HomeMy WebLinkAboutMINUTES - 09162008 - C.23 (3) CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
BO TION: ' SEPTEMBER 16, 2008
Claim Against the County, or District Governed by )
the Board of Supervisors, Routing Endorsements, ) WNOTICE TO CLAIMANT
and Board Action. All Section references are to ) The copy of this document mailed to
California Government Codes. you is your notice of the action taken
�gQd on your claim by the Board of
Supervisors. (Paragraph IV below),
AUG 1 12008 given Pursuant to Government Code
AMOUNT: UNKNOWN COUNTY COUNSEL Section 913 and 915:4. Please note all
MARTINEZ CALIF. "Warnings".
CLAIMANT: RICHARD BACHMAN
ATTORNEY: UNKNOWN DATE RECEIVED: AUGUST 11, 2008
ADDRESS: 111 WEST BAXTER STREET, BY DELIVERY TO CLERK ON: AUGUST 11, 2008
VALLEJO, CA 94590
BY MAIL POSTMARKED: AUGUST 08, 2008
FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
AUGUST 11 2008 JOHN CULLEN, .ler
Dated: By: Deputy
LL. FROM: County Counsel TO: Clerk of the Board of S pervisors
( ) 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).
O 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).
O Other:
Dated: �' / O By: Deputy County Counsel
III. FROM: Clerk of the Board . TO: County Counsel (1) County Administrator (2)
O Claim was returned as untimely with,notice to claimant (Section 911.3).
IV. QOARD ORDER: By unanimous vote of the Supervisors present:
(L.V 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.
AVID TWA
Dated: ___, CLERK, By Deputy Clerk
WA NI. G (Gov. code section 913).
Subject to certain exceptions,you have only six(6) months front 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 ofTliis Notice.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that ,1. aur 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: DAVID TWA i, CLERK By Deputy Clerk
ti.
This warning"does not apply to claims which
are not subject to the California Tort Claims
Act such as actions"-ineinversepchndemnation
actions for specificx6 efsuch as-mandamus or
injunction, or Fede MOO Rights el'a'ims. The
above list is not exhaustive and legal
consultation is essential; to;;understa'nd all the
separate limitations periods that may apply.
The limitations period within which suit must
be filed may be shorter or longer depending on
the nature of the claim. Consult the specific
statutes and cases applicable to your particular
claim.
The County of Contra Costa does not waive any
of its rights under California Tort Claims Act
nor does it waive rights under the statutes of
`limitations applicable to actions not subject to
the California Tort Claims Act
x ,
4
OFFICE bF THE COUNTY COUNSEL SEAL SILVANO B. MARCHESI
COUNTY OF CONTRA COSTA q ' '' ��+ COUNTY COUNSEL
Juvenile Division •
P.O.Box 69 SHARON L. ANDERSON
Martinez, California 94553-0116 = -_ CHIEF ASSISTANT
GREGORY C. HARVEY
(925) 335-1830
�' -�--'�•+:ro�11P}11 '8*�€-."�-.� ' VALERIE 1. RANCHE
(925) 646-2461 (fax) ; .. a
ASSISTANTS
ODST'4
COU13'� 'G4'
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
August 12, 2008
TO: Richard Bachman, DVM
111 West Baxter Street
Vallejo, CA 94590
RE: CLAIM OF RICHARD BACHMAN
Please Take Notice as Follows:
The claim you presented against the County of Contra Costa or District governed by the Board of
Supervisors fails to comply substantially with the requirements of California Government Code Section
910 and 910.2, or is otherwise insufficient for the reasons checked below:
[ ] 1. The claim fails to state the name and post office address of the claimant.
[ ] 2. The claim fails to state the post office address to which the person presenting the claim desires
notices to be sent.
[X] 3. The claim fails to state the date,place or other circumstances of the occurrence or transaction
which gave rise to the claim asserted.
[ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or
loss, if known.
[ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000).
If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount
claimed as of the date of presentation, the estimated amount of any prospective injury, damage
or loss so far as known, or the basis of computation of the amount claimed.
[X] 6. The claim is not signed by the claimant or by some person on his or her behalf.
Richard Bachman
Re: Claim of Richard Bachman
August 12, 2008
Page Two
[ ] 7. You are required to submit.your claim on the proper form, which is enclosed. Please resubmit
your claim on the enclosed form, including all the required information. Gov. Code, § 910.4.
Please be aware that you have only a limited period of time in which to file an amended claim.
See Gov. Code, § 910.6.
[
18. Other:
SILVANO B. MARCHESI
COUNTY COUNSEL
By: l
Monika L. Cooper
Deputy County Counsel
CERTIFICATE OF SERVICE BY MAIL
(Code Civ. Proc., §§ 1012, 1013a, 2015.5; Evid. Code, §§ 641, 664)
I am a resident of the State of California, over the age of eighteen years, and not a party to the within action. My
business address is Office of the County Counsel, 651 Pine Street, 9th Floor,Martinez, CA 94553-1229. On
August 12, 2008, I served a true copy of this Notice of Insufficiency and/or Non-Acceptance of Claim by placing
the document in a sealed envelope with postage thereon fully prepaid, in the United States mail at Martinez,
California addressed to Richard Bachman, 111 West Baxter Street, Vallejo, CA 94590, as set forth above. I am
readily familiar with Office of County Counsel's practice of collection and processing of correspondence for
mailing. Under that practice, it would be deposited with the U.S. Postal Service on that same day with postage
thereon fully prepaid in the ordinary course of business.
I declare under penalty of perjury under the laws of the State of California and the United States of America that
the above is true and correct. Executed on August 12,2008, at Martinez,California.
Enclosure
cc: Clerk of the Board of Supervisors (original)
Risk Management
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAMANT
A. A claim relating to a cause of action for death or for injury to person or to personal properly-or ' .
growing crops shall be presented not later than six months after the accrual of the cause of
action. A claim relating to any other cause of action shall be.presented not later tha�n,one year .
after the accrual of the cause of action.
(Gov. 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
narii.e 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.
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Claim By: Reserved for Clerk's filing stamp
l
c�-- RECEIVED
Against the County of Contra Costa or ) AUG 1 1 2008
District) CLERK BOARD OF SUPERVISORS
(Fill in the name) I CONTRA COSTA CO.
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) r2e�"�+�—
2. Where did the damage or injury occur? (Include city and county
3. How did the damage or injury occur? (Give full details;use extra paper if required)
4. What particular act or omissionpn the part of county or district officers, servants, or employees
caused the injury or damage? / KkY1— -q>,Py(AZ,
5 What are the names of county or district officers,servants, or employees causing the
damage or injury?
6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages
claimed. -Attach-two estimates for auto damage.)
Av I-0--_D5A
. 7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
2 9_�TItrlc,5
8. Names and addresses of witnesses,doctors, and hospitals:
9. List the expenditures you made on account of this accident or injury:
DATE TBE AMOUNT
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.Gov. Code Sec. 910.2 provides"The claim shall be
signed by the claimant or by some person on his
behalf."
SEND NOTICES TO: (Attomev) 1
Name and address of Attorney )
(claimant's Signature)
(Address)
Telephone No. )Telephone No.
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PUBLIC RECORDS NOTICE:
Please be advised that this claim form, or any claim filed with the County under the Tort Claims Act, is subject to
public disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) Furthermore, any
attachments,addendums, or supplements attached to the claim form, including medical records, are also subject to
public disclosure.
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NOTICE:
Section 72 of the Penal Code provides:
Every person who, with intent to defraud,presents for allowance or for payment to any state board or officer, or
to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or
fraudulent claim, bill, account voucher, or writing, is punishable either by imprisonment in the County jail for a
period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), 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.
! 07/24/2008 at 05:20 PM Job Number:
39600
A-1 COLLISION REPAIR
BAR# ARD00178014
970 Broadway
Vallejo, CA 94590
(707) 642-5242 Fax: (707) 642-2824
PRELIMINARY ESTIMATE
Written By: Steve Coats
Adjuster:
Insured: RICHARD BACHMAN Claim #
Owner: RICHARD BACHMAN Policy #
Address: 111 WEST BAXTER ST Deductible:
VALLEJO, CA 94590 Date of Loss:
Day: Type of Loss:
Evening: Point of Impact:
Inspect
Location:
Insurance
Company: Days to Repair
2003 FORD FOCUS ZTW 4-2.3L-FI 4D WGN Int:
VIN: 1FAHP36Z93W208696 Lic: 5BAH796 CA Prod Date: Odometer:
Air Conditioning Rear Defogger Tilt Wheel
Cruise Control Telescopic Wheel Intermittent Wipers
Keyless Entry Rear Window Wiper Body Side Moldings
Dual Mirrors Console/Storage Luggage/Roof Rack
Clear Coat Paint Power Steering Power Brakes
Power Windows Power Locks Power Mirrors
AM Radio FM Radio Stereo
Search/Seek CD Player Driver Air Bag
Passenger Air Bag Cloth Seats Bucket Seats
Recline/Lounge Seats Automatic Transmission Overdrive
Aluminum/Alloy Wheels
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
1 REAR BUMPER
2 R&I R&I bumper cover 1 . 0
3* Rpr Bumper cover 1.0 2.8
4 Add for Clear Coat 1.1
5 Repl Step pad 1 33.05
6# Repl Tint paint color 1 0.5
7# Repl Flex additive 1 8 .00 T
8# Subl Hazardous waste removal 1 5.00 X
-------------------------------------------------------------------------------
Subtotals =_> 46.05 2.5 3.9
Parts 33.05
Body Labor 2.5 hrs @ $ 86.00/hr 215.00
Paint Labor 3. 9 hrs @ $ 86.00/hr 335.40
Paint Supplies 3. 9 hrs @ $ 40.00/hr 156. 00
Sublet/Misc. 13.00
----------------------------------------------------
SUBTOTAL $ 752 .45
Sales Tax $ 197 .05 @ 7.3750% 14 .53
----------------------------------------------------
GRAND TOTAL $ 766. 98
1
07/24/2008 at 05:20 PM Job Number:
39600
PRELIMINARY ESTIMATE
2003 FORD FOCUS ZTW 4-2 .3L-FI 4D WGN Int:
ADJUSTMENTS:
Deductible 0.00
----------------------------------------------------
CUSTOMER PAY $ 0.00
INSURANCE PAY $ 766. 98
I authorize Al Collision Repair to perform the needed repairs to my vehicle.
Repairs include parts, labor, and diagnosis. The above estimate is based on our
inspection and does not cover additional parts or labor which may be required
after the work has started. Worn or damage parts, not evident on first
inspection, may be discovered and you will be contacted for authorization for
additional work.
Parts prices are subject to change without notice.
ACKNOWLEDGEMENT: I have read and understand the above estimate and authorize
repair service to be performed, including sublet work and acknowledge receipt
of this estimate. An express mechanics lien is hereby acknowledged on the above
vehicle to secure the amount of repairs completed.
Authorized By:
Signed: Date:
Supplement Authorized By;
Signed: Amount Date:
Work Accepted By:
Signed: Date:
POWER OF ATTORNEY: I do hereby appoint the aforementioned business as my
attorney in fact to accept on my behalf any and all checks, drafts, or bills of
exchange for deposit to the aforementioned business' account for credit on my
account for repairs on my vehicle which had been released and accepted.
Signed: Date:
2
-� 07/24/2008 at 05:20 PM Job Number:
39600
PRELIMINARY ESTIMATE
2003 FORD FOCUS ZTW 4-2.3L-FI 4D WGN Int:
FOR YOUR PROTECTION CALIFORNIA LAW REQUIRES THE FOLLOWING TO APPEAR ON THIS
FORM:
ANY PERSON WHO KNOWINGLY PRESENTS FALSE OR FRAUDULENT CLAIM FOR THE PAYMENT OF
A LOSS IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN
STATE PRISON.
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:
B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT
LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS:
ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE
PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT
PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL
AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT 0/H=OVERHAUL OP=OPERATION
NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY
REPLACEMENT PART COMP REPL PARTS=COMPETITIVE REPLACEMENT PARTS
RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE
AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT
W/ =WITH/ SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE. .MOTORS DATABASE
INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NOTES ATTACHED TO
LINE. MQVP-MANUFACTURER'S QUALIFICATION AND VALIDATION PROGRAM. OPT
OEM=ORIGINAL EQUIPMENT MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR
OTHERWISE PROVIDED WITH SOME UNIQUE PRICING OR DISCOUNT. NWCPP=NATIONWIDE CRASH
PARTS PROGRAM.
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived
from the Guide DR2JK00, CCC Data Date 07/01/2008, and the parts selected are OEM-parts
manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at
OE/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (Alternative OEM) parts are OEM parts
that may be provided by or through alternate sources other than the OEM vehicle dealerships.
OPT OEM or ALT OEM parts may reflect some specific, special, or unique pricing or discount. OPT
OEM or ALT OEM parts may include "Blemished" parts provided by OEM's through OEM vehicle
dealerships. 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. Tilde sign (-) items indicate MOTOR Not-Included Labor operations. Non-Original
Equipment Manufacturer aftermarket parts are described as AM, Qual Repl Parts or Comp Repl Parts
which stands for Competitive Replacement Parts. Used parts are described as LKQ, Qual Recy
Parts, RCY, or USED. Reconditioned parts are described as Recond. Recored parts are described
as Recore. NAGS Part Numbers and Benchmark Prices are provided by National Auto Glass
Specifications. Labor operation times listed on the line with the NAGS information are MOTOR
suggested labor operation times. NAGS labor operation times are not included. Pound sign (#)
items indicate manual entries. Some 2006 vehicles contain minor changes from the previous year.
For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and
parts data from the previous year may be used. The Pathways estimator has a complete list of
applicable vehicles. Parts numbers and prices should be confirmed with the local dealership.
CCC Pathways - A product of CCC Information Services Inc.
3
` t
Date: 7/24/2008 05:32 PM
Estimate ID: 363
Estimate Version: 0
Preliminary
Profile ID: DEFAULT RATE
SONOMA AUTO COLLISION
3330 SONOMA BLVD ,VALLEJO,CA 94590
(707)643-4518
Fax: (707)643-5667
Tax ID: 20-1610287 BAR#: AJ235656 EPA#: 16416
t
Damage Assessed By: WILLIE ZEIDAN
Deductible: UNKNOWN
Insured: RICHARD BACHMAN
Address: 111 WEST BAXTER ST,VALLEJO,CA 94590
Telephone: Home Phone: (707)481-2703
Mitchell Service: 910626
Description: 2003 Ford Focus SE
Body Style: 4D Wgn Drive Train: 2.3L Inj 4 Cyl 4A FWD
VIN: 1 FAHP36Z93W208696
OEM/ALT: A Search Code: B867414
Options: ALUM/ALLOY WHEELS,AIR CONDITIONING,AUTOMATIC TRANSMISSION
Line Entry Labor Line Item Part Type/ Dollar Labor
Item Number Type Operation Description Part Number Amount Units
1 001492 BDY REMOVE/INSTALL REAR BUMPER COVER 1.0
2 001494 BDY REPAIR REAR BUMPER COVER ASSY Existing 2.5*
3 AUTO REF REFINISH REAR BUMPER COVER C 2.2
4 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 4.00 *
5 936014 ADD'L COST FLEX ADDITIVE 7.00 *
6 AUTO REF ADD'L OPR CLEAR COAT 0.9
7 AUTO ADD'L COST PAINT/MATERIALS 111.60 *
* -Judgment Item ST4CE
C - Included in Clear Coat Calc tiyt' ono ni
,�c► Ant Collision
w �4
�w Willie Zeidan
A� Manager
Estimate Totals GUAR a1
Phone(707)643-4518 J 3330 Sonoma Blvd.
FAX#(707)643-5667 Vallejo, CA 94590
Add'1 1 www.sonomaautocoillsion.com
Labor Sublet
I. Labor Subtotals Units Rate Amount Amount Totals IL Part Replacement Summary Amount
Body 3.5 78.00 0.00 0.00 _273.00
Refinish 3.1 78.00 0.00 0.00 241.80 Total Replacement Parts Amount 0.00
Non-Taxable Labor 514.80
Labor Summary 6.6 514.80
ESTIMATE RECALL NUMBER: 07/24/2008 17:31:56 363
Mitchell Data Version: OEM: JUN-08_A UltraMate is a Trademark of Mitchell International
Copyright(C)1994-2008 Mitchell International Page 1 of 3
UltraMate Version: 6.5.018 All Rights Reserved
Date: 7/24/2008 05:32 PM
Estimate ID: 363
Estimate Version: 0
Preliminary
Profile ID: DEFAULT RATE
III. Additional Costs Amount IV. Adjustments Amount
Taxable Costs 122.60 Customer Responsibility 0.00
Sales Tax @ 7.375% 9.04
Total Additional Costs 131.64
I. Total Labor: 514.80
II. Total Replacement Parts: 0.00
III. Total Additional Costs: 131.64
Gross Total: 646.44
IV. Total Adjustments: 0.00
Net Total: 646.44
This is a preliminary estimate.
Additional changes to the estimate may be required for the actual repair.
POWER OF ATTORNEY
THE UNDERSUGNED, HEREINAFTER CALLED "INSURED'S" AUTOMOBILE, DOES
HEREBY GRANT TO SAID SONOMA AUTO COLLISION, INSURED-S POWER OF
ATTORNEY TO SIGN OR ENDORSE ANY CHECKS AND/OR DRAFTS MADE PAYABLE TO
INSURED'S CLAIM FOR DAMAGES TO THE ABOVE DESCRIBED AUTOMOBILE"
INSURED DATE
I HEREBY AUTHERIZED THE ABOVE REPAIR WORKS TO BE DONE ALONG WITH THE
NECESSARY MATERIALS. YOU AND YOUR EMPLOYEES MAY OPERATE VEHICLE FOR
PURPOSE OF TESTING, INSPECTION, OR DELIVERY AT MY RISK. AN EXPRESSME
MECHANICS LIEN IS ACKNOWLEDGED ON ABOVE VEHICLE TO SECURE THE AMOUNT
OF REPAIRS THERETO. IT IS UNDERSTOOD THAT THAT YOU WILL NO BE HELD
RESPONSIBLE FOR LOSS OR DAMAGE TO VEHICLE OR ARTICLE LEFT IN VEHICLE
IN CASE OF FIRE, THEFT OR ANY OTHER CAUSE BEYOND YOUR CONTROL. IT IS
ALSO UNDERSTOOD THAT FULL PAYMENT FOR REPAIRS IS DUE UPON RELEASE OR
DELIVERY OF VEHICLE, INCLUDING SUPPLEMENTAL CHARGES.
SIGNATURE DATE
ESTIMATE RECALL NUMBER: 07/24/2008 17:31:56 363
Mitchell Data Version: OEM: JUN_08_A UltraMate is a Trademark of Mitchell International
Copyright(C)1994-2008 Mitchell International Page 2 of 3
UltraMate Version: 6.5.018 All Rights Reserved
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