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MINUTES - 09172002 - C.28-C.29
CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION. Sept 17,2002 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 E!Ep 5.4. Please note all "Warnings". AMOUNT: $2800.00 Approx 6 4 2002 CLAIMANT: William Ingleman COUNTY COUNSEL MARTINEZ CALIF. ATTORNEY: DATE RECEIVED: Sept 3,2002 ADDRESS: 1275 Central Blvd#263 BY DELIVERY TO CLERK ON: Sept 3. 2002 Brentwood, CA 94513 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETEN, Clerk Dated: Sept 3 2002 By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors {o�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). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) { ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: {` 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: ` F "" t^ s f `_� JOHN SWEETEN, CLERK,By 'f f f `r '� ;< ;� , 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 Claimants,-addressed to the claimant as shown above. Dated:,JV sf/; _. JOHN SWEETEN, CLERK By , 1, 4 # % W Deputy Clerk claire to; BOARD OF SUPERVISORS OF tXWRA COST?9� I315` UCTIONS TO CLAD4PM W % � A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1967, must be presented not later U n the 100th day after the accrual of the cause of action. Claims relating to carries 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. Claim's relating to any other cause of action malst 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 Roes 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 Cvmty, the tie of the Distriot should be filled in. D. If the claim is against more than one public entity, separate claims roust be filed against each public entity. E. " Fraud. See penalty for fraudulent claims, Penal, Code Sects 12 at the end of this form. RE: Claim, By Reserved for Clerk's filing stamp Against the County of contra. Costa or S ' Districts c� � �SiJS Fill in nates ' The mdersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of � ��, �;�;� � _���r,,x, and in support of this claim represents as follows ?. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury caecum (Include city and county) 3. How did the damage or� injury occur? (Givefullfull details; use extra paper if r'BQulred Opti GL ! r` i tr (A 0 � 3, ` ., k ie x 4. What particular act or omission on the part of county or district officers, servants or .employees caused.the.injury or damage? ��`���� �,,�.,`'�'11""� ^�^,� t��(`"?� '`�r�C�:.'F`�i v~,c� ��`�-.:•-�QCs �� � �C�».��'�� C:�'r"1 F2��;,.� (over) 5. what are the names of county or district officers, servants or employees causing the damage or injury? 5. What damage or injuries do you claire resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. e X11-, 0�, e 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) $. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 91M provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) orb s erson. on his behalf." Name and Address of Attorney ` s Claimant's Signature 1-5 evA .�P {.; Address Telephone No. * Telephone No. E � r ` NOTICE Section 72 of the Penal Code provides: "Every person: who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if .genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine.,- or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($101000, or by both such imprisonment and fine. Job Number: GEN BODY AND PAINT, INC IE7121 Federal- LD- 4:-f�4ZZ22&- 00 Harvest Park Dr. Brentwood, CA 94513 ;925}516-1999- Fax:.- E925�51fi 91F PRELIMINARY ESTIMATE Written bv: Kevin Vornhagen # Adjuster: Insured: WILLIAM INGLEMAN Claim # Owner: WILLIAM INGLEMAN Policy # Address: Deductible: Daae of Loss: Cellular: (925)240-1984 Type of Loss: Paint of Impact: Inspect VORNHAGEN BODY AND PAINT, INC Business: (925) 516-1969 IroeatL : 60- Harvest Park Dr. Brentwood, CA 94513 Insurance Company: Days to Repair 1995 NISS ALTIMA GXE 4-2.4L-FI 4D SED Int: VIN: IN4BUBIDXSC100341 Lic: 3PBT929 CA Prod Date: 07/1994 Odometer: Rear Defogger Tilt Wheel Intermittent Wipers Tinted Glass Body Side Moldings Dual Mirrors Clear Coat Paint Power Steering Power Brakes Power Windows Power Locks Power Mirrors AM Radio FM Radio Stereo Cassette Driver Air Bag Passenger Aix Bag Cloth Seats Bucket Seats Recline/Lounge Seats Automatic Transmission ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 1 FRONT BUMPER I 07/22/2002 at 03: 13 PM Job Number: 25297 PRELIMINARY ESTIMATE 1995 NISS ALTIMA GXE 4-2.4L---EI 4D SED Int: ------------------------------------------------------------------------------- NO. OP. DESCRIPTTON QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 2 O/H bumper assy 0 0.00 2.5 0.0 3* Rpr Cover assy 0 0.00 1.0 2.5 4 Add for Clear Coat 0 0.00 0.0 1.0 5 FRONT LAMPS 6 R&I R&I headlamp assy one side 0 0.00 0.5 0.0 7 R&I R&I headlamp assy one side 0 0.00 0.5 0.0 8 R&I RT Marker lamp 0 0.00 0.3 0.0 9 R&I LT Marker lamp 0 0.00 0.3 0.0 10 HOOD 11* Rpr Hood 0 0.00 1.0 3.5 12 Overlap Major Adj. Panel 0 0.00 0.0 --0.4 13 Add for Clear Coat 0 0.00 0.0 0.6 14 FENDER 15* Rpr RT Fender 0 0.00 11®0 2.8 16 Overlap Major Adj . Panel 0 0.00 0.0 -0.4 17 Add for Clear Coat 0 0.00 0.0 0.5 18* Rpr LT Fender 0 0.00 11_0 2.8 19 Overlap Major Adj . Panel 0 0.00 0.0 -0.4 20* Add for Clear Coat 0 0.00 0.0 0.5 21 WINDSHIELD 22 Repl Glass Nissan all 1 392.98 3.5 0.0 23 ROOF 24* Rpr Roof panel 0 0.00 1.0 3.3 25 Overlap Major Adj. Panel 0 0.00 0.0 -0.4 26* Add for Clear Coat 0 0.00 0.0 0.6 27# COVER CAR 1 5.00 T 0.3 0.0 28# HAZARDOUS WASTE 1 3.00 T 0.0 0.0 ------------------------------------------------------------------------------- Subtotals _> 400.98 12.9 16.5 2 07/22/2002 at 03:13 P114 Job Number: 252917 PRELIMINARY ESTIMATE 1995 NISS ALTIMA GXE 4-2.4L-FI 4D SED Int: Parts 392.98 Body Labor 12.9 hrs @ $ 62.00/hr 799.80 Paint Labor 16.5 hrs @ $ 62.00/hr 1023.00 Paint Supplies 16.5 hrs @ $ 28.00/hr 462.00 Sublet/Disc. 8.00 ---------------------------------------------------- SUBTOTAL $ 2685.78 Sales Tax. $ 862.98 @ 8,2500% 71.20 ---------------------------------------------------- GRAND TOTAL $ 2756.98 ADJLSTl NTS: Deductible 0.00 ---------------------------------------------------- CUSTO1MR PAY $ 0.00 INS,URAN PAX $- 2756,98 This is just an estimate of repairs, if on futher inspection, additional parts or repairs are needed, you will be contacted for authorization. We are not responsible for loss or damage to your vehicle from fire, theft, accidents, or causE beyond our control. Nor a.re..we- responsible for any damage to car aa..arms and stereos? We warrant our workmanship, including refinishing, for one year. 1 3 07/22/2002 at. 03:15 PM Job Number: 25297 PRELIMINARY ESTIMATE 1995 NISS ALTIMA GXE 4-2.4L-FI 4D SED Int:: THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES: S=BODY AOR D—DIAGNOSTIC E=ELECTRICAL E=-ERMA Z G=GLASS M41ECHANTCAT, P=--PAINT LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS: ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLVD=BLEND CAPA=CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT PRI_C9 MULTIPLIED BY THE QUANTITY INCL=INCLUDED M7SC=MISCELLANEOUS NAGS:=NATIONAL, AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT O/H=OVERHA.UL OP=OPERATION NO=LINE NUMBER QTY=QUANTITY QUAL RELY=QUALITY RECYCLED PART QUAL REPL=QUALITY REPLACEM�ENT PART RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT-RIGHT .SECT=SECTION SUBL=SUBIKET LT=LEFT W/O=WITHOUT WI =WITH/- SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE. .MOTORS DATABASE INFORMATION WAS CHANGED] *.*=DATABASE LINT, WITH AFTERMARKET N=NOTES ATTACHED TO LINE. Estimate based on MOTOR CRASH ESTIMATING GCIIDE. Unless otherwise noted all items are derived from the Guide ARF3789 Database Date 7/2002 and the parts selected are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. Asterisk {*) or Double Asterisk (**) indicates that the parts and/or labor information provided by MOTOR. may have been modified or may have come. from an alternate data source. Non-Original Equipment Manufacturer aftermarket parts are described as AM or Qual Rep! Parts. Used parts are described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recon. Recored parts are described as Recore. NAGS Part Numbers and Prices axe provided from National Auto Glass Specifications, Inc. Pound sign (#) items indicate manual entries. Pathways - A product of CCC Information Services Inc. 4 CLAIM x BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Sept 17;2002 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 y 915.4. Please note all"Warnings". AMOUNT: $1118.68 RSEP 0 : 2-902 CLAIMANT: Sandra Baldwin COUNTY IN Z CALIR 1!t#�BT�t��Z�AL� ATTORNEY: DATE RECEIVED: Sent 3, 2002 ADDRESS: P.O. Box 272755 BY DELIVERY TO CLERK ON: Sept 3, 2002 Concord, CA 94527 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETEN, Clerk Dated: Sept 3, 2002 By: Deputy II, FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( } This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). { ) Other: Dated: By: �` =z- 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: AA This Claim is rejected in full. O 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 ,Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned,have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated - i JOHNSWEETEN, CLERK By Deputy Clerk j Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CL.A1�'4ANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1937, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for-death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action.. Claims relating to any ether 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 efiled against each public entity. E. * Fraud. See penalty for fraudulent claims, Venal Code Sec. 72 at the end of this form. RE: Claim By } Reserved for Clerk's filing stamp } E } Against the County of Contra, Costa S E P 3 2,r,;. or District) Q 0P"', A,COS ME in mune ) The undersigned claimant hereby, makes claim against the County of Contra Costa or the above-named District in the sum of �.Z 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) j ' ? tJ r J CSL j L7 Ca � ty P✓P /? i rs�'�y �G S � % 1 G r � �a r7`1 3. How did the damage or injury occur? (Give full details; use extra paper if required) __� > f j z .....L.. f� ;a� � �G'a`>�/1'P :7" ,tl/b ,.�.�cy.t c�-• �,.,� }''1 4�..��J^ � 7 4,1-.- 1 q el;fY� 6. ��i...�......�.»�sSM�`�,.�46�,� �e��t ; r� 4. What particular act or omission on the part of county or district officers, servants or .employees caused" the injury or damage? Yf C1 Cr1'k4 e CJ f � 'L' \ i j €� K j Tcr& 5P Oc 'evi5c � /-T,:> i<--A, " if 0CX rpt }1.26' 1 i £?.. ; C sirs czc ,ej JCS € tic' �`v < raT�y (over) ! i } p l.h S 4-e'r �i: a' L,c a"/ �--. r ✓ t t 0 3 �' UC es 5. wnat are the names of county or district officers, servants or employees causing the damage or injury? l 1 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (include the estimated amount of any prospective injury or damage.) , r 3. Names and addresses of witnesses, doctors and hospitals. < 0 r, -'- 9. List the expenditures you rude on account of this accident or injury: DATE AMOUNT CY d 3 , Gov. Code Sec. 910;2 provides: "The claim must be signed by the claimant SEND NC"TtES TO. (Attorney)_ or by some person on his behalf." Name and Address of Attorney Claimants Signature (Address) tL C f.. T Telephone No. Telephone No. ;�� � '� C, NOTICE Section. 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if .genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine; or by imprisonment in the state prison., by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. r� f �f t n ' x 'mss .,....�...K:;,n,x...x..�.._ .. .:,:w..x....x�s,�xx_.....<: , n,,...n..,.,x..�.....� :.�..; n :«......... .......�..xx,.,, ..»,.,> n.,..:�..,x...x...x� ...,...,.n..vrx.,�........._... ; . ...< ye son `ems'% ,''r�y*,.c�'•` { ................ 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Date: 8127102 06:15 PM Estimate ID: 4898 Estimate Version: 0 Preliminary Profile ID: CONTRA COSTA COUNTY PRECISION PAINT & COLLISION 1932 ARNOLD INDUSTRIAL PLACE CONCORD,CA 94620 (926)609.8585 Fax: (926)609-9407 Damage Assessed By: Frank Mercado Payer: Customer Deductible: Insured: CONTRA COSTA COUNTY Address: 2467 WATERBIRD WAY MARTINEZ,CA 94853 Telephone: Work Phone: (926)313-7074 Mitchell Service: 911490 Description: 1998 Chevrolet Camaro Body Style: 20 Cpe Drive Train: 3.8L Inj 6 Cyl 4A VIN: 2G1FP22K7W2129711 License: 4ROW528 CA Color: BLACK Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units 1 100006 REF REFINISH FRT BUMPER COVER C 2,6 2 100007 BOY REMOVEIINSTALL FRT BUMPER ASSY 2.0 3 100803 SOY REPAIR R FENDER PANEL Existing 1.0*# 4 AUTO REF REFINISH R FENDER OUTSIDE C 2.5 5 106300 BOY REMOVEIREPLACE R FENDER ADHESIVE MOULDING 10179176 GM PART 14.03 0.2 6 1166$0 BOY REPAIR R FRT DOOR REPAIR PANEL Existing 2.0"# 7 AUTO REF REFINISH R FRT DOOR OUTSIDE C 2.0 8 116790 BOY REMOVEIINSTALL R FRT BELT MLDG 0.2 9 116840 BOY REMOVEIINSTALL R FRT REAR VIEW MIRROR 0.2 # 10 116910 BOY REMOVEIREPLACE R FRT DOOR ADHESIVE MOULDING 88892066 GM PART 26.24 0.2 11 117180 BOY REMOVEIINSTALL R FRT DOOR TRIM PANEL INC 12 117594 BOY REMOVEIINSTALL R FRT DOOR HANDLE&LOCK CYL 0.7 # 13 101261 BOY REPAIR R QUARTER OUTER PANEL Existing 2.0*# 14 AUTO REF REFINISH R QUARTER PANEL OUTSIDE C 2.0 15 100344 BOY REMOVEIREPLACE R QUARTER ADHESIVE MOULDING 10179162 GM PART 13.32 0.2 16 900600 BOY' ADD`L LABOR OP MASK FOR OVERSPRAY —Qua[Repl Part 6.00" 0.2* 17 900600 REF" REFINISHIREPAIR FLEX ADDITIVE —Qual Repl Part 5.00" OA" 18 AUTO REF ADD L OPR CLEAR COAT 2.3" 19 AUTO ADD'L COST PAINTIMATERIALS 226.00 t 20 AUTO ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00* * -Judgement Item #-Labor Mote Applies C-Included in Clear Coat Calc ESTIMATE RECALL NUMBER: $127102 17:14:07 4898 UltraMate is a Trademark of Mitchell International Mitchell Data Version: JUL_02_A Copyright(C)1994-2001 Mitchell International Page 1 of 2 UltraMate Version: 4.8.010 All Rights Reserved Date: 8127/02 05:15 PM Estimate ID: 4888 Estimate Version: 0 Preliminary Profile ID: CONTRA COSTA COUNTY Add"I Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 8.9 40.00 0.00 0.00 356.00 Taxable Parts 63.59 Refinish 11.3 40.00 0.00 0.00 452.00 Parts Adjustments 5.36- Sales Tax @ 8.250% 4.80 Non-Taxable Labor 808.00 Total Replacement Parts Amount 63.03 Labor Summary 20.2 808.00 Ill. Additional Costs Amount IV, Adjustments Amount Taxable Costs 226.00 Customer Responsibility 0.00 Sales Tax @ 8.250% 18.65 Non-Taxable Costs 3.00 Total Additional Costs 247.65 1. Total Labor: 808.00 IL Total Replacement Parts: 63.03 III. Total Additional Costs: 247.65 Gross Total: 1,118.68 IV. Total Adjustments: 0.00 Net Total: 1,118.68 This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair. WARNING: Accidental air bag deployment is possible. Personal injury may result. Avoid area near steering wheel and instrument panel even if air bags have deployed. Dual-stage air bag modules may be present that could contain an undeployed stage. When disposing of a deployed dual-stage air bag,always treat it as a"live"module. See appropriate MITCHELL®AIR BAC SERVICE&REPAIR MANUAL,or OEM information. ESTIMATE RECALL NUMBER: 8127102 17:14:07 4898 UltraMate is a Trademark of Mitchell International Mitchell Data Version: JUL 02 A Copyright{C}1994.2001 Mitchell International Page 2 of 2 U#raMate Version: 4.8.10 All Rights Reserved CLAIM BOARD OF SUPERVISORS OFCONTRA COSTA COUNTY BOARD ACTION: Sent 17. 2002 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 t4:3019� 915.4. Please note all "Warnings". AMOUNT: $425.00 0 4 2 ? CLAIMANT: Alex NicollMARTINEZO N L ATTORNEY: DATE RECEIVED: Aug 30, 2002 ADDRESS: 36 Julianne Ct BY DELIVERY TO CLERK ON: AuQ 30. 2002 Walnut Creek, Ca 94595 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEEf-il , Dated: Aug 30, 2002 By: Deputy `ii tl igf? II. FROM: County Counsel TO: Clerk of the Board of Supervisors" dP :. {4/This claim complies substantially with Sections 910 and 910.2. ( } This Claim.FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( } Claim is not timely hied. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). { } Other: Dated: _ 2".' �-- y: � 'L B Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( } Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( } This Claim is rejected in full. ( } Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. r VA, ' Dated: f f JOHN SWEETEN, CLERK, By,�' � ��;��'� f �� , Deputy Clerk WARNING{Gov. code section 913} Subject to certain exceptions, you have only six.(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned,have been a citizen of the United States, over age 18, and that today I deposited in the United States Postal Service in;Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: µ�= r y;4 i'< < ,JOHN SWEETEN, CLERK By�; � �> �f � r� y �� Deputy Clerk Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY 2 `' •`a4s� INSTRUCTIONS TO CLAD iANI' A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for-death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claim must be filed with the Clerk of the Board of Supervisors at its .office in Room 105, County Administration Building, 681 Pine Street, Martinez, CA 94553. C. Zf 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, Peral, Code Sec. 72 at the end of this form. HE: Claim By ) Reserved for Clerk's filing stamp A 5 ► � �� ) RECEIVED ) � Against the County of Contra Costa } AUG 2002 ' or } CLERK BOARD of SUNERMSui;`a District) CONTRA"O TA CO. Fill in name ) The undemigned claimant hereby makes claim the County of Contra Costa or the above-named District in the sump of $ �ins '= and in support of this claim represents as follows: 1. `rIhen. dial the die car it ju. occu.^? (Give exact date and hour) 2. Whe did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) , r ��y�-, !- :.scIu r vr. Uc w�ct_ 9 =Lllk- 44- 4. Whatparticular act or omission on the part of county or district officers, servants or .employees caused. the.injury or damage. � $v+d di ' of 4--c ...6 crC'.t-€6t.:t++. '.''�- 6'r,, ',w� n t. - i✓ t�t+h i �3 p ���� - (over) 5. wnat are the names of county or district officers, servants or employees causing the damage or injury? �.«.3G... p,.✓16 4 ay(.. 0 t" .r C,i�.< to•`- 1'"7.:.ns v,.- .' ,y--. ''._A"�'f '°y, . 6. What damage or injuries do you claim resulted? (Give full extent of injuries or es claimed. Attach two estimates for auto damage. eA. o;;- A-C- ""�Fes_ '� ;sr"t? "�f -'�Cs -� !,e� .�� E� ' s�a•f� �" � } .e3,'xN b:.t 7. How was the amount claimed above computed? (Include the estimated amount of any� ta ` : : prospective injury or damage.) 0 sV v�- k I c- cs m �;�i c. �a, 4 _i 8 p"", ,{ e 8. Naves and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DAM ITEM At�X3T.�`NT Gov. Code Sec. 910;2 provides: "The claim must be signed by the claimt an SENT) NOTICES TO: (Attorne ) or by some person, on his. bea1f." Marne and Address of Attorney .-- (Claimant's Signature Address Telephone No. 'Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if .genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1.,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,0001 or by both such imprisonment and fine. Date: 8126/02 02:31 PM Estimate ID: 520 Estimate Version: 0 Preliminary Profile ID: CUSTOMIZED PROFESSIONAL AUTOMOTIVE ENTERPRISES 3331 MT.DIABLO BLVD.LAFAYETTE 1160 ERICKSON RD. CONCORD,CA 94520 (925)283-2160 Fax: (925)283-2169 Damage Assessed By: SCOTT MCKENZIE Condition Code: Good Deductible: UNKNOWN Owner ALEX NICOLL Address: 36 JULIANNE CT.WALNUT CREEK,CA 94595 Telephone: Home Phone: (925)938-3899 Mitchell Service: 911224 Description: 1990 BMW 3251 Vehicle Production Date: 3190 Body Style: 20 Sed Drive Train: 2.5L Inj 6 Cyl 5M VIN: WBAAA131XLAE56266 License: 4YBF556 CA Mileage: 84,809 Color: GRAY Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units 1 900500 BDY* ADD'L LABOR OP TAR REMOVAL Existing 4.5* 2 900500 BDY* ADD'L LABOR OP REWAX EXTERIOR Existing 1.0* * -Judgement Item Add'1 Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals 11. Part Replacement Summary Amount Body 5.5 60.00 0.00 0.00 330.00 Total Replacement Parts Amount 0.00 Non-Taxable Labor 330.00 Labor Summary 5.5 330.00 Ill. Additional Costs Amount IV. Adjustments Amount Total Additional Costs 0.00 Customer Responsibility 0.00 1. Total Labor: 330.00 11. Total Replacement Parts: 0.00 Ill. Total Additional Costs: 0.00 Gross Total: 330.00 IV. Total Adjustments: 0.00 Net Total: 330.00 ESTIMATE RECALL NUMBER: 8/26/0214:27:11 520 UltraMate is a Trademark of Mitchell International Mitchell Data Version: AUG®02_A Copyright(C)1994-2002 Mitchell International Page 1 of 2 UltraMate Version: 4.8.011 All Rights Reserved Date: 8/26/02 02:31 PM Estimate ID: 520 Estimate Version: 0 Preliminary Profile 10: CUSTOMIZED This is a preliminary estimate, Additional changes to the estimate may be required fQr the a tuW osidL Point(s)of Impact 16 Non-Collision(S) I HEREBY AUTHORIZE PROFFESIONAL AUTOMOTIVE ENTERPRISES TO COMMENCE REPAIRS ON MY VEHICLE PER THIS ESTIMATE. SIGNED DATE WARNING: Accidental air bag deployment Is possible. Personal Injury may result. Avoid area near steering wheel and Instrument panel even If air bags have deployed. Dual-stage air bag modules may be present that could contain an undeployed stage. When disposing of a deployed dual-stage air bag,always treat it as a'live"module. See appropriate MITCHELLO AIR BAC SERVICE&REPAIR MANUAL,or OEM Information. ESTIMATE RECALL NUMBER: 8126/02 14:27:11 520 UltraMate Is a Trademark of Mitchell International Mitchell Data Version: AUG_02_A Copyright(C)1994-2002 Mitchell international Page 2 of 2 UltraMate Version: 4.8.011 All Rights Reserved SALES,E S,ORDER f�p1111f �Mi flMf�gpllMll aEGAM AUTO D € IW7 3rdve, *d Cr*,CA WXN . CUSTOMERS'PRDER NO. DEPARTMENT NAMEtvs *buts 777_ rIT,1.S.TATE,€-10 aVi✓ut y ^xt h L.t; . Vk{kFi i4 ACCT. { A k3} { } t J; } 3 ws ✓ 13 W�,.�W .� � p f 7 , --------- fall Y- t 3: KEEP THIS SLIP FOR RErERIrNCE No 6805 SALES ORDER. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Sent 17, 2002 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 2X(r 915.4. Please note all "Warnings". AMOUNT: $160.31 SEP 10 2J02 CLAIMANT: Howard Hall COUNTY COUNSEL WRTINEZ CALIF ATTORNEY: DATE RECEIVED: Sept 4,2002 ADDRESS: 98 Edgeview Ct BY DELIVERY TO CLERK.ON: Sept 4, 2002 Discovery Bay, CA 94514 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEI TEN, Cl ' k Dated: Sept 5,2002 By: Deputy y , < Ll ;� II. FROM: County Counsel TO: Clerk of the Board of Supervisors` {.-) -This claim complies substantially with Sections 910 and 910.2. ( } This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: s ", 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 minutes for this date. Dated 9 ,_. k i s -r JOHN SWEETEN, CLERK., By S ' h �<F , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned., have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. 1 'r SF Dated. ;^ �., .: :;JOHN SWEETEN, CLERK B - Deputy Clerk y Clain to: BOARD OF SUPOVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sor.,a.l property or growing crops and which accrue on or before December 31, 19871, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal. property or growing craps 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 yeaar after the accrual of the cause of action. (Govt. Code 5911.2.) B. Claims must be filed With the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against Wh public entity. E. Fraud. See penalty for fraudulent claims, Pena? Code Sec. 72 at the end of this form. RE: Claim By } Reserved for Clerk's filing stamp j EC " ...� Against the County UT Contra Costa } or ) SEP 4 2002 District) TTV"75 OF L;u EAVIS0RS Fill in name } l;C:L'91L C0u7A Ute. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) 3. How did the damp or injury occui%R' (Give full details; use extra paper if required) sj✓e,7,.v�cs z-a r 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? ;f, f I, _f "4�.t,c r ,Ck/ rf � all (over) 5. What are the names of county or district officers, servants or employees causing the damage or- injury? 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. - Attach two estimates for auto damage. r f,L�, a ' 7. How was the amount,, claimed above computed? (Include the estimated amount of any prospective injury or damage,) £ eu_ ci f:.4 04C 8. Names and addresses of witnesses-^, doctors �and hospitals,_ 'J4i'+•iX'�iC.e};/'1 9. List the expenditures you made on account of this accident or inury: DATE ITEM: AMOUNT z Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant. SEND NOTICES TO: (Attorne ) or by someerson on his behalf." ams and Address of Attorney s . Cla3.ma it rs Signature A ss Telephone No. Telephone No. t43 a N 0 T I C E .Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any Bounty, -city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. __ ED Caron iettnn CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT C:A0070000 Leat 14 P.0, Box 391, art#nex,CA 94553-0039 Ej su¢plernsn*at [I ON.[]HRO tL7 ARAF_3 n,633. -DR No, 2.Clky Coda 3.Nme/Ctassl¢catioSn 4.Detail 1. 5.Rantassi. P. ttoatior 6,V1,4m Name j ,F,M) 7,Oat*Orap,deport a.Employes No. 13 S.AddrAsa I L&catlon of Owwrence 10,Saa¢a;t's Narita(L,F,td) t t.Prop".,Description: Impoundad,Recovered,Found,Last,Stolen-ttern Number,Ariicls,uuan?fty, Model Number,Rede!hiurtiber,McoianaouE Description,location Where Taken,Valve, rc vde Tots1 ws•LiBT IN f�.)LLOWNa ORDER:A Contin Notes; Jsue: G Cwhink Pum Dt vaA#Naa;El OtFos nt f Riidin YYs.etc.:G'Firearms'H)Houashoid Gn f)M{so. 12.R000vered Property 13.Narrative r Statements o:Zda ra,Aw (`{'� ?wilLt�f r ��...� �"iL�1'F�Sm'.. .t.��.��.^i�s.a.."„�,� gJ`,,t-�,$ �•e '�,t% � '���"' t'!'.�r�l_�-"� �it'.�.,.._.., Fi) 1'3:2z%titC "T Gc s z co .a- . err " d.L •r �~ 1 1 ':cj a JCS_ a t y a (rte). __- _ - ��:.�'EL�%tr-,�,,,,+�:•ra, Y .�,�t� � (22) 14.Ustrlt utian - '5 Additional Pouting 08 Q-M [IDA EIDE [(L C30A i~OA 08R 011 0 Investigation L V,--e [;Narcotica []Juaan,le 1-1 Coronsr t 3.Ra¢nrtayg t5E#nitY (Print) 17.Datemme Written is.pispo. D Property c=eA [ Acs [J Inte;gsnce 0 R.0. []sate ustrd Cantetn Ccm¢katlnt Ot tce fv doa Petry. 0,DV GnSt t3.Approving Supv. {Prayt) 20.5 t¢v.Na. zt.pate 22.Papa otter ct FORM+3 PRECISION GLASS COMPANY copy 1 1731 MAIN ST. ReRnrt#1 OAKLEY, CA 94561 PH: (926)679-2400 FAX: (926)679-2335 vuo#:993 Fed Tax ID:68-0481000 P/0# : Cust State Tax ID: invoice: 1438 Taken By: 0031 Cust Fed Tex ID: Installer: A.S. Ship Via: PLATE Cate: 811612042 SalesRep: 001 A v.Code: RPT Bill To: Sold To: Mall,Howard Hail, Howard 98 Edgeview Ct. Discovery Bair, CA 94514 Phone:(925)634-1039 Phone: (925)634-1039 QPar#Number Description — - List Disc Sell—Total 1 AnninslowE (31 318 x 30 318)3/4"dA Annealed $125.00 0.00 $125.00 $125.00 Insulated Unit 1 Labor Labor To install Glass(Fiat gate) $25.00 0.00 $25.00 $25.00 Always Use A Licanced Contractor. Licence Number 795812 Sufi Total : $150.00 Tax : $10.31 Total: $160.31 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION. Sept 17, 2002 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 DPursuant to Government Code Section 913 and � 915.4. Please note all"Warnings". AMOUNT: $910.00 UG � ��� COUNTY COUNSEL, CLAIMANT: Pacific Bell MARTINEZ CALIF, ATTORNEY: DATE RECEIVED: Aug 26, 2002 ADDRESS: 666 Folsom Room 920 BY DELIVERY TO CLERK ON: Aug 26. 2002 San Francisco, CA 94107 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETEIs l' Dated: Aug 26 2002 By: Deputy .s II. FROM: County Counsel TO: Clerk of the Board of Supervisors` (0`fiis claim complies substantially with Sections 910 and 910.2. ( } This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). ( ) Other: r Dated: ` By: ` & � `# Deputy County Counsel III. FROM: Clerk of the Board TO.- County Counsel (1) County Administrator(2) ( } Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (' 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 S` ' i I s � ' 1 '., #� - ;Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated. -� "'^ ,t 'JOIIN SWEETEN, CLERK.By #� : t s' ' . �, � :. ..��, � ti.._., �� ,�� �, .....___ Deputy Clerk rntzni letter.txt AUG 2 � l12 CCE K R'JAR�CE C INV C SA 0, iSpR5 ��TA CG, CLAIM AGAINST CONTRA COSTA COUNTY Pacific Bell presents a claim for damages against the COUNTY OF CONTRA COSTA as provided in Government Code Section 900 et. seq. CLAIMANT' S ADDRESS : Pacific Bell 666 Folsom, Room 920 San Francisco, CA 94107 DATE OF OCCURRENCE: 5-28-2002 LOCATION: JOHNSTON ROAD DANVILLE, CA CIRCUMSTANCES GIVING RISE TO THE CLAIM: EMPLOYEE OF CONTRA COSTA COUNTY DUG UP OUR CABLE WHILE USING A BACKHOE DESCRIPTION & ITEMIZATION OF DAMAGE: NEEDED TO RE-BURY THE CABLE WHICH WAS EXPOSED NAME (S) OF PERSON(S) CAUSING DAMAGE: THE EMPLOYEE IS NOT KNOWN TO US Page 2 muni letter.txt AMOUNT OF CLAIM: $ 910 . 00 DATE OF CLAIM: AUGUST 20, 2002 PACIFIC BELL CLAIM NUMBER: PACB-CN-200205-OG-0058 ------------------------------------- STACY RIGGS MANAGER RISK MANAGEMENT SERVICES Page 3 ?acificBell TelepfSoneCompany g BELLk, BSH'C Risk Management Service PACIF# new k 666 Folsom Street,Room 920 San Francisco,California 94107 (800)728-4202 Bill For DSma eS To: CONTRA COSTA COUNTY OF Date: 8/13/2002 1911 SAN MIGUEL DRIVE Page 1 of 1 SUITE 200 Claim#: PACB-CN-200205-OG-0058 WALNUT CREEK,CA 94596 Charge For Damage To: PACIFIC BELL FACILITIES On Or About: 5/28/2002 At: JOHNSTON ROAD DANVILLE,CA By: CONTRA COSTA COUNTY OF While: BACKHOE Our Records Indicate: LABOR REPAIRING BURIED CABLE 7.50 REG HRS $858.38 MATERIAL BB2X24 CLOSURE I QTY $43,62 MATERIAL 750 GRAM ENCAPSULANT 1 QTY $8.00 Amount Due: $910.00 This bill is due upon receipt. If payment is not received within 15 days further collection action will be taken. REMIT PAYMENT TO:Pacific Bell Attn:Risk Mgmt. Svcs. ONE BELL CENTER,ROOM 39-N-13 ST.LOUIS,MO 63101 Inquiries call TOLL FREE 1-800-728-4202 Hours:Mon.-Fri.7:00 am-4:30 pm or DIRECT 1415-542-0269 FAX 415-542-0111 CUSTOMER COPY PACIFIC BELL Page 1 of 1 BREAKDOWN OF CHARGES FOR DAMAGES RUN DATE: 8/20/2002 CLAIM NUMBER: PACB-CN-200205-0G-0058 TIME DATE OF REG REG OVT OVT DBL DBL EMPLOYEE REPAIR HRS RATE HRS RATE HRS RATE AMOUNT TM 5/28/2002 3.50 114.45 $400.58 FK 5/28/2002 4.00 114.45 $457.80 LABOR SUB-TOTAL $858.38 MATERIAL DESCRIPTION QUANTITY UNIT COST AMOUNT BB2X24 CLOSURE 1 $43.62 $43.62 750 GRAM ENCAPSULANT 1 $8.00 $8.00 MATERIAL SUB-TOTAL $51.62 CONTRACTOR CONTRACTOR NAME AMOUNT LOSS OF USE DESCRIPTION QUANTITY UNIT COST AMOUNT OTHER ITEMS DESCRIPTION AMOUNT TOTAL TIME.MATERIAL. CONTRACTOR LOSS OF USE,OTHER ITEMS $910.00 Stacy Riggs SBC Pacific Bell f Manager Telephone Company t• Risk Management Services 3235 N.Texas Street muni letter. tXt Room 200Fairfield,CA 94533 707.428.2426 Phone 707.428.2427 Fax August 20, 2002 Case: PACB-CN-200205-OG-0058 CONTRA COSTA COUNTY CLERK BOARD OF SUPERVISORS 651 PINE STREET ROOM 106 MARTINEZ, CA 94553 Ladies/Gentlemen: We are sending you the attached claim notice pursuant to Section 910 of the Government Code. Sincerely, f ;_1 STACY RIGGS MANAGER RISK MANAGEMENT SERVICE Attachment Page 1 .. ................................................. Iry ; �}�:�•:�,.�.�: ra• {4.. 4� U) cr- ` �• 0 w, r U) O U) LO � dLL W C7 LLI o W .�.............-. cZ al W r- Z t- : CLO .�....r.W...r.- r Z lt! T- �y cr o LO f m C3 G7 C Ln C3 ru aw�rrn.�++wrrwr tip � M 6 Ql m V x d U ami m o `C N C } mak.. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Seat 17, 2002 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: $100.00 COUN7Y COUNSEL CLAIMANT: John Howshall MARTINET CALIR ATTORNEY: DATE RECEIVED: Aug 23, 2002 ADDRESS: 104 Old Oak Ct BY DELIVERY TO CLERK ON: Aug 23, 2002 Oakley, CA 94561 BY MAIL POSTMARKED: August 22, 2002 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. , JOHN SWE ,l Dated: Au 23 2002 By: De ut ' p y II. FROM: County Counsel TO: Clerk of the Beard of Supervisors` (This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). { ) Other: Dated: . '_ ' By: l Z 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 ofthe'Board's Order entered in its minutes for this date. t Dated: JOHN SWEETEN, CLERK, By ,~,1,r ' , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18, and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: f , �'., ' �}r _ .' JOHN SWEETEN, CLERK By ,':�� � ;�- 'f` .`;� A�`t�'� ��---_. _ Deputy Clerk °{ r 'y` ''" 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 per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for-death or for injury to person or to personal property or growing craps 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 ether cause of action gust be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claim must be filed with the Clerk of the Board of Supervisors at its .office in Rocco 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board, of Supervisors, rather than the County,_ the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. ' Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp ) RECEIVED Again the County of Contra Costa ) AUG 2 3 20.02 or ) C7 I District) CONTRA COSTA 00, Fill in name ) -The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of /,00,00 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? ('Include city and county) 3. Flow did the damage or injury occur? (Give full details; use extra paper if required) a 4. What particular act or omission on the part of county or district officers, servants or .employees caused. the injury or damage? (over) 5. wnat are the names of county or district officers, servants or employees causing the damage or injury? 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (include the estimated amount of any prospective injury or damage.) $. Names and addresses of witnesses, doctors and hospitals. C/9 9. List the expenditures you made on account of this accident or injury; DATE ITEM AMOUNT A. Gov. Code Sec. 91G.2 provides: "The claim must be sigr:ed by the claimant SEND NOTICES TO: (Attorney ) orsome erson on his. behalf." Name and Address of Attorney C1c31rtr3l7t�v Signature (Address) Telephone No. Telephone No. ' �t * N 0 T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if .genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county ,jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such' imprisonment and fine; or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. CLAIM �r BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY ' BOARD ACTION: Sent 17,2002 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all"Warnings". AMOUNT: Unknown AUG 2 E ?Go; COUNTY COUNSEL CLAIMANT: Stacy Passeri �,MRTINEZ CALIF ATTORNEY: DATE RECEIVED: Aug,26, 2002 ADDRESS: 317 Sequoia Terrace BY DELIVERY TO CLERK ON: Aug 26, 2002 Danville, CA 94506 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET4-N, IOTA t; Dated. AuP 26, 2002 By. Deputy 1 t{ , II. FROM: County Counsel TO: Clerk of the Board of Supervisors (V This claim,�omplies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.$). { ) 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). (, ` C)ther: t - --fit n_)icy `V � l 16t tr �' A cl r(( Dated: - By: . . I ip Depii�'ty County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) LU-c'�-Vi s L ( ) Claim was returned as untimely with notice to claimant(Section 911.3). 0.14�` ;. [tot .410M i t IV. BOARD ORDER: By unanimous vote of the Supervisors present: Cleo av iN) 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: €: `° `n s ; - JOHN SWEETEN CLERK, By € 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. fi �i �.�^"F it`tij •Y,;�#� mTj'-'"�.':� ' n Dated3OHN SWEETEN,CLERK By, 3 F €: `k.. 1 ��- .-- Deputy Clerk Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY MIRUCTIONS TO CLAIMANT A. Claims relating to causes of actions 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 no 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 then 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 then end of this form. RE: Claim By Reserved for Clerk's filil g st CEIVED 00 to c 00 AUG ., df ) CLSR K BOA€�C' �:200]2 RS Against the County of Contra Costa or ) L'.4�b Rh{i�, / cC� . .District) (Fill in name) ) ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named,district in the sum of$ and in support of this claim represents as follows: 1. When}did the damage or injury occur?-(Give exact date.#and hours)_ t + L ~_ i.: i-6 .EtA ! v i t•: �tL:V C 1fLv1' € # iE x h• :.J 2. Where did the damage or injury occur? (Include City and County) ai 4 ����.,i��*�� 3��� (�.�✓,°�i-�'�Y_i'�f'i�r:3'.., 3..4,,. ,,3_+�`��_t.9; f� �-..._ t''S'� v, 'h _. J.➢>i_k..3 3. ' - -. .:; , `. s -. How the damage or injury occur' (Give full details•, use extra paper if required) a-�6A 4} { s t c r •-[�-". ��J� `'?is L,,�-,.{°✓;� 4, What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage?. r ;'<:1" v�° s �-�� -)o s �`. L am . C.. 5. What are the names of county or district officers, servants, orplo�'y�ees causing � the damage or injury? [ ':..3..% '�'"ra1'e 4_.�,...-1 °�.5'. �e. .r"' 4} `•'i..-.. t \ 4 _;3 z fie` �e c 6 //.` # � L.L...i• yi, �. �+..L Y�f 3` �: .F�',.r L q�96.,,;�� ,V"i.. �..,.�4�.. '.. 6. What damage or injuries do you clairrr'resulted? (Give full extent of injuries or damages claimed Attach two estimates for auto damage.) ° � vovkx C J .K e t �.. ' - 7 C l i t r•, •- ° .- s til ,, € Ai( .1 t r r t s f 4 � � � bi .sSkd` ( SL1{ k .i o•l \ 5 - �, d r''° { ,` 1i IL $ Y do 3t. 6CLi;si4�k' 7. How was the amount claimed above computed?, (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors, and hospitals. r :f Lok ' . ` �.. 1< - ' �' `�i 4F .:� f,r. ,:��6-.•�Y4-,_'.—b�.-t� L.4:.iE 4'•6..r` c _,t J AI EE99 't..� .`„ b ...-'i..)'Li F 2 Y f i :-s r:•.{d U.5, 9. List the expenditures you made on account of this accident or injury. DATE TIME At7UNT- �VI C _s ) Gov't Code Sec. 910.2 provides"The claim must be ) signed by the claimant or by some person on his behalf." SENT}NOTICES TO. (Attorney) Name and Address of Attorney ) ( la Signature) ,�✓b''� l� F '' T_l�S .. (Address) s.�, f ;..-�� < ��-�F y ..�� � 1 � C' V' } Telephone No. ) Telephone No 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 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. C:\WINDOWS\TEMP\County Claim Form.doe m 25 Cr p a m r n E m [ I sB int � tit d i.} r' L4 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Sent 17,2002 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: $4510.27 R!UG 2 7 7''o COUNTY COUNSEL'- CLAIMANT: Eugene Norton tAA8T1N_PZ CALF ATTORNEY: DATE RECEIVED: Aug 26, 2002 ADDRESS: 2313 Acorn Ln BY DELIVERY TO CLERK ON: Aug 26,2042 Ceres, CA 95347 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE Dated: Aug 26,2002 By: Deputy ' ; s f v ° ' U II. FROM: County Counsel TO: Clerk of the Board of Supervisors (v�Th claim complies substantially with Sections 910 and 914.2. ( ) This Claim FAILS to comply substantially with Sections 914 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 914.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( } Other: Dated: "<. , By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (�} 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 ,Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions, you have only six (6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned,have been a citizen of the United States, over age 18, and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant addressed to the claimant as shown above. Dated: :: .:r } `;r s'`_JOHN HN SWEETEN CLERK By, f < : .,r r , .... Deputy Clerk Claim to: BOARD OF SUPERVISORS OF CMCRA COSTA C(7= INSrRISCITIONS TO CL.ADWiT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing craps and which accrue on or before December 31., 1987, must be presented not later than the 180th 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, mast be presented not later than sic months after the accrual of the cause of action. Claims relating to any ether cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Cade 5913.2.) B. Claims rust be filed with the Clerk of the Board of Supervisors at its office in Room 1036, County Administration Building, 651 Pine Street, Martinez, CA 94553. C_ if ^!a, ,s_ aa7*�s�. a rte tri;n saver ed by the Board of Supervisors, rather l-Laan the County, the name oftheDistrict 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 fora. RE: Claim By } Reserved for Clerk's filing stamp } ,Against the County of Contra Costa } or } District) Fill in 77a The undersigned claimant hereby ekes 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. 4,5 1,D, 1. When did the damage or injury occur? (Give exact date and hour) u t' o 2. Were dial the damage or injury occur? (Include city and county) 3. How did the damage or injury occur' (Give i details, use extra paper if rewired). � cU. ev .C�_ ... Y s- .( r z c x €! P 4. What particular act or omission on the part of county or district officers, servants or enployeesy caused. the inJury czars }d-aa ge? } 7 y} ,,,, ..Y f7�.. �~,.*�.`_`.�� �...:�{�.+i.X;•'1`�, _.f���✓C.. *�.,�� -.""L.fi�i�'�+{.'.fL`- `,#.^',.�. Y• '^"�^,}•'�i;.= �'I' "F..,-i: (over) �. wnat are the names of county or district officers, servants or employees causing the damage or injury? ..` 6. What damage or injuries do you claim resulted? {Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8, Names and addresses of witnesses, doctors and hospitals. ii 9. List the expenditures you made on account of this accident or injury: MOUNT DAMP ITEM Gov'. Code Sec. 910:2 provides: "The claim mast be signed by the claimant SEND NOTICES T0: (Attorney orb some erson on his. behalf." Name and Address of Attorney �,'► � - a �r ^Claimant's Signature Telephone No. Telephone 2#0: NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state hoard 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, bili., 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 ($19000), or by both such imprisonment and fine,- or by imprisorment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. 08/02/02 12.49 I D.I NTERST TRUCK COL DIV PARC.209. 944-01 3 PAGE 2 COLLISION DIVISION ESTIMATE Custorner. Contact: Phone: Fax: manufactumr- FearBud: Engine S W CPUAR Mvdet: Serial# License: „ Mileage: unit R R P P Labor Feint Parts L R t:ra".mr Dan tiara Time Time Oty Paris Description Sublet Amount Paint Code Paint Matarials'9k iTAI`PORTANT: SUMMARY OF CHARGES Prices on this estimate are valid for thirty (30) days. The amount Farts shown for labor, parts and supplies are estirriates only, if additional major repairs are required upon being dismantled, Q Rate which could not be detected on original appraisal, you will be contacted for authorization prior to proceeding with such additional repairs. Parts prices are subject to stock order availability. No freight charges have been included unless otherwise indicated. Supplies r Prices are subject to manufacturer's price increases, Sublet Tax _ Tectal Estlrnate INTERSTATE TRUCK CENTER COLLISION DMSION Submitted by. 641 SO. HARMON ST., STOCKTON, CA 95206 PHONE: (209) 466743561 Date: � a CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION. Sent 17.2002 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 Es, 907 }�`+ suant to Government Code Section 913 and .4. Please note all "Warnings". AMOUNT: in excess of X25,000 UG 2 7 HHS COUNT`COUNSEL, CLAIMANT: Misako Casmer MARTINEZ CALIF. ATTORNEY: Thomas Kaster DATE RECEIVED: Aug 26, 2002 ADDRESS: 807 Montgomery St BY DELIVERY TO CLERK ON: Aug 26. 2002 San Francisco, CA 94133 BY MAIL POSTMARKED: 1, FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE tlrr,#� S i!r ,f` Dated: Aug26 2002 By: Deputy .. f,'f f s �.. 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). ( } 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: 1LIC rll i ; In � -f/1 e— .�.. �t t��t'?• 1. -tom� �'��`.����.:� fi Dated: By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (y This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:.. ,�, £ . ,, f 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,,i addressed to the claimant as shown above. Dated: s. i :' ' JOHN SWEETEN, CLERK.By ; r �� � � �< �� Deputy Clerk County of Centra Costa CAO—Risk Management Division 2530 Arnold Drive, Suite 140 Martinez, California Phone:341443 Fax:5-1421 August 23, 2002 TO: Clerk of the Board FROM: Ron Harvey Risk Manager SUBJECT: Claim of Misako Casmer Please process the attached claim, which was received in our office in August 20, 2002. If you have any questions feel free to call me at 5-1443. LAW OFFICES of ARNOLD LAUB Cjn1 A PROFESSIONAL CORPORATION Co"ORATE HEADQUARTERS # THE LAUB BUILDING 807 Montgomery Street - San Francisco, CA 94133 EC 1W, �V AUG 2 6 2002 jlf- CURK BOARD OF SUFAE-pVISORS August 14,2402 Administrator Ron 14arveY Contra Costa Regional Medical Center 2500 Alhambra Avenue 4UG Martinez, CA 94553 Re: Patient: Misako Casmer INTENT To SUE P_URSU AN _E OF CML rROC X TO SECTION 364(4).CQD Dear Administrator: This office represents Misako Casmer,who received treatment from nurses and medical personnel employed by Contra Costa Health Services,Contra Costa Regional Medical Center and Contra Costa Health Centers from on or about September 4,2001 until May 2,2002 for a right u1nar fracture. Said treatment fell below the standard of care as the fracture was displaced and appropriate treatment was not instituted to correct it,including surgery. As a result,the fracture has failed to heal properly,resulting in a non-union of the fracture site, substantial loss of function of the right arm,severe pain,and significant deformity, all of which have caused my client physical and emotional suffering and which will necessitate future medical treatment including a more complicated surgical attempt to correct the mal-union. Pursuant to Section 364(a)of the California Code of Civil Procedure,Misako Castner hereby gives notice of her intention to commence an action against nurses and medical personnel employed by Contra Costa Health Services, Contra Costa Regional Medical Center and Contra Costa Health Centers for professional negligence,as a result of care and treatment provided to her. Please refer this letter to your insurance carrier and direct all correspondence to the undersigned. Very truly yours, Thomas J. Raster Tel:415/362-0101 - Fax: 415/296-8841 - E-Mail: alaubOlaub-com - Web Page-, www.laub.com sAN JOSE: ill West Saint John,Suite 770,San Jose,CA 95113 •408/297-5060 - Fax:408/288-5191 LAW OFFICES OF ARNOLD LAUB { THOMAS J. KASTER(#148776) 807 Montgomery Street f San Francisco, CA 94133 Telephone: (415)362-0101 4 i Attorney for Claimant 'i MISAKO CASMER f 7' MISAKO CASMER, ) 8 Claimant, } CLAIMANT'S GOVERNMENT CLAIM (Sec. 910, et seq. of Government Code) 1 9 vs., oi ) fj } f JASON A.PPEL,M.D.,CONTRA ) } COSTA REGIONAL MEDICAL } CENTER,CONTRA COSTA ) } -HEALTH SERVICES, CONTRA ) 'COSTA HEALTH CENTERS, ) Respondents. ) 1. Claimant Misako Caser resides at 36 Seaview Drive, Bay Point, CA 94565. 2. Claimant desires that all notices be sent to: 17I Thomas J. Kaster I Law Offices of Arnold Laub 807 Montgomery Street San Francisca, CA 94133 2-1-1 3. This claim arises out of the care and treatment provided to Misao Casmer by 1 22 Jason Appel, M.O. and nurses/medical personnel employed by Respondents who failed to 2 properly treat a displaced right ulnar fracture from on or about December 20, 2001 f continuing to May 2,2002 when claimant's treatment with Respondents ended . Said w ; treatment by Respondents failed to meet the standard of care which required, inter alia, ?w i' _ that the fracture be surgically corrected. V 2811 f 4. Respondent Jason Appel, M.D. failed to exercise the proper degree of i 2 r l knowledge and skill in caring for her commonly required of orthopedic surgeons i practicing in the state of California,and respondents' nurses and medical personnel failed to exercise the proper degree of knowledge and skill commonly required of r ; nurses;and medical personnel practicing in the state of California. 7 5. On July 31, 2002 claimant consulted with another orthopedic surgeon and �i 8 �j thereafter learned that Respondents' treatment fell below the standard of care. g 6. As a result of respondents' negligence, claimant's fracture has failed to heal E l ! properly,resulting in a non-union of the fracture site, substantial loss of function of the ' 1 arm, severe pain, and significant deformity, all of which have caused claimant physical 12 i i' and emotional suffering. Claimant,who is 69 years-old,has incurred medical and related expenses and claims special damages in addition to the general damages described above, 15 and she will require a more complex surgery in an attempt to correct the mal-union,a i procedure with much less likelihood of success and a much longer convalescence. 7 11' 7. The address of the public employees causing the injuries/damages is: Contra Costa Regional Medical Center g 2500 Alhambra Avenue i 1 Martinez, CA 94553 20 2-1 E} 8. The amount of damages claimed is in excess of$25,000 and therefore { 22 jurisdiction over the claim would rest in Superior Court. E Dated: ' I q-- 2. LAW OFFICES OF ARNOLD LAUB E - IE ( Thomas J. Kaster V ! } Attorneys for Claimant MISAKO CASMER `t 2 I PROOF OF SERVICE 2 I, the undersigned, declare that I am a citizen of the United States, over 18 years of age, 3 and not a party to the within-entitled action; I am employed at and my business address is 807 4 Montgomery Street, San Francisco, California 94133. On the date set forth below, I caused to 5 be served in the manner set forth below,by placing a true copy in a sealed envelope, addressed 6 as set forth below, the attached document, to wit: 7 INTENT TO SUE PURSUANT TO SECTION 364(A), CODE OF CIVIL PROCEDURE 8 and CLAIMANT'S GOVERNMENT CLAIM 9 X By certified mail,return receipt requested,by placing the envelope(s)in the outgoing mail 10 receptacle of the office address set forth above which, in the normal course of business, 11 will be deposited in a United States postal box at San Francisco,California,with postage 12 fully prepaid,the same day as placed for processing. 13 by facsimile to the facsimile number(s) shown below. 14 by causing the document to be hand delivered during this business day. 15 _ by overnight delivery(Federal Express) 16 ADDRESS: 17 Administrator 18 Contra Costa Regional Medical Center 2500 Alhambra Avenue 19 Martinez, CA 94553 20 I declare under penalty of perjury under the laws of the State of California that the 21 foregoing is true and correct,except as to matters stated on i rmation d belief,and as to those 22 matters, I believe it to be true. 23 DATED: August 14, 2002 24 25 26 CLAIM c BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Sent 17,2002 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". AUG 2 9 ncq AMOUNT: Unknown COUNTY COUNSEL CLAIMANT: Family Stress Center MARTINEZ CALIF ATTORNEY: DATE RECEIVED: Aug 28, 2002 ADDRESS: 2086 Commerce Ave BY DELIVERY TO CLERK ON: Aug 284 2002 Concord, CA 94520 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN ryWEET6CJCfe' rK y Dated: Aug 2.9, 2002 By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (,)/This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claire 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 ,e- - Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) Coun dministrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911. 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: r OHN 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 Beard Order and Notice to Claimant, addressed to the claimant as shown above. Dated: w ;:' € �< _`'`� JOHN SWEETEN,CLERK B ` r, ` ' ; £ t A, �:' _- y � Deputy Clerk August 2, 2002 Contra Costa County 1 � Fire Protection District AUG 2 8 2010 Geary Road Zr�0 g Pleasant Hill, CA 94523 VCiK FAMILY Attn.. Mike George STRESS Dear Sir, CENTER On May 29, 2002 Captain C.J. 8edgood, who was answering an emergency BOARD OF DIRECTORS call to the Shennum Center our next-door neighbor, came into our office to laia ertinuaez inform us that the parking lot iron drainage grate has collapsed under his fire Car;,nuni,y Johe-' er truck weight. He expressed his intention to report this immediately to the &all am art Risk Management Department with the purpose of processing as soon as Human Resou-ce Speewlist possible a reimbursement for the damages. " ` ;1,9, I talked to him on the phone couple of days later and he informed me that c;cmr,?2an2:y!;�urtselOT the report was in progress and to call you for more information. When I did T raansng Coardi?tatogager natoenryr r so you notified me that this kind of process takes several weeks and that we < will need to present at least couple of proposals to your department. You " ``:a Hooper also understood our concerns about the big open hole on the parking lot left Director,D nor Serv:ees by the broken grate and the dangerous situation that our Nursery kids were she' I rat�ei Cnsultonv&cnt exposed to. Due to this situation, we did not have another choice than to fix � this problem as soon as possible instead of waiting for your reimbursement. Robert E.s a urs Iresurarre Fx2cettiY,m I hope we could reach a solution for this problem as soon as possible. hat> �a �7t Attached are the two bids and the invoice for the repair of the damage. If F2rze:ncsal you have any questions or comments, please contact me at (925) 827-0212 01"a hXvritz ext. 103. Educator Louise Sever,; Sincerely, hind Raising Co7asultant '� 1 Gary Snyder Attorr�e (aura walker _ Patricia N vine Director Au otions Office Manager BOARD OF ADVISORS Cheryl and t€l Bafogh Elizabeth and William E Brod t Kathie A7.-ker Ron WeVer Carol,arza Dr.Neil K lsou EXECUTIN-E DIRECTOR Barbara Bysieh,JLC.S.%' STRENGTHENING FAMILIES& PROTECTING CHILDREN WILLIE MAE AND JOHN MARSHALL TYLER BUILDING 2086 COMMERCE AVENUE CONCORD, CA 94520 (925) 827-0212 FAX(925) 827-1122 invoice DDA co?wRUMON CO. 745 Palmer Road DATE � A+�1tO1� Walnut Creek,CA 94596-6016 7/9=02 686 i a p JOB ADDRESS F,a,Mmr.Y STRESS CrrER � ti ;2086 CONBIExCE AVE i 12'�086+��■XC�J��N..{{fsy��?y�r r RCE AVE �CONCORD,CA .'{.,ONCORD CA 6 f3ESORMT#0M' a AMOUNTI Contcua#02236-true on completion I 190.00 I a j I 4 j i f _�7td1 S190:00 I ' Invoices are due upon reeipt Office(125)932-5320 THANK YOU FOR YOUR PROMPT PAYMLrNT Fax(?25)95'2.4373 JLN-6-2002 12•.12A FROM:" CONSTRUCTION 4926 A& PROPOSAL AND CONTRACT No: 02226 DENMS and DAVM AL UMAUGH Ref- 745 PALMER ROAD WALNUT CREEK,CA.94596 Since 1975 License#746719 Office(925)932.-5320 Fax(925)952.4373 TO: Family Stress Center DATE: 615/02 2086 Commerce Ave PHONE: 827-0212 Concord,CA MAS'REF: WE PROPOSE to furnish labor and material m strict accordance with the plans and specifications as follows: Supply and install a 16x16 grate and remove the existing broken gate. NOTE: All painting is to be done by other unless otherwise noted. All dirt and debris is to be removed from.site Unless otherwise noted.Contractor is not responsible for damage to landscaping or gavel paths including low voltage lighting. Any damage to sprinider litres is to be repaired. For under house work the crawl space mast be dry enough to work and freae of animal life(rodents,skunks,raccoons,etc.). Flans,permits and engineering are not included unless mentioned above. Any additional work not included in contract will be quoted on request or billed on a time and material basis at$55 per hoar and material+20*/*. Service cath are subject to a 2-hour minimum. PRICE: FOR THE TOTAL SUFI!OF$190.00 DOLLARS TERMS: $190.00 is due on completion. Any balance not paid when due is subject to a 1.5%per month f ince charge. If it becomes necessary to talcs legal action to collect unpaid moneys,the owners understand that they will pay for any and all related costs. The owner;rinrther agrees to submit to binding arbitration through normally recognized arbitration channels. The contractor may,at his discretion,cancel is contract if not accepted within 30 days.. You the buyer may cancel this transaction at any time prior to midnight of the irness day after the date of this transaction. See the attached notice of cancellation form. for an explanation of this right. SUE =AP D IS R AU'GH DDA CON CTION CO. 745 Palmer R Walnut Creek„Ca. 94596 DATE ACCEPTED: -'r _.. __ JUN-6-2002 12:1`R FROM:DDA CONSTRUCTION r U:Ue_(11ee STATE LAW REQUIRES ANYONE W140 CONTRACTS TO DO CONSTRUCTION WORK TO BE LICENSED BY THE CONTRACTORS STATE LICENSE BOARD IN THE LICENSE CATEGORY IN WHICH THE CONTRACTOR IS GOING TO BE WORJKING—1F THE TOTAL PRICE OF THE JOB IS 5500 OR MORE(INCLUDING LABOR AND MATF..1?3ALS). LICENSER CONTRACTORS ARE REGULATED BY LAWS.DESIGNED TO pROTECT THE PUBLIC.IF YOU CONTRACT WITH SOMEONE WHO ROES NOT HAVE A LICENSE,THE CONTRACTORS STATE LICENSE BOARD MAY BE UNABLE TO ASSIST YOU WITH A COMPLAINT. YOUR ONLY REMEDY AGAINST AN UNLICENSED CONTRACTOR MAY BE IN CIVIL COURT,AND YOU MAY BE LIABLE FOR DAMAGES ARISING OUT OF ANY INJURIES TO THE CONTRACTOR OR HIS/HER EMPLOYEES. YOU MAY CONTACT THE CSLB TO FIND OUT IF THIS CONTRACTOR HAS A VALID LICENSE. THE BOARD HAS COMPLETE INFORMATION ON THE HISTORY OF LICENSED CONTRACTORS,INCLUDING ANY POSSIBLE SUSPENSIONS,REVOCATIONS,JUDGMENTS,AND CITATIONS. THE BOARD HAS OFFICES THROUGHOUT CALIFORNIA. PLEASE CHICK THE GOVERNMENT PAGES OR THE WHITE PAGES FOR THE OFFICE NEAREST YOU OR CALL 1-800-321-CSLB FOR MORE INFORMATION. NOTICE TO OWNER Under the California Mechanics'Lien Law,any contractor,subcontractor,laborer,supplier,or other person or entity who helps to improve your property,but is not paid lbr his or her work or supplies,has a right to place a lien on your home,land or property where the work was performed and to sue you in court to obtain payment. This means that after a court hearing,your home,land, and property could be sold by a court officer and the proceeds of tete sale used to satisfy what you owe. This can happen even if you have paid your contractor in full if the contractor's subcontractors,laborers,or suppliers remain unpaid. To preserve their rights to file a claim or lien against your properly,certain claimants such as subcontractors or material suppliers are each required to provide you with a document called a"Preliminary Notice." Contractors and laborers who contract with owners directly do not have to provide such notice since you are aware of their existence as an owner. A preliminary notice is not a lien against your property. Its purpose is to notify you of persons or entities that may have a right to file a lien against you property if they are not paid. In order to perfect their lien rights,a contractor,subcontractor,supplier,or laborer trust file a mechanics'Iien with the county recorder,which then becomes a recorded lien against your property. Generally,the maximur n time allowed for filing a mechanics'lien against your property is 90 days after substantial completion of your project. Upon satisfactory payment being tirade for any portion sof the work performed,the contractor shall furnish a full and unconditional release from any claim or mechanics'lien for that portion ofthe work for whiichpayment has been made. TlINS4RnEXTRA PROTECTION FOR YOURSELF AND YOUR PROPERTY, YOU MAY ISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS: 1) Require that your contractor supply you with a payment and performance bond(not a license bond),which provides that the bonding company will either complete the project or pay damages up to the amount of the bend. This payment and performance bored as well as a copy of the construction contract should be filed with the county recorder for your further protection. The payment and performance bond will usually cost from I to 5 percent of the contract amount depending on the contractor's bonding ability. If a contractor cannot obtain such bonding,it may indicate his or her financial incapacity. 2) Require that payments be made directly to subcontractors and material suppliers through a joint control. Funding services may be available,for a fee,in you area,which will establish voucher or other means of payment to your contractor. These services may also provide you with lien waivers and other form of protection. Any joint;control agreement should include the addendum approved by the registrar. 3) Issue joint checks for payment,grade out to both your contractor and subcontractors or material suppliers involved in the project. The-joint checks should be made payable to the persons or entities which send preliminary notices to you. Those persons or entities have indicated that they may have lien rights on you property;therefore you need to protect yourself. This will help to insure that all persotrr due payment are actually paid. 4) Upon malting payment on any completed phase of the project,and before making any further payments,require your contractor to provide you with unconditional"Waiver and Release"forms signed by each material supplier,subcontractor, and laborer involved in that portion of the work for which payment was made. The statutory lien releases are set faith in exact language in Section 3262 of the Civil Code. Most stationery stores will sell the"Waiver and Release"forms if your contractor does not have therm. The material suppliers,sub contractors,and laborers that you obtain releases from are those persons or entities who have fried preliminary notices with you. If you art not certain of the material suppliers, subcontractors,and laborers working,on your project,you may obtain a list From your contractor. On projects involving improvements to a single-family residence or a duplex owned by the individuals,the persons signing,these releases lose the right to file a mechanics'lien claim against your property. In other types of construction,this protection may still be important,but nay not be as complete. 5) To protect yourself under this option,you trust be certain that all material suppflers,subcontractors,and laborers have signed s'k the"Waiver and Tease"form. If a mechanics'lien has been.filed against your property,it can only be voluntarily released by a recorded"Release of Mechanics'Llee signed by the person or entity drat filed the mechanics' lien against your property unless the law suit to enforce the lien was not timely filed.. You should not make any final payments until any and all such liens are removed. You should consult and attorney if a lien is filed against your property. -JUN-5-2002 12:13R FRL7M:DUR CONSTRUCTIUN 1 U:UC-1 r I Ids NOTICE OF RYGHT TO CANCEL Notice of.Cancellation (enter date of transaction) You may cancel this transaction,without any penalty or obligation,within three business days from the above date. If you cancel,any property traded in,any payments made by you under the contract or sale.and any negotiable instrument executed by you will be returned within 10 days following receipt by the seller of your cancellation notice,and any security interest arising out ofthe transaction will be canceled. If you cancel,you must make available to the seller at your residence,in substantially as good condition as when received,any goods delivered to you under this contract or sale,or you may,if you wish,comply with the instructions of the seller regarding the return shipment of the goods at the seller's expense and FIs. If you do make the goods available to the seller and the seller does not pick them up within 20 clays of the date of your notice of caaceellation,you may retain or dispose of the goods without any further obligation. If you fail to make the goods available to the seller,or if you agree to return the goods to the seller and fail to do so,than you remain liable for performance of all obligations under the contract. To cancel this transaction,mail or deliver a signed and dated comply of this cancellation notice,or any other written notice,or send a telegram to. DDA Construction 1112 Mountain View Blvd Walnut Creek,CA 945% Not later than midnight of ( ) I herby cancel this dwsaction (date) (buyer's signature) NAT U R E t i3C,X5122$8 TEHN U Patricia/The Family 5treee Center June 27, 2002 2086 Commerce Avenue Concord, CA 94521 925-827-0212 Re- Drainage Project Thank you for allowing ury to repair your drainage problem. The following detailed propoeal reflects your rcqueet to repair your 16" equare broken drain grate and le oubmitted for your approval. The coat to replace thie item io $ 225.00. With your authorizing signature and a 50%down payment we will procure and replace thin item onelte within one week of receipt of thio propol5al received at our office here in Concord, Ca. s and Field Condit The repairs detailed in thio proposal only outlines our recommendations to properly correct the problem. The intent of our proposal is to inform you of the exact nature of the repair rewired and by no means ie intended to be u6e4l by other contractoro for bidding purpooce, This proposal ie good for 30 dayI5 and may be extended upon a written requeet. If it meets your requirements and you would like ury to proceed with our recommendations to correct your problem, pleaoe sign and return or fax one copy of this proposal to our office. I'lea6e 0end a retainer of 50% and the balance will be due upon completion. We are a licenced contracting firm with current warkman'o compensation and liability inourance. Any queetiono you may have concerning this proposal ohould be directed to our office at 925-827-3600. Sincerely, Richard Mariani Cilent'o Approval of Propoeal: `+ M so LANDSCAPE $ 225.00mo DEVELOPMENTGated: - - gna Authorized Siture . " 1674 Farm Bureau Rd. Concord, Ca. 594519 . . . . . . . . ' Tel (5925) 944-5263 Fax (925) 68.7.1952 (Legal Notice) "CONTRACTORS ARE REQUIRED BY LAW TO BE LICENSED AND REGULATED BY THE CONTRACTORS' STATE LICENSE BOARD. ANY QUESTIONS CONCERNING THE RESPONSBI rIUS OF CONTRACTOR:MAY BE REFERRED TO THE CONTRACTORS STATE LICENSE BOARD,9835 GOETHE ROAD,SACRAMENTO,CA 95827. MAILING ADDRESS.BOX 26000,SACRAMENTO,CA 95826" UNDER THE CALIFORNIA MECHANICS LIEN LAW ANY CONTRACTOR, SUBCONTRACTOR,LABORER,SUPPLIER OR OTHER PERSON WHO HELPS TO IMPROVE YOUR PROPERTY,BUT IS NOT PAID FOR HIS/HER WORK OR SUPPLIES,HAS A RIGHT TO ENFORCE A CLAIM AGAINST YOUR PROPERTY. THIS MEANS THAT AFTER.A COURT HEARING,YOUR PROPERTY COULD BE SOLD BY A COURT OFFICER AND THE PROCEEDS OF THE SALE USED TO SATIS TY THE INDEBTEDNESS.THIS CAN HAPPEN EVEN IF YOU HAVE PAID YOUR CONTRACTOR IN FULL IF THE SUBCONTRACTORS, LABORERS OR SUPPLIERS REMAIN UNPAID. TO:PRESERVE THEIR RIGHT TO FILE A CLAIM OR LIEN AGAINST"YOUR PROPERTY CERTAIN CLAIMANTS SUCH AS A SUBCONTRACTOR OR MATERIAL SUPPLIERS ARE REQUIRED TO PROVIDE YOU WITH A DOCUMENT ENTITLED"PRELIMINARY NOTICE." ORIGINAL(OR PRIME) CONTRACTORS AND LABORERS FOR WAGES DO NOT HAVE TO PROVIDE THIS NOTICE. A PRELIMINARY NOTICE IS NOT A LIEN AGAINST YOUR PROPERTY. ITS PURPOSE IS TO NOTIFY YOU OF PERSONS WHO MAY HAVE A RIGHT TO FILE A LIEN AGAINST YOUR PROPERTY IF THEY ARE NOT PAID. (GENERALLY,THE MAXIMUM TIME ALLOWED FOR FILING A CLAIM OR LIEN AGAINST YOUR PROPERTY IS NINETY (94)DAYS ATTER COMPLETION OF YOUR PROJECT.) TO INSURE EXTRA PROTECTION FOR YOURSELF AND YOU PROPERTY,YOU MAY WISH TO TAKE ONE OR MORE OF THE FOLLOWING STEPS; 1. REQUIRE THAT YOUR.CONTRACTOR SUPPLY YOU WITH A PAYMENT AND PERFORMANCE BOND(NUT A LICENSE BOND),WHICH PROVIDES THAT THE BONDING COMPANY WILL EITHER COMPLETE THE PROJECT OR PAY DAMAGES UP TO THE AMOUNT OF THE BOND. THIS PAYMENT AND PERFORMANCE BOND AS WELL AS A COMP OF THE CONSTRUCTION CONTRACT SHOULD BE.FILED WITH THE COUNTY RECORDER FOR YOUR FURTHER PROTECTION. 2. REQUIRE THAT PAYMENTS BE MADE DIRECTLY TO SUBCONTRACTORS AND MATERIAL SUPPLIERS THROUGH A JOINT CONTROL. ANY JOINT CONTROL AGREEMENT SHOULD INCLUDE THE ADDENDUM APPROVED BY THE REGISTRAR OF CONTRACTORS. 3. ISSUE JOINT CHECKS FOR PAYMENT. MADE OUT TO BOTH YOUR CONTRACTOR AND SUBCONTRACTOR OR MATERIAL SUPPLIERS INVOLVED IN THE PROJECT. TIM WILL HELI'TO ENSURE THAT ALL PERSONS DUE PAYMENT ARE ACTUALLY PAID 4. AFTER MAKING PAYMENT ON ANY COMPLETED PHASE OF,THE PROJECT,AND BEFORE MAKING ANY FURTHER PAYMENTS,REQUIRE Y CONTRACTOR TO-1 PROVIDE YOU WITH UNCONDITIONAL LIEN RELEASES SIGN bRY- ACH MATERIAL SUPPLIER.AND SUBCONTRACTOR INVOLVED IN THAT PORTION OF THE WORK.FOR WHICH PAYMENT WAS MADE. ON PROJECTS INVOLVING IMPROVEMENTS TO A SINGLE FAMILY RESIDENCE OR DUPLEX OWNED BY INDIVIDUALS,THE PERSON SIGNING THESE RELEASES LOSE THE RIGHT TO FILE A CLAIM AGAINST YOUR PROPERTY. IN OTHER TYPES OF CONSTRUCTION THIS PROTECTION MAY STILL BE IMPORTANT,BUT MAY NOT BE AS COMPLETE. ,TO PRO T YOURSM,UNDFR M PTI O T BE CERTAIN THA_ T_ALL TIE CRE HA NLD.RT Date I have rear/and hereby acknowledge the above Signature of Owners NOTICE OF CANCELLATION YOU MAY CANCEL THIS TRANSACTION, WITHOUT ANY PENALTY OR OBLIGATION, WITHIN THREE(3)BUSINESS DAYS FROM THE ABOVE DA'Z'E. IF YOU CANCEL ANY PROPERTY TRADED IN, ANY PAYMENTS MADE BY YOU UNDER TTIE CON'T'RACT OR SALE, AND ANY NEGOTIABLE INSTRUMENT EXECUTED BY YOU WILL BE RETURNED WITHIN TEN (10) DAYS FOLLOWING RECEIPT BY THE SELLER OF YOUR CANCELLATION NOTICE, AND ANY SECURITY INTEREST ARISING OUT OF THE TRANSACTION WILL BE CANCELLED. IF YOU DO MAKE THE GOODS AVAILABLE TO THE SELLER AND THE SELLER.DOES NOT PICK THEM UP WITHIN T"WE"NTY(20)DAYS OF THE DATE OF YOUR NOTICE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. IF YOU FAIL, TO &LkKE THE MOODS AVAILABLE TO THE SELLER, OR IF YOU AGREE TO RETURN THE GOODS TO THE SELLER AND FAIL TO DO SO, THEN YOU REMAIN LIABLE FOR.PERFORMANCE OF ALL OBLIGATION'S UNDER THE CONTRACT. IF YOU DO NOT AGREE TO RETURN TI-IE GOODS TO THE SELLER OR IF THE SELLER DOES NOT PICK THEM UP WITHIN TWENTY (20) DAYS OR OF THE DATE OF YOU NOTICE OF CANCELLATION, YOU MAY RETAIN OR DISPOSE OF THE GOODS WITHOUT ANY FURTHER OBLIGATION. TO CANCEL THIS TRANSACTION, MAIL OR DELIVER A SIGNED AND DATED COPY OF THIS CANCELLATION NOTICE, OR ANY OTHER WRITTEN NOTICE, OR SEND A TELEGRAM TO NATURE'S TECHNIQUE. NO LATER THAN MIDNIGHT OF I HEREBY CANCEL THIS i TRANSACTION Bayer's Signature Date L x NAT '�"R E ' tic.#51228£3 TECHN&UE Re: Client Referra(o Liotl©rainage 1-5herry Hoover 10-Mr. & Mrrg. l3ob Beavers 3212 Sharon Circle 3974 Paeco Grande Lafayette, CA 925-283-5688 Moraea, CA 925-254-1584 2-Mr. & Mra. Pon Vaughn 11-Mr. &'Mro. Jlm Delay 2881 Madlera Way 1161 Fair Weather Circle Pleaeant Hill, CA 925-939-5814 Concord, CA 925-689-1969 3-Mr. & Mro. Hoille Hardy 12-Mr. & Mro. Keith Bornemann 1734 Keliz Valley Road 22 Mountaire Court Lafayette, CA 925-933-9543 Clayton, CA 926-072-65093 4-Mr. & Mro. McKinnon 13-Mr. & Mre. Tim 5teven6i 124 Eaot Selbourne Way 2151 Wood€eaf Way Moraga, CA 925-283-3065 Mountain View, CA 650-938.7762 5-Mr. & Mro. Ron Oliver 14-Mm. Tamara Kay 51 Oak Knoll Loop 175 Donald Court Walnut Creek, CA 925-933-0123 Danville, CA 925-- 736-3664 6-Rhonda Lathrop 15- Rene Drolly 9 Via Decaneada 1966 Altura Drive Orinda, CA 925-254-8079 Concord, CA 925-691-4034 7-Mr. & Mro. Richard Carleton 16-Norm Connolly 1535 gunny Court 1534 l3errelleea Street Walnut Creek, CA 925-935-2094 Martinez, CA 925.229-3337 &-Mr. &. Mro. Brad Turner 17-Jerry Smith & Kathleen Roe 390 Ramona Road 3460 Sutcliffe Court Portola Valley, CA 650-851.9425 Walnut Creek, CA 925-944-0567 9-Mr. & Mro. Lee Gerke 16-Mr. & Mro. Steve Borcich 1707 Farm Bureau Road 545 Morninghome Read Concord, CA 925-687-5783 Danv€lle, CA 925-362-4949 We look forward to adding your name to our list of very oatlofied cuotomerel LANDSCAPE DEVELOPMENT 1674 Farre,Bureau Ind. Concord, Co.94519 Tel (925) 944-5263 Fox (925) 687.1952 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Sept 17,2002 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". MUG 2 9 2,0012 AMOUNT: $50,000 COUNTY COUNSEL CLAIMANT: Brendi Rodriguez MARTINEZ CALIF. ATTORNEY: Lina Lobaton DATE RECEIVED: Arg 28,2002 ADDRESS: 241 William Way BY DELIVERY TO CLERK ON: Aug 28. 2002 Pittsburg, CA 94565 BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWE ,C,le Dated: Aug 29, 2002 By: DeputyH. FROM: County Counsel TO: Clerk of the Board of Supervisor (vThis claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ` By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. O Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. µItLi, 1/or; '4 DatedJ� } �; ; . JOHN SWEETEN, CLERK, By f s -`„ , Deputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age '18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant addressed to the claimant as shown above. i 1 f SWEETEN, CLERK ByDated. JOHN v w Deputy Clerk f 241 William Way,Pittsburg,California 94565 Tel.(425)432$241 Email: bralobston-,vahooxom August 26, 2002 RECEIVED The Clerk of the Board of Supervisors AUG 2 8 200 Centra Costa County 651 Pine Street CLERK BOARD OF SUPERVISORS Martinez, CA 94553 _and- CONTRA COSTA CO. Ms. Penny Bailey, Liability Claims Adjuster Contra Costa County County Administrator 2530 Arnold Drive, Suite 140 Martinez, CA 94553 Subject Claimant: Brendi Rodriguez Claim No.: 50665 Dear Honorable Clerk and Ms. Bailey: The undersigned hereby makes claim in behalf of claimant Brendi Rodriguez against the County of Contra Costa in the sum of $50,000.00, and in support of this claim represents as follows: Nature and Cause ofAccident That on Friday, May 24, 2002, at about 12:40 p.m., claimant was driving in the carpool lane from Pittsburg towards Hwy 4 West almost along side with the 1999 GMC white van driven by James L. Remick who was on the third lane from claimant's lane. Both claimant and Mr. Remick were driving at parallel legal speed limit starting from the Bailey Exit up to the accident location. Just after the curve from Bay Point Exit, claimant saw a two-car collision ahead and signalled and looked to his right shoulder to prepare to make a lane change. Before claimant could make the lane change,however,he suddenly noticed Mr. Remick ahnost in front of him suddenly driving at a very slow speed of approximately 5-10 mph. At that point,there was no clear chance and opportunity for claimant to totally avoid Mr. Remick's vehicle. Still hoping, however,to avoid Mr. RemicVs vehicle, claimant braked hard, but was unable to stop in time. Consequently, the left front of claimant's Ford Explorer collided into the right rear of Mr. Remick's van. The CHP were summoned to the scene of accident and.concluded(as per attached Police Report No. 5-298)that Mr. James Remick caused the collision by being in violation of Vehicle Code Section 22107 VC for unsafe turning movement[Exhibit .1]. Claim No. 50665 -- Brendi Rodriguez, Claimant Page 2 Resultant Property Damage The impact caused claimant's left front tire to fly several meters away and claimant's Ford Explorer sustained major damage and was declared a total loss by claimant's insurance carrier. [Exhibit 21. Resultant Physical Injuries The collision caused physical injuries to the claimant who suffered immediate blurred vision, severe pain in back, neck, head, arms, and lacerations in both hands. Due to the extent of claimant's injuries,he was transported by the American Medical Response Team to John Muir Medical Center in Walnut Creek for emergency care. He was attended by 4 physicians and was diagnosed with acute cervical and thoracic contusion[Exhibit 31 Claimant was advised to stay in bed and refrain from doing any physical activity for at least one week.. A friend from Santa Rosa carne to pick up and bring claimant home. Claimant spent the subsequent week literally in bed and was unable to perform the basic normal activities for daily living. He suffered quietly with Tylenol, Motrin, cold and hot compress, neck and wrist braces, and waited for friends to bring food and supplies. On June 3, 2002, claimant went to Kaiser Santa Rosa and the attending physician did not allow him to return to work for another week. Due to severe pain and discomfort on his upper extremities specifically his left wrist and arm, claimant was further restricted from any lifting activity on his left arm to no more than 10 lbs. and was advised to avoid any repetitive use of his left arm. [Exhibit 4]. Claimant was told to continue taking Motrin and Tylenol and apply Bengay and use the arm brace or tourniquet to alleviate the pain on his left wrist and arm.. The same advise was reaffirmed by the attending physician during claimant's July 7, 2002 visit to Kaiser Santa Rosa[Exhibit S]. Prior to the accident of May 24th, claimant was able to lift, carry; push, and pull tools, materials, and equipments of his trade weighing from 75 lbs. to 120 lbs. at any given time. After the accident, claimant can no longer perform his normal work activities without experiencing extreme pain and discomfort. Such physical agony is more pronounced at night time and continues to be a real traumatic existence for claimant until this time. Dr. Michael Bellin, D.C. confirnied that claimant is suffering from cervical thoracic and spinal strain with associated headaches)and the wrist sprain/strain has caused 75% loss of strength in claimant's left wrist with a lot of associated pain and weakness[.exhibit dJ Dr. Bellin believes that claimant's job as a carpenter will slow down and hamper his ability to heal quickly and completely and strongly recommends that claimant should refrain from actively using his left arm and wrist during the treatment period for a more pronounced recovery. Names and Addresses of Attending Physicians John Muir Medical Center - Dr. Ron Cooper Walnut Creek, CA 94598 Dr. Jacob Epstein Dr. Thomas Tighe Dr. Barry Engelstad Claire No. 50665 — Brendi Rodriguez, Claimant Page 3 Kaiser Permanente.Hospital Dr. Victor Cucina Family Medicine Service, Santa Rosa, CA Bellin Chiropractic Dr. Michael Bellin 3700 Delta Fair Blvd. Suite L Antioch, CA 94509 Resultant Lass of Wages and Other Income Claimant is a dry-wall carpenter and sheet rock operator and works an average of 40-55 hours per work week. His pay stubs reflects his actual pay rate at $31.61 per regular hourly rate and$48.58 overtime hourly rate[Exhibit 7]. Claimant was scheduled to work on June 1, 2002;however,due to Kaiser's unable-to-work- advise for another week, claimant reported to work instead on June 11, 2002. As shown in H.L. Heggst d's Employee Payroll Detail, claimant's injury has taken its adverse effect on his work- hours. On the pay dates ending 6/28, 7/5, 7/12, 7/19, 7/26, 8/02, claimant was unable to perform the normal work hours and overtime hours thus depriving him of actual income equivalent to approximately 30 regular hours and 60 overtime hours[.Exhibit 81. Claimant's inability to perform his normal work load is highly noticeable and a constant subject of conversation among his peers and supervisors. On several occasions,he has considered taking time off to rest his disability, however;the need to provide for his family based on his usual regular income, prevails. On weekends and/or vacations, claimant performs framing and sheet rock installation projects as additional income for his family. At the time of accident, claimant was spending his vacation doing framing and sheet rock installation job for The Happy Feet Family Day Care in Antioch, California [Exhibit 91. The project started on May 22 and was scheduled for completion on May 30, 2002. However, due to injuries sustained from the accident, claimant had to subcontract the remaining work so as not to lose face with his client. Instead of hoping to earn$7,500, claimant ended with only$2000. On August 19, 2002, claimant complained of headache and pain on his upper extremities and wrist. Dr. Michael Bellin strongly advised claimant to immediately refrain from doing his normal physical work activities to allow healing to the injury. As such, Dr. Bellin certified a one-month disability for claimant commencing August 20th to September 22, 2002 and believes that claimant's estimated treatment time will last from 3 to 6 months[Exhibit 10]. This disability is another loss of actual salary and other income for claimant who does not get paid without working. Claim Na. 501665 -- Brendi Rodriguez, Claimant Page 4 Summary of Actual expenses and Lass of Income CLAM DETAILS Bine+ CA=P / t •', Alm64 It MEDICAL EXPENSES $3,251.89 Co-pay/Kaiser for John Muir/M#Diablo Hospital E/Care $11,601.05 $580.45 11 Co-pay/Kaiser for John Muir/Mt Diablo Physicians Grp 1,542.00 405.44 12 Co Pay/Kaiser for 6/03 and 6/07 visits plus Motrin — 38.00 13 BioFreeze 8/20 Dr Michael Bellin 28.00 28.00 14 Est.Treatment Fees Dr.Michael Bellin not covered by Kaiser — 2,200.00 6 MILEAGE AND TRANSPORTATION 1,253.10 To/From Pittsburg/Santa Rosa Kaiser on 6/3 and 7/7 89.60 (I 80m round tripr-2 visits x$0.32/m) American Medical Response(Ambulance) 1,163.80 1,163.80 15 PROPERTY DAMAGE(Insurance Deductible) 500.00 500.00 509.00 IHSS OF INCOME 19,864.30 Happy Feet Dav Care(Aborted Job) 7.500.00 5,500.00 9 Heggstad 6/1 -6/10( 80 Reg hrs x$31.61/hr) .2,528.80 Nates on #8 Heggstad 6/1 -6/10(20 OT hrs 1$48.58/hr) 971.60 Notes on #8 Heggstad unavailed Reg/0T hrs from 6/28 to 8/02 pay periods Notes on averaged at(30 Reg hrs x$31.61/hr)and 948.30 #8 (60 OT hrs x $48.58/hr) 2914.80 Heggstad No Pay Disability 8/20-9/22=4 inks averaged at 10 (40 Reg hi s/,,vk-X 4 w s)and(10 OT hrs/xvk x 4-,vks) Regular hrs -, 5,057.60 OThrs - 1,943.20 Total Actual ftpenses esxd Loss of Income 4,24314.95' $24,869.59 Summary Justification for Claim The accident resulted to a hard tissue injury to claimant which significantly and adversely affected his ability to perform his normal occupation and trade at least for the next six months. The appurtenant pain and suffering resulting from this injury should be accordingly justified and compensated. Thus, claimant demands a total claim for his injuries covering actual medical costs, out-of-pocket expenses, loss of income, and pain and suffering in the amount of$50,000.00. If you have any question,please feel free to call me at(925)432-8141. I look forward to hear from your offices soon. Sincerely, I:ma L,obaton Attorney-in-Fact for Brendi Rodriguez Claim No. 50665 -- Brendi Rodriguez, Claimant Page S Exhibits Attached Exhibit 1 Traffic Collision Report 5-298 2 Kemper Insurance Property Settlement Statements 3 John Muir/Mount Diablo Medical Report 4 Kaiser Permanente June 3, 2002 Visit 5 Kaiser Permanente July 7,2002 Visit 6 Bellin Chiropractic Diagnosis/Report 7 H.L. Heggstad Pay Stubs 8 H.L. Heggstad Employee Payroll Detail 9 Happy Feet Family Child Care Contract 10 Bellin Chiropractic Disability Certification 11 John Muir/Mt Diablo Hospital Emergency Care Billing Statement 12 John Muir/Mt Diable Physicians Group Billing Statements 13 Kaiser Permanente Copayment statement 14 Heifetz/Bellin Chiropractic Bio Freeze Receipt 15 American Medical Response Statement SPECIAL POWER OF ATTORNEY KNOW ALL MEN BY THESE PRESENTS. I, BRENDI RODRIGUEZ, of legal age, and a resident of 1120 East Leland Road Apt. ##141, Pittsburg, California 94565, depose and state: 1. That I hereby appoint, designate, and authorize Ms. Aquilina J. Lobaton as my Attorney-in- Fact to act in my behalf pertaining to my insurance claim.with Contra Costa County per Claim No. 50665; 2. That as my Attorney-in-Fact, Ms. Lobaton has full and complete authority to make representations, discuss, , negotiate, make and accept settlement offers and receive final settlement payment resulting from my insurance claim with Contra Costa County, and 3. That Ms. Lobaton is further fully authorized to make full representations in my behalf in the course of obtaining all the necessary information and documents with any party relating to my accident on May 24, 2002. Done this 27th day of July 2002 in Pittsburg, California. BRENDI RODRIGI.IEZ7� I Claimant City of Pittsburg ) Contra Costa County ) S.S. BEFORE ME, appeared Brendi Rodriguez, (CDL#D2189966)who acknowledged that he executed the above Special Power of Attorney in favor of Aquilina Lobaton, of his own free will and volition. Signed this Al- day of August 2002. MARCiA A ISLAS + Commission#1349343 � Notary Public-Cal tr mia 3: z Contra Costa County My Comm:!Jf Iran Apr 29,2006 .�At ' 02 yr (,Hp ass pa a-4(fKay.-&97) OPI 442 $PLI+:LLL CONDITi�"#3.. x M"a atw cm A)DICLAL DISTRICT LOCAL REP(R'7## lowno moanIAarsRaluAa wlrt� GifUtaTr REP{,tRTING DI$TRiOT 7a3 - COLLISION ACG RED ON MO. DAY YEAR TIME D24M NCIC. OFFICER m p M!LEPO$T INFORAM.TIAN DAY OF WEEK TOW AWAY PHOTOGRAPHS$Y: (. L) _ FEETA"ab. OF S W IOrb'.I' 9 YES (D NO QAT INTERSECTION MTN STATE HWI REL 4R: PEETAAWSi Oor JA= YES El NO - �ARTY DRIVERSLICENS€Nt)M$ER E7ATE CA CkASS SxFETY VEHf.YEAR MA!AMOOELLICCOLLOR LICENSE MA*" STATE EDU!P. / o#ISA NAME rFNRsr."toD a LAST? 'SSC 1 OWNER's NAME � SAME AS DRIVER r>' 3. STREET ADDRESS _ - (—( ;Z.3,605- Jam,.;' cqQ&" / .�- OWNERS ADDRESS j SAME AS DRIVER �AR#tO CtTYWATMIP 4RICU DISPOSMONofVEHICLEONORDERSOF: VQOFFICERDRIVER OTHER arcr- SEXM EYES HEKOH'T Yel:IC.tir S!RTHDATE PACE :113i }�,r► ,fes �+y Mo. +Dry ! r .✓ _V /� f.I PRIOR MECKMOCAL DEFECTS. tk APPi4FREH� REM TO NARRATIVE 31NO HOME PHONE PPHONE �'y y'� $USMESS PHONE VEHICLE IDENTIP"'ICON!N LI AM '.._1 7 I a f�o�+r"�o -3 CHP un ONLY DESCRiSE VEHICLE OAMAtM $KAM If DAMAGED AMA vv INSURANCE CARRIER FOCMCY tiJC.tSEHt rem LINK. ®NONE n MINOR ,l 01 ' MOD. MAJOR Ej ROLL-OVER DNR OF TRAVEL,ON STREET OR HtGHV1AY SPEW L�MIIT � DOT 4.�f1 — _J CAL.T _.„-..,—.,____,,,_„TCP"C ---._ _ ---_ ARTY DRIVER'S LK&4E NHL"✓W STATE CLASS SAFETY V'EH.YEAR AKA)EL)COLOR LMENSE Hume" STATE EAUIP. z RI /999_G~ G_ _ __ G.;L ?.l'--- -C4w NAME IFJPS'r,U000.E,LAST} A 6 S L � . SAME A DRIVER i "�'a�1 STREET ADDRESS A �K+++�+'S J 9Go 'mal't 46 . c+jAAwTR" ��DDRESS SAME AS DRIVER x##tp CITYVSTATSTIP ✓p p(W iI.( +L TY+A.ai NICID DISPOSITION OF VEHICLE ON ORDERS OF: ED OFFICER Z]DRIVER OTHER -ICY S€X HAIR EYES HIEIGNDT WE'D T BIRTHDATE RAC.£ � L #} �W 6eJ &t.j b-00 160 C 9'� 9Db� � PR!oRMEGikN4Cy DEP1Or$: NONE APPARET2T R RTONIRRATPIE � H If PHONE GLIGOIESSPHONE VEHICLE IDENTIFICATION NUVMR: 67d,031.3—tY ^1-) CNP USE ONLY DESCRIBE VEN'ME.DAA"GE SHADE IN DAMAGED AREA INSURANCE CARRIER POUCY NNA$ER VEHICLI TYPE LINK NONE MINOR �L.F LJi I MOD. MAJOR ROLL-MRv'4�y DIR OF TRAVEL ON$TREET EED HIGHWAY SPL!AT �"" CA DOT S4e- CAL•T TCPA SC.___ _ -- - RTY DRIVER'S LICENSE NLUA$ERSTkTE CLASS SAFETY VEH.YEAR OR LICENSE NIAASER STATE NDR NAME(FU?ST.AWOLE.IASL) W OWNER'S NAME ® SAME AS DRIVER 4� oF5 STREET ADDRESS .. . k I OWNER'S ADORES$ SAME AS DRIVER 100 CITY1$TATE21P DISPOSITION OF VEHICLE ON ORDERS OF: 0 OFFICER DRIVER D OTHER ''' SEX HAIR EYES HEH3HT - WEIGHT BUtTHiD#eS>< RAGE M ( Mo. Day Year - �' 2I PRIOR MECHANICAL DEFECTS: NUKE APPAf{EtDF R 'iR TCONARRATh£ 'JA HOME PHONE $U$t,*IESS PHONE VEHICLE IDENTIFICATION NUMBER: ,. I CH r USE ONLY DESGRIOE VE44 CLE DAMAGE SHADE N DAM+GW AREA j VEHfCLE TYPE 13 E] [:] •,�.-.—..�..'.- tIk# C _j .E3 S�_j L�[ zN$uRANCE CARRIER PDLICv NCIMBER t3NK. NONE MINOR MOD. l�3 MAJOR[]ROLL-OVER CHR OF TRAVEL ION STREET OR HIOHWAr... SPEED Lima CA�_.T.. - _ DOT ! CAL-T _ TCPPSC LAR€R'$NAME OiSPATCH NOTIFIED R IER'lArme DATEAEVo4o pr/ YES NCI NIA I STATE OF C4L IFORNIA TRAFFIC COLLISION CODING CHP 555 P e 2 Rev.8.97 CPI 042 N" raga.tie,,of f SAT[OP COLLtMON(00 CLAY YEAM TIME 12 001 Ncc i ORfCCER C.D. NUMlIER _ - - a OI A'S N"ME - rfiMNER'S ADWSS NOTWIED i 4 ~' PROPERTY WA YES DAMAGE DESCRIPTION Of DAVAGE SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE OCCUPANTS L-AIR SAG DEPLOYED M I C BICYCLE-HELMET A.N kN VEHICLE M-AIR SAG NOT DEPLOYED 0-NOT EJECTED A S-UNKNOVAI N-OTHER DRIVER - I-FULLY EJECTED C-LAP BELT USED P-NOT R€OUIRED V-NO 2-PARTIALLY EJECTED D-LAP BELT NOT USED W•YES 3-UNKNOWN 1 2 3 1-DRIVER E-SHOULDER HARNESS USED 2 TO&-PASSENG€RS F-SHOULDER HARNESS NOT USED CHILD RESTRAINT PASSENGER 4 S d 7-STATION WANG NN REAR G-LAPISHOULDER 14AAMESS USED Q-INVEHICLE ED x-NO 8-REAR OCG.TRK.OR VAN H-LAP/SHOULDER HARNESS NOT USED R-IN VEHICLE NOT USED Y-YES 3-POSITION UNKNOWN J-PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN 7 K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE D-OTHER U-NONE IN VEHICLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(`)SHOULD BE EXPLAINED IN THE NARRA'T'IVE. PRIMARY COLLISION FACTOR TRAFflC CONTROL DEVICES 2 TYPE OF VEHICLE $ 3 MOVEMENT PRECEDING .NST NUMBER OF PARTY AT FAULT COLLISION IA w s c Ywuran rm€5 A CONTROLS FUNCTIONING PASSENGER CAR I STATION WAGON A STOPPED mo- 2 ;?.a)o?Kt. YEs 8 CONTROLS NOT FUNCTIONING* PASSENG CAR WITRANLER 8 PROCEEDINGS STRAIGHT 13 OTHER IMPROPER DRIVING. C CONTROLS OBSCURED C MOT CLE I SCOO R C RAN OFF ROAD 0 NO CONTROLS PRESENT I FACTOR* D PIC OR PANEL K D MAKIN RIGHT TURN ;C OTHER THAN DRIVER- TYPE Of CXX3 usm E PI i PANEL UCK M TRAILER E MAKING LEFT TURN D UNKNOWN' A HEAD-ON F RUCK OR CK TRACTOR F MAKING U TURN E FELLASLEEP' SN7E SWIPE TRUCK TRACTOR W/TRLR. G BACKING C REAR END H SCH BUS }# SLOWING 1 STOPPING WEATHER I TO 2 NTEIINS D BROADSIDE I O R BUS I PASSING OTHER VEHICLE A CLEAR E HIT OBJECT J RGENCY vE LE J CMAtNGING LAN€s 8 CLOUDY F OVERTURNED HIGHWAY C EDUIPME K PARKING MANEUVER C RAINING G VEHICLE N PEDESTRIAN SIGYCLE L ENTERING TRAFFIC D SNOWING H OTHER'. M OTHE HICLE M OTHER WWE n2!!t* E FOG I VISOLITY FT, N PED m N XING INTO OPPOSING LANE F OTHER'. MOTOR VEHICLE INVOLVED WITH 0 M ED C#PARKED 44IN A NON-COLLISION P MERGING LIGMT'ING B PEDESTRIAN TRAVELING WRONG WAY A OAYLICiMT C OTHER MOTOR VEHICLE # Z � OTHEiE ASSOCIATED FACTOP4s) R OTHER' 8 DUSK=DAWN D MOTOR VEHICLE ON OTHER ROADWAY IwNANK i TO 217€IYIS} a C DARK-STREET LIGHTS E PARKED MOTOR VEHICLE A w ucnowYgtArlcsr erctn YES [ DARK-NO STREET LIGHTS F TRAIN L- E DARK-STREET LIGHTS NOT G BICYCLE VC WrON VNXAY 0K cma $ FUNCTICNIING* ANIMAL: 140 RUG ROADWAY SURFACE H C Ycsssmrvwursae ar€n n, 1 2 3 �PHYSICALL A DRY ) FIXED OBJECT: (MARK i TO 21T At57 8 W€T A HAD NOT BEEN ORINKlltt; C SN11`NW-ICY *f OTHER OBJECT: E VISION oescuREINENT: EI HBO-UNDER INFLUF14CE SLIPPERY MUDDY OILY ETC F INATTENTION": C HSD-NOT UNDER INFLUENCE' ROADWAY CONDITIOWS) G STOP&GLS TRAFFIC D HBO-wApAIRMENT UNKNOW+I* (MARK I TO 2ITEMS) PEDEMtANS ACTIONS H ENTERING N LEAVINGS RAMP E UNDER DRUG INFLUENCE. A HOLES.DEEP RUT' A NO PEDESTRIANS INVOLVED X I PREVIOUS COLLISION I IF IMPAIRMENT-PHYSICAI-* B LOOSE MATERIAL ON ROADWAY' 8 CROSSING IN CROSSWALK I I J UNFAMILIAR VM ROAD G IMPAIRWNT NOT IWOINN C OBSTRUCTION ON ROADWAY" AT INTERSECTION I K DEFECTIVE Vem3 EOUIP': CITED tI NOT APPLICABLE 0 CONSTRUCTION-'REPAIR ZONE C CROSSING IN CROSSWALK-NOT yEg ! I SLEEPY d FATIG D E REDUCED ROADWAY WEDTH AT INTERSECTION NN5 SPECIAL INFORMATION F FLOODED- D CROSSING-NOT N CROSSWALK I L UNINVOLVED VEHICLE I I IA-HAZARDOUS MATERIAL ;G OTHER E IN ROAD-INCLUDES SMOULDER M OTHER` H NO UNUSUAL CONDITIONS I IF NOT IN ROAD N NONE APPARENT G APPROACHING V LEAVING SCHOOL BUS 1 10 RUNAWAY VEHICLE 0146 L1 t-r J ETCH MISCELLANEOUS M1i14CAn DOOM �� DOT - 1 01 _CR CRA NR J� s3 L,I 19C Cl{! o. _ far 014 DA PD/so CT OTH�U Ess R + .�4—`-# C5P 9U 13" STAVE L1t;CALWORP" CHP INNJURED 1 WITNESS l PASStNGiRS 1§2 04 Pap 7ATE Of - ohc CLLY Y�FAR'} TNAE Q l MCiC t 0"00"I.C'-{}gWAS(r-'X- RNAAAMM14"R 05 aq 407- 12�67 1, 931-0 mai ►Aaa�iF3ElG EXTENT OF INJURY("X"ONE) INJUREDGNE)AOEBit ortm OTNIER VJBJai.t CDMPL�IINT dRtWER ►Alli• ItT OTJi87ilf Ot, NFNACY PAM UJURY WtAWY OF PAIN SAME 1 D.D.B.I ADDRESS _ A.' A-1• - TELIPHOWE NJURED OKYS TRANSPORTlED BY: TAKEN TO: � - t fWZ Al LAtVCi 7 lJC r4 ldi7f5C . { ESCRIBE 10"IEi ,+1 V!I!A..aJ Atnj of M M 1)"- eCL4eC4 Vrj 8Ur;1 1l lei VICTIM Of V*LENT CRBAE NOTFIED AME TELEPHONE 1 D.O.i.J ADDRESS � f J -I 7�o ? i aIQ >RxC1St 9�J.Z �.�y 5� +tJUR'ED ONLY)TRANSPORTED BY: TAKEN Til: E8CR1t�IN.OJRtEB - ` VIGTiM OF VIO"o"ME NfJTIfIED T7 Q]TflT #ME 1 D.O.L t ADDREii TELEPHONE dJURED ONLY)TRANSCWSR'fD aY: TAKEN TO: 'SCRIBE INJURIES ❑=TIM OF VKXENT MVW 407" J �# ❑ ❑ ❑ ❑ Q ❑ Q ❑ Q Q WE 10.O.a./ADDRESS _TELEPHONE NJURED ONLY)TRANSPORTED BY: TAKEN TO: :SCRtt9E RWRIGS VICTIM w,V".ENT CSS.Now= WE 10.O.S.I ABOREM TELEPHONE UURED ONLY)TRA14SPORM BY, - TAKEN TO: :SCRIBE INJURIES t VICTIM OF VIOLENT CpfME NOTIFIED �# Q Q ® ❑ ❑ Q ❑ Q Q Q ,ME 10.D.S.I ADDRESS TELEPHONE UURED CWLYI TRANSPORTED BY: TAKEN TO: :SCRIBE iMNRIEs VJCTIM OF VIOLENT OR"NOTIFIED tEPARP"NAME I.D.NUMBER MO. DAY YEA RVVWWW"NAME "0. DAY YEAR V 12 6j DS A4 t, T - I FACTUAL DIAGRAM - DAM ar rxaecmm arcs. DAY reucr twrtt n sae: crams�.D. `•i�► �# . A"ire wrS MM APMOXWTI AM Marr V WALE tff""SUM W.AU* � , &§-OM )"m1AJ mom Jar oc tsx s,fr rd $0646'Y4 Ak4 !2+ / 4� I-JI GW Ass $6. a4e!40-re Life � As,�►t�`,srtGyutAr�. PARED tY ,J i.D.NU►IQER M6 DAY YtAA , 7l M1FtC5 mma MO. DAY YW } . ,. OSP a+wr3 STATE OF CALIFORNIA NARRATIVEISUPPLEMENTAL PACE' `of7 DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 05124/02 1258 9320 12688 5-298 01 Facts 02 Noti ration 03 04 A collision call with unknown details was dispatched to Officer Warner#13548 at 1256 hours. After she had arrived at the scene she requested another unit to assist and I responded from Port Chicago 05 Highway at Riverside Rd. and arrived at the scene at approximately 1312 hours. After my arrival, it 06 was determined that this collision had occurred after the original collision(5-294)that Officer Warner investigated. 07 08 Times, 'speeds and measurements were approximate. Measurements were made by vehicle odometer and estimation. 09 10 Seene 11 SR-4 w/b w/of Willow Pass Rd. (Bay Point)is a 5 lane freeway and a posted 65 mph zone. Prior to 12 this collision there had been another collision with an involved vehicle in the center median and partially blocking the#1 lane and another involved vehicle on the right shoulder w/of it. For further 13 details,refer to the factual diagram. 14 Parties 15 16 P-1 (Rodriguez)was located standing on the right shoulder of SR-4 w/b w/of Willow Pass Rd. (Bay Point). P-I was identified by his CA drivers license and his own statements as the driver of V-1. 17 ,f 8 V-1 had been driven to the right shoulder by P-I after the collision and prior to CHP arrival. V-I had moderate damage to its left front bumper,grill,fender and its left front wheel assembly was missing. 19 20 P-2 (Remick)was located standing in the lanes directing traffic around vehicle debris upon my arrival on SR-4 w/b w/of Willow Pass Rd. (Bay Point). He was contacted on the right shoulder and he 21- identified by his CA drivers license and his own statements as the driver of V-2. 22 V-Zhad been moved to the center median prior to CHP arrival by P-2 and after my arrival to the right 23 shoulder. V Zhad minor damage to its left rear corner which included the bumper,door and body. 24 Its left rear fender was damaged as well as the exhaust pipe. 25 25 27 28 PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE Mola, J. 12588 05127102 y STATE OF CALIFORNIA + NARRA"VEISUPP'LEMENTAL PAGE4of7- DATR OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER . 05124102 1258 9320 12688 r 5-298 01 Statements 02 / t scene. - related he was driving V-1 P-1 {.Rodriguez} was Contac d at hes n P t � , w/b SR-4 wfof Willow 03 Pass Rd. (Bay Point), in a#1 lane, at an unknown speed. P-1 observed V-2 suddenly pull out in 04 front of him from the le . He braked V-I hard but was unable to stop in time and the left front of V-I collided into the right rear of V-2. P-I was able to steer V-1 to the right shoulder and stop. 05 Yd 06 P-2 (Remick) was contacted at the scene. P-2 related he,•was driving;V-2, w/b SR-4 w/of Willow Pass Rd. (Bay Point)at approximately 65 mph,in the#1 lane. P-2 observed the previous collision 07 ahead of him so he began to brake V-2 and steer left towards the center median. P-2 observed V-1 08 approaching him from behind in the#2 lane at a fast rate. V-I then collided into the rear of V-2 after which, P-2 drove V-2 into the center median and stopped. 09 10 W-I (Levine)was contacted at the scene. W-1 related she had stopped her vehicle in the center medianof SR-4 w/b w/of Willow.Pass Rd. (flay Point)to assist the parties of the previous collision. 11 She observed V-2 stop in the center median in front of her. V-2 then pulled out into the#1 lane in an 12 attempt to get to the right shoulder as V-I approached at approximately 70 mph in the#1 lane. V-I braked hard but was unable to stop in time and the left front of V-1 collided into the right rear of V-2. ` 13 14 Opinions and Conclusions 15 Summarty 16 P-1 (Rodriquez) was driving V-1, w/b SR-4 w/of Willow Pass Rd. (Bay Point), in the#1 lane,at 17 approximately 65 mph, approaching the previous collision scene. P-2 (Remick)was driving V-2, 4.18 which was stopped in the center median of SR-4 w/b w/of Willow Pass Rd. (Bay Point),w/of the previous collision scene. P-2 accelerated V-2 while steering right entering the#1 lane in front of V-1. 19 P-1 braked V-I but was unable to stop in time and the left front of V-I collided into the right rear of 20 V-2. After the collision, P-1 steered V-1 to the right shoulder and stopped and P-2 steered V-2 to the center median and stopped. 21 22 Area ofmQact (.4011 23 A01 was approximately 3468 feet w/of the a/edge of Willow Pass Rd. (Bay Point)u/c and 24 approximately 4 feet n/of the s/roadway edge of R-4 w/b. This was based on statements and vehicle damage... 25 26 27 28 PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE Mala, J. 12688 05/27/02 i - r STATE UF CALIFORNIA NAt Rk'MVEISUPP'1r.E11 ENTAL PAGE/'of of C?R,TI:OF INCIDENT TIME NM NUMBER OFFICER J.D. NUMBER 05124102 1258 9320 12688 5-298 01 Cause 02 P-2 (Remick)caused this collision by being in violation of Vehicle Code section 22107VC (unsafe 03 turning movement). P-1 (Rodriquez)was an associated factor in this collision by driving at an unsafe 04 speed for conditions(previous collision scene/partially blacked lane)in violation of 22350VC. This was based on statements,vehicle damage and the nature of this collision. 05 IR 06 ecoMmerndations 07 Mone. 08 09 10 Y 1 1 12 13 14 15 16 17 P8 19 20 21 22 23 24 25 26 21 28 PREPARED BY I.D.NUMBER DATE REVINVE"NME MATE Mola, J. 12688 05/27102 t tvtarycet valuation Report Wage 2 of 25 Claim reference : 786163124 Return to top Report Reference Number:29365 75 Vehicle Valuation Summary 1995 Ford Explorer 4X4 4 Doer Sport Utility Vehicle - Santa Rosa, CA Below are the components included in this local market valuation: Component Code Value The base value is the local market value Base Value $8,531.00 of a vehicle of the same year,make,and XLT +266.66 model as the lass vehicle,including Odometer 107,311 -342,00 average mileage,and all standard and predominant equipment. Equipment Transmission As such,the vehicle equipment listing Automatic Transmission AT +291.00 reflects proper deductions for all standard 4 Wheel Drive 4W Standard Included or predominant equipment which is not Power present on the lass vehicle. Power Steering PS Standard Included In cases where a standard or predominant Power Brakes PB Standard Included option is superseded by a replacement or Power Windows PW +58-00 upgrade,a corresponding addition will Power Lucks PL +58,00 appear for the option which supersedes Power Driver Seat SP +58.00 the standard/predominant option. Power Passenger Seat PC +58.00 Decor/Convenience Air Conditioning AC +349.00 Rear Defogger RD +58.00 Cruise Control CC +58.00 Leather Seats LS +233.00 Bucket Seats BS Standard Included Dual Mirrors DM Standard Included Fog Lamps FL +29.00 Keyless Entry KE +87.00 Radio AM Radio AM Standard Included FM Radio FM Standard Included Stereo ST Standard Included Cassette CA +58.00 Roof/Other Luggage/Roof Rack RR +29.00 Other Group I Tinted Glass TG Standard Included Running Boards/Side Steps BD +87.00 Anti-Lock Brakes(4) AB Standard Included Air Bag AG Standard Included Passenger Air Bag RG Standard Included Other Group 2 Intermittent Wipers IW Standard Included Dual Mirrors DM Standard Included file:HC:1TEMP1ema IP300 2002 OS 30 192039 00487.httnl 05/31/2002 Market Valuation Report Page 3 of 26 Local Market Value $9,900.00- Current Condition Adjustment +610.00 Additional Considerations +43.00 Actual Cash Value $10;553.00 Pre Tax Amount $ 10,553.00 Vehicular Sales Tax 7.50% +791.47 Sales tax reflects all applicable-state, county,and municipal taxes. Adjusted Vehicle Value $ 11,344.47 Oci r x.r file://C:1TEMP\emaiIP300 2002 05 30 192039 00487.html 05/31/2442 AUTO ATIO N FOR PAY OFF UCE��SE PLATE Nuf�lBiY VEHICLE IDENTIFICA PION NUMBER MAKE BODY`TYPE MO(3EL Y>;AR . DATE �.�j�. �"� at -TO e r-lfi 1 ( AL OWNER'S NAME) (� s� 1J 1 '(ADDRESS) The undersigned hereby authorizes and directs you to accept from (PAYOR'S NAME) of ti (ADDRESS) or order,the pay-off due you on my account in the amount ofand surrender to herr, or order,the properly endorsed Certificate of Ownership to the above described vehicle. (Cross out one that does not apply,) 2. The Insurance policy covering said vehicle,which I hereby assign to above payor. 2. To cancel the insurance policy covering said vehicle and apply the return premium deriving therefrom to my account. (Signed) X AUTHORIZATION FOR PAY OFF 7 .. t � = STATE OF CALIFORNIA ti ! K05020709D6 CERTIFICATE OF TITLE AUTOMOBILE YR ,. VEHICLE 10 NUMBER MODEL MAKE. PLATE NUM9ER 1F'MDU34X2SZ895141 1995 FORD 3NLR561 UNLADEN REGISTRATION L BODY TYPE MODEL AX WEIGHT FUEL TRANSFER DATE FEES PAID EXPIRATION DACE �tttt�i "t UT G NONE 09/20/2002yp t .SOD CLASS `YR Ma EQUIPMTtTRUST NUMBER ISSUE DATE i ° 1995 CX 2001 HU 07/17/02 �`#1 MOTORCYCLE ENGINE NUMBER ODOMETER DATE ODOMETER READING - '.. ; 07/13/2001 88807 MI RGIsTERccawNFRts; ACTUAL MILEAGE g RODRIGUEZ BRENDI A 1120 E LELAND RD APT 141 � PITTSBURG CA 94565 3 I certify under penalty of perjury under the laws of She State of California,that THE SIGNATURE($)BELOW RELEASES INTEREST IN THE VENiCLE, yy DAA- 9IM'ATURE OF REGISTERE5 OMP ' Irl#ft . tb. X s!. DATE SIGNA`URE OFR STEREO OWN a tt ` �t eGerai and State law requires that you state the mileage upon transfer of ownership.flallure to complete or pro jiding a t i ' false statement may resutt in fines and/or imprisonment, �tt The odometer now reads Im _.. ,(,.—L_.J--J (no tenths),miles and to the;lest of my knowledge reflects the actual mileage unless one of the following statements is checked. WARNING 11 Odometer reading is not the actual miieage. 0 weage exceeds the odometer mechanical limits. f certify cinder penalty of perjury under the laws of the State of California that the foregoing is.true and correct. r." �f# {7AY€ YNM4i€RGutt SE64EF 8KiryAYUMt31 $AYf Fp,VyS�Ep„gf8i!Y�i}�if3NASL'R€{$S X X gSyy;# ?�+BiTED NLi4}E tri Atr�M SiGtAKs F2N:A L-:fJMihHw f'RMiF D NAtd.E Gr IUCNF 8*i r.FOP A ro."SY fl IMf+CJR7'r�NT READ CAREFULLY Any change of Lienhoider(holder of security interest)must be reported to the Department of Motor Vehicles within d 10 days. UENHOLDERIS) KEMPER INSURANCE COMPANIES 2. X g Signature releases interest in vehicle.( mpany : PO B O X 526007 names must be countersigned) ,sr SACRAMENTO CA 95852 Release Date CA 8 r }'# 028976 REG.17AOJAEV.2198) 91 VEHICLE/VESSEL TRANSFER AND REASSIGNMENT FORM A Public Sarvice Agency INSTRUCTIO14S ON REVERSE SIDE ALL SIGNATURES MUST BE IN INK PHOTO COPIES NOT ACCEPTED cs - SECTION 1: VehICIelllessei[)escription CAI— IDENTIFICATION NUMBER � �YEAR MODEL MAKE LICENSE pLATEfGF MOTORCYCLE ENGINE-2,—T � SECTION 2. Rill of Sale :IIWe ' 1'� sell,transfer, and deliver the move vehicle/vessel (PRINT sII.I,:ER°s NAME(st) . .6Ito on �IfortheamountofL$ -- mj (PRINT BUYER'S NAMEtS)) MO DAY YR (SELLAE) E (lf this was a gift, indicate relationship: - _ -_ (e.g.,parents, spouse, friend, etc.) _CGIFT VALUE) SECTION 3: ',Odometer Disclosure Statement (Void if Mileage is,filtered or Erased) Federal and State Law requires that you state the mileage upon transfer of ownership. Failure to complete or providing a false statement may result in fines andlor imprisonment. ~ { ,n� no tenths riles, and to the best of m knowledge E The odometer now reads� D� } L��� 4 j� { � ' Y 9 0Eref iects the actual mileage unless one of the following statements is checked. WARNING—ODOMETER DISCREPANCY Odometer reading is NOT the actual mileage ❑ Mileage exceeds the odometer mechanical limits 1 Explain odometer discrepancy: –- SECTION 4: Buyer and Seller(MUST print his or her name,date and sign this section.) BUYER 1 acknowledge the odometer readin and the facts of the transfer. f certifyunder penalty of perjury under the laws of the State of California that the in ormation i have provided is trine and correct. ,PRINT NAME 1 SiGNA7URE DATE DL,iD OR DEALER 8 �I -- -- I i ? E ! 1 :31D h7A;eE tS;GNATUHE iDATE DL,1D.OR DEALER� TRi,TT NA, gtl ,�;NATU€;E DATE DL,ID OR DEALER# i X I ¢IMALIN—ADDRESS CITY — -- STATE ZIP DAYTIME PHONE# I i SELLER 1 certify under penalty of perjury ander the laws of the State of California that the information 1 have provided is true and correct. PRINTNAME _ C't1AT DATE LTL.FD OR DEALER B sj# �1PRiNTNAME SiGNATUR^ DATE DL.IrSOADEALERA v t✓' }PRINT NAME SIGNAT DA 3 E DL,(D OR DEALER" X a� f MAILING ADDRESS CITY JFTAZIP DAYTIME PHONE# 'SECTION 5: Power of Attorney E:i I/we f'l {,) appoint (PRINT NAME[S)) (PTiit T NAI9EJSj) as my attorney in fact,to complete all necessary documents,as needed,to transfer ownership as required by law. Signatu�rrwred by rso at ng Power at Attorney DATE,/ ° X - 7 w Signatu equired b pe€so Poi i t� r of Attorney DATE REG 262 JREV.812000) d _. _. �ff W.M STATEMENT OF ERROR A PLtbftc SjM-Agency OR ERASURE VEHICLE LICENSE PLATE DR VESSEL CF NO. `JEHICi. UI L IDENTIFICATION NUMBER MAKE OF VEHICLE OR VESSEL BUILDER The name appearing on or erased from line of the CERTIFICATE OF OWNERSHIP Issued for the above described vehiclelvessel was in error and has no bearing on the ownership of the-vehicle/vessel.The name signed or erased should not be a part of the ownership record. REASONS FOR ERROR ERASURE I certify under penalty of perjury under the laws of the State of California that the foregoing is true and correct. CATs SIGt4A ADDRESS x V4 C ITY, ST,AT DAYTIME TELEPHONE,NO. � 9S 29521 Fin rowIAEY.emsl F+r'eUUATION FOR VEHICLE LICENSE FEE REFUND CONSTRUCTIVE TOTAL LOSS OR LICENSE PPC Ta~rs MSEFI NON-REPAIRABLE VEHICLE VEHICLE 3I ENTIF0Tt—ON NUMBER MAKE The above described vehicle is a constructi OHN MUIRA MT.DIABLO Eme-rgenc Semic C-i- A E--T7- f, S Y S T E M y es 'anent Name: RODRIGUEZ, BRENDI Date of Birth: 11/12/1975 Int Number: 0763394 Sex: M _ ccount Number. 5555512666 FACE SHEET SOCIAL SECURITY NO, AGE - E TTED§Y 584-89-7247 26y ARIUL STATUS NANCiAL CLASS ATIENT TYPERRIVAL MODE ADMIT TIME T DATE 13:34 05/24102 I PATIENT ADDRESS.IINCL.APT.NO) - CITY OR TOWN STATE Zip CODE 12 365 MEADOW WAY#121 SANTA ROSA CA 05404 i ALTERNATE ADDRESS(LINE 1) - PATIENT TES#PHO WORK TELEPHONE T.PHONE 707280-2013 PATIENT EMPLOYMENT EMPLOYER MPLOYER PROBE OCCUPATION EULOYMENT STATUS 1 EMP_OYER ADDRESS - MP.STATE MP.Zfp GUARANTOR GUARANTOR NAME GUARANTOR ADDRESS BRENDI RODRIGUEZ 2365MEADOWWAY#121 SANTA ROSA,CA 95404 GUAR EMPLOY.STATUS GUAR-wap S N GUAXM59 PHONE UAR RELATION GUARANTOR OCCUPATION (707)280-2013 5UARANTOR EMPLOYER GUAR EMPLOYER PGUARANTOR EMPLOYER ADDRESS WALNUT CREEK,CA 94598 INSURANCE INSURED NAME INSURANCE COMPANY PHONE INSURANCE POLICY# NSURED SSN BRENDI RODRIGUEZ 10619590 584897247 INSURANCE COMPANY lNgUTANCE GROUP PHONE INSURANCE PLAN DESCRIPTION KAISER INSURANCE COMPANY ADDRESS GROUP INFORMATION PO BOX 12923 OAKLAND,CA 94612 NEXT OF KIN INFORNIN ION NEXT OF KIN#1 NEXT OF KIN RELATION 01 EXT OF KIN TELEPHONE#1 NEXT OF KIN XMR-ESt#i NEXT OF KIN CITY OR TOWN#S EXT OF KIN STATE#1 EXT OF KIN ZIP 91 NEXT OF KIN t2 EXT OF KIN RELATION#2 7KIN T£I PHONE#2 IN EXT OF KIN TELEPHONE 02(W) MEDICAL.INFORMATION REFERA NG PHYSIC{AN PRIVATE PHYSICIAN ATTENDING PHYSiC1AN NATURE OF ACCOEM: ACCIDENT TYPE: ACCIDENT DATE: ACCIDENT TIME >ATIMT REASON FOR VISIT M1TTiNG OX: Trauma IS rATwfTmAwEfADmSS PHONE:ISSN DATE nMEi AEG. FM PAT.ACCTyNO arr RODR IGUEZ SREND I 05/24/02 13.38 39 55555-12666 —TR 2365 MEAD6U WAY-t 121 (707)280-2013��� �� SEX MB arc - s84-�8? -"7247 MEMREc.Nc SANTA RC1a�A CA 9 5404 11/12/75 2L Y M U C}7b--33 '7 P DR u4Jma ADDftSS OR REIArVE REC+ $ CLO i3UARANTORNAirJtDbf1E55 PRONE SSN RE1JITt4N6H1a RODR IGUEZ DREND I (707)280-2013 x;84-8997247 SELF 2365 MEAD6U WAY #121 SANTA OSA CA 9540 ft'" NT NA IADORESS OCCUPAnON GUARANTDAEMPLOYER NAME/ADDRESS OCCUPATION WALNUT CREEK CA 94598 WALNUT CREEK CA 94598 CARAlE`sR r Pedal I GROUP!MUFF CLAIM S-m f-RErC plel T•-GROUP s : . MEp,t3RpEAS KAISER 10619590 oRmR KAISER 007001 TIME CARD COPY (800)464-4000 PHYS40" PRIMARY CARE PWSiCM ,. COOPER I ROtIAL,D E.' OT I TEME OF ACC. TYPE OF ACC)DVfr PL4M r NATURE OF ACCIDENT COMPLAwr r 0 M MFNT AAAWAL MODE MVA r. AMBULANCE �s,.: �, �yy. ■R. t-.`�v.i�. �} .}I F f.D •� a"st. �L�, iwf?f 'Y44ii kr OLD CHART URINE DIP PA 1 LAT CXA CSI+ E!Kr3 PORTABLE VM CHEM PANE. n4GER S=K AAN ORTHOWATICS PT)m OXYGEEt E»O OMN Levu PCILSE OX 01%MEAD M G ftLMHrl OVAL OTHERS: ABDOMEN WO COMM EiT SL000 4"WTURES AMEN Wr CONTRAST UA L"Ne G+$ URIFrETox Al* us: ##ALR PCR#i diEtO M E')t8POE3tt : pIG't'A'TXSNNo. CJ Adm@ 0 Oise Woo [3T'rsnstsr 0 Oscssssd ACONDTTION ESN OX. 0 Good ❑For 0 urEous 0 Critics! C]CTaARTOWPLET COMPUTER AFTEROARE ENSTRUGTEONS GIVEN* w ('3 vss 13 Ne sur 6btiTTi13C19E�rt8: ME READ AND PJ4TtENT1sYGIFUITUfiE >'kMYSrC1ANSIdNATtiRi itDSTARTUME's ?EEE38'EAND THE WE 1tJMUC77UN$ Page 1 of 6. John-Muir Medical tenter - Walnut- Creek , CA 9459 �.. Patient RODRIGUEZ,BRENDI DOB: 11112/1975 Age/Gender:26 M 5/24/2002 13:34 Trauma MR#:0763394 Acct#: 5555512666 Private Phys: ED Phys: Tam Tighe,MD CHIEF COMPLAINT: Trauma Enc.Type:Initial ACUITY: Urgent Physicians caring for patient: Tom Tighe,MD VITAL SIGNS InitialslDate/Time Temp(C) Rt. Pulse Resp Syst Diast Pos. 02 Sat Pain Scale 117 5/24/2002 5/24/2002 14:28 70 18 117 63 L 49 2 DMH 5/24/2002 17:26 63 18 117 79 St d DISPOSITION NURSING Discharge:Mode:ambulatory Discharged to:horde Discharge instructions given to:patient<DMH 05/24/02 17:26> IV discontinued with catheter intact.Sterile dressing applied to site.<DMH 05/24/02 15:44> Time patient discharged from the ED:Friday,May 24,2002 17:27<DMH 05/24/02 17:27> HISTORY OF PRESENT ILLNESS NOTE Dictated note< T 05/26/02 16:55> 1 st Dictation Number:3443416<TT 05/26/02 16:55> Notes: <Y 05/27/02 14:34:09> ** ************* REPORT NOT FINAL, UNTIL SIGNED **************** CHIEF COMPLAINT: Trauma activation. HISTORY OF PRESENT ILLNESS: Randy is a 26-year-old male who was a restrained driver of a Ford Explorer who was traveling at freeway speed when he was struck by another vehicle. 'There was extensive automobile damage to bath vehicles. There was no air bag deployment. The steering Printed by Virgil L.Pfautch,MEDRC on Monday,August 12,2002 1:16:06 PMComplete Chart RODRIGUEZ ,BRENDI MR. 0763394 26y DOB 11/12/1975 M 7 FIN 5555512666 Medical Chart Page 2 of 6 John 'Mur Medical Center - Walnut Creek , CA 94598 Patient:RODRIGUEZ,BRENDI DOB: 11/12/1975 Age/Gender:26 M 5/24/2002 13:34 Traurna MR#:€1763394 Acct#: 5555512666 " Private Phys: ED Phys: Tom Tighe,MD wheel was intact. There was no loss of consciousness although he seems somewhat confused in the field and dazed and subsequently paramedics were called to the scene and transported him here in full C spine precautions on a back board. He had stable vital signs en route without hypotension or tachycardia. He had no neurologic symptoms what so ever. He was complaining of pain in the thoracic spine and some neck tenderness as well. REVIEW OF SYSTEMS: Hedenies any chest pain or shortness of breath. He denies abdominal pain. Denies any tingling or numbness to the extremities or other injury. ALLERGIES: PENICILLIN. MEDICATIONS: Clindamycin. PAST MEDICAL HISTORY: He is undergoing root canal hence the Clindamycin. Last tetanus unknown. SOCIAL HISTORY: He does not smoke or drink, does not use any illicit drugs. He is married. PHYSICAL EXAMINATION: VITAL SIGNS: Temperature 36.9 orally. Pulse 66, blood pressure 138/95. Pulse oximetry on room air was 300%. Respirations 16 regular. GENERAL: He is alert and cooperative. Speech and mentation appropriate. He has a slight Spanish accent. HEENT: Head normocephalic, atraumatic mid face, teeth and tongue. Pupils equal, round, and reactive to light and accommodation. NECK: Tender in the mid C spine. He was left in the collar. He has upper Printed by Virgil L.Pfautch,MEDRC on Monday,August 12,2002 1:16:06 PMCompiete Chart RODRIGUEZ ,BRENDI MR 0763394 26y DOB 11/12/1975 M 7 l`IN 5555512666 Medical Chart Page 3 of 6 Jahn Muir Medical enter - Walnut Creek , CA 94598 Patient.RODRIGUEZ,BRENDI DOD: 11/12/1975 Age/Gentler: 26 M 5/24/2002 13:34 Trauma MR#:0763394 Acct#: 5555512666 Private Phys: ED Phys: Tom Tighe,MD T spine tenderness as well. CHEST/PELVIS: AP and lateral compression of the chest and pelvis nontender. LUNGS: Clear to auscultation. CARDIOVASCULAR: Regular, no murmur, gallop or rub. ABDOMEN: Scaphoid with active bowel sounds. Abdomen nontender, nondistended. EXTREMITIES: All extremities can be ranged completely. There is no obvious tenderness or discomfort. NEUROLOGIC: Cranial nerves II through XII are grossly intact. Muscle strength 5/5 times four. Deep tendon reflexes 2/4 symmetric. Finger to nose rapid alternating movements all within normal limits. Sensory to sharp, dull and light touch intact. Toes down going. BACK: Tender at the T1-T2 area. PROBLEM LIST: Acute neck and thoracic back pain. EMERGENCY ROOM COURSE: The patient had routine x-rays of the neck. Preliminary reading by myself was normal and this was confirmed by over view of the complete series by radiology. Portable chest x-ray showed normal cardiomediastinal silhouette. In the AP view there was no obvious injury to the back. There was no obvious Nemo or pneumothorax as well. Due to the possibility of loss of consciousness and somewhat dazed condition while he was in the field he had a CT scan of the head without contrast that was read by radiology as entirely normal. He was observed here in the emergency room. He was eventually seen by trauma surgeon, Dr. Ron Cooper. Disposition will be made from the emergency room by Dr. Cooper for possible admission for observation. TENTATIVE DIAGNOSIS: Acute cervical strain and thoracic contusion. PAT. NAME: RODRIGUEZ, BRENDI ADM. DATE: 05/24/2002 PHYS. : THOMAS TIGHE, DO MR#:076-33-94 DOB: 11/12/1975 Doc ID#: 303985Acct#: 5555512666 DD: 05/26/2002 DT: 4:52 P Printed by Virgil L.Pfautch,MEDRC on Monday,August 12,2002 1:16:06 PMComplete Chart RODRIGUEZ ,13RENDI MR 0763394 26y DOB 11/12/1975 M 7 FIN 5555512666 Medical Chart ......._. ._ .. ............... .._........................._. . ......... ...._. . _. ..... .... . _. . .. .. . ...................... _. _.._. ..__........... _. Page 4 of 6 - John Muir Medical Center - Walnut Creek , CA 94598 - Patientt RODRIGUEZ,BRENDI DOB: 11/12/1975 Age/Gender:26 M 5/2412002 13:34 Trauma MI2#: 0763394 Acct#: 5555512666 Private Phys: ED Phys: Torn Tighe,MD TRIAGE Arrival:Patient arrived by gurney via ambulance from field accompanied by EMT/paramedic<CG 05124/02 13:35> PROCEDURES NURSING Patient ready for radiology:Yes<TF 05124/02 14.10> Patient in radiology:Patient in CT department. <F 05/24102 14:10> Patient radiology exam complete: Patient back from CT department.<7F 05/24/02 14:28> GIRDERS LAB Trauma chem panel COOPER,RONALD. User N.Interface 5/24/2002 13:50 Test:Type and screen;Specimen source:Blood COOPER,RONALD. User N.Interface 5124/2002 13:50 RADIOLOGY Test:CT head/brain without contrast;Transportation:Gurney COOPER,RONALD""MD. User N. Interface 5/24/200214:05 Test:C-spine limited;Transportation: Portable User N.Interface 5/24/2002 14:21 Test:Chest I view;Transportation:Gumey User N.Interface 5/24/2002 14:22 RESULTS LAB Trauma chem panel COOPER, RONALD. Result I User N.Interface 5/24/2002 14:19 Trauma chem panel Glucose 94 mg/dl, 70.110 F Urea Nitrogen 13 mg/dL 9-22 F Creatinine 1.1 nWdL 0.8-1.3 F Sodiorn 141 numl/L 136-145 F Potassium 4.2 nmtoVL 3.5-5.1 F Chloride 103 tmnoVL 98-107 F Carbon Dioxide 29 mrnoVL 22-33 F Amylase 34 UAL 25-115 F Akohoi(ETON)Level-Senan None Detected g/dL None Detected F Result 2 User N.Interface 5/24/2002 14:19 Trauma chem panel Teat Ftg Value Uaait4 Rtt 1ttuse Stato Printed by Virgil L.Pfautch,MEDRC on Monday,August 12,2002 1:16:06 PMCornplete Chart RODRIGUEZ yBRENDI MR 0763394 26y DOB 11/12/1975 M 7 FIN 555551.2666 Medical Chart ......... ...111.1 ... ....... ........ ............... ......... ......... .......................... _11.11 ........................ _.... ..... ..__... .......................................................................... Page 5 of 6 - John Muir Medical Center - Walnut Creek , CA 94598 Patient:RODRIGUEZ,BRENDI DOB: 11/12/1975 Age/Gender:26 M 5/24/2002 13:34 Trauma MR#: 0763394 Acct#: 5555512666 Private Phys: ED Phys: Tom Tighe,MD +Y yTraum`a chem panel lyia Glucose 94 mg/dL 70.110 F Urea Nitrogen 13 mg/dL 4-22 F Creatinine 1.1 mg/dL 0.8-1.3 F Sodium 141 mmoVL 136-145 F Potassium 4.2 rrawYL 3.5-5.1 F Chloride 103 rmmVL 98-107 F Carbon Dioxide 29 mmol/L 22-33 F Amylase 34 U/L 25-115 F Result 3 User N.Interface 5/24/2002 14:19 Trauma chem parcel Glucose 94 mg/dL 70-1103 F Urea Nitrogen 13 rng/dL 9-22 F Creatinine 1.1 mg/dL 0.8-1.3 F Sodium 141 mmol/L 136-145 F Potassium 4.2 mmol/L 3.5-5.1 F Chloride 103 mmol/L 98-107 F Carbon Dioxide 29 mmol/L 22-33 F Amylase 34 U/L 25-115 F Alcohol(E T`4H)Level-Serum None Detected g/dL Nene Detected C Test: Type and screen; Specimen source: Blood COOPER, RONALD. Result 1 User N. interface 5/24/2002 14:35 Test. Type and screen;Specimen source.Blood ;Test <; # Fig t'4'� tueIi>t'ts r >lef„Range Sttus Blood Group A n/a F Rh type Pos n/a F Antibody Screen Negative Negative F Nursing Data electronically signed by:Dorothy Hall,RN 5/24/2002 17:28 Printed by Virgil L.Pfautch,MEDRC on Monday,August 12,2002 1:16:06 PMComplete Chart RODRIGUEZ ,BRENDI MR 0763394 26y DOB 1 111 211 975 M 7 FIN 5555512666 Medical Chart ..................... Page 6 of 6 Jahn Mur Medical Center Walnut Creek , CA 94598 Patient:RODRIGUEZ,BRENDI DOB: 11/12/1975 Age/Gender:26 M 5/24/2002 13:34 Trauma MR#: 0763394 Acct#: 5555512666 Private Phys: ED Phys: Tom Tighe,MD Bed Assignments: RAMI I <CG 5/24/2002 13:34> RM 15<PP 5/2412002 14:58> Chart electronically signed by:Torn Tighe,MD 5/28/2002 18:20 This chart documented by: MW: Margaret .Withers, SUPV CG:Cheryl.Ginilo,EDSEC TT:Tom.'Tighe,MD DMH:Dorothy.Hall,RN JF:John.Freeman,RN KE:Kelly.Engles,EDTEC KGON: Karen.Gonzalez,EDREG AF:Allison.Franks,EDSEC UNI:User N.Interface, Patient released 5124/2002 17:28 Released by Dorothy Hall,RN Printed by Virgil L,Pfautch,MEDRC on Monday,August 12,2002 1:16:06 PMComplete Chart RODRIGUEZ ,BR:ENDI MR 0763394 26y DOB 11/1211975 M 7 FIN 5555512666 Medical Chart S.M.. 4 _ 11 ASP As ill t �l �eYn an 'Avdtlksdb t i # j vyvtl� .. _ may►�`� � �` �, 1� ! � # R a Alt WWI, $REND V f tFor rnfirnw*n About - Plan Beans `IIS�t �wf dun re�a. u .. . Wit....... 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Circulation Normal capillary raii3t and BP>100 2 OfIling-02FArY TOM Of SP 4512i 00 No SUL9gry reMs per insnt hx: Respiration 62 m,ada Abn2mllj Ilam pt,flhagowt 1 aiisryte*: th rroMencier TOTAL iNTAtCt Abdomen A =: Abdorrss�rs gr ttxsrax tender # Abdansn abd,flail t,or psnstratin2 wounds to amen csr thorax p PCOLLAR ACKBOARD NO, NC MASK Motor Normal 0AtRWAY ORAL ET RM"way to pan(olher than decerebrate) t 0 TOWEL ROLLS PRONE SUPINE No res nso(or dacerebrate O BLEED3NG CONTROLLED 0 �'R 0 D Speech Normal 2 IVs 0 Coniww f O MEDS No MMftbte words 0 W: Eye -spontaneotts # 4 sr .. Opening To Voice 3 3 3 3 3 To Pain 2 2 2 2 None 1 # t # Verbal Oriented 5 S 5 s Response Confused # i 4 # IrsuzRoate Words 3 3 3 � 3 3 Incomprehensible Words 2 2 1 2 2 2 � None # t # t MotorCommand b 6 6 8 r Response Localizes Pain s _ s 5 5 Withdraw in 4 #� 4 1 4 # 1i • r flexion{pairs) ! 3 3 3 3 Extension pain 2 Z 2 2 2 - •-- N4ne # # # # # t E TRAUMA TEAM RESPONSE NAME ARRIVED TRAUMA SURGEON F /�iE E.D.PHYSICIAN CONTROL R.N. SUPPORT R.N. SCRIBE O.R.R.N, f X PAY I!G' { 1/ R.T. y� r ,yt tjj �apdj�-k J gjli�L"�J CONSULTS CALLED ARRIVED NEURO ORTHO ' INTAKE-"RA,UMA AC 0&l DIAGNOSTIC TEST RESU fS w o- � a x •. N � t# a' a # � �l°� �sy fir.", f d ?''g, y'`^�'�._'�t ^� . LAB RESULTS latelets TOTAL URINE NG/SALEM SUMPIEMESIS CHEST TUSE#2 v. ■ ' ' ypC" v � r -- ! P #- # - i RPR `s ff• f fR �- _� �� ,,�,,TOTAL OUTPUT MAMMA s .. r!G- AIRWAY 1 CLEAR ®NP AIRWAY 0 OP AIRWAY 0 ET TUBE(FIELD) 0,L/MIN BY BREATHING NORMAL C RAPio 0 SLOW ®SHALLOW MASK NASAL Q LABORED DECREASED INTUBATION:ET X CIRCULATION 9,NORMAL CAI?REFILL ULSES PALP. i 0 DELAYED CAP.REFILL ,RHYTHM. /ti ART LINE SITE CUTDOWN CVP SITE SKIN SIGNS �}NORMAL kWARM iDRY PALE ®CYANOTIC O COOL 0 DIAPHORETIC [3 FLUSHED LOC K&LERT IKOMENTED kCOOPERATIVE 0 SOMNOLENT O COMATOSE Q CONFUSED [ COMBATIVE RESPONDS TO: VERBAL C)PAIN [I UNRESPONSIVE PUPILSI' ftL ®UNEOUAL HEAD kCLEAR JIM CLEAR 0 ABNL: - NECK []CLEAR 0NON-TENDER 0I'ENQER TRACHEA DEVIATED fiT T TUBE: RT CHEST X LEAK EXPANSION 0 CREPITUS E2 FLAIL R or L LT N 0 PNEUMOTHORAX R or L. ®HEMOTHORAX R or L DRAINAGE BREATH 00LEAR Q DECREASED PERICARDIOCENTESIS DONE AT SOUNDS ®RALES ( RHONCHI 0 WHEEZING THORACOTOMY DONE AT NG TUBE INSERTED ABDOMEN „SOFT „FLAT ION-TENGER BOWEL SNDS + . Dt$S'TICK BLOOD, + - ®RIGID Q DtSTEN 0 TENDER PERITONEAL LAVAGE DONE AT DRAINAGE PELVIS STABLE 0 UNSTABLE 0 RECTAL NEG STOOL 08 + GU EATUS CLEAR Q BLOOD AT MEATUS POLEY INSERTED otPSTICK + - DRAINAGE EXTREMITIES &MAE ®DEFORMITY BACK EXAM: 42NE TETANUS STATUS: &CHWKED Q GIVEN LAST TETANUS US STOCK NO i C-S Irra lateral C- Ins swimmors 7 Chest y r Skutt PAT9ENr'S FINAL DISPOSITION: TIME: Pefvis CT of (' VALUABLES. HOME KUB WITH PATIENT IVP ENVELOPE# Anglogram Arm R L Leg R L SCRIBE: CONTR L NURSE: RESPIRATORY THERAPY CHART SHEEN PHYSICIAN ORDER: PHYSICIAN ORDER: EQUIP. DATE TIME COMMENTS CHANGE THERAPIS r L JOHN MUIR MEDICAL CENTER �- r ; . Respiratory JAY Thera Departmentertt . . _ _ .._ Awc _ _... _ .................................................................. rf'KAISEttae � . _ t�►j PMrVVtANeSffE VISIT VEHIFICATIflN/fAMILY LEAVE Health Care Provider Cartifif atioll PL> A� t �,.� -Z (This section must be completed and determined by treating previdsr only) Patient Name THE ABOVE NAMED PMOIL- d entffi At{I C�,_r- t) r C NO,does not have a"Serious Heath Conditlon"(see reverse for further Information)OR M YES,has a"Serious health Condition",as defined be€ow(check one): t.D Hospital care 4.El Chronic condition requi ft treatment 2.D Absence plus treatment 0 is currently incapacitated IMPRINT AREA 3.C Pregnancy C is nal currently Incapacitated ,flu 5.r Perrnanentlionq-term condition requiring supervision 6.Ll Multiple treatments(non-chronic condition) . 0 Hasa Serious Health Condition"and requires a family member to take time off from work to provide basic medical,personal or safety needs,transportation,or psychological comfort. The probable frequency and duration of this need is 12,Estimated date"of-Surgery fProcedurs/Delivery: -- - - El Diagnosis(Complete on patient request only): THE ABOVE NAMED PERSON: j as seen at this office on: I, Co i -L 0Has been given telephone advice on: as been Ill and unable to attend work/schooll � � `i � '2-- through physics€education � C States he/she has been Ill and unable to attend work/schoollphysical educatffsn ( through XCen return to full duties with NO RESTRICTIONS on J ip t �` - OR N-Cart participate In a modified work program starting �t Lt �� and contlnulng to (Please note:If modified work is not available,this patient Is then unable to work for this time period.) Cl Restrictions: hours per day hours per week BASED ON AN 0-HOUR DAY EMPLOYEE CAN: stand/walk minutes per hour total hours .........,.C7 no restrictions sit minutes per hour total hours ...........El no restrictions s, drive minutes per hour total hours ...........0 no restrictions E r z w U T/CARRY Occasional) ` Y Frequently m up to%workday): -' (Occasionally y'-up to !s workday. uenfi � 0-iia Ills. ........ ..................'0 not at all E]occasionally i1 frequently 11 no restrictions "" Z a 41-25 this. .............................Chi not at all 0 occasionally 0 frequently CO no restrictions 26-40 lbs. ..........................J not at all C7 occasionally .0 frequently ❑no restrictions Can lift/carry up to lbs. � o EMPLOYEE IS ABLE TO: 0 bend ... .............................❑not at all ❑occasionally El frequently El no restrictions r squat ..........0.not at all 0 occasionally 0 frequently n no restrictions .2 - kneel .. ..............................13 not at all El occasionally 13 frequently 0 no restrictions climb ..................... .........®not at all C1 occasionally. 0 frequently D no restrictions m reach above shoulders ....:.....0 not at all ❑occasionally 0 frequently El no restrictions perform repetitive hand motions ......... , .D not at all 0 occasionally El frequently, Q no restrictions ASSISTIVE DEVICES? e.g.,cast,brace,crutches) k. ' RESTRICTIONS: l/ p 4 € OTHER: fl sem. TREATMENT PLAN: � +b w s �- D Medication effects which could Impair performance: LL 0 0 Physical therapy required. Frequency: Cl Re-evaluation on.• v NOTE: If patient is Industrial,physician signature Is REQUIRED. 8I NATUR AND TITLE DA NAME(PRINT) y / LOCA 1 NI/A DRESS PHONE e� 98082(REV.(5.99) DISTRIBUTION: WHITE.CHART•PINK 8 CANARY PATIENT KAISER DATE: � .-. Team Assigned PEERMA€��e MS E ARRIVED: ivED: lwlE:t MEDICAL SCREENING 'EXAMINATION Age: ale L_ Female PMD: E rr E # R O D R I C U E Z Mode of Arrival: #iced i Ambulance C PD _Carried F W esichair C Gurney s. i �j 11 75 Arrived From: hme F_Clinic C Other EO ` Industrial s' j2:Workp€ace (3thet Hosp€taiF SNF/ECF C JaiEMSE PFt#t3RiTY:Chie# plaint: I _`�` 2 w- i Clinical presentation does notncy Medical condition exists per Standardized Procedure History of Present Illness: #V #S Weight: .KG&BS Teen � �D Distress None Mild Moderate Severe I Medications* ne Duration of Symptoms: Health History: StAenles Asthma1COPD C Smoking E Diabetes H ertens#on Seizures Cardiac CVA L Psych. J Abuse Screen� = Other: Allles: C NKA N s #n#ortx nt: e## rent _ Paramedic L=-Other: Language: _ lish Otheri7rans#ator: !alt Tetanus: rimary: Cardiac __ non-contributory Pain Scale 0-10 I Neuro Field Care chest pressure — radiating —stabbing I �ale��rtge appropriate — � a _-- intermittent nstant i— disoriented _ C spine =bac and chest tightness c Splint chest pa#n(E7 10) C - burningLv f ,Loss of C+5t3CiousnBSS j a OZ �= _ other: other: _ _ - es,duration — meds pulse!-! eg _ !frog G# non-contributory i Pupil Size Rhythm Respiratory _- non-contributory - nausea == vomiting {R} mm (L) m Other: I - p Oiascow Goma Scale Nurse Action dyspneie/SOB - diarrhea constipation cough productive _ other, }Bye Verbal Spontaneously a Oriented 5 —Chest Pain tocol (optional) Wheezing y # To spasm a dowsed UA perprotocol (optional} GU _ non-contributor to Pan a Ina prpoviate "s + — crackles rhonchi _ dysuria hernaturia i core rin°�P:ene's'°{e ? — UPTer protocol (optional) retracting SPO- °', i Ottawa protocol (optional) arthopnei PL- Li d discharge ' _ foley cath in pias Obeys Motor Command a —X Ray per protocol(optional) other: 't r.� . 'i-ocalizea Maio 5 G_P_AB wfthdra%va` Stu, Sign's Han wortutary Total �- i — Dressin othe, g Sp#inAbnormai cxtensw t — _ Ice diapncretic do MlrSclSke#. non-contributoryrtaccic t —Sling `R&B Explained ° paig t ; We€ght gear€ng # =NPO Instructions Given "MS int t 'stat of in#nry i.ftrtl' — partial flushed Ed — Resp. Precautions Init# d _ other. : nom. _ unsteady dusky harm _ Secitr#ty Standby ras^ hives Psych. _ non-contributors l Ri Bilateral beftGrasps ._ =5#35 KG " mu- ct tss membranes: _ risk to selfiothers # U, I _.strong _ ,rang j — ETOHlsubstana abu Visual Acct : m?tSt dC'J WeaR Weak # other': _ absent absen` OS: Oso: OU: tNJU /LACERATION Notes: — LABEL AND SHADE AREAS INVOLVED — - A= Abrasiors _ : . B= Burns _ -77r = E= Ecchymosis _ — - FB = orcign Sou - -- -...- H = He ell a ? = derte-Rt,"—IEl;i Disoos€tion from MSE: Pa,. UC-1 LljtttBv– s � s ::,r i tlovr- Rm..Z.` - _.-- -- 7lrTTe --- - _ arty Meant+ service KAJSERJUN 0 3 .200 > �E SMART TOOL r UCINA, M.D. INTERNAL MEDICINE - BRENDI Rfl D RICUEZ New Patent []Established Patient 0 2nd Opinion Consultation:Requesting;UD - 1( l C Dru&Ht: : �Age `ln Wt8M€: $P: R: P; PEER: 02 Sat: VA:OS OU _ DO Sm e. ❑Y, N C Quit in past 12 mos. Present' obtains: '1 IMPRINT AREA RN&VICIMA ignature: Interpreter name; Eangueget "HISTORY 1. CC 1 HPI. (Location,Quality; 71ming,Severity,Duration,Context,Moditying Factors,Ass 0&a signslsymptorns) 4. Medications: (1-3 PFfEXP,4+ OR Status of 3 Chronic t Inactive Conditions DetalledlComprehensivej 0 Agree with CIPS C-2— Le ,` ., ,j`"` f D See visit d Refer to chart chronic med list E. GIPS Reviewed Interval changes and additions noted 2.Review of Systems—Cheek for nap or norm—Circle Abnormais t4 Elaborate(1 brief,2-9 dot.,10+compl.) X—Constitutional ENT C Gl El Resp ® GU ED Hem/lymph 0 Neuro O All others neg =a Eyes 0 Skin Alilirnmutioi W CV C1 Endo 0 MIS n Psych 01 See above 3. Past,Family,Social History:Marital status,employment,alcohol,tobacco,family. C. SESSiCIPS Reviewed 0 SESS updated 1 See above 0 Domestic violence (Checking the box indicates that tate exam was performed and within normal limits_circle abnormals.)Exclude items in#suer from element count. Constltutionaf aM acute distress WD/VJN D Obese 0 til-appearing n Cachectic Pertinent t 1. Eyes _ [' Conjunctivas/lids L..: Pupils/irises(reaction,size&symmetry) C Ophtha€exam disks/post segments C Visvol fields 2. ENMT(Ear.flow,Month&Throat) ED Hearing [:1 Lips,teeth and gums D Otoscopic:exam rF] Oropharynx C l'hlJ EACs,tympanic 1-1 Nasal mucosa l septum I turbinates ED External ears,nose membranes 3. Neck -,I Masses,appearance,symmetry Thyroid 4. Respiratory Respiratory effort 0 Percussion Auscultation/breath sounds 2 Palpation 5.Cardiovascular PMi JVP Pedal pulses Auscultation of heart Abdominal aorta 0j Extremity edema!Varicose veins Carotid arteries ; Femoral arteries OPrechcek ti.Breasts . 4 Insp(ss/m,nipple discharge) .- Masses/lumps,tender _ . Axillae A7iBNT tiAAtE OATS Mff/ PWSICIM 'EXAM—continued (Checking the box indicates that the exam was performed and svlthin normal limits-cirele abnormals.)Exclude items in ftalics from element count. .,- 3. Gastrointestinal Pertinent Abdominal exam(tenderness/masses) Guster: El Arius/perineum/p.r. -- Howelsovads o Hernia (sphincter tone,masses, y Liver/spleen hemorrhoids) Obtain stool sample(if indicated) E Deferred Pr.refused B. Ganitourinary —7- Male: Female: Scrotum Testes 0 External genitalia 0 Urethra Penis ; €pJdidyinfs D Uterus 0 Bladder -' Digital rectal of prostate 13 Pt.refused 0 Adnexa/parametria C Cervix L Lymphatic System Palpation of lymph nodes in two or more areas: _- Neck Axillae E Groin !� Other: Q. ailuScuitiskeletaf [j_ Erythema Inspection/palpation of digits and nails Gait and station '__,Vuro/vascular intact Exam Of#Dints/boneS/muscles(incl.Palpation/ROM/Stability l Strength/tone) �� '� -I--* Effusion.© Effusion Head and neck r� .� -f ,, , � C1 Fender C1 FROM Spine/ribs _. t + -c. �� � e.~ _. 0 Deformity Ext.(LIR) y, .�. , , Warmth 1. Skin L Inspect skin and subcutaneous tissue Ll Palpation Rash 0 Torpor 2. Neurologic Cranial nerves ._i Sensation ! deep tendon reflexes ;4.A- of•c r-p _. Motor Cerebellar ,_. a., > .r 3. .Psychiatric Mood/affect(depressed,anxious) Recent/remote memory Orientation:time,place,person Judgement and insight ~ob-foc(1-5 butlers},Exp Prob-Foc(6-T2 bullets),Catailed(2+bullets from 6 arealsys or 12+bullets from 2+arealsys), ,mprehensivtr(perform all#laments and document 2+bullets from 9+arealsysl M Ed materials given/disct;;ssed D Stop smoking advice given CC to Requesting M.D. iC: pin weeks/months tav weeks/months ADMITTED OTHER- ment approximately {3i)I{minutes)in counseling andlor coordination of care during this encounter,which included discussion of the following. ltaf visit time:_ .)MPLETED BY DATE ___—_ M.D./I:)OJhl.P./:P:A 588(REV 11.01)REVERSE` --_ PATxxmT # Pamum [ CJLT1ramr J YTiw E FR DATR I TO DATR I I 10514590 I I "Drez ar I RSpRl�__- I - / /_.. 1 - 1.-.. / I - -----------,---- ----r,. ----- -- t--------- -.r- ---,o----..,.- --------- ..-�..r Personal Physician : VICTOR R CUC-rNA,H.F. -Sw X0ZRX0JPt,B MMX 201x Radiology Report sxam 1 of 1 Page 1 L WRIST, COMPLRT5 Ordered By: JOSFiU& B WXXL,M.D. on 06/03/2002 11:30 at SRO $MZn=MCY Performed In: SRO - Read By,, BOLlY,MG R BLSY,M.D." tt HISTORY *+: Pain ** FINDINGS i*: No radiographic evidence of fracture, dislocation, or significant degenerative change is noted. *+ IMPOSSION +*: Negative exam. L WRIST, COMPLSTY Ordered By: JOSHUA B WRIL,M.D. on 06/03/2002 11:38 at SRO RH$RGRNCY Performed In: SRO - head By: WOLiMXG R BLEY,M.D. W R WAY, M.D. DD: 06/05/2002 DT: 06/05/2002 WIAB ♦:►t+*t•t*wt�#tr*t•r+rrat*:•*rtr End of Report tttr*ititr,rrtr*rfttt,►t:�r►t►�rr,rr RAD.REV SROT3C 08/13/02 14:21 _ ......................................................................... /J� KA€St DATi4: .Cha cam A��s`tgned _ PERMANEhf C a TIME ARRIVED: _ � MSE TIME: MEDICAL SCREENING EXAMINATION ' a. "R t tZ Age:_.�� Male E Female PMD: {Made of Arrival: Walked i_.Ambulance C PDJ ! 7 - Carried C Wheelchair is Gurney ;„ E Arrived From: JZHome C Clinic C Other ED Industrial - Needs Chart Workplace C Other Hospital C:SNF/LCF C,fail � � $Chief Complaint: ____ �•, Ct'r`rcctf_ s tr MSE PRIORITY: `1 Ciinicaf presentation does not suggest an Emergency Medical condition exists per Standardized Procedure Vitae Si ns: H€s of Present Illness: r r-, +- 6 z - r- weight.' Kt1LBS �iemp P R_L(_0_BP- 1 } _�I Medications: t�.f�Vone Distress _ None Mild _ Mfldefate eVere �* Duration of Symptoms: -- Heaith History: Aerilts . C Asthma/COPD C Smoking C Diabetes Hypertension C Seizures Cardiac CVA i Psych. I.V./Abuse Screen Other: Altar les: NKA Informant: )XSelf C Parent C: Paramedic C Other- rs � Language: &English �Other/Translator: %:/iAnA4 bast Tetanus: 'J C Pr#mary Cardiac __ non-contributory I Pain sscaie t __j- _tc__. Neuro Field Cafe a chest pressure i — radiating stabbing 414 ;+ aleR/age appropriate `� ;� —C-spine backboard _ chest tightness intermittent v constant - disoriented w Splint _ IV r chest path - _ - -- - _._ — burning 7/ Loss of Consciousness — 02 Other: I _ other: #' n sty No _Yes,duration Meds El Pulse: : te _ irre Pupil Size --- µ g g GI non contributory —x — Rhythm Respiratory =non-contributory I _nausea vomiting (R) -mm (L) mrn _father: le Coma Sc _.dyspneic/St?B � —diarrhea `- constipation Giascow -a Nurse Action 0 MSE _ cough W productive ( other. ry �x Eye-�--- Verbal S — Spontaneously 4 Oriented 5 —Chest Pain Protocol(optional) _wheezing - To sreech s Confused a _ GU non-contributory To Pain 2 Inappropriate 3 UA per protocol(optional) ) + —� crackles W rhonchi -dysuria hematuria "ono t inrompret:ens,bia 2 —UPT per protocol (optional) retracting __SP02 °lo None t — LMP: Motor P Z v Ottawa protocol (optional) _ orthopneic , — PF - — _ discharge v Coley cath in pi evays command 6 —X-Ray per protocol (optional) _ Other: eta( iu+ Locaiized Pain 5 _ G P AB Flevon withdrawat 4r _ Skin Signs _ non-Contributory _other: Abnormal Flexion 3 _ Dressing i; l�; s iS a9normat Extension 2 Total sem- g —SplintlCe diaphoretic $dry _ F laccid t —Sling ®R&8 Explained Y pale _ret Musc/Skel. _ non-contributory Welgh# i#earinp NPO Instructions Given -_ flushed _` CMS intact distal of injury Kfull —partial cold ` other. '%4- _ none — unsteady = Resp. Precautions Initiated _. dusky - warrT l ` Security Standby El rash —hives Psych. _ non-contributory R1 ht" Bilateral _FS9S o EKG eft muc us membranes: 1 v risk to self/othersgstrOng �strong moist =dry ETON/substance abuse _weak weak Visual Acuity: other: = absent absent OS: GD: OU: INJURY/LACERATION Notes: AND SHADE AREAS INVOLVED A-Abrasions _ v B = Burns E= Ecchymosis FB = Foreign Body _ - H a Hematoma L= Laceration _ P= Pain PW= Punct. Wound R = Reddened - R?GHT LEFT LEFT RICHT S = Swelling Disposition from MSE: X-Ray UCC LWBS : t= Pulse Present ED waiting room E.D. Rm.# Time b -= Pulse Absent '/4-Clinic:: ? n _ Provider: l ROM au v,� tGraaruE ` _J--- - -- ' —t- 0 = 0 ROM A,, r Jb \'V'-5`- ORtivrbCR beim 010302 tie% ;KAJSER at PERMANEWE* tl i;;y Medicine Name SMART TOOL- JUL 0 5 ZOOZ MR# _.._..... INTERNAL '11#EDICINE New Patient 0 Established Patient [2 2nd ppinion 0 Consultation:Requesting Z. ��� ti� I ?OORIGVrZ Drug Allergy O NKDA Age4��. .l Wt<, 5zHt: BM#: _BPr� R: P: PEER 'hs: Obl i j { f 7 02 Ba# VA:OS QD,_ o Smoke: 0 Y Quit in past 12 mos. ms: uMr�nirrr,�w.A Presenting proble R�l/LV#d/[�tA S#gnalure: terpreter's nai�ic: t<ariguatge ' - i. CC J t#Pt: (Lrrcatlan,Qu�lif� Trtn}np Stlty,Dur�tin�.L'a�text,Mod}tyln�r facfats,ftssoeiatad s}gnstsymptnms) 4. tAedlcutirtr�.t.,��'E ''L.�,,,.� f f-3 I'FfEX}?4� Dfi Status of 3 Chrortic l inactive Cond€titins tletaltedfCrrmprehens}ve) � Agree wlih C#PS } See visit f � 0✓' � Deter to chart chronic med list r CIPS Reviewed #nterva#changes and additions rioted 2. Review of Systems-Check for neg or norm--Circle Abnormals&Elaborate(1 brut,2-4 dot,tt#+sompt.) Constitutional �; Eldt � O# � Resp 6 UHem/lymph 0 neuro 17 All others neg Eyes � A1111mmunol -� CV Iv Endo S 0 Psych 0 See above & Past,Family,Social N#story;Marital status,employment,alcohol,tobacco,family. El KSS/CIPS Reviewed 0 SEES updated 0 See above C! Domestle violence (Checking the box indicates that the exam was performed and within normal limits--circle abnorrnals)`Exclude items In ttailesfrom element count. Constitutional NO acute distress ,t# WDANN 73 Obese 0 111-appealing El Cachectic 1. Eyes M Conjunctivas t lids E! Pupils I Irises(reaction.We&symmetry) D Ophthal exam d[sks/post segments C Visual tTetdt 2. ENMT(Ear,Nose,Mouth&Throat) C Bearing 0 Lips,teeth and gums 0 Otoscopic exarn C- Otopharynx C TMJ EACs.tympanic C3 Masai mucosa t septum/turbinates D External ears,nose membranes I 3. Neck E] Masses,appearance,symmetry El Thyrold 4. Respiratory Respiratory effort t.i Percussion Auscultation/breath sounds 0 Palpation 5.t:ar$lovasrtrlar G Plvtit JYP ;D Pedal pulses _7 Auscultation of heart _ Abdominal aorta 0 Extremity edema 1 Varicose veins D Carotid arteries �D femoral arteries 0 OP recheck 6.Breasts `' Insp(sym,nipp!e discharge) Masses/lumps,tender 0; Rxtf s 91158 (riEV.t i•ttt) ��.;TENT NAMc tYA73< rix PHY53CtAN continued (Checking the box indicates that the exam was performed and within normal limits–circle abnormats.)Exclude items In italits from element count. 7. Gastrointestinal Abdominatexam(tenderness/masses) Gualac Anus/perineum/p.r. Bowel sounds Hernia (sphincter tone,masses, Liver/spleen hemorrhoids) .r Obtain stool sample(if indicated) Deferred Pt,refused 8. Genitourinary Mate: f=emale: Scrotum Di Testes O External genitalia 0 Urethra Penis 0 Epididymis 0 Uterus C Bladder Dtglia#rectal of prostate 0 Pt.refused Adnexa/parametria 0 Cervix 9. Lymphatic System Palpation of lymph nodes in two or more areas: Neck .W Axftlae �-- Groin i:_ Other. t0. uscuioskelatal Erythema _r Inspection/palpation of digits and nails Gait and station LE-3Neuro/vascular rota � � � 0 Effusion Exam of joints/bones/muscles(tnct.Patpation J ROM/Stability l Strength/tone) � 4 0 Tender He and meek ❑ FROM F-1 Deformity Spinefribs I pelvis y i 0 _ Ext.(LIR) ! 11. Skin d Inspect skin and subcutaneous tissue r Palpation Rash ``- Turgor 12. Neurologic Cranial nerves Sensation Deep tendon reflexes Motor - Cerebeflar 3. Psychlatric - Moodlaffect(depressed,anxious) Recentfremote memory — Orientation:time,place,person Judgement and insight 'rob-foc(1-5 bullets),Exp Prob-foc(6-12 bullets),Detailed{2+buffets from 6 arealsys or 12+gullets from 2+arealsys), .:ampremeasive(perform all elements and document 2+bullets from 5+areal$Ys) Nil Ci Ed materials given/discussed CJ Stop smoking advice given he -'I ,V/ - LOT;041202 79-$7015yyR15T � M) � CONTOuREla �s a� FOR SUPPORT OF u CC to Requesting M.D. ttC: rn.• weeks/months tau weeks/months A13Mt13Ei3 flTtit R. spent approximately _(ell!(minutes)in counseling sndlor cotrrdinahon of care during this encounter,which included discussion of the following: 0taf Visit time. c�x�PtETExs a � �. s ��^^'` CN,P.I .A. I AF �`s$St 1REVERSE a.... :�.�, 4WIvIr iotttx ar#r+sp2taE _ r .!"} (.. a ItG- l✓ k.s':,... }arse cotWots tens enadicat tat3aet to vwWs us to prctass tM ctaim sf row pstiont A nuo4ed intamvuon suthoritation k attached. CalilFtifttttq t MT. F(R-YOM PWTECT" AUF(FVCA;LAW AEOUM THE FOLtOWii`G TO APPEAR ON TK3 VOW. Any parson who know6V1y prssanta Nos or fr&AA*nt daim for the *:d MW ba att6iest to fines and r onfinen+sr+t in stat*wisan. Payt�+sstt at bss k Ote�ty of►con" 'MEDICAL INSURANCE CLAIM FORM NAME OF (� s To be completed by Physician) INSURED ?r��� E` (�, � Ch� (t Ll 0 FULL tlANIE C- tMARTIAL STATUS Q s Lt DATE OF BIRTH 111)1-175 >ATIENT ADDRESS . l,- 0, �( C f 5 c,�f L c� OCCUPATION ` f SOCIAL SECURMY.S3tI��7��L EMPLOYER Sit � DATE OF INJURY �r� Ll d,-)� LOCATION OF ACCIDENT �r di 0.<G't +� t-. l t rt A (.L r Y t Zr Patient Hospitalized ? IV L3 Name of Hospital 100- P ' ,it tltFc+*iiCxYHistory as described by patient ` #" txdl W I1L°'L i ilr o i YL t9 F ✓ pert Z /fqO Is this claim baro f=atft Date of First treatment �presented under WORKERS'COMPENSATION 7 ©Yaa i Date taken IZ\I 1p-_'I w.513[/ By Whom? #:ajSe Y J_h2Sj 1 t;tl Address -RAYS = Of whet part(s) of body Findings ,CL LwGa i } yti q u►? �} , is 34,4✓' V ac )IAGNOSI q t,e- L i+f G ( t vi' t -L—.UkA7 6tf O f ,}} Describe any physical Impairment or condition not the result of the above Injuries or the ac*ldent In question LSNTRfBUTOFtY ACTORS Have you treated YES If so,for what Dates Patient Previously? AiO illness or injury? Treated Surgical,Procedure,Treatment and medication prescribed up to and Including`this date U8,1PERY OR P0,V} CF e_ I,� acs u •El 1':ATION Was physical therapy prescribed- U YES U NO If so,give frequency and period of time ;� r, t✓' t 5-'t'' p (r�etl � t # V1jt n•f S cit rr�CCut e cf I�fa{iy4 c 'i Ire a-v O�tvr 41g, 1jcnA- ^_Vr` tt*Vol'iel) 4C, U.t*YaAS®s twD � f€et>ViLA( S ffrt�+ 04144 rs ROGNOSI$ Is complete recovery probobfa? 3 M wfi�f If not explain hY t 'er ;. (i`-f 5 f N jf- ' -- G�wY4tai,,��tintic- Ll�jOC i .. 1t i� Les i rrltxtt'' Y�'Gfi'• ifYf ..tit Gt � i� � � - • :' Ida ure and Extent je o Wfiat extent,if any, does Ifie cont re u say ec or esnrt e e ova a ec or ex en a tae et y ISABItj,TY DISABLED From to DISABLED From to PART TIME WORK DATE RELEASE TO ESTIMATED FUTURE DURATION PARTIAL FULL TIME WORK OF TOTAL DISABILITY DISABILITY i L'1'Fi a7� r TO SATE $ �-' �1� TOTAL CHARGES & CIU YOU ANTICIPATE vtIELE BE INCURREt7$ iC q#ffa e ORT � lr ADDRESS {� L`7 Vt f fotkn Lei PHONE q 5' 7-7g 66 PHYSICIAN'S / :LN: IV45 64134 SIGNATURE / �'� H.L.HEGGSTAD,INC. 43661 G` ` '# EMPLOYEE BRE EDI RODRIGUEZ HOURS CURRENT TO-DATE SOC SEC# 584-99-72247 HOURS RATE AMOUNT REGULAR 32.00 GROSS PAY 1011.52 8250.21 REG RATE 31.610 32.00 31.610 1011.52 1.5 OT 0.00 TAXBL PAY 1011.52 8250.21 2.0 OT 0.00 FIT 85.97 736.16 PER ENDED 07/30102 TOTAL 32.00 FICA 77.38 631.13 CHK DATE 08102102 SIT 18.55 173.42 CHK# 43661 OTH STAX 9.10 74.26 NET PAY 736.00 � PAY WAGES 1011.52 VACATION 54.40 443.70 UN.DUES 29.12 237.51 CHK AMT 736.00 NET PAY 736.00 5954.03 H.I..HEGGSTAD,INC. 43178 178 EMPLOYEE BRENDI RODRIGUEZ HOURS CURRENT TO-DATE SOC SEC# 584-99.7247 HOURS RATE AMOUNT REGULAR 8.00 GROSS PAY 252.88 8503.09 REG RATE 31.610 8.00 31.610 252.88 1.5 OT 0.00 TAXSL PAY 252.88 8503.09 2.0 OT 0.00 FIT 0.00 736.16 PER ENDED 07130102 TOTAL 8.00 FICA 19.35 650.48 CHK DATE 08/02102 SIT 0;00 173.42 CHK# 43178 OTH STAX 2.28 76.54 NET PAY 210.37 PAY WAGES 252.88 VACATION 13.60 457.30 UN.DUES 7.28 244.79 CHK AMT 210.37 NET PAY 210.37 6164.40 xxzx h.L. hr.uGail~u, tHri.ur tt rKr xuLL Uc rxl�. rage 1 08/20102 2002 to Date Li-IrLUfLL: &0 nUUK1.UULL, UrLt*Ul )VU )Lt. ft. U64-zl�-1L41 PAY DATE HOURS GROSS FIT SOC SEC MEDICARE SIT OST- LIT PLAN OTHER NET PAY CHECK 06/21/02 40.00 1264.40 129.97 78.39 18.33 33.77 11.38 0.00 104.40 0.00 888.16 41021 06121102 16.00 505.75 15.10 31.36 7.33 0.00 - 4.55 0.00 41.76 0.00 405.66 41032 u6.i6fu2 51.06 915.91 11[.13 {}0-, 14.il 16.0 6.64 u.uu bu.9d u.uu 110.34 41441 07/05/02 40.00 1264.40 129.97 78.39 18.33 33.77 11.38 0.00 104.40 0.00 888.16 41676 07112/02 24.00&) 758.64 49.04 47.04 11.00 7.02 6.83 0.00 62.64 0.00 575.07 42137 u+11�il6L ,5`1.00 0 1c3t.19 141.44 /6.43 11.66 11.6,5 11.10 0,06 101.19 u.u0 61G..54 4e666 07126102 39.00 1232.79 121.44 76.43 17.88 31,83 11.10 0.00 101.79 0.00 872.32 42796 08102102 32.000 1011.52 85.97 62.71 14.67 18.55 9.10 0.00 83.52 0,00 736.00 43661 ut5lwloL g.00 4:)4.66 U.uu 16.66 S.bl U.Uu Z i6 0.Ou 4U.66 0..00 41u.Jl 431/6 08109/02 40,00 1295.60 138.40 BOX 18.79 36.27 11.66 0.00 105.60 0.00 904.55 44101 08%119!02 10.00 518.24 16.34 32.13 7.51 0.00 4.66 0.00 42.24 0.00 415,36 44102 08/16/02 39,00 1263.21 129.65 78.32 18.32 33.68 11.37 0.00 102.96 0.00 888.91 44562 08/16/02 12.00 583.02 22.82 36.15 8.45 1.10 5.25 0.00 47.52 0.00 461.73 44563 TOTALS- 370.00 12163.16 1043.37 754.11 176.37 244.47 109.48 O.00 1000.41 0.00 8834.95 REPORT PERIOD TOTALS 374.00 12163.16 1043.37 754.11 176.37 244.47 109.48 0.00 1000.41 0.00 8834.95 i .L. tiLUUfi IAA, flit. tMVLUYtL 1'AMLL ULIAIL - 08JZDI02 June, 2002 s tMPLUYLL: iiiO KUUKlbUtL, bELNUI Mit, 5LC fr". 5t54-99-1241 PAY DATE HOURS GROSS FIT SDC SEC MEDICARE SIT OST LIT PLAN OTHER NET PAY CHECK � 06/21/02 40.00 1264.40 129.97 78.39 18.33 33.77 11.38 0.04 104.40 0.00 888.16 41021 . 06/21/02 16.00 505.76 15.10 31.36 7.33 0.04 4.55 0.00 41.76 0.00 405.66 41032 06/28/02 31.00 9/9.91 82.23 60.15 14.21 16.65 8.82 o.Ul1 80.91 0.00 j16.34 41441 TOTALS- 87.40 2750.07 227.34 170.50 39.87 50.42 24.75 0.00 227.07 0.00 2010.16 REPORT PERIOD TOTALS- 87.00 2750.07 227.30 170.50 39.87 50.42 24.75 0.40 227.07 0.00 2010.16 1�qkln C, a Com. ..................... _. ............... f 2365 Meadow Way#121.Bents Rasa,CA 95404 Tei.(7037)280-2013 May 5,.2002 Mrs'. Ramonita Baughman Owner, happy Feet Family Child Gare 2024Putnam Street Antioch, CA 94509 Deer Mrs. Baughman: I am pleased to propose the framing and sheet rock installation of your day care play roam, as follows: 1. Estimated Cost of Materials and Parts $ 3,270.00 Wooden Frames 1600.00 Sheetrock 1200.00 {Other Barts 110.00 Stacking Fee 160.00 Scrapping Fee 200.00 il. Labor $7,500.00 Ill. Target Completion Dates: • Framing - 7 days from receipt of 50%payment • Sheet Rock - 2 days from completion of plumbing/electricals IV. Payment Terms: 508 upon contract signing 50% upon contract completion You,may opt to purchase the materials and parts and just contract the labor cost, whichever is convenient for you. At any case, please signify your concurrence and approval to this job contract by signing on the space provided below. If you have any questions, please let me know. Sincerely yours, Brendi Rodriguez (707)280-2013 ACCEPTED AND AGREED(pteasa sign and date): U Materials and Labor Contract U Labor Only 5W PAYMENT ENCLOSED: .�, '`SST.� C//1- _.........11.11 ......... ......_.. ......... ................ . . __ _. ......... _...._... .._...... ......... __ . ........ .......... .. .........._... ... __ ............................................................................... i 2365 Maselcw way#121, 5ants Rosa,CA 95404 Te€. (707) 280-2015 May 15,2002 Mrs. 'Ramonita Baughman _ Owner, Happy Feet Family Child Cara 2920Putnam Street Antioch, CA 94509 Dear Mrs. Baughman: This is to confirm the labor contract for the framing and sheet rock installation of your garage to be completed according to the following schedule: FRAMING Start Date: May 22, 2002 End date: May 28, 2002 SHi•~ET ROCK Start Date: May 30, 2002 End date: June 'l, 2002 As agreed, sheet rock installation will tJNLY commence after completion of any plumbing and/or electrical connections. Please let me know if you have any questions. Sincerely, 15'�� Brendi Rodriguez halt L BAN 2693 FAMILY (il'iMkl~ 211 J,t jtog )atept7 3 , E Ako ay nogtatagalog BLLIN Alm I RAIL Naichael Bet#in D.C. l 100 ©ritA parr 41v6..Suite L •Ant}oth•CA 94 S09•ftt:l17$177 ti-ik60 par:(r2 slr r!-24 t0 r�is�bK'litY C�ti�Ca�te _ Date ' This is its certify that , fo}'��,�(, j>Jq /l.G77- has been under my prrsfcssional care and was: (,wtally Incapacitated Partially Incapacitated from � � ���O to q A,-). �?_ I emirks: �UlICE 1. 11 j j �1t.� �? i �t / W J,-, �\/' C.Ct� traLt(C. reuNAC. cwc_,lP ►1 �#c'cKt3rXcv4f� A./ f Ali CLY'a alai_ Of PLEASE REMIT YOUR LO HE NT TO: ��" fPAIJENT ACCOUNT JOHN MUIF)#M3;DiAB {3 IiALTI-I SYSTEM B PO.BOX 39000 DEPARTMENT 33370 SAN FRANCISCO,CA 94139-3370 PLEASE PUT THIS ACCOUNT (925)947-33,36 NUMBER ON YOUR CHECK PATIENT NAME BRENt)I RODRIGUEZ STATEMENT DATE 08112102 ADMISSION DATE 05/24/02 1 0li/24/02 DISCHARGE DATE INTERIM FROM 05/24/02 I05/24/ 2 INTERIM THROUGH TO: CHARGE TO MY: F B REND I RODR I13UE Z - d VISA 0 MASTERCARD []AMEX n DISCOVER 2365 MEADOW WAY #121 CARD# SANTA ROSA CA 95404 EXP.DATE LW J SIGNATURE - AMOUNT PAID$ PLEASE DETACH AND RETURN THIS PORTION WITH YOUR REMITTANCE 4TIENT NAME REND I RDDR I SUEZ PATIENT ACCOUNT NO. 55555-12666 PAGE 001 250 PHARMACY 5/24 6400 EMERGENCY ROOM OXYGEN 218. 00 218. 00 5/24 8400 EMERGENCY ROOM OXYGEN -218. 00 -218. 00 TOTAL_ PHARMACY 0. 00 0. 00 300 LABORATORY OR (LAB) 5/24 10150 ANTIBODY SC.RN/INDIRECT COOMBS 131. 20 131. 20 TOTAL LABORATORY OR ( AB) 131. 20 131. 20 301 LAB/CHEMISTRY 5/24 10890 ALCOHOL (ETHYL.) LEVEL 203. 40 203. 40 5/24 11670 AMYLASE 132. 00 132. 00 5/24 12277 BASIC METABOLIC PANEL 267. 90 267. 90 TOTAL LAB/CHEMISTRY 603. 30 603. 30 305 LAR/HEMATOLOGY 5/24 14400 WBC: - CHRG ONLY 21. 65 21. 65 5/24 14401 HEMOGLOBIN - CHRG ONLY 20. 10 20. 10 5/24 14402 HEMATOCRIT - CHRG ONLY 20. 15 20. 15 5/24 14403 PLATELET COUNT -- CHRG ONLY 38. 10 38. 10 TOTAL LAB/HEMATOLOGY 100. 00 11210.00 320 DX X-RAY 5/24 1040 C-SPINE LTD IP (2-3 VWS) (72 140) 551. 75 551. 75 TOTAL DX X--RAY 551. 75 551. 75 324 DX X--RAY/CHEST 5/24 1026 CHEST 1 VIEW 1P (71010) 257. 00 267. 00 TOTAL DX X-RAY/CHEST 267. 00 267.00 351 CT SCAN/HEAD 5/24 8300 CT HEAD/BRAIN WO CNTRST 0. 00 0. 00 TOTAL CT SCAN/HEAD 0. 00 0. 00 390 BLOODBLOOD/STOR-PROC Continued 'HE HOSPITAL BILLS FOR CERTAIN HOSPITAL BASED JOHN MUIR I MT.DIABLO HEALTH SYSTEM PLEASE RETAIN THIS DETAIL.STATEMENT 'HYSICIAi+NS.YOUR SURGEON,ASST.SURGEON, POC BOX 39000 FOR YOUR RECORDS,ALL SUBSEQUENT 1NESTHESIOLOGIST,RADIOLOGIST,ETC.MAY SILL YOU DEPARTMENT 33370 STATEMENTS WILL REFLECT BALANCE 'EFARATELY FOR THEIR SERVICESSAN FRANCISCO,CA 94139-3370 FORWARD ONLY. E17ERAL TAX I.D.NO.94-14,81843 FOR BILLING INQUIRIES PLEASE GALL 19251"744-TV .* PLEASE REMIT YOUR PAYMENT TO: JOHN MUIR t MT.DIABLO 44EALTH SYSTEM OWN Pol BOX;3mo DEPARTMENT 33370 SAN FRANCISCO,CA 94139-3370 PLEASE PUT THIS ACCOUNT (925)947.33315 NUMBER ON YOUR CHECK PATIENT NAME B RENI)1 RL3I3 R I GUEw Z STATEMENT DATE 08/12/02 ADMISSION DATE 05/24/02 05/24/02 DISCHARGE DATE INTERIM FROM 05/24/02 05/24/02 INTERIMTHROUGH TO: CHARGE TO MY: RE #I3I ROE3I;I CllE -I El VISA Q MASTERCARD ©AMEX 0 DISCOVER 2365 MEADOW WAY #121 . CARD# SANTA ROSIN CA 95404 EXP DATE Lv J SIGNATURE AMOUNT PAID$ PLEASE DETACH AND RETURN THIS PORTION WITH YOUR REMITTANCE kTIENT NAME BREND I ROD R I GUE Z PATIENT ACCOUNT NO. 55555-12666 PAGE OOP. w 5/24 10401 ABO BLOOD GROUP 1 124. 85 1224. 85 5/24 10402 ' RH' BLOOD TYPE '- CHRG ONLY 93. 20 '93. 20 TOTAL. BLOODBLOOD/STOR PRC1 218. 05 211.x. 05 }} 450 EMERG ROOM 5/24 3007 ER-TRAUMA SERVICES 99291 1, 901. 00 1.901. 00 5/24 3007 ER-TRAUMA SERVICES 99291 1, 901. 00 1, 501. 00 5/241 3007 ER-TRAUMA SERVICES 99291 -1, 901. 00 -1, `�01. �►0 5/24 3008 ER--TRAUMA ACTIVATION 99291 6, 589. 00 6t589. 00 5/24 3008 ER-TRAUMA ACTIVATION 99291 6, 589. 0.0 6, 589. 00 5/24 3008 ER-TRAUMA ACTIVATION 99291 -6, 589. 00 -61589. 00 5/24 3017 PARAMEDIC DIRECTION 16. 50 15. 50 5/2'1 5087 BLOOD PRESSURE MONITOR 69. 00 89.0+ 5/2`.'4; 5087 BLOOD PRESSURE MONITOR --69. 00 -69. 00 TOTAL EMERG ROOM 6, 506. 50 8, 506. 50 460 PULMONARY FL)NC 5/24 6500 OXIMETRY EMERGENCY ROOM 38. 00 38. 00 5/24 6500 OXIMETRY EMERGENCY ROOM --38.00 -38. 00 TOTAL. PULMONARY FUNC 0. 00 0. 00 569 MED SOC SERV/OTHER 5/24 5500 SOCIAL SE ERV I CE, TRAUMA RESPONSE= 1, 223. 25 1, 223. 25 TOTAL MEI} SOC SERV/OTHER 11223. 25 11223. 25 11, 601. 05 7/0 52 10035KAISER PAYMENT 0070 --11, 021. 00 7/0 52 A0036COMME RC I AL INSURANCE (IDJUIST 0070 0 -580. 0**`.r -11, 601.05 0. 00 DIAGNOSIS CGDE: 847. 0 'HE HOSPITAL BILLS FOR CERTAIN HOSPITAL BASED JOHN MUIR 1 MT.DIABLO HEALTH SYSTEM PLEASE RETAIN THIS DETAIL STATEMENT 'HYSICIANS.YOUR SURGEON,ASST.SURGEON, P.G.Box 39000 FOR YOUR RECORDS.ALL SUBSCOUENT ,NESTHE3tOLMIST,RADIOLOGIST,ETC.MAY HILL YOU DEPARTMENT 33370 STATEMENTS WILL REFLECT BALANCE. ,EPARATELY FOR THEIN SERVICES SAN FRANCISCO,CA 94159 3371) FORWARD ONLY. 'EDERAL TAX I.D.NO.94.1461643 FOR BILLING INQUIRIES PLEASE CALL(925)9473336 2251(- PLEASE REMIT YOUR PAYMENT TO. JOHN MUIR!MT.DIABLO HEALTH SYSTEM � P.O.BOX 39w DEPARTMENT 33370 SAN FRANCISCO,CA 94139.3370r {925 947-3336 PLEASE f.UT T NIS,AGC OUNt PATIENT NAME 8 RE N D I ROD R I GUE Z NUMBER ON YOt1E� NECK STATEMENT DATE 08/12/02 ADMISSION DATE 05/24/02 05/24/02 DISCHARGE DATE INTERIM FROM 05/24/02 05/24/02 INTERIM THROUGH TO: CHARGE TD MY; BhENT3I RC1DR I CaIIEZ ❑VISA 0 MASTERCARD ❑AMEX - 0 DISCOVER 2365 MEADOW WAY #121 CARD# SANTA: ROSA CA 55404 EXP.DATE L_ SIGNATURE AMOUNT PAID$ PLEASE DETACH AND RETURN THIS PORTION WITH YOUR REMITTANCE \TIENT NAME BREND I RODR I GUEZ PATIENT ACCOUNT NO. 55555-12666 PAGE 001 Fl SERVICE DESCRIPTION. t , . 7Cg300LABORATORY A RMACY til. 00 7 OR (LAB) .131. 20 8/CHEMISTRY 603. 30 C305LA8/HEMATOLOGY 100.00 C320DX X--RAY 551. 75 C324DX X-RAY/CHEST 267. 00 C351CT SCAN/HEAT) 0. 00 C330Bl.,OODBLOOD/STOR PROC "` 218. 05 C450EMERG ROOM 8, 506. 50 I C460PULMONARY FDNC � et. 00 C569MED SOC SERV/OTHER 1, 223. 25 TOTAL CHARGES .11, 801. 05 DIAGNOSIS CODE: 847. 0 HE HOSPfTZ-slad FOR CERTAIN HOSPITAL BASEL} JOHN MUIR I MT.DIABLO HEALTH SYSTEM PLEASE RETAIN T;IIS DETAIL STATEMENT 'HYSICIANS.YOUR SURGEON,ASST SURGEON, Ptd.BOX 39000 FOR YOUR RECORDS.ALL SUBSEQUENT .NESTHESIOLOOIST,RADIOLOGIST,ETC.MAY BILL YOU DEPARTMENT 33370 STATEMENTS WILL REELECT BALANCE 'EPARATELY FOR THEIR SERVICES SAN FRANCISCO,CA 94139-3370 FORWARD ONLY. 'PhPRAI 'rax In Nn QA-lAAiAAR Al K41SER 1EMA+yN NMt Kaiser Foundation Health Plan P.O. Box 12923 Oakland, California 94604-2923 (80 ) 390-3519 June 24, 2002 - - Rodriguez Brendi 2366 Meadow Way APt121 Santa Rosa, CA 96404 EXPLANATION OF OUT-OF-PLAN BENEF'IT'S Patient name: Rodriguez, Brendi Medical record no: 11-10619590 Claim no: 1560653/001 Provider Name: John Muir Medical Center Gate of service: 05/24/2002 Patient Acct No.. 5555512666 Dear Member: It has been a pleasure to assist you with your claim. Our goal is to reduce your medical casts and to provide excellent service. We have made the following payment(s) according to your Out-cif-flan benefits for emergency services. Billed Amount: $11,601.05 Current raiser Paid: $11,021.OQlohn Muir/Mt Diablo Health System You are responsible for any disallowed amounts, copayments or supplemental charges applicable to your Health Plan coverage. Our payment for this bill will be mailed within the next few days. Please help us serve you by notifying us of any errors or inconsistencies between services billed and services provided. Sincerely, Regional Health Plan Claims Department Kaiser Foundation Health Plan STATEMENT Jahn Muir Trauma. Physicians ACCOUNT NUMBER AAtEa GEi P.C . Bax 9021 29292-1-85 08-12-02 1 Walnut Creek, CA 94596 (925) 947-5288 . AMOUNT ENCLOSED L 170 . 10 TO: BRENDI RODRIGUEZ � FEDERAL I.D.NUMBER 2365 MEADOW WAY #1.21 .68-0130606 Santa Rosa, CA 95404 L FBILL TYPE- =a 3-s er i PLEASE DETACH ALONG PERPORATiON AND RETURN UPPER PORTION WITH YOUR PAYMENT y �,. s' 'Y F a7 `v € . �.. .` r 777 ` BRENDI 05=24-02 99291. .85 } Crit Care - 1st Fir 1 78009 568 .00 BRENDI 05-24-02 99292 �5 Crit Care Adel' 1 30 Min 1 178009 284 .00 BRENDI 06-04-02 85 SENT. Kamer Foundatio BRENDI b7-08-02 e5 ; Kaiser Pymt 681.90- . f i i i ! I j k PHYSICIAN: Ron Cooper', M.D. ( t Patient 0.00 0 .00 170.10 0.00 0 .00 170 .10 RODRICUEZ, BRENDI C>-$ GAYS 31 »S{i DAYS fit -`9E1 DAYS $� .2�^0 DAB'S w WI This Statement Represents Physician Services Rendered At John Muir Trauma Center. . If You Have Any Questions, Please Call (925) 947-5288, 9 :00 AM To 4:00 PM. 14 SER PERVANENTEe Kaiser Foundation Healtb Pian P.O. Box 12923 Oakland,California 94604--2923 (800).390-3510 June 21', 2002 Rodriguez Brenda 2365 Meadow Way Apt121 Santa Rasa, CA 95404 EXPLANATION OF OUT-OF-PLAN BENEFITS Patient name: Rodriguez, Brendi Medical record no: 11-10619590 Claim no: 1560653/002 Provider Name: John Muir Trauma Physicians Date of service: 05/21/2002 Patient Acct No.: 73838 COOPER Dear Member: It has been a pleasure to assist you with your claim. Our goal is to reduce your medical costs and to provide excellent service. We have made the following payment(s) according to your Out-of-Plan benefits for emergency services. Billed Amount: $852.00 Current Kaiser Paid: $681.90 John Muir Trauma Physicians You are responsible for any disallowed amounts, copayments or supplemental charges applicable to your Health Plan coverage. Our payment for this bill will be mailed within the next few days. Please help us serve you by notifying us of any errors or inconsistencies between services billed and services provided. Sincerely, RegionalHealth Plan Claims department Kaiser Foundation Health Plan STATEMENT 41 Jahn Muir Trauma Physicians � ACCOUNTAUMBER DATA PAGE' P.O. Box 9021 29292-1-214 08-12-02 1 Walnut Creek, CA 94591 (925) 947--528871-oEWM*149AMOUNT ENCLOSED 235 .34 TO: FEDERAL J.D.NUMBER BRENDI RODRIIGuEZ 1 2365 MEADOW WAY #121 68-0130606 Santa Rasa, CA 95404 Kaiser.BILL TYPE KLI:J.ser jE tom,.. PLEASE DETACH ALONG PERFORATION AND RETURN UPPER PORTION WITH YOUR PAYMENT y K .s k.I. p,a,& BRENDI 05-24-02 70450 214 CT Head Or Brain W/O C 1 95901 690 .00 BRENDI 07-08-02 214SENT: Kaiser Foundatio BREMI 08-07-02 ` X14 Kaiser Pymt 454 .66- i 1 i I i I j i 5 I PHYSICIAN: Jacob Epstein, M.I . Patient 0 .00 0.00 235.34 0 .00 0.00 235.34 RODRIGUEZ, BRENDI 0-30 DAYS 31 -6a DAYS 61.-90 DAYS 91 -110 DAY'S - � K41SEt PEMAN Kaiser Foundation Health Plan P.O. Box 1292 Oakland,California 94604-2923 (800) 390--3610 July 29, 2002 Rodriguez Brendi 2366 Meadow'L+ftay Apt121 Santa Rosa, CA 95404 EXPLANATION OF OUT-OF-PLAN BENEFITS Patient name. Rodriguez, Brendi Medical record no: 11-10619590 Claim no: 1560653/003 Provider Name: John Muir Trauma Physicians Gate of service: 05/2412002 Patient Acct No.: 744071EPSTEIN Dear Member: It has been a pleasure to assist you with your claim. Our goal is to reduce your medical costs and to provide excellent service. We have made the following payment(s) according to your Out-of-Pian benefits for emergency services. Billed Amount: $6903.00 Current raiser Paid: $454.66 John Muir Trauma Physicians You are responsible for any disallowed amounts, copayments or supplemental charges applicable to your Health Flan coverage. Our payment for this bill will be-mailed within the next few days. Please help us serve you by notifying us of any errors or inconsistencies between services billed and services provided. Sincerely, Regional Health Plan Claims Department Kaiser Foundation Health Plan FROM: STATEMENT 2 John Muir `Ira.uma .Physicians � ACCOUNT NUMBER DATE PAGE. P.O. Box 9021 29292-1-163 08.-12 1` Walnut Creek, CA 94596 {9'25) 947-5288 AMOUNT ENCLOSED cs 0.00. ' TO. BRENDI RODR GUEZ � FEDERAL I.D.�t�rM$ER- 2365 MEADOW WAY #121 68-0130606 Sant. Rosa, CA 95404 BILL'TYPE, Kaiser PLEASE DETACH ALONG PERFORATION AND RETURN UPPER PORTION WITH YOUR PAYMENT 77 BRENDI 05-24--02 99284 163 Ed Pt L4 Dtl H&E Mod C 2 8470 208.00 BRENDI 05-24-02 71.020-26 163` Chest 1 View 2 8470 38 .00 BRENDI 07-16-02 163 SENT: Kaiser Foundatio BRENDI 08-07-02 1.63 Kaiser Pymt 246.00 PHYSICIAN. Thome T1D.O. �ir�e, t Patient 0.00 0.00 0.00 0 .00 0.00 0.00 RODRIGUEZ, BRENDI 0-30 DAYS 1 31 -60 CLAYS 1 61 -90(SAYS 1 91 :.120 DAYS 14 KAISER PeRNOWNTEo Kaiser Foundation Health Plan P.O.Box 1292:3 Oakland,California 94604-2923 (l0)39{x-3510 July 29, 2002 - Rodriguez Brend'i 2365 Meadow Way Apt121 Santa Rosa, CA 95404 EXPLANATION OF OUT-OF-PLAN BENEFITS Patient name: Rodriguez, Brenda Medio record no: 11-1 061 9590 Claim no: 1560663/005 Provider Name: John Muir Trauma Physicians Cate of service: 05/24/2002 Patient Acct No.: 74618/TIGHE Clear Member: It has been a pleasure to assist you with your claim. Our goal is to reduce your medical costs and to provide excellent service. We have made the following payment(s) according to your Out-of-Pian benefits for emergency services. Billed Amount: $246.00 Current Kaiser Paid: $246.00 John Muir`trauma Physicians You are responsible for any disallowed amounts, copayments or supplemental charges applicable to your Health Plan coverage. Our payment for this bill will be railed within the next few days. Please help us serve you by notifying us of any errors or inconsistencies between services billed and services provided. Sincerely, Regional Health Plan Claims Department Kaiser FoundationHealth Plan FROM: STATEMENT 3 F John Muir Trauma Physicians � ACCOUNT NUMBER DA, E JPAGE• P.O. Box 9021 29292-1-209 08-12-02 � Walnut Creak, CA 94596 (925) 947-5288 E ► AMOUNT ENCLOSED L._ 0 .00 TO: BRENDI R©DRIGUEZ FEDERAL I.D.NUMBER 2365 'MEADOW WAY #121 68-01.30505 Santa Rosa, CA 95404 BILL TYPE Kaiser L PLEASE DETACH ALONG PERFORATION AND RETURN UPPER PORTION WITH YOUR PAYMENT fir . , �f°r! tip "e`, ,- ,.s7 { E <. BRENDI 05-24-02 71010-26 209 Chest 1 View 1 ' 9598 38 .00 BRENDI 05-24-02 72040-26 209 Spine Cervical AP/Lat � ; 7224 43 .00 BRENDI 07-08-02 209 SENT: Kaiser Foundatio BRENDI 08-07-02 209% Kaiser Pymt I 81.00- i i i I i I , t t PHYSICIAN: Barry Engel.stad, M.D,. Patient 0.00 0 .00 0 .00 0 . 00 0 . 00 0.00 RODRIGUEZ, BRENDI 0-30 DAYS 31 -60 DAYS 61 -90 DAYS 91 -120 DAYS r 10ZER P!sFMANEN Ee Kaiser Foundation Health Plan P.O. Box 12923 Oakland California 94604-2923 (800) 390-3510 July 29 2002 Rodriguez Brendl 2365 Meadow Way Apt121 Santa Rosa, GA 95404 EXPLANATION OF OUT-OF-PLAN BENEFITS Patient name: Rodriguez, Brendi Medical record no: 11-10619590 Crim no: 1560653/004 Provider Name: John Muir Trauma Physicians Dateof service: 05/24/2002 Patient Acct No.: 74406/ENGELSTAD Dear Member: It has been a pleasure to assist you with your claim. Our goal is to reduce your medical costs and to provide excellent service. We have made the following payment(s) according to your Out-of-Plan benefits for emergency services. Billed Amount: $81.00 Current Kaiser Paid: $81.00 John Muir Trauma Physicians You are responsible for any disallowed amounts, copayments or supplemental charges applicable to your Health Plan coverage. Our payment for this bill will be mailed within the next few days. Please help us serve you by notifying us of any errors or inconsistencies between services billed and services provided. Sincerely, Regional Health Plan Claims Department Kaiser Foundation Health Plan ! 4w1alr(43) %%AWOVI lUms JENTE STATEMENT PACE 1 OF 1 Breritli RC}DRIGUEZ DUE DATE STATEMENT DATE 07 .}3{02 -- 2365 MEADOW WAY APT121 07118/02 If you have any questions concerning SANTA ROSA CA 95404 this bill please call: 1-800-201-2123 Or write to: Kaiser Permanente Guarantor # 10619590 File 55571 Los Angeles,Ca 90074-5571 -« ACCOUNT# PATIENT NAME LOC SERV,DATE ACCOUNT ACTIVITY AMOUNT 5650627-0001 Brendi ROORIGUEZ SRO 06/03/0 CO--PAY, HEALTH PLAN FEE 5.00 06/03/02 ADMINISTRATIVE SURCHARGE 5.00 BALANCE DUE 10.00 ---------------------------------- --- --------- ------------------------------------------ 01ARECTI Rev 04/18/02,W8 TOTAL AMOUNT OF ALL ACCOUNTS $10.00 TOTAL BALANCE DUE FROM YOU $10.00 Any payments,charges,or adjustments received after the statement date above will appear on your next statement. Thank you for choosing Kaiser as your health care provider. Please pay your balance in full . PLEASE DETACH AT PERFORATION.AND RETURN BOTTOM PORTION WITH PAYMENT Make rheck payable to Kaiser Permanente I PREFER TO PAY AS FOLLOWS: STATEMENT DATE 07/03/02 1{F SCI PE tMANC.lVTE ❑ VISA ❑ MASTERCARD GUARANTOR # DATE DUE EXP.DATE: --- 10619590 07/16/02 NAME AS IT APPEARS ON CARD; BALANCE DUE AMOUNT PAID ACCOUNT NUMBER: 0 0 0F] [1[1[1[1 0 0 0F] F1 0 0 n $10.00 SIGNATURE OF CARD HOLDER; DATE: File 5.5571 BrendiRODRIGUEZ 2365 MEADOW WAY APT 121 SANTA ROSA CA 95404 870000106195900000001000 0703027 NS-5478(4.97) SALES DRAFT HEIFETZ CHIROPRACTIC 3760 DELTA FAIR BLVD SUITE L ANTIOCH, CA 94509- (925) 776-3268 4301322133922571 TID : 43013221339225788000001 DATE : 06/15/02 0044:14 PM THU ACCT : 000#0030178 VI BATCH : 165 TRAN # : 0323 AMOUNT $28.00 THANK YOU, PLEASE COME AGAIN, APPROVAL: 010441 mwep 081MORA Now DOLLARS fOR R `T t ' OR s ACCT cacti 1700 Delta Fair Bivd;,SSuite`L . CHECK Art OW, DUE t Alp 6,453 American Medical Response P.O. Box 3429 Modesto, CA 95353 July 01, 2002 —_ BRENDI RODRIGUEZ .... 1120 E LELAND RD APT 141 PITTSBURG CA 94565-5373 AMERICAN MEDICAL RESPONSE FILE 73329 PO BOX 60000 SAN FRANCISCO, CA 94160-3329 PATIENT NAME: BRENDI RODRIGUEZ TRIP NUMBER; MAT2213277000 DATE OF SERVICE: May 24 , 2002 BALANCE PAST DUE: 1163.80 r DEAR BRENDI RODRIGUEZ WE ARE PLEASED THAT WE COULD SERVE YOUR MEDICAL TRANSPORTATION NEEDS. OUR PAYMENT TERMS ARE NET 30 DAYS. IF YOU HAVE ALREADY PAYMENT ARRAGEMENTS, PLEASE DISREGARD THIS NOTICE. IF YOU HAVE INSURANCE COVERAGE OR WISH TO DISCUSS PAYMENT OPTIONS, PLEASE CONTACT OUR OFFICE. ACCOUNTS WHICH HAVE HAD NO PAYMENT OR CONTACT WITHIN 45 DAYS ARE, UNFORTUNATELY, FILED FOR CREDIT ACTION. IF YOU HAVE ANY SPECIAL NEEDS, DO NOT HESISTATE TO CONTACT US IMMEDIATELY. WE ARE PREPARED TO ASSIST YOU. OUR OFFICE HOURS ARE 8:00 A.M. TO 5.00 P.P. PACIFIC STANDARD TIME. ***** WE ACCEPT VISA, M/C, DISCOVER AND AMEX EXPRESS***** THANK YOU, PATIENT BUSINESS SERVICES (800)913-9106 OR (209)238-4710 PLEASE REMIT PAYMENT TO: AMERICAN MEDICAL RESPONSE FILE '73329 PO BOX 60000 SAN FRANCISCO, CA 94160--3329 alp 5,501 C.29 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Adopted this Order on September 17, 2002, by the following vote: AYES: Supervisors Uilkema, Gerber, DeSaulnier, Glover & Gioia NOES: None ABSENT: None ABSTAIN: None SUBJECT: Deny claim of Patrick and Isabel Kesler for refund of taxes for 1996 through 2000 tax years. RELISTED to September 24, 2002 1 hereby certify that this is a true and correct copy of an action taken and entered on the minutes of the Board of Supervisors on the date shown. Attested: September 17, 2002 John Sweeten, Clerk of the Board Of supervisors and County Administrator Deputy Clerk ontr TO: BOARD OF SUPERVISORS + r ► +i � a•Y FROM: JOHN SWEETEN, County Administrator Costa DATE: SEPTEMBER 17, 2002 � County SUBJECT: DENY CLAIM OF PATRICK AND ISABEL KESLER FOR REFUND OF TAXES FOR 1996 THROUGH 2000 TAX YEARS SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: DENY Claim of Patrick and Isabel Kesler for refund of taxes for 1995 through 2000 tax years. BACKGROUND: On June 19, 2002, the County Administrator received the attached letter from Tad M. Heilig, CPA, on behalf on Patrick and Isabel Kesler, requesting that the Board of Supervisors instruct the Assessor to correct an alleged clerical error that impacted the tax roll values and to issue refunds plus statutory interest due to the Keslers. County Counsel's investigation of the facts and circumstances of this situation indicate that the Kesler's 1995 transfer of property title to their children was incorrectly identified as a change in ownership, prompting a reassessment of the property. The laws governing this situation provide relief only for the year in which the matter was appealed and subsequent years, unless the appeal was made within three years from the property transfer. The Kesler's did not make their appeal within the three-year appeal period and are, therefore, not entitled to relief for periods prior to their appeal. We, therefore, recommend that the Board deny the Kesler's claim for refund of taxes for the 1996-2000 tax years. CONTINUED ON ATTACHMENT: ® YES SIGNATURE: . Z RECOMMENDATION OF COUNTY ADMINISTRATOR ❑ RECOMME TION OF BOARD COMMITTEE ®APPROVE ❑OTHER SIGNATURE{S}: ACTION OF BO D�}N APPROVED AS RECOMMENDED Q OTHER ❑ VOTE OF SUPERVISORS: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND UNANIMOUS{ABSENT j ENTERED ON THE MINUTES OF THE BOARD OF AYES: NOES: SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: ATTESTED Contact: JOAN SWEETS ,CLERK OF THE BOARD OF cc: Supervisor Gerber SUPERVISORS AND COUNTY ADMINISTRATOR Assessor County Counsel County Administrator By: — Deputy t Office of the County Counsel Contra Costa County 651 Pine Street, 9th Floor Phone: (925) 335-1800 Martinez, CA 94553 Fax: (925)646-1078 Crate: July 30, 2002 To: John Sweeten, County Administrator From: Silvano Marchesi, County Counsel By: Dennis Graves, Senior Financial C I Re: 6/19/02 Letter of Tad Heilig, CPA, on behalf of Patrick and,Isabel Kesler, APN 208-110-007 You recently forwarded the subject letter to this Office, asking us to comment on the Keslers' request for refund of taxes back to 1996. Although not specifically denominated as a refund claim, Mr. Heilig evidently intends that the letter be treated as a formal claim for refund to the Board of Supervisors. (R+TC Sec. 5096.) Since Mr. Heilig's letter includes little background, we have asked the Assessor to inform us as to the details of this case. The following analysis is based upon that information and the limited information in the Kesler claim. The issue arose in February of 1996, at which time there was a transfer between parents (the Keslers) and one of their children in order to protect against creditors of the parents. The taxpayer having provided incomplete information, it appeared to the Assessor that a change of ownership had occurred, and the property was reassessed. Several years later— in 2001 -- the Keslers filed assessment appeals board applications asserting that the 1996 event was not a change of ownership. In 2002, the appeals board agreed with the Keslers, ruling that the 1996 transfer was not a change of ownership. There are a number of code sections that potentially apply when administering requests for corrections to assessed values in various circumstances, and it is sometimes confusing as to which might apply in a given situation.- Revenue and Taxation Code Section 63.1 specifically addresses requests for relief in situations of parent-child transfers. Under Subsection (e)(1) thereof, the Keslers should have requested relief within 3 years (no later than 1999) if they were fo be granted refunds back to the 1996 year in which the event in question occurred. Subsection (e)(2)(A) thereof provides that, under the circumstances of delaying their request until 2001, the Keslers cannot be given relief for years prior to that year. This is consistent with Revenue and Taxation Code Section 80, which is the section 1 generally applicable to assessment appeals board determinations on such issues. Subsection 30(a)(5) thereof specifies that a reduction in base year value by an assessment appeals board shall apply for the year in which the matter is appealed and years subsequent thereto. In the present case, that would be for 2001 and subsequent years. We conclude that refunds should be allowed only for the years 2001 and subsequent. Since the Assessor has already processed the paperwork for such refunds, the claim for relief prior to 2001 should be denied by the Board. We recommend a consent item agendaed as follows. "Deny ctalm of PatOck and Isabel iKesler for refund of taxes for 1 96 through 2000 tax years." cc. Supervisor Donna Gerber Gus Kramer, Assessor Attn: Steve Dawkins, Asst. Assessor C:kesler.doc-3 2 Tad Ma of �.w -,.-Cerfified Public Accountant June 19, 2002 Mr . John Sweeten, Clerk and County Administrator Contra Costa County Board of Supervisors 651 Pine Street Martinez, CA 94553 'REGISTERED RETURN RECEIPT Re : Patrick & Isabel Kesler Appeal Application Dumber 2001-198 through 202 Pear Mr . Sweeten, In accordance with the instructions by Donna Gerber' s Staff, I am respectfully requesting you to schedule the Board of Supervisors to take the following action: ACTION REQUESTED Instruct Office of the Assessor to recalculate tax rolls for the years 1996 . 1997 , 1998 , 1999 and 2000 to correct a clerical error and request the Auditor/Controller' s Office to issue refunds plus statutory interest due . FACTS AND CIRCUMSTANCES 1 . Assessor' s office agrees refunds are due but state they do not have authorization or procedure (s) to process . 2 . They have, however, corrected the 2001 roll and all rolls thereafter . SUPPORTING DOCUMENTATION Attached for your reference is the following: 1 . Copy of the Assessment Appeals Board decision (legal issue) finding no change in ownership occurred on February 13, 1996 . 9.39 Haitz Wav (925) 8/20-6848 Suite 106 Fax: (925) 831-9189 Danville,ille, CA 94526 Ew,,a l: to MpaCaaol.co 2 . Copy of letter form Assessor' s Office correcting (2001 and forward only) for the "clerical error" . 3 . Copy of Revenue and Taxation Code 5095 (b) , stating "Any taxes paid before or after delinquency shall be refunded if they were erroneously or illegally collected" . (Clerical error substantiated and agreed to) . 4 . The refund and related interest is to be computed under Section 5151 (c) (1) , 5151 (A) , and 5151 (B) . (Copy attached) . Since I am the property owner' s authorized representative, it is requested all calculations, documents and other requests be sent directly to my office . They are elderly and temporarily living in Bakersfield, California for health reasons . Thank you in advance for your assistance in this matter. Sincerel Tad M. Hei rg TMH/as Enclosures cc: Donna Gerber District III Supervisor Office of the Assessor, w/o encl . Auditor/Controllers Office, w/o encl . H. Alan Huovinen, Esq. , w/o encl . Client, w/o encl . `^ < Mft BEFORE THE ASSESSMENT APPEALS BOARD OF CONTRA COSTA COUNTY, STATE OF CALIFORNIA In the Matter of Application of DECISION AFTER HEARING (Legal Issue) Patrick & Isabel Kesler P.O. Box 1040 Danville; CA 94526 Application No. 2001-0198 ihru 0202 Parcel No. 208-110-007-1 et al The application of the above named person for changed assessment having been regularly heard before the Assessment Appeals Board: The Board hereby finds that a change in ownership did not occur on February 13, 1996 Decided on February 7, 2002 by the following vote: A 1 S: V.G. Rousaville; P.F. Schwenger, J.J. Doherty NOES: None ABSENT: None A copy of the Decision was mailed to the above named applicant at the address given in the application on February 8, 2002 ATTEST: JOHN SWEETEN, Clerk of the Assessment Appeals Board and County Administrator - , Deputy Clerk cc: Applicant Agent Assessor Tax Collector Contra Office of Assessor Cuss A95Y4{Yso Kramer F CastsStephen Dar loci 25 O?err?ta1tE Drive, 5ttttc pit'?t? Assistant As.+smsor Count Mat-tinez, C alfforriia X14553-4350 Valuation t AX: (925) 313-7660 Lori Koch Teleplu)iw: (925) 313-750H0 Assistant Assessor Administration May 17,2002 IG MR. TAU M. HE IILI 939 HARTZ WAY, SUITE 106 DANVILLE, CA 94526 Re: 208-110-007 Dear Mr. Heilig: Per our phone conversation on May 15, 2002, you requested a letter stating what action will be taken by the Assessor's Office regarding the Kesler Appeal, Application number 2001 - 198 through 202. The Appeals Board determined that the transfer in February of 1996 between Patrick and Isabel Kesler and Randell Kesler was not a change in ownership. Per Section 51.5(a) of the Revenue and Taxation Code, we are correcting the clerical error(1996 transfer) in the year in which it was discovered and per Section 80(5) of the Revenue and Taxation Code we are correcting the 2001 roll as a result of the assessment appeal and correcting all rolls perspectively thereafter. Your very truly, Steve Dawkins, Assistant Assessor, Valuation For flus Kramer, County Assessor SD.jv heilig CA Codes (rtc:5096-51 X38) Page 1 of 9 I REVENUE AND TAXATION CODE SECTION 5096-5108 5096. Any taxes paid before or after delinquency shall be --efunded if they were: (a) Paid more than once. (b) Erroneously or illegally collected. (c) Illegally assessed or levied. (d) Paid on an assessment in excess of the ratio of assefsed value to the full value of the property as provided in Section 40, by _reason of the assessor's clerical error or excessive or improper assessments attributable to erroneous property information -.Upplied by the assessee. (e) Fail on an assessment of :improvements when the :mp::cirements did not exist on the lien date. (f) Paid on an assessment in excess of the equalized value of Lh,,i property as determined pursuant: {:o Section 1513 by the cou%: _y board of equalization. (g; Paid on an assess.rtent in excess of the value of the Properi:y as determined by the assessor pirsuant to Section 469. 5095.1. Except•, as hereinafter piovided, taxes collected on', behal:: of a local agency from a taxpaye:r whose property has been annexed to a second local agency but was not detached from the first Deal agency due to error or inadvertence shall be dee=med to have been erroneously collectze,d for purposes of Section 5096 if the g�verninq board of the first local agency makes a finding by resolution that detachment proceedings were riot :commenced due to excusable neglect. If the first local. agency is a, f'i.re protection district the! governa.r g body of the annexing agency may make the finding by resolution that detachment proceedings were not., corvoienced following annexation due t,,s excusable neglect. For purposes of determining the amount o� the refund the property shall be deemed to have been detached from the first local agency can the date annexation proceedings were rpompleted. This section shall riot: apply to taxes which would be caoliectible under authority of Government Code Section 55492 even though the annexed property had been detac~hed from the :special distri.cW. 50356.3. (a) To dispose ref cc :t t: ti.n lawsuits and assessment appeals that have been filed, and to the filing of other ci.aims relating to (1) the assessment, equalization, and as>sessabI ity of certain possessory interests in publicly awned airports and; (2) aircraft valuation and equalization by Alaska Airlines, Inc, , American Airlines, Inc. , Continental Airlines, Inc. , Delta Air lines, Inc. , Federal Express Corporation, Northwest Airlines, Inc. ; Trans World Airlines, Inc. , United Airlines, Inc. , United Parcel Service, U.S. Airways, Inc.. , ',linins We:,t Airlines, Southwest Airlines; America Nest Airlines, in their own right or as Successors in interest, counties shall provide future tax credits in the following amounts- http:l/ ,ww.leginfo.ca.gov/cgi-bin/displayeode?section=rtc&group=05001-06000&file=5096.5! 3/1/02 CA Cedes (rte:5150.5-5153) Page 1 of 2 REVENUE AND TAXATION CODE SECTION 5150.5-5153 5150. 5. In any action ira wlaic.ta i'tte recovery of a penalty assessed pursuant to paragraph (1) , (2) , ":"r (3) of subdivision (a) of Section 830 is allowed by the court, thu plaintiff shall be entitled to interest on the penal A,es For, whi.c-.h recovery is allowed, at the applicable rate or r.at:es in t f te:c.t from time to trims and payable on a refund of case as provided J.-, 5151 . This interest shall be payable from the date of fi l inn ut the claim for refund, but in no event earlier than the date ot payment of the penalty or installments thereof sought to be refunded, t.c, the date of entry of judgment. This accrued intere,,t be included in the judgment. 5151. (a) Interest .at the greater. of 3 percent per annum or the county pool apportioned rate shall be paid, when that interest is ten dollars ($10) or -norc!, on any amount refunded under Section 5096.7, or refunded to a taxpayer for aany reason whatsoever. However, no .interest shall be paid gander the Provisions of this section if the taxpayer has been given the r:o : icuc} required by Section 1635 and has failed to apply for tho refund within 30 days after the mailing of that: notice. for pux p():,e;s Of this section, "county pool apportioned rate" means the annualized rat, of interest earned on the total amount of pooled idle .funds .from all accounts held by the county treasurer, in exC:oss of the county treasurer's administrative costs With respect to that:: cafrourat, of June 30 of the preceding fiscal year for which the rotund is c!aa:lculated. For each fiscal year, the county treasurer --mull aadvi;s. r.ht' Controller of the county pool apportioned rate, and of coo-mput ations made in deriving that rate, no later than. 60 days after the end of that fiscal year. (b) The interest rate provided for in subdivision (a) does not :apply to i.nl-eres. on retunds of those amounts of tax that became due and payable before Match 1 , 1.993. Interest on refunds of amounts of a qualified tax sh.ail bc; paid a'at that rate provided for by this section as it bead prior to January 1, 1993. As used in this section, a "quail-tied tax" me iris a tax that became due and payable before March 1, 1993, orad had riot been refunded as of April 6, 1995. This subdivision shall not c!onstr'ued to affect the interest paid on refunds of -.hose rarrtount:s of tax that became due and payable before March 1, 1993, and have been rofurded as of April 6, 1395. (c) (1) The interest oo,inputation period shall commence with the crate of payment of the tax when any of the following apply. (A) A timely application for reduction in an assessment was filed, without regard to whether thra refund ultimately -results from a judgment or order of ra c..ourt., an order of a board of equalization or assessment appeals board, ox .an assessor's correct ion to the assessment roll. (5) The refund .i4 pursuant t.(> a roll correction resulting from the determination or �idjustrrtent by t:hf� assessor or a local assessment appeals board of a base year value. (C ) The re.tund .roesults from as ciorre.ction to the assessment roll pursuant to Soc,,ticjn 4831 oc 4W16. (2) Interest on .r.-E,fund,,; of t.aaxes on property acquired by a publi, agency in eminent domaitr shall. a,ccrue from the date of recordation f httpe//www.'Ieginto.ca.gov/cgi•bin/dispi,iyeode?section=rtc&group=05001-06004&file=5150.5- 3/1/02 a d �s E B 1�-) 4-I s > Q ca '4D VV y JO5N a� d ct) LO F:� 41 Ln >= s~ Ln � U Jc1 `s Q0- F � w cu rn a) [— t.0 _ U) ul cn u) m < 7S O •11 = m U � 0 # LLI O m N I €# h -'4 �A O, 104 ri m s4 +J � 41 U U rrEsrrrwa �` :.;: —• _n ....... ................ ... cl CJ a ��r Ln wrw� Lf} C3 +rri+ ru C.7 WWAMUM C3 C`- �,.,,-, �� r„-�. ����.- .4 S: YSY }': S: �� �f �y �'. �• 1 �`V,. G. �� J. •F. b. �: �. R; kk 2 �: }25£ �: �}5£ t r �� } �$ t �S 54 �5 f �. �., �i Tad M. Heilig ' ' Certified Public Accountant September 18, 2002 RECEIVED Silvano Marchesi, County Counsel 651 Pine Street SEP 19 20692 9th Floor CLERK BOARD OF SUPERVISORS Martinez, CA 94553 CONTRA COSTA CO Re : September 17, 2002 Board of Supervisors Meeting Re : Consent Item C-29 Dear Mr . Machesi, I trust you have or will soon receive a copy of my memo and related exhibits presented to the Board of Supervisors yesterday. You should know, I attempted to contact Dennis Graves of your office on Friday September 13, 2002 to discuss his comments and conclusion per his correspondence of July 30, 2002 . Since he was unable to get back to me prior to the meeting, there was not sufficient time to provide all documentation to your office. Moreover, as a result of the short time frame allowed at the Board of Supervisors hearing, I was unable to correct a "highlighting" error on my Exhibit 16, Page 2 (enclosed) . I believe you will find it applicable in this situation in addition to other information previously provided. Upon further review, I expect your office will revise its position and advise the Board to approve this item and instruct refunds to be issued. 939 Hartz Way (925)820-6848 Suite 106 Fax:(925)83I-9189 Danville, CA 94526 Email:trnhepa@aol.com In the event I can be of further assistance, please contact my office. Sincerel C� Tad M. Ilei g TMH/as Enclosures cc: Supervisor John M. Gioia, Chair District I Supervisor Gayle B. Uilkema, District II Supervisor Deanna. Gerber, District III Supervisor Mark DeSaulnier, District IV Supervisor Federal Glover, District V Dennis Graves, Senior Counsel John Sweeten, County Administrator Gus Kramer Assessor Steve Dawkins, Assistant Assessor H. Alan Huovinen, Esq. Patrick & Isabel Kesler Mr. Chuck Brough February 11,2002 Page 2 1 If the 1990 base year value error involved value Judgment.no time remains under section 51.5 fib)to correct it if it was clerical all years should be corrected under section 1 5 ff} back to 1990. Section 5 1.1 provides specific authority and timing for assessors to correct base year value errors. Correction of errors or omissions not involving the exercise of an assessor's judgment as to value is authorized under subdivision(a),whereby the assessor may at any time go back to the date of the event to make the correction. The assessor's correction of clerical errors,as defined in subdivision(f),may also be undertaken at an time,back to the date of the event. Correction of errors or omissions involving the exercise of the assessor's value judgment authorized under subdivision(b)however,must be made"within four Years(after July 1 of the assessment year for which the base year value was first established." To determine the number of years to be corrected,the assessor must first make a determination of the type of error involved. The type of base year value error—whether nonjudgmental, involving value judgment,or clerical—is a question of fact in each case. Neither the Legislature nor the courts have promulgated a standard or"test" applicable to every scenario.' The Board staff"guidelines" suggested below are merely interpretations made by the courts in applying subdivision(a), (b) or(f)of Section 51.5. Subdivision(a)-Unlimited time to Correct Noniudgmental Errors a) In Montgomery Ward& Co. v. County of Santa Clara(1996)47 Cal.App.4" 1122, a change in ownership occurred and timely reported,but the assessor did not enroll the base year value within four years after July 1 of the assessment year in which it occurred. Held: value judgment had not been exercised,the error could be corrected at any time-section 51.5(x). b) In Sunrise Retirement Villa v. Dear(1997) 58 Cal.App.4'948,the assessor reappraised for a change in ownership and enrolled the new base year value within four years. Almost ten years later,Taxpayer established that assessor's change in ownership determination was a mistake. Held: value judgment was not exercised where the issue is a change in ownership,and if the appeals board found that a change in ownership did not occur,the error could be corrected at any time-section 51.5(x). c) In Firestone Tire do Rubber Co. v. County of Monterey(1990) 223 Cal.App.3d 382; County of San Diego v. Assessment Appeals Board No. 2 of San Diego County(1983) 148 Cal.App.3d 548,the error in base year value was due to waste contamination. ' Further,there is no statutory standard of proof required to establish whether a particular error involves value judgment or is clerical or nonjudgmental in nature. M rn t3� C �' to ' N 0 C) .� cp_ C > (D CD 4 , 0 m > P J M. 4 N Y k f r j }� a CONTRA COSTA COUNTY BOARI? OF SUPERVISORS ` SES' 17 2002 MEMO RE: CONSENT ITEM C.29 C K BOARD OF SUPERVISORS SEPTEMBER 17, 2002 CONTRA COSTACfi, I . REQUEST: +� Board grant claim of Patrick & Isabel Kesler for refund of taxes for 1996 through 2000 tax years . II , REASONS: A. County Administrator was to have only requested Board to establish Non--Existing Procedures to issue refund, not whether or not refunds were to be allowed. He, in error, sent back to the Clerk of the Assessment Appeals Board, to forward to County Counsel . B. County Administrator is now incorrectly advising you to deny claire based on an opinion of the Office of the County Counsel that, as stated in their correspondence, is based solely on " little background" in my letter and information provided solely by the Assessor' s Office. Jim Lynch argued Revenue and Taxation Code Section 63 . 1 at Appeals Board hearing (relative to 3 year statute) and was overruled based on no change in ownership in 1996 . In fact, had Section 63 . 1 applied, the claims for refund would have been denied. Accordingly, Revenue and Taxation Code Section 80 is also inapplicable . There was no attempt made to contact my office and, to the best of my knowledge background information was not requested from the Assessment Appeals Board either . C. Assessment Appeals Board ruling is "final" . You will be, in fact, overruling them based on County Counsel and Ccunty Administrator improper recommendations . 1 could not have appeared before you had they ruled adversely upon the taxpayer. D. A denial decision by you will necessitate my recommending my client to seek legal counsel to file suit in Superior Court. CONTRA COSTA COUNTY BOARD OF SUPERVISORS MEMO RE: CONSENT ITEM C. 29 SEPTEMBER 17 , 2002 PAGE 2 III . SUPPORTING DOCUMENTS AND STATEMENTS: A. Incorrect action_ being requested. (I I :A, above) • Exhibit 1 : Copy of my June 19, 2002 correspondence • Exhibit 2 : Assessor's office has agreed to .issue refunds Assessor's office has stated no current mechanism exists to process refunds • Exhibit 3 : Board of Supervisors created Assessment Appeals Board • Exhibit 4 : Assessment Appeals Board authorized to resolve disputes • Exhibit 5 : Assessment Appeals Board is authorized and has previously resolved valuation dispute. You are being asked to overrule Assessment Appeals Board. Further, Assessment Appeals Board ruled no change in ownership recorded. Since a clerical error there is no statute of limitations. • Exhibit 6 : The decision of the Appeals Board is final . Any adverse action by the Assessment Appeals Board can only be timely .filed in Superior Court by either the applicant or the Assessor. CONTRA COSTA COUNTY BOARD OF SUPERVISORS MEMO RE: CONSENT ITEM C.29 SEPTEMBER. 17, 2002 PAGE S B. County Administrator ill -advised Board regarding legal basis for denial (Ii :B, above) • Exhibit 7 : County Administrator recommending incorrect vote • Exhibit 8 : Legal opinion incorrect since there was no transfer and therefore no statute of limitation • Exhibit 9 : Assessor admits to "clerical error' which mandates refunds • Exhibit 10 « 11 : Taxes must be refunded if erroneously collected • Exhibit 12 : Taxes must be refunded without a formal claim by taxpayer C . Appeals Board ruling is final (II :C, above) • Exhibit 13 : Role correction based on Appeals Board decision D. Anticipated action to be taken in Superior Court upon denial of claim. (I7- : D, above) • Exhibit 14 : Only recourse upon denim. is Superior Court • Exhibit 15 : Person who paid tax must bring suit. • Exhibit 16 : Courts have held statutes are aimed toward ".inequitable retention of money that has been improperly collected CONTRA COSTA, COUNTY BOARD OF SUPERVISORS MEMO RE: CONSENT ITEM C.29 SEPTEMBER 17 , 2002 PAGE 4 IV. CONCLUSION: Board should approve claim and instruct Tax Collector and Auditor to immediately process refunds, inclusive of interest. Tai. M. Heft Certified Public Accountant June 19, 2002 Mr. Jahn Sweeten, Clerk and County Administrator Contra Costa County Board of Supervisors 651 Pine Street Martinez, CA 94553 REGISTERED RETURN RECEIPT Re : Patrick & .Isabel Kesler Appeal Application Number 2001-198 through 202 Dear Mr. Sweeten, In accordance with the instructions by Donna Gerber' s Staff, I arra respectfully requesting you to schedule the Board of Supervisors to take the following action : ACTION REQUESTED Instruct Office of the Assessor to recalculate tax rolls for the years 1996. 1997, 1998, 1999 and 2000 to correct a clerical error and request the Auditor/Controller' s Office to issue refunds plus statutory interest due. FACTS AND CIRCUMSTANCES 1 . Assessor' s office agrees refunds are due but state they do not have authorization or procedure (s) to process . 2 . They have, however, corrected the 2001 roll and all rolls thereafter. SUPPORTING DOCUMENTATION Attached for your reference is the following: 1 . Copy of the Assessment Appeals Board decision (legal issue) finding no change in ownership occurred on February 13, 1996 . 939 Hartz Way (925) 820-6848 Suite 106 Fax: (925) 8319189 Danville, CA 94526 Email: tmhcpa@aol.com 2 . Copy of letter form Assessor' s Office correcting (2001 and forward only) for the "clerical error" . 3 . Copy of Revenue and Taxation Code 5096 (b) , stating "Any taxes paid before or after delinquency shall be refunded if they were erroneously or illegally collected" . (Clerical error substantiated and agreed to) . 4 . The refund and related interest is to be computed under Section 5151 (c) (1) , 5151 (A) , and 5151 ($) . (Copy attached) . Since I am the property owner' s authorized representative, it is requested all calculations, documents and other requests be sent directly to my office . They are elderly and temporarily living in Bakersfield, California for health reasons . 1"hank you in advance for your assistance in this matter. Sincerely, Tad M. Heilig TMH/as Enclosures cc: Donna Gerber District III Supervisor Office of the Assessor, w/o encl . Auditor/Controllers Office, w/o encl. H. Alar Huovinen, Esq. , w/o encl. Client, w/o encl . TELEPHONE CALL SUMMARY The following telephone conference abstracts are provided under penalty of perjury, to the best recollection of Tad. M. Heilig, 'CPA (Agent) . DATE: May 28, 2002 CONTACT: Gus Kramer COMMENT: "Refunds will be issued. Trouble figuring out how. Call Jim Lynch" DATE: May 28, 2002 CONTACT: Jim Lynch COMMENT: "Go to Board of Supervisors-no mechanism exists with Tax Collector or Auditor to issue prior year refunds ." DATE: June 5, 2002 CONTACT: Jay at Donna Gerber' s office COMMENT- Asking how to address Board of Supervisors DATE : June 13, 2002 CONTACT: Jay at Donna Gerber' s office COMMENT: Provided specific instructions to request Board action allowing me to draft my June 19, 2002 letter. PHONE LOG DATE TIME OF FRGi1K TO TIME CLIENT REGARDING t t e I I t u 1 t ; i t 1, 1' k> C� f. l u coi f It tt . 4 ` 4 :. PHONE LOG DATE TIME OF FROM TO TIbS CLIENT REGARDING r PQ i , , i i :F A five-member Board of Supervisors, each of whom Is elected on a non- partisan basis from a separate district where he/she lives, governs Contra Costa County. Within the broad limits established by Article XI, Section 5 of the State Constitution and the State Government Code, the Board Is the governing body of County government and of 186 special districts. The Board enforces various State statutes and enacts local legislation to serve and protect County residents. The Board establishes general policies and plans for the operation of County government. �e< a. Sohn M.Moia Says.S.tii#icama tonna WtUuinkw Pokrai'tiir Chair tisirlct II ofstrict III Diftrict IV Disbict V District I As defined by General Law, the duties of the Board of Supervisors are as follows: a Appoint most County Department Heads, except elected officials, and provide for the appointment of all other County employees. a Provide for the compensation of all County officials and employees. m Create officers, boards and commissions as needed, appointing members and fixing the terms of office. • Award all contracts for public works and all other contracts exceeding $25,000. http://www.00.conte-costa.ca.us/BOS/lrndex.html 9115/02 . Adapt an annual budget. • Sponsor an annual audit made of all County accounts, books and records. + Supervise the operations of departments and exercise executive and administrative authority throughout County government through a County Administrator. • Serve as the appellate body for planning and zoning Issues. • Serve as the County Board of Equalization (the Beard has created an, sment App+ea s oto perform this function). The Supervirlal Districts and their incorporated cities, and other primary areas, are as follows (as of September 2001): District 1 District 2 District S District 4 District 5 BayView/Montaivin Alhambra Alamo CIa on Antioch Manor Valley East Richmond Canyon Blackhawk Clyde Bay Point Heights El Cerrito Crockett Brentwood Concord Bethel Island El Sobrante Hercu Byron Pacheco Oakley (part) Kensington Wan= Danville Pleasante P `r Hill North Richmond Martinez Diablo Pleasant Hill BART Richmond MQrag.a Discovery Walnut Bay (part) Rollingwood Mt. 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'{a r a ♦a "'�_ '. ,Iw .'� BEFORE THE ASSESSMENT APPEALS BOARD OF CONTRA COSTA COUNTY, STATE OF CALIFORNIA i In the Matter of Application of i DECISION AFTER HEARING (Legal Issue) Patrick& Isabel Kesler P.O. Boy 1040 Danville, CA 94526 Application No. 2001-0198 thru 0202 Parcel No. 208-110-007-1 et al The application of the above named person for changed assessment having been regularly heard before the Assessment Appeals Board: The Board hereby finds that a change in ownership did .not occur on February 13, 1996 Decided an February 7, 2002 by the following vote: AYES: V.G. Rousaville; P.E. Schwenger; J.J. Doherty NOES: None ABSENT: None A copy of the Decision was mailed to the above named applicant at the address given in the application on-- February 8. 2002 ATTEST: JOHN SWEETEN, Clerk of the Assessment Appeals Board and County Administrator By: v. , Deputy Clrk cc: Applicant Agent Assessor �� SSE 305-AH(sem)REV.3(3-00) INFORMATION AND INSTRUCTIONS FOR APPLICATION FOR CHANCED ASSESSMENT The-State Board of Equalization has prepared a pamphlet to assist you In completing this application. You may download a copy of Publication 30, Restdentiaf Property Assessment Appeals, at www.boe.ca.gov or contact the clerk of your local board for a copy. Fling this application for reduced assessment does not relieve the applicant from the obligation to pay the taxes on the subject property on or before the applicable dual date shown on the tax bill. If a reduction Is granted, a proportionate refund of taxes paid will be made by the county. Based on the evidence, the appeals board can Increase as well as decrease an assessment.The decision of the appeals board upon this application is final; the appeals board may not reconsider or rehear any application. However, either the applicant or the assessor may bring timely action In superior court for review of an adverse action. An application may be amended until 5:00 p.m. on the last day upon which the application might have been timely filed. After the filing period, an invalid or incomplete application may be corrected at the request of the clerk or amendments may be made at the discretion of the board.Contact the clerk for information regarding correcting or amending an application. The appeals board can hear matters concerning an assessors allocation of exempt values. However, it cannot hear matters relating td a person's or organization's eligibility for a property tax exemption. Appeals regarding the denial of the Welfare Exemption should be referred to the State Board of Equalization, Policy, Planning, and Standards division, MIC-64, PO Box 942879, Sacramento, CA 94279-0064. Appeals regarding the denial of any other type of exemption are under the jurisdiction of the assessor and/or the courts. The following-numbered instructions apply to the corresponding numbers on the application form. Please type or print in ink all Information on the application form. Box 1. Enter the name and mailing address of the applicant. If the applicant is other than the assesses (e.g., leased property), attach an explanation. NOTE:An agent's address may not be substituted for that of the applicant. Box 2. Provide the name and mailing address of the agent or attorney, If applicable. If the agent Is not a California-licensed attorney, you must also complete the agent's authorization section, or an agent's authorization may be attached to this application.An attached authorization must contain all of the following information: • The date the authorization is executed. • A statement that the agent is authorized to sign and file applications in the calendar year of the application. • The specific parcei(s) or assessment's) covered by the authorization, or a statement that the agent is authorized to represent the applicant on all parcels and assessments located within the county that the application is being filed. • The name, address, and telephone number of the agent. The applicant's signature and title. • A statement that the agent will provide the applicant with a copy of the application. Box 3. If this application Is for an assessment on secured property, enter the Assessor's Parcel Number from your assessment notice or from your tax bill. if the property Is unsecured (e.g., an aircraft or boat), epter the account number from your tax bill. If appropriate, enter the name of the business (DBA). Enter a brief description of the property location, such as street address, city, and zip code, sufficient to Identify the property and assessment being appealed. 6 For a single-family dwelling, indicate if the dwelling Is owner-occupied. Box 4. Column A: Enter the figures shown on your assessment notice or tax bill for the year being appealed. If you are appealing a current year assessment (base year or decline in value) and have not received an assessment notice, or are unsure of the values to enter In this section, please contact the assessor's office. If you are appealing a calamity reassessment or an assessment related to a change in ownership, new construction, roll change, or escape assessment, refer to the reassessment notice you received. If you are appealing a penalty assessment, NOTE: a penalty assessed by the tax collector for nonpayment of taxes cannot be removed by the appeals board. Column B: Enter your opinion of value for each of the applicable categories. If you do not state an opinion of value, It will result In the rejection of your application. QMATAV30F_"h4S0MAH-0G 5-3-00 F- TO: BOARD OF SUPERVISORS ontra FROM: JOHN SWEETEN,County Adminfsttator40 Costa DATE: SEPTEMBER 17,2002 County SUBJECT: DENY CLAIM OF PATRICK AND ISABtEL KESLER FOR REFUND OF TAXES FOR 1996 THROUGH 2000 TAX YEARS SPECIFIC REQUEST(S)OR R=M 24DATION41 t BACKGROUND ANC JUSTIFICATION RECOM-MgNOATION: DENY claire of Patrick and Isabel Kesler for refund of taxes for 1996 through 2000 tax.yeam, MCKGROUND: On June 19,2002,the County Administrator received the attached letter from Tad M,Heillg, CPA,on behalf on Patrick and Isabel Kesler,requesting that the Board of Supervisors Instruct the Assessor to correct an alleged clerical error that Impacted the tax roll values and to issue refunds plus statutory interest due to the Keslers. County Counsel's investigation of the facts and circumstances of this situation indicate that the Kesiefa 1996 transfer of property title to their children was incorrectly identified as a change In ownership,prompting a reassessment of the property. The lays governing this situation provide relief onIV for the year in which the matter was appealed and subsequent years,unless the appeal was made within three years from the property transfer. The Kesiers did not make their appeal within the three-year appeal period and are,therefore,not entitled to relief for periods prior to their appeal, We,therefore,recommend that the Board deny the Kesler's claim for refund of taxes for the 1996-2000 tax years. CONTINUED ON ATTACHMENT: 0 YES sKI NATURE: RECOMMENDATION Of COUNTY ADMINISTRATOR RECOMME TION OF BOARD COMMITTEE APPROVE 0 OTHER ffiIONATUiRE 8: ACTION OF BO N APPROVED As RECOMMENDED ❑ OTHER [] VOTE OF SUPERVISORS: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTtON TAKEN AND UNANIMOUS(ASSENT 3 ENTERED ON THE PtNNUTES OF THE BOARD OF AYES: NOES: SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: ATTESTED Contact: JOHN SWEETEN,CLERK Of THE BOARD OF Cc: Sspsrvisor Ssrbar BUP'EKVISORS AND COUNTY ADMINISTRATOR Asaeascr County Counaoi County Administrator By. nsputy Contra Off +ce of Assessor Gus Assessoso Kramerr Costa 2530 Arnold Drive, Suite 400 Stephen llessor s Assistant Assessor Martinez, California 94553-4359 valuation County FAX: (925)313-7660 Lori Koch Telephone: (925) 313-7500 Assistant Assessor Administration May 17, 2002 MR. TAD M. HEILIG 939 HARTZ WAY, SUITE 106 DANVILLE, CA 94526 Re: 208-110-007 Dear Mr. Heilig: Per our phone conversation on May 15, 2002, you requested a letter stating what action will be taken by the Assessor's Office regarding the Kesler Appeal, Application number 2001 - 198 through 202. The Appeals Board determined that the transfer in February of 1996 between Patrick. and Isabel Kesler and Randell Kesler was not a chane in ownership. Per Section 51.5(x) of the Revenue and Taxation Code, we are correcting the encs err 1996 transfer) in the year in which it was discovered and per Section 80(5) of the Revenue and Taxation Code we are correcting the 2001 roll as a result of the assessment appeal and correcting all rolls perspectively thereafter. Your very truly, Steve Dawkins, Assistant Assessor, Valuation For Gus Kramer, County Assessor SD:jv heitig l ti LUCKS �fLL:JU7U`J f L10J rage i of Y ItE EN E AND TAXATION CODE SECTION 5096-5108 5096. Any taxes paid before or after delinquency shall be refunded if they were: (a) Paid more than once. (b) Erroneously or illegally collected. (c) Illegally assessed or levied. (d) Paid on an assessment in excess of the ratio of assessed value to the full value of the property as provided in Section 401 by reason of the assessor's clerical error or excessive or improper assessments attributable to erroneous property information supplied by the assessee. (e) Paid on an assessment of improvements when the improvements did not exist on the lien date. (f) Paid on an assessment in excess of the equalized value of the property as determined pursuant to Section 1513 by the county board of equalization. (g) Paid on an assessment in excess of the value of the property as determined by the assessor pursuant to Section 469. 5096. 1. Except as hereinafter provided, taxes collected on behalf of a local agency from a taxpayer whose property has been annexed to a second Local agency but was not detached from the first local agency due to error or inadvertence shall be deemed to have been erroneously collected for purposes of Section 5096 if the governing board of the first local agency makes a finding by resolution that detachment proceedings were not commenced due to excusable neglect. If the first local agency is a fire protection district the governing body of the annexing agency may make the finding by resolution that detachment proceedings were not commenced following annexation due to excusable neglect. For purposes of determining the amount of the refund. the property shall be deemed to have been detached from the first local agency on the date annexation proceedings were completed. This section shall not apply to taxes which would be collectible under authority of Government Code Section 55492 even though the annexed property had been detached from the special district. 5096. 3. (a) To dispose of certain lawsuits and assessment appeals that have been filed, and to preclude the filing of other claims relating to (1) the assessment, equalization, and assessability of certain possessory interests in publicly owned airports and (2) aircraft valuation and equalization by Alaska Airlines, Inc. , American Airlines, Inc. , Continental Airlines, Inc. , Delta Air Lines, Inc. , Federal Express Corporation, Northwest Airlines, Inc. , Trans World Airlines, Inc. , United Airlines, Inc. , United Parcel Service, U.S. Airways, Inc. , Wings West Airlines, Southwest Airlines, America. West Airlines, in their own right or as successors in interest, counties shall provide future tax credits in the following amounts: http://www.leginfo.ca.gov/cgi-bin/displayeode?section=rtc&group=05001-06000&dile=5096-51 3/1/02 Office of the County Counsel Contra Costa County 651 Pine Street, 91h Fio& Phone: (925)335-1 Boo Martinez, CA 94553 Fax:(925)646-1078 Date: July 30, 2002 To: John Sweeten, County Administrator J' From: Silvano Marchesi, County Counsel , By: Dennis Craves, Senior Financial C l Re: 6/19/02 Letter of Ted Heilig, CPA, on behalf of Patrick and Isabel Kesler, APN 208-110.007 You recently forwarded the subject letter to this Office, asking us to comment on the Keslers' request for refund of taxes back to 1996. Although not specifically denominated as a refund claim, Mr. Heilig evidently intends that the letter be treated as a formal claire for refund to the Board of Supervisors. (R+TC Sec. 5096) Since Mr. Heilig's letter includes little background, we have asked the Assessor toti Inform, us as to the details of this case. The following analysis is based upon that information and the limited information in the Kesler claim. The issue arose in February of 1996, at which time there was a transfer between parents(the Keslers) and one of their children in order to protect against creditors of the parents. The taxpayer having provided incomplete information, it appeared to the Assessor that a change of ownership had occurred, and the property was reassessed. Several years later— in 2001 -- the Kesiers filed assessment appeals board applications asserting that the 1996 event was not a change of ownership. In 2002, the appeals board agreed with the Keslers, ruling that the 1996 transfer was not a change of ownership. There are a number of code sections that potentially apply when administering requests for corrections to assessed values in various circumstances, and it is sometimes confusing as to which might apply in a given situation. �( Revenue and Taxation Code Section 63.1 specifically addresses requests for relief in � o ituations of parent-child transfers. Under Subsection (e)(1) thereof, the Keslem shou?d j. ave requested relief within 3 years (no later than 1999,E if they were to be granted funds track to the 1996 year in which the event in question occurred. Subsection �0 J )(2)(A)thereof provides that, under the circumstances of delaying their request until 2001, the Keslers cannot be given relief for years prior to that year. This is consistent with Revenue and Taxation Code Section 60, which is the section 10 VP� generally applicable to assessment appeals beard determinations on such issues. e Subsection 80(a)(5) thereof specifies that a reduction In base year value by an assessment appeals board shall apply for the year in which the matter is appealed and r years subsequent thereto. In'the present case, that would be for 2001 and subsequent years. We conclude that refunds should be allowed only for the years 2001 and subsequent# ` ' Since the Assessor has already processed the paperwork for such refunds, the claim for relief prior to 20011 should be denied by the Board, We recommend a consent Hem � � .� agandaed as follows: "deny claim of Patrick and Isabel Kesler for refund of taxes for ,o°c�dd 1996 through 2000 tax years," cc: Supervisor Donna Gerber Gus }garner„ Assessor Attn: Steve Dawkins, Asst. Assessor COUN'fRA MSTJA COUNMN RECEIVED r l C:kesler.doc-3 2 STATE OF CALIFORNIA STATE BOARD QE EQUALIZATION JOHAN KLEHS 460 N STREET,SACRAMENTO,CALIFORNIA Fist District,Hayward (PO BOX 9+42878,SACRAMENTO,CALIFORNIA 94279.0082) DEAN ANDAL TELEPHONE(916)323-7713 Second DI*Id,Stockton FAX(916)323.3367 ctauDt:FARRisw Third District,Torrance �+ t �y JOHN CHIANG February 1 1,2002 Fourth District,Las Angaias KATHLEEN CONNELL Controtfer,Sacramento Honorable Thomas P. Kidwell �Exd a �o Madera County Assessor Attn: Mr. Chuck Brough, Chief Appraiser 209 West Yosemite Avenue Madera, CA 93637 Attn: Mr. Chuck Brough Re- Base Year Value Corrections, roll corrections,.Refunds Bear Mr. Brough: This is in response to your letter of September 20,200 1,to Chief Counsel Timothy Boyer requesting our interpretation of several Revenue and Taxation Code sections applicable to correcting a base year value error and issuing appropriate refunds. Please excuse the delay in responding as other previously scheduled Board matters have occupied our time. Based on the 1 circumstances described in your letter, we conclude that 1) if'the 1990 base year value error C� �X' � involved value judgment, there is no time remaining under section 51.5 subdivision(b)to 0 't correct; however, if it was clerical, the error should corrected under section 51.5, subdivision(f) 0 for all years back to 1990; 2) if the error is clerical(nonjudgmental),the years available for correction are not limited by the statute of limitations on roll corrections under section 4831; and 3)if corrections are made for all years,the taxpayer has one year from the date of notice under section 263 5 to claim refunds back to 1990. Facts A change in ownership occurred in October 1990,and an error in the base year value was made in that the assessed value,based on comparable sales,should have been$50,000 less than the value actually enrolled. The taxpayer did not question the value (nor did the assessor discover it) until 2001, at which time the assessor's office determined that a correction was necessary for the 2002 roll. You wish to know: 1)whether section 51.5 authorizes a reduction in base year value for all years or only four years since the 1990 change in ownership;2)whether reductions under section 51.5 are limited to the number of years for which roll corrections can be made under section 4831; and 3) whether refunds resulting from a base year value reduction are available for all years under section 2635, or limited to four years under section 5097. Mr.Chuck Brough February 11, 2002 Page 2 1. If the 1990 base year value error involved value idgment<no time remains under section 51.5 N to correct it, if it was clerical, all years should be corrected under section 5 1.5 (f), back to 1990. Section 51.1 provides specific authority and timing for assessors to correct base year value errors. Correction of errors or emissions not involving the exercise of an assessor's judgment as to value is authorized under subdivision(a),whereby the assessor may at snv time go back to the date of the event to mare the correction. The assessor's correction of clerical errors, as defined in subdivision (f), may also be undertaken at My time,back to the date of the event. Correction of errors or omissions involving the exercise of the assessor's value judgment authorized under subdivision(b)however,must be made"within four years lafter July 1 of the assessment year for which the base vear value was first established." To determine the number of years to be corrected,the assessor must first make a determination of the type of error involved. The type of base year value error—whether nonjudgmental, involving value judgment,or clerical--is a question of fact in each case. Neither the Legislature nor the courts have promulgated a standard or"test" applicable to every scenario.' The Board staff"guidelines" suggested below are merely interpretations made by the courts in applying subdivision(a), (b)or(f)of Section 51.5. Subdivision(al - Unlimited time to Correct Noajg d_Mental.Errors a) In Montgomery IV and& Co. v. County sof Santa Clara (1996)47 Cal.AppAt' 1122,a change in ownership occurred and timely reported, but the assessor did not enroll the base year value within four years after July 1 of the assessment year in which it occurred. Feld: value judgment had not been exercised;the error could be corrected at any time - section 51.5(a). b) In Sunrise Retirement Villa v. hear(1997) 58 Cal.App.4ffi 948,the assessor reappraised for a change in ownership and enrolled the new base year value within four years. Almost ten years later,Taxpayer established that assessor's change in ownership determination was a mistake. Held: value judgment was not exercised where the issue is a change in ownership; and.if the appeals board found that a change in ownership did not occur,the error could be corrected at any time - section 51.5(a). c) In Firestone Tire &Rubber Co. v. County of Monterey(1990) 223 Cal.App.3d 382; County of San Diego v. Assessment Appeals Board No. 2 cifSan Diego County(1983) 148 Cal.App.3d 548, the error in base year value was due to waste contamination. ` Further,there is no statutory standard of proof required to establish whether a particular error involves value judgment or is clerical or nonjudgmental in nature. Mr. Chuck Brough February 11, 2062 Mage 3 Held: ffinformation on the condition had been provided to the assessor at the time of the event triggering the new base year value and the information was omitted(not considered)by the assessor in making the valuation, it was nonjudgmental, and may be corrected at any time. (Value judgment not exercised with regard to the known condition of the property.) Subdivision lbl—Four years to Correct.Errors In Value Judgment. a) Errors in discounting to cash equivalency—Plaza Hollister Limited Partnership v. County of San Benito (1999) '72 Cal.App.4' 1. The assessor may correct within four years after July 1 of the assessment year for which the base year value was first established. (The date first established means the date it was enrolled.) b) Error regarding inclusion of enterprise value in the unit—Service America Corp. v. County of San Diego (1993) 15 Cal.App.4' 1232. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled c) Mistake due to failure to discount nominal sales price -Prudential Ins. ofAmerica v. City and County of San.Francisco(1987) 191 Cal.App.3d 1142. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. d) Erroneous allocation of goodwill—Sea World, Inc. v. County of San Diego (1994)27 Cal. App.4'h 1390. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. e) Error in estimate of value -caused by incorrect book values submitted by taxpayer- Kuhlemeir v. County of Los Angeles(193 5)2 Cal.2d 2.57. The assessor has four years after July,1 of the assessment year for which the base year value was enrolled,unless the incorrect values resulted from taxpayer's fraud,concealment, misrepresentation-- in which event the errors may be corrected at any time,per section 5 1.5 (c). f} Error in measuring the value(in contrast to quantity or extent)of property in the appraisal unit—El Tejon Cattle Company v. County of San Diego (1967)252 Cal.App.2d 449. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. Subdivision(f) -1 nli ited time to Correct Clerical Errors. If the erroneous base year value entered on the roll based resulted from a defect of a mechanical,mathematical, or clerical nature, not involving judgment as to value,-- the error is clerical and may be corrected at any time. A computation or calculation Mr. Chuck Brough February 11, 2002 Page 4 error is one that results from an unintentional mistake,not deliberately made at the time value was determined(LTA leo. 88/501, 7/I/88, p.2) r� � Based on the foregoing, either subdivision(b) or subdivision(f) is relevant to the facts you describe. The error does not fall under subdivision(a), as the assessor's determination of the 1990 change in ownership was correct. There are two reasons the 1990 CP base year value was too high. First, the mistake was due to improper application of a valuation method (comparable sales approach), and to that extent was deliberate and intentional(per subdivision(b)). If the facts substantiate this, then it was an error in the appraiser's value judgment, and no correction is possible, since section 51.5(b) allows only "four years after July 1 of the assessment year for which the base year value was first established." The phrase"the assessment year for which the base year value was f rst established, "means,,four years of July 1 of the assessment year during:which the assessor actually enrolls the new base year value resulting,from a change in ownership or completion ofnew construction.! Hence, even if the new 1990 base year value was not enrolled.until 1994,there are still no years remaining to correct the error if it involved value judgment per section 51.5(b). If on the other hand the error occurred because of improperly calculating the value, transposing or misreading numbers, or substituting the wrong data, i.e., a clerical or computational error, then it was a clerical mistake and unintentional (per subdivision(f)). If the facts substantiate this scenari then no value judgment was involved, and a correction for all years back to 1990 is possibld y the express terms of subdivision(a),the assessor is required to correct"any error or omission in the determination of a base year value ... including the failure to establish that base year value,which does not involve the exercise of an assessor's judgment as to value, ... in any assessment year in which the error or omission is discovered." We have consistently interpreted this to mean that there are no time limitations on the correction of nonjudgmental or clerical base year value errors;rather they are to be corrected whenever discovered. (Montgomery Ward& Co.,p. 1124.)Hence,the assessor should correct all the years back to and including the 19901 base year value if the error proves to be clerical. In the event that the taxpayer disagrees with the assessor's determination on this issue, an appeals boa gm has jurisdiction to determine whether an error is judgmental or nonjudgmental (clericaWe courts have consistently held that an appeals board may begin the process of invoking its jurisdiction in response to information received from a taxpayer, an assessor, or by any other means. In responding to information submitted,the board may (although it is not required to)conduct a preliminary hearing for the purpose of determining whether reasonable cause exists to invoke its jurisdiction in a given matter. (Stevens v. Fox Realty Corp. (1972) 23 Cal.App.3d 199.) In effect, this constitutes a jurisdictional hearing in which a board decides whether to exercise its jurisdiction or not. If a board decides that a controversy centered on whether an error in base year value was judgmental or nonjudgmental(clerical) is within its Mr. Chuck Brough February 11, 2402 Page 5 jurisdiction, it may thereafter proceed to make a determination of the factual issues. (Property Tax Rule 309,assessment Appeals Manual,page 41. See also Sunrise Retirement Villa v. Dear (1997) 58 Cal.App.4th 948. 2. )If the error was clerical(nonjudgmental), the years available for correction are not limited by the statute of limitations on roll corrections under section 4831. Base year value corrections are not"roll corrections." There are at least three separate and distinct tools to bring about changes in the assessed value of enrolled property: 1) roll corrections(per section 4831 et seq.); 2)escape assessments (sections 531 et sec}.); and 3)base year value corrections (sections 51.5 and 80). The correction of an entry on the roll under section 4831 has its own four-year time limit.'The fact that the property being assessed by a particular roll entry is later the subject of an escape assessment made under section 531 or a base year value correction under section 51.5, does not extend or change the four-year limit on the roll correction of that entry. Section 4831 is a specific procedure separate from the procedures for enrolling escape assessments or correcting enrolled base year value errors. For example, section 4831 is permissive,stating that the assessor may process roll corrections for errors on the roll within four years after the making of the assessment which is being corrected, e.g., four years from the date of discovery of the error. (Section 4831(x).) Section 51.5 is mandatory and requires that a base year value correction shall be reflected in either appropriate cancellations or refunds of taxes, or levies of escape assessments --whether that correction is made under subdivision(a)or(f) (nonjudgmental, clerical) or under subdivision (b) (value judgment). Section 51.5 lacks any express language that would authorize roll corrections. As explained in Letters to Assessors Bios. 88/50, 89/34,and 95/54, and in various legal opinions, section 51.5 does not authorize or provide for roll corrections, primarily because base year value corrections are not roll entries. Thus,even though a base year value must be corrected under section 51.5, it may be untimely or not permitted as a"roll correction"under section 4831. Section 51.5 authorizes the correction of the base year value where the base year value is the"roll value" and mandates that appropriate escape assessments and cancellations or ref rods be made as a result. Section 4831 authorizes corrections of certain types of entries on the roll based on its own four-year(or one-year)time limit. Specific authorization for delivering base year value corrections to the auditor without invoking roll correction procedures under section 4831 is now included in proposed Property Tax Rule 264, "Base Year Value Corrections," subdivision(c), as follows: If a correction authorized by subdivision(a) or(b) [of section 51.5] reduces the base year value, the assessor shall transmit the correction to the auditor by means of information noted on the roll, and appropriate cancellations or Mr. Chuck.Brough February 11,2002 Page 6 refunds of tax shall be granted in accordance with Division 1 of the Revenue and Taxation Code. If the correction increases the base year value, the assessor shall transmit the information regarding the correction by means of a notation on the roll,and appropriate escape assessments shall be imposed in accordance with Division 1 of the Revenue and Taxation Code. 3. If corrections are made back to 1990 the tax a er's rit to re s is-unlimited if otice is received under section 2635an a claim is filed within one While offering our opinion on the issue,we hasten to acknowledge that questions relating to whether refunds should be made is a matter for the county auditor or the county tax collector, not the assessor. While the Board advises assessors, it is the State Controller who advises county auditors and tax collectors. In offering our advice, we take into account such opinions and publications of the State Controller as are available to review. Since the Controller has issued an opinion affecting this controversy, we defer to the conclusion stated therein as discussed below. (See Garry Hori letter State Controller's office, 5/7/2001,attached.) For this reason,you may wish to address additional inquiries to the State Controller. In Letter to Assessors No. 91/53 (attached), Board staff stated that section 51.5(d) requires appropriate cancellation or refunds of taxes, or escape assessments as the result of a base , year value correction. Such refunds, cancellations, or escape assessments are justified and required by any base year value correction that leads to such a result. According to section 51.5(d) -whether a refund, cancellation,or escape assessment is timely in a given case depends entirely on the particular statutory requirements for each: "(d) If a correction authorized by subdivision(a)or (b)reduces the base year value, appropriate cancellations or refunds of tax shall be granted in accordance with this d�tvr,'siioont If the correction increases the base year value, appropriate escape assessments shall be imposed in accordance with this division. (Emphasis added.)" The phrase, "in accordance with this division,"means Division I of the Revenue and Taxation Code. Division I contains the procedures for refunds under sections 5096-5097, cancellations under section 4896, escape assessments under section 531 et seq., and appeals of base year value pursuant to section 1601 et seq. or section 80. (See Division 1 consisting of sections 50 through 5911: Part 1 through Part 14.) To determine whether and when a taxpayer is entitled to a refund, cancellation or an escape assessment, section 51.5(d)requires the application of each respective set of statutes to the facts. Regarding the time for making refunds, section 5097(a)(2)provides that no order for refund shall be made except on a claim filed within four years after the making of the payment sought to be refunded, or within one year after the mailing of the notice prescribed in section Mr. Chuck Brough February 11, 2002 Page 7 2635, or the period agreed to as provided in section 532.1, whichever is later? If the first time period applies,the taxpayer must file a refund claim within the four-year limitations period, even though a base year value appeal was timely filed and the reduction granted by the appeals board. (Mission Housing Development Company v. City and County of San.Francisco (1997)59 Cal.App.4' 55.) If the second time period applies(as in this case),the taxpayer must file a refund claim within the within one year after the date of the notice under section 2535. Paragraph 1610 of the State Controller County Tax Collector's.deference Manual notes that"Section 5096 is remedial and should be liberally construed to cavy out its intent of preventing the inequitable retention of money that has been improperly collected."` Paragraph 1600 of the 1999,state Controller County Tax Collector's Reference Manual states: When more than four years have elapsed after an erroneous or illegal collection, an assessee may not originate a petition for refund unless first notified of the oy r�avment by the county in accordance with §263 5, or unless the statute of limitations has been extended by mutual written agreement between the taxpayer and the assessor(§§5097 and 532.1). Thus, it is apparent that the legal construction of these statutes by the Controller's office is aimed toward the "inequitable retention of money that has been improperly collected," as the basis for refunding tax money and for the broad interpretation of sections 2635 and 5097(x)- set forth in the enclosed legal opinion issued by Cary Hori.' Section 2635 states: "When the amount of taxes paid exceeds the amount due by more than ten dollars($10),the tax collector shall send notice of the overpayment to the taxpayer. The notice shall be mailed to the taxpayer's last known address and shall state the amount of overpayment and that a refund claim may be filed pursuant to Chapter 5 (commencing with Section 5096) of Part 9". In the Controller's opinion, the one-year claim filing period under section 2535 is an alternative to the four-year claim filing period under section 5097(a). Mr. Hori states on page two of the letter, ' Section 2635 is a mechanism for the tax collector to notice the taxpayer of the right to a refund,in addition to the 4-year time limit imposed by section 5097,where the notice identifies an overpayment to the taxpayer. Upon receipt of such notice,the taxpayer has one year to file a claim for refund. 4 The Controller's statement is supported specifically by Pack Coast Co. v. Wells(1901) 134 Cal.471;Midstate Theatres v. Board of Supervisors(1975)and Focus Cable v.Alameda County(19 85)173 Cal.App.3d.519. s See County Tax Collectors'Reference Manual, 1999,California State Controller,page 82,which paraphrases the statue and states that tax collectors and auditors have authorization to make refunds under these conditions. _:. Ivry. Chuck Brough February 11, 2002 Page 8 "...we find that four years is not the sale limitations period under Revenue and Taxation Code section 5097. Section 5097 expressly permits tax refunds to be filed within four years after making the tax payment sought to be refunded or within one near after the mailing o,f the notice prescribed in r.Revenue and Taxation Code?Section 2635, or the period agreed to as provided in section 532.1, whichever is tater." "In surn, we conclude that a county is required to allow a taxpayer's refund claim within one year following the mailing of the notice of overpayment (under Revenue and Taxation code section 263 5) even though the overpayment corresponds to an assessment year beyond four years." As applied to the instant case, if the assessor corrects the base year value for the years in question(back to 1994), and the facts establish an overassessment of the taxpayer's property for each of the years, the assessor is required by §51.5(4)and Rule 264(c)to deliver that information to the county auditor. That information would then necessarily be passed on to the tax collector who is required by §2635 to notify the taxpayer of an overpayment of taxes resulting from the overassessment. Per subdivision(a)(2)of§5097,the taxpayer would have one year from the date on the notice of overpayment to file a claim for refund. In Letter to Assessors No. 91153 (p. 2),the Board staff advised that §2635 should not be given a broad interpretation that would extend the payment of refunds beyond four years. Based on the recent views and opinion published in the 1999 Controller's Manual and the May 7, 2001 letter, LTA No. 91153 should be considered to be superseded and no longer an accurate summary of the law on this question. The views expressed in this letter are only advisory in nature. They represent the analysis of the legal staff of the Board based on present law and the facts set forth herein, and are not binding on any person or public entity. Very truly yours, Kristine Cazadd Supervising Tax Counsel Attachments KEC:eb prop/prec/baymors/02141 kec Mr. Chuck Brough February 11, 2002 Page 9 cc: Mr. David Gau, MlC:63 Chief of PPSD, MIC:64 Mr. Harold Hale,M1C:61 Ms.Jennifer Willis, MIC:70 R&`fi Cade Sections Involving Assessment, Collection, Appeal, and Refund Equalization By A Local Board. 1610.8. After giving notice as prescribed by its rules,the county board shall equalize the assessment of property on the local roll by determining the full value of an individual property and by reducing or increasing an individual assessment as provided in this section. The full value of an individual property shall be determined without limitation by reason of the applicant's opinion of value stated in the application fair reduction in assessment pursuant to subdivision(a)of Section 1603. The applicant for a reduction in an assessment on the local roll shall establish the full value of the property by independent evidence. The records of the assessor may be used as part of such evidence. The county board shall make a determination of the full value of each parcel for which an application for equalization is made. 1612. The clerk of the county board shall record,in a book kept for that purpose,all changes and orders made by the county board and,no later than the second Monday of each month,shall prepare a separate statement listing all such changes made during the preceding calendar month. 1613. After five days succeeding the time when notice of the date when the matter will be investigated is sent by the clerk of the county board to all persons interested,the county board may direct the assessor to: (a)Assess any taxable property other than State assessed property that has escaped assessment. (b)Change the amount,number,quantity,or description of property on the local roll. (c)Make and enter new assessments,at the same time canceling previous entries,when any assessment made by him is deemed by the county board so incomplete as to render doubtful the collection of the tax. 1614. On the second Monday of each month the clerk shall deliver the statement of all changes made by the county board during the preceding calendar month to the auditor with an affixed affidavit,subscribed by him,as follows: "I, ,swear that,as Clerk of the Board of Equalization of County,I have kept correct minutes of all the acts of the board during the month of , ,touching alterations in the assessment roll,that all alterations agreed to or directed to be made have been included in the attached statement and that no other alterations are included therein." Equalization By The BOE 758. If the board roll has been transmitted to the local auditors,the board may make an assessment of escaped property or a roll correction. At least 30 days prior to transmitting a statement of assessment of escaped property or making a roll correction,the board shall notify the assessee whose property's full value has increased as a result of an escape assessment or roll correction of the assessed value of that property as it shall appear on the corrected roll. The notice shall be mailed to the assessee at its address shown in the records of the board. The notice shall advise the assessee of the date by which and the place where a petition for reassessment may be filed. The date for filing the petition shall not be less than 50 days from the date of the mailing of the notice of value. The provisions of Sections 741 to 744, inclusive, shall be applicable to petitions and hearings pursuant to this section except for the dates prescribed for decisions of the board. The Auditor Recalculates And Corrects The Roll. 1646.1. Upon receiving a statement from the clerk prepared under Section 1614,the auditor shall forthwith correct the roll to reflect the changes made by the county board. The Auditor Or The Tax Collector Can Refund Taxes Without A Formal Claim For Refund By The Property Owner If The Refund Is Made Within Four Years Of Payment. 5097.2. Notwithstanding Sections 5096 and 5047,any taxes paid before or after delinquency may be refunded by the county tax collector or the county auditor,within four years after the date of payment,if: (a)Paid more than once. (b)The amount paid exceeds the amount due on the property as shown on the roll. Jim Bone lege 2 of 3 March 1, 2002 CAProgrern FIIWArnerica Online 7.0fdownloadKCLetterre26351Refundafterfouryearsonalysis,doc &T Code Sections involving Assessment,Collection, Appeal, and Refund (c)The amount paid exceeds the amount due on the property as the result of corrections to the roll or cancellations after those takes were paid. (d)In any other case,where the claim for refund is made under penalty of perjury and is for an amount less than ten dollars($I0). (e)The amount paid exceeds the amount due on the property as the result of a reduction attributable to a hearing before ar�assessment a a s oaDor an assessment hearing officer. If No Refund Is Made,Then The Roll Will Shorn An Overpayment And The Tax Collector Must Send The Property Owner A Notice That They Have One Year To File A Claim For Refund. 2635. When the amount of taxes paid exceeds the amount due by more than ten dollars($10),the tax collector shall send notice of the overpayment to the taxpayer. The notice shall be mailed to the taxpayer's last known address and shall state the amount of overpayment and that a refund claim may be filed pursuant to Chapter 5(commencing with Section 5096) of fart 9. The Property Owner Can File A Claim For Refund Until The Later Of One Year From Notice Under 2635 Or Four Years From Payment Of The Tax. 5097. (a)No order for a refund under this article shall be made,except on a claim: (1)Verified by the person who paid the tax,his or her guardian,executor,or administrator. (2)Filed within four years after making of the payment sought to be refunded or within one year after the mailing of notice as prescribed in Section 2635,or the period agreed to as provided in Section 532.1,whichever is later. ("o)An application for a reduction in an assessment filed pursuant to Section 1603 shall also constitute a sufficient claim for refund under this section if the applicant states in the application that the application is intended to constitute a claim for refund. if the applicant does not so state,he or she may thereafter and within the period provided in paragraph(2)of subdivision(a)file a separate claim for refund of taxes extended on the assessment which applicant applied to have reduced pursuant to Section 1603 or Section 1604. (c)If an application for equalization of an escape assessment is filed pursuant to Section 1603,a claim may be filed on any taxes resulting from the escape assessment or the original assessment to which the escape relates within the period provided in paragraph(2)of subdivision(a)or within 60 days from the date the board of equalization makes its final determination on the application,whichever is later. 5097.02. The claim shall be in writing,specifying: (a)Whether the whole assessment is claimed to be void or,if only a part,what portion. (b)The grounds on which the claim is founded. 5096. Any taxes paid before or after delinquency shall be refunded if they were: (a)Paid more than once. (b)Erroneously or illegally collected. (c)Illegally assessed or levied. (d)Paid on an assessment in excess of the ratio of assessed value to the full value of the property as provided in Section 401 by reason of the assessor's clerical error or excessive or improper assessments attributable to erroneous property information supplied by the assessee. (e)Paid on an assessment of improvements when the improvements did not exist on the lien date. (f)Paid on an assessment in excess of the equalized value of the property as determined pursuant to Section 1613 by the county board of equalization. (g)Paid on an assessment in excess of the value of the property as determined by the assessor pursuant to Section 469. .Jim Sone Page 3 of 3 March 1, 2002 0:1Prograrn Files\Arnerica Online 7.0\download\KCLetterre2635\Refundafterfouryearsanslysis.doc __ _ _.. L t3 l,UucJ kS L! .J Z JtJ.J-J 1 J3) rage 1 01 G BEV- All TTIQI +C{ It SECTION 5150.5-5153 5150.5. In any action in which the recovery of a penalty assessed pursuant to paragraph (1) , (2) , or (3) of subdivision (a) of Section 630 is allowed by the court, the plaintiff shall be entitled to interest on the penalties for which recovery is allowed, at the applicable rate or rates in effect from time to time and payable on a refund of tax as provided in Section 5151. This interest shall be payable from the date of filing of the claim for refund, but in no evert earlier than the date of payment of the penalty or installments thereof sought to be refunded, to the date of entry of judgment. This accrued interest shall be included in the judgment. 5151. (a) Interest at the greater of 3 percent per annum or the county pool apportioned rate shall be paid, when that interest is ten dollars ($10) or more, on any amount refunded under Section 5096.7, or refunded to a taxpayer for any :reason whatsoever. .However, no interest shall be paid under the provisions of this section if the taxpayer has been given the notice required by Section 2635 and has failed to apply for the refund within 30 days after the mailing of that notice. For purposes of this section, "county pool apportioned rate" means the annualized rate of interest earned on the total amount of pooled idle funds from all accounts held by the county treasurer, in excess of the county treasurer's administrative costs with respect to that amount, as of June 30 of the preceding fiscal year for which the refund is calculated. For each fiscal year, the county treasurer shall advise the Controller of the county pool apportioned rate, and of computations made in deriving that rate, no later than 60 days after the end of that fiscal year. (b) 'Phe interest rate provided for in subdivision (a) does not apply to interest on refunds of those amounts of tax that became due and payable before March 1, 1993. Interest on refunds of amounts of a qualified tax shall be paid at that rate provided for by this section as it read prior to January 1, 1993. As used in this section, a "qualified tax" means a tax that became due and payable before March 1, 1993, and had not been refunded as of April 6, 1995. This subdivision shall not be construed to affect the interest paid on refunds of those amounts of tax that became due and payable before March 1, 1993, and have been refunded as of April 6, 1995. (c) (1) The interest computation period shall commence with the date of payment of the tax when any of the following apply: (A) A timely application for reduction in an assessment was filed, without regard to whether the refund ultimately results from a urt, an order of a board of equalization or dtminniffikEor an assessor's correction to the assessment roll. (B) The refund is pursuant to a roil correction resultinq from the determination or adjustment by the assessor or a local assessment appeM�boar:. of a base year value. (C) The refund results from a correction to the assessment roll pursuant to Section 4831 or 4676. (2) Interest on refunds of taxes on property acquired by a public agency in eminent domain shall accrue from the date of recordation of http://NA, .leginfo.ca.gov/cgi-bin/displayeode?section=rto&group=05001-06000&File=5150.5- 3%1/02 80E 305-AH(52F)REV.3(3.00) INFORMATION AND INSTRUCTIONS FOR APPLICATION FOR CHANGED ASSESSMENT The--State Board of Equalization has prepared a pamphlet to assist you In completing this application. You may download a copy of Publication 30, Residential Property Assessment Appeals, at www.boe.ca.gov or contact theclerk of your local board for a copy. Filing'this application for reduced assessment does not relieve the applicant from the obligation to pay the taxes on the subject property on or before the applicable dud date shown on the tax bill. if a reduction Is granted, a proportionate refund of taxes paid will be made by the county. Based on the evidence, the appeals board can increase as well as decrease an assessment.The decision of the appeals board upon this application is final; the appeals board may not reconsider or rehear any application. However, either the applicant or the assessor may bring timely action In superior court for review of an adverse action. An application may be amended until 5:00 p.m. on the last day upon which the application might have been timely filed. After the filing period, an Invalid or incomplete application may be corrected at the request of the clerk or amendments may be made at the discretion of the board.Contact the clerk for information regarding correcting or amending an application. The appeals board can hear matters concerning an assessor's allocation of exempt values. However, It cannot hear matters relating to' a person's or organization's eligibility for a property tax exemption. Appeals regarding the denial of the Welfare Exemption should be referred to the State Board of Equalization, Policy, Planning, and Standards Division, MIC:64, PO Sox 943879, Sacramento, CA 94279-0064. Appeals regarding the denial of any other type of exemption are under the jurisdiction of the assessor and/or the courts. The following-numbered Instructions apply to the corresponding numbers on the application form. Please type or print In Ink all Information on the application forme. Box 1. Enter the name and mailing address of the applicant. If the applicant Is other than the assesses (e.g., leased property), attach an explanation. NOTE:An agent's address may not be substituted for that of the applicant. Bax 2. Provide the name and mailing address of the agent or attorney, If applicable. If the agent is not a California-licensed attorney, you must also complete the agent's authorization section, or an agent's authorization may be attached to this application.An attached authorization must contain all of the following information: • The date the authorization is executed. • A statement that the agent is authorized to sign and file applications In the calendar year of the application. • The specific parcel(s) or assessment(s) covered by the authorization, or a statement that the agent is authorized to represent the applicant on all parcels and assessments located within the county that the application is being filed. • The name, address, and telephone number of the agent. • The applicant's signature and title. • A statement that the agent will provide the applicant with a copy of the application. Box 3. If this application is for an assessment on secured property, enter the Assessor's Parcel Number from your assessment notice or from your tax bill. if the property Is unsecured (e.g., an aircraft or boat), eoter the account number from your tax bill. If appropriate, enter the name of the business (DBA). Enter a brief description of the property location, such as street address, city, and zip code, sufficient to Identify the property and assessment being appealed. , For a single-family dwelling, indicate if the dwelling is owner-occupied. Box 4. Column A: Enter the figures shown on your assessment notice or tax bill for the year being appealed. If you are appealing a current year assessment (base year or decline in value) and have not received an assessment notice, or are unsure of the values to enter In this section, please contact the assessor's office. if you are appealing a calamity reassessment or an assessment related to a change in ownership, new construction, roll change, or escape assessment, refer to the reassessment notice you received. If you are appealing a penalty assessment, NOTE: a penalty assessed by the tax collector for nonpayment of taxes cannot be removed by the appeals board. Column B: Enter your opinion of value for each of the applicable categories. If you do not state an opinion of value, It will result In the rejection of your application. G,.'0AYAWEF0RMSW5AH•CC 5-3-W y stivuG its ,d t�ry-�t•r�.J f rage 1 oI b tr �REVENUEAND TAXATION 1 CODE SECTION ION 5140-5149.5 5140. The person who paid the tax, his or her guardian or conservator, the executor of his or her will, or the administrator of his or her estate may bring an action only in the superior court against a county or a city to recover a tax which the board of supervisors of the county or the city council of the city has refused to refund on a claim filed pursuant to Article 1 (commencing with Section 5096) of this chapter. No other person may bring such an action; but if another should do so, judgment shall nct be rendered for the plaintiff. 5141. (a) An action brought under this article, except an action brought under Section 5148, shall be commenced within six months from and after the date that the board of supervisors or city council _ejects a claim for refund in whole or in part. (b) Except as provided in subdivision (c) , if the board of supervisors or city council fails to mail notice of its action on a claim for refund within six months after the claim is filed, the claimant may, prior to mailing of notice by the board of supervisors or city council of its action on the claim, consider the claim rejected and bring an action under this article. (c) if an applicant for the reduction of an assessment states in the application that the application is intended to constitute a claim for refund pursuant to Section 5097, the claim for refund shall be deemed denied on the date the final installment of the taxes extended on such assessment becomes delinquent or on the date the equalization board makes its final determination on the application, whichever is later. 5142. (a) No action shall be commenced or maintained under this article, except under Section 5148, unless a claim for refund has first been filed pursuant to Article 1 (commencing with Section 5096) . No recovery shall be allowed in any refund action upon any ground not specified in the refund claim. (b) When the person affected or his or her agent and the assessor stipulate that an application involves only nonvaluation issues, they may file a stipulation with the county board of equalization stating that issues in dispute do not involve valuation questions. To the extent possible, the stipulation shall also indicate the parties` agreement as to the assessment amounts that would result under their respective positions on the issue or issues in dispute. The board shall accept or reject the stipulation, with or without conducting a hearing on the stipulation. The filing of, and the acceptance by the board of, a stipulation shall be deemed compliance with the requirement that the person affected file and prosecute an application for reduction under Chapter 1 (commencing with Section 1601) of Fart 3 in order to exhaust administrative remedies . However, the filing of, and the acceptance by the board of, a stipulation under this subdivision shall not excuse or waive the requirement of a timely filing of a claim for refund. http://vw-ww.leginfo.ca.gov/cgi-bin/displaycode?section=rtc&group=05401-46000&file=5140-51 3/1/02 STATE OF CALIFORNIA STATE BOARD OF EQUALIZATION JOHHAN KLEHS 450 N STREET,SACRAMENTO,CALIFORNIA Firm'Disiricl.Heyward (PO BOX 942879,SACRAMENTO,CALIFORNIA 94279-0082) DEAN ANDAL TELEPHONE(916)328-7713 second District,Stockton FAX(916)323-3387 CLAtDE isARRiSH Third District,Torrance JOHN CHIANG February 11,2002 fourth District,Los Angeles KATHLEENCONNELL ' Controller,Sacramento Honorable Thomas P. Kidwell LEx�t�a motor Madera County Assessor Attn: Mr. Chuck Brough, Chief Appraiser 209 West Yosemite Avenue Madera, CA 93637 Attn: Mr. Chuck Brough Re: Base Year Value Corrections, roll corrections,Refunds Dear Mr. Brough: This is in response to your letter of September 20, 2001,to Chief Counsel Timothy Boyer requesting our interpretation of several Revenue and Taxation Code sections applicable to correcting a base year value error and issuing appropriate refunds. Please excuse the delay in responding as other previously scheduled Board matters have occupied our time. Based on the circumstances described in your letter,we conclude that 1)if the 1990 base year value error involved value judgment, there is no time remaining under section 5 1.5 subdivision(b)to correct; however, if it was clerical,the error should corrected under section 51.5, subdivision(f) for all years back to 1990; 2) if the error is clerical(nonjudgmental), the years available for correction are not limited by the statute of limitations on roll corrections under section 4831; and 3)if corrections are made for all years,the taxpayer has one year from the date of notice under section 2635 to claire refunds back to 1990. Facts A change in ownership occurred in October 1990, and an error in the base year value was made in that the assessed value,based on comparable sales, should have been 50,000 less than the value actually enrolled. The taxpayer did not question the value (nor did the assessor discover it)until 2001, at which time the assessor's office determined that a correction was necessary for the 2002 roll. You wish to know: 1)whether section 51.5 authorizes a reduction in base year value for all years or only four years since the 1990 change in ownership; 2) whether reductions under section 51.5 are limited to the number of years for which roll corrections can be made under section 4831; and 3)whether refunds resulting from a base year value reduction are available for all years under section 2635, or limited to four years under section 5097, :Mr. Chuck Brough February 11, 2002 Page 2 1. If the 1990 base year value error involved value,judgment, no time remains under section 51.5 {b to correct it; if it was-61-an W.all years should be corrected under section 51.5 (f).back to 1990. Section 51.1 provides specific authority and timing for assessors to correct base year value errors. Correction of errors or omissions not involving the exercise of an assessor's judgment as to value is authorized under subdivision(a),whereby the assesses may at an time ime go back to the date of the event to make the correction. The assessor's correction of clerical errors, as defined in subdivision(f),may also be undertaken at any time,back to the date of the event. Correction of errors or omissions involving the exercise of the assessor's value judgment authorized under subdivision(b)however,must be made"within four years {after July 1 of the assessme yea for which the base year value was first established." To determine the number of years t6 be corrected,the assessor must.first make a determination of the type of error involved. The type of base year value error—whether nonjudgmental,involving value judgment,or clerical-is a question of fact in each case. Neither the Legislature nor the courts have promulgated a standard or"test"applicable to every scenario.' The Board staff"guidelines" suggested below are merely interpretations made by the courts in applying subdivision (a), (b)or(f) of Section 51.5. Subdiyisio a)-Unlimited time to Correct Nonrudgmental Errors a) In Montgomery TVard& Co. v. County of Santa Clara(1990 47 Ca.l.14pp.4" 1122, a change in ownership occurred and timely reported,but the assessor did not enroll the base year value within four years after July 1 of the assessment year in which it occurred. Field: value judgment had not been exercised;the error could be corrected at any time - section 51.5(a). b) In Sunrise Retirement Villa v. Dear(1997) 58 Cal.App.4'948,the assessor reappraised for a change in ownership and enrolled the new base year value within four years. Almost ten years later,Taxpayer established that assessor's change in ownership determination was a mistake. Held: value judgment was not exercised where the issue is a change in ownerships and if the appeals board found that a change in ownership did not occur, the error could be rtorrected at any time -section 51.5(x). c) In Firestone Fire & Rubber Co. v. County of Monterey(1990) 223 Cal.App.3d 382; County of San Diego v. Assessment Appeals Board No. 2 of San Diego County(1983) 148 Cal.App.3d 548,the error in base year value was due to waste contamination, ' Further,there is no statutory standard of proof required to establish whether a particular error involves value judgment or is clerical or nonjudgmental in nature. _. Mr. Chuck Brough February 11, 2002 Page 3 Held:yinformation on the condition had been provided to the assessor at the time of the event triggering the new base year value and the information was omitted(not considered)by the assessor in making the valuation, it was nonjudgmental,and may be corrected at any time. (Value judgment not exercised with regard to the known condition of the property.) Subdivision(b)—Four years to Correct Errors In Value Judyhent a) Errors in discounting to cash equivalency—Plaza Hollister Limited Partnership v. County of San Benito (1999) 72 Cal.App.4' 1. The assessor may correct within four years after July 1 of the assessment year for which the base year value was first established. (The date first established means the date it was enrolled.) b) Error regarding inclusion ofent6rprise value in the unit—Service America Corp. v. County ref`San Diego(1993) 15 Cal.App.4' 1232. The assessor has four years mer July 1 of the assessment year for which the base year value was enrolled c) Mistake due to failure to discount nominal sales price-Prudential Ins. of America v. City and County of San Francisco(19 87) 191 Cal.App.3d 1142. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. d) Erroneous allocation of goodwill—Sea World, .Inc. v. County of San,Diego (1994) 27 Cal. App.4' 1390. The assessor has four years after July 1 of the assessment year for t which the base year value was enrolled. e) Error in estimate of value - caused by incorrect book values submitted by taxpayer- Kuhlemeir v. County of Los Angeles(1935) 2 Cal.2d 257.The assessor has four years after July.1 of the assessment year for which the base year value was enrolled, unless the incorrect values resulted from taxpayer's fraud, concealment,misrepresentation— in which event the errors may be corrected at any time,per section 51.5 (c). f) Error in measuring the value(in contrast to quantity or extent) of property in the appraisal unit—EI Tejon Cattle Company v. County of San Diego (1967) 252 Cal.App.2d 449. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. Subdivision(f) -Unlimited time to Correct Clerical Errgrs If the erroneous base year value entered on the roll based resulted from a defect of a mechanical, mathematical, or clerical nature,not involving judgment as to value,— the error is clerical and may be corrected at any time. A computation or calculation Mr. Chuck Brough February 11, 2002 Page 4 error is one that results from an unintentional mistake,not deliberately made at the time value was determined(LTA No. 88/50, 7/1/88,p.2) Based on the foregoing, either subdivision(b) or subdivision(f) is relevant to the facts you describe. The error does not fall under subdivision(a), as the assessor's determination of the 1990 change in ownership was correct. There are two reasons the 1990 base year value was too high.First, the mistake was due to improper application of a valuation method(comparable sales approach), and to that extent was deliberate and intentional (per subdivision(b)). If the facts substantiate this,then it was an error in the appraiser's value judgment, and no correction is passible, since section 51.5(b)allows only "four years after July 1 of the assessment year for which the base year value was first established." The phrase "the assessment year for which the base year value was first established, "means,four years of July I of the assessment year during which the assessor actually enrolls the new base year value resulting from a change in ownership or completion of new construction.! Hence,even if the ndw 1990 base year value was not enrolled until 1994,there are still no years remaining to correct the error if it involved value judgment per section 51.5(b). If on the other hand the error occurred because of improperly calculating the value, transposing or misreading numbers,or substituting the wrong data, i.e., a clerical or computational error, then it was a clerical mistake and unintentional (per subdivision (f)). If the facts substantiate this scenarien no value judgment was involved, and a correction for all yearrs back to 1990 is possibl' y the express terms of subdivision(a),the assessor is required to correct"any error or omission in the determination of a base year value ... including the failure to establish that base year value, which does not involve the exercise of an assessor's judgment as to value, ... in any assessment year in which the error or omission is discovered." We have consistently interpreted this to mean that there are no time limitations on the correction of nonjudgmental or clerical base year value errors; rather they are to be corrected whenever discovered. (Montgomery Ward& Co.,p. 1124.)Hence,the assessor should correct all the years hack to and including the 1990 base year value if the error proves to be clerical. In the event that the taxpayer disagrees with the assessor's determination on this issue, an appeals bold has jurisdiction to determine whether an error is judgmental or nonjudgmental. (clerica4we courts have consistently held that an appeals board may begin the process of invoking its jurisdiction in response to information received from a taxpayer, an assessor, or by any other means. In responding to information submitted,the board may(although it is not required to) conduct a preliminary hearing for the purpose of determining whether reasonable cause exists to invoke its jurisdiction in a given matter. (Stevens v. Fox Realty Corp. (1972)23 Ca1.A.pp,3d 199.) In effect,this constitutes a jurisdictional hearing in which a beard decides whether to exercise its jurisdiction or not. If a board decides that a controversy centered on whether an error in base year value was judgmental or nonjudgmental(clerical) is within its Mr. Chuck Brough. February 11, 2002 Page 5 jurisdiction, it may thereafter proceed to make a determination of the factual issues. (Property Tax Rule 309,Assessment Appeals Manual,page 41. See also Sunrise Retirement Villa v. Dear (1997) 58 Cal.App.4" 948. 2 )If the error was clerical (nonjudgmental),the years available for correction are not limited by the statute of limitations on roll corrections under section 4831. Base year value corrections are not"roll corrections." There are at least three separate and distinct tools to bring about changes in the assessed value of enrolled property. 1)roll corrections (per section 4831 et seq.); 2) escape assessments (sections 531 et seq.); and 3) base year value corrections (sections 51.5 and 80). The correction of an entry on the roll under section 4831 has its own four-year time limit. The fact that the property being assessed by a particular roll entry is later the subject of an escape assessment made under section 531 or a base year value correction under section 51.5, does not extend or change the four-year limit on the roll correction of that entry. Section 4831 is a specific procedure separate from the procedures for enrolling escape assessments or correcting enrolled base year value errors.For example, section 4831 is permissive, stating that the assessor may process roll corrections for errors on the roll within four years after the making of the assessment which is being corrected, e.g.,four years from the date of discovery of the error. (Section 4831(a).) Section 51.5 is mandatory and requires that a base year value correction shall be reflected in either appropriate cancellations or refunds of taxes, or levies of escape assessments -- whether that correction is made under subdivision(a) or(f) (nonjudgmental, clerical) or under subdivision (b) (value judgment). Section 51.5 lacks any express language that would authorize roll corrections. As explained in Letters to Assessors Nos. 88/50, 89/34, and 95/54,and in various legal opinions, section 51.5 does not authorize or provide for roll corrections,primarily because base year value corrections are not roll entries. Thus,even though a base year value must be corrected under section 51.5, it may be untimely or not permitted as a"roll correction"under section 4831. Section 51.5 authorizes the correction of the base year value where the base year value is the"roll value" and mandates that appropriate escape assessments and cancellations or refunds be made as a result. Section 4831 authorizes corrections of certain types of entries on the roll based on its own four-year(or one-year)time limit. Specific authorization for delivering base year value corrections to the auditor without invoking roll correction procedures under section 4831 is now included in proposed Property Tax Rule 264, "Buse Year Value Corrections,"subdivision(c), as follows: If a correction authorized by subdivision(a) or(b) [of section 51.51 reduces the base year value,the assessor shall transmit the correction to the auditor by means of information noted on the roll, and appropriate cancellations or Mr. Chuck Brough February 11,2002 Page 6 refunds of tax shall be granted in accordance with Division 1 of the Revenue and Taxation Code. If the correction increases the base year value,the assessor shall transmit the information regarding the correction by means of a notation on the roll,and appropriate escape assessments shall be imposed in accordance with Division 1 of the Revenue and Taxation Code. 3. If correctio are made-back to 19901 ax the ta e 's right to refunds is unlimited if notice is received under section 2635 and a claim is riled within one year. While offering our opinion on the issue,we hasten to acknowledge that questions relating to whether refunds should be made is a matter for the county auditor or the county tax collector, not the assessor. While the Board advises assessors, it is the State Controller who advises county auditors and tax collectors. In offering our advice,we take into account such opinions and publications of the State Controller as are available to review. Since the Controller has issued an opinion affecting this controversy,we defer to the conclusion stated therein as discussed below. (See Gary Hari letter State Controller's office, 517!2001, attached.)For this reason, you may wish to address additional inquiries to the State Controller. In Letter to Assessors No. 91153 (attached),Board staff stated that section 51.5(d) requires appropriate cancellation or refunds of taxes,or escape assessments as the result of a base year value correction. Such refunds, cancellations,or escape assessments are justified and required by any base year value correction that leads to such a result. According to section 51.5(d)-whether a refund, cancellation,or escape assessment is timely in a given case depends entirely on the particular statutory requirements for each: "(d) If a correction authorized by subdivision(a) or(b)reduces the base year value, appropriate cancellations or refunds of tax shall be granted in accordance with this division. If the correction increases the base year value,appropriate escape assessments shall be imposed in accordance with this division. (Emphasis added.)" The phrase,`cin accordance with this division."means Division I of the Revenue and Taxation Cade. Division I contains the procedures for refunds under sections 50196-5097, cancellations under section 4896, escape assessments under section 531 et seq., and appeals of base year value pursuant to section 1601 et seq. or section 80. (See Division 1 consisting of sections 50 through 5911: Part 1 through fart 14.) To determine whether and when a taxpayer is entitled to a refund, cancellation or an escape assessment, section 51.5(d) requires the application of each respective set of statutes to the facts. Regarding the time for making refunds, section 5O97(a)(2)provides that no order for refund shall be made except on a claim filed within four years after the making of the payment sought to be refunded, or within one year after the mailing of the notice prescribed in section W. Chuck Brough February 11, 2002 Page 7 2635, or the period agreed to as provided in section 532.1, whichever is later? If the first time period applies,the taxpayer must file a refund claim within the four-year limitations period, even though a base year value appeal was timely filed and the reduction granted by the appeals board. (Mission Housing Development Company v. City and County of San Francisco (1997) 59 Cal.App.4h 55.) If the second time period applies(as in this case),the taxpayer must file a refund claim within the within one year after the date of the notice under section 2635. Paragraph 1610 of the State Controller County Tax Collector's Reference Manual notes that"Section 5096 is remedial and should be liberally construed to carry out its intent of preventing the inequitable retention of money that has been improperly collected."' Paragraph 1600 of the 1999,state Controller County Tax Collector's Reference Manual states: When more than four years have elapsed after an erroneous or illegal collection, an assessee may not originate a petition for refundess fust notified of the overgavment by the county in accordance kth §2635, or unless the statute of limitations has been extended by mutual written agreement between the taxpayer and the assessor(§§5097 and 532.1). Thus, it is apparent that the legal construction of these statutes by the Controller's office is aimed toward the "inequitable retention of money that has been improperly collected," as the basis for refunding tax money and for the broad interpretation of sections 2635 and 5097(a) - set forth in the enclosed legal opinion issued by Gary Hori.i Section 2635 states: "When the amount of taxes paid exceeds the amount due by more than ten dollars($10),the tax collector shall send notice of the overpayment to the taxpayer. The notice shall be mailed to the taxpayer's last known address and shall state the amount of overpayment and that a refund claim may be filed pursuant to Chapter 5 (commencing with Section 5096)of Part 9". In the Controller's opinion,the one-year claim filing period under section 2635 is an alternative to the four-year claim filing period under section 5097(a), Mr. Hori states on page two of the letter, ' Section 2635 is a mechanism for the tax collector to notice the taxpayer of the right to a refund,in addition to the 4-year time limit imposed by section 5097,where the notice identifies an overpayment to the taxpayer. Upon receipt of such notice,the taxpayer has one year to file a claim for refund. ° The Controller's statement is supported specifically by Pack Coast Co. v. Wells(1901) 134 Cal.471;Midstate Theatres v.Board of Supervisors(1975)and Focus Cable v.Alameda County(1985) 173 Cal.App.3d.519. s See County Tar Collectors'Reference Manual, 1999,California State Controller,page 82,which paraphrases the statue and states that tax collectors and auditors have authorization to make refunds under these conditions. Mr. Chuck Brough February 11, 2002 Page 8 "...we find that four years is not the sole limitations period under Revenue and Taxation Code section 5097. Section 5097 expressly permits tax refunds to be sled within four years after making the tax payment sought to be refunded or within one year aftgr the mailing Qf_the notice prescribed in Revenue and Taxati n Code Section 2635, or the period agreed to as provided in section 532.1, whichever k later. "In sum, we conclude that a county is required to allow a taxpayer's refund claim within one year fallowing the mailing of the notice of overpayment (under Revenue and Taxation code section 2635)even though the overpayment corresponds to an assessment year beyond four years." As applied to the instant case, if the assessor corrects the base year value for the years in question(back to 1990), and the facts establish an overassessment of the taxpayer's property for each of the years,the assessor is required by §51.5(4) and Rule 264(c) to deliver that information to the county auditor. That information would then necessarily be passed on to the tax collector who is required by §263 5 to notify the taxpayer of an overpayment of taxes resulting from the overassessment. Per subdivision(a)(2) of§5097,the taxpayer would have one year from the date on the notice of overpayment to file a claim for refand. In Letter to Assessors No. 91153 (p. 2),the Board staff advised that §2635 should not be given a broad interpretation that would extend the payment of refunds beyond four years. Based on the recent views and opinion published in the 1999 Controller's Manual and the May 7, 2001 letter,LTA No. 91/53 should be considered to be superseded and,no longer an accurate summary of the law on this question. The views expressed in this letter are only advisory in nature. They represent the analysis of the legal staff of the Board based on present law and the facts set forth herein, and are not binding on any person or public entity. Very truly yours, Kristine Cazadd Supervising Tax Counsel Attachments KEC.eb proptpreclbayrcorsf02101 kcc Mr. Chuck Brough February 11, 2002 Page 9 cc: Mr. David Gau,MIC:63 Chief of PPSD,MIC:64 Mr. Harold Hale,MIC:61 Ms. Jennifer Willis, MIC:70 __ .. ............... ..... ... 111.1._1111 . .__. __. 1.111. _. . . _. 1111 ...... _111.1 ... 1111.. _._. 11.11 .._. _1111 _. ._._ . .. _1.111.. _. . _. ........................................................................................................................................................................................................................................................................................................................ 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MMFM1ll+Ml�ri�^ ................. Tact M. Heiiig Certified Public Accountant September 18, 2002 RECEIVED Silvano Marchesi, County Counsel 651 Pine Street SEP 2002 Stn Floor CLERKBOAROOF UPERVISORS Martinez, CA 94553 CONTRA COSTA Co. Re : September 17, 2002 Board of Supervisors Meeting Re : Consent Item C-29 Dear Mr. Machesi, I trust you have or will soon receive a copy of my memo and related exhibits presented to the Board of Supervisors yesterday. You should know, I attempted to contact Dennis Graves of your office on Friday September 13, 2002 to discuss his comments and conclusion per his correspondence of July 30, 2002 . Since he was unable to get back to me prior to the meeting, there was not sufficient time to provide all documentation to your office. Moreover, as a result of the short time frame allowed at the Board of Supervisors hearing, I was unable to correct a "highlighting" error on my Exhibit 16, Page 2 (enclosed) . I believe you will find it applicable in this situation in addition to other information previously provided. Upon further review, I expect your office will revise its position and advise the Board to approve this item and instruct refunds to be issued. 939 Hartz Way (925)820-5848 Suite 105 F'ax:(925)831-9189 Danville, CA 94526 Email:tmhcpa@aol.com In the event I can be of further assistance, please contact my office . Sincerel Tad M. Hei q TMH/as Enclosures cc. Supervisor John M. Gioia, Chair District I Supervisor Gayle B. Uilkema, District II Supervisor Donna Gerber, District III Supervisor Mark DeSaulnier, District IV Supervisor Federal Glover, District V Dennis Graves, Senior Counsel John Sweeten, County Administrator Gus Kramer Assessor Steve Dawkins, Assistant Assessor H. Alan Huovinen, Esq. Patrick & Isabel Kesler iV1r. Chuck Brough February 11,2002 Page 2 1. If the 1990 base value error inv lv _vALW' d ent a2 time remaias under section 51.5 t itJf it m§clerical.all c dmadsr se 1.5 back to 1990. Section 51.1 provides specific authority and timing for assessors to correct base year value errors. Correction of errors or omissions not involving the exercise of an assessor's judgment as to value is authorized under subdivision(a),whereby the assessor may At any time go back to the date of the event to make the correction. The assessor's correction of clerical errors,as defined in subdivision(f),may also be undertaken at any tires, back to the date of the event. Correction of errors or omissions involving the exercise of the assessor's value judgment authorized under subdivision(b)however,must be made"within four vexrL(aftguly 1 of tie assessment year fQr w 'c ear vahx w &g& to 1' To determine the number of years to be corrected, the assessor must first make a determination of the type of error involved. The type of base year value error—whether nonjudgmental,involving value judgment,or clerical—is a question of fact in each case. Neither the Legislature nor the courts have promulgated a standard or"test"applicable to every scenario.' The Board staff'"guidelines"suggested below are merely interpretations made by the courts in applying subdivision(a), (b)or(f) of Section 51.5. Subdivision W-Unlimited time to Correct N wk4 rntal frrors a) In.Montgomery Ward& Co. v. County of Santa Clara(1996)47 Ca1.App.41" 1122,a change in ownership occurred and timely reported,but the assessor did not enroll the base year value within four years after July 1 of the assessment year in which it occurred. Held: value judgment had not been exercised;the error could be corrected at any time-section 51.5(x). b) In,Sunrise Retirement Villa v. Dear(1997) 58 Cal.App.41948,the assessor reappraised for a change in ownership and enrolled the new base year value within four years. Almost ten years later,Taxpayer established that assessor's change in ownership determination was a mistake. Held:value judgment was not exercised where the issue is a change in ownership; and if the appeals board found that a change in ownership did not occur,the error could be corrected at any time- section 51.5(a). c) In Firestone Tire +&Rubber Co. v. County of Monterey(1990) 223 Cal.App.3d 382; County of San Diego v. Assessment Appeals Board No. 2 of San Diego County(1983) 148 Cal.App.3d 548,the error in base year value was due to waste contamination. ' Further,there is no statutory standard of prof required to establish whether a particular error involves value judgment or is clerical or nonjudgmental in nature. CONTRA COSTA COUNTY BOARD OF SUPERVISORS SEP 17 2002 MEMO RE: CONSENT ITEM C.29 OLE K SOARS}OF SUPERVISORS SEPTEMBER 17, 2002 CONTRA COSTA CO. I. REQUEST: �J• Board grant claim of Patrick & Isabel Kesler for refund of taxes for 1996 through 2000 tax years . TI. REASONS: A. County Administrator was to have only requested Board to establish Non-Existing Procedures to issue refund, not whether or not refunds were to be allowed. He, in error, sent back to the Clerk of the Assessment Appeals Board, to forward to County Counsel . B. County Administrator is now incorrectly advising you to deny claim based on an opinion of the Office of the County Counsel that, as stated in their correspondence, is based solely on "little background" in my letter and information provided solely by the Assessor's Office. Jim Lynch argued Revenue and 'laxation Code Section 63 . 1 at Appeals Board hearing (relative to 3 year statute) and was overruled based on no change in ownership in 1996 . In fact, had Section 63 . 1 applied, the claims for refund would have been denied. Accordingly, Revenue and Taxation Code Section 60 is also inapplicable . There was no attempt made to contact my office and, to the best of my knowledge background information was not requested from the Assessment Appeals Board either. C. Assessment Appeals Board ruling is "final" . You will be, in fact, overruling them based on County Counsel. and County Administrator improper recommendations . I could not have appeared before you had they ruled adversely upon the taxpayer, D. A denial decision by you will necessitate my recommending my client to seek legal counsel to file suit in Superior Court . CONTRA COSTA COUNTY BOARD OF SUPERVISORS MEMO RE: CONSENT STEM C.29 SEPTEMBER 17 , 2002 PAGE 2 III , SUPPORTING DOCUMENTS AND STATEMENTS : A. Incorrect action being requested.. (IL :A, above) • Exhibit l : Copy of my June 19, 2002 correspondence • Exhibit 2 : Assessor's office has agreed to issue refunds Assessor's office has stated no current mechanism exists to process refunds • Exhibit 5 : Board of Supervisors created Assessment Appeals Board • Exhibit 4 : Assessment Appeals Board authorized to resolve disputes • Exhibit 5 : Assessment Appeals Board is authorized and has previously resolved valuation dispute. You are being asked to overrule Assessment Appeals Board. Further, Assessment Appeals Board ruled no change in ownership recorded. Since a clerical error there is no statute of limitations . • Exhibit 6 : The decision of the Appeals Board is final . Any adverse action by the Assessment Appeals Board can only be timely filed in Superior Court by either the applicant or the Assessor. CONTRA COSTA COUNTY BOARD OF SUPERVISORS MEMO RE: CONSENT ITEM C.29 SEPTEMBER 17, 2002 PAGE 3 B. County Administrator ill-advised Board regarding legal basis for denial (II :B, above) • Exhibit 7 : County Administrator recommending incorrect vote • Exhibit 8 : Legal opinion incorrect since there was no transfer and therefore no statute of limitation • Exhibit 9 : Assessor admits to "clerical error' which mandates refunds • Exhibit 10 & 11: Taxes must be refunded if erroneously collected • Exhibit 12 : Taxes must be refunded without a formal claim by taxpayer C . Appeals Board ruling is final (II:C, above) • Exhibit 13 : Role correction based on Appeals Board decision D. Anticipated action to be taken in Superior Court upon denial of claim. (II :D, above) • Exhibit 14 : Only recourse upon denial is Superior Court • Exhibit 15 : Person who paid tax must bring suit. • Exhibit 16 : Courts have held statutes are aimed toward "inequitable retention of money that has been improperly collected CONTRA COSTA COUNTY BOARD OF SUPERVISORS MEMO RE: CONSENT ITEM C.29 SEPTEMBER 17 , 2002 PAGE 4 IV. CONCLUSION: Board should approve claim and instruct Tax Collector and Auditor to immediately process reffunds, inclusive of interest . Tad M. Heft19- Certified Public Accountant June 19, 2002 Mr. Jahn Sweeten, Clerk and County Administrator Contra Costa County ward of Supervisors 651. Pine Street Martinez, CA 94553 REGISTERED RETURN RECEIPT Re: Patrick & .Isabel Kesler Appeal Application Number 2001-198 through 202 Dear Mr. Sweeten, In accordance with the instructions by Donna Gerber' s Staff, I am respectfully requesting you to schedule the Board of Supervisors to take the following action: DICTION REQUESTED Instruct Office of the Assessor to recalculate tax rolls for the years 1996. 1997, 1996, 1999 and 2000 to correct a clerical error and request the Auditor/Controller' s Office to issue refunds plus statutory interest due. FACTS AND CIRCUMSTANCES 1 . Assessor' s office agrees refunds are due but state they do not have authorization or procedure (s) to process . 2 . They have, however, corrected the 2001 roll and all rolls thereafter. SUPPORTING DOCUMENTATION Attached for your reference is the following: 1 . Copy of the Assessment Appeals Board decision (legal issue) finding no change in ownership occurred. on February 13, 1996 . 939 Hartz Way (925) 820-6848 Suite 106 pax. (925) 831-9189 Danville, CA 94526 Email: tnhcpa@aol.com 2 . Copy of letter farm Assessor' s Office correcting (2001 and forward only) for the "clerical error" . 5 . Copy of Revenue and Taxation Code 5096 (b) , stating "Any taxes paid before or after delinquency shall be refunded if they were erroneously or illegally collected" . (Clerical error substantiated and agreed to) . 4 . The refund and related interest is to be computed under Section 5151. (c') (1) , 5151 (A) , and 5151 (B) . (Copy attached.) Since I am the property owner' s authorized representative, it is requested all calculations, documents and other requests be sent directly to my office . They are elderly and temporarily living in Bakersfield, California for health reasons . Thank you in advance for your assistance in this matter. Sincerely, Tad M. Heilig TMH/as Enclosures cc . gonna Gerber District III Supervisor Office of the Assessor, w/o encl. Auditor/Controllers Office, w/o encl. H. ,Alan Huovinen, Esq. , w/o encl. Client, w/o encl . TELEPHONE CALL SUMMARY The following telephone conference abstracts are provided under penalty of perjury, to the best recollection of Tad M. Heilig, GPA (Agent) . DATE: May 28, 2002 CONTACT: Gus Kramer COMMENT: "Refunds will be issued. Trouble figuring out how. Call. Jim Lynch" DATE:: May 28, 2002 CONTACT: Jim Lynch COMMENT: "Go to Board of Supervisors--no mechanism exists with Tax. Collector or Auditor to issue prior year refunds ." DATE: June 5, 2002 CONTACT: Jay at Donna Gerber' s office COMMENT: Asking how to address Board of Supervisors DATE: June 12, 2002 CONTACT: Jay at Donna Gerber' s office COMMENT: Provided specific instructions to request Board action allowing me to draft my June 19, 2002 letter. PHONE LOG CLIENT REGARDIN TnM OF �'Rt�M Tt7 TIM 't oil- -4:3 :3 n d4 f vw # t 1 1 t 5•�' ' itt{ i, 01 � �x t .f. e•4�t:e:'�3.��w T.. of 3:Vt ,1 'Yk:` A five-member Board of Supervisors, each of whom is elected on a non- partisan basis from a separate district where he/she lives, governs Contra Costa County. Within the broad limits established by Article XI, Section 5 of the State Constitution and the State Government Code, the Board is the governing body of County government and of 186 special districts, The Board enforces various State statutes and enacts local legislation to serve and protect County residents. The Board establishes general policies and plans for the operation of County government. Sohn tiw MOW 0"lit»UMOM WNW 4M1W 14*rk D" hd+aral Glavor cihsirt?iskriet II District III District Iv 019bict v District I As defined by general Law, the duties of the Board of Supervisors are as follows. • Appoint most County Department Heads, except elected officials, and provide for the appointment of all other County employees, • Provide for the compensation of all County officials and employees. • Create officers, boards and commissions as needed, appointing members and fixing the terms of office, • Award all contracts for public works and all other contracts exceeding $25,000. http.Ihwvw.co.contra-costa.ca.us/BOS1iAdox.html 9115102 r Adopt an annual budget. s Sponsor an annual audit made of all County accounts, books and records. . Supervise the operations of departments and exercise executive and administrative authority throughout County government through a County Administrator. . Serve as the appellate body for planning and zoning Issues. i Serve as the County Board of Equalization (the Board has created aniznnnm-ent Appea s perform this function). The Supervisorial Districts and their Incorporated cities, and other primary areas, are as follows (as of September 2001): District i District 2 District 3 District 4 District S BayView/Montalvin Alhambra Alamo la on Antioch Manor Valley Bast Richmond Canyon Blackhawk Clyde Bay Point Heights ELCeLEft Crockett Brentwood Concord Bethel Island El Sobrante her5uLu Byron Pacheco Oakley (part) Kensington I.Aftntte Danville Pleasant, Pira Hill North Richmond Martinez Diablo Pleasant Hill BART Richmond Discovery Walnut Bay Qftk (part) Rollingwood Mt. View Dougherty Valley San Pablo fid. 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F4R ax i' ,ai .Hl11 H a' ila: ,H1'1 - t• `2 IA t. # # ♦f ♦ d f S k1 t '.... a -. .; FUTI 77 It 71TqT#77-T,1F#. •' IS. 0:U. "Al Ha!lS,... ♦ „<Y::11 • 1. Tit I t# R+'"49 !f i #'. •-'!' # 2 2 ^asir iI f 9 ♦ ! f l.'F. Is, ,R 77- 7 '57.11".771"77,11, •S - 4 4,• S f f� - • ! F}.:.� tt• - _ S #`. i f f.-,'} i ♦} # 4` e' R• 4 } -`-•= S# i S a R d 4 d •d 1 !PF ♦ It}` S } _lit ♦, k.: t,. t: A�iliaflf� R• RIMs • kf _ #.. -1 Is R' k ♦ # : as ll 4 R- f • R_'e ' ►a r` 1 a -'9 •. 9 6� • b � •-: i 4)i! q• i- a 0 # c.Ls.A- !;a s•}y.[. R;e�:f,� - •b:,1fl:#.. ■»}„(=.a E; It r ♦# .x: F It BEFORE THE ASSESSM[ENT APPEALS BOARD OF CONTRA COSTA COUNTY, STATE OF CALIFORNIA In the Matter of Application of DECISION AFTER.HEARING (Legal Issue) Patrick& Isabel Kesler P.O. Box 1040 Danville, CA 94526 Application No. 2001-0198 thru 0202 Parcel No. 208-110-007-1 et al The application of the above named person for changed assessment having been regularly heard before the Assessment Appeals Board: The Board hereby finds that a change in ownership did n©t occur on --Yebruary 13, 1996 Decided on February 7, 2002 by the following vote: AYES: V.G. Rousaville; P.E. Schwenger; l.1. Doherty NOES: None ABSENT: None A copy of the Decision was mailed to the above named applicant at the address given in the application on _ FebaM 8,2002 ATTEST: JOHN SWEETEN, Clerk of the Assessment Appeals Board and County Administrator By: JH� I,/ IA Deputy Cl rk cc: Applicant Agent Assessor : ; SOE 305-AH(S2€}REV.3(3.00) INFORMATION AND INSTRUCTIONS FOR APPLICATION FOR CHANGED ASSESSMENT The-State Board of Equalization has prepared a pamphlet to assist you in completing this application. You may download a copy of Publication 30, R'esidentlal Property Assessment Appeals, at www.boe.ca.gov or contact the, clerk of your local board for a copy. Filing this application for reduced assessment does not relieve the applicant from the obligation to pay the taxes on the subject property on or before the applicable dug date shown on the tax bill. If a reduction is granted, a proportionate refund of taxes paid will be mads by the county. Based on the evidence, the appeals board can Increase as well as decrease an assessment,The decision of the appeals board upon this application Is final, the appeals board may not reconsider or rehear any application. However, either the applicant or the assessor may bring timely action In superior court for review of an adverse action. An application may be amended until 5:00 p.m. on the last day upon which the application might have been timely filed. After the filing period, an Invalid or incomplete application may be corrected at the request of the clerk or amendments may be made at the discretion of the board.Contact the clerk for Information regarding correcting or amending an application. The appeals board can hear matters concerning an assessor's allocation of exempt values. However, It cannot hear matters relating to a person's or organization's eligibility for a property tax exemption. Appeals regarding the denial of the Welfare Exemption should be referred to the State Board of Equalization, Policy, Planning, and Standards Division, M€C.64, PO Bax 942879, Sacramento, CA 94279-0064. Appeals regarding the denial of any other type of exemption are under the jurisdiction of the assessor and/or the courts. The fallowing-numbered Instructions apply to the corresponding numbers on the application form. Please type or print In Ink all Information an the application form. Bax i. Enter the name and mailing address of the applicant. If this applicant Is other than the assesses (e.g., leased property), attach an explanation.NOTE- An agent's address may not be substituted for that of the applicant. Box 2. Provide the name and mailing address of the agent or attorney, If applicable. If the agent Is not a California-licensed attorney, you must also complete the agents authorization section, or an agent's authorization may be attached to this application.An attached authorization must contain all of the following information: • The data the authorization is executed. • A statement that the agent is authorized to sign and file applications in the calendar year of the application, • The .specific parcel(s) or assessment(s) covered by the authorization, or a statement that the agent is authorized to represent the applicant on all parcels and assessments located within the county that the application is being filed. • The name, address, and telephone number of the agent. • The applicants signature and title. • A statement that the agent will provide the applicant with a copy of the application. Box 3» If this application is for an assessment on secured property, enter the Assessor's Parcel Number from your assessment notice or from your tax bill. If the property is unsecured (e.g., an aircraft or boat), anter the account number from your tax bill. If appropriate, enter the name of the business (OBA). Enter a brief description of the property location, such as street address, city, and zip code, sufficient to Identify the property and assessment being appealed. j For a single-family dwelling, Indicate If the dwelling is owner-occupied. Box 4. Column A: Enter the figures shown on your assessment notice or tax bill for the year being appealed. If you are appealing a current year assessment (base year or decline In value) and have not received an assessment notice, or are unsure of the values to enter in this section, please contact the assessor's office. If you are appealing a calamity reassessment or an assessment related to a change In ownership, new construction, roll change, or escape assessment, refer to-the reassessment notice you received. If you erre appealing a penalty assessment, NOTE: a penalty assessed by the tax collector for nonpayment of taxes cannot be removed by the appeals board. Column 8: Enter your opinion of value for each of the applicable categories. If you do not state an opinion of value, It will result In the rejection of your application. QA0ATA % , s a�ao CA46TO: BOARD OF SUPERVISORS Doug FROM; JOHN SWEETEN,County Administrator Costa GATE: SEPTEMBER 17, 44 y 2002 County SUBJECT: DENY CLAIM OF PATRICK AND iSABEL KtESLER FOR REFUND OF TAXES FOR 19"THROUGH 2000 TAX YEARS SP90FI C RlCUUTtla ORrRyE,GOMMENDAT10")X DA090ROUND ANC JUVVICATIAN DENY claim of Patrick and Isabel Kesler for refund of taxes for 1998 through 2000 tax Year.C,...._ ..... BACKO'f3UND On June 19,2002,the County Administrator reoelved the attached letter from Tad M.Hellig, CPA,on behalf on Patrick and Isabel Kesler,requesting that the Board of Supervisors instruct the Assessor to correct an alleged Clerical error that imputed the tax roll values and to Jesus refunds plus statutory interest due to the Keglers. County Counsel's investigation of the farms and cirvaratancees of this situation Indicate that they Kesler's 1996 transfer of property title to their children was incorrectly identified as a change in Ownership,prompting a reassessment of the property. The laws governing this situation provide relief only:for the year in which the matter wage appealed and subsequent years,union they appeal was made within three years from the property transfer, The Kesler's did not make their appeal within the three-year appeal peariod and are,therefore,not antille d to relief for periods pricer to tf3etr appeal. We,therefore,recommend that the Board deny the Kesler's claim for refund of taxes for the 1996-2000 tax years. CONTINUED ON ATTACHMENT: 0 YES SIANATUREI RECOMMENDATION OF COUNTY ADMINISTRATOR 0 RECOM ME T)ON OF BOARD CO 101ITTEE APPROVE [ OTHER Srr#NATURE S: ACTION OF BO N APPROVED AS RECOMMENDED OTHER � VOTE Of SUPERVISORS: I HER93Y CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTON TAKEN AND _ UNANIMOUS(ASSENT I ENTERED ON THE MNUTU OF THE BOARD OF AYES:-NOES; SUPERVISORS ON THE DATE SHOWN. ABSENT: ABSTAIN: ATTESTED Coatact: JOHN SWEETEN,CLERK Of THE BOARp OF a c: Supsavlabr Asrbee SUPERVISORS AND COUNTY ADMINISTRATOR Assemr County Coutmol County Administrator gy: Deputy us Contra Office of Assessor Asses. Kromer Assessor Costa2530 Arnold Drive, Suite 400 Stephen Dawkins Assistant Assessor Martinez, California 94553-4359 Valuation County, FAX: (925)313-7660 Lori Koch Telephone: (925) 313-7500 Assistant Assessor Administration May 17, 2002 MR. TAIL M. HEILIG 939 HARTZ WAY, SUITE 106 MANVILLE, CA 94526 Re: 208-110-007 Dear Mr.Heilig: Per our phone conversation on May 15, 20€12, you requested a letter stating what action will be taken by the Assessor's Office regarding the Kesler Appeal, Application number 2001 - 198 through 202. The Appeals Board determined that the transfer in February of 1996 between Patrick and Isabel Kesler and Randell Kesler was not a chane in ownership, Per Section 51.5(x) of the Revenue and Taxation Code, we are correcting theT'e`irtl 1996 transfer) in the year in which it was discovered and per Section 80(5) of the Revenue and Taxation Cade we are correcting the 2001 rail as a result of the assessment appeal and correcting all rolls perspectively thereafter. Your very truly, Steve Dawkins, Assistant Assessor, Valuation For Gus Kramer, County Assessor SD:jv heiiig . t li L-UucPs krLL;:jV�F1j-J i VO) ., . i� 3J C1 .+ Ll TAXATION SECTION 5096-5108 5096. Any taxes paid before or after delinquency shall be refunded if they were: (a) Paid more than once. (b) Erroneously or illegally collected. (c) Illegally assessed or levied. (d) Paid on an assessment in excess of the ratio of assessed value to the full value of the property as provided in Section 401 by reason of the assessor's clerical error or excessive or improper assessments attributable to erroneous property information supplied by the assessee. (e) Paid on an assessment of improvements when the improvements did not exist on the lien date. (f) Paid on an assessment in excess of the equalized value of the property as determined pursuant to Section 1513 by the county board of equalization. (g) Paid on an assessment in excess of the value of the property as determined by the assessor pursuant to Section 459. 5095.1. Except as hereinafter provided, taxes collected on behalf of a local agency from a taxpayer whose property has been annexed to a second local agency but was not detached from the first local agency due to error or inadvertence shall be deemed to have been erroneously collected for purposes of Section 5096 if the governing board of the first local agency makes a finding by resolution that detachment proceedings were not commenced due to excusable neglect. If the first local agency is a fire protection district the governing body of the annexing agency may make the finding by resolution that detachment proceedings were not commenced following annexation due to excusable neglect. For purposes of determining the amount of the refund- the property shall be deemed to have been detached from the first local agency on the date annexation proceedings were completed. This section shall not apply to taxes which would be collectible under authority of Government Code Section 55492 even though the annexed property had been detached from the special district. 5096.3. (a) To dispose of certain lawsuits and assessment appeals that have been filed, and to preclude the filing of other claims relating to (1) the assessment, equalization, and assessability of certain possessory interests in publicly owned airports and (2) aircraft valuation and equalization by Alaska Airlines, Inc. , American Airlines, Inc. , Continental Airlines, Inc. , Delta Air Lines, Inc. , Federal Express Corporation, Northwest Airlines, Inc. , Trans World Airlines, Inc. , United Airlines, Inc. , United Parcel Service, U.S. Airways, Inc. , Wings West Airlines, Southwest Airlines, America West Airlines, in their own right or as successors in interest, counties shall provide future tax credits in the following amounts: hip://w-ww.ieginf'o.ca.gov/cgi-bin/d splaycode?section.==rtc&group=05001-06000&file=5096-51 3/1/02 Office of the County CounS01 Contra Costa County 6151 fine Street, 9th Floor Phone: (525)335.1800 Martinez, CA 94553 Fax.(SM 646-1075 Date. July 30, 2002 To: Jahn Sweeten, County Administrator From: Silvano Marchesi, County Counsel By: Dennis Graves, Senior Financial C l Re; 6/19/02 Letter of Ted Heitig, CPA, on behalf of Patrick and Isabel Kesler, APIA 208-110-007 You recently forwarded the subject letter to this Office, asking us to comment on the Kaslers' request for refund of taxes back to 1996. Although not specifically denominated as a refund claire, Mr. Heilig evidently intends that the letter be treated as a formal claim for refund to the Board of Supervisors. (R+TC Sec. 5096.) 0�. Since Mr. Hellig`s better includes little background,we have asked the Assessor to ,0 Inform us as to the details of this case. The folio-wing analysis is based upon that information and the limited information In the Kesler claim. The Issue arose in February of 1996,at which time there was a transfer between parents(the Keslers) and one of their children in crater to protect against creditors of the parents. The taxpayer having provided incomplete information, it appeared to the Assessor that a change of ownership had occurred, and the property was reassessed. Several years later—in 2101 -- the Keslars filed assessment appeals beard applications asserting that the 1996 event was not a change of ownership. In 2002, the appeals bard agreed with the Keslars, ruling that the 1996 transfer was not a change of ownership. There are a number of code sections that potentially apply when administering requests for corrections to assessed values in various circumstances, and it is sometimes confusing as to which might apply in a given situation, Flevenue and Taxation Cade Section 63.1 specifically addresses requests for relief in ituations of parent-child transfers. Under Subsection (a)(1) thereof, the Keslers should i ave requested relief within 3 years (no later than 1999) If they were to be granted r�) funds back to the 1996 year In which the event in question occu€red, Subsection (2)(A)thereof provides that, under the circumstances of delaying their request until 2001, the Keslars cannot be given relief for years prior to that year. This is consistent with Revenue and Taxation Code Section 80,which is the section 1 generally applicable to assessment appeals board determinations on such issues. k��"��,��'� Subsection 80(a)(5.) thereof specifies that a reduction In base year value by an assessment appeals beard shall apply for the year in which the matter Is appealed and �r years subsequent thereto. In the present case, that would be-for 2001 and subsequent years. We conclude that refunds should be allowed only for the,years 2001 and subsequent. Sine the Assessor has already processed the paperwork for such refunds, the claim for ralief prier tc 2001 should be denied by the Board. We recommend a consent item t� � agendaed as follows: "Deny claim of Patrick and Isabel Kesler for refund of takes for f�p, V 1986 ttrrc�ugh 2t'�34 tax years. t cc: Supervisor donna Gerber Gus Kramer, Assessor Attn: Steve Daw#dns, Asst. Assessor CONTRA- # COUM RECEIVED C:kssler.doc-3 2 STATe OF CALIFORNIA STATE BOARD OF EQUALIZATION JOHANKLEHS 450 N STREET,SACRAMENTO,CALIFORNIA First Distft Heyward (PO BOX 942878,SACRAMENTO,CALIFORNIA 94279-0082) DEAN ANDAL TELEPHONE(916)323-7713 Second District,Stockton FAX(916)323-3387 CLALtOE PARRiSH Third Disiricr,Torrance JOHN CHIANG February 11,2002 fourth District,Les Angeles KATHLEEN CONNELL Controller,Sacramento Honorable Thomas P. Kidwell E.L. �. Execuem&ti�+e Dirireoior Madera County Assessor Attn: Mr. Chuck Brough, Chief Appraiser 209 West Yosemite Avenue Madera, CA 93637 Attn: Mr. Chuck Brough Re: Base Year Value Corrections, roll corrections,Refunds Dear Mr. Brough: This is in response to your letter of September 20,2001,to Chief Counsel Timothy Boyer requesting our interpretation of several Revenue and Taxation Cade sections applicable to correcting a base year value error and issuing appropriate refunds. Please excuse the delay in responding as other previously scheduled Board matters have occupied our time. Based on the /T \d circumstances described in your letter, we conclude that 1) if'the 1990 base year value error involved value judgment, there is no time remaining under section 5 1.5 subdivision(b)to correct; however, if it was clerical,the error should corrected under section 51.5, subdivision{ for all years back to 1990; 2) if the error is clerical(nonjudgmental),the years available for 0 correction are not limited by the statute of limitations on roll corrections under section 4831; and 3) if corrections are made for all years,the taxpayer has one year from the date of notice under section 2635 to claim refunds back to 1990. Facts A change in ownership occurred in October 1990,and an error in the base year value was made in<that the assessed value,based on comparable sales,should have been$50,000 less than the value actually enrolled. The taxpayer did not question the value (nor did the assessor discover it)until 2001,at which time the assessor's office determined that a correction was necessary for the 2002 roll. You wish to know: 1)whether section 51.5 authorizes a reduction in base year value for all years or only four years since the 1990 change in ownership; 2)whether reductions under section 51.5 are limited to the number of years for which roll corrections can be made under section 4831;and 3) whether refunds resulting from a base year value reduction are available for all years under section 2635, or limited to four years under section 509'7. Mr.Chuck Brough February 11, 2002 Page 2 1. I -the 1990 b-aseywyalue eaor inyolyvd.valuejm41=nL no time rem-4 under section 51.5 (bltogo t it: if it mm a at a co ec d under e 5 (f). back to Section 51..1 provides specific authority and timing for assessors to correct base year value errors. Correction of errors or omissions not involving the exercise of an assessor's ,judgment as to value is authorized under subdivision(a),whereby the assessor may at any time go back to the date of the event to make the correction. The assessor's correction of clerical errors, as defined in subdivision(0,may also be undertaken at gU time,back to the date of the event. Correction of errors or omissions involving the exercise of the assessor's value judgment authorized under subdivision(b)however, must be made"within four years(after July 1 of the as es e t Year for which-t-h-c thmo Year-Kaluewas hrst a tablished." To determine the number of years to be corrected,the assessor must first make a determination of the type of error involved. The type of base year value error-whether nonjudgmental, involving value judgment,or clerical—is a question of fact in each case. Neither the Legislature nor the courts have promulgated a standard or"test" applicable to every scenario.' The Board staff"guidelines" suggested below are merely interpretations made by the courts in applying subdivision(a), (b) or(f)of Section 51.5. Su vi 'on a - 'te t' a to orrect on'ud ental Errors a) In Montgomery Ward& Co. v. County of Santa Clara (1996)47 Cal.App.4t' 1122, a change in ownership occurred and timely reported,but the assessor did not enroll the base year value within four years after July 1 of the assessment year in which it occurred. Held: value judgment had not been exercised; the error could be corrected at any time-section 51.5(a). b) In Sunrise Retirement Villa v Dear(1997) 58 Cal.App.4' 948,the assessor reappraised for a change in ownership and enrolled the new base year value within four years.Almost ten years later,Taxpayer established that assessor's change in ownership determination was a mistake. Held, value judgment was not exercised where the issue is a change in ownership; and,if the appeals board found that a change in ownership did not occur,the error could be corrected at any time w section 51.5(a). c) In Firestone Tire &Rubber Co, v. County of Monterey(1990) 223 Cal.App.3d 382; County ofSun Diego v. Assessment Appeals Board No. 2 of San Diego County(1983) 148 Cal.App.3d 548, the error in base year value was due to waste contamination. ' Further,there is no statutory standard of proof required to establish whether a particular error involves value judgment or is clerical or nonjudgmental in nature. Mr. Chuck Brough February 11, 2002 Page 3 Meld: ffinformation on the condition had been provided to the assessor at the time of the event triggering the new base year value and the information was omitted (not considered)by the assessor in making the valuation, it was nonjudgmental, and may be corrected at any time. (Value judgment not exercised with regard to the.known condition of the property.) u -vision —Four years to Qorreet-Emars-Ln Yale ud ment. a) Errors in discounting to cash equivalency—Plaza Hollister.Limited Partnership v. County of San Benito (1999) 72 Cal.App.4'h 1. The assessor may correct within four years after July 1 of the assessment year for which the base year value was first established. (The date first established means the date it was enrolled.) b) Error regarding inclusion of-enterprise value in the unit—Service America Corp. v. County of San Diego(1993) 15 Cal.App.4'g 1232. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled c) Mistake due to failure to discount nominal sales price-Prudential Ins. ref America v. City and County of San Francisco (1987) 1.91 Cal.App.3d 1142. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. d) Erroneous allocation of goodwill--Sea World, Inc. v. County of San Diego (1994)27 Cal. kpp.4* 1390. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. 3 e) Error in estimate of value -caused by incorrect book values submitted by taxpayer- Kuhlerneir v. County of Los Angeles(193 5)2 Cal.2d 257. The assessor has four years after July.1 of the assessment year for which the base year value was enrolled,unless the incorrect values resulted from taxpayer's fraud, concealment,misrepresentation— in which event the errors may be corrected at any time,per section 51.5 (c). fj Error in measuring the value(in contrast to quantity or extent) of property in the appraisal unit—El Tejon Cattle Company v. County of San Diego (1967)252 Cal.App.2d 449. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. &bdivision M) -Unlimitged tim to Qorrect Clerical Errors. If the erroneous base year value entered on the roll based resulted from a defect of a mechanical,mathematical, or clerical nature, not involving judgment as to value,— the error is clerical and may be corrected at any time. A computation or calculation __...._. Mr. Chuck Brough February 11, 2002 Page 4 error is one that results from an unintentional mistake,not deliberately made at the time value was determined (LTA No. 88/50, 7/1/88,p.2) Based on the foregoing,either subdivision(b)or subdivision(f) is relevant to the facts you describe. The error does not fall under subdivision(a), as the assessor's f� determination of the 1990 change in ownership was correct. There are two reasons the 1990 base year value was too high. First, the mistake was due to improper application of a valuation method (comparable sales approach), and to that extent was deliberate and intentional(per subdivision(b)). If the facts substantiate this,then it was an error in the appraiser's value judgment, and no correction is possible, since section 51.5(b)allows only "four years after July 1 of the assessment year for which the base year value was first established." The phrase"the assessment year for which the base year value wasfirst established, "means,four years ofJTuly J of the assessment year during which the assessor actuall rol s the new base velLr value res ultin tom a chane in ownershia or c m Ceti n f new anstruction.2 Fence, even if the new 1990 base year value was not enrolled until 1994,there are still no years remaining to correct the error if it involved value judgment per section 51.5(b). If on the other hand the error occurred because of improperly calculating the value, transposing or misreading numbers, or substituting the wrong data, i.e., a clerical or computational error,then it was a clerical mistake and unintentional(per subdivision(f)). If the facts substantiate this scenarien no value judgment was involved, and a correction for all years back to 1990 is possiblaRy the express terms of subdivision(a), the assessor is required to correct"any error or omission in the determination of a base year value ... including the failure to establish that base year value,which does not involve the exercise of an assessor's judgment as to value, ... in any assessment year in which the error or omission is discovered." We have consistently interpreted this to mean that there are no time limitations on the correction of nonjudgmental or c1grical base year value errors; rather they are to be corrected whenever discovered. (Montgomery Ward& Co.,p. 1124.)Hence,the assessor should correct all the years back to and including the 1990 base year value if the error proves to be clerical. In the event that the taxpayer disagrees with the assessor's determination on this issue, an appeals bo4rd has jurisdiction to determine whether an error is judgmental or nonjudgmental. (cleric a courts have consistently held that an appeals board may begin the process of invoking its jurisdiction in response to information received from a taxpayer, an assessor, or by any other means. In responding to information submitted, the board may (although it is not required to)conduct a preliminary hearing for the purpose of determining whether reasonable cause exists to invoke its jurisdiction in a given matter. (Stevens v. Fox Realty Corp. (1972) 23 Cal.App.3d 199.) In effect,this constitutes a jurisdictional hearing in which a board decides whether to exercise its jurisdiction or not. If a board decides that a controversy centered on whether an error in base year value was judgmental or nonjudgmental(clerical) is within its _. .._ _ . . . ............................................. Mr. Chuck Brough February 11, 2002 Page 5 jurisdiction, it may thereafter proceed to make a determination of the factual issues. (.Property Tax Rule 309,Assessment Appeals Manual,page 41. See also Sunrise Retirement Villa v. Dear (1997) 58 CaLApp.4h 948. 2. If the error was clericalnon'ud ental the ears available for correction are not limited-by the statute ofli: itations on roll corrections under section 4831. Base year value corrections are not"roll corrections.,' There are at least three separate and distinct tools to bring about changes in the assessed value of enrolled property: 1) roll corrections(per section 4831 et seq.); 2)escape assessments (sections 531 et seq.); and 3) base year value corrections (sections 51.5 and 80). The correction of an entry on the roll under section 4831 has its own four-year time limit.' The fact that the property being assessed by a particular roll entry is later the subject of an escape assessment made under section 531 or a base year value correction under section 51.5, does not extend or change the four-year limit on the roll correction of that entry. Section 4831 is a specific procedure separate from the procedures for enrolling escape assessments or correcting enrolled base year value errors. For example, section 4831 is permissive;stating that the assessor may process roll corrections for errors on the roll within four years after the making of the assessment which is being corrected, e.g., four years from the date of discovery of the error. (Section 4831(a).) Section 51.5 is mandatary and requires that a base year value correction shall be reflected in either appropriate cancellations or refunds of taxes, or levies of escape assessments --whether that correction is made under subdivision(a) or(f) (nonjudgmental, clerical) or under subdivision (b)(value judgment). Section 51.5 lacks any express language that would authorize roll corrections. As explained in Letters to.Assessors Nos. 88/50, 89/34,and 95/54, and in various legal opinions, section 51.5 des not authorize or provide for roll corrections,primarily because base year value corrections are not roll entries. Thus,even though a base year value must be corrected'under section 51.5, it maybe untimely or not permitted as a"roll correction"under section 4831. Section 51.5 authorizes the correction oft ebase year value where the base year value is the"roll value"and mandates that appropriate escape assessments and cancellations or refunds be.made as a result. Section 4831 authorizes corrections of certain types of entries on the roll based on its own four-year(or one-year)time limit. Specific authorization for delivering base year value corrections to the auditor without invoking roll correction procedures under section 4831 is now included in proposed Property Tax Rule 254, "Base Year Value Corrections," subdivision(c), as follows: If a correction authorized by subdivision(a) or(b) [of section 51.5]reducers the base year value, the assessor shall transmit the correction to the auditor by means of information noted on the roll, and appropriate cancellations or Mr. Chuck Brough February 11,2002 Wage 6 refunds of tax shall be granted in accordance with Division 1 of the Revenue and Taxation Code. If the correction increases the base year value,the assessor shall transmit the information regarding the correction by means of a natation on the roll, and appropriate escape assessments shall be imposed in accordance with Division 1 of the Revenue and Taxation Code. 3. If correcti are ma e�back to 1990 e a e ' ri t t r ds i unlimited if notice is received under section 2§15 and a claim is filed within one Year. While offering our opinion on the issue,we hasten to acknowledge that questions relating to whether refunds should be made is a matter for the county auditor or the county tax collector, not the assessor. While the Board advises assessors, it is the Mate Controller who advises county auditors and tax collectors. In offering our advice, we take into account such opinions and publications of the State Controller as are available to review. Since the Controller has issued an opinion affecting this controversy,we defer to the conclusion stated therein as discussed below. (See Gary Hori letter State Controller's office, S17M2001,attached.) For this reason, you may wish to address additional inquiries to the State Controller. In Letter to Assessors No. 91153 (attached),Board staff stated that section 51.5(d) requires appropriate cancellation or refunds of taxes, or escape assessments as the result of a base . year value correction. Such refunds,cancellations, or escape assessments are justified and required by any base year value correction that leads to such a result. According to section 51.5(d)-whether a refund,cancellation,or escape assessment is tme y in a given case depends entirely on the particular statutory requirements for each: "(d) If a correction authorized by subdivision(a)or (b)reduces the base year value,appropriate cancellations or refunds of tax shall be granted in aceorda=with this division, If the correction increases the base year value,appropriate escape assessments shall be unposed in accordance with this division. (Emphasis added.)" The phrase, "in accordance with this division."means Division I of the Revenue and Taxation Code. Division I contains the procedures for refunds under sections 5096-5097, cancellations under section 4896, escape assessments under section 531 et seq., and appeals of base year value pursuant to section 1601 et seq. or section 80. (See Division 1 consisting of sections 50 through 5911: Part I through fart 14.) To determine whether and when a taxpayer is entitled to a refund, cancellation or an escape assessment, section 51.5(d)requires the application of each respective set of statutes to the facts. Regarding the time for making refunds,section 5097(a)(2)provides that no order for refund shall be made except on a claim filed within, + vafter the making of the payment sought to be refunded, or within one after the mailing of the notice prescribed in section Mr. Chuck Brough February 11, 2002 Page 7 2635, or the period agreed to as provided in section 532.1, whichever is later? If the first time period applies,the taxpayer must file a refund claim within the four-year limitations period,even though abase year value appeal was timely filed and the reduction granted by the appeals board. (Mission'Housing Development Company v. City and County of San Francisca (1997) 59 Cal.App.4"' 55.) If the second time period applies(as in this case),the taxpayer must file a refund claim within the within one year after the date of the notice under section 2635. Paragraph 1610 of the State Controller County Tax Collector's Reference Manual notes that"Section 5096 is remedial and should be liberally construed to carry out its intent of preventing the inequitable retention of money that has been improperly collected.ir' Paragraph 1600 of the 1999 State Controller County Tax Collector's Reference Manual states: When more than four years have elapsed after an erroneous or illegal collection, an assessee may not originate a petition for refund galess fLr t notified of v a ent by 1kc*=In a r e with 2 5, or unless the statute of limitations has been extended by mutual written agreement between the taxpayer and the assessor(§§5097 and 532.1). Thus,it is apparent that the legal construction of these statutes by the Controller's office is aimed toward the`inequitable retention of money that has been improperly collected," as the basis for refunding.tax money and for the broad 'interpretation of sections 2635 and 5097(x)-set forth in the enclosed legal opinion issued by Cary Hori.3 Section 2635 states: "When the amount of taxes paid exceeds the amount due by more than ten dollars($10),the tax collector shall send notice of the overpayment to the taxpayer. The notice shall be mailed to the taxpayer's last known address and shall state the amount of overpayment and that a refund claim may be filed pursuant to Chapter 5 (commencing with Section 50.96) of Part 9". In the Controller's opinion,the one-year claim filing period under section 2635 is an alternative to the four-year claim filing period under section 5097(x). Mr. Hori states on page two of the letter, ' Section 2635 is a mechanism for the tax collector to notice the taxpayer of the right to a refund,in addition to the 4-year time limit imposed by section 5097,where the notice identifies an overpayment to the taxpayer. Upon receipt of such notice,the taxpayer has one year to file a clam for refund. ` The Controller's statement is supported specifically by P'acifle Coast Ca v. Wells(1901) 134 Cal.471;Midstate Theatres v.Board of Supervisors(197 5)and Focus Cable v.Alameda County(1985)173 Cal.App.3d.519. ' See County Tire Collectors'Reference Manual, 1999,California State Controller,page 82,which paraphrases the statue and states that tax collectors and auditors have authorization to make refunds under these conditions. _ _ _ __ _ _ _. Mr. Chuck Brough February 11, 2002 Page 8 " ..we find that four years is not the sole limitations period under Revenue and Taxation Code section 5097. Section 5097 expressly permits tax refunds to be filed within four years after making the tax payment sought to be refunded or within one ar after the mailing ofthe notice prescribed in LRevenue and Taxation Code J-`ection 2535,or the period agreed to as provided in section 532.1, whichever is Cuter." "In sum, we conclude that a county is required to allow a taxpayer's refund claim within one year following the mailing of the notice of overpayment (under Revenue and Taxation code section 2635) even though the overpayment corresponds to an assessment year beyond four years." As applied to the instant case, if the assessor corrects the base year value for the years in question(back to 1990), and the facts establish an overassessment of the taxpayer's property for each of the years, the assessor is required by §51.5(d)and Rule 264(c)to deliver that information to the county auditor. That information would then necessarily be passed on to the tax collector who is required by §2635 to notify the taxpayer of an overpayment of taxes resulting from the overassessment. Per subdivision(a)(2)of§5097,the taxpayer would have one year from the date on the notice of overpayment to file a claim for refund. In Letter to Assessors No. 91/53 (p..2),the Board staff`advised that §2635 should not be given a broad interpretation that would extend the payment of refunds beyond four years. Based on the recent views and opinion published in the 1999 Controller's Manual and the May 7, 2001 letter, LTA No. 91153 should be considered to be superseded and no longer an accurate summary of the law on this question. The views expressed in this letter are only advisory in nature. They represent the analysis of the legal staff'of the Board based on present law and the facts set forth herein,and are not binding on any person or public entity. Very truly yours, Kristine Cazadd Supervising Tax Counsel Attachments IC:eb I�€�Pnelbayrwrsto2Jaf kec Mr. Chuck Brough February 11, 2002 Page 9 cc: I& David Gau, MMC:63 Chief of PPSD, MIC:64 Mx. Harold Hale, MIC:61 Ms.Jennifer Willis, MIC:70 R&T Code Sections involving Assessment, Collection, Appeal, and Refund Equalization By A Local Board, 1610.8. After giving notice as prescribed by its rules,the county board shall equalize the assessment of property on the local roll by determining the full value of an individual property and by reducing or increasing an individual assessment as provided in this section.The full value of an individual property shall be determined without limitation by reason of the applicant's opinion of value stated in the application for reduction in assessment pursuant to subdivision(a)of Section 1603. The applicant for a reduction in an assessment on the local roll shall establish the full value of the property by independent evidence. The records of the assessor may be used as part of such evidence. The county board shall make a determination of the full value of each parcel for which an application for equalization is made. 1612. The clerk of the county board shall record,in a book kept for that purpose,all changes and orders made by the county board and,no later than the second Monday of each month,she prepare a separate statement listing all such changes made during the preceding calendar month. 1613. After five days succeeding the time when notice of the date when the matter will be investigated is sent by the clerk of the county board to all persons interested,the county board may direct the assessor to: (a)Assess any taxable property other than State asses$ed property that has escaped assessment. (b)Change the amount,number,quantity,or description of property on the local roll. (c)hake and enter new assessments,at the same time canceling previous entries,when any assessment made by him is deemed by the county board so incomplete as to render doubtful the collection of the tax. 1614. On the second Monday of each month the clerk shall deliver the statement of all changes made by the county board during the preceding calendar month to the auditor with an affixed affidavit, subscribed by Wun,as follows: 1, ,swear that,as Clerk of the Board of Equalization of County,I have kept correct minutes of all the acts of the board during the month.of -3 ,touching alterations in the assessment roll,that all alterations agreed to or directed to be made have been included in the attached statement and that no other alterations are included therein., Equalization By The ROE 758. if the board roll has been transmitted to the local auditors,the board may make an assessment of escaped property or a roll correction. At least 30 days prior to transmitting a statement of assessment of escaped property or making a roll correction,the board shall notify the assessee whose property's full value has increased as a result of an escape assessment or roll correction of the assessed value of that property as it shall appear on the corrected roll. The notice shall be mailed to the assessee at its address shown in the records of the board. The notice shall advise the assessee of the date by which and the place where a petition for reassessment may be filed. The date for filing the petition shall not be less than 50 days from the date of the mailing of the notice of value. The provisions of Sections 741 to 744, inclusive, shall be applicable to petitions and hearings pursuant to this section except for the dates prescribed for decisions of the board. The Auditor Recalculates And Corrects The Roll. 1646.1. Upon receiving a statement from the clerk prepared under Section 1614,the auditor shall forthwith correct the roll to reflect the changes made by the county board. The Auditor Or The Tax Collector Can Refund Taxes Without A Formal Claim For Refund By The Property Owner If The Refund Is bade Within Four Years Of Payment. 5097.2. Notwithstanding Sections 5096 and 5097,any taxes paid before or after delinquency may he refunded by the county tax collector or the county auditor,within four years after the date of payment,if.. (a)Paid more than once. (b)The amount paid exceeds the amount due on the property as shown on the roll. Jim Bone Page 2 of 3 March 1, 2002 C:1Program Fi WArnerica Online 7.01down#oadlKCLatterre26351Refundafterf6uryearsa nalysis.doc R&T Code Sections Involving Assessment, Collection,Appeal, and Refund (c)The amount paid exceeds the amount due on the property as the result of corrections to the roll or cancellations after those takes were paid. (d)In any other case,where the claim for refund is trade under penalty of perjury and is for an amount less than ten dollars($10). (e)Ti e amount paid exceeds the amount due on the property as the result of a reduction attributable to a hearing before assessment aea s oar r an assessment hearing officer. If No Refund Is Made,Then The Rall Will Show An Overpayment And The Tax Collector Must Send The Property Owner A Notice That They Have One Year To File A Claim For Refund. 2635. When the amount of taxes paid exceeds the amount due by more than ten dollars($10),the tax collector shall send notice of the overpayment to the taxpayer. The notice shall be mailed to the taxpayer's last known address and shall state the amount of overpayment and that a refund claim may be filed pursuant to Chapter 5(commencing with Section 5096) of Part 9. The Property Owner Can File A Claim For Refund Until The Later Of One Year From Notice Under 2635 Or Four Years From Payment Of The Tax. 5097. (a)No order for a refund under this article shall be made,except on a claim, (1)Verified by the person who paid the tax,his or her guardian,executor,or administrator. (2)Filed within four years after making of the payment sought to be refunded or within one year after the mailing of notice as prescribed in Section 2635,or the period agreed to as provided in Section 532.1,whichever is later. (b)An application for a reduction in an assessment filed pursuant to Section 1603 shall also constitute a sufficient claim for refund under this section if the applicant states in the application that the application is intended to constitute a claim for refund. If the applicant does not so state,he or she may thereafter and within the period provided in paragraph(2)of subdivision(a)file a separate claim for refund of taxes extended on the assessment which applicant applied to have reduced pursuant to Section 1603 or Section 1604. (c)If an application for equalization of an escape assessment is filed pursuant to Section 1603,a claim may be filed on any taxes resulting from the escape assessment or the original assessment to which the escape relates within the period provided in paragraph(2)of subdivision(a)or within 60 days from the date the board of equalization makes its final determination on the application,whichever is later. 5097.02. The claim shall be in writing,specifying: (a)Whether the whole assessment is claimed to be void or,if only a part,what portion. (b)The grounds on which the claim is founded. 5096. Any taxes paid before or after delinquency shall be refunded if they were: (a)Paid more than once. (b)Erroneously or illegally collected. (c)Illegally assessed or levied. (d)Paid on an assessment in excess of the ratio of assessed value to the full value of the property as provided in Section 401 by reason of the assessor`s clerical error or excessive or improper assessments attributable to erroneous property information supplied by the assessee. (e)Paid on an assessment of improvements when the improvements did not exist on the lien date. (f)Paid on an assessment in excess of the equalized value of the property as determined pursuant to Section 1613 by the county board of equalization. (g)Paid on an assessment in excess of the value of the property as determined by the assessor pursuant to Section 469, Jinn Bane Fuge 3 of 3 March 1, 2002 CAPrograrn ReMArnedca{inline 7.Oldown#oad\KCf.etterre2635\Refundafterfouryearsanatysis.doe REVENUE AND TAXATION CODE SECTION 5150.5. 5153 5150.5. In any action in which the recovery of a penalty assessed pursuant to paragraph (1) , (2) , or (3) of subdivision (a) of Section 830 is allowed by the court, the plaintiff shall be entitled to interest on the penalties for which recovery is allowed, at the applicable rate or rates in effect from time to time and payable on a refund of tax as provided in Section 5151. This interest shall be payable from the date of filing of the claim for refund, but in no event earlier than the date of payment of the penalty or installments thereof sought to be refunded, to the date of entry of judgment. This accrued interest shall be included in the judgment. 5151. (a) Interest at the greater of 3 percent per annum or the county pool apportioned rate shall be paid, when that interest is ten dollars ($10) or more, on any amount refunded under Section 5096.7, or refunded to a taxpayer for any reason whatsoever. However, no interest shall be paid under the provisions of this section if the taxpayer has been given the notice required by Section 2635 and has failed to apply for the refund within 30 days after the mailing of that notice. For purposes of this section, "county pool apportioned rate" means the annualized rate of interest earned on the total amount of pooled idle funds from all accounts held by the county treasurer, in.excess of the county treasurer's administrative costs with respect to that amount, as of June 30 of the preceding fiscal year for which the refund is calculated. For each fiscal. year, the county treasurer shall advise the Controller of the county pool apportioned rate, and of computations made in deriving that rate, no later than 60 days after the end of that fiscal year. (b) The interest rate provided for in subdivision (a) does not apply to interest on refunds of those amounts of tax that became due and payable before March 1, 1993. Interest on refunds of amounts of a qualified tax shall be paid at that rate provided for by this section as it read prior to January 1, 1993. As used in this section, a "qualified tax" means a tax that became due and payable before March 1, 1993, and had not been refunded as of April 6, 1995. This subdivision shall not be construed to affect the interest paid on refunds of those amounts of tax that became due and payable before March 1, 1993, and have been refunded as of April 6, 1995. (c) (1) The interest computation period shall commence with the date of payment of the tax when any of the following apply: (A) A timely application for reduction in an assessment was filed, without regard to whether the refund ultimately results from a ud ment or order of a court, an order of a board of equalization or assessment appeals boar or an assessor's correction to the assessment roll. (B) The refund is pursuant to a roll correction resulting from the determination or adjustment by the assessor or a local assessment appea s briar of a base year value. ) The refund results from a correction to the assessment roll pursuant to Section 4831 or 4876. (2) Interest on refunds of taxes on property acquired by a public agency in eminent domain shall accrue from the date of recordation of http://www.leginfo.ca.gov/'cgi-bin/displayeode?section rtc&group=05001-06000&file=5150.5- 3/1/02 __ __ _ 800 305-AH(S2F)REV.3(3-00) INFORMATION AND INSTRUCTIONS FOR APPLICATION FOR CHANGED ASSESSMENT The-State Board of Equalization has prepared a pamphlet to assist you In completing this application. You may download a copy of Publication 30, Resldentlal Property Assessment Appeals, at www.boe.ca.gov or contact the, clerk of your local board for a copy. Flling'this application for reduced assessment does not relieve the applicant from the obligation to pay the taxes on the subject property on or before the applicable dud date shown on the tax bill. If a reduction is granted, a propprtlonate refund of taxes paid will be made by the county. Based on the evidence, the appeals board can Increase as well as decrease an assessment,The decision of the appeals board upon this application Is final; the appeals board may not reconsider or rehear any application. However, either the applicant or the assessor may bring timely action in superior court for review of an adverse action. An application may be amended until 5:O0 p.m. on the last day upon which the application might have been timely filed. After the filing period, an invalid or Incomplete application may be corrected at the request of the clerk or amendments may be made at the discretion of they beard.Contact the clerk for Information regarding correcting or amending an application. The appeals board can hear matters concerning an assessors allocation of exempt values. However, It cannot hear matters relating tci a person's or organization's eligibility for a property tax exemption. Appeals regarding the denial of the Welfare Exemption should be referred to the State Board of Equalization, Policy, Planning, and Standards Division, 14110:64, PCI Box 942879, Sacramento, CA 94279-0064. Appeals regarding the denial of any other type of exemption are under the jurisdiction of the assessor and/or the courts. The following-numbered Instructions apply to the corresponding numbers on the application form. Please type or print In Ink all Information on the application form. Box 1. Enter the name and mailing address of the applicant. If the applicant is other than the assessee (e.g., leased property), attach an explanation. NOTE:An agent's address may not be substituted for that of the applicant. Box 2. Provide the name and mailing address of the agent or attorney, if applicable. If the agent Is not a California-licensed attorney, you must also complete the agent's authorization section, or an agent's authorization may be attached to this application.An attached authorization must contain all of the following Information: • The date the authorization Is executed. • A statement that the agent Is authorized to sign and file applications In the calendar year of the application. • The specific parcel(s) or assessments) covered by the authorization, or a statement that the agent is authorized to represent the applicant on all parcels and assessments located within the county that the application is being filed. • The name, address, and telephone number of the agent. • The applicant's signature and title. • A statement that the agent will provide the applicant with a copy of the application. Box 3. If this application Is for an assessment on secured property, enter the Assessor's Parcel Number from your assessment notice or from your tax bill. If the property Is unsecured (e.g., an alrcraft or boat),. enter the account number from your tax bill. If appropriate, enter the name of the business (DBA). Enter a brief description of the property location, such as street address, city, and zip code, sufficient to identify the property and assessment being appealed. , For a single-family dwelling, indicate if the dwelling is owner-occupied. Box 4. Column A: Enter the figures shown on your assessment notice or tax bill for the year being appealed, if you are appealing a current year assessment (base year or decline in value) and have not received an assessment notice, or are unsure of the values to enter in this section, please contact the assessor's office. if you are appealing a calamity reassessment or an assessment related to a change in ownership, new construction, roll change, or escape assessment, refer to-the reassessment notice you received. If you are appealing a penalty assessment, NOTE: a penalty assessed by the tax collector for nonpayment of taxes cannot be removed by the appeals board. Column B: Enter your opinion of value for each of the applicable categories. If you do not state an opinion of value, It will recruit in the rejection of your application. f3 WA 54-W _.. _. . __.... I -EVE E E A T'A. ATIC ► CODE E SECTION 5140-5149.5 51.90. The person who paid the tax, his or her guardian or conservator, the executor of his or her will, or the administrator of his or her estate may bring an action only in the superior court against a county or a city to recover ,a tax which the board of supervisors of the county or the city council of the city has refused to refund on a claim filed pursuant to Article I (commencing with Section 5096) of this chapter. No other person may bring such an action; but if another should do so, judgment shall not be rendered for the plaintiff. 5141. (a) An action brought under this article, excerpt an action brought under Section 5198, shall be commenced within six months from and after the date that the board of supervisors or city council rejects a claim for refund in whole or in part. (b) Except as provided in subdivision (c) , if the board of supervisors or city council fails to mail notice of its action on a claim for refund within six months after the claim is filed, the claimant may, prior to mailing of notice by the board of supervisors or city council of its action on the claim, consider the claim rejected and bring an action under this article. (c) if an applicant for the reduction of an assessment states in the application that the application is intended to constitute a claim for refund pursuant to Section 5097, the claim for refund shall be deemed denied on the date the final installment of the taxes extended on such assessment becomes delinquent or on the date the equalization board makes its final determination on the application, whichever is later. 5142. (a) No action shall be commenced or maintained under this article, except under Section 5148, unless a claim for refund has first been filed pursuant to Article I (commencing with Section 5096) . No recovery shall be allowed in any refund action upon any ground not specified in the refund claim. (b) When the person affected or his or her agent and the assessor stipulate that an application involves only nonvaluation issues, they may file a stipulation with the county board of equalization stating that issues in dispute do not involve valuation questions. To the extent possible, the stipulation shall also indicate the parties' agreement as to the assessment amounts that would result under their respective positions on the issue or issues in dispute. The board shall accept or reject the stipulation, with or without conducting a hearing on the stipulation. The filing of, and the acceptance by the board of, a. stipulation shall be deemed compliance with the requirement that the person affected .file and prosecute an application for reduction under Chanter l (commencing with Section 1601) of Part 3 in order to exhaust administrative remedies. However, the filing of, and the acceptance by the board of, a stipulation under this subdivision shall not excuse or waive the requirement of a timely filing of a claim for refund. http://ww w,leginfo.c .gov/cgi-bintdisplaycode,?section--rtc&group=05001-06000&file=5140-51 3/1/02 STATE OF CALIFORNIA STATE BOARD OF EQUALIZATION JOHAN KLEliS 450 N STREET,SACRAMENTO,CALIFORNIA First Dial 4 Haywad (PO BOX 942879,SACRAMENTO,CALIFORNIA 94279-0082) DEAN ANDAL TELEPHONE(918)323-7713 Second Dutricd Stockton FAX(418)323-3387 Cl.lt3DE pAF+ftiSH `third Dlatrid,Torrance JOHN CHIANG February 11, 2002 Fourth Dietriot,Loa Angela: KATHLEEN CONNELL ' Controller,Sacramento R. Honorable Thomas P. Kidwell E.L.stein"SORRNDir nor ExewUve Director Madera County Assessor Attn: Mr. Chuck Brough, Chief Appraiser 209 West Yosemite Avenue Madera., CA 93637 Attn: Mr. Chuck Brough Ice:Base Year Value Corrections, roll corrections,Refunds Dear Mr. Brough: This is in response to your letter of September 20, 2001,to Chief Counsel Timothy Bayer requesting our interpretation of several Revenue and Taxation Code sections applicable to correcting a base year value error and issuing appropriate refunds. Please excuse the delay in responding as other previously scheduled Board matters have occupied our time. Based on the circumstances described in your letter, we conclude that 1)if the 1990 base year value error involved value judgment, there is no time remaining under section 51.5 subdivision(b)to correct; however, if it was clerical, the error should corrected under section 51.5, subdivision(f) for all years back to 1990; 2) if the error is clerical (nonjudgmental),the years available for correction are not limited by the statute of limitations on roll corrections under section 4831; and 3)if corrections are made for all years,the taxpayer has one year from the date of notice under section 2635 to claim refunds back to 1990. Facts A change in ownership occurred in October 1990, and an error in the base year value was made in that the assessed value,based on comparable sales,should have been$50,000 less than the value actually enrolled. The taxpayer did not question the value (nor did the assessor discover it)until 2001,at which time the assessor's office determined that a correction was necessary for the 2002 roll. You wish to know: 1)whether section 51.5 authorizes a reduction in base year value for all years or only four years since the 1990 change in ownership;2) whether reductions under section 51.5 are limited to the number of years for which roll corrections can be made under section 4831; and 3) whether refunds resulting from a base year value reduction are available for all years under section 2635, or limited to four years under section 5097, 14r. Chuck Brough February11,2002 Wage 2 e 1990 base v _ e r` v v 'ud t no,Jime-mm-a' section 51.5 t it: if i was e cormotod Und-trsection- to 1990. Section 51.1 provides specific authority and timing for assessors to correct base year value errors. Correction of errors or emissions not involving the exercise of an assessor's judgment as to value is authorized under subdivision(a),whereby the assessor may at any time go back to the date of the event to make the correction. The assessor's correction of clerical errors, as defined in subdivision(f),may also be undertaken at any time,back to the date of the event. Correction of errors or omissions involving the exercise of the assessor's value judgment authorized under subdivision(b)however,must be made"wttt four years (after July 1 of the asscsgMMt year for_w_WghAhe base year value established. ' To determine the number of years to be corrected, the assessor must first make a determination of the type of error involved. The type of base year value error--whether nonjudgmental,involving value judgment,or clerical—is a question of facet in each case. Neither the Legislature nor the courts have promulgated a standard or"test"applicable to every scenario.' The Board staff"guidelines"suggested below are merely interpretations made by the courts in applying subdivision(a), (b)or(f) of Section 51.5. Subdivision(a) -1.Inlimited time to Corretonjud ental errors a) In Montgomery Ward& Co. v. County of Santa Clara(1996)47 Cai.App.4' 1122, a change in ownership occurred and timely reported,but the assessor did net enroll the base year value within four years after July 1 of the assessment year in which it occurred. Held: value judgment had not been exercised;the error could be corrected at any time -section 51.5(x). b) In Sunrise.Retirement Villa v. ,Dear(1997) 58 Cal.App.4`h 948,the assessor reappraised for a change in ownership and enrolled the new base year value within four years. Almost ten years later,Taxpayer established that assessor's change in ownership detennination was a mistake. Held: value judgment was not exercised where the issue is a change in ownership; and if the appeals board found that a change in ownership did not occur, the error could be corrected at any time -section 51.5(a). c) In Firestone Tire&Rubber Co. v. County of Monterey (1990)223 Cal.App.3 d 382; County of San Diego v. Assessment Appeals.hoard No. 2 of San Diego County(1983) 148 Cal.App.3d 548,the error in base year value was due to waste contamination. ' Further,there is no statutory standard of proof required to establish whether a particular error involves value judgment or is eledcal or nonjudgmental in nature. Mr.Chuck Brough February 11,2002 Wage 3 Held:(information on the condition had been provided to the assessor at the time of the event triggering the new base year value and the information was omitted(not considered)by the assessor in making the valuation, it was nonjudgmental, and may be corrected at any time. (Value judgment not exercised with regard to the known condition of the property.) Su vi o —Four a rrect rr rs In tea ue Ju ment. a) Errors in discounting to cash equivalency—Plaza Hollister Limited Partnership v. County of San Benito (1999)72 CaLApp.4t` 1. The assessor may correct within four years after July 1 of the assessment year for which the base year value was first established. (The Mate first established means the elate it was enrolled.) b) Error regarding inclusion of-ent6rprise value in the unit—Service America Corp. v. County of San Diego(1993) 15 Cal.App.4' 1232.The assessor has four years after July 1 of the assessment year for which the base year value was enrolled c) Mistake due to failure to discount nominal sales price-Prudential.Ins. of America v. City and County of San Francisco (1987) 191 Cal.App.3d 1142. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. d) Erroneous allocation of goodwill—Sea World Inc. v. County of San Diego(1994) 27 Cal.App.e 1390.The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. e) Error in estimate of value-caused by incorrect book values submitted by taxpayer K"uhlemeir v. County ofLos Los Angeles(1935)2 Cal.2d 257.The assessor has four years after July J of the assessment year for which the base year value was enrolled.,unless the incorrect values resulted from taxpayer's fraud,concealment,misrepresentation in which event the errors may be corrected at any time,per section 51.5 (c). f) Error in measuring the value(in contrast to quantity or extent) of property in the appraisal unit--EI Tejon Cattle Company v. County of San Diego (1957)252 Cal.App.2d 449. The assessor has four years after July 1 of the assessment year for which the Mase year value was enrolled. S�bdivisicrn f)-U ki ted tune to Correct Clerical mars If the erroneous base year value entered on the roll based resulted from a defect of a mechanical,mathematical,or clerical nature,not involving judgment as to value,-- the error is clerical and may be corrected at any time. A computation or calculation Mr. Chuck Brough February 11, 2002 Page 4 error is one that results from an unintentional mistake, not deliberately made at the time value was determined(LTA No. 88/50, 7/1/88, p.2) Based on the foregoing,either subdivision(b) or subdivision(f) is relevant to the facts you describe. The error does not fall under subdivision(a),as the assessor's determination of the 1990 change in ownership was correct. There are two reasons the 1994 base year value was too high.First, the mistake was due to improper application of a valuation method (comparable sales approach), and to that extent was deliberate and intentional (per subdivision(b)). If the facts substantiate this,then it was an error in the appraiser's value judgment, and no correction is possible, since section 51.5(b) allows only "four years after July 1 of the assessment year for which the base year value was first established."' The phrase "the assessment year for which the base year value was first established, "means,four years of July 1 of the assessment year during which the assessor actuall enrolls the new base year value resultingom a thane in ownershi or completion of new construction Hence, even if the new 1990 base year value was not enrolled until 1994,there are still no years remaining to correct the error if it involved value judgment per section 51.5(b). If on the other hand the error occurred because of improperly calculating the value, transposing or misreading numbers, or substituting the wrong data, i.e., a clerical or computational error, then it was a clerical mistake and unintentional (per subdivision (f)). If the facts substantiate this scenari en no value judgment was involved, and a correction for all years back to 1990 is possibl y the express terms of subdivision(a),the assessor is required to correct"any error or omission in the determination of a base year value ... including the failure to establish that base year value,which does not involve the exercise of an assessor's judgment as to value, ... in any assessment year in which the error or omission is discovered." We have consistently interpreted this to mean that there are no time limitations on the correction of nonjudgmental or clerical base year value errors,rather they are to be corrected whenever discovered. (Montgomery Ward& Co., p. 1124.) Hence,the assessor should correct all the years back to and including the 1990 base year value if the error proves to be clerical. In the event that the taxpayer disagrees with the assessor's determination on this issue, an appeals board has jurisdiction to determine whether an error is judgmental or nonjudgmental (clerica409he courts have consistently held that an appeals board may begin the process of involving its jurisdiction in response to information received from a taxpayer,an assessor,or by any other means. In responding to information submitted,the board may(although it is not required to)conduct a preliminary hearing for the purpose of determining whether reasonable cause exists to invoke its,jurisdiction in a given matter. (Stevens v. Fox Realty Corp. (1972) 23 Cal.App.3d 199.) 1n effect, this constitutes a jurisdictional hearing in which a board decides whether,to exercise its jurisdiction or not. If a board decides that a controversy centered on whether an error in base year value was judgmental or nonjudgmental(clerical)is within its Mr. Chuck Brough February 11, 2002 Page 5 jurisdiction, it may thereafter proceed to male a determination of the factual issues. (Property Tax Rule 309,Assessment Appeals Manual,page 41. See also Sunrise.Retirement Villa v. Dear (1997) 58 Cal.App.4ffi 948. 2. lithe error was clericalnon'ud mental the ears available for correction are not limited-b the statute of limitations on roll corrections under section 4831. Base year value corrections =not"roll Corrections." There are at least three separate and distinct tools to bring about changes in the assessed value of enrolled property: 1)roll corrections (per section 4831 et seq.); 2) escape assessments (sections 531 et seq.); and 3) base year value corrections (sections 51.5 and 80). The correction of an entry on the roll under section 4831 has its own four-year time limit. The fact that the property being assessed by a particular roll entry is later the subject of an escape assessment made under section 531 or a base year value correction under section 51.5, does not extend or change the four-year limit on the roll correction of that entry. Section 4831 is a specific procedure separate from the procedures for enrolling escape assessments or correcting enrolled base year value errors. For example, section 4831 is permissive, stating that the assessor may process roll corrections for errors on the roll within four years after the making of the assessment which is being corrected, e.g., four years from the date of discovery of the error. (Section 4831(x).) Section 5 1.5 is mandatory and requires that a base year value correction shall be reflected in eitherappropriate cancellations or refunds of taxes,or levies of escape assessments -- whether that correction is made under subdivision(a) or(f) (nonjudgmental, clerical) or under subdivision (b) (value judgment). Section 5 1.5 lacks any express language that would authorize roll corrections. As explained in Letters to Assessors Taos. 88150, 89134, and 95/54, and in various legal opinions, section 5 1.5 does not authorize or provide for roll corrections,primarily because base year value corrections are not roll entries. Thus,even though a base year value=t be corse ed under section 51.5, it may be untimely or not permitted as a"roll correction" under section 4831. Section 51.5 authorizes the correction of the base year value where the base year value is the"roll value"and mandates that appropriate escape assessments and cancellations or refunds be made as a result. Section 4831 authorizes corrections of certain types of entries on the roll based on its own four-year(or one-year)time limit. Specific authorization for delivering base year value corrections to the auditor without invoking roll correction procedures under section 4831 is now included in proposed Property Tax Rule 254, "Base Year Value Corrections,"subdivision(c), as follows: 1f a correction authorized by subdivision(a)or(b) [of section 51.5] reduces the base year value,the assessor shall transmit the correction to the auditor by means of information noted on the roll, and appropriate cancellations or Mr. Chuck Brough February 11,2002 Page 6 refunds of tax shall be granted in accordance with Division 1 of the Revenue and Taxation Cade. If the correction increases the base year value,the assessor shall transmit the information regarding the correction by means of a natation on the roll, and appropriate escape assessments shall be imposed in accordance with Division 1 of the Revenue and Taxation Code. 3. if co=gt` Made-k-to 1990, taxa ' t to re united if tice is Leceivcgec 5 and a c a ar.e While offering our opinion on the issue,we hasten to acknowledge that questions relating to whether refunds should be made is a matter for the county auditor or the county tax collector, not the assessor.While the Board advises assessors,it is the State Controller who advises county auditors and tax collectors. In offering our advice, we take into account such opinions and publications of the State Controller as are available to review. Since the Controller has issued an opinion affecting this controversy,we defer to the conclusion stated therein as discussed below. (See Gary Hori letter State Controller's office, 51712001,attached.)For this reason, you may wish to address additional inquiries to the State Controller. In better to Assessors No. 91153 (attached),Board staff stated that section 51.5(d) requires appropriate cancellation or refunds of taxes,or escape assessments as the result of a base year value correction. Such refunds, cancellations,or escape assessments are justified and required by any base year value correction that leads to such a result. According to section 51.5(d) -whether a refund, cancellation,or escape assessment is timely in a,given case depends entirely on the particular statutory requirements for each: "(d) If a correction authorized by subdivision(a) or(b)reduces the base year value,appropriate cancellations or refunds of tax shall be granted_in accordance with this division. If the correction increases the base year value,appropriate escape assessments shall be imposed in accordance with this division. (Emphasis added.)" The phrase,"in accordance with this division."means Division I of the Revenue and Taxation Code. Division I contains the procedures for refunds under sections 5096-5097, cancellations under section 4896,escape assessments under section 531 et seq.,and appeals of base year value pursuant to section 1601 et seq. or section 80. (See Division 1 consisting of sections50 through 5911: Part 1 through Part 14.) To determine whether and when a taxpayer is entitled to a refund, cancellation or an escape assessment, section 51.5(d)requires the application of each respective set of statutes to the facts. Regarding the time for snaking refunds, section 5097(a)(2)provides that no order for refund shall be made except on a claim filed withinafter the making of the payment sought to be refunded, or within one Xg after the mailing of the notice prescribed in section Mr. Chuck Brough February 11,2002 Page 7 2635, or the period agreed to as provided in section 532.1,whichever is later.3 If the first time period applies,the taxpayer must file a refund claim within the four-year limitations period, even though abase year value appeal was timely filed and the reduction granted by the appeals board. (Mission Housing Development Company Y. City and County of San Francisco (1997) 59 Cal.App.4' 55.) If the second time period applies(as in this case),the taxpayer must file a refund claim within the within oney after the date of the notice under section 2635. Paragraph 1610 of the State Controller County Tax Collector's Reference Manual notes that"Section 5096 is remedial and should be liberally construed to carry out its intent of preventing the inequitable retention of money that has been improperly collected."' Paragraph 1600 of the 1999 State Controller County Tart Collector's Reference Manual states: When more than four years have elapsed after an erroneous or illegal collection, an assessee may not originate a petition for refund u t of the oveMaMgg e Mit , or unless the statute of limitations has been extended by mutual written agreement between the taxpayer and the assessor(§§5097 and 532.1). Thus, it is apparent that the legal construction of these statutes by the Controller's office is aimed toward the"inequitable retention of money that has been improperly collected," as the basis for refunding tax money and for the broad interpretation of sections 2635 and 5097(a) -set forth in the enclosed legal opinion issued by Crary Mori.' Section 2635 states: "When the amount of taxes paid exceeds the amount due by more than ten dollars(S 10),the tax collector shall send notice of the overpayment to the taxpayer. The notice shall be mailed to the taxpayer's last known address and shall state the amount of overpayment and that a refund claim may be filed pursuant to Chapter 5 (commencing with Section 5096)of Part 9". In the Controller's opinion, the one-year claim filing period under section 2635 is an alternative to the four-year claim filing period under section 5097(a). Mr. Hori states on page two of the letter, ' Section 2635 is a mechanism for the tax collector to notice the taxpayer of the right to a refund,in addition to the 4-year time limit unposed by section 5097,where the notice identifies an overpayment to the taxpayer. Upon receipt of such notice,the taxpayer has one year to file a claim for refund. ` The Controller's statement is supported specifically by Pactfle Crust Co. v hells(1901) 134 Cal.471;Midstate Theatres v.Board of Supervisors(1975)and Focus Cable Y.Alameda County(1985) 173 Ca1.App.3d. 519. ' See County Tax Collectors'ltef nCe Manual, 1999,California State Controller,page 82,which paraphrases the statue and states that tax collectors and auditors have authorization to make refunds under these conditions. Mr.Chuck Brough February11,2002 Page 8 ``...we find that four years is not the sole limitations period under Revenue and Taxation Code section 5097. Section 5097 expressly permits tax refunds to be filed within four years after making the tax payment sought to be refunded or within ne xear et t e mailing of the notice,prescribed in jRevenue and-Taxation CodkJ Section 2635.or the period agreed to as provided in section 532.1, wh has jS layer:" "In sum, we conclude that a county is required to allow a taxpayer's refund claim within one year following the mailing of the notice of overpayment (under Revenue and Taxation code section 2f 35)even though the overpayment corresponds to an assessment year beyond four years." As applied to the instant case, if the assessor corrects the base year value for the years in question(back to 1990), and the facts establish an overassessment of the taxpayer's property for each of the years,the assessor is required by §51.5(d)and Rule 264(c) to deliver that information to the county auditor. That information would then necessarily be passed on to the tax collector who is required by §2535 to notify the taxpayer of an overpayment of taxes resulting from the overassessment. Per subdivision(a)(2)of§5097,the taxpayer would have one year from the date on the notice of overpayment to file a claim for refund. In Letter to Assessors No. 91153 (p. 2),the Board staff`advised that§2635 should not be given a broad interpretation that would extend the payment of refunds beyond four years. Based on the recent views and opinion published in the 1999 Controller's Manual and the May 7, 2001 letter,LTA No. 91/53 should be considered to be superseded and no longer an accurate summary of the law on this question. The views expressed in this letter are only advisory in nature. They represent the analysis of the legal staff of the Board based on present law and the facts set forth herein, and are not binding on any person or public entity. Very truly yours, Kristine Cazadd Supervising'fax Counsel Attachments KEC:eb Mp/procAayrcoWO2JD1 kec Mr. Chuck Brough February 11, 2002 Page 9 cc.Mr. David Gau,NUC:63 Chief of PPSD,WC-.64 Mr. Harald Hale,MIC.61 Ms. Jennifer Willis, MIC.70 Ccunty Administmdon Building County .JOHN GIOIA 651 Pine 5tmet, 11t`Fbor >>,mvicr martiner,Cetifrtmis 94553.4M GAYt!I.WE" V-925.335-1080 � � � 2nd DWCt F-926-335-1098 DONNA GOW John 9W**%6 9W Dbw-t County Administrator MAU DOAuurn Oh Disfti 1110 RAI O.CROvcN so,Diswel TRANSMITTED VIA FACSIMILE September 30, 2002 Tad W Heiiig, CPA 939 Hartz Way Danville, CA 94526 Ike: October 1, 2002 Board Meeting, Item SD.5 Dear Mr. Hellig., I appreciated your letter dated September 25, 2002 clarifying the additional documents you provided to the Board of Supervisors, the County Counsel, and me. However. this office will uphold its original ro ommendatlon to the Burd of Supervisors to deny the claim of Mr. and Mrs. Kesler based upon the facts of the case and the applicable laws. A copy of the recommendation is transmitted herewith for your Information. Sincerely, JOHN SWEETEN County Administrator J IE ENEA nior Deputy cc: Board of Supervisors Members Air BOARD OF SUPERV16ORS Contra FROM: JOHN SWEETEN,County Administrator Costa DATE: OCTOBER 1,200 County SUBJECT: CLAN OF PATRICK AND MABEL KESLER FOR REFUND OF 1"A7r�S FOR It"THROUSH 2000 TAX YOM$ SpnsFIC RlOUEST(S)OR A&COMMENOATION(S)i•ACKBROUNC AND dUX"FCATION aMON ENE ATION: DENY claim of Patrick and Isabel Kesler for refund of taxes for 1096 through 2000 tax years. BAQKt3�: On dune 19,2002,the County Administrator received the attached letter from Tad M.Hellig, CPA,on behalf on Patrick and Isabel Kester,requesting that the Board of Supervisors Instruct the Assessor to o"ot an alleged clerical error that Impacted the tax roll values and to Jesus refunds plus statutory Interest due to the K+esslars. County Counsel's investigadon of the facts and circt#mtences of this situation Indicate that the Kesler's 1996 transfer of property tl#Irs to their children was Incurred Identified as a change in ownership,prorrong a rsessaSernerd of the property. The laws governing this situation provide relief only for the year In which the matter was appealed and subserquent yam,unto"the appeal was made withln three years from the property transfer. The Kesler's node their appeal,which was,approved by the Ass+essrnent Appeals Board,two years after the three-year appeal period explred. County Counssi has deterTnlned that under the applicable statutes,the Keeler's are not entitled to relief for periods prior to their appeal. At the Board's request on September 16,2002,County Counsel revislwed the Revenue and Taxation Garde to dstermine the extent of discretion that itis Board of Supervisors ray exercise in resolving Bairns made to It. Following a discussion of the applicable law with County Counsel and a review of the circumstances of this case with the County Assessor,it Is my recommendation that your Board decry the claim for property tax refunds for the 1996 through 2000 talc years. CONTINUED ON ATTACHIMY: 0 YES SIGNATUM }�RECOMMENDATION OF COUNTY ADMINISTRATOR (:]RECOMMEJ4ATION OF DOARD CONIMITTEE 0 APPROVE (3 OTHIM saw-UM-90P ACTION OF DOARII ON APPROVED AS RECOMNEN011) 0 OTHER C3 VOTE OF SUPERVISORS: I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTK)N TAKEN AND UNANIMOUS tAls ENT 1 ENTERED ON THE NNUTES OF THE BARD OF AYES:_HOES:_ SUPERVISORS ON THE DATE SHOWN. ABSENT: A*STAIN• ATTIKSTED Contact: JOHN SWEETIN,CUM OF THE BOARD OF ac: Supervisor Gorbor SUPORViSORS AND COUNTY ADMINISTRATOR Assessor Cov*Covassl Could AdmiAleftlor Illy: Doputy Tad M.Ho ft CPA, 9310 Raft Walk 80 104,AaevMs,CA $4&" In the Matter of Application of DECISION AFTER HEARING (Legal Issue) Patrick & Isabel Kesler P.Q. Box 1044 Danville, CA 94526 Application No. 2001-0195 thru 0202 Parcel No. 208-110-007-1 et al The application of the above named person for changed assessment having been regularly heard before the Assessment Appeals Board: The Board hereby finds that a change in ownership did not occur on February 13, 1996 Decided on February 7, 2002 by the following vote: AIMS: V.G. Rousaville; P.E. Schwenger; J.J. Doherty NOES: None ABSENT: None A copy of the Decision was mailed to the above named applicant at the address given in the application on February 5, 2002 ATTEST: JOHN SWEETEN, Clerk of the Assessment Appeals Board and County Administrator By: 14a" Deputy Clrk Gus S. Kramer -Contra office of Assessor Assessor Stephen Dawkins Costa 2530 Arnold Drive, Suite 400 Assistant Assessor Martinez, Cafif`ornia 94553-4359 Valuation County FAX: (925) 313-7660 Lori Koch "telephone: (925) 313-7500 Assistant Assessor Administration May 17, 2002 MR. TAD M. HEILIG 939 HARTZ WAY, SUITE 106 DANVILLE, CA 94526 Re: 208-110-007 Dear Mr. Heilig: Per our phone conversation on May 15, 2002, you requested a letter stating what action will be taken by the Assessor's Office regarding the Kesler Appeal, Application number 2001 - 198 through 202. The Appeals Board determined that the transfer in February of 1996 between Patrick and Isabel Kesler and Randell Kesler was not athan e in ownership. Per Section 51.5(x) of the Revenue and Taxation Code, we are correcting theeleriea err© 1996 transfer) in the year in which it was discovered and per Section 80(5) of the Revenue and Taxation Code we are correcting the 2001 roll as a result of the assessment appeal and correcting all rolls perspectively thereafter. Your very truly, Steve Dawkins, Assistant Assessor, Valuation P �7" t� For Gus Kramer, n, County Assessor SD:jv heilig ai STATE OF CALIFORNIA STATE BOARD OF EQUALIZATION JOHAN1tLEHS 450 N STREET,SACRAMENTO,CALIFORNIA Fist OW0,Heyward (PO BOX 942679,SACRAMENTO.CALIFORNIA 94279-0082) DEAN ANDAL TELEPHONE(916)323-7713 Second District,Stockton FAX(916)323-3387 CIAtJDE t'ARRtSH Thiel DlsMct,Torrence JOHN CHI ANG February 11, 2002 Fourth District,Los Angeles KATHLEEN CONNELL Cor ,frollar,Sacramento Honorable Thomas P. Kidwell E.LExecut sSD or Madera County Assessor Attn: Mr. Chuck Brough, Chief Appraiser 209 West Yosemite Avenue Madera, CA 93637 Attn: Mr. Chuck Brough Re: Base Year Value Corrections, roll corrections,Refunds Bear Mr. Brough: This is in response to your letter of September 20,2001,to Chief Counsel Timothy Boyer requesting our interpretation of several Revenue and Taxation Code sections applicable to correcting a base year value error and issuing appropriate refunds. Please excuse the delay in responding as other previously scheduled Board matters have occupied our time. Based on the circumstances described in your letter, we conclude that 1)if'the 1990 base year value error involved value judgment, there is no time remaining under section 51.5 subdivision(b)to correct; however, if it was clerical, the error should corrected under section 51.5, subdivision(f) for all years back to 1990; 2)if the error is clerical(nonjudgmental),the years available for correction are not limited by the statute of limitations on roll corrections under section 4831; and 3)if corrections are made for all years,the taxpayer has one year from the date of notice under section 2635 to claim refunds back to 1990. Facts A change in ownership occurred in October 1990, and an error in the base year value was made in that the assessed value, based on comparable sales, should have been$50,000 less than the value actually enrolled. The taxpayer did not question the value (nor did the assessor discover it)until 2001, at which time the assessor's office determined that a correction was necessary for the 2402 roll. You wish to know: 1)whether section 51.5 authorizes a reduction in base year value for all years or only four years since the 1990 change in ownership; 2)whether reductions under section 51.5 are limited to the number of years for which roll corrections can be made under section 4831; and 3)whether refunds resulting from a base year value reduction are available for all years under section 2635,or limited to four years under section 5097. Mr. Chuck Brough February 11, 2002 Page 3 Held: ifinformation on the condition had been provided to the assessor at the time of the event triggering the new base year value and the information was omitted(not considered)by the assessor in making the valuation, it was nonjudgmental,and may be corrected at any time. (Value judgment not exercised with regard to the known condition of the property.) Subdivision(,bl Four wears to Correct Errors Irk Value Judgment a) Errors in discounting to cash equivalency--Plaza Hollister Limited Partnership v. County of San Benito (1999)72 Cal.App.4' 1. The assessor may correct within four years after July 1 of the assessment year for which the base year value was first established. (The date first established means the date it was enrolled.) b) Error regarding inclusion ofenterprise value in the unit—Service America Corp. v. County of San Diego (1993) 15 Cal.App.4' 1232.The assessor has four years after July 1 of the assessment year for which the base year value was enrolled c) Mistake due to failure to discount nominal sales price-Prudential Ins. of America v. City and County of San Francisco(1987) 191 Cal.App.3d 1142. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. d) Erroneous allocation of goodwill—Sea World, Inc. v. County of San.Diego (1994)27 Cal.App.4' 1390. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled. e) Error in estimate of value -caused by incorrect book values submitted by taxpayer- Kuhlemeir v. County of Las Angeles(1935)2 Cal.2d 257. The assessor has four years after July.1 of the assessment year for which the base year value was enrolled,unless the incorrect values resulted from taxpayer's fraud,concealment,misrepresentation— in which event the errors may be corrected at any time,per section 51.5 (c). f) Error in measuring the value(in contrast to quantity or extent)of property in the appraisal unit—El Tejon Cattle Company v. County of San Diego (1967)252 Cal.App.2d 449. The assessor has four years after July 1 of the assessment year for which the base year value was enrolled.. subdivision(f)- Tnlimited time to Corrcw Clerical Errors. If the erroneous base year value entered on the roll based resulted from a defect of a mechanical,mathematical, or clerical nature,not involving judgment as to value,— the error is clerical and may be corrected at any time. A computation or calculation Mr. Chuck Brough February 11,2002 Page 4 error is one that results from an unintentional mistake,not deliberately made at the time value was determined(LTA No. 88150, 7/1/88,p.2) Based on the foregoing, either subdivision(b)or subdivision(f)is relevant to the facts you describe. The error does not fall under subdivision(a), as the assessor's determination of the 1990 change in ownership was correct. There are two reasons the 1990 base year value was too high. First, the mistake was due to improper application of a valuation method (comparable sales approach),and to that extent was deliberate and intentional(per subdivision(b)). If the facts substantiate this,then it was an error in the appraiser's value judgment, and no correction is possible, since section 51.5(b) allows only "four years after July I of the assessment year for which the base year value was first established." The phrase"the assessment year for which the base year value was first established, "means,four years of July I of the assessment year during which the assessor actually enrolls the new base year value resulting from a change in ownership or completion o new construction.! Hence, even if the new 1990 base year value was not enrolled until 1994,there are still no years remaining to correct the error if it involved value judgment per section 51.5(b). If on the other hand the error occurred because of improperly calculating the value, transposing or misreading numbers,or substituting the wrong data, i.e., a clerical or computational error,then it was a clerical mistake and unintentional (per subdivision(f)). If the facts substantiate this scenarien no value judgment was involver!, and a correction for all years back to 1990 is possibl&My the express terms of subdivision(a), the assessor is required to correct "any error or omission in the determination of a base year value ... including the failure to establish that base year value,which does not involve the exercise of an assessor's judgment as to value, ... in any assessment year in which the error or omission is discovered." We have consistently interpreted this to mean that there are no time limitations on the correction of nonjudgmental or clerical base year value errors, rather they are to be corrected whenever discovered. (Montgomery Ward& Co.,p. 1124.)Hence,the assessor should correct all the years back to and including the 1990 base year value if the error proves to be clerical. In the event that the taxpayer disagrees with the assessor's determination on this issue, an appeals boaxd has jurisdiction to determine whether an error is judgmental or nonjudgmental.. (cleric , e courts have consistently held that an appeals board may begin the process of invoking its jurisdiction in response to information received from a taxpayer, an assessor, or by any other means. In responding to information submitted,the board may(although it is not required to)conduct a preliminary hearing for the purpose of determining whether reasonable cause exists to invoke its jurisdiction in a given matter. (Stevens v. Fox Realty Corp. (1972)23 Ca1.App.3d 199.) In effect, this constitutes a jurisdictional hearing in which a board decides whether to exercise its jurisdiction or not. If a board decides that a controversy centered on whether an error in base year value was judgmental or nonjudgmental(clerical) is within its Mr. Chuck Brough February 11,2002 Page 5 jurisdiction, it may thereafter proceed to make a determination of the factual issues. (Property Tax.Rule 309,Assessment Appeals Manual,page 41. See also Sunrise Retirement Villa v. Dear (1997) 58 Cal.App4h 948. 2. ) if the error was clerical (nonjudgmental),the years available for correction are not limited by the statute of limitations on roll corrections under section 4831. Base year value corrections are not"roll corrections." There are at least three separate and distinct tools to bring about changes in the assessed value of enrolled property: 1)roll corrections(per section 4831 et seq.); 2)escape assessments (sections 531 et seq.); and 3)base year value corrections(sections 51.5 and 80). The correction of an entry on the roll under section 4831 has its own four-year time limit. The fact that the property being assessed by a particular roll entry is later the subject of an escape assessment made under section 531 or a base year value correction under section 51.5, does not extend or change the four-year limit on the roll correction of that entry. Section 4831 is a specific procedure separate from the procedures for enrolling escape assessments or correcting enrolled base year value errors. For example, section 4831 is,permissive, stating that the assessor may process roll corrections for errors on the roll within four years after the making of the assessment which is being corrected, e.g., four years from the date of discovery of the error. (Section 4831(a).) Section 51.5 is mandatory and requires that a base year value correction shall be reflected in either appropriate cancellations or refunds of taxes, or levies of escape assessments--whether that correction is made under subdivision(a)or(f) (nonjudgmental, clerical) or under subdivision (b)(value judgment). Section 51.5 lacks any express language that would authorize roll corrections. As explained in Letters to Assessors Nos. 88/50, 89/34, and 95/54, and in various legal opinions, section 51.5 does not authorize or provide for roll corrections,primarily because base year value corrections are not roll entries. Thus,even though a base year value must be corrected under section 51.5, it may be untimely or not permitted as a"roll correction"under section 4831. Section 51.5 authorizes the correction of the base year value where the base year value is the`troll value's and mandates that appropriate escape assessments and cancellations or refunds be made as a result. Section 4831 authorizes corrections of certain types of entries on the roll based on its own four-year(or one-year)time limit. Specific authorization for delivering base year value corrections to the auditor without invoking roll correction procedures under section 4831 is now included in proposed Property Tax Rule 264, "Base Year Value Corrections," subdivision(c), as follows. If a correction authorized by subdivision(a)or(b) [of section 51.51 reduces the base year value,the assessor shall transmit the correction to the auditor by means of information noted on the roll,and appropriate cancellations or W, Chuck Brough February 11,21102 Page 8 x`...we find that four years is not the sole limitations period under Revenue and Taxation Code section.5€197. Section 5097 expressly permits tax refunds to be fled within four years after making the tax payment sought to be refunded the-M-44 Un Pf I¬ice and a tionCoAlSectign or the period agreed to as provided in section 532.1,whicIm— rib "In sum, we conclude that a county is required to allow a taxpayer's refund claim within one year following the mailing of the notice of overpayment (under Revenue and Taxation code section 2635)even though the Overpayment corresponds to an assestsinent year beyond four years," As;applied to the i�ant ca , ifthe. scar corrects the base year valise for lie}yea in question-(back to 1990).and the fiwAs establish an ave s ssrxent of the taxpayer's property for eadi of the yews, the assessor is required by §5.1.5(d)and Rule 264(c)to deliver that information to the county auditor,That information would then necessarily be pasted on to the tax collector W i " .r0d by §2635 wliotify.the taxpayer of an overpayment of taxes resulting from the oYamessthent. per subdiv sidn (aX2)of§5097,the taxpayer would have one year from the date oglh mtk*46vetpayment.to filen claim fbr refiu . In Letterto Assessors No. 91/53 (p. 2), the lard staff advised that §2635 should not be given a broad interpretation that would extend the payment of refunds beyond faux years, Based on the recent views and opinion published in the 1999 Controller's Manual and the May 7,2001 latter,LTA No.91/53 should be considered to be superseded and no longer an accurate summary of.the law on this question. The views expressed iu this letter am only advisory in nature. They re-present the analysis of the legal staff ofthe Bow based on present law and the facts set forth herein, and are not binding on any person or public entity. "Very truly yours, Kristine Quad Supervising Tax Counsel Attachments K C.eb ANIr. Chuck Brough February 11,2002 Page 7 2635,or the period agreed to as provided in section 532.1,whichever is later.' If the first time period applies,the taxpayer must file a refund claim within the four-year limitations period,even though a base year value appeal was timely filed and the reduction granted by the appeals board. (.Mission Housing development Company v. City and County ofSan Francisco (1997) 59 Cal.App.4' 55.) If the second time period applies(as in this case),the taxpayer must file a refund claim within the withinn1, a year after the date of the notice under section 2635. Paragraph 1610 of the Stag Controller County Tax Collector's Reference.Manual notes that"Section 5096 is remedial and should be liberally construed to carry out its intent of preventing the inequitable retention of money that has been improperly collected."' Paragraph 1600 of the 1999 State Controller County Tax Collector's Reference Manual states: When more than four years have elapsed after an erroneous or illegal collection, an assessee may not originate a petition for refundbless it t notifigg oit he oyent b.y tb&co=in amordanct with 2635,or unless the statute of limitations has been extended by mutual written agreement between the taxpayer and the assessor(§§5097 and 532.1). Thus, it is apparent that the legal construction of these statutes by the Controller's office is aimed toward the"inequitable retention of money that has been improperly collected," as the basis for refunding tax money and for the broad interpretation of sections 2635 and 5097(a) -set forth in the enclosed legal opinion issued by Clary Hari.' Section 2635 states: "When the amount of taxes paid exceeds the amount due by more than ten dollars($10),the tax collector shall send notice of the overpayment to the taxpayer. The notice shall be mailed to the taxpayer's last known address and shall state the amount of overpayment and that a refund claim may be filed pursuant to Chapter 5 (commencing with Section 5096)of Part 9". In the Controller's opinion,the one-year claire filing period under section 2635 is an alternative to the four-year claim filing period under section 5097(x). Mr. Hori states on page two of the letter, Section 2635 is a mechanism for the tax collector to notice the taxpayer of the right to a refund,in addition to the 4-year time limit imposed by section 5097,where the notice identifies an overpayment to the taxpayer. Upon receipt of such notice,the taxpayer has one year to file a claim for refund. 4 The Controller's statement is supported specifically by P'vcifte Coast Co.v. Wells(1901) 134 Cal.471;Midstate Theatres v. Board of Supervisors(1975)and Focus Cable v.Alameda County(1985) 173 Cal.App.3d.519. See County Torr Collectors'Reference Manual, 1999,California State Controller,page 82,which paraphrases the statue and states that tax collectors and auditors have authorization to make refunds under these conditions. Tad M. Heilig Certified Public Accountant September 26, 2002 John Sweeten, County Administrator Contra Costa County Board of Supervisors RECEIVED 651 Pine Street Martinez, CA 94555 SEP 2 7 2002 CLERK BOAREI(I "PEAVISOAS CONTRA COSTA CO. Re: September 24 , 2002 Board of Supervisors Meeting Short Discussion Item SD. 5 Dear Mr . Sweeten, As a -result of the postponement you requested this past Tuesday, 1 was not able to address the most recent additional documents provided to you, the Board and County Counsel . They are briefly summarized as follows : 1 . Jim Bone is a colleague of mine whose firm specializes in California Property Tax Law. He is assisting my office and concurs with my position. 2 . A copy of an e--mail exchange between Bone and myself essentially summarizes the entire scenario including the Appeals Board action suggested and taken. As you know they ruled no ownership transfer occurred. 3 . Copy of R&T Code Sections involving Assessment, Collection, Appeal and Refund, showing refunds, based on above Appeals Board action can be issued without further action by Taxpayer . rte 939 Hartz way (925)820-6848 Suite 106 Fax:(925)831-9189 Danville, CA 94526 Email.tmhcpa@aol.com Re : September 24, 2002 Hoard of Supervisors Meeting Short Discussion Item SD. 5 Page 2 ?'_ease peel free to contact my office if I can be of further assistance . I would also appreciate your informing my office of your recommendation to the Hoard by the close of business on Monday September 30, 2002, if possible . Respectfully submitted, Tad M. Heilig TMH/as cc : Supervisor John M. Gioia, Chair District I Supervisor Gayle H. Uilkema, District II Supervisor Donna Gerber, District III Supervisor Mark DeSaulnier, District IV Supervisor Federal Glover, District V Silvano Marchesi, County Counsel Gus Cramer, Assessor Steve Dawkins, Assistant Assessor H. Alan Huovinen Patrick & Isabel Kesler � I « � E � . k . $ , : » � � ¥ : # : 4 � a � . / 0 0 . @ 0 $ \ _ @ $ JOg CO CD. tn Ul � % \ 2L c 0 Cl) > ~ c - { \ � j ( jv �S J t �i' Office of the Counter Counsel Centra Costa County 651 Pine Street, 9th Floor Phone: (925)335-1800 Martinez., CA 94553 Fax: (925)646-1078 Bate: September 20, 2002 To: John Sweeten, County Administrator From: Silvano B. Marchesi, County Counsel M Re: Claim for Refund of Property Taxes by Tad Heilig(Patrick and Isabel Kesler) At the Board's request on September 17, 2002, the following memo supplements the memo previously provided to your office. Claim. for Refund On June 19, 2002, Tad Heilig, CPA, submitted a letter on behalf of Patrick and Isabel Kesler seeking a refund of property taxes for the 1996 through 2000 tax years. The letter has been treated as a claim for refund under Revenue and Taxation Code Section 5096 et seq. A primary purpose for the claim for refund procedure of Revenue and Taxation Code Section 5096 et seq. is to allow compromising claims when the Board determines that the failure to grant a refund could result in costly, time-consuming litigation with potential for an adverse decision. Background The Keslers transferred property in 1996. Not realizing that the transfer could be within the parent-to-child exclusion from changes of ownership (Rev. and Tax. Code, §63.1), the Assessor assessed a new(higher)Prop. 13 base year value. The Keslers waited until 2001 to file with the Assessment Appeals Board(AAB), contending that the 1996 transaction was excluded from change of ownership as a parent-to-child transfer. Once all the facts became known,the AAB agreed that the parent-to-child exclusion applied, so that there should have been no change of ownership reassessment. Determining only that the parent-to-child exclusion applied,the AAB did not address the issue of the period for which refunds could be granted. When Mr. Heilig sought refunds for all years back to 1996, County staff informed him that the AAB decision could operate to provide relief only for 2001 and subsequent years because statutory law allows refunds in such a case only beginning with the year in which an AAB appeal was filed. (See Rev. and Tax. Code, §§ 63.1(e)(2)(A), 80(a)(5).) Mr. Heilig then filed a claim for refund with the Board of Supervisors. John Sweeten, County Administrator September 20, 2002 Pa e 2 Countystaff review and recommendation The County Administrator submitted a report and recommendation for the September 17, 2002 meeting, recommending that the request of Mr. Heilig be denied. That recommendation was based upon the memorandum of County Counsel,dated July 30, 2002, which confirmed that the County staff interpretation of the relevant statutes was legally correct. While we believe the Assessor's interpretation was correct under the applicable statutes, it is undeniable that this is a muddled area of the law, with occasionally inconsistent statutes, court decisions, and interpretations by the State Board of Equalization.' The Courts sometimes have been liberal in situations when the equities appear to favor refunds back to the date of an erroneously increased assessment. Although none of these cases may be directly on point,the cases nonetheless offer support for a Board determination to compromise on a strict interpretation of the statutory limits in the present case. As indicated, a primary reason for the claim for refund procedure is to allow the Board of Supervisors to exercise discretion when considering claims for refunds. One factor the Board may consider is the avoidance of costly litigation and the potential of adverse judgments in such litigation. Another factor may be the length of time by which the Keslers missed the three-year statute of limitations (roughly two years). Should the Board determine that the equities favor refunds back to 1996 in the present case and that administrative concerns favor refunds in order to avoid time-consuming and costly litigation,we think the Board's decision would be legally defensible. cc: John Sweeten, County Administrator Attn: Julie Enea, Senior Deputy Administrator—Administration Gus gamer, County Assessor Attn: Steve Dawkins,Assistant Assessor—Valuation Tad M. Heilig, CPA 3 The interpretative letters of the SBE are not binding on the courts and do not carry the weight of opinions of the Attorney General.