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HomeMy WebLinkAboutMINUTES - 10221991 - 1.26 I 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 October 22, 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: 5,000,.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: CRESSY, Sheri Ryan ATTORNEY: Date received September 26, 1991 ADDRESS: 10 Corte Holganza BY DELIVERY TO CLERK ON Orinda, CA 94563 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. September 27, 1991 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (x) 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: RECEIVE® S v UNS rA INEZ, C4llF F. Dated: BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Couns 1 (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. 0 0� Dated: OCT 2 2 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 No to Claimant, addressed to the claimant as shown above. Dated: OCT 2 3 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed With the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is 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 T–or—M. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVE® Against the County of Contra Costa ) SEP 2 61991 or ) District) CLERK BOARD OF SUPERV SORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim,, against the County of Contra Costa or the above-gamed District in the sum of $ 1�110D,do 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; us���P p�pe f a 20 Dip required) /? /,.Y& 4���" P/ 4,<l ���9 )"VR) AieOWO AiIA /j,�/7/ /1 N1017MIAIV- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? A) A/l §NZb�_ A61991-V&0 ,6�" /7,--- z�XlVoql, (over) 5. - What are the names of county or district officers, servants or employees causing the damage or injury? --- Z --A�- , '�.�-TYST��/ _ 1---------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) _---- �lll __ _---------D/� G- S ------------------- 8. Names and addresses of witnesses, doctors and hospitals. JA ----���1/ET __�P�/Gl/����__fav_�'�l��t/D_���D�✓_�� /���if�-- 9. List the expenditures you made on account of this accident or injury: DA7 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 / Clai is Signat Address Xyz)q , zAf 4�3 Telephone No. Telephone No. Ild' /'/DZZ 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. RRECE6VE® SEP F1991 61991 CLERK BOARD-pF SUP:o.�ORS — — _ CONTRA COSTA NOTICE,,SENTENCE,COMMITMENT FORM 7 ATE sTES CLERK'S DOCKET AND MINU DEFENDANT55Y� SHER 76EP'T.- -D ATE 5�li 7l TIME.- �E3• 3QFli1. ADQRESS lE)`CURT Ht9! GftN?A 11 ` 9��b3DOeDRINDA, CA _ �;5t4__. ROC .1T hSISD PROB _;DEFENSE"ATTORNEY. _H_OVE ED TIME =WAIN CUSTODIAL STATUSARGOT -DATE cSil14!'�t CHARGES. d2 M PC :213tP) 6-20 `PROCEEDINGS COURT DEPUY MINUTES CERTIFIED CORRECT JUDGE P VAN ;`11d(�hHa REPORTER. _ MFAC�LEY. -"-CLERK* JA>rj F,t7GL7E:N N.' COURT ,,_DEPUTY_ _._. ,T RT. JUDGE__ ptL REPORTER D ;CLERK APPLICABLE ENTRIES MARKE AXINSIX 77 7 VZ11 .• , ap C]In Gusto y Deft. not appearing !l Answers true name as,charged ❑ Bench/Arrest Warrant to ssu. Wit y Att PUb..D eputy. Ist Atty. ❑Waives reading of Complaint F'QNo'PTA,Release,ONO Vol App Deputy-Probation:Off, p Handed copy of ComplaintEl Interpreter sworn ❑Handed copy of Discovery Cl'Recalled ❑Filed :QSetAside Q Order Interpreter .❑Defendant duly arraigned [7.Hold Until - Q Deft.;proceeds in PROPER O DL 310 served C3 Warrant to- 'Remain Outstanding `- .0-Referred `0Referred To:PUBLIC DEFENDER ❑Pleads Guilty, Ct.#. Date Time For . `Referred To: PROBATION. ❑>Pleads Not Guilty, Ct# ❑Pre-Plea ❑'Bail Study ❑Restitution E] Pleads No.Contest, Found Guilty, Ct#_ ❑ r ❑'R&S ❑Diversion '❑Supplemental ❑.Jury Trial Waived/DemandedQ: O Rub:Def. Conflict Filed;Appointed `❑Time for Trial/Sent-Waived/Not'Waived Written plea of'Not Guilty/No Contest/ ..❑ ❑,;Report to for booking Guilty Filed, Found Guilty Ct.# ❑ erredto DA Diversion Time for PX 10/60 days C7Waived/Not Waived Q Vacate date of _❑ Admits priors • • . • • 8-Q N action an • . ,Mot io tol r r � C.. . . ,'.. �`tY� ❑.•Bail forfeited and continued 190days';for;Drspo. Q;Argued Submitted 'RSubmitted without argulInent. ❑ Bail forfeiture set aside and reinstated. "Granted ❑Denied EITaken;UnderS bmission, t,�. ❑Upon pmt.of Assessment by .0Grounds: b.rt�T .1L)94 �c O YY1: ❑ Disposition date of` Vacated ❑,Complaint amended on i ce to add Ct# a violation ❑ Bail forfeited and no further proceedings. of section ❑Pursuant to 23103.5 cvc ❑ Bail exonerated C!Excess bail exonerated.. Q,The words feiony,&.feloniously are stricken 8a the word misdemeanor . ❑Summary judgment entered against substituted in its place wherever.it appears in Complaint. in the`amount of$ Bond# , "Deft.:waives arraignment on amended,.complaint (]::Ball.fo apply.to,fine upon aigned'waiver'by D.Civil compromise(PC 1377-78);Deft.discharged. El •••: • . • ❑ Formai,:❑Court Q Probation Revoked.Defendant.found in violation of probation Probation Reinstated/Modlfied::Original termsin :❑ Probation/Diversion:Terminated/Denied full force and effect except as follows; L�Ori incl fine sta ed to:` ❑�;Criminal-Proceedings`Reinstated/Dismissed 9 y pay to ORC in monthly installments. ,Probation Termination-Extended To D;Defendant given rights to Revoc Hg Admits/Denies allegations ❑.Placed on Court'Probation for duration of"term. ❑;Probation'.terminates upon pmt."of fine/Comp of jail sentence •• � W •. � . ❑Pay a fine of$ +:.$ ,P A on;Ct# Be imprisoned `hrs/days/months Pay a.fine of$ '. +.$ P.A.on"Ct# D airs/day/months,xcrediUswspended ❑:In Ileu\of fine be Imprisoned at$ per,day O`Attend ' by :,_p Sentenceao commence voluriteer work wlth CD.Proof shown dismiss Ct-,# ❑,terve consecutive/concurrent with ❑'Per CourUDA`dismiss,:Complaint/Cf# ❑:fNaln Jail. `Marsh Creek':Det Work Furlough recommended Judgment Suspended on Ct# ❑Work Alternative P,,rogram: reporticomplete by {�?Fine/ProofNof work/Adm feedue by . �,,.Q"Sentence::comrxiuted to time'served ' ,�Referred to:CRU for Attorney Fee Costs of$ ❑Commitment to=Issue"C�Electronic Hflme'Detention.Permitted Pay Fine(s,by;or comply,by ; � � i�4� t� �, ., � ❑.Work AltProg in #'� ' •':Count :allowed 1 _ . t 113 Rerilanded to County Jail Batl set$ kCommitted to Custody of She Sheriff of Contra Costa County tiQ Ordered_Released ❑qn own ORw❑Rromiseto Appear filed r ~until sentence is satisfied in fuq .. 4 Y ❑Order to Produce Issued s} � �, - �- gyp '{ f QPenalty Assessment waived i#°fine satisfl>3d m full by Imprisonment. tCl;Def tote Allowed ¢ { : � phone balls � '� ''' �Q � � � ,• "�. �?�, k, x � 7 THE SHERIFF:COMMITMENT(See he 121J PC),:I reby .ify that thwfo4owmg s a true copy of the Entry ot.Judgmenbor Order iridis your authority for the eicewtron ttuxeot d5;.�`-> $ ��GJ SEE OTHER MINUTE PAGES � ... �, �' :,FOR ADDITIONAL:PRO�EEDjNGS -BATED -.- �y� ~:' 'ti ORM'2743�i(6-271 �w� � a °:��: �.`� „"m,. .•> �, �;,„.. a .<< �' �Y ,��(JUDGE-OF TIi€Mi7N1GaP./)L COURT) ..p1iMOrtcc"- _. .<,...r.:,, ._.w `„n . n..3s ._.r ,;v...$". ,ram .. - �•. , 'tom�'z` .,.. �j��'''�Tt,�'`�"';z.,u ��'•"m{ . CLAIM `t BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 22,1991 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:Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: EAST BAY MUNICIPAL UTILITY DISTRICT ATTORNEY: Date received ADDRESS: 2130 Adeline Street BY DELIVERY TO CLERK ON September 27, 1991 Oakland, CA 94607 BY MAIL POSTMARKED: September 20, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: September 27, 1991 ��: Deputy CL 0 1'. P-9 J 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: C Dated: ' �y BY: Deputy County Counsel // rr III. FROM: Clerk of the Board TO: County CounsQl (_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 RECEIVE® (X This Claim is rejected in full. SEP '27 1991 ( ) Other: Cal 1— rn�fi6 MARTINEZ, CALIF. I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. nAMA P Dated: OCT 2 21991 PHIL BATCHELOR, Clerk, ByDeputy 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 Noti a to Claimant, addressed to the claimant as shown above. Dated: OCT 2 3 19Q BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: EBMUD 2130 Adeline Street Oaklaind, California 94607 Re: Claim of East Bay Municipal Utility District i 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 i's otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post ,office address to which the person presenting the claim desires notices to be sent. 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. X 4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ( $10 , 000 ) . if the claim totals less - than ten thousand dollars ( $10, 000 ) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000 ) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court . 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN Co ty Counsel By: / epol y Couyrty Counsel CERTIFICATE OF RVICE BY/MAIL C.C.P. §9 1012 1013a 2015 . 5 • Evi C. 9§ 641 664 My business address is the County. Counsel' s Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, . and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s ) having delivery service by U.S . Mail ) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was , on this day deposited in the U.S . Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. ; Dated: jSeptember 30, 1991 at Martinez, Californ' f cc: Clerk of the Board of Supervisors ( ginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 4 , 910 . 8 ) EAST BAY �� MUNICIPAL UTILITY DISTRICT RE NED� Contra Costa County SEP 2 7 1991 ATTN: County Clerk 725 Court CLERK BOARD OF SUPERVISORS Martinez, CA 94553 C0NTRACOSTA CO- District'File- .._ Date of Incident August 23, 1991 Location 101 Parr Blvd. , Richmond District Property: 1 1/211 service buried during your raising of the road. Damage has occurred to District Property as noted above. The information indicates that the damage is your responsibility; therefore, you will be billed for the repair costs. It is suggested that your insurance agent or company be notified of the claim. If insurance is not carried, please contact our office to arrange for payment. You will receive an invoice in the next 45 days. IF YOU DO NOT AGREE WITH OUR CONCLUSIONS, PLEASE ADVISE IN WRITING WITHIN 30 DAYS. Sincerely, G-� ?�/ Rachel M. Garz Claims Representative (415) 287-0167 Letter dated: September 19, 1991 2130 ADELINE STREET.OAKLAND.CA 94607.(415)835-3000 BOARD OF DIRECTORS SANFORD M.SKAGGS.MARY C.WARREN.HELEN BURKE JOHN M.GIOIA. WALTER R.McLEAN.NANCYJ.NADEL.KENNETH H.SIMMONS { NN N 3m w , cD f z � D m � � D r ® ® ® D rn C> � h r Ar r. 9 • o 1 r 4 40 tS� 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 October 22, 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: $317.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: HASTINGS, Christopher Jon ATTORNEY: SEP M j 1991 Date received ADDRESS: 1201 Cambridge Drive BY DELIVERY TO CLERK ON SeptEgftt W.WSd1991 Lafayette, CA 94549 #WMINU' CALIF. BY MAIL POSTMARKED: September 18, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 25, 1991 PQHHIL BATCHELOR, Clerk DATED: eputy r"YA ot LIU II. FROM: County Counsel TO: Clerk of the Board of Supervisors `(J ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: /2 5 I q� BY: - Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: . By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's 0 e entered in its minutes for this date. Q Dated: OCT 2 2 1991 PHIL BATCHELOR, Clerk, By Deputy Clerk OL 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. (lo Dated: OCT 2 3 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim to: - -. BOARD-OF SUPERVISORS OF'. bom A 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 irijuryito person or to personal property or,growing crops and which' accrue Ion or after" January 1, 1988, must be presented not later than six months after the accrual-of the cause .orf aotion. Claims relating to any other cause of action must be pre ented 'not later than-..one year after-the accrual�,of 'the cause of action. (Govt. Code .$911.2.) Be 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 morethanone 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. *,.* � * *,.*- �: �, *.� � �_::F.�.*• * ,� .e ��;e :*:*•.�; a :E a .e * �t'•e l�. *•* '� -� "e * * ��`e a e e ._ RE: Claim By `yr ) Reserved for Clerk's Pili 'stamp Ct,r•�s�o�.r ��,:. •1�-I'iT5 --� ' L;NE RECEIVED . - ) ` r .. 2 01991 . ".Against the''County of` Contra Costa,' ) . CLERK BOARD OF SUPERVI District) _ CONTRA COSTA CO. Fill in naive )... The undersigned:`clamant here"by makes claim against the County of Contra Costa or the above-named District in the sum of $ 3�-I� ovand in support of this claim represents,.as follows:. MN---N--N•N-NN�N-M M-ANN-NMMYN-M�MNNN- 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)' .. O �• TWI -N�--N--N--NNFMO N�--N-M-..-NDN NN-rN------ 111 3. How did the damage or injury occur? (Give full details; use extra paper, if. required). ;7 e �3a: Q_r . a ed`IJ Qv.:M ?-N�--M--��N---�--N-N-�--NM-�-N- 4.' What particular.,act or:,omission,,on the'�part of-county or 'district officers, servants or employees caused the­injury::or 'damages ' hJ c�` / gco.JeA 1c-F4 C.m U er/ dUAwGr-*L leq-k j%,C-Q_ 'rle- Sri e_1 L.ac s c, I zzxa a ".fc.n` s�•.1c1 G tea , N a C�.w��e" si5w5 �-4eA o_l oq 2n CC�iic�� -!o *a— S,�K.S Crsn��.rV SG.mf hcW¢ f�uJati e.•��(mclu nos o� +L-0- R%xA' 51owi4 -W,!rXi . 40 a SPeeA .Z\,Q 'e.(( WOL_uod .� ve�((ove M 7. 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:auto damage. w�.els iueL , C)P 4 /9e 7. How=was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ' 1= - 'wG s. cmy�.r�^ c V. se� a; _N_______ ------ N--___ ______ S. Names and addresses. of witnesses., doctors and.hospitals: - ________________N____N�____ 9... List the expenditures you made: on account'of this accident or injury: ' ' DATE. ITEM AMOUNT - iF IF 9F * � $ * � � *;� 1F .�F 'iE'1F, * �E �-� �,if �" IF"i6 * * '#•,�F�,IF 1F .� ! �F,#i*_iF '# * .1F IF !F.� Gov. Code-Seca 910:2 provides: T' 'O;' "The claim must be signed .by the claimant . SEND NOTICES T0: (Attorne ) . or -b ,,some person on his behalf." Name and Address of Attorney , 3 .#; Claimant's Signature _ Address) a. � yg Telephone No. a . Telephone No. 7aa6r 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'anq 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. ADDENDUM TO -THE.. CLAIM ;OF C Itis i 5 5 ,- (Print your full n e) ( 1) Do you use the roadway as part f a. daily commute?"'.'. Yes ( X ) No ( ) ( 2) Were you aware that construction would,be commencing on the roadway? Yes ( �O �No ( ) ( 3) Was an alternate route available?`" - Yes ( k ) No ( ) ( 4) Did you read about the impending resurfacing in- the local newspaper? Yes ( ) No (5) Did you see .warning signs •advising '�of -•loose,.gravel • and a - 25 'mile per hour 'adv isory sign? Yes No ( ) ( 6) Did the damage result from .ano_ther:%vehicle,:.exceed n'g the "25"mile per"hour advisory? Yes ( ) No (7) Did a vehicle traveling in theisame direction -sand exceeding the 25 mile per hour advisory sign attempt to pass you? Yes . ( ) No ( 1( ) (8) Did a vehicle coming from the opposite direction cause gravel to be thrown .onto your car? Yes ( ) No ( X ) (9). Was the vehicle located directly in front of you exceeding the speed advisory? �e , ' Yes ( ) No ( �( ) 7, (10) Did ;you, travel-:the., roadway more than. once during the resurfacing,: prior: to the damage sustained to your car? Yes. ( x ) No ( ) ( 11) Did you obtain the identity of the car relating to questions 6 thru. 9? -. L �. Yes ( fit ) No ( ) If yes, please provide identification below: 5 11 r�eo� `ltd�5 Gael PIC&MAAJ ( 12) Please describe in your own words how the gravel caused damage to your vehicle and the angle the gravel was thrown onto the car- along-.with'. the :specific -damaged parts on your vehicle. Z UXL5 Ar1,0,4 laAti nA, )a- for 3lOd. I r� �tCb�� nt nti,,l 'LII.(_. cLg��,ed tbCk.S were— 1 o bb r n,ti� V-VU 4 0&-r ` d - � 0 ( 13) Were you aware that using the road during the chip seal process might result in damage to your car? „ Yes (N• ) No ( k '. I . dedlare that the. above. information is true and correct under. the penalty of .perjury. e moi;• � ? -., .. '. . . _ . .' . . .•^s �^ ': i♦; .- r: ' . .. . . ( Si nature), (Date) v-1 ti l w 4 W N p � ' ° r T Q 6= . moa P � d cc w a O � N � u r 2 � �•a a wNY .o y O _ "omm �iN m E Q 4 tL U i0 Q Y • � � GA N�9 QUO OWN �.2' O y p tf7 d It d o w w ° ,2• O ✓, to G 4 o N V-�Q and �.2 Zr 7:• 'es 31 OS O es W Y � N zs"Qrn US l[1 Nm i N LG�%G 4 <L. -0 c v C6 N ,•- ,r .o p m E p •i6 i�O m„ d dm+'m G W � � O 1w11 N ��N. W r yom9°�6 mL•dN% p.- VO +' 'O Q. 2 ,�j`y �b a 3Nsc'°'�°'s m 2 Y d, d. � ;N c R T"'d a d x u o G'tW U7 NY m Q mdtm9Gtm O(>W 01 Nom 0 N {n %s'l OQW oEyyo mao ro� 60 W p t�; 7 d es 0Jr--J� `at�o yms.omy N ,W N � m ?m cd 15 r Q m s 07- 6 °'ao¢•�4E`°mcm W ,�` �r O J 1 [A Lic 00 . ��j+�Gm N JRmS� Y N ♦ �+, P in l;m Y U•1 co O..NmY GU'm Ay O N d U .. N y�9 � Qom'cdCd Op rw U W Q 6 floe mdIDo.md 2 no W C, W m ,- d mm.mw m comas Qu' w a r O c9 ° t � � o�t�m�a•o°-ao pa x - NZ Q m � � A d NJ o 01 �o EdymNa c�W O��' . w'mo Ym n3aG Nd Q W O an d A U W 4 C 7� 2w�C oa x N l A m m tt Ir r N N U U" t6 p)•N •... ' w ¢ 2 Z� O r @ a„ •.� p 4 Z l\ Q rd w 9 i O t.,�" W �•-q aC� w Z �1 0�3 �\ � W © � U �✓ pda77LUl ('� N E v N Z Y x s ZQ O n tl W W O > NO 4- [t Z N .j 3 A.i4a w.,nn 19 �� VV 3 a' 00, ✓J V v O N .9 oP � L z cr V ° 0 tU d i o WU o ouj F;U�J:Fc�,Qj D� �N � Q� pd `ccs � GC i. V1 Q m c/a o 0 ■ U ■ ■ ■ t 1 r BUTLER-CONTI, INC. DODGE 3434 Mt. Diablo Blvd. Lafayette,Californi SALES AND SERVICE 0 284-4491 DATEOWNER /� APPRAIS ORDER NO. LOCATION OF CAR MAK�i// LE 1W DE�AV MOTOR NO. SERIAL NO. LIC. NO/ �"f MILEAGE CONDITION Symbol FRONT Labor ; Labor Mrs. Parts Symbol LEFT Labor $ Labor Mrs. Parts Symbol RIGHT Labor $ Labor Mrs. Parts Bumper(U) Fender, Frt. Fender, Frt. Bumper(L) Fender Shield Fender Shield Bumper Brkt. Fender Mldg. Fender Mldg. Bumper Gd. Headlamp Headlamp Frt.System _ Headlamp Door Headlamp Door R Sealed Beam Sealed Beam Gross Member. Cowl Cowl Stabilizer Windshield Windshield Wheel Door, Front Door,Front Hub Cap Door Hinge Door Hinge Hub& Drum Door Glass Door Glass Knuckle Vent Glass Vent Glass Knuckle Sup. Door Mldg. Door Mldg. Lr.Cont.Arm Door Handle Door Handle Lr.Cont Shaft Center Post Center Post Up.Cont.Arm Door Rear Door Rear Shock Door Glass Door Glass Spring Door Mldg. Door Mldg. Tie Rod Rocker Panel Rocker Panel Steering Gear Rocker Midg. Rocker Mldg. ~ Steering Wheel Floor Floor Horn Ring Frame Frame Gravel Shield Dog leg Dog leg Park. Light Quar. Panel Quar. Panel Rad.Grille,Ctr. Quar.Mldg. Quar.Mldg. Rad.Grille,Side Quar.Glass Quar.Glass Grill Mldg. Stone Shield Stone Shield REAR MISC. Bumper Inst. Panel Name Plate Bumper Brkt. Front Seat Horn Bumper Gd. Front Seat Adj. Baffle,Side Gravel Shield Trim Baffle,Lower Lower Panel Headlining Baffle,Upper Floor Top Lock Plate,Lr. Trunk Lid Tire % Worn Lock Plate, Up. Trunk Light Tube Hood Top Trunk Handle Battery Hood Hinge Tail Light Paint Hood Mldg. Tail Pipe Undercoat Ornament Gas Tank Rad.Sup. Frame Rad.Core Wheel Anti Freeze Hub&Drum ESTIMATE VOID 30 DAYS AFTER Rad.Hoses Axle Fan Blade Spring DATE Fan Belt Water Pump Motor Mts. RECAPITULATION Clutch linkage Labor Hours. . . . . . . . . . . .at. . . . . . . . . . . . . .$ . . Parts&Material . . . . . . . . . Le Dis e "THIS ESTIMATE, BASED ON OUR INSPECTION, DOES NOT ` INCLUDE ANY ADDITIONAL PARTS OR LABOR THAT MAY BE Sublet&Net Items . . . . . . . . cam.—'"9/ . . . . . . . .$ .{�� . . . . . . . REQUIRED AFTER THE WORK HAS BEEN STARTED, OCCA— Sales Tax. . . . . . . . . . . . . . . . . . . . . . . . . . . . .$ SIONALLY, AFTER WORK HAS BEEN STARTED, DAMAGED OR . BROKEN PARTS ARE FOUND WHICHWERE NOT EVIDENT ON TOTAL $ V/4•r THE FIRST INSPECTION. BECAUSE OF THIS, THE PRICES (NOTE—WE NEVER AUTHORIZE REPAI S) HEREWITH ARE NOT GUARANTEED." 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 October 22, 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 Arr.-)unt: $677.03 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: HUMPHREY, Nancy s= - p>•, ATTORNEY.: SEP � 1 Date received (�yT uNse6e tember 24, 1991 ADDRESS: 435-A 37th Street BY DELIVERY TO 4W�hPlkr'C, ^� p Oakland, CA 94609 BY MAIL POSTMARKED: Hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk DATED: September 25, 1991 �q: Deputy LOk 4 4414 �L II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 12) �r1� BY: Deputy County Counsel —r 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 Ord e entered in its minutes for this date. Dated:—OCT 2 2 1991 PHIL BATCHELOR, Clerk, By L AAAAA A,jQL, 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 Not'ce to Claimant, addressed to .the claimant as shown. above. Dated: 0 CT 2 3 1991 BY: PHIL BATCHELOR by ° Deputy Clerk CC: County Counsel County Administrator .r RECEIVED SEP 2 41991 CLERK BOARD OF SUPERVISORS _CONT_RA_COSTA-Co . -po Doo - --- - - --- -- -- -- ---- - - ---- - --- -- -- - - -�'1,�.-�-►�-e�j,-cit-9�`�S3___.�_�-�---- .- --- - -�--__---- --- --- ------�.-__----------- Ju- of �J - - . - - c a .e- ✓P��- (-e e =--� fl' �a e�(_ cq& — _ a_c_L��.cr�-�aY --- - - - } -- Visble iDam� e u� tatin411635 E �«,. '�1 `1F .$ r: - A. iI.S� F •a .,f d1-. T; y i. i - :.� 1 •� ..� - NAME 1 YEAR _MODEL , ADDRES/S� .� LICENSE NO. � � C _MILEAGE CITY�[�r, -- STATE 4.L/�C ZIP VIN NO. H.PHONE W.PHONE PROD.DATE BODY CODE PAINT TRIM INS.CO. ADDRESS DATE OF LOSS CLAIM N0: ADJUSTER PHONE LIC.NO. FILE NO. D.D. DETAILS OF REPAIR .PARTS INDEX a LABQR HOURS LINE RE RE 4 s :� NO. PAIR PLACE R Repair_ S Sttalghten;, A"-Aftermarket N New PI PARTS ,'r SUBLET/MISC A. /C=Recycle/R<ectjrome/Recore, U_=Used, R_-Rebuilt BQDY PAINT FRAME MECH 1 ;: ,-- 3 4 .$ ?., .,a •a .`x.6 rr-.s 'ven..iT'n'.t af;5.�,f6"i.$. `J'. ...lr i.:_.sc'.. __.�... �._.f.,. ,c......+,. ' i •...,.#:,.. c.?_"-,:.A:^... .iY.i:_,�R �.....__, 9 7 4 13 ,,• grF ii ,.> v x .16 ,,, J? � 4yrL'}-i,�r1•d b£ t)x ;_vt1 .,._c'•. +.i'`Xi #s.' 'd'.,x �sd�.' "'4 .tjr yT t iFB $...t a�.!`� � ""S 17 }, a•., i, s� (r,:"f i t,y:'1.' 7 t 3 i -°,.,k..;_ yt' ?`c., v * r°''t is y h= :. .?Y `,,.5 J` 4 a Y .:..*,y t1 s r ?' .t -,t',; f �+3'e 'r'^t,t _ ..4" 5. 3x w`R �} y- 19 a' U 20 ',.`. ,g =u'?`� ,.G �- -S�n,vrw+;r..n t �;-:--.4'� ti7r� n.='ter'.` swr3 ..sa t^£ rv,F 4.- }�.t•��� -�a.. -Fk.� �'r-'.¢�_T' 't,ti�4,�'t'� t 3 tu.x�xs�$�; . .. 21 s,:, i a i•- eG-1 t . ..:. x n �3i 4- e v-w ,y ,.e3 ?- is t r.n-� -t , a _ '•.. _ _ 'z u.:7 3'. ;c s�.t--1° :m.Y+r.•-•ria :x.X,.•;y. �',_ � A......4,�# a. r_ ce t-: 5, ,.-z.7.u: 23 . ' Win- z,-,•,,. .� -my '�.. r.-.�• F.r,Y 1,S,rz.S.-'4 �, ., :- .. r..� a•r ' 25 24: .. -sav c =...s t `�` `�s+au-La•r�•c•x"�r' ;� 'rt �.r �r a, •*��y5.. �.„t � .�..t - -a-�.� � � c^. �Y• � -4, �::� c� i x 27 OLD PARTS WILL BE DISCARDED UNLESS OTHERWISE INSTRUCTED TOTALS b .SOMETIMES AFTER THE WORK HAS BEEN STARTED,ADDITIONALLY DAMAGED OR.WORN PARTS ARE-DISCOVERED '�; @-'— .WHICH WERE NOT EVIDENT ON FIRST INSPECTION THIS DAMAGE REPORT DOES NOT COVER OR INCLUDE ANY ADDI L BODY hrs. --TIONAL PARTS OR LABOR WHICH,MAYBEREQUIRED.ALL PARTS PRICES ARE SUBJECT TO INVOICE _ _ _ _. B PAIN hrs.@ I hereby authorize the above work and acknowledge receipt of copy. .-......._ __ _._. __._._ .__... _.. .___... .. -- O FRAME hrs.@ Signed X Date R MECH hrs.@ PARTS Prices subject to invoice SUBLET/MISCELLANEOUS Paint Suppa'Zi"l'@Imp '^ Body Supplies—hrs.@ 4960 Pacheco Boukward Towing/Storage Marbnez, Cahfornia 94553 EPA/Waste Disposal Charge — Phone D Phone (415) 372-63999 BODY WORKS SUBTOTAL .............• PERFECTION • Metal • Paint TAX 4115'on$ WRITTEN BY TOTAL ©1988 I/DIE/A inc.Form No.1024 IID/E/A inc.,One I/DIEIA Way,Caldwell,1D 83605-6902•CALL TOLL FREE 1-800-635-9261 1.;2 'CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C1aim;Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT O c t o b e r 22 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your ndtice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915,4. Please note all "Warnings". CLAIMANT: RECEIVEDJENKINS , James and DAHLIN, Kim ATTORNEY: SEP 2 7 1991 Date received COUNTY COUNSEL ADDRESS: 4611-33rd Street BY DELIVERY TO CL 'qDNEZSequitember 27, 1991 San Diego, CA 92116 BY MAIL POSTMARKED: Hand deliverd via Risk Mgmt . I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppFHIIL BATCHELOR, Clerk DATED: September 27, 1991 BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (k) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ^2` BY: / Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (.11y 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 t>4 This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 2 1991 PHIL BATCHELOR, Clerk, By a Deputy Clerk fWARNING (Gov. code section 913) t 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 No a to Claimant, addressed to the claimant as shown above. Dated: 0 BY: PHIL BATCHELOR b IAVNa Deputy Clerk CC: County Counsel County Administrator a � x MUNICIPAL RISK MANAGEMENT INSURANCE AUTHORITY 1407 OAKLAND BOULEVARD • SUITE 200 o WALNUT CREEK, CA 94596 (415) 943-1100 FAX (415) 943-1301 September 17, 1991 Contra Costa County Administrator Risk Management 651 Pine Street, 6th Floor Martinez, CA 94553 Attn: Ron Harvey Liability Claim Officer RE: CLAIMANTS: James Jenkins & Kim Dahlin OUR PRINCIPAL: City of Lafayette DATE OF LOSS: 7/12/91 Dear Mr. Harvey: Enclosed please find A copy of a claim inadvertently given to us for handling. I called Julie Aumock, who informed that this claim had not been presented to your office. Julie also requested that I instruct the City of Lafayette to reject this claim, and I have done so. I have requested that I be sent a copy of the rejection notice for my files. Should you.not receive Notice of Rejection, please let me know, and I will rectify that situation. Should you have any questions, please feel free to contact me.. Sincerely yours, ' WILL VENSKI Liability Claims Adjuster RECEIVED WV:kd SEP 2 7 1991 cc: Sue Jusaitis, City of Lafayette CLERK OARRD OF S a CRViCONTsoRs o LETTER OF TRANSMITTAL TO: CONTRA COSTA COUNTY Date: 8-23-91 MUNICIPAL RISK MANAGEMENT INSURANCE AUTHORITY 1415 Oakland Blvd., Suite 215 Walnut Creek, CA. 94596 Attention: Jake O'Malley FROM: Sue Jusaitis t City of Lafayette REGARDING CLAIMANT: James Jenkins 4611 33rd Street San Diego, CA 92116 WE ARE SENDING YOU XX ORIGINALS PHOTOCOPIES OF: XX NEW CLAIM INTERNAL CLAIMS MEMORANDUIM POLICE REPORT SUMMONS DENIAL LETTER AS REQUESTED OTHER: REMARKS: Incident occurred on 7-12-91, 5:30 a.m. with Lafayette police officer David Pascoe (x-ref Kim Dahlin) COPY TO: Charlie Williams, City Attorney SIGNED: s� PHONE _. NCT=CS C :+Ci1 AGS►=:'STC-== Or (Gone==ent Code ss 910 , 910 . 2) i RETURN :0: City Clerk' s Office CE City o_ Lafayette AUG 2 2 1991 CITY OF LAi—A 'E CLAIMANT' S NAME: James Jenkins CLAI_*4ANT' S ADDRESS: 4611-33 rd. St. I7uaber Street San Diego Ca- 92, 16 6 City State Zip Code NATE' A'N'D ADDR=SS OF PERSON TO WHOM NCTIC=S' Rs'G?_RDZNG Tc7S CLA='� 5"r.Oi; D PE S"Zi T (if different than above) : Same as above DATE OF T -EE ACCIDENT OR OCCU:R SIC::_. 7-12-91 PLACE Or TH-Z ACCIDENT OR. OCCffRcUM CE. Mount Diablo plvd. GEN -R" DESCRIPTION OF . ACCIDENT OR OCCURR_NCR (attach add_t_ona? paces i= more space is needed) : See attached NAA+zS, IF MTOTY-N, Or ANY PUBLIC EMPLOY—l".S CRUS=NG TE: IN.7LR`_' OR LOSS: Poli .eman David R_ Png nap VnH MA,-43l L.'2 _ MUTES AND ADDR SS Or UT_":�MESSLS: NAME James Jenkins , Kim Dahlin, David Pascoe, and unknown officier_ 2-. - NA_?4Z AND ADDRESS OF DOCTORS, ECSr=':ALS tj�R E TREATED: ADDRESS �E02.M 1. See attached . 2 GZNZ2<,L DISC=2T1.0N OF :OSS, =Njuay OR DAM;X See attached. (over) TvTAL AMOUNT CLAIM-ED: SE 50,000,00 - TNF. BASIS OF COMPUTING TEE TOTAL AMOUNT CLAIMED 1S AS FOLLOWS : Damages incurred to date: Estimated at $1 ,000.00, '-ut Medical Expenses : Snot fully determined_ Loss of. Earnings : $Not fully determines and may depend on medical Special damages for: treatment. See attached. copies if available) I/we , the undersigned ,~declare under penalty ofperjury that --!/we have read the foregoing claim for damages and know the contents thereof; that the same is true of my/our own knowledge - and belie ,- save. and excea_t. as to those maters wherein stated. on information and belief, and as to them, 1/we believe it to -be true. --- DAT=: _...8-20-91 James Jenkins - - SIGNATURE OF CLAZMANT(S) Received in City Clerk 's Office this Ozday of *****7e**7C 7P#*******7r###*#yr#zZ=7t###!* 'A''k* FOR C:A:MS PW:,A TED TO ?NJURY TO PERSON OR PERSONAL PROPERTY. TBI a -FORM MUST BE F-TL=- WI TE C=".' Or WiTET-N SIX MONTES ?ROM TEE ACCRUAL OF T=- CAUSE OF ACT=ON. A CLAIM R=. MTZD TO ANY CTEER CAUSE OF ACTION SrE_ALL BE PR SEIv'T� NO :r':'ER T'BAN ON-z YEA_-j ACCRUAL OF CAUSE OF ACTION. -2- ATTACHMENT TO CLAIM On July 12, 1991, at approximately 5: 30 a.m. , JAMES JENKINS and KIM DAHLIN were contacted by Officer DAVID R. PASCOE, Badge No. 43143 , of the Lafayette Police Department. The contact occurred on Mount Diablo Boulevard. Mr. Jenkins, seeing the patrol car approach, stepped out of the Avis rental car, California License 2VYL531, and introduced himself to the officer. Officer Pascoe requested Mr. Jenkins' driver's license and it was promptly produced for him. A moment or two later, the officer heard a call on his police radio and immediately removed his gun from his holster, pointed it within inches of Mr. Jenkins' head and said, "You're under arrest for stealing this car. Spread your legs, put your hands on the trunk, or I ' ll blow your fucking head off. If your partner inside moves, I 'll kill you. " Officer Pascoe then patted Mr. Jenkins down for weapons and was informed by Mr. Jenkins that the car was rented from the Avis Agency at the San Diego Airport and the rental papers were in the glove compartment. Officer Pascoe replied, "Shut the fuck up. " He continued pointing the gun at my head and there was silence for approximately ten minutes until another vehicle approached. The second officer pointed his gun at my head while Officer Pascoe handcuffed me so tightly that the handcuffs were digging into my wrists. I was then put in the back of a patrol car. Officer Pascoe then pulled his gun back out of his holster and pointed it at the head of KIM DAHLIN. Ms. Dahlin was told to spread her legs and then, smiling at his fellow officer, Officer 1 Pascoe told her to put her hands on the trunk. Officer Pascoe then put his gun away, removed his gloves, winked at his fellow officer who continued to aim his gun at the head of Ms. Dahlin, and began a "patdownn search" of Ms. Dahlin. This patdown search was conducted inappropriately. It was obvious to the officer from the clothes Ms. Dahlin was wearing that she could not conceal a weapon. Ms. Dahlin was dressed in black tights. Nevertheless, Officer Pascoe ran his hands over Ms. Dahlin's buttocks, chest, waist, inner thighs and crotch. Ms. Dahlin was then handcuffed behind her back and placed in the patrol car. Officer Pascoe then put on his gloves and proceeded to rummage through the rental vehicle. When Officer Pascoe discovered the paper work with Avis that had earlier been reported by Mr. Jenkins, Officer Pascoe and his colleague appeared to joke and laugh out loud about the situation. The officers reviewed the paper work and apparently called for a supervisor. After waiting approximately 20 more minutes, the supervisor appeared and the three seemed to find the situation humorous. Mr. Jenkins and Ms. Dahlin believed they would be released at that point in time. Instead, Officer Pascoe reported to both that they were being transported to the police station. At the police station, nearly another hour elapsed while Mr. Jenkins and Ms. Dahlin remained handcuffed and in discomfort in the back of the patrol vehicle. Officer Pascoe finally came to the patrol vehicle, informed Mr. Jenkins and Ms. Dahlin that he had made a mistake, the car was not stolen, and stated, "You're free to go. " The handcuffs were 2 removed from Mr. Jenkins and Ms. Dahlin at 7;15 a.m. and each was driven back to the rental vehicle by Officer Pascoe. The conduct and demeanor of Officer Pascoe and his unknown colleague were demeaning, unprofessional, offensive and unnecessary. Mr. Jenkins has been a high school teacher and coach for 12 years. Ms. Dahlin has been employed as a research scientist at the La Jolla Cancer Research Foundation for the past 6 years. Neither party was rude or discourteous to the officer. Neither party offered any resistance. Both parties have suffered emotional distress and anxiety as a result of having a gun pointed at their head. Both have sought professional counseling to assist them in resolving the anxiety, fear and nightmares that they have experienced since the incident. A long awaited vacation trip was ruined and shortened. Avis Rent- A-Car's offices in San Diego where the vehicle had been rented are open 24 hours a day. A simple telephone call could have confirmed the report provided by Mr. Jenkins at the outset. The offensive and intrusive search of Ms. Dahlin would not have been necessary and the parties would not have been painfully handcuffed behind their backs for nearly two years. The conduct of the officers described above has caused each of the claimants to suffer severe emotional distress and anxiety as a result of the confrontation and the fear and humiliation each suffered as a result of the unnecessary and excessive force of Officer Pascoe and his colleague. Claimants each have suffered damages in the sum of $50, 000. 00, together with ongoing medical 3 expense, future medical expense and potential loss of earnings not at this point fully determined. 4 U LETTER OF TRANSMITTAL TO: CONTRA COSTA COUNTY Date: 8-23-91 MUNICIPAL RISK MANAGEMENT INSURANCE AUTHORITY 1415 Oakland Blvd., Suite 215 Walnut Creek, CA. 94596 Attention: Jake O'Malley FROM: Sue Jusai ti s r City of Lafayette �v REGARDING CLAIMANT: Kim Dahlin 4611 33rd Street San Diego, CA 92116 WE ARE SENDING YOU XX ORIGINALS PHOTOCOPIES OF: XX NEW CLAIM INTERNAL CLAIMS MEMORANDUM POLICE REPORT SUMMONS DENIAL LETTER AS REQUESTED OTHER: REMARKS: Incident occurred on 7-12-91, 5:30 a.m. with Lafayette police officer David Pascoe (x-ref James ,t nkia4 COPY TO: Charlie Williams City Attornev SIGNED PHONE # : ��-xv NCTICE C_ *AI 1 AG;.ZNST T.iE C=TY OF CAr.I:CRNIr, (Gove_—=e=t Code ss 910, 1010 .2) i RETURN TO: City Clerk' s Office W-p City of Lafayette AUG y 2 1991 rKim Dahlin CIT' OF I..f�rAYkr41`� CLAIMAN'�' S NAME.. CLAIMANT' S ADDRESS: 4611-33 ra � St Number Street. San Diego Ca. 92116 C4 -Y State Zip Code NAE' AND ADDRESS OF PERSON TO WHOM NOT_TC ES REGARDING TEIS C:,AIM SHOO-NAME' EE SENT (if different than above) : Same as above_ DATE OF THE ACCIDENT OR OCCURRENCE: 7-12-91 PLACE OF TEF. ACCIDENT OR OCCURRENCE: Mount Diablo 'Plvd. GLNMR. AL DESCRIPTION OF "IME ACC=DENT OR OCCURRENCE ( attach additional pages if more space is needed) : See attached. NArt.ES, IrF R:VO«N, OF ANY PUBLIC EMPLOYEES =kUSING THE INJURY OR LOSS : Policeman DaviA RPASCoe Madge i94_314_3 - IU;14ES A11D ADDRESS OF t1ITNESSES: iv IKZ nDLIRE SS 1• Kim Datil ir► Jamec ,TAMkin8 David Pagnnp _ n A:_jMAg;q% 2. NAME AND ADDRESS OF DOCTORS, ECSP'TALS WEERE Ttt ATPD: NMM ADDRESS TE .EPECs._ 1, See attached. 2 . =17MRAL DiSC:,IPTION OF '=..vE LOSS, ZNJUMY OR DAN.AGE SUFFERED: See attached. -1- (over) r" TOTAL AMOUNT cLAnAED: $ 50,000.00 TEE BASIS OF COMPUTING TEE TOTAL AMOUNT CLAIMED 1S AS FOLLOWS : Damages incurred to date: Estimated at $1 ,000.00, rut Medical Expenses: $_not fully determined,, Loss of Earnings: S Not full_- determined and may depend on medical Special damages for: treatment. See attached- (Attach copies if available) I/We , the undersicned , declare under penalty of perjury that !/we have read the- foregoing claim for damages and know the contents thereof; that the same is true of my/our own knowledge and belief, save and except as to those matters wherein stated on information and belief, and as to them, I/we believe it to be true. DATED: 8-20-91 Kim Dahlin - SIGNATURE OF CCLA�j*SA�NT(S) Received in City Clerk 's Office this day of , TU z FOR CLAIMS PWLATED TO INJURY TO PERSON OF. PERSONAL PROPERTY, TE=S FORM MUST BE FILED WITE TEE C?'I'F OF -. WIT= S=X MONTES FROM TEE ACCRUAL OF TEE CCAUSE OF ACTION. A CLAIM R-ELATED TO ANY OTE-ER CAUSE OF ACTION Su LL BE PRESENTED NO Lr TER T EAN ON7E YEAR A.TER ACCRUAL OF CAUSZ OF ACT ION. -2- ATTACHMENT TO CLAIM On July 12 , 1991, at approximately 5:30 a.m. , JAMES JENKINS and KIM DAHLIN were contacted by Officer DAVID R. PASCOE, Badge No. 43143 , of the Lafayette Police Department. The contact occurred on Mount Diablo Boulevard. Mr. Jenkins, seeing the patrol car approach, stepped out of the Avis rental car, California License 2VYL531, and introduced himself to the officer. Officer Pascoe requested Mr. Jenkins' driver's license and it was promptly produced for him. A moment or two later, the officer heard a call on his police radio and immediately removed his gun from his holster, pointed it within inches of Mr. Jenkins ' head and said, "You're under arrest for stealing this car. Spread your legs, put your hands on the trunk, or I 'll blow your fucking head off. If your partner inside moves, I'll kill you. " Officer Pascoe then patted Mr. Jenkins down for weapons and was informed by Mr. Jenkins that the car was rented from the Avis Agency at the San Diego Airport and the rental papers were in the glove compartment. Officer Pascoe replied, "Shut the fuck up. " He continued pointing the gun at my head and there was silence for approximately ten minutes until another vehicle approached. The second officer pointed his gun at my head while Officer Pascoe handcuffed me so tightly that the handcuffs were digging into my wrists. I was then put in the back of a patrol car. Officer Pascoe then pulled his gun back out of his holster and pointed it at the head of KIM DAHLIN. Ms. Dahlin was told to spread her legs and then, smiling at his fellow officer, Officer 1 Pascoe told her to put her hands on the trunk. Officer Pascoe then put his gun away, removed his gloves, winked at his fellow officer who continued to aim his gun at the head of Ms. Dahlin, and began a "patdown search" of Ms. Dahlin. This patdown search was conducted inappropriately. It was obvious to the officer from the clothes Ms. Dahlin was wearing that she could not conceal a weapon. Ms. Dahlin was dressed in black tights. Nevertheless, Officer Pascoe ran his hands over Ms. Dahlin's buttocks, chest, waist, inner thighs and crotch. Ms. Dahlin was then handcuffed behind her back and placed in the patrol car. Officer Pascoe then put on his gloves and proceeded to rummage through the rental *vehicle. When Officer Pascoe discovered the paper work with Avis that had earlier been reported by Mr. Jenkins, Officer Pascoe and his colleague appeared to joke and laugh out loud about the situation. The officers reviewed the paperwork and apparently called for a supervisor. After waiting approximately 20 more minutes, the supervisor appeared and the three seemed to find the situation humorous. Mr. Jenkins and Ms. Dahlin believed they would be released at that point in time. Instead, -Officer Pascoe reported to both that they were being transported to the police station. At the police station, nearly another hour elapsed while Mr. Jenkins and Ms. Dahlin remained handcuffed and in discomfort in the back of the patrol vehicle. Officer Pascoe finally came to the patrol vehicle, informed Mr. Jenkins and Ms: Dahlin that he had made a mistake, the car was not stolen, and stated, "You're free to go. " The handcuffs were 2 removed from Mr. Jenkins and Ms. Dahlin at 7: 15 a.m. and each was driven back to the rental vehicle by Officer Pascoe. The conduct and demeanor of Officer Pascoe and his unknown colleague were demeaning, unprofessional, offensive and unnecessary. Mr. Jenkins has been a high school teacher and coach for 12 years. Ms. Dahlin has been employed as a research scientist at the La Jolla Cancer Research Foundation for the past 6 years. Neither party was rude or discourteous to the officer. Neither party offered any resistance. Both parties have suffered emotional distress and anxiety as a result of having a gun pointed at their head. Both have sought professional counseling to assist them in resolving the anxiety, fear and nightmares that they have experienced since the incident. A long awaited vacation trip was ruined and shortened. Avis Rent- A-Car's offices in San Diego where the vehicle had been rented are open 24 hours a day. A simple telephone call could have confirmed the report provided by Mr. Jenkins at the outset. The offensive and intrusive search of Ms. Dahlin would not have been necessary and the parties would not have been painfully handcuffed behind their backs for nearly two years. The conduct of the officers described above has caused each of the claimants to suffer severe emotional distress and anxiety as a result of the confrontation and the fear and humiliation each suffered as a result of the unnecessary and excessive force of Officer Pascoe and his colleague. Claimants each have suffered damages in the sum of $50, 000. 00, together with ongoing medical •3 expense, future medical expense and potential loss of earnings not at this point fully determined. 4 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 October 22, 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 Amou,)t: $20,500.00 approx. Section 913 and 915.4. Please note all "Warnings". R CEIVE® CLAIMANT: ;JOHNSON, Carol Jean SEP 2 5 1991 ATTORNEY: ,Jacqueline Coulter-Peebles, Esq. Attorney at Law Date received ARN$ePt=ieer 23, 1991 ADDRESS: 3718 Mac Donald Avenue BY DELIVERY TO CLERK,ON_ Richmond, CA 94805September 20; 1991 8Y MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppH gg DATED S e,.tembPr ?r,, l Q�ll EY DeputyLOR, ClerkAA 4 d II. FROM: County Counsel TO: Clerk of the Board of Super iR ors �(�! ) This claim complies substantially with Sections 910 and 910.2. /)5 hA9Laare p5 A&-:Z 3JZG�9� Gw� ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, so notifying r claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 2 9I BY: I )_ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present 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. c� qA 00 Dated: ®CT 2 {v 13 . PHIL BATCHELOR, Clerk, By 0Deputy 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 Not' a to Claimant, addressed to the claimant as shown above. Dated: OCT 2 3 1991 BY: PHIL BATCHELOR by 444LDeputy Clerk CC: County Counsel County Administrator COULTER-PEEBLES & WINTOSH 3718 MacDonald Ave. Richmond, California 94805 JACQUELINE COULTER-PEEBLES An Association (415) 237-2613 of LESA R. McINTOSH September 19, 1991 Attorneys at Law (415) 237-2618 FCLER[K ECEIVE Clerk of the Board of Supervisors EP 2 31991 County of Contra Costa ARD(jr SUFERVISORS County Administration Building Room 106 CONTRA COSTA CO. 651 Pine Street Martinez, California 94553 RE: Presentation of Claim--Carol Jean Johnson Dear Madame: Enclosed herein is the claim of Carol Jean Johnson to be presented to the Board for consideration. Your cooperation and prompt attention in these regards will greatly be appreciated. Sincerely, C ), acq eline Coulter-Peebles, Esq. ENCL. P.S. : A copy has also been enclosed to be stamped and returned in the self-addressed envelope enclosed herein. C;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 914553• 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 CAROL JEAN JOHNSON ) FSEP VE® Against the County of Contra Costa ) or 1991 ) DEPT. OF .SOCIAL SERVICES, et alDistrict) CLEFK BOARD UPERVW— Fill .in name ) CONM CMA Co. IjA The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 20,500--a=nx and in support of this claim represents as follows: �s fees & costs . -------------------____N_-____-NN--N___-N-______-____N_-_-_----_-------_____ 1. When did the damage or injury occur? (Give exact date and hour) Commencing 1/1/88 and continued through and including approximately June, 1991 NN_-------- ----�-N_N_ N_M_N_N---�_N-M--N------------.M--------- 2. Where did the damage or injury occur? (Include city and county) Richmond, Contra Costa County, California and Martinez, Contra Costa County, Calif. NN----N--N-_---_N--- 3. How did the damage or injury occur? (Give full details; use extra paper if required)During the period above-referenced, Claimant has either paid directly to or caused the Federal Department of Social Security to pAy directly to the County money that the County wrongfully claimed and demanded. County demanded and claimed it had a right to all of said sums as payment for 'the _care of MARCEL RAY JOHNSON, minor Lla.W 4 �_ -b'b,4_ _ -l�J e412 .��. .�14111�-L 1ST€ �t ..ECQb .tion. 4. What particular act or omission on the part of county or district officers,- servants or employees caused the injury or damage? Either or both the County Dept. of Social Services, Probation Dept. , and/or the County's Auditor-Controller .(or treasurer) demanded that said sums be paid to County for-. and on behalf of the above-referenced minor while the minor was placed outside of laimant's home, under Welfare and Institutions Code Section 602, rather than 300. Then County Dept. of Social Services filed a law suit against Claimant for $62,500.00 dollars; thereafter County caused said suit to be dismissed, (over) after Claimant retained. counsel and defended against the law suit. 5. What are the names of county or district officers, servants or employees causing the damage or injury? Mrs . Fanucci , with the District Attorney Family Support Division--Claimant. is unsure of all the names , titles , and locations of others who caused the claim for $62, 500.00 dollars and- all other sums to be made, and those who calculated and demanded that the approx. $20, 500 dollars be demanded. ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Money paid to the County that was wrongfully demanded and accepted. Attorney' s fees and costs ; ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) The amount was calculated by approximating the monthly amounts paid to the County by the Fed. Social Security Dept . plus the amounts paid directly out-of-pocket„-by Claimant . ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Mrs . Fanucci of the office of the County District Attorney, Family Support; Francine Carley, Deputy District . Attorney. ------------------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Attorney' s fees and costs , according to proof , in defense of the Superior Court action filed against Claimant . Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his be 1f." Name and Address of Attorney JACQUELINE COULTER-PEEBLES, ESQ. Attorney at Law Claimant's S tore 3718 MacDonald Avenue Richmond, California 94805 (510) 237.1-2613 Address Telephone No. Telephone No. �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. Frank Saxen zr� GENERAL INSURANCE NLRANCE AG"2 1500"A"STREET F I R S T F L O O R September 1 9, 1 991 ANTIOCH,CA 94509 (41 5) 754-3600 Public Works Risk Management Dept. 651 Pine St. Martinez, Ca 94553 Attn: Joe Tonda On August 22, 1991 , there was an accident in which a car driven by Debra Case collided with a car owned by Timothy Medzius of 5468 Sandmound Blvd. Oakley, Ca 94561 . As a result of that accident, repairs were necessitated in the amount of $2053.36, as indicated on the enclosed estimate. Please forward this estimate to your insurance company in order to expidite settlement. If -you should find that your insurance does not cover your liability for this damage, I am sure you will arrange for prompt payment of the repairs to Mr. Medzius ' s car. So that I may know what action has been taken, would you please contact our office at your earliest convenience. . SincerejA yours, or Frank Saxen rSEP EIVE® Frank Saxen Insurance Agency 2 7 1991rlsOFSUPERVISORS cc: Mr. Timothy Medzius COS7AC0, d Enclosures: Estimate Byers Auto Body $2008. 36 Towing Charge Casey' s Towing $45. 00 Police Report i � J cc 0 O wrA V 4 � 0 ro o 4 � � OrA � U AU �N 44 440 � N UUU � � t N - O m Q d o CO c Wa. p SO lu r� 0 c �� 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 October 2 2, 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: $2053. 36. Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MEDZIUS, Timothy ATTORNEY: Frank Saxen 'Date received ADDRESS: Frank Saxen Insurance Co . BY DELIVERY TO CLERK ON September 27, 1991 1500 A Street First Floor BY MAIL POSTMARKED: September 20, 1991 Antioch, CA 94509. I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pH. DATED: Sept -member 27, 991 BYTE Deput3LOR _ Clerk o II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ~ BY: / Deputy County Counsel III. FROM: Clerk of the Board TO: County ug� Col (1) County Administrator (2) ( ) Claim was returned as untimely with notice to clajmant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present RECEIVE® DQ This Claim is rejected in full. SE P N 7 1991 ( ) Other: COUNTY COUNSEL I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. q Dated:_0 CT 21 1� g PHIL BATCHELOR, Clerk, By immo 41 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 andNot'ce to Claimant, addressed to the claimant as shown above., Dated: OCT 2 3 1991 BY; PHIL BATCHELOR by0 Deputy Clerk CC: County Counsel County Administrator BTATEDPC SEP9319- 91 ' RAFFIC=CQ .IS10 REPOR _ _. , q • or S►tCIALEONDITION • UMttll Nrtwllll►/ CITY ' _ �tIbHD1AL B�PORT NIRIBSR .-s IRI m HIT SRUN COUNTY REPORTING BEAT • ��� '�' O 5 EAT01MIM URREDON DAY YEAH TIME(1100) NCK:1 OFFICIA L Q. os__ _ ----��-------ATION WYOPWEEK TOW AWAY HOTOOM/1q Or: SMT S attNo u /JECTHkI wm1 STATE HAFT ML. ETI E, ❑Yp No NONE L: PARTY onva"NCENaENUMtER STATS CZ10 SAFETY VIK MAN MAKEIMOOtLICOLOIt iNEE NUMNIN STATES 1 E DRIVER NAM Ag E n .MIDDL J - t HAY nsi5 PEDES• TEAT MOMESS OWNER'S NAME SAME M DRNER THAN fPARKED mw& A ) ch?-h wry WE LE pTrr A rEV t-p O Ao011 EAS DRIVtII 7519 CA s mo/ &&�2 kip CMC'Y-T.. BEE HAIR ErEE HmW WRIGHT BIR p1oYAT1 RACE 00-11T1ON"'"CLE ON o110EM o► ofncEN PONVER oTNER -71 OTHER HOME PHONE BUSiNE"►MCN[ PRIOR MECHANICAL DEFACTS: NON&A►►ARLM RERR TO NARAATYE❑ . ❑ NCO) O � /�� 3I " CH►USE ONLY DESCRISI VEHICLE DAMMS SNADt N DAMAGED AREA tWURANCS CARRIER VOLK`.Y NUMBER VEHICLS TYPE Arp 00. grM„ m ft% ONSTUNTOft?§G WAr - S►EE1181TAT9 v, v WQ? cvr PoPARTY DRIVER"LHCENSE NUMBIIt CLASS SAFEN VSA VIM MAKE/MOOEDCOL011 E NUMB9R STATE 2 � • r DRIVER NAMEI"*ST,MDDLE,LAST) .77 / t U� .._.... _... . , PEOEt• RISTADONESS OWNER?NAME ('�EAYE AllDRIVEN -q . p vim, {� 3 . .PARKED CM ISTAT91 ZW OWNE117 ADDRESS-} SAMBAS Oman . A l BEE HART EYES /"DONT Wt10M BIRiN 7B BACE OIS►OM110N OF VEMCI.[ON OROEMI OP: •E...1 Q 0111ER•.r.,..: IID DA in-I 1 - X HgtE PHONE womota rIBd1 rECMANCALDEFtK Tk N01N AMARNfT RtIEIITONMMIW[ ( (yon, �, .:-- ❑ CHIP USEMV OtSGSBE YEMICLE 0AMA0E...•`•.-_••.....SIMDEN DAIIAOES AIILA MISYIIANCECARIII[R PONCVIIMNIER. r. NONE MINOR`S n � __ M00. gMAJOR Al• . OP ON STREET 011 NIOHWAr TMVtl P{K jrCH►p PARTY DR alirsu:ENSENUMBER STAT[ CLASS SAPSTV VEK VIM MAKEIM4109LICOLON LJC4XS1 NUMBER STATE n EOIN►. DRIVER NAMR(NMT.MIDOLI,LAST) • • • • • • • • • • • • • • ►EOEa STREATMOR1111110 OWNER'S NAME OSAME AS DRIVER . TMm PARKED CTI/STATE/31P OWNK"ADDRESS ❑SAME ASDMVER VEHICLE El BICY••. •EEE HAIR EYES NEIONT WIDOW NRTNOAi[ RACE DISIONTION OF VSHICLE On ORDERS OF. QOFnCER aoMGt OOTHEII CLOT Ma = OAr � YEMI E0 • i OTHER HOME PHONE BUMNESE PHONE PRIORMECHANCALDIFIROM NOW APPARENT[] REF[RTONAMIATgE[] ❑- . (. , d - - ( ,• CH►USE 0IKY DtSCMBE VEHICLE DAMAGE IHADE N DAMMED AREA INSURANCE CARMEN POUCV NUMBER - - --`. VEHICLETII/�. Bw--O'01 "` TOTALBMDD. ' eemm 01A OP ON STRISTOR NONWAr [►EEO IMP TRAVEL LII11T PUCa 1,6PARIA' NAME INSPAT NOTIFIED R E '_ DA RcvlEwEoC� .. • _/ ✓/'v YES No D WA / .. ._ r ......_.; ,,. CNP i5b'PAGE t(RRY t•it)ON 04 _ ��.� :.;o�mE•i�+u; _., 68 4W? �;w+ T �_ ��t>..ihf......�.. �.,, �,,y. ..� r.c. ,a�`... �''�;t fs[,•.` ,P+ '�: "'':� �7 {���i?,y�e� fi!oy'�a��. 'e"�:;fit',`(' 95+12IS STAYSOFCAUP00" 1 ♦ S• r TR FFIC COLLIS1 N CO I d^ r I , i3? PA0.1^• DATE OF COLLISION 7M[( ) NUM Ell R MO. 10 DAY 11A0 z, OWHER•[ EIADDAES[ NO EO PROPERTY DAMAGE YEs �� DESCNPTION OF DANAO[ SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE ` <=UPA L-AIR BAG DEPLOYED /C Blcrcl v_.Het MET_ A.NONE IN VEHICLE M-AIR SAO NOT DEPLOYED a NOT EJECTED •- DRIVER 1•FULLY EJECTED 8•UNKNOWN N-OTHER V-1,10 a-PARTIALLY EJECTED C•LAP BELT USED P-NOT REQUIRED W-YES i-UNKNOW N 1•DRIVER 0.LAP BELT NOT USED 1 2 3 2 TO E-PASSENGERS E-SHOULDER HARNESS USED PASSENGER IF HARNESS NOT USED CHILD RESTRAINT 4 S G T•STATION WAGON REAR O-LAP/SHOULDER HARNESS USED O-IN VEHICLE USED X-No e. OCC.TRK. VAN H•LAP/SHOULDER HARNESS NOT USED R•IN VEHICLE NOT USED Y•YES 9-POSITION UNKNOWN -PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN 7 0.OTHER K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U•NONE IN VEHICLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(')SHOULD BE EXPLAINED IN THE NARRATIVE MBFACTOR UST NUER(N O PARTY AT FULT TRAFRC CONTROL DEVICES 1 2 '3 TYPE OF VEHICLE 2 $ MOVEMENT PRECEDING COLLISION • AVC SECTION OLATED: MY �� ACoNTROLS FUNCTIONING PASSENGER CAR/STATION WAGON ASTOPPED B CONTROLS NOT FUNCTIONING I IBPASSENGER CAR W/TRAILER B PROCEEDING STRAIGHT B OTHER IMPROPER DRIVING•: CONTROLS OBSCURED IC MOTORCYCLE/SCOOTER C RAN OFF ROAD ONO CONTROLS PRESENT J FACTOR• D PICKUP OR PANEL TRUCK MAKING RIGHT TURN (+OTHER THAN DRIVER' TYPE OF COLLISION E PICKUP/PANEL TRUCK W/TRAILER MAKING LEFT TURN D UNKNOWN• HEAD•ON F TRUCK OR TRUCK TRACTOR MAKING U TURN SIDESWIPE GTRUCKITRUICK TRACTOR W/TRLR. BACKING REAR ENDSCHOOL BUS SLOWING/STOPPING RK 1 TO 21 EMS BROADSIDE I OTHER BUS I PASSING OTHER VEHICLE ACLEAR HIT OBJECT j EMERGENCY VEHICLE CHANGING LANES S CLOUDY OVERTURNED I lKHIGHWAY CONST.EOUIPMENT K PARKING MANEUVER RAINING VENT UIPEDESTRIAN L BICYCLE ENTERING TRAFFIC SNOWING Pf OTHER': OTHER VEHICLE OTHER UNSAFE TURNING E FOG/VISIBILITY FT. MOTOR VEHICLE INVOLVED WITH PEDESTRIAN JONG INTO OPPOSING LANE F OTHER•: A NON•COLLISION MOPED PARKED G WIND 6 PEDESTRIAN MERGING LIGHTING UOTHER MOTOR VEHICLE TRAVELING WRONG WAY ADAYLIGHT MOTOR VEHICLE ON OTHER ROADWAY OTHER ASSOCIATED FACTORS) OTHER': B DUSK-DAWN E PARKED MOTOR VEHICLE 1 2 3 (MARK i TO 2ITEMS) (`DARK-STREET LIGHTS FTRAIN v vpu W D DARK-NO STREET LIGHTS BICYCLE NO DARK.STREET LIGHTS NOT ANIMAL: Bvc[[ vwu pY1p FUNCTIONING• ENO DRY OADWAY SURFACE (FlI(ED OBJECT: �OE�NO 1 2 3 SOBPHYSICAL E Y.DRUG )C AYES (MARK 1 TO 21TEMS) _BET J OTHER OBJECT:D NO HAD NOT BEEN DRINKING WY �Y D B HBO•UNDER INFLUENCE SLIPPERY I MUDDY,OILY,ETC.) EVISION OBSCUREMENT: HBO•NOT LINGER INFLUENCE INATTENTION•: ROADWAY CONDITIONS) HBO•IMPAIRMENT UNKNOWN' (MARK 1 TO 2 ITEMS) PEDESTRIANS INVOLVED G STOP i GO TRAFFICHBO. UNDER DRUG INFLUENCE ANO PEDESTRIAN INVOLVED H ENTERING/LEAVING RAMP F IMPAIRMENT•PHYSICAL• A HOLES,DEEP RUT• CROSSING IN CROSSWALK PREVIOUS COLUSION IMPAIRMENT NOT KNOWN B LOOSE MATERIAL ON ROADWAY• B AT INTERSECTION UNFAMILIAR WITH ROAD NOT APPLICABLE (•,OBSTRUCTION ON ROADWAY• DEFECTIVE VEK QUIP.: p CROSSING IN CROSSWALK-NOT E2Yn I SLEEPY/FATIGUED D CONSTRUCTION•REPAIR ZONE AT INTERSECTION ONO SPECIAL INFORMATION E REDUCED ROADWAY WIDTH D CROSSING-NOT IN CROSSWALK L UNINVOLVED VEHICLE I IAHAZARDOUS MATERIAL 4%KTcH OODED' IN ROAD-INCLUDES SHOULDER OTHER•: HER•; NOT IN ROAD NONE APPARENT UNUSUAL CONDITIONS APPROACHING I LEAVING SCHOOL BUS RUNAWAY VEHICLE / _ MISCELLANEOUS i j , 3 631 r✓ N011fN _LHQ DOT / -.� SSS Atm ._.i CR CRNR '• � I • � G��Z' wwWRX 02 19C CHP �._.._ J DA PD/SO WIV FJNCC --.-CT OTHER `� r •. Page 3 08/22/91 0645 9320 7860 #8-245 NOTIFICATION: Received a call at approx. 0700 hrs . of an 11-82 accident and arrived at the scene at approx. 0708 hrs. all measurements are approximations taken with a rolatape. SUMMARY: V-1 was S/B Sellers Ave. at a slow rate of speed looking for a place to turn around. V-2 was S/B Sellers Ave. to. the rear of V-1. When V-1 slowed down to turn around V-2 started passing V-1 on the left side. At the same time V-1 started to make a left turn into a private driveway on the E/side of Sellers and .the R/F portion of V-2 struck the L/side portion of V-1 in the N/B lane of Sellers Ave. Q. CHP to D-1 (CASE) Did you have your turn signal on? A. 'Yes. I believe I did' . Q. CHP to D-2 (MEDZIUS) Did you see a turn signal? A. 'She definitely did, not have her turn signal on. I wouldn' t have tried to pass her if she did' I/O is of the opinion that D-1 failed to give a proper signal prior to turning. POINT OF IMPACT: was determined by statements and physical evidence (tire marks) to be in the N/B lane of Sellers Ave. approx. .2 miles S/of E. Cypress Road. CAUSE: This T/C was a direct cause of D-1 (CASE) attempting to make a left turn `into a private driveway on the E/side of Sellers Ave. without giving a proper signal as V-2 was in the process of passing V-1 on the left side due to V-11s reduced speed. when V-1 turned into the path of V-2 in the N/B lane, the RIF portion of V-2 struck the L/side portion of V-1 D-1 (CASE) was in violation of 22107 CVC -TURNING FROM A DIRECT COURSE OF TRAVEL WITHOUT GIVING AN APPROPRIATE SIGNAL. RECOMMENDATIONS: NONE. t i ,�. G. BELTON #7860, 08/29/91 n. . . DEPARTMENT OF CALIFORNIA HIOHWAY PATROL • INQUIRIES MUST INCLUDE COUNTER RECEIPT THE NUMBER SHOWN A CHP 251 (Rev 2-91)OPI 071 HERE Nll'*� / O. 2 9`+ If this receipt Is for an accident report purchase, NO AUTOMATIC NOTICE OF ❑Cash rilchock DArL SUPPLEMENTS WILL BE GIVEN;PROCUREMENT IS YOUR RESPONSIBILITY. 1 7 O� LOCA ION File Referee Serial num r s: ❑Money order • RECEIVED FOR AMOUNTmm��, Accident report(s) 6 V� RECEIVED OF Photographs / � Publication(s) (J Other(specify) Sales tax �3 TOTAL RECEI Yt, � USE PREVIOUS EDITIONS UNTIL DEPLETED 95 91590 �.�..... �..�,-..,-ra+..-....�.•r..vn_+V*r�•ns.+a�4:snr....si.. - ar•� . ,. .. T�IT#a`1 'M'fAl Nk)1.'..: .`... ,..�3j .A.3.y'S.'�•�:��'''�+Yf.l.:e�e:�•`•i�f'K{�.i•T{.. 1��.wr•na.�ti`�`•bh.�.��:�:r ..r�•.n.�+1.••�...r ., "t t t t t Estimate. Form, Name- Y71!!� ad-4 Date Address _Zip s6Phone r � Year • Make Model'`;:,ZS0 /;Ui I.D. No. r i/� ✓��/a7/03�� Color Prod. DA/e-, Trim Mileage License No. Ins.Co. ' File No. Claim No. Appraiser Lic. No. Phone Written By LinNoe pair. pace DESCRIPTION OF DAMAGE PARTS LABOR PAINT 3 Ute......... c . . .. /- 5 �. ,. 9 3iwr' :;:z:;:;.. X. 7 s : ................................................ s -,oma 0 .;.::::. 11 G. ,9 12 .................... ... .. ... ................:....... 13 14 15 16 17 /.d S OfzO 18 .........:; 19 20 <::...... 1' 21 ' f' 22 23 - 24 25 26X. 27 26 29 V 30 TOTALS PARTS Prices subject to invoice $ "" BYER'S AUT REPAIR • INC` LABOR hrs.@$ $ O BODY � Paint $ 7911 Brentwood Blvd. Paint SuppliesShop Brentwood, California 94513 Towing /'Storage $ Towing/Storage $ Phone (415) 634-3198 sublet $ Tax $ �" DAMAGE REPORT TOTAL $ '� RADIO UISPA7 CHFD y/�)sjy�ie [1j +_ ) 24 HOUR SERVICE • itV�T X � i } ✓ 1 --•l L . G ASEY' ISLAND TOWING -; DICK CASEY &ROAD SERVICE (415)634.4090 P.O. Box.166.: • Bethel Island,California 94511 BILL TO Tj 01i° t2 DATE/&19 ADDRESSD .t"4or�►�►d PHONE (7 lett MAKE OFNEHICLE LICENSE '3 y Q32 OWNER'S NAME TOW FROM / r ri r �• TOW To �/ ADVANCE CHARGES - st T �- 2hd TOW :w g DOLLY TOW. .......... LABOR AT'SCENE STORAGE w. DAYS RATE IMPOUND DAYS. RATE ,RELEASED TO ;`DATE RELEASED ,. 4 - t SIGNED CA ' T br"1x { 4 +, ✓ty�Jla'b'Y' .. � -T . Z�l Y�j3' !• 1`.Y�42 .t H {��i� I'1 ;.- a Y� A-\4 ' l,rMJ.:t �^�i i.4 i ! ..y�..•i?FY4^:. Dfl't2T_d��iYR � .,-. .i'kY:: • 'I,� �f \.S.Y.'L�y,-, v �€`` ���►fid" G � O Oc0 N N r� A ulA a to 1 a x ; 09 0 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 October 22, 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: $2,500.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: t100REHEAD, Barbara ATTORNEY: SEP , Date received ADDRESS: 2351 Monument Boulevard BY DELIVERY TO CLERK ON Sep temb6m2fy,cctWU Space #1 MARTINEZ, CALIF. Concord, CA 94518 BY MAIL POSTMARKED: via FAX machine I. FROM: Clerk of the Board of Supervisors TO:_County Counsel Attached is a copy of the above-noted claim. DATED: September 25, 1991 JAIL BAATTCtyLOR, Clerk 1I. FROM: 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: 151 BY: 'i' Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 2 1991 PHIL BATCHELOR, Clerk, ByA 0�111 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 14AILING 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 Notic to Claimant, addressed to the claimant as shown above. R Dated: OCT 23 gIPVC Is BY: PHIL BATCHELOR by a Deputy Clerk CC: County Counsel County Administrator U`L'TRAE1 q,q,M, TEL No' . 415 322 4.521 Sep 24 , 91 8 :55 P . U2 i Clair: to: BOW 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' 319 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 j RECEIVED Y Against the County of ntra Costa ) or SEP 2 51991 ) 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 $ o?, and in support of this claim represents as follows: --------------rr--------...w.rw.._owr-w.r_�_�r��-..__-_w_�.r--rrw-___w4_�-_.. 1. When did the damage or injury occur? (Give exact date and hour) -r-r------w-----_- ------rw-..w.._air---.w -----fr------------------------- 2. Where did the damage or injury occur? (Include city and county) ,;;-2 3 S( I'l Is.v u,w.1\ &U Sr,4 cR I Qo.✓ea 2�O �A a+qt A e c ------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) ekF usr.v� E' Avo -----------r--_---- -_ww-_..-_-�r----. _�rrw._-r+-o-rr_-r_-w----r..--------- -w------- 4. What particularact or omission on the part of county or district officers, servants or employees caused the injury or damage? AZ // ///� (over} ULTF/A�CAM-` ` " TEL No . 415 822 4521 Sep 24 , 91 8 : 57 P .01 J x r 5. what are the names of county or district officers, servants or employees causing the damage or injury? /v//4 --------------------------------------------- -- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. J ----------------------------------------------- ----------/---------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ---'-------------rr----------------------- ----------------..+-----------w-------------- B. Naves and addresses of witnesses, doctors and hospitals: ----------------------------------------------------- ------------------------------ 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim angst be signed by the claimant SEND NOTICES TO: (Attorney) or by soros person on his behalf." Name and Address of Attorney aimant s Signature A ess - Telephone No. Telephone No. .5�/D eeeeeeee * eye see 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 Sail 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 ($10,0001 or by both such imprisonment and fine. U LTR'REA CA 1� TEL No 415 822 4521 Sep 24 ,91 8 : 54 P - 01 BILL A YERS P.O.Box 293 ORD— Rodeo,CA,94572 I,Ir fdr DATE OF OFMA BUS.(415)882-6022 570 ' 7 13 060101 fAKLN RY CUB %6mAuMiil1f---- XDAY WORK LI CONTRACT L)EXTRA To -)T4r,6,vrA. lv7o 0#-e,4eoo( Jou.lq.447Nalfiil `3 )/Vly 4JOB PHONE BTARTM DATE 00 .4 TERMS: /000 r)`,e)qe?xi-r, 0A., ("11� v, QTY. f MATERIAL PRICE AMOUNT DESCRIPTION OF WORK > V3 K cv 3 6�Y- &OU/d (Art, ReOLdr< Pr-1-17S/1 Aeel!4Z 4AtC-(- 97v loe - 'b '00 OTHER CHARGES —7 z r CJbrsYmew �O 00 TOTAL OTHER LABOR HRS. RATE AMOUNT 1 625 nv&tl c -e'xl 3 :L4,d -K- e-250,57' g�Zoj2t e Al f� 392-0 S20 00 TOTAL LABOR .20 00 TOTAL MATERIALS 477 !Y- DATE COMPLETED TOTAL MATERIALS TOTAL OTHER 70 00. Work ordered by Signature 09"Cq&W TAX 1,V I hereby acknowledge the satisfactory namoletion of the above described work. TOTAL I,Dar,PHONE 701 fREE I+SM225,63n 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 October-15, 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: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: RAHMANY, Khalil ATTORNEY: PETER J. HINTON, ESQ. Hinton & Alfert .� �Bii'te received ADDRESS: 1646 N. California Blvd. SEP CO��l�apELIVERY TO CLERK JON September` 19, 1991 Suite 600 �OkA0 e Walnut Creek, CA 94596-411!W91 N � BY MAIL POSTMARKED: Hand Delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 20, 1991 EqiL DeputyLOR, Clerk 6A-� J II. FROM: 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: i BY:� ' S Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (�Q This Claim is rejected in full. f { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date, gf9ry V Dated: -� 2 la a1 PHIL BATCHELOR, Clerk, By 4 ° 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: "��b•s a _ BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator • RIECEIVE® PETER J. HINTON, ESQ. HINTON & ALFERT NP 19 In A Professional Corporation 1;pS P. W. 1646 North California Boulevard CLERK BOARD OF SUPERVISORS Suite 600 1 CONTRACOSTACO. Walnut Creek, Ca. 94596-4113 , Telephone: (415) 932-6006 CLAIM AGAINST THE COUNTY OF CONTRA COSTA TO: , THE BOARD OF SUPERVISORS COUNTY OF CONTRA COSTA 651 Pine Street Martinez, CA. 94553 This claim is presented by the law offices of HINTON & ALFERT, A Professional Corporation, on behalf of KHALIL RAHMANY. Claimant resides at 3132 Bonifacio Street, Concord, California 94519. Notices concerning the claim should be sent to the law offices of HINTON & ALFERT, 1646 North California Blvd. , Suite 300, Walnut Creek, Ca. 94596-4113 . In 1989 claimant became aware that the County of Contra Costa had announced openings for the position of Eligibility Worker I. Claimant applied for the position and took the required eligibility examinations. Claimant passed both the written and oral examination and was informed by employees of the County in June or July, 1990, that his name was at the top of the list and that he would be hired by the County within two to three weeks. Thereafter, a significant period of time passed with no communications. Over a period of several months extending through the first half of 1991, claimant telephoned the County to inquire about his Y'• , employment status. He received a number of non-responsive replies and promises of future communications which did not occur. Despite the repeated inquiries by claimant, it was not until July 25, 1991 that the County Personnel Department responded. In a letter of that date from the Assistant Director of Personnel, claimant was notified that his name was being removed from the Eligibility Worker I employment list effective August 9, 1991. That notice did not satisfy the County's Personnel Management Regulations Section 611.3 notification requirements in that the reasons cited for the County's actions failed to specify the factual basis for the County's proposed actions, and instead explained only that its actions were based upon "serious concerns by the Social Services Department" without specifying the content of those "concerns" and how they related to claimant's eligibility. On August 16, 1991, this office hand delivered a letter to the Director of the Personnel Department of Contra Costa County requesting a further written statement of the factual basis for their decision to remove Mr. Rahmany's name from the list. As of this time, however, we have received no response. Although claimant was qualified and eligible for employment with the County; the Director of Personnel, Contra Costa County, and its employees failed, to hire claimant, intentionally delayed in responding to claimant's repeated inquiries into his employment status, and intentionally failed to follow their own - 2 - guidelines, regulations, procedures and practices so as to limit, segregate and classify applicants for employment in a way which deprives claimant of employment opportunities because of. said claimant's race, religious creed, color, national origin, ancestry, and sex and further intentionally failed and refused to offer employment to claimant because of claimant's race, religious creed, color, national origin, ancestry, and sex. As a proximate result of the said failure of the Director of Personnel, the County of Contra Costa and its employees, claimant has suffered injury and emotional distress and has incurred damages including loss of income past and future, general damages and attorneys' fees and costs. The amount claimed by KHALIL RAHMANY as of the date of the presentation of this claim, is sufficient to establish jurisdiction in the Superior Court of the State of California. Dated: September 17, 1991 HINTON & IfRT BY J. HINTON J?tAorneys for Claimant 3 - f 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 October 22, 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: Exceeds $10,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ROBY, Franklin ATTORNEY: SEP 5 1991 Date received COUNTY COUNSEL ADDRESS: 317 Soule Avenue BY DELIVERY TO CLERK ON. September 23, GAUF Pleasant Hill , CA 94523 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. EVIL BATCHELOR, Clerk DATED: September 25. 1991 : Deputy 14s"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: q_ BY: I)LAL 4UJ A Deputy County Counsel /A 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 C>< 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 Dated: OCT VT 2 2 I��i PHIL BATCHELOR, Clerk, By ° Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) montns 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 Not' a to Clamant, addressed to the claimant as shown above. OCTP Dated: C 2 3 T`_Nll o BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator RECEIVE® . • SEP 2 31991 �:ss��• CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. CLAIM AGAINST COUNTY OF CONTRA COSTA 1 TO: COUNTY OF CONTRA COSTA, COUNTY DEPARTMENT OF HEALTH SERVICES 2 AND MERRITHEW HOSPITAL 3 The claimant herein presents the following claim for 4 damages against the above-named governmental agency and in 5 compliance with the California Government Code sets forth in 6 detail the following information: 7 A. The name and post office address of the claimant 8 is : Franklin Roby, 317 Soule Avenue, Pleasant Hill, CA 94523 . 9 B. The post office address to which notices in 10 connection with this claim are to be sent is : Franklin Roby, 317 11 Soule Avenue, Pleasant Hill, CA 94523 . 12 C. The date, place and circumstances of the 13 occurrence which giv rise to the claim are as follows : On and 14 before March 26, 1991, Lawrence James Romeo, who was age 29 15 years, the stepson of claimant and a citizen of the County of 16 Contra Costa, repeatedly presented himself at Merrithew Hospital 17 requesting needed medical and mental health services . On all 18 such occasions the County of Contra Costa, Department 'of Health 19 Services, Merrithew Hospital and various employees of the County 20 of Contra Costa, Department of Health Services and Merrithew 21 Hospital failed, refused and neglected to determine the need for, 22 undertake, provide or to competently provide needed examination, 23 testing, investigation, diagnosis, admission for treatment, 24 prescription for treatment and medications, referrals or 25 transfers to other proper specialists, institutions or programs, 26 -1- 1 confinement or custody. Instead, on March 26, 1991, and on 1 2 occasions prior thereto, Lawrence James Romeo was discharged from 3 Merrithew Hospital and released to his home and family in a 4. disturbed and dangerous mental state, without proper medication, 5 treatment, supervision, confinement or warning of his condition 6 to his family members or other members of the community. 7 Within hours of his last discharge to his family on 8 March 26, 1991, and while in the aforesaid disturbed and 9 dangerous mental state Lawrence James Romeo shot and killed his 10 mother, Barbara Roby, and shot and wounded his stepfather, 11 Claimant Franklin Roby, who was the lawful husband of Barbara 12 Roby and who was present when Barbara Roby was shot and who was 13 with her until she died. 14 D.. A general description of the injuries and the loss 15 incurred, so far as is known at the present time, is as follows : 16 This claim on behalf of Franklin Roby is for the 17 wrongful death of his wife, Barbara Roby, the infliction of 18 emotional distress upon Franklin Roby by reason of his being 19 present at the time and place of the shooting and death of 20 Barbara Roby and for the personal injuries and damages sustained 21 by Franklin Roby as a result of having been shot by Lawrence 22 James Romeo. Actual monetary damages attendent to these claims 23 are unknown at present. 24 E . The name of the public employee causing the injury 25 is : The names of individual doctors, nurses, staff personnel or 26 other County personnel responsible for the above circumstances -2- i and losses are unknown to claimant but are well-known to the 1 2 County of Contra Costa, Department of Health Services and 3 Merrithew Hospital. 4 F. The amount claimed as of the presentation of this 5 claim is : The amount claimed exceeds $10,000 . Jurisdiction over 6 this claim would rest in the Superior Court. 7 Dated: 9-- a3'^ 1991 8 9 FRANKLIN R 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 -3- CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA SEP 1991 Claim Against the County, or District governed by) BOARUNSEL the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT CALIF. October 22, 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 Amoint: $1,133.71 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: TOROSIAN, Vartan/ITT Hartford. ATTORNEY: ITT Hartford San Francisco Regional Office Date received ADDRESS: P.O. Box 3615 BY DELIVERY TO CLERK ON September 25, 1991 San Francisco, CA 94119-3200 Via Risk Management BY MAIL POSTMARKED: ana g 1. FROM: . Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk V DATED: September 26, 1991 �q: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors j ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY: ` Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. 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: OCT 2 2 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: OCT 2 3 1991 BY: PHIL BATCHELOR by 6 Deputy Clerk CC: County Counsel County Administrator Ron Marcy SEP 2 01991 ITT HARTFORD San Francisco Regional Office 455 Market Street Clerk of Board of Supervisors P.O. Box 3615 651 Pine Street, Rm 106 San Francisco, CA 94119-9971 Martinez, Ca. 94553 Telephone (415) 995-3200 Att: Julie Aumock Sept. 16, 1991 Re: Our Insured : Vartan Torosian Our Claim #: 543 MD 54354 D/ of loss : 7/5/91 Amt of claim $1 ,133.71 Dear Mrs. Aumock: On behalf of our insuredy 'Hartford is submitting a claim to you for damages that occured to Mr. Torosians vehicle. Hartford has paid for the damages caused by construction crew and by virtue of our right to subrogate look to the city for reimbursement of this loss. Sincerely, , Franco Hastings 9 Claims Processor Hartford Accident & Indemnity Co. 415-995-3508 I: E EIVE SEP 2 51991 cc: file CLERK BOARD OF SUPERVISORS CONTRA COSTA CO���U ITT Hartford Insurance Group Hartford Fire Insurance Company and its Affiliates Hartford Plaza, Hartford, Connecticut 06115 i .`343= :�4D 54354 TOROSIAN VARIAN' J n CHARLENE D 1x—p Polley Number ClelmanUPrinelpal Name Number CO- CT-1.3 5 '1 PHA 1620585 TOROSIAN, VARTAN J & CHARL.ENE 1295816 I Issue batelaaua Olf.Cade Nature of Payment Number 090491 1930 WINDSHIELD X1370414434 12958162 0 i Type Pry Open.I.D. A.I. Key File Clalm Number Loss Date Agency Name I' AXJ AX J 070591 L.EXANDER & ALEXANDESOUTHINGTON CT MUST BE PRESENTED WITHIN 60 DAYS ITT HARTFORI j PAY DOLLARS TWO HUNDRED FIFTY EIGHT AND 95/100 TR Connecticut Bank&Trust,Co. i F.T_] F HARMON GLASS COTO � 5700 IMHOFF DRIVE ,SUITE a ORDER CONCORD CA 94520 NON.-NEGOTIABLE ORDER OF . Authorized Signature lasalnp SA N f-R A N F S O L J I OHks Name: 1 r i 2 9 5816 201' I L i 900 5 Z P: &11500 &IF IF YOU HAVE: QUESTIONS F:C=CtARDIN( THIS PAYMENT, CONTACT : DOROTHY RICH TEL : 995-3371 I I I i I I I I j I I I i j HANDLING ID i i HARMON GLASS CO j 3700 IMHOFF DRIVE SUITE A CONCORD CA 94520 99 Form CT-1.3 Printed in U.S.A. Swatwm*w- ._ Naowetrwa.aAobtlpav - .. ._ .- _. •fig„' " •o : x147... 543' j4V� 3+4354' TOROSIAN0 VARTAN J. & CHARLENE' B. „g I Policy Number CkhnanNPrineipai Number CD- CT-1-3 55 , PHA 624585 TOR©SIAM', VARTAN J 6 CHARLENE 1795921 L_ Issue Date Issue ON.Code Nature of Payment Number CO ().90591 930 VEHICLE DAMAGE 12955213 2 TYpe Pryoper.I.D. A.I: I Key Fib Claim Number 1.Data Aganry Nama F JAXJ AXJ 070591 LEXANDER & ALEXANDESOUTHINGTON CT MUST BE PRESENTED WITHIN 60 DAYS ITT HARTFOR! PEIGHT HUNDRED TWENTY FOUR AND 76/100 DOLLARS **,****824:766 I R Connecticut Bank 6 Trust,Co. r VAR1'AN J G CHARLENE H TOR05IAN —� 2092 MOHAWK DRIVE TO THE PLEASANT HILL CA 94523 NON-NEGOTIABLE ORDER OF Authorized Signature ! Issuing SAN FRAN FSCs L J Office Name: 1 I rLERSSai3air &ROOS? W* 633500 90 I L_ I IF YOU HAVE QUESTIONS REGARDIN( 'THIS PAYMENT, CONTACT : DOROTHY RICH TEL : 995-3371 i I r 1 1 i i I I I HANDLING ID VARTAN J & CHARLENE B TOROSIAN 2092 MOHAWK DRIVE PLEASANT HILL CA 94523 1 99 1 Form CT-1.3 Printed in U.S.A. I D_m BUREAU OF AUTOMOTIVE V r` °EPAIR • CERTIFICATE #21743 1/�/� / �,�r / ALIGN OH-OVERHAUL tL"(J(.��n u t creel 0c4 y V Paint Sk or N -NEW S-STPAIGHTEN OR RCPAiR O MAKE YEAR - 1435 PIVIE STREET-P.O.BOX 4391 •PHONE 935-2220 •FAX 935-2479 -WALNUT CREEK,CA 94596 ' NAME,{I V�E �r d� G J/ DATE � Y _ STYLE Mo L/,,• - c. HOME-7 p t� ADDRESS C>u' /��/V N-9 � �p KJ '' '_PHONE ��+9 �G d �" I SE o. CITY / e�° 09 yf INSURED � - PHONE LE UC. BHna PHONE _? � —L ' � RIGHT FRONT LABY OR LABOR PARTS LABOR LABOR PARTS LABOR LABOR PARTS RIGHT FENDER AMT. MRS. AMT. SM. UNDER HOOD AMT. MRS. AMT. SVM. LEFT SIDE AMT. HRS. AMT. FENDER FRONT WATER PUMP N R.PANEL FENDER,SHIELD MOTOR MTS. 011'tft A,kVHEtL HOUSE FENDER,MLDG. CLUTCH LINKAGE T. HEADLAMP ASSY. GENERATOR L4R.tDLG. HEADLAMP DOOR Aft.6LASS SEAL BEAM QTR.ORN. COWL RIGHT RIGHT SIDE SI1W LIGHT PARK-LIGHT DOOR FRONT A N ER SIDE LIGHT DOOR HINGE Y. SEP DOOR GLASSINDLE VENT.GLASS 'j/ V10 JPLR.CO ARM SHAFT DOOR MDLG. UP.CO ARM-SHAFT HOOD DOOR HANDLE SHOO NAME PLATE DOOR LOCK HUB& UM HOOD TOP CENTER POST TIE ROD HOOD HINGE 4.1 7 DOOR,REAR GAS TANK HOOD MLDG. DOOR GLASS AXLE ORNAMENT DOOR MLDG. SPRING WINDSHIELD DOOR LOCK WHEEL ADHESIVE ROCKER PANEL FRT.SYSTEM ROCKER MDLG. HUBCAP OR COVER LM LEFT FRT.FENDER DOG LEG TRIM RING FENDER,FRONT 1OTR.PANEL FRAME FENDER,SHIELD QTR.MLDG- CROSS MEMBER FENDER,MLDG. QTR.GLASS FLOOR HEADLAMP ASSY. SIDE LIGHT HEADLAMP DOOR SEAL BEAM REAR misc. COWL BUMPER STEERING GEAR PARK,LIGHT BUMPER TIP STEERING WHEEL LENS BUMPER BRKT. HORN RING SIDELIGHT BUMPER SHOCK INST.PANEL _ BUMPER GD. DASH PAD BUMPER FILLER FRONT SEAT LOWER PANEL TRIM FRONT GRAVEL SHIELD TOP _ BUMPER _Q TRUNK HINGES TIRE %WORN BUMPER TIP TRUNK LID FED.TAX _ BUMPER BRKT. TRUNK LIGHT IBATTERY _ BUMPER SHOCK TAIL LIGHT BUMPER GD. TAIL PIPE BUMPER FILLER REAR GLASS STRIPES GRAVEL SHIELD — LEFT LEFT SIDE RAD.GRILL DOOR FRONT ORNAMENT DOOR HINGE PAINT i MATE A DR.HINGE POST r DOOR GLASSS UNDER HOOD VENT.GLASS A�tl DOOR MLDGS. SAINT n RAD.SUP. DOOR HANDLE Y� RAD.CORE DOOR LOCK MATERIAL 0 ANTI FREEZE CENTER POST NET PARTS RAD.HOSES DOOR REAR FAN BELT ODOR GLASS BO YVyQRHRS. FAN BLADE DOOR MLDGS. $LIB LET FAN CLUTCH DOOR LOCK FAN SHROUD ROCKER PANEL ADV. TOW AIC CONDENSOR ROCKER MLDGS. TAX A1C RECHARGE DOG LEG GRAND TOTAL This estimate is based on our inspection and does not cover additional parts or labor which may be required after the work has been started.After the work has started, worn or damaged parts which are not evident on first inspection may be discovered. Naturally this estimate cannot cover such contingencies. This estimate is for immediate acceptance. Description of �� THE HARTFORD Photographs " "°' ��' Claim Number The Insurance People of ITT —%3 N1 Insured Claimant Date of Accident l 1 V LA® LOGE Location/View/Where standing&height camera held Corr, Comments Location/View/Where standing&height camera held Location/View/Where standing&height camera held Comments Comments Weather Date/Time Taken Taken by Form LC-4287.2 Printed in U.S.A. Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY a` INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person oho per- l\ 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 Torts. * * W * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RE: Claim By ) Reserved for Clerk's filing stamp n4 /Z0 's ) )- Against the County of Contra Costa ) or ) -4,LA4,L 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 $ and in support of this claim represents as follaws: �N�NNM�MN- 1. When did the damage or injury occur? (Give exact date and hour) JL)Mr�NN-�_M�-N�Ny- � • 2. Where did the damage or injury occur? (Include city and county) Eiwrc,✓ 3. How did the damage or injury occur? (Give Rall details; use extra paper if required) pA G� O C,Gv2�d F c " •-,.rT.-d �.✓�e La nr J T2✓GT" • AT.2 E�9 . &✓•Trt S f r/r 2_.a-4 ✓/y</e r L/E J 1p of .r.r,..v F A 7- AY +1 C R R A 7• ,v R a Cl k a.t, ,C1Z1W✓.E c, c A. N�� uJ�dH• �!, 0 o 147 c/� G/2 O Ju.r7-9� J �!✓.y.c.tsps C,�/�v.s _ /�Ltv �rGsn.i i� Mee, M- 4. What particular act or omission on the part of county or district officers, E�A;�va,nts.or employees caused the injury or damage? R E K-k ~Tt, G , ✓rr, A ry p L os W A R M .v G p/Z T ��/✓r/z Co .vri,2vG-%. o .Y /'1 !Zk - ALfo Ivo opT 7-0 AU 3 0 1 cl x L, o ,v L/ • 9 Iz ra v 12o-4 UY OFAC"E #9A (over) �. wnat are the names of county or district officers, servants or employees causing the damage or1injury? p� / cJ4 ot a/ - L) d o 0 hi / T/f. 1 I N �a 2H.4 T. v r0 tJN ___-_12�c.�►-�J tv . ��- J!/.j c� �.,/ [,.�' l,Fo w R .T I �J ��� /lam.-/� 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. _D a r, a G -:;7-1,--v-Y t.✓ , 4J di sig, i 4 AJ d L Y a a/, A✓ G << d Ic. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) /L- r Al CIL o"J 0.L ------------------------------ ------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. --------------------- --__w___M-w_..-_-.._--__--_--_--_-____--_-__ 9. List the expenditures you made on account of this accident or injury: DATE ITEMUNT - 7 � � q� S/aIIsI- �ao Dr_ vcJ �TI � L�. Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or ome person on his behalf." Name and Address of Attorney -- - Claimant's Signature // Address 0 /7 • 9 y J,Z,5 Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, 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. ( 10) Did you travel the roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( ) No ( ) ( 11) Did you obtain the identity of the car relating to questions 6 thru 9? Yes ( ) No ( }() If yes, please provide identification below: ( 12) Please describe in your own words how the gravel caused damage to your vehicle and the angle the gravel was thrown onto the car, along with the specific damaged parts on your vehicle. s � (4,1 ,13S /24 V o A/ Pfd a Iv,�' /34. f/ C/ W /Y/rAA 7Jis lLA4 [3; GA ,J- OR L✓iTs�ouT /� �► ,oL� cJg2i✓. .✓L 13Y T�«� C'����/2 ✓u oN C2fsu�/ S �or .d d evl .�JhL/ ✓r !-1� cL is n) /-/Allay t C/L+'�✓r% w Ti t J r r/��-� L !/r Al' C, rO /i fs � AJ N/r U,2 r4 1 L� J� — <S M , L 1E-i 4 /-1 / 0 /4 ✓o i ci/ 7 R r J N a ✓ 2 D �o G�! �C..4✓�L T/d A T is�z.. �nJG r�c/ lay o e-r, ✓F- zl G T�fc � � M,P/� � 1G,�r1s _ /�Ido �✓/�/i G✓/a.r � n> Gid n-/Llr2 8 � 0 o ,.J a f!� e.T p v c d �d r-� ✓ .✓� S /9 D L d A v ra c/ d-! 'cfl A i✓y /3 .✓ q c_ d ,q �►-i .� ( 13 ) Were you aware that using the roads during the chip seal proce-ss might result in damage to your car? Yes ( ) No w I V A L/r,- v s:(- aL f} L/ A L %/a.rvq Tr= �a uT r 9 1,16A) op%o, I declare that the above information is true and correct under the penalty of perjury. (Signature) (Date) ADDENDUM TO THE CLAIM OF (Print your full name) ( 1) Do you use the roadway as part of a daily commute? Yes ( ) No (�) ( 2) Were you aware that construction would be commencing on the roadway? Yes ( ) No ( 3 ) Was an alternate route available? Yes No ( ) ( 4) Did you read about the impending resurfacing in the local newspaper? Yes ( ) No ( 5) Did you see warning signs advising of loose gravel and a 25 mile per hour advisory sign? Yes ( ) No ( 6) Did the damage result from another vehicle exceeding the 25 mile per hour advisory? Yes / X ) No ( ) (7) Did a vehicle traveling in the same direction and exceeding the 25 mile per hour advisory sign attempt to pass you? Yes (X) No ( ) ( 8) Did a vehicle coming from the opposite direction cause gravel to be thrown onto your car? Yes ( ) No/O<) (9) Was the vehicle located directly in front of you exceeding the speed advisory? Yes/�) No ( ) HARMON GLASS A Corporation l HARMON GLASS CO. 415-827-4520 J 5700 IMHOFF DRIVE, SUITE A CONCORD, CA 94520 RAR AB1.37773 ACCOUNT NO. CUSTOMER P.O.NUMBER DATE 85U133 9561160 r07/18/91 WORK ORDER 1.370010434 . y TO HARTFORD—AARP—HARMON NETWORK I VARTAN TOROSIAN 4502 SW 35TH ST N 2092 MOHAWK DRIVE ORLANDO, FL 32811 U PLEASANT HILL, CA 94523 R 9.33-8029 E Req : HN RO#, VIN, CI.1st info & sign. MLT GO THRU HARMON NETWORK F.I.N. 41-068364 F'H: (800) 866-8000 CSR: RUBY (—TERMS: • • • • -• • LICENSE NO. YEAR MAKE AND MODEL SERIAL NO. $ HONDA ACCORD JHMCA564XHCO49677 POLICY NO, STYLE CLAIM NO. VERIFIED BY 55PHA620585 I 4D SEDAN FLEET NO. UNIT NO. DEPARTMENT DRIVER MILEAGE QUAN. PART NO. COLOR D E S C R I P T 10 N UNIT PRICE AMOUNT 1 FCW520 S Windshield 464. 0 X55. Labor, 25. v11, Kit SCHE ULED : FRIDAY 07/ 19/91 APPIT TIME: . •00 SERVICE TYPE : MO ILE INSTRUCTIONS : BETWEEN 1 & 1 APS Subtotal 287. LESS DEDUCT I BL 50. 0i State tax 66 21 . 6, THIS IS A WORKORDER — DO NOT PAY � � 258• 9; LOSS REPORT You are hereby authorized to pay the sum designated as "TOTAL" to HARMON GLASS COMPANY in full settlement of the loss under the policy; and upon such payment being made all claim and demand described above sha be thereby released. Shall part or all of the loss not be covered by insuran , I guarantee payment on receipt of invoice. DATE 4F LOSS PLACE AND CAUSE OF LOSS SIGNAT ; v 07/05/91 ROCK X • =— AMENDED APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT October 22, 1991 Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911 .8 and 915.4. Please note the "WARNING" below. Claimant: COURTOIS, Daniel Lynn RECEIVE® Attorney: SEP ' 7 1991 Address: COUNTY COUNSEL P.O. BOX 23 MARTINEZ, CALIF. Carmichael , CA 95609 Amount: Unspecified By delivery to Clerk on 9-23-92 and 9-24-91 Date Received: By mail, postmarked on Hand delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Applica 'on File L t Claim. DATED: September 27, 199'PHIL BATCHELOR, Clerk, By Deputy 44 Z II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). The Board should deny this Application to File Late Claim (Secti:. ffi.6). DATED: ��i/ VICTOR WESTMAN, County Counsel, By Deputy j III. BOARD ORDER , By unanimous vote of Supervisors pre t, (Check one only) ( ) This Application is granted (Section 911.6). This Application to File Late Claim is denied (Section 911 .6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this .date. DATE: OCT 2 2 1951 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code §911.8.) If you wish to file a court action on this matter, you must first petition the ' appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Goverment Code Section 946.6. Such petition must be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of any attorney of your choice in connection with this matter. If you want to consult an attorney, u should do so immediatel IV. FROM: Clerk of the Board T0: 1 County Counsel 2 County Administrator Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. OL DATED: OCT 2 1991 PHIL BATCHELOR, Clerk, By Deputy V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM ECEIVE® SEP 2 41991 SUPERIOR COURT OF THE STATE OF I IA AND FOR THE COUNTY OF CO ST " 2 41991 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. CONTRAS COUNTYCO2LU RK DANIEL LYNN COOURTOIS, ) 8Y TY Plaintiff ) D vs ) JOHN DOE, ) CASE NO. : C91-02399 Defendant ) ) ORDER ALLOWING AMDENDMENT The Court having read and considered the Declaration of James I.Gabby, K.D. , grants plaintiff's request to file an Amended Complaint pursuant to Sec. 340.1 CCP. DATED: JUNE 24, 1991 WILLIAM A. O'NALLEY JUDGE OF THE SUPERIOR COURT PROOF OF SERVICE I hereby certify that I am a citizen of the United States, over the age of 18 years and not a party to the within action. I served a true copy of the forgoing document by placing the same in an envelope which was sealed, fully provided with postage thereon and depositediin the United States Mail at Martinez, CA on June 24 . 1991. Said envelope was addressed to: DANIEL LYNN COURTOIS P.O. BOX 23 CARMICHAEL, CA 95608 I certify under penalty of perjury that the foregoing is true and correct. Dated at Martinez, California on `/ J rlettani, Clerk 1 TO: Board of Supervisors of Contra Costa County 2 Amended Request for Leave to File a Late Claim. 3 Additional Declaration of James I. Gabby, M.D. Request for 4 Board of Supervisors of Contra Costa County to take notice. 5 6 Dated: September 23, 1991 By DANIEL LYNN COURTOIS 7 8 DECLARATION ATTACHED 9 10 11 RUECE V9 E® 12 SEP 2 31991 13 CLERK BOARD OF SUPERVISORS 14 CONTRA COSTA CO. 15 16 17 18 19 20 21 22 23 24 25 26 27 28 I DANIEL LYNN COURTOIS P.O. Box 23 CFD 2 3`�99r 2 Carmichael, CA 95609 Telephone: (916) 481-7405 3 IN PRO PER S.L.WEIR,COUNTY CLERK 4 CONTRA COSTA COUNTY BY A.HABERMAN DEPUTY SUPERIOR COURT OF A 5 . . COUNTY OF CONTRA COSTA 6 7 DANIEL LYNN COURTOIS, ) Case No. C91-02399 Plaintiff, ) 8 ) DECLARATION OF VS. ) JAMES I. GABBY, M.D. 9 ) Exhibit "B" JACK EDWARD BIGELOW and , ) REQUEST FOR 10 PHYLLIS BIGELOW, ) JUDICIAL NOTICE Defendants. ) (Evid. Code § 452, 453) 11 > 12 I have been seeing Daniel Lynn Courtois as a patient for 13 psychological problems sporadically since 1983, in between the 14 times of Daniel 's being in and out of psychiatric hospitals. 15 During the time that I have seen Daniel, he never mentioned 16 anything about his childhood sexual molestations, until this 17 last April when he came to me, and started talking about his 18 childhood sexual molestations. As of April 1991, it is my 19 Professional opinion as Daniel Lynn Courtois's psychiatrist that 20 Daniel suppressed all memory of his childhood sexual 21 molestations before last April by a combination of his Psychological problems and his drug abuse. 22 23 I am a practicing psychiatrist in the State, of California. I am no party to this action. I do hereby declare that the 24 above statement is true and correct, under the penalty of 25 perjury, pursuant to CC 340. 1 for Plaintiff. 26 27 28 1 `Jhup Dated: September 23, 1991 By . �J3 S I. GABBY, M.2 Laurel Street San Francisco, CA 94118 3 Telephone: (415) 567-4777 4 DECLARATION: 5 -_ Exhibit "B" - Request for Judicial Notice (Evid. Code § 452, 6 453) 7 8 9 10 11 12 13 14 15 16 17 is 19 20 21 22 23 24 25 26 27 28 ZC 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 October 2.2 , 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: $3,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JENKINS, Darrell Wayne ATTORNEY: Date received c90TY CQPNS4 ADDRESS: 42 Merrimac Place BY DELIVERY TO CLERK ON SeptemberW.gTiH9J9t^Wand Pittsburg, CA 94565 September 23, 1991 BY MAIL POSTMARKED: No envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. EVIL ATCHELOR, Clerk o DATED: September 25, 1991 : Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors Aet.c�a Thi s, * aim 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: 1 125 T BY: �' Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. a Dated: OCT 2 2 199 I PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the dote 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 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: OCT 2 3 1991 BY: PHIL BATCHELOR b OJ Deputy Clerk CC: County Counsel County Administrator \ VICTOR J. WESTMAN CONTRA COSTA COUNTY COUNSEL TVl C ...AAA111VvVVa P.O. BOX 69, CO. ADMIN. BLDG.. MARTINEZ. CA 94553 PATE SUBJECT�Qm`C�� J a RECEIVED SEP 2 3 1991 BOARDCI ERK C(zi I E;3\ . C CONTRA COSTA CO. 8 V� -e� •`"i Claim to: BOARD OF JPERVISORS SOF !CONTRA COSTA C0U2`71Y INSTRUCTIONS TO CLAD ANT A. -Claims relating to causes of action for death or for injury to pers�Q or to per- sonal property or growing crops and which accrue on or before December 31, 1981 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-Buil-ding, 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 Sac. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp 012�Aldl RECEIVE® u2 w,,e- r c 9'4 1 Against the County of ontra osta ) 1991 or District)- CLERK BOARD OF SUPERVISOR Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim a a n t the County of Contra .Costa or the above-named District in the sum ofd and in support of this claim represents as follows: --------------------------------------- 1 en di d j r oc ? (Give xact date and hour) c 4+ --------------- ------ ------------------- ------------- ------- ------------ 2. Where did the damage or njury occur? (Include city and county) -------- - ---------------------------------- ----------- --------------- 3. How did the `damage or injury occur? (Give full details- use extra paper if required) o e k N o s ' &-iC 'NA � _ -` - ------ �_ --��-� -- -------------------------------------- 4. What particular act or omission on the pert of county. or district officers, servants or employees caused the injury or damage? C.A\ (over) What are the names of county or district officersy servants or eInyees causing the damage or injury? 5. What damage or injuries do you claim resulted? t( zce a;!l: eiterat of injuries or damages claimed. , Attach two estimates for auto dt.,=ge- 7. How was the amount claimed above computed? (Incl �,tlt� .a punt of n P Y pros ctive injury or damage.) JoeA a h ,� 3 P � Z o 3 O at ?"o u K4 o w aN t�v, u V., %%.0w V%11 ---------------------------------------------------- 3. Names and addresses of witnesses, doctors and hca-gdta1a„ 9-. List the expenditures you made on account of this acx; :i i +r'try: DATE ITEM IM90, Gov. Code Sec.. z==mZ i a "The claim m be ser i y/ ` -a, elah ant SEND NOTICES TO: (Attornev) or by some errsmn ons ; ��y Name and Address of Attorney '2N O V\._ Telephone No. Telephone No.; 2 N O T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presemft . foi, a�71�ov, er Cr for payment to any state board or officer, or to any camit3i„ ci.w,;v cr ddstrint :board or officer, authorized to allow or pay, the same if gm!:aa, apr�, l''Blse ur fraudulent claim, bill, account, voucher, or writing, is puni dLe e3i�ier FqF im:pr3sx-ment in the county jail for a period of not more than one 'L*.T- a f'iTin of not exceeding one thousand ($1,000), or by both such imprisonment ant -fire, or tT irprisonment in the state, prison, by a fine of not exceeding ten ttn.uasant dr-122M (($10,'D0D,, or by both such imprisonment and fine. * . CIDENT REPORT SUPPLEMENT CO RA COSTA COUNTY SHERIFF'S DEPARTMENT DATE OF INCIDENT i DATE: "2=27-91 ORIGINAL: 2-26-91 INCIDENT: MISSING INMATE PROPREPORT _: 91-443 N fill HOUSING, INMATE: JENKINS, DARRELL WAYNE BOOKING : 91-4301J ASSIGNMENT: C-46 Last First -Middle . ❑ CONTINUATION SUPPLEMENT ❑ STATEMENT ❑ DISCIPLINARY INVESTIGATION NARRATIVE/INVESTIGATION: ON2-27-91 I RECEIVED A TELEPHONE CALL FROM FORMER INMATE DARRELL JENKINS. HE TOLD ME THAT HE WAS RELEASED YESTERDAY MORNING WITHOUT HIS PROPERTY (THF,_. PERSONAL PROPERTY BAG) AND HE ASKED ME TO LOOK INTO THE MATTER. I CHECKED WITH DSW MCKNIGHT AND ASKED HIM TO BRING ME A COPY OF THE TOWN RUN SHEET FOR" 2-18-91, THE DAY THAT JENKINS WAS SENT TO THE FARM, HE DID SO, AND THL SHEET CLEART,Y SHOWS THAT JENKINS ARRIVED HERE WITH BOTH HIS CLOTHING AND PROPERTY BAG, TH . ATTA .H .D COPY. I DID A DUMP ON INMATE JENKINS' RECORD, IT CONFIRMED THAT JFNKINS DTD NQT T.FyAVF` THE MCDF DURING THE NINE DAYS HE WAS HERE. I CONTACTED SHERIEA SERVI . ,S SIN .F. JULY NOW HAVE CUSTODY.OF'JENKINS' BOOKING. I ASKED THEM 'TO FAX ME A COPY OF ALL OF JENKINS' PROPERTY SLIPS. THEY DID, SO. PRO ERTY RECEIPT #93752 SHOWS THAT JENKINS 'C01%.2.aC �t3�o►�c t� MDF WITH TWO Y/M RINGS, A GRAY METAL NECKLACE, KSS AND A WA_ TCH_ DEPUTY B. BROCK WAS THE DEPUTY WHO TRANSPORTED INMATE JENKINS TO CONCORD BART. SEE''THE ORIGINAL IR, IR #91-443. BECAUSE THE TOWN RUN BUS WAS FULL YESTERDAY, DEPUTY BROCK- PUT THE TEN MALE RELEASES IN THE MCDF VAN AND TOOK THEM IN. THE TWO FEMALE RELEASES WENT OUT ON THE REGULAR BUS. I CHECKED WITH •TRANSPORTATION DEPUTY T. FRANCIS. HE TOLD-ME THAT HE DID NOT HAVE ANY EXTRA PROPERTY LEFT OVER AFTER HE DROPPED OFF THE TWO RELEASES. DEPUTY BROCK SAID THAT. JENKINS WAS VERY UPSET BECAUSE HE DID NOT GET HIS PROPERTY BACK. HE SAID THAT JENKINS WAS THE ONLY INMATE WHO DID NOT HAVE A PROPERTY BAG. THAT WAS THE REASON HE WROTE THE ORIGINAL IR AND REFERED JENKINS TO ME, ACTION TAKEN: I REQUEST THAT THE SHIFT SUPERVISOR, SGT. McELROY CONDUCT- AN INVESTIGATION TO LOCATE THE MISSING PROPERTY AND TO DETERMINE WHY JENKINS WAS RELEASED WITHOUT HIS PROPERTY OR AN INCIDENT BEING WRITT BY HIS STAFF. M. MEAD 39473 REPORTING EMPLOYEE 5 SUPERVISOR OPERATIONSDIRECTOR O.D. ROUTING INSTRUCTIONS: White to Facility Manager - Yellow to Bookina File - Pink to B1S - Gold to Inmate Rev. 8/80 PaaeOf ___ I * INCIDENT REPORT SUPPLEMENT CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT DATE OF INCIDENT DATE: 2-27-91 ORIGINAL: 2-26-91 INCIDENT: MISSING INMATE PROP REPOPT =: 91-443 HOUSING INMATE: JENKINS, DARRELL WAYNE BOOKING #: 91-4301) ASSIGNMENT: C-46 Last First Middle O CONTINUATION SUPPLEMENT Q STATEMENT Q DISCIPLINARY INVESTIGATION. NARRATIVE/INVESTIGATION: I LOOKED UP THE TOWN RUN SHEET FOR THE RELEASES ON 2-26-91. JENKINS NAME WAS ON IT, BUT THE BLOCKS FOR INMATE PROPERTY WERE ALL LEFT BLANK. THE RELEASES WERE APPROVED BY SGT. J. McELROY, BUT THERE .WAS NO SIGNATURE TO SHOW WHO ACTUALLY RELEASED THE INMATES. SEE THE ENCLOSED TOWN RUN SHEET AND DAILY COUNT AND MOVEMENT. I NOTED THAT THE INMATE PROPERTY SLIPS WERE SIGNED BY JENKINS, BUT WERE NOT - COUNTERSIGNED BY THE RELEASING. OFFICER. I CALLED INMATE JENKINS AND ASKED HIM WHO HAD RELEASED HIM. HE SAID HE DID NOT KNOW THE DEPUTY'S NAME. HE TOLD ME THAT HE SIGNED THE FORM WHILE HE WAS IN THE CAMP LAUNDRY AND THAT HE DID NOT SEE HIS PROPERTY BAG. HE WAS TOLD THAT HE WOULD GET THE BAG WHEN HE GOT OFF THE BUS AT BART. HE SAID HE SIGNED THE SLIP WITHOUT VERIFYING WHERE HIS PROPERTY WAS BECAUSE HE DID NOT WANT TO CREATE AN INCIDENT AND HAVE TO SPEND MORE TIME IN JAIL. ... JENKINS TOLD ME THAT HE HAD THE FOLLOWING PROPERTY ON HIM WHEN. HE WAS BOOKED: 1-GOLD MAN'S RING,BLACK HILLS GOLD, WITH A HARLEY DAVIDSON INSIGNIA ON IT, $352.00. 1-GOLD MAN'S RING, 1971 HIGH SCHOOL, HORSEHEAD HIGH SCHOOL, W/BLUE STONE, $75.00. !-BLACK LEATHER TIE W/SQUARE GOLD NUGGET TIE TACK, $30.00 EACH, 1- KEY RING WITH 15 MISC KEYS, AND 1- SILVER ROPE CHAIN W/ANTIQUE CROSS, $200.00. ( `4QWXX=X0WXX)D0DC- JENKINS ALSO SAID THAT HE HAD SEEN HIS CLOTHING BAG AND PROPERTY BAG WHEN HE ARRIVED AT THE FARM. I CHtCKED THE INMATE PROPERTY ROOM AND WAS UNABLE TO LOCATE JENKINS' PROPERTY BAG. I A XXM: CHECKED ALL OF THE CLOTHING BAGS ON THE 'J'. RACK WITH NEG. RESULTS. I EXPLAINED TO JENKINS THAT I WOULD CONTINUE TO INVESTIGATE THE LOSS AND THAT I WOULD Uti1 1�'tc�- 35 -7-3 REPORTING PL 14 SUPERVISOR OPERATIONSDIRECTOR O.D. ROUTING INSTRUCTIONS: White to Facility Manager - Yellow to Booking File - Pink to BaS - Gold to Inmate Rev. 8/80 Page 'Z o` 3 * INCIDENT REPORT SUPPLEMENT CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT DATE OF INCIDENT DATE: 2-27-91 ORIGINAL: 2-26-91 INCI.DENT:MISSING INMATE PROP REPOPT 91-443 HOUSING INMATE: JENKINS, DARRELL WAYNE BOOKING #: 91-4301J ASSIGNMENT: C-46 Last First Middle ❑ CONTINUATION SUPPLEMENT ❑ STATEMENT ❑ DISCIPLINARY INVESTIGATION NARRATIVE/INVESTIGATION: RECONTACT HIM IF I FOUND THE PROPERTY. I SAID I WOULD MAIL HIM A COPY OF THIS REPORT AND A COUNTY CLAIM FORM IF I COULD NOT LOCATE THE PROPERTY. JENKINS' CORRECT TELEPHONE NUMBER IS 427-6718. SEE THE ATTACHED DUMP FOR HIS ADDRESS. 2 uns ° `c't \A VV nn c�..•e� 5 n�v. cel . �-� e��-� ��. , T�,P, `� �\.-e S� 0. COMMENTS & CONCLUSIONS: ACTION TAKEN: REPORTING EMPLOYEE F SUPERVISOR tt OPERATIONS: DIRECTOR. O.D. ROUTING INSTRUCTIONS: White to Facility Manager - Yellow to Bookina_ File - Pink to BAS - Gold to Inmate Rev. 8/80 Pa -ce—3— , i c�11�rc '`yl PROPERTY INVENTORY LIST CONTRA COSTA COUNTY DETENTION FACILITY fNMATES TRANSFERRED TO: JYIG !� r� /z'1f1� C DATE: -- INSTRUCTIONS -- Please total the money and place it into one envelope. Proper credit can be made from this inventory. NAME LAST FIRST MIDDLE BOOKING tt MONIES PROPERTY zz C"xxf:!�D' 43. / c2 2lG� �' q �-- 7. bio 0- 119 A/12G4_t.: � � I 1 $"' G o ZI-O gn4 S o rel ��i i f-I go O 12. 13. 14. 15. TOTAL $ RELEASED BY: ACCEPTED BY: APPROVED BY: AGENCY: TRANSPORTED BY: DATE: TIME: i....J I::i: :31s ACT I VE INMATE INFORMATION AS OF 02/27/91. AT 1.1. C 37 F't+C.iE {)2 BV NBR: `•r'1.00 301,J I D••—NBR: 070070062 CC I N NBR a 070070062 TEMPORARY RELEASES RELEASE C:HO DATE" OF TIME OF ENTERED DATE:: CIF TIME 01='T'YPl` N BR RELEASE E I"tiF"l._EA E BY. RETURN RETURN, AGENCY • :,cxac NO DATA INMATE E NiME ' ECOV I � iLALi!F It �'i'10x3�7it3�,S MD17 I 00 02/18/91 08:40 MDF I 00 0 INMATE fA•T•E NAME° ,JENK I NS DAi RELl_ W sYNl:: BCJOK I NGNB1 „ 91004301J 62/1S/91. C01 WC 1.4601. M NO BAIL 4 02/14/71. 1000 SENT TO 20 DAYS P! CONCUR W/682779—:1 l! C:t:}N C:l1RRW/6881.60—.1. N CON CURR W/685022-6 N SENTENCE DATE: 02/18/91 P3<OJE::C`.TE D RELEASE: DATE: i•i i•i RELEASED SED BY%. DATE: TIME-. APPROVED BY g ri _.._.._.._......__....___ __.-____.-...- _....__........__....__..__ i•i �} I2 `i'L. -jF AV k) ,v S �I TTS 6U pG-, C-14 02'27!91_--_x,15:34 FAX 415 646 2426 CCC, RECORDS 4-�4 DETENTIO\ )iCDF la0 4' 004 ' PROPERTY/CLOTHING RECEIPT CQNTW COSTA COUNTY RE JO. 9 3 T.5 DATE: �^ %^G o MDF E TIME: f': "x WFC - NAME:---% f:r� .�rT'l�[�rf WCJC 1 BOOKING NBR: OTHER lffjlmm=. Mill CASH: . ❑ SHIRT/BLOUSE CI DRESS ❑ COAT/JACKET /SCAP,E f E ElSHORTS/PAN'CIES J = Z DAJI1r-f—//2 17/x9 #' ❑ SOCKS/NYLONS �Y� /!�?� !. ❑ SWEAT—R/SWT_SHIRT WATCH F-7 BELT !❑ PANTS/SK1Frr. j ❑ SHOES/BOOTS .} i ❑ T-SHIRT/BRA ❑ WALLET HAT/PURSE Eg KEYS ❑ KNIFE Q GLASSES I ❑ OTHER i s CSKCi UFC: 4 INMATE S�FNATURE I . J ' I have r eared of myq per- DATE: nal p rry nd cI ing. .i REL OFC: X (_ IN NATURE h. P , 0 1 +: TRANSACT I O[l REPORT + FEE-21 -91 WEIi 16 : 32 + +: BATE STARTSENDER R ; TIME PAGES MITE + +: FED-27 16 : 30 415 646 2426 2912" 4 ---------------------------------------=----------------------------------------------------------------- 1 --------------------------------------------------------------------------------------------------- 02,`27/91 15:34 FAX 415 646 2426 CCC RECORDS DETENTION MCDF- X1003/004 _*'■ "4 �-v "k VUEN ION FACILITY RPERTY RECEIPT DATE. TIME: Q2i2Si91 0184.1 RE-C: 2139 S[ FACILITY: MOF NAME: JENKINS DARRELL W.AyM BOOKING NBR [r °• - a ITEM UNDER CoUNEr�O4Y U�R N CASH: 5 1.4y- . JEWELRY: DESC: r�l WATCH: nrrsC: WALLET/PURSE: KEYS: N GLASSES: BELT: r'1 KivlFE: N OTHER: r} ONE SAG SEALED PROPERTY BKG OFC. 4I 15 3 PROPERTY BOX ASSIGNED: x +�*hwre R Mill DATE: 1 HAVE REQ 1V ONAL R p LL O MY REL OFC: TY INMA TUk er 02/27/91 15:34 FAX 415 646 2426 CCC.RECORDS DETENTION MCDF 10002/004 ..�,.... ►wSTa d ENTION FACILITY Ls s 13 0TH.lrqG RECEIPT _ DATE: 02/18/91 TIME. 0841 FAR CIL[ - 213950 NAMC-{C, F, M): MOF JENKINS DARRELL BOOKING NBR °/' =• 91004301) COAT/JACKET SrJRT �ORTS/PAN77ES /BOOTS KS/NYt T-SHIRr/BRA _,-.i_ ONS [�HAT/PURSE . ��a�ATER/51NT SHIRT DRESS OTHER , «I k� DATE. HECE VE I.HAVE REL OFC: CL KMATE RE K r Ar � a Y a 1P.R34 CREEK DETENTION FACILITY. TRANSFER OF PRISONERS TO: I:II?AL RELEASES DATE 2/26/91 DORM & PROPERTY TME , I4AI-IE BOOKING BULK P BAC SER tiOL_D CIJURT TI�`IE :ONEY 1. ARESTRONG, ANGELA 90-17279J A50 XX CITE RELEASE 33.9 rev� ?, BOOTH, CHAD 91-4614J B54 XX CLEAR 3. BLYTHE, LA; :ENCS 91•-4471) C17 XX CLEAR 1.2 +. JENKIN S, DA RRELL 91-430IJ C46 XX CLEAR 29.4 i. RODRIMEZ, RANO ] 91-4617) , C50 XX CLEAP. -61 i. JO'r]ES. KOR RY 91-3336J. D25 XX CLEAR 40.( 7. PSTROSS, JANES I91-330J D03 XX CLEAR. 3.: 3. SANDERSON, DEAN 91-697J E0,2 XX CLEAR 6.. ), FRAKES, CLINTON 91-3641J E52 XX CLEAR 20.; '.O, COOPER, i4IC,iAEL 90-29185 G73 XX CLEAR .j '1. MARTINEZ, LOUIS 90-20833J G01 XX CLEAR -z�- L2.SHELTON JAYANN 91-1759J A73 XX CLEAR L3. L4. L5. L6. L7. _ L8. L9. !01 >2. �3. f COOKINGS UPDATE BY-:- RELEASED BY: ,PPROVEDBY: 11 f t ACCEPTED BY: TR,% PORTATIO FFICER: r, p CG\7, COSTA COUNTY P ,RS11 CRF is T:EEJETFION FACILITY D I ILY COTNT til ?110 F�IETZI r EFJ�T FERSONTNTEL, ON 1)HyS�,GEAiti'1: J. McElroy 022591 D';'1:,. )EPUIIES: Gilbert/Leaall�-n, Moore, Singleton, Belson, Annis, I<:`': Monday Fawell, .Miller, Sloan, Struntz, Fithian (K9). S�7 •i': Evening \T G ifISC Dia T 1 t,FE' TJ' L rOR, f C A-NEP GIL OUB 0 CA- -�;L\KS- •JM . 1800 476 64 405 4 Shift change, count clear. 4 *Firemenout: Johnson, Lovelace, Doran, Ponce. 3 H/C: Welch Richards, Fanning, S11 1805 476 65 1 405 2 ZE 1 From H C: [•delch. JM 1940 508- 69, 433 2 4 Town run in: 22 Male returns: Algood, Corro, Rodrigues Watson, Breshers, Gerhart, Treece, Ilieczek, Perkins, Simmons, King, Baker Holman, Morgan, Ralph, Retherford, Lesh, Simongkhoun, Valadez; Currier, Jenkins, Snaith. 6 Male nese: Alvarez, Barajas, .Archuleta, Burks, McDowell, Lizarraga. • 4 Female returns: Davis-, Mcdrall, Shelton ` = Shaver. JM 2100 503 69 430 0 4 Town run out: ` . 2 Rejects: Richards, Fanning. 3 Final releases: . Holman, Lesh, Breshers: JM- 2130 503 69 430 .0 4 Roll call count clear. JM.. 2155 - .503 69 434 -0- 0 4 Firemen- e.turn: - Johnson, Lovelace, Doran, Ponce. JM 2300 503 69 .434 0 0 Roll call count clear. JM 0545 467 64' 403- 0 0 Town run out: 3 Females to ct: Shaver, Ault, Wiese. 2 Female releases: Armstrong, Shelton. _ 30 Males to ct: Farley, Freitas., Miller,: Bar-tett,.-Mercado,. Hughes, ._Thompson, guggY� . Stevenson, -Brown.; Daniels,.- - Davis,- .Hawkins,. Johnson-Newell, Shell Thomas, Craven, Carkhuff, Jones, Miliusis,. Naylor., Benz, Gonzalez, Nunez, Currier; -Folan, Laub, Ralph, Whi to. 1 Male enroute: Love. ! JM. 0550 . 457 64. 393 10 . .0 10 [ e releases to H C: Booth,. Blythe, _ Jenkins, Rodriguez, Jones, Petross, Frakes 'Sanderson Coo er..Martinez. JM 0600 457 64 393 10___r 0 Shift change. 4n T_l _ ___- __ TT/,-