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HomeMy WebLinkAboutMINUTES - 01201987 - 1.21 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 2 0 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of _California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $750 , 000. 00 Section 913 and 915.4. Please note all "Wawm9pty Counsel CLAIMANT: DEBRA SUCH a. Loc.c X A-r-h JAN 0 G 1987 Law Offices of Steven A. Greenfield ATTORNEY: 1460 Maria Lane #320 Martinez, CA 94553 Walnut Creek, CA 94596 Date received ADDRESS: BY DELIVERY TO CLERK ON December Z6 , 1986 BY MAIL POSTMARKED: December Z4, 1986 Certified P 735 144 717 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 31 , 1986 BbIL Bepu ATCyELOR, Clerk L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� This claim complies substantially with Sections 910 and 910.2. ( ) This .claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: � l Dated. ��cY BY: ` /�-�C�lC r�e�ut�County Counsel 1II. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present NThis Claim is rejected in full. ( )) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JAN 2 0 1987 PHIL BATCHELOR, Clerk, By � _,� Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 2 1 1987 BY: PHIL BATCHELOR by G�ee Deputy Clerk CC: County Counsel County Administrator 1 LAW OFFICE OF RECEIVED 2 STEVEN A .GREENFIELD Creekside Oaks Office Park 3 1460:Maria Lane - Suite 320 Walnut Creek,California 94596 4 ` 5 ATTORNEY FOR DEBRA BUCH 6 7 CLAIM AGAINST COUNTy Oil CONTRA COSTA 8 AND CONTRA COSTA COUNTY HEALTH_SERVICES 9 10 11 TO: Clerk or the Board of Supervisors 12 Countv of Contra Costa 651 Pine Street 13 Martinez , California 94553 AND TO: Administrator , Contra Costa County 14 Health Services Merrithew Memorial Hospital 15 2500 Alhambra Avenue 16 Martinez , California 94553 17 AND TO: Contra Costa Sheriff ' s Department Detention Division 1000 Ward Street 18 Martinez , California 94533 19 CLAIMANTS : Debra Buch and Lou Buch 20 140 Mt . Etna Clayton , California 94507 21 AMOUNT OF CLAIM : ( 1 ) Debra Buch 22 General and special damages for severe physical injury to Mrs . 23 Buch ' s shoulders , face and head as well as to her health , strength 24 and activity , shock and injury to her nerves and nervous system, 25 and great mental and emotional distress , including , but not 26 limited to, mental and emotional distress and anguish from being 27 deprived of proper medication and medical supervision . Medical 28 expenses to date: $2 ,617 . 95 and continuing . Total claim is 1 $750 ,000 . 00 . 2 ( 2 ) :Lou Buch General and special damages for 3 loss of consortium and .performance of his Wire, Debra 'Buch ' s necessary 4 duties and services usually per- formed in the care, maintenance and 5 management of the family home . Total Claim: $750 ,000 . 00 . 6 ADDRESS TO WHICH NOTICES SHOULD BE SENT: LAW OFFICES OF STEVEN A. GREENFIELD 7 1460 Maria Lane, Suite 320 Walnut Creek , CA 94596 (415 ) 939-6222 9 DATE OF OCCURRENCE : November 6-8 , 1986 10 PLACE OF OCCURRENCE: Contra Costa County Detention Facility, Martinez , CA 11 and Merrithew Memorial Hospital 12 Martinez , California 13 HOW DID INCIDENT OCCUR: Beginning on November 6 , 1986 claimant was deprived of her pre- 14 scribed medication while in custody at the Contra Costa County 15 Detention Facility . Claimant had provided the prescribed medica- 16 tion (Xanax) to the officer upon entering the facility, and the 17 prescription was clearly marked on the medication bottle ( 3 times 18 a day ) . Despite numerous assurances that she would receive 19 her medication , Mrs . Buch was not given the medication . On 20 November 8 , 1986 , Mrs . Buch was given an unknown substance and 21 promptly went into convulsions , falling to the ground , dislocating 22 her left shoulder , breaking her glasses , suffering cuts , bruises 23 and contusions to her face . 24 On November 8 , 1986 while at the Merrithew Memorial Hospital , Mrs . 25 Buch continued to experience convulsions . Physicians , nurses , 26 staff and agents of the County Hospital were negligent in the care 27 and tr-eatment , and in failing to 28 C 4 e properly treat and care for claim- ant or in properly performing medical and hospital services for 2 claimant , failing to restrain • claimant who fell out of bed during 3 another convulsion and dislocated her -right shoulder . 4 _ DATED: 5 6 STRVEN ..A . GREENFIE 7 Attorney for Clai ant 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 • CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20, 187 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice o California Government Codes. ) the action taken on your claim by'the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $750, 000. 00 Section 913 and 915.4. Please note all •WarnQWn'iy C� " Lm C, CLAIMANT: DEBRA BUCH AND LOU BUCH Detention Facilit yJA N 1 6190-7 Law Offices of Steven A. Greenfield foertire ATTORNEY: 1460 Maria Lane, #320 z, CA 945,za Walnut Creek, CA 94596 Date received Januar 2 1987 CC vJ ADDRESS: BY DELIVERY TO CLERK ON Y BY MAIL POSTMARKED: no envelope 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. BATCHELOR, Clerk DATED: January 15, 19 8 7 IV!' Deputy L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors (� This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: B Pjpputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (X ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JAN 2 o 1987 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions. you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Goverment 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. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a Citizen of the United States. over age 16; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 21 i987 BY: PHIL BATCHELOR by • e� puty Clerk CC: County Counsel County Administrator J . is-ate 1 LAW OFFICE OF 2 STEVEN A .GREENFIELD Creekside Oaks Office Park 3 1460 Maria Lane - Suite 320 Walnut Creek,California 94596 �N d' 5 ATTORNEY FOR DEBRA BUCH 6 7 CLAIM AGAINST COUNTY OP C COSTA AND CONTRA COSTA COUNTY HEALTH SERVICES 8 --- -- -- -- — 9 10 11 TO: Clerk of the Board of Supervisors 12 County of Contra Costa 651 Pine Street 13 Martinez , California 94553 AND TO: Administrator , Contra Costa County 14 Health Services Merrithew Memorial Hospital 15 2500 Alhambra Avenue 16 Martinez , California 94553 AND TO: Contra Costa Sheriff ' s Department 17 Detention Division 1000 Ward Street 18 Martinez , California 94553 19 CLAIMANTS : Debra Buch and Lou Buch 20 140 Mt . Etna Clayton , California 94507 21 AMOUNT OF CLAIM: (1 ) Debra Buch 22 General and special damages for severe physical injury to Mrs . 23 Buch ' s shoulders , face and head as well as to her health , strength 24 and activity , shock and injury to her nerves and nervous system, 25 and great mental and emotional distress , including , but not 26 limited to, mental and emotional distress and anguish from being 27 deprived of proper medication and medical supervision . Medical 28 expenses to date: $2 ,617 . 95 and continuing . Total claim is 1 $750 ,000 . 00 . 2 ( 2 ) Lou Buch General and special damages for 3 loss of consortium and performance of his Wife, Debra Buc'n ' s necessary 4 duties and services usually per- formed in the care, maintenance and 5 management of the family home . Total Claim: $750 ,000 .00 . 6 ADDRESS 'PO WHICH NOTICES SHOULD BE SENT: LAW OFFICES OF STEVEN A. GREENFIELD 7 1460 Maria Lane, Suite 320 8 Walnut Creek , CA 94596 ( 415 ) 939-6222 9 DATE OF OCCURRENCE : November 6-8 , 1986 10 PLACE OF OCCURRENCE: Contra Costa County DeLerition Facility , Martinez , CA 11 anrI Merrithew Memorial Hospital 12 Martinez , California i3 HOW DID INCIDENT OCCUR: Beginning on November 6 , 1986 claimant was deprived of her pre- 14 scribed medication while in custody at the Contra Costa County 15 Detention Facility . Claimant had provided the prescribed medica- 16 tion (Xanax) to the officer upon entering the facility , and the 17 prescription was clearly marked 18 on the medication bottle ( 3 times a day ) . Despite numerous assurances that she would receive 19 her. medication , Mrs . Buch was not given the medication . on 20 November 8 , 1986 , Mrs . Buch was 21 given an unknown substance and promptly went into convulsions , 22 falling to the ground , dislocating her left shoulder , breaking her 23 glasses , suffering cuts , bruises and contusions to her face . 24 On r]ovember 8 , 1986 while at the Merrithew Memorial Hospital , Mrs . 25 Buch continued to experience convulsions . Physicians , nurses , 26 staff and agents of the County Hospital were negligent in the care 27 and treatment , and in failing to 28 properly treat and care for claim- ant or in properly performing medical and hospital services for 2 claimant, failing to restrain claimant who fell out of bed during 3 another convulsion and dislocated her right shoulder . 4 DATED: 5 A. 6 STEVEN GREt,14FIEO' 7 Attorney for Clant 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 r PROOF OF SERVICE BY MAIL -C.C.P. 1013a , 2015 .5 • 1 I declare that I am employed in the City of Walnut 2 Creek , County of Contra Costa , State of California . 3 I am over the age of eighteen years and not a party to 4 the within entitled cause; my business address is 1460 Maria 5 Lane, Suite 320 , Walnut Creek, California 94596 . 6 On December 24 , 1986 I served the attached: 7 8 CLAIM AGAINST COUNTY OF CONTRA COSTA AND CONTRA COSTA COUNTY HEALTH SERVICES 9 10 11 in said cause by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid , in the 12 United States mail at Walnut Creek , California addressed as 13 follows : 14 15 Clerk , Board of Supervisors Merrithew Memorial Hospital Contra Costa County Administrator_ , Contra Costa 16 651 Pine Street County Martinez , CA 94553 2500 Alhambra Avenue 17 Martinez , CA 94553 Contra Costa Sheriff ' s Department 18 1000 Ward Street Martinez , CA 94553 19 20 I , Debbie Gautney declare under penalty of 21 perjury that the foregoing is true and correct, and that this 22 declaration was executed on December 24 , 1986 , at Walnut Creek , California . 23 24 25 26 Re: DEBRA BUCH 27 Case No. 28 ` CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements. ) NOTICE TO CLAIMANT January 20, 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below). given pursuant to Government Code Amount: $750., 000: 00 Section 913 and 915.4. Please note all •Yarni�gS". C�o::r: y CLAIMANT: DEBRA BUCH AND LOU BUCH JAIN 1 Fi 1O�i Law Offices of Steven A. Greenfield ATTORNEY: 1460 Maria Lane, #320 ,y;��ci���,, CA ��JJ Walnut Creek, CA 94596 Date received ADDRESS: BY DELIVERY TO CLERK ON January 2 , 1987 CC BY MAIL POSTMARKED: no envelove Certified P 735 144 .'71R 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL ATCHELOR, Clerk DATED: January 15 , 1987 BY: Deputy L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors (�) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Gated: /S ; BY:� ut unty Counsel LV V 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (X) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JAN 2 0 1987 � � PHIL BATCHELOR, Clerk, By Deputy Clerk YARNING (Gov. code section 913) Subject to certain exceptions. you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all .tiims herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 21 1987 BY; PHIL BATCHELOR by -�____ Oeputy Clerk CC: County Counsel County Administrator 1 LAW OFFICE OF STEVEN A .GREENFIELD t Creekside Oaks Office Park RECEI 3 1460 3laria Lane Suite 320 lVatnut Creek,California 94596 tt 5 ATTORNEY FOR DEBRA UC 6 7 CLAIM AGAINST COUNTY OF CONTRA COSTA AND CONTRA COSTA COUNTY HEALTH_SERVICES 9 10 11 TO: Clerk or the Board. or Supervisors Countv of Contra Costa 12 651 Pine Street Martinez , California 94553 13 AND TO: Administrator , Contra Costa County 14 Health Services Merrithew Memorial Hospital 15 2500 Alhambra Avenue Martinez , California 94553 .16 AND TO: Contra Costa Sheriff ' s Department 17 Detention Division 1000 Warta Street 18 Martinez , California 945.53 19 CLAIMANTS : Debra Buch and Lou Buch 140 Mt . Etna 20 Clayton , California 94507 21 AMOUNT OF CLAIM: ( 1 ) Debra Buch General and special damages for 22 severe physical injury to Mrs . Bum ' s shoulders , face and head as 23 well as to her health , strength and activity , shock and injury 24 to her nerves and nervous system, 25 and great mental and emotional distress , including , but not limited to , mental and emotional 26 distress and anguish from being 27 deprived of proper medication and medical Supervision . Medical 28 expenses to date: $2 ,617 .95 and continuing . Total claim is 1 $750 ,000 . 00 . • 2 ( 2 ) Lou Buch General and special damages for 3 loss of consortium and performance of his Wife, Debra Buch' s necessary 4 duties and services usually per- formed in the care, maintenance and 5 managanen t of the family home . Total Claim: . $750 ,000 . 00 . 6 ADDRESS TO WHICH NOTICES SHOULD BF SENT: LAW OFFICF3 OF STEVEN A. GREENFIELD 7 1460 Maria Lane, Suite 320 8 Walnut Creek , CA 94596 ( 415 ) 939-6222 9 DATE OF OCCURRENCE : November 6-8 , 1986 10 PLACE OF OCCURRENCE : Contra Costa County 11 Detention Facility , Martinez , CA ani Merrithew Memorial Hospital 12 Martinez , California i3 HOW DID INCIDENT OCCUR: Beginning on November 6 , 1986 claimant was deprived of her pre- 14 scribed medication while in custody at the Contra Costa County 15 Detention Facility. Claimant had provided the prescribed medica- 16 tion (Xanax ) to the officer upon 17 prescription the facility, and the prescription was clearly marked 18 on the medication bottle ( 3 times a day ) . Despite numerous 19 assurances that she would receive her medication , Mrs . Buch was not given the medication . On 20 November 8 , 1986 , Mrs . Buch was given an unknown substance and 21 promptly went into convulsions , falling to the ground , dislocating 22 her lett shoulder , breaking her glasses , suffering cut: , bruises 23 and contusions to her face. 24 On November 8 , 1986 while at the Merrithew Memorial Hospital , Mrs . 25 Buch continued to experience convulsions . Physicians , nurses , 26 staff and agents of the County 27 Hospital were negligent in the care and treatment , and in failing to 28 PROOF OF SERVICE BY MAIL -C.C.P. 1013a , 2015 .5 1 I declare that I am employed in the City of Walnut . 2 Creek , County of Contra Costa , State of California . 3 I am over the age of eighteen years and not a party to 4 the within entitled cause; my business address is 1460 Maria 5 Lane, Suite 320 , Walnut Creek , California 94596 . 6 On December 24 , 1986 I served the attached: 7 8 CLAIM AGAINST COUNTY OF CONTRA COSTA AND CONTRA COSTA COUNTY HEALTH SERVICES 9 10 11 in said cause by placing a true copy thereof enclosed in a 12 sealed envelope with postage thereon fully prepaid , in the United States mail at Walnut Creek , California addressed as 13 follows : 14 15 Clerk , Board of Supervisors Merrithew Memorial Hospital Contra Costa County Administrator_ , Contra Costa 16 651 Pine Street County Martinez , CA 94553 2500 Alhambra Avenue 17 Martinez , CA 94553 Contra Costa Sheriff ' s Department 18 1000 Ward Street Martinez , CA 94553 19 20 I , Debbie Gautney declare under penalty of 21 perjury that the foregoing is true and correct, and that this 22 declaration was executed on December 24 , 1986 at 23 Walnut Creek , California . 24 /. 25 26 Re: DEBRA BUCH 27 Case No. 28 properly treat and care for claim- ant or in properly performing medical and hospital services for 2 claimant , failing to restrain claimant who fell out of bed during 3 another convulsion and dislocated her right shoulder . DATED: x STFVEN ..A-.: GREt,14FIE 7 Attorney for Cl ant 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by, the Board of Supervisors (Paragraph IV below), given pursuant to,4ovV rn. C de i Amount: $250, 000. 00 Section 913 and 915.4. Please note all��++"WWar��niings . CLAIMANT: KERI LYNN DORAN JAN 0 61987 25 Meadowbrook Circle Martinez, CA 94553 ATTORNEY: Pittsburg, CA 94565 Date received ADDRESS: BY DELIVERY TO CLERK ON December 23 , 1986 hand del . BY MAIL POSTMARKED: no envelope 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pH BB DATED: December 30, 1986 BrIL DeputX_LOR, Clerk L. Hall 1I. FROM: County Counsel TO: Clerk of the Board of Supervisors (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. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: -k ;�- t �!r BY: �/ C_.C'GL/`-['epuy County Counsel I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (J�) This Claim is rejected in full. ( �) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. JAN 2 0 10 7 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you-want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. JAN 21 1987 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLAIM TO: BOARD OF SUPERVISORS OF CONTRA CO§*AR Yapplication to: Instructions to Claimant0erk of the Board RIO M rtinez,Califomia 94553 A. Claims relating to causes of action for death or or 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 must be filed against each public entity. . E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end oof- this form. RE: Claim by )Reserved for Cler ' tamps RECEIVED ,J'•er•i Tann l�nrai) � 2', _ McRdn-"'hrnn'- r rnI e' Pitts - C) 01az A9ainst the CGUNTY OF CONTRA COSTA) or DISTRICT) SU (Filln name ) J"" The• undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $250, 000.00 and in support of this claim represents as follows: T7 When did the damage or �n�ury occur? Give exact date ani hour] September 30, 19YE, 9: 00 A .M. WFieze �i� tFie damage or �n�ury. occur? Zinc�ude city and countyS Juvenile Court, 825 Brown Street, Napa, Calif. 3. How did the damage or injury occur! (Give fuleta�is, use ext=a sheets if required) Ted Jorgenson of Contra Costa Family Court Council,not council to case, aquired a court order to send his prepared report based on his personal feelings about plaintif to the Napa Protective Service worker Miriam 1_1dri=au. Her report based on his report i$ hijhJ prejudice and now in e.Q_S�.p)at. �.St2r__1T� =;aaa_Y3�_�17Y��S4_i� rL3es-----�--- --- 47--ghat particu ar act or omission on the part of county or district officers, servants or employees caused the injury or damage? Plaintif and Lawyer Greta Wilson were not made aware of Mr. Jordensonts report or of its content . This clearly violates Section 4602 of the Civil Code . All attempts to obtain said report from Mr. Jorgenson have so far failed. Mr. Jorgenson indicated we needed a motion to a uire his report . Plaintif became aware of report about Sept . 27, 198�over) 5. What are the names of county or district officers, servants or' -employees cat'sing, the damage or injury? Mr.Ted Jorgenson, Family Court Counceling Supervisor 6. what damage or injuries 210 you claim resu�te�? ZG�ve dull extent of injuries or damages claimed. Attach two estimates for auto damage) Extreme emotional distress, financial distress, and outrages fees incurred. Reoort_ 1a�dbeen det:vamecgtal to me, to the safety of my ' t: ,--------------- 7. How was the amount claimed above computed? (Include the estimated - amount of any prospective injury or damage. ) .The persecution.,I .incurred and emotional,. financial, mental distress, and the expences of medical.mPntal health.and work lost . Lawyer fees .and serious concern of the. 6:afety of my children. All.still on going. ----------------- -w---------------- ----------------------------------- 6. Names and addresses of witnesses, doctors and hospitals. Miriam Landridan, C .P.S ., 3244 Old Sonoma Road Napa, Calif. 9+559 Judge Snowden, Superior Court,Napa County, 825 Brown, rlapa, Calif.94559 Steven Croyer, D.A . , 1125 Third St . Napa, Calif. 94559 Gretta Wilson, Attorney, 1615 Bonanza St ., Suite 403, Walnut Creek, Calif ( More K__List the expenditures you made on account of this accident or injury: DATE ( ITEM AMOUNT Not totalled yet . The prejudiced report based on Mr. Jorgensonls personal point of view was filed in Contra Costa to be used against plain-if in up coming hearing. Mr. Jorgenson, also has coiunitted other illegal acts that Je0pardized the healt'i and safety of my ni it�w�.cn;,.rx, �- Go t. ComeZ"`91"0.2 providesz "T a claim signed by he claimant SEND NOTICES TO: (Attorney) 0 by i(bKo, etib-h on is behalf. " Name and Address of Attorney ig ature ddre s - ys6 sr Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, ':or to any county, 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. " `�• . . •it -: - , CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20, 1987 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board ofrvisor (Paragraph IV below), given pursuant to Governmk?"�� o U nsei Amount: Unspecified Section 913 and 915.4. Please note all "Warnin"J'A'N U G 1987 CLAIMANT: CSI VENDING SYSTEMS ET AL Martinez, CA 94553 c/o Capps , Staples , Ward, Hastings & Dodson ATTORNEY: A Professional Corporation 1280 Boulevard Way #204 Date received ADDRESS: Walnut Creek, CA 94596 BY DELIVERY TO CLERK ON December 26 , 1986 BY MAIL POSTMARKED: December 24, 1986 . 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. HIL BATCHELOR, Clerk DATED: December 31, 1956 JY: Deputy L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors (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. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �� / , � ;7 BY: (�J e_< �c� ��-«--Cr-,,4, �ity_Cbunty Counsel I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (x) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order-entered in its minutes for this date. Dated: JAN 2 0 1987 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. JAN 21 19V Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ]RECEIVED Ec�CLAIM Pursuant to the notice requirements of Government Code Sections 910-911.2, the undersigned hereby presents the following claim against the COUNTY OF CONTRA COSTA. TO: CLERK OF THE BOARD OF SUPERVISORS YOU ARE HEREBY NOTIFIED that CSI VENDING SYSTEMS, and COFFEE SYSTEMS, INC., presents the following claim against the COUNTY OF CONTRA COSTA. 1. NAME AND ADDRESS OF CLAIMANT: CSI VENDING SYSTEMS, INC. and COFFEE SYSTEMS, INC., c/o CAPPS, STAPLES, WARD, HASTINGS & DODSON, A Professional Corporation, 1280 Boulevard Way, Suite 204, P.O. Box 5607, Walnut Creek, CA 94596. All notices should be sent to the above law office. 2. NATURE OF CLAIM: This claim is for indemnity/equitable contribution arising out of an action filed by DONALD R. ANDRADE, JUDITH A. ANDRADE, and MARIO S. JONES.. Said action is filed in the Superior Court of California, County of Contra Costa, Action No: 292812. Said Complaint alleges that on or about January 4, 1986, plaintiffs' decedent, SAMANTHA LYNN ANDRADE, was operating a 1979 Toyota Celica automobile, along and upon the generally eastbound lanes of San Pablo Dam Road, approximately 3,230 feet east of Tri Lane, Contra Costa County, California. At said time and place, defendant, SIONE SOILETI TAUSINGA ( deceased) negligently, carelessly, recklessly operated said 1974 Ford box- van vehicle upon the westbound lane of said San Pablo Dam Road so as to cause it to cross over into the generally eastbound lane occupied by plaintiffs' decedent, at which time a head-on collision occurred. Said Complaint further alleges that the injuries and damages were proximately caused by the negligence and carelessness of defendants. Said Complaint was served upon defendants, CSI VENDING SYSTEMS, COFFEE SYSTEMS, INC. , on or about November 17, 1986. 1 3. NATURE AND EXTENT OF INJURIES/DAMAGES: As indicated above, CSI VENDING SYSTEMS and COFFEE SYSTEMS, INC., seek indemnity and/or an apportionment of fault from COUNTY OF CONTRA COSTA in the event that any judgment is awarded to PLAINTIFFS as set forth in said Complaint. DATED: December 24, 1986 CAPPS, STAPLES, WARD, HASTINGS & DODSON A Prof M orporation By: KEN H C. WAID Attorney for aid defendants 2 :..._-CountY COUnsei 16l CLAIM JAN U fi 1987 60ARD 0t' SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Martinez, CA 84553 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Zovernment Codes. ) the action taken on your claim by-the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $25 , 000. 00 Section 913 and 915.4. Please note all •Warnings". CLAIMANT: LEE ALAN LACY c/o Virginia V. Hart ATTORNEY: Hart , Trice & Spunaugle Attorneys at Law Date received ADDRESS: 207 37th St. , BY DELIVERY TO CLERK ON December 26 , 1986 hand del . Richmond, CA 94805 BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL BATCHELOR, Clerk DATED: December 31 , 1986 BY: Deputy L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �' / �a p BY:i /i�� \% L r�-Iepd'ty County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in-its minutes for this date. Dated: JAN 2 Q 1987 PHIL BATCHELOR, Clerk, By 6 Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 2 1 1987 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator 1 RECEr- 6 2 HART , TRICE & SPUNAUGLE Attorneys at Law OEC ' 3 VIRGINIA V. HART . 207 - 37th Street 4 Richmond', CA 94805(415) 236-67815 Attorney for Claimant 7 CLAIM AGAINST CONTRA COSTA SHERIFF ' S OFFICE 8 9 1 . Name and address of claimant : LEE ALAN LACY 10 1030 Cragmont Avenue Berkeley, CA 11 2. Send all notices to : VIRGINIA V. HART, HART, TRICE & SPUNAUGLE , Attorneys at Law, 207 - 37th Street , Richmond , CA 12 94805 13 3 . Date of occurrence : 9124/86 14 Place of occurrence : Berkeley , CA 4 . Circumstances of occurrence : Upon claimant ' s arrest , he. 15 was handcuffed in a manner that exacerbated a previous elbow injury. He remained in handcuffs for an extended period of 16 time , including transportation from the City of Berkeley Corporations Yard to 1030 Cragmont , where he remained during 17 the execution of a search warrant and then to the Martinez 18 County Jail . 19 5 . General description of injury: injuries to the body and injury to the nervous system and person of claimant . 20 Physical and emotional injuries the exact extent of which are unknown at this time . These injuries include , but are 21 not limited to : injury to claimant ' s shoulder and arm , stiffening of the elbow and limited movement of the arm . 22 6 . Amount of claim and basis for computation : claimant has 23 been unable to obtain medical treatment due to his incarceration . Treatment will commence upon his release . 24 Therefore , the exact amount of his medical bills are unknown at this time . Claimant expects to suffer general damages 25 and special damages in the aggregate amount - of TWENTY FIVE THOUSAND DOLLARS ($25 , 000 . 00) , and makes claim therefore . 26 DATED: DECEMBER 18 , 1986 27 � 28 LE AN LACY ' s CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by-the Board of Supervisors (Paragraph IV below), given pursuant to GovernmePOMely Counsel Amount: $1, 000, 000. 00 Section 913 and 915.4. Please note all "Warnings"JAN a o 19v CLAIMANT: SAMUAL YOSHIOKA c/o Dale Minami, Esq. Martinez, CA 94553 ATTORNEY: Minani & Lew 300 Montgomery St. 7,`10.00. Date received ADDRESS: San Francisco , CA 9.4104 BY DELIVERY TO CLERK ON December 29 , 1986 BY MAIL POSTMARKED: December 23 , 1986 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 31 , 1986 BYIL �ep�tylOR+ Clerk L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This c a.imompI ' substantially ith Senctions 910 and 910.2 ell, GC �L X. ( ) This claim FAILS to comply ascan Tally with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). Claim is not timely filed The C1� should ret claim on ground that it was filvti late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated:0 � �i B : i-cL/.h.C.�--l4{.--A_C­,Deputy County Counsel v III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) (K) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( M Other: Portion of original claim not previously returned as untimely is rejected in full . I certify that this is a true and correct copy of the Board's Order entered in.-its minutes for this date. JAN 2 0 1987 Dated: PHIL BATCHELOR, Clerk, By C� Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. N 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. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 21 1987 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator - CL.FM. _ 2-75 CLAIM AGAINST THE C COUNTY OF CONTRA COSTA ,r \ Government Code Sections 910 to 911.2 requir that all claims must be presented to the O� Controller within 100 days from date of acc CLAIMANT'S NAME: SAMUAL YOSHIOKA AMOUNT OF CLAIM: $ 1 ,000,000.00 CLAIMANT' S ADDRESS: P. 0. Box 2171 Martinez , CA 94553 Phone 372-4416 ADDRESS TO WHICH NOTICES ARE TO- BE SENT: DALE MINAMI ESQ. MINAMI & LEW, 300 Montgomery St. , Suite 1000, San Francisco, CA 94104 (415) 788-9000 DATE OF ACCIDENT: Continuing, last ac-t on November 17„ 1986 LOCATION OF ACCIDENT: Health Services Dept, Martinez , CA. . HOW DID ACCIDENT OCCUR: Messrs . Mark Finnucane, Paul Ingels , and Pat .Godley have continued a pattern and practice of intentional infliction of emotional distress at least over this past year. (See ,Attachment A for further specifics) DESCRIBE INJURY OR DAMAGE: Deteriorating health, mental and emotional distress , interference with enjoyment of life. NAME OF PUBLIC EMPLOYEE OR EMPLOYEES CAUSING INJURY OR DAMAGE, IF KNOWN: Mark Finnucane, Paul Ingels , and Pat Godley ITEMIZATION OF CLAIM: (List items totaling amount 'set forth above. ) Medical/Counseling Expenses $ Unknown Future Loss of Income Capacity $ Unknown General Damages $ - 500,000,00 . �_ Punitive Damages $ 500,000.00 / 12000,000.00 r Signed by or on behalf of claimant: NOTE: CLAIM FORM MUST BE FILED IN DUP ' E. BOTH COPIES MUST BE SIGNED. ATTACHMENT A Over the past year, each of the named public employee continued a pattern and practice of harrassment , intimidation and intentional infliction of emotional distress by participating in decisions which resulted in adverse employment consequences as follows: 1 . Denial of opportunities to compete for vacant positions; 2 . Denial of promotions; 3. Refusal to process grievances properly filed under County Policy and Procedures; 4. Harrassment through requiring an extraordinary amount of time on computer terminal work while denying opportunities for other types of work; 5. Refusal to meet to discuss health problems ; 6. Failure to complete evaluations of Claimant as required under the policies and procedures; . 7. Failure to provide assistance to Claimant; 8. Failure to allow time off. Each employee had knowledge of Claimant ' s health and eye sight were deteriorating because of his overwork on computer terminal. Despite complaints, doctors ' letters and recommendations, Claimant is being forced to work on duties which not only jeopardizes health but precludes further advancement and opportunity to obtain experience. These individuals have acted with the knowledge that claimant is vulnerable and susceptible. Said employees are supervisors and/or managers superior to Claimant and have abused their position in causing injuries to him. o CLAIM JAN U 81981 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Ma rt$nex CA 845S3 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20, 1987 and Bor.rd Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim bythe Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $10. 4 Million Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PATRICIA A. CAZENAVE 111 Patricia Drive ATTORNEY: American Canyon, CA 94589 Date received ADDRESS: BY DELIVERY TO CLERK ON December 24, 1986 BY MAIL POSTMARKED: no envelope 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pH gg DATED: December 31 , 1986 BYIL DepuLjL Clerk L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors (�) This claim complies substantially with Sections 910 and 910.2. (/ ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) 'Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY:c>Lr ��Tc /c �.0 �..1E-�tpe�uty County Counsel L I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOAARX D ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JAN 2 O 1987 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 2 1 1987 BY: PHIL BATCHELOR byW?�/�Z"puty Clerk CC: County Counsel County Administrator ontra.Costa County r�. ► �` CE1 �� RECEIVED To: The COUNTY of CONTRA COSTA L CC ��1��� D E C 4 4 1986 Date: 24 December 1986 'sit non � Office of "A T unty Administrator eyr.......... I. Patricia A. Cazenave, hereby make claim against the COUNTY of CONTRA COSTA for the sum of $10.4 million, and make the following statements in support of the claim: 1 . Claimant's post office address is: 111 Patricia DR American Canyon, CA. 94589 2. Notices concerning the claim should be sent to the above address. 3. The place and date of the occurences giving rise to this claim are The COUNTY of CONTRA COSTA West Juvinile Court, 31 Oct 1986. 4. The circumstances giving rise to this claim are as follows: On 31 Oct 1986, agents of the County of Contra Costa delivered testimony which was the culmination of a farce of an investigation, initiated on 18 Oct 1986, by Child Protection Services: On initating the investigation CPS removed my step-children from the loving and secure home which I have provided for them, since December 1982. CPS placed the children in the control of their biological mother, Thelma J. Olsen. CPS was informed that Mrs. Olsen previously lost all custodial rights in Nov 1985, because she kidnapped the children in an effort to deprive myself and their father and the children of affections and the familial relationship. CPS failed to investigate. CPS was informed that Mrs. Olsen had subjected the children to mental cruelty, in that she constantly demeaned the familial relationship to the children. CPS ignored their duty given by CA. codes to investigate this. CPS has gone so far as to close their minds to statements made by the children themselves to their own agents, which maintain the truth in this matter. Although, CPS was ordered to insure visitation, they acted to limit visitations. Penny James was witness to the deterioration of the relationship and disregarded her duty to make reasonable efforts to return the children to their home. In breaching their mandatory duties of enforcement, proper investigation, and reporting, the county by it's agents, injured the claimant by contributing to deprivation and alienation of the the children's affections. Also, due to the extreme emotional distress suffered by the claimant, irreparable damage has been done to the claimant's marriage. 5. Claimant's injuries are extreme pain and suffering and insurmountable emotional distress. -1- 6. The names of public employees causing the claimants injuries are: Robert E. Jorlin Penny James Colleen Johnson Dr. James Carpenter 7. My claim as of the date of this claim is $10.4 million. 8. The basis of computation of the above amount is as follows: Alienation of affection of Step-Child Katrina D. Cazenave. 2.6 million Alienation of affection of Step-child Eugene J. Cazenave. 2.6 million Alienation of affection of Step-child Constance E. Cazenave. 2.6 million Emotional Distress, general 2.6 million Total: 10.4 million Dated: 12/24/1986 f��A��/ CSC•�_�.���'/'c-G�ct� Patricia K Cazena#b CLAIMANT -2- • CLAIM @I BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA JAN 061987 Claim Against the County, or District governed by) BOARD AC fU0Z, C the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20, 125/553 and Board Action. All Section references are to ) -The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim bythe Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: WILLIAM SHAWN YEAGER A MINOR, BY HIS GUARDIAN AD LITEM, SHIRLEY LUKENS c/o Gooding, Heidenreich & Shinnick ATTORNEY: Joan V. Heidenreich 535 Pacific Ave, 2nd Floor Date received ADDRESS: San Francisco, CA 94133 BY DELIVERY TO CLERK ON December 23 , 1986 BY MAIL POSTMARKED: December 17 , 1986 Certified P 334 170 987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 30 , 1986 gdl� �eputyLOR, Clerk L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors (,-4 This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated:4—L/t-- c 1 Y BY �/ %� �- 1�1 pu�Cy County Counsel I1I. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (X) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. JAN 2 01987 ` Dated PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. JAN 21 1987 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 4 f CROSS-CLAIM AGAINST THE COUNTY OF CONTRA COS1.1 TO: THE COUNTY OF CONTRA COSTA, CLAIMS DEP TME The following cross-claim for damages is hereby made by William Shawn Yeager, a minor by his Guardian ad Litem, Shirley Lukens against you and each of you and the particulars of the claim are as follows: a. Name and address of cross-claimant: William Shawn Yeager (a minor, by his Guardian ad 1544 Springbrook Road Litem, Shirley Lukens) Walnut Creek, CA 94596 b. The address to which notices are to be sent: Gooding, Heidenreich & Shinnick Joan V. Heidenreich 535 Pacific Avenue, Second Floor o San Francisco, California 94133 N C. Amount of cross-claim: No definite amount is alleged in plaintiff ' s. complaint. d. Date and place of occurrence: rn June 14 , 1986 at the intersection of 1544 Springbrook Road where the common driveway meets Springbrook Road in the County of Contra Costa, State of California. e. Other circumstances of occurrence: On or about September 9 , 1986 , minor William Shawn Yeager was served with a complaint filed in the Superior Court of Contra Costa. (see attached) . The action is brought by Nick Steve Skoumbas, a minor by Guardian ad Litem, Steve Skoumbas. Mr. Skoumbas was injured in the accident which occurred on June 14, 1986 when his automobile, which was travelling along Springbrook Road, collided with an automobile, driven by minor, William Shawn Yeager at the intersection of 1544 Springbrook Road. In this collision, Nick Steve Skoumbas alleged that he sustained severe personal injuries. f. Itemization of injuries : Plaintiff sustained an injury to his knee and back. g. This cross-claim is for contribution and indemnity against the County of Contra Costa for failure to maintain the area adjoining the roadway. DATED: December 17, 1986 GOOD HEIDEN CH & SHINNICK BY: J N V. HE E REICH At for defe nt WILLIAM SHAWN YEAGER, a minor by and through his Guardian ad Litem, Shirley Lukens 1 NICK T. RECKAS E 2 A Professional Corporation 465 California Street, Suite 200 3 Merchants Exchange Building AUG 7 1986 San Francisco, CA 94104 4 Telephone: .- (415) 989-8999 '. �, OLSSON, Cou ft COSTA CO Y j 5 Attorney for Plaintiff, W KAREN BRAY no" NICK STEVE SKOUMBAS 6 7 8 SUPERIOR COURT OF THE STATE OF CALIFORNIA -9 FOR THE CITY AND COUNTY OF CONTRA COSTA 10 11 NICK STEVE SKOUMBAS, a minor, Action No. oQ9gg40 12 by his Guardian ad Litem, Steve Skoumbas, 13 Plaintiff, COMPLAINT FOR DAMAGES. 14 (Personal Injuries) vs. 15 WILLIAM SHAWN YEAGER, and DOE 16 ONE through DOE TWENTY, 17 Defendants. 18 19 20 As and for a FIRST CAUSE OF ACTION, plaintiff NICK STEVE 21 SKOU14BASl a minor, by his Guardian ad Litem, Steve Skoumbas, 22 complains of defendants WILLIAM SHAWN YEAGER, FIRST DOE through 23 TWENTIETH DOE, and each of them, and alleges as follows: 24 I 25 26 The true names and capacities, whether individual, 27 corporate, associate, or otherwise, of defendant named herein as 28 FIRST DOE through TWENTIETH DOE are unknown to plaintiff, who 1 1 therefore sues said defendants by such fictitious names, and 2 plaintiff prays leave to amend this complaint to show their true 3 names and capacities when the same have been ascertained. 4 II 5 6 At all times mentioned herein, defendant WILLIAM SHAWN 7 YEAGER, through the FIFTH DOE were, and each was the servant, agent g and/or employee of SIXTH DOE through TENTH DOE; and at all times 9 herein mentioned, defendants WILLIAM SHAWN YEAGER, FIRST DOE through 10 FIFTH DOE were and each was, acting in the course and scope of his 11 employment. 12 III 13 14 At all times mentioned herein, defendant WILLIAM SHAWN 15 YEAGER, ELEVENTH DOE through TWENTIETH DOE, and each of them, 16 manufactured, sold, distributed, serviced, repaired, leased, rented, 17 and/or otherwise provided said 1984 Ford Taurus automobile to 18 defendants SIXTH DOE through TENTH DOE. 19 IV 20 21 At all times mentioned herein, defendant WILLIAM SHAWN 22 YEAGER, FIRST DOE through TWENTIETH DOE, and each of them, owned 23 entrusted, maintained, serviced, repaired, or otherwise controlled 24 said 1984 Ford Taurus automobile. At all times mentioned herein, 25 defendant WILLIAM SHAWN YEAGER, FIRST DOE and SECOND DOE,were, and 26 each was, the operator of said 1984 Ford Taurus automobile and 27 operated same in a general southerly direction on Springbrook Road 28 near 265 Hillcroft Way. 2 1 V 2 At all times herein mentioned, Springbrook Road and 3 Hillcroft Way were public streets located in the City and County of 4 Contra Costa, State of California. 5 6 VI 7 That on or about the 14th day of June, 1986, at or about 8 6:30 p.m. of said day, plaintiff NICK STEVE SKOUMBAS was the 9 operator of a 1966 Mercedes Benz, 280 SL, Said Mercedes, with 10 plaintiff as an operator, was proceeding in a westerly direction on 11 Hillcroft Way. 12 13 VII 14 That at said time and place, defendant WILLIAM SHAWN 15 YEAGER, FIRST DOE through TWENTIETH DOE, and each of them, so 16 carelessly and negligently entrusted, managed, controlled, 17 maintained, operated, manufactured, sold, distributed, serviced, 18 repaired, leased and/or rented said 1984 Ford Taurus so as to 19 proximately cause it to collide with the front end of said Mercedes 20 Benz, of which NICK STEVE SKOU1BAS was the operator. 21 22 VIII 23 That as a direct and proximate result thereof, NICK STEVE 24 SKOUMBAS, was caused to, and did, sustain serious physical injuries, 25 including but not limited to, injury to his back and spinal column, 26 head, arms, legs, severe shock to his nervous system, and other 27 injuries, the exact nature and extent of which are not known to 28 3 I plaintiff at this time, and was thereby made sick, sore, lame and 2 disabled, and ever since said time has suffered, and for an 3 indefinite future time will continue to suffer, much pain. 4 IX • 5 6 That by reason of these premises, plaintiff NICK STEVE 7 SKOUMBAS, has been compelled to incur the obligation as and for 8 medical services, the care and services of physicians,nurses and 9 laboratory technicians, x-rays, medicines, and medical supplies, and 10 will be compelled in the future to incur additional obligations 11 therefor; that plaintiff does not at this time know the reasonable 12 value thereof, but prays that the same may be set forth herein when 13 ascertained. 14 X 15 16 That by reason of these premises, plaintiff NICK STEVE 17 SKOUMBAS, has suffered a loss of wages and earning capacity and will 18 suffer additional loss thereof; that plaintiff does not at this time 19 know the full extent of said loss of wages and earning capacity and 20 prays leave to amend his complaint herein to set forth said loss of 21 wages and earning capacity when the same has been ascertained. 22 XI 23 24 That by reason of these premises, plaintiff NICK STEVE 25 SKOUMBAS, sustained damage to his automobile in excess of 26 $15,,000.00. 27 28 4 1 XII 2 That by reason of these premises, plaintiff NICK STEVE 3 SKOUMBAS, has been damaged generally in excess of the jurisdictional 4 limit of the municipal court. • 5 6 WHEREFORE, plaintiff NICK STEVE SKOUMBAS prays judgment 7 against defendants, and each of them, as follows: 8 9 1 . General damages according to proof; 10 2. For property damage to his vehicle in excess of 11 $15,000.00; 12 3. For special damages for medical expenses and lost wages in 13 an amount to be proven at the time of trial; 14 4. For costs of suit herein; and 15 5. For such other and further relief as may be meet and just 16 in the premises. 17 18 Dated: August 5, 1986 NICK T. RECKAS 19 A Professional Corporation 20 a C 1 21 BY NICK T. RE KAS 22 Attorney for Plaintiff 23 24 25 26 27 28 5 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the ,"oard of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 20 , 1987 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by-the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $150, 000. 00 Section 913 and 915.4. Please note all •WarningCpunty COUnsel CLAIMANT: BETTY L. RICHARDSON JAN 0 G 1987 c/o Derek B. Jacobson ATTORNEY: 11cGuinn, Hillsman & Palefsky Martinez, CA 94553 451 Jackson St. Date received ADDRESS: San Francisco, CA 94111 BY DELIVERY TO CLERK ON December 24, 1986 BY MAIL POSTMARKED: December 22 , 1986 Certified P 194 088 024 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk DATED: December 31 , 1986 BY: Deputy L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Datedc -h ` BY: � �C - —�{aeputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (� ) This Claim is rejected in full. (! �) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JAN 2 0 1987 PHIL BATCHELOR Clerk By Deputy`� De ut Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that 1 am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 2 1 1987 BY: PHIL BATCHELOR by (�� Deputy Clerk CC: County Counsel County Administrator " J (gypUf0lry, C F C.0�.3rf�k C.pgTA NOTICE OF AM AGAINST CALIFOR A RETURN TO: :3-n— nrth Main Street LA M �� Pleasant M�^�"" ► 1, herewith presents a claim against the at 14i11,_ County of Contra Costa, State of California, in the sum of for personal injury, damages, other (Specify reason for claim by crossing out those of the above that do not app y.) CLAIMANT'S ADDRESS % die- Jr� 5.� PHONE W: lu <<7 vl v►n� 1 r5 �- f Jiklt fsk_� _(B) St-, SFS CA e7 Y-111 PLACE OCCURRED: Ss-1 e0-aM( _qA B)va/ tai' AW SAID CLAIM ARISES FROM THE FOLLOWING CIRCUMSTANCES: " (Describe briefly the circumstances necessitating this claim. If additional space is required, use reverse side of this sheet.) C��.•r,��� �-i., f-1c�c.to•"S�it wu-7 `�- 6.►,,;..,ed�,.z, ��i rtvtt.� ��.s„ .�-te��.-,d►z.-.fiic�+- 1.i• ✓��L►�t�JL -P— ITEMS, NATURE AND EXTENT OF DAMAGES OR INJURIES: c oG c.rt�-� �Oss f I/We, the undersigned, declare under penalty of perjury that I/We have read the foregoing claim for damages, and know the contents thereof; that the same is true of my/our own knowledge and belief, save and except as to those matters wherein stated on information and belief, and as to them, I/We believe it to be true. DATED: /Z ' 2 / " •t.' j �.__ .fa.•r (� 2 t So-,., SNNAIURE OF 1ANI Received in City Attorney's office this day of 1986. (Signature) Gov 0TY THIS FORM MUST BE FILED WITH THE WITHIN ONE HUNDRED (100) DAYS FROM DATE OF LOSS OR INJURY. ee., 1 ioC APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT January 20 , 1987 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" belftunty Counsel Claimant: DEANNA MARIE ARBELAEZ JAN 0 G 1987 c/o Malcolm Leader-Picone, Esq. Attorney: Hanson, Bridgett , Marcus , Vlahos & Rudy Martinez, CA 94553 333 Market St . #2300 Address: San Francisco, CA 94105 Amount: Unspecified By delivery to Clerk on December 24, 1986 Date Received: December 24, 1986 By mail, postmarked on December 23 , 1986 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application oFile Late Claim. DATED: 12-31-86 PHIL BATCHELOR, Clerk, By 1 Deputy L. Hal 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: {�rl. /L X VICTOR WESTMAN, County Counsel, III. BOARD ORDER By unanimous vote of Supervisors prese (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: JAN 2 0 1987 PHIL BATCHELOR, Clerk, By ?��� Deputy WARNING (Gov. Code 5911.8) 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 immediately. IV. FROM: Clerk of the Board TO: 1 County Counsel 2 County Administrator Attached are copies of the above Application. We notifed 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. ,�/� DATED: JAN 21 1987 PHIL BATCHELOR, Clerk, By i'Y � Deputy 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 APPLICATION TO FILE LATE CLAIM APPJ.;I,CATI_QN TO PUBLIC ENTITY FOR . LEAVE TO PRESENT LATE TORT CLAIM (Government Code Section 911. 4) In the Matter of the Claim of ) DEANNA MARIE ARBELAEZ, against ) APPLICATION FOR LEAVE the COUNTY OF CONTRA COSTA ) TO PRESENT LATE CLAIM RECEIVED TO: COUNTY OF CONTRA COSTA 651 Pine Street, Room 106 Martinez , CA 94553 1. Application is hereby made for leave to present a late Claim under Section 911. 4 of the Government Code. The Claim is founded on a cause of action for personal injuries which occurred on December 23 , 1985 . For additional circumstances relating to the cause of action, reference is made to the proposed Claim attached hereto as Exhibit A and made a part hereof. 2 . The reason for the delay in presenting this Claim is the mistake , inadvertence and excusable neglect of the Claimant' s former counsel who failed to see the potential liability of the public entity. The circumstances are more particularly described in the Declaration of Malcolm Leader-Picone , Esq. , attached hereto as Exhibit B, and made a part hereof . 3 . This Application is presented within a reasonable time after the accrual of the cause of action, and within the statute of limitations , as shown by the Declaration of Malcolm Leader-Picone, Esq. , Exhibit B. WHEREFORE, it is respectfully requested that this Application be granted and that the attached Claim be received and acted upon in accordance with Sections 912 . 4 912 . 8 of the Government Code. DATED: December 23 , 1986 HANSON, BRIDGETT, MARCUS VLAHOS & RUDY ti MALCOLM LEADER-PICONPr Attorneys for Claimant Deanna Marie Arbelaez CLAIM AGAINST GOVERNMENT ENTITIY TO: County of Contra Costa 651 Pine Street, Room 106 Martinez , CA 94553 CLAIMANT' S NAME: DEANNA MARIE ARBELAEZ CLAIMANT' S ADDRESS : 988 Seascape Circle Rodeo, California 94572 CLAIMANT' S PHONE NUMBER: (415) 799-3042 AMOUNT OF CLAIM: $500 , 000 ADDRESS TO WHICH NOTICES ARE TO BE SENT: Malcolm Leader-Picone , Esq. Hanson , Bridgett , Marcus , Vlahos & Rudv 333 Market Street , Suite 2300 San Francisco , CA 94105 DATE OF OCCURRENCE : December 23 , 1985 HOW ACCIDENT OCCURRED: Claimant was shopping at the Sunvalley Mall Shopping Center in Concord, California, when an aircraft crashed into the mall and injured claimant. The City of Concord negligentiv designed, constructed and operated the Buchanan Field Airport prior to and during the aircraft accident. As a result of the accident, claimant sustained injuries to her neck , eyes , head, and great physical and mental suffering. ITEMIZATION OF CLAIM: General Damages : $500 ,000 Medical Bills : Unknown Lost Earnings : Unknown DATED: December 23 , 1985 HANSON, BRIDGETT, MARCUS , VLAHOS & RUDY 14ALCOLM LEADER-PICONE Attorneys for Claimant Deanna Marie Arbelaez EXHIBIT A In the Matter of the Claim of) DECLARATION IN SUPPORT DEANNA MARIE ARBELAEZ ) OF APPLICATION FOR LEAVE TO FILE LATE CLAIM I , MALCOLM LEADER-PICONE, declare: 1 . I am an associate with Hanson, Bridgett, Marcus, Vlahos & Rudy, attorneys for claimaint herein. 2. I am informed and believe and thereon allege that the following events occurred with respect to this claim, constituting mistake, inadvertence, or excusable neglect under Government Code section 925. 6 . 3. Claimant has at all times been diligent in pursuing her claims for injuries arising out of the Sun Valley Mall aircraft crash on December 23, 1985 . In January 1986 , she first contacted counsel Eric H. Ivary of Gwilliam and Ivary, 1401 Lakeside Drive, Suite 800 , Oakland, California, 94612. The case remained in Mr . Ivary' s hands until October, 1986 . 4 . During that time, claimant was never advised that a claim would have to be filed with possible defendants who were public entities. Also, it appeared from a letter to claimant from Mr. Ivary, dated June 10, 1986 , that Mr. Ivary had considered claims against public entities and concluded that there was no appropriate theory of liability either as a result of mistake, inadvertence or excusable neglect. EXHIBIT B 5. Thereafter, on October 13 , 1986, claimant retained the Law Offices of Melvin Belli, Sr. to represent her. However, on November 10, 1986, Richard E. Brown, Esq. , of that firm wrote to her informing her that Mr. Belli would not represent her because of the failure to file a timely claim against this public entity. Upon receipt of that letter, claimant first learned of the 100 day claim statute. 6 . Claimant, at the time of her injuries was a minor. She turned 18 years old on May 26, 1986. At all times since her injuries, she has attempted diligently to obtain competent counsel to protect her interests. Through the mistake, inadvertence or excusable neglect of counsel, a claim was not presented within 100 days of claimant ' s injuries. 7 . Declarant' s law firm was first contacted with respect to this claim at approximately 2:00 p.m. on December 22 , 1986. 8. Claimant has suffered extensive personal injuries and will be extremely prejudiced if this late claim is not permitted. Furthermore, this public entity has been fully apprised of the facts giving rise to liability and of the identities of all those persons injured in the Sun Valley Mall crash, through the Complaint in Interpleader, Contra Costa Superior Court case No. 283812 and numerous other lawsuits, including but not limited to Etzler v. Beechcraft West, Contra Costa Superior Court No. 289512 , and Guadagui v. Beechcraft Aircraft Co. , Contra Costa Superior Court No. 286111 . -2- I declare under penalty of perjury under the laws of the State of California that the foregoing is true and .-correct. Executed this 23rd day of December at San Francisco, California. ' � r MALCOLM LEADE -PICONE -3- i I (PROUf OF z[M.,!CE BY trAl!•101c2.•eD15.S CCP; 1, THE UNiDERK QLD. HEREBY CERTIFY UNDER PENALTY DF APPLICATION TO PUBLIC ENTITY y 2 PER!UUY THAT I ANI OVER THE AGE OF 18 YEARS AND NOT A FOR LEAVE TO PRESENT LATE TORT PARTY TO THE WIT!;iN ACT10'1; THAT MY BUSINESS ADURESS CLAIM (Government Code Section IS 333 MAKET STREET. SAN FRANCISCO, CALIFORtilA 3 AND THATI ON TIII.S DATE I PLACED A TRUE COPY Of THE 911 . 4 fDREGO)NI DOCUMENT IN AN ENVELOPE, AND CAUSED IT TO 3E 4 SEALED AND DEPOSITED IN THE U.S. MAIL AT SAN FRANCISCO, CLAIM AGAINST GOVERNMENT ENTITY CALIFORNIA, WITH POSTAGE FULLY PP,EPAM THEREON, AD- 5 DRESSED IN THE MANNCR SET FORTH BELOW. DECLARATION OF MALCOLM LEADER- DATED AT SAN FRANCISCO, CALIF.ON 12/2 3/8 6 P ICONE 6 11rt 7 Deborah Harris 8 9 Board of Supervisors County bf Contra Costa 10 651 Pine Street, Room 106 Martinez, CA 94553 11 12 13 14 15 16 17 i8 19 20 21 22 23 24 25 26 27 28 I I 1 I j - I