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MINUTES - 12052000 - C22-C23
CIAINI ROARS OF SUPERnS RS OF CONTRA COSTA COUlNM CALIFORNIA BOARD ACn DECEMBER. 5, 2000 Claim Against the County, or District Governed by the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to 1 The copy of this document mailed to you is your California Goverment Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given \u x ° pursuant to Government Code Section 913 and -µ< > sw 915.4. Please note all "Warnings" AMOUNT: $65,000.00 CLAIMANT: DAVID ANTHONY FALLON ATTORNEY: DATE .RECEIVED: NOVEMBER 7, 2000 ADDRESS: Box 141173 BY DELIVERY TO CLERK ON: NOVEMBER 7 2000 San Francisco CA 94114-1173 BY MAIL POSTMARKED: NOVEMBER 6 2000 L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BA.ICHELOR, Cle Dated: NOVEMBER 7, 2000 By: Deputy 11. FROM County Counsel TO: Clerk of the Board of Supery ors ( ) 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 910.0. ( ) 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� ' By:._Cys; u � �1..--� 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: <.iWPe,i 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: �� " By: PHIL BATCHELOR By 7i 4 J ' eputy Clerk 'C: County Counsel County Administrator VICTOR J.WESTMAN DEPUnr;S: PHILLIPS.ALTHOFF COUNTY COUNSEL JANICE L.AMENTA NORA G.BARLOW B.REBECCA BYRNES ANDREA W.CASSIDY SILVANO B.MARCHESI CONTRA COSTA 0 MONIKA L.COOPER CH IEF ASSISTANT COUNTY COUNSEL n T f� r. VICKIE L.DAWES OFFICM,OF I HE doo SEL MARKES.ESTIS SHARON L.ANDERSON VI� V a►/+ MICHAELILLIAN .FUJII R C AFp�INIISTFIVI JIL IN DENNISC.GRI ASSISTANT COUNTY COUNSEL TRE, "" JA N T L.HOLMES JANETL.HOIMES MARtWtZ CALIF���� 29 KEVINT.KERR GREGORY C.HARVEY BERNARD L.KNAPP ASSISTANT COUNTY COUNSEL r r EDWARD V.LANE,JR. .� °,,'A BEATRICE LIU MARY ANN MASON GAYLE MUGGLI PAUL R.MUNIZ VALERIE J.RANCHE OFFICE MANAGER NOTICE OF INSUFFICIENCY STEVEN P. HMIDT DAVID F.SCHNilDT DIANA J.SILVER PHONE(925)335-1800 ANDZOR JACQUELINEYWOODS FAX(925)646-1078 NON-ACCEPTANCE OF CLAIM TO: DAVID ANTHONY FALLON P.O. Box 141173 San Francisco, CA 94114-1173 RE: CLAIM OF: DAVID ANTHONY FALLON 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: [ 11. The claim fails to state the name and post office address of the claimant. [ ] 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [X] 3. The claim fails to state the date,place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [X] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 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 ($10,000),the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. Page 1 +Maim to: ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100 'day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against mo:a than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. ****************************************************************************************** RE: Claim By Reserved for Clerk's filing stamp FCLERK CEI ED NOV Against the County of Contra Costa or ) , COF STA CO. District) (Fill in name) ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$£T -"' ``' and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) F w x - ( .,may 2. Where did the damage or injury occur?(Include city and county) -:' a ',i /..:� Y'"p I ':;q d � i .✓i✓s ^' .G :� :'-:'. . ,_.:.♦ .`b.L..,i4y G.-..' :S .., ., k -- 3. How did the damage or injury occur? (Give full details,use extra paper if required) .t' r r t'f,.a .tT � ♦ ;�...,v ¢,; � .. ./. " ,.1. °�" _ I'r. :A F: ''` •.� �i:.,.'� e' '_ ..� � -I...�:, .;SS... .. t. I r '. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? S. What are the names of county or district officers, servants, or employees causing the damage or injury? "h ?.>.. :�. M ._,A �'l+ !Y t.. _{: 6-t/..,; ✓ EYG;J ✓ .�i., .., : < "' 4.4 ,w-:: .. '::r:4,. _ ,E�✓:� � t i��7 .:.e ` r Pi`a::;a :�;;:: i.: r;?'k w#��;` �r". , �, ♦ � �1 I i1 .. ;'.<: •: ',,arrr �',•:;f .,A-:. r`•.;r;: 6. What damage or injuries do you claim resulted? (Give full extent of�njuries or damages claimed. Attach two estimates for auto damage.) z , s •E' � t c 3�: ✓f�a. -y:. r r.'.; -4 .:. ,. :y:: < s e�' - - .t d :, ✓x f a.,, a 'ur• : ,f: f. r f .. y; %. � 3 ..fir, t• r•3 E '` t .;��./> :; ". tx:.3 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) S Names and addresses cif witnesses, doctors, and hospitals i.,,r..: .5.., � ..� � .. ..�..':,p :r»r .. r, ,� .,'y• .. 7 ! , "r D ,t f t- d!.. .'s+'. / .�; r [[i,`•i � dx. �¢,: '�}, .> .. .. r� l�,': f �Yr 11• J t ✓ c" ,',. 9. List the expenditures you made on account of this accident or injury. DATE TIlVM - AMOUNT : Gov. Code Sec. 910.2 provides "The claim must be END NOTICES signed by the claimant or by some person on his behalf" rn Name and Address of Attorney ) ,, .'r '�3 ✓f`J c,.r f y,te• (Claimant's Signature) yf ) . ,PG rid 3�•!i.-.4f � �x-' . '.F c, /9', '.:t,S'.d 1��.'- j .. . ) K_ (Address) s Telephone No Telephone No. NOTICE Section 72 of the Penal Code Provides. Every person who,with intent to defraud,Presents for allowance or the payment to any state hoard or nfFiicer;or Many county,city,or district board or officer,authorized to allow or Pay the same if genuine,any false or fraudulent claim,bill,account, voucher,or writing,is Punishable either by imprisonment in the county jail for a period of not more than one year,by a fine of not exceeding one thousand($1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars($10,000),or by both such imprisonment and fine. .w 4. f � f.L{ w r �. h to tn t � we n CLAIM BOARD OF OF SUPERVISORS OF CONMA COSTA CQUiTY, CALIFORNIA BOARD ACT1011t DECEMBER 5, 2000 Claim Against the County, or district Governed by ) 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 California Government Codes. .- = 77 notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given t;<,., 5 pursuant to Government Code Section 913 and Pi 4`CI �. 915.4. Please note all "Warnings". AMOUNT: ,JURISDICTIONAL MINIMUM OF CLAIMANT: HEATH NUNES ATTORNEY: c/o ROBERTS. ARNS DATE RECEIVED: NOVEMBER 2, 2000 ADDRESS: THE ARNS LAW FIRM BY DELIVERY TO CLERK ON: NOVEMBER 2, 2000 101 Spear Street Suite 215 LAND-DELIVERED San Francisco CA 94105 BY MAIL POSTMARKED: I. PRONE Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: NOVEMBER 2, 2000 By: Deputy H. FROM- County Counsel TO: Clerk of the Board ofSupervisors ( A This claim complies substantially with Sections 910 and 910.2. ( ) This claim PAILS 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: Py Dated: By: /// uty County Counsel M. FRONI Clerk of the Board TO: County Counsel (1) County Admini /tor (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:_ r_ r' PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code sectio 13) 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 N AHJNG 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: 0/:Z." By: PHIL BATCHELOR By `' �— Deputy Clerk CC: County Counsel County Administrator 1 CLAIM AGAINST PUBLIC ENTITY 2 ---.� TO: BOARD OF SUPERVISORS N V • 2 0 4 COUNTY OF CONTRA COSTA CL KS S 65;1 Pine St. Com iAS •` Martinez,CA 94553 6 DEPARTMENT OF PUBLIC WORKS 7 COUNTY OF CONTRA COSTA 8 255 Glacier.Drive Martinez, CA 94553 9 10 CONTRA COSTA COUNTY FLOOD CONTROL&WATER CONSERVATION DISTRICT 11 651 Pine St. Martinez, CA 94553 12 13 COUNTY OF CONTRA COSTA PUBLIC WORKS MAINTENANCE OFFICE 14 2475 Waterbird Way is Martinez,CA 94553 16 CITY COUNCIL CITY COUNCIL OF ANTIOCH 17 3`d&H Streets 18 Antioch,'CA 94509 19 Please Take Notice that the undersigned hereby serves and makes a demand upon you 20 for the cause and amounts set forth in the following claim: 21 Claimant's Name and Address: 22 23 Heath Nunes 8181 Street 24 Lincoln,CA 95648 25 Claimant's Mailing Address 26 Robert S. Ams 27 THE ARNS LAW FIRM 101 Spear Street, Suite 215 pub 'oWm I San Francisco, CA 94105 2 Amount of Claim: i 3 Special damages, expenses and general damages legally caused by the occurrence 4 5 described below are in excess of the jurisdictional minimum of the Superior Court. Claimant s seeks damages in the amount of Special damages consisting of$2,900,000.00 past and future 7 wage loss and approximately $100,000.00 in future medical; General damages of 8 $2,500,000.00. 9 to Date of the Occurrence Giving Mise to the Claim Asserted: 11 This incident giving rise to the claim herein occurred on or about August 30, 2000, in 12 Antioch, California during the construction of a new water tank for the City of Antioch and/or 13 County of Contra Costa. Claimant. 14 15 Description of the Occurrence: 16 That on or about the aforementioned date, the above named public entities by and 17 through their agents, servants, and employees whose,names and identities are unknown to 18 claimant, owed a duty of reasonable care toward claimant and others based upon said Public 19 20 Entities ownership, possession, and operation of the subject premises where the injury causing . 21 incident occurred. Said duty was based upon said Public Entities', contractual obligations, 22 custom and practice in the industry,right to control the details of the work, exercised of control 23 over the details of the work, authority to control the details of the work, and the coordination of 24 25 the details of the work. zs 27 2s -2- pub adW claim 2-1ubYclaim 1 Additionally, said duty was premised on said Public Entities' obligations to furnish men 2 and materials to the project that were safe and appropriate, and to bidi the job with all required 3 safety included within the bid. 4 5 Additionally, said duty is based on the requirements of Civil Code §1714 requiring all 6 persons to act in a reasonable manner toward others. 7 Also, said duty is based on the requirements of Cal OSHA § 8.3212. Floor Openings, 8 Floor Holes and Roofs, in conjunction with Labor Code §6400 and §6304.5. In that said public 10 entity was an "employer" as that term is used under the Labor Code and had duty to ensure 11 compliance with said safety regulation. Claimant contends that said Public Entity is negligent 12 per se failing to properly cover the hole pursuant to said safety regulation. 13 Said Public Entities, and each of them breached said duty by negligently, carelessly and 14 1s recklessly constructing, inspecting, maintaining, contracting, subcontracting,. supervising, 16 controlling engineering, designing, performing, planning and holding out for bid, construction 17 work and supplying men and materials for the job site referred to herein, in that said Public 18 Entities failed to coordinate and.control the work being performed on said job site in a safe and 19 20 proper manner,thereby creating a risk of injury to men working on said job site. 21 Further, said Public Entities, and each of them breached said duty by negligently failing 22 to request any precautions in the written contract between parties and failed to properly bid the 23 work being done at the time of the incident. Said Public Entities failed to anticipate and require 24 25 bidding on specific items of safety that were lacking on the subject job. Said job should have 26 required line items of safety within the bid and required contractors to provide for the hazards 27 identified. 29 _3_ pub=My claim I Further, said Public Entities, and each of them, negligently and carelessly allowed the 2 area where claimant and others were working to exist and remain in ai dangerous condition; and 3 further that they failed to provide adequate safety devices and floor opening barricades, caution 4 s tape or secure covers in and about the area where claimant and others were working; that said 6 Public Entities, and each of them, had actual or constructive knowledge of the unsafe 7 conditions, as aforesaid. s Further, said Public Entities, and each of them, failed to provide claimant and others 9 to with safe and proper access to the work; that said Public Entities, and each of them, failed to ii provide safe and proper work platforms, flooring materials, and floor opening covers and/or 12 barricades; and further in that they negligently and carelessly failed to provide proper and 13 adequate equipment and methods to transport, store, secure, install construction materials, and 14 15 further failed to properly and safely plan, control and supervise the said construction site on 16 said job site,and 17 Further, that said Public Entities, and each of them, failed to have pre-job safety and 18 planning conferences and failed to have a site specific safety plan that included discussions of 19 20all potential hazards. 21 As a direct and legal result of the.negligence and carelessness of said Public Entities, 22 and each of them,while Claimant,HEATH NUNES,was assisting in the construction of a new 23 water tank for the City of Antioch/County of Contra Costa,he stepped on what appeared to be 24 25 solid ground, but in reality was hole concealed by plastic tarp covered with debris. Claimant 26 fell up to his waist into the hole injuring his leg and back. 27 28 -4- pub a&y cWm 1 Additionally, said duty is based on the requirements of Rowland v. Christian (1968) 69 2 ; Cal.2d 108 regarding liability of land for a possessor of the premises. i 3 Additionally, said duty is based on the requirement of said Public Entities, and each of 4 s them,to provide a safe place for claimant to work pursuant to Labor Code §6400. 6 Said Public Entities and each of them created, maintained, controlled and allowed a 7 dangerous condition of the premises to exist in the area where claimant and others were 8 working. Said dangerous condition consisted of hole concealed by a plastic tarp covered with 10 debris. In the alternative, said Public Entities and each of them were aware or should have been 11 aware of said dangerous conditions. 12 This dangerous condition was not known or reasonably discoverable by the claimant or 13 others, and the condition was not the subject of the work contemplated by the claimant or his 14 15 employer. Additionally, the risk of this dangerous condition was increased by said .Public 16 Entities' own affirmative conduct. 17 As a direct and legal result of the negligence and carelessness of said Public Entities, 18 and each of them, while claimant was assisting in constructing an water tank for the City of 19 20 Antioch / County of Contra. Costa, claimant stepped on said concealed hole and fell up to his 21 waist into said hole. Claimant was caused to sustain severe personal injuries. 22 23 24 25 26 27 28 5 pub entity oWm I Description of Injury: 2 The above described occurrence caused injury to claimant'sback and knee the exact 3 nature of which is unknown to claimant. 4 s 6 DATED: October 30, 2000 THE ARNS LAW F 7 8 By: 9 PAEyr to 11 12 13 14 Is 16 17 18 14 20 21 22 23 24 25 26 27 28 .6. pub mdty claim i CERTIFICATE OF SERVICE 2 I,the undersigned,declare as follows: 3 I am a citizen.of the United States, over the age of 18 years and not a party to, nor interested in, the 4 above-entitled action. I am an employee of The Arns Law Firm, A Professional Corporation, and my business address is 101 Spear Street,Suite 215,San Francisco,CA 94105 5 On November 2,2000,1 served the following: claim Against Public Entity on all interested 6 parties in the above cause,by: 7 REGULAR MAIL by placing a true and correct copy thereof enclosed in a sealed envelope with postage thereon fully prepaid. Said envelope was thereafter deposited in the United States Mail at San 8 Francisco, California in accordance with this firm's business practice of collection and processing correspondence for mailing of which I am readily familiar. All correspondence is deposited with the United States Postal Service g on the same day in the ordinary course of business. 10 ,OVERNIGHT MAIL by placing a true and correct copy thereof enclosed in a sealed overnight service envelope with postage thereon fully prepaid. Said envelope was thereafter deposited with the 11 overnight service at San Francisco, California in accordance with this firm's business practice of collection and processing correspondence for overnight service of which I am readily familiar. All correspondence is deposited 12 with the United States Postal Service on the same day in the ordinary course of business. 13 X HAIR DELIVERY by placing a true and correct copy thereof enclosed in a sealed envelope with the name and address of the party to receive the document. Such document was then given to the service or 14 individual signing the bottom of this Proof of Service showing delivery made. 15 FACSIMILE by placing a true and correct copy thereof with a facsimile cover sheet showing service upon the following individuals. 16 The envelopes were addressed as follows: 17 BOARD OF SUPERVISORS DEPARTMENT OF PUBLIC WORKS 18 COUNTY OF CONTRA COSTA COUNTY OF CONTRA COSTA 651 Pine St. 255 Glacier Drive 19 Martinez,CA 94553 Martinez,CA 94553 20 CONTR A COSTA COUNTY FLOOD CONTROL& CITY COUNCIL WATER CONSERVATION DISTRICT CITY COUNCIL OF ANTIOCH 21 651 Pine St. 3'd&H Streets Martinez,CA 94553 ANTIOCH,CA 94509 22 COUNTY OF CONTRA COSTA 23 PUBLIC WORKS MAINTENANCE OFFICE 2475 Waterbird Way 24 MARTINEZ,CA 94553 25 1 declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct: 26 Executed on November 2,2000 'S Francisco, i rma. 27 28 { ANA O A a1. CLAIM (tee ViaAM DECEMBER 5,_ 2000 Crim Against the County, or District Governed by ) 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 California Government Codes. } notice of the action taken on your claim by the ° Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and r .:. 915.4. Please note all "Warnings". AMOUNT: $75.00 . .,`,`,Tf COUNS5L NEZ CALIF- CLAIMANT: STUART j. pOON ATTORNEY: DATE RECEIVED: NOVEMBER 2, 2000 ADDRESS: 2345 DAPPLEGRAY LANE BY DELIVERY TO CLERK ON: NOVEMBER 2, 2000 WALNUT CREEK CA 94596 BY MAIL POSTMARKED: NOVEMBER 1, 2000 L FROM; Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: NOVEMBER 2, 2000 By: Deputy !V\-/ II. FROM: County Counsel TO: Clerk of the Board f 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 911.0. ( ) Other: f Dated u{;- r 3 Z0496 By: ZDeputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) Coin Administrator (2) ( ) Claire 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. r'" Dated: ,,, .?, � ' PHIL BATCHELOR, Clerk, By , rGc�'t Deputy Clerk WARNING (Gov. code section913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. :Dated: By: PHIL BATCHELOR BDeputy Clerk CC: County Counsel County Administrator I-Alm 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 personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100'` day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988,must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code§911.2.) B. Claims must be filed with the Cleric 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 eachpublic entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim by ) Reserved for Clerk's Filing Stamp RECEIVED Against the County of Contra Costa NOV .. 2 2000 or CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. District) (Fill in Name) The undersigned claimant hereby makes claim against the County of Contra Costa or the above named District in the sum of S. �and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact nate and Hour) °toy , . 0 �;RK `70 m k ��oo & X30 2. Where did the damage or injury occur? (include city and County __ ___ ------------ ___________ ____ j L -m J 6ON T 47-h ------------------------------------------------------------------------------------- 3. How did the damage or injury occur? (Give INA details,use extra paper if required) b v ON YPU rTF 5)OF 0-F- ic '------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? 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AMOUNT: TO BE DETERMINED CLAIMANT: NOEL ROBERTS MARTIN. CALIF' ATTORNEY: c/o ANNE M. WHATLEY DATE RECEIVED: NOVEMBER 3, 2000 ATTORNEY AT LAW ADDRESS: 1.735 ALHAMBRA AVENUE BY DELIVERY TO CLERK ON: NCVEMBER 3, 2000 MARTINEZ CA 94553-2501 BY MAIL POSTMARKED: Hand-Delivered L FRONE Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated:NOVEMBER 3, 2000 By: Deputy H. FROM: County Counsel TO: Clerk of the Board o Supervisors ( his 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: Dated: ���c '" By: t7 Deputy County Counsel 111. FRONL• 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:_ & PHIL BATCHELOR, Clerk, By �. 1�, 4? , 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: DLL , By: PHIL BATCHELOR By Deputy Clerk CC: County Counsel County Administrator Claim 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 personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100 `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. (Gov't 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. ru . See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp Noel Roberts ) RECEIVED } Against the County of Contra Costa or } } CLERK BOARD OF 5#JPERVISORS 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$- THD - and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) May 3 , 2000 @ approximately 101.45 p.m. 2. Where did the damage or injury occur? (Include city and county) Martinez , Contra Costa County 3. How did the damage or injury occur? (Give full details; use extra paper if required) See attached letter. 4.- What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? Negligent maintenance of sidewalk. 5. What are the names of county or district officers, servants, or employees causing the damage or injury? Does 1 thru 10. 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) Injury to right ankle . 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Amount to be based on medicaL bills , wage loss and pain and suffering . 8. Names and addresses of witnesses, doctors, and hospitals. Contra Costa Regional Hospital - Martinez Dr. Cadang - Hercules San Francisco Specialist 9. List the expenditures you made on account of this accident or injury. DATE TIME AMOM Expenditure documents being assembled. Gov. Code Sec. 910.2 provides "The claim must be signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attorney Name and Address of Attorney ) Anne M. Whatley ) "7� Attorney at Law ) 1735 Alhambra Avenue ) (Claimant's Signature) Martinez , CA 94553-2501 ) 2538 Leslie Avenue (925 ) 228-0800 ) (Address) Martinez , CA 94553 ) Telephone No. )Telephone No. {925} 313-9357 ****************************************************************************************** NC1nCE Section 72 of the Penal Code provides. Every person who,with intent to defraud,presents for allowance or the payment to any state board or officer,or to any county,city,or district board or officer,authorized to allow or pay the same if genuine,any false or fraudulent claim,bill,account, voucher,or writing,is punishable either by imprisonment in the county jail for a period of not more than one year,by a fine of not exceeding one thousand($1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars($10,000),or by both such imprisonment and fine. WHATLEY LAW FIRM ANNE M.WHATLEY Attorney at Laws 1735 Alhambra Avenue+Martinez*{,A*94553*Telephone(9251228-0800*Facsimile(92$)228-9898 WILLIAM R.CROCIATA KAREN M.JUNES Ofte Manager . Legal Assistant November 3,2000 County of Contra Costa 651 Pine Street Martinez, CA 94553 Re: Neel Roberts Dear Sir/Madam: All correspondence concerning this claim should be directed to the above address. The incident giving rise to this claim occurred on May 3, 2000. The incident giving rise to this claim occurred in an unincorporated area of Martinez in Contra Costa County on Vista Way(between Palm Avenue and Howe Road). This claim arises from the following facts: In the late evening of May 3, 2400 while walking her dog at 10:45 p.m.,Noel Roberts fell on the sidewalk where the cement dropped below the rest of the sidewalk surface. Where the sidewalk drops down, it is approximately 2 �/4 inches lower than the surface. There are no street lights in this area. There were no porch lights on in the area. The County of Contra Costa acted negligently in that the County is the entity responsible for maintaining the sidewalks located in the unincorporated area of Martinez, where this incident occurred. Ms. Roberts suffered a "severe sprain" to her right ankle requiring medical treatment including the prescription of a walking cast. Very truly yours, WHLEY LAW FIRM Y� AN M. WHATLEY Attorney at Law AMW:kj Enclosures CI.,AIM ',BOARD OF SUPERVISORS OF CONTRA COSTA CQUNno CAI IFORNIA BOARD A00 DECEMBER 5, 2000 Claim Against the County, or District Governed by ) 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 California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given - pursuant to Government Code Section 915 and ( , , 915 4 Please note all "Warnings". AMOUNT: $10,5000.00 COUNT? f MAR�`fi''e CA,ciF.L' >t CLAIMANT: MARY S. ATTORNEY: DATE REAM61 11t'5I&OVEMBER 2, 2000 ADDRESS: GENERAL DELIVERY BY DELIVERY TO CLERK ON: NOVEMBER 2, 2000 PLEASANT HILL, CA 94523 BY MAIL POSTMARKED: NOVEMBER 1, 2000 L FRONE Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: N0VEM]3ER 2, 2000 By: Deputy --' H. FROM: County Counsel TO: Clerk of the Board f Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. { ) This claim NAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.$). { ) 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: t r - ,Jt t , Dated: LV ftlt• L&( _00&) 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: _ ` PHIL BATCHELOR, Clerk, By GY J l , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MA -ING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: =, By: PHIL BATCHELOR By ,r putt' Clerk 1 CC: County Counsel County Administrator - October 26, 2000 RECEIVES NOV - 2 2000 CLERK BOARD SUPERVISORS CONTRA COSTA CO. Contra Costa County J Board of Supervisors 651 Pine St. Martinez, CA 94553 CONFIDENTIAL Reference: Notice of Claim Dear Sirs: Enclosed is claim information in an amount stated. I believe that you need to get your priorities straight. Are you as an authority, and one that the public looks to, for statutory rape, or, are you as an authority against statutory rape? You put a young girl' s life in danger in a negligent manner. I am concerned that more young girls will attempt to end their lives, due to your current policies, practices, and promotions . You need to realize how that is affecting and impacting other members of the public, and you failed to guard against that from happening. This is not a "frivolous" claim. It is not so much for or against either the minor female in the case or the defendant. It is important to get to the truth of what happened, and I am seeking compensation for injuries to the public that were negligently caused. Please close the teen clinic located in Concord, it is a clinic of ill-repute, and is not necessary in our county. Teens can get standardized medical care at regular, not specialized, clinics in Contra Costa. Please notice that the same state and county that was prosecuting Bloom, was also dispensing condoms to 16 year-old males in the county. This is a gross conflict of interest. Teenage girls do not generally move in circles where older men congregate and are, and I am questioning why the minor female in the case was placed in that environment (the cadet program) under the direction of the county. Please note that I have not put my last name to the claim as yet, due to the sensitivity of the matter. I also would like to add that I do not know Wayne doom or his lawyer, and I have filed this claim of my own accord without their knowledge. Please send any notices or informational messages to the mailing address stated on the claim. Sincerely, ;' . I / Mary S. IN THE MATTER OF THE CLAIM OF: MARY S. , a County resident AGAINST Contra Costa County Name and P.O. Address of Claimant General Delivery Pleasant Hill, Ca 94523 SPACE ABOVE FOR CLAIM NO. STAMP THE UNDERSIGNED CLAIMANT HEREBY MAKES CLAIM AGAINST: Contra Costa County IN THE SUM OF $ 10,500 .00 AND IN SUPPORT OF SAID CLAIM REPRESENTS THE FOLLOWING: 1 .WHEN DID THE DAMAGE OR INJURY OCCUR? May 9, 2000 2 .WHERE DID THE DAMAGE OR INJURY OCCUR? Walnut Creep Superior Court, C.C.C. 3.HOW DID THE DAMAGE OR INJURY OCCUR? Dissemination of factual matter to the public by public officers related to the case, - maintaining an artificial premises, 2450 Stanwell Dr. , Concord, CA, representations by public officers related to the case 4,.WHAT PARTICULAR ACT OR OMMISSION OF THE PUBLIC OFFICERS, SERVANTS OR EMPLOYEES CAUSED THE INJURY OR DAMAGE? Same as item #3, biased investigation of Wayne Bloom leading to prosecution, placing the associated minor female' s life in danger, engaging in agreements that: (1) are contrary to public morals and injurious to public safety, (2) that solicit and exploit minor females in the county, (3) that promote greater victimization of minor females though unequal penalties, (4) that promote illicit sexual activity involving minor females, (5) that tend to restrain marriage, (6) that glorify teen pregnancy, (7) that bring about privatization of the district attorney' s office S.WHAT ARE THE NAMES OF THE PUBLIC OFFICERS, SERVANTS OR EMPLOYEES WHO CAUSED THE DAMAGE OR INJURY? Including, but not limited to: members of the district attorney' s office, members of the sheriff' s department 6.WHAT DAMAGE OR INJURIES DO YOU CLAIM RESULTED? Reckless infliction of emotional distress to innocent and unsuspecting members of the public, bodily harm 7 .HOW WAS THE AMOUNT CLAIMED ABOVE COMPUTED? Medical expenses - $ 47 .00 Future medical expenses - Emotional trauma - $ 10, 453.00 Misuse of public funds, Public accounting of printing costs for Not yet computable minor female promotional announcements: or known B .-NAMES AND ADDRESSES OF WITNESSES, DOCTORS AND HOSPITALS G. Vreeland, M.D. , Gregory Lane, Pleasant Hill, CA EXPENDITURES MADE ON ACCOUNT OF ACCIDENT OR INJURY See above. Medical bills, pharmaceutical bills SEND NOTICES TO CLAIMANT AT THE FOLLOWING MAILING ADDRESS: General Delivery Pleasant Hill, CA 94523 Signa r of Claimant 0 ut 0 P-1 a; 0 m (;) Q-4 $4 >, U :: 0 0) ro > ulZ cc w as oi 41-4 m w 0 co AjcU• -r4 W a) va to 0) '4 w 0 ga. W CO W 4j4 0 u 0 s� to W Q W 0 u co 0 co > co w �w w ca = 10 to 0 04 a) to 10 w 0 4) w ba to 44 =u u I 0 >0) 0 0 41 cl. 44 -4 Cdrw to 1:- 1-4 �• 0 " A4 as =) u w ;Lj co Cd w < to p 0, . 0 k-4 > w Cd u -e. ca04 .1-1 co 0 co U PO U to u a) 9 0 -4 6 = >1 0 4-4 0 0 U ttl AJ -H -4 E-4 44 VI) 0 0 0 > 0 U) r. . 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GL p. to 0 to w 41.3 0 0 0 U 4 1 4-4 41 .,4 p, m a Wm 0 $4 Lk 6j toru toco • .,4 U E- C14 bo > 4) W (L) :3: m E-0 rn 0 0 mod pq 16m daft cn 0 74-9 Sentencing Guidelines for Common Offenses §74.2 Pen C§ Description of Crime Sentence lam~ -247(b) Discharging firearm at uninhabited 1 year and$1,000 maximum(Pen C§672); building or unoccupied vehicle defendant may not possess firearm for 10 years(Pen C§12021(c)(1)) 261.5(b) Unlawful sexual Intercourse with minor 6 months and/or$1,000 maximum(Pen C who is not more than 3 years-aider or 3 §19);discretionary maximum$70 additional years younger than defendant(Note:Pen fine for AIDS education fund(Pen C C§264 is inconsistent with§261.5(b)in §§264(b), 1463.23);mandatory AIDS testing that it provides maximum 1-year county (Pen C§1202.1);defendant may be liable for jail term and defines all violations of Pen civil penalties(Pen C§261.5(e)) C§261.5 as wobblers) '261.5(c) Unlawful sexual intercourse with minor 1 year and$1,000 maximum(Pen C§672); who is more than 3 years younger than discretionary maximum$70 additional fine for defendant AIDS education fund (Pen C§§264(b), 146323);mandatory AIDS testing(Pen C §1202.1);defendant may be liable for civil penalties(Pen C§261.5(e)) `261.5(d) Unlawful sexual intercourse with minor Same as above who is under age 16 by defendant 21 year;of age or older `266 Seduction of minor for prostitution 1 year and/or$2,000 maximum;additional mandatory fine of$100(1st offense)or$204 (2nd or subsequent offense), unless defendant unable to pay(Pen C§290.3); mandatory registration with law enforcement under Pen C§290 '266c Inducing commission of sexual act 1 year and$1,000 maximum(Pen C§672); through false representation creating fear mandatory registration with law enforcement under Pen C§290 `270 Non-support of minor child (wobbler if 1 year and/or$2,000 maximum defendant acted with notice of court adjudication that he or she is child's parent) 270a Abandonment or non-support of spouse 6 months and/or$1,000 maximum(Pen C §19) 270c Adult child's non-support of indigent 6 months and/or$1,000 maximum(Pen C parent §19) `271 Desertion of child under age 14,with 1 year and/or$1,000 maximum Intention to abandon '271a Abandonment or refusal to maintain child 1 year and/or$1,000 maximum under age 14 272 Contributing to the delinquency or 1 year and/or$2,500 maximum;probation for dependency of a minor maximum 5 years;registration with law enforcement under Pen C§290 and additional mandatory fine of$100(1st offense)or$200(2nd or subsequent offense) under Pen C§290.3, if offense involves lewd and lascivious conduct •Wobbler,alternative rrusdemeanortfelony I STD/Family 1 CONTRA COSTA PACT ` 1—:2 Public Health Billing \ a division of Sheet Health Services l 4 vise Date: 4 Insurance T e: circle MediCal ' F-P.A.C.T CCHP Private Pav 1,GbMNT PAYMENT circle): Insurance# I L Nqm CLERKIAIDE Print Name): Y --n 0 a ' C, Copa $ PRIMARY DX CODE CONDITION CQDE SECONDARY DX CODES tifePDecaeNi NEW VISIT EXAM(minutes) BARRIER:SpemVNFPIFAWAB&50*kPreg ❑ FA Oral Contraceptive CHLAMYDIA Ml7>FNP 10 20 30 40 Other Eval S501 ❑NSU/NGU (7994 — ❑ FB Contraceptive Injection ❑Urethritis-CT 09941 RN 10 15 30 40 Other ❑ Maintain 5502 ❑ FC Contraceptive Implant ORAL CON(COC,ECP,POP} p p ❑Lower genitourinary sites 09953 ❑ FD IUD ❑Other Other 10 20 30 40 Other ❑ Eval 5101 GENITAL HERPES ❑ Maintain 5102 ❑ FE Diaphragm ❑Genital herpes,unspecified pacified 05410 ®initis!FP Counsel(Female) 29751 INJECTION ❑ FG Spermicides ❑Other ❑ Eval 5201 FH Male Condom GENITAL WARTS ❑Male Ed/Counsel 29752 ❑ Maintain 5202 13 Viral warts 0781 RETURN VISIT EXAM ❑ FI Female Condom 12Other (Minuses) IUD 13 FJ Fertility Awareness GONORRHEA MD/FNP 5 10 15 25 Other ❑ Evai 5401 ❑Urethritis-Acute 0980 ❑ Maintain 5402 EI FK Natural Family Planning ❑Cervicitis-Acute 09815 RN 5 10 15 25 Other IMPLANT/NORPLANT ❑ FL Sterilization ❑GC-Pharnyx 0986 ❑ Eval 5301 13 FM 0987 FM Infertility Management 11 RETURN ED/COUNSEL(Minutes) 0 Other ❑ Maintain 5302 ❑ FP Rely on Female Partner PELVIC INFLAMMATORY DISEASE MD/FNP(F.�r) 15 30 45 Other [Pregnancy Test Only 5601 Method ❑Acute 6150 ❑Confirm Pregnancy Test 560213 FQ Seeking preg or preg ❑Chronic 6151 . RN ,rem) 15 30 45 Other 13 Other❑BTL (Screen/Eval) 5701 test with no FP method SYPHILIS ❑Vasectomy(screen/Eva)) S801 or client defers sexual Other FWnale} 15 30 45 Other ❑Other ❑Fertility Evaluation 5901 activity VAGINITISNAGINAL DIS RGE Male Ed/Counseling 29752 LABORATORY MEDICATIONISUPPLIE3 ❑Candidiasis arvwvaand v 1121 ❑Trichomonal vuivovag�i �" 3101 ❑ Thin Prep 88141 ''BARRIER(X1500) ❑Cervicitis and endocervit�tis Al 60 ORALTREATMENTS • LCR GC 87591 Condom-M # 11 VAGINITIS AN DVULVOVAGINTTiS—' 6161 13Azithrom cin 250m #4 X7716 [3 Other _ y g ❑ LCR-CT 87491 ❑ Condom-M-LF # Z7610 ❑ Phi Determination 83986 11 ❑UTI 599 Condom-F # CONCURRENT rite applicable) ❑ Acyclovir 200mg#50 ❑ Wet Mount n87210 ❑ Diaphragm # ❑DYSPLASIA 6221 ❑ Cephalexin 250mg#40 C7 Herpes Cutture(H )$7252 X Film-VCF #= ❑ Clindamycin 150mg#28 ❑ Gonorrhea Cult. 87081 ❑ Foam # ❑ Bicillin 2.4r„uu(600,000uwcc) 5770 ❑ Doxycycline 1 00m#14 ❑ Gram Stain 87205 ❑ Gel # ❑ Ceftriaxone 250mg X5864 ❑ Doxycycline 1 00m#20 ❑ Darkfield 87164 ❑ Other: # ❑ Ceftriaxone 125mg X5864 ❑ Doxycycline 1 00m#28 ❑ Urine Preg.Test 81025 ❑ Other ❑ Erythromycin SOOmg#28 ❑ Urine Dipstick 81000 OC(X7708) CREAMS 27610 ❑ Fluconazole 150mg#1 ❑ Hemoglobin 85018 ❑ LoOvrai # ❑ Clindamycin 40gm tube ❑ Metronidazole 500mg#4 ❑ Clotrimazole 45gm tube ❑ VDRL 86592 ❑ Micronor # ❑ Miconazole 45gm tube ❑ Metronidazole 500mg#14 ❑ Blood Collection & ❑ Ortho-Cyclen # ❑ Miconazole 2% 28 gm tube 1:7 Metronidazole 250mg#21 Other Sry 25220 ❑ Ortho-Tri # ❑ Terconazole 45gm tube ❑ Nitrofurantoin 1 00m#28 PROCEDURES(Female Onl ❑ Ovrette # 2 ❑ Ofloxacin 400mg#1 ❑ Wart Treatment (56sor,5esoizm) 0 Benadryl 25mg#10 5738 13 Other: # ❑ Ofloxacin 4OOmg#28 ❑ IUD Removal (58301+5e30,zM) ❑ Compazine 1 Omg #4 ❑ TMP/SMX(160/800mg)#6 ❑ Diaphragm Fitting (57170) C3 DMPA X6051i50m #1 ❑ Podophyllum Resin 1ccZ7610 ❑ Other: ( ) El Other: ❑ Other: ❑ Other: PHOS FP018 Rev.7/30199 _ ..__ .._ ..... ......... ......._. ......... .................................... _... FRIDAY, MAY 19, 2000 A23 ' • it M, Dismissed Uty vould be a geld mine." Pleads Not Guilty Ier f �� wTo Assaulting 'O r Bail hearing set for this afternoon By Charlie Goodyear ,�tyt x+ � °�• , CHRONICLE STAFF WRITER Comedian A veteran Contra Costa sheriff's /// u� deputy fired last week after he wase N w n s charged with having sex with a 17- DoBotched r year-old sheriffs cadet pleaded not r N guilty yesterday amid allegations " 4Na that he used his uniform as a"dating Bypass Surgery draw." Wayne Bloom remains jailed in By Harriet Chiang l� Alameda Count;,on S190,000 bond +n `yeti ��.. CHRONICLE LEGAL AFFAIRS WRITER �} pending a bail hearing this after ;. noon. Comedian Dana Carvey said it u la ! Prosecutors re,.Baled that the Vic- as a somber day when he learned tim in the case attempted suicide that a doctor had operated on the <" last week. ,vrong artery during Garvey s dou- Bloom. 39,was charged with four ble bypass surgery in 1998. ° counts of statutory rape and one Garvey, who has a family history count of oral copulation with a mi- of high cholesterol, had the surgery � X• 'an,, a nor after an internal investigation to clear a blocked artery.Because of that allegedly showed he had sex the surgical mishap,the blockage in •,t with a teenager he met through the the diseased arter_tiremained. He '4n department's cadet program. has since made a•complete recov- 'The sex acts took place in March ery.But yesterday he was in court to and April at Bloom's apartment in testify in his 57:5 million lawsuit San Ramon after he went off-duty against the San Francisco surgeon from his,swing shift,police said.Au- who made the mistake. KAT WADE!The Chronicle thorities were alerted after the girl After he learned of the botched )mmunity Center in Concord, laughed with an employee. did not return home for a day and surgery, he said; he was devastated. her mother filed a missing persons "I remember just wing in my bed report. just sobbing," Caney told the jury In court yesterday, Bloom, in San Francisco Superior Court. "I dressed in red jail clothing and can't believe they connected it to handcuffed, said simply, "Yes,Your the wrong artery,"he kept saying to TEENAGER:Page A24 Col.4 ►CARVEY:Page A26 Col. I 0 (Dm ID) (D � 0 2 � @ � � a Ln N) . Q . % mm $ �� Rz 10 $ R = (D 0 i / J0 UCo (-t ` ko n _� . ,: a (A) } ■ � � � � - \ 0 . � t;ounrys urban umiL ane will ve Uuln vi wttaLrvCi .-. .- -.-»v held June 7. Justments the state gives the Dublin period• r r D-%Pu'LY Pleads Not Guiltyt ► Assault Char ie" . TEENAGER ki said. count that this is not some violent one out to hurt From Page A23 The prosecutor said Bloom ssomebod tor thaGa en said outside he e might be a flight risk because he y g cmade a statement before his arrest courtroom. 9 Honor,"when Contra Costa Superi- that he was "going to resign his or Court judge Merle Eaton asked position and move to Nevada." The attorney said that his client is whether he was agreeing to waivejailed in a cell for 24 hours a day his rights to a speedy preliminary Bloom's attorney, Bill Gagen,in- because of his status as a former hearing sisted that his client would continue peace officer.Gagen called the con- te to cooperate with authorities, not- finement more appropriate for a "c Prosecutor Dana Filkowski told ing that Bloom had turned himself � "mass killer." s Eaton that Bloom should be consid- in and never attempted to coerce or ered a flight risk and a threat if intimidate the victim during the po- Eaton indicated that he is willing of released from jail. lice investigation. to lower Bloom's bail,although not to the $10,000 level suggested by iat 6 s There is a belief in our office Gagen said both Bloom's mother the defense. Attorneys will discuss ed that the defendant is a danger to the and brother —who attended yester- today whether Bloom can be placed community,"she said. day's hearing — live in Livermore on electronic home detention. where Bloom plans to stay if he is ne Investigators have learned that released on bail. Bloom's brcther is Bloom faces a maximum five Ve Bloom posed in uniform and with a police officer in Alameda County years,eight months in prison if he is pt. his patrol car for a picture that was and accompanied Bloom earlier this convicted. He was fired last week ire posted on an Inte-net matchmaking month when he turned himself in. after a 13-year career with the de- ise site. Bloom "appears to be using his partment.Police said Bloom has ad- uniform as a dating draw," 1 iikows "One does have to take into ac- mitted the relationship. DaewooUS—com ► 87VAEWOO __--.__ CLAIM _ BOARD OF SUP RTO S OF CONTRA COSTA C UNIL CAI IFORNIA_ �ARp ACTIN DECEMBER 5, 2000 Claim Against the County, or District Governed by } the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to } The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". F'. s AMOUNT: $370.89 CO UNI Y COUNSEL ir1C 1 i(V P RTii•� .: CrwiR CLAIMANT: EDITH SCHUBERT ATTORNEY: DATE RECEIVED: NOVEMBER 1, 2000 ADDRESS: .3742 GAINSBOROUGH DRIVE BY DELIVERY TO CLERK ON: NOVEMBER 1, 2000 CONCORD CA 94518-1645 BY MAIL POSTMARKED: TRANSMITTAL L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: NOVEMBER 1, 2000 By: Deputy II. FROM: County Counsel TO: Clerk of the Board of S pervisors ( 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: It K j Dated: Czt�� �^-wL" y: t Deputy County Counsel .. M. FROM: Clerk of the Board TO: County Counsel (1) Cou y 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: ``` ' PHIL BATCHELOR, Clerk, By �r?TJ�!, � n 'y 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 M411JNG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: By: PHIL BATCHELOR Byeputy Clerk CC: County Counsel County Administrator Cltiim 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 personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988,must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code§911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building,651 Pine Street,Martinez,CA 94553. C. If Claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity,separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim by ) Reserved for Clerk's Filing Stamp e r Against the County of Contra Costa RECEIVED or NOEng -12000 ('tYV t7 C '�+' District CL R BOARS) SUPERVISORS CONTRA COSTA CO. (F l in Name) The undersigned claimant hereby makes claim against the County of Contra Costa or the above named District in the sum of$ 370, Y J and in support of this claim represents as follows: 1. When did the damage-jvAAvqvt5"iceur? (Give exact Date and Hour) ct - � - - -� �---- --� ---------- -r--f- --- -------------- 2. Where did the damage cf ( e city and county) 3'n , rra�l,n C� 1�l�tCO-f2lr-4� --CO-S l_a___CC)tft2 � --------------- 3. How did the damage occur? (Give tun tails-,use extra paper tf re uired ) 'y y qr, s© nlc�s Q/7 irn car �lrbra� �ir� cf t1i .!;t`q (or f ` �r �t l'"EE' fi J L rt _JLC_ ' _ '? _LC__liQ _ __ l_LE'_ ly 4. What particular act or omission on the pa rf of county or district officers, servants, or empl gees caused the injury or damage? o a ptl CSC P7 ,/t r It L�n � 01 1 " u n d r ct t ! E L of jYT �/ ,y1 '-� (Over) .�' ` re_ �f �� In" M V 'A rate,, a e a j ( +� v i�'f it r?c E' " , ti _1 Z. n k&_dT-Ya 14OLY, ec ._ _....... . _.-_-.. _..-..-_.. t..-. .J, --- (, < _ -fir' __ _; pw pw ;iR E B F- S BGR --v <jV ............ 8�; 97 "F E Ew 7 -2 E P. z,:� Qrc, va, e-,- 'T ........... Am ourt ¢Q yr K E lk z >,e CUSTOMER COPY - SEE REVERSE SIDE FOR TERMS AND LIMITED WARRANTIES -9, Address Tel sphon,,� vehicle (VIM) License Mi i.e aN ... ._ .._..,...:. ._..__.. ,,..w..,._......_._ .._._.._....,_...,,........._._.�..__........_�.__............._....,..,...,_. ..............._......,....,.,,...,.. Time Printed 8/8/00 4011 W, Volkswagen I jetta 1993-99 1. 91., 2. OL (1915-99) € Actual Before }1�`ecified Range!e! -------------Be----------------------At,.L�tC:lfore i�3�.2?f�"3�'ei� FSCi t € ,--------y.---------_,............... -0, 71 t. .*o •)�.., .,_0.90 -0. 30 _... v.� --0 r Camber i NO* i .,,.,0.80 _0.03 _0.30 0.. ��.1 # 0.040 € .0.�.W 0�000 Toe 1 })�� '!� ..T.��st k7 i�.f1%.3� 01 000 i HOM r I , i - .. {. c ♦. ,a i o v .:+c v . �t'6(.f. � h s c v w . + ♦ . . r w f Annie T f ,, .. , . .. . . . . .. 1-1.420 -0.75u U"'>tling &Q-Diff, 1 . . . . . . > .. > . #- .k.. {i C'.A .. 0. l J4 _ .,...._.w.,,......_. .._..._,w.,_..____.._._... f-;'"•,n Cross Camber 0. 10 1 0141 , 1 -0.30 0130 i Total Toe 1 0.041 1 0.040 1-0. 171 0, 170 1 Cross Turn W& i . . . . . € . . . . s ------------------------------------- Left Nat- Right Rear i nt.�.�.& .,€. B. Fore }.'�j:3..c1?`'1,ed Range! i Acf�'}S .al Before Opecified Range! -------- --------+---------------i -------- --------4---------------i 0. 15, 0. _5, 1 0.08', 0.250 ? tt` € 0. 18b 0. 180 0. 080 0.250 _.. --------------------------- ------------------------------- -Rear _._- ,,....,,.__..u...._.. ._._... .......,._.,- ear ----------------------------------- i Actual 1 BeAve 1 ........__.........�_...,,_......._...,...----,...,,..... _.....___..».,,€ Cross Camber e 0 # -0.20 1 -0,30 3 0 0..30 i Total Too 1 0. 330 i 0.330 1 0. 170 0000 Thrust Angle 1-0.020 1-0.020 1-0. 330 0.330 ,,..._.- _,-'_'.,,_..._.....p....._......_......_..,...------ "alp 117-3021M, CA €''age. 026)0704 r;1, E '4;�£?ate#* ,I f�j S� . ,'w��j �^• ?�?+�# ...i %?Y isi: .':.t 'aE�'I^�r�:�#.7 w.r. C��SW '914574 VR 996 PC; odovhm: P'3rts Pat;.km-sber E:! p4 0 Qf'r` t`'8.'f EC;'i _-.?rte yeas sj-,4s' il&0040 n� v •:,i s; Cayf *a 1.oio c.Go 0 U.S.E' >t ..;£RW: lA.wV"" 1TEM ;.AL... -.q.^�4^.>.f..t J��R.t i.*3�_ el a. .'�, FEE ;�...�,T T e E. D "a>;..3SA,....- STATE t f.% 0 .�.f: '.'2.,,' 1 00 115 135 �'`5:as>� t>±e%. `Q, ...�3?rL,f N?iii�.ts !.'"•J...ii5�;'� '.. ........ ..............__}.........._,._. ? �^r_..._._._.._..__.,._ .._._..,...._....�.,-•` �s5,;.1"•__ l'g -a',,.�_............._......... Type Amount F---.arts t t.;i..:f_• $01501 FE t ` ...;gib:tr i ..'�N `wes T•.xa ./12 CUSTOMER COPY - SEE REVERSE SIDE-FOR TERMS AND LIMITED 1NARNTIES �1 1 tit err �r .lS h r CLAIM C 02,. BOARD OF SUPER)ISM ORS O C SURA COSTA C'OUNIL -CAI IEDENIA BOARD ACTIO DECEMBER 5, 2000 Claim Against the County, or District Governed by ) 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 California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given k, _ i,M pursuant to Government'Code Section 913 and -v 915.4. Please note all "Warnings". AMOUNT: $3,153.53 t. CLAIMANT: JAMIE A. STAVERT MARTINEZ CALIF. ATTORNEY: DATE RECEIVED: OCTOBER 25, 2000 ADDRESS: 240 LAWMN ST. , #C BY DELIVERY TO CLERK. ON: OCTOBER 25, 2000 ANTIOCH CA 94509 BY MAIL POSTMARKED: OCTOBER 24, 2000 L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: OCTOBER 25, 2000 By: Deputy �w 1L FROM: County Counsel TO: Clerk of the Board oir 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: f Dated: 1 r ?- ��' - ,�_i wry y: , Deputy County Counsel M. 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. 1 Dated: PHIL BATCHELOR, Clerk, By . eputy 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 NIAILIN+G 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:D&, ?'C� By: PHIL BATCHELOR By _V,-, Deputy Clerk CC: County Counsel County Administrator Claim 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 personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100`h day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988,must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code§911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building,651 Pine Street,Martinez,CA 94553. C. If Claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. I?. If the claim is against more than one public entity,separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec.72 at the end of this form. RE: Claim by ) Reserved for Clerk's Filing Stamp RECEIVED - Against tho County of Contra Costa OCT 2 5 2000 or CLERK BOARD OF SUPERVISORS District CONTRA CO TA CO, (Fill in Name) ` The undersigned claimant hereby makes claim against the County of Contra Costa or the above named District in the sutra of S );'-15.53 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact Date and Hour) •-_ 1i�__ r = __�_ c3 ?`{ei ---------- ---------- 2. Where did the damage or injury occur? (include city and county) 5 C. VAL.LL.-1 RD. k ¢)PPRoy: 'y�; frltt E, Rt7rY1 fna,.,;r e, Itis til H10H eOACQL.,, iOtST t3(-tLAtJC -------------- 3. Dow did the damage or injury occur? (rive Hill details;use extra paper if required) SEC, . ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? CbL,,rtt- +1_"0v17e,0 .-ritf C,,,�3`rRL.,e-n0Nf Fop r�t� ► tF�c� Nt�ustr�lt� ]DsQtL01(n0K) -n,-tf_ 1JoqTlj S t € (>t:: srn(trt- rte , DuC-7 LAD - Ht, -r-, Q,f,VAiQ, .-TW kopf) eoea�c~�t kt. 7-46 (Over) c>P -ri-A {hrJ P-QL .1 •aug pun juautuostxduxt Bans g;0q Sq ao `(000`01S sxnllop punsnogl ua4 gutpaaaxa jou jo auU n Sq 4uostxd alms ag;ut juaxuuosudtut Sq xo'amj pun I.uamuostxdmi gans tpoq Sq to`( 00011S) sxnllop punsnoq;auo gutpaaaxa lou 3o auU n ng 'xnaS auo ungj axotu jou jo potxad n x0;Itnf Slum aqt ut juauxuostxdutt nq xaytra algvgstund st 12ut;pm xo `xaganoA';unoaan `lpq `tutnla aualnpnnx3 ao asst nun`autnua2 jt mus aqt find xo .nolle of pawogjnn'xa:)Ujo xo pxnoq Iatxlstp xo S#a s)unw nun ol xo'.mWo xo pxnoq alvis nun oa luatunnd xoj xo aaunuolln xo,I sauasaxd'pnnxtap ox xua;ut gjIm'ogAt uosaad kma, :saptAoxd apoj Inua,d aq;jo ZL uotiaaS 33IJLOtai °oK auogdala lx� _ ) •oN auogdalaZ )("_�a� g - (ssaxppv) .A- - (axe;nu�tS s�;unuxtnl�) (j-Qd A -N� Sauxouy,Io ssaxppy pun atunm «-jingaq stq uo uosxad auxos Sq xo (nauxouv) :OJL SaaZ,om amas 4uummia aqx nq pauits aq;snux tutnla aq y„ :SapxAoxd Z-016-aaS 3p0,3 •Ao5 b INC.1 SS i�G1 �f k7i'(j ( cx-)`- '9 i IONV WUJA :Unfu!xo luaplaaw stgt jo lunoaan uo aputu non sait tpuodxa ag;4sl I •6 _""- �s '�►'� �1 '_id',� r�1"-74'WNc6 S; �9Z t.,) f t?f "-7�Cl-j 1)h-UJ i 6? and w! iZr_yZ tvlsNrJ `� —� �''�03�7 C3hZ N€7jt}�C?� stn;tdsoq pun Xsxomp Isassaul!mjo sassaxppn pun sauxnN ' •g ----------__________________________________________. ___-______-_____-__-______-_-_-- -3 4-J --Ac -I-jyj::j -�o©-j S3-Lbw"S3 (•aaeump ao Sinful anpadsoxd aue jo;unoure pa;—psa aip aputaul) Lpa;ndxuoa jnnotun pauxtnla aAogn aq;sym A1og 'L -------------------------------------------------------- _ __ ___ (•aaeutsp a;ns jai sal-Psa oey tP 'v 'pau(m saaamvp ao saWnful3o xua�xa tm ahtf)) Zpa;Insax uxtnla non op sazxnfut.xo sagnuxnp 119gA& s '�'�'� s.�vr�'tCr`"��--�f�L-�i�-`.�i�C!C�cr��'��_" "�--7��`nb'�"°�:.�a�_'��'"��.�.'_�"__C7i3`3"►" rbc» ' ?�71,�ti`1�xCx � l,ar� 3N1 LSl��t�"�txC�aa�autf 3?;) u�+dry Qti� /,�rert�itz, Ljtvit,.-;+H .It-?<;f -,?LA) C2.! �.b�t f�C����?Ei`rtt ��� S�anC3or" i1'�1 �0 5?tubi► 3;i� 49infut xo agruxnp aqa Autsnna saanolduxa xo's;unAxas`sxa3wo PYIStp x0 Slunoa P sauxnu ag;an 4vgM g Attachment 3 & 6 My claim against Contra Costa County results from and incident that happened on the evening of June 2"d, 2000, in the unincorporated area of Danville. My claim was first filed with the city of Danville on August 2311, and they informed me that Contra Costa County was responsible for that portion of road where the incident took place (see enclosed letter from Danville's City Attorney and the original claim filed). The facts regarding this incident are: On the above date my roommate, Daric Johnson, who was a passenger in my vehicle (a Chevy 87 5-10 Blazer), co-worker Tim "ruse (not a passenger) had attended a barbecue in Danville at 121 Hope Street at another co-workers home. Daric and I left the barbecue that evening around 10:OOpm to go home traveling west on Stone Valley Road, going towards the freeway ® with co-worker Tim Cruse following behind us on his Harley. About 1/4 mile past Monte Vista High School...the road began to go up a small hill, slope down and turn to the right. What •+h: occurred next was I hit a large patched portion of asphalt in the road - there was no warning signs of uneven pavement, road construction or rough road, I had no time to brake and 4 Esubsequently hit the poorly patched portion of the road and the blazer launched what felt like two feet into the air, hitting our heads on the roof... there was a cracking sound and I sprayed rocks and debris back on Tim Cruse behind me. The headlights went off upon impact. The dash in the Blazer rose about two inches and the engine sounded different. Shaken, I pulled over as soon as there was enough room on the shoulder to inspect my vehicle for damage. The vehicle was disabled and we cautiously drove it back to the co-workers house at 121 Hope Street in first gear, then started trying to obtain a ride home. While waiting, Tim and Daric did a more thorough inspection. We discovered that when we hit the unevenly patched portion of road, that the under carriage portion of the crossmember was damaged and cracked, the vehicle would shift into reverse but in drive would not shift out of first gear (an automatic transmission) and I had a broken transmission mount. Also, the rocks and debris from impact had sprayed back had broken one of the turn signal covers on Tim's Harley. The following day we returned, had the vehicle towed to a transmission repair shop — where repairs were made (see enclosed, invoices). Once the transmission was fixed, I had the front end and crossmember inspected for damage — which estimates are enclosed for these repairs to make my vehicle safe. These are the facts regarding the incident that resulted in the damage to my blazer. Find enclosed statements from the passenger and witness. e x t; r .t i 8 b 45 IJ RECEIVED r. t c%- 2 jtj-�, Date: 9/13100 10:04 AM Estimate ID: 4243 Estimate Version: 0 Preliminary Profile ID: BRENTWOOD[56125] BRENTWOOD AUT'OBODY 4535 O'HARA AVENUE BRENTWOOD,CA 94513-2206 (925)634-6366 Fax: (925)634-2593 Tax ID: 94-2958593 BAR#: AD 199319 Damage Assessed By: RON WARREN Deductible: UNKNOWN Owner JAMIE STAVERT Address: 240 LAWTON STREET C ANTIOCH,CA 94509 Telephone: Home Phone(925)7455-8252 Mitchell Service: 913489 Description: 1987 Chevrolet S70 Blazer Body Style: 2D Ut 100"WB Drive Train: 2.8L Inj 6 Cyl 2WD VIN: 1GNCS18RBH8141487 License: 4HXZ382 CA Mileage: 136,321 OEM/ALT: O Search Code: None Color: BLACK Options: AIR CONDITIONING,POWER STEERING,POWER BRAKES,POWER WINDOWS,POWER DOOR LOCKS TILT STEERING WHEEL,AM-FM STEREO CASSETTE,AUTOMATIC OVERDRIVE,IMPACT STRIPS TRIP COUNTER,2-DOOR Line Entry Labor Line Item Part Type/ Dollar Labor CEG Item Number Type Operation Description Part Number Amount Units Unit -1 310670 FRM REMOVE/REPLACE FRAME ASSEMBLY ORDER FROM DEALER 1,230.60 25.1 24.5T 2 313060 MCH REMOVE/INSTALL R SUSPENSION ONE SIDE -M INC 2.3 3 313070 MCH REMOVE/INSTALL L SUSPENSION ONE SIDE -M INC 2.3 4 313190 MCH ALIGN FRONT SUSPENSION -M 1.5 1.5 5 345020 MCH REMOVE/INSTALL RR AXLE&RR SUSPENSION ASSY -M INC 2.6 Add'I Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals If. Part Replacement Summary Amount Frame 25.1 56.00 0.00 0.00 1,405.60 Taxable Parts 1,230.60 Mechanical 1.5 56.00 0.00 0.00 84.00 Sales Tax @ 8.250% 101.52 Non-Taxable Labor 1,489.60 Total Replacement Parts Amount 1,332.12 Labor Summary 26.6 1,489.60 Ill. Additional Costs Amount IV. Adjustments Amount Total Additional Costs 0.00 Customer Responsibility 0.00 ESTIMATE RECALL NUMBER: 9/13100 10:04:36 4243 UltraMate Is a Trademark of Mitchell International Mitchell Data Version: AUG_00—A Copyright(C)1994-1999 Mitchell International Page 1 of 2 All Rights Reserved Date: 9113100 10:04 AM Estimate ID: 4243 Estimate Version: 0 Preliminary Profile ID: BRENTWOOD[55125] 1. Total Labor: 1,489.60 If. Total Replacement Parts: 1,332.12 Ill. Total Additional Costs: 0.00 {cross Total: 2,821.72 IV. Total Adjustments: 0.00 Net Total: 2,821.72 This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair. ESTIMATE RECALL NUMBER: 9113100 10:04:38 4243 UltraMate is a Trademark of Mitchell International Mitchell Data Version: AUG_00_A Copyright(C)1994-1999 Mitchell International Page 2 of 2 All Rights Reserved Date: 7/12/00 04:29 PM Estimate ID: 8180 Estimate Version: 0 Preliminary Profile ID: GLENN'S GLENN'S AUTO BODY 1610 WEST 10TH STREET ANTIOCH, CA 94509 (925) 778-1330 Fox: (925) 754-5426 Tax ID: 68-0156216 BAR #: A0139236 Damage Assessed By: CHARLIE COWAN Deductible: UNKNOWN Insured: JAMIE STAVERT Mitchell Service: 913489 Description: 1987 Chevrolet 510 Blazer Body Style: 20 Ut 100" WB Drive Train: 2.8L Inj 6 Cyi 2WD VIN: iGNC518R5H8141487 Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units 1 310670 FRM REMOVE/REPLACE FRAME ASSEMBLY ORDER FROM DEALER 1,230.60 24.5 2 933005 BDY ADD'L OPR RESTORE CORROSION PROTECTION 10.00 * 0.5* * Judgement Item Add'I Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 0.5 55.00 10.00 0.00 37.50 Taxable Parts 1,230.60 Frame 24.5 55.00 0.00 0.00 1,347.50 Sales Tax 0 8.250% 101.52 Non-Taxable Labor 1,385.00 Total Replacement Parts Amount 1,332.12 Labor Summary 25.0 1,385.00 III. Additional Costs Amount IV. Adjustments Amount Total Additional Costs 0.00 Customer Responsibility 0.00 ESTIMATE RECALL NUMBER: 7/ 3/00 15:32:32 8180 UltraMate is a Trademark of Mitchell International Mitchell Data Version: JUN-0Q_A Copyright (C) 1994 - 1999 Mitchell International Page 1 of 2 All Rights Reserved r. Date: 7/12/00 04:29 PM Estimate ID: 8180 Estimate Version: 0 Preliminary Profile ID: GLENN'S I. Total Labor: 1,385.00 II. Total Raplacietneert.Parts. 1,332.12 III. Total Additional Costs: 0.00 Gross Total: 2,717.12 IV. Total Adjustments: 0.00 Net Total: 2,717.12 This is a preliminary estimate. Additional changes to the estimate may be required for the actual re air. I HERBY AUTHORIZE THE ABOVE REPAIR WORK TO BE DONE ALONG WITH THE NECESSARY MATERIALS. GLENNS AUTO BODY CAN OPERATE THE ABOVE VEHICLE FOR PURPOSE OF TESTING, INSPECTION OR DELIVERY. GLENNS AUTO BODY WILL NOT BE RESPONSIBLE FOR LOSS OR DAMAGE TO THE VEHICLE OR ARTICLES LEFT IN THE VEHICLE DUE TO FIRE OR THEFT. GLENNS AUTO BODY UNCONDITIONALLY GUARANTEES ALL WORKMANSHIP INCLUDING REFINISHING PERFORMED ON YOUR VEHICLE FOR AS LONG AS YOU OWN YOUR VEHICLE. ALL PARTS SUBJECT TO INVOICE. IF YOUR VEHICLE IS NOT PICKED UP WITHIN 4 DAYS OF COMPLETION THERE WILL BE A $20.00 PER DAY STORAGE CHARGE. SIGNED/DATE X ESTIMATE RECALL NUMBER: 7/ 3/00 15:32:32 8180 UltraMate is a Trademark of Mitchell International Mitchell Data Version: JUN 00_A Copyright (C) 1994 - 1999 Mitchell International Page 2 of 2 All Rights Reserved T'. FF 7; LD mb p`..ml} v x Ma -i .. fm-01 C� cn � .. m _ {fid C a m y 4 � 0 u+ s' • tna (� � »cwnncos aO4 BMs Um<m S n F r; m Ct m® t7 f!S c� rm 9 a . D� a mMn r ❑ .:r „n r -� m a < ❑ :A � '°`sem Z o< ar+ d► r.n ► �s v► as def ' i b C7 m �?;1 g > G�7Lo 6 DATE: c.,, iw1l RO# TIME IN: ACCT# PROMISED: r.. ...` I'• LIG . .... _ .:" ODOMETER: {.r, MECHANIC ._ H PH: W-PH: `i VEHICLE: P.O.: ORIGINAL ESTIMATE: `• ;.-' ADDED AMOUNT OK BY DATE TOTAL ESTIMATE: .. .. . ,. '�,'`b + �i,:: s '' s ::. ° ;. •st�r1 En* ;.� ���! zT"'t r"s�'r}�xs x?� .. �"' ` ',:" r'..::`Fx� �tS �'l;e a a k°tt'�" c, � �, v.r �.. ,a .;', ;F Cc"�'+pS'?: �,�tcrtti' Y ".9 } "C 1 y rr �t•rr $ 3 ^ yk e DI,3N f{'i2 5i ..aM,r'. ��*.s '�r ac $iv.�1 i.��s EStr•..C:4r�2�..'����,:1�+„+ :k�t�>l „_. . :Fi; ,J : `'4"'' r l ;0}} .,. .... g ..,nO ins+ A t 20,ii _ �y r :s L..�y 111 TO t , __ . dd.o 2a..07j fi 2,SJ #t 3 a I./.�}.��i �A t�'slr"�4�St!S� ��fis"* .,, 2:a sift �•,vLf� r 'a g,,,,., r,-„r``s�•^•°"',• ff s,. s ✓ .. .. 7” PA ? 4� ?� tl? i I Ir i"T i i t 1`'ii 1 hereby authorise the above repair work to be done along with the necessary material,and hereby grant you and/oryour,employees,permission to operate the car,truck or --------- vehicle """vehicle herein described on streets,highways or elsewhere for the purpose of testing and/or Inspection, An express mechanics lion is hereby acknowledged on above car,truck -x A. ��, at or vehicle to secure the amount of repairs thereto. You will not be held responsible for loss or damage to vehicle or articles It}ff,�n vehl -n case of fire,theft,accident or any other cause beyond your control FA�TU�bjt DISCLAIMER OF WARRANTIES: ANY WARRANTIES ON THE PRODUCTS SOLD HEREBY ARE THOSE MADE BY THE MANUTHE SELLER HEREBY EXPRESSLY - y DISCLAIMS ALL WARRANTIES, EITHER EXPRESS OR IMPLIED, INCLUDING ANY IMPLIED WARRANTY OF MERCHANTASILITY,aQFI FITNESS FOR A PARTICULAR PUR- POSE. AND NEITHER ASSUMES NOR AUTHORIZES ANY OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH THE SALE OF SAID PRODUCTS. BUYER SHALL NOT BE ENTITLED TO RECOVER FROM THE SELLER ANY CONSEQUENTIAL DAMAGES, DAMAGES TO PROPERTY, DAMAGE FOR LOSS OF USE, LOSS ' OF TIME,LOSS OF PROFIT OR INCOME,OR ANY OTHER INCIDENTAL DAMAGES. ta; IN THE EVENT THAT IT IS NECESSARY TO RETAIN AN ATTORNEY TO COLLECT FOR THE SERVICES AND GOODS SHOWN ON THIS INVOICE, THE REPAIR FACILITY E WILL BE ENTITLED TO A REASONABLE ATTORNEY FEE IN ADDITION TO ITS COURT COSTS. AUTHORIZEO BY Yahoo! Maps and Driving Directions Paige 1 of 2 "SM��1MAPS Yahoo! - Maps-Yeiiowmages- Help Powered by Mapquest.com (tm) Yahoo! Travel - book airline tickets, hotel rooms, cruises, rental cars Welcome, Guest User Create My Favorite Locations-Sign in Interstate 6801 Stone Valley Rd, Danville, CA New Location Tools Interstate 680 / Stone Valley Rd, Glanville, CA Driving Directions Zoom Out A 4 A 4 4 4 4 4 A 0 Zoom In • To this location • From this location u -11800 + « Favorite Locations Customize your maps Printable Map Email Map Biz Finder Click on icon for locations. Mate Form illsrs1r`''`' atDtee� R� Nearby Services V1J " � E Nearbrb Businesses " • Gas Stations _ � � • Hotels and itarlal Rd ' s Motels • Restaurants . Nearby Classifieds Inside Yahool Yahoo. Classifieds Wow IMst+quw.com,Ino.;0I Naviq�on 7ichnabUf������5 Yahoo! Traffic S Yahoo! Travel Yahoo! Wallet thriving Directions Find Nearby Businesses Camp Yahoo! Map a New Address Or, choose location.[(Use address below) Please sign in to use Favorite Locations. Stnwt Addrew Intorsedion or/Airesort code ...d t0LV1 ICt V d1IUytriU(Xt:l Ly—LJd1IVIIIt:(Ub LdLC—lrMOtS1 L—J!.Or-1/V1CXZ)1�11--1 e-JL.=70Z/ 101 VV f ! 11 SL C8 n I ak r r �? ? fix 1 I I ' M ra leiQ Ln �a a �. ® C7 ! {� Addressee Copy =02 t j gk*ft aft "' +� ridarr r�ruar� �nr�rM� ` "'�`b1°���•►'aiaiwc CI AIM BOARD OF SUPERVISORS OF CONIRA COSTA COUNTY, _AI_.iFORNIA BoARp An DECEMBER 5, 2000 Claim Against the County, or District Governed by ) 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 California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below, given r< Ca a7_ ;Z� pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $5,000.00 N O V 0 r t CLAIMANT: JASON TAKAE MAPTINNTY COUNSEL LIF. t�An�ril���c��.�i=. ATTORNEY: DATE RECEIVED: NOVEMBER 6, 2000 ADDRESS: 664 BYNUM COURT BY DELIVERY TO CLERK ON: NOVEMBER 6, 2000 OAKLEY CA 94561 BY MAIL POSTMARKED: LAND-DELIVERED L FRONE Clerk of the Board of supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: NOVEMBER 7, 2000 By: Deputy 4.1 H. FROM: County Counsel TO: Clerk of the Board dT Supervisors ( is 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 L By: _ r Deputy County Counsel M. FRONL• 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: &Cl Z 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. *Por Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILJNG 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: Dee,, -7 a By: PHIL BATCHELOR By eputy Clerk CC: County Counsel County Administrator ,Slavm tc� BOARD OF SUPERVISORS OF CONTRA COSTA COUNT' NSTRUCTIONS TO QLAIMA T A. 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 before December 31, 1987, must be presented not later than the 10&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. (Gov't 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. F—ra-md. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Deserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa or - - -) NOV - 6 2000 ) District) CLERK B ARCS 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 U;iRed and in support of this claim represents as follows: 1. When did the damage or injury occur?(Give exact date and hour) O y Co, ';),OC C) 11'3a A m, 2. Where did the damage or injury occur?(Include city and county) 6(o� B A V^J C- C05¢ C" Altly 3. How did the damage or injury occur?(Give full details; use extra paper if required) ru,{ a, t.,g,,#- � 4. 'What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? 101,29 J 5. What are the names of county or district officers, servants, or employees causing the damage or injury? 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damn e.)"! ,.,,r. 5 prsQ„J -`o eo' e)4 C-� Iv,,Z -t--,4 � -F a� T k P i ZLIN r . , i s 7. How was the amount claimed above co;Outed? (IncluYe the estimated amount of any prospective injury or K^�` damage.) - i5 �V-v /-nU' would 11wve- d,:, 8. Names and addresses of witnesses, doctors, and hospitals. 1rt.1h ss"` ' rix_ +r S 9. List the exp96idttures you made on account of this accident or injury. DATE TIME AMotrraT Gov. Code Sec. 910.2 provides "The claim must be signed by the claimant or by some person on his behalf." SEND N TI E (Anorna Name and Address of Attorney ) (Claimant's Signature) (Address) Telephone No. )Telephone hTo((7-Z,5) 6 .s- 9/'ff NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,presents for allowance or the 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(S 1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars($10,000),or by both such imprisonment and line. CLAIM '� � B!QARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BC`)AMD ACTIN DECEMBER 5, 2000 Claim Against the County, or District Governed by } 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 California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given { i ,« pursuant to Government Code Section 913 and k 915.4. Please note all "Warnings". AMOUNT: $29,000.00 . COUN'Yy COUNSEL CLAIMANT: Lillian '.Pores W,AR,, ,'---Z 0 -i . ATTORNEY: c/o Steven E. Mendelson DATE RECEIVED: OCTOBER 24, 2000 120 ELEVENTH STREET OCTOBER 24 2000 ADDRESS: OAKLAND CA 94607 BY DELIVERY TO CLERK ON: BY MAIL POSTMARKED: OCTOBER 23, 2000 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated:s OCTOBER 24, 2000 By: Deputy Z J H. FRONL• County Counsel TO: Clerk of the Board of Supervisors ( L4 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 Bled late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ( w ? B ✓ ! y: !` 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. HOARD 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: PAIL BATCHELOR, Clerk, ByDeputy 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 NIkE.ING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: - `� By: PHIL BATCHELOR By Deputy Clerk CC: County Counsel County Administrator -MENDELSON 9 MENDELSON STEVEN E. MENDELSON 120 ELEVENTH STREET (SIO) 45t-13E38 ROBERT A. MENDELSON, RETIRED OAKLAND, CALIFORNIA 94607 FAX (510) 451-1934 SHELC7ON C7T15, PARALEGAL SEMENDELCAOL.CO SEMENDEL�LAWYER.COM MARIANA M. HARRIS, PARALEGAL' October 23, 2000 RECEIVED OCT 2 4 2000 Contra Costa County Clerk ct Rpt$°A ° F SUPE ISOs Board Of Supervisors cc�r��raa ccsTa CO, 651 Pine Street, Room 106 Martinez, CA. 94553 Re: Lillian Torres CLAIM PRESENTED TO THE COUNTY OF CONTRA COSTA Dear County Clerk: Enclosed please find the original and two copies of the Claim Presented to Contra Costa County above-referenced matter. Please file the originals and return the endorse- filed copies to me in the envelope provided. Thank you for your cooperation. If you have any questions, please contact me immediately. Very truly yours, \ try ��....•-•�\`;, f' r,,,\ Mariana M. Harris Paralegal to Steven E. Mendelson CLAIM AGAINST: Contra Costa County CLAIMANTS: Lillian Torres CLAIMANTS'ADDRESS: 14433 Bancroft Avenue, #6 San Leandro, Ca 94577 ADDRESS TO WHICH NOTICES IS TO BE SENT: Mendelson & Mendelson 120 Eleventh Street, 2nd Floor Oakland, CA 94607 DATE OF INJURY: May 10, 2000 WHAT HAPPENED: Ms. Torres was rear-ended by a vehicle driven by a County employee named Alejandro. The collision happened on 98" Avenue at Kitty in Oakland. ACTOR(S)WHOSE CONDUCT FORMS THE BASIS FOR THE CLAIM: Unknown AMOUNT OF CLAIM: $25,000 ITEMIZATION OF CLAIM: HOSPITALIZATION $2,000 t MEDICAL TREATMENT $2,000 ± FUTURE MEDICAL unknown t LOSS OF EARNINGS $ 5,000 f GENERAL DAMAGES $ 220,000± TOTAL DAMAGES - _ $ 29,000 t (Claimant's Agent) (510)451-19 8 Telephone Number F:\1\0 Clt\Torres\govt tort torm.02.wpd o ' M 7°a� o a IZ o o ko v LA to i t�w � a � 76 , rz a APPLICATION TO FILE LATE CLAIM DECEMBER 5, 2000 BOARD OF VISORS OF CONTRA STA C)NTY, CALIFORNIA HOARD ACTION Application to File Late Claim NOTICE TO APPLICANT Against the County, Routing ) The copy of this documenE malleU 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 wWARNING" below. Claimantt SARAH SALGADO, RENE SALGADO, AND SARAH SALGADO, as su vt to the ESTATE OF NOAH RENE SALGADO, and the ESTATE OF NOAH RENE SALG '` Attorneys c/o LAW OFFICES OF BRUCE G. FAGEL AND ASSOCIATES BRUCE G. FAGEL €> ; Address: 445 SOUTH BEVERLY DRIVE, SUITE 200 BEVERLY HILLS CA 90212 ;M d- ALL N Amount: JURISDICTION OF SUPERIOR By delivery to Clerk on � I2000 COURT Date Reoeived: 11-02-00 By mail, postmarked on Hand-Delivered by Jim King at 11:40 AM : -Merk of thel§&R of Supervisors Tot County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: November 3, 2000 PHI, BATCHELOR, Clerk, By Deputy I. PWs MMEy Counsel MY Clark o f o Supervisors C ) The Board should grant this Application to File Late Claim (Section 911.6). C The Board should deny this Application to File Late Claim (Section 911.6). DATED: "7-a0 VICTOR WESTMAN, County Counsel, B*-�� Deputy Iff 9M ER mous vo e o Supero sora 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: . c 0J,3 PHIL BATMELOR, Clerk, By Deputy MAMM (Gov. Code 3911.$) If you wish to file a oourt action on this matter, you mist 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 oourt within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of my attorney of your c3hoioe in oonnection with this matter. If M want to oonsult an attorne Ym should do so immediate) . . FROIKt Clark of M I&R TOt y Counsel (2) County a s or 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 v^ Dewy -r V. ?RCM: unty Co County A nis rotor 70: Clerk o t Bcaazr of Supervisors Received oopies of this Application and Board Order. DATED: County Counsel, By. - County Administrator, By APPLICATION 1-M FILE LATE CLAIM RE EI V G� 1 Law Offices of Bruce G. Fagel NOV - 2 2000 and.Associates 2 Bruce G. Fagel, State Bar Number 103674 CLERK�pARD OF,Up RViSt7R60 445 South Beverly Drive, Smite 200 0011TRAC(3STaC0` 3 Beverly Hills, California 90212 Telephone: (310) 277-1288 4 5 Attorneys for Claimants SARAH SALGADO, RENE SALGADO, SARAH SALGADO, 6 as successor-in-interest to the ESTATE OF NOAH RENE SALGADO, and the 7 ESTATE OF NOAH RENE SALGADO, s 9 APPLICATION FOR LEAVE TO PRESENT 10 CLAIM FOR DAMAGES AND PERSONAL INJURIES 11 12 SARAH SALGADO, APPLICATION FOR LEAVE TO RENS SALGADO, PRESENT CLAIM PURSUANT TO 13 SARAH SALGADO, as successor-in-interest GOVERNMENT CODE SECTION to the ESTATE OF NOAH RENE 910 14 SALGADO, and the ESTATE OF NOAH BENE SALGADO, 15 16 Claimants, RECEIVED 17 vs. 18 CLERK SOA8D OF SUPERVISORS 19 COUNTY OF CONTRA COSTA, operating C�,NT".A COS A ca /"k,L the CONTRA COSTA REGIONAL 20 MEDICAL CENTER, and other health care l/,- facilities, and 21 DOES 1 through 250, inclusive, 22 Respondents. 23 24 TO THE COUNTY OF CONTRA COSTA, operating the CONTRA COSTA 1AW offiCe9 25 REGIONAL MEDICAL CENTER, and other health care facilities, and to each of the above Of 26 named entities, individuals and health care providers: Bruce 0.ragas Assoc iat� 27 SARAH SALGADO, RENE SALGADO, SARAH SALGADO, as successor-in- 28 interest to the ESTATE OF NOAH RENE SALGADO, and the ESTATE OF NOAH RENE 1 Claim Pursuant to Government Code Section 910 1 SALGADO, hereby apply to COUNTY OF CONTRA COSTA, operating the CONTRA 2 COSTA REGIONAL MEDICAL CENTER, and other health care facilities, for leave to present 3 a claim pursuant to section 911.4 of the California Government Code. 4 The cause of action of Claimants, as set forth in the Claimants' claim attached hereto as 5 Exhibit A, did not accrue prior to September 28, 2000, a period within one year of the filing of this 6 application. 7 Claimants believe that the claim is filed within six months of accrual, but seek relief, 8 because if accrual is found to have been more than six months from the filing of the claim, but less 9 than one year from the filing of the claim, then Claimants are entitled to relief pursuant to section 10 911.4 of the Government Code. 11 SARAH SALGADO was admitted to CONTRA COSTA REGIONAL MEDICAL 12 CENTER(the hospital), for the purpose of giving birth to Noah Rene Salgado, who was delivered 13 on December 19, 1999, by the medical personnel at the hospital. RENE SALGADO was the 14 father of Noah Rene Salgado. 15 The medical personnel at the hospital negligently failed to properly monitor SARAH 16 SALGADO and Noah Rene Salgado, negligently cared for and attended them, negligently 17 provided prenatal, perinatal care and negligently attended the labor and delivery and antenatal care 18 and treatment. As a consequence, both the minor and the mother were physically injured and 19 damaged. 20 On or about December 19, 1999, Noah Rene Salgado died as a result of the above 21 mentioned injuries. 22 Following Noah Rene Salgado's birth and death, the medical personnel at the hospital never 23 told Claimants that the minor's medical condition and resultant death were caused by medical 24 negligence. 25 None of the physicians who had seen the decedent have ever told Claimants or led them to 1AW Of 26 believe that the decedent's condition, the decedent's death or the condition of SARAH Bruce 0.Faget & 27 SALGADO was caused by medical negligence. a�o��a�es 28 Claimants were never told, nor did they ever suspect that the damage to the minor or to 2 Claim Pursuant to Government Coda section 910 1 SARAH SALGADO was or could have been the result of anyone's negligence. 2 On or about the end of September 2000, Claimant SARAH SALGADO went to the 3 medical center at the University of California at Davis wherein she discussed the delivery of 4 decedent Noah Rene Salgado. The medical personnel at the medical center told SARAH 5 SALGADO that they would never have let the events occur which did occur regarding the 6 delivery of decedent Noah Rene Salgado, Thereafter, SARAH SALGADO decided to seek legal 7 advice. 8 On or about October 13, 2000, Claimants contacted the Law Offices of Bruce G. Fagel. 9 They did not know whether anyone had been negligent, and only requested information on the 10 reasons for the decedent's death. 11 Claimants could not have made an earlier discovery of the possible involvement of medical 12 negligence or of the cause because the hospital personnel either concealed or failed to reveal the 13 cause of injuries. No physician has ever told Claimants that the above mentioned injuries resulted 14 from medical negligence. Claimants are lacking in any medical sophistication or knowledge that 15 would have led them to suspect that the above mentioned injuries might be the result of medical 16 negligence. 17 For the foregoing reasons, Claimants have exercised reasonable diligence and are not at 18 fault for not having made earlier discovery, in that Claimants had no actual or presumptive 19 knowledge of facts sufficient to put them on further inquiry(Sanchez v, South Hoover Hospital 20 (1976) 18 Cal.3d 93; Brown V. BleibM(1982) 32 Ca.3d 426; Code Civ. Proc. § 340.5). 21 In light of the above facts, this application is being presented within a reasonable time, less 22 than one year after the accrual of the cause of action in question, as required by Government Code 23 section 911.4 (b). 24 Further COUNTY OF CONTRA COSTA, operating the CONTRA COSTA 25 REGIONAL MEDICAL CENTER, and other health care facilities,its agents, servants, LAW CffW1% Of 26 employees, contractors and physicians it employs or allows to practice in its facilities, did & 27 fraudulently conceal the injury and its negligent cause from the Claimants. The COUNTY OF Associates 28 1 CONTRA COSTA, operating the CONTRA COSTA REGIONAL MEDICAL CENTER, and 3 a�u ..aun<m�r ,wawm claim pursuant to Government Code Section 910 1 ether health care facilities, made false representations in stating that it did not knew the cause of 2 the.injuries or the negligent cause. The COUNTY OF CONTRA. COSTA, operating the 3 CONTRA COSTA REGIONAL MEDICAL CENTER, and other health care facilities, made 4 false representations in failing to reveal the injuries and the negligent cause. These false 5 misrepresentations were intentionally made so as to prevent claims for liability. Further, such 6 intent may be inferred pursuant to Civil Code section 1572, 1573, 1574 and 1710. The above 7 mentioned health care providers had "superior knowledge" of the injury and its negligent cause so s as to establish"scienter" pursuant to Pacesetter homes in. v. Brodkin(1970) 5 Cal.App.3d 206. 9 Claimants did rely upon the above misrepresentations believing the above entity and individuals 10 were not responsible for the injury or its negligent cause. The Claimants have been damaged 11 because they did not know the injury or its negligent cause; consequently, remedy was delayed. 12 Dated; Law Offices of Bruce G. Fagel 13 and Associates 14 I t Irney 15 Bruce G. Fagel for Claimants Its 17 18 19 20 21 22 23 24 2s Law Offlow Of 26 Emco 0.Fagel 27 Associates 28 4 Claim Pursuent to Government Code Section 910 1 Law Offices of Bruce G. Fagel and Associates 2 Bruce G. Fagel, State Bar Number 103674 445 South Beverly Drive, Suite 200 3 Beverly Hills, California 90212 Telephone: (310) 277-1288 4 s Attorneys for Claimants SARAH SALGADO, RENE SALGADO, SARAH SALGADO, 6 as successor-in-interest to the ESTATE OF NOAH RENE SALGADO, ESTATE OF 7 NOAH RENE SALGADO 9 CLAIM FOR DAMAGES AND PERSONAL INJURIES 10 11 SARAH SALGADO, CLAIM PURSUANT TO 12 RENS SALGADO, GOVERNMENT CODE SECTION SARAH SALGADO, as successor-in- interest 910 13 to the ESTATE OF NOAH RENE SALGADO, and the 14 ESTATE OF NOAH RENE SALGADO, 1$ Claimants, 16 vs. 17 18 COUNTY OF CONTRA COSTA, operating the CONTRA COSTA REGIONAL 19 MEDICAL CENTER, and other health care facilities, and 20 DOES 1 through 250, inclusive, 21 Respondents. 22 23 TO THE COUNTY OF CONTRA COSTA, operating the CONTRA COSTA 24 REGIONAL MEDICAL CENTER, and other health care facilities, and to each of the above "Law oM25 named entities, individuals and health care providers: Of 26 /ll Bruce G.Fagel & 27 111 Associates 2s 11/ 1 ClaimMnt to ntBYT rr AlFode Section 910 i NAME AND POST-OFFICE ADDRESS OF CLAIMANTS: 2 3 You are hereby notified that SARAH SALGADO, RENE SALGADO, SARAH 4 SALGADO, as successor-in-interest to the ESTATE OF NOAH BENE SALGADO, and the 5 ESTATE OF NOAH. RENE SALGADO, whose addresses are in care of their Attorney, Bruce 6 G. Fagel, 445 South Beverly Drive, Beverly Hills, California, 90212, claim damages from the 7 above-mentioned entities and individuals. 8 9 POST OFFICE ADDRESS TO WHICH THE PERSON PRESENTING THE CLAIM io DESIRES NOTICES TO BE SENT 11 12 Send notices to Attorney Bruce G. Fagel, 445 South Beverly Drive, Beverly Hills, 13 California, 90212 14 15 THE DATE, PLACE,AND OTHER CIRCUMSTANCES OF THE OCCURRENCE OR 16 TRANSACTION WHICH GAVE RISE TO THE CLAIM ASSERTED 17 1� The Claim is based on the death of decedent Noah Rene Salgado on December 19, 1999. 19 Prior to December 19, 1999, and at all times mentioned herein, Noah Rene Salgado, was placed in 20 and remained under the care and control of Respondents, and each of them, for the purpose of 21 receiving medical, surgical, hospital, diagnostic, and nursing and other care, 22 At all times mentioned herein, Claimant SARAH SALGADO was the mother of the 23 decedent, and Plaintiff RENE SALGADO was the father of the decedent, and as such, both 24 Claimants were heirs at law of the decedent. At the time of the filing of the Complaint in this a + 25 matter, SARAH SALGADO will make application to the Superior Court for appointment as Law offic" Of 26 . successor-in-interest to the ESTATE OF NOAH BENE SALGADO. Bruce 0.FaSel & 27 While decedent was under the care and control of Respondents, and each of them, as ,noc►a 28 aforesaid, Respondents, and each of them, negligently, carelessly, and unskillfully examined, 2 Claim Pumuent to Government Code Section 910 1 diagnosed, treated;-operated upon, cared for, administered to, and otherwise handled and 2 controlled decedent and negligently failed to possess and exercise that degree of skill and 3 knowledge ordinarily possessed and exercised by other physicians and surgeons, hospitals, nurses, 4 technicians, attendants and the like engaged in said professions in the same locality as Defendants, 5 and each of them. At all times herein mentioned when the decedent was in the exclusive control of 6 the Defendants, and each of them, at no time prior to the events, conduct, activities, care and 7 treatment herein complained of did the Respondents herein, or any of them, obtain knowledgeable, 8 informed consent for said care, treatment or conduct. Prior to the initiation of or performance of 9 said care, treatment, procedure or conduct no opportunity was afforded the decedent or any 10 authorized agent of the Claimants to exercise voluntary, knowledgeable and informed consent to 11 said care, treatment, procedure or conduct. 12 As a result of the negligence of the above named entities, physicians, medical staff and 13 personnel of the COUNTY OF CONTRA COSTA, operating the CONTRA COSTA 14 REGIONAL MEDICAL CENTER, and other health care facilities, the decedent died on 15 December 19, 1999. The damages were caused by the negligence of the employees or agents of 16 the above named Respondents, whose names are presently unknown. The Claimants also claim 17 extreme and severe emotional distress. 18 As a direct and proximate result of the aforesaid negligence, carelessness and unskillfulness 19 of the Defendants, and each of them, and the resultant death of said decedent, Claimants suffered 20 damages according to law and were compelled to and did incur and expend a sums to be 21 determined for medical and surgical attention, hospitalization, medication, nursing expenses, 22 convalescent, therapy, funeral expenses and burial expenses of said decedent, to Claimants' further 23 damage in said sums. 24 The claim is also based on the failure to adequately select the medical staff'and other r 25 employees, as well as to adequately review their competence, as well as failure to maintain the LAW MICes Of 26 premises and equipment and negligent failure to inform of the medical alternatives available. Bruce G.Fagel & 27 Additionally, SARAH SALGADO was injured in health, strength and activity, sustaining Associates 28 severe shock, and injury to the body, all of which said injuries have caused and continue to cause 3 owpae,�r�w, Claim Pursuant to Govemment Code Section 910 I the Claimant great.physical, emotional, and nervous pain and suffering, and which said injuries the 2 Claimant is informed and believes, and thereon alleges, will result in loss of earnings, permanent 3 disability and impairment of earning capacity all to Claimant's damage in a sum in excess of the 4 jurisdiction of the Municipal Court. SARAH SALGADO also claims damages for loss of her 5 child's services, medical bills and severe emotional distress including but not limited to the 6 emotional distress she claims pursuant to Burgess v. Super. Ct. (Gutta) (1992) 2 Cal.4th 1064. 7 At no time prior to the events, conduct, activities, care and treatment herein complained of 8 did the Respondents herein, or any of them, obtain knowledgeable, informed consent for said care, 9 treatment or conduct. Prior to the initiation of or performance of said care, treatment, procedure 10 or conduct no opportunity was afforded the claimant or any authorized agent of the claimant to 11 exercise voluntary, knowledgeable and informed consent to said care, treatment, procedure or 12 conduct. 13 Further, there are injuries and damages to the minor's father, RENE SALGADO, who 14 suffered loss of his child's services, medical bills, and severe emotional distress. 15 The above named respondents have done negligent and intentional actions or omissions to 16 act or actions or omissions with reckless disregard of the condition of the decedent that would 17 injure the decedent and would lead to serious emotional distress in SARAH SALGADO and is RENE SALGADO so that they suffered damages of negligent and intentional infliction of 19 emotional distress. 20 The above named claimants have both suffered a loss of consortium. 21 As a direct and proximate result of the aforesaid negligence, carelessness and unskillfulness 22 of the Respondents, and each of them, Claimants will have a lien placed on any monies received 23 from any action which is to be paid to entities including but not limited to the California 24 Department of Health for Medi-Cal benefits and other benefits pursuant to law. Consequently, + 25 Respondents identify such liens as further damages. LAW 01110M Of 26 lil Bruce 0.Fagel &. 27 111 Associates 2s Ill 4 Claim Pursuant to Oovemment Code Section 910 1 THE NAME OR NAMES OF THE PUBLIC EMPLOYEE OR EMPLOYEES CAUSING 2 THE INJURY, DAMAGE, OR LOSS, IF KNOWN 3 4 Claimants are uncertain as to the names of the public entity employees, however, Claimants 5 name the entities, physicians, medical staff and personnel of the COUNTY OF CONTRA 6 COSTA, operating the CONTRA COSTA REGIONAL MEDICAL CENTER, and ether 7 health care facilities. 8 9 A GENERAL DESCRIPTION OF THE INDEBTEDNESS, OBLIGATION, INJURY, 10 DAMAGE OR LOSS INCURRED SO FAR AS IT MAY BE KNOWN AT THE TIME OF 11 PRESENTATION OF THE CLAIM. 12 13 The claims against the Respondents are calculated at the presentation of this claim as 14 follows with the amounts claimed in excess of$10,000.00 with jurisdiction in Superior Court: 15 16 SARAH SALGADO FOR WRONGFUL DEATH 17 1. General damages within the jurisdiction of the Superior Court, 18 2. Special damages and all doctor, hospital, medical and incidental expenses within the 19 jurisdiction of the Superior Court, 20 3. For funeral and burial expenses according to proof, 21 4. For costs of suit incurred, 22 5. For such other and further relief which as to the Superior Court may deem proper. 23 24 SARAH SALGADO FOR NEGLIGEN E F 25 1. General damages within the jurisdiction of the Superior Court, z,uW oalOft Of 26 2. Special damages and all doctor, hospital, medical and incidental expenses within the Bruce G.Fugal & 27 jurisdiction of the Superior Court, Anociutes 28 3. For costs of suit incurred, S Claim Pursuant to Csovemment Code Section 910 1 4. Fonsueh other and further relief which as to the Superior Court may deem proper. 2 3 SARAH SALgADO FOR NEGLIGENT INFLICTION OF EMOTIONAL DISTRESS 4 1. General damages within the jurisdiction of the Superior Court, 5 2. Special damages and all doctor, hospital, medical and incidental expenses within the 6 jurisdiction of the Superior Court, 7 1 3. For costs of suit incurred, s 4. For such other and further relief which as to the Superior Court may deem proper. 9 io SARAH SAL ADO FOR INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS 11 1. general damages within the jurisdiction of the Superior Court, 12 2. Special damages and all doctor, hospital, medical and incidental expenses within the 13 jurisdiction of the Superior Court, 14 3. For costs of suit incurred, 15 4. For such other and further relief which as to the Superior Court may deem proper. 16 v RENE SALGADO FOR WRONGFUL DEATH. 18 1. General damages within the jurisdiction of the Superior Court, 19 2. Special damages, doctor, hospital, medical and incidental expenses within the 20 jurisdiction of the Superior Court, 21 3. For costs of suit incurred, 22 4. For such other and further relief which as to the Superior Court may deem proper. 23 24 BENE SALGADO FOR NEGLIGENT INFLICTION OF EMOTIONAL DISTRESS 25 1. General damages within the jurisdiction of the Superior Court, Law Offices -f 26 2. Special damages, doctor, hospital, medical and incidental expenses within the Bruce G.Fagot & 27 jurisdiction of the Superior Court, 28 3. For costs of suit incurred, 6 0%ftwvw.**A�04— Claim Pursuant to Government Coda Section 910 1 4. Fonsuch ether and further relief which as to the Superior Court may deem proper. 2 3 RENE SALGADO FOR INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS 4 1. General damages within the jurisdiction of the Superior Court, 5 2. Special damages, doctor, hospital, medical and incidental expenses within the 6 jurisdiction of the Superior Court, 7 3. For costs of suit incurred, 8 4. For such other and further relief which as to the Superior Court may deem proper. 9 10 RENE SALGADO FOR LOSS OF CONSORTIUM 11 1. General damages within the jurisdiction of the Superior Court, 12 2. Special damages, doctor, hospital, medical and incidental expenses within the 13 jurisdiction of the Superior Court, 14 3. For costs of suit incurred, 15 4. For such other and further relief which as to the Superior Court may deem proper. 16 17 ESTATE OF NOAH BENE SALGADO 18 1. Special damages, doctor, hospital, medical and incidental expenses within the 19 jurisdiction of the Superior Court, 20 2. For funeral and burial expenses according to proof, 21 3. For costs of suit incurred, 22 4. For such other and further relief which as to the Superior Court may deem proper. 23 24 All Notices or other communications with regard to this claim should be sent to the 25 Claimants in care of their attorney. Law Officea Of 26 111 Bruce 0.Fagel 27 Anoc►ates 28 7 o c wi o..n Claim Pursuant to Govemment Code Section 910 I DATED: _ _ , - Law Offices of Bruce G. Fagel and Associates By: rt 3 B ce G. Fagel 4 ttorneys for Claimants 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Law Offices Of 26 Bruce G.Fagel & 27 Associates 28 8 o. Claim Pursuant to Govemment Code Section 910 RECEIVED 1 Law Offices of Bruce G. Faget NOV � �� and Associates 2 Bruce G. Fagel, State Bar Number 103674 445 South Beverly Drive, Suite 200 CLERK 8oA DOF SUPERVISORS 3 Beverly Hills, California 90212 CONTRACOSTACo. Telephone; (310) 277-1288 4 5 Attorneys for Claimants SARAH SALGADO, RENE SALGADO, SARAH SALGADO, 6 as successor-in-interest to the ESTATE OF NOAH RENE SALGADO, ESTATE OF 7 NOAH RENE SALGADO 8 9 CLAIM FOR DAMAGES AND PERSONAL INJURIES 10 11 SARAH SALGADO, CLAIM PURSUANT TO 12 RENE SALGADO, GOVERNMENT CODE SECTION SARAH SALGADO, as successor-in-interest 910 13 to the ESTATE OF NOAH RENE SALGADO, and the 14 ESTATE OF NOAH RENE SALGADO, 15 Claimants, 16 vs. 17 18 COUNTY OF CONTRA COSTA, operating the CONTRA COSTA REGIONAL 19 MEDICAL CENTER, and other health care facilities, and 20 DOES 1 through 250, inclusive, 21 Respondents. 22 23 TO THE COUNTY OF CONTRA COSTA, operating the CONTRA COSTA 24 REGIONAL MEDICAL CENTER, and other health care facilities, and to each of the above LaW olfices 25 named entities, individuals and health care providers: Of 26 Bruce Q ragas & 27 Associates 28 1 Gwp"�C,,;,,, Claim Pursuant to Government Code Section 910 1 NAME AND POST OFFICE ADDRESS OF CLAIMANTS: 2 3 You are hereby notified that SARAH SALGADO, RENE SALGADO, SARAH 4 SALGADO, as successor-in-interest to the ESTATE OF NOAH RENE SALGADO, and the 5 ESTATE OF NOAH RENE SALGADO, whose addresses are in care of their Attorney, Bruce 6 G. Pagel, 445 South Beverly Drive, Beverly Hills, California, 90212, claim damages from the 7 above-mentioned entities and individuals. 8 9 POST OFFICE ADDRESS TO'WHICH THE PERSON PRESENTING THE CLAIM 10 DESIRES NOTICES TO BE SENT 11 12 Send notices to Attorney Bruce G. Fagel, 445 South Beverly Drive, Beverly Hills, 13 California, 90212 14 15 THE DATE, PLACE,AND OTHER CIRCUMSTANCES OF THE OCCURRENCE OR 16 TRANSACTION WHICH GAVE RISE TO THE CLAIM ASSERTED 17 18 The Claim is based on the death of decedent Noah Rene Salgado on December 19, 1999. 19 Prior to December 19, 1999, and at all times mentioned herein, Noah Rene Salgado, was placed in 20 and remained under the care and control of Respondents, and each of them, for the purpose of 21 receiving medical, surgical, hospital, diagnostic, and nursing and other care. 22 At all times mentioned herein, Claimant SARAH SALGADO was the mother of the 23 decedent, and Plaintiff'RENE SALGADO was the father of the decedent, and as such, both 24 Claimants were heirs at law of the decedent. At the time of the filing of the Complaint in this 25 matter, SARAH SALGADO will make application to the Superior Court for appointment as IAW OTices Of 26 successor-in-interest to the ESTATE OF NOAH RENE SALGADO. Bruce 0.Fagel & 27 While decedent was under the care and control of Respondents, and each of them, as Associates 28 aforesaid, Respondents, and each of them, negligently, carelessly, and unskillfully examined, 2 claim Pursuant to Government Code Section 910 i diagnosed, treated, operated upon, cared for, administered to, and otherwise handled and 2 controlled decedent and negligently failed to possess and exercise that degree of skill and 3 knowledge ordinarily possessed and exercised by other physicians and surgeons, hospitals, nurses, 4 technicians, attendants and the like engaged in said professions in the same locality as Defendants, 5 and each of them. At all times herein mentioned when the decedent was in the exclusive control of 6 the Defendants, and each of them, at no time prior to the events, conduct, activities, care and 7 treatment herein complained of did the Respondents herein, or any of them, obtain knowledgeable, 8 informed consent for said care, treatment or conduct. Prior to the initiation of or performance of 9 said care, treatment, procedure or conduct no opportunity was afforded the decedent or any 10 authorized agent of the Claimants to exercise voluntary, knowledgeable and informed consent to 11 said care, treatment, procedure or conduct. 12 As a result of the negligence of the above named entities, physicians, medical staff and 13 personnel of the COUNTY OF CONTRA COSTA, operating the CONTRA. COSTA 14 REGIONAL MEDICAL CENTER, and other health care facilities, the decedent died on 15 December 19, 1999. The damages were caused by the negligence of the employees or agents of 16 the above named Respondents, whose names are presently unknown. The Claimants also claim 17 extreme and severe emotional distress. 18 As a direct and proximate result of the aforesaid negligence, carelessness and unskillfulness 19 of the Defendants, and each of them, and the resultant death of said decedent, Claimants suffered 20 damages according to law and were compelled to and did incur and expend a sums to be 21 determined for medical and surgical attention, hospitalization, medication, nursing expenses, 22 convalescent, therapy, funeral expenses and burial expenses of said decedent, to Claimants' further 23 damage in said sums. 24 The claim is also based on the failure to adequately select the medical staff'and other 25 employees, as well as to adequately review their competence, as well as failure to maintain the Law Offices Of 26 premises and equipment and negligent failure to inform of the medical alternatives available. Bruce O.Fagel & 27 Additionally, SARAH SALGADO was injured in health, strength and activity, sustaining Associates 28 severe shock, and injury to the body, all of which said injuries have caused and continue to cause 3 ov�rY .m Maim Pursuant to Government Code Section 910 I the Claimant great physical, emotional, and nervous pain and suffering, and which said injuries the 2 Claimant is informed and believes, and thereon alleges, will result in loss of earnings, permanent 3 disability and impairment of earning capacity all to Claimant's damage in a sum in excess of the 4 jurisdiction of the Municipal Court. SARAH SALGADO also claims damages for loss of her 5 child's services, medical bills and severe emotional distress including but not limited to the 6 emotional distress she claims pursuant to Burgess v. Super. Ct. (Gupta) (1992) 2 Cal.4th 1064. 7 At no time prior to the events, conduct, activities, care and treatment herein complained of 8 did the Respondents herein, or any of them, obtain knowledgeable, informed consent for said care, 9 treatment or conduct. Prior to the initiation of or performance of said care, treatment, procedure 10 or conduct no opportunity was afforded the claimant or any authorized agent of the claimant to 11 exercise voluntary, knowledgeable and informed consent to said care, treatment, procedure or 12 conduct. 13 Further, there are injuries and damages to the minor's father, RENE SALGADO, who 14 suffered loss of his child's services, medical bills, and severe emotional distress. 15 The above named respondents have done negligent and intentional actions or omissions to 16 act or actions or omissions with reckless disregard of the condition of the decedent that would 17 injure the decedent and would lead to serious emotional distress in SARAH SALGADO and 18 RENE SALGADO so that they suffered damages of negligent and intentional infliction of 19 emotional distress. 20 The above named claimants have both suffered a loss of consortium. 21 As a direct and proximate result of the aforesaid negligence, carelessness and unskillfulness 22 of the Respondents, and each of them, Claimants will have a lien placed on any monies received 23 from any action which is to be paid to entities including but not limited to the California 24 Department of Health for Medi-Cal benefits and other benefits pursuant to law. Consequently, 25 Respondents identify such liens as further damages. Law offices Of 26 /ll Bruce G.Friel & 27 Associates 28 Ili 4 Claim Pursuant to Government Code Section 910 1 THE NAME OR NAMES OF THE PUBLIC EMPLOYEE OR EMPLOYEES CAUSING 2 THE INJURY,DAMAGE, OR LOSS, IF KNOWN 3 4 Claimants are uncertain as to the names of the public entity employees, however, Claimants 5 name the entities, physicians, medical staff and personnel of the COUNTY OF CONTRA 6 COSTA, operating the CONTRA COSTA REGIONAL MEDICAL CENTER, and other 7 health care facilities. s 9 A GENERAL DESCRIPTION OF THE INDEBTEDNESS, OBLIGATION, INJURY, 10 DAMAGE OR LOSS INCURRED SO FAR AS IT MAY BE KNOWN AT THE TIME OF 11 PRESENTATION OF THE CLAIM. 12 13 The claims against the Respondents are calculated at the presentation of this claim as 14 follows with the amounts claimed in excess of$10,000.00 with jurisdiction in Superior Court: 15 16 SARAH SALGADO FOR WRONGFUL DEATH 17 1. General damages within the jurisdiction of the Superior Court, 18 2. Special damages and all doctor, hospital, medical and incidental expenses within the 19 jurisdiction of the Superior Court, 20 3. For funeral and burial expenses according to proof, 21 4. For costs of suit incurred, 22 5. For such other and further relief which as to the Superior Court may deem proper. 23 24 SARAH SALGADO FOR NEGLIGENCE 25 1. General damages within the jurisdiction of the Superior Court, I.aw offices Of 26 2. Special damages and all doctor, hospital, medical and incidental expenses within the nruca G.Fagel & 27 jurisdiction of the Superior Court, Anociatts 28 3. For costs of suit incurred, 5 a oaww.m ..wed.- Claim Pursuant to Government Code Section 910 y 1 4. For such other and further relief which as to the Superior Court may deem proper. 2 3 SARAH SALGADO FOR NEGLIGENT INFLICTION OF EMOTIONAL DISTRESS 4 1. General damages within the jurisdiction of the Superior Court, 5 2. Special damages and all doctor, hospital, medical and incidental expenses within the 6 jurisdiction of the Superior Court, 7 3. For costs of suit incurred, 8 4. For such other and further relief which as to the Superior Court may deem proper. 9 10 SARAH SALGADO FOR INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS 11 1. General damages within the jurisdiction of the Superior Court, 12 2. Special damages and all doctor, hospital, medical and incidental expenses within the 13 jurisdiction of the Superior Court, 14 3. For costs of suit incurred, 15 4. For such other and further relief which as to the Superior Court may deem proper. 16 17 RENE SALGADO FOR WRONGFUL DEATH 18 1. General damages within the jurisdiction of the Superior Court, 19 2. Special damages, doctor, hospital, medical and incidental expenses within the 20 jurisdiction of the Superior Court, 21 3. For costs of suit incurred, 22 4. For such other and further relief which as to the Superior Court may deem proper. 23 24 RENE SALGADO FOR NEGLIGENT INFLICTION OF EMOTIONAL DISTRESS 25 1. General damages within the jurisdiction of the Superior Court, Law OffiCOS Of 26 2. Special damages, doctor, hospital, medical and incidental expenses within the Bruce G.Pagel & 27 jurisdiction of the Superior Court, Anociatm 28 3. For costs of suit incurred, 6 Maim Pursuant to Government Code Section 910 1 4. For such other and further relief which as to the Superior Court may deem proper. 2 3 RENE SALGADO FOR INTENTIONAL INFLICTION OF EMOTIONAL DISTRESS 4 1. General damages within the jurisdiction of the Superior Court, 5 2. Special damages, doctor, hospital, medical and incidental expenses within the 6 jurisdiction of the Superior Court, 7 3. For costs of suit incurred, 8 4. For such other and further relief which as to the Superior Court may deem proper. 9 10 RENE SALGADO FOR LOSS OF CONSORTIUM 11 l. General damages within the jurisdiction of the Superior Court, 12 2. Special damages, doctor, hospital, medical and incidental expenses within the 13 jurisdiction of the Superior Court, 14 3. For costs of suit incurred, 15 4. For such other and further relief which as to the Superior Court may deem proper. 16 17 ESTATE OF NOAH RENS SALGADO 18 1. Special damages, doctor, hospital, medical and incidental expenses within the 19 jurisdiction of the Superior Court, 20 2. For funeral and burial expenses according to proof, 21 3. For costs of suit incurred, 22 4. For such other and further relief which as to the Superior Court may deem proper. 23 24 All Notices or other communications with regard to this claim should be sent to the 25 Claimants in care of their attorney. Law Offices Of 26 Bruce G.Pagel & 27 Associates 28 7 r,�d�.mwia.a o n Claim Pursuant to Government Code Section 910 p 1 DATED: iv, zap Law Offices of Bruce G. Faget and Associates 2 By: 3 ce G. Fagel 4 ttomeys for Claimants 5 6 7 8 9 to 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 Law offices Of 26 Bruce O.Pagel & 27 Associates 28 8 aaowi�myw „wc, Claim Pursuant to Government Code Section 910 TO: BOARD OF SUPERVISORS r FROM: Phil Batchelor, County Administrator Contra : DATE: December 5, 2000Uusta b SUBJECT: Final Settlement of Claim '"'unty Barbara Cimino vs. Contra Costa County U Superior Court No. C00-00580 SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AID JUSTIFICATION RECOMMENDATION: Receive this report Concerning subject final settlement and payment from the General Liability Trust Fund in the amount of$300,000 plus costs not to exceed $7,500. BACKGROUND/REASONS FOR RECOMMENDATION: Thomas A. Watrous, defense counsel for the County, has advised the County Administrator that within authorization an agreement has been reached settling the general liability claim of Barbara Cimino vs. Contra Costa County, This Board's November 14, 2000 closed session vote was: Supervisors Canciamilla, Gioia, Uilkema, DeSaulnier, and Gerber, yes. This action is taken so that terms of this final settlement and the earlier November 14, 2000 closed session vote of this Board authorizing its negotiated settlement are known publicly. CONTINUED ON ATTACHMENT: SIGNATURE: ,'RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF BOARD COMMITTEE ----APPROVE OTHER SIGNATURE(S): ACTION OF BOA6� December 5, 2000 APPROVED AS RECOMMENDED X OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN AND ENTERED ON THE MINUTES OF THE BOARD X UNANIMOUS {ABSENT OF SUPERVISORS ON THE DATE SHOWN. AYES: NOES: ABSENT: ABSTAIN: ATTESTED DECKER 5, 2000 *(District V Seat is vacant) PHIL BATCHELOR,CLERK OF THE BOARD OF SUPERVISORS AND COUNTY ADMINISTRATOR Contact: Ron Harvey—335-1443 cc: CAO Risk Management Auditor-Controller BY DEPUTY