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HomeMy WebLinkAboutMINUTES - 11062001 - C.38 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 Codeection 913 and 915.4. Please note all "Warnings". AMOUNT: .$25,000 OCT 2 3 2001 RECEIV CLAIMANT: Justin Jacobsen COUNTY COUNSEL OCT 2 4 ATTORNEY: Steven Jacobson DATE RECEIVED: October 22 20 ADDRESS: 1212 Broadway St 900 BY DELIVERY TO CLERK ON: October 22, 2001 Oakland, CA 94612 BY MAIL POSTMARKED: 1 0- 19-01 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE r Dated: October 22, 2001 By: Deputy WWV--,,k II. FROM: County Counsel TO: Clerk of the Board of 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: /0'0?3-0/ By: �I /��L' l�� 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: 0 JOHN SWEETEN, 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: U4AI JOHN SWEETEN, CLERK By { Deputy Clerk This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of.its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. , r 1 STEVEN R.JACOBSEN RECEIVE® BAR No.95246 2 2 2001 2 LAW OFFICES OF STEVEN R.JACOBSEN OCT 1212 BROADWAY, SUITE 900 3 OAKLAND, CALIFORNIA 94612-1805 CLERK BOAR)OF SUPERVISORS (510) 465-1500 CONTRA COSTA CO. 4 ATTORNEYS FOR CLAIMANT 5 6 7 8 CLAIM AGAINST THE COUNTY OF CONTRA COSTA 9 10 In The Matter of The Claim of 11 JUSTIN JACOBSEN 12 Against 13 THE COUNTY OF CONTRA COSTA / 14 15 To: The County of Contra Costa, its Officials, Supervisors, Officers, Directors, 16 Agents, Independent Contractors and Employees (hereinafter collectively referred to as 17 "the County"): 18 Justin Jacobsen (hereinafter referred to as "claimant") hereby makes claim 19 against the County, and makes the following statements in support of the claim: 20 1. Claimant's post office address is: c/o The Law Offices of Steven R. Jacobsen, 21 1212 Broadway, Suite 900, Oakland, California 94612-1805, telephone (510) 465- 22 1500. 23 2. Notices concerning the claim should be sent to The Law Offices of Steven R. 24 Jacobsen, 1212 Broadway, Suite 900, Oakland, California 94612-1805. 25 3. Claimant makes this claim for personal injuries and damages which he 26 sustained as more fully set forth hereinafter. 27 4. The date and place of the occurrence giving rise to this claim are: April 21, 28 2001 on Alhambra Valley Road, and on the real property adjacent to the road, .7 miles -1- CLAIM AGAINST THE COUNTY OF CONTRA COSTA 1 west of Bear Creek Road, in the County of Contra Costa, California (hereinafter 2 referred to as "the site"). 3 5. The circumstances giving rise to this claim are as follows: On the date of the 4 occurrence, claimant was lawfully riding his motorcycle on Alhambra Valley Road 5 approaching the site. Claimant was licensed to ride the motorcycle. Claimant, at all 6 times, acted as a reasonably prudent person under the circumstances would have acted. 7 As claimant attempted to maneuver his motorcycle around the "S" curve located at the 8 site, he was unable to negotiate the curve, left the roadway and struck a concrete 9 headwall and a steel drainage pipe in a ditch immediately adjacent to the roadway. The 10 collision caused claimant to be thrown from his motorcycle. He landed against the 11 concrete headwall and steel pipe. His motorcycle landed on top of him. 12 The design, construction and maintenance of the roadway make the "S" curve 13 difficult to negotiate. The defects in the roadway at the site include, but are not limited 14 to the following: 15 The roadway has an improper slope for the curve; 16 The slope varies throughout the curve; 17 The elevation is not uniform across the roadway; 18 The site contains a reverse "S" curve with no tangent between the curves; 19 The pavement on the roadway is uneven, defective and dangerous; 20 The roadway surface is not firm and smooth; 21 There is no "recovery zone" at the side of the roadway; 22 There are dangerous fixed objects too close to the roadway; 23 A ditch which serves no purpose, an uncovered drainage pipe and a 24 concrete headwall are located immediately adjacent to the roadway; 25 There is no guardrail at the site to protect motorists from collision with the 26 dangerous fixed objects adjacent to the roadway; 27 There are no warning signs or the signs are inadequate to warn drivers of 28 the condition of the curve and the roadway, and the adjacent obstacles at the -2- CLAIM AGAINST THE COUNTY OF CONTRA COSTA 1 site. 2 The conditions listed above and the other conditions of the roadway and the 3 adjacent property created a dangerous condition on the property of the County. The a County is liable for claimant's injuries and damages caused by the dangerous condition 5 of its property. The property was in a dangerous condition at the time of the injury, the 6 injury was proximately caused by the dangerous condition and the dangerous condition 7 created a reasonably foreseeable risk of the kind of injury which was incurred. A a negligent or wrongful act or omission of an employee of the County within the scope of 9 his or her employment created the dangerous condition. The County had actual and 10 constructive notice of the dangerous condition a sufficient time prior to the injury to 11 have taken measures to protect against the dangerous condition. The County had 12 actual notice of the dangerous condition. The County had actual knowledge of the 13 existence of the condition and knew or should have known of its dangerous character. 14 The County had constructive notice of the dangerous condition because the condition 15 had existed for such a period of time and was of such an obvious nature that the 16 County, in the exercise of due care, should have discovered the condition and its 17 dangerous character. Many accidents have occurred both before and after claimant's 18 accident, in which motor vehicles have left the roadway at the site because they have 19 been unable to negotiate the curve. The occurrence of these accidents has also placed 20 the County on notice of the defects in the roadway at the site and of the dangerous 21 condition on the property of the County. 22 The design of the roadway creates an unreasonably dangerous condition. The 23 design of the roadway was never approved by the County. The roadway was not 24 constructed according to an approved design. 25 The construction of the roadway at the site does not meet the specifications of 26 any approved plan. It is not constructed according to the design. The roadway and 27 adjacent land was constructed in a negligent manner. That negligence created the 28 conditions which lead to claimant's injuries. -3- CLAIM AGAINST THE COUNTY OF CONTRA COSTA 1 The roadway condition is the result of negligently performed maintenance and 2 repair. 3 This incident and claimant's resulting injuries were the result of the negligence of 4 the County, the improper design, construction and implementation of the construction 5 plans for the site, the negligent and dangerous maintenance and repair of the site, the 6 dangerous condition created on the property of the County, and the failure of the 7 County to properly hire, screen, train, supervise and control its employees, agents and s independent contractors. The County violated those policies, statutes, ordinances and 9 regulations which required it to design, construct, maintain, repair and implement the 10 construction plans for the site in a safe manner, the statutes, regulations and 11 ordinances which require safe conditions on and adjacent to the roadway, and other 12 policies, statutes, ordinances and regulations which have not yet been determined, and 13 which resulted in the damages to claimant as herein alleged. 14 Notwithstanding its knowledge of the dangerous condition and of the risk 15 inherent therein, the County negligently failed to remedy the dangerous condition or to 16 warn claimant or others of the dangerous condition at the site. As a result of the 17 dangerous condition and of the negligence of the County, claimant was injured as set 18 forth herein. 19 The County failed to properly hire, train, instruct and supervise its employees and 20 independent contractors, so as to prevent them from acting as set forth above and 21 creating the aforesaid danger for claimant and other members of the public. 22 The construction plan for the premises was unreasonable and was the cause of 23 claimant's injuries. The plan did not comply with plans and designs approved as required 24 by Government Code §830.6. Further, since the implementation of the construction plan, 25 the County had become aware of the dangerous condition created at the site, and had 26 failed to take reasonable steps to remedy the dangerous condition, though it was within 27 the power and ability of the County to do so. In addition, the County failed to warn 28 claimant of the danger. -4- CLAIM AGAINST THE COUNTY OF CONTRA COSTA 1 6. Claimant has suffered injuries to his legs, feet, ribs, shoulder, lungs, nerves, 2 head, neck and back, has suffered internal injuries, has suffered permanent injury and 3 disability, and has suffered other injuries and damages not yet determined. 4 7. The names of the public employees causing claimant's damages are 5 unknown to claimant. 6 8. Claimant's claim as of the date of this claim is in an amount in excess of 7 $25,000.00 and within the jurisdiction of the Superior Court. 8 Dated: October 19, 2001. LAW OFFICES OF STEV JACOBSEN 9 10 By STEVEN JACOBSEN 11 Attorn for Claimant 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -5- CLAIM AGAINST THE COUNTY OF CONTRA COSTA 1 PROOF OF SERVICE BY MAIL - C.C.P. 1013a, 2015.5 2 1 declare under penalty of perjury, under the laws of the State of California, that: I am employed in the County of Alameda; I am over the age of eighteen years and not a 3 party to the within action; my business address is 1212 Broadway, Suite 900, Oakland, California 94612; on the date below written I served copies of the attached 4 5 CLAIM AGAINST CONTRA COSTA COUNTY 6 on all parties to the within action by placing true copies thereof in sealed envelopes, with postage fully prepaid, in the United States mail at Oakland, California, addressed 7 as follows: 8 CONTRA COSTA COUNTY CLERK 9 Room 106 651 Pine Street 10 Martinez, CA 94553 11 Executed at Oakland, California on October 19, 2001. 12 13 Ar D. JACKSON 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 .�:� r: .:..: :., �h!: �� _�t�r :��` `� ��. �� f '', \ 1 �� i /� 1 � ! :.ta I � ��'� ¢F', . •mac �� ¢ Q w m Q. N Go N � Q N tp N W =' a 6 CST CND :.- � O O � O C .> �o N CD O � p i 21 CLAIM J� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 ode 1'3 and 915.4. Please note all "Wt[ ..1 Ir AMOUNT: $950,000 OCT 2 3 2001 OCT 2 6 i 0 l COUNTY COUNSEL CLERK BOARD U_ MARTINEZ CALIF. CONTRAU I CLAIMANT: Stephen Ford ___._._....._, ATTORNEY: Runnion & Runnion DATE RECEIVED: October 22, 2001 ADDRESS: 2047-C Arnold Ind. Way BY DELIVERY TO CLERK ON: October 22, 2001 Concord, CA 94520 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET Dated: October 22, 2001 By: Deputy Il. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. ( Phis Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: /��°��' By: 19-7 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 Or8&1, er entered in4-61A, ittsminutes for this date. Dated: Nn,k1`P�WI /1 �,()f JOHN SWEETEN, 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: JOHN SWEETEN, CLERK By Deputy Clerk hL1 r This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims' Act. L I _,,,iaim 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"i 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. 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 M Against the County of Contra Costa or ) District) (F' 1 in nam ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$qQn9,0497 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur?(Include city and county) CpV-fira0v5fa �. i�A 1 iUed►G; e,a14fee AaG�, d 61 Jy 3. How did the damage or injury occur? (Give full details; useextrapaper if required) fi Ilk IL/ . 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage?I C^e t4",eira& due W---5 (a>r ry-1,5t IA a 14 Jr ... S. What are the names of county or district officers, servants, or employees causing the damage or injury? /A • 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) C�t►�o h;e� S e���r� z C(�,�u`te Si���ir� �¢ Uess V � J<2�2k re.A✓c-- l rJS� c>� ' o S�1t`- StJ-Ef iC.�¢yr y l �f-C'�i�.�. � 7. How was ttte amount claimed above computed? (KInclude the estimated amount of any prospective injury or damage.) v`1 t45 J'dSO Liss e -Mvr&o-o e5> aO 8. Names and addresses o`ffwitnesses, doctors, and hospitals. l TOLV\ v�ah /�. V ( � �J2VeV� �z'6ar-t Ar,,v- i 51 V1 0-0-RM xzcro s a,SQ7AII�P-uthf2 -�da1 7,C 9the List expenditures you made on account of this accident or injury. DATE TIIyIE AMOUNT �•L" (5-!01 e+ pa..'r o-�(1,-tA 6ee4 7 Z Pvcle ) 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 T ) U 6 0ti (Clatma s Signature) UJ / (Address) j �r7ac1r�d ok l'`(ydo Telephone No.ft;�: 3 D 4 )Telephone No. ���� Q�(� " � -5-o5 •******s*•***«**s *************ss****�***ss****ss********s***«***s*«**s«**««***«*****«**** 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 fine. s; SILVANO B.MARCHESI DEPUTIES: COUNTY COUNSELS E ( PHILLIP S.ALTHOFF JANICE L.AMENTA ` NORA G.BARLOW B. NES SHARON L.ANDERSON =a— g-_., .°\ ANDRE W.CASCA IDY � �.%�-" ANDREAW.CASSIDY ASSISTANT COUNTY COUNSEL CONTRA COSTA_ AC.OUN1 Y MONIKAL.COOPER s \, VICKIE L.DAWES GREGORY C.HARVEY OFFICE•OFTHE C:O.UNET?6M6UNSEL MARKES.ESTIS ASSISTANT COUNTY COUNSEL ,I °"-'m'19"I I LILLIANT.FUJII r;L'O�1N7Y=ADMINIST RAOtJ�BUI LDI�/G 1 JANET L.HOLMES DENNIS C.GRAVES 5d E.INE=STREET�9.:-.FELIO ' KEVIN T.KERR �••� - " �'^+'�� BERNARD L.KNAPP SENIOR FINANCIAL COUNSEL MARTINEZ CALIF R I'A 5.— 229 EDWARD V LANE.JR. � _ •� \MUGGLI \ ~ BEATRICE LIU GAYLE �:;-- - �,T MARY ANN MASON OFFICE MANAGER r PAUL R.MUNIZ A CC1iJI1 VALERIEJ.RANCHE PHONE (925) 335-1800 NOTICE0N=S=IIFFICIENCY STEVEN P.DAVID RETTIG IDT HM FAX (925) 646-1078 DN AAJ.SILVERDT AND/OR JACQUELINE Y.WOODS NON-ACCEPTANCE OF CLAIM PAMELAJ.ZAID TO: Runnion & Runnion 212.1 N. California Blvd. Walnut Creek, California 94596 RE: CLAIM OF: Stephen Ford 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: [ ] I. The claim fails to state the name and post office address of the claimant. [ ] 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [XX] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. 1f the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. [ ] 6. The claim is not signed by the claimant or by some person on his or her behalf. [XX] 7. Other: Please provide information regarding the late discovery. Page 1 O.,.OUN I ST807 lot! . , .tip. SILVANO B. MARCHESI COUNTY COUNSEL By: Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5;Evidence Code§§641,664) I declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California 94553;I am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California. I certify under penalty of perjury that the foregoing is true and correct. Dated: October2� 2001,at Martinez,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE:OF INSUIl ICI1 NCY OF CLAIM:GOv'r.CODE:§§910,910.2,920.4,910.8) Page 2 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 913 and RT.(ZM1tV3 W ease note all "Warnings". AMOUNT: $10,000 OCT 2 6 2001 CLAIMANT: Alphonso & Lynn Daniels COUNTY COUNSEL p MARTINEZ CALIF. ATTORNEY: David RathDATE RECEIVED: October 26, 2001 DR�e- q ,s�e�z4��°r ADDRESS: 2451 hurt. Ln, Sp e 49 BY DELIVERY TO CLERK ON: October 26, 2001 San'\Pablo, Ca 4806 BY MAIL POSTMARKED: October 25, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWE1 Dated: October 26, 2001 By: Deputy fg II. FROM: County Counsel TO: Clerk of the Board of Super-viss ( 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: ��''a���� 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 tered in its minutes for this date. Dated: JOHN SWEETEN, 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: 10j CO, 0l JOHN SWEETEN, CLERK ByDeputy Clerk This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. CLAIM AGAINST GOVERNMENT ENTITY A. The name and post office address of the claimant: Alphonso and Lynn Daniels Kimball's Trailer Park 2451 Church Lane, Space 49 San Pablo, CA 94806 B. The post office address to which the person presenting the claim desires notices to be sent: Alphonso and Lynn Daniels c/o David L. Roth,Esq. One Kaiser Plaza, Suite 601 Oakland, CA 94612 C. The date, place and other circumstances of the occurrence or transaction which gave rise to the claim asserted: Incident: July 18, 2001 Claimants were assaulted by Contra Costa County Sheriffs department employees. D. A general description of the indebtedness, obligation, injury, damage or loss incurred so far as it may be known at the time of presentation of the claim: Claimants suffered severe physical and emotional injuries, medical expenses, past and future, lost income, and other damages. E. The name or names of the public employee or employees causing the injury, damage, or loss, if known: Not known. F. The amount claimed if it totals less than ten thousand dollars ($10,000) as of the date of presentation of the claim, including the estimated amount of any prospective injury, damage, or loss, insofar as it may be known at the time of the presentation of the claim, together with the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), no dollar amount shall be included in the claim. However, it shall indicate whether *** the claim would be a limited civil case: The claim would not be a limited civil case. �� 2S' 200 Date: / / 44 Davih L. Roth, Authorized Agent of Claimants j �r ' _.. O � m d om o Z C� O P #t x. t v� 9:s r� 'i• • ✓+y y l r r s l 1 1 'ti. \� �` �` �\ �� i i Z CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 RiecZaVIEM)Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: $500,000 0 C T 2 5 2001 COUNTY COUNSEL CLAIMANT: Brenda Richardson . MARTINEZCALIF. ATTORNEY: Michael Reed DATE RECEIVED: October 24, 2001 ADDRESS: 6959 Norfolk Rd BY DELIVERY TO CLERK ON: October 24, 2001 Berkeley, CA 94705 BY MAIL POSTMARKED: October 22, 2001 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE ��V�� Dated: October 24, 2001 By: Deputy Il. FROM: County Counsel TO: Clerk of the Board of Supervisors Pm-/7-q A ( 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). (vr Other: 6lal i s 7�0 4LAC4tiA o c Cul-1-1 Or? 01"ea rr l as a00 la i riot 7� 7Lhal . v JbV,, Code Se ll ans 911. - /at 2. Dated: /4•3o-of 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: 61 JOHN SWEETEN, CLERK, By Deputy Clerk WARNING (Gov. code section 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 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:LW&YPI bell JOHN SWEETEN, CLERK By Deputy Clerk r This warning does not apply to claims which are not subject to the California Tort'Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. To: Ms. Gina Martin Clerk of the Board of Supervisors Contra Costa County 651 Pine Street, Room 106 RECEIVED Martinez, Ca. 94553 OCT 2820011 Public Entity Claim: County of Contra Costa CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Name of Claimant: Brenda Richardson Mailing Address: 4457 Rock Island Dr., Antioch, Ca. 94531 TELEPHONE NUMBER (925) 778-4257 Claim is not filed on behalf of a minor Name of agency against which claim is filed: County of Contra Costa Incident Date: July 1, 1999 and continuing through present Circumstances that led to alleged damage or injury: See attached DFEH Complaint Claimant Represented by attorney(send response to claim to Michael Reed; Attorney at Law; 6959 Norfolk Rd.; Berkeley, Ca. 94705 Telephone Number (510) 540-6400) Amount of Claim: $500,000.00 ALSO ENCLOSED IS A COPY OF THE FACE SHEET OF THE CLAIM. PLEASE FILE STAMP THE FACE SHEET AND RETURN TO THIS OFFICE IN THE ENCLOSED SELF ADDRESSED STAMPED ENVELOPE. Dated: October 15, 2001 Michael J. Reed Attorney for Claimant (145.007) * * EMPLOYMENT GOM,PLAINT OF DISCRIMINATION UNDER DFEH # THE PROVISIONS OF THE CALIFORNIA DFEH USE ONL FAIR EMPLOYMENT AND HOUSING ACT CALIFORNIA DEPARTMENT OF FAIR EMPLOYMENT AND HOUSIN YOUR NAME(indicate Mr.or Ms. TFlEPHC E NUMBER(INCLUDE AREA CODE) Ms. Brenda Richardson (925)778-4257 ADDRESS 4457 Rock Island Drive ITY/STATE/ZI COUNTY COUNTY COD Antioch, Ca. 94531 Contra Costa NAMED IS THE EMPLOYER, PERSON, LABOR ORGANIZATION, EMPLOYMENT AGENCY, APPRENTICESHIP COMMITTEE, OR STATE OR LOCAL GOVERNMENT AGENCY WHO DISCRIMINATED AGAINST ME NM E IELEPHONIE NUMBER(Include Area Code COLinty of Contra Costa Regional Medical Center,Contra Costa Health Centers,Michelle Shanks 925 335-8850 ADDRESS I DFEH USE ONLY 2500 Alhambra Avenue CITY/STATE/7JP COUNTY I COUNTY CODE Martinez, California 94553-3191 NO.OF EMPLOYEESIMEMBERS(if known) DATE MOST RECENT OR CONTINUING DISCRIMINATIO I RESPONDENT CODE approximately 100 plus TOOKPLACE(nond.day,andyear) September 1, 2001 THE PARTICULARSARE On 07/01/99continuing through present .I was xx fired denied employment denied farriiy or medical leav laid off denied promotion denied pregnancy leave xx demoted denied transfer denied equal pay XX harassed denied aoconrrndatio denied right to wear pants forced to quit xx other(speclfy Verbally harassed and discriminated against on the basis of my race. by Michelle Shanks manager Name of Perso Job Title(supervisor/manager/panel director/etc. sex XX race/color physical disability (Circle one)filing age national ongin/ancestry mental disability protesting:participating in famil marital status medical ocnditio investigation retatiation for) religion assoclatio other(specify the reason given by Michelle Shanks Name of Person and Job Title vm becrose Of see attachment [please state what you believe to be re"s)] I wish to pursue this malter in court. I hereby request that the Department of Fair Employment and Housing provide a right to sue notice.I understand that if I want a federal notice or rignt-to-sue.I must visit the U.S.Equal Employment Opportunity Commission(EEOC)to file a complaint within 30 days of receipt of the DFEH Notice of Case Closure,or within 300 days of the alleged discriminatory act. whichever is earlier. I have not been coerced into making this request.nor do I make it based on fear of retaliationif I do not do so. I understand it is the Department of Fair Employment and Housing's policy to not process o reopen a complaint once the complaint has been Closed on the basis of"Complainant Elected Court Action." I declare under penalty perjury under the laws of the State of California that the foregoing is true and correct of my own knowledge except as to matters stated on my information and belief. and as to those matters I believe it to be true. Dated COMPLAINANT'S SIGNATUR At c ity DATE FILED CFEK300-03(07/97 DEPARTMENT OF FAIR E PLOYMENf Alm HOUSIN F145.001 STATE OF CAUQRN I , RIGHT-TO SUE COMPLAINT INFORMATION SHEE We need a separate signed complaint for each employer,person,labor organization,employment agency,apprenticeship committee,state or local government agency you wish to file against.If you are filing against both a company and an individual(s),please complete separate complaint forms naming the compan or an individual in the appropriate area. Please complete the following so that we can process your complaint and for DFEH for statistical purposes,and return with your signed complaint(s): XX Harassment YOUR RACE(Check one) _Pregnancy XX African-American —Denied Right to Wear Pants Asia `Other Allegations(List) Discrimination Caucasia Native American YOUR AGE: 44 Other(List YOUR GENDER YOUR ETHNICITY:(Check one) X _Hispanic(Other than Mexican _ Male or Mexican-American; Mexican-American YOUR OCCUPATION _ Mexican National Clerica _ Filipino _ Craft Polynesia _Equipment 0perato Other(List — Labore _Manager IF FILING BECAUSE OF DISABILITY -Pa raprofeassiona YOUR DISABILITY —Profession AID _Sales Blood/Circulation — Service _Brain/Nerves/Muscles _Superviso _DigestivelUrinarylReproduction - Technica Hearing xx Nurse _ Hear HOWEADYOUHEARABOUTDFE , Limbs(Ams/Legs XX Attorney Menta _ Bus/Bart dvertisement _ Sight _Community Organization _Speech/Respiratory EBD _SpinaUBack ED Frien IF FiLING BECAUSE OF MARITAL STATUS. Human Relations Cornrnissio YOUR MARITAL STATUS:(check one) Labor Standards Enforcement Cohabitatio Local Government Agenc Divorce _ Poste Marrie Prior Contact with DFE _Single Radio _Telephone Book T IF FILING BECAUSE OF RELIGION YOUR RELIGION:(Check one DO YOU HAVE AN ATTORNEY — Catholi XX _ Jewish Yes _ No Protestant Seventh Day Adventist Other(List) . Your Signatur Dat DFEH 300-03-1(07/97) DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING STATE OF CALIFORNIA F 145.002 IF FILING BECAUSE OF SEX.THE REASON Attachment to Complaint Dated 10/08/01 The County of Contra Costa is a public entity and as such is subject to suit under the California Fair Employment and Housing Act pursuant to Government Code Section 12926(d). Complainant, Brenda Richardson is informed and believes that Michelle Shanks, at all times herein mentioned was a resident of Solano County, and an employee of the County of Contra Costa. At all times herein mentioned, in doing the things herein alleged, Michelle Shanks, was acting within the course and scope of her employment with County of Contra Costa and in her capacity as complainant's manager. Complainant was employed by the Contra Costa Regional Medical Center Contra Costa Health Centers in the position of Charge Nurse beginning in July 1999. Throughout the period that complainant was employed by the County of Contra Costa, the County of Contra Costa, acting through its agent and complainant's supervisor Michelle Shanks engaged in the following acts with the intent of discriminating against and harassing plaintiff on account of her race in violation of the provisions of the California Fair Employment and Housing Act (FEHA) (Govt. C. §§12900- 12996) During the time complainant was employed by the County of Contra Costa, Department of Health Services she was discriminated against with respect to the terms, conditions, and privileges of her employment because of her race and color. Such discrimination consisted of unfounded complaints made by Michelle Shanks concerning complainant's work; complainant's assignment by Michelle Shanks to perform menial and demeaning duties; repeated racial insults and slurs concerning complainant in complainant's presence and the presence of the others by Michelle Shanks; and repeated acts of harassment and discrimination by Michelle Shanks directed at complainant which for her created a hostile work environment. Specifically, these acts of harassment and discrimination included but were not limited to the following acts of harassment and disparate treatment. L. h ankilrop; hot olhownwo SWO iz J. WAi 'IFF w0p ma o ZIA 0 .1 wAynh oxvAnnA"Wo QW-1, I. Michelle Shanks or other individuals at her direction, would arbitrarily change the staff assignments scheduled by complainant so that a different staff than the one she had scheduled would be present when complainant arrived at work. 2. Michelle Shanks unfairly allowed an LVN to access employee personnel files that the complainant was denied access to. 3. Michelle Shanks discriminated against complainant with respect to her time off work by denying her the opportunity to take weekends off. 4. Michelle Shanks discriminated against complainant with respect to on the job educational opportunities and privileges by denying her the opportunity to attend a two day trauma nurse core class. 5. Michelle Shanks singled out the complainant and ridiculed her when the complainant informed her that she wanted to go back to school. 6. Michelle Shanks subjected complainant to disparate treatment by singling her out for close monitoring and supervision during the performance of her duties and countermanding complainant's on the job decisions. 7. Michelle Shanks failed to send in complainant's paperwork for a lateral move from evening to day shift and attempted to block complainant from obtaining the position of charge nurse. 8. Michelle Shanks unfairly sought to thwart complainant's transfer to day shift charge nurse position by attempting to have another nurse in the department talk the complainant out of transferring. 9. Michelle Shanks informed complainant that the day shift did not want her on that shift. 10. Michelle Shanks informed complaint that she was not competent to handle the day shift responsibilities despite the fact that the duties and responsibilities were similar to the evening shift responsibilities the complainant had been handling. She also told •• 4• r 20. Michelle Shanks instructed the evening charge nurse to watch over and monitor complainant when he began his shift and to report complainant's activities during her shift back to Ms. Shanks. Complainant was the only employee singled out for this type of unfair monitoring and treatment. 21. Michelle Shanks issued Complainant a counseling letter for personal telephone use and required complainant to pay for telephone calls. Other employees engaging in similar conduct were not required to pay for their telephone calls and were not issued counseling letters. The County of Contra Costa and Michelle Shanks knew or should have known of these harassing and discriminatory actions because Michelle Shanks was complainant's supervisor and because Michelle Shanks discriminatory and harassing behavior was brought directly to the attention of the County of Contra Costa. Despite the County of Contra Costa's actual and constructive knowledge of the above mentioned harassment, and the knowledge of its supervisors and agents, the County of Contra Costa failed to take immediate and appropriate corrective action to stop the discrimination and harassment. Furthermore, before the harassment occurred, County of Contra Costa failed to take all reasonable steps to prevent such harassment from occurring. As a proximate result of defendant's discriminatory actions against complainant as alleged above, complainant has been harmed in that complainant has suffered the loss of the wages, salary, benefits, and additional amounts of money she would have received had she not been demoted. Complainant has suffered the intangible loss of other employment-related opportunities such as additional experience in the position held by complainant at the time of her demotion as well as the opportunities for advancement and promotion. Complainant has suffered humiliation, mental anguish, and emotional and physical distress, and has been injured in mind and body. (145.004) j: • � f- t. �` ,` �� i 1�% TR.y�.rH "��'f�.'.:. ✓�" .� ,, �,,�. "�'� ; ���`...� ��1 t f I 1 1 �,r /� �� �------_ r Lo 0 a O AL CD CD0 n o m `P o N N N N 9> CD O tD O p. i 0 > CD N r i t t: 1 SILVANO R.MARCHESI DEPUTIES: PHILLIP S.ALTHOFF COUNTII�,COUNSEL �-��-- JANICE L.AMENTA ,St1w_'_ UF• NORAG.BARLOW B. ES SHA`HON L. ANDERSON '- ANDRE WCASCA DY a.,':=1�-•' �_�_`-=`�� ANDREA W.CASSIDY ASSISTANT COUNTY COUNSEL , -X MONIKAL.COOP ER CONTRA COSTA_B-OsUNTY /� /,-• ' s. - 74v ., \ l� VICKIE L.DAWES GREGORY C.HARVEY OFFICE DF—THE-COUNTYSC�OUNSEL MARKES.ESTIS ! •= LILLIANT FUJII ASSISTANT COUNTY COUNSEL �+-�z"= 'I .. II(^.,COUxADMINISTRATI�ON�BUILDIuJG� JANET L.HOLMES DENNIS C.GRAVES 65;11�2INE'STFtEEf_,z4 i.FLO'OFi)J KEVIN T.KERR v /..,v r.._ _ l�„-yt BERNARD L.KNAPP SENIOR FINANCIAL COUNSEL MARTINEZ,-CALIFORNIA�94553-1229 EDWARD V.LANE,JR. BEATRICE LIU - _.= _ . GAYLE MUGGLI ;;� ,'�,1' MARY ANN MASON OFFICE MANAGER ��5• ,______ 't'-i'.t PAUL R.MUNIZ VALERIE J.RANCHE STEVEN P.PHONE (925) 335-1800 DAVID F.SCHMIDIG FAX (925) 646-1078 NOTICE OF UNTIMELINESS JDACOUELINEYWOODS AS TO A PORTION OF THE CLAIM PAMELA J.ZAID TO: Michael Reed Attorney at Law 6959 Norfolk Road Berkeley, California 94705 RE: CLAIM OF: Brenda Richardson Please Take Notice as Follows: In regards to the claim you submitted on October 22, 2001, on behalf of Brenda Richardson, portions of the claim are timely and portions are untimely. The portions of the claim prior to April 22, 2001 that you presented against the County of Contra Costa governed by the Board of Supervisors fail to comply substantially with the requirements of California Government Code Sections 901 and 911.2, because they were not presented within six months after the event or occurrence as provided bylaw. Because the portions of the claim prior to April 22, 2001 were not presented within the time allowed by -law, no action was taken on those portions of your claim. The claim was forwarded to the Board for action only on the timely portions of the claims. The only recourse at this time is to apply without delay to the County of Contra Costa governed by the Board of Supervisors for leave to present a late claim as to the claims which are untimely. See Sections 911.4 to 912.2, inclusive, and Section 946.6 of the Government Code. Under some circumstances, leave to present a late claim will be granted. See Section 911.6 of the Government Code. SILVANO B. MARCHESI COUNTY COUNSEL Y Monika L. Cooper Deputy County Counsel Page 1. CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5; Evidence Code§§ 641,664) I declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street, Martinez,California 94553; 1 am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. 1 served a true copy of this NOTICE OF UNTIMELINESS AS TO A PORTION OF THE CLAIM by placing it in an envelope addressed as shown above,scaled and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California. I certify under penalty of perjury that the foregoing is true and correct. Executed in Martinez,California. Dated:November ,2001 cc: Clerk of the Board of Supervisors(original) Risk Management Page 2 f. r CLAIM ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 913 and 915.4. Please note all "Warnings". AMOUNT: $20,000 OCT 2 2 2001 R.� OVED - COUNTY COUNSEL CLAIMANT: Jamisi J. Callaway MARTINEZ CALIF. 0C'T`2 4 1p, it C1. ERK B A r OF SUPERVIS $ ATTORNEY: None DATE RECEIVED: October 19, 200 ADDRESS: P.O. Box 7100 BY DELIVERY TO CLERK ON: October 19, 2001 Corcoran, CA 93212 BY MAIL POSTMARKED: October 17, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel. Attached is a copy of the above-noted claim. JOHN SWEETS. Dated: October 22, 2001 By: Deputy ! 1I. FROM: County Counsel TO: Clerk of the Board of 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: I0' 3 By: "1 � c'� 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: N) 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. I Dated: b� JOHN SWEETEN, 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 Claiman ddressed to the claimant as shown above. Dated: LUM JOHN SWEETEN, CLERK By �— Deputy Clerk This warning does not apply to claims which are not. subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending.on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. Clairy to: BOARD. OF SUPERVISORS OF CONTRA COSTA CO f INSTRUCTIONS TO CLAIMANT O C T 1 9 2001 C RK BOA •U ���A 3 A Claims relating to causes of action for death or for injury to person or to perso a ;ty�gf. 9 crops and which accrue on or before December 31, 1987, must be presented not later than t e a 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. 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 ) Against the County of Contra Costa or C.54,Va 111 ) / /�!/ �' v 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$ eJGt?=' and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) q-,,25 -01- 2. -o?5S -41-2. Where did the damage or injury occur? (Include city and county) �Yl�,°�'i•�-�Z L�� ��✓ 3. How did the damage:or injury,occur? (Give full details; use extra paper if required) ��O�.r��G�f�' �..�•�.. �d,��`�aR/! �.�LGrE'dti..�1a�7��i��c1O/C� Ile �, ' 4 R 4. What'particular act or omission on the part of county or district officers, servants, or employees caused the r injury or damage? �i� /L/fG✓��6�/_. �r,� �S'�-.�/ ms`s r^. 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 damage.) �i��eN c� 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 5 e:,elG��vN�>�vc 7��� 8. Names and addresses of witnesses, doctors, and hospitals. 9. List the expenditures you made on account of this accident or injury. DATE TIME AMOUNT ) 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 ) (Claimant's Signature) (Address) Telephone No. )Telephone No. NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,presents for allowance or 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 fine. il [1_. ` +• . �....i'�. Nu J Pit y tr:t i { 1 � h 9 1 J-7E wa � �CL- P:l oil 51*1 ._..... t i, :�:.:�.�. � i; �. ._..... ` ..^... � t ........ „`,`r � �� �....... \ !J `�.. �:�::: � ::,::: � ;' ,'.', c ,` �' . cc N Wo MIMM `r' Coco o° tr o o� 0 to U Ut Nyir- 2 oo(J), © r N V 'O 1 iN to °1a oro- 00 rs m E d G � r•'4 G t� J: co CIO Oz am �m -in m zmrn. OM mm MM Z \. GZ Om Z M. ti z c) -4 Q�. C �n 1 T W6 $ ` Zap r cc c3 rG N v 0 0 m r r r r �•. 7! Yom. V f V !F na z - cm 3n m Z-+o om z"v mm MM zZ , am z r' CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 913 and 915.4. Please note all "Warnings". AMOUNT: $20,000 OCT 2 2 21101 ffg-7-�ETpp, . 111 ,_ _. COUN'T'Y COUNSEL CLAIMANT: Jamisi J. Callaway MARTINEZ CALIF. 2 4 ' QQ.1 C! • F p£�iV15'ATTORNEY: None DATE RECEIVED: October 19, 200 S ADDRESS: P.O. Box 7100 BY DELIVERY TO CLERK ON: October 19, 2001 Corcoran, CA 93212 BY MAIL POSTMARKED: October 17, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETE Dated: October 22, 2001 By: Deputy 1 - II. FROM: County Counsel TO: Clerk of the Board of Supervisors (v),'This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: 1 Dated: ICS `� ��� By: �' "�J ,y 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: N) 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: � V bI JOHN SWEETEN, CLERK, Bytilqb4f, ��ti , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have orily'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 Claima ddressed to the claimant as shown above. Dated: JOHN SWEETEN, CLERK By ` n �- Deputy Clerk This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list ' is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may,apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. .: CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY d BOARD ACTION: Nov 6, 2001 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 913 and 915.4. Please note all "WarninNECEIVED AMOUNT: $10,000 OCT 1 $ 2001 OCT 2 8 2001 i.UUiNTY COUNSEL CLAIMANT: Kathy Roberts MARTINEZ,CALIF. CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. ATTORNEY: None DATE RECEIVED: October 16, 2001 ADDRESS: 1655 Toulumne #2 BY DELIVERY TO CLERK ON: October 16, 2001 Vallejo, CA 94590 BY MAIL POSTMARKED: October 15, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE C1 Dated: October 16, 2001 By: Deputy ­ ))II. FROM: County Counsel TO: Clerk of the Board of Supervisors (N),'f 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: By: �40-tg,,V (4Deputy 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:h0lM A W r 61 JOHN SWEETEN, CLERK, By ,� I/ di , 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. a Dated: b9 JOHN SWEETEN, CLERK By 'h� Deputy Clerk This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil' Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. � �Ad 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 orb owing 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 ore owing crops and which accrue on or after January. 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating 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. II ) Reserved for Clerk's Filing Stamp RECEI Against the.Count. of,Contra Costa E® Oar 1 6 2001 CLERK BOARD OF S District) CONTRA COSTq�0VISORS (Fill in Name) - The undersigned claimant hereby makes claim against the County of Contra Costa or the above named District in the sum of,%/O Dom_ DC) and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact Date and Hour) --==---- -�- -�a_---=---a'--- - ----- ------ - ---------------- Where did the damage or injure occur? (Include City and County 1 W� 1�b --k�to-, Cal- -- ------------- 3. How did the damage or injury occur? (Give full details.use extra paper if required) ---a _- J----- ,--- ---- ---- c--_-------� A-- -------------------- 4. What particular act or omission on the.part of ounty or district ficers, servants, oar employees caused the injury or damage? 5 � J�J C (Over) •aug pur juamuosridmr Bans gloq nq to `( 000`ols ) sirllop pursnogj ual lourpaana jou jo aug r iq `uosud alrls aql ur luauiuosudwi .:q io.aug pur luamIIOsudmi Bans gloq ::q io `( 0()()`js ) urjlop pursnogl auo Duipaaasa lou ;o ang r :►q `iraA auo urgl aiow jou jo pouad r loj lrrf Sluno:) aql ur luawuosudmi ::q iaglra algrgsiund si turju.a io °iaganoA `junooar `llrq wrup jualnpnr.ij to aslrj .iur �auinuaL jr avers aql .ird to .%ollu o1 pazuoglnr `iaaWo io piroq joulsip to lua '.i4unoa :iuu olio laag;o to piroq ams Aur of ivawrird ioj to aaur.++ollr lo3 sluasaid •pnri3ap of lualui qj!A+•oqe+uosiad ,uaAa,, :sapriwd apoj jruad aql;o ZL a0113as 11 OK •or, auogdalas •ok auogdafal, W- 7 �/Z ( ssai PF) (aimuhis s; irM .1 SaiuouF jo ssaippt pur amr�4 3irgaq srq no uos iad awos.�q to (.:au-iouv) :01 saDuoN. a ias lurwirla aqj.+q� pais aq jsnw wrrla aqZ„:sapr.toici 0j(, mac7( (- rJe� •U',-`L�� S` _� P 7QL /�� x 3: r. x x >: I• :R � x �R a: � 7 � -tl Pr)aj- -T-�-tt4yzrr�j IXAOIINtV waii ailva �7 :Sinful to luappm srgl jo lunoo3r no aprm.nori saiturpuadaa aql isiq F PL//V l -slrardsoq pur •siojaop ;sassaullm}o sassaippr pur, saiurk •g - -- --- ------- ----- - --- - -- ------------------------------------------------------- a etuep io.Canfut a,%zpadsoad.nuc jo iunowe pairtunsa aq3 apnpuI) ;pajndwoa junomr pawrrla aAogr agl fir." .Aog Am---- -- -------- - =--------------------•--- •--------------------- -ascuirp oine xoj sawuipsa oma tpunv 'pawtcla saoeutcp so saunfut jo ivatsa nnj paljnsai mrrla noe op saunfur":io satrmrp lrgtA -9 T •' !i -------------1�" --- -- - - -------- �- - ;,e.infur to anruirp agl Dursnra saaeoldma to'slurAlas`sia��}o jauzsip to :�lunoa;o saiarn aql air lrgM •S t� C57 '" } t r 1c .. r i \ 'r• ��. �. .,.; \ f, ,� f r �: ._ , j � _. 1� f ;, . . ,� �� ". ``\ t J ��. ,.• /� CLAIM zl� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 913 and 915.4. Please note all "Warnings". _ OCT ;l M1 ����� AMOUNT: $2,103.11 COUNTY COUNSEL MARTINEZ CALIF. OCT 2 4 2Uii i CLAIMANT: Gary Rodrigues CLERK BOARD Of CUPpERVISi .';; ATTORNEY: None DATE RECEIVED: October 19, 200 CONTRAC,-;:!ii CO. ADDRESS: 2741 W. Newell Ave BY DELIVERY TO CLERK ON: October 19, 2001 Walnut Creek, CA 94595 BY MAIL POSTMARKED: October 17, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET01�611 Dated: October 22, 2001 By: DeputyI/6 II. FROM: County Counsel TO: Clerk of the Board of Supervisors ('This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: I Dated: By. il'L� 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 i jsminutes for this date. Dated: JOHN SWEETEN, CLERK, By G , �J'� , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 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: UJ JOHN SWEETEN, CLERK By �+ L X,_ Deputy Clerk This warning does not apply to claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. RECEIVED Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY ,OCT 1 9 2001 INSTRUCTIONS TO CLAS CANT CLERK BOARD OF SUPERVISORS CONTRAOSTA CO. A. Claims relating to causes of action for death or for injury to person or to personal prop • or 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, 19M 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 GARY D. RODRIGUES ) ) Against the County of Contra Costa or 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 2,103.11 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact Date and Hour) Officer Garibay (CCSheriff'sDept) _September_21,_2001__ hour unknown but_aEprox:_ 12:30_p_m.__ See police _report_O1_27263) 2. Where did the damage or injury occur? (Include City and County) 2741 West Newell Avenue, Walnut Creek in Contra Costa County ------------------------------------------------------------------ 3. How did the damage or injury occur? (Give fail details:use extra paper if required) Rocks thrown at vehicle caused by county road crew grinding cracks in the street. The cracks were later filled with tar. ---------------------------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? 1. Not notifying me of work to be done beforehand. 2. Directing grinding machine towards vehicle and grinding 4 cracks in street in front of vehicle. See police report No. 01-27263. (Over) Z0'd TZbT S22: SZ6 iN3W9UNUW ASId 000 8T:bT . TOOE-60-i00 20'd _1dl0i. S. What are the names of county or district officers,servants,or employees causing the damage or injury? Unknown. ------^------------------------------------------------------------------------------ 6. What damages or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for sato damage_) Broken windshield with approximately 20 rock chips in window. Numerous rock chips in paint (hood, grill, bumper-, fenders, et-c.) See photographs. ------------------------------------------------------------------------------------- 7. Hoa'was the above claimed amount computed' (Include the estimated amount of any prospective injury or damage.) - By- auto body shop-estimators: (see- estimates) --------------------------- ----------- 8. Names and addresses of witnesses,doctors,and hospitals. Barbara Hopkins, 2733 W. Newell Avenue, Walnut Creek Viola Collins, 2740 W. Newell Avenue, Walnut Creek Dave Miscovich, 2749 W. Newell Avenue, Walnut Creek ,Officer- A. Garibay, Contra Costa County Sheriff's Dept. 9. List the expenditures you made on account of this accident or injury.- DATE njury:DATE ITEM AIvIOII'�T N/A Gov. Code Sec 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney J (Claimant's mature) 2741 West Newell Avenue (Address) Walnut Creek, CA 94595 Telephone No. Telephone No. (925) 939-5140 NOTICE Section 72 of the Penal Code provides: "Every person who,with intent to defraud,presents for allowance or for payment to any state board or officer,or to any county, city or district board or officer,authorized to allow or pay the same.if genuine,any false or fraudulent claim, bill, account,voucher, or writing,is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand dollars (S1,000 ),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars (S10,000 ), or by both such imprisonment and fine- 20'd ine-20'd TZbT S22 SZ6 1N3WJdNUW 71SId 300 8T:VT . T00Z-60-100 10/05%2001 at 03:01 PM Job Number: 15546 MIKE'S AUTO BODY OF WALNUT CREEK License #:AB170842 Federal ID #:680291453 WHERE QUALITY COUNTS 2140 N• BROADWAY WALNUT CREEK, CA 94596 (925)210-1739 Fax: (925)210-1772 PRELIMINARY ESTIMATE Written by: HERB JACKSON # Adjuster: Insured: GARY RODRIGUES Claim # Owner: GARY RODRIGUES Policy # Address: 2741 WEST NEWALL AVE Deductible: WALNUT CREEK, CA 94595 Date of Loss: Day: Type of Loss: Evening: Point of Impact: Inspect MIKE'S AUTO BODY OF WALNUT CREEK Business: (925)210-1739 Location: 2140 N. BROADWAY WALNUT CREEK, CA 94596 Insurance Company: 5 Days to Repair 1999 CHEV S10 4X2 EXTENDED SPORTSIDE 6-4.3L-FI 2D P/U WHT Int: VIN: 1GCCS19W6X8158553 Lic: CA Prod Date: 02/1999 Odometer: Air Conditioning Intermittent Wipers Dual Mirrors Clear Coat Paint Power Steering Power Brakes Anti-Lock Brakes (4) Driver Airbag Passenger Airbag Cloth Seats Split Bench Seats Rear Step Bumper Aluminum Wheels ------------------------------------------------------------------------------- NO• OP• DESCRIPTION QTY EXT• PRICE LABOR PAINT ------------------------------------------------------------------------------- 1 FRONT BUMPER 2 Repl Add for fog lamps 1 0.00 0.3 0.0 3* Rpr Front bumper 0 0.00 1_0 2.0 4 Add for Clear Coat 0 0.00 0.0 0.8 1 • 10/05/2001 at 03:01 PM Job Number: 15546 PRELIMINARY ESTIMATE 1999 CHEV S10 4X2 EXTENDED SPORTSIDE 6-4.3L-FI 2D P/U WHT Int: ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 5 GRILLE 6 0/H bumper assy 0 0.00 1.8 0.0 7 R&I R&I grille assy 0 0.00 Incl • 0.0 8* Rpr Grille w/Sport pkg• painted 0 0.00 1.0 1.3 9 Repl Emblem gold 1 18.75 0.1 0.0 10 HOOD 11* Rpr Hood Chevrolet 0 . 0.00 2.0 2.8 12 Add for Clear Coat 0 0.00 0.0 1.1 13 FENDER 14 Blnd RT Fender 2WD 0 0.00 0.0 1.1 15 Blnd LT Fender 2WD 0 0.00 0.0 1.1 16* R&I RT Flare front Chevrolet 0 0.00 0.3 0.0 17* R&I LT Flare front Chevrolet 0 0.00 0.3 0.0 18* R&I RT Flare rear, Chevrolet w/o X 0 0.00 0.4 0.0 19* R&I LT Flare rear, Chevrolet w/o X 0 0.00 0.4 0.0 20 WINDSHIELD 21* R&I RT Nozzle 0 0.00 0.2 0.0 22* R&I LT Nozzle 0 0.00 0.2 0.0 23 Repl Glass GM 1 364.96 1.5 0.0 24 Repl Urethane kit 1 48.10 0.0 0.0 25 Repl Upper molding 1 9.50 Incl. 0.0 26 Repl RT Side molding 1 27.25 Incl• 0.0 27 Repl LT Side molding 1 27.25 Incl• 0.0 28# Repl COVER CAR 1 5.00 T 0.2 0.0 29# TINT COLOR 1 0.00 0.5 0.0 ------------------------------------------------------------------------------- Subtotals =_> 500.81 10.2 10.2 2 10/05/2001 at 03:01 PM Job Number: 15546 PRELIMINARY ESTIMATE 1999 -CHEV S10 4X2 EXTENDED SPORTSIDE 6-4.3L-FI 2D P/U WHT Int: Parts 495.81 Body Labor 10.2 hrs a $ 62.00/hr 632.40 Paint Labor 10.2 hrs a $ 62.00/hr 632.40 Paint Supplies 10.2 hrs a $ 27.00/hr 275.40 Sublet/Misc. 5.00 ---------------------------------------------------- SUBTOTAL $ 2041.01 Sales Tax $ 776.21 @ 8.0000% 62.10 ---------------------------------------------------- GRAND TOTAL $ 2103.11 THIS IS A PRELIMINARY ESTIMATE AND ADDITIONAL CHANGES MAY BE REQUIRED FOR THE ACTUAL REPAIR. PARTS PRICES SUBJECT TO CHANGE ! Estimate based on MOTOR CRASH ESTIMATING GUIDE• Unless otherwise noted all items are derived from the Guide DRlGD94 Database Date 8/2001 and the parts selected are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. Asterisk (#) or Double Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have been modified or may have come from an alternate data source. Non-Original Equipment Manufacturer aftermarket parts are described as AM or Qual Repl Parts. Used parts are described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recon Recored parts are described as Recore• NAGS Part Numbers and Prices are provided from National Auto Glass Specifications, Inc. Pound sign (#) items indicate manual entries. Pathways - A product of CCC Information Services Inc. 3 • • Date: 10/5/01 03:31 PM Estimate ID: 7372 Estimate Version: 0 Preliminary Profile ID: Mitchell JIM'S AUTO BODY, INC. Jim's Calif.Auto Body,Inc. 2100 North Main Street Walnut Creek,CA 94596 (925)933-2109 Fax: (925)933-8015 Damage Assessed By: Rick Torres Condition Code: Good Deductible: UNKNOWN Owner GARY RODRIGUES Address: 2741 WEST NEWELL AVE WALNUT CREEK,CA 94595 Telephone: Home Phone: (925)939-5140 Mitchell Service: 916492 Description: 1999 Chevrolet S10 LS Vehicle Production Date: 2/99 Body Style: 2D PkupXCb 6'Bed 122"WB Drive Train: 4.31-Inj 6 Cyl 2WD VIN: 1GCCS19W6X8158553 License: NUG581 CA Mileage: 27,406 OEM/ALT: O Search Code: None Color: WHITE Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units 1 600049 REF REFINISH FRT FACE BAR C 0.9 2 600078 REF REFINISH FRT FILLER C 0.6 3 600080 REF REFINISH FRT AIR DEFLECTOR C 1.0 4 630238 REF REFINISH FRT AIR DAM C 1.2 5 600083 BDY OVERHAUL FRT BUMPER ASSY 1.6 # 6 600106 BDY REPAIR FRT BUMPER FACE BAR Existing 1.0* 7 600359 BDY REMOVE/INSTALL GRILLE ASSY INC 8 631181 BDY REPAIR GRILLE Existing 0.5* 9 603200 BDY REPAIR HOOD PANEL Existing 2.0* 10 AUTO REF REFINISH HOOD OUTSIDE C 2.5 11 606080 REF REFINISH R FENDER OUTSIDE C 1.6 12 606090 REF REFINISH L FENDER OUTSIDE C 1.6 13 617750 GLS REMOVE/REPLACE W/SHIELD GLASS Sublet 280.00* 0.0*# 14 900500 BDY* REMOVE/REPLACE FLEX ADDITIVE New 7.50* 0.0* 15 AUTO REF ADD'L OPR CLEAR COAT 2.1 16 933003 REF ADD'L OPR TINT COLOR 0.5* 17 933007 REF ADD'L OPR FILL,SAND AND FEATHER 18 AUTO REF ADD'L OPR COLOR SAND&BUFF 1.3* 19 933018 REF ADD'L OPR MASK FOR OVERSPRAY 5.00* 0.2* 20 AUTO ADD'L COST PAINT/MATERIALS 336.00* ESTIMATE RECALL NUMBER: 10/5/01 15:31:14 7372 UltraMate is a Trademark of Mitchell International Mitchell Data Version: SEP_01_A Copyright(C)1994-2000 Mitchell International Page 1 of 3 UltraMate Version: 4.7.007 All Rights Reserved •, Date: 10/5/0 1 03:31 PM Estimate ID: 7372 Estimate Version: 0 Preliminary Profile ID: Mitchell -Judgement Item #- Labor Note Applies C - Included in Clear Coat Calc Remarks OWNER REPORTS VEHICLE DAMAGED FRONT END AND W/SHIELD DAMAGED DUE TO CITY WORKERS WORKING ON ROAD THREW ROCKS HITTING VEHICLEAT Add'I Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 5.1 60.00 0.00 0.00 306.00 Taxable Parts 7.50 Refinish 13.5 60.00 5.00 0.00 815.00 Sales Tax @ 8.000% 0.60 Non-Taxable Labor 1,121.00 Non-Taxable Parts 280.00 Labor Summary 18.6 1,121.00 Total Replacement Parts Amount 288.10 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 336.00 Customer Responsibility 0.00 Sales Tax @ 8.000% 26.88 Total Additional Costs 362.88 I. Total Labor: 1,121.00 II. Total Replacement Parts: 288.10 Ill. Total Additional Costs: 362.88 Gross Total: 1,771.98 IV. Total Adjustments: 0.00 Net Total: 1,771.98 This is a preliminary estimate. Additional changes to the estimate maV be required for the actual repair. Point(s)of Impact 16 Non-Collision(P) Repairs Authorized By: - - - - - - - - - - NO CREDIT CARDS ACCEPTED - - - - - - - - - ESTIMATE RECALL NUMBER: 10/5/01 15:31:14 7372 UltraMate is a Trademark of Mitchell International Mitchell Data Version: SEP_01_A Copyright(C)1994-2000 Mitchell International Page 2 of 3 UltraMate Version: 4.7.007 All Rights Reserved Date: 10/5/01 03:31 PM Estimate ID: 7372 Estimate Version: 0 Preliminary Profile ID: Mitchell Company Code: Drop Off Date: 10/5/01 Repair Dates: Promise Date: 10/5/01 Start Date: 10/5/01 pick Up Date: `10/5/01 Completion Date: 1015101 ESTIMATE RECALL NUMBER: 10/5/01 15:31:14 7372 UltraMate is a Trademark of Mitchell International Mitchell Data Version: SEP_01_A Copyright(C)1994-2000 Mitchell International Page 3 of 3 UltraMate Version: 4.7.007 All Rights Reserved \ �2 � UA . � « � \ n % . a g . � , � . a \ x . � ¥ + � � - � � va a ' 0 00 � tit\ � \ � � r' t t i� ��� �s '� ' . � ' '. �} : �" r - � ►. � ` � .. :.. '.r; �v � s ., _ '+� _ , � , . y 2 ` J � � � O 1 v � � y. `` `, ' .. ti Q J f` 'A - . n `n � - • •{ p � .. a _ .b� � ;+ `,, � 4 ' r o f�. _ .� . y .r ';4� � - �r ', of•.J. '^ � � wt� ' �' � t�'. j�=�� ♦ tom%. � �+ :� . - .. 'r. j y x'. �i' - '"S•; •t.-1 �" „tf\.' '.,}� \1 .\:�.at�`:.•f'�'+�v'�'•. x't•.•tt'f^° Y. \�' � wt tl,}•.-'a.�• '.ti..�{�'4 �_.+� 'J'� tai,',:•\� J ':..� .fir• ,;. i' •�'+ ��'. , n ' •s` aid '..'�w�. +ylr ��?- ' ;t.. " 'C,,C• f.1` "- ft. H. +i a 'w .:.tj' .[. !w -`,• _ `4 �'�,,�' lCr.'.'. elf.' ••.4.• �1'.t.',e•�U °.•ti 5''( `t� � •3 �.l ,•L. A'.t Sid;.' \�}r�..j}�..',�r'�., r"i ���3 .. 4 .�'S•.k.. -d •...�An,�sa ':l� ';F• �- 'ice...',�14• '''. tl+} .::ata.: a:;Af i.. ,_. .J .... t.•:�+,t``:. iy .' .^•. ... ,• +,. ,fir'' :,:,.•..�' s`i.-:• ♦::' .. - �,.j} yd.-` .moi_ -,�,`��•: .c ti,F•, ,7..:.. 'y+'� 4:.:%•;�'•%'rt•'Y�^� ���;^•C'�;.';�."".^�iti �. 9. .yi$�:�, •x a°ri"-i '`:r�'.;a'w T.'-�.. "4'sr 't•: :••IV,r 5* ,i..'c_'•'�`.:.: +;tt'.Z,: F.yt.:::,:'44...!``; :r6rd, fir_. .. _ •��.a. -y.r.' >. •:� s;: '.c��° :F;r!.�y`,ti�.y-.:�k-.4.p2'.;.r`+;:"}j� �• 'i-a: -?r)'i' ;� . .�' - :d ++_: ,,!-•.ate"'+ .{}.i�: i Y"',.t,'� ^� •�'' M.•r_ �' ,. �• Y:. +�:;'^'a',�vo• - y wFt4YM�°'';�::�.Y .• .,.,:�.: .,�;.,.,;9, ry'' .:,y.'y�y. .°_ `• �•,.*'-%..:'r .:•j.{�'Ry Ha+•,.•••1_•Gti'�`t f�.y %7''>> °tit ?ap•.y. .'y,r�� r1�^r'�'-fy' .:�?.� #•r-kv+y.,:Y t, h w: ;Y'T"J.•.i s�/,+',�.Nr. •. t,�• t 1W a y, CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 913 and 915.4. Please note all "Warnings". AMOUNT: $207.26 OCT 2 2 2001 F-T-7-r! COUNTY COUNSEL r ----__ CLAIMANT: Kerry Schwartz MARTINEZ CAUF. j Oi;r 2 4 ATTORNEY: None DATE RECEIVED: October 22, 2061. gCARD OF SUPERVISORS CONTRA COSTA co. ADDRESS: 106 Windover Dr BY DELIVERY TO CLERK ON: October 22, 200 Danville, Ca 94506 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE.Pftef Dated: October 22, 2001 By: Deputy I1. FROM: County Counsel TO: Clerk of the Board of Supervisorsl. (q-f'Eis 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: �L�'�3-"��/ 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: Ly JOHN SWEETEN, CLERK, B;b- /U , 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. 14 Dated: IVQ �lY/1 �,dl JOHN SWEETEN, CLERK By / v Deputy Clerk This warning does not apply 'to :claims which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. Claim to: BOARD OF SUPERVISORS OF CONTRA,COSTA COUNTY INSTRUCTIONS TO CLAINLaNT 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 1001' 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 propem 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. i_ at tihe erlu of anis form. RE: Claim by . ) Reservedfor Clerk's Filing Stamp �( KerrV Sc�war�Z Cou o -r Com fi-4 CC RECEIVED RECEIVED Agai st the County of Contra Costa OCT 2 2 2001 or F CLERK BOARD OF SUPERVISORS District CONTRA COSTA CO. ) (Fill in Name) The undersigned claimant hereby makes claim against the Countv of Contra Costa or the above named District in the sum of S a0�o� a and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact Date and Hour) uy------------ -2_at, t---, _f__�_20 0�------ --- ------------ 2. Where did the damage or injury occur? (include City and County) RoQa�_�ea�iil�_soufh_�e,�ie_f�e-_mZain ga{e.S - ------------ aTl~-ck�►ai✓K �u,t 3. How did the damage or injury occur? (Give fall details. use extra paper if required 1 y Liu 1 / w as drl✓i.l SO C4 -, oh Slezcic-ti a w/' /2o a cl C[ ve, a hole OUflal fhaf IS usually e-0V by �'L►t Sc h o/eS ai.e. � a // r der �-h,° ra� dS a.ha' `n u f� 6-e Uf�.</. ��p���;� �fr�cl --- ye -------------------------- - - ------------------- - --------- (---e fJa�tr�-- 4. What particular act or omission on the part of county or district officers,. servants, or employees caused the injury or damage? 44 d e. Bio/e �ee►17 �rO�pe,/SCC/ C Glave be�'7- rl(D w a V io/ m y C a,� �l _� /f GvY a'nq a n Cl Ct v . �G Fres Se-✓ere d, ��y --mAc� C_aIle-d � z c (J(".11�1 ✓coa0 ed (Over) Cove�� ooh �zIcevcua�c�- S Cove /L aug par wawuosudmi q:)ns gloq .�q Jo `( 000`0IS ) ur.11op pursnogl ual lulpaaaza 1oa jo aug r .Cq `uosud aids aq1 at waaiuosudmi .Cq Jo `aulj par luaaruosudurr q-jns gloq .Cq Jo •( 000•IS ) urllop pursnogl ano yuipaazza lou jo aug r Sq `Jra� auo argl ajoui IOU jo pouad r Joj urf .C4unoa aql ai laawaosudun .Cq Jaglia algrgsiund si 12upwA Jo `Jagonon `iunoaar `lltq *wmID lualnpnrJj Jo-aslrj .Cur �auinuat jt awrs ayl .Crd Jo .%ollr of pazuoglnr `Ja:)Wo Jo pJroq laulsip to .iva '.Clunoa .Cur 01.10 `Jaag;o Jo piroq aids .iur of waw:Crd Joj Jo aaur.++ollr Joj swasaJd `pnuajap of luawi glias`oq.i. uos.Jad .Clan3„ :saptioJd apoJ lruad aqj jo Zi. aotloaS 3JI10 8 U—S ori auogdataZ o4 auogdalal L� (ssaJ pt• ) � ( rutic s iurunrlJ ) .Ca(uouyjo ssa.ippV par aaruA; jlrgaq siq uo uos.ad awos .Cq Jo (.CauJouF) '•O L S3JIL04 Q,35 lurwtrl:)aq1.Cq pauuis aq lsnw turrl:) aqs„ :sapi.toJd Z'0I6 •aac apeJ 'AAD wa L1 alyQ :.CJnfut Jo luapiaar sigl jo runoa:)r ao aprar nog sairuipuadza aql lsi-I '6 oSfid /7v%i�-j-���- L�th- t£g(szb) slriidsoy pur •sJoiaop •sassaalr.a jo sassaJppr par sarurti g ------ ------- ---------- - ---------- ---- �:p- -- -- - ---�-- v ---� pq c(� �u�c�i o LU fx�v '1-F �1'' f y-V y )�q (•a$rwrp to.ijnfut aAwadswd.sur jo iunowr pairwnsa aq3 apnpul) paindwoa lunoair pawrrla anogr ay1 sr.tf ,AO El _ �n0-vi�1a" ;?fu�07-a�,a i►') -a -uo"----%.[ - ,r------ (aoeiuep olna loj Mau[gsa o.bl gpruv "pautl¢p saoeucrp so saunfui jo ivazxa Mu anti) Zp2gnsaJ mala non op saunfal Jo sauralrp irq,%A '9 ------------------------.----------------------------- - -------------------- --- ;,:C.rnfur Jo aarurrp ayl�atsnra saaeoldma Jo`slareJas`slaar�o laulsip Jo .uanoa jo sauna aql aJr lrg�b •y Th e cap was /90Co ve-�-j /if pal-b-culae- /7 o Ae a r) of d up on d ,S'e-vo-e-d b ,� yes o -tk drjverS or � e- &,ar /? o Way 7 i C' VD f �o Se e C )12�r could Aave- Board of Supervisors of Conta Costa County Instructions to Claimant Re: Claim by Kerry Schwartz Against the County of Contra Costa The undersigned claimant hereby makes the claim against the County of Contra Costa or the above named District in the sum of$207.26 and in support of this claim represents as follows: I. When did the damage or injury occur? Monday, August 20, 2001 at 5:30 p.m. 2. Where did the damage or injury occur? On Blackhawk Road heading South before the main gates to Blackhawk Country Club 3. How did the damage or injury occur? I was driving south on Blackhawk Road and went over a hole in the ground that is usually covered by metal cap... these holes are all over the roads and must be used for piping issues. The cap was not covering this particular hole and it flipped up and severed both tires on the driver's side of the car. There was no way to avoid it or to see it coming. Had the hole been covered properly it could have been avoidable. 4. What particular act or omission on the part of county or district officers, servants, or employees caused the damage? Had the hole been properly covered there would have been no way for my car to hit it wrong and have both tires severed. (My father called the county road department which apparently replaced the cover soon afterward- county roads los #2294) 5. What are the names of the county or district officers, servants, or employees causing the damage or injury? Blackhawk Road 6. What Damages or injuries do you claim resulted? Both tires on the passenger side were completely blown out. 7. How was the above claimed amount computed? My car was towed by AAA to the closest tire shop. Early the next morning Big O Tires replaced both tires costing a total of$207.26 8. Names and addresses of witnesses, doctors, and hospitals. Marty Schwartz- 106 Windover Drive, Danville, CA 94506 925-838-4117 9. List the expenditures you made on account of this accident or injury: Date: August 21, 2001 Item: Replace two tires Amount: $207.26 Receipt enclosed. iromm, NO REFUNDS ON DEPOSITS OR SPECIAL ORDERS NATIONAL CUSTOMER SERVICE' ' PHONE#oonou1-24*o CUSTOMER MUST PRESENT COPY OrINVOICE FOR ANY vvxnnANTY BIGOTIRESOFSANRAMON * * * INV8ICE * * * 2089 CAMINO RAMON Invoice# 1-49180 SAN RAMON, CA 94583-13�1- S 08/21/01 E 08/21/01 (925) ) 355-9500 Page: 1 Sold To Veh:88 MBZ 260E Bar ID: AB182436 SCHWARTZ, KERRY Lic:2JNB146 EPA ID: CAL000142202 367 UNION AVE APT. #B Unit-0 Ship To CAMPBELL, CA 95008 Miles: 194, 504/0 Other Information H Emp: 1-143 / 1-2 W 650-937-0958 PO#: -- -Slsm -Me:h -- -Part'0 - '-QTY -0escriptiom . '- -- '---- Parts Labor FET Total 143 AbT28 2.00 1T5,/M5 91H FULDA AS0URO H 82.99 0.00 0.00 165.98 1432 WA0Hc1! 2.00 WARRANTYROAD HAZARD PRO-RATED 0.00 0.00 0.00 0.00 THESE TIRES HAVE APRO-RATED WARPANTYAGlNSTFAILURE DUE 0DEFECTS lNWORKMANSHIP OR MATERIALS AND AQqINSTROAD HAZARD FAILURE FOR THE FIRST 3 YEARS OF THE ORIGINAL TREAD UOWN TO 3/32NDS OF AN INCH OF REMAINING TREAD. INCASE OF AN ADJUSTMENT, THERE WILL EEACHARGE 0MOUNT AND BALANCE THE NEW TIRE. *FREE RE-BALANCING* *FREE FLAT REPAIRS* *FREE TIRE ROTATIONS 143 LBTlCB8UT 2.00_ TlREMOUNT 9-8ALAHCE &YALVE STEM. 0.00 12.00 0.00 24'00 143 ` EWT 2.00 ENV. DISPOSAL TAX FEE FOR TIRES '� 0.00 1.00 0.00 2.08 �S� �00 8 ! ' ��� FB ' � 1.� 000 2 � 143 [SPOSAL�TI8[ D 0. . . ' ' � - Cash Check Charge Card Parts: 165. 98 0. 00 0. 00 0.00 207. 26 Labor: 28. 00 Check #: Subtotal: 193. 98 Sales Tax : 13. 28 / oft i..t 1. /ACKNOWLEDGE NOTICE AND ORAL wppnov^Lopm*/woREASs/wr*son/e/NALsormArsopn/cc. TIRES: Limited Warraritu fol•Bitl.O'&Fulda Brand Tires: i. ,.c:ondition nt:ay re'siJlt:.Big O.,%yi11'rfieck flee lctg nuts on,new c:tnstcim or inaq;wh".1r, L'very I31g,0 Brand tire bearing the Big narne,'with serial number cold not inarked free of charge and Bi_O assumes no responsibilittrfor dainiha6q or injury that,coL`ildi- "Bleni".purnt chased at a Big O Tires Store,is warraed apinstfailnre.due to defects' occur if customer fails to have the Iug nuts chcc•kcc!as;recon:rnhended:•' ' in wor'limariship ur materials and 4wns( road hazard damage or failure for the lilt: of the original I.read(down to,2/�12nds ci:an inch of'rennaining(.read).Any such tire BIG O LMffTED BRAKE WARRANTY: ' that.bccome's t.mseti-iceable Boring the period specified(lifetime, 4 year. 3 year,2 Your newbrake shoes and disc brake pacts are warranted by Big O'fires for mileage year. 1 veal et.c.) on•tire foci(of I.his;Invoice will be repaired or re-placed free of or time period specified oil the front of this invoice,which ever comes first.lt'inileage charge at any.Bl .C).,'fires_Store,,You`may be charged for installation and any sales or flue is not otherwise specified on the franc of this invoice.a 9.000 mile/9 month, Lax.Should a suitable,replacement tire not-be available in a reasonable time, the whichever comes first policy is in effect.If during this period any of the brake shoes origin.il }nn-chpse price;.inic)tidin ,sali_s fax will be refunded. After the free replaceritent p&iod; an allowance wiiI%c given against. the purchase price of a and/or disc brake pads become defective or worn out..new brake and/oi disc replacement arc,based upon Lite life of arc original tread at the Linhc of its damage pads tell]be it upon the presentation of your invoice to any Big 0 Tire Store or failure.. If not specified on the front of the invoice then a t year.warranty will providingbrake serice without charge for the brake shoes and/or disc brakepatds. apply, The brake•shoes!and/or dtsc'brake pads,vvill be consideree) worn out when the shoes'or pads'minimum thickness is less(hall manufacturer's specifications or: With the purchase of your Big 0 Brand'i'ire and Uhc installation package:you will it' no manufacturer's specifications are applicable, Lhe minimum thickness of receive: 1/32nds of an inch or less. IJ&iine Flat Repairs Lifetime Re-balancing Lifetime Rotations ALL OTHER BRANDS NOT LISTED ABOVE: What is not covered in your Limited Brake Warranty: Every new non-Big 0'rare purchased at Big O Tires Store is warranted against •l'he warranty does not cover any additional parts or labor to upgrade the brake- failure clue to defects in workmanship or material for the file of the original tread. systenitto current Tedcral and/or state safety standards. You must authorize the Any such tire which failS under the terms of this warranty(down to 2/32nds of Big O•Store to-rest.orc the entire brake system Lo its proper operation, or il•vora an inch of remaining Lread) will be replaced at current retail price, including do nett, you will receive non-installed, non-warranted brake shoes and/or disc F.ET.. less an allowance for depreciation based on wear. brake pads. This warranty is not:to be construed as a guarantee.that you will Several service packages are available with the purchase of your non Big O, never. experience brake problems.'Abuse, neglect., accidents, and ,unusual or Prestige. or Fulda Tires. these packages are sold separately, as indicated oil Lhc. severe driving condilions can adversely affect. your braking system. it is front(.))'this invoice. There are three packages: reconvncnd'ed•there-—e.,that you have your braking system checked every 5.000 miles at: your nearest. Big 0 Tires Store.., free of charge. Brakes requiring 1. Basic Package includes rubber valve stems,computer balance.&standard replacement and/or.repair due. to accident or other casualty, theft, vandalism, mounting. abuse or neglect are hereby excluded from this w•arraihty. 2. Delui-re Package all Reins in Basic package plus Free flat repairs &.Fred: Rotations. Limitation of Consequential and Incidental Damages: Liability under limited warranty is limited to the replacement.parts and costs of 3. Rernirirn Pack—age-all items in Deluxe package plus 3 year!ro-Baled Ryall installation of these parts at Ifie Big.O'Fires Store providing brake service. '1'hc iI:rzard Warranty down to'2/32nds of an inch of rcrnaining tread R Free above warranty does not cover consequential or incidental damages,includingbut n'e-balancing. q } not limited to, loss of use,towing charges or Lruyportaton charges. USED TIRE WARRANTY: Some states do not allow the exclusion or limitation of incidental or consequential damages.so these limitations may not.apply.111is warranty provides specific,Ieg d Every used tire purchied at Big O-lire s Store is warranted against,failure due to rights.and there may be parer rights'thai may vary from state to state.' defects is workmanship or•inaterial for 30 days:Any such tlr�which'I:ril's under the terms of this limited warranLy will be replaced at current retail prier_,including fr' - F.E.f..less an allowance for depreciation based on wear. WARNING!! NEW'BRAKESrr Your car has been relined%v-ith Premitiiir Brake Lining.-You ake cautioned against WARRANTY ADJUSTMENT CHARGES: making rapid or severe brake..applications immediately adi.cr installing new brake For any tire replaced under warranty it.is the Owner's responsibility to pa;applic_ fining.A new set of relined brakes should be treated similar to a new engine that able taxes and/or governmental J'cxs as well as dealer seriecs such as mounting, has been-overhauled.Since the surface of the brake.lining and possibly the drum balancing,and road hazard warranties when applicable,which you may authorize. surface }las been machined and ground, the brakes will require sealing before attempting severe stops. Apaly your brakes moderately for the first 500 rriiles. Any Big O Tires Store will honor these limited warranties and provide a comparable . priced replacement tire, or a cash refund of the original purchase price can be 'ALIGNMENT WARRANTY 6 MONTHS,6,000 MILES IJMTED WARRANTY SUUStitUt.ed eat our discretion. Tread wear is pro-rated on the basis that the fire tread is wona dowm to 2/32nds of an inch remaining tread groove depth or to treadyear indicators on tires containing thenh for Big 0&Fulda Brand Tires.The FRONT END N SUSPENSION PARTS: replacement cost is determined by muiLiplying the current suggested list price of if a front end/suspension part listed on the front of this invoice and installers file replace- by a Bis-*, 0 Tires Store ceases to function because of failure of materials, nient tire by the percentage of tread used and adding F.E.T. and state taxes. workmanship, or wear for the period or mileage specified on the front. of this All Tires Purchased from Authorized Big O Tires Stores: invoice (12 months or 12.000 miles if not specified on the front of this invoice:), General Conditions & Dclinitions: a new part will be furnished. if during this period the parts become clefective Proof of Purchase Required -Big O's limited warronties for Lires purchased from or worn out., new warranted parts will be installed upon presentation of your all authorized Big O Tires Store. will be honored at any Big 0'Fires Store. The invoice to any authorized Big 0 Tires Store with a front. end department, failed ire must be returned Lo a Big O 'Fres Store. This w•arraniv is not without charge for the parts.This warranty does not cover:any addiLional parts transferable. Warrant, applies to original purchaser only. For warranty. lire to restore the front cod/suspension system to current.federal safety standards. ovancrs must. present their sales invoice. if you do not. authorize the. additional work. you will receive non-installed, Proper 'fire Renoir - All Tires must. be repaired in accordance with Big O's non-warranted parts. appropriate 'fire Repair Policy. An improper repair does not constitute an adjustable condition.'fires that fail cis the result. of an improper repair are This warranty is not to be construed as a guarathtee that you will never excluded from warranty. experience front end/suspension problems. Abuse, neglect. acc•idcnts and Road Hazard Failure •The tenu "Road Hazard Failure" includes non-repairable unusual or severe driving conditions can adversely affect your front punctures. cuss, impact breaks, bruises and similar injuries. end/sus tension s seem. Bi O 'fires rreomnhends Lhat you have our front Repairable Tire-A puncture or penetration(not,to exceed %"at its widest.point) i y g y y will be repaired as specified under Big O's'fire Repair Policy. end/suspension system checked periodicalh• at your nearest. Big O Tires Store. Life of Tread - "Life of Tread" means down to 2/32nds of an inch of remaining Sec Front End, Suspension, Shocks/Struts General Conditions Below. tread on all Tires. at which point the tires are considered worn out and no SHOCKS/STRUTS&STRUT CARTRIDGES-LMUTED WARRANTY: longer warranted. Big 0 Tires shocks.MacPherson strict sealed units and strut cartridges shall be Limitation of Consequential Damage - The; above warranties do not cover warranted for as long as you own the vehicles on parts and 12 months ore labor. consequential damage and any liability is limited to repairing or replacing the Bit;O Tires air shocks shall be warranted for 12 nhonlhs from the time of purchase tire at a Bir; O Tires Store in accordance with the terms set forth above. on parts and labor. If the air shocks, shocks, MacPherson shut sealed unit or Exclusions from Warrant- - Those tires which become unserviceable, due to strut.cartridge cease to function because of a failure of materials, workmanship accident, fire. theft, chain damage. vandalism. racing, improper balance or or wear during the period specified. it will be replaced lay an air shock, shock. alignment (uneven or irregular wear) lack of or improper rotation, improper MacPherson strut sealed unit,or start cartridge of equal or superior quality.If Big repair, improper inflation pressure. repairable: putnctureS, overloading. vehicle O Tires installed it,the new one will be installed,as per Lhc above steed warranty. obstruction :.and similar types of damage or abuse are excluded( from warranty. 0 Tires ine.Front End,Suspension,Sh will be i nst General Conditions stateBelow•w • ' Ozone, or weather cracking(superficial cracking)will not be covered by warranty after five vears from the date of purchase. A lire is not adjuslable for problems of appearance after the first 10'A of treadweaar. A tire is not adjustable-for ride Alignment,Front End,.Susuension,Shocks/Struts General Conditions:' disturbance after the first 2/32nds of an inch of treadwear.Any implied warranty Limitation of Consequential damage - The. above warranty does not cover of merchantability qr fitness for a particular purpose, if applicable. is lhrhited consequential damage. and any liability is limitedto repairing or replacing to the duration of this express warranty. Loss of tinhc, inconvenience, kiss of the part at a licensed Big O retail store in accordance with the terms set forth use of vehicle. and other incidental or consequential damages are not•covered above. Some states do not allow the exclusion or Limitation of incidental or by this warranty. '17i above warranties do not inter e tjrcgat.a Bi damages consequential damages, so these limitations may not apply Lo you. '!'his and any liability is limited to repairin}, or replacing the fleet al:.a Big O 'ilres Store in accordance with the terms set lorih above. Sonic slimes do not allow warranty gives you specific legal righi.s,and Vou may also have other rights the exclusion or limitation of incidental or consequential damages or liinitation which van-frorn state to slate.The shock&strut warrcuhty described above on flow long an implied nvarrantv-lasts: so fhese•exeiuSiOnS,or limitations may oniy,appliCSAO. shpc k atnsorlicrs iiivi;:tlled,ofilprivaLely-gwrred.vehicles..: ndit apply,;.-Th is-ivarrf'rily p-idvides spccilic legal!-r.his:and t4cre1hay:be_otlicr rights. which vary from state to stcite. Ge �s�'VAarrtatantk: '"All parts and/or'.labor will have.a 90•day . i_i Caution regarding wheals: Lig nuts part on new customs or nhag wheels could or 4,00.0 rutile.warrafity;whichever=comes first.,finless otherwise become•foosc during-thc first 100 miles of driving. if the lug nuts are-not checked to r,tightness after Lhc[irbl 2$'rrtiles of driving and again aL 100 miles, an unsafe ^ SpeGififq above.., �. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: Nov 6, 2001 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 913 and 915.4. Please note all "Warm � 0 C T 2 2 2001 AMOUNT: Unknown COUNTY COUNSEL MARTINEZ CALIF. ED CLAIMANT: Steve & Sue PlunkettVISORS. ATTORNEY: None DATE RECEIVED: October 19, 2001 ADDRESS: 1160 Meadow Ln #103 BY DELIVERY TO CLERK ON: October 19, 2001 Concord, CA 94520 BY MAIL POSTMARKED: October 10, 2001 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETS C Dated: October 19, 2001 By: Deputy ` -II. FROM: County Counsel TO: Clerk of the Board of Supervisors V'This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ��'�� 3...y� By: �/ /�p'i2'L r� ���� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: 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: � ( JOHN SWEETEN, CLERK, By9)4k � �' , 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: JOHN SWEETEN, CLERK By uv Q�f Deputy Clerk This warning does not apply to claims, which are not subject to the California Tort Claims Act such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular claim. The County of Contra Costa does not waive any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. �I SHARON HYMES-OFFORD CIaim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY OCT 11 2001 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. D. If the claim is against more than one public entity.separate claims must be filed against each public.entity. E. Fraud. See al.-;for fraudulent ,. ms. Penal_ Code c '=at the end of this form. ' . 1 RE: Claim by. ) Reserved for Clerk's Filing Stamp ; Sieve. Qt cl Sue, _�\v nK r✓4 w ro "er RECEIVED . '• o n Cl _119-0 I Against the County of Contra Costa OCT 1 9 2001 or LERK ASSESSMENT APPEALS BOARD ...� 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 Date and Hour) ------------------------------------------------------------------------------------- '_. Where did the damage or injury occur? (Include City and County) �lec�s�. Sem c �1•.e� d�.��r••�, -------------------------- ---------------------------------------------------------- 3. How did the damage or injury occur? (Give full details:use extra paper if required) was 8r.,v�nc� �y �vsl�c,nd -�c'ucK on Steed VVWM%A, –Where?, w¢,r-r_ no 1rcc,d SirigjS Ccenslruc-�,on zone ac- vmeve* ec.vement) WVneCIL 3. V;%* r, 4,or neve Qcverna,/\+ Zone. My Front enc is c� O.—.o.cra A-o 444,e Pots+ .,�her e - - c-.s c lc. w,%\1 u,e: S N c-�jk�- o --.------.--: -- 'r- .--- -- ----=-- --'--:---------------------------------------------- 4. What particular act-or omission on the.,p.art.of county or district officers, senyants,.or employees caused the injury or damage? �T'he�e were no rcno.C� SITl � �- Y1�-�e� nets yC--JeMe.t,,'4' C,v u'neve-t r. �rluglor� � �,. . Corn iY �or riPaye'len - Yas 9n� c. r1Zo�Ke -l6-,e_ Cor)S+V-UC,+ton Cor►A fcit� y s�oolc� y1aie Pes kea S1�c�s �} Over •N-•e Prv�ne� • ` -he r! .dere C36- aSp�Gv�-, ;-- 1A*- enc) o� ei-e Qc.v�ng t t'k' wC-S C'sr1't�t�-. 4e 'aug put, luamuos!tdmi-{ans gloq +q io `( 000`OIS ) urllop pursnogl am'u!paaaxa lou jo aug r Sq `uosud alrls aql III mavanosuduii Sq to`aug par luamuosudmi q:)ns gloq ,iq io `( OOOiIS ) urllop pursnogl auo au!paa;)xa lou jo aug r Sq `tra,i'auo argl atom lou jo pouad r ioj I!rf .,4unoz aql u! luamuosudart Sq iagl!a algrgs!und si `2uuum io `taganoA `lummu `ll!q 'w!rio lualnpnrtj to aslrj .iur "amnuaL j! amrs aql .►rd to .aollr of pazuoglnr `ta:)Wo to p.iroq lauls!p.lo .u!a 6.11unoz) :iule of to `taagjo to ptroq alrls :iur of luaw.ird toj to a:)ur.>Aollr toj sluasatd 4pnrtjap of maim oq.a uossad .itaA3,, :sap!Aotd apo Iniad agl jo Z.1 aouaaS 3JI10 K 'ori auogdalaZ -o_k auogdalal � s YD 7 �Q1 �vnl e>avu S (amuro'm S,lurmlm ) - ;y, .iaruouF;}o�ssatPPF.P.ur:aairk ;4-jlrgaq s!q uo uossad awos .iq to (.iautouF) •:O:L S'3JI. o-K QN.3S lurmlrlD aql.iq pauL!s aq lsnm mrrlo aqs„ :sapuwd ;'OI6 'aaS apeD -.too ]F *Jx X bb1'S_t-5C 4. uawv.�\�a -]�- uclij �osr. ���oys �U•Q�� I��B X01 .LNC IOKt' I13LI 3,LdQ :.itnfu! io ivap!a:)r sup jo lunoonr uo aprm noe satiulpuadxa aql ls!Z -6 �k�>\L-A c` s rildso ur -S-0130 sassaal'-,A o sassat r�,Pur samF;; - i 4 P P�' j. PP P k 'g (jaocturp jo.iinfdt anwadsosd.ittr jo tunotur patewgsa,atf3 apti(attl`), palndmoa,lanomP:pamM:),aAOgF aql Sr.11i.110H _ i ?.a, �:,- •-- . ,li -----spy--- .-�-(-e-- -,----- --------------- -- --i--�----r-----------^j-• �• c. ? . ',,% _ '��Vj.(�(i QTS \.��'�✓v.:vi\"j �Ja�(+7 .571"�G�S'`1'[1e�..'�o:�'a�a �' _ V-AQj, J.o d 'acs 21 w u'at ���. �V u4J. ; ate- �' p T S`p(Y� .'i' \� a - ;�' (a"aeuirp osns. �.ioj saitsumR oAt tPruv,—Datumsaoeturp 10 saunftn jo tuatza f[ttj aAlo.) ;,pallnsat,m!rla noe op saitnfIIi to sa;rmrp lrq,b 9 . Ct Clfi L Unfui to aarmrp agl ouisnrz)saaiiduia'lo`slue uas staagjo lauls!p'io ijuno3m 3o samru aql atr NO REFUNDS ON DEPOSITS ORSPECIAL ORDERS NATIONAL CUSTOMER SERVICE BIG O TIRE #27 * * * I N V O I C E * * * PHONE#mmou1'u446 1440 A CONCORD AVE Invoice# 1-39268 CUSTOMER MUST PRESENT COPY CONCORM, CA 94520 4:110/08/01 E 10/08/01 OF INVOICE FOR ANY WARRANTY 925 6�6-1200 Page: 1 Sold To Veh: 89 MITS MIGHTY MAX Bar ID: AK2112'j8 PLUNKETT, STEVE Lic: 5U68887 EPA ID: CAD053044053 1160 MEADOW LN Unit# Ship To 0103 Miles: 122,491/0 C01ACORD CA 94520 Other InforNation H 925-691-5396 Emp: 1-13 /' 1-7 W PD#: Slsm Mech Part # QTY Description Parts Labor PET Total =====================================================�=�=====��============== 13 0FEC 1.00 DECK B VISUAL DKSPB3ION 0.00 0.08 0.00 0.00 13 PK0R 1.80 PRD8LEM WT.SHOULD W[ LOOK FOR 0.80 0.00 0.00 0.00 RECONMEND LEFT FRONT TIRE (SEPARATING) AND POSS. ANPL%GMENT-425.00 TO CHECIA AND $54.99 TO DO. OTHER THAN THAT WE CUULD NOT SEE ANYTHING VISUALLY BAD OR THAT HAD PLAY . ' Cash Check []harge Card Parts: _ 0.00 0.00 0.00 0. 00 Labor: Check #: Subtotal : Sales Tax : Total : 9 5� /ACKNOWLEDGE NOTICE AND ORAL APPROVAL opANY INCREASE/mTHE onm��ESTIMATED PRICE: TERMS: (NET 10th PROX. UNLESS OTHERWISE SPECIFIED) PAST DUE CHARGE IS COMPUTED BY A "PERIODIC RATE"OF 1.5%PER MONTH ON UNPAID BALANCE WHICH IS AN ANNUAL PERCENTAGE RATE TERMS ACKNOWLEDGED uRECEIVED m OF 18%.IF NECESSARY TO INSTITUTE LEGAL ACTION TO ENFORCE NDER THIS INVOICE.BUYER AGREES T��Y���ECESSARY��T��D'�f6RNs�S��.TION OF THE '`' ``^ x ` �' BRAKES .- SHOCKS ���T� �� xxxxu~�� ��xxu~u.u.�� u��,��xmu~�� ~~�������a�__��,_"�°�� ��__�n~~xGNxomu.NT -TIRES: .. Limited Warranty for Big O 8t.Fulda Brand Tires: condition may result. Big O will check the lug nuts on new custom or in. g wlieel5 Every Big O Brand tire bearing the Big O name.with serial number and not marked free of charge and Big O assumes no responsibility for damage or Injury that could "Blern•".purchased ata Big O Tires Store,is warranted agalnst'failure titre to defects occur if customer fails to have the lug nuts checked as recouanrende,J. in workmanship.or tuatcrials and against road hazard damage or failure for the lite of the original tread(clown to 2/32nds of an inch of remaining tread).Any such tire BIG O LIMTED BRAKE WARRAN77: that.becomes unserviceable during the period specified (lifetime,4 year. 3 year, 2 Your new brake shots and disc brake pads are warrant ed by Big O'lires for mileage year, 1 year eLe.) on the front of this invoice will be repaired or replaced free of or time period specified on the front of I leis invoice,which ever comes first.If mileage charge at any Big O Tires Store.You may he charged for installation and any sales or time is not other ise specified on the front of this invoice,a9,000 mile/9 month, tax. Should a suitable replacement tire not be available in a reasonable time, the 'whichever comes first.policy is In effect.If during this pe}iod any of the brake shoes original purchase price, including sales tax will be. refurldcd. After the free replacement. period, an allowance still be given against. the purchase price of a and/or disc brake pads become defective or worn out.,new brake shoes and/or disc replacement Lire,based upon Lhe life of the original tread at the time.of its damage pads Will be installed upon the presentation of your invoice to anv Big O Tire Store or failure. If riot specified on the front of the invoice then a 1 year warranty will providing brake service without.charge for the brake shoes and/or disc brake pads. apply. The brake shoes and/or disc brake pads will be considered worn out when the shoes'or pads minimum thickness is less than manufacturer's specifications or: With the purchase of your Big U Brand Tire and lire Installation package you will if no manufacturer's specifications are applicable, the minimum thickness of receive: 1/32nds of an inch or less. Lf)effore Flat Rc:pairs Li%erinte Re-balancing Lifetime Rotations ALL OTHER BRANDS NOT LISTED ABOVE: What is not covered in your Limited Brake Warranty: Every new non-Big O Tire purchased at Big O Tires Store. is warranted against The warranty does not cover any additional ports or labor to upgrade the brake failure.clue to defects in workmanship or material for the lie of the original tread. system to current federal and/or state safety standards.You Hurst authorize the Any such tire which fails under tine terms(.)]'(his warranty(down to 2/321lds of Big O Store to restore the enure brake system to Its proper operation, or if you an inch of remaining tread) will be replaced at. current. retail price: including do not, you Will receive non-installed, non-warranted brake shoes and/or disc F.E.T.. less an allowance for depreciation based on wear. brake pads. Tins warranty Is not.to be construed as a ,guarantee that you will Several service packages are available with the purchase of your non Big O, never experience brake problems. Abuse. neglect. accidents, and unusual or Prestige. or Fulda Tires, these packages are sold separately, as Indicated on the severe dritdng conditions can adversely affect. your braking system. It is front of this invoice.There are three packages: recommended therefore, that.you have your braking system checked every 5.000 miles at your nearest. Big O Tires Store, free of charge. Brakes requiring 1. Basic'Package-includes rubber valve stems,computer-balance.&standard replacement and/or repair due to accident or other casually, theft, vandalism, mounting. abuse or neglect are hereby excluded from this warranty. 2. Deheu Package -all items in Basic package plus Free flat repairs & Free Rotations. Limitation of Consequential and Incidental Damages: 3. Prcrnium Package all items in Deluxe package plus 3 year Pro-Rated Road Uability under limited warranty is limited to the replacement parts and costs of Hazard Warranty down i t.o in Dees of an inch of remaining tread & Free installation of these parts at the Big O Tires Store providing brake service. Tile Hazard War. above warranty does not cover consequential or Incidental damages,including but re-bnot limited to,loss of use,towing charges or transportation charges. Some states do riot allow the exclusion or liniftation of incidental or consequential USED TIRE WARRANTY: damages,so these limitation's may not apply.This warran Ly provides specific legal Every material tire.purchased at atO Tyres Store s.warranted against failure.clue to arid there may other rights that may vary from state to stale. defects in workmanship or terial for 30 days.:'troy such t.ire which fails tinder rights,a the terms of this limited warranty will be replaced at current retail price,including F.E.T..less an allowance for depreciation based on wear. WARNINGII NEW BRAKESH Your car has been relined with Premium Brake Lining.You are cautioned against WARRANTY ADJUSTMENT CHARGES: making rapid or severe brake applications immediately after installing new brake For anV tire replaced under warranty it is the owner's responsibility to pay applic- lining•A new set of relined brakes should be treated similar to a new engine that able taxes and/o'governmental fees as well as dealer services such as mounting, has been overhauled.Since the surface of the brake lining and possibly the drum balancing,and road hazard warranties when applicable.which you may authorize. surface has been machined and ground, the brakes will require scaling before attempting severe stops. Apply Your brakes moderately for the first 500 miles. Any Big O Tires Store will honor these limited warranties and provide a comparable priced replacement tire, or a cash refund of the original purchase price can be ALIGNMENT WARRANTY 6 MONTHS,6,000 MALES LEOTED WARRANTY substituted at our discretion. Tread wear is pro-riled on the basis that the tire tread is worn clown to 2/32nds o1'an inch remaining tread groove depth or to treadwear Indicators on tires containing them for Big O&Fulda Brand Tires.The FRONT END & SUSPENSION PARTS: replacement cost is determined by multiplying the current suggested list price of If a front end/suspension part:listed on the front of this invoice and installed the replace- by a Big O Tires Store ceases to function because of failure of materials, tient the by the percentage of tread used and adding F.E.T. and state taxes. workmanship, or wear for the period or mileage specified on the front. of this All Tires Purchased from Authorized Big O Tires Stores: Invoice (12 inonths br 12:000 miles if not specifted on tine front of this invoice). General Conditions & Definitions: a new part.will be'furnished. If during this period the parts becorile defective Proof of Purchase Required- Big O's limited warranties Cor tires purchased from or worn out, new warranted parts Will be installed upon'presentation of your all authorized Bit;O'fires Store, will be honored at any Big O Tires Store. The invoice to any ant.horized:Big O Tires Store With a front end department., failed tire must, be returned to a Big O Tires Store. This warranty is not. without charge for the parts. This warranty does not cover any additional parts transferable. Warranty applies to original purchaser only. For warranty, tire to restore the front end/suspension system to current federal safety standards. owners must present their sales invoice. If you do riot authorize the additional work, you will receive non-installed. Proper Tire Repair' - All Tires must be repaired in accordance with Big O's non-warranted parts. appropriate 'lire Repair Policy. An improper repair does not constitute an adjustable condition. Tires that fail as the result of an improper repair are This warranty is riot to be construed as a guarantee that you will never excluded from warranty. experience front end/suspension problems. Abuse, neglect. accidents and Road Hazard Failure -The term "Road Hazard Failure" includes non-repairable unusual or severe driving conditions can adversely aftecl Your front punctures. cuts, impact breaks, bruises and Similar inJudes, cid/susrenslon system. Bt U Tires recommends that-you have our front Repairable Tire-A puncture or penetrLion(not,to exceed IV,"at its widest point) I } g Y Y will be repaired as specified under Big O's fire Repair Policy. end/suspension system checked periodically at.your nearest: Big U•fires Store. Life of'tread - "Life of'Tread" means down to 2/32nds of wl inch of remaining See Front End, Suspension, Shocks/Struts General Conditions Below. tread on all Tires, at which point the tires are considered worn out and no SHOCKS/STRUTS&STRUT CARTRIDGES-LIMITED WARRANTY: longer warranted. Big O Tires shocks, MacPherson strut sealed units and strut cartridges shall be Limitation of Consequential Damage - The above warranties do not cover warranted for as long as you own the vehicles on parts and 12 months on labor. consequential damage and any liability is limited to repairing or replacing the Big O Tires air shocks shall be warranted for 12 months from the time of purchase tire at.a Big O Tires Store in accordance with the terms set forth above. on parts and labor. if the air shocks, shocks, MacPherson strut sealed unit or Eicclusions from Warrantv - Those tires which become unserviceable due to strut.cartridge cease to function because of a failure of materials,workmanship accident, fire, theft, chain damage, vandalism, racing, improper balance or or wear during the period specified. it will be replaced by an air shock, shock, alignment (uneven or irregular wear) lack of or improper rotation, improper MacPherson strut sealed unit,or strut cartridge of equal or superior quality.if Big repair, improper inflation pressure, repairable punctures, overloading, vehicle obstruction and similar types of damage or abuse are excluded from warranty. O Tires installed it,the new one Will be installed as per the above stated warranty. Ozone, or weather cracking(superficial cracking)will not be covered by warranty See Front.End,Suspension, Shocks/Struts General Conditions Below. after five years from the elate of purchase. A lire is not adjustable for problems of appearance after the fust 10% of treadwear. A tire is riot adjustable for ride Alignment,Front End,Suspension,Shocks/Struts General Conditions: disturbance after the first 2/32nds of an inch of treadwear.Any implied warranty Limitation of Consequential damage - The above warranty, does riot cover of merchantabllitV or fitness for a particular purpose, if applicable, is limited consequential damage, and any liability is limited to repairing or replacing to the duration of this express warranty. Loss of time. inconvenience, loss of the part at.a licensed Big O retail store in accordance with the terms set forth use of vehicle. and other incidental or consequential damages are not covered above. Some states do not allow the exclusion or]irritation of incidental or by Ills warranty. 'file above warranties do not cover consequential damages consequential dama geti so these limitations may not apply ly to you. This and any liability is limited to repairing or replacing the tire at a Big U 'Circ 6 I P- Store in accordance with the t:ernhs set forth above. Some states do riot allow warranty gives you specific legal rights,and you may also have other rights the exclusion or limitation of incidental or consequential damages or limitation which van,from state to state.The shock&strut warranty described above on how long an implied warranty lasts, so these exclusions or limitations nlay'- .. prily applies to shock.a,bsorbcrs installed on privately-owned vehicles. not apply. This warranty provides specific legal rights, and-there may be-Other rights. which vary from'state to state. General Warranty:_All parts,and/or labor will have.'a 90 day Caution rct?ardin�wheels: Lug nuts puL on new customs or niag wheels could o'r 4,000 mile warranty,.w.hicllevel'6o1T1e5 first; Unless otherwise become loose during the first 100 unites of driving.df Ilea lug nuts are not-checked for tightness after the first 25 miles of driving and again at 100 miles,an unsafe specified,above.. � '000 � _ Cfi d la----- ----------- ------- --- - i �� � x '� �� -�--- ----------_-----�___----.- -----.-- -- -------...-.---- ---------------T--- - __ __ ___j_ ______ _ . _____________ ___ _�_-__ .__ ► _ Y.. �t. _.�_.�I_�_.v____-- _.___._______�-_---___-�- ----.�.-�_ __�__. � _�.___.�_�_.___..__-_ . . Z! �o w� re IT IV3� r `'� - /� �� �` ,,., <<� �' ��, r; �, /i ,\ / ,. i '� % 1 ` j ' . 1 \,. '� �'� ,,1 } ....._. ;` f ...�. �' ....._ 1 - ..__ �; :.::_ � ,..:.� t ._: G �' � ��= � '.:. / � ;':=. ." /j I � '....., f � � .�.._ �/ F / f -'