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MINUTES - 11081988 - 1.1 (2)
CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA f• "%laim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routling Endorsements, ) NOTICE TO CLAIMANT Novegib e r 8 1988 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: $409 . 35 Section 913 and 915.4. Please note all "Warnis" boOnty Counsel CLAIMANT: Marcie L. Hays UC; I 1 1988 ATTORNEY: 2239 Lynbrook Drive Pittsburg, CA 94565 Date received Martinez, CA 94553 ADDRESS: BY DELIVERY TO CLERK ON October 11, 1988 BY MAIL POSTMARKED: October 10 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 11, 1988 PPHHIL ATCHELOR, Cle DATED: BY: Deputy . Bosar e I1. FROM: County Counsel TO: Clerk of the Board of upervisors (✓) 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:Z BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD RDER: By unanimous vote of the Supervisors present ( ) This Claim is reje ted in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: N O V 8 1988 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 Sta-.es, 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. ��lteo: Nov 9. 1988 BY: PHIL BATCHELOR by (W. IZe-4eputy Clerk CC: County Counsel County Administrator C aim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person . or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this Toren. RE: Claim By ) Reserved for Clerk's filing stamp �v Y-L t 4- -ZhusRECEIVED Against the County of Contra Costa ) G T I 1 19K or ) PHIL BATCHELOR District) CLERK BOARD F3UPERVISCRS Copa, OSTA Co. Fill in name ) By ... ...Q Ileputy The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ H f.3b�" and in support of this claim represents as follows: -------------------- --------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) 0",�. P9, )Igo �:�Up.�l . ----------------- ---------------------- ------------------------------------------- 2. Where did the damage or injury occur.- (Include city and county) a -- - � ---- ------ -=G` —�-- C�n -- --- 3. How did the damage or injury occur? (Give full details; use extra paper if required) low-,e - at-�-Q-, __- -------- -------- ------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? U (over) What are the names of county or district officers, servants or employees causing ;the damage or injury? 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed.! Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) --------------- --------------------------------------------------�..w�------ 8. Names and addresses of witnesses, doctors and hospitals. ----------------------------------------------------------------------------- --- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT 1 Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney Claimants Signature Address Telephone No. Telephone No. �42 7 (o //Z NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account; voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by� a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. I :STIMATE j� HARMON GLASS NQ A29296 of a � QUOTATION TO y )I t S DATE ADDRESS RESIDENCE PHONE 4GL 7-600? CITY BUSINESS PHONE UANTITY MATERIALS UNIT PRICE AMOUNT (7/0 a clv.Te,- GW'1 0 �ivS G G �0 ,L THIS ESTIMATE IS SUBJECT TO CHANGE AFTER 30 DAYS a CD y c inLnc o w CD 0 1 n fA o CD m a m o = o a a a a O fD m "' d 0 D C)a N x C w a O �"'„ z c o N o rn F-I a o � c � o Ln -1 [A cn o .o (7% w FJ- y W D (n (~D '� rn � R� � u' O O K r� cn � N p \ ((D N a A a o 00 co =+ CLAIM ;r ' t BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Rout'ng Endorsements, ) NOTICE TO CLAIMANT November 8 , 1988 and Board Action. All Section references are to ) The copy of this document ,wiled 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: $360 .80 Section 913 and 915.4. Please note all "Wanings" Bounty Counsel CLAIMANT: William E. Wagner OCT 11 1988 ATTORNEY: 2775 Miner t Road Concord, CA 94518 Date received Martinez, �A 94553 ADDRESS: BY DELIVERY TO CLERK ON October 11, 198 BY MAIL POSTMARKED: Hand delivered 1. FROM: Clerk of the Board of Supervisors TO: :.Xounty Counsel Attached is a copy of the above-noted claim. - October 11, 1988 , BY:gpHHIL BATCHELOR, Clerk DATED: Deputy J S sarge II. FROM. County Counsel TO: Clerk of the Board of Supervisors ( )) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to (comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely (filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: � BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ODER: 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. c1p� Dated: N O V 8 191 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, �ou 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 atltorney of your choice in connection with this matter. If you want to consult an attorney, you should do so ii ediately. 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 U,.Ited 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 abov NOV 9 198 Dated: BY: PHIL BATCHELOR by1qZ ty Clerk CC: County Counsel County Administrator t Asim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 must be presenteid not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must. be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) lResepv d f glk Is fill-Ing -stamp E dA .1 RECEIVED Against the County of Contra Costa ) or 1988. District) L PHI SAJ R C „a s0 RVISCR;;Fill in name ) Or ABY C ..apAp�t, The undersigned claimant hereby makes claim ag inst the County of Contra Costa or the above-named District in the sum of $.36D.�Q and in support of this claim represents as follows: ----------- -------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ---- v�\f --2� --- --a`�y :_-_b e'rv� t�-_ �,—--1� _l 0_SoP------------------- 2. Where did the damage or--injury occur? (Include city and county) mss- 3. How did the damage or injury occur? (Give full details; use extra paper if required) Dr• v"Ns rid w.e Bch e6i'ce►V-J v O1v� V�5 a �ir>Jti/L i `�"t v.q ►'l ! � �'.'�uVti( O r� t�`r/cer-�S S/L� "y car W.-S, w 4k 5r�V-c( F'Y-O— Ss,' , Garr 9raVcl✓lt beev. h Ft ori 0. `fL �Cklayer o1l PAvpw��y�rCr�c:'t1`V�J a ha7ltr�" T'rG�racll`a+• an �u`�ms coh 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 7k*-- a�r«.� ,'oh rdf va sitov,�� J•Avti 6 c( ca,n �p ,"w, ta+� t ) tt p `t'l.r .�,v e w-e�- `r•-1r re by L'.1 ba`+! H q A `s rtaZarll, / (over) 9.` What are the names of county or district officers, servants or employees causing- the ausingthe damage.or Injury? U Y%k YLG w N� -------------------j------------------------------------------------------------�--- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed Attach two estimates for auto damage. �a w.o q Z c� vvy w %J 5S J,� 44 ��� c,c�r v--1— C I— 5,Veral�sP � �5 —WL) O Ae - --------------------------------------------•.------------------- 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. rower --------------------I 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be pigned by the claimant SEND NOTICES TO: (Altorne ) or by some perso4,16n his be f." Name and Address of _Attorney Claimant's 277"6 , cam Address C-��►� , Cox. 9�/.S/� 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 stateltioard or officer, or to any county, city or district board or officer, authorized }},,�o allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for 4 period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by, a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. , (NAME OF PERSON QUOTE GIVEN TO or RECEIVED FROM) _T O FR 6! FIR NA SSS QUOTE R Y KOA JO N E JOB DATE JOB LOCATION JOB PHONE JOB NUMBER TYPE OF WORK D CRI?TION OF WORK _ .rte 71I 1 ; I I jY • � ! SI 0 6 0 3 1945 W,-A,RKET ST. CORD, CA 940 AS LISTED AND MATERI ESTIMATE OF REPA►IRSVERBALAGREEMENOTSNOT BINDING-ESTIMATES FREE OWNER _ DATE ADDRESSPHONE EST.NO. Z tv i ►� 2-7 J INSURANCE CO. ORDER NO. L!!! NUMBERHONE LICENSE : 0 0-3 YEAR-MAKE MODEL MILEAGE MOTOR NO. SERIAL NO. R P •` • •' •' • •' l sem' �i / � c�- L Sl , ,✓ S~ } O Cl'► Z N PARTS PRICES BASED ON STANDARD CA TAtOGPROCUREMENT PRICE LISTS SUWECT TO CHANGE WITHOUT NOTICE... TOTAL 'PROCU,REIAENT AND DEtf E CHARGES M'AY;BE ADDED fOR SPECIAL SERVICE ON ITEMS NOT AVAILABLE tOCA1tY. MATERIAL OLD PARTS.REMOYED�f+"[ARS WILL BE JUNKED UNLESS OTHERWISE INSTRUCTED IN WRITING. TOTAL LABOR CC THE ABOVE IS AK IESTJMAATE BASED ON OUR INSPECTION AND DOES NOT COVER'-ADDITIONAL.PARTS _ OR LABOR WHICH'MAY BE RfflUiRfD AFTER THE WORK HAS BEEN OPENED UP.OCCASIONALLY AFTER -WORK HAS STARTED WORN PARTS ARE DISCOVERED WHICH ARE fIOT EVIDENT ON'FtRST:INSPECTION.: TOTAL MATERIAL' S L} BECAUSE.OF THiSTttg ABOVE fGR,ICES IpRE NOT GUARANTEED ESTIMATE TAX S3 ESTIMA ED BY APPROVED ELY PAID OUT-TOW&STORAGE AUTHORIZED ANO ACCEPTED SUBLET REPAIRS 8Y OYYNER of;!A enrr BATE • -3(�<� �t5 , aH 429 AMFOW CLAIM Ir ' t ( BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) $OARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 8 , 1988 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: $10, 000' 10, 000,0001 00 Section 913 and 915.4. Please note all "WarQ0"nty Counsel CLAIMANT: RONALD P. KRULETZ 0 C T198 1 � 8 ATTORNEY: 133 Roxanne Ct. #2 Martinez, CA 94553 Walnut Creek, CA 94596 Date received ADDRESS: BY DELIVERY TO CLERK ON October 11, 1988 BY MAIL POSTMARKED: hand delivered I. FROM: Clerk of the Board of Supervisors TO: ,--County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: October 11, 1988 ��: Deputy Bosarge II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( ( This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: jQ l -2i ( IO U BY: _ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BO7) This DER: By unanimous vote of the Supervisors present ( 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. Nov 8 1988 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 Uiii ted 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: NOV 9 1988 BY: PHIL BATCHELOR by �_�$E�puty Clerk CC: County Counsel County Administrator :Cleim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19870 must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code 6911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each }public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this Tor-. RE: Claim By ) Reserved for Clerk's filing s p X33 ; RECEIVED Against he County of Contra Costa ) or ) T 1 11988. District) PHIL BATCHELOR Fill in name ) LK o Ocos ERWSC�;� e Deputy The undersigned claimanit hereby makes claim against the County of Contra Costa or the above-named District in the sum of $kt ,n n b , ©O and in support of this claim represents asfollows:-------- ��u 'C�, a - ___________________ _ 1. When did the damage or injury occur? (Give _eAct date and hour) \R 1-`_Z--------------- ----------------------------------------------------------- 2. Where did the damagle or injury occur? (Include city and county) =---------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) ltd 0 �kck -------------------------------------- 4. What particular actl or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5. That are the names of county or district officers, servants or employees causing th2 damage or injury? 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. s ---------- -_----_---�- 7. - How was the amount claimed above com�uted? (Include the estimated amount of any prospective injury or damage.) -----------------------I------------;----------------P:------------------------------ 8. Names and addresses of witnesses doctors and hospitals. r -------------------------------------------- 9. -------------------------------------------9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: •(Attorney) or by some person on his behalf." Name and Address of Attorney Claimant's tune e cLtvN ,e- ( Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district.board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. CLAIM A/0 i1 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim,4gain;t the County, or District governed by) BOARD ACTION the Soaru of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 8 , 1988 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: $10 , 000, 000.i 00 Section 913 and 915.4. Please note all 'weOW# Y Counsel CLAIMANT: RONALD P. KRULETZ OCT 11 198$ ATTORNEY: 133 Roxanne Ct y #2 Martinez, CA 94553 Walnut Creek, CA 94596 Date received ADDRESS: BY DELIVERY TO CLERK ON October 11, 1988 BY MAIL POSTMARKED: hand delivered I. FROM: Clerk of the Board o'f Su is TO: !County Counsel Attached is a copy of the above-noied claim. PPHHIL ATCHELOR, Clerk DATED: October 11, 1988 BY: Deputy J. osarge II. FROM: County Counsel TO: Clerk of the Board of Supe isors ( )) 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. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( his Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board' Order entered in its minutes for this date. Dated: N O V H 1988 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 i iediately. 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 Ctates, 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. NOV 91 . 1988 BY: PHIL BATCHELOR by -/C..---,16eputy Clerk l CC: County Counsel County Administrator .C'al im t,�: BOARD OF S[JPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CI.ADWiT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 must be presented not later than the 10th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code 6911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this arm`. RE: Claim By ) Reserved for C erk's i ing stamp o"\ P Z �1)c �V1 RECDi1��� Against the County of Contra Costa ) i or rKF.A"CHELCR C . 'SO D OF SUPE V15r,- Fill in name ) ori cosy The undersigned claimant hereby makes claim against the Cy�unty of Contra Costa or the above-named District in the sum of $ \O ©0 8 Oat • and in support of this claim represents as follows: ------------------------ ------- ---------------------------------- - 1., When did the damage or injury occur? (Give exact date and hour) Cep _ -------------- ------------------ - - - ---------------------------------- 2. Where did the damage or injury occur? (Include city and county) ----------- ------------------------------------------------------------ 3. How did the i-2- ge or injury occur? (Give full details; use extra paper if required) o ------------------------------------— 4. What particular abt, or omission on the t of count or district Paz' per' Y officers, servants or employees caused the injury or damage? (over) 5. Whit are the names of county or district officers, servants or employees causing the damage or injury? 5. What damage or in do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. ��- ---------------------------_�__�--------- - 7. How was the a t 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: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney On (Claimant's-Signature! 4)w at�1 V)f. Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district.board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($109000, or by both such imprisonment and fine. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Clafm Against. the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 8, 1988 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: $471.-03 Section 913 and 915.4. Please note all "Warnicuullty Counsel CLAIMANT: KNAPP, James 6 Barcelona Ct. i 10 1988 ATTORNEY: Pittsburg, CA 94565 Date received Martinez, CA 94553 ADDRESS: BY DELIVERY TO CLERK ON October 10 , 1988 BY MAIL POSTMARKED: October 6, 1988 I. FROM: Clerk of the Board of Supervisors TO: County -Counsel Attached is a copy of the above-noted claim. October 10 , 1988 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy C J:11 Bosarg II. FROM: County Counsel TO: Clerk of the Board of Supervise s ( Vf 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 Boarc 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: I� CJ BV: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARDD ORDER: By unanimous vote of the Supervisors present (V) 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. nn Dated: NOV 8 �'I�� PHIL BATCHELOR Clerk By Gt- 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 Unite) 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. / NOV 9 1988 CSted: BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator t r Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA OMTNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for. injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) OCT/V 1988 or ) PHIL BATCHELOR District) CLERK BOARD OF SUPERVISORS eY �/ y;ONTA STA CO.� t Fill in name J ) (� ��'/� Li The undersigned claimant hereby makes claim ainst the Count 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 'n ' occur. -Give exact date and hour- _ =______ _P_�________---------------------------- 2. Where did the damage or injury occur? (Include city and county) -- �%'------------.. 3. How did the damage or injury occur? (Give full details; use extra paper if required) I 7L 7ftEIC 4. What particular act or omission on the part of bounty or district officers, servants or employees caused the injury or damage? (over) 5.�°What are the names of county or district officers, servants or employees causing the damage or injury? 11 � 1/x/1 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. ----------- ---�L- / --------- -- -----— 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: DATEITEM AMOUNT 5 aGov. Code Sec. 910.2 provides: The claim must be signed by the claimant SEND NOTICES :.TO: • (A torney) or by some person on Ms behalf." Name and Address of Attorney ! . C1 i 's Si Address ZE Telephone No. h; r p Telephone No. J,,� NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, preseAs- t`or,allowanee or for payment to any state board or officer, or to any countA;�� �y'cii�.,district board or officer, authorized to allow or pay the same if genu a ank;i%lse br fraudulent claim, bill, account, voucher, or writing, is pu�ishab either by imprisonment in the county jail for a period of not more than cue, by al , a of not exceeding one thousand ($1,000)i, or by both such imprisonmen ' d`if1pe, or by imprisonment in the state prison, by ;a fine of not exceeding ten thousan8`46� ($10,000, or by both such imprisonment and fine. w w < m m R CO m d Z IQ C D l a V N Q N � PD m 4 � Z D m m l _ Cl) Q C Z f _ � z m 0 Ablk —� e � k r . � BILL BRAND 'FORD-CHRYSLER DODGE, 6 ,44 B 1245 Mighw.ay No. 4 Phone 634-3551 a 5 ' " Ji BRENTWOOD,CALIFORNIA 94613 E.; I `w DATE 19 ' ADDRESS �~ COST. ORDER NO. CASH P CX GE RETD. GOODS WHOLESALE, SALESMAN = CODE ' QUAN. I PAPT NO. DESCRIPTION LIST NET TOTALAMDUNT �" -....- 2 - -F - ew( tics: 20% Handling,Charge On All Merchandise Returned For Credit. THANK YO TAX Returns After 30 Days.No Refunds On Elet°ftical Or Special;Orders. T07A I I y 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 November 8, 1988 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 $319. 30 (Paragraph IV below), given pursuant to Government Code Amount: Section 913 and 915.4. Please note all "Warn i gs" EDWARDS Charles W. G�ounty Counsel CLAIMANT: 509 #B Rincon Road ATTORNEY: Wl Sobrante, CA 94503 OCT 1 � 1g88 Date received October 1P,rt'M8CA 94553 ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: October 6, 1988 1. FROM: Clerk of the Board of Supervisors TO: - County Counsel Attached is a copy of the above-noted claim. gg DATED: October 10, 1988 BYIL DeputyLOR, Clerk �.FBosariee II. FROM: County Counsel TO: Clerk of the Board of Superviso s ( ") 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 Boarc cannot act for 15 days (Section 910.8). ( } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( } Other: Dated: BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOY) This DER: By unanimous vote of the Supervisors present ( 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. n o Dated: NOV 8 188'9PHIL BATCHELOR, Clerk, By (_ _,e .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 fj^ited 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 otice to Claimant, addressed to the claimant as shown above. NOV .9 1958 BY: PHIL BATCHELOR by uty Clerk CC: County Counsel County Administrator alai to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY a INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserve „1p Q1 4T RECEIVED OCT Av >7. Against the County of Contra Costa ) 1986 or ) PHIL BATCHELOR CLERK OF S EROVISORS District) GG ��i�'1�i� Fill in name I ) e t The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 311 , and in support of this claim represents as follows: --------------------j--------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) pre-) 2. Where did the damage or injury occur? (Include city and county) ��CI�CSS T-H L S T-PI(_L-i F fo/Y7 67,9 S,0^1 PfJ,61 0 4✓6-- ------- -- 3. How did the damage or injury occur? (Give full details; use extra paper if required) I1 k S T Roo./ I?o c.ci 11/ � �G T CC',.ed 19,e q w rN LI-1-4 L P`- ,'4 0--t. F- 05 i P_V A! Q U cL1/✓ 5 77,7C2-i L 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 772-e�e 7- (over) 45. What are the names of county or district officers, servants or employees causing the damage or in, Ury? ------------------------------------------------------ ---- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. S!C e 7-e"rc '0 ul N ZO Fl ae�-2 S 7• How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) -------------------- ---------------------------------------------------------------- B. Names and addresses of witnesses, doctors and hospitals. wr-' 799- r,2 6-5'v ------------------------------------------------------------------------- -------- 9• List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT t • r ,. y Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES'TOa (Attorne ) or by some _person on his behalf." Name and Address-.of, Attorney , , Claimants Signature Address Telephone No. p Telephone No. oDt 3 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 officQr ,ipfi; ny bbdhty, city or district board or officer, authorized to allow or pay the sgme;--if-genuine, any false or fraudulent claim, bill, account, voucher, or writing,'-'! - ishable either by imprisonment in the county jail for a period of not more]man ;'.liar, by a fine of not exceeding one thousand ($1,000)li, or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not a � d#fig -: ern(U&fshnd dollars ($10,000, or by both such imprisonment and fine. VOID AFTER 30 DAYS R E PAI R ySPLENDORIO'S AUTO BODY & PAINT 160 -!MRo ST .ESTIMATE P.O. BOX 486, STA. A RICHMONQ, CA 94808 / �n PHH,O1NI E�2/3�8-6793 Date z5 Car Ow/n'er� C L lE ` 1s Address909 �. Phone Z23 6yq, Make�-i7�U -Year license No ,F57/77 Type Mileage business Phones - I.D. Adjuster A Phone Insurance Co. Inspecto Symbol • H4 ouor PARTS Symbol Honor PARTS Symbol _*RTS Bumper Fender Front Fender, Front Bumper Brkt. Fender Shield Fender Shield Fender Mldg. Fender Mldg. Headlamp Bumper Gd. _ Headlamp Headlamp Door Fri. System Headlamp Door Sealed Beam Frame Sealed Beam Cowl Cross Member CowlDoor, Front .Ff oor, Front Z.5 Door Hinge Wheel Door Hinge Door Glass Hub Cap Door Glass Vent Glass Hub 8 Drum Vent Glass Door Mldg. Knuckle Door Mldgs. Door Handle Knuckle Sup. Door Handle Center Post Lr. Cont. Arm-Shaft Center Post Door, Rear License Frame-Brkt. Door, Rear Door Glass Up. Cont. Arm-Shaft Door Glass Door Mld . Shock Door Mldg. Rocker Panel Windshield Rocker Panel Rocker Mldg. Rocker Mldg. Sill Plate Tie Rod Sill Plate Floor Steering Gear Floor Frame Steering Wheel Frame Dog Leg Horn Ring Dog Leg Quar. Panel Gravel Shield / e Quar. Panel Quar. Mldg. Park. Light Quar. Mldg. Quar. Gloss Grille Quar. Glass Fender, Rear Fender, Rear Fender Mldg. Fender Mldg. Fender Pad Fender Pad Mirror Inst. Panel Horn Bumper Front Seat Baffle, Side Bumper Rail Front Seat Adj. Baffle, Lower Bumper Brkt. Trim Baffle, Upper Bumper Gd. Headlining Lock Plate, Lr. Gravel Shield Top Lock Plate, Up. Lower Panel Tire Hood Top Floor Tube Hood Hinge Trunk Lid Battery Hood Mldg. Trunk Lock Paint 7 Ornament Trunk Handle Undercoat Rad. Sup. Tail Light Polish Rad. Core Tail Pipe Misc. Materials Radio Antenna Gas Tank Rad. Hoses Frame Fan Blade Wheel AUTHORIZATION FOR REPAIRS Fan Belt Hub$ Drum You are hereby authorized to make,the above Water Pump Back Up Light specified repairs. Motor Mts. License Frame—Brkt. Sign Labo Parts A-ALIGN N-HEW OH-OVERHAUL S-STRAIGHTEN OR REPAIR. Ek-EXCHANGE Wrecker Service E RC-RECHROME U-FOR USED PARTS B-RESUILT Tax S OS This estimate is based on lowest possible cost consistent with quality work, and as such, is Sublet S guaranteed. Items not covered by thisl estimate or hidden will be additional $ TOTAL $ 4 tefv bone: 550 San peblo avenue (415) 799-4135 c, p , u�q rodeo, California 94572 OWNER PHONE -a DATE ACC.DATE cam. ADDRESS - AGENT INSURANCE CO. PHONE MILEAGE I.D.NUMBER LICENSE NO. YEAR YE • MAKE • MODEL • BODY TYPE • IMA Y FRONT LABOR reS. PARTS LEFT LABOR HRS. PMTS RIGHT LABOR MRS. PARTS MISCELLANEOUS LABOR HRS. PARTS Bumper >Finder Frt. - Fender Frt. Bumper Gd. Finder ShMld Fender Shield drill. Fender Mldg. Fender Mldg. Frame Header Headlamp Cross Member Hiodlomp Door Headlamp Door Frt.System Si-led Beam Sealed Beam Wbeel Park.light Park.Light Hub Cap Disc. Cowl-Dash Cowl-Dash Hub i Oram Windshield T� Windshield Mldg. Knuckle Door•IF a$ Door,Front Knuckle Sup. Door C Door Hinge Lr.Cont.Arm Door Glass 'TRA Door Glass TCIEAR Up.Cant.Arm Vo$Glass � Vent Glass Tint R Gravel Shield Door Mwg. Door Mldg. Steering Gear Dior Handle Door Handle Steering Wheel Eater Post Center Post Horn Ring Door Rear Door Rear Rod.Gri16 Door Glasspoor Glass TINT CIEAR Door NYdg. Door Mldg. ,. Rocker Panel Rocker Panel Rocker Mgdg. Rocker Mldg. FLOOR 8 W/HSG. FLOOR 8 W/HSG.' Quer. Quar.Panel F•nder PANEL Fender PANEL QY w.Ext. Quar.Ext. Q,--Mmg. Quar.Mldg. Tail Liam Tail light Hood Top Hood Hinge Hood Mwa. REAR MISCELLANEOUS 0mament11 Ramps Front Seat-Adj. Lock Pk",up. Samper Gd. Top 1a&Pkft.Lr. "We",Brkt. Aerial Born Greed Smew Tire/W! , Rod.Sup. Frune Paint f /4- and.Core Gas TWA Anti-Frwse Tai Pipe . Rad.Hoses Lower Pawl oo Fan diode-Mft Floor Labor Hours (d1�� $ 6 O Wars Pump,Pall" Tr&lid Parts Less Disc. $ 3 Motor Mrs- Trwdk Mich• Sublet&Net Items $ Trans.fink UlUeel Hub A Dram Axle Towing $. Soles Tax $. Total $ A-Align 1111-New OH-Owrhwrl S-Slrarlgmen or Repair EX-Exchange. RC-Rechromo U•.For Used Parts gued'eeTiuATe Evoioee Rn neve cQnAA nATC a CLAIM 1/16 - -BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 8 , 1988 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: $30- 00 Section 913 and 915.4. Please note all "War in s" G�'vUnty Count;e'► CLAIMANT: DAVID ALLEN EI ANS 57 Eola Street OCT 191988 ATTORNEY: Pittsburg, CA 94565 Date received MaI'(Ifl@Z, CA ,g4553 ADDRESS: BY DELIVERY TO CLERK ON October 14, 1988 CC BY MAIL POSTMARKED: no postmark I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy Iof the above-noted claim. DATED: October 18 , 11988 g�IL BAATTCtyLOR, 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: Dated: U C BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOA7) This RDER: By unanimous vote of the Supervisors present ( Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: N O V 8 1986 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 im ediately. 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. Oed: N O V 9 19w AtBY: PHIL BATCHELOR by �/, WZ_1t107___Peputy Clerk CC: County Counsel County Administrator PO,R.R: OF SUPERVISORS OF CONTRA CO��+ Cpi y �i8�'urti briyW1 apptloatlon to: Instructions to Claimant Clerk of the Board P.O.Box 911 A. Claims relating to causes of action for death or for�in�ury�t`o�533 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 aigainst 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 'ng stamps R E C F, I V E[r)" RE . (f1988Against the COUNTY OF CONTRA COSTA) TCHCLORor DISTRICT) OF S7PER�I(Fill in name) ) � Depu;y - 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 : l. When did the damage or injury occur? (Give exact date and hour) t,esf ---- --------- -- ——————— ———— f� � Where . 1(i rhPi r7.amaa_- or in jury occur? (Inolnd.e cltj1-and county) L.O.$j 3. How did the damage or injury occur? (Give full details,---- use extra sheets if required) T /6�< al lfoec/�/te R vto �. o•v e e,c/t l<£ rtlo, 1"7r d ack c f 80f pi J EN E a;�� �( ,��6 P£�' �Y '`�11a f' c�Ac�C£�/ �s on1 ►�t( feoroc,e�Y �zCf 4 t+ 4 . What particular act or omission on the part of county or district officers , servants or employees caused .the injury or damage? � � L LG.�6 I ��J (over) " '.:5.. :•,��.at! are.,t�ie'...names of county or district affioars,� servants or emp4oyees_:causing the damage or injury? lee Tq .. ... IC rn c)Pe IC f.. w��f� r eo,20 ly --------------- -----------------------r---------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent offinjuries or lama-ges claimed. Attach two estimates for auto damgef 7� �foie�/>o�£'1•�!N Z G�J�n,/d�12£/��£.0 !.c/s�s !7r rs��C r'd.i'�r✓.✓a��o.!'�� 7' _____H_ _ ________1_ �.91lJJI ----__---.__----_---_----_-- 7. ow_ wa___s the 'amount claimed above computed? _ (Include the estimated amount of any prospective injury or damage. ) l �f.C.SlArdilS.C�'tw Z 8. Names and addresses of witnesses , doctors and hospitals. ----est the xp--------------------------------------------------------- 9 . ist the e enditures you made on account of this accident or injury: •DATE ITEM AMOUNT /<-e 7- � Govt. Code Sec. 910. 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by _spme person on his behalf. ' Name and Address of Attorney C aimant s Signature '57 efoi� �t Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, 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 _ CLAIM *J BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION ' the Board of Supervisors, Routling Endorsements, ) NOTICE TO CLAIMANT November 8., ,- 1988 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: $50, 000. 0 0 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: WILLIAM D. ROSSMAN Cpunty Coun�.; I c/o Kenneth D1 Robin ATTORNEY: Attorney at Law 1988 2204 Union Street Date received a ADDRESS: San Francisco I CA 94123 BY DELIVERY TO CLERK ON October 1 '� 8 C� 153 BY MAIL POSTMARKED: October 13 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk DATED: October 18J1988 1988 �b: Deputy S4 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: A Dated: ` CJ BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: N O V 8 1988 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 i iediately. 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 Unite4 States, over age 18; and ithat 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 aboove. Dated: NOV 9 988 BY: PHIL BATCHELOR by puty Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF OONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 319 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code 6911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against� a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is aga�nst more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp WILLIAM D. ROSSMAN II RECEIVED Against the County of Contra Costa ) or ) U T District) Fill in name I ) CLE R P qR T HE NTR SORS 0 By ... ....... eputy The undersigned claimant hereby makes claim against the y 0I nUra os or the above-named District in the sum of $ 50 ,000 and in support of this claim represents as follows: 1. When did the damage or injury occLL-? (Give exact date and hour) M ---------------- 8/18/88---aP P r__ 4 :3 0 .Z_T:_".----------------------------- 2. Where did the damage or injury occur? (Include city and county) Northbound on Brioadwa_y in Walnut Creek ntra Costa Courity�_____ ----------------------------- --------------------_12( -------------------- --- 3. How did the damage or injury occur? (Give full details; use extra paper if required) Collision between Sheriff's van -(in which Claimant was being transported) and B�V driven by Jody Green (and awned by Ed Green) due to negligence of, inter aiia, the driver of the van and the Sheriff's Department 4. What particular act%or omission on the part of county or district officers, servants or employees caused the injury or damage? negligence of the van driver: speeding, not paying attention; negligence of the Sheriff's Department: failure to supervise, discipline and properly instruct it's employee (the van driver) ; absence of seat belts or other safety features to protect passengers in the van from injury in the event of sudden stops or collisions; handcuffing and chaininv together of prisoners preventing them from protecting themselves from injuries in the event of sudden stops or collisions (over) 5. What are the namesofcounty or district officers, servants or employees causing the damage or injury. Unknown to Claimant at this time -------------------------- --------- 5. What damage or inj�ries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Serious and substantial and enduring pain to lower back and left leg, constant pain, soreness in ribs, and painful bumps and bruises --------------------- I ------------------------------------------------------ - 7. How was the amountclaimedabove computed? (Include the estimated amount of any prospective injury or damage.) . General damages claim was computed on the basis of undersigned counsel's 20+ years of experience in calculating such damages and in negotiating and trying suits based thereon, in terms of Claimant's past, present and prospective non-economic injury - --------------------------- ------------------------------------------- ---- 8. Names and addresses of witnesses, doctors and hospitals. Name and address of van driver, other van passengers (other transported prisoners) , and other driver (of the BM unknown at this time by Claimant but known to Sheriff's Departidht personnel;- Clair.ant .treated at Main Jail (Martinez) , Clayton facility medical personnel and County Hospital personnel (names and addresses unknown to Claimant but known to Sheriff's Department personnel) . ---------------------- ------------------------------------------------ ----------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec 10.2 provides- "The claim t be ' e claimant SEND NOTICES TO: (Attorne ) or by so erso i " Name and Address of Attorney 67 �911 KENNETH D. ROBIN r ATTORNEY AT LAW K neth 1C1. o in, Sai fatM4 in fact for Claimant 2204 Union Street see notice address San Francisco CA 94123 Address Telephone No. 4563-2400 . Telephone No. (415) . 563-2400_ NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or distriet.board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. � • � CLAIM 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 November 8 , 1988 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: $520. 31 Section 913 and 915.4. Please note all "Wa►qu§OtY CovnW CLAIMANT: MARY A. ENRIQUEZ s;i �, 1988 4360 Via Dora Drive ATTORNEY: Antioch, CA 94509 Martinez, CA X34553 Date received ADDRESS: BY DELIVERY TO CLERK ON October 17 , 1988 BY MAIL POSTMARKED: October 11, 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: October 18 , 1988 ��: Deputy L. Hall II. F�ROMM- County Counsel TO: Clerk of the Board of Supervisors ('l/) 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: a� )\i— Dated: V BY: VDeputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned Is 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. NOV 8 1988 PHIL BATCHELORCerkBy Dated: Deputy uty 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 ilmediately. AFFIDAVIT OF MAILING I declare under penalty of perjulry that I am now, and at all times herein mentioned, have been a citizen of the Si.ates, over age 18; and Ithat today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order an otice to Claimant, addressed to the claimant as shown above. ;. OV 9 1988 BY: PHIL BATCHELOR by �eputy Clerk CC: County Counsel County Administrator Claim to:� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. _ Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code See. 72 at the end of this form. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * .* * * * * * * * * * * RE: Claim By ) Reserved for Clerk's filing stamp 6/_ R E C V E D Against the County of Contra Costa ) i �,- 17T"- 7 1988 r ) PH AT"- LGR o District) LCLEE YI NT R_Fill in name ) pity The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 4-1 Jd[7, 3 and in support of this claim represents as follows: ,dcE g4r,&A4t ,ems y,2 z ------------------- ------------------------------------------ ------------------- 1. When did the damage or injury occur? (Give exact date and hour) ------------------- F-- -- 9_/l /---� � _— u c — fi y—_ iV 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) �� u � ,. ,t u��-� c�z is MP/� &i a e�Z OZ c�iurt , xAt- � � 2� ,ems y)L_ 2�,� ?/vT"���� 61- ele . -- ----- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage) (over) 5. What are thd' names of county or district officers, servants or employees causing >> the damage or injury? ---------- —------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: ~M DATEITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney C1 imant's i ture 111q Oen? c Address A77krh, C1.4 yvl�v9 Telephone No. Telephone No. �.�T�33�/��7crr�C) 75 O `f9,Fi NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine;�.lony;,f see. &I.ifi^audulent claim, bill, account, voucher, or writing, is punishable '"either by _imprisonment in the county jail for w period of not more than one year, by a' fine of not exceeding one thousand ($1,000), or by both such imprisonment and fin@;_; bri6yi1&prisonment in the state prison, by fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. ,, Delta Mass } 101 Railroad Avenue 3 9 U I Antioch, California 94509 (415) 757-5300 1 DATE 19 � NAME PHONE NO. ADDRESS JOB JOCATION 1 PHONE NO. INs. CO. L ` • ON( DESCRIPT16 AMOUNT � iSSCLti� O Y1 i t i AMERICAN GLASS CO. DATEIU..,<.v'�y� ' ESTIMATE OF REPAIRS ESTIMATE No. .................... AUTO GLASS DEPARTMENT N° 302 NAME........_..,-,144...........E%.fll.../_` . ... 1�. Z--_..........--••............................----.....---....-------•-•--•-----...........-----........._._. ADDRESS................... .................................................. ............................................... JOB LOCATION............................................... MAKE OF CAR...... 1 �'_. / .. '..I ..V.. ........................................................................LICENSE No. ........_..._..._._................_.._. �W. QUANTITY I PRICE AMOUNT re L, 44UiCt /d `sf' NOTICE . . . Please do not issue chock in payment of this estimate. If the above Mass replacement is made we will send you our invoke for payment. ESTIMATED BY Old parts removed from cars will be junked unless otherwise instructed in writing. TOTAL MATERIAL-f/(3'.._.__.. ..._...... The above is an estimate based on our tospectlori and does not cover additional parts or labor which may be — required after the work has been opened up. Occaslonnfly atter work has started worn parts are discovered TOTAL LABOR X00 ...... 00 are not evident on Tint inspection. Because of this the above prices are not guaranteed. 24-Hou, Emergency Plate Glass Service. 446-798? �O 2 HOUR EMERGENCY SALES TAX .. �._.. ...... AUTO GLASS 4 PLATE GLASS SERVICE Y DOWNTOWN-600 Sunbeam Avenue 441-1848 ........................ X FRUtTRIDGE-588D Stockton) Blvd. 421.262f X TOWN 8 COUNTRY-2613 Cottage Way 483 9581446.7987 TOTAL x NORTH HIGHLANDS-37071 adison Ave. 332.977C IN ROSEVILLE-521 Vernon Sfreet 782.2125 x STOCKTON-6860 Pacific Avenue 477-4820 Mob le Auto Glass Service. dd1_19eo men -- ___ _ ■ _ C::;IM 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 November 8 , 1 9 8 8 and Board Action. All Section references are to ) The copy of this document mailed to you is your notire of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $500, 000. 00 Section 913 and 915.4. Please note all "Warni-ngs' . CLAIMANT: BRYANT WILRIGHT iJ 156 c/o Fred T. Jenner ATTORNEY: A Professional Corporation atfine?: ;$ 553 100 Webster Street-Penthouse Date received ADDRESS: Oakland, CA 94607 BY DELIVERY TO CLERK ON October 12 , 1988 hand del . 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. 1 9 8 8 pH IL BgATCHELOR, Clerk DATED: October 18, BY: Deputyz�y —I-,' 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: '/ ~ Deputy County Counsel III. FROM: Clerk of the Board TO: County,Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 0 DER: �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. pp Dated: O V 8 1988 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: NOV 9 1988 BY: PHIL BATCHELOR by A�k/_/�C---BePIIty Clerk CC: County Counsel County Administrator I 1 FRED T. JENNER A Professional Corporation ' 2 100 Webster Street, Penthouse Suite RECEIVED Oaklandi California 94607 3 (415) 893-7333 i.; - - n ., I .1 r.. 4 Attorney for Claimant PKIBA7FHELOR CJ G QN COST PE ViSO? g Dopury 6 7 Claim of BRYANT WILRIGHT, 8 Claimant, CLAIM FOR DAMAGES (Government Code 9 vs. Section 910) 10 COUNTY OF CONTRA COSTA, 11 and DOES I through X / 12 TO: THE COUNTY OF CONTRA COSTA, and DOES I through X: 13 That the true names or capacities, whether individual, 14 corporate, associate or otherwise of DOES I through X are 15 unknown to claimant, who therefore cites them by such fictitious 16 names . Claimant is informed and believes, and therefore alleges, 17 that each of the persons designated herein as a DOE is responsible 18 in some fanner for the events and happenings herein referred 19 to, and caused the injuries and damages sustained by claimant 20 as herein alleged. 21 You are hereby notified that BRYANT WILRIGHT, by and 22 through hIs attorney, FRED T. JENNER, A Professional Corporation, 23 100 Webster Street, Penthouse Suite, Oakland, California, 24 Telephone: 893-7333 , does hereby file claim for damages against 25 the COUNTY OF CONTRA COSTA, and DOES I through X. 26 That on or about July 5, 1988, in "B" Dormitory in 27 the Correctional Facility, Clayton, County of Contra Costa, 28 State of California, claimant suffered injuries rendering -1- J •i I him blind in one eye and additional facial injuries; that 2 claimant suffered said injuries when struck by another prisoner 3 with a 2 x 4 piece of wood; that CONTRA COSTA COUNTY and. DOES 4 I and X did so carelessly and negligently maintain supervision 5 in said facility as to cause and allow the circumstances and 6 act to take place. 7 Claimant is under medical treatment and not aware of the 8 full nature and extent of his injuries . 9 The total medical and other special damages caused claimant 10 by reason of the facts alleged herein are unknown at this time. 11 The amount claimed as of this date is FIVE HUNDRED THOUSAND 12 DOLLARS ($500, 000. 00) general damages plus special damages 13 according to proof when the same have been ascertained. 14 All notices and other communications with respect to this 15 claim should be sent to claimant' s attorney, FRED T. JENNER, 16 A Professional Corporation, 100 Webster Street, Penthouse Suite, 17 Oakland, California 94607. 18 Dated: October 7, 1988 19 20 21 , FRED T. JEN 22 23 24 RECEIVED ON BEHALF OF THE 25 COUNTY OF CONTRA COSTA: 26 By: 27 28 Dated: -2- 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 November 8 , 1988 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: $218 . 00 Section 913 ana 915.4. Please note all "Warnings". CLAIMANT: ROBERT PARISEAU - CoL#r'ty COunso! 1530 Manor Drive G u I 19 1988 ATTORNEY: San Pablo, CA 94806 Date receivedMa rineZ, Cl�1 Q4553 ADDRESS: BY DELIVERY TO CLERK ON October ll, 17 8 BY MAIL POSTMARKED: October 6, 1988 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: October 18 , 1988 ��: Deputy - L.' Hal l 11. FROM: County Counsel I 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: 10 tio k�0 BY: _ Deputy 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 0 DER: By unanimous vote of the Supervisors present (ZThis Claim is rejectld 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. NOV 8 1988 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 llnite4 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. N O V 9 1988 BY: PHIL BATCHELOR by uty Clerk I CC: County Counsel County Administrator I ' ,CLAIM TO: BOARD OF SUPERVISORS OF CONTRA Covet RS�� pp • - e ur i � application t0. • !" '` Instructions to Claimant Clerk of the Board P.O.Box 911 On,ez.Calllorni 94533 A. Claims relating to causes of action for death or for injury tao ` person or topersonal 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 of this form. RE: Claim by ) Reserved for Clerk' s filing stamps Against the COUNTY OF CONTRA COSTA) 1 X I9J83 I; or DISTRICT) ' (Fill) in name) ) c I - The undersigned claimant hereby makes claim against t�ie &untY of Contra Costa or the above-named District in _ the sum of $ and inn support -of this claim represents as follows : --------------------- ------- -- ---------------------------------------- 1. When did the damage or injuryoccur Give exact date and hour 2. Where did the damage or injury occur? (Include city and county) fir r Al �al�r� i How did the damage or injury occur? (Give fug details , use extra sheets if required) 9 . What particular act-or omission on the part of county or district officers , servants or employees caused the injury or damage? ES -S (over)TY l r . - - .rr. ...,_a- _ -.+.w.►'-..qs+�+..a.a.:i.e.::.,. •.r..r..r. ..'.+i+.-...... ..:.a::.r►......a..a�rs4: '-��"z._—.��dr.YTY 4 .•.; ..�.., °is are,tie'.,names of county or district officers, servants or employees-,causing the damage or injury? ' --- � 1 � _ � -------------- 6. What damage_or injuries do you claim resulted? (Give full extent of injuries, or damages claimed. Attach two estimates for auto damage) J ------------------- -------- --- ---- 7. How was thel amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 71 8. Dames and addresses of witnesses , doctors and hospitals. - ---------------------------- -•-------------------------------------- 9.--List the expendd - itures you ma-e on account of this accident or injury_ DATE 2 , ITEM AMOUNT r% ,� �)'L1Y)thc-/�-S C•(`JLYrII,� k• �G��Ii - 0 - 60 C// i . Govt. Code Sec. 910 .2 provides : "The claim signed by the claiman-t SEND, NOTICES TO:,— (Attorney) or by some oerson on his behalf. ' Name and Address of Attorney � � ��C�.?_C�_CC�t-�- Claimant' s Signature Address Telephone No. Telephone No. /I iO^J L 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, anv false or fraudulent claim, bill, account , voucher . or writing, is guilty of a felony. ' --...,_.... - �a.+.-......-iay.,..�e *...ut;.:^:ai..,.w:�,....•..::.:.o.•....-_c..._t.. _..t.__,....1..:...:::-a. %r:r's.e:��r.rtiieMj 6.is0, i:asi - - i•.- q.� CONTCOSTA DETENTION FACILITY 1 . a 00 i��Isi f" CLOTHING RECEIPT. . .. : DATE: REC: 5 . _ TIME: FACILITY: "' -p 137 G : -MF" I , NAME (L, F M): PARISEAU ROSE BOOKING NBR: 88024207.E - INTAKE LOUSE 4,57, fo /SKIRT�L� AT/JACKET [� OOTy�/Jr I PANTIE T-SHIRT/BRA � a YLONS> )3 HAT/PURSE . ATER/SWT. SHIRT HDRESS OTHER • BKG OFC: - INMATE SIGNATURE , RELEASE DATE: I HAVE RECEIVED ALL OF MY CLOTHING. REI OFC: r X \ INMATE SIGNATURE i i it Z IJ £.ill i }