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HomeMy WebLinkAboutMINUTES - 10251988 - 1.14 CLAIM ' BOARD OF SUPERVISORS 0' CONTRA COSTA COUNTY, CALIFORNIA ,r Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25 , 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: $392. 25 Section 913 and 915.4. Please note all "Wa.,pin s" �Lri—I CcE��I� 1 CLAIMANT: ROBIN E, KEYES 903 Dover St . S 7 P 2 no 19�� ATTORNEY: Hercules , CA 94547 Date received ;`(`n e z' CA 9,4553 ADDRESS: BY DELIVERY TO CLERK ON September 26, 1988 BY MAIL POSTMARKED: September 24, 1988 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ��IL DATCHyELOR, Clerk DATED: September 28 19$8 epu —klZ�Z� 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: i Dated: ' : � BY: _ 1 N ! Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( his 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. e C Dated: OCT 2 5 1988 PHIL BATCHELOR, Clerk B '/�-�t y 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 9nired 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 claimantas shown above. Dated: OCT 2 6 1988 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim t6:- 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 EC'Fk IV ED ) Against the County of Contra Costa ) s n P or District) CLEr Q A E CRS Fill in name ) EIN eputy The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ .. .�`j and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) -�-C35 a� F,'oo a•m ------------------------------------------------------------------------------------ 2. Where di damage or injury occur? (I elude cit and ounty) 3''1:, he o Dam Ed - Con--t'a S to CIOU ------------------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details; use extra paper if required) i W a S d 1--,n uooY`r__- 4ye lz� `0 C L"yvW6(: C-yo kS, a Ve h c k 54EJ '97-leoI n reC117 ox)---------------------! ------------------------- 4 ------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? cvef ,d roc-45 an G�4Y� i n v4 ON �D - 02 i VI-t, 6� ple )due 0 7 Vo 1 a ai mak �r v-n� U`� /O - T (over) 7 /[a � 5. What , re the names of county or district officers, servants or employees causing the damage or injury? 149 --------------------------------------------------------- 5. What damage or injuries do you claim resulted? (Give Hill 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.) L C41 OL --9 ('02ZLeWA 8. Names and addresses of witnesses, doctors and hospitals. /v )P- -------------------------------------------- 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 gomeperson on his behalf." Name and Address of Attorney Claimant's Signat Address Telephone No. Telephone No. Z3� 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. WAD19WORTH GLASS COMPANY DATE 4160 APPIAN WAY,EL SOBRANTE,CALIF.94803 /�j�/ INVOICE NO. TELEPHONES:223.7380-223.7381 ORDERED MAIL PHONE CALL OUR P.O.NUMBER .J L 5(" TAKEN BY - YOUR ORDER NUMBER STREET n --5 vse CITY SL PHONE CHARGE COLLECT 4 PHONE FIRST WHEN DONE BY JOB NAME PICK UP DELIVER TIME ADDRESS LIGHTS SIZE DESCRIPTION LIST TOTAL UST DIST TOTAL x42 x x x x x x x x x x x x x x x x TERMS:ALL BILLS DUE END OF MONTH OF PURCHASE.DELINQUENT AFTER 10TH OF FOLLOWING MONTH,8 PER CENT INTEREST CHARGED AFTER 60 DAYS. PLEASE PAY FROM INVOICE.NO STATEMENT SENT UNLESS REQUESTED. RECEIVED THE ABOVE IN GOOD CONDITION DELIVERED BY DATE 3291 Auto Plaza Hilltop Richmond,CA 94806 WALT MARTIN HILLTOP NISSAN (415)222-6900 ESTIMATE OF REPAIRS FOR BODY AND MECHANICAL WORK CUSTOMER'S NAME LICENSE # MAKE MODEL Ic7i �0 VEHICLE ID NUMBER MANUFACTURER'S DATE PART NUMBERA ESCRIPTION OF PART LABOR 7,17/.lPVo 7d 7&0 P OO .27 3 O. a?70,- Pka003 / 2d-K2S;--P7 00 PARTS OO TAX v2 / SUBLET p LABOR TOTAL CLAIM BOARD OF SUPERV:f ORS 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 25 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: $411. 22 Section 913 and 915.4. Please note all "Ward+ �ilty COLIi1Su CLAIMANT: SHERYL LYNN GRANZELLA S P 2 u 1983 4451 Fieldcrest Drive ATTORNEY: Richmond, CA 94803 f1`'::',1rti.ne , GA 945:`'1'd Date received ADDRESS: BY DELIVERY TO CLERK ON September 26, 1988 BY MAIL POSTMARKED: September 23 , 1988 Certified P 757 712 969 I. FROM: Clerk of the Board of,Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: September 28 , 1988 PpHHIL BATCHELOR, Clerk BY: 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: r ,z Dated: BY: l Deputy County Counsel I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 0 DER: By unanimous vote of the Supervisors present ( 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 2 5 19808 PHIL BATCHELOR, Clerk, By__Z � 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. Datad: OCT 2 6 1988 BY: PHIL BATCHELOR by r eputy Clerk CC: County Counsel County Administrator ^Clam'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 ac�i 7- r 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.aetion 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 form. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVE® Against the County of Contra Costa ) or ) SEP 2 81988. District) PH CIER Rp T OR Fill in name ) TF.A P R �C By ... ..(.............. D The undersigned claimant hereby makes claim Inst the County of Con ra r or the above-named District in the sum of $ j/. o2 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ---JJ ---�-L- `� ---a ---/,.2`c 3 0 P.M. --------------------------------- 2. Where did the damage or injury, occur? (Include city and go ty) (thy flic 5-F CXt-i'n keSrfruoj r 3. How did the damage or injury occur? (five full details- use extra paper if required) 71 was fallo�� 0, &0/4r, v�h�(Ae 4ie. �u�► vJ�ZS WQrk�'t an i . a rauGend �-�- 'm w n�Shre of �cusiru' the. W�ndshie �� nou> hauc b�� s+Gr � r� 14, 1 Ac s.p, pxm RdC was all gr�u a�- e +i rn . b C a 05C _e-�_f h e_CA)ey- _ was P j -- gr J2� --l-------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? roue I on �/4e road 4 w QS 09QJL� � o� �n�- �e U n cl h ie ,O'J (over) 5. What are theYnames.of county or district officers, servants or employees causing the damage or injury? U3-- 0- �4 r� - ec)34q, vr- tau C k --------------------------------------------------------------------------I--------- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto dapage, 1'.V .b-e5)n n -n6 40 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) a neWwrndshieO,) 1 (4— and ObOr -14r ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Jeereon,e, Oar. -------------------------------------------------- -- 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--Telephone No. Telephone No. N O T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by 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 ($10,000, or by both such imprisonment and fine. - ` ' •• i. -- ADOREss" - _ TsTaTE+t;� z�P 1, cn 0 ID m Y11 PHONE. YEAR #ANKE -u �-MODEL orm0 YAD NUMBER _ r— C�r TRIM MILEAGE r CD ` 7 ADJUSTER �FIL•E-kc CLAiR�I`NO ^� , z I m r� m� r I kl o m i rr m n -i m CA O m p m m m m g r F nx> g m 0m o o m - C ; m o o m o m m m y � nooo o o mtxD x sn ag m O a d o = tirn ? w r - m o a m V) m f n x m m m D� -1 27 00 m v m z D / o C < m m 0 m m m 0 m C C 0 y w = C C T m C C C p m m C'1 0 " � Q m � y 3 m m6 � � � w � 3 � ? v3 N' o o. m 0 0 m 9. m W 3 0 (n v m a o m o m m v n 0) n n ti o r y 3 m T 0 n m D H ? 3 3 m o n 0m / m - Q o < �_ rp : Z m n � - o m � CD G7 b m _ a � 1 N b c r A ca m1vt o 0 1 • P' is z 4 vw m(mj mwaDo mo on wzx m no mx w mm uym nm m mD m n m S o o w m o a _ n o o omb n m wwa30onom _ co zr ccn 3 ov o o •"'" MV! .� - n a j y a g n m o m T m o f7 1 9 .7 v m m w = m o m m o o Z 3 1 n R ID p. YTi m w m N r c 0 AY -j m ..X+SV..F-8u...m..-Q..�15.c'Ym:.. _D. ID 3 ­- c3me$ m �a ma mma n m an d n m ac o m S c o g a m< = o rn c o 3m, m coZ w mc3Ny mO O V: C-c w3 O C-) a - w m 3� -� m m' r^ ? m' m - m 3 n H m ��...m. .Z 4F m rl �s-.F ••.O✓ m n m w - r" - n C O m m m m Q m = m m $ O - N . J'Jt r LL 7 w w ©Form No. 10101/D/EIA,Inc.Caldwell,Idaho 83605,Call Toll Free 14100-635.9261 o ��ffLL 1134 Page V of Pages Mami� r� TEKNI-KOLOR BODY & PAINT 12 20th Street RICHMOND, CALIFORNIA 94801 (415) 235-7271 N E ' PHONE D �� r T IT l ^ 1 YEA OR MO E 1 CAb vacb REGISTRATION NO. WCIAL NO. ODOMETER ESTIMATE PREPARED BY INSURANCECO. ADJUSTOR REPLACE REPAIR - DESCRIPTION PARTS LABOR REFINISH SUBLET t - CA TOTALS The above is an estimate based on our inspection and does not TOTAL PARTS $ cover any additional parts or labor which may be required after the work has been started. Occasionally, worn or damaged parts are TOTAL LABOR . . . . . . . . . . . . . . . . $ discovered which may not be evident on the first inspection. Because of this,the above prices are not guaranteed.Quotations on parts and TOTAL REFINISH . . . . . . . . . . . . . . $ labor are current and subject to change. AUTHORIZATION FOR REPAIR.You are hereby authorized to TOTAL SUBLET . . . . . . . . . . .. . . . $ make the above repairs: TAX . . . . . . . . . . . . . . . . . . . . . . . . . $ SIGNED: $ DATE: TOTAL . . . . . . . . . . . . . . . .AA $ CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the, County, or D.istrict governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October2t5 1f988 and Board Action. All Section references are to The copy of this document mailed to you is your no Ide o California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $183. 9 2 Section 913 and 915.4. Please note all °Warnin " CountysCaU:�se� CLAIMANT: LEYNA ABNEY ET AL 1749 San Jose Drive St Q 2 U 198 ATTORNEY: Antioch, CA 94509 Date received (Martinez, CA 945',53 ADDRESS: BY DELIVERY TO CLERK ON September 27 , 1988 trans . BY MAIL POSTMARKED: September 26, 1988 I. FROM: Clerk of the Board of.Supervisors - TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL DATCHELOR, Clerk DATED: September 28 , 1988 epuy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: �l G � Dated: , p �( BY: i/ / �� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BO7) This DER: By unanimous vote of the Supervisors present ( Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 5 1988 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the -United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, •California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. OCT 2 8 1980 .Dated: BY: PHIL BATCHELOR by eputy 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 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 Cle ing st RECEIVED Against the County of Contra Costa ) 4, 2 or ) District) CLER B p TC SU R Fill in name ) By T S puty The undersigned claimant hereby makes claim ainst 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) --- -----------/I '2-------------------------------------- -- 2 -------------------------- -- 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full det ls; use extra paper if required) a tr� 6ko -------- -f..------� 1_- - ------------------ &_----- 4. What particular act or omission on the t of count or district officers ani c�w� Paz' Pte' Y � servants or employees caused the injury or damage? �a,cc wat�lC (over) i Wh,, t_ •e the names of county or district officers, servants or employees causing the - ge ,-or injury? c- GLC X10 r ------ �- C�D�c c� �u� �r wG�.� cin _ Qn 5. What damage or injuries do you claim resulted? (Give full extent of injurii 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.) r L) 8. Names and addresses of witnesses, doctors and hospitals. I-J`1q /t QST 1�lz 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 T0: (Attorney) , orb some person on his behalf.." Name and Address of-Attorney _ aimant ignat ��G1 oSG�/1 Address Telephone No. TelephontY �f'7 — N O T I C E Section 72 of the Pena 1 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. F CLAIM BQ RD._% 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 25 , 1988 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $100 ,000- 00 Section 913 and 915.4. Please note all "WUIC0,� cowls ; CLAIMANT: DEBORAH DAVIS c/o George R. Beavin S k P 2 1988 ATTORNEY: 1099 D Street Martinez, 94-1"1 Penthouse Suite D Date received ��sctF�.C1�z� `� u�v_=� ADDRESS: San Rafael , CA 94901 BY DELIVERY TO CLERK ON September 23 , 1988 BY MAIL POSTMARKED: September 22 , 1988 1. FROM: Clerk of the Board of_Supervisors T0: County Counsel Attached is a copy of the above-noted claim. DATED: September 28 , 1988 gaIL BAeTputyLOR, Clerk L. Hall I1. FROM: County Counsel TO: Clerk of the Board of Supervisors (Y ) 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: � e 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 ORD 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. Z Dated: OCT 2 51989 PHIL BATCHELOR, Clerk, ByGc- 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 Unitod 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: 2 6 1047M BY: PHIL BATCHELOR byZ,&Z_a_,eputy Clerk CC: County Counsel County Administrator 1 LAW OFFICES OF GEORGE R. BEAVIN A Professional Corporation 2 1099 D Street, Penthouse, Suite D San Rafael, California 94901 3 Telephone: (415) 454-1096 Attorney for Claimant RECFIVED4 DEBORAH DAVIS 5 SEP 3 13 6 ccs,, F0 r DUfy 8 DEBORAH DAVIS, ) 9 Claimant, ) CLAIM FOR PERSONAL INJURIES 10 V. ) (Gov't Code Sec. 910) 11 COUNTY OF CONTRA COSTA. ) 12 TO THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA COSTA: 13 YOU ARE HEREBY NOTIFIED that DEBORAH DAVIS, whose address is 14 in care of George R. Beavin, 1099 D Street, Penthouse Suite D, 15 San Rafael, CA 94901, claims damages from the COUNTY OF CONTRA 16 COSTA in the amount (computed as of the date of this claim) of 17 ONE HUNDRED THOUSAND DOLLARS ( $100, 000 . 00) . 18 This claim is based on personal injuries and other monetary 19 damages sustained by claimant on or about August 22, 1988 and 20 following at 142 Hollyhock, Hercules, CA under the following circumstances: 21 Claimant was threatened with expulsion from a live-in 22 support program for single mothers in which she was enrolled if 23 she did not comply with certain unlawful and unauthorized 24 requirements demanded of one Ruby Moore. Claimant was 25 thereafter assaulted and battered by Ruby Moore when claimant 26 refused to comply with said requirements . Ruby Moore was 27 supervising and administering said program for single mothers on 28 said property on behalf of and under the direct supervision and -1- 1 control of the Contra Costa Department of Community Services 2 which funded said program. Claimant was further denied 3 specified monetary support from Ruby Moore and/or the County of 4 Contra Costa which had been promised claimant when she was 5 admitted to the subject program. 6 The injuries sustained by claimant, as far as known on the 7 date of presentation of this claim, consist of injury and pain 8 to her neck, shoulders and chest, mental anguish and anxiety, 9 and other injuries . 10 The amount claimed, as of the date of presentation of this 11 claim, is as follows : 12 DAMAGES INCURRED TO DATE: 13 Medical Expenses: $Unknown Loss Of Earnings : $Unknown 14 Other Special Damages : $Unknown 15 General Damages : $100, 000 . 00 16 TOTAL DAMAGES TO DATE: $100, 000 . 00 17 ESTIMATED PROSPECTIVE DAMAGES: 18 Medical Expenses : $Unknown 19 Loss Of Earnings : $Unknown 20 Other Prospective Special Damages : $Unknown 21 TOTAL AMOUNT OF CLAIM AS OF THIS DATE: $100,000.00 22 All notices or other communications with regard to this 23 claim should be sent to claimant at c/o George R. Beavin, 1099 D 24 Street, Penthouse Suite D, San Rafael, CA 94901 . 25 26 DATED: September 22, 1988 27 GEORGE R. BEAVIN 28 Attorney for Claimant DEBORAH DAVIS -2- 1 PROOF OF SERVICE BY MA L .C.C.P. 551013, 2015 .5 2 3 4 I am a citizen of the United States and I am employed in the County of Marin, State of California. I am over eighteen 5 (18) years of age and not a party to the within-entitled action. My business address is : 1099 D Street, Penthouse, Suite D, 6 San Rafael, CA 94901. On the date below, I served the following w documents: 7 Claim for Personal Injuries - 9 10 by placing true copies thereof, enclosed in sealed envelope with postage thereon fully prepaid, in the United States Post Office 11 at SAN RAFAEL, CALIFORNIA, addressed as follows : 12 Board of Supervisors 13 County of Contra Costa 651 Pine St. , Room 106 14 Martinez , CA 94553 15 16 1 18 19 20 21 22 23 24 I declare under penalty of perjury that the 'foregoing is true and correct and that this declaration was executed at 25 SAN RAFAEL, CALIFORNIA. 26 DATED: September 22, 1988 27 28 ter E y to GEORGE R. BEAVIN • f APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COMM, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT October 25 , 1988 Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and hoard Action.) notice of the action taken on your application by (All Section References are to the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. Claimant: SOPHIA BERLING County Counsel 361 Lilac Circle Attorney: Hercules , CA 94521 S t P 2 8 1988 Address: Martinez, CA 94553 Amount: $101, 28,4,:50 By delivery to Clerk on _ September 21, 1988 Date Received: September 21, . 1988 By mail, postmarked on September 19, 1988 I. FROM: Clerk of the Board of Supervisors -;TSO: County Counsel Attached is a copy of the above noted Application o F e to C im. September 21, 1938 DATED: PHIL 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). (V) The.Board should deny this Application to File Late C1 m .6). . DATED. VICTOR WESTMAN, County Counsel, B� Deputy i 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 2 519% PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code S911.8) If you Wish to file a court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed With the court Within six (6) months from the date your application for leave to present a late claim Was denied. You may seek the advise of any attorney of your choice in connection with this matter. If you Want to consult an attorney, u should do so immediately. IV. FROM: Clerk of the Board TO: 1 County Counsel (2T-County Administrator Attached are copies of the above Application. We notifed .the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703• C OCT 2 61988 DATED: PHIL BATCHELOR, Clerk, By putt' V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: 'County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM Jr ' ♦y Application to Public Entity for ave to Present Late Tort Claim [Gov C Sections 911.4, 911. 6] In the matter of the Claim of Sophia Berling APPLICATION FOR LEAVE TO PRESENT against the County of LATE CLAIM [Gov C Section 911.4] Contra Costa, TO THE COUNTY OF CONTRA COSTA: 1. Application is hereby made for leave to present a late claim under Section 911.4 of the Government Code. The claim is founded on a cause of action for personal injuries, which accrued on April 26, 1986, and for which claim was not timely presented. For additional circumstances relating to the cause of action, reference is made to the proposed claim attached hereto as Exhibit A and made a part hereof. 2. The reason for the delay in presenting this claim is that the prior attorney did not file a claim within the 100 day period and Ms. Berling' s injuries are now more serious than originally thought and exceed the amounts of her uninsured motorist coverage. 3 . This application is presented within a reasonable time , after the accrual of the cause of action as shown by above. WHEREFORE, it is respectfully requested that this application be granted and that the attached claim be received and acted upon in accordance with Sections 912.4-912 .8 of the Government Code. Dated: �( -- :LAW OFFICES F D UB JEREM A.v ARCHDEACON Attqr y for Claimant RECEIVED 21, 198-8- PH L- k PH CLE B R3 By ... ... puty TO: Clerk of the Board of Supervisors County of Contra Costa 651 Pine Street Martinez, CA 94553 NOTICE OF CLAIM FOR PERSONAL INJURIES DUE NEGLIGENCE (PURSUANT TO GOVERNMENT CODE SECTION 910.2) 1. CLAIM AGAINST: County of Contra Costa 2 . NAME AND POST OFFICE ADDRESS OF CLAIMANT: Ms. Sophia Berling 361 Lilac Circle Hercules, CA 94521 3 . THE DATE, PLACE, AND OTHER CIRCUMSTANCES OF THE OCCURRENCE OR TRANSACTION WHICH GAVE RISE TO THE CLAIM ASSERTED: Date: April 26, 1988 Place: Atlas Road - 33 ' East of Rachel Road Circumstances: The road was defectively designed and/or there were inadequate warning signs . so as to advise defendant of the risk that his vehicle would cross over into the opposite traffic lane when traveling at or near the posted speed. 4. A GENERAL DESCRIPTION OF THE INDEBTEDNESS, OBLIGATION, INJURY, DAMAGE OR LOSS INCURRED SO FAR AS IT MAY BE KNOWN AT atment in the amount of $1,284 .50. Lost Wages - none. General Damages - $100, 000. 00. 5. THE NAME OR NAMES OF THE PUBLIC EMPLOYEES CAUSING THE INJURY, DAMAGE OR LOSS, IF KNOWN: unknown 6. AMOUNT CLAIMED IF UNDER $10,000. 00 OR STATE WHETHER JURISDICTION LIES IN MUNICIPAL OR SUPERIOR COURT: Jurisdiction lies in the Superior Court Dated: \� V Signatur ki�;;;EREMY A. CH EACON Attorney plaintiff CLAIM St),ARD 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 2 5, 1988 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $147 . 98 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ALLAN F . NOACK ETAL 2725 Alamo Court ATTORNEY: Antioch, CA 94509 ADDRESS: Court's CCjLfnS�j BYDELIVERY Datereceived CLERK ON September 22 , 1988 SEP 2 19°8 BY MAIL POSTMARKED: September 20, 1988 E;AarUnez, GA 9 4 E 5 3 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 28 , 1988 : 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: / l � Dated: V ! BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 0 ER: 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. OCT 2 51988 57 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 6 CT 2 6 1988 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator J` CTait 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 ALLAN F. NOACK & SYLV IA A. NOACK ) 7-' t' Against the County of Contra Costa ) or District) Fill in name 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) 08"01"68 - BETWEEN THE HOURS OF 5:00 P.M. - 6:00 P.M. ---------------------------------------------------------------------------------- 2. Where did the damage or injury occur? (Include city and county) KIRKER PASS ROAD, PITTSBURG, CA, CONTRA COSTA COUNTY ------------------------------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) DEBRIS FROM COUNTY ROAD REPAIR CRACKED NEWLY INSTALLED WINDSHIELD (COPY OF RECIEPT ENCLOSED). DEBIS NOT CLEANED UP ON ROADWAY SURFACE. NO WORK CREW ON THE SCENE. ------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? DEBIS NOT CLEANED UP ON ROADWAY SURFACE. NO WORK CREW ON THE SCENE. (over) 5. What are the names of county or district officers, servants or employees causingv' . . the damage or injury? UNKNOWN (COUNTY HI-WAY DEPT. ) ------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. CRACKED WINDSHIELD 1985 FORD-ESCORT 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) NEW WINDSHIELD 8. Names and addresses of witnesses, doctors and hospitals. NONE ------------------------------------------------- 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 beh lf." Name and Address of Attorney Claimant's Si 2725 Address fANTIOCH,, CA 94509 Telephone No. Telephone No. t �J` —.2 2-' N O T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for . payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by 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 ($10,000, or by both such imprisonment and fine. -7-7 ""MOMMM-2- 5'_FT;r.'MwT- 7"-7 TP-1 DAN'S CONTRA COSTA GLASS MOBILE.,G4ASS SERVICE 15907 Specializing in Auto Glass Residential& Commercial 1140 ERICKSON ROAD CONCORD, CA 94520 (415) 827-4173 DATE NAME S4 4Z=A=:� '� I A O.B. )RESS C'), F, INVOICE NO. SOLD"I 4-t"O D. CITY 09 0 CHARGE CUSTOMER'S ORDER NO, POLICY NUMBER RANCE AGENT PHONE &MAKE TYPE&MODEL SERIAL Nr, SPEEDOMETER NO. LICENCE NO. � RNIAH FURNISH LABOR I DATE PROMISED lik VTIAIM.@t IAUTHORIZED &INSTLL EONLY ONLY I TITY PART OR SIZE NO. DESCRIPTION LABOR r 90- 0C i/ 6277. 15_Q SALVAGE ESTIMATE$ TOTAL PARTS VER TO TOTAL 4 Y�rml_CALL LABOR L NAME sa, I k-PC 0 DELIVERY TAX M SUB RIESS M TOTAL DEDUCT TOTAL 4�7' E PHONE —WORK PHONE 3 nxi CLAIM BOARD OF SUPERVISORS 6 CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25 , 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: $540 . 1 5 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ELIZABETH L. CONRON 28 Ray Court ATTORNEY: Danville, CA 94526 Date received ADDRESS: COLtnt`y Counsel BY DELIVERY TO CLERK ON September 20, 1988 Risk Mat SEP 2 U 1 °GH BY MAIL POSTMARKED: September 17 , 1988 bR pC,;Z 1 h" PA553 � 7'C�I S �� T I. FROM: Clerk of the Board of Suopervisors TO: County Counsel Attached is a copy of the above-noted claim. Se tember 28 1988 PpHHIL BATCHELOR, Clerk DATED: p , BY: Deputy L. Hall II. FROM- County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: Z ;; L/ 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 DER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date, e Dated: OCT 2 5 1980 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: O CT 2 6 19800 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim tc; 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 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 form. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) or ) SEP 20 M88- District) ,� ELo Fill in name ) SLE''' NTR P Solis By ePuty 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) ---- �- --------- ----- - ----------------------------------------------- 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage oinjury occur? (Give full details; use extra paper if required) �� ,�,e-Clz- pa,,,d- A-co&, Li.)al_Q-�x �2 ��i�C. --------------------------------------------------------------- ---------- \ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) f 5. "What`are the names of county or district officers, servants or employees causing the damage or injury? -L&L)-Pww___www----------__-______ww.�_ 5. What damage or injuries do you claim re uited? (Give full extent of injuries or damages claimed. Attach two estimatep for auto e. -w__--__ _______________________ 7. How wa 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 exditures you made on accoun0of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES T0: (Attorney) or by some person on his behalf." Name and Address of Attorney Claimant's Signature dress Telephone No. Telephone No. (L//5) 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 � , i ?;,district board or offieer, 'authorized to allow or pay the same if genu Ra�l�@+br fraudulent claim, bill, account, voucher, or writing, is punishab by imprisonment in the county jail for a period of not more than one yeas pby of not exceeding e one thousand ($1,000), or by both such imprisonment an f¢ , by imprisonment in the state prison, by a fine of not exceeding tend dollars j$10,000, or by both such imprisonment and fine. � ��t�!ia g%em en i a r j ILI- Don Forbes JE AUTO GLASS 4 DATE Satelite Auto Glass YR.&MAKE 2049 Contra Costa Blvd. L`�� C` Pleasant Hill,CA 94523 t' BODY STYLE f— _� _... (415)687-7200 ESTIMATED BY: ADDRESS ESTIMATE GOOD FOR 30 DAYS CITY. ITEM/SIZE DESCRIPTION PRICE DISC. AMOUNT r JAWV "-' r' MERCHANDISE TOTAL SALES TAX 3� r' LABOR (/ 0V SUB TOTAL CUSTOMER'S SIGNATURE X LESS DEDUCT TOTAL X5 ^�� �.a C A R S , N RKEY IMPORTED CARS, lNi�. James 'Wimo"Sanchez y 5940 STONERlRGE MALL RD. c gomer Service Counselor PLEASANTON, CA 94566 -4330 Rosewood Drive•ple=anton,California 94566 D FOR LABOH AND MATERIALS (415)463-9510 kGIREEMENTS NOT BINDING • tSTIMATES FREE _. DAT zm •HOWL EST;N IV42URANCE CO.' AODREti ►KOKE LICENSE PIUMbEff VaAR MAK[ MOOtL MILiAG[ M TOR NO. iER1AL NO. . . 00 G otoo taro-- i Tf i PARTS PRICES BASED GN f.T,: 4ZARD CATALOG PROCUREMENT PRICE LISTS SUBJECT TO CHANGE WITHOUT NOTIC:. 1 OTgL PROCUREmENI AND DEUVEkr CHARGES MAY 6E AUDED FOR SPECIAL SERVICE ON ITEM5 NO[ AVAILABLE LOCALLY, MATERIAL _ OLD PARTS REMOVED FROM CARS WILL bE JUNKED UNLESS OTHERWISE INSTRUCTED IN WRITING. Ag"IFO tHE ABOVE IS AN ESTIMATe BASED ON OUR INSPECTION AND DOES NOT COVER ADDITIONAL PARTS TOTAL LABOR .')R LABOR WHICH MAY BE HEOUIRED AFTER THE WORK HAS BEEN OPENED UP.OCCASIONALLY AFTER kVORK HAL 7TARTED WORN PARTS ARC T)13COVERED WHf,-H ARE NOT EVIDENT ON FIRST INSPECTION. T7.AL MATERIAL I }+ BECAUSE OF THIS TME AL-LOVE PRICES ARE NOT GUARANTEED TIMATE ES _IM SY �� PPROVED BY TAX yr�rr� `a AUTHORIZED AND.ACCEPTED PAID OUT -TCM AGE STL)RAGE— BY OWNER SUBLET REPAIRS I Q�' l OR AGENT � �a • ,� DATE i H 429 fF_UF0rQj ( CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA � 1 Claim Against the County, or District governed by) BOARD ACTION , the Boardiof Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25 , 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: $110. 0 0 Section 913 and 915.4. Please note allarni " G� `�� Cou�s�l CLAIMANT: KENNETH ANDREWS ETAL 664 Donna Mae Court 19c3 ATTORNEY: E1 Sobrante, CA 94803 Pf� ,�,� ���� �FEy Date received ADDRESS: BY DELIVERY TO CLERK ON September 27 , 1988 BY MAIL POSTMARKED: Septeuiber 26 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. �bIL BATCHELOR, Clerk DATED: September 28 , 1988 : Deputy L. Hall II. F 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: i 1 Dated: F �,7� 5 BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 0 ER 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. pe Dated: OCT 2 5 19$$ 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, Lalifornia, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above: OCT 2 6 19$8 BY: PHIL BATCHELOR b eputy Clerk CC: County Counsel County Administrator Claim ��o_ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed With the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one-public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * 4 * * * * RE: Claim By ) Reser ' fill i RECEIVED Against the County of Contra Costa ) EP 2 7' 1988: or ) CL P BAG LOi� J District) sjFill in name ) epu The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ //Do 0 Q and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) /.'00 /0M ------------------------------------------------------------------------------------ 2. . Where did the damage or injury occur? (Include city and county) Soc-ig-4 OE P i - �1 3�-?- 1--����o12=-2_�� _--------��-1- irtoni??--- orr Tia 5 r ft_C_c?ui�r�/ �3. How did the damage or injury occur? (Give full details; use extra paper if 7' - required) WE WEec '7'"oz_D Tt/A r o u,2 c,�//Z- VPC4/ /`N67- I'M0e A^/ by Su��iPu/sow GkAcE alo'-I-Wocc/ V 40c /�9415r 00A-6041 eR E.5,e7 7f Rc deal'�T GRa7E ESL�f}�l7� /,t/� Tfffa T 17- 0-0 U TC;ou 4 c 111d�1=�11_�-,6 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? AS STAT //v 7-4�'_3 ai6- qAl G,Vhl Z , ,.qln 01V 47_1� OF OuP� (over) 5. What are the names, of county or district officers, servants or employees causing the damage or- injury? �AGc)P..�NGE loop G�Rcc C�iJ - SC10"I 150r --- --------------------------------------------------------------------- 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. P,gUZ-/"9c W J3--)ynT-0n yy& S 1615-0 1601-/)aTS1;- . ---- `= u"- ----------------------------------------------------------------------- 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 someperson on his behalf." Name and Address of Attorney 4,n Claimant's Signature (Address) Zz- (2A '7q�o 3 Telephone No. Telephone No. -22 2- F/--5- 2 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. .�-- jli 1 ---14714-;11.A/i`9/.AJ 6 yN - -Alli CAI OCIR. - 111 ,,57/9 /�� T HT._ f, 0 _ Tom/' _ N �4 c�it5�c 1STii�� _71GCl- ri! 176-X57-Pd/ A�y .T��/� -_'CGcT � _1 T fes._. SU_.GIG woreer , 112 04 05ailon 6066 ohrn�, /tu6�JanG�.� Sens -c' t6 - -m cs- - D er cin-- -z C h_ac en _In" i, cr :i OCs771an i n- - -- - - -._ 1 E a r c�.c,1s E -.had- it .had.._w.�y y -- - ' _A-'Ss co c i c, - -- 71oLe-si-- cc ---An - -�_e-_ honePens�?r� s -- -,U/-).-GSE!--woo - _ - - - C,h�.� -c,lo(_ -noT- - - xG it-) a C,t, • u nT y � s As ConSu T enoU G� tSLusSecf -�. t't --- 5 U nCje ' E�-T.-1(� = wa,S ..- r " x .G m _ wo u e -a n _Q -- -_ � T IF -= -ctin Ex_c.r�r ,n ec:�efc� _ : o u,.)r� YY1 _ ._ -t-�c` lrY� _ _ lJl r�d�c wCl�o ='- ?o�n c/ o LA-7 7t . �O(' - -��lE �G ► ct�- -_ _�i`_U._I_G� _�PT. /\i.OT 'M �_I°' T-h� - -re5-T _ f� e- S LL.L_T SC_G.tf1�l C�. I�CSG iL r S t..6 M-41 Tri a c,o 4 OP_. . T_ e b+e__L_ -1`e_ . Mss- Urderwcoo( --- e . .1 -r _c _Via_.,._C"k- 0 u e tel . __ - _fiery wer_ u.7p,- - ___o :tY�ss� t , pTA 0-o� o LidaQ4. ...- _ - 2 _B I_L L o _._.S _(tN ;I ELMER R.GROSSMAN.M.D. ,►- . HOWARD S.GRUBER.M.D.,INC. s RAGNA C.BOYNTON,M.D. JAMES G.CUTHBERTSON,M.D. 1650 W�nut StrNt HELAINE B.►LEET,M.D. Berkeley,California 86709 SUSAN D.EHRLICH.M.D. 068.2666 Federal I.D. #94-1246384 To be completed by INSURED: P 'Ez e First, middle initial, last name Birthdate � &L�_ I Male Percale Address City State zip Relationship to Subscriber Subscriber or Policyholder Insurance Carrier C Address City State zip Ins. I.D.# Group I authorize my insurance carrier to make direct payment Other Medical Coverage No Yes to my physician. Name of carrier: (Signature) Date DESCRIPTION RVS FEE DESCRIPTION RVS FEE ESCRIPTION RVS FEE 1. EXAMSNATIONS 3. LABORATORY 4. DWUNIZATIONS & _ DICATIONS Re ar Exam 0060 D -MEC Tete Blood Count 8502 PT or Brief Exam 90050 Hemoglobin -8501 OPV olio K 20 Extended Exam 900701 Hemcqram 8502 Seaslesl 2 s; Rubella 0 21 Involved Exam Min. 00 0 ROH re 8721 s-Rubella 0 22 Talk visit 0 min. 0 2 Mono Test 860 IF 0 2 Talk visit 0 min. 9903Nose Culture 8706 TB test 6 Talk visit 1 min. 0 4 Occult blood 8227 Procaine Penicillin 0 0 Other Culture 8707 Aller Consultation 111 Bicillin 0 PCV or Hematocrit 85014 �b After Hours Surchar e0 0 Gamma Globulin 0 Pinworm slides 8721 Sun. or Holiday Surcharge 99054 Sensitivities 87184 Antigen Injection 90782 House Call 90100 Smear 87205 Adrenalin Sus hrine 90 Hospital Visit 90260 Theo h lline level 8442 Terbutaline 9p C--section attendance 99039 Throat Culture 8706 Pneumovax Attendance at delivery 0 Urinalysis- 8100 OTHER PROCEDURES Initial ComPrehensive VxA 9002N Urine Culture 870861 Ear Wash 69210 2. HEALTH MAI27I�N� pNDg _ White g Diff. 8500 Tympanometry256 WELI� CHI7� Aller skin test 0 Baby, under 1 year e 1 through0763 suppLiEs Age 4 through11 0 2 6. Sterile Suture Set99070 Age 12 through 17 061 DATE OF SERVICE: Steri-Strips 2LOLO 18 and over Burn Dressing 70 Newborn Exam -Hospital 02 DATE OF ACCII7ENP: Ace Bandage 0 i 51 ewborn Exam -H 1901DOI � 1 � DIAG270SiS: ��- Od 44 6918 - Eczema _ 6963 - Pityriasis rosea �'1Q _ 682 - Abscess _ 7883 - Enuresis _ 481 - Pneumonia 7061 - Acne _ 4871 Flu Syndrome 59080 - Pyelonephritis 9952 - Allergy (drug) - Pbreign body _ 057 - Roseola 3733 - Allergic dermatitis - Fracture _ 057 - Rubella _ 477 - Allergic rhinitis _ 7806 - PUO _ 133 - Scabies _ 493 - Asthma _ 466 - Bronchitis — 558 - Gastroenteritis _ 73730 - Scoliosis _ 112.9 - �didiasi tis —. 784 - Headache _ 690 - Seborrhea 7852 - Cardiac murmur - innocent _ - �etigo _ 3811 - Serous otitis _ 74689 - Congenital heart anomaly — 075 - Infectious Mononucleosis _ 461 - Sinusitis 682 - Cellulitis _ 280.9 - Iron deficiency anemia - Sprain _ _ 0529 - Chickenpox - Laceration _ 5207 - Teething 789 - Colic, infant _ 785.6 - Lymphadenitis _ 727 - Tendonitis 372 - Conjunctivitis _v71.9 - No disease _ 1105 - Tinea corporis 5640 -Constipation _ 732.4 - Osgood-Schlatter's Disease _ 460 - Upper Respiratory Infection _ 692 - Contact dermatitis _3801 - Otitis externa _ 708 - Urticaria - Contusion _381 - Otitis Media _ 616 - vaginitis —' 464 - Croup _ 6819 - Paronychia 0579 - Viral exanthem 5950 - Cystitis 132 - Pediculosis 0781 - Harte 832.01- Dislocated radial head462 - Pharyngiti v202 - Well child T 1274 - Pinworms ,- 0 - Well adult IN3SI'RUCTIONS TO PATIENT FOR FILING INSURANCE CLAIMS: 1) Complete upper portion of this form. 2) Sign and date. 3) Mail direatly tin.vftwr — Date --- ' CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY CALIFORNIA Claim Against the Court_+y, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25 1 9#8 and Board Action. All Section references are to ) The copy of this document mailed to you is your nofice or California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $234. 44 Section 913 and 915.4. Please note all "Warnings". rt .,.:;lnty Counsa, CLAIMANT: ROSEMARY ARROYO 1988 Chardonnay Drive 2 j �ggg ATTORNEY: Oakley, CA 94561 Date received Martinez, Cad ADDRESS: BY DELIVERY TO CLERK ON September 15 , 1988 BY MAIL POSTMARKED: September 14, 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL ATCHELOR, Clerk DATED: September 20, 1988 �d: Deputy Z. 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: L 'l' 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 OR R: 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. �ee Dated: O CT 2 1�8o 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. OCT 2 6 1988 Dated: BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator " Claim tc � . 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 RECIAVED ) _ 1 Against the County of Contra Costa District) P OAT P R RS CL RK a N R Fill in name ) BY The undersigned claimant hereby makes claim again t the County of Contra Costa or the above-named District in the sum of $ 3 y and in support of this claim represents as follows: �- ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) -----J - -----= '�_!1 -��-�----� /S__��_ ---------------------- 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)C�-ra v P ki 4'-1 G h CA6 7//7 ea��GIhGt � �C /C Gr � CI �'tP L� le- Ce- / © v a o e o P, -- tie ��-- ��c�c P�'--kil y r� Q% 4. What particular act or omission on the part of county or district officers, servants or employees caused the i jury or damage? i- / sv f (over) 5. . 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 esti tes for auto damage./71 7. How was the amount claimed above computed? (Include the estimated amount of an prospective injury or damage.) 10 C�-- 7' 61y e s ------------------------------------------------------------------------------------- $. Names and addresses of witnesses, doctors and hospitals. "12 9. List the expendit&es 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 ppme person on his half." Name and Address of Attorney Cla' 's Signature nAddress 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. Delta Glass 6 1 (7f- 101 Railroad Avenue �LASS Antioch, California 94509 (415) 757-5300 DATE 19 0 C> NAME \L �1' ��✓l (� �V ADDRESS PHONE NO. JOB LOCATION_ PHONE NO. INS. CO. ` ((`�l.4{ �'•. ON, DESCRIPTION AMOUNT 1 . ESTI. TE HARMON GLASS N2 A29291 �a a QUOTATION TO OSif , / R,& ( 6 DATE ADDRESS I otO RESIDENCE PHONE --Z;-) CITY G L BUSINESS PHONE QUANTITY MATERIALS UNIT PRICE AMOUNT 2 THIS ESTIMATE IS SUBJECT TO CHANGE AFTER 30 DAYS 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 OctQber 25 ,. 19P8 and Board Action. A1.1 Section references are to The copy of this document mailed to you is your notice o California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $250. 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: HARRY SATCHER 256 E. Trident Drive ATTORNEY: Pittsburg, CA 94565 '~ - Date received [Ai3rCift@Z � 45"" ADDRESS: BY DELIVERY TO CLERK ON September .16, 08 �� G.9 hand de. 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 20, 1988 ��: Deputy L. Hall I1. FROM:: County Counsel TO: Clerk of the Board of Supervisors ( VJ 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: r r Dated: �• �`� BY Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (/This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 5 1988 PHIL BATCHELOR, Clerk, By, C 1eputy 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. AFFIDAVI7 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 2 6 1988 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator ,17,AIM TO: BOARD OF SUPERVISORS OF CONTRA CO�TtAur�g�i iT�R i �; •r e application to: Instructions to Claimant Clerk of the Board M P.O.Box 911 A. Claims- relating to causes of action for death or torn injuryn o�533 " person or to personal property -or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of_ the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors, rather than-the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims,. Penal Code Sec. 72 at end FF this form. RE: Claim by ) Reserved for Clerk' s filing stamps L REP) - , ) , k ) AlC'E il5 Against the COUNTY OF CONTRA OSTA) Q1v �y�� or �� Q DISTRICT) Q rT f�o� LCL RK P SORS (Fill in name) ) � o Deputy - The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in . the sum of $ ; -Sp, 'oo _ and inn support of this claim represents as follows : ------------------------------------------------------------------------ 1. When did the damage or injury occur? (Giv exact date and hour) po -/A , 3,3 2. Where did the damage or in ur C'occur?/ Include cit and count 9 7 Y ( y) LL 3. How flid the damage or injur� 9ce r? (Gi e full details, se extra i sheets if required) �,�-f�� �c-t 4 s t.A-. 5 �- 4 . What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? (over) - r—�— _- M.tn .w. a —rs — 1 -`,i+YSllOr'�}•'µ<:v's Y'�a.....li�--vv.'. ' �.aW<YFr....3waWYfv'yrl-v+ • "Ilbf.��1 — .aItL- — — _ a_ x.zo. What. are.,t# e...;n�-ames of county or district officers, servants or J: emnl,oyees:causIg the damage or injury? ---- - - --------------------------------------------------------- -6-.--What-dam--a-ge--or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimateop auto damage) /�. /l' OZ�� peS ` j .• VL 7. How was the amount claimed above ; Mputed? (In,itude the estimated amount of any prospective injury or damage. ) - /�� ,r Sys 6S 8. Names and'addrses of witnesses , doors and hositals. •t� r s ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Govt. Code Sec. 910.2 provides : "The claim signed by the claiman- SEN NOTICES TO: (Attorney) or by some person on his behalf. ' Name and Address of Attorney ZZ" A_A Cla a ' s S ' gnature Irl Add r ss , /f5y AS S �� 1 Telephone No. Telephone No, p /;27V 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. " •mac•-•... _ . .�,►v-+..-...�v...re�Yw.G?L.rrcw�r a.:v:��..e.......r:.._...._�..._..r.a^.:..i. —►:r i��� •i:fl�Rr'33NCI�IYY6�i,�`�i ___ _'`YiL•'�' Y i CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25, 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: $795, 000. 00 Section 913 and 915.4. Please note all "Warnings". �::►snty �:Gun��a! CLAIMANT: TODD FREEMAN Hirschfield & Nadler, A Professional Corporation ATTORNEY: c/o Frederic L. Hirschfield 205 Keller St. Date received [Martinez CA 945;1 ADDRESS: Petaluma, CA 9.4953 BY DELIVERY TO CLERK ON September 16, 1988 BY MAIL POSTMARKED: September 15 , 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 20,. 1988 : Deputy L.. Hall II. FROM/: County Counsel TO: Clerk of the Board of Supervisors (✓) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: IL23iff BY: LI _ �'l/ , Deputy County Counsel i III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. ' BOARD 0 R: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: i I certify that this is a true and correct copy ofi the Board's Order entered in its minutes for this date. OCT 2 5 1988 'Dated: PHIL BATCHELOR, Clerk, Byfl� -� 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. i AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at allitimes herein mentioned, have been a citizen of the ')nited 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. OCT 2 6 1988 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator i i i HIRSCHFIELD & NADLER, 1 A Professional Corporation By: FREDERIC L. HIRSCHFIELD, ESQ. 2 205 Keller Street, P. O. Box 2538 Petaluma, California 949531 3 Telephone: (707) 763-4155 �61988 4 Attorneys for Claimant, i S0- TODD FREEMAN 5 r. AF J� UW 6 �r V I 7 In the Matter of the Claimlof: 8 TODD FREEMAN 9 I against the COUNTY OF CONTRA 10 COSTA I � 11 TO: COUNTY OF CONTRA COSTA 12 Clerk of the Board ; 651 Pine Street, Room 106 13 Martinez, California 94553 14 Claimant, TODD FREEMAN, Ihereby makes a claim against i 15 the COUNTY OF CONTRA COSTA for the sum set forth below, 16 and makes the following statements in support of the 17 claim: 18 1. Claimant's address! is 4312 Little Fairfield 19 Street, Eureka, CaliforniaJ95501. 20 2 . Notices concerning this claim should be sent to i 21 HIRSCHFIELD & NADLER, A Professional Corporation, c/o 22 Frederic L. Hirschfield, 205 Keller Street, P. 0. Box 23 2538, Petaluma, California94953 . 24 3 . The date of the occurrence that gave rise to this 25 claim is April 6, 1988. 26 i 4. The events that gave rise to this claim occurred 1. on Minaker Drive and the Atchison, Topeka and Santa Fe 2 1 railroad tracks near the Domtar Gypsum Plant, 235 feet 3 north of Wilbur Avenue, City of Antioch, County of Contra 4 Costa, State of California.{ 5 5. The circumstances giving rise to this claim are as 6 follows: Claimant, Todd Freeman, was proceeding to the 7 Domtar Gypsum Plant in a northerly direction and was 8 crossing the railroad tracks when his truck was struck by 9 a railroad engine whose conductor was B.N. Scheiter. 10 The location in question was in a dangerous and 11 defective condition at theitime of the subject accident in 12 the following respects: the crossing was not safe because 13 . it did not have crossing gates; the view of a train 14 approaching the crossing is obscured; that the flashing 15 ' light signals were defective in design and were not 16 working properly due to improper maintenance. Contra 17 1 Costa County had both actual and constructive notice of 18 the dangerous and defective nature of the railroad 19 1 crossing in question. Furthermore, Contra Costa County 20 had such constructive and 'actual notice for a significant 21 22 period of time prior to the subject accident such that 23 remedial action could easi11 Ily have been taken if due care had been exercised. 1 24 � 6. The injuries sustained by claimant include, but 25 are not limited to, severely injured left leg and pelvis. 26 2 I I Claimant is informed and believes that the medical bills 1 ' 2 to date are in excess of $45,000.00. 7. The full extent of 'said injuries are not known at 3 this time. The names of public employees causing the 4 1 claimant's injuries are unknown at this time. 5 8. The amount of the claim as of this date is 6 $795, 000. 00. 7 8 9. The basis of the computation of the amount of the claim is as follows: 9 10 Medical Bills $ 45,000. 00 � General Damages $750, 000. 00 11 12 DATED: September 14, 1988 HIRSCHFIELD & NA� ER,'' Profe ion 1 orpora i n 13 14 gy Frederic L. Hirschfield 15 Attorney for CLAIMANT 16 17 18 19 20 21 22 23 24 25 26 3 I I i I CLAIM l (<OARD 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 25 1988 and Board Action. A1.1 Section references are to ) The copyof 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: $275. 87 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: EILEEN L. DELAGARDELLE V__�-urlt1 Counsel 1813 Alicante Court ATTORNEY: Concord, CA 94521 I `' 2 i 1988 Date ADDRESS: BYDELIVERY eTO CLERK ON Sept embe;�Ial-§nejq� ' 94500 i BY MAILPOSTMARKED: September 16, 1988 I. FROM: Clerk of the Board of.Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BepuIATCHELOR, Clerk DATED: September 20, 1988 �b: ty L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors i ( 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). I ( ) Other: i I r) I � Dated: ,A 2( ; BY: v ) Deputy County Counsel c I -- I 1I1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). i IV. BOARD ORDER: By unanimous vote of the Supervisors present I ( This Claim is rejected in full. I ( ) Other: I I certify that this is a true and correct copy of! the Board' Order entered in its minutes for this date. OCT 2 5 1988 Dated: PHIL BATCHELOR, Clerk, ty Deputy Clerk I 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. i AFFIDAVIT OFI MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the IJ-4ted 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. OCT 2 6 1988 BY: PHIL BATCHELOR by GCeputy Clerk CC: County Counsel County Administrator Claim to.. ``" BOARD Or SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911,2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp ..-� 17 .. : 1 - ) RECIrIVEU ) Against the County of Contra Costa ) S€P_1 198R or ) F BAT District) Y�', rt� �E� �; Fill in name ) o TY ' The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ L7,�� 8 and in support of this claim represents as follows: ------------------------------------------------------------------------------------ 1. When did the damage or injury occur? (Give exact date and hour) -----�Z/j --------se,P1, --------------------------------------------- 2. Where did the die or injury occur? (Include city and county) ------ � � -------- b� _ ----------------------- 3. How did the dama.e 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? 16 6 (over) 5. Vf&t are the names of co!,mty 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. --------------r 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 son on his behalf." Name and Address of Attorney i Claimant's Signature) Address a Telephone No. Telephone No. — 72 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. t� QuO't E No. DATE U9—()8-88 ACCT, NO. INSURANCE CO.NAME AGENT'S NAME E I LEEN ADDRESS CITY,STATE AND ZIP PHONE NO. POLICY NAME THANK YOU FOR YOUR TIME L—VERIFIEDBY AND SPEEDY PAYMENT O; MAKE MODEL CAUSE 1984 YEAR DOORS LICENSE NO. DEDUCTIBLE SERIAL NO. TERMSCaSh CUSTOMER ORDER SOLD BY SHIPPED VIA SHIPPED FROV DATE SHIPPED NO W942 Shaded !G. GG C G' C' 482. 90 19t3a 16 -ti 62. 66 Tax 13. 21 RECEIVED BY. ]NOTE: ALL CLAIMS AND RETURNED GOODS 275. 87 MUST BE ACCOMPANIED BY THIS RECEIPT. All material is guaranteed to be as specified. All work to be completed in a All goods and services ordered or received by the above named party,or their workmanlike manner according to standard practices_ Any alteration or principals,are subject to the following conditions which are hereby accepted deviation from above specifications involving extra costs will be executed only and agreed to by the person ordering or receiving said goods or services. upon written orders, and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond All claims and returned goods must be accompanied by this receipt. Terms of our control. Owner to carry fire,tornado and other necessary insurance. Our payment are ten(10)days net from invoice date. All accounts are commercial workers are fully covered by Workman's Compensation Insurance. accounts and not open accounts All delinquent accounts shall bear interest at the rate of 1';,oro per month,an annual percentage rate of 18%, DATE 19 I (NAME OF PERSON QUOTE GIVEN TO or RECEIV D FROM) TO FFU J ' FIRM NAME ADDRESS uq nn- QUOTE R ORDED BV JOB NAME liOB VATE , JOB LOCATION I JOB PHONE I+JOB NUMBER OF WOF.t 7an ekt=u CAM b� DESCRIPTION OF WORK i I I I CLAIM �T BbARD OF, SUKRVISORS 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 25, 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: $275 .87 -Section 913 and 915.4. Please note all "Warn.,ngs'E�, C;Gu 1i'ui CLAIMANT: JAMES C. DELAGARDELLE 1813 Alicante Court `_-P 2 1988 ATTORNEY: Concord, CA 94521 Martinez, CA 04553 Date received ADDRESS: BY DELIVERY TO CLERK ON September 19 , 1988 BY MAIL POSTMARKED: September 16, 1988 1. FROM: Clerk of the Board of.Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 20, 1988 PPHHIL BATCHELOR, Clerk DATED: P BY: Deputy L. Hall II. FROM County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: d Dated: � 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 OR ER: 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 2 5 1988 PHIL BATCHELOR, Clerk, By, - eputy 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 calbove. Dated: OCT 2 6 198$ BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Clai74 tor.: 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 kJ_ RECrIVE0 Against the County of Contra Costa ) t or ) SEP 19 1988. _ District) P AT Fill in name ) B`_,.-°,VTR �uP °R Qouf The undersigned claimant hereby makes claim against the County o 0 or the above-named District in the sum of $ - /aZ(3 y and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) -----------�G �J- $--------------��- � ------------------------------------- 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) . —��`:Ln:�1r_— .� _l.t,_-G �4.c.�.�J—y ��--�-rc.�L(itJ•��•Etic°—�i.J-- - 4. What particular act or omission on the part of county or district officers, servants or employees causedp the injury or damage? (/ ��/ (over) 5. 'Uhat`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. ----( ---------------- lx --------------------------------------------------- 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 Cov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by sWne person pn his behalf." Name and Address of Attorney V/� k141M, laimant}s Signature (Address) Telephone No. Telephone No. %2 --7 2-,:N-5� N 0 T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the s,-Lme 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 -40,- GC]h1CC) i I3 " V EP4UE. 3 C--C) FZL) , t5i iE:Cg E+ 1 t--C+ 8c-8: ? 1 Quot No. ► 09-08-88 ACCT. 1 .. DATE NO INSURANCE CO.NAME AGENT'S NAME E I LEEN ADDRESS CITY,STATE AND ZIP PHONE NO. POLICY f NAME THANK YOU FOR YOUR TIME POLICY AND SPEEDY PAYMENT NU VERIFIED MBER BY CLAIM CODE DATE OF AUTOMOBILE LOSS E MODEL CAUSE I DOORS LICENSE NO. DEDUCTIBLE SERIAL NO. ::ash CUUSTOMER ORDER I SOLD BY SHIPPED VIA SHIPPED FROM DATE SHIPPED 1 Tax 9. 33 T 8 !ED BY NOTE: ALL CLAIMS AND RETURNED GOODSL 2. 39 MUST BE ACCOMPANIED BY THIS RECEIPT. All material is guaranteed to oe as specified. All work to be completed in a All goods and services ordered or received by the above named party,or their workmanlike manner according to standard practices. Any alteration or principals,are subject to the following Conditions which are hereby accepted _i deviation from above specifications involving extra costs will be executed only and agreed to by the person ordering or receiving said goods or services. upon written orders. and will become an extra charge over and above the estimate. All agreements contingent upon strikes,accidents or delays beyond All claims and returned goods must be accompanied by this receipt. Terms of -control. Owner to carry fire,tornado and other necessary insurance. Our payment are ten(10)days net from invoice date. All accounts are commercial .a are fully by Workman's Compensation Insuranceaccounts and not open accounts. All delinquent accounts shall bear interest at the rate of 1',%per month,an annual percentage rate of 18%, • DATE 19 (NAME OF PERSON QUOTE GIVEN TO or RE EIVED FROM) f I '7' FRQM r N LjjL 0-s� ADDRE - � �. PHONE QUO RECORDED BY JOB NAME JCf.WtATE JOE LOCATION JOB PHONE JOB NUMBER QTYPE OF WORT' • , DESCRIPTION OF WORK i I I I I - I I i i _ I i I CLAIM BOARD OF SJ�ERVISORS 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 25, 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: $313. 93 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: RITA MACIN,TIRE C_;unty Counsel 2348 Cypress Street ATTORNEY: Antioch, CA 94509 Sc.P 2 1988 Date received ADDRESS: BY DELIVERY TO CLERK ON Sept -'45`' BY MAIL POSTMARKED: September 19 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 20 1988 HHIL BATCHELOR, Clerk DATED: p BPPY: Deputy L. Hall II. FROM: ounty 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: c{ /,g BY: Deputy County Counsel 1 � V— I - 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 2 5 1988 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter., If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the Un`.ted States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. ; OCT 2 6 1988 uat:ed: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Clalfftto-, 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, 19871 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 TO RE: Claim By Reserved for Clerk's filing stamp RECEIVED Against the Co my of Contra Costa S F p 20 1988. District) CLE,x P A B 'F SELOR Fill in name ) BY - �" c �' o�"�'''� / E My I The undersigned claimant hereby makes claim ainst 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) _'Lt (a Satot-ct-cecf_ l:i'i� �rn ---------------------------------------------------------------------------------- 2. Where dick the die or inj occur? (Include city and county) >\rE2 K e V< YaS� rL SlaUr�j C'A ------------------------------------------------------------------------------------ 3• How did the damage or injury occur? Give full det �i.l u e extra paper if required) Cgrov_d -Prom '-rZ:2, road at uz�r� civ pr�c Oar On y c tiQcl -�'ron+ w��nc�ShielC�, u�1d QISO CfGIC�PC� C, -- ------------------------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? t�� �zv.-� �ar �( v�i ��e �aa�' anc) � usf l-eF� 110 TawG�� IQtC� down �2��� . OJ�� ��. I,UOS 7r1ch� (over) 5. W! at are the names of county or district officers, servants or employees causing the damage or injury? ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ------------------------------------------------------------------------------------- 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 Ad ess Telephone No. Telephone No N 0 T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by 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. •"`► • „t = •^•r:^ .t:;'yo.' +- _.,•"^,.'Yr.: -wL t •`f sY,'C+'Y;^;..>,r�.. r ..-r=+v -r`+ j,f.,.gs„- • - -NATIOL _ _ ONAL GLASS 1 WO A I3ETROIT AVE — .CONCORD _. 520.. . .. _ !s) �6e5126a -- _ ,tom :.NAME - -- _.c1 ._,JOB' �- _.ADDRESS ti -CITY STATE ZIP 1 //-- �� 'p� wtrcT• to L*A cr•,x{..Y.... :DATE: THANK YOU FOR THE -OPPORTUN I TY OF B I DD I NG -THE .ABOVEAND. #iA1rEf? fSllRE .' - IN SUBMITTING OUR PROPOSAL AS .FOLLOWS: - _ .. ._ - -- - . ... »tea., _ ..�`aC<'��9 .._ 'a.� ..ver _ yam,.•_... ... _.. 'COR LY SUBMITTED' -oz.s;• FRANK BERG I _ - _•; . _ _.a, r F j= CC�ITFtAC'E ORS LIC #,-37433 _ — -- - ———— — ----- '...:.-.�,. -. .. _.,:: .. -.,.,. -„:-:.-:.w •..:.,..,:+..,,•.�;�,.:..s�.._..,..e«..>>..m.-_z.;... ..:m- ...x,k.a,., . . ••, .r....,..w.. r.:-. t..rte.=s=..�«,,:,,,..:�.,. ....,�.,._ .. .. QUOTED PRICE GOOD FOR $r ” PROPOSAL 'CONTRACT _ACCEPTED BY: ------=---------------- — .` DATE:---------------------------------- CONCORD AUTO GLASS 1759 CONCORD AVENUE • CONCbRD, CA 94520 (415)685-3674 Name Date written by Received Address �/ Promised Y r City Ins. Co. Phone Claim No. Home Phone Business Phone veer Make Model Color License Speedometer vehicle I.D.0 �' C,7 fG1�r-1 OPER. INSTRUCTIONS HOURS; .AMOUNT , �f • 3 :moo ZZ NOT RESPONSIBLE FOR ANY PERSONAL ITEMS LEFT IN CAR I hereby authorize the above repair work to be done sting with the necessary materials.You and your employees may operate the above vehicle for purposes of testing,Inspection or delivery at my risk.An express mechanic's lien Is, admowbdged on the above vehicle to secure the amount of repairs thereto.You Will not be held responsible for loss or damage to vehlcle or articles left In vehicle in ase of fire.theft,accident or any other cause beyond your control. STORAGE WILL BE CHARGED FORTY43GHT HOURS AFTER REPAIRS ARE COMPLETED, IN THE EVENT LEGAL ACTION IS NECESSARY TO ,PARTS ENFORCE THIS CONTRACT, 1 WILL PAY REASONABLE ATTORNEY'S FEES AND COURT COSTS. ;LABOR bUBLET SIGNED X TAX /y_ ►3 ,0� ' 9 TOTAL 3 Q Terms: STRICTLY CASH Unless Arrangements Made / J 3 CLAIM //Z/ 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 25 , 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: $190.45 Section 913 and 915.4. Please note all �iIj�,g$"(�pttEl� l CLAIMANT: SOCORRO MALDONADO 39 Hillcrest Avenue SEP 2 8 1988 ATTORNEY: Pittsburg, CA 94565 Martinez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON September 20 , 1988 Risk Man. BY MAIL POSTMARKED: September 16, 1988 I. FROM: Clerk of the Board of-Supervisors. TO: County Counsel Attached is a copy of the above-noted claim. Se tember 28 , 1988 PpHHIL BATCHELOR, Clerk DATED: P BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (1 ) 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: J11� Deputy County Counsel iw 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 (L/This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board2erentered in its minutes for this date. OCT 2 51988 Dated: PHIL BATCHELOR, Clerk, By puty 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 Posta 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 2 s ,Jyy BY: PHIL BATCHELOR byDeputy 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 Socorro Maldonado ) I RECIFIVEDT Against the County of Contra Costa ) or ) SEP 20198 District) PHS A Epp Fill in name ) c�-� TR F' Up- v -ORS By uty The undersigned claimant hereby makes claim ai st the County of Contra os a or the above-named District in the sum of $ and in support of this claim represents as follows: --------------------------------------------i------------------------------------ 1. When did the damage or injury occur? (Give exact date and hour) 7-12-88 Windshield was chipped in approximately 3 areas, then on 7-19-88 the wind- shield started to crack from one of the chips. It has continued to crack . ------------------------------------------------------------------------------------ 2. Where did the damage or injury occur? (Include city and county) Kirker Pass Road, Contra Costa County. - ----------------------------------------------------------------------------------- 3. How did the damage. or injury occur9 rOfQ4 ve trill��p,js; use extra paper if Ca- required) j OSi RF�C►11 Road repair in progress with loose grave on e roadway, causing it to fly as other cars passed. Road work was 8ftP pJ9p"&$ controlled for traffic flow. ------------------------------------------ - -- , � � 4. What particular act or omission on t���� y`or district officers, servants or employees caused the injury or damage? The use of flagmen or other caution methods should have been used to avoid these types cf damages. (over) 5:' Wpat aile the names of county or district officers, servants or employees causing the dairage,,or injury? Contra Costa County Road Repair/Maintenence Department. --------- ------ - 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Crack windshield, it need to be replaced as it obtructs view while driving. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) From Glass Repair estimates attached. 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 None Yet. Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by someperson on his behalf." Name and Address of Attorney Utz -mac ZClaimant's Signature) 39 Hillcrest Avenue Address Pittsburg, CA. 94565 Telephone No. Telephone No. (415) 439-5407 * * I V W V WN I V I I T * * * NOTICE Section 72 of the Penal Code provides: contra "Every person who, with intent to defraud, prese4 1�Ydq nce or for payment to anstate board or officer or to an co t , r district board or Y Y yy officer, authorized to allow or pay the same if genshl,�]agy se or fraudulent claim, bill, account, voucher, or writing, is pi.�fishable-eit�by imprisonment in the county jail for a period of not more than oA,**p h}� fine of not exceeding one thousand ($1,000), or by both such imprisonment an 'f' , f] y imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. � y �. DAN'S CONTRA COSTA GLASS MOBILE GLASS SERVICE Specializing in Auto Glass and Windshield Repair Concord Pitts./Ant. (415)827-4173 (415)754-0799 ES TIp1A TE MAZZEI PONTIAC-CADILLAC Aug. 24, 1988 ' WEST 10th ST. ANTIOCH,CA. 1986 Cadillac Eldorado Windshield W901 Sh. $380.05 65%. . . . . . . . . ... .$133.01 Tax... . . . . . . . . . . . . . . . . . . . . . ... . . . .. . . . 8.64 Labor. . . . . . . .. . .. . . . . . . . . . . . . . .. . . . .. . 35.00 Total. . . . . . . . .. . . . .. . . . . . . . . . . . - . . . . . 1 76.65 cm /Y 77 I SAFELITE AUTO GLASS A NAME DATE ADDRESS. YR.&MAKE CA INS.CO. BODY STYLE �7?CJIV06 10 � 4 AGENT ESTIMATED BY: ADDRESS ESTIMATE GOOD FOR 30 DAYS OTY. ITEM/SIZE DE RIP ON PRICE DISC. AMOUNT Don Forbes 2049 Contra Costa Blvd. 'z Pleasant Hill,CA v (415)687-7200 MERCHANDISE TOTAL SALES TAX LABOR v SUB TOTAL CUSTOMER'S SIGNATURE X LESS DEDUCT L C( TOTA CLAIM •BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Acainst the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25, 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: $190. 00 Section 913 and 915.4. Please note all (►Wi 4% sgoUns. CLAIMANT: JAIME A.RICO S r P 2 8 1988 817 Eberhardt Court ATTORNEY: Clayton, CA 94517 marunez, CA 94-b- Date received ADDRESS: BY DELIVERY TO CLERK ON September 21, 1988 BY MAIL POSTMARKED:September 20, 1988 1. FROM: Clerk of the Board of_Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: September 28 , 1988 EbIL ELOR, Clerk gATCH: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (WThis 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: BY: Dated: 1 �( /- t .fit Deputy County Counsel � r 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 DER: By unanimous vote of the Supervisors present (100 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 2 5 1988 PHIL BATCHELOR, Clerk, ByX��,_"��eputy 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 1 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 2 6 1988 BY: PHIL BATCHELOR by0��/� eputy Clerk CC: County Counsel County Administrator Clatm --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. RE: Claim By ) Reserved for Clerk's filing stamp ) RECEIVED Against the County of Contra Costa ) S E P 211988- or ) District) CLZKQ�)R AFill in name ) By ..... .. eputy The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ � �Tp ro x . and in support of this claim represents as follows: ------------7--------------7-7------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) Z�t_2 -�_L� _�.L------------------- 2. Where did the damage od injury occur? (Include city and county) "14 ao- r.L ef-A 2 S L----- 3. How did the damage or injury occur? (Give full details; use extra paper if required) 1 vJaS pra ee�edu at�U^4+w- u�.sOL-C Ua� n k-4 r ke V- Pas-S �jOt,nc�+0 V'�s i s log rr) . PI M 5 O-Q, `- e r CCLc k S*-rt�+ 0-JeaheX W e*--C_ g L� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? -The. ire-e-V Cte&rc, Sc.LjcA +-c y va2re w,4jA 44\'a Conk_. Paky-tA&VxLnex De pcl v",e�-t Wv j�Lw a 0QW Swed . (over) 5. What ire the names of county or district officers, servants or employees causing the damage or injury? 1 d4 MA- c)e'- Jae, d-rIVCY-S r)CLrne j�D n I y 4Kt C , ►tit aim,t S we�epe�► 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 a amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses ofwit�ses, doctors and hospitals. -SakLLgr--- - Luc.&-�-------A----4- 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 some on his behalf." Name and Address of Attorney ` Claimant's Signature nA . Address yt CJS c14sI'l _ Telephone No. Telephone Nbs (6� 2,- (gd y 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. DATE 19 (NAME OF PERSON QUOTE GIVEN TO or RECEIVED FROM,) To F RESS Zo JOBr"dAr<,E JOB DATE JOB LOCATION JOB PHONE ' JOB NUMBER , /pc/�g1PTI I --- ---- - � —--�- 'Com---� i DAN'S CONTRA COSTA GLASS a� MOBILE GLASS SERVICE Concord Specializing in Auto Glass and Windshield Repair Pitts./Ant. (415)827-4173 (415)754-0799 Sept. 13,1988 ESTIMATE 1983 Ford LTD Wagon Windshield - W948 Sh. . . . . . . . . . . . . . . . . . . $186.77 Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12.14 198.91 N r,& Mrs. Jack Rico 817 Eberhardt,Ct. Clayton, CA. 94517 CLAIM //14Z BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA r Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25 , 1988 and Board Action. .All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government-Code Amount: $100, 000- 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: IN SOON DOTY ETAL c/o Shawn Steel & Associates ATTORNEY: 610 S. Harvard Blvd. #200 Los Angeles , CA 90005 Date received ADDRESS: BY DELIVERY TO CLERK ON September 29 , 1988 BY MAIL POSTMARKED: September 27 , 1988 Certified P 478 327 361 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL BATCHELOR, Clerk DATED: September 29, 1988 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (✓f 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: 7 2 Q Dated: BY; I 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. BOARDD ORDER: By unanimous vote of the Supervisors present (V) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's rder entered in its minutes for this date. Dated: OCT 2 5 1988 PHIL BATCHELOR, Clerk, By �Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated:— OCT 2 6 1988 BY: PHIL BATCHELOR by �ep`uty Clerk CC: County Counsel County Administrator 1 SHAWN STEEL & ASSOCIATES i A Professional Corporation 2 610 S. Harvard Blvd. , Suite 200 RECIAVED Los .Angeles, CA 90005 3 SEP 291988. 4 (213) 739-9000 ' P B EIOR ` CL K B P SGRS t ,T Attorneys for Claimants . .. ,vuty_; 5 IN SOON DOTY and SOO NAM LEE By 6 CLAIM AGAINST THE -COUNTY OF CONTRA COSTA and CITY OF CONCORD PURSUANT TO GOVERNMENT CODE SECTION 910 8 TO THE COUNTY OF CONTRA COSTA and CITY OF CONCORD 9 The undersigned respectively submits the following claim and information currently available relative to persons and/or 10 personal property: 11 1. Section 910 (a) : 12 a. Name of Claimants: In Soon Doty and Soo Nam Lee; b. Address of Claimants: Doty: 1009 Claremont Dr. , 13 Concord, CA 94518 ; Lee: 4455 Melody Dr. , #108 , Concord, CA 94518; 14 2 . Section 910 (b) : 15 a. Address for notification and information concerning this claim: Shawn Steel & Associates, A. P.L.C. , 610 S. Harvard 16 Blvd. , Suite 200, Los Angeles, CA 90005, (213) 739-9000. 17 3 . Section 910 (c) : 18 a. Date of Occurence: July 18 , 1988 ; b. Circumstances of Occurence: On said date, at 19 approximately 5: 30 p.m. , while Claimants were carefully negotiating a turn at the intersection of Monument Blvd. and 20 Cowell Rd. , Concord, they were broadsided by another vehicle that failed to stop for signal lights which were out due to the 21 negligence of the county of Contra Costa and city of Concord. 22 4 . Section 910 (d) : 23 The Claimants suffered personal injuries, the full extent of which is not known at this time. 24 The Claimmants also suffered property damages, of which the estimates have not been prepared at this time. 25 5. Section 910 (e) : 26 The County of Contra Costa and the city of Concord are 27 liable for Claimants ' injury. 2$ 6. Section 910 (f) : -1- I The amount of damages sustained by Cl mants will be in 2 excess of $100, 000. 00. ,These damages are or personal injuries, medical bills, pain and suffering, prope y damages, and loss of 3 earnings. The Superior Court o California will have Jurisdiction over this mattei,. /- 4 r- 5 Date: September 24 , 1988 SN EEL S S, A.P.L.C. 6 - B awri�zSteel, Esc 8 L- 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -2- State of California 1 County of Los Angeles 2 Shawn Steel & Associates, A.P.L.C. 610 S. Harvard Blvd. , Suite 200 3 Los Angeles, CA 90005 4 (213) 739-9000 5 PROOF OF SERVICE BY MAIL 6 I, DERRICK NGUYEN, am a citizen of the United States, a 7 resident of the county of Los Angeles, state of California, over 8 the age of eighteen years, and not a party to the within action. 9 I am employed in Los Angeles County at 610 South Harvard 10 Boulevard, Suite 200, Los Angeles, California 90005. 11 on the below date, I served the following documents: CLAIM 12 AGAINST THE COUNTY OF CONTRA COSTA AND THE CITY OF CONCORD on the 13 parties in this action by placing a true copy thereof in an 14 envelope with postage fully prepaid, in the United States mail at 15 Los Angeles, California, addressed as follows: 16 Board of Supervisors County of Contra Costa 17 651 Pine Street, Rm. 106 Martinez, CA 94553 18 Concord City Clerk 19 1950 Parkside Dr. Concord, CA 94519 20 I declare under penalty of perjury that the foregoing is 21 rue and correct. 22 Executed on 09/26/88, at Los Angeles, California. 23 24 25 DERRICK NGUYEN Law Clerk 26 27 28 -1- CLAIM BOARD OF KSUPERMORS 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 25 , 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: $68. 95 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MARIO E. ALVARADO 1----ur•ty Counsel 942 Meadowvale Court ATTORNEY: Martinez, CA 94553 5! P 2 v 1988 Date received ADDRESS: BY DELIVERY TO CLERK ON SeptemberT;r"f8 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. September 28 , 1988 PpHHIL DATCHyELOR, Clerk DATED: epu L. Hall II. FROM:: County Counsel TO: Clerk of the Board of Supervisors ( [/j 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: �- `�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. BOY) This DER: By unanimous vote of the Supervisors present ( Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. / Dated: OCT 2 5 1988 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order an Notice to Claimant, addressed to the claimant as shown above. ;;ATRO. OCT 2 6 1988 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator ^�t.A3M TO: BOARD OF SUPERVISORS OF CONTRA COSATe ly a ur i application to: " . 4 Instructions to Claimant Clerk of the Board i P.O.Box 911 A. Claims- 'relating to causes of action for death or zorninjurynr►o�533 ` person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors, rather tharn_the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims,_ Penal Code Sec. 72 at end of this form. ` :RE: Claim by ) Reserved for Clerk' s filing stamps Against the COUNTY OF CONTRA COSTA) (' SEP 2 7198.8. or ATZ Ve}eja) -bGCJi DISTRICT) (Fill in name)" CLE K P Aqd ELOR - - The undersigned claimant hereby makes claim a o Contra Costa or the above-named District in the sum of $ pucy ;and inn support of this claim represents as follows : ---------------—-------------- ------------------------------------------------------------------ ---------------- 1. When did the damage or injury occur? Give exact date and hour) L1 . Gov-�?yy,��� o:7 a - r zoo 2. Where did the damag or -injury occur? (Include-city-and county)- - 3. How did-the damage or injury-occur?- (Give full-detail , use extra--. sheets if required) Np6 541;(W� phf� sacks s1 4 . What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? ole (over) - fes..:.►• What: ar.e..t#�e...:names of cvovinty 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 foruto damage) -_ / or�__ e l �j cf�i� SGS e� C �S S�c�JP 2UD ------------------------------------------------------------------------ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) 'c7o. A. dame- T�t5-� 1sYJa _______________ 8. names and addresses of witnesses, doctors and hospitals. ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMTOUNT Govt. Code Sec. 910. 2 provides : "The claim signed by the claiman4 SEND, NOTICES TO: (Attorney) or by some oerson on his b half. ' Name and 'Address of Attorney Claima is Signatu_ Address Telephone No. Telephone No. i NOTICE Section 72 of the Penal Code provides: "Every .person who, with intent to defraud, presents for allowance or for payment to any state board or officer , or• to any county, town, city district, ward or village .board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher. or writing, is guilty of a felony. " . .... ... -:. . -.,:+v+-.:.....•-1.L.•.+�o�.ru''4.,rm.:-a:�:.a-. .,.��•............ ..... _:..,...-..:L�..a. wJe...r rFiai./I.�:tili6ifZ+asep Yf-�F'"=`= � -- 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 25 , 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: $243. 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: RANDY SCHNiIDT 4404 Sugarland Court ATTORNEY: Concord, CA 94521 Date received ADDRESS: BY DELIVERY TO CLERK ON September 29 , 1988 BY MAIL POSTMARKED: September 28 , 1988 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 29 , 1988 PpHHIL ATCHELOR, Clerk DATED: P BY: Deputy L. Hall II. FROM:. County Counsel TO: Clerk of the Board of 'Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: / r �1 BY: � i� �� / Deputy County Counsel II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 5 1988 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: O C T 2 'JB B BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator at . , Chaim-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 +�ah� SCAw, J t ) L/'-/0qs�. ����� �f cv�[o•cQ c ) RECEIVED Against the County of Contra Costa ) or ) EP 2 9 1988. District) Fill in name ) CLER PNS OR e uty The undersigned claimant hereby makes claim against th B . or the above-named District in the sum of $ ____?_y 3 � 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) Cr On K%-,ke, A s.$ 6.54 04 5 �2 CT �NS lci ------------------------ --------------------------ep"-- -----------------------�---- 3. How did the damage or injury occur? (Give full details; use extra paper if required) lar,v at P.Q.=� _5�P= 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? fcas h)IA snh.,e (.4 45dkld� WiAv,L � U�Pn't1 S e ct c�•�. ,e 1 �n G y ,Ji. (over) w, 5. What are the names of county or district officers, servants or employees causing the damage or injury? lis 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.) /Uss 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 2erson on his behalf." Name and Address of Attorney v (C9laimant's Signature 6/90 / nn /d�dress �a Co h W rCX; `{t t tt5 Z I Telephone No. Telephone No. y 3 2 —S-0 3 9 * * * * * V V 9 W V V I V W * * * * * * * * 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 ($10,000, or by both such imprisonment and fine. • EW BAY CITIES GLASS UbbW-Owens-Ford Co. Glass Centers Q, Date Subject aj"A-ifle-L.) ii ANTIOCH BERKELEY COf:CORD UPERTUIO OUBLHI FAEMONT FUIYWARO NO. 77"BOO 644.1111 685-8400 18825 So.2B0.1899 8293722 791.2929 782.5753 Mobile Mobile 1555 Galindo StmeI Tama u Mobile 57276 Maple St. 20525 Mission BIM. HAYWARD SO. UVERMORE PALO ALTO RICHMOND SAN FRANCISCO SAN JOSE 8818888 449-6200 1 452-5010 424-8200 529-1991 857-5959 281-1112 Mobile Mobile 2412 Broadway 3875 EI Camino Real 12826 San Peblo 35 Fell S1. 463 Blossom Hili SAN JOSE SAN MATED SAN RAFAEL SAN RAMON WALNUT CREEK 296-2411 343-5700 1 485-1230 1 836-8104 944-0112 350 So.Kiely BNd. 525 East 4tb Ave. Mobile 15 Bela Cl. 2012 N.Mein St. Toil Free 800-972-0908 7T. WIN 3�`msrfl�> Rte' Wl?c+xr r _ Ir � N A NATIONAL GLASS :,-.4090-A ZETRO I T-AVEwt d CONCORDA 19 4520 . _ �, .... : _ r x aww..ry, s..S•N1c. -%.�»c "3s.'r.+[t'"a ak'�rw'Nt�,e kfi„u» �tais� was Saba rr • :-,ADDR Ot404 •�83 _Ess :. , CITY STATE UM(-f,,Il ��1P - Y PHONGE ��- - DATE! ?THANK�XOU ;FOR THE mtIPRORTUNITY OF BIDDING THE -ABOVE. AND HAVE IN SUBMITTING .OUR -PROPOSAL -AS •FOLLOWS. C{,J 4 w� 3 T r C9 0 0Lobo Y Y 27 + # , bA,..'G'-.c$r_T......c-r-'s:.,. . ;,..,.,. .: ... ... _.„..:. .,.-,,.,..i •.ns:..:,..J-,::. ._ ._.yv. -.,^ - ,_ _ , :r.,.,,..- .K,-K-- r..F. ':m�,is':Tee'v:......_s�niir.:k+.:.:. . _ 9 m x • CORDIALLY,.SUBMITTED :FRANK; SERG I _ C Ate. ONTRAC't'ORS =LIC _ 1 .au.fi„ 't...?}3rk" i .. "'r5J* --. _.• :+'f:"'4.r. e - -�" . v >rxe ---rw.'c•m.x.+�r-rs,nm+.,...:-...r:�_... ,an.t...r.-w , .-i,.-.,. .. +...,-.*ura•-zn-.•- v.n._.. _�.v-,.s,n mei .. sn r. _vim sao- ,tea... •.. �, »+wv-r..w..ww,w w�._:.:'«st-:__.:rtw-.+. a...,:)+-.+�ti:.+-.+erfe�3i-h-...':wsr,:"..sr.:.,.....r n.:'«n..-.s .u.�`•,.ws.:hx�`".e"+ rX.�+w*t',}..,?iaLlL".•m-".-•i..:,u'." "QUOTED "PRICE"°"GOOD `FOR PROPOSAL .CONTRACT =ACCEPTED BY: _ DATE:---------------------------'------- _4 CLAIM ///4Z BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the 'oard of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25, 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: $1,450. 0 0 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ARNEL CANGEO RIBANO 1453 Serpentine Court ATTORNEY: Vallejo, CA 94589 Date received September 29, 1988 trans . ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel 'Attached is a copy of the above-noted claim. DATED: September 29 , 1988 PpHHIL ATCHELOR; Clerk BY: Deputy L. Hall I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. (✓) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: 17 Dated: G BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County. Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (/This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 5 1988 PHIL BATCHELOR, Clerk, By, �GL� 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 2 6 1988 BY: PHIL BATCHELOR by L-E- puty Clerk CC: County Counsel County Administrator ""^LAIM TO: BOARD OF SUPERVISORS OF CONTRA CO�TAt �g I� f.- a ur i apptloatlan 10: Instructions to Claimant Clerk of the Board P.O.Box 911 A. Claims: relating to causes of action for death or torn injury-o�533 ` person or to personal property -or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106 , County Administration Building, 651 Pine Street, Martinez, California 94553. C. If claim is against a district governed by the Board of Supervisors, rather than -the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims - must be filed against each public entity. E. Fraud. See penalty for fraudulent claims,, Penal Code Sec. 72 at end of this form. RE: Claim by ) Reserve" -,�, RECEIVED S E P 2 9198.8_. Agai s COUNTY OF CONTRA �COSTA) CLE B 8 TF f;c'LOR � or /�io�. g r/A1G 4 DISTRICT) o ISORS (Fill inn e) ) ey Bpub - The undersigned claimant hereby makes claim againsthe County of Contra Costa or the above-named District in the sum of $ d . and i!n support of this claim represents as follow-?: / / . 1. When di t agor in ur---occur? Give exact date and hour) 2. Whe id the d ge or injury cur? - (In ude cit 'Ind county) ��.�._ZJo ------------------------------------------------------------------------ How did the damage or injury occur? (Give full details, use extra sheets if required) 4 -What particular act or omission on the part of county or-district officers , servants or employees caused the injury or damage? (over) ••w� '- n..ee... - '.. .�41a.isYr.'inb:w.•µ .s..r'r....r`.f..• .w -r4L.YFr.. -' 'Yir SiiiiA'♦�Y(i.�l�i�1.�',s 1314�.•`iiii�•' - - `` 5..,0 What: are.,the...names of county or district officers, servants or W1.' '�eMp oy`ee�s Icausing the damage or injury? .r - 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) , J r--——r——r----——--—r--—-----------—------———r—--———--------——------------— 7. How was the amount claimed above computed? (I.nclude the a timated amount of any prospective injury or damage. ) T -------------------------------------------------------------------------- 8. Names and ' -d- sses of witnesses , doctors and hospitals. 9. .1 st--the EXpend"i"tures you made on account of this accident or injury: :FATE ITEM I . AMOUNT Govt. Code Sec. 910.2 provides : "The claim signed by the claiman- SEND) NOTICES TO: .(Attorney) or by some person on his behalf. ' Name and 'Address of Attorney Claimant' s Signature "4 Address - Telephone No. Telephone No. i NOTICE Section 72 of the Penal Code provides: - "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or. to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " .�..-..... .. -..ti.r..,.�...Asa.-+.w:aw..u_hew...a::.�:w �<.a.'.,._c _..�.._.t..._....A..:...i, .w.%rr..+:. r.�i+.�r.dY'ide/.�irdWsyi�j:�''`�'. — •_ CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim r'gain,t the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 25 , ,1988 and Bo,drd Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $100, 000. 00 Section 913 and 915.4. Please note all Cftint�@sfounspel CLAIMANT: RONALD PAUL KRULETZ 133 Roxanne Court Apt . 2 SE1988 ATTORNEY:Walnut Creek, CA 94596 [Martinez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON September 27 . 1988 hand del . BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of_Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHHIL BATCHELOR, Clerk DATED: September 28 , 1988 putX L. Hall 1I. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ({This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: L( 7 Gl BY:u �' f Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD DER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 0 C T 2 5 198$ 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 2 6 198p BY: PHIL BATCHELOR by ` Deputy Clerk CC: County Counsel County Administrator Claim too: 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 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 §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 orm. RE: Claim By ) Reserved for Clr 's filin tamp RECEIVED Against thA County of Contra Costa ) or ) SrP 2719W PHIL 8ATCHELOn District) CLERK BOARD Fill in ) �°,c9f �' � � 6y Deputy The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 1\©f ) b c9 O 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) C_�--------------------------------------------�- 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 '&7e the names of county or district officers, servants or employees causing the damage or injury? 1 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 ahy prospective injury or damage.) V\1 O`� 8. Names 11and 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 vl�- \ Claimant's ignature r-,-i ri AA WA qDi 2, (Add ress n:LA 0-5Z Q�� Telephone No. Telephone No. '{� t -2- NOTICE 2NOTICE 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. Second Amended Claim APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT October 25 , 1988 Against the County, Routing ) The copy of this document mailed to you is your E;ndorsements, 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 NWARNING" below. Claimant: RALPH FLORES HERNANDEZ County Counsel c/o P. O. Box 8251 1988 Attorney: Pittsburg, CA 94565 SEP 2 8 Address: Martinez, CA 94553 Amount: $10, 000. 00 By delivery to Clerk on September 26, 1988 hand de. Date Received: September 26 , 1988 By mail, postmarked on no envelope I. FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above noted Application toil Lat Claim. September 28, 1988 DATED: PHIL 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). (V ) The Board should deny this Application to File Late.Cla' tion 11.6). DATED: �I � VICTOR WESTMAN, County Counsel, By 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 2 5 1988 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code 5911.8) If you wish to file a court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of any attorney of your choice in connection with this matter. If you want to consult an attorney, u should do so immediately, IV. FROM: Clerk of the Board T0: 1 County Counsel 2 County Administrator Attached are copies of the above Application. We notifed the applicant of the Boards 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 2 6 1988 PHIL BATCHELOR, Clerk, By eputy V. FROM: 1 County Counsel 2 County Administrator TO: 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 I APPLICATION FOR L1 AYE TO PRESENT SECM ENDED MLA I M AGA I NST Imo' JBL I G .ENT 1 T I ES 2 (Gov. Code. §900 et seq. ) 3 RALPH FLORES HERNANDEZ, 4 Applicant, F I L E 5 V. SEP 2 6 1988 6 COUNTY OF CONTRA COSTA, CITY OF ANTI OCH, PHIL BATCHELOR and DOES 1-Z, CLERK B BOARD OFST P RMOI.S AC P Claimees. ----------------------------------------- 8 9 Application is hereby made for leave to present the 10 attached Second Amended Claim Against Public Entities on account 11 of the following stated reasons (Gov. Code, §911 . 4 . ) , to wit : 12 1 . The original claim, filed on April 21 , 1988 , was timely. 13 (Gov. Code, §911 . 4 . ) It was also acted upon its merits by 14 another Claimee, the City of Pittsburg. 15 2- No final action thereon or on the First Amended Claim 16 Against Public Entities filed on August 24 , 1988, has been taken 17 by either of the two Claimees named above, and the latter claim 18 as amended relates to the same occurrence which gave rise to the 19 original claim. (Gov. Code. §910.6(a) . ) 20 Both such claims as presented complied substantially 21 with Sections 910 and 910 . 2 . (Gov. Code. 8910.6(b) . ) The first 22 was acted upon its merits by another Claimee, the City of 23 Pittsburg. The second has yet to be acted upon by Claimee-the 24 City of Antioch. 25 Both the original claim and the proposed Second Anended 26 Claim Against Public Entities attached to this application 27 include a claim for equitable indemnity and for paftial 28 - 1 - 1 equitable indemnity against public entities. (Gov. Code, §901 . ) 2 S. The failure to present the claim, if: there was such a 3 failure, was through mistake, inadvertance,, surprise or 4 excusable neglect and the public entities will not' be prejudiced 5 in their defense of the claim by failure to present the claim 6 within the time specified in Section 911 . 2, if there was such a 7 failure. (Gov. Code, §946 .,6 . ) 8 6. To grant this application for leave to present the 9 attached Second Amended Claim Against Public Entities would 10 further the interests of justice and its administration by 11 dispensing right now of any future need to petition the court 12 for its order of relief from the provisions of Section 945 . 4 . 13 (Gov. Code, §946 . 6; see also Downing and Tehin, Constitutional 14 Infirmity of the California Government Claim Statute, ( 1974 ) 1 15 Pepperdine L.Rev. 209. ) 16 i 17 Dated: _ 2 i 9 x: R H ORES HERNA 18 ppl ant 19 20 21 22 23 24 25 26 27 28 1 U'COND AMMED CLA I AGA I NSA' PUBLLC ENT I T�-S (Gov. Code, 6900 et seq. ) 2 RALPH FLORES HERNANDEZ, 3 Claimant, 4 V. 5 COUNTY OF CONTRA COSTA, CITY OF ANTIOCH, 6 and DOES i-Z, 7 --------------------------------Claimees_ 8 (a ) The name and address of the Claimant is RALPH FLORES 9 HERNANDEZ. 163 Panoramic Ave. . Pittsburg, California, 94565 . 10 (b) The post office address to which the person presenting 11 this claim desires notices to be sent :is RALPH FLORES HERNANDEZ, 12 c/o P.O. Box 8251 , Pittsburg, California, 94565 . 13 (c) The date and place of the occurrence giving rise to the 14 assertion of this claim are Tuesday , January ' 12 , 1988, at 15 approximately 7 :30 a.m. at Pittsburg/Antioch Highway and at its 16 intersection at Arcy Lane. 17 The circumstances of the same are such that this stretcy of 18 highway. bordered ori the west by Loveridge Road in Pittsburg and 19 on the: east by Somersviile Road in Antioch, lies within the 20 jurisdictions of both the City of Antioch and the County of 21 Contra Costa, and may very well fall within the sprawling 22 jurisdiction of the City of Pittsburg at its so-called A.D. 23 See-no "Baker Property." 24 Hence, Claimees, its officials , employees and agents, and 25 each of them, are the public entities responsible for 26 maintaining, improving and regulating that stretch of the 27 Pittsbur?/Antioch Highway. 28 - 1 - 1 The Pittsburg/Antioch Highway pre-dates the 'former Camp 2 Stoneman Army Base and served as the major transportation artery 3 for East Contra Costa County prior to the post-war construction 4 of Highway 4 . 5 Only within the last few years was Arcy Lane constructed 6 and connected with the Pittsburg/Antioch Highway. Yet at this 7 new, 90 degree intersection, there are no turn lanes; no stop 8 signs, no stop lights; no flashing lights nor other forms of 9 adequate warnings to slow down or to beware of vehicles entering 10 and exiting at that intersection; the two highway lanes are not 11 of even width but both are too narrow and lack proper shoulders; 12 there are no concrete barriers or other dividers to separate the 13 two lanes; the paving is poor ; the grading is grave; and the 14 posted maximum speed limit of 50 miles per hour of the two lade 15 thouroughfare where it passes Arcy Lane is much too high. 16 To exacerbate these dangerous conditions affecting newly 17 constructed Arcy Lane, there was also at the time of the 18 occurrence in question, as well as now, excessive traversing of 19 vehicles on Pittsburg/Antioch Highway due to tho explosive 20 increase in the area's housing, commercial and industrial 21 development, resident population, and local , business and 22 commuter traffic. 23 Because of these striking changes in circumstances 24 impacting upon old Pittsburg/Antioch Highway, any reasonable 25 person would rightly expect that the responsible public entities 26 would and should have acted to correct those defective roadway 27 and intersection conditions to ensure the safety of the public. 28 -2- t 1 For example, ghat the Arcy Lane intersection really needs 2 is to be regulated by turn lanes and tri-lane stop lights, just 3 like a mile up the road at USS-POSCO in Pittsburg, which 4 electronically regulated intersection has been in effect for 5 scores of years, which fact wipes out any argument to the 6 contrary that such regulation is necessary and feasible just 7 down the road at Arcy Lane. 8 Or the Arcy Lane intersection needs to be regulated by a 9 left turn lane and tri- stop signs just like a mile or so down 10 the road at Meadows Avenue and Buchanan Road in Pittsburg. 11 Or the Arcy Lane intersection needs flashing lights or 12 other forms of adequate warnings to slow down or to beware of 13 vehicles entering and exiting at that place; the two highway 14 lanes need to be made of even width and made more wide with 15 proper shoulders; or concrete barriers or other dividers to 16 separate those two lanes neea to be erected; the roadway needs 17 to be regaved and regraded; and the posted maximum speed limit 18 of 50 miles per hour of the two lane thoroughfare where it 19 passes Arcy Lane needs to be lowered to 35 miles per hour . 20 However , notwithstanding these marked, adverse changes in 21 circumstances concerning that roadway and intersection . Claimees 22 failed to carry out not one of these acts of reasonable 23 maintenance, improvements or regulations in spite of their 24 actual and constructive knowledge that by neglecting to do so 25 would pose a. foreseeable risk of a traffic collision. 26 Furthermore, it is directly and proximately because of this 27 omission by Claimees to perform these reasonable acts of 28 -3- 1 maintenance, improvements and regulations that on the above 2 date. time and place an automobile accident occurred. (See State 3 of California, CHP Traffic Collision Report. No. .AT-88-0051 4 (Officer M. Truitt , Badge No. 49 , CHP Martinez Office, 5001 Blum 5 Road, Martinez, California, 94553. ) , which governmental record 6 is incorporated by reference herein as though fully set forth. ) 7 And this report names the involvement of the following four 8 individuals . to wit : 9 1 ) Daniel William Bickar 1540 Lipton Street 10 Antioch, CA 94509, 11 2 ) Robert Eugene Roman 1928 Birch Avenue 12 Antioch, CA 94509 , 13 3 ) Helen Marie Morrison 109 School Street 14 Pittsburg, CA 94565, and 15 4 ) RALPH FLORES HERNANDEZ Claimant 16 163 Panoramic Avenue Pittsburg. CA 94565 . 17 18 (d) Personal injury for negligence, emotional distress, 19 pain and suffering, equitable indemnity and partial equitable 20 indemnity. wages, costs and attorneys ' fees--these compensable 21 causes of action can be said to be a general description of the 22 indebtedness , obligation, injury damage or loss incurred by 23 Claimant so far as it is known at the time of presentation of 24 this claim. 25 (e) The name or names of the public employee or employees 26 causing the injury, damage, or loss are not actually known by 27 the Claimant other than to assert that they are past and present 28 -4- 1 members of the Board of Supervisors of the County of Contra 2 Costa and the Mayor and Council members of the City of Antioch 3 on down through the respective chains of co"and. 4 (f) The amount claimed as of the date of presentation of 5 the claim, including the estimated amount of any prospective 6 injury, damage or loss , insofar as it may be known at the time 7 of presentation of the claim, together with the basis of 8 computation of the amount claimed, exceeds ten thousand dollars 9 (5101000 ) , so no dollar amount is included: however , 10 jurisdiction over the claim would rest in superior court. 11 12 Dated: R P I.ORF RNAND Z 13 C 1 an t 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28