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Home My WebLink AboutMINUTES - 02271996 - C.28-30 CLAIM BOAR: OF SI,PEGy:SOPS OF CON'RA COSTA COUNTY,_ CALIFORNIA FEBRUARY 27, 1996 Claim Against the Courty, or District governed by) BOAR: 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 Governmert Code Amount: $1,046.88 Section 913 and 913.4. Please note 811 "Warnings,,. CLAIMANT: ALLSTATE INSURANCE COMPANY 1663433835 ATTORNEY: EV WILKOM Date received ADDRESS: PO BOX 2246 BY DELIVERY TO CLERK ON FFRRTTARY 6, 1A96 BREA CA 92621 BY MAIL POSTMARKED: HAND T)FT,TVFRFT) VIA: RISK MGMT I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a Copy of the above-noted claim. FEBRUARY 7 1996 IL BATCHELOR, Clerk DATED: ��: �eputy II. FROOM 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: _ 7 _ f �e BY: Deputy Courty Couns III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (� This Claim is rejected in full. ( ) Other: I certify that this is a true and correct Copy Of the Board's Order entered in its minutes for this date. Dated: Dx - ,tZ1�v,_ PHIL BATCHELOR, Clerk. 9y �_,,) _, 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 wail to file A court action on this claim. See 60ver wnt Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you went to consult an attorney. you should do so iamediately. • For Additional Warning See Reverse Side Of This Notice AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at ail tints herein mentioned, have been a citizen of the United States, over age 10; 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: oa— aT -- 9(a BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator ' . . ^ �� ' ��'��0��N�� ' "" ��'��"�� ALLSTATE INSURANCE CO . 01/24/96 P . O . BOX 2246 BREA CA 92621 (800) 640-0614 RECEIVED V LA LEnKnv"`'`.~� - CONTRA COSTA RISK MANAGEMENT 651 PINE ST 6TH FLOO MARTINEZ CA 94553 OUR INVESTIGATION INDICATES THAT YOUR INSURED WAS RESPONSIBLE FOR THIS LOSS . SINCE WE HAVE ALREADY MADE A SETTLEMENT WITH OUR POLICYHOLDER , THE CLAIM HAS BEEN ASSIGNED TO US , COPIES OF THE FINAL PAPERS RELATING TO THE LOSS ARE ENCLOSED . PLEASE ACCEPT THIS LETTER AS NOTICE OF OUR SUBROGATION CLAIM . YOUR PROMPT PAYMENT WILL BE APPRECIATED . THANK YOU . SINCERELY , SUBROGATION DEPARTMENT CBP : G ALLSTATE INSURANCE CO . EV —'~`° x«�� -�� YOUR FILE �� |NO . � IA1624 -- YOUR INSURED CONTRA COSTA COUNTY ADDRESS / 651 PINES ST FLR 6 MARTINEZ CA 94553 OUR CLAIM NO . 1663433835 RJT OUR INSURED � RON J RICHMAN LOSS UATE / 12/12/95 LOCATION � 55O SALLY RIDE � BUCHANAN AIRPRT PKNGCONCORD CA AM0UNT OF LOSS � $1 ,O46 . �8 ALLSTATE INSURANCE COMPANY CENTRAL AUTi i Mi_i i 1797 FOX [:DRIVE. SAN JOSE, CA 25131 1 (800) @29-019 CD LOG NO 850 -0 DATE 01-17-96 ESTIMATE .CLAIM INFORMATION CLAIM 4 166 343 383 5 POLICY 4 0`4 67::3 193. COMPANY DKK AGENT INSURED LOSS DATE 06-27-95 CLAIMANT LOSS TYPE COLLISION INSPECTION . APPRAISER NAME HENRY PINNEY WORK PHONE (r U U) 829-0129 x8189 FAX (51 0) 937-0526 -:X526 . . ADDRESS 3496 BUSKIRK AVE. INSP, DATE CITY STATE PLEASANT HILL CA LOCATION ZIP 94523- CITY STATE" OWNER NAME RICHMAN, RON/CHERYL WORK PHONE REPAIR VEHICLE 84 MERCEDES BENS. 500 SEC 2 60OR SEDAN 8 CYL ENG 5. 0 LITRE OPTIONS SUNROOF BODY COLOR BURGUNDY MILEAGE 97, 41F, CONDITION GOOD VIN WDB►_A44A8EA004666 LICENSE U 3GBY553 CODE 3121 LICENSE STATE CA VEH Ply, # REMARKS 43 ASSIGNMENT- SETTLE COLLISION L QTR PAINT BLEND OPEN. DAMAGE ON LF DOOR IS OVER THE INCURS10N BAR. THE LF DOOR CLADDING IS OPEN. ITS INSERT IS DEFINATELY DAMAGED. THE CLADDING ISTUSHED PUSHED IN, MAY BE OK - PART GDE OPERATION PRICE LABOR RT STRIPES AND MOULDINGS Mlds, Fender Lower- L/R 011:3 R&I Assembly u. 4 SM M'1dg, Front Door- Lower- LT i i 199 R<I Assembly U. 6 SM M1da, Fcont. [Noor- Side LT 11201 Replace OEM 39. 50 0. 2 ON 1266981980 0 FRONT BUMPER Front Bumper- RBI 0006 R&I Assembly 1 . 0 SM FRONT END PANEL AND LAMPS lem*;, Far'klamp LT ut:+10 RNI '1sNamb1M FRONT BODY AND WINDSHIELD $& MERCEDES BENZ 500 SEC, 2 Int,OR SEDAN DA rE< 01-17-W. CLAIM 4 166 343 383 5 LOG 850 ' Fender,,Front LT 0103 Refinish 1 . 5* RF FRONT DOORS Door..Shell,Front LT 0207 Ropa i r 7. 0* SM Door Shell,Front. LT 0207 Refinish 2. 4 RF Surface 2. 4 Handle,Front Door Otr- LT 0213 R&I Assembly 1 . 4 SM P0, Inner Door- Trim LT 0231 R&I Assembly SM M1dg,Front• Door- Belt LT 0239 R&I Assembly U. 4 SM Mir-ror,Outer R/G LT 0243 R&I Assembly 0. 3 SM MANUAL ENTRIES Polish Paint M12 Repair 1 . 0* RF** Color- Tint And Blend M09 Repair- 1 , 0* RF* 14 ITEMS FINAL CALCULATIONS & ENTRIES PARTS GROSS PARTS 39. 51) OTHER PARTS.- PAINT MATERIAL 123. 90 ADJUSTMENTS DISCOUNT MARKUP PARTS TOTAL 1'f • 4'' TAX ON PARTS €c MATERIAL @ 8.250% 13. 48 LABOR RATE REPLACE HRS REPAIR: HRS 1-SHEET METAL 50.90 11 . 3 !t-- `75. 00 2-MECH/ELEC 50. 01) 3-FRAME 50. 01) 4-REFINISH 50. 00 3.9 2. 0 1 . 95. 00 5-PAINT 21. 01) LABOR TOTAL A M&ON. LABOR la �y SUBLET� RE PAIRS, ' `,'.'TOWING T STORAGE GROSS TOTAL 1 , i i.�.r:,. = t co LESS: NET DEDUCTIBLE WAIVED- «� k cn fi NET TOTAL = P ;N Yes 1 ,=_ocode: 94523 PLEASANT HILI._ SPPL No ADP PENPRO W030 ES LOG 1=50 —0 01- 17-96 1.6: 16: 02 REL 3.0 CV 12/95 COPYRIGHT, AUTOMATIC DATA PRO E=SSING. IN+W. 1995 THIS ESTIMATE HAS BEEN PREPARED EASED ON THE USE OF _FA`H PARTS SIJPE'•L_:. ED By f) SOURCE OTE•Ik:;R THAN THE MANUFACTURER OF YOUR MOTOR VEHICLE. ANY lA:(aEtRMN f.E:0:- Rf„..P"A1,.:.EMENT PART@ @ AfiM PfCQV Y:[;AD MY THE Mt3f tUrr its i Uf.I:_Q 1 _ 4D. W o , c Cok o iB CO 0 o ' W ` N N . tr Q I °d CC) - -- M J O U ' U l � LLI o 4 A. IA CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 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 Goverment Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $1,000,000.00 Section 913 and 915.4. Pleas $j$ ISI) CLAIMANT: ODIS C BOWENS JAN 3 p 1996 ATi ORNE Y: COUNTY COUNSEL Date received MMTINEZCAUF. ADDRESS: PO BOX 23453 BY DELIVERY TO CLERK ON JANUARY 30, 1996 PLEASANT HILL CA 94523 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: TANUARY 'jo, 1 AA6 IYjL B�PuLyLOR, Clerk Il. 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: 1/31 q 8Y: Deputy County Counsi II1. FROM: Clerk of the Board t0: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARDS ORDER: By unanimous vote of the Supervisors present ( ✓) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 6a -a7 - 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 wail to file a court action On this claim. See Government Code Section 945.6. you may seek the advice of an attorney of your choice in connection with this matter. If you went to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of Ibis Notice AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today 1 deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: p--1, - a 1`f`I BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim *to: , BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY C . A INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim Bv Reserved for Clerk's filing stamp -77) ) Against the County of Contra Costa JAN 3 0 1 District) CLERK'E ORS Fill in name ) cc ; _ The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ IoC)Z)c,. GU , 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) 3. How did the damage or injury occur? (Give full details; use extra paper if required)Al N;A2 And .S Ca//e,1 � S h Ic r j �"�� Q�i,—fI e;�� c=.�,y��Anck Do 5+4nj le 1�I hr I - Uv-e- Ve lkn4z,�',1 �,��k �+ �- B..�-�r -z w� ,A ,X �� Al 0ce �,e Ste" e ��1' /_4 6 L,Le,cit ce�tLiIVr A` e.� - �4A iWi,n7 , 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? �� q ,3 ,�-tfc-e r-S Plgz"e�l /�)e- �+�t.e�' r �-�. C' �. � ��.tf � F r k "Tre a le s� 5 5 i►2� . hC QF c �j ;��7, -e � � �j�F� fec� / 1 " Nover)� 1x � � Lln�z5 A rre 5. What are the names of county or district officers, servants or employees causing the damage or injury? �t Jif e�T Swre e n h 61 LAC�,1� - e 3 ---- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Fn1,5-e. Arr-es-� else Svv��r� 5 ��+1me �"t\` 'ctr�ci fl7t�r-t-�� t�(�'ce lend,J 1ureSS`�a l��r°�� C1r;ldten c� urrti 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors and hospitals. M r -D caV'e M C-,Vu rrtd r C5/U) `�3 s=��2 y �'��-er re q7 7-�5�v X S.. 17?.Ira Ufa (5,T) & 8 E� -- 7 8'F/ 9. List the expenditures you made on account of this accident or injury: DATE IYEM AWUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney Claimant's Signature . 3 if Address Telepihune No. I Telephone No. (5-/ 8 8 X 9 1 * * * * * * * * * * * * F'i * * * 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. CLAIM C,;, BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 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: $3,563.78 Section 913 and 915.4. Please note all "warnings% CLAIMANT: BYRON WAYNE BUIE Ityculawlij) ATTORNEY: JAN 3 0 1996 Date received OOUNTY COUNSEL ADDRESS: 400 SPARROW DR BY DELIVERY TO CLERK ON JANUAI �I HERCULES CA 94547 BY MAIL POSTMARKED: HAND DELIVERED I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gg DATED: JANUARY 30, 1996 Bpp ail BATCHELOR, Clerk Il. FROM: County Counsel TO: Clerk of the Board of Supervisors ( f This Claim complies substantially with Sections 910 and 910.2. ( This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY. ► Deputy County Counsf II1. 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. Gated: Cd-;L7- 199-15 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 to 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: 8Y: PHIL BATCHELOR b w � y _�_Deputy Clerk CC: County Counsel County Administrator V. . Claim 'to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY C INSTRUCTIONS TO CLADWU 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 5911.2.) 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 ane public entity, separate claims must be filed r-Sairst• each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this To-m. e * * * � � * e * tee * * • * e * eeee • eeeeee * eeeeeeeeeeeee RE: Claim By Reserved for Clerk's filing stamp yRECEIVED Against t County of Contra Costa ) JA 3 0 rt!6 or ) CLERK �= ;VISORS District) cof , CO!CT,�. .:o�.E Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 35(o�, �'� and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. mere did the damage or injury occur? (Include city and county) t7 �:1 1 MLv 1 1 til t-CC��U�ES -T IA M 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, servants or employees caused the injury or damage? (over) C.X's 5. What are the names of county or district officers, servants or employees causing the damage or injury? NIS 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.) 8. Names and addresses of witnesses, doctors and hospitals. -A ( "-\u� LI TUI'k 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT seese * ecce * feeeeeeeaee • eeeeeefeae * e # a * • eaa Gov. Code Sec. 910.2 provides: "The clam must be signed by toe claimant SEND NOTICES TO: (Attorney) or by Vm person an his behalif." Name and Address of Attorney (Claimant's Sign7a ) , (Address) �(�rl cUL CA gLl5- � Telephone No. Telephone No. L5/o) -79 i-J(/3i'7�' ee * 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 waiting, is punishable either by imprisonment in the county jail for a period of not more than ane year, by a fine of not exceeding one thousand ($19000), 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. •dl 0 :sPPa Z,--, L UCS CA SCj cq ;_� - - c I t,-k\j L-"-,-\j C-('3 C..z:U C OC-I----�'.lCci'`»(,Y\C2c.-----l�l\i��--___.__- �tl�r k PP�l L-C) 0 ------------ A U 35 ------------ -1!1vv\,ru C-12� p6t�5 __(3-S--.-_- u-�L vcb--o' -1k.If _'Ti A,-Ja -jb :TSp PT t4 OiCICU _�'�-rE ��c l�_v_P_- ; t�1 -7►{E_._2 w��s-_2i�Z- ��,�;z�.2...Q�'�n.,_�. _-- _ _ =T►oma--- e2,��.--h -tel _.u __� _b, c __t .�_�o -- _ -- O ---�Nz _ - . i2,�► "[ �� ._t_if� 1�� - _ AC�a�: K)-rc-A_sc-c-rj oa -Apr --Tv c..,( i:�teCL4J'(:5c A_. rTt -TkA-T _ktS _ .A�o LA,)G____iwto &Czca� --------- 16;�E� 1l a F P"4�k &4 le" 760 SAN PABLO AVENUE a PINOLE, CA 94564 a (510) 724-8482 Bureau of Automotive Repair A AA115196 Owner �/� � Expert Fender And Body Work Date Address anc_), ��J�LX.t `�✓ PhonHsee 1C�� ~c lL' J�Lic. No. ,� � ) Work City -Phone Order No. Vehicle I.D. • Year Make /l! Model -//i(/q v Mileage DUAN. DESCRIPTION Of LABOR OR MATERIAL PART NO. MATERIAL LABOR N F FNS 2 /?0 ? l Y Al L /J D�/ 1y® fir 13 /, O /1 �0 S dO le)f T C/ dP&,e T/F L Jre!; 77( /3 (,,Io N 67, It- /37 3 . // I r //toe A 's L 12(, 11 . 3 IV 13 In 4 C ttto tP7-9 /0 3 A o /V '291 291 ;� 2 2.z f y /3 /"Ile- 377(377 .� rr rr �r L 577/ 3 /✓ L 5 /C-zslL 57 r/S- - 2 Al Ilt i r 37 e( 1lwo tArely 3d10/1012T I? ?g Z �✓ '' '� 33 sz z i 30 a a a r / PARTS PRICES BASED ON STANDARD CATALOGUE PROCUREMENT PRICE LISTS SUBJECT TO CHANGE WITHOUT NOTICE TOTAL /�� PROCUREMENT AND DELIVERY CHARGES MAY RE ADDED FOR SPECIAL SERVICE ON ITEMS NOT AVAILABLE LOCALLY MATERIAL Old pats renteved from carr will be junked unless otherwise instructed in writing TOTAL LABOR150 The above is an astinlate bored on our inspection and does not co.*, odd,Konal.pares or labor which may be required after TOTAL MATERIAL 9 O rhe .work has been epee.d up Occorianolly afro work has►rowed worn ports ore discovered which ore not ev= on hrrr in &pacthon Becouse sl this IM above pricer ore not guaranteed Estimate IstirnaNd By Approved By TAX Q AUTHORIZED AND ACCEPTED PAID OUT• Tow.SToe,.GE Date SUBLET REPAIRS °gene' at TOTAL 563 7S or Agent COMPLETE BODY AND FENDER WORK FREE ESTIMATES ESTIMATE OF REPAIR COSTS % INSURANCE WORK OUR SPECIALTY Date Phone 2737!1 0-6 13 ASO :. Ica �?7 - "2° Name 1100%, ONOP J �%� tS Qt y '- � Address VyO id A kwz)u> Z '' City NN ALEXANDER r >t /C� ! 17 Y/ Year D.O.M. .ZSL Make Model C S Style 7� c License No. Cf 0;4 1P Body No. Serial No.`s v! ;� /��laim No. Insurance Quan, WORK TO BE DONE Labor Material Gc 2 3 is )M L CSL 4 5 6 } 7 �- /q 7�r7 GL 1 1 �j U g � 10 O 11 r 7 'Y- 12 t I, 13 14 fl 15 16 c f1 17 .. 19 Z 20 REFINISH ATERIAL RUST PREVENTION MATERIAL BLEND&MATCH GRAVEL GUARD MATERIAL TOTAL PER PARTS PRICES SUBJECT TO INVOICE LABOR HRS. 32.3v X$ f/ HR. -s 14 Y 7, 3 z PARTS The above is an estimate based on our inspection and does not O LISTS LESS —%DISC. -$ ' cover any additional para or labor which may be required after the work has been opened up. Occasionally after work has started, SALES TAX $_ ��— worn or damaged parts are discovered,which are not evident on PAINT,MATERIALS III NET ITEMS $ the first inspection. Because of this the above prices are not guar- anteed and are for immediate acceptance only. TOTAL REPAIR COST S Accepted by Owner or Agent COMPLETE SODY AND FENDER WORK FREE ESTIMATES ESTIMATE OF REPAIR COSTS / INSURANCE WORK OUR SPECIALTY Date Phone �? Name � � 800 SH Op Address Ri t City LYNN ALRXANOtR P14 Year_ D.O.M. Make Model Style License No. Body No. Serial No. Claim No. Insurance Quan, WORK TO BE DONE Labor Material 2 .r , 12_ to 3 4 415 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 REFINISH MATERIAL RUST PREVENTION MATERIAL BLEND&MATCH GRAVEL GUARD MATERIAL TOTAL PARTS PRICES SUBJECT TO INVOICE LABOR HRS. X$ HR-$ PARTS The above is an estimate based on our inspection and doer not a LIST= LESS %DISC. -$ cover any additional para or labor which may be required after the work has been opened up. Occasionally after work has started, SALES TAX $ worn or damaged parts are discovered,which are not evident on PAINT,MATERIALS di NET ITEMS $ the first inspection. Because of this the above prices are not guar- anteed and are for immediate acceptance only. TOTAL REPAIR COST $ Accepted by Owner or Agent CLAIM BOAR: OF SLFE;V:SORS OF CON'RA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 Claim Against the County, Or O}Strict governed by) BOAR: ACTION the Board of Supervisors, Rcuting 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 pu0104a de Amount: $3925.70 Section 913 and 915.4. Pit astrni CLAIMANT:CALIFORNIA STATE AUTOMOBILE ASSOCIATION FEB Q 7 1996 01-3D4945-2 ATTORNEY: SANIA SEILS � " Date received ADDRESS: PO BOX 1128 BY DELIVERY TO CLERK ON FEBRUARY 6. 1996 CHICO CA 95927 BY MAIL POSTMARKED: HAND DELIVERED VIA: RISK MGMT I. FROM: Clerk of the Board of Supervisors TO: County Counsel Atu ched is a copy of the about-noted claim. QQ DATED:_ FEBRUARY 7, 1996 IV BepuLyLOR' Clill erk J 11. FROM: County Counsel TO: Clerk of the Board of Supervisors x M 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 to 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), — 7 ---q Ca __De;uty CDurty Couns 1II. 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 (V) This Claim is rejected in full. ( } Other: i certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 09 -A 7 — 1611(a NIL BATCHELOR, Clerk, By , Deputy Clerk WARNING Nov. code section 913) Subjtct to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in tht Yil to fill a court action On this claim. See 6overnaent Code Section 945.6. You way seek the advice of an attorney of your choice in connection with this latter. If you want to consult an attorney. you should do :o inediately. * For Additional Warning See Reverse Side Of This Notice AFFIDAVIT OF MAILING I declare under penalty of perjury that 1 am now, and at all tilts herein mentioned, have been a citizen of the 1lnited States, over age 16; and that today I deposited in the United States Postal Service in Martinez. California. postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. _ Dated: - 5 —i2cl n BY: PHIL BATCHELOR by ,, Deputy Clerk CC: County Counsel County Administrator . . . California State Automobile Association � ,w�� w~-~ < Qq>� <*>-Tllnter-lnsurance Bureau CHICO (916) 891-8601 P.O.8X 112B( 2221 FORES7 ) CHICQ CA 95927 ' FEBRUARY 1 , 1996 CONTRA C0S7A RISK nGMTNYHART ,HEIDI ,K 651 PI;E ST 6TH FL N�: O1-3D4945-2 MARTINEZ CA O-22-95 DEAR C01,111RA CUSTA R]�K MGMT: THIS IS NOTICE OF OUK SUBROGATION INTEREST ARISING FROM THIS LOSS. WE HAVE ARRANGED �E7TLEMENT WITH OUR INSURED. FLEASE MAKE YOUR PAYMENT DIREClLY T[ THE CALIFORNIA STATE AUTOMOBILE ASSOCIATION INTER-INSURANCE BUREAU ( CSAA-IIB) . ATTACHED ARE : �EPAlR f", RFNTAL BILL $ 506.33 TOTAL � 3925. 70 RALPH WALLER WAS DRIVING A CONSOLIDA7ED FIRE DlS7RICT VEHICLE. I HAVE ENCLOSFD A CDPf DF THE POLICE REPORTORR.Y IT IS SUCH A BAD COPY. O7HER : A7�EwTIONiULIE AUMOCK RECEIVED SINCERELY , LFEB - 61996 »L > CLAIM REPRESE`T�lI�E - ' California State Automobile As,sociation Inter-Insurance Bureau 032 730397032 L730397-1--R DATE DATE 01:LOSS CLAIM 10-22-95 01-3D4945-2 fyUpA"TEHEIDI; R _V5 DATE ' - 6 -S PAY P 1 16 OF LOS 6Y L T, HEIDI, P $3, 419. 3-7 A6y_6PE ldf LOSS 00 ADJUSTER NO IN PAYMENT OF Through r 7 1 Bank of America NT&SA 11-35 LAF 6791 VEHICLE REPAIRS San Francisco Commercial Rankin 1210 345 Montgomery Street )TddCo.CA 94104 PAY *THREE THOUSAND FOUR HUNDRED NINETEEN 37 IT IT TIN: 94-1710725 rT (r, SUN VALLEY BODY SHOP tz� 1260 DIAMOND WAY rr TO CONCORD CA 94520 IZED StGNATU E DOVIE LOW ORDER NOT NEGOTIAB E OF M.O. COPY U603273039?96 4120003S81: 12330,„90948,1' ile,Association Inter-insurance Bureau 0327301 53 032 L7301 513-61-R California State Automob DATE 11-29-95 iNSURED'SNAME DATE OF LQ5�, �GLAIM 0 10--22-95 1-3D4945-2 NYHARToHEII)I, R M PAY z CLAIMANTS NAME $ 00 :FF1 POLICY—TYPE K NYHA`T; HEIDI R M 4k6- j'b E KIND 4F Th'. Cn (aA' M L n Th,ugh NT&SA 11-35 0 Through ENT OF Bank of America NT&SA 0 00 a . �o e'-at Banking 1210 ADJUSTER NO n Franc�,sco Commercial Ei�nk,ng z F Street DO INV#DO48988-10 DAYS RENTAL San Montgomery eel LAF 30620 345 Montgorn"Street MI ------------- San Francis=CA 941 ITI *ONE HUNDRED FIFTY 00/100* m .2 m PAY M Cn M TIN: 36-3041733 (n ENTERPRISE RENT A CAR* M Po BOX 2074 AUTHORIZED SIGNATURE DAWN MARIINEX TO THE SAN LEANDRO CA 94577 NOT NEGOTIABLE ORDER OF M.O. COPY 118032730153,10 1: 121000358l: 1233OW9094846 c . 2g ENTERPRISE INVOICE RENT-A-CAR - _'EMENT NOAD 048988 1260 LiAMOND WAY DESCRIPTION RATE AMOUNT CONCORD CA 94520-5226 26 DAY FED TAX ID# 36-3041733 BILLING INQUIRIES CALL 510-674-1110 AAA INS-LAFAYETTE ATTN: MARTINEZ*DAWN* BILL 3390 MT DIABLO BLVD TO LAFAYETTE CA 94549 DATE OUT =/21/95 10/26/95 RENTER HOMEPHONE HEIDI NYHART 510-938-2857 ADDRCSS OFFICE PHONE 109 ROBLE RD APT 103 415-95 - CITY STATE ZIP WALNUT CREEK CA 94596 SALES TAX% 8 .25 38 . 59 DRIVER'S LICENSE STATE EXPIRES A3597683 CA 3/13/99 DOBHEIGHT WEIGHT SOCIAL SECURITY ft 3/13/72 5 7 105 ON FILE RENTER HAS REAG,UNDERSTANDS AND AGREES TO THE TERMS AND CONDITIONS. ORIGINALDOCUMENTWITH RENTER'S SIGNATURE IS ON FfLE_RENTALAGREE- MENT RENTER X SIGNATURE ON FILE TOTAL CHARGES 506. 33 REQUEST FOR PERMISSION FOR PERSON OTHER THAN RENTER TO DRIVE. NAME NO OTHER DRIVER PERMITTED AGE LICENSE NO. STATE EXP_ LESS AMOUNT RECEIVED . 00 CHARGED TO OTHERS 356. 33 BILLING INFORMATION: $15. 00 PER DAY • ■ 150 . 00 NO SALES TAX NOT TO EXCEED $ 150 . 00 TOTAL RENTAL VEHICLES CLAIM INFORMATION COLOR LICENSE NO. CLAIM»/POLICY#/P.O.K gp.n 1--fIDMR04 01-3D49452 MODEL UNIT x INSURED COLOR LICENSE NO. DATE OF LOSS I NEED A REPLACEMENT VEHICLE - THEFT ACCIDENT BECAUSE YOUR OWN IS IN THE MODEL UNIT x TYPE CAR REPAIR SHOP I SHOP? CALL YOUR NEAREST HYUNDAI SUN VALLEY FI ENTERPRISE OFFICE TODAY! --------------------------------------- ------------ --- --- -------- 150 . 00 • i I ._.: ..: ..^',I II :.S. .'.:'f5i ,...'ii PAID BY: REMIT TO: ENTERPRISE RENT A CAR AAA INS-LAFAYETTE ATTN: ACCTS RECEIVABLE ATTN: MARTINEZ*DAWN* PO BOX 2074 3390 MT DIABLO BLVD SAN LEANDRO CA 94577 LAFAYETTE CA 94549 CUSTOMER= I RENTAL TICKET x AMOUNT GP.OR PLEASE USE REVERSE SIDE FOR COMMENTS OR SUGGESTIONS AAA2325i D048988 150 . 00 2331 11/22 666 7796 1260 DIAMOND WAY CONCORD CA. 94520 (510) 686-5007 Fax# (510) 798-2161 N7-,L oxa--aL I n.-=xM=-LSa Qxaot-=-L+--i c=sri 0 7 7 9 6 by STEVE MORASH on 10-26-95 109 ROBLE # 103 style 4DR SED Insurer : CSAA-CONCORD Lic. Plate: 0 Adjuster : WALNUT CREEK, CA 94596 Paint code: App r ai s e Phone: 415 951 1038/510 938 2857 Prod. Date: 6/95 Claimant'4- 95 HYUNDAI ACCENT Profile AAA insured q : VIN: KMHVF14N3SU155441 Deductible; 0.00 Policy V : mileage: 648 Claim # options: 7 Labor Op Description Price Labor Paint Labor 6'f6*1s'--Prics,4 I OVERHAUL FRT COVER ASSY 0.00 1.8 0.0 BODY 2 REPLACE FRT BUMPER COVER 132.35- INC 2.3 NEW 3 REPLACE R FRT BUMPER BRACKET 2.55- INC 0.0 NEW 4 REPLACE L FRT BUMPER BRACKET 2.55- INC 0.0 NEW 5 REPLACE FRT UPR CTR BUMPER BRACKET 44.39- INC 0.0 NEW 6 REPLACE FRT BUMPER 11-TACT ABSORBER 139.80- INC 0.0 NEW 7 REPLACE FRT BUMPER REINFORCEMENT 238.06- INC 0.0 NEW 8 CK/ADJUST HEADLAMPS 0.00 0.4 0.0 BODY 9 REPLACE R H/LAMP ASSEMBLY 152.39- INC 0.0 NEW 10 REPLACE L H/LA11P ASSEMBLY 152.39- INC 0.0 NEW 11 REPLACE R PARK/SIGNAL/MKR LAMP ASSEMBLY 27.85- INC 0.0 NEW 12 REPLACE L PARK/SIGNAL/MKR LAMP ASSEMBLY 27.85- INC 0.0 NEW 13 REPLACE HOOD PANEL 218.96- 1.0 2.7 BODY NEW 14 REFINISH HOOD UNDERSIDE 0.00 0.0 1.3 REFINISH 15 REPLACE HOOD ADHESIVE EMBLEM 8.42* 0.1 0.0 BODY NEW 16 REPLACE HOOD PRIMARY LATCH 24.54- INC 0.0 NEW 17 REPLACE EVACUATE & RECHARGE AIR CONDITIONING -M 0.00 1.4 0.0 MECHANICAL is REPLACE AIR COND REFRIGERANT RECOVERY -M 0.00 0.3 0.0 MECHANICAL 19 REPLACE AIR COND CONDENSER -M 282.28- INC 0.0 NEW 20 REPLACE FRONT BODY RADIATOR SUPPORT 166.82- .7.5 0.0 BODY NEW 21 REFINISH RADIATOR SUPPORT COMPLETE 0.00 0.0 1.5 REFINISH 22 ALIGN FRONT SUSPENSION =M 0.00 I.,T 0.0 MECHANICAL 23 CX/ADJUST SET FRAME BENCH & MEASURE 0.00 ;,-1*j 0.0 BODY EXISTING 24 ADL LABOR PULL FRT UNIBODY 0.00 3.0* 0.0 BODY 25 ADL LABOR TINT AND BLEND 0.00 0.0 -1"0*.4 26 ADL LABOR TEAR DOWN FOR BLEND PANEL 0.00 1.2* 0.0 L BODY 27 ADL LABOR COVER CAR FOR OVERSPRAY 5.00* 0.1. 0.0 BODY * NEW 29 ADL LABOR FLEX ADDITIVE 5.00* 0.0 0.0 NEW 29 ADL OPER CLEAR COAT 0.00 -LVT 0.0 REFINISH - 30 ADL COST FREON & OIL 35.00* 0.0 0.0 - Judgement Item ESTIMATE RECALL NUMBER: 10-26-95 08:59:06 F:tiMate Plus is a trademark of Mitchell International Copyright 1991-1995 All Rights Reserved $7796 95 HYUNQAI ACCENT NYHART Page— . 4 0— e 6 iaxnxn ML r'v --- BODY 6 J lc-r6@ 53.00 444+ y'• ` FREON S OIL 35.00T NEW 1631.20T REFINISH'.;,_'14+^3@ 53.00 S4&-9O �'�t ,�-r� PAINT MATERIALS ?HGr&eT MECHANICAL" 3 -O@ 53.00 bG� Non-Taxed Labor 1584-r7G,- Taxed Costs 244"0 ;' . t 1 Taxed Parts 1631.20 .' ✓'x. � Tx 8.250% 24-58 . . �` Tx 8.250% 139.57 ^ L. Labor ( 23..9 hra) "� Add'1 Costs/Materials .46+V16 0 ! Parts 1631.20 Tax G r ca-L ri c3 Tota 1 - - = - - r v 4M'�h �4, ESTIMATE RECALL NUMBER. 10-26-95 08:59:06 EstiMate Plus is a trademark of Mitchell International Copyright 1991-1995 All Rights Reserved PAINT MATERIAL WORKSHEET COLOR CODE 4 2�(,(, PAGEr-- COST CHART PAGE CLEAR COAT ` 6Tv TYPE OF PAINT ENA hfELIURETH i r-IE PANT TIME CALCULATTONS ---�"� SPOTBLEND (INC. CLEAR COAT) FULL PAINT Panel Hours Panel Exterior Interior Overlap 2. 44 4. a 5. s. TOTAL TOTAL LESS OVERLAP COLOR HOURS REiv1Ti`iDER COSTS 1. Consider Spot Paint Refinish Hours y� f Cosi S j z,). r 2. 'When Spot Painting one SPOT/BLENE) panel materials are calculated HOURS— from the full panel rate chart. iMETAL WORK HOURS 3. When calculating nvo tone S',1vIC(Fibergla5s) materials, DO NOT add the WORK HOURS total paint time to figure the materials FLEX PANEL WORK HOURS TOTAL iYIATERLAL COSTS CLEAR COAT CALCULATIONS I. BUtiLPER X .2 OR.4= 2. FIRST PANEL X.4= rNTERIORS X ? = REitiI1AR-lING X .-) = TOTALS 1. TOTALS 2 .SI�fAX) TOTAL TWO TONE - EXTI=RIOR PAN LS _ THREE STAGE �'C CLEAR COAT) FIRST P.AN"EL X .5 = FIRST P A�NEL X .7= RE?.L�_�+TyiG X .- _ RF?rLAINTNG X TOTAL TOTAL SUN VALLEY BODY SHOP SU1 55441 1 1 3 0 9 3 1 1260 Diamond Way P.O. BOX 27968 NYHART INVOICE CONCORD, CALIFORNIA 94527-0968 HEIDI BAR NABOOS112 EPA#CAD S82516742 109 ROBLE # 103 PHONE 4� WALNUT CREEK CA 94596 E 1 (510) 686-5007 HOME: 415-951-1038 BUS: 938LZa53�� SERVICE ADVISOR: 6214 STEVE /AAA COLOR YEAR ::MAKE/MODEL VIN: LICENSE :MILEAGE::::: TAG::: - 1RED 95 � HYUNDAI ACCENT FKMHVF14N3SU15441 0 648/648 rB823 ....:DEL DATE PROD. DATE WARR. EXP.:: ESTIMATE TO COMPLETION PO.NO. PAYMENT : JNV.:DATE.: I - 01JUN95 01JUN95 01JUN95 17: 00 04NOV95 C -[25NOV95 R.O. OPENED READYr OPTIONS: DLR:SVF 08 : 54 260CT95 12:24 25NOV95 I LINE OPCODE TECH TYPE HOURS LIST NET TOTAL A REPAIR AS PER CSAA ESTIMATE RB BODY REPAIRS COMPLETED. 403 CB 433 CB 1109 . 16 1109. 16 B REFINISH AS PER CSAA ESTIMATE RP PAINT REPAIRS COMPLETED. 402 CP 517 CP 437 CP 424 CP 545 .90 545.90 C** GENUINE VOLKSWAGEN PARTS. RB BODY REPAIRS COMPLETED. 99 CVW 0. 00 0.00 D** GENUINE PARTS RB BODY REPAIRS COMPLETED. 99 CH 0. 00 0. 00 1 86510-22000 COVER ASSY 132. 35 132. 35 132. 35 1 97606-22050 A/C CONDENSED'5"'A 282. 28 282. 28 282. 28 2 86535-22000 BRACKET-FR 91rte` 2.55 2. 55 5 . 10 1 86532-22000 RAIL-FR BU 44.39 44. 39 44.39 11 86520-22050 ABSORBER-F DEC 139 .80 139 .80 139 .80 1 92101-22050 HEADLAMP A 7 52.39 152. 39 152.39 1 92102-22050 HEADETAMP A X152.39 152. 39 152. 39 1 92305-22050 LAMP ASSY- 27 .85 27.85 27.85 1 92306-22050 LAMP ASSY- 27.85 27 .85 27.85 1 66400-22020 PANEL ASSY 218.96 218.96 218.96 1 86341-22200 EMBLEM-SYM 8. 42 8. 42 8.42 1 81130-22001 LATCH ASSY 24.54 24. 54 24.54 1 64100-22301 PANEL COMP 166.82 166. 82 166.82 ADDITIONAL AMOUNT FOR DATE TIME BY PHONE #/PERSON DESCRIPTION TOTALS 1. $ LABOR AMOUNT 2. $ PARTS AMOUNT 3. $ OIL/LUBRICANTS -1- L SUBLET AMOUNT NOTICE TO CONSUMER: I acknowledge notice and oral approval of any additional customer or warranty work performed and/or increase in the original estimate price. I also acknowledge and approve all repairs as itemized MISC. CHARGES and/or receipt of vehicle. I also acknowledge receipt of additional Consumer and Warranty Information TOTAL CHARGES contained on the reverse side. TOTAL ORIGINAL AMOUNT SALES TAX ESTIMATE $ APPROVED $ PLEASE PAY Customer Signature THIS AMOUNT DEALER COPY SUN VALLEY BODY SHOP SU155441 1 3 0 9 3 1 1260 Diamond Way P.O. BOX 27968 NYHART INVOICE CONCORD, CALIFORNIA 94527-0968 HE I D I BAR•AS 005112 EPA*CAD 982516742 109 ROBLE # 103 PHONE WALNUT CREEK CA 94596 PAGE 2 (510) 686-5007 HOME: 415-951-1038 BUS: 938-2857 SERVICE ADVISOR: 6214 STEVE AAA COLOR YEAR MAKE/MODEL VIN:: LICENSE MILEAGE`: TAG' RED 95 HYUNDAI ACCENT KMHVF14N3SU15441 0 648/648 B823 DEL DATE PROD:!DATE WARR.EXP. : ESTIMATE TO COMPLETION PO N0_ PAYMENT:...- INV. DATE:t....' 01JUN95 101JUN95 01JUN95 17:00 04NOV95 C I `--NOV95 R.0>OPENED READY'' OPTIONS: DLR:SVF 08:54 260CT95 12:24 25NOV95 LINE OPCODE TECH TYPE HOURS LIST NET TOTAL 1 86530-22050 RAIL ASSY- 238.06 238. 06 238.06 MISC PAINT AND MATERIALS CBM _ " 171 . 60 171 . 60 MISC FREON & OIL phi CBM r= 35 . 00 35.00 a j 1jf ADDITIONAL AMOUNT FOR DATE TIME BY PHONE#/PERSON DESCRIPTION `_'-:TOTALS 1. $ LABOR AMOUNT 1655 .06 2. $ PARTS AMOUNT 1 621 . 20 3. $ OIL/LUBRICANTS 0.00 NOTICE TO CONSUMER: I acknowledge notice and oral approval of any additional customer or warranty work SUBLET AMOUNT 0.00 performed and/or increase in the original estimate price. I also acknowledge and approve all repairs as itemized MISC. CHARGES 206. 60 and/or receipt of vehicle. I also acknowledge receipt of additional Consumer and Warranty Information contained on the reverse side. TOTAL TOTAL CHARGES 3482.86 00 ORIGINAL AMOUNT SALES TAX 1 50. 79 ESTIMATE $ APPROVED $ PLEASE PAY Customer Signature THIS AMOUNT 3633.65 DEALER COPY � . -7- PhotoCaliforniaor la State eutm Automobile bil Inter-Insurance Bureau ❑ INSURED ❑ CLAIMANT LAF ?22C`� NEGATIVE FILM POLAROID DATE t HOUR A.M. BY A LOCATION 70� MAKE OF CAO—YEAR LICENSE NO. ` O ... DATE 4W, HOUR A.M. BY LOCATION MAKE OF CAR—YEAR ~� LICENSE NO DATE HOUR A.M. ❑ BY LOCATION MAKE OF CAR-YEAH LICENSE NO JR-1-29 96 17:�l FF0M:i '_HH LRFPYFTTE 510-284-5-739 TO:916 741E 0891 C-1 PReE:02 i 1-14-1'",> V4- l ft ll rrtu,, ira,Irotea&r mw T l +DN fl � lV 1#�If Tater L� r Z 494U s owl PARTY W"+ Jv dews .*�u.tir•�x e''rS ,�t�'►ry ,�f ,�, , raitliJ !,s' . .v� "^'" K7+r7I I Kv1Nw� At � _0 t O+GIf"M ►k1 I�I1�M< fG'�(C�' �+(iV !ter rr �[wo,�ilfliilLR r acawl,Y/1 tom- -Wmw e%vv mom �+'� M �1 blucom slaw r X44 = .oma 1�1 .►+ad�. fid , . ".r. _ . . 10 LIZ r�.� onca 7 (vpls) r Al s. ,� aIA ala S +�+a ci:3 nes I oma• gWwnww rrp .rr,rranbr+Irr _.. iris iFl�F+iat qh Cr a,Maipa.rr:Nt ---"RoomrYNIM�RMIU► r9�i11�Q11MIwt�iM 97w� C&MM Whom aOYCt F�PMK� �� = too."" IVF C2 W" A13sd Owe C3 No C2*A - * 4. cry s"male v Fl tta.t.M t aa!FMa NOV 14 1995 JAN-2'? qE 17:c2 FROM:(-SHA LHFRYETTE F10-294-57 '-D Ti=i:91r, 45 0Gg1 9 0 p E:tI^ [A 1.1.-11-17`y� UiM- iorri rtlt�iv iia r.��an, .y �.�1... ... �__- - -- �eEffimAm ►ic y�r PF 1 T w+ A{Y�l — E30W rw�wsr . au�t Aosta err rr �t�Rror�t awt r Mom :uv.rr ureo ��waw w o+ Tw 45 6 ;�o rtaaaerQea :up jw► ? M7Mtl(1M�fMaANpM AN 4 MIOMgIV MW 4WD ^•moi �.�IItIN�1f i1/grs%M MIItI r.r�n�p«w�.sr.rt nWinr sumbo# mpm 2 31IM11� t +frts 111 3 ►*T w� fssr>sx�Ar�n sTRwreo / Z� suMo�r�, a• . o�rr r�+w oweosmuuo a PloAcw Tt'T6MpAsPAM T R= T TUW Ap ##ESE1lT I {!1• 4T11FA 111AM apYW• '"OL sltUCR f ;JIAOlRWltl' ail 1ma Ltk T1TIIiIL �- 7�,R r 7tl lllR o *�tlls Stell sis i .,01M1!! 1iA11YfIG + ��! �� wwrl+l•� ppQ apw��iAJ� etmm a Asoomi"F Olmw'a o• ~ 1 'j a i tliilnt 1 t�IAMN Iwo Wil11t 51lIFET dwNa-Np>f/y1R,NY ttt - claw- am �T iMtJMV.lm � ti>mr � v� Milan= s - 1 e ol1 NOW �owAr Oatw�R+A J pMp r <IlafMt t Tp s rrlml �, NaT ttnCl�N r myT• rtiM •_ Low MA7i DJ111�---- lLiEPrJ ami erw araswplM rms.t10rt GOI�tTT1NG1fiIT1•R�Alt AOtrr at wfl1M two 1MLIIOdIIi !1 pa=ouCFO pOAI)M►AT woTM p7�i•; M�eoais IRl1� dt11LM'1 � stet s11MMtirr I' � iz �erstt�Rl II � X x x NOV 14 JAH-? 96 17-:53 FRO''i:(' AA LAFA'YETTE TCI:09 6 � c Gt^91 a t::t F'AE:OS FACTUAL DIAGRAM _ - y ORRW t'Oi 1S10N �y y�+' ,�y NNMlCw p�Ir4+ muwIrs— MOP ..�' /tt-L MEA%UAjbk4KNYI&ApC APPLWo iM^T9 AND 140T TO§C Al-K UO#L*aa ii',a TG6 CSCAL_t r i+HliNft r h OMtr a� Alms: 1 ,CE tea! �IvEr� F�lruttr Pwo ) i�r OPAWS d4AW Md. Bi&V L*MdreA,4 31 fi>< r� tCr�st�t 'ela�� haat )�t,�u� CD 170'o ow me dv 6f�+",� �ptias�iGl�/Wrl�+ �Ie+'�iFfl'� A-4 -W f�-low-10 Auf1 ellA44A-04O ' 460I i f 4/4 � t � �� w!e'&AW-,ft IW /r4OIW"�V t W aW ^0 t%r G+*0.1 AC;PW4WAwV A J"P r•. w /i N trtnf+l� of N p i oaasw wk � ..n,NUY0e11 Me. va. rr, 4aLvarra•'6 r�rr wo, w.. mow. / "e- y11iF",yG1y+"Rayp•iftiw'tt��pPt Ona ULoccivia NOY 1 S95 TAN-29 136 1.5:57, FROM:CSAR LAFAYETTE 510-294-575' T=i:918 X4 91 5 08 '9 0 NARRAYi'V�.IPPLF�II�NTAL .- ---__.., _ . __ _ C" CHP 856 fty 74D)C"042 tlMTe ol�.MupIICtr M.MfBEA — pC �{� nT.ama 0- 1CO�iEowrvv4 t?11A1l/tl rYM114 0 Nam" 9 Calisim Depart LJ RA update ]Fatal C]m and nm up&* {�au uteri Q om: Q twm*w nmndam Samd bus ❑mw. t7'tY 1lI�T ARC�IT� ��rRT ORAT�GOt�a�R 1. toT you ®UD t. rA s. __ _� r. +✓�. igifA LO- fro &i-04rr 4. ..__ ►• Ad A e/,t►N� 1,x.3di��. _ ..fits.OF �:...x_.....�.--._. E __�� _ .. �� _�_L'�_� mil s�li�A wl��►L•��is'' g. _ •ply►.6� ► Le��un�i_ D� f � A' _rsttl -- 12, 19, i�d++�� (J' of ,�► J � a�..,,,�,�/ '' ,� .4 lel �A�C 21L 41AA44692*MS gaf— Ag�rY 7..-A4W 26. 30. C s,. 44 P.Vr=bee,emo ve Azo► j' CAM�w1 �� w� ;, no+nkwcirswM Psi fg udo pX*V;M.*d"s uvW deOetgd m MAI I�CCCIWCL7 NOV 14 1995 JAH-29 96 13:54 54 FROM:CSf4i LHFRYETTE 510-284-5739 TO:916 .545 0691 9 tai PRGE:0 NARRATiY6 VUPP"W41NTAt cw Sm F§v 7-tj l7P1 tA-2 _ PAS#�+aM7E WE Mit mmua� r �JMMtEti * ► + Aow moon Q$A upda% Feta► CJ Fitt and►urs q.1 m ootr. g MCNAUM tFtttbrab WxW btaw Q Qltter _ _ r,ny4 utn.yjjumct*L04-111-7 11�/f�" iy I�t<ftl p t.�#ra � St►7��wCiPIh1�Y lit3A78o ryvaf� _..__ do AWORM2 yrt/.V l�'� !�'" SIJ- tail � ,rr AF& e, __ __ �J',�v�t'!_... �..�b ,+,�r�y _. ►_ ��! �t .'mow_� +�.� � , ,rit AAAJ 14. r. - �` M �' A* plow- 17, 1 S. Ae Ag Ar Xft~ AP AfWA-- t�__ '_ .�. r�►,��°r.rr� �r�.�,I• tf<.�Y__��+ '�f.;�.T��+�[.�'E�._l��_is�'a�.!L.', 27. _ --- 29. 30. P OATW r _ Use pnhmmm sdift"unO doPkftd NOV 14199 JNhd b 17.5-4 FROM:CSAR LAFAYETTE c1El-E2�-�i''� TO:916 34'5 n_gl 9 l_1 FHaE:1 yy—yy—a-1�� v_" r �Ii i rlc4'I f'Idf KnaM 8 I<e8a IIJ 91rJ1� � 57 � �.�� MARRIA'TIMSUPPLELIE TAL 1, V GiiP 556(Rev 74KQ Qph PQpno aa„�o�+.ec�ocwra souarrea«sa nwe a." artw rEw '- %W cc La-amw — .�� r 2d I www"umTa -�Wn --- - Ftarasro Cc*sirnf mpw Fj DA upowo LJ-_ Fadi m aril run m t m Ci ,rr Q cow. _T T 1) N �aa+•t F Ll cotww bu; Q o"W: a;rTM a�.nrsrwat�r - tosr ear.,o..�,sua� — ifr a ! l�c ; '4 16. a��pS+uwE A110 1i o.unwt:a !H �nFw�wo Ir nn,a Ude AVA ins unci Oa kftd. ie ry,t iiti«crciVcoo 17 T':IT(-L P. Nov 14 TOTAL F.08 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 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: UNKNOWN Section 913 and 915.4. PleaSe--nolA CLAIMANT: CITY OF WALNUT CREEK FEB 0 1 1996 ATTORNEY: AMARA L KOSS 00LINN00UNSEL Date received MARTINEZOAUF. ADDRESS: PO BOX 8039 BY DELIVERY TO CLERK ON FEBRUARY 1. 199.6 WALNUT CREEK CA 94596 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. IV IL FRRRTTARY 1 1 AAF, 81 11 Bepuiy�' Clerk 11. 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: Gated: LQ BY: Deputy County Counsf I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (� This Claim is rejected in full. ( ) Other: I certify that this is a true and Correct Copy of the Board's Order entered in its minutes for this date. Dated: ZU - 1 7-1 9 9 _HIL BATCHELOR, Clerk, B Deputy Clerk WARNING (Gov. Code section 913) Subjtct to certain exceptions, you have Only six (6) months from the date this notice was personally served or deposited in the wail to file a court action on this claim. See Government Code Section 945.6. You way seek the advice of an attorney Of your Choice in Connection with this Matter. If you want t0 Consult an attorney, you should do to immediately. t 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 Citi2en 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: Ca—�`� —J`��j �o BY: PHIL BATCHELOR b 1 Deputy Clerk CC: County Counsel County Administrator C .a THOMAS HAAS, City Attorney(State Bar A 045279) PAUL VALLE-REESTRA, Assistant City Attorney(State Bar #119321) 2 AMARA L. KOSS, Assistant City Attorney (State Bar# 142584) City of Walnut Creek 3 P.O. Box 8039, 1666 North Main Street Walnut Creek, CA 94596 RECEIVED 4 (510) 943-5813 1 1 5 Attorneys for Claimant City of Walnut Creek -FEB 6 CLERK BOARD OF SUPERVISORS CONTRA COSTA Co. 7 CLAIM PRESENTED TO CONTRA COSTA COUNTY 8 TO: CONTRA COSTA COUNTY 9 The City of Walnut Creek hereby makes this claim against the County of Contra Costa for lo equitable indemnification, apportionment of fault and declaratory relief and makes the following ii statements in support of the claim: 12 1. Claimant City of Walnut Creek's address is as follows- Walnut Creek City Hall, 13 1666 North Main Street, P.O. Box 8039, Walnut Creek, California 94528, The phone number 14 for the claimant is (510) 943-5813. 15 2. Notices concerning the claim should be sent to the address identified above, and 16 directed to the attention of Amara L. Koss, Assistant City Attorney. 17 3. The date and place of the occurrence giving rise to this claim are on or about 18 November 28, 1995 when the City of Walnut Creek was served with the attached Summons and 19 Complaint for personal injuries by plaintiff Nicholas Davidson, Contra Costa County Superior 20 Court No. C 95-04109. 21 4. The circumstances giving rise to this claim are as follows: Plaintiff contends he 22 was injured when he rode his bicycle into an unguarded construction site in the center of Ward 23 Street, near its intersection with Solveig Street at approximately 2:00 p.m. on August 3, 1994. 24 Such streets are both within the jurisdictional boundaries of Contra Costa County. Claimant is 25 informed and believes, and based upon that information and belief contends, that County was 26 performing work in the street in the immediate vicinity of the location of plaintiff's alleged 27 accident on or about the date of the alleged accident. Despite this, plaintiff has failed to name 28 County as a defendant. Claimant makes this claim for equitable indemnity, declaratory relief and Page 1 1 apportionment of fault based upon claimant's belief that County is the party responsible for 2 plaintiff s alleged injuries. 3 5. Claimant cannot accurately estimate the amount of its damages but plaintiff's claim 4 filed with the City of Walnut Creek on February 2, 1995, claims over$100,000 in damages. 5 Based upon this information, the claim as of the date of this claim is in an amount that would 6 place it within the jurisdiction of the superior court. 7 6. The names of the public employees causing Claimant's damages are unknown at 8 this time but the responsible individuals will be named once their identities are ascertained. 9 Dated: January 26, 1996 i 10 ARA L. KO Assistant City Attorney it 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Page 2 (Cl TACION JUDICIAL) fOR COUNT NSf ONLY MOM"&W of a eo.rr) NOTICE TO DEFENDANT: (Aviso a Acusado) CITY O)~ WALNUT CREEK, AND DOES 1 THROUGH 25, JNCLUSIVE, YOU ARE BEING SUED BY PLAINTIFF: !A Ud. le est! demandando) NICK DAVIDSON, A MINOR, BY AND THROUGH MICHAEL W. DAVIDSON, ESQ. , HIS GUARDIAN AD LITEM. You have 30 CALENDAR DAYS after this sum- Despu6 de que k entneguen esta citad8n judicial usted mons Is served on you to file a typewritten re- Bene un plazo de 30 DIAS CALENDARIOS para presentar sponse at this court. una respuesta escrita a mSquina en esM torte. A letter or phone call will not protect you;your Una carts o una !Ramada telefdnka no le ofrecera typewritten response must be in proper legal proteccidn; su respuesta escrita a m3quina tiene que foam If you want the court to hear your case. cumplir con las formalidades legiles apropiadas si usted If you do not fife your response on time,you may quiere que la torte escuche su taco. lose the case, and your wages, money and pro- . Si usted no presents su respuesta a tiempga puede perder perty may be taken without further warning from el casq,y lepueden qukar su salad4 su dinero y otras cocas the court. de su propredad sin aviso adidonal por parte de la torte. There are other legal requirements. You may Exhten otros requhitos legales. Puede que usted quiera want to call an attorney right away.If you do not llamar a un abogado inmediatamente. Si no conoce a un know an attorney,you may call an attorney refer- abogada, puede llamar a un servido de referencia de ral service or a legal aid office(listed in the phone abogados o a una oficina de ayuda legal(vea el direrorio book). telef&ico). CASE NUMBER: V w m"Cacti The name and address of the court is: (El nombre y direcci6n de la torte es) C9�—�ll 'OCj-/ CONTRA COSTA COUNTY SUPERIOR COURT v ! 11 1020 WARD STREET MARTINEZ, CA 94553 (510) 646-1542 - The name, address, and telephone number of plaintiff's attorney, or plaintiff without an attorney, is: (El nombre, la direcci6n y e/ndmero de tel6fono del abogado del demandante, o del demandante que no bene abo¢_do. es) ROB R. MACKEY, ESQ. (SBN 99887 ) ATTORNEY AT LAW P.O. BOX 1063 SAN RAMON, CA 94583 ('510) 275-3037 2 DATE: SEP 19 1995STEPHEN L. 1IVEIR Clerk, by Deputy (fecha) (Actuado) ` (Delegado) [SEAL] NOTICE TO THE PERSON SERVED: You are served 1. Q as an individual defendant. 2 Q as the person sued under the fictitious name of (specify!: 3. 0 on behalf of (specify): The City of Walnut Creek under: = CCP 416.10 (corporation) Q CCP 416.60 (r lrcr) Q CCP 416.20 (defunct corporation) 0 CCP 416.70 (conservatee) Q CCP 416.40 (association or partnership) 0 CCP 416.90 (individual) � other. CCP 416 . 50(a) [public entity] 4. Q by personal delivery on (date!: Fotm Adopted by Rule 982 Moo ravarca fnr Prnnf of Sarvice) ATTORNEY OR PARTY WITHOUT ATTORNEY(NAME AND ADDRESS): TELEPHONE: FOR COURT USE ONLY ROB- R. MACKEY , ESQ. (510)275-3037 Attorney at Law SBN 99887 P.-O. Box 1063 San Ramon, CA 94583 ATTQRNEY FOR(NAME): Plaintiff NICK DAVIDSON FILED Insert name of court,judicial district or branch court,if any,and post office and street address: CONTRA COSTA COUNTY SUPERIOR COURT Owl � & S SEP 1020 Ward Street 9 1995 Martinez , CA 94553 C'l "4qftj (510) 646-1542 ruy„ „�- 1)I STEPHEN L.WEIR,COUNTY CLERK '�-1�" y CONTRA COSTA COUNTY BY DEPU� '�Ou 5i PLAINTIFF: NICK DAVIDSON, A MINOR, BY AND THROUGH MICHAEL W. DAVIDSON, ESQ. , HIS GUARDIAN AD LITEM DEFENDANT: CITY OF WALNUT CREEK , AND ®DOES1 TO 25 , inclusive. CASE NUMBER: COMPLAINT—Personal Injury, Property Damage, Wrongful Death a MOTOR VEHICLE QOTHER(specify): Bicycle MProperty Damage Q Wrongful Death ®Personal Injury Q Other Damages(specify): five 1. This pleading, including attachments and exhibits+consists of the following number of pages: 2. a. Each plaintiff named above is a competent adult ® Except plaintiff(name): NICK DAVIDSON F-1 a corporation qualified to do business in California F-1 an unincorporated entity(describe): M a public entity(describe): ®a minor o an adult © for whom a guardian or conservator of the estate or a guardian ad litem has been appointed Q other(specify): other(specify): 0 Except plaintiff(name): Q a corporation qualified to do business in California =an unincorporated entity(describe): =a public entity(describe): =a minor Q an adult F-1 for whom a guardian or conservator of the estate or a guardian ad litem has been appointed a other(specify): 0 other(specify): b. Q Plaintiff(name).- is name).is doing business under the fictitious name of(specify): and has complied with the fictitious business name laws. c. Q Information about additional plaintiffs who are not competent adults is shown in Complaint- Attachment 2c. (Continued) Form Approved by the Judicial Council of California COMPLAINT—Personal Injury,Property Damage, Effective January 1. 1982 `SHORT TITLE: CASE NUMBER: DAVIDSON vs . CITY OF WALNUT CREEK COMPLAINT—Personal Injury, Property Damage, Wrongful Death Pagatwo 3. a. Each defendant named above is a natural person ® Except defendant(name): Q Except defendant(name): City of Walnut Creek Q a business organization, form unknown Q a business organization, form unknown Q a corporation Q a corporation Q an unincorporated entity(describe): Q an unincorporated entity(describe): ® a public entity(describe): A city C]a public entity(describe): incorporated in Contra Costa County Q other(specify): Q other(specify): Q Except defendant(name): Q Except defendant(name): Q a business organization, form unknown 0 business organization, form unknown Q a corporation Q a corporation Q an unincorporated entity(describe): Q an unincorporated entity(describe): Q a public entity(describe): Q a public entity(describe): Q other(specify): Q other(specify): b. The true names and capacities of defendants sued as Does are unknown to plaintiff. c. Q Information about additional defendants who are not natural persons is contained in Complaint— Attachment 3c. d. Q Defendants who are joined pursuant to Code of Civil Procedure section 382 are(names): 4. ® Plaintiff is required to comply with a claims statute, and a. ® plaintiff has complied with applicable claims statutes,or b. Q plaintiff is excused from complying because(specify): 5. This court is the proper court because Q at least one defendant now resides in its jurisdictional area. Q the principal place of business of a corporation or unincorporated association is in its jurisdictional area. ® injury to person or damage to personal property occurred in its jurisdictional area. ® other(specify): The defendant CITY OF WALNUT CREEK is located in its jurisdictional area . 6. ® The following paragraphs of this complaint are alleged on information and belief(specify paragraph numbers): Prem. L-1 through PREM. L-5 ; GN-1 (Continued) Page two SHORT TITLE: case NUMBER DAVIDSON vs . CITY OF WALNUT CREEK COMPLAINT—Personal Injury, Property Damage, Wrongful Death(Continued) Page three 7. Q The damages claimed for wrongful death and the relationships of plaintiff to the deceased are Q listed in Complaint—Attachment 7 0 as follows: 8. Plaintiff has suffered Q wage loss Q loss of use of property ®hospital and medical expenses ®general damage ®property damage Q loss of earning capacity ®other damage(specify): future medical expenses for removal of orthopedic plate 9. Relief sought in this complaint is within the jurisdiction of this court. 10. PLAINTIFF PRAYS For judgment for costs of suit;for such relief as is fair,just, and equitable; and for ®compensatory damages ®(Superior Court)according to proof. 0(Municipal and Justice Court)in the amount of$ Q other(specify): 11. The following causes of action are attached and the statements above apply to each: (Each complaint must have one or more causes of action attached.) Q Motor Vehicle ®General Negligence 0 Intentional Tort Q Products Liability ®Premises Liability Q Other(specify): ROB R. MACKEY, ESQ. J (Type or print name) (Signature of plaintiff or attorney) COMPLAINT—Personal Injury, Property Damage, Page three Rub 982.1(1)(cont'd) Wrongful Death(Continued) CCP 425.12 SHORT TITLE: cnSE NUMBER, DAVIDSON vs . CITY OF WALNUT CREEK FIRST 4 CAUSE OF ACTION—Premises Liability Page (number) ATTACHMENT TO Q Complaint Q Cross-Complaint (Use a separate cause of action form for each cause of action.) NICK and through his Guardian ad Litem, Prem.L-1. Plaintiff(name): DAVIDSON,� y g alleges the acts of defendants were the legal(proximate)cause of damages to plaintiffMICHAEL W. DAVIDSC On (date): August 3 , 1994 plaintiff was injured on the following premises in the following fashion(description of premises and circumstances of injury): Plaintiff NICK DAVIDSON, a minor , was lawfully riding a bicycle on Ward Street , near its intersection Solveig Street, in the County of Contra Costa. Plaintiff fell off of his bicycle when he rode into an unmarked and unguarded excavation site in the roadway, created by defendant CITY OF WALNUT CREEK and/ot it ' s sub-contractors , whose identities are not known to plaintiff . Plaintiff sustained fractures of both bones of the left forearm, requiring surgical reduction with plate fixation. Prem.L-2. ®Count One—Negligence The defendants who negligently owned, maintained, managed and operated the described premises were(names): CITY OF WALNUT CREEK and ®Does 1 to_ 5 Prem.L-3. Q Count Two—Willful Failure to Warn (Civil Code section 846) The defendant owners who willfully or maliciously failed to guard or warn against a dangerous condition, use, structure, or activity were (names): Q Does to Plaintiff, a recreational user, was Qan invited guest Qa paying guest. Prem.L-4. Q Count Three—Dangerous Condition of Public Property The defendants who owned public property on which a dangerous condition existed were(names): Q Does to a. Q The defendant public entity had F-1 actual Qconstructive notice of the existence of the dangerous condition in sufficient time prior to the injury to have corrected it. b. Q The condition was created by employees of the defendant public entity. Prem.L-5. a. ® Allegations about Other Defendants The defendants who were the agents and employees of the other defendants and acted within the scope of the agency were(names): ®Does—1 —to 25 b. Q The defendants who are liable to plaintiffs for other reasons and the reasons for their liability are Q described in attachment Prem.L-5.b ®as follows(names): as set forth in Prem. L-1 , above . Form Approved by the Judicial Council of California Effective January 1.1982 0%A I rnff- nr w^Tl fn 11 n__r r,., 1 t..ktrta., elro alt 11) SHORT TITLE: CASE NUMBER. DAVIDSON vs . CITY OF WALNUT CREEK SECOND CAUSE OF ACTION—General Negligence Page S (number) ATTACHMENT TO ®Complaint [DCross-Compialnt (Use a separate cause of action form for each cause of action.) GN-i. Plaintiff(name): NICK DAVIDSON, by and through his Guardian ad Litem, MICHAEL W. DAVIDSON , ESQ. , alleges that defendant(name): CITY OF WALNUT .CREEK and LTJ Does 1 to 25 was the legal (proximate) cause of damages to plaintiff. By the following acts or omissions to act, defendant negligently caused the damage to plaintiff on(date): August 3 , 1994 at(place): Ward Street , near its intersection with Solveig Street in the County of Contra Costa (description of reasons for liability): Defendant and it ' s agents , employees and/or subcontractors created a dangerous condition during construction of the South Broadway Extension , Phase III , under contract No. 91-12 . The condition was an unguarded and unmarked excavation site in the public roadway that plaintiff rode into while lawfully riding his bicycle , resulting in the injuries and damages complained of herein. Form Approved by the Judicial Council of California E"ec1Au a 962 i SUPERIOR COURT OF CALIFORNIA, COUNTY OF CONTRA COSTA COURT USE ONLY 725 COURT ST. MARTINEZ CALIFORNIA 94553 (510)646-2356 FILED PLAINTIFF: _ • �� SEP 19 1995 STEPHEN L WEIR.COUNTY CLERK DEFENDANT: CONTRA COSTA COUNTY AA"" BY Y. DPUTY MARZETTE E NOTICE OF FIRST STATUS CONFERENCE CASE NUMBER: 0? C_Oq I 1. Notice is given that the First Status Conference has beenischeduled as follows DATE: - --9� DEPARTMENT: Iq TIME: if THIS FORM, A COPY OF THE NOTICE TO PLAINTIFFS,. THE ADR INFORMATION SHEET, A BLANK STATUS CONFERENCE QUESTIONNAIRE;-"AND A,BLANK ADR STIPULATION FORM ARE TO BE SERVED .ON .OPPOSING PARTIES. ALL PARTIES SERVED ,WITH .SUMMONS AND COMPLAINT/CROSS-COMPLAINT OR THEIR ATTORNEY OF RECORD MUST APPEAR. 2. You may, stipulate to an earlier status conference. _If all parties agree to an early status conference, please contact the court administrator's office at 646-2356 for assignment of ari earlier date. 3. You must be ..familiar with the case and be fully .prepared to participate effectively in the-`status conference and to discuss the suitability of . this .case for the EASE Program, private mediation, binding or non-binding arbitration, arid/or use of a Special Master. 4. At any status conference the court may make pretrial orders, including the following: a. an order establishing a discovery schedule; . b. an order referring the case to arbitration; c. an order transferring the case to the municipal or justice court; d. an order dismissing fictitious defendants; e. an order scheduling exchange of expert witness information; f. an order setting subsequent conferences and the trial date; g. an order consolidating cases; h. an order severing trial of cross-complaints or bifurcating trial of issues; i. an order determining when demurrers, motions to strike and other motions will be filed. SANCTIONS If you do not file the Status Conference Questionnaire or attend the status conference or participate effectively in the conference, the court may impose sanctions (including dismissal of the case and payment of money) . STEVEN L. WEIR, County Clerk, County of Contra Costa I declare under penalty of perjury that I am not a party to this actio , am at least 18 years of age, and that I personally delivered or mailed a copy of this No f yYsvVatue Conference with the conference date and hearing time inserted to r . a person representing the plaintiff/cross-complainant. �j Dated: � ! / l}(/�!/1� .Deputy CLAIM BOAR.- OF SLPE;vISORS Of CON'RA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 Claim Against the Courty, or District governed by) BOARD ACTION the Sca-d 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 Governmer-t Code Amount: UNKNOWN Section 913 and 915.4. P1am== s . CLAIMANT: PATRICIA KUNICH FEB 0 8 1996 ATi ORNE Y: COUNTY uh%M Date received ADDRESS: 460 WOODMONT PLACE BY DELIVERY TO CLERK ON FEBRUARY 7 19A6 OAKLEY CA 94561 BY MAIL POSTMARKED: FEBRUARY 6, 19% I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED:_ FEBRUARY 8_ PpHHIL BATCHELOR, Clerk DeEr' H. 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: a—8 - (Q BY: Deputy Courty Coun! I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOAR'w ORDER: By unanimous vote of the Supervisors present (✓ ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: &R- 0?7 -- l9 9 L,, PHIL BATCHELOR, Clerk, B Deputy Clerk YARNING Nov. code section 913) Subject to certain exceptions, you have only six (6) 0 0nths 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. Tou may seek the advice of an attorney of your choice in connection with this matter. If you want t0 consult an attorney, you should do so iomediately, m For Additional Warning See Reverse Side Of This Notice AFFIDAVIT OF MAILING I declare under penalty Of perjury that 1 am now, and at ail 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 shorn above. Dated: 69, -_Q_9 - 19 9 BY: PHIL BATCHELOR JDeputy Clerk CC: County Counsel Courty Administrator C1a:r- to: BOARD OF -SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLADUM 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 nape 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 RE: Claim By ) Reserved for Clerk's filing stamp RECEDED Against the County of Contra Costa ) FEB — 7 W6 or ) V tQ" Scat District) CLERK BOARD OF-SUPERVISORS CONTRA CQSTA CO. Fill in nine ) 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: 1. When did the damage or injury occur? -(Give exact date and hour) ft Z G � II 2. Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) JUv£k)IL_C-s (_10be'R.. _50PE?_Vis16.Jj OF_ 01DO -Y 100Oeklal_ D)() LNU�t ?3RPJO, 66- Ok) GUi—) FFticES e�n�OG 'r��rQ�y7' 7 f�; +_ 'r k��i�r &'TT?', i W� SPT ro V Ki TC l iEk (4Jik)D00 J THE (_'D0Wy 3ACKCTS _-- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 5. wnat are tne na--jes of coLinuv or district officers, servants or employees',taus i ng the damage or injury? ix-) A-)o r eju o 6t.1 --------------— 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. I 0`TPrL rEK)CZ- bRMPf6--E-8 - �EE 14rrftCJJEb EST-J/KW1=- 7. How was the amount claimed above computed? (include the estimated amount of any prospective injury or damage.) 2 &STI M TES -5. Names and addresses of witnesses, doctors and husplLal's. TP�T Y-0 L) I C 11 tAwC) U_=(� yv\CA�r PL. 0 R K LT--- qq SO 9. List the expenditures you made on acc=t 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 some person on his behalf." Name and Address of Attorney �Claimant's Signature) (Address) 4 4). h,14? Telephone No. Telephone No. 0) T I V T V V * * * * * * * * 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 ($10,000, or by both such i.,rprisonument and fine. ICVG CONSTRUCTION Proposal No. 1540 Quail Valley Circle Sheet No. Oakley, CA 94561 Lic.#626982 (510) 625-4738 Date — roposal Submitted To Work To Be Performed At Name Street Street City State City State Zip Date of Plans Telephone Number Architect We hereby propose to furnish the materials and perform the labor necessary for the completion of Estimate Total Signature Note - This proposal may be withdrawn by us if not accepted within days. Page No. of Pages DECKS BY DESIGN All Wood Construction & Landscaping P.O. BOX 3563 • ANTIOCH, CA 94531 (510) 778-9410 License No. 681371-C27 PROPOSAL SUBMITTED TO PHgNE DATE (1f V yr IL CL--- &ZS (__)`7 r— ?/.L- STREET zSTREET JOB NAME q (0 .0 L1j t9 t)j .�8�� V/ CITY, STATE AND ZIP CODE JOB LOCATION 0"o, ( ifs ARCHITECT DATE OF PLANS JOB PHONE We hereby submit specifications and estimates for: CA- VLew6,_ . ��- cam-*� ��6L vv' Kam. roskq ,_V-g Js , �001-05 l _ktcky.w:) L-Irl-4 1-6.LUO L Bit Fropose hereby to furnish material and labor — complete in accordance with above specifications, for the sum of: qr 0 0 dollars ($ aZ � l � ). Payment to be made as follows: All material is guaranteed to be as specified. All work to be completed in a workmanlike manner according to standard practices.Any alteration or deviation from above specifica- Authorized tions involving extra costs will be executed only upon written orders, and will become an Signature extra charge over and above the estimate.All agreements contingent upon strikes,accidents or delays beyond our control.Owner to carry fire,tornado and other necessary insurance. Note:This proposal may be Our workers are fully covered by Workmen's Compensation Insurance. withdrawn by us if not accepted within days. Feptanre of fropood—The above prices, specificationsditions are satisfactory and are hereby accepted. You are authorized Signature e work as specified.Payment will be made as outlined above. Acceptance: Signature ` J V 1 1 wy♦ a CLAIM BOARO OF SLFERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 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: $10,451.73 Section 913 and 915.4. Please note all "Warnings°, CLAIMANT: JEFF SAROUHAN ATTORNEY: 1 AA) � 1 19Q5 ADDRESS: 3553 N MARIPOSA ST COUNTY 0,009EL Date received FRESNO MA 93726 MARTINEZ CAI IR• By DELIVERY TO CLERK ON JANUARY 31, 1996 BY MAIL POSTMARKED: VIA: COUNTY COUNSEL 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: JANUARY 31, 1996 Bpeputy AIL lATCHELDR. Clerk 61 Pi 11. 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 910.6). ( ) 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: 3 —g BY: Deputy County Couns I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (J ) 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: - x 7 - 19 9 C PNIL BATCHELOR, Clerk. By `! l 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 patter. If you want to consult an attorney. you should do so immediately. * For Additional Warning See Reverse Side Of This Notice AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen Of the United States, over age 16; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: (1,2 - R j,`�`3 BY: PHIL BATCHELOR by `Deputy Clerk CC: County Counsel County Administrator Claim *to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY C - P-S INSTRUCTIONS M CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and Which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 19889 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 5911.2.) 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. than ... b i n ant,i*y. aep-m- n1 a i ms �tct y. If `� �.in is ae�irst �^-�e ....�.. :z:e ,,...,__.. ....�.;.,., ..,,�......,P be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this To. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) A3 or ) vu District) CLERK BOARD CORA COSTA CO. (Fill Fill in name ) •- 'The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named .District in the sum of $ /�, QCs- i 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) 3. How did the damage or injury occur? (Give full details; use extra paper if required) �O�r'-'.C�IT�f�iT �.��l,�T ��' C��r�-5 1��s s�F�it�•��,v� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5. . What are the names of county or district officers, servants or employees causing �� the damage or injury? S. 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.) . S Ar7-Af �s 8. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code See. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person owbis behalf." Name-and Address of Attorney iImant's Signature (Address) Telephone No. I Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher,-or uniting, 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. 24 HOUR EMERGENCY C:nEscLOW DELIVERY RATESE EQUIPMENT SERVICES -/7 9-zz Z /D i2 51 - 13RTI�EZ RICHMOND (510) 228-9811 (510) 233-5677 24 HOUR EMERGENCY C:nEsc LOW DELIVERY RATESE EQUIPMENT SERVICES Z71 /o //5 11- 7 /o 11- 57 12-- 13 - io 12,2 11 - 17 16 30 11-21 /10 '11-22 /O z9 MARTINEZ RICHMOND (510) 228-9811 (510) 233-5677 CLAIM BOAAC OF SLPE=vISORSOF COh''RA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 Claim Against the Courty, or District governed by) BOARS 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 Califorria Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Governmert Code Amount: UNKNOWN Section 913 and 915.4. FitaseR31M � CLAIMANT: TARRY AND SHARON STAMBAUGH FEB 0 6 1996 ATi ORNE Y: OOUNTY OOUNSEL Date received MARTINEZ CALIF. ADDRESS: 176 BROWN DRIVE BY DELIVERY TO CLERK ON FEBRUARY 2_ 1996 PACHECO CA 94553 BY MAIL POSTMARKED: HAND DELIVERED VIA: COUNTY COUNSEL I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: FEBRUARY 6, 1996 Jy1L SATCHELOR. Clerk eputy 11. 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 art 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 tate claim (Section 911.3). ( ) Other: Dated: a " LA BY: G� Deputy County Couns 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 (✓) This Claim is rejected in full. t ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 09,-- c9,7 - 1471)& PHIL BATCHELOR, Cltrk, By , Deputy Clerk YARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) senths from the date this actio was personally served or *posited in the nil to file a court action on this claim. Set 60verwnt Code Section 945.6. Vow may seek the advice of an attorney of your choice in connection with this Utter. If you want t0 consult an attorney. you should do so imodiately. * 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 titi2er Of the United States, over age 18; and that today 1 deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 6A -_3k-9 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator OFFICE OF COUNTY COUNSEL DEPUTIES 1i CONTRA COSTA COUNTY PHILLIP S. ALTHOFF •�- SHARON L. ANDERSON BRANDON D. BAUM COUNTY ADMINISTRATION BUILDING ANDREA W. CASSIDY VICKIE L. DAWES P.O. BOX 69 MARKE S. ESTIS VICTOR J.WESTMAN MARTINEZ, CALIFORNIA MICHAEL D. FARR COUNTY COUNSEL 94553-0116 LILLIAN T. FUJII DENNIS C. GRAVES SILVANO B.MARCHESI TELEPHONE (510) 646-2041 GREGORY C. HARVEY ARTHUR W.WALENTA,JR. FAX (510) 646-1078 KEVIN T. KERR ASSISTANTS EDWARD V. LANE, JR. MARY ANN M. MASON PAUL R. MUNIZ February 6, 1996 VALERIE J. RANCHE DAVID F. SCHMIDT DIANA J. SILVER VICTORIA T. WILLIAMS NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Larry and Sharon Stambaugh 176 Brown Drive Pacheco, CA 94553 RE: CLAIM OF: Larry and Sharon Stambaugh 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. [x] 4 . The claim fails to state the name (s) of the public employee (s) causing the injury, damage, or loss, if known. [x] 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 . [x] 7 . Other: Please specify the date of injury, the employee/entity causing the injury, and the relief you desire, as well as the above-noted information. VICTOR J. WESTMAN, County Counsel By: Deputy County Counsel 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: February 6, 1996 at Martinez, California. cc: Clerk of the Board of Supervisors (original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE §§ 910, 910.2, 920.4, 910.8) CONFIDENTIAL COUNTY COUNSEL'S OFFICE CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA MEMORANDUM Date: February 2, 1996 To: Jeanne Maglio, Clerk of the Board of Supervisors FROM: Victor J. Westman County Counsel By: Gregory C. Harvey, Deputy County Con el RE: Claim of Sharon Elizabeth Stambaugh and Larry e Stambaugh Please treat the attached document as a claim against a public entity. It is clearly insufficient and frivolous . However, we should follow our normal procedure. REC7ED � ��a�� FEB J A N 3 0 1996. COUNTY COUNSEL MARTMEZ CALIF. CLER CONTRAO OSTA Cp ISORS PROOF OF PERSONAL SERVICE -------------------------------- I , declare under the laws of Almighty G D and the common law perjury penalty: A. That I am a California Republic de jure Common Law citizen, sovereign, indefinitely living therein, over the age of 18 who is not a party to this Action; B. That I have personally served the following document/package / item COMPLAINT, RECORD AND REPORT OF TRESPASS & THEFT OF FRIDAY 1-26-1996 RE ( 1 ) REPORT/CASE/INCIDENT # 96023945 , AND ( 1 ) ATTACHMENTS TO COMPLAINT: EXHIBIT "A" , 3 pages, Notice of Lis Pendens EXHIBIT "B" , 3 pages , Fax & letter to Equitable Deed Co. EXHIBIT "C" , 2 pages , letter to Larry & Sharon Stambaugh EXHIBIT "D" , 2 pages, Notice of Trustee 's Sale of 12/28/95 EXHIBIT "E" , 3 pages, Affidavit by Larry & Sharon Stambaugh dated January 24, 1996 EXHIBIT "F" , i page, Insurance Co reference information in re 1-26-96 report of trespass & theft EXHIBIT "G" , 1 page, reference information in re copy & note to Sheriff on 1-9-96 of/by Larry Lee and Sharon Elizabeth: Stambaugh, sui juris, dated January 26 , 1996 to/at : SHERIFF Warren E Rupf Contra Costa county 651 Pine Street , 7th Floor Martinez, California. 94553 C. And, that , on this 2-�9 hb- day of JC}NuGLP-k( 1996 , the above mentioned document/package/ item was served to the above listed address and was received by: �� nuc GYI Time : � 7 (signature of sere Co Mf/'k ;ii"l )-e C C) f Ci 1"J_ re- c' ), 'P 1 jl' t7 YC' k CI r y 0 t-t_ G r Q �0 Lk+ CL )Iq 4 r e )Oylor, L cle- / x..5„14,./^ Pit;v ,,x-Y') ��} lT"1��"! G' t/! ('' �t'�=L C.J1 L�T ��L�; /k:,�!�`' �t't' � �y'� C �) /��PL rr Marc Ramsiand t4l Atrustee agents' supervisor No rl F 5"tle r _j t, A- 5 ro E,;-�q 3-,1j agency sales and E'(),--I F 11-t lyl<_Ik_L t posting inc.-�8801 CAJt folsom blvd. suite 230 CC hI 112.� o sacramento ca 95826 t� &44 -w,8e CD 800 683 2468 CD 916 387 7000 "J Az 4 e A 916 387 . 7740 J3 ) kJo +0 Warren E.Crandall Wj4{td 5 51 Owner L))i J K fkf Crandall Security Services PPO 11262 C) ct, P.O.Box 2745 "�OSC T21 tAlyd"141 C V San Ramon,CA 94583 (510)551-8168 e Fe )e y NOTICE OF LIS PENDENS and NOTICE of : Discharge of Debt --- Satisfaction of Obligation --- Rescission of Contract Trespass --- Threat of Trespass --- Conversion --- Threat of Conversion Felony Criminal Conversion --- Threat of Felony Criminal Conversion Violation of Contract --- Intent to Preserve An Interest Re: 1 . Private wholly owned real property (abode, land, building, etc. ) located within Pacheco township of Contra Costa county of California state recorded as Lot 38 of Tract 2283 in county records, near the commonly known street's address 176 Brown Drive. 2 . Alleged NOTICE OF TRUSTEE'S SALE Reference No. 13642-22735 and Trustee Sale No. B125410-54 dated 12/28/95 by Officer/Agent Gabrielle Leach of EQUITABLE DEED COMPANY. The mortgage/loan debts/obligations on real property, by reference #1 mentioned above, were discharged and satisfied in full through payment tendered in good faith on November 27, 1995. An Affidavit dated January 24, 1996, with attachment of proof of discharge and satisfaction, can be supplied as evidence, if necessary and if requested and at a fee of ten ($10 . 00) dollars. CAVEAT If anyone attempts to sell or purchase said property, wholly owned, through the alleged Notice of Sale, by reference #2 mentioned above, trespass and conversion shall be recorded against anyone claiming to sell or purchase! ATTACHED is a duplicate copy of Certified Copy of my Notice of Intent to Preserve An Interest filed in county records on Thursday, January 25, 1996. Under the Holy LAWS of Almighty GOD and the common law perjury penalty, I swear to GOD only and declare to all man-kind that the foregoing is true and correct, so help me GOD. Sharon Eliza the Stambaugh Date Lawful Owner, -Holder in Possession /RiC6RDWG REQUESTED BY REC RDED AT REQUEST OF AND WHEN RECORDED MAIL TO WE. Sharon Elizabeth: Stambaugh . STREET JAN 2 5._199f� ADDRESS: c/o 176 Brown Drive i cAT II((-�O'CLOCK k M CITY. Pacheco �-v�10 CONTRA CQSTA COUNTY RECORDS STATE: California STEPHEN L• WEIR ZIP CODE. Pzone: 94553/TDC FEE: COUNTY RECORDER SPACE ABOVE THIS UNE FOR RECORDERS FUSE NOTICE OF INTENT TO PRESERVE AN INTEREST-_ `�- This notice is intended to preserve an interest in real property from extinguishment pursuant to Section 880.020 et seq of the Civil Code of the State of California. I, Sharon Elizabeth: Stambaueh and husband Larry Lee: claimant, claim the following described interest in real property Four Hundred Seventy Six Thousand Dollars&no/100 (S476,000,00) The above described interest is claimed based on that certain Deed of Trust recorded on September 26 . 19 83 in the Office of the County Recorder of Contra Costa County, State of California as Recorder's No. 83 138882 The real property upon which the above described interest is claimed is described as follows: Property located in Pacheco township of Contra Costa county of California state,Lot 38,chap of Tract No. 2283, filed June 29, 1960,Map Book 78,page 16,Contra Costa county records. (See"MMIT A"for full legal description attached) I assert under penalty of perjury that is notice is not recorded for the purpose of slandering title to real property and I am informed and believe that the information contained in this notice is true. �k C C@nant Claimant Dated: V h� 17 9 G ALL PURPOSE ACKNOWLEDGMENT State of California County of CONTRA COSTA On before me,the undersigned, DATE // Name.Tdo d Officer,a g..*Jww Doe,Notary Public' personally appeared 5#,44o v �L/Zf1!'tt�-y 11-,07A#usti ,4sv11 L,W LASE 64z Name(s)of Clamart Sigrwr(s), ❑ personally known to me-OR- proved to me on the basis of satisfactory evidence to be the persons) sere names(s)i are ubscribed to the within instrument and acknowledged to me tha $naty ei xecuted the same in his/her it authorized capac�and that hisAfie it r s)on the instrument the person(s), or the entity upon behalf of which the perso s ted,executed the instrument Gurtt Varus= Witne hand official seal. cwnm eT,t 1t,t�a v tz as w�a�osr�►ca�`� �A Signature of fary 1 t r J� c 1 1 !� �"J #r3 "EXHBfT An LOT 38, MAF'OF TRACT NO. 2283,FILED JUNE 29, 1960,MAP BOOK 78,PAGE 16,_CONTRA COSTA COUNTY RECORDS EXCEPTING THEREFROM: Rights reserved in the deed from Financial Title Company, recorded August 7, 1963, Book 4424,Official Records, page 697, as follows: 'All oil,gas, casinghead gas, asphaltum and other hydrocarbons and all chemical gas now or hereafter found, situated or located in all or any part or portion of the lands above described lying more than five hundred feet(500 feet) below the surface thereof,together with the right to slant drill for and remove all or any of said oil,gas, casinghead gas, asphaltum and other hydrocarbons and chemical gas lying below a depth of more than five hundred feet(500 feet)below the surface thereof, and the right to grant leases for all or any of said purposes but without any right whatsoever to enter upon the surface of said lands within five hundred feet(500)feet vertical distance below the surface thereof.' w-+k 11,1o4ke Of 1,,,,+e,,+ 7"o P+tc5erve An.rx+ere S, ReVer5c 05 de o � N#17e a PP Zt+eke Tp �'r�serVc k k�ereS� I hereby certify that this is a true copy ) � ,� of the original on record in this office. ] caS KAY'0 M—40E[it elk C ATTEST: JAN 2 51°°6 1 STEPHEN G WEIR cou " C .0 By C� •e2,� A 21rticle 31, § 2 Oobernment c/o Rgug QC13rigt Zibminiotrator, 30[ Vugefg &ounb %xicultural &ocietp, limiteb, V6261 (a &ocietp for a 10oral pCbrigtian Veople) January 26, 1996 0 Article I, Section 2 Government c/o JCA/PSASL 1055 Sunnyvale Saratoga Road Sunnyvale, California (94087-2539) Fax# 408 732 1844 and Phone # 408 732 1776 Fax Cover Sheet / Page 1 of 5 Gabrielle Leach, Trustee Sale Officer Equitable Deed Company Trust Deed Unit# 38434 Los Angeles, California (90017) Fax 213 345 8939 Borrower: Larry Lee Stambaugh and Sharon Elizabeth Stambaugh Property: 176 Brown Drive Pacheco, California (94553) Good Evening Miss Leach: Following this cover letter you will find: 1) NOTICE OF INTENT TO PRESERVE AN INTEREST - two pages; and 2) Letter of Notification of Default -two pages (Both documents 1) and 2) shall be also forwarded via the U.S. Postal System with proof of service on this day, January 26, 1996). Please contact our office as soon as possible to discuss this matter. i FKal ely, fsbeek, President CC: Bank of America NT& SA Attn: Bonnie Parmenter, # 5759 Northern California CLC P.O. Box 2366 Rancho Cordova, California 95741 Fax 916 8516090 i i•� l 1 fxecutorg, 2butini9tratorg, &uarbiaim Crugteeg �� 4 Zrtide 3, § t & 2 for Califontia Cootitutimt- antenbmiag 1, jX, & x for the congtitution of the Mniteb &tateg of gnterica ) O C 2 A Zirticte 31, § 2 Oobernment c/o jvwo QCbrigt Zlbminigtrator, J CiI j3ugefo fiounb Zlgricutturat *ocietp, btniteb, V*Zfb'IL (a bocietp for a Acrat 40riotian Peopte) January 26, 1996 0 Article I, Section 2 Government c/o JCA/PSASL 1055 Sunnyvale Saratoga Road Sunnyvale, California (94087-2539) Fax#408 732 1844 and Phone #408 732 1776 Gabrielle Leach, Trustee Sale Officer Equitable Deed Company Trust Deed Unit# 38434 Los Angeles, California (90017) Borrower: Larry Lee Stambaugh and Sharon Elizabeth Stambaugh Property: 176 Brown Drive Pacheco, California (94553) Good Day Miss Leach: Your attention is directed to the following for immediate action and compliance compelled by the duties of your position. We are writing to you once again in behalf of Larry Lee Stambaugh and Sharon Elizabeth Stambaugh. Miss Leach you were requested as required to conform with FRCP 44(a)(b) and 12(a)(b); and, including but not limited to your Articles of Incorporation of your use of the corporate name affixed by its duly authorized officer, duly authorized by resolution of your Board of Directors. We directed your action for all supporting documents as required herein above, by return mail; and, in the event that there are no such documents please so advise us. Unless the duly certified documents requested were received by us within 5 days from the mailing of the January 22, 1996 letter including asseveration and proof of service default will occur. To this date we have not received any correspondence from you or your office and therefore default has occurred in this matter pertaining to the supposed obligations of Larry Lee Stambaugh and Sharon Elizabeth Stambaugh. With your default comes the affirmation of our prior assumption that you are in violation of the Law and multiple Constitutional constraints stated in our previous correspondence. Your status as a "Holder in Due Course" has not been provided as requested and therefore a "Proof of Claim" is not evident. Accordingly, you are once again directed to order all personnel responsible for such to cease and desist in all such activities/actions against Larry Lee Stambaugh and Sharon Elizabeth Stambaugh and tgxecutorg, Mnllniotratarg, guarbians, Crugteeg a&k tA, k y a 41 11?6 Zrticte 1, § i & 2 for California Conotitutimt- r 1 1 Q t !1ntenbmentg .1, IN, & X for the ecanitutimt of the Vniteb *tatm of Onterica p� D their property or severe sanctions and harsh letters shall follow. Further, please furnish us the enabling act required as set forth in the Constitution for the United States of America in Article I, § 8, Clause 18. Your immediate compliance is anticipated and greatly appreciated. Sincerely, (qz�,—� a �Kalfsbeek, President CC: Bank of America NT & SA Attn: Bonnie Parmenter, # 5759 Northern California CLC P.O. Box 2366 Rancho Cordova, California 95741 executorg, IbntinWrators, guarbtang, grugtees • %Ittide 3, § 1 & 2 for California (Congtitutimt- Snteubments 1, 3N, & X for the congtitutimt of the ifflniab obtatcg of anterica w � C� zg A Zrticle 3, § 2 gobernment c/o 3eguo Qrigt Rbminigtrator, 301 J)uyft &ounb Rocultural &ocietp, limited, a*1 (a bocietp for a doral QCfjrigtian Veople) A Article I, Section 2 Government January 26, 1996 c/o JCA/PSASL 1055 Sunnyvale Saratoga Road Sunnyvale, California (94087-2539) Fax #408 732 1844 and Phone #408 732 1776 Larry Lee Stambaugh c/o 176 Brown Drive Pacheco, California (94553) Non-Domestic Good Day Larry and Sharon: A letter was written directed to Gabielle Leach, Trustee Sale Officer of Equitable Deed Company in Los Angeles for specific documents prior to our approval of your application for refinancing or foreclosure/transfer of the property. We have placed a hold on the process due to concerns of the present situation with Bank of America and/or Equitable Deed Company and/or Continental Auxiliary Company in the matter with Larry Lee Stambaugh and Sharon Elizabeth Stambaugh. Whenever we contemplate refinancing any property, it is our practice/policy to inquire into the status of the financial institution holding a trust deed in the favor against the property. One of the items of particular concern is the bona fide "Holder in Due Course" standing of Bank of America and/or Equitable Deed Company and/or Continental Auxiliary Company. In order to satisfy our concerns we contacted Gabielle Leach, Trustee Sale Officer in your behalf on January 22, 1996 requesting bona fide "Holder in Due Course" documentation prior to any approval for refinancing or foreclosure/transfer of the property. Unfortunately to date, Miss Gabielle Leach, Trustee Sale Officer has not been forthcoming with the necessary items listed below. We can not approve and shall not approve your application until these documents are produced to satisfy our request that Bank of America and/or Equitable Deed Company and/or Continental Auxiliary Company is the bona fide "Holder in Due Course" of your existing loan. The documents requested are as follows: 1) Original loan (promissory note). 2) Original Deed of Trust(collateral for Loan). 3) Show how money was loaned, as entered in accounting records including, but not limited to, entries, comments, and analysis of the loan transaction as attested to by the independent CCertified executorg, ZbmutiWatorz guarbiang, Zrugteeg tA.&►r y gfrticte 3, § 1 & 2 for Catito nia Cmtgtitutimt- � `� r��I antcnbments $, IN, & X for the coustitutimt of * aniub 6tates of anterica l 0 � Public Accountant(s) and furnish documents regarding such. 4) Furnish minutes of approval and corporate resolution concerning the loan transaction and all comments regarding the status of said loan including, but not necessarily limited to, sale, transfer or hypothecation of such loan. 5) Furnish a copy of loan assumption agreement (if loan was assumed). 6) Status of Lender and Trustee as Holder in Due Course on the original note, ab initio to date. 7) Was loan assigned, traded, pledged, or offered as collateral, ab initio to date; and, furnish copies of such transactions. 8) All correspondence from the date of such loan, ab initio to date; or if loan assumed, from that date, to date. If you could contact Bank of America and obtain these documents, I will be glad to have the hold removed from your account upon being furnished with the requested documents that are to our satisfaction. Sincerely, ames Kalfsbeek, President 'UqN VcO r z�i 19 y executorgf, lIDminiotratorg, guartdang, Mrugteeg G Srtic[c 1, § t & 2 for Califon►ia QLmtgtitutiou- anienDmentg 35, IN, & x for the coitotttution of the Muiteb *tateg of !enterica 01 't 12/27/95 WED 16:39 FAX 2133458938 EQUITABLE DEED ASAP NEW 002 RECORDING REQUESTED BY AND WHEN RECORDED MAIL TO EOWABLE DEED COMPANY TRt;ST DEED UNIT#38434 333 SOUTH BEAUDRY AVENUE 11TH FLOOR LO$ANGELES,CA 90017 iNuLLT7 00 LL1K1 N �— � a-JJrc5��►� Title Order No. 51240719 Trustee Sale No. 131254,.0-54 Reference No. 13642-22735 ' APN No. 125-155-002-4 NOTICE OF TRUSTEE'S SALE YOU ARE IN DEFAULT UNDER A DEED OF TRUST DATED o2Ljqjs3 UNLESS YOU TAKE ACTION TO PROTECT YOUR PROPERTY, IT MAY BE SOLD AT A PUBLIC SALE. IF YOU NEED AN EXPLANATION OF .THE NATURE OF THE PROCEEDINGS AGAINST YOU, YOU SHOULD CONTACT A LAWYER Oq 01/26/96 at 10 :00 A.M. , EQUITABLE DEED .COMPANY, AS SUCC SOR -IN INTEREST BY MERGER TO CONTINENTAL AUXILIARY COMPANY as the duly appointed Trustee under and pursuant to Deed of Trust, recorded on 83 as Document No. 83 138882 Book 11457 Page 4 2 9 of 9ffWa ecor the office of the Recorder of CONTRA COSTA County, Cagfornia, executed by: S H AND SHARON E. STAMBAUGH, WHO ARE MARRIED TO EACH OTITKR • _ f 1 + WILL SELL AT PUBLIC AUCTION TO THE�IGH T � CASH (payable at time of sale In lawful money of the United tStates)-at: A C- ST I' CE, TO THE CITY HALL, • 1666 NORTH MAIN STREET, WAI4 REEK ' all right, title and interest o a ONrider said Deed of T n the property situated in . said County, California d E 'AATTA TO AND MADE A PART HEREOF. _ gyp. gel The total amount of the unpaid balance of the obligation secured by the property to be sold and reasonably estimated costs, expenses and advances at the time of the initial publication of the Notice of Sale is S51, 598 .95 . Payment must be by cash, a cashier's check drawn on a state or national bank, a check drawn by a state or federal credit union, or a check drawn by a state or federal savings and loan aasoclation, savings assodation, or savings bank specified In section 5102 of the Rnancial Code and aythorized to-do business in this state. ._�n..U�ayy CwUnued an page 2 Page, x ; (CANO5I7A) Yi 7l95 WED 16:39 FAX 2133458938 EQUITABLE DEED AS NE Title Order No.: 51240719 • Truptee Sale No.: B125410-54 Reference No.: 13642-22735 API No.: 125-155-002-4 The street address and other common designation, if any, of the real property described above Is purported to be: 176 BROWN DRIVE, PACHECO, CA 94553 The undersigned Trustee disclaims any liability for any Incorrectness of the street address and other common j dgslgnatton,If any,shown herelm E Beneficiary: BANK OF AMERICA NT & SA, ATTN: BONNIE PARMENTER, #5759, NORTHERN j CALIFORNIA CLC, P.O. BOX 2366, RANCHO CORDOVA, CA 95741 Tglephone No.: (9 16) 8 51-5 78 9 Sold sale will be made,lbid without covenant or warranty, expressed or Implied, regarding tltle, possession, or ericumbrance4i for -the purpose.of satisfying the Indebtedness secured by said Deed of Tiust including the fees, charges and expenses of'the Trustee. The trustee under said Deed of Trust caused a Notice of Default and Election to Sell to be,recorded In the county where'the real .property Is locat and,more than three months have elapsed since such,recordatlon. DATE: 12/28/95 . EQUITABLE DEED COMPANY, .AS 'TRUSTEE TRUST DEED UNIT ##38434 LOS ANGELES, 'CA 90017 .1 Teicphone Number: (213).345-M Qx- Q '� G RIELLE LEA ,. TRUS Cr -Page 2- iciXos»l AFFIDAVIT in support of NOTICE OF RESCISSION and DECLARATION OF DISCHARGE R£: (1) REAL PROPERTY, abode/house and buildings within Pacheco township, near street's address of 176 Brown Drive, recorded as Lot 38 of Tract 2283 in Contra Costa county records Map Book 78 page 16.- (2) 6;(2) NOTE/LOAN Agreement * 0141-2-57004 of about September 13, 1983, current account * 1364-2-22735, and DEED OF TRUST with Bank Of America recorded as Document * 83 138882 Book # 11457 Page # 429; 0) ESCROW account contract opened on or about June 1 , 1995 with Puget 's Sound Agricultural Society, Ltd ESCROW Company regarding refinance-and clearing of Title on the above noted Real Property; <4) NOTE * LSS-951024-01 payment on or about October 24, 1995; and, (5) CERTIFIED BANKERS CHECK < CBC ) 1541 dated November 17, 1995 and tendered as payment in good faith on or about November 27, 1995 and received by Bank of America on November 28, 1995 as discharge and satisfaction in full of the above NOTES, DEED and account. united States of America ) California state ) ss Contra Costa county ) We, Larry Lee and Sharon Elizabeth: Stambaugh, the undersigned Affiants, being of sound mind over the age of twenty one (21) and of the necessary Character to invoke and choose the applicable Law, within the proper territorial application, hereby attest to and acknowledge the following to be true, correct, certain and relevant usable in any court of law if we were called to testify to its/their veracity to wit: Affiants realize and understand, regarding the MAXIMUMS OF LAW, that TRUTH IS SOVEREIGN in commerce, and also in all things. Affiants realize and understand that an . Affidavit, by its nature, is TRUTH and the HIGHEST FORM of prima facie EVIDENCE, as indicated by but not limited to U.S. v KIS, 658 F2d 526,536, being hereby made and presented as such TRUTH and EVIDENCE. Affiants realize and understand that an Affidavit can be challenged ONLY by another Affidavit; therefore, Affiants hereby invite any such challenge and reserve the right to correct any mistake and/or forgivable error on ANY document made by and concerning or relating to the Affiants. Affiants have, from the beginning of NOTE/LOAN Agreement and account by reference #2 mentioned above, timely and continually tendered payments by cash, check, U.S. Postai Money Orders and other commercial negotiable and/or non-negotiable instruments in satisfaction of said NOTE/LOAN and account . Affiants did, on or about June 1 , 1995 by reference #3 mentioned above, contract with and open an escrow account through Puget 's Sound Agricultural Society, Ltd ( PSASL ) , ESCROW Company having Affiant's Power Of Attorney to act in Affiant 's behalf for the purpose of refinance and clearing of Title by the removal of any and all clouds of Title on and of Real Property, by reference *1 mentioned above, wherein any and ail monthly Mortgage payment monies, through said ESCROW contract and agreement, were required to be held in escrow until close, with respective creditors being duly informed. Affiants, since June 1 , 1995, have been informed several times by the ESCROW Company that creditors and Mortgage holders and/or their Trustee<s) , .ar+�.c�,ry ,��, 199 ,E X AFFIDAVIT month 2�day, 1996 Page one of three v r 2 1 J including but not limited to Bank of America and Equitable Deed Company, have fallen silent, failed to produce, and will not and have not provided _the demanded and required documents for the purpose of proper-escrow process and the clearing of Title. Affiants in good faith did, on or about October 24, 1995 by reference #4 mentioned above, present and tender to Bank of America, by U.S. Postal Service REGISTERED MAIL # R 761 603 812 by third party Proof Of Service with RETURN RECEIPT indicating delivery on October 27, 1995, a proper NOTE in lawful money of account as evidenced by original NOTE (loan) # 0141-2-57004, by reference #2 mentioned above, as payment for the purpose of satisfaction of said loan balance and all fees, costs and late charges, with Affiant's reasonable expectation of Bank of America's timely response returning the overage and difference between balance due and tendered NOTE amount. Affiants, to date, have only received silence and no response from Bank of America regarding the overage due and owing concerning above mentioned NOTE tendered October 24, 1995. Affiants in good faith did, on or about November 27., 1995 by 'reference #5 mentioned above, present and tender to Bank of America, by Proof Of Service by Notary and by Federal Express # 8419646012 proof of delivery on November 28, 1995, a CERTIFIED BANKERS CHECK # 1541 as final payment for the purpose of discharge and satisfaction in full of NOTES, DEED, and account, by reference #2 and #4 mentioned above, with Affiant's having a reasonable expectation of Bank of America's timely response returning any overage and difference between total balance due and payment tendered. Affiants, to date,- have only received silence and no response from Bank of America regarding the overage due and owing concerning above mentioned payment tendered November 27, 1995. Affiants did, on or about January 17, 1996, obtain assistance of Notary in presentment of FORMAL CERTIFICATE OF PROTEST OF COMMERCIAL PAPER, under Uniform Commercial Code ( U.C.C. ) section 3-509, through/by Federal Express # 8715023936 delivery and U.S. Postal Service First Class Mail dated January 17, 1996 to COMPTROLLER OF THE CURRENCY via -DEPUTY DELORA JEE and Postmaster of U.S. Post Office in Martinez, California, with copy(ies) directed also to Bank of America NT & SA, Officer Bonnie Parmenter & Officer/Mgr Norm Wegard of Bank of America, and Maker/Surety LeRoy M. Schweitzer, A true & correct copy of Notary's PROTEST with its attachments is attached as evidence. Affiant's Christian Appellation/name, each respectively, is Larry Lee and Sharon Elizabeth spelled using upper and lower case letters as shown, and Affiant's family Christian Appellation/name is Stambaugh spelled using upper and lower case letters as shown, AND ANY DEVIATION FROM THIS mentioned notation and spelling is required RECORDED as being a false and/or fictional representation of the Christian Affiant man and/or woman, and as a MISNOMER; and, Affiants at all times reserve the right to correct any misnomer ( error or oversight ) that may have been made in the past concerning the Affiant 's Christian Appellation/name, which is required RECORDED as being printed and signed, full and complete with no initials, by Affiants, ab initio. Affiants are who they say they are and NOT who someone else might say they are through or by the use of some or any MISNOMER. Affiant's law book is their family Bible, and they do at all times honor and respect any of man's law that is made in harmony with and not in conflict with the Bible, the Holy LAW of Almighty GOD; and, Affiants do at all times reserve and make explicit reservation of all ' GOD given Inherent —To-,t- ,easy A 4 1 9 6 /-7 � b E, AFFIDAVIT S� month -a� day, 1996 Page two of three O� 3 and Unalienable rights, powers and liberties, waiving none. Affiants truly believe and understand that SILENCE must be considered fraud as indicated by but not limited to court case of United States v Tweel < 1977 ) 550 F.2d 297, 299 wherein stated: "Silence can only be equated with fraud where there is a legal or moral duty to speak or where an inquiry left unanswered would be intentionally misleading. " Affiants claim that fraud and trespass and violation of contract has occurred against Affiants by the actions and/or lack of actions of Bank of America NT & SA and its Officers, Agents, and Trustees; therefore, Affiants rescind contract NOTE/LOAN Agreement and account by reference *2 mentioned above, which additionally was discharged through payment mentioned herein. Affiants further saith naught. ,j teste meipso this e1'' `tmonth this t'4✓" `�Z fo"r± day in the year of our LORD, our Redeemer and Messiah YAHSHUA Jesus the CHRIST through our Mighty One YAHWEH GOD the Father, Nineteen Hundred Ninety Six ( 1996) A.D. Under the Holy Laws of Almighty GOD and the common law perjury penalty, we swear to GOD only and declare to all mankind that the foregoing is true and correct, ,so help u� 3 , L ry ee. ,ambaugh, sui ju Sharon Eiizabe Stambaugh, alieni u s sta e n law/in fact, sove ign, a state in aw/in fact, sovereign, ^RING P of freeman Character PRINCIPAL of freeman Character ACKNOWLEDGMENT BY NOTARY of Affiant statements, signatures, and attachments united States of America ) California state ) ss Contra Costa county On this 0/ / '�y 111994 , before me a NOTARY PUBLIC duly appointed and commissioned and bonded in and for the People of California state, personally appeared Larry Lee Stambaugh and Sharon Elizabeth Stambaugh who is personally known to me - and/or - proved to me on the basis of satisfactory evidence to be the one(s) whose name(s) are subscribed to on this _,&FFIDAVI'[ instrument, and acknowledged to me: that they executed same in their authorized and/or actual Sovereign PRINCIPAL freeman capacities; and, that by their signatures) on this instrument, the persons-) or entity, upon behalf of which they acted, executed this AFFIDAVIT instrument before me at C.�/itew,. 4,e California. W' Go Mdt fit.VanRooyen IIIComm.095M Mrrueuc-cauFoa IR' WW ooara CWM A o m.E�F@&17.1 SEAL: 7 /p Fee: Not.#y _ 4o �C AFFIDAVIT month day, 1996 Page three of three p) SAFECO INSURANCE COMPANY OF AMERICA P 0 BOX 25150, SANTA ANA, CA 92799 R.G. & G.L. PEFFLEY INSURANCE 6503 TRINIDAD CT. t, AUG. 16 1993 SAN JOSE CA 95120 5507 n '� POLICY NUMBER Vi -1 h t p OA929163 AGENT TELEPHONE: (408) 997-5444 ,,,�'r j r 77/v _ / / eV following renewal on your awn 2,4� s in coverages to better protect 3 f building materials and labor . d as follows : pe A) have been changed from coverage limits listed below have are factors of your dwelling age B) have been changed from ac d erage C) have been changed from 15, 1993, after payment of the this letter with your insurance `tOk +ger ' Q� _ 1 3. 00 renewal premium to your to make a change to your policy, please contact R . G. & G. L . PEFFLEY INSURANCE at : (408) 997-5444 . We look forward to continuing to serve your insurance needs . Den D.McLean.President toJ 1 OC-429/EP V99 PRINTED IN U.S.A. G1 CQ I ., NOTICE & RECORD OF NULLITY DOCUMENT AND MAIL REFUSED FOR CAUSE AND ACCOUNT SATISFACTION BY AFFIDAVIT TO: PRESIDENT/CEO Stephen Niles FIRST CLASS MAIL EQUITABLE DEED COMPANY by Notary Proof of Service 10600 Valley View Street Cypress , CA 90630 TO: OFFICER/AGENT Gabrielle Leach FEDERAL EXPRESS * 7067614562 EQUITABLE DEED COMPANY by Notary Proof of Service 333 So. Beaud.ry Ave. , 11th Floor Los Angeles, CA 90017 FROM: Larry Lee : Stambaugh DATE: January 09, 1996 Sharon Elizabeth: Stambaugh non—resident delivery --T c/o 176 Brown Drive r + Pacheco, California (no zip RE: ( i) Your NOTICE OF TRUSTEE'S- SALF dated 12/28/95, a NULLITY, founditP_Y'r �� W�crYCyL ] +aj0� Your mail postal dated DEC 28 '9! addressed (misnomer) and hereby r dishonor and without recourse to /1�j ( J NOTICE & REt � `y '�'h� 1s,-� w;1-e 3� �Yo�eY+7 united States of America ) �,tLQ [�►l.Y �a10.1�1 j SY'G°��eKe� California state ) ss ! / 1 Contra Costa county ) '}'o �B 5�"oteh- 9k FY1-�G-4 �o b o+1�" l �.re� �. We, Larry Lee & Sharon Elizabeth: St a a �a h1 a.h.11 being of sound mind over the age of tw L(.N Z,AWFLt1. Sale axC c oKv6r5 i DYl Character to invoke and choose the app territorial application, hereby attest rr r p �rr be true, correct , certain and relevant Pr do } 5"Y�e P,�+,�a e PYp 2YT y called to testify to its/their veracit / -^ oKY' ohl y (40�e i n packe C-0, Affiants realize and understand, ve J aka w"1 y'cYr OV_Y' TRUTH IS SOVEREIGN in commerce , and al 0 or Pepw�l � ass�4�"avLc� aid Affiants realize and understand t] TRUTH and the HIGHEST FORM of prima fat eK+ limited to U . S . v KIS, 658 F2d 526, 536 l" such TRUTH and EVIDENCE. pro-fdC I' Oi(� Pro�oey1Y o�kd �iq,A,�S Affiants realize and understand t] ONLY by another Affidavit ; therefore. challenge and reserve the right to core error on ANY document made by and concel Affiants realize and understand that any document, containing one or more error(s) , is required recorded as an error in total , a. mistake, and a NULLITY; therefore, the Equitable- Deed Company NOTICE OF TRUSTEE'S SALE, by .t r/ / - z� -IIIP FxkI � ' & WITTr V Z P7rOPn Pnot 1 of 4 AFFTDAVTT of t CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA FMUARY 27, 1996 Claim Against the County, or District governed by) BOARD 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: $30,000.00 Section 913 and 915.4. Please note all •warnings% CLAIMANT: LONNIE L STILL 'RS(roallw7m ATi ORNE Y: i e N 3 1 199' UOUNTY�' Date received ADDRESS: 2976 SBERMAN AVE "111= BY DELIVERY TO CLERK ON JANUARY 31, 1996 PITTSBURG CA 94565 BY MAIL POSTMARKED: VIA: RISK MGMT I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ° IL pp DATED: JANUARY 31, 1996 BATCHELOR, ClerkJJ 8d: �puty 11. 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: _ 3 —� By. Deputy County Couns II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to Claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (✓ ) This Claim is rejected in full. ( ) Other: I certify that this is a true and Correct copy of the Board's Order entered in its minutes for this date. Dated: Gid - ;Z 7- l9 9 6 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (6ov. 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 wail to file a court action on this Claim. See Government Code Section 945.6. ilou may seek the advice of an attorney of your Choice in Connection with this clatter. If you want to Consult an attorney, you should do so immediately. w For Additional Warning See Reverse Side Of this Notice AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a Citizen of the .United States, over age 16; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a Certified Copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: (D a- )-T 19 cY (o BY: PHIL BATCHELOR by t Deputy Clerk CC: County Counsel County Administrator Cla i- to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNI'X •O�g INSTRUCTIONS TO CLAIMANT A. Claius 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 5911.2.) 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 rime 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 £orm * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RE: Claim By ) Reserved for Clerk's filing stamp Against the County of Contra Costa ) JAN 3 or CMK BOARD >0u6� ' Cis kV Ck r District) CONTc ., -� 1 Fill ifi name) ) The undersigned claimant hereby makes claim against the County of Contra Cc4a. or the above-named District in the sum of $ and in supports 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) ii-i tliv - 3. occur? (Give full details; use extra paper if, did the damage or injury required) ,L-t cL�"" Sc�. -.arses .�=av��L1f��C� �' S '• tU �iiJu4:� 17� c'e "v-.. �h Qe `cs/rY� 'l��e e ;L c0 ;3- )C 4. What particular act or omission on the part of county or district officers, servants or employees caused `the injury or damage? L A Cid k`,,r o `C'e� QN t5 t� &fo Ce_, wc�SyC � , cv� )r� Cs S �(c_.,�;c'-�< <=�`� Cr"r��v2 Y , �i �Y �_ C��E f2 ot'`Lcv Sa t�e�y c{�a-CSc�k�lzs Ov VCr d.A&3ge?,C cLi�C�tS >htGtvS s_�G�ZI�� a �sr�}(�� fltv�y � `K n61 �- IS hto _Vrav c !- �� ,_i\c\. �,Auz hR�� _ r Cil `x� 1 1F \S N� C�S C, �f� �0.�r N� f' ��Y'v _.sb �LvCt;Z.�'- Lr 7. wnaL are wne names of county or district officers, servants or employees causing( he _-'a:-_age or injury? 1 hr-, fa M�i+ r jr''Y. 'r,.' C C: y �� J��' ti + E /u cil� "F�+"C'�e V \C, t t ,A 5. What damage or�injuries~do'you claim resulted? (Give full extent of injuries or j damages claimed. Attach two estimates for auto Damage. •.T R.e,:- L��-O u��Y VF ,�� ; fuC pp �£fi�llS_ Or-A 'i v1 C�� r v�1\f (}t? i yet NSC'- `C � M 1t"Y �, Vec` -� E'v2. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) y 4V-1 N 4— V\.i c)'O �ti� 3,L, ' C3oca t V-1V tX '4 t'. t v^5 C'A. `'`'". 01 1��' $. Names and addresses of witnesses, doctors and hospitals. a u y y r 3 C�S✓�:' °� -C_} _{VLA?4 C3yf t cY C5 t c.l,.t'�'-Y J C� �-- c'%:rc�l� b�,,�.,�''�^" •CTav C� c� -�-11£'. tf t yy. •"�'L t�'��a c3.'Y �.;;;U�� `a �', �.i�.'?� �..•�.;�J"'�� 'uL tu.',� A, 4 tV� C. C� ac 1✓�t', W cam..: C,ti?# �:rv' Y f � �- t �l.cl rt W ° zt� SCC �, 1:E' c ; ,-vtiC.SX_ tt �,.. t •-Y- � •�`' �? _ ?�c:;=cw•'.a C si c, 9• List the expenditures you made on account of this accident or injury: DATE. ITEM AMOUNT c�LC -' VtV V2C>:V) 'C�k � `'1'� ivlr' t. t- �,-1:� i �a� �� C3` � nr,4� �yL tet,CL t t Gov. Code Sec. 910:2 provides: "The claim must be signed by the claimant SEND NOTICES T0: (Attorney) or by some person on his behalf." Name and Address of Attorney I i � Claimant's Signature 1liudre;r$: 3 - Telephone No. Telephone No. : NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such i=risonment and fine. 1 , c r _ , , I _ . C oil 5 ' , z , 1 ' i r .... - 17 r i � ��' �� . , , , r , : , . , , , _ . . ,� , � �� - __ � , ,� .. ,� 1 .� _ w ,.�. .� ,_ t—� _. � l , � � , �" -. _;, � -, ` ,. I r ,. � � � � , ;� ._.� �, .> _ , ,� _. , ; ., � _ _ " � , � t �, - � l '� ,, �� .. -�E i ; . i �_. y ..�_ r ._ _,, . f ,. . , -� � I � � � � ) ;, - ` _. �, . , . ,., .- ... _.. . . �. _. _ . - � ... _._-. , __ q � , ; _. � ! ' , ''- r �� ` \ . . ., I '� ;' .. + ; ".l w. i �- r, li l �. - � - I �' t � i t � � *. dd,,,, ..,� y � � - � ,,. � �:� i �_, � �� _ _ .o t l � _.. � � �- � � 5 .• - .............. ..,_.s....,.__.._,,., . :. .. � f _.�..,.....,, .4._.._......_ .., i � f � CLAIM BOA;: OF SLFEcv:SOPS 0F_COh'RA COSTA COUNTY, CALIFORNIA FEBRUARY 27, 1996 Claim Against the Courty, 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: $10,000.00 + Section 913 and 915.4. P1jjIQ,� � . CLAIMANT: ANN AND JOSEPH ALFONSO ZAVALA FEB 0 8 1996 ATiORNEY: RORY D. JENSEN COUNTY COUNSEL Gate received MARTINEZ CALIF. ADDRESS: 1299 NEWELL HILL PLACE SUITE 300 BY DELIVERY TO CLERK ON FFRRTTARY 7 9A26 WALNUT CREEK CA 94596 BY MAIL POSTMARKED: NAM nFT,TVFRFn 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ! DATED: FEBRUARY 8 P, 1996 DaIL pepuiy OR• Clerk U. 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 an 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: 02- IF? `"i Lk BY: Deputy County Couns 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 (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. Dated: Zia-a.7- q9 G PHIL BATCHELOR, Clerk, By Deputy Clerk WUNING (Gov. code section 913) "J#Ct to Certain exceptions, you have Only six (6) Wnths froom the date this notice was personally served or deposited in the wail to file a court action on this claim. See 60vermaent Code Section 945.6. You way seek the advice of an attorney of your choice in connection with this wetter. 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 tires herein wentioned, 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: ();I -a-V - !`1'-! BY: PHIL BATCHELOR by FDeputy Clerk CC: County Counsel County Aoministrator ;FEB W GOVERNMENT TORT CLAIM AGAINST CLERK BC3F�R�OF SUPERVISORS CONTRA COSTA COUNTY BOARD OF SUPERVISORS CONTRA COSTA CO. HAND DELIVERED TO: CONTRA COSTA COUNTY BOARD OF SUPERVISORS 651 PINE STREET MARTINEZ, CA 94553 1. Name and address of Claimants: Ann Zavala and Joseph Alfonso Zavala 570 Webster Drive Martinez, CA 94553 2. Address to which notices should be sent: O'Brien, Sullivan & Jensen 1299 Newell Hill Place, Suite 300 Walnut Creek, CA 94596 3. Date and place of accident: On or about August 8, 1995 at approximately 4 :00 p.m. The accident occurred at the Mount Diablo High School, 2450 Grant Street, Concord, California 94520. 4. General description of the accident: Claimant, Ann Zavala, was injured when she was walking through the parking lot at Mount Diablo High School in an attempt to go to the gymnasium area at Mount Diablo High School. The accident occurred near the gymnasium at Mount Diablo High School, Concord, California. The accident was the result of an unsafe condition at Mount Diablo High School in an area where there was approximately a two inch difference in elevation on the sidewalk/concrete slab area between the parking lot and the Mount Diablo High School gymnasium, toward which Claimant, Ann Zavala, was walking. This difference in elevation between the surface where Claimant, Ann Zavala, was walking caused her to trip and fall and severely injure herself. The accident was the negligent failure of the Mount Diablo Unified School District, its agents, employees, managers, and representatives to provide a safe place for pedestrians, such as Claimant, Ann Zavala, to walk while visiting Mount Diablo High School in Concord, California. 1 The Mount Diablo Unified School District, its agents, employees, managers and representatives were also negligent in creating and allowing a dangerous condition to exist and not correcting such a dangerous condition at Mount Diablo High School, including, but not limited to making certain the walkways were in a safe condition for pedestrians such as Claimant, Ann Zavala. S. General description of the injuries and damages: As a result of the accident as described above, Claimant, Ann Zavala, suffered from a severely injured and broken right foot and ankle. Claimant was then treated for a right, distal, fibular fracture, along with severely torn ligaments, tendons, muscles, tissues, and joints. Claimant was forced to wear a cast on her right foot/ankle for several months after the accident. Claimant, Ann Zavala, also suffered from a severely sprained left ankle and left wrist, along with numerous bruises, abrasions, and contusions to her body, as a result of the accident as described above. In addition, Claimant, Ann Zavala, suffered from injuries to the tissues, muscles, ligaments, bones, and cartilage of her body, including but not limited to injuries to her head, torso, neck, back, hip and extremities. In addition to the above, Claimant, Ann Zavala, fell on her face and head as a result of the accident. This trauma has caused Claimant to continue to suffer from memory loss, confusion, dizziness, and headaches. Claimant has found it difficult to hold objects without dropping them since the accident. Claimant was diagnosed as having a concussion which was the result of a closed head injury. In addition, the blow to Claimant's head and face resulted in damage to the area surrounding her nose, and her nose, which has caused the loss of Claimant's ability to smell and to taste foods. In addition to the above, Claimant, Ann Zavala, reports that three toes on her right foot no longer have normal feeling and that they appear to be numb and insensitive and appear to be as the result of the accident. It is further believed that the broken bone in the area of Claimant, Ann Zavala's right ankle will result in future degenerative problems of her foot/ankle, including but not limited to arthritis, rheumatism, and other bone, joint and tissue injuries. 2 As a result of the above, not only has Claimant, Ann Zavala, been injured in her body and her psyche and her person, but she has also experienced pain and suffering, and suffered a significant wage loss in this case, estimated to be in the area of $50, 000. 00. Claimant also had to go to the additional expense of hiring persons to do things which she normally would have been able to do for herself, if it had not been for the accident as described above. Claimant, Ann Zavala, has incurred or will incur medical expenses of approximately $25, 000. 00 as a result of this accident, and requests reimbursement for such expenses, including those described above, according to proof at time of trial. Claimant's injuries are chronic and permanent, and it is believed that the above-described injuries will never heal completely. The dollar amount of Ann Zavala's claim exceeds $10, 000.00 and is within the jurisdiction of the Superior Court. At the time of the accident involving Claimant, Ann Zavala, she was the wife of Claimant, Joseph Alfonso Zavala. As a result of the August 8, 1995 accident at Mount Diablo High School, Claimant, Joseph Alfonso Zavala, suffered loss of consortium damages because his wife, Claimant, Ann Zavala, was no longer able to provide him with the same love, companionship, comfort, affection, society, solace, moral support, sexual relations, physical assistance in the operation and maintenance of the home, and any and all other duties which Ann Zavala normally was able to provide her husband, Joseph Alfonso Zavala, before the August 8, 1995 accident which is the subject-matter of this Government Tort Claim. The above-described loss of consortium damages of Claimant, Joseph Alfonso Zavala, are submitted herein as a separate claim from the damages of Claimant, Ann Zavala, even though such loss of consortium damages relate to the physical and mental injuries suffered by Claimant, Ann Zavala, as described above. The dollar amount of Joseph Alfonso Zavala's claim exceeds $10, 000. 00 and is within the jurisdiction of the Superior Court. 3 6. The name of the public employee causing the injury: Unknown. Dated: February 2, 1996 R tWorney for Cla' a Zavala and Jo ep A Eso Zavala I U 4 1 . AMENDED CLAIM BDARC OF SL'FEGy:SDRS_OF CON-;A COSTA COuNTY, CALIFORNIA FEBRUARY 27, 1996 Claim Aga"nst the Courty, 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 GCve►nment Codes. ) the action taken on your claim by the Board Of SuperviSCrS (Paragraph IV below), given pursuant to Governmert Code Amount: $202,962.00 Section 913 and 913.4. Please note all "Warnincs% CLAIMANT: SHAWN W CONDY ATTORNEY: FEB 0 6 1996 Date received MtJb6 ADDRESS: 3 IMPERIAL PROMENADE, 4TH FLOOR BY DELIVERY TO CLERK ON FAJW ��-,% �. SANTA ANA, CA92707-5908 BY MAIL POSTMARKED: HAND DELIVERED VIA: COUNTY COUNSEL 1. FROM. Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: FEBRUARY 6, 1996 Ipll BATCHELOR, Clerks 11. 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). ( 1 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: `1J ! 1 BY: Deputy Cou-ty Couns 1I1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: QpL -a-1 - 19Gc, PHIL BATCHELOR, Clerk, By 1 ) 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 Coot 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, t 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. , 7 ' Dated: U'�_—_)S — 19416 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator CONFIDENTIAL COUNTY COUNSEL'S OFFICE CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA MEMORANDUM Date: February 2 , 1996 TO: Jeanne Maglio, Clerk of the Board of Supervisors FROM: Victor J. Westman, County Counsel �`K By: Gregory C. Harvey, Deputy County Counsel ' RE:: Claim of Shawn W. Condy Please treat the attached as an amended notice of claim. FEB- 1-96 THU 14:05 P, 01 �•• 1:Wv^. 'X H. •.itl�,�Aq .a#�.:V�^ �`Je nLne S; . .., .... CONDY&PERE'IRA Attorneys at Law 3 Imperial Promenade, Suite 400 Santa Ana, CA, 92707-5707 (7141) 433-7850 Pax: (714) 433-7371 FAX TRANSMISSION COVER SHEET Data: .February 1, 1996 `I'o: Contra Costa County Counsel .pax. (510) 6,16-1078 Ro. Amended notice of claim against Contra Costa County Sheriffs, Civil Bureau Sander: Shazon W. Cond y Note: YOU SHOULD .RECEIVE 5 PAGE(S), INCL,UDINCy THIS COVER SHEET IF YOU DO NOT RECEIV.6 AZL, THE PAGES, PLEASE C.AL,L, (714) 433-7850. THIS MhSSAGE IS PRIVILFGHD, CONFIDENTIAI.,AND EXEMPT FROM DISCLOSURE UNDER. APPLICABLE LAW AND IS INTENDED ONI-Y FOR TI-IE WSS. OF THE INDIVIDUAL OR ENTI'T'Y TO WHICH IT IS ADDRESSED. IF THI' RI-ADER OF THIS MESSAGE IS NOTTHE INTENDED RECIPIHNT, YOU ARE I-IERPHY NOTIFIED TIiAT ANYDI55EzMWATION, DISTk18U'i1ON, OR COPYING OF THIS COMMUNICATION IS S'C1:IGnYPROH1131TED. IF YOU HAVE RECEIVED COMMIIMCWrION IN ERROR, PLEASE NO'1'TPY US IMM11DIATELY BY TFIT.41114ONE AND RE'T'URN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRIjSS VIA THE U.S. POSTAI., S1-RVICE FEB-01-1996 14:06 P.001 FEB- 1-96 THU 14:05 P. 02 e. ' 1 Shawn W. Condy Bar# 158630 2 CONDY&PEREIRA v�� Attorneys At Law RECEIVED 3 3 Imperial Promenade, 4th Floor Santa Ana, California 92707-5903 4 (714) 433-7850 FEB _ 219 5 _ CLERK BOARD OF SUPERVISORS 6 Attorneys for Claimant, Shawn W. Condy CC)NTRA COSTA Co. 7 8 In the Matter of the AMENDED CLAIM FORDAMAGES AGAINST Claim of SHAWN W. CONDY CONTRA COSTA COUNTY SHERIFF 9 [Gov. Code §§ 910 et seq.] 10 11 SHAWN W. CONDY, Claimant, presents this claim to the CONTRA COSTA COUNTY SHERIFF 12 pursuant to sections 905 et seq. of the Government Code. 13 1. Claimant's address is 3131 Bern Dr,, Laguna Beach CA, 92651. 14 2. Claimant desires notices concerning this claim to be sent to the following address: 15 3 Lnperial Promenade,4th Floor, Santa Ana, CA 92707, 16 3. The date, place, and circumstances of the occurrence giving rise to this claim are as 17 follows: On or about January 17, 1996, at 3018 Willow Pass Rd., Concord, CA 94519, the 18 Contra Costa Sheriffs,namely the supervisor in charge of the civil bureau located at the above mentioned 19 address, wrongfully and intentionally released funds, in the amount of 567,629.00 which had been 20 received pursuant to a valid levy upon the judgment debtor's bank account, back to the judgment 21 debtor's bank in deliberate violation of the duties and obligations imposed by law. 22 4. Claimant has been damaged in that he has been deprived of use of the funds in 23 satisfaction of his judgment, has incurred additional attorney's fees and costs in executing enforcement 24 of the money judgment, and has had his civil rights violated in that he has been wrongfully and 25 intentionally deprived of his property by an individual acting under the color of government authority. 26 5. The names of the public employees causing the uiju y, damage, or loss are: Warren E. 27 Rupf, and the supervisor(name unknown at this time)in charge of the Contra Costa County Sheriffs civil 28 bureau located at 3018 Willow Pass Rd., Concord, CA 94519. FEE-01-1996 14:07 P.002 FEB- 1-96 THU 1406 P. 03 1 6. The amount of claimant's claim is $202,962.00 2 3 Dated, February 1, 1996 4 C4NDY&PEREIRA 5 6 B ,..r, q awn W. Condy 7 Attorneys for Claimant, Shawn W, Condy S 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 2s -2- FEE-01-1996 14:07 P.003 FEB- 1-96 THU 14:06 P. 04 A. M Y OR Cw.trr WI H .♦ ,4 *7 Aoxv"r. d,; —�•' A}i RCC:'IROQt'S ISE Lilr l M Rb, O+Ong r"OUMKil;ysntlresumTp: _ (714) 433-785 • .. - Shawn W. Condy,:,„State:-Sar. #,:158630 CONDY & PEAEYRA, ATTORNEYS AT LAW � • 3 Imperial Promenade, 'Suite 400- ! Santa Ana, CA 92707-5707 A, rO4NE'rFORO”-): .Shawn W.. Candy —E or ccu n: ORANGE COUNTTY SU--P=Q*-R CO[7RT s,a=�AMAM, 700 Civic Center brive West c-r.x:zleeo�� Santa ria, CA 92701-62.00 i I na+�+c��E. Central Distr_icE r 1 k 02-Fi=NDANT: CIB a Ca?-fo_n?a ; 1CC:=a Costa Sheri— MEMORANDUM OF GARNISH-" -� W-i 1o:: Pass :wad ' (A:•�4r,n@e1I=Et•rf�rxtne•,;�r�a�rtien;} ;CO�Oc.:c, C% 9:5,e NO710E TO PERSON SERVED WTN i4'R17 AND MOTILE o� L&-jy OR No ICa 0= lil.CHMEhi; Tnis Merao:and:n mus:be car..+4nDc S.nC=%i . or 5+•4Neft-- - ",`.-."`- .s"- ;"`P— .he "`P - :he levying Ci6er w h in 7 0 Bays after service on y v';11e w i a*IC na�oe C, IeVy Of x-zV1)nen: unless you have luny oomSLec w!j) the wy. F�lUr2 conple:e and re turn his mernorandun nay r',e!laer y-ju L`atkie f.r:nn.. e a:s:s a a-orneytees Ino- mec in ab:aif)ing tie jk-W#.,L^ ' " 711:5-er .� - inum ones n== - R-11URN F.- PIEFF THIS COS OFF M:-W0"NDVM i0 Tri- LFvYING Da SIC` - ^:s 's^:CM-11 1' yo:;War.no! celhver:e :ne 12vvint ot'f,=er any p•o:>ery Iev1eY voan. ov= ipe ^= enc tris re S]n!o n ca.:v;. A - f. ��✓ G � L , 2. For writ of exewrtlon only Describe any woaerry o`ine)oopmnt oeo:or no:leviae,.oar.:n.;;a In.yoyr DDESSMo n.or un B.-yas Control: 2. It you owe money to ine juogment Debtor vn1::` you Will no; ,By tL Erie r-1".E•• ct".lw ;o: cr0un. dnG :isrGs o:Inc obligation anC tree reason for not Darng It to the levying office': 9 J (C`arranuer o,^rewrso) Fom,,Aae ecoyrise },�,=MOt�L' iJJA! b=Q RNIISi'=��` . JAI Oirbi G�Jr,�.a.cal,l2m,? �43.i•. [he- FEB-01-1996 hwFEB-01-1996 14:08 P.004 FEB- 1-96 THU 14;07 P. 05 SHORTTIfitF= SHAWN w. CON, V. GIB DEVELEOFMENT LEWINGaFFICERFIt.6140.: CouATCASENo.: S": J ] • 754594 DeScriDe the amount and terms of any obligation owed to the judgment debtor that is levied upon but is not yet due and payable: ., For wnt of exec LrUcin only Describe the mount and terms of any obligation owed to the judgment debtor that Is not levied upon: s DeSCrlbe any Claims and rignts of other persons to the property or obttgation levied uAOn that are known to you ant!the names and aocresses of the other aersohs: DECLARATION aectare unser penalty of perjury under ins lays of the State or California that trig foregoing Is true and correct, . fne�pR{ �Lt+iE7� ts+cvaru3E) If you need more Space to provide the information required by this memorandum, you may attach atyditional pages. Q Total number of pages attached: MEMORANDUM OF GARNISHEE .s-rer.G-152fKaw.Iv7 t.*seal (Attachment-Enforcement of Judgment) V-109 two P.005 FEB-01-1996 14:08 V TO: BOARD OF SUPERVISORS r Contra FROM: Phil Batchelor, County Administrator 4,/r j Costa o: s County DATE; February 27, 1996 SUBJECT: Final Settlement of Workers ' Compensation Claim - Claudia Hallissy vs. Contra Costa County WCAB No. SAC 0213916 SPECIFIC REQUESTS)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Receive this report concerning subject final settlement and payment in the total amount of $37,500 from the Workers ' Compensation Trust Fund. REASONS FOR RECOMMENDATION/BACKGROUND: William R. Thomas, defense counsel for the County, has advised the County Administrator that within authorization an agreement has been reached settling the workers ' compensation claim of Claudia Hallissy vs . Contra Costa County, WCAB No. SAC 0213916 . This Board's January 23, 1996 closed session vote was : Supervisors Bishop, Smith, DeSaulnier, yes; Supervisors Rogers and Torlakson, absent. This action is being taken so that terms of this final settlement and the earlier January 23, 1996 closed session vote of this Board authorizing its negotiated settlement are known publicly. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR -RECOMMENDATION OF ARD OMMITT E APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON FP_bruary 27, 1996 APPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE _X_UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED February 27, 1996 Contact: Tony Schleder - 646-2281 PHIL BATCHELOR,CLERK OF THE BOARD OF cc: CAO Risk Management SUPERVISORS AND COUNTY ADMINISTRATOR Auditor-Controller Thomas, Salter & Lyding (via Risk Management) BY DEPUTY County Administrator Contra Liability Claims (510)646-4155 Risk Management Risk Administration (510)646-2014 Costa Safety (510)646-2203 County Administration Building ^ Vocational Rehabilitation (510)646-2239 651 Pine Street,6th Floor [County Workers'Compensation (510)646-2926 Martinez,California 94553 vvv Fax Number (510)646-2547 e� PRESS RELEASE February 22, 1996 For further information: William R. Thomas Attorney at Law Thomas, Salter & Lyding 930-7270 The Board of Supervisors has approved and will finalize on February 27 , 1996 the settlement of a workers ' compensation claim filed against Contra Costa County by Claudia Hallissy, widow of Daniel Hallissy. The claim, which settled for $37,500, contends Mr. Hallissy' s heart attack and death were related to stresses of his employment in the Assessor' s Office. X X X TO: BOARD OF SUPERVISORS SEL Contra FROM: Phil Batchelor, County Administrator Costa o. s ��"� • - -�� Count DATE: February 27, 1996 ' sT..-_- • y a count SUBJECT: Final Settlement of Workers ' Compensation Claim - Dennis Cusack vs . Contra Costa County WCAB No. SF 380059 SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: Receive this report concerning subject final settlement and payment in the total amount of $43,500 from the Workers ' Compensation Trust Fund. REASONS FOR RECOMMENDATION/BACKGROUND: David V. Costa, defense counsel for the County, has advised the County Administrator that within authorization an agreement has been reached settling the workers ' compensation claim of Dennis Cusack vs . Contra Costa County, WCAB No. SF 380059 . This Board' s February 6, 1996 closed session vote was : Supervisors Bishop, Smith, DeSaulnier, yes; Supervisors Rogers and Torlakson, absent. This action is being taken so that terms of this final settlement and the earlier February 6, 1996 closed session vote of this Board authorizing its negotiated settlement are known publicly. CONTINUED ON ATTACHMENT: YES SIGNATURE: ) RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF B R COMMI TEE APPROVE OTHER SIGNATURE(S): ACTION OF BOARD ON February 27, 1996 APPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS X I HEREBY CERTIFY THAT THIS IS A TRUE UNANIMOUS(ABSENT ) AND CORRECT COPY OF AN ACTION TAKEN AYES: NOES: AND ENTERED ON THE MINUTES OF THE BOARD ABSENT: ABSTAIN: OF SUPERVISORS ON THE DATE SHOWN. ATTESTED February 27, 1996 Contact: Tony Schleder - 646-2281 PHIL BATCHELOR,CLERK OF THE BOARD OF CC: CAO Risk Management SUPERVISORS AND COUNTY ADMINISTRATOR Auditor-Controller Mullen & Filippi (via Risk Management) BY 1 ' DEPUTY