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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 14 Application is hereby made for permission to present the 15 attached claim after expiration of the time limit provided in 16 Government Code Section 911 . 2. 17 ( 1) As stated in the attached claim, claimant ' s cause of 18 action accrued on or about September 2 , 1987. 19 (2) The time for presentation of such claim under Government 20 Code Section 911 . 2 expired on or about December 12 , 1987 . 21 (3) The reason for the failure to present such claim within 22 the time provided in Government Code Section 911 . 2 was as 23 follows : Plaintiff was hospitalized , underwent two surgeries , 24 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 27 present such claim due to inadvertence , excusable neglect , and 28 1 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 5 correct . 6 Dated : �- 7 RIC D DELFJMENTINO 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 2 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) WAS --�- V� k,h r.T J �u s '�a'a",�,. . p `'J"Vo ZIQ ��.s ur 0. � �- L o ,X 0 , 5 w W;ccs10s 'C i h •'T K•Z . �, o ss mss . o � �`� ...�..rr ..-----rrrrT-rT---..rrrrrr - -r�.rr r-.....-.rrr.--T---T----- - •-.t 4: -What-particular act or orris on on the part of county or district' ' officers, servants or employees cauged the injury or damage? .::.; ►:;:::';•.:. (over) v 5. . a .are the names of county ,or district officers, servants or y employees causing the d&mag6­or injury? . ..wwwwwww•w wwwwwwww w.Tww.r..ww�.wwww�.wwwwTwwww..wwww ww wTw www.�rwwwaww�.wwwww 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) _ .14 ww www Nw—w—ww—www--www--H�o-wwwNas--thwwe. �mwowuwnt—cwwimed above computedw__wwn;wuaw_wthwwe www wwww wwwww� estimated amount of any prospective injury or damage.) • C h s Q�•• �-• '�,.$$ . .`rv.. �3,,L..L.�D-l_a .� �.\.,.q .l�.f al-'•�C.� , a_ -e. \Ja V, T�a� UJ !cam S :. .� `Chi. �il..�.F oL•� d► , `' . '♦ � �l _ �;s�: Awwwwwwwwwwwwwww—wwwwwwww—wwwwwwwwwwwwwwwwwwwww-----MwwwwNwwwNwwwMw..w = i 8. Names and addresses of witnesses, -doctors- and hospitals. rr; cab RaSGD V,. �•. ter,, . t +ww Twwwww�. www. www—Twwwwwwwwwwww—wwwww..wwww w w www w w wTwwwwwTwwwwwwwwTwTwwww expend•�,f,�,res_ ou made on account of this accident or .. ITEM AMOUNT C_ asc a R�. 6 � 00, 0• � ' 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 • t _ w.. _ ' � er.::it++•n•^a.•ar.:.r'S:.t:r..r;.:'— — �:r.'Faer i:.�•i:+�i3i+J+-•si'�"ia'�E13A'•�i :7r6Y�rar3tie _ 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 �// <- R,,do cs f �O-3J •ni r�� �Ocr XZt� a /,11 c r..Jc�I T�� T`z1J74 � ov r) i► �` ck- O»c*le 440e/ 6c6 - ,f�y'u 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. a' ,G� r�G G �+ 77 /� C�d� G2 �Q' l�� Ire CEzu de7 �et7e ,iii �� g ��.r�, �iW) '' el ac/ ��- cfrcC �f~{�� °c i o✓tii�►�r� �,vl 1` ?�' ,190 C�ye Qi�t g i�'► /� G'u Ct� iGf cam` ; L �T- JN\ J3 co C,-40 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. i C C � co CA JO CP CP Ch a CD r F) O ` �_ 3 r 4 , N LIN ra 00 01 Op�Z Vrn ii Z P' �`r, 3 50— .R.��' � rD )> ll mp r Z r Z G 0 Z— o x 3 �p co go � Evi r 01 m cWo Zo NSD a� 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. U cc O Sc 0 1 z a w � a a 0. a o a w m ` z (A ul 0 ¢ wt Q V � w o o � O , N a d � z LOz ` Q 0 >c `ti a~- o w s ~ q M a a 3 0 � t4) p �.i J U cc Uo � aac CSOz U O C) ui o %--1 o 0o) 0z V CJ = O w Cf o a, 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 S O L D T O S H S{�ert � 5 ; ICA w - 93� — z:�� I P T i O 'ZI CHARGE ACCT RETAIL CONTRACT WALLPAPER GLASS AUTO0ION0 0 0 0 DUAN. DESCRIPTION UNIT PRICE AMOUNT //7 f z IC v° 0/ 1v kvo _ c- LABOR 35• v� 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 j `O ~ O r O C N n fD K h M i fD r N N M h O N �-+ O h+ M k 0 r+. H rT "►� M �•i n w O tS M 9 M A 1' �C rt rt M. w "rt 0 CD CA 0 N. 9 R N k H M oIC i ..o 0 was i 4-- H ,. w •• M ~ •o cc a d • �o ��. M v+ H o fD lJ+ v N O n I W. rn N. �O Cr O O O, r+ M r+ w i . a , CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD.ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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. . 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