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APPLICATION TO FILE LATE CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA December 6, 1994;
BOARD ACTIONv
Application to File Late Claim ) NOTICE TO APPLICANT
Against the County, Routing ) The copy of this document mailed to you is your
Endorsements, and Board Action.) notice of the action taken on your application by
(All Section References are to the Board of Supervisors (Paragraph III, below),
California Government Code.) ) given pursuant to Goverment Code Sections 911.8 and
915.4. Please note the "WARNING" below.
Claimant: Lamos W. Sturgis
Attorney: Peter C. Pappus
Address: 2400 Sycamore Dr., Ste. 40
COUNTY COUNSEL
Antioch, CA 94509 MARTINEZCALIF.
Amount: $10,000,000.00 By delivery to Clerk on November 7, 1994
Date Received: November 7, 1994 By mail, postmarked on November 5, 1994
I. FROM: Clerk of the Board of Supervisors 4TO: -County Counsel
Attached is a copy of the above noted Application to File Late Claim.
DATED: November 8,_1994 PHIL BATCHELOR, Clerk, By %J Deputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
( ) The Board should grant this Application to File Late Claim (Section 911.6).
( ✓f The Board should deny this 'Applieation to File Late Claim (Section 911.6).
DATED: 9 VICTOR WESTMAN, County Counsel, By Deputy
T
III. BOARD ORDER By unanimous vote of Supervisors present
(Check one only)
( ) This Application is granted (Section 911.6).
(✓� This Application to File Late Claim is denied (Section 911.6).
I certify that this is a true and correct copy of the Board's Order entered in its
minutes for this date.
DATE: 0 E C ' 6 1994 PHIL BATCHELOR, Clerk, ByDeputy
WARNING (Gov. Code $911.8)
If you wish to file a court action on this matter, you must first petition the
'I appropriate court for an order relieving you from the provisions of Government Code
Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such
Ipetition must be filed with the court within six (6) months from the date your application
,I
for leave to present a late claim was denied.
You may seek the advise of any attorney of your choice in connection with this
matter. If you want to consult an attorney, u should do so immediately.
IV. FROM: Clerk of the Board TO: 1 County Counsel 2 County Administrator
i Attached are copies of the above Application. We notifed the applicant of the
Board's action on this Application by mailing a copy of this document, and a memo thereof
I has ben Piled and endorsed on the Board's copy of this Claim in accordance with Section
29703.
7 X994 QQ •
DATED: DEC PHIL BATCHELOR, Clerk, By Deputy
V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board
of Supervisors
Received copies of this Application and Board Order.
DATED: County Counsel, By
County Administrator, By
APPLICATION TO FILE LATE CLAIN
i - sem
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- NOV 7 M
CLERK BOARD OF SUPERVISORS
CONTRA COSTA CO.
Claimr•to: BOARD .OF SUPERVISORS OF CONTRA COSTA OOUN7Y
INSTRUCTIONS TO CLAIMANT _
A. Claims relating to causes of action for death or for injury '-.-o 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 oIn or after January 10
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.Supervisors,)
D. If the claim is against more than 'one public entity, separate clai= 'must oe
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this
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RE: . Claim By ) Reserved for Clerk's filing stamp
-
ill 14 QS G✓ � r 7-u� "-
�_.. _s RECEIVED r
Against the County of Contra Costa ) AUG 10 1994
or )
CLEWBOARD OF SUPERVISORS
,Q Q District) CONTRA COSTA CO. _
(Fill in name)
The undersigned claimant hereby makes claim against the County of Contra Costa or-
the above-named District in the sum of $ /0. 00,0, Of1a and in support of
this claim represents as follows:
1. When did the damage or injury o'ccu'r? (Give exact date and hour)
9,7
2. Where di e damage or injury occur? (Include city and county)
3. How did the damage or injury occur? (Give full details; use extra paper cif-J/ toy
required) c,r,�s �c T,��Me� f/ai /Z�di y %C yele W rpt ivo 9FAcl L;y1if. ufAg s�-� �/
!-ftc� ]70u�At 0tV 7"rfE q1-bv�! -� e@-crW,� W r �j;rf A&--3- R�SiSY_ Bu (.�s ��r�-EY�e� ud,7�C
��/�!'Er S�J�a1, �'1.4eC 3y ofj�;'eer� mu��Pa`a�. i i7�c�n/of ?ceE;►� r2corc.�! ij7E✓b 'lea��
��1L Fs4cr c,4,.s nth �rr►2G�h Z,r�f� prk9rt7aC��• ----
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage? �, l �„�-
Las;,zy c7CC VSs i 1/C I�C NE1�CG�n -M,56 �! Vel-?e
Folr 7n1+cF D ctirns
(over)
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5. What are the names of county or district officers, servants or employees causing
the damage or injury? O �c ZI'< MUCO Z, ,Ot - //iG!
6. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage _E-r1V,4n-P-A IMAM
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.) ?rl�nr� 2� Z -Moll 6 �E-�V(
8. Names and addresses of witnesses, doctors and hospitals. �uyt 9 �, )
Nurses cJ,0 UW ��k' � ���� ��� a �1 e ,�� ; �
r47T�l�'�vEly
9. List the expenditures you made on account of this accident or injury: M�
DATE ITEM AMOUNT
• any „' * * � ' 'aeaaa �► � .
Gov. Code Sec. 910.2 provides:
The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) w or by some person on his behalf.”
Name and Address' of 'Attorriey ' "•' q
�RAS g13. Claimant's Signature
ANT®(? r , Address
Telephone No. flo) 7'S�-�'.77� � Telephone No. A19_ 41-79--70��
eye * * i " '�F�' '�-3'�' � s� at ,� a► f
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 ($10000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($109000, or. by
both such imprisonment and fine.
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