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HomeMy WebLinkAboutMINUTES - 11011988 - 1.18 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, j NOTICE TO CLAIMANT November 1, 1988 an21 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: $791. 24 Section 913 and 915.4. Please note all "Warni s" CLAIMANT- MARION, James and MaryAnn bounty Counsel 1031 Sparrow Lane OCT 1. 0 1988 ATTORNEY: Fairfield, CA 94533 Date received Martinez, CA 8455 ADDRESS: BY DELIVERY TO CLERK ON October 7 , 1988 BY MAIL POSTMARKED: October 5 , 1988 I., FROM: Clerk of the Board of Supervisors TO: -County Counsel. Attached is a copy of the above-noted claim. October 10 , 1988 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy 9, EE22�' J. Bos�rge II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY: JjIJDeputy County Counsel 0149t 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 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. �I Dated: NOV O r`� 1 19M 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 _4 St:tes, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. N,-3V 3 1,001 BY: PHIL BATCHELOR by Clerk CC: County Counsel County Administrator Cia`n` 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�f in --stamp 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) 4LJ,C,S, 2 21/ i 'i W� ---------------------------------------------------- 2. Where .did the damage or injury occur? (Include city and county) ,r - Con-�1 /A/J3 IV All �rnJ_A._ -------------- -------- -------- ---_/ ------------------------------------------ 3. How did the damage or injury occur? (Give full details; use extra paper j�*f required) 1 .e iti' C�3sty/�,c; lv�r Z, (,,Z n4 A k gC� Cady ,4aelf's Gf � her�itrdC � , � . L,,�re c�Cllt .ersel /y �'ucs11� �r�(�ec C 'rue;e — --------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants !{or employees caused the injury or damage? `J,�jj� UL/L([�ea Cit Lam= �0 O S /ci G P. v (over) A 7; kMt 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. f --------- - ---------------------------------------------------------- 7. ----- ---- - - ------ 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 someperson on his behalf." Name and Address of Attorney ' � �l��C�lGE7✓ , ' Claimant's Si ure Addre X07 P�27 1/95 Telephone No. Telephone No. yis z.`iel6d -ti-- �/5 2j" a1,1 a Sis s 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 bylmprisonment 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 ($10,000, or by both such imprisonment and fine. Dram' a Report A07691 NAME DATE ORK E h-787-21V HOMEPHONE H 7� ADDRE/.S�S�'/�� CITY STATE P YEARyW MAKE M EL D.NO. PAINT COD ROD.DATE 0 v'TRIM MILEAGE LICENSE NO. •^+�, GATE OF LOSS WRITTEN BY INS.CO. FILE NO. CLAIM NO. P.O.NO. ADJUSTER LIC.NO.- - PHONE Deductible/Betterment - Line Re Re DETAIL$OF REPAIR ` No. pair place N=NEW U=MUSED =R--REPAIR S=S IGHTEN RIC RECYCLE I RECHROME/RECORE PARTS LABOR `'._PA1N? Sl3BLETIMISC 1 �l� + - 3' 5 611-Ade -1a Ant _ 7 " 'r 8 9 10 11 12 13 14 15 16 17 18 19 20i 21 '' 22 23 24 25 26 _ 27 28: I hereby authorize the above work and acknowledge receipt of copy. TOTALS Sighed X Date PARTS Prices subject to ' VOICe $ �y�• lC— LABOR�iShrs.w_ $ .�-L.�&-3 Shopu plies $ PAINT hrs.@ �� $ ��, 00 WATSON AUTO BODY & FIBERGUM Paint Supplies e 18-0.0 $ - 2.2v Towing/Storage OW-01— $ 515 CQ SublettMiscellaneous $ W , CB��f+of ft 94M EPA/Waste Disposal Charge $ Phone (707) 427.2417 or (707) 425- 674 $ BAR OAD109270 SUB TOTAL $ $ TAX . ...ley .... .. $ L��i� TOTAL $ Z& 7a +,1988 Form No.1006 I/DIE/A inc.,One I/D/E/A Way,Caldwell,ID 83605-6902•CALL TOLL FREE 1.800-635-9261 CLAIM �.. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the. Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 1, 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: $188 . 28 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: CAIN, Denise S. County Counsel 3302 Andrade St. OCT 10 1988 ATTORNEY: Richmond, CA 94806 Date received 6M8t$ , CA 94553 ADDRESS: BY DELIVERY TO CLERK ON October 1 BY MAIL POSTMARKED: October 5 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 10 , 1988 PpHNIL ATCHELOR, Clerk DATED: BY: Deputy J sarge Il. 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 t 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: 0 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: Nov 1 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. hated: N O V 3 1988 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator OCTOBER 4, 1988 TO WHOM IT MAY CONCERN: I HAVE COMPLETED THE ATTACHED FORM TO THE BEST OF MY KNOWLEDGE. SINCE I DON'T KNOW WHO IS RESPONSIBLE FOR THE DAMAGE, I HAVE LEFT MANY AREAS BLANK. I HAVE ENCLOSED ESTIMATES FOR A NEW WINDSHIELD. I DID NO INCLUDE ESTIMATES FOR NEW PAINT FOR THE HOOD OF MY TRUCK. I HAVE NOT BEEN ABLE TO GET TO A BODY/PAINT SHOP THAT DOES THAT KIND OF WORK, AS THEY ARE CLOSED DURING MY AVAILABLE HOURS. I HOPE m0 OBTAIN AN ESTIMATE BEFORE THE 100 DAY GRACE PERIOD EXPIRES AS INDICATD ON THE ENCLOSED CLAIM FORM. PLEASE ADVISE ME AS SOON AS POSSIBLE IF I NEED TO COMPLETE ANY FURTHER FORMS. SINCERELY, DENISE CAIN 3302 ANDRADE ST. RICHMOND, CA. 94706 DAYS: 945-3711 (AREA CODE 415) EVES: 235-4513 BAY CITIES GLASS abbey-Owens-r-ord Co. — Glass Centers t o fl Date ' Subject <7(SqAUTO HOME - MIRRORS PLATE " waCKsttt act Cflaad 2042N. Main Street • Walnut Creek, California Phone 935-5340 !RD CUPERTINO DUBLIN FREMONT HAYWARD NO. w0 280-1899 So.Tan 829-3722 791.29le 782-5753 0 Street 10025 So.Tanta Mobile 37276 Maple St. 20525 Mission Blvd. I I D ND PALO ALTO RICHMOND SAN FRANCISCO SAN JOSE 7Qr O10424-8200 529-1991 957-5959 281-1112 Manly 5676 d Camino Real 12626 San Pablo $L 463 Blossom HIII E0 SAN RAFAEL SAN RAMON WALNUT CREEK 00 1 485-1230 838.8104 944-0112 O� rAve. Mobile 15 Beta LY. 2012 N.Main St. �- Toll Free 800-972-0908 413. ad ins 2. 8 6x rgs . ag z y 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 on 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 toycauses 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 ?0—M. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against the Co my of Contra Costa O C (� 1988 District) rH«BATCHELOR C CO A CUS -i ISORS Fill in name ) s The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ J!F ;, cR?) and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) t (c rCsckkAu-�� rn d s h k e_toQ3 104- " ( ------- 2. Where did the damage or injury occur? (Include city and county) __--S t�►J_P�a o___l�_c�n�_ c� _ n_ v LLL LLQg u ---------- 3. How did the damage or injury occur?(( (Give full details; use extra paper if required) �� oJ,�pv�leo� roo o` ail trC�q�@ rnd� t n 5 in 044-\ dcu�S -�in,--i e A a, k o ve.) 1�aw�� wc�5 bean - - ----u p i-oyr-� o�f�� r cars 0- -t� cc r '( e.h, pVQc� �n --------- --J---- --------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? lac:oSQ c�rc�,'-C-1 60e-�, cta- ca �q_-) p& n C�Ockp_d Lvm8skite ( d , (41�i nvnjPro05 (UnCLUn ( c� bl�� pctii n+ �h ipS clams Se_c� on h c)ocl� �3q 06 rmQJ • (over) What are the names of county or district officers, servants or employees causing the damage or injury? - • —_—N_----------_ _—__NN_N—N_—N—N--_MN--_—N_..__—__N.._—__ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. mnk 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) � n -•-----------------------------------NN--------NN--------------------------------- $. 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 g0: (Attorney) or by some person on his behalf." Name and Address of Attorney_. w+ry, ...W:: +wo M>N'.• •ewrr vr.y.y>-. / /L.1/u/�i\✓ �/`.it/(r'�J Claimant's Signature /— (Address) Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. 1 ' CLAIM I-If BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Agair'ist the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 1, 1988 and Buard 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: $350, 00 Section 913 and 915.4. Please note all "WarniWO-nty Counsel CLAIMANT: SCOTT, Marilyn - 617 Major Vista Ct . 1_)C 1 n 1988 ATTORNEY: Pinole, CA 94564 Date received Martinez, CA 94553 ADDRESS: BY DELIVERY TO CLERK ON October 6, 1988 BY MAIL POSTMARKED: October 5 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pHIL BATCHELOR, Clerk DATED: netnbPr 10 , 1988 BY: Deputy Bos'axfe 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: I C 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. 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. NOV 1 1988 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. /f Oatod- Nov 3 1988 BY: PHIL BATCHELOR by C �C�ty 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 310 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 i f Against the County of Contra Costa or ) District) _ Fill in name »vl The undersigned claimant hereby makes claim agaipst 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� ti Cqc 410 Pik - 2. Where did the damage or injury occur? (Include city and county) , owl ----------------------------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) z4v- Arm -e � I G� c� 4. =What tieul act or omis on on lithe t of count or district�rs Paz" Paz' Y ,,,�/ -- servants or employees caused the injury or damage. �- (over) ''S. , What are the names of county or district officers, servants or employees causl-ng- ' the damage or injury? G' 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. f 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ------------------ ----- - - ---------- 8. -----8. Names and addresses of witnesses, doctors and hospitals. IV/A 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney C imant's Si ture A ess Telephone No. Telephone No. '/ / Z7Z 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. BANDUCCI GLASS COMPANY Frank Banduccl ,t AUTO * SENIOR CITIZEN DISCOUNT Dave Merkel Owner * RESIDENTIAL * MOBILE SERVICE Manager it AUTO GLASS TINTING * MIRRORS * FREE ESTIMATES q�1 (415) 233-4104 l G AC( o �i - C> rz y .. L \ 55 6 b t—a►�G C, ► 0. y Ct Q � Jodi 125001/2 San Pablo Avenue 4216 CLINTON AVE. Richmond, CA 94805 RICHMOND, CA 94805 SAT. 9:00 a.m.-1:00 P.M. Windshields �Sun Roofs Mobile Auto Glass 1-800.772.4043 t o ceD /Y PLEASANT HILL SAN RAFAEL FREMONT 2049 CONTRA COSTA BLVD. MOBILE SERVICE 37473 GLENMOOR DR. 687.7200 457-4020 7975020 SAN FRANCISCO SAN JOSE OAKLAND HAYWARD SAN CARLOS 1488 HOWARD 2281 STEVEN CREEK 3300 BROADWAY 20979 MISSION BLVD. 800 EL CAMINO REAL 626.0101 287.4400 834.3535 278.2353 595-5546 LIVERMORE RICHMOND DUBLIN ANTIOCH 4001 FIRST ST.,4B1 9B BROADWAY MOBILE SERVICE 3670 DELTA FAIR BLVD. 455-8207 234.3004 829.2400 778-1180 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA t Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November. 1 1 988 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings";. CLAIMANT: STACEY AGNITSCH ATTORNEY: Date received 10/4/88 hlar€El'tZ... v ADDRESS: 5611 Esmond Avenue BY DELIVERY TO CLERK ON Richmond, CA 94805 September 30 , 1988 BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: . County Counsel Attached is a copy of the above-noted claim. DATED: October 6, 19.88 JaIL Bep�tyLOR, Clerk G Ann Cervelli I1. FROM: County Counsel TO: Clerk of the Board of Supervisors (t/ This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: i Dated: BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD��RDER: By unanimous vote of the Supervisors present ( V) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. NOV 1 1988 ' Dated: PHIL BATCHELOR, Clerk, By ,A_�.�Ueputy Clerk WARNING (Gov. code section 913) Suu-Ject 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 ars 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. 00 ,�'n1� 3 19ou BY: PHIL BATCHELOR by A4zeuty 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 RECEIVED Against the County of Contra Costa ) 0 C T �4 1988 or ) PHIL BATCMELOqq District) CLERK B ARRD OF S P2 VISORS a���T `C. Fill in name ) sr �aN��G4C2tr oranr The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows ------------------------------------------------------------------------------------- l. When did the damage or injury occur? (Give exact date and hour) ------------------------------------------- `npL�t� ------------------ 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) �'^ cQC, c 5m-c 4VL�_ ;_rr godd-- �,Jh► �� `rim 4. What particular act or omission on the part of county or district officers, N servants or employees caused the injury or damage? (over) :e 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. Attacb-two estimates for auto damage. h G..'`.'c ro«s C1,►¢S i,-, 1��cG ,ect � c �e w; �21.i� C ).�i _ :_ �ss .._ 7. How was the amount chimed above computed? nclude the estimated amount of any prospective injury or damage.) [�,., v.�U �t�s 1 >�l 1 C� 0.Ce. e.(��C .-L- r" :SCS Q.�L67 B. Names and addresses . witnesses \� v mho %sc eCmrnU-A e �czti^• h` �c�tK. b 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT -tLu�eA. Ac,, re pock , d;, S t. oy-\ - ,�5 c1o_�� 60 ccs ,, ck- CL Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: . ('Attorne .) or by some person on his behalf." Name and Address of Attorney J C tant'd Signature /l Ls 00 ((Address)) R,ch mange 0,11 Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defrau�,rpresents for ahowance or for payment to any state board or officer, or to any eounty, ..city or district board or officer, authorized to allow or pay the same if genuine, Fany,false or fraudulent claim, bill, account, voucher, or writing, is pur4:iable kttier by imprisonment in the county jail for a period of not more than one year, by a fire of not exceeding one thousand ($1,000), or by both such imprist`#gd..fine; •or by imprisonment in the state prison, by a fine of not exceeding Wousand dollars ($10,000, or by both such imprisonment and fine. c� i� ` HILLTOP FORD ESTIMATE OF REPAIRS • ' 3280 Auto Plaza R.O. NO. Phone 222-4444 RICHMOND, CALIF. 94806 Complete Service All Makes of Cars NAME. << r ADDRESS .�q` ATE _ \-J\C.•� �L`?^1�} "�`:�.'�.. `vll��` �.�%�1"1`l 1LY �..li�.+ L 1`�,F•{ �.71�l. � Y �•_ � i MAKE OF VEHICLE r : EAR TYPE LICENSE NO. MILEAGE SERIAL NO.(VIN NO.) _ `: 1' I R_i C 1 t!y °1%' !F Z H" 'Z`3 y INSURED BY ADJUSTER l INSPECTOR PHONE! pS y 2J t HOME t BUSINESS(U/S ',r 4u�" •�/yU Labor✓ Labor Labor. "_ ` SYN. Hours PARTS SYM. Hours PARTS STM. :CARTS Bumper Fender Fender Bumper Rail Fender Ornament Fender Ornament Bumper Brkt. Fender Shield Fender Shield Fender Mldg. Fender Mldg. Bumper Gd. Headlamp Headlamp Frt. System Headlamp Door .Headlamp Door . Frame Sealed Beam Sealed Beam Cross Member Cowl ICOWI Door,Front. Door,Front Wheel Door Lock Door Lock Hub Cap Door Hinge Door Hinge Hub&Drum Door Glass Door Glass Knuckle Vent Glass Vent Glass Knuckle Sup. Door Mldg" Door Mldg. Lr.Cont. Arm-Shaft Door Handle Door Handle License Frame-Brkt. Center Post Center Post Up.Cont.Arm-Shaft Door, Rear Door, Rear Shock Door Glass Door Glass Windshield Door Midg. Door Midg. Rocker Panel Rocker Panel Tie Rod Rocker Midg. Rocker Mldg. Steering Gear Sill Plate Sill Plate Steering Wheel Floor Floor Horn Ring Frame Frame Gravel Shield Dog Leg Dog Leg Park. Light Quar. Panel Quar. Panel Grille Quar. Midg. Quar. Midg. Quar.Glass lQuar.Glass Fender,Rear Fender, Rear Fender Midg. Fender Midg. Fender Pad Fender Pad Mirror Inst. Panel Horn Bumper Front Seat Baffle, Side Bumper Rail Front Seat Adj. Baffle,Lower Bumper Brkt. Trim Baffle, Upper Bumper Gd. Headlining Lock Plate, Lr. Gravel Shield To Lock Plate,Up. Lower Panel Tire C'1=1 Hood Top Floor Tube Hood PoNjef;,Lo Trunk Lid I 18attery Htg.". Trunk Lock Paint r✓✓' Hood'bouws Te An 5t e,- / C Trunk Handle Undercoat Ornament Tail Light jPolish Rad.Sup. Tail Pipe IMisc. Materials Rad. Core Gas Tank AUTHORIZATION FOR REPAIRS Radio Antenna j. Frame You are hereby authorized to make the above Rad. Hoses Wheel specified repairs. Signed Fan Blade Hub&Drum Labor 4--/ Hrs. /Hrs. C 4 _S 9,q ` Fan Belt Back Up Lite Parts g i Water Pump Wheel Shield Wrecker Service—$ Motor License Frame—Brkt. Tax $ i' Sublet $ A—Align N—Now OH—Overhaul S—Straighten or Repair EX—Exchange RC—Rechrome U—Used This estim to is based on to est possible cost q latent wrth yality work, and as such, is guaranteed items not cover. by this estimate or�l��en will be adr7ltlonal. TOTAL $ FORM ER-1002-NC(4-79) Jim Rose 810 SAN PABLO AVENUE ROSE AUTO BODY REG. NO. AE 87853 ALBANY 526-1562NIA 94706 A / � /� tt OWNER �- (/ C.Dfb ESS PHONE IT MAKE Va.E I XE MODEL 4— LICENSE DATE FRONT PARTS LABOR RIGHT PARTS LABOR LEFT PARTS LABOR MISC. PARTS LABOR Bumper Fender, Fri. Fender, Fri. Bumper Britt. Skirl A Baffle Skirt, Baffle _ Bumper Gd. Fender Midg. Fender Midg. r / Fri. System Fender Side Midg. Fender Side Mldg. Frame Heodiomp Headlomp Cross Member He!)(amp Door 11/ Headlamp o Stabilizer AVied Boom Sealed Boom Wheel Pork light, Lens, Door k t, Hub Cop Door, Front Door, Front Hub and Drum Knuckle Door Hinge Door Hinge Knuckle Sup. Door Glass Door Gloss Lr. Cont. Arm Vent Gloss Vent Gloss lr.Cont. Shaft Door Mldg. Door Midg. Up Cont. Arm Up Cont. Arm Shaft Door Handle Door Hondie Steering Gear Center Post Center Post Steering Wheel Door, Rear Door, Rear Horn Ring Door Gloss Door Gloss Grill Mldg. Upper Door Mldg. Door Mldg. Right Door Handle Door Handle Left Center Rocker Panel inner of Outer. Rocker Panel nnr lower Rocker Midg. Rocker Midg. Frons Deflector Floor Floor Horn Frame Frame Baffle, Side Baffle. Lower Ouor. Panel Ouor. Panel Baffle, Upper Ouor. Midg. Qua,. Midg. Lock Plate, Lr. Lock Plate, Up. Ouor. Glass Ouar. Glass Hood Top Fender, Rear Fender, Rear Hood Hinge Fender Mldg. Fender Midg. Hood Mldg. Ornament REAR MISC. Name Plate Bumper Inst. Panel Rod. Sup. Bumper Brki. Front Seat Rod. Core Bumper Gd. Rear Seat Anti Freeze Grovel Shield Front Seat, Adj. Rod. Hoses Lower Panel Trim Fon Blade Floor Headlining Fan Belt Trunk lid Roof Panel Water Pump Trunk Light Tire % Worn Cowl Trunk Handle Tube — tte y Windshield Toil Light, Door, Lens int Windshield Mldg. Tail Pipe, Brackets Undercoat Gas Tank- Door Aerial �- Motor Mts. Frame TOTAL MATERIAL Clutch Linkage Wheel TOTAL LABOR s Hub and Drum Transmission Linkage Axle TOWING Spring SUBLET REPAIRS SYMBOL A-ALIGN N-NEW OH-OVERHAUL S-STRAIGHTEN OR REPAIR EX-EXCHANGE RC-RECHROME THE ABOVE IS AN ESTIMATE BASED ON OUR INSPECTION AND DOES rAX NOT COVER ANY ADDITIONAL PARTS OR LABOR WHICH MAY BE RE. OUIRED AFTER THE WORK HAS BEEN OPENED UP OCCASIONALLY ��� ^_ AFTER THE WORK HAS STARTED DAMAGED OR BROKEN PARTS ARE TOTAL l� DISCOVERED WHIrH ARF NOT FVIDFNT r1N - cIOGT INeec�T�nN Ry CLAIM — . BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November r—, -n88 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: $150. 0 0 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: DALE ETHERTON ATTORNEY: D-96262/V353U Date received Mar€(I1ez) CA ADDRESS: P. O. Box 2000 BY DELIVERY TO CLERK ON October 5 , 1988 Vacaville, CA 95696-2000 BY MAIL POSTMARKED: 9/30J88 & 10J1/88 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. r` ��IL gATCHELOR, Clerk DATED: October 6, 1988 : Deputy t An Cervelli 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: �j� / / BY Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 0 DER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. D / Dated: Nov 1 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 ')nitee 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 ta�s shown above. Cited: fd0 N .11BY: PHIL BATCHELOR byuty Clerk CC: County Counsel County Administrator .^�_:TO: _APARD 0F._SDPERVISORS--OF, COAITRA�COy �" • appitCatlen Mnez:Galifo 9433 5 . ' A. Claims relating to causes -of action for death or or-.,injuryo . . .person or to personal , -orgrowing crops -must-:he presented not later than the 100th day -after-#h e-accrual---of-- e---$usi-' . -action. .-,Claims relating to any other ._cause of_..action"-mustt ,presented not later than one ,,_year aftier =the accrual of-,tie aus�e --of action. .(Sec. 911.2, `Govt. ..Code) t_ a B. Claims -must be filed with .the .Clerk of .the Board of Supervisors _ - - at its office -in Room 106, County Administration Building,- 631--YPine Street, Martinez, California 94553. -_ C. -If claim is against a district -governed by the --Board of -Supervisors., rather than.-the County, the name of the District-.should'-be.,-filled -in. D. If -the claim is against .more than one -public entity, -separate claims must be filed against each public entity. .- E. ntity.E. Fraud. See penalty for fraudulent claims,_ `Penal Code,-.See -M 4t-'�-4end FT this form. Claim by " )Reserved for-.Clerk's ,fil-ing stamps VD Against the COUNTY OF CONTRA COSTA) OCT 988 or (�' b/S �'� r,6 S 6 A , C_Q DISTRICT) M• -!Pt:! g�- r K c - - (Fill in name) COSTA CO rs Dewi -. - The 'undersigned claimant hereby makes claim against the Count of-Contra ' -Costa or the above-named District in the sum of $ . ISO, o ` , "-t---and .A support -of this claim represents as - follows: -----------------------r_ ------_---_---_------------------ -------.--N—_ 1. When did the damage or injury occur? (Give exact date 'and .hour) : :. _s_3o A-m--------------------------------- - --- -- - �.2. .:Where did the damage or injury ocur? (Include -._and county)-- - - - ----- - _ L =m . How did the damage or injury occur? (Give full details, _use- 'extra sheets if required) - -_ - f ► s r s+ o�_e.�n__ _p 1 . .:�T "_L'�Sre. -977,,What particular act or omission on the part of county. or' . district.,._ _ officers;_--servants or ,employees -caused -;the injury or damage? .nr ..(� ' :.(moi✓ _ � � Go,c o ca UO Y -(over) _ _ r ...`-- " .. +wry.— .` i_^s .� �.ra,.rite.0..,.:iir.r•.....'.w�.r::..ifLri`— __ �'�1CWh — 'M1_.�,.- .a.r j 5 .,�. What. ar.e...the....-names of county or district officers, servants or ' anployees-causing the damage or injury? ------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) j • l sa , 00 Lo-------------------------+�- '''' --- a'�=' ---------------------- 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. - a G(/14 S �l 14 l� i h C.-T C, tr (-Ck ST o K ej ------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DP_TE ITEM • .MMOUNT 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 ,� q/ Claima is Signature 0 -90,6 2. 6 - ?5f u .-1 ox Add ess J OoQ VHC-A (I6tCA 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, anv false or fraudulent claim, bill, account, voucher. or writing, is guilty of a felony. " ` - j� oolC1- 0 °� NIM Tgolc � 9 s � E. 0 13911oI ,k C . r)')E� .::.... T. ...,._..`..+.+.c.: .. -<+....-+:c._.:.�e3r..:4"+u::"�..<....a.:.:..:........:.s'•.....c... 1..._....:.. ..._.,.a%.:r... "�s--�. �.araa. f`5 - .s +a+ CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA r Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 1, 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: $140 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: LUIS SANTOS County Counsel i C) 1'1988 ATTORNEY: Date received )` pct![( �a - ',c� �c 3 ADDRESS: 3850 D Northwood Drive BY DELIVERY TO CLERK ON October , 1988 Concord, CA 94520 BY MAIL POSTMARKED: Hand delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 4, 1988 ppNNIL BATCHELOR, Clerk ° DATED: BY: Deputy 0. nn r e i 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: lJ (� BY: A 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' Order entered in its minutes for this date. NOV 1 1988 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. OatPd. NOV 3 1988 BY: PHIL BATCHELOR by uty Clerk CC: County Counsel County Administrator Claimxtt%r 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 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 To—r—M. RE: Claim By ) Reserved fr erk' filing stamp 1 Urs �N7`o� � I L E iffl J" Against the County of Contra Costa ) OCT 03 1988 or ) PML G.ATCH;LOR CLERK BOARD O U?ERVISOGS District) ICONTRAC TA O. Fill in name ) B 1 :a °e °tY The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ ' 0 0 and in support of this claim represents as follows: ----------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) t mvctf OF I9�� 2. Where did the damage or injury occur? (Include city and county) ------------------I ----------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if IF(c Lp required) /C(C 77 re 0 f 0 V S(Ngl ,E14,Ac d� � _2 .K o�✓Te! 1,0 P&2JJ91"' I' -�Or✓� Hca —�tC' TC J'roP OdWC rf/tyT NVIMe l3��O�J BCC��✓6 za ffC%o eO/CPOO na'v C491-MW (-C/Z e-o"-d ele T(v 6 A/( Tri e,, W 2 fI.✓O e7fi L4r/z mer o Ree --------------------------------------- 4. What particular act or omission on the part of county or district officers _ servants or employees caused the injury or damage? - �(re- ( Ir-'e r e- 7✓ _,T,q/`2 tS Q �C�So� CAc c .,� -�r0 NF"& vt 7e„cJ- 1 ) .2 S7. o? SLr (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? ON ------- ----------------------------------- --------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. -•--------------- --------------- -- - 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. ---------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT prt"C-1 fol 2 'f 5-0 - f4%.- F-02 C44 FCC �ti cce2K o . Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some perso " Name and Address of Attorney Claimant's Si ture 950 61/100P Pk- Address c4P�L192J9 ca- 9 Telephone No. Telephone No. 7-11- 0 * * * * * * V V * * * * * * * * NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district.board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or Districtgoverned by) BOARD ACTION thc: Beard of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 1, 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 . 00 Section 913 and 915.4. Please nolaMltl+�r�O �'� CLAIMANT: RICHARD .R. PAULSON OCT U 11988 ATTORNEY: �— P.O. BOX 211 Date received Martinez, CA 94553 ADDRESS: MARTINEZ, CA 94553 BY DELIVERY TO CLERK ON October 3 . 1988 BY MAIL POSTMARKED: October 1 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk Al't 0 �4: DATED: October 4, 1988 �� e : Deputy Ann Cervelli 11. 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: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( v) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's rder entered in its minutes for this date. 1 D� Dated: NOV 1 1988 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 "^;*..ei 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. NU OV 3 1988 BY: PHIL BATCHELOR b C y �eputy Clerk CC: County Counsel County Administrator Cla;�, As. -- BOARD OF SUPERVI!%RS OF CONTRA C=A COLWY 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 6911.2.) B. Claims must be filed With the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district" governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this T-Or—M. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVE® Against the County of Contra Costa ) ( tet 03� j988 or ) PHIL MATCH g District) c C PA CO },V13QR„ Fill in name ) B . pepwy 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) = 7 7 ------------ - - - - --------- ---1:�� - - rY� --------- 2. Where did the damage or injury occur? (Include city and county) 3• How did the 4amage ori jury �oyccur? Give full etails; a extra pa r if _rn required) I c) "t f 0 �`T L I OA l��' o A; .� JA* �� -r r tQ "T� ( qQJ 4. What particular act or ssion on the t of count or distr' P� par' y ict o ficerp, servants or.employee caused the injury or damage? �Q C �t �Z (�� � I R—�6 ��Lk tA� 2, 7P t_.� (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 estimates for auto damage. fes; .e;y ----------- -- ----------- - - -- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.^g o�, -------------------------------------- --------------------- --------- 8. Names and addresses of witnesses, doctors and hospitals. t < It -------�_ 1--'. - _ -1 - ---------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT o I 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 A:�," k gam_. mant's Signature) Clai PC) X Zl Address M_0 f 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. rS E'i'�_t%�!t+�^,�`� `x.•52.;;t °tr�a rY _�`t�{;+ `�':�'C' ���y3 q"r-•-:.:� � 4!w .��:�*'+v="4:'.+,-.��y,•v:�ay^;,. . ��y1+,.r..•�irst��;:=- ,. Ras 'a SoW .Sewece. 4Iocc, - it 2524 3630 Alhambra Avenue — Martinez, California; 24 Hour Towing = Phone 228-7115 Date.Q - s� - -- Time-,2 ' -.. 1........... ...__. ,NAME.................. / = ADDRESS. - ` - - 'TELEPHONE ----`---------G------ Make-- 1 -�: Year 1�-- ----- Model. UI--1I/e-- Licensee•. /4 From_GJG�:�_. -L�JTf`./5_lfTJ- TO . , s---------- ---Mileage ------------- -------------- Front p Rear ,4— Dollies p / R.O. or Insurance mparry---------------------------------- - --_. Policy No._.-__ Cash _ Charge p Check p Credit Card p P. O. No----------------- MEMO:�� J STORAGE - - - $__7 _—------- DOLLIES - - - - �- V PICK UP - - MILEAGE - - $ - -- ----------- �� MISCELLANEOUS - $_---------- TOTAL - - - - $ Authorized By,- i- IE not remitted within 30 days there will be a 4% bookkeeping chargee. DEPARTMENT OF JUSTICE NOTICES THIS FORM IS FURNISHED ALL PEACE OFFICERS WITH THE REQUEST NOTICE OF STORED VEHICLE THAT IT BE USED IN REPORTING VEHICLES REQUIRED BY SECTION 22852, C.V.C. IMPORTANT: IF VEHICLE WAS REPORTED STOLEN, SEND A COPY OF THIS NOTICE TO THE DEPARTMENT REPORTING STOLEN VEHICLE. A ATTENTION VEHICLE OWNER Section 22852 of the California Vehicle Code requires that the registered and legal owners of a vehicle stored under Chapter 10 be notified of the location of the vehicle. Records .,f the Department of Motor Vehicles indicate that you are the.registered and/or legal owner of the vehicle described below. Information regarding condition of the vehicle or release procedures may be obtained by contacting the garage where the vehicle is stored. FF ROBERT VAN BRUNT 712 CHARLETON DRIVE PLEASANT HILL, CA. 94523 L I L_ 1 REGISTERED OWNER t 1 LEGAL OWNER j YEAR AND MAKE BODY STYLE I LICENSS No..STATE.AND YEAR SNGWE HG. 1984 CADILLAC 2 door COUPE DE VILLE , CA#1HGL141 9-8-88 Y.I.N. VEHICLE REMOVED FROM DATE REMOVED 1G6AM4782E9013124 I WARD & ESTUDILLO STREETS 5-25-88 REMOVAL AUTHORIZED BY-1.0.No. MA TI p�Z1 EZ POLICE DEPARTMEN DEPT.CASE NO. OFFICER R. RAY #71 88-2279 AUTHORIZATION FOR REMOVAL AND REASON FOR STORAGE CONDITION OF VEHICLE ODOMETER READING 22651h CVC no licensed driver in veh DRIVEABLE I NOTIFYINGAGENCY BY MARTINEZ POLICE DEPARTMENT - B. WALMSLEY, DISPATCHER � B CERTIFICATION I hereby certify that notices with postage prepaid were deposited in the U. S. mail, and that these notices, of which this is a copy, were addressed to the persons named herein. DATE DEPOSITED LOCATION - BY (NAME AND TITLE) 5-25-88 MARTINEZ , C COMPLETE THIS SECTION IF VEHICLE WAS REPORTED SI&EN ❑ DEPT.REPORTING STOLEN VEHICLE CHECK THIS BOX TO INDICATE THAT A CARBON COPY OF THIS NOTICE WAS SENT TO REPORTING DEPT. D NOTICE TO DEPARTMENT OF JUSTICE (CHECK IF APPROPRIATE) ❑ We have been unable to give notice to the owner of record as required by Section 22852 of C.V.C., and the vehicle, after 120 hours of storage, has not been returned. NOTE: Send to P.O. Box 13417, Sacramento, California 95813. (Sec. 22853, C.V.C.) j VEHICLE STORED AT j j REPORTING DEPT. j f—RON'S SHELL TOWING SERVICE F 3630 ALHAMBRA AVENUE MARTINEZ POLICE DEPARTMEN MARTINEZ, CA. 94553 525 HENRIETTA STREET X228-7115 uARTINEZ, CA 9455?