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HomeMy WebLinkAboutMINUTES - 12171991 - 1.22 CLAIM IVO I/ di PAD . BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA CO �' 11� 44gQTN� c0 t�7 Claim Against the County, or District governed by) BOARD A>r-�I* the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT December 17. 1991:: 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: Indemnification Section 913 and 915.4. Please note all "Warnings". CLAIMANT: GRAND RENT"A CAR DBA AVIS RENT A CAR ATTORNEY: Date received ADDRESS: 360 N. Sepulveda #3000 BY DELIVERY TO CLERK ON November 18, 1991 E1 Segundo, CA 90245 BY MAIL POSTMARKED: November 14, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: November 21, 1991 ggIL DeputyLOR, Clerk a II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: j 51 BY: rl Deputy County Counsel V III. FROM: Clerk of the Board TO: County Counsel (1) County ANzAtrator (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. 1 Q Dated: . DEC 1 a�1 1991 PHIL BATCHELOR, Clerk, By �jy- �j,� 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: n E C 17 BY: PHIL BATCHELOR by � Deputy Clerk CC: County Counsel County Administrator :Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to'per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action.. Claims relating to any other cause of action must be presented not later than one-year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed With the Clerk of the Board of Supervisors at its office in Room 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. 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 GRAND RENT A CAR DBA AVIS RENT A CAR ) RE ENED Against the County of Contra Costa ) NOV 1 8 1991 or ) District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ TNppMNTFT _ATT_ON and in support of this claim represents as follows: ---------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) _QZLl�Lg1LQ�24-------------- ------------------------------------------------ 2. Where did the damage or injury occur? (Include city and county) SERVICE ROADi 100YARDS�WEST OF LAFAYETTE RES. 3. How did the damage or injury occur? (Give full details; use extra_ paper if required) PLEASE-SEE-ATTACHED LETTER AND POLICE REPORT. 4.. EPORTN4.. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? THE CLAIMANTS, JAMES JENKINS AND KIM DAHLIN, ALLEGE UNFAIR TREATMENT, ASSAULT, AND DETENTION AS A RESULT OF A RENTAL 'VEHICLE BEING INCORRECTLY REPORTED STOLEN. (over) 5. What are the names of county or district officers, servants or employees causing .the damage or injury? PLEASE SEE THE POLICE REPORT ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. GRAND RENT A CAR REQUESTS INDEMNIFICATION FOR ANY AND ALL CLAIMS RELATING TO THE PROCEDURE, PROCESS AND CONDUCT OF THE COUNTY EMPLOYEES. ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) THE ATTACHED DOCUMENTATION IS THE ONLY INFORMATION AVAILABLE. ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. SEE ATTACHED. ------------------------------------------------------------------------------------- 9. List the expenditures you-made on account of this accident or injury: DATE ITEM AMOUNT 0 Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person D-n his behalf." Name and Address of Attorney . NONE S Si tore /y A ss Telephone No. Telephone N NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding. one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. R, AVIS RENT A CAR SYSTEM i GRAND RENT A CAR CORP.,360 N.SEPULVEDA BLVD..SUITE 3000,EL SEGUNDO,CA 90245 (213)615-4300 4 i LICENSEE 10/15191 -• ` i-_ CITY OF LAFAYETTE RECORDS DIVISION - 651 PINE ST. = ; MARTINEZ, CA 94553 Attention: Traffic Records 5 i Gentlemen We have an interest in the subject matte appreciate your forwarding a copy of yot _. Drivers Involved /JENKINS Licence #: JAMES JENKINS Date of loss : 07/12/91 Time Loction of Loss : LAFAYETTE CA Reporting Officer: Badge #: DR Number : 91-22496 Our Claim No. : 000033480 01ABI Enclosed is our check in the amount of $10.00, cover the expense of the £- report, A return emvelana-hen ►+Aon ��-..--_a -_ ____- INVOICE NUMBER AMOUNT ACCOUNT NUMBER REMARKS V DATEHIE�` 00-07-0455: E033480-O1�iBI 10 . 04 22496 10 . 00 : PLEASE DETACH THIS REMITTANCE GRAND RENT A CAR CORP. THIS IITCHECK HM�s ETENDERED IN PAYMENT ADVICE BEFORE DEPOSITING CHECK 360 N.SEPULVEDA BLVD. - SUITE 3000 - EL SEGUNDO.CA 90245 Use reverse for reporting Em. D IMPOUNDED f-RECQVERED D STORED ® RELEASED -VEHICLE REPORT bezzled/Stoten Vehicles/Plates. REPORTING D!r!wT%.NNT LOCATION COD! OATH/TIM!RtPQ; PIL!MUMMER J S Clwo Ir /wt�OV E)t���R� O� �E I"l WAD"WIONEORNOOD OR Ano^CMECuaw raw WITNESSES.LEAOf,CLWUVI fr��TMRS• I n� yj�1 I T EIt FLAIR IM RERAN SAD OR ON SRPAMATw One .TSR . FED �I NO TOWING/STOMAGS CONCEMM NAME AMD AOOWESS TELEPHONE NUDISM" TOWED TO/erOAOD AT TELtPHOME Mu MOaR O E �,�GC1L /V 14 REPORTWO Or NOME AODOUSS TELEPMONE Rune a OU/In SMS AMORE TELEPHONE MUMMER DESCRIPTION AND OWNERSHIP . vcAM IMAnIffa cow*(cOmb(motlonJ Lletnes MUMeaw(S) IMONT" lTRww STATE 471 /. VI t CSI Two O :9.� _64 VEHICLE IOWNTIFICArlo.MUMMER(VIN) janorma NUMBER(EN) VIM COMPA0VIN ADMAN VIM CUMARIN aVe LIC.NUMOR* Sj ..T..so,CARD ALTERED/Ra MOV'D CLEAR an... 181t,1^01217181`213 f Elyou ❑.D ❑YUS NN. ❑vws ®No ❑Ta■ a.. IP 1ITOLRM. AME.OATR AMD CA{a MU ■ao OP REPORTING AO ENCU - WAS van.wETYRNED TO STORAGE AUTHORITY OWNER Q v� �III �ref Si Mo I Y NaGISTMMEa OWNER •ADDRESS \\ TELtrNOME(f)psome and business) �N ,UaFs Z '7/ LEGAL OWNER, AOowWe■ Take P"OMf(ei( me usMSf _S,&fte 3 ME CONDITION AND INVENTORY UseRemarks a or attach se arate descriptions as needed. OOOMtTt11 wtADIMO Onlv■AMLM "AVE YOU ENTSNEO MHNNw.IOOMTI/1AELt PARTS I.MI1f1 ODescribe fully in J rc 1:1NO ED UNNNOWN0 you S NO remarksWaee CONOITICN Vaal NO ITUMS Y!M No IT<MM Taal NO TIM!!/wHIERLM ONDITIONITlMMe IDiNTIPICAT1oN MUMMMR Ww ECNGN SEAT(front) na OlSTw wT10N x LER rao"T t1O CARPER OuwMSO SaAT(rsor) x ►LT/GENMwATOR X WIGHT FRONT eazwCARGO rANDALIESO X wADiO x MATrawv LEPT NEAR AO VESSELAe LOA UNG/VRAMe S"Ir X TAPM DECW TAUTONATIC PanaIMAL x MIGHT NEAR F1wEARMe "too.PARTS STRIP TAPES(DI j NeY1ff1ON X ePAAMISj OTHaN wool METAL STRIP X OT"Ew RADIO ( ) qq. ':"' HYw CAq(• VIM SWITO. som-nor NET UAL ( j i% �` %# WNEELe .� REMARKS Use additional blank sheets as required.Include all Pertinent information. LILT POOPEIITY.TOO",vENICLM DAMAGE!,LAST DRIVER OP VEHICLE,ANwESTS(full names,charg",where detobwd) sc.I ,w v Ita�E -E;rpzAra As!jr gois., w Ag.7 gad d Z Fn 44/4 - eAe AOS ii►tAN� ) jP.EtXASt><Q M J*A4e.Iu5 &/Nb �,I#A AIA GQ ;J,4CONTIMVED On SEPARATE.-a— �irez .►PICS*O.OnM/Mq VSNICLt STanao fs(gnatu ) I.O.NYMSfR DAMAGE PRINCIPAL OR AGENT DTORIwG VON S na re DATE ANO TIME ' VALUAT:JN RELEASE DISPOSITION 6%Nc COvallr Te"TTra(date and Na0UINSO nwncns SENT TO NfOlfrenao• IP no If CNKCRMO.IWDICATM OSASOW AVA PROONAM A number) Le.AL oWRawe(Sea.2?852 VC) f - 0 VMS ❑no Q/ !IW LVS NATE AND"MR OF APPRAISAL ArVRAISINO OPPICER'S SIGNATURE I.O.Nu Mwww W ( O thortty/coneem) oATe Pte, wJ we��LE ToM�s ADDRESS S *� S70NATl E Or P OwIZINO■ELEAfe CERTIFICATION: I, the undersigned, do hereby certify that I am legafjy i V authorizedand entitled to take possession of above described Vehicle. V VOTE: CHP 180 if fumizhed ail peace officers by the California Highway gOMATVRW Gr PwwDGN TAMING POSSESSION Patrol. �y P 180(Rev 5-85)OPI 066 Use Previous edition until depleted L ---... _._��. ❑Face Paye CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat �Q scontinuaticn P.O.Box W, Martinez,California 94553-0039 Cl Supplemental ❑HRO ❑Arrest ❑SI 1 Ofl No... 2.C1ty Code3.Crime/cum iecaUon a.Detail, /Qac'/ s.More F .i fT -�2 2. Parsons &Day/Date/T'me of Occurrent 7.Date/Time R ported 8.Emplo a No. ❑ -biz-9176q d -� 9.ncatio si- ticabon 10.Address/Location of Occurrence - rdy� � ' /Q ❑ Zvi C1F T /✓ 70 TP 11. in PRI ❑Vic ❑WIT ❑MSP ❑RUN ❑SUS ❑LEAD ❑Other 12.Name(L,F. ) 13.Race/Sex/Age 14.DOB 15.Drhrer License No. 16.Address (zip Code) 17.Home Phone 1&Employed By or School 19.Work Phone ( y 20.Hair 21.Eyes 22.Ht 23.WL 24.AKA/Maiden Name 25.Social Security No. 26.Further Description(Scars,Tattoos,Mannerisms,Clothing,Eta) 27.Booking or Cite No. 28. ❑PRI 23 Vic ❑WIT MSP ❑RUN ❑sus ❑LEAD ❑Other 29.Name(L,F.M) 30.Race/Sex/Age 31.OOB32.Driver License No. NT 33.Address Rip Code) 34.Home Phone 35.Employed By or School 3&Work Phone -71 qZ 37.Hair 38.E;;;7.Ht 40.Wt 41.AKA/,Marden Name, 42.Social Security No. 43.Further Description(Scars,Tattoos,Mannerisms.Clothing,Etc.) 44.Booking or Cita No. 45. ❑PRI ❑Vic -awrr ❑MSP ❑RUN ❑sus ❑LEAD other 46 a(L,F,M) 47.Race/Sex/Age 48.DOB 49.Driver License No. vib 50.Address (Zip Coda) 51.Home Phone r S. T o Ps 941S41 ( ) 52 Employed By or school� 53.Work Phone �rt�; pueg T` (54.Hayes 56.Ht 57.WL 58.AKA!Maiden Name 59.Social Security Na 60.Further Description(Scars.Tattoos,Mannerisms.Clothing,Etc.) 61.Booking or Cite No. 62.Veh/Ves 63.Lic.No.(State) 64.Year 65.Make 6&M04,el 67•Body S" 61 Color Tap51-L&KC cis Vlct ZVW -%N Le Bottom 6g.Status 70.Registered O 71.R.O.Address •l \ er' a Leh -JLTS � --*7S7--*7S7 /V. N,#Ad&e Z � p N XA6 &&- ❑Impound 72.Towed to or Rebased W 73.Who has keys? Stored I A444 .�tL�J•V 74.Evid. []Yes, 75.F/P ❑Yes 76.Dispo of Evidence 77,S Missing 78.b Dame No I a No /!V 79.Brief Synopsis of Incident (1) (2) (3) (4) (5) (81 1 80.Distribution 61.Additional Routing ❑B ❑C E]DA ❑DE IFL 0 E]SR ❑V f'Investigation []Vice ❑Narcotics ❑Juv ❑Coroner W-lemp Deputy(Print) II&Date/Time written 84.Dispo. ❑Property ck. qA�s„❑Emelt ❑R.O. ❑sHC 7-12- / 1600 C.Ht� P Captain pt Oft C]Marine Patrol 85.�pp►ovl `(PrtrtQ t86.�Sypv,�tc� i Dr;"" l e6.Pie Lure 7�� •( � Lot r FORMA (Rev.1/89) C]Face Page CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beat 15P-0he^uation. P.O.Box 391,Martinez,California 94553-0039 0 Supplemental C]HRO [3 Arrest C]St 1.DR No. ;. 2.City Code 3.Crime/Ctatesification 4.Detail 1 /Q aS/ 5.More .91 .ZY / FT Zzogeew Persona 8 Dar/Date/row of Occurrenspe 7 Data/Time R 8.Employee No. ❑ Y ZZ- Z'9 S - ' / o y.3✓y 9.Reciassi- 10.Address!Location of Occurrence_ fication OC C1,3"U Y __ *- C r" /�1 11. ❑PRI ❑VIC ❑WIT ❑MSP. ❑RUN M SUS ❑LEAD ❑Other 12.Name(L:F 13 /111M 1Sex/Age 14.DOB 15.Driver License No. 3 /D-DS'S2 rasa (Zip Code) 17.Home Phone 18.Employ 19.Work Phone ( 20.Hair 21.Eyes 22.HL23 Wt 24.AKA/Maiden Name 25.Social Security No. 66-o /,go 26.Further Description(Stara,Tattoos,Mannerism,Clothing,Etc.) 27.Booking or Cite No. 28. ❑PRi ❑VIC ❑WIT ❑MSP ?N;- SUS ❑LEAD ❑ the Or Age 31.DOB .019- -G 33 (zip Code) 34.Home Phone o d ( 35.Em pfo 36.Work Phone ( ) 37.Hair 38.Eyes 39.K 40.Wt 41.AKA/Maiden Name 42.Social Security No. 57--o v /2 ' 43.Further Description(Scars,Tattoos,Mannerisms.Clothing,Etca 44.Booking or Cite No. 45. ❑PRI ❑Vic D WIT ❑MSP RUN ❑SUS LEAD Other- 46.Verne(L.F,M) 47.Race/ /Age 48.DOB 49.Driver License No. eA61611"f. A. 60.Address (21p Code) 51.Home Phone 52.Employed 8 or School 53 Work Phone d t4 AAE- /'yl (6 CIP ) 23/-7/YJ 54.Hair 55.Eyes 56.Ht 57.Wt 58.AKA/Maiden Name 59.Social Security No. 60.Further Description(Stara Tattoos.Mannerisms.Clothing,Etc.) 61.Booking or Cite No. 62.Veh I Ves 63.Lic.No.(State) fi4.Year 65.Make 66 Model T757dy Style 63.Color Top S ❑Viet Bottom 69.Status 70.Registered Owner 71.R.O.Address ❑Left ❑Impound 72.Towed to or Released to 73.Who has keys? I Stored 74.Evid ❑Yes 75.F/P [j Yes 76 Dtspo of Evidence 77.S Missing 78.S Damaged No No 79.Brief Synopsis of Incident r) J41LSr' (2) (3) (4) (5) (el 7 80.Distribution 81.Additional Routing ❑6 C3 E]DA 0D ❑L 0 [3 SR ❑V ❑investigation ❑Vice ❑Narcotics ❑Juv ❑Coroner 62. Deputy(Prirtq 83.Date/Time Written 84.Dispo. p Property Ck. ❑ACS ❑Wnell. ❑R.D. ❑SHC ❑Patrol Captain .❑ComPl Ofa ❑Marine Patrol 88.Approving Supa 88.Supv.No. 87.Date 88.Page ,Other a of FORMA (Rea 1/89) ©Coatlrw0jon CONTRA COSTA COUNTY SHERIFF'S OFPARTMENT CA00700M a„ppWmrAW P.O.Box 391,Martinez.Califomia 64553-0039 p MAO p Arroal p st 1.OR Nd 2 aly Cods S CMms/ctsssdcmbn 4.DOW t O s Radassi- Y= C� 2 - 2. smson d wdMn NL..a(L F.h0 7.Dau Oda Report a.Emptoyw Nm O 7-I 2-9 3 ams/ Location O , ccurence 10 Suwwft fftig FN) 11.Pmwty Moon. mvwndsd.Aoc waq Found Lost SUm-Main Numbs,Araots.Ouw*.8r&rwmsm1manwwuws ma"Humbo.Sow mmew.BAw*W mous Daatpdm Location Whoa TWWa VHw.V"bft TOW Loa-LW IN FOLLOWING ORDER A)C-W4y.NOW 8)J*W ft.C)CIOlhtnp,Furs;M Whitt$;E)Oft*Epui WIL F)R"O.TVa Oft- 0)fbm"w M Houseftid Goodt 0 Abse. 12.ftoorwad Pigmey S 1.1 Harrstva/Ste WWO It) Apb (2) eOAI 7-/Z-9/ s 43) Ft �.vt1 d,F (4) ~ U J GU (5) IliAtEA&&rSrr /�J m +� z- [cf /n1 - (a) /Cfiv L ! J; ng - ,✓ rr �> !rE I�� r11 ...,s , tF gyvtW 4 v4leA (1a) AS AS &rf= .r,E I rG.1 bb' ,2a 274E r3l eAbiLt,4e AIAS Aml 1 - .SdAy //:=c ra rd1 / ow / F/ I^ rel r ,V ,v Co (171 A poelzF dA—e rel ,E f tt9) tzb [art N T;eOC 27— lbl Fif / r< U L AS an 1 F �2 f;r)CO F cls► Age. 14.Dislribueon 1S AddGWW foul% ❑e ❑c ❑DA ❑DE OL ❑o pSR pv O w'sooWOn []vim Ot4soeoees p Jw ❑cwww ❑Pr000ty CIL O ACS p kWL ❑RO. ❑PC 1aty m" 1%Do.,Tlar t!Dt.Po. O Prtrat cown ❑ComPL OIG O uffl"Pew Dsw7-,+2.9/ /Guo U. P" ❑Odnr - ,�Approving SuPK 20.Supe ft M.D*ft2ZP _ d FOrw a (Ra�c veal 2 CW*WA W CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CAW M000 Ben y4 0&VOwnw" P.O.Box 391,Martinez.Caftmia 94553-0039 OHM 0 Aim O Sl ,.DR No. 2.coy Cods, �C�/C�sd�oaYoe 4.Doha.L a.Reciasu- Z�W2. acaaon a WON t .a F.M) 7.Oft Odd Rayon a EWlm Na ❑ aAddmes Ocat on o = ccurence ,,.Property oaatxi000rg - - ZgwArry hvmnded.Raeova ft Found.Loaf SOW-item Numbs.AAkJa OUNMI&&WW/Maks/Mwwftcwmes I'm Nwnbar.Serial Nwabar.MbDOWnaoaa Daratpt M Location %Mw Taken Vtdtra.kck de Total Lor-LOT IN FOLLOWMiO ORDEtt A)Cwnnry�Notaa W aaw@by.Q pro.Fum%wlranc 4 ofta Ear4pwwrt:F)Radio TVs stn_ E)FWOWM M MOLWh ld 01ww 12.A oo .4 Property E3 is Na qww*/swom"m m m s - sr� �� � DIF it' ✓� - r� r I s �r3_ fuer,.=i7 (4) r I Fe,-, fJ.P `P-34,17 d-4/ T.v,97 (5) ZZ,4�d I Eel PI Ea> viAwk ,4A1_Al / are.,-- PA E E9f vi�/4 1,V TAv / T F Et01i 9941IJ AQW-LeT cat) 4&W6 Cyr n� (14) Z& 0,- 4Ae C !e'er nn �- ne► r� ry T E mi ,o N rF (23) lJtl, N E24) U N 14.Diarfbutlon 1S AdMofW AwAnS [30 0 Cl DA DDE ❑L ❑O [3 OR QV ❑rwoo4som ❑vita p Narw t a ❑.luv Q Corartw 0 PIOPIb cls,. ❑ACS ❑k" ❑ILO. ❑SMO , oep+h lakr0 17.Dom TWO to Ohm. p Paan+coon Q cmw.m p Maria Para •brseoi - Z-9/ /dv0 L/ Q Dow ,4.Mateo 20.8upc Nn 21.Dain a FORM 9 (Rev.t AM dCalttlrlu0ktlon CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 a O suvvWMWwat P.O.Box 391,Martinez.Calitomia 94653-0039 OHM O Arran OSI 1.on No 2 Cielr Coda Z Crlaw/Caauftedon OsftB 5 Rsdnii- f 2. scasot av1c*mw6..s0. ." 7.OstaDelaRome t aano.wpsa Q Azf e, aAaar.nrOe it P opmty Dear"= ation o ccu ence Nasw0..F wq Anpoutdsa 1lscom Found.Lost soft-Um Nwnbw.ArMO.Ouaaetr ErandrMOWMan bckwar's Model Number.Serial KWW.Misosistsous Description,Locsaon YAWS TGMM V"Wuds Total Lon-UST 1N FOLLOWING ORDER:A)Cwntrc%Nm 8)dawshY Q Cao *i&FwL DI VeNcles:E)011ie Equipment F)Reft Tft stc: G)FW4wM M NOusslrold Gaols;9 Mlsc 12.Psooarad Plowty S 11 Narrative/stawmty (t) i3► i41 Gr[O lSl S L ir__ "A.1 'wh I-- 70 p} AA722 44460L Ar 77—VE 01 �. 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O swc +s ospuy aF1u+4 »ow,-n"wplass1a o4oe. ❑PoWCWWn OContOR.ota. (3MWe ftft 7-12-9/ WU GWx ORM. 11L Appov to Sups 2a Supt Na 21.Dae 22.P.O. Za FORM a F'w 118% WContinwson CONTRA COSTA COUNTY SNERWFS DEPARTMENT c/woMW ❑supp)wtlrnlal P.O.Box 391,Martinez.CWfti is 94553-0039 p KID p AT" ❑SI 1.DR N0. 2 Cay Cods 3.CrYns/GlsaNfeauon L vada 1. 1496-le a.AsCAMW /—zz</ 2. tkaaon s vlf*n w . F rq z Dam ori.mon a Ewe"no. ❑ 75 44e -/2-9 9.Admu/ Location o _cc ren a to&moodsNama 11.Prapwly OsaoMpdon: w wdsd Radom Found LosL eww-Man mwmw M" .Brand/Maks1mv&t mWs Modal Numpsr,sww NWWW.MisasMwaow Dwerw4cm Looauon Whw*TiIw%%%kPlL Wudsalos TaLo -LIST IN FOLL OW NG ORDER A)Currwie%I l m- B)iwavh C)G &ft fun;D)Vshklas;IDOM=fto*wlt F)RsdkL TVs.sm- G)Fkssrnw N)11ousM►o1d Goods;9 Mbc 12.psoora Prowly i A Nwra"/Shownwft (i) (2) tor. rIJ45 (4) T tat ''%ri. P I .a.+I.,i (e) VjFP t i iQ,-- 7AC W�J_IeLIF5 SrzVjToV. m AVE MCA— A IA.r ,ND (a) 4& M. rdG4:N. (13) .4Z.*Q A�Ivb 7WoC &4&0.1601, /v Dir► v (14) 11� / N1r Now(1T) ANd S v .� r oPi/r Vs) f t a AN6 �•CS ao� L / - /�l d/ /F S/ru of7d W- (23) S.4 0,6 SMEfze."0v ,,w. (24) (M 14.Dial WWAOn I&AddMW Routing OB OC ODA ODE OL OO OSFc Ov - ❑Irpat(on O vtos O NWWW O JW O c m O P,"atr Ca< 130= O k+ L Ono. O smc 1 t>,q,q 9 0.am/TWO""on I&orpo O Paval coda► O cQffwL OIC. O Mains PaW 7-/2- / .��-- O 0VW 19.AppoMnp Supt 01r", 2M strpt Na 21.Dur 22 Paps gor FORM B (Rau 1/!!� ,;PROM AUIS COST. ADJ. DEPT 9. 11. 1991 11126 P. 3 JMZS JZNKXNB AND 1K7X DABLIN 4611 33rd 8treet San Diego, CA. 92116 x•-11 - Ob a� August 14., 1991 171 V1 AUG 2 71991 Mr. Joseph Vittoria Avis Rental car world headquarters 900 old Country Road Garden City, New York 11530-9795 Dear Mr. Vittoria: On June 26, 19910 1 rented a Cadillac from your San Diego Airport location. The license number of the vehicle was California No. 2VYL531. The quality of the vehicle and the rate that I received was really welcomed because my fiancee and I were taking a long awaited vacation to Northern California. We left San Diego on Thursday morning and really enjoyed the car. We had seen about half of the places we wanted to visit before the unfortunate incident occurred. At approximately 5:30 a.m. on July 12, 1991, on Mt. Diablo Boulevard in Lafayette, California, the nightmare began. A City of Lafayette police officer approached our vehicle. I stepped out of the car and introduced myself and was requested by the officer to show my driver's license. He asked what we were doing parked at that location so early, and I informed him that I had been tired and pulled over to rest for a few moments. About that time, a report was broadcast over the officer's radio and he immediately withdrew his pistol from his holster, pointed it within inches of my head and said, "You're under arrest for stealing this car. Spread your logs,,, put your hands on the trunk, or I'll blow your fucking head off. If your partner inside moves, I'll kill` you." ' „r The officer then patted me down for weapons and I explained to him that Y had rented the car from Avis at the San Diego Airport. The officer responded, "Shut the fuck up" . I was frozen in this position for approximately ten minutes. During that ten minute interval, I came to know fear. To place things in proper perspective, you would have to understand how, in recent months, there have been a number of law enforcement shootings of innocent pedestrians and motorists. The climate of rKuet RUIS COST. ADJ. DEPT 9. 11. 1991 11,27 P. 4 Mr. Joseph Vittoria Page 2 August 14, 1991 citizen/law enforcement relations in this State, especially Southern California, has been rather high strung. My knees were shaking and the back of my legs quivered, and I began to sweat uncontrollably. within a few moments, another vehicle arrived, and the officer, gun drawn, jerked my arms behind my back to the point where the cuffs caused abrasions and broke the skin on my wrists. I was then placed in the back of the patrol car. All this time, my fiancee had been sitting in the car, wondering what was happening and why it was happening. The first officer then went to the car, pointed his pistol at my fiancee, and ordered her out. She was then told to place her hands on the trunk and to spread her legs. With a wink and a smile at his fellow officer, the policeman put his gun away, removed his gloves, i "patted down" my fiancee in an entirely inappropriate way. Please know that my fiancee was not wearing baggy clothes that might have concealed a weapon--she was wearing black tights and a pullover net shirt. Nevertheless, the ofricer ran his hands over her buttocks, chest, waist, and thighs and crotch. At this point, my tear partially dissolved to anger at the offensive manner in which my fiancee was being treated. We were treated like murderers, not suspected car thieves. My fiancee was placed in the rear of the vehicle. At this point, the officers finally decided to verity our earlier statements that the vehicle had been rented. They began tearing through our things in the trunk, then the passenger portion of the vehicle, and they found the papers. At this time, I assumed we would be released. Instead of being released, the officers insisted that because Avis had reported the vehicle stolen, we .were going to have to be taken to jail. A sergeant was called and arrived at the scene. He told us he was taking to the station to be booked for stealing a rental car, drove us to the station and left us in the back seat of the police car. By this time, my fiancee was complaining about her wrists, arias and shoulders really hurting. I was also in pain from the position. Atter nearly an hour of sitting in this position, the officer came out and took us into the station. The officer semi-apologized and explained that Avis was at fault for reportinq the vehicle stolen and then told us we were free to go. My fiancee is a research scientist and has been so employed for the past six years at La Jolla Cancer Research Foundation. I am a high school teacher and for 12 years have been associated with ..FROM NUIS.CUST. ADJ. DEPT 9. 11. 1991 11128 P. S Mr. Joseph Vittoria Page 3 4 August 14, 1991 the Oceanside Unified School District. We are both contributing, respectful, law abiding citizens who were treated like common criminals. our vacation was ruined. My fiancee is receiving medical attention and therapy for her shoulder condition and we both have sought independent counseling for the emotional trauma we endured as a result of this confrontation. Unless you have had a gun pointed at your head and know the fear, humiliation and lack of control that accompanies that predicament, you could never understand how poorly we feel. Your company representative in San Diego offered to forgive the rental fees for our "inconvenience". It was not inconvenience, it was just as I said earlier, a nightmare that we have re-lived countless times in the last month. A forgiveness of $941.00 in rental fees is not adequate compensation for what we have endured. My fiancee and I feel that an appropriate measure -of compensation for our "inconvenience" is the sum of $15, 000.00. I am personal friends with a number of lawyers who I know would be happy to represent me. To be completely candid with you, I am reluctant to even discuss this with other friends because I stili am embarrassed and humiliated, not only for the way we were physically treated, but for the mental anxiety each of us suffered. My fiancee did not know if I was going to be shot. I did not know if she was going to be more seriously sexually assaulted. if you think she was not assaulted, consider a loved one of yours being fondled by a police officer whose partner continues to point a gun at your loved one. In considering this request, you should realise that neither one of us is unaccustomed to physical exertion. I have been a collegiate football player, a competitive weightlifter, and I have been a football coach at various levels over the past 12 years. My fiancee is a distance runner and cross trainer. Unfortunately, the discomfort in her shoulder has progressed to the degree where she is obtaining physical therapy because she cannot run without discomfort. You should also know that my fiancee and I do not subscribe to the apparent trend of running to a lawyer or filing suit every time life presents an obstacle. What I have requested is a reasonable means of resolving a horrible situation that directly flowed from your agency's negligence in renting a vehicle to as that had previously been reported stolen, apparently because it could not be located in the designated parking stall at the airport facility. One might argue that it was a small mistake on your part and that 9. 11. 1991 11128 P. 6 Mr. Joseph Vittoria Page 4 August 14, 1991 Avis should not be responsible for the conduct of the police officers. However, without the error by Avis, none of this would have occurred. We look forward to your prompt consideration of this request and a certified or cashier's check. Any necessary form that you want to have signed that relinquishes any further claims against your Company or which would acknowledge that your payment is in full satisfaction of our claims against you will be promptly signed and returned. Please know that if we cannot settle this matter now, we will angage an attorney. Thank you for your consideration. Very truly yours, *-SrJEK 14 3 Kf9 DAIiLIN - � 4! O �� r ©� . . G � CD � y 2z n . Ar to $ $ 4 e q � k :f, . ata A ' © . D , y rA toQ . AVIS RENT A CAR SYSTEM/GRAND RENT A CAR CORP.,360 N.SEPULVEDA BLVD.,SUITE 3000, EL SEGUNDO,CA 90245(213)615-4300 RECEIVE® AVIS FEB 18 1992 February S4, 1992 CLERK BOARD OF SUPERB CONTRA COSTA CO. Board of Supervisors Contra Costa County Clerk of the Board of Supervisors County Administration Building 651 Pine Street Room 106 Martinez, CA 94553 RE: Our File No. :33480 Date of Loss :07-12-91 Claimants :James Jenkins and Kim Dahlen Dear Sir/Madam: I am attaching copies of a claim previously submitted. We have not received a response to the claim. Please advise the current status of this claim. If you have any questions, please advise. Thank you. Very truly yo W. A. Caughlin Director of aims Administration WAC/pp Enclosures Aw I find OM— lib IM P--Gt Mn. Claire to: BOARL .)F WFERVISORS OF CONTRA COSTA uj&M INSTRUCTIONS 110 CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating .to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code 5911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Roam 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. 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 GRAND RENT A CAR DBA AVIS RENT A CAR ) ) I—p inst the County of Contra Costa ) or ) District) Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the SUM Of $ TNnrmmTFT ATTQN and in support of this claim represents as follows: ------ ----------���_ ------- 1. When did the damage or injury occur? (Give exact date and hour) 07/12/9 /01;24 2. Where did the damage or injury occur? (Include city and county) N SERVICE ROA2, 100YAMS WEST OF LAFAYETTE RES. 3. How did the damage or injury occur? (Give full details; use extra paper if required) PLEASE SEE ATTACHED LETTER AND POLICE REPORT, 4. What particular act or amission on the part of county or district officers, servants or employees caused the injury or damage? THE CLAIMANTS, JAMES JENKINS AND KIM DAHLIN, ALLEGE UNFAIR TREATMENT, ASSAULT, AND DETENTION AS A RESULT OF A RENTAL VEHICLE BEING INCORRECTLY REPORTED STOLEN. (over) 5. , What are the names of county or district officers, servants or employees causing the damage or injury? PLEASE SEE THE POLICE REPORT ------------------------------------------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. GRAND RENT A CAR REQUESTS INDEMNIFICATION FOR. ANY AND ALL CLAIMS RELATING TO THE PROCEDURE, PROCESS AND CONDUCT OF THE COUNTY EMPLOYEES. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) THE ATTACHED DOCUMENTATION IS THE ONLY INFORMATION AVAILABLE, 8. Names and addresses of witnesses, doctors and hospitals. SEE ATTACHED. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT 0 Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person -w his behal ." Name and Address of Attorney NONEs Si tore 7-8eLL1 ,510 -� 30Co A ss Telephone No. Telephone N .3m2 * * * 1 9 1 W W I I IFe e NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. �---`' a � � Ul 4 a t3 �'/ • 7 Q � t § . . 01 � g P ƒ 4 u 40 00 ek « . � 0 fit 0 . \ \ o ° ® f o3 c Q A \0 F P � & m �D : </\ $i 0 \ �\% \ g° $ = S ¥ « ® k � $ J UUl . � � ��C G C�OG2n1��C7 FROM ` TO, SUBJECT- v�° REF: _ MESSAGE FOLD l.,l 1 _.tet t ti..,, f�y'rt f 1' .{ !�. ;�..� f. d L^�z r� Lr•!_o '�✓xf.:r? " f I l - err / ',-SIGNED ;;� DATE J :fes"<_ '� =`f — REPLY FOLD SIGNED DATE F-178(REV. 1 3/84) features GM carsRETURN TO SENDER ;�; Avis . ok7li ytltltlyyy.y 1FtlMy0 co � v l s01 o N Uro 44 d � wU ul Z :,O ONS c9 z a � r wl w w N �Z N U Q J MARTINEZ, CALIF.. / �J CLAIM RWEPVE® BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA NOVN 7 1991 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Decembeztilak TY and.Board Action. All Section references are to ) The copy of this document mailed to you is your b 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 "Warnings". CLAIMANT: KELLY, Henry KELLY, Urania ATTORNEY: Nanette Zavala, Esq. 207-37th Street, Suite 111 Date received ADDRESS: Richmond, CA 94805 BY DELIVERY TO CLERK ON November 22, 1991 2451 Greenwood Drive San Pablo CA 94806 BY MAIL POSTMARKED: Hand delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. November 27 1991 PpHHIL BATCHELOR, Clerk I 1AALIZ.DATED: SY: Deputy Ale— 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: _ h. ) 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. BOA-RDD 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. � q Dated:—DEC 17 ` PHIL BATCHELOR, Clerk, By _L1JJDeputy 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: D E C 1. 7 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator C)K1Uj"f�—! _ .CI..A?M T.O• BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY - Instructions to Claimant Return original application to Clerk of the Board 651 Pine St., Room 106 t/ Martinez. CA 94553 A. Claims relating to causes of action for death or-for Injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. - Claims relating to any other cause of action 'rust 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 forfrauduleit3 claims, Penal Code Sec. 72 at end of this form. -- ---- --- .- ------- RE: ---RE: Claim by. )Reserved for Clerk's filing stamps Henry Kelly ) RECEIVED Urania Kelly ) Against the COUNTY OF CONTRA COSTA) NOV 2 21991 /;Os- Pic: or N/A DISTRICT) CLERK BOARD OF SUPERVISORS (Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim againstthe County of Contra Costa or the above-named District in the sum of $- ' $25 . onn _ nn and in support of this claim represents as follows: -- ----------- -------- ------------- ------------------ - --- ---- �. f�Ten did the damage or injury occur? Give exact date and hour] May 25 ; 1991 at-- 8 : 00 p .m. 1. Rfiere dad tfie damage or in3ury occur? �Inciude city and county 2451 . Greenwood,, Drive , San Pablo , CA Contra Costa County T-------_-- -------------(Give-�uii-detaiSs 3. )Flow dad the damage or in3ury occur? , use extra sheets if required) CCCSO T. Anderson approached Henry Kelly in a sudden and excited manner . Henry Kelly was frightened and went into his house , CCCSO Anderson.. ran into the house and tackled Henry Kelly while racial slurs , CCSO Anderson gged Mr.. Kelly -from the kitchen to the yelling (See attached page) -----------o—'r--------------- --s--------••------....------------ter--- ----�. 4. what particular act or omissaon on the part of county or dastrct officers, servants or employees caused the injury or damage? Racial Slurs , Beating , ' Prolonged incarceration , Failure to provide medical treatment , malicious prosecution (over) 5. What are the names of county or district officers, servants or' ' employees causing the damage or injury? unknown county employees . Officer T . Anderson 6. What damage or injuries do you clsim resulted? ZGive full extent of injuries or damages claimed. H,ttach two estimates for auto damage) Loss of work , medical damages , severe emotional distress scar to left cheek . 7. How was the amount claimed above computed? _ (Include t_he estimated amount of any prospective injury or damage. ) The amount claimed is not yet known but .it is- expected that it willvexceed the statutory limits of Municipal Court 8. Names and addresses of witnesses,�doctors and --------------- Tim Tim Garrido , Urania Kelly , . Manuel ._B:ellorin , Aurora Cruz , Imara Durate Karla Durate , Dr . Berman , unknown emergency room doctors or nurses �. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT wi 1 1 proviAee Dh sugh�a�t�torney when .received ✓� ,ode Govt. Code' Sec. 910.2 provides "The i ;Jgne- d by the claimant SEND NOTICES TO: (Attorney) or by rson on his behalf. " ti Name and Address of Attorney NANETTE ZAVALA , Esq . C1�45re'���wlood at 207 37th Street, Suite .111 rive . Richmond , CA 94805 Addres ( 510) 233-4187- San Pablo , CA 4806 Telephone No. Telephone No. 223-8969 NOTICE- . Section 72 of the Penal Code provides: "Every person who, 'with intent to defraud, presents for allowance or for payment to any state board or-officer? or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher , or writing, is guilty of a felony. " NA NETTE ZAVALA Attorney at Law 207 37th Street,Suite 111 Richmond, California 94805 Telephone: (415)233-4187 CLAIM AGAINST THE COUNTY OF CONTRA COSTA CLAIMANT : Henry Kelly ------------------------------------------------------------------------- ------------------------------------------------------------------------- #3 continued : living room and beat him in front of his family . . When Mrs . Kelly tried to get CCSA Anderson . to stop , he hit her . Mr . Kelly was arrested for driving under the influence and resisting arrest . Mr . Kelly was then held -it the Martinez jail for five days and did not receive any medical treatment for his injuries . Mr . Kelly received medication for high blood pressure only after his family made arrangements though an outside doctor . ' CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOA;N& the Board of Supervisors, Routing Endorseaents, ) NOTICE TO CLAIMANT De r 1 991 and Board Action. All Section references are to ) The copy of this document mailed to �ou is<ygirJP�tice of California Government Codes. ) the action taker, on your claim by t40Nd of S19�rvisors (Paragraph IV below), given pursuant t3'� �t Code Amount: $125,000.00 (general ) Section 913 and 915.4. Please note all "Warni�rgs". Special Damages Pending CLAIMANT: GORE, Jessica (a minor) through her guardian ad Litem Dorothy Gore ATTORNEY: Michael D. Goforth, Esq. Goforth & Lucas Date received ADDRESS: 2300 Clayton Road, Suite 520 BY DELIVERY TO'CLERK ON November 19, 1991 Concord, CA 94520 BY MAIL POSTMARKED: November 14, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. November 21, 1991 PpHHIL ATCHELOR, Clerk DATED: BY: Deputy 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 R10.8). ( ) 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 BY: I r � 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. BOA-RDD ORDER: By unanimous vote of the Supervisors present V ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Q Dated: , D `r� a� 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: DEC 17 1991 BY: PHIL BATCHELOR by 11.iDeputy Clerk CC: County Counsel County Administrator Cl�,itn to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY �; . INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of' the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at. its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Jessica Gore, a minor ) Reserved for Clerk's filing stamp through her guardian ad ) Litem Dorothy Gore � RECEIVED , Against the County of Contra Costa ) ENOV 1 91991 or ) Martinez State Preschool District) CLERK BOARD OFSUPERVISORS11 Fill in name) ICONTRA COSTA CO. 6 The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 125,000( eneral ama9g%M in support of this claim represents as follows: Special damages: Pending ----------------------------------------- -------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) On or about -September 30, 1991 , at approximately 11 :35 a.m. ---------------------------------------------- ------------------------------------- 2. Where did the damage or injury occur? (Include city and county) at the premises located at 600 F Street, Martinez, California,Couty of Contra Costa ----------------------------------------------=------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) Minor tripped over unattended lawn mower causing her to sustain second degree burns to her left leg. ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? unattended County employyees left a gas powered lawn mower . .. and in dangerous proximity to a. footpath whith ,was in use by juvenile day care students. As a proximate result, claiman- while leaving her day care class, was. severely burned when she came into contact with the mower engine which was hot. (over) 5• What are the names of county or district officers, servants or employees caul+ing ' the damage or injury? Martinez State Preschool ---------------------------- What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. , Attach two estimates for auto damage. Second , degree ;burns to.. left leg. ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Special damages: Pending General damages : $125,000.00 --------=-------------------=--------------------------------------------------------- 8. Names and addresses of witnesses, doctors and. hospitals. ---- -- -'J-,", - Elizabeth Franz, 600 alhambra Way, #39, Martinez, CA 94553, (510)) 370-7756 --------------------------7---------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT On or about 9-30-91 Pending Gov. C Snperson provides: k "The cl imigned by the claimant SEND NOTICES T0: (Attorney.) or ome his Name and Address,'of Attorney`, Michael D. Goforth, Esq. cc,a' ignature GOFORTH & LUCAS CLAIMANT' s TORNEY: MICHAEL 7D- GOFORTH 2300 Clayton Road, Suite 520 concord, CA 9.4520 Addres Telephone No. (510) 682-9500 Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than. one year, by a fine of not exceeding one thousand ($1,000) , or by both.such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. v w p .,O s •lt ��•`i tt 9 � � �N rA N rA v 4 un N D0o �1 ul w tNo �� V t ° tc H ZU � ti g " ) g 1 O °� U V CLAIM �.a2 ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNI4��' Claim Against the County, or District governed by) 1V0 V 9 OARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Qsl , be �'I,�d 1991 and Board Action. All Section references are to ) The copy of this document mai%* Km is your notice of California Government Codes. ) the action taken on your claim by thI? rd of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: HERNANDEZ, Jackie L. ATTORNEY: Date received ADDRESS: 810 Rogers Way BY DELIVERY TO CLERK ON November 20, 1991 Pinole, CA 94564 Hand delivered via Risk M mt. BY MAIL POSTMARKED: g I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. November 21, 1991 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy (L 044A&4 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: 21 AI BY: �/� J -.l 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: E_ 17 qn qI`��I PHIL BATCHELOR, Clerk, By ,.., J'J'j' 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: nFc 17 1991 BY: PHIL BATCHELOR by Deputy Clerk .CC: County Counsel County Administrator Clatrr� to: BOARD OF SUPERVISORS :OF.CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT _. A. Claims .relating �to"causes of action for death or for injury to person or to per- sonal property .or growing crops and which accrue on or before December 31, 1987, must ,be presented,not later than the 100th, day.,after the accrual-of-the cause of action. Claims relating to causes of action.,for death.-or•, for. injury•to-person or to personal property or grow ng•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 1061, 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 nameof. the-District should.-be filled in. D. If the claim is- against more than one public entity, separate claims must be filedragainst each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE: Claim By f ) Reseruerl for Cle k's fili stamp RECEIV YED Against the County-of-Contra Costa ) t or , -) NOV 2.01991 District) CLERK BOARD OF SUPER1 WAM Fill in name) _ � .. .. _. 'CONTRA 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: .Al ��o 0 c) 1. When did the damage or injury occur? (Give exact date and hour) 91 ------------- 2. Where did the damage or injury occur? ° (In6lude 'city-:and ,county) 3. How did the damage or injury occur? (Give, full details; use.,extra paper Af. required) r . y 4. ,What particular act or.. omission on th`e part'eofncounty or.. .distrct`officers, .,.servants ,or -employees caused" the injury or damage? . . , �o 0A- �'Cou L� a 7 (over) 5. What are the names of county or district officers, servants or employees causing ' the damage or injury? 5. What .damage or injuries`'do you claim resulted?• (Give full extent of injuries or damages claimed. Attach' two-estimates•for .autod'amage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or.damage.) --------------------------------------- ---------------=-------------------------- Names and addresses of witnessesh doctors and h spitals. ' -_N---------------------------------------- -N--NN--------_-----------_M-----_ 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 NOT eaqss Atbrne or b' som erson on hjp behalf." Name and LA, f.A-ttorney - Clai 's Signature Address. . - Telephone No: "' ' 'Telephone No. * +� NOTICE Section 72 of the-Penial tode 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-P .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 ($10,000, or by both such imprisonment and fine. pacq�a 13 04 • 760 SAN PABLO AVENUE e PINOLE, CA 94564 a (415) 724-8482 s Bureau of Automotive Repair #AA 115196 SS Expert Fender and Body Work Owner \\ a_c<-\ C1 "J Date \� Home (� Address n, O \ 3��� Phone�2A— t O—I tS� Li.. No, �--� Work City ��� �O\ei Phone Order No. Vehicle I.D. # Year !take \ Nadel 1 Mileage DUAN. DESCRIPTION Of LABOR OR MATER AL PART NO. 4MATERIAL LABOR 2P s-- � , c:5 s G i Cf e s rT- lr `—L� ,? C.) AliG o ezlt I PARTS PRICES BASED ON STANDARD CATALOGUE PROCUREMENT PRICE LISTS SUBJECT TO CHANGE WITHOUT NOTICE TOTAL / PROCUREMENT AND DELIVERY CHARGES MAY BE ADDED fOR SPECIAL SERVICE ON ITEMS NOT AVAILABLE LOCALLY MATERIAL i Old ports removed from cars will be junked unless otherwise instructed in .ailing TOTAL LABOR%,AGJ ' ab The abate is on estimate bored on Our insppection and does not cover oddil�onoI ports or labor which ropy be required offer TOTAL MATERIAL 00 the work has been opened up Occosionolly of ter work has started worn ports ore discovered which ore not evident on last Is 17 inspection Because of this the above prices are not guaranteed Estimated By Estimate TAX \ l0� Approved By AUTHORIZED AND ACCEPTED PAID OUT -TOW a STORAGE Dote :SUBLET REPAIRS By Owner nl A or Agent TOTAL \ a\,a \q BUD'S BODY SHOP • 1900 MARTIN LUTHER KING JR WAY 465-7186 OAKLANI 0. ;k i +-�NAME DATE 8.00 +7�D ADDRESS [� �f(awl I�/IAKE _S1—jL- 1 .50 + INSURANCE CO. " 9, `�/0/ R LICENSE 2°00 + 4.50 + Symbol FRONT Labor Hrs. Parts Symbol LEFT Labor Hrs. Parts Symbol RIGHT labor 1 7-50 Bumper(U)Ex New Fender, Fri.$ Ext. Fender,Fit.8 Ext, Bumper(L)Ex-New Fender Shield Fender Shield 1 7°5 X Bumper Brkt. Fender Mldg. Fender Mldg. 45- Bumper 5°Bumper Gd. Headlomp Headlamp 787-50 Headlomp Door Headlomp Door Sealed Beam In Out Sealed Beam In-Out 30-00 + Fri System Cowl-Post Cowl-Post 78- 00 + Frame Windshield T-Cl. Windshield Kit 80-00 + Cross Member Door, Front Door,Front j ------ 1 88-00 * Stabilizer Door Hinge Door Hinge — Wheel Door Glass Door Glass 188- X _Hub Cop-Sm.-lge. Vent Glass Vent Glass 8-25 7 Hub& Drum Door Mldg. Door Midg. Door Handle Door Handle 15-51 Knuckle Sup. Center Post Center Post Up. Cont. Arm Door Rear Door Rear 787-50 + Up. Cont. Shaft Door Glass T-CI. Door Glass T-CI. 1 38'70 + Lr. Cont. Arm Door Mldg. Door Mldg. 15-51 + Lr. Cont, Shaft Rocker Panel Rocker Panel 991 - 01 Shock Rocker Mld . Rocker Mldg. Tie Rod-Ends Floor Floor Steering Gear Quar.Inner Const. Ovor,Inner Const. R/F 0% Steering Wheel Quar.-Ext, Quar.-Ext, Spare Horn Ring Quar.Panel Upper Quar,Panel Upper _ Gravel Shield Quor.Lower / Quar.Panel Lower Paint Interior Park.Light Quar.Mld s. Quar.Panel Mldgs. Good Rod.Grille,Ctr, Quar.-Glass T-CI. Quar.-Glass T-CI. Avg. Rod.Grille,Side Poor Grille Mldg. 145- W REAR MIsc. o D n to 0 Bumper_Ex.-New Inst.Panel Bumper Brkt. Front Seat Horn Burnper Gd. Front Seat Tracks Baffle Gravel Shield Rear Seat Lock Plate, Lr. Lower Panel Headlining Lock Plate, Up. Floor Top Hood Top Trunk Lid Tire %Worn Hood Hinge Trunk Lid-Hinges Hood Mldg. Trunk Handle Mldgs. Battery a Ornament Tail Light Antenna rte. Rad. Sup. Tail Pipe.--Muffler Mirror A Rad. Core Back Up Light AX Point 8 Material Coolant Frame Crossmember Rod. Hoses Gas Tank Fan Blade Hub 8 Drum Fon Belt I Axle- Housing Water Pump - Pulley Spring Ai. Cond. Core Control-Arms Labor Hours @ $ Dehydrator Wheel Rechorge.A/C Parts & Motl. Less Disc. $ Motor Mts. Sublet & Net Items $ Trans. Linkage Sales Tax $ Agreed MCITotal $ OH - REPAIR - OVERHAUL_,. N- NEW R.C. - RECHROME NOTE: WE NEVER S - STR. -•X - ITEMS MISSED ON GARAGE EST. EX - EXCHANGE CIRCLED ITEMS INDICATE OLD OR UNRELATED DAMAGE. AUTHORIZE REPAIRS .1 Z2 S6 CLIM + BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA �FrFjV6 Npv� o Claim Against the County, or District governed by) ��CIOUN OAW N the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT De cellll� 1 and Board Action. All Section references are to ) The copy of this document mailed to you notice of California Government Codes. ) the action taken on your claim by the Board bf Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $1,000,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: STURGIS, Lamos Wayne ATTORNEY: Date received November 20, 1991 ADDRESS: 114 Loveridge Street BY DELIVERY TO CLERK ON Pittsburg, CA 94565 BY MAIL POSTMARKED: November 19, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PPHHIL BATCHELOR, Clerk DATED: November 21, 1991 BY: Deputy 11. FROM: County Counsel TO: Clerk of the Board of Supervisors (V ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: i� ) �1) BY: I� Deputy County Counsel "—T 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. ry p Dated: �EQ 1-` 199f� 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 16; 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: DEC 17 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLAIM "!'O4. BOARD OF SUPERVISORS OF CONTRA CORT_-krROYappilcationto: Instructions to ClaimantClerk of the Board Tworammm-1-6,do Martinez,Califomla94553 A. . Claims relating to causes of action for death or for injury to person or t'o personal property or growing crops must be presented not latex 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. : raud. See penalty forifraudulent claims , Penal Code Sec. 72 at end obis form. RE: Claim by ) Reser_ve_.d-fo.raGlerk'ls f=iling stamps "Mo RECEIVED NOV 2 01991 Against the COUNTY OF CONTRA COSTA) } CI ERK BOARD OF SUPERVI or DISTRICT) (Fillinname ) gQ TRA COSTA CO. .: .The' undersigned claimant hereby makes claim against the County of. Contra . Costa or.. the above-named District in the sum of $ -1.000. noo and • in .'support of this claim represents as follows : 1. When aid the damage or injury occur? -. (Give - exact date and �iourj _�? -- -T----------------------:--_ 2. Where d the_10�damage oriinjury occur? . (Include city. -and_-__coun- tyj -._- - ..iyi.•i7i.L�L..._S•cn..rLI.i._ S..r.•:.1�65+ � �P.'=•.C�—_..12._3:3� �1c r _— _— —T—."—_..rr r 3. How did the Ramage Tr injury occur? (Give: fullydetails, use extra sheets if required) —I� _er,�S _ Y _ _� .J=-yfJ��G.�/.�._ 4. �Whatparticulak act or om�.ssion on the_part-of county— or district officers , servants or. employee,s caused the injury or damage? T ►�c($ S HAc.-fC E_A' To q4,c A,S'►a �le4T�, i Lo rn r_10 t c.A l (over) . .. r�7' ✓41.F/-lip � t7//( �.- 1711971 -al lah AL All -- �� - -cif/' �- �� ''/��L��• _I��'-���-�Z_.� _ _ ���/';2�?- - -�L�- -- - --- -- - �i,.�f-_:��,:=-�2,-.�.i_ _�la"�L-k'�----�f=��✓�'`i7- - fi'''r~ -��L, ��- �� - - ---- ---- -- - -- -- �----��; - - - ;— �d��� _-- -�-cry-ate- •- -- - -- -- -- --- -- _.:�� -�.�.•��- ---- - — /=/ — - ---Q.�F/-_C���ws3���-tet.,��. _��'�=a1— - — -- - ,J -- ® i -- What are the names of county or district officers , servants or employees causing the damage or injury? � pEw--1 TTZ 70b1(dj PEP 1 Sokrt, Cp �;►y a�a-n- t®�� ' 6.�%A-&t hadamage or 3 juries do you claim resulted?Give full _e tent r• of injuries* or damages claimed. • Attach two estimates for auto damage) ;c qj '":�• 7 . How wasrthe�amount claimed above computed? (Include(Include the estimated^ amount of 'any prospective injury or damage. ) Wzc -IF .: . 8.^ Names d anaddresses of^w itnesses,�doctors and hospitals.___ _ """_____ 1AJ7 � e�aD -�.s �1/ �- c--�� / �o�opt- G✓I • .�._... .- •..... ____ _�....____— _ �.... .i.___-- ___ ..�.�....._ 9 . List tFie�expendi.tu_res_... —you made on account of this accidentror�in�ury: DATE q ITEM AMOUNT ..- ---•....—�OOH b /� .. - - •_ ......_:. _ ��/� ._..... J�e�(�MIi�S� • Govt. Code Sec: 910.2 provides : "The claim signed by the claims. SEND NOTICES • TOz - ('Attorney) or by some person on his behalf Name and 'Address- bf Attorney /r/iI?I41-L �••. Claim tl' s 8-ignatur� e'" ��" � /1 `Z •�is►.,i�-Jr'-r...� A_�-- l S 'Address / . :�• .. Imo."/��,.�o��., �'�- 9�':4-.F� 1 Telephone No. Telephone No. NOTICE Section 72 of-:the Penal Code provides: "Every person who, with. intent to defraud, presents for.allowance of for payment to any state board or officer, or to any county, town, city district, ward 'br village board or officer, •authorized to allow or,-pay the same if genuine, any false or fraudulent claim, bill, .account, vouchc or writing, is guilty of a e:1-ony. '.' •;,. (�1.s,i•,Yr•, :�}!ti'+2�, •''V`r•:t'..•ir•. •:t' ,•`• r •`•l ^,tiPt��'.•. •1: ..�:(•.. 'IN4 .a• Wit.• �i•'�•Y Ni;,.�:'r.i�,r r•f:�•.�.\�. _ •.r. •I. '�1+I"::•�4•.: ��',i,��}:' 1�'"'.x�. •,�'". ;.Fr:1_�I::fi!:iflri::.\Ei�_ �.%i'. .. ,...r!' • „Ci � - � INO r i }F 4 Fj 4� 1 3 +f4 { D .00 R� rr�� CLAIM I Z BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C1aim.Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Ef+dorsements, ) NOTICE TO CLAIMANT December 17, 1991 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: $139.91 Section 913 and 915.4. Please note avezfrnings CLAIMANT: MUNIZ, Paul Richard NOV 1 ATTORNEY: coUN7Y Date receivedRT�NQ, FE2 ADDRESS: 494 41St Street #B BY DELIVERY TO CLERK ON November 19. '1991 (741 Oakland, CA 94609-2534- BY MAIL POSTMARKED: Hand delivered I. FROM: Clerk of th? Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: November 21, 1991 ��: 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: /91 BY: Deputy County Counsel / I �0 TJ 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. BOA'RDD ORDER: 'By unanimous vote of the Supervisors present ( v) This Claim is rejected in full. ( ) Other: I certify that this is a true.and correct copy of the Board's Order entered in its minutes for this date. (+ 1 ®�C 1 r7 Ems.: Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: p E C 17 1991 BY: PHIL BATCHELOR byyaa"_ JJdJL_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. Cla'.ims relating to causes of action for death or for injury to person or to persorial' property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual bf the cause of action: Claims relating to any other cause of-action must be- presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. ~ Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA'94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D.' If the claim is against .more than one public entity, separate claims must be filed against each public entity. " E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at--the end of this form. - RE: Claim By -; ) Reserved for Clerk's f*l' g stamp OWN Paul Richard Muniz ) RECEIVED 7 Against the County of Contra Costa ) NOV9 or ) 3 G District) CLERK BOARD OF CONTRA (Fill in name The undersigned claimant hereby makes claim against the Coilnty of"'Contra Costa or the above-named,Distriet In :the sum° of $ 139. 91 and in support of this 'ciiim represents as'follows,' ---------•-------------- ----,-------------------------------------------------------- 1. Wher did the damage or,injury occur? . (Give exact date and hour) June-4 ,~ 1,991,, 1: 10 p..M. 2. Where did the damage or injury occur? (Include 'city and county) Onwthe south side of Escobar Street, Martinez, Contra Costa County, about 24" east of the boundary between` 1122 Escobar_ and the county vehicle lot. ----------------------------- ---- ----- 3. How did the damage or injury occur? (Give full"details; use extra paper if required) _- tt SEE ATTACHMENT .3. 4. What particular act or omission ori the part -of county or district officers, servants or employees .caused the injury or damage? Ne ligent installation and maintenance of 'a hazardous- obstruction, in `a 'publ c''highwAy. • The drain pipe from the County vehicle lot protruded about 1. 5" into Escobar Street through the south curb. (over) J. 1 5. What are the names of county or district officers, servants or employees causing' V the damage or injury? Unknown. ! 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. My -right front tire was irreparably damaged when its sidewall was 'cut by the protruding drainpipe. Tire replaced on 06/04/91 at cost of $139. 91. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury Or damage.) Actual price for purchase and installation of equivalent tire. ---------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Witness: . Marke S. Estis, Office of County Counsel, F.O. Box 69; Martinez CA 94553-0116 . Tel: (510) 646-2606 , ------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT 06/04/91: Repacement tire $139.-91 }tet � Gov. Code Sec. 910.2 provides "The claim must be signed by the claimant SEND NO T3�C�ES�Tas� (Attorney) orb some rson on his behalf." Name arid°`Address'°`of`°Attorney , JA42 A, Cla tIs S gnat 494 41st strpet 4B Address Oakland CA 94609-2534 (w) _(-51-0) 646-2608 Telephone No. Telephone No.�h) (510)' 601-1948 .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. - f ATTACHMENT 3 TO CLAIM OF PAUL RICHARD MUNIZ AGAINST THE COUNTY OF CONTRA COSTA On June 4, 1991, at about' 1:-10 p.m. , I was parking my personal vehicle at the southerly curb of Escobar Street, in the City of Martinez, in the first parking space west of the west (exit) gate' to the County vehicle maintenance facility. I had pulled into the curb lane ahead (east) of the parking space, and as .I° backed into the space-,.my right front tire brushed against the curb. When it did so, it- was cut in the sidewall by the lip of what appeared 'to be a .cast iron- drain pipe which protruded from the curb. The damage to the tire was irreparable, and-I replaced the tire that day at a cost to me of $139. 91. The drain pipe is a 4-3/8" outer diameter° pipe which appears to run under the parking lot of- the -County vehicle maintenance 'facility, fed by a drain fromthe roof of the building at the facility and .a drain. in the pavement of the facility -parking `lot.. It passes underneath the sidewalk at an angle. The north end of the .pipe ;is cut square,: rather than cut: flush with the curb, and it protrudes ,from the curb about 1-1/2" . ' The center of the pipe is about 3" above the street grade where 'it exits from'. the ,curb. I had purchased -the- tire which was damaged ,on March 25, 1991., and I- estimate that I. had driven about 3, 000 miles on it before it was destroyed on June 4 . CLAIM f, BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA i Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing .Endorsements, ) NOTICE TO. CLAIMANT Decembb_ 'F 7.; 499W1. and Board Action. All Section references are to ) The copy of this document mailed to you t;JryjQu[,LTLM�Fe of California Government Codes. ) the action taken on your claim by the BW`_JmZ,S visors (Paragraph IV below), given pursuant to Government Code Amount: $2,000,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PAMFILOFF, Eugene ATTORNEY: Date received ADDRESS: P.O. Box 772 BY DELIVERY TO CLERK ON NoVember 22, 1991 Alamo CA 94507 BY MAIL POSTMARKED: Hand delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: November 27, 1991 EVIL BATCHELOR, Clerkeputy- IIF"ROM: County Counsel TO: Clerk of the Board of Supervisors N ) 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 12- BY: /✓ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( V) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: D E C 17 199 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 ;,his 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: DEC 17 1991 BY: PHIL BATCHELOR by J Jj 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 with the Clerk of the Board of Supervisors at its office in Room 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. 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 fili stamp ()C /� i4 �`'� LOFT j "RECEIVED Against the County of Contra Costa ) or ) NOV 2 21991 District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA►COSTA CO. ` The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ ��QL'Q;000o0- and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) ---------------------- -------------------- --------------------- 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) /gS(�zT£i� ,�r`ATlritlr /Tl'U2 `D BY 1�vN 1,A i Li-.E/P- ; ed uAlry 4. What particular. act or omission on the part of county or district officers, servants or employees caused the injury or damage?,tom y e-,i V ('L- 1 �7`S� F AJO? ► T i4 �.1 Fly .F_"P( 1 T 0"—" /46�tJ 43—,9Y /11,0Q A V�/7�i� (_!!!!57C_7 �' i� i5/Al(9 �4r✓ /9 '(56A) "��R" � ST2.4-ial.�/� .�o�iier) e97W'_Y`<- f What are the names of county or district officers, servants or employees causing J 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. M mer U�=%� [a2 y 7� aur �u 7 �c_ 1�D�r.�, :F�" 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) a-1 � y Gq� r.= -)W t jv/1 Lc� -rD ftrkr -t 7^, Ai�� ivD , sem V Co LA 7/!�)/-(_ _ - > Vic_---��- 8. Names and addresses of witnesses, doctors and hospitals. kA ------------------------------ --------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney (Claimant's Signature or-1 772- (Address) Telephone No. Telephone No. � S-6 /3 NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by'both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. CLAIM frp • BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA N 17 190-1 Claim Aybinst the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT December` F and Board Action. All Section references are to ) The copy of this document mailed to you is your hotice'of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $635.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: WMUNGER, Lisa ATTORNEY: Date received ADDRESS: P.O. Box 272593 BY DELIVERY TO CLERK ON November 26, 1991 Concord CA 94527-2593 BY MAIL POSTMARKED: November 25, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: November 27, 1991 PPHHIL BATCHELOR, Clerk dd BY: Deputy G�1Ll�tml.O Jj.,A; 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: h. r BY: I 5 Deputy County Counsel 1 9 \1U 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 W) 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: DEC 17 1991 PHIL BATCHELOR, Clerk, By—A 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. I-ee 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:— DEC 17 c g1991 BY: PHIL BATCHELOR by _Deputy Clerk CC: County Counsel County Administrator _ (;laim 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 ftled ed _e irrt Mcg' pub1 I C wnt 4}y . 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 LISA: WENNINGER ) ll RECOVE© Against the County of Contra Costa ) NOV 2 6 1991 or ) CLERK BOARD OF SUPERV';,�e- District) CONTRA COSTA CO.` Fill .in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 635 . 00 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 10/01/91 and/or 10/0.4 /91 and/or 10/05'/91 and/or 10106/91_��______�, 2. Where did the damage or injury occur? (Include city and county) _ City of Pinole and/or Cite of Martinez . County of Contra Costa 3. How -did the damage or injury occur? (Give full details; use extra paper if required) Please see attached. 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Please see attached. County employees were careless and negligent in and surrounding the harms inflicted upon and losses incurred by claimant . (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? Detective Eubanks; Detective Washington; Sergeant Hammond; Sue Parvin; other officers and/or employees who remain unknown 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Please see attached -----------q How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Please see attached, and below (item #9 ) . ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. WITNESSES : _ Sergio Negoesco Ellen Varga 18 Sonora Way 644 Quirnan Corte Madera, CA 94925 Pinole, CA ----------- List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT 10/08/91 Auto locks/ignition rekeyed $120 . 00 (See attached receipt) Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney - ClaimantIs Signat Post Office Box 272593 Address Concord, California 94527-2593 Telephone No. Telephone No. ( 510) 797-2509 NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period'' of not more than one year, by a fine of not exceeding .one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. Re : Claim by Lisa Wenninger against County of Contra Costa Claimant was arrested on October. 3 , 1991 , approximately 9 : 00 p.m. , in the City of Pinole, County of Contra Costa . At the Pinole Police Department , claimant ' s personal property ( itemized below and on Exhibit "A" , a true and accurate copy of "Contra Costa County Detention Facilities Inmate Request for Personal Property Reimbursement" ) was collected- by a female , uniformed police officer . A male officer was also present at the time . On October 4, 1991 , claimant was transported by a male uniformed Pinole police cadet to the Contra Costa Detention Facility in Martinez . Claimant was detained in this facility for three days . Upon release from the facility, claimant ' s personal property could not be located. Claimant completed paperwork as requested (Exhibit "A" , identified above) and was told the property would be returned if recovered in the process of inventory and search for missing items . To date , the claimant has received no notice of these items being located. Especially because of the sentimental value attached to the jewelry, claimant requests that the County of Contra Costa conduct a thorough search for the missing pieces , and claimant ' s preference is that the items be returned rather . than receiving monetary compensation. SCHEDULE OF LOST PROPERTY 1 pair pierced earrings , gold leaf-design $ 15 . 00 with blue inset 2 silver rings with large cabachon amethysts 100 . 00 ( $50 . 00 each) 1 silver ring ( shaped like a woman ' s 50. 00 silhouette) 1 gold ring with small , pear-shaped diamond 125 . 00 1 gold ring with several hematites 50. 00 1 watch, cut-•crystal round face , gold details ; 150 . 00 macram6 band with beads 1 necklace (white and cream-pink pooka shells) 15 . 00 3 BMW car keys (ignition, door/trunk, gas cap) 130 .00 on keychain ( "Echokiller" and Lego man) TOTAL VALUE OF CLAIM: $ 635 . 00 CONTRA COSTA COUNTY DETENTION FACILITIES INMATE REQUEST FOR PERSONAL PROPERTY REIMBURSEMENT -- --=-MDF -------WCDF -------WFF -------MCDF This Section Is To Be Completed by Inmate/Claimant NAME: — � n ADDRESS: T 0. �Q r� � (��� 5 )� TELEPHONE: (HOME)" Hc,:7 did the loss or damage occur? 4 i Description of Lost or Damaged Property z f � Item Describe fully) Original Purchase Price - ' & Date of Purchase i hJul DET. 087 . FRM _ REV. 4/90 Distribitzn: Original, Director of Support Services Yellow Copy, Inmate ADVANCED LOCKSMITH SERVICE (415)843-160,0 P.O. BOX 261 BERKELEY, CA 94701 -ST C MIER'S ORDER NO. PHONE - DATE ` / '•' - . 1d E )HESS tt r K. .✓.5'.KY v �,��f�!e'[}.il.,,�.,+�'�'-C.�ay�..� �>OLD BV CASH I C.O.D. CHARGE ION ACCT.I MDSE.RET'D PAID OUT i I I s f ' t I I I I i I I I TAX $ FINED A TOTAL 1� , U All claims and feturned goods Tha"k You MUST be accompanied by this bill. PRODUCT 2531 i : o oj ,9 •r i �Q a cn�a:•ayw � _ _ 4-4 >~ c O = w ca U-) . fi3 �4 -It O -W 4-) CY� FA U) U •r-I N -H a= U +) r= U 4-1 <� G) \�O N O O N P.•rl � s~ x +., a O a � ,1o� rl OL, O W s ?oU. cn aR O LO O d B M Z �v ON ull N (a 1 N M lf, N n N Q' U >4 O pq �4 O O U cn AMENDED �. 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 December 17, 1991 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:$300,000. 00. Section 913 and 915.4. Please note all "Warnings". CLAIMANT: GRIMAL; Marcos by Roslynn Grimal �° � � ATTORNEY: DEC ' 1091 Date received ADDRESS: 333 40th Street BY DELIVERY TO CLERK ON Dec0Z0,,,F1991 Richmond, CA 94805 Hand .Delivered 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 2, 1991 EVIL DAputyLOR, Clerk (L 014444ill, II. FROM: County Counsel TO: Clerk of the Board of Supervisors -This/DT'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). ( j 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 BY: Deputy County Counsel \VJ III. FROM: Clerk of the Board TO: County 'Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( V) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. ®EC 1991 1 '7 Dated: PHIL BATCHELOR, Clerk, ByJJA:�uDeputy 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: REG 17 -1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Mrs. Roslynn Grimal --333 40th Street --Richmond, CA 94805 RECEIVED DEC 2 1991 /:szd may. November 25, 1991 CLERK BOARD OF R SORS CONTRA COSTA Mr. Ron Harvey Liability Claims Manager RISK MANAGEMENT 651 Pine Street 6th Floor Martinez, CA 94553 RE: Marcos Grimal, Roslynn Grimal vs Contra Costa County (Juvenile Facility) Dear Mr. Harvey: In response to our telephone conversation of 11/14/91 in which you informed me that after investigating the claim against the Juvenile Facility in Martinez, you felt that you now have substantial notes to verify that the incident did in fact occur and the you were now prepared to settle the claim. In my initial claim that I made in writing to the County (copy inclosed) and after speaking with my son, Marcos, I wish to amend that claim to $300,000.00. I await your response. Sincerely, ROSLYNN GRIMAL Claiu� to: ` . BOARD OF SUPERVISORS'OF CONTRA COSTA COUNTY INSTRUCTIONS. TO CLAIMANT m'_n dcj �. Claims relating to causes of action for death or for injury to person or to per- %sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person.. or to personal property or, growing crops and which accrue on or after January 1, .1988, must be presented not later .than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code§911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, .651 Pine Street, Martinez, CA 94553• C. If claim is against a district;°governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved. for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) DEC 21991 or, TV V Z* A L0L -" ( trict) CLERK BOARD OF SUPER SOBS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against tc !ounty of Contra Costa or the above-named District in the sum of $ g )0.'00 'and in support of this claim represents as follows: e~- 1. When did the damage or injury occur? (Give exact date and hour) Do �r► � 2. Where did the damage or injury occur? kinclude city and county). 3• How did the damage or injury occur? (Give full details; use extra paper if required) �o�nJc CP1rn5 �asYtet�c�l/� ct_ilD�"I�eou�' 14. What particular act or omission on the part of county or district officers, servants or employees.caused the injury or damage? /l/vnses oh - -�' did r�oi �v!C LexCa4,pcj �� wad uy4 l� �►�u.e-v, a, � c� r�7cc ,�.��c. � S GZ� �. my -nye f /J (over)x0 ny D = P��,� hyo . (-56C7MACH6b 9 � 5. What are the names of county or district officers, servants or employees causing the damage or injury? ------- --- -----_ �_. — -------------- S.�What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. C Frac r<-.d -41 h�.e 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. F loo P- Go y,sR—t o re-'s a V 'CA, � � ��� sI 1 z� 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT ) � a r) - �� Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by so a peaison on his behalf." Name and Address of Attorney aimant's Signature)._, 3 �o 7 (Address) Telephone No. Telephone No.02�✓� +��2 D :�J� 720 ): fi is fi f NOTICE ' i 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 ($1090009 or by both such imprisonment and fine. AMENDED. , ! 2 : CLAIM ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA DEC 9 1091 Claim Against the County, or District governed by) BOA TI N the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT DecembfllNARTJNZ4 Cdlsl yl 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: Indemnity Section 913 and 915.4. Please note all "Warnings". CLAIMANT: KAISER FOUNDATION HOSPITALS, KAISER FOUNDATION HEALTH PLAN, INC . THE PERMANENTE MEDICAL GROUP, INC . , D. AVIDO, M.D. , J. BERRY, M.D. ATTORNEY: MICHAEL BUTLER, M.D. , J. BAYER, M.D. Willis F. McComas , Esq. Date received ADDRESS: Archer, McComas & Lageson BY DELIVERY TO CLERK ON Llecemh.Ar gr1AA1 2033 North Main Street , -Suite 800 Hand delivered from Count Coun, Walnut Creek, CA 94596 BY MAIL POSTMARKED: y 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 9 1991 PpHHIL BATCHELOR, Clerk BY: Deputy nAVn 11. FROM: County Counsel TO: Clerk of the Board of Supervisors � This)) r_\" rj,,cTaim 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: Gated: 12 I �) BY: ' �, ) Deputy County Counsel II1. FROM: Clerk of the Board TO: . County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice, to claimant (Section 911.3). 1V. 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. Q Dated: D E C 1 7 1991 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: DEC 17 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LAW OFFICES LEE A.AER 9 ARCHER, MCCOMAS & LAGESON WILLISIS F.F.MC McCOMAS ERNEST B.LAGESON,P.C. A PROFESSIONAL CORPORATION H.PAUL BRESLIN 2033 NORTH MAIN STREET,SUITE 800 SAN MATEO OFFICE RODERICK D.JONES TIMOTHY M.McMAHON PERI EXECUTIVE CENTRE RAND L.CHRITTON P.O. BOX 8035 SAN MATEO CENTRE STEVEN R.FAIRES ' ERIC G.LUNDBERG WALNUT CREEK, CALIFORNIA 94596-3728 Fag��",�p�IL'f11820 GATEWAY DRIVE, (510) 930-6600 G40 SUITE 360 JEFFREY A.LITTLE FAX NO.(510)256-6627 DEC 9 1SA MATEO, CALIFORNIA JUDITH B.ANDERSON W.ERIC BLUMHARDT 94404-2471 WILLIAM 1.FEENEY COUNTY ROBERT L.SALLANDER,JR. COUNSEL415 JULIE WELSH CURRAN ) 312-9840 I OSEPH C.WRIGHT MARTINEZ,, ��F�'AX NO. 415 312-9849 ERIC D.BERGSTROM DONALD B.FORN DEBORAH K.WE SSSIER December 5, 1991 RECEIVED TOBY M.MAGARIAN .I EUGENE C.BLACKARD,JR. LAWRENCE D.HILTON �� - 1��� STEPHEN B.WELCH ROBERT J.SCOTT,JR. ' NANDOR B.KRAUSE NF1 °COSTA CO isoRs Victor J. Westman, Esq. Office of County Counsel 4 Administration Building P.O. Box 69 Martinez, CA 94553 RE: Howell v. Kaiser Foundation Hospitals, et al. Dear Mr. Westman: We have received your notice of insufficiency and/or non- acceptance of claim in the above matter. We are the attorneys for Kaiser Foundation Hospitals, Kaiser Foundation Health Plan, Inc. , The Permanente Medical Group, Inc. , A. Avido, M.D. , J. Berry, M.D. , Michael Butler, M.d. and J. Bayer, M.D. In your notice of insufficiency, you state that the claim "fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. " I enclose for -your re-review, a copy of the claim for indemnity and call your attention to paragraph 7 which indicates that the incident in question occurred on or about January 3, 1991 at 15 Cleopatra Drive, Pleasant Hill, California 94523 . In paragraph 9, it is stated that claimants seek indemnity, either total or partial from the County of Contra Costa by reason of the allegations of plaintiffs Kevin Howell, individually and as Guardian ad Litem for Melanie Danille Howell, a minor. We attach as Exhibit "A" a copy of the Howell complaint. In the Howell complaint (page 7) it is alleged that defendant County of Contra Costa owed plaintiffs and plaintiffs' decedent a duty to report in writing to the California State Department of Motor Vehicles, the name, age address and condition of defendant Patricia Hazel Tomsik as suffering from a disorder characterized by lapses of consciousness and/or control which was severe enough to be likely to impair her ability to operate a motor vehicle safely. Victor J. Westman, Esq. December 5, 1991 Page 2 The Contra Costa County Department of Health was advised on at least two occasions by my clients that Patricia Hazel Tomsik had a condition which required evaluation concerning her ability to safely operate a motor vehicle. The first of those notifications occurred on or about July 26, 1989. The second of those notifications occurred on or about December 28, 1990. Should you require additional information, please advise. It appears to me as though all of the requirements for the making of a claim against the County of Contra Costa have been satisfied. Very truly yours, ARCHER, MCCOMAS & LAGESON Willis F. McComas WFM:Clf Enclosures Willis F. McComas, Esq. ARCHER, McCOMAS & LAGESON 2033 North Main Street, Suite 800 Walnut Creek, CA 94596 (510) 930-6600 CLAIM FOR INDEMNITY AGAINST THE COUNTY OF CONTRA COSTA 1. Name and mailing address of claimants: CROSS-COMPLAINANTS KAISER FOUNDATION HOSPITALS, KAISER FOUNDATION HEALTH PLAN,. INC. , THE PERMANENTE MEDICAL GROUP, INC. , D. AVIDO, M.D. , J. BERRY, M.D. , MICHAEL BUTLER, M.D. , J. BAYER, M.D. , P.O. Box 8035, Walnut Creek, CA 94596. 2. Nature of claim: Full indemnity and/or partial indemnity. 3 . When did the damage or injury occur: January 3, 1991, 10:31 a.m. 4. Amount of claim: Claimants seek indemnity from the County of Contra Costa for any damages suffered by cross-complainants from the claims of Kevin Howell, individually and as Guardian ad Litem for Melanie Danille Howell, a minor. 5. Location of damage or injury: 15 Cleopatra Drive, Pleasant Hill, County of Contra Costa, State of California. 6. Specific damage or injury: plaintiffs Kevin Howell and Melanie Danille Howell, a minor seek damages for the death of Terry Howell, the spouse and mother of said plaintiffs, respectively. 7. The incident giving rise to this claim occurred on or about January 3, 1991 at 15 Cleopatra Drive, Pleasant Hill, California 94523 . On or about said date Patricia Hazel Tomsik drove her motor vehicle into the residence of Kevin Howell, Terry Howell and Melanie Danille Howell, a minor. Plaintiffs Kevin Howell and Melanie Danille Howell claim that this occurred by reason of the medical condition and/or disorder of Patricia Tomsik characterized by a lapse of consciousness and control. A police report was prepared and has been supplied to the County of Contra Costa by plaintiffs Howell. B. Claimants herein are health care providers. Plaintiffs Howell allege that claimants knew or should have known that Patricia Tomsik suffered from a medical condition and was given medication for it which caused her to be unable to safely operate a motor vehicle. Plaintiffs Howell also allege that defendants State of California and County of Contra Costa knew of this condition and failed to take action concerning it. 9. Claimants herein seek indemnity, either total indemnity or partial indemnity from the County of Contra Costa by reason of the allegations of plaintiffs Kevin Howell, individually and as Guardian ad Litem for Melanie Danille Howell, a minor. 10. Attached hereto and marked Exhibit "A" is a copy of the Howell complaint which is pending in the Superior Court of the State of California, County of Contra Costa and bears Action No. C91-05013 . 11. Attached hereto and marked Exhibit "B" is a copy of the tort claim of plaintiffs Howell as against the County of Contra Costa. 12 . The complaint, Exhibit "A" and the claim, Exhibit "B", are incorporated herein by reference as though fully set forth at length. 1 ) 13. The names of the public employees causing the claimants, injuries and damages or losses are now known at the present time, however, investigation is continuing. DATED: NOVEMBER I� , 1991. ARCHER, M COMAS & LAGESON BY: •WILLIS F. McCOMAS Attorneys for Cross-Complainants. 13. The names of the public employees causing the claimants, injuries and damages or losses are now known at the present time, however, investigation. is continuing. DATED: NOVEMBER A , 1991. ARCHER, M COMAS & LAGESON BY: WILLIS F. McCOMAS Attorneys for Cross-Complainants. . � 1 WILLIAM E. GAGEN, JR. r GAGEN, McCOY, McMAHON & ARMSTRONG U 2 A Professional Corporation 279 Front Street, P.O. Box 218 OCT 2 1-9913 Danville, California 94526-0218 Telephone: (510) ' 837-0585 4 S.1. WEIR.OSTA COW ITY Ceijntl rr•:rfS Attorneys for Plaintiffs rC CONTRA 9 5 KEVIN HOWELL, individually and as ti. Tk1l17,Ue.•=;y Guardian Ad Litem for 6 MELANIE DANILLE HOWELL, a minor 7 8 SUPERIOR COURT OF CALIFORNIA, COUNTY OF CONTRA COSTA 9 THIS L�'-,i� DET. 1/_ 10 .._.� , WD UNDER GiJ�'Ercr�n�lu�<i c ouwl;J 11 KEVIN HOWELL, individually and as NO. C g _ d 5 d l s Guardian Ad Litem for MELANIE 12 DANILLE HOWELL, a minor, 13 Plaintiffs, COMPLAINT FOR DAMAGES (WRONGFUL DEATH) 14 VS. 15 KAISER FOUNDATION HEALTH PLAN, INC. , A CORPORATION; KAISER 16 FOUNDATION HOSPITALS , IA CORPORATION; KAISER PERMANENTE 17 MEDICAL GROUP; KAISER PERMANENTE MEDICAL CENTER; D.-AVIDO, M.D. ; J. 18 BERRY, M.D. ; MICHAEL BUTLER, M.D. ; J BAYER, M.D. ; PATRICIA HAZEL 19 TOMSIK; STATE OF CALIFORNIA; CONTRA COSTA COUNTY; and DOES 1 20 through 200, inclusive, 21 Defendants. 22 23 Plaintiff KEVIN HOWELL, individually and as Guardian Ad Litem 24 for MELANIE DANILLE HOWELL (hereafter "Plaintiff") alleges: 25 26 Law Offices GAGEN, McCOY, MCMAHON & ARMSTRONG A Professional Corporation i:\vol2\client\22336\Complain.pld 279 Front Street —1— Danville, CA 94526 W i t 1 FIRST CAUSE OF ACTION 2 (NEGLIGENCE AGAINST DEFENDANT PATRICIA HAZEL TOMSIK) 3 Wrongful Death 4 5 1. Plaintiff KEVIN HOWELL, is the surviving spouse of 6 Decedent, and Plaintiff MELANIE DANILLE HOWELL is the surviving 7 minor daughter of Plaintiff's decedent and are decedent's sole 8 heirs at law. KEVIN HOWELL was appointed by Order duly given and 9 made by the above-entitled court and now is the duly qualified and to acting Guardian Ad Litem of Plaintiff MELANIE DANILLE HOWELL for 11 the purposes of this action. 12 2 . The true names or capacities, whether individual, 13 corporate, associate, or otherwise, of Defendants DOES 1 through 14 200, inclusive, are unknown to Plaintiffs who therefore sue said i5 Defendants by such fictitious names. Plaintiffs are informed and 16 believe and thereon allege that each of the Defendants designated 17 herein as a DOE is legally responsible in some manner for the 18 events and happenings as herein referred and legally caused injury 19 and damages proximately thereby to Plaintiffs as herein alleged. 20 3. At all times herein mentioned Defendant PATRICIA HAZEL 21 TOMSIK and DOES l through 20, and each of them, were the owners of 22 a motor vehicle hereinafter referred to and generally described as 23 a 1983 Ford Thunderbird, California license #1GPZ128, herein 24 referred to as 111983 'Thunderbird. " 251 4 . At all times herein mentioned Defendant PATRICIA HAZEL 26 TOMSIK drove the 1983 Thunderbird with the consent, permission and Law Offices GAGEN, WCOY, McMAIION & ARMSTRONG A Professional Corporation is\vol2\client\22336\Complain.pld 279 Front Street _2_ Danville, CA 94526 I knowledge of Defendant DOES 1 through 20, and was acting as the 2 agent and employee of each of these Defendants and was at all times 3 acting within the purpose and scope of said agency and 4 employment. 5 5. At all times herein mentioned Sherman Drive and Cleopatra 6 Drive were public streets and highways within the judicial district 7 of the above-entitled court. 8 6. On or about January 3, 1991, at approximately 10:30 a.m. 9 Defendant PATRICIA HAZEL TOMSIK was the driver of the above- 10 described 1983 Thunderbird proceeding in a general northbound 11 direction on Sherman Drive near the intersection of Cleopatra 12 Drive. 13 7 . At said time and place Defendant PATRICIA HAZEL TOMSIK 14 and DOES 1 through 20, and each of them, so negligently supervised, 15 entrusted, managed, maintained, drove, and operated the 1983 16 Thunderbird so as to cause said vehicle to collide into Plaintiffs' 17 residence located at 15 Cleopatra Drive in Pleasant Hill, 18 California, and thereby proximately caused the death of Plaintiff 's 19 Decedent TERRI L. HOWELL. 20 8 . At all times herein mentioned Defendant PATRICIA HAZEL 21 TOMSIK and DOES l through 20 had actual or constructive notice that 22 PATRICIA HAZEL TOMSIK suffered, from a medical condition and/or 23 disorder characterized by lapses of consciousness and control and 24 which were serious enough to be likely to impair her ability to 25 operate a motor vehicle safely. 26 Law Offices GAGE N, McCOY, McMAI ION & ARMSTRONG A Professional Corporation is\vol2\client\22336\Complain.pld 279 Front Street —3— 'Danville, CA 94526 1 9. Defendant PATRICIA HAZEL TOMSIK and DOES 1 through 20 2 owed Plaintiffs and Plaintiffs' decedent a duty of care which was 3 breached by Defendant PATRICIA HAZEL TOMSIK and DOES 1 through 20, 4 and each of them, .by negligently supervising, entrusting, managing, 5 maintaining, driving and operating the 1983 Thunderbird with said 6 knowledge of Defendant PATRICIA HAZEL TOMSIK's medical condition 7 and/or disorder characterized by lapses of consciousness and 8 control which were serious enough to be likely to impair her 9 ability to operate a motor vehicle safely. 10 11 SECOND CAUSE OF ACTION 12 (NEGLIGENCE AGAINST DEFENDANTS KAISER FOUNDATION HEALTH PLAN, INC. , 13 A CORPORATION; KAISER FOUNDATION HOSPITALS, A CORPORATION; KAISER 14 PERMANENTE MEDICAL GROUP; KAISER PERMANENTE MEDICAL CENTER; 15 D. AVIDO, M.D. ; J. BERRY, M.D. ; MICHAEL BUTLER, M.D. ; J. BAYER, 16 M.D. ; STATE OF CALIFORNIA; AND CONTRA COSTA COUNTY) 17 Wrongful Death 18 10. Plaintiffs incorporate paragraphs 1. and 2. of the First 19 Cause of Action as though fully set forth herein. 20 11. At all times herein mentioned Plaintiffs are informed and 21 believe and thereon allege that Defendants KAISER FOUNDATION HEALTH 22 PLAN, INC. , a corporation and KAISER FOUNDATION HOSPITALS, a 23 corporation, were and are corporations duly licensed in the State 24 of California and authorized to conduct business in the State and 25 California. 26 Law Offices GAGPN, McCOY, MCMAIION & ARMSTRONG A Professional Corporation is\volt\clicnt\22336\Complain.pid 279 Front Street _4_ 'Danville, CA 94526 + 1 12. At all times herein mentioned Plaintiffs are informed and I 2 believe and thereon allege that Defendants KAISER FOUNDATION HEALTH 3 PLAN, INC. , a , corporation; KAISER FOUNDATION HOSPITALS, a 41 corporation; KAISER PERMANENTE MEDICAL GROUP; KAISER PERMANENTE 5 MEDICAL CENTER; D.* AVIDO, M.D. ; J. BERRY, M.D. ; MICHAEL BUTLER,- 6 M.D. ; J. BAYER, M.D. ; and DOES 21 through 50, were acting as the 7 agents and employees of each other and at all times were acting 8 within the course and scope of said agency and employment and were 9 doing business in Contra Costa County and provided health care 10 services, consultations, advice, recommendations, testing and 11 evaluation of Defendant PATRICIA HAZEL TOMSIK prior to January 3, 12 1991, and determined that Defendant PATRICIA HAZEL TOMSIK suffered 13 from a medical condition and/or disorder characterized by lapses 14 of consciousness and/or control which were severe enough to be 15 likely to impair Defendant PATRICIA HAZEL TOMSIK's ability to 16 operate a motor vehicle safely. 17 13 . Plaintiffs are informed and believe and thereon allege 18 that at all times herein mentioned Defendants KAISER FOUNDATION 19 HEALTH PLAN, INC. , a corporation; KAISER FOUNDATION HOSPITALS, a 20 corporation; KAISER PERMANENTE MEDICAL GROUP; KAISER PERMANENTE 21 MEDICAL CENTER; D. AVIDO, M.D. ; J. BERRY, M.D. ; MICHAEL BUTLER, 22 M.D. ; J. BAYER, M.D. ; and DOES 21 through 50, owed a duty to the 23 Plaintiffs and the Plaintiffs' decedent to immediately notify the 24 local county or state health officer or department in writing of 25 the name, date of birth, address and condition of Defendant 26 PATRICIA HAZEL TOMSIK as having been diagnosed as suffering from Law Offices GAGEN, McCOY, McMAHON & ARMSTRONG A Professional Corporation is\volt\client\22336\Complain.pld 279 Front Street _5_ Danville, CA 94526 1 a disorder characterized by lapses of consciousness and/or control 2 which were serious enough to be likely to impair her ability to 3 operate a motor vehicle safely. 4 14 . Plaintiffs are informed and believe and thereon allege 5 that prior to January 3, 1991, Defendants KAISER FOUNDATION HEALTH 6 PLAN, INC. , a corporation; KAISER FOUNDATION HOSPITALS, a 7 corporation; KAISER PERMANENTE MEDICAL GROUP; KAISER PERMANENTE 8 MEDICAL CENTER; D. AVIDO, M.D. ; J. BERRY, M.D. ; MICHAEL BUTLER, 9 M.D. ; J. BAYER, M.D. ; and DOES 21 through 50, breached their duty 10 and failed to notify the Contra Costa County Health Department or 11 officer and/or the State of California Health Department or health 12 officer of Defendant PATRICIA HAZEL TOMSIK's medical condition 13 and/or disorder characterized by lapses of consciousness and/or 14 control which were severe enough to be likely to impair her ability 15 to operate a motor vehicle safely. 16 15. Plaintiffs are informed and believe and thereon allege 17 that at all times herein mentioned Defendants CONTRA COSTA COUNTY 18 and DOES 51 through 75, were duly organized and existing under the 19 laws of the State of California and that DOES 51 through 75 were 20 acting as the agents and employees of Defendant CONTRA COSTA COUNTY 21 and were at all times acting within the purpose and scope of said 22 agency and employment. 23 16. Plaintiffs are informed and believe and thereon allege 24 that prior to January 3, 1991, Defendant CONTRA COSTA COUNTY and 25 DOES 51 through 75 received actual or constructive notice from 26 Defendants .KAISER FOUNDATION HEALTH PLAN, INC. , a corporation; Law Offices GAGEN, WCOY, McMNION & ARMSTRONG A Professional Corporation is\vol2\client\22336\Complain.pld 279 Front Street _6_ Danville, CA 94526 I KAISER FOUNDATION HOSPITALS, a corporation; KAISER PERMANENTE 2 MEDICAL GROUP; KAISER PERMANENTE MEDICAL CENTER; D. AVIDO, M.D. ; 3 J. BERRY, M.D. ; MICHAEL BUTLER, M.D. ; J. BAYER, M.D. ; and DOES 21 4 through 50, that 'Defendant PATRICIA HAZEL TOMSIK suffered from a 5 medical condition and/or disorder characterized by lapses of 6 consciousness and/or control which were severe enough to be likely 7 to impair her ability to operate a motor vehicle safely. 8 17. Plaintiffs are informed and believe and thereon allege 9 that at all times herein mentioned Defendant CONTRA COSTA COUNTY 10 and DOES 51 through 75 owed Plaintiffs and Plaintiffs' Decedent a 11 duty to report in writing to the California State Department of 12 Motor Vehicles the name, age, address and condition of Defendant 13 PATRICIA HAZEL TOMSIK as suffering from a disorder characterized 14 by lapses of consciousness and/or control which were severe enough 15 to be likely to impair her ability to operate a motor vehicle 16 safely. Plaintiffs are informed and believe and thereon allege 17 that Defendant CONTRA COSTA COUNTY and DOES 51 through 75 failed 18 to perform its duty to so notify the California State Department 19 of Motor Vehicles of Defendant PATRICIA HAZEL TOMSIK's condition 20 as set forth herein. 21 18. Plaintiffs are informed and believe and thereon allege 22 that at all times herein mentioned Defendant STATE OF CALIFORNIA, 23 and DOES 76 through 100 had actual or constructive notice that 24 Defendant PATRICIA HAZEL TOMSIK suffered from a medical condition 25 and/or disorder characterized by lapses of consciousness and 26 control which were severe enough to be likely to impair her ability Law offices GAGEN, McCOY, McMAIION & ARMSTRONG A Professional Corporation is\volt\client\22336\Complain.pld 279 Front Street _7_ Danville, CA 94526 I to safely operate a motor vehicle. 2 19 . Plaintiffs are informed and believe and thereon allege 3 that at all times herein mentioned DOES 76 through 100 were acting 4 as. the agents and employees of the STATE OF CALIFORNIA and were at 5 all times acting within the purpose and scope of said agency and 6 employment. 7 20. Plaintiffs are informed and believe and thereon allege B that at said time and place Defendant STATE OF CALIFORNIA and DOES 9 76 through 100 had a duty to report in writing to the Department 10 of Motor Vehicles that Defendant PATRICIA HAZEL TOMSIK was 11 suffering from a medical condition and/or disorder characterized 12 by lapses of consciousness and control which were severe enough to 13 be likely to impair her ability to operate a motor vehicle safely. 14 Plaintiffs are informed and believe and thereon allege that 15 Defendant STATE OF CALIFORNIA and DOES 76 through 100, failed to 16 perform its duty to so notify the Department of Motor Vehicles of 17 PATRICIA HAZEL TOMSIK's condition as set forth herein. 1s 21. Plaintiffs are informed and believe and thereon allege 19 that at all times `mentioned Defendant STATE OF CALIFORNIA and DOES 20 76 through 100 had a duty to suspend and/or revoke Defendant, 21 PATRICIA HAZEL TOMSIK's driving privileges. 22 22 . Plaintiffs are informed and believe and thereon allege 23 that at all times herein mentioned Defendant STATE OF CALIFORNIA 24 and DOES 76 through 100 had actual or constructive notice that 25 Defendant PATRICIA HAZEL TOMSIK was the involved driver in motor 26 vehicle accidents and Vehicle Code violations, that she failed to Law Offices GAGEN, McCOY, McMAll0N & ARMSTRONG A Professional Corporation is\vol2\client\22336\Complain.pld 279 Front Street —8— •Danville, CA 94526 I pass a State of California driving examination and that PATRICIA 2 HAZEL TOMSIK suffered from a medical condition and/or disorder 3 characterized by lapses of consciousness and/or control which were 4 severe enough to be likely to impair her ability to operate a motor 5 vehicle safely. 6 23 .. Plaintiffs are informed and believe and thereon allege 7 that at all times herein mentioned Defendants STATE OF CALIFORNIA 8 and DOES 76 through 100 failed to comply with their duty to revoke 9 or suspend Defendant PATRICIA HAZEL TOMSIK's privileges to drive 10 and because of the premise Defendant PATRICIA HAZEL TOMSIK drove 11 her motor vehicle on ' or about January 3, 1991, thereby colliding 12 into Plaintiffs' residence, thereby proximately causing the death 13 of Plaintiffs' Decedent TERRI L. HOWELL. 14 24 . On or about May 31, 1991, Plaintiffs presented a claim, 15 a copy of which is attached as Exhibit "A", to Defendant CONTRA 16 COSTA COUNTY by certified mail, return receipt requested, for the 17 injuries, disabilities, losses and damages suffered and incurred 18 by Plaintiffs by reason of the above-described occurrence all in 19 compliance with the requirement of the Government Code. By notice 20 dated June 25, 1991, attached hereto as Exhibit "B" Contra Costa 21 County formally rejected Plaintiffs' claim. 22 25. On or about June 3, 1991, Plaintiffs presented a claim 23 to Defendant STATE OF CALIFORNIA by certified mail, return receipt 24 requested, through the State Board of Control for the injuries, 25 disabilities, losses and damages suffered and incurred by 26 Plaintiffs by reason of the above-described occurrence all in Law Offices GAGIN, McCOY, McMANON & ARMSTRONG A Professional Corporation i:\vol2\client\22336\Complain.pld 279 Front Street —9- Danville, CA 94526 1 compliance with the requirements of the Government Code. A copy 2 of this claim is attached to this complaint as Exhibit "C. " On or 3 about June 21, 1991, Plaintiffs presented an amended claim to 41 Defendant STATE OF CALIFORNIA by certified mail, return receipt 5 requested, through' the State Board of Control. A copy of this 6 claim is attached to this complaint as Exhibit "D. " Pursuant to 7 Government Code section 911. 6 (c) , on August 6, 1991, the claim was 8 deemed to have been rejected since the State Board of Control 9 failed to act upon Plaintiffs' claim within the statutory time. 10 26. As a proximate result of said negligence of Defendants, 11 and each of them, in the death of said decedent, Plaintiffs have 12 been deprived of the decedent's love, companionship, comfort, 13 affection, society, solace, moral and financial support, physical 14 and moral assistance and support, personal services, advice and 15 training in the operation and maintenance of the home. Plaintiff 16 KEVIN HOWELL in addition has suffered the loss and enjoyment of 17 sexual relations, decedent's ability to have children, and 18 decedent's role in the rearing of decedent's minor daughter and 19 funeral and burial expenses. 20 21 WHEREFORE, Plaintiffs pray judgment against Defendants, and 22 each of them, as follows: 23 24 1. For loss of support, comfort, society, protection and 25 affection according to proof; 26 2. For funeral and burial expenses according to proof; Law Offices GAGPN, McCOY, McMAI ION & ARMSTRONG A Professional Corporation is\vo12\client\22336\Complain.pld 279 Front Street -10— Danville, CA 94526 1 3 . For costs of suit incurred herein; and 2 4 . For such other and further relief as the Court may deem 3 just and proper. 4 Dated: October 22 , 1991 5 GAGEN, McCOY, McMAHON & ARMSTRONG A Profession orporation 6 7 By William E. a n, r. 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Law Offices GAGEN, McCOY, McMAIION & ARMSTRONG A Professional Corporation is\vol2\client\22336\Compiain.pid 279 Front Street —11- Danville, CA 94526 . .�� CO�j C |!w . �� , « &� $ \ ) 2 . , 2 r-4 U ' CO) \��� k � � /� k * L) % % � V k § . \ A r4 V4j ® 99 \ > 02 $ K / } 0 \CO / / # a u @ } ) w0 o I \ / u25 } \ \ \ 2a / yk { ( / * ` ? ` 7 \ \ 2 \ g # ¥ ~ � CLAIM RECEIVED BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA NOV 18 1091 Q aim•Against the County, or District governed by) BO_A�ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAMANT December, 17 , 1991 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 Clair^ by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Indemnity Section 913 and 915.4. Please note all "Warnings". CLAIMANT: KAISER FOUNDATION HOSPITALS ,. .KAISER FOUNDATION HEALTH PLAN, INC . THE PERMANENTE MEDICAL GROUP, INC . , AVIDO D. , M.D. , BERRY J. ,M.D. , ATTORNEY: BUTLER, MICHAEL, M.D. , BAYER, J. , M.D. Willis F. McComas , Esq. Date received ADDRESS: Archer McComas & Lageson BY DELIVERY TO CLERK ON November 15 , 1991 2033 North Main Street , Suite 800 November 14 1991 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. November 15 1991 ppHHIL BATCHELOR, Cler ro - __3 DATED: , BY: Deputy __ L 4, II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. l ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act forv15 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 V) Other: .� �;, \\/qrtc ('r,nn 0IP 1111 `S Sen vert Dated: It 17 91 BY: Deputy County Counsel 11JU 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: 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: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Willis F. McComas, Esq. ARCHER, McCOMAS & LAGESON 2033 North Main Street, Suite 800 Walnut Creek, CA 94596 Re: Claim of KAISER FOUNDATION HOSPITALS, et al . 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. WESTMAN, County Counsel By: N� . Deputy C my Counsel CERTIFICATE OF SERVICE BY MAIL; C.C.P. 99 1012, 1013a, 2015 . 5; Evid. C. §§ 641 , 6641 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: 12-2-91 , at Martinez, California. cc: Clerk of the Board cf Supervisors ( 7ginal ) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910. 2, 920 . 4 , 910 . 8) - ' • LAW OFFICES ARCHER, MCCOMAS &LAGESON LEE A.ARCHER A PROFESSIONAL CORPORATION WILLIS F.McCOMAS ERNESTB.LAGESON,P.C. 2033 NORTH MAIN STREET, SUITE 800 SAN MATEO OFFICE H.PAUL BRESLIN PERI EXECUTIVE CENTRE RODERICK D.JONES TIMOTHY M.McMAHON P.O. BOX 8035 SAN MATEO CENTRE RAND L.CHRITTON WALNUT CREEK, CALIFORNIA 94596-3728 1820 GATEWAY DRIVE, STEVEN R.FAIRES ERIC G.LUNDBERG SUITE 360 (510) 930-6600 SAN MATEO, CALIFORNIA JEFFREY A.LITTLE FAX NO. (510) 256-6627 94404-2471 JUDITH B.ANDERSON W.ERIC BLUMHARDT (41 5) 312-9840 WILLIAM].FEENEY ROBERT L.SALLANDER,JR. FAX NO. (415) 312-9849 JOSEPH C.WRIGHT JULIE A.WELSH ERIC D.BERGSTROM November 13 , 1991 DONALD B.FORNASIER DEBORAH K.WEISS TOBY M.MAGARIAN EUGENE C.BLACKARD,JR. LAWRENCE D.HILTON STEPHEN B.WELCHp 9 n /7 ROBERT J.SCOTT,JR. (R E C(L,:j ' I Il NANDOR B.KRAUSE Clerk of the Board of Supervisors NOV 1 5 1991 651 Pine Street, Room 106 Martinez, CA 94553 CLERK BOARD OF SUP-�3V.-;o-�^" CONTRA CO SI&Co. Re: Howell v. Kaiser, et al. Gentlemen: Enclosed please find the Claim for Indemnity Against the County of Contra Costa. Thank you. Very truly yours, ARCHER, McCOMA & LAGE ON A A Willis F. McComas WFM:clf RECE ED Willis F. McComas, Esq. NOV 1 5 1991 ARCHER, McCOMAS & LAGESON 2033 North Main Street, Suite 800 CLERK BOARD OFSUPEFiV'^�,>, Walnut Creek, CA 94596 CONTRA COSCO. (510) 930-6600 CLAIM FOR INDEMNITY AGAINST THE COUNTY OF CONTRA COSTA 1. Name and mailing address of claimants: CROSS-COMPLAINANTS KAISER FOUNDATION HOSPITALS, KAISER FOUNDATION HEALTH PLAN, .INC. , THE PERMANENTE MEDICAL GROUP, INC. , D. AVIDO, M.D. , J. BERRY, M.D. , MICHAEL BUTLER, M.D. , J. BAYER, M.D. , P.O. Box 8035, Walnut Creek, CA 94596. 2 . Nature of claim: Full indemnity and/or partial indemnity. 3 . When did the damage or injury occur: January 3 , 1991, 10: 31 a.m. 4 . Amount of claim: Claimants seek indemnity from the County of Contra Costa for any damages suffered by cross-complainants from the claims of Kevin Howell, individually and as Guardian ad Litem for Melanie Danille Howell, a minor. 5. Location of damage or injury: 15 Cleopatra Drive, Pleasant Hill, County of Contra Costa, State of California. 6. Specific damage or injury: plaintiffs Kevin Howell and Melanie Danille Howell, a minor seek damages for the death of Terry Howell, the spouse and mother of said plaintiffs, respectively. 7 . The incident giving rise to this claim occurred on or about January 3, 1991 at 15 Cleopatra Drive, Pleasant Hill, California 94523 . On or about said date Patricia Hazel Tomsik drove her motor vehicle into the residence of Kevin Howell, Terry Howell and Melanie Danille Howell, a minor. Plaintiffs Kevin Howell and Melanie Danille Howell claim that this occurred by reason of the medical condition and/or disorder of Patricia Tomsik characterized by a lapse of consciousness and control. A police report was prepared and has been supplied to the County of Contra Costa by plaintiffs Howell. 8. Claimants herein are health care providers. Plaintiffs Howell allege that claimants knew or should have known that Patricia Tomsik suffered from a medical condition and was given medication for it which caused her to be unable to safely operate a motor vehicle. Plaintiffs Howell also allege that defendants State of California and County of Contra Costa knew of this condition and failed to take action concerning it. 9 . Claimants herein seek indemnity, either total indemnity or partial indemnity`( from the County of Contra Costa by reason of the allegations of plaintiffs Kevin Howell, individually and as Guardian ad Litem for Melanie Danille Howell, a minor. 10. Attachdd hereto and marked Exhibit "A" is a copy of the Howell complaint1which is pending in the Superior Court of the State of California, County of C,.,ntra Costa a..-.d bears Action No. j . k C91-05013 . 11. Attached hereto and marked Exhibit "B" is a copy of the tort claim of plaintiffs Howell as against the County of Contra i Costa. 12 . The complaint, Exhibit "A" and the claim, Exhibit "B",. i are incorporated herein by reference as though fully set forth at length. °c. 13 . The names of the public employees causing the claimants' injuries and damages or losses are now known at the present time, however, investigation is continuing. DATED: NOVEMBER I� , 1991. ARCHERaMCOMMAAS & LAGESON BY: WILLIS F. McCOMAS Attorneys for Cross-Complainants. a - CO �1 �A6 0 0 a Lo tY..' a p � N LO O � � U `fl � 7 F.4 F.4 z N Z Z o W U p LL o z Z U m 4 3 N fw 0 W oz U r i'