Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
MINUTES - 01111994 - 1.26
IR�J 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 JANUARY 11 , 1994 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 Governrhent Code Amount: $15 ,000 .00 Section 913 and 915.4. Please note all •Warnings". CLAIMANT: WILLIAMS , Perry ATTORNEY: R. Nicholas Haney Date received ADDRESS: 223 Broadway BY DELIVERY TO CLERK ON December 17 . 1993 Richmond, CA 94804 BY MAIL POSTMARKED: Hand Delivered via : Risk Mgmt . 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. QH gg DATED: I� _ 1 / 199_3 Blfit DeputyLOR, Clerk ` l I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. (✓) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: /9,93 BY: C'• cry- 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. n Dated: a„"_ll3�gq 4- PHIL BATCHELOR, Clerk, By ` A Q 0.� ) 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• / • BY: PHIL BATCHELOR by a^{', Pik, Q Q, _ Deputy Clerk CC: County Counsel County Administrator d .Q OFFICE OF COUNTY COUNSEL DEPUTIES: '., PHILLIP S. ALTHOFF CONTRA COSTA COUNTY SHARON L. ANDERSON ANDREA W. CASSZDY 1 '• VICKIE L. DAWES COUNTY ADMINISTRATION BUILDING MARKE S. ESTIS t MICHAEL D. FARR 651 Pine St., 9th Floor LILLIAN T. FUJII MARTINEZ, CALIFORNIA DENNIS C. GRAVES VICTOR J. WESTMAN GREGORY C. HARVEY COUNTY COUNSEL 94553-0116 KEVIN T. KERR EDWARD V. LANE, JR. SILVANO B. MARCHESI TELEPHONE (510) 646-2074 MARY ANN M. MASON ARTHUR W. WALENTA, JR. FAX (510) 646-1078 PAUL R. MUNIZ VALERIE J. RANCHE ASSISTANTS DAVID F. SCHMIDT DIANA J. SILVER VICTORIA T. WILLIAMS NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: R. Nicholas Haney 223 Broadway Richmond, CA 94804 RE: CLAIM OF: WILLIAMS, Perry 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. [X] 3 .The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4 . The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ( $10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. [ ] 6 . The claim is not signed by the claimant or by some person on is behalf. [ ] 7 . Other: VICTOR J. ESTMAN, County Counsel By: e. Deput Jhtyldounsel L CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a, 2015.5; Evidence Code §§ 641, 664) I declare that my business address is the County Counsel's Office of Contra Costa County, 651 Pine Street, Martinez, California 94553; 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 addressed as shown above, sealed and postage fully prepaid thereon, and thereafter was, deposited this day in the U.S. Mail at Martinez, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: December 22, 1993 at Martinez, California. cc: Clerk of the Board of Supervisors (original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE SS 910, 910.2, 920.4, 910.8) Page 2 ro R. NICHOLAS HANEY ' Attorney at Law 223 Broadway Richmond, California 94804 (510) 237-1624 December 3, 1993 QVC 16 3 Contra Costa County HADD DELIVERED Risk Management Division 651 Pine Street RECEIVE® 6th Floor `u Martinez, CA 94553 DEC, 17 19M Attn: Julie Aumock !J CLERK BOARD OF SUPERVISORS RE: My Client(s) : WILLIAMS, PERRY CONTRA COSTA CO. Claim Number: IA 687 J U�;a�, g_A� `W Date of Loss: 10/11/93 �. Dear Ms. Aumock: Please be advised that my client(s) are at this time prepared to settle any and all claims they may have against Contra Costa County. Subsequent to this accident, Mr. Williams contacted Dr. Patrick Szucs of Broadway Chiropractic in Richmond, CA. He was diagnosed as having acute traumatic sprains of the cervical and lumbar spine as well as left knee injury with associated nervousness and headaches. Said treatments continued through and until this date where he is being seen on an active basis. Medical specials from Dr. Szucs at this time amount to $2070.00. I am also enclosing records from Brookside Hospital where Mr. Williams was X-rayed. Mr. Williams hereby demands the amount of $15,000.00 as and for complete settlement of this personal injury claim. . Please contact my office at your earliest convenience -so that we may discuss this matter. Thank you for your anticipated courtesy and cooperation in this matter. Sincerely, R. Nicholas Haney MEDICAL REPORT Claim No. Patient's Name PERRY WILLIAMS Age 56 ❑ S ❑ M Phone 237-9391 Occupation RETIRED Employer Phone Address 731 — 9TH ST. , RICHMOND, CA. 94801 Date of Injury 10-11-93Date of First Treatment 10-12-93 Patient's Account of Injury POLICE CAR BACKED INTO MY CAR, MY CAR WAS SITTING STILL. Diagnosis ACUTE TRATJMATIC SPRAINS,_ STRAINS, HEAD, NECK, LUMBAR, LEFT KNEE SPRAINS, STRAINS, NERVOUSNESS, HEADACHES, ASSOCIATED PAIN, SPASM, RESTRICTION. Pre-existing Injuries or Illness 4 Treatment Rendered PHYSICAL & ORTH EXAM, PHYSICAL THERAPY, ICE, HEAT, ULTRA— SOUND, MASSAGE. X-Rays YES BROOKSIDE Findings SEE ATTACHED Hospitalized ❑ Yes ® No If yes, where?_ Surgery ❑ Yes ® No If yes, explain Prognosis PATIENT CONTINUES TO HAVE ON—GOING MODERATE EXACERBATIONS OF SYMPTOMS. Permanent Impairment ❑ Yes EX No If ye:;, explain in detail U Patient still under treatment ❑ Patient discharged(Date) ❑ Patient disabled from To Date of last visit 11-19-93 Have you reported this injury to any one else? ❑ Yes M No It yes, to whom? Bill to Daae$__2070. 00 (Itemized statement attached) Estimated Final Bill$ Has this bill been paid? ❑ Yes ® No If yes, by whom Provider's Name Typed PATRICK J . SZUCS, D.C. Degree CHIROPRACTIC Address 221 BROADWAY RICHMOND, CA. 94804 _ Fine 232-8434 IRS No. 68-0071699 Date 11-19-93 Provider's Signature I19-N MISSION PRINTING(2091 227.78W BROADWAY CHIROPRACTIC; (41 5)232.8434 "P.J.SZUCS.D.C.":DCO.13887 TAXPAYER IDENTIFYING NUMBER:68007169.4 221 BROADWAY. RICHMOND. CA 94804 . Re: PERRY WILLIAMS D.O.L. : 10-11-93 90020 I.O.V. $100 . , 97000 Modality $24 . , 97200 Combination Office Visit and Physical Therapy Including Intermidiate Evaluation and Treat- ment With 2 or More Modalities $50 . 97201 Additional Modalities and Procedures $15 . Date Procedure Codes Amount ppRR 10-12-93 90020-97200-97201-990�6-C&&R$$448ALpp MBAR $235.00 I 10-13-93 97200/97201 65.00 10-14-93 97201197201 65.00 00/97201 _ $15.00 972 10-15-93 99070-SUPPORT 80.00 10-18-93 97200!97201 66.09 972041197201 65.00 10-20-93 97200197201 65.00 10-21-93 97200197201 66,00 10-22-93 97200197201 66.00 10-25-93 97200197201 65.00 10-26-93 97200197201 65.00 10-27-93 97200197201 65.08 10-28-93 97200197201 65.00 10-29-93 97200197201 66,00 11-01-93 97200/97201 65.00 1 11-02-93 97200197201 65.00 11-03-93 97200197201 65.00 11-04-93 97200197201 66,08 Total (S .S. # 125-38-3461 .D.# 68-0071699 . I .D.# 13887 BROADWAY CHIROPRACTIC 14151 232.8434 "P.J.SZUCS,D.C.": DCO-13887 TAXPAYER IDENTIFYING NUMBER:68007169.1 221 BROADWAY.RICHMOND.CA 94804 r PERRY-WILLIAMS .L. : 10-11-93 90020 I.O.V. $100 . , 97000 Modality $,24 . , 97200 Combination Office Visit and Physical Therapy Including Intermidiate Evaluation and Treat- ment With 2 or More Modalities $50 . 97201 Additional Modalities and Procedures $15 . Date Procedure Codes Amount 11-05-93 97200197201 65.00 11-08-93 97200/97201 I 11-09-93 97200197201 66,60 11-10-93 97200197201 66.08 11-11-93 97200197201 6&nn 11-12-93 97200197201 66_00 11-15-93 97200!97201 65.08 11-16-93 97200197201 66.00 11-17-93 97200/97201 66,00 i 11-18-93 97200/97201 66,00 11-19-93 97200197201 66,09 Total $2070.00 S. S. # 125-38-3461 .D.# 68-0071699 Oa_-_I -D- # 13887 BROADWAY CHIROPRACTIC UPDATE (415)232-8434 12-7-93 "PJ.SZUCS.D.C.":DCO-13887 TAXPAYER IDENTIFYING NUMBER:680071 69£. 221 BROADWAY,RICHMOND.CA 94804 Re• PERRY WILLIAMS 10-11-93 D.O.L. • 90020 I.O.V. $100 , , 9700.0 Modality $24 . , 97200 Combination Office Visit and Physical Therapy Including Intermidiate Evaluation and Treat- ment With 2 or More Modalities $50 . 97201 Additional Modalities and Procedures $15 • Date Procedure Codes Amount 11-23-93 97200197201 . 66.00 11-24-93 97200197201 66.00 ' 97200197201 11-30-93 66.Oil 12-02-93 97200!97201 66.04 12-07-93 97200/97201 f5.00 ) i i i I I I i I I Total $325.00 S.S. # 125-38-3461 TOTAL BALANCE $2395. 00 LD.# 68-0071699 I.D. # 13887 i � � ' t.��,a., __J(f.. – —,t..,. . .,s:� rte► �. -�'�"�+r"� rr� a �.�- • �.t•..� ._'■'. �...y���I�nc•-�."....�r . III ._J/'� y'�.� / . 1 ' • r • „� ��.lit � .�_.,.._�..; , f. 1r • jH pY I_- p�a9 ;� � 3.. q _mow-,.... '''""""t� , �� b6-�- ✓ /f-A L iHYS,CAL THE,RAP" 4 _ Notes !� Oslo r. ,3 - LL/ ................................... — -- ' —s --r 1 1 1 ` � � J i I c�� ER�pY 'lam' p;a9N0 ies o ' r w Li illy r l �z t R 1 BROOKSIDE HOSPITAL 2000 VALE ROAD l SAN PABLO, CALIFORNIA 94806 TELEPHONE (510) 235-7006 x 2892 WEST CONTRA COSTA RADIOLOGIC MEDICAL' GROUP, INC. R. W. JANG, M.D. M. M. LAPP, M.D. E. M. TAO, M.D. W. G. WIERZBOWSKi, M.D. REPORT OF ROENTGEN EXAMINATION OF� WILLIAMS , PERRY 57 700152 Name Age Patient Number REFERRED BY: DR . PATRICK SZUCS , 221 BROADWAY , RICHMOND 94804 X-RAY NO 04-84-41 DATE: 1112193 ROOM NO: op SKULL': Frontal , right and left lat.eral and occipital views . No skull fracture or other bony abnormality is detected . No abnormal . .intracranial calcifications are seen . The bones are well mineralized. CERVICAL SPINE : AP and lateral . There is no prevertebral soft tissue swelling . C1 to C7 align normally . There is mild disc narrowing at C5-6 and C6-7 with small adjacent degenerative spur formation . There is small posterior spur seen at the C5-6 disc level . . Mild facet degenerative change Is also present . There Is no fracture . CONCLUSION �k Degenerative disc and bone ohnges at C -6 and C6-7 . 4 _EMT: jw E .M. TAO , M.D . November 2 , 1993 Previous x-ray : 12/7/92 < < [♦ �'T.,h;% BROADWAY CHIROPRACTIC CENTER C PATRICK J.SZUCS D.C. RICHARD M.NORTON D.C. 221 BROADWAY RICHMOND CA,94804 510 232-8434 NAME—E- AGE $b p ADDRESS DATE 1� t Dr.Signature I I' i rS r'r.�'k-. —. t:, '?r} 21[;: ,-y,� tt4to-w e"'� ai*,d.'•. R UIRED FOR YOUR CASE HISTORY FILEkPW / t Date /0—//—r City State Zip fwl Social Security No. — D river's License No. p Vis» — Sex hi alp Marriage Status: M ()S W D No.Children tX Employer Years Employed Vftjw�A ►e _ Work Phone Bank »'%"W"o Occupation Employer n trspos+aib+o tot this account Referred by INFORMATION rcu covetod by Medicare? Yes ❑ No CI Medi-Cal? Yes ❑ No ❑ County s pcw have any group, union or personal health and accident insurance?' Yes ❑ No ❑ acne of Insurance Company Group No: I.D. No. Sdress City State Zip your condition due to an accident or illness? Id your accident occur while at work? Yes ❑ No ❑ When 'ere you involved in an automobile accident? Yes ❑ No ❑ When ash payment Other— _ SYMPTOMS J AD: LOW BACK: SHOULDERS: HIPS, LEGS& FEET: Headache 9�11_ow back pain ❑ Pain in shoulder point(R-L) ❑ Pain in buttocks(R-L) b entire head ❑ Low back pain,is worse when: ❑ Pain across shoi.,Iders ❑ Pain in hip joint(R-L) ❑ back of head ❑ working ❑ Bursitis(R-L) ❑ Pain down leg(R-L) ❑ forehead ❑ lifting ❑ Arthritis(R-L) ❑ Pain down both legs ❑ temples ❑ stooping ❑ Can't raise arm ❑ Leg cramps ❑ migraine ❑ standing ❑ above shoulder level ❑ Pins&needles in legs(R-L) Heads feels heavy Xsitting ❑ overhead ❑ Numbness of leg(R-L) Loss of memory `Zlbending ❑ Tension in shoulder(R-L) ❑ Numbness of feet(R-L) Light-headedness ❑ coughing ❑ Muscle spasms in shoulders ❑ Numbness of toes Fainting ❑ Pinched nerve in low back ❑ Feet feel cold Lights bother eyes ❑ Slipped disc ARMS& HANDS: ❑ Cramps in feet(R-L) Loss of smell ❑ Low back feels out of place ❑ Pain in upper arm ❑ Swollen ankles(R-L) Loss of taste ❑ Muscle spasms ❑ Pain in forearm ❑ Swollen feet(R-L) Loss of balance ❑ Arthritis ❑ Pain in hands ❑ Painful joints in toes Dizziness ❑ Pain in fingers ❑ Pain in foot(R-L) Loss of hearing ❑ Pinched nerve in arm N Pain in knee R Pain in ears ❑ Pinched nerve in fingers :5 VJtj Ringing in ears MID-BACK: ❑ Sensation of pins&needles in arms Buzzing in ears ❑ Mid-back pain ❑ Sensation of pins.&needles in fingers ❑ Pain between shoulder blades ❑ Fingers go to sleep :CK: ❑ Sharp stabbing pain in mid-back ❑ Hands cold GENERAL: _Pain in neck ❑ Muscle spasms ❑ Swollen joints in fingers X Nervousness Neck pain with movement ❑ Sore joints in fingers ❑ Irritable Pinched nerve-in neck ❑ Arthritis in fingers ❑ Depressed Neck feels out of place ABDOMEN: ❑ Loss of grip strength ❑ Fatigue Stiff neck ❑ Nervous stomach ❑ Generally feel run-down Muscle spasms in neck ❑ Nausea CHEST: ❑ Loss of sleep Grinding sounds in neck ❑ Gas ❑ Chest pain ❑ Loss of weight Grating sounds in neck ❑ Constipation ❑ Shortness of breath Popping sounds.-in neck ❑ Diarrhea ❑ Pain around ribs Arthritis in neck Have you had X-rays before? ❑ Yes ❑ No When? What areas were X-rayed? WOMEN ONLY: ❑ Menstrual Pain ❑ Cramping ❑ Irregularity Date of last period? Are you now pregnant? EI Yes ❑ No How long? PAYMENT IS EXPECTED AT TIME OF VISIT, UNLESS OTHER A ANGEMENTS)H,AVE BEEN MADE. 36 PATIENT'S SIGNATURE SON PRINTING•3 E.SHIELDS•FRESNO.C�93XN • � ` P:aTIENT'S PAIN CHART • Number: Please use all of the figures on both sides of this page to show` me exactly where ,a1,]•, your pains are,. end where they radiate to. Shade or draw with blue pen. Only the patient is to fil'. out thio sheat. Please be as precise and d' tailed as possible. Use RIGHT LEFT RIGHT LEFT RIGHT O J .EFT = ,._ RIGHT � LEFT ' f t RIGHT LEFT �✓ t U - V OVER ..> i AAA900EDCLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA APRIL 26, 1994 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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:- $15,000.00 Section 913 and 915.4. Please note all IvA ningso. ' CLAIMANT: WILLIAMS, Perry ATTORAEY: R. Nicholas Haney Attorney at Law Date received ADDRESS: 223 Broadway BY DELIVERY TO CLERK OHA;r,_, 1AA4 Richmond, CA 94804 BY RAIL POSTMARKED: March 31 - 1 AA4 Certified Mail 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: X9 9 IVIL SeputylOR, Clerk PA AA .11. FROM: 'County Counsel TO: Clerk of the Board of Supervisors AOAEN06'0 (✓) 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 1S 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). ( Y ) Other: THIS tS htJ (AWI00)ED C\_A1t&, ThE 0r-1611JAL CLiRIM WA'S rU,ED t _e"Ee� -rED ©N 2APUAV_{ t1,1q V, �uR.SkLA0V Ta Goy'T CODC % R16.(. 'Tkkts Ag�kEMDGD CLPorA A6 - izeNTEp 8 _?a OF GZJGiMAtL CLAIM rov tet. u - Sys Ofk&I AL Cl-Wiwi A'9 FCt►EU AtjERGTb. PrCTLIQtQ 1S _'�_E LI(RCD . Dated: _AAAA S1 i9q y BY: Deputy County Counsel 111. FROM: Clerk of the Board 70: County Counsel (I'y County Administ ator (2) ( Claim was returned as untimely with notice to claimant (Section 911.3). 1Y. BOARD ORDER: By unani us vote of the Supervisors present 1 This Claim is roje d in full t Other: . I Corti f�Aat this isrue and rtct copy o the Board's der onto in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By . Deputy Clerk MARK G (Gov. ode section , 3) Sun to In ,*x tions, have on ix ( nths date is tic s sone se d or deposits the it to a coup ction on is elm See we nt a tion S. . sZloz of I►ec Fou may seek the advice of an attorney of your choice in connection with this ratter. If you want to consult ®E 1_1Z_q q to attorney, you should do so immediately. *For additional Warning see reverse side of this notice. AFFIDAVIT OF MAILTNG I declare under penalty Of perjury that I am now, and at all tines herein ftentioned, have been a Citizen Of the Jnited States, over aye 18; and that today I deposited in the United tales stat Service in Kartinez. :alifornia, postage fully prepaid a Certified copy of this Board Order and Notice to Claimant, addressed to the ciaiaant as shown above. BY: PHIL BATCHELOR by C&,L 0„ Deputy Clerk X: County Counsel County Administrator •Claim* to:- BOARD OF MIERVISORS 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 `gi,owing 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 '10 any other cause of action must be- presented -note later than one year after the accrual of the cause of action. (Govt. -COdo §911.2.) B. Claims must be filed with the Clerk of the Board cf Supervisors at its offied in Room 106, County Administration Building, 651 Pine,, Street, Martinez, CA 94553• C. If claim. is against a distr.ii:t governed by the Boar9 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 fra::c?ulent claims, Penal -w.-.,de Sec. 72 at the end of this form. RE: Claim By r ) Reserved for Clerk's filing stamp FERRY WILLIAMS RECEIVED Against the County of Contra Costa > APR "_1 1994 or ) CLERK BO;5 OF SU=PERVISORS District) C.ONTi-A COSTA CO. Fill in name ) :R The undersigned claimant hereby- makes claim against the County of Contra Costa ory the above-named District in the sum of $ 15 ,000 . 00 and in support of this claim represents as follows: ------------------------------------------------------------------------------------ 1. When did the damage or inji.:ry occur? (Give exact date and hour) October 11 , 1993 at , 5 . 30 p.m. -------------------- ---------------------------------------------------- 2. Where did the damage or injury occur? (Inc-lude city and county) Silver Avenue, Morth Richmond , Contra Costa County ---------------------------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) See attached police report . Co:itra Costa County Sheriff vehicle backed up into claimants vehicle causing injury and damage. ----------------------------------------------------- ------------------------------- 4. What particular act or omission on the part of co:.inty or district officers, servants or employees ca= d the injury or damage' County employee Sean sates unsafely bacl-(., d his vehicle into claimants vehicle in -violation of CalifaMia Vehicle Code Section 22106 . (over) 5 IL 5. What are the names of county or district officers, servants or employees causing the damage or injury? Sean Glen Yates ---------=-------------------------------------------------------------------------- 6. What damage 'or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Damage to claimants vehicle. Also sprains to ',,':clamants neck, back and knee. ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of 'any prospective injury or damage.) $2,000 .00 in medical bills $13,000 .00 in general damages ; ----------------------------------------------------- ----------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Dr. Patrick Szucs, 221 Broadway, Richmond , Ca . 94804 ------------------------------------------------------------------------------------- 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 bye signed by the claimant SEND NOTICES TO: (Attorney) or by some persor on his behalf." Name and Address of Attorney R. NICHOLAS HANEY Attorney at Law Cl 's Signat e 223 Broadway Richmond, CA 94804 94804 (Address)- Telephone ddress Telephone No. 510 - 237-1624 Telephone No. 510 - 237-1624 r N O T I C E SecticP 72 of the Penal Code provides: I< "Every person who, with in5ent to defraud, presents for allowance or for payment to any state board or cfficer, 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 ofnot 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. rt � n r p � � ► t O� f Ltd • 13.1 i N � CrO O 0 1x � 5C ¢ Cr rr -0,. r'4C O ¢t"h ' ►nct �+ r . CIC45 & :. O _ i N t i CLAIM 1, 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 JANUARY 11 , 1994 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: $8 , 560 .00 Section 913 and 915.4. Please note all 'Warnings". C-tiTY 6 F b,5 tT-rL.- CLAIMANT: , S . IRa+eA1EY`� oYt1GG6 ATr'N ATTORNEY: , e !t/A iA�SHA N &Do TR5U kT1t IkVi--5, IOTA Fir Date received ADDRESS: 1218 Third Ave . , Ste . 1800 BY DELIVERY TO CLERK ON December 16, 1993 Seattle, WA 9810 — BY MAIL POSTMARKED: Hand Delivered via : County Counsel & the D.A. 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pHIL BATCHELOR, Clerk DATED: I LQr�.,..•��A e2� 1q9_ 81f: Deputy I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( V4 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: �;Q,tnc, 2( 4f 3 BCZ, �. Deputy County Counsel I1I. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 1V. BOARD ORDER: By unanimous vote of the Supervisors present (A)' This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. n Dated: IgTPHII 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 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: BY: PHIL BATCHELOR by ��� �ppDeputy Clerk CC: County Counsel County Administrator ,I CONTRA COSTA COUNTY TO DATE ( ` FRO ggd .SUBJECT , RECEIVED DEC i s 1993 .i K8 ARDOF SUPERVISORS CONTRA COSTA CO_ SIGNED PLEASE REPLY H E TO DATE e . 77 SIGNED INSTRUCTIONS - FILL IN TOP PORTION,REMOVE DUPLICATE (YELLOW) AND FORWARD REMAINING PARTS WITH CARBONS.TO REPLY,FILL IN LOWER PORTION AND SNAP OUT CARBONS.RETAIN TRIPLICATE(PINK)AND RETURN ORIGINAL. FORM M 103 SEATTLE CITY ATTORNEY MARK H. SIDRAN RECEIVED ��I 1993 November 24 , 1993 D�C 6 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. i Gary T. Yancey FIRST CLASS AND District Attorney CERTIFIED MAIL Contra Costa County RETURN RECEIPT REQUESTED 40 Muir Road Martinez , CA 94553 RECEIVED Re: Gregory S. Gurley v. The City of Seattle King County Cause No. 93-2-24060-1 DEC 16 OW Assignment Order D91-00323 Gregory S. Gurley, SSN 537-44-2552 CLERK BOARD OF SUPERVISORS Account No. 637248 CONTRA COSTA CO. Dear Mr. Yancey: The referenced complaint was served on the City of Seattle on September 28 , 1993 . The complaint seeks damages for failure to pay portions of plaintiff's salary. It appears that the City withheld certain sums from the salary of Gregory S. Gurley pursuant to and in compliance with an Order of the Superior Court of California, Contra Costa County. (Enclosed are copies of the complaint, the Order, and a December 31, 1992 letter from our office to Mr. Gurley's attorney that provides additional background information. ) By this letter, the City of Seattle is tendering . this complaint to Contra Costa County. Mr. Gurley's complaint alleges the following: The State of California did not obtain any State of Washington liens, notice or collection orders . Rather, California obtained a document in the State of California claiming to be an earnings assignment order. Since the City of Seattle was merely following an order entered by Contra Costa County, and since the City sent the garnished wages to that county, the City asks that Contra Costa County defend and indemnify the City for any amounts recovered. The City is not the appropriate party to respond to Mr. Gurney's allegations because any liens, notices, or collection orders, if required, should have been initiated by Contra Costa County, not the City of Seattle: CIVIL DIVISION An equal employment opportunity-affirmative action employer 600 FOURTH AVENUE, 10TH FLOOR,SEATTLE,WASHINGTON 98104-1877 (206)684-8200 TDD(206)233-7206 FAX(206)684-8284 Gary T. Yancey November 24 , 1993 Page 2 The garnishee is a mere stakeholder. From a monetary standpoint, it can make no difference to him whether he pays what he owes to his employee or to the creditor of such employee, but he is interested in being protected against double liability. Weitzel v. Weitzel, 27 Az . 117 , 230 P. 1108 (1924) . The City of Seattle was merely the "stakeholder" of Mr. Gurley's debt. The duty to properly register the Contra Costa County Earnings Assignment Order was not the City's duty, but the duty of Contra Costa County. Because the City was not the appropriate party to register the debt with a Washington State Superior Court, the City asks that Contra Costa County defend this lawsuit. Furthermore, Contra Costa County should defend this lawsuit because the City, in good faith and without negligence, followed the direction of the Order of the State of California. The City's compliance with the California order is analogous to a sheriff taking property under a writ of attachment at the direction of a creditor. A sheriff who follows the express directions of the creditor and attaches the property pointed out by the creditor, and who does not have notice that it is the property of another, is not negligent and is entitled to indemnification: [F]rom the directions given to serve it in a particular manner, a promise will be implied in law from the creditor to the sheriff to hold the latter harmless of the natural results of obeying such directions. Standley v. Marsh, 1 Wash. 512 , 20 P. 592 (1889) . The City complied in good faith with an Order of the Superior Court of Contra Costa County. The Order was valid on its face and contained no apparent errors or defects. The City followed the express directions contained in the order by withholding the required sums and sending them to Contra Costa County. The City therefore requests that the County defend this lawsuit and pay any judgments awarded. If this tender is not accepted, the City of Seattle has the option of bringing Contra Costa County into the . case as a third party defendant. For these reasons, the City of Seattle is tendering the referenced complaint to Contra Costa County. If the correct addressee of this tender is not the Office of the District Attorney, please notify us as soon as possible of the correct addressee. Gary T. Yancey November 24, 1993 Page 3 . Please provide us with your written acceptance of this tender on .or before December 171, 1993 . If you would like to discuss this matter, I can be reached at my direct telephone number, (206) 684-8221. Very truly yours, MARK H. SIDRAN Seattle City Attorney By MARCIA M. NELSON Assistant City Attorney MMN/LMM Enclosures cc: L. Douglas Pipes (first class and certified mail, return receipt requested) Senior Deputy District Attorney Director, Family Support Division Office of the District Attorney Contra Costa County s NAND DELIVERED 1 RECEIVED 2 DEC 16199Q 51 V F { a �� 3 C � CLERK BOARD OF SUPERVISORS 4 CONTRA COSTA CO. { i : ' t C.', t I C. 5 �,Ry 6 :;;IN -THE . SUPERIOR:.COURT .OF THE STATE OF WASHINGTON FOR KINu COUNTY 7 8 Gregory S. Gurley ) PLAINTIFF, 9 _ � ) NO :.. 10 ) 'COMPLAINT FOR City.,of;.Seattle dba, ) UNPAID WAGES ;11 Seattle City Light ) 12 DEFENDANT. ) 13 I . THE PARTIES. 14 The plaintiff is a single man employed by the defendant. 15 The Defendant is a wholly owed municipal corporation of 16 the City of Seattle doing business in the state of Washington, 17 City of Seattle as Seattle City Light ( here in after,City Light) . 18 II . VENUE 19 All parties as residents of the county of, King. This is 20 based upon an employment contract, entered into in .the county of 21 King, . and all actions thereunder occurred in the County of King. 22 III . STATEMENT OF FACTS. 23 While the plaintiff was employed by City,-Light, City 24 Light received claims from the State of California as to the claim 25 of the State of California for funds due to it from the plaintiff. 26 LAW OFFICES OF JEFFERY A. MESS 27 AND ASSOCIATES Complaint for Wages 1218 Third Ave. Suite 1800 28 Page 1 Seattle, WA 98101 624-2401 lIl The . State of. California did not obtain any State of 2 1 Washington liens, notice or collection orders . Rather California 3 obtained a document in the State of California claiming to be a 4 earnings assignment order. No notice was served on the plaintiff. 5 City Light there after withheld funds from the 6 plaintiff' s wages . 7 City Light, with out authority withheld the sum of $4115 8 in 1992 and the Sum of $4445 in. 1991 . 9 10 Wherefore, the plaintiff prays; 11 For a judgment against the defendant, to be proven at I12 trial, but for purposes of default claim is made in the 13 amount of $ 81560 . ; 14 That pursuant to RCW 49 . 52 .070 these damages be doubled; 15 That pursuant to RCW 49 . 48.030 that he be awarded his 16 attorney fees and costs herein. 17 18 Respectfully; submitted 19 f 20 JE_ �H SS, �SBA#7072 21 � 22 I HEREBY CERTIFY UNDER PENALTY OF PERJURY OF°:THE=LAWS OF 23 THE STATE: OF.':WASH INGTON' THAT I HAVE READ THE ABOVE COMPLAINT,.,AND 24 THAT THE'' CONTENTS THEREOF. ARE TRUE- AND. CORRECT.. 25 26 LAW OFFICES OF JEFFERY A. HESS ::- 27 AND ASSOCIATES Complit for ,Wages 1218 Third Ave. Suite 1800 281 Page 2 Seattle, WA 98101, 624-2401 ��ji�CL� QI Jis�ricl r�'\L!�1r , COn1ra - �-- --- CostG T. Yancey Fam ly Sucpor Division Mur aoaC Dis^iC.Anorney L. Douglas Pipers Marinez.California Count Y Semor Decury DSU c;Anorney FAX: 646-1322 ' Dlrec.or Phone- 646.4 u 1 � _ RECEIVED DF.TE: 'May 28 , 1991 �..: }} May 3 i' i1,�1 _ • The enciesed Order tissign- ng zarnings is a court-ordered deduction under Section 41390 et secof the California Civil Code for Greco v Scott Gurley -r LASE SAD IT C IEEE r r You must comply with its iOvisions . This order assigning Earnings will remain' in, e_fect until t1ne court issues another order . It does not ter^ nate au'tor-nati cally. r.n order _ss__ __ng e_-n_:gs _s authori sed oy Civ_' Code Section 4390 , which went -::to e==`ct on July 1 , :990 . This new Civil Code provis, cn is s Broadened the former wage ass-Lgnment _n two ways . �rSt, the order app!=eS t0 "ea--mi ^lgs , ', not just "wages" . "E'arnings" includes the following. _ (,1 ) Wages , Salary, zcnu,S , money, and retlremenz and VGCct:-on 4 Oe-ne� its . ( 2 ) Payments due for Serv3.ces off independe.mt contractors , dividends , -rents , royalties, residuals , patent rights , or mi neral or Other ..atu_al resource rights . ( � ) P_=-r ;lents of cred ios Cue or becom:.ng due as a result of Wr ._-ten or Ora-', c.^,r:t_acts -for See v...CeS or sales whether denominated as wages , salary, c0runiss=on,, bonus , or otherwise . ( 4 ) Any other :ayme is or cr edits Cue or bec_-m;,-,g due periodically as a result of an enforceable obligation. Sec-_nc, the order applies to the individual nzumed 2J'' ove if that person pe-_o=s se_ Y_ s =_or "rl.. a, _.1 .. .. ZO r fur J.iCjiit t.7 ..r.�i� w,iat and how t:.e services 11 be done . : _ -J.�,us , hiS rr� 4." _4 e ne:5vis named a.oOVe eveni� iie�Sile is not your employee but is an independent cont:actor wor_-.-g -for you _F she above name,4 =erson _s not c::__.enz:J em-micvec yc''., Vou 7r LtSt re?- - . �.._S Ur"e= --: lg _a''::_n CS _:2nd Serve 1: up-n he e..SS_7. _ person whe:, he Cr sale re _erns Zo work for you. _.- the person zerminates his/her empio, neat , you must JL,-,Llediately roti v the C rice c� t e District A��crn�y pa* �ly Support 1 Divisyon , and -,,-cu ;,ust also provide this cf�_ce with `he pe,son ' s list mown address and the name and aC:�reJs of t:�s/her new employer, known. `,fL � � fir' lr the merson works for 'VOL-ac*: a -full-t-me basis , you may prorate the amount to be withheld as explained in paragraph 9 on the reverse side of the order. -• �; cwever , your decis-on to =���' ?e' `e' wit.held supporte do s not rel _eve `ou or VOLT Obl_gat7 , _On under tRC i: CCrt OrCer tC W1tti2.'2r.lCl the amount specified in the order . If you prorate the withholding and the oerscn Coes not work f i .11t?me durini g the month, you are stL1l liable to send the Bill amount per th.e court order as long as the amount withheld does not exceed 50% of the merscn' s net income. We call to v_ cu,r attention Civ-L-1 Code section 4390 . 10 (b) , which ^rovides : "Ail e.i,p' over who w,i 11 ,-,:.1 1 y _-i is to wi thhold and :c--w+ard support t ,••)•rro t valid der re n , n t} e pLrsi.Lai1L o a C n� V Va Cry,. entered d a .� Served LOC em-31cve_ pursuant to this Chapter is, liable to the obligee for the amount O SL'ppert not withheld, -_=n4arded, Or Otherwise paid to the obligee . n addition to anv ether penalty or liability provided by lana, willful by an e:Mcicver to ccrtpl v with such an order is puna. sh—=- o�e as 7. conte:i Civil Code sect-Lor. 42390 - 10 (c ) .Either provides t.^.at serV4 ce of th s order creates a lien uzon thLe earzii ncS O. the a=bove-na.:T:ed nerson that are required to be withheld. --f also creates a lien upon all Ci 'yCur _ _Op _ v t'n=- S-,SD]e.... �O she enforcement Of a money jLG; - L_ i e ..tet e tied y e with—h-el � T r� this �i?ti..a.. n til a.trc.'v:.� r �.. _ �O O w_...�.�_� DLrsua L to ,. s Order. This 11e n coL'i roues .or one year from the d=ate the earnings of the above named person become payable, unless the amount re aired to be with::eld by this order is paid as rec-uired by law. Within ten days of the date the above named person is . paid, payments must be sent and ;Wade payable to: A.udicor-Controller, Centr al Collections Division, Finance 3L'ilding, Room 203 , Martinez , CA 9"333 . Please be sure that Account No. 63724:8 and the name of the above named person appears on *,our, remittance. Arty .,uest.icns ~egarc ^.S t--_s order should be directed to F . .T . C-1 -ark , jr . Thank you for vour cooperation in this matter. -?9lY (7/90 ) z 4, G1Str1 zt A C t 0 n e Costa ' County EY: FRAIN,-C!'v7- CARL-- Y , Deputy DA 1 40 -Nui- Road , `Martinez , CA 94553 -�L 1 1-1 -Ell �,TOQNE" As-si�,nee .,UFERlOR COURT OF CALIFORNIA, COUVVI Y OF C 0 N TRA 2 0 S EA' ,TMET ADDRESS 725 Court Street MAY 2 3 1991 MAU-t"G ADDRESS P. 0. Box 511 is t1 I k,W141, ,Lt,,K crTy AND ZPP CODE. fUrti ne.,. Ca 94553 C ijl.*'1. GS i A C 0 1i f 4 T Y BAANC:M NAV.5 —1 5y P=Tl7l0N-R,PLAiNTiFF: CONI?-,A COSTA COUNTY AS ASSIGNEE OF THE 'T SUPPORT RTr,-nTTS FOR BARBARA ANN GURLEY, (SPRAGUE) RESPONDENT/DiE=ENDANT GREGORY SCOTT GURLEY Assignee : CONTRA COSTA COUNTY CASE NUMBER. :-�"a'\TINGS ASSIGNMENT ORDER Modification = Child Support 7-1, Spousal or Family Support D011-00323 TO THE EMPLOYER: This is a court order. You must withhold a portion of the earnings of /employee's name and Social Se.-Liriry correct GREGORY SCOTT -S S 537-44-2-552 jne"jt and pay as direc-,ecl. Onsrucuon5 cornpuring the amounrs are on the reverse.) Cory 6 the orli6l, THE COURT ORDERS YOU TOr tkl 0,tilce 1. Pay par-L of The earnincs of the employee as foflo,.vs: imi a. 77"1s 235 . 00 per month for child support. M b. = s per month for spousal support. ClerV, and I%-Gtticlo L\N1,1 L State C. F7 $ per month for family support. c,,rhen 0i .ra Cr d. 77-1 s 400 . 00 per month for arrearages. e. = s per month for attorney fees. The payments orcered unce, items Ia. It, and Ic shall be paid to (name, r A dc� ess) AUDITOR-CONTROLLER C-ENTRAL COLLECTIONS DIVISTO 3. 7KA Tne payments ordered under item ld shall be paid to (name, address): FINANCE BUILDING - ROOM 203- MARTINEZ, CALIFORNIA 9451 The payments ordered under item le shad be paid to (name, address): 4. 1 1 . ACCOUNT NO. 637248 5. The payments ordered under item 1 shall continue until further written notice from payee or the court. 5. This order modifies an existing orcar. The amount you must withhold may have changed. The existing order continues in effect until :his modification is effective. 7. Give the employee a copy of this order within ten days. S. The total deductions under item I shall not exceed 50 percent of The employee's disposable earnings, unless this court order specifies a greater percentage below in item 10. (See the reverse for the definition of disposable earnings.) 9. This order affects all earnincs p-ayaole beginning as soon as possible but not later than 10 days after you receive it, unless a later Cate is shown in item 10, 10. 77Y, Other: Payments s'l-l-r-11 commence june 1 , 1991 THE COURT FliNDS ,he total arrea.ace to be as follows: Amount As of (date) 11. a. Child support: $14 , 935 . 00 May 31 , 1991 b. 0 Spousal supoor-,: C. Family support: �IAy 2 3 1.9191 R. TREMBATH Date: JUDGE 0;7.k SUPEAIOA COUR7 (See reverse for information and instructions) ;o— R.-c 122S �C Tk�CS ASSIGNMENT ORDER C--Z�cr i A 39: 2 J 29C C�jl, (Family Law) .'cact of Z-,P,ccece 4 '06 990� 'ev 7/90) --16 72 !Z25 70 ire, '111 it �67. A S S I Grj,%,1,L(:T 0RD';R 7r.e:e instruct ons aooly only to this E—_.a,'1✓S --si T*rtL Cl__ra: LS-rai 1); a Cam. i. �.5;ior.m:_•r,; orders are now issued automatically in all cases involving suopor,. 2. if .n+s emoloyee stocs working for you. you must notify the Gerson shown in re.m 2 on the front not later than the date of the next payment. You must sen; this notice by first mass mail postage prepaid, even if your employee does so. 4, Give ;he employee a copy of this order within 10 days. rq/yy b'd;;hhold money from the earnings payable to the employee using the Computation Instruct5Ionr� c� 5 3/- gig :. You may deduct $1.00 from the employee's earnings for each periodic payment you make. G� o. If you are unable to pay the withheld amounts for six months or mere due to the failure of the person to whom money is to be paid to notify you of a chance of address, advise the employee so that a tour; order terminating the withholding can be obtained. Make no further payments under this order and return all undeliverable payments to the employee. This order has top priority over all other orders. including earnings withholding orders (wage garnishments). Do not withhold earnings for any other order until the amounts necessary to satisfy this order have been withheld in full: When this order is for child support, it has top priority over a similar order for spousal support. The front of the form will tell you which types of support this order is for. E: If the employee is paid by a different time period from that specified in 'he order, you should prorate the amount ordered to be v:ithheld so a part of it can be withheld from each of the employee's paychecks. For example, if the support is paid monthly and the employee is paid weekly, you should divide the support by 4i; to see how much should be withheld each week. You may ac- cumulate the %vithho(dings and pay it monthly if the order so provides. You will be liable for any amount you do not withhold and you can be held in contempt. California law forbids your firing, refus- ing to hire, or taking.any disciplinary action against any employee because of a �^-nlrpc A551 ilTrri� QrG�. 10. '.."hen sendinn the wiihhel c�_ o the ;avee, state the care of the paycheck from .which the..., were withheld. + CF."i 11I PSS COMPUTATION INSTRUCTIONS State and Federal laws limit the amount of earnings that you should vAthhold and pay as directed by this order. The limitations are s–nted as a specified percentage of the employee's dis.00sable earnings. Drsoosable earnings are different from gross pay or take home pay. camincs include any money, whether called wages. salary, commissions, bonuses. or anything else if it is paid by an e,moloyer to an err,;loyee for personal services. Vacation or sick pay is subject to wit`hoidina as it is paid to tae employee. Ti;,s are generally not included as earnings since they are not paid by the employer. Reimbursement of expenses is not earnings. (b) Disposable earnings are the earnines left after subtracting V%e pa„ of the earniocs that state or federal law requires an empioyer to % ,r.nold. Generally these required deduc;ions are (1) federal inccme tax, i2) federal social security, (3) state income taz, (4) state j;sabiii,,y insurance, and (5) payments ;o public employees' retirement systems. Disposable earnings change when re;ruired dec!uctions chance. If tax or Gay rates change, you may have to reficure the withholding. After the employee's disposable earnings are known, wit^hold me amount require--'by the order, BUT NO MORE THAN 50 PERCENT, UNLESS THE COURT ORDER SPECIFIES A HICr'ER ?ERCEN .4G;: Federal ;zvi prohibits withholding more than 85„ .ercent of disposable earnings. Questions about federal law and the rules will be answered by mail, telephone, or personal interview at any office of the Wave and Hour Division of the U.S. Department of Labor. Offices are listed in the telephone directory under the U.S. Department of Labor in the ; .S. Government listing. These offices also provide publications free of charge. EMPLOYES INFORMATION Civet Code section 4390.9 describes the procedures available for you to ask the court to cuash this order. You must act within 10 days :ter receipt of this order. See the procedure set fork in Civil Code section 4390.11. Civil Coee sect on 4290.14 tells you when and how to petition the court to end tnis wage assignment order. These ia%:,s may be found in any law library. TO THE EMPLOYEE. The law requires that you notify the person to whom the support is paid (item 2) if you change your employment. You must provide the name and address of your new employer. 7' 7: ASSIGNMENT ORDER Page +wo rFamily ].Awl SEATTLE CITY ATTORNEY MARK H. SIDRAN December 31 , 1992 Jeffrey A. Hess , Esq. 1218 Third Avenue -, Seattle , WA 98101 71 _ rn m RE: Gregory S. Gurley `-' in I-TI Dear Mr. Hess : .` The City withheld child support payments from the salary o€, Gregory Scott Gurley for the support of Gina Michelle Gurley,,) - born June 6 ,1978 , payable to Contra Costa County, pursuant '-to an order of the Superior Court of California, Contra Costa County, as assignee of Barbara Ann Gurley, dated May 23 , 1991 , and June 14 , 1991 ; which are in turn based upon a "Stipulation and Agreed Order Modifying Decree of Dissolution" and "Decree of Dissolu- tion" dated September 18 , 1980 , and May 7 , 1980 , respectively, of the Superior Court of the State of Washington for King County. City staff state that when the City received the order from the Superior Court of California, it notified Mr. Gurley of the order and its intent to start withholding. See Notice, dated May 28 , 1991 , with notation. Mr. Gurley made no objection. By letter dated May 1 , 1992 (enclosed)., he requested a modification in the amount, stating that he had paid the arrearage, and consented to a withholding of the current payment. Later still , ;he requested that withholding cease, and the City then ceased doing so. Under RCW 74 . 20 , the Superior Court of California, the assignor or the City could have referred the order to the State of Washington, Department of Social and Health Services , Office of Support Enforcement, for an order of enforcement of the court judgments; or the obligees could have sought a mandatory wage assignment under RCW Chapter 26 . 18 . This additional step would have added expense, which under RCW 74 . 20 . 040 (6) would have been payable by Mr. Gurley. The withholding was fully in compliance with RCW 4.9. 48 . 010 . RCW 49 . 52 . 070 has no pertinence because Mr. Gurley consented orally and in writing to the withholding, and the withholding was made in good faith pursuant to Court orders . CML DMSION 600 FOURTH AVENUE. 10TH FLOOR.SEATTLE.WASHINGTON 98104.1877 (206)684.8200 FAX(206)684-8284 Jeffrey A. Hess , Esq. December 31 , 1992 Page '2 A copy of the court judgments is enclosed. Very truly yours , 14ARK H. S IDR- N City A orney / Y' Jar en G. Bader si Astant City Attorney JGB:bse Enclosure cc: Finance Director CLAIM 3 ' 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 JANUARY 11 , 1994 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $4 , 038 . 10 Section 913 and 915.4. Please note all •Warnings". CLAIMANT: Pfister Excavating, Inc . ATTORNEY: Date received ADDRESS: P.O. Box 4312 BY DELIVERY TO CLERK ON December 16 . 1993 Vallejo, CA 94590 BY MAIL POSTMARKED: Fax Delivered via: Public Works 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gg - I DATED:����.�..,.1l.�.. �-l. 1 gr 9_'k ��ll Deputy OR, Clerk %L P�� I1. FROM: County Counsel TO: Clerk of the Board of Supervisors (V) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: fF�Gt,��..e (X� 2� �� BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (✓f This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. /1 Dated: A hs- PHIL BATCHELOR. Clerk. By t aA' Q 0�..� , 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: BY: PHIL BATCHELOR by—J, . 24 4,p 4� – l Deputy Clerk LC: County Counsel County Administrator DEC-16-1993 15:11 FROM C-C-C-PUBLIC WORKS TO CLK. OF BOARD P.02 IDELIVERED RECENED To: Board of Supervisors 6 Contra Costa County 255 Glacier Drive g5vis RS Martinez, Ca. 94533 Of S CO. cLERK'a0AR RACES CONTR t'� NOTICE OF CLAIM /VERIFIED CLAIM This claim is presented by Pfister Excavating, Inc. The office of claimant is 1500 Green island Road, Napa, CA 94589, and all notices respecting this claim should be sent to Pfister Excavating, Inc. P.O. Box 4312, Vallejo, CA 94590. The date and place of this transaction giving rise to this claim is that certain written contract entered between the Contra Costa County and the claimant, to Wit: and the claimant furnished labor, material and equipment for the installation of a Storm Drainage Area 29 C, Project No. : 7555-8507-92 and related work between July 28 , 1993 and September 10, 1993 . Said claim is based upon damages incurred by this claimant as a result of the breach of contract by Contra Costa County for extra costs over and above contractual obligation in the sum of Four Thousand Thirty Eight Dollars and Ten Cents. The amount claimed is the sum of $4, 038. 10. Said damages are based upon the actual records and books of claimant . Gregory J "P X,te Se Se Presid tary • 0 November 12, 1993 To: Board of Supervisors Contra Costa County 255 Glacier Drive - LL Martinez, Ca. 94533 NOTICE OF CLAIM /VERIFIED CLAIM This claim is presented by Pfister Excavating, Inc. The office of claimant is 1500 Green Island Road, Napa, CA 94589, and all notices respecting this claim should be sent to Pfister Excavating, Inc. P.O. Box 4312, Vallejo, CA 94590 . The date and place of this transaction giving rise to this claim is that certain written contract entered between the Contra Costa County and the claimant, to Wit: and the claimant furnished labor, material and equipment for the installation of a Storm Drainage Area 29 C, Project No. : 7555-8507-92 and related work between July 28, 1993 and September 10 , 1993 . Said claim is based upon damages incurred by this claimant as a result of the breach of contract by Contra Costa County for extra costs over and above contractual obligation in the sum of Four Thousand Thirty Eight Dollars and Ten Cents . The amount claimed is the sum of $4 , 038 . 10 . Said _ . damages are based upon the actual records and books of t claimant. Gregory J Pl ter Presid Setary V E R I F I C A T I O N I, the undersigned, say': I am a officer of the claimant, and authorized to make this verification on its behalf; the foregoing is true of my own knowledge, except as to those matters which are therein stated in my information or belief, and as to those matters, I believe it to be true. I declare under penalty of perjury that the foregoing is true and correct. Executed on November 12, 1993, at Napa, California. P1 Gregory Pf YP,ter Presid / ec etary d e _ , • V AMENDED 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 JANUARY- 1 1 , 1994 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: • Not to exceed $25 ,000 . 00 Section 913 and 915.4. Please note all 'Warnings". CLAIMANT: RAMOS , Velena ATTORNEY: Jacoby & Meyers Elizabeth Guagenti Date received ADDRESS: 100 Bush St . , Ste . 700 BY DELIVERY TO CLERK ON December 17 , 1993 San Francisco, CA 94104 BY MAIL POSTMARKED: December 16 , 1993 Certified Mail P 842 723 238 I. FROM: Clerk of the Board of Supervisors TO: County Counsel \Attached is a copy of the above-noted claim. QH g DATED: 1Jt �.t l . X14�? Bl iL DepuLylOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( V� 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). (150 ( ) 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). ( vi Other: Dated: C;-.ens 6e.L 21 1 7p 3 BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 1V. BOARD ORDER: By unanimous vote of the Supervisors present W-1 This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR. Clerk, By �,� ,QQa _ . 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 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: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LA a JACOBY& MEYEM LAW OFFICES RECEIVED PERSONAL INJURY UNITj 100 Bush Street,Suite 700,San Francisco,CA 94104 LAN5 1993 415/399-8951; FAX:415/399-1939 CLFR COOARD NPE TRA COST:--VI'SORS'CO January 3, 1994 Board of Supervisors, Contra Costa 651 Pine Street Martinez, CA 94553 Re: Velena Ramos Date of Loss: June 24, 1993 Dear Sir or Madam: Please be advised that this law firm is no longer representing the above-referenced client in connection with the claim for personal injuries. You will, presumably, be contacted directly by the former client or new counsel. Thank you for your cooperation. If you have any questions, do not hesitate to call. Very truly yours, z eS M. Gu ti EMG/pba We use recycled paper. OFFICE OF COUNTY COUNSEL DEPUTIES: PHILLIP S. ALTHOFF CONTRA COSTA COUNTY SHARON L. ANDERSEN ANDREA W. CA.SSIDY %6 VICKIE L. DAWES COUNTY ADMINISTRATION BUILDING MARKE S. ESTIS MICHAEL D. FARR 651 Pine St. , 9th Floor LILLIAN T. FUJII MARTINEZ, CALIFORNIA DENNIS C. GRAVES VICTOR J. WESTMAN GREGORY C. HARVEY COUNTY COUNSEL 94553-0116 KEVIN T. KERR EDWARD V. LANE, JR. SILVANO B. MARCHESI TELEPHONE (510) 646-2074 MARY ANN M. MASON ARTHUR W. WALENTA JR. FAX (510) 646-1078 PAUL R. MUNIZ VALERIE J. RANCHE ASSISTANTS DAVID F. SCHMIDT DIANA J. SILVER VICTORIA T. WILLIAMS December 22, 1993 Dlorah D. Spence, Esq. JACOBY & MEYERS 100 Bush Street, Suite 700 San Francisco, CA 94104 RE: Claim of VALENA RAMOS Dear Ms . Spence: Your references to Blair v. Superior Court and Phillips v. Desert Hospital District are not helpful to me. Phillips deals with an insufficient claim where a public entity waives the insufficiency by failing to give notice of the insufficiency. Blair applies where the entity owns and has a duty to maintain the property. What we are pointing out to you in the notice of insufficiency, and the point that you have not corrected, is that the alleged site of the accident according to the claim, the park, is owned by a separate and distinct public entity, i .e. , the City of Pleasant Hill . You have not claimed that Contra Costa County owned, or had a duty to provide for the maintenance or security of the park. I am again noticing the insufficiency of the claim so that the County does not waive the insufficiency under the "Phillips rule. " The matter will be rejected by the Board of Supervisors (whether you further amend or not) at its meeting on January 11, 1994 . Hopefully, you will find this information helpful . I would also suggest that before you make a final decision as to whether to file suit against the County that you review the provisions of Code of Civil Procedure section 1038 . Very truly yours, VICTOR J. WESTMAN Coun Counsel By G y C. Hary y Depu County Counsel GCH:ky cc Risk Management Page 2 JACOBY& MEYERS LAW OFFICES PERSONAL INJURY UNIT 100 Bush Street,Suite 700,San Francisco,CA 94104 415/399-8951; FAX:415/399-1939 December 16, 1993 Board of Supervisors, Contra Costa County County Administration Building, Room 106 651 Pine Street Martinez, CA 94553 RE : Our Client(s) : Velena Ramos Date of Loss : June 24, 1993 To Whom It May Concern: The above referenced claim was received by your office on December 10, 1993 . Your office sent a Notice of Insufficiency and/or Non- Acceptance of Claim dated December 15, 1993 . The claim substantially complies with all of the requirements of Gov.C. Sec. 910 and 910 . 2 . This satisfies the requirements of the claims act (please see [Blair v. Sup. Ct. 9 Dept. of Transp. ) ( 1990) 218 CA3d 221, 225, 267 CR 13, 16 ] and [Phillips v. Desert Hosp. Dist. ( 1989 ) 49 Cad 699, 706, 263 CR 119, 124] ) . Nevertheless, we are re-filing said claim with the requested information handwritten as addendum. Please return one copy stamped received in the envelope provided. If Contra Costa County wishes to reject the claim, please send such notice to the address listed on the letterhead. Thank you for your attention. Very truly yours, JACOBY & MEYERS LAW OFFICES Dlorah D. pence Enclosures We use recycled paper. 1 BOARD OFA 9IIPERVISORS OF CONTRA COSTA COQ}'rY IK=CTIONS TO CLAIMANT N A. Claims 'relating to causes of action for death or for injury to person or to per- sonal property or growing crops' and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 11 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Roan 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 ) VELENA RAMOS ) RE CEIVED Against the County of Contra Costa ) DEC -17 03 or ) _J PARK District) CLERK BOARD OF SUPERVISORS 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 $ (*) and in support of this claim represents-as_follows: (*) Total amount_not_to P225,000 . 1. When did the damage or injury occur? (Give exact date and hour) 6-24-93 at 7 : 00 p.m. 2. Where did-the damage or injury occur? (Include city and county) ~ Pleasant Hill Recreation & Park Dirstrict ,L 4 � - 147 Gregory Lane, Pleasant Hill, CA 94523 3. How did the damage or injury occur? _(Give full details; use extra paper if rgqt,ired) Nine year old claimant sat on a swing, which' is a tire hanging on three steel chains . After claimant was in swinging motion, one of the chains broke where it connects to the tire and struck claimant on her face, arms, back_ and her head w_M 4. What particular act or omission on the part of county or district officers, servants or gmployees caused the injury or damage? The City of Pleasant Hill failed to maintain public property in a safe condition. cis �4�- S Apecl\ (over) -5. . What are the names of (-mty or district officers, serv`:cs or employees causing • the damage or injury? .,Pleasant Hill Recreation & Park District 6. What damage or injuries do you -claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.. Bruises scratches to head, arms, and back. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injumy or damage.) foro AVI ascertained at this time � j;,�- f P/Xcz�� 'afj 000 8. Names and addresses of witnesses, doctors and hospitals. Merrithew Memorial Hospital Concord Health Clinic 2500 Alhambra Avenue 3052 Williw Pass Road Martinez , CA 94553 Concord, CA 94519 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT no,(ascertained at this time 1tJO1-e'X"Ce-V-d1'1k� ;y0O' Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some Wson on his behalf." Name and Address of Attorney > e4'av� u� �C�BY 9cy�5 ai is Signatwv /PV 6V6H 5-f�T 1245 Pine Creek Way �vt rt 70D &W f ,CAOWCO) CA �jyloy Address EUZA$fZf+ 6N*f-C4sT11 CSQ Concord, CA 94520 Telephone No. `� Telephom No. (510) 798-4874 f f 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 ($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. � 2� � \ \ ^ ^a k \ § � � \ . m q . : f : : & _ r ■ � . � q . 2 � \« \ k ±e< 9 h \ % \ % ! « ? ) ; 7 ) � . , y941 \0.� e . » V \ . . . � . . � . ' % \ . f o � & t \ \ i . 0) c \ Q # . �