , JOHN SWEETEN Clerk, By / /� 6'. . Ili ' , 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 n the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an ttorney of your choice in connection with this matter. If you want to consult an attorney, you should do so mmediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United tates, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully repaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. JOHN SWEETEN, CLERK R., li 'l ' `41- npn„r., r,ip.t. This warning does not apply to..claiins which are not subject to the California Tort Claims Act. such as actions in inverse condemnation, actions for�specific`relief such as mandamus or injunction, or Federal. Civil .Rights claims. The above list is not exhaustive and' IegAll consultation is essential to un'derstand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor'does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I i . I THOMAS G. McLAUGHLIN, CSB#: 71904 LAW OFFICES OF THOMAS G. McLAUGHLIN 3105 Lone Tree Way, Suite D Antioch, CA 94509 (925) 754-9900 Fax (925) 754-6604 ANDREW C. SCHWARTZ CASPER,MEADOWS & SCHWARTZ A Professional Corporation 2121 North California Boulevard, Suite 1020 Walnut Creek, CA 94596 (925) 947-1147 Attorneys for Claimants Carol Covarrubias/Erasimo Covarrubias Claim Against the C aunty of Contra (costa o TO: Board of Supervisors County of Contra Costa 65.1 Pine Street, Room 106 Martinez, CA 94553 RECEIVED PRESENTED BY: J U L 2 6 2001 CAROL COVARRUBIAS and CLERK BOARD OF SUPERVISORS ERASIMO COVARRUBIAS, CONTRA COSTA CO. / Claimants CT.ATM FOR PERSONAL IN.HMIES,WRONGFUL DEATH You are hereby notified that Carol Covarrubias and Erasimo Covarrubias (hereinafter described as "claimants") whose address is 844 Carpetta Circle, Pittsburg, California 94565, telephone number 925-432-6357, claim damages from the County of Contra Costa. This claim is based on personal injuries sustained by claimants as a result of the wrongful death of their son RYAN COVARRUBIAS, hereafter "Decedent" , on or about January 30, 2001, at the West County Detention Facility for Contra Costa County. At said time and place and on or about said date, decedent RYAN COVARRUBIAS, while incarcerated in Building 5, B Side, Room 43, of the West County Detention Facility, hung himself until he died. ~� e 1. tj t At all times herein relevant decedent was suffering from mental disorders and had self destructive tendencies which disorders and tendencies required immediate medical care and treatment. At all times herein relevant decedent was in the custody of the Contra Costa County Sheriffs Office at the West County Detention Facility. Various Contra Costa County employees, whose names and identities are unknown to plaintiffs, including employees of the County of Contra Costa County Sheriffs Department were aware of, or in the exercise of reasonable diligence, should have been aware of the medical disorders, including the self-destructive tendencies, of decedent and his need for immediate medical care and treatment. The aforementioned Contra Costa County employees, among other things, negligently and carelessly kept decedent in the general population and negligently and carelessly failed to supervise, oversee, take the necessary precautions to ensure that the decedent would not injure himself and/or take his life and failed to obtain immediate medical care and treatment for decedent. As a direct and proximate result of the negligence of the County of Contra employees and their failure to obtain immediate medical care and treatment for decedent, decedent, on or about January 30, 2001, hung himself and died. The damages sustained by claimants as far as known as of the date of presentation of this claim are as follows: the loss of love, comfort, care, society, support and companionship of their son RYAN COVARRUBIAS. Jurisdiction over this claim would rest in the Superior Court. All notices or other communications with regard to this claim should be sent to attorney THOMAS G. McLAUGHLIN, 3105 LONE TREE WAY, SUITE D, ANTIOCH, CALFIORNIA 94509, Telephone Number is 925-754-9900. Dated: July 25, 2001 By: NOMAS G. McLAUGHL CLAnI BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY CALIFORNLA BOARD ACT10August 14, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, I NOTICE TO CLAIMANT and Board Action. All Section references are to I The copy of this document mailed to you is your California Government Codes. notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below, given RMCIZIEWpursuantMID, to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $200 J U L 18 2001 COUNTY COUNSEL. CLAIMANT: Antone Goyak MARTINEZCAUEi- ATTORNEY: None DATE RECEIVED: July 13, 2001 ADDRESS: 411 Fensalir Ave BY DELIVERY TO CLERK ON: July 13, 2001 Pleasant Hill, CA 94598 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. SWEETEN, Clerk Dated:__ July 17, 2001 By: Deputy IL 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: 2Deputy County Counsel M. 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/li�t/s�minutes for this date. Dated:' �� ,� JOHN SWEETEN Clerk, By �, 11/A T�''� , 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 N'IALUNG 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:C Bv. JOHN SWEETN, CLERK R„I �� � (Na�L,�Lwu�14 This warning does not apply to claims which are not subject to the California Tort Claims Act such-as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and, legal consultation is essential to understand all the separate,limitatioris periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I Claim to: BOARD OF SUPERVISORS OF CONTRa,COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 19877, must be presented not later than the 100"' 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 propem or growing crops and which accrue on or after January 1. 1988, must be presented not later than sia 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.'_. ) 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. 2 at the end of this form. RE: Claim by. ) Reserved for Clerk's Filing Stamp RECEIVED Against the County of Contra Costa or JUL 13 2001 CLERK BOARD-OF SUPERVISORS District) CONTRA COSTA CO. (Fill in Name) The undersigned claimant her by makes claim against the County of Contra Costa or the above named_ District in the sum of S and in support of this claim represents as follows: 1. When did the damage or injury occur. r Give exact Date and Hour /id ----.- --------'_. Where the damage or injure occur? (Include City and County) C e n Ave A S-e O� h- t C 4 >rZ v� -.----------------L -� �-- ------CD-`---------------------------------- --- 1 3. How did the damage or injury occur? 1 Give full details: use extra paper if required) vY n n k to 14 b � / - 1Y1 h tl� l rtrui - I,c)& /AL2 -�- Y1 e(JCn "� -- -� -__= h-_ c` G I kff�P(1 __ ze -- 4- ---� ------ `� YN 4. What particular act or-omission on the pan off county or district officers, servants, or employees cau ed the injury or damage? b�� (Over) 'aug par luamuosildmi q:)ns gloq .iq to `( 000'0IS ) Sirllop pursnogl ual liuipaaaza lou;o auu r Sq `uosud air-is aql ui luamuosudmi .Cq .io `aug pur luamuosudmi pns gloq .iq ao •( 000'IS ) urllop pursnogl auo "outpaaaza lou 3o ang r .iq `Jrae auo urgl a-lom lou ;o pouad r ioi itrf .iiunoa aql ui luamuosudmi .C.q iaglp algrgsiund si `2uppm so laganon •lunoaou `litq •lump lualnpnrl;.io asirj .iuL, •amnuaL 1T amus aql .-.rd to .,&ollr of pazuoglnr `ia:)Wo 10 p iuoq 1Julslp to .iva -.iiunoo :Cur 01.10 `nou;o to psroq alrls :iur of luam.lyd Io;to aJUr.Holir 10)sivasaad �pntmpp of halm glln,�oqm uosud ..Nana„ :sapi%wd apoD iruad aql jo Z, uoilaaS 3JI10 K -off auogdalaZ o4 auogdalal ( ssalpPF ) i a ruDic s,lur,wiriJ ) .iausou o l ur amu - F .l ssaPPF P . • }irgaq Sig uo uossa uios .iq to (:iaujout) :01 53 iio-sti ( v;35 luruli I:)agl,iq pais aq 1sntu Lump ag,I,,. i. :sappoad 2.016 -qac apo] •Ao0 1.�;_lcif�t. Iti3.Ll 3.LtQ :.Clnful io luapToar sigl;o lunoJJr av aprm nori sa.iniipuadza aq1 1sTZ '6 ------------- ---------- --------------------------------- - ------------------------- •sirudsoq pup •s.101;30p �Sassauii.++jo sassalppp pup Samrhi g ------------- ------ - --- ---- ------- --------------------------------------------------- V 77 ( aoetucp lo.ilnfui antlaadsoid.Cue.jo tunotur paietupsa atp apniaul) p?lndtuoa lunomr pamirla anogr aql Sr,b .vog ----r---- -------- ----------------- ------ o S ;r :✓ 1 S�f I Y� U� c � SalS'?7� /� (aoetuep oine 10j saietugsa OAU t{ae73y 'paW= saoetuep to saunfta}o ivaixa Mq anti) Lpalinsw mmp noe op saunfuc-io saormrp irgA 9 ---------------------------------------------------------5- - ----- ;,unfui so aormrp aql nutsnra saaeoldma so`s1ur.�.ras`slaa�o laulsip to.ilunoa�o samrn aql alr 1rgM 'S r� CLIkim BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNLA BOARD ACTIO August 14. 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, I NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. I notice of the action taken on your claim by the R]Ecmaw�� Board of Supervisors. (Paragraph IV below), given �J pursuant to Government Code Section 913 and J U L 1 '8 2001 915.4. Please note all "Warnings". AMOUNT: $3,000,000 COUNTY U T YCOUN IEL CLAIMANT: W. Simpson, E. Allen,. M. Allen ATTORNEY: None DATE RECEIVED: July 10, 2001 ADDRESS: 2134 Road 40, BY DELIVERY TO CLERK ON: July 10, 2001 San Pablo, CA BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JO ti ET N Wlerk Dated: July 17, 2001 By: Deputy II. FROM County Counsel TO: Clerk of the Board of Supervisors ( his claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 91 ].3). ( ) Other: Dated: -By:_ npputy County Counsel M. 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: ,' JM( JOHN SWEETEN Clerk, By �' 1/140,444,�,—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 NLkH ING 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:1u.C� l `( ,���Av: JOHN SWEETEN, CLERK n Z'Z nP,,,it., riP.L- This warning does not apply to .claims- which are not subject to the California TortClaims Act such as actions in inverse condemnation, actions ifor specific relief such as mandamus or injunction, or Federal Civil. Rights claims. The above list is not exhaustive and. legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations .applicable to actions not subject to the California Tort Claims Act. I Jul -1Q,.;,-,01 15 : 39 Friedman Law Offices 510 234 0656 P . 02 ,= GOVERNMENT CODE CLAIM JUL 10 2001 TO: COUNTY OF CONTRA COSTA CLERK.ASSESSMENT APPEALS BOARD CONTRA COSTA-CO. OUR CLIENT & CLAIMANT: WANDA SIMPSON, EUGENE ALLEN, MICHAEL ALLEN DATE OF INJURY: JANUARY 11, 2001 PLACE OF INJURY: 2134 ROAD 20, SAN PABLO, CA DESCRIPTION OF INCIDENT: Claimant Simpson an Allen were burned in a fire at 2134 Road 20 . There was insufficient inspections and failure to adequately safeguard claimant ' s apartment� on the part of Contra Costa Housing Authority. NATURE OF DAMAGES: Third degree burns head and body.. AMOUNT OF CLAIM: $3 , 000, 000 . 00 ATTORNEYS TO WHOM NOTICES SHOULD BE ADDRESSED Elliott Friedman, Esq. Law Offices of Elliott Friedman 11100 San Pablo Avenue, Suite 200B E1 Cerrito, CA 94530 (510) 234-1616 DATED: July 10, 2001 Elliott Friedman - .Attorney for Claimant PROOF OF SERVICE -BY HAND DELIVERY. I declare that I am a citizen of the United States'..Fand a resident of the County of Contra Costa, California. . over the age of eighteen years and not & party :to the w ., hin cause. My business address is: 11100 Sap,�Pabl-o. Avenue Su•i°te 200B, E1 Cerrito, California. On July 10, 2001, I served a copy of the following:' Government Code Claim on all interested .parties by placing a true copy thereof; :. enclosed by hand delivery on: the following:•.- Name : e�� k. a f �t v � _ Roanc .106 Place: &S/ Pew Sf-, 41- Time : 1Time : I declare under penalty of perjury,•:under.�.'the laws •.of the State of California that .the foregoing Ist;rue and'.., correct . DATED: July 10, 2001 Craig R ste_ i' JUL 2 6 2001 CLAEVI BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, A -PFORNyIA', BOARD ACTIO August 14, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, I NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: Unknown CLAIMANT: Joan .Anne Rex ATTORNEY: Steven J. Choi DATE RECEIVED: July 25, 2001 ADDRESS: 1999 Harrison St #1990 BY DELIVERY TO CLERK ON: July 25, 2001 Oakland, CA 94612 BY MAIL POSTMARKED: July 24, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOIN EN, Cler Dated: July 25, 2001 By: Deputy 11"n 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: '�� By: Deputy County Counsel M. 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: (k) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order t in its minute for this date. RIK411A�1' 'r ,,rr��-,IIl 1964X Dated: �`1,"( JOHN SWEETEN Clerk, By .Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF NIAII.M 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, ddresse�dd to the claimant as shown above. Dated: JOHN SWEk'TEN, CLERK R„. f �!/1/ { nP„ ►r., rio.� r This warning does not apply to claims which are not subject .to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes 'of limitations applicable to actions not subject to the California Tort Claims Act. i RICHMOND OFFICE 3150 HILLTOP MALL ROAD RICHMOND, CA 94806 AJ510.839.4300 PERSONAL I N J U R Y A T T O R N E Y S CH • SAN FRANCISCO OFFICE ONE SANSOME STREET, SUITE 2000 • SAN FRANCISCO, CA 94104 415.777.4878 LAKE MERRITT P4AI�A •21 992 Y vul WJISON STREET, SUITE 1990, OAKLAND, CA 94612 • TEL 510.444.4878 • FAX 510.444.4432 • E-MAIL CHOIODNALCOM J4 RECEIVED Clerk of the Board of Supervisors County Administration Building JUL 2 5 2001 651 Pine Street, Room 106 Martinez, CA 94553 CLERKCO TRA OFS01-TACO.ISORS Re: Our Client: Joan Anne Rex Your Insured: Richmond Landfill Dump Truck Claim No.: Unknown Date of Accident: May 3, 2001 Dear Sir/Madam: Our office represents Joan Anne Rex with respect to the above claim. Please note we are making a claim for money damages and that legal action may be taken in the event this matter is not resolved. Please advise in writing if this notice of claim has been sent to the wrong person or is insufficient in any respect. If you or your insured is a Public Entity, please construe this letter as a valid notice of claim tolling the statute of limitations, or notify our office in writing within 10 days of this letter that it is insufficient or directed to the wrong address. I. Adjuster and Claim Number: Please advise us of the adjuster and claim number of this case. Please forward all documents needing execution. II. Bodily Injury: Our clients were injured in this accident and will be making a claim for personal injuries. III. Authorization: Please find enclosed an Authorization pursuant to Section 2695.2 of the California Insurance Code. Please direct all communications to the undersigned. IV. Medical Authorization: If you wish to obtain the medical records yourself, please forward an authorization within 15 days. If we send an authorization you must request the medical records as soon as possible so as not to delay the resolution of this case! Please send a letter of acknowledgement to the undersigned at our Oakland office. Thank you for your courtesy and cooperation. Very truly yours, 144 - Kelly Tsai Law Office of Steven James Choi Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100's day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2. ) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building,651 Pine Street,Martinez,CA 94553. C. If Claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity,separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim by ) Reserved for Clerk's Filing Stamp Against the County of Contra.Costa RECEIVED or JUL 2 5 2001 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 S and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact Date and Hour) -----M -3- t--- f_: �iXi► �i --g__ZS_�r►- ---------------------- ---------------- - 2. Where did the damage or injury occur? (Include City and County) -. - --- --------------------- 3. How did the damage or in urvy o�c�SSA�ur. Give ft l details; dextra p�apper if required) �l�M4�f N/q5 �f Gf 1,�N�1 L' �F 7`u �/GG�tr�i1� � • i(Jf ,!/(/►� CSL�(/� Gam'f vrfGlrv� j ""al kzello; aid i f �� /U4-aG>k-;—. ------------------------------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? /J / JkOW $41( e !/Iit 4(AIW AW *r�rZ W 10g7 k7V 10914�)y "i n *mlt7 "i,e HW,0�y (Over) 5. What are the names of county or district officers,servants,or employees causing the damage or injury? A,nm-- 6. What damages or injuries do you claim resulted? (Give Hill extent of injuries or damages claimed. Attach two estimates for auto damage.) wu�c Gas-s ------------------------------------- ------ 7. How was the above claimed amount computed? (Include the estimated amount of any prospective injury or damage.) P� ----------=--------------------------------------------------------------------------- 8. Names and addresses of witnesses,doctors,and hospitals. lidnfU`( (iasfa X41 k pic &W.#1 ej VWu ----- I Ius�s :p------I------------------------------------------------------------- 9. . List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT K` S 7 S�3 k( G<st�dill j�h'K � slat to /Gd i4v-/LIGE%!mac Gov. Code Sec. 910.2 provides: - "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney / , L art Xhu s a'f neveH 7arnes Choi ( Ott., laimant's Signature) 1��7S2ti Y W11$'tri, glr6 ���0 (Address) Telephone No. /G- zlyy- 11L71 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 dollars ($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. cc;�Z U Z NVf Qar".i--o ad Authorization I. Authorization to Obtain Records: The undersigned hereby authorizes the Law Office of Steven James Choi, and the following insurance company: to inspect and make copies of the following records: police reports, medical records, employment records, which relate to my accident dated: May 3,2001. This authorization is limited to records that relate to the above-referenced accident! A photocopy of this general authorization shall be considered as valid as the original. This general authorization shall expire when all claims arising from the above accident are resolved. II. Authorization To Handle Insurance Claim: Pursuant to Section 2695.2 of the California Insurance Code, I hereby authorize the Law Office of Steven James Choi to handle my insurance claim arising out of the accident dated: May 3, 2001. This authorization is valid for one year from the date set forth below unless otherwise revoked or renewed in writing by the undersigned. All prior authorizations are hereby revoked. A photocopy of this authorization shall be construed as effective and valid as the original. Dated: J0lO gan Anne Rex t7`o r 0 �S o � 0 a G o �a , a co zr a � at a 0 ° M m N N K d a 0 m a Y Q � OLL tC N W G r T q � J } Q' 4 t` JUL .2 5 2001 CLAIM rrYr rA'y,.T.v. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALTFOI�L 'pplp�-L BOARD ACT1011t August 14, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT:- Unknown CLAIMANT: Timothy Dukes ATTORNEY: James Rogers DATE RECEIVED: July 17, 2001 ADDRESS: 1941 Jackson St BY DELIVERY TO CLERKQT.-_ - July 17.20.01: Oakland, CA 94612 BY M,-UL POSTMARKED:; I. FROI E Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. l Dated: July 25, 2001 By: Deputy JQ� ,Ti 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: Deputy County Counsel M. FROM Clerk of the Board TO: County 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 that this is a true andel ccorrect copy of the Board's Order entered in/� its minutes for this date. Dated: JOHN SWEETEN Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney,of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF NIAlLING 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 Claiman ddressed to the c aimant as shown above. r Dated: ��G1�' 1�i Bv: JOHN SWEET , CLERK R„ � ¢ '1,� �' �` nantitu riPri, I i This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to un'derstand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases .applicable to your particular claim. The'County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I r SImft 6-MARCHESI DEPUTIES: PHILLIP S.ALTHOFF COUNTY COUNSEL S E L t1�-_. ---'_=- � JANICE L.AMENTA NORAG.BARLOW r - \. B.REBECCA BYRNES SHARON L. ANDERSON ,;'_ '. e_-t ,%, ASSISTANT COUNTY COUNSEL =� ANDREAW.CASSIDY CCOSTA;6=,'l Y MONIKAL.COOPER /! /.� te VICKIE L.DAWES GREGORY C.HARVEY OFFICE OF T_H__E_ ,C,O.UNTINI •.OUNSEL MARKES.ESTIS ASSISTAN7COUNTYCOUiJSEL �11-' ,I • "..-"`-�.I I� LILLIAN T.FUJII ,} JANET L.HOLMES (°;,000N7V-DMINISTRATIOMBUILDING►7DENNIS C.GRAVES 65',1•RINFSTBEET 9tti'F100R KEVINTKERR >� -. -+ " �r—;++�„ �r� �., BERNARD L.KNAPP SENIOR FINANCIAL COUNSEL MARTNE_Z_;---CALIFORNJI: -51 1229 .r-/ y EDWARD V.LANE,JR. V� BEATRICE LIU GAYLE MUGGLI l — �L7` MARY ANN MASON OFFICE MANAGER �s� �?=t.� PAUL R.MUNIZ VALERIE J.RANCHE PHONE (925) 335-1800 NOTICE OF I1�TS' ICIENCY STEVEN P.RETTIG F. FAX (925) 646-1078 DAVNDAJ.SILVERIDT AND/OR JACQUELINE Y.WOODS NON-ACCEPTANCE OF CLAIM PAMELA J.ZAIO TO: James M. Rogers, Esq. 1941 Jackson Street Oakland, CA 94612 RE: CLAIM OF: Timothy Dukes Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: [XX] 1. The claim fails to state the name and post office address of the claimnant. [XX] 2. The claim fails to state the post office address to which the person presenting the claim.desires notices to be sent. [XX] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [XX:l 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [XX] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claiin fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the,arnount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. IXX] 6. The claire is not signed by the claimant or by some person on his or her behalf. ] 7. Other: Page 1 SILVANO B. MARCHESI COUNTY COUNSEL By: 1V&nom Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013x,2015.5;Evidence Code§§641,664) 1 declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California 94553;I am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. 1 served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S. Mail at Martinez,California. I certify under penalty of perjury that the foregoing is true and correct. Dated: July',2001,at Martinez.,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIA4:GOVT.CODE§§910,910.2,920.4,910.8) Page 2 LAW OFFICES JAMES M. ROGERS JAMES M. ROGERS 1941 Jackson Street Tel. (510) 4444464 JUDITH W.MARSfI Oakland, California 94612 July 6 , 2001 County of Contra Costa �r 'EIVED County Recorder P.O. box 350 Martinez , CA 94553 .1111 1 7 Z001 CLE.=='[30ARC OF SUPERVISORS Re : M� .Client• TIMOTHY DUKES CONTRA CG.STA CO. Date of Accident: 5/22/01 Type of Accident: Personal Injury Dear Recorder : This office has been .retained to represent the above-named client with respect to the injuries sustained as a result of the above-referenced accident 1"f you are insured, please forward this letter to your insurance carrier inunediately so as to protect your rights under your policy. If you are not insured, please contact this office so that we may avoid taking further legal action. If we do not hear from you soon, we intend to have a lawsuit filed agains- you. Thank you for your courtesy and cooperation. Sincerely, Anne Boyd Assistant to John Bell, Esq . (510) 444-4464 x 323 LAW OFFICES JAMES M. ROGERS JAMES M. ROGERS 1941 Jackson Street Tel. (510) 444-4464 JUDITH W. MARSH Oakland, California 94612 July 6 , 2001 County of Contra Costa "FINED County Recorder P.O. box 350 Martinez, CA 94553 .1111 1 7 2001 CLEC ;30ARC OF SI.JPERVIsORS Re : M.,,� Client- TIMOTHY DUKES i ONTRraCGSTACO. Date of Accident: 5/22/01 Type of Accident: Personal Injury Dear Recorder : This office has been .retained to represent the above-named client with respect to the injuries sustained as a result of the above-referenced accident If you are insured, please forward this letter to your insurance carrier immediately so as to protect your rights under your policv. If you are not insured, please contact this office so that we may avoid taking further legal action. If we do not hear from you soon, we intend to have a lawsuit filed agains- you. Thank you for your courtesy and cooperation. Sincerely, Anne Boyd Assistant to John Bell, Esq. ( 510) 444-4464 x 323 y 1•'' CLAL7'-�VR' '1 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNLA BOARD AC710August 14, 2001 Claim Against the County, or Oistrict Governed by 1 the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below►, given %1g(Z3111Vr 1X1D pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: Unknown J U L 19 2001 COUNTY COUNSEL CLAIMANT: Cornelius Williams MARTINEZ CALIF. ATTORNEY: None DATE RECEIVED: July 19, 2001 ADDRESS: 2172 Abbott Ave BY DELIVERY TO CLERK ON: July 19, 2001 Pittsburg, CA 94565 BY MAIL POSTMARKED: July 18, 2001 I. FRONZ Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN t E , C e r i Dated: July 19, 2001 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisors (Vr'Ths 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was. filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 7- —By: —GNU/ .( 00,Q Deputy County Counsel M. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). N. 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 Orde�Atered in its minutes for this date. Dated:6(GQ lif Ail dn/ JOHN SWEETEN Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF IVIAIIgiG 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. � f� / , PI/ in/Dated:b(I tk1-C - r /Bv' JOHN SWEETEI`T, CLERK R„ '�t� 'v�� � nA.,ivt„ r farL- 1 f This warning does not apply to claims which are not subject to the California Tort .Claims Act ,such. as actions in inverse condemnation, actions for specific relief such as . mandamus or injunction, or Federal Civil; Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I ORIGINAL 4! CORNELIUS WILLIAMS RECEIVED c/o Vivian Williams 2172 Abbott Ave. JUL 1 9-1 2001 Pittsburgh, California 94565 [ 1 (925) 473-9563 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. In Proper Persona CLAIM AGAINST THE COUNTY OF CONTRA COSTA TO - Board of.C,:pervis^rs .. County of Contra Costa 651 Pine Street, Room 106 Martinez, California. 94553 CLAIMANT'S NAME CORNELIUS WILLIAMS CLAIMANT'S ADDRESS 2172 Abbott Ave. Pittsburgh, California 94565 CLAIMANT'S TELEPHONE (925) 473-95.63 AMOUNT OF CLAIM In an amount exceeding the jurisdiction of the Superior Court ADDRESS TO WHICH NOTICES ARE TO BE SENT CORNELIUS WILLIAMS c/o Vivian Williams 2172 Abbott.Ave. Pittsburgh, California 94565 DATE OF OCCURRENCE January 28-29, 2001 PLACE OF OCCURRENCE Contra Costa County Jail Contra Costa County, Martinez, California Page I . HOW DID CLAIM ARISE: On or about January 28, 2001, Claimant was housed as an inmate at the Contra Costa County Detention Facility in Martinez. The facility is operated, maintained, and controlled by the County of Contra Costa, under the authority of the Sheriff of Contra Costa County, Warren Rupf. This claim is based upon the personal injuries sustained by Claimant as a result of the detention facility's staffs refusal to provide Claimant with adequate medical care, including his medication for hypertension. As a result, Claimant suffered a stroke on or about January 30, 2001, for which he was treated at the Contra Costa County Regional Medical Center. The claims asserted herein include, but are not limited to: 1. The failure of the County, through its employees, to provide reasonable medical care to Claimant, whose condition required such care; 2. Claimant was so negligently and carelessly confined, assigned, treated, classified, managed, controlled, supervised, and cared for so as to proximately result in the injuries above so described ; 3. Claimant was"treated by health care providers who were the agents, servants, and employees of Contra Costa County, and who negligently and carelessly treated, diagnosed, examined, classified, assigned, confined, and otherwise cared for Claimant so as to proximately caused the injuries as set forth above; 4. At all times relevant, the County of Contra Costa failed to provide adequate or sufficient equipment, personnel, or facilities, required by State law and as further required by the regulations of the State Department of Health Services, proximately resulting in the injuries set forth above; 5. The detention facility was carelessly, negligently, and effectively designed, constructed, owned, operated, repaired, controlled, inspected, supervised, installed, used, and maintained by the County of Contra Costa as to render it unsafe, defective and dangerous, proximately resulting in the injuries to Claimant. The injuries sustained to Claimant, as of the date of presentation of this claim, consist of the loss of future earnings, and pain and suffering of Claimant. Page 2 ITEMIZATION OF CLAIM: Jurisdiction over the claim would rest in the Superior Court. Loss of Earning Capacity: Undetermined at this time. General Damages, including loss of love, comfort, and society: Undetermined at this time. 1 Dated: CORNELIUS WILLIAMS l Page 3 U.S. POSTAGE PAID ;.. PIrTSBURG.CA `• 9fi�GS ni JLiA AMOUNT V 1 0339-09 o �� _n ..�� Q... Ln . _n _n l e Rd, * \k f ..�.� o , ! .�.� ...a �O i n .._._,_ a i ia� I `ryr \ro I _low ` 146 STAT E! yIC f i Y ,f } i JUL 1 9 2001 CLAI� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALrFORNL`AouNSEL enawev a ao•a�s,CALIF. BOARD ACT10ACust 17, 2001 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, I NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. I notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section .913 and 915.4. Please note all "Warnings". AMOUNT: Lai CLAIMANT: 11En Allen ATTOR'N'EY: ELise SarOlimtti DATE RECEIVED: July 18, 2001 ADDRESS: 1646 N. California Blvd # 600 BY DELIVERY TO CLERK ON: July 18, 2001 W31mt Creek, CA 945% BY MAIL POSTMARKED: I. FRO.'VL• Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. SWEETEN � Clerk Dated: July 18, 2001 Dy: Deputy; , 1/ 1 H. FROM: County Counsel TO: Clerk of the Board of Supervisors ( W01ris 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: tow" De uty County Counsel M. 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: (k) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Ordere eyed in its minutes for this date. Dated: �,�PG � � JOHN SWEETEN Clerk, By d�� � 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 MA.ILIl`TG 1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant addressed to the claimant as shown above. Dated: ' /1 , �/��Bv JOHN SWEk'TEN, CLERK 1 This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to un'derstand all the separate limitations periods that may apply. The Iimitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The Countv of Contra Costa does. not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I .4 I SCOTT H. Z. SUMNER, State Bar No. 156304 ELISE R. SANGUINETTI, SBN 191389 HINTON & ALPERT RECEIVED A Professional Corporation 6r 1646 No. California Blvd. , Suite 600 Walnut Creek, California 94596-4113 ,IU(_ 1 8 2001 Telephone: (925) 932-6006 Facsimile: (9 2 5) 932-3412 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Attorneys for Claimant, MAGDALEN M. ALLEN In The Matter of: ) CLAIM AGAINST AN UNINCORPORATED AREA OF CONTRA COSTA COUNTY, COMMONLY KNOWN AS KENSINGTON MAGDALEN M. ALLEN ) (Calif. Gov. Code §910) Claimant. ) The above named Claimant, acting by and through attorneys HINTON & ALFERT, hereby makes the following claim against: AN UNINCORPORATED AREA OF CONTRA COSTA COUNTY, COMMONLY KNOWN AS KENSINGTON C/O CONTRA COSTA COUNTY BOARD OF SUPERVISORS 651 Pine Street Martinez, California 94553 1) NAME/ADDRESS OF CLAIMANT: MAGDALEN M.ALLEN 82 Norwood Avenue Kensington, California 94707 TELEPHONE: (510) 528-9189 SOCIAL SECURITY #: 626-66-5640 DATE OF BIRTH: 5/14/60 ADDRESS WHERE HINTON & ALFERT NOTICES ARE SENT: 1646 North California Blvd. , Suite 600 Walnut Creek, California 94596 2) DATE OF INCIDENT: March 31, 2001. 3) LOCATION OF Sidewalk in front of residence, INCIDENT: 265 Arlington Avenue, Kensington, California. 4) DESCRIBE THE On March 31, 2001, claimant Magdalen INCIDENT: M. Allen was walking on the sidewalk on Arlington Avenue with her two children, one of which was in a stroller. Claimant stepped onto a buckled portion of the sidewalk and slipped and fell . There were no warning. signs. 5) DAMAGES INCURRED Claimant Magdalen M. Allen suffered a AS A RESULT OF THE chip fracture to her left distal fibula INCIDENT: with extensive swelling. Claimant seeks general and special damages for personal injury and emotional distress arising from this fall which occurred on property owned and maintained by the unincorporated area of Contra Costa County, commonly known as Kensington. Said damages include, but are not limited to, medical expenses, past and future, and incidental expenses . 6) NAME OF PUBLIC Public employees, agents, and/or EMPLOYEES CAUSING personnel of an unincorporated area of THE DAMAGES CLAIMED: Contra Costa County, commonly known as Kensington, presently unidentified, who were involved with the maintenance of the sidewalks located on Arlington Way, Kensington, California. 7) NAME OF WITNESS (ES) Public employees, agents, and/or ADDRESS AND PHONE: personnel of an unincorporated area of Contra Costa County, commonly known as Kensington, presently unidentified, who were involved with the maintenance of the sidewalks located on Arlington Way, Kensington, California. 8) AMOUNT OF CLAIM: An unspecified amount of general damages within the jurisdictional limits of the Superior Court. Medical special damages are continuing. DATED: July 18, 2001 HINTON & ALFERT By: I ELISE R. GUINETTI Attorneys for Claimant Receipt of the above claim is hereby acknowledged this day of 2001. CONTRA COSTA COUNTY By (Title) 0-7 JUL 19 2001 CLAIM COUNTY COUNSEL T T PAAR,vtn, BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY CALIFO " NLF4Z,CALIF. BOARD AC110tlb A igwt 14, 2001 Claim Against the County, or District Governed by ) 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 California Government Codes. ► notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $8.06 CLAIMANT: Marais Series ATTORNEY: DATE RECEIVED: July 18, 2001 ADDRESS: g01 Cart St BY DELIVERY TO CLERK ON: July 18, 2001 NEarri , CA 94553 BY MAIL POSTMARKED: July 17,2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JO ETE[V, !C1 r Dated: July 18, 2001 �l By: Deputy. 11. FROM County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 70 0*41' 0 By: 01Ahm 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: (x) . This Claim is rejected in full. ( ) Other: I certify that this is atrrue and correct copy of the Board's Order entered in its minutes for this date. Dated: (IUCY110:fiV, JRA JOHN SWEETEN Clerk, By �G'' cYDeputy Clerk 14 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 MAII,ING 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 Claiman addressed to the claimant as shown above. Dated: ,( I�`l�1 /7,&Bv. JOHN SWE1aZ'E�1, CLERK R„ �`'/((/ (/`— rlanittx, M.A. This warning does not apply to claims which are not subject .to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to un'derstand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County -of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I cF Claim to: BOARD. OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100'h 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. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ='` u\ 2rved for Clerk's filing stamp RECEIVED Against the County of Contra Costa or ) CLERK':a' 77T SUPERVISORS 1 i.O`;iFACDsiACO. .1�0 . \ 4 District)! (Fill in name) ) The undersigned clai nt hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ ' and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) 0���� �� � 3. How did the damage or injury occur? (Give full details; use extra paper if required) LeA r . ' Y... , . . , 4. What wa' *lar act or omission on the part of county or district officers, servants, or employees caused the injury or damage? J ► � . v� � � �1�� ��V�J 5. What are the names of county or district officers, servants, or employees causing the damage or injury? Cc, Lc) %(X-) I 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) J ,r 7. How was the amount claimed above computed? (Include the estirnIted amount of an ros ective injury or � YP damage.) �� S � S 8. Names and addresses of witnesses, doctors, and hospitals. .�- bAb �tk'� 0-120rzM V� 9eti � . ����G�� CA .935,5 9. List the expenditures you mace on account of t is accident or injury. DATE TDAE AMOUNT ou�f Gov. Code Sec. 910.2 provides "The claim must be signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attorney Name and Address of Attorney ) A (Claimant's Signature) (Address) ) Telephone No. ) Telephone No. , I NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,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 jail for a period of not more than one year,by a fine of not exceeding one thousand(S 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(S 10,000),or by both such imprisonment and fine. 1 PROOF OF SERVICE 2 1 am a citizen of the United States. I am over the age of 18 and not a party to 3 the within action; my business address is 5900 Hollis Street, Suite N, Emeryville, 4 California 94608. 5 On July 16, 2001, 1 caused to be filed and served a copy of: CLAIM TO 6 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY 7 on the following person(s) by placing a true copy thereof enclosed in a sealed 8 envelope and having hand del iv.-red/mail--d/faxed the same.on the following parties: 9 Warren E. Rupf, Sheriff Contra Costa County Sheriffs Department 10 651 Pine Street, 7th Floor Martinez, CA 94553 11 I certify or declare under penalty of perjury that the foregoing is true and 12 correct. 13 Executed on July 16, 2001 at Emeryville, California. 14 15 16 Lindo M. 81glich 17 18 19 20 21 22 23 24 25 26 i I I o x 0 v� �o c Z T • 3 rD1 fD n - y O 7 v X, A _ I 0) 00 U h @1 ir7 � o y o r 0 to 0- n� I � i.� 3 - W cnO O O (D = � O C U 3 R. ':; co N m 0 > 00 — _ 0 3 w -1 D (D N CO CD O 4 0 W "a � `` z . 0o � o c _ o (n co /lrN9"r�� ` 4 V la 3 448 '_HV EF( � 0-7 JUL 18 2001 - CLAIM , BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALdBQRiN•A,- - _4 MARTINEZ,CALIF. BOARD ACT10tlk August 14, 2001 Claim Against the County, or District Governed by ) 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 California Government Codes. ► notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $6500 CLAIMANT: Christopher Cook ATTORNEY: None DATE RECEIVED: July 17, 2001 ADDRESS: 510 Sonoma Ave BY DELIVERY TO CLERK ON: July 17, 2001 Rodeo, Ca 94572 BY NUML POSTMARKED: I. FROAZ Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. i0m SWEr Clerk Dated: .h11;1 17- 2001 By: Deputy— . i H. FROM County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( is 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By. CDeputy County Counsel M. 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. . /I JOHN SWEETEN��(1l��`I, ��� Clerk, By?�4) _, Deputy Clerk J 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 A'IAILING 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: �vti�. y, aAv. JOHN SWEEM, CLERK This warning does not apply to claims which are not subject .to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within.which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject. to the California Tort Claims Act. I i I claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY e INSTRUCTIONS TO CLAIMANT <c 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 100'h 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. 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 �if2 iS7aP�e Co�-� � RECEIVED ) Against the County of Contra Costa or ) JUL 1 7 2001 CLERK BOARD OF SUPERVISORS District) CONTRA COSTA CO. (Fill in name) ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ 1-sZ 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) Mlie r/.vE 21 �4z-i F i✓is} - C WM4 a0,121 Co w✓T+� 3. How did the damage or injury occur? (Give full details;use extra paper if required) p wkra')S ZAE20AJ&M1,5, To A4_-- tt4ede, 4.' What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? d,2.vicez�o -1,47 XiVee,9wce-C 77 Xe6 445 60 r 7 S6'T. B+e,6 Y om► DE�i".e2 0,� S. What are the names of county or district officers, servants, or employees causing the damage or injury? Scar. z� F>rz e cs o . 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) you o¢ w�po.vs oN ���4ys Mq,e -, 8. Names and addresses of witnesses, doctors, and hospitals. 9. List the expenditures you made on account of this accident or injury. DATE TIME AMOUNT ) Gov. Code Sec. 910.2 provides "The claim must be ) signed by the claimant or by some person on his behalf." SEND NOTICES TO: Attorney Name and Address of Attorney ) a ant's Signature) (Address) �5-10) afts-e1?3 9 Telephone No. )Telephone No. (S7o) Xf'Z -- Z7z,3 *s*s*«**•*******�*******�***�**�*«**«*****s************sss*ssss*,****r*ss«*«*«**««*«***s** NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,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 jail for a period of not more than one year,by a fine of not exceeding one thousand(S 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. SILV4NP B.MARCHESI DEPUTIES.A E PHILLIPSS. LTHOFF COUNTY COUNSEL S----I JANICE L.AMENTA `` \�I� NORAG.BARLOW SHARON L. ANDERSON r� -` ,• B.REBECCA BYRNES ° -_=<` ANDREAW.CASSIDY ASSISTANT COUNTY COUNSEL "= C NTRA COSTAWCOUN`Y MONIKAL.000PER VICKIE L.DAWES GREGORY C.HARVEY OFFICE-OFTH&C-QUNTTYM NSEL MARKES.ESTIS ASSISTANT COUNTY COUNSEL I ,I9`I�I LILLIANT.FUJII r;COI =ADMINISTRATION:BUILDIL4G ff JANET L.HOLMES 165 _ • .,::. :.,.....-:—:,.�•. DENNIS C.GRAVES 1I:RIN.FSTREET-9th1V-W KEVINT.KERR °^ '" ' '"1''/� BERNARD L.KNAPP SENIOR FINANCIAL COUNSEL MARTINEZ'CALIFORNIAQ94'559-1229 EDWARD V.LANE.JR. BEATRICE LIU GAYLE MUGGLI `� P'(�1` MARY ANN MASON OFFICE MANAGER CD �1-- ' ' PAUL R.MUNIZ COU VALERIEJ.RANCHE PHONE (925) 335-1800 NOTICE OF INSUFFICIENCY STEVEN P. IG DAVID F.SCHMIDHMIDI' FAX (925) 646-1078 LVER AND/OR JDACOUELIINEY WOODS PAMELA J.ZAID NON-ACCEPTANCE OF CLAIM TO: Christopher Cook 510 Sonoma Avenue Rodeo, CA 94572 RE: CLAIM OF: Christopher Cook Please Take Notice as Follows: The claim YOU presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: ] 1. The claim.fails to state the name and post office address of the claimant. ] 2. The claim fails to state the post office address to which the person presenting the claim.desires notices to be sent. [XX] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claiin asserted. 1 4. The claim fails to state the name(s) of the public einployee(s) causing the injury, damage, or loss, if known. 5. The claim fails to state whether�the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount clanned. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claiuu would rest in municipal or superior court. [ ] 6. The claim is not signed by the claimant or by some person on his or her behalf. [ ] 7. Other: Page 1 v'1 SILVANO B. MARCHESI COUNTY COUNSEL By: Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013x,2015.5;Evidence Code§§641,664) I declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California 94553;I am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above,scaled and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S. Mail at Martinez,California. I certify under penalty of perjury that lie foregoing is true and correct. Dated: July LI,2001,at Martinez,California. cc: Clerk of the Board of'Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE §910,910.2,920.4,910.8) Page 2 AMENDED CLArnI BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CAUFORnA BOARD ADTIo August 14, 2001 Claim Against the County, or District Governed by ) 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 California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: Unknown J U L 2 3 2001 COUNTY COUNSEL CLAIMANT: John Davlin MARTINEZ CALIF. ATTORNEY: Donald Patterson DATE RECEIVED: July 17, 2001 ADDRESS: 3260 Blume Dr BY DELIVERY TO CLERK ON: July 16, 2001 Richmond, CA 94806 BY MAIL POSTMARKED: I. FRO.'NL Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JO 11 WT-, V Dated: July 23, 2001 By: Deputy. % 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). I ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: UDeputy County Counsel M. 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 inu es for this date. Dated: Iti61��7 r JDA SWEETEN Clerk, By I� F�' ' t✓, 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 MAIILING 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. l ZfDated: ��' UkA+1 ,ate Bv. JOHN SWFETEN, CLERK -v `"I i i i I I i I i i i I This warning does not apply to claims which are not subject to the California Tort Claims Act.such.as.,actions in inverse condemnation, actions*.for specific relief such as i mandamus or injunction, or Federal o.C.Ni1• Rights claims. j The above list is not exhaustive and legal"consultation is essential to un'derstand all the separate'.limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. i I The Countv of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. i i i I i . i i i i i i I I • i i i i i 1 i i LAW OFFICES PELLETREAU, ALDERSON & CABRAL PLAZA TWO. HILLTOP OFFICE PARK 3260 BLUME DRIVE' SUITE'410 RICHMOND.CALIFORNIA 94806-5277 MICHAI=:1.L.ALDERSON* ROBERT W. PELLETREAU* Retired ALFRN)A.CABRAL* DONALD E. PATI ERSON Telephone: (510) 262-2100 Facsimile:(510) 758-4921 Website: Pelletreaulaw.com 'A Prof—ion:.I Corponnion •.A Professional Coryo al-, July 16, 2001 Contra Costa County Board of Supervisors Attention: Deputy M. Horton RECEIVED 651 Pine. Street, Room 106 Martinez, CA 94553-1293 JUL 17 2001 Re: John Davlin; Claim Filed on July 2, 2001; CLERK BOARD OF SUPERVISORS Assault by Security Guard on December 30, 2000 CONTRACOSTACO. Dear Deputy M. Horton: John Davlin has requested that I write to you on his behalf: Mr. Davlin _filed a claim against Contra Costa County on July 2, 2001, i:or personal injuries received in an incident. of December 30, 2000. The claim is attached. Mr. Davlin received a Notice to Claimant of Late- Filed Claim under Government Code Section 911.3 signed by you dated July 10, 2001. The purpose of this letter is to respectfully request that you reconsider your decision regarding Mr. Davlin's claim for the following reasons: Although your calculation of the six-month period to file this claim was completely correct in that the deadline was June 30, 2001, you may have failed to consider. that June 30, 2001 was a Saturday and that July 1, 2001 was a Sunday. The document was filed on Monday, July 12001, the first business day that your office was open following June 30. As you know, the office of the County Clerk, Clerk of the Board, is closed all day Saturday and Sunday. Pursuant to California Code of Civil Procedure, Section 12a, "if the last day for performance of any act provided or required by law to be performed within a specified period of time shall be a holiday, than such period is hereby extended to and including the next day which is not a holiday. The term "holiday" as used herein shall mean all day on Saturdays, all holidays specified in section 6700 and 6701 of the Government Code and, to the extent provided in section 12b of this code, all days which by terms of said section of 12e are required to be considered holidays . . . Under CCP §12b, "if any City, County, State or Public Office other than'a branch office is closed for the whole of any day insofar as the business of that office is concerned, that day i i . . " 1 i � . . . , . . . . . . . i i i i � . � i � r. .. i . .. _ ,. ., .. - . � � , i I I i I i i I I i I i I Contra Costa County Board of Supervisors Re: John Davlin July 16, 2001 Page 2 shall be considered as a holiday for the purposes of computing time under §12 and 12a." Under Government Code §6706, "whenever any act of a secular nature . . . is appointed by law or contracted to be performed upon a particular day which falls upon a holiday, such act maybe performed upon the next business day with the same effect as if it had been performed upon the day appointed." Where the last day for tiling a claim against a City falls on November 11 (a holiday), the claim maybe properly filed on the following daj. :-::ea Cita_of San Ser: ardinr 0 9 36) 7 Cal. 2"' 688. If the office of City Manager, to whom city charter specifies that claims must be presented, was not open for business on Saturday which was the 90" day for presentation of a claim by a former policeman against the city for compensation.for holidays worked and vacations accrued but allegedly not taken, without waiver of rights, at special instance and request of the city, claim therefore was timely when filed on the following Monday. Adams v.. City of Modesto (1960) 53 Cal. 2" 833. Given the foregoing facts and law it appears that Mr. Davlin's claim was timely tiled, Monday, July 2, 2001. I respectfully request that you reconsider the decision as set forth in your letter of July 10, 2001 (attached) and accept Mr. Davlin's claim. If you do not agree, then his next recourse will be to make application for pernlisEion to present a late claim, although I do not believe, based upon the above, this is necessary. I urge you to consider consulting with County Counsel's office regarding this matter and the citations that I have set forth above, in that I believe, by doing so, the necessity for application to present a late claim may be avoided. I thank you for your kind attention to this matter and for your anticipated prompt response. ry truly yours lll/ r, C onald E. Patterson DEP:cm Enclosures The board of Supervisors John Sweeten , Contra Clerk of the Board Costa and County Administration Building County Administrator 651 Pine Street. Room 106 (925)335-1900 Martinez, California 94553-1293 Count John Gioia, 1st District 1V Gayle B.Uilkerna,2nd District Donna Gerber,3rd District _ �1 Mark DeSaulnier,4th District Federal D.Glover,5th District " Cr LO TO: John Davlin 3716 San Pablo Dam Road, #23 EI Sobrante, CA 94803 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 July 2, 2001, has been reviewed by County Counsel and is being returned to you herewith because: X Your claim for an injury to person or personal property 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) John Davlin Re: Claim Page Two 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. Date: JOHN SWEETEN, Clerk of the Board i of Supervisors and County Administrator B AR, Deputy Clerk Enclosure Affidavit of Mailinq 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-FILED CLAIM), addressed to the claimant as shown above. Date` i,t Deputy Clerk I:\TOK'I-WS i-MGT\.CLA I\IS\LATE\Davlin.wpd • � � RECEIVED JUL 2 2001 CLAIM AGA[NST COUNTY OF CONTRA CO ERK BOARD OF SUPERV!' + - - CONTRA COSTA CO. TO: COUNTY OF CONTRA COSTA and MERRITHEW HOSPITAL aka CONTRA COSTA HEALTH SERVICES The claimants herein present the following claim for damages against the above- named governmental agency and in compliance with Section 910 of the California Government Code sets forth in detail the following information: A., The names and.posi office address of the claimants are: John Davlin, 3716 San Pablo Dam Road, 423, El Sobrante, California, 94803. B. The post office address to which notices in connection with this cia'm are to be sent is: 3716 San Pablo Darn Road, ##23, El Sobrante, California, 94803. C. The date, place and circumstances of the occurrence which give rise to the claims are as follows: On December 30, 2000, approximately 11:00 p.m., claimant was assaulted and battered by security au irds at Merrithew Hospital in Martinez. Claimant received personal injuries as a result. D. A general description of the injuries and the losses incurred, so far as are known at the present time, are as follows: Claimant suffered injuries to his face, neck, arms and chest pain. E. The names of the public employees causing the injury are: Merrithew Hospital aka Contra Costa Health Services. -1- i i , , . �_ � I i I i i i i i i i i i i i i E. The amount claimed as of the presentation of these claims are: Damages in this action are within the jurisdictional limits of the Superior Court. Dated: July 2, 2001 By cJ T Davlin, In Pro Per consul is\.200 I\dav I i n\clai m -2- 0 0)W Na 0 0 Ar z Co C-. r- c > m z 00 9 L 0 0 -n I <m -0 C) A - 0 M o (f) 0 n C� > C) oz z 0 M M 0) > > C) 10 til ED wmmmmmmmm. tij w HN1-3 r1i tij M C3 C3 0 > 0 0 = p Ir ru -) LLJ Ln V) LAJ > CD CD, -T. C) 0 C) f '� 1' i _._,_...._--r---- ,----.^�_.__. _.�_ f' -r _� r ,� � : • 1 \\`\ �� \ * ' APPLICATION TO FILE LATE CLAIM �I BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA q BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT August 14, 2001 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 111, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. Claimant: Salima Ahmadi Attorney: Joseph Welch J U L 2 3 2001 Address: 1006 4th St. #220 COUNTY COUNSEL Sacramento, CA 95814 MARTINEZ CALIF. Amount: Unknown By delivery to Clerk on: July 20, 2001 Date Received: July 20, 2001 By mail, postmarked on: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Latc a �. DATED:July 20, 2001 JOHN SWEETEN Clerk B : UTY > Y I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). The Board should deny this Application to File Late Claim (Section 911.6). DATED: 731-01 SILVANO B. MARCHES), County Counsel, By: - DEPUTY Ill. BOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 911.6). This Application to File Late Claim is denied (Section 911.6). 1 certify that this a true and correct copy of the Board's rder entered in its inutes for this date. DATE: I 1-4 ��JOIIN SWEETEN, Clerk, Bv: � � � �1 DEPUTY WARNING (Gov. Code §911.8) If you wish to file a court action on this matter,you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so immediately. IV. FROM: Clerk of the Board TO: (1) County Counsel (2) County Administrator Attached are copies of the above Application. We notified the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: I qtXZjJOHN SWEETEN, Clerk, B,y: '/ 777 DEPUTY V. FRO: . (1) County Counsel (2) County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By: County Administrator, By: APPLICATION TO FILE LATE CLAIM 1 JOSEPH A. WELCH, ESQ. SBN# 119312 Law Offices of 2 HINTZ & WELCH 3 1006 4`h Street, Suite 220 FrMiTPIAMSTA CEIVED Sacramento, California 95814 4 Telephone: (916)444-5203 2 0 2001 Telecopier: (916)444-8702 5 RD OF SUPERVISORS 6 Attorneys for Plaintiff, CO. SALIMA AHMADI 7 8 9 APPLICATION TO PRESENT LATE CLAIM 10 In Re: Claim of Salima Ahmadi 11 Discovery of Date of Loss: March 2001 12 13 Pursuant to Government Code Section 911.4, Claimant, Salima Ahmadi, presents this 14 15 Application for Late Filing of her claim pursuant to the July 10, 2001 "Notice to Claimant of 16 Late-Filed Claim", which was received from the Contra Costa Board of Supervisors on July 11, 17 2001. 18 19 FACTS 20 According to the June 24, 2000 Discharge Summary, Claimant, Salima Ahmadi, was 21 admitted to the Contra Costa Regional Medical Center on June 19, 2000 and discharged on June 22 24, 2000. (Please see Exhibit"A", a true and correct copy of the 3-page Discharge Summary.) 23 24 Both the Discharge Summary(Exhibit"A") and the Obstetrical History and Physical (please see 25 Exhibit `B", a true and correct copy of the June 19, 2000 Obstetrical History and Physical), Ms. 26 Ahmadi indicated at the time of admission that she had a family history of allergies to Penicillin, 27 but that she had not been administered Penicillin. Even though Claimant indicated a family 28 -1- APPLICATION TO PRESENT LATE CLAIM I history of allergies to Penicillin, Ampicillin was administered and Claimant suffered a"diffuse 2 erythematous rash secondary to administration of Ampicillin". (Exhibit "A".) 3 On June 29, 2000, Ms. Ahmadi returned to the Contra Costa Regional Medical Center 4 5 complaining of severe headaches, dizziness, flashing lights in vision in both eyes, and "fuzzy" 6 vision. (Please see Exhibit"C", a true and correct copy of the June 29, 2000 Outpatient Notes 7 from the Contra Costa Regional Medical Center.) There was an indication that the rash was 8 resolving. There is a separate entry that her headaches were more consistently"possibly related 9 to Prednisone." (Exhibit"C".) 10 11 On July 13, 2000, Claimant returned to the Contra Costa Regional Medical Center 12 complaining of ongoing headaches on the left side, which radiated around her head and neck. 13 These headaches were worse at night and interrupted her sleep. She also complained of 14 dizziness and itching. Dr. Aria Arrizabalaga diagnosed(1) tension headaches, and (2) a rash. 15 16 Ms. Ahmadi was not advised that her headaches and dizziness might be due to anything other 17 than tension. (Please see Exhibit"D", a true and correct copy of the 7/13/00 Outpatient Notes 18 from the Contra Costa Regional Medical Center). 19 On August 10, 2000, Ms. Ahmadi returned to the Contra Costa Regional Medical Center 20 complaining of severe back pain and headaches. (Please see Exhibit"E", a true and correct copy 21 22 of the Outpatient Notes from the Contra Costa Regional Medical Center.) Dr. Arrizabalaga 23 diagnosed tension headaches and did not relate the problem to the administration of 24 Ampicillin/Penicillin. 25 Two to three months after the birth of her child on June 19, 2000, Ms. Ahmadi sought 26 treatment from Dr. Sultan Hamid, who has no affiliation with the Contra Costa Regional Medical 27 28 Center. Dr. Hamid treated Ms. Ahmadi for her ongoing headaches and dizziness. It was not -2- APPLICATION TO PRESENT LATE CLAIM 1 s ,� i ,` :,, �t �� 4 .�, 1 1, ., ,, 4 '� �, 1 ,` �` i ,` 1 �\ 1 1 ;, i 'r ,` :, �` �� - 1 t 1 ,,� r ,` i r 5 1 1 1 until approximately March 2001 that Mr. Hamid indicated to Ms. Ahmadi that her continuing 2 headaches and dizziness might be related to the administration of Ampicillin/Penicillin between 3 June 19, 2000 and June 21, 2000. 4 5 POINTS AND AUTHORITIES 6 (Commencement of Statute of Limitation) 7 Government Code §911.2 provides that a claim relating to a cause of action for personal 8 injuries shall be presented no later than six (6) months after the accrual of the cause of action. 9 Government Code §911.4 permits a Claimant to present a late claim within a reasonable 10 I 1 time after the running of the six-month statute, as long as filing does not exceed one year after 12 accrual of the cause of action. 13 Code of Civil Procedure, Section 340.5's discovery rule provides that the statute of 14 limitations begins to run when a claimant suspects or should suspect that her injury was caused 15 16 by wrongdoing. (Kitzig v. Nordquist (2000) 81 Cal.App.4th 1384, 1391; 97 Cal.Rptr.2d 762.) 17 This rule sets forth two alternate tests for triggering the limitations period: 18 (1) A subjective test requiring actual suspicion by the plaintiff that the injury 19 was caused by wrongoing; and 20 (2) An objective test requiring a showing that a reasonable person would have 21 22 suspected the injury was caused by wrongdoing. 23 The first to occur under these two tests begins the limitations period. (Kitzig v. 24 Nordquist, supra, 81 Cal.App.4th 1391.) 25 Ms. Ahamadi's primary problem at the present time are her persistent headaches, 26 dizziness, problems with her equilibrium and problems with her vision. She was not informed, 27 28 until March 2001, that these persistent symptoms are probably due to the administration of -3- APPLICATION TO PRESENT LATE CLAIM . . i • ,, ,, �, .- 5 ', 1 ,� i ;, t t y '� ,` ` . t � , ,. ,` i �, 1 1 ', ', ;` �� i� ,' 1 i t, 1 �l V i t �� ' t E i i �i 1 ,, �� ,� 1 ,, ;� 1 Ampicillin/Penicillin beginning on June 19, 2000. In fact, she was told on June 29, 2000 that her 2 headaches were possibly related to Prednisone, not Ampicillin/Penicillin. (Exhibit "C".) After 3 reviewing the June 29, 2000 Outpatient Notes, there is no mention that her existing symptoms 4 5 were related to Ampicillin/Penicillin. 6 In fact, during her July 13, 2000 examination, the indication from the Outpatient Notes 7 are that her headaches were tension related. Again, there is no mention that her headaches or 8 dizziness, which continue to persist, were due to the June 2000 administration of 9 Ampicillin/Penicillin. (Exhibit"D".) The same is true on August 10, 2000, when she continued 10 11 to complain of headaches; and again, they were characterized as"tension headaches". (Exhibit 12 "E".) Employing the first test set forth in Kitzig, there is no evidence that Ms. Ahmadi possessed 13 an "actual suspicion" that her headaches, dizziness, and abnormal vision were the result of any 14 wrongdoing related to the June 2000 administration of Ampicillin/Penicillin. In fact, employing 15 16 the objective test set forth in Kitzig, it would have been reasonable for Ms. Ahmadi to 17 characterize her headaches, dizziness, and abnormal vision as related to either(1) the prescribed 18 Prednisone upon discharge or(2) "tension". 19 As stated above, Ms. Ahmadi did not suspect that her headaches, dizziness and abnormal 20 vision were rclated to the June 2000 administration of Pencillin/Ampicillin until Dr. Hamid 21 22 advised her of the probable relationship in March 2001. 23 Therefore, the accrual of Ms. Ahamadi's cause of action did not occur until she was 24 advised of the probable cause of her symptoms in March 2001. 25 Assuming arguendo that it is concluded that Ms. Ahmadi should have suspected that her 26 injury was caused by wrongdoing at some point sooner in time than March 2001, one must 27 28 consider the rule that the statute of limitation does not run while the doctor/patient relationship -4- APPLICATION TO PRESENT LATE CLAIM �� , �, s �, ., ,` i ', ,, . ;1 t 1 ;, 1 ` :� t ., 1 ,� �, �, ,, ti °� ,` ;1 �. 1 1 5 ., 1 i ,, l .. 1 �\ i S 1 �} 1 t �, �, �` I continues. (Gray v. Reeves (1977) 76 Cal.App.3d 567, 575; 146 Cal.Rptr 716.) This would 2 mean that the earliest that Ms. Ahmadi's cause of action could accrue would be at some point 3 after her August 10, 2000 examination by Dr. Aria Arrizabalaga at the Contra Costa Regional 4 5 Medical Center. At that point, Dr. Arrizbalaga continued to diagnose Ms. Ahmadi's headaches 6 as "tension headaches" and made no reference concerning a possibility that Ampicillin/Penicillin 7 was involved. (Exhibit "E".) Consequently, Ms. Ahmadi should be allowed to make an 8 Application to Present a Late Claim since this Application would be within one year of the 9 accrual of her cause of action. 10 11 Government Code §911.4 requires that an Application to Present a Late Claim state the 12 reasons for the delay. In determining the suitability of approving the Application, Government 13 Code 911.6(b) provides that the Board shall grant the Application where any one or more of its 14 subsections applies. Subsection (b)(1) provides that the Application shall be granted when 15 16 failure to present the claim was through mistake, inadvertence, surprise or excusable neglect, and 17 the public entity was not prejudiced in its defense of the claim by the late filing. 18 In this particular case, Ms. Ahmadi was not aware that the Contra Costa Regional 19 Medical Center was a governmental entity within the meaning of Government Code §911.2. She 20 was not aware that her persistent symptoms were related to prior treatment. Consequently, she 21 22 did not seek legal advice until April 11, 2001. Medical records were ordered within a reasonable 23 period of time and received on approximately May 15, 2001. Because Ms. Ahmadi did not know 24 that the Contra Costa Regional Medical Center was a County Hospital, she did not mention that 25 to her attorney, Joseph Welch. Mr. Welch, being unfamiliar with Contra Costa County and its 26 hospitals, did not know that the Contra Costa Regional Medical Center was a County facility. 27 28 There is no mention in the name "Contra Costa Regional Medical Center"that -5- APPLICATION TO PRESENT LATE CLAIM 5 �'i 1, '.} . `' �� `5 ,, . '� �` �` `` !. �\ ,\ , ��� i\ �1 ,` ;` ,� ,, �. �, ,, 1 '� ,� l ,` 1 would suggest to a reasonable person not familiar with Contra Costa County's facilities that this 2 was a county run hospital. Therefore, no claim was made pursuant to Government Code §911.2 3 or §911.4. Instead, the requirements of Code of Civil Procedure §364 were followed, (which 4 5 does satisfy Government Code Tort Claim requirements). Immediately upon receipt of the 6 Contra Costa County"Notice to Claimant of Late-Filed Claim" on July 11, 2001, the preparation 7 of this Application to Present Late Claim began. It should be noted that Contra Costa County 8 has not suffered any real prejudice, since the statute of limitations did not begin until, at the very 9 earliest, after August 10, 2000 and probably not until March 2001. In fact, because the running 10 11 of the statute of limitations did not begin to run until Dr. Hamid advised Ms. Ahmadi of the 12 probable relationship between her symptoms and the Ampicillin, the six-month limitation period 13 imposed by Government Code §911.2 has not yet expired. 14 (Equitable Estoppel) 15 16 A public entity may be estopped from asserting non-compliance with the California Tort 17 Claims Act when affirmative acts of its agents, especially authority figures, deter the filing of a 18 timely claim. (Ovando v. City of Los Angeles, (2000) 92 F.Supp.2d 1011.) 19 With regard to Ms. Ahmadi's claim, the treating physician, Dr. Aria Arrizabalaga, 20 reported on June 29, 2000 that Ms. Ahmadi's headaches were possibly related to Prednisone. 21 22 There was no mention that Ampicillin/Penicillin might be the cause. (Exhibit "C".) 23 On July 13, 2000 and August 10, 2000, Dr. Arrizabalaga reported that Ms. Ahmadi's 24 headaches were due to "tension". (See Exhibit "C" and"D") There is no mention that her 25 persistent complaints of headaches, dizziness and visual problems were related to the June 2000 26 administration of Ampicillin/Penicillin. Based on Dr. Arrizabalaga's position as Ms. Ahmadi's 27 28 treating physician and the doctor's obvious position of authority, the County of Contra Costa -6- APPLICATION TO PRESENT LATE CLAIM ,\ �1 ;i 4 1 ;, 1 . . �� �, �,, ti ,` ', ,l 1 y ,1 �� ,+ �` s ,h .1 �� 't ,� �t ;, ,` i ,�� l `` �, �� :, �� �} I should be estopped from asserting non-compliance with the Tort Claims Act when Dr. 2 Arrizabalaga caused Ms. Ahmadi to reasonably believe that her headaches and related symptoms 3 were caused by something other than the administration of Ampicillin/Penicillin 4 5 (Filing of Tort Claim) 6 Ms. Ahmadi is filing a separate claim for damages pursuant to Government Code. 7 However, the Code of Civil Procedure §364 claim made on June 18, 2001 and received by the 8 Contra Costa Board of Supervisors on June 28, 2001, should suffice. Nevertheless, out of an 9 abundance of caution, a separate and new Claim for Damages will be filed along with the 10 11 Application to Present Late Claim. 12 CONCLUSION 13 Based upon the Points and Authorities and arguments set forth above, it is clear that Ms. 14 Ahmadi did not discover that her persistent symptoms of headaches, dizziness, and visual 15 16 problems were probably caused by the June 2000 administration of Ampicillin/Penicillin until 17 she was advised by her present treating physician of the probable cause of her symptoms in 18 March 2001. Assuming arguendo that this contention is not accepted by the Contra Costa 19 County Board of Supervisors, the Board must accept that the statute of limitations does not run 20 while the doctor-patient relationship continues. It is clear that Ms. Ahmadi continued to receive 21 22 treatment at the County facility from Dr. Aria Arrizabalaga through at least August 10, 2000. 23 Consequently, Ms. Ahmadi's late claim should be allowed pursuant to Government Code 24 §911.4, which permits a claimant to present a late claim within a reasonable time after the 25 running of the 6-month statute, as long as filing does not exceed one year after accrual of the 26 27 28 -7- APPLICATION TO PRESENT LATE CLAIM I cause of action. Since her cause of action could not have accrued by any argument until after 2 August 10, 2000, the one-year limit imposed by Section 911.4 has not expired. 3 4 Dated: July 20, 2001 HINTZ& WELCH 5 6 By: 7 J . W LCH, ESQ. 8 torneys for Plaintiff, SALWA AHMADI 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -8- APPLICATION TO PRESENT LATE CLAIM `4 ,� i t ;y ��.'` �, �`� . '� . � �. :\ `� .. ��, �i` i ,` z } �� �tt , 4 �� �� �i r �1 1r ;+ �1 i 1 f 'i ,1 �\ t ,` i t 4 ,, �t 1 t i ,1 • CONTRA COSTA HEALTH SERVICES MR# : OOOOOOM007567902 Contra Costa Regional Medical Center NAME : AHMADI , SALIMA, Martinez Health Centers DOB: 06/05/1972 2500 Alhambra Avenue, Martinez, CA 94553 DISCHARGE SUMMARY DATE OF ADMISSION: 06/19/00 DATE OF DISCHARGE: 06/24/080 �,p,Q-o�1 W �fZ�'ao,•� ATTENDING STAFF: M.D. CHIEF COMPLAINT: Spontaneous rupture of membranes . PRINCIPLE DISCHARGE DIAGNOSIS : Primary low transverse Cesarean section, delivery of well infant . OTHER DIAGNOSES : 1 . Failure to descend in vaginal labor. 2 . Diffuse erythematous rash secondary to administration of ampicillin. PROCEDURES PERFORMED: 1 . Primary low transverse Cesarean section. 2 . Chest x-ray showed no acute disease and no signs of TB. • HOSPITAL COURSE/TREATMENT/FINDINGS : The patient is a 26-year-old G1, PO, LMP 9/19/99, EDC 6/27/00 , EGA 38-6/7, consistent with 19- week ultrasound. Prenatal . care by Dr. Aria Arrizabalaga since 2/99, nine visits . No previous Cesarean sections . Physical examination on admission was notable for some rash which was noted to be a papular rash with only slight erythema, consistent with pruritic papules of pregnancy. • VDRL nonreactive . HBSAG negative . PPD positive . Chest x-ray: Not yet done at time of admission. Rubella immune . Blood type O+ . She has had no previous surgical history. Medications include prenatal vitamins . The patient described at time of admission that she had a family history of allergies to penicillin but at that time stated that she, herself, had not had penicillin. Physical examination notable for positive ferning, positive Nitrazine on pelvic exam. Exam also reveals papular rash on arms, torso, and legs . Term primapara with rupture of membranes . Expected management was begun. The patient was then noted to have had a group B positive culture on a previous visit to the antenatal and testing center. Patient was asked about her • Page 1 of 3 DISCHARGE SUMMARY Original EXHIBIT."A" :'. i i ;� i ,. �� 4 t i i s 1 I ..... .... .. ,` c v i { ;, 4 ;� r w . , j 1 1 1 l ,� !j i i MR# : OOOOOOM007567902 • NAME : AHMADI , SALIMA, penicillin rash and stated to Dr. W�Lnrich that she had a family history of allergy to PCN but had not herself. ever taken penicillin as a medicine . As it appeared she did not have a personal history of allergy, patient was begun on ampicillin. The patient ' s admission was performed on 6/19/00 . By 6/20/00, the patient had reached complete and pushing at approximately 6 : 00 a.m. but had little progress . Station did not change despite over an hour of pushing . Risks and benefits were discussed. The patient deferred Cesarean section at 0700 hours and wanted to continue trial of labor, attempted squat bar and variable positioning, low dose Pitocin for augmentation of contractions . One hour later, still no progress had occurred and the patient was taken to the OR for Cesarean section. Primary low transverse Cesarean section performed without complications as dictated under separate dictation. A well 39-week AGA male infant was delivered with Apgars of 9 at one minute and 9 at five • minutes . During her postoperative course, the patient was noted to have blossoming of rash to her skin, widespread, maculopapular, erythematous rash throughout her skin on both extremities, upper and lower and torso but sparing the face . Rash was felt to be possibly due to the ampicillin although some rash had been noted before the patient was even admitted. It was decided to attempt • steroids and see if that elicited response . On postpartum day #2 , the rash was noted to be persisting. Dermatology consult was requested and they felt the rash was consistent with a drug rash from the ampicillin that the patient had received. Recommended steroids with a steroid taper. The patient had some shortness of breath and anxiety early in the morning on the 24th. However, she had normal labs at that time; • including ABG. Chest x-ray also normal . Shortness of breath was attributed to anxiety. Discussed events with the doctor attending overnight , Dr. Madrigal and the event was felt to be due to anxiety. It was discussed with patient and it was felt that she was ready to go home nonetheless . The patient was discharged to home stable . Discharged with baby. DISCHARGE INSTRUCTIONS : Activity and diet instructions as per preprinted instructions . Chart check with the baby' s appointment in one week. Followup in family practice clinic in six weeks with Dr. Arrizabalaga. • DISCHARGE SUMMARY Page 2 of 3 Original i MR# : OOOOOOM007567902 • NAME: AHMADI ; SALIMA, Discharge medications : Iron sulfate 325 mg p.o. q.d. #60 ; ibuprofen 600 mg p.o. q.d. #30 ; diphenhydramine 50 mg p.o. q. 6h. p. r.n. dispensed #30 ; Simethicone 80 mg p.o. q. 6h. p.r.n. gas, dispensed one bottle; prednisone 20 mg tabs three tabs p .o. q.d. x3 days, two tabs p.o. q.d. x5 days, one tab p.o. q.d. x5 days,. dispensed quantity sufficient . i Corrected Copy 10/18/00 Aria Arrizabalaga, MD AA:EDiX12432 D: 07/03/00 16 :36 T: 07/04/00 04 : 04 DOCUMENT: 200007030821075900 • • • DISCHARGE SUMMARY Page 3 of 3 Original �� �' i i . . 1 I 4 i 1 i l E 1 i ;r i i { ,. i - i i ` i , i f R i a k is I t s j i �' A s i I i i 4 t f i CONTRA COST —9LTH SERVICES 1 A A CONTRA COSTA RECW ,LMEDICAL CENTER T nt5 6��'$I;•a� r,9 OBSTETRICAL ^ �4 HISTORY AND PHYSICAL • ����y/ 1�Tj 10EIZlutt �` ` d� 0/S Chief Complaint and Presenting history: Mother's ID C- h Mother Transfers eddiin-?E] Yes No: Age`'() Grav:J_Para:O Live Births:Living: Died: Abortions: LMP: ( EDC: /�L" +Gest.Age:C). Prenatal Care: ❑ None, ❑ Unknown,zff5:Yes:First visit date. #of visits._Provider: A Previous C-Sectiat>'No Unkn(o�Yes: VBAC to be attempted?❑ Yes ❑ No Language: ng.❑ Span.❑ Other LABS:VDRItM� HbSA PPD /Chest X-ray Rubella titer Blood type. Rhogam given 28 wks?E] Yes ❑ No Past Medical History details/Prenatal Complications details: -.- Previous surgic I history: C �- -1 Medications: Allergies: l .fv ` ! Prenatal Complications/Risks/Procedures:❑ None;❑ Unknown;❑ Yes- ✓ below all Items that apply Substance Use Obstetrical Prenatal Procedures ' ❑ Alcohol use(3050) ❑ Bleeding/hemorrhage(6419) ❑ Preterm labor,prematurity ❑ Amniocentesis(751) i ❑ Cocaine/Crack(3056) ❑ Preeclampsia,mild(6424) (6440) ❑ Antepartum NST/CST(v288C ❑ Heroin/methadone(3055) ❑ Preeclampsia,severe(6425) ❑ Tocolytics(v288D) ❑ Ultrasound(88.78) . ❑ Other IV(3059A) ❑ Eclampsia(6426) ❑ RH Isoimmun/sensit(6561) ❑ Cerclage(v288A) ❑ Other non-IV(3059B) ❑ Fetal anomaly(6559) Previous OB HX ❑ Chorionic villus samp(v288R) ❑ Tobacco(3051) ❑ Incompetent cervix(6545) ❑ Prev.<2500 gms BW(v234A) ❑ Version attempted ❑ Oligohydramnios(6580) ❑ Prev.>4000 gms BW(v234B) Infections ❑ Polyhydramnios(6570) ❑ Prev.preterm<37 wks(v234C) ❑ Rubella(6475) Medical ❑ UTI/Cystitis(6466) ❑ Anemia< 10 gms Hgb(6482) ❑ Hypertension,essential(6420) ❑ Isoimmunization,other(6562) ❑ Hepatitis B,active(703A) ❑ Asthma(4939) ❑ Immune deficiency(2799) ❑ Liver disease(6467) ❑ Hepatitis B,carrier(70381 ❑ Pulmonary dis.,other(5188) Hemoglobinopalhy: ❑ Lupus(7100) ❑ Herpes,genital(541) ❑ Diabetes,gestational(6488) ❑ AS(2825) ❑ Psychiatric dis.,major(6484) ❑ Positive VDRL(971) ❑ Diabetes,pregestational(6480) ❑ S That(2824) ❑ Renal disease,other(6462) ❑ Pyelonephritis,acute(5901) ❑ Exposure,toxic/hazard(9899) ❑ SC(2626A) ❑ Seizure disorder(7803) ❑ STD,other(6472) ❑ Heart/cardiac disease(6486) ❑ SS(2826B) ❑ Thrombophlebitis(6713) ❑ Tuberculosis,active(6473) PHYSICAL EX :T P D BP b FHT ( `O WGT HGT HEENT: Heart: YL_ft� Lungs: Presentation: Vertex❑ Breech❑ Transverse❑ Other: Fundal Height: Est.F eight: Vaginal exam: Speculum exam Pooling: 0 Ferning: Ni razine: TrCI CQ r""`—" ' �- Membranes:❑ Intact F1Ruptured Extremities-Edema: Reflexes: Clonus: _ Lab:UA CBC Other: _. • c��.. r��-t ` c S n_o.�� 1 �b� ASSESSMENT: I� Plan: Date: � � Time: Physician: ._Signature: M.0. 7. origin.: .. Y( OBSTETRICAL HISTORY& PHYSICAI- MR 542-5(12/97) EXHIBIT.66B7'. 1 1.� �+ .S 1 1 I' 1 �' 4 i ', �f :, y ,_: 1 �` �� l .,. 4 '� ,. _' � - .,. ;t t t i i i 4 '� ,� i i t 'ry I I, 1 1 4 - �` ''`1 7 4 �` y '� y ii f t t r mw-�- CONTRA COSTA REGIONAL •lEDICAL CENTER& -- ' CONTRA COSTA Hie H CENTERS 6387 MARTINEZ HEALTH CENTER wW�. • AHN'A D I SAL I MA OUTPATIENT NOTES . F 6/015/ 1972 925 680-2657 DATE Martinez Family Practice 1 0 0 , Sb i 9 0 - 2 JUN 2 9 2000 Reasc n �� > � BPS ✓ Wt Du PIP' Smoked Fonnery ever S m o k ng Status within prev. Smoked Smoked ` Pt Ve balizes understanding of: cb) �-- w ,.1N 1`121 C� I lo1`"17 G, Q I T-7 (I S V xo/(.o G 5 _ ,-3 Oc ' s -- 9,-TC -Zw MR-I-MTZ-6 (9197) Side 1 OUTPATIENT NOTES EXHIBIT "C" ' ^0 CONTRA COSTA REGION :DICAL CENTER & r .;,;....., CONTRA COSTA HPIRL fH CENTERS 16 ".:.: A111AADI SAL IMA P " ' MARTINEZ HEALTH CENTER r) �5/ 19 7 2 9 2 5 680-2657 • Martinez Farn'%�WAWENT NOTES 15h -I90 - 2 G JUL 13 2000 � IABALAGA . ARIA r^ART DATE adqi f0l V101-L. S m�..cd Fourcily ev r Smok 3 yrs. j Pt Vprhgjl�ot linflor-8tallding 01. Alda S c L I + A-�4 I C c cd F4�L i N4V C Th��t k Ltd S r � �n la Z ria ArrizOa MR-I-MTZ-6 (9/97) Side 1 KT(, J'"'"- 60,T IENT NOTES « EXHIBIT D 99 CONTRA COSTA REGIOHW EDICAL CENTER& .6387 CONTRA COSTA .'H CENTERS J 00 .'T 7./F P r MARTINEZ HEALTH CENTER '""'' AHMA01 SALIMA I • OUTPATIENT NOTES F 6/05/ 1972 925 680-2657 00 , b �90 . 2 cc DATE ' IQ11ABALAGA , ARIA HART AUG 10 2000 Primary Care Date: i Reason for Visit: I BP Wt (Due annually or PRN) Smoked Formerly Never Smoking Status wIlhln prev. Smoked Smoked Pt Verbalizes understanding of: I • 2 r1 � rp,C) / c MR-1-MTZ-6 (9/97) Side i « „ OUTPATIENT NOTES EXHIBIT E ' s .. ,` •t ':\ ,, 1 �'+, , i �` �` ,\ `\ `� t ,4 ;` �� .. . ,, , ,5 \� �j '`tt l ,` �• �� �'l , °` '� 1 ,` `� 1 �` ., �, 1 1 1 �� ,` �� �, `` t �� ,` �, CLAIM FOR DAMAGES NOTE:If the occurrence happened on January 1, 1988,or after this date,then a claim for bodily injury or death,damage to personal property, or damage to growing crops must be filed not later than six months after the occurrence out of which the claim arose. All other claims must be filed not later than one year after the occurrence. (Refer to California Government Code,Section 911.2) If the occurrence happened on or before December 31, 1987,a claim for bodily injury or death,damage to personal property,or damage to growing crops must be filed not later than 100 days after the date of occurrence. (Refer to California Government Code,Section 911.2) INSTRUCTION:Send the original and one copy of the claim form to the Contra. Costa County Board of Supervisors County Administration Bldg, Please attach all bills for expenses before mailing. 651 Pine Street , Room 106 , Martinez , CA 94553-1293 NAME OF CLAIMANT: MI. (Injured to damaged parry) Ms. Ahmadi S a f i ma MIs. (Last) (First) (Middle) June 5 , 1972 074-74-6732 (Date of Birth) (Social Security No.) (CDL No.) HOMEADDRESS/PHONE: 2421 River Plaza Dr . , #160 , Sacramento, CA ( 916) 419-2280 (Number/Street) (City/State/Zip Code) 95833 (Phone No.) BUSINESSADDRESS/PHONE: N/A N/A (Number/Street) (City/StatelZip Code) (Phone No.) (If Claimant is a Minor) PARENT/GUARDULN NA,VIE: Not applicable (Last) (First) (Middle) DATE OF INJURY/DAMAGE/LOSS: Injury discovered in March 2001 A.M. (%Iontiv'Day/Year) (Dav of Week) (Time of Day) P.M. LOCATION WHERE INJURY/DAINIAGFJLOSS OCCURRED(School.Street:address,intersecting street,or other location): Contra Costa Regional Medical Center, 2500 Alhambra Avenue, Martinez , CA 94553 DESCRIBE HOWINJURY/DAMAGFJLOSSOCCURRED: Between 6/19/00 and 6/21/00 , Ms . Salima Ahmadi was administered Ampicillin/Penicillin after a reasonable medical deef;e shot.-Id have susp;rtect*hat sbe was a] l prgi o And Ghnl3l r3 havP administered an allergy test to determine if the claimant was allergic . LIST NAME/ADDRESS/PHONE NO.OF ALL KNOWN WITNESSES:(Use additional sheet,if needed) Dr . Aaron Wernham, Dr . Aria Arrizabalaga , and Dr. Donald Weinreich, c/o Contra Costa Regional Medical en er . LIST NA.b1E(S)OF DISTRICT ENIPLOYEE(S)INVOLVED: Same as above . POLICE/CHP/SHERIFF REPORT NUMBER: WHAT ACTION O INACTION OF DISTCT PLOYEE(S)CAUSED YOU INJURY/DANIAGE/LOSS? As stated above , between 6/RI�NIa 19/00 and 1 0 , Ampicillin/Pencillin was a minis ere o r•1a; mant. whan t-ha hrRAH ng phyGicians named above knew, or should have known that the claimant was allergic . WHAT INJURIES/DAMAGES/LOSSESDID YOU SUFFER? Claimant continues to suffer from headaches , dizziness and visual problems related to the administration of Ampicillin/ Perk Tor avIouN •cL.al�[ED: S A proof/Unlimited Jurisdiction. 7/20/01 (Sign (Print Mame) (Month/Day/Year) � itarney for a ma Ahmadi Hintz & Welch 1006 4th Street (Relationship of signer,if not claimant) (Address) S u i t e 220 (Phone No.) Sacramento, CA 95814 ( 916) 444-5203 ' `OTE:PRESENTATION OF A FALSE CLAIM IS A FELON'. (Refer to California Penal Code Seaton 71) ' ,•r • • 1 IN RE: CLAIM OF SALIMA AHMADI DISCOVERY OF DATE OF LOSS: MARCH 2001 2 3 PROOF OF SERVICE 4 I am a citizen of the United State, employed in the County of Sacramento, State of California. My business address is 1006 4t Street, Suite 220, Sacramento, California 95814. 1 5 am over the age of 18 years and not a party to the above-entitled action. 6 1 am readily familiar with Hintz & Welch's practice for collection and processing of correspondence for mailing with the United States Postal Service. Pursuant to said practice, each 7 document is placed in an envelope, the envelope is sealed, the appropriate postage is placed 8 thereon and the sealed envelope is placed in the office mail receptacle. Each day's mail is collected and deposited in a U.S. mailbox at or before the close of each day's business. (Code 9 Civ. Proc. section 1013a(3)). 10 On July 20, 2001, I caused the within Application to Present Late Claim; 11 Claim For Damages, the original of which was produced on recycled paper, to be served via 12 13 ® FAX AND MAIL--- 14 I personally sent to the addressee's telecopier number indicated below a true copy of the above-described document(s) before 5:00 p.m. I verified transmission without error by a 15 transmission report issued by the facsimile machine upon which said transmission was 16 made immediately following the transmission. Thereafter, I placed a true copy in a sealed envelope with first class postage affixed and mailed as follows: 17 © PERSONAL SERVICE--- 18 By causing delivered by hand to the addressee addressed as follows: 19 Contra Costa County Board of Supervisors 20 County Administration Building 651 Pine Street, Room 106 21 Martinez, California 94553-1293 22 ® (State) I declare under penalty of perjury under the-laws of the State of California that 23 the above is true and correct. 24 Executed on July 20, 2001 at Sacramento, California. 25 26 / 27 Steve Lee 28 -9- APPLICATION TO PRESENT LATE CLAIM y.:� . .R \'` �` `. '. ,` ,` '� ., \` i °� .,\ �'� t; �` i ,\ �� �\ i 1 �� i �` ,� ,. `, ,` ;� �\ IN THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, STATE OF CALIFORNIA Resolution 2001/357 In the Matter of Commending the Federal Regional Council's) North Richmond Task Force for their Efforts } and Contributions in North Richmond ) WHEREAS, the Federal Regional Council, Region IX was established in 1998 as an outgrowth of the Region IX Federal Interagency Welfare Reform Task Force created in 1996 to meet the challenges of welfare reform; and WHEREAS,the membership of the Federal Regional Council. Region IX includes regional representatives from the following departments:Agriculture, Education, Energy, Health and Human Services, Housing and Urban Development, Justice, Labor, Interior and Transportation, and the following federal agencies: Environmental Protection Agency, Small Business Administration, Federal Deposit Insurance Corporation and Social Security Administration; and WHEREAS, the Federal Regional Council selected North Richmond as one of two neighborhoods in Northern California where federal collaboration could have a positive impact addressing issues of high poverty status and historical problems with service delivery; therefore, the North Richmond Task Force was created; and WHEREAS, in the two years since the creation of the Federal Regional Council's North Richmond Task Force, tangible results in the areas of inter-agency communication, child education and welfare, employment and training, physical improvements, transportation and capacity building have been achieved; and WHEREAS,these results include a U.S. Department of Transportation grant to expand bus service in North Richmond, the U.S. Department of Health and Human Services' coordination of over a thousand books and toys to North Richmond youth, the U.S. Department of Agriculture's donation of 25 computers to Verde School, a financial literacy program sponsored by the FDIC, a special bus program to transport North Richmond residents to work in Marin, a 21" Century Learning Center afterschool grant awarded to Verde School by the U.S. Department of Education and U.S. Department of Housing and Urban Development's success in increasing community self-sufficiency and securing employment opportunities for North Richmond residents; and NOW, THEREFORE, BE IT RESOLVED THAT THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,IN CONJUNCTION WITH THE CITYOFRICHMOND, hereby recognize the Federal Regional Council and its North Richmond Task Force for its citizens centered and results-oriented approach to partnership with all key stakeholders which includes City and County staff that have made a positive difference in North Richmond. PASSED and ADOPTED by the unanimous vote of the Board on the 14" day of August, 2001. 1 hereby certify that the foregoing is a true and correct copy of a resolution entered on the minutes of the Board of Supervisors on the date aforesaid. Witness my hand and the-seal of the Board of Supervisors affixed this 14th day of August 2001. John Sweeten, Clerk of the Board of Sup iso(, d County dmin 6trator. By fa Deputy Clerk IN THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, STATE OF CALIFORNIA In the Matter of Commending the Federal Regional) Council's North Richmond Task Force for their ) RESOLUTION NO. 20011357 Efforts and Contributions in North Richmond ) WHEREAS, the Federal Regional Council, Region IX was established in 1998 as an outgrowth of the Region IX Federal Interagency Welfare Reform Task Force created in 1996 to -neet the challenges of welfare reform; and WHEREAS, the membership of the Federal Regional Council. Region IX includes regional representatives from the following departments: Agriculture, Education, Ener y, Health and Human Services, Housing and Urban Development, Justice, Labor, Interior and Transpo ation, and the following federal agencies: Environmental Protection Agency, Small Business Administ ation, Federal Deposit Insurance Corporation and Social Security Administration; and WHEREAS, the Federal Regional Council selected North Richmond as one f two neighborhoods in Northern California where federal collaboration could have a positive impact addressing issues of high poverty status and historical problems with service delivery; therefore, the North Richmond Task Force was created; and WHEREAS, in the two years since the creation of the Federal Regional Co ncil's North Richmond Task Force, tangible results in the areas of inter-agency communication, child education and welfare, employment and training, physical improvements, transportation and capaci y building have been achieved; and WHEREAS, these results include a U.S. Department of Transportation grant to expand bus service in North Richmond, the U.S. Department of Health and Human Services' coordination of over a thousand books and toys to North Richmond youth, the U.S. Department of Agriculture's donation of 25 computers to Verde School, a financial literacy program sponsored by the FDIC, a special b is program to transport North Richmond residents to work in Marin, a 215' Century Learning Center afterschool grant awarded to Verde School by the U.S. Department of Education and U.S. Department of Housing and Urban Development's success in increasing community self-sufficiency and securing employment opportunities for North Richmond residents; and NOW, THEREFORE, BE IT RESOLVED THAT THE BOARD OF SUPE VISORS OF CONTRA COSTA COUNTY, IN CONJUNCTION WITH THE CITY OF RICHMOND, hereb recognize the Federal Regional Council and its North Richmond Task Force. for its citizens centered and results-oriented approach to partnership with all key stakeholders which includes City and County staff that have made a positive difference in North Richmond. PASSED and ADOPTED by the unanimous vote of the Board on the 14th day of AL gust, 20, 2001 ayle B. UilkemChair John Gioia Donna G er Mark DeSaulnier Federal D. Glover I hereby certify that the foregoing is a true and correct copy of a resolution entered on the minutes of the Board of Supervisors on the date aforesaid. Witness my hand and the seal of the Board of Supervisors affixed t iis 14th day of August 2001. John Sweeten C m of/ a oard f Supervi rs and u o . Lam. By Deputy Clerk RESOLUTION NO. 2001/357