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HomeMy WebLinkAboutMINUTES - 10201992 - 1.17 CLAIM �; `NE® BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNI_A Clai;.m Against the County, or District governed by) BOARD ACTION the 07 1992 the Board-of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October , COUNSEL and Board Action. All Section references are to ) The copy of this document mailed to you is your not %rF4 CAUK California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $100 ,000 . 00+ Section 913 and 915.4. Please note all 'Warnings". CLAIMANT: BIEDA, JR. , John ATTORNEY: Kenneth S. Katzoff, Esq. Katzoff & Riggs Date received ADDRESS: 2054 University Ave. BY DELIVERY TO CLERK ON September 23 , 1992 Fourth Floor Berkeley, CA 94704 BY MAIL POSTMARKED: From Public Works 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, gg H DATED: October 6 , .1992 ��IL Depu yLOR,Clerk a (L 01. II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( i1 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: `( Nloca_& 1A ewz�lia.., ;s ca e��4 Ta eeT witl,i� Dated: (�H4V e� 1gl 9 Z 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 ER: 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. i Dated: O C T 2 0 1992 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code sect13) 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 additional warnina 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. j i Dated: 0 C T 21 1992 BY: 'PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator I r 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. Speediset®Moore�uaineas Forms,Ing. T6 z .WRITE IT.! - DON'T SAY IT! i Tl 2 TO R I'J K MO: iy`4-7L.!'► ICJ 1& DATE 5 i2- FROMPIabtlC rVdrks SUBJECT- �C���1 �11� bf a"Jr. We, re-ce i ded �:Hnl5 Cw M Dfr -the.,. C1 jocye �. have- nn =M, pf re-cel vi na an LA t rf WK)ck:t 1 d n f=ra 2 t5 K 1rY1C�,rtQG�ern�n - E h 0'��' �4- Gt, alty— (i m i i-s 6f RECEIVED Vi � - j ` CONTRA COSTA CO. SIGNED- eik� CJkn2-.INC jI PLEASE REPLY HERE TO DATE SIGNED 1 CLAIM AGAINST GOVERNMENT ENTITY may 2 (COUNTY OF CONTRA COSTA) y RE�EIl9E® 3 CLAIM FOR DAMAGES To person or property SEP 2 3 101 4 To: COUNTY OF CONTRA COSTA CLERK BOARD OF SUPERVISORS 5coNTRA COSTA co. 1. NAME OF CLAIMANT: JOHN BIEDA, JR. 6 2 . DATE OF BIRTH/AGE: March 3, 1976 7 3 . HOME ADDRESS OF CLAIMANT: 344 FUNSTON AVENUE, SAN 8 FRANCISCO, CALIFORNIA 9 4. BUSINESS ADDRESS OF CLAIMANT: N/A 10 5. ADDRESS TO WHICH CLAIMANT DESIRES NOTICES OF COMMUNICATION TO BE SENT REGARDING THIS CLAIM: KENNETH 11 S. KATZOFF, ESQ. , KATZOFF & RIGGS 2054 UNIVERSITY AVE. , FOURTH FLOOR, BERKELEY, CALIFORNIA 94704 12 5. HOW DAMAGE OCCURRED: On or about March 31, 1992, 13 Claimant was driving his motorcycle on a stretch of county road called E1 Toyanal (nearest cross street, 14 Lomas Contadas) in or near Orinda, California. He came upon a patch of the road which was improperly 15 maintained, spun out and injured both his motorcycle and his person. 16 6. DAMAGES RESULTING: Lacerations on the leg and damage 17 to his knee. Motorcycle sustained extensive damage. 18 7. AMOUNT OF CLAIM• 19 Tom Waddel Clinic Unknown at this time. 50 Ivy Street 20 San Francisco, California 94102 21 General Damages $100, 000 22 Special Damages Unknown at this time. 23 Legal Fees Unknown at this time. 24 Total Unknown at this time. 25 8. FUTURE MEDICAL CLAIMS (ESTIMATE) : Unknown at this -time. 26 9. INSURANCE PAYMENTS MADE: Unknown at this time. 27 - 10. EXPENDITURES RESULTING FROM INJURY: Unknown at this 28 I time. 2 11. WITNESSES, DOCTORS AND HOSPITALS INVOLVED: 3 Tom Waddel Clinic 50 Ivy Street 4 San Francisco, California 94102 5 Others unknown at this time. 6 12 . JURISDICTION 7 Superior Court. 8 9 Executed on this 17th day of September, 1992 at Berkeley, California. 10 11 KATZOFF & RIGGS 12 By: ) L 4 ' )1A4 13 Ken eth S. Katzof Attorney for John Bieda, Jr. 14 15 16 Received on this day of 1992 at California 17 By: 18 County of Contra Costa 19 20 21 22 23 24 25 26 27 28 1 PROOF OF SERVICE 2 I declare that I am over the age of eighteen (18) and not a 3 party to this action. My business address is 2054 University Avenue, Berkeley., California 94704. 4 On September 17, 1992 I served the attached CLAIM AGAINST 5 GOVERNMENT ENTITY on the interested parties in this action by placing true and correct copies thereof, enclosed in sealed 6 envelopes addressed as follows: 7 Department of Public Works County of Contra Costa 8 255 Glacier Drive Martinez, CA 94553 9 [X] I am readily familiar with the business' practice for 10 collection and processing of correspondence for mailing with the United States Postal Service. I know that the correspondence 11 was deposited with the United States Postal Service on the same day this declaration was executed in the ordinary course of 12 business. I know that the envelopes were sealed and, with postage thereon fully prepaid, placed for collection and mailing 13 on this date, following ordinary business practices, in the United States mail at Berkeley, California. 14 [ ] BY PERSONAL SERVICE: I caused such envelopes to be 15 delivered by hand to the above addresses. 16 [ ] BY OVERNIGHT DELIVERY: I caused such envelopes to be delivered to the above addresses within 24 hours by 17 overnight delivery service. 18 [X] Executed on September 17, 1992 in Berkeley, California. 19 [X] I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct. 20 [X] I declare that I am employed in the office of a member of 21 the bar of this Court at whose direction the service was made. 22 23 4on ochner 24 25 26 27 28 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT OCTOBER 20, 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: Unknown Sectior�_03_ Jd15.4. Please note all "Warnings". Ediv CLAIMANT• EISENBERG, Michael. (05-0979-416) E� ATTORNEY: Dawn HudsonW_ _ Sr. Claim Representative Date' ADDRESS: State Farm Insurance Companies BY DELIVERY TO CLERK ON September 22, 1992 333 Civic Drive Pleasant Hill, CA 94523 BY MAIL POSTMARKED: September 21, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. September 22 192 PpHIL BATCHELOR, Cler DATED: p B�: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors 0 ( ) This claim complies substantially with Sections 910 and 910.2. ( P;f' 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: C.• 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. BOA7) This ER: By unanimous vote of the Supervisors present ( Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:-OCT 2 0 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 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 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: OCT 2 1 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator M 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. NOTICE OF INSUFFICIENCY AND OR NON-ACCEPTANCE OF CLAIM Dawn Hudson TO: Sr. Claim Representative State Farm InsuranceCompanies 333 Civic Drive 'Pleasant Hill , CA 94523 Re: Claim of S'TftTE FSRL 1033 k kQCC C WA_? t )[e Michael Eisenberg Claim #05-0979-416 Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: 1. The claim fails to state the name and post office address of the claimant. 2. The claim fails to state the : post office address to which the person presenting the claim desires notices to be sent. _Z3. The claim fails to state the date, place or other circum- stances of the occurrence or transaction which gave rise to � the claim asserted. . The claim fails to state the ;name(s) of the public employees causing the injury, damage, or loss, if known. V' S. 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 woulc rest in municipal or superior court. 6. The claim is not signed by the claimant or by some person on his behalf. 7. Other: A VAepu STMAN, County Counsel B C P u n t y T o u n s e CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a, 2015. 5; Evid. C. §§ 641, 664 ) My business address is the County Counsel 's Office of Contra Costa County, Co.Admin.Bldg. , P.O. Box 69, Martinez, California 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non- Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s) having delivery service by U.S. Mail) , which envelope(s) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: September 24, 1992 , at Martinez, Calif ia. 7 cc: Clerk of the Board of. Supervisors iginal) Risk Management (NOTICE OF INSUFF] 'NCY OF CLAIM: GOVT. C. ' §§ 910, 910. 2 , 92^ . 4 , k • STATE FARM State Farm Insurance Companies 0400 INSURANCE pp RECEIVED 333 Civic Drive September 21, 1992 "Off Taylor Boulevard" SEP 212 1992 Pleasant Hill,California 94523 Contra Costa County (Vehicle - Jitney Bus #9044) CLERK BOARD OF SUPERVISORS Mail:P.O.Box 4011 651 Pine St. Suite 106 CONTRA COSTA CO. Concord,California 94524 Martinez, CA 94553 Phone: (510)680-4100 RE: Claim Number: 05-0979-416 Date of Loss: ' September 10, 1992 - _ Our Insured: Michael Eisenberg Dear Sir/Madam: Our insured has reported the above-captioned loss to us. The facts, as reported, indicate that you are responsible for this accident and the resulting damages. The repairs to our insured's vehicle have not been completed to date, so we do not know the total amount of our subrogation claim at this time. If you have insurance, please send this letter to your insurance company. Please ask them to contact us to confirm that they are handling this loss on your behalf. If you. do not have insurance, please advise. Once the final repair cost has been determined, we will notify you of the amount due. Sincerely, Dawn Hudson Senior Claim Representative (510) 680-4137 State Farm Mutual Automobile Insurance Company DH/lv cc: Agent 2168 HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001 f. i .ti�YYgyy MYY�g� fit! wo w w a (( r w � f o�� 2c et Q U^ Wj d TsO o Zaio z co do U 'z o tom- U �, c r Ic") cn � CLAIM r '. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA U C T 07 1992 k p4 i v COUNSEL Claim AOinst the County, or District governed by) BOARD ACT ION, 'AiM$0r, ^AUF the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 20 , 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: In Excess of Jurisdictional Stctiont9P and 915.4. Please note all •Warnings". imi CLAIMANT: HOY, Nancy and LARSEN, Ronald ATTORNEY: Steven R. Clawson to received Wells , Call , Clark, & Bennet ADDRESS: 1710 Pennsylvania Ave. , Suit Y PELIVERY TO CLERK ON September 29 , 1992 Fairfield, CA 94533 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. 1992 eYIL BATTCVELOR, Clerk DATED: October 6 , e u rim." 01 AAIJ II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( vl� 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: �� ' -t ( `�9 Z 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. BOA711 0 R: 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:0 CT 2 0 1992 PHIL BATCHELOR, Clerk, B , Deputy Clerk WARNING (Gov. code sec 13) Subject to certain exceptions, you have only six (6) months from the date this-notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice' in connection with this matter. If you want to consult an attorney, you should do so immediately. *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:—OCT 21 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator r 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. TO: Boy= OF SUMEVISCRS OFCONT �ppt►cavoh Ya: Instructions to Cla ttoierk of the Bosrd Martinez,Catitomiia 94553 A. Claims relating to causes of .action t6i7 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 its office in Room 106 , County Administration Building, 651 Pine Street, Martinez, California 945S3. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should he filled in. D. If the claim is against more than one public entity, separate claims must .be filed .against each public entity. . B. Fraud. 'See penalty for fraudulent claims, Penal Code Sec. 72 at and OT this form. F=- : Claim by )ReserOAFD—OF ler ' s filing staxnps NANCY HOy and .See Exhibit "A" RECEIVED ED RONALD LARSEN ) Against the COUNTY OF CONTRA COSTA) EP 2 9 1992 1 or . DISTRICT) SUPERVISORSi in name ) ONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ In excess of jurisdictional limits and in support of this claim represents as follows 1 -----__-----------------------_--_-------------------------------------- . When did the damage or injury occur? (Give exact date and hour) April 4, 1992 at approximately 6:30 p.m. 2. >rthere did the damage or *7L=-'Y occur? (Include city and county) Pt. Chicago Highway at its intersection with Panoramic Drive, City of Concord, Countv of Contra Costa, State of California. -T------------------------------------c-----------r- ------------------- 3. How eid the damage or injury occur: (Give f111 ceta_ls, use extra sheets if required) See Exhibit "A" ..--_-------..T--- .... ----..-_--T--"-----------------------••-----T---T -- 4. AThat particular act: or oMIssion on the part o: county Cirdistrict officers , servants or employees caused the injury or damage? See Exhibit "A" (over) 5, wvhat are the nam ' of county or district of<_ ars, servants employees causing the damage or injury? The specific:names of the County or District officers, .servants or employees causing the damage is unknown :to"Claimants at this time. The County of Contra Costa, .its employees, agents, principals, councils, departments and divisions are responsible for causing the injuries claimed. b, what dasaage or in�urZes do you claim resulted? Give full extent of injuries or damages claimed. Attach two -estimates for auto damage) Special Damages as identified below. General damages for the pain -and suffering as a result of .the wrongful death of claimants'' daughter, including but not limited to those damages enumerated in BAJI 14.52, CCP Section 376 and 377 _ T. flow was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Claim in txcess of $25,000. Jurisdiction rests in Superior Court. ---------------------------------------------------------- 6. Nacres and addresses of witnesses, doctors and hospitals--.------------- Joseph Alfred Severino, 31. D Front Street, Healdsburg, CA- Dru Smith, 35 First Street, Knightsen ' Mt. Diablo Hospital, 2450 East Street, Concord, CA --....�------ ..2-------.----.-�---.... -----------.r..��---- 9, List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Medical Expenses - In excess of $25,000 Funeral Expenses - In excess of $5,000 Govt. Cade Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some ersor n is behalf . " Name and Address of Attorney _ Steven R. Clawson Claimant' S Signature Wells, Call, Clark & Bennett 1710 Pennsylvania Avenue, Suite C Address Fairfield, CA 94533 Telephone No. (707) 426-5300 Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person, who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account , voucher , or writing, is guilty of a felony. " CLAIM AGAINST COUNTY OF CONTRA COSTA Claim By: Nancy Hoy 3905 Rimrock Drive Antioch, CA 94509 Ronald Larsen 4005 Cowell Boulevard, #203 Davis, CA 95616 Nancy Hoy, as Special Administrator for the Estate of Jenny Larsen 3905 Rimrock Drive Antioch, CA 94509 3. How did the damage or injury occur? 4 . What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? This claim is based on injuries sustained by claimants, Nancy Hoy and Ronald Larsen, as a result of the wrongful death of their minor daughter, Jenny Larsen, which occurred on or about April 4, 1992 at the intersection of Pt. Chicago Highway and Panoramic Drive, City of Concord, County of Contra Costa, State of California under the following circumstances: Jenny Larsen, a minor, daughter of claimants, Nancy Hoy and Ronald Larsen, was driving her motor vehicle on Panoramic Drive across its intersection with Pt. Chicago Highway. Jenny Larsen came to a complete stop at the stop sign at Panoramic Drive and checked for oncoming traffic. It was approximately 6:30 p.m. when the accident occurred. After obeying all of the traffic control devices, looking both ways and proceeding cautiously and withe due care into the intersection, Ms. Larsen was broadsided by a vehicle driven by Joseph Severino who had been travelling southbound in the through lane of Pt. Chicago Highway. This impact caused significant external and internal injuries, pain, suffering, disfigurement and other shock and injury to Ms. Larsen who was wearing the lap and shoulder belt equipped in her 1988 Dodge Colt. Triage care was provided to Jenny Larsen who was transported to Mt. Diablo Hospital where she died some time later. Pt. Chicago Highway at its intersection with Panoramic Drive was negligently and carelessly designed, constructed, owned, operated, repaired, controlled, inspected, supervised, installed and maintained by the County of Contra Costa and their agents, principals, employees, councils, departments, supervisors, divisions and committees as to cause the said roadways to be defective, making it dangerous and unsafe, and proximately causing the death of Jenny Larsen and the subsequent injuries and damages to claimants, Nancy Hoy and Ronald Larsen. Jenny Larsen' s injuries were proximately caused by the above-described condition of the roadway at the intersection of Pt. Chicago Highway and Panoramic Drive in the City of Concord, County of Contra Costa, State of California. Said condition of the roadway as above-described constituted a dangerous condition of public property that created a substantial and foreseeable risk of injury to individuals using the roadway with due care, and which proximately caused the broadside collision between Joseph Severino and Jenny Larsen. The County of Contra Costa, including its agents, principals, employees, councils, departments, divisions and committees had actual and constructive notice of the condition of the roadway as above-described. Said condition had existed in substantially the same state and appearance for a substantial period of time prior to the time of the April 4, 1992 automobile accident sufficient to allow the County of Contra Costa to have taken measures to protect against and/or remedy the dangerous condition. The above-described dangerous condition was of such an obvious nature that the condition and its dangerous character should have been discovered by the County of Contra Costa and would have been discovered had there been a reasonably adequate inspection and/or inspection system maintained and operated with due care. The conditions above-described created a reasonably foreseeable risk of the kind of injuries suffered by Jenny Larsen and her parents, Nancy Hoy and Ronald Larsen. The County of Contra Costa had actual notice of the defective condition of the roadway at the intersection of Pt. Chicago Highway and Panoramic Drive via reports of numerous similar accidents that occurred at that same intersection prior to the April 4, 1992 accident. The County of Contra Costa, its employees, agents, principals, councils, departments, divisions and committees, by their failure to redesign and make safe the intersection of Pt. Chicago Highway and Panoramic Drive after it first learned of the dangerous nature of that intersection, proximately caused the injuries claimed herein. Jurisdiction over this claim rests with the Superior Court. Claimants do not now know the specific names of the public employers or employees causing the damage, injury or loss as above set forth. All notices or other communication with regard to this claim should be sent to claimants at Steven R. Clawson, Wells, Call, Clark & Bennett, 1710 Pennsylvania Avenue, Suite C, Fairfield, CA 94533, (707) 426-5300. DATED: Lis --� Z STEVEN R. CLAWSON CLAIM x. 17 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA ,Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT OCTOBER 20, 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: $123.96 Section. p�P615.4. Please note all "Warnings". CLAIMANT: JACOBSON, Jolenne 3 1992 16711 Marsh Creek Rd. #128 ATTORNEY: Clayton, CA 94517 COUNTY MUNP:f Date ft�R ADDRESS: BY DELIVERY TO CLERK ON September 16, 1992 BY MAIL POSTMARKED: September 15, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: September 22, 1992 gplL BePCHtyLOR, Clerk II. FROM• ounty 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: Y Z BY: �� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:—O CT 2 0 1992 PHIL BATCHELOR, Clerk, B , 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 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: 0 C T 2 1 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator i 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 'to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must.be presented not later than the 100th day after the accrual of'"the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must 'be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented .not later than.one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must .be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 'Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp rRECE ED Against the County of Contra Costa ) SEP 61992 or ) District) Fill in name The undersigned claimant hereby makes claim again the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents.as follows: -----------------------------------------— - -- ----- 1. When d'd the damage or i 'ury occur? (Give exact date and hour)2�- / y- .------------------------------------------------------------------------------------ �l 2. Where did t_he damage or injury occur. (Include city and county) /(-7/1/ualJz ------------------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details; use extra paper if " required) , f��� ��� �&04 <�ry, Z a =----------------=-------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? .49 aAh (over) ✓a�2,J �, 5. What are the names of county or district officers, servants or employees causimg the damage or injury? r, � C'� ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuri s orr,�c damages claimed. Attach two estimates for ut�eB�t%��� �''�`=`'-�'�-'`------------- zz ------ - ----------------------------------- 7. How was the amount claimed above computed? (Include the �els�timated unt of any prospective injury or damage.) oofJ c 0 �2�C Xel", YO� --------------------- ----------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. aw--� cam/ -------------------------------------------------------------------------------------- 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 Q42,,, Claimant' Signature Address Telephone No. Telephone No. sl N 0 T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or .pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by .both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. Y,22„ C" -67 . _ 14 � e � '., ( � y i "� nnq nwwny sciso� I � � , 9 a6 — VP Li N a w cn Z U' '^ �•yQ vi v� +y v C CLAIM ItECEI /E® BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim A`gainst the County, or District governed by) BOARD ACTIOQCT 07 1992 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 20 , JDbNqr� COUNFIL and Board Action. All Section references are to ) The copy of this document mailed to you is your n6WVNP CAUh California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Exceeding $50 , 000 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: KLAASSEN, Mary Ann . ATTORNEY: Robert A. Walker Attorney at Law Date received ADDRESS: Law Offices of Vaughn E. BY DELIVERY TO CLERK ON September 28 , 1992 Spunaugle 3150 Hilltop Mall Road BY MAIL POSTMARKED: Hand delivered Richmond, CA 94806 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: October 6 , 1992 CYIL RAATTCVELOR, Clerkepu �1__) 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: Z 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. BOAR"00 ER: 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: 0 C T 2 0 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sect 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 additional warnina 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: OCT 2 1 1992 BY: PHIL BATCHELOR by Z Deputy Clerk CC: County Counsel County Administrator r ti 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. •, 1 ROBERT A. WALKER, ESQ. R _D �• THE LAW OFFICES OF VAUGHN E. SPUNAUGLE ���UVE® 2 3150 Hilltop Mall Road Richmond, CA 94806 81992 3 (510) 970-7661 $ 2 Attorneys for Claimant BOARD 4 Mary Ann Klaassen CLERKCONTRAOCOS'TA CQ{SOR 5 6 CLAIM AGAINST THE SHERIFF AND COUNTY OF CONTRA COSTA 7 8 1 . Name and address of claimant: Mary Ann Klaassen, 2451 Olivera 9 Road, #El , Concerd, California 94520. 10 2. Send all notices to ROBERT A. WALKER, Attorney at Law, The Law Offices. of Vaughn E. Spunaugle, 3150 Hilltop Mall Road, Richmond, 11 California 94806 . 12 3 . Date of occurrence: March 28 , 1992. 13 Place of occurrence: The Martinez Detention Center, Martinez , California. 14 4 . Circumstances of occurrence: While incarcerated at the Mar- 15 tinez Detention Center, Claimant was so negligently supervised and controlled as to be permitted to attempt to take her own life 16 three times, the last time culminating in a fall from the second tier of said institution. 17 5. General description of injuries: Claimant sustained severe 18 fractures to both heels, her left elbow and her spine as well as various bruises and contusions. 19 6 . Amount of claim: Medical expenses, lost wages and earning ca- 20 pacity, pain and suffering in an amount exceeding $50,000 . 00.. 21 --•1 22 DATED: T' 23 ROBERT A. WALKER Attorney for Claimant 24 25 26 27 28 I �� , d N a. r CO Q � OO N � v N W a N W � O Q O O EA N i N 4 w � v N va .a E � 4a$ r � a ` � 1 GO 1 a 7 1 RECEIVE® 1, / 7 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 0 C T 07 1992 ::OUNTY COUNSEL Claim Against the County, or District governed by) BOARD ACT TiNE4 CAUR the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 20 , 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: $120 , 000 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: LANE, Richard R. ATTORNEY: Date received ADDRESS: 1170 Amanda circle BY DELIVERY TO CLERK ON September 24 , 1992 Brentwood, CA 94513 Hand delivered BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: - October 6 , 1992 JyIL BAATTCVELOR, Clerk eputo 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: Z 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 'ER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 0 1992 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code sect' 3) Subject to certain exceptions, you have only six -(6) months from the date this-notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *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: 0 C T 2 1 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator 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 consultationis 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 AND ITS AGENTS AND EMPLOYEES Richard R. Lane hereby presents a claim for damages against the County of Contra Costa and its agents and employees. ADDRESS OF CLAIMANT: Richard R. Lane 1170 Amanda Circle >rRECEIVED Brentwood, CA 94513 ADDRESS TO WHICH NOTICES SHOULD BE SENT: SEP 24 cl. lk" Richard R. Lane CLERK BOARD OF SUPERVISORS Address as above CONTRA COSTA CO. DATE, PLACE AND CIRCUMSTANCES OF OCCURRENCE: On March 17, 1992 Claimant was taken into physical custody by the Contra Costa County Sheriff's Department, purportedly to insure Claimant' s safety against great bodily harm or death. At the time of this detention, Claimant was under the care of personal physicians for a gunshot wound and a fracture of the right arm. Medical Staff at the Martinez Detention Facility were apprised in detail of Claimant' s medical condition and care status at the time of intake. Claimant was later examined by facility medical representatives after he was placed on the module, and it was determined that Claimant's injury was healed and that he should resume normal physical activity. Claimant followed this advise and began daily exercises as directed. On March 28, 1992 Claimant was injured while in custody, suffering a radial fracture of the right humerus, the same arm which had been previously injured. Claimant was examined at Merrithew Hospital on March 28, 1992 , placed in a cast and returned to the Martinez Detention Facility. Within days, the arm began swelling, which resulted in a pressure point sore, which in turn became infected. Medical staff were notified but no action was taken immediately. Further delay occurred causing the infection to worsen, at which time Claimant was transported back to Merrithew for removal of the cast and treatment of the .infection. Claimant was placed in a fracture brace at this time. It should be noted that the fracture brace offered no support in allowing the arm to mend, as it was unable to keep the broken bone in place. The 'sheriff's department was non-responsive to Claimant's medical needs, failed to inform Claimant of upcoming appointments at Merrithew, failed to take Claimant to appointments at Merrithew, and refused Claimant access to his own personal physicians at his own expense. The missed appointments at Merrithew caused the arm to be unevaluated and to go untreated by a physician during a critical time in the healing process. On numerous occasions Claimant required assistance from the MDF medical staff and custodial management staff with regard to medical care. One time the arm brace broke and was never replaced. Claimant was able to obtain a court-ordered release on two occasions for surgical evaluation from his own physicians at and at his own expense. He was awaiting a third pass for final surgical evaluation, which was .denied. This denial prolonged the pain and recovery process. Claimant was given a court-ordered medical release on June 18, 1992, and on July 8th, had reconstructive surgery done on his right arm. This should have been performed back on March 28, 1992 when it first occurred. Claimant returned to full-time employment on July 29, 1992 . Through all of this the County and its agents and employees repeatedly denied Claimant access to his own personal physicians, and in addition failed to ensure that Claimant was properly evaluated and treated at the County Medical Facility. The County and its agents and employees further failed to establish and maintain a set program to ensure recovery and improvement in Claimant' s health. Throughout this whole matter, Claimant followed the prescribed procedures while incarcerated, but his medical needs were either ignored or discounted. PARTIES RESPONSIBLE: The County of Contra Costa and its agents and employees whose identities are presently unknown AMOUNT OF CLAIM: $20 , 000 punitive damages against the individual agents and employees; $100, 000 compensatory damages against the County of Contra Costa. GENERAL DESCRIPTION OF INJURIES AND BASIS OF COMPUTATION OF DAMAGES: Compensatory damages are based upon cost of medical care for the diagnosis and surgery, as well as neurological testing which was necessary because of the undue delay by the County; and on the general damages accompanying the injury which occurred in County custody and the undue delay by the County in getting Claimant ' s medical needs met, all done with deliberate indifference to Claimant's medical needs. Punitive damages are based upon the outrageous, malicious nature of the unknown agents and employees' acts. The above- described acts of these agents and employees were willful, wanton, malicious, oppressive and fraudulent and done with deliberate indifference to Claimant's medical needs. tl Dated: September 23 , 1992 RICHARD R. LANE CLAIM RE� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Agaihst the County, or District governed by) BOARD ACTION O C T 07 199Z the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT October 20 , ljOrft COUW,EL and Board Action. All Section references are to ) The copy of this document mailed to you is your notivWTcH x CALIFti California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $33 .50 Section 913 and 915.4. Please note all •Warnings". CLAIMtANT: MC CRACKEN, Denver J. ATTORNEY: Date received ADDRESS: 166 Cragmont Drive BY DELIVERY TO CLERK ON September 29 , 1992 Walnut Creek, CA 94598 BY MAIL POSTMARKED: Vi a R i �k Management I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. H�{ DATED: October 6 , 1992 BAIL Deputy OR, Cler CL 0J.4A,B-z.�' , 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: ( , � z 8Y: Deputy County Counsel V V III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: OCT 2 0 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code secti ) 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 additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am ncw, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified,copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: OCT 2 1 1992 BY: PHIL BATCHELOR by _ Deputy Clerk CC: County Counsel County Administrator 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. Denver J. MCCrachen 166 G-9mont Drive Walnut Creek, Galifornia 94598 RECEIVE September 8, 1992SEP 2 9 1992 CLERK BOAR®OF SUPERVISORS CONTRA COSTA Ca O County Administrator 651 Pine St. Martinez, CA 94553 Dear Sir: Claim is herewith filed against Contra Costa County for damage to my automobile on September 7, 1992 on Cragmont Drive in Walnut Creek by excessive gravel left on the street during recent paving operations. The amount of the claim is $33.50 as per the enclosed invoice from Walnut Creek Nissan. All of us on the street would appreciate it if the excess gravel could be removed. Sincerely, r f Z66L 0 T dls G3A!3338 Aluno,j elsao BJJU03 92105933 6 8 0 3 3 R71-14 INVOICE DENVER MCCRACKEN 2659 N.MAIN STREET 166 CRAGMONT DR WALNUT CREEK,CA 94596 WALNUT CREEK CA 94598 PAGE 1 (510)938-1744 - HOME: 932-0758 BUS: BM 8 AD 124097 SERVICE ADVISOR: 120 CHRIS EA . ...........................,­­.­.....­.......-LICENSE ........... MILEAGElNJMUT :T.. .. ... ...... WINTER BLU 92 INISSAN MAXIMA I JN1EJ01P5NT105933J 2 ZCN628 1 8425/8425 it SERVICE DiAT£ A ...... ...... ........... 6 0 Y R9 1 - ...PROW:DATE IVARR...2 P` S F: ::4 DATE 01DEC91 1 17:00 OSSEP921 1 67.001 CASH OSSEP92 ................ OPTIONS: TRN:5SPEED... ... .......... ................... .... .. ..._.......... 08:45 08SEP92110:23 08SEP92 LINE OPCODE TECH TYPE HOURS LIST NET TOTAL A CHECK LEFT FT BRAKE SQUEALS AT TIMES CHECK AND ADVISE GW FOUND GRAVEL IN LOWER CONTROLE ARM AND CALIPER CLEANED AND RETESTED 119 CC 0.50 33.50 33.50 X SEP 0 81992. � By STATEMENT OF DISCLAIMER ..................... ....... T, .................. .....T.0:ALS ON BEHALF OF SERVICING DEALER, I HEREBY CERTIFY THAT THE The factory warranty constitutes all of INFORMATION CONTAINED HEREON IS ACCURATE UNLESS the warranties with respect to the sale of LABOR AMOUNT 33.50 this item items. The Seller hereby OTHERWISE SHOWN. SERVICES DESCRIBED WERE PERFORMED AT NO expressly disclaims all warranties either PARTS AMOUNT 0.00 CHARGE TO OWNER. THERE WAS NO INDICATION FROM THE express or implied, including any implied APPEARANCE OF THE VEHICLE OR OTHERWISE, THAT ANY PART warranty of merchantability or fitness for GAS,OIL, LUBE 0.00 , particular purpose. Sellerneither SUBLET AMOUNT 0.00 REPAIRED OR REPLACED UNDER THIS CLAIM HAD BEEN CONNECTED assumes nor authorizes any other person IN ANY WAY WITH ANY ACCIDENT, NEGLIGENCE OR MISUSE. to assume for it any liability in connection RECORDS SUPPORTING THIS CLAIM ARE AVAILABLE FOR (1) YEAR with the sale of this itemAtems. MISC.CHARGES 0.00 FROM THE DATE OF PAYMENT NOTIFICATION AT THE SERVICING ORIGNAL ES—ATE I M THORIZED ADDMONS I TOTAL CHARGES 33.50 DEALER FOR INSPECTION BY MANUFACTURER'S REPRESENTATIVE. I ACKNOWLEDGE NOTICE AND ORAL LESS INSURANCE 0.00 APPROVAL OF AN INCREASE IN THE ORIGINAL ESTIMATED PRICE. SALES TAX 0.00 (SIGNED) DEALER,GENERAL MANAGER OR AUTHORIZED PERSON JDATE) CUSTOMER SIGNATURE ............. PLEASE PAY ........... ... THIS AMOUNT 33 5'0 CUSTOMER COPY AS IS The only warranties applying to this part(s)are those which may be offered by the manufacturer. The selling dealer hereby expressly disclaims all warranties,either express or implied,including any implied warranties of merchantability or fitness for a particular purpose,and neither assumes nor authorizes any other person to assume for it any liability in connection with the sale of this part(s)and/or service. Buyer shall not be entitled to recover from the damages to property,damages for loss of use,loss of time,loss of profits,or income,or any other incidental damages. 1. Customer is hereby notified that the said property is not insured or protected to the amount of the 7. Said Dealer is authorized to deliver the vehicle described herein or any of its contents to actual cash value thereof, or otherwise,against loss occasioned by theft,fire or vandalism while the any person presenting this receipt. property remains with 1;:dealer. S. n addition to any and all other legal remedies available. I authorize Said Dealer to have a 2. Customer states no articles of personal property have been left in the vehicle and dealer is not lien on the vehicle described herin for all changes for repairs,including labor and parts, responsible for inspection thereof. storage and/or towing, and to enforce such lien. Said Dealer is hereby expressly authorized to sell said vehicle at public auction after giving a twenty 120)day written 3. The dealer is not responsible for unavailability of parts or delays in parts shipment beyond dealer's notice by certified mail to the legal owner,registered owner,and Department of Motor control. Vehicle of intent to do so. On the sale date,the vehicle shall be sold to the highest cash bidder and the proceeds of sale must be used first to satisfy the lien plus storage costs 4. Due to the type of service requested some repairs must be sublet. and costs incident to sale.'and the balance shall be forwarded to the legal owner,or if none,to the registered owner,or if the address is unknown,it shall be forwarded to the 5. All charges for repairs including labor and materials furnished are due and payable simultaneously with Department of Motor Vehi6les. the delivery of the within described vehicle or prior to delivery upon the expiration of three (3)days after notice that the repairs have been completed. Notice shall be deemed to have been given upon the Said expenses for sale shall also include a resonable attorney's fee, which may be deposit in the United States mail,postage prepaid,of written notification to that effect addressed to the necessarily incurred. customer at the address given on the reverse side hereof. 9. If any such charges remain unpaid for thirty(30)days after such request for payment, 6. If the vehicle described herein is not called for within three(3)days after such notice is given,a storage Said Dealer may also refer such charges to its attorneys for collection and the customer charge of$16.00 per day will be made for each day thereafter. will pay a reasonable attorney's fee. 10.By law,you may choose another facility,to perform any needed repairs or adjustments which the smog check test indicates we necessary. STATEMENT CONCERNING AMENDMENTS TO THE SONG-BEVERLY WARRANTY ACT AS FOLLOWS: "A buyer of this product in California has the right to have this product serviced or repaired duriry the warranty period. The warranty period will be extended for the number of whole days that the product has been out of the buyer's hands for warranty repairs. If a defect exists within the warranty period,the warranty will not expire until the defect has been fixed. The warranty period will also be exterided if the warranty repairs have not been performed due to delays caused by circumstances beyond the control of the buyer, or if the warranty repairs did not remedy the defect and the buyer notifies the manufacturer or seller of the failure of the repairs within 60 days after they were completed. If,after a reasonable number of attempts,the defect has not been fixed,the buyer may return this Product for a replacement or a refund subject,in either case,to deduction of a reasonable charge for usage. This time extension does not affect the protections or remedies the buyer has under other laws.' F'VA"- c' L -,- L -� Lp SEP, County Administrator 6511 Pine St. Martine7, CA 94553 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT OCTOBER 20, 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 (Paragrl h , ow), given pursuant to Government Code Amount: $1,731.6 0 Section an 15.4. Please note all "Warnings". CLAIMANT: SILVERIA, Sue Ann SEP 2 3 1992 621 Perrin Way c�pUpmr ,� ATTORNEY: Martinez, CA 94553 .QlfLllf, Date received ADDRESS: BY DELIVERY TO CLERK ON September 21, 1992 (via Risk Mgmt BY MAIL POSTMARKED: September 17, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: September 22, 1992 gyIL BAATTCYELOR, Clerk epuy. II. FROM: County Counsel TO: Clerk of the Board of Supe ors ( L4 . 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: (lam 23 /y L BY: , Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Adminis ator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( his Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 0 C T 2 0 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sectLon 3) Subject to certain exceptions, you have only six (6) months from the date this-notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *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: O C T 2 1 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator p. .4 1 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 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.' ction. 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'. f Clam ;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 Pilin stamp STT MIL, Sue Ann ) { �� RECEIVED V�u, Against the County of Contra Costa j SEP 2 11992 or . ) CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. District) _ ... Fill--in--n—am-e7 The undersigned-claimant- hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ �� 31, d{� and in support of this claim represents as follows: to When did the damage_or-injury occur? (Give exact date and hour) dui I�a -11�010J1�_ 2. Where Ad or injury occur? (Include city and county) 3. How did the damage od injury occur? (Give full details; use Wtra paper if required) Oak Aa-� ,Q,p 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 7. wnat are the names of county or district officers, servants or employees causing the damage or injury? ---- ----------------------------------------------------------------------- 5. What damage or- in,juries do you claim resulted? (Give full extent 'of injuries or dam es claimed. Attach, two e t Pes for ,au damage..g2 q�cr�� � � cR, o-/,ttlY�GG n c cX o� U 4 a 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) $. Names and addresses of witnesses, doctors and hospitals. _ _. ..—..—__ .._--t--------------------------- List t 9 L he expenditureg you made on account of this accident or injury: DATE ITEM AMOUNT _4,_11qffJWA1& WL q,0, tw&Z 16 q,o(gy 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 i Claimant's Signature Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: - - "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the- state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. ' 3845 MIKE * S AUTO B ODY Serving all of Contra Costa Area Since 1972 "Our Goal is Total Customer Satisfaction" 2001 Fremont Street Concord, CA. 94520 (510) 686-1739 Visual Damage guotatiozz 03845 by SAL CONTRERAS on 09-17-92 S UE ANN S=LVE R=A Style 4X4 V6 Insurer . Lic. Plate: TONKJOY Adjuster : x' Paint code: Appraiser: r Phone: 229-9013 /372-1310 Prod. Date: 1-83 Claimant : 83 CHEWY S15 JIMMY-2DR Rate code : STANDARD Insured . VIN: 1G5CT18B5D8504333 Deductible: 0.00 Policy # : Mileage: 35106 Claim # I► Labor Op Description Price Labor Paint Labor Grote Price Groff 1 R&I GLASS, W/SHIELD 0.00 1.9 0.0 GLASS Y. 2 RMV/REP ADHESIVE KIT, W/SHIELD 38.00 0.0 0.0 NEW 3 RMV/REP REVEAL MOULDING, W/SHIELD-BLK 12.25 0.0 0.0 NEW 4 R&I HEADLINER, ROOF 0.00 2.3 0.0 BODY 5 RMV/REP ASSEMBLY, ROOF RACK 108.00 1.8 0.0 BODY NEW 6 REFINISH ROOF PANEL, REFINISH 0.00 0.0 3.6 7 REFINISH DOOR OUTSIDE, FRT REFINISH LETTER 0.00 0.0 1.5* 8 (WINDOW FRAME ON DOOR) 9 RMV/REP HINGED GLASS HINGE, REAR GATE R-W/D 19.25 0.2 0.0 BODY NEW 10 RMV/REP HINGED GLASS HINGE, REAR GATE L 19.25 0.2 0.0 BODY NEW 11 RMV/REP REVEAL MLDG, QTR GLASS R 39.00 1.0* 0.0 BODY NEW 12 RMV/REP REVEAL MLDG, QTR GLASS L 39.00 1.0* 0.0 BODY NEW 13 REPAIR ROOF 0.00 10.0* 0.0 BODY 14 COVER CAR 5.00* 0.3* 0.0* BODY NEW 15 COLOR MATCH 0.00 0.0 0.5* 16 HAZARDOUS WASTE DISPOSAL 5.00* 0.0 0.0 NEW #• 3845 `8Y CTIEVY S15 JIMMY-2DR SILVERIA Page 2 Summa ry BODY 16.8@ 50.00 840.00 PAINT MATERIALS 5.6a 22.00 123.20 T NEW 284.75 T REFINISH 5.6a 50.00 280.00 GLASS 1.9@ 50.00 95.00 Labor ( 24.3 hrs) 1215.00 Material 123.20 Price Group 284.75 Subtotal 1622.95 Tax 8.250% 33.65 Grand Tota 1 1 6 5 6 6 0 ***** Parts Prices Subject to Invoice ***** * SIGNIFIES ESTIMATORS JUDGEMENT AUTHORIZED AND ACCEPTED: You are hereby authorized to make the above specified repairs. I understand that payment in full will be due upon release of vehicle, including additional supplemental damage charges, and hereby grant you and/or your employees, permission to operate the car, truck, or vehicle herein described on streets, highways, or elsewhere for the purpose of testing and/or inspection. An express mechanic's Lien is hereby acknowledged on the above car, truck, or vehicle to secure the amount of repairs thereto. You will not be held responsible for loss or damage to the vehicle or articles left in vehicle in case of fire, theft, accident or any other cause beyond your control. OLD PARTS REMOVED FROM CAR WILL BE DISCARDED UNLESS OTHERWISE INSTRUCTED. Authorized by Date Thank you for coming to MIKE'S AUTO BODY! We appreciate your business! 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