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MINUTES - 01101989 - 1.24
5. What are the names o4ounty or district officers, servants or employees causing the damage or injury? cis . ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. A3 /3 �v �'�66 -- AL�Cl/0% �-�CJ C Lei S' 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 - 7`f Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES T0: (Attorney:) or by Aome person on his behalf." Name and Address of Attorney 4zt4�4 i. Cl i 's Signature 3U_31�� (�_ Addres Telephone No. Telephone No. 7z 7 * * * * * i * * * * * * * * 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. Claim to: , BOARD OF SUPERVISORS OF CONTRA COSTA An 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 -publie 'entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. * * * * * * * * * * * * * * * * * * * * * * * * * * * * *` * * * * * RE: Claim By ) Resery ' t !31 ® Against the County of Contra Costa 19881 or ) !0=Cb q - P". PHIL BAT;IHELOR CLE OAR O Of SUPERVISORS District) C TR COSTA CO. Fill in name ) By Oepury The undersigned claimant hereby makes elai 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) Iva v ---------------- ----------------- -- ----------------------------------------- 2. Where did the damage or injury occur? (Include city and county) SAS Pl13c_oA r'-- � �=�-` gg- --�L- > 2z---��-w�rtA_ s 3. How did the damage or injury occur? ( ive 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? 6AI-61 7176A.) . (over) s f� i! • 3� (Z+V.AJ G. Ur+3nu� G+�:. ` fW +43 AA t ► tJ�"�, , ZC} `! G. # 1c�r"--R W t i-t-F LWs s '-r, 14 3 Da k ORr- CW42LC-J3 , OF v 7 CALs w' 9 �M o0 t6 aNJAi \IW ° Z cn LU N 11 H Z -'< ` ¢ W Wp Ww ow �w w �� v¢ w ; i r . .,�' W U wa z zw ow zz �Y Q �!U-� JLL ZZ tq h t, t .y'. Q N p a ar ¢w ¢a -aa F -o? a� c7p C• t. /� T ¢J WJ S¢ °¢ O of wz J¢ \U` ULL tiU UY-' cR ¢ C¢U• ¢Q 4LL Q O \ p�,�'!+ v 0 y ¢ J 0 •. G � �„ ! Z Y D <w a- `` / , r. _I to Q w � QD w a F-. i. t� J w a ¢ o a <w t: o ¢ w 0 Lij �O = aLLI o rn r o� W Y N z LU cc m ¢ U m ui a x � a z cc C3 L U' a Q m (7 w0 F U U U a to ao v O. ui uj= D s H C C � m H a Q �r N m ¢ a oz I F- Y. N w C a ,,�: W W ,\ 11 1 I O J W i2 0 o m cDa % Z E > U - a F W¢ < e. `.., Z13 > W T w ¢ , 3Z z J U a J O - r -i`4 ' m F ,Ln Y a w = - FN z o U Q tH F- REM -O a ri i U \ W a W Q2 0 0 t' t E L f- N b N � � 3 E s w w - c -mpEel i n t F ''moi O 41) > M N O N O r^ C Ln d _ ., � T Q T N O m 0 ` .. ; i' C CO O.d ..I- ` Q: Q.. (13 O U J QRl Q m 7 C o¢ o lk l,.p 1 cc _O.. o Q (� LO LO coz t 3: R. 02 t .� v' o i` ti V1 W co afro0 moz z Z v �-1 p W D -L o.aJ_ v \ v � _ r W. a � mm W o 1� d 'S ❑ ❑ (A ° FmyS' { z z > \ W m m`m d i--•` Q YW.. NIApo ` fJo N W a W N �� S O co 0 Ow 690 Z zE 0 M t J t F- 1- :/ _ Ir z Q W O wa 2 1' >. Q . O < -� Q m w 3 w C na J/ y �¢> O> F- 2 H a 4 z ow W ti '} co w' >N ouj > W O ¢ �Q m •;�- f"!t 3 L Z T. z0 cc Lu Q Q Oz w ° o W _ t.' ti w �w to H m J ° ^.�.. �+ 4 m H: ¢ W LL +.. W ¢ Z U W _ O J Q w Q w O O ,-+O p - m w z ¢ U a > t7 N a Q w w d F S¢ Q ¢Q 3�RM3.>Q NJw3 E- zLL U UU a, ~ Qy2wy Raw W v, Q[n ❑ ❑ aOWO� aWN� Y� 15, 4599 0009 b0b2 ' RETRIEVAL NO. AUTHORIZATION CO E NATE i 5,45,rNOR 04/09 .k — { SA►I.ES I;ECEI�T2:j;:;:LSALES NO. JA 47, SIG SU OUAN. CLASS DESCRIPTION'43Qi ?0901025957tIL, RLa T4 NER El SUB- SALES D AND RECEIPT PIED PURCHASERJACCEPTOR W t The Is uer f the card Identified thl Item Is authorized to pay the amount T a show as OTAL upon proper to Cation.1 omiae to-pay such TOTAL (toga er Ith any other charges u ereon)sub 00 to and In accordence with the 9 r ment governing the use o such card. Bank of America NsA sA€ pFO U.S,Pat.4,40 ,793 ` . TQTAL"7� � r SHEPHERD PONTIAC-HONDA (415) 825-8000 v 1300 CONCORD AVE P.O. BOX 6006 poNnac CONCORD, CALIFORNIA 94524 H'�ivur� PARTS DIRECT LINE I 825-8016 • 825-8017 S 1 {�•. WE APPRECIATE YOUR PATRONAGE I i of t{11 '4i1,+' trr ,1 r:1 g.::; :I. :s:01 71`•. , tll► s tT I t} r l 1 rut;= � y c � Q } F �H s `' r o • AMOUNT flr aiy L,`riJ i tttt i, SUB TOTAL Notice: All Returned Parts Subject to 20% Handling Charge. "il Special Orders and Electrical Items Not Returnable. No Refunds on Any Parts After 10 Days TAX 2 r; I:;.i::: � :t. h ;:, , i.;r r,;-y t_7 r::a . r:ui NO REFUNDS FREIGHT ;)i: WITHOUT THIS INVOICE 42 60 - i 1 4 f'8 9 Chevron `" ' ChevronU.S.A..Inc. i 4 E Thanks for buying CHEVRON Customers �. ICopy o )l��"�1� t � 4 E -J 045123 E cuca5 sn . 0 N T i $.L PRODUCTS Ouantity, Price Amount r e C "1 SUPREME REGULAR UNLEADED DIESEL a C,tstomer agrees to pay a fate charge CUSTOM SPECI I DELL Gts. on past due•balances of t'/.%, 2;0 o mcn!h or the maximum rats wed in cuss s statrr of esidr q@i 4p0 e:hichc or is fess. ales Tar Jsi.r�7p N Cuslumer Si alwe tT cel CFR 433.21 rs incorporate here ig� Total `� © —_�� �3�� Price includes motor vehicle fuel tax authnrirahen No., cense Numhcr '�— iit applicable). State t...i Lr S? C'► ]3 ,61fLn 4 C' w' CP �. CID,. Ln CO� ,C) a � c 00 C I 00Cr ru 00 MERCHANT IDENTIFICATION —.- .. _ . :. ... .... :.' EXP DATE ACCO N0. k_ D SEO NO TYPE 0 .DATE REF N0. AMOUNT m 3 a DUAN. DESCRIPTION AMOUNT m 70 O Z a v U) ca (A.• N. Trac a C® 'TOTAL =a C>Cardholder acknowledges receipt-of goods and/or ser- r vices in the amount of.the TOTAL shown hereon and M agrees to perform the obligations set forth in the o p o =Cardholder's Agreement w suer. i ra C n S �NF17CA 77 CARDHIPLOW COPY i VAL STROUGH'S EI Cerrito Honda, Ltd. TELEPHONE (41 5) 529-1323 11820 SAN PABLO AVE. EL CERRITO, CALIFORNIA 94530 INVOICE CUSTOMER DATE NUMBER NUMBER NAME Z IESS 12/01/88 .56513 ADDRESS DISCLAIMER OF WARRANTIES " o 11—dtl boreby a metla by I TbenSo lerPrE1 Cer.ito Hontlo,b rebv o y-c - ' . _ :� ubilit Yen sW;re a vlertl;Pwtio ola sulr Ce;�;o j . tliob iP 11 soitl nronve,son I QTY. PART NUMBER/DESCRIPTION BIN LIST NET AMOUNT f 1 284858 44733—'SEO-981 TRIM 44E5 4465 4465 1 I I c I 1 i SOLD COST, CASH CHG WHSL RTL INTL OTR RT" I BY 10 P.O.NO. X X GROSS 44i65 NOTICE 20%HANDLING CHARGE ON ALL RETURNED MERCHANDISE I L ALL CLAIMS AND RETURNED GOODS MUST BE ACCOMPANIED BY THIS BILL SUB TOTAL 44;65 I NO REFUND AFTER 30 DAYS 290 .I - - NO REFUNDS ON ELECTRICAL OR SPECIAL ORDER PARTS TAX .. _ PARTS MUST BE IN ORIGINAL CONTAINER OR NO REFUND ALLOWED PAY THIS AMOUNT 4755 RCVD.BY 385-02505(AA-3333)NORICK OKLAHOMA CITY r. S�tlS 4599 ''0.009 b0b2 = 52b1805 :; AUTH.NO. DATE D INITIALS - 3.545 1. "JAKE QQaa O�I�� 2 I I "AKE I�A.RIGS G 1ISS. MO. ID/ IrR. ❑SEND ` QIIAN CLASS DESCRIPTION UNI OST AMOUNT -------------- 4301 ?09010259571 EL 'CERR I TO' HONDA I -'FL C E R R!T 0 Issoe,v IN Ks&RR4d m IR'S 4M is 8UODUea ID MY IN iFoUlll ShoM as YZL------------- C Awm pw pv=t m.I Xffft m PRY acn TOTAL( wn any Xv&aW me Vmw) SUB &4W ward in ma m rk use of such card. -TOTAL OR ®• SIGNTAX HERE J, SALES SLtE7 TOTAL a SAPTPERF°U.S.Pat.4,403,793 CARDHOLDER COPY H) Bank®$A6' erica— IMPORTANT: RETAIN THIS COPY FOR YOUR RECORDS s -_J ij _0 - ' INCLUDES APPUC ABLE FEDERAL,STATE Aryp OCAL TAXES Ot•I MOTOR VEHI �� C•r:_EFUEL•PAYMENT-OF WHICH MAY BE ASSUMED BY UN -"r'J-%�.�+.�*�!f q �AlocAL 1J4J PRODucr. `a QTY. PRIfE AMOUNT 4 ucefion is sob 76 SUPER::76 NLE This t tett to the rem's and _s .76 LEAs,' 1 h� (os Y be r> fieri from time to 76 ESEL Ct d Atto—withte[{uAed noficeJgf the Unto]Credit O t 9mement os costa sed on the r PER PREMIUM 20W/5SIG�mort trot est f SV SERVICE 1. ER c ORDER NQ kA RIZAi{ON DR R`S r "est t ORIGINAL INVOICE SALES TAY CENSE NO. Lr FORM�3.2K95 (REV. TOTAL + I VEHICLE LICENSE NO STATE )PRINTED IN USA I 45 ----- bOb LU rY. class a f c A4 r DES ION 411 jet ti �i r t , , PRICE AMOUNT �Q516$ -� I 41 OO�HE�TY =TRUCtK D a E` CRR1 T® a p TE+ I M/q k _} AUTHORIZATION S 7. i UB 1 D/LICENSE NO.STATE TOTAL �CUSTO k t 4' : a REOJDEPT, CLERK TAX• i Mt ll3N qE i y i,£ . I Q j �5G I r 0 Pon properPrp � tl°nhtl°n so t Hn°eon)•sue°et to mlon,t txC, to a autho l L J1 to. .. SAF'j'�RF 91082 ( I y �° FIrl ccc7 ( r • a{ rx.._.,i f i ena In aeortlen �i he ap Tri �gor�amWnO MnotMr cf 3 TOTAe E f' U.S.'Paf. 4,403,793 (`.(�$T IIpYf" - / ua of.00h Darn. - �MWORTA��:R OflAER COPY RETAIN THIS COPY FOR Y - OUR RECORDS w �_T""a.`-�4�.�+�'�...l+i�.��`�' .3.�','rt'��='>F%`,^�"*� ,."a. _� a�..""^-`-'-"7�'e'•"3':^:-r`.-^-^`-r•:' - Y: ._ _ T .' -_gyp--• -'- --^._ ^-`_ _: _ -�----_ - ----- -- ---_- - --- - - --� -T r — .. :—^—T^'r—r.;.��--^P^•_""'_"!,—._'—•�'�P'•_ ` ,�� .• a wy-^•• S?ta � �°�:�u� .. .;-a .k ..,:X� �-� ':d ..: � _.�. r•5 +,Eyrr q ^r'•s +�ua '�� �.,r t� 3D �r§. i aC.-ti,:'�"m _-_-�-._-s=--_.=.�-.,.-- '—_'.�� `�""...f .1�...�{1c" '.� _�.y""p �'_.._[ "'""=',_,��..��•- ,"�"'�",F° r 77r-�_ ,ais'•_� "m' drs e't. deft' F t u."'a'f i t ,. n $� �.. (/� rCONCORD +v Y = DEPOSIT:, , - `(c'y.,�r.ILS�Y Y WE.�tfY.S� t� CiCand AlJTO' R�OV �� InIC• A `OFFICE CASH'.' CHECK PO NUMBER.4 ��a z� ` { 10895 San Pablo"Ave ;2491 Monumenillvd.•' 2076fM Diablo=Blvd WALNUT CK. REMIT t cyI Cerrito Co 94530 Concord Co?94520 Walnut Creek Ga 94596- OFFICE- 5 EF D RECD BY TO 'r =234 6025 529 2272' 798 6200'""' 934"0800 Et=CERRITO; g i - - zSF" 234 336. - — — .:OFFICE ..L >?- ti 'Y'� • • • • • • •� 'x,�. _ �ESTA7{Qty�r t_C la"r DRTVE)2 S IICENSE`•fT u'I� ��v "' T s ✓ i _ S^ <' �`t.}- DATE } �r - ,—.•r NO yam;}• ,-• zf"y f s - ` S xi .VNO tCLE r ay L_ b� C:J{.`. - } a3 570.7E .. s ` e "• k vY TIME IN r' S ai EXPI DATErF37 r �sd •-i �P+ ^t*'•7 '' s jvtAKEB r.. .. i.. � T. E�i ra,+Ary rY, �t 5� y... •( i� a rr; r jF t t t,TI USED ME �} G BIR HDATE*� �"'• t tt s �„ ,r,. a v`��' -t,�•`' '' '"' SODE : _ f �. r, 9 4 \~-� LES IN - °nr$ a hfY } V �ris v \° Wlll DATE ,TI OCIAC SECURITY N0 •� r - '' ^I' RETURN - �` "�Irtc-onsiderution'ofthe coyeoantahereincontalned.the undersigned owrier hereby teases to the undersignedrrenter upon thelerms covenants and condinons _ _ herein shout t e•motoCvehicle dexnbed asove-herein"after referred to os Vehicle _ h - - _.._t TOTAL.MILEAGE i41)rRenter.ackfio`wledgas'that soldve(itcle tf the property of�Owner ondthaf he received it in'good mechanical condition _ USED _ _ r j2)•Renter agrees thothe--will return sdiyehfcle`tiiOwnerssiahon frodl whlch,n was rented;in the same�cond tion os ha iecerved.rJord nary wear and rear ' - _ - ceptad bn the retain date stated above oc•sooner upon demand of Owner TE RA (3)ReNer agrees not to use said vehite for thearonsportohoroof persons or property for hire,express or implied;not to'use it In iolation of any Federal State;pro HOURLV vinaol or Muniupalaaw orduibnce rulear"fegulanon,goyernmg the use or.returnthereof;no to remove it.from.this state without the written consent thereto of Owner.. 'Ly : 1 (4)�Ronter bemg�'one of tfie.assured.und the msurdn"ce poic`y:covenng said vehicle agrees to comply with all the terms and co4tions oficid policy,which by reference ;tea- - J V- J. v thareto.are incorporated herein and mode o`part thereof and tocomply wlthalie terrtiis and conditions appearing on this contract - R (5)Renter further expressly.agrees fo iindemnlfy the ansurbnce'Company fj r and all loss,damage cost;and ezpen dor mcuried by the Insyr e.Eompany WEEKLY b'e`couie;of,miunes Ar damages susIa id?iy'.otcuponts of said vehicle n states where;the`I"makes Owner oi,its Insure Iia jurires t c nts of,satd (; vehlde,or becauseof m�uites or darrSages.resuihng from the operation of sold vahlde.in violation of any ofdhe termstondin - ring o i"' ntrett ,_., ,..,s. - -- - - _ (6J Renter expressly ogrees•io pay to Qnoer on.demand :: - �`"< •'�'� _ —z;'. tTHIY -=-r - �' v jo)A mileage charge contduted gtJhe rate above specified for the mileogecovered by said vehicleduring the period of this rental EAGE/'� �� (b)Service a;iind time chdrges compuied at the mro speufieH above for l6e period of this rental.. HARGE�� `J Irl`' -y.(c)A sum:equal to.the cost of alt damages to said vehlde:during.thts-rental penod provided,however.the:;*mer's liability shall berlimited to 54000.00 per occident - '< except irycks unless vehidewos operated_m violation of any of the pro Bions of r .y rt�Is rental agreement o- r r - ! - ONAUTOS ONLY r (d)/\sum:equ�al to thevolge of all-tires tools and accessories lost or stolen ham said vehicle `4{p t(r �„.(e)A sum,egfal to,totglr value of altmotenol.�omage to,trucks unless addrhonal nisurance is paid s=, - __ - ' ,man .OOLIY - s�(7)rlt•ri axpfey.agreerd that Renter n`no1 the agent se•ant of employee;of Owner in any r,;er-whatsoever. :. OUT `E t I/i, _ t/7�, % F If 1Fi6 box hes been inlltoled.b fay oe alldif�g nal,charge ownar•a jraes to relieve Renter of all liability for collision damage to Owners vehicle = .r whilay7t is opeFnted rIt ianFor _?t• at ,cgreem�n i However Renter shall be fully Ifable,for all_domoge if said vehicle is:operated in violation _COE[ISL any'taw'-or roVisfom oFthfs'!e al isgrq, n1a-No eompSe�hepmve insurente included. --� _ __ ___ __ -� 'TRUCKS ., Not ,ihstand rg�ihe proviiions sial ngeo toll s onpiotechon appearing abo a and�o'n'ahe:reJeiseheraof;-the Tenter shall'be fully response=` ^DAMAG -.ble, r a)I damo9e tort ceh cla Ye'3'uhing from ts'corelesr'or'reckless hondl ng;it cluding.but not limited-to,damage,caused by-driving dm_ &.BUSES else a{iniofficient wioi.hetgbr s has sttuoNons,tnvolving.lov+'bridges;roofs;YreesdndIT 1 3igns,bnd cotiidion wtthsucl.obleds asjpoles ' -P:AI s 'Y� $1.2:95 PERrDAY-` bsis an lo6dirig plotformsj t•.; .. ^' �' •' `- 3 aiw ECONO r i- r I• CARGO, 6 : Cf N.0 r AUTO Sr }( /� PICK UPS r ::��>� �� �� -V ®�� !S� ;CA ®;V.-E D =� F y { MISC HDDITIONAL DRIVER "' a _3DRIVER.S.IICENSE SUB TOTAL „ M CITY r� g Al {•` �{ �� $xfi�.:yl'h�..a-'S't _ ?` �, -Yt _ E t •h a.:,c _. t 3 - - TAX ON SU':TOT CITY L' _ TOTALv PRINT;NAME "` DDRESS' - RAIU GAS1t `LHEGK_�: CHASGE.,`i( - _ AUTHORIZED CHECKED OUT BY ..: DRIVER$' 1)X T / ,/ ,t •,Z)X t -' X VIS- AE DISC DC' _C BY s:is ✓S;T); ik' IMPORTANT READ:.CAREFULLY•AND_PLEASE INITIAL BOX st - "FOLLOWINCUSTOMER/RENTEE IS FINANCIALLY;,RESPONSIBLE FOR - ' _ _. k. G - - a 4 Flat.tires on-trucks ore_Renter's responsibility_ - '- _ j ��WLT-CUSTOMER IS LIABLE FOR ALL-`OVERHEAD AND'BOX DAMAGE ON�' � '� �O P ,TRUCKS;NOT COVERED BY COLLISION.DAMAGE,-WAIVER . _:•> ~Q r * 1 ALL DkMAGE TO TIRES AND'TUBES�CAUSED BY BLOWOUT BRUISES,CUTS ROAD HAZARDS OR - - '•OTHER CAUSES INHERENT IN THE USE OF EQUIPMENT.- 1 ' "3" -y- p ®.; 1 - l N * CHANICAL DAMAGE CAUSED BY;DRIVER/OPERATOR NEGLIGENCE NY MISSING EQUIPMENT ON TRUCKS OR EQUIPMENT SUCH AS SPARE TIRE,—LIFT—GATE MOTORS,-,ETC- -77--7 — -` - * 5«•DAMAGE CAUSED By OVERLOADING .. • - .� • I- * 6.UNAUTHORIZED REPAIRS CO - •DUPLICATE l-Y _- �[^•7:-ALl CONTRACTS�SUBJE&TO FINAL AUDIT `a • s s s • • • s ,� • • !� ,@w ' c t • ..�....� .,�.,... w �•v.•� �....+ -v,,. .r ..r• e r �+tt• •�• ....... ..... ,...,.,..e t, _zryR�10895 San Pablo Ave: 2491 Monument Blvd. 2076 Mt. Diablo Blvd. J WALNUT CK. REMIT', I EI Cerrito,Ca. 94530 Concord,Co. 94520 Walnut Creek,Ca. 94596 ''"�' OFFICE cAs REF D RECD.BY . 234.6025 529.2272 798-6200 934.0800 Et CERRITO L 234-3386 1' OFFICE \. ..t O • • ' 1 1• • t • ESTIN. .i )RIVER'S LICENSE * DATE - TIME OUT VEHICLE_ - LIC. MATE NO. C NO. Z ©� 1✓I -I •� t TIME IN XPIR.DATE 'i�... ... MAKE ' .. ..'.ef+o- BODY TIME USED .- .. { IRTHDATE" STYLE MILES IN. y. .. DAE lIl1AE .... _ WILL ..I RETURN \ � �. , OCTAL SECURITY NO. - ,MILESOUT... r) In consideration of the covenants therein contained,the undersigned owner,hereby leases to the undersigned renter,upon the terms,covenants and conditions".. f erein set out,the motor vehicle described above,hereinafter referred to as"Vehicle." - <. TOTAL MILEAGE-- (1)Renter acknowledges that saidvehicleif the property of Owner and that he received it in good mechanical condition. -" - � - ";��:�•� USED (2)Renter agrees that he will return said vehicle to Owner's station from which it was rented;.in the some condition as he received it,ordinary wear and tear e-:. epted,on the return date stated above or sooner upon demand of Owner. �," RATE 3 Renter agrees not to use said vehicle for the transportation of persons or property for hire,express ress or implied;not to use it in violation of an Federal,State,Pio- HOURLY ( ) 9 P Pe P Pe Y P P� Y inial or Municipal law,ordinance,rule or regulation governing the.use or return thereof;nor to remove it from this state without the written consent thereto of Own4r. 4 Renter being one of the assured under the insurance policy coverers said vehicle agrees to comply with all the terms and conditions of said lit which b reference DAILY ( ) 9 Po'ty 9 a9 P Y policy, Y terata are incorporated herein and mode o part thereof,and to comply with the terms and conditions appearing on this contract (5)Renter further expressly agrees to indemnify the Insurance Company for any and all loss,damage,cost and expense paid or incurred by the Insurance Company "WEEKLY- ecause of injuries or damages sustained by occupants of said vehicle,in states where the law makes Owner or its Insurance Carrier liable'for injuries to occupants of said (I ehiele or because of injuries or damages resulting from the operation of said vehicle in violation of any of-the terms and conditions appearing on this contract. MONTHLY (6)Renter expressly agrees to poy to Owner on demand: - (a)A mileage charge computed at the rate above specified for the mileage covered by said,vehicle during the period of this rental. - MILEAGE (b)Service and time charges computed at the rate specified above for the period of this rental. . — CHARGE nkoo W (c)A sum equal to the cost of all damages to said vehicle during this rental period provided,however,the renter's liability shall be limited to$4000.00 per accident except trucks,unless vehicle was operated in violation of any of the provisions of - - GAS this rental agreement. i ON AUTOS ONLY (d)A sum equal to the value, all tires,tools and accessories lost or stolen from said vehicle. .IN E '/4 t/2 3/4 1 1ADS OLLY (e)A sumequalto total volue;of all.material damage to trucks unless additional irtsurbnce if paid. (7)It is expressly agreed that Ranter.is not the agent^"se`r'vant or employee of Owner in any manner whatsoever.., _OUT E. ..'/4 "''/2 3/4 If the box has been initialed.by Owner,then for an additional charge owner.agrees to relieve(tenter of all liability for-collision damage to Owner's vehicle ., while it is operated in conformity with this lease agreement.However;Renter shall be fully liable for all damage If said vehicle is operated In violation of COLLISI any law or provisions of chi rentat'agceement.No comprihensive insurance included." i -- / TRUCKS Lble ot ithst6nding the provisions rely ing to collision protection appeoringpbove and on the reverse hereof,the renter shall be fully response- DAMAG V & BUSES r all damage to the vehicle,ieiulting from ils,careless or reckless handling,including but not limited to,damage caused by driving ll in re of insufficient width or heighLt,such as situations involving low bridges;roofs,trees and signs,and collisionwith such objects as poles, P.A.1. $12.95 PER DAYost aid loading platforms. ECOO'S N0-LINE ND IAUT A - ._ -. CARGO }� � I❑pIII}� TT�� Rn }� PICK-UPS RLS VS�,�4'Lt ANCE V®RD. RF CAIS ® V ERDUE. ..., ..� . M95 PER DAY 7.95 PER DAY H... MISC. ,DDITIONAL DRIVER DRIVER'S LICENSE SUB TOTAL " .DDRESS PHONE"NO. ---CITY----DTAX ON SUB TOTAL VORK AT - PHONE NO. `�' ` �� ; (, i CITY 'j ll"-S fL� ' TOTAL PINT NAME �~ 1 ,ADDRESS 01-1. PAID. _.CASH CHECK, CHARGE AUTHORIZED /�t y :NECKED OUT BY DRIVERS _ 1)X A'.�J l X - 'BY X VISAJ MC AE DISC DC ,k IMPORTANT READ CAREFULLY AND PLEASE INITIAL.BOX CUSTOMER/RENTEE IS-FINANCIALLY RESPONSIBLE FOR THE FOLLOWING: Flat tires on trucks are Renter's responsibility.CUSTOMERAS. LIABLE z * RUCKS NOT COVERED BY COLLISION. DAMAGE ON COLLISION DAMAGE WAIVER * 2. ALL DAMAGE TO TIRES AND TUBES CAUSED BY BLOWOUT, BRUISES,CUTS, ROAD HAZARD$OR _ OTHER CAUSES INHERENT IN THE USE OF EQUIPMENT. :" -.:'. '•r- = "' ` CUSTOMER COPY No 71 * 3.,MECHANICAL DAMAGE CAUSED By DRIVER/OPERATOR NEGLIGENCE. � "� - * 4. ANY MISSING EQUIPMENT ON TRUCKS,OR EQUIPMENT SUCH AS SPARE TIRE LIFT GATE MOTORS ETC. _ * 5. DAMAGE CAUSED BY OVERLOADING. • • * 6. UNAUTHORIZED REPAIRS. - -*.7::ALILCONTRACTS SUBJECT TO FINAL AUDIT c • • • • • • 12 K-1 . • O Y;r ;p r. 41 CLP.IM BOAR*SUPERVISORS OF CONTRA COSTA COUNTY, COORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10, 1989 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: $500, 000. 00+ Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PAMELA AGPALO-WESTABY c/o Steven A. Reaves ATTORNEY: Concord Airport Plaza 1200 Concord Avenue #260 Date received ADDRESS: Concord, CA 94509 BY DELIVERY TO CLERK ON December 12 , 1988 BY MAIL POSTMARKED: December 94 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 19 1988 PPHHIL BATCHELOR, Clerk DATED: , BY: Deputy ' L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (A/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). County Counsel ( ) Other: DEC ! 9 Martinez, CA 94553 Dated: �C) 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 ( ) This Claim is refected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. JAN 10 1999 Dated: PHIL BATCHELOR, Clerk, By s 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 'Initad States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 BY: PHIL BATCHELOR� by Jerk CC: County Counsel County Administrator STEVEN A. REAVIES , Attorney At Law December 9 , 1988 1988 Clerk of the Board c.r_.., l `c' Contra Costa County Board of Supervisors 651 Pine Street, Room 106 Martinez, CA 94553 Case Title: In the Matter of the Claims of JAMES WESTABY, PAMELA AGPALO-WESTABY and JOSHUA WESTABY, a minor, Against CONTRA COSTA COUNTY Dear Sir or Madam: We have enclosed the following documents : Three (3) Claims for Damages (Govt. Code §910 , et seq. ) for JAMES WESTABY, PAMELA AGPALO-WESTABY and JOSHUA WESTABY, a minor, by and through his natural father and guardian, JAMES WESTABY. Please file the enclosed and return endorsed copies to us in the envelope provided. Ve my your , \ A. REAVES SAR/j mr Enclosures Steven A. Reaves Attorney At Law Concord Airport Plaza Central County (415) 682-7777 1200 Concord Avenue, Suite 260 West County (415) 232-0794 Concord, California 94520 East County (415) 754-7777 I STEVEN A. REAVES Attorney at Law 2 Concord Airport Plaza 1200 Concord Avenue, Suite 260 Rg � 's "F� 0. 3 Concord, CA 94520 (415) 682-7777 4 r, Attorney for Claimant 5 PAMELA AGPALO-WESTABY E` 'gip ops CLE oN �+ v 6 8Y _ _ 7 8 CLAIM AGAINST PUBLIC ENTITY 9 10 In the matter of the Claim of ) PAMELA AGPALO-WESTABY, ) 11 ) CLAIM FOR DAMAGES Claimant , ) (Govt. Code §910 , et seq. ) 12 ) -against- ) 13 ) CONTRA COSTA COUNTY ) 14 ) 15 1. I , STEVEN A. REAVES , attorney at law, representing 16 PAMELA AGPALO-WESTABY, present this claim for damages as a 17 person acting on behalf of the claimant. 18 2 . I desire notice relative to this matter to be sent to 19 my following business address : Concord Airport Plaza, 1200 20 Concord Avenue, Suite 260 , Concord, California 94520 . 21 3. The name and address of claimant are : PAMELA AGPALO- 22 WESTABY, 4549 Deefrield Drive, Antioch, California 94509 . 23 4 . The date and place of the occurrence that gave rise to 24 this claim are as follows : July 15 , 1988 on Interstate 680 25 1275 feet South of Milepost 680 Co. Co. 13446 Walnut Creek, 26 Contra Costa County, California. 27 5 . The circumstances of the occurrence which gave rise to 28 the claim are : A Contra Costa County vehicle being driven by I a Contra Costa County employee, NANCY ;INA' STROM, collided with 2 the vehicle that claimant was operating, from behind while 3 going at a high rate of speed. Said County vehicle was being 4 operated by an inattentive driver who was: speeding. The County 5 and its employee proximately caused claimant ' s. injuries and 6 damages . 7 6 . A general description of claiman.t ' s. injuries, damages, 8 and losses incurred so far as is' now known are follows : 9 Severe personal injuries including, but not limited to, 10 contusions , lacerations , concussion, neck, back and other 11 injuries . Said injuries resulted in special damages for 12 property damage, wage loss , loss of earning capacity, medical 13 bills , future medical expenses , all of which are unknown at this 14 time . Claimant also has general damages for her injuries as 15 well as a loss of consortium claim for injuries caused to her '16 husband, JAMES WESTABY, as well as a claim for emotional distress 17 under Dillon v. Legg for witnessing. her. husband and step-son 18 being injured in said accident. 19 7 . If known, the name(s) of the public employee(s) causing 20 said injuries , damages , and. losses is/are : NANCY INA STROM. 21 8 . The amount claimed as of the date of presentation of 22 this claim consists of general damages and special damages 23 relative to claimant ' s. injuries and property damage and loss of 24 use of same in amounts unknown at this time but in the aggregate 25 not less than $500 , 000 ..00 and exceeding the jurisdiction of the 26 Municipal Court of the State of California. Claimant reserves 27 28 =2- I the right to insert said amounts e ame are a rtained. 2 DATED : December , 1988. 3 4 �._S EN A. RE ~' Attorney for C aimant 5 PAMELA AGPALO-WESTABY 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -3- PROOF OF SERVICE BY MAIL (C.C,P .. 1013A, 2015 .5) STATE OF CALIFORNIA COUNTY OF CONTRA COSTA I am a citizen of the United States and a resident of the county of Contra Costa. I am over the age of eighteen years and not a party to the within above-entitled action. My business address is 1200 Concord Avenue , Suite 260 , Concord, CA 94520 . On December 9 , 1988 I served the within CLAIM FOR DAMAGES (Govt. Code §910 , et seq. ) Claimant : Pamela Agpalo-Westaby on the parties in said action, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the United States mail at Concord, California, addressed as follows : Clerk of the Board Contra Costa County Board of Supervisors 651 Pine Street, Room 106 Martinez , CA 94553 I , Joan M. Ritter, certify (or declare) , under penalty of perjury that the foregoing is true and correct. Executed on December 9., 1988 at Concord, California . G-^ co o (� 9 o0 v+ o W O O P : rd. `r1 'dam •� �t aicUne 1 .s t CLAIM PARD-UPERVISORS OF CONTRA COSTA COUNTY, CLO NIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT J anuar v 10, 1989 and Board Action. All Section references are to ) The copy of this document mailed to you is yoGr 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: $500, 000. 00+ Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JAMES WESTABY c/o Steven A. Reaves ATTORNEY: Concord Airport Plaza 1200 Concord Avenue #260 Date received ADDRESS: Concord, CA 94509 BY DELIVERY TO CLERK ON December 12 , 1988 BY MAIL POSTMARKED: December 9 , 1988 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 19 , 1988 PpHHIL BATCHELOR, Clerk DATED: 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: Goijnt. Counsel UEG 19 !H8 Ta Martinez, CA 94563 Dated: BY: 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 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: JAN 10 1989 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 11nitpd States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 1989 BY: PHIL BATCHELOR byV4��&�puty Clerk CC: County Counsel County Administrator o 1 STEVEN A. `REAVES " Attorney at Law 2 Concord Airport Plaza 1200 Concord Avenue , Suite 260 3 Concord, CA 94520 " ? (415) 682-7777 ECEIVED 4 Attorney for Claimant (; n 5 JAMES WESTABY ' CL 6 a oNr� ko Y �� .f 7 � �S 8 CLAIM AGAINST PUBLIC ENTITY 9 10 In the Matter of the Claim of ) JAMES WESTABY, ) CLAIM FOR DAMAGES 11 ) (Govt. Code §910 , et seq. ) Claimant , ) 12 > -against- ) 13 > CONTRA COSTA COUNTY. ) 14 > 15 1 . I., STEVEN A. REAVES , attorney at law, representing 16 JAMES WESTABY, present this claim for damages as a person acting 17 on behalf of the claimant. 18 2. I desire notice relative to this matter to be sent to 19 my following business address : Concord Airport Plaza, 1200 20 Concord Avenue, Suite 260 , Concord, California 94520 . 21 3 . The name and address of claimant are : JAMES WESTABY, 22 4549 Deerfield Drive, Antioch, California 94509 . 23 4 . The date and place of the occurrence that gave rise 24 to this claim are as follows : July 15 , 1988 , on Interstate 680 25 1275 feet South of Milepost 680 Co. Co . 1346, Walnut Creek, 26 Contra Costa County, California. 27 5 . The circumstances of the occurrence which gave rise to 28 the claim are : A Contra Costa County vehicle being driven by w 0 1 a Contra Costa County employee, NANCY INA STROM, collided with 2 the vehicle that claimant was a passenger in, from behind, while 3 going at a high rate of speed. Said County vehicle was being 4 operated in a negligent manner by an inattentive driver who was 5 speeding. The County and its employee proximate caused claimant ' 6 injuries and damages . 7 6 . A general description of claimant ' s injuries , damages , 8 and losses incurred so far as it now known are as follows : 9 Severe personal injuries including, but not limited to, abrasions , 10 contusions , neck injuries , back injuries , chest injuries , forearm 11 and arm injuries and concussion/head injuries . Said injuries 12 resulted in special damages for property damage, wage loss , loss 13 of earning capacity, medical bills , future medical expenses , all 14 of which are unknown at this time . Claimant also has incurred 15 medical expenses for his son, JOSHUA WESTABY' s medical treatment 16 and will continue to do so in the future. Claimant also had 17 general damages for his injuries as well as a loss of consortium 18 claim for injuries caused to his wife, PAMELA AGPALO-WESTABY, 19 as well as a claim for emotion distress under 'Dillon. v. Legg for 20 witnessing his wife and son being- .injured in said accident. 21 7 . If known, the name(s) of the public employees) 22 causing said injuries , damages, and losses is/are : NANCY INA 23 STROM. 24 8. The amount claimed as of the date of presentation of 25 this claim consists of general damages and special damages 26 relative to claimant ' s injuries and property damage and loss of 27 use of same in amounts unknown at this time but in the aggregate 28 not less than $500 , 000. 00 and exceeding the jurisdiction of the -2- 1 Municipal Court of the State of California. Claimant reserves 2 the right to insert said amounts when same are ascertained. 3 DATED : December , 1988. 4 5 , -TEVEN A. REAVE Attorney for Claimant 6 JAMES WESTABY 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -3- PROOF OF SERVICE BY MAIL (C .C.P ,_ 1013A, 2015 .5) STATE OF CALIFORNIA COUNTY OF CONTRA COSTA I am a citizen of the United States and a resident of the county of Contra Costa. I am over the age of eighteen years and not a party to the within above-entitled action. My business address is 1200 Concord Avenue, Suite 260 , Concord, CA 94520 . On December 9, 1988 I served the within CLAIM FOR DAMAGES (Govt. Code §910 , et seq. ) Claimant : James Westaby on the parties in said action, by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, in the United States mail at Concord, California, addressed as follows : Clerk of the Board Contra Costa County Board of Supervisors 651 Pine Street, Room 106 Martinez , CA 94553 I , Joan M. Ritter, certify (or declare) , under penalty of perjury that the foregoing is true and correct. Executed on December 9, 1988 at Concord, California . � CLAIM BOARLO SUPERVISORS OF CONTRA COSTA COUNTY, OORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10 , 1989 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: SHEREE C. BROWN c/o James F. Kemp ATTORNEY: 428 1st Street East Sonoma, CA 95476 Date received ADDRESS: BY DELIVERY TO CLERK ON December 12 , 1988 BY MAIL POSTMARKED: December 9 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 19, 1988 ppHHIL BATCHELOR, Clerk BY: Deputy L. Hall II. 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). County Counsel ( ) Other: DEC 19 198EF Martinez, CA 94553 Dated: 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. BOA7) This DER: By unanimous vote of the Supervisors present ( Claim is refected in full . ( ) Other: I certify that this is a true and correct copy of the Board' Order entered in its minutes for this date. Dated: JAN 10 1989 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 'lnitpd States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 1989 BY: PHIL BATCHELOR by puty 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, 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 1911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Roam 1069,• 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. , •). if the -claim -is against morethan 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 r I 's i s p SHEREE C. BROWN ) fi �/j �f � '��r��t 1 Jy Jl.y\] Against the County of Contra Costa ) AJC 1 2 1988 orINK ) District C!EF.'. Or.Rp i rill PE EY t� 'iS ! Fill in name ) Gx o: De u? The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of .$ 100 , 000 ;and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) July 11 - 18 ,' 1988 --------------------------------------------------------------------- 2. Where did the damage or injury occur? (Include city and county) 2415 Maine Avenue, Richmond, Contra Costa County, CA 94804 3. How did the damage or injury occur? (Give full details; use extra paper if required) County failed to extinguish fire in Safeway warehouse downwind . 4. What particular act or omission on the part of county or district officers, servants or 'employees caused the injury or damage? Failure to extinguish fire (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? unknown M_ --------------------------------------------- ----------------------------- 5. What damage or injuries do you claim resulted? .(Give full.extent of injuries or damages claimed. Attach two estimates for auto damage. =i "Respiratory problems, irritation: to skin, eyes, nose, throaf from pro- longed exposure to and ''inhalation of smoke "& toxic fumes; ..damage to autos ----azid =--------------------—"_—�----- ------------------------ -- 7. :How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) from bills and pain and suffering and anticipated future injuries 8. Names and addresses of -witnesses, aoctors and hospitals. Merrithew Memorial Hospital and' Outpatient ' Clinic, 2500 Alhambra Ave. , Martinez, CA 94553 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT to follow Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or bSr some person on his behalf." Name and Address of Attorney- JAMES F. KEMP Cla t° S tore 426 First Street East At orney for Claimant ` . P. O. Box 176 ' 24 5 Maine Avenue Sonoma, CA 95476 Address Richmond, CA 948G"s Telephone No. 707 938-2700 Telephone No. f 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. S PROOF OF SERVICE BY MAIL I declare that: I am a resident of Sonoma County, California. - I am over the age of eighteen years and not a party to the within entitled cause; my business_ address is 428 First Street East, Sonoma, California. On December 9 , 1988 , I served the attached . Claim form NE oRl�-iN.4/ by placing a-e—oe-py thereof enclosed in a ;sealed envelope with .ostagc t1hereon fully Yic.Pciu, :iii 'Cile united S-tates Mall at Sonoma., California, addressed as .follows: Clerk of the Board of Supervisors Room 106 .County Administration Building 651 Pine Street Martinez , CA 94553 I declare under penalty of perjury under the laws ',of the State of California that the foregoing is true and correct and that this declaration is executed on December 9 , 1988 at Sonoma, California. L {`' < CLAIM BOARS SUPERVISORS OF CONTRA COSTA COUNTY, CGORNIA Claim Against the County, or District governed by) BOARD ACTION the Board.of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10, 1989 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: BERTHA RUTH JORDAN 1131 Gilman Avenue ATTORNEY: San Francisco, CA 94124 Date received ADDRESS: BY DELIVERY TO CLERK ON December 16 , 1988 BY MAIL POSTMARKED: December 15 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 15 , 1988 PPHHIL BATCHELOR, CTerk j DATED: BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. (✓) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). County Counsel ( ) Other: Martinez, GA 94-51 Dated: 62 2,0 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/RDER: By unanimous vote of the Supervisors present V ( ) This Claim is refected in full, ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JAN 10 1989 PHIL BATCHELOR, Clerk, By /y,-/_�___1,6eputy 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 iinitpd 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 tice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 1989 BY: PHIL BATCHELOR by y Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND OR NON-ACCEPTANCE OF CLAIM TO: Bertha h Jordan 1131 Gilman venue San Francisco, A 94124 Re: Claim of BERTHA RUTH JORDAN Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. x 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTO J. WESTMAN, County Counsel By: epi y County Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. 99 1012, 1013a, 2015 . 5; Evid. C. 99 641 , 664 ) My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s) having delivery service by U.S. Mail) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: \� � , at Martinez, California. Y cc: Clerk of the Board of Supervisors (o 'ginal) . Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 4, 910 . 8) i6wA9 Yew a� ,t " �Y ra �1 j CLAIM BOARD SUPERVISORS OF CONTRA COSTA COUNTY, CALONIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10, 1989 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- 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ROBERT.::EDMUND HENNESSEY 2022 Cavallo Road ATTORNEY: Antioch, CA 94509 Date received ADDRESS: BY DELIVERY TO CLERK ON December 16 , 1988 BY MAIL POSTMARKED: December 6 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 19 , 1988 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (✓ ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911C-39 U my Counsel DEC 19 1988 ( ) Other: Martinez, CA 03 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 ( VI This Claim is rejected in full . ( ) Other: I certify that this is a true and correct copy of the Board' Order tered in its minutes for this date. A p Dated: JAN 1 0 19®J PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 JS BY: PHIL BATCHELOR by ty Clerk CC: County Counsel County Administrator C;.AIM TO: B! OF SUPERVISORS OF CONTR�O9�r 'TYapplication to: Instructions to ClaimartC!erk of the Board O.60X ri 1 Martinez,Calif omia94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Zlaims 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 94 .53. C. If claim is against 'a district governed by the Board of Supervisors , rather than the County, the name, of the Distript 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 f rk' Ili stamps .2,q2ZRECEIVED Against the COUNTY OF CONTRA COSTA) DCC 1 6988 or DISTRICT) T oR (Fill in name CIER AR F RV 5 ONTR 8 ... ... .(...... The undersigned claimant hereby makes claim agains a ontra - Costa or the above-named District in the sum of $ ) Sb •' and in support of this claim represents as follows : �. When did the damage or injury occur? (Give exact date and hour ;re-11"d-the damage or in3ury..occur? (Include city and county) 3. How did the damage or injury occur? (Giveuli details, use extra sheets if required) •r wAs sent- FrbM M,gRstA Ca'E)6V-.�`c 10�\ F tl►1 Y C)N Akx% s 1Z , (r1�� �(3 VA 0,?__T!Q'ET.. Q Q) %QI L Aa' r=ow �ret�A2�,r�d� Fra_ 5�.��� -c-719AIALok • e.^��u� o � (ia►aSpaQT �� (JlA5v .ate ,hJ 4. What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage?-C�ER�Ty hnnN aZ Muf-sb.cre-e--V--���e���-�o F ae�L�T"� . �kp�T� V%LLF,C� to C_1_�► Oiv �ekl &U'CR"i\o�► �c Nz L (over) 5. What are the nacres of county or district officers, servants or employees causing the damage or injury?D��.TLe gab%SLA is Vl\-� of %U9- -Vnb w1 was c�r�r.,sposa-gip Tc3" �� Cs»,r ..5c+�1.. � �.,-rI �a�►� OKkU1��, C-14?-12 t.�rts 1�c 1���� c�lv.yaL.woQ�i��c� llr. 6. What Zamsg-e or injuries do you c:Iaim r-e-s-u-1-t'1,iU Give-full extent. of injuries or damages claimed. ' Attach two estimates for auto 's r damage) rAy i3lACl� l-LATNt2 'TACK et' Qwitso►,), task ?1 uS n-1 o.lF-w. 'd,VAct Say bcf� kr-k PA14--s O-r k way Ne:,S Ask Sczhx ow lrosAr' �' A& 1 -Z.I.--°;q •�o II- L1 ------------.:.------------------------------------,.------------------------- i 7. How was t:he amount claimed above computed? . (Include the estimated i amount of any prospective injury- ori damage. ) -rp nod qs d�Lea�s f°'Z SA:c-re4 L o N SA L.E) rK%l nj£.moi s-01 Gos Nt� 3� New Ai wk*.rV y,,jw s JPi.,.s; A^-1 ?XA5.E �►c L CAI C OS k rLg—, r C VrU OM9- j-09 ALS-0. COS;V, "P— A(Z-r -----------------------------------e-------------------------------------- B. Names and addresses of witnesses, doctors and hospitals. 37 s accident or injury: -ITEM AMOUNT r Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES 'TO: (Attorney) or by^ some person on his behalf. " Name and Address of Attorney Claimant' s Sign t e 0_72— 'CAU ALL,`-&A . Address - -- --- - - - - ��ta�-N I c° jA-1 • ��5 e�1 . Telephone No. _ Telephone No.(4f 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. " "CONTRA COSTA DETENTION FAC, Y 4 �Jis i .:CLOTHING•RECEIPT - DATE:' . 07/21/88 :'" '-REC: : 14 8 I. TIME: .0603 FACILITY::..••,MDF.: - •' t NAME (L, F, M):• HENNESSEY' ROBERT' EDMOND ''.BOOKING NBR 8801850GJ` r I� ..• ._yam SHIRT/BLOUSE '- PANTS/SKIRT- QEz'U ® COAT/JACKET SHOES/BOOTS 0 SHORTS/PANTIES QT-SHIRT/BRA S' Q SOCKS/NYLONS HAT/PURSE' Q SWEATER/SWT. SHIRT DRESS 4 OTHER -vx., IN`ATE 51 NATURE RELEASE Q� 4 '.� 4 • DATE i`I �" i-HAVE RECEIVED ALL'OF* CLOTHING REL OF - e er e r '- tax ssy r INMAtE SIGNATURE- .. co 9 Sol e b C ftf S .�=� ��������.,� �.� fir" � ��-..��.� i� ��e¢�� �� �� �� ��v �� ��/�, ��� - ys'say - - _ _ ��:��r yisJ Gay-�s/s/ - - - - - - - - CLAIM BOAR* SUPERVISORS OF CONTRA COSTA COUNTY, C*"ORNIA C ' C1aim.Against the County, or District governed by) BOARD ACTION the Bourd of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10, 1989 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: $45 . 00 Section 913 and 915.4. . Please note all "Warnings". CLAIMANT: JUDY A. OLIPHANT 27414 Silver Drive ATTORNEY: Pioneer, -'CA:,'\.. 95666 Date received ADDRESS: BY DELIVERY TO CLERK ON December 16 , 1988 BY MAIL POSTMARKED: December 10 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 19 , 1988 PpHHIL ATCHELOR, Clerk DATED: BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). County Counsel ( ) Other: D F C 1 9 19800 Makinep-, GA 94553 Dated: �� BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD RDER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. JAN 1 O 1989 Dated: _ 7HIL BATCHELOR, Clerk, B} 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 'lnitpd 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 asshownabove. Dated: JA N 1 O 19M BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator t �� �. �''_�` �� ` , ��p �, �C, �� . �.''" Tt'' '. {per ��'; •, n�o� � � ,.. ,a� '-.n0 S ,.� . Qs�.o p �. �y�.p •��s pA s a �``� � '"" a t "`�...; 0R E rY�.� . w � �::+© Q. '. ��_ :6 '�'''ti (^� ,r ��r.(i,, j f'� a � V ,. � ,� �� �� �._ :, N °$ �;. _. � , � � � . . � 1 M!- Y RD OF SUPERVISORS OF CONT CO.�RTPt. �gUh� e ur Ri i appHcatlon to,. „ . Instructions to Clamant Clerk of the Board P.O.Box 911 A. Claims relating to causes of action for death or fornin�urynto�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 ode Sec. 72 at end of this form. RE: Claim by ) Reserved amps J u D �A A) ) I�ECEI�1' u ) PD ) DEC.. 161988 Against the COUNTY OF CONTRA COSTA) L BA ELOR C OA ER or DISTRICT) B .. .......9 De (Fill in name) ) . The undersigned claimant hereby makes claim against t Count of Contra Costa or the above-named District in the sum of $ .Si La _ E� 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--;in` jury occur? (Include city and county) I:A C i L LSU.L ------------------------------- ----------- 3. How did the damage or injury occur? (Give full details , use extra sheets if required) 16S 1 rv� - ------------------------------------------- 4-.---What-----particular-----------act----or---o-mission on the part of county or district officers , servants or employees caused the injury or damage? J (over) :5..:,:•j� iat: arei.:the...;namef county or district off rs , . servartts� cx employees:: causing*e damage or injury? - - - - -------------------------- - ---------------------------- 6 .--W-h-at-d-amage------or-- d injuries o 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 estimatea--- amount ed -amount of any prospective injury or damage. ) D F P-G P C?CS ;ZA� 0 9 ---- ----- 4" �- +opo_L- ��,�5-----nl N 5 __s .I -------------- 8. Names and addresses of witnesses ; doctors and hospitals_. L 9 . Lstt'h`e�"expend_itures you made on account of this accident or injury !TEM AMOUNT Govt. Code Sec. 910 . 2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some oerson on his behalf. " Name and Address of Attorney OAddress an ',s S i 'n ture Telephone No. Telephone No NOTICE Section 72 of the Penal Code provides : "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer , or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine , anv false or fraudulent claim, bill , account , voucher, or writing , is guilty of a felony. " gq6 (>Jl'jt7O 00 °D moo° fix,,.o hr{ r o u -0Z ro X00 f to � CLAIM /e'�� .•_ BOARS SUPERVISORS OF CONTRA COSTA COUNTY, CJ*ORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 1 0,. 1989 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: LEO STEIMER c/o Steven J. Duca ATTORNEY: 414 13th Street 5th. Floor Oakland, SCA 94,612 Date received ADDRESS: BY DELIVERY TO CLERK ON December 15 , 1988 Risk ManagE BY MAIL POSTMARKED: December 12 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL BATCHELOR, Clerk DATED: December 19 , 1988 BY: Deputy 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). County Counsel ( ) Other: ULU 19 198T Martinez, CA 94553 Dated: BY Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date.. ep Dated: JAN 10 1%9 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 ilnitpd States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant„as shown above. Dated: JAN 10 1%q BY: PHIL BATCHELOR by 4���eputy Clerk CC: County Counsel County Administrator r -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, 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 Co Sec. 72 at the end of this form. RE: Claim By ) Res � e tee ) � � epi/f► x//�/ / V E D Against the County of Contra Costa i ° C 15 198$ or ) P BATCHELOR CLERK CB RU OFOSUPE VISOfi District) BY Fill in name The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ P. _ and in support of this claim represents as follows: ---------------------------------.�� ��. -------- 1. When did the damage or injury occur? (Give exact hour) ---------------------------------------------- 2. Where did the damage or injury occur? (Include city and county) � �� Z-1 �'-__, � � 1 _--- -' -�, -------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if �y ,required) or ow - ----------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? � (:v/e r) .s 5. What are the names of county or district officers, servants or employees causing . the dams or in j 5. What damage or in ' s do you cl resulted? ( v full extent of injuries or dam es ,claimed. tach two esti tes for aut eZ CX . -� J 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addre e w es, doctor o 9. List the expenditures you made -on account of this ident or ury:,le,49 DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO:. (Attorney) .. or b ome so on his behalf." Name and Address of Attorney aimanttore Addie Telephone No. Telephone No. F I>> '�.1'- Zai N 0 T I.C �E ur_. y D i9&8 Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents or 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. _ PROPERTY/CLOTHING RECEIPT CONTRA COSTA COOTY REC. NO.29002 DATE: AL RACK# MDF TIME: Q.2- 2 0 CLH BOX MCDF. PROP.BOX WFC NAME: -57-C--I,?'l ;t° i <> WCJC BOOKING NBR: � ` '�,f'.''� T OTHER CASH: $ ❑ SHIRT/BLOUSE ❑ DRESS ❑ COAT/JACKET ❑ TIE/SCARF ❑ SHORTS/PANTIES ❑ JEWELRY ❑ SOCKS/NYLONS ❑ SWEATER/SWT. SHIRT ❑ WATCH N BELT ❑ PANTS/SKIRT ❑ SHOES/BOOTS ❑ T-SHIRT/BRA ❑ WALLET ❑ HAT/PURSE ❑ KEYS ❑ KNIFE ❑GLASSES ❑ OTHER J BKG OFC: X INMATE SIGNATURE Ill lis III is have received all of my per- DATE: sonal property . and clothing. REL OFC: X INMATE SIGNAYURE CONTRA COSTA DEnNT N FACILITY ' ' • PROPERTY R EIPT DATE: � ,,�.� , REC: 1al��s TIME: "` G 7 FACILITY: h1TjF NAME: S'r"E1MER L.EG D.O.B.: -s• :• BOOKING NBR: SE�l3.CfW2 :'r,, ITEM UNDER COUNTER: Y OR .N INTAKE CASH: $ A JEWELRY: N. DESC: WATCH: , DESC: LIGHTER: WALLET/PURSE: N KEYS: G . GLASSES: N BELT: N KNIFE: i a OTHER: ONE SEALED BAG .. BKG OFC: 319 12 8 .r- INMATE'SIGNATURE RELEASE DATE: I HAVE RECEIVED ALL OF MY PERSONAL PROPERTY. REL OFC: X INMATE SIGNATURE ;.PROPERTY/CLOTHING RECE EIPT-` ONT.RA, COSTA :COATY` REC. ►vo.4�9�� FACILITY DATE: . 1 BAcKa MDF TIME: CLH 80) MCDF PROP.BOX WFC NAME: � WCJC IM0z BOOKING NB j' OTH I INTAKE CASH: $ -f ❑ SHIRT/B;LOUSE ❑ DRESS ❑ COAT/JACKET ❑ TIE/SCARF ,F ❑ SHORTS%PANTIES ❑ JEWELRY ❑ SOCKS/NYLONS _ ❑ SWEATE�/SWT:SHIRT �-1NArTGH-------». :_:.:_ :...: _-.•.� --ww-<.., r❑ BELT ❑ PANTS/SKIRT - ❑ SHOES/BOOTS ❑ T-SHIRT'/BRA ❑ WALLET 4' ❑ HAT/PURSE ❑ KEYS f ❑ KNIFE ❑GLASSES -❑ OTHER - s BKG OFC: X/ : r . I ' ATE SIGNATURE j�. have received all of my per- DATE: sonal property and clothing. REL OFC: ,< `X INMATE SIGNATURE 3diniVNCJIS 31VWNI :OJO 138 Ala3dO�ld -IVNOS83d AW .30 -lid (13AI303» 3AVH I :31VC 3MfllVNDIS 31VWNI ' ' a ZIP, :3jo Eme V9 0�3W 3 '3NO :83HIO :3�INN 1139 del :S3SS`d1J :SA3)1 GA; :3ssnd/1311t/M :8 31H OI1. :DS3a :HDIVM :DS30 N :A813M31 $ :HSVD N 2,�0 A :831Nnoo 834Nn WRI �°Il ?18N ONI1009 :3WVN r1l 6 AlI11Jb'3 :3WI1 I ti T 0321 I I B f�T p` :31V(J ldl3:)321 AiM021d A11117Vd NORNma VIS0:) V?IiNOJ RELEASE AND PROMISE TO APPEAR FROM CONTRA COSTA COUNTY DETENTION FACILITY (Penal Code Section 853) The People of the State of California vs . ) Booking No. Warrant No. 's o In consideration of being released from custody, I hereby agree: 1. That I will appear at the Walnut Creek Municipal Court located at 640 Ygnacio Valley Road , Walnut Creek Q Bay Municipal Court located at 100 - 37th Street, Richmond QMt. Diablo Municipal Court located at 1950 Parkside Drive, Concord Mt. Diablo Municipal Court located at 1010 Ward Street, Martinez Delta Municipal Court located at 45 Civic''Avenue, Pittsburg [] Other Court: DATE ` TIME on the charge of violating Section(s) A4,11 /'L! of the Cal i forni a('P-e.nal,)Vehi cl e.Co� 2. That if I fail to appear and am apprehended outside the State of California, I waive extradition. 3. I understand that any court or magistrate of competent jurisdiction may revoke this order of release and either return me to custody or require that I give bail or other assurance for my appearance. 4. I further understand that if I fail to appear when required to do so that I may be charged with the additional crime of a misdemeanor under Section 1320A of the California Penal Code. Date: Defendanti Address City & Phone White to Booking Yellow to Complaint Deputy Pink to Defendant Rev. 2/87 v J RELEASE AND PROMISE TO APPEAR FROM CONTRA COSTA COUNTY DETENTION FACILITY (Penal Code Section 853) The People of the State of California vs . ) Booking No. Warrant No. 's In consideration of being released from custody, I hereby agree: 1. That I will appear at the V Walnut Creek Municipal Court located at 640 Ygnacio Valley Road , Walnut Creek Q Bay Municipal Court located at 100 - 37th Street, Richmond Mt. Diablo Municipal Court located at 1950 Parkside Drive, Concord Mt. Diablo Municipal Court located at 1010 Ward Street, Martinez Delta Municipal Court located at 45 Civic Avenue, Pittsburg 0 Other Court: DATE l ` t 7 ,` ) uf`' TIME on the charge of violating Section(s) A� of the Californiglki4l/Vehicle Code. 2. That if I fail to appear and am apprehended outside the State of California, I waive extradition. 3. I understand that any court or magistrate of competent jurisdiction may revoke this order of release and either return me to custody or require that I give bail or other assurance for my appearance. 4. I further understand that if I fail to appear when required to do so that I may be charged with the additional crime of a misdemeanor under Section 1320A of the California Penal Code. ; Date: A, 1 <--� Defendant Address r r City & Phone White to Booking Yellow to Complaint Deputy Pink to Defendant Rev. 2/87 ' S'7 CLAIM — BOARD90 SUPERVISORS OF CONTRA COSTA COUNTY, COORNIA �A Clair Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10 , 1989 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: $.5 0, 000. 0 0 Section 913 and 915.4. : Please note all "Warnings". CLAIMANT: MATTHEW C. LITTLEMOON 1525 Waller Street ATTORNEY: San Francisco , CA 94117 Date received ADDRESS: BY DELIVERY TO CLERK ON December 15 , 1988 BY MAIL POSTMARKED: December 14, 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 19 , 1988 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy I., 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). County Counsel ( Other: DEC 19 1988 Martinez, CA 94553 Dated: � � 0 1 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 ( ) 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,.^�,t 1 Dated: AN 10000 PHIL BATCHELOR, Clerk, ByL/. "X6,"�oeputy 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 ilnitpd States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: J A N 10 1989 BY: PHIL BATCHELOR by AZ Deputy Clerk CC: County Counsel County Administrator ' CLAIM ''°'.CO BOARD OF SUPERVISORS OF CONTRA COPT ArFt9WYapplication to: Instructions to ClaimantVerk of the Board ( 5i P, ,s/io C Martinez,California 94553 A. Claims relating to .causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk -of the Board of Supervisors at its office in Room 106 , .County Administration Building, ,651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, . the name of the District should be filled in. ' i D. If the claim is against more than one public entity, separate claims must be filed against each public entity. . E. :• •aud. See penalty for /fraudulent claims , Penal Code Sec. 72 at end obis form. RE: Claim by ) Reserved amps' M s'ft� Lg) i i*i*r n R"E C E. VV E D Against the COUNTY OF CONTRA COSTA) 1 J 19 ) or DISTRICT) H, c H , Fill in. name ) c�E eo FA v By /'PA . The' undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ . Q 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 EH7aamage or injury occur? Include city and county) LJ MMMZ�CgA 3. How did the damage or injury occur? (Give fullydetails use extra sheets if required) ' n��, 6prC1ftC4I npl (TISACe-) fro Jor ntahtvMpI1ar,4'e, GPr)e� &,\a_(.)tN 0 n151,1m vk t at kloyle jl2 11,am � P 0-bi-?�Itit� 6, ' P(l�'z � ►� � v° ' �A 6( 4. What particular act or omission on the part of county or district • officers , servants or employees caused the injury or damage? An cdmostd d V;Vlkti'w� �6. See(. ����� 673 c�J ofkars ���. ����� �lpZ>���'1�Ary ajj [� ttjCGt �N` QA 4 i IghOM 1 j '��'v �g ��.��� �f b'�� Ir�� ��$a1J F hN �G`( i.t e L- 7 'E-,rY'\ 'S r';Aca `" P�fO'Y C•4+ K\k �O`S�� ari';%.9 1f;7' ate.ICU�►� A,' � �Q�� ��.�.�ur`�:�� �.�o � � �� � i� S�`ri� P�� a� ►�`" r�� f1 �d ?` (over) 5.. What are the nao f ounty or district oi*cers , servants oar, em loyees causin#the damage or in ury7 a 5�lEvicr�n2r .i haPd .fair&� f�55t So.er; a�rvtin E.R�pP,Rec�rds�vreav►M r .1,wes Cow ars apt;L.D. 5iwtmonS, Lr. U, Aorn Ser j„arr Au1:c4,,S i'R Te w,pIC1isti,S l�t�r�^4:{ FDPd Q�SO N.0 Carol,N.P.Connie,Cat'1NI-)a0Vmca",Ie.,�,q„�Brom t, Dep VDKirty,Dep.Yil-r-J OI}y�9ap•�i•�oob8�,"s9�, Sry•;th�Dip C3�Ctny4�� EAI'ost°-Shk, , 0;Sol liVAV NO Janso�A, Oap RAFeIAJ%4 � ` ok4oitar MD Fs%Sgt ---------- 6. . What damage or injuries do you, claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) �Alur kd V€�e r � , ri � ' � � ���le; ' p. v 'pa1'eltAw �fp 'sok � b t � �� �s�� c t�naa br�aac t)n smrh Pa, �,1��►a�^ �r �! e�e�� � �r VpP` It�1r�4$, � Ct6�`t�(�, t�s � Ea1� t���1� lea ,i4i 9 $tUkjgk�8�$�lE� $19ri �aV'4Mi6� �3�1b► �ia6 �dt!t��PVnQ, Yeti hl�t �^�.e�r+a�at�►��t�Q�l $�rg6,fM9AAq�� C��bn��iaaL o���t��d�d eb0�a�f;g i_Qia_�kgr c�E1t�aS�r�o� ,�$�a3s '_�?��t �a�9 e 7. How was the amount claimed above computed? (include the estimated amount of any prospective injury or damage. ) Tk6 110 �pAj to °w til t d'A 0100JIq wl�ork - ------ 8. Names and addresses of witnesses , doctors and hospitals. 1 g��,b��4B ��,� ��� u�� 9��i' ��.(� �+�a� �'` 'd��7fi�a � , ot,������ � P.-�°rJ�r��sl�`I" i�1';�PVi'�r�lms`s•` $,W.- SH'ct,�►�N1i�IC 6DY-nt'n,P40-fit(1+ &f;rfI 4J 9. List the expenditures you m� � �`ccount of this accident or injury: DATE tiG C� Pi: AMOUNT L 4thfuA04-1 , 'gook- w*j - ON�P_ data. ktteko Govt. Code Sec. 910.2 provides: "The claim signed by the claimant ` SEND NOTICES”"T'0.:.., (Attoriae ) or by some Eerson on his behalf. " Name and 'Address of Attorney werele Claimant s Signature Address . s Fiwx ci sc p fv///17 Telephone No. Telephone No. 0l0 44AJSV 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 fe-lbny. " Ila oar G;Z7- an p� STATE OF CALIFORNIA ° this.A .. .....day of.U�4:��WA-in the year..l�/�� .. s.. ........... I ..... ......................,before me,_ COUNTYOF6!!!:. ... ..... . • Nota ubl' Sta of California, duly commissioned and sworn,personally appeared. `.. ^�P ............. �.J! ................. ............................... personally known to me (or proved to me on the basis of satisfactory evidence) to be the person....whose name.......!L-9.............................................. OFFIC A SEAL �,°'.rtiP subscribed to this instrument,and acknowledged that. . . . he . . . . executed it. DIANE B GONSAFOR t IN WITNESS WHEREOF I have hereunto set m hand and affixed m official seal ,4 m 9 NOTARY PUBLIC-CALIFORNIA ( y y ' CONTRA COSTA COUNTY in e... ...............County of My comm. expires JUN 12, 1�5`(J� I ��/�j on the date set forth above in this certificate. This document is only a general form which maybe proper for use in simple transactions and in no way acts,or is intended to act,as a substitute for the advice on an attorney.The printer does not Notary Public,State of California make any warranty,either express or implied as to the legal validity of any provision or the / suitability of these forms in any specific transaction. My Comm n';sion expirelev. Cowdery's Form No. 32—Acknowledgement to Notary Public—Individuals—(C.C. Sec. 1189) 1/83) 13 Dce- 8.9' pkval-" PAe.-I 06,- AMA A� -tA' . C ..}.`-'tel {✓� �'l � \ V '4lY CIS a c 57 `OD c el {r w a 7i K �' CLAIM r BOARD SUPERVISORS OF CONTRA COSTA COUNTY, C&ORNIA Claim-Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10 , 1989 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: �6, 725 , 000. 00 Section 913 and 915.4. : Please note all "Warnings". CLAIMANT: KAREN ANN CHEEK c/o Law Offices of B. Palmer Riedel ATTORNEY: 2700 Ygnacio Valley Road #130 Walnut Creek, CA 94598 Date received ADDRESS: BY DELIVERY TO CLERK ON December 14, 1988 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. December 19 , 1988 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( K) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). County Counsel ( ) Other: ute 1901, Martinez, 4553 Dated: !/ BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the BoaRrder entered in its minutes for this date. JAN 10 1989 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 1Initad 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. D?tee{: JAN 10 1989 BY: PHIL BATCHELOR by V, A/d&—Doputy Clerk CC: County Counsel County Administrator T� A RE@ �V E D C C 14 1988; B. Palmer Riedel CLERK BOARD asuPERvIsoFS OF COUNSEL Jack M. Bonner CONTRA COSTA CO. Carolyn Morris Leland P. Jarnagin By Deputy Robert Rademacher PARALEGAL Stephen J. Schori Kat Miriam R. Schwartz Kathleen A.TremPy December 14, 1988 Clerk PERSONAL DELIVERY 12/14/88 Contra Costa County Board of Supervisors Administrative Offices 651 Pine Street, Room 106 Martinez, CA 94553 Dear Sir: Enclosed is a claim against the Contra Costa County Consolidated Fire District in reference to the incident described in the claim. Since the six months date for filing this claim . runs on December 15, 1988, we file this claim in order to protect the rights of our client, Karen Ann Cheek. We have not yet determined whether or not there is a sufficient evidentiary basis for prosecuting this claim. We would appreciate your bringing this matter to the attention of the Fire Districts legal counsel so that we may explain our position further. We regret any inconvenience that early compliance with these statutory requirements may necessitate. Very truly yours, LAW OFFICES OF B. PALMER RIEDEL LELAND P. JARNAGIN d:\WP\3\CHEEKFIRECLM.LTR LAW OFFICES OF B. Palmer Riedel 2700 Ygnacio Valley Road • Suite 130 •Walnut Creek, California 94598-3455 • (415) 934-4111 FAX # (415) 934-4428 • P.O. Box 1043 • Lafayette, California 94549-1043 . RECEIVED 0E.0 14 1988: CLERK BOARD OF SUPERVISO,� By CONTRA�OSTA CO. Deputy Claim Against Public Entity (Government Code Sections 905, 905.2, 910, 910. 2) TO: Contra Costa County Consolidated Fire District KAREN ANN CHEEK, hereby makes claim against the Contra Costa County Consolidated Fire District for the sum of $6, 725, 000 and makes the following statements in support of the claim: 1. Claimant's post office address is 123 MacAlvey Drive, Martinez, California 94553 . 2 . Notices concerning the claim should be sent to Law Offices of B. Palmer Riedel 2700 Ygnacio Valley Road, Suite 130 Walnut Creek, CA 94598 3 . The date and place of the occurrence or incident giving rise to this claim are: June 15, 1988 at 6: 34 p.m. at Putnam Boulevard, about 120 feet south of Sunnyvale Avenue, Walnut Creek, California. 4 . The circumstances giving rise to this claim are as follows: Initially, Christopher Atkinson, the driver of a van struck the claimant, KAREN ANN CHEEK, with his vehicle while she was crossing at a marked crosswalk. The claimant was thrown up onto the hood of the vehicle and then thrown onto the ground where she struck her head on the pavement. 5. It is hereby alleged that at said time and place as r` • aforesaid, Contra Costa Consolidated Fire District personnel negligently and carelessly failed to give proper emergency care to claimant at the scene of the accident and enroute to the hospital for the severe head injuries suffered in the accident. See Incident Report Number 07523 of June 15, 1988. 6. Claimant's injuries are serious, irreversible physical and emotional damages due to brain damage, loss of earnings and earning capacity; other charges are unknown to date. 7. The names of any public employees causing the claimant's injuries are unknown. See Incident Report Number 07523 of June 15, 1988. 8. The amount of my claim as of this date is $6,725, 000. 9. The basis of computation of the above amount is as follows: Medical Expenses Incurred to Date: $ 75, 000 Estimated Future Medical Expenses: 150, 000 Loss of Wages 1,500, 000 General Damages 5, 000, 000 TOTAL 6,725,000 Dated: December 13, 1988 LAW OFFICES OF B. PALMER RIEDEL BY• LELAND P. J GI Attorneys for Claimant KAREN ANN CHEEK CLAIM ��� ` BOARD SUPERVISORS OF CONTRA COSTA COUNTY, COORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10 , 1989 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 2 5 . 27 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: KERRIN BELAND 1395 Enchanted Way ATTORNEY: San Mateo, CA 94402:: Date received ADDRESS: BY DELIVERY TO CLERK ON December 14, 1988 BY MAIL POSTMARKED: December 13 , 1988 Certified P 818 208 238 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 19, 1988 ppHH BgATCHELOR, Clerk DATED: BY D puty k.A�� 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). County Counsel ( ) Other: artlnez, CA 9 553 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 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' Order entered in its minutes for this date. JAN 10 1989 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 'Initpd States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order a Rice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 1989 BY: PHIL BATCHELOR by uty Clerk CC: County Counsel County Administrator Claim toi BOAR�OF SUPERVISORS OF CONTRA COSTA ONTY 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 Cod Sec. 72 at the end of this form. H RE: Claim By ) Rese i p RE I V E Against the County of Contra Costa ) or ) ii CLE. PHI RD TC P R T!� C District) y 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) A)Clie � '� `� ,��t$8 �{ � 2. Where did the damage or injury occur? (Include city and county) \ 0<- �-c C0.r�an Q �C ��eat ��c�gC's>' CG�`�� �0. -------------- --d= '==�-�c_.�-"-r�- _d -�:� V��cz��c o. C,astG cc�'.XK-\ y 3. How did the damage or injury occur? (Give full details; use extra paper if required) C DG ---- ----------- 1^ ti - `---- ---------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? .. (over) 5. What are the names of Qty or district officers, servOts or employees causing the damage or injury? C� VOoc,S ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries .or damages claimed. Attach two estimates for auto damage. M S , { S �� u �\s em (3x. .ek %X� , eo 5, -------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) (60 -UCN--1A6 ------------------------------------------------------------------------------------- 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 Boa 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 1 3 IT `�C�,C> Address Telephone No. Telephone No. 9 1 01►-3) 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 ($10,000, or by both such imprisonment and fine. • HANSON'S AUTO REPAIR REP LLINS ROAD AIR • t 7E OF 1222 RO . REP BURLINGAME, CALIFORNIA 94010 toT,ii _ PHONE:340-8333 � �1�c LICENSEJK\4�14:� P Pts OWNER ( RES SERIAL B S. ,Y ^ P ONE 1 MILEAGE C'M ADDRESSii, XALo CITY Wt B n ENGINE Mldg INSURANCE JOB* Li Mirror YEAR MAKE MODE L Bumper w/grd w/ped FRONT own PARTS rr""°' REAR Noun PARTS rr""' LEFT own PARTS ar""' Nobe RIGHT Noun PARTS Bumper Ctr. Bumper C me Plate Name Plata Bumper Rein. er Rein, Fender Fender Bumper Pad. Bumper Pad Fender ext. Fender ext. Bumper grd. Bumper Gird. lFender Shid. Fender Shld. Bumper Brkt. Bumper Brkt. Fender Mldg, Fender Mldg. Gravel Shield Gravel Shield fender Mid .O. Fander Mldg W.O. Lower Shield Lower Panel I S,da Marker Side Marker L.c. Britt. Floor k I l4eat lamp Front S am Trunk h [HoodlameM Headlemp Dr. Frame 01 1LUMN Jldo. is@,-Beam Seal Boom X mb t Hin a i Park Lamp Whe I d Stem Trunk Lock Cowl Cbwl Tirenk R barW/S Mldg.,.: r W;$Midg. Hullcap L,c Door Frt. DoorFrt. Lw .Control ArmT Pipe Oddr Fra Door Frame Up Control 6 it Ntuff"' Doorfm�� Door Mldg. Sho k Gas T ajak&N Door go Door Hinge $pr. p _9asyenkibo r W Itfoor Glass Door Glass Sp•nd e F Vent Glass Vent Glass St0erin Whee d Ste Door Handle Door Handle P.S.Pu Tire I ILIOWNCenter Post Center Post Rad.Shot I Door Rear Door Rear Rad, Gr-n4 Ctr. b 6 drum 77 f Door Frame Door Frame Grille Midg. Axle Door Glass Door Glass Morn Housing DOOr Mldg. Door Mldg. Sof fie Side I Back Plate I lRocker Panel Rocker Panel Baffle Lwr I spring Rocker Mldg. Rocker Midg. Baffle Upr Shock Floor Floor Lock Plate Lwr Radio Speaker Frame Frame Lock Plate Upr Dog leg Dog 1 Hood MISC. Qtr.Panel Qtr.Panel Mood Midg. Windshield Qtr. Ext. Qtr. Ext. Hood Hinge Kit Qtr.Mldg. 10,r.Midg. Ornament - Antenna 10tr.Mid -W.O. 1Qt1.Mid •W. . Rad.Sup A.G.Condense. 10tf.Name Qtr.Name Rad.Core Recharge Qtr.Skirt Qtr.Skirt Ant. Freere Inst.Panel Side Marker Side Marker Rad. ►f'ose Firewetl Qtr.Glass Qtr.Glass Fan Blade Frt.Seat Adj. Tail Lamp Tail Lamp Fan Belt Seat Frame Bk•uo Lamp Sk•up Lamp Fan Shroud Trim Mirror Mirror Alternator Headlining Mrs.#$ P.•Mr. LABOR water Pump TopPARTS S Theabove ban estimate bwd en our ltipeelion Punas Tire end ones not ower any after tpesr labor MISC which meY DB required utred that rp work has bean Moloy Tube Or Stem opened up. Oooestonally after the York hes SUBLET atoned,worn or damaged harts ars discovered. Motor mounts Battery which are not evident an the first '-Npestion. SALES TAX S Because of this the above prices are not guaren- Trans.Lin kage Point tend.and are for lm b o,,14y: y ESTIMATE TOTAL S irosaw in the cost parts 11 be bllhd an Vo•lage Rag. Stripe in`ro�• 1 1ADVANCE CHARGES S impact Cost DATE `k `1 $2) GRAND TOTAL 4 2oloeone Underasal BY r t , —posit )' ;� Dppos i t .2: . RENTAL CO IN-apo" sit 3: t : LESSOR , Pr r` {-'ay Code Pe Pre - .d by CAR,419D #' South Valley I'San Jose Aix par/ Mountain V rw S.F.AQ��t ��/ jj'''`` B'��+'QQ Francisco i'' 2280 Liocoln,A4enue 560 Nrlvhaii Stxaet JArA�N I I Ca--,rtII-i 9290 Ar ly-,h JY¢t'r t• ''4`•tb O'Farrell Street San Josd CA 95125 San Jose.CA 951 10 Mnuniau vi,",CA 94040 NurUnymoe.CA 94010 . San Francisco,CA 94102 ..+f- C 408.9�>#•1555 408-287-3548 415-9410680 416.348.595S 41S-441.4778 - _ - -u,•' 9 • - DATE �� !`�-r :.i_.._.-.,_,•---•-it:i:::,":'t."•i RE T R'SIT-TAME -_ -� - - -- - -y - - •---- - - _--REPLACEMENT CAR t: Grff• LQ1/ � OWNING Y { .tj D E OF�TH_ CORP.RATE lD.Np. CREDIT Al1TH rDATElAfv/OUNT� - LOCATION '-_ id. I.D. - -- -- CAR NO. LI£ENSE IUU►MBBEIR EXPrr�iiRrA ?N DATE /$fj-AAL[ to _ LICENSE NO: +a-7 ESIDENCE t . �i �. SP 3T 'FhGn1eA �tw# E C 1 F L SP MODEL' - t� ., < S� 11P CODE CI -' TIME IN F .. HOME E' E:UM�E,g _ .' { .. TIME OUT I i.i�- -- .I-*-� -' COMP NY - COtvl'r JY PHON,€�ONyp,'�� - F MILEAGE IN' COMPANY ADDRESS `---' - - -- - v -_- _MILEAGE OUT - .. LOCAL ADDRESS{CONTACT :Y Y * INiLE$DRIVEN /►� ojd�' _ : .- ---- -_ ,rav16 SPL te, ijj - --` -- - - MLS fA a MILS � - .n4 -AfhAj 1,/ SPIL S I HR$ q ry E }► ,I I DAT HRS S. s } y. Elry, lc ts3w;f u j ♦ kj r x 'c` t S r / -1 ` DAY SLt7 DRAY :.. UCENSE NUMBER EXPIRATION DATE -- - STATE SPL: + WKS WKS 11 AGREE TO RETURN THIS VEHICLE ON OR BEFORE THE INDICATED DUE BACK DATE TO THE SAME- MO t a LOCAT►OE1 AT WHICH IT WAS RENTED+OR TOTHE AVCA11 OFEICESPECIFIED IN"THEAOX BELOW.• SPL IL'OR©P_CHARGE MAY APPLY IF CARTS RETURNED TQ OTHERT4AN RENTING LOC g TIME AND r '� - _ SPECIAL TIME AND I - Al "r ' '�+ ,• k. X THORNED RETURN- MILEAGE CHARGES CHARGES ' / '• �e.(�� 4.? .RE , ANCIALTTINQ TH.lIY E FN q ALRN'-BY_. RUTH:BY' HARGEB. rs,.x ::_IMPORTANT NOTICE? OPTIONAL Cmay have this'esponsihilityOLLISION i.<CeRtttCt,iDbietl;te.-fiA1Ud-il;:`"=, ,;lE$S6i8COUN'i'i r :�. r s 7.Vehicles iausi be_ehaeked in and 'i -inspected 611110,30 deye renN{t:'r' p _ 'I the lellsed vehiChi and loss � 3:-'All tretfk violauens sn the d", -` S � -.�- !• 11 Ij:ttdIp.ss of neqlit COW s tibiiNy af:ibe r$M ~ E:'bfHeepe'readln�taken Gol1l faetaTy= DROP EEE9 =' installed atbmeler �' + `'' s r n Eti6.'vehlCll must ifs fetaruadt6 RfRtihp ' OTHER-.' g�EEOffice. Othemise. a recevarY teeOwn - tS+= Will be charged. a Nnthorised drivers,mOtt.be 21. peMt or aider and'lMns a valid ` .- lies _ TAX @R Ht1RC 1_ '+r rt a.t r - T tests wiflet bider any circon ` I #;x - ` 'stances surrender the an of the` flEF EUNB� Rental Vehicle to anyyerWa at at then those listed an the tolNratl PAJ,(PER r # # 8>Qne-Aoargrace peTiodafltwaboAl�'' $,. m f 1F r- ))) - on day vehicle is returned. PEC(PER DAY) I 4.* - .tom , :- - S fry t� ,r � �/ `._ ♦iii.i W� T© � p BECODPONSCNEA S i OTHER. r x o r GedDAMAGE- .- -CIDAMleotimSCRtBE 'offONT!+'�';ti TO' r r1 'P' 1 7�{!,•} A@ " `-' AOOITIONAL� � LESS REFUND FOR ��t •,.Tr h', ®A _____. .------- __,...___._ _.__. _'-- - '---- 'CASH DEPOSIADDITIONAL ` S _.1 '1. .. .__,. ._ y V'y = � +fII�{4'S• 'L�!i�rE,� p `'�L� " LESS, f z ' T 1 ES X=bENT' -SCRATCH O-MISSING IDIAtDEPOSIT* TOPAZ 3 DEPOSIT ' tAUFOR%U VEHICLE COOS f COSS STATES•WNE%tVtR ANY PI RSON WHO HAS UASEO OR RENTED A VEHICLE WILLFULLY - - NET DUE ADD INTENTf011At1T FAitb TO RETURN THE YteIMI TO THE OWHIR WITHIN FIVE 151-DAYS ALTER 1HE LEAST ON RENTAL REfUNO 8 RENTER ARNtIEIEENT NAS EXPIA[0,THAT PERSON SNAIL OF PRESUMED 10 HAYS EMREZZLto THE VEHICIE.' __ - --- - RAVE READ TERM$AND WXM"OHS ON HOTN SIDES OF THIS RENTAL AGREEMENT AND AGRFE TO OF BOUND eY ITS RENTER'S- V_ •''<�' NET DUE'- RMS AN • .t(�,. TED Cd%OIRDB AND Witt FIEFON%VENMUM 10 AVIAN RENTAI AT THE file[AND PLACE SPECIFIED.1 AGREE TO INITIAL X AVCAR- FROCE#"OFMTCREWtCAN I=CRAR4`15' IRUGOo 1113CO%TIACTItN 10 ST OTHER MEANS.TN ISWlll4430 CK IN LOCATION 'TA�COMM.DUE� CHA C.ED _ CAS ICK AI OM►AIO Iyitlt a101AT1�q. f _ __. _ _T _.__._.i eY CASH TRAVEL eY ECK AYCAR Mt C. EMP.NO. CLOSED OY-EMP.NO. --., __..-_ _.....__. y._ Y' ^ t ' ....F..+;-.x+,r- aF,.. 5.' - i/�i.>�✓�"?�f3't"- g � w�� ��s- (t�. �r:. f. z a ! f k 'Fy, Al AUTHORIZATION r' 7' F r I CME{KiOR BILL.R ►N { , 1 1. " tfra n MO D�F * rear. t ti 'DESCRIPTION a `�'vt t AMOUNTd /) ••/ee�'{/j�.:AA��aatl+fy�{`;1i�6 5 ��,1 i Sy...� � }a K x y'L t- >t f Q��.'� �eA�_� ¢1 r t :�,#' Pr havtt'd dr tad IdwlW m dda 1Ma 4 au�Wndl mare dors i T07At k u ,� �< a s- , , L. ,-� ..•z.c-" d- +gory A!a0r p�raaatkii.t b`-arb iOTN. .. .�h, -aMr dir �'� { ..'� � '+ �, s. SLiP�; �a �� ti a .T.. pt..w-...a„+. a s 3 z .;. 'F ,R '�i'a�,k s �r a rt!` s - SAFER�RF US"Pet 4 403,783 rx TPL 84t 687 }/�����yy�� ..yyt�� /a/,�� CARD MOWER�rM!'Yi'7 -V 'tt IC AJIet"ICaN=INIPOItTAgNT; ,R�AETAIN"TN18 tOPYtORjOt1RRECORDStt }; ,r, �k f "�- .; M x °w tpi i- r� k'� 4 f C + v teji�'<n ttt � i� Iv 113 co m CO N go 0-0 1 cc c, Al l� s I � -------- -- -- - - t' U Z Z , O< m ❑ m cn Z `LL s "� o -OTO CLAIM r - BOARD SUPERVISORS OF CONTRA COSTA COUNTY, CAORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10 , 1989 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: $13 , 2 9 1. 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JOHANNES P. VAN KRIEKEN 150 Shirley Court ATTORNEY: Vallejo, CA 94590 Date received ADDRESS: BY DELIVERY TO CLERK ON December 14, 1988 CC BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 19 , 1988 EVIL BAATCYELOR, Clerk epu L. Hall II. FROM/: County Counsel TO: Clerk of the Board of Supervisors (v) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). County Counsel ( ) Other: n e r` i n 996$ Martinez, UA 94553 Dated: 2 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: IBy unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JAN 10 1989 989 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 ilnitad States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 1 198g BY: PHIL BATCHELOR by 4&DVxjty Clerk CC: County Counsel County Administrator 1 . COUNTY COUNSEL'S OFFICEa CONTRA COSTA COUNTY Date: December 14 , 1988 MARTINEZ, CALIFORNIA D E C I 1988 `� PML BATCHELOR CL ' OARil O�SUPERVISORS To: Clerk of the Board of Supervisors `" 'R '"" r`' From: Victor J . Westman , County Counsel By : Andrea W . Cassidy , Deputy County Counse o�� Re: Billing from J . P . van Krieken Our office has received the attached billing from J . P . van Krieken . Please process it as a claim . AWC : da Attachment To• A Frio. Oiohann s P . van Krieken CO ^� L)tiSFL..S O r'Y 150 Sh ley court Val o Ca, 94590 .1Ns, 5341 P PP gZ O county Counsel BI oNj 13 1988 RE: Notice of Bill due and av Dle to Johannes P.van Krieken DEC (Craig vs . Missouri 20 US (IV pet) 410, 433-36 1830) Martinez, CA 94,553 Dear+/Madam, This Billing is to prevent irrepairable damage to the Undersigned due to irresponsible actions by you: in civil cases No. ' s B-939984-1 and B-940810-5 and for failing to observe the conditions of the October 27th, 1988 Order to Show Cause hearing which discharged your fictional claim of authority, leaving me with a limited remedy of billingjou for the amount due and payable to me in the amount of (�o1�1O for case B-939984-1 and O G:2-7 D O for case B-940810-5. (Craig vs. Missouri 20 US (IV pet) 410, 433-36 (1830) . You are advised of the amount due and payable to me, as you are required by law to produce the consideration of your claim on request or show cause why I should not direct the clerk of court to issue a warrant for your arrest. You are given this request for admissions regarding the consideration of your claim, under the rules of discovery. YOU ARE ADVISED THAT MY EXERCISE OF THE ALTERNATIVE HAS STRIPPED YOU OF ANY CORPORATE IMMUNITY AND YOU ARE NOW PERSONALLY LIABLE FOR THIS AMOUNT DUE. (THIS IS YOUR MIRANDA WARNING) . THE TOTAL DUE: t V3 291 W . (see attached worksheet) Be advised that the amount due is payable on or before the END of this month. Please pay the amount promptly to avoid further costs ! ! WARNING! ! ! FAILURE TO PAY OR OTHERWISE SATISFY THIS BILL ON OR BEFORE THE TIME GIVEN HEREIN THIS "NOTICE" , MAY RESULT IN THE LOSS OF PROPERTY AND THE GARNISHMENT OF WAGES/SALARY THAT MAY BE SUBJECT TO ATTACHMENT AND/OR SOLD BY THE SHERIFF OR FORFEIT TO SATISFY THIS LIEN. THIS IS AN OPEN ACCOUNT UNTIL PLACED FOR COLLECTION. I am currently negotiating for the terms and conditions of a registered bond to secure this billing when it is placed for collection. Should the Sheriff ' s sale fail to collect the full amount of this bill, the subsequent actions may result in your forfeiture of all the property you currently own. You may even be subject to receive a deficiency claim if it is determined your property is insufficient for a complete discharge of your liability. Be further advised that any property you may attempt to convey, conceal or otherwise assign, is subject to attachment or other action. For the Law requires that you warranty good title and affirm that no liens are pending against you to satisfy this claim or other action. YOU NOW HAVE NOTIC= OF THIS LIEN! ! ! You do not have a clear title to any property until you satisfy this lien. This lien is in force beginning ��C�FlC3E�i 8� page 1 of 2 ��nd _ T/_ f��� J After the amount due is not paid interest on this sum acrues at the maximum amount permitted by law of 1 1/2 % compounded monthly. The interest accrues thirty days from the due date of this billing and is compounded each month thereafter. Sincerely Yours, Dated: 2 rt2 r s s Johannes P. van Krieken P R O O F O F S E R V I C E I, the undersigned, hereby certify that a copy of the foregoing "NOTICE OF BILL DUE AND PAYABLE TO JOHANNES P. VAN KRIEKEN" and "ATTACHED WORKSHEET' was sent by first class mail to the above named person to the address shown below the name on this /a f'`� day of D LCyy�/3F.C_ 1988 . Signed- page 2 Of 2 i Case # B-939984-1 Case # B-940810-5 i . i Fine $ 64.00 S 127.00 550 .00/day since issue of citation to Oct 27, 1988 _ S 355D.00 $ 3550.00 Travel,postage, service, 1 notaries and Legal fees S 500 .00 S 500 .00 Legal research and typing $ 2500.00 $ 2500.00 SUB TOTAL S 6614.00 S 6677.00 • 4 /C CLAIM BOAR* SUPERVISORS OF CONTRA COSTA COUNTY, OFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10, 1989 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: $388 . 00 Section 913 and 915.4. ; Please note all "Warnings". CLAIMANT: DONALD J . HEINEY 905 W. Miner-St.: . #61 ; ATTORNEY: Ureka, CA 96097 Date received December 15 , 1988 ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: December 12, 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: December 19 , 1988 �b: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). County Counsel ( ) Other: E 19 1948 P, Martinez, UA 94553 Dated: �i '�r U BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOAZT DER: 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. JAN 10 1911, 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 ilnitad 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. De.ted: JAN 10 1989 BY: PHIL BATCHELOR by f puty 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, 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 agains'c 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 e ) Reserved for Cler-,k=_ _ Oe UEC:h Against the County of Contra Costa ) 1988 or District) C' ---ti De u 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) -------- --� -f-1� - -------------------- ----------------------------- 2. Where dii the damage or injury occur? (Include city ar�d county) �q 5 t��z-e P_d c eco R��►� q Fze&� � "CL i v- C' 0 � S= S r. W CLt0Q -�C-'V t to (6q TeA -C�,4- 6C,tV_-n t w•e.0•2_ 3. How did the damage or injury occur? (Give full details; use extra paper 'if if required) CO rNT2,c, Co sT C 1 f cl �c: C� 6 q(V-e- T4�_(Z$ Irlerz ia'l Z Glc r►16 4� P`i� �h� �c �t�n� 6-- 5w �RsSc -------------------------------------------- ------------�--------------- T- ems 4. What pai-ticular act or omission on the.part of county or district officers, servants or employees caused the injury or damage? -r4 // r C y- (J Sr m « S (fai Cyosl 5�- fii �S (over) i • I 5. What are the names of county or district officers, servants or employees causing the damage or injury? - fru S S 006k--N 1 04:F rc e.RS -------------------------------------------------------------------------I----------- 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.) Z f� 4 C-O(d —ktCr in 0,0 bne PaiP- 0f- AtVCAP-NeT ----------------------------------------------------------------------- LA FR -- 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 Cla" i s Signa (705 c,J Inlnre sr for G� Address 'Te'6 f 7 Telephone No. , Telephone No /6 es--'J22 * * * * * * * * * * * * * * * '* * * 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 net 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. eA at _ c . KEITH A. HILLEGASS COMPANY, INC. INSURANCE ADJUSTERS & ADMINISTRATORS November 14, 1988 Mr. Donald Heiney 905 West Miner St. , # 61 Yreka, CA 96097 Re: Our File No. : L88-0024 Our Client CO. OF MARIN D/E 10/19/88 Dear Mr. Heiney: This firm represents the County of Marin, in the capacity of claims agents. I am in receipt of the claim that you recently filed against the County, having to do with lost personal property while in the jail facility. Investigation with the Sheriff' s Department revealed that none of the items that you listed were inventoried in at the Marin County jail. I have attached a copy of the property slip from the county, as well as a copy of the property slip from Contra Costa. You will note that you did not sign the slip from Contra Costa as having received your property. The transporting deputy has also verified that he did not receive any of your property at the time of your transfer from Contra Costa to Marin County. I would suggest that you contact Contra Costa County and/or file a claim with that agency with regard to your lost earrings and sunglasses. Under the circumstances, we can be of no assistance to you. Your claim will be reviewed shortly by the Board of Supervisors and you will be advised of their action upon your claim. PUREE truly yours, N A. SHUTTS MAS/mm cc: Co. of Marin 155 Callan Avenue, Suite A - San Leandro, CA 94577 Ph. (415) 351-1600 (1) Name (Lost) �t� (M�iddl "^"„r• (2) Booking No. (3) Box No. (4) Cash Received —)d- Currency Coin: iD + Article Qt Mem Date s Y' Description Color Condition / Agency Officer's (Circle Item Recd. aka Time Initials (5) at ap (6) carFnivig---- (7) 1 -Coai/Jacket (85weate Gloves 1 ' (9) Ult/DLL--s__- . . hitt/ louse Pants!shorn r (12) I ' ,304-- (13) oder; iJIJkC I ' T-ShiriLWeor- (14 Z t7� I I _ - --- - -• (15) L� - (16) Watch (17) Knife/Sheath I Wallet/Purse (19)Quantity of Credit Cards list Type:. (20)Check Book Bon;: - (21)Baggage-Describe: location: I (22)Quantity of Keys i (23)Jewelry-Describe: 1 (24)Misc.Papers I ' (25)Misc. Items(Items received after booking-use reverse page 2) _ I I (26)Medical Records/Medicotion (27)Property Kept by Inmate (28)Inmate Acknowledging PropertyToken (29)In cknowledgin Prc Received t30 Si nature Officer Rcvg.Pro rty Dote/Time �--. 31 Signature Officer Rlsg.Property Date im 3310-4 Rev. 1%78 m t r 3 JAIL COPY 1 _ CLAIM BOA* SUPERVISORS OF CONTRA COSTA COUNTY, ASFORNIA y Claim Against the County, or District governed by) BOARD ACTION the Boardiof Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10, 1989 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: ARTHUR COPENING c/o James F. Kemp ATTORNEY: 42.8 1st Street East Sonoma, CA 95476 Date received ADDRESS: BY DELIVERY TO CLERK ON December 12 , 19$8 BY MAIL POSTMARKED: December 9, 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. c� December 19 , 1938 PPHHIL BATCHELOR, Clerk GATED: 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). County Counsel ( ) Other: n n i n inoo MaFtlnez, UA 94553 Dated: BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD 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. n - Dated: JAN 10 1989 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 11nitod 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 otice to Claimant, addressed to the claimant as shown above. Dated: JAN 1 989 BY: PHIL BATCHELOR by ` put.Y Clerk CC: County Counsel County Administrator r o 00AW" Claim tot BOARD SUPERVISORS OF CONTRA COSTA C96 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 i of action. Claims relating to any other, cause of action must be presented not dater 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. i 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 ust '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 's filing stamp ARTHUR COPE°dING ) e6�C Against the County of Contra Costa ) i-d or ) 2 1� � 1988 District) ' Fill in name The undersigned claimant hereby makes claim°against the County onura-m'� or the above-named District in the sum of $ 100 , 000 : .,an in ,support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) July 11 - 18, 1988 2. Where did the damage or injury occur? (Include city and county) ', 2415 Maine Avenue, Richmond, Contra Costa County, CA 94804 3. How did the damage or injury occur? (Give full details; use extra paper if required) County failed to extinguish fire in Safeway warehouse downwind. 4. What particular act or omission on the part of county or district officers, N servants or 'employees caused the injury or damage? Failure to extinguish fire (over) 5. What are the names of county or. district officers, servants or employees causing the damage or injury? unknown ------- --------------------- ------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Respiratory problems, irritation to skin, -eyes , nose, throat from pro- longed exposure ,to and :'inhalation of smoke & toxic fumes; -damage to autos ; --~ d-�ro ser=----------------------------- 7. -- ------7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury`or damage.) from bills and pain and suffering and anticipated future injuries dames and addreesses of 3;*iti-lesse s, doctors and hngp i t.a l s r ?ierbert C. Getman, M.D . , 2101 Vale Road, Suite 300 ,-' San Pablo,. CA 94806 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT to follow Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or b' ome person on his behalf." Name and Address of Attorney JAMES F. KEMP Claim t S' »ature 428 First Street East tto ney for Claimant. P. O. Box 176 415 Whine avenue Sonoma, CA 95476 Address a?i mond, CA 94804 Telephone No. 707 938-2700 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. PROOF OF SERVICE BY MAIL I declare that: I am a resident of Sonoma County, California. I am over the age of eighteen years and not a party to the within entitled cause; my business address is 428 First Street East, Sonoma, California. On December 9 , 1988 I served the attached Claim form b lacin a H y p g �-egy thereof,:enclosed in a ..sealed_ envelope with pv�tu7c icrc vii %iliiy .picpaiu,, iii tiiC Ujutud States .Mall at Sonoma, California, addressed as follows: Clerk of the Board of Supervisors Room 106 .Couhty Administration Building 651 Pine Street Martinez , CA 94553 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and- that this declaration is executed on December 9 , 1988 at Sonoma, California. o , -w M \ \ z / „ & 00 , ! � A d e' w / @ ! . . g / 0R1 3ul � $ . L11 / h m Q R © m U3 � . �>■ ) j ! � CLAIM �• y BOAF�F SUPERVISORS OF CONTRA COSTA COUNTY, FORNIA / Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10 , 1989 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: ROSEMARY COPENING c/o James F. Kemp ATTORNEY: 428 lst Street East Sonoma, CA 95476 Date received ADDRESS: BY DELIVERY TO CLERK ON December 12 , 1988 BY MAIL POSTMARKED: December 9 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. L December 19 1988 PpHHIL BATCHELOR, Clerk , DATED: BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( Vl)"' 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. BO7) This RDER: 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: JAN 10 1%9 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 1989 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ' Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. if the claim is asp -nst 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 f Cler 's 'lin st p ROSEMARY COPENING 4(` Sr. Against the County of Contra Costa j Dt C � 1988 District r ` Fill in name The undersigned claimant hereby makesclaim -againstthe County of Contra Costa or the above-named District in the sum of $ 100 , 000 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) July 11 - 18 , 1988 ------------------------------------------------------------------------------------ 2. Where did the damage or injury occur? (Include city and county) 2415 Maine Avenue, Richmond, Contra Costa County, CA 94804 ------------------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details; use extra paper if required) County failed to extinguish fire in Safeway warehouse downwind. ---------------------------------=-------------------------------------------------- 4. What particular act or omission on the part of county or district officers,, servants or employees caused the injury or damage? Failure to extinguish fire (over) PROOF OF SERVICE BY MAIL I declare that: I am a resident of Sonoma County, California. I am over the age of eighteen years and not a party to the within entitled cause; my business address is 428 First Street -East, Sonoma, California. On December 9 , 1988 , I served the attached . Claim form by placing a--tree—clrpy thereof ' enclosed in a sealed 'envelope with postage ..h Creon fully prepaid, i!1 the united States M--aii at 6onoma, California, addressed as follows : Clerk of the Board of Supervisors Room 106 .County Administration Building 551 Pine Street Martinez , CA 94553 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration is executed on December 9 . 1988 at Sonoma, California. AMENDERI M J ` B-0 OF SUPERVISORS OF CONTRA COSTA COUNTYLIFORNIA C1'aim Against the County, or District governed by) BOARD ACTION ` the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 10 1 and Board Action. All Section references are to ) The copy of this document mailed to you is you notide ,P89 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: MCINERNEY & DILLION One Kaiser Plaza - 13th Floor ATTORNEY: Oakland, CA 94612-3609 Attn: Randy 0. Wright Date received ADDRESS: BY DELIVERY TO CLERK ON December 13 , 1988 BY MAIL POSTMARKED: December 12 , 1988 Certified P 835 464 857 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL BATCHELOR, Clerk DATED: December 16 , 1938 BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim coply substantially with Sections 910 and 910.2. ( r� This aim 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: '2 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 ( ) This Claim is rejected in full . ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. JAN 10 1989 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen •of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 10 1989 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator 1 ! .i NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: McInerney Dillon One Kaiser Pza - 18th Floor Oakland, CA 946'1 -3609 Attn: Randy 0. Wr�,ght Re: Amended Claim of William P. Young, Inc. Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. x 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s) of the public employee(s ) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ( $10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTO J. TMAN, County Counsel By. Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. §§ 1012, 1013a, 2015 .5; Evid. C. 99 641, 664 My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s ) addressed as shown above (which is/are place(s ) having delivery service by U.S. Mail) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. i Dated: Q� at Martinez, California. cc: Clerk of the Board of Supervisors (o 'ginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 .4, 910 . 8) r i LAW OFFICES M,ANERNEY & DILLON WILLIAM H. MONERNEY PROFESSIONAL CORPORATION AX (415 465-8556 MARADON M.DILLON TIMOTHY F. WINCHESTER ONE KAISER PLAZA - 18TH FLOOR O EL ROBERT L.LESLIEOAKLAND.�.�.��,����)�l NIA 94612.3601) LS RICHARD F RENTON - WILLIAM H.MCINERNEY,,JR, ED L.RANDOLPH HARRIS TELEPHONE (4151465-7100 MICHAEL E.LONDON RANDYO.WRIGHT CrIIa V FRANKLIN H.YAP MICHAEL D.VALE ROBERT G.Z cIENKA NERN TIMOTHY L.MCIRNEY O CHARLES E.TO EAMONN P. CONLON _ RUTH PASKEVICIUS WILLIAM A.BARRETT DAPHNE D.GOLLIHER December 12pMI TC L THOMAS A.GRAUDIN , 1988 CLE 8O TPE By Mr. Patrick S. McGovern VIA CERTIFIED MAIL Deputy County Counsel No. P 835 464 859 Office of County Counsel Contra Costa County County Administration Building P.O. Box 69 Martinez, CA 94553 Re: William P. Young, Inc. v. Contra Costa County, et al. ; Case No. C8804696 Dear Mr. McGovern: We are in receipt of your Notice of Insufficiency and/or Non-Acceptance of Claim for the Claim of William P. Young, filed by this office. Although the item checked on your Notice is somewhat broad in that it claims that our Notice fails to state the date, place or other circumstances of the occurrence giving rise to the claim, it is our understanding that your true concern is with the date of the occurrence giving rise to the claim. This, at least, was the information given to us by David Schmidt of your office. As I told Mr. Schmidt in an earlier letter, it is our position that the act giving rise to the claim was the exhaustion of our administrative remedy in July of this year. At that time, we received Mr. Schmidt's letter stating that the County was rejecting our claim after numerous meetings with the County's representative. It was only then that our obligation, and right, to file a claim arose. See Van Alstyne, California Tort Liability and Practice, CEB, §5. 36. Furthermore, as we previously indicated to Mr. Schmidt, it is our position that our tort claim was properly presented Mr. Patrick S. McGovern December 12, 1988 Page 2 to the County Public Works Board. Therefore, the 45-day rejection period commenced when service was made on that government entity. As a result, the time has now passed for the County to be requesting the information set forth in your Notice of Insufficiency. However, in the spirit of cooperation and in the hope that reasonable minds will prevail, we are pleased to provide you with the information you are seeking in this matter. If you wish to treat this letter as an amendment to our claim, that is your choice. However, it is our position that the time for requesting such an amendment has passed. If we can be of further assistance to you in this matter, please do not hesitate to contact us. r truly yours, M Inerney & Dillon, P.C. andy Wright. ROW:meb , /! 3972*C288 v cc via Certified Mail: Director, Contra Costa County Public Works Board Director, Contra Costa County Board of Supervisors cc: David F. Schmidt b K;i-t r. •{Is i• -y-e fc.F„- f P ao 7 ra ct I � 0 U to to I-zr rq ((f 6) �'- > a � 04 U U W J•1 4� 4 OJ N 0 0 r� a) U 2'I 4-) a4 -ri y J4 ri +) ri 0 O to M as C) its. _., co1,9 Ln co 1210 u � o . � c 0Wa J a ? ::� 47 Z J a _..— n- U) N (j w a zL �-- 0 w e �U ¢ z i. a