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HomeMy WebLinkAboutMINUTES - 01261993 - 1.17 1A 001inty SCoons /o /7 AN � ei CLAIM 8 1993 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALI1 �� J ' C Claim Against the County, or District governed by) BO�O`911 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 26, 1993 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:$118 .0 8 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: BOE—LOWERY, Diane ATTORNEY: Date received ADDRESS: 305 Ponderosa Court BY DELIVERY TO CLERK ON December 30, 1992 Richmond, CA 94803, via Risk Management BY MAIL POSTMARKED: $ I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. QQH gg DATED: Jani nr34 R 1 C� B IL Depuiy OR, Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( VJ 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: Oq 3 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. BOARR: 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: JAN 2 6 1993 PHIL BATCHELOR, Clerk, Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *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 pa's shown above. Dated: JAN 2 6 1993 BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator ;tom,; � �.. ,_ �i�t�,• _r. r r 1 A 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 injuryto 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 ite 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 B ) Reserved for Clerk's f .rin 4> g V D Contra Cost" C 'n f DEC 301992 REMED Against the County of Contra Costa ) ®E G 2 199 LERK B8XRD OF SUPERVISORS or ) CONTRA COSTA CO. District) Risk Mana rroPn. Fill-.in RwY The undersigned-claimant hereby makes claim against the County of Contra Costa or C the above-named District in the sum of $ and in support of _^ ,� this claim represents as follows. Cor�/�'eU/rte p . • � 1. When did the damage or- injury occur? (Give exact date and hour) �-•M 2. Where-did-the damage or injury occur? (Include city and county) 40d e!5_7 .....���� 3• How did the damage or injury occur? (Give full details; use extra paper if Cv� required) � � mho lis , l� Ile 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? '7�p EDGE "W A-0 a-_Z_arVIOU.S O�C��'x..�cNl � oO" (over) �. wnat are the names of county or district officers, servants or employees causing the damage or injury? 5. What damage or- injuries do you claim resulted? (Give full extent of injuries or cDN206-Ai damages claimed. Attach two estimates for auto damage. ecl e_!� 'c�� .&uraa� et c:2-0 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) k6- __cteJe, ---—------------ 3. Names and addresses of witnesses, doctors and hospitals. -_s------------------------- --__-_-__..- 9. List the expenditures you made on account of this accident or injury: DATE ITEM R a�.S lam AMOUNT Dec.-1195a 41 VI) Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) orbperson on his..behalf." Name and Address of Attorney Claimant'sSignature) 3os &;ei . _ (Address) Telephone No. Telephone No. -2 S 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 'coun'ty 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. ESTIMATE OF REPAIRSF". WtLcggPg� EI Cerrito Honda 11820 San Pablo Ave. xoivnA EL CERRITO, CALIFORNIA 94530 (415) 529-1323 NAME ADDRESS DATE YEAR MAKE / MODEL LICENSE NO. L-11SPEEDOMETER SERIAL NO.(VIN NO.) r Z L l INSURANCE CARRIER JADJUSTER PHONE VEHICUF LOCATED AT - OPERATIONS PART NO. PARTS LABOR Q i INSURED PAYS $ INS. CO. PAYS R. 0. N0. T O T A CS z_v WRECKER INS. CHECK PAYABLE TO _-_ SERVICE The above is an estimate, based on our inspection, and does not cover additional parts or labor which TAX may be required after the work has been opened up. Occasionally, after work has started, worn, broken or damaged parts are discovered which are not evident on first inspection. Quotations on parts and labor are currant—a;�d subject to change. TOTAL OF EST. MADE BY Z ESTIMATE AUTHORIZATION FOR REPAIR.You are hereby authorized to make the above specified repairs to the vehicle described herein. SIGNED DATE— FORM ER-81-C 14-791 1 m • � " Q w N d 77 60 '• w- a• `� O 6 Or O O N 00 r rS. du; ZUp y} ,,.1 (n CO .G • N Z C, WW cW9N cr) 6 Zcr W 54 4 6 O U p 7O 44 �'o u Ct N 0 d eh , A lo N _ 0 U s �('� 1y Ce)to co C-4 N m o d E a tJj s 0A V Z '63- O Q at 4 c J 1� rAlm,- Q -d�r o n d r w d JN Ps cn w m G n t.0 N yn m ° rn kth 111 V d W r5 (h��O 6 0)V.0 add�o Ar- LO may. m 3 a m m s ¢ CCa C Ncr.z x°oda OVOuy oaGaow co Z > odro m Ln r N 10 O a d m Y G 6 N m G Z � \ v a d °°r¢a �Q p , iU O YQ�o`a n 9 g O Ov °d A�-O m 77 Vol 04CC O� C3. s vi coo TAAy OW _ ty \ N _SW N p. Z N U PZ 7�1 Sus= o J ;•'J g n 3 � W N ¢Q drN o O 1..,-•- w .t iOd • W � �.- UL o- u O N0 Z4w cp 14 ! is` y. 11+•"U 1 i..,� 9 n W Y o m 4 LU o aN°m 4Ns d O y w¢ i��.3NK.an jWNp N S © smi a m7 DO 20 d VN I c� o t r x' �. . r-�97Y Co«nxy C CLAIM dUnSQ/ • BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA JA IV - 8 199,3 Claim Against the County, or District governed by) �VJq�tl��WMP 4C.T.,01 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANTJ a nu 4 1993 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: $2 264 .47 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: DAVIS , Peakl ATTORNEY: Date received ADDRESS: 58 Solano Avenue BY DELIVERY TO CLERK ON December 30, 1992 West Pittsburg, CA 94565 via Risk Management BY MAIL POSTMARKED. ana g I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Januar 8 1993 ppH IL BATCHELOR, Clerk o DATED: Y 61: Deputy _ OAYV� 4 a II. FROM: County Counsel TO: Clerk of the Board of Supervisors o-A 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: �cb-, 1. 1�7 3 BY: /� �• Deputy County Counsel 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 ORDE ' 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: 'JAN 2 6 1993 PHIL BATCHELOR, Clerk, 8 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 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. JAN 2 6 1993 Dated: BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator 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. Clain: to: BOARD OF SUPERVISORS OF COMRA COSTA COMM INS"RC'TIGNS "10 CL11I?',ti'T 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 mist 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 stampp RECEIVED � SSP DEC 3 01992 Against the' County of Contra Costa ) or ) CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. District) __...... .g11 .. n name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the scan of $ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) 17 � ��: Jr.11.-.1w r Y.�er "+ r•��'I' �-- ! %� ` �1 t I /.!" f /, - .�:, 3. How did the damage or injury occur? (Give full details; use extra paper if required) 4. What particular act or omission on the part of county or district officers, servarts or e=ployees caused the injury or damage? D. wnat are the na.-jes of cou.^.ty or district officers, servants or employees causing the dat-.nge or in fury? ---------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7• How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Sze $. Names and addresses of witnesses, doctors and hospitals. I �� /1'f l�/t'1� S•t'��/ t,�e 5 c�,v�'r2 .�t�✓c� _�I• `bLF`��FL.f����f�LrG..�....►:�Y.� .'v L.i.r i�^/�:i_� �..r�....��__� �_s�sr_w 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 someper-son on his behalf." Name and Address of AttorneyP4)ae'v a, (Claimant's Signature Address Telephone No. Telephone No. oCG j G� LZ * ' 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 imprisonme—nt in the state prison, by a fine of not exceeding ten thousand dollars ($100000, or by both such imprisonment and fine. t� ------- ----------- ----------- --------- f, --- i r 12 _-_-_-�-`_--_- __ ---,. _�✓�j_.-��,-(/r--.,.--r.,�.��2�j...��_�.,,�_�-�-`_-Yom_-��.��4�t�j-� .t_! �J,�___�''-_...�_-gin�_ _`-=�C____L�=-y'i,���-s=?---�'��--_�_- t='�__.` � ������G��•--(�'i_._�<�J_�{•��, --. _ - ��r'�-"-'Y''-- -AL1-���-�---�L"- -l����^��. ..-'_l::'-•�".-.t���� -�"�- �`=-«-i-, - `.[`.�_ l .�'�_-.�.-'' c.xiacier Drive ROAD NO.: SSS Martinez, CA 94553 PERMIT NO. : ?c;L9j PI;Z= ZED DO WCNK IN AODUMANCE WTTH TITLE 10 OF THE ORDUWXE ODUE OF CWM CSMA CDUNrY, COIIIW'Y CATICNS, AND ANY SPEXUAL REQUIREMENTS S OM OR LISTED HEREIN. Receipt No. . ry 717e /r P =7 U Permit Fee: e-1 dt C,. - 9 Soy ? Inspection Fee: Bond/Deposit: $ u,5-" 77 J? — /05 �' P OI-13E RMD TJY AND KEEP IT AT r= WORK SITE. TC ATAMNGE FM 1NSPF3C.TICN 1 3.13=Z32DAT 48 BCURRS EEFCM YOU SP1 IF gIIS PEST IS FM AN RICHT OF WAY, IT IS Mr VALm WrnIOUr A anUMU USA NUMBER. PmnrEnmzmcm 3 - I - 9.3 (If the work is not ccupleted by this date you must get a new permit) . Permit is issued for a street cut at 5'S .t e /.,L r,e �z,•-�. Section I and III of this permit apply. APN: f!") D33 — The permittee agrees to save, indemnify and hold harmless the County of Contra Costa or its representatives frcm all liabilities imposed by law by reason of injury to or death of any person or persons or damage to property which may arise out of the work covered by this permit and does agree to defend the County in any claim or action asserting such action. Accepting this permit or starting any work hereunder shall constitute acceptance and agreement to all of the conditions and requirements of this permit and the ordinance and specifications authorizing issuance of such permit. Signature of Permittee J. Nla�AM ARD PUBLIC WORKS DIRECIOR By: Permit Engin Date• 1,,-2 1 I. GENERAL INSTRUCTIONS 1. WORK MUST BE INSPECTED - Call 646-4470, at least 48 hours before starting or resuming work. The inspector will answer all question;. Work done without inspection may have to be resnoved or done over again. 2. PROTECTION - Provide and maintain enough barricade's, lights, signs, flagmen and other safety measures to protect the public, in accordance with the State Department of Transportation Manual of Traffic Controls for Construction and Maintenance Work Zones (Current Edition). 3. TRAFFIC - A County road may not be closed to public traffic without the approval of the Board of Supervisors. While working, keep one 10-foot wide traffic lane open to traffic; at all other times, two 10-foot wide lanes shall be open. 4. STANDARDS - Work shall be in accordance with the County Standard Specifications and Standard Drawings. 5. UTILITIES - Utility relocation is the responsibility of the permittee. 6. UNDERGROUND SERVICE ALERT (USA) - Must be contacted prior to excavating in a County road right of way. Telephone 800-642-2444. Any work found in progress without a valid USA number will be shut down and the roadway cleared. 7. INSPECTION CHARGES - Will be billed to whoever takes out the permit. Any exceptions must be resolved before the permit is issued. II. SPECIAL REQUIREMENTS - DRIVEWAYS (THE DRIVEWAY SHALL BE CONSTRUCTED FROM EDGE OF PAVEMENT TO PROPERTY LINE) 1. Minimum driveway construction shall consist of two inches of asphalt pavement on six inches of Class 2 Aggregate Base. Concrete driveways within the County road right of way shall consist of a minimum of six inches of Class B concrete over three inches of Class 2 Aggregate Base. The driveway is to be sloped to prevent sheet flow from crossing the road and shall not interfere with drainage or cause erosion or deposition of silt. 2. The driveway shall not enter a roadway within five feet of existing or planned curb returns, shall not interfere with a legal encroachment or create a hazard or nuisance, and shall be spaced to make maximum street parking available. 3a. The top elevation of driveway five feet behind curb is to be 0.60 feet (7 1/4-inch) higher than the flow line of the gutter. 3b. The driveway elevation at the property line shall be within one-foot of the elevation of the near shoulder and shall merge with the shoulder to preserve the roadbed section. 4. if existing driveway depression is not used, it shall be completely removed (curb, gutter and sidewalk) by saw cut at next nearest expansion joint or score mark and replaced with concrete to conform to adjacent improvements - form board to be used at gutter lip and the pavement restored with asphalt concrete. Sidewalk and curb which is replaced shall be dowelled. (See CC 3068) 5. Existing curb and gutter, or curb, gutter and sidewalk shall be removed for full width of driveway by saw cut at next nearest expansion joint or score mark. (See CC306) A form board must be used at the gutterlip and the pavement restored with asphalt concrete. .The new sidewalk and curb shall be dowelled. (See CC 3068) 6a. Shape a valley gutter across the driveway. The flow line shall match the flow line of existing roadside ditch. 6b. Install a culvert for full width of driveway. This culvert is to be laid to the flow line grade of existing roadside ditch. Only corrugated galvanized metal, corrugated aluminum pipe or reinforced concrete pipe may be used. The culvert size is noted on reverse side of permit. 7. The driveway will require the use of a template to determine acceptable clearances. The template will be 18' 6" long and will have two six-inch projections from its bottom plan, one located three feet and one five feet from an end. This template shall be used to control finished grades. B. All broken curb, gutter and sidewalk shall be completely removed by saw cut at nearest expansion joint or score mark and replaced to true grade and cross-section. The new curb and sidewalk shall be dowelled. III. SPECIAL REQUIREMENTS - STREET CUTS (See County Standard Specifications for Detailed Requirements) 1. TRENCH EXCAVATION - Do not start until pipe and other material are at the site. Open up only that length of trench which can be backfilled the same day. Shoring shall comply with current government safety orders. Pavement shall be scored to neat lines. Removal shall not cause damage to pavement outside the scored lines. Excess excavated material shall be removed immediately from the site. 2a. TRANSVERSE TRENCH - (More than 10 degree angle with centerline of road) or antrench less than 50 feet ion in the pavement or within four feet of a paved area, shall be backfilled with Pozzolan Mix County Standar Type 4 Backfill) and the surfacing replaced in the paved area. 2b. A LONGITUDINAL TRENCH - (Less than 10 degree angle with centerline of road and 50 feet minimum length), in all paved areas including curbs, sidewalks or other concrete shall be backfilled with Class 2 Aggregate Subbase (or better material), from the top.of pipe bedding to a level 18" below the finished road surface. The remaining trench shall be backfilled with the structural section replacement in paved areas. In all other areas, longitudinal trenches may be backfilled from the pipe bedding to the ground surface with suitable material from the excavation or better material. 3. COMPACTION - The relative compaction of all trench backfill to below the roadway sections shall be not less than 90 percent. The structural section shall be compacted to not less than 95 percent. No jetting is alloyed under any laved roadway or within a distance of four feet from the edge of existing pavement. Backfill s a be compaete by impact, vibration or any combination of these.- getting will be aT ower d only when more than four feet from the pavemer..-t and when the backfill and trench are suitable for jetting and shall be supplemented with mechanical compaction to obtain required relative compaction. 4. TEMPORARY PAYING - Temporary paving (or permanent paving) shall be placed at the end of each work day. Temporary pavement shall be 1 1/2-inch minimum thickness and shall be replaced within two weeks with permanent pavement. If not done in two weeks, it may be done by County forces and the owner will be charged the cost plus appropriate overhead charges. 5. BASE AND PAVEMENT REPLACEMENT The roadway structural section shall be replaced as stated on the permit; otherwise, replacement shall be in kind except that the minimum replacement shall be two inches of asphalt concrete and 16 inches of Class 2 Aggregate Base. IV. SPECIAL REQUIREMENTS - SIDEWALK DRAINS 1. Install a three inch inside diameter non-corrosive pipe through curb or through curb and sidewalk. One panel of sidewalk curb and gutter, or where there is no sidewalk, one foot of curb. only (don't remove gutter) to be removed by a saw cut. Pipe PROPOSAL AND STANDARD CONTRACT ILI This Proposal made this . . . . . . y of . . + w . . . 19 . . . . ..by . : . . .�. . . . . . . . . . Compan " 'y, h reinafter called Contractor, to \ ,r�a . . . mpany,whose address is 5�• • . . 4AA.�. . . . .W.t . ° . .. . . . . . . . . . . . . . . . . . . hereinafter called the Developer. Contractor proposes to: furnish all labor, materials, supplies and equipment and perform the work of improvement to the satisfaction and acceptance of the local public agency within whose jurisdiction the work is to be performed as set forth and shown on the plans and specifications for . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ;latest revision date . . . : 77. . . . . . as prepared by . . . . . . . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . .. hereinafter called the Engineer, at the unit price for bid items as shown below: . . . . . . . .1. . . . . . . . . . ? . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .a., . . . . . . . . . . . : :: . . ." '`. . . . . . . . . . . . . . : : : : : : : . . . . . . . . . . . . . .... . . . . . . . . . . . . . . . . . . ,. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . :� ; . . . . . . . . . . . . . . . . . . . :x:3. :5 :�: .... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . � . . . . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . The qualtities as shown above are approximate only and subject to verification by field measurement when the work has been completed. All engineering, surveying, staking, inspection, and the fees for such services shall be arranged by and paid for by the Developer. Contractor shall: have the right to spread any surplus dirt excavated within the limits of the project and shall not be required to export or import any dirt to or from the project site unless specific provisions including payment thereof are made in the above list of said items of work to be performed; and, submit an estimate of total quantities and value of work done at the end of each calendar month to Developer which shall be verified by the Engineer. Developer shall pay Contractor in full for all work performed during the preceding month on or before the 10th day of the following month, less a 5% retention. This proposal is good for . . . . . . .days from date after which said date it shall be deemed revoked. If Developer accepts,then Contractor shall be allowed to commence said work within . . . . . . . .days of such acceptance. Contractor agrees to commence work under this proposal upon receipt of ten (10) days written notice from Developer and to complete all of the work covered by this proposal within . . . . . .working days thereafter subject to excusable delays as hereinafter set forth. Should the Contractor find that he is unable to complete all of said work in the time agreed, he shall make application to Developer for an extension of time and set forth the reasons such request is made. Within 30 days after;the work is physically completed and in an acceptable condition,which shall be evidenced by a statement from the local public agency involved that the work is.in such condition. Developer shall pay to Contractor in full all moneys'due under the terms of this agreement. Developer agrees to send written notice to Contractor when a formal notice of completion has been recorded covering all of the works of improvement on this particular subject. As used in this contract, completion of the work means the substantial physical accomplishment of the work as itemized above. As used in this proposal,completion of work does not include work to be done by others at the site. In the event work not specified herein as within this proposal becomes necessary to Contractor's performance of this agreement, Developer agrees to pay additional compensation,either at an agreed price in writing,or on a time and material basis,which shall include the total direct costs plus 20% for overhead and 10% for profit. Payment for extra work shall be in full for the amount invoiced for work performed each month due and payable on the 10th of the month following. Developer shall: furnish Contractor with sufficient sets of plans and specifications in order that Contractor may diligently pursue the work of improvement; and, designate location of all sewer laterals and water services to be installed under this agreement and Contractor shall not be responsible for errors in their designated location. Contractor shall: receive fair extensions of working time for any reasonable delays caused by the Developer or beyond the control of Contractor;and use due diligence in the performance of the work hereunder. Contractor agrees: to hold Developer harmless from all liability arising from the acts of.Contractor, its sub-contractor, agents or employees, all employees in connection with work under this agreement on the premises;and,that it will have in full force and effect and maintain Public Liability Insurance, Property Damage Insurance and Worker's Compensation Insurance in reasonable amounts sufficient to protect Developer. Any damages caused to facilities installed by Contractor or by any other crafts working on the job site should be the responsi- bility of the Developer and his contractors required to make repairs shall be compensated for such repairs as extra work. Unless otherwise specifically provided in the items of work set forth above,Contractor shall furnish all manhole frames,covers, y and other appurtenances to be installed at street level and it shall be the obligation of the grading-paving contractor to install sucF. items. If suit is brought to enforce any provisions of this agreement,the prevailing party shall be entitled to reasonable attorney's fees as may be fixed by the court. Should Developer fail to pay Contractor the moneys called for under this agreement when they become due,then such unpaid sum shall bear interest at the-r-nAxjMum legal rate until payment in full has been received. This Pro 1> if accepted by toper, shall inure to the benefit of and be binding upon the heirs, successors,and assigns of the parties hereto. N. 1A ACCEPTED: Developer . . . Contra �. l. . . . . . . . . . . . . . . . . . . . . . . . . By. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . By . . .� `. :. . . . . . . . . . . . . . . Dated . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . DELTA DIABLO SANITATION DISTRICT Parcel No. y 2500 Pittsburg-Antioch Highway, Antioch 94509 i Telephone: (510) 778-4040 Receipt No. CONN ECTIONIANNEXATION RECEIPT Subdivision / Lot. No. 1 ����"'� ���a Telephone Owner , Q�g � Location (Street address reference to property or road) l , 'sued by: Date for General anager/bistrict Engineer i WHITE—Permittee.YELLOW—City,PINK-Oistricl i UNTY OF CONTRA CCISTA — GENERAL RECEIPT G 679019 CCI RECEIPT S .19��.. DOLLARS$ i 6t! irI17 F..�x.► ytr�► D 6 v - �_ .,e.c•�-� #`' .3 �'S -- �' �"/� cast+ AM? CENED FROM CHECK PAID MyowBAS ORDER DUE y tir 3.6..5 BY: D57 REV.7/89) r PITTSBURG, CA 94565 DANVILLE, CA 94526 2150 PIEDMONT WAY ASM 555 SAN RAMON VALLEY BLVD. (510)-432-1600 (510) 837-4475 ;'`.THIS ISA CONTRACT. THE WORDS RENTER, SALES, INC. ESRTABLID�HEDSOPENOUIRED IN ADVANCE. ACCOUNTS ARE DUE AND, ' 'BUYER, YOU AND YOURS MEANS THE PER- SON WHO SIGNS THIS CONTRACT (OR ARE PAYABLE;NET 10 DAYS. PAST DUE ACCOUNTS OBLIGATED UNDER ITS TERMS). WE,OUR BEAR LATE PAYMENT PENALTIES AT 1+/2% PER ` AND DEALER :REFER T(?-',THE' BUSINESS x MONTH.' ; ,,t NAMED AT;RIGHT: _ l !" f r - �_ : I =1':1 IITiZAI–"T NUM Ef E4•4l,_:4?*:3 '•'' - Iw T f=; i it P•! [ c_t 1-054;.::-'14-00 � L T F: P T 1.::_/ 12/92 DAVIS PEARL_ A FIAVJS PEARL. A 511=: :=-.O1_ANO AV F'11 1­T'=?B1._1R z L?A .,,156.5 457 11.57 :!CIE+ SAME OUT. ---;AT 12/12/92 09: 40 �ii_ia_. ,moi IN1211, /92 i)9: 4i� ITEM N0. -- -.—f !TY==LIE:-;Cf- I F'T.i 1-lr.a_ �:_:::�:_:: .....::_:.:: :_:r"�r'3TF i r�ll�hl=:-�-=--=��__�i T=-EX1 ENLIEI:I ..c'l7fi:• Ci« 1 SNA1,::E, ELE�,' ED T `,/ X 1f lf->' AH 1,C). QQ/DA1' t-.tt;0060.00;;EN:L_ ::,N ER464: f .�+. .7 c:f, S'�ca t_:y /y c't, c_>c-?1 LS :c,=1 r.+_ to C?/W 540. O 6/, j. ' # I HEREBY I",t4—..NOW.-ED E THAT I HAVE= RECEIVED WRITTEN AND C':-,,AI; SAFETY AND AND I=IPERAT I NI_� T N,_;TFZLJ :T I f-iN:=:, 1-HAT I AM RE'=;F'I_IN: I BL_E "III READ ANDLINLIERr;TANLI #rte THEM C�EEf iI�E OF'Er�AT i ryi; T H I' EI I_I I F'i'IENT, IF i=t;y H t:=; i,;I L_L BE t:iPE R(aT i rit I # ACCEPT RE,=Pi Ii`•,:=I ES I i I TY F Of"t TI'F a F, :SAFETY_.__. _.____.___._._________SIGNATURE # # t I j f i ____P1r_Ir,:;_..__.._-- ' . i r f:=, =!.!t��!CRY-- --- -- - — - F'!_!- —1F'::.. , F I r., N;_i 'F!A, r F_1h+T'= i'iAYE f.:SE Ehl hiA[IE jlA1-1r.)f" G Wni I V;=13 l r_if_? r_ if:1N T 1 C T PATER A."IT LI!-IF 70. t I accept/decline the damage waiver,of waiver declined,please initial I as provided on the RETURN _ EQUIPMENT BY: =;1 i(t 1 '?('i i•=i (f•_,_. �i ; ! reverse side and agree to pay the above described addifonai charges therefor. __ -' the undersigned renter, specifically acknowledge that I have received and understand the written and: ! or ora'.instruct ons regarding the use and operation of the rented equipment. �( iRenter further acknowledges that he has read and fully understands the within equipment rental contract /� '=-ill f t SILLLGNATURE .md agrees to be bound by all of the Perms, conditions and provisions hereof. Renter acknovAed;es that he has received a true and correct copy of this agreement at the time of execution hereof, THIS IS YOUR CONTRACT.READ BOTH SIDES BEFORE SIGNING. L i,: ; .T..., ;, _ CUSTOMEKCOPY" U 71x ACONCORD � i (',lt':Af��b'i71' CREEK r ' Hsi -42— a�_�`�+a� � 9.s�o . T. 6,3240 Y. SfWER AND pRAlN CLEANING ELECT tI AlLY -x.+rfi .a-,.• ` '� .^y� 1s;5 PMTS URd SS' �'< "'"��" 'y'""Ci SEDTIC?ANK�PUlviPED AtSQ tNSTAtLED_ ' ' WE�T•EOUiiT1�' i ,•'T58=8fC10' _. SEWERS,S4 &YARIXDRAI S INSTALLED BRENTWOOD € OFFICE' p 2Ap1p'N DISPATCHED SERy3CEi} ' 4 DISCOV RYi8AY 754-$866 € ANTIOC `-- ; 195 MASON CIRCLE —,CONCORD, CA 945 (415)',798`'' T ' N $iCAS� � AX =4 . 4TE a M F NAMrE d "` �•` "e ' i ' I _ADDRES5 JOB yIL t OYftlEAD,CHARGE ST HOUR OPERATOR ✓f < i MINIMUM MACHINE ROYALTY A I ?' ADDMONAL- • ,'v .,M. :•r';.• TIME �4 r. SEPTIC TANK PUMPING I ST LOAD ^- P' ' %op ,,.� f 1�. i !;. OPERATOR u CASH ECK T TOTAL. IF, ' CHARGE N DATE TO BE PAIN r` F 4. 6 i. CUSTOMER'S SIGNATURE If not paid by 14th of month following doze as+ndicared af;,, a evetdue accounts, w tch rs !S°io•ann li in case suit is ce Cherge of I':r io per month will be charged said invoice,purchaser agrees to y uo n ybe commenced to enforce payment of any sum due unde{ 9r pay reasonable attorney fees to be fixed by Court. , r PERMIT NO. SEWER PERM !T RECEIPT NO. DELTA DIABLO SANITATION DISTRICT PARCEL NO. CONTRA COSTA COUNTY SANITATION DISTRICT NO.7-A 2500 Pittsburg-Antioch Highway, Antioch, CA 94509 J Q NER ADDRESS J TELE P H O NE } ENGINEER ADDRESS TELEPHONE CONTRACTOR ADDRESS TELEPHONE LOCATION AND NATURE OF WORK ADDRESS( OCATION TYPE OF OCCUPANCY NO.OF UNITS No.of / MAIN SEWER Encroachment 7*mber Easement Required Laterals MAINTENANCE BOND Subdivision M Unit Through Unit • STATEMENT OF PERMITTEE PERMISSION IS GRANTED TO THE UNDERSIGNED PERMITTEE TO PERFORM THE DESCRIBED,LISTED,OR NOTED WORK PURSUANT TO THE CODE OF THE CONTRA COSTA COUNTY SANITATION DISTRICT NO.7-A.PERMITTEE SHALL ADVISE THE DISTRICT 24 HOURS IN ADVANCE OF BEGINNING OR RESUMING WORK.PERMITTEE AGREES BY ACCEPTANCE OF THIS PERMIT TO ABIDE BY ALL PROVISIONS OF THE DISTRICT CODE AND TO ARRANGE THE ADJUSTMENT OF THE PUBLIC SEWER,IN- CLUDING STRUCTURES,TO ANY REQUIRED CHANGES RESULTING FROM DEVELOPMENT OF THE PROPERTY BEING SEWERED.PERMITTEE TO OBTAIN ENCROACH- MENT PERMITS FROM GOVERNMENT AGENCIES WHEN NECESSARY.THIS PERMIT SHALL BE VOID IF THE WORK IS NOT COMPLETED WITHIN 6 MONTHS OF DATE OF IS- SUANCE.IF RETESTING IS REQUIRED,OR IF PERMITTEE SCHEDULES A TEST AND FAILS TO BE PRESENT WITHOUT GIVING AT LE HOURS NOTICE,THEN PERMIT- TEE WILL BE CHARGED THE APPROPRIATE FEES FOR THE ADDITIONAL INSPECTION VISIT. By: Tel.No.: Signed: SEWER CONTRACTOR(PERMITTEE) PHONE OR CONTACT THE DISTRICT,(510)778.4040 TWENTY FOUR(24)HOURS IN ADVANCE FOR INSPECTION A copy of this Permit must be kept at the work site. INSPECTION RECORD SEWER LOCATION SKETCH Pipe Size Type Joint I' Length ft.Distance ft. N from structure No. Backwater relief(Y/N) Number of �CClleanouts Cover at connection: P.L. ft. nproval Dates: Trenched: i I Installed: Tested: / / `'ted: / I PERMIT APPROVAL PERMIT APPROVED: Ronald A. Tsugita, General Manager/District Engineer tnr ,an?.a'rAanager'vi5liiGt i:npineer WHITE—Permillee.YELLOW—Enaineerinn PINw- -••- Yio < � C'0l/rrtV CLAIM coUnS9/ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFW . Claim Against the County, or District governed by) a/I/f..ez C BOAR ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT J a n $ 6 , 1993 and Board Action. All Section references are to ) The copy of this document mailed to you is yo r 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: $6,006 . 14 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: FARMERS INSURANCE GROUP—Richmond Claims Office Aminder Sandhu ATTORNEY: Date received ADDRESS: 3211 Auto Plaza BY DELIVERY TO CLERK ON December 28,_ 1992 Richmond, CA 94806 BY MAIL POSTMARKED: December 24 , 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH g DATED: January 8, 1993 B1IL DeputyLOR, Clerk c II. OAIW 4 Z FROM: County Counsel TO: Clerk of the Board of Supervisors ( 1f 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 910.6). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY. . Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORD 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: JAN 2 6 1993 PHIL BATCHELOR, Clerk, B Deputy Clerk WARNING (Gov. code sec ion 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: JAN 2 6 1993 BY: PHIL BATCHELOR Deputy Clerk CC: County Counsel County Administrator ' cl ilio 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. .r ; Claim to: B�A�, SOPERVISORS OF CONTRA OOSTA1% �1STRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 19879 must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other, cause of action must be presented not later than one year after the accrual of.the cause of action. (Govt. Code §911.2.) B. Claims must be filed With the Clerk of .the Board of Supervisors at its office in Room 106, County Administration Building --651 Pine Street, Martinez, CA 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 ?0-r—M. RE: Claim By ) Reserved for Clerk's filing stamp F Ito SIA rahce Group ) RECENED C�a��►f ���'� ) 7-BOARD 81992 Against the County of Contra Costa ) or ) CLERF SUPERVISO District) OSTA CO. Fill in name ) , The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 6, do 6 , /q and in support of this claim represents as follows: — I 1. When did the damage or injury occur? (Give exact date and hour) -9 2- ---------- -------- 2. Where did the damage or injury occur? (include city and county) �J �/0�.-/Ter rfrPetJ A'elre GW COxi6w 6.0J'7`u. ��-- -----------------� -_____�------ -- ---- - -- - -- -- ap -- 3. How did the damage or injury occur? (Give full details; use extra per if required) U ur in f u red f/rr„yi c+'e r rf G;'hCf/ cvC_e mak � a- /Q,� fu.'fv Q fti 's vehl'c& VAe /;iH -, ecl.' at h�yGmeed wi;�yrezcf /i�,hfs fr hrear oy_ur�i�jftLv_ 'r 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? F a /ur rte. y i'e/at �•�h t a -�v o f a, G� fra//rv( h f eT✓t��i�� (over) O 5. What are the names of county or district officers, ger.., ..-s or employees causing" z Y , the. damage or injury? ` _ /-/e�u�eea ,Oa/c� /e��✓f # Tr/'2-UOS/ YLo f Gia�%6/� 6u f �Pir J-11 ei/`111,61 , th i,c e,-S were I n 92,1,7t- /i/o, 2J'31 ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates. for auto damage. 60�h14 to /t,4" /Pjlr e Go.!'J ---------------------•---------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage:) �ffrmafG ynQa'e. uta.. cry-rr�ulfG�'ze�+l✓'t�JfGm- a�ed.�-�c.e. �i',�e�'i� yYLa zua.� %,*vrialra_e 6a-pe-W Gn G1 q fe,%z� •�-��ii���Lsrv� je c--------- 8. �ri/Iry ------------------- ----------- --------------------------- ------- --------- 8. Names and addresses of witnesses, doctors and hospitals. GtJl ic,�: Vtlex'-e rrli,�f is�� 2z/s/3ZL3 13q ---------------------------------------------------- List the expenditures you made on account of this accident or injury: . DATE ITEM AMOUNT el-/y 92 7-0 Aa Gaff 5-0 G , y t SGS a&o&zo/ le, G,o06, /y Gov. Code Sec. 910.2 provides: "The claim must .be signed by the claimant SEND NOTICES T0: (Attorney) or by some person on his behalf." Name and Address of Attorney laimant's Signature Ad ss AWA ,laza.. lflcho nW Telephone No. I Telephone No. (S/16) Z 2 2-S-JGU- X�1� N O T I C E Section 72 of the Penal Code provides:- "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized -to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. CLAII`- SEP: �L1�'J1 ._:,R#_ U 13TEL: BCO# �—SALN: _ ❑ P.D. INSURED: �� `'� � nUC S „n r��nAOL.# `�(P �.Z� y�5 � �-S D/L: Sc I 1 31�r Z ❑ THEFT CLAIMANT: LICENSE #: S �3 STATE: ❑ FIRE COMPANY: ❑ FARM i- MCA ❑ TRUCK ❑ TEXAS VIN: ��2,M X �a . �L UUP -7 SUBRO C ❑ NO ❑ ALL OTHER VEHICLE DESCRIPTION VEHICLE bbilbITION YEARc� + ry� TRANSMISSION: Body / Sheet Metal MILEAGE I 3 p STD I<AUTO MAKE T o ❑ABOVE AVERAGE' .. ❑AVERAGE ❑ BELOW.AVERAGI ENGINE SIZE: `J ,y ❑ 3 s ❑.4 s . ❑ 5 s . ❑ PREVIOUS BOQY DAMAG - MODEL . . oss; WHEELSMIHEEL COVERS: Describe: �' 1 r. EDITION �CLJ CYLINDERS(cir p STD 0 WIRE Est. knount$ 16 Co DRIVE 3. 4.. 5. 6 Z. .. 8. 12 ❑ MAG ❑ OTHER p R7er DAMAG GAS ❑TURBOISUPERCHARGED BATTERY: Dbe UDOORS Ll BRAND: Emount$ ❑ DIESEL AGE: J ❑TRIM DAMAGE BODY STYLE �� �, . Describe: . EQUIPMENT / OPTIONS (circle) Est. Amount$ POWER OPTIONS D COR/CONVENIENCE pl0 ROOF OPTIONS MOTORCYLES pale! ❑METALLIC ❑TWO TONE ❑ OTHER ' PS%Pwr Steering it Conditioning AM V Vinyl Roof HE Headers Pwr Brakes ear Defogger FM ES lectric Steel FF Full Fairing ❑ ABOVE AVERAGE ❑ AVERAGE ❑ BELOW AVERAGE Pwr Windows . It Wheel Stereo Electric Glass PF Plexi Fairing D Original ❑ Chipped L- Pwr"Locks ruise Control A Cassette MS Manual Steel CU Custom Seat ❑ Mismatched [-]:.,.Other damage S Pwr-Drive Seat eather Seats SE Seek/Scan MG Manual Glass MB Saddle Bags p Oxidized PC Pwr Pass Seat D 4 Whl Disk Brakes 8T Eight Track FR.Flip Roof'_ TV Travel Trunk ABS Anti Lock Brakes TL Telescopic Wheel. CB CB Radio TT T-Tops - GE Engine Guard ❑ Explain: AB Air Bags AL Auto Load Level, CD Compact Disk RR Roof Rack ' GC.Case Guard_. Interior. ❑VINYL: -_D CLOTH ❑.LEATHER 'O OTHEI 3S.3rd Seat(Wagons only) EO Equalizer. CT Soft Top RS Back Rest. b \�. (0� 4 J\��� HT Hard Top Other O ABOVE AVERAGE : ❑AVERAGE BELOWAVERAGI TRUCKS/VANS/UTV'S/OTHER ``" ❑ Soiled rnlCr D d SB Step Bumper. DT Deep Tinted,Glass ..TP Trailering Package . package SW Sliding Rear Window DA Dual Air Conditioning 8P.Eight Passenger Set ea rner ..❑ Dash 't] Carpet XT Auxiliary Fuel Tank BD Running Boards RB Roll Bar.:. Heavy.weaf SY Sport Wheels FL.Fog Lights TB Tool Box (Permanent) p, Other(explain) 2T.. None PaintBL Bedliners GG Grill Guards.: D2.•Deluxe 2-Tone Paint AR Chrome Bed Rails . . PO Positraction. SETTLEMENT DETAIL Mechanical . ❑ABOVE AVE RAGE .`.- O AVERAGk❑BELOW_ AVERAGI VALUATION METHOD USED: Obvious Def cts O R ent VALUATION LOSS OF USE . Explain: ADJUSTMENTS-$ APPARELILUGG $ ❑Verificat $ cord:.:.,DEDUCTIBLE ❑ Receipts. _ ;. U do(, 71 i..,} )o LESS SALVAGE $, ❑ Other' .. Tires SUB TOTAL. $ NET TOTAL $ RJrU(a �� LT. FT 1 32 FT 0 /.,32 SALES TAX $ DISTRIBUTION OF PAYMENTS LT. RR. RR. %-132 LIC.1fRANS. FEE $ !y. D ' OWNER` $ (� SUB TOTAL $ MORTGAGEE ' $ SPARE ,.l 32 BRAND: SALVAGE REPORT Overall Rating ;. LOCATION OF SALVAGE: n p l! p Exceptional ❑Average :% �_C t c-v 7<� - ,23 ❑Above Average ❑ Below Average NAME ADDRESS PHONE#_. SALVAGE RELEASED T0: Salvage Bids �'�� BUYER AMOUNT - PHONE �.. SALE#' STALL# NAME ADDRESS PHONE# 2.. ADVANCE TOW,$ r '.' 0 YES o NO DATE RELEASED: 3. STORAGE/DAY $ ` -" ❑YES O NO BCO# SETTLING 4. SERVICE CHRG $ ❑YES' ❑NO BCD#SELLING REPORTED TO COMPANY REPORTED T fB/COI. ASSIGNED,TO 1ST C CR SIGNATURE DATE DATES � !'7 ��� C�12 REPORTED TO NATE ASSIGNED TO VENDOR DATE SETTL�DI SUPER OR ROVAL DATE ' 23-0637 5i90 11001 wizoo ciaoo v' 17 9' — GJ(e 2 .O. COPY .. • • ' '•� f �t � .. .� _.. �y ..._ .-.._ _ _ _ .. _I - - - _ � r,�� � .. .. .„... . . . .. .. . .. .... .. `�l _ .. __ ' uv. ., .,y� _ _. _ uto Non Former t 8 F,3e 6 S FARMERS INSURANCE GRO . RECEIPT Q OF COMPANIES • t n ® 86 UP Cas HIM Check gMOU1VT$ ' O Fa„�. 0 Pmt: i RECEIVED CHECK# s 310 Sib 31 r .l^ OF j.... 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F �i "v' 5*} • �� 1't;�Smu P x rt• t _r. ��d My �t �, � t 1 �a�. d r �°�;�,�..�9�.,c - fir`d "� 'v '{;2 a. ��r�,o�� a r ty fn•.i� .� !� � s Y adq �'"dw,i'i jy; �m i "v;r`iM �' �t � � r F` +�,p (�s,,�,. .r� •`l� s°�f•h r �r � .� , �•: yal;�4 , '44 i 7s S* t'.. r k ,J {I ADP V A L V A - T I O N SERVICES VALUATION ' C920902 . 1350 1 _ SYS ___-___ -_ __ ._ ___-____----_ _______---____-- ---_____-`- II Received : 09/02/92 ; 11 :51a PST Available : 09/02/92 ; 11 : 52a J _____._____ ___________----^- --. -y ___________ KIM MURPHY INSURED SANDHU FARMERS INSURANCE GROUP CLAIMANT <� 3211AUTO PLAZA CLAIM 1,10 0763013 RICHMOND , CA 9480,6 ONLN LOSS DATE : 08/ 13/92 -- __----_-- __-____. --___ __ _ _____.-w_____.--------------------_--_-.__- VIN : JT2.MX63E6E0052773 NO ERRORS FOUND YEAR : 1984 DCDOiZlSEXT COND : LOW GOOD MAKE : TOYOTA BODY SEDAN INT COND VERY GOOD MODEL : CRESSIDA MECH GOND: GOOD EDIT LUXURY COLOR : BLACK TIRE GOND: GOOD _..--------------,---_----___-..._____--_.__.___.__. _ COMPUTATION OF CURRENT LOSS ADJUST j MARKETVALUES - VALUE --------- ---------------------------------- ------ .____ BASE. VALUE 4210 4210 1 ENGINE ' STD 6CYL-2 . 8-GAS 6CYL- 2 . 8-GAS 0 TRANSMISSION STD 5-SPEED AT-3 120 EQUIPMENT: AZR CONDITION STD YES p CRUISE CONTROL STD YES - 0 * REAR DEFROST STD YES 0 REMOTE MIRROR STD YES 0 * POWER ANTENNA . STD YES 0 *. POWER:.k3RA�tE,S STD . .. YE5 0 .. * POWER LOCKS"- STD YES 0 '�. POWER STEERING STD YES 0 '; � . 'POWER WINDOWS . STD YES qr- PWR/SUN ROOF., 120: YES 120 ,'' 1 VELOUR SEATS STD YES 0. , LEATHER SEATS 180 YES 180 TILT W. HEEIL STD YES 1 0 * ALUM WHEELS STD YES 01. AM/FM STEREO STD NO 0 DLX SOUND 105 YES 105 p'EQUIPMENT SUB TOTAL 405 - SPECIAL OPTION! PACKAGES : (NONE)` ___ __ ___ --------- - ------ 23.0618 8-91 12201 C/1 100 I VALUATION C920902 . 1350 (CONTINUED) II COMPUTATION OF CURRENT LOSS ADJUST I MARKET VALUE VALUES VEHICLE -MENT. ------------------------------------ --------------------------------- CONDITION ADJUSTMENT 0 � . MILEAGE ADJUSTMENT AVG 118 , 000 .100 ,000 2.00 ____-_-_____ ------------------------_._ -__-___-..._ -_.-_-----._-..-----_ NOTE: VALUATION FOR LOSS VEHICLE : -- $ 4935 Indicates options PRIOR DAMAGE ADJUSTMENT: $ 1 found on a majority of AFTER MARKET EQUIPMENT: $ . . . . vehicles of this year , OTHER : $ . . . make, model , edition . ADJUSTED VALUE : $ . . . - -_-__-_-_ --------------------.__.---- __-_-. ----.-- --__._.._-._ _._.._--__---w_ COMMENTS : PREVIOUS DAMAGE REFLECTED IN RATINGS ; I' I " I I { I I I I ( I • I s II i I I I I. I 23-06188-9112201 Cl1100 A D P V A l_ U A T I O N S E R V I C E S I . VALUATION C920902 . 1350 --__._--____-___ __-_.---------------.:_-_______-.-- -------_ $ MARKET PRICE TREND -- 1984 TOYOTA CRESSIDA LUXURY _____________________ __ - _-_-___- 5350 _*.. I. 5300 f µ� 5250 5200 � . 5150 o' 5100 0 5050 o 5000 0 4950 f 0 0 4935 4900 4850 4800 + ------ --------------------------------- .. _._.__' MAY ,.tUt�! JUL `-YW- -__--_ ------ AUG SEP__ APR I. ____________-___-_-_--______--_____-_-___-______ 'et ________________-.__.ORIGINAL. EQUIPMENT GUIDE YEAR ..- 1984-M--`_---_ -- CYL- LIT/CID TYPE COST---_ TRANSMISSIONOPTIONS . I\, MAKE TOYOTA 6 2 ..8/ 170 GAS STD AUTOMATIC 3 SP 400 MODEL : CRE SSIDA 5 SPEED, MANUAL STD . EDIT : LUXURY DOORS : 4 BODY.. SEDAN ' BASE V: 1 STD` :AIR aCOND -y~�-STD _:pWR ANTENNA --500 -: PWR/SUNROOF STD :ALUM ' WHEEL STD :CRUISE STD :PWR BRAKES N/A :OTHER ROOF N/A :AM;'RADIO. . STD .: REAR DE6 STD :PWR LOCK5 . NfA :VINYL ROOF N/A . :AM/FM STD- :REPO MIR N/A :.PWR SEATS STD :VELOUR SEAT STD :AM/FM ST 245 :TUTONE.. FAINT STD : PWR STEER 600 :LEATHER SEAT N/A :AM/FM TAPE' . STD : PWR WINDOW STD :TILT WHEEL 480 :DLX SOUND -------. ---_-__- --------------------------------------------------- OPTION PACKAGES : DIGITAL GAUGES 480 I ------------------------------------ -------- --------------------------- For, further, as5'istance please contact the ADP//Autotr,ak Account Services Department for FARMERS INSURANCE GROUP AT 1 -800-347-4237 EXT. 3040 _____.__------------_ ------------------- --- ------------ INSURED : SANDHU ADjUSTER MURPHY I . CLAIM # : 0763013 LOSS DATE : 08/ 13/92 I 23-08188.91 12201 C/1 100 A D P V A L t_I A T I 0 N S E R V I C E S VALUA -------------------------------------------------------- -_._--------- SON ---C920902 . 1350 3 --------___--_--------._____ . The following local Dealers are among those who provide information to ADP" �., concerning available vehicles which may be suitable to replace the lost vehicle . HILLTOP NISSAN RICHMOND CA (415) 222-4900 SMITCH JEEP-EAGLE RICHMOND CA ( 510) 237-8269 s; SMITH CHRYSLER-PLYMOUTH RICHMOND CA (415) 237-8289 HILLTOP DODGE RICHMOND CA ( 4- 15) 222-4122 1 FAIRFIELD TOYOTA FAIRFIELD CA ( 707 ) 443-3155 AUTOWEST TOYOTA FREMONT CA ( 511 ) 795-9595 CROSSROADS TOYOTA-PONTIAC DUBLIN CA ( 510) 629-7700 FAIRFIELD TOYOTA FAIRFIELD CA ( 707 ) 422-3060 (, --------------------------------------------_-___----_ ----_--_...___-___-_--- -.___ DEALER VEHICLES - - ----_-. ______ - - 1984 TOYOTA- CRESSIGAY- LUXURY-•4-DRPHONE : ( 510) 638-'4428 �N--�- CITY : OAKLAND I, LLOYD WISE NISSAN 08/20/92 AIR CONDITIONING POWER WINDOWS POWER LOCKS AUTO 3-SP TRANSMISSN 6 CYLINDER ENGINE CRUISE CONTROL � . POWER BRAKES POWER STEERING ALUMINUM WHEELS TILT WHEEL POWER ANTENNA REAR WINDOW DEFROST' VELOUR SEATS REMOTE MIRROR ASKING PRICE : $ 5684 * TYPICAL SELLING PRICE RANGE : . $ 4825 - $ 5590 _- - - _ -..-- --------PRIVATE------------------ ------------------------VEHIC�,ES .,. __-_ _________ ______________________ _____-______________- 1984 TOYOTA CRESS"IDA LUXURY 4-DR PHONE : ( 510) 531 --9057 CITY : OAKLAND USAN JOSE AUTO TRADER DOMESTIC 08/07/92 'COLOR : TAN 1 AIR CONDITIONING•,. POWER WINDOWS POWER LOCKS AUTO 3-SP TRA.NSMISSN MANUAL SUN ROOF LOADED CRUISE CONTROL POWER . BRAKES POWER STEERING ALLOY WHEELS TILT WHEEL POWER ANTENNA J' REAR. WINDOW DEFROST LEATHER SEATS REMOTE MIRROR ASKING PRICE : $ 4500 TYPICAL SELLING PRICE RANGE : $ 3690 - $ 4275 (CONTINUED ON NEXT PAGE) 1 -----INSURED : SANDHUT-�+----�----`_____-.--_--�-' ADJUSTER- MURPHY CLAIM # : 0763013 LOSS DATE : 08/ 13/92 23.0818 8-91 122010 1100 1 ,, 1. - A :D P V A L U A T T O N S E R V I C E S VALUATION _ x920902 V135Q REPRESENTATIVE VEHICLE DATA: (CONTINUED) _______..________________________.__-__-_--________--. --____----___.__.____.____ 1984 TOYOTA CRESSIDA LUXURY 4-DR PHONE : (415) 994- 1775 CITY : SAN FRANCISCO SAN FRANCISCO EXAMINER 07/26/92 I , AIR CONDITIONING POWER WINDOWS POWER LOCKS AUTO 3-SP TRANSMISSN CRUISE CONTROL POWER BRAKES POWER. STEERING ALUMINUM WHEELS TILT WHEEL POWER ANTENNA REAR WINDOW DEFROST VELOUR SEATS REMOTE MIRROR ASKING PRICE : $ 3700 TYPICAL SELLING PRICE RANGE : $ 3034 - $ 3515 I - - TOYDTACRESSIDA y -- LUXURY- 4�DR--Mµ--y-Y-`--N-- PHONE : (415 - , 479-8614 w------ 1984 I CITY : SAN RAFAEL SAN RAFAEL GAZETTE 07/ 12/92 ODOMETER : 134K (` COLOR.: BLACK AIR ..CONDITIONING POWER WINDOWS POWER LOCKS AUTO 3-SP TRANSMISSN CRUISE CONTROL. POWER BRAKES POWER STEERING ALUMINUM WHEELS TILT WHEEL AM/FM STEREO POWER ANTENNA REAR WINDOW DEFROST VELOUR SEATS REMOTE MIRROR ASKING PRICE : $ 5200 I;. * ' TYPICAL SELLING PRICE RANGE : $ 4264 - $. 4940. _w---__-_-__ ------- ---- ----------------------------- --------_ .. . _ _ _- --- - 1984; TOYOTA CRES1.SIDA ' LUXURY 4-DR PHONE : ( 510) 376 8.86 CITY : MORAGA I . SAN FRANCISCO EXAMINER 06/28/92 AIR CONDITIONING. POWER WINDOWS POWER LOCKS ' I CRUISE 'CONTROL POWER BRACES POWER STEERING ALUMINUM WHEELS TILT WHEEL POWER ANTENNA REAR WINDOW DEFROST VELOUR SEATS REMOTE MIRROR ASKING PRICE : $ 5495 I.. * TYPICAL SELLING PRICE RANGE : . $ 4506 - $ 5220 I I I * THE selling price of vehicles of the same year , ma4e and model -typically ranges from 5 - 18% below the asking price , reflecting variance:.Ls, in equipment , I mileage , condition and each unique buy-sell situation . I ------- ----------- . INSURED : �SANDHUW______________ ADJUSTER -. -MURPHY -~y--wNW-a---�- CLAIM It 0763013 LOSS DATE : 08/ 13/92 I 23-0618 8.91 12201 C11100 •. '�t.'!.� hi ut9 't � :�: M " 1:H.,.la. � �, v.�..a ..�.u,...i�.� 1'ti ..r-�._�.�.............n_ ._...,......�._-..�a.s�..-...�_ a)' ... ....�r�-:r i ,f.:.,ltE;.,'Y' :d+/ F .. •�✓,r.l�:, -. �S. .�. - -. .. -- RICHMOND TIRE: 08-Market Ave; SAN PABLO, CA 94i . '(510) 237-2712 JA4z•�l•c +c+PS�`y �A'�3' +�f5a�` CUSTOMER'S ORDEfl NO. PHONE DATE NAME ADDRESS C i"' ``C OD s CNAROE S ON ACCT MDSE RET D' PAID OUT {tt .N'S d Coy' g3xs.,r+i y,•.< �*v -:U,1.. b "� 4 3R� 'Ai°�r'` , 'Y^7- L11 r q. n.. _.................... L:. �1.....................:........................................... . ........... _ .........1......�.__.... r "-, _ ........ m RECEIVED BV '+... � q TOTAL All claims and returned goods MUST be. accompanied by this bill. '77w-Ou .* v� s Q o 4Q�6'�• '-PNOp1Cf 609 bees Ix GMan km 1171 ' _ 4. ts'ar s ;' .,t'�i-'*a"Y Jr�r. , � Hyl%� ';i>t';� r:KW+"P,/a'•£t a1"34�.?i: .r +i�ki t1. t h ! JC..e'�Q+1,rY a 4Y„t, ainti t:�1>+�"� S ,w i tt���,•�a 'F7S .ti.�' - + F - /4 �- _ ...> i_.� a- eS j+e,.a.+0�f; .-`_�}r +'"z'Tr�-g...�� y i�'.,l. t ♦Y 4,? 7x,E"'�°X� H'C 7 ,�sk...'F ti�� j [ .. r.. ./ _ _ s- ' t [ FOLDIHERE O 71 Q \m i J 0 jf ro oo m m O 4 m 0T, m z C- 0 m � Qo i a i co f j j to a =rZ to .44 ( Q N• o^ p y ted 0) ur kjqR x t'> o a CD _�� J > X rr, W Z I v00 _. M ' --1 5rr ►`� o m 00 x a _ r,f Q • Cf•• � ;p.= a � Q o 00 � :fr3{`:f���t F."t^*K-.• �'"���a w z � .. zt"ir 2"YYa y�, i;i tr-' tr.t. � 'q'�. St,°�{�C�x } :�. - r.�.e ��'� r �',�..t - �i��",�~N J� !•t�J r. r'n S 3��.{5t'J�r i t it i ., �, . . _ . . , i � i. 4 `. ` `! ,� -'ti � �t l '� `F ti � + t ��� � w .. � , - ` '_ - . i .. � y_, ..' f, .} `', �< . ; -' � •• } S�� 7' a A u �y t p L u7 3, p,O N..• - m to / N n b {\ x mi O o C m ,x O @b NC. . r .mac e A q a A p a md .m i n m �o�$ r o m LS 'o t9 N P.n co a fop n C in o o n 'f► rt. ;c C� O N m C-1 o s (� �b 0 m mss'"m9 f� M `� moi. a 9 M- 4 �� me -1110V6. CD lo iizz 7- CAW cov 0 o mby�Va m �a oQ,o4� w �.. 31Sa tall o Vii 's13 �" o 'm g .m e t Z N 03m RZ s G 9 rf7 CZ 90 nA -A Sv �o� 1� Q1 Z p� inp! 'r .4 7. n 01 NWy6Yp3°� Q C if 9 O �nm$s3c A Ap�FtANG`�CK i,. `, CPSN U�pp�PN INFORM � -, BERMS p�E gEE - S i � � � � �. _ �. v. i � ` � ., 9 .. .� i ' � - , - ' 6 _ 1 _. .. i ._+ � � .. .. _ . ._ Y�`♦ � � tY �. .. � �� ` } 1 i - .� } •' ., ( 1 t ' � � , � � y .i i � ' i ' �. .r . ' � � STATE OF CALIFOPNIA / 60492052217 CERTIFICATE OF TITLE > f . : AUTOMOBILE YR, ; �s( } /fffSlf -;VEHICLE ID NUMBER, :. - MODEL, MAKE t>y„it JT2MXb3Eb005277.3 84. 70YT� 4 , ,i i .• UNLADEN i E , '. w } •-i t 1 -••t # REGISTRATION { `w- ! U fI7fE'EEi! BODY TYPE MODEL AX WEIGHT FUEL TRANSFER DATE FEES PAID # # ,MTM DATE do S1�- , `G- 0�t, 2 i35 OED T CLASS. 'Yfi MO EDUIPARITAUST NUMBER Sok ISSUEE DATE AQ 92 XE � ,'06l07/f92 f, '” :n vy }.�}` s ,tit vs= 'MOTORCYCLE ENGINE NUMBER ODOMETER DATE ODOMETER NEADItKi °' �Tut- sa �; � .�4! E-�•�-i15; §§ a .. Fly REGISTERED OWNERS) SANDHU PUSHPINDER SINGH ta,ere 807 WINDWARD DR : b %v, RODEO CA 94572 .. .. - L' t ,i 3 j7. r yy � E li fryr,'� FEDERAL:LAW'REQUIRES Ghat you state the mileage upon trahsfer of ovvnershlp tsai(ure to complete oc making; tt ;r�� a false statement may,result m fines and/or imprisonment: a- arz i t g:Is , (nb tenth )whjch Is:thf actuai'mileage of;A6 Odometer readinvetuCteltnesI,or yf to o#Jott rt�EStatementsr ';tt((Tft1. ...,_ ;st { r t }� ' liftE#Iffy; Is checked WARNING Mileage Is not the actual mi eage : O Exceeds thea odometerlsleCktaotca[Nmd r f'a w I certify under penalty of perjury-un erthe laws of the'State ofCallforni�that+tltg slgnaturt s b' lovr releases ' Eptelest lr� e;v0fiicle,And;cglrtifie�t9 thfy::tru , . nd;sccuracy of,the�rtflea 'wfor 1 t }t} a�x . $�. �.. y {f- - .••�.' { ..y.. ,')'�j 1 ..��.1-• ,.- (i. �� t tet,—/�!t "►"'# J".���� �: ��I�""��f�'V'•�f 1 9";^�y �. .mss ;1a.. ^ � -C:.. "� ' ���%//- t ,-•-, i * wr;�r�ri-�aif t f=.tf���ys~ �'a SIGNATURE OF REGISTERED ' ei A Y v' 4�•des v �.y>s i! i 1 li E, + r � 1 : -1 t i X -i I.. �i- vii • •>; } �f f i-3�I f"�l f t-4--d t':�-►`�:_..� �';9#8-�.}: { ��: _ 4 •j!! _ ' DATE SIGNAW9E 4F IBVpS A.FA E �r IMPORTA'AITREAD CAREFO,1Y.► �{t)tEEEtEt _ t r c t Lj#ftfff fpm!change oftephol�er,{holdQ�o� securEty rntest�must be reportedit4 3t�$ofltao�lehfeles wtlGti •�� OR R IQ days .1+ij ! '�"'� .t,.�i.�.a3.+ + -t -��^'3 -•-r -i 5. 2' �".i cr� �� �-j�""'a.wT "`�°7 w � � ... U •' I ; 1 ^Y ((1 S 'S ^'T t i-Y {"V 's'-x�'d R ^'?'� 4 T- ?t'� d a . 7.Y } } :v .: ca+ �-. + � e} -x s... a , i -a..: s, -•-.a.- w-} �•.A�.o....-i 1+v a u�w• cap .-V-a sr n rs r � --rw-' �r t{ 3 7 6 4 r` Y tit Y f E $1gflEtUfe fele ��lterl511B Veh'c18 t y 1 r i f t c ,t t a r ¢ ,t i I ,N6-r" 011911 f t E P'2r t; siflttvll „". HSG ax 30�REv C1 9i ;s#f##tEf1 r � . .. • -, r -'a�' ' �. :� �.. .. ... .... .•M1 I - - __ CVS: Lienholder�'erificittion System Print - Version 9. 14 REFERENCE 0: 07-63013 LaA 1-E: 09/02/12 TIME: 1 1 : 47 Request: 2V::C5 3 • Requested EXP: 02/12/93 LIC: 2VSC53 VIN: JT2i 1Xb3EfaE1i�i�277 - .. : 4 YRMD: 84 *YR0 92` MAKE: TOYT BTM: SD. R/O: SANDHU PUSHPINDER SINGH 807 WINDWARD DR RODEO CNTY: CONTYA -COSTAZIP: 94572 SOLD: 00/00/S4 RCID: 05/22/92 OLID: soh 07/92 LOCD: TYPE: 11 VEH: 12 BODY: it CLAS: AO FEE: 0000 POWR: G _ • f REC STATUS: 05/22/92 . VR INSPECTION EXEMPTION NO MAILING ADDRESS 02/1=/91 - PREV LIC 1JXP-13:a . --- END of LV5 Printout CCR Exact Fee Calculation Transaction: Prorated license fee ref=und Processing dates 9/ 2/92 Last fee paid: 2/12/92 Loss date: 8/1.3/92 License Fee paid 51 .00 License Fee used - 30. 00 DMV Administration Fee - 7. 00 LICENSE FEE REFUND: 14. 00 i{r --- END of Fee Calculation - _- 29-08188.91 12201 G1100 •��j e+b�v t '^��' 1 tz Al J' G o � Q o 0 Q 1 . 17 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA p EG 2 8 1992 Claim Against the County, or.District governed by) BOARDCN( MMCOUNSEL the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT JANU� C :3 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $7:;:000:;.000..00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MICHAEL, John Douglas ATTORNEY: Thomas C. Knowles Van Blois & Knowles Date received ADDRESS: One Kaiser Plaza Ste. 2245 BY DELIVERY TO CLERK ON December 21, 1992 Oakland, CA 94612 BY MAIL POSTMARKED: hand delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 23, 1992 JYIL BATCHELOR, Cler epuII. FROM: County Counsel TO: Clerk of the Board of Supervisors (1) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: �a-K K (o i9 q 3 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. BOAR�DRQ 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: JAN 2 6 1993 PHIL BATCHELOR, Clerk, BY,, Deputy Clerk WARNING (Gov. code se 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: JAN 2 6 1993 BY: PHIL BATCHELOR b 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. p I - RECENED WC 2 11992 CLERK BOARD GF SUPERVISORS 1 VAN BLOIS & KNOWLES COi�TRA COSTA COQ, One Kaiser Plaza, Suite 2245 2 Oakland, CA 94612 444-1906 3 Attorneys for Claimant 5 6 J 8 IN THE MATTER OF THE CLAIM OF JOHN DOUGLAS MICHAEL .9 against CLAIM 10 COUNTY OF CONTRA COSTA 11 / 12 TO: COUNTY OF .CONTRA COSTA 13 John .Douglas Michael hereby makes claim against the above- 14 named public entity for the sum of one million dollars 15 ($1, 000, 000) ., and makes the following statements in support of the 16 claim: 17 A. NAME AND POST OFFICE ADDRESS OF CLAIMANT: 18 John Douglas Michael 7.441 Flagstone Drive .' 19 Pleasanton, CA 94588 20 B. POST OFFICE ADDRESS .TO WHICH NOTICES CONCERNING THE .CLAIM ARE TO BE SENT 21 Van Blois &Knowles 22 One Kaiser Plaza, Suite 2245 Oakland, CA 94612 .23 C. DATE, TIME AND PLACE OF THE OCCURRENCE OR TRANSACTION 24 GIVING RISE TO THIS CLAIM: 25 The events giving rise to this claim occurred on or about June 26 27 , 1992 , on the public street and highway known as Crow,. Canyon 1 1 Road, at or near its intersection with the entrance/exit road to 2 the Cobblestone subdivision, in the City of San Ramon, County of 3 Contra Costa, State of California. 4 D. CIRCUMSTANCES GIVING RISE TO THE CLAIM: 5 The circumstances giving rise to this claim are as follows: On 6 or about June 27 , 1992 , and for some time prior thereto, the above- 7 named public "entity, by and through its agents, servants, employees 8 and independent contractors, so negligently and carelessly 9 designed, constructed, owned, operated, controlled, maintained, 10 repaired, and equipped the aforementioned Crow Canyon Road, the 11 .entrance/exit road to the Cobblestone subdivision, the intersection 12 thereof, the approaches to said intersection, and the structures, 13 signs, striping, contours, cross-sections, alignment and" other 14 things upon, adjacent and appurtenant thereto, such that the same 15 were caused and all.owed to be, and. were, in a dangerous .and 16 defective condition, constituting, in certain respects, a concealed 17 trap for motorists thereon, in that, among other things : there was - 18 insufficient and inadequate sight distance for motorist_= travelling 19 east on Crow Canyon and north .out of the intersecting entrance/exit 20 for the Cobblestone subdivision to be able to see each other 21 adequately and safely so as to avoid colliding with one another; 22 further, there were inadequate and insufficient warnings to 23 motorists travelling in each of the directions set forth above of 24 the unseen presence and potential hazard presented by motorists 25 approaching in the other direction; further said public property 26 failed to have adequate and sufficient signs .and warnings and other 2 P 1 devices to safely control and curtail the movement of traffic 2 through said intersection with dueregardfor the inability of 3 eastbound and northbound Motorists to have sufficient view of each 4 other to safely negotiate . said intersection. Other conditions as 5 yet unknown may have contributed to the dangerous and defective 6 character of said public property, and to its concealed traps, and 7 claimant will pray leave to assert same as they become known. By 8 reason of the foregoing, said public, property was in a dangerous 9 and defective condition, constituting, . in various respects, a 10 concealed trap for motorists using same, and creating a substantial. 11 risk of harm to persons using same, and the property adjacent 12 thereto, with due care in a manner in which it was reasonably 13 foreseeable said public property would be used. Also, said public 14 entity was further negligent and careless in that, by and through 15 its agents, servants, employees and independent contractors, it 16 knew, or in the exercise of ordinary care should have known, of the 17 dangerous condition of said public property, of the concealed traps 18 thereby created for those using same, and of the risk of injury 19 created thereby, and nevertheless failed to remedy said condition, 20 although having a reasonable opportunity to do so. 21 As a direct and proximate result of the negligence and 22 carelessness of said public entity, and of the dangerous and. 23 defective condition of public property, and the concealed traps 24 thereby created, as aforesaid, at the time and place hereinabove 25 set forth., a "1991 Yamaha motorcycle, being then and there operated 26 by claimant in an easterly direction along and upon said Crow 3 1 Canyon Road, was caused to collide with. a 1991 Nissan Pathfinder 2 automobile, bearing California license 2XEL556, being then and 3 there operated in a northerly direction out of the entrance/exit 4 for. the Cobblestone subdivision and across the. eastbound lanes of 5 said Crow Canyon. Road. As a direct and proximate of the foregoing, . 6 claimant Was caused to sustain .severe and permanent injuries. J 7 E. NAMES OF PUBLIC .EMPLOYEES CAUSING .INJURY, DAMAGE OR LOSS.- 8 OSS:8 The names of the public employees causing claimant' s injuries 9 and damages are unknown at this time. 10 F. ITEMIZATION OF CLAIM AS OF DATE OF PRESENTATION: 11 The amount of the claim as of the date of its .presentation is 12 the sum of one million dollars ($1, 000 , 000) . The basis of 13 computation of this amount is as follows: 14 Expenses incurred by and on behalf of claimant for the services of health care 15 Practitioners and facilities to care for and treat claimant's injuries both to date 16 and in the future, in an amount presently unknown, but estimated to be 17 the approximate sum of:. . . . . . ... . . . $100, 000 . 00 18 Damage to claimant's earnings and earning capacity both to date and 19 in the future, inanamount presently unknown, but estimated to be the 20 approximate sum of: . . . . . . . . . . . $200 , 000 . 00 21 General damages in the sum of: . . $700 , 000 . 00 22 Total: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . $1, 000, 000.00 23 Dated: December 21, 1992 VAN BLOIS .& KNOWLES 24 25 by Thomas C. Knowles 26 Attorneys for Claimant 4 Counsel CLAIM JAN BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, C ARNIA l%g.� a ez. �qq Claim Against the County, or District governed by) BOA _ ON the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT January 26, 1993 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: NELSON, Douglas Raymond ATTORNEY: In Pro Per Date received ADDRESS: 2830 Emerald Drive BY DELIVERY TO CLERK ON Dprpmher 289 1992 Walnut Creek, CA 94596 BY MAIL POSTMARKED: vi a C oijnty C:niinsel 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Januar 8 1993 PpHHIL BATCHELOR, Clerk DATED: y ' Bl: Deputy ad , II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ✓ This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 1 113 BY: /4 �. 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 ORD 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: JAN 2 6 1993 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions. you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JAN 2 6 1993 BY: PHIL BATCHELOR bDeputy 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. CONFIDENTIAL COUNTY COUNSEL'S OFFICE RECEIVE® CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA DEC 2 81992 MEMORANDUM CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Date: December 28, 1992 TO: Jeanne Maglio, Clerk of the Board FROM: Victor J. Westman, County Counsel By: Gregory C. Harvey, Deputy County Counsel RE: Claim of Douglas Raymond Nelson Attached for your attention is a claim received from Lieutenant Tom Moore of the Sheriff ' s department. This apparently relates to an alleged failure to transport a prisoner properly. cc Lieutenant Tom Moore (Without attachment) ;TORNEY OR PARTY,WITROUT -AATTORNEY(NAME AND ADDRESS): TELEPHONE NO.: FOR COURT USE ONLY JDCLI GL AS N- [W Mr N D 1�i FuS6,N e'S76I S-3K`1.5-s�_ —;4 i T.—) F=l N C Y P Fz,0 PG-- 1-`-- 'S:50 Z'S:50 EM EFZ/ALDDr2�VL t,✓/41-/vu r z rREEe. LA 9ti59� r fTORNEY FOR(NAME): UPERIOR COURT OF CALIFORNIA, COUNTY OF C N MA CLS TA STREETADDRESS: 1()RC, WApr STREET (JLIVCNILE aVPr 4AILING ADDRESS: FACS i G I=F(LC 3C X 9// TY AND ZIP CODE: ( 11A-2rIN Z BRANCH NAME: 1 dV RE AT KLENE MME ELSON:.*we awid3R TITIONER: SPONDENT: ORDER TO SHOW CAUSE AND CASE NUMBER: DECLARATION FOR CONTEMPT <70` 1602 NOTICEI IAVISO! A contempt proceeding Is criminal In nature.if the court finds Un procedimlento de contumacla es de indole criminal.Si la you in contempt,the possible penalties Include jail sentence and torte le encuentra en contumacla,los castigos posibles Incluyen fine. sentencia en la circel y mufta. Usted bene el derecho de los servicios de un abogado a qulen You are entitled to the services of an attorney who should be se le Bebe consuttar ensegulda para que pueda asistirle.Si usted consulted promptly In order to assist you. if you cannot afford no esti en conditions de pagar los serviclos de un abogado, an attorney.the court may appoint an attorney to represent you. la torte le podri nombrar un abogado que le represente. 1. TO CITEE(Name): S .L YNC-/ w,r s, �/ � .ry Cr,��rs 720N I 2. YOU ARE ORDERED TO APPEAR IN THIS COURT AS FOLLOWS TO GIVE ANY LEGAL REASON WHY THIS COURT SHOULD NOT FIND YOU GUILTY OF CONTEMPT AND PUNISH YOU FOR WILLFULLY DISOBEYING ITS ORDERS AS SET FORTH IN THE DECLARATION BELOW AND REQUIRE YOU TO PAY,'FOR THE BENEFIT OF THE MOVING PARTY.THE ATTORNEY FEES AND COSTS OF THIS PROCEEDING a. date: time: 164,,-� in=Dept.: 1Z El Div.: [=]Rm.- b. Address of court: Dated: . . . . . . . . . . . . . . . . . . . . . Judge of the Superior Court DECLARATION 3. Citee has willfully disobeyed certain orders of this court as set forth in this declaration a. Citee had knowledge of the order in that(specify): "IMDE.P o�REPVIU/L &/!tea REQulleel:�) rRAT X- Q0-rtealc-, T-o THC I=Aeit-Ir/ Fi9-ovI WhYZi-/ r wrlS Pr71ZVA50 �O 2`LSE-Pr 9 2 �if�JD/D l J141 FN4[Y DELo'� IV S49✓CrN.C-7Au77A/ /.V �. fcc/fir 21 29,M q-Y 92 S%/Lc.D/o /-r Y5 6LIAV,7'A1 //✓ _s5 ezz,St.c,, TCtz2��� fCA4s7lJ1f.1G Fu[Li✓mac .a4/.O ��ucr.uL- L�uPr f3,cZo6t_' 77!l.�TS w,�� �Er��cur-r� Ffi'�.✓! "�L.LSG,r� " b. Citee was able to comply with each order when it was disobeyed. WZ-Zl.0 1-7 Y4 aE Tl 4. Based on the instances of disobedience described in this declaration,there have been a.IW No prior applications b.Q Prior applications as follows(specify applications and dispositions): (Continued on reverse) A copy of the moving party's income and Expense Dedaration must be attached.when attomey fees are requested.The declaration under penalty of perlury mustbe signed in catHomla,or in a state that authorfzes use of a declaration in place of an affidavit otherwise an affidavit Is required. FJud Aal C „und Rule 12ania ORDER TO SHOW CAUSE AND DECLARATION FOR CONTEMPT Judidal t of California Revised Effective January 1.1980 M1NN_1--Y 1✓i4 X ro 0 614 - �- or.� rte' tsoN IUC 1 'sal it wEI IN THE SUPERIOR COURT OF TILE STATE F CALI71ZN I IN AND FOR THE COUNTY OF CONTRA COSTA In Re the Matter of Case No. J90-01602 KATHLENE NELSON, ORDIM EOR REMOVAL OF PRISONER FOR §232 CIVIL CODS OR §300 WELFARE 6 A Minor. INSTIUTIONS CODS PROCEEDINGS / (§2625 PENAL CODE) To: New Folsom State Prison (Ranch) P.O. Box 29, Repressa, CA 94671 You are commanded to deliver Douglas Raymond Nelson #H2O549 DOB: 05/ into the custody of the Sheriff of thin County for a hearing on August 10, 1992 at 1:30 P.M. in Department No. Tvelve of this Court. Said defendant, Douglas Raymond Nelson shall be kept in the custody of the Contra Costa County Sheriff until further order of the Court n 0 after which he/she is to be returned t 4KF facil'"IOR h v he/she etas removed. �^ D Dated; July 143 1992 N GTliS Sr, ^' a . %• �Qd�%�yl/I����f•����7'o' JOpHIV C. .2i�1 t�at the�� a�s�a tau czs�ti . rl /a /YC! f.1-L ?v r K Dl!� Q�` ��/Y � [ G ��Lsi/i+L'!iL(� Z J�'D� ' Ji1�: I s 19 N CAurt i th 5,21 k M; ILC$A1C J nty ` .a Dated: Aa g t o isone 0 s ACKNOWLEDGMENT OF REFUSAL TO.APPBAR authorized representative of as y • ' pr9aon) declare that !'�h`{/•�l.o� d lU. Sa has stated thahe/ he does not wish to appear at the above schedu �d proceedings. Clare under penalty of perjury that the fo egoin ;s true an orrect. Dated: T 7soner a and tit (To authorized re resentative: If the refuses to be transported, please have him her sign the waiver. If he/she refuses to sign the vaiver, please sign the acknowledgement of refusal to appear.) " 'Z7 2 3 4 Ax! IMOMIDwAlt- 6 111mrlAfs,1,c-1N1 Yo hl-W.IES&Jfy 7 N9 10 Yell 12 13 14 o4,,, 15 16 17 Z-- 77 -5 UW-Ve�Al IVNI-2 IhVD 18 29 19 a///z,-2 Z-57 � 111V Al 20 21 ,5W12 AIE- C,71512�51�V /,v /lup 5r�/�A- 22 A,26-, 23 -z 24 4 Z- 25 26 27 28 2 3 4 I'A'r'`;,n lvlti/�z 5 6 7 V/- 8 9 10 49AI 12 ASW 4 13 14 15 16 1,V I11e,4A-rfeA1 17 A-r ) 1 Sj 8 Ak 19 20 21IJ IN6' 77 7Y 22 5-7 7,1-�,- > A x7141772! e 0 9rG-� 23 24 Tv 1,C&P 25 26 27 �'/ z, A2,25-11-Zr 28 "12 J F- 1. Z ' 1 tN FZE : KAVVI L ENE WE- _"ELS ON, "w&R, I1-3-E7 GON7�A GQSrA C�U.,VTy�� 9� - t 60� 2 8u7'rE Lou N TY tri 18 3 CAciF�,QN/A COUPTok —ADSSDOO 4 PrAyr­romo " r=1_50N , f ET1noMEFR. NAru¢AL FAVNER�-- 5 2£3� EME2AL17 oRIvc -JEN PRO P E R WALNUT CREEK , CA-I_/i= ?Y6V9 6 t Sr o) 935-y332 7 DEGLA,RATID1/ rr, Su i�PoRT_ 8 ` p� PCrl rJON a g a 10 - � . k O i 12 CONTRA COSTA COUNTY 13 - DETENTION FACILITY ( )INMATE REQUEST FOR INFORMATION ( ) MEDICAL REQUEST N � 14 4y� TO � iaA a %" 15 _9p---) cell-.JYD-/bOz Uj j From: U6 5 Al�/i~Y� �I�n` ;O� Bkg #�22/,6Z// Looe) 0 16 Date: Housing Assignment: (1 CQ 17 D/ -amu �1 18 R/NVuest:6,4� FD2�GOM�.CA��tJT 19 _4s�- 9� 41noR ZK OC ,Ai4Wr may- '7;? 21 /N /�✓1/D IINS/,�i� A�1/O /F ��YDC /,tom/�0� 22 y✓,,5_M11 lCV21% �i9�� r22 IAIIK,4r 040_- 23 24 zzll S Akso t m elRUG � 25 �• r4wzz",,-- y1w �1�E/V�r 26 p/�aF'�e !fie SLr1,r>�, �viNQJu,�s , J/ Nl/f/. z�1 27 28 / / Recd By: Routed To: IP IL EA4 D 1 NG � PAG E ANSWER: ( ) APPROVED { ) DENIED-(state reason) l � • If r • r • I I r • 1 , r r 1 I r f • .FLY NUT TREE - f?t,4Yr.. , '�,__ •mac..:=5` ���'�� a r••� �''� ' to � t w �t" ', 2 0 M VF: KA'rHLE-NF- tlAf:-_ " ELSON, !t-.S-8'l 2 SUTTV- 1171 e 0141-IFORNIA COURT 61;:7 APPAFALS —A-SS000 4 JDOUG�py� VA,/x p _ W O(V E-T171OUER NNTURAL FA.TUEFZ , — A �n N e7kor en r->c- 2 P 2830 G-MC-rZAL0 r)iZtVrz- — -1 t4 PRO PER WALNUT 4CPEE16 eS A).I FO R M I A '7 YSVf 6 (slo) 7 8 -CERFIFICATION ani AFFIDAVIT ,q -SERVICE 6y MNL 9 0iR--LAQe n-Wr Z AN CVL--R ME: A&C of MC-pejN C>CCCI21 BED 10 Z Y TNt A -rW4SCoC"m&-N7:S AAIL> Pr-LEAD65-F: C> Qc 11 _r ,SERVED TSE AFFIXED DoCu MEN-r:S; To wi-Hr 10 L 12 13 13Y PLPe--lN,4, A r2Lke CoF-V, "&=PEDF ENCLOSer) IN A Sf 5A tj--D ENV640. 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