The URL can be used to link to this page

Home My WebLink AboutMINUTES - 10231990 - 1.17 CLAIM �. BOARD OF •SUPERy','SORS OF CONTRA COSTA COUNTY, CALIFORNIA Oct . 23 , 1990 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE JO CLAIMANT 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: $ 350 . 00 Section 913 and 915.4. Please note' all "Warnings". CLAIMANT• Catherine Marie Grimsley 9IECEIVED . 6 Dove Lane SEP `' B 19911 ATTORNEY: E1 Sobrante , CA 94803 Date received COUNTY COUNSEL ADDRESS: BY DELIVERY TO CLERK ON 9/21/90 MARTINEZ, CALIF. Cert . Mail BY MAIL POSTMARKED. 9/20/90 P 3 '10 257 R1 I I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, eeHHII BATCHELOR, Clerk DATED: Segf. 28 , 1990 I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. This claim FAILS to comply substantially with Sections 910 and 910.2, and.we:are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section '911.3).. ( ) Other: Dated: 5 C1 BY: 12 _ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:O C T 2 3 1990 PHIL BATCHELOR, Clerk, By . Deputy Clerk WARNING (Gov. code.sect 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 tabovv�e. Dated: C T 2 3 19�u BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County. Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Cathe a Marie Grimsley 6 Dove Lan El Sobrante, 94803 Re: Claim of CATHERINE MARIE GRIMSLEY 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: x 1 . The claim fails to state the name and post office address of the claimant. x 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. 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. x 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel . BY Deputy C my 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. ta cc: Clerk of the Board of Supervisors ( iginal) 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. 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 f g s p 7 Against he County of Contra Costa ) = Or ) j p{IILBATCHELOR i Cl@R C60ARD OF SUPERVISORS District) a " Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ SSD °a and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) o------------------------------------------------------------- 2. Where did the damage or injury occur? (Include city and county) -�a---�.layE_�14r�1�__�1`-�a�3a�B_�llt�,_LdQ:��Q3--- o.✓�.e,9--��--��jtC 3. How did the damage /or injury occur? (/Give ful�l/ details; use extra paper if required) D/,/ /(p/f`U f�yjo2oX�/�A>E� //%°Y� f/J7 Shoa�ivy C_C'Ze.2eeP Af �fic i.C'fi %em �,� /aC.9�Eo/AT 3��D /�aCFs7ZICot //o-L c�//�n/ �/�� i'v�:v �o°"� s�/•V//' s' o li.✓/�/o d p n/ PAsH_ cr.vY�/ € rl_s_ _ iYE/�_ °9E .2C� A,jeR/�/T_7`d !� .eIEVE; F�� 4. What particular act or omission on the part of county or district officers, �a ' servantsor employees caused the injury or�� damage ��l)odl nc� ONn/A �I A�m / G2' ime �CE�/c �vvis// �M ER/ hE // / /^/ 00 , E CDS? 0 ✓ �/J//y , PAS S. (over) %. 7-,6,c40vW1,40USA 16 RPP'tzOilim 5. What are the names of county or distr-ict• officers, servants or employees causing '• the damage or injury? - 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. QE----------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) iso OV 41*w_---_____ 8. Names and addresses of witnesses. doctors and hospitals. / ---------- ------------ ----------------------------1---------------------------- 9. List the expenditures you made on account of this accident or injury: DATE //I--TEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO::� (Attorney) or b . some person on his behalf." Name and Address of Attorney Claimant's Signature (O C1�0VE LA�c/F (Address) Telephone No. Telephone 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 t1e state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. COUNTY OF CONTRA COSTA, STATE OF CALIFORNIA e No. C � J The property or things listed below (or on the attachment hereto) was taken from E)ov+- 1""N 0 o D pursuant to the Search Warrant dated the day of 19 i ' , issued by Judge Ari �. , -T- :.,j LL I In addition to the above-listed items, the seizure of which was commanded by the Search Warrant, other items were seized which were not listed on the Search Warrant.. A listing of them is attached hereto. f` GT Z H rJ DoT_"'I "' (print name) by whom this Warrant was served, do swear that the above and/or the attached inventorylinventories contain(s) a true and detailed account of all the property taken during the service of this Search Warrant. All the property seized which was listed on the Search Warrant will be retained in my custody subject to order o this or any other court in which the offense in respect to which the property was taken is triable. Signed in Presence of Issuing Magistrate GIVEN under my hand and dated this day of 19 . Magistrate Judge of the Court, Judicial Distrii Leave 1 copy at place searched Within 10 days of ISSUANCE of Warrant, swear to original before issuing Magistrate who will file with Clerk; 1 copy for police file Page of RETURN TO SEARCH WARRANT List seized items named on search warrant COUNTY OF CONTRA COSTA, STATE OF CALIFORNIA OTHER COUNTY(IES) No. THE PEOPLE OF THE STATE OF CALIFORNIA, to any sheriff, policeman, or peace officer in the County(ies) of Contra Costa 07HERCOUNTYIIESI r PROOF by affidavit having been made before me by Sergeant Jehn Dodd AFFIANT(S) that there is probable cause to believe the property or things described herein may be found at the location(s) set forth and that such property is seizable under 1524 (a) P.C. in that it: was stolen or embezzled; was used as the means of committing a felony; is possessed by a person with the intent to use it as a means of committing a public offense; OR is possessed by another to whom he may have delivered it for the purpose of concealing it or preventing its discovery; — is evidence which tends to show a felony has been committed or a particular person has committed a felony; is evidence which tends to show sexual exploitation of a child, in violation of Penal Code 311.3, has occur- . red or is occurring; YOU ARE THEREFORE COMMANDED TO SEARCH: THE PREMISES located at and described as: #6 Dove Lane, in the incorporated city Of Richmond, County of Contra Costa, California. The residence #6 Dove Lane is a two story townhouse, light brown and dark brown wood construction. The number 6 is attached to the mailbox in front of the residence at the foot of the driveway. The residence is east of the Sikh Temple located at 3550 Hillcrest Rd. El Sobrante. including basements, attics, storage spaces, appurtenant buildings, the surrounding grounds, and all containers therein and thereon which could contain any of the items sought. strike out inappropriate words. THE CONTAINER located at and described as: THE VEHICLE(S) described as: i including the passenger compartment, storage areas such as trunk and glove box, and any containers within the vehicle(s) which could contain any of the items sought. strike out inappropriate words. THE PERSON(S) identified and described as: flEV.4/69 SEARCH WARRANT-1 for the following property: 1. To Photograph and retrieve one bullet lodged in the 4outh livingroom wall of the residence. and to seize it or any part thereof and retain such property in your custody subject to order of this court, pursuant to Penal Code Section 1536. GOOD CAUSE HAVING SEEN SHOWN by Affidavit, you may do the following which bears my initials: You may serve this warrant at any time of the day or night, under Penal Code Section 1533. GIVEN under my hand and dated this day of , 19 a.m. at p.m. Magistrate Judge of the Superior/Municipal CourtJudicial District. SEARCH WARRANT-2 REV.4187 CN. e o 0 l� b � i'A 1 o 1 1 w m M ru Ln f.7j s/ 3 j \ A 3 { # rt** *SAA* l i i CLAIM :-_ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Oct . 23 , 1990 Claim Against the County, or District governed by) ' BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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 0 , 0 0 0 Section 913 and 915.4. Please note all "Warnings". CLAIMANT Isidro Ramirez RECEIVE® 40 Madison Ave . ATTORNEY: Pittsburg , CA 94565 SEP `' 8 1990 Date received ADDRESS: BY DELIVERY TO CLERK ON 9/21i/9 0 COUNTY COUNSEL eftf. BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH gg . i DATED: Sept : 28 . 1990 IV DepuLyLOR, Clerk69 II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. i ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and welare so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return. claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). I ( ) Other: !: f Dated: go BY: /J Deputy County Counsel V ' III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) i ( ) Claim was returned as untimely with notice to claimant (Section 911.3). i IV. BOARD ORDER: By unanimous vote of the. Supervisors present ( his Claim is rejected in full. ' ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. i Dated: 0 C T 2 3 1990 PHIL BATCHELOR, Clerk, By I, , Deputy Clerk WARNING (Gov. code sec 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. !If you want to consult. an attorney, you should do so immediately. i i AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: OCT 2 3 1990 BY: PHIL BATCHELOR by ;, Deputy Clerk CC: County Counsel County Administrator ! I. a J i CLAIM AGAINST THE COUNTY OF CONTRA COSTA ISIDRO RAMIREZ presents a claim for damages against the County of Contra Costa, and its agents and employees. Address of Claimant: 40 Madison Avenue, Pittsburg, CA 94565 ;' RECEIVED Address to Which Notices are to be Sent: 7EP I FA Ramirez CLERK BOARD OF SUPERVISORS 40 Madison Avenue, Pittsburg, CA 94565 CONTRA COSTA CO. Date, Place and Circumstances of Occurrence: On March 22 , 1990, Claimant's home was searched pursuant to a seach warrant when Claimant was absent. The search warrant was issued without cause and without any reason to believe that the residence was being used as a methamphetamine laboratory,' or for any other purpose involving illicit narcotics -1or non-narcotic controlled substances. The agents searching the residence included officers of the Contra Costa County Sheriff's Department . ,and Contra Costa County Narcotic's Enforcement Team. None of the residents of the Ramirez household were present during the aforementioned search. Claimant is informed and believes that while executing the search warrant, the officers took property belonging to Claimant c and Claimant's family without the intent of returning the same to their rightful owners. This property included the sum of $1, 000. 00 in cash, which was removed from the inside of my passport; two (2) passports belonging to Ponciano Ramirez-Amaro and Maria Felix Ramirez-Amaro; and three (3) photographs of 1 Claimant's deceased son, Javier Ramirez. Claimant did not consent to the taking of the aforementioned property by the officers who executed the search warrant. This property has not been returned to Claimant and Claimant's family. Additionally, the officers forcibly broke into Claimant's home, thereby causing damage currently estimated to be approximately $100. 00. Parties Responsible: Contra Costa . County; Contra Costa County Sheriff's Deputy Michael F. Newman; and other unknown agents and employees of the County of Contra Costa. Amount of Claim: $ 10, 000. 00 Claimant suffered the loss of one-thousand dollars in currency and important legal documents. Damages are computed on the basis of the value of the documentation and currency taken, plus punitive and exemplary damages based on the wrongfulness of the offending officer's conduct and their relative wealth. Dated: September 21, 1990. ISIDRO RAMIREZ Claimant 2 _ CLAIM a 3 1 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Oct. a•8, 1990 cl(*,;Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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 MCEIVED Amount: $1,611.08 Section 913 and 915.4. Please note all "Warnings" Insured: : SEP fJ ) 81990 CLAIMANT: The Farmers Insurance Group of companies Senthong Pasansouk COUNTY COUNSELRichmond Claims Department Policy No. : 12886 11 4%RTINEZ, CALIF. ATTORNEY: 3211 Auto Plaza Richmond, CA 94806 Date received ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: 9/28/90 IaIl Bepp�tylOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( . ) This claim complies substantially with Sections 910 and 910.2. N ) 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: 1G i116BY: J- /J Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 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:0 CT 2 3 1990 PHIL BATCHELOR, Clerk, B , Deputy Clerk WARNING (Gov. code secton 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to .consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 0 C T 2 3 1990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: The Fa ers. Insurance Group of Companies Richmond aims Department 3211 Auto P a Richmond, CA 9 4-8Q 6 Re: Claim of THE FARMERS INSURANCE GROUP OF COMPANIES 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. 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. x 6 . The claim is not signed ,by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN,-,County Counsel By: S. Q l � Deputy o nty. Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. 95 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: ��O , 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) THE AM Farmers Insurance Group .F COMPANIES RICHMOND CLAIMS DEPARTMENT Date:.September 21, 1990 3211 AUTO PLAZA RICHMOND,CA 94806 415-222-5300 -Brad Kershaw 651 Pinole Shores dr . �,�,, n n�- D Pinole, Ca 94564 ED IN REPLY PLEASE REFER TO: Our Insured: Sen thong Pasonsouk o YL Date of Loss: 7/15/90 µ P Our Policy No: 12886 11 93 - -- SALN: 07 . 47180 Accident Location:R i c h Ill o n d, Ca Total Amount of: $1, 611. 08 Claim to Date (Incl.Our Ins. Deduct.) $300. 00 ( included in total ) A review of the facts of the loss indicates that our insured is entitled to recover damages from you. Therefore, we have the right to make claim for these damages in our insured's behalf. This letter is to notify you of our subrogation rights and to advise you that no one has authority to give you a release for our interest except a representative of this Company. If you carried liability insurance to protect you for such losses,we shall present our claim to your Company. Please complete the following information and return to us. Insurance Company Name: Policy No. Address Name and address of Agent or Adjuster If you are not insured, please send us your check for the amount due. If you.are unable to fulfill this obligation, please contact the undersigned immediately. . Ver truly ygurs, Signed Vee Peace, ext 31 SUBROGATION CLAIMS 23-0386 7$9 1601 WI200 C11200 PRINTED IN U.S.A. M WE ARE MEMBERS OF THE INTERCOMPANY ARBITRATION AGREEMENT CLAIM �•f BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT OCTOBER ?3, . 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: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SENGTHONG PASOMSOUK ATTORNEY: E. James Higuchi Attorney at Law Date received ADDRESS: Higuchi & Higuchi. BY DELIVERY TO CLERK ON September 20, 1990 (via Risk Mbmt) 3325 Wilshire Blvd. Suite 509 Los Angeles, CA 90010 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 21 1990 IL BATCHELOR, Clerk DATED: P 1a: Deputy I II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: (14 1 190 BY: _� Deputy County Counsel 11I. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORD By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 3 1990 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. codes v 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. 'If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: OCT 2 .1 1990 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator i . I i NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Se thong Pasomsouk c/o James Higuchi Attorne t Law Higuchi & uchi 3325 Wilshire lvd. , Ste. 509 Los Angeles, CA 010 Re: Claim of SENGTHONG PASOMSOUK 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 Codel;section 910 and 910 . 2, or is otherwise insufficient for the reasonsrchecked 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. 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 ori!-superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel �r ) By: � ;: J_ ti• Deputy Co my Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. §§ 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 tolthis 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 fullylhprepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. i I certify under penalty of perjury that the foregoing is true and correct. Dated: �p�\ Oke , at Martinez, California.. cc: Clerk of the Board of Supervisors ( iginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 91 0 . 2, 920.4, 910 . 8) JULIE AUi'riOCK LAW OFFICES 1 SEP 2 01990 HIGUCHI & HIGUCHI WILEY HIGUCHI 3325 WILSHIRE BOULEVARD, SUITE 509 TELEPHONE E. JAMES HIGUCHI -5765 LOS ANGELES, CALIFORNIA 90010 RECEIVED 511111111 September 14 , 1990 - V,� SEP 2 0 1990 4 Contra Costa County Risk Mangement Div. C xBQAR0OFSUPERVIS 651 Pine St. , 6th Fl. NTRA COSTA CO. i Martines, CA 94553 ATTN: Ms . Julie Aumock/Claims Rep. RE: OUR CLIEN (S) Sengthong Pasomsouk DATE OF LOSS 7-15-90 OUR FILE NUDER ER 90-131 YOUR POL/CLAIM NO : 1A91002 YOUR INSURL,D Bradley Dean Kershaw Dear Ms . Aumock: This office has been informed that you are the insurance carrier or agent for the above-ntumed insured. Please be advised that a claim for damages is hereby made on behalf of our client(s) for injuries and damages arising out of the accident above-described. Will you please inform this office, inwriting within ten days, of the public liability coverage extended to your insured, including; policy limits, the amount of any deductible, and the indentity and nature of any coverage provisions. We also ask that you forward any statements obtained or later acquired by you from our client(s) relating in any way to the above natter. Please direct all calls and correspondence to this office and refrain from contacting our client(s) in any manner whatsoever.. We thank you in advance for your promptness in this matter. Very truly yours, 6 E. JA4- 71iG' Attorney at La EJII:sp Ps . Enclosed .please find copy of SR-1 , in accordance with your request. Also police report enclosed. j I"W-hiC COLLISION REPORT rt I k rl l%"u Iv u ru t_I C E DEPT, ;P„QE SPaUAL CONDMCK dS, NUMBER R NA RUM J, I.DISTRICT mw • - INJURED FELONY N MBER WT A RLN COUNTY REPORTING DISTRICT BEAT KILLED MSO. , ❑ C -7 COLUSTON OCCURRED ON YO. DAY --AR TIME("A", NCI:■ OFFICER I.Q. DATA r.N T) E c, MLEP05T INFORMATION DAY OF WEEK TOW AWAY PHOTOGRAPHS BY: I- �/M� CF MEEPOST I L I I f S T W T F S ❑YES u NO AT IMERSELTION WITH . STATE NWT REL OR: 70, FEETI•MIHBS OF �Z.� ❑YES NO El NONE PARTY DRIVER'S LICENSE NUMBER STATIECLAS$ cu VEIL YR, MAKE I MODEL I COLOR UCEMENUMBER STATE DRIVER NAME(FIRST,MIDDLE.LAST) ,/ -? r PEDES- STREET ADDRESS EA' E ❑ SAME AS DRIVER TRIAN PARKED CITY I STATE I ZIP O NEA•6 ADDRESS a SAME AS DRIVER VEHICLE Tz. Or7lz.S � n BICY- SEX HAIR -IE. ' NEK:HiT W...1 YRTHDATTi .1 DISPOSITION OF VEHICLE ON ORDERS OF: OFFICER (�DRIVER ❑OTHER COST YQ DAY • YEAR ❑ iM Y3lr( 'Lti�l ZCSJ C51 OTHER HOME PHONE BUSNESS PHO//NE / PRIOR MECHIANNON12 CAL DEFECTS: E APPARENT REFER TO NARRAWa E]El / / `{�5 l��l�- -24;9� CnP USE ONLY DESCRIBE VEHICLE DAMAGE $MADE IN DAMAGED AREA INSURANCE CARRIER ►OuCY NLIY6ER VEHICLE TYPE ❑INK. ONOME 0MNpI COY04 O,MAJOR ❑TOTAL OIR.Oi ONSTREETORNGMVAY SPEED PCF ICC [3I TAN EL LMT PUC ❑ 3czf }T Z (US CHP ❑ PARTY DRIVER'S LICENSE NUMBER STATE CLASS SAFETY VEIL VA. MAKE/MODEL/COLOR LICENSE NUMBER STATE FOtAP, DRIVER NAME(RAST,MIDDLE.LAST( V`• PEDES- STREET ADDRESS 'AV/NER' ANF SAME AS DRIVER TITIAN T � . ❑ T VEHRKICLE CITY I STATE I ZIP OWNER' ADDRESS r)SAME AS DRIVER BICY- SEX I HAIR I EYES I H JGHT WEIGHT SIRTHOATE RACE DISPOSTION OF VEHICLE ON ORDERS OF: ❑OFFICER (D DRIVER E]OTHER CLIST MO. DAY YEAR ❑ _ I OTHER NOME PHONEBUSINESS PHONE -PRIOR MECHANICAL DEFECTS: NONE APPARENT El REFER TO NARRATIVE ❑ ❑ ( -J S) 2 3-7—(��I ( J CMP USE ONLY DESCRIBE VEHICLE DAMAGE SHADE N DAMAGED MEA VEHICLE TMP[ INSURANCE CARRIER POLICY NUMBEfl ❑uNK ❑NONE m WMOR MOD. ❑MAJOR ❑TOTAL DION STREET OR HIGHWAY SPFED PCF ICC ❑ I TRAVEL LIMIT PUC ❑ ' CMP ❑ PARTY DRIVER'S LICENSE NUMBER STATE CLASS SAFETY VEK YRL MAKE 1 MODEL I COLOR LICENSE NUMBER STATS Eouv. 3 DRIVER NAME(FIRST,MIODLE,LASH ❑ I 1 PEDES- STREET ADDRESS r',•S1�.F'AS DRIVER TMAN ❑ EN- IT —CSP. I�iLJ.rC PARKED OTT I STATE I ZIP I WRIER' ORES$ SALE I'AS DRIVER VEHICLE {Icy- SE HAIR EYES HEIGHT WEICH(Jj CrM Op•P•NMTD r UA ruJi 117tCC I• STIOMP CLE ORb QOFFICER ❑DRIVER ❑OTHER Glrt OTHER NOME PHONE __ I , PRI ECHAMC STONE APPARENT [] REFER TO NARRATIVE Cl ❑ ( AD),i- ISL. C-IP USE L DESCRIBE VCyCLE DAMAGE SHADE N DAMAGED MEA V_HIC INSURANCE CARRIER POUCY NL.ABER (C� ❑kK NONE ❑MINOR CCVVVV// MOO. MAJOR O TOTAL DIR.OF ON STREET OR NGMVAV SPEED PCF KC ❑ TRAVEL LMT PIJC ❑ CHP ❑ I PREPARER'S NAME DISPATCH NOTIFIED REVIEWERS NAME JATE REVIEWED c{.(Z prEs ❑No o wA SGT. E.JOHNSON CHP 555-Page 1 (Rev.7-87)OPI 042 87 453" i liwll V•{:AV'VINA TRAFFIC COLLISION_CODING Pali DATE OF COLLISK)N .. TIME((2-400) NCIC NUMBER OFRCtA L D NLYYfR DAY,(S YEAH Lf t_ ) `T-7 t ! U Z •. OWNERS FAME/ADDRESS NOTIRED PROPERTY []YES No DAMAGE EscwrnoN of DAMAGE SEATING POSITION OCCUPANTS SAFETY EQUIPMENT „/C BICYCLE_H I M T EJECTED FROM VEH. 1- Is A-NONE IN VEHICLE L-AIR BAG DEPLOYED 0.NOT EJECTED A& 2 TO 6-PASSENGERS B-UNKNOWN M_ AIR BAG NOT DEPLOYED DRIVER I-FULLY EJECTED 7-STA.WGN.REAR C•LAP BELT USED N.OTHER Y•NO 2-PARTIALLY EJECTED ••RR OCC.TRK_OR VAN D-LAP BELT NOT USED P-NOT REQUIRED W•YES 3-UNKNOWN P•POSITION UNKNOWN E-SHOULDER HARNESS USED I. 123 0-OTHER F-SHOULDER HARNESS NOT USED CHLD RESTRAINT PASSENGER 4 5 6 G•LAP/SHOULDER HARNESS USED O-IN VEHICLE USED X-NO H-LAP/SHOULDER HARNESS NOT USED R.IN VEHICLE NOT USED Y-YES 7 J•PASSIVE RESTRAINT USED 8-IN VEHICLE USE UNKNOWN K-PASSIVE RESTRAINT NOT USED T.IN VEHICLE IMPROPER USE U-NONE IN VEHICLE ITEMS MARKED BELOW WHICH ARE FOLLOWED BY AN ASTERISK(•)SHOULD BE EXPLAINED IN THE NARRATIVE. PRIMARY COLLISION FACTOR TRAFFIC CONTROL DEVICES 1 2 3 TYPE OF VEHICLE1 2 3 MOVEMENT PRECEDWG LIST NUMBER(s)OF PARTY AT FAULT it A VC SECTION VIOLATED: 08rEs A CONTROLS FUNCTIOHING A PASSENGER CAR/STA.WGNL COLLISION pC� NO B CONTROLS NOT FUNCTIONING' B PASSENGER CAR W I TRAILER „ A STOPPED I BOTHER IMPROPER DRIVING• C CONTROLS OBSCI12ED C MOTORCYCLE/SCOOTER B PROCEEDING STRAIGHT D NO COHTROL4'I: '.._NT!FACTOR' D PICKUP OR PANEL TRUCK C RAN OFF ROAD C OTHER THAN DRIVER' TYPE OF COLLISION E PICKUP/PANEL TFOL W/TLFL D MAILING RIGHT TURN D UNKNOWN• AHEAD-ON F TRUCK OR TRUCK TRACTOR E MAKING LEFT TURN E FELL ASLEEP' B SIDESWIPE G TRK/TRK.TRACTOR W/TLR. F MAKING U TURN C REAR END H SCHOOL.BUS G BACKING WEATHER(MARK i TO 2 ITEMS) D BROADSIDE I OTHER BUS H SLOWING I STOPPING A CLEAR E HT OBJECT J EMERGENCY VEHICLE I PASSING OTHER VEHICLE l B CLOUDY F OVERTURNED K HWY.CONST.EQUIPMENT ,J CHANGING LANES C RAINING G VEHICLE/PEDESTRIAN L BICYCLE I K PARKING MANEUVER D SNOWING H OTHER': MOTHER VEHICLE L ENTERING TRAFFIC E FOG/VISIBILITY FT. MOTOR VEHICLE INVOLVED WITH N PEDESTRIAN M OTHER UNSAFE TURNING F OTHER: ANON COLLSION O MOPED N XING INTO OPPOSING LANE G WIND B PEDESTRIAN 0 PARKED LIGHTING /C OTHER MOTOR VEHICLE P MERGING A DAYLIGHT D MOTOR VEH.ON OTHER ROADWAY OTHER ASSOCIATED FACTOR Q TRAVELING WRONG WAY B DUSK-DAWN E PARKED MOTOR VEHICLE Z 3 (MARK I TO 2 RENS) R OTHER:• C DARK.STREET LIGHTS F TRAIN AVC SECTION VIOLATION: CITED D DARK-NO STREET LIGHTS G BICYCLE ❑'YEs ❑mo E DARK- STREET LIGHTS NOT H ANIMAL: B vc 6Ec ION VIOLATION,' CITED FUNCTIONING' OYES 0 N SOBRIETY-DRUG ROADWAY SURFACE I FIXED OBJECT: C VC SECTION VIO ATIOII uTED 'Z 'J PHYSICAL A DRY [I'YEs (MARK 1 TO 2ITEMS) 6 WET C SNOWY•ICY J OTHER OBJECT: D c]NO A HAD NOT BEEN DRINKING It D SUPPERY(MUDDY,OILY,ETC.) E VISION OBSCUREMENT: B HBD.UNDER INFLUENCE C HBD-NOT U F INATTENTION' ROADWAY ROADWAY CONDITIONS G STOP i GO TRAFFIC ! D HBD-IMPAIRMENT UNK.' (MARK I TO 2ITEMS) PEDESTRIANS ACTION E UNDER DRUG INFLU.' ANO PEDESTRIAN INVOLVED I PREVIOUS H EHTIOUS COLLISION IaNG/LEAVING RAMP I F IMPAIRMENT.PHYSICAL' A HOLES,DEEP RUTS- CROSSING IN CROSSWALK G IMPAIR•.IE T NOT KNOWN B LOOSE MATERIAL ON RDWY' B AT INTERSECTION J(DEFEECTIVE J UNFAMILIAR WITH ROAD VEH.EQUIP.: CITED H NOT APPLICABLE C OBSTRUCTION ON ROADWAY* C CROSSING IN CROSSWALK;=NOT J]YEs I SLEEPY/FATIGUED D CONSTRUCTION-REPAIR 20NE AT INTERSECTION ❑NO SPECIAL INFORMATION E REDUCED ROADWAY WIDTH D CROSSING-NOT IN CROSSWALK L UNINVOLVED VEHICLEI A MAURDOUS MATERIAL F FLOODED- E UN ROAD.INCLUDES SHOULDER M OTHER•: G OTHER': F NOT IN ROAD N NONE APPARENT H NO UNUSUAL CONDITIONS G APPROACH/LEAVING SCHOOL BUS 0 RUNAWAY VEHICLE SKETCH [ I I ) MISCALLAIIEOUS I (� / INDICATE aINOATM n O � � r • co I f� Y 7 ID N 0 m q a In Ln r I NARRATIVE/SUPPLEMENTAL_ PAGE DATE eF INCIDENTT/p URENCE TIMEJ24M '� 'ICJCNUMBFR OFFICER 10. " NUMBER 7fi� 1�i Oriko I %-!17 c7U- -Zoz �Z 'A'CNE W ONE TYPE SUPPLEMENTALCX'APPLICABLE) ` 1/I NARRATIVE ❑ COLLISION REPORT ❑ BAUPDATE FATAL )VT4 a D E S t 'MA••----�' ❑ SUPPLEMENTAL ❑ OTHER: ❑ HAZARDOUS MATERIALS ❑ SCHOOL BUS OTHER: CITY ICCUNTYIJUDICAL DISTRICT REPORTING DLSTRiCT/BEAT CITATION NUMBER LL-, LOCAT 1041 SUBJECT STATE HIGNLVAY RELATED YES NO L 1�( , CJS TA—Zli t\I Lk-- 2_i z -1 C V— FAV r 2. I 3. 5. Z3 � 2�G-r•.f2C-> (�- T �� I r,Lsf IM. I. lc,— Ark P\f, L W% ,L .- "7 .6 \L�LiLI� r Y.�Ltit F�22lVeaL` ��1-L Or�LT�re. Lr4Ca� �hZY��-� i\.L� 7. `ill L 8. 9rz �. I� -1 r V N-L� � Vim.- 101. 2^3C� �� S� CX3S C-rL-�I r'(7 :� S�2A 67ACr !Y-' •1 -f-f-�.v T^C1 11. i - 12. Mr�� z, 1-.� F�2 G� . L w� d- tea. L •r�T �T L ``�.2 13 a- T'b R�LC 14 15, {- t7 nl -cc�r;o F N-LT �_ =_�f rL L` `r L-a. <-C�L. 16. -2 17. 'c'm ;��r 2 -rr� -,—� �/ z. C- vy. r_ -cz 19. 20 crXarc ,�,I -Z W. to L ��j /?�+�i �C�P-nl T �' LST+ �L( r-a LL•4- '� 21. L,-.�r.'�C-s2S'M,��(�. 1�-�?T LRS.�iC-�LSr;21L.O t��S-►'1 S7-Z 1�� 11-?!� �t�'L 22. 7s�63 �. ��. r r SN-.Izn- 23. �2c>c� -,cz, 24 25. r` 26. 27. rrYcm 28. 29. Zz I,, rlati IL r-r rt7�� rz. �-L I 30 ��lTQt r� r Tt-,� ( �T i t T�f �� l�-Z_ cc,, fl I o,rr-� T-L, 31. 'rD .o_T ,.,asp,...-rlc-A, -rz=� t:vT u� 32. MEPARER'S NAME I.D.NUMBER MONTH/DAY/YEAR REVIEINER•SNAME MONTH/DAY/YEAR CHP 556(Rev.7-87) OPI 042 . �"a'"°"'°0°^L°n10'P"'0 ��`� Ba 4b641 SR t (R&.51&4). STATE OF CALIFORNIA REP4.rtT OF TRAFFIC ACCIDENT Every driver of a motor vehicle involved in on occident on a publi-•treat or highway resulting in injury or death of any person,or property damage to any one person(inc,udrng the driver)in excess of$500 DMV File No. must within 15 days,report the accident on this form to the Deportmeia of Motor Vehicles. MAIL THIS REPORT TO DEPARTMENT.OF MOTOR VEHICLES--FINANCIAL RESPONSIBILITY P.O.BOX 12431,SACRAMENTO,CALIFORNIA 95632 MONTH DAY YEAR HOUR 1t:Gfq 1 S tsI Q 3(J A.M. El P.M. LOCATION OF ACCIDENT rSTRENT OR HIGHWAY) CITY COUNTY NUMBER VEHICLES N ACCIDENT NUMBER PERSONS INJUREDNUMBER PERSONS KILLED 9 � 77 YOUR VEHICLE: . ... OTH R V2111 CLE.:. ;>;>:: .;:.:: .;:.., Stopped / Legaffy Other Stopped Legally Other ❑ in Traffic Moving ❑ Parked ❑ (Explain) ❑ in Traffic [ Moving ❑ Parked ❑ (Explain) DRIVE 'S NAM(FIRST. MIDDLE LAST) DRIVER'S NAME,(FIRST, MIDDLE, LAST) DRIVER-3 ADDRR VY(NMBER AND STREET) DRIVER'S ^DDR (NUMBER AND STREET) 101,ki 12 CITY STATE ZIP CODE CITY STATE ZIP CODE DRIVEWS LICENSE (NUMBER AND STATE) DATE OF BIRTHDRIVER'S LICENSE (NUMBER AND STATE] DATE OF BIRTH 1 0.0- DAY. YEAIV '? / I� •10.. DAY, ruw= Sv . G - r `1y L G OWNER OF VEHICLE YOU WEMEt DAIVM/G FIRST, MIDDLE LAST) OWNER OF OTHER VEHICLE OFIRST. MIDDLE. LAST) S:.t/►I^t_ G/1 [%y1n, ;/�`— C.Gn��. CL's�(-. �c) ADDRESS(NUMBER AND STREET) ADDRESS(NUMBER AND STREET) CRY STATE ZIP CODE CITY STATE ZIP CODE OWNER'S DRIVER'S LICENSE(NUMBER AND STATE) DATE OF BIRTH OWNER'S DRIVER'S LLICENSE(NUMBER AND STATE) DATE OF BIRTH Mo-DAY.YruW / fro. DAY. YEAR) VEHICLE YOU WEh DRMNG LA AND MAKE) BODY TYPE OTHER VEHICE (YEAR AND MAKE) .'BODY TYPE VEHICLE LJCRNM E1000140 OR LD. NUMIMA VEHICLE LICENSE ENGINE OR LD- NUMBER ewa/q A10 e.Ur*-II Rwiq ' C Gt/11 ✓) C w_ ESTIMATED COST OF REPAIRS ESTIMATED COST OF REPAIRS $ �>- SDG . Uy S ) U Were You Driving a.Vehicle Owned, Operated or Were You Driving a Vehicle Owned, Operated or Leased by Your Employer and With His/HerPermission? ❑ Yes ❑ No Leased by Your Employer and With His/Her Permission? ❑ Yes ❑ No EMPLOYER-3 NAME AND ADDRESS EMPLOYER'S NAME AND ADDRESS If Yes if Yes ... .:. NAME OF OBJSCTM OWNER'S NAME AND ADORE35 DAlIIiAGf�;:.: TO;OTHER; NATURE OF DAML3 AaESTIMATED COST TO REPAIR DAMAGE PROPERTY s INJURIES AND DEATHS CAUSED BY THE ACCIDENT E:r GE Your Vehicle NAM€ �f/LI/h Gl•'L A C1In Other Vehicle ❑ Pedestrion ADORKS4 �A -TO❑Dpi NAME AGE FI;::': ❑ Driver ❑ In Your Vehicle ,E ❑ Passenger ❑ In Other Vehicle ❑ Pedestrian ADDRESS w[LATIONM!TO SER d, gMglfiltR,ETC") Was a policy of LABILITY insurance or a bond,covering the operation of your vehicle DBARTAUNT USE OItAY in effect at time of occident? Yes ❑ No IF YES GIVE NAME OF INSURANCE COMPANY OR SURETY COMPANY V*OT AGENCY) POL&CYIOR BOND NUMBER 1 rn ril/� l-rv. ra.I. c e Cu ? X-1J-G 1/ 7 3 I CERTIFY UND& PBdALTY OF PERJURY THAT THE ABOVE LS TRUE TO THE BEST Of MY KNOWLEDGE. SIGNED AT ICrrY1 DATE ^ 7 / SIGN 'L May\ •L G �,�i HERE Lr INSURANCE OR BOND INFORMATION DO NOT DETACH DMV FILE NUMBER CALIFORNIA The Department surds this port to the insurance company or surety company indicated.If not " h1ly cornpleted,it will be assumed you were not insured or bonded for the occident. NAME OF INSURANCE COMPANY OR SURETY COMPANY I'. (NOT AGENCY) THAT ISSUED POLICY OF LIABILITY INSURANCE III; OR BOND COVERING THE OPERATION OF YOUR VEHICLE Gifrwvt� YLI/1ti POLICY OR BOND NUMBER POLICY OR BOND PERIOD IV FROM TO DRIVER'S LICENSE NUMBER DATE OF ACCIUZNT IN OR NEAR �.�loRrvER of row er (CITY OR TOWN) - 141-%C MA O E YOUR VE TYPE YEAR ENGINE OR I.D. NUMBER VEHICLE LICENSE IIITAM r. Ale ;Iv::. DRIVER ADDRESS s f yy OWNER A DRESS 17r IIIA AMENDED CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Oct. 23, 1990 . Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed tolyou 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 ��lclely Amount: $82.00 Section 913 and 915.4. Please note; all "Warnings" /) ZU CLAIMANT: Bruce A. Lawrence ot1v 04 /,no 143 West chanslor Ave. FI SUNS ATTORNEY: Richmond, CA 94801 �llF Date received ADDRESS: BY DELIVERY TO CLERK ON 10/3/90 via County Counsel BY MAIL POSTMARKED.. 9/28/90 1. FROM: Clerk of the Board of Supervisors TO: County Counsel I Attached is a copy of the above-noted claim. j DATED: Oct. 4, 1990 JaIL DeputyLOR, Clerk i I1. FROM: County Counsel TO: Clerk of the Board of Supervisors . � ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). i ( ) 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 ` I: Dated: Iq cl BY I �/ ) . +, Deputy County Counsel I. III. FROM: Clerk of the Board TO: County Counsel (1) County Administra r (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARDORDSBy 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: O C T 2 9 19 90 PHIL BATCHELOR, Clerk, By Deputy Clerk . .WARNING (Gov. code sec �on 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section;945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: O C T 2 3 1990 BY: PHIL BATCHELOR byZ Deputy Clerk CC: County Counsel County Administrator i 1 RECEIV `off/ 0�`�", 19919 14q UN�Y CSC/ 99r! .� NsFi OCT ` 3 1990 '7F Z_W elz! CLERK 8 D OF SUPERVISORS ;._ CONTRA COSTA CO.. .J olj CONTRA COSTA DETENTION FACILITY:.—.. C/ Je.te CLOTHING RECEIPT DATE: Ota,/OFA/90 REC: 1.9sl(':-)'6 -' TIME: 1757 FACILITY: N,DF., NAME (L, F, M): L_AL.II�ENCI 'L E iiLL..EN D.0.B.. • • BOOKING NBR: 9001.41261-1-: Q SHIRT/BLOUSES/SY+R- ✓�� COAT/JACKET HOES/ OTS [2,SHORTS/PYtNlES7— EL -SHIRT/RRA ©.SOCKS/NYMNS [:]HAT/PURSE 0 SWEATER/SWT. SHIRTDRESS ED OTHER BKG OFC: f Q l v X .` INMATE SMNATUR5 l DATE: d 1 1 HAVE RECEIVED ALL OF MY CLOTHING. REL OFC:,g��b X ,INMATE SIGNATURE • DEMAND VENDOR NO. A C I 4 4 D L_I on the Treasury of the COUNTY OF CONTRA COSTA Made Sy: STATE OF CALIFORNIA DATE La W re-ncell LPA, NAME (LAST) (FIRST) /� IMPORTA.'VT q3e,�.�e_�-�-- C iia ws10 r iti See Instructions on Reverse Side ADDREss I ,.h l(Y1 Cy t'1& -CA C 50 TCITY, STATE ZIP CODE For the sum of �,` d aDollars $ oo � As itemized below: DATE DESCRIPTION AMOUNT 6-q- qc> Leif tS . 561 JeA5 Pge 4 3c;� , 0 0 4-eyi h is ve s Loo-Mer b ao Shor -s an 56ck!5 The undersigned under the penalty of perjury states: That the above claim and the items as therein set out are true and correct; that no part thereof has been heretofore paid, and that the amount therein is justly due, and that the same is presented within one year after the last item thereof has accrued. Signed AQ,,r VENDOR NO. Received, Accepted , and Expenditure Authorized DEPARTMENT HEAD OR CHIEF DEPUTY SUM.NO I INVOICE AA7 0 ACCOUNT CUN RAM N0.JP/C PAYMENT AmOukt i # 1 r 1 TAXABLEAMOUNT SK OPTION ACTIVITY iPEC. I L• . DISCOUNT 1 I r r I r sum. NO. INVOICE DAT[ DESCRIPTION PUND/OR•. ACCOUNT ENCUMBRANCE NO. IF/Cl PAYMENT AMOUNT } ' 1 ACTIVITY Y 0ISC UNAEABL[ AMOUNT TTA K 0PTION r r I r I FFFM SUN 90. INVOICE DAT[ DESCRIPTION FUND/One. ACCOUNT ENCUMBRANCE N0. P/CJ# PAYMENT AMOUNT r , I • ACTTYSPEC. F •! DI C uNT TAXABLE AMOUNT TASK ITY • r • 1 # 1 I 5 R DI Re v.I0 7 7 � NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Bruce A. Lawrence 143 West Chanslor Ave. Richmond, CA 94801 Re: Claim of BRUCE A. LAWRENCE 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 ok 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. 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. WEST.MAN,- County Counsel By: Deputy County Counsel ! CERTIFICATE OF SERVICE BY MAIL \1 C.C.P. SS 1012, 1013a, 2015 .5: Evid. C. 66 641 , 664) My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg . , P .O. Box 69, Martinez, California, 94.553,. 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: ��\'� ls , at Martinez, California. cc: Clerk of the Board of Supervisors ( iginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910. 2, 920.4, 910 . 8) ' 4 • Q co T7y10 v\j V t 4 , t 5. S so- 1 AMENDED CLAIM Oct . 23 , 1990 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County. or District governed by) BOARD ACT10N - the Board of. Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $50 , 000 Section'913 and 915.4. Please note all "Warnings". CLAIMANT: Millar Elevator Service C.ompany2 RECEIVE® ATTORNEY: P • M . Bessette , Esq. OCT 011990 Wright, Robinson, McCammon et al Date received COUNTY COUNSEL ADDRESS: 44 Montgomery St. , 18th Floor BY DELIVERY TO CLERK ON 9/27/90 MARTINEZ, CALIF. San Francisco, CA 94014 BY MAIL POSTMARKED: 9/25/90 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: 10/1/90 gaIL BATCHELOR, Clerk I1. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk-.should return claim on ground that it was filed late and send warning of claimant's right to apply for Teave to present a late claim (Section 911.3). ( ) Other: Dated: ! 96 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 ORD By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 3 1990 PHIL BATCHELOR, Clerk. By , Deputy Clerk WARNING (Gov. code sec 13) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. if you want to consult an attorney, you should.do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California. postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: OCT 23 1990 BY: PHIL BATCHELOR by Deputy Clerk :-County Counsel County Administrator > ' Claim to: BOAR.. iF SUPERVISORS OF cone COSTA _jm 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 befilledin. I U. If the claim is again t. amoreAsan 0,.o Public ^ti J ecr?raf.a ^_]aims mist he filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec.:-72 at the end of this form. RE: MaVkXB�., A 6 ided'"Claim By ) Reserved for Clerk's filing stamp Millar Elevator Service Company ) R'ECEtVED (successor-in-interest to American ) Elevator Company) ) Against the County of Contra Costa ) 2 7 MU or ) CLERK OARD OF SUPERy1SOq$ District) CONTRA COSTq C0 Fill in name ) _ The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ $50,000 sand in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) May 24, 1989 2. Where did .the damage or injury occur? (Include city and county). Contra Costa County Courthouse, Richmond, CA 3. How did the damage or injury occur? (Give full details; use extra paper if required) See attached sheet. 4. What particular act or omission on the part of county or• district officers, servants or employees caused the injury or damage? See attached sheet. (over) ADDENDUM TO CLAIM 3 . How did the damage or injury occur? (Give full details; use extra paper if required) On May 9, 1990 , plaintiff, Bernetta Rand-Dunham filed the Complaint which is attached hereto, naming Dover Elevator Company, American Elevator Company and Does I through XXV as defendants in her action for personal injuries attributed to an alleged accident in an elevator at the Contra Costa County Courthouse on May 24 , 1989 Plaintiff Bernetta Rand Dunham served Millar Elevator Service Company, successor-in-interest to American Elevator Company, with said Complaint on August 13 , 1990 , at which time Millar first acquired knowledge of plaintiff ' s alleged injuries in the _suit thereon. ' Millar is mailing this Tort Claim pursuant to the requirements of Government Code Sections 900, et sec within the 6 month period during which a claim must be brought against the county. 4 . What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? This is a claim for contribution and indemnity. Millar Elevator Service Company, successor-in-interest to American , Elevator Company, is a defendant in the action Bernetta Rand-Dunham v. Dover Elevator Company, et al . , Contra Costa County Superior Court, Case No. C 90-02096 . Plaintiff has alleged that Millar' s predecessor-in-interest negligently constructed, owned, operated and maintained an elevator at the Contra Costa County Courthouse, proximately causing serious injuries to plaintiff ' s left wrist, hand and thumb. Millar Elevator Service Company denies plaintiff ' s claims in their entirety and alleges that the County of Contra Costa as owner, operator and manager of the County Courthouse, was negligent and therefore is expressly, and impliedly, equitably liable in indemnity, or is otherwise liable under the principals of contribution for plaintiff ' s damages , if any. '182.1-1) it of 3) ATTORNEY OR PARTY WITHOUT ATTORNEY(NAME AND ADDRESS): TELEPHONE: FOR COURT USE ONLY JACQUES DLOXHAM, ESQ. (415) 934-6647 '43 PANORAMIC WAY. WALNUT CREEK, CA 94595 ATTORNEY FOR(NAME): BERNETTA RAND-DUNHAM Insert name of court, udicial district or branch Court.II any,andpost office and street address: SUPERIOR COURT OF CALIFORNIA, CONTRA COSTA COUNTY 725 Court Street Martinez, CA 94553 MAY 9 i S. L \K'GIR,COUNTY CLERK PLAINTIFF: CONTRA COSTA COUNTY BY BERNETTA RAND-DUNIIAM .T,)I 1�1ARtllPd Deputy DEFENDANT: DOVER ELEVATOR COMPANY, AMERICAN ELEVATOR COMPANY ®DOES 1 TO 25 CASE NUMBER: COMPLAINT—Personal Injury, Property Damage, Wrongful Death Q MOTOR VEHICLE =OTHER(specify): =Property Damage Wrongful Death [Personal Injury [� Other Damages(specify): G 9 U — - 020 96 ii 1. This pleading, including attachments and exhibits, consists of the following number of pages: 4 2. a. Each plaintiff named above is a competent adult ! j� 11O f'��: (LOCAL RULE 5 U Except plaintiff(name): t =a corporation qualified to do business In California THIS CASE IsASSIGNED TO DEPT. - F7 an unincorporated entity(describe): AND COMES UNDER GOVERNMENT CODE 68600 a public entity(describe): I []a minor an adult for whom a guardian or conservator of the estate or a guardian ad (item has been appointed Q other(specify): M other(specify): Q Except plaintiff(name): a corporation qualified to do business in California I =an unincorporated entity(describe): =a public entity(describe): Me minor an adult 0 for whom a guardian or conservator of the estate or a guardian ad Ille'm has been appointed Q other(specify): other(specify):. b. =Plaintiff(name): is doing business under the fictitious name of(specify): and has complied with the fictitious business name laws, c. Information about additional plaintiffs who are not competent adults Is shown In Complaint— Attachment 2c. (Continued) Form Appioved by the Jude'clCouncil of 1. 1982a COMPLAINT—Personal Injury, Property Damage,, Ellecave January 1. 1982 Rule 982 10) Wrongful Death CCP 425 12 SHORT TITLE: 7) CASE NUMBER: RAND-DUNHAM vs. DOVER ELEVATOR COMPLAINT—Personal Injury, Property Damage,Wrongful Death Page two 3. a. Each defendant named above Is a natural person Except defendant(name): (Except defendant(name): AMERICAN ELEVATOR COMPANY - DOVER ELEVATORI COMPANY a business organization, form unknownvivia business organlzatlon, form unknown a corporation a corporation;; Q an unincorporated entity(describe): Q an unincorporated entity(describe): Q a public entity(describe): Q a public entity(describe): Q other(specify): other(specify): r , Except defendant(name): DOES 1-10 =Except defendant(name): a business organization, form unknown =a business organization, form'unknown Q a corporation =a corporation Q an unincorporated entity(describe): an unincorporated entity(describe): Q a public entity(describe). a public entity(describe): =other(specify): other(specify): b. The true names and capacities of defendants sued as Does are unknown to plaintiff. c. Q Information about additional defendants who are not natural persons Is contained In Complaint— Attachment 3c. d. Q Defendants who are joined pursuant to Code of Civil Procedure section 382 are(names): 4. Q Plaintiff is required to comply with a claims statute, and a. 0 plaintiff hes complied with applicable claims statutes, or b. Q plaintilf Is excused from complying because(specify): 5. This court is the proper court because [� at least one defendant now resides In its jurisdictional area. j� the principal place of business of a corporation or unincorporated association Is In Its jurisdictional area. injury to person or damage to personal property occurred In Its jurisdictional area. [] other(specify): 6. The following paragraphs of this complaint are alleged on Information and belief(specify paragraph numbers): g a• (Continued) Page two 981 101;)• ('3-of 3) SHORT TITLE: CASE NUMBER. RAND-DUNHAM vs. DOVER ELEVATOR COMPLAINT—Personal Injury, Property Damage, Wrongful Death.(Contlnued) Page three 7. Q The damages claimed for wrongful death and the relationships of plaintiff to the deceased are Q listed in Complaint—Attachment 7 Q as follows: 8. Plaintiff has suffered wage loss Q los, of use of property hospital and medical expenses Mgeneral damage property damage r34 loss of earning capacity Q other damage(specify): 9. Relief sought in this complaint is within the jurisdiction of this court. 10. PLAINTIFF PRAYS For judgment for costs of suit; for such relief as Is fair,just, and equitable; and for PSI compensatory damages (Superior Court) according to proof. Q (Municipal and Justice Court) in the amount of S Q other(specify): 11. The following causes of action are attached and the statements above apply to each: (Each complaint must have one or more causes of action attached.) Q Motor Vehicle General Negligence Q intentional Tort Q Products Liability Q Premises Liability (Q Other(specify): JACQUES BLOXHAM, ESQ.- Vt__ (Type or print name) (Signature of plaintiff or Corney) COMPLAINT—Personal in I ryProp rty Damage, Page three Rule 982.t(t)(conrd) Wrongful D at (Co tlnued) CCA 425.12 li • :ti,40RT TITLE: 1 j1 CASE NUMBER RAND-DUNHAM vs. DOVER ELEVATOR FIRST CAUSE OF ACTION—General Negligence Page FOUR (number) _ ATTACHMENT TO (Complaint =Cross-Complaint (Use a separate cause of action form for each cause of action.) GN-1. Plaintiff(name): BERNETTA RAND-DUNIIAM alleges that defendant(name): AMERICAN ELEVATOR, DOVER ELEVATOR COMPANY i Does 1 to 25 inclusive r was the legal (proximate) cause of damages to plaintiff. By the following acts or omissions to act. defendant negligently caused the damage to plalntlff on(date): May 24, 1989 at(place): Richmond, California (description of reasons for liability): Defendants so negligently and carelessly constructed ' owned, operated and maintained the elevator at the Contra Costa County Courthouse, proximately causing serious injuries to Plaintiff's left wrist, hand and thumb. I Form Approved by the Judicial Council of California EneclRule 982 January3) 1982 CAUSE OF ACTION—General Neallaence cca 425 12 913PERIOR COURT OF CALI ) 1IA, COUNTY OF CONTRA m, COURT USE ONLY = - 125` COURT ST. XARTINEY. C-OWIFORNIA ,94553 (415)646-29!)0 HCl�I//>r i/ ._. ...... ._. •) *0TICE OF FIRST STATUS SCE CASE NUMBER C 90 - - 02096 1. 10710E is given that the first $total Conference hass been Scheduled as follows: Date: ��l 131 1990 Time: 3!30 4M Dept. : l JJ� Room: Address of court shown above is: / (J L PARTIES SERVED WITH SUMMONS AND COMPLAINT/CROSS-COMPLAINT OR THEIR ATTORNEY OF RECORD )MST APPEAR. 2. You must file and serve a completed States Conference Questionnaire at least five days before the status conference. 3. You must be familiar with the case and be fully prepared to participate effectively in the status conference. 4. At the status conference the court may sake pretrial orders, including the following: a. an order establishing a discovery schedule. a b. an order referring the case to arbitration. c. an order transferring the case to the municipal or Justice court. d. an order dismissing fictitious defendants. c. an order scheduling exchaoge of expert witness information. f. an order setting subsequent conferences and the trial date: j V. an order consolidating cases. A. an order severing trial of cross-complaints or bifurcating trial of Issues. i.. an order determining when desurrers. , notions . to strike and other notions SANCTI0NS If you do not file the, Status Cam ereaoe Questionnaire' or attend the status conference or participate:;offectively in the conference, the court may impose sanctions (including dismissal of the case and payment of money) . STEVEN L. WEIR - County Clerk, County of Contra Costa. declare ender penalty of perjury that I''an mot a party to this bction. as at least is years of age and :hat I personally _0-14-vsnt/or nailed a cc of this r!Vbice f first Status Conference with the :onference date and bearing time inserted to C UA4 aperson representing he plaintiff/ � , 0 / - ( . 0 . . P )atcd:-_.__y�� Deputy 1 . PROOF OF SERVICE 2 I declare that: 3 I am a citizen of the United States, employed in the 4 City and County of San Francisco, over the age of eighteen 5 years, and not a party to the within cause. My business 6 address is 44 Montgomery Street, 18th Floor, San Francisco, CA 7 94104 . On September 26, 1990, I served the within: 8 9 AMENDED CLAIM TO BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY 10 on the parties in said cause, by placing a true and correct 11 copy thereof enclosed in a sealed envelope with postage thereon 12 fully prepaid, in the United States mail at San Francisco, 13 California, addressed as follows : 14 15 Clerk of the Board of Supervisors County Administration Building 16 Room 106 651 Pine Street 17 Martinez, CA 94553 18 I declare under penalty of perjury that the foregoing is 19 true and correct and that this declaration was executed on 20 September 26, 1990, at San Francisco, California. 21 22 J� &W7 HILDA ALVAR 23 24 25 26 27 28 WRIGHT,ROBINSON, MCCAMMON, OSTHIMER&TATUM 44 MONTGOMERY STREET 18TH FLOOR SAN FRANCISCO, CALIFORNIA 94104 (415)391-7111 WRIGHT, ROBINSON, MCCAMMON, OSTHIMER & TATUM ATTORNEYS (A PARTNERSHIP OF PROFESSIONAL CORPORATIONS) 44 MONTGOMERY STREET, 18TH FLOOR SAN FRANCISCO,CALIFORNIA 94104 (415)391-7111 TELEFAX(415)391-8766 411 EAST FRANKLIN STREET 888 SOUTH FIGUEROA STREET RICHMOND,VIRGINIA 23219-2205 LOS ANGELES,CALIFORNIA 90017-5455 (804)783-1100 September 26, 1990 (213)488-0503 TELEFAX(804)783-1138 TELEFAX(213)624-3755 RECEIVED Clerk of the Board of Supervisors cCn County of Administration Building 4~ 2 7 Room 106 651 Pine Street Martinez, CA 94553 CLERK80ARDOFSTACO. RS CONTRA COSTA CO. Re : Rand-Dunham v. Dover Elevator, et al . Our File No . 100200 . 0012 Dear Clerk: Enclosed is an original and a copy of an Amended Claim against the County of Contra Costa on behalf of Millar Elevator Service Company, defendant in the above-referenced case. Please return the copy with a "received" stamp on it in the envelope I have provided. I have also enclosed a copy of the original claim submitted to your office on September 14, 1990 . Should you have any questions regarding this matter, please do not hesitate to contact our office. Ve y �truly yours, H ' a Al arez Secretary to P.M. Bessette PMB:ha. Enclosures `n ow Claim to: pALF SUPERVISORS OF CONTRA COSTA .-JM 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. ��+-;*.. ac rata Claims ct L. If the claim is against more ;ar, conc. public ,.,, , _ m!i he filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Chaim By,, - ) Reserved for Clerk's filing stamp Millar Elevator Service Company RECEIVED (successor-in-interest to American Elevator Company) ) Against the County of Contra Costa A or ) N SM District) CLERK BOARD OF Fill in name ) COQ COSTA CO. 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) May 24, 1989 2. Where did the damage or injury occur? (Include city and county) Contra Costa County Courthouse, Richmond, CA ---------------------- - - -----------------—--------------- 3. -- ------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) See attached sheet. 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? See attached sheet. (over) What are the names s � t �l 5. of ,:ounty or district officers, a ..n s ;,orp ` r, s causing the damage or injury? Unknown, discovery has just commenced. 6. What damage or injuries do, you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Damages in an unkown amount for contribution and indemnity for plaintiff Bern'etta Rand-Dunham's alleged injury to her left wrist, hand and thumb. 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. Discovery has only recently commenced. ------------------------------------------------------------------------------------ 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Discovery has only recently commenced. Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES: Tbi_ (Ati;orne ) or by-some peron on his ,behalf." Name and Address .of Attorney P.M. Bessette Esq. Claimant's Si tore Wright, Robinson, McCammon, et 'al. ! 44 Montgomery St. , 18th Floor San' Francisco, CA 94104 44 Montgomery Street,, 18th Floor Address San Francisco, CA 94104 Telephone No. (415): 391-7111 Telephone No. (415) 391-7-ill 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. ordistriet 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 1' by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. i NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: P.M. Bessette, Esq. Wright, Robinson, McCammon, et al . 44 Montgomery St. , 18th F1. San Francisco, CA 94104 Re: Claim of MILLAR ELEVATOR SERVICE COMPANY 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. 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. i 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 datelof 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. x 6 . The claim is not signed'by the claimant or by some person on his behalf. 7 . Other: VICTOR J. WESTMAN, County Counsel B y: Deputy Cdbnty Counsel CERTIFICATE OF SERVICE BY MAIL ! C.C.P. 55 1012, 1013a, 2015.5; Evid. C. 55 641, 664 ) My business address is the County Counsel's Officel;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 )i 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 :rue orld correct. Dated: cx\� ,O , at Martinez, California. r cc: Clerk of the Board of Supervisors iginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.SS 910, 910. 2, 920.4, 910. 8) ADDENDUM -TO CLAIM 3 . How did the damage or injury occur? (Give full details; use extra paper if required) On May 9, 1990 , plaintiff, Bernetta Rand-Dunham filed the Complaint which is attached hereto, naming Dover Elevator Company, American Elevator Company and Does I through XXV as defendants in her action for personal injuries attributed to an alleged accident in an elevator at the Contra Costa County Courthouse on May 24 , 1989 . Plaintiff Bernetta Rand Dunham served Millar'tlevator Service Company, successor-in-interest to American Elevator Company, with said Complaint on August 13 , 1990 , at which time Millar first acquired knowledge of plaintiff ' s alleged injuries in the suit thereon. Millar is mailing this Tort Claim pursuant to the requirements of Government Code Sections 900 , et sec within the 6 month period during which a claim must be brought against the county. 4 . What particular act or omission on the part of county or district officers , servants or employees caused the. injury or damage? This is a claim for contribution and indemnity. Millar Elevator Service Company, successor-in-interest to American Elevator Company, is a defendant in the action Bernetta Rand-Dunham v. Dover Elevator Company, et al . j Contra Costa County Superior Court, Case No. C 90-02096 . Plaintiff has alleged that Millar' s predecessor-in-interest negligently constructed, owned, operated and maintained an elevator at the Contra Costa County Courthouse', proximately causing serious injuries to plaintiff' s left wrist, hand and thumb. Millar Elevator Service Company denies plaintiff' s claims in their entirety and alleges that the County of '!Contra Costa as owner, operator and manager of the County Courthouse, was negligent and therefore is expressly, and impliedly, equitably liable in indemnity, or is otherwise liable under the. principals of contribution for plaintiffs'- damages , if any. ATTORNEY OR PARTY WITHOUT ATTORNEY(NAME AND ADDRESS): TELEPHONE: FOR COURT USE ONLY JACQUES BLOXHAM, ESQ. (415) 934-6647 43 PANORAMIC WAY WALNUT CREEK, CA 94595 ATTORNEY FOR(NAME): BERNETTA RAND-DUNHAM Insert name of court.'udicial district or branch court.II an and post office and street address: SUPERIOR COM11: OF CALIFORNIA, CONyi'RA COSTA COUNTY D 725 Court Street Martinez, CA 94553 MAY t S. I. WEIR,COUNTY CLERK PLAINTIFF: CONTRA CGS'FA COUNTY BERNETTA RAND-DUNIIAM Dl'I(rTr�j MARVIN Deputy I DEFENDANT: DOVER ELEVATOR COMPANY, AMERICAN ELEVATOR COMPANY IEKIDOESITO 25 CASE NUMBER: COMPLAINT—Personal Injury, Property Damage, Wrongful Death F7 MOTOR VEHICLE =OTHER(specify): =Property Damage =Wrongful Death =Personal Injury = Other Damages(specify): G 9 0 - — 0 2 0 9 6 t. This pleading, including attachments and exhibits, consists of the following number of pages: 4 2. a. Each plaintiff named above is a competent adult I J� = Except plaintiff(name): j+IOT'+,L': LOCAL RULE 5 fJ llJt =a corporation qualified to do business In California THIS CASE IS ASSIGNED TO DEPT. an unincorporated entity(describe): AND CONICS UNDER GOVERNMENTCODE68600 j =a public entity(describe): I a minor an adult Il = for whom a guardian or conservator of the estate or a guardian ad Idem has been appointed I = other(specify): III 0 other(specify): Except plaintiff(name): =a corporation qualified to do business in California I =an unincorporated entity(describe): =a public entity(describe): [=a minor []an adult = for whom a guardian or conservator of the estate or a guardian ad Ilteh► has been appointed = other(specify): 0 other(specify):. I b. =Plaintiff(name): is doing business under the fictitious name of(specify): and has complied with the fictitious business name laws. c. = information about additional plaintiffs who are not competent adults Is shown In Complaint— Attachment 2c. (Continued) Form Approved by the Judicial Council ofCaiirornis -COMPLAINT—Personal Injury, Property Damage, EIIeclrve January 1. 1982 Rule 982 1(1) Wrongful Death CCP 425 12 i SNORT TITLE: CASE NUMBER: RAND-DUNHAM vs. DOVER ELEVATOR COMPLAINT—Personal Injury, Property Damage, Wrongful Death Page two 3. a. Each defendant named above Is a natural person Except defendant(name): j Except defendant(name): AMERICAN ELEVATOR COMPANY DOVER ELEVATOR COMPANY �]a business organization, form unknown a business organization, form unknown b a corporation Q a corporation jQ an unincorporated entity(describe): Q an unincorporated entity(describe): Q a public entity(describe): Q a public entity(describe): = other(specify): Q other(specify): Except defendant(name): DOES 1-10 =Except defendant(name): a business organization, form unknown =a business organization, form unknown jQ a corporation =a corporations Q an unincorporated entity(describe): Q an unincorporated entity(describe): Q a public entity(describe): Q a public entity(describe): 0 other(specify): Q other(specify): b. The true names and capacities of defendants sued as Does are unknown to plaintiff. c. Q Information about additional defendants who are not natural persons Is contained In Complaint— Attachment 3c. d. Q Defendants who are joined pursuant to Code of Civil Procedure section 382 are(names): 4. Q Plaintiff is required to comply with a claims statute, and a. Q plaintiff has complied with applicable claims statutes, or b. Q plaintiff Is excused from complying because(specify): 5. This court is the proper court because Q at least one defendant now resides In its jurisdictional area. the principal place of business of a corporation or unincorporated association is,in'its jurisdictional area. injury to person or damage to personal property occurred In Its jurisdictional area. Q other(specify): 6. The following paragraphs of this complaint are alleged on Information and belief(specify paragraph numbers): 3 a. (Continued) Page two 9811(t). j3 of 3) SHOAT TITLE: CASE NUMBER RAND-DUNHAM vs. DOVER ELEVATOR COMPLAINT—Personal Injury, Property Damage, Wrongful Death (Continued) Page three 7. Q The damages claimed for wrongful death and the relationships of plaintiff to the deceased are Q listed in Complaint—Attachment 7 Q as follows: 1 8. Plaintiff has suffered wage loss Q losg.of use of property hospital and medical expenses general damage property damage loss of earning capacity Q other damage(specify): 9. Relief sought in this,complaint is within the jurlsdicllon of this court. 10. PLAINTIFF PRAYS For judgment for costs of suit; for such relief as is fair.Just, and equitable; and for compensatory damages [$�(Superior Court) according to proof. Q(Municipal and Justice Court) In the amount of 3 Q other(specify): 11. The following causes of action are attached and the statements above apply to each: (Each complaint must have one or more causes of action attached.) Q Motor Vehicle General Negligence Q Intentional Tort Q Products Liability Q Premises Liability Q Other(specify): JACQUES DEOXHAM, ESQ.. r� (Type or print name) (Signature of pialntiff or lorney) COMPLAINT—Personal in l ry Prop rty Damage, / Page three Rule 982 t(1)(conl'0) Wrongful D at (Co tinned) CCP 425.12 • SHORT TITLE: ) CASE NUMBER RAND-DUNHAM vs. DOVER ELEVATOR FIRST CAUSE OF ACTION—General Negligence Page FOUR (number) ATTACHMENT TO 4Complaint =Cross-Complaint (Use a separate cause of action form for each cause of action.) GN-t. Plaintiff (name): BERNETTA RAND-DUNIIAM alleges that delendant(name): AMERICAN ELEVATOR, DOVER ELEVATOR COMPANY ,]Does 1 to 25 inclusive r was the legal (proximate) cause of damages to plaintiff. By the following acts or omissions 'to act, defendant negligently caused the damage to plalntlfl on(date): May 24, 1989 at(place): Richmond, California (description of reasons for liability): Defendants so negligently and carelessly .constructed, owned, operated and maintained the elevator at the Contra Costa County Courthouse, proximately causing serious injuries to Plaintiff's left wrist, hand and thumb. Form Approved by the Judicial Council of California EffectiveJanuary 982)(� ) i9B2 CAUSE OF ACTION—General Neallaence CCP 475 12 6'OPERIOR COURT OF CALL tIA, OOIIN'I'Y OF CONTRA CO: COURT OSE ONLY =�•L 725 COURT ST. XARTINEB CAA-IFORNIA 94553 (415)646-2950 -�' � - t . 4,1 9 91 NOTICE OF FIRST STATUS SCE CASE KMMER C190 - 02096 1. NOTICE is given that the first Status Conferemce basirbeen scheduled as follows: Date: 54, -(l 13, 1990 Time: 3!30 ,}P) Dept. :/ Roam: Address of court shown above is: .L PARTIES SERVED WITH SUMONS AND COMPLAINT/CROSS—COMPLAINT OR THEIR ATTORNEY OF RECORD X2ST APPEAR. 2. You must file and serve a completed States Conference Questionnaire at least five days before the status conference. 3. You must be familiar with the case and be fully prepared to participate`effectively in the status conference. 4. At" the status conference the court say sake pretrial orders. Including the following: a. an order establishing a discovery schedule. a b. an order referring the case to arbitration. c. an order transferring the case to the municipal or justice court. d. an order dismissing fictitious defendants. e. an order scheduling excbamge of expert witness information. f. an order setting subsequent conferences and the trial date:` g. an order consolidating cases. b. an order severing trial of cross-complaints or bifurcating trial of issues. 1. an order determining when demurrers, motions to strike and other lotions SAFCTIONS If you do not file the Status Conference QuestionnaL a or attend the status conference or participate:;offectively in the conference, the court may impose sanctions (including dismissal. of the case and payment of money) . STEVEN L. WEIR - County Clerk, County of Contra Costa. declare under penalty of perjury tbat I"as sot a party to this action. as at least 16 years of age and :hat I personally -0-14-vorr*W or sailed a cc of this N ca of first Status Conference with the :onference date and bearing time insertedto f ulz D a person representing he plaintiff/ Deputy dated: 1 PROOF OF SERVICE 2 I declare that : 3 I am a citizen of the United States , employed in the 4 City and County of San Francisco, over the age of eighteen 5 years , and not a party to the within cause . My business 6 address is 44 Montgomery Street, 18th Floor, San Francisco, CA 7 94104 . On September 13 , 1990 , I served the within: 8 r 9 CLAIM TO BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY 10 on the parties in said cause, by placing a true and correct 11 copy thereof enclosed in a sealed envelope with postage thereon 12 fully prepaid, in the United States mail at San Francisco, 13 California, addressed as follows : 14 Clerk of the Board of Supervisors 15 County Administration Building Room 106 16 651 Pine Street Martinez, CA 94553 17 I declare under penalty of perjury that the foregoing is 18 true and correct and that this declaration was executed on 19 September 13 , 1990 , at San Francisco, California . 20 21 ,�. J10a, 22 HILDA ALVAREZ 23 24 25 26 27 28 VRIGHT, ROBINSON, MCCAMMON, )STHIMER&TATUM AONTGOMERY STREET 18TH FLOOR SAN FRANCISCO. CALIFORNIA 94104 (415)39 1-7111 4 4W,1 Cl� cn Ana `� �- � 01 son