HomeMy WebLinkAboutMINUTES - 01231990 - 1.18 CLAIM 41,
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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: Unknown Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: FIELDS, Ventearous
11989
ATTORNEY:
Date received MartinezGIA N-45
ADDRESS: 4735 Arno Ct. BY DELIVERY TO CLERK ON December 28, 1989 (via Clerk's
Richmond, CA 94804 Office)
BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim. ppHH gg
DATED: December 29, 1989
JV DeputELOR, Clerk
Y
11. FROM: County Counsel TO: Clerk of the Board of Supervisors
( ) This claim complies substantially with Sections 910 and 910.2.
This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: 9 1 196 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
( his Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy o.f the Board's Order entered in its minutes for
this date.
Dated:,= 2 3 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code sec ion 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 2 3 1990
BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Vente ous Fields
4735 Arn t.
Richmond,. CA 4804
Re: Claim of VENTEAROUS FIELDS
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.
x 4 . The claim fails to state the name(s) of the public
employee(s) causing the injury, damage, or loss, if known.
x 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:
VICTOR J. WESTMAN, unty Co sel
By:
Deputy C Counsel
CERTIFICATE OF SERVICE BY MAI
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: \\� \b at Martinez, California.
cc: Clerk of the Board of Supervisors (oliginal)�
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 .4, 910 . 8)
SI Ieriff-Coronertr Richard K. Rainey
Contra SHERIFF-CORONER
P.O. Box 391Cos}� Duayne J. Dillon
Martinez, California 94553 l Assistant Sheriff
(415) 372- 4494 County Inty Warren E. Rupf .
Assistant Sheriff
Al
DEC,2 81989
PHIL BATCHELOR
CLERK BOARD OF SUPERVISORS
C COSTA CO.
B ............ .-Deputy_
Le
Enclosed, is a County Claim Form., Please list the missing
articles and their value, along with any documents you may
have, i .e. , receipts etc. Be sure you have included pertinent
dates that tie in with your loss. These dates should show
when you were brought here and when you left. Then you must
return this form to Contra Costa County, Clerk of the Board;
P.O. Box 911, Martinez, Ca. 94553
r
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C. Ludwig
Support Services Dept.
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JAN EQUAL OPPORTUNITY EMPLOYER
L-AIM,% TCS• BOARD OF SUPERVISORS 01' CADMI,IM C=1 ,� ,r �,npplfcatlen to.
Instructions to C1al rant ClarkW 6aard
�(Cw'itornla 94533
A. Claims relating to causes of action fcxx lde-at:b or, '100. , .Zu3ury, to
person or to personal property or grou-lm:g crmas Wit= be ;presented
not later than the 100th day after they; accc=a+all of t: cause ,of
action. Claims relating to any other cam-me of =artier str be
presented not later than one year after• t a, . !bf t;ae icause
of action. (Sec. 911. 2, Govt.- Code)
B. Claims must be, filed with the Clerk of 'It be Board of :5 rv3sors
at its office in Room 106 , County _Adin. .aln:strfa,tivn 3u.-ill n:gA 1651 Pine
Street, Martinez , California 94553.
C. If claim is against a district govern-e by tEhe Bva-_-uH cmf .:Supervisors ,
rather than the County, the name of the :1D: _strict shazmil(d be milled in..
D. If the claim is against more than one pmb11ic cemt;itov„ sepasat-e claims
must be.. filed against each._public entfli, _ -
E. Fraud. See penalty for .fraudulent clazms, Pezp;1 C,c mac_ 72 at end
of this form.
RE: b ) FZese=-zd for (C?Lark"s filing stamps
' RECEIVEir
u
\110- ue ry-:5 _*M
Against the'_COUNTY OF CONTRA COSTA) DEC ZH81989
* ~ ) PHIL.BATCHELOR
or � DISTRICT) --.
CLERK COARD OF SUPERVISORS
(Fill n name) ) C TR COSTA CO. De u
eg.
• The undersigned claimant hereby makes claim, a.ca s�t. Cb=ty of Contra
Costa or the above-named District in the s= n (of
and in support of this claim represents as o11cws;
----------- ,_._-- -------
1. When did the damage or injury occur? Wive exact aaaa-ite amd hour)
2. Where did the damage or injury occur?-- 41 ,c3a�a� �.1 ,j ar�tt caunty) _
----------------------------------------- -------
3. How did the damage or injury occur? �JGive full, details, use extra
sheets if required) "
9 What particular act or omission on the, pmt acot comntsy or dastrict
officers , servants or employees cause the iMja x:F err d zge?
(over)
'.:5..:-:•j� zat.. ar.e.:the_..names of county or district officers, servants or
I employeescausing the damage or injury?
6 . What damage or injuries do you claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage) -
--------------------------------------------------------------------------
7 . How was the amount clsimed 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
L.
t AFr0 1nk 14-
Govt.
-Govt. Code Sec.. 910 . 2 provides :
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) or by some Gerson on his behalf. "
Name and Address of "Attorney
Claimant ' s Signature
41 w Ar r'o. C+:
Address I GU y
1 kMAh,1 C Pt
Telephone No. - Telephone No. 2 -g"? 2 Z
NOTICE
- i
Section 72 of the Penal Code provides:
"Every person who, with intert to defraud, presentz 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. "
'.:5..:.:•J` zatt ar.e.,the...names of county or district officers , servants or
I employees:: causing the damage or injury?
-
- - ---•�d- �•-• -... .- --- ------------
6-.- -
What amage-----or--in-juries- ---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. )
----n; ------------------------- ------------------------------------
8. ames------and addresses of witnesses- doctors and hospitals
I
1
-------------------------------------------------------------------------
9 : List the expenditures you made on account of this accident or injury:
DATE 7--MOUNT
iy ►� pave Rllc
i AFro YIrvK
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 Signature
. � y'� 3� r r►o C-1'
Address
c 4, m h hC PF ► 9Y�oY
Telephone No. - Telephone No. 3
NOTICE
- - p
Section 72 of the Penal Code .provides:
"Every person who, with intert to defraud, presents for allowance or
for payment to any state board or officer , or to any county, toy,*n, 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. "
I
L INi� TCS- BOARD OF SUPERVISORS OF` Cao
T" • Instructions tt� C21aimant 'Mark:if Berard
i�fhert.tC$'Irfor l 94533
A. Claims relating to causes of action f,= a, oar, for M--M.3ury to
person or to personal property or grow :g cis t be presented
not later than the 100th day after the ;ac=m l 0f t ccau-s-e of
action. Claims relating to any other Damm: of :a •t 4om ast be
presented not later than one year aftem titer aiczl 6f. the cause
of action. (Sec. 911. 2 , Govt.- Code)
B. Claims must be__ filed with the Clerk of Moard of Supervisors
at its office in Room 106 , County .-Aa=ma.stra-,t_1vn 3a.i.1 tgA 651 Pine
Street, Martinez , California 94553:
C. If claim is against a district governed b, _v t�he ;Bma=d cof S=,ervisors ,
rather than the County, the name of the aizt=dct sh=d12 'ba filled in..
D. If the claim is against more than one pmOblic iFamtf v„ paT.at-e claims
must be filed against each...public ent±+ice_
E. Fraud. See penalty for ,fraudulent cla=z Vie:: ;1 C,=3e Ll;e:c. 72 at end
of this form.
RE: b ) Izeserved fir (Clzml- "s filing stamps
��lis } , •_ ..
R,ECEINTE"
Against the_BOUNTY OF CONTRA COSTA) [jEC 2H81989
TCH
or �V DISTRICT) - PHRDOF SUPESUPER
CLERK COARD OF
(Fill n name) ) C TE COSTA CO. De u
- The undersigned claimant hereby makes clam :against e Cb=- -ty of Contra
Costa or the above-named District in the s7=u of $ w
and in support of this claim represents as :fa11cws;: 71,
- -- -------------------------------__
i -- . �e,__-__--- ---
wh-en--did the damage, or injury occur? ,Give iexa;ct -tan-d hour-) -
2. Where did the damage or injury occur?--
tinclude :_. t�y ars.. euunty) -
3. How did the damage or injury occur? '�Glve full demalls, use extra
sheets if required)
—
------------------------------------------- �.�___ ---------
Z. What particular act or omission on tfi � - cofmzrats� mr district
4
officers , servants or employees caused e .imJTzm:p or (damage?
(over)
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 199f0
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice o
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $25,000.00 Section 913 and 915.4. Please note all "Warnings"
CLAIMANT: PENARELLI, Dolores
ATTORNEY: Darren J. Kessler _x
Attorney at Law Date received Martine° C" t",,.552
-
ADDRESS: 207-37th Street BY DELIVERY TO CLERK ON December 28, 1989
Richmond, CA 94805 Cert. No P584-367-737
BY MAIL POSTMARKED: December 27, 1989
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
UVIL BATCHELOR, Clerk
DATED-. December 29, 1989 BY: Deputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
) This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: f / 15 U BY: AJ Q, J • AU J A Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
1V. BOARD ORDER: By unanimous vote of the Supervisors present
( This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Dated: 1 2 3 1990 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 2 3 1990 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
♦, .C4
Darren J_ Kessler RECEIVED
Ce.♦, pSfy-3107-737
ATTORNEY AT LAW DEC.2 81989
207 37#h Street
PHN BATCHELOR
Richmond,Cry 94805 CLERK BOARD OF SUPERVISORS
4 b2o—o39 C CONTRA A CO.
4Sy
t JJ e u
December 26, 1989
To: Contra Costa County Coroners Office
1019 Center Ave.,
Martinez, CA 91553
To whom it may concern;
Enclosed is a Governmental Claim against the Coroner's Office of Contra
Costa County. Please stamp both copies and return one to me in the
enclosed self- addressed envelope. Thank you.
_ ce 1y:
Curren J. Kessler
Attorney At L
DARREN J. KESSLER -
ATTORNEY AT LAW
207 37th Street RECEIVED
Richmond,CA 94805
(415)620-0398 DEC.2 81989
PHIL BATCHELOR
CLERK BOARD OF SUPERVISORS
C T COSTA CO.
Attorney for Claimant: Dolores PenarelIi B ... De Ut
CLAIM AGAINST:
1. Name and address of claimant.- Contra Costa County Coroners
Office, 1019 Center Ave., Martinez, CA 94553
2. Send all notices to: DARREN J. KESSLER, Attorney at Law,
207-37th Street, Richmond, CA 94805.
3. Date of occurrence: July 25-26, 1989
Place of occurrence: Berkley, Richmond, and Martinez, CA.
4. Circumstances of occurrence: Death Certificate negligently not
signed until one day after funeral. Reliance on the assurances of
a Deputy Coroner who said certificate would be signed caused the
burial to commence as scheduled. Consequently, however, when
the certificate was not signed and made available on the day of
the burial, the deceased was disinterred and not permanently
buried until the following day.
5. General Description of injury: Emotional distress.
6. Amount of claim and basis for compu ._anion- $25,00
DATED: December 22, 1989
DSA `J. KESSLE
Attorney for Clai fant
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CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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
C'n.!,Int,
Amount: $273.00 Section 913 and 915.4. Please note all "W hi-ngV.CounSel
CLAIMANT:- SALMON, Nancy LL
ATTORNEY: Martinez. Grp; 415752
Date received
ADDRESS: 4334 Campbell Drive BY DELIVERY TO CLERK ON December 29, 1989
Pittsburg, CA 94565
BY MAIL POSTMARKED: December 28. 1989
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: December 29, 1989 �tlt DeputyLOR, Clerk
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
�) This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: ( BY: ( J Deputy County Counsel
I1I. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
( his Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy o.f the Board's Order entered in its minutes for
this date. n
Dated: JAN 2 3 1990 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 2 3 199
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 19$7,
must "be presented: not later''-than the 100th, day'after the: accrual- of:.the ,cause :of
action.' Claims relating to-causes .of action for death or for injury to person .
or to personal property or growing crops and which acerue. on or after. January ,l,
1988, must be presented not later than six months after the accrual .of the cause.
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration-Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, sepa"rate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal, Code Sec. 72 at the end of this
form.
RE: Claim"By ) Reserved for Clerk's filing stamp
Nancy Salmon ) REC7LRE V.�
Against the County of Contra Costa ) OEC 2 9 1989
or )
PHIL BATCHELOR
CLERK BOARD OF SUPERVISORS
District) COSTA CO. De u
Fill in name )
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of..$. and_.in .support of
this claim represents-"as follows:
-------------------------------------------------------------------------------------
1. When did the .damage -.or injury occur? (Give 'exact date and hour)
August 8, 1989 �s6metime between !':45 a.m.' and 7:55 a.m.
2. Where did the damage or injury occur? (Include city and county)
On Marsh Creek Road, Clayton,. Contra Costa County
------------------------------------------------------------------------------------
3. How did the damage or injury occur? (Give full details; use--extra paper if
required)See attachment
-------------------------------------------------------------------------------------
4. What particular:act or omission on the part of county or district officers,
servants or employees caused the. injury or damage?
See attachment
(over)
5. What are the names of county or district officers, servants or employees causing .
the damage or injury?
Contra Costa County
--------------------------------7----------------------------------------------------
5. What damage,or injuries' do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
Front wind cracked
-------------------------------------------------------------------------------------
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
Van was taken to Autolite which is the company Nationwide Insurance uses to fix
broken windows.
-------------------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
-- J1nrt,.`Linquis_t_-_230_Mountaire,.,.Clayton._ _ , . . - _--.
------' Dennis Lawrence 5455 Dodge Count, Concord
Dick Rasmussen - 40 Mt. Reiner Court, Clayton
-------------------------------------------------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
8/08/89 Front window $273.00
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: '(Attorney), or by some 2erson on his behalf."
Name and Address of Attorney:
�� ✓Yc�
��� (Claimant's Signature-
�G1h�.D�P�� Ar
�(Add ess
Telephone No. - - - Telephone No. -yo7-�y/�_-4Ja�1L.
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 sueh :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.
5. What are the names of county or district. officers, servants or employees causing
the damage or injury?
Contra Costa County
5. What damage,or injuries' do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
Front wind cracked
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
Van was taken to Autolite which is the company Nationwide Insurance uses to fix
broken windows.
w '
------
8. Names and addresses of witnesses, doctors and hospitals.
_i r_t..:.Linquis_t_--230 Mountaire,,Cl ytgn
Dennis Lawrence — 5455 Dodge Count, Concord
Dick Rasmussen - 40'Mt. Reiner Court, Clayton
------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
8/08/89 Front window $273.00
Gov. Code Sec. 910.2 provides:
r "The claim must be signed by the claimant
SEND NOTICES TO: "(Attorney), or by some person on his behalf."
Name and Address ofAttorney>
C a mant's Signature A
(Addfess)
Telephone No. -- Telephone No. v74y/� _lvorlL
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 .exceedingrten thousand dollars ($10,000; or by
both such imprisonment- and fine. .
Claim.-to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or .to per
sonal property or growing crops and .which accrue- on or before December 31 1987,
trust be .presented not later than 'the 100th° day -after- the accrual of: the cause :of
action. ` Claims relating to causes .of. action for .death or for"injury to person
or to personal property or growing crops and which accrue. on or after. January 19
1988, must be presented not later than six months after the accrual of the cause.
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553.
i
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
RE: Claim'By ) Reserved for Clerk's filing stamp
Nancy Salmon ) FL%10EIVED
Against the County of Contra Costa ) OE C•2 9 1989
or )
PHIL BATCHELOR
CLERK f;iP,RD OF SUPERVISORS
District) ?? COSTA CO.
De u
Fill in name )
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of.$_. . and in .support of
this claim represents--as follows:
-------------------------------------------------------------------------------------
1. When did the damage-.or injury occur? • (Give exact date and hour)
August 8, 1989 sometime between 7:45 a.m.' and 7:55 a.m.
-------------------------------I-- ------- ---------------------------------------------
2. Where did the damage or injury occur? (Include city and county)
On Marsh Creek Road, Clayton, Contra Costa County
------------------------------------------------------------------------------------
3. How did the damage or injury occur? (Give full details; use--extra paper if
required)See attachment
------------------------------------------------------------------------------------
4. What particular .act or omission on the part of county or district officers,
servants or. employees caused the, injury or damage?
See attachment
(over)
Question 3
I believe the County was negligent in this accident. The County had
been rocking Marsh Creek road for several days. I believe they were
wrong in not having more traffic patrols setup during the time the
gravel was first layed down or at least until the gravel was more
embeded in the road. What I don't understand is why they had
traffic partol on Monday, 8/7/89 p.m. and Wednesday, 8/9/89 a.m.
but did not use traffic patrol on Tuesday, 8/8/89.
Question 4
There was still a lot of rock on the road that had not either been
embeded in the road by using the roller or swepted off by the
County.
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CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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: $25,000.00 Section 913 and 915.4. Please note all "Wa.Dings"
¢vi.1ty Counsel
CLAIMANT: HADIX, Connie UL J 1C1 ?
ATTORNEY: Mr. Darren J. Kessler J ,• 5i&'r;
Attorney at Law Date receivedII1F✓"" ,R't;�. ,�a, t
ADDRESS: 207-37th Street BY DELIVERY TO CLERK ON December 28, 1989
Richmond, CA 94805 Cert. # P584-367-736
BY MAIL POSTMARKED: December 27, 1989
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
December 29 1989 EVIL BATCHELOR, Clerk
DATED: eputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
) This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
i
Dated: 2 BY: I _ Q 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
( �is Claim is rejected in full .
( ) Other:
I certify that this is a true and correct copy o.f the Board's Order entered in its minutes for
this date.
Dated: A A N 2 3 1990 PHIL BATCHELOR, Clerk, By a Deputy Clerk
WARNING (Gov. code sec n 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 2 3 1990 BY: PHIL BATCHELOR by Deputy Clerk
CC: County CounselCounty Administrator
Darren J_ Kessler i RECEIVED
ATTORNEY AT LAW DEC 2 8 1989
207 37th Street
PHIL BATCHELOR
Richmond,CA 94805 CLERK BOARD OF SUPERVISORS
T
(415)620-039$ 6 ........COr�.F A De ut
December 26, 1989
To: Contra Costa County Coroners Office
1019 Center Ave.,
Martinez, CA 94553
To whom it may concern;
Enclosed is a governmental Claim against the Coroner's Office of Contra
Costa County. Please stamp both copies and return one to me in the
enclosed self- addressed envelope. Thank you.
sorely:
i
Darren J. sler
Attorney At Law
DARKEN J. KE55LER
ATTORNEY AT LAW
207 37th Street RECEIVED
Richmond,CA 94805 C6r j., # P 5811-3(07-73(,
(415)620-0398 DEC,2 81989
PH!L BATCHELOR
CLERK BOARD OF SUPERVISORS
?%A COSTA CO.
Attorney for Claimant: Connie Hadi; a ......... De ut .
CLAIM AGAINST:
1. dame and address of claimant: Contra Costa County Coroners
Office, 1019 Center Ave., Martinez, CA 94553
2. Send all notices to- DARREN J. KESSLER, Attorney at Law,
207-37th Street, Richmond, CA 94805.
3. Date of occurrence: July 25-28, 1989
Place of occurrence: Berkley, Richmond, and Martinez, CA.
4. Circumstances of occurrence: Death Certificate negligently not
signed until one day after funeral. Reliance on the assurances of
a Deputy Coroner who said certificate would be signed caused the
burial to commence as scheduled. Consequently, however, when
the certificate was not signed and made available on the day of
the burial, the deceased was disinterred and not permanently
buried until the following day.
5. General Description of injury: Emotional distress.
G. Amount of claim and basis for computation: $25,000
DATED: December 22, 1989
D R 4 J. KESS ER
Attorney for Cl imant
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CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23 1990
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: $2.5,000.00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT:- HAAS, Kay
ATTORNEY: Darren J. Kessler
Attorney at Law Date received
ADDRESS: 207-37th Street BY DELIVERY TO CLERK ON December 28, 1989
Richmond, CA 94805 Cert. No.P584-367-739
BY MAIL POSTMARKED:
I.. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: December 29, 1989 �tIl DeputyLOR, Clerk
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section .911.3).
( ) Other:
Dated: ) 19 Igo BY: / _JA Deputy County Counsel
1 0 "*1_qJ
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 o.f the Board's Order entered in its minutes for
this date.
Dated: JAN 2 3 199Q, PHIL BATCHELOR, Clerk, By _, Deputy Clerk
WARNING (Gov. code secon 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: J A N 2 3 1999 BY; PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
i%
Darren J_ Kessler RECE-11V D
ATTORNEY AT LAW DEC 2 81989
207 37th Street
Richmond CA 34805 PH!( tD OF
R
��yy t CLERK BOi�nD OF SUPT:RVtSORS
( 1 JJ 620-0398 CONTPA COSTA CO
l 6 ............. De of
December 26, 1989
To. Contra Costa County Coroners Office
10 19 Center Ave.,
Martinez, CA 94553
To whom it may concern;
Enclosed is a Governmental Claim against the Coroner's Office of Contra
Costa County. Please stamp both copies and return one to me in the
enclosed self- addressed envelope. Thank you.
(Dply:
ar-re-MJ. E'essley At La
4
DARREN J. KESSLER
ATTORNEY AT LAW
207 37#nRECEIVED
Richmond,CA
cA 94805 q
(,415)620-0398 Co',h. PSI-367 73 I
DEC.2 81989
PHIL BATCHELOR
CLERK BOARD OF SUPERVISORS
Attorney for Claimant: Kay Haas C COSTA CO..... De ut
a
CLAIM AGAINST:
1. Name and address of claimant: Contra Costa County Coroners
Of f ice, 1019 Center Ave., Martinez, CA 94553
2. Send all notices to: DARREN J. KESSLER, Attorney at Law,
207-37th Street, Richmond, CA 94805.
3. Date of occurrence: July 25-26, 1989
Place of occurrence: Berkley, Richmond, and Martinez, CA.
4. Circumstances of occurrence: Death Certificate negligently not
signed until one day after funeral. Reliance on the assurances of
a Deputy Coroner who said certificate would be signed caused the
burial to commence as scheduled. Consequently, however, when
the certificate was not signed and made available on the day of
the burial, the deceased was disinterred and not permanently
buried until the following day.
5. General Description of injury: Emotional distress.
6. Amount of claim and basis for computation: $25,000
DATED: December 22, 1989
DARREN J. KE LER
Attorney for r laimant
C1
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CLAIM 8-
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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: $25,000.00 Section 913 and 915.4. Please note all Q_a.-Pn'lin$g°s u
"GonSL')
CLAIMANT: G
SNELL, Richard
ATTORNEY: - �/arfine., C° 0141,, ¢,0-
Darren J. Kessler
Attorney at Law Date received
ADDRESS: BY DELIVERY TO CLERK ON December 28, 1989
207-37th Street
Richmond, CA 94805
Cert No. P584-367-738
BY MAIL POSTMARKED: December 27, 1989
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: December 29, 1989 pHIL gep�tELOR, Clerk
BY: BATCHy
I1. FROM: County Counsel TO: Clerk of the Board of Supe rs
(moi ) 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: 2 9 p BY: f S. 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 Superviscrs present
( his Claim is rejected in full .
( ) Other:
I certify that this is a true and correct copy o.f the Board's Order entered in its minutes for
this date.
Dated: JAN 23 1399 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 2 3 19�1(�0 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
Darren J_ Kessler RECEIV]ED
ATTORNEY AT LAS DEC 2 8.198
207 37th Street
PH!L BATCHELOR
Richmond,GA 94805 CLERK BOARD Of SUPER
� , b2o_03r8 C CONTRA O CC
December 26, 1909
To: Contra Costa County Coroners Office
1019 Center Ave.,
Martinez, CA 94553
To whom it may concern;
Enclosed is a Governmental Claim against the Coroner's Office of Contra
Costa County. Please stamp both copies and return one to me in the
enclosed self- addressed envelope. Thank you.
rel y:
Darren J. Kessler -
Attorney At La,
DARREN J. KE55LER
ATTORNEY AT LAW RECEIVED
207 37#h Street
Richmond,CA 94805 (�{.-4 1�58Y-367-738
(415)620-0398 DEC.2 8 1989
PHIL BATCHELOR
CLERK BOARD OF SUPERVISORS
C LTk COSTA CO.
B .......... De ul
Attorney for Claimant: Richard Snell
CLAIM AGAINST:
1. Flame and address of claimant: Contra Costa County Coroners
Office, 1019 Center Ave., Martinez, CA 94553
2. Send all notices to: DARREN J. KESSLER, Attorney at Lave,
207-37th Street, Richmond, CA 94605.
3. Date of occurrence: July 25-26, 1969
Place of occurrence: Berkley, Richmond, and Martinez, CA.
4. Circumstances of occurrence: Death Certificate negligently not
signed until one day after funeral. Reliance on the assurances of
a Deputy Coroner who said certificate would be signed caused the
burial to commence as scheduled. Consequently, however, when
the certificate was not signed and made available on the day of
the burial, the deceased was disinterred and not permanently
buried until the following day.
5. General Description of injury: Emotional distress.
6. Amount of claim and basis for computation: $25,040
DATED: December 22, 1989
EN J. (SES 'ER
Attorney for Claimant
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d CLAIM
` BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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 Go�x;ernept ode
Amount: Undetermined Section 913 and 915.4. Please note all "Warn ngs' C3tlyd9C1
CLAIMANT: BILLER, Jack D. U L C 2 2 SZ389
ATTORNEY: Martinez, CA((N
Date received
ADDRESS: 1814 Dixon Lane BY DELIVERY TO CLERK ON December 21, 1989 (hand delivered)
Concord, CA 94521
BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
ppM IL gATCH,ELOR, Clerk
DATED: December 21, 1989 BY: Deputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
( ) This claim complies substantially with Sections 910 and 910.2.
This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: 12 21 r BY: I �_ Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
( his Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy o.f the Board's Order entered in its minutes for
this date.
Dated: 'JAN 2 3 1990 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 2 3 1990 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
1 ,
y
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Jack D. Biller
1814 Dixon Lane
Concord, CA 94521
Re: Claim of JACK D. BILLER
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:
VICTOR J. STMAN, County Counsel
By:
Deputy County C u s 1
CERTIFICATE OF SERVICE BY MAIL
C.C.P. 99 1012, 1013a, 2015 .5 ; Evid. C. §§ 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.
cc: Clerk of the Board of Supervisors (original)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 .4, 910. 8)
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.. T f the claim is aga 9 nst more than one public ent.1 ty:, separate. claims Mist 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 j Resry d f ak�fil' g stamp .
_DEr
Against the County of Contra Costa ) ®E C,aQj
or )
S1WCA. m
District) 5 PER
�P-' iARD CSP 5PER'�1SORS
P'A C S.
Fill in name ) B
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ LO 00 °�-F- and in support of
this claim represents as follows: , ��j
1. When did the damage or injury occur? (Give exact date and hour)
-- 11-9117---------------------- -----------------------------
. 2. Where did the damage or injury occur? (Include city and county)
W----� ���-- - -��-t--- ----
dew r-r�- ------- --------------------
3. How did the damage or injury occur? (Give full details; use extra paper if
required)
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
(over)
5. What are the names of county or district officers, servants or employees causing
the damage or injury?
---�------ d---------------------------------------------------
6. What damage or injuries .do you .claim resulted? (Give full. extent of injuries or
damages claimed. Attach two estimates for auto damage.
---------- ------ ----- ---------- ------ --_-
------ -----
How was the amount claimed above computed? ( nclu a the estimated amount of any
prospective injury or damage.)
8. Names and addresses of witnesses, doctors and hospitals.
--- - '----------------------------------------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides%
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney),. or, some persorl ontas behalf."
Name and Address of Attorney
L
Claimant's Signature
Address
Telephone No. I Telephone No.
N 0 T I C E
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
This letter is to inform you that on final approval of
Contra Costa County Building Permit Number 153036, I shall
begin legal proceedings against the County of Contra
Costa .
The amount claimed shall be in excess of Forty
Thousand Dollars ( $40, 000 ) , which shall reflect reductions
in both real estate value and overall quality of life at
1814 Dixon Lane, Concord, California .
This injury was created by the inability or
unwillingness of the Contra Costa Community Development
Department to define, address, and act upon Sections
82-4 . 212 and 84-4 . 402 of the Contra Costa Code(Planning
and Zoning) April 1985 . This department is headed by Mr .
Harvey Bragdon.
The above dollar figure was estimated by discussions
with both real estate professionals and employees of the
Contra Costa Community Development Department . Names and
address of witnesses are not applicable at this time .
I have noted above that action will begin on final
approval of this permit . Until this time I more than
willing to listen to alternate plans for this structure
which will accurately reflect the definitions noted in the
Planning and Zoning Codes .
urs,
`
-7)'
ack D. Biller
Claimant
cc: S . McPeak
CLAIM /d
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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: $20,000.00 Section 913 and 915.4. Please note all "Ca7c11,6 Counsel
CLAIMANT: STEEN, Owen U L G 9, 1 IZ-11j
ATTORNEY: Ms. Maryanne Britten r Martine. A P,4653
Attorney at Law Date received
ADDRESS: 2151 Salvio Street, Suite 310 BY DELIVERY TO CLERK ON December 20, 1989 (hand delivered)
Concord, CA 94520
BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim. ppHH gg
DATED: December 21, 1989 BYIL DeputyLOR, Clerk
1I. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: 12 1127 10 BY: , �_ S Deputy County Counsel
U N
111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
(lam ) This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy o.f the Board's Order entered in its minutes for
this date.
Dated: JAN 2 3 WO PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov, code sectn 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 2 3 1990 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator .
i WK TO BOARD OF SUPERVISORS OF CONTRA CC**Q? 'application to:
Instructions to C1af�.ntC'.erk of the Board
&S�P.., Q S{y pyo
M rtinez,Calitomia 94553
A. Claims relating to causes of action for death or or 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.
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;`Pe`nal Code Sec. 72. at end
r P
of this form.
RE: Claim by ) Reserved._.for_..-.Cler 's ing stamps
OWEN STEEN ) t
'SCE
Against the COUNTY OF CONTRA COSTA) DEE, 1089
iELOP
or DISTRICT) FML OF SUPERVISORS CLcBi;NOARD OF SVISORS V
-ONTRA COSTA De ut
(Filln name )
B
The* undersigned claimants hereby makes' claim against the County of Contra
Costa or the above-named District in the sum of $ 20-,000 : 00_ D1 us Job Renstate-
and in support of this claim represents as follows: _ ment
I. When did the damage or �nlury occur? Give exact date ani-hour]
June 26, 1989 at approximately 3:30 p.m.
-- -------- ---------- -- ---- ------------- ---
�: Wfieie-aid-tie damage or �n3ury occur? �Inc�ude city and county]
Martinez , California
3.
-:----How----did---the--------------- ------------------ -- -------------
damage or injury occur? (Give �uIS �eta�is, use extra
sheets if required) Claimant had been employed as a temporary employee with
the Contra Costa- County Sheriff for one and one-half years . He had been told by
his Sergeant that as soon as the County began hiring permanent deputies , claiman
would be hired as a permanent employee. Tom Young arranged for claimant to be inter-
viewed by Dr. .Roberts, and claimant allegedly failed the psychological exam.
4. What particular act or omission on the part of' county or d1;uIa
officers, servants or employees caused the injury or damage?
See Attached letter dated October 11 , 1989
(over)
5'. What are the na- -s of county or district o`ficers, servants or'
employees causi- I the damage or injury?
Tom Young
6. What damage or injuries do you claim resu�te�? ZG�ve full extent
of injuries or damages claimed. Attach two estimates for auto
damage) Claimant was terminated from employment after demonstrating
excellent job skills based upon a biased and prejudiced psychological test.
7. How was the amount claimed above computed? ZInclude the estsmatea
amount of any prospective injury or damage. )
Loss of income, general damages
----N--------------------------------------------------------
6. ames and addresses of witnesses, doctors and hospitals.-------------
9. List the expenditures you made on account of the accident or injury:
DATE ITEM AMOUNT
n/a
RRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRRR
Govt. Code Sec. 910.2 provides :
"The claim signed by the claima
SEND NOTICES TO: (Attorney) or by some person on his behalf
Name and Address of Attorney
LAW OFFICE OF MARYANNE BRITTEN Claimant's S gnature
3400 .Atl.as Road A t. 3902
2151..Salvio Street , Suite 310 Address
Concord, CA 94520 :. :, ,.- Richmond, CA 94806
Telephone No. 825-9448 Telephone No. 222-8261
RRRRRRRRRRRtRRRRRRRRRRRRIRRRRRRRRRRRRRRR�RRRRRRRRRR#RRRRRRRRRRRRR**RRRRRR
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, vouche:
or writing, is guilty of a felony. "
Law Office Of Salvio Pacheco Square
air ride 2151 Sal0�oo St t suite 3J9
.� Caaicoi�d,CA 950
Htten 415/825.9448
October Ili 1989
Merit Board Secretary
County Administration Building ;
651 Pine . Street
Martinezy Caiiforfiia 94553 .
` t 3 Owed" Steen '
Dear Secretary!
1' tepresent Owen Steeriy a former Deputy Sheriff, with regard
to hia termination from temporary employment on or about June 26,
1989,
Deputy Steeh hereby lodges a complaint' with the Merit Board
based
on .the following grounds:
14 beputy Steen was ' disariminated against based upon his
national j6figifiid as a 4iiipino. It is my understanding that there
is only one Piiipiito employee currently working for the Contra
costa,..CoUht Sheriff's tie gr'trdent,
y �
2, beputy`' Steertwas ";discriminated against based upon his
political activities . Arid .his association with other deputies
similarly < teik ihaited, ' Oh the date of Mr: Stee'n's termination,
another <te>apotarjj; deputy Vitae advised that he also was terminated.
At such tiineo `Maid deputy. contacted the various persons in the
hierarchy in of �atteihpt to obtidr copies of his p
psychologiclaI eersonnel file and
yAliiatiori, Said deputy was met with a lack of
cooperatioh aiid ,a`rcftlsal :to ' proAiide him with his personnel file.
Mr. Steen" Waa vie d Aa ` beih4 ;Associate d with said deputy on a
personal 6fid pr6fasgi6fifd : 1eve1by the Sheriff's Department.
3, Deputy Stems had beefs e�tployed on a temporary basis since
May 1988. The evaluations of beptity Steen prepared by Sgt. Scott
Daly rated Deputy steel gsitceedincf an acceptable level. Sgt.
Daly!S evaluations co'n" 61 decl`"that bepUty Steen was recommended for
a permanent positiono Cdpie of Deputy Steen's Monthly
Observation Reports ' dated 6fli ' 26� 1989 and June 26, 1989 are
attached heretd as Bxhibits�`nAi.1. dhd ''B'i� respectively, and by this
reference made . A part her6o i. ,
4: Based upon beputy SteeM!8 ekceilent performance during his
Merit Board Secretary
October il, 1969
Page Two
temporary employmentwith Contra Costa County, he was repeatedly
advised by his superiors that as soon as the County began hiring
permanent deputies, Deputy Steen would be hired as a permanent
employees Based upon these representations, Deputy Steen failed
to seek employment elsewhere. Had Deputy Steen been aware that the
County of Contra Costa neve' intended to hire him permanently, he
would have applied for a position in another county. It is
submitted that the hiring . personnel, and Mr. Tom Young in
particulari negligently and intentionally allowed Deputy Steen to
provide excellent service ' to the Department knowing that when
Deputy Steen sought permanent status he would be terminated. It
is further submitted that, based upon Deputy Steenks excellent
employment record; the alleged results of the psychological
examination were enhanced. and exaggerated to provide a basis for
termination. .
4. The County of Contra Costa, in its employment relationship
with Deputy Steen, owed him the duty of good faith and fair dealing
in that relationship. Testimony will demonstrate that Tom Young,
in his capacity as pre-employment screener for the Sheriff's
Department, often exercises discriminatory practices in rejecting
applicants who are otherwise qualified. It is submitted that Tom
Young made his: decision from the initial interview with Deputy
Steen that he world reject Deputy Steenis application for a
permanent position, it is submitted that said decision was either
completely arbitrary or discrimatory. In either event, said
decision was not.`based upon any appropriate criteria and certainly
not on $ny °`jok = relevant considerations. If the County hires
temporary Waployees 'to save the County money without intending to
ever allow ...those ,einpIdyees to become permanent employees, the
County hda 'srf`` obligation to so advise the employee. To so
otherwise .ie! ftaUd� and misrepresentation.
it is hereby!' requeeted that Deputy Steen be reinstated in his
position as bdiputy Sheriff and that a valid and proper
psychological evaluation be conducted as required. Deputy Steen
is seeking a perinaient ' position as he has been promised for many
months. beputy Steeh is also seeking retroactive pay from his date
of termination:
Sincerely,
MBivp Maryanne Britten
ccsowen Steen
i
CLAIM /. h?,
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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: exceeds $10,000.00 Section 913 and 915.4. Please note all "WaQ%�4"y Counsel
n
CLAIMANT: COBURN, Lynn U L C f, w lJ
ATTORNEY: Martine , CA ,!M -3
Ms. DeirdreCraig, Attorney
Date received
Bledsoe, CCathcart, Leahy, Starr
ADDRESS: and Bledsoe,
BY DELIVERY TO CLERK ON December 19, 1989 (hand delivered)
111 Pine Street, 18th Floor
San Francisco, CA 94111 BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PpHHIL BATCHELOR, Clerk
DATED: December 21, 1989 BY: Deputy
11. FROM: County Counsel TO: Clerk of the Board of Supervisors
� ) This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: 12 h 9 BY: QO Deputy County Counsel
I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
(-!i) 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:)A N 23 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code sec ion 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 2 3 1990 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
LAW OFFICES
ROBERT S.CATHCART BLEDSOE, CATHCART, LEAHY, STARR & HARDIMAN
CYNTHIA L. LEAHY 18TH FLOOR
CRAIG A.STARR ROGLEIGH ER M. BLEDSOE
SMITH
MICHAEL F. HARDIMAN III PINE STREET STANLEY P.SMITH
RICHARD S. DIESTEL SAN FRANCISCO, CALIFORNIA 94111 STANLEY JOHNSON
KEVIN MCCONNELL OF COUNSEL
RENEE WELZE LIVINGSTON 415) 981-5411
KAREN E.SUM'
L.JAY PEDERSEN TELECOPIER 981-0352
CONNIE D.EASTERLY
P. RANDALL NOAH
GREGORY L.SPALLAS
DEIRDRE E.CRAIG
MICHAEL F.SWEENEY
ROBERT K. PHILLIPS
December 19, 1989
xxEM Lj
LIRE
a
L BAXFICLO
RD OF S PERVISORS
HAND DELIVERED TP,A ACO....... Deputy
Clerk, Board of Supervisors
County of Contra Costa
651 Pine Street
Martinez, CA 94553
Re: COBURN CLAIM
WHOM IT MAY CONCERN:
Enclosed please find Lynn Coburn and State Farm Fire and
Casualty Company's Claim against the County of Contra Costa.
We have enclosed one copy for your reference, as well as
another copy, that we ask you file-stamp and return to us in
the enclosed self-addressed, stamped envelope.
Thank you for your cooperation in this matter.
Very truly yours,
BLEDSOE, CATHCART, LEAHY,
STARR & HARDIMAN
Deirdre Craig
DC:e
Enc.
--1!1 V D
NOTICE OF CLAIM AGAINST -1-��ce.�
THE COUNTY OF CONTRA COSTA D E�; /9
M� PATCHEL02
C F..6'BOO,PU OF SUP RVISORS
CLAIMANT'S NAME: LYNN COBURN s CONTRA COT CO.
1541 Woodland Drive °e 0}
Pittsburg, CA 94565
(415) 427-0420
s
STATE FARM FIRE AND CASUALTY
COMPANY
395 Taylor Boulevard, Suite 110 •
Pleasant Hill, CA 94523
(415) 674-4351
SEND NOTICE TO: BLEDSOE, CATHCART, LEAHY, STARR
& HARDIMAN
ATTENTION: RENEE WELZE LIVINGSTON
or DEIRDRE CRAIG
111 Pine Street, 18th Floor
San Francisco, CA 94111
(415) 981-5411
TYPE OF CLAIM: Property Damage with respect to Lynn
Coburn and Indemnification with
respect to State Farm Fire and
Casualty Company
DATE OF INCIDENT: June 20, 1989, 3 :53 p.m.
LOCATION OF INCIDENT: 1533, 1541 and 1549 Woodland Drive
Pittsburg, California
DESCRIPTION OF INCIDENT: The damages incurred by the
claimants resulted from a fire that
originated in the backyard of 1533
Woodland Drive. 1533 Woodland Drive
is directly west of 1541 Woodland
Drive, Ms. Coburn's home. Jackie
Woodall is the owner of property
located at 1533 Woodland Drive. At
the time of the fire, Janet Danner,
a juvenile foster child was living
in Ms. Woodall's home and under her
care. Ms. Coburn was partially
insured at the time of the fire
under a renter' s policy issued by
State Farm Fire and Casualty
Company.
The investigation of this fire
revealed that the foster child,
Janet Danner, set fire to areas of
Ms. Woodall's backyard and the fence
that borders the backyard. This
fence separates Ms. Woodall 's and
Ms. Coburn's property. The fire
spread quickly to Ms. Coburn's
property, and because of its
incendiary nature, Ms. Coburn's
property sustained extensive fire,
smoke and water damage.
Further investigation has shown that
the foster child, Janet Danner, has
longstanding psychological and
emotional problems , including
pyromania, of which the Contra Costa
Department of Social Services was
or should have been aware. However,
the Department of Social Services
never informed Ms. Woodall, the
foster parent, of Janet Danner's
psychological history and this .
failure was the proximate cause of
damage to claimants.
NATURE OF DAMAGES: The fire spread from the backyard of
1533 Woodland Drive to the backyard
of 1541 Woodland Drive, destroying a
quarter acre of grass in Ms .
Coburn's backyard. The fire then
spread to a pine tree adjacent to
Ms. Coburn's home, which in turn
caused the fire to spread to the
northeast corner of Ms. Coburn's
roof. The fire heavily damaged the
roof, attic and second story of Ms.
Coburn's house. The fire also
heavily charred the tops of all the
rafters on the second floor and it
caused the ceiling sheetrock to
fall. Damage was also caused by
falling debris in all the rooms on
the second floor. There was extreme
heat damage to all second story
rooms, which caused some miscel-
leneous items to melt. Furniture
tops were also scorched, as well as
some bedroom walls. The second
story carpet was also heavily
damaged. Substantial expense was
incurred in cleaning and relocating
Ms. Coburn's property.
2 -
AMOUNT CLAIMED: The amount claimed is in excess of
$10,000. 00, and jurisdiction of this
claim rests in Superior Court.
NAME OF PUBLIC EM-
PLOYEE CAUSING DAMAGE: Unknown.
I declare under penalty of perjury under the laws of the
State of California that the foregoing is true and correct
upon my information and belief and that this declaration was
executed at San Francisco, California on December 19, 1989.
BLEDSOE, CATHCART, LEAHY,
STARR & HARDIMAN
By ICT�.iy'w�
Deirdre Craig
Attorneys for Claimants
LYNN COBURN and STATE FARM
FIRE AND CASUALTY COMPANY
3
J. CLAIM A /Y
• BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 23, 1990
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: $18,393.01 Section 913 and 915.4. Please note all °�W_41AysgounsEl
CLAIMANT: LEE, George R. D C C 2, N 198-9
ATTORNEY: Mr. Willard E. Stone Martinez.. GA x'4553
Attorney at Law Date received
ADDRESS: 1211 Newell Ave. , Ste. 124 BY DELIVERY TO CLERK ON December 21, 1989 (hand delivered)
Walnut Creek, CA 94596
BY MAIL POSTMARKED:
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim. ppkk BATCHELOR,
DATED: December 21, 1989 BYIL Clerk
II.\.FROM: County Counsel. TO: Clerk of the Board of Supervisors
r ) This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: 1-1122/1. BY: Q A Deputy County Counsel
u
'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 o.f the Board's Order entered in its minutes for
this date. c
Dated: AN 23 1200 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 2 3 1990
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, 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 v'ith the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, 'CA '94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. if the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form.
RE: Claim By Reserved for Clerk's filing stamp
GEORGE R. LEE
RE-,E E'
Against the County of Contra Costa
or )
District)
r�_;'.Roi.YD OF SUPERVISORS ..
-f
Fill in name ) s The undersigned claimant hereby makes claim uainst the County' of Contra Costa or
the above-named District in the sum of $ 18, 393 . 01 and in support of
this claim represents as follows:
---------------------------------- -------------------------•------------------------
1. When did the damage or injury occur? (Give exact date and hour)
- S e p t e:b e r- 6 , 1989 7 : 55 p . .---------------
---------------
2. Where did the damage or injury occur? <Include city and county)
San .Miguel Drive, Walnut Creek, Conga Costa County
3. How did the damage or injury occur? (Give full details; use extra) paper if
required)
See Attachment
---- -------r—rr--.— ....."::..rw—rrr--------r---------.------r----r------r-----------rrrr
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
See Attachmen-t
(over)
• 4
5. What are the names of _junty or district officers, servw.its or employees causing
the damage or injury?
HOWARD JAMES GRANT
----------►_. ..r..
--------------- -----------
,6. What damage or injuries do you-claim, resulted? (Give full extent of injuries. or
damages claimed. Attach two estimates for auto damage.
See Attachment
---------------------.G-r-�----..-.--.--nisi..-►_._ .Jia-----------------------------
7. How was the amount claimed above compu-sed? (Include the, estimated amount of any
prospective injury or dama8e.)
See Attachment
-'--------------......---------• ------------•----------
8. Names and addresses of witnesses, doctors and hospitals.
Kristin Jarvis , .32.':,E1..Camino. Corte, Walnut Creek, CA. 94595 was a witness
to the comments made by the Responsible driver and viewed the scene of
the accident. I was later treated by my family physician, Wai: F. Yeung M.D.
12 Camino Encinas , Orinda, California
. -----------------------1 --------------- ---------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
See attachment
Gov. Code See. 910..2 provides:
"The claim must be signed by the claimant
SEND NOTICES. TO: (Attorney) or by so erson 9n his behalf."
Name and Address of Attorney I
Willard E. Stone ,
Attorney at Law (Claima_ n#s ignatu e) +
1211 Newell Ave,
Suite 124 P.O. Box 6042
Walnut Creek, CA. 94596 (Address)
Moraga, CA. 94570
Telephone, No. 41 45-1 11 Telephone No. "(415) 376-2451
IF
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 thousand4 ($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 of GEORGE R. LEE against the COUNTY OF CONTRA COSTA
Further response to Claims Form:
3 . The Claimant was driving southbound on San Miguel Drive
just south of Adeline Drive at approximately 25 miles per
hour when suddenly without warning, a County vehicle driven
by HOWARD JAMES GRANT negligently and carelessly attempted
to make a left turn onto San Miguel Drive from a private
driveway in order to proceed southbound on San Miguel Drive.
The Claimant applied his brakes in an attempt to avoid an
accident, but because the other automobile had turned
directly in front of the Claimant and was blocking his lane
of travel , the Claimant was unable to avoid a collision and
the left side of the motorcycle hit the right front of the
automobile causing the Claimant to be thrown from the motor-
cycle striking the ground and landing on his head, back and
knee.
4 . The driver of the County vehicle negligently and care- E
lessly pulled out from the private driveway and failed to
yield the right of way to the Claimant in violation of
21804 (A) CVC as confirmed by the traffic collision report
prepared by the investigation officer of the Walnut Creek
Police Department under their report number 9-75 .
y
6 . As a result of the collision the Claimant suffered a
severe back and neck strain which required medical treatment
and care. The Claimant further suffered the following
economic loss:
a. Total loss to 1989 Honda Motorcycle: $6,541 .42
b. Tow bills: 109 .00
c. Damage to helmet: 139 .05
d. Replacement of clothing: 23 .54
e. Loss of use of motorcycle thirty (30 )
days at $50 per day: 1 ,500 .00
f . Doctor bills: 80 .00
TOTAL: $8 ,393 .01
Claimant further submits a claim for general damages and
non-economic loss for pain and suffering in the amount of
$10 ,000 .
7 . The amount claimed for economic loss or special damages
is based on estimates and actual bills or expenditures made
to date . Claimant may require further medical treatment and
physical therapy in an estimated amount of $1 ,000 .
9 . The following expenditures have been made on account of
this accident and injury to dated:
a. Tow bill from scene to residence on September
6 , 1989: $ 60 .00
b. Tow bill from residence to motorcycle
shop on September 7, 1989: 49 .00
c. Dr . Yeung, September 7, 1989: 40 .00
d. Dr . Yeung, November 2, 1989: 40 .00
TOTAL: $ 189 .00