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HomeMy WebLinkAboutMINUTES - 11191991 - 1.32 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 19 , 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: $172 . 75 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: HOLLEMAN, Terri FwF� y 4n� ATTORNEY: •? � �� N �G ��Ng�YDate received ADDRESS: 4854 Northridge Road,o�NrFyjiMf8Y DELIVERY TO CLERK ON October 21 , 1991 Martinez , CA 94553M "N BY MAIL POSTMARKED: October 18, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pp}{ gg DATED: October 21 , 1991 BYIL DeputyLOR, Clerk a (7/VJ/V1 01.4_,U 0 II. FROM: County Counsel TO: Clerk of the Board of Supervisors `(..., ) This/�cl im`complies substantially with Sections 910 and 910.2. \ ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: (Q zBY: Deputy County Counsel U_" III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. 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. p Q Dated: N o Y1/ 1 E 1� PHIL BATCHELOR, Clerk, By (JODeputy 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 2 0 BY: PHIL BATCHELOR by ° Deputy Clerk CC: County Counsel County Administrator NO MORE MR. NICE GUY 91 / RK BOARD OF S'OR I� , \ � I�. �a • CONTRA CO A 1 o s4rockchJS _ ov to (o-al �,)m l-��o innICojoE,011 {n cs Ou 10/'10/91 16:50 M 80056-47775 P. 01 iafl A I 1ff 1 !A M 1 ij Pa A ER �R� F I 4A toll rf6ei 1'.(8 00 i Fox I' i. ' 04 � I I t i ; J i I . •'.,I. . 1 11 014 ill i i'_j 11 r_ n. Ti. ACCOUNT TO: Date TL--RRI 110LUJIAN Nnmn. Address—.....- CITY Wit 71P=1 Zip Coda PI iot ioNo, Work Mv2n.�Nv, Fulloy No. Palc Of Lgoc. 1102son for Loss vlalrfi NO. Uvonut-Nu. 80 OVIC TRUC PU Otairlid), Ll.t TOTAL All I' I W8050 S W I NC. SVI I FL-D 218. 70 95- 4 -' 98. 42 1 LnBOR 05. 0 11 pals. 00 1 KIT 1F. oc I 12. ovi Wl-ri A4n 261 0", 26. 07 F RECEIVED OCT 2 1 1991 — SUPERVISORS CLERK BOARD OF ­0 CONTFIA TOTAL COST MATInIALS 136. 49 Req.Frorn No. Data RELEASE AND AUTHORIZATION TO PAY OTHER THAN INSURED OR CLAIMANT SUB-TOTAL 1316. 4h Tim Wlvu:6 Imus Dunn F"pl6%7;v3d to voy 6&CMacticir, and I authorize——_-._- SALES TAX 11. 26 LABOR to make direct payment to OENTRAL ALLIED (Non-Taxable) QLA&& COMPANY the Will uFfluuIlt dUU F11C LJIIkJVF tht: WrIlOd V( lily -,::*-!:Vy vvvulilfv Illu V'uitj 103b. ; understand that I? 145r any reason my Insurance company e.a_6 ciol puy this uluirn, I RAI ANC.'I! 17E. 75 will be reaponaible for payment of name, Insured ........ Date, L CA-10; I)EMUL i'10LE 0. 00 30-700 THIS WORK "Ab BEEN DONE TO MY SATISFACTION MATERIAL NOT RVTUnNABILI! WiTHOIJT PRIOR APPROVAL TOTAL 17 P. 7!w, (30 G 1(.0,L R Q 0 P Y Omftca I NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF. CLAIM TO: Terri Holleman 4854 Northridge Road Martinez, California 94553 Re: Claim of HOLLEMAN, Terri R. 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 requiremeif-s -of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s ) of the public employee(s ) causing the injury, damage, or loss, if known . X 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ( $10, 000 ) . If the claim totals less than ten thousand dollars ( $10, 000 ) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ( $10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel By: i Deputy(Munty CmNl�j CERTIFICATE OF SERVICE BY MAIL C.C.P. SS 1012 , 1013a, 2015 . 5 ; Evid. C. SS 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 amia 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: � /99/, at Martinez, California . 7 /� � cc: Clerk of the Board of Supervisors ( ginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 4, 910 . 8 ) RECEIVED CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, AU&OPM A . 1931 Claim Against the County, or District governed by) TIN COU%a BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT item er10, 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: HOLLEMAN, Terri R. ATTORNEY: Date received ADDRESS: 4854 Northridge Rd. BY DELIVERY TO CLERK ON August 15, 1991 Martinez, CA 94553 BY MAIL POSTMARKED: August 13, 1991 I. FROM: Clerk of the BOLrd of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. August 19, 1991 EYIL BATCHELOR, Clerk a DATED: BY: Deputy (I.— A.A II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: Gi BY: i A�L Deputy County Counsel U \e I III. FROM: Clerk of the Board TO: County Counsel (1) County Admi i r for (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV.- BOARD ORDER: By unanimous vote of the Supervisors present t>< This Claim is rejected in full. ( ) Other: 1 certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: SEP 10 1991 PHIL BATCHELOR, Clerk, By ° Deputy Clerk WARNING (Gov. code section 913) . Subiect to certain exceptions. you have only six (S) rronths frim 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:.: SEP 11 1991 BY: PHIL BATCHELOR by OJ Deputy Clerk CC: County Counsel County Administrator fe co U)to ..� to r r t <U C L2 W n_I 1 0 cr 1 u v 0 Z •m Aaus!G 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 19, 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" RIECSIVto CLAIMANT: TABOR, Allan M. and Suzanne OCT 18 1991 ATTORNEY: Ryan & Tabor Allan M. Tabor Date received COUN��9�°L1� ADDRESS: 50 San Francisco Street BY DELIVERY TO CLERK ON October lAaTi Suite 122 San Francisco, CA 94133 BY MAIL POSTMARKED: October 16, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. October 18 1991 PPHHIL BATCHELOR, Clerk DATED. BY: Deputy ._ nAIVO 01 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: (( l BY: I5. Deputy County Counsel III. FROM: Clerk of the 'Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (This Claim is rejected in full. { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: NOV 19 1991 PHIL BATCHELOR, Clerk, BylZU-1 X. Deputy Clerk S&A w^ - ---.- 4w0l 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 0 V 2 0 1991 BY: PHIL BATCHELOR bya Deputy Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM Ryan & Tabor TO: Allan M. Tabor 50 San Francisco Street Suite 122 San 'Francisco, CA 94133 Re: Claim of TABOR, Allan M, and Suzanne 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 I the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent . X 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name( s) of the public employee(s ) causing the injury, damage, or loss, if known. 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ( $10, 000 ) . If the claim totals less than ten thousand dollars ( $10, 000 ) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000 ) , the claim fails to state whether jurisdiction ' over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel By: Deputy CT:Ey Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. ISIS 1012 , 1013a, 2015 . 5 ; Evid. C.- 9S 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: &Ywlelt, 472/9 M/ , at Martinez! California. cc: Clerk of the Board of Supervisors (o ginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 41 910 . 8 ) i 7 I I RYAN & TAB OR ALLAN M. TABOR 2 STATE BAR NO. 52846 �ECEIV =® 50 Francisco Street, Suite 122 San Francisco, CA 94133 3 ( 415) 981-2010 �� 7 191 4 Attorneys for Plaintiff CLERK B N'RD OF SUPERV CORITRA COSTA CO 5 , 6 7 CLAIM FOR DAMAGES 8 9 ALLAN M. TABOR AND SUZ ANNE TABOR, 10 Claimants , 11 v S. 12 EAST BAY MU N I CI PAL 13 WATER DISTRICT, CITY OF DANVILLE, COUNTY OF 14 CONTRA COSTA, 15 Respondents. 16 17 Claimants ALLAN M. TABOR AND SUZ ANNE TABOR present the 18 following claim of damages : 19 1. Claimants' business address is 50 Francisco, Suite 122, 20 San Francisco, CA 94133 21 2. Notices are to be sent to the law firm of Ryan & Tabor, 22 50 Francisco, Suite 122, San Francisco, CA 94133. 23 3. On or about September 1991 claimants purchased a home at 24 460 Eagle Valley Way, City of Danville (Blackhawk) , County of 25 Contra Costa, State of California. Said premises has tainted 26 water which was brought about by the negligence of defendants and 27 each of them. Also each of said entities are strictly liable in 28 tort for the defective product. RYAN 3 TABOR ATTORNEYS AT LAM 1 00 FRANCISCO ST.,SUITE*122 SAN FRANCISCO.CA 04170 11101 001-2010 1 4. Claimants have been damaged in the loss of value of the 2 property, loss of rental income and other damages which shall be 3 ascertained at the time of trial, including but not limited to 4 physical injury and mental suffering and emotional distress. 5 5. Names of public employees are unknown at this time. 6 6. Jurisdiction rests properly in the Superior Court. 7 DATED: October 15, 1991 RYAN & TABOR 8 BY 9 ALLAN M. T AB O R 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 RYAN 8 TABOR ATTONNETS AT LAW 2 OO FNANCIICO ST SUITE*122 SAN FeANCISCO,CA O4133 14151 oil-2011 PROOF OF SERVICE BY MAIL 1 (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 5 business address is 50 Francisco Street, Suite 122, San 6 Francisco, CA 94133. 7 On October 15, 1991, I served the within CLAIM FOR DAMAGES in 8 said action by placing a true copy thereof enclosed in a sealed 9 envelope with postage thereon fully prepaid, in a United States 10 Postal service mail box at San Francisco, California addressed as 11 follows: 12 EAST BAY MUNICIPAL 13 WATER DISTRICT P. 0. Box 2060 14 Oakland, CA 94604 CITY OF DANVILLE 15 510 LaGonda Way 16 Danville, CA 94526 COUNTY OF CONTRA COSTA 17 Board of Supervisors 651 Pine Street, Room 106 18 Martinez, CA 94553 19 I declare under penalty of perjury that the above is true and 20 correct. Executed on the above date at San Francisco, 21 California. 22 23 ALLAN M. TABOR 24 25 26 27 28 RYAN 3 TABOR ATT0NN4TA AT LAW 3 00 FNANCINCO iT..001T2 A!122 0AN Fa IANCIACO,CA 01122 1 1101 001-2010 r Y l CA P- r o c-Acn 1 N a` ) r , al" N N -� � 0 4a N t`^ oA • A� rt ,� 05 Cd N JAN D OLO .� v w ` o N cr LD 0 Na N Q� #6 0 ar a �QQN"j N N U mop N ZUU ?,.OU rQ CC (- W A- /V(� �Z Q N /Yllz 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 19 , 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 ,000. 00 Section 913 and 915.4. Please note all "Warnings". RECEIVED CLAIMANT: RUSSELL, Reginald Melvin ATTORNEY: OCT 18 1991 Date received COUNTY CO�UpNSEL ADDRESS: 2908 Carmona Way BY DELIVERY TO CLERK ON October 1 / ,RT� 91 LSF' Antioch, CA 94509 BY MAIL POSTMARKED: Hand delivered _ 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: October 18, 1991 BYIL BATCHELOR, Clerk eputy0,14411 44 4 L-0-, II. FROM: County Counsel TO: Clerk of the Board of Supervisors j ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ��` BY:- AW � 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 (41 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. rto 0, Dated: N 0 V 1 9 1991 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: N 0 V 2 0 1991 BY: PHIL BATCHELOR by a Deputy Clerk CC: County Counsel County Administrator -'` LOST .PROPERTY CLAIM Return original application to: Clerk of the Board PO Box 911 Martinez, CA 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than - the 100th day after the accrual of the cause of action. Claims relating to any other cause of. action must be presented not later than one year after the accrual of' the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at it's office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claic 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 - Section 72'of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance of for payment to any state board or officer, or to any county, town, city district, ward, or village board of officer, authorized to allow .or pay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, is guilty of a felony. " ','c'e;�'c:c4c'c;c:e:c::'.c:c'c;e'e;e:c:c'e•'..''.•;c:Y:c'e•,'.4c:e�c'c�'.•,�:'e'•G;:n•'cn•�'r:'c�:elcsck: •��'.e'c:c:e�'rk�e:c*��c:c'::;��:t�e����:�:'c��c�* _ RE: Claim By Res r` ed o lerk's:.f*ling stamps 'v RcCEIVEE� j f `OCT 11991 Against the COUNTY OF CONTRA COSTA �L' '� DISTRICT- LERK BOARD OF'SUPERVISORS or � — CONTRA COSTA CO. (Fill in name) The undersigned claimant hereby makes claim against the 'County of Contra. Costa or the above-named District in the sum of $ Vand in support of this claim re- presents as follows: 1. When did the damage or injury occur? (Give exact. date and hour) Adhere did th�a e or injury occur: ^� ^V �~ - g ((Include city and county.) How did the dama,e injury occur?'- ((Ci e full etail ; use extra sheets if required.) 4•4Wa"�t�'p"arcular act or omission on the part of coup y d district officers, servants, or employees caused the injury or d ma ? A&W ._ over - .� ......... 5.. What are the names or county or district officers; servants, or employees causing the damage or injury?. 6. 0hat Jamage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors, and hospitals: 9. List the expenditures you made on account of this .accident or injury: DATE ITE:I L IOUNT Govt. Code Sec. 910.2 provides: "The claim signed by the claimant or b some person on his behalf." SEND'NOTICES TO (Attorne{) R Name and Address of Attorney Cla' a Signa tu e Address 95%510 Telephone Number: 4(I 3) Telephone Number: a rte/ i r X�o ,rte Ae 0N7 ► pS?H ` DATFr3-// SACK ; �l E: 2�/ saes' - ox R4P.BOX • • /�. "�-BOOKING NBR: f ; F ETHER Q • t_ A40 • 0 i • � • � 'CASH: Z2 •fes" ' C ® 4 �.:. C) • 4 • I_ `�_ • HI OUSE• C ® � �. • k COAT/JACKET . . 3 , O -Tt�E/SCARF -- --— /PANTIES..f "� 1=► JEWELRY.. `��+2sC,�l.IdYO .:.L•!s�e:� /NYLONS /" SG`vt.0 CcYua r.�x4C ,�iir/` SWEATER/SWT. HIR.BU VyATCH �. " i ® IRT" 00 Gs=;i; RA .. KEYS Fr I 7E, S GLASSES v I f> OTHER' BKG.OF.C."' l , '�NMATE SIGNATURE I have -received all of my,per- I DATE: sonalproperty, 'and :clothing. t: FIZEt'OFC: x . IN AIATURM . GN 04• x !_ , 00 • .033 ,0 :3-330- 0031JDD .DD0 • CERTIFICATE OF RELEASE As required by the provisions of Penal Code SeOtion 851.6 (as amended by Stats. 1970, Ch. 1603), I hereby certify that the taking into custody of �J C r t/ On Subject's Name Date by the Name of agency taking custody was a detention only, not an arrest. was released on, Su jett's name ' /- `5/� _by the �sG Date) (Name of Releasing Agency) pursuant to the provisions of: Paragraph (1) of subdivision (b) of Penal Code Section 849; or: Paragraph (3) of subdivision (b) of Penal Code Section 849, pertinent portions of which appear on the reverse of this certificate. (Signed) 20 C v E Title Ste; CO- State alLoo whether releasing officer or his superior officer) CHARGES . ,J� - Facui 1 Pt y: No Cha ta: X O/13/9 dam:3c> - J 485613 CONROY. t --'6#VTR4 COSTA -BOUNTY DETENTION FA�7L:r'TY CLQ,THXNG RECEIR:T 1 Name ll. F I"# PUSSELL '-REGINALD MEL VIN UOS: :-11/X 1/647 Rack. A&39 Book910. 3G2 ' . ;,.. Intake { Slrlrt/Blouse. _ Y s t : At - . -, Coe t/.lack e t: N t 1 Shorts/Panties: Y' Socks/Ny1 ons. Y' r SweaterlSwt.Shirt: N Pen ts,,/Skirt: Y `: Shoes Boa is•: Y' 81-K DRESS T-shirt/Bra: ?' ha t,/Purse: A/ Press.. N Other« N N f'< t � l` q The `urbov�os, accu ate; • s+ � 't 4f:�Aty. CIO�hftTg. i4 '!;�f .}F i.• _ _ . 333 I hsve- received a21 . vt` mY clothXns�. 1 Richard K. F " ; r -CoronerCOntrd SHERIFF-COF • P.O. Box 391COS�a Ouayne J.0111t Martinez. California 94553. As Sheri (415) 372- 4495 County Warren E. Rup Assistant Sheri -J Enclosed, is a County Claim Form. Please list the missing articles and their value, along with any documents you may have, i .e. , receipts etc. Be sure you have included pertinent dates that tie in with your loss. These dates should show when you were brought here and when you left. Then you must return this form to Contra Costa County, Clerk of the Board, 651 Pine _St. , Room'106, Martinez., CA 94553, AN EQUAL OPPORTUNITY EMPLOYER 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 19, 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: $260.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ROBBINS, Richard QKEPM ATTORNEY: OCT, 8 1991 Date received October 2!�oUAIRNoUNSEL ADDRESS: P.O. BOX 183 BY DELIVERY TO CLERK ON 44ARTNEZ, r=A&!r. Martinez, CA 94553 October 18, 1991 . BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk DATED: October 28, 1991 fid: Deputy ' L 4 J 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: i Dated: o BY: Q. 0 Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Boar 's Order entered in its minutes for this date. 1 gQQq Dated: NOV 1 9 1�td1 PHIL BATCHELOR, Clerk, By C , 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 1 0 Dated: NOV 9 0 � BY: PHIL BATCHELOR by a Deputy Clerk �..._ CC: County Counsel County Administrator . C LOST PROPERTY CLAIM Return orig i".l application to: Clerk of the Board PO Box 913- Martinez, 11Martinez, CA 94553 Z 1 1991 l A. Claims relating to causes of action for death or 'or CLERKarson or to personal property or growing crops must be presented not later •ttrari- the 100th clay after the accrual of the cause of a;:tion. Claims relating to any' other cause of, action must be presented not later than one year after the e.ccrual of•the cause of action. - (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at it's office in Room 106, County-Admihistration Buildin , 651 Pine Street, Martinez, CA 94553. C. I.f clalm is against a district governed by the 6 * s, rather than the county, the name of- the distric D. If the claim is against more tha-n one. public enY seR ym mulc be-:filed against each public entity. 9� ts E. Fraud - Section 72�of the Penal Code provides: ARK B Rp SUPE ISORS COCOSTA CO. _ "Every person who, with intent to defraud, presen s or allowance or for payment to any state board or officer, or to any county, town, city district, ward, or village board of officer, authorized to .allow or pay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, is .guilt`_y of a felony." *'.c'.•„:klYs't:cic3t::;f'YyY:t:'t't.�c::drit�':it�t'.rs'.iY�L'�tic��:�:;-.'::c'c;:it'.F�..•t.::;::Y:csY"c-kaYic'..'��'.t:::t�.`�cyk�c::pct.*'.:��s:#�ic��:k�FYic:9�r�-�. _ RE: Claim By Reserved for Clerk's:.filing stamps b 8. _ r� FILED Against the COUNTY OF CONTRA COSTA ` 29 In 2 71991 or j� � � • DISTRICT'" � '` e � -�..= a... in naive d.�'*B�RDOFSUPEftVI:'•.��a (FI-1_�. ) ,..! ,ZONM COSTA CU. The undersigned :laimant hereby makes claim a ainst the County of Contra. Costa or the above-named ''istrict in the sum of $�-i&Q and '.n support of this claim re • - presents as follows: _ 1. When did the damage or injury occur? (Give exact.-date and hour)-------------- - 2. Where did the damage or injury occur: (Include cit•j and county.) Lot, lr'' -�- 2_ , 3. How did the dama; or injury occur? (Give full det< °ls; use ex ra sheets if required.) E(JS (�tf/TL�� 0po!Il./ ?/g C ,e fJC7,e3 54jot 4 What particular act or om ssion on the part of count;,; or district officers, servants, or employees caused th2 injury or damage? r + p over - 5. [khat 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 claimed. Attach two estimates for auto damage. ------------ ----------------- ------------ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. 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 TO: (Attorney) or by some person on his behalf." Name and Address of Attorney Claimant's Signature) R), Addres - MTz. Al Telephone No. Telephone No. 1E �FiF * it V V V I ViE * �E �F1FiE * NOTICE Section 72 of the Penal Code provides: "Every person who, iiith intent to defraud, presents for allowance or for payment to any state ba3rd or officer, or to any county, city n, district board or officer, authorized to ;k1low or pay the same if genuine, any false or fraudulent claim, bill, account, ic�ucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fire of not exceeding one thousand ($1,000), or by both such imprisonment and fine, oc° by imprisonment in the state prison, by a t'j.ne of not exceeding ten thousand doll& y ($10,000, or by both such imprisonment and fine. ----_----------'_-.PROPERTY/CLOTHING RECEIPT CONTRA,COSTA COUNTY REC. NO. 130138 sACK+Y DATE: 'Z =MDF TIME: ' �� �M t?4"BOX MCDF PBDP.,BDX :WFC NAME:R!4G(s t�+S� Rtt�tfo �aYrvrcNd WCJC . ;:OTHER a 0 •= -- — BOOKING NBR: 4 C" • (_ • • (_. T ® ( • a CASH: $ C) • ( C • L _. C Q a i '�__ C� tag y" ❑ SHIRT/BLOUSE ❑ DRESS • ( �� • ( . ❑ COAT/JACKET ❑ TIE/SCARF04 ; C • I ❑ SHORTS/PANTIES ❑ JEWELRY C • C_ ❑ SOCKS/NYLONS ❑ SWEATER/li'J 'i SHIRT ❑ WATCH ` ❑ BELT ❑ PANTS/SKIRT ❑ SHOES/BOOTS ❑ T-SHIRT/BRA ALLET ❑ HAT/PURSE �EYS ❑ KNIFE ❑ GLASSES ! I OTHER Lcs1,fcr _z / n k t C.( / VQ r n,—�; � C BKG OFC: J"X INMATE SIGNATURE Yt t have received all of my per- DATE: _ __ sonal property and clothing. REL OFC X INMATE SIGNATURE ^may 4 '------ _..__--- - --...---__----- C • C CC • • 3 � 33333J :30DD :: ;:� ,. ) _u► • • s y4« ti —MINNOW cri Q�a1 1� �\ j1 ,f'"��/''�J� � •o[�� ,-1"1„0. Sa0SIAH ns i o ammos ammomu to 16619 Z M, Aye " CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim A90,nst the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 19, 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: $500.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: REED, Dwight T. *.,, i1 ATTORNEY: OCT �4 8 Bate received ADDRESS: 2224 Ohio Avenue BY DELIVERY TO CLERK ON October a,- WN7l 9dUNSEt Richmond, CA 94804 MAMMA CAtIft- BY MAIL POSTMARKED: October 24, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: October 28, 1991 gVIL BATCHELOR, Clerk ok II. FROM: County Counsel TO: Clerk of the Board of Supervisors Z`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: Iq BY: f� Deputy County Counsel U_ NIQ 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 Boar 's Order ntered in its minutes for this date.. ga_ Dated: NOV 1 9 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 Noti a to C1ai nt, addressed to the claimant as shown above. Dated: N O V 2 0 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CIUM tog DOAM OF STiMLSORS OF i�L*MA COSTA OOUNTY UCTIONS TO UD4W A. ClaimB 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, gust be presented not later than the 100th day after the accrual of the cause of Claims relating to causes of action for death or for injury to person fi.v �.o personal property or growing crops and which accrue on or after January 1, must be presented not later than six months after the aoorual 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 to filed with the Clerk of the Board of Superaisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C, If claim is against a district governed -4y 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 riled against each public entity. R. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the and of this O . a L3 * * * * * * * 0 L� 0 0 0 0 a 0 * 0 0 0 0 * * A * 00 01 of # * * 4 RE: Clain By ) Reserved for Clerk's .ftling stamp 0 7EED_Against;the t�unty o ntra osta ) CLER F "'� nw me ) The undersigned claimant hereby makes clsiu, r i"t the County of Contra Costa or the above-named District in the sum of � d and in support of this claim represents as ?'Mows: 1. When did the doge cP injury occur` (Gide oxact date and hour) 40sk-_id'A�_t_1__ 2. Where did the damage or in-�'Loy : "' (Inolade city and county) M1y U.N 3. How did the damage or in w�k ',IIUvc detO.Is$ use extrA paper if re uirad) ., CAS C °4,0 k &4,5[�-4 Q�4CLhh� ACE./ QC?_ �a�-�i��a✓���� 4o 'What particular act Qr omission on the t of county or Officerso servants or employees caused the in ju,/ or 5. What are the names of county or district officers, servants or employees causing the damage or injury? Oak 6.--What-damage-or�injuries�do-you�claim�resulted?--(Give full extent of injuries or damages claimed. Attach two estimates for auto damage. , L.,& Of 14 viz ---------------------------------------------------------------------mow-------------- 7. How was the amount claimed above computed? (Include the estima ed amount of any prospective injury or damage.) ----------------------------------------------------------------_@---------------_-- 8. Names and addresses of witnesses, doctors and hospitals. --------------------------m-------------------,---------------------------------------- 9. ------------------------------ 9. List the expenditures you made on account of this accident or injury. DATE ITEM AMOUNT A/ Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney OD Claimant's Signature W _0 Ad�ress� �L V NN 0 K a Telephone No. �- •" p , .'x�lephone No. �� a �� 3 � �,� Section 72 of the Penal Code providesi "Every person who, with intent is defraud, presents for allowance or for payment to any state 'hoard c:� officer, or Lo 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 ' y imprisonment in the state prison, by a fine of not exceeding ten thousand do:ilars $:10,000, or by both such imprisonment and fine. "WIght INC: What Good Is Money, If You Can't Spend It 2224 Ohio Avenue . Richmond, CA 94804 e (415) 233-1.167 Pager # (41.5) 430-6925 TITLE 11.6 CIVIL RIGHTS 4 t. , .1 11540. Restoration of Property Wrongly U"of torso, khrea%or dtarwaoa ofto telerim Taken. ' with anothtr'e eaeretee M civil Ponlli . If it appears that the property taken is not the raw oa of+cria,a for pwpoee of iaterta*With ematteer'a same as that described in the warrant, or that, exereiae or Ciw rishtber law&1Ja6ment,aexs.7, I there is no probable cause for believing the exis. Proeaenttoa uty9a ot>ser�t4s!4�2LA, �' vlolad" of Civil order protecW4 e:erd" at dva riot*— tenoe of the grounds on which the warrant was tutaameaL 14W. issued, the magistrate must cause it to be restored w the person from whore it was taken, 1,eg.H. 0422.6. Use of Force,11rests, or Destrnetion 1872. - _ Of PrOPtrty to interfere Wits! Anothees ExereW Rel Cal. Fou P1. Pr.. "Criminal Procure M Kl)": Of QVll R19dtt—punishment. '� ill.CAA net.hen,CL 21•'search gad Sdzwt Moom ; (A) oto person, whether or' not acdag 6de>r color of law, shall by force or threat of force, will. Cully injure, Intimidate or Interfere with. oppress. or threaten any other person in the free exercise or enjoyment of any right or privilege secured to him or her by the Constitution or laws of'this state or by the Cmetitution or lases of tbe*UnitW States because-of the other person race, color. §f46. Officer Acting Withow Regula,° religion, ancestry, ttational origin,or sexual orien- tation. '��,�.,<n.,, "t �., r,ii�r9 a:.,t �,.:e a Every public officer, or person prett a public officer, who, Lander the prete (b) tea P6,sgn, wheth'ir or not mctfttg nntjer of any process or other legal autho ars d� :actor of laroi+, tahall Btnowia y defttoo,,t; 1e: oe atiy person or detains him against his will, or destroy the real or property il ttayother seizes dr levies uponIny property, or dispossesses . person for the of intkWdatting orianterkv any one of any lands or tenements. without a reg- mg anth the exerciee 'or enjoyment-of-any ular process or other lawful authority therefor, is tight or privii q e secured to the other person by guilty of a inisdemeanor. Leg.ld. 1872. the Constitution or laws of this stare or by the Constitution or laws of the united 5tatsa.because Clef.:Cai. Fms III,Sc 11r.."Cnminai Procedure rpt M." of the other person's race. color,, • • ous &Does• try,national origin,or sexual o o�antataon.•e�' . (c) A.nyconvicted eg vioiating'subdivi. cion (a) or b}�ti be pu&4W by imprisomaaeal In she comty, W In(�zSize wmtfaa,or b) a rwe -not Jo ��-��� Fwo .%o ad dollm (55,000), or by e } tied fins encs impubome at. provider, howgvvo ',N at Be, n C'bill, be victed of *Ml ag aubdiviarn (a) t�,2upog speech alone, e-neept upon nt�Eam s.0 .�bmQ cJl� speed, hsOf tbmtened violence ag p_n�� >, person or ;roup of persons 4nd thm the e dans bad the apparent gbilRy to m y ,x.^, -,�N � H. 1987 ch. 4277. ::Z;;wn rs ( . A PCI \ Q4 Lo ® 4t 44 . 1 4 \ /110 - (D . » i » U @ a @ © � ® § \ / 2� I 4-) . Ln \ / � U � � . - f Ln \ \ ■2 �/2 'IV « \ �� Q /\w a � ■ \ J� . ƒ - % � . � CLAIM d 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 19, 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: Indemnity Section_ 913 and 915.4. Please note all "Warnings". RECEIVE® CLAIMANT: MILLER, Jack Ira CCTN,' 191 ATTORNEY: Laurel L. Simes, Esq. Wild, Bowman, & Zaragoza Date received MARTIN COUNSEI ADDRESS: 1700 Montgomery Street BY DELIVERY TO CLERK ON October g1�!_'14991 Suite 110 San Francisco, CA 94111 BY MAIL POSTMARKED: Hand delivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: October 21 , 1991 EVIL BAATTCYELOR, Clerk epuI. FROCL/Vi 0_1f 41441 a9 , M: 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: ( J 0MQJJ(� 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 ( 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 NOV1 0 Dated: . 9tl9 1991 PHIL BATCHELOR, Clerk, 8yA4 1 LA,, Deputy Clerk _Q 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 2 0 1991 BY: PHIL BATCHELOR by °1 Deputy Clerk CC: County Counsel County Administrator I DONALD R. WILD LAUREL L. SIMES 2 WILD, BOWMAN & ZARAGOZA o3 bRS03 VHIN00 1700 Montgomery Street SMOSIAa3dns d0 ade0e)IH313 3 Suite 110 San Francisco, CA 94111 ) I z leo 4 (415) 434-0640 5 Attorneys for Defendants ®3��3��� and Cross-Complainants 6 JACK IRA MILLER and TOM BRAZIL 7 8 CLAIM AGAINST THE COUNTY OF CONTRA COSTA 9 10 Pursuant to Government Code Section 910, the following claim is 11 made against the County of Contra Costa. 12 A. Claimant: 13 Jack Ira Miller General Delivery 14 Minden, Nevada 89423 15 B. Notices should be sent to: 16 Laurel L. Simes, Esq. WILD, BOWMAN & ZARAGOZA 17 1700 Montgomery Street Suite 110 18 San Francisco, CA 94111 19 C. Amount of Claim: 20 Indemnity rights unknown to claimant at present. 21 D. Date of Occurrence: 22 December 12, 1989 is the alleged date of injury to 23 plaintiffs in the action out of which the right of indemnity may 24 arise. Plaintiffs, as set forth in the complaint attached as 25 Exhibit 1, alleged that claimant had negligently operated his motor 26 vehicle, a semi-trailer truck, thereby causing plaintiffs' injuries 27 on December 12 , 1989. 1 28 I E. Place of Occurrence: 2 The automobile accident giving rise to plaintiffs' claims 3 of personal injuries took place on Interstate 80 near the Pinole 4 exit, in an area where freeway construction was underway and the 5 road had been narrowed during the construction phase which 6 conditions were in effect on or before and after December 12, 1989. 7 F. Nature of Occurrence: 8 Plaintiffs' complaint for personal injuries is attached to 9 this claim as Exhibit 1. It alleges that claimant, Jack Ira Miller 10 is negligent and otherwise responsible for the injuries and damages 11 set forth. That suit, Maria Burns et al v. Jack Ira Miller, et 12 al. was filed in the San Francisco Superior Court, Civil Action No. 13 922560. The summons and complaint was never served on claimant Jack 14 Ira Miller. However, an answer was filed on Mr. Miller's behalf on 15 June 13, 1991. Claimant Miller files this claim so that he may have 16 the right to file a cross-complaint for indemnity with regard to the 17 injuries and damages made by plaintiffs. The nature of the 18 allegations made by plaintiffs are contained in the complaint which 19 is attached as Exhibit 1. 20 G. Itemization of Injuries and Damages: 21 Claimant anticipates that . he may be held responsible to 22 plaintiffs in damages for the injuries and damages alleged by 23 plaintiffs as set forth in Exhibit, 1. To the extent claimant may be 24 held responsible, claimant will seek indemnity against the County of 25 Contra Costa. 26 27 2 28 I H. Miscellaneous: 2 Claimant presents this claim to the County of Contra Costa 3 as he is informed and believes that the County of Contra Costa is a 4 governmental entity which employs the personnel who were involved in 5 the incidence out of which the right of indemnity may arise. If you 6 are aware of any other governmental entities which you contend own, 7 possess, control, supervise or otherwise have responsibility for the 8 freeway work being performed on December 12, 1989, it is requested 9 that the undersigned be informed immediately. 10 DATED: October 17, 1991 11 WILD, BOWMAN & ZARAGOZA 12 13 By: LAUREL L. SIMES 14 Attorneys for Defendants and Cross-Complainants 15 JACK IRA MILLER and TOM BRAZIL 16 17 18 19 20 21 22 23 24 25 26 27 28 3 • • • A [A_TTOANE Y OR PARTY WITHOUT ATTORNEY _AND ADDRESS) TEL A. FOR COURT USE ONLY JOHN H. PETERSON 415-939-8508 1511 Treat Blvd. , 1400 Walnut Creek, Ca 94598 ENOOasED ATTORNEY FOR(NAME): MARIA BURNS & MARGARITA HERNANDEZ F Iprrorcow Insert name of court.Judicial district or txanch court.it any,and post office and street address: F►enclaao county SuW SUPERIOR COURT OF CALIFORNIA It SAN FRANCISCO . COUNTY �iQUG 400 Van Ness Avenue W.DtCKMOK CkA San Francisco, Ca 94102 MARIAJUSTINIANO PLAINTIFF: MARIA BURNS and MARGARITA HERNANDEZ DEFENDANT: JACK IRA MILLER, TOM BRAZIL, JAMES EDWARD HOUSE, STATE OF CALIFORNIA, ®DOES 1 TO T6TFNTY CASE NUMBER. COMPLAINT—Personal Injury, Property Damage, Wrongful Death - ®MOTOR VEHICLE MOTHER(spieeily): �� t:" (--' t-% ZOroperty Damage Q Wrongful Deathersonal Injury 'r J ry Q Other Damages(speciry): 1. This pleading. including attachments and exhibits, consists of the following number of pages: 2. a. ach plaintiff named above is a competent adult [�Lxcept plaintiff(name): 0 corporation qualified to do business in California Q an unincorporated entity(describe): Ma public entity(describe): M a minor ®an adult M for whom a guardian or conservator of the estate or a guardian ad litem has been appointed M other(specify): CD other(specify): Q Except plaintiff(name): Q a corporation qualified to do business in California Man unincorporated entity(describe): Ma public entity(describe).- (:Da describe):Ma minor =an adult Q for whom a guard;an or conservator of the estate or a guardian ad titem has been appointed M other(specify): M other(specify): b. Q Plaintiff(name).- is name).is doing business under the fictitious name of(specify): and has complied with the fictitious business name laws. , c. Q Information about additi"I plaintiffs who are not 4ompetent adults is shown in Complaint— Attachment 2e. (Continued) For,x Aopmved eY me rudK:e+t:a,+xil or .e a.,c�r•�r�A_1NY-�Do►�r+A�t (nh+ry Prnnarfv fla�nsne '4HORT TITLE: CASE NUMBER. BURNS vs MILLER et al i COMPLAINT—Personal Injury, Property Damage, Wrongful Death Pao.two 3. a. Each defendant named above is a natural person CK] Except defendant(name): Q Except defendant(name): STATE OF CALIFORNIA C]a business organization, form unknown =)a business organization, form unknown 0 a corporation Q a corporation 0 an unincorporated entity(describe): Q an unincorporated entity(describe): ® a public entity(describe): Q a public entity(describe): Q other(specify): Q other(specify): Q Except defendant(name): Q Except defendant(name): C] a business organization, form unknown Q a business organization, form unknown Q a corporation Q a corporation Q an unincorporated entity(describe): Q an unincorporated entity(describe): 0 a public entity(describe): 0 a public entity(describe): C] other(specify): Q other(specify): ) b. The true names and capacities of defendants sued as Does are unknown to plaintiff. Con t inue on page 5. C. Q Information about additional defendants who are not natural persons is contained in Complaint— Attachment 3c. d. Q Defendants who are joined pursuant to Code of Civil Procedure section 382 are(names): d. (—X:) Plaintiff is required to comply with a clayns statute, and a. [ plaintiff has complied with applicable claims statutes, or b. 0 plaintiff is excused from complying because(specify): S. This court is the proper court because W at least one defendant now resides in its jurisdictional area. 0 the principal place of business of a corporation or unincorporated association is in its jurisdictional area. Q injury to person or damage to personal property occurred in its jurisdictional area. Q other(specify): 6. Q The following paragraphs of this complaint are alleged on information and belief(specify paragraph numbers) (Continued) ►roe two 1 .SNORT TITLE: CASE NUMOEN. • BURNS vs MILLER et al COMPLAINT—Personal Injury, Property Damage, Wrongful Death(Continued) rage Yugo 71 Q The damages claimed for wrongful death and the relationships of plaintiff to the deceased are listed In Complaint—Attachment 7 CD as follows: e. Plaintiff has suffered wage loss ®loss of use of property bospital and medical expenses ®general damage property damage ®loss of earning capacity Q other damage(specify): Contusions, abrasions, wrenches and sprains about their head, torso and extremities, particularly a wrenching and spraining of the bones of the neck, back, spine, shoulders , arms and lower extremities , with injury and damage to the muscles and ligaments in the region thereof all causing pain and suffering of a lasting COn t.inti Q nature 9. Relief sought tn`this complaint is within the jurisdiction of this court. 10. PLAINTIFF PRAYS For judgment for costs of suit; for such relief as is fair,just, and equitable; and for [ compensatory damages Q(Superior Court) according to proof. 0(Municipal and Justice Court)in the amount of S ' other(specify). 11. T"- following causes of action are attached and the statements above apply to each. (Each complaint must have ori or more causes of action atlachel.) Motor vehicle ' CD General Negligence Q Intentional Tort []Products Liability Premises Liability 0 Other(specify): JOHN H. PETERSON 1� � (Type orp,•"t name) / (Signature o1 plaintiff or attorney) `SHORT TITLE: I CASE NUAIBE� I BURNS vs MILLER et al _pIR,ST CAUSE OF ACTION--Motor Vehicle Page—.4._____ (number) ATTACHMENT TO ®Complaint Cross-Complaint (Use a separate cause of action 1brm for each cause of action.) Plaintiff(name): MARIA BURNS and MARGARITA HERNANDEZ MY-1. Plaintiff alleges the acts of defendants were negligent: the acts were the legal (proximate) cause of injuries and damages to plaintiff:the acts occurred on(date): DEC 129 1989 at(place): eastbound lanes highway I-80 .3 miles east of Appian Way overcrossing, Pinole, Contra Costa County, California MV-2. DL+ENDANTS a. The defendants who operated a motor vehicle are(names): rACK IRA MILLER, JAMES EDWARD HOUSE Q Does—____—. to___ -- b. ® The defendants who employed the persons who operated a motor vehicle In the course of their employment are(names): ALL -DEFENDANTS t , ! M Does -----.___. to -- __-.-- c. The defendants who owned the motor vehicle which was operbted with their permission are(names): ALL DEFENDANTS Q Does _ __. _ to d. M The defendants who entrusted the motor vehicle are(names): ALL DEFENDANTS Q Does--—.-_,__-to -- - - e. q3 The defendants who were the agents and employees of the other defendants and acted within the scope of the agency were(names): ALL DEFENDANTS , f. CD The defendants who are liable to plaintiffs for other reasons and the reasons for the liability are []listed in Attachment MV-2f as follows: QDoes to_:._--__---- �offl Aw9vett by the Juftw CoUM9 Of Cahtornia Enedna 14"U"1. 198Q r' a1�.-� nr ■n,r�n. 1 BURNS VS. MILLER Complaint -- Attachment Item 3b 3' Plaintiffs are ignorant of the true names and capacities of 4 defendants sued herein as DOE ONE through DOE TWENTY inclusive, 5 and therefore sue these defendants by such fictitious names. 6 Plaintiffs will amend this complaint when their true names and capacities are ascertained. Plaintiffs are informed and 8 believe and thereon allege that each defendant designated as a 9 DoE is negligently responsible in some manner for the events 10 and happenings herein referred to, and thereby proximately 11 caused plaintiffs' damage as herein alleged. z a 12 � s 13 a = � tz; o2 H 14 x ¢ Q 15 aj 16 o = 17 18 19 20 21 22 23 24 25 26 ` 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 19, 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: $297.21 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: LOKHOFF, R. Kristina 4" ATTORNEY: OCI u 4 Date received OctobMNW�0199'1 ADDRESS: 3444 Echo Springs Road BY DELIVERY TO CLERK ON ., pnNFZ, CALIF. Lafayette, CA 94549 BY MAIL POSTMARKED: October 18, 1991 Certified No. P 999 -921 194 I. FROM: Clerk of the Board of Supervisors TO: - County Counsel Attached is a copy of the above-noted claim. October 22, 1991 PpHHIL ATCHELOR, Clerk DATED: BY: Deputy0UP I1. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: I o2y /c(I BY: I Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (V1 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. r'nq Dated: NOV 1 9 1a a! PHIL BATCHELOR, Clerk, By J JAJJLDeputy 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 OrderAnd Notice to Claimant, addressed to the claimant as shown above. Dated: NOV BY: PHIL BATCHELOR by LoDeputy Clerk CC: County Counsel County Administrator - -- R . KRISTINA LOKHOFF J 3444 ECHO SPRINGS RD. LAFAYETTE , CA 94549 (510) 932-1443 County Administrator Risk Management Division 651 Pine Street , 6th Floor Martinez , CA 94553 October 17 , 1991 Dear Sir/Madam: I am submitting to you the claim form which I requested from your office on Tuesday , July 2nd , 1991 . Please find enclosed two estimates for windshield replacement , along with two photographs in support of my claim, especially pertaining to question # 4 . I have also enclosed a stamped , self-addressed envelope to facilitate the return of my photographs once the processing of this claim is completed . If you have any additional questions , I can be reached at (510) 825-6772 days , and evenings at (510) 932-1443 . Thank you , R . Kristina Lo off �V OCT 2 2 1991 CLERK BOARD OI'SUPERVISORS CONTRA COSTA CO.F / enclosures : 5 Contra Costa Cay."ty: RECEIVI OCT 21199 Risk ManagL,W.,,t 1 ,R 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. Claimsrelating to causes of action for death or for injury to person or to!I ersonal ro ert or growing crops and which accrue on or a�` er anuary 1, 19 , must be resented not a er six months after the accrual of the cause o action. Claims relating to any other cause of action must be presented not a ,er n 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 ) Reser ed for Clerk's filing stamp R .. KRISTINA: ,LOKHOFF ) E_ EVE D. Against the County of Contra Costa ) OCT 2 2 1991 or ) District) CLERK BOARD Or SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $--297 . 21--------- and in support of this claim represents as follows: PLEASE SEE ATTACHED ESTIMATES . 1. When did the damage or injury occur? .(Give exact date and hour) FRIDAY JUNE 28 , 1991 BETWEEN 8 :00 AM & 8 : 10 AM EXACTLY. r..r----rrr—r—rrrr--r----rrr—rrrrr--r--..r--rrrr..r----rrr----.err----------------. 2. Where did the damage or injury occur? (Include city and county) * (PLE'ASE SEE RUBS 1 & 2) CONTRA COSTA COUNTY TAYLOR BLVD. BETWEEN GRAYSON RD. & WITHERS AVE. (P. H. /LAF. . BORDER) rr—r—r—w. —r--------r------r—----r..----------------r—r—r—r..rrrrr—.�—�.r--..—r 3. How did the damage or injury occur? (Give full details; use extra paper if required) PLEASE SEE ATTACHED SHEET. --------- -------------------------------------------------------------------------- 4. What particular act or omission on the part of-county or district officers, servants or�employees caused the injury or damage? 1 ) EXCESS LARGE CHUNKS OF LOOSE GRAVEL LEFT COVERING ROADWAY-*(R SEE 2) NO SIGNS ADVISING OF DETOURS ) 3) WARNING SIGNS THAT WERE POSTED WERE ALL PLACED AT GROUND LEVEL *(PLEASE AND, BEING APPROXIMATELY ONLY TWO FEET TALL , THEY WERE UNABLE TO SEE BE SEEN FROM BEHIND OTHER CARS . (THE SIGNS WERE ALSO LACED Pf3( m IMMEDIATELY WHERE THE GRAVEL STARTED AND NOT over 1 & 2) SUFFICIENTLY BEFOREHAND). er 7. wnat are the names of county or district officers, servants or employes causing the damage or injury? PUBLIC WORKS DEPT. ; FIELD OPERATIONS ; _ROAD MAINTENANCE. _ 5. What damage or in do you claim resulted? (Give full extent of injuries or damages claimed. Attach .two estimates for auto damage: THREE CRACKS %,IN THE' WINDSH.IELD OF MY BRAND NEW. CAR,, AS WELL AS EXTENSIVE PAINT-CHIP DAMAGE -'TO THE HOOD ',OF THE CAR. ;. 7. How was the amount claimed above computed? - (Include the estimated amount of'- any prospective injury or damage.) BY OBTAINING TWO ESTIMATES FOR :WIND°SHhELD REPLACEMENT FORA 1990 MAZDA PROTEGE FOUR-DOOR SEDAN. (PLEASE . SEE ATTACHED ESTIMATES) ----------------------------------------- ------------------------------------ 8. ------------------- --- ---------------------------------=------------------------- 8. Names and addresses of:witnesses, doctors and hospitals. (510~) 370-8982 MR . BRAD A . MENDONSA 576,3 LIKINS CT. MARTINEZ, CALIFORNIA 94553 (WITNESS) 9. List. the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT NONE (YET) Gov.' Code Sec.- 910.2 provides':. "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or b ome peuon on his behalf." Name and Address of Attorney aiis Siur e)3. 3444 ECHO SPRI .G-S09D _ . Address LAFAYETTE , CALIFORNIA 94549 Telephone No. Telephone No. (510) 932-1443 V 32-1443 * 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. 3 . How did the damage or injury occur? (Give full details ; use extra paper if required) ON FRIDAY, JUNE 28 , 1991 , AT APPROXIMATELY 8 :05 AM, I WAS TRAVELING TOWARDS LAFAYETTE ON TAYLOR BLVD . I WAS STOPPED AT THE TRAFFIC SIGNAL ON TAYLOR AT GRAYSON ABOUT FOUR OR FIVE CARS BACK, AND THERE WAS CONSIDERABLE TRAFFIC . I CONTINUED_ TO PRO- CEED ON TAYLOR TOWARDS WITHERS WHEN SUDDENLY THERE WAS LOOSE GRAVEL ALL OVER THE ROAD . I ADJUSTED MY SPEED ACCORDINGLY , AS DID THE OTHER VEHICLES I WAS TRAVELING WITH. DESPITE THE DE- CREASE IN SPEED, GRAVEL BEGAN TO SPRAY--OUT FROM UNDER THE TIRES OF EVERY VEHICLE IN VIEW, AND FROM THE VEHICLE IN FRONT OF ME UP ON TO MY HOOD AND WINDSHIELD. ONCE I NOTICED THE DAMAGE, I PULLED OVER ON THE NEXT SIDESTREET, (AS DID ANOTHER DRIVER) , TO INSPECT THE DAMAGE TO MY CAR . THOUGH THERE WAS NO REAL DAMAGE TO HIS VEHICLE , HE AGREED TO BE A WITNESS ON MY BEHALF, AS HE HAD BEEN TRAVELING NEXT TO ME THROUGH THE GRAVELLED PORTION OF THE ROAD . UPON DETERMINING THAT THE AREA IN QUESTION WAS UNDER COUNTY CONTROL, I CONTACTED RISK MANAGEMENT TO OBTAIN THIS CLAIM FORM TO SEEK COMPENSATION IN ORDER TO REPLACE MY BROKEN .WINDSHIELD. ADDENDUM TO THE CLAIM OF R . Kristina L,okhoff (Print your full name) (1} Do you use the roadway as part of a daily commute? Yes ( ) No ( X ) ( 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 ( X } No i ) ( 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 ) ( 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? (NOT APPLICABLE) 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 with the specific damaged parts on your vehicle. THE GRAVEL WAS THROWN ON TO MY CAR FROM THE TIRES OF THE VEHICLE TRAVELING IN FRONT OF ME , AT APPROXIMATELY BETWEEN A 100-350 ANGLE, IN MY OWN ESTIMATION. THERE WAS SO MUCH GRAVEL ON THE ROAD THAT I FEEL THIS INCIDENT WAS TOTALLY UNAVOIDABLE IN THE PRESENCE OF OTHER VEHICLES THE DAMAGE THAT I INCURRED WAS THREE LARGE CRACKS IN MY WINDSHIELD AS WELL AS HALF A DOZEN PAINT CHIPS IN THE HOOD OF MY CAR . ( 13) Were you aware that using the road during the chip seal process might result in damage to your car? Yes ( ( UNABLE TO ANSWER. BECAUSE NO DEFINITION OF 'T-H_IP. AAL" HAS BEEN PROVIDED . I declare that the above information is true and correct under the penalty of perjury. ,Si `ture) (Date) .'3 '1 rl k' :} :5r';- .1 HFEL:TE GLASS P. 02 r SAFELI TL AUTor AL.S rORF'. '.JDTE 0 R G D GTE: 1.C,-16--•91 E098 ST CONCORD, CAo NSURED lK 1.S'r Np. f_CIKHOF-F di 15 G 3:-..i al_: +44 EC-;O Ste'' RD LAF'AYE f T E, r-P S;4 549 P H 0 N E 1 o 5'1.0-9?c- -•14432 CASH' SALESt -70 1 POLICY # ., 2098 MARKF._.. STREE-I. CLAIM #: C0r C!-1RD.. Cid '74`a?t:r (iCt00 RUTH/VER: LOSS LOC : : I. OE;B: J 4TE. CAUSE: :-_•___-•------_>-r ru :z==z=.=z- =._.omf=-'Yr-- __--••---__•-•-__-_--_-•-- - E MODE.7- �€N9E STPTE VE H•r•r'L E TD INUMBER 199C) rnn7 ------------ OFY PARI iiF= -- ,_ - LI'ST a_�t_l.h�,"_i LA30R VIT MATER,.At- ExTENSION r WEL� 431 ,.:, 15 t 4. i 49. t 9 95 27 , t_,8 T' c.. tP.' WDSHIELI D `i I ,R 9 1 S A Q._'13T L•_ f-AR`f SUP TU 1 AL 224. z F, rO k'!UT 'RY FR011y, `�':., �; ;�f�C,. I,. ,.ATF LPTBOR SUE TOTAL. 49., Q"-.) :=SUB TOT^L E:7. . OF, i :_�NLES TAX 18. 48 0TAL ESTIMATE 291 .54 i 'YOU CH0061t 1-: ':fDF,-YC'UR ri__I1'1:1CL __.,__ - � �:SS NEEDS __. ____ . . ;h.ISi'-�;i_L.EF _ •!FC,n�i,11IJh1=- 1 =Ct._rA%MAt`�T=- i X 4: t O riiT 14 '91 04: 1 7t='f•1 I-PS STORE . J -50 SAN RAt'irid =MER [C:A, INC., (R ) TIME : 04: 10PM 2.157 SAN RAMON VALLEY BLVD. SAN RAMON. CA 94S815 dUGTE (510) 83?-0888 KR I SI NA Q U072 NO. . 005895 GA'15H S LE 6 A Y A.RE,�. RF.- DP"I'S' 10/14/91 2221 " w`'J"W:PtiS CPQ: tsLV. ' :_'!S'T # 10025 SAN :J- A 9.592�i }# i` tF#3#atif ?f Y F•." SS K # u 1f +'r 7 .4#i44 ?�a*i4 o-X # k d# MAKE : MAZDA M01',c_ , 3"S PF,,' F;'3'E. SE„ LX YEAR ; 1:?90 A',APT �n'Y J.,llY AMT RD Sr i FpEo FCW64&l j- A W 1.n d s r,T n ' cl 1 ? 202. 05 LABOR 3. 5 a . S 40. 00 L; IT 3 '. 0. 00 klii643:X IIAZr,p F -. _ PRr1'," _(;r= 1 1 35. 53 P P 1' $1'37. 61 4 0. 0(l-' )! T s0. 00 SALES 7AX 619. 6 UP0F,S TOT AL $297. 21 NET TOTAL $297. 21 >>> QUOTE ONLY. NOT VALID FOR mftRF THAN 30 DAYS QOM & RPnL;FST er.' �' DAT:- OF REQI►ES'T <<< r 3 { a j y sec y,. 'f y t may^, �, r tray 1 P 4Oz w 4 iT M n� 'Al Ovi R T y r ?,'# Va way e t o Vol, AGS. o to . • �r r 1 1F16 �+ . w o �� � � a0 111 VOW �4 rj � oD O t4 6 O O a ash v Q` �w N � OD G C� .rA w p.t O � O � � ra 3z • 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-79;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: BYRD, Jeffrey F. ATTORNEY: Timothy D. Timmons, Esq. OCT 2 Law Offices of Timothy D. TiMM=Se received COUNTY COUNSEL ADDRESS: Concord Gateway I BY DELIVERY TO CLERK ON OCtdWINR C-`41§91 1850 Gateway Boulevard Suite 1085 BY MAIL POSTMARKED: October 21, 1991 Concord, CA 94520 I. FROM: Clerk of the Board of Supervisors TO: County Counsrl Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: October 23, 1991 fib: Deputy aAAM 01, AA-1 V� 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: �C! 124 91 BY: I ri Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (� This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. 1 (1 Dated:—NOV 1 9 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 NOVs shown above. Dated: N 2 0 1991 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator i 1 TIMOTHY D. TIMMONS, ESQ. LAW OFFICES OF TIMOTHY D. TIMMONS 2 Concord Gateway I 1850 Gateway Boulevard, Suite 1085 3 Concord, California 94520 Telephone: (510) 685-6530 i I®CT 22 1991 4 Attorney for Claimant, -- �� JEFFREY F. BYRD LCLEFR6CON RA COSTA CO ARD OF SUPE - 6 - - - 6 7 BEFORE THE BOARD OF SUPERVISORS 8 OF THE COUNTY OF CONTRA COSTA 9 10 In the matter of the claim of CLAIM FOR DAMAGES I1 JEFFREY F. BYRD Presented pursuant to 12 against Government Code §900, et seq. 13 THE COUNTY OF CONTRA COSTA, CALIFORNIA 14 15 TO THE CLERK OF THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA 16 COSTA, CALIFORNIA: 17 A. Claimant's name: JEFFREY F. BYRD. 18 B. Claimant's address: 4811 Eagle Way, Concord, CA 94521. 19 C. Amount of claim: Unknown at this time. Claimant seeks 20 compensation for physical, emotional and financial damages 21 he sustained as a result of a pole climbing accident. 22 D. Address to which notices are to be sent: Timothy D. 23 Timmons, Esq. , Law Offices of Timothy D. Timmons, 1850 24 Gateway Boulevard, Suite 1085, Concord, CA 94520. 25 E. Date of occurrence: April 22, 1991. 26 F. Place of occurrence: Worldwide Educational Services, 600 27 Marin Street, Vallejo, CA 94590. 28 G. Nature of occurrence: Claimant was injured when he fell I from a pole while participating in a training program 2 operated by Worldwide Educational Services (Worldwide) , 3 that was federally funded under the Job Training Part- 4 ner_ship Act (DTPA) . This program was administered on a 5 local level by the Contra Costa County Private Industry 6 Council (CCCPIC) . The CCCPIC contracted with Worldwide to 7 provide job training funded by the JTPA. 8 The CCCPIC has a mandatory duty to provide oversight 9 for the Federally funded job training programs and to 10 administer these programs in accordance with regulations 11 and provisions set forth in the JTPA, which include 12 requirements to protect the health and safety of the 13 program participants. The CCCPIC failed to exercise 14 reasonable diligence in the exercise of that duty. More 15 specifically, the CCCPIC failed to inspect, and to provide 16 Proper oversight of, Worldwide's cable installer job 17 training program and permitted Worldwide to operate in 18 violation of the standards set forth in the JTPA as 19 follows: 20 1. The students were inadequately trained and supervised, 21 and claimant was required to climb the pole in spite 22 of dangerous and inclement weather conditions. 23 2. No safety devices (nets, harnesses or mats) were in 24 place around the pole during the training, and the 25 safety standards and procedures for the program were 26 inadequate. 27 3 . The insurance coverage for the program supplied by 28 Worldwide Educational services was insufficient, given 2 - 1 H. Name(s) of employees) causing the injury, loss or damage, 2 if known: Unknown. 3 I. Itemization of injuries and damages: Claimant seeks 4 damages including wage loss, loss of earning (capacity, 5 vocational rehabilitation costs, hospital and medical 6 expenses, and general damages. Claimant does not presently 7 know the full extent of his damages, but is informed and 8 believes', that jurisdiction over the claim would rest in 9 Superior Court. 10 Dated: October 21, 1991 LAW OFFICES OF TIMOTHY D. TIMMONS 12 TIMOTHY . TIMM NS, Attorney for 13 Claima , JEFFREY F. BYRD 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 3 - F 1 PROOF OF SERVICE BY MAIL - CCP 1013a, 2015. 51" 2 I declare that: 3 I am employed. in the county of Contra Costa, California. 41 I am over the age of eighteen years and not a party to the 5 within cause; and my business address is Concord Gateway I, 1850 6, Gateway Blvd. , Suite 1085, Concord, California 94520. 7 On October ,21,, 1991, I served the attached CLAIM FOR DAMAGES 8 upon all parties in said cause, by placing a true copy thereof in 9 a sealed envelope with postage thereon fully prepaid, in the 10 United States mail at Concord, California, addressed as follows: 11 12 Clerk of the Board of Supervisors Contra Costa County 13 651 Pine Street Martinez, CA 94553 14 15 I declare under penalty of perjury under the laws of the 16 State of California that the foregoing is true and correct, and 17 that this declaration was executed on October 21, ' 1991, at 18 Concord, California. /� r 19ja l�` Patricia A. Holcomb 20 21 22 23 24 25 26 27 28 }rr 3 � i ! C 3 O + Ji •� `37 r R 4.1 �O{ CJ y I, PNi7 U � a O 4) tV N 4J a '� (P 4) H Lo ko c�UA �tS C-1 Q cb U) m z o O -tLLJrua o � a ::) Lo � 2w v�m U Q O 0 � U O O O m 0 cr = O O f-- 2�z 0L) �� O Ln 00 A CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA J r Claim Against the County, or District governed by) BOARD ACTION the BoaH of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT November 19 1 1 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice o California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $215 . 37 Secctti� and 915.4. Please note all "Warnings". CLAIMANT: .a JORDON, John E. or Jeannette ATTORNEY: California State Automobile CO�N� � � Dd�R��cei ved ADDRESS: Association Inter—Insurance BY DELIVERY TO CLERK ON October 21 , 1991 Bureau 2055 Meridian Park Blvd. BY MAIL POSTMARKED: October 18. 1991 Concord, CA 94520 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk DATED: October 21 , 1991 �d: Deputy L eg.1 4L4 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: ffl _( ,�, BY:— Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (% This Claim is rejected in full. ( } Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. 09 q Dated:—NOV®V 1 9 1991 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and No ice to Claimant, addressed to the claimant as shown above. Dated: ®V BY: PHIL BATCHELOR by -b i Deputy Clerk -- CC: County Counsel County Administrator .�� alifornia State Automobile Association nter-Insurance Bureau ^ CONCORD (510) 671-2708 2055 MERIDIAN PARK BLVD CONCORD CA 94520 OCTQBER 18, 1991 B8ARD OF SUPERVISORS INSD : JORDON,JOHN,E OR JEA#NETTE 651 PINE ST ROOM 1O6 C�M-MO: O6-X979O1-5 MARTINEZ CA 94553 L 07 : -15-91 DO BEAR BOARB OF SUPERVISGRS: ` THIS IS NQTICE OF OUR SUBROGATION INTEREST ARISING FROM THIS LQSS. WE HA;E ARRAN8ED SETTLEMENT WITH OUR INSURED. PLEASE MAKE YOUR PAYMENT DIRECTLY TO THE CALIFORNIA STATE AU[O ASSOCIATICN INTER-INSDRANCE BUREAU (CSAA-IIB) . ATTACH[0 ARE: REPAIR BILL: $215.37 ATTN: JULIE AUMOCK SINCERELY , CT 21 BRUCE HOFFMANM CLAIM REPRESEhTAT1VE - ,Claim to: BOARD OF SWWW 0� " A COSTA COUNTY UCTIONS TO CLAIMANT A`. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or-before December 31, 1987, must be presented not. later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue- on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code§911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of, the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See. penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. e � � �• � � � �t * * * � � ee � * � � e � e � � a * � � e � � * ee � ee * � � e � � RE: Claim By ) Reserved for Clerk's filing stamp RRC OVED~ Against the County of Contra Costa ) 109 2 11991 orE District) i CMX MARD OF SUPERV9 Fill in name ) ® 4► / COSTA CO. y 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:,- ---------- ollows:•--M-------rr-N-----rr-r---.----rrrr�rrrN-rrrN O 1. When did the damage or injury occur? (Give exact date and hour) -------- - ---- -- 2. Where did the damage or injury occur? (Include city and county) P � 3• How d the damage or injury occur? ( ve full details; use extra paper if required). 4. What particular act or omission on the part of county or district officers, //��__//-"✓✓� YY servants or employees caused the injury or damage? rJ_ (over) cue names ai county or district officers, servants or employees causing# the damage or injury? --------------------- ------ - -- -------------------------------------- 5. What damage or injuries do you claim-resulted? (Give full extent of injuries or damages claimed: Attach two estimates for auto damage. -- ----- ------------- 70 amage. -7. How was the amount claimed above computed? . (Include the estimated amount of any prospective injury or damage'.) -M-------------------------------0----N-----------OM--- -------------M------------- 8. Names.and addresses of witnesses, doctors and hospitals. —....----------------------r....— -------.... ------------s—.rte.-----••------ 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT - - _Gov. Code Sec.- 910:2 provides: "The claim must be signed _by the claimant SEND NOTICES TO: (Attorney or by some person on his behalf." Name and Address of Attorney Cla'. is Signature Address). 19 S" 3 Telephone-No. Telephone No. O .t- 3 �.� 0 S NOTICE ' Section 72 of%the. Penal,Code-provided: "Every person who, with. ntent 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 bf.: 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 ($10,000, or by both such imprisonment and fine. 4 (1Q) Did you travel the roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( No ( ) ( 11) Did you obtain the identity of the/ car relating to questions b thru 9? Yes ( ) No ( x) If yes, please provide identification below: " \\ ( 12) Please describe in your own words how the gravel caused damage to your vehicle and the angle the gravel was thrown onto the car, along with the specific damaged parts on your vehicle. rw (r�v-��;�i;r �r.�,r.".av+-�- .li►'��r,�.�i���L���.�Ci�"�,,m�`-' y� ( 13) Were you aware that using te road during the chip seal process might result in damage to your car? Yes ; ( ) No" I declare that the above information is true and correct under the penalty of perjury. o ( S' nature) ( a e) OCT-16-1994. 11:24 FROM LOF CENTRAL NO. CAL.ON TO 6897939 P.02 'sem � }^""`",.Yy_"�,�,.,w.•%.""` tr Mt,_'t`k r _"'._,,'��._ �g r.ac,y, st�;.r � '' t t�y } 1, ' 1 .,• _ . J`&`4� '1�"�iMY1�...,a�4F. i�7fyr.�''l•. a -7D�' yp�j1"'� i h � _ P;A61T TO 333 S. ANITA CR.. STS, 900 • u �.c•o� " .. .. • ' -,r ORANGE. CA 82666 (rig) 976- 311 _ FED. !•A- 34-106854 p�?zi1 Y ° CaAA Z h4 , �Firr,;CE �� �._ ______— ___ _ •�I 9,9' 415-372-4�I.�y4� JCiI i�� ' C92532 43177 llUVE}! ��-•� ' C; ; L .. W970S DOME$T IC WINDSHIELD LI►W' T I C W T N DS' .a lZw i i f I _ _ GL't`tr'i�f'. ..,. •'• ya eNPiq U; CL-PZ, lkr llllRTINF-Z OR - r) 5 13 ISL' — --� �. �•.� 9 � Ra E 4l ~ AINQ�10 AUTO CLAIM MASTER SUFFIX INFO 4661 INSD: JORDQN,JOHM,E OR JEANNETTE CLM-NO: 06-X97901-5 DOL: 07-15-91 SFX CLMT KOL DO REP CB-RESV STAT 01 INSURED GLA CON 18275 680.00 CLSD STR: 321 LAVA CT CITY: MARTINEZ ST: CA ZIP: 945530000 SUBRO ARB SALV MP-TRST LIT X-INSD-POL-NO L-P L-ACTY-DT: 09-20-91 CUM-PMNTS: 165.37 COV: 50 NO PAYEE: DO REP FOR DRFT-NO BRFT-AMT ISS-DT DTC BK 01 *LOF GLASS CENTERS CON 18275 18275 L4818765R 165.37 09-12-91 F B 28 01=INQ-MENU 05=CLM-MSTR 10=SFX-IMFO 20=RECOVERY 28=INSD-VEH SFX: 01 / 01 NEXT-ID: NEXT-DOLz F j'S � 1fr t' W 0 1Sl N I l W � i ° a j 44i z � 1 pm� � o I $ C J N 4 U a �mci ¢ C. C o a - -- z u 0 u