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Home My WebLink AboutMINUTES - 09081992 - 1.53 J' CLAIM AUG 1 ti 1992 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COUNTY COUNSEL Claim Against the County, or District governed by) BOARD AdWRNEZ_ CALIF. the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT September 8, 1992 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: $347.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ARANDA, Sheila 3862 L.i.nden Lane , ATTORNEY•• El Sobrante, CA 94803 Date received August 7, 1992 ADDRESS: BY DELIVERY TO CLERK ON Au g BY MAIL POSTMARKED: August 6, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: August 10, 1992 IVIL BAATTCHELOR, Clerk tQ&0;2a� II. FROM: County Counsel TO: Clerk of the Board of Su sors _ __1 N This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: / 121GZ BY: 1'Q Q �, �' 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 Z"" (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: SEP 8 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk 17 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. FOR ADDTTTONAT, WARNING SEE REVERSE SIDE OF THIS NOTICE 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 he _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. SEP 14 1992 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. Clair. 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, "1-987, 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.) I 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 --ll ) Reserved for Clerk's filing stamp ) . Against the County of Contra Costa ) � ENO- " 1992 or ) r District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned-claimant- hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ _5Y-loo and in support of this claim represents as follows: r j 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if /required) /' L "/fOlzG� jcJor"� GvCLS �e/req C�D!'I e -- �ryCJhS Gv�e .005 ��G� v/h o r 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage/? or/V/f7 A01- /"020� Oh 5 �o (over) �. wnat are the names of county or district officers, servants or employees causing the darage or in fury? _so '=---------------------------------- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 25 Aid 6 �o/c� �h - eho�c.gh - ds� �/ �ro�e� 0 s - n--- -1--------------------�C r� _�.r ----------------- --- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective' injury or damage.) ,21- /t ef,q V/ OGt-S $. Names and addresses of witnesses, doctors and hospitals.9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT - pevldlv�j -repo-, v Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorne ) or by some person on his. behalf." Name and Address of Attorney 2 Claimant's Signature Address Telephone No. Telephone No. S/O 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 imprisonr.�ent and fine. ADDENDUM TO THE CLAIM OF -,j`j t?_/ (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 ( ti/) ( 3) Was an alternate route available? Yes ( No ( ) ( 4) ' Did you read about the impending resurfacing in the local newspaper? Yes ( ) No ( 5) Did you see warning signs advising of loose gravel and a 25- mile per -hour advisory sign? Yes ( ✓) No ( ) ( 6) Did the damage result from another vehicle, exceeding the 25 mile per hour advisory? Yes ( V1, 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 sustained to your car? Yes ( ) No ( 11) Did you obtain the identity of the car relating to questions 6 thru 9? Yes ( V) No ( ) If-dyes, please provide provide identification bellow: e- 60 /79 GL CI��GL6 Q�uLgr��e✓% �.�� e� /.y �i-i�aC, fo s e 124-/C.5 das/ 4 rex ve/ F/y,�� ( 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. L/40 71 CSS G� �h e 45 1y z was126 1.,J6Uxf> e zxc D7 ,� r ( 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) (Date) ALS GLASS TO _..---.. __._.-____..._... ..__-__...__......___ _ 40121/2 SAN PABLO DAM RD. EL SOBRANTE, CA 94803 ' _-_____.._._....-_.....__....____.._.___.....__. _.._.-...----...._.... .._._...__._..._._.. ._.._....__...._.... ._._.__....._� 1291 SUBJECT:_ -, _ ..� .. _.._ .... _ _...-__ ..._.__..-.._...-..._.. _......._.....__ 1992.....,1 DA E.. _.__- ..........._......... .... . ..._AUG ._.�_. FOLD 1& 50 co v�7 fes'_ _..... .....__.. f _. fil ...W_..____._�..___ __ ._._ ..._ SIGNS ITEM NO.PK111R-2 AVAILABLE FROM BUSINESS ENVELOPE MANUFACTURERS,INC DEER PARK.N.Y. ANAHEIM,CALIF. AUG 1 � 1992 Z CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COUNTY COUNSEL AMlltt.% r,4lIF1, Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 8, 1992 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: $405.74 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: CHINN, Ruth 73.36 Hansen Drive ATTORNEY: Dublin, CA 94568 Date receivedAugust:3, 1992 ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: July 31, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppH�{ll BATCHELOR, Clerk DATED: August 10, 1992 BY: Deputy 1. FROM: County Counsel TO: Clerk of the Board of SupeKisors v ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 1 �L �`Z 8Y: I�.X.max r Deputy County Counsel \JV I11. 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 ORD R:- By unanimous vote of the Supervisors present • (0-,"This Claim is refected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: SEP 8 1992 PHIL BATCHELOR, Clerk, By . Deputy Clerk WARNING (Gov. code sectin 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. FOR ADDTTTONAT, WARNING SEE REVERSE SIDE OF THIS NOTICE, 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 14 1992 BY: PHIL BATCHELOR by 05�1 It Deputy Clerk CC: County Counsel County Administrator r ti�'f ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act 'nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. fey 319 SUPERVISORS(_L DL _j -46 31992 Clair to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY LCLERK, INSTRUCTIONS TO CLAIMANT CLERK BOARD OF SURRVJISJORS Claimp relating to..-'.'daU31�S- of.actdon for death or,, for in t N Co A. CO CO. 11 Jq3 sonk:p�r"op-er-ty or growing crops an which accrue on or before r;ecember 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 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 af ter'the accrual of-the cause ipresented ent�d ni .ot' of actib'rii-: Claims relating to any other cause 'of action must-be later,than .one year after the accrual of the cause of action. (Govt!: C6de ,§911.2.) B. Claims must b6 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., It. 6:1!aim 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 19F ECEIVED Against the County of Contra Costa 'AUG 3 1992 or '1 District) CLERK BOARD OF SUPERVISORS CONTRA COSTA Co. (Fill in name) The undersigned claimiant- hereby makes'dla' im against t e County of Contra Costa or the above-named District in the sum of $ _Y 05, '7y and in support of this claim represents as. follows: -—-------- - - ----- 1. When did the damage or injury occur? (Give exact date and hour) ` YACU& :16 -pm -------------------------------------------- 2. -— —----------—----------------- 2. Where did the damage-or injury occur (Include city and county) "W80 a1c CrA., arn A Can - �a ..� -f -----------—------ 3. How did the damage or incur occur? (Give full detair4uextra paper if required) . , L - VJ., \N� 4L kome_% _ C4 I racL a-- -4L- 9-(a oqp A_AtOCL Gve..u-e Al 6kU4tA_1 LA.�k 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage?q�k_6xck, qkk_ -AY UZZ 1 +)q6U_3,1 VIOLtjek eXAA0 4t&, and Q_ays.I (over) 5. Wnat are the nates of county or district officers, servants or employees causing the damage or injury? ri1P, . ----------- --------------------------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. b�.a ems, _��,I?Y_� -----=-------------------COJ----------------------------------------- 7•. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) --------------------------------7---------------------------------_--_-------------- 8. Names and addresses of witnesses, doctors and hospitals. "/A7- 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 oA his. behalf." Name and Address of Attorney r • Claiman 's Signature Address Telephone No. Telephone No. 0�� • . ' „ N_.0 Z C,g . ... _, 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?countyor. district board.or officer, author.ized to allow or pay the."same. if genuine,�ariy 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 prisbn; by-a fine of.:,•notexceeding"Iten thousand dollar<s' ($10",000;` or by f both: such imprisonments and -fine. �,. »:• _ - : :,i... ADDENDUM TO THE CLAIM OF1�"t'V� � ► lf\1/� (Print your full name) r ( 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:.•roadways 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.iadv_i•sing of: loose•.gravel and a `25' mile per hour advisory sign? ( 6) Did the damage result from another vehicle exceeding the 25 -mile per "houradvi sdry? :zJ. �• ': Yes' ( ) No. (7) Did a vehicle; traveling in the 'same< direction ,,and exceeding the 25 ''m ii `per 'hour advisory sign attempt to pass you? Yes ( ) No ( ) N ( 8) Did a vehicle coming from the opposite direction cause % ; ' '. gravel to be thrown onto your car? i Yes '( ) No ( j�) ( 9) Was the vehicle -located directly in front of you exceeding the speed 'ladvisory? Yes ( No ( ) k (10') . ,D.id,. you: travel./'the"roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( ) No ( ) MIA' ( 11) Did you obtain the identity of the car relating to questions 6 thru 9? Yes (y) 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. lLbw e \7Y�u. 4�1 ik1-4=rk rn L4J �S LO -- U C6 -a A "( 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. t ( Signature) Zz - 9L (D ) • CONTRACTOR'S LICENSE #368834 • DUBLIN GLASS CO. AUTO RE=PAIR REGISTRATION 4AM 099092 7779 AMADOR VALLEY BLVD. EMPLOYER 10. DUBLIN,CALIFORNIA 94568 4942350131 PHONE:(415)828-3010 AUTO GLASS • MIRRORS • PLA'TE 8. WINDOW GLASS • ALL""INUM SASH SHOWER & TUB ENCLOSIIRES SCREENS OF ALL TYPES DATE OUST.ORDER NO. INVOICE NO. 77 � S O �j =nyl L D T O S H I P T O CASH CHARGE ON ACCT RETAIL CONTRACT WALLPAPER GLASS AUTO 0 0 0 0 0 0 0 0 DUAN. p DESCRIPTION UNIT nPRICE AMOUNT /Eat,. ✓'� 1 rivls�,^elo/ � /� / /�'J sl Ger k 7-3 9� LABOR eo PLEASE PAY FROM THIS INVOICE. NO STATEMENT WILL BE SENT. TAX ALL CLAIMS 8 RETURNED GOODS MUST BE ACCOMPANIED BY THIS INVOICE. TOTAL 3,'l- 2-- RECEIVED —RECEIVED BY: X FINANCE CHARGES at the following rcltes will be charged on past due accounts: (a) 1 Y2% (.hitt,is on ANNUAL PERCENTAGE RATE of 18%) of the unpaid balance up to and including $1,000, plus(b) 1% (which is on ANNUAL PERCENTAGE RATE OF 1 2%)of the unpaid balance in excess of$1,000. NOTICE: "Under the Mechanics' Lien Law (California Code of Civil Procedure, Section 1161 et seq.), any contractor,subcontractor,taborer,supplier or other person who helps to improve your property but is not paid for his work or supplies,has a right to enforce a claim against your property.This means that,after a court hearing, your property could be sold by a court officer and the proceeds of the sale used to satisfy the indebtedness.This can happen even if you have paid your own contractor in full,it the subcontractor,laborer, or supplier remains unpaid." CUSTOMER COPY STORE: 150 WINDSHIELDS DATE: 07/23/92 SAN^RAMQN-150 � AMERICA. INC. (R) TIME: 04: 56PM 2157 SAN RAMON VALLEY BLVD. ================= ' ' ' ` SAN RAMON. CA 94583 QUOTE (510) 838-0888 **************************************** OWNER: CHINN. RUTH QUOTE NO. : 007963 150 CASH SALES - SAN RAMON REQ DATE : 07/23/92 2157 SAN RAMON VALLEY BL CUST # : 40714 SAN RAMON. CA 94583 510-838-0888 **************************************** MAKE: NISSAN MODEL: SENTRA E. GXE. XE, .YEAR: 1991 PART DESCRIPTION QTY QTY AMT NO ORD SHIPPED FW00663S Windshield (Green) 1 1 261 . 29 LABOR 3. 5 3. 5 45. 00 1 1 6. 95 UKIT ^ MOLDINGXAAA DEALER MOLDINGS 1 1 65. 00 LABOR 0 0 0.00 ***TOTAL*** PARTS $326. 29 LABOR $45. 00 KIT $6. 95 SALES TAX $27. 50 GROSS TOTAL $405. 74 ======================= NET TOTAL $405. 74 >>> QUOTE ONLY. NOT VALID FOR MORE THAN 30 DAYS FROM DATE OF REQUEST <<< RECEIVED CLAIM JUL 3 11992 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COUNTY COUNSEL Claim Against the County, or District governed by) BOARD AMMr, '-A"'. the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 111 SEPTEMBER 8, 1992 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: $325,000.00 Section 913 and 915.4. Please note all •Warnings". CLAIMANT: SAVAGE, John ATTORNEY: Law Offices of Neil A. Cook Date received ADDRESS: 1547 Palos Verdes Mall , #109 BY DELIVERY TO CLERK ON July 29, 1992 (hand delivered) Walnut Creek, CA 94596 BY NAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a.copy of the above-noted claim. DATED: July 31, 1992IL Bep�tyLOR, Clerk I FROM: County Counsel TO: Clerk of the Board of Sup rvisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 713 I Z BY: �j J Deputy County Counsel U 111. 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. n Dated: S E P 8 1992 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code sects 913) Subject to certain exceptions, you have only six (6) aronths from the date this notice was personally served or deposited in the nail 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. FOR ADDITIONAL WARNING SEE REVERSE SIDE OF THIS NOTICE AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 16; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: S E P 14 1992 BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. CLAIM AGAINST COUNTY OF CONTRA COSTA John Savage presents a claim for damages against the County of Contra Costa as follows: AMOUNT CLAIMED: $75,000 special damages, $250,000 general damages CLAIMANT'S ADDRESS: 2932 16th St. San Pablo, CA 94804 ATTORNEYS FOR CLAIMANT: Law Offices of Neil A. Cook 1547 Palos Verdes Mall, 109 Walnut Creek, CA 94596 DATE OF OCCURRENCE: 1/31/92 PLACE OF OCCURRENCE: Brookside Hospital CIRCUMSTANCES OF OCCURRENCE: Claimant's wife, Helen Savage, sustained a stroke during the course of an angiogram. As a result of this claimant's wife has been unable to care for herself, perform her usual household duties, work in the family business or to engage in sexual relations with claimant. ITEMS, NATURE AND EXTENT OF DAMAGES AND INJURIES: Loss of consortium, loss of business income as a result of wife's inability to continue as secretary/bookkeeper. HOSPITAL EMPLOYEE(S) INVOLVED IN TREATMENT: Richard A. Rubenstein, M.D. , names of other agents or employees are presently unknown. WITNESSES: Helen Savage, Richard Savage, Toni Lee Armstrong ORIGIN RECEI ED " L JUf29 1992 CLERK BOARD OF SIJPERVISORS CONTRA COSTA CO. RECEIVED `5 y, CLAIM JUL 3 i 1992 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COUNTY COUNSEL MARTINEZ. MF. Claim Against the County. or District governed by) BOARD ACTION the Board of Supervisors. Routing Endorsements. ) NOTICE TO CLAIMANT SEPTEMBER 8, 1992 . 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: $375,000 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SAVAGE, Helen ATTORNEY: Law Offices of Neil A. Cook Date received ADDRESS: 1547 Palos Verdes Mall , #109 BY DELIVERY TO CLERK ON July 29; 1992 (hand delivered) Walnut Creek, CA 94596 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Cler DATED: July 31, 1992 : Deputy Il. 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: 7 / 1 1 Z BY: � — 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. SEP 8 1992 Dated: PHIL BATCHELOR. Clerk, By Deputy Clerk WARNING (Gov. code sec 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. FOR ADDTTTONAL WARNING SEE REVERSE SIDE OF THIS NOTICE. 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: S E P 14 1992 BY: PHIL BATCHELOR bff Deputy Clerk CC: County Counsel County Administrator ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to .understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any -of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. • CLAIM AGAINST COUNTY OF CONTRA COSTA Helen Savage presents a claim for damages against the County of Contra Costa as follows: AMOUNT CLAIMED: $125,000 special damages $250,000 general damages CLAIMANT'S ADDRESS: 2932 16th St. San Pablo, CA 94804 ATTORNEYS FOR CLAIMANT: Law Offices of Neil A. Cook 1547 Palos Verdes Mall, 109 Walnut Creek, CA 94596 DATE OF OCCURRENCE: 1/31/92 PLACE OF OCCURRENCE: Brookside Hospital CIRCUMSTANCES OF OCCURRENCE: Claimant Helen Savage sustained a stroke during the course of an angiogram. As a result of this claimant has sustained injuries to her physical and mental health. ITEMS, NATURE AND EXTENT OF DAMAGES AND INJURIES: Permanent partial paralysis . Inability to continue work in family business . Decreased ability to function normally. HOSPITAL EMPLOYEE(S) INVOLVED IN TREATMENT: Richard A. Rubenstein, M.D. , names of all additional agents/employees are presently unknown. WITNESSES: John Savage, Richard Savage, Toni Lee Armstrong ORIGINAL RECEIVE® JUL 29 W2 W.60 p.m , CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. • RECEIVE® 5 CLAIM AUG 11' 1992 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COUNTY COUNSEL MARTINEZ, CALIF. Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 8, 1992 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: $854.54 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SINGH, Vikram 52.1 Appi.an Way ATTORNEY: E.1. Sobrante, CA 94803 Date received ADDRESS: BY DELIVERY TO CLERK ON August 7, .1992 BY 1441L POSTMARKED: August 6, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppy�IL BATCHELOR, Clerk DATED: August 10, 1992 BY: eputy JIF 11. FROM: County Counsel TO: Clerk of the Board o Sup isors 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: p IZ I�(Z- BY: l �,Q'-�l,�j ,,..r Deputy County Counsel J I11. 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 0 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: SEP 8 1992 PHIL BATCHELOR, Clerk, By ZDeputy 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. FOR ADDTTTONAL WARNING SEE REVERSE SIDE OF THIS NOTICE. 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 IB; 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:_ S E P 14 199 BY: PHIL BATCHELOR b Deputy Clerk 01/ CC: County Counsel County Administrator L ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. i Clair,: to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or-before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating ,to. causes of action for -death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later.than .one year after. .the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code-Sec. 72 at•the end of this form. RE: C1aim.By ) Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) AW 71992 or ) District) CLER CONTRA COSTA CO ISORs Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-nalined District in the sum of $ $�L{, _. and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) --- t._ ` --..A----------------------------- 2. Where di the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full deta'ls; use extra paper f ^ n_ required) 0 2 GZ�-l3� -`7f�1►�1 ".�e�v �`' C�►� _Alt --- _-- a-- - -----�.._---- --- - - --------------------------- 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 the names of county or district officers, servants or employees causing the damage or injury? J ' JOT .- 1Gv6 of N 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. LiNK ---------------®---------------------------------- ------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) �s4 .sCI $. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEMAMOUNT _ No ri 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 (ClaimantYs Signature Address Telephone No. Telephone No js 192 2 "' 3L►(7 g 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. STEVEN L.MCALLISTER CO. 2028 THOMPSON LANE EL SOBRANTE CAL. 94803 ( 510 ) 758-3751 OFFICE ( 510 ) 262-1060 PAGE Jul 19 , 1992 CUSTOMER NAME: CHECKER OIL CO. JOBSITE: SAME BILLING ADDRESS : 521 APPIAN WAY EL SOBRANTE CA. 94803 ( 510 ) 222-3408 REMOVE CHAIN LINK FENCE AND THREE POLES AND PUT IN THREE NEW POLES AND 17FT.._ OF . 6FT. HIGH NEW CHAIN LINK FENCING AND TWO NEW 6FT BY 6FT GATES ON THE SIDE OF BUILDING AT 521 APPIAN WAY EL SOBRANTE. TOTAL COST OF FENCING MATERIALS $529. 54 TOTAL COST OF LABOR TO DO JOB $325 . 00 TOTAL COST OF LABOR AND MATERIALS $854 . 54 ESTIMATED BY STEVE MCALLISTER DATE 7-19-92 APPROVED:BY -----------=--------------- DATE ------------------------ PAYMENT TERMS $529 . 54 DOWN AND $325 . 00 WHEN JOB IS DONE .. THANK YOU S-.L.MCALLISTER CO. RMIVED • AUG 1 `- CLAIM 1992 6 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COUNTY COUNSEL "T'N �, CALIF. Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 8, 1992 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $5,000,000 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: UNGA, . Haloti ATTORNEY: James R. Chiosso, Esq. Gwi.11iam, Ivary, Ch.i.osso, Date received ADDRESS: Cavalli. & Brewer BY DELIVERY TO CLERK ON August 5, 1992 (hand delivered) 1401 Lakeside Dr. , #800 Oakland, CA 94612 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED• August 10, 1992 OIL BAATTCHELOR, Clerk 1,I. FRty OM: County Counsel 70: Clerk of the Board of Supervisors \�N ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: r Ado,Dated: �� 3�- 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. BOARD OR 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: $FP R 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 nail 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. FOR ADDITIONAL WARNING SEE REVERSE SIDE OF THIS NOTICE. 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 14 7992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 3 ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. RECEVED rAUG 51992 CLAIM AGAINST 0.3 P H_COUNTY OF CONTRA COSTA CLED OF SUPERVI ORS CONTRA COSTA CO. (a) NAME AND ADDRESS OF CLAIMANTS: Haloti Unga Address: 3761 E. Cypress Oakley, CA 94561 Telephone: Home 510/684-9601 Work 510/754-302 (b) SEND ALL NOTICES TO: Gwilliam, Ivary, Chiosso, Cavalli & Brewer 1401 Lakeside Drive, #800 Oakland, CA 94612 Attn: James R. Chiosso, Esq. Phone: 510/832-5411 (c) DATE OF OCCURRENCE: 2/6/92 at approximately 5:20 p.m. PLACE OF OCCURRENCE: At or about the intersection of Cypress Road and Jersey Island Road CIRCUMSTANCES OF OCCURRENCE: On the above day and place, decedent, Meliame Unga, was driving a 1988 Dodge automobile eastbound on Cypress Road when a vehicle ahead of her slowed to come to a stop behind a vehicle that had stopped on eastbound Cypress to make a left turn on to Jersey Island Road. Decedent's automobile was travelling at a rate of speed between 45 and 40 m.p.h, the speed limit is 50 m.p.h. at that location. Decedent turned into the westbound lane of Cypress to avoid striking the automobile in front of her and collided with a westbound automobile. Plaintiffs allege that the section of Cypress Road where this accident occurred constituted a dangerous condition of public property which created a reasonably foreseeable risk of injury in that traffic travelling at 50 m.p.h. would have to make sudden stops for traffic, slowing for, or turning on to and from Jersey Island Road and adjacent roads and driveways. That the State of California (CALTRANS) had notice of these conditions and failed to warn motorists of these conditions and failed to correct said conditions by measures which include but are not limited to posting signs, advising motorists of traffic slowing, stopping, cross traffic, intersection ahead, reducing the speed limit, creating left turn pocket, placing warning bumps on the roadway, providing traffic control devices, making the intersection more visible to motorists. Claimants reserve the right to amend this claim upon discovery of additional information. (d) GENERAL DESCRIPTION OF INJURY, DAMAGE OR LOSS INCURRED: Wrongful death of plaintiff Haloti Unga's wife and mother of the four minors. (e) NAMES OF EYEWITNESS (ES) : See attached traffic collision report (e) AMOUNT OF CLAIM AND BASIS OF COMPUTATION: General damages: $5, 000, 000 Special damages: Loss of income/earning capacity in excess of $700, 000 based on $24 , 000 plus a year income at the time of her death. Loss of services of wife and mother in excess of $650, 000. Buriel and Funeral expenses in excess of $10, 000. Property damage: $500 Interest as allowed by law. Attorneys' fees as allowed by law. JURISDICTION: Superior Court I declare under penalty of perjury, that the above is true and correct. Signed by or on behalf of Cl i ats Dated: August 5, 1992 James Chiosso, Esq. Receipt of a copy of the within claim is hereby acknowledged this day of , 1992 . Y STATS OF CALIPV/RHIA TRAFFIC COLLISION REPORT PAGE/ OF /0 S►EGALCONDITIONS NUMBER HITE RUN CIT/ JUDICIALDISTRICT LOCAL R[PORTNUMSER �A d N I IJL 2-� 1V J1 ► •�( ' N NT A RUN COUNTY REPORTING Go"A"T BEAT �///� .. w YS G COLLISION OCCURRED ON YD. DAY YEAR TIME(]IDG) NGCB OFFl ER�. 17 Z ey - ------------------------- d2 66 G 92 / L� q Zc S ---------- --------------------- MILEPOST INFORMATION DAY OF W K TOW AWAY PHOTOGRAPHS BY: < SMT F U FEET/MILE! Of S M,- RIND fA¢7-PcTL 9450 0 AT INTERS CTION WITH \,I _ STATE NWT R[L OR: FEET4AlMfi`IV Of � � I 1>/ �YL! NO NONE PARTY ORIVER'B LICENSE NUMBER STATE CLASP SAFETY VE YEAR MAKE i MODEL I COLO UCENSENUMBER STATE DRIVER NAME(MAST.MIDDLE.LAST) ki ELI A-MA5 /'NMJ1 C.cN(s BE1�1 PEDES- TREET ADDRESS OWNERS NAM[ f'"')SAM[AS DRN[R a 3 �1 E. PARKLD CITY/STATE/LP OWNERS ADDRESS Wi SAYE AS ORN[R V`p`o []j BICY• SEK I HAIR EYES MSIG/fTI WEIGHT BIRTHDATE PLACE DISPOSITION OF VEHICLE ON ORDERS OF: OFRCER ❑DRIVER ❑OTHER MO. DAY �EAR r112101 D3 No C? CURT OTHER HOME PHONE BUSINESS PHONE ❑ � � � PRIOR MECHANICAL DEFECTS: NONE APPARENT REFER TO NARRATIVE /\ CMP USE ONLYTH-10D. RIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA VEHICLE TYPE INSURANCE CARRIER POLICY NUMBER NIL 13NONE 11 MINOR 3 73 0 ( MAJOR OTAL RIR OF 10"STREITORMIGMA Y SPEED PCF ILC❑ ti � "" P,P_ES5 2l75Z�c-N C„;o PARTY lomvirtsUCENSENUMBER STATE CLASS SAFETY VE Y MAKE/Y00[L/COLOR EHSENUMSER STATE 2 CO 67-9 4 �P j�� u 1 1z� P`L,% 2'D�. q F 52 *SD • G DRIVER NAME(RRBT."DDL[ AST) • .EOSTREET ADDRESS OWNERS NAME SAM[AS DRIVER` ►ARKLDCITY/ TA /ZI► OWNERS AOOR[p SAME AS DRYER VEHICLE SICY• SEE I HAIR YES HEIGHT JE� BIRTHDATE RACE DISPOSITION Of V[HK:LE ON ORDERS OF: PACER ❑DRIv ER [:]OTHERCLIST YD OTHER HOME PHONE BUSINESS IP-11 PRIOR MECHANICAL DEFECTS: NONE APPARDIT REFER TO NARRATIVE El Q ( ) ! 6 / CHP USE ONLYTEC: RIB[VEHICLE DAMAGE SHADE IN DAMAGED AREA INSURANCE CARRI R POLICY NUMBER VEHICLE TY.[ NONE �YNOR . OYAJOR TOTAL RIR OF ION STREET OR HIGHWAYSPEED PCF ICC❑ ' IL CVL Ll LHP❑ PARTY DRIVER'S LICENSE NUMBER STATS CLASS SAFETY VEH YEAR YAKS/YODEL/COLOR K S[NUMBER STATE s C.376 91. A*IIsR. .P . . . . S�(Ps7 DRIVER NAME(RAST.MIDOLE.LAST) Lit- - Z cNt�1 PEOES- STREET ADDRESS OWNER'S NAM[ SAME AS DRIVER .Q ttlo 4x, 14y'7 9 PARKED CITY/ TATE I ZI I OWNER'S AGGRESS ®SAME AS DRIVER VEHICLE ./�❑ cA V:g- WCY. SEX I HAIR EYES HEIG/H�/T WEIGHT /Y o. BIRTHDATE RACE DISPOSITIONOI,FVEHK:LEONOROERS Of: OOFFlCER RIVER ❑OTHER CLIST OTHER HOME PHONE BUSINESS PHONE PRIOR MECHANICAL DEFECTS: NONE APPARENT REFER TO NARRATIVE❑ ❑ ( > "1�2,Z ( !O� CHP USE ONLY DESCRIBE VENCL[DAY SHADE IN DAMAGED AREA INSURANCE CARRIER [ POLICY NUMBER UNK.VEHICI[TYPE 11 MOO. 0MAJOMI29 TDL R OTOA O10.OF IOIISTIIEET011411MW AY SPEED PCF ICC❑ ' ZVEL C � �(��1 1J� ►UC❑ i`• (�•.� f�U CHPr] PREPARER 5 NAME DISPATCH NOTIFIED REVIEWER 5 NAME //i DATE REVIEWED J� [4 YES ONO C NIA Avl 4l//-&sr-?e� 7/ CHP SSS PAGE 1 (RBv l-") OPI OE2 jI�/ x8667 TRAFFIC COLLISION CODING PAGE Z o^,rl OF COLLISION /�LL 4h TME(7A001 NGC NUMBER OFRCER 1.D ! NUMBER y MO. , DAY•+V YEAR / L G V 'v` OWNERS NAME/ADDRESS NOTIFIED PROPERTY N!to F]YES ONO DAMAGE DESCRIPTION OF DAMAGE SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE UPANTS L-AIR BAG DEPLOYED M/C BICYCI E-HEI MET 0-NOT EJECTED S A-NONE IN VEHICLE M•AIR BAG NOT DEPLOYED DRIVER I-FULLY EJECTED B-UNKNOWN N-OTHER V-NO 2-PARTIALLY EJECTED C-LAP BELT USED P-NOT REQUIRED LV.YES 3-UNKNOWN I-DRIVER D-LAP BELT NOT USED 1 2 3 2 TO 6-PASSENGERS E-SHOULDER HARNESS USED PASSENGER 4 5 6 7-STATION WAGON REAR F-SHOULDER HARNESS NOT USED CHILD RESTRAINT x-No 8-REAR OCC.TRK.OR VAN G•LAP/SHOULDER HARNESS USED O-IN VEHICLE USED Y•YES P-POSITION UNKNOWN H-LAP/SHOULDER HARNESS NOT USED R-IN VEHICLE NOT USED 7 0-OTHER J-PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U-NONE IN VEHICLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(•)SHOULD BE EXPLAINED IN THE NARRATIVE PRIMARY COLLISION FACTORUST NUMBER (r) M OF PARTY AT FAULT TRAFFIC CONTROL DEVICES 1 2 '3 TYPE OF VEHICLE 2 3 MOVEMENT PRECEDING COLLISION I AVC SECTIOOLATED: ciaooEa ACONTROLS FUNCTIONING APASSENGER CAR/STATI AGON ASTOPPED -L175Z C LJJNo B CONTROLS NOT FUNCTIONING• B PASSENGER CAR W/TRAJ&R N B PROCEEDING STRAIGHT N B OTHER IMPROPER DRIVING C CONTROLS OBSCURED C MOTORCYCLE/SCOOTO I C RAN OFF ROAD D NO CONTROLS PRESENT/FACTOR• ROCKUP OR PANEL TRVCK D MAKING RIGHT TURN C OTHER THAN DRIVER' TYPE OF COLLISION E PlquP/PANEL TRY16K W/TRAILER IE MAKING LEFT TURN D UNKNOWN• 77[ HEAD-ON F TRU OR TRUC RACTOR IF MAKING U TURN 0 EFELLASLEFPI B SIDESWIPE GTRUCK/ UC RACTOR W/TRLFL GIBACKING REAR END H SCHOOL BLV XjqSLOWIa4*QP44NG WEATHER( MARK I TO 21TEMS) D BROADSIDE I OTHER BU I PASSING OTHER VEHICLE ACLEAR E HIT OBJECT J EMERGEOCY VEHICLE I J CHANGING LANES BCLOUDY FOVERTURNED KHIGHWAY CONST.EdYIPMENT K PARKING MANEUVER C RAINING VEHICLE/PEDESTRIAN L BI CLE L ENTERING TRAFFIC D SNOWING IH OTHER': QTHER VEHICLE IMOTHER UNSAFE TURNING E FOG/VISIBILITY FT. MOTOR VEHICLE INVOLVED WITH 19 PEDESTRIAN FNXING INTO OPPOSING LANE F OTHER•: ANON-COL.USION MOPED PARKED G WINO JB PEDESTRIAN P MERGING LIGHTING C OTHER MOTOR VEHICLE TRAVELING WRONG WAY A DAYLIGHT D MOTOR VEHICLE ON OTHER ROADWAY OTHER ASSOCIATED FACTOR(S) OTHER•: B DUSK-DAWN E PARKED MOTOR VEHICLE 1 2 3 (MARK I TO 2ITEMS) CDARK-STREET LIGHTS FTRAIN AvcBECTTONv10LATIO4: cITEo D DARK-NO STREET LIGHTSYED BICYCLE K 2�3S� []NO DARK-STREET LIGHTS NOT ANIMAL:H Bvc BECT10N VIOLATION: FUNCTIONING ❑p SOBRIETY-DRUG ROADWAY SURFACE FIXED OBJECT: �p 1 2 3 PHYSICAL I `vc SE A DRY CTION Vaun ❑YE1 (MARK I TO 2ITEMS) B WET OTHER OBJECT: 13 No C SNOWY-ICY HAD NOT BEEN DRINKING J D 13 HBD-UNDER INFLUENCE D SLIPPERY(MUDDY,OILY,ETC.) E VISION OBSCUREMENT: HBD-NOT UNDER INFLUENCE F INATTENTION•• HBO•IMPAIRMENT UNKNOWN ROADWAY CONDITION(S) G STOP i GO TRAFFIC E UNDER DRUG INFLUENCE (MARK I TO 21TEMS) PEDESTRIANS INVOLVED A NO PEDESTRIAN INVOLVED PREVIOUS H I /LEAVING RAMP F IMPAIRMENT-PHYSICAL' A HOLES,DEEP RUT' B UNFAMILIAR WITH ROAD CROSSING IN CROSSWALK I PREVIOUSOUS COLLISION IMPAIRMENT NOT KNOWN (j LOOSE MATERIAL ON ROADWAY• AT INTERSECTIONI IR NOT APPLICABLE C OBSTRUCTION ON ROADWAY• CROSSING IN CROSSWALK-NOT K DEFECTIVE VEK EQUIP.: DEs I I SLEEPY/FATIGUED D CONSTRUCTION•REPAIR ZONE AT INTERSECTION ❑NO SPECIAL INFORMATION E REDUCED ROADWAY WIDTH D CROSSING•NOT IN CROSSWALK L UNINVOLVED VEHICLE AHAZARDOUS MATERIAL FLOODED f IN ROAD-INCLUDES SHOULDER IM OTHER-: G OTHER•: F NOT IN ROAD IN NONE APPARENT H NO UNUSUAL CONDITIONS G APPROACHING/LEAVING SCHOOL BUS JORUNAWAYVEHICLE SKETCH MISCELLANEOUS �HQ DOT nolcAn No1mI . CR __L14C CHP DA PD/SO ,g CT OTHER CHP 555 PAGE 2( Rev 148)OPI 042 ST A.Tn OF CJLLIFOANA INJURED / WITNESSES / PASSENGERS PAGE 3 DATE OF C ON /// TIME(2400) NCIC NUMBER OFFICER I.D NUMBER EXTENT OF INJURY ( "X" ONE) INJURED WAS ( "X" ONE )WITNESS PASSENGER AGE SEX PARTY SEAT SAFETY EJECTED ONLY ONLY NUMBER POS. EOUIP. FATAL SEVERE OTn ER VISIBLE COMPLAINT INJURY INJURY INJURY OF PAIN DRIVER PASS. PED. BICYCLIST OTHER ❑tt o ❑ ❑ ❑ ❑ I ❑ I ❑ ❑ NAME/D.O.B.l ADDRES .,, `r '00TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES lv ��•�� C C!>S• -vwLC-lotl Z:) &TZ VICTIM OF VIOLENT CRIME NOTIFIED ❑� ❑ Z /tom ❑ ❑ ❑ ❑ ❑ ❑ ❑ 2.- iID NAME/D.O.B.I ADDi{(BI//"1,-�E�// TELEPHONE (INJURED( URED ONONLY)TRANSPOR►�T B� TAKEN TO: DESCRIBE INJURIES ❑ VICTIM OF VIOLENT CRIME NOTIFIED ❑ 150 n ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ NAME I D.O.B.I ADD. 2z h` pz /� TELEPHONE s� L L, ONJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES ❑ VICTIM OF VIOLENT CRIME NOTIFIED (>r2 ❑ ❑ ❑ ❑ ❑ ❑J 1:11131 EJ '1 ❑ NAME/O.O.B.I ADDRESS M /i' ,l il 10 E ONJURED ONLY)TRANSPORTED BY: AV TAKEN TO: 41 ' DESCRIBE INJURIES VICTIM OF VIOLENT CRIME NOTIFIED NAME,D.O.B.:ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES ClVICTIM OF VIOLENT CRIME NOTIFIED 0# I El ❑ LJ ❑ ❑ ❑ ❑ ❑ El 101 NAME/O.O.B./ADDRESS TELEPHONE ONJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES VICTIM OF VIOLENT CRIME NOTIFIED ipRE; 'S N4 I.D DAY YEAY IMP CHP 555-Page 3(Rev. 7-87) OPI 042 87 43637 FACTUAL DIAGRAM PAGR •• OATS OsCOLLISION //%�� TIME �1'H0/0)�`J NCIC U •Eq OEPI Ew I.O.(/�J UMB 'R ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED (SCALE n INO NORRTHTM I I I 14 ' - � 3 -40 - Ln s i yP.�� e 1.D. 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J �Q111�'1�/��1i7)' coiYTiJc T 1C.- i �iT 24. 25. 26. 27. b 28. 29. 30. 31. PREPARER'S NAME AND I.O.NUMBER DATE REVIEWER'S NAME DATE s Use previous editions until depleted. 90 57541 NARRATIVE/SUPPLEMENTAL PAGE DATEOF INCID_ENT`OCCU ENCS —^ TIME(:�O��iy NCIC NUMBER OFFICER I. D NUMBER 'X'ONE Z C/J (O+/N'E i/•,G/•C+ TYPE SUPPLEMENTAL C/C APPLICABLE) IY I NARRATIVE COLLISION REPORT a BA UPDATE FATAL ❑ NIT A RUN UPDATE v❑� SUPPLEMENTAL LL❑J� OTHER: ❑ HAZARDOUSMATEWALS ❑ SCHOOLBUS ❑ OTHER: CITY ICGUNTY/JUDICAL DIST RICT RE PORTING DISTRICT/BEAT CITATION NUMBER LOCATION i SUBJECT STATE HIGHWAY RELAT ED YES [71NO 2. 3. 4. TSYTI: ��5�'� 11J ��SE�i.GL� `T7J Ik"f 6 Qom! e y/N�1� 6. `(J �l/L� w/ V-3 7. V& nI�T 8. SZ �� r�` .a- I/W <Sbl&&T- 10. `V / ^P/Zr�'l'�G lNts T alV mh Alf E-Z(J" 12. ,� I/-`) c, x-511�^`'7�/�A,�,�I L 21Al/k 13. �K� �d f 1�L1 ll-. %/1 L. to i, ✓ '1. J a *x'o 14. A- ak.,b W& Avty 15. Lfi ArL.t.`'t 0 % al 'r vt l GGL-L l t�Lr 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. '\/ PHE REBS NAp�>'� I.D.NUMBE V L %H/DAyly REVILINERS NAME MONTM/CAY/YEAR CHP 556(Rev. 7-87)OPI 042 U"plO. *wb r unu d4oaIwa 88 48641 7CLAIM �q BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA co Claim Against the County. or District governed by) BOARD ACTION the Board of Supervisors. Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 8, 1992:' and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $5,000,000 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: UNGA, Haloti for minors, Kenton, Alexandra, John and David ATTORNEY: James R. Chi.osso, Esq. Gwi.l..l..iam, Ivary, Ch.i.osso, Date received August 5, 1992 (hand delivered) ADDRESS: Cavalli & Brewer BY DELIVERY TO CLERK ON 1401 Lakeside Dr:..#800 Oakland, CA 94612 BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHyLOR T . Cler DATED: August 10, 1992 k e ut OM: County Counsel TO: Clerk of the Board of Supervisors FR ) 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_ 2 _ BY: QtAX-1) Deputy County Counsel 1 : J 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. n Dated: S E P 8 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sects n 913) Subject to certain exceptions. you have only six (6) months from the date this notice was personally served or deposited in the wail 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. FOR ADDTTTONAT. WARNING SEE REVERSE SIDE OF THIS NOTICE AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now. and at all times herein mentioned. have been a citizen of the United States. over age 16; and that today I deposited in the United States Postal Service in Martinez. California. postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: SEP I � ,1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ADDITIONAL WARNING This warning does' not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. RECEIVED L � ' CLAIM AGAINST AUG 51992 COUNTY OF CONTRA COSTA P1°3 p R' CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. (a) NAME AND ADDRESS OF CLAIMANTS: Haloti Unga, as parent (and guardian ad litem) of: (a) Kenton Unga, a minor, (b) Alexandra Unga, a minor, (c) John, a minor, and (d) David, a minor Address: 3761 E. Cypress Oakley, CA 94561 Telephone: Home 510/684-9601 Work 510/754-302 (b) SEND ALL NOTICES TO: Gwilliam, Ivary, Chiosso, Cavalli & Brewer 1401 Lakeside Drive, #800 Oakland, CA 94612 Attn: James R. Chiosso, Esq. Phone: 510/832-5411 (c) DATE OF OCCURRENCE: 2/6/92 at approximately 5: 20 p.m. PLACE OF OCCURRENCE: At or about the intersection of Cypress Road and Jersey Island Road CIRCUMSTANCES OF OCCURRENCE: On the above day and place, decedent, Meliame Unga, was driving a 1988 Dodge automobile eastbound on Cypress Road when a vehicle ahead of her slowed to come to a stop behind a vehicle that had stopped on eastbound Cypress to make a left turn on to Jersey Island Road. Decedent's automobile was travelling at a rate of speed between 45 and 40 m.p.h, the speed limit is 50 m.p.h. at that location. Decedent turned into the westbound lane of Cypress to avoid striking the automobile in front of her and collided with a westbound automobile. Plaintiffs allege that the section of Cypress Road where this accident occurred constituted a dangerous condition of public property which created a reasonably foreseeable risk of injury in that traffic travelling at 50 m.p.h. would have to make sudden stops for traffic, slowing for, or turning on to and from Jersey Island Road and adjacent roads and driveways. That the State of California (CALTRANS) had notice of these conditions and failed to warn motorists of these conditions and failed to correct said conditions by measures which include but are not limited to posting signs, advising motorists of traffic slowing, stopping, cross traffic, intersection ahead, reducing the speed limit, creating left turn pocket, placing warning bumps on the roadway, providing traffic control devices, making the intersection more visible to motorists. Claimants reserve the right to amend this claim upon discovery of additional information. (d) GENERAL DESCRIPTION OF INJURY, DAMAGE OR LOSS INCURRED: Wrongful death of plaintiff Haloti Unga's wife and mother of the four minors. (e) NAMES OF EYEWITNESS (ES) : See attached traffic collision report (e) AMOUNT OF CLAIM AND BASIS OF COMPUTATION: General damages: $5, 000, 000 Special damages: Loss of income/earning capacity in excess of $700, 000 based on $24, 000 plus a year income at the time of her death. Loss of services of wife and mother in excess of $650, 000. Buriel and Funeral expenses in excess of $10, 000. Property damage: $500 Interest as allowed by law. Attorneys ' fees as allowed by law. JURISDICTION: Superior Court I declare under penalty of perjury, that the above is true and correct. Signed by or on behalf of claimants Dated: August 5, 1992 ame nR. C iosso, Esq. Receipt of a copy of he within claim is hereby acknowledged this day of , 1992 . • STATt i!A11fQRNu TRAFFIC COLLISION REPORT PAGO/ OF /0 • SPECIAL CONDITIONS NUMBERIR E RUN CIT/ JUDICIAL DISTRKT LOCAL REPORT NUMBER NJ RED FELONY F/ •-rA ` N HTE RUN COUNTY j Ki MIe REPORTING DISTRICT 2 .Sl,r SEAT ", C4N, OLLISION OCCURRED ON MO. DAY YEAR TIME(]100) NCIC/ OFFI ER D. Z c — — p � ti (bb s� ---------- -------------------------------------------- ) µILEPOST INFORMATION DAY OF W K TOW AWAY PHOTOGRAPHS BY: < SMT F S COY- ❑- rA97LkTZ,9950 MI U FEET/ LES OF FAT INTERS CION WITH _ M� STATE HWY REL. OR: FEET Of SLh ' � 1r 1 1)r pY[� NO pNONE PARTY JaPivER'.LICENSE NUMBER STATE CLASS I SAF:;YV[ YEAR MAKE/MODAL/COLOR ENSE NUMBER STATE DRIVER NAY[(FIRBT,MIDDLE,LAR) ELt�w� i'►"�"N� c.cNCr� ¢0-1-- (� b PEDES- ADDRESS OWNER'S NAME SAME AS DRIVER o [TREAT 3 � um PARKEDCITY I STATE 21P OWNER'S ADDRESS (Sj18AY[A6 DRN[R �`p E o � �j SICY. SEE HAIR [YES HWONT WEIGHT BIRTHDATE RACE DISPOSITION OF VEHICLE ON ORDERS OF: OFFICER pOPoVER POTHER OTHER HOME PHONE BUSINESS PHONE ❑ � � � � PRIOR MECHANICAL DEFECTS: NONE APPARlM REFER TO NARRATIVE❑ CHP USE ONLY DESCRIBE VEHICLE DAMAGE INSURANCE CARRIER POLICY NUMBER SHADE IN DAMAGED AREA VEHICLE THF[ C- PUNK- PHONE MINOR r-111-Z^6-ml ��-�ZJ�dZ-X3 .73 O t pYOD. pMAJOR OTAL E` DOR OF ON STREET OR HIGHWAY SPEED PCF ICC❑ AYpuss 2175ZC��V< <�o PARTY DRIVER'S UCENSE NV BER STAT[ CLA6t SAFETY YE Y YAK[I MOOEL I COLOR ENSi HUMBER STATE f 1 1L� P�� 2�� 2 CO 67.°I �,�P 1 � 7 t c DRIVEA NAME(FIRST.MIDDLE AST) 41 41 FK.—.- TREET ADDRESS OWNER'S NAME p9AME AS DRIVER YNAN PARKED Cl // TA /21f OWNER'S ADDRESS �SAME AS DRIVER VEHICLE EO[ nb CA V� aY Srt1 ,TN �ti TI o4- r.6 BOGY. SEE I HAIR YY�E�B H.,OiGKr WEIGHT SRRTHOATE RAC[ DISPOSITION OF VEHICLE ON ORDERS Of: fRCIA pDRIVER POTHER CLIST Mo U / OTHER HOME PHONE BUSINESS P 1HONE PRIOR MECHANICAL DEFECTS; NONA APPARANT20 REFER TO NARRATIVE p 11 ( ) ! l5' / CHP UBE ONLY VEHICLE DAMAGE INSURANCE CARRIR POLICY NUMBER p SHADE IN DAMAGED AREA V[HCL[THF[ O iL 2- , WK. DFSCRIti 0. MINOR L p MOD. 011/IJOA 9TOTAL PIR.OF ON STREET OR HIGHWAY SPEED PCF ICC❑ ' TA VEL G �SS FUC0 CHP p PARTY IDAIVEASUCENSE114UMBER STATE CLASS SAFE" VEII.YEAR MAKE/MODEL/COLOR K [" ' " BER STATE 3 G3? `� lo5"0 X14 6 '91 �2F-j.�/&Ut. .P . . . 57 DRIVER NAME(FIRST,100016,LAST) Er- PEDES. STREET ADDRESS OWNERS NAME SAME AS DRIVER TMAN El te�?O 4K 1079 PARKED CITY/ TATE/ZI ^ ./�/ //�� 9L /��,,� OWNER'S ADDRESS ®SAME A9 DRIVER VEHICLE .i J v 1 14✓ /-+ I BICY. SEE HAIR EYES HEIGHT WEIGHT BIRTHDATE RACE DISPOSITION OF VEHICLE ON ORDERS OF: pOFFICER RIVER POTHER CAST ❑ rn 5.9 W u%. is bo - OTHER HOME PHONE BUSINESS PHONE APPARENT R ❑ � � ��q622- � � !O� PRIOR MECHANICAL DEFECTS; NONE APPAREEFER TONARRATIVEp CHP USE ONLY DESCRIBE VEHCI[DAY SHADE IN DAMAGED AREA INSURANCE CARRIER POLICY NUMBER V6NCL[TIP[ AM -7 DvNL 74— pMOD. pMAJOR pTOTAL DORLOf OSTR �O�RG�HW'AY CQ EL ISPEEO JPCF PUC❑2! C- 4U ' CHP 1PREPARERSH ME DISPATCH NOTIFIED REVIEWER'S NAME/ JOAIE REVIEWEEDD 14YES ❑ NO E3N/A �/��►/� / /p CHP SSS PAGE T (R/Y IBS) OPI Ott /W`r I �(}! z ZZ ��48667 _ TRAFFIG COLLISION CODING PAGE Z DATE JF COlUS10N THE(700) NqC NUMSfR OIHcfR I.0 Q NUYYER \r MO. ' DAY`�� YEAR 92 ^✓`� ZG OWNER'S NAME/ADDRESS NOTIFIED PROPERTY I Hit Ae YES [:]No DAMAGE DESCRIPTION OF DAMAGE - SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE OCCUPANTS M/C BICYCLE. 1 MET L-AIR BAG DEPLOYED 0-NOT EJECTED - A-NONE IN VEHICLE M-AIR BAG NOT DEPLOYED DRIVER t-FULLY EJECTED B•UNKNOWN N-OTHER V-NO 2•PARTIALLY EJECTED C-LAP BELT USED P-NOT REQUIRED W_YES 2-UNKNOWN I.DRIVER D.LAP BELT NOT USED 1 2 3 2 TO 6.PASSENGERS E•SHOULDER HARNESS USED PASSENGER 4 rj 6 7-STATION WAGON REAR F-SHOULDER HARNESS NOT USED CHILD RESTRAI X_No 8-REAR OCC.TRK OR VAN G-LAP/SHOULDER HARNESS USED Q.IN VEHICLE USED Y_YES 0•POSITION UNKNOWN H-LAP/SHOULDER HARNESS NOT USED R-IN VEHICLE NOT USED 7 0.OTHER J-PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U.NONE IN VEHICLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(')SHOULD BE EXPLAINED IN THE NARRATIVE PRIMARY COLLISION FACTOR UST NUMBER (N) OF PARTY AT FAULT TRAFFIC CONTROL DEVICES 1 2Z 3 TYPE OF VEHICLE 2 3 MOVEMENT PRECEDING COLLISION r AVC SECTIO DIRTIED: ciao ACONTROLS FUNCTIONING APASSENGER CAR/STATI AGON ASTOPPED YES I -V-7-57- C � �No B CONTROLS NOT FUNCTIONING• I B PASSENGER CAR W/TRA#R B PROCEEDING STRAIGHT III BOTHER IMPROPER DRIVING.: CONTROLS OBSCURED C MOTORCYCLE/SCOOT RAN OFF ROAD D NO CONTROLS PRESENT/FACTOR• CKUP OR PANEL TR4K D MAKING RIGHT TURN C OTHER THAN DRIVER• TYPE OF COLLISION E UP/PANEL TR K W/TRAILER E MAKING LEFT TURN D UNKNOWN• HEAD-ON F TRU OR TRUC RACTOR F MAKING U TURN r E FELL ASLEEP* 9B SIDESWIPE G TRUCK/ UC RACTOR W/TRLR GBACKING REAR END H SCHOOL BLW JISLOWINZj:6TOPPNIG WEATHER( MARK 1 TO 21TEMS) D BROADSIDE I OTHER BU I PASSING OTHER VEHICLE ACLEAR E HIT OBJECT J EMERG Y VE LE J CHANGING LANES B CLOUDY F OVERTURNED K HG Y CONST.EOYIPMENT KPARKING MANEUVER C RAINING VEHICLE/PEDESTRIAN IL BI CLE L ENTERING TRAFFIC D SNOWING IH OTHER JUISTHER VEHICLE MOTHER UNSAFE TURNING E FOG/VISIBILITY FT. MOTOR VEHICLE INVOLVED WITH PEDESTRIAN N X114G INTO OPPOSING LANE F OTHER•: ANON-COLSJSION 0 MOPED PARKED G WIND PEDESTRIAN P MERGING LIGHTING C OTHER MOTOR VEHICLE TRAVELING WRONG WAY A DAYUGHT D MOTOR VEHICLE ON OTHER ROADWAY OTHER ASSOCIATED FACTOR(S) OTHER•: B DUSK-DAWN E PARKED MOTOR VEHICLE 1 213 (MARK t TO 2ITEMS) CDARK-STREETLIGHTS F TRAIN AvcSECTIONvgLATION: �D D DARK.NO STREET LIGHTS BICYCLE 22g 'd [0]NO DARK.STREET LIGHTS NOT ANIMAL: BVCSECT1GNYpLATION: CITED' FUNCTIONING• ❑YES ROADWAY SURFACE ❑NO SOBRIETY-DRUG FIXED OBJECT: p 1 2 3 PHYSICAL ADRY J CvcsfcnoNvaun ❑Yo (MARK t TO 2ITEMS) B WET OTHER OBJECT: ❑� HAD NOT BEEN DRINKING C SNOWY•ICY J D D SLIPPERY(MUDDY,OILY,ETC.) E VISION OBSCUREMENT: B HBD-UNDER INFLUENCE F INATTENTK)N•: HBO-NOT UNDER INFLUENCE Hao-IMPAIRMENT UNKNOWN ROADWAY CONDITIONS) G STOP GO TRAFFIC E UNDER DRUG INFLUENCE' (MARK t TO 21TEMS) PEDESTRIAN'S INVOLVED '=A O PEDESTRIAN INVOLVED H ENTERING/LEAVING RAMP F IMPAIRMENT.PHYSICAL' A HOLES,DEEP RUT• CROSSING IN CROSSWALK I PREVIOUS COLLISION IMPAIRMENT NOT KNOWN B LOOSE MATERIAL ON ROADWAY• B AT INTERSECTION Ij UNFAMILIAR WITH ROAD NOT APPLICABLE _:#H C OBSTRUCTION ON ROADWAY• CROSSING IN CROSSWALK-NOT K DEFECTIVE VEFi EQUIP.: Qofs I SLEEPY/FATIGUED D CONSTRUCTION•REPAIR ZONE AT INTERSECTION ❑NO SPECIAL INFORMATION E REDUCED ROADWAY WIDTH IDCROSSING-NOT IN CROSSWALK L UNINVOLVED VEHICLE A HAZARDOUS MATERIAL FLOODED• IN ROAD-INCLUDES SHOULDER M OTHER•: G OTHER': NOT IN ROAD NONE APPARENT H NO UNUSUAL CONDITIONS APPROACHING/LEAVING SCHOOL BUS 1 10 RUNAWAY VEHICLE SKETCH MISCELLANEOUS .IDICATE NDIRN �HQ DOT CR 14C CHS DA PDJ50 - OTHER CHP SSS PAGE 2( Rev t b8)OPI042 ST!TE-OF GALIFORNA ' IWURED / WITNESSES / PASSENGERS PAGE DATE OFC ON - n TIME(26 00) NCIC NUMBER OFFICER I.DV5Q I NUMBER 40 EXTENT OF INJURY ( "X" ONE ) INJURED WAS ( "X" ONE )WITNESS PASSENGER PARTY SEAT SAFETY EJECTED ONLY ONLY AGE E FATSEVERE OTHER VISIBLE COMPLAIN NUMBER POS. EQUIP. AL INJURY INJURY INJURY OF PAIN DRIVER PASS. PED. BICYCLIST OTHER NAME/D.O.B./ADDRES (r TELEPHONE � ` � /! (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES 1 m /lytc coknIx- VICTIM OF VIOLENT CRIME NOTIFIED ❑# ❑ 1 ❑ ❑ ❑ ❑ 10 1 ❑ 10 Z- i NAME I D.O.B.I ADD TELEPHONE INJURED ONLY)TRANSPORTEp BYLTI I TAKEN TO: DESCRIBE INJURIES �•i�.J,�. '�5y��1.� •'��iJ G'.�,'!-t ,`'Tr L. 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DAY Yq, J"EIIE...'. NA.E I MO. OAY Yq ,AL✓nr�— a�27u ,.2-G-9z CHP 555—Page 4 (Rev 11851 OPI 042 ST,4TE OF,CALIFCRNIA NARRATIVE/SUPPLEMENTAL CHP 556(Rev 7-90)OPI 042 Page DATE OF INCIDENT/OCCURRENCE TIME(2400) NCIC NUMBER OFFICER I.D.NUMBER NUMBER •4Z. -Q 3Zfi 995° ,X''ONE 'X'ONE TYPE SUPPLEMENTAL('X-APPLICABLE) 9 Narrative XCollision report ❑BA update ®Fatal ❑Hit and run update ❑Supplemental ❑Other: ❑Hazardous materials ❑School bus ❑Other: CITY/COUNTY/JUDICIAL DISTRICT REPORTING DIST RICT/BEATCITATION NUMBER LOCATION/SUBJECT STATE HIGHWAY RELATED I ❑Yes ❑No 2. CALL.- c'Dtsf 4 r 1b A A, -r y�,�� lfrttl y _ � x /hX-xjila �aJ sc- � e 4 3. AT 1VW,0A v- 100. 4. 6. 1,A. &-A-<6s' j T!G A 7. �/ l�✓DV / ,Fla 7. ��`�- fL )�Y a"Cm 14F CICS' X.. J� 9. 10. 12. Td AL T/-X��- Tb T* -.C�74?S.107Z 13. --K7�a1(t c-rZ 14. 5. �/-Z �4 �T ' V-ti i-' V//%ft/Y7 K- v-Z 16. i 7I i/ ?D /'L &-XcTiAe ✓ 17. 18. -tZ&5T'- �1Zc--.E72 iZ �-D iA-&7A7^-. V-- � -,-Ai 0 19. 20. 22. 115ef ff c&1tdTAj 1 A- 23. 24. -D-25. [. 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DATE OCIDENTCURRNCE TIME 12400NCIC NUMDBER NUMBER ,02 L) B 'X'ONE 'X'ONE TYPE SUPPLEMENTAL rX•APPLIC E) Narrative Sl Collision report ❑BA update Fatal ❑Hit and run update ❑Supplemental ❑Other: ❑ Hazardous materials ❑School bus ❑Other: CITY/COUNTY/JUDICIAL DISTRICT REPORTING DISTRICT7BEAT CITATION NUMBER LOCATION/SUBJECT STATE HIGHWAY RELATED []Yes ❑No 2. 1✓ uN I�kJN�' i 3. 5. 6. Jf 8. -L' EJU� Ix - !`L 9. E//D &A-) c.7IAZ-ss A-F I%kZ S4-t?7dJ 4-le �r �� X S4n A* AIJAI/i( - fi� 2<<Il fry 54t.0-L- 10. 11. -ro 51 Z —711l0 r -vLf jGLc 1rl/'1�f� 13. S a 14. &gff1t4-e 15. !- S 'I1Af IWV 1 Z % fry eXW4b I 17. / fw /fin �Z Nt�r � ul l `. 1D 18. l�` X4 ( {/ 2 19. (.t)''// ( v•f .?r�r A �f r U —fX�r L/� � Dt � G7` P!U 20. 21. '41 CGY�K 4 A-S' /3 (f 22. �c7l.C��L��77? 1iC7.CfA� 23. �,1 11� / f'1� �Tglr`Z w�.,a�t�?L� 5.?lIU U,'i' &A1 (v c'. 124. Q/4St1�, f ' ��e"T E� Imo`-+> t L 4'T 171e - 7"St c y/,.Aj_/* SYf1 D 25. A-r IWPAot fu 26. [c�fL eAli, &--I 4.,,-A-SN-T 27. 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CAW t c L 28. 61,1MCI - 29. 30. 31. lie f 'D-Z� T !'Z 1' V Vc- V*-4'b -DL. /W 17 !S VC NJ �U " C PREPARER'S NAME AND I.D.NUMBER DATE REVIEWER'S NAME DATE d-Z A-5zj Use previous editions until depleted. 90 57541 _ STgTE'bF"CAUFOf;NIA NARFIATIVE/SUPPLEMENTAL CHP 556(Rev 7-90)OPI 042 Page DATE OF INCIDENT/OCCURR CETIME(2400) NCIC NUMBER OFFICER I.D.NUMBER NUMBER b0 . 06 - 7 za 9'95 o r2 X'ONE •X•ONE TYPE SU PLEMENTAL('X•APPLICABLE) N Narrative A�l Collision report ❑BA update I ' Fatal ❑Hit and run update ❑Supplemental ❑Other: ❑Hazardous materials ❑School bus ❑Other: CITY/COUNTY/JUDICIAL DISTRICT REPORTING DISTRICT/BEAT CITATION NUMBER LOCATION/SUBJECT STATE HIGHWAY RELATED ❑Yes ❑No el,— 2. 4. 6. - y. 8. 9. - - 3l�FT /�ZMi IJ AJ V w AeC _ _ - /rs lo. /% WKS — - 11. n- y - 13. P /7 14. S SO UnSIE IZZA7, Z2,110 15. NO 7 T11W L-:— /—Z) Z��XkZ -y� — 0026- 17. - /7 ///9Z) TD '7Z WJl/ SIZ115WIJ 7D e;Z7- N 18. 7. 19. P — 20. — � 21. T 22. 23. �� y� 114y coiYTwG7- -2' - 7717 - 24. 25. 26. ZX 27. 28. 29, 30, 31, PREPARER'S NAME AND I.D.NUMBER DATE REVIEWER'S NAME DATE Use previous editions until depleted. 90 57541 � S"ITEOF_;L1FlANIA NARRATIVE/SUPPLEMENTAL PAGE DATE OF INCID02- - 69 T`OCCU ENCE —^ TIME(:W01/�7/� NCIC NUMBER OFFICERI D NUMBER _ 'X ONE GG LO•/niE /i/r VC zz TYPE SUPPLEMENTAL()C APPLICABLE) y� li I NARRATIVE COLLISION REPORT O BA UPDATE II/I FATAL ❑ MIT A RUN UPDATE SUPPLEMENTAL LLL❑ OTHER: ❑ HAZARDOUS MATERIALS /l❑� SCHOOLBUS ❑ OTHER: CIIT--YYi COUNT YIJUDICAL DISTRICT REPORTihG DISTRICT/BEAT CITATION NUMBER LOCATION;SUBJECT STATE HIGHWAY RELATED YES NO qL Wff 4. ?S6TL= �!1Y5�� 1�I�J ��SE � `f7l�'T �3?7 G O Ute/ 8. SL ,& G46*r(, . kAr f/l& A- 11W &N&A- 10. Vo, AYV1744e,41 Nis Or aIV /AA 17,1Z ✓ . 11. 51 t7(f FZv E2--:D 13. VJ 43 /d'J %7A-r- 10 4. ✓ . oIII /d 14, igt -.Srm 5?7E Z)/DINT 15. A, / Vt ! "u-t D Lr . 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. PRE KERSNnpI2�� D.NUMBE ` MONTH/DAP Y1 IrE,�q REVI EWER'S NA ME MONT"/DAY/YEAR U H CHP 556(Rev.7-87)OPf 042 uA.p•wo..aea•�ni14w•I.4 88 48641 MOWED /.,3 ' CLAIM JUL 3 11992 S _ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA couNTY COUNSEL MARTINM. CAuk Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEPIBER 8, 1992 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: $2,245.61 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: YBA.RRA, Alex ATTORNEY: Jaime Pena Attorney at Law Date received July 29, 1992 ADDRESS: 345 East Main St. , Ste. 501 BY DELIVERY TO CLERK ON (inter office) Stockton, CA 95202 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. p�HH BATCHELOR, DATED: July 31, 1992 BY�L Clerk II. FROM: County Counsel TO: Clerk of the Boa f ervisors 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: [ Z BY: ►J Q � J '—�� / Deputy County Counsel I11. 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 0 R: By unanimous vote of the Supervisors present ( ) This Claim is refected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: S E P 8 1992 PHIL BATCHELOR, Clerk, By . Deputy Clerk WARNING (Gov. code sect on 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the nail 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. FOR ADDTTTONA , WARNING SEE REVERSE SIDE OF THIS NOTICE 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 14 1992 BY: PHIL BATCHELOR byz Deputy Clerk CC: County Counsel County Administrator S � ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. I CLAIM AGAINST COUNTY OF CONTRA COSTA CLAIMANT'S NAME: Alex Ybarra AMOUNT OF CLAIM: $2,245.61 (property damage only) CLAIMANTS' ADDRESS: 1532 Lettia Road, San Pablo, CA 94806 ADDRESS TO WHICH NOTICES ARE TO BE SENT: c/o JAIME PENA, Attorney At Law, 345 East Main Street, Suite 501 , Stockton, CA 95202 DATE OF ACCIDENT: April 4 , 1992 LOCATION OF ACCIDENT: Richmond Dump DESCRIPTION OF HOW ACCIDENT OCCURRED: Alex Ybarra was operating his 1978 Oldsmobile. His wife, Enedina, and infant daughter, Ruby, were passengers. Alex Ybarra followed directions given by a dump employee, Mr. Gomez , to the area where he was to dump his garbage. The Ybarras' vehicle was hit on the passenger side by a Datsun truck being operated by Kelly Lewis, a minor. Kelly Lewis was also following directions given by a dump employee. DESCRIPTION OF INJURY OR DAMAGE: See attached estimate from KARBER'S AUTO BODY. NAME OF PUBLIC EMPLOYEE OR EMPLOYEES CAUSING INJURY OR DAMAGE, IF KNOWN: Mr. Gomez ; unknown as to any other employee who might have been involved. ITEMIZATION OF CLAIM: See attached estimate for itemization. JURISDICTION of this claim would lie with Municipal Court. Dated: July 21 , 1992 c �J Signed by or on behalf of Claimant: ✓✓✓✓ �, /JAIME PENA ttorney For Claimant REC ED JUL 2 91992 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. K 11 FT MB R=te YF, S' .'J C) :11 B. A..R. # 418 _.RD STREET Phone: (5110) -2734-12: 4 RICHMOND, CA 948()4 VISIBLE DAMAGE QUOTE �F#•'.?-�F�•�E#:+•-if�F yc�l-•i### '.?b:+##�F?f••?E�E-!E�•'�#aF�(-•x�.:r.�.#.!F x-#7E•�,F�.#.?c aE•!!'tir#.#.?E'#-iF##?�#�FiF#:F#.gs.:#i(--p1.;(..i.�i.#=*7E••'t�•:.t#:;.#j:._. # Date : , 04/05/92 Page 1 Est W YBAR Date Of Est #k: 04/009 #�!•'E?F�:E'!-x-�.?!..?t..#=!•-?E.u.?�..e.:#•#• -#•#�.?}'{.�•.sF•?!•�E•?F##'F=(-#4#'!'•3i•iF=4?Fii•###?E•?t'.a'•R•####'#j'##?f#if'#i';.•�••?�•3!•?E•s,�..t.:a..�s�.:�xs?�.�.3 Name njBARRA, ALEX L a r 78 OLDSMOB I LE DELTA Pc. . Addra 1532 LETTIA RD VIiV .City•. : SAPS YABLO CA 94SO6 Lic .#: Mi 1e•aae Phone:. (.510} -_??-oi n` BusF'/Dat: .i�ci/78 Paint; BREI . .. ,::''�iaf"##j!'#'fdL#�¢':iR'-ii'?!'?�':�E'•3F'�'.a('#:f"N"a('ii"?f•,�^.f••�F f'##'�!'�I'^#"�'y(";!'.�s�•##'!f•i�•'�.#a(•.7�s�"' ('�'.s�'.�'.�#.r�'�"�'#J.'�•#�'�f'#7f"�(':.("�('.r�'F•:'E"�"!¢#�•y�•�'t Inst_ir:. CSAR INS{ Adjuster :.F'l�YLLT_S BF;IC S:•: • Add r : 14560 SAN PABLO AVE " Claim: ## , - Jity : SAP.( PABLO CA 94806. :'' Date of Loss , Phone: (5101 - 3-SSOO . . ... Deductible ±s*4*4##4#4•3EW'!'� Co.. ^y. .rjg r �1992 Mitchell intarnalioiia p' n - -:.. 'r, • _ '; � -a��r ;F'ar.rs <F`sin� # Labor- r.cpair'. t3esc; _pticn --- 777E-- ----=-- -=---=----=------7-7777 7"7777-7- 1 F: -. God;✓ �� :F'ar-i«_-1 . Otter. Sedan ".. . Front door 5. :+ _. _ 4 w r :Pad : FMoulding; Eide Adhesive •7tonlStandard - . y C:,S- . R ', R Body,R Moulding, Edge Guard w/! ger. Side , Motilding 9. 45 .•` R ': F: Body F: F'anel . Outer t�c.ar= er- paneii:..0 4412 • !_0 � 31 f5 _ - 5 R €: R Body R Moulding, Side Adhesiye 3ti'..,wjli'* Standar !. = 27.'60 R F.. Born R Moulding4 Suede Adhesive �_. � . 2 Z5. 50 7 _. F ��+�d . �!m"24109, Wheal Opening 'j_tL r ter pane ! a. -'$, 5+i Paint 6. 3 Hauls .-- Q. 4 C . �r,la.p 5 :9 11;:, 0;., 1029. Refinj 9 hr - 0 "47. 00 S 277. 30 .- Parts -7 30Par, t F2 i,-: E ail Ta;; L E ^5% 71 , _ = �.a yn�J. Mai=.,i_�is; a . , \` \ TOT4L 2245. 61 245 = • V. \••: STEVE KARBER 3�. r PROOF OF SERVICE BY MAIL - CCP 1013a, 2015.5 STATE OF CALIFORNIA ) COUNTY OF SAN JOAQUIN ) I am a resident of the United States and employed in the county aforesaid; I am over the age eighteen years and not a party to the within action; my business address is 345 East Main Street, Suite 501, Stockton, CA 95202 . On July 24, 1992 , I served the within CLAIM AGAINST COUNTY OF CONTRA COSTA on the persons and entities listed below. I am readily familiar with the business practice for collection and processing of correspondence for mailing with the United States Postal Service. The above-described document will be deposited with the United States Postal Service on this same date in the ordinary course of business , the envelope will be sealed and .placed for collection and mailing on this date following ordinary business practices at Stockton, California, addressed as follows: County Clerk P.O. Box 911 Martinez , CA 94553 I certify or declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. Executed on July 24 , 1992 at Stockton, California. Gilfian Ewing CLAIM AUG 1 � 1992 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COUNTY COUNSEL Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT SEPTEMBER 8, 1992 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: $944.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MORSE, Jeffrey 1579 Ashwood Drive ATTORNEY: Martinez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON August 5, 1992 (via Risk .Mgmt) BY NAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. p� BATCHELOR, DATED: August 10, 1992 gYIL Clerk ' 1. FROM: County Counsel 70: Clerk of the Board of S4kery>iors 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: -p �J ) 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. Dated: S E P S 1992 PHIL BATCHELOR, Clerk, B Deputy Clerk —41 I WARNING (Gov. code seht 6n913) 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. FOR ADT)TTIONAT, WARNING SEE REVERSE SIDE OF THIS NOTICE 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 1 deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: `� p 1 1992 BY: PHIL BATCHELOR by Deputy Clerk CC:,,.. County Counsel County Administrator R r, ADDITIONAL WARNING This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. Clair to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLADISr I 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 11 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 V RECEIVED Against the County of Contra Costa ) AUG 5 199 or ) CLERK BOAHD OF SUFERVIS Ra V District) CONTRA cosra,Co. � Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or i the above-named District in the sum of $ and in support of this claim represents as follows:1. When did the damage or injury occur? (Give exact date and hour) k y l 1 `lC12. J �'DC-) 2. Where did the damage or injury occur? (Include city and county) /S79 Asti-A)ovd Or n q--f -�e�� 64 --Co 7 q_11 Cos.F_r Cb=-sf,I - 3. How did the damage or injury occur? (Give full details; use extra paper if required) , Sl, Co. 5 C0114-C40" 64- ev;�ehC'e- by ------------------- ------- --___-__.._-___._------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? OI K not k;n� dowh door +0 r; is ® �emov4 o� Scc�,o� a,P cca�pe4 as ev?dptice rrP.:-,4-S ov e.- goofs wc�Ils W"140,+ r4,C1 -Cr poo-i� c(eG., ;wy etc . ' cJ (over) 7. wnat are the names of county or district officers, servants or employees causing the 'damage or injury? I r �,n Uer'r�� WGII�S G� CCov+�p4rr�:�ci ��/ 5everc� S�P�;Tfib lv-( Ill ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. See / +} r,CC � 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) S� e. e , -----------------------------------------.--------- ------------------------------ 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 - 7/ct Doe,r r4^e- 4/67, * # * * W * 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 Claimants Signature Wov� Address Telephone No. Telephone No. CZ,o 1 37a-ct3-70 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. Attachment to Claim Form Regarding Forced Entry by Contra Costa Sherriffs Deputies on July 1, 1992 to residence of 1579 Ashwood Drive,Martinez, CA. Response to Item#6 and#7: Resulting Damage and estimated cost, 1. Broken Front Entry Door to Residence $169.00 2. Removal of Section of carpet in bedroom $500.00 3. Cleaning of carpets where fingerprint dust has been tracked $50.00 4. Painting of doors and walls where fingerprint dust was applied and not completely removed $75.00 5. Repair of wall where light fixture was removed $150.00 Total $944.00