Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
MINUTES - 01231996 - C16
C. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 23; 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 1V below), * t t -gZnment Code Amount: Unknown Section 913 and 913.4. ase note all �' ings". CLAIMANT: Black Mountain Spring Water Co. D E C 2 6 1595 ATTORNEY: Grace MadoniaCOUNTY COUNSEL Esq. MARTIMEZ CALIF. Date received ADDRESS: 201 N. Civic Dr. #102 BY DELIVERY TO CLERK ON December 22, 1995 Walnut Creek, CA 94596 BY MAIL POSTMARKED: December 21, 1995 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 26, 1995 IVIL BVCC ELOR, Clerk \ Il. FROM: County Counsel TO: Clerk of the Board of Supervisors (This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 1 -2- _ '� Ce BY: Deputy County Counse 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: 1. 2.3- /`r 9& HIL BATCHELOR, Clerk, By ,=� Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. • For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today 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: - —/ q 9 !n BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Cla;_- to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person • or to personal property or growing crops and Which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code 5911.2.) B. Claim must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 551 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 for R£: Claim By ) Reserved for Clerk's filing stamp Black Mountain Spring Water Co) RECEIVED Against County of Contra Costa_ ) Against the County of Contra Costa ) DEC 2 2 1995 or ) CLERK BOARD OF SUPERVISORS District) CONTRA COSTA Co. Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ unknown arid in support of this claim represents as foll aws: 1. When did the damage or injury occur? -(Give exact date and hour) 10/18/94 per Complaint of Robert Ac 2. Where did the damage or injury occur? (Include city and county) jdhago Bou.l�_-nard 3. How did the damage or injury occur? (Give full details; use extra paper if required) _ automobile v. motorcycle 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Reglit-gen.t-design .of :public roadway a. wnat are tne names of counLy or district officers, servants or employees causing the damage or in jury? Unknown ——---------—-- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Per Complaint of Robert Acord; this claimant will seek indemnity from the County of Contra Costa How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Damages to Acord not yet ascertained. Names and addresses of witnesses, doctors and hospitals. Unknown at this point. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910-2 provides: ,.,-i)--`,i"The claim must be signed by the claimant SEND NOTICES TO: (Attorney) = -orb some person on his behalf." Name and Address of Attorney Grace Madonia, Esq. Maloney and Associates Claimants Signature) 201 N. Civic Dr. #120 2Q1 N- Civin nr, g3 0 Walnut Creek, CA 94596 kAddress. - Walnut. Creek, CA 94596 Telephone No. 510-947-6499 Telephone No. 510-947-6499 V V I V 9 V T V I I V T 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 010,000, or by both :stich impriso.-ffient and fine. �LCL.1G.1�7J 7•1J1'v i ua�.r� i ..r-i i u. SUMMONS (CtTACION JUDICIAL) RMCOMMONY =0 PARA uco CIEu OWTV NOTICE TO Who ho a Aeusado) BIACR MOUNTAIN SPRING WATER COMPANY, ROY LAN JINKS, an DOES 1 though 25 ' � c YOU ARE BEING SUED BY PLAINTIFF: � ^ (A Ud. le estd demandando) ROBERT ACORD, JR. k4h n You haw W C&ENDAR DAYS after this summons is Desputs de quo to entreguen este oftoldn Judicial us4ad bene served on you to file a typewritten response at this un plam de 30 DIAS CALENDARIOS para presenter una Court. respuesto asctft a m dqukm on este cone. A letter or phone can will not protect you; your Una cafe o urn r7amsda Islef6nica no 1€r ofrecerd pmmcci6n, typewritten response must be in proper legal form N su reVuesta ascnta a maqulne Creno qua cumplir con las you want the court to hear your Case. fomoNdades/agates apropiadss sl usfed qulere quo la come escucho su case. ff you do not the your response on time,you may lose 5i usted no presents su res a ffempo,puede rdor el Me case. and your wages, money and property may P AussM Po be taken without further warning from the court. caso;y fe pueden qultar su salado,su d/Hero y otras mess de i su propiedad aln aWso adcionW por parte de la come. There are other legal requirements. You may want to &gen oboe mquisfios legates.Puede quo usted quiets Usmar Cd an attorney right away. if you do not know an a un abogado inmedlataments. Sf no conoce a un abogado, anomey,you may can an attorney referral service or a puede#emar a rut servlcio do referencla de abogedocs o a una legal aid office(nsted In the phone book), opcbm de ayrnda legal tV"a/dlrectorfo felef eco). The name and address of the court is:(El nombre y diracci6n de 18 coma os) G6Er NUMBER:Pwwsm earCUD) MUNICIPAL COURT OF CALIFORNIA, CONTRA COSTA COU)= MT. DIABLO JUDICIAL DISTRICT 2978 Willow Pass Road Concord, CA 94519 The name,address,and telephone number of plaint's attorney,or plaintiff without an attorney,is: (El nombre,la direcci6n y el numero de telftno del abogado del domandan1%o del demandants quo no bene abogedo,es) TSOMAS P. GREERTY (SB #085616) 510-370-8400 Attorney at Law 706 Ferry Street Martinez, CA 94553 f 4' 1 DATE: OCT 16 Clerk-b, k6 lL e(% ,Deputy NOTICE TO THE PERSON SERVED:You we served 1. M as an individual defendant. 2. Q as the person sued under Me fictitious name of(specify):H �� 3. �--on behalf of(specifya&l � under: CCP 416.10(corporation) CCP 416.60(mires CCP 416.20(deiU=Corporation) C9 CCP 416.70(conservatee) CCP 416.40(association or C 416.90:;Individual) lU other.(� t. -4. by personal d on(date,)77- t: , 12 1995 hoAOMXW ty A*on (See reverse for Pmof lid Soevl�p RTHERN cALIFORNiA Jeww C-14 C&Iwft a SUMMONS tMSERVICECENTERb i4l0 "" m-1"Wr CALENDAREDSp LICL..1G.177J 71Jn1_i rxn i n wn u. EY oa PAM WrrH=ATTORNEY( E AND ADDFIM): TELEPNo _ Fold couar usa owy T$oh" P. GRF.ERTY (Ss f0a5s�y) 510-370-s4__ Attorney at Law 7-R A C K 1 706 FeM Street Nartine2, CA 94553 PROOF CF- SEWCE AT MMEf FOFi(NAME). ROBERT ACORD JR. GtE �l �CR"S hiaert name of court judicial dtatriat or branch court R any.and post oftice and street address: MUNICIPAL COURT OF CALIFORNIA, CONTRA COSTA COUNTY 11T. DIABLO JUDICIAL DISTRICT SET FJF: 2970 Willow Pass Road Concord, Cd 94519 c;�}A �OE: 5-4A(P PLAINTIFF: ROBERT ACORD, JR._ CA TIME: J;WA» r DEFENDANT:BUCK MOUNTAIN SPRING WATER COMPANY, ROY ALLAH JIARS��DAREp -S • MUNICIPAL COURT Of CAUFORNIA COUNTY OF CONTRACOSTA MT.DIABLO JUDICIAL DISTRICT ® DOES t TO �,� OLVI< CASMMISM OEPU i(C'.IRK COMPLAINT—Personal Injury, Property Damage,Wrongful Death [2 MOTOR VEHICLE Q OTHER(Specify}: (2 Properly Damage Q Wrongful Death ®Personal injury (2 Other Damages(specify): 4Z5 a7(f Pais and Suffering 1. This pleading,including affachments and exhibits,consists of the fallowing number of pages: 5 2 a. Each plaintiff named above is a competent adult Q Except plaintllf(name): Q a corporation qualified to do business In California Cl an unincorporated 9"(describe): Q a public entity(describe): Q a minor = an adult Q for whom a guardian or conservator of the estate or a guardian ad iltem has been appointed Q other(specify): D other(specify): (� Except piainuff(name): Q a corporation qualified to do business In California Q an unincorporated entry(describe): a public entry(describe): Q a minor = an adult Q for whom a guardian or conservator of the esrare or a guardian ad Otem has been appointed C3 other(speciftyl: Q other(spec+7y): b. Plairi i#(name): Is doing business under the fic tious name of(spechW: and has complied with the tladdous business name laws. a Q Infomatlon about additional plaintiffs who are not competent adults is srmn in Complaint-(Continued) d 'COMPLAINT— Personallnlury"Propertyoarrtage, Eu.assnA) Wrongful Death. r` LC.I..1G.177J 7• lona a,�r. i. , ......,.. . SHOATTnLE: ACORD v. $LAC$ MOUNTAIN SPRING WATER at al. CASE NUMBER: COMPLAINT— Personal Injury,Property Damage,Wrongful Death Pap tac 3. a Each defendant named above is a natural person (2 Except defendant(name): Q Except defendant(name): BLACK MOUNTAIN' SPRING WATER COMPANY 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): f—I a public entity(describe): Q a public entity(describe). Q other(specify): Q other(specly): Q Except defendant(name): Q Except defendant(name): 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): Q a public entity(describe): Q a public entity(describe): Q other(specify): ©other(specty): 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. CL Q Defendants who are joined pursuant to Code of Civil Procedure section 382 are(names): 4. Q Plalnti f Is required to comply with a claims statute,and L Q plaintiff has complied with applicable claims statutes,or b.Q plaintiff is excused from complying because(specify: 5. "fids court Is the proper court because Q at least one defendant now resides In'hs jurisdictional area Q the principal place of business of a corporation or unincorporated association Is in Its jurisdictional area. E0 injury to person or damage to personal property occurred in its jurisdictional area. Q other(specify): 8. The following paragraphs of this complaint are alleged on information and beilef(specify paragraph numbers): GN-I, MV-I, XV-2 a., b., a., d., e. (Continued) , �,, .SHORTTM-E: ACORD v. 8L R UNTAIN SPRING WATER at al. { CASENUMSER: COMPLAINT— Personal Injury,Property Damage,Wrongful Death (Continued) rm°a,r. 7. O The damages claimed for wrongful death and the relationships of plaintiff to the deceased are 177 listed In Complaint—Attachment 7 [3 as follows: S. Plaintiff has suffered [2 wage loss C,Z loss of use of property [0 hospital and medical expenses QJ general damage QI Property damage loss of earning capacity (�other damage(specV: pain and suffering 9. Relief sought in this complaint is within the jurisdiction of this court 10. PLAINTIFF PRAYS For judgment for costs of sut for such rsiW as is fair,just,and equ'Itab'e;and for [Z compensatory damages p (Superior Court) according to proof. ® (Munkipal and Justice Court) in the amount of$ 0 other(specffy): 11. The following causes of action are attached and the statements above,apply to each: (Each complaint must have one or more causes of acdorr attached,) Motor Vehicle [;2 General Negligence F-1 Intentional Tort M Products Liability D Premises Liability p other(specify): THOMAS P. GMERTY (ryp�a pdntnnny Prahm d o41n I COMPLAINT— Personal Injuiy,Property Damage, P"e4i1°° WaeeVM1wreco Wrongful Derith(Continued) =P4U12 VWIC.la77 7' loran uw r. rri.r rr..u. SHORT TrrLE: ACORD v. BLACK I NTAIN SPRINT WATER at al. t cul WU YIRST CAUSE OF ACTION— Motor Vehicle Page Four Nf ATTACHMENT TO (yam Complaint Q Cross-Complaint (Use a separate cause of action form for each cause of action.) plaintiff(name): ROBERT ACORD, JR. MV-1. Plaintiff alleges the acts of defendants were negligent; the acts were the legal (pro)imate) cause of injuries and damages to plainW,the acts occurred on(date): 10/18/94 at(place): Paeheco Boulevard, 1250 feet east of Morello Avenue in the incorporated area of Contra Costa County, California. MV-2 DEFENDANTS a Cta The defendants who operated a motor vehicle are(nemea): ROY ALLAN JIM and Ga Does I _to s b. The defendants:who employed the persons who operated a motor vehicle in the course of their employment are (names): ROY ;ALLAN JINKS and CO goes 1 to - 25 c. Ca The defendants who owned the motor vehicle which was operated with their permission are(names): BLACK MOUNTAIN SPRING WATER COMPANY and C� Does i to_2A d. 10 The defendants who entrusted the motor vehicle are(names); BLACK MOUNTAIN SPRING WATER COMPANY and ®Does i to 25 e. ® The defendants who were the agents and employees of the other defendants and acted within the scope of the agency were(names): ROY ALLAN JINKS, BLACK MOUNTAIN SPRING WATER COMPANY and Ga Does I to 25 f. C7 The defendants who are liable to plalntiffs for other reasons and the isasons for the liability are [M listed in Attachment MY 2f [=as follows €�sloes to FvmJ&pPVmd by e» .NtlkW Caundl dCallfanda efto" 190CAUSE OF ACTION—motor vehicle =,,aU L)Lt—Id.1777 7 101,11 r,L-rl r 1 1 r r wrr r r r� . ._._ SHORT IM,E: ACORD v. BLACK H0, ZAIN SPRING HATER at al.' casff NUMSM sRco CAUSE OF ACTION— General Negligence Page Fiv., ATTACHMENT TO ®Complaint Q Cross-Complaint (Use a separate cause of scbon form for each cause of actfon.) GN-i. Plaintiff(name): ROBERT ACORD, JR. alleges that defendant(name): BLACK MOUNTAIN SPRING WATER COMPANY, ROY ALLAN JINKS and ® Does i to 25 _. was the legal (proximate) cause of damages to plaintiff, By the following ads or omissions to acz defendant negligently caused the damage to plaintiff on(date): 10/18/94 : at(place): Pacheco Boulevard, 1250 feet east: of Morello Avenue in the unincorporated area of Contra Costa County, California (deecdpdon of reasons for Ilability): Plaintiff was travelling eastbound on Pacheco Boulevard on. his 1980 Earley Davidson motorcycle, vears"ag a helmet, vhen a 3-axle truck driven by Defendant ROY ALLAN JINKS, owned by BLACK MOUNTAIN SPRING WATER COMPANY, pulled out from a Shell gas station directly in Plaintiff's path, causing Plaintiff to veer to the left to avoid a collision, which caused his motorcycle to crash to the pavement causing Plaintiff's injuries. rwm Approved by ar. Judkkf Caund!of c,�Nanca °' ,�,, ,.,96` CAUSE OF ACTION—General Negligence COPQ&II y P a o � z � v0 `< 1 � =a t a Q mx m x y d i > H i u Q a as a M W t i F i t' X rn 9d tx1 � r0W rt. tl (Dpo0 NtDrnt H En {7C» � (DD O N m 0 K to ct st C UI EO ul ct ko 3 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA - JANUARY 23, x.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 mrunent Code Amount: Unknown Section 913 and 915.4. Please note "Warnings .�MID CLAIMANT: Zackery Charne DEC 2 2 1995 COUNTY COUNSEL ATTORNEY: MARTINEZ Date received CALIF• ADDRESS: 785 60th St. BY DELIVERY TO CLERK ON December 21, 1995 Oakland, CA 94609 BY MAIL POSTMARKED: December 19, 1995 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ILApCHyIOR Clerk DATED: December 22. 1995 �q: BATCHELOR, o II. 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: 6-e4 2-Z BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD( ORDER: By unanimous vote of the Supervisors present ( �1 This Claim is rejected in full. ( } Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: /-A-A - 19 cl PHIL BATCHELOR, Clerk, Bye . Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 9 9 /1 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim 'to: BOARD OF SPERVISORS 'OF CION7RA`CIC06 COMY INSnUCTIONS TO CLADiWr A. Clam relating to causes of action for death or for injury to person or to per- soral 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. Claiss relating to causes of action for death or for injury to person or to personal property or growing crpps and which accrue on or .after January 1,' 1948, *lust be presented not later than_*,'si'x 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. C?aimszost be tiled With the Clerk of the Board of Supervisors at its office in Ronin IC-5, County Administration Building, 651 Fine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, 'rather than the County, th2 name of the District should be filled in. D. if the el-5im In, more than one public entity, separate claims must be filed aga'.rst -aah po'.;lic en+-i.ty _ v '� t'j� ��„� �,-�•�a:,I�:at _^l.aimF _ Pe^ 7P R'' the �:rd fo-. RE: Claim B;. } Reserved for Clerk's filing sta:rp } } LkEEII/Ep k; 2ESUPERWS0 nuny a: C-ontra CoorO RS i __ District) COM RA COSTA Co. The undersisne:' clai,=-:_!t hereby makes claim against the Coun,,',y of 'Contra Costa or the above-:z=-,l District in the s= of $ ���1o,i, � - xnd in support of �^ . this �-laim rep:,�sents as follows — _.w_^______..o.. .___ ........... w.w.i..t...r... •yIs_'r--�.. - _ _�._..._�+_,....�e.�+•w+_1.s ti. -----_„--_--- 1. When did t"le rlazage or ldml,,Vry occur? (Give exact date and hour) 4 -v- d Dr'{:k, ur .,tjur+y occur? (Include' city and county) - - 3. Now did �-h,% or ,.o j�7�y occur" (Civ t tails; us�� extra pater if \'� -- -.•,• ._��^?'_.,,,. ._.._�-�a.ct+.�y►•...._..c..r�_.:--�.._..., 1 _..r�.._ ...:.. .2�=�5� �""'"'h4C'� Vw�� �-�'15t, (1.�•.4�.�Q. 4. What particular act or omission on the Part of county or district officers, ssrvants or employees caused the injury or .damage? (over) 5, 1,*.;st are the na:,es of co-mty or district officers, servants or employees �causi`� the d age or ,injr4ry? L. -� -------- ---+�- 1-��_ .._ ----..�------------- - --- E . w:-,-=t ge or i juries do you claim resulted? (Give full extent of injuries or domes claimed. Attach. two estimates for, auto da*e 7. H Mrs. the am-=a c 1 a _d above co_p--,te�? (Include the estiszte iin of apy prospective injury or damage.) (aA ._ x ... _(_ —� 6. Naaes and addresses of witnesses, doctors and c —es a t'-.iS accident or i'i;;ur- . c the exp,r4ittr^_ yam; -�,d o- a u-�� r nrT, ' 3 C-c . Code Sec. 910.2 provides: IT.-je c1aiw mast be signed by the SENA tIpTI7--5 TO: 'Attonne ' cr ty s,?me erscn on his be-:'If." Nam ail ti Eess of rttcrn=y Oc v J Adare s R TeIephone N--. _ _ Telez-.—e No. 4 4 # # • f f .f f � it .i �� +r�� ��� U # N 0 T I C E Section 72 of the Per., l Code provides: "Every person le':o, with intent to defraud, presents for allow:nye- or for pa}meat to any state board or officer, or to any county, city or district board or officer, authorized to allot: or pay the same if genuine, any false or fraudulent claim, bill, acco,t, voucher, or u7iting, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding cae thous'': (�1,000) , or by both such imprisonment and fine, or by imprisonr�er.t in the state priscn, by a fine of not exceeding ten thousand dollars ($10,000, or by ',,:'`..`ti7 S'�_y i""^i5.''_ a:--' fine. ..j.. .. rD 0-1 45t 00 t t 4� 1 f CoLo �+ M CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA :JANUARY 23;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: $279.78 Section 913 and 915.4. Please note a1)T4#1, rr,:i:ngs" CLAIMANT: James A. Flagstead ATTORNEY: C0uN-r Date received PAAR11N NSEIL ZZ GALW, ADDRESS: 1038 Stimel Dr. BY DELIVERY TO CLERK ON December 21_, 1995 Concord, CA 94518 BY MAIL POSTMARKED: DPCPmher 2.n, 1995 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppH BATCHELOR, DATED: December 22, 1995 BAIL Clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( +/f This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: (PQ- 1 ls-ee z2 . If i.$ BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (�) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: /—as3=�qq (a PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. J Dated: 'a?*-/994 BY: PHIL BATCHELOR bya4,yPj�eputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT a b IM�y �a ✓�S �cpu57Clf A. Clai:.s relating to causes of action for death or for injury to �erson or o per- UJK,Sdi4 sonal property or g p Y p p y 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. Claim must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 551 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the nave 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 f orm. R£: Claim By ) Reserved for Clerk's filing stamp ��►�S - Fig a d RECEIVED sa y ) DEC 2 1 1995 Against the Count of Contra Costa ) or ) District) CLERK BOARD OF SUPERVISORS CONTRA COSTA Co. Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 07 9, 7 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) �Jecev� �e� 12 , ---- 2. Where did the damage or injury occur? (Include city and county) e�60L21 .0 �V,�C4 3. How did the damage or injury occur? ��(Give details; use extra/pa/per if1 rewired) �,el� i'E `4cl(-lam �) &11 rl J 0�0 too-l& � /rCtd Dor 1,e7 c��i�� s �l Corr/r-a ,0Is7rI'cf , ah ��� � GP��� � y ll clCross e S X-LIean /n y Cz7r C r u S err L4,1 in _ i� /c� - - -- ---------------- --- - V u. What particular act or omission on the part of county or district officers, servants/or employees caused the injury or damage? �4i''i to Ili l wnat; are the names of county or district officers, servants or employees causing 'he :ama;ze or injury? V 5. What damage or injuries do�you claim resulted? (Give full extent of injuries' or damages claimed. ]j Attach two estimates for auto damage, �S j -Pro-,, � t�/t Yl Cl.� �le Id- j Of t FF � AW4 �E� �/ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or danage.)f /J $. Names and addresses of witnesses, doctors and hospitals. IJP ane s'a�J ff1� re� % � '. ��sScS � fi 744-- 4'�r 9. List the expenditures you made on account of this accident or injury: DATE ITEM: AMOUNT Gov. Code Sec. 910:2 provides: : � . "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney Claimant' Signature Address) Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by 'Doth such im-prisanrient and fine.ne. 1 Up NV a � S ... 'GP 946 O cr, T —= b0 © S Lo i' _7 6 k v 8Ln � x iE ,L,A ii SOS sop ...-�N yr' ger O O + v% _ Von- •o O i �7 Joval , . N A CA = mss . ay. O N cp 9 c a Op� GUS' We c FEDERALI.D. #.84-0628277 WORK ORDER TO.. :,t',{ 1. ►„''� ; , ,; !, ..4��1J'f y.�t.'; WINDSHIELDS AMERICA PURCHASE ORDER POLICY NO. CLAIM UNIT NUMBER DATE OF LOSS TAKEN BY ORDER DATE 1NqR�ORDER NUMBER WORK ? JOB DATE INSTALLER SHIP VIA DEDUCTIBLE TERMS VERIFIED BY CAUSE OF LOSS 0 INSURER BILL TO COST. NO. INSURED OWNER 1`14 TYPE OF VEHICLE VEHICLE ID NUMBER LICENSE /4 J 7 `T! rl FW005---2008 Windshieid (Blue) (BU-86 ) 1 5 iz' 0o '"P�3 G-GVLR Jil 0f-;RMwibE 4 j i CUSTOMER SERVICE HOTLINE: 1-800-800-96& A; OTAL Shield Saver Attempted: Dyes”El no If not attempted or failure, Reason: TOTAL PARTS If declined, Customer signature: LABOR oyer w SALES TAX STATEMENT OF AUTHORIZATION AND SATISFACTION GROSS TOTAL REPLACEMENT HAS BEEN MADE TO MY SATISFACTION AND I HEREBY AUTHORIZE THE ABOVE INSUR— ANCE COMPANY TO PAY DIRECT IN FULL TO WINDSHIELDS AMERICA,INC.FOR SAID INSTALLATION. IF FOR ANY REASON THE INSURANCE COMPANY DOES NOT PAY FOR THESE REPAIRS OR REPLACEMENTS, DEDUCTIBLE THE BELOW SIGNED AGREES TO PAY FOR SAID REPAIRS OR REPLACEMENT.SUBJECT TO WORK ORDER TERMS SET FORTH ON REVERSE SIDE AND INCORPORATED HEREIN BY THIS REFERENCE. PAYMENT RECD ij DATE :!5--SIGNATURE 1 17 1 'A" FOR INTERNAL USE ONLY CUSTOMERDOCUMENT CONTROL I.D. At XU CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Januaary 23, 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 belowgiven pursuant to Government Code Amount: Unknown Section 913 and 915 LN` note J� arnings". CLAIMANT: Matthew Higbee DEC 2 9 19Fi COL1N'ry CULINSEL ATTORNEY: Gillin, Jacobson, Ellis, Larsen & Doyle MARTINEZ CALIF, PO Box 523 Date received ADDRESS: Berkeley CA 94701-0523 BY DELIVERY TO CLERK ON DerPmhPr 28, 1995 BY MAIL POSTMARKED: Hand Delivered via* LAO . 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Q g F1 DATED: December 29, 1995 Egtl Deputy OR, 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: Dated: 2- - rI (-e BY: — Deputy County Counse 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: I-&13-199A PHIL BATCHELOR, Clerk, By ,440l-J, Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 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. V i il Dated: /- 2c _4ga(A BY: PHIL BATCHELOR by deputy Clerk CC: County Counsel County Administrator RECEIVED' ..Fry t DEC 281995 GOVERNMENT CODE CLAIM CLERK EitDARD OF SUPERVISORS CO;`dT:,A,COSTA CO. . TO THE GOVERNING BODY OF : CONTRA COSTA COUNTY OUR CLIENT and CLAIMANT Matthew Higbee c/o GILLIN, JACOBSON, ELLIS, LARSEN & 'DOYLE 2030 Addison Street, 7th Floor Post Office Box 523 Berkeley, California 94701-0523 DATE OF INJURY July 22 , 1995. PLACE OF INJURY Byron Highway, 413 feet south of Sunset Road, in Unincorporated Contra Costa County. (Hereafter referred to as "roadways") . DESCRIPTION OF INCIDENT (1) On or about July 22 , 1995, MATTHEW HIGBEE, while operator of a motor vehicle, sustained injury when his vehicle left the roadway and went in to a ditch, and collided with other objects, causing claimant's ejection from the vehicle. (2) At said time and place herein alleged, said roadways, owned and maintained by the COUNTY OF CONTRA COSTA, constituted a dangerous condition of public property, as that term is described in Government Code Section 830, in that: (a) One or more signals, signs, markings or devices (other than described in Section 830. 4 of the Government Code) were necessary to warn of a dangerous condition which endangered the safe movement of traffic and which would not be reasonably apparent to, and would not have been anticipated by a person exercising due care -- specifically, said dangerous condition consisted of loose gravel upon the roadways as a result of a "chip seal" road repair project in progress. Although claimant is informed and believes that a single warning sign at the relevant location was, in fact, in place, claimant is informed and believes that said warning sign was: (1) in an adequate location to provide notice to drivers such as claimant; (2) not sufficiently visible, due to size, marking and otherwise, to provide adequate notice of said .condition to claimant and other motorists. (b) The roadways were physically changed, flawed, and damaged by the placement of (and failure to remove) loose gravel upon said roadways in the process of a "chip seal" road repair project, causing the forseeable use of said roadways by motor vehicle traffic to be potentially dangerous, even when said roadways were used with due care, in that the presence of loose gravel inhibited, unsafely and dangerously, vehicle performance with regard to braking and turning maneuvers of vehicles, including claimant's vehicle. Said dangerous condition resulted in the above- described incident, which occurred when claimant made a right turn from eastbound Sunset Road on to southbound Byron Highway, said loose gravel causing him to lose control of his vehicle, causing the injuries and damages herein described. (3) Separately and distinctly from the allegations set forth in Paragraph 2 above, claimant further alleges that the County of . Contra Costa is legally liable for claimant's injuries, pursuant to Government Code Section 815.2, as a result of the following: The County of Contra Costa did owe a duty to claimant, among others, to maintain said roadway in a reasonably safe condition for motor vehicle use; the County did, as a result of the breach of said duty by unknown employees thereof, negligently, dangerously, and unsafely own, operate, maintain and control said roadway so as to permit said roadway, as a result of the loose gravel located thereon, to be dangerous and unsafe, resulting in the injuries to claimant herein described. (4) The injury sustained by claimant, as alleged herein, was proximately caused by the dangerous ,condition of the roadway above-described, and by the negligence of the County, through its unknown employees, above-described; and (a) A negligent or wrongful act or omission of an employee of the public entity within the scope of his employment created the dangerous condition; and (b) The public entity had actual or constructive notice of the dangerous condition a sufficient time .prior to the injury to have taken measures to protect against the dangerous condition. (5) Claimant is informed and believes, and thereupon alleges, that the above-described dangerous condition had existed for a substantial period of time and was of such an obvious nature that the public entity in the exercise of due care, should have discovered the condition and its dangerous character. NATURE OF DAMAGES Brain damage, ability to walk only with cane or walker, loss of sexual function, urinary function and bowel control; other internal injuries, and related general damages. AMOUNT OF CLAIM An amount within the jurisdiction of the Superior Court. ATTORNEYS TO WHOM NOTICES SHOULD BE ADDRESSED GILLIN, JACOBSON, ELLIS, LARSEN & DOYLE 2030 Addison Street, 7th Floor Post Office Box 523 Berkeley, California 94701-0523 (510) 841-7820 DATED December 27 , 1993. C. APPLICATION TO FILE LATE CLALM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 23 1995 BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. 'Ce.= Claimant: John F. Paxton Attorney: D E",. 2 � COUNTY COUNSEL Address: 15 April Court MARTINEZ CALIF. Pleasant Hill, CA 94523 Amount: $3,136.00 By delivery to Clerk on Doromher 2 ., 1995 Date Received: December 22, 1995 By mail, postmarked on Hand Dpliv d I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: December 22, 1995 PHIL BATCHELOR, Clerk, By Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). (� The Board should deny this Application to File Late Claim (Section 911 6) DATED: /`Z 5 & VICTOR WESTMAN, County Counsel, By --0,,__L:--Deputy III. BOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 911.6). ( ✓) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATE: I -,a3 —19 96 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code 5911.8) If you Kish to file a court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the court Within six (6) months from the date your application for leave to present a late claim Was denied. You may seek the advise of any attorney of your choice in connection with this matter. If you want to consult an attorney, u should do so immediatel . V. FROM: Clerk of the Board TO: 1 County Counsel 2 County Administrator Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29T03. DATED: /- -199 b PHIL BATCHELOR, Clerk, By Deputy V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM RESA D1, ;DEC ( 9 I9i CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. December 18, 1995 John F. Paxton 15 April Court Pleasant Hill, CA 94523 Clerk of the Board of Supervisors Room 106 County Administration Building 651 Pine Street Martinez, CA 94553 RE: Application for Leave to Present a Late Claim To the Clerk of the Board of Supervisors: I hereby apply for leave to present a late claim. As presented in the attached letters from PG&E, I originally filed a claim to PG&E in May for the damage to my stereo equipment caused by a power surge on November 30, 1994. I was not aware of any claim process for damage caused by power surges until an acquaintance told me about it. PG&E did not inform me until September that the power surge was caused by a tree of unknown ownership falling on their power lines at the specified location. At the time, I did not know what to do, since I believed PG&E's claim that they were not responsible. I did not know what to do until I learned late this year that it is possible to find out who owns property from assessors maps. This was new and unexpected information for me, so I checked the location'of the tree described by PG&E.and then checked the assessors maps. It was only then, November 1995, that I learned that the tree causing the problem was owned by Contra Costa Flood Control. This is why my claim has taken more than six months to file. Thank you for your time and attention to this matter. Please inform me in writing of any decisions regarding this claim. Thank You, T John F. Paxton TO: John F. Paxton 15 April Court Pleasant Hill, CA 94523 NOTICE TO CLAIMANT (Of Late-Filed Claim) (Government Code Section 911 .3) The claim you presented to the Board of Supervisors of Contra Costa County, California, as governing body of the County of Contra Costa and/or District, on December 1, 1995 has been reviewed by County Counsel and is being returned to you herewith because: Your claim for an injury to person or personal property which arose on or after January 1, 1988 was not presented within six months of the event or occurrence as required by law. (See Government Code sections 901 and 911 .2) Because the claim was not presented within the time allowed by law, no action was taken on the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code sections 911 .4 to 912 .2 and 946 . 6) Under some circumstances leave to present a late claim will be granted. (See Government Code section 911 . 6) You may seek the advice of an attorneyof your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administrator By: DelWty Clerk Dated: 0 7 -/996 Enclosure . t r NOTICE OF LATE CLAIM Page 1 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 copy of the above Notice to Claimant (of Late Submitted Claim) , addressed to the claimant as shown above, Date: /d�-t�'7 -l99�' By Phil Batchelor by Deputy Zerk NOTICE OF LATE CLAIM Page 2 Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA CMM INSTRUCTIONS TO CLAIMANT A. Clai= relating to causes of action for. death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for-death or for, injury to person • or to personal property or growing crops and which accrue on or after January 11 1988, 'must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code 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 nave 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 f o.+� lFvlFy�f RE: Claim By ) Reserved for Clerk's filing stamp L' ) RECEIVED I Com. �. !{i �� � ySZ3 Against the County of Contra Costa ) DEC -- 11995 or ) Co.•f,..�Cos L, F'lcvd .-ice-f District) CLERK BOARD OF SUPERVISORS Fill in n_ ) I CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 3 / oto • O O and in support of this claim represents as follows: 1. When did the damage or injury occur? '(Give exact date and hour) /Vo `3 U � S Awl 2. Where did the damage or injury occur? (Include city and county) 1S' Apri I c -/ . Pleasa._+ 14 , 11 C/4- Q gS'Z3 3. How did the damage or injury occur? (Give full details; use extra paper if required) /)G d-C r o � Su►- -4 (G 4e dl 4-,a =4 a w`o 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? S o c+)a, e -P q l a.1,4. e c g l y p f u s f ( o►•. C. 4 /= i S c e of r c 2 2 a�c� ,� ►�' ( c a p1+ 1-1r I . 7�-2 i c i off?.•- C a M V-C of Ol a",e.- s u `� 7. wnat; are the a----,nes 01` county or district officers, servants or employees causing r the dazage or injury? 5. What damage or injuries-doYyou claim resulted? (Give full extent of-injuries-or damages claimed. Attach l"two estimates for auto .damage. --,e :'t t" o Q✓' ct u-yC� 1 +t Q W—a alto of - (')(Jv�-e Yf W"` f s1U js✓l oti"� c cri,lp t-e� d.•P T�� a� . G� �r2 a�j [i!-rP^ � Q wtia.e,SZ JCY� . 7. How Was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.),( 1 �7--- AM,C,--� C�Ck �-t o� 1 164�' - 04^_ ►rQ p(Ctc e fw c N ae+-P�- tz+•- r P +'Q" ,� *4 P C.,n'- o-'p r►-P a may, �p (.a p -a-�-�. 8. Names and addresses of witnesses, doctors and hospitals. 9 o C te u e t�►- 62ot . - P. !4 It C/4•- C1 Y 5 Z 9. List the expenditures you made on account of this accident or injury: DATE ITEM" AMOUNT It/ F"(9 4 P ,t, -l— l��� r" �$ 76 . co o Z Mr Tse Q� C�z:��,;.��s'tSo Gov. Code Sec. 910:2 provides. .. ; "The claim must be signed by the claimant SEND NOTICES TO: (A or or b some erson on his behalf." Name and Address of Attorney Claimant's Signature / P y (Address) Telephone No. Telephone No. f-/,O N 0 T I C E Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding . one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not, exceeding ten thousand dollars ($10,000, or by both such impriso•v:)ent and fine. Pacific Gas and Electric Company Diah;_ ��Ivision 1031.11 ij0i(A� iiLje Ci7[1i0_, CA 91510-2437 June 12, 1995 i VJ �f IE`�... John F. Paxton 15 April Court Pleasant Hill, CA 94523 Dear Mr. Paxton: We have received your claim for an incident that happened on November 30, 1994. am investigating this incident and will get back to you within 30 days to answer any questions you may have about the status of your claim. Please be advised that I will be on vacation from Friday, June 16 to Wednesday, July 5, 1995. Should you have any emergency questions, you may contact my associate Jim Breuner at (510) 674-6356. After that time, you can call me at (510) 674-6525 if you have any questions or would like to discuss your claim. Sincerely, Michael J. Ta ry Claims Investigator MJT:sda F'aci1i Gas and Electrii. sDrnpany September I. 1995 Mr. John Paxton 15 April Court Pleasant Hill. CA 94523 RE: Our CIaim No. 94-10269 Date of Incident 11/30/94 Dear Mr. Paxton: Following my Ietter of June 12, 1995. I have been informed of the following circumstances. 1. On November 30. 1994, a tree limb fell into one of our overhead lines. causing an interruption of service. This loss occurred near Beatrice where Beatrice crosses the canal.. 2. The tree is owned by unknown parties. 3. Any damage that you have incurred should be addressed to the owner of the tree for their review and handling. PG&E is sorry for the damages you sustained.but cannot accept responsibility for the incident. Attached for your review is a cipy of California Public utilities Commission Rule and Regulation 14E, which outlines the company's responsibility to furnish electric service to our customers. You may also wish to place your carrier on notice of this loss, as you may have coverage available. Should you have any questions, please feel free to contact me at(510) 674-6525,. Sincerely. Michael J. Taylor Claims Investigator MJT:nag enclosures WOOD& UR PARK 2ND '^HIDDEN ST 17' ,; LES Z; BUCIANAN i Hidden, —aj CT es CT 4b i —D-LAKES OPEN SPACE cl, --i-1 1 3RO t; SNADO—OD PK FIELD GOLF COURSE DR. H Oo IR— OLE �5 MOHAR, ,gI eD o` m O Sy OW Jo i / �. X02 T/ f(0 lost N TNGO CIKE 6 5TH AV, BRIAR DR, ',,—LN- Ro 1.WREST-E K C LOACK 1,LLAKE CIR�EBT,CT. Got, /'IRON 0 D 1.LA�l I OSHAD' UN IN GREYHO SAVER MAR DR. YVEWCER11 DO B.SHAD C cl—SIDE C of CH— COSTA nip C,H8 JA CONTRA' C, "WAY 0 'TL COUNTRY; C, C. kv us COLLEGE WY. PAS. DIABLO 7 --- VALLEY _ . ) ell IPA OPEN SPACE COLLEGE OF, fASCI, BENHAMNIR in NODAL HCl ENC Ey4VN V\Y'\ Lm AUDI �l 2 HETLAAID I';, 10, PLEASANT &NFA. • YM,c.A P DR. Art, ODIN W DR. iERE BIFROST ou Cl�lcm; SALPME _01 P cQkfy clt K. "Ll EIL GEPcIE -2, "A BRIXH 2CIE LOIS HILL10. �T R.011PI� L 5 LITTLE LN.'DIZ, APPALACHIAN SE G WAVERLY 0 n r �111 F 'Z BEY A CT. DUIETC, DEVONWILLIAM HENRY PARK a WINSLOW CT RECEA;. n DORAY MINE DR ADIM E�TOKAY ,U L 6 D A -SLATER is KATHRYN R. P�fiEaE° < DR. cl CT DR. cKWOOD LN, GLAW DR --b 'NORT" op BSN x% MARYAL z wEWro OG 'm EL A �' O CG,\ F' o'k'r F 9 !5(. ?0� NANCY LN. DR. )AKMONTNA BETTY LN. MOM'CIR. MEMORIAL GVALLEY VIEW RD BUD _8 I... GREGORY PK F.T. PARK CEDARoORIET GRAYS N�g k UPSON wY 1. 6 RIl* JULIAN �_y RO. DEL CEMETERY tsi, g AGSL Y CT112 TIRE 10 AM. `E Cp�b 0' iE 6R. M. 'ALLEN WY 'VOIECO CT. I -1 CONTSEN RAM � /I , . C w4v- . I I IUMEN I USA LIN. C�A.— ERRY T DR T A, R. 01,N- SA 4NZ 'C' D BERGUM (/STARLYN OR RAN - T �HN N 11.4 l0UlAY i�TERE,TREATxg KINNEY Io _`!WiRF C BRISTOL DUDAr ' CT y SUNSET DR. M.K CT KATIE Z. AE 'NOF -E MC GRATH OAKV LOMAS VERDES —yeituOTT BABEaE -L"' 9-i�. —BRUCE o PL. CHARLTOr"" EA C! CT BEATRICE G(Qq/A ir RD. 0 D:K�MJDA�,2 OAXVUE HAR- EFTA L PPP_u FiVMD L L, 'DGE RD_ ORNE ROUE UAl wARxE0.EK. SHAW WW16A Dfl. OAK CAL F.ET� nE I.ER DR dIEABANT TONO LN U C%IR GL?, COATS N LL% C MAYHEW WY. TY;;FOR IN, ti Tn'N!IAL i. le"107RD. CENTER .1 �A -_�-;�l�; t' LE J&,,. XIG LE WY L�Lu Z�g _ONGHLIfXRDKR. —WHIT �Kj' . I y aIMROICrO Ci I ,_Sl_ RO �-5 OAK 55 VO-C,\ ElU��A ANA Cf P JE, bHADOwi, )GE�S --Coo, qcl HUDSON Fj LN. 44 VIA DEL VALLEY VICKI LAIN.. 11.1'tt'44 ED N JUKTJ HOOVER z SUNNI AV ZELM -E AlL MONEY iRUL -siP .z' AV. �Lu EA BEL BABE A CARRIE wo LN �2; GEA t Asr R HARMONY Rli JONES LI CAR C CARLOS I FIRST d Is LN. nAVEk-UV. Rul— 3 COT( LII. )k DR. CT llGAl A, 81tj t-2 1! FRICS HR STINA ZNTI. Alt a-M CHEF CT A t CIL. ORO'aOAK CT t ES L GMLT. I t _j LOMMEL 6 E, 5 mmwo I MAIN CT HUB aG 3WALDENSEVEN \ -1� ,. � ROBI v .0 TC A ACALANES iY5 OR w, A BE JU.. — BABETTE ACRES UNIT NO. I Me 51 – 1 TAX CODE AREA POR. RANCHO LAS JUNTAS 12 _EAVELAND ��•es __ ROAD 77 7.4 --�9 40 Be ro Go--,,y re+io-57 106 7 ' o 7 B� r, '• � 32 � 9B.6? A .43Ac I m o so•IS! 77 O h A 5C 93"E //5 Bc ec ' Q 11"457 1., z1 /0 O -.5/.w (; p Am in wt I r //5 a O U ✓oa,�s'w /G0 UJ 3.71 s/^w V O h a9 /03.79 . DB 6 0 ° n /40 A I C23 ?B0 49 Ac G[ O z. .vn•rsw / c sots✓ .*, w h V NC'�Sw /GC ° 735.03 62 4S /elo.OZ .✓a V4.Q 7h' W 0 C/ 3 0 14 Qcr- w m ASSES; BOOK AA\V-WA • 0%0%e•-9 Pacific Gas and Electric Company 62-0918(Rev.9i94) Maim Form Claims Department t 1030 Detroit Avenue Concord,CA 94518 ` 510/674-6525 PLEASE PRIM Q Name: Mr./Mrs./M . Spouse's Name Home Telephone Work Telephone jo\ ,_ r, �qx-�o- Ce Ci t SL-e QLV4 (S70 )GEo-057 1 (51o ) 57y-32-31 Mailing Address Street Apt No. City ,rr State Zip Code C'f Piro Q 9; C /�Y Date of Incident Time Location ai N0Ue4.%-j— 3 (QQ c{ / —2 a.m. /SA v- l Cpu�- 1 c 0 Description of Incident n n _ Po evt%e- 41A. 1 r7't—� r CL p by X U�S . A c,..t✓ C a V.. _ /7 a r CC. 0,. a m ' ok -w� wWA- w C: 0 `` U v cJrre�— C CA-A� ti 4 C !C, C.•- O Other Information a� a� C: 0 O —+ "- DESCRIPTION OF DAMAGED PROPERTY:(PLEASE ATTACH REPAIR ESTIMATES,INVOICES,.PROOF OF PURCHASE,OR SUPPORTING DOCUMENTS). m Z Items ModeVSerial No. Age Repair Cost Original Cost Amount Claimed z CL tv.orl.�ac sLU A-1 le—rc S uv..eyac,.. �� �• rr rr rr �/c0 O l Other Losses P e L P ^ d l— l ',X (, / cam{ C U O NOTE TWO REPAIR ESTIMATES ARE NEEDED IF VEHICLE WAS INVOLVED. c AN ITEMIZED LIST IS NEEDED FOR FOOD SPOILAGE.USE ADDITIONAL PAPER IF NECESSARY. Witnesses: (Name,Address,and Telephone) ❑ PG&E Employee .1�3 Other �s/�5 !g o Cfe-jel� /2�,( /, /�. �/•' // Z5 —/397 a) Agent Telephone Have you contacted your insurance carrier? ❑ Yes ❑ NoCo +1 1 ( ► C y I certify that the forgoing is true and correc /�/J CL Prepared By Date /,r �!j 30, !9 qJ a) L I— PLEASE FOLD,SEAL AND MAIL L i / ,, . iu* ' PACKING LABEL AUDIOACCE�S/FOSGATE/CrTATION 2�O46 EDEN LANDINB ROAD TE 5 HAYWARD CA 94545 PH�NE NO: ' DEALER NO: 8O0-787-67' 66 ------------________________________________________________________________ �ILL TD: SHIP TO: �ohn Paxton John Paxton 15 April Ct. Pleasent HilI , CA 94523 CREDIT �T�TUS: ATTN; RE: R-0382 _________________________________________________________________-___ ______ RA HOLD: N, N SHIP VIA: SELF DILlVERY BILLlNG INSTRUCTI�NS: NO CHARGE WARRANTY RA ITEM ENCU]SED: CC2 COMMENTS� 3 of the four were ` 72 was damaged by (---jectrical surge bey nd re pair. Unit was eva} u un repairable. c- * **�***� eMiS31 1Na31 SNOB I — inohiv.� u / 69� a0aS8 • aNt� I�11119H1ft1/�t1 —tiH a=_v��r„ice 6ib'Jd J1.133(8f1S # a3aa0 A80M�� Q ��lvo �. 65 L lP8 �0�8) X 3NON t'J t, 43NI1034 SI 1VWIlS3 03SIA3y OILti6 d3 1313�a38 V dl HO AHiHOM-81Vd98 lON a3sonr sl 11 Al O 'oNnod do ' AVM NUSllb L08 u W3190ad ON dl N3A3 3OIAa3S JO 31VG 1N3Wd1n03 d0 3O31d H�V3 NO 3CJ111M 3a3H1 CZ �'�d�' a � aVHO WnWIN 9 c9 C3iVdI011Nt/ S3IHOSS300V HlVd3H 3ONV1SIS3a d0/.1H3dOHd 3Hl 3W0039 ' �+ 00 ON ❑ S3A [:] 111M 301AH3S d0 31VG 3Hl ONOA39 Sl.VO 09 1431 1N3Wd1n03 Ci 1 LlOtflNlSnl :ONV1Sa30NnI T I GNO S1HVd 3JIAH3S 1N3N&nP3 43SIA3H O3NHMSH SW311; - - S1Hdd 30 3S. - - V U U r� D �. T V N fn C0CL LLJ 11 r J T ” � ¢ w O o a U a ti o Q (n U_ d r O r O G Q a- Q > w W O a -� ? 0 0 3 W 3 ❑ L ❑ U Q ~ W T _ w W Lo CJ I- O T J Q X X L Or x � f, }' 4 Z't tmn w W J � LU Z �. Y z0 w > �. . W ~ w ED —C7 z LL� ,W 0 U '}> a Luz zzW OZ CWI =oQO�S Q ;. W W < i CL W a W W z �� '� j UOQ O� rb ,.� cr t- ¢ > v O WCl) SW r ' 1 �� 3 �` CD 0 �'W Q Q Q cr U) LLJ N W r ` Y <T Q F- I � rs J � p Z: Zfa: �° 000 CCn JE cr r 1 d W_spa Q C4 W W v f w Z. P Cl W t Z H } � Cr IWi O W O 0 H O. ; Q C O � C3n- W 0 W Q :J U t� W Cn O I I w t— L Q= O W L Z ' O W,�W �� `' W p W \ r,.. . QW' PCZ .� I� —� Cl.wv �� w J t� v � WWW UQcr Q i Q 1 '� W J � G `Z W `i ,�' mJ �] Qp < D Q �/ r W �T 2;� ( ` �'� r WQW � w (90 Q� Z W } z ¢ Q U O i5ccw ¢ � o vo W ❑ C ' [� ❑ Wow ►_- °L AMEI`TDED CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA JANUARY 23;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: $2,000,000 Section 913 and 915.4. PleaseTtt�e�a1Q= ">;ta�. U � s CLAIMANT: JESSICA 0. ABURIME "4 A' Q 1 1996 ATTORNEY: LOUIS E. KAHN COUNTY COUNSEL 3100 OAK ROAD, SUITE 230 Date received MARTINEZ CALIF. ADDRESS: PO BOX 5331 BY DELIVERY TO CLERK ON JANUARY 5, 1996 WALNUT CREEK CA 94596 BY MAIL POSTMARKED: JANUARY 4, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: JANUARY 5 1996 QHIL BgATCHELOR, Clerk 811: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Vf 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: 0,� c Deputy County Counse 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. BOARDD 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: /-P3 -/9 9& PHIL BATCHELOR, Clerk, By OA, POADeputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that 1 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: l-a - /9 9 & BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator RECEIVED LAW OFFICES OF JAN - 5 1996 )OHN F MARTIN A PROFESSIONAL CORPORATION CLERK BOARD OF SUPERVISORS STATION PLAZA I CONTRA COSTA CO. 3100 OAK ROAD, SUITE 230 POST OFFICE BOX 5331 TELEPHONE: (510) 937-5433 WALNUT CREEK, CALIFORNIA 94596 TELECOPIER: (510) 938-5567 January 4, 1996 Ms. Shirley Casillas The Contra Costa County Supervisor's Clerk's Office 651 Pine Street, Room 106 Martinez, CA 94553 . RE: Jessica O. Aburime's Administrative Claim Dear Ms. Casillas: Pursuant to our telephone conversation on December 20, 1995, I am submitting the following information as, an amendment to Ms. Aburime's claim filed on December 5, 1995. The amount of damages being claimed by my client was entered incorrectly as $100,000. The correct sum that my client is claiming against the County of Contra Costa is $2,000,000. Additionally, in response to question no. 9 regarding expenditures my client has made on account of the injury, please note the following changes. I would place a note after the listing for the catholic charity psychotherapy sessions stating that my client continues to receive psychotherapy from the catholic charities at a cost of$10.00 per session, the duration of this therapy is unknown at this time. Additionally, I would note that my client has been required to make co-payments on all of the therapy and treatment she received from Kaiser Hospitals. The amount of co-payment required from her is not known at this time. Please include this letter along with the claim when it is presented to the Board of Supervisors. Very truly yours, LAW OFFICES OF JOHN F. MARTIN A Professional Corporation BY: G! �. OUIS E. KAHN LEK:nc/sc 1227.1tr z w 4 -1 p 8 0 n 0 N y = m o � > zf TI 0 r y r m ° ro nm *+ p m 0 y to X N o m > 0 —Nio w ro a Z OLn z 4 n .. f.A c sr o � G vt D LN � � N s♦sr�sw�����• DEC 2. 2 1995 APPLICATION TO FILE LATE CLAIM �v coUNr-J-ANiJARY 23, 1996 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALL& CALIF. BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to the Board of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4• Please note the "WARNING" below. Claimant: Rhonda Rabago Attorney: Clyde I. Butts, Esq. Address: 1225 Alpine Rd. ,'"Ste. 204 Walnut Creek, CA 94596 Amount: $10,000.00 + By delivery to Clerk on December 20, 199 Date Received: December 20, 1995 By mail, postmarked on - D o mber 19. 199 I. FROM: Clerk of the Board of Supervisors 70: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: December 22, 1995 PHIL BATCHELOR, Clerk, By ,� Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) The Board should grant this Application to File Late Claim Section 911.6). (1� The Board should deny this Application to File Late C1 (Section 11.6). DATED: Zz i9�5 VICTOR WFSTMAN, County Counsel, By Deputy II. BOARD ORDER By unanimous vote of Supervisors seht (Check one only) ( ) This Application is granted (Section 91.1.6). (✓) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATE:1- - 9 PHIL BATCHELOR, Clerk, By ago Deputy WARNING (Gov. Code 5911.8) If you wish to file a court action on this matter, you must first petition the appropriate oourt for an order relieving you from the provisions of government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such petition must be filed with the oourt within six (6) months from the date your applioation for leave to present a late claim was denied. You may seek the advise of any attorney of your choice in oornection with this matter. If you want to consult an attorneX, you should do so immediately. V. FROM: Clerk of the Boar TO: i County Counsel 2County Administrator Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: PHIL BATCHELOR, Clerk, By YJAX11 0,.A Deputy Y. FROM; 1 County Counsel (2) County Administrator TO: Clerk of the Board Of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM 1 Clyde I. Butts, Esq. State Bar No. 88020 2 LAW OFFICES OF CLYDE 1. BUTTS 1225 Alpine Road, Suite 204 RECEIVED 3 Walnut Creek, California 94596 Telephone: (510) 943-1850 DEC 2 O 1995 I 4 Facsimile: (510) 943-7994 ' a 5 Attorneys for Claimant 1CLERK-B-04 ®F SUPEP,-i QRS RHONDA RABAGO CON RA COSTA Co. 6 7 8 In the Matter of the Claim of: ) APPLICA.TION FOR LEAVE TO PRESENT LATE CLAIM 9 RHONDA RABAGO, ) (Government code Section 911.4) 10 against ) 11 COUNTY OF CONTRA COSTA ) 12 13 TO THE COUNTY OF CONTRA COSTA: @ 14 I. �U ® y 15 :Application is.hereby made for leave to present a late claim under Section 911.4 of the 16 Government Code. The claim is founded on a cause of action for personal injury which accrued on U •� 17 January 9, 1995,for which a claim was not presented. For additional circumstances relating to the cause 18 of action reference is made to the proposed claim attached hereto as Exhibit 1 and made a part hereof. 19 II. 20 The reason for the delay in presenting this claim is the mistake and/or inadvertence and/or 21 surprise and/or excusable neglect of the claimant and her attorney, Gregory D. Rueb, Esq., as is more 22 particularly shown in the declaration of Gregory D. Rueb, Esq., attached hereto as Exhibit 2. The 23 County of Contra Costa was not prejudiced in the defense of the claim by the failure to file the claim 24 in a timely manner, as shown by the declaration of Gregory D. Rueb, Esq., attached hereto as Exhibit 25 2, and made a part hereof. 26 III. 27 This Application is being presented within a reasonable time after the accrual of this 28 cause of action, as shown by the declaration of Gregory D. Rueb,Esq., attached hereto as Exhibit 2,and -1- I made a part hereof 2 WHEREFORE,it is respectfully requested that this Application be granted and that the 3 attached claim be received and acted on in accordance with Sections 912.4-912.8 of the Government 4 Code. 5 Dated: December 19, 1995. LAW OFFICES OF CLYDE 1. BUTTS 6 7 By YDE I. BUTTS 8 Attorney for Claimant 9 10 11 12 V) 13 14 o U U ® y � 15 ro aU 16 U '-� 17 18 19 20 21 22 23 24 25 26 27 28 -2- I Gregory D. Rueb, Esq. State Bar No. 154589 2 GORDON, DeFRAGA, WATROUS & PEZZAGLIA 611 Las Juntas Street 3 P. O. Box 630 Martinez, CA 94553 4 Telephone: (510) 228-1400 Facsimile: (510) 228-3644 5 6 7 8 In the Matter of the Claim of: ) DECLARATION OF GREGORY D. RUEB IN SUPPORT OF APPLICATION FOR 9 RHONDA RABAGO, ) LEAVE TO PRESENT CLAIM BY RHONDA RABAGO, CLAIMANT 10 against ) 11 COUNTY OF CONTRA COSTA ) 12 13 1, GREGORY D. RUEB, declare: 14 1. I am an attorney at law, duly licensed to practice before all of the courts of the 15 State of California, and am an associate in the law firm of GORDON, DeFRAGA, WATROUS & 16 PEZZAGLIA, and as such, was one of the attorneys of record for Claimant, Rhonda Rabago, in the 17 above-captioned action. 18 2. On January 9, 1995,at approximately 8:00 p.m.,claimant Rhonda Rabago,while 19 on Magnolia Apartments'property, fell, causing serious injury to herself. The accident occurred at the 20 Magnolia Apartments, in a drainage ditch, which was maintained and controlled by the Magnolia 21 Apartments,and which is more particularly described in the Attachment to Claim,which is incorporated 22 herein by reference. The drainage ditch was backed up with debris and was not functional. On the 23 above-mentioned date, during a rainstorm, Ms. Rabago was walking towards the cinder block wall, 24 which separates the Magnolia Apartment property from the 76 Unocal Gas Station property. As she 25 approached the wall, she unknowingly stepped into the drainage ditch, which she later determined was 26 flooded and covered with debris. Ms. Rabago fell to the ground, seriously fracturing her left wrist. 27 3. On February 13, 1995, 1 met with Rhonda Rabago at the Magnolia Apartment 28 complex regarding her accident. During this meeting, I was shown the location on the Magnolia 4- I Apartments property where the injury occurred. The drain was completely backed up with debris and 2 was not functional. At the time of the inspection, the weather was clear yet the drain was still backed 3 up with water. Also during the inspection, I was shown several photographs taken by Ms. Rabago 4 shortly after the incident, which also showed debris and backed up water. It was my opinion that the 5 sole cause of Ms.Rabago's injuries was the negligent maintenance of the drain by Magnolia Apartments. 6 1 was not informed, nor did I consider, that the flooding of the County of Contra Costa Flood Control 7 District Canal, which is near Fitzuren Road, may have contributed to the drainage ditch backing up, 8 flooding and becoming filled with debris. 9 4. Following numerous attempts to ascertain Magnolia Apartments' insurance 10 information, on June 20, 1995, I was finally contacted by Heather Wallach, a claims adjuster for the 11 insurance company. 12 5. Over the next three (3) months, I monitored Ms. Rabago's injury status. On 13 September 20, 1995, 1 telephoned Ms. Wallach to provide an update on Ms. Rabago's injury status. 14 During this conversation,Ms. Wallach indicated that, following a site inspection, Magnolia Apartments 15 appeared to be liable for Ms. Rabago's damages. 16 6. I continued to monitor Ms. Rabago's injury status. On December 7, 1995, 1 17 telephoned Ms. Wallach to provide an additional update on Ms. Rabago's treatment status. During this 18 phone conversation, Ms. Wallach revealed that Magnolia Apartments was now contending that the City 19 of Antioch was, at least partially, responsible for Ms. Rabago's injury. Specifically, Ms. Wallach 20 indicated that the City of Antioch's lack of maintenance, and/or design of the adjacent public roadway 21 may have caused the flooding. 22 7. After I spoke with Ms. Wallach I realized that the County of Contra Costa may 23 also be liable for Ms. Rabago's injury, due to its lack of maintenance,and/or design of the district canal, 24 which traverses underneath and/or near Fitzuren Road, near Holly Court, and which may have 25 contributed to the flooding of Fitzuren Road. 26 8. Until I spoke with Ms. Wallach on December 7, 1995, I did not consider the 27 County of Contra Costa to be responsible for Ms. Rabago's injury, which was due to my mistake, 28 excusable neglect, surprise and/or inadvertence. -2- 1 9. The County of Contra Costa has not been and/or will not be prejudiced in the 2 defense of this claim. I am informed and believe that the condition of the district canal has not been 3 changed in any way since Ms. Rabago's accident and remains the same to this day. 4 I declare under penalty of perjury under the laws of the State of California that the 5 foregoing is true and correct and if called as a witness,I could competently testify to the same, and that 6 this declaration was executed on December 19, 1995,at Walnut Creek,Contra Costa County, California. 7 8 GREGORY D. RT-FEB 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -3- I PROOF OF SERVICE BY MAIL (C.C.P. §§ 1013(a), 2015.5) 2 I am employed in the City of Walnut Creek, County of Contra Costa, State of California. 3 I am over the age of eighteen years and am not a parry to the within-entitled action; my business address 4 is: 1225 Alpine Road, Suite 204, Walnut Creek, California 94596. 5 I am readily familiar with the business' practice for collection and processing of 6 correspondence for mailing with the United States Postal Service. On December 19, 1995, at the above 7 referenced location, I sealed an envelope(s) enclosing: 8 DOCUMENT(S) MAILED: 9 APPLICATION FOR LEAVE TO PRESENT LATE CLAIM; EXHIBIT 1 - CLAIM AGAINST 10 COUNTY OF CONTRA COSTA and COUNTY OF CONTRA COSTA FLOOD CONTROL 11 DISTRICT; EXHIBIT 2 - DECLARATION OF GREGORY D. RUEB 12 MAILED TO: 13 Clerk of the Board of Supervisors County Administration Building 14 651 Pine St., Room 106 Martinez, CA 94553 15 16 and placed.them for collection and mailing following ordinary business practices to be deposited with 17 the United States Postal Service on December 19, 1995. 18 I declare, under penalty of perjury under the laws of the State of California that the 19 foregoing is true and correct. 20 Executed at Walnut Creek, California, on December 19, 1995. 21 22 23 24 25 26 27 28 LAw OFFICES OF CLYDE 1. BUTTS 1225 Alpine R..d 0 .Suite 204 0 Walnut Creek, CA 94596 _ Telephone: (5110) 943-18500 Fax: (510) 943-7994 RECEIVE® j December 19, 1995 DEC 2 01996 CLERK BOARD OF SUPERVISORS Clerk of the Board of Supervisors CONTRA COSTA CO. County Administration Building 651 Pine St., Room 106 Martinez, CA 94553 Re: In the Matter of the Cb...—mof: Rhonda Rabago REQUESTED ACTION: X Please file original(s), and return endorsed-filed copies. Please present to the Judge for signature,file original(s), and return endorsed-filed copies. Please issue original summons and return. Please certify copy(ies) and return. Other: ENCLOSURE(S): Check in the amount of$ X Self-addressed, stamped envelope. X DOCUMENTS: APPLICATION FOR LEAVE TO PRESENT LATE CLAIM; EXHIBIT 1 - CLAIM AGAINST COUNTY OF CONTRA COSTA and COUNTY OF CONTRA COSTA FLOOD CONTROL DIST.; EXHIBIT 2 - DECLARATION OF GREGORY D. RUEB Sincerely, L/OFFES OF CLYDE I. BUTTS Kaffin, Legal Assistant to CLYDE I. BUTTS Enclosure(s) - : i 1 r �t as to °o ct cy P►. `t Gas JQ k I'IHT-11z-177� 14•4a 1-NUM U-1- MI1OK 1"IHYHUtI'ItNI IU (7V'+ r.UlrJl B4hP.D . �, SJPERVISIORS OF (MNT'RA COSTA INSTRUCTIONS M CLAIKAn A. Clai:.s 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 rich 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. Cade §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 146, 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 r.-me of the District should be filled in. D. If the claim is against more than one public entity, separate alaims must be filed against each public entity. E. Fraud. See penalty for fraudulent claizz, Penal. Code Sec. 72 2t the end of this fog ee � * . � * � � � � � � � � * � * � e � � * � e � �t * * � * � e * � � � � * ee � � RE; Claim By ) Reserved for Clerk's filing stamp RHONDA L. RABAGO } Against the County of Contra Costa } or ) COUNTY OF CONTRA COSTA and COUNTY OF CONTRA COSTA District) Fill in nme FLOOD CONTROL DISTRICT The undersigned claimant hereby makes claim against the County of Contra Costa or the above-reamed District in the sum of $ IN EXCESS OF and in support of this claim represents as follcws: I. When did the damage.or injury occur? *Wive exact date and hour) 1-9-95 at approximately 8 :00 p.m. 2. Where did the damage or injury occur? (include city and county) 1015 Fitzuren Road, Antioch, CA 3• How did the damage or injury occur? (Give full details; use extra paper if required) • See Attached 4. What particular act or omission on the part of county or district officers, se--vants or employees caused the injury or damage? See Attached TOTAL P.01 NRY-13-1995 1425 FROM CCC RISK MRNRUEMENT TU is rr+r4 h'.Uli�Jl 5. wnat are the names of county or district officers, servants or exployees causing the da.-age or in jt2- ,? Unknown 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto dammge. Fracture of left wrist, requiring immobilization and ultimate surgery, with permanent residual weakness, and loss of range of motion. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) The amount claimed is an estimate based upon the nature and extent of claimant' s injuries . Claimant' s medical bills have not yet been ascertained. S. ?vanes and addresses of witnesses, doctors and hospitals. Delta Memorial Hospital -3901 Lone Tree Way, Antioch, CA 94509 Clark E. Williams, M.D. - 3741 Sunset' Lane, Antioch, CA 94509 John Merson, M.D. - 1479 Yqnacio Valley Rd. , #207, Walnut Creek, CA 94598 Michael A. Oberlander, M.D. - 2485 High School Ave. , #208, Concord, CA ti 9. List the men itures you made on account of this acaideni or injuryi DATE ITE? MNT Unknown at -this time e e e e +� � � � � .� � * � � � � � e •� e.e !� i► a #t e e e � � � * e e e � e � e e e e Gov. Code Sec. 91042 provides: "The claim must be signed by the claimant SE'N'D NOTICES TO: (Atto_*rne ) or by some 2ersor. an his behalf." Name and Address of Attorney Clyde I . Butts, Esq. LAW OFFICES OF CLYDE I . BUTTS Claimant's Signature Attorney 1225 Alpine Road, Ste. 204 for Claimant Walnut Creek, CA 94596 1225 Alpine Road, Ste. 204 Address, Walnut Creek, CA 94596 Telephone No. (510) 943-1850 Telephone No. (510) 943-1850 eeee +ree 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 eouaty, 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 jai 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,tl00, or by both s�c'1 L,risozr,ent and fine_ TOTAL P.©1 r • Attachment to Claim Presented to the County of Contra Costa 3 and 4. At or about 8:00 p.m.on January 9, 1995, claimant stepped into a concrete drainage ditch, which is located near the southwest corner of the property line of the Magnolia Apartments - 1015 Fitzuren Road, in Antioch, where claimant resides. The drainage ditch runs parallel to the property line which separates the Magnolia Apartment property from the adjoining 76 Unocal Gas Station. Because of flooding on Fitzuren Road, claimant was forced to cross the front lawn of the apartment complex, which was not flooded, to avoid walking in standing water that had risen up over the curb and onto the sidewalk. When claimant walked to the edge of the property line, she intended to stand next to a cinder block wall which separates the respective property lines of the Magnolia Apartments and the 76 Unocal Gas Station. However when claimant walked into this area, she unknowingly stepped into the drainage ditch,which she was not aware of,nor did she observe,and which was later discovered to be flooded and covered with debris. When claimant stepped into the drainage ditch, she lost her balance and fell to the ground, severely fracturing her left wrist. Claimant is informed and believes that the County of Contra Costa is liable for her injuries because the County of Contra Costa Flood Control District Canal, which traverses underneath and/or near Fitzuren Road,was allowed to flood due to inadequate maintenance and/or the design of the district canal. Had the County of Contra Costa properly maintained the district canal in said area, the street and sidewalks on Fitzuren Road would not have.flooded thereby causing claimant to take a route which placed her in immediate danger and.peril. Further, as a result of flooding in the street,the drainage ditch which claimant stepped into had backed up and became flooded and filled with debris. The County of Contra Costa's negligent maintenance, design and/or construction of the district canal was a concurrent cause of the flooding of the drainage ditch where claimant was injured. In addition, claimant is informed and believes that the district canal was negligently designed, constructed, maintained, and/or cared for by the County of Contra Costa, which allowed the roadway and adjoining areas of Fitzuren Road to become flooded thereby constituting a dangerous condition of public property. Claimant is further informed and believes that the County of Contra Costa has had numerous complaints in the past pertaining to flooding on Fitzuren Road but has not taken appropriate or adequate remedial measures to correct said dangerous and/or defective condition of public property. Claimant is further informed and believes that the County of Contra Costa is liable for her injuries because of its negligent design, construction and/or maintenance of the district canal, which traverses underneath and/or in close proximity to Fitzuren Road. As a proximate result of said negligence, Fitzuren Road floods, which constitutes a dangerous condition of public property.