HomeMy WebLinkAboutMINUTES - 02051991 - 1.2 (2) 1.do
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 FEBRUARY 5, 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: :$25,000.00 Section 913 and 915.4. . Please note all "WarninggtCF1\1r_
CLAIMANT: ALLEN, Robert John
JAN
14 1991
ATTORNEY: John C. Willbrand; COUNTY COUNSEL
Attorney at Law Date received MARTINET, MIF,
ADDRESS: 2280 Diamond Blvd. #440 BY DELIVERY TO CLERK ON January 8, 1991 (hand delivered)
Concord, CA 94520
BY MAIL POSTMARKED:
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PPHHIL BATCHELOR, Clerk
DATED: January 11, 1991 BY: Deputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantially with Sections 910 and 910.2.
C ) 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''' right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: ( mcil BY: rX Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Adminis rator (2)
y ( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
( his Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this dater.
Dated: FEB 5 1991 PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code sects 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 .aabove.
Dated: FEB 8 1991 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
JOHN C. WILLBRAND
ATTORNEY AT LAW
COMMERCE CENTER TELEPHONE: (415)676-8800
2280 DIAMOND BLVD., SUITE 440 FAX: (4.
CONCORD, CALIFORNIA 94520 RECEIVED
CLAIM FOR DAMAGES 04
JAN 8 1991 !
B0�►RD OF SUPER S
CONTRA COSTA C .
TO: CITY OF MARTINEZ and the COUNTY OF CONTRA COSTA
Claimant, ROBERT JOHN ALLEN, whose address is c/o John C.
Willbrand, Attorney at Law, 2280 Diamond Blvd. , #440, Concord, CA
94520, hereby makes a claim against the CITY OF MARTINEZ and the
COUNTY OF CONTRA COSTA for a sum in excess of $25,000 . 00, and makes
the following statements in support of the claim:
1. All notices concerning this claim shall be directed to the
following:
John C. Willbrand, Esq.
2280 Diamond Blvd. , #440
Concord, CA 94520
415/676-8800
2 . The incident giving rise to the claim occurred on December
1 , 1990.
3 . The circumstances giving rise to the claim are as follows:-
Due to the negligence of the CITY OF MARTINEZ and CONTRA
COSTA COUNTY, and their employees and agents, claimant was attacked
by a police dog and sustained injuries to his arm and leg, incurred
medical expenses, pain and suffering, all in a value in excess of
$25,000.00. His damages are continuing.
4 . Claimant seeks in excess of TWENTY-FIVE THOUSAND DOLLARS
in general and special damages.
DATED: January 7, 1991
Q,-( 0,4, mjw��
JO N C. WILLBRAND, Attorney for
C aimant
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 FEBRUARY 5 , 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: $100 ,000 . 00 Section 913 and 915.4. PleaseMOY)"Warnings".
CLAIMANT: DAVIS, Pauline JAN 7 1901
ATTORNEY: John A. Pettis , Esq . COUNly COUNSEL
MART INE7, CALIF.
Attorney at Law Date received
ADDRESS: 3701 Lone Tree Way, Ste . 11 BY DELIVERY TO CLERK ONDecember 31 , 1990
Antioch, CA 94509
BY MAIL POSTMARKED: December 28 , 1990
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
January 4 , 1991 EVIL BgATCHELOR, Clerk
DATED: BY: Deputy
II. FROM: County Counsel TO: Clerk of the Board of S6pgr4,rsors
) . 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 �I(, BY: n Deputy County Counsel
9 - 41 — -
`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:
1
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Dated: FEB 5 1991 PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov, code se 13)
Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or
deposited in the mail to file a court action on this claim. See Government Code Section 945.6.
You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult
an attorney, you should do so immediately.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, overage 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: FEB 8 1991 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
JOHN A. PETTIS 6 ASSOCIATES
ATTORNEYS AT LAW
December 28, 1990 RECEIVE®
DEC 3 1 1990
Clerk of the Board of Supervisors
Contra Costa County CL�ERKSOARDOFSUPERVISORS
651 Pine Street, Room 106 CONTRACOSUPER
Martinez CA 94553
TA Co.
RE: Our Client: Pauline Davis
Date of Loss: 08/01/90
Dear Mr. Batchelor:
This is to advise you that the representation letter from our
office on November 19 , 1990 was and is in no way to ,be construed
or intended as a formal Claim against Contra Costa County under
the Government Code.
Enclosed please find Pauline Davis ' formal Claim against Contra
Costa County in this matter which is being submitted at this
time.
Please do not hesitate to contact me if you have any questions or
if you feel that there is an issue as to which document
constitutes the formal Claim and starts the time running for the
filing of the complaint.
Very truly ours,
OHN A. PETTIS
JAP:dc
Enclosure: Formal Claim.
3701 LONE TREE WAY,SUITE I1 • ANTIOCH,CALIFORNIA 94509 • (415)757-2400
In the matter of the Claim of
PAULINE DAVIS, CLAIM AGAINST
PUBLIC ENTITY
Claimant, (Gov' t Code Sections
905, 905. 2, 910. 21 )
against
COUNTY OF CONTRA COSTA
Respondent.
To: CLERK OF THE BOARD OF SUPERVISORS- CONTRA COSTA COUNTY:
PAULINE DAVIS hereby makes a claim against the COUNTY OF
CONTRA COSTA and makes the following statements in support of
the claim:
1. Claimant' s address is 968 Carpino Avenue, Pittsburg,
California 94565 .
2 . Notices concerning this claim should be presented to
JOHN A. PETTIS & ASSOCIATES, ATTORNEYS AT LAW, 3701 Lone Tree
Way, Suite 11, Antioch, California 94509.
3 . The date and place of the occurrence giving rise to
this claim were August 1, 1990 at Del Tren Avenue & Teatro
Avenue, in the City of Pittsburg, County of Contra Costa,
State of California. This area of Pittsburg is part of the
E1 Pueblo Housing Project maintained by Contra Costa County.
4 . The circumstances giving rise to this claim are as
follows: Claimant was a passenger in a vehicle driven by Mr.
Willie McWardley and owned by Hyster Company. As the vehicle
was crossing over the manhole at the intersection of Del Tren
Avenue and Teatro Avenue the manhole cover came off causing
the vehicle to fall into the manhole, and resulted in
injuries to claimant.
5 . The name of the public employee causing the injury
to claimant is unknown.
6 . Claimant' s injuries include: Soft tissue injuries to
her neck and back and other injuries, the nature and extent
of which are unknown at this time.
7 . Claimant' s claim for damages as of this date is
$100, 000. 00.
Dated: December 28, 1990 JOHN A. PETTIS & ASSOCIATES
ATTORNEYS AT LAW
<1XvW9?tE-
JOHN PETTI
Attorneys for Claimant
PROOF OF SERVICE BY MAIL
I declare that:
I am employed in the County of Contra Costa, California.
I am over the age of eighteen years and not a party of the
within entitlee cause; my business address is: 3701 Lone
Tree Way, Suite 11, Antioch, California 94509 . On
December 28, 1990 I service the attached:
Formal Claim
on the parties in said cause, by placing a true copy thereof
in the United States mail at Antioch, California, addressed
as follows:
Clerk of the Board of Supervisors.
Contra Costa County
651 Pine Street, Room 106
Martinez CA 94553
I declare under penalty of perjury under the laws of the
State of California that the foregoing is true and correct.
Executed on December 28. 1990 at Antioch, California
Debbie Clifton
- CLAIM
�µ 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 FEBRUARY 5, ;1991
and Board Action. A1.1 Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code.
Amount: $1,064.37 Section 913 and 915.4. Please note all "Warni Wr
CLAIMANT: DOW, Maria Rosario
c/o San Francisco Music Box Company J A N 14 1931
ATTORNEY: 6121 Hollis Street COUNTY COUNSEL
Emeryville, CA 94608 Date received MARTINEZ,, CALIF,
ADDRESS: BY DELIVERY TO CLERK ON January 8, 1991 (transmittal)
BY MAIL POSTMARKED:
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
Januar 11 1991 PPHHIL BATCHELOR, Cler
DATED: Y BY: Deputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
^� ) This claim complies substantially with Sections 910 and 910.2.
( . ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days. (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: )/15 `� BY: 4D S _1%U 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:— FEB 5 1991 PHIL BATCHELOR, Clerk, By, _, Deputy Clerk
WARNING (Gov. code s cti 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: F E B 8 1991 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
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Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes'of action for.death or f6F injury to person` or oto`;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 acton.for, death" or. for :injury.to person
or to personal property or growing crops andywhich accrue,,on,,or after January 1,
1988, "must be presented not.later.'3thAn -s;ix month's after•,thea accrual of xthe4 cause
-of action. Claims-relating "to any�other-'cause,of action must be presente& not -
latera than one- year after the accrual of.,the cause of action. _ (Govt. Code-1911.2.)
B. Claims. must be filed with the Clerk of" the"`Board of Supervisors at. its office in
Room 106, County Administrat on Building, 651 P,fne;;Street�;.. Martinez,, Cjl�,9 553•
A
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.
il=led in:D. If the claim is against more than one_publiib-..ent(iity., 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
AAM RECE ED
Against Pe ounty-of Contra Costa ) . - JAN 8 1991
_.. _ .. District). p,�KBOARDOFSUPERVIS0
4.. ) CONTRA COSTA CO.-
Fill in name �,��, _ s�"'� ♦<, ,
The undersigned claimant hereby .makes ,claim against the County of Contra Costa or
the above_named; and in support of
this claim'f represents as follows: w,j/A ,¢ �wlq G1ielzz elrl4 �e t
0 7
---------------------------- =' - --'_ _ ---------------------------
l. When did the damage.:4:or injury occur?:,;(;Give exact date and hour)
---------------------------- -
Where did the damage-or injury occur? (Include city and county)
1IM&My 6M tleu/� c%se, f" %,,qf 6/vd .�a/` &7&Me '
--------- -------------L------------ -- ----- ----------- --
-----------
3. How did the damage or injury occur? (Give full details; use extra paper if
required) X 4r1RsAh� 6si `ti roAy. 6d'0 4561G ih
AK. h t Igyl�.
Ana' 6o coh
, oed ,lie 4,ecw�X AeO&A eJ4116 '(11WS -WR
..
W ,
4. What particular act or- omission on the part of county or district officers, .
servants`.or employees caused,the injury or-damage?
Z4e.41 e 10-erwt�n -A '
4ndloe 7Wilellino
C.
r damage?
' C.
(over)
5. What are the names of county or district officers, servants or employees caus=rig
the damage or injury?-..-
#,n
njury? _.
laleen
5 What :damage or::injuries' do you claim.resulted? (Give .full :extent of injuries or
'damages 'claimed. :Attach two estimates :for auto:-damage::
Howwas the amount claimed above computed?.:- (Include~the estimated amount sof. any
prospective injury or damage.)
$.
Names and addresses of-witnesses,';' doctors.and_ 'hospitals:
--------------=---------------------^------------------------------------------------------------- --------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
' �^F +AAffiL�:,aid})Oi'_4S?�'3n'I�>Rtu1+'?��i'd'�:.k.:.'T'x}_•..-:� fir' �,' .. + ,1. +.
f. �S"""aauacscac sa�cs�—,�.^`.ro¢m:Adtu�g k!
Gov. Code-Sec. 910.2 provides:
I
"The claim must fesr red' b `}�tht"claimant
SEND.NOT_ICES T0: or by some person on his behalf."
Name and Address of Attorne ROW
{
Claimant's/�Signature)
�
.(Address
Telephone Noi?"", ,°:,'<` ,; �• y TeT'ep_hone No. , '3' 1191M
Mh5AR/o
s{q N ,9 T I C E . ; . t
'�'�4}�`'t`.+�J\\��Sv ^^ +Y .x tg� a:�a� r'• ..en t'� _�'t t S'S\ �`;♦;1�� f h a° �'i�%'\\`5�� `i`^\
Section 72- of the Penal Code provides:-
"Every person who, with•+intenttto defraUd; ,presents,,+for,.a�llowLnce;or for
t�. L+ \ +f 1tL k f '4 ♦ ���+ , ,J.J i.* ..rs.•.- '1"•♦ lT` r'e
payment4 tq any state"board or°,dfficbr', or,to any .c! ty, city' or district board_,;or
o f e r, authorized;,to* peg e same ifs genui���,��any�,\fal-se m\fraudulent'
t , r
•claim,;billy f `accou ter;, you her>,,^or�wr3t?ing'� is, punishable,`either by S mprisoriment;An
the county�`jactl for`a° period�'of not'°more' thari`"orie;yeat' by a- fine"of fi ti 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 risonmens.
im t ;and
p :..A
+,a�4 i�—:s '1,jy,,• ..+ E. k'^� `C•1•.a1'.q�'f. :+o ' Dts.k': k: C' �Tw._j9a ;,,,', ..;'y
-, 1089-11690 NORICK OKLAHOMA CITY meson
PARKER-ROBB CHEVROLET ESTIMATE OF REPAis
..
f 1707 No. Main St. - Phone 934-4481
}� WALNUT CREEK, CALIFORNIA 94596
DATE
NAM ', /^ ADDRESS CITY ZI DAYTIME PHONE F'
?,10
YEAR MAKE, LICENSE NO. SPEEDOMETER SERIAL NO.(VIN NO.)
INSURANCE CARRIER,/ADJUSTER CLAIM#
REP/ RE- PARTS LABOR REFIN- PAINT
PLACE DESCRIPTION @ LIST HRS. ISHING MATERIALS
HRS. &SUBLET
2
3
4 /`
5 /s2 U5-
6
a
8
9
10
12
13
14 &
15 ?� •�
16 '7
17 /
i>3
19
20 I
21
22
23
The above is an estimate, based -on our inspection, and does not cover TOTAL $ C)
additional parts or labor which may be required after the work has been
opened up. Occasionally,after work has started,worn, broken or damaged LABOR HRS. Z
parts are discovered which are not evident on first inspection. Quotations
REF.HAS.
on parts and labor are current and subject to change. TOTAL �� L/ if PER j
LABOR HRS. X$ , HR. _ $ /✓ `�
PARTS /�
Q� a LIST$`�9�4 LESS %DISC. _ $�.�.2.�
EST. MADE BY
PAINT&MATERIALS$ I
THANK YOU FOR BRINGING YOUR CAR TO SUBLET$
SALES TAX$
TOTAL OF —417PARKER-ROBB CHEVROLET. C Q T I U e T C Q //S/
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA .000NTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT FEBRUARY 5, :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: $324.50 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: MC CARTNEY, Patricia
5505. Connecticut Drive , JAN 14 1011
ATTORNEY Concord, CA 94521
Date received COUNTY COUNSEL
ADDRESS: BY DELIVERY TO CLERK ON January 9, M�-!NE(haAfff,de1ivered)
BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim. PPHH gg
DATED: - January .11, 1991
RV DeputyLOR, Clerk
11. FROM: County: Counsel TO: Clerk of the Board of §epeKisors
�I ) 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 isnot 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: 115/91 BY: I S. �JA 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:'' FEB 5 1991 PHIL BATCHELOR, Clerk, B Deputy Clerk
WARNING (Gov, code s io 3)
Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or
deposited. in the°•mail to file a court action on this claim, See Government Code Section 945.6.
You may. seek the advice of an attorney of your choice in connection with this matter. If you want to.consult
an attorney, you should do so immediately.
AFFIDAVIT OF MAILING
.1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the United States Postal Service in Martinez,
California, postage. fully. prepaid a certified copy of.this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated: E E B 8 1991 BY: PHIL BATCHELOR Deputy Clerk
CC: County Counsel ,County Administrator
E
Claim 'to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
form. re
RE: Claim By ) Reserved for Clerk's filing stamp
Patricia McCartney j E�
5505 Connecticut Dr.� Concord, Ca 94 21
Against the County of Contra Costa )
JAN 91991
or
C.C.C. animal Control, Spay p
4849 Imhoff Pl , Martinez Ca District) DOARD OF SUPERVISORS
Fill in name) ►COSTA CO. i
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $3-24 .5 0 and in support of
this claim represents as follows:
-------------------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
( 1 ) . 8-13-90 . ( 2 ) 10=3-90 . JOWL 10-16-90 . dew 11 -8-90 .
The dog-was-taken to each clenic approximately each morning_,.,- _8-Z"M--
2. Where did the damage or injury occur? (Include city and county)
C.C.C. Spay Clenic , 4849 Imhoff P1 ,' Martinez , Ca.
------------------------------------------------------------------------------------
3. How did the damage or injury occur? (Give full details; use extra paper if
required)
Inclosed you will find a detailed letter explaining each incident
and. why I feel the animal Control Spay Clenic is at fault. They botched
-------------------------------------------------------------------------
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
First spay- ;wirersi`aer.e_Ieft_-to jlong .and(,-pot clipped. one of the spay
t Pts,_told me,.Th j,s ¢ SFcond.,operation Dr Soloum said he
(over)
would take out a coyel of wire, no big deal and dog would be fine.
After second surgery wirer was still in dog and I had to have a third -
rc� own vet to have tc�e e, wir s removed.
: iayte 'ie names of county or dhis rict officers, servants or employees causing
the damage or injury?
Animal, ( o--t.
-- --- --- ------- -----------------------------------------------------
you°claim resulted? (Give full extent of injuries or
6. What damage or injuries do
damages claimed. Attach two estimates for auto damage.
C.C.C.Animal services , Spay Clenic Attention Diana Iwassa., or Mr. Ross .
Because information was refused, , not sure of first Vet. The second Vet is
---------------------------------------------------------------------------
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
An over night stay at Vets, A third surgery and transportation to
all the different clenics .
--------------------- --------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
Spay Clenic 4849 Imhoff P1 , Martines Ca, DISNET PET HOSPITAL
3554 Concord E1 Concord
MONTE VISTA VETERINARY
1488 WasIjington B1 Concord
-------------------------------------------------------------------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
r 2130_
=' c Gov. Code Sec. 910.2 provides:
The claim must be signed by the claimant
SEND NOTICESI�,,T.®;.,,,U., r. e- , g or by some person on his behalf."
Name and Addre'ss, ofAttorriey ,, ,
Clai s Signature
5505 Connecticut Dr. Concord
94521
Address
Telephone No. Telephone No( 41 5 0 672-2707
* * * W 9 * * �t
N O T I C E
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
\ I
Pat McCartney
5505 Connecticut Dr.
Concord, Ca 94521
Diana Iwasa:
This letter is in regards to my two year old fe'male BritneV,
Spanel , named Brandy. I had her spayed at the Spay Clenic,
at 4849 Imhoff Pl, Martinez , Ca on 8-13-90 .
I feel the Spay Clenic was negligent with the spay surgery,
and botched up the surgery they preformed on 8-13-90 . Since
that surgery, Brandy has had to go through two more additional
surgeries , exrays and an over night stay at DisneysVeterinary
Hospital '.
This a total of three surgeries , exrays, an overnight
stay in thr clinic, at least 14 trips to the various clinics,
great trama and stress to my dog as well as to. my self and
family.
I am asking that you reimburse me for extra expenses
I incured because of the Spay botch up. Such as exrays done
on 10-3-90 , costing me $ 150 .00 . Then the third surgery that
was done at Monte Vista Hospital , by Dr. Mary Beth R)(Mer 1488
Washington Blvard, Concord, Ca 94521 , at a cost of $ 146 . 50 .
Total of these two bills $296 . 5.0 . In addition, I would like
$2 . 00 a trip totaling $28 . 00 for the 14 trips it took me to
get to the various plases .
On 8-13-90 I picked Brandy up from her surgery at the
spay clenic, took her home : and kept her confined and quiet
for three weeks of healing.
As time wen 't by Brandy did not become her normal self .
She would let out a cry now and then, hide under the bed,
cry when she tried to jump up and it was difficult for her
toP ump up on the bed. Sometimes she acted like she was scared
by the way she hunched up when the wires poked her.
On 10-3-90 , I took Brandy to Disney Pet Hospital because she
was in so much pain. She just layed on the floor and cryed.
Dr. Roth had to start some place. He thought by the way she
acted and the pain she was having it was posibly a pinched
nerve in her neck or back. Dr. Roth exrayed Brandy end kept
her over night. 1488 Washington BL Concord Ca.
The next day 10-4-90 , I picked up Brandy. The exrays
were showen to me and did not reveal or appear to be a pinched
nerve. I was told to keep her quiet at home for a few days
and observe her. This Cost me $ 150 . 00 .
When We got home, I let Brandy lay on the bed. My daughter
and I were petting Brandy and it was then that we discovered
the wirers poking up in Brandys skin where she had her spay..'syzrgery.
The wirers looked as though they were about to protrude threw
the skin, you could see them as well as feel them.
I called Disneys again, they felt that because I had
the surgery done at the Spay Clenic, I should take her back
there.
At this point I called Marian Long with the S .P.C.A. ,
she called Elsie Ring.gly and that is how Elsie got involved.
I wen ' t to the Spay Clenic to make another appointment.
At the next appointment Brandy was checked out by Dr. Solomen.
He said he would snake an incission and take out a coil of
wire. He said it was no big problem and there was nothing
wrong with my dog and insisted there was something else rong
with my dog. I found Dr. So 1,ome.n to be short and abrupy with
me. He also said sarcasticly that the wirers could not be
hurting my dog. The surgery was set up for twc. weeks later.
Elsie said two weeks was to long to wait. =,Brandy would
be suffering to long. So after a lot of imbarassement gi;Ven
to me by the spay clenic, I got the surgery moved up one week
earler.
( 2 )
r ,
Not feeling satisfied and very unconfortable with Dr. Solomen
I made another appointment to see the Spay Clenics other Dr.
Dr. Gets . I feFd!l comfortable with Dr. Gets oppenion.
Dr. Gets examened Brandy and ` said yes the wire was poking
in her stomic and who ever did the Spay surgery did t not cut
the wir that the wirers were catching in her stomic and
he advised me to keep the appointment and have the wirers
removed .
The second repair (surgery) was done on 10-16-90 . When
I wen ' t back to pick up Brandy, I was asked to wait in the
waiting room. Dr. Solomen left word that he wanted to talk
to me.
When Dr. Solomen came out in the waiting room, there
were other people there also and Dr. Solomen proceeded to,.
raise his voice asking me whats the deal , why did I talk to
Els and that Els4 jumped him, he said nothing was rong with
my dog, the wirers wern' t hurting my dog and that he took
a coil of wore out of Brandy. My daughter and I were very
embarassed becaude peopl were looking.
There was something wrong, my dog had to go through another
surgery.
I took Brandy home and again kept Brandy quiet and confined
for three weeks . As Brandy healed, I watched her incission.
I could still feel the wirers that were previously there.
Brandy still was not her self. So I called ElsigAjj ,told
her I still felt the wirers and what did that Dr. Solornen
do to her? I told Else that the Spay Clenic Botched up ,two
surgeries on Brandy, that I was going to take her to, my own
Veterinary and have her checke4',.; out because I didnottrust
the Spay clenic to do it .
Next I took Brandy to Dr. Mary Beth Rymer at Monte Vista
Veterinary Hospital , 1488 Washington Blvd. , Concord Ca 94521 .
Dr. Rymer could feel the wirers in Brandys stomic. I explained
that I had taken Brandy to the Spay Clenic to be spayed and
again to have a repair for a removal of a coyal of wire:
( 3 )
These wirers were still the same wirers that were there before
the repair.
This time the third surgery was set u for 11-8=90 :
Dr, Rymer spent several hours working on Brandy in surgery
to. make sure she got all the wirer out of.**�_Dr: r Rimier
took sever lengths of wirer out of Brandy aswell as small
gpped pij I have these wirers in my possession know.
Again I feel that the Spay Clenic was neglegent and -Botched „
up Brandys surgery and spay causing me large expenses and
extra time lost not to mention the stress and wear and tear
on my dog.
Lastly I would like this matter resolved in two weeks
from the date recei'Ved. I am sending coppies and a ,;picture
of the wirers . zav
Pat McCartney
( 4 )
' 1
f r
r r ,
MONTE VISTA VETERINARY HOSPITAL, INC.
1488 Washington Blvd.
Concord, CA 94521
(415)672-1100
CLIENT: MCCARTNEY, PAT ADDRESS: 5505 CONNECTICUT DR., CONCORD, CA 94521
ACCT# DATE ANIMAL SERVICE FEE CR/KBIT BALANCE TR: 10334
Prey Balance r #0.00
1. 273 08 NOV 90 BRANDY PRE ANESTHETIC MED $6.50
1. 273 08 NOV 90 BRANDY INHALATION ANESTHETIC $48.50 `.
1. 213 08 NOV 90 BRANDY SURGICAL PREPARATION $9.00
1. 273 08 NOV 90 BRANDY SURGICAL SERVICES $60.00
1. 213 08 NOV 90 BRANDY DAY CARE HOSPITALIZATION $13.00
1. 273 08 NOV 90 BRANDY AMPICILLIN $9.50
1. 273 08 NOV 90 Chg to Acct $146.50 $146.50
1. 273 08 NOV 90 Cash Paid on Acct -$60+00 -$60.00
New Balance $86. 0
----------------------------------------- --------------
PATIENT MEDICATION: Please medicate your Pet as prescribed on dispensed
medication or as instructed by your veterinarian.
PATIENT HOME CARE INSTRUCTIONS: Withhold food until tomorrow morning.
Give water in small quantities frequently after 7:00 PM this evening.
Please return in 7-10 days for the removal of your pet's suture`s. .`
Please telephone us if you have further questions regarding your pet's
home care. 672-1100
TO AVOID INTEREST OR STATEMENT PREPARATION FEE PLEASE SUBMIT BALANCE BY
NOVEMBER 30. 1990. INTEREST RATE IS 1.5% PER MONTH; STATEMENT PREPARATION
FEE IS $5.00 PER MONTH.
i
q � ,
�+'}" lbixt }, J` '.;i �.t'-§4F'k ati`u qq��,,_'L"ef^z'~t._ -
•.� # 3 - ) r��§ Ic; r n
CANSUMEi , BUSINESS,ANd'iNVESTMENT FRAUD COMPLAINT FORMS
• ro
4
CONTRA COSTA COUNTY DISRICT,ATTORNEY `= SPECIAL OPERATIONS DIVISION
725 Court St ,.:,Rm.�,f4'03, P:0: Box..670, Martinez; CA 94553
PLEASE PRINT OR TYPE, ig OlbtmgLE
C.C:C. Animal Control, Spay Clenic• 4.8.E :Martnez..
9.. Uh if ..Pl : ;.................
NAME OF BUSINESS OR PERSON COMPLAINED OF ADDRESS OF SAME
AQ. n �jd(, q ? .
TEL��FI�NE I�17MO'95 SALESPERSON .............................................
-1
j8�RR-11i3-�000;pp 10pp3���-q�,9,,p�0,'`;tt10=16-90 11 8=`90 Spay Clenic twice,
RAPtt A011 NCk6F'TRI�IOSkkVTXRs a"VetS 1
.F
NAME OF PRODUCT OR SERVICE INVOLVED WAS A CONTRACT SIGNED? (IF SO, ATTACH COPY OF CONTRACT
;r;• OR SEND ORIGINAL FOR US TO COPY AND RETURN.)
DATE AND LOCATION WHERE MONEY PAID '1
IF PRODUCT OR SERVICE ADVERTISED. WHEN WHERE .............................................
(ATTACH COPY OF AD OR SEND ORIGINAL, FOR US TO COPY AND RETURN.)
g li
COMPLAINT INVOLVES MISREPRESENTATIONSs ADVERTISELS`` v O ORAL O .OTHER ( BELOW)
HAVE. YOU CONTACTED A PRFVATE ATOItNEY? WHO?
no wouldlike your advice:
EXPLAIN FULLY : (DESCRIBE EV EN TS JN THE;ORDER.IN WHICH THEY HAPPENED IF POSSIBLE! ATTACH EXTRA SHEET IF "I
NECESSARY:) � ,; .
x t
I am enclosing the fetter I wrote tottie Animal Conttol5ervicesV
explaining the problems
I feel the Spay cleric 'botched- up the "spay as wel' . as the,
second surgery they preformed on my, dog.
I had .my dog spayed at themspay Clen ic 8713-90 . hen tooX My. '
dog tor-vet for pain. :": Found wirers poking out 'in her stomicft �',
: Yiii`'` g
advised
Y mY t� at
Ito the clen�c
where Ihad' herspayedOnevet saidwho ever- spayed
her
Sstomic The" other spay vet said when
left the wirers too longand did not clip them; leaving them
to poke and catch in �� � p y �.(p �, 560 u Qll)
he was going to open the""'dog, ttp again and take a , coyel of
wirer out: Second surgery 10 16=90 After the second surgery,
I found that the same Wirers weris still in my dog and cousing
her painhe third, suYgery I _took my dog to my vet 11 -8-
90 . The vet took out different lengths of wbrer of which
I still have and have made A'" Copp~ of: I don't understand-
,..
I Y . � •� � � �� �' 4,4"'.i`
g ° Y p . take out
z a co el of wite,ii then wh was al the wirer still in the
why if the vet in the second sur er was su ose to
Y Y
} dog the second time: Dr Soloum is lie, vet that operated
on my dog .the second time and I}am not., sure if he .was the SDIpG�n�
same vet. for the first time: I f6dfidtiscDr S63dhen to be
rude, • short and..i . of a def§ive�afifii t�dci6 : Though m' .dog is not
a human, she does not deserve to be` treate'd in this manner.
Also how many other animals have gone threw this: I :know
the spay clenic . was havin '`"`"
g problems trying to hirera new 'vet
because their old one r'etired, ` but do they have to settel
for this one I have hexed other` pe"ople"complain about his
attitude; but i have riot found 6U't' if ahyroneaee has 'had
AMEbr� X?UQRES�ER tYESgS n S��fi���� Be net_t• -55U5• Coiirie•ct•icizt• •Dr••CCrncnrd
C : .94521.�,.... . .. ... . .. ... . ... .. ... . . . ..... .. ... . . . . . . . . .. . . .. . .. . . . .
� ;.'
THIS COMPLAINT MAY BE SENT JO THE~COMPANY COMPLAINED ABOUT YES : :. : . .. . . NO .': : . ... . : :. . .
•I WIsH TO.FILE A COMPLAONT AGAINST THE COMPANY NAMED ABOVE' I,UNDERSTAND THAT THE DISTRICT ATTORNEY IS UNABLE
TO REPRESENT PRIVATE CITIZENS SEEKING THE RETURN OF THEIR MONEY OR OTHER PERSONAL REMEDIES. 1 AM, HOWEVER,
FILING THIS COMPLAINT.TO NOTIFY.THE DISTRRICT•AT70` N EY Y >+O.
N F-THE ACTIVITIES OF THIS COMPANY. .
Patricia McCartney .7� 5505::Conriect ,cut.Dr;..Con-cord
COMPLAINANT'S NAME r ADDRESS C&j 94521 r, y
6722.7.Q7 7 .. ik
TELEPHONE•NUMBERS (RESIDENCE AND BUSINESS) 3 13USINESS ADDRESS
DATE .!: ::i.:. SIGNED .: .. .
I
r
DA 229 ` WHITE COPY DISTRICT ATTORNEY
YELLOW COPY - COMPANY OR POLICE AGENC'
PINK COPY - COMPLAINANT
i
,. yy
1
r �
{ �"• ,•t ly�tijN
DATE RECEIPT ANIMAL FEE { PAYMENT ADJUST- BALANCE PREVIOUS NAME
NO. MENT .BALANCE
t
SERVICES RENDIIRED
1. OFFICE PROCEDURES Estimatectz'2 6. RIDIOLOGY Estimate Actual DATE: "s
,�Office Call �"( ► In4pretation
• ( ► Exam-Routine ( ► Plan Film CLIENT NAME:
( ► Exam-Extended 1 1 CoArast Study
1 1 Consultation I ANIMAL NAME:
O Recheck O
O Emergency Service 7. DIINTISTRY REASON FOR VISIT:
O Health Certificate ( ► Extactions
( ► O Filiigs
( ► O Ultrasonic Cleaning f
2. VACCINATION ( ► Polifiing $ DEI
( 1 DHLP-P O
( ► Parvo ( ► PAID BY:,
I 1 Bordatella S. SURGERY ( ► CASHCHECK ( ► B of,A, ( 1 MC
( ► Corona ( )
( ► Rabies 1 1
FVRCP INSTRU IONS:
I 1 O
1 1 FeLV
( ► Chlamydia 9; HOSPITAL CARE I'
Professional Service's
1 1
Day Care / f i
3. PROFESSIONAL SERVICES ( ► Hospital Room&Board O
( ► Anal Glands days @ per day
1 1 Catheterization days @ per day
( ► Deworming O Intensive Care
O E&D days @ per day
( ► Ear Treatment 10. BOARDING
O Fluid Therapy O days @ per day
O Fox Tail 114l ( )
/j>°lwwions ( )
✓O Nall Trim 11. PHARMACY(Non-Taxable)
( ► Splints&Dressings O Prescriptions i
O Transfusion ( ►
11 11 '
4. LABORATORY 12. GROOMING
( ) Biopsy ( ) Bath&Dip
;>dulgod Chemistry ( ► Medical Grooming ( ► Request Stool/Urine Sample
( ► CBC ( ► 1 1 To Return For Further Vacc.in C
( ) Culture/Sens Bacterial ( ) ( 1 To Return For Progress Check in C
( ► Cytology 13. DIETS(Taxable) To Return For Suture Removal in C
( ► Dermatological Scraping ( ) Prescription Diets ( ) Phone Check in Hours C
OEKG O
O Eye Stain ( )
( ► Fecal Direct ( )
( ) Fecal Flotation 14. PRODUCTS(Taxable)
O Fungal Culture ( j
O Heartworm ( ►
O Pathology ( )
( ) Urinalysis ( ) DISNEY PET HOSPITAL
1 1 15. SALES TAX LAWRENCE ROTHE,D.V.M.
l ► ( ) 3554 CONCORD BLVD.
5. ANESTHESIA J 1 1 CONCORD,CA 94519
,t>Ogdation � (415)689-4244
( ► Local
1 1 General c
11
O TOTALCHARGES S
• SENDER: Complete items 1 and 2 when additional services are desired wand complete,Items
3 and 4. r = r
t,+, qtr7q
Put your address in the"RETURN TO" Space on the reverse side:,Failure to do this tvlll prevent Phis card 2
from being returned to you.The return recei t fee will provide ou the.name of the erson delivered to and:
the date of deliver . For ad -tions ees the tollowing services are•aval a e: onsu t;postmaster or ees €
and checkbox(es) or additional service(s)requested. , , ,
1. ❑ Show to Whom delivered, date, and addressee's address f 2. . Restncled Delivery
(Erma charge) (Extra charge), i"-) rf E'
3. Article Addressed to: 4EAfeirr "
a � f
ype of s Ice s
❑,Re Bred r❑ Insured rs x a!
ertified ❑ COD
❑ Express IVjall i t❑ Retum.Recei t 3 )'
M,,.for Merch6 ise'rr4�jt.
Always obtain signature of addressee f.�:�s ;
or agent and DATEDATE DELIVERED;`rxa 5.r tI
5. Signature — Addressee 8 Addressees Addfess (ONLYi
,requested and jee piud) tt
44 Pr
6. ig re A
a e f Deliv ry
t 1 ^+i k 9 At s.kz.. i t
PS Form 3811, Apr. 1989 •U.S.G.RO.1989-238-915 f +R ,�c, , DOMESTIC RETURN RECEIii
f
' CLAIM /
- . s BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
• Against the County, or District governed by) BOARD ACTION
�Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT FEBRUARY 5, 1991
Zand Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: Unspecified Section 913 and 915.4. Please note all "Warnings%�CFIVE®
CLAIMANT: PACIFIC GAS AND ELECTRIC•:°COMPANY JAN 14 1001
ATTORNEY: Iathan T. Armand COUNTY COUNSELMARTINEZ, MIK
Attorney -at Law Date received
ADDRESS: P.O. Box 7442 BY DELIVERY TO CLERK ON January 10, 1991 (Via P.O. Box)
San Francisco, CA 94120
BY MAIL POSTMARKED:
I. FROM: Clerk of the Board of Supervisors T0: County Counsel
Attached is a copy of the above-noted claim. .
PPHHIL BATCHELOR, Clerk
DATED: January 14, 1991 BY: Deputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
a ) 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 ICS `il BY: ' ) . Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3):
IV. BOARD ORDER: By unanimous vote of the Supervisors present
( his Claim is rejected in full.
( ) Other:
I certify that this is .a true and correct copy of the. Board's Order entered in its minutes for
this date. A
Dated: FEB
L B 5 1991 PHIL BATCHELOR, Clerk, Deputy Clerk
WARNING (Gov. code s on 913)
Subject to certain exceptions, you.have only six (6) months from the date this notice was personally served or
deposited in the mail to file a court action on this claim. See Government Code Section 945.6.•
You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult
an attorney, you should do so immediately.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
United States, over age 18; and that today I deposited in the' United States Postal Service in Martinez,
California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown1above.
Dated: F E B 8 1991 BY: PHIL BATCHELOR Deputy Clerk
CC: County Counsel County.Administrator
RECEIVED
JAN 1 01991
✓I '�' CLAIM FOR DAMAGES
CUMK s Ur sup 3 DEC
00,
TO: COUNTY OF CONTRA COSTA S . VCOUNTY CLE_
CONTRA WEIRCOSTA COUNT
FROM: PACIFIC GAS AND ELECTRIC COMPANY BY DEPUTY.
Claimaint above-named presents this claim to the County of
Contra Costa pursuant to Government Code Section 910, et seq.
(1) The name and address of the claimant is:
Pacific Gas and Electric Company
77 Beale Street
San Francisco, CA 94106
(2) The name and address to which claimant desires notice
of this claim to be sent is:
Iathan T. Annand
Attorney at Law
P. O. Box 7442
San Francisco, CA 94120
(3) The date, place and other circumstances of the
occurrence or transaction which give rise to this claim are:
As set. forth in the attached complaint which has been
served on claimant and is attached as Exhibit A and incorporated
herein by reference.
(4) A general description of the indebtedness, obligation,
injury, damage or loss incurred so far as it may be known at the
time of this claim is:
As set forth in Exhibit A, attached hereto.
(5) The name or names of the public employee or employees ,
causing the injury, damage or. loss is not known to claimant at
this time.
(6) The amount claimed is as set forth in Exhibit A, .
attached hereto.
DATED: December 28, 199
By:
L,'�
IATHAN T. ANNAND
Attorneys for Defendant
PACIFIC GAS AND ELECTRIC COMPANY
ATTORNEY OR PARTY WITHOUT ATTORNEY(NAME AND ADDRESS): TELEPHONE: FOR COURT USE ONLY
t LAW OFFICES OF STANLEY J. BELL (415) 391-3700 '
A Professional Corporation
Two Transamerica Center, 505 Sansome St. , 18th Floor
San Francisco, California 94111
ATTORNEY FOR(NAMEY Plaintiff(s)
Insert name of court,judicial district or branch court,if any,and post office and street address: 0 a
SUPERIOR COURT OF CALIFORNIA
COUNTY OF CONTRA COSTA NOV 1 5 ISMO
Contra Costa County Courthouse, P.O. Boz 911
Martinez, California 94553 srP=:-NL '�`>> -cc c?L='�
�N
PLAINTIFF: Ci;:Tar COSTA C'C�
'? I,..*.:ARVIN,D pL-y
CARL R. GUSTAFSON and JOANNE C. GUSTAFSON
DEFENDANT: ecw
See Attachment for List of Defendants' PLT,4P. pv�
DUE: ra — 3
®DOES 1 TO 6 0
'stated: computed•
CASENUMBER .
COMPLAINT—Personal Injury, Property Damage, Wrongful Death
®MOTOR VEHICLE [XOTHER(speci/y): Premises Liability
QProperty Damage Qj Wrongful Death $ 0
®Personal Injury Q Other Damages(specify):
1. This pleading, including attachments and exhibits, consists of the following number of pages: Nine
2. a. Each plaintiff named above is a competent adult --�--r
Q Except plaintiff(name): NOTICE: -- 1�— �r-•:
Q a corporation qualified to do business in California THS CASE IS ASSIGNED TO DEPT. '
Q an unincorporated entity(describe): A,`140 COMIES UNDER GOVERNMEN CODE 68600
=a public entity(describe): (LOCAL RULE 5)
=a minor an adult
[� for whom a guardian or conservator of the estate or a guardian ad litem has been appointed
Q other(specify):
[]other(specify):
Q]Except plaintiff(name):
=a corporation qualified to do business in California
=an unincorporated entity(describe):
Qa public entity(describe):
Qa minor =an adult
Q for whom a guardian-or conservator of the estate or a guardian ad litem has been appointed
Q other(specify):
other(specify):
b. Q Plaintiff(name).
is doing business under the fictitious name of(specify):
and has complied with the fictitious business name laws
c. Q' Information about additional plaintiffs who are not competent adults is shown in Complaint—
Attachment 2c.
(Continued)
Form Approved by the
Judicial Council of California COMPLAINT—Personal Injury, PropertyDamage,
Effective January 1.1982 g
Rule 982.1(1) Wrongful Death CCP 425.12
SHORT TITLE: CASE NUMBER
GUSTAFSONNv. CONTRA COSTA, et al. ,
COMPLAINT-Personal Injury, Property Damage,Wrongful Death Page two
3. a. Each defendant named above is a natural person "
® Except defendant(name): ISL—]Except defendant(name):
COUNTY OF CONTRA COSTA PACIFIC GAS AND ELECTRIC COMPANY
Q a business organization, form unknown Q a business organization, form unknown
Q a corporation [X]a corporation
[D an unincorporated entity(describe): Q an unincorporated entity(describe):
a public entity(describe): Political Q a public entity(describe):
subdivision of the State" of
= other(specify): California , O other(specify):
® Except defendant(name): Q Except defendant(name):
PACIFIC BELL
Q a business organization, form unknown =a business organization,form unknown
Ci a corporation =a corporation
Q an unincorporated entity(describe): . Q an unincorporated entity(describe):
Q a public entity(describe):- Q a public entity(describe):
Q other(specify): Q other(specify):
b. The true names and capacities of defendants sued as Does are unknown to plaintiff.
C. Q Information about additional defendants who are not natural persons is contained in Complaint—
Attachment 3c.
d. Q Defendants who are joined pursuant to Code of Civil Procedure section 382 are(names):
4. Plaintiff is required to comply with a claims statute, and
a. plaintiff has complied with applicable claims statutes, or
b. jQ plaintiff is excused from complying because(specify):
5.:This court is the proper court because
Q at least one defendant now resides in its jurisdictional area.
Q the principal place of business of a corporation or unincorporated association is in its jurisdictional area.
injury to person or damage to personal property occurred in its jurisdictional area.
Q other(specify)
6. Q The following paragraphs of this complaint are alleged on information and belief(specify paragraph numbers):
(Continued) Paye two
GUASTAFSON v. CONTRA COSTA, et al. , Page Three
ATTACHMENT FOR LIST OF DEFENDANTS
COUNTY OF CONTRA COSTA, a political subdivision of the State of
California; PACIFIC GAS AND ELECTRIC COMPANY, a cororation;
PACIFIC BELL, a corporation; FRED STORNETTA, SR. , individually
.and doing business as Stornetta Enterprises; FRED STORNETTA,
JR. , individually and doing business as Stornetta Enterprises;
EVELYN STORNETTA, individually and doing business as Stornetta
Enterprises; JAMIE A. WEATHERBY
SHORT TITLE: CASE NUMBER:
GUSTAFSON v. CONTRA COSTA, et al. ;
COMPLAINT—Personal Injury,Property Damage,Wrongful Death(Continued) Page Four
7. Q The damages claimed for wrongful death and the relationships of plaintiff to.the deceased are
0 listed in Complaint—Attachment 7 Q as follows:
S. Plaintiff has suffered Each Plaintiff
®wage loss Q loss of use of property
®hospital and medical expenses ®general damage
r--1 property damage ®loss of earning capacity
FC]other damage(specify):
Plaintiff JOANNE C. GUSTAFSON has suffered general damages as the result
of the loss of consortium of her husband, plaintiff CARL R. GUSTAFSON.
9. Relief sought in this complaint is within the jurisdiction of this court. ,
10. PLAINTIFF PRAYS - Each Plaintiff
For judgment for costs of suit;for such relief as is fair,just, and equitable;and for
compensatory damages
(Superior Court)according to proof.
Q(Municipal and Justice Court)in the amount of$
Q other(specify):
11. The following causes of action are attached and the statements above apply to each: (Each complaint must have
one or morecauseso1 action attached.)
�J Motor Vehicle
Q General Negligence
Q Intentional Tort .
Q Products Liability
�]Premises Liability
Q Other(specify).
STANLEY J. BELL
(Type or pint name) (5 na f ntifl r y)
COMPLAINT—Personal Injury,Property Damage, Page three
Q.d.ORO Vl%fn,•,4% Wrongful Death(Continued) CCP 425.12
SHORT,TITLE: CASE NUMBER
FIIRSM CAUSE OF ACTION—Premises Liability Pag ive
(number)
ATTACHMENT TO Complaint Q Cross-Complaint
(Use a separate cause of action form for each cause of action.)
Prem.L-1. Plaintiff(name): CARL R. GUSTAFSON
alleges the acts of defendants were the legal(proximate)cause of damages to plaintiff.
On (date): March 27, 1990 plaintiff was injured on the following premises in the following
fashion(description of premises and circumstances of injury):
Marsh Creek Road, west of Deer Valley Road, County of Contra Costa,
State of California: -
See
alifornia:See Attachment to Premises Liability L-1.
Prem.L-2. Count One—Negligence The defendants who negligently owned. maintained, managed and operated
the described premises were(names):
COUNTY OF CONTRA COSTA; PACIFIC GAS AND ELECTRIC COMPANY;
PACIFIC BELL;
Does__._.1 to _35
-
Prem.L-3. Q Count Two—Willful Failure to Warn [Civil Code section 846] The defendant owners who willfully
or maliciously failed to guard or warn against a dangerous condition, use, structure, or activity were
(names):
Q Does to
Plaintiff, a recreational user, was =an invited guest Qa paying guest.
Prem.L4. r_X-1 Count Three—Dangerous Condition of Public Property The defendants who owned public property
- on which a dangerous condition existed were(names):
COUNTY OF CONTRA COSTA;
0' Does 1 to 35
a. The defendant public entity had ®actual ®constructive notice of the existence of the
dangerous condition in sufficient time prior to the injury to have corrected it.
b. M The condition was created by employees of the defendant public entity.
Prem.L-5. a. PM Allegations about Other Defendants The defendants who were the agents and employees of the
other defendants and acted within the scope of the agency were(names):
®Does 1 to 35 .
b. The defendants who are liable to plaintiffs for other reasons and the reasons,for tge'rJiapilit are
® described in attachment Prem.L-5.b as follows(names): P1 a int i f is y informed
and beeves, and thereon alleges that each of the fictitiously
named defendants, DOES 1 to 35, is negligently responsible in some
manner for the occurrences herein alleged, and plaintiff 's damages,
''" ' Fgpin. a-lleged, we-ap rosimately caused by their rnnAiir f-
Form ADprovetl Dytne
Judicial Council of California
EflectRule 982.1(5) 1982 CAUSE OF ACTION—Premises Liability - CCP 425.12
GUSTAFSON v. CONTRA COSTA, et al. , Page Six
ATTACHMENT TO PREMISES LIABILITY L-1.
That at said time and place, as aforesaid, defendants, and
each of them, negligently and carelessly controlled,
supervised, designed, constructed, altered, . repaired, owned,
maintained, operated and entrusted the aforementioned roadway
so . as to proximately cause and permit said roadway, shoulders
and turn-out of said roadway to be in a dangerous, defective
and unsafe condition in that there were sharp and dangerous
curves in said roadway and that defendants, and each of them,
failed to post warning signs or other proper control devices to
warn oncoming motorists of said sharp and dangerous curves; and
further in that a shoulder, and/or turn-out of said roadway was
allowed to exist in the area of said sharp and dangerous
curves; and. further in that defendants, and each of them,
allowed obstacles, including but not limited . to telephone
and/or power poles to exist in close proximity to the roadway,
shoulder and/or turn-out, thereby creating a foreseeable risk
that motorists may strike said telephone and/or power poles
while taking evasive action to avoid collisions; that in all
respects the unsafe conditions as stated above constituted a
trap for vehicular traffic using said roadway; that defendants,
and each of them, were further negligent and careless in that
they knew, or in the exercise of ordinary care should have
known, of the dangerous condition of said roadway and the risk
of. injury created by same, and failed to remedy said
conditions, having a reasonable opportunity to do so; that as a
direct and proximate result of the negligence and carelessness
of defendants, and as a further direct and proximate result of
the dangerous and 'defective condition of public property,. as
aforesaid, . .while plaintiff was traveling westbound on said
roadway, a semi-truck operated by Jamie A. Weatherby was caused
to travel into the lane .in which plaintiff was driving, thereby
causing plaintiff to take evasive action to avoid striking the
semi-truck, causing plaintiff to strike a telephone and/or
power pole, and further causing him to sustain severe personal
injuries.
SHORT TITLE: CASE NUMBER:
GUSTAFSON v. CONTRA COSTA, et al. ,
SECOND CAUSE OF ACTION—Motor Vehicle Page Seven
(number)
ATTACHMENT TO MComplaint (Cross-Complaint
(Use a separate cause of action form for each cause of action.)
Plaintiff(name):
CARL R. GUSTAFSON
MV-1. Plaintiff alleges the acts of defendants were negligent; the acts were the legal (proximate) cause of injuries
and damages to plaintiff;the acts occurred
on at (date): March 27, 1990
at(
Marsh Creek Road, west of Deer Valley Road
County of Contra Costa
State of California
MV-2. DEFENDANTS
a. M The defendants who operated a motor vehicle are(names):
JAMIE A. WEATHERBY;
®Does 36 to 60
b. ®The defendants who employed the persons who operated a motor vehicle in the course of their employment
are(names): FRED STORNETTA, SR. , ind/dba Stornetta Enterprises; FRED
STORNETTA, JR. , ind/dba Stornetta Enterprises; EVELYN STORNETTA, ind/dba
Stornetta Enterprises;
j Does 36 to . 60
c. [T)The defendants who owned the motor vehicle which was operated with their permission are(names):
FRED STORNETTA, SR. , ind/dba Stornetta Enterprises; FRED STORNETTA, JR. , ind/dba
Stornetta Enterprises; EVELYN STORNETTA, ind/dba Stornetta Enterprises; .
] Does 3 6 to 6 0
d. The defendants who entrusted the motor vehicle are(names): FRED STORNETTA, SR. , ind/dba
Stornetta Enterprises;. FRED STORNETTA, JR. , ind/dba Stornetta Enterprises;
EVELYN STORNETTA, ind/dba Stornetta Enterprises;
Does 3r—to 6Q
e. a]The defendants who were the agents and employees of the other defendants and acted within the scope
of the agency were(names):
JAMIE A. WEATHERBY;
FX Does 36 to 60
f. rX-]The defendants who are liable to plaintiffs for other reasons and the reasons for the liability are .
=listed in Attachment MV-2f ®as follows:
Plaintiff is informed and believes, and thereon alleges that each of
the fictitiously named defendants, DOES 36 to 60, is negligently
responsible in some manner for . the occurrences herein alleged, and
plaintiff 's damages, as herein alleged, were proximately caused by
their conduct.
®Does 36 to 60
Form Approved by the
Judicial Council of California
Effective January 1,1982
- Rule 982.1(2) CAUSE OF ACTION—Motor Vehicle CCP 425.12
SHORT TITLE: CASE NUMBER:
GUSTAFSON v. CONTRA COSTA, et al. ,
THIRD CAUSE OF ACTION—General Negligence Eight
(number)
ATTACHMENT TO ®Complaint MCross-Complaint
(Use a separate cause of action form for each cause of action.)
GN-t. Plaintiff(name): JOANNE C. GUSTAFSON
alleges that defendant(name): COUNTY OF CONTRA COSTA, PACIFIC GAS AND ELECTRIC
COMPANY; PACIFIC BELL, and .each of them, by and through their agents, servants and
employees, who at all times herein mentioned, were acting within the course and
scope of their said agency and employment;
®Does 1 to 35
was the legal (proximate) cause of damages to plaintiff. By the following acts or omissions to act, defendant
negligently caused the damage to plaintiff
on(date): March 27, 1990
at(place): Marsh. Creek Road, west of Deer Valley Road
County of Contra Costa, State of California
(description of reasons for liability):
1. Plaintiff refers .to all of the allegations contained in the
First Cause of Action and by such reference incorporates the same
herein .as though fully realleged and set forth herein in detail.
2. That at all times herein mentioned, plaintiff JOANNE C.
GUSTAFSON was and is the wife of plaintiff CARL R. GUSTAFSON.
3 . That as a direct and proximate result of the negligence and
carelessness of defendants, and each of them, as aforesaid,
plaintiff JOANNE C. GUSTAFSON has been deprived of the consortium,
conjugal society, comfort, affection, companionship, moral and
emotional support of her said husband, and continue to be deprived
thereof for an indefinite time in the future, all to his general
damage in an amount in excess of the jurisdictional minimum of the
Superior Court.
Form Approved by the
Judicial Council of California
Effective
Ru a 982.1(3)January 1982 CAUSE OF ACTION—General Negligence CCP 425.12
SHORT TITLE: CASE NUMBER:
GUSTAFSON v. CONTRA COSTA et al.
FOURTH CAUSE OF ACTION—General Negligence Page Nine
(number)
ATTACHMENT TO ®Complaint r7Cross•Complaint .
(Use a separate cause of action form for each cause of action.)
GN-1 Plaintiff(name): JOANNE C. GUSTAFSON
alleges that defendant(name): FRED STORNETTA, SR. , ind/dba STornetta Enterprises
FRED STORNETTA, JR. , ind/dba Stornetta Enterprises; EVELYN STORNETTA, ind/dba
Stornetta Enterprises, and JAMIE A. WEATHERBY, and each of them, by and through
their agents, servants and employees, who at all times herein mentioned, were
acting wtihin the course and scope of their said agency and employment;
®Does fib--to 6 0
was the legal (proximate) cause of damages to plaintiff. By the following acts 'or omissions to act, defendant
negligently caused the damage to plaintiff
on(date): March 27, 1990
at(place): Marsh Creek Road, west of Deer Valley Road
County of Contra Costa, State of California
(description of reasons for liability):
1. Plaintiff refers to all of the allegations contained in the
Second Cause of Action and by such reference incorporates the same
herein as though fully realleged and set forth herein in detail.
2. That -at all times herein mentioned,' plaintiff JOANNE C.
GUSTAFSON was and is the wife of plaintiff CARL R. GUSTAFSON.
3 . That as a direct and proximate result of the negligence and
carelessness of defendants, and each of them, as aforesaid,.
plaintiff JOANNE C. GUSTAFSON has been deprived .of the consortium,
conjugal society, comfort, affection, companionship, moral and
emotional support of her said husband, and continue to be deprived
thereof for an indefinite ' 'time in the future, all to his general
damage in an amount in excess of the jurisdictional minimum of the '
Superior .Court.
Form Approved by the
Judicial Council of California
Effective
Ru a 98213)'1982 CAUSE OF ACTION—General Negligence CCP 425.12
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 FEBRUARY, 5, 1991
and Board Action. A1.1 Section references are to ) The copy of this document'mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV.below), given pursuant to Government Code
Amount: $150-.00 Section 913 and 915.4. Please note all "WarnAWgVED.
CLAIMANT: BROWN, Gregory C. JAN 14 1991
F Dorm, Bunk #26
ATTORNEY: 12000 Marsh Creek Road COUNTY COUNSEL
Clayton,' CA 94517 Date received N1AP.TEc1E3; CALIF.
ADDRESS: BY DELIVERY.TO CLERK ON January 10, 1991 (via P.O. Box).
BY MAIL POSTMARKED: December 31, 1990
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a,copy of the above-noted claim.
DATED: Januar 14 1991 PPHHIL BATCHELOR, Cle"rk
y BY: Deputy
II.. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantia,lly. 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) BY: .I Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOY) This
ER: By- unanimous vote of.the Supervisors present
( Claim is refected in full.
( ) . Other:
I certify that this is a 'true and correct copy of the Board's Order entered in its minutes for
this date. cl
Dated:—FEB 5 1991 PHIL'BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code sects 13)
Subject to certain exceptions, you have only six (6) months from the date .this notice was personally served or
deposited in the mail to file a court action on this claim. See Government Code Section 945.6.
You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult
an attorney, you should do so immediately,
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the
.United States, over age '18; and that today'l 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: FEB 8 1991 BY: PHIL BATCHELOR b Deputy Clerk
CC: County Counsel County Administrator
,
►7
LOST PROPERTY CLAIM =
Return original application to: Clerk of the Board
PO Box 911 -
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 must be p.resented: 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 it's,
office in Room i06;. Cdunty 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 d .strict 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 - 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 of officer, authorized to allow :or pay the same if
genuine, any false of fradulent claim, .bi.11, account, voucher, or writing,
is guilty of a felony. "
" n�-�•-/L.JC iC n-•/=,-�..0 J.J.J..I.J J J.J J-J J.J-J.J.J J.J-.I.J.J , .J.J.J.J.i i�J.J.J.-L J,.t,..�J.4 J,. 4/�-�� ✓ J- � �-•.I.•n� .1, 1-L.1.�h_ A
_
RE:.,,, ..Claim By Reserved for Clerk's.:filing stamps .
RECEIVED
Ag ainst the .COUNTY.. OF CONTRA COSTA ''i'` - JAX 1 0 1999
u . VL
.O.
or. a 2 j�).�,` DISTRICT' ' CLERK BOARD OF SUPERVISOPA
.(Fill in name) i CONTRA COSTA CO.
;The undersigned claimant hereby.,,makes claim sgainst the 'County,:. of, ra. Costa or
the :above-named District in the sum of ,$ and in support of:,Ibis claim re
_presents as follows:
l When; did the; damage or .injury occur? (GJ-ve exact.;date 'and hour) .
-
2. Where did the damage or injury occur: ('nclude cit; and, county.)
3. How.;d,id the dama;e or injury occur? (Give full details: use extra sheets
if required.)
1
t. partieul`ar act. or omission on the art oI county district office s,
servants, or employees caused the injury or damage?
c>
hid t�a2e ' t
What are the names or county or district officers, servants, or employees
causing the damage or injury?.
O �' . _� � � �� - d .appp
6. [ at damage or injuries do, you, claim resulted? (Give full extent of injuries f `
or lamages-f�claimed., :Attac tw+ es6ima� or_guto damage.) r�('(�
kin1 . T � C
7.. How was the. amount claimed above computed? (Include 6he est-i ted aunt
of any prospective injury or damage ),14)4 �e }��i 'e5 � ' aid, U
&-Olnct _0_eSQ__ ' ite_ms �1 1
8. Names and addresses of witnesses, doctors, and hospitals:
9. List the-.expenditures you made on account of this .accident or injury:
DATETal AMOUNT -
o1►s q v _U,CC Li��a�
fenio
74,
Govt. Code Sec. 910.2 provides:
"The. claim signed by the claimant
or by some person. -on his behalf,"
SEND NOTICES TO- (Attorney) _
Name and Address of. Attorney y _ •
la nts Signature '
_ w - -
�J�3 � Address
G '
Telephone Number: Telephone Number:
f
1
i
70
ptp ,
ov
4
Ca ti �4 O.
Q
4tv � 0040
1.0
G, o n
Q G
N
Nv N
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
A
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT FEBRUARY 5, 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: $150.00 Section 913 and 915.4. Please note all "WarnwFIVED
CLAIMANT: BROWN, Gregory C. ,JAN 14 1901
F Dorm, Bunk #26
ATTORNEY: 12000 Marsh Creek Road COUNTY COUNSEL
Clayton, CA 94517 Date received MARTINEZ, CALIF
ADDRESS: BY DELIVERY TO CLERK-ON January 10, 1991 (via P.O. Box)
BY MAIL POSTMARKED: December 31, 1990
I. FROM: Clerk of the Board of Supervisors TO: ount—VI IUMIS
Attached is a copy of the above-noted claim. ppH. . gg
DATED: January 14, 1991 B�jIL DeputyLOR, Clerk
I1. FROM: County Counsel TO: Clerk of the Board of Sup rvisors
� ) This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning .of claimant's right to apply for leave 'to present a late claim (Section 911:3).
( ) Other:
Dated: ) 1 I�j /9) BY: I S. Deputy County Counsel
III. FROM: Clerk of the Board. . TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOA•RDDO ER: 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: FEB 5 19911
PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code sects 3)
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: FEB S 1991 BY: PHIL BATCHELOR Deputy Clerk
CC: County Counsel County Administrator
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 FEBRUARY 5, 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: $107..00 Section 913 and 915.4. Please note all "WarnincIRECEIVED
CLAIMANT: THURMAN, Bonnie I Af
905 Estudillo Street d�t@ � �
ATTORNEY: Martinez, CA 94553 ZO NTY COUNSEL
Date received
Z, CALIF.
ADDRESS: BY DELIVERY TO CLERK ON January 10, 1991 (via P.O. Box)
BY MAIL POSTMARKED: December 28, 1990
I. FROM: Clerk of the Board of Supervisors iTO: County Counsel
Attached is a copy of the above-noted claim.
Januar 14 1991 PpHHIL BATCHELOR, Clerk
DATED: y BY: Deputy
11. FROM: County Counsel TO: Clerk of the Board of Supervisors
'(� ) This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially wilth 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: `ll 3Y: ) 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 O R: By unanimous vote of the Supervisors present
( , ) This Claim is rejected inn full .
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this dater.
Dated: FEB B 5 1991 PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code 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 FEBs shown above.
Dated:. E 8 1991 BY: PHIL BATCHELOR b Deputy Clerk
CC: County Counsel County Administrator
e � LOST PROPERT:I CLAIM
Return original application to: Clerk of the Board
PO Box 911
Martinez, CA 94553
A. Claims relating to causes of action for death or forfin�j•}Ary person or
to personal property or growing crops must be presented' , tA.'than
the 100th day after the accrual of the cause of action. Claims relating
t'o any other cause of. action must be presented no lateX thanVine ;+year
after the accrual of the clause of action. (Sec. �1 1'Gove.,lCod')' �
B. Claims must be filed with the Clerk of the Board of Supervisors at it's
office in Room 106, County Administration Building, 651 Pine Street,
Martinez, CA 94553.
C. If claim is against a district governed by the Board ofpervisars,,
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 - Section 72'of the Penal Code provide--
"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 o.r officer, authorized to allow or pay the same if
genuine, any false of fradulent claim, bill, account, voucher, or writing,
is g6iity of ,a felony. " :,:,...,.,,,..,..: ....».,».
<" ::'c;c';'ckxx�cic:c'<d;'c:<:<ic:c;c•'c:::::'c:c;<:c4c:t:;cdc'c'cdcicic:c:c:..,..'•c>.;c'c:�i< ;;k'c:..:kk'cic..;:4cic:c:c'.c'c<:r:: ;�',ckYkic*�Yx:.t.kk�F
RE: Claim By Reserved for Clerk's.' filing stamps
RECEIVED
- l-�-; JAN 10199
Against the COUNTY OF CON'CRA COSTA ''I - A0.
CLERK BOARD OF SUFE
or _ DISTRICT- CONTRA COSTA CO.
(TEI-1 -
( ll in name)
The undersigned claimant hereby makes cla* against the County of Contra Costa or
the above-named District in the sum of $7/6�, — and in support of this claim re
resents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
--•-______�-�-- -2- _fid _���___�--�-�-s-,►,��,_�..�� - . _
:. Where did the damage or injury occur: (Include city and county.)
J. liow did the dama;efo .injury occur? (Give ful details; use extra sheets
if required. )
4. What particular act or owl si4 ocr the part ''a county or strict offic . s,
servants, or employees caused the injury or damage?
5,. What are the names or county or district officers , servants, or~ emplo, 4'
causing the damage of 'injury..
b. �gnac damage or injuries do you claim re ulted? (Give full,. extent of injuries ._
or damages claimed. Attach two estimates for 'auto-'damage.,)
How 4.'.^.'= the al tja i c'4a,sled ac, .4p ci>mptltLO �itO U, uric •...L1. QXCL� :i,
of any Dr—upctl it1_i.ury nr. damage.)'
�e•
games and addresses of witn-2sscs, (IOL,'-,)rs, ai.d hospytals:
9 YList the expenditures you made on account of this accident or injury: -
DATE
njury: -
DATE _ ITEIt AMOUNT �
Q- �v o- l la',_
1�26
Govt. Code SeL 910. 2 provides:
"The, claim sii;ned by ,the claimant
x or by some person on• his behal`l."
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CLAIM
BOARD OF SUPERVISORS OF.CONTRA COSTA COUNTY, CALIFORNIA
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT FEBRUARY 5, 1991
and Board Action. A1.1 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: Undetermined Section 913 and 915.4. Please note all "Warnings"
CLAIMANT: WEBER, John L.
2885 Willow Road #6 JAN 14 1991
ATTORNEY: San Pablo, CA 94806
Date received COUNTY COUNSEL
ADDRESS: BY DELIVERY TO CLERK ON January 7, 1991 T(handd 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: January 11, 1991 gyIL BeT�tX_ ClerV,
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
�(,•i ) 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
III. FROM: Clerk of the. Board TO: County Counsel (1) County Adminis ator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
( Vf�'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.g
Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code sec 3)
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 claimantasshown above.
Dated: FEB B 8 1991 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
`
RECEIVED
JAN 7 1991
***********
* CLAIM * W LPWMj4
***********
TO: The governing boards of the County of Contra Costa and
the Kensington Community Services District, and to
the Chief of Police of the City of Kensington
PLEASE TAKE NOTICE
`
Pursuant to Sections 910 and 911. 2 of the California Government
Code ( "Government Tort Claims Act" ) , John L. Weber (hereinafter,
the "claimant" ) ' hereby presents the following claim against the
County of Contra Costa, the Kensington Community Services
District, the Police Department of the City of Kensington, and
the public employees named hereafter:
1. Claimant ' s full name and post office address:
John Louis Weber, Jr.
2885 Willow Road 06
San Pablo, California 94806
2. Notices shall be sent to;
John Louis Weber' Jr..
2885 Willow Road #6
San Pablo, California 94806
3. On July 7' 1990, at the approximate hour of 2: 30 a.m. , near
the intersection of Arlmonte Road with Arlington Avenue, in the
City of Kensington, County of Contra Costa, California, claimant
was seized and arrested without warrant or order of commitment or
other legal authority of any kind, by M. Warnock and D. Nevin,
employees of the Kensington Police Department acting within the
course and scope of their official duties, when claimant had not
committed any crime or public offense. Warnock and Nevin accused
claimant of violation of Sections 12021 (a) and 12031 (a) of the
California Penal Code, but in fact the offense had not occurred'
nor did Warnock and Nevin have reason to believe that it had
occurred or that claimant had committed it. Warnock delivered
claimant to the County Detention Facility in Martinez,
where claimant was imprisoned for approximately 12 hours, until
claimant procured his release from custody by posting a cash bail
of three thousand dollars ($3, 000) .
1
'
'
4. As a result of the incident set forth in Paragraph 3 above,
claimant has suffered substantial economic harm, in the form of
lost earnings and otherwise unnecessary expenditures of personal
funds, the wrongful seizure and conversion of his property,
invasion of his privacy, false imprisonment, libel, public
humiliation, and psychological disability, as well as great
mental anguish and emotional distress.
S. Insofar as they are known to claimant at this time, the
public employees causing and contributing to the foregoing
injuries are M. Warnock ' D. Nevin, J. Jermiason' and Janes Bray.
Additional persons ( "DOES" ) , unknown to claimant prior to
discovery, may have been implicated in claimant 's injuries.
6. The amount claimed is greater than ten thousand dollars
($10, 000) v and jurisdiction in any litigation pertinent thereto
would lie in the Superior Court of the State of California, in
and for the County of Contra Costa.
------- �-_-_---------------
Claimant
2
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CLAIM
�. 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 FEBRUARY S ,, 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: $128 . 40 Section 913 and 915.4. Please note 11, "Waxi 9
n s".
CLAIMANT: ZONTEK, Thomas
22 Circle Court JAN 7 1901
ATTORNEY: Richmond, CA 948.01
COUNTY COUNSEL
Date received MARTINEZ, CALIF
ADDRESS: BY DELIVERY TO CLERK ON January 3 , 1991
BY MAIL POSTMARKED: January 2 , 1991
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
Januar 4 1991 ppHHit BATCHELOR, Clerk
DATED: Y BY: Deputy
II. FROM: County Counsel TO: Clerk of the Board ofSuper0sors
This claim complies substantially with Sections 910 and 910.2.
{ ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days. (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: BY: Deputy County Counsel
'F- 1
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
1
(VrThis Claim is rejected in full.
( ) Other:
I
I 'certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date. f
Dated: F E B 5 3991 PHIL BATCHELOR, Clerk, By Deputy Clerk
WARNING (Gov. code s 913) 1
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
p above.
Dated: FEB 8 3993 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
r LOST PROPERTY CLAIM
Return original application to: Clerk of the Board
PO Box 911
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 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 it's
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, ,tlre name u:L 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 — 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, e
ward, or village board of officer, authorized to allow or pay the same if
genuine, any false of fradulent claim, bill, account, voucher, or writing, i
is guilty of a felony. " J L J L L L J 1
_ RE: Claim By Reserved for Cle,rk's:.filing stamps
ZA
Cdr, s d e RECEIVE®
yy JAN ' 3 1991
Against the COUNTY OF CONTRA COSTA_
CLERK BOARD OF SUPERVISORS
or DIST RICT
CONTRA COSTA CO. ,
The undersigned claimant hereby makes c_1, st the County of Contra. Costa or
the. above-named District in the sum of $� e nd in'support of this claim re-
presents as follows:
I. When did the damage or. injury occur? . (Give exact. date and hour)
eo
2 Ae re did the da gy e or injuroccur: (Include+-eity and county.)
Dan /~ Ju Iq dr iheZ
3. y Ho did the dama;e or injury occur? (Give full details : use extra sheets
if required.)
�Sr#144
4. What particular act or omission on he part of county r district of icers,
servants, or ployees caused the injury or damage?
acot lwr ,, Slle r1i Ac ron-e r Ce f a
/y� % -c-�J C _" h0 5 A// ��U�`j t hq over -
What are the names or county or district officers,; servants, or' empl.oyees
causing the damage or injury?.
CDU)7Tra_, XOT f� fi P.-; cJ S
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i�" What damage or injuries do you claim resulted? (Give full extent of injuri s
or /damages claimed. Attach two estimates for auto damage.)
How was the amount claimed above computed? (Include the estimated amount
of any prospective injury or damage.)
8. Names and addresses of witnesses, doctors, and hospitals:
°. 9. List the expenditures you made on account of this .accident or injury:
DATE ITal AMOUNT
l0 7
Govt. Code Sec. 910.2 provides:
"The claim signed by the claimant
or by some person on his behalf."
SEND NOTICES TO (Attorney)
Name and Address of Attorney _!
aimants Signature /
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- Address
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