Loading...
HomeMy WebLinkAboutMINUTES - 10221985 - 1.2 (3) i av CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COLMTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22 , 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: GLEAN J . FRANCISCO Cuunty "Imanwi': Attorney: Lazzarini & Frazier SEP .2 4 1985 A Professional Corporation Address: 49 Quail Court, Suite 212 Martinez, CR 94553 Amount: Walnut Creek, CA 94596 By delivery to clerk on $100, 000.00 Date Received: September 23 , 1985 By mail, postmarked on September 20, 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept . 23 . 1985 PHIL BATCHELOR, Clerk, By , Deputy n Cervelli II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( ) This claim complies substantially with Sections 910 and 910.2. (x) 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. 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: q ? SSS By: Z Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present C><) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its mi��t2 Zfojjis date. Dated: e PHIL BATCHELOR, Clerk, By ° , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703• ( ) A warning of claimantts right to apply for leave to present a late claim was mailed to claimant. 0 DATED: OCT `�� 1qp� PHIL BATCHELOR, Clerk, By O , Deputy Clerk cc: County Administrator (2) County Counsel (1) --.. /" A Tlf RECEIVED r BOARD OF SUPERVISORS SMP 3 �5 CONTRA COSTA COUNTY ; 651 Pine Street � cto""too s Martinez, CA. 94553 CpsTA GLENN J. FRANCISCO, claimant, does hereby make a claim against the BOARD OF SUPERVISORS, COUNTY OF CONTRA COSTA, for the sum of One Hundred Thousand Dollars ( $100, 000. 00 ) and makes the following statement in support of the claim: 1 . Claimant' s post office address is 1450 Creekside Drive, #16 , Walnut Creek, CA. 94596 . 2. Notices concerning the claim should be sent to LAllARINI & FRAZIER, A Professional Corporation, 49 Quail Court, Suite 212, Walnut Creek, CA. 94596 . 3. The date and place of the occurrence giving rise to this claim is August 12, 1985 at the intersection of Nicholson Road and Dewing Lane in an unincorporated area in Contra Costa County, California. 4 . The circumstances giving rise to this claim are as follows : Claimant was injured as a result of a collision between claimant and another vehicle that had not stopped at a designated stop sign which was obscured by foilage and trees. Additionally , the painted " stop sign" was faded and hard to read . 5. The names of the public employees causing the injury to claimant are unknown. 6 . The claim as of the date of this claim is ONE HUNDRED THOUSAND DOLLARS ($100,000.00 ) . 7. The basis for computation of the above amount is as follows : Medical Expenses $ 7, 000. 00 Lost Wages 7,000.00 General Damages 86 .000 .00 TOTAL DAMAGES: $100,0 Dated : September , 1985. f � `. GLEN J. FRANC CO 1. Claim denied 2. Francisco Glenn J ..vt.et) VUUIIJ(j1 SEP 2 4 1985 CILUM Martinez, CA 94053 BOARD OF SUPERVISORS OF CONTRA COSTA CO[)NTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22 , 1985 governed by the Board of Supervisors, ) The copy of this document mailed. to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California"Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: LINDA PHILLIPS as Guardian for KIMBERLY SUE PHILLIPS , a minor Attorney: LINDA PHILLIPS 804 West Madill Street Address: Antioch, CA 94509 transmittal Amount: Approx. $600, 000. 00 By delivery to clerk on September 23 , 1985 Date Received: September 23, 1985 BY mail, postmarked on I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept . 24, 1985 PHIL BATCHELOR, Clerk, By Deputy n er i II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( ) This claim complies substantially with Sections 910 and 910.2. (X) 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. 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: ��7-_ �prt� Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present This claim is rejected in full. ( ) Other: I certify that this is a true and correct cop oft Board's Order entered in its minutes for this date. Dated: Q]'_LPHIL BATCHELOR, Clerk, By J , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 9+5.6. 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) AQQwarning of claimant's right to apply for le to esent a late claim was mailed DATED:,f"195 PHIL BATCHELOR, Clerk, By Deputy Clerk cc: County Administrator (2) County Counsel (1) rTarM 44 t RECEIVED CLAIM AGAINST PUBLIC ENTITY TO: COUNTY OF CONTRA COSTA S M23 1985 Clerk, Board of Supervisors PHRGATCMELOR 651 Pine Street, Rm. 106IERI u�or vISO" 1 girtC TRA CO Martinez , California 94553 CLAIMANT' S NAME: LINDA PHILLIPS as Guardian for KIMBERLY SUE PHILLIPS, a minor CLAIMANT' S ADDRESS: 508 West Madill Street Antioch, California 94509 AMOUNT OF CLAIM: $600 , 000. 00 ADDRESS TO WHICH NOTICES ARE TO BE SENT: LINDA PHILLIPS 804 West Madill Street Antioch, California 94509 DATE OF INCIDENT: June 16, 1985. LOCATION OF INCIDENT: Intersection of Meadow Lane and Robin Lane, Concord, California., County of Contra Costa. -3OW DID IT OCCUR: My daughter, KIMBERLY SUE PHILLIPS, was riding as a passenger on a motorcycle driven * (SEE ADDENDUM by my husband, FRANK PHILLIPS. My husband ATTACHED HERETO) was travelling generally north along Meadow Lane approaching the intersection of Robin Lane when another motorist, Mr. Kenneth Turner, struck the motorcycle and my daughter while attempting to make a turn. The other driver, Kenneth Turner, proceeded into the intersection as he was unable to see to his right due to the presence of a fence and trees which blocked that driver' s view. DESCRIBE DAMAGES OR INJURIES: Compound fracture of the right leg requiring surgery and numerous skin graft procedures. My daughter will be required to undergo further medical treatment including additional skin grafts or other reconstructive surgery and other treatment not yet disclosed. : NAME OF PUBLIC EMPLOYEE(S) CAUSING INJURY OR DAMAGE, IF KNOWN: Presently unknown. ITEMIZATION OF CLAIM: Medical specials: Approximately $100,000 General damages: 500,000 TO $600,000 DATED: Sept. 17, 1985. ( LINUPP-BILLIP9, As guard a oz KIMBERLY SUE PHILLIPS, a Minor - Claimant ADDENDUM (HOW DID IT OCCUR: ) The County of Contra Costa failed to inspect and maintain the property adjacent to the intersection so as to afford drivers a clear view at the intersection. 1. Claim denied 2. Phillips Linda j I 3. Same as 1 4. Phillips Kimberly Sue • CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COMM, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22 , 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government -Code Section 913 and 915.4. Please note all "Warnings". Claimant: STUART A. MAC EACHRAN County Counsel Attorney: SEP 2 4 1985 Address: 500 Texas Street Apt. 1 Martinez, CA 94553 Antioch, CA 94509 transmittal Amount: $20. 00 By delivery to clerk on September 23,' 1985 Date Received: September 23, 1985 By mail, postmarked on I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept. 24, 1985PHIL BATCHELOR, Clerk, By AV1 OV JAA J 0 Deputy nnerve L II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( ) 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. 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: a By: 2 Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present (54 This claim is rejected in full. ( ) Other: I certify that this is a true and correct cop of the Board's Order entered in its miDutes� fofgdis date. Dated: t�+Il PHIL BATCHELOR, Clerk, ByPi , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for le ve to present a late claim was mailed o cl ant DATED:OCT 198 PHIL BATCHELOR, Clerk, By0 A- , Deputy Clerk cc: County Administrator (2) County Counsel (1) r 1 ATM C US.Bt-TO: BOARD OF SUPERVISORS OF CONTRA CO§7'.0Tr'F09Yappiication to: Instructions to ClaimantClerk of the Board .O.Box 911 A. Claims relatingto causes of action for death orM rtinez,California94553 �or injury to person or to personal property or growing crops must be presented not later than the 100th day after L•he 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. (Sec. 911.2, Govt. Code) 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, California 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 end of-TFiis form. RE: Clan by )Reserve r ClezkAs iling stamps "14 0�= RECEIVED. Against the COUNTY OF CONTRA COSTA) SEPP3, 1N5 ) or DISTRICT) aTcou (Filln name ) r� �� � The undersigned claimant hereby makes claim again t the Comity of Contra Costa or the above-named District in the sum of $ , /� and in support of this claim represents as follows: �. When did the damage orn3ury occur? Give exact date ani riourj 0,73 �. WFiere did tie damage or in3ury occur? �Inc�ude city and countyf /�FF�►-j ��T��r,�� roc , -,r, �w -100 Z_ / c C_"_57-,4 3. Bow did the damage or injuiy occur? Give �uSS detail's;-use ext=a- sheets if required) i)UQ1NG THf t3z�><,r6 cc-Ess = � TC r+ :51 LLQ ?U P C C eR o PE 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? �A VJATLtt WAS rJoT Q(_10E0 1IV /--trl�. (over) 5. , , What are the names of county or district officers, servants or employees causing the damage or injury? pEe"7 5(LV1A- 6. W�iat damage or �n3uiies �o you c�a�m resu�te�? ZG�ve dull extent of injuries of damages claimed. Attach two estimates for auto damage) -rt-{E L os S -7 CA -rte 64 , 7. How was the amount claimed above computed? Include the estimate amount of any prospective injury or damage. ) or C-A S,C 8. Names and addresses of witnesses, doctors and hospitals. it%vxpendztui^es you made on account of this accident or �n�ury: . ,• + " ti ..b i e ITEM AMOUNT i Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by ,some person on his behalf. " Name and Address of Attorney a a s Signature A rens Telephone No. Telephone No. p` 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, town, city. district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony.' CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA Comm, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22 , 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: WILLIAM A. BROOKS iy Cout�sal Attorney: SEP 2p 1985 Address: 2710 Rose Street Martinez, CA 94553 Amount: Martinez, CA 94553 By delivery to clerk on $3,000. 00 Date Received: September 20, 1985 By mail, postmarked on September 18 . 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept . 20 , 1985 PHIL BATCHELOR, Clerk, By 0, ° Deputy Cei i II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( ) 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. 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: H 2 C5 By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present (>6 This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of thBoard' rder entered in its n�.i=tes_for this date. C­� Dated: 2 25 PHIL BATCHELOR, Clerk, By o , Deputy Clerk 06 WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703• ( ) A warning of claimant's right to apply for lear to present a late claim was mailed to claimant. J� DATED:OGT 22198�_PHIL BATCHELOR, Clerk, By a , Deputy Clerk cc: County Administrator (2) County Counsel (1) CLAIM' TO: . r BOARD OF SUPERVISORS OF CONTRA. CO�7_-,Oy nCOYapplication to: Instructions to ClaimantC'erk of the Board .O.Box 911 Martinez,Cal ifomia94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911.2,. Govt. Code) 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, California 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 *rust be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by )Reserved for Clerk' s filing stamps RECEIVED i Against the COUNTY OF CONTRA COSTA) S E Pio 1985 or DISTRICT) Et+c �oissuuO1 (Fill in name) ) tos"` The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ .;o^) and in support of this claim represents as follows: 1 When did the damage or injury occ2cur? (Give exact date and hour) J � 2. Where did the damacge^Or injury occur? (Includc ci}y and county) �q �►�, �`!1�� ('c'���f r hr l��:f���r/mss �1���. �r.[�ir�pi r'r�, {� ((. 3. How did-tale damage or injury occur? (Give full details, use extra sheets if required) t4)e0 � _A_ P Gl(-Q1n n�, �aG✓! ------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? /re toe<s IV/4 cc , (VU /. ,_c .�,�f s I� ��zs I � 1,. � , � 1?11 41 6- r1� f�"•�_ �� z�G= 'i;�,,, (over) f ��<< -h : .� fig;;�_ over 5. What,.are the names of county or district officers, servants or, Qmployees causing thuet damage or injury? 14weve� �'S 1.01 `�: �� oIytf-F 1-6, -------------------------------------------------=-- ---------------- 6. What damage or injuries do you claim resulted? Give full extent of injuries or damages claimed./ Attach two estimates for auto d mage) r `fit :r2,,-� CcG� ('mac ►��it� D7, �# n eei7- "S/' J- 0,4 fq6t tua `� Pr �' { (r,�.ctv'cN�' �-s �in•s:u.:7- ------------------------ --------------------------------------------- 7. How was the amount claim----ed above computed? (I el �.kude the estimated amount of a y rospective injury or damage. ) a l� t � ��. ��' /n(�xri/•►t; � {�. �}�� ,o l� -ft:,rE� j r..�++,,r115_tl� s------------ - ----------------------------------- 8. Na me$ and dresses ,of witnesses, doctors and hospitals. a�ZG b' eSS �C�►���61.:r4 l r �' N%k'3. (2ij u - ���; -,��!�� �. z? l_� k�, . �� t�u.f �.ree - ----- G --- ------ — -- — 9. List the exeni„ e you made on account of this accident or injury: R.,... e ..... PILE # . ITEM AMOUNT A,9 SP :7 I Tvv�_ 04 �'Ot,--VJ 0r L 6a-�0�-�c y�t' x F' Govt. Code Sec. 910.2 provides : :(�� Cn��h�" "The claim signed by the claimant SEND NOTICES TO: ( ey) or by some person on his behalf. " Name and Address of Attorney S'7 Ve0 'tu 0X C Claimant's Signature �cr�� CtiC� u� t,4- IqS Address lephone No. ` t 0 Ili 7-510 Telephone No. ��I � 3 77--611 -5 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " 1. Claim denied 2. Brooks. William A CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22 , 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: ROBERT L. BAILEY Attorney: Address: 2805 Lavender Drive Walnut Creek, CA 94596 Amount: $57 . 82 By delivery to clerk on Date Received: September 25 , 1985 By mail, postmarked on September 23 , 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept . 25, 1985 PHIL BATCHELOR, Clerk, By Deputy el i II. FROM: County Counsel TO. -Clerk of the Board of Supervisors (Check only one) (X5 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. 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: C72E a By: Z 172.. Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present ><I This claim is rejected in full. ( ) Other: I certify that this is a true and correct cop oft Board's Order entered. in its minute o is date. Dated: OCT 9 PHIL BATCHELOR, Clerk, By ° , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months frcm the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703• ( ) A warning of claimant's right to apply for 1 e to resent a late claim was mailed to claimant.. DATED:0 CT 2 2 1985 PHIL BATCHELOR, Clerk, By , Deputy Clerk cc: County Administrator (2) County Counsel (1) ,4 `CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911. 2, Govt. Code) 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 (or mail to P.O. Box 9.11, Martinez, CA) 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 end of this form. RE: Claim by )Reserved for Clerk' s filing stamps Robert L. Bailey ) ) RECEIVED Against the COUNTY OF CONTRA COSTA) SEP 00S 1%5 ) or DISTRICT) lavcwtow (Fill in name) ) is c regi cos C .00S The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 57.82 and in support of this claim represents as follows : ------------------------------------------------------------------------ d l. When did the amage or injury occur? (Give exact date and hour) September 9 , 1985. 6: 30 AM 2. Where did the-damage or injury occur? (Include city and county) In Contra Costa County in Alamo on Livorna Road near Sugarloaf Hill Drive ( site of new housing development) ------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details, use extra sheets if required) My auto, 1978 Olds , ran 'over a huge uncovered )5XXX1XXXKX hole in the road. The hole was the. result of roadwork done by the county public works department. Apparently rain during the early morning of 9/9/85 had caused the roadwork to "sink" and create the huge hole . ------------------------------------------------------------------------ 4 . What particular act or omission on the part of county or district officers , servants pr em�p to ees ca sedd th in u or damage? There were no markers/warning iden ifing he orl . There was no steel road plates or blinking sawhorses in evidence . Burned out flairs were on the road but they had burnt out prior to the incident which occurred at 6: 30 AM. It was raining and no streetlights in the immediate locale resulted in a very dark area and unavoidable incident. (over) a r i 5. , . What are the names of county or district officers, : servants:iur-, <a I employees causing the damage or injury? The Contra Costa County Public Works Division, in my opinion, was responsible for digging and repacking the roadway which subsequently sunk in the wet weather. Therefore , they have responsibility for creating the 6."Sa }fat-lege or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) Enclosed is my claim for actual damages of $57.82 . Enclosed is another estimate of damage for $120 .10, considerably higher. I claim only actual out of pocket expense of x$57.82. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) By vendor statement (Firestone Tire & Rubber Co. ) of actual cost incurred. ------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. At 7 : 00 AM on 9/9/85 Mike DiMaggio of the Public Works Dept. was at the scene of the open hole with his camera and. put up protective barriers over the sunken hole . We exchanged names and phone numbers at that time . ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: ATEii~""--' ITEM AMOUNT / �8� yr �A / a +- «• Wheel Rim Tire stem valve $57 ,82 F C Balance of tire (see vendor invoice) Govt. Code Sec.' 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some /�p99erson on his behalf. " Name and Address of Attorney t�CZ2 laimant' s Sign ure Address 2805 Lavender Drive , Walnut Creek a orn a 94596 Telephone No. Telephone No. (415) 938-3824 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or .writing, is guilty of a felony. " Z v1 C d` .t Z oil om �G � T� K�� 1iGmd OIS sop 7, (7'- �'Y\ - J'v�or m(� z '0 n, ,O` OynO�,p 2- 3� O�p➢Z 20� 11 + Q� n �, m \\ �O mOj6 7,S o t p ty a A io10 3iG p ._ _ � �➢Zxpc➢per a � z 70 O O m 9 cp 1 A Z,:p C9 � ➢ 9 m , 2 Ctr � a O r O•" � � �.. i ,moi+ 0 N �r 6,a O 0 ,a3 Zp Omn N*^ O tom/' LIN i m ➢A V ?r 0 �7C y O X ,p N `s O Z m VIA cp \/\ :� ✓ a� -c G. An A Ln ,. Z 71 v so VA v of : - OZ o _ C7 % N O G G � ESTIMATE OF REPAIRS - -� ANDERSON OLDSMOBILE-GMC 2100 N. Main Street— P. O. Box 5530 -� OL�SMOBILE Telephone 937-5060 TRUCKS WALNUT CREEK, CALIFORNIA 94596 R.O. NO. tG SHEET NO. OF PHON ,.X 1 S� _3X``- NAME _! t. DATE E BUS. ADDRESS CD PHONE INSURED BY ADJUSTER PHONE YEAR I �! 7 MAK tr�I Com/ MODEL fJ COLOR LIC. NO. 19/l 46JI L/ BODY PROD. DATE COLOR TRIM MLDG. N0. MILEAGE SERIAL NO. J,_ PART PARTS NECESSARY AND ESTIMATE OF LABOR REQUIRED SUBLET LABOR COST PARTS COST NUMBER ESTIMATE ESTIMATE J.. THE ABOVE IS AN ESTIMATE BASED ON OUR INSPECTION AND DOES NOT COVER ANY ADDITIONAL PARTS OR LABOR WHICH MAY BE REQUIRED AFTER THE WORK HAS BEEN LABOR HRS. AT OPENED UP. OCCASIONALLY AFTER THE WORK HAS STARTED DAMAGED OR BROKEN PARTS ARE DISCOVERED WHICH ARE NOT EVIDENT ON THE FIRST INSPECTION. PARTS LESS PARTS PRICES AREEC TO INVOICE. 7 ALL WORK CASH UNLESS OTHER ARRANGEMENTS MADE IN ADVANCE. SUBLET YOU ARE HEREBY AUTHORIZED TO MAKE THE ABOVE SPECIFIED REPAIRS. TAX SIGNED DATE TOWING h 13-10329 NORICK OKLAHOMA CITY TOTAL G' L� 1. Claim denied i 2. Bailey Robert L a CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22, 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: ELMER F. MEYER CUunty PA1V 6Cr4 Attorney: SEP 2 7 1985 Address: 1310 Rose Ann Drive Martinez, CA 94553 Martina, CA 94553 Amount: $1, 238 . 49 + By delivery to clerk on Date Received: September 26 , 1985 By mail, postmarked on September 25, 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept. 26 , 1985pHIL BATCHELOR, Clerk, By Deputy e e i II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( 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. 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: 15 o By: I Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present l� This claim is rejected in full. ( ) Other: I certify that this is a true and correct cop of th Board's Order entered in its minutes for this date. 0 Q Dated: U, 2 2 PHIL BATCHELOR, Clerk, By `' , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for le to esent a late claim was mailed to e ant. DATED:0 CT Vi985 PHIL BATCHELOR, Clerk, By , Deputy Clerk cc: County Administrator (2) County Counsel (1) °CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY + Instructions toClaimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911. 2 , Govt. Code) 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 (or mail to P.O. Box 911, Martinez, CA) 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 end of this form. RE: , Claim by ) Resery lerk' s filing stamps RECEIVED Against the COUNTY OF CONTRA COSTA} SEPAL 1%5 FM KATCNftoa or DISTRICT) IERa214 �v►w= rs CCOST, (Fill in name) ) The undersigned claimant hereby makes claim against the Coynty of Contra Costa or the above-named District in the sum of $ /,�2 3,S, and in support of this claim represents as follows: -------------------------------------=---------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) 42,', -----------T------------------------------------------. -- 2. Where�d-id the damage or, injury occ ? (Incl/ud�e� city and county) � 3. How did_U damage o injury occur? (Give full details use ext a sheets if required) �J7 v j/ -- ----------------- _H_4 What artier act or omiss on the acount or dstrct P PY �fficers , servants or employees caused the injury or damage? _47V_ 1 v 5. What are the names of county or district officers, servants,,--or;. j ;mp5liyees causing the damage or injury? ----� ? - --- ---- - ---_��� ---- --------- ----- - 6 . What-damage or--injuries do you claim resulted? (Give full extent of injuries or damages claimed.-*Attach two estima es for auto damage) �� �!/(f �z-•�.-t ill'l f.��• fA-��- - a 10;1� r ---- ----- d 7. =:�'How was the amount claimed a ove computed? (Inclu e the e tied amount of any prospective injury or d ge. ) _ ��- i - G -------------------------------------------------------------------------- 8. Names and addressers of witnesses, doctors and hospitals. sy 0 �� �L�� Yo��, e�- . 9 ys� 9 r iQ.+6iie tai eS you made on account of this accident or injury: E - ITEM AMOUNT CC 914 A Aa �-'� ��+i� � j�t/ � ,- ..s�'j/J l L'�vr-� .•�'Js..x- �z (��-CJ'.7� a" y�-�-c_ Govt. Coc'�e Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or -some person on his behalf. " Name and Address of Attorney Cla ant' s Ej5Ptnature Address Telephone No. Telephone ************************************************************************** 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill , account, voucher, or writing, is guilty of a felony. " STATEMENT OF ACCOUNT I If Address Or Insurance Information Shown Below Is Incorrect,Please Enter Changes On Back And Check This Box Amount► MT DIABLO HOSPITAL MEDICAL CTR _ Paid - - P.O . BOX 44261 SAN FRANCISCO, CA. $ 93. 53 94144 Pay This Amount Payment Due BV ADDRESS CORRECTION REQUESTED 3010272031 A Refer to Above Pt.No.on All Ing. of Information l ardingthisState- 4156828200 ient. Telephone FC=B Patient Name MEYER , ELMER F Send Payment To • Guarantor MT DIABLO HOSPITAL MEDICAL CTR 3010272031 P. O . BOX 44261 ELMER F MEYER SAN FRANCISCO, CA . 94144 1310 ROSEANN DR FED ID . 94-6003847 MARTINEZ, CA 94553 --TO INSURE PROPER CREDIT TO YOUR ACCOUNT DETACH ALONG DOTTED LINE---AND-RETURN-TOP PORTION WITH YOUR PAYMENT. D94 BLUE CROSS . 00 Patient Name MEYER , ELMER F Last Stmt. Prev.Bel.$ . 00 08/16/85 1 EMERGENCY RM C 45. 53 08/16/85 1 ERMD FEE 4 48. 00 Hospital: MT DIABLO HOSPITAL MEDICAL CT 7EO�tete• 08/23/85 Patient No.: 3010272031 08/16/85 $ 93. 53 s . 00 s 93 . 53 Adm. Date Discharge Date Account Balance — Est. Insurance Due* *Insurance is Estimated For Billing, Any Balance Unpaid Will Be Billed To The Patient. Pay.ments_And Charges_Recei_v_ed After The Date Of This Statement Will Be Reflected On The Next.Statement._...--, V m oro j Z �. ✓P r�vD >o m s. > -bi • 'n of coo Lp G?4m m zOO zCm rn • D CDS m N Zt ` > tet'! CDm =a ren • � '�. j�.� O cow C,)= IA OM 10 mr- 00 Woo rrn31 mss+ —� mx0 cy. m =-M On aCz v a ar - V20 mrn a x r�- _ m ao > r o< •o-c zz Orn o � � O { G a,r N rr+m r NCI Cr Op p T1gn t -cm C Ln rn 1= O a0 r. .,I O Arn co I n`- 'O C Mtn rn S W �.+ m� rn� mD xm C Cl R WOO Zmy` O < O�m -4[J1 z 1�Gr Tp0 'V= m 'O 00 am m_ e O 0 ZO <DtU O O 7 CD N O n O OM0-0 3: 'a O_ " GQ y ' nam o ;cD�o cn 0 rw �,ar •� mar m "� . 9b.0 ^rII110ifT. DIABLO HOSPIT! j4gRICAL CENTER •2540 EAST ST.; CONCORD, CA 94520 • (415) 682-8200 Patient Identification, � —charge Instructions PHYSICIANS LJ MICHAEL J. BUCHEL G 029252 AS 6782684 C 7 3 M s�► 3' .24P ❑ KENNETH T. DELUCA G 030840 I AD 6871809 AE �Eft ELKER F ❑CHARLES H.HANSEN G 045312 AH 1118985 h E tit L FID ❑ HOWARD G. KORNFELD G 034976 AK 8038641 C!-0?ra3 ! fR a/!4 /gs J;I- AND G. MEW G49960 AM 2519102 ❑ STUART B. SHIKORA G 42847 AS 9423954 t ❑ STRENGTH OR DISP. # SIG: REFILLS Rx CONCENTRATION r- - 2 3 4 �. 5 kk D TOTAL NUMBER PHARMACIST MAY SUBSTITUTE E--�ApK k` GENERIC EQUIVALANT i//+ El OF MEDICATIONS UNLESS THIS BOX IS CHECKED SI NATURE PHYSICIAN DATE 'kFIll F LLS ¢¢ 'FINAL DISCHARGE DIAGNOSIS OR ASSESSMENT(NO SYMBOLS OR ABBREVIATIONS) 1; L Z INSTRUCTION SHEET(CIRCLE) u O z V 1 HEAD INJURY 11 CAifTaCARE 2 LACERATIONS, 12 PID-GC-NGU 2 3 SPRAINS/CONTUSIONS 13 EYE 'r. f C7 4 WOUNDS-BURNS-BITES 14 POISONS-DRUG O.D. Q / (/ 5 BACK B NECK INJURY 15 CHEST PAIN _ 6 SORE THROAT 6 "FLU" 16 HEALTH p7 FEVER 17 EXERCISE 8 ABD. PAIN-NVD 18 OTHER: 9 UTI 10 EAR INFECTION TAKE MEDICATIONS AS PRESCRIBED ABOVE M.D. LIST(S) GIVEN ❑YOUR X-RAYS WERE INITIALLY READ BY THE EMERGENCY PHYSICIAN, AND WILL BE REVIEWED WITHIN 24 HOURS BY THE RADIOLOGIST. WE WILL ATTEMPT TO NOTIFY YOU OF ANY CHANGE IN THE DIAGNOSIS. PHYSICIAN YOU MUST SEE M.D. SPECIALLEPH E IN HAYS AND AS NEEDED YOU MAY RETURN TO: MODIFIED WORK REGULAR WORK RETURN TO THE EMERGENCY DEPT. IF ANY PROBLEMS OCCUR AND YOU ARE UNABLE TO SEE YOUR REGULAR OR REFERRAL DOCTOR I ACKNOWLEDGE RECEIPT AND UNDERSTANDING OF THESE INSTRUCTIONS, INCLUDING INSTRUCTION SHEET(S)CIRCLED ABOVE, &WILL OBTAIN FOLLI IW-,) ARE AS DIRECTED 71 / TI E C RGfiD DI HARPED BY SIGNATURE OF � / -t--f J � PATIENT X ' DISPOSITION: HOME (ACCOMP IED BY )❑WORK ❑ ADMITTED TO M.D.H. TO DR. ❑ TRANSFERRED TO VIA DR. / - - ACCEPTING ❑ CORONER 12POLICE ❑ 51-50 ' Cl AMA ITION ON DISCHARGE COPY PHYSICIAN i �--� � i, G00C �.FFIF POOR SHOCK EXPI;FCl TO M.D. X n w 7e?:; %. ,URE Claim denied 2. Meyer Elmer F i CLAIM BOARD OF SUMVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22 1985 governed by the Board of Supervisors, ) The copy of this doe mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: VICTORIA LOERA OAI!!1 Pnl.C1SE! Attorney: Stanely T. Grydyk SEP 2 0 1985 Attorney at Law Address: 4006 Macdonald Avenue Martinez, CA 94553 Richmond, CA 94806 Amount: $255, 000. 00 By delivery to clerk on See Jesus Loera claim Date Received: September 20, 1985 By mail, postmarked on SPptPmhPr 19 , 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy.of the above-noted claim. Dated: Sept. 20. 1985 PHIL BATCHELOR, Clerk, By �' Deputy Arias ('.Pr� PI 1 � II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) �) 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. 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: 20 5 By: -= Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present (?� This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy the ard's Order entered in its mi ute or is date. Dated: �CT 1985 PHIL BATCHELOR, Clerk, By o , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leav to pr sent a late claim was mailed to claimant. DATED:OCT 2 21985 PHIL BATCHELOR, Clerk, By ° , Deputy Clerk cc: County Administrator (2) County Counsel (1) CLAIM AGAINST PUBLIC ENTITY RECEIVED TO: Clerk of the Board of. Supervisors SEPaa 1995 Contra Costa County PHK&ATCMELO! 651 Pine Street IE"K TRA COS R7M �O[S Martinez, CA 94553 a VICTORIA LOERA hereby makes claim against Contra Costa County and the County Hospital for the sum of $255 , 000 and makes the following statements in support of the claim: 1. Claimant' s post office address is 1347 Lake St. , San Pablo, California, 94806 . 2 . Notices concerning the claim should be sent to Stanley T. Grydyk, Attorney at Law, 4006 Macdonald Ave. , Richmond, CA 94805. 3. The date and place of the occurrence giving rise to this claim are July 5 and 6, 1985 at the County Hospital in Martinez , California. 4. The circumstances giving rise to this claim are as follows: Claimant went to the County Hospital on Friday, July 5 , 1985 with stomach pain. Diagnosis and treatment was given for a bladder infection. At 1: 00 a.m. on July 6 , 1985 , claimant was taken to Kaiser Hospital , Richmond, where a diagnosis of ectopic (tubular). pregnancy was made and arrangements made for immediate ambulance transport and surgery at the county hospital. Claimant arrived at the county hospital at 4 :00 a.m. and surgery was to be at 8 : 00 a.m. Surgery was not performed until 6 : 00 p.m. of July 6 , 1985 after the tube ruptured. As a proximate result of said negligence to properly diagnose said condition on July 5 , 1985 and to properly treat and care for claimant on July 6 , 1985, claimant has suffered and will suffer damages of pain, suffering, loss of affection, society and inability to bear children in the future. 5. Claimant' s injuries are described in the preceding paragraph. 6. The names of the public employees causing the claimant' s injuries are unknown. 7 . My claim as of the date of this claim is $255 , 000. 8. The basis of computation of the above amount is as follows: Medical Expenses incurred to date : $ unknown Estimated Future Medical Expenses : $ 5 , 000 . 00 General Damages : $250, 000. 00 Total "' $255, 000. 00 Dated: September 18 , 1985 ST LEY T. GRYDYK . Attorney or Claimant 4 j 1. Claim denied 2. Loera Victoria CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COMM, CALIFORNIA BOARD ACTION Claim Against the County, or bistriet ) NOTICE TO CLAIMANT October 22 , 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: LAWRENCE BERT HOOPER Cutmtv 1n;arse; Attorney: SEP 2 5 1985 Address: #86 Bayview, Apt. 1 Pittsburg, CA 94565 Martinez, CP, 94553 Amount: $95. 00 By delivery to clerk on Date Received: September 25 , 1985 By mail, postmarked on September 20 , 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept. 25, 1985 PHIL BATCHELOR, Clerk, By d Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( 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. 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 By: 2 4 . n% Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present (X) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of th Board's Order entered in its minuteis date. Dated:OCT �flW PHIL BATCHELOR, Clerk, By ° , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's acti-on on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703• ( ) A warning of claimant's right to apply for lea top sent a late claim was mailed to clai ant. DATED: OCT 2 1985 PHIL BATCHELOR, Clerk, By a , Deputy Clerk cc: County Administrator (2) County Counsel (1) �(t?kfk TO: BOARD OF SUPERVISORS OF CONTRA CON Wapplication to: Instructions to Claimant0erk of the Board .O.Box 911 Martinez,Califomla 94353 A. Claims relating to causes 'of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911.2, Govt. Code) 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, California 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the Distr4ct--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 end o this form. RE: Cla*m�y J &1�1 )Rese ved for Clerk's filing stamps I �" ECE VE Against the COUNTY OF CONTRA COSTA) SEP05' MS DISTRICT) l ACOS Or i 8. E«c �of +so�5 Fi n name ) C -COS The undersigned claimant hereby makes claim againstthe County of Contra Costa or the above-named District in the sum of $ O 8 and in support of this claim represents as follows: �. When did the amage or in3ury occur? (Give exact date and hour] T —a------- 1 .. —T TL —— —T —-------------- V / Al d1 t amage or in3vey oc ur? (Inc de y and county) _D� 3. How did th damage or 3ury occur? (Give buil detaiSs, use extra sheets if required) &K_;a_F�g�_EvBular pnhe—' ---------act or omsssioartof county or district ervants or employeehe injury or damage? (over) 5., What are the names of county or district officers, servants or employees causing the damage or injury? 6. What damage or �n3uries do you lain resulted? ZGive dull extent of injuries oz damages claimed. . Attach two estimates for auto damage) --------------------------------------------------------------------- -- 7. How was the amount claimed above computed? (Include the estimate amount of any prospective injury or damage.) ------------------------- ------------------------------------------- �. Names and addresses of witnesses, doctors and hospitals. mare+ "-------------------------- ---------------r—v---- �. L st.JAI' made on account of this accident or injury: !:�, .. ��, i .� ITEM AMOUNT �-tf leo UVW25 t� -T A J7 n! *RBBB * r!R**RR�RR�� RRRRRRRRRRRRR RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR*RR t vt Udeftc. 91 provides: Seovides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or some person on his behalf. " Name and Address of Attorney �`� U���.C'� 1_L V a nt Signa r r s .- �j Telephone No. Telephone No. D RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR 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, town, city district, ward or village board or officer', authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " A� 1 , Claim denied . 2, Hooper Lawrence Bert ViA BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION October 22 , 1985 Claim Against the County, or District ) NOTICE TO CLAIMANT governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: GAYLEN R. WALTERS Attorney: County Govnse�l SEP 2 51985 Address: 1438 Earl Street Napa, CA 94559 Martinez, CA 94553 Amount: $283 . 73 By delivery to clerk on Date Received: September 25 , 1985 By mail, postmarked on September 24, 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept. 25 , 1985 PHIL BATCHELOR, Clerk, By a Deputy Ann Cervelli II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) (�) 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. 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: q,-?E 5S By: P.�fi�; �F"_�'T/L Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present (� This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the ard's Order entered in its minutes is date. Dated: OCT 2 iA PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for lea to resent a late claim was mailed DATED t(oe"85 PHIL BATCHELOR, Clerk, By , Deputy Clerk cc: County Administrator (2) County Counsel (1) CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must 'be presented not later than the 100th day 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. (Sec. 911. 2 , Govt. Code) 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 (.or mail. to P. 0. Box 911 , Martinez, CA) 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 end of this form. RE: Claim by ) Reserved ' tamps DECEIVED SEP cK INS Against the COUNTY OF CONTRA COSTA) r►N► ATCMBG or DISTRICT) A*Of 'sms C t Cos . J (Fill in name) ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ JZ' 9 -� and in support of this claim represents as follows : ------------------------------------------------------------------------ 1 . When did the damage or injury occur? (Give exact date and hour) q;,2(j F/71 .Tim l y 171q85- 2. Where did the damage or injury occur? (Include city and county) .T (�fj S �ll v;'r✓� /��c R rk o,v T/,'L C RZ). V4AA'`1F CkOS-S ?rlt/, /Scf ESN/{.,& 7 ------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details , use extra sheets if; required) WRS Dgf'l ij lj iN Tfff_ SLOW L/9/✓E 6_,#61v /I CR/? ORoUC- P/1S7- /Y7E . 7-/i F_ T;RF S Lv y F f'/= /R6!)m)�i Tit'I yR,9 V/_L b F f THfr!� Al 4' i J ' tI1�S /YJ Y T PG!c k w 1 n, n sh F;z p ,� 2'� ��itE % ��n S'Fv�PAL f 4'9�E S -------------------------------------- -- --- -- - - ------__----- 4 . What particular act or omission on the Tart of cc,anty cc district officers , servants or employees pause' the injur , rY 0.E-, lacy-7 IJ'lc5T O/V my C ��F e �4' T/�� IV j=x'T46 �T- 6 N �/� L C�/� R o r� D �'i 4. L , 5:' What are the names of county or district lrrf.f`ieers., :servants or employees causing the damage or -injury-? s- en eJ3A-- - 6. What damage or injuries do you clai�-esulted. (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) 7----------- th -------------------------------------------------------------- . How wase amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) 8. Names 4nd addresses of witnesses, doctors and hospitals. /0 _________________________________________________________________________ 9 res you made on account of this accident or injury: r ITEM AMOUNT a ii E-1. &Zli ? Govt. Code Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Claima s (;-I,g ature J 4:3 P Fel Addr s Telephone No. Telephone No. ?Q2r,2S�- 80S ************************************************************************** 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " GARY HALL rio 707 252-3233 HALL B] & 1900 A CA�LFORNIA9 559 ESTIMATE GLASS SCREENING. ell as:e For t" ` Year C/ &17-21 Make Fog-.0 Body style P'<.4<-- u'1 Ousn. Part No. Description Ust Net 4 azo (`7�-<<tp Sub-Total ! G Labor State Sales Tax ! u Total Material and 38 Labor o Thank You! This is an estimate only and not a statement or bill for material and/or services. This estimate good for 30 days from date of offering. �r m v ao z Z N D �Cva\ D O ;.tea r> O.O m CD Z ao w rn n 7D m 0 =t t7 H p Z Z � � n --1 Ao N � Z to m j 1. Claim denied 2. Walters Gaylen R i CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANT October 22, 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: ERNEST D. MONETTE County Counsei Attorney: - SEP 2 3 1985 Address: 1896 Brookwood Vacaville, CA 95688 Hand delivered Martinez, CP. 94553 Vacav Amount: $3, 061ille, By delivery to clerk on September 23 , 1985 . 74 Date Received: September 23, 1985 By mail, postmarked on I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Sept. 23, 1985 PHIL BATCHELOR, Clerk, By ) Deputy A Cervelli II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) (X) 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. 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: q123_ By: r =1Z2 Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present C>< This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of thBoard's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, ByDA= , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703• ( ) A warning of claimant's right to apply for le e to pr sent a late claim was mailed to claimant. DATED:OCT 2 21985 PHIL BATCHELOR, Clerk, By , Deputy Clerk cc: County Administrator (2) County Counsel (1) CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911. 2 , Govt. Code) 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 (or mail to P.O. Box 9.11 , Martinez, 'CA) 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 end of this form. RE: Claim by ) Reser stamps CE SEP-23)INS Against the COUNTY OF CONTRA COSTA) VW 1ATCWk09 Moo t A CpSt� or DISTRICT) L I J". - p (Fill in name) ) The undersigned claimant hereby makes claim against the Count of Contra Costa or the above-named District in the sum of $ (Q( ? and in support of this claim represents as follows : ------------------------------------------------------------------- d ----- l. When did the amage or injury occur? (Give exact date and hour) 1215 /:::�W ------------------------------------------------------------------------ 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 sheets if required) Com+r6k Co54-c, 6eyu �- 4y sk4r., 45 W,er� 110J , '[12_60; t o� G t1�1 p�-ov C �:v !'� �,►� +� ----�j-(�c,� _ 01 t---i yt '��.Q�_ ;_rr J 1'� (I _� l�ca _-�✓Or�- c --r� - ----I (--- 4 . WPlat particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? P C/ 1 9�il A T 1 U f 1 1 k(� Q G C �^�t l� l L T 4Ya_ G\% Vle C.IL / (over) . 1. 5. What are the names of county or district officers , ..servants =nor- I employees causing the damage or injury? __ a FF1 c �s __ G_,�_�__-y 6 . What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) xdvo ----- ----- ------------------------------------------------ claimed-- --- --7. How was the amount above computed? (Include the estimated amount of any prospective injury or damage. ) ------------------------------------------------------------------------- 8, Names and addresses of witnesses, doctors and hospitals. OF 9. ssT'°" expen itu es you made on account of this accident or injury: . � ITEM AMOUNT � 7 Govt. Code Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Y/ HZ 0-,- Clai nt' s Signature eo o ACu7©o CJ d res �R Telephone No. Telephone No� ?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 board or officer, or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill , account, voucher, or writing, is guilty of a felony. " LES SCARLETT'S WE USE BODY SHOP oU PONT 1851 WOOLNER AVE. FAIRFIELD, CA 94533 SUN ROOFS Phone (707) 429-1800 T-TOPS REFInISH 60' SPRAY BOOTH BODY AND FENDER REPAIRS • EXPERT REFINISHING NAME -?10Q;/x _ ��'�_ • r 4ZJ�• DATE ADDRESS. INVOICE NO. REGISTRATION NO. ./ 7 DATE PHONE _f --+-_`-- � WANTED HOURLY RATE YEAR-MOD -COLOR MA E OF CAR BODY Y CE E N SERI L NO. MFG. PAINT NO. MILEAGE I c �f��_ REPAIR REPLACE SUBLET PARTS AND WORK MATERIALS LABOR REFINISHING i D z!''iC -� ✓cam � � �� - , l A. f L SUBJECT TO INVOICE PRICE CHANGES SUB TOTALS THIS ESTIMATE 15 BASED ON OUR INSPECTION AND DOES NOT COVER ADDITIONAL PARTS OR TOTAL LABOR WHICH MAY BE REQUIRED AFTER THE WORK HAS BEEN STARTED. AFTER THE WORK HAS STARTED. WORN OR DAMAGED PARTS WHICH ARE NOT EVIDENT ON FIRST INSPECTION MAY BE DISCOVERED. NATURALLY THIS ESTIMATE CANNOT COVER SUCHCONTINGENCIES. PARTS SALES TAX PRICES SUBJECT TO CHANGE WITHOUT NOTICE.THIS ESTIMATE IS FOR IMMEDIATE ACCEPTANCE. GRAND TOTAL THIS WORK AUTHORIZED BY - Name f�'�' Date 04602 MD7DCZn Address I v�•1 - - - L- `. - Staff' Zip o D�C Z O wyMa r �' r. 'a -0 l/�.t 7 7 J- `' Year-f/ Make !l r Model i c.� � o•• 7C Phone M Style ID No. Color Prod.Date �r n r O W r- Trim Mileage Lic.No./L r 2 36 Ins.Co. O M M, Appraiser Lic. No. Phone File No. Claim No. rrn c Wtn (D 3 n SO C) r29 KM 200 0 cn-0mcn=2 � mT Q 3 m �7 7p�p r m a.x+ =0 0 0 a — �' O M O m �• a m y m �'0 0 O a d O y m co : aPr x CD C m - n m n >77 C ti d m C oy N� Zi co m od �; -v m�`^ add �v 3 ? CD c _'� _ � � _ N M c M. ° T cn 3 � �co 3 = Z7 cD 3 0 CD 13D CD S ]�O m r. r c e M0M-i G�G�� � 22 cn TI �cn r 7C 7C ==cn� OC) m M< T MMco00 3 3 ti m =._. = O O O m OS c c c c0' v0 M =C m < od—i m' m °' ?c x -0 -, 3n 3 ° N.0 cnvor 7_0 33 a 3 �mOmN CO ° mfg cnm � :: � `; � � C < av c m _ ACL M `_° 7 s ° D c ° Q <�o ark 0 -I c 3 ° s&mcn 3 `� D 3 ° 3 � 1 � a ° m _ J M 7 mXc3 :. c ` �. � < d 4b ® cNi� z dCL O' j . R 1wSID � c F. 'r, M - p O c c cno N 00 c»� W �om� _<� � � � rrF== >m>> = :E-n ocn DWW ® 0 CD .-. C d O ,o'., m O H m >'O �• a O O p ii m y oo N " O w d a E2.C < d .. > ••� .+ a 7 � c O -� > C C1 Cl a ° C7 3 n(7 > > a O0 .,. a .'^.,a • � � � CD E2 " �D v O CCD 3 c — p \a a 77 m a 0 m W 0 m � W co'c �m j 0' cDi o —� r� y�3 ° -� vim = �� c I (D 0 1 -0 a o 0 0 )MOm //N�� -° y 0 M M O _ lD N G1 ►l a M c li. O 0 m _I T< m c Q • OID .. CD O . O 3 cD O n y O y CD 3 TIT - S N G r .1i m . m y y . X C Z n � m C C o S L an d M CD 90 -� cmc = x Q .G o �' �' cr cn �o =�c) n OG�-Ir L�< T rL�m�oWc)W 2 C D d �D •'O .�► .► O �' c 0 obi c ?O oI N y a n O a m C O a 0 = n'c 7 fD c c O. Z .� °' M n m m m H Nin n � cDv`^ 3 = tO �cm JC� c '+ ° ° � � < miD � � � t1T3 C Cm x mC)- cD Dom- - = � � �� m 3 ra �� _. N m in'O H 3 °' om cow m o�� v� r 0 � fns fl cD D Dye ,-► � ra". =' a °-13 CU N, = ° cn ii �o1D� � �� 0 r' p d N• N• \H o• X = �•m rn c=D �_ _I m a °a o m E O m C v 6191.g c `° S. x M H 1. < < 'M Q! (a 44 4* 6S V7 P! Q!�YJ W 'M , N w 01 .Form No.1010 I/D/E/A Inc..Caldwell Idnhn R3fin5 r,11 Tn❑Fro.1.Rnn.R3FA9R1 • ' + � � SEP 11 1985 ST,AYE OF CALIFORNIA TRAFFiC-COLLiSiON REPORT '31L CIA8 CONDITIONS NO.INJVRED N R CITY JUDICIAL DISTRICT NUMBER FELONY j NO KILLED Row COUNTY REPORTING DISTRICT S[AT . �(�.�F/� ❑ CU/UTIZfI fOS/� /I, COLLISION OCCURRED ON MO. DAY YR. TIM{ (LOO) NCIC NUM{[R OP/IClw I.D. - 9 : 9 ,SS x337 93 a Q.0 ---C-N E L E -t�-UC ------- ---------------- I ML[►OST INFORMATION I�NNJURV,KNA k—OR TOW AWAY STATE NIGNWAY RELATED 4% V FEET OF MILEPOST TES ID Ll NO YES ®MD 0 PNOTOGRAPNS 1 AT INTERSECTION —TNy11� -�OR: F9[T(MILRS OP F 1 F I �� / ��`. D YES 91 NO PARTY NAME (FIRST, MIDDLE, LAST) OWNERS NAME Ej SAME AS DRIVER 1 T�1- T? 0! A4--b - DRIVER STREET ADDRESS MOMS PRONE OWNER'S ADDRESS I SAME AS DRIVER 1 X 50, `/a. 5FpaZ s 77 RIS - 97V7 2900 P{DSS- CITY:SIATEIZIP BUSINESS PHONE DISPOSITION OF V[N. ON ORDERS OF i TRIAN //� �/J� f� Ri CHmorL-)Z CK.F FICER �DRIVIR E OTHER PARKED DRIVER'S LICENSE N.:MBER STAT! SIw TN DA TE SEI TRACE DIRECT'ON OF ON:1a�s (STREET OR NIGNWAY) 1111191 LIMIT VLM MO. DAV YR. ( TRAVEL -A,(, 5 70 e S Z C -5 5 ■JCV- VEN. YR15) MAKE(S).MODEL10/COLOw(E) LICENSi No.jS 1TATEl3) CMP U$E VEHICLE DAMAG!-E%TENT/LOCATION GUST FRAMC I ONLY '^1 �I a yf}(nF;t�-{/�! /3Llt SA,.4. . . . . . . . . . .a 3a . . �V CLE T-11MINOR MODERATE FJ MAJOR U TOTAL OTN{R ALL CDU c_ 2 i2��L vr✓� PARTY NAME (FIRST,MIDDLE,LAST) OI3'NER 5 MAME —.--- AS DRIVER 2 L1ZN�S A2ZL�L YYl E-7E OR'V{R STREET ADDR{SS MOM{ PNON! OWNER'S AODRESS 1 SAME AS ORIVlw P{O[S- CITYiSTAT[/ZIP SU11NEi1 PRONE DISPOSITION OF VEN..ON ORDERS OF TR IAN /3��.� /1� // (/�� QJ f` j/�� �j (�� V 1 1`A V�LL`r `A . I 9+ e\i � D�l UGv �OFFICER �i DRIV{R �.,�)OTHER PARKED DRIVER'S LICENSE NUMBER STATE SINT—AT[ T!I JPAC! DIRECTION OF ON A'SWi (ITR{[T OR NIGNWAY) 1613),s Pago LIMIT ) V[N MO. DAY TR=VEL ` NV/ (33.75'/ CA / 6 m C�/ -S A ' ■ICY- VIN. —(S) MA KE(5):SLODLL(S Ii COLOP It) LICENSE O.(S) STATE(S) CNP USE VEHICLE DAMAG!-EIT[NT/LOCATION CLIST (/�/ ^•��} , _ `7 ONLY I!—II .� I 'OLDS -am- L,.�J TI I J LL 6,73 6A A . VEHICLE TYP j,�-' MINOR EK MODERATE :.-�!MAJOR LTJ TOTAL OTHQR' I . PARTY .—t(FIRST.MIDDLE,LAST) !OWNER'S NAME `j SAME AS DRIVER 3 ORII'ER STPE[T ACDpf 3'- HOME "ONE OWNER S AZOR 655 SAME AS P RE Ot NS- --STATBi21P __— BVD�h L35 P.•OVE IbPObITI ,.On L'pP[,944 O - —} TRIA I I DFFIC ER ,_ 1w n•ew r'oTHeR ~..K EO DRIVEPS LICENSE vVMB[R ST ATC {IPT 4pA TE Si., E �DiRE CTIGh OF'pN IA4.R.i46 (STREET DR NIinWAY) LPE[D LIMIT DAY YR. TPAVEL � I I SIC"- V'[K. YR(S) MAP.E(b(:MOOE_(5)ICOLOp(5) CLIC hO.(S) STATES) I CMP LI$E :VEHICLE Ow MA Gl--6ITENT!L OC ATION CULT I i ONLY I IV EHI:LE TY P� —I MINOR L—I MODERATE �— MAJOR ;J TOTAL OTN[P . . . . . . . . . . . . . PARTY NAME (PEPS-,MICDLE, LAST) 10—El'S 'A-' SAMS AS DRIVER 4 t — Dp:VCR b`R![T AC Dp6 E5 MOM[ ..ONE OW NER•L ADDRESS -II S DwIV[P I 1 iREDES- C!1-161AT[JZIP SUIINESS PHONE D ITION OF V{H- ON Ow OCFS OF T—AN t^' �_._- L.^'O►►ICER DRIV[w O CTHEP AFK[p �R.\'EP 3 LI CEN1i NUMS[p STATE BIRTH^ {[)[ FAC{ DIRE CTiON 61ON;ACR 051 (STREET OR NIGNWAY) is"'mr, LIMIT FVCN. -- MO V YR. � TRAVEL I SIc- VEN. YR(S) 'MA K!(b('N-�[:./ LON(S) LICENSE NO.(S) SrATE(i) I CNP L'$E IYi NICU DAMAGE—[AT{NT/LOCATION : ' CLIST ONLY I (I��! I �V 6H ICLE TY► f —'j MINOR MOD[w ATE L.(MAJOw L_,.:TCT.. F OTHER . . . . . . . . . . . I ( ' CHF'55s—Page 7 ;Re. 5-84Oma. 0:2 �x TRAFFIC COLLISION CODING •AGE Q DATE OF COILIS104TIM! (2LD0' RYRS a 3�� INo /Da PROPERTY DAMAGE DSSCRIPTION OP DAMAGE OWNER'S NAM[/A DOR ESS MOTIIIED ElYES ED.. VIOLATION IS) PARTY f ►ARTY 2 PARTY 3 PARTY d CHARGED a�f�Sk A\ U,C. PRIMARY COLLISION FACTOR RIGHT OF WAY CONTROL 1 1 2 3 1 d TYPE OF VEHICLE 1 2 3 d MOVEMENT►RECEDING IL15T NUMBER(R)OF PARTY AT FAULT) A CONTRDLS FUNCTIONING A PASSENGER CAR/STA.WAGON COLLISION R A VC SECTION VIOLATIONr: B CONTROLS NOT FUNCTIONING B PASSENGER CAR W/TNAILEw AUTO PKD �\ l a 3 I SQQ, 1.F 1 ] C CONTROLS OBSCURED C MOTORCYCLa/SCOOTEN B PROCEEDING STRAIGHT ;A B T.C. IMPR O►!R DRIVING• D NO CONTROLS PRESENT D PICKUP Ow PANEL Tq UCKC RAN OFF ROAD E PICKUP/PANEL TRK W/TRLR 0MAKING RIG"T TU— C OTw[R THAN DRIVER• TYPE OF COLLrSION F TRUCK OR TRUCK TRACTOR E MAKING LEFT TURN D UN KNC WN• A NEA.-ON G TRK/TRK TRACTOR W(TRLR F MAKING U TURN WEATHER (MARK 1 TO 2 i­s) B SIDE SMTP! M SCHOOL BUS G BACKING A CLEAR C REAR END I OTHER BUS H SLOWING—STOPPING B CLOUCY jD BROA ASID! J EMERGENCY VEHICLE I PASSING OTHER VEHICLE C w NING E HIT OBJECT K HWV CONST.RGUIP14KNT J CHANGING LAPIaf D sNOWING F OVERTURNED L BlcYcl.E K FAR KING MANEUVER E FOG G AUTO/PEDE[TRIAN M OTHER VB./CLE EN TERiNG TRAFFIC FROM F OTHER•: H OTHER•: N PEDESTw1AN *M OULDaR,MEDIAN, L G WINO � MOPED PARKING {TRIP OR LIGHTING MOTOR VEHICLE INVOLVWITH PRIVATE DRIVE A .AVLIGw A NON-COLLI f ION 1 2 3 d OTHER ASSOCIATED FACTOR M OTHER UNSAFE TURNING B DUSK—DAWN J,�B PEDKSTP1AN (MARK I TO 3 ITEMS) N ZING INTO OPPOSING LANE C DARN--STRRBT LIGHTS C OTHER MOTOR VEHICLE A VC SB CTION VIOLATION: D PARKED Z D DARK—NO STREET LIGHTS D MOTOR VCM.ON OTHER ROADWAY F MERGING STREET LIGHTS NOT E PARKED MOTOR VEHICLE B VC SECTION VIOLATION: Q TRAVELING WRONG WAY* E DARK— EDPUR CTIONIMG• F Tn.,N R OTNEw R: G BICYCLE C VC SECTION VIOLATION. ROADWAY SURFACE H ANIMAL: 72 3 a SOBRIETY—DRUG— IA DRY D VC SECTION VIOLATION: PHYSICAL B WET I FI.ED OBJECT: (MARK 1 TO S ITEMS) C SNOWY—ICV E VISION OBSCUREMENT*: A MAO NOT BEEN DRINKING D SLIPPERY (MUDDY,OILY.ETC.) J OTHER OGJECT: B HEO—UMDaf IN..vaMCa F INATTK.11DN C.2D—NOT UNDER INILV.- ROADWAY CONDITIONS G sTo-a Go TNAP►IC DNED—IMPAIRMENT URKN• MARK 1 TO 31TEMS) PE'_IEETRIAN'S ACTION M ENTERING/LRAVIMG RAMP E UNDER DRUG IN►LUf MCa•t A HOLES,Dail'RUTS• SIA NO P[Da STRIA. INVOLVED I ►Ra MOUS COLLISION FIMPAIRMENT—FNY*ICAL• B LOOSE MATERIAL ON PGADWAV• CROSSING IN CROSSWALK J UNFAMILIAR WIT"ROAD G IMPAIRMENT NOT KNOWN B C OBSTRUCTIO.ON ROAOWLV• AT INTlRSE CTION K DEFECTIVE VEN.EQUIP.: H NOT AFRICA BLE D CON STRVCTION-REPAIR -ONE CROSSING IN CROSSWALK—NOT I SLEEPY/FATIGUE. E F[DU C[D ROAD v WIDTH !C AT INTE PS[CTIOM L VNINVOLV[C VEHi CLE 1—�F FLOODED• D CR c5S1N.:—NOT IN Cw OSSWALK 1 M OT.*.': 1 2 3 0 SPECIAL INPORMATiON ! IG oTH ER•' E ROAD--INcw DEs cHDULDCA N w-Hc Al-- iA w 2AR000S MATERIALS* j iio UN US..A, CONCtTioNs �F NC_ IH ROAD O P:Jwa WAY "ff—CLE 8 rlwa INVOL—D• --- — 1G A ROL=WING!L[4VING SC-ODI BUS _------ C TIE[ DRracT;r AILuwE• iSKETCH M15 C E LLA N EOUS j 1 I F ROE wCICA TE LL/ \\ I NORTH i 1 1✓� _ _ PHYSiC4L-lDESCR1PTtON OF PARTY G7 t I y HUNGER MAIN - - E7EE T Nf3aMT WataMT PRE•L Rr P•S HANE C.Ii:�Ma[R MO. DA`" YR. RC V.6 W[Rf NA [ '-"" - -.. .MO. 'DAY R. S, L/ H' 555—Page 2 ll�e, 5.04' OP; 042 *Explair, it ncrrc!ive STATE OP C. INJt11RED/WITNESSESMASSENGERS PAGE 3 _ DATE OF COLLISION TINS (1,1100) CIC NNUM.[R OPFICtw I.D. mu NNW MD wr 01 EXTENT OF INJURY("X"One) INJURED WAS("X"One) - WITNESS PASSENGER PARTY BEATING ONLY ONLY AGE SEXIATAL IMJURr S..... OTNER VI BiBL. COMPLAINT DRIVER PASS. IED. .ICP CLIfT OTNtw NUMBER POSITION IMJUwr INJUR1.f OF ►AIN ❑ ❑ ❑ ❑ 1:1 Li NAM./AOOR[f{/T[l.►NON. � �`� ��� KI\� - TRAM{IORTtR.Y/TAK.N TONJVR.D ONLY) Z. DEfCRI.E/NJURI.[' �ZCCx� 1=\Z t`n.]�. , }"C741 C OAT ; aZ 07= U:-TT &r---LP 3 0 I ❑ o - NAM[/A OOR[fTE L.IN ONE f,� �` �� � `� �� I TRANSPORTED BY/TAKEN TO (INJURED ONLY) DESCwI.E INJURIES ❑ S ❑ ❑ ❑ El El 11 ED LJ NAME/A OD Rt1if(Tt TUB ►;ONC�O / l� = ��� _p TRANSIOw TKD BY/TAKEN TO (INJURED ONLY) DESCRI.t INJURIES ❑ ❑ 1 'T L NwMt/AODRtff/76LE►NON[ TRAN{►O—MO BY/TA K[N TO (INJUR HO ONLY) D[SCRIBS IMJVRIES ❑ ❑ ❑ JEl 0 1 EI AM[/AOOPEff/TElF—ONE _ J TRANSPORTEC BY(TAKEN TO (IN—RED ONLY) ! DESCRIBE INJUwIES NA MC/wOORE iS/TCL6 Pr,ONE 1 TRANS FOPTtC BY/TAKEN TO (INJURCO ONLY) OBSCR:89 INJURIES i wE�a RE R'S NAME IGD.NUM B6R MO. DAY Yw. REYICMtRG NAMEMO. DAY YP. i CHF 555—Page 3 (Rev 5-84! QPI 042 -.r�Ar arti.t �'.��sas.-.�-_-- ..�.. .1.��.�._.v w.�... _aww_.. _-v� � �..e � �1� • •.��Y1�-ill�'.a'1ZiiTi-�Sa1�3:�-_ __ - �-1 Y:A:.-rJ-:t_a.ii FACTUAL DIAGRAM PACE y DATE b� COLLI{IOM 9 TIME (2400)7 NCIC MUM/FR OPFI/C In I.D. MYY/ER YO. 9 DAV / YR. / F� U f�O[ ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED (SCALE- I 1111111 Hi 1 111111111 111111111 111111111 11111111 1— ♦ a( ' INDICATE MORTM i I ! o � I i 4, I � a• 3• 3. 41 I ST. ... I f Al I' \ C iTY 6.7 41 L �LCJ ✓E . I 7" r � 7.. i B �.. 2,. 3.. 4.. 6.. 6.. 7.. oFC• FEF�S,hAME , � ' � I.D. hJM/E F. i MO. DAV V�FEVIC WEFT{NAME YO. DAV ♦R! CHP 555—Pa c 4 !Rev&82'; OPi 042 IL, • J PAGE � � CN[Ch ON[ CNlCR ONE J NARRATIVE/SUPPLEMENTAL NARRATIVE D SU►►LEM ENTAL COLLISION REPORT ❑ OTHER: DATE OF ORIGINAL INCIDENT TIME j (2tDs) NCGC MUMEER OIFICIR I.D. MUMMER MO. , DAY .YR, G>.S V\ 1 D AD S CITY/COUNTY/JUDICIAL DISTRICT NEIOw TING OIMTRICT/MEAT CITATION MUMMER LOCATION/sUEJKCT ,. F RCT-S.4' l TZ-ELLL.UL�ll F� CAC-L CSF' 144-1 I1-75r Acc2zL,L_T 2. ]. P�m IU'_Ar,. C. - A , (lig/�?ox, Iq►?�2 u�� r T HL Sc. & ALS a - � ��;�UX. a I,-4. 5. I 2L- tF-7L 7o F-4c76.c "gL a. CSE. S : 9. V-/ W f?S I O C f? /=-T A rL)0i-2 1 N—V IL `/ j3-ZILcC -Z CD C:�E-11 Ci D /-2,4 fin ,,. FL,-);L rn E(? SL.ZCn-,L�l� . :. )Amcv.-ii)?1.,3Lx-iQZ /7-7Ec.y.4 14. U- cy. Lam n.S I_ c' L - 0 z,: _/ [ , �t �.c S t' r. c 1.z(f -Z!^u A A 15.. .i Z L= rte.a I,V- ;? c.=,:�,Z 7c) 16. L"''a S Lc 7-.?q—'7 rt-,E-1 t--'7 i t7, Gv,tic `iD ,I'a nii-G. a%r'z�.� FL /�Ci-CCi_( .c� e:i2L 19. I 19. 20. _ z�1 i� C/ rc: i=%�c , L F c Vic=�;,3C i Zvn- ✓-a 7 L1 119 L i i� RC�Aw[w'[ N/1M! I.D. MUMMER YO. DAv YR, �'R[y;[W ER's MAME MO. OAY YR, CHP 556 'Rev 4B3;OPI 042 Use previous editions unti;depleted. . � � ►AOS � .• GNSCK ON[ CHUCK DS ft. NARRATIVE/SUPPLEMENTAL NAR RATI.a NO SU►►Lt MKNTAL COLLISION Rt►ORT ❑ OTNtR: VATS o► ORIOINAL INCIDKNT TIPS (SAN) NC/C NUYKKw OWIICSR L.D. NUYSSK MO. DAY .YR 5 CIT'/COUNTY/JUDICIAL DISTRICT RKPORTINO DISTRICT/S[AT CITATION NurSSR LOCATION/SUSJKCT STI;TEAD S TO l`ES LL..))q S LL n-r-1 3 C i 7CI c-L-,c .q O'l1���1��iC STJq:c-.-, 7 - -A"'4-7 Y-ZLs 2-72AIiLz- Z2c. s. G y c S �(- D>- i. ALL o F SLs s1' J=.z =.-u 9. LL-)E i2 L l(L) OF V-/ C.L. 1 / N 7-HC—JA- rel f 1 L J A- 2. rri t:� A !t(i-") Q 051, t' = ,-+ L t cn-� c.�Co��.G �� LSco .y'_l Ya/LD S��Lcti L4-, 7L,c_ 15.. �7C1 JA ✓�. y� �,ZE API��Ldr. SD / - 1�6. eE 17. _ L E-) 7 U S70 P TO:t %NL. mos :r 1 S6g- ,' e2 19. 20. 21. s�i?;� �IS[�A R-R 1 AA Y[ I.D.NYM[Kw YD. DAv YR, R[VI[NKR'S.MAYK MO. DA• YR. I -HP 55E. {Fe. 4$3i pPi 042 Use previous editions untii depleted. osr . 'P•.. . - PAGE _ CN[CR ONH CHECK ONE NARRATIVE/SUPPLEMENTAL NARRATIVE ❑ SUPPLEMENTAL 0 COLLISION REPORT ❑ OTHER, DATE O.' ORIGINAL INCIDENT TIME 12000 "CIC NUMBER OFFICER I.D. NUYBE" NO. , � •DAY G YR. L]� CITY/CO.INTY/JUDICIAL DISTRICT REPORTING DISTRICT/BEAT CITATION NUMBER LOCATION/SUBJECT N�SLL`-1 Avg 6, 6. -S lJF-1 71 7. TZ L L E 1 L i't..`( 1� �^ to Co moi[L�'1-� 7 E. L U\ 07- _Lm t`'(\C.,1 6. T 1-t c- O,i, (U- 1 VS . V-�. ( v 11S L U Cs4 A�2C� P Ii D -X\-� I-a^J 0 T F I F i 'ST. ti'-N,,-]r, A?P R UQ'. ►D ' (v 'moi �-'� �� ��, tvo.L. : . �� �i L�J � r iZvc.c�►�- 07 ,s.. T l 1 S C CSL_ S Q)_ P, L L C � t�l�< <�11 - YUP tN- `!�'•� TL L >—(J1Z d3J:d za. �IA. I 2S. _ ~Rl11w[p'f AAM[ 1,0. A_NBER I YO. DAY YR. TF[VI[M[R'6 nAME YD. OAY YR. CHP 556 iRe.4.$3}OPl 0:2 Use previou,edhions until depleted. ;s= • CMaCR ONa CNaCR own O, NARRATIVE/SUPPLEMENTAL � NARRATIV9 ❑ SU►►LUM[NTAL COLLISION RR►ORT ❑ OTNiR: DATa qr ORIOI6AL/NeloaatTIYa (as[[) Nele NuraaR O►r`icaR I.D. "unman ro. awY YR. ��o IDa 8� CITY/COUNTY/JUDICIAL DISTRICT RaPORTINO DISTRICT/a[AT CITATION LAUNDER LOCATION/SUaJUCT c�- n 4. 9. 9. 9. I0. ii. 12. 1L. f1. 16. 117 1B. I!9. rz f I 21. I if 22. I Z2. i L. I 2�s• -- ._ �rRL•Aq[Rf NAY[ Rm7_0*Av Yq-A[VI[M[►'1 NAM[ YO. DAY Vq. CHP 555 ;Rev 4-8-21 OPE ,42 Use previous editions untl: depleted. 1. Claim denied 2 . Monette Ernest D /.go CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Claim Against the County, or bistriet ) NOTICE TO CLAIMANT October 22, 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: Helen Whittie Attorney: �'41011tixn Address: 577 South 28 Street - SEP 2 Q 1985 Richmond CA 94804 transmittal Amount: $160. 00 By delivery to clerk on SepogWMZ; (22451985 Date Received: September 20, 1985 By mail, postmarked on September 5 . 1985 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: S ep t. 2 O_, 19 8.a`PHIL BATCHELOR, Clerk, By ° Deputy QA n CerNZ l II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) ( 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. 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: 9 2 3 s_ By: 2 Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present ( This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Boardfs Order entered in its minutes or this date. Dated: OCT 2 198 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this. document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimants right to apply for lea to p sent a late claim was mailed to cl DATED: OCT S5 PHIL BATCHELOR, Clerk, By , Deputy Clerk cc: County Administrator (2) County Counsel (1) eCAI ''TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day 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. (Sec. 911. 2 , Govt. Code) 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 (or mail to P.O. Box 911, Martinez, CA) 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 end of this form. RE: Claim by ) Reserved for Clerk' s filing stamps ) RECEIVED Against the COUNTY OF CONTRA COSTA) SEPAO1ms or DISTRICT) PW SATCOCON (Fill in name) ) I-6Z ee�e ��osr v O.J 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 di-d-the-d-amage or--i-njury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details, use ex4i sheets if required) ----- -------- -------------------------- 4 . What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? tic n� 7 �/z_ (over) t t 1 � • •5. What are the names of county or district officers, servants-_;Ax-< I 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) 4(,40,00 S_ 7zyeF DISH -Sc 2- NSti 7� -,20.00 v Zc�� �C l Y�?�. 3 - vlf5 E / �v. Ll - - 30, �o ------------------------------------------------------------------------- 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. 9 . List the expenditures you made on account of this accident or injury. � •�- -� *^-��- ITEM AMOUNT Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney 1 imant' s S 'gnature , J /. � A4dress Telephone No. Telephone No. S b NOTICE Section 12 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, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill , account, voucher, or writing, is guilty of a felony. " i PROPERTY DAMAGE RELEASE FOR AND IN CONSIDERATION of the payment to meius at this time of a draft in the sum of r'D� > _ Dollars ($ the receipt of w ich is hereby acknowledged, I/we, Ing of lawful age, d hereby release, acquit and forever discharge_ .�-�:, -,�7; �_,c_-.�2 /h L r?4 �`iC� of and from any and all actions, causes of action, claims, demands, damages, costs, loris of services, expenses and compensation, on account of, or*in any way growing out of, any and all known and unknown property— dsmage resulting or to result from accident that occurred on or about the C% day of at or near 577 In making this release and agreement it is understood and agreed that 1; we rely wholly upon my,our own judgment, belief and knowledge of the nature and extent of said property damage, and that I-we have not been influenced to any extent whatever in making this release by any representations or statements regard- ing said property damage, or regarding any other matters, made by the persons, firms or corporations who are hereby released, or by any person or persons representing him or them. It is further understood and agreed that this settlement is the compromise of a doubtf ul end disputed claim, and that the payment is not to be construed as an admission of liability on the part of .,,x. / 4� -/Z /-7E 6` Y , by whom liability is expressly denied: It is further acknowledged that I/we hereby expressly waive the provisions of Section 1542 of the CIVIL CODE OF THE STATE OF CALIFORNIA, which reads as follows: "A general release does not extend to claims which the creditor does not know or suspect to exist in his favor at the time of executing of the release, which if known by him must have materially affected his settlement with the debtor," This release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are contractual and not a mere recital. I/we further state that I/we have carefully read the foregoing release and Code Section and fully under- stand the same and I/we sign the same as my/our own free act. WITNESS hand and seal this j day of Jc�t�✓i,���� 19 In Presence of: CAUTION: READ BEFORE SIGNING (peal) (seal) (Seal) (Seal) SSP 6 � ,�"� ���� jt�-x"„' • c v y L LJ- Loi 4-1 " _ f , 3 .� �?L, mac•, �� � ��j V C_ ;� �� .. �. �., �•, `� �; -. �""� { 'r i ` 7 �69 Z�/tiC h IC C Li R. L ` 4w t' N I4 dl. k r" c,. f.� 1. Claim denied i 2. Whittle Helen 4 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COLgM, ''CALIFORNIA BOARD ACTION Claim Against the County', or District ) NOTICE; TO CLAIMANT October 22 , 1985 governed by the Board of Supervisors, ) The copy of this document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". Claimant: JESUS LOERA Attorney: Stanley T. Grydyk Attorney at Law Address: 4006 Macdonald Avenue EP Q O 1985 Richmond, CA 94805 Amount: $250, 000. 00 By delivery to clerk on Martinez, CA 94553 Date Received: September 20, 1985 By mail, postmarked on Spat-PmhPr 1 () , 11995 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: Segt . 20. 1985 PHIL BATCHELOR, Clerk, By a Deputy Ann Cervel,l' II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) (�) This claim complies substantially with Sections 910 and,1910.2. ( ) 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. 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 0 By: I_ /L_ Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant „(Section 911.3). IV. BOARD ORDER By unanimous vote of Supervisors present CX) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of th Board's Order entered in its minu,t;�t 1 date. Dated: lJ PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. Code Section 913) '' Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703• ( ) Awarning of claimant's right to apply for le a to pr ent a late claim was mailed DATE UAQCc H 1985 PHIL BATCHELOR, Clerk, By , Deputy Clerk cc: County Administrator (2) County Counsel (1) i I RECEIVED 1 CLAIM AGAINST PUBLIC ENTITY' TO: Clerk of the Board of Supervisors SEPI`' 1995 Contra Costa County WK 8A1a+t1C* 651 Pine Street ItssAOF' mons Martinez , CA 94553 JESUS LOERA hereby makes claim against Contra Costa County and the County Hospital for the sum Of $250 , 000 and makes the following statements in support of the claim: 1. Claimant' s post office address is 1347 Lake St. , San Pablo, California 94806 . 2. Notices concerning the claim should be sent to Stanley T. Grydyk, Attorney at Law, 4006 Macdonald Ave. , Richmond, CA 94805 . 3. The date and place of the occurrence giving rise to this claim are July 5 and 6 , 1985 at the 'County Hospital in Martinez, California. 4. The circumstances giving rise to this claim are as follows : Claimant' s spouse went to the County Hospital on Friday, July 5 , 1985 with stomach pain. Diagnosis and treatment was given for a bladder infection. At 1 : OO ,a.m. on July 6 , 1985 , claimant' s spouse was taken to Kaiser Hospital, Richmond, where a diagnosis of ectopic (tubular) pregnancy was made and arrange- ments made for immediate ambulance transport and surgery at the county hospital. Claimant' s spouse arrived at the county hospital at 4 : 00 a.m. and surgery was to be at 8 :00 a.m. Surgery was not performed until 6 : 00 p.m. of July 6 , 1985 after the tube ruptured. As a proximate result of said negligence to properly diagnose said condition on July 5 , 1985 and to properly treat and care for claimant' s spouse on July 6 , 1985 , claimant has suffered and will suffer damages of pain, suffering, loss of affection, society and spouse ' s inability to bear children in the future. 5 . Claimant' s injuries are described in the preceding paragraph. 6. The names of the public employees causing the claimant' s injuries are unknown. 7 . My claim as of the date of this claim is $250 ,000. 8. The basis of computation of the above amount is as follows: General damages : $250 , 000 . 00 Dated: September 18 , 1985 r /'�~ LG /• SCG -STANLEY T. G7K, Attorn or Claimant I. Claim denied I 2. Laera Jesus t !..?p APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA and Ex-Officio as the Governing Board of Contra Costa BOARD ACTION County Flood Control and Water Conservation Dist. October 22 , 1985 Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. Claimant: JACK STA14GEL County Counsril Attorney: Francis X. Driscoll SEP 2 5 1985 1990 N. California Boulevard, Suite 802 Martinez, CA 94553 Address: Walnut Creek, CA 94596 transmittal Amount: $250, 000. 00 By delivery to Clerk on ; SPrtPmhPr �5, 19f�5 Date Received: September 25 , 1985BY mail, postmarked on I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: Sept. 25 , 19 8 5PHIL BATCHELOR, Clerk, By 0a Deputy Ann Cervelli II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). �) The Board should deny this Application to File Late Claim (Section 911.6). DATED: q 1 Z� KS VICTOR WESTMAN, County Counsel, By t�. /, jUz Deputy III. BOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 911.6). (�) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATE: OCT 2 21985 PHIL BATCHELOR, Clerk, By ° Deputy WARNING (Gov. Code §911.8) If you wish to file a court action on this matter, you'must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of any attorney of your choice, in connection with this matter. If you want to consult an attorney, u should do so,, immediatel . IV. FROM: Clerk of the Board TO: 1 County Counsel2 County Administrator Attached are copies of the above Application. We notified the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. 1985 PHIL BATCHELOR, Clerk, By DATED:: OCT 2 2ODeputy V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By ,. County Administrator, By A nnT T!v A TTn1T Mn L'TT V T A IV rT ATM FRANCIS X. DRISCOLL, ESQUIRE S' D . DATE: September 10, 1985 SEP - X65 PUBLIC WORKS DEPARTMENT 255 Glacier Drive T0: CONTRA COSTA COUNTY FLOOD CONTROL Ma-nez, Calif. AND WATER CONSERVATION DISTRICT 10T' 255 Glacier Drive Martinez, CA, 094553-4897 r RE: STANGEL CLAIM ENCLOSURES: 1. Application for Reconsideration of Claim, etc. F 2. Declaration of SACK STANGEL, etc. 3. Notice of Claim cooy't These are furnished for the purpose designated below: ( ) Your signing and returning the enclosures in the enclosed envelope ( ) Filing ( ) Issuance of Process ( ) Filing and returning of the endorsed, filed copies in the envelope provided. ( ) Recording and returning to the undersigned ( 1 For your records and information ( ) My check (in the amount of) (not to exceed) $ to cover costs/fees. Kindly return your receipt. ( X ) Other: Please present to the Board at the earliest opportunity. V�y truly yours, DECEIVED t: S E P,z INS GATCOgIC Secretary Dof Sty a Enclosures ATTORNEY AT LAW/ 1990 N. California Blvd., Suite 802 / Walnut Creek, CA 94596 / (415)944.9303 TELEX: 338510 RANCIS X. DRISCOLL, ESQ. RX-ECEIVEL 1 990 N. California Blvd., Suite 802 2 alnut Creek, Ca. 94596 415) 944-9303 SEP-15' INS 3 Nttorney for Claimant, a P tTCwtof �C O.� 115 4 5 ACK STANGEL APPLICATION FOR RECONSIDERATION 6 Claimant, OF CLAIM AND/OR IN THE ALTERNATIVE 7 vs. FOR LEAVE TO PRESENT LATE CLAIM PURSUANT TO 8 ONTRA COSTA COUNTY FLOOD GOVERNMENT CODE SECTION 911.4 ONTROL AND WATER CONSERVATION 9 ISTRICT 10 Respondent. 11 TO CONTRA COSTA COUNTY FLOOD CONTROL AND WATER CONSERVATION 12 ISTRICT: 13 141. Application is hereby made to reconsider the Claim filed herein on August 13, 15 1985, by Claimant JACK STANGEL, a copy of which is attached hereto and incorporated 16 erein as if fully set forth. 172. The request for reconsideration is based on the ground that injury from a 18 rolonged flooding of land is of a continuing nature, and the owner is entitled to treat 19 he claim as one that keeps accruing from time to time and present periodic claims 20 s the damage persists (Natural Soda Products Co. Vs. Los Angeles (1952) 109 CA2d 21 40, 240 p2d 993), or he may treat the entire sequence of events as the occurrence 22 from which the claim arose and compute the time for claim presentation from the ast event in the series. 23 24 25 26 27 28 ' M 1 See Natural Soda Products Co. Vs. Los Angeles (1943) 23 C2d 193, 143 p2d 193, 143 2 2d 12 (flooding); Amador Valley Investors Vs. Livermore (1974) 43 CAM 483, 117 CR 3 49 (repeated discharges of treated sewage). See aksi Aaron Vs. Los Angeles (1974) 4 0 CAM 471, 115 CR 162. 5 3. In the alternative, Claimant seeks leave to present a late claim as the 6 ailure to present this claim within the statutory period was, through mistake and/or 7 urprise, and Contra Costa County was not prejudiced by this failure, all as more 8 articularly shown by the attached Declaration of JACK STANGEL. 9 4. This application is being presented within a reasonable time after accrual 10 f this cause of action, as more particularly shown by the attached Notice of Claim. 11 5• Finally, the Respondent has had knowledge of all the facts enumerated 12 n the claim from the time of their happening. 13 WHEREFORE, it is requested that this application be granted ant that the 14 attached proposed claim be received and acted on in accordance with Sections 912.4-913 15 f the Government Code. 16 17 ATED: September 9, 1985 18 FRANCIS X. DRISCOLL Attorney for Claimant, 19 JACK STANGEL 20 21 22 23 24 25 26 27 28 1 rancis X.' Driscoll, Esq. 1990 N. California Blvd., Suite 802 2Walnut Creek, CA 94596 415) 944-9303 3 4 ttorney for Claimant 5 6 7 8 IN THE MATTER OF THE CLAIM OF JACK STANGEL 9 10 ACK STANGEL DECLARATION OF JACK STANGEL FOR RECONSIDERATION OF CLAIM 11 Claimant, AND/OR IN THE ALTERNATIVE FOR LEAVE TO PRESENT LATE 12 S. CLAIM PURSUANT TO GOVERNMENT CODE SECTION 911.4 13 IONTRA COSTA COUNTY FLOOD ONTROL AND WATER CONSERVATION 14 ISTRICT 1 Respondents. / 16 17 1s I, JACK STANGEL, declare and say that: 19 1. I am the claimant in the above entitled action. The I facts set forth 20 erein are known personally to me, and I could and I would truthfully testify thereto 21 f I am called to so testify. 22 2. Our property at 3209 Lunada Lane, Alamo, California has been subjected 23 o heavy flooding for some time now. The flooding still continues. The latest incident 24 f flooding having taken place long after this claim was filed with the County and 25 he Flood Control Department on or about December 14, 1983. 26 27 28 1 3. On or about theweekend of October 1 - 3, 1983, after some heavy 2 looding, I called the County and demanded an appraisal of what it was going to do. 3 Initially, a maintenance man came out who checked the creek and said everything was 4 O.K. 5 4. I was furious. However, since then I have talked to Mr. Milton Kubicek, 6 Deputy Director, Operation and Flood Control, who came to assess the extent and 7cause of damages to our property. 8 5. On his specific recommendation, county workers came in and dredged the 9 reek to a level of about 5 feet deep. 10 6. Mr. Kubicek even told me that he had personally recommended that the 11 ounty underground the creek but that he was voted down by the Flood Board of 12 Supervisors who wanted to spend $75,000.00 somewhere else below our property. 13 On the basis of the foregoing, it is evident that the County is well aware of 14 he problem. They want to ignore the problem though and intend to spend money 15 somewhere else. Obviously the County cannot be prejudiced by its own decision. 16 17 I declare under penalty of perjury the foregoing to be true and correct this was 18 xecuted on September 9, 1985 at Walnut Creek, California. 19 20 / 21 J, K S AN 22 laimant 23 24 25 26 27 28 r i I FRANCIS X. DRISCOLL, Esq. 1990 N. California Blvd., Suite 802 Walnut Creek, CA, 94596 2 (415) 944-9303 3 Attorney for Claimant 4 5 IN THE MATTER OF THE CLAIM OF JACK STANGEL 6 ACK STANGEL NOTICE OF CLAIM 8 Claimant, 9 s. 10 ONTRA COSTA COUNTY FLOOD CONTROL DEPARTMENT and 11 ONTRA COSTA COUNTY, 12 Respondents 13 14 JACK STANGEL hereby presents this claim to the CONTRA COSTA COUNTY 15 LOOD CONTROL DEPARTMENT and CONTRA COSTA COUNTY ("Respondents" 16 ereinafter), pursuant to Government Code Section 910. 17 1. The name and post office address of Claimants are as follows: 18 Jack and Constance Stangel, 3209 Lunada Lane, Alamo, CA, 94507. 19 2. The post office address to which Claimants desire notice of this claim 20 o be sent is as follows: 21 FRANCIS X. DRISCOLL, Esq., 1990 N. California Boulevard, Suite 802, 22 Walnut Creek, CA, 94596. 23 3. Claimant has owned the property at 3209 Lunada Lane, Alamo, California, 24 ince May of 1968. The deed provides for a drainage easement of 35 feet wide 25 xtending 115 feet across the back of the lot. Over the past 15 years, the County 26 Flood Control Department has done minimal maintenance with the Creek, but has not 27 esolved the problems created by the condition of the Creek. 28 1 4. A Creek at the Southeast border of the Stangel property flooded in 1982. 2 The County has been working on this Creek to correct the conditions since then. 3 This has caused loss of land, trees, and landscaping on this property, which is continuing 4 to the present. 5 5. This continuing damage has not only resulted in the loss of property, but 6 has and continues to cause mental anguish to the owners of this property. 7 8 PRESENT PROPERTY DAMAGE to date is estimated at $150,000, and, 9 PRESENT MENTAL SUFFERING AND ANGUISH estimated at $100,000 10 TOTAL $250,000 12 13 FRANCIS X. DRISCOLL Attorney for JACK STANGEL, CLAIMANT. 14 Dated: August 12, 1985 15 16 17 18 19 20 21 22 23 24 25 26 27 28 fay 1. Claim late appl denied 2. Stangel Jack