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HomeMy WebLinkAboutMINUTES - 01051988 - 1.35 CLAIM If 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 5 , 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: $6 , 731. 63 Section 913 and 915.4. Please note all "W"rSUn� of Counsel CLAIMANT: CHESTER L. WILLIAMS c/o Terrence W. Andrews DEC 01- 1987 ATTORNEY: 901 Peralta Avenue Albany, CA 94706 Date received Martinez, CA 94553 ADDRESS: BY DELIVERY TO CLERK ON November 24, 1987 BY MAIL POSTMARKED: November 23 , 1987 I. FROM: Clerk of the jioard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 4, 1987 QH IL BATCHELOR, Clerk DATED: BY: Deputy L. Hall II. FROM: County Counsel - n TO: Clerk of the Board of Supervisors X�ccs� Gi�,Q.2 c /" / (� Thi `ifim-complies substntially with SgctioYSs 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: G �A�Oeputy County Counsel III. FROM: Clerk of the Board PwTO: County Counsel (1) County Administrator (2) (v< 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. (X ) Other: Portion of original claim not' previously returned as untimgly 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 5 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 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 a=eputy addressed to the claimant as shown above. Dated: -JAN 8 1988 BY: PHIL BATCHELOR by Clerk CC: County Counsel County Administrator r RECEIVED NOTICE OF CLAIM NOV 241987 P A ELOR CLER D S E S By . �.. . TO: COUNTY OF CONTRA COSTA Chester L. Williams, hereby makes claim against the County of San Francisco, for the sum of $6 , 731 . 63 and makes the following, statements in support of the claim: 1 . CLAIMANT ' S POST OFFICE ADDRESS IS: 2486 83rd Oakland, California 94605 2 . NOTICES CONCERNING THE CLAIM SHOULD BE SENT TO: Terrence W. Andrews 901 Peralta Avenue Albany, California 94706 3 . THE DATE AND PLACE OF THE OCCURRENCE GIVING RISE TO THIS CLAIM ARE: On or about November 1 , 1986 Contra Costa County, State of California 4 . THE CIRCUMSTANCES GIVING RISE TO THIS CLAIM ARE AS FOLLOWS : On or about August 14 , 1987, the claimant informed the San Francisco County District Attorney' s Family Support Division that his support obligation had been changed. The San Francisco County District Attorney' s Family • Support Division had been collecting child support pursuant to a San Mateo County court order issued in September of 1982 for the amount of $125 . 00 per child for the support of two children for a total of $250 . 00 . On or about August 14, 1987, the claimant advised the San Francisco County District Attorney' s Family Support Division that one of the supported children had been living with him for approxi- mately 1-2 years and that he had paid a substan- tial amount to his ex-wife. During the month of September, the amounts that were owing to San Francisco County were adjusted reflecting the afore-stated change of circumstances . Sometime in 1985 , Contra Costa County, since the ex-wife moved to Contra Costa County, opened an account against said claimant and requested that San Francisco County continue the collection thereof from said claimant. Contra Costa County in 1985 also filed a tax intercept for amounts due from claimant. As a result of the above referenced modifications ai)d adjustments made by San Francisco County reflecting payments made to claimant' s ex-wife outside of their wage assignment and for adjustments reflecting that one child had been residing with said claimant, claimant' s balance due to Sari Francisco County and Contra Costa County was $2, 507. 58 . Sometime • in October, Contra Costa County received a tax intercept in the amount of $9, 239. 21 and - 2 - consequently paid to claimant' s ex-wife approxi- mately $8 , 200 . , thus overpaying said ex-wife the sum of $6, 731 . 63. Contra Costa County made no effort to stop issuance of the overpayment to claimant' s ex-wife or to stop payment on the check that had been issued to claimant' s ex-wife. 5. THE INJURIES SUSTAINED ARE: Claimant, Chester L. Williams, suffered the following injuries, including but not limited to: (a) loss of use of $6 , 731 . 63 from August of 1987 plus loss of use of interest on said money at the legal rate from said date. 6 . THE NAMES OF THE PUBLIC EMPLOYEES CAUSING THESE INJURIES ARE Unknown Contra Costa County Employees . 7 . THE CLAIM FOR DAMAGES, AS OF THE DATE OF THIS CLAIM IS AS FOLLOWS: $6 , 731 . 63 from August 1987 at the legal rate of interest. 3 - 8 . THE BASIS OF THE COMPUTATION OF THE ABOVE AMOUNT IS AS FOLLOWINGS : $9 , 239 . 21 (amount intercepted) -$2, 507. 58 (amount owed) balance is $6 , 731 . 63 . Dated: I !` ERRENCE W. AND EWS Attorney for Claimant l _. 4 - i 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 5 , 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 an your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $10,000, 000. 00 Section 913 and 915.4. Please note all "Warnings". County Counsel CLAIMANT: GABRIEL ORTEGA, A :MINOR c/o Emily Graham DEC 11' 1987 ATTORNEY: Law Offices of Thomas Steel , APC 2424 Pine Street Date received Martine , CA c�455 ADDRESS: San Francisco, CA 94115 BY DELIVERY TO CLERK ON December 8 , 1987 and 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. DATED: December 11, 1987 ppHH1L ATCHELOR, Clerk BY: Deputy 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: BY: Deputy County Counsel 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: J A N 5 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 1 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: .IAN 8 1988 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLA.1M TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant Return original aPDlitation tc Clerk of the Board 651 Pine St., Room 106 Martinez, CA 94553 A. Claims relating to causes of action for death or"for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. ' Claims relating _to any other cause of action must be presented not later than one year after the accrual of the -cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors , rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. , E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end orTRis form. RE: Claim by )Reserved for Clerk's filing stamps GABRIEL ORTEGA, a minor R,EC IVE Against the COUNTY OF CONTRA COSTA) DEC 8 1987 or DISTRICT) AT LOA (Fill in name ) w ay The undersigned claimant hereby makes claim a f Contra Costa or the above-named District in the sum of $ lo ,000 .000 .00 and in support of this claim represents as follows : w wr w r w q w w w-- w w r.,w w r r w ww w w w w w w r�w w w w w w w r w ww w w w w w w w wwww I. t�T�ien a1� the damage or �n3ury occur? ZGive exact Bate ani fiourj September 1, 1987 at approximately 11:50 a.m. ww rwr t. ww rrrwrwww wr�r.wwww�.r-11 . .....w rrrww=www-wwwwwwwwr wwww �il�iere 3. amdamage or N3U occur? 11M;de city and countyT At the railroad tracks near Port Chicago Highway at the Concord Naval Weapons Station, an unincorporated area in Contra Costa County . w T w w w w w w w�.rw w r r w w r w r w w w w w r w w w w ww ww wr ww r T w w r w w w w w r w ww wwww ww w ww 3. How did the damage or in�ury occur? Give tuSS d'eta�Is, use extra sheets if required) See attached. i. `i��iat pat`t�eu�ar act oi`om�sa�on on the part ot`county oz aaeti�ct"` officers, servants or employees caused the injury or damage? See attached. (over) 5. Whit are the nar—,-s of county or district officers, servants or' employees causing the damage or injury? See attached. 6. what damage or injuries do you claim resulted? ZG�veu�� extent of inj} ries or damages claimed. Attach two estimates for auto damage? See attached ?. How was the amount claimed above computed? (Include the estmate� amount of any prospective injury or damage. ) The claim is based on the severe emotional and physical distress suffered by Claimant. --- ---------------- 6. Names-and-addresses-of witnesses, doctors and bosp�tals. Unknown at present time. Names and addresses will be provided when ascertained, but also See Attachment �. Llat the expenditures you made on account of this accident or �n�ury: DATE ITEM AMOUNT Unknown at present time. Will be provided when ascertained. �Rt�tR�tietr*rt*#�e+��r�«qtr«�*�*i� R:ict�r*���i��t:l��***�*t�tR��RI��RRRR�I�RRtt«RRtllRlk \ Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Emily Graham EMILY GRAHAM LAW OFFICES OF THOMAS STEEL, APC c/o 2424 Pine Street t Claimant 2424 Pine Street Addfess San Francisco, CA 94115 San rancisco, CA 94115 Telephone No. (415) 929-1915 Telephone No. (415) 929-1915 NOTICE Section 72 of the Penal Code provides: "Every person %-ho,. 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. " Sr No. 3: Claimant Gabriel Ortega, a 14-year-old minor, is the son of Holley Rauen and the stepson of S. Brian Willson. Mr. Willson was struck by a train on the railroad tracks near Port Chicago Highway at the Concord Naval Weapons Station while he and- Claimant- and other protesters were lawfully exercising their First Amendment rights and were peacefully protesting the shipment of arms from the United States to Central America. Notice of the planned demonstration had been given to County, State, and local officials, including, inter alia, the Contra Costa County Sheriff-Coroner's Department, and also to officials at the Concord Naval Weapons Station. Despite such notice, a munitions train was driven into the peaceful protesters without warning, striking Mr. Willson and causing him to suffer near fatal injuries, and causing Claimant to suffer severe emotional distress as he witnessed the grievous injuries inflicted on his stepfather. No. 4: Agents, officials, and employees of Contra Costa County, including but not limited to, officials and employees of the Contra Costa County Sheriff-Coroner's office, unlawfully and knowingly owned, operated, managed, controlled, and maintained the public property located at and adjacent to Port Chicago Highway and the Concord Naval Weapons Station, and the railroad tracks, signals, and warnings thereon, in a dangerous condition; failed to warn users, including Claimant and his mother and stepfather of the dangerous condition of said property, and failed to protect against said dangerous condition; undertook to protect and/or to take precautionary measures on behalf of the protesters, including Claimant and his mother and stepfather and did so negligently; unlawfully failed to protect or warn the protesters, including Claimant and his mother and stepfather, although they had undertaken to do so and had a mandatory duty to do so, and were relied on by Claimant and his mother and stepfather and other protesters to do so; wrongfully failed to notify the train crew .and supervisors, and other personnel at the Concord Naval Weapons Station, that protesters, including Claimant' s stepfather, intended to block the train; unlawfully failed to properly control and monitor the protest and the assembled protesters, and to employ adequate crowd control procedures; failed to properly train, supervise, and control law enforcement personnel in the handling of peaceful demonstrations; negligently hired and retained unfit law enforcement personnel; unlawfully failed and refused to provide necessary medical assistance to Claimant and his mother and stepfather and unlawfully acted in concert with other persons to deprive Claimant and his mother and stepfather of their constitutional rights. No. 5: Agents, officials, supervisory employees, and other employees of the Contra Costa County Sheriff-Coroner' s office, including Sheriff-Coroner Richard Rainey, Acting Division Commander Donna Irwin, Sgt. Al Earle, Capt. Gary Ford, Sgt. Ovid 1 w . Holmes, and other Sheriff Department employees whose identities are not presently known to Claimant, county agents, servants, and employees responsible for providing emergency medical and ambulance service, whose identities are not presently known to Claimant; and other officials, agents, servants, and employees of Contra Costa County whose identities are not presently known. No.6: As a result of the incident, Claimant suffered extreme emotional and physical distress, loss of his constitutional rights, and other injuries. No. 8: continuation Marilyn Coffy 4101 Howe St. #110, Oakland, CA Robert Lassalle 9898 East 14th St. , Oakland, CA David Hartsough San Francisco, CA Rev. David Duncombe address unknown Micahel Kroll 460 Weldon Ave. , Oakland, CA. Ellen Earth P.O. Box 7294, Santa Cruz, CA Duncan Murphy address unknown Andrew Peri 814 E Stret, San Rafael, CA Francisco Herrera 9898 East 14th St. , Oakland, CA Robby Labovitz 1845 15th Ave. , Santa Cruz, CA John Skerce P.O. Box 26068 San Francisco, CA Marjorie Wall Concord, CA Laura Hagan 5351 Coast Rd, Santa Cruz, CA Chris Ballin P.O. Box 427, Santa Cruz, Ca Stephen Brooks 5351 Coast Rd. , Santa Cruz, CA Scott Rutherford P.O. Box 9586, Santa Cruz, CA Marie Seaman 4845 Fetter Rd, Milpitas, Ca Helen Williams address unknown Sydney Vilen San Bruno, Ca Train crew: David Humiston, engineer, Antioch, CA Robert Mayfied, brakeman, Vacaville, CA Ralph Dawson, conductor, Vallejo, CA Train supervisors: Edward Hubbard, Concord, CA John M. Banta, Pittsburg, CA Also, numerous civililan and military employees whose names and addresses are presently unknown. 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 5 , 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. 00 Section 913 and 915.4. Please note all "4ntm" Counsol CLAIMANT: HOLLEY RAUEN c/o Emily Graham DEC 1 1987 ATTORNEY: Law Offices of Thomas Steel, APC Martinez, CA 94553) 2424 Pine Street Date received ADDRESS: San Francisco, CA 94115 BY DELIVERY TO CLERK ON December 8 , 1987 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. IL gATCHELOR, Clerk DATED: December 11, 1987 fib: Deputy . Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors XThis 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: -Lao, 1� � BY: Deputy County Counsel I!!. 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 O This 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: J A N 5 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: J A N 8 19 88 BY: PHIL BATCHELOR by / Zt// Deputy Clerk CC: County Counsel County Administrator CLA M Td: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant Return original application tc Clerk of the Board 651 Pine St., Room 106 Martinez. CA 94553 A. Claims relating to causes of action for death or­for 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. 911.21 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 and of this form. RE: Claim by )Reser ' ng stamps REdHOLLEY RAUEN ) &" Against the COUNTY OF CONTRA COSTA) 9 4%U E C 8 1987 or DISTRICT)Fin name 4�0 .. ...... The undersigned claimant hereby makes claim against the Countyy of Contra Costa or the above-named District in the sum of $ 10 ,000 ,000 .D0 and in support of this claim represents as follow-s .- September ollows :September 1, 1987 at approximately 11:50 a.m. �. ` ifi`eie`�i� tfie �nmage o`r Injury occui?`�ZInclude city and county At the railroad tracks near Port Chicago Highway at the Concord Naval Weapons Station, an unincorporated area in Contra Costa County . r►7777-��. r------777777777- --777777777 .r.rrr 7 7 �.rr 777r77�77r777 3. How did the damage or in�ury occur? ZGive IuII aetalI7s, use extra sheets if required) See attached page 7r 7777777 rr 77777777-rrr 77 7777777777777777 77777777777 .�7 r.7 ��r�r 1. �fhat particular act or omisslon on the part o� county or aistr�ct officers , servants or employees caused the injury or damage? See attached page (over) 5. %?bat are the names of county or district officers, servants or ' empldees causing the damage or injury? See attached --------- --------T- --T--- -----�•---T------ -- ----------- extent ----------extent of inj ries or damages claimed. Attach two estimates for auto damage See attached ---------------------------------------------------------------- ---- --- 7. eow was the amount claimed above computed? (Include the est�ntate� amount of any prospective injury or damage. ) The claim is based on the severe emotional distress suffered by Claimant, and the value of services she must provide to her husband and son as a result of their injuries . _ ------------- -- -------------- ----------- -------------- ---- N 8. ames and addresses of witnesses, doctors and hospitals. Doctors unknown at present; their names and addresses will be provided when known. See Attachment B �. List the expenditures you made on account of this accident or �n3ury: DATE ITEM AMOUNT Unknown at present. Will be presented when ascertained. !!R!!lRRRRRRlRRRRRRRRRRlRlRRRR!!RR!!R!!!R!!!R!!R!!f!!!R!!!!!!!!!!!!RR!!!!R Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney F11 )t- lilt-e-lt, - EMILY GRAHAM C a ant s ignature LAW OFFICES OF THOMAS STEEL, APC 2424 Pine Street Address San Francisco, CA 94115 c/o 2424 Pine Street San Francisco, CA 94115 Telephone No. (415) 929_1915 Telephone No. jai -,a !!!R!R!!!!!!!!!R!!!!!!!#!*!!RRlR!!!!!!!!!!!!!!!R!!!!!!!!!!!!!!!R!!R!!!!!!R NOTICE Section 72 of the Penal Code provides: "Every person who, :with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, 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. " No. 3: Claimant Holley Rauen is the wife of S. Brian Willson. Mr. Willson was struck by a train on the railroad tracks near Port Chicago Highway at the Concord Naval Weapons Station while he and Claimant and other protesters were lawfully exercising their First Amendment rights and were peacefully protesting the shipment of arms from the United States to Central America. Notice of the planned demonstration had been given to County, State, and local officials, including, inter alia, the Contra Costa County Sheriff-Coroner's Department, and also to officials at the Concord Naval Weapons Station. Despite such notice, a munitions train was driven into the peaceful protesters without warning, striking Mr. Willson and causing him to suffer near fatal injuries, and causing Claimant to suffer severe emotional distress as she witnessed the grievous injuries inflicted on her husband. No. 4: Agents, officials, and employees of Contra Costa County, including but not limited to, officials and employees of the Contra Costa County Sheriff-Coroner's office, unlawfully and knowingly owned, operated, managed, controlled, and maintained the public property located at and adjacent to Port Chicago Highway and the Concord Naval Weapons Station, and the railroad tracks, signals, and warnings thereon, in a dangerous condition; failed to warn users, including Claimant and her husband, of the dangerous condition of said property, and failed to protect against said dangerous condition; undertook to protect and/or to take precautionary measures on behalf of the protesters, including Claimant and her husband, and did so negligently; unlawfully failed to protect or warn the protesters, including Claimant and her husband, although they had undertaken to do so and had a mandatory duty to do so, and were relied on by Claimant and her husband and other protesters to do so; wrongfully failed to notify the train crew and supervisors, and other personnel at the Concord Naval Weapons Station, that protesters, including Claimant and her husband, intended to block the train; unlawfully failed to properly control and monitor the protest and the assembled protesters, and to employ adequate crowd control procedures; failed to properly train, supervise, and control law enforcement personnel in the handling of peaceful demonstrations; negligently hired and retained unfit law enforcement personnel; unlawfully failed and refused to provide necessary medical assistance to Claimant and her husband; and unlawfully acted in concert with other persons to deprive Claimant and her husband of their constitutional rights. No.5: Agents, officials, supervisory employees, and other employees of the Contra Costa County Sheriff-Coroner' s office, including Sheriff-Coroner Richard Rainey, Acting Division Commander Donna Irwin, Sgt. Al Earle, Capt. Gary Ford, Sgt. Ovid Holmes, and other Sheriff Department employees whose identities are not presently known to Claimant, county agents, servants, and employees responsible for providing emergency medical and 1 ambulance service, whose identities are not presently known to Claimant; and other officials, agents, servants, and employees of Contra Costa County whose identities are not presently known. No. 6: As a result of the incident, Claimant suffered extreme emotional and physical distress, loss of consortium, loss of constitutional rights, and other injuries. As a further result of the incident, Claimant must provide care and services to her husband due to his serious injuries and permanent disability, and care and services to her son, Gabriel Ortega, for injuries he received as a result of this incident. • Y ATTACHEMENT B: WITNESS LIST Marilyn Coffy 4101 Howe St. #110, Oakland, CA Robert Lassalle 9898 East 14th St. , Oakland, CA David Hartsough San Francisco, CA Rev David Duncombe address unknown Micahel Kroll 460 Weldon Ave. , Oakland, CA Ellen Earth P.O. Box 7294, Santa Cruz, CA Duncan Murphy address unknown Andrew Peri 814 E Stret, San Rafael, CA Francisco Herrera 9898 East 14th St. , Oakland, CA Robby Labovitz 1845 15th Ave. , Santa Cruz, CA John Skerce P.O. Box 26068 San Francisco, CA Marjorie Wall Concord, CA Laura Hagan 5351 Coast Rd, Santa Cruz, CA Chris Ballin P.O. Box 427, Santa Cruz, Ca Stephen Brooks 5351 Coast Rd. , Santa Cruz, CA Scott Rutherford P.O. Box 9586, Santa Cruz, CA Marie Seaman 4845 Fetter Rd, Milpitas, Ca Helen Williams address unknown Sydney Vilen San Bruno, Ca Train crew: David Humiston, engineer, Antioch, CA Robert Mayfied, brakeman, Vacaville, CA Ralph Dawson, conductor, Vallejo, CA Train supervisors: Edward Hubbard, Concord, CA John M. Banta, Pittsburg, CA Also, numerous civililan and military employees whose names and addresses are presently unknown. A- . 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 5 , 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: $25 , 000, 000- 00 Section 913 and 915.4. Please note all "WarOG=nty C0G,1S.1 CLAIMANT: S . BRIAN WILLSON c/o Emily Graham DEC 1 1987 ATTORNEY: Law Offices of Thomas Steel, APC Martine-,, CA 9453 2424 Pine Street Date received ADDRESS: San Francisco, CA 94115 BY DELIVERY TO CLERK ON December 8 , 1987 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. December 11, 1987 geHHIL BATCHELOR, Clerk DATED: eY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors XThis 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: ��/, f i2k BY: 5 Deputy County Counsel rROM: 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. Gated:JAN 5 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: JAN 8 1988 BY: PHIL BATCHELOR byVA_t//_&��eputy Clerk CC: County Counsel County Administrator TO: .t BOARD OF SUPERVISORS OF CONTRA CUb'1•A l.vu"a a Instructions to Claimant Return original application tc Clerk of the Board 651 Pine St.. Room 106 Martinez, CA 94553 A. Claims relating to causes of action for death oz for Injury to person or to personal property or growing crops must be presented not later than. the 100th day after the accrual of the cause of action. - Claims relating to any other cause of action must be presented not later than-one year after the accrual of the -cause of action. (Sec. 911.2, Govt. Code) S. 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 and of this form. �..*...*.***f..**:.*.*:*.:.:.*****....,►.*�****:::****.:�+�ar*:,►.:�**•yea►** RE: Claim by )Reset c g stamps S. BRIAN WILLSON � � '� 'EC 8 1987 Against the COUNTY OF CONTRA COSTA) w+ T LOR or DISTRICT) u s (Fillin name ) ey "� The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 25, 000 ,000. 00 and in support of this claim represents as follows: I. -i�l�ien�did the dnmage�or injury occur? ��Give exact date end fiouzf"' September 1, 1987 at approximately 11: 50 a.m. d"amage`oi` n�uzy ocouz?��ZInclude`oity bnd�eouny���-� At the railroad tracks near Port Chicago Highway at the Concord Naval Weapons Station,ap unincorporated area in Contra Costa County. 3. Bow did the damage oz �n�ury occur? ZG�ve �ul� aeta�Ss, use extra sheets if required) See attached page Z.` khat p`art�cu�ni act or om�ss�on�on the pait o��county`o=`3ie`tr�ct officers , servants or employees caused the injury or damage? See attached page (over) l 5. :fiat are the namesi,of county or district officers, servants or' employees causing the damage or injury? SEE ATTACHED 6. What damage or injuries do you claim resulted? �G�ve �u�I extent of inj ries or damages claimed. Attach two estimates for auto damage SEE ATTACHED ---------------------------------------------------------------- -- - --- 7. eow was the amount claimed above computed? (Include the est�mate� amount of any prospective injury or damage. ) SEE ATTACHED ----------------------------------------------------- ------------- - 8. Names and addresses of witnesses, doctors and hospitals. John Muir Hospital, Walnut Creek, CA, and numerous physicians associated with that hospital Dr. Robert Baran, U.C. Medical Center, San Francisco, CA. Dr. Norman Livermore, Walnut Creek, CA Dr. Cavett Mr. Robert, Jr. , Walnut Creek, CA Other doctors & health care providers unknown at present, and see attached V--List the --r---- list �. List the expenditures you made on account of this accident or �n�ury: DATE ITEM AMOUNT Unknown at present; costs will be provided when ascertained Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Emily Graham on behalf Willson Emily Graham Cla ant sSignature Law Offices of Thomas Steel, APC 2424 Pine Street 2424 Pine Street Address San Francisco, CA 94115 -Egn Francisco . cA 2411-9 Telephone No. (415) 929-1915 Telephone No. (415) 929-1915 NOTICE Section 72 of the Penal Code provides: 'Every person who, with intent to defraud, presents for all*wance 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. " ATTACHMENT TO CLAIM OF S. BRIAN WILLSON No. 3: Claimant S. Brian Willson was struck by a train on the railroad tracks near Port Chicago Highway at the Concord Naval Weapons Station while he was lawfully exercising his First Amendment rights and was peacefully protesting the shipment of arms from the United States to Central America. Notice of the planned demonstration had been given to County, State, and local officials, including, inter alfa, the Contra Costa County Sheriff-Coroner' s Department, and also to officials at the Concord Naval Weapons Station. Despite such notice, a munitions train was driven into the peaceful protesters without warning, striking claimant and causing him to suffer near fatal injuries. No. 4: Agents, officials, and employees of Contra Costa County, including but not limited to, officials and employees of the Contra Costa County Sheriff-Coroner' s office, unlawfully and knowingly owned, operated, managed, controlled, and maintained the public property located at and adjacent to Port Chicago Highway and the Concord Naval Weapons Station, and the railroad tracks, signals, and warnings thereon, in a dangerous condition; failed to warn users, including Claimant, of the dangerous condition of said property, and failed to protect against said dangerous condition; undertook to protect and/or to take precautionary measures on behalf of the protesters, including Claimant, and did so negligently; unlawfully failed to protect or warn the protesters, including Claimant, although they had undertaken to do so and had a mandatory duty to do so, and were relied on by Claimant and other protesters to do so; wrongfully failed to notify the train crew and supervisors, and other personnel at the Concord Naval Weapons Station, that protesters, including Claimant, intended to block the train; unlawfully failed to properly control and monitor the protest and the assembled protesters, and to employ adequate crowd control procedures; failed to properly train, supervise, and control law enforcement personnel in the handling of peaceful demonstrations; negligently hired and retained unfit law enforcement personnel; unlawfully failed and refused to provide necessary medical assistance to Claimant; and unlawfully acted in concert with other persons to deprive Claimant of his constitutional rights. No. 5: Agents, officials, supervisory employees, and other employees of the Contra Costa County Sheriff-Coroner's office, including Sheriff-Coroner Richard Rainey, Acting Division Com- mander Donna Irwin, Sgt. Al Earle, Capt. Gary Ford, Sgt. Ovid Holmes, and other Sheriff Department employees whose identities are not presently known to Claimant; county agents, servants, and -- e employees responsible for providing emergency medical and ambulance service, whose identities are not presently known to Claimant; and other officials, agents, servants, and employees of Contra Costa County whose identities are not presently known. No. 6: As a result of the incident, both of Claimant' s legs were amputated below the knee, and he sustained a fractured skull, a fractured wrist, severe lacerations of his head, cheek and ear, severe abrasions and contusions over his entire body, pain and suffering, and other injuries; and loss of his constitutional rights. No. 7: The claim is based on Mr. Willson's medical bills, which currently total approximately $150, 000 .00, his future medical, nursing, rehabilitative, prosthetic and domestic expenses, special housing and transportation costs, the permanent dimunition of his earning capacity, and severity of his permanent disability, and the extent of his pain and suffering. No. 8: See next .page. -2- • ATTACHMENT TO NO. 8: WITNESS LIST Marilyn Coffy 4101 Howe St. #110, Oakland, CA Robert Lassalle 9898 East 14th St. , Oakland, CA David Hartsough San Francisco, CA Rev. David Duncombe address unknown Micahel Kroll 460 Weldon Ave. , Oakland, CA Ellen Earth P.O. Box 7294, Santa Cruz, CA Duncan Murphy address unknown Andrew Peri 814 E Stret, San Rafael, CA Francisco Herrera 9898 East 14th St. , Oakland, CA Robby Labovitz 1845 15th Ave. , Santa Cruz, CA John Skerce P.O. Box 26068 San Francisco, CA Marjorie Wall Concord, CA Laura Hagan 5351 Coast Rd, Santa Cruz, CA Chris Ballin P.O. Box 427, Santa Cruz, Ca Stephen Brooks 5351 Coast Rd. , Santa Cruz, CA Scott Rutherford P.O. Box 9586, Santa Cruz, CA Marie Seaman 4845 Fetter Rd, Milpitas, Ca Helen Williams address unknown Sydney Vilen San Bruno, Ca Train crew: David Humiston, engineer, Antioch, CA Robert Mayfied, brakeman, Vacaville, CA Ralph Dawson, conductor, Vallejo, CA Train supervisors: Edward Hubbard, Concord, CA John M. Banta, Pittsburg, CA Also, numerous civililan and military employees whose names and addresses are presently unknown. 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 5 1988 and Board Action. All Section references are to ) The copy of this document mailed to you is yo r 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: $2 f.958 000 - 00 Section 913 and 915.4. Please note al l "Warnijrtuuni :�,qty Couns .,,cl CLAIMANT: DAVIDIEUGENE WHITE c/o Law Offices of William L. Veen DEC 1 1987 ATTORNEY: 711 Van Ness Avenue #220 Martine_,, San Francisco, CA 94102 Date received December 9 , 1987 ' GA �`t''' ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: December 8 , 1987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. EYILDATED: December 11, 1937 BATCeputHy ELOR, Clerk D L. Hall I1. 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: Z!;� BY: eputy County Counsel II1. 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. JAN 5 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 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 8 1989 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ;z LAW OFFICES OF 1 WILLIAM L. VEEN A PROFESSIONAL CORPORATION 2 711VAN NESS AVENUE. SUITE RECEIVED SAN FRANCISCO. CALIFORNIA 941010 2 3 TEL. (415) 673-4800 9 1987 4 5 ATTORNEYS FOR CLAIMANT 6 7 IN THE MATTER OF A CLAIM FOR DAMAGES OF: 8 DAVID EUGENE WHITE, ) 9 Claimant , ) a ) �A 10 vs . ) CLAIM FOR DAMAGES AGAINST A PUBLIC 11 CONTRA COSTA COUNTY , CALIFORNIA ) ENTITY 12 Defendants . ) i ) 13 14 TO: BOARD OF SUPERVISORS, CONTRA COSTA COUNTY: 15 1 . You are hereby notified that David Eugene White , whose i 16 address is 3155 Willow Pass Road, West Pittsburg, California 17 94565, claims from Contra Costa County two million, nine hundred 18 fifty-eight thousand dollars ($2, 958, 000.00) for damages to 'q 19 himself and property. 20 2. This claim is based on a motorcycle-automobile accident 21 which occurred on October 4, 1987 at the intersection of Port 22 Chicago Highway and Riverside Drive in an unincorporated area of 23 Contra Costa County, California. 24 3• The claimant does not know the names of the public 25 employees who caused claimant's injury and damage . 26 4. The injuries and damages sustained by claimant to date 27 consist of: 28 i, sr d 1 (a') Past Medical Treatment: $100,000.00 (est . ) 2 (b) Property Damage: 5, 000.00 !" 3 (c) Pain- and Suffering: 250 ,000.00 4 (d) Loss of Wages: 81000.00 5 5. The injuries expected to be incurred in the future 6 include: 7 (a) Future Medical Care: $1009000 .00 8 (b) Pain and Suffering and Loss of Enjoyment: 750 ,000.00 9 10 (c) Loss of Future Earning Capacity: 1 , 7509000.00 �t 12 6. All notices and communications with regard to this claim i - i 13 should be sent to: 14 LAW OFFICES OF WILLIAM L . VEEN 711 Van Ness Avenue 15 Suite 220 San Francisco , CA. 91102 16 17 DATED: December , 1987 LAW OFFICES OF WILLIAM L. VEEN i 18 19 20 21 AVEVIN LANCASTER neys for Plaintiff 22 23 24 25 26 27 28 LAW OFFICES OF WILLIAM L. VEEN A PROPESSIONAL CORFORAnON 2 :i 711 VAN NESS AVC..SURE 720 SAN FRANCISCO.CA 94102 TEL.(415)E7348W I declare under penalty of perjury that the following is 2 true and correct: 3 I am a citizen of the, United States , over the age of 18 ` 4 _years and not a party to the within action. My business address :w< 5 is 711 Van Ness Avenue , Suite 220, San Francisco , California. 6 On December 8, 19879 I served a true and correct copy of the 7 following document: 8 CLAIM FOR DAMAGES AGAINST A PUBLIC ENTITY 9 on the parties to this action by placing same in a sealed ±: 10 envelope , with postage thereon fully prepaid and depositing same 11 envelope in the United States mail at San Francisco , California, 12 addressed as follows : 13 14 BOARD OF SUPERVISORS 15 Contra Costa County P .O . Box 911 Martinez , CA. 94553 16 17 18 19 20 Executed the date first above written at San Francisco , 21 California. 22 23 Teri yenielo 24 25 26 27 28 LAW OFFICES OF - WILLIAM L. VEEN A PROFESSIONAL CORPORATION 711 VAN NESS AVC.S.11.220 j SAN FRANCISCO.CA 94102 " TVJ-(415)67}4800 CLAIM BOARD OF SUPR VISORS 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 5 , 1988 and Board Action. All Section references are to ) Thecopy 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: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MAURICE F. HEYWOOD !,')L;rtty COu;Ir 1489 Ashwood Drive 1987 ATTORNEY: Martinez, CA 94553 1 ` Date received �� 987� o,' ADDRESS: BY DELIVERY TO CLERK ON Decerinber-'4', BY MAIL POSTMARKED: December 1, 1987 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 11 1987 PPHNIL BATCHELOR, Clerk DATED: ► BY: DeputyXy, ZQ�, ztlo�l _1_/ 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: no fi_1�-ll , �— BY: y Deputy County Counsel ??1. 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. JAN 5 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 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 81988 �` � Dated: BY: PHIL BATCHELOR byV_d_e�uty Clerk CC: County Counsel County Administrator f` CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be . presented not later than one year after the accrual of the cause of action. (Sec. 911.2., Govt. Code) B. Claims must be filed with the Clerk -of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553 (or mail to P.O. Box 911, Martinez, .CA) . C. If claim is against a district governed by the Board of Supervisors, rather than the ._County, -the, name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. ,: E. Fraud. See penalty for fraudulent-claims, Penal Code Sec. 72 at end of this form. RE: Claim by )Resertd for Clerk' s fili stamps Naa vie- 'e. 14cf W(90901 RECEIVED 11I ��,� �,•. /�'l�wf,;�ti c;, DEC 4 1981 Against the COUNTY OF CONTRA COSTA) ) r oR RV or DISTRICT) ►+� (Fill in name) ) The undersigned claimant hereby makes claim against the Coujipy 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 ]ury occur? (Give exact date and hour) r�.d-,,,. . � • c� ,9 d� �a�� 2. Where did the dama a or injury occur Include city and count DN y ,�¢ ati► b hA A-7 /1'I aw7"ii�G ,� co vtwo -Cod ---------------------------------------------- --------------------- 3. How did the damage or injury occur? (Give full details, use extra sheets if required) I Ao r d R�d-.v$e v, P4 RA e,4 Iv -me. q o ArWlt v'e.r y t t{1 rye 4 �l o e i i'v5 ' '@-t yvs¢ y w t,v t ead 4x11 b n,,ec i t What rticular act or omissifSn on the part of county 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 injur ? �r�`veV` vQ Tkle Fid. ------------------------------------1------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages-claimed. Attach two estimates for auto damage) C.C� 347 e� 6S '1� 7. How was the amount claimed above computed? (Include the estimated amount o£ nypr,ospective 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: ., ,a.-<............... ! ITEM AMOUNT Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Claimant' s Signature Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state. board or officer, or to any county, 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. " C5C3 , � V t i } cr :.l CD QD O ON WOS-3 P A t � — ' t IP to �s - q N m Z � N � Z � p y i o 4 1 N o 9 CD ;t l No W Z Q N 73 t 3 tG C t �mfl m Z 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 5, 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 Gover91-19, 1��Code Amount: $793 . 43+ Section 913 and 915.4. Please note all "Warnings'{. CLAIMANT: ANNETTE FREKMAN DEC I 1 ' 19R7 465 Suisun Avenue ATTORNEY; Rodeo, CA 94572 Martinez, Grp ..;;, ;; Date received December 8 , 1987 ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: December 7, 1987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 11, 1987 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (A 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: y � /l/ � _ BY: C Oeputy 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. BOAX RDD 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: AN 5 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 d No ice to Claimant, addressed to the claimant as shown above. JAN 8 1988 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator n CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, CA) . C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by ) Reserve ing stamps ) RECEIVED Against the COUNTY OF CONTRA COSTA) DEC $ 1987 Or DISTRICT) (Fill in name) ) i By '�' The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 793.43 alus car rental and in support of this claim represents as follows: ------------------------------------------------------------------------ 1. When did the damage or injury occur? (Give exact date and hour) 9/19/87 0240 - ---------------- --------------------------- 2. Where did the damage or--injury occur? (Include city and county) Viewpoint Blvd., Contra Costa County ---------------------------------------------- 3. How did the damage or injury occur? (Give full details, use extra sheets if required) (See attached paper) - -- ------------------------------------------- 4-.--Wh-at---particular-----------act----or---o-mission on the part of county or district officers , servants or employees caused the injury or damage? The driver of Veh. 2, a trained peace officer, was not merely driving through the intersection in a normal traffic pattern. She was intending to back up in the middle of an intersection and did not activate the red or amber emergency lights to alert the driver of Veh. 1 (myself) or any other approaching vehicle) that she (a trained peace officer driving a Emergency Vehicle) was intending to makro-'!�M maneuver other than the normal driving procedure through the intersection. 5. What are the names of county or district officers, servants or employees causing the damage or injury? Jackeline Marie Meiers-Ely of the Contra Costa County Sheriff's Department ----------------.-----a-t-d--a-m-a-g-e--o-r--i-nj--u-r-ie--s-d--o--y-o-u--c-l-a-i-m--r-e-s-u-l-t-ed----G-ive full extent---- of of injuries or damages -claimed. Attach two estimates for auto damage) (See attached estimates) Damage is to left lower rear of pickup bed. -7-.-- - ----- ----- H-ow--w--a-s-is-e--a-mo-u-n-t--c-l-a-i-m-e-d-above -ed-----I-n-c--ude---h-e-es-t-m-ate-d --- amount of any prospective injury or damage. ) (See attached estimates) ------------ -- -------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Passenger in Veh. 1 - Shauna Mae Martell, 2856 Cornelius Dr., San Pablo, CA ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Rep i ns a�+e t been made tflas of this date. Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES T --JAttew- ) or by. some erson on his behalf. " Name and Address of Attorney Claimant' s Signat re 465 Suisun Avenue, Roden, CA 94572 Address Telephone No. Telephone No. (415) 799-3300 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. " 3. Veh. 2 was topped in front of the house on the corner of Viewpoint and California Avenues. Since my lane was clear, I put on my directionals and made my left turn in my lane. 1 glanced over at Veh. 2 and saw back up lights. I then sped up to avoid Veh. 2 hitting my truck. Initially, Veh. 2 only had brakes lights applied. Veh. 2 neglected to look in her mirrors to check and see that I had completed my left turn and see if the Gane was clear before backing up. Therefore, hitting the left lower side bed of my truck with her bumper. It is also apparent from the damage that my truck was leaning into the left turn, and this is why the damage is on the lower part of the bed of the truck. CROCKETT DATALINERFrame E ui Moet ;urrers�Technology PAINT9 P• In Auto Body Repair. � '�(�B�-Y as A. Weis �)E��J! Down Draft Spray Booth 1000 Loring Avenue FRAME ALIGN, (415) 787-2742 Crockett,Ca. 94525 Daniel M.Welsh . Quality Service& Attention to Detail Date /u - 2 Owner Zjfzz-- i+.— Address '5Zg S_ Ph. # Make Yrdt� Lic. # 3 /v3o Type Mileage Bus.# (9S�SX�6S�5 Built Date ID# lollPaint Code Sy FRONT LABOR Parts Sy LEFT LABOR Parts Sy RIGHT LABOR Parts HOURS HOURS HOURS Bumper C L R Fender Fender Reinforcements Aron Aron Absorbers L R Molding Molding Guards L R Strips L R Fillers C L R Side Marker Side Marker Headlamp Headlam Park Lamp Park Lam Cowl Cowl Align Wheel F R Suspension Door Frt Door Frt Molding Molding Door Rear Door Rear Set-up Gauge Molding Molding Frame L R Frt Panel l Quart.Panel Quart.Panel Inner Constr. Inner Constr. Grill C L R Braces Emblem I Moldins U Moldings Al 41 /r � v I D 6 S� it t: ood Hinges L R Lock REAR MISC Lock Support Bumper C L R To Safety Lock Reinforcements Insulation Absorbers L R Mldg C F R Guards Glass- Tint. CL Ant W Strips L R '— o^ V Fillers C L R 14 Battery Rad Support Radiator Trunk Lid Paint -overlap= Fan Hinges L R 2 Sta a 7_0 Schroud Lock Fan Clutch Undercoat 0' O C/W3 Coolant a r"" zL Stripe Tail Lams R r--- _2 � Labor Hrs. $ -7 Mechanical Parts' $ Rear Body Panel Wrecker Service $ Tax Fuel Tank 7 Sublet $ *PARTS PRICES SUBJECT TO CHANGE TOTAL $ INS DOL Claim# AUTHORIZATION FOR REPAIRS This estimate,based on our inspection,does not include any additional parts or laborthat may be required after the work has been started.Occasionally after work has been started,damaged or broken parts are found which were not You are hereby authorized to make the above specified repairs. evident on the first inspection.Because of this,the prices herewith are not guaranteed. signed ALL PARTS ARE NEW except when specified. a t11�! auto *, DOMESTIC FOREIGN EXPERT BODY REPAIRS RESTORATIONS 686 PARKER AVENUE a RODEO, CA 94572 (a speciality) (4151799-0606 Date 4�- Res.Phone Car Owner \ Address - Make 4 — r License N 1�� 7 �1 TYPe Mileage Bus.Phone I.D.# 71 Aj Sy FRONT Hours Parts ;Sy LEFT Hogs Parts Sy RIGHT Labor Parts Hours Bumper Fender Fender --- r- --- — -- Frame Headlamp Headlamp Frt.System Cowl - -- --- - -- Cowl Door Frt._ _ Door Fri. Glass Frt. Panel Door Rear Door Rear Park Lamp Ouor. Panel — -- — l Ouor. Panel Grill --- 3-07 - — Hood Rear Fender Rear Fender --- - MISC. MAR Bumper IX To Rad. Sup. Undercoat Rear Panel i Trunk Lid A Paint Tail lamp AUTHORIZATION FOR REPAIRS You are hereby authorized to make the above specified repairs. Motor Signed Labor Mrs. _ S Parts S o O Wrecker Service $ This.estimate,based on our inspection,does not include any additional parts or labor that may be required after the Tox $ work has been started.Occasionally,after work has been started,damaged or broken parts are found which were not evident on the first inspection.Because of this,the prices quoted herewith are not guaranteed. Sublet a Terms are C.O.D.Payment in full due on delivery.Storage charges will begin to accrue immediately after completion of work. PARTS/PRICES / SUBJECT TO CHANGE TOTAL $ 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 J anu arty 5 , 1 9 8P and Board Action. All Section references are to ) The copy of this document mailed to you is y ur 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: $250, 000- 00 Section 913 and 915.4. Please note all "WaGnUt46Ytj/ COunSC'I CLAIMANT: CITY OF ORINDA . 1987 c/o William G. Hoback, Esq. ATTORNEY: 1304 Willow Street ��` rtlrez, GA 9455, Martinez, CA 94563 Date received ADDRESS: BY DELIVERY TO CLERK ON December 9, 1987 BY MAIL POSTMARKED: December 8, 1987 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 11, 1987 JgIL BAATTCYELOR, Clerk epuy�_ Z, __� L. Hall I1. 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: , /�-7---� BY: eputy 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 (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 5 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 Notice to Claimant, addressed to the claimant as shown above. Dated: J A N 8 1988 BY: PHIL BATCHELOR by O��eputy Clerk CC: County Counsel County .Administrator RODRIGUES vs. COUNTY OF CONTRA COSTA RECEIVED Contra Costa County Superior Court No: 296547 UEC 9 19e7 CLAIM AGAINST THE COUNTY OF CONTRA COSTA AF 'LOA C:LEAKits TO; BOARD OF SUPERVISORS COUNTY OF CONTRA COSTA THE CITY OF ORINDA hereby makes a claim against the COUNTY OF CONTRA COSTA for the sum of $250,000.00 plus interest from February 18, 1986 and makes the following statements in support of said claim: 1. Claimants address is CITY OF ORINDA, Tom Sinclair, City Manager, 26 Orinda Way, Orinda, California 94563. 2. Notices concerning the claim should be sent to William G. Hoback, Esq. , 1304 Willow Street, Martinez, California 94553. 3. The date and place of the occurrence giving rise to this claim is 23 Hall Drive, Orinda, California; said property having originally been damaged and continuing to be damaged by a mud slide from Hall Drive. 4 . The circumstances giving rise to the claim are as follows: On November 5, 1987, the CITY OF ORINDA, was served by mail with a Summons and Complaint entitled John J. Rodrigues and Wanda J. Rodrigues v. County of Contra Costa, et al. , case number 296547. The plaintiffs filed said complaint on February 2, 1987. The plaintiffs allege that public entities, the COUNTY OF CONTRA COSTA and the CITY OF ORINDA, have been indifferent to the main- tenance and creation of Hall Drive so as to cause damage to plaintiffs' real property abutting said street and further alleges that a mud slide from Hall Drive has resulted in damage to their dwelling. A copy of said complaint is attached hereto and incorporated herein as Exhibit "A" . 5. As a result of the filing of the complaint described above, claimant has been forced to engage the services of an attorney to defend them in connection with said action thereby causing claimant to incur legal expenses. Furthermore, claimant may be required to pay damages to plaintiffs in connection with said complaint even though the claimant denies any liability whatsoever for plaintiffs' alleged injuries. Claim Against the County of Contra Costa Re: Rodrigues v. County of Contra Costa, et al. , Page 2 6- The names of the public employees causing the claimant's injuries are unknown. 7. My claim as of the date of this claim is $250,000.00 plus interest from February 18, 1986 and attorney's fees as incurred. 8. The basis of the amount is as follows: See Exhibit "A" wherein plaintiff seeks judgment in the sum of $250, 000. 00, plus interest, costs and attorney' s fees. Dated : December 8, 1987 ERICKSEN, ARBUTHNOT AYNTER & BROWN, INC. B Y illiam G. o ack Attorney for Claimant • ( 1 t It II OkNr v F sc.IN,w17H601 ATlop.t:_r(nAW( AN:)ADDF,EE•S). TELEPHONE Mr.COURT Ot CURRAN .& ALSCHULER, n A Professional Corporation Vt 0 . 166 Santa Clara Avenue Oakland, CA 94610 (415) 653-7207 FEB - 20 1987 ATTOF.N!VF OF.(NAME) Plaintiffs John J. and Wanda L. Rodrigues. Insert narrmc.of court.judicial d:sVtc.1 or branch Court,it any,and post office and street address: I R.OLSSON Coynty Clerk mN7RA CTA '{y IN THE SUPERIOR COURT OF_. THE STATE OF CALIFORNIA, _ IN AND FOR THE COUNTY OF CONTRA COSTA, 725 Court O"OE"`O�"'T' Street, Martinez, CA 94553 . 1 PLAINTIFF JOHN J. RODRIGUES and WANDA L. RODRIGUES DEFE14DANT: THE COUNTY OF CONTRA COSTA, THE CITY OF ORINDA, JOHN A. THIEL and MRS . JOHN A. THIEL, MARCUS FUH and MRS. MARCUS FUH, DOES 1 TO 25., inclusive. CASE t.,.IVBEF; COMPLAINT—Personal Injury, Property Damage, Wrongful Death C:MOTOR VEHICLE i?L +OTHER(specify): ! 2 B C 5 4 j ;_Properly DamaoE _W.'ronoful Depth 1 Personal Injury X; Other DzF,eceE (specih): INVERSE CON– ! DE!-ZATION , NUISANCE AND NEGLIGENCE: . 1 1C 1'.Ci'iC - E:.c. .T:_ a'I� E).'.i:': C C' , Ic 1C J\':•:'�_ f. .er C%. PG.".._. ._.�... ris E cc!rpe!rn! ExceF! ,4. Ana^ie C a cb7r0!E!'•X+ CUE'aie•� 10 OG tjUSirlEcc i'• Ca'11:T-:,E. L_! E^ Unir1GC!p.rciE`C E't;l f IOESC.:i:.'•f;� `SIE pih!i- env 1)•(C`E _;1.'.'F.). iia minor C En. EdJ:t for V.~::rn- a ouard*,Fn Or COnser\Elor C` in e!'a1E O; ii currd,En ac: 1•1,Er': has been 51C� •':1EG ott.e' (spr-c11);7 r;Othe- (Specif"; Excep', (na L—'2 qUa'•!:ed 10 co bus!r'iess in Ca'''O'nia j—,an unincc--orate t -�n pU�iiC E r•1.1) (OES:tl:•f 1' =a rnmpr ar, adU11 C for who—. a Quardian or conservator 01 tr,e ertale or a ouard,an au !herr, has beer', arpninleb Ci other (sere ify): other(spcctf)) t J Flaintif!(name) i!. dc.in-- business under th( fictitlou� name of(-cpecay) a!•Ct bw CC•n:(•t,( Y:ith th( f;Ct:!.OJt bu!inE'S' narnf. r -1 / r 1 1 • 1 rl c h r C Li 1::1(•rn,<:. u!1 a. _a! aC'Ci'(,:•.liu pli,:n1,1,F V.ho te!( r,C.1 corr,�•(•tCnt a..Jlt: t_ s.Iciv. 1 t!. Ccn,pti!!)}— t+!Sir;t.ntf fit qua _ f' CO!APLAlf%'1--P(•rEon:,1 injur)-. Propt My D.^m _ s . --- l , SHORT TITLE 'JO 1\2 ' 0 . RODRIGUES., et al . , Plaintiffs, vs. CASE NUMBER CP T F CONTRA COST.,k, et al . , Defendants. i j r COMPLAINT—Personal Injury, Property Damage, Wrongful Death Page 1*0 3 a Each�defendant named above is a natural person 19j✓ Iitr t7r� NefEridani(name): rn Except defendant.%name): f ictitiously named elki yl HE CITY OF ORINDA as DOES 20 through 25 are builders, de • ::yam ��.><: ;. si�ners a business organization, form unknown pr RE+:6NS1ne%PAgMtAIion, form unknown a carporation a corporation an unincorporated entity(describe): an unincorporated entity(describe): a u lice it desc ibe). itv 1 char- D a public entity(describe): :eyed or inco a an gating &Self• t9 'YaNrs >f the State of-California oerr seif)) C other(specify) - M Except defendant(name): =Except defendant(name): THE COUNTY OF CONTRA COSTA �J a busi-tess orozn.zat,on. form unknown =a business ores ..nation. form unknown C o [CrpC ra,:,,n _a corpotalion an unincorporatEd entity(descri:)e,. En unincorporated en(:,)—(describe) �+. n A ccrinty, duly char- '—!E publ-c. eni, ),(C"srrlbe) tered, incor,;5rate� a_*id operating under the la�.s of / the State of-Californiz l b. T^F t'uE nareE Eric o' dE'Enna-. SUE.^ a! DoeE are UnEnov.,n td p!_-n1:t1 C. `_E I•:fc'rrT,St:.rr, atzut c`j.oct �a! L40en�an*! v:'rC ate no: r,atuta• pE'son- is col,,a:r In COrrpla:nt— AsioEhrneni 3c d :7—I tJEfEndo'ri5 v,-10 are jcmez pursuer: 1.: Codi- of &,,;' Proce�ure Scdt:on 3:.2 are (neme.,,): not 4. tc- cc:' ply v:i?t, a cla-ms sl_-',u f , and a p'a;-,t,u haE c::rnplic-d v ;ttr 2r^, :.G2 E GIf'...,_ 5a:u1�E. Or L ` pl .r,t;f1 is excused 1rorr comp'yirrc because 5. This court is the proper court because j. at least one defendant now resides in Its jurisdictional area the principal place of business of a corporation or unincorporated association is in it:. jurisdictional area. injury to person or damage to personal property occurred in its jurisdictional area u other(spe;iry) The real property subject of this complaint is located within Contra Costa County. G. [j! The follov;ino paragraph: of this complaint are alleoed on information and belief(spe:cif}•paragraph numbers), As set forth in the causes of action . (Grrntlr.uact) Par• r•.: An £.HORIIII LE , JOHN J . RODR_ JES, •et al . , Plaintiffs, j CARIYUMFEF SHE COUNTY OF CONTRA COSTA, et al . , Defendants. COMPLAINT—Personal Injury, Property Damage, Wrongful Death (Continued) P.;1e,hrt 7. Cj The damages claimed for wrongful death and the relationships of plaintiff to the deceased are =listed in Complaint-Attachment 7 =as follows: 8. Plaintiff has suffered wage loss loss of use of property Q hospita! and medical expenses a�,general damage L', property damace loss of earning capacity other damage (specify): Physical damage to real property and improvements, resulting in a reduction in the fair market value of the property in the amount of $250 , 000 . 00 , more or less. G. ReNEt sc;.:Qht in this ccmP!z;r., I5 w1t,'n the of 0.1E court. 1Cr FLAl%7IF:F PRAYS Fa' Ir-. .. f; ctc C'': s_.a. fc.i ss1c`, re*:,e' a5 i5 fa ! fuE'. E: c! E ..JI:a: _ c' f; ! (Superro! Court, a-Cc'c:"c !C' p C)G- (Municipal and Ju!lice Court) r,, lhE S..._-..-_•-_ -.- --'---._—.-- ct;:e: In addition to the losses mentioned in paragraph 8 , for such other and further relief as the Court might deem proper, including but not limited to reasonable attorneys ' and expert witness costs, and all costs of relocation and replacement of real and personal property caused by the losses alleged herein . 11 The fUllq\'.. eouse5 pf action are aiicGhEj anz! lf!e' sta:E'TiEi:S c:C\f r tC each: (Each C•rrE c;.' mD!c- ,Fusei o1 oCi:; r el:ancc• f 1- I Inle rliana!Tort �l FiCrdl':i� Li?bi!:iy Pre.miLe•: Liabdily h_O!�rer (spE.ci Inverse condemnation, Nuisance (damages) . G. A. Alschuler COMPLAINT— Pert;nnal Injury. Property Darnaof•, r ! Wrongfol Depth (Cotttinut•:1) r' r ' z SHORT TITLE: JOHN J. RODRIGUES, et al . , Plaintiffs, CASE NUMBER: ? vs. THE COUNTY' OF CONTRA COSTA, et al , Defendants . FIRST CAUSE OF ACTION--Inverse Condemnation Page 4 . 3 ( ATTACHMENT TO Complaint. 4 Plaintiffs .are the owners of certain real property S commonly known as 2.3 Hall Drive in the City of Orinda', County of 6 �! ; Contra Costa, improved with a single family dwelling and 7 appurtenances thereto, including but not limited to driveways b I and sidewalks. The real property is more fully described in the 9 Official Records of the County of Contra Costa . ]0 Plaintiffs ' real property is on a hillside ; a public I i. road, knov:n as Hall Drive, runs adjacent to the downhill side 12 of plaintiffs ' real property . The conception , design, construc- tion , operation, maintenance and very existence of said public l; road have caused portions of plaintiffs ' real property to slip, i 15 ' slide and subside, damaging the single family dwelling , and 16 placing it in hazard of total destruction. 17 i Plaintiffs were unable to pay the cost of repair and 18 reconstruction of the hillside in order to save their home from 19 destruction, and vere forced to sell the house and lard at a 20 reduced price, all to their damage in the amount of equity loss 21 of approximately $250 , 000 . 00 . �2 Plaintiffs have had to hire attorneys, engineers, and 23 )` others are hive been required or will be required to pay the same , I. 24 as a result of the foregoing , all to their damage , according to 25 proof . 26 I B the facts alleged herein, defendants COUNTY OF II y� g 27 ' CONTRA COSTA, THE CITE' OF ORINDA, ar.!i DOES 1 through 5 have 2� exercised dominion and control over the real property and is l is i I i SHORT TITLE: JOHN J. RODRIGUES, et al . , Plaintiffs, CASE NUDIBER: vs. THE COUNTYy OF CONTRA COSTA, et al , Defendants . isFIRST CAUSE OF ACTION--Inverse Condemnation (Cont. ) Page 5 . 3 f ATTACHMENT TO Complaint. 4 5 improvements of plaintiffs, resulting in a direct and substantial F ; environmental burden upon the plaintiffs, which they have been 7 singled out to suffer, and which proximately caused the damage v `. complained of . 9 l0 CAUSE OF ACTION 1 . 5--Inverse Condemnation. l � The preceding allegations of this complaint are incor- porated herein by reference; this cause of action number 1 . 5 13 against defendants COL-QTY OF COUTP-k COSTA and CITY OF ORINDA la states a similar inverse condemnation claim against them with 15 regard to Keith Drive in the City of Orinda , whereas the first cause ofc action refers to Hall Drive . 17 For cause of action against said defendants , plaintiffs 1 :> allege that a public road known as Keith Drive runs uphill of 39 plaintiffs ' real property . Otherwise, the allegations of this i 20 cause of action are the same. i 21 23 i 24 25 26 27 �. 2b I. 1 . SHORT TITLE: JOHN J . RODRIGUES, et al . , Plaintiffs, CASE NUMBER: y vs . THE COUNTY OF CONTRA COSTA, et al , Defendants. n i; SECOND CAUSE OF ACTION--Nuisance (Damages) Page 6 . 3 !. ATTACHMENT TO Complaint. a i• I Plaintiffs allege against defendants as follows : S i The allegations of the form complaint pages and the 6 ! first cause of action are incorporated herein by reference. 7 I: Plaintiffs further allege against all defendants herein, the following : Defendants Thiel and Fuh and 9 !! those defendants fictitiously named as DOES 6 through 20 10 1: are owners of real property improved by means of development 11 I: including installation of roads and storm drainage systems, and 12 i failure to install adequate storm drainage systems , most of 13 but not all`', said defendants ' real property is improved 14 t":ith single fanmily &,elling; and appurtenances thereto,. When 15 ' and if the identit'. 7 Of the fiCtit1Ous1,' named defendants is 16 } determined , plaintiffs will amend the complaint to properly narie l7 ' them and describe their real property . is The real property of said names defendants 19 I' is uphill of the real property and improvements of plaintiffs, 20 i and, in some cases, is adjacent thereto, and that defendants, is and each of them, have. continued to gather, direct, channel , accelerate and discharge storm and other drainage upon the 23 I` surface of the property of, and into the property of plaintiffs 24 below the ground, in such fashion as to have caused, continue 25 i, causing, and in the future will cause the real property and 26 ! i� improvements of plaintiffs to slip, slide and subside, and be 27 ;t �! otherwise damaged, so injures and offends the plaintiffs, and 28 so obstructs the free use of their property, so as to interfere (p i ; SHORT TITLE: JvHN J. RODRIGUES, et al . , Plaintiffs, CASE NUMBER: ( vs. THE COUNTY OF CONTRA COSTA, et al , Defendants. i 2 SECOND CAUSE OF ACTION--Nuisance (Damages) (Cont. ) Page 7 . i ATTACHMENT TO Complaint. a 5 with the comfortable enjoyment of life and property, and, at the ! i same time, affects or threatens to affect others in the neighbor- 7 !, hood, all constituting a nuisance under the laws of the State S of California . 9 WHEREFORE, plaintiffs seek a declaration that the 10 r acts, omissions and events alleged herein constitute a nuisance , II '. which nuisance has so diminished the fair market value of their 12 real property and improvements so as to require sale at a much 13 diminished fair market value, all to the damage of plaintiffs 1' in the amount of $250 , 000 . 00 , plus such other and further relief 15 as the Court might deem proper . including the reasonable fees 1 t� of attorneys, expert witnesses, and the costs of relocation and replacement of real and personal property . 17 *Defendants JOHI\' A. THIEL MRS . JOHN A. THIEL, MARCUS FUN and MFS . KkRCUS FUH are owners of real property improved ]9 wi _0 th single family dwellings located at 17 Keith Drive , Orinda , i 21 and 19 Keith Drive , Orinda , respectively ; the properties thus � _22 commonly described are more fully described in the records of the County of Contra Costa . 23 24 ;. 2%5 i 26 !` 27 R I t i. I SHORT TITLE: JOHN J . RODRIGUES, et al . , Plaintiffs, CASE NUMBER: vs . THE COUNTY OF CONTRA COSTA, et al , Defendants. 2 THI_PV CAUSE OF ACTION--Negligence Against 3 j; Uphill Landowners and Developers. Page 8 . II I 4 is ATTACHMENT TO Complaint. f� i - 5 The allegations of the ;form complaint pages and 6 preceding causes of action are incorporated herein by reference. 7 l For causes of action against defendant uphill landowners as S j previously identified, .and against DOES 21 through 25, who were 9 , the developers and marketers of the developed and undeveloped 10 real property of DOES 6 through 20, and of any other real propert• 11 ± in the vicinity which may contribute to the circumstances allege . is 12 ; of which said developers might still be mgners, or be legally 13 ' liable for . 14 Defendants named herein, and each of them, so neali- J5 gently acted or failed to act upon, beneath the surface of and 1G 'Wlth res-,,?ct totheir real property , so as to proximately cause I - - i 17 i the damage to real property and improvements of plaintiffs, as 18 it alleged herein, all to the damage of plaintiffs as set forth in I: 19 the prayer of the complaint and previous causes of action hereof . 20 +` 2] 22 I. 23 j I 24 f 25 I 26 ii 27 e 24 i; SHORT TITLE : JOHN J . RODRIGUES, et al . , Plaintiffs, CASE NUMBER: vs. THE COUNT]'' OF CONTRA COSTA, et al , Defendants. -, FOURTH CAUSE OF ACTION--Developers' Liability 3 j; Without Fault. Page 9 . 4 ; ATTACHMENT TO Complaint. 5 For cause of action against fictitiously named defen- 6 dants DOES 21 through 25, plaintiffs allege : 7 The allegations of the form complaint pages and . 3 preceding causes of action are incorporated herein by reference ; 9 Defendants DOES-21 through 25 owned or otherwise 10 controlled real property uphill of the real property and improve 11 ments of plaintiffs, that they subdivided, planned and develops Q the same , and constructed thereon single family dwellings for t3 1; the purpose of marketing them, and did market and. sell the same 14 to owners thereof or said owners' predecessors in interest. 15 That SAir7 ^evelopers committed various acts and 1G omissions in the development of the tract composed of the real 17 property improvements of defendants uphill landowners, including 1S but not limited to the failure to properly channel storm drainage 19 i. in a fashion that would not damage the real property and improve- 20 I ments of plaintiffs, and in fact, such damage was caused by such 21 storm drainage as previously described herein, for which the 22 developers are liable without fault under the laws of this State , i 23 j' all within ten years prior to the filing of this complaint. i; I; 24 WHEREFORE, plaintiffs pray for damages and other relief 25 �' as previously pleaded herein . 26 27 I' �8 I: r� JAMENDED7_,, 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 5 , 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 GovnnmL,n �� COUnSC?I Amount: Unspecified Section 913 and 915.4. Please note all "Warnings . CLAIMANT: WILHELMINA JOHNSON DEC 11' 1987 c/o Padway & Padway Martinez, CA 9455; ATTORNEY: 515 6th Street Oakland, CA 94612 Date received ADDRESS: BY DELIVERY TO CLERK ON December 8 , 1987 BY MAIL POSTMARKED: not legible I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 11 1987 HHIL ATCHELOR, Clerk DATED: BPpY: Deputy 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: Am, e % 12= BY: Ad'-f-4 /7 tDeputy County Counsel 1 111. PROM: 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: D� 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 5 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: JAN 8 1988 BY: PHIL BATCHELOR by4_,e�eputy Clerk CC: County Counsel County Administrator w a POwdTPADWAY A Professional Corporation Other Offices 515 Sixteenth Street San Francisco Oakland,CA 94612 San Jose (415) 8397999 December 7, 1987 Clerk of the Board 651 Pine Street, Room 106 Martinez, CA 94553 Re: Our Client Wilhelmina Johnson Date of Loss: August 25, 1987 Dear Sir or Madam: Please find enclosed a copy of the Claim sent by Mrs. Johnson, and received by you on November 20, 1987. Please be advised that we now represent Mrs. Johnson, and would appreciate all further correspondence sen to our office. Thank you for your cooperation. Very truly yours, Laurence F. Padway LFP:su Enclosure RECEIVED DEC 8 1987 P AT M R $ CL NT CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant Return original application t: Clerk of the Board 6s2 Pine St., Roan 106 Martinez. CA 94553 A. Claims relating to causes of action for death or-for injury to person or to personal property or growing crops must be presented not later than the '100th day after the accrual of the cause of action. - Claims relating to any other cause of action must be presented not later than -one year after the accrual of the -cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors ' at its office in Room 106, County Administration Building, 651 Fine 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. *i,a*ee*ins*�*�**+►*+►*:*:::�s:iso:*,►:s:+►*+►s**e*f*���:e,tsit***tese*tt**s*�� RE: Claim by )Rene ad �j ng stamps i tL CI-441 eoZ Against the COUNTY OF CONTRA COSTA) NOV 1987 U.UT OA or DISTRICT) a (Fill in name ) a' i The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows : —W—h—;;--rrd —a "Ira— --------- --r------------ --------------..--� .. ��� ���� the damage or �n3ury occur? ZGive exact date and �iouzj �.rr i/e/il�e-aid-tFierdam ge-oz-1n3urry-occuz?r-�Z`n`clude`-city-and reountyj---- C.- �?G+ca�-7�7`C �.'.h� �►i�v~�j.,�y / " /�'� L o-r/mss' L Over [r ���--.�� 3. Bow did the damage or in3ury occur? . ZGiveuII details, use extra sheets if requiredi �� 70•x':''���''� � u &11 --•�-,ods/-=.-��� - 7�4 Zn at part�cu�az act or om�ss�on on the part o� county or distr ct officers, servants or employees caused the injury or damage? (over) ;. What are the names of cdunty., or district officers, servants or, empl'oyeek causing the damage or injury? 6:""what"damag`e-oz"injuries"c�o-you-claim iesu�ted?""ZG�ve"�uii�extent"-�" , of inj ies or damages claimed. Attach two estimates for auto damage ' """"".."Zi"""fit"""""-n"--""""""""-a"-o"""""-m"""""-"""""-c-1""""""""N-t" ate 7. Bow Was the amount claimed above computed? (Include the estimate amount of any prospective injury or damage. ) 8. Names and�addresNs of witnesses, doctors and hospitals. �. List the ixpenKitures you made on account of this accident or snlury: DATE t` ; ' , ' t '. �� t :• ITEM AMOUNT s i •*•trRtr�*+rt•t1t�rlttfttr*t*t�*.�t��ttwl!l�*t*tf+t*!,t*�t�:t*::**«t**tflttft**tRtr:tt Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney 7 Claimant's nature Addres,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 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. " s� .- 7� � - v J f � �< �.� y� !� ..�J 4 fes' ♦� e CLAIM TO: BOARD OF SUPERVI5UxJ ur %_u vlrn _._._ . Instruc-tion_s to Claimant Return original application t: Clerk of the Board 651 Pine St., Room 106 Martinez, CA 94553 A. Claims relating to causes of action for death oi'for Injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. - Claims relating to any other cause of action Faust be presented not later than one year after the accrual of the -cause of action. (Sec. 911.2, Govt. Code) S. 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 oT E is form. RE: Claim by )nese ask' ng stamps Against the COUNTY OF CONTRA COSTA) NOV 1987 M BAT 00%or DISTRICT) tx T (Fillin name ) By ... .. ..�.. ... The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: rrr rrr .r r .�""rrrrrrr"rr rrrrrrr rr rrrrrrrrr �"� rrrr I. mien did the damage or In3ury occur? IGive exact date and fiourj i d" die"aam ge"oi"In3 u=y"o�cc�urj?""Z�,IGncl ude"cit/y"and rcountyj"" rTrrrrrr rr" rr"�.r"""rrr"" rrrrrrrr""rr r.rrrr r r" rr""rrrrrr rrr 3. Bow id the damage or in3ury occur? .GiveulI aetalls, use FUM -7 if req_u_i_red) ��' �.. 4;i ,, , � - -r-r r r r rr"rr r r r rr " r r-r r r r r r r rr r r r r --rrrrr rr �r«particular act or omlaslon on the part o county or antr ct officers, servants or employees caused the injury or damage? (over) 5. What, are, the names of county or district officers, servantt- or' • ' employees causing the damage or injury? --------� --------T-�t--T----�.�----••--T------ — -- •• --- — ---•------- 6. what �nmage or injuries do you claim resulted? ZG�veul� extent of inj ries 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. ). - -- ---- - ; ;7-- -- - -- - ----------- 8. Names and addre�s`es of wstnesedoctors and hospitals. --T------- --.—� Tom.....—.r.err..Tt!tieAt,•------- --T— ---T--------T—T---- . List the e�•xpenditures you made on account-------of---this—accident or injury: DATE ' t ITEM AMOUNT E Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Cla�►ant Is )1!5,gnature C � Addrg.srs 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. " y f . 4 e CLAIM r 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 5, 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: $2558. 19 Section 913 and 915.4. Please note all "Yafr� 'COUnSel CLAIMANT: STATE FAR1,1 MUTUAL AUTOMOBILE INSURANCE COMPANY P. O. Box 4011 f F 0 1987 ATTORNEY: Concord, CA . 94524 Martinez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON November 30, 1987Risk Manag 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. DATED: December 4, 1987 gaIL BAATTCYELOR, Clerk epuL. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors XThis 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). t 1 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: g 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: JAN 5 1988 PHIL BATCHELOR, Clerk, By Gte,� , 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. Dat ed.� JAN 8. 1988 Z&:z�Z�eputyBY: PHIL BATCHELOR by Clerk CC: County Counsel County Administrator STATE Aprw,= "STATE FARM MUTUAL , STATE FARM LLOY `��''�'"� AUTOMOBILE INSURANCE COMPANY ❑STATE FARM FIRE AND CASUALTY COMPANY STATE FARM COUNTY MUTUAL INSUNANCC STATE FARM GENERAL INSURANCE COMPANY INSURANCE COMPANY OF TEXAS DATE JOURINSURED ACCIDENT DATE CLAIM NUMBER 11 19 87 Financial Advisory Center Inc. 8 9 87 05 0206 791 NOV 20 1987 r- Contra Costa County From: FARM INSURANCE CLAIM OFFICE Risk Management Dept. 333 Civic Drive 651 Pine Street 6th Floor Pleasant Hill, CA -martinez, CA 94553 P. O. Box 4011 Concord, CA 94524 By: Mike McNerthney Fold — Agent Code: 5936/88 We are writing you about the accident in which you were involved with our insured on t inIgation of this accident indicates that you are responsible for this accident. r�+r Please accept this letter as notice of a claim we have for Personal Injury Protection (PIP). E Vehicle Damage. NOV 30 t98 01 ❑ Medical Payments Coverage (MPC). ❑ Other: ❑ Should we be called upon to make payment under our policy, we will be looking to you or yoMn for reimbursement. ❑ If you have insurance to protect you against such liability, please refer this letter to your insurance company. ❑ Please send us the name of your insurance company, its address, and your policy number. ❑ We have had no response to our previous letter concerning our claim. We assume you have overlooked writing us. Please let us hear from you at once. EX We have made the following payments and request reimbursement as shown below: Net Vehicle Damage Other Name of Our Payee PIP/MPC Payment (Less Salvage) Payment/Expense* Eugopean Motors $ $ 2558.19 $ $ $ $ * Our insured ran over a manhole cover lying in the road . We are attaching copies of drafts and estimates. Net Amount Paid 2558.19 Insured Vehicle 1000.00 3558.19 By Company $ Deductible $ TOTAL We enclose a return envelope for your assistance in replying. (160)G 4378.5 REV.2A6 PRINTED IN U.S.A. ` ---~��~— 11-4t121{ ummyt InaURANCE FILE COPY 02 211 943 NORTHERN CALIF- "NIA OFFICE NOT NEGOTIABLE 1 V a MfYlAMU ROHNERT PARK,G' ANIAe 05 0206 791 POL. 1191 266 05D CAR 11 6 87 CLAIM NUMBER NO;. NO. DATE PAY TO THE European Motors ORDER OF 'Main street Walnut Creek, CA 94596 THE SUM OF Seven Hundred Ninety-three and 42/100--- ~DOLLARS $ 793.42 COVERAGE IN PAYMENT OF LOSS WHICH OCCURRED ABOUT (DATE OF ACCIDENT) 8 9 87 Financial Advisory Coat,. INSURED C DRAWN ON COMPANY MARKED nx .` STATE FARM MUTUAL AUTO INS.CO. '�`� �, j•}(-� f ',4��\' •1.'.I. -..-t 403-3 tj l STATE FARM FIRE AND CASUALTY CO. CLAIM REPRESENTATIVE STATE FARM GENERAL INS.CO. �j n T+�A CL�4NIt QSTATE FARM COUNTY MUTUAL 5T1J� IO CODE 354 501 7 30 Li INS.CO.OF TEXAS V 1100218 1: L 2 1,0000 4 41:9 28 EBI 9 L0,9711" APPROVED BY 11-4/1210 rd STATE FARM INSURANCE FILE COPY ki NOT NEGOTIABLE 1 0 2 18 3 '2 3 Q El NORTHERN CALIFORNIA OFFICE 6 ROHNERT PARK,CALIFORNIA a� POL, CAR \ CLAIM NUMBER 05 0206 791 NO. 1191 26fi 05D NO. —DATE— PAY 17 !!7 PAY TO THE ORDER OF 2288 N. Main Ste Walnut Creak- Ck 94596 'THE SUM OF + DOLLARS $ 28S.24 (OVERAGE IN PAYMENT OF LOSS WHICH OCCURRED ABOUT ( - (DATE OF ACCIDENT) k 7►y�y INSURED ( DRAWN ON COMPANY MARKED E l/•. STATE FARM MUTUAL AUTO INS.CO. f 1�; f ?F� ' Y - t•7 t ' I li-" 403-3 tj l STATE FARM FIRE AND CASUALTY CO. CLAIM REPRd8#ATIVf t STATE FARM GENERAL INS.CO. a UNIT TAE ID COO£ CI INS.TCO.STAE FARM COU OF EXANTY MUTUAL IIS4 01 730- LLW 11 60 2 L 8 APPROVED BY acic • +: L 2 1000044+:9 28Eet9 L449 ?I+' -- --i'1-4%1210 FILE COPY 1 1 0 2 13 8 920 fTFTt T.fM STATE FARM INSURANCE NOT NEGOTIABLE ' NORTHERN CALIFORNIA OFFICE ROHNERT PARK,CALIFORNIA x IMf Y\AMC% CAR a PDL. NO._ _----DATE u CLAIM NUMBER NO. PAY TO THE ORDER OF 22$6 N. Main St. LLAR �t> S THE SUM OF tN PAYMENT OF LOSS WHICH OCCURRED ABOUT Financial AdvisovT CentE COVERAGE (GATE OF ACCIDENT) Q A 87 v 7 INSURED DRAWN ON COMPANY MARKED nx STATE FARM MUTUAL AUTO INS.CO. CLAIM REPRESENTATIVE / STATE FARM FIRE AND CASUALTY CO. CL UNIT 403-1 01 m STATE FARM GENERAL INS.CO. TATE O CODE 165 M STATE FARM COUNTY MUTUAL Lai i1 54 501 730 t INS.CO.OF TEXAS Lam-=+ APPROVED BY II.O 2 L8 +: L 2 10000441:9 9 ?11' O© REPAIR ESTIMATE CLAI�L TT7 DATE OF INSPECTION&/ESTIMATE WHERE 1 P CTED LIqENsEa INSURE,O /V /V�'y7�' ��i/ L.yt� `• � ( ��a% ��( ^/ t N MEEK L ME WORK ADDREr9S/ `f Il��l i+ /V �J PHOf OONE PHONE MAKE , ! YEAR �r�� SERIES BODY STYLE DATE MANUFACTURED MILEAGE 'VIN ��••__••// REPAIR RE DESCRIPTION PARTS LABOR REFIN- PAINT SHING MATERIALS PLACE LIST HRS, J/ ? HRS. 8 NET ITEMS 2 3 4 5 ' �:. r 91 ` s a 9 10 J9 11 12 \' 13 14 15 . 16 TOTAL fie(' 50 $ ] LABOR HRS. CLAIM NO. L.�-- v �f REF. HRS. C ?_ I AUTHORIZE 1 / TOTAL _ APER 9 LABOR HRS. X $�HR. _ $ TO REIZED. ALSO, I A REE TO ER B STARTED. PARTS .31V I LIST$ LESS /. DISC.INS % SALES TAX$ SIG ' DATEEPAINT, MATERIALS, &NET ITEMSWE �EMIPED.� y?q.S� REP RER'S TOTAL REPAIR CO $ SIG TORE DATE LESS BETTERMENT $ THE EP�1IF �E EN COMPLETED. I A�Ij $ .zi.lT. KE _ t y`;:% PRIOR DAMAGE $ PAY - r0 T a L DEDUCTIBLE .� INSU ED'S FL.�.I<v.:- f i ifL 'vV! OP ON MY BE LF. F SIGN TURE DATE f TOTAL DEDUCTIONS'$ STAT FA CLAIM COMPANYTO P $ v A� REPAIR SHOP: RETURN THIS ORIGINAL F4 PAYMENT TO CLAIM OWNER TO PAY SERVICE OFFICE AT I� D 0r O r 2 Q p c4 zz n '� r Q V c A 71 cn M b D w Cpr r A O m to M Oro DM z 0m \ i m 14 O O':r r 3 cn Q � m '. o O02 Za M lZIM O C• p C m2 D M 00 o�°gag o• m 0 ID x. O iO i p 2 p () `r mp, -+ w K -0 m m A C m'3Qmcmic � m m x z Q*,— Z a m m C? Us G s m�om�Om I <O A A A � � > � ) i 7 CD, Nw C w m ; T ��yy <9 > �`�✓ rD int m mmmc4 W^ - C7 +p, m °m mi° 7 m A A A m + Z :I>iD m • �39 m b c7 � � O}�~ K to toiffill } �a�mm�m � �• � � � 0 6_i3F$ cn ==C ❑ N Q 6m � m'����5 ❑ n N m > 7J p i 'nn CIA r Z ; s NN AN G D O O Or Oi m > "r > > p M y z G1 p 1 O a O ro to > m z m 0 n t)M � t 0 T '0 i p m O n m m > -r z S p y m r i r b r b -� > O O -{ O D 9 3 > y > D Q Z O Z 2 '' v A „� O .4 N 2 m ... N o *► M 1 n >m AdOO SIVWUS3 cc mrc W< QI u CL am ul c,rm 0 ❑ ❑ ❑ ❑ ❑ Doo ❑ N < ¢ x 'S.,F < C a W F ...- Z Z O J J¢ C Z m ¢ b W f-:7 fl ZU < W W 4 J J O J 0 � dd W U U ¢ W �t 24 U' W ON« <F 6 �i p p H Yi m 0¢ 0a <N j IC SJ C LL JZ O O < p F W I7 f ? J UO Ua F O ¢ < W �' F V N NU NN W O HU i m v' .c C ¢ o ❑ Fors O O mCA 0 0 1 0 > tg'gm m Z �}mr w r ':D / m m m' 91152 O Ld O) w v y / L Amo==mc z v m<a 9 IbF�;= O L1 d f- Z _LLJ ;00 Ir i W W W W dam' G^ 3 z z ¢ I I sc�7>jL= a o mc�n C w_ Y ¢ ¢ 30 _.;V f F •c o 8 co is < 9 ¢ l0 mm mm�m \: tWn Om m yue2c L a E $� � �$ w � g red W W W O rSm 9—:6 Q ` a & m a D < < < a v En 0arccul ; < IL c a LD � cvIr m" < rp U \ ` a \ O m�mC'wo W O \ W �� c a =mmS�m-O m uj f m Z ion-HE - _l a - !'mS= -� 'O 06 o` P wE =m�'cg a.m m pQa N ; K mEorm`mm !- \� U Z J W W W p 61 m�O$= W � W W ¢ « o � o �a 14c E o W Z [ [ O Z4 W < W < UU d�-yboFi- Q W\ ¢ > O 0 w w 2 .W O f y I m I m.= m �o�=_.�$ H . Qppp /- z W -� Y- L N N W N W p�_ a •� G 3 m m•c Z_ Z < U tl ¢ m 7 �O. O W C W W � tai UU W ❑ , n m Z W O ,N L Q p cr W W Iru V Q W S F `.a m -j I K < > > t o ' m W Y Z G < a w g es0 x I x I < 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 5 , 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: $400. 00 Section 913 and 915.4. Please note all °W nin 11CoUAI Counscl CLAIMANT: MICHAEL SHERMAN 384 So. 34th Street DEC 1 1 ' 1997 ATTORNEY: Richmond, CA 94804 Date received Martinez, CA ADDRESS: BY DELIVERY TO CLERK ON December 7 , 1987 hand del . BY MAIL POSTMARKED: no enveloDe 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 11 1987 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy L. Hall 11. FROM: County Counsel TO: Clerk of the Board of Supervisors o� 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: I BY: ' / Deputy County Counsel TT? 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 5 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. r 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 d Notice to Claimant,, addressed to the claimant as shown above. JAN 8 1988 Dated: BY: PHIL BATCHELOR by puty Clerk CC: County Counsel County Administrator CL:;_I*IYM 70: B07--RD OF SUPERVISORS OF COINTRA CC -,a n t Clerk of the Boarc Instructions to iT C. Box 911 nAariinez, CalitorniL 945S'. -o causes action for death or --Or lniu.-v zc aims relating - -of - I - person or to personal property or growing crops must be presented not later than the 100th day atter the accrual of the cause of action. Claims relating to anv ct- her cause of action must be Dresented not later than. ane v;ar after the accrual of the cause of action. (Sec. 911. 2 , Govt. Code) B. must, be f,;'_led with the Clerk of the Board of Supervisors P `--F4ce in Room 106 , Count-,,7 Ad-minstra-4on 31,` Idnc, 651 Pine Street, i f 0 rn i-x 94 3 t--L n e C a_1 4. 7 ' - ­4Tr. 4s a-ains-: L dis:r : ct -_cver.ned b-:- the Board of Su;Dervisors , the 1 "listr`Lc4- Should be 4:*- I` ec, .-ather ha-a- --he Countv, the :-.,ante " h e c I_=i:T i is acainst more thar one zuh_- Ic ent-i--y- , separate c2airr.-s T-.,",s,: be --__ed against each public entitv. E. F r a ud. See penalty for fraudulent --!aims , Penal Code Sec . 72 at end REClair: by IPeserstam- :7's -,IV 7 / so T L 7 C07zrr- E C;7 1987 / A-a4-st he COUINTY 0 p 1. -,-N C 11 T ODA or in name) . ... .. The undersigned claimant herel.­v makes claim. acainst tne ountv of Contra Costa or -he above-named District -* ;- the sur. f I,-' /Z. I'll J c Aa4, and in suv=ort . of this claim re-crese-t-s as fLI__IL)IAS ; -------------- -----------------l' -e------exact date and----------- 1;o -v hen did the damaoe or injury :occur? (G ---------- --------------------------____ ;�_Z;�_did the a e or injury occur - (InClude city and county) --- --- -- -� ; ------------------------ , -ai ls, use extra injury -occur?- Giveull det ow did �h_ damage orJ sheets if required} xxl" , - Gc 4 . -What-par hcular actor-omission-on the part of count�y or district --------- -- ----- - officers , servants or employees caused the injury or damage? 5.. What: are,. t4e:.names of county or district officers, servants Gr .etrp1oyees;ca sing the damage or injury? 6 . What dama �or injuries do you claim resulted? (Give full extent ofinjuries or damages claimed. Attach two estimates for auto damage) ---ll� d/��r_�7/��" l -LiuGE' l �Z2 -- ==-=- - - --- ----- 7 . How Oas the� a amount clmed above computed? Include the estimated amount of any prospective injury or damage. ) ----------------------------------•--------------------------------------- fi . Names and addresses of witnesses , doctcrs and hospitals . --------------- ---------------------------------------------------------- e.exge, �,�res you made on account of this accident or injure: '``a'(((''' n ITEM AMOUNT - k{ r �* **!'�t'9tlF`7Ei•*'Irk**'***.** **#*****#*##*******#*#****#******#*****************-. 114 ..,.�.,.�. ;; , Govt. Code Dec. 910 . 2 provides : ' "The claim signed by the claimar SEND NOTICES TO: (Attorney) or by some Derson on his behalf. -Name andAddressof Attorney ic. , CCC ) Clai ht ' s Signature �� sO . 3 ��' k1Address s C:11K Telephone No. Telephone No. NOTICE Section 12 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine , any false or fraudulent claim, bill , account, vouches or writing, is guilty of a felony. " co TRA COSTA DETENTION FACILITY CLOTHING RECEIPT , 1 J 5 DATE 1~0/28/87 T REC 119354 { TIME FACILITY x 0828 NAME (L, F, M) SHERMAN MICHAE .; BOOKING NBR _ 1 �870255881INTAKE ;. - "i Afsj SHIRT/ AaPANTS/ IRr COAT/JACKE HOES/�69 HORTS/P `= T-SHIRT/BRA SOCKS/Ri*te".- HAT/PURSE Q SWEATER/SWT SHIRT DRESS F-1 z OTHER t . . �l X INMATE SIGNATURE RELEASE DATE I HAVE RECEIVED ALL OF MY CLOTHING REL OFC f X _ INMATE SIGNATURE 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 5 , 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: $100, 000. 00 Section 913 and 915.4. Please note all 11Wa(t1r gTJJy Counsel CLAIMANT: MARY EILEEN TRONVIG c/o David W. Falconer of Barrett DEC 1 1987 ATTORNEY: Penny & Byrd, A Professional Corporation Martine.-, CA 9451;503 1900 Point West Way #274 Date received ADDRESS: Sacramento, CA 95813 BY DELIVERY TO CLERK ON December 4, 1987 BY MAIL POSTMARKED: December 2 , 1987 Certified P 056 749 841 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk , DATED: December 11, 19.87 �b: Deputy 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: �pf1�B /� - BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. a Dated: J A N 5 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: AN 8 1988 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator RECEIVED DEC 4 1987 AMENDED CLAIM AGAINST CONTRA COSTA COUNTY Cl co B ELOp RS 1 . This claimant' s name and address is: Mary Eileen Tronvig, 1460 Piedra Drive, Walnut Creek, CA 94596 . 2. Post Office address for notices in connection with this claim: c/o David W. Falconer of Barrett, Penney & Byrd, A Professional Corporation, 1900 Point West Way, Suite 274, Post Office Box 13160, Sacramento, California 95813. 3. Circumstances giving rise to Claim: On September 21 , 1987 , Claimant' s automobile was rear ended by an automobile driven by Rosa Olivia Grajeda at the intersection of Treat Boulevard and Coggins Drive located in the County of Contra Costa, State of California. At that time, the intersection was under .heavy construction by County maintenance crews who negligently failed to properly control the intersection thereby creating hazards to drivers approaching Treat Boulevard from Coggins Drive. The Claimant had just made a right turn onto westbound Treat Boulevard from southbound Coggins Drive when the Claimant observed a red traffic signal and stopped believing it was for her. At that time, a vehicle driven by Rosa Grajeda collided with the rear of the Claimant' s vehicle. The County failed to properly control this intersection when it barricaded the southbound lanes of Coggins and redirected south- bound traffic to the northbound lanes of Coggins thereby creating circumstances where southbound traffic would believe the signal controlling Treat Boulevard was in fact controlling Coggins south- bound traffic. 4. General description of obligations: This claimant contends that Contra Costa County is responsible and legally liable to the Claimant for the injuries she sustained as a result of the accident as described in Paragraph 3 of this claim. 5. Names of public employees causing injury, damage or loss: The specific names of individuals acting for or on behalf of the County of Contra Costa are presently unknown. 6. Amount of claim as date of presentation of this claim: A. Loss of wages: As of December 11 1987 $2 , 788 . B. Medical expenses: Approximately $2, 000 . 00 as of December 1, 1987. C. Property damage: $2, 155. PAGE 1 OF 2 6. Amount of claim as date of presentation of this claim: (CONTINUED) D. General damages: $100, 000 . .n DATED: December L— , 1987 Signed on behalf of Claimant by her attorneys: BARRETT, PENNEY & BYRD A Profess 'onal Corporation 'DAVID W. FALCONER' CERTIFIED MAIL - No. P 056 749 841 RETURN RECEIPT REQUESTED PAGE 2 OF 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 J anuary 5 , 198 and Board Action. All Section references are to ) The copy of this document mailed to you is yoLr notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Codeou Counsel Amount: $71 , 495 . 50 Section 913 and 915.4. Please note all "WAZAF� x CLAIMANT: ROGER JOSEPH FULOP, JR. DEC 0 V 1987 c/o William E. Gagen, Jr. ATTORNEY: 279 Front Street Martinez. CA 94553 Danville, CA 94526 Date received ADDRESS: BY DELIVERY TO CLERK ON November 30 , 1987 BY MAIL POSTMARKED: November 25 , 19-87 Certified P 064 666 373 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pp�HI gg DATED: December 4, 1987 BYIL DeputyLOR, 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: ���,o BY: eputy 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. JAN 5 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 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 8 1988 BY: PHIL BATCHELOR by uty Clerk CC: County Counsel County Administrator K, 1 WILLIAM E. GAGEN, JR. DIANE J. MORIN 2 THIESSEN, -GAGEN & McCOY RECEIVED A Professional Corporation 3 279 Front Street Post office Box 218 NOV 301987 4 Danville, California 94526 Telephone : (415) 837-0585 P T A cL Tp S Y 5 Attorneys for Claimant er •• • •• ••`••• .... .. ammupw 6 I 7 8 CLERK, BOARD OF SUPERVISORS , COUNTY OF CONTRA COSTA 9 10 11 ROGER JOSEPH FULOP, JR. , ) NO. 12 Claimant, ) NOTICE OF CLAIM 13 vs. ) 14 COUNTY OF CONTRA COSTA, ) BUSINESS , TRANSPORTATION AND ) 15 HOUSING AGENCY, DEPARTMENT OF ) TRANSPORTATION, CALIFORNIA ) 16 HIGHWAY COMMISSION AND CALTRANS, ) 17 Defendants. ) 18 19 TO THE COUNTY OF CONTRA COSTA and the BUSINESS , TRANSPORTATION 20 AND HOUSING AGENCY, THE DEPARTMENT OF TRANSPORTATION, CALTRANS, 21 AND THE CALIFORNIA HIGHWAY COMMISSION: 22 YOU ARE HEREBY NOTIFIED that ROGER JOSEPH FULOP, JR. , claims . . 23 damages from those entities above-named and employees thereof, 24 in an amount to exceed $1 Million, which amount will be shown 25 according to proof. 26 LAW OFFICES -1- ESSEN.GAGEN 8 McCOY 04-18950 PROFESSIONAL CORPORATION '9 FRONT STREET WVILLE,CA 94526 TEL.837-0585 1 This claim is based on the personal injuries of ROGER JOSEPH 2 FULOP, JR. , on or about August 29, 1987, on Camino Tassajara 3 Road west of Leema Drive between Lawrence Road and Crow Canyon 4 Road. This section of Camino Tassajara Road is in an 5 unincorporated part of the County of Contra Costa adjacent to 6 the City of Walnut Creek . The basis of the claim is as follows: 7 On August 29 , 1987 , at approximately 5: 05 p.m. , ROGER JOSEPH 8 FULOP, JR. , was a passenger in a vehicle being driven by Steven 9 William Dinelli , westbound on Camino Tassajara Road in the 10 vicinity heretofore described. Also in the vehicle were Sandra 11 D. Stacey, John D. Root and Brian D. Battaglini . As the vehicle 12 approached a curb at about 45 mph, the right tires left the 13 roadway and as the vehicle rounded the curb the driver lost 14 control of his vehicle. 15 At the time and place of the collision, the roadways and 16 traffic control signs were defective in manners including, but 17 not limited to, the following: the speed limits on the roads 18 were far too high for safety, considering the physical features 19 of the road, the cautionary signs were placed too near the curve 20 in the road and the edges of the road were negligently 21 constructed and maintained causing drivers to lose control of their vehicles as they rounded the curve. 22 The listed government entities were negligent in that they 23 designed and installed and maintained signs which were defective 24 25 because they set speed limits on the roads which were too high for safety and placed them negligently on the road, and the 26 -2- LAW OFFICES 04-18950 `-SSEN,GAGEN&MCCOY PROFESSIONAL CORPORATION '9 FRONT STREET MILLE,CA 94526 TEL.837-0585 1 roads were negligently constructed and maintained so that, for 2 the above-described reasons, these conditions presented an 3 unreasonable, foreseeable risk of injury and death to persons 4 operating and riding in vehicles in the afore-described portion 5 of Camino Tassajara Road . 6 These dangerous conditions and design defects caused the 7 afore-described collision. ROGER JOSEPH FULOP, JR. , was 8 severely injured as a result of the accident, sustaining 9 injuries including but not limited to: a skull fracture 10 including internal head injuries; a chipped sixth and seventh 11 vertebrae; abrasions to his shoulder; damage to the area around 12 his left eye; a ripped ear ; and a scalp which was cut open. 13 Medical expenses to date approximate $71,495.50 and are 14 ongoing. General damages cannot now be given a value due to 15 ongoing treatment and the difficulty in predicting the level of 16 recovery. 17 All notices and other communications with regard to this 18 claim should be sent to Claimant' s attorney, WILLIAM E. GAGEN, 19 JR. , 279 Front Street, Post Office Box 218, Danville, 20 California 94526. 21 Dated : November ,? �, 1987 THIESSEN, GAGEN & McCOY A Professional Corporation 1 22 /7 / 23 ,�, j1. B 14. oc I / .. . . Y 24 WILLIAM E./,,GAGEN, R. Attorneys- for Claimant 25 ROGER JOSEPH FULOP, JR. 26 LAW OFFICES -3- :SSEN,GAGEN&MCCOY 04-18950 PROFESSIONAL CORPORATION 9 FRONT STREET ,NVILLE,CA 94526 TEL.837-0585 I DECLARATION OF SERVICE BY MAIL 2 I, the undersigned, declare: 3 That I am a citizen of the United States , over the age of 4 eighteen years, and not a party to the foregoing action; that my 5 business address is 279 Front Street, Danville, California. 6 That on November 25, 1987 I served copies of 7 the within NOTICE OF CLAIM 8 9 by placing them in the envelopes addressed as follows : 10 11 Clerk, Board of Supervisors County of Contra Costa 12 651 Pine Street, Room 106 Martinez , CA 94553 13 (Certified Mail, Return Receipt 14 Requested and Regular First Class) 15 16 17 18 19 20 which envelopes were sealed and deposited, postage prepaid, in the 21 United States mail at Danville, California; that there is regular 22 service between the place of deposit and each of the foregoing 23 addresses. •. 24 I declare under penalty of perjury that the foregoing is 25 true and correct. 26 Executed November 25 , 1987 , at Danville, CA LAW OFFICES SSEN,GAGEN&McCoy A PROFESSIONAL CORPORATION 279 FRONT STREET Che L. Barrett DANVILLE.CA 94526 TEL.837-0585 - 1 1,-:�6 ' 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 5 1989 and Board Action. All Section references are to ) The copy of this document mailed to you is yoLIr 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: $71 ,495 . 50 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ROGER JOSEPH FULOP, JR. County Counsel c/o William E. Gagen, Jr. � � 1987 ATTORNEY: 279 Front Street OF(' Danville, CA 94526 Date received NovemberWling;89A 94!J53 ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED:Novenber 25 , 1987 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: December 4, 1987 ��: Deputy L. Hall 11. FaROM: 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: .✓ !�/LJ Z0_9 BY: Deputy County Counsel r Tll . 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. p Dated: JAN 5 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: BY; PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 1 WILLIAM E. GAGEN, JR. DIANE J. MORIN �� • �� 2 THIESSEN, GAGEN & AicCOY j A Professional Corporation 3 279 Front Street NOV 30 1987 Post Office Box 218 4 Danville, California 94526 T 8rL Telephone: (415) 337-0585 5 aaltr 1 Attorneys for Claimant 61 71 81 CLERK, BOARD OF SUPERVISORS , COUNTY OF CONTRA COSTA I 91 1 10 ' I 11 ROGER JOSEPH FULOP, JR. , ) NO. i ) 121 Claimant, ) NOTICE OF CLAIM 13 vs. ) 14I COUNTY OF CONTRA COSTA, ) BUSINESS , TRANSPORTATION AND ) 15 HOUSING AGENCY, DEPARTMENT OF ) TRANSPORTATION, CALIFORNIA ) 16 HIGHWAY COMMISSION AND CALTRANS, ) 17 Defendants. ) 18 19 TO THE COUNTY OF CONTRA COSTA and the BUSINESS , TRANSPORTATION 20 AND HOUSING AGENCY, THE DEPARTMENT OF TRANSPORTATION, CALTRANS , 21 AND THE CALIFORNIA HIGHWAY COMMISSION: 22 YOU ARE HEREBY NOTIFIED that ROGER JOSEPH FULOP, JR. , claims 23 damages from those entities above-named and employees thereof, 24 in an amount to exceed $1 Million, which amount will be shown 25 according to proof. 26 LAW OFFICES -1- THIESSEN,GAGEN&MCCOY 04-18950 A PROFESSIONAL CORPORATION 279 FRONT STREET DANVILLE,CA 94526 TEL.837.0585 I 1 This claim is based on the personal injuries of ROGER JOSEPH 2 FULOP, JR. , on or about August 29 , 1987 , on Camino Tassajara 3 Road west of Leema Drive between Lawrence Road and Crow Canyon I 4 Road. This section of Camino Tassajara Road is in an VIII 5 unincorporated part of the County of Contra Costa adjacent to ` 6 the City of Walnut Creek . The basis of the claim is as follows : 7 On August 29 , 1987 , at approximately 5 : 05 p.m. , ROGER JOSEPH 8 � FULOP, JR. , was a passenger in a vehicle being driven by Steven 9 ) William Dinelli , westbound on Camino Tassajara Road in the 101 vicinity heretofore described. Also in the vehicle were Sandra I 11i D. Stacey, John D. Root and Brian D. Battaglini . As the vehicle I 121 approached a curb at about 45 mph, the right tires left the 13 roadway and as the vehicle rounded the curb the driver lost 14i control of his vehicle. 15 At the time and place of the collision, the roadways and 16 j1 traffic control signs were defective in manners including, but I 17 not limited to, the following: the speed limits on the roads 18 were far too high for safety, considering the physical features 19 of the road, the cautionary signs were placed too near the curve 20 in the road and the edges of the road were negligently i constructed and maintained causing drivers to lose control of 21 their vehicles as they rounded the curve. 22 The listed government entities were negligent in that they 23 designed and installed and maintained signs which were defective 24 because they set speed limits on the roads which were too high 25 for safety and placed them negligently on the road, and the 26 -2- LAW OFFICES O4-18950 THIESSEN,GAGEN 8 MCCOY A PROFESSIONAL CORPORATION 279 FRONT STREET DANVILLE,CA 94526 TEL.837.0585 1 roads were negligently constructed and maintained so that, for 2 the above-described reasons,. these conditions presented an 3 unreasonable, foreseeable risk of injury and death to persons 4operating and riding in vehicles in the afore-described portion 5 of Camino Tassajara Road. 6 These dangerous conditions and design defects caused the 71 afore-described collision. ROGER JOSEPH FULOP, JR. , was 8 severely injured as a result of the accident, sustaining 9 injuries including but not limited to: a skull fracture 101 including internal head injuries; a chipped sixth and seventh 11 vertebrae; abrasions to his shoulder ; damage to the area around 12 his left eye; a ripped ear ; and a scalp which was cut open. 13 Medical expenses to date approximate $71,495. 50 and are 14 . ongoing. General damages cannot now be given a value due to 15 ongoing treatment and the difficulty in predicting the level of 16 recovery. 17 All notices and other communications with regard to this 18 claim should be sent to Claimant ' s attorney, WILLIAM E. GAGEN, 19 JR. , 279 Front Street, Post Office Box 213, Danville , 20 California 94526. 21 Dated : November .-j— , 1987 THIESSEN, GAGEN & McCoy A Professional Corporation 22 / AT :23CB Y 24 WILLIAM E. ..GAGEN, -JR_, Attorneys- for Claimant 25 ROGER JOSEPH FULOP, JR. 26 LAW OFFICES -3 THIESSEN.GAGEN 8 MCCOY 04-18950 A PROFESSIONAL CORPORATION 279 FRONT STREET DANVILLE.CA 94526 TEL.837-0585 1 DECLARATION OF SERVICE BY MAIL 2 I, the undersigned, declare: 3 That I am a citizen of the United States , over the. age of 4 eighteen years , and not a party to the foregoing action; that my 5 business address is 279 Front Street, Danville, California. 6 That on November 25, 1987 I served copies of 7 the within NOTICE OF CLAIM 8 9 by placing them in the envelopes addressed as follows : 10 11 Clerk, Board of Supervisors County of Contra Costa 12 651 Pine Street, Room 106 Martinez , CA 94553 i3 (Certified Mail, Return Receipt 14 Requested and Regular First Class) 15 16 17 18 19 20 which envelopes were sealed and deposited, postage prepaid, in the 21 United States mail at Danville, California; that there is regular 22 service between the place of deposit and each of the foregoing 23 addresses . 24 I declare under penalty of perjury that the foregoing is 25 true and correct. 26 Executed November 25 , 1987 at Danville , CA LAW OFFICES THESSEN.GAGEN&WCOY A PROFESSIONAL CORPORATION 279 FRONT STREET Cheryl, L. Barrett DANVILLE.CA 94526 ✓ TEL.837.0585 CLAIM _ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA .R Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT J anuary 5 , 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: Unspecified Section 913 and 915.4. Please note alCoor"gCQunse) CLAIMANT: RUTH MCINTYRE D E C 0 V1987 3096 Marguita Court ATTORNEY: Dublin, CA 94568 Martinez, CA 94553 Date received December 1 , 1987 ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Jcoard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: December 4, 1987 �b: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors r 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: -d��! ? y0 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 XThis 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 5 1988 Dated: PHIL BATCHELOR, Clerk, By__s 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. JAN 8 1988 Dated: BY: PHIL BATCHELOR by , Deputy 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 personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2 , Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , CA 94553 (or mail to P.O. Box 911, Martinez, CA) . C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by ) Res ing stamps �� RECEIVED ., i , ✓i< < Cry Against th, COUNTY OF CONTRA COSTA) rJtl, 1981 j ) 48A fLoA or DISTRICT) EAc (Fill in name) ) By . .. .. ...... The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: l.- When did the damage or injury occur? (Give exact date and hour) _ 9 _Z. Z-L -- -- a — l — — -- --- --- --- -- - - - ------------ - -- --- ----- 2. W ere did the damage or injury occur? (Include city and county) ------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details, use extra sheets if required) 4 . What particular act or omission on the part of ounty 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? All ---------------------------------------------------- ------------------- 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: DATE ITEM AMOUNT I Govt. Code Sec. 910.2 provides : r,,�„- "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney ff r Cla alt' s Signature Address - Telephone No. Telephone No. I 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. " f ---------- ir' v f' / i. ,!.,,'• /`•. :- �;, _ � � � � �//v✓ CCC ✓ , /�,�'� r / J� VOID AFTER 30 DAYS - REPAIR DUBLIN AUTO BODY B DMNOSM CENM rESTIMATE Nobft rA"m l ` (41M WIM • MWALMM "' reralen iced Date !� 000 566 Car Owner Address Home Phone Make Year License No.A/0 Mileage Business Phone I.D. D Adjuster Phone Insurance Co. Inspector Symbol Labor PARTS Symbol Labor PARTS Symbol Labor PARTS Hours Hours Hours. Bumper < Fender Front Fender,Front Bumper0:0. Fender Shield ender agipld Fender Mldg. Fender Mldg. Headlamp Bumper Gd. Headlamp Headlamp Door .:F " ; Frt.System Headlamp oor Sealed Beam Frame Sealed Beam Cowl Cross Member Cowl Door,Front Door,Front Door Hinge Wheel Door Hinge Door-Glass Hub Cap Door Glass Vent Glass Hub&Drum Vent Glass Door Midg. Knuckle Door Mldgs. Door Handle Knuckle Sup. Door Handle Center Post r, Lc Cont.Arm-Shaft Center Post Door,Rear License Frame-Brkt. Door,Rear Door Glass Up.Cont.Arm-Shaft Door Glass Door Mldg. Shock Door Mldg. Rocker Panel til Windshield Rocker Panel Rocker Midg. Rocker Midg. Sill Plate Tie Rod Sill Plate Floor Steering Gear Floor Frame Steering Wheel Frame Dog Leg Horn Ring Dog Leg Quar.Panel Gravel Shield Quar.Panel Quar.Mldg. Al Park.Light Quar.Midg. Quar.Glass Grille Quar.Glass Fender,Rear Fender,Rear Fender Midg. J Fender Midg. Fender Pad go Fender Pad 4147 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 i Ornament Trunk Handle Undercoat Rad.Sup. Tail Light Polish Rad.Core Tail Pipe Misc. terials • 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, Signed Labor. 7 Hrs._W1_d_W$ Parts 's P74 A-ALIGN N-NEW OH-OVERHAUL 5-STRAIGHTEN OR REPAIR EX-EXCHANGE Y $ RC-RECHROME - U-FOR USED PARTS 6-RESUILT _ Tax $ This estimate is based on lowest possible cost consistent with quality work, and as such, is Sublet $ guaranteed.items not covered by this estimate or hidden will be additional. $ TOTAL $ RE-661-3 Kama a .Reort - i b til 11 s DATE NAME -'.1 J T-1—ltd _ •f.?R MAKE ��'�t/' ✓_T MODEL IJ.'{ ADDRESS � -c��/ _.- '�(.f NSE NO / T v K f� (:�.y. MILEAGE .. .._.._. - Tt -7 2 L\\\ -�7%� Tt 7 2L �1 cc,7/,5 % wN NO !� CITY _ - STATE ZIP H PHONE 1 w PHONE --- ,l(iDATE-` -�J._BODYCODE ___.-____ PAINT__.. WS CC ADDRESS —_- -DATE OF LOSS- .._. ..__--___.. LAIM NO... ADJUSTER... _.._.._..___._._ ..- PHONE_ ..--LIC.NO. ----_ ....... ----------FILE NO._ Lm Re- Re DETAILS OF REPAIR LABOR HOURS PARTS SUBLET/MISC No pan place N=NEW U=USED R=REPAIR S=STRAIGHTEN PJC=RECYCLE/SECHROME I RECOREBODY PAINT FRAME MECH 1 2 k f - !` 3 x } \r tom,. -1 2— G3 4 + — `3 C, l�S 5 c-sit1), c 6 A 7 8 Y lQ t :,,t- 1 11 3A i 12 13 14 15 1S , 17 16 19 20 21 22 23 24 25 26 OLD PARTS WILL BE DISCARDED UNLESS OTHERWISE INSTRUCTED i OTALS _ SOMETIMES AFTER THE WORK HAS BEEN STARTED ADDITIONALLY DAMAGED OR WORN PART ARE DISCOVERED f WHICH WERE NOT EVIDENT ON FIRST INSPECTION.THIS DAMAGE REPORT DOES NOT COVE' OR INCLUDE ANY L BODY�`l hrS.G:� ADDITIONAL PARTS OR LABOR WHICH MAY BE REQUIRED ALL PARTS PRICES ARE SUB*CT TO INVOICE. A - PAINT -hrS.(t B - --- - I hereby authorize the above work and acknowledge receipt of copy. Oi FRAME hrs,h Date —- R MECH _ h,,,,;, PARTS Prices subject to rnvo,ce_-. CRO" N C �p}5ROUT I U7�� Supple SUB MISCELLANEOUS__ Paint upplle'S__�rs BODYSHOP Body Supplies__ hrs(i-.._ -_- ------- __-- _-_- Towing/Storage -- -- - 7544 Dublin Boulevard a Dublin, California 9450-8 EPA/Waste Disposal Charge _______ Phone (415) 828-6500 - ------ SUB TOTAL -- _-----_----_-.-- _ B.A.R. IAA2466N TAX .1 on -- — $_ A c'( \-- _ TOTAL $ WRITTEN BY -- _--- _. -- _ —. I-n. N;, ICO.i,r,:r n ­_ r, «en I)r360S .'an Tn!f,..., :-AIEI�., .. REV 10-(1C CLAIM �. BOARD OF SUPERVI.SORS 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 5 , 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 Coe Amount: $7, 000. 00 Section 913 and 915.4. Please notCi10rtWrQ e CLAIMANT: KATHLEEN A. K.RUMBEIN ETAL DEC o i, 1987 193 Manor Drive ATTORNEY: West Pittsburg, CA 94565 ,.,irt;nez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON December 1 , 1987 hand del. BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the hoard of Supervisors T0: County Counsel Attached is a copy of the above-noted claim. December 4, 1987 PPHHIL BATCHELOR, Clerk DATED: BY: Deputy 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: BY: Deputy County Counsel J 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). 1V. 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: A 5 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: JAN 8 1988 BY: PHIL BATCHELOR by , VGt�Deputy Clerk CC: County Counsel County Administrator CLAIM T'��,.M '.}; BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to Claimant Return original application tc Clerk of the Board 651 Pine St., Room 106 Martinez, CA 94553 A. Claims relating to causes of action for death or'*for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. - Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. . E. Fraud. See penalty for fraudulent claims , Penal Code Sec. 72 at end of LFiis form. RE: Claim by )Reser v g stamps RECEIVE -'TT-- 1987 Cr Against the COUNTY OF CONTRA COSTA) l0; 4Sq. 7 Pm. H 6 TCMEL A or DISTRICT) K ACOST (Fill in name ) The undersigned claimant hereby makes claim against the Count of Contra Costa or the above-named District in the sum of $ "7 0�- and in support of this claim represents as follows: 1. mien aid the damage or �n3ury occur? Give exact date and dour idfiere aid tie .damage or n3ury occur? Include city and county] 3. Bow did the damage or in3ury occur? ZGive �uII-aetalSs, use extra sheets if required) 5,7-- S.�G���,� �C���,F J�A�S�oTs � a ,y�i_d AS cx,, �� js -,"x/D s 1 ti Ui�PE� // SG 611P 7 // 7 �Z,e� ti 101c V s 9 �8 C' sA s �4 �. Mhat particular act or omisslon on the part o co my or district officers , servants or employees caused the injury or damage? (over) tr, � 5. What -� � -,:he names of c1311,y or district officers, servants or' employees causing the damay',t�_,or injury? 04f% UvF P✓lzlt- ['OUB 6. What damage or in�urles �o you claim resulted? ZGlve dull extent of inj ries or damages claimed. Attach two estimates for auto damage) -7-.--H--ow--w--a-s--th--e--am--o-u-n-t--c-l-a-i---------------- med above computed---!!;;!;a; --- the estimate$ amount of any prospective injury or damage. ) N l/� J o- llikfip Ail, ------------ ------------------------------------ -------------- 8. Names and addresses of witnesses, doctors and hospitals. �. ' List the: ea.xpenditures you made on account of this accident or injury: DACE ! ' a ITEM AMOUNT L F 4 RRRRRRRRRR•R'R�RRRRRR*RRRRRR�t.• RRRRRRR*RRRR#RRRRRRRRRRRRRRRRRRRRRRRRRRRRRR Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by hsom rs n on his behalf. " Name and Address of Attorney ✓/ Claimant s ignature / �s re s s�,� 7[o �(G i Telephone No. (oy D Telephone No. lye"lg?3 RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRlRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR 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. " f CLAIM �f 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 5 1 9-8 8 and Board Action. All Section references are to ) The copy of this document mailed to you is yo r notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Gvern nt L�ode Amount: ^1, 000, 000. 00 Section 913 and 915.4. Please note all arCI yS,C:OUnSe( CLAIMANT: JENNIFER FRYE ETAL DEC 90 V1987 c/o Law Office of Michael R. Quirk Martinez, CA 94553 ATTORNEY: 1615 Bonanza St. , #205 Walnut . Creek, CA 94596 Date received ADDRESS: BY DELIVERY TO CLERK ON Deceriber 1, 1987 BY MAIL POSTMARKED: November 30, 1987 I. FROM: Clerk of the hoard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 4, 1987 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy 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: 1 � BY: eputy 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 (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 5 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: ',AN.8 198 BY: PHIL BATCHELOR byZL_Ueputy Clerk CC: County Counsel County Administrator MICHAEL R. QUIRK ATTORNEY AT LAW 1615 BONANZA STREET,SUITE xx 205 WALNUT CREEK,CALIFORNIA 94596 (415)943-6400 REC November 30 , 1987 CLAIM AGAINST PUBLIC ENTITY TO: County of Contra Costa Jennifer Frye and Gracia Carroll hereby make claim against the County 'of Contra Costa for the sum of $1 , 000 , 000 . 00 and make the following statements in support of the claim. 1 . Claimants ' post office address is in c/o Law Offices of Michael R. Quirk at the above address . 2 . Notices concerning the claim should be sent to the above address . 3 . The date and place of the occurrence giving rise to this claim are August 24 , 1987 , at 3 : 37 p.m. at 2011 Arnold Industrial Way, Concord, California. 4 . The circumstances giving rise to this claim are as follows : At the above time and place, Andrew Frye, deceased, was involved in a traffic collision, to which employee firemen from the County of Contra Costa responded. Said employees of the County of Contra Costa refused to assist the deceased, refused to allow others to assist the deceased, and physically abused the deceased prior to his being placed into an awaiting ambulance . As a proximate result thereof, the deceased died . 5 . Claimants Jennifer Frye, sister of the deceased , and Gracia Carroll , mother of the deceased, claim injuries of loss of support, comfort and society. 6 . The identity of the responsible firemen are unknown. 7. 7. The claim is in the sum of $1, 000 , 000 . 00 on the basis of lost support, comfort and society . Dated: November 30 , 1987 . M tC L UR. Q U 1 RK Attorney for Claimants 1 PROOF OF SERVICE BY MAIL 2 I am employed in the County of Contra Costa, State of 3 California, with my business address at 1615 Bonanza Street, 4 Suite 205 , Walnut Creek, California 94596 ; I am over the age 5 of eighteen (18) years and am not a party to the within cause. 6 On November 30 , 1987 , I served the CLAIM AGAINST PUBLIC 7 ENTITY by placing a true and correct copy thereof in a sealed 8 envelope, with first class postage thereon fully prepaid, in 9 the United States Mail at Walnut Creek, California, addressed 10 as follows : 11 Clerk of the Board of Supervisors of Contra Costa County Y N 12 651 Pine Street, Rm. 106 Q < Martinez , CA 94553 vi 013 dg � o - 14 J i "' rn V W O Z w = aZ U v15 01..U m i 16 � � 3 1/ - 18 19 20 21 22 I declare under penalty of perjury under the laws of the 23 State of California that the foregoing is true and correct. Dated: November 30 , 1987 • 24 25 Danielle Signo ella 26 27 28 APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE 10 APPLICANT January 5 , 1988 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 *WARihMN below. Claimant: HOYT E. SLOAN County Counsel c/o Lewis & Lewis Attorney: 595 Market Street #2700 DEC ] 1 * 1987 San Francisco , CA 94105 Martinez, CA 94553 Address: Amount: Unspecified By delivery to Clerk on December 7, 1987 Date Received: December 7 , 1987 By mail, postmarked on December 4, 1987 I. FROM: Clerk of the Board of Supervisors 70: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED:December 11 , 1987PHIL BATCHELOR, Clerk, By V. Puty L. Hall 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: �� ��J C fD� VICTOR WESTMAN, County Counsel, By Deputy III. BOARD ORDER By unanimous vote of Supervisors pr sent (Check one only) ( ) This Application is granted (Section 911.6). (x) 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 5 1988 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 Pram 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 ooruection with this matter. If you want to consult an attorney, u should do so immediately. IV. FROM: Clerk of the Board T0: 1 County Counsel (-2T County A nis ra or 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: J" 8 1988 PHIL BATCHELOR, Clerk, By Z, 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 I MARVIN K. LEWIS, ESQ. RECEIVEID3pp E BELOW FOR FILING STAMP ONLY) ZEEI JEDP C 2 LEWIS & L.[---',"IIS D 98 "ENDORSED" Dj�d 7 1987 3 FE". T cop \1\kkl I ,1141 1 I. 111 K 0 CL K 4 SAN I KAN(IM(l.(Al 1! Ik M ..... .41... . .. ...... 6 ATTORNEYS FOR--Cla-imant HOYT E. SLOAN 0 U Y _E 7 8 IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF SOLANO 10 11 HOYT E. SLOAN, 12 Claimant, No. 98388 13 V. APPLICATION FOR LEAVE TO PRESENT LATE CLAIM ON BEHALF ]A MT. DIABLO COMMUNITY HOSPITAL OF HOYT E. SLOAN [Section AND MEDICAL CENTER, LAYBON 991. 4 of the Government 15 JONES, JR. , M.D. , WILLIAM Code] SWEEZER, M.D. , AARON MELTZER, 16 M.D. , M. SHELDON, M. D. , MICHAEL E. EIN, M.D. , LOREN 17 JOHNSON, M.D. , A. JOHNSON, M. D. , ) MARK GOLDBERG, M. D. , and DOES 18 1 through 50, inclusive; 19 Defendants. 20 21 TO MT. DIABLO COMMUNITY HOSPITAL AND MEDICAL CENTER AND 22 LAYBON JONES, JR. , M.D. , AARON MELTZER, M.D. , LOREN JOHNSON, 23 M.D. : 24 1. Application is hereby made, pursuant to Government 25 Code Section 911.4, for leave to present a late claim founded on 26 the cause of action for personal injuries which accrued on July 1 f - i I� 1 29, 1987 for which a claim was not presented within the 100 day period provided by Section 911. 2 .of the Government Code. For ; additional circumstances relating to the cause of action, 4 ; reference is made to the proposed claim attached to this II 5 ! Application. 6 2. The reason that no claim was presented during the 7 period of time provided by Section 911. 2 of the Government Code ! is that the claimant, HOYT E. SLOAN, and his attorneys of record 9 Idid not know that the Mt. Diablo Medical Center was a government 10 Jentity. The first time that plaintiff ' s attorneys learned that 11 the Mt. Diablo Medical Center was a government entity was upon ,. 12 receipt of the letter from the attorneys for Mt. Diablo Medical 13 Center dated November 13, 1987 , in which they claimed that Mr. x - 14 Sloan' s action was barred because he had not complied with the IS claim procedures. Therefore, the claim was not made within the 161100 day period specified by Section 911 . 2 of the Government Code ii 171idue to mistake and surprise, and Mt. Diablo Medical Center was I; 18 ':.;not prejudiced by this failure, which is more fully set forth in t 19 !attached declaration of LauReen F. Perkins, secretary to Marvin 20 K. Lewis, and the declaration of Marvin K. Lewis, attorney .for 21 claimant HOYT E. SLOAN. 22 3 . This application is being presented within a 23 reasonable time after the accrual of the cause of action, as more 24 particularly shown by the attached declaration of Marvin K. 25 Lewis. 26 4 . The "late discovery doctrine" and the principles of 2 i li � 1 estoppel against the government and substantial compliance support claimant' s request that his application for leave to present a late claim should be granted. WHEREFORE, it is respectfully requested that this 5 '!application be granted and that the attached proposed claim be 6 received and acted on in accord with Sections 912 . 4 through 913 7 of the Government Code. RDATED: November 24 , 1987 LEWIS & LEWIS 9 By . i 10 i RVIN K. . LEWIS 11 Attorneys for Claimant _ - HOYT E. S LOAN '. 12 iNOTE: The addresses to which the notices relating to this z 13 Japplication are to be sent are:14 j I T x (Marvin K. Lewis, Esq. Lewis & Lewis II 15 1595 Market Street, Suite 2700 16 IjSan Francisco, CA 94105 i i 17 19 Ii I 19 I 20 21 22 23 24 25 26 3 �i - I If I 1 MARVIN K. LEWIS ESQ. (SPACE BELOW FOR FILING STAMP ONLY) i i 2 1_[=k�'15 L.t_t\'Is 'ENDORSED:' j 3 4 6 ATTORNEYS FOR-_.. -_ -Claimant ---------- HOYT E. SLOAN 7 8 IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF SOLANO 10 11 HOYT E. SLOAN, ) )2 Claimant, ) No. 98388 13 V. ) DECLARATION OF MARVIN K. LEWIS 14 MT. DIABLO COMMUNITY HOSPITAL ) AND MEDICAL CENTER, LAYBON ) 15 JONES, JR. , M. D. , WILLIAM ) SWEEZER, M.D. , AARON MELTZER, ) 16IM. D. , M. SHELDON, M. D. , ) I� MICHAEL E. EIN, M.D. , LOREN ) 17JOHNSON, M.D. , A. JOHNSON, M. D. , ) I MARK GOLDBERG, M. D. , and DOES ) 18 + 1 through 50, inclusive, ) } 19 Defendants. ) 20 21 I, MARVIN K. LEWIS, declare as follows: 22 1. I am an attorney at law duly licensed to practice in 23 the State of California and the attorney of record for claimant 24 HOYT E. SLOAN. 25 2 . on July 29, 1987 I met with HOYT E. SLOAN in my 26 office to discuss his suit. At that time, I spoke with a doctor 1 I on the telephone in Mr. Sloan's presence who informed myself and Mr. Sloan that the cause of the gangrene which led to amputation Z of his left leg was due to medical negligence on the part of Mt. 4 Diablo Medical Center and the doctors who treated Mr. Sloan. ' 5 3 . This doctor informed myself and Mr. Sloan that the 6 reason his leg was amputated was that poor circulation was caused 7 by the constricting of the TED stocking which was placed upon Mr. 8 Sloan's leg subsequent to his coronary bypass operation at Mt. 9 Diablo Medical Center. Prior to this time, neither myself nor 10 Mr. Sloan knew of any facts supporting medical negligence on the a 11 part of the doctors at Mt. Diablo Medical Center or the hospital x 1 itself. l 13 4 . Prior to this date, Mr. Sloan had been informed by Y - doctors at Mt. Diablo Community Hospital and Medical Center that 14 the cause of the circulation problem in his legs was due to 15 16 possible gout or the fact that he had poor circulation. Prior to 17 (this time, no doctors from Mt. Diablo Medical Center informed Mr. 11; Sloan that the gangrene in his leg which ultimately caused him to 19 have his lower left leg amputated were caused by the application 20 of the TED stocking. 21 5. The doctors and personnel at Mt. Diablo Medical 22 Center had knowledge that Mr. Sloan's leg was amputated by Dr. 23 Trewin because Mr. Sloan returned to Mt. Diablo to seek future 24 medical assistance in this regard. 25 6. During the time subsequent to Mr. Sloan's coronary 26 bypass Mr. Sloan was heavily medicated and sedated for pain he 2 I I+ . I� I +experienced due to his recent surgery. Subsequent to the amputation of his lower left leg Mr. Sloan was also heavily +sedated and medicated for pain he experienced due to the i '!amputation. I' 7 . Due to the surgeries Mr. Sloan underwent and his 6 medication and sedation, Mr. Sloan was physically incapacitated j i for a substantial period of time. As such, Mr. Sloan was unable I h to endeavor to find out the cause of his gangrene which resulted 9 in the amputation of his lower left leg. 1(1 8 . I had no knowledge that Mt. Diablo Medical Center ! ! was a government entity. The first I learned that Mt. Diablo = z Medical Center was a government entity was on November 13 , 1987 12 13 when counsel representing Mt. Diablo Medical Center notified me t by letter that our office had failed to comply with the claims 14 1procedures 15 in cases involving government entities. I 9 . The complaint in this case was filed September 14 , l� li 17111987 , less than one year after Mr. Sloan' s initial coronary .I I�bypass surgery and even less time elapsed from the date his cause 18 li 19 10f action accrured which was on July 29 , 1987 . This complaint Iwas also filed less than 100 days after the cause of action 20 against Mt. Diablo Meeical Center accrued on July 29 , 1987 . 21 22 10. Mt. Diablo Medical Center is not prejudiced by the ! 23 delay in filing a late claim because the information provided to 24 the medical personnel at Mt. Diablo Medical Center subsequent to 25 r. Sloan's leg amputation as well as the complaint apprised Mt. 26 Diablo of the injuries sustained by Mr. Sloan and its potential 3 it I liability. 2 11. On October 11, 1987 an employee of my office telephoned Mt. Diablo Medical Center to inquire as to its status 4 ;as being private or a government entity. This is a regular 5 procedure which our office follows prior to serving complaints in 6 all cases against hospitals. At that time my secretary was 7 informed that Mt. Diablo Medical Center was a community hospital. K My secretary then informed me that Mt. Diablo Medical Center was 9 not a government entity. Our office then proceeded to begin 10 service of the summons and complaint upon the defendants in this 11 case on the next day, believing Mt. Diablo Medical Center to be a I � Y 12 private hospital . x I declare under penalty of perjury that the foregoing is - 13 Y ; - 14 true and correct and that this declaration was executed on 15 November 24 , 1987 , at San Francisco, California. I6 17 MARVIN K. LEWIS ! 19 I 20 21 22 23 24 25 26 4 i� i 1 MARVIN K. LEWIS, ESQ. (SPACE BELOW FOR FILING STAMP ONLY) 2 LEWIS & LEWIS 3 - AF1'ORNF.YS A I I AN' 4 595?1ARAli'F SI REIJ,SI:111..71M) SAN FRANCISCO.CALIH)RNIA 94105 i 5 (415)777-888K I 6 ATTORNEYS FOR Claimant HOYT E. SLOAN 7 _ I 8 IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF SOLANO 10 11 HOYT E. SLOAN, ) 12 Claimant, ) No. 98388 13 V. ) CLAIM FOR PERSONAL INJURIES [Section 910 of the t4 MT. DIABLO COMMUNITY HOSPITAL ) Government Code] AND MEDICAL CENTER, LAYBON ) 15 JONES, JR. , M.D. , WILLIAM ) SWEEZER, M.D. , AARON MELTZER, ) 16 M.D. , M. SHELDON, M.D. , ) MICHAEL E. EIN, M.D. , LOREN ) 17 JOHNSON, M.D. , A. JOHNSON, M.D. , ) MARK GOLDBERG, M.D. , and DOES ) 18 1 through 50, inclusive, ) 19 Defendants. ) 20 I 21 TO MT. DIABLO COMMUNITY HOSPITAL AND MEDICAL CENTER, 22 LAYBON JONES, JR. , M.D. , AARON MELTZER, M.D. , LOREN JOHNSON, 23 M.D. : 24 You are hereby notified that Hoyt E. Sloan whose address 25 is 1405 Magazine Street, Vallejo, CA 94590, claims damages from 26 the Mt. Diablo Community Hospital and Medical Center in the 1 I amount, computed as the date of the presentation of a claim in an 2 amount presently undetermined. The claim is based on personal 3 injuries sustained by claimant on or about September 19 , 1986, in 4 the vicinity of Mt. Diablo Community Hospital and Medical Center 5 under the following circumstances: Claimant was treated at Mt. 6 Diablo Community Hospital and Medical Center for chest pains 7 which were later diagnosed as congestive heart failure. 8 Defendants conducted a coronary artery bypass surgery on 9 claimant. on or around September 22 , 1986 defendants negligently 10 failed to treat and diagnose the pains claimant complained of in sa 11 his legs due to lack of circulation caused by TED stockings. n , a 3 F z 3J � o 12 Ultimately, claimant contracted gangrene and was forced to 13 undergo amputation of his left foot and lower leg. Defendants O 4,< s Z � < < 14 also failed to properly advise claimant of the proper care of his i. Z 15 legs while using the TED stockings, and of the risks involved in 16 employing a TED stocking. 17 The names of the public employees causing claimant's 18 injuries under the described conditions are Laybon Jones, Jr. , 19 M.D. , Aaron Meltzer, M.D. , Loren Johnson, M.D. , and other public 20 employees whose names are not presently known to claimant. 21 The injuries sustained by claimant, as far as known, as 22 the date of the presentation of this claim, consist of the 23 amputation of lower portion of claimant's left leg. Claimant 24 suffers extreme pain, loss of enjoyment of life, embarrassment, 25 and is unable to undertake to perform tasks required of daily 26 life. 2 I 1 The amount claimed, as of the date of the presentation of 2 this claim, is computed as follows: 3 _ Damages Incurred to Date: 4 Expenses for medical and hospital care $ Unknown 5 Loss of earnings $ Unknown 6 Special Damages for employment of a housekeeper $ Unknown 7 General Damages $ Unknown 8 Total Damages Incurred to Date $ Unknown 9 Estimated Prospective Damage as far 10 as known: 11 Future expenses for medical and hospital care $ Unknown -' = 12 Future loss of earnings $ Unknown = 13 � ; Other prospective special damages $ Unknown w < r < -75< 14 Prospective general damages $ Unknown a Z " r 15 Total Estimated Prospective 16 Damages $ Unknown 17 Total amount of claim as of the presentation of this claim $ Unknown 18 All notices or other communications with regard to this 19 claim should be sent to claimant' s attorney Lewis & Lewis, 595 20 Market Street, Suite 2700, San Francisco, CA 94105. 21 DATED: November 24, 1987 LEWIS & LEWIS 22 23 By I�--- 24 MARVIN K. LEWIS Attc.rneys for Claimant 25 HOYT E. SLOAN 26 3 1 CERTIFICATE OF MAILING 2 I, LAUREEN F. PERKINS, declare as follows: 3 _ I am a citizen of the United States over the age of 18 4 years, an am not a party to the within action. I am employed at 5 LEWIS & LEWIS and my business address is 595 Market Street, Suite 6 2700, San Francisco, CA 94105. 7 On this date I served the attached document by placing a 8 true copy thereof enclosed in a sealed envelope with postage 9 thereon fully prepaid by certified mail, return receipt 10 requested, in the United States mail at San Francisco addressed a 11 as shown below. n < I declare under penalty of perjury that the foregoing is - v •° 12 N 13 true and correct. � " WZ 14 Executed at San Francisco, California on November 25, 15 1987. 16 17 LAUREEN F. PERKINS 18 CASE: Sloan v. Mt. Diablo Community Hospital and Medical Center 19 - Solano County Superior Court Action No. 98388 20 Attatched Document: Application For Leave To Present Late Claim On Behalf of Hoyt E. Sloan; Declaration of Marvin K. Lewis; 21 Declaration of LauReen F. Perkins; and Claim For Personal Injuries 22 Judith S. Craddick, Esq. 23 Craddick, Candland & Conti Professional Corporation 24 Danville-San Ramon Medical Center 915 San Ramon Valley Boulevard, Suite 260 25 P. O. Box 810 Danville, CA 94526-0810 26 1 I Peter Dixon, Esq. Law Offices of Moore, Clifford, Wolfe, 2 Larson & Trutner A Professional Corporation 3 The Kaiser Center, 17th Floor Oakland, CA 94612 4 5 6 7 8 9 10 3 � z 3 ` x 12 w _ r i 13 V� Z v w < 14 c. { s 15 16 17 18 19 20 21 22 23 24 25 26 2 I 1 CERTIFICATE OF HAND DELIVERY 2 I, LAUREEN F. PERKINS, declare as follows: 3 - I am a citizen of the United States, over the age of 18 4 years, and am not a party to the within entitled action. I am 5 employed at the law offices of LEWIS & LEWIS and my business 6 address is 595 Market Street, Suite 2700, San Francisco, 7 California 94105. 8 On this date I served the attached document by placing a 9 true copy thereof enclosed in a sealed envelope address as shown 10 below and caused it to be hand delivered. s a 11 LQ I declare under penalty of perjury that the foregoing is 12 -4Q J _ true and correct. � Z 13 Executed at San Francisco California on November 25 14 Ll a E a P 1987. Z15 f 16 7 17 LAUREEN F. PERKINS 18 CASE: Sloan v. Mt. Diablo Community Hospital and Medical Center - Solano County Superior Court Action No. 98388 19 Attached Documents: Application For Leave To Present Late Claim 20 On Behalf of Hoyt E. Sloan; Declaration of Marvin K. Lewis; Declaration of LauReen F. Perkins; and Claim For Personal 21 Injuries 22 Geoffrey A. Mires, Esq. Rankin, Sproat & Pollack 23 1800 Harrison Street, Suite 1616 Oakland, CA 94612 24 25 26 1 I l r, I CERTIFICATE OF MAILING 2 I, LAUREEN F. PERKINS, declare as follows: 3 _ I am a. citizen of the United States over the age of 18 4 years, an am not a party to the within action. I am employed at 5 LEWIS & LEWIS and my business address is 595 Market Street, Suite 6 2700, San Francisco, CA 94105. 7 On this date I served the attached document by placing a 8 true copy thereof enclosed in a sealed envelope with postage 9 thereon fully prepaid by certified mail, return receipt 10 requested, in the United States mail at San Francisco addressed T 11 as shown below. LU < v 1� I declare under penalty of perjury that the foregoing is true and correct. 13 3 � � Z 14 Executed at San Francisco, California on December 4 , 1987. a z " r 15 16EEN 4F. PERKINS 17 CASE: Sloan v. Mt. Diablo Community Hospital and Medical Center, 18 et al. - Solano County Superior Court Action No. 98388 19 Attatched Document: Claim For Personal Injuries [Section 910 of the Government Code] ; Application For Leave to Present Late Claim 20 On Behalf of Hoyt E. Sloan; Declaration of Marvin K. Lewis; Declaration of LauReen F. Perkins 21 22 Contra Costa County Board of Supervisors, Clerk 23 651 Pine Martinez, CA 94553 24 25 26 1 I x , III I 1 I MARVIN K. LEWIS, ESQ. (SPACE BELOW FOR FILING STAMP ONLY) t 2 LEWIS & [J-AVIS "ENDORSED" I 3 \ f„H _ I� 4 p 5 .. . 6 ATTORNEYS FOR--..--- Claimant. HOYT E. SLOAN ---- 7 8 IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF SOLANO )0 11 HOYT E. SLOAN, ) 12 Claimant, ) No. 98388 13 V. ) DECLARATION OF LAUREEN F. PERKINS 14 MT. DIABLO COMMUNITY HOSPITAL ) AND MEDICAL CENTER, LAYBON ) 15 JONES, JR. , M.D. , WILLIAM ) SWEEZER, M.D. , AARON MELTZER, ) 16 M.D. , M. SHELDON, M. D. , ) MICHAEL E. EIN, M. D. , LOREN ) 17 JOHNSON, M.D. , A. JOHNSON, M. D. , ) MARK GOLDBERG, M. D. , and DOES ) 18 1 through 50, inclusive, ) 19 Defendants. ) 20 i I 21 I, LAUREEN F. PERKINS, declare: I I 22 1. I am secretary to Marvin K. Lewis, attorney for i 23 claimant for HOYT E. SLOAN. 24 2. On October 11, 1987 I telephoned Mt. Diablo Community 25 Hospital and Medical Center to inquire as to whether the hospital Z6 was a government entity or a private hospital. 1 1 3 . I do not recall the name of the receptionist I spoke with. The information she conveyed to me was that Mt. Diablo 3 Hospital was a community hospital. 4 _ 4 . Upon this basis, I concluded that Mt. Diablo Hospital 5 ,was not a government entity. I informed Marvin K. Lewis that Mt. 6 Diablo Hospital was not a government entity. 7 5. on the following day I sent the summons and complaint K out to be served upon the defendants in the instant action. 9 I declare under penalty of perjury that the foregoing is i 10 true and correct and that this declaration was executed on 11 November 24, 1987, at San Francisco, California. a _ 12 y� r � z 13 :J UREEN F. PERKINS 14 J - z T 15 16 17 I 1K I I 19 I 20 21 22 23 24 25 26 2 I I } 1 APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COMM, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT January 5, 1988 Against the County, Routing ) The copy of `;anis rirlaiicli: rAallad 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 MWARNING" below. Claimant: MARTINA FEMANDEZ U."Ity Counsel C/o Law Offices of Steven R. Jacobsen Attorney: 436 14th Street #1212 DEC , 198 4 Address; Oakland, CA 94612 a rtr nez C Q A Amount: $1, 019, 503 . 51 By delivery to Clerk on December 4, 1987 Date Received: By mail, postmarked on December 2, 1987 GertifieU P 567 786 332 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: 11 , 1937PHIL BATCHELOR, Clerk, By Dept L. Hall 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: VICTOR WESTMAN, County Counsel, By "� puty II. BOARD ORDER By unanimous vote of Supervisors pre nt (Check one only) ( ) This Application is granted (Section 911.6). (x) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Boardfs Order entered in its minutes for this date. DATE: JAN 5 1988 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code 5911.8) If you wish to file a oourt 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 oourt 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. It M want to oonsult an attorne u should do so Immediately. IV. FROM: Clerk of the Board TO: 1 County Counsel 2 County A nis ra or 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 Boardfs copy of this Claim in accordance With Section 29703. DATED: JAN 8 1985 PHIL BATCHELOR, Clerk, By 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 1 employee of the County of Contra Costa. 2 5 . Claimant has suffered fractured ribs, a fractured 3 collarbone, a collapsed lung, injuries to her left knee and 4 back, pain and suffering , medical expenses and other injuries 5 unknown to claimant at this time , but claimant believes that she 6 will suffer some permanent impairment as a result of her 7 injuries . 8 6. The names of the public employees causing claimant' s 9 damages are: Tapas R. Padille , and other persons unknown to 10 claimant. 11 7. Claimant' s claim as of the date of this claim is in the 12 amount of $1 ,019,503 . 51 . 13 8. The basis of computation of this claim is as follows : 14 Medical expenses to date: $ 19,5.03. 51 15 Future medical expenses Unknown 16 Lost wages to date Unknown 17 Future lost wages Unknown 18 General damages : $1,000,000. 00 19 Total claim : $1,019, 503. 51 20 Dated : December 2 , 1987 21 22 � 23 STEVEN Rvor JAC OBSEN Attorney Claimant 24 25 26 27 28 -2- i_ CLAIM BOARD OF SUPERVISORS OF .CONTRA COSTA COUNTY, CALIFORNIA Cla..im Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 5f 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 Supig6,sors Vt (Paragraph IV below), given pursuant to Government Code X C Amount: .$440. 90 Section 913 and 915.4. Please note all "Warnings/q,--,, 41 . CLAIMANT: CALIFORNIA STATE AUTOMOBILE ASSOCIATION INTER-INSURANCE BUi&W. 1'9,9;, P. O. Box 7 (Donna Day) ' C, ATTORNEY: San Pablo, CA 94806 Date received ADDRESS: BY DELIVERY TO CLERK ON DeceTiber 7 , 1987 Sheriffs- 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. ��IL gATCHELOR, Clerk DATED: December 11, 1987 : Deputy 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: �/`JlGr /7a j�" BY:� ��1ij{ Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (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 5 1988 PHIL BATCHELOR, Clerk, By • l"o �1,� Deputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. 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 8 1988 BY: PHIL BATCHELOR by wle—, �puty Clerk CC: County Counsel County Administrator RECEIVED Claim For Damages DEC 7 1987 In accordance with Section 910 of the California Government Code, this is. f .. .... ........ . .. . ... notice of our subrogated claim for the loss described below. Date: NOVEMBER 03 19 87 • CONTRA COSTA COUNTY SAN PABLO , California SHERIFF'S CRIME LAB 1120 ESCOBAR ST. MARTINEZ, CA 94553 Claim is hereby made and filed against the CONTRA COSTA COUNTY SHERIFF'S CRIME LAB as follows: Nameof Claimant: California State Automobile Association Inter-Insurance Bureau Address of Claimant: (Send notices to this address) P.O. BOX 7, SAN PABLO, CALIFORNIA 94806 Date of Occurrence: NOVEMBER 02, 1987 Place of Occurrence: SAN PABLO AVENUE AND ROOSEVELT IN THE CITY OF RICHMOND, CALIFORNIA Nature and Amount of Damages AUTOMOBILE DAMAGE/$440.91 Items Making up said Amount: RIGHT QUARTER PANEL, RIGHT BUMPER TIP AND MOLDINGS Name of Public Employee(s) causing said Damage(if known): STEPHEN MORRIS OJENA Facts & Details: BOTH PARTIES WERE NORTHBOUND ON SAN PABLO AVENUE. DRIVER X61, OJENA WAS IN THE #3 LANE WHICH IS MARKED RIGHT TURN ONLY. DRIVER #2, HARRIS, WAS IN THE #2 LANE WHICH HAS THE OPTION TO TURN RIGHT OR GO STRAIGHT. DRIVER #1, OJENA PROCEEDED STRAIGHT AND STRUCK THE RIGHT QUARTER AREA OR DRIVER #2, AS DRIVER #2 ATTEMPTING TO MAKE RIGHT TURN. California Stat Automobile Asso 'ation Inter-Insur c Bureau By: G '' F1688 (REV.5-78) DONNA DAY assi nment of -claim and subrogation agreement of In consideration of the payment to the undersigned of a (] a Ethe sum sum estimated to be FOUR fiM4DRF.D FORTY & 90/100 Dollars, being the full amount of loss and damage insured against under an automobile insurance policy, number W11209-0 issued to the undersigned by the CALIFORNIA STATE AUTOMOBILE ASSOCIATION INTER-INSURANCE BUREAU, said loss and damage having occurred on or about the. 02ND day of KgV=E:R 1987 the said undersigned hereby assigns and transfers to said Bureau said claim in the above amount plus ooxo additional claim for damage resulting from said accident, not �1 covered under said policy of insurance, in the amount of$ 44090 constituting a totalclaim a total estimated in the amount of$---440-90. Said Bureau is hereby subrogated in_ HER place and stead to the extent of the above amount of the said total claim and is hereby authorized and empowered to sue, compromise or settle in HER name or other- wise to the extent of said total claim for loss and damage, and to endorse in my name any check made payable to me therefor, and collect and receive any money payable thereby. The undersigned covenants that _gTTE hag not released or discharged any such claim or demand against such party or parties and that gwt-, will furnish to said Bureau any and all papers and information in HFu possession, necessary for the proper prosecution of such claim. Dated at - this 3J41 day of 19S-1-7 LI WITNESS F1433 (REV.7-77) CLAIM FOR DAMAGE, INS"fRUCTIONS: Prepare in ink or typewriter. Please read carefully the OM and B instructions on the reverse side and supply information requested on both Approval No. INJURY, OR DEATH sides of this form.Use additional sheet(s)if necessary. 80-RIII 1. SUBMIT TO: 2. NAME AND ADDRESS OF CLAIMANT (Number, street, city, State, CONTRA COSTA COUNTY and Zip Code)CALIFORNIA STATE AUTOMOBILE ASSOCIATION SHERIFF'S CRIME LAB 14560 SAN PABLO AVENUE 1120 ESCOBAR ST. MARTINEZ CA 94553 SAN PABLO, CA 94806 3. TYPE OF EMPLOYMENT 4. AGE 5, MARITAL 6. NAME AND ADDRESS OF SPOUSE, IF ANY (Number, street, city, State, and STATUS Zip Code) O MILITARY o CIVILIAN -- -- -- 7. PLACE OF ACCIDENT (Gine city or town and State; if outside city limits, indicate 8. DATE AND DAY 9. TIME mileage or distance to nearest city or town) OF ACCIDENT (A.M OR P.M) SAN PABLO AVENUE AND ROOSEVELT, RICHMOND, CALIFORNIA 11-02-87 5:00 MONDAY 10. AMOUNT OF CLAIM.(in dollars) A. PROPERTY DAMAGE B. PERSONAL INJURYWRONGFUL DEATH D. TOTAL r 440.90 -- -- 440.90 11. DESCRIPTION OF ACCIDENT(State below, in detail,all known facts and circumst m es utteu,ling the damage,injury,or death,identifying persons and property involved and the cause thereon OUR INSURED'S VEHICLE SUSTAINED DAMAGE DUE TO A CITY DRIVER HITTING HIM ON THE RIGHT QUARTER AREA OF THEIR VEHICLE. OUR INSURED WAS ATTEMPTING TO MAKE A RIGHT TURN WHEN HE WENT STRAIGHT FROM A RIGHT TURN ONLY TURNING LANE. 12. PROPERTY DAMAGE NAME AND ADDRESS OF OWNER, IF OTHER THAN CLAIMANT (Number,sheet,city.Stale,and Zip Code) ANTHONY OR LEDERELE HARRIS, 2453 MERRIT STREET, SAN PABLO, CA 94806 BRIEFLY DESCRIBE KIND AND LOCATION OF PROPERTY AND NATURE AND EXTENT OF DAMAGE(See instructions on reverse side for method of subslantialin,e claim) 1976 MERCEDES, 4 DOOR SEDAN, CALIFORNIA LICENSE NUMBER 447 SCB DAMAGED AS PER ATTACHED REPAIR BILL IN THE AMOUNT OF $440.90, WHICH INCLUDES THE INSURED'S DEDUCTIBLE. 13. PERSONAL INJURY STATE NATURE AND EXTENT OF INJURY WHICH FORMS THE BASIS OF THIS CLAIM NONE 14. WITNESSES NAME ADDRESS (Number,street,city,Stale,and Zip Code) NONE NONE I CERTIFY THAT THE AMOUNT OF CLAIM COVERS ONLY DAMAGES AND INJURIES CAUSED BY THE ACCIDENT ABOVE AND AGREE TO ACCEPT SAID AMOUNT IN FULL SATISFACTION AND FINAL SETTLEMENT OF THIS CLAIM 15. SIGNATURE OF CLAIMANT (This signa re should be used in all future correspondence) 16. DATE OF CLAIM CIVIL PENALTY FOR PRESENTING CRIMINAL PENALTY FOd PREVISITING FRAUDULENT FRAUDULENT CLAIM CLAIM OR MAKING FALSE STATEMENTS e claimant shall forfeit and pay to the United States the sum Fine of not more than $10,000 or imprisonment for not more of $2,000, plus double the amount of damages sustained by the than 5 years or both.(See 62 Stat.698, 749; 18 U.S.C. 287, 1001.) United States.(See R.S.§3490,5438;31 U.S.C.231.) 16 1 GENERAL SERVICES ADMINISTRATION-FPMR 101-11:8 STANDARD FORM 95 95-105 REVISED FEBRUARY 1971 CSAA FORM F1679 (5-75) GSA FPMR 101-I1.6 418- 23rd STREET , (415) 234-1204 RICHMOND, CA 94804 liS�� Q g-tJ�3 SoS —o ESTIMA TE for REPAIRS Dal. // -,Z _ to IIIF ,y,�,/ r,.�-, IDDtESS ++ pll Hoff�?zz� -�>Ys/ /wokelIM 2 FO 41e& Y- 74 Se.1ol No 1/4 (,6U /Z 1!1 / Body Style Style No m.leoge Llcenae No Pont No r,.- No Inwronce Co ` 1a80R I Pa RTS 1 SUB�c r.....1 r.,..,,, ESTIMATE OF REPAIR COSTS I HRS 6"f_;2 Z= I 3 1 3 0 0 + 0 5 0 + I 0 + • � 1 i I I I 1 0 3 0 + I 7 6 0 - I 7 6 0 x 3 9 = 2 9 6 . 4 0 + C 6 9 • 2 2 + – — I 5 4 0 0 + – 1 2 5 0 + I 1 3 5 7 2 TQTAt...__—___ 1 > 7 2 x 6 • 5 = / 7 00 G/ —.5 OF LABOR CA S .3f---PER e82 . 18 + PARTS -- PAINT MATERIALS S� C ;LIRANCE DFOUCTIFILE SU9LET S SALES TAX S 1 '5 • 7 _ .J .... r.N ESTIMATE TOTAL _ - c., .o.r.a•.- .u.r...wrrce• •a.•• ADVANCE CHARGES S 1 (SRANO TOTAL S y S 4 4 . 3 7 4 i• / — ^ av -.( C•�{_`�.._ •��3;�"stigG��+'ht�'T,'�,�'*�Aitli + ' California State Automobile Association Interflnsurance Bureau 021,134939 �.®...� ® `ort u: ;'1' ! ��;• trf {• �z'` ?)� ,{r1+S.» �+5.::+F f Yrs±f.:y.1. t-; r , DATE OF LOSS - CLAIM + ",• 6 NSUREDS NAME r " ["11 J1 '.. df s�fi + r y t + 3 4J1 909 OS }* {CtiR1'{:�S .UI;�LCI1 BELE' .2-02—;3� POLICY .TYPE KINOOFLOSS L^ MA_NTS NAME AY t: Z hw� �,,� SUFFIX �' rK .r,. YrTX`��. O UTO 4, , ff TN i�lY::C IL�2>yvS'fnIE0i i't `1,Y,i__F ✓I'tioA. M.I.co wa�zN Zs'"Fp8006 %cft 11-4 'AD O tN COL'FfmO . . ..-� r. •.� - , .,(.: '�,y—' A �1' s n Fw1W4ca CA 04 x PAY °� " `ra> } a ,v ra"� `t� .t� k n ij 2.:. ✓ { m *FOR.'MUNDR L" F.PKTLn KAf:E�ER'S AUTO. TO AND ANTHONY HARRIS AUTHORIZED SIGNATURE 0 THE :418 23RD ,STREET ;,- .NOT NEGOTIABLE OF RICHMOiII! 844- r M.O. COPY GATE OF COLLISION TIMES(7124001 NCIIC NUMBER OFFICER 10. NUMBER -��/�/� (y�r PAGE MO • DAY O 0!1 3 1. 1 Z7 V V I� COLL! ION NARRATIVE - 0 t 1._ s,,ml ..T� ►J - ►J Aj _ N uo MAaKvtA, L l�r\. 4C K3 e 2 \- uS-e►JA ` ` Svc P ,�P �m L�,?S,�r� '•c_iZ ' I I,) SLR"- sn, 1Aj_7wo kaN49La0l n tic T -77vnU'r —Tj:�p _— ,J lh nhfkKS oat 3009 i�) o ►e�xjQ _ 11 PRIMARY COLLISION FACTOR RI>HT OF WAY CCINI.,l" I „ 3 I TYPE OF VEHICLE 1 2 3 4 MOVEMENT PRECEDINL; A V EC I N V�OLATI���ppp,,,N / A CONTROLS FUNCTIJNING __ _ A Pa�SENGER CAk(INC LUDI I COLLISION �r q CONTROLS NOT FUNCTIONING - - `STATION WAGON) I _ A STOPF_C, _ B OTHER IMPROPER DRIVING' 7_C CONTROLS OBSC_U_RED _ _ B PASSENGER CAR W/TRAILE t }1' _ B-- LT 1 RAIGHT C OTHER THAN DRIVER' D NO CONTROLS PRESENT _ - C MOTORCYCLE./SCOOTER I C RAN OFF ROAD__ —7.–UNKNOWN* TIRE OF COLLISION _ D PICKUP OR PANEL TRUCK D_MAKING RIGHT_URN WCATHER lkl;.­ 'Ir`7 !21a;i EAD CN E PICKUP OR PANEL TRUCKI _ E MAKING LEFT TURN A CLEAR B SIDESWIPE W/TRAILER I F MAKING U TUR': jr-lcLOUOY C REAR END _ F TRUCK OR TRUCK TRACTOR_ C RAINING D BROADSIDE _ _H SLOWING_-STCPPING G - TRUCK OR TRUCK TRACTOR _ O SNOWING E HIT OBJECT W/TRAILER(S) _ 1 PASSING OTHER VEHICLE E_FOG F OVERTURNED H SCHOOL BUS _ _ J CHA_NGIN_G LANES _ F OTHER_ G AUTO/_PEDESTRIAN _ _ I OTHER BUS _ __K_PAR_K_IN_GMANEUVER-' G WIND H OTHER'. J EMERGENCY VEHICLE ENTERING TRAFFIC FROM LIGHTING K HWY CONST,EOUIPME NT SHOULDER.MEDIAN A AYLIG HT MOTOR VEHICLE INVOLVED WITH _ _ L BICYCLE _ L PARKING STRIP OR _ _ H DUSK-_L?'rl++ A NO 'COLLISION M OTHER VEHICLE _ PRIVATE DRIVE__ C DARK-STREET LIGHTS B EDESTRIAN _ _N PEDESTRIAN MOTHER UNSAFE TURNING O DARK-NO STREET LIGHTS C OTHER MOTOR VEHICLE O hK7PFD NCROSSLO INTOOPPOSINC E DARK-STREET LIGHTS NOT D MOTOR VEHICLE_O N_J_T .:= ;;c;:•:.i _;"j _ �.�� .;�d._�.I,:t�.: .`,L FUNCTIONING' _ E PARKED MOTOR VEHICLE I I tMa�� 1 to 3,I,--%l O P4 RKED 9E140WAY SURFACE F TRAIN A VC SECTION VIOLATION P MERGING _ DRY G BICYCLE t 0TRAVELING WRONG WAY- 8 WET H ANIMAL: B VC SECTION VIOLATION ROTHER C SNOW-ICE �D SLIPPERY IMUDOv.OILY.ETC,) 1 FIXED OBJECT. C VC SECTION VIOLATION 1 I 3 4 I SOd RIETY-DRuG- t NDITIONS(Mark 1 10 3 Ilemsj PHYSICAL ROADWAY CO Imo, I IO?,wP s) _ I A HOLES.DEEP RUTS _ J OTHER OBJECT. - I( D VC SECTION VIOLATION A HAD NO_T BEEN_CRINKIvC, 18 LOOSE MATERIAL ON ROADWAY' I B H80-UNDER INFLUENCE_ _ C_OBSTRUCTION ON ROADWAY' E VISION OBSCUREMENTS C HBO-NOT UNCER DCONS TRUCTION.REPA I R ZONE INFLUENCE' _ E REDUCED ROADWAY WIDTH PEDESTRIAN 5 ACTION Ve F INATTENTION DHBD-IMPAIRMENT F FL-DED' _ _ A NO PEDESTRIAN INVOLVED G STOP 9 GO TRAFFIC UNKrJOWN' G THE R B CROSSING IN CROSSWALK H ENTERING/LEAVING RAMP _ E UNDER DRUG INFLUENCE' PREVIOUS COLLISION _ _ _ F_IMPAIRM_ENT-PHYSICAL' H NO UNUSUAL CONDITIONS C CROSSING IN CROSSWALK—NOT I `J UNFAMILIA R__WITH ROAR__ _ _ GIM PAIk MENT__NU OT nN_WN AT INTRECTION K DEFECTIVE VEHICLE EQUIP - .I_"--_—" -_-- --_ - --`__—_ ESNOT E APPLICABL _— __— N ..._ .. D CROSSING-NOT IN CROSSWALK MENT �I I SLEEPr/FArL:LT:I - t --------- "T--- E_IN ROAD-INCLUDES SHOULDER - L LININVOL VED VEHICLEZ J J SIC<;IAI.INF(:)­Atoo, I — F NOT INROAD M OTHER'. A HA-ARD OUS MAI ERIAL`.;' I G APPROACHING/LEAVING SCHOOL BUS N NONE APPARENT 8 FIRE INVOLVED' I RUNAWAY VEHICLE - _ C TIRE DEF`ECT/FAILURE- TRA-r*1C"COLLISION REPORT PAGE of 2. I •l t TAI Cl INI III I11N`i NO IN IIIRf U .11 f1 It CATY J NUMOFR t1,1 UNY I I RICHMOND YYbtJ/�►'at.{_ 2 `� �3 NO HILI ED 1/K fl COUNTY Q J V—(r '6 c3 C7 M.,D CONTRA COSTA D { J [ t l) :.tiIUN Ul:Cl1 ! Ut)Ny� U 1 V 1 Tir.E1:JlJU NL'IL NUMIIIH () flCt l'U G L t7 Ave ' ' 0710 I IN TI'N51C IIt IN WIf)1 ; e INJURY.FATAL O TOW AWAY STA IE HM Y R E(A(EJ lO)1 II( 1111/MTI I"•� ()1 "VES "YF� �") PARTY NAMI 11111•:1 MIO tJ-LA511 OWN ,5 NAME SAME AS URI.LR �)i e-q�-h 4, E N OA-p'TRt\- Cl-\!b p4 ' LkN Lid NI(IVt 1f It_ ::IHFIIAUUI/1;�.4 — MO 1L OWNER AUORESS pSAME AS DRIVER Pm, Qx 3� 1 �21n�e �� �c��� VO -,�Ux 1 I11�ry t_ITY - ST TE Bu'�INt`.:'.i PHONE DIRE TON OF ONrACt:y.��S T R EF'OR HIGIIwAYI DLtM1T 2y 51!!S ?� �-ArJ �I�3 l ; ' vlfl UH�O L •IF 11U P(1( y'1�ATE BIRTHDATE SE R.7VE DISPOSITION OF VEHICLE Y DRIVER ON O RS OF PA S,°.� Hu Y 2�•/ CIS- .IG�0 , L'�V/ , J U ( '( l'I li(:1).YR M4KElMUDEL/C:)LORIS) "� LICENSE NO ST"E VEHICLE DAMAGE VIOLATION CHAAGED (� r �' .}/�- 1 4+/ rl A EXTENT (1 LOCATION UIItF 11 �I • f— � l V I V /1 MINOR MOD. 1 \ �/ Cf2.D 1 ��(ZiYI T 1 MAJOR ••TOTALI 1 N(MF,If IRS1.MIDDLE..LA STIP I OWrvER'S NAME M' I c PARTY -eAe�e �e �l �-��,�P,ib2) 2 HONE OWNERS ADDRESS K— E q9 SFJ ) elrai T ('iFv ST F 11U51NE55 PHONE DIRECTION OF Fl y/��' {yam j(7� //� T-/y (/.\/f1 O^+ -CROSS ISTHE ({O.R HIGHWAY) SP�cLJj'D LIMIT 1'LUI 1 !� 1 /•J�D LJ — l /�� • V S 11��� ✓ O TITIAN Pn HKFD Ill/l 11/";I.It_1 N::1 NIIMRFH TATE BIRTHDATE _E% RACE DISPOSITION OF VE HIL=L 'X DRIVER ON ORDERSOF PASS �2o2y�2p ��- `T 9�" Ion r � J7Ri�1� Q tiT VF IIICI.L YR lNIAK(-/mooELCoL�oRISj F LICENSE NO. STAT. VEHICLE DAMAGE VIOLATION CHARGED /7t ((pp_ D/ / tl /)`Y) 1(.�I.+�-{1 //�� _j/ EXTENT 1 LOCATION ()ln.H / ` eIe�� 1 7� 1 / / �t \ '•'1 Ma OR ::TOT-L" • 1�C.rA� I u"CI(If•TIUN OIDAMA GL W dOWNER 5 NAME ADDRESS NOTIFIED O m AYES NO N_ INJURY IN JURED WA$Il.l.r!C.�•n. WI INI'..:: AGE SEX —.. _ _ HAHTY FATAL SEVERE WOUND OTHER VISIHLE S BICY. 11N1Y I v I)I$TORT ED M EMBER IN 11/RIES CO!•7PLAINT OF PAIN DHIL'ER I P4y5 PLO ('1 ItiT OTHER NUA(HLR ❑ ❑ ❑ a ❑ ❑ o NAMI PHONE U) ADIMI S': TAKEN TO(IN CURED ONLY) W H Q Q ❑ ❑ ❑ Q I ❑ ❑ ❑ ❑ 3 NAMI PHONE _W a' A01110 S!; - TAKEN f0 TIN 1 l 1RED ONLY) D L Q L7 ❑ U ❑" u ❑ ❑ ❑ i O NAMI PHONE I nl>IIRf:ti': TAKEN TO(INJURED ONLY) SKETCH I / MISCELLANEOUS A. T. STAT/ T. E G. OTHER R. FILE co5a-� iJ I / INDICATE NUHIH .. T. SEC. CRIM. CORP. OTHER TOT L G F.O.B. STONE D. A. ACTION ADM. 15B. /nom^ PHYSICAL DES RIPTION OF PARTY NUMBER i1A1R EYES HEIGHT WEIGHT INSURED PHOTO PAGE california state automobile association I..: TI 1.:S.,1:k, .i ,C___rrq_S_urJE D H f Ej CL",IMANT FILM 6NEL'AT1 V E ❑ POLAROID DATE 3IF7 _PO L)_R P.M. B V. LOCATION A D VIF)�N gilt r PLEASE ATTACH PHOTOS WITH MAK�7F CAR—YEAR LICENSE NO. -7 DATE AouR A.M. P.M- TY; LOCATION AND VIEW M-A—K,C- OF CAH—YEAR DATE HOUR A.M. P.M. LOCATION AND VIEW JF -MAKE OF CAR—YEAR -_Fc N S-E-—.14 0. y 1. 35 THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA DATE: January 5, 1988 MATTER OF RECORD SUBJECT: California State Automobile Association Inter-Insurance Bureau Claim Supervisor Powers abstained from voting on the California State Automobile Association Inter-Insurance Bureau claim because of possible conflict of interest. THIS IS A MATTER FOR RECORD PURPOSES ONLY NO BOARD ACTION TAKEN