HomeMy WebLinkAboutMINUTES - 10041988 - 1.2 (3) APPLICATION TO FILE LATE CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
BOARD ACTION
Application to File Late Claim ) NOTICE 10 APPLICANT October 4, 1988
Against the County, Routing ) The copy of this oorment 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 ■WARN NG" below.
Claimant: RICHARD DEL FIORENTINO County COunSei
c/o Eugene M. Hannon
Attorney: Attorney at Law
1934 Contra Costa Blvd. SEP 0 " 1988
Address: Pleasant Hill, CA 94523 Martinez, CA 94553
Amount: $25 , 000. 00 By delivery to Clerk on September 2 , 1988 hand del .
Date Received: September 2 , 1988 By mail, postmarked on no envelope
I. FROM: Clerk of the Board of Supervisors 10: County Counsel
Attached is a copy of the above noted Application t F le Late Claim.
DATED:September 2 , 1988PHIL BATCHELOR, Clerk, By Deputy
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 ,C1 m tion 1.6).
DATED: C VICTOR WESTMAN, County Counsel, Deputy
III. BOARD ORDER By unanimous vote of Supervisors present
(Check one only)
( ) This Application is granted (Section 911.6).
This Application to File Late Claim is denied (Section 911.6).
I certify that this is a true and correct copy of the Board's Order entered in its
minutes for this date.
DATE: OCT 0 41988 PHIL BATCHELOR, Clerk, By 0Deputy
WARNING (Gov. Code 3911.8)
If you wish to file a court action on this matter, you must first petition the
appropriate court for an order relieving you from the provisions of Government Code
Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such
petition must be filed with the court within six (6) months from the date your application
for leave to present a late claim was denied.
You may seek the advise of any attorney of your choice in oonneetion with this
matter. If you want to consult an attorney, u should do so immediatel
V. FROM: Clerk of the Board TO: 1 County Counsel 2 County A s 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: OCT 0 6 1988 PHIL BATCHELOR, Clerk, By Lflw ° Deputy
V. FROM: 1 County Counsel 2 County Administrator 70: Clerk of the Board
Received copies of this Application and Board Order. of Supervisors
DATED: County Counsel, By
County Administrator, By
APPLICATION TO FILE LATE CLAIM
r
R ECrI
EUGENE M. HANNON , ESQ. D
2 1934 Contra Costa Boulevard ( SEP 2 1988.
Pleasant Hill , California 94523
415 676-5160 2PH JnrLOR
3 ( ) CLETFFF CR'
4 Attorney for Plaintiff By ' "r
ty
5
6 IN THE SUPERIOR COURT OF THE STATE OF CALIFORNIA
7 IN AND FOR THE COUNTY OF CONTRA COSTA
8 RICHARD DEL FIORENTINO, )
No.
9 Plaintiff ,
APPLICATION FOR PERMISSION
10 vs . ) TO PRESENT LATE CLAIM
(Gov. Code Section 911.4)
11 BILLY SMITH , et a1 . , )
12 Defendants . )
13
To : BOARD OF SUPERVISORS , Contra Costa County
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Application is hereby made for permission to present the
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attached claim after expiration of the time limit provided in
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Government Code Section 911 . 2.
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( 1) As stated in the attached claim, claimant ' s cause of
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action accrued on or about September 2 , 1987.
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(2) The time for presentation of such claim under Government
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Code Section 911 . 2 expired on or about December 12 , 1987 .
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(3) The reason for the failure to present such claim within
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the time provided in Government Code Section 911 . 2 was as
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follows : Plaintiff was hospitalized , underwent two surgeries ,
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disabled , recuperating from surgery and his injuries and involved
25
in assisting the district attorney bring his assailant to trial
26
and therefore , in addition to his physical disabilities failed to
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present such claim due to inadvertence , excusable neglect , and
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1 mistake , and no prejudice will result to the CONTRA COSTA COUNTY
2
by its delay in presenting this claim.
3
I certify and declare under penalty of perjury under the
4
laws of the State of California that the foregoing is true and
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correct .
6
Dated : �-
7 RIC D DELFJMENTINO
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r'
NOTICE OF CLAIM
TO: BOARD OF 5I3PPN!/-ISORS, CSA COSTA COUNTY
RICHARD DEL FIORENTINO hereby sakes a claim against the
CITY OF OAKLEY, Contra Costa County, California, for a sum in
excess of $25,000.00, and makes the following statements in
support of the claim:
1 . Claimant ' s address is 4501 Oak Forest Avenue, Oakley,
California 94561 .
2. Notices concerning the claim should be sent to EUGENE M.
HANNON, Attorney at Law, 1934 Contra Costa Boulevard, Pleasant
Hill , California 94523 .
3. The date and place of the assault and battery incident
giving rise to this claim are September 2, 1987, at the Oakley
Field, Oakley, California .
4 . The circumstances giving rise to this claim are as follows:
At the above time and place, claimant was forseeably using the subject
property in a foreseeable manner and as a result of the dangerous
and unsupervised condition of the field (in that the field was not
properly maintained, managed, supervised and controlled by the
CITY OF OAKLEY) Claimant was assaulted and battered resulting in
severe injury to Claimant .
5. Claimant ' s injuries, as presently known, are:
(a) Broken ribs;
(b) Broken jaw;
(c) Numerous cuts, lacerations and bruises;
(d) Extreme and severe mental anguish and physical pain;
(e) Other injuries unknown at this time.
6. The name of the public employees causing the claimant's
injuries are unknown, but Claimant is informed and believes that
the COUNTY OF C...C._2 owns the Oakley Field property and had the COTIM
properly maintained, managed, supervised and controlled said field,
this accident would not have happened.
7. My claim Ws of the date of this claim is in excess
of $25, 000.00.
S. The basis for computation of the above amount is as
h
follows:
Medical Expenses Incurred to Date: Total not yet ascertained
Estimated Future Medical Expenses: Total unknown
Loss of Wages Total unknown
General Damages In excess of $25,000. 00
Total In excess of $25,000.00
Dated:�j�„�.
EU EN HA NON" tSQ.
On Behalf of Claimant
RICHARD DEL FIORENTINO
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim *Aga:nst the County, or District governed by) _vBOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 4, 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 all "Warnings".
CLAIMANT: ARTHUR BIRGE
45 Camel Back Court
ATTORNEY: Pleasant Hill, CA 94523
Date received
ADDRESS: BY DELIVERY TO CLERK ON September 2 , 1988 hand del .
BY MAIL POSTMARKED: no envelope
I. FROM: Clerk of the Board of_Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
EVIL gATCHELOR, Clerk
DATED: September 7 , 1988 : Deputy 2� �
L. Hall
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
(� This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: U 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
(V� This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Dated: OCT O 4 1988 PHIL BATCHELOR, Clerk, By Nv
( 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: OCT O i1 1988 BY: PHIL BATCHELOR by U Deputy Clerk
CC: County Counsel County Administrator
BOARD OF SUPERVISORS OF CONTRA COATA Vapplicatlonto:
.. Instructions to ClaimaritVerk of the Board
.O.Box 911
Martinez.Califomla 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 Yater 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. 911.20 Govt. Code)
B. Claims must be filed with the Clerk of the Board of Supelsors
at its office in Room 106, County Administration Buildin�rYg, 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 at end
o his form.
RE: Claim byii � 5e )Reserved for Clerk's .filing stamps
Against the COUNTY OF CONTRA COSTA) 198
8
or DISTRICT)Fi 1n name ) K MSThe undersigned claimant hereby makes claim agar s y of Contra
Costa or the above-named District in the sum of
and in support of�' this claim represents as follows:
n3ur-------------------------- ------ _7_
=��. When did the damage or injury occur? (Give exact date and hour]
�. Wuryy6ere did tie damage or injoccur? d
(Inclue city and county) _
— �T.�.,. Q ..�._ gc...--..
3. Rw did the damage or injury occur? (Giveu .l details, use extra
sheets if required)
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4: -What-particular act or orris on on the part of county or district' '
officers, servants or employees cauged the injury or damage? .::.; ►:;:::';•.:.
(over)
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5. . a .are the names of county ,or district officers, servants or
y employees causing the d&mag6or injury? .
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6. What damage or �n�uries do you claa.m resulte33 ZGive—full extent
of injuries o= damages claimed. - Attach two estimates for auto ~'
damage) _
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estimated
amount of any prospective injury or damage.)
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T�a� UJ !cam S :. .� `Chi. �il..�.F oL•� d► , `' . '♦ � �l _ �;s�:
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8. Names and addresses of witnesses, -doctors- and hospitals. rr;
cab RaSGD V,. �•. ter,, .
t
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.. ITEM AMOUNT
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Govt. Code Sec. 910.2 provides: ;
• "The claim signed by the claimant
SEND NOTICES TO: (Attorney) or by some person on his behalf."f
Name end'Address of Attorney
Claimants Si nature
Address
Le
Telephone No. Telephone No. ,y,} .r4►
M
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, Ll
or writing, is guilty of.-a felony."
i
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_ CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
t
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Rout•iKg Endorsements, ) NOTICE TO CLAIMANT October 4, 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: $192 . 73 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: DONALD R. GILBERT
837 Navaronne Way
ATTORNEY: Concord, CA 94518
Date received
ADDRESS: BY DELIVERY TO CLERK ON September 6 , 1988 hand del .
BY MAIL POSTMARKED: no envelope
I. FROM: Clerk of the Board of_Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
1988 BgIL BATCHELOR, Clerk
DATED: September 7 , eputy
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).
:1G ;i
( ) Other:
n
u 19x3
Dated: I b U� BY DeputyCountyCounsel
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
(V_r 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: OCT 0 11988 PHIL BATCHELOR, Clerk, B 0J I A Y
OVO
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
uniteo 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: OCT 1 q u 1m 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 per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be- presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after. the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal, Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
)
R E C�,IV D
Against the County of Contra Costa ) KS E p
or )
P!L. BA ELOR
District) °� 'K T ° AFill in name ) Bruw
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ /92 . 73 and in support of
this claim represents as follows:
-------------------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
------------------------------------------------------------
2. Where did the damage or injury occur? (Include city and county)
A,: 04 J Ll-q >/I J 7
3• How did the damage or injury occur2 (G* full details; use extra paper if
required) 14-1111e WaAl 7-�YJJw 71vwrVre C OAvc 04P
iliac'7�� � �v�.0 �c-�Ii- �r` J"�at/���-- v��� �ucC� ;,dpi i c�! t�ci�_✓' ,4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or� damage? ,I
�/ yip �c° 7 - /yQ�nFf �1C� ri,#;74 la e)e r
�I S���L�. �L'v� //!C�JC� Wim{✓ �I�U` Vf) QDU � Q. c�/' /�7
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5. What are the names of county or district officers, servants or employees causing
the damage or injury?
�ttiD /ic 1,002kIS'
5. What damage-or injuries do you claim resulted?(Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
ifz� Zee w'Ma,G JrX/C
_-------- ----------------------------- ---------------_--_---
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
lo
-------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or by some person on his behalf."
Name and Address of Attorney
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, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
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CLAIM
BOARD U'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 October 4, 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 all "Warnings".
CLAIMANT: BRIAN AND LINDA HALEY
53 Lawnview Court
ATTORNEY: Pittsburg, CA 94565
Date received
ADDRESS: BY DELIVERY TO CLERK ON Septeriber 6, 1988
BY MAIL POSTMARKED: September 2 , 1988
I. FROM: Clerk of the Board of,Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
IL gATCHELOR, Clerk
DATED: September 74 1988 gV: Deputy t
L. Hall
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
t� 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: Ci '�� 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
(✓j This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Dated: 0Q T O 11988 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: OCT Q 19 88 BY: PHIL BATCHELOR by 0Deputy Clerk
CC: County Counsel County Administrator
Claim '£o: •, BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
v
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later .than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
R EC� IVED
Against the County of Contra Costa ) s 1988.
or )
District) CLE PN p TF `UPR CRS
Fill in name ) By .• . . C• •• Deputy
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:
-------------------------------------------------------------------------------------
/`T When did the damage or injury occur? (Give exact date and hour)
------------------------------------------------------------------------------------
�5�- , Where did the damage or injury occur? (Incl e city and county)
p �_5_16DW��)O /Z121<EP__ 4)P55 kU . i TI5f3 G)C'->•�ic CC -P� co .
-J-k5T- 6Ef_ F_ YC- 5T9:�kk7`- L,,P -Tft-_-- )'L-L-
ow
LLLow did the damage or injury occur? (Give full details; use extra paper if ,S►�
required)
IIA3 TftE
IQ Rock-_ ;KSTJ GJ1�� 4CIZIKDCn, -/,o &,QPCc_ -I-1p
-------------- JSS__0- ---------------
--- --= �-- - ESC
4. What particular act or omissi7on�onie'Part of county or district officers, Cf-
servants
servants or employees caused the injury or damage? �jce LCI
j 1� �� J`� �+f�S OCC U� iS 6EC.Q,�3E O:F f_-F_GU r-, 0,.
G� ,J>4:�JiL1ofG -T0 5L,'FP_P _TT-tE_ C-,kjA�
T / j ✓E� � � �l (over)
5. What'-are the names of county ordistrictofficers, servants or employees causing
the damage or injury?
------------
What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two'estimates for auto damage.
LJA�)P-G-Ir- C+h�CYQ% -F20�J-I 4�:> ��O►2
--------------------------------------------- ---------------------------------------
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
`J LAJ 7 jOt3 QGC. TO cdl
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or by some perlon n his behalf."
Name and Address of Attorney 4 _
(Glat6al
is i ture
Address
I / LCt
Telephone No. Telephone No.--
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
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CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the BoarO of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 4, 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: $459 . 39 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: BARBARA CHU
1278 Fascination Circle
ATTORNEY: Richmond, CA 9.4803
Date received
ADDRESS: BY DELIVERY TO CLERK ON September:,-6,, 1988
BY MAIL POSTMARKED: September 2 , 1988
I. FROM: Clerk of the Board of.Supervisors TO: County Counsel
Attached is a copy of the above-noted claim. j
1988 ��IL �ATCHELOR, Clerk ��.�,
DATED: September 7 , eputy
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
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.
0 Dated: OCT 04 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 shown1988 BY:
Dated: OCT 0 6 198 8 BY: PHIL BATCHELOR by_Q4,,, 01,t4y � Deputy Clerk
CC: County Counsel County Administrator
Claim 4;0: ter• BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 319 19879
must be presented not later than the 100th day after the accrual of. the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must. be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
4oYbaro C,
Against the County of Contra Costa )
RECEIVES
or
District)
Fill in name ) CLE
Y
The undersigned claimant hereby makes claim against g' r. ... n ra Costa or
the above-named District in the sum of $ q5 T 32 and in support of
this claim represents as follows:
-------------------------------------------------------------------------------------
1. When did the damage or injury occur? . (Give exact date and hour)
6/4188 around T/Y a.m.
-------------- ----------------------------------------------------------------------
2. Where did the damage or injury occur? (Include city and county)
On San Pablo .1Dcrm Rood , he6 rL CrJfen (��'ndcv �' m /ltC 7?0 d,
3. How did the damage or injury occur? (Give full details; use extra paper if
required) 65-h�ra CaS710,
�aunf�
---.
Ode_ cl n'vr q.-- fhe 4ra uc� ah. road _h,:_t__7 is _kt n d sh(dd ald caured ca
_.- d. .
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
C"s fyv dio? Wool u�, Son Ah/o Sam Road
(over)
5. What arm the names of county or district officers, servants, or employees causing;
the damage or injury?
un(cno wnJ
-----------7------------------------------------------------------------------------
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
CracAt W;»dsh;c1d . -filo esJ'mates Gre en%se.(,
-------------------------------------------------------------------------------------
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
yi2 --Z 'n
e � � � o
YvM 0/e
--------------------- -------------------
8. Names and addresses of witnesses, doctors and hospitals. z
wI tn�SS Olgn JCnsert. Cpassenger i'n Car,
508' Chob re Gait✓L `JJ
- s0hhLf
------------ -- 8-3--------------------------- -----
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
D
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or by some person on his behalf."
Name and Address of.Attorney
_ Claimant'sSignature)
127? �(S c,n ai O O o (�(✓GQR._._
Address
9l C. art 0n d , &Z
Telephone No. Telephone No. C" 15)
2 2 30 ko?K 2o
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
ESTIMATE OF REPAIR COST
4b I in Honda,) SHEETNO OF--SHEETS
7ogq hmador Play, Rouj'
Dublin Co- • 'l1t568 (415) 828-cM-0
BILL TO ORDER NO - --
ESTIMATE
ADDRESS MADE DY
COST. NAME DAT 19
ADDRESS PHONE
BELOW IS OUR ESTIMATE TO REPAIR YOUR AUTOMOBILE
MODEL qICENSE NO. MOTOR NO. SERIAL NO. MILEAGE
PARTS NECESSARY AND ESTIMATE OF LABOR REQUIRED PARTS COST PAINT COST LABOR COST
ATE ESTIMATE ESTIMATE
TOTALS
PARTS AND LABOR ESTIMATE GRAND TOTAL
*A
DAMAGED OR WORN PARTS REMOVED FROM CAR WILL BE JUNKED UNLESS OWNER
INSTRUCTS US OTHERWISE IN WRITING. IF NEW PARTS LISTED HEREIN OR REQUtI7ED
ARE NOT AVAILABLE, WE RESERVE THE RIGHT TO REPAIR SUCH DAMAGED OR WORN
PARTS, WHERE POSSIBLE. THE CHARGE FOR WHICH WILL BE MADE ON AN ACTJAL SIGNED
TIME BASIS AT OUR PREVAILING LABOR RATE PER HOUR. THE ABOVE IS AN APPROX-
IMATE ESTIMATE OF REPAIRS REQUIRED-BASED ON THE INSPECTION MADE. A7D1-
TIONAL PARTS,OR LABOR, MAY.BE REQUIRED AFTER THE WORK HAS STARTED. WHICH
WERE NOT EVIDENT ON THE FIRST INSPECTION. SUCH ADDITIONAL LABOR AND 'BY
MATEaIAL WILL BE CHARGED FOR IN ADDITION TO THE ABOVE.
AUTHORIZATION FOR REPAIRS
YOU ARE HEREBY AUTHORIZED TO MAKE THE E ECIFIED REPAIRS TO MY CAR
SIGNED DAT 19`
NO. A4--LAW PTG. CO.,
"EI Cerrito Honda
P "Ill"
11820 San Pablo Ave.
3F10PJ1D.F1 EL CERRITO, CALIFORNIA 94530
(415) 529-1323
NAME - ) ADDRESS .L4I+�►OM PHONE DATE
Bor Gro. Cl+ti ��� I`ti fes,.«��%�` C�;- 4y7 7Si30 $ �e
YEAR MAKE - MODEL .4 O0o LICENSE NO. SPEEDOMETER SERIAL NO.WIN NO.) - -
,5 (0 N o��� - Ac c c x a FA w 99 3 s�YO 7 Tyr� BA X&COA 33
INSURANCE CARRIER ADJUSTER PHONE VEHICLE LOCATED AT -• -
G.,��, d4he,
OPERATIONS PART NO. PARTS LABOR
�� sh��lo1 at 3 831
3031C
/Q w 19av , 5,er. 1 8 (643 d) VV S 0
�6 a` ��
INSURED PAYS $ INS, CO.PAYS R. 0. NO. TOTALS 3a0
WRECKER
INS. CHECK PAYABLE TO SERVICE
The above is an estimate, based on our inspection, and does not cover additional parts or labor which TAX ! a
may be required after the work has been opened up. Occasionally, after work has started, worn,
broken or damaged parts are discovered which are not evident on first inspection. Quotations on
parts and labor are currt an s tect to change. TOTAL OF q
FST. MADE BY W�D ESTIMATE t0
AUTHORIZATION FOR REPAIR. You are hereby authorized to make the above specified repairs to the vehicle described herein.
X
SIGNEC DATE
FORM ER-81-C 14-791
J
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
C)aim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 4, 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: $700 - 00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: MADELINE TRIDENTE
5360 Boyd Avenue
ATTORNEY: Oakland, CA 94618
Date received
ADDRESS: BY DELIVERY TO CLERK ON September 6, 1988 hand del .
BY MAIL POSTMARKED: no envelope
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim,
IL gATCHELOR, Clerk
DATED: September 7 , 1988 fib: Deputy G
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:
tj
Dated: , 0() BY: (1' 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: O C T O 4 1988 PHIL BATCHELOR, Clerk; By P(C> Deputy Clerk
WARNING (Gov. code section 913)
Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or
deposited in the mail to file a court action on this claim. See Government Code Section 945.6.
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: OCT 0 6 1988 BY: PHIL BATCHELOR by 0eputy Clerk
CC: County Counsel County Administrator
,:LAIM TO: BOARD OF SUPERVISORS OF CONTRA COV,tur�biWatapplication to,
L Instructions to Claimant Clerk of the Board
P.0.Box 911
A. Claims. relating to `'causes of action for death or to n injuryn o4533
` ,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.
ntity. .E. Fraud. See penalty for fraudulent claims,. Penal Code Sec. 72 at end
of this form.
RE: Claim by r ) Reserved for Clerk' s filing stamps
RE , a
Against the COUNTY OF CONTRA COSTA)
61:Vn G 1988
or DISTRICT) _
(Fill in e) ) P t A f E°R
A
L
- The undersigned claimant hereby makes claim ag �_ - Contra
Costa or the above-named District in . the sum of $ ,
and inn support of this claim represents as follows :
1. When (did the damage or injury occur? (Give exa t date and hou
Ak---------- ---- - ------ ---
2. Where did the damage---or injury----occur?-- (Inc de city and county)
3 How did the damage or incur occur? (Give ulliailsT use extra
i sheets if r quire ) t AI
Ck
- - -- ---- --�- -- --
9 What artic lar1_ ct mission the
p u or on part of county or district
-,
of fic s , sery nts �o�r/empl yees(,caused th in) ry damage?
r. (over)
.rre -.._......... •.:+e.►- •— a.:.•.•:,:,....ii,,..r.u...•.Is..v.. ..:._..'+as.:�+�.....y�aarr.: ri..- -'- 1 fic�tM+rlh�9f 1C'rti'�r`� ,r f�'T..'.i. -
L
5..::�• What. are.:t#ie.:names of county or district officers, servants or
employees.,causir:g the damage or injury?
f
---- - _ ---- ----------------------
- -------------- -----------
6-.--What-damage-- or---injuri-es do you claim resulted? (Give full extent
of ipjuries or damages claimed. Attach two estimates for auto
da age) � ��
7. How was the amount claimed above comp ted? (InClu the estimated
amount of any prospective injury or damage. )
8. Names and 'address of witnesses , doctors and hospitals.
9 . List theexpendituresyou made on account of this acrid nt or injury:
DATE ITEM �i}� ,¢ AM- OUNT
T �
Govt. Code Sec. 910.2 provides :
"The claim signed by the claiman-
SEND, NOTICES TO: (Attorney) or by some versos on his behalf. '
Name and Address of Attorney
Claimant' s S gnature
Add re
. �lGi o
Telephone No. Telephone No. � �T 7�4
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. "
... .,_... .. . ...wr<-�..-.+►s..,..+o3ti*....::.+x+.`.a.....r:t.....+..::r:.s•....4.. ... .....��...a..:..:�.�a.r:'.:r :.�.a�:.ri�rwas�4s.,aaam6r���-• -- vr�.w..t+U—� `a
1.1;L0
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
.r
Clz{m Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 4, 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 all "Warnings".
CLAIMANT: VICTOR STELMACHUK
3401 May Road
ATTORNEY: Richmond, CA 94803
Date received
ADDRESS: BY DELIVERY TO CLERK ON September. 2 , 1988
BY MAIL POSTMARKED: August 27 , 1988
1. FROM: Clerk of the Board of.Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
Se tember 2, 1988 ppHHIL BATCHELOR, Clerk
DATED: p BY: Deputy `t-
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).
Cc;unty Counsel
( ) Other: r;-n n 6 i9H_
MEirtineZ, UA P5.53
Dated: v' / BY: `J- I_.. �� J 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
p<j This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Dated: 0 C T G 4 1988 PHIL BATCHELOR, Clerk, By J I 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
Uio t:eG hates, 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: OCT d 6 1988 BY: PHIL BATCHELOR by `� Oeputy Clerk
CC: County Counsel County Administrator
C•1EAt to BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 319 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form. n
RE: Claim By ) Reserved for Clerk's filing stamp
RECEIVED
Against the County of Contra Costa > X988
or ) S Q 2
District) pA F ELo R.
Fill in name ) CLER NTR A c
By c tY
The undersigned claimant hereby makes clai 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 �,1� i� i(
1. When When did the damage or injury occur? (Give exact date and hour)
---------------------------------------------------
2. Where didhe llama a or injur occur? (Include city and county) ,
N3p K P�)g L c) `-Otq Yn I fin• TJ v/Z;N 6- fir` — ,Ola v c I At 6_ cv
S+•--s--------------------------------------------------
3• How did the damage or injury occur? (Give full details; use extra paper if
required)
P/9,5 s I N L` c 11 s2 c X)v S c ra /9 �� y/N 6- G1*?Iq vim'4 ry ;-r-
/,N 0
-r—
/NUJ SHtrP(,PJ F t — FvRto Guy (��f� U
----------------------------- -------
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
(over)
5: ',What are-*Yhe names of county or district officers, servants or employees causing
the damage or injury?
- -------------- --------------------------------------------- -
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
-------- ----------------------------------------------------------------���_
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
-----------------------------------------------------------------------------------�
8. Names and addresses of witnesses, doctors and hospitals.
---------------------------------------------------- --
-------- ------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or by some person on his behalf."
Name and Address of Attorney
jA
C a mart s t o
A ess
Mon 10 P.0 gU
Telephone No. Telephone No.
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
CLAIM
-' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
t-,%im Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October,-4, 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 all "Warnings".
CLAIMANT: LORETTA BECKWITH
3136 Persimmon Street
ATTORNEY: Antioch, CA 94509
Date received
ADDRESS: BY DELIVERY TO CLERK ON September 2 , 1988 Risk Manag
BY MAIL POSTMARKED: August 31, 1988
I. FROM: Clerk of the Board of.Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
September 2, 1988 PpHHIL BATCHELOR, Clerk
DATED: p BY: Deputy
L:. Hall
I1. FROM: County Counsel - TO: Clerk of the Board of Supervisors
(L-,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).
County Counsel
( ) Other:
r.P 0 6 IT88
Martinez, CA 94553
Dated: + BY: / ��� Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
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.
Lan
Dated: O C T 4 4 1988 PHIL BATCHELOR, Clerk, By C44JI.° , 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 1aQbove.
Dated: OCT 0 6 IJ88 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 per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action.* Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. ' (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its offioe in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
RECEIVED
Against the County of Contra Costa ) S E p 7 19@Bl
or )
District) c� �R$AT U °yl r oR �
Fill in name ) 6y �" putt'
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ and in support of
this claim represents as follows:
-------------------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
Y 1 c t� 7."36 Am
2. Where did the damage or injury occur? (Include city and county)
-K(CJ14.�--p -- ---- _�?c, ------------------------------------------
3• How did the damage or injury occur? (Give full details; use extra paper if
required)
-----------------------------------------------------------------
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
rock S
(over)
•5. What are the names of county or district officers, servants or employees causing
,the c%magP„ or injury?
'ILL
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.)
'LiSJL:L -+-------L.1 h.
8.
p8. Names and addresses of witnesses, doctors and hospitals.
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES, TO: (Attorney) or by some person on his behalf."
Name and Address of Attorney
/(Claimant's Sig tune)
(Address)
Telephone No. Telephone No. r75" cl-1
NOTICE
a �a
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
DRTE � 19 Q V
E yy (NAVE OF PERSON QUOTE GIVEN TO or RECEIVED FROM)
TO 0
-926
f �
FIRM,NA c
t
ADDRESS cr PHONE
QUOTA RECORDED BY
JOB NAME I_
I JOB TE
Cc� A�>��,(.k� ►`-Tom,}//_`rl
JOB LOCATION JOB PHONE
JOB NUMBEFf
PE OF RK
DESCRIPTION OF WORK
I
_ j
'USTOMER INSURANCE '� K�� �� '"�
7
IME h NAME
,
)DRESS 2- ADDRESS
TY A- I tx`_ STATE 21PF CITY ` :STATE ' ZIP,':
S.PHONGE BUS.PHONE DATE ESTIMA DATE�PPROYEIf. AD�UBTOR S NO;4;�*
75 /`"!/C�/ V • f.?lT �° 9 F. , sem 11Kxr`�
AP MAKES g MODELCODE VIN Ax MIt,AOE' CNyM A ka f�� &�a* ,
PART NO.
1 , r;i- ti t�.. ,� �.•� ,� JEXTN .PREFIX 80DY i SUFFIX DESCRIPTON
(Mcuc,LT. CE OXT
t ky4y�-�1y .. .
Tr
101�
a.
IAVW 11100
t
1 l�,t Sfiy r,;
Y:
I 1 .
� -�fxy 3 ?r�S i ;., ��4.t r„},yi{ f•: :st�'.'f7�-"f19:�-
I •q^t -It L -J'iS R" :.i sa;! A, F-,�_y.
I.NO. SUBLET 8 • ri .3� rr ?Ee ,,,, .
TOWING COST L�
TOTAL`HOURS �. HRS. X
... r 6 '"�"r'°d``°K' ,� ••.r,:�. f) is yf .r�.4+ t• p sc�+'»,�* n T. ,
STM' •TOTAL'
SUBLET, '� +s►
', ►{_y + TOTAL PARTS � `
� � mer���.. �<.•�
� t n �,.�` � �. ,� rOYAL.�O�R�.a"�-r��' Vii`' " •
e`er - A
..
� � _.•��� � !'`..:^`''�"�,.a"`=y.;cam�•~r"�s� ��"i��y i"�'� `
CARRENTAL
NISSAN•PEUGEOT*SERVICE•A4RplmTS .
SU9rfOTAL �:... ., r
2659 N Main Sr►eeta WaAnut CrtteK CA 94595 �� r , ,� J
A!Al t
''> T f Xr ,'� '«� DEDUCTABLE ;g4
0TOTAL .. . -
�( p .`1&'�Y � > �a:j Th +�,:. •M v.' V Y�+y tll� h
.. :�r:-:. , ....• ya d&ik�3x.n..., If,.A�:t�1aR.'TrtrF.Y4 .. 'k.V'.�t.:._.
CLAIM
r ` BOAAD OF SOPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 4,. 1988
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. _ ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $30 - 00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: STEVE L. PRICE
1077 Edgemere Lane
ATTORNEY: Hayward, CA 94545
Date received
ADDRESS: BY DELIVERY TO CLERK ON September 2, 19$8 Risk Manage
BY MAIL POSTMARKED: August 30, 198$
I. FROM: Clerk of the Board of.Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: September 2, 1988 ppHHIL DBATCHELOR, Clerk
BY: eputy
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
aunty Counsel
( ) Other: S E P 0 G 1988
Martinez. CA 94553
n
Dated: '/ BY: !. lC � 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: OCT 0 4 1988 PHIL BATCHELOR, Clerk, By Of i,1A 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: OCT 0 6 1988C PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
Claire to: i BOARD OF SUPERVISORS"OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
RECEIVED
Against the Count of Contra Costa ) SEP 2 1988:
or )
WKBR
AT^ L R
District) CLE oRs
Fill in name ) By ry
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ ��,d �7 and in support of
this claim represents as follows:
-------------------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
2. Where did the damage or injury occur? (Include city and county)
-------------
3. How did the damage or injury occur? (Give full details; use extra paper if
required)
4. What particular act or omission on the part of county or district officers, Z �
servants or employees ca = injury or damage? L
(over) �qh
5.* Mhat`:are the names of county or distract officers, servants or employees"causing
'the damage or injury?
,.
2e_� --22L ------------
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
7. How was the amount claimed above computed? (Include the estimated amount of any 6
prospective injury or damage.) L
_;e_� C-;?
8. Names and addresses of witnesses, doctors and hospitals.
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: ..: (Attorne ) or by some person on his behalf."
Name and Address of Attorney
Claimant's Signature
Addre
J
Telephone No. Telephone No. /S— 3�o/o
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a .fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison; by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
i♦`
INVOICE NO.
• 5152
SOLDTO SHIPPEDTO t
714o
I& Y�F
STREET&NO. STREET 8c NO.
CITY STATE ZIP CITY STATE ZIP
CUSTOMER'S ORDER SALESMAN TERMS F.O.B.
V
ICPg7
La's 'T5 I?f0
Z
7H 722
� fi�f� l a w
l-
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Againstvthe County, or District governed by) BOARD ACTION
•the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 4, 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: $183 . 05 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: Kay Colleen Caddow
929 Jensen Circle
ATTORNEY: Pittsburg, CA 94565
Date received
ADDRESS: BY DELIVERY TO CLERK ON August 31, 1988
BY MAIL POSTMARKED: August 30, 1988
I. FROM: Clerk of the Board of_Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
IL gATCHELOR, Clerk
DATED: September 2, 1988 ��: Deputy
L. Hall
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
( (,4"'This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
CV-unty Counsel
( ) Other:
tP U 6 198
1 Martinez, CA 94553
67/ /
Dated:
/ (,(' BY: Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
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: O CTO 4 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, .
Galifornia, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
0
t'?d OCT 0 6 1988 BY: PHIL BATCHELOR by �ODeputy Clerk
CC: County Counsel County Administrator
Cl&,im ta_: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
r
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be- presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's f'Ing stamp
RECEIVED
Against the County of Contra Costa )
or ) AU G_311988
District)
Fill lri name ) CLE NTR A E� FS
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:
------------------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
7/,�;9/,- A• M.
------------------------------------------------------------------------------------
2. Where did the damage or injury occur? (Include city and county)
------ --------------------------------------- -----------------------------
3. How did the damage or injury occur? (Give full details; use extra paper
required) , ttk&t& AA
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
over)
S.'- What., are the names of county or district officers, servants or employees causing
the damage or injury?
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
-N------ --NN--------N----------N-N--------N-N------N--------------- --
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.
N/A
-----------------------------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or by some person on his behalf."
Name and Address of Attorney
Claimant's Signature
Address
72 9-6w)a—A/I /-Y
Telephone No. Telephone No.
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
DATEsd ;ga
�9
(NAME OF PERSON QUOTE GIVEN TO or RECEIVED FROM)
' ' FROL' `
FIRM A-
ADDRESS PHONE
aoCA ►`.� � mi-i
DUO RECORDED BY
1
JeR DATE
JOB LO ON JOB PHONE '
JOB NUMBER
TYPE O�WORK ..
DESCRIPTION OF WORK
I
UUP CA
- l3- C �_
. I
The Glass Station
Western Sunscreen and Storm Window 1410 C Concord Ave.
_ Home - Auto - Commercial Concord, Ca. 44520
License ; 428709 (415) 676-2415
CA,ao- Oats L
ESTIMATE Salesman
Phone
Subject to twenty(20)days acceptance of
LABOR QUAN. DESCRIPTION
Ir /3
F.O.B. Job site:
Exceptions: Foreward
TERMS: Net Bids subject to clerical error corrections.No protection or
cleaning of glass or metal.No responsibility for damage by
others.Scoffolding by others.No responsibility for delays Accepted Date
beyond our control.
. > CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Clai0 Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 4, 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
Anount: $3 ,000- 00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: WILLIAM PEON DEL VALLE
270 Christine Drive
ATTORNEY: San Pablo, CA 94806
Date received
ADDRESS: BY DELIVERY TO CLERK ON August 31, 1988
BY MAIL POSTMARKED: August 30, 1988
I. FROM: Clerk of the Board of_Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: September 2 , 1988 gyIL BATTCYELOR, Clerk
epuAL-,
L.. Hall
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantially with Sections 910 and 910.2.
( j 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: County Counsel
�t n (lam►1288
i
4563
Dated: C ' , BY: f 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
j This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date. 1 Q Q
Dated: OCT 0 4 19 8 8 PHIL BATCHELOR, Clerk, By c Deputy Clerk
WARNING (Gov. code section 913)
Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or
deposited in the mail to file a court action on this claim. See Government Code Section 945.6.
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
L'nitad 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.
c4 ed OCT 0 6 1988 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
Claim+ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. ' Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 319 19879
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 19
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code 5911.2.)
B. Claims must be filed With the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553•.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
T orm.
RE: Claim By ) Reserved for Clerk's filing stamp
RECEIVED
Against the County of Contra Costa-
or
1988
or 9��c ) AUG 31
;oU t/ Cpm P a - LOR
j/l C'a U/li District) CLE: AR F P G
Fill in name ) B Ut,
By
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ _?000 and in support of
this claim represents as follows.:-.
1. When did the damage or injury occur? (Give exact date and hour)
-------------
2. Where Where did the damage or injury occur? (Include city and county)
CoUrvl'.e�4
3. How did the damage or injury occur? (Give full details; use extra paper if
required) Cl-72 /jrzo%c /Joeve,
T�,e,Y
�,v /,�i2T .�°�7�/ �'ohj� �, r�.e T �y 7'2 cc% To �v<< c •q� o,c'� '`�
204?6N��<L o.v /.�/�� �=91� .. •ved..ei�_l�Ee �se o �' Ce,rf
------------------------ --------- ----------
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
/r/ar L OAe r c1 �r�e �/,���/ S!� fe o.e
AX0/!Je- 0�Gl GUy %o Gf/.rli�' �1 over)--
5; WW=,ice the names of county or district officers, servants or employees causing
.the damage or injury?
------- ------------------------------------ ------------------
6. What damage or injuries do you claim resulted?`` (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
40------------ Al
----- -----------------------
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
<<s �jL cr --- -----
--���`�- -=--��-��---�J--"-G=Q ee=--- °
8. Names and addresses of witnesses, doctors and hospitals.
• --�-------- 'irk-off
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
CIA
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or by some person on his behalf."
Name and Address of ,Attorney
Claimant's Signature
Address
Telephone No. Telephone No .f-
* * +t *
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district.board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
berth such imprisonment and fine.
CLAIM
BCgaRD 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 October 4 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: $172. 42 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: SHERRI SMITH
120 Reflections Drive #28
ATTORNEY: San Ramon, CA 94583
Date received
ADDRESS: BY DELIVERY TO CLERK ON August 31, 1988 Risk Manage.
BY MAIL POSTMARKED: August 29, 1988
I. FROM: Clerk of the Board of_Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
Se tember 2, 1988 IL BATCHELOR, Clerk
DATED: r ��: 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: County Counsel
!988
Dw_ "
- ' 4553
Dated: BY
Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
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: OCT 0 4 1988 PHIL BATCHELOR, Clerk, By A�tt>;
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: OCT 0 6 1988 BY: PHIL BATCHELOR by 0AU1 0 1 b Deputy Clerk
CC: County Counsel County Administrator
Clain.ti�: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
+ A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. . Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
SHERRI SMITH
120 Reflections Dr. #28 San Rayon, CA RECEIVED
Against the County of Contra Costa '7
58 3
or ) AUG 311988.
CONTRA COSTA District)
Fill in name ) CL R JFP FHn S:tY..1
B
The undersigned claimant hereby makes claimt t e County of Contra Costa or
the above-named District in the sum of $ } '4 and in support of
this claim represents as follows:
-------------------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
July 29; 1988 at 8: 30 p.m.
------------------------------------------------------------------------------------
2. Where did the damage or injury occur? (Include city and county)
Kirker Pass Rd. in the county of Contra Costa
-
3. How did the damage or injury occur? (Give full details- use extra Paper if
required) The road has been under construction for roa r pair, and at the
time I drove , the road was covered with gravel . There was one
sign at the beginning of Kirker Pass noting gravel on:-the road
and to take it,.. slow. I did but gravel still hit the car and
__________yiHdshield at_35 mph and_with other cars driving-around_ me .
4. What particular act or omission on the part of county ordistrictofficers,
servants or employees caused the injury or damage?
There should have been some kind of warning that damage could
have occured to a vehicle if you drove on Kirker Pass your car
could be damaged by flying gravel . And the county should have
known that even at - the slowest speed the gravel would be kicked
up and thrown in the air hitting any vehicle s it was driven.
lover)
5. What are the names of county or district officers, servants or employees causing
-the damage or injury?
• ROAD MAINTENANCE FOR THE COUNTY OF CONTRA COSTA
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
WINDSHIELD WAS DAMAGED AND HAD TO BE REPAIRED. SEE ENCLOSED
--------------------------------------- -
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
SEE ENCLOSED - -
8. Names and addresses of witnesses, doctors and hospitals.
I was the only passenger at the time.
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
New front windshield $172.42
Gov. Code Sec. 910.2 provides:
{
The c aim must be signed by the claimant
SEND NOACES TO: (Attorney) orb s e person o his behalf."
Name and; Address of Attorney
Cl 'mantis Signature
ess
lei
Telephone No. Telephone No.
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
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CONTRACTOR'S LICENSE
#368834
DUBLIN GLASS CO.
• 7779 AMADOR VALLEY BLVD. AUTO REPAIR REGISTRATION
aAM 099092
DUBLIN,CALIFORNIA 94568
PHONE:(415)828-3010
AUTO GLASS MIRRORS PLATE 6 WINDOW GLASS • ALUMINUM SASH
SHOWER a TUB ENCLOSURES SCREENS OF ALL TYPES
DATE I COST.ORDER NO. INVOICE NO.
42773
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'ZI CHARGE ACCT RETAIL CONTRACT WALLPAPER GLASS AUTO0ION0 0 0 0
DUAN. DESCRIPTION UNIT PRICE AMOUNT
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kvo _ c- LABOR 35•
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PLEASE PAY FROM THIS INVOICE. TAX
NO STATEMENT WILL BE SENT. 8 73
ALL CLAIMS 8 RETURNED GOODS MUST BE TOTAL /
ACCOMPANIED BY THIS INVOICE. r 7 Z
RECEIVED BY: X
FINANCE CHARGES at the following rates will be charged on past due accounts:
(a) 1Y2% (which is on ANNUAL PERCENTAGE RATE of 18%) of the unpaid botance
up to and including $1,000, plus(b) 1% (which is an ANNUAL PERCENTAGE RATE
OF 12%)of the unpaid balance in excess of$1,000.
NOTICE:"Under the Mechanics'Lien Law (California Code of Civil Procedure,Section 1181 et sect.),any
contractor,subcontractor,laborer,supplier or other person who helps to improve your property but is not paid
for his work or supplies,has a right to enforce a claim against your property.This means that,after a court
hearing, your property could be sold by a court officer and the proceeds of the sale used to satisfy the
indebtedness.This can happen even if you have paid your own Contractor in full,it the subcontractor,laborer,
or supplier remains unpaid"
_ s
> STODDARD, LEPPER & FALCO nLra C. tr County
MICHAEL T. STODDARD ATTORNEYS AT LAW F' "' "• `-
GARY M. LEPPER i t Ltl V w
ROBERT A.FALCO 1440 MARIA LANE.SUITE 300
MATTHEW P. HARRIWGTON WALNUT CREEK,CALIFORNIA 94596 AUG O ill
GEORGE W.PFEIFFER (415) 938-6100 'J
KENNETH R.BERGOUIST ,,^^
JOHN DOR
MARK R..REEDY i'Osk Management
REE
GLENN W.CADY
August 29, 1988
Mr . K. C. Farn wortth
GEORGE HIL ' COMPANY, INC.
P. O. 4096
Wait Creek CA 94596
Re: Angela D. Freeman (Hutchison) v. Contra Costa County
Claim No. : AL 88-123
Date/Loss: 02/11/88
Dear Mr . Farnsworth:
Thank you for your letter of August 19, 1988 , enclosing the
police report and investigative file in the above-entitled claim.
Once again, we are treated to the rolling tragedy of a motorcycle.
Between the police report and your fine investigative
report , the only mystery seems to be what sort of catatonia
gripped Mr. Hutchison immediately prior to the collision. All of
the basic variables seem to have been identified : speed ,
visibility, operation of the illuminated arrow, timeliness of
warning ,, etc. Frankly, we do not think it would be helpful to
alert an accident reconstruction expert in advance, although his
testimony would be essential in the future to validate that which
you have already determined.
Our copy of the police report ends at page 9 , in the middle
of a sentence. We would appreciate your sending the remaining
pages of the police report.
Our only suggestions presently consist of the following:
1. To the extent possible , the motorcycle should be
preserved;
2. We found no reference to drug testing (alcohol testing
was negative) . Was any test conducted for drugs?
i � 1
Mr . K. C. Farnsworth
Claim No. : AL 88-123
August 29 , 1988
Page 2
We will stand by a-nd await the filing of what will be a
marginal lawsuit. One way or the other , we appreciate having
been selected to defend the interests of the County.
Sincerely yours,
STODDARD, LEPPER & FALCO
GA PPER
GML/mw
�: Ron Harvey, County Liability Officer
o� •
Cer*jfy,
REAL ESTATE OF NORTHERN CALIFORNIA, INC.
1777 North California Boulevard,Suite 300
Walnut Creek,California 94596
Business(415)932-2021
SHERRI D. SMITH
License Training Department
Each Office is Independently Owned and Operated
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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 October 4, 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: $496. 32 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: WENDY STEWART
5350 Willow Lake Court
ATTORNEY: Byron, CA 94514
Date received
ADDRESS: BY DELIVERY TO CLERK ON September 6, 1988
BY MAIL POSTMARKED: September 2, 1988
I. FROM: Clerk of the Board of_Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
IL BATCHELOR, Clerk
DATED: September 7 , 1988 �b: Deputy ,
L. Hall
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
( V 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:
37Dated: O 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: 0 C T 0 4 1988 PHIL BATCHELOR, Clerk, B 01 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: OCT 0 6 1988 BY: PHIL BATCHELOR by D Deputy Clerk
CC: County Counsel County Administrator
Cla: .to: BOARD,.OF ,SUPERVISORS OF COh''TRA COSTA COUNTY
a
INSTRUCTIONS TO CLAIMANT
A. Claims relating ,to causes of action for death or for injury to person or to per-
sonal property'or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. ' Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
)
E
I VE D
Against the County- of Contra Costa
or
Contra Costa County
Sanitation District No. 19 District) CLCD �.,:;.MA a Lo
Fill in name
The undersigned claimant hereby makes claim penufy
gn y against the County o sta or
the above-named District in the sum of $ t�, , `% and in support of
this claim represents as follows:
-------------------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
------------------------------------------------------------------------------------
2. Where did the damage or injury occur? (Include city and county)
i��se owe 3 Cb tit P—fk cc�-Vpt cu-Vc ou I �
------------------------- ---------------=---------------------------------------
3. How did the damage or injury occur? (Give full details; use extra paper if ._
required)
--- -- ---------------------------------------
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
(over)
5.�What are the names of county or district officers, servants or employees causing
` the damage or injury?
Ir r2_ �ts ,cam
------------ ------------------------------------------------------------------------
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
T\A10
-------------------------------------- -------------------------------
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
ll
----------- ---------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
--- �---v�� � � =--- -"-' --- � _ ' --- - -=-----------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or ly some Person on his behalf. .
Name and Address of Attorney
't -- -
(Cla antlS Signature
(Address)
i4-S 1
Telephone No. Telephone No.
N O T I C E
Section 72 of the Penal Code provides:
"Every person, who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisc:lment in
the county jail for a period of not more than one -.ear, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
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