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MINUTES - 11051991 - 1.33
433 " CLAIM .4, 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 November 5 , 1991 and•Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $2 , 570 . 55 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: CANNA, Guy ATTORNEY: OCT 1 1 1001 Date reny��C��OUNSEL ADDRESS: 1032 Bret Cove Court BY DELIWTD'C ON October 10 , 1991 San Jose , CA 95120 BY MAIL POSTMARKED: October 3 , 1991 via Risk Mgmt . I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: October 11 , 1991 EVIL BATCHELOR, Clerk a BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). y ( ) 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: 1� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (V, This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date.Dated: NOV'y5 199PHIL BATCHELOR, Clerk, By n 01 JA,, a Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: N o Y 6 1991 BY: PHIL BATCHELOR by OAW Deputy Clerk CC: County Counsel County Administrator • Claim, tar BOARD OF SUPERVISORS OF' CONTRA' COSTA COUNTY , ` INSTRUCTIONS TO CLAITWTr 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 w action: ?Claims:relating`to.`caises 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 'it 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 xthe••District should be filled izi. 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 or Clerk's _filing stamp RECEIVED OCT I O 1991 Against the County a Contra Costa or CLERK BOARD OF St�€�E�dVISORS District} CONTRA COSTA co. , F111 in'name ._ M{. The undersigned_.clamant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 2570 . 55 and in support of this claim represents.as follows: ,ri . , ,. s..w��■r.MM--N+--r#�� -M«■-N.�Ir.■wi- 1. When did the damage or inJury occur? (Give,exact date and hour) July 30 1991 at. ,11,:-,0 0 A.M. - N■■M-■IM-FNM-MII--M.■-YMM-rII-�I�MNIr-■■1-�1#-Y #MYN.NN#M#uM-Yr-##,�-�M--i■.■li#■■-#,r-4r�1#-■III�--#Mr## 2. Where did tht- damdge or injury occur?` (Include city and county) -«. n t e r s e c t i o o f .H i h w a -.4& l e. rd'. ... #.CGu3 .3Z#•• 3. How did the damage or injury occur? (Give full" details; use,,ex ra paper if required), Y .. .,•-##--i#iMf--------- 4.,' D#.■-#,■1-M4.n' What. partigular,faet ;or,omission,.on the,µpart.iof-county `or`district officers, servants ,or epployees r caused the`•iniury or� datag@?' Poor" r o a d" `maintenance : A failure. to ,re,mo.ve, an extremely ,exce,ssive and Wazrardous.,.amount of gravel" from the intersection of highway,:,4 :'& B .xl`er; Rd:: (over) w D. what.are the names of county or district officers, servants or employees causing the damage or injury? Contra Costa County ; Risk Management ; Board -of Supervisots .of G.o•ntr.a Cos-ta County .,, --------- ------ --------------- 5. What damage.or, ipjUries do.<you claim resulted? .+(Give full extent of injuries or damages`claimed. . Attach.-two estimates.-for auto--damage. Personal, 'Pr(fiperty :arid :general' damages : se`e a&tach`ed estimates . - .--- ---- --NN--N---N-----------N�1NNM---N--NSI--N--N-���------ ---M---- A . "7: How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) I-. took the. average 'of 'the two estimates =_f-or- my �1986 GM,C pickup , plus ahe . amo,un,t. .of` dama.ge,,_:to. -the .` 1-990 Jeep Cherokee , plus gemeral damages . --------------- --- -- -r-----� �--------��--- ------- 8. Names and addresses of witnesses, doctors and hospitals. W i t n e s s e s : Joe ,Bedard, 1418. Ma.rl.in T-lace , Byr-on, Ca .;, ..,9,4'514 Frank Biondo 6167 Paseo- Pueblo- Drive , . Sairi'.Josel,. ,C'a . , 9512`0 Joe Garcia 4850 ,,,King,dale Drive , San, Josie_, .,Ca . ,. 95.124.. -------------------------------------------------------------------- ----N--�/------- 9.' List the expenditures .you made on account of this accident or injury: DATE ITEM AMOUNT - r 8/06/91 check. fo+r Jeep Cherokee $758,._00 4co y of check enclosed) Gov. Code Sec. 910:2 provides: . "The claim must be signed.by the claimant SEND NOTICES TO: (Attorney) or�b ..,some. erson on his behalf.". Name and Address of Attorney .._ f•. t,s 4 Caiman Signature Cove r _.. _ . .. „ , , - ,Address San Jose , Ca : , 95120 Telephone--No. :.Telephone No. 40 8 2,6 8`=2 6 3.1 ' 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" tfa ne�-of-not exceed ing one thousand ($1,000), or by both-such imprisonment and f-ine, or by' imprisonment in the state prison, by a fine of not .exceeding ten thousand dollars ($109000, or by both such imprisonment and fine. ADDENDUM TO THE CLAIM•QF ? G u-y. C a fi h a (Print `your fulll'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 ( X ) ( 3) Was an alternate route available?. Yes ( ) No ( X ) (4) ,. Did. you .read.,.about, the impending -resurfacing in the local � newspaper? Yes ( ) No ( X ) ( 5) Did you see warning. signs advising. of- loose gravel and a 25- mile--per hour advisory sign? Yes (. .. ), No ( x ) (6) Did the damage result from another vehicle exceeding the - 25 -mile per hour advisory? _ Yes ( } No ( x ) (7) Did a vehicle traveling in the same direction and exceeding the 25 mile �per hour advisory sign attempt to pass you? Yes ( } No ( x ) i (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? Yes ( ) No ( x ) (10) Did you travel the roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( ) No ( X ) ( 11) Did you obtain. the identity of the car relating to questions:,--6 thru 9? ; Yes ( ) No ( X ) 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 wi, th'the specific damaged parts on your vehicle. This rl'aim has nothing to do with the chip seal' j ( 13) Were you aware that using-the road during the chip seal process might result in damage to your car? , Yes ( ) No `( X } I declare that the above information is true and correct under the penalty of perjury. (Signature) (Date) I was traveling W bound on Highway 4 in ,my . 1986 GMC pickup , approaching the intersection of Highway ' 4 & Bix1'er Road . A ,red 1990 Jeep cherokee was waiting at the stop sign on Bixler Road , facing S bound , waiting to attempt to approach E bound on Highway 4 . I slowed down and and proceeded to turn right onto Bixler Road . As I entered into the turn, an excessive amount of gravel caused my front wheels to slide sideways , c,ausing 'my 1986 GMC pickup to collide with the 1990 Jeep Cherokee , causing damage to the rear door and quarter panel of the 1990 Jeep Cherokee, and tothe front end of my 1986 GMC pickup . There were no warning signs present, and the amount of gravel is ridiculous , as my pictures show. ..a a •'v's f v r,f ,L{'�' f . •� ,` tppt3 t.�p¢: . i�y�' r�t� 1 ►. �,:, 7'� L ij �4 ad�r,J•� 1 '� "'^�r i�7 2:i�f gy��i7lwY x+�•r +;..k a a l.•fi." C"1`*',..�-a. �`�''� � � 3� ` �s c `_+ Ji >iii�iti3ta`} r �'Y { r"Yet e '�• r��. it � .r�.t.�,�.kn �"y �.'"�`-..� �:��. ✓>;� ����fi tl'. a� t y ���t y �C('ten-a � f �f i;•�.q��i.�,""yZF3 � {Y�-" _�• ,7 � �� x ,. cot e t su •{, rX n..� yyf��y�`n c� KiA'tTt t w��� �ir�y�.�.��}'�' -v ... .` r f - e ti p y:xw„� � ..•'r'�t6Y-�kk;,i.•,�•�`�c"' +k,�,r�, r _{� Y a _ e��`y�`y`• ti Sq�$ ��"y+�'����.��x„y.ct'$,{`��'r�1 ���y,".�,;,w`��. ,>`•t-,.�.���-�„�, ,��,�;'��t �. Y r i r CS vs krY i i it t lam K3 » nonc ia�f $t xyr. �>�t.`�5",a,,,.�.�`�l �����}} n•SS�' � f.y`��i�''���'fat�"�t�l'��.?�w",�.Y f 1 rm ., N, ; is,_a,,c',„t��•:,firr� ! i^L t",�,'4^�1r,2. }}A:_rt."N rk.k df"`"y i.-0 •y � t 3' k �c,1F r'Y �tj.i yr V1�+ '� 1'Af s m *ra �G # lt35 �lits `Stdw goo AA t i 4if"'4ei-+xtt 3+'mr__lf4'ivne +��rpyryit' "t;' 'E " 7"�� "2��s 24""G.tl �p� � 'L e °a"��✓1 s%`4tj , ,� -d xi r. 4J z i `��.' d'• ra �x y.f�. •$q'�a tt e J'r)i i��� to '�# tik'ai r'..++• xhy� k. x v4a "' x .ry ba r tmr r^ ��jsi�`°^� o-�'�✓�� ,F`s�,vJ. � Y� ��� ����a�r4� k�f" � �, Q lo,+c! F�` k �n* ft l fif nor t A tittr �fb tCi'oFd4ty°i � ✓ F �" L Y 55'� i♦t\�4� g�4 777-7 IN - J, '. L- , t•-Y s YF owl' wd r t+ "C V tk —R +'.y� ! t r low w. � NOT; 1 AW tie.. r, A' JU n f T WF,�Y\y � .r�>, ryyr � Fta L '�5� 1�'A�Lrl�t'r'•-.a.t r � �•'4 + �rA � 8 i �t,7dry�v aSti"{ y'ty ^v r�' r in �yFf � r`a.Yy °�x tewiia a £, ty°�` SK ', r^ d`'�� ""a � ]t. =�P'a`✓,i 'b�e t c�C3ah'' '� Zt"1 t' t't' `�,.� r,. �t x x t ."{ r�''''`i +�r �ry ��'r.• 7' .a -�(a i X zr>v+� r^'v"`l!� -l t` t �� ns 7 y °.r,`iRa rt � ,�� � r^�rf1Faz5 trvui" 001 S` 1, fitp x,' J� R �� th •e � 4r; i9 ko F. .. � �. • A ��C. �CSS co N z: m \ tp �� rte.. 2875 S.Winchester Blvd. Campbell.-Ca.95008 ° ESTIMATE � (408)379-855 OF REPAIRJS' BODY SHOP N'2 11 3®6803 1 NAME v V s G Nh ADDRESS /03a �/c / C e C-7 PHONE PHONE NO MAKE s"` VEAR!F( STYLE OV SERIAL it LIC # Z494/57/6`37 DATE BAI-91""--____. Probable INSURANCE CO ADJUSTER_ Down Time PHONE NO. LaborFRONTOF CAR RIGHT SIDE Parts Sill ble,HHoursours Parts Sublet IL i Hours UMPER FENDER FENDER �umper Brki 0CFender Skirt Fender Skirt _- Bumper Guard S Fender Ext Fender Ext Bumper Reinf Fender Mldg Fender Mldg Bumper Pad W O Mldg, W O Mldg. Gravel Shield Cowl Cowl Valance - eadlamp Headlamp Headlamp Door Al Headlamp Door HEADER PANELSealed Beam Sealed Beam Grille Park Light Park. Light Grille Mldg Side Mark. Lamp Side Mark. Lamp Grille Brkt Vert.Supt. DOOR, F RONT DOOR, F RONT Frame Door Hinge Door Hinge _ Cross Member Door Ri Door Remi CORE SUPT. Door Mldg. Door Mldg. Radiator Doo, Handle Door Handle Rad.Shroud Door,Glass Door,Glass Rad:Hoses Anti-Freeze DOOR, REAR Fan Blade Door Mldg Door Mldg Fan Belt Center Post Center Post Fan Clutch Rocker Panel Rocker Panel Rocker Mlda. Rocker Midg. - A.C. CONDENSOR QUAR. PANEL QUAR. PANEL Recharge A.0 Quar. Ext. Quar. Ext. Air Cond. Line Quar.Wheel Hse. Quar.Wheel Hse. Dog Leg Dog Leg Quar.Mldg. Quar.Mldg. HOOD Wheel,Open Mldg. Wheel,Open Mldg. Hood Hinge Fender,Rear Fender,Rear Hood Mldg. Tail Lamp Tail Lamp Hood Latch - - Side Mark. Lamp MSark,Lamp Ornament REAR F CAR ITEMS Name Plate Bumper Antenna Bumper Brkt. Battery Bumper Reinf. SPINDLE Bumper Guard Wheel Bumper Pad sf� Tire °a Worn Body Panel I Hub Cap Gravel Shield Up.Cont.Arm Floor Up.Cont.Shaft Gas Tank Low.Cont.Arm TRUNK LI Low.Cont.Shaft Trunk Lid Mldg. RECAPITULATION Wheel Align. - Trunk Hinge Motor Mts. Trunk Lcck _ 2 G- 1 4 U' Labor Hrs.,1. @ $ WINDSHIELD t-'c Light Parts $ Sid Adhesive Kit Backup Lamp- Tax $ � Moulding Open Items — -- It the customer wishes to claim used and/or damaged parts,please check this box F-1Matzrial 5 I hereby authorize the repair work listed to be done along with the necessary parts and materials My car will be driven by your J t7 employees to make required tests at my risk.An express mechanics lien is hereby acknowledged on above car or truck to secure the - Sublet amount of repairs thereto I herby waive the Statute of Limitations and if any action on this account requires employment of an attorney I /- agree to pay t':°°Interest per month which Is an annual percentage rate of 18°'°from date.reasonable attorney 5 tees arc:[Durr costs Storage will be charged 48 hours after repairs are completed Not responsible for loss or damage to cars or articles ieh,n cars m case of 22 fire.theft accident or any other cause beyond our control TOTAL $ ✓ /<' Authorized by X_____ _ _ 460498 .NAME `�-' r t�l I ( I"'C^ t9 DATE / �//WORK PHONE HOME PHONE S- 2 ADDRESS CITY STATE `� � ZIP YEAR MAKE MODEL •�'�" LD.NO. `'S,�i F l i 3 PAINT CODE PROD.DATE TRIM MILEAGE LICENSE NO. DATE OF LOSS WRITTEN BY ©� tti i INS.CO. FILE NO. CLAIM NO. P.O.NO. ADJUSTER LIC.NO. PHONE Deductible/Betterment 1 1 ' t�, sirar r' ls,,4!"!T.•4 "r - }t _ 'a t"s' sm i e LINE RE j' '6E� ,{ 4} 'm,DETAILS OFREPAIRrx t ,s;sR Rye aii S ;?Stral hten r`° ` � 3 PI ` �P RTS Y�1 LABOR, kr .,. ; N0, PAIR PLACE „P.; 6 9 ; A Aftermarket N41�Newx m � b j x ) PAINT SUBLET/MISC: ..r;�< F :, •e;;r ..,RlC,f Recycle/Rechrome/.Recore�t, ,3 r �U� USed s R ,�;Retiwltl'�ir £��.��� ��,��n�fi�€�� Ichl;�3r�rr~� r �l� _ 2 �t�� ti ,12% K.. :» a ..�'-s,'7tFt ts,�:.r,�. i.n: Me t�,r, a 1 t tryhv-A 5 +� `�•�p 4`.r � t d , 'v t{ �` i ) ;ft i.. f..�� >r,.1., r � ° at�"�n�',acj.,}��i:'•'� �' k< �wro�;.A�5������+:;'tt:� .�.i'7�'"y"�,��xSs �,t�j v .'t�s �<rCz. �x. 'l.rd ry .x.3r, /i�T qr 3 �. 2�a ev <,ae4. 'i(�a ut� ocri' $ c 'n • Gap n, Irv`�� 3 G / ft % t fa, 4 , a r� r R�?� r , 5 ..&, :X 1�/- -,, .tq,i ��a� 7 s•F�'f,•:"�/ v"^rT�i t .e�, u�� :;ry t tk�u '� mss' S" �2{�'�P rl a s'1`Se•-' �. ,r J � *�r s s t ��1..,+,�'t'G� y,;�.•r��pp , 1��,1��I�,��xyST L.VyY.,a)s ��, a.,��S r�, A�hr.,� p�. a 7 r? L�4. (o6i 1 , 7 , +.kyr rc �',,„"�'� -Sln 3' 2t ��• v . (S"i fl.`� L},p t'' F r3f Ps'5. t rrV_ f ' t 9 .. .. .-.... .... 16 try! ipf<Msipt a » °str} k a5ri n$tT n rte r ?4 n cr s Via^ tt 7 t c z t �4. 11 - 12 { � � u YYs t21fi 3K1 At Sri Y n r x 1A f 4 IJ _^,� Cr `firs r.ti`` rrr A x1 •r .�s.t.n,1„,s �y:43. 1 .°e,t,a,,. ,d 4 ;1t bP 'W 13 14. c a rt .y t r 3dti err 2F, x.,.*', e 15 16 17 } s �8 {,W. � Z` i, 'u rHTr # nrS1n1yE2 f *a't, V' wA .{�+u., .k;„ r ia,6r - 19 � . n 20 3 � 21 22 st,. 'z,' „F �,�ik a i'Tx�sauM � rt,, i1.S rr/ a. a�,� qqtt z� 3, �r. s» ti`s i ;���,.a t1 '�i zz k•'i�tri t rS'7 ; r. > s � .��rN*` us r �t��,_,. fix,-s rv�4t a„�.f,:+{” rcM".,a+r, �v, uYi��s�s°+� � ' 't�"� �t`�y��h- �y+ ;:'���,) i � 'iy4 J � ..•a 23 24 &0101 6�'is�' �".. ,+i, �a S�r1Y. ,t."•k'trr,.§�"n> I tj Art_V3J .. >Sd..*1iG,.m` .-}`'"4J 5s`7 `Y+, .?`-T .. t�!. �i-j°' .�v.�C�1"v.,, { s„xr�, at;'t»". t... ti R x ^; r 25 t r't i M *” r-+/•+,fgT�t�''R a4`' eu� F '},h ,; .'s.'"r 'y.r,idrrsyY'3<�y .s 's „�. .;;'. t t ti. v 26- }` A r'.,s •t� X13+' 'Grr. �!;'Ir~kr � `i �,K��1;`f a�tr!'��.� '''1cs�� �.�t ��"+`R. .,t 3-#� Inl✓N�^�^�.�^t���°��� �iw r 1 ��y& ! 15,o 27I hereby authorize the above work and acknowledge receipt of copy. TOTALS 0 PARTS Prices subject to invoice $ 3 Signed X . .. ,... . Date , ... @LABOR�hrs. $ Z ANTIUGH .AUT - PAINT lllviiJ Shoe SuDP�%ehrs.@a G.$_ 2 )• 7 o . Paint Supplies $ �2f' 100 RailiOad Ave. l _ Antioch, Californi8i 94509 Towing/Storage $ f"L 757-358_6! lam► C Sublet/Miscellaneous $ Phone (41$5))► 9 BAR #AG96504 EPA/Waste Disposal Charge $ FAX # (4 Y 5) 757-5246 $ RON YORK _ Owner SUB TOTAL $ JOHNNY BROWN - Arlanag$r $��� 1 TAX ....................... $ J r 7 TOTAL $ 5th" ', ©1988 I/DIEIA Inc.Form No.1002 I/D/FJA Inc.,One I/D/E/A Way,Caldwell,ID 83605-6902•CALL TOLL FREE 1-800-635-9:, t. $ o S $ (ID Q � ■ 5 , . 7 MOD . 0 � •�� 9 . � � �rl.� �Q�O VA. M0 & 0 ` .. . a � . - A \ � 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 November 5 , 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Pl es.se note all "Warnings". CLAIMANT: Shari Gigli o RECEIVED ATTORNEY: OCT 14 1091 Date received 6 NTY COON ADDRESS: 20 Camino Court BY DELIVERY TO CLERK ON O Ili0y lfa , 1991 Lafayette , CA 94549 BY MAIL POSTMARKED: October 10 , 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 14, 1991 PpHHIL BATCHELOR, Clerk Pt ,DATED: BY: Deputy 11. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed,. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 19 Al BY: ' Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (V/) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. 06 Dated: N 0 V e 5 1991 PHIL BATCHELOR, Clerk, ByU , 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 depositeu 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. 0_ Dated: N 0 V 6 1991 BY: PHIL BATCHELOR by34M °Deputy Clerk CC: County Counsel County Administrator i Claim to: BOARD OF SUPERVISORS OF,CONTRA COSTA COUNTYr 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,Deeember 31, 1987, must be presented not later than the 100th day 'after"tYie' 'accrual of the cause of action. Claims relating to causes of action for death or for-, injury to,person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the, accrual of the cause of action. Claims relating to any other cause of action must be presented not later than.one year after .the accrual. of.the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C: If claim 'is against a district governed by the Board. of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal, Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against -the-County of Contra Costa ) OCT 1 1 1991 or ) - _ CLERK BOARD OF SUPER District) CONTRA COSTA C Fill in name ) . The undersigned claimant hereby makes claim against the County of Contra Costa or : the above-named District in the sum of $ and in support of this claim-represents'as follows: __----N---N__N__-__M_______--_- 1. When did the damage or injury occur? (Give exact date and hour) -7 .-_ --- - - -------- ----- - 2. Where-did the damage or •injury occur? (Include city-echd county) s 3. How did the damage or injury occur? (Give full details; ,use. extra paper if required) ---- --- - -- _---------------------------------------=----- 4. , ' What particular act or 'omission,on, the part of county or district officers,. servants or employees caused the injury or damage? --,1 �sSl (over) j . 5. What are the names of county or district officers, servants or employees causing the damage or injury? VVV� ---------------- -------------------------------------------------- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach'twa{estimates for auto damage. v1d's-Z-A ___ -------- N______-N_-------------------------------- 7. --_ -_ --------------- - 7. How was the amount claimed above computed? (Include the -estimated amount of any prospective'In jury: or damage.) -- ---_N------------- Names _---__----- Names and addresses of witnesses, doctors and hospitals. -----------------------------------—-- ------------------------------------ 9. List the expenditures you made on account of this accident or injury: DATE . ITEM AMOUNT - Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES::TOa. (-Attorney.) or-by some person on .his behalf." Name and Address of Attorney S(slC2 r; Z_ LJ Claiman�'s Signature CcSv\. 0 rAddress 1-t.iz Telephone No. Telephone No. * * * # N-NOTICE; - Section 72 of the Penal Code provides': "Every person who, with intent to defraud, presents for allowance or for" payment to any state board or officer, or to ,any_.county, .city,or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, 'bill, account, voucher, or writing, is punishable either'by imprisonment in the county jail for a period of not. more than one year, by a fine of not exceeding one thousand ($1,000)," or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. ADDENDUM TO THE CLAIM OF - (Print yo r full name) ( 1) Do you use the roadway as part, of a daily commute? Yes ) No ( ) ( 2) Were you .aware that construction would be co-qTencing on the roadway? _ Yes C ) No ( ) ( 3 ) Was an alternate route available? Yes ( ) No ( ) ( 4) Did you read about the impending resurfacing lin the local newspaper? :Yes (. ) No ( " ) ( 5) Did you see warning g - vel and a 25 mile per hour -advisory sign? Yes ( 6) Did the damage, result„ f}rom another ,vehicle+:exceeding Ythe 25 mile per- hour `advisory? Yes ) No ( ) (7) Did a vehicle traveling in the same direction and exceeding the--25 mile -per hour advisory sign attempt to pass you? Yes ) No ( ) ( 8) Did a vehicle coming from the opposite direction cause gravel to be thrown onto your car.? Yes ( ) No ( ) (9.), Was the vehicle located directly in front of you exceeding 'zthe-speed---ad��visory? . ...� �'_ 'rC/�L+ti C__ Yes (ti ) - No V)_ D �� , , ) �_.. (10) Did you travel the roadway more than once during the resurfacing prior to the damage sustained toyourcar? Yes ( 11) j Did you obtain ,the identity of, the car, relating to questions '6 thru 9? Yes { ) No ( ) If, yes,;- 'please pr6vide ,"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. ( 13) Were you aware that using the road during 'the` chip. seal - process might result in damage to your car?�" ..Yes ( ) No (� a I declare that the above information is true and correct under the penalty of perjury. (Signature) (Date) 14:50 FROM LOF CENTRAL NO. CAL. TO � WALNUT CREEK P.01 2412 NORM MAIN ST. WAWW CRTC.CA' TV (416),W.4112 Libby-(wens-Ford Co. $Alt *AL143354 ! Q� ESTIMATE 202165225 Glass Centers FW ID 034-10" i {ORDER SILL. TO: Et� T I M A T E SALESMAN 10108!91 GATE SOLD TO ADDRESSIA�KF1MQaEL • In STATION VA ADDRESS CITY,STATE " * °' ucG ftE# MILEAGE CLAIMANTr' SPCIAL!NST. DATE TIME WORK PHONE# HOME PH CUSTOM # CASH !NST# COMP.DATE TIME INSTO# QUANTITY 11EM NUMBER 0E5C ON LIST PRICE SALE PRICE TAX 1 CW417$ OREIGN ;WZND i*E.>_ELD 141. 10 X j 1 -FW ABORbE13REI.CN bizNDSHIE 25. 00 r. t i laymt Reference Approval. -. .,Date. Amount Bub 166. 10 ._---- -------------------- ------------- ----- ---------- Tax 11. 64 Balance Total 177. 74 THIS IS NOT AN INVOICE DO NOT PAY INSURANCE COMPANY INFORMATION BELOW THIS LINE Ql—� TO:: INSt1�It�ftdY AGENT NAME • SHARI NAME ADDRESS ADDRESS ADDRESS ADDRESS f C1Tv.STATE LAFAYETTE CA CITY,STATE }PHONE# FLEET# PHONE# POLICY s CLAIM# INSURANCE DATE OF. " CAUSE OF VARIFIED BY LOSS LOSS �'^; l- �_ �� �. n . � � � � � ��� � � n�, o ��� r—" � 1 �Q "' �' �� - �. �N u, �� � � o� �, �- ,. ��s GS � e .� �a a;Y ... D t.. � � � . �/'� t9�„ � �-i/ �Y ,. 0 � � 1 `\ �� ,p \ � d Q 1 �,� ', �� �1 tom"' � �S �t �i � � �� �i � �+ � !� � � ,, � �.... '� 1 �}�,- \ ��,�`i` � ii /,3,3 ' 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 November 5, 1991 and Board Action. All Section references are to ) The copy.of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: U n s p e c i f i e d Section 913 and 915.4. Please note all "Warnings". CLAIMANT: KELLEY , Gerald ATTORNEY: OCT 1 7 19`31 Date received ADDRESS: 1733 Danki nger Road BY DELIVERY TO CLERK ON October 1&wNTJ�-81)N Concord , CA 94521 MARTINEZ, CALIF. BY MAIL POSTMARKED: October 11 , 1991 I. .FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: October 16', 1991 PpHHIL BATCHELOR, Clerk a BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors �1 ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �(j`� /�) 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 (Vol 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: N O V _ 5 1991 PHIL BATCHELOR, Clerk, B 0a 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: NOV 61991 BY: PHIL BATCHELOR b hAIJU Deputy Clerk CC: County Counsel County Administrator - RECEIVED OCT 1 5 1991 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. CONTRA COSTA COUNTY DETENTION FACILITIES INMATE REQUEST FOR� PERSONAL PROPERTY REIMBURSEMENT -------MDF ------=WCDF -------WFF --------MCDF This Section Is To Be Completed.by Inmate/Claimant NAME ADDRESS• ;j irk L �rc TELEPHONE: (HOME)"" u-7 Ui (WORK) How did the loss or damage occur?, -7W/n t Description of Lost or Damaged Property Item Describe fully). origi:na-l-_P- urci�a'se P~ rases j { & Date of Purchaser b L) i"�lli7 M! :U3 ry c L o o SRY r�c� S /0101 `, s s �-0 DET. 087 .FRM 0 . REV. 4/90 Distribition: Original, Director of Support Services 3 Yellow Copy, Inmate Y i 1'IV Pled Pcck7-� r/-/4r G,jqs z-os -r- A c --ro LCASE ID - CA/ <?j -ur- �-r(t4le 141\j-ID 6l2Ao n3 RECEIVED OCT 1 5 1991 CLERK BOARD OF SUPERVIP,--Npc- "CONTRA COSTA CO... W L � � O tj tri V� Cy h a� 0 y 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 November 5 , 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code A^iount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: NORTON , Ruthie ftk-EtV D ATTORNEY: OCT 10 1991 Date received October 1"oUIT _NSEL ADDRESS: 1 101 S i l v e r h i l l Court BY DELIVERY TO CLERK ON M34ar CALIF. Lafayette , CA 94549 BY MAIL POSTMARKED: October 4 , 1991 via Risk Mgmt . I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gH , DATED: October 9 , 1991 gdILATCELORCler : DeputyP. m., 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: 1�� 1 I� /�� BY: I ) •� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 1V. BOARDORDER: By unanimous vote of the Supervisors present (vrThis 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: N O V _ 5 1991 PHIL BATCHELOR, Clerk, By a J , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may'seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as sChow1nQ above. Dated: NOV u BY: PHIL BATCHELOR by, Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Ruthie Nortcn 1101 Silverhill Court LafaYette, California 94549 Re: Claim of Ruthie Norton Please Take Notice As Follows : The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially, with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. XX 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ( $10, 000 ) . If the claim totals less than ten thousand dollars ( $10, 000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ( $10,000 ) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . I Other: i VICTOR J. WESTMAN, County Counsel By:_ , S Deputy hty Counse CERTIFICATE OF SERVICE BY MAIL C.C.P. SS 1012, 1013a, 2015 . 5 ; Evid. C . 99 641 , 6641 My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69 , Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s ) having delivery service by U.S. Mail ) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S . Mail at Martinez/Concord, Contra Costa County, California . I certify under penalty of perjury that the foregoing is true and correct. Dated. /9` , at Martinez, lifornia . J � cc: Clerk of the Board of , Supervisors (or' nal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 4, 910 . 8) RECEIVE® OCT - 7 1991 Ruthie Norton L— CLEWK ea RD OF SUPE9vls�.IRS 1101 Silverhill Court ' ' . v'a`t Loo yLafayette, CA 94549 Aon Halve 415/256-8772 oCT o 7 1991 October 2, 1991 / Mr. Joe nda, Risk Manager '�O;AD� Contr ~Costa County 651 Pine Street, 6th Floor Martinez, CA 94553 OG� RE: Car Damage Dear Mr. Tonda: Enclosed please find my initial letter to you of July 30, 1991 sent via certified mail #P581 399 528 along with a completed claim form dated August 30, 1991 and the Volvo estimate of charges for replacement of the windshield as well as painting which is required because of the chipped paint. Please acknowledge receipt of this letter and indicate what action will be taken and within what timeframe as I would like to get the windshield repaired due to the fact the split in the windshield is now spreading. g_Rrds, Rut ,ie Norton Enclosures . n 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. relat'ing. to. causes of action for death' or for injury to person or to personal proper-ty�.br'grawing"'crops 'and 'which`accrue`on "o'r after January 1, 198$, 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"6f. action. ..(Govt. Code,-5911.20) B. Claims must be filed with the Clerk of the Board 'ofSupervisors 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 ofthe-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 m By Reserved for,Cl.erkts filing sRECEV ump ED Aga ns the, County of,Contra Costa 7 or } . CLERK-BOARD OF,S`JPERV1Soas District).. :. :. a co. Fill in name }.._ The undersigned--dlaimant hereby makes claim against the County of Contra Costa or the above-named District in the° sum of $ and in support of this claim represents as follows: ,, _, ..s ., - MMM-MN!!N-iNMI---M.! .. - iMii-iNNlMlMMi-!ilirMl�liii ! 1. When did the damage or injury occur?? (Give exact date and hour) llMlMiir�Nl�M�.�ifMr�w�Ir+�Vlw�wii+��Yi�iMriM�lI �I �1Y ----_----i�i1i� 2. Where did the damage or`injury* occur? (Include city and county *U� , J6 3. How did the damQe or injury occur? (Give full*detai�`j use extra er if Quired) r }� A !llM�iiMl•itMM,IM-iNiYi�.I�M-iMMMI�IFNM.i-MMMT!!-iNIN-lIII-YRi-iiMMi�i--lr-! 4. What,_,partieular ,apt or omission on the-part of eounty, or district officers, ; servants or; employees-=caused the injury or damage?' , (over) �. what are the names.of county or district officers, servants or employees causing., the damage or injury? 6. What damage or injuries, do,':you claim resulted? (Give full'extent, of injuries or damages ciaimed.. ' 'Attach twin, ,estimates.-,for auto damage-4- ------------------- amage:-------.w....----.r---. ------ 7. How was the amount claimed-above computed? (Include the estimated amount of any prospective injury or damage.) fi e �M��r•��s.��Y�r1�iYM.I�IIIM��OiA1�Y��y�rlli�r�r�y��Yr�..�M��•P�Y�fIY��r�w��lrl�--t---------- ------- 8. Names and addresses of witnesses, doctors and.hospitals. --l—rw—w► -----r------���Ysf����Y��1��1�A��r�Y�A��Nhi,ll�� 9... List the expenditures .you;made on account,�of this accident 6r- injury:' DATE ITEM ., # Y f': ' AMOUNT r-w----- 9 -A $,iF * 1F" iF ' '"iF : !F lF. C �lE it Gov,. Code See. 910:2 provides: "The claim must be signed -by the claimant SEND NOTICES T0: (Attorney) or • s e:. erso on his behalf.". Name and Address of Attorney � - Clai .aht s gnature, Address z IN Telephone No. Teleph a .No•. �J�P ( NOTICE Section. ?2 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, ..ispunishable either by imprisonment" in the county jail for -a period- of_not more..than one year,:.by'•a fine of not exceeding one thousand {$11000), or by both, such Imprisonment and,-,fine, or-by"impris6n6ent in the state prison-, by a fine of not exceeding ten thousand dollars ($10,0000 or by both such imprisonment and fine. ". • . ADDENDUM "1'O ;THE CLAIM OF (P'ri'nt your` full name) (1) Do you use the roadway as part of a/dda ly commute? Yes (d ) No ( ) ( 2) Were you aware that construction would be commencing on the roadway? - . Yes O 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_vehcle exceeding the -25 mile per- hour advisory?'- Yes' -( Yes ( ) No (7) Did a vehicle traveling in_the, _same..direction....and exceeding the 25--mile per- hour� advisory�sign attempt .to pass you? Yes ( } No (8) Did a vehicle coming from the opposite direction cause gravel to.:be thrown onto your car? Yes ( ) No (9) . Was the vehicle located directly in front of you exceeding the. speed advisory? Yes ( ) No (� ( 10) Did you travel the roadway more than once during the resurfacing prior to the damage sus " fined 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. V'�L U V nu� U A -Q (13) Were you aware that using the road during the chip seal process might result in damage to your car? Yes No I declare that the above information is true and correct under the penalty of perjury. (Signature} t FROM 9FWRENCE VOLVO P. 1 ArO lE tea LAWRENCE VOLVO � 2791 North Main Street • Walnut Creek,CalIfornla 94.596 a Phone(415)939.3333 3 WORK....._ 4 !L,kc;�- HCME &7 O-I]1...._ 2444-Er�_ MODEL ��',� LS � ��� 'LI CggF-,Zld l INS CLM�� �Yp1QIr r>zTnT,rTL1N PART --L $Ef,' TIME NECH 1 I ' LAB. RATE I .. ...� .. .. ..._..........._._.__......-- —,...._. ..__...._._...- --_.__........__...�.,.... ` TC.9 LA`BR. TIME C7 �. CLLR MATCH .Pam Serving Contra Costa County S;ncc 1021 } FP.OM OP-WRENCE VOLU.O P. 1 '"vo LAWRENCE VOLVO r: 2791 Nurth Malo Street 0 Walnut Creek,Californla 94396 i Phone(415)939-3.333 h. { �. MODEL LIC INS,v. LS , . . . . r� ._... . ,. ... . CLM¢, ;Tm-,!r A 11P DRq'cRiPT-TnN. , .WLABOR L,..»._.._.,. .P.A�T� R�,F. TIME '���.... T. LAB. RATE _.... _ �{?�.��CH 1,ABR. TIME - CLR MATCH TOTAL _..,.. .,,....�---�. r 1 CD � sQn O CL n p o � (IQ CD i � t 0 0 0 O O o P 0_0 1 A* J gg Q 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 November 5, 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $4,260,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: O'CONNOR, Leanne RECEIVE® ATTORNEY: Stan Casper Casper, Loewenstein & Schwartz Date received OCT 4 1001 ADDRESS: One Corporate Centre BY DELIVERY TO CLERK ON October 2 19�f UNTY 1320 Wi11ow Pass Road, Suite 500 MARTNE�zZcouNsF Concord, CA 94520 BY MAIL POSTMARKED: October 1, Mr, CALIF. Certified P 044 943 470 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. H g DATED: October 4, 1991 EYIL DeputyLOR, Clerk d dAll 0,�4/k. 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: /0 — Y — ! BY: Deputy County Counsel f s III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with noice--to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (1/<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. - Nov � 1 Dated: N O V 5 I9Q1 PHIL BATCHELOR, Clerk, By ° Deputy Clerk f4=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:—NOV 6 1991 BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator i I STAN CASPER CASPER, LOEWENSTEIN & SCHWARTZ 2 A Professional Corporation RECEIVED One Corporate Centre 3 1320 Willow Pass Road, Suite 500 Concord, California 94520 _ 2 1991 4 Telephone: . (510) 827-0556 5 Attorneys for Claimant, CLERK BOARD OF SUPERV Leanne O'Connor CONTRA COSTA CO. 6 7 8 10 LEANNE O'CONNOR, CLAIM FOR PERSONAL INJURIES (Government Code, § 910) 11 vs. 12 CONTRA COSTA COUNTY, CALIFORNIA 13 / 14 TO: Board of Supervisors, Contra Costa County: 15 YOU ARE HEREBY NOTIFIED that Leanne O'Connor, whose 16 address is 42 Sherwood Court, Pittsburg, California, claims i7 damages from Contra Costa County, California in an amount that 18 is within the jurisdiction of the Superior Court. 19 This claim is based on personal -injuries sustained by 20 claimant Leanne O'Connor on or about July 31, 1991, in the 21vicinity of Kirker Pass Road, one mile south of Nortonville 22 Road, Contra Costa County, California, under the following �3 circumstances: 24 Claimant was injured in a motor vehicle accident that 25 occurred at the above-described place and time as a result of 26 a hazardous condition of public property resulting from the 27 negligent design, maintenance and/or operation of the roadway 28 by unknown employees of Contra Costa County, California. Said CASPER,LOEWENSTEIN AND SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 - Concord,California 94520 (415)827-0556 I employees either created or allowed to exist an 'apparent left- 2 turn lane for northbound -traffic at the end of a downhill curve 3 that prevented oncoming traffic from observing vehicles 4 utilizing said apparent left-turn lane. The failure to 5 adequately warn of or correct said dangerous condition, whether 6 by installation of a proper left-turn lane, or otherwise, 7 despite the evidence dangerous nature of the condition of the 8 roadway, was the direct and proximate cause of claimant's 9 serious injuries. 10 The names of the public employees causing 11 claimant's injuries under the described circumstances are 12 presently unknown to claimant. 13 The injuries sustained by claimant, as far as known as 14 of the date of presentation of this claim, consist of a 15 fractured skull, multiple facial and scalp lacerations, bone 16 fractures and loss of neurological function. 17 The amount claimed, as of the date of presentation of 18 this claim, is computed as follows: 19 Damages Incurred To Date: 20 Expenses for Medical & Hospital Care $ 150,000.00 (approx. ) 21 Loss of Earnings 10,000 .00 (approx. ) General Damages 2,000,000 . 00; 22 Estimated Prospective �3 Damages As Far As Known: 24 Future Expenses for Medical & Hospital Care 100,000 .00-plus 25 Future Loss of Earnings , Unknown Prospective General Damages 2,000,000 . 00 26 Total Amount Claimed 27 As Of Date Of Presentation Of This 28 Claim $4,260,000 . 00 CASPER,LOEWENSTEIN AND SCHWARTZ A Professional Corporation 2 — ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 Concord,California 94520 (415)827-0556 1 Jurisdiction over the claim would rest in the Superior 2. Court. 3 All notices or other communications with regard to this 4 claim should be sent to claimant at the following address: 5 Mr. Stan Casper Casper, Loewenstein & Schwartz 6 Attorneys at Law 1320 Willow Pass Road, Suite 500 7 Concord, California 94520 8 DATED October �, 1991. 9 CASPER, LOEWENSTEIN & SCHWARTZ A Professi nal Corporation 10 11 By `f 12 STkt-ICASPhIf 13 Attorneys for laimant 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CASPER,LOEWENSTEIN t AND SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 Concord,California 84520 (415)827-0556 n Y PTJm r > O Z N O O O o C) D U) r p O m n o o > cn m f > r Q W1 m m O �--� tm33 ii O m O (Z O > o y rn A M 1 N o m O' N o Oz n D� r x C-)M 95 N U1• N O-N0C.) � 03 In O F-4 r ►-4 fD rt 0 n o rjw`C m 0 O o N fD O FhW rt p rp C� rtn :D' W > ri O m rD rt %.D rt n O C:3 � W W In L, n a w N O rt r-h f P3 S, b n n (D C-1 O Fj co v w O ti co m ltl ' fi h�J S^ 0 �� r> n l Z3 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA QpomyFD Claim Against the County, or District governed by) BOA1!Tj0l 1991 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November and Board Action. All Section references are to ) The copy of this document mailed to you pE 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: ROBERTS , Regina M . ATTORNEY: Law Offices of Meisel & Sherman 456 Montgomery Street Date received ADDRESS: Suite 1800 BY DELIVERY TO CLERK ON October 15 , 1991 San Francisco , CA 94104 BY MAIL POSTMARKED: October 11 , 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 16 , 1991 PpHHIL BATCHELOR, Clerk a DATED: BY: Deputy OA41n OJ I�A 0 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: IQ ( 91 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 (X 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 C this date.- - •- Dated: NovtY 5 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. �J Dated: N O V 6 1991 BY: PHIL BATCHELOR by Ii - APi Deputy Clerk CC: County Counsel County Administrator Regina M. Roberts, CLAIM AGAINST WALNUT CREEK POLICE DEPARTMENT, CITY OF Claimant(s) , WALNUT CREEK, COUNTY OF CONTRA COSTA VS. _ Walnut Creek Police RECEIVED Department, City of Walnut Creek, County of Contra Costa, IOU 1 5 1991 and DOES 1-25, public entity ' and its employees. 6f.W,eRJ011i1!Y.1:COZ, CLAIMANT'S SOCIAL SECURITY NO: 556-66-0141 CLAIMANT'S ADDRESS: 127 Bay Vista Avenue, No. 108, Oakland, California 94161 TELEPHONE: (Home) 601-1910 (Work) ADDRESS TO WHICH NOTICES ARE TO BE SENT, IF DIFFERENT FROM ABOVE: Law Offices of Meisel & Sherman, 456 Montgomery Street, Suite 1800, San Francisco, CA 94104 DATE OF ACCIDENT: April 14, 1991 TIME: 5: 10 p.m. LOCATION OF ACCIDENT: Main and Civic Drive DIRECTION PUBLIC VEHICLE WAS TRAVELING? northbound Main Street HOW DID THE ACCIDENT OCCUR? Walnut Creek Police Officer, Mark E. Ebbold, made an unsafe U-turn, thereby colliding with claimant's vehicle causing her injuries and damages. INJURY OR DAMAGE CLAIMED: Claimant's vehicle causing injuries to nzcj�, b-c'_, and shoulder. NAME AND/OR I.D. NUMBER OF PUBLIC EMPLOYEE(s) INVOLVED: Mark E. Ebbold NAMES(s) OF 1. TEL. NOS. EYEWITNESS(es) : 2. 3. { CLAIM AGAINST Page 2 ADDRESS(es) OF 1. EYEWITNESS(es) : 2. 3. Damages include, but are not limited to loss of earnings and capacity to earn, medical and hospital bills, past, present and future, and pain and suffering, emotional trauma and general damages. Information provided herein is based on that which is available to claimant as of the date of the . presentation of this claim. Damages are sought in an undctez-unincd a ouit, pursuant to California Government Code Section 910, and said damages are in excess of the minimum jurisdiction of the Superior Court of the State of California. I DECLARE, UNDER PENALTY OF PERJURY, THAT THE OVE IS TRUE AND CORRECT. Signed by or on behalf of claim nt: ._-=*—~– ew H. M `isel Attorney M,' Claimant V 4994clm PROOF OF SERVICE BY MAIL - CCP 1013a I, being first duly sworn, deposit and state that: I am a citizen of the United States and am employed in San Francisco, California. I am over the age of eighteen years and not a party to the within entitled cause. My business address is 456 Montgomery Street, Suite 1800, and San Francisco, California 94104. I am familiar with the practice of Meisel & Sherman for collection and processi;;g o- correspondences' for mailing with the United States Postal Service. It is the practice that correspondence is deposited with the United States Postal Service the same day it is submitted for mailing. I served the foregoing: Claim Against Walnut Creek Police Department and City of Walnut Creek, County of Contra Costa on the defendant in said cause, by placing a true copy thereof for collection and mailing, in the pourse of ordinary business practice, with other correspondence of Meisel & Sherman, located at 456 Montgomery Street, Suite 1800, San Francisco, California 94104, on October 11, 1991, enclosed in a sealed envelope, with the postage fully prepalu, as follows; Attention: Ms. Nancy Sanderson City of Walnut Creek County of Contra Costa P. 0. Box 8039 Walnut Creek, California 94596 Board of Supervisors County of Contra Costa 651 Pine Street No. 106 Martinez, California 94553, ANNA CARR 4094clm z 0 � c� c 7 O r -_ o r" �R a � v, � xP, y A C) 1'1 0 m D® `Cl)—! G�1j z 1 ITI 0 00 �co aye 9 _ a o s z o� � " ° 0 C � rnnbd av, 00 rt :J wrorta (OS- 4 D0 � (D0 f) rt00 Rt " 0 I'd m Z m P-N rt M rt " O A) N- " z m 0 000 P On al N (A H f$ _ O Qi %O ON Ln Ul w SA r ' T 7 00 5!� ' _ 5 - 0404:auK4+r0 • CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA DECEIVE® Claim Against the County, or District governed by) BOARD 119 91 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November , 19 1 and Board Action. All Section references are to ) The copy of this document mailed to you is 314M1h`bt:ftVs5rF California Government Codes. ) the action taken on your claim by the Board l+RAW rvMrs (Paragraph IV below), given pursuant to Government Code Amount: $297.56. Section 913 and 915.4. Please note all "Wa,nings". CLAIMANT: SMITH, Stephen ATTORNEY: Date received ADDRESS: 135 Gilger Avenue BY DELIVERY TO CLERK ON October 1, 1991 Martinez, CA 94553 BY MAIL POSTMARKED: September 30, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 2, 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: Dated: " 5:7 C BY: ,>` Deputy County Counsel III. FROM: Clerk of the Board TO: County CoV6,1• (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: q Dated: C4 0 Nov 5 199! PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on 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: N 0 V 6 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 3 t Ciair. 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. 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 SPE� � RECEIVED Against the County of Contra Costa ) i 11991 or ) CLE RPC BOARD OF SUPER!/'�Pr District) CONTRA COSTA C.O. Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 7 ��' and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Wher did, the damage or injury occur? (Include city and county) AW 3. How did the damage or injury occur? (Give full details; use extra paper if required) ------------�=-- ---� Zc. ---------_----=z. ---� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5. wnat are tne names of county or district officers, servants or employees causing the damage or injury? v),7 k- -—-------- -----—----—---- ----- ---------------------------I 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. t1wbc,1 4 CS, 7. How was the amount claimed above computed? (Include the estimated amour of any prospective injury or damage.) P Names and addresses of vitnesses, doctors and hospitals. --------— ——---------—- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code See. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or bysome person on is balf Name and Address of Attorney 47 hCla t I eSAM iman tune) a 14-e Address Telephone 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. L. 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 advisorysign? Yes ( x ) No ( ) ( 6 ) Did the damage result from another vehicle exceeding the 25 mile per hour advisory? Yes ( ) No (7) Did a vehicle traveling in the same direction and exceeding the 25 mile per hour advisory sign attempt to pass you? Yes ( ) No ( �, ( 8) Did a vehicle coming from the opposite direction cause gravel to be thrown onto your car? Yes ( ) No (�T ( 9) Was the vehicle located directly in front of you exceeding the speed advisory? Yes ( ) No (� ( 10 ) Did you travel the roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( \A 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. ( 13 ) Were you aware that using the road during the chip seal 1process might result in damage to your car? gv7 r' -(k� eov- Yes ( ) No ( ) I d(2clare t7aft t e above information is true and correct under the penalty of perjury. Siggnaat e (Dat ) q o ..- m UO o o O Us 9 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 November 5 , 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: S Y K E S , Holly RECEIVED ATTORNEY: Allan M . Tabor OCT 111091 Ryan & Tabor Date received ADDRESS: 50 Francisco , Suite 122 BY DELIVERY TO CLERK ON OctolR']_ NsgL991 San Francisco , CA 94133 ' BY MAIL POSTMARKED:October 3 , 1991-from Merrithew �lo���tal 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: October 11 . 1991 �d: Deputy op Atjvi� 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: 1C ( BY: / Deputy County Counsel u kQi 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. - NOV 5 .19910 Dated: PHIL BATCHELOR, Clerk, ByZ ° 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. 0 Dated: N Oy V 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 7s I � err'thew • .yea emoreal @O WN&d OCT 9 1901 A N D C L I N I C S COUNTY COUNSEL MARTINEZ, CALIF. TO: Office of County Counsel DATE: October 7, 1991 Contra Costa County FROM: Mark Finucane Y RE: CLAIM Health Services Director Holly Sykes 031960-8 The attached claim for the above named patient was received by Merrithew Memorial Hospital and Samuel Gross, M.D. , on October 7, 1991. SP R EIV "® Attachment OCT 1 0 1991 cc: Risk Management Department CLERK BOARD 07 S(I-RrRVIsoRS colvTRa coS�-�ca. , n. Contra Costa County A-301A (3/87) 1 RYAN & TAB OR ALLAN M. TABOR 2 STATE BAR NO. 52846 50 Francisco Street, Suite 122 3 San Francisco, CA 94133 (415) 981-2010 4 Attorneys for Plaintiff 5 6 7 CLAIM FOR DAMAGES 8 HOLLY SYKES, No. 9 Claimant, RECEIVE® 10 vs. 11 MERRITHIN% MEMORIAL HOSPITAL OCT I Q in AND DR. SANfT EL GROSS, 12 CLERK BOARD OF SUPERVISORS Respondents CONTRA COSTA Co. 13 � 14 1 . Holly Sykes lives at P. 0. Box 246, Martinez , CA 94553 . 15 2. Notices are to be sent to the law firm of Ryan & Tabor, 16 50 Francisco, Suite 122, San Francisco, CA 94133 . 17 3 . On or about March 3, 1989 through March 7, 1989, 18 defendants undertook the treatment of plaintiff ' s right wrist . 19 On or about April 9, 1991 , plaintiff required surgery on said 20 wrist because of a fracture which went undiagnosed and untreated 21 by Merrithew Memorial Hospital and Dr . Samuel Gross. 22 4. Damages are to injured right wrist. 23 5. Names of public employees responsible are unknown at 24 this time. 25 6 . Jurisdiction rests in the Superior Court. 26 DATED: October 2 , 1991 RYAN & TABOR 27 BY "V4 28 AN M. TAB OR RYAN&TABOR ATTORNEYS AT LAA SO FRANCISCO ST.,SUITE A'ISi 1 SAN FRANCISCO,CA 24100 PROOF OF SERVICE BY MAIL (CCP SECTION 1013 (A) , 2015.5) 2 I am a citizen of the United States and am employed in the 3 City and County of San Francisco, California. I am over the age 4 of eighteen years and not a party to the within action; my business address is 50 Francisco Street, Suite 122, San 6 Francisco, CA 94133 . 7 On October 2.- 1991 1 served the within Claim For 8 Damages on respondents in said action ,by , 9 10 placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid , in a United States Postal service 11 mail box at San Francisco, California addressed as follows: 12 Merrithew Memorial Hospital 13 2500 Alhambra Avenue Martinez , CA 14 Dr. Samuel Gross 15 Merrithew Memorial Hospital 2500 Alhambra Avenue 16 Martinez, CA 17 1 declare under penalty of perjury that the above is true and 18 correct. Executed on the above date at San Francisco, 19 California. 20 21 ALL N �M. TABOR 22 23 24 25 26 27 28 RYAN 8 TABOR ATT011EY8AT LAW 50 FRAN91SCO AT SUITE*111 2 SAN FIANCISCi,CA WAS (0161061-2010 7s \y$9p . /, \k O � . a � . .Ul . « q . � � . � � A $ m . VA I' . � CT# � � t & � ¥ & , . 0 ®> FRS ` / �2 ` cA / . A; , � \ y\%\ '0111�{ \ fin\i\ r ' ' »: \ 'S� » / t A / . CLAIM ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the .Cpunty, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 5, 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SYKES , Holly ATTORNEY: Allan M. Tabor OCT Ryan & Tabor Date received ADDRESS: 50 -Francisco, Suite 122 BY DELIVERY TO CLERK ON QDLt ►bQNSk0 . 19 91 San Francisco , CA 94133 MAUINU, CALIF. BY MAIL POSTMARKED:October 3 . 1991-from Merri thew I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. a oil, DATED: October 1 . 1991 91. BeAputyLDR, clerk 4 I. 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: ��/ N Deputy County Counsel I1I. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( } Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( VThis 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. r �QQ1 Dated: �� PHIL BATCHELOR, Clerk, ByOtAAU , 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: NOV 1ann9t BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 1 RYAN & TAB OR ALLAN M. TABOR 2 STATE BAR NO. 52846 50 Francisco Street, Suite 122 3 San Francisco, CA 94133 (415) 981-2010 4 Attorneys for Plaintiff 5 6 CLAIM FOR DAMAGES 8 HOLLY SYKES, No. 9 Claimant, 10 vs . 11 ME RRI TH&q%' MEMORIAL HOSPITAL AND DR. SAnJ EL GROSS, 12 Respondents 13 14 1 • Holly Sykes lives at P. 0. Box 246, Martinez , CA 94553 . 15 2• Notices are to be sent to the law firm of Ryan & Tabor, 16 50 Francisco, Suite 122, San Francisco, CA 94133 . 17 3 . On or about March 3 , 1989 through March 7 ,1989, 18 defendants undertook the treatment of plaintiff ' s right wrist. 19 On or about April 9, 1991, plaintiff required surgery on said 20 wrist because of a fracture which went undiagnosed and untreated 21 by Merrithew Memorial Hospital and Dr. Samuel Gross. 22 4. Damages are to injured right wrist. 23 5. Names of public employees responsible are unknown at 24 this time. 25 6 . Jurisdiction rests in the Superior Court. 26 DATED: October 2 , 1991 RYAN & TABOR 27 BY (N"/( N M. TABOR 28 RYAN A TABOR ATTORNEYS AT LAW 1 00 FRANCISCO ST.,SUITE#122 SAN FRANCISCO.CA 14133 141 51 001-2010 I PROOF OF SERVICE BY MAIL (CCP SECTION 1O13 (A) , 2015.5) 2 I am a citizen of the United States and am employed in the 3 City and County of San Francisco, California. I am over the age 4 of eighteen years and not a party to the within action; my 5 business address is 50 Francisco Street, . Suite 122, San 6 Francisco, CA 94133 . 7 On October 2. 1991 , I served the within Claim For 8 Damages on respondents in said action by 9 placing a true copy thereof enclosed in a sealed envelope with 10 postage thereon fully prepaid, in a United States Postal service 11 mail box at San Francisco, California addressed as follows: 12 Merrithew Memorial Hospital 13 2500 Alhambra Avenue Martinez , CA 14 Dr . Samuel Gross 15 Merrithew Memorial Hospital 2500 Alhambra Avenue 16 Martinez , CA 17 I declare under penalty of perjury that the above is true and 18 correct. Executed on the above date at San Francisco, 19 California. 20 21 ALLAN M. TABOR 22 23 24 25 26 27 28 RYAN d TABOR ATTORNEYS AT LAN 2 60 FRANCISCO ST..SUITE*122 SAN FRANCISCO.CA 04123 14161 001-2010 2 m 0 m Z> 0z 0 zn-, Z O 0< M D , r=-4 �co C z m _ O D # A N M � N Cl) co 07 Ul (D I"S t+J M En " O tirr ort y FD Ln ti U) H c rt tc (D F•- H 07 E (D tri d �.7 P (D G) H y C 0) El h5 'lJ H W O O y r C � r G � (D t,] O U� m y *(� r9 rt �p,N FRj CO �� tin LD 3 .0 (\h`1 'I Fya *;��n anaaaaaa �,�jJ CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA r Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 5 , 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $7 , 500 ,000 . 00 Section 913 anO 915.4. Please note all "Warnings". CLAIMANT: WALSH , John J . , WALSH , John M . , WALSH , Katie ATTORNEY: Paul M . Monzi one , Esq . OCT 14 1091 Belli , et al Date received ADDRESS: 574 PaCifiC Avenue BY DELIVERY TO CLERK ON 0 1ah4N�, c.�i 19 91 San Francisco , CA 94133 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. �bIL BATCHELOR, Clerk v DATED: October 14 , 1991 : DeputyA-00 AA41 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 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 OzThis 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: NOV 5 190 q_ 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: ®� X991 BY: PHIL BATCHELOR by J I AA i ° Deputy Clerk CC: County Counsel County Administrator RECEIVED s OCT 1 11991 CLAIM AGAINST THE COUNTY OF CONTRA COSTA CLERK BOARD OF SUPER SORB CONTRA COSTA CO. - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - CLAIMANTS' NAMES: JOHN J. WALSH JOHN M. WALSH KATIE WALSH CLAIMANTS' ADDRESS: c/o BELLI, BELLI, BROWN, MONZIONE, FABBRO & ZAKARIA MELVIN M. BELLI, SR. , ESQ. PAUL M. MONZIONE, ESQ. 574 Pacific Avenue San Francisco, CA 94133 AMOUNT OF CLAIM: $7, 500, 000 . 00 DATE OF INCIDENT: On or about 4/14/91 LOCATION OF INCIDENT: Parcel #373-040-003-7 Marine Services Complex 245 North Court Street Martinez, California 94553 DESCRIPTION OF INCIDENT: The above named Claimants entered into a lease agreement with the City of Martinez and others to lease a certain parcel of real property commonly known as the above referenced property, which is the boat yard at the Martinez Marina. Claimants leased said property for the specific purpose of building a large commercial fishing trawler. Majority co-tenants on the subject property, with the knowledge, consent, and ratification of and participation by the County of Contra Costa, have made a practice of and engaged in the improper and unsafe handling, use and storage of hazardous and toxic materials, including, but not limited to: sandblasting operations without proper precautionary safety or protective measures; improper collection, storage and disposal of toxic materials and residue; failure to remove gas and fuel tanks from underground storage on the subject property. As a result of said negligence and wilful acts, Claimants JOHN J. WALSH and JOHN M. WALSH has suffered serious debilitating s and degenerative illnesses requiring extensive medical care and treatment, and will continue to require medical care and treatment for an indeterminate time. As a further result of said negligence and wilful acts, Claimant KATIE WALSH has suffered loss of consortium in addition to other damages set forth herein. Additionally, all Claimants have suffered and will continue to suffer economic damages in the form of lost use and enjoyment of the fishing vessel which was to have been completed on the subject property, the value of their professional services, as well as general and special damages related to their exposure to the dangerous conditions set forth above, including lost income, past, present and future, and medical expenses, past, present and future, emotional distress, pain and suffering. SPECIFIC CAUSES OF ACTION: 1. BREACH OF CONTRACT: Claimants had a direct contractual relationship with the County of Contra Costa, or were third party beneficiaries of such a contract. The County of Contra Costa breached the contract by its failure to properly supervise and maintain the subject property and by leasing the same parcel of real property to majority co-tenants whose purposes and activities were both illegal and dangerous, and the County knew or should have known of the dangerous conditions. As the County owns, controls, maintains or is otherwise responsible for the subject property, it had a duty to keep said property free of the dangerous conditions and unlawful activities herein described. 2 . NEGLIGENCE: Claimants allege negligence in the County' s failure to properly monitor and supervise conditions on the subject property, thereby allowing illegal and dangerous activities to continue. Claimants further allege negligence based on the County' s failure to timely and properly dispose of hazardous materials in and around the subject property, thereby further permitting the existence of dangerous conditions. 3 . FAILURE TO WARN AND INSTRUCT: The County knew or reasonably should have known of the dangerous conditions and hazards described herein on the subject property, and failed to properly warn and/ instruct 'Claimants herein of such dangers and hazards. NAME OF PUBLIC EMPLOYEES CAUSING INJURY OR DAMAGE, IF KNOWN: The specific identities of any individuals who may be directly responsible for the claims made herein is currently unknown. 1150I 2 ITEMIZATION OF DAMAGES : Past, Present and Future Hospital and Medical Expenses and General Damages: $5, 500, 000 . 00 estimated Past, Present and Future Economic Losses: $2, 000, 000 . 00 estimated Signed by or on behalf of Claimants: '�L P 1 M. Monzio , Esq. Dated: October 11, 1991 11501 3 33 M 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 November 5 , 1991 and Board Action. All Section references are to } The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $208 . 45 S^ction 913 and 515.4. Please note all "Warnings". CLAIMANT: WEDELL , John W . ATTORNEY: OCT 11' 1 Date received C( LINTY "'OUNL• ADDRESS: 50 La Espi ral Road BY DELIVERY TO CLERK ON Octal Orinda , CA 94563 BY MAIL POSTMARKED: October 7 , 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gpJ�{IL BATCHELOR, Clerk DATED: October 9 . 1991 BY: Deputy _ 11M 01 fA4LI 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: I 111 ��() BY: A Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (VThis 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: N 0 V 5 1991 PHIL BATCHELOR, Clerk, By a Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. 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. 0 Dated-- NOV 6 1991 BY: PHIL BATCHELOR by 0 Deputy Clerk CC: County Counsel County Administrator Claim.;to: BOARD OF SUPERVISORS OF CONTRA COSTA COUM INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of`,actionµfor. death or for injury 'to person*or to per- sonal property or growing crops and which accrue on or before December 31, .19$7,. ,must be .presented not-later than the-100th day after the accrual.of.the cause. of action: Claims.relating to causes of aetion `for • eath or, far ira ury' to ,persan or to personal property.,or growing crops and which accrue on or-ifter 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 11 be filed with the Clerk of the Board of°Supervisors at'its,office in Room, 106,*County Administration,Building 9 651 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.., 4`4`44 e e a .,tt. # * i*.,: ..e.s. ..: *r: lF:.�F * ..e:!! . . !E a �t e * �! e ,V* RE: -Claim, By ) Reserved for 'Clerk's filing stamp RECEIVED} Against the .County of antra Costa ) `OCT 8 1991 CLERK BOARD District) SUPERVI District}-.. . CONTRACoss Co: Fi11 in .naive _ Y The undersigned claimant'hereby�makes claim against the County of Contra Costa or the above-named District in the sum of $ 2-08, 45 and in support of this claim represents as follows: . rrrrrw+isiriw.�awr�,�rw�.���r —.�rr—�r�rr..r*e—+`rNrrrwrrw.� rrrs.rrrr.�—rrr 1. When did the damage or injury occur? (Give .exaet date and hour) .a. _?. _.._!_r_ .NM�IwY-re..YrMr-4r-r-,IMrr-!_rsrM_rrlrrtlNMM-lwl�.li�41,-MI_rM ri -r-A---rM►rr11rIYr.Mr�M_r_'. Z. ,Where did,.�the. damage or injury occur?- (Include city and county) �.rrr+err--r..rr.�rrr+r.—.�—rr—.—rr..rr.rrrr—�rrrrrsr r—,+rrrrrrr—,r_.w—_—.e.._.sr—,rsr---.ter 3. How did the damage or injury occur? (Give :full �details,f use',"extra paper if required), apRt b�� Luk5 UV-401=RW, TK>' Mrd? >rLAYJa C® U Eli w ► Z-c,o'SF � U � 1� . `Rrre 4 }w �� 9;a 2eU E 1, T► 1 R t3u,N P/y i''t 1,.> t2.. -HeA v`l �Q u+ P!�t .;,-u-- a:R Ani, }aui?� 1VIl� L �,J,►u FF-herr of w1 lig - cA N_" „co�u nc;T.w�-�N -tvt WtN05ui�, 4..''`What particular .act or omission on the- part,4of"county or`.district ,officers, c gra clt��sl� servants or employees caused the,,injury_ or,damage? -------------- TYPE (over) D. what are the names-of county or -district officers, servants or employees causing the damage or in3ury ? . � . �N� lV�•�..� 6'(2-C- -CUI b `7 15 E k4 V L 6 �CSC 6TCa uS?�vcg-rl v Q. ----------MN---------------------------�_--------------- ---_--M-------------- 5. What damage 'or injuries•-do--you,claim resulted? (Give•-full extent of injuries or damages claimed. Attach two.estimates for auto damage. fA Y\A W► ��s� i�LO �:s c p cK'� � .o P -pC15 s. o a 70 How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage..) -_-N------ -_N----- ------ 8. 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 - GOV. Code Sec. 910:2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) orb . some erson on his.-behalf." Name and Address of Attorney laimant'sSignature) , 540 � n, � . � Rc L Address . . o ., 0D cb Telephone No. 'Telephone NoX0'2-54— 18 53 Section, 72-of the; Penal Code.•provides: ry "Every person who, with intent to- defraud, presents for allowance or for~ payment to any state board or officer, °onto 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 I by imprisonment in the county jail for a :period of.not more than one.year,4-,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. ADDENDUM, TO THE CLAIM-OF ��`1;Vyy ��ai,.- (Print .your full name) ( 1) Do 'you use the roadway as part of a. daily commute? Yes ( ) No ( D�) ( 2) Were you aware that construction would be commencing on the roadway? Yes ( ) No ( X) ( 3) Was an alternate route available? Yes ( X ) No ( ) (4) -;.Did you read. about the impending resu_i.facing inf`the local newspaper? Yes ( ) No ( X ) ( 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 Anothe`i: vehicle xce eeding the 2.5 mile-per hour.. advisory? Yes ( ) No (X ) (7) Did a vehicle traveling in the same direction and exceeding the- 25-mile -per hour advisory sign attempt to pass you? Yes ( ) No ( X ) (8) Did a vehicle'coming from, the opposite direction cause gravel to be thrown onto your car? Yes ( ) No ( �) ( 9) Was the vehicle located directly in front of .you exceeding the speed advisory? Yes ( ) No ( �C ) (10) .Did .you• travel the roadway more than once during the resurfac'irigr.prior to the damage sustained to your car? Yes. ( j 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' an your vehicle. U E-L 5W--1 V t AA G t t5 L-tD A � Vv'A a v! N G 'S6y-rL4 6N-) A L_o �' f5t_y A l Adam:'-, (13) Were you aware that using the road during the chip seal process might result in damage to your car? , Yes J ) No ( �} I declare that the above information is true and correct under the , penalty of perjury. Signature W �) � (Date), :JCT-04-1' 91 15.33 FROM LOF CENTRAL NO. CHL.ON TO WHLNIJT CREEK P.01 2012 NORTH 641A1N ST. WALNUT CREEK,CA 94696 Libby-Owens-Ford Co. A1ESTIMATE 202164841 EARlk �AL141t43654� Glass Centers Fw ID #34-15&6C4 WORK ORDER INVOICE w.,.,7 SALESMAN 09 SILL TO: _ E S T I M A T E DATE 10/04/91 I SOLD T() CASH--SAY I ADDRESS MAKE/MODEL 71, MERCURY, COUGOR ADDRESS ►;',N F. V.I.N.# CITY,STATE �. LICENSE* MILEAGE CLAIMANT SPECIAL INST I DATE TIME WORK PHONE# HOME PH CUSTOMER 3 CASH INST# j COMP DATE TIME IN'SIPO# OUANTTY ITEM NUMBER - DESCRIPTION LIST PRICE SALE PRICE TAX 1 W773S DOMESTIC. WINDSHIELD I 159. 52 TX I �DWCASH AB©R,-kD©MES.T.IC W/S 25. 00 1 DW I T DOMF�-ST.I C. ACJ I NDSH I EL 9. 95 TX � I I j i i Raymt Reference Ap^ Ival Date Amount Sub 194. 47 --------------------- ---- ------- ----- ----------- Tax 13. 98 Balance Total 208. 45 *�* THIS IS NOT AN INVOICE DO NOT PAYS — — — — INSURANCE COMPANY INFORMATION BELOW THIS LINE ~u INS Y AGENT NAME JOHN WEDELL NAME ADDRSS ADDRESS � ADDRE55 ADDRESS CITY.STATE t)R t.':DA CA 0;7,,STATE i PHONE# LE€T A PHONE# POLICY k CLAIM INSURANCE DATE OF CAUSE OF VARIFIED B,, LOSS LOSS Ir'. CC' 415 538 4757 j E UNITED . GLASS ' ,COMPANY 477 TWENIY•FIFTH STREET 8*1—een Broodway d feleyroph1ELEPHONE 832.6514 OAKLAND,LAtIFORNIA 94612 °...• ES - t No Con. No. Job Dateeg ESTIMAT11 Location — Salesman j s Architect . Off Ice. � Subject to twenty (20)days acceptance. Bid to. _ Sheet LABOR QUAN. DESCRIPTION -- _ /77 �_--�A SNI/--CN////V��/�-.t e 4 F.O.B. Job site: EF-1 Exceptions:. ForewaFd i Bids 'iubject to clerical error corrections No prolectton ` Terms:- Net-10 days or cleaning of glass or ml. No responsi, itity`,for Interest on past due age by others. Scoffolding by others. No responsibllltyj f r- o0ccturitt", colt 01.1Led at: fordalaysbeyond aurcontrol, Acre to ,fJ„ „ a� o c UN O fir, C a i l� VVV i' i �. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim'iAgainst the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 5, 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors RECEIVED (Paragraph IV below), given pursuant to Government Code Amo,:nt: $2,500,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: WHITEHILL, Lee OCT 7 1991 COUNTY COUNSEL ATTORNEY: Stan Casper MARTINEZ, CALIF. Casper, Loewenstein & Schwartz Date received ADDRESS: 1320 Wi l low Pass Road, Suite 500 BY DELIVERY TO CLERK ON October 4, 1991 Concord, CA 94520 BY MAIL POSTMARKED: October 3, 1991 Certified P 044 943 472 I. FROM: Clerk of the Board of Supervisors 1'0: County Counsel Attached is a copy of the above-noted claim. DATED: October 7, 1991 JVIL BAATTCHELOR , Clerk FRO4411 M: County Counsel TO: Clerk of the Board of Supervisors \r ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 10 BY Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1)" County Admin tr for (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: Roy 5 1991 PHIL BATCHELOR, Clerk, By a Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. .See Government Lode Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: N 0 V 6 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator a I STAN CASPER CASPER, LOEWENSTEIN & SCHWARTZ IV ED 2 A Professional Corporation - One Corporate Centre 3 1320 Willow Pass Road, Suite 500 E 41991 Concord, California 94520 4 Telephone: (4,15) 827-0556 CLERK BOARD OF SUPERVI O 5 Attorneys for Claimant, CONTRA COSTA CO. LEE WHITEHILL 6 7 . 8 CLAIM AGAINST COUNTY OF CONTRA COSTA 9* TO: Clerk .of the Board of Supervisors County of Contra Costa 10 651 Pine Street Martinez, CA 94553 . 11 - 12 CLAIMANT'S NAME LEE WHITEHILL 13 CLAIMANT'S ADDRESS 65 E. Madill Street Antioch, CA 94509 14 CLAIMANT'S TELEPHONE (510) 778-2850 15 AMOUNT OF CLAIM $2,500,000. 00 16 ADDRESS TO WHICH 17 NOTICES ARE TO BE SENT: Stan Casper Casper, Loewenstein & Schwartz 18 1320 Willow Pass Road, Suite 500 Concord, CA 94520 19 DATE OF OCCURRENCE October 5, 199. 0; March 3, 1991 20 DATE OF DISCOVERY August 19, 1991 21 PLACE OF OCCURRENCE Martinez, California 22 HOW DID CLAIM ARISE This claim is based upon the medical 23 negligence of Dr. Kofoed and other staff members of the 24 Merrithew Memorial Hospital in failing to properly treat 25 claimant's broken right leg suffered as a result of a 26 automobile accident. 27 Upon his transfer to Merrithew from the Mt. Diablo 28 CASPER,LOEWENSTEIN Medical Center, claimant had the external fixation from his AND SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE — 1 — 1320 Willow Pass Road Suite 500 Concord,California 94520 (415)827-0558 I right leg removed on or about October 5, 1990, which removal 2 was premature. 3 Claimant subsequently had a rod placed in his right leg, 4 which was done negligently, shattering the bone in his leg. 5 During the entire time of his treatment at Merrithew, up 6 and until August 19, 1991, when claimant sought a second 7 opinion from another orthopedist, he was led to believe by Dr. 8 Kofoed and other staff members of Merrithew that his leg had 9 been treated properly. Claimant learned for the first time on 10 August 19, 1991, that both the early removal of the external 11 fixation device as well as the surgical implanting of a rod 12 were performed negligently. 13 The injuries sustained by claimant as far as known as of 14 the date of the presentation of this claim, consists of lost of 15 earnings, the costs of additional surgeries and 16 hospitalization, anxiety, severe emotional distress, and fear. 17 Jurisdiction over the claim would rest in the Superior 18 Court. 19 ITEMIZATION OF CLAIM Loss of earning capacity, 20 $1,000,000. Incursion of medical bills and surgeries, 21 including future surgeries, $500,000. 22 General damages including emotional distress, trauma, 2 3 . humiliation, pain and suffering, $11000,600.00. 24 Dated: October 3, 1991. 25 CASPER, LOEWENSTEIN & SCHWARTZ A Professional Corporation 26 27 By 28 AN CASPER CASPER,LOEWENSTEIN Attorneys for tlaimant AND SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE _ 2 1320 Willow Pass Road Suite 500 Concord,California 94520 (415)827-0555 tTl O O 0 2 N m O O n NCD Y 9 O N 9 J, C O O ? O �q r rn zs r N 00 C'� z g N 0 o (�y�r rn 33 N N w 00 � � ti o o; 0 tn N @ M ct ,= p ('1 rt t 0 -0 � 0 � P U3M ft l � Ct Ft 0 13) Li t y N "' 0 w ma ct Y C-1 �� Y• v LO . a LO o N o a D AMENDED /,33 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 November 5 , 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $9 , 792 . 26 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JIHONG, Ok/The Farmers Insurance Group of Companies QLAXVED Policy #12237 11 55 SALN 07 54197 ATTORNEY: Farmers Insurance Group OCT 14 1991 Richmond Claims Department Date received ADDRESS: 3211 Auto Plaza BY DELIVERY TO CLERK ON October LAUNr 88&hSEI Richmond, CA 94806 October 10 1991 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: October 14, 1991 gaIL �ep�tyLOR, Clerk Ppc II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claims complies substantially with Sections 910 and 910.2. 4�QN1�1(`Cl � ) 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: t Dated: BY: I� S- Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Adminis ator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (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: N 0 V 5 1991 PHIL BATCHELOR, Clerk, By0id6"0,4' > 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: Ar�V 6 1991 BY: PHIL BATCHELOR b Y1AA J eputy Clerk CC: County Counsel County Administrator C NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Farmers Insurance Group 3211 Auto Plaza Richmond, CA 94806 Re: Claim of Jihong, OK Policy #12237 11 55 SAUT 07 54197 Please Take Notice As Follows : The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise. insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. XX3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, if known . 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10, 000 ) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ( $10, 000 ) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WEST County Counsel By:. Deputy o my Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. 59 1012, 1013a, 2015 .5; Evid. C. 95 641 , 664 ) My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s ) addressed as shown above (which is/are place(s ) having delivery service by U.S. Mail) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S . Mail at Martinez/Concord, Contra Costa County, California . I certify under penalty of. perjury that the foregoing is true and correct. Dated: at Martinez, California. cc: Clerk of the Board of Supervisors (oi inal ) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 .4, 910 . 8 ) . a 0 Z , r � y a l� a ° ��- � O O top m cD N � ,c, �, 6 d'► o0. MC a r Oil © fl 1p 4p ,.>o Ull m w ll 0 -0�D w W Q a N N NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM .� Farmers Insurance Group T0: Richmond Claims Department 3211 Auto Plaza Richmond, CA 94806 RECEIyE® Re: Claim of JIHONG, OK Claim #12237 11 55 OCT11 199, Please Take Notice As Follows : MARrl �EL The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent . X 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise o tie claim asserted. 4 . The claim fails to state the name(s ) of the public employee( s ) causing the injury, damage, or loss, if known . 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ( $10 , 000 ) . If the claim totals less than ten thousand dollars ( $10, 000 ) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ( $10, 000 ) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court . 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: RECEIVED VICTOR J . WESTYLAN, County Counsel EOCT41991 BpgpDOFSUPE �.,—De.puty County C unsel CERTIFICATE OF SERVICE BY MAIL C .C.P. §S 1012 , 1013a, 2015 . 5; Evid. C . §§ .641 , 6641 My business address is the-County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69 , Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s ) having delivery service by U.S . Mail ) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was, on this 'day deposited in the U.S . Mail at Martinez/Concord, Contra Costa County, California . I certify under penalty of perjury that the foregoing is true and correct . Dated: at Martinez, alifornia . i cc: Clerk of the Board of Supervisors (or' ./nal ) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C .§§ 910, 910 . 2, 920 . 4 , 910 . 8 ) gag _ 4 a, CL P: :3 +-) O S.- S- co c3c. to W o a) o ao v � c (A fo � cord N r d U c U ti O ^ "6 4-) S- O d O (1) E E E t r C S- U r U co •r N •r LL m M G= T LO c LO LO G � c Q 7 0 x U 0 m � r c $ O'.r �, 3 a Z ')7 az -o �vZ 2 n co 0 0 m � � O m O G 'U O n 0 O -o r yCLAIM ., BOARD OF SUPERVISORS OF CONTRA ,COSTA COUNTY, CALIFORNIA Clain Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 5, 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $9,792,26 Section 913 and 915.4. Pleare note all "Warnings". CLAIMANT: JIHONG, Ok / The Farmers Insurance Group of Companies REICEIVED 12237 11 55 ATTORNEY: Farmers Insurance ~:'Group OCT 3 1991 Richmond Claims Department Date received c��iU1 COUNsa ADDRESS: 3211 Auto Plaza BY DELIVERY TO CLERK ON October 1, MEM CAI IN, Richmond, CA 94806 BY MAIL POSTMARKED: Hand delivered via Risk Mgmt. I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is 'a copy of the above-noted claim. DATED: October 2, 1991 PpHHIL BDATCHELOR, Cler eputy !(;� 110) BY: II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. \\X 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: Co u ty Counsel County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARDORDER: By unanimous vote of the Supervisors present (✓.) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury,that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Farmers Insurance ,Group Richmond Claims Department 3211 Auto Plaza Richmond, CA 94806 Re: Claim of JIHONG, OK Claim #12237 11 55 Please Take Notice As Follows : The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of. California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. X 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise o the claim asserted. 4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ( $10, 000) . If the claim totals less than ten thousand dollars ( $10, 000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000 ) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court . 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WE , Co my Counsel By: puty County n s e 1 CERTIFICATE OF SE ICE BY MAIL C.C.P. SS 1012, 1013a, 2015 . 5; Evid. C . §§ 641 , 664 )_ My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69 , Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s ) addressed as shown above (which is/are place(s ) having delivery service by U.S . Mail ) , which envelope(s ) was then sealed and postage fully prepaid thereon, and thereafter was , on this day deposited -in the U.S . Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: ��, / �� at Martinez, alifornia. cc: Clerk of the Board of Supervisors (or• i.nal ) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 4, 910 . 8 ) THE Farmers Insurance Group .F..MPAN,E. RICHMOND CLAIMS DEPARTMENT 3211 AUTO PLAZA RICHMOND,CA 94806 415-222-5300 Date: September 30, 1991 . Contra Costa Risk Management RECEIVED 'Z' 651 Pine st . 6th floor Martinez, Ca 94553 Attn . Julie Aumock OCT 1 1991 IN REPLY PLEASE REFER TO: 1"16 r."', Our Insured: J i h Ori g Ok CLERK BOARD OF SUPERVISORS Date of Loss: 7/07/91 CONTRA COSTA CO. Our Policy No.: 12237 11 55 .. SALN: 07 54197 Location: El Portal dr . , San Pablo, Ca Your,Insured: Contra Costa Sheriff dept . x+xftmdriver : Roland Jerry Bryant Jr . YourP0jiogXgx: Vehicle lic# E 112053 Ca . Total Claim: $9, 792. 26 (incl. our ins. deduct.) Deductible: $240 . 00 ( included in total ) &$315. 75 rental Our investigation has established that the above loss was caused by the negligence of your insured. ® We have made payment to our insured for the damage. By virtue of our subrogation rights, we request reimbursement from you for the amount shown on the attached repair bill. ❑ By virtue of our subrogation rights this is to advise you that we shall seek reimbursement from you for the amount of the damage. We are arranging for repairs and when completed, a copy of the repair bill will be forwarded to you. Our name should appear-on any draft made payable to our insured in settlement of his damage. If you have already made a settlement with our insured, please advise us immediately. " Your prompt consideration of our claim will be appreciated. Very trulygrs, �..�.� Vee Peace, ext 31 SUBROGATION CLAIMS 23'-03889-901301 W/200C/4200PRINT*EDINU.9.A. WE ARE MEMBERS OF THE INTERCOMPANY ARBITRATION AGREEMENT REQUEST FOR CLAIMS CHECK SALLA' INSURED: 3 ~-'� < PAYMENT FOR: El INJURY LIABILITY ❑ INJURY MEDICAL E1-MATERIAL DAMAGE ❑ OTHER DAMAGE ❑ PROPERTY IS 1099 L1 YES IS PAYMENT ❑ Y IF PYMT. IS FOR D, D, OR COMP., IS PAYMENT ❑ YES APPLIES TO: REQUIRED?: ElNO ADDIT'L./SUPPL.?: NO NEED CR. NAME ASSOCIATED? ��—�O— ❑Loss OF USE (DO NOT USE DI) — '" ❑WAIVE= UM DED. COLL. =AUTO RENTAL CLAIMANT'S NAME: REIMBURSEMENT . TYPE OF PROPERTY LOSS; ❑ BUILDING ❑ ALE ❑ CONTENTS ❑ OTHER o SPL.EQUIP..CBETC.) Y: CHECK IDENTIFIER INFORMATION(May also be used for Payee Name(s)) PAYEE(S)NAME(S) s� � 3 NUMBER AND STREET CITY STATE ZIP CODE AMT. OF13 FaLD TOTAL CASH OWNER CHECK: $ FINAL ❑ PARTIAL 2 HANDLE ❑ LOSS ❑ IN LIEU ❑ RETAINED SALVAGE CODE: CODE ;;-S —I3 ❑ NO SUB INSTRUCTIONS: DATE REQUESTED BY: � REQUESTED G'9 /,' APPROVED BY: IF REQUIRED Pteasanton Regional Office Check Number 1106011167 Date 09/19/91 PAY VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID Amount $8,936.51****** TO the 07 54197 BODY s order 538 BRYANT ST. of SAN FRANCISCO, CALIFORNIA BRYANT AUTO BODY j ESTIMATE (415)512-7575 OF REPAIRS LEE(B.P.)739-4140 538 BRYANT ST. (3RD&4TH) "(. IAN(B.P.)978-7446 SAN FRANCISCO,CA 94107 NAME � t , [� *`••-- ADDRESS PHONE NO.0 /0, MAKE 1 r YEAR STYLE SERIAL# �� LIC.# DATE — INSURANCE CO. ADJUSTER CLAIM # ESTIMATOR BUMPER FENDER FENDER t Bumper Britt. Fender Skirt Fender Skirt Bumper Guard Fender Ext. Fender Ext. Bumper Reinf. Fender Mldg. Fender Mldg. r f Bumper Pad W.0. Midg. W. 0. Midg. i Gravel Shield Cowl Cowl , . Valance Headlamp Headlamp 77 Headlamp Door Headlamp Door HEADER PANEL Sealed Beam Sealed Beamfi Grille Park. Light Park. Light ' Grille Midg. Side Mark. Lamp h,;',; Side Mark. Lamp x; Grille Brkt. DOOR, FRONT DOOR, FRONT y� Door Hinge Door Hinge , , _ j Door Reinf. Door Reinf. ' ' Door Mldg. Door Mldg. Radiator Door Handle Door Handle a n Rad: Shroud �': •" Door,Glass Door,Glass , Rad. Hoses Anti-Freeze DOOR, REAR DOOR, REAR , Fan Blade Door Midg. - Door Mldg. to Fan Belt Center Post Center Post '; Fan Clu Rocker nal RockerPanel 7"} Rocker Midg. Rocker Midg. r.. 1„ A.C. CONDE SOR QUAR. PANEL QUAR. PANEL 02s Recharge A.C. Quer. Ext. Quer. Ext. 3 E t kxh abs..p ,'.,i• Air Cond. Line Quer.Wheel Hse. Quer Wheel Hse. Dog Leg 7 77 Quer. Midg. Quar. Mldg. ZV ' HOOD Wheel,Open Mktg: Wheel,Open Midg. ' Hood Hinge Fender, Rear Fender,Rear �t J ._HooCVMldg. �, Tail Lamp .� .,. _ Tail Lamp . Hood Latch J-W Side Mark, Lamp Side Mark, Lamp _ Ornament REAR OF CAR MISC. ITEMS Name Plate Bumper Top Bumper Brkt. Antenna Bumper Reinf. Battery ., SPINDLE Bumper Guard Gas Tank _ Wheel fi Bumper Pad Frame . ¢ 5: Tire 96 Wom :r; Body Panel Cross Member Hub Cap Gravel Shield Motor Mts:, Up.Cont. Arm Floor Undercoat Up. Cont. Shaft Towing &Storage Low. Cont.Arm TRUNK LID Refinish As Nec. Low_Cont. Shaft Trunk Lid Midg. RECAPITULATION Wheel Align Trunk Hinge , Trunk Lock' �'-) Labor ®t 1 .C� i 153 WINDSHIELD Lic. Light Adhesive Kit i Back-up Lamp OV(� Parte S Moulding , ' r (��1 Tax $ Open Items r,. •fi �-t `1 rias $ K the ctatomer tbbthes to atalm used andlor damaged parts,pNsso cheek this boar ❑ I I hereby authorize the repair work hated 6D be done a�loronrqg with the necessary parts and materials.My car will be driven by your employees z to make required Deets at my risk.M express mechanicslien is hereby admowisdgsd on above car or truck to secure the amount of repairs ✓ blef $ thereto.I hereby waive the Statute of Limitations and It any action on this account requires em ol an attorney I agree ro pay 1%% interest per month which is an annual percentage rate of 18%from date,reasonable nay a fees a court costs.Srorage.will be charged 48 hours atter repairs are completed.Not responsible for Ion or damage ro care or a�rticke left in cars in case of fire,thalt,accident or —-n ne..d—--.d„r TOTAL E i 00MO 10951 OW 8WIN PAGE i FARMERS INSURANCE GROUP 3211 AUTO PLAZA RICHMOND, CA 94eO6 (415) 222-5300 Al LUG NO 3503639 DATE 07/ 17/91 CLAW 07 5419 ;' POLICY# 96 122371155 INSURED JIHONG Of,, CLAIMANT NONE 1._OS'S DATE 07101/51 TYPE OF LOSS CULL/F INSP GATE 07/ 1219.1 LOCATION J & J AUTO ADJUSTER M . MC t:PiTVRE 7823 COMPANY LIQ::# 2WAT20 VIN 1P4GH54R3MK54585 ENG/COLOR MILEAGE 100000 #:A=NEW PART E:f:.:=iii AL REPL PART FU=L.I:KE: KIND &. QUALITY E P=SEE PK RFT P=CHECK =REPA:IR/AL TGN,r``>I.lE1_ET L=REFI:NI;SH N=ADDI ZONAL LABOR t1,1'ERA"PION f..E. _PAk /PARTIAL. F;EPLACE ET=LAFS,OR/PARTIAL REPLACE I'T=LAEOR/PARTIAL REPAIR AA--APPEARANCE ALLOWANCE. RP==RELAT'ED PRIOR DAMAGE UPMUNRELATED PRIOR DAMAGE W/'S SAPELITE: 1091 PLYMOUTH GI':r.ND VOYAGER LE WAGON 066140 OPTNS H/ OP GDE Mew: DESCRIPTION MFG . F'AR'T NO. PRICE AJ% HOURS : R 005 DI.IMPEF , O R N-T 4451 749 69 .00 . 5 1 E 018 COVED , F kT BUMPER 4451 706 285 .00 1 018 COVE:6 , FRT BUMPER REFINISH 2 . 2 4 E 010 URK , :: Ul BMPR MTG RT 4451 752 10 . 50 1 028 GRILLE ASSEMBLY 4451677 69 . 00 1 E: 040 LEN'S , iL.ADLAMP R.T.. 4451730 70 . 00 1 048 PANEL ,f- DLMP MTG RT 4515296 67 . 00' 1 E 050 PARKLAMP ASSEMBLY R.T.. 4399918 80. 00 i 07:3 0'7 PANEI_ , kAD SUPT 4490948 310 .00 10 .5 1 L 073 PANEL , PAD SUPT REFINISH 1 .2 4 075 07 CRSM1: P , RAD . PNL L.WR 4490165 44 .00 1 L 075 CRSMe , FA.D PNL LWR REFINISH . 1 4 091 07 REIN{= , I;'AD SUPT PANEL 4490745 13 . 50 1 N 977 A/C S",`S ','EM RECHARGE ADDTL. LABOR 20. 00' 1 .4 2 E 731 CONDENSER ,A/C 5264416 275 . 00 1 E 083 PANEL ,HOOD 4490100 210 .00 1 .2 1 083 PANEL ,f-iOOD REFINISH 3 .5 4 E 104 FENDtWRONT RT 4636400 110 . 00 2. 3 1 104 FENDER , f RONT RT REFINISH 2 . 6 4 152 07 PANE:L , TNR FENDER RT 4534076 82 . 00 4 .8 1 152 PANEL , :I0P FENDER RT REFINISH . 6 4 4 106 SKIP } , INR FENDER RT 4534432 23 . 50 . 3 1 664 CRSME;r , f RONT SUSP 4449166 235 . 00 2 . 9 2 4 182 C ANN:I V IE R , FUEL VAPOR 4241839 60. 00 .4 2 902 WHEEL , PPONT R.T.. 4472440 116 . 0iJ . 2 2 934 C:OVEf; , F F ONT WHEEL. RT'' 4472247 72 . 00 1 2 4 . 20 . 5 2 _ 672uEA`L , ��.f I WHL CsRO RT' 5212535 F 678 S NUCKR.L STEER- -- R/F 4449466 88 . 00, 2 oot uo toss►064 81WEZ LYMOUTH GRAND VOYAGER LE WAGON PAGE 2 CLAIM # U7 541'9.' Al LUG NO 3503639 DAT . 07/ 17/91 . ... 654 ARM , I.`WP CONTROL R/F 4322200 118 .00 1 . 2 2 _ 656 U l AESCiF;:1: E W&TRUT R/F 4449634, 54. 00 . 8 2 692 01 :SHAF i ,AXLE DRIVE R/F 4841239 100 . 00 . 5 2 894 MIRRI. R , 1/S DAY/NIGHT 4520336 28 . 00 , 2 1 208 DOOR >HELL &ROr4 T R.T.. REPAIR/ALIGN 2 . 5* 1 !_ 208 DOOR S;aELL , FRONT RT REFINISH :2. 1 4. 210 PML , F T DOOR OTR RT 4480218 170. 00 7 . 3 1 E 479 SHELL T.a.ILGA'T"E 4378488 370 . 00 5.6 1 479 $HELL , f AIL.GATE REFINISH 4 . 8 4 b34 10 _ by ki 43999U6 ' L dud D0Ok uHLLL , FHUNT kJ REFINi5H 2. 1 4 K 21U', . PNL , FkT DOOR 07R RT 44$821$ � 170. 00 7 . 3 1 ~ E � 47Q. 8HELL , TAILGATE 4378466 ' 370~00 . � 5.6 1 , L 47A^. SHELL ^TAILGATE REFINISH ` . . 4 . W 4 E' 534 TAILLAMP ASSY RT 4399906 ^3 1 i '588 COVER ` kR BUMPER REFINISH 2 ~ 0 4 L 901 CLEAR COAT REFINISH 2 .244 N09 COLOR TINT AND BLEND REFINISH . 5*4 EC RT FRT TIRE . ECONOMY PART '05' ` L M0UNT & BALANCE SUBLET ; 12 .00! I ALIGN FRT END REPAIR/ALIGN ' 'f / 110* 1 [ STRIPE PAINTED SUBLET' � ! Sn~ 00 ' E IMPACT CHROME NEW PART ^ 21.42* [ WINDSHIELD SUBLET 292 . 99* I FRAME SET REPAIR/ALIGN 1 .5*3 � PULL AND ALIGN REP�IR/�LI�N � i 2 0*3 - � | ^ l AT FRAME RAIL 2 ,5 REPAIR/ALIGN *1 , ' ' � RT UPPER RAIL REPAIR/ALIGN � ' 2 .\)11� I RT FRONT WHEEL HOWE REPAIR/ALIGN 2 . 6* 1 REF WHEEL HOUSE REFINISH . /*4 53 ITEMS ` NC MESSAGE � 01 CALL DEALER FOR EXACT PART # REQUIRED ' | | 07 STRUCTURAL PART AS IDENTIFIED BY I-CAR � .� INAL CALCULATIONS & ENTRIES GROSS PART8 OTHER PARTS ' 100~0, PAINT MATERIAL 419~ 9, � PARTS TOTAL 3 , 722. Q ^ � TAX ON PARTS & MATERIAL 8 ,258% ' - 307 . 15 LABOR RATE REPLACE HRS REPAIR HRS . / 1 -SHEET METAL 44 ^ 80 33 ^ 0 18~0 1 °0$2 .00 2MECH/ELEC - ' 44 . 00 * . 5 1 .4 3 -FRAME 44 . 00 1 , 5 4-REFINISH 44 .00 22 . 1 ' 072.46` 5-PAINT MATERLAL 19 . 08 LABOR TOTAL TAX ON LABOR SUBLET REPAIK, ' �64 °89 TOWING & STORAGE ` �USS TOTAL ' � � 7 , y��� , 1 1 LESS : DEDUCTIBLE ` ' 040, 00- LESS: 4U 0 BETTERMENT L 4 . 50 AET TOTAL 0P AUDATEX Al U CO LOG _ E03639 DATE 01411191 11 :4; 091:1/0 Immi OWL w1wcz PLYMOUTH GRAND VOYAGER LE WAGON PAGE # 07 154 19'/ Al LOG NO ' 35036;9 DATE ' 071171pi wxN:NN/00/00/00/00 CUM-00/00/00/00 . NSU - ---------------- -------------------- / REQUEST FOR CLAIMS CHECK SAL N: 5 INSURED: J �, PAYMENT FOR: ❑ INJURY LIABILITY ❑ INJURY MEDICAL C MATERIAL DAMAGE ❑ OTHER DAMAGE ❑ PROPERTY IS 1099 ❑ YES IS PAYMENT ❑ YES IF PYMT. IS FO MD PD, OR COMP., IS PAYMENT YES o POL`IIE�O E REQUIRED?: C� NO ADDIT'L./SUPPL.?: D'f�10 NEED CR. NAME W'-"` ASSOCIATED? ❑ NO ❑WAIVE UM DED. (DO NOT USE DI) OLL PLUS ❑AUTO RENTAL CLAIMANT'S NAME: REIMBURSEMENT Cl SPL EQUIP-CB.ETC.) TYPE OF PROPERTY LOSS; ❑ BUILDING ❑ ALE ❑ CONTENTS ❑ OTHER ❑ CHECK IDENTIFIER INFORMATION(May also be used for Payee Name(s)) PAYEE(S)NAME(S) NUMBER AND STREET CITY STATE ZIP CODE AMT. OF�,� G V FI TOTAL CASH OWNER CHECK: s`3' INAL ❑ PARTIAL ANDLE Cl LOSS Cl IN LIEU Cl RETAINED SALVAGE CAT. SHOP CODE: CODE UB ❑ NO SUB INSTRUCTIONS: DATE REQUESTED BY: --�/i�l REQUESTED �� APPROVED_BY:__,. Pleasanton Regional Office Check Number 1 106®0922 Date 07/17/91 PAY`7OID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID VOID v w Amount $300.00******** TO 07 54197O order 7190LASOK N ° of RICHMOND, CA 94805 FARMERS INSURANCE GROUP OF COMPANIES INTER-OFFICE SPEED MEMO CORRESPONDENCE DATE: August 14, 1991 TO: RICHMOND AUTO BCO 3 211 AUTO PLAZA . RICHMOND, CA 94806 � t RE: JIHONG OK SALN 07-54197 FROM: 96-77-312 Please see the attached rental car bill from Enterprise. The insured has paid by credit card. Please reimburse her as her coverage allows. She has k2 which is $15.00 per day. Once paid, give to Vee Peace as part of the subrogation package. js , Bickham-Devine 758-1070cc. ile 406, 1Qay AMERICA CAN DEPEND ON FAR,%4n 7 S ^ RENT-A-CAR COMIF:AUYOF NCISCO XO 7:30A' 5:30P TU 7�30A- 5:30' �� �32�� SAN, PABLO AVE 415 100 WE 7:3�A- 5:30P TH 7:30A- 5:30P ' SAN PABLO CA 94806-3980 , 2322 FR 7:30A- 5:30P SA 8�00A-12:00r S PHOTr MOUNTING SHEET INSURED:_ CLAIMANT:- POLICY NUMBER: DATE TAKEN:_ SALLA NU'Mt3LF3: -�, _ _-- _..-- -- __-- ADJUSTER DATE OF LCOS& __- VEHICLE. PICTURE NUMBER: IL DESCRIPTION: i «.A , A a t r I , r t` \\ L' I c � 4 li I i F 23-0750 11-90 14501 SH/1000 7, PHOTO MOUNTING SHEET INSURED: CLAIMANT: POLICY NUMBER: DATE TAKEN: SALN NUMBER: ADJUSTER: DATE OF LOSS: VEHICLE: PICTURE NUMBER: r- DESCRIPTION: t l i f+� r I I i 23.0750 12.89 16001 SH/100 7F PHOTO MOUNTING SHEET CLAIMANT:-----------___ __----_--- ADJUSTER DATE OF LOSS ti I 't I i r E Vii �`_- I1 I r- .�•���.; ; I i 1 i I I I 4.n I i � I 23-0750 11-90 /. ' AMENDED 3 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 November 5 , 1991 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $25 , 000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PARTIN, Charles and Kath.ryV • ATTORNEY: 6018."received ADDRESS: 155 Shore Road C,a NFy,B LIVERY TO CLERK ON October 21 , 1991 Pittsburg, CA 94565 BY MAIL POSTMARKED: October 18,1 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PQHHIL BATCHELOR, Clerk DATED: October - 21 , 19 1 8Y: Deputy 014.4110-3 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: 10 12-1 /9 I BY: I Cj' J Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (; his Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. _ (1 q 0i Dated:—NOV 5 1991 • PHIL BATCHELOR, Clerk, By ,'IDeputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant .as shown above. Dated: N O V 6 1991 BY: PHIL BATCHELOR by &Deputy Clerk CC: County Counsel County Administrator RECEIVED OCT 2 1 1991 A M E N D E D CLERK BOARD OF SUPERVISORS CONTRA COS74 CO. CLAIM AGAINST THE COUNTY OF CONTRA COSTA AND ITS AGENTS AND EMPLOYEES Claimants CHARLES PARTIN and KATHRYN PARTIN hereby present a claim for damages against the COUNTY OF CONTRA COSTA and its agents and employees. ADDRESS OF CLAIMANT: Charles and Kathryn Partin 155 Shore Road Pittsburg, CA 94565 ADDRESS TO WHICH NOTICES SHOULD BE SENT: I Charles and Kathryn Partin 155 Shore Road Pittsburg, CA 94565 DATE, PLACE AND CIRCUMSTANCES OF OCCURRENCE: At about 5:00 a.m. on May 27, 1991 Claimant CHARLES PARTIN, who is a Baptist minister, and Claimant KATHRYN PARTIN, his wife, were awakened from sleep by a loud pounding on their door. They heard voices on the outside of the door, but were unable to understand what was being said. Claimant CHARLES PARTIN asked the people outside who they were and what they wanted. Claimants heard more voices, but again were unable to understand any words. With further knocking and more voices, Claimant CHARLES PARTIN threatened to call the police and warned the voices that he had a gun. Claimant KATHRYN PARTIN, peeking through the window next to the door, informed her husband that she thought the people outside were police officers. Claimant CHARLES PARTIN opened the door slightly and peeked around the door, and found himself looking down the barrel of a handgun, which was just inches from his face. ' Claimant CHARLES PARTIN asked that the gun be taken from his face, but the man did not comply. He then stated that he was going to get dressed. No announcements were made by the men on the other side of the door. One of the men kicked the door open, causing Claimant CHARLES PARTIN to jump backwards. He then told them "come on in, I don't have a gun. " Two men entered, one still pointing his weapon at Claimant CHARLES PARTIN. Claimants believe and thereon allege that one of the officers was an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT and that the other was an agent or employee of the CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT. Claimants further believe and thereon allege that additional officers were present, and that at least one of these additional officers was an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT. The remainder of the officers, who remained in the back yard area, were of unknown affiliation. Upon entering the house, one of the men asked Claimant CHARLES PARTIN what address this was. Claimant responded that it was 155 Shore Road. The man then asked Claimant why it was 155 and not 153 . Claimant responded that he didn't build the houses so didn't know why they were numbered the way they were. One of the officers told Claimants that they had assumed that this house was 153 Shore Road. Another officer asked Claimant why he didn't plainly display the address of the house, in response to which Claimant CHARLES PARTIN pointed to the six- inch block numbers above the mailbox in the front of the house. This officer, whom Claimants believe to be an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT, informed Claimants that the address was "in the wrong place. " One of the officers, whom Claimants believe to be an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT, yelled at Claimant KATHRYN PARTIN, who was very frightened, that "if you've done nothing wrong, you've got nothing to worry about. When these officers left the house, they asked where 153 Shore Road was located, and Claimant CHARLES PARTIN responded that there was no such address. The officers laughed and left the house. Claimants are informed and believe and thereon allege that there was not at the time of this incident, or at any time prior to this incident, an address of 153 Shore Road. PARTIES RESPONSIBLE: COUNTY OF CONTRA COSTA and other unknown agents and employees of the COUNTY OF CONTRA COSTA SHERIFF'S DEPARTMENT. AMOUNT OF CLAIM: $25, 000.00. GENERAL DESCRIPTION OF INJURIES AND BASIS OF COMPUTATION OF DAMAGES: Both Claimants were extremely frightened during the whole episode, particularly Claimant CHARLES PARTIN, who had a weapon pointed at him during much of the time. Some 15 to 20 minutes after the officers left, Claimant CHARLES PARTIN fell into an extreme nervous state and began vomiting. His stomach was in such discomfort that he was unable to eat any food for the next day and a half. As a direct and proximate result of the wrongful conduct of the above-named responsibles, Claimants CHARLES PARTIN and KATHRYN PARTIN suffered fear, anxiety, outrage, humiliation and extreme emotional and mental distress causing s shock to their nervous systems, and embarrassment that such a thing could happen to them. Claimant CHARLES PARTIN was in such a state that he was physically effected, as described above. A neighbor, who happened to see some portion of the incident, has asked Claimant CHARLES PARTIN about it. Claimant CHARLES PARTIN is informed and believes that knowledge of the early morning visit by these errant officers has passed throughout the neighborhood, impugning his reputation as a member of the clergy and as a law abiding citizen. Dated: October 17, 1991. IC CHARLES PARTIN 4KATHR TIN Zmo � LT%� a Gn .-•"°°" 10 yc N C O -Z „'A PI no Q d O d -a , ul JY fn •r- CLAIM RECEIVE® BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA (}(;T Clain'Against the County, or District governed by) BOARD ACTION 3 1991 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 5, 1n' COUNSEL and Board Action. All Section references are to ) The copy of this document mailed to you is you rTd�Fte� F 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 "karnings". CLAIMANT: PARTIN, Charles and Kathryn ATTORNEY: Date received ADDRESS: 1551Sbore Road BY DELIVERY TO CLERK ON September 30,' 1991 Pittsburg, CA 94565 BY MAIL POSTMARKED: no postmark I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 2, 1991 ppHHIL ATCHELOR, Clerk DATED: BY: Deputy CLAM A44 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: Dated: BY: /'� Deputy County Counsel III. FROM: Clerk of the Board TO: County nsel (1.)" County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator fi RECEIVED SEP S 01. CLAIM AGAINST THE COUNTY OF CONTRA C T AND ITS AGENTS AND EMPLOYEES CLERK BOARD OF SUPUMMUM CONTRA COSTA Claimants CHARLES PARTIN and KATHRYN PARTIN hereby present a claim for damages against the COUNTY OF CONTRA COSTA and its agents and employees. ADDRESS OF CLAIMANT: Charles and Kathryn Partin 155 Shore Road Pittsburg, CA 94565 ADDRESS TO WHICH NOTICES SHOULD BE SENT: Charles and Kathryn Partin 155 Shore Road Pittsburg, CA 94565 DATE, PLACE AND CIRCUMSTANCES OF OCCURRENCE: At about 5:00 a.m. on May 27, 1991 Claimant CHARLES PARTIN, who is a Baptist minister, and Claimant KATHRYN PARTIN, his wife, were awakened from sleep by a loud pounding on their door. They heard voices on the outside of the door, but were unable to understand what was being said. Claimant CHARLES PARTIN asked the people outside who they were and what they wanted. - ' Claimants heard more voices, but again were unable to understand any words. With further knocking and more voices, Claimant CHARLES PARTIN threatened to call the police and warned the voices that he had a gun. Claimant KATHRYN PARTIN, peeking through the .window next to the door, informed her husband that she thought the people outside were police officers. Claimant CHARLES PARTIN opened the door slightly and peeked around the door, and found himself looking down the barrel of a handgun, which was just inches from his face. Claimant CHARLES PARTIN asked that the gun be taken from his face, but the man did not comply. He then stated that he was going to get dressed. No announcements were made by ,the men on the other side of the door. One of the men kicked the door open, causing Claimant CHARLES PARTIN to jump backwards. He then told them "come on in, I don't have a gun. " Two men entered, one i still pointing his weapon at Claimant CHARLES PARTIN. Claimants believe and thereon allege that one of the officers was an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT and that the other was an agent or employee of the CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT. Claimants further believe and thereon allege that additional officers were present, and that at least one of these additional officers was an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT. The remainder of the officers, who remained in the back yard area, G IN I Gil � were of unknown affiliation. Upon entering the house, one of the men asked Claimant CHARLES PARTIN what address this was. Claimant responded that it was 155 Shore Road. The man then asked Claimant why it was 155 and not 153 . Claimant responded that he didn't build the houses so didn't know why they were numbered the way they were. One of the officers told Claimants that they, had assumed that this house was 153 Shore Road. Another officer asked Claimant why he didn't plainly display the address of the house, in response to which Claimant CHARLES PARTIN pointed to the six- inch block numbers above the mailbox in the front of the house. This officer, whom Claimants believe to be an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT, informed Claimants that the address was "in the wrong place. " One of the officers, whom Claimants believe to be an agent or employee of the CITY OF CONCORD POLICE DEPARTMENT, yelled at Claimant KATHRYN PARTIN, who was very frightened, that "if you've done nothing wrong, you've got nothing to worry about. When these officers left the house, they asked where 153 Shore Road was located, and Claimant CHARLES PARTIN responded that there was no such address. The officers laughed and left the house. Claimants are informed and believe and thereon allege that there was not at the time of this incident, or at any time prior to this incident, an address of 153 Shore Road. PARTIES RESPONSIBLE: COUNTY OF CONTRA COSTA and other unknown agents and employees of the CCOUNTY OF CONTRA COSTA SHERIFF'S DEPARTMENT. AMOUNT OF CLAIM: Claimants are informed and believe that the amount of their claim falls within the jurisdictional amount of the Municipal Court. GENERAL DESCRIPTION OF INJURIES AND BASIS OF COMPUTATION OF DAMAGES• Both Claimants were extremely frightened during the whole episode, particularly Claimant CHARLES PARTIN, who had a weapon pointed at him during much of the time. Some 15 to 20 minutes after the officers left, Claimant CHARLES PARTIN fell into an extreme nervous state and began vomiting. His stomach was in such discomfort that he was unable to eat any food for the next day and a half. As a direct and proximate result of the wrongful conduct of the above-named responsibles, Claimants CHARLES PARTIN and KATHRYN PARTIN suffered fear, anxiety, outrage, humiliation and extreme emotional and mental distress causing s shock to their nervous systems, and embarrassment that such a thing could happen to them. Claimant CHARLES PARTIN was in such a state that he was physically effected, as described above. A neighbor, who happened to see some portion of the incident, has asked Claimant CHARLES PARTIN about it. Claimant CHARLES PARTIN is informed and believes that knowledge of the early morning visit by these errant officers has passed throughout the neighborhood, impugning his reputation as a member of the clergy and as a law abiding citizen. Dated: September 10, 1991 CHARLES PA TIN THRYN PA IN COKER & RAM I REZ ATTORNEYS-ABOGADOS JOHN DIAZ COKER A. ARACELI RAMIREZ RHONDA WILSON RICE nr��w --RECEIVED Clerk, Board of Supervisors SEP 3 01991 County of Contra Costa 651 Pine Street CLERK BOARD OF SUPERVISORS Martinez, CA 94553 CONTRA COSTA CO. September 27, 1991 RE: Claim of Charles and Kathryn Partin Enclosed please find the original and one copy of a claim presented on behalf of our clients, Mr. and Mrs. Partin. Please retain the original of said claim and return the copy, marked with your received stamp, and return it to our office in the attached self-addressed, stamped envelope. Thank you. Sincerely, Secretar�i me Enclosures 525 MARINA BOULEVARD • PITTSBURG, CALIFORNIA 94565 • (415)432-7373 448 -o N z7q < 9 n Z � rr ri ON 0 If to y= p r t4 fi i i r APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT November 5 , 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: FISHER, Phillip Attorney: Robert J . Z w e b e n 1730 Sol ano Avenue Address: Berkeley , CA 94707 Unspecified October 7 991 kE Amount: p By delivery to Clerk on Date Received: October 7 , 1991 By mail, postmarked on October 4 , 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Applica n to ile L laim. r DATED: 0 c t o b e r 9', 19 91 PHIL BATCHELOR, Clerk, By c) Deputy 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 (Section 911 ) DATED: I IU VICTOR WESTMAN, County Counsel, By: Deputy III. BOARD ORDER By unanimous vote of Supervisors preserW (Check one only) ( ) This Application is granted (Section 911 .6). (p-j 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: N O V 5 1991 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 Government 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 immediately. 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• _ DATED. NOV 6 1991 PHIL BATCHELOR, Clerk, By—QDeputy 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 1 LAW OFFICES OF zwebelf 1730 SOLANO AVENUE BERKELEY. CA.94707 . PHONE(415)526.1669 APPLICATION TO FILE LATE CLAIM �E If D TO: CONTRA COSTA COUNTY OCT 7 1991 RE: CLAIM OF PHILLIP FISHER _ _ A CLERK 60 MOFSUPERVISORS FROM: ROBERT J. ZWEBEN t °.i RA COSTA CO. The accident occurred on March 21, 1991. The police report indicates that the accident occurred in the City of Richmond. There is now some question whether the police report is correct. This claim is now being presented to the County as an Application to File a Late Claim under the Government Code. Assuming the facts indicate that the police report is incorrect, than this Application requests that Mr. Fisher be allowed to process his claim through the County. Normally, such an Application should be approved unless the County could show , some prejudice. The claim would have been timely filed if presented by.September 21, 1991. Only thirteen (13) days have passed and it would seem that this short a time period would cause no prejudice. Mr. Fisher and'the police were both of the belief that this incident occurred within the City of Richmond.. As attorney for;Mr. Fisher, it seemed'reasonable to rely on that information. Although'Richmond has not stated the accident occurred in the County, I -was informed today by City of San Pablo, that the area may be in the County. This matter is not a large claim, but Mr. Fisher should not be foreclosed from filing a claim with the County of Contra Costa under these circumstances. ' Thus, I'd request that the attached claim be accepted and processed as I believe it is appropriate to grant pursuant to Government Code Section 911.6, especially subpart (b)(1). Dated. October 3; 1991 ROBERT J. 2VVEBEN } CLAIM AGAINST THE COUNTY OF CONTRA COSTA CLAIMANT• Name: Phillip Merle Fisher Phone: (510) 223-9730 Address: 2957 Chevy Way, San Pablo, CA PERSON TO WHOM ANY NOTICES CONCERNING CLAIM SHOULD BE SENT: Name: Robert J. Zweben, Esq. Phone: (510) 526-1669 Address: 1730 Solano Avenue, Berkeley, CA 94707 WHEN DID DAMAGE/INJURY OCCUR? Date: 3/21/91 LOCATION OF OCCURRENCE: E1 Portal Drive near Via Verde CIRCUMSTANCES OF OCCURRENCE: Claimant was riding bicycle northbound on E1 Portal Drive near Via Verde when his bicycle was flipped over due to a pothole in the road. DESCRIPTION OF LOSS, DAMAGE, OR INJURY: Bicycle damaged: $671.94 Phillip sustained whiplash, stiff neck, (which lasted for several months) , thirteen (13) stitches above left eye, slight scar along eyebrow, face scratched. NAME AND ADDRESS OF ANY WITNESSES, DOCTORS AND/OR HOSPITALS: Brookside Hospital, 2000 Vale Road, San Pablo, CA (510) 235-7000 ($814 . 15) Richmond Health Center, 100-38th Street, Richmond, CA (approx. $100. 00) IF THE AMOUNT CLAIMED IS $10, 000. 00 OR LESS, PLEASE INDICATE THE BASIS FOR THE AMOUNT CLAIMED. Pain and suffering and personal injury suffered form the bike fall. IF THE AMOUNT CLAIMED EXCEEDS, $10, 000.00, PLEASE INDICATE THE JURISDICTION OVER THE CLAIM. (x) MU CIPAL COURT J DATE: October 3, 1991 &1 J1 Robert J. Zwebe Attorney at Law LAW OFFICES OF Zwebelf 1730 SOLANO AVENUE BERKELEY. CA 94707 PHONE(415)526.1669 October 3 , 1991 Clerk of the Board 651 Pine Street, Room #106..-. Martinez, CA 94553 Re: Personal Injury of PHILLIP. MERLE FISHER Date of Accident: March 21, 1991 Dear Clerk: Enclosed please find a Claim Against the County of Contra Costa. This office is filing the Claim on behalf of Mr. Phillip Merle Fisher. Mr. Fisher was riding his bicycle and was injured when a pothole in the road caused the bicycle to flip causing my client to fall. After the accident, my client went to Brookside Hospital. A copy of the bill . in the, amount of Eight Hundred Fourteen and 15/100 Dollars ($814. 15) from Brookside Hospital is enclosed for your review. Thereafter, Mr. Fisher had follow-up treatment at the Richmond Health Center. At this time, we do not have a bill for that follow-up treatment, but it is anticipated that the charge is less than One Hundred •Dollars ($100.00) . The bicycle damage amounted to Six Hundred Seventy One and 24/100 Dollars ($671.23) . . Enclosed is an estimate for repair. Mr. Fisher .sustained a whiplash- type of injury which resulted in a stiff neck and restrictive movements for approximately several months. He also received thirteen (13) stitches above his left eye . and numerous abrasions on his face. cont./ October 3 , 1991 Clerk of the Board County of Contra Costa Personal Injury of PHILLIP MERLE FISHER Page Two We desire that you review this file to make a determination whether you wish to attempt to settle this matter. At this time I propose that this be resolved for the sum of Three Thousand Four Hundred Sixty Dollars ($3,460.00) . Please contact my office to discuss a resolution of this matter. Very,-truly yours, ROBERT J. ZWEB RJZ:jn enclosure(s) : as noted r} ?IJK ;ztt.R is 41 E 3820-SAN AN AS ANt �CA X803;: EL SOBF� r• , 222 -3420 I h ", IV's� �I✓`YN 1 , � a' Ph6ne X23 , Customer's No. I d � Order address rAof� Riro. ►Aio ou►. of ACM A t.J t A AMOUNT i PRICE. DESCRIPTION . udnMY f r � th 111 .`t R 1 t' a gctompanled by s jb t goods MU5 II cic�lms ar+d returned y.. . 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