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Home My WebLink AboutMINUTES - 01141997 - C19 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 14, 1997 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 mailet 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 not 40a:119 CLAIMANT: Donna E. Chaddock DEC 1 7 :. ATTORNEY: COUNTY COUNSEL Date received MARTINEZ CALIF. ADDRESS: 450 Woodmont Place BY DELIVERY TO CLERK ON December 17, 1996 Oakley, CA 94561 BY MAIL POSTMARKED: hand delivered; via Risk Mgmt. I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 17, 1996 IVIL Depu tyl�t, Clerk', �� 1I. 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). 1" Other: AIL /�rf6 Q Dated: �° Zg/7 4� BY: Deputy County Counsel --r 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 (X) 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 fors, this date. Dated: //��9� PHIL BATCHELOR, Clerk, �j�-�/�-e �jt-d` — , 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. Dated: 7 BY: PHIL BATCHELOR by�/L'�'^�� --ev-—Deputy Clerk CC: County Counsel County Administrator RECEIVED mpm 17 10 450 Woodmont Place CLERK BOARD OF SUPEKVISORS Oakley, Ca. 94561 CONTRA COSTA CO. (510) 625=7828 Risk Management December 12,1996 Julie. Aumock 651 Pine Street Martinez, Ca. 94553 To: Julie Aumock From: Donna E. Chaddock I am the property owner of the address listed above and my backyard fence faces Laurel Avenue. Three years ago my husband was in our backyard and small melons were being thrown over the fence onto our property. My husband was obviously concerned not only for his own safety, but he was also thinking about the two small children who live next door who could be seriouslyinjured should one of these flying melons strike them. He promptly went around to the public street behind our property. Another neighbor, George Ginelo accompanied him up to Laurel Street where he had a discussion with the adult in charge of supervising the juvenile probation work crew. A complaint was made to the adult supervisor and the melon throwing stopped. In November 1995, another juvenileprobation work crew was working on Laurel Avenue. Another neighbor, Pat Kunich was at home_on this afternoon and. observed several young men actually walking on the upper level of her backyard terrace. Her property also backs up to Laurel Avenue. It isnot unreasonable to-assume that they damaged the fence in order to obtain access to her property. In addition, the fence separating my property from Laurel Avenue.was in excellent condition.on the Saturday morning my husband left for work. Four or five flours later when he arrived home for lunch.he'discovered the fence had been damaged. Sand had been placed in a pile against the entire stretch of wooden fence.Numerous boards were either torn loose, hanging from a nail or broken in half.`Furthermore, one of the main fence posts had been broken which has caused my fence to weaken and lean. My fence was not the only one.damaged and if you will check your records my assertion will be confirmed. A complaint was made to a representative in Risk Management . At this time my only request was to stop this work from occurring in the future in order to prevent any further damage to my fence. I specifically requested that these juvenile work crews stay away from my property. An official in Risk Management told me this was absolutely not possible. On Saturday December 7, 1996 1 returned home to find another juvenile work crew on Laurel Avenue behind my property:Supervisor Harold (last name unknown) was on duty. This work crew had taken the sand clustered on the sidewalk and had shoveled it nearly two feet high onto my fence. This sand blows onto the public sidewalk from the open fields across the street. This sand is extremely heavy when wet and piled into a heap against the fence. It should be removed from the sidewalk and relocated. It should not be relocated against my fence. Several boards were again knocked loose and hanging from the top nails. In addition, as.you can see from the photos , my fence is sagging and bending from the pressure of the heaped-up sand. If you look closely you can see the sand pushing from underneath the fence,and the sand leakage from between the slats of the individual boards. I have done everything in my own power to preserve the lifetime of this 9 year oId fence. It defies logic to pile up sand against a weathered fence which runs for over one hundred feet. I spoke to Mr. Wolfes on 12/6/96, regarding this incident and he was most sympathetic.' He asked "What can 1 do to satisfy you?" He offered to remove Laurel Avenue from the list of.county streets serviced by these crews. Although his offer is completely ironic, I would like to see this happen. It is obvious that these work crews are at the least, negligent in carrying out their duties , and at the most they are destructive. I am requesting they stay away from my property altogether. I-am also requesting that the county hire a contractor to replace the original fence post that was broken in November.1995. At this time the contractor should be able to ascertain whether or not the surrounding posts have been weakened by the original break. If this professional maintains that the broken post has caused damaged to the adjacent posts and/or any other parts of the fence, then 1 would request that be replaced as well. As a property owner in Contra Costa County I pay taxes to support landscaping. I would like to know where this money is spent. It appears to me that my property is being destroyed because of the incompetence of a supervisor that instructs his juvenile work crew to carry out work which defies common sense, and then denies that any damage was done. l admit my wooden fence is weathered but it should remain standing for some.years to come if it were not subjected to the harsh, .destructive, continually abusive treatment rendered by the members of the juvenile work crew. I am furious with the manner in which the county is approaching this ;problem. For three years in a row I have attempted to.solve this situation and it is quite obvious that the county resists taking responsibility for this dilemma. I have never asked for work to.be done on Laurel Avenue and I would think that the individuals in charge of this program would take responsibility for what has transpired. These crews are dangerous, destructive and not intelligently supervised . If the county denies responsibility then tell me who is in charge here? Sincerely, `C Donna E. Chaddock cc: Kent Wolfes CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA . January 14,".1997 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 pis your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given Code Amount: $10,000.00 Section 913 and 9I5.4. Ple note all "Warm . CLAIMANT: Rose Mary Nunn DECO 3 '996 ATTORNEY: , COUNTY.;000NSEL MARTINEZ CALIF. Date received ADDRESS: 4180 Berk Ave. BY DELIVERY TO CLERK ON December 2. 1996 Richmond, CA 94608 BY MAIL POSTMARKED: November 30, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. December 3 BgHH , GATED: , 1996 � ILATCELORC1er : Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors' (l�) 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 isnot 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: ' ZI 3 �ylp 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 (x) 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. r1 Dated: /�`�Ig / PHIL BATCHELOR, Clerk, By Deputy 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: /�/Lvl q 7 BY: PHIL BATCHELOR bL-� CJ`J 'Deputy Clerk CC: County Counsel County Administrator Claims to: BOAPM OF SJPERVISORS OF CONTRA COSTA COUNTY • INS RUCTIONS TO Ci.AD4ANT ,- ,: Cl2i=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, 1 41 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 %hich 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.) 84 Claim must be filed with the C eAc 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, thelname 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 44a ra Ali, 3 RECEIVED Against the County of Contra Costa ) 2 or DEC District) CLERK BOARD OF SUPERVISORS Fill in nj- ) CONTRA COSTA CO. M2e undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ { , 660 and in support of this claim represents as follows 1. When did the damage or "injury occur? "(Give exact date and hour) A-AA Where did the damage or injury occur? (Include city and county) e-7"r Ir4 t� 3. How did the damage or injury occur? (Give full details; use extra paper if reouired) What particular act or omission on the part of county or district officers, _ serivvj{ants or employees ca ed the injury or damage? j. wnat are me nares of county or district officers, servants or employees causing the dar .:'..pt`' Or Injury? 5. 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 abovh computed? (Include the estimated amount of any prospective injury or damage.) "eA t GC, 1 `-—+-,e C_(7K/1 I8. iv�ames and,addresses. of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMXW Gov. Code Sec. 910.2 provides: ttT e claim must be signed by the claimant SEND NOTICES TO: (Atto* ie '); ,`�r� `� 'b " some son on his behalf." Name and Address of Attorney _.,;...._..- Claimant Is,Signature),, I -CV VE Address. ' Telephone No. Telephone No. GC a 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 s� ?�� i�r� r?e sa� ^„ and fine. , .dr ACCIDENT & INJURY CLINIC 2315 Cutting Blvd. Suite C, Richmond, CA 94804 (510) 970-800 Dr. Michel Tetrault Chiropractic Orthopedist RECEIVED 11-21-96 DEC -2 Lq% Clerk of the Board of Supervisors CLERK BOARD OF SUPERVISORS 651 Pine Street Room 106 CONTRA COSTA CO. Martinez, CA 94553 RE: Rose Nunn Dear Clerk, Mrs. Rose Nunn has been under my care for injuries sustained from a slip and fall injury that occurred on 6-10-96 at the Crescent Park Children's Center. She continues to experience disabling pain. She also continues to receive treatments at this office for these injuries. If you need further information, feel free to contact me. Yours truly, Michel Y. Tetrault, D.C. Chiropractic Orthopedist +�N! �VI. t4v,''ry\>'a ` American Medical-Response P.O. Box 7423 San Francisco, CA 94120-7423R�p FMT-01 33917 6 001' 00014729: j PATIENT NAME { ROSEMARY'NUNN W.t QF S 'RitIC 06/1 0/_j,,9916- `,11..4' `; AM.0UNT � 672 X30 g 09/2011,9`. a'�. « x!_ t t'3�+f 5x -.a - �r vF '>r" r. „ ROSEMARY NUNN FMT0133917600 ..REMIT PAYMENT TO 41 $0 BERK AVE SAN PABLO, CA 94806. AMR WEST COASTAL P PO BOX 7423 F{ SAN FRANC TSCO; xCAx94120` `k t J EASE CHIT MY: ❑VISA ❑l MASTERCARD c4 COUNT `: ❑❑L_J ❑ ❑ C�sHS:aEXPIRATION GNATURE PLEASE ENTER AMOUNT PAID " PLEASE DETACH AND RETURN THIS PORTION WITH:YOUR PAYMENT }�. PATIENT NAME 3 , ` ' A+vCCJVNT N4 f tT ET _ ,,tfdlt�t� E, �ROSEMr- .'Y NUNN 000147293=0001 FMT 01339�1"l�i00' 09/20/1996 y` )ATE ° :UICE' `',` SERV �120M F�F> SFS .«..,< '06/1 0 ' 996 5050 HARTNETT AV KAISER RICHMOND~ M k' Rt 113C►<L ;,try Yz, :ssxsf �'sWK G � IMP AN f M5SAG'. If you have insurance or program coverage such a.s. Medicar4l6r r ' that •ril'_ assist in paying for the seri. ices provided, 'PtasC send us a copy of the card with the reverse side .of.'this` 'form completed. THIS BALANCE IS DUE AND PAYABLE: NOW {COpE �DE5GRIPTION' GH, O ITS&; IT s,-" T,3Tt�,CN1 faE v ,1,104 ALS BASE 1 565.; 70 » ,565 7[ ,2100 ALS MILEAGE 3 10 .91' ;3016 EKG ELECTRODES X5029 EKG MONITOR 1 : 00 `' r OC 4 ;3031 02 MASK/CANNULA 1 00 OC 50,56 INFECTION CONTROL 1 13`: 33 13 3 s - ,a R 672 . 30 T: NSF-C'RT REASON: T14 INJURY BY FALL Ces.dL I'.:';VD : 08 :52 DIAGNC IS : 9591 9597 4019 E885 ' u SEE REVERSE SIDE FOR INSURANCE INFORMATION."." 'r N� Sernj billing inquiries to: AMBULANCE BUSINESS SERVICES, P:O. 60X`7423, SAN FRANCISCO, CA 94120x7423 r.. PROVII R# ZZZ90964Z FED TAX ID11=0324.711 Phone t*. nber: 1-800-913-9106 Keep this portion for your records. Local Number 11409-238-471D Accident & .`Injury Clinic._ S.T A T E M E N T Dr. Michel' Tetrault 2533 :N ,Carson St.."Ste 2645 11-06-96 . a•�,. Carson City, NV . 89706, , it 510m-:976"79"'8, 00, BALANCE: $ 576 .0(' ACCOUNT ` - Rose N11nn r 1000=11 LAST CLAIM: 11-05-5 . -t 4180'Burk :Ave PI-F LAST PAYMENT: 10-29-9;. Richmond CA. 94$04 . LAST CHARGE: 11-06- 9, Date Description Code Charge Credit Adjust B-1 ancei t} K 103896 , ;,K *NP OV.,...Intermediate 99204 100 .00 0 .00 0 .00 ;0 . 00 :4 201896 ;, *Hgh, Volt, therapy 97118 25 .00 0 .00 0 .00 :..;75 .00, _ _` 101896 *Ultrasound Therapy, 97035�-� 25 .00 0 .00 0 .OQ :.n0 .00 `- 2Q1896 V h *Activit,ies 'Daily- :moi= 97540 51.00 0 .00 0 .00 1 .00{ ` 102296*,',-..,,,`1-i *EP OV' Brief 99211 25:.00 0 .00 0.00 6 ,00 102296 *H gh ,Volt, tYierapy, 97118 25 .QO 0 .OQ 0 .00 �.:` 1,.00 << 102296 ;; *Ultrasound Therapy 97035 25 . 00 0 .00 0 .00 6 .00 ' : 202496 >k *EP OV Brief 99211 25 . 00 0 .00 0LQ0 . 1 . 00 .> <: 202496 , *High .Volt therapy 97118• 25 .00 0 .00 0 . 00 :,6 . 00 6 102496rt *Ultrasound Therapy 97035 25 .00 0 .00 0 .00 351 .00 102596 *BR OVBrie€•. 99211 25 .00 0 .00 0 .00 ?' 6 .00 ' � _ 102596, *High Volt therapy.' 97118 25 .00 0 .00 0 .00 1 .00 2.596 t *Ultrasound: Therapy 97035 25 .00 0 .00 0 .00 a{6 .00 1_ 102996 *EP OV Brief 99211 . 25 ,00 0 .00 0 :00 t` 1.00 `x 102996 *Hgh�tVolt therapy ,. 97118 25 .00 0 .00 0 .00 = 6 ,00 3. 102996w *Ul trs`sound -Thera -9----9015 : 1:. 00 , l5f110696 EP 'OV Brief 99211 25 . 00 0 . 00 0 . 00 r 5 .00K 110696 i 'i4 High Volt therapy .' 97118 25.,00 . • 0 .00 0 . 00 E 1 . 00 110696 ,1} Ult.rasound Therapy : 97035 25 .00 0 .00 0 .U0 r' x . 00 T©TAIiS 576 .00 0 .00 0 .00 r tx=c ** MESSAGE not final . statement r is Current 31-60 Days 61-90 Days 92-120 Days 1,21.4 Days 75 00 501 .00 0 .00 0 .00 ,00 ' a).M t'3,.y'�'• ; s...-:{r.v. .1 ,5.."ti L„• 'J. .. P :r s r _ •. i For, proper credit,/y please enclose this portion with. your payment . 3'r Rose,Nunn ' BALANCE: $ 576 .00 s 83 4 :;� 4 , ;{ Richmond CA'. 94804 PAY THIS AMOUNT: $ 576 .�0 X AMOUNT ENCLOSED: ` Please fill in blank. DATE DUE: ACCident g& 'Injury Clinic 7 ' Dr4 Michel Tetrault Tax, ID:88-0361957 THANK YOU. ,2533 N '"'Carson .St Ste 2645 kray cars on`2City ' NV 89706 ACCOUNT NUMBER: 1000-11 Rk • Rose Nunn 4180 Berk Ave Richmond CA. 94804 - September 27, 1996 .RE: ACCIDENT REPORT On June 10th 1996 approximately 8 :52 am. , Monday morning I was taking my daughter to her class, at the Crescent Park Children Center, located at 5050 Hartnett Ave, Richmond Ca. I had signed her in with her teacher, I was saying my farewells, gave her kiss then suddenly slipping in some sort of wet substance on the floor. I fell, is such a awkward position landing on by buttocks the fall proved to have a profound impact on my lower back I lost conscience, when awaken I was commanded not to move an inch. -The American medical Service called. The medical team arrived and I was rushed Kaiser Emegercy for • treatment. My treatment required me to stay at the hospital for about 6-8 hours I was given an injection of some sort of pain reliever to decrease the tremendous pain in my spin. I was then release,and prescribed several different kinds of pain reliever, I was told to stay in the bed for several days. However, I was not physically able to return to work, but I went back on or about August 28, 1996. On September 11, I went for my follow-up appointment with my personal Doctor and was informed I needed additional bed rest until he releases me to return to work. 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Ci t -�'Kr}'y w �e� � ,-wrrf�`r"'.s4.,y�t* Ma vv��Ti� y," ,;y�� lr+�8"�.'iti�'''j�Z 3• �X�,�i J m-•�Y'I �lh .t Y ,?4 , tit �'rG`t �F• �' •-t;.. k {4�tz.tA. r��m�' d�+S- �r�}F''r„�i .#� 'f•,r'�'�.��2a�r'r-,.::� 'i�� r, � ,i 'Fs��t 1.,�,.t,'iit di �i �i t� re'cr 5�$'�y, ��r '{ �� i;=*� �•�L`F''4� t .y'�:��a�3��-. r�,��.`r�tis +,y7"� �-R,,a-y } r�,�F�r +", r a ,i sf •s,y h.' 41F'M+.k "4�ic;t �� ! "] ��3 j p'-'y�'�^��'`#�'- �2`ar It a i'�'�ia�e�..a- L-fid'�;s'rS }�i,,R-" "� �S„ 1rcr i. s � t 2,s 1y 't's� - �r ti�F.i- r{ -2•la{rsJrtd..'+�"xa--=J}�•S1�� a�Pn lex ,+� .,. kc �#.r At4y t n.sk 4�r i:F• �,j M 1 r" ° c f•r�� t -x Lk '414 J5R�4*'z � �,�s�]�*g, i r :nr"�l' �'_y 2�i'`-�E x x��s`a °' r.e }t 'F tt Xs td ' 1.. e..,ri� g CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 14, 1997 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 Amount: $10,000.00 Section 913 and 915.4. Please note "Naming'r CLAIMANT: Angel G. Pacheco DEC 13 1996 ATTORNEY: COUNTY COUNSEL MARTINEZ CALIF.. Date received ADDRESS: 1760 Greylodge Apt. '`#17, BY DELIVERY TO CLERK ON December 12, 1996 Detroit Ave. Concord, 'CA BY MAIL POSTMARKED: December 11, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHHIL ggeTCHtELOR, Cler DATED: December 13 1996 61': D pu y II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated �2fI3/�� 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 M 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:— /// 7 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: i�ic�/77 BY: PHIL BATCHELOR by �' �j�-ad�1" Deputy Clerk CC: County Counsel County Administrator C3a=r- to: BOAP,D OF S)PERW SM OF CONTRA {COSTA t)Oi M IRSTRUC'rI©NS TO CLAMANT A.A Clam relating to causes of action for death or for injury to person or to per- sonal property or ;growing crops and vhich 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 mases of aetica for,death or for injwT to per3o4 • Or to Personal Property or grudag crops and utich accrue an or after JaM aty 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 ease of action. (Govt. Code $911.2.) B. Claims must be filed with the Cleric of the Board of Supervisom at its office in Room 306, Cmnty Administration Building, 651 Pine Street. Martinez, CI 9k553• 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 ria: est be filed against each public entity. E. Praud. see penalty for fraudulent claims, Penal.Code ser. 72 at the end of this BE: M vAn By } Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa or ) DEC 2. George Miller Memorial Ca2tvict). sname) �, } CLERK BOARD OF SUPERVISORS `n # CONTRA COSTA CO. 'die tandersigned claimant hereby makes claimatcainst the County of Centra Costa or the above-named District in the sum of $(,Spa Note _A a.—Ad in support- of this claim represents as follows: 1. Mhen did the damage or injury occur? '(Give exact date and hour} October 29 ,- 1-995 _tifcra: 12 :00 . ailu' i :00 2. Wbem did the image or`injury-occur? (Include city and county) George Miller- ir Memorial Center Playground East contra Costa Count 3. How did the damage or injury occur? (Give full details; use extra paper if required) (Refer to Attachment - Note ) 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? The playpen is not well inspected of defective components such as rubber pads/tiles that are looping . up or loose to the Cement that causes injuries to children and guardian watching the children. j. wnat are vne nwnes of countiv or district officers, servants or employees causing the 4 ::--ge or in jlur y? Workers and their supervisors that maintain the playground and places, including the playpen,that causes hazzards ublic. S. Ubat damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. (Refer to attachment Not T. How Was the amount,claimed above computed? (Include the estimated amount 'of any prospective injury or damage.) Refer to attachment Note -3 is. MUM and addresses of wV-;n =r • , d0--N—VS A"Od hospitals. Teachers and Nurses in George Miller Jr Memorial Center Employees and Doctors who attended to me when I was treated in Merrithew Memorial Hospital Emergency Department. g. List the expenditures ym made_ oa acoomt of this accident or injury DATE ITEM AMJUNT .Anti '"biotics, tylorial;and advil and other over the counter drugs to relieve`means.aid rom Doctors' prescription, (Forgot date) Gori. Code Sec. 910.2 provides: "The claim must 'geed by the claimant " 7 his behalf." �"' D N0�1'IC£S--:TO:e �`(FAttorne Name and,-Address of Attorney- -( ., Gki f / Claimant's Signature i No Attorney consulted 1760 GreyLodge Apt. # 17 • Ave. Address- Concord, Contra Costa County Telephone No. Telephone No. I f e a * e e NOTICE Section 72 of the Penal. Code provides: "Every person Who, with intent to defraud, presents for allowance or for paym nt 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 imprisonmment in` the state prison, by a.,fine of not exceeding ten thousand dollars ($10,0001or by 'Doth such i-risoxrje^t and fine. Enclosed: Attachment 1 ' ~ . . , . ` ATTACHMENT 1 ( CLAIM TO BOARD OF SUPERVISOR OF CONTRA COSTA COUNTY ) Note 1 ( Anwser to item no. 3 ) While walking normally inside the playpen guiding my granddaughter, !von Pacheco (a studend in the starter class) , my left foot got caught inside a loop of a rubber pad/tile that were laid out above the cemented area inside the playpen. I fell flat on my stomach with my face, chest, arms hitting the steel ladder/stair. inside the playpen. The rubber pad/tile bear the same color as the cement floor. Note 2 ( Answer to item no. 6 ) ' When my feet got caught in the loop of the rubber pad/t ` le, .my face, chest, shoulder and arms hit the steel ladder/stair inside the play— pen. My whole face, chest, left and right arm got severly swollen. Both of my face stayed closed for more that a week. Myforehead bleed because of a cut, my nose got fractured and slightly deformed and the fall significantly effect my movility. I limp significantly and I still can feel pain in both of my feet. Two of my teeth broke and I hive a lot of bruises in my body. Note 3 ( Answer to item no. 7 > The pain and suffering I endure due to my swollen face, the consistent chest pain, temporary lost of hearing and significant lost of my mobility to walk around, n%ctured sinus and doses of over the counter drugs I am taking to ease pain. ' Note (Amount claim) Dollar amount - $ 0, 000. 00 ( Ten Thousand Dollars ) Medical experLges. incurred as a result of the accident that may be billed by Merrithew Memorial Hospital Emergency Department will also be paid by the Contra Costa County. ` , . .. r T„ ek- Ir CD rn 3 -' C . i9 . CLAIM It BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 14 11997 C11im 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 pursuant1 , RCode Amount: $1,000,000.00 Section 913 and 925.4. Please note a �►"'rn�t". CLAIMANT: Joan Sparks DEC 0 21 1996 ATTORNEY: Carl A. Lindstrom, Esq. COUNTY COUNSEL 653 N. San Pedro_St. Date received MARTINEZ CALIF. ADDRESS: San Jose, CA 95110 BY DELIVERY TO CLERK ON November 27, 1996 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. December 2 1996 EVIL BATCHELOR, Cl DATED: BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. . ( . ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.( ection 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.� Ar6 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: i��y�9 7 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. Dated: ��9 7 BY: PHIL BATCHELOR b "tea '—"Deputy Clerk CC: County Counsel County Administrator Marie to: BOAPM OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT k. Claiss relating to causes of action for death or foie injury to person -or toper-.:- , sonal property or growing crops and which accrue on or before December -31, 19,87-1 ; 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 mouths 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 Roan 106, County Administration Building, 651 Pine Street, Hartinez, CA 94553. C. If claim is-against a district governed by the Board of Supervisors, rather than the Comity,.-the mme of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed -against.eachpublic entity« E. Fraud. See penalty for fraudulent claims;' Penal Code See. 72 at` the end of this fo RE: Claim By } Reserved for Clerk*s filing stamp } RECEIVED : ' JOAN SPARKS }. . } rNOV 71996 Against the County of Contra Costa 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 $1,000,000.00, and in support of this claim represents as foll'aos; ' 1. When did the damage or injury occur? '(Give exact date and hour) June 1, 1996 and thereafter 2. Wbere did the damage or injury occur? (Include city and county) All cities within Contra Costa County where the Contra Costa Times and Ledger Dispatch are circulated and where the County's cable access channel is viewed 3. How did the damage or injury occur? (Give full details; use extra paper if re uir�d)Claimaint's reputation was severely hurt and Claimaint suffered severe emotional an� physical distress due to the false statements that were made about her performance and 'health to the media and to the general public 4. What particular act or omission on the part of county or district officers, se-^vants or employees caused the injury or damage?False statements were giVdr to the media and general public about the medical Condition of Claimant and false accusations were made about the performance of Claimant to the media and general public �. wnaL are �,ne vanes of counzv or district officers, servants or employees causing r; the da:-;age or injury? Scott Tandy, Assistant County Administrator; Phil Batchelor, County Administrator; Jeff Smith, M.D. , Chairperson, Board .of Supervisors; Al Prince, ASO, Community Services Department What damage or injuries do you claim resulted? (Give full extent of injuries or 5. damages claimed. Attach two estimates for auto damage. l3ersonal injury and emotional distress damages; damages to reputation; damages resulting from limiting her employment opportunities; medical expenses and other wage/benefit losses (past, present .and future) 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Amounts were estimated based upon information known at this time. Claimant will amend this claim once. more exact damages .are ascertained. (There are other witnesses who are $. N. ames and addresses of witnesses, doctors and hospitals.not ascertained at this time. This Dr. Schatz, Kaiser Hospital, Concords CA claim will be amended when such OTHER DOCTORS TO BE NAMED WHEN CLAIM IS AMENDED information becomes available.) Witnesses: Daneen Cali, Gayle Bishop, Supervisor,Contra Costa County; any person who, reads the Contra Costa Times 9. List the expenditures you made on accomt of this accAMMINident or injury: DATE ITEM �. . . A complete list of.expend'itures ,w 'l be provided on the Amended Claim once they -. are ascertained. � v,-;Code Sec. 910:2 providesthe claimant The im must be signed by SEND NOTICES TO: (Attorney) Or his behalf-" Name and Address of Attorney _)4— SignatUre . . INDSTROM, JR. , -- 653 N. S reet ESQ. San Jose, alifornia 95110 (-408) 294=5700 Telephone No. ft R._I174f-- ,�-70 hone No. N0TI .C .E -- Section 72 of the Penal Code provides: . "Every person who, with intent to defraud, presents for allowance ty or district cfor. t payment to any state board or officer, or to any county, ci -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 iod.of not.more than one year, by a fine of not exceeding the"county jail for a_per� imprisonment in. one- thousand ($1,000),- or by both such imprisonment and fine, or by p the state prison, by a., fine of. not exceeding ten) thousand dollars ,( 10,000,. or by both s=?z and f i nn_ \ J APPLICATION TO FILE LATE CLAIM January 14, 1997 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 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 Goverment Code.) ) given pursuant to Government Code Sections 911.8 and 915.4• Please note the "WARNING" below. Claimant: Courtnee Turner Attorney: UEC 0 5 1996 Address: 4139 Camelot Ct. COUNTY COUNSEL Pittsburg, CA 94565 MARTINEZ CALIF. Amount: $10,000.00 By delivery to Clerk on December 4, 1996 Date Received: December 4, 1996 By mail, postmarked on Hand Delivered; via Risk Mgmt. 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 4, 1996 PHIL BATCHELOR Clerk, By�_ i 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: /telS�� o VICTOR WESTMAN, County Counsel, By Deputy II. BOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted (Section 91.1.6). (>e,) 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: ° /`/l9'�° PHIL BATCHELOR, Clerk, BYL;:� 40LV4(r_ Deputy WARNING (Gov. Code $911.8) If you wish 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 requirmwt). 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 Mwant to consult an attorney, you should do so Immediately. V. FROM: Clerk of the Boar 70s 1 County Course 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: l//olgq PHIL BAT=DR 9 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 c � To Whom it may concern : I courtnee turner am requesting a leave to file a late claim against the contra costa sheriff ' s department . due to wrong information from an attorney i estimated that i had up to-I full year to file a claim. now that i know that the information was �rrong.�;i am askingt you to please consider my case and over ride the six month dead 'line . Due to the fact that my civil rights were deliberately violated. m SincerIly Courtnee Turner RECEIVED DEC 41996 ADD CLERK CONTRACCOS A CO. ISORS CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 14, 1997 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 t r� r Amount: $6,000,000.00 Section 913 and 915.4. Please note al ngs - CLAIMANT: Igor Verkhoshanskiy DEC 19 1996 ATTORNEY: Richard Shikman, Esq. OOUNTYCOUNSEL 15 Boardman Pl. Date received MARTINUCALIF. ADDRESS: San Francisco, CA 94103 BY DELIVERY TO CLERK ON December 17, 1996 BY MAIL POSTMARKED: December 13, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 19, 1996 ga1L gATCH , Clerk : DeputELORy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (�) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). Q� Other: , Dated: /T� �J BY: _ �u L� I'� 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: i�i��9 7 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. Dated: ��LP�9� BY: PHIL BATCHELOR by�,cA .`/ c,-P Deputy Clerk CC: County Counsel County Administrator RICHARD'B.'SHIKMAN ATTORNEY AT LAW 15B BOARDMAN PLACE TELEPHONE SAN FRANCISCO, CALIFORNIA 94103 (415)863-9425 NOTICE OF CLAIM RECEIVED. On- 17 nm PRESENTED TO: CONTRA COSTA COUNTY CLERK BOARD OF,SUPERVISORS CONTRA COSTA CO. Name and Address of Claimant: Igor Verkhoshanskiy 1643 Siskiyou Dr. Walnut Creek, Ca Address to which Notices are to be Sent: Richard Shikman, Esq 15 Boardman P1. San Francisco, CA 94103 Date, place and . circumstances giving rise to Claim See Oakland Police Dept. Vehicle Colision Report No. 5373 On June 28, 1996 a vehicle driven by the son of claimant Alex Verkhoshanskiy drove off the roadway on Grizzly Peak Blvd. about 1/2 mile west of Claremont Blvd. Both Alex Verkhoshanskiy and his sister (daughter of claimant) were killed in the accident. This is thus a claim for wrongful death based on the dangerous condition of the roadway based in part on the absence of a guardrail where the accident occurred and/or deficient signage on the roadway. Decedent's vehicle went off the treacherous curve. Damages This is a claim for damages based on wrongful death and the components of damage that go with said claim such as loss of companionship, support, emotional distress. Claimant's son was 20 years of age. Plaintiff's daughter was 16. Claimant claims $6, 000, 000. 00. Dated:— Richard ated: Richard Shikman Attorney for Claimant VER'CLE COLLISION REPORT COPY TO KED !! «.�. INCIDENT NO. '° j 0 0 7 9 P OF 2 OAKLAND POLICE DEPARTMENT NO.INJ. KILLED HITS RUN INVESTIGATED REPORTED COLLISION IIe R NO. r :...�i TF-3047(4/96) 2 2 F ❑ M ❑ ❑ CA on � ARRESTED: YES ❑ NO ❑ SECTION(S) ARRESTED FOR: DISPATCHED ON-VIEW r q CITE NO. ❑ ftj ARRESTED:' YES ❑ NO ❑ SECTION(S) ARRESTED FOR: DATE/TIME REPORTED (� 2 CITE NO. 28-JUN 9 6 0048 © COLLISION OCCURRED ON: BLOCK NO. DAY/DATE/TIME OCCURRED NCIC NO, OFFICER ID GRIZZLY PEAK BLVD FRI 28JUN96 30 0109 7293 ❑ AT INTERSECTION WITH: INJURY / FATAL I TOWAWAY STATE HWY.RELATED O� OR 1/29r./MILES(N) (E) (S) of: YES -O—NO ❑ YES NO PART NAME (LAST FIRST MIDDLE) VEHICLE OWNER SAME AS DRIVER 1 VERKHOSHANSKIY ALEX DRIVER RESIDENCE ADDRESS PHONE ( ) OWNER'S ADDRESS CITYIZIP IR SAME AS DRIVER CK 643 SISKIYOU DR. BUS.PHONE PED CITYIZIP VEH.DISPOSITION OPD TOWED lU: OPD ❑ WALNUT )98 ❑ O.R. N PARKED DRIVER'S LIG NO. STATE D.O.B. SEX RACE DIRECTION ON:(STREET) VEH SPEED ZONE SPEED VEH. OF TRAVEL ❑ B4554631 19APR76 M W E GRIZZLY PEAK BLVD 35+ 30 BICYCLE AGE HEIGHT WEIGHT HAIR EYES INSURED INSURANCE COJPOLICY NO. EXTENT OF DAMAGE SHADE IN DAMAGE AREAS ❑ ❑ YES ❑ MINOR ❑ MAJOR , 20 6-3 250 B RO GRN ❑ NO ❑ MODERATE N TOTAL OTHER LICENSE NO. STATE VEH.YR. MAKE MODEL COLOR(S) PED CLOTHING ❑ LIGHT --—CROSSWALK ❑ 3GYG135 94 MITSU ❑ DARK ❑ MARKED ❑ PED INSIDE ❑ UNARKED ❑ PED OUTSIDE PARTY NAME (LAST FIRST MIDDLE) VEHICLE OWNER ❑ SAME AS DRIVER DRIVER RESIDENCE ADDRESS PHONE ( ) OWNER'S ADDRESS CITYIZIP ❑ SAME AS DRIVER PED CITY/ZIP BUS.PHONE ( ) VEH.DISPOSITION ❑ OPD TOWED TO: 0 ❑ O.R. PARKED DRIVER'S LIG NO. STATE D.O.B. SEX RACE DIRECTION ON:(STREET) VEH SPEED ZONE SPEED VEH. OF TRAVEL BICYCLE AGE HEIGHT WEIGHT HAIR EYES INSURED INSURANCE CO./POLICY NO. EXTENT OF DAMAGE SHADE IN DAMAGE AREAS ❑ ❑ YES ❑ MINOR ❑ MAJOR ❑ NO ❑ MODERATE ❑ TOTAL OTHER LICENSE NO. STATE VEH.YR. MAKE MODEL COLOR(S) PED CLOTHING ❑ LIGHT CROS WALK ❑ ❑ DARK MARKED PED INSIDE UNMARKED PED OUTSIDE PARTY E (LAST FIRST MIDDLE) I VEHICLE OWNER ❑ SAME ASD�E 3 - — VERKHOSHANSKIY, ALEX VERKHOSHANSKAYA, Ilona DOA at Scene DOA at Scene 28 Jun 96 28 Jun 96 0126 hrs. 0126 hrs Dr. Buhler Dr. Buhler Coroner' s Report# 9601642 Coroner' s Repnrtf19601643 ` LI UNMARKED LI PtU UUIWUt DESCRIPTION OF DAMAGE �W ADDRESS CITYIZIP NE ( ) NOTIFIED � OWNER'S NAME 83 234 `LYES W Q PG&E r:o a:E DESCRIPTIO DAMAGE oa oc d NER'S NAME ADDRESS CITYIZIP PHONE ( ) OTIFIED 1_ S T.1 N 'TRAFFIC COLLISION CODING Date of Collision Time NCIC No. Serial No. Collision or Report No. z8JUN96 ` 0030 0109 7293 S3'73 WITNESS (Last Name First Middle) Residence City/Zip PhoVN ne(Include Area Code)) z s. 4. Approximate Point of Impact Determined By: #1 1/2 mW/W 18 ' 6" S/S 0 Dirt 0 Damage 0 Driver# _ o Debris o Skids 0 Wdness# _ M Vehicle# pos. Describe Collision In Detail: GRIZZLY PEAK BLVD IS A TWO LANE ROAD RUNNING EAST TO WEST. V1 WAS APPARENTLY E/B ON GRIZZLY PEAK BLVD WHEN IT LOST CONTROL.V1 LEFT THE ROADWAY,STRUCK A POWER POLE,THEN PLUMMETED DOWN THE HILLSIDE.D1 AND R/F PASS . WERE EJECTED OUT OF V1 AND FOUND NEAR VI ' s PT. OF REST.BOTH REAR PASS. WERE TRANSPORTED TO A HOSPITAL. COLLISION ANALYSIS PRIMARY COLLISION FACTOR RIGHT OF WAY CONTROL 1 P2R3 4 TYPE OF VEHICLE 1 P2 3Y 4 MOVEMENT PRECEEDING N A V.C. COLLISION VIOLATION: A CONTROLS FUNCTIONING A PASSENGER CAR/STATION WAGON A STOPPED 8 CONTROLS NOT FUNCTIONING B PASSENGER CAR WlTRAILER B OTHER IMPROPER DRIVING: C CONTROLS OBSCURED C MOTORCYCLEISCOOTER B PROCEEDING STRAIGHT C OTHER THAN DRIVER D NO CONTROLS PRESENT D PICKUPIPANEL TRUCK C RAN OFF ROAD D UNKNOWN E PICKUP/PANEL TRK.W?RLR D MAKING RIGHT TURN TYPE OF COLLISION F TRUCK OR TRUCK TRACTOR E MAKING LEFT TURN WEATHER (1 to 2 items) A HEAD-ON G TRKITRK TRACTOR WRRLR F MAKING U-TURN B SIDESWIPE G BACKING A CLEAR C REAR END H SCHOOL BUS H SLOWING—STOPPING B CLOUDY D BROADSIDE I OTHER BUS I PASSING OTHER VEHICLE C RAINING E HIT OBJECT J EMERGENCY VEHICLE D SNOWING F OVERTURNED K HWY.CONST.EQUIPMENT J CHANGING LANES E FOG G AUTO/PEDESTRIAN L BICYCLE K PARKING MANEUVER F OTHER: H OTHER M OTHER VEHICLEENTERING TRAFFIC FROM L SHOULDER.MERIDIAN,PARKING G WIND N PEDESTRIAN STRIP OR PRIVATE DRIV: MOTOR VEH. INVOLVED WITH: Q MOPED M OTHER UNSAFE TURNING LIGHTING A NON-COLLISION N X ING INTO OPPOSITE LANE B PEDESTRIAN A DAYLIGHT PARTY OTHER ASSOCIATED O PARKED 1 2 3 4 e DUSK—DAWN C OTHER MOTOR VEHICLE FACTOR 1 to 3 items P MERGING C DARK—STREET LIGHTS ON D MOTOR VEHR,ON OTHER RDWY. A VIOLATION: - O TRAVELING WRONG WAY D DARK—NO STREET LIGHTS E PARKED MOTOR VEH. B VIOLATION: R OTHER: E DARK—STREET LIGHTS OFF F TRAIN ROADWAY SURFACE G BICYCLE C VIOLATION: H ANIMAL: PARTY SOB RIETY•DRUG•PHYSICAL A DRY D VIOLATION: 1 2 3 4 mark 1 to 2 items B WET A HAD NOT BEEN DRINKING I FIXED OBJECT: C SNOWY-ICY E VISION OBSCUREMENT: B HBD—UNDER INFLUENCE D SLIPPERY(MUDDY,OILY ETC.) - POWER POLE C HBD—NOT UNDER INFLUENCE ROADWAY CONDITIONS J OTHER OBJECT: F INATTENTION D HBD—IMPAIRMENT UNKNOWN A HOLES,DEEP RUTS G STOP ENTERING/EXITING GO TRAFFIC ' E UNDER DRUG INFLUENCE B LOOSE MATERIAL ON ROADWAY PEDESTRIAN'S ACTION H PREVIOUSCOLIST RAMP F IMPAIRMENT—PHYSICAL C OBSTRUCTION ON ROADWAY A NO PEDESTRIAN INVOLVED I PREVIOUS COLLISION IMPAIRMENT UNKNOWN D CONSTRUCTION—REPAIR ZONE B CROSSING IN CROSSWALK— J UNFAMILIAR W/ROAD H NOT APPLICABLE E REDUCED ROADWAY WIDTH AT INTERSECTION K DEFECTIVE VEHICLE EQUIPMENT I SLEEPY/FATIGUED F FLOODED C CROSSING IN CROSSWALK— NOT AT INTERSECTION L UNINVOLVED VEHICLE y G OTHER D CROSSING—NOT IN CROSSWALK M OTHER(explain in narrative) 1 PR 73 4 SPECIAL INFORMATION XI H NO UNUSUAL CONDITIONS ROAD-INCLUDING SHOULDER E IN_ N NONE APPARENT A HAZARDOUS MATERIALS FACTORS NOT LISTED ABOVE: F NOT IN ROAD 0 RUNAWAY VEHICLE B FIRE INVOLVED A G .APPROACH/LEAVING SCHOOL BUS C TIRE DEFECTIFAILURE B REPORTING OFFICER SERIAL NO. ASSISTING OFFICER TIME CONSUMED FOLLOW-UP SERIAL NO. C AR IF L M GREB 2 7477 T 5 HRS z , 4 { t L SS Q d �; CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 14, 1997 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 Amount: $6,000,000.00 (Paragraph IV below), given pursuant to Gover i QWIM) Section 913 and915.4. Please note all "War s" CLAIMANT• Eugenia Verkhoshanskiy DEC 19 1996 COUNTY COUNSEL ATTORNEY: Richard Shikman, Esq. MARTINUCALM 15 Boardman Pl. Date received ADDRESS: San Francisco, CA 94103 BY DELIVERY TO CLERK ON December 17, 1996 BY MAIL POSTMARKED: December 13, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. HFI -- DATED: December 19, 1996 JVIL DepCtyLOR, Clerl�90047— II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( Other: yL Dated: 1 Z BY: t� r(/� 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 (x) 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: /��/q7 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, overage 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: BY: PHIL BATCHELOR by `�j�'�"�``��-ate- Deputy Clerk CC: County Counsel County Administrator S , RICHARD B. SHIKMAN ATTORNEY AT LAW 15B BOARDMAN PLACE TELEPHONE SAN FRANCISCO, CALIFORNIA 94103 (415)863-9425 RECEIVEDLE N DEC 17 1996 - i NOTICE OF CLAIM CLERK BOARD OF SUPERVIl s:)ri5> CONTRA COSTiA C:�. PRESENTED TO: CONTRA COSTA COUNTY Name and Address of Claimant: Eugenia Verkhoshanskiy 1643 Siskiyou Dr. Walnut Creek, Ca Address to which Notices are to be Sent: Richard Shikman, Esq. 15 Boardman P1. San Francisco, CA 94103 Date, place and circumstances giving rise to Claim See Oakland Police Dept. Vehicle Colision Report No. 5373 On June 28, 1996 a vehicle driven by the son of claimant Alex Verkhoshanskiy drove off the roadway on Grizzly Peak Blvd. about 1/2 mile west of Claremont Blvd. Both Alex Verkhoshanskiy and his sister (daughter of claimant) were killed in the accident. This is thus a claim for wrongful death based on the dangerous condition of the roadway based in part on the absence of a guardrail where the accident occurred and/or deficient signage on the roadway. Decedent's vehicle went off the treacherous curve. Damages This is a claim for damages based on wrongful death and the components of damage that go with said claim such as loss of companionship, support, emotional distress. Claimant's son was 20 years of age. Plaintiff's daughter was 16:. Claimant claims $6, 000, 000. 00. Dated: Richard Shikman Attorney for Claimant YEHICL COLLISION REPORT co v To K�� a b'"�' Nci ENT NO, I .- I; a 1 0 I 0 I 19 I P of OAKLAND POLICE DEPARTMENT NO.INJ. KILLED HIT&RUN INVESTIGATED REPORTED COLLISION OH p NO ...,s TF-3047(4196) 2 12 F ❑ M ❑ N ❑ 'h ARRESTED: YES ❑ NO ❑ SECTION(S) ARRESTED FOR: DISPATCHED ON-VIEW 1 �. CITE NO. I ❑ ARRESTED: YES ❑ NO ❑ SECTION(S) ARRESTED FOR: DATE/TIME REPORTED �Q CITE NO. 2-8JUN96 0048 Q COLLISION OCCURRED ON: BLACK NO. DAY/DATE/TIME OCCURRED NCIC NO. OFFICER ID GRIZZLY PEAK BLVD FRI 28JUN96 0 0109 7293 ❑ AT INTERSECTION WITH: { INJURY I FATAL I TOWAWAY STATE HWY.RELATED OR 1/29T./MILES(N) (E) (S) of: YES Z I NO ❑ YES NO PART NAME (LAST FIRST MIDDLE) I VEHICLE OWNER [2[SAME AS DRIVER 1 VERKHOSHANSKIY ALEX DRIVER RESIDENCE ADDRESS I PHONE ( ) OWNER'S ADDRESS CITYIZIP IR SAME AS DRIVER CX 1643 SISKIYOU DR, BUS.PHONE ( ) VEH.DISPOSITION ) OPD TOWED TO: PED CITY/ZIP I OPD ❑ n161E n ❑ O.R. TPATNIPq nPTATT N PARKED DRIVER'S LIG NO. STATE D.O.B. SEX RACI DIRECTION ON:(STREET) VEH SPEED ZONE SPEED VEH. OF TRAVEL ❑ B4554631 19APR76 M W E ]GRIZZLY PEAK BLVD 35+ 30 BICYCLE AGE HEIGHT WEIGHT HAIR EYES INSURED I INSURANCE COJPOUCY NO. EXTENT OF DAMAGE SHADE IN C,AMAGE AREAS ❑ ❑ MINOR ❑ MAJOR , 20 6-3 250 B RO GRN ❑ NO ❑ MODERATE ® TOTAYES L OTHER LICENSE NO. STATE VEH.YR, MAKE MODEL COLOR(S) PED CLOTHING ❑ LIGHT CROSSWALK ❑ 3GYG135 94 MITSU ❑ DARK ❑ MARKED ❑ PED INSIDE ❑ UNMARKED ❑ PED OUTSIDE PARTY)NAME (LAST FIRST MIDDLE) VEHICLE OWNER [� SAME AS DRIVER DRIVER I RESIDENCE ADDRESS PHONE ( OWNER'S ADDRESS CITYIZIP O SAME AS DRIVER ❑ PED CITY/ZIP BUS.PHONE ( ) VEH.DISPOSITION ❑ OPD TOWED TO: ❑ 1 ❑ O.R. PARKED DRIVER'S LIG NO. STATE D.O.B. I SEX RACE DIRECTION ON:(STREET) VEH SPEED ZONE SPEED VEH. OF TRAVEL ❑ II BICYCLE AGE HEIGHT WEIGHT HAIR EYES INSURED 'INSURANCE CO./POLICY NO. EXTENT OF DAMAGE SHADE IN DAMAGE AREAS ❑ ❑ YES I ❑ MINOR ❑ MAJOR ❑ NO ❑ MODERATE ❑ TOTAL OTHER LICENSE NO. STATE VEH.YR. I MAKE MODEL COLOR(S) PED CLOTHING ❑ LIGHT CROSSWALK ❑ ❑ DARK 8 MARKED LJ PED INSIDE UNMARKED Ll PED OUTSIDE I PARTY E (LAST FIRST MIDDLE) I VEHICLE OWNER ❑ SAME AS DRIVER 3 — d/ i I . VERKHOSHANSKIY, ALEX I VERKHOSHANSKAYA, Ilona DOA at Scene DOA at Scene 28 Jun 96 � 28 Jun 96 0126 hrs. 0126 hrs Dr. Buhler Dr. Buhler Coroner' s Report# 9601642 Coroner' s Report#961643 I .� LI UNMARKED LI I1tU UUIWUt DESCRIPTION OF DAMAGE OWNER'S NAME ADDRESS CITYIZIP $3 E ( 2 3 4) NOTIFIED W Q PG&E YES Ci YE NO CL DESCRIPTIO DAMAGE OQ CL NER'S NAME ADDRESS CITY/ZIP PHONE ( ) I OT,FSED fl N TRAFFIC COLLISION CODING Dale of Collision Time NCIC No. Serial No. Collision or Report No. 29JUN96 ` 0030 0109 7293 S WITNESS (Last Name First Middle) Residence City2ip Phone(Include AlrEC�ode)), T. )i-v 2- 3.J. 4. Approximate Point of Impact Determined By: #1 1/2 mW/W 1816" S/S o Dirt 13 Damage o Driver# — 0 Debris 0 Skids O Mess# _ M Vehicle# pos. Describe Collision In Detail: GRIZZLY PEAK BLVD IS A TWO LANE ROAD RUNNING EAST TO WEST. V1 WAS APPARENTLY E/B ON GRIZZLY PEAK BLVD WHEN IT LOST CONTROL.V1 LEFT THE ROADWAY,STRUCK A POWER POLE,THEN PLUMMETED DOWN THE HILLSIDE .D1 AND R/F PASS . WERE EJECTED OUT OF V1 AI\TD FOUND NEAR V1 ' s PT. OF REST.BOTH REAR PASS . WERE TRANSPORTED TO A HOSPITAL. COLLISION ANALYSIS PRIMARY COLLISION FACTOR RIGHT OF WAY CONTROL t P2R3TY 4 TYPE OF VEHICLE t PARTY 4 MOVEMENT PRECEEDING 1a A V.C.VIOLATION: LD CONTROLS FUNCTIONING A PASSENGERCAR/STATION WAGON COLLISION CONTROLS NOT FUNCTIONING B PASSENGER CAR WITRAILER A STOPPED B OTHER IMPROPER DRIVING: LS OBSCURED C MOTORCYCLE/SCOOTER B PROCEEDING STRAIGHT D PICKUPIPANEL TRUCK C RAN OFF ROAD C OTHER THAN DRIVER TROLS PRESENT E PICKUP/PANEL TRK.WlTALR O MAKING RIGHT TURN D UNKNOWN TYPE OF COLLISION F TRUCK OR TRUCK TRACTOR E MAKING LEFT TURN WEATHER (1 to 2 items) A HEAD-ON G TRKITRK TRACTOR WTTRLR F MAKING U-TURN B SIDESWIPE G BACKING A CLEAR C REAR END H SCHOOL BUS H SLOWING—STOPPING B CLOUDY D BROADSIDE I OTHER BUS I PASSING OTHER VEHICLE C RAINING E HIT OBJECT J EMERGENCY VEHICLE D SNOWING F OVERTURNED K HWY.CONST.EQUIPMENT J CHANGING LANES E FOG G AUTOIPEDESTRIAN L BICYCLE K PARKING MANEUVER F OTHER: - H OTHER M OTHER VEHICLE ENTERING TRAFFIC FROM L SHOULDER,MERIDIAN,PARKING G WIND N PEDESTRIAN STRIP OR PRIVATE DRIVE MOTOR VEH. INVOLVED WITH- D MOPED M OTHER UNSAFE TURNING LIGHTING —ANON-COLLISION N X-ING INTO OPPOSITE LANE PARTM OTHER ASSOCIATED O PARKED DAYLIGHT B PEDESTRIAN t z 3 4 3 it 1 to ems B DUSK—DAWN C OTHER MOTOR VEHICLE FACTOR P MERGING C DARK_STREET LIGHTS ON D MOTOR VEH.ON OTHER RDWY. A VIOLATION: 0 TRAVELING WRONG WAY D DARK—NO STREET LIGHTS E PARKED MOTOR VEH. B VIOLATION: R OTHER: E DARK—STREET LIGHTS OFF F TRAIN ROADWAY SURFACE G BICYCLE C VIOLATION: H ANIMAL: PARTY SOB RIETY•DRUG-PHYSICAL A DRV D VIOLATION: 1 2 3 4 mark t to 2 items LPCESENOWY-ICY WET A HAD NOT BEEN DRINKING I FIXED OBJECT: E VISION OBSCUREMENT: 8 HBO—UNDER INFLUENCE ERY(MUDDY,OILY ETC.) x POWER POLE C HBO—NOT UNDER INFLUENCE ROADWAY CONDITIONS J OTHER OBJECT: F INATTENTION D HBO—IMPAIRMENT UNKNOWN A HOLES,DEEP RUTS G STOP GO TRAFFIC E UNDER DRUG INFLUENCE 8 LOOSE MATERIAL ON ROADWAY PEDESTRIAN'S ACTION H ENTERING/EXITING RAMP F IMPAIRMENT—PHYSICAL C OBSTRUCTION ON ROADWAY A NO PEDESTRIAN INVOLVED I PREVIOUS COLLISION IMPAIRMENT UNKNOWN D CONSTRUCTION—REPAIR ZONE 8 CROSSING IN CROSSWALK— J UNFAMILIAR WIROAD H NOT APPLICABLE E REDUCED ROADWAY WIDTH AT INTERSECTION K DEFECTIVE VEHICLE EQUIPMENT C CROSSING IN CROSSWALK— I SLEEPY/FATIGUED F FLOODED NOT AT INTERSECTION L UNINVOLVED VEHICLE G OTHER D CROSSING—NOT IN CROSSWALK M OTHER(explain in narrative) 1 PARTY 4 SPECIAL INFORMATION H NO UNUSUAL CONDITIONS E IN_ROA_D-INCWOING SHOULDER N NONE APPARENT A HAZARDOUS MATERIALS FACTORS NOT LISTED ABOVE: F NOT IN ROAD O RUNAWAY VEHICLE 8 FIRE INVOLVED A G .APPROACH/LEAVING SCHOOL BUS C TIRE DEFECT/FAILURE B REPORTING OFFICER SERIAL NO. ASSISTING OFFICER TIME CONSUMED FOLLOW-UP SERIAL NO. C AR tt F+L C� M GREB 2 7477 5 HRS �!! ;5 t m t e71 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA January 14, 1997` 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: $1,000,000.00 Section 913 and 915.4. Please note all�l� �� CLAIMANT: Richard E. Kirkpatrick DEC 0 9 1996 901 Court St. ATTORNEY: Martinez, CA 94553-1700 COUNTY COUNSEL Date received MARTINEZCAUP. ADDRESS: BY DELIVERY TOCLERK ON December 9, 1996 BY MAIL POSTMARKED: Interoffice Mail I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: December 9, 1996 IVIL RAATTCUELOR, C1eepuTy r O� II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days.(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Gated: 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 (X) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, ByY� "��" � 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: /�/t��9� BY: PHIL BATCHELOR by /i-� puty Clerk CC: County Counsel County Administrator VICTOR J.WESTMAN 0CEtOF COUNTY CO'NSEL DEPUTIES: PHILLIPS.ALTHOFF' SHARON L.ANDERSON COUNTY COUNSEL CONTRA COSTACO'UNTY BRANDON D.BAUM E � , I. ANDREA W.CASSIDY COUNiY ADMINISTRATION BUILDINGS VICKIE L.DAWES SILVANO B.MARCHESI g `' MARKE S.ESTIS ARTHUR W.WALENTA,JR. 651 PINE STREET 9th FLOOR MICHAEL D.FARR MARTINEZ CALIFORNIA 94553-1288 LILLIAN TFUJII ASSISTANTS a' DENNIS G GRAVES a GREGORY C.HARVEY �� GAYLE MUGGLI � �� ~�� KEVIN T.KERB EDWARD V.LANE,JR. OFFICE MANAGER VIVIAN LILY MARYANN MASON PAUL R.MUNIZ PHONE(510)335-1800 VALERIE J.RANCHE FAX(510)846-1078 DAVID F.SCHMIDT DIANA J.SILVER VICTORIA T.WILUAMS JACQUELINE Y.WOODS NOTICE OF INSUFFICIENCY_ AND/OR NON-ACCEPTANCE OF CLAIM TO: Richard E. Kirkpatrick 901 Court Street Martinez, CA 94553-1700 RE: CLAIM OF: Richard E. Kirkpatrick 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: [ ] L 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. [XX] 3. The claim fails to state the date,place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation,the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000),the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. Page 1 [ ].6. The claim is not signed by the claimant or by some person on his behalf [ ] 7. Other: 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: December 9, 1996 at Martinez,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCYOF CLAIM:GOVT.CODE§§910,910.2,920.4,910.8) Page 2 Claim Ito: BOARD OF SUPERVISORS OFCONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMS M A., Claims relating to causes of action for death or for injury to person-or to per- sonal property or growing crops and which ar,,crue_°on or before December 31, 1987, must be presented hot later than the 100th day after the accrual of the cause of a,:tion. 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 f RE: Claim By ) Reserved for Clerk's filing stamp tEIVED Against t County of Contra sta ) or ) DEC -. 9 1996 {.,. cji ,4'cl ceS 5 co CLERK CLER► BORD OF SUPERVISORS Fill in name ); CONTRA COSTA CO. The undersigned claimant hereby makes claim a inst h County of Contra Costa or the above-named-District-in the sum of $ 40 L')' &?* and in support' of this claim represents as follows: 1. When did the.,damage our 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; ua extra paper if required) A+6(n ey �or- cPJ(ckiytA�F/FJ- pito 4 Ce> ,s-eX_ k,,M F r q ma. �h�%wQL o f o~-t. o_M rAxg4 ivLA- 66 tt r 4. What particular act or omission on the part of county or district officers, servants 'or employees caused the injury or damage? 1 4,J S- C b r e__ c,�o 3 i _,Le54_1- $ : (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? �-` J1 6. What damage or injuries do you claim rvsulte ? (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.) O S. Names and addresses of witnesses, doctors and hospitals. Je, Iii Per lD 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,.vome/perpon on his if." Name and Address of Attorney (Cl imant s t ddress 01 Telephone No. Telephone No.1W NOTICE Section 72 of the Penal Code provides: "Every person, who, with intent to defraud, presents for allowance or for officer,to authorized to allow or pastate board or y the same or to IfY county, anyyor falseior district board r f . Y 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 such imprisonment and fine. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA .January 14, 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 pursuantiSb Amount: $101.72 Section 913 and 915.4. Please not e ++Warnings". CLAIMANT:David Feldhammer DEC 0 5 996 ATTORNEY: OOUNN COUNSEL MARTINEZ CALIF. Date received ADDRESS: 169 Paseo Del Rio BY DELIVERY TO CLERK ON December 4, 1996 Moraga, CA 94556 BY MAIL POSTMARKED: December 3, 1996 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ��IL BATCHELOR, Clerk' / DATED: December 4. 1996 : Deputy II. FROM: County Counsel TO; Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: � 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 (x) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By�9jte-^�-�,r--ate" , 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: /�/IP/97 BY: PHIL BATCHELOR by�=7�.- C_ eputy Clerk CC: County Counsel County Administrator C4ai!c ;oz BOAM) OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUMONS TO CLAI Wirt A. Claims relating to causes of action for death or for injury to person or to per_ conal 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. Maims 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 Ser. 72 at the end of this fo.=. BE: Claim By ) Reserved for Clerk's filing stamp } RECEIVED Against the County of Contra Costa DEC - 4 W or ) District) CLERK BOARD OF SUPERVISORS Fill in name } CONTRA COSTA CO. Zhe undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of . T2_ and in support of this claim represents as follo•4rs 1. When did the damage or injury occur? '(Give exact date and hour) 2. Where did the a or .injuryur? (Include city and county) - L -�urs'ZZC` - x- /�?,� -- 3. How did the damage or injury occur? .--(Give full details; use extra paper if A f required) �� '� ;;(A C,e x. u. What particular act or omission on the part of county gr district ofi'icers, servants or employees caused theinjury or damage? / �4 wnaL are the nares of counLv or district officers, servants or employees causing t he ,da.age or 5. Whaat'damage or injuries do you claim resulted? (Give full extent of injuries or dairies claimed. Attach two estimates for auto damage. a 7. Hoyt was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 6 .--Names__andladdresses of. witnesses, doctors--and hospitals. _ last the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT -77 R Gov. Code Sec, 910;2 provides: _"The claim must be signed by the claimant SEND NOTICES T0: (Attorney)' orb some persop on his behalf.'" Name and Address of Attorney ,^ t�- Claimant's Signature r (Address) y{� Tele L.�o1 "" Telephone No.,. hone No.p S731 (0 N0T `Z. CE r Section 72 of`the Penal Code provides: !'Everyperson who; 'with -intent to' defraud; presents for allowance or for payment to`-any-state board or, officer, -tor to any county, city or district board or officer, •`authorizdd 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``irnprisonment and fine,_ or by imprisonment in the state prison, by' a fine of•-not exceeding ten thousand dollars {$10,000, or by 4 k *Doth s=h i*Yriso ire^ a d ' ?nn . . ..... `m p w ZmOntc mp ao m _ c o r - -� a . _ m 95, ! mm C-T 7►m m, � �m i € O m, x x. p ; ; _ m s4 _ _ _ - �_ �_ �------------n _ __ O ?m°O S'Q �: —µ.Vi C N m w.m�•:w 0 \ ',��m O N o b a m.p1 y 9?t>[T�j <� ,.,�'. - c'e7. � T o �o Tam 1€r� -aW ; �• - m a�O pp d' -n f _ t m vi C D u ;lD ,.0 5 m� hiE "'1x"G'a 4 F 77 � ,,� F ea a 3 o? .d� O'' r 3 :. 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