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HomeMy WebLinkAboutMINUTES - 01162001 - C10 CLAIM r QF SUTULUSMS OF CON'T'RA COSTA CQUins CAL NIA a BOARD ACTtJANUARY 16, 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 1y Board of Supervisors. (Paragraph 1V below), given �'�� pursuant to Government !rode Section 913 and 915.4. Please note all "Warnings". 01E LICf` AMOUNT: $10,0020.00 ; f. S iEL MA TME CALIF, CLAIMANT: AMCO INSURANCE COMPANY ATTORNEY: DATE RECEIVED: DECEMBER 13, 2000 ADDRESS: C/O BRIAN TERRY BY DELIVERY TO CLERK, ON: DECEMBER 13, 2000 RECOVERY SUPPORT TECHNICIAN DECEMBER 5 2000 (To County AMCO INSURANCE COMPANY BY MAIL POSTMARKED: &OM&R 3ffr2682 Counsel's address �+ NOTE: No enclosures were sent. L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHI ATCHELOR, Clerk Dated: December 15, 2000 By: Deputy f H. FRONL County Counsel TO: Clerk of the Boarq of Supervisors { } This claim complies substantially with Sections 910 and 910.2. ( This claim FAILS to comply substantially with Sections 310 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 310.8). { } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). { ) Other: Dated: 1. By: t7� Deputy County Counsel I[[. 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 ORDFI : By unanimous vote of the Supervisors present: j This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Date 16 f PHIL BATCHELOR, Clerk, By 404") A/ , eputy Clerk WARMING (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. AFMAVIT OF NL4HI G I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: +� + -;,W) By: PML BATCHELOR. By Deputy Clerk CC: County Counsel County Administrator NXTOR 4.WE$TMAN DEPUTIES: COUNTY COUNSEL AL. NICEAMENTAF NORA G.BARLOW B.REBECCA BYRNES SILVANt7 B.MARGHESI CONTRA �Q�- _ ,y e ,,/ ANDREA W.CASSIDYR CH IEF ASSISTANT COUNTY COUNSEL CONTRA L '7 t� t" MONIKA L.COOPER OF /� ■ VICKIEL.pAWES VI• '� "'�{ S,AF HF �� � NS�rL MARKES.ESTIS G� MICHAEL D.FARR *rc ..., f SHARON L.ANDERSON ISfiRAT 4AV1L JNG LILLIANT.FUJII ASSISTANT COUNTY COUNSEL *+ DENNISC.GRAVES tEEA JANET L.HOLMES MAI 'C1I Z CALIF 2 KEVINTKERR GREGORY C.HARVEY BERNARD L.KNAPP ASSISTANT COUNTY COUNSEL r EDWARD V.LANE,JR. t i BEATRICE LIU GAYLE MUGGLI MARY ANN MASON � , w E PAUL R.MUNIZ OFFICE MANAGER NOTICE OF tIMCIENCY VALERIE P.RETTIG iV V STEVEN P.RETTIG 7^� DAVID F.SCHMIDT DIANA PHONE(925)335'1$00 AND/OR JACQU LINE R FAX(925)$4$-107$ JACOUELINEY.WOOD$ NON-ACCEPTANCE OF CLAIM TO: Brian Terry Recovery Support Technician AMCO Insurance Company 3820 109x'Street, Dept. 2004 Des Moines, IA 50391-2004 RE: CLAIM OF: AMCO Insurance Company Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: [ ] 1. The claim fails to state the name and post office address of the claimant. ] 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [XX] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. [ ] 6. The claim is not signed by the claimant or by some person on his or her behalf. [ ] 7, Other: Page 1 VICTOR J. WESTMAN COUNTY COUNSEL By: Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5;Evidence Code§§641,664) 1 declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California 94553;I am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California. I certify under penalty of perjury that the foregoing is true and correct. Dated: December 4T,2000,at Martinez,California. 1 cc: Clerk of the Board of Supervisors(original.) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE§9 910,910.2,920.4,910.8) Page 2 x Alpe' DECEMBER 04, 2000 Insurance a member of Nationwide InsuranceGCz DEC ?Goo t CLERK 90ARD O; CONTRA COSTA CONTRA COS ATTN: COUNTY ATTORNEY OFFICE P.O. BOX 350 pts � MARTINEZ CA 94553-0350 DEC 112000 RE: AMCO INSURANCE COMPANY COUNTY OOUN6 eL Vs - MS DANA STEEAT KARTINEZ,GAIUF Case #: 00-016681 Claim #: 84FG3288 RAS 7800635730 Dear County Attorney: AMCO INSURANCE COMPANY is seeping RESTITUTION from the above- refernced individual in the amount of $10020 . 00 for damages which occurred on 06/30/00 at or near 0 YGNACIO VALLEY RD. . A copy of our proof of loss and a police report, if available, are enclosed for your review. Please advise this office in writing the status of the restitution and if our claim will be included or not . Please call if you have any questions about our claim. Sincerely, BRIAN TERRY RECOVERY SUPPORTTECHNI IAN AMCO INSURANCE COMPANY 3820 109TH ST DEPT 2004 DES MOINES IA 50391-2004 (800) -532-1212ext. 5839 L48 Li p F a 3 s 4. _ �r . -lit • 0 -� -. _ f 0 00 i � ' C� i ` ' i i ' i • rU) , :.. FIRST ctAsd r A IQ " tit E. V c t � � Off ' ' tom` ' ! " '* SILVAN10 B.MARCHESI DEPUTIES- PHILLIP S.ALTHOFF COUNTY COUNSEL, J JANICE L.AMENTA NORA0.BARLOW B. NES SHARON L.ANDERSON \ ANDRE W.CASCA IDY > ,�� ANDREAW.CASSIDY ASSISTANT COUNTY COUNSELCONTRA C0 +�4 MONIKA L.COOPER .. VICKIE L.DAWES GREGORY C.HARVEY OFFICE OF Ery. COUNSEL MARKES.ESTIS LILLIAFUJII ASSISTANT COUNTY COUNSEL I f JANE L HOL 1NISTRATII'SN JANETLHOLMES +STRE T KEVIN?KERR DENNIS C.GRAVES ,y BERNARD L.KNAPP SENIOR FINANCIALCOUNSEL MANN LIFT w} ����229 EDWARD V LANE,JR. "� � ,II BEATRICE LIU GAYLE MUGGLI r. '. .y,;� MARY ANN MASON OFFICE MANAGER PAUL R.MUNIZ \1 t s'/ VALERIE J.RANCHE VEN P PHONE (925) 335-1800 DAVID F SCHEN DIT FAX(925) 646-1078 DIANAJ.SILVER August 24, 2001 JACOUELINEY WOODS PAMELAJ.ZAID Brian Terry Recovery Support Technician AMCO Insurance Company COPY 3820 109 ' Street,Dept. 5595 Iles Moines, IA 50391-5595 Re: Claim regarding June 30, 2000 loss; your case number 00-016681 Dear Mr. Terry: We received your July 25,2001 correspondence. You initially filed a claim for the above referenced incident on December 13, 2000. On December 19, 2000, we sent you a letter explaining that we did not have all the necessary information to process your claim. No further information was received from you, and the Board of Supervisors rejected your claim in full on January 16, 2001. Notice of the Board's decision was mailed to you that same day. Our Risk Management Department also left messages for you three different times in January and February, with no response. Pursuant to California Government Code section 945.6, you were required to file a lawsuit within six months from the date the notice of the Board's rejection was mailed to you. Because we received no further information from you, we closed our file. No further action will be taken on your claim. Thank you for your cooperation. Please call with any questions. Very truly yours, SILVANO B. MARCHESI COUNTY COUNSEL Byy� � Monika L. Cooper Deputy County Counsel JULY 25, 2001 AUG i is r CONTRA COSTA m ATTN: COUNTY ATTORNEY OFFICE P.O. BOX 350 MARTINEZ CA 94553-0350 RE: AMCO INSURANCE COMPANY VS . MS . DANA STEEN Case # : 00-016581 Claim # : 84F63288 RAS 7800635730 Dear County Attorney: AMCO INSURANCE COMPANY is seeking RESTITUTION from the above- refernced individual in the amount of $10020 . 00 for damages which occurred on 06/30/00 at or near 0 YGNACIO VALLEY RD. . A copy of our proof of loss and a police report, if available, are enclosed for your review. Please advise this office in writing the status of the restitution and if our claim will be included or not . Please call if you have any questions about our claim. Sincere, BRI TERRY RECOVERY SUPPORT TECHNIC AN i[ + ' AMCO INSURANCE COMPANY � t" 3820 109TH ST DEPT 5595 DES MOINES IA 50391-5595 AU � 2oa1 (515) -440--5839 (866) -333-3301---- ext . 5839---- couNr' (;uul\6 L, MARTINEZ,CALIF L48 CIAIM BOARD QE SUPXJMSM Of Q WMA AOJANUARY 16, 2001 Crim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your California Government Cordes. ) notice of the action taken on your claim by the gzf, Board of Supervisors. (Paragraph IV below►, given pursuant to Government Code Section 913 and xu 915.4. Please note all "Warnings". AMOUNT: $500.00 CCUNV N COUNSEL MARTINEZ CALIF. CLAIMANT: DONALD PAUL BORGES ATTORNEY: DATE RECEIVED: DECEMBER. 4, 2000 ADDRESS: 1011 NEBRASKA STREET BY DELIVERY TO CLERIC ON: DECEMBER 4, 2000 VALLEJO CA 94590 BY MAIL POSTMARKED: HAND-DELIVERED L FRONL• Clerk of the Beard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECEMBER 6, 2000 By: DeputyVJ IL FRONL- County Counsel TO: Clerk of the Board o upervisors ( 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 faded late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( } Other: Dated: By: 2Zae�el__ �`�`T7eputy County Counsel M. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: _ / PHIL BATCHELOR., Clerk, By »� , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF NLkHJ NG 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. 14By: PHIL BATCHELOR By� � eputy Clerk !`/"• f nzznt, f`nzzncnl. ("...znr„ AA-*-;--- Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100'' day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988,must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (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 RECEIVED Against the County of Contra Costa D E C " 4 2000 A:41 1n or CLERK BOARC�� SJr�BRV1SORs 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 sura of S,5 ?and in sup ort of this claim represents as follows: 1. When did the damage or injury occur? C Give exactD e and Hour) �-� ---_---�/ ------------------------------------------------------------r 2. Where did the damage or injury occur? (Include city and County) --` /)?Iles _ " t o- _h r�' -_ eo_ Guar% __ e,_Ig _ '_ "`!J / _a '#.r1 3. How did the damage or injury occur? (Give full details;use extra paper if required)- _T alas s4ruak by 5herflq 8rrcci� F . Kt�l�ADW� kl LoKilie T U3r.t,5 Pcv,lle� � �� 1^l� 6hatc.Id er 4-0 �y - j xt/ow Pvrsw-+ y�ciles ,h y . Ile 6v" &Mrox. a 0p�zhiid � 4. What particular act or omission on the part/of county or district officers, servants, or employees caused the 0 injury or damage? e_'9_r plewid befwn %P_ lanes ©- -1+"tt i d tai �o like a line Wye. A4tta W&S 40' ejlablf il\ p r ID Sfee-ci Whafe C oAd 14I;n,3 did nli- 0-11OLDSit 0, 9W 6�,t I t e°c t Lo-r AASeJ a-U6 ru.n a&4,6 ,,5e i>1 e x&Ci`1 fie. SLI.m a NWWC 4,S P. 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W/J 9 IpI I -W itIf ZLinfupo aftump aqj gutsma saagoldma jo IsjuvAjas isiaoWo 43!J:P!p.10 A:4unoa jo sowvu aqj a"Ivqm I; g` . OD „ tV IN cli � d OD CV CV � t t � d �4: 4 ` m• � W Cao 8 r^ I ICr CD0 `a Z A A Im U) CM a c t 5 r j ct� t ix ED {.? N w l Shop Registration #:BAR AL-186431 426 MISSISSIPPI ST. VALLEJO, CA 94590 PH (707) 647-3538 ESTIMATE FAX (707) 647-3538 BORGES DATE-:1 I/15/2 UO.O REPORT# 931 OWNER:DON BORGES HOME PH#: (707) 647-3938- ADDREH9': 1011 NEBRASKA ST, VALLEJO-, CA 94590 WORK PH# (707) YEAR: 1994 STYLE: TRUCK IN: 1FTHX26G2RKA95452 MAKE- Ford COLOR: COPPER/GOLD L I CENSE: MODEL:Pickup P2.50 PROD DATE: l MILES IN: INS CO: PHONE# : 707) ESTIMATOR:DAVE ADJUSTER: CLAIM#. DEDUCTIBLE:$ U.00 ACTION SSBI DESC -I TION PARI-Em PRICK Im UBOR Pk NR LAOOR ESC Due- REPAIR LEFT * OUTER PANEL, N/DUAL FU- 2.5* 3.5 MAJOR EL DOOR, 5 NOT BOX +CL7t W 1,{* R & I FUEL DOOR, (EACH) 0.3 R & I_ FUEL DOOR (SACH} 0.3 REPLACE LEFT QUARTER PANEL, FRONT A- F2TZ9929077AY 39°.9E 0.1 DHBSIVE MOLDIN, B FOOT BOX REPLACE LEFT- QUARTER MIL, REAR ADS nTIMI019AT 2t.90 0.2 HESIVI MLDG R & I LEFT WHEEL OPENING 0.2 REPLACE LIFT REAR TAIL LAMP ASSY 19TI13405C 38.00 0.3 REPLACE REAR STEP BUMPER, CHRO- V2TZ17MI 400:00 1.3 ME REPLACE LIFT * S'T`RIPE TAPE, FENDER, F- _14?Z1520001BAA 47;25 1.0* -DOOR, BOX * ADD FOR TWO-TONI PAINT 1.5* * MASI FOR OVIRSPRAY 5.00* 0.3* * COLOR TINT 0.3* * HAZARDOUS.WASTE. RIMOVAL S OO*. SUB TOTALS -> 563.16 6.6 6.7 0.00 Page# 1 �► � F ,AU''TCf S H Y 1'� Shop Registration # :BAR AL-186431 426 MISSISSIPPI ST. VALLE"JO, CA 9-4' 90 PH (707) 647-3538 ESTIMATE FAX (707) 647-3538 BORGES DATE:11/15/2000 REPORT#: 931 HRS RAT BODY LABOR � .6 x 55 . 00/hr 363 .00 PAINT LABOR6 .? x 55 .00/hr 368 .50 FRAME LABOR 0.0 x 55 .00/hr 0 .00 MECH LABOR: 0 .0. x 60 .00/hr 0 .,00 PARTS = 563 .1-6 LKQ PARTS 0-00 PNT SUPPLIES 6 . 7 at 24 .00/hr 160 .80 MISE 0. 00 SUBTOTAL 1455 .46 TAX ON. $ 563 .16- at 7.3 70 41 .50 —TRA' TOTAL $ 1496.06 Estimate bitten on EASY WRITE ESTIMATING SYSTBM(C), prices based on MOTOR CRASH GOID$(C) (D12MA92) 9/ 0, Indices-NstimatorIs Judgment D E t Autustin warrents-vorkmaasbip, including refinishing; for one year from date of completed repair Page# 2 11/m=at al:47 PM File ID .RVA-37141 56574 MOT VA=XVIwan BENICIA BENICIA.,_CA..94510 - (M7)745-M Fax: (7117)751-11472' Britten by. RILL BELK # 11109/20M01;47 PM j t For: ACO MURAHM AMN'CIES - SAN RM Adjuster) PAM BOLDEN 0 BRTI��t�ItD" Insured: DON BORGES Claim #AM2936 00=: DON BORGES Poli-ay-f Address: ILII NEBRASKA ST Date of Loss: 11/01/2!O VALLE40i CA 94M Type of-'Loss: Collision Day: Point of Impact: 6. Rear Fivming: ^.. I 011 NEBRASKA ST �,�' HOME Locations: VALLEJO, CA 94590 Repair 00( Days to Repair Facility: License # 1994 FORD F250 4X4 SUPERCAR HD 6-7.5L-FI 20 P/U 2 TONE Int: vX. 1FTHX2662RKA95452 Lic: 4Y65617 CA Prod Date: odometer: UNK Air Conditioning _ Cruise Catrcl- Intermittent Wipers Auxiliary Fuel Tank Tinted Glass Body Side Moldings Dual Mirrors clew that Paint TWO Tame Paint Metallic Paint Power Steering Peer Bnakes Power V.Wows Power locks AM Radia FM Radio Stireo Cassette Anti-Lock Brakes (2) Driver Airbag Automatic Transmission Overdrive ---rr-r--rr----------------------r_-_-___--r-r---r-rrrr-------------------,-_-. NO• OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT .rrrr.—�.. — ..�.wr—wwrr+wrrrrrrrwrar++rararw.rwrrurrwnrr�.rrrs 1 REAR BUMPER 2- #/H rear bumper w/cushions 1.3 3** Repl t 00 Step bumper, chrome 1 251-M Incl 1 11/0912CM at 01;47 PM File ID= YVA 37141 .x8874 ISS O IMCW' 1994 FORD F250 4X4 SUPERCAR HD 8-7.5L-FI 2D P1U 2 TONE Int: NO, OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT _______ ----____.._____-__.._..________________ 4 Repl LT Pad upper 1 61.97. IrKl- 5 REAR LAPPS 6 Repl LT tail lamp asst' 1 38.00 0.3 7 PICK UP BOX 8* Rpr LT Outer panel wtsingte fuel d 3.5 9 Add for Clear Coat 1.4 10 Add for Two Tone 1.4 11 Repl LT Quarter panel front adhesio 1 41.35 0�2 12 Repi LT Quarter panel-rear adhesive 1 34.35 0.2 13 R&I LT Wheel opening 0.2 14 STRIPE TAPE 15 Rept LT Stripe tape fender, door, b 1 87.20 16 Repl LT Stripe tape fender, door, b 1 49-.55 174 Repl COVER CAR 1 5.00 T 0.2 18e' Rpr COLOR NAtTCH- 0.5 ___________________________„___-___--_-_________---____-----__-___r .-_______-_ Subtotals'==> 568.42 4.9 6.31 Parts 563.42 Body Labor 4.9 hrs 57.00Jhr 279,30 Paint Labor 6.3, hrs. 57.00thr 351.10 Paint Supplies 6.3 hrs O 0 25.M/hr 157.50 SubletAisc. 5.00 __ ____.._______________ SUBTOTAL �__..___....__..__.....,,.__ -- 0 136432 Sales Tax O 725.92 1 8.25W. 51.69 TOTAL COST OF REPAIRS 4 1424.21 ADJUSTMENTS' _ Deductible -------------------------------------------- -TOTAL ADJUSTMENTS 0.00 NET COST OF REPAIRS 4 1424.21 2 11/09/3.000 at 01:47 PM file ID. VVA 37141 58874 19TIhQM Of RECORD 1994 FORD F250 4X4 SUPERCAR HD 9-7.5L--FI 2D P/U 2 TONE Int: THIS REPORT-'IS--GENERATED BY' AN INDEPENDENT'APPRAISER'BILL BELK'. THIS` IS NEITHER ,AUTHORIZATION TO ORDER PARTS, OR TO PERFORM REPAIRS. AUTHORIZATION FOR REPAIRS MUST COMIE FROM THE VEHICLE OWNER-; THIS IS NOT AN AGREEMENT TO-PAY FOR ABOVE REPAIRS• AN AGREED PRICE OF REPAIR ISNOT AN AGREEftENT FOR PAYMENT. PAYMENT AUTHORIZATION MUST COME FROM THE-OWNER,AND/OR.INSURA0CE..COMPA#Y INVOLVED. NO SUPPLEMENTS WILL BE HONORED-WITHOUT-PRIG APPRWAL ROM APPRAISER. THIS ESTIMATE HAS'BEEN PREPARED BASED ON THE USE OF CRASH PARTS SUPPLIED BY A SOURCE OTHER T1fAN.-THE MANUFACTURER OF:YOURff0TOMVEHICLE- ANY VARRARr;ES APPLICABLE TO THESE REPLACEMENT PARTS ARE"PROVIDED"BY THE MANUFACTURER'OR DISTRIBUTOR-'OF THE PARTS, RATHER THAR BY THE ORIGINAL MANUFACTURER OF YOUR VEHICLE. Estimate eased to EN WCU111STIRATIl 0I1f, ho-isterisk(s) item are derivet from the luide IRiAP22 Iatibase late 10/2100. Double,asterisk(n) item indicate parts supplied by a supplier other'thltte erigiffd et[fl mot mimfidw-er. Pound-sign M iterinicitE-awt entrl@s- CPA items Aave bean certified for fit and finish by the ferttifitd kato Parts Association. 1161 Fart Iftert, Frices and Labor Tres are provided-from tatioaal lute Glass Specifications, Inc. Pathways - i product of CCt Information Services Inc. 3 11/09/2000 at 01:47 Pf! File ID: VVA 37141 59674 g -or - 1994 FORD F250 4x4 SUPERCAR HD 6--7.5L-FI 2D PJU 2 TONE Int: AFTTRRtARKET PAM SUPPLIERS 3 RECOND Step bumper chrome Part No. 07-31-FO1102259 Price *251.00 STOCKT'ON BPR & BODY PART (209)946-IXI 632-SOUT'N ELDORADO STOCKTON; CA 95203 STOCKTON BPR & BODY PART (916)372-3300 IM-TRIANGLE COURT; MITE B (d• SACRAMENTOy CA 95605 STOCKTON-SPR 9 BODY PART" (6001794- 911 1069 HENSLEY STREET (511)234-6960 RICM010-1 CA 94901 ailn _ E'L'ATE OF CALIF00" I, RAf FIC COLLISION REPORT CHP 555 CARS Page 1 (Rev&V$)OP4 042 POP Y at �. NPLpCYct.COIKIfTYW�M - - Baa.DtNTaucr LOM REPORT f0ju t! cxa=DLtT Y EM13tGENCYVMCIE KUM 0 Pn7MBU RG_ DFJ_TAMUM moomomm 0011IIrn DWW= am D COMtCMA, 4M MO DAY Sac. OFFICERI.D. 1 t • 17M -9320 low t7pl NyDAY OF 99= 1r7WIWIMY PHOTOCAAPW W. (K NONE �' T YYYTFt rLTATlMMYRIN. ARTY OIEYMri11011IME NNLM M 7CA7� A•ANN [&4pm L cam NtARIER ATE 1 0078}?6"T' C: -1"4- ff»sa}} _ - ------ 4wIfi_ -- `�A- SM LAN - - X DONALD PAUL BORG ES OV*&"NAM t Q NAMN:AN DRIVEN �` sTREerADDREss 1011 NEBRASKA STREET OMMIM ADDRM ®NAMNi AN ORtVER PARKNO CITY/OTATEIZpWENNO ' VALLEIO CA 945% ol 00 VEHI E ONORDmop: t Tmm t arc HANC ma HEK3tIT YVEiW1T lIIRTlcD�ATE RACE l3$LVENAWAY M [URN [BLU 5-}} 240 }}/29f}955 few PRtDaMr[CKaeTE Ta NONEArr. MOM TOMANVATWE OTliEIR HONIS PHONE VEMCLE 0ENTiPtCATM MUMMER: (707)647-3938 (925)427-}045 CHP USE ONLY 0E6CRINE VEHiCtE OAMMOE a�awE eu ESAMMwEta POLICY Nth VEHICLE TYPE txA+E - TCP a SEC INS. CA401-3087 RDLL 6 R LEN D� ompt or ON MET WEED LjowmT SR-4 65 T TCPAMC MAW PAIM MTATERAFfT1f VEH.YEAR MAKE/UOON�.I COLOR LK ENSE mimeER sun 2 C5144260 CA7cFORD CzaavvNW BLK E992905 CA X BRIAN.EDWARD KAL94OWSKI - WN—miwm NAME AS DRIVER > vnowrxmmr C0N`rRh-COSTA G��PTif 1989 MUIR ROAD OWN" &M A8CRIVEPt rNYNNICtA TATErzr 45TVVATERR-__ WAY;MAR'S'rrM QK94553- pmsBURG CA -94565 DP wEtnae ON DRDERi cr fi`ice (�mm o�..��rr R}VEN AWAY l� t� I J axT ol !► [BRN__jBLU 60} }60 07f}6i}968 vur W R�tecrs X NONCAFr. RtTc�NARRATIVE DTt1Ett ttOt�PFtONE eLMIEnnp"ONE . VMNMLN7EN ATK7N (925)313-2323 .111mmu 'T o cvswaaatcw+t�ne -NMYCiNt murerR rDLiDrRtaNae� W4MURED . 01 Maw nam Ilm"m CNtOFal—I CRMGKV f -e?Neru wr aA rjCry g 185 cou'r TDPm WIM PWN7YOw#wG UCRNN MRS VrAM OWN WA YUR VAN/UOIDE ICOLOR LKS WAWMTOTA 7 ---» --------------- tflUT.1Al.tAN'fj OVRJHL'N RAMM (�SAME AS DRIVER NTANlT ADOI�Ni {� OVi14M ADOPWM rISAM'IE AN DRIVER CIOPommm OF VEHICLE ON OROM OF: _ OPPiCEIt OItlYER L C� ✓� � EYNiS ttae};r 7w � �� Y— RAC@ PRIOR M ECHAHC"DEFECTS TO wyNeATTYE O_THER HOME P P�iO11E YEhMidE MEMTNIGTIONNI t . CHP WEWY--- DE VAP INAMACE WCADE 01 SZ'N D AMA DAIWERYMJf [ VEHICLE TYPE LINK NOME MSNDR YOD uum OVER CA DDT TCY mw M�C1MDt OLNPATCH PA STAAT�TE xxO�F CAL�:t�F+ORHNA�- ` + tSM IN CHP 55' CAR$P 8195 OPI 042 Pyr 2- of 11PoU2000 1728 .491'!1 14813 11` +2 fr omrR ADM OFFIC VIED PROPERTY 5 ©.� DAMAGE OCCUPANTS L-AIRMADMOVEG MICBICYCLE-HELMET Q-,NOTEMTAD A-NONE.ItVEHICLE. M-AIR.BAIM NOT DEPLOYED 1-FULLY EJECTED B-UNKNOWN N-OTHIBt DRIVER 2-PARTOWILIECTED I-DRCIIER C-LAP TUSED P-NOT V-NO12 3 -� '-11lIG aHI 2 TO -E D`LAP�,T NOT USED W YE8 4 5 6 � CHILD RESTRAINT 7-STA vwtiltREAR F-SHOULDERHARNIMIMUSED ®-RIZ OCC TRK OR VAN a.!APP DER W1ANM USED R-It VEHICLE NOT USEES YN0 O-OTHER J tow T-INV944MNAPROPLRUSE K-PASSIVE RESTRAINT NOT VIVID U RONBBIVLHICLE 3 ITEMS MAPMED BELOW 8Y 1'1 110 IK T11E4T11VM- Up WOFPARTYATKVXT TRAM 12twfll .TEYLCIE :1; 2� 3 TYPECFYEi� �. � � movE A vas-woue�u oats- iy X FUNCTIONIIgt 'P RI#TATKHN NOTFUNCTIOMW MWITRAN.ER _ 811HIa01lT OTHER ORRINW �gg LAMSEWMACTW PICKUP OR PAM TRUCK 11IlAIgCRiIIIrMtTTURN Jt Ona 1.PIINEL.TRUKIK4WTRAElR _ _ MANJNOLEFT TURN UNKNOW HEAD-ON TRUCK-Olt TRUCK TRACTOR u nm ASLEEP' = ODESMAE TRUCKITRUCKTRACTORWYRL.A: BACHIIi13 X C REAR DID VICHOOL, G P iiTS1EKVElom ' HCI'oejwT_ VEHIICLE LANEI_ 13 CUHltET4' Ovomimm HBLNY CONNT. P . VEHICLEIPEDEBTRWt L Imo' FIC SNOWING OTHER' WMER rre+rcLE 3FOTmm nNSAt=E TtlRFiWG" FO0/V ILHTY Pf XING INTO-OPPOSING LANE PAR1iEt!_" Vww `C MEirQtNG P1 STRIAN TRAVELING WRONG voky DAYLIGHT Xc OTHER MO10R VEHICLE, OTIAEI AssomTED rAC70RS OTHER- DUSK DAMt�tcrCKK7 R rIIp3 oNt3�ifIERIiGIA�IY1� 1 _. C l:uH2►7181 Li NEFFIERY Mmw MV Fm �I- _ !SARK-PEO STREET UGHTS TRAM No -STREETLJGHTSNOT BICYCLE B vaarenortvau�stx , mm mmmm ft S08ttlETY-DRUG C ucras vvttruuuoe omto _ , 1 2 1 PHYSICAL -BRY FLlMD (MARK I TO 2 ITEMS) QT HAG NOT SEEN-FAMO NG JECT. ICY J OTHER OBMWN HBO-UNDER INFLUENCE' ItATTFIIIfif7it' HSO-NOT.UNDER- E` iNi67 AM '1ilAFfIC #IBD-AWANOMNT UNXMOVM* ,} _Tr F, LSIkVMt4RAW DEEP RUT' X A NO BNOLVW W fOU9 COLLISION IMPAIRMENT-PHYSICAL' LOOft MAMMAL,ON ROiADV^Y' s NLK:RtSffiIgIIW.YI UNFAMILIAR W(TH ROAD IMPAIRMENT NOTKNOiNN ONROADWNY• ATINTERiEC710N DEFECTtVEVEH.EQUIP.: CITED INOTAPPLICABLE C IN _}OT vu I SLEEPYN-FATIGUED 15 CRDI" 1 1 TL UNINVOLVED VEHICLE? A HAZARDOUS MATERIAL ItRflADD + UDES OTHR': E NO UM1SUlHt NOT INROAD A NONE APPARENT 16 APPROACflAILiWINGSCtI3OLBIE RUNAVWkYVEWLE SKETCH0 //yy �}�yy��yY . . �Vi DOT NgICATI NOR IN 199 CHP p. /PD/�e- STATE OF CALIFORNIA RAUMV-1ITNESSIM PASSENGERS- CHP 555 CARS`P 3 Rev&W ON 042 �+ 11/01/20001 1728• 9320 14815 17-0myaav AA[ �Ec mffw OF wjm" WAS(`71'Ol1Ef t. FATAL ` ► a mAr s n o' +anreeir Fw sear ruwr rlev OFFAPIOwww MGY�ONST C7R o a_ _`Il Mares/o,0.�.1 • DELVDi WATTS (05/31/1970) 1980 MUIR ROAD,MAR'1Tr 4-CA 94553 T (KAW4D ONLY)TRANSPORTED8Y: • TAMW TO: DESCRIN • i it(CTIR OFN(pC!NTr.RW NOTN Q T7v7-- (PUUMOKY)TRAIN18PORMIM. TAKEN M. VICrNiIoFV 'IrCRw M AMEi D.QB.i ADDRESS I 7 70 +".£Cfi�,.a:kava;,<Hi[� w-�••- _'.......•--.°..m.• V#CMOFVWWCRIMENOTWW EI11 NAME I MMB./ADDRESS El TRAPHONE BRED ONLY)TRANSPORTED W. + TAWN TO: VICTIM OF VIOLENT CRIME NOTA NAME i .9./ • u tJ I t_J LJ ONLY1 TRANSPOMD W. TA"TO. i [I jDin 0 'o I 1 1 1 VIC'fiM OPV(Ot.�tF CRM1E i�'}71FIEt!` . iDOJL/ t umo ONLn TROMPORTED by. TAX N yo- Sam : CIES: VIC WOFVIULENrrAWMOUgW RWAMft NAME D.MAINR DAY YEAR RIEV ENIPS NAMIE pAy YAR t nnrs7srtrt\ir I AOI t -9 t IRI mtvkn _ STATE OF MIFORNIA DATE OF DIIMENT TIME NCIC NUMBER OPRM I.D. NUWHM l illioo_ 1728 9320 14815 , - 11-26 Baer Road f P'Wented vv,, we- W14 r � f*, 1 PUPARWSNA M I.D.Q. DATE.. REVMWEWSNAME DATE J ROBINSON 14815 . 11/1/40 STATE OF CPt MRhitX- DAIM OF INCMEW -nmE NCICNUMM OFF6CE T. i ER EIS SQ. % r Y i Batley Road � 4 Riot-it shoutdw- Dirt t t s t Painted White € DasWed Lina K - 1 RiEPARM4 NAME J ROMS T 1481 11/1!60 - - STATE OF CALIFORNIA < DATE OF INCIDENT TIME NCIC NUMBER OFFICERI.D. NUM ER 1171/4341 I'M93W 14915- f 146 1 FAM 2 3 NOTIFICATION 4 5 1 was dispatched to assist the Contra Costa County Sheriff's Department with a pursuit of a stolen vehicle on 6 the freeway 1 at 1723 hours. I responded from Pods Avenue @ Schooner Way and arrived on the scene at 7 1729-hos. All-times, speeds and cesare- MeasureniAts,were ma&by-ems ion. 8 9 141 SCENE, 11 12 SR4 is an east-west aligned rowh y:- The roadway-is l+euel and composect of conte. See factual 13 diagram. 14 15 16 PARTIE 17 19 D-t(urges)was-located sttazncUng newt to;V-1 was kentifiedby his CCalifornia+cfriver's license and P established as the driver of V-1 by his statement and being-the R/0- 20 21 V-1(Fordywas-movedto the-fightshouldergriorto CHP-arrival. V-27sustainectminor lefrrear damage, 22 including a cracked tail light and a scraped quarter panel with white paint transfer. 23 24 D-2 av i}.vias load standi next-tn V-2. He was-identified-by his.Calif -driver's-1icensp and 25 established as the driver of V-2 by his statement. 26 27 V-2(patrol car)was moved to the dirt area off the right shoulder prior to CHP arrival. V-2 sustained minor 28 front end damage,including a scraped bumper. 29 �. 30 31 32 33 D-1 (Borges)related to me at the scene that he was driving V-1 on SR4 E/B at 5 mph in the#2 lane. He 34 saw a Contra Costa County Sheriffs vehicle pursuing V 1 approaching from the rear. He moved V-1tp the 35 right of the lane. He was struck by the vehicle the Sheriff's vehicle was pursuing(see AJI# 11-25). V-2 36 then collided with V-1. 37 39 D-2(Deputy Kalmowski)related to me at the scene that he was in pursuit(using wig-wag lights and siren)-of 39 a stolen car,which was splitting traffic between the#1 and#2 lanes at 141-15 mph. While pursuing the stolen 441 car,V-2 collided with V-1. PREPARERS NAME I.D.NWMER DATE REVIEWER'S NAME DATE 11 BTL+IRQItit 14915 L1117 .,M CALIFORNIA HIGRMY PATROL 510 646 4980 P.02 SWE CIF CAI.a'"t3FJM 11f1 8- Im 93211-- 14815. 11-26 I WPPLZMW4TA L 2 3 In respotm to Veronica Borges'written suppl submitted 11/13/00 at the Contra Costa CHIP office,I 4 see tyre are scnmcorrecdom mededto report-11-26 0*4be 'omr n ami heae. The 5- :;irrecti nit we a follows: s6 - y 8 STATEMMS 7 ' 10 D»1 (Borges)related to me as the a�aae that he was driving V=1 on 911-4 BIB at 5 mph in the#2 lone. D-1 11 saw&Comm Cast&Cay 9beriff`s v+ehicte puimft on=kwm dole appmaebing fi m the rear.- D- 12- t d_V-I_tm.*&ri&of the Lam. V-1 was struck by the vehicle the Sherffs vehicle was -(see All 13 #11-25). --V-Z sc, hided WI&V 1. M"AM'S NAM I.D NUSGIM DATE REVMWErSNAM DAT$ I RABIISON 14815- W21100- STATS O CALW-OF@A" DA'M -1NCME1VT TIFr NC C'l3t?1GlB C O FiCERT.IT NUMBER 11/1/00 1728 9320 . 14815 11-26 1 Q t3NS AM CtJ►NUSIt3N 2 3 SUNUKARY 4 5 D-1 was driving V-1 on SR-4 E/B at 5 mph in the#2 lane,ahead of V-2. D-2 was driving V-2 an SR-4 IEDB 6 at 10-15 mph,:splitting trade between the#1 and#2 ienc , a bn astokn, vehicie. D-1 moved V-1toz 8 ..:. 10 AREA OF PACT(A01) 11 12 Th+e-A€}1-vwa -determined-by the statements The-AOI-was-.Samile-eastof the east.roadway edge ofBaiky 13 Road and 10 feet north of the south roadway edge of SR.-4 EJB. 14 15 16 CAUSE 17 18 The.cause for-this-collis -.was-other dr% . :D-2 vas-in.pursuit.ofa-stol+en- -in accordancew 19 21055 VC. The cause was based on the statements-and the velucie damages. 20 21 22 RECONMENDATI@NS 23 24 None PREPARS9'S NAME IA NUMBER DATE R rMWER'S NAME DATE _ J ROBINSON14915 11/1/00 ���,,,�,.,A�, �� fid` P'1A �Ql&MN` f tuA- TRAFIRCtOLUMCKREPORT `•CNP 555 CARS Page 1 (Rev W98)OP1042 Pop of 19 spBCAt Co"VITIONA wx.rm VILOWrarrr OM3Yp�CT 0 Pn*mBURa DELTA MUM 0 X1 CONTRA COSTA 403 Mo DAFT p + cr arpK +.�. SR-4 BOB IIA)2f2= 1727 9320 14915 -MANOR MUMM7CIMf+MM++1tVMOTOOPAPHS BY: 5 NgLEM BAST OF 4 CC 20.13THUtlSDAY vea x +o �",d _-� YYIIltS STATE++IN nft I-Woft .5 MILE($�EAST OF BAILEY ROAD X YEA NO PAM V V IIWS MANSE NUMBER STATE CLAM_.. 1�&Qmm VEH:YEAR l tC4lvCR UCENAE NUFMIERTL A4291828 CA_ U. . 1990 t1R➢PROBE At U 3C RTti 13 NliME+'NMBTbloom LSAT) .�- ,., ..y...-------------- --....-_- - - IEONARD COVARRUBIAIS_, NAM 1I tflT7Mi6�. sTREETADCMEttA RAYMOND OR,STAP COOPER 2201 SAN J=DRWE-VW 04-. C11'Y`!srA7L/XiP CYPRESS CA 94365 +v AAeu� EYES H6K#+T vA�.16HT CA tWtY?iC94-09.. MACE 74+o0iq DFS q*=cr+3:P�+rB LED SCENE Rt BRN 5-88 165 Q3f21t197 Y H rrrNae Towwunre' AM NWiIIEAmom PIiDNE VEHKXE IDEN'TtRpATM NLN WA; ... Cw U SI'm y- 31 t Af A MKIN4401GICAMMI It PourDy VEH CLE TYPEMo* +�IGIVE +iYlt1M Tp viv CA DCA'- 1+�MNiC ti[lIID( AMTY ucom iTA - -CLASS flYgE'TY vsi. WKWINIODILIGOWK mom_ l i?6I267 ICAC. € ._ 994 ObmnwmW- W85617 VWM MUNIMIT MXL&LAST) ------------ -- X DONALD PAUL wwE u M AS W." tmcl+ Lx� 1011 NEBRASKA SST AODR!ffitt AAM As ORPA R VALLE10 CA 94594MWCWMAopvEHtct E ON artDEMA OF: auer� M [BRN Em ++EwHr M40 11 .)SA�AzW QTt= 14OEK D�Ecsa NC-lMiAM. ..� MipAltT_t_t +Wtlt7T+1YE v tCE+tL TfCATWNNU+�fflt (707)647-3938 (925)427-104$ ew USE O+A,.Y rescMISE VEHH"DAMAW tKAMINDAVAGIDAW .,, Poucy NtAAE1EM VIMCAA TWE PastNCMm LEN SEC INS. CA401-3087 22wr weDD C.I!Of TMAvq ON ant-T OR Htommy E_Pm tit ESR-4 65 CA4! �tC1Rat VV t mim"R t{TATif "An RVQTY YltLYFAR d ATC 3 , OvIla A N"m 1 Iautr"OlUm SW T-M r~ OVAl;IMACOld" AaDMMM max It9w, woor loom vi116FMf !A oRTt1�TM +wr MAIGl._ Pt1+ii1tM UNAMfit awlem �NOMA . TOtU1MMMrAAd �� i+OMMtW+iNiE PNCN[ A +TM9NtMMitiNC William to ap=17-offm ia Rsiwv M MlM;NG1�1t7E01101pAM MOWDV`l7(J�F- VrN04Arl�1;-- tAOtJ i L_ _ WE; TQC 1MDIlGt roa us roanan.0 aruuY.n OTArTELOF CALIFORNW- TRA'1<FIC,COLLISION CODING crP135 CARS Pam cari alz Pop 2 or� I . L722 4320 14815 /'�G+M PERM DAMAGE 09001010FTION OFOA r11G POSMON OCCUPANT8 _ AW BIGYCLt-HELMET AWBAGDEPILOYM Q.M8)TEJECTED- A& .A& A-NONE IN VEHICLE M-'AIR BAO NOT DEPLOYEO 'I-FULLY EJECT J't WN N-OTIB£R DRIVER Y-PARTIALLY LIECTED 1-DRIVER O-LAP BELT UBM R-NOT V-NO S-UNIOX YN�1 *-SH BELT NOT USED USED 0"-RESTRAMIT 4 5 6 ` W-YES 2Tt7d- T` t PASBENW 8-RR;OCCTRMCORVAN a-LAp NAIMMUM R-I*VBHMENOT USED . X-NO 9=POWIONi1NlCNOYNt" 9lR410MNESS NGT D •S•SI VEHICLE USE UNIQKWA Y-YV Q-tlili> J,PASSIVE RESIRAINT UM T-IN VEHICLE WROPER USE K-PASSIVERE.SfRAINTNOTUM U-NONE IN VEHICLE BMW SEC $Y {") THE.HARRA FAUTURLIST W OF PARWATtAULT e 2 t3- TYP&OF vEfNCLE r-_ � X2 1 _ X LiFUNCrM" CAR tBTRT N S70PPED i� � 15 CONTROLS NOT FUNCTIONN I3` W I TRARAt PRBC - GRNM!>+i - #iO !SCOOTER RAN OFF ROAD E FACti01l` -PICIAIP OR PANEL TRUCK MAKING Rmu WRN THAN DR PK:KUPIPANELTRUCK WTRARJNt - MAKING LEFrltIMiN - MEAD•ON #i KORfRtIGKTRACT{iR MAKING UTURN. . couimu FELL SRS SWC TRLKXCX IRUCKIRACTORt+ETAL1t" eAGIC1NG X RM END IN2 04 SUS SLO1MNCi t STOPPING OTHERIN11 IT PASSING OTHER VEHICLE HITOBJL*CT � V CRANGINGtANES CL fSSMINYNl OONST:EQUf41EW -.FARKM MANEUV . . VEHICLE IPEDESTRRIAIIt-- ,,BICYCLE OTNER' OTHER I'AE OTHER UNSAFETURNING Fm PEDESTIWX XING INTO OPPOSING LANE MOTOR VSHICtB ;w—m 0 MOM 10 PAN= vww NON- PEDESTRIAN r;_ X c OTIMMOTC7RVEHICLf. OTHER ASOOMIMF•ACTORSXR OTHER'JJNLURTURN �a5 ,�r� w S I t a 7 PARKED MOTOR VEHICLEA " °� rf v . .1112 DARK-STREET LKPITS NOT BICYCLE vc wconv44Aeo _ 1lds FUNdPONING`. ND E 3C9REYDR( i V4810MNVKXATM ano L- � 3 - PHYSICAL X DRY I FDsED OB&CT (MARK I TO 2ITEMS) 'yA HAD NOT BEEN DRiN UW SNOWY-ICY J OTHER OBJECT _V ON NT H8D-UMIGMcR iHF1LEIcINCE' IYMtfIN111ON' HE0-NOTUNOER7NF NU ROA0WAY CONDITIONISI TTS .._ M@D:IMPAliliiflES: 1 To 2 JTEl^ ONTEMMILEAVINtIRAW UNDER MVFL AL HOLMO IRM NO *&MVED PFEvtowcmmwm LOOSE MATERIAL ON RQAM*4Y• B cRosSmINCROlomX UNFAMSJAR V01TH ROAD *APJYtENTNO7 ON ROADVS►Y At INTERSECTION 'DEFECTIVE VEM.EQUIP_ CITED NOTAPPLICAM.E CONSTRUCTION.REPAJRZONt C CROSSING IN CROSOVALK-NOT, res - 8LEEftifAMQ=_ , ROAD'AS WVv TH AT INTERSECTION ND It=IRFORNKM CROSQ-NOTI* UNINVOLVED VE}NCLE MATERIAL OTHER' SI ROAD-INCLUDES SHOUIDER OTHER`. NOtoRNIUAL CONDrrmm NOT IN ROAD NONE APPARENT JU /tEEA BUl - --RtALAWW4Y-VEIYCLE SKETCH fAMICELLAWBOUS 0 NOWATR NORTH J STATE OF CALIFORNIA _ Kw 1 Vfl1ITNESSESI PASSENGERS- CHP` CARS P e 3 Rev OPI 042 PW 3 of 11/02/2000 1727 9320 14815 AM ,� �C1'EN T QF�i lUttY�'1f'opo IK D wits("ONN) rwrrx rs+►r ��rt 0016irSAO= W OIaLY PA Ntmt PQ` NAM oppm aw+ ►.- .,am eaL,txxJrr C� Q 21alaw NAMCl CCS C C NAtrLE l aaa r RAYETTE MENDIV11. (12/07/1478) 346 MM.ONY DRIVE,Pn-mBuRO,CA 44553 (INJURED ONLY)TRANWORTED W. YAXW TO: IIUURS& VEL OF VIOLENT CRM E NOyfft' X Q 3` w e BRIAN EDWARD KA J NOWSIU (07tl6fln 198D M1R ROAD MA1i CA 94353 425 i3.2S25 {IN�tJRED ONLY}TRANiPORTi�Y 8Y TAM TO. tILLs��tee: • v aF VLOLENT s NAME/D.O.b.1ADDAZU TELEPHONE t • i CIESCRI8E 1MURIES. VICTIM OF VIOLENT CROM NO'TIFIeD El=0 El El El 1-11. F11 El El ONLY) a4lk vcm vR vajw cium NOTA w o't. _01 0 0 1,01.01 0 1 Ell T 7-- L NAL#E tt?{ke.r TNONE N ONLY)TRAM or TARN TO: bum=woum VICM OR VIOLENT CRIME NOTWW NAME t CLO. ! • TAKEN TO CIESCRIK PUUPAM VICTIM O>=i ttT CRS°NOW= FREPARER'E MENLCI NUMBEt.. CLAY YEAR NAME LKS _w mawl i T?fSTi2i7tiTilfl7tT i A81C. y t In+SMnlYh STATE OF CALIFORNIA . PA `DATA O _INCIIDENT TIME- NCIC 2IUMBER- OFFICER IMI NUMBEit.- 1111/00 1727 9320 14815_. 11.25- SKEIQH (Not To Scaled R- E/B B # , , Road nY f Rlt shoe-r 3 Dirt Road Edi Y amt4d . A i, PREPAREIVS NAME I.D.NUMBER DACE REVIEWMVS NAME DATE I ROBNSM 14815 STATE OF CALIFORNIA OFFICER- 11/110014814 _ 1 Factual Diagram (Not To Scats) R-4 -E/B •w' Y Ailey! F k ' tII � F a t Wide 1 F '400d edge Painted,VVM6 I paf ' lik Ire MUARWS NAME I.D.NUMBER DATE REVIEWER'S HANE DATE J R48INSON 14815 1111100 STATE OF CALIFORNIA f DATE ORINCIDENI'T TIME NCIC NUMBER OFFICER T..D. NUMBMt_ 1t'� 1 I/l/00 1727 9320 -; + 14815 CT 2 3 NOTMCATION 4 5 I was dispatched to assist the Contra'Costa County Sheriffs Department with a pursuit 6fa stolen vehicle on 6 the freeway at 1723 hours. I responded from Polaris Avenue @ Schooner Way and arrived on the scene at 7 1729-hours: All tunes, speeds and disumes are approxi. ire `tnts were made-by tion. 8 9 10- SCIENE 11 12 SR-4 is aneast-westaligned roadway. The-roadway is flat,level and composed of concrete. See factual 13 diagram. 14 15 16 PAIRTIES 17 18 D-1 ( ovarrubias}waa loeated fleeing the scene by the Pittsburg Pow Department at 1732 hours in-the-area 19 of Power'Avenue' -Ra1hmd Avenue fie was identified by-the Deputy Kalinowsid#43591.-and-estabhshed 20 as the driver of'` -1 by the Deputy Kalinowski. 2.1 22 V-1 (Ford)fled the scene rnI SR-4 E/B. V-I, minm damage,imluding a de d-right front bumper 23 and fender. 24- 25 IL-2( orges)`was 4ocated finding next to V-•2: He was identifiWby his California-driver"s-licenseAwd 26 established as;the driver of V 2 by his statement and tieing the RIG. 27 28 'V-2(Fend) -mated `right aid or ' �: V-2 matained , 29 including atrackertta l`light and a scraped quarter panel; 30 31 32 HU AND-RUN- 33 34 Upon my arrival,I contacted D-2. He related his account of the collision. He added that after the collision 35 D-1 fledthe-scene-in-V-1-on SR-4 F1B._ He._could not_identify D-Lif he saw him again. I contacted Deputy 36 B. Kftlinowsid#43-WI at the scene. He was in pursuit of V,I,a stolen-car,at the-t meof'the-collision. Ater 37 V-1 intentionally rammed his patrol car,V-1 continued at 45'mph on the right shoulder of SR4E/B: Y-1 . 38_ was involved in.a pmwous collision.(see All report number 11-422). D-1 was fleeing the scene of the 39 previous.rullision..on.SR4.E/B,splitting_traffic_between the#1 and#2 lanes at 10-15 mph and was involved 401 in other collisions(see AiT report number 11-21 and 11-24): V-1 continued to flee-the-scene-an SR.--• -E/B at PREP'AiRMS-NAME I NLVM ft TiATfi- _ REVEWEW&NAME-_ DATE J ROBINSON 14815 ll./l-/00 STATE of CALIFORNIA DARE O INCIDENT TIME NCIC NLFMI:3ER OFFICER I.D. NI&WER 11/1/00 : 1727 9320 14815 11-25 . 1 HIT AND RUN-CONTEWED 2 3 10-15 mph splitting traffic between the#1-and#2-Tunes. V-I collided with V-2. After the collision,Dr-1 fled 4 the scene-in—V-l.on SR-4 E/B. V-1 became disabled on SRA EBjust west of Railroad Avenue. D-1 fled 5 the scene on foot northbound across SR-4 EB and SR4 W/B lanes'of traffic. D-1 was apprehended by 6 Pittsburg PD on Power Avenue(a Railroad Avenue. ' 7 8 9 STATEMENTS- ' 10 11 U-1 (Covarrubias)refused to make a statement. 12 13 D-2(Borges)related tome at the scene that he was driving V-2 on SR-4 E/B at 5 mph.in the#2 lane. He 14 saw a Contra Costa County Sheriffs vehicle pursuing V=-1 approaching from the rear. He movecI V-2 to the 15 right of the lane. V-1.collided with V-2. 16 17 Witness-1 (Deputy Kalinowski)related to me at die scene that he was in pursuit of'V-t. V-t was involved in IS previous.collisions(see.ALLreport number I-1=22, 11-23,and-11.oN). D-1 was fleeing_the scene of the 19vious collisions on SR-4 EB .pre � , spltxing.traffic..between the#l.and#2 lanes at 10-15 mph Y-1 collided 20 with V-2. 21 22 . 23- AT'TS ANTI CIINCI+O� 24 25 SUMIKARY 26 27 D-1 was driving-V-1 on SRA EB at 10-15 mph, splitting tra#fic between the#1 and#2 lanes. D-2 was 28 driving V-2 nn SR-4 E/B at 5 mph in the#2-lane,ahead of V-1. While fleeing f om pursuing deputies,,D4 29 turned V-1 to the right. V-1 collided-with V---Z STATE OF CALIFORNIA DATE OF INCIDENT TIME NCIC NUMBER C3FFICER I.D. NUMBER 14815 11=25 11/1/00 1727. 9324 ,�: ::: . �. . .. CAUSE 2 1 fl-1 (Covarrubias)-caused this collision by driving and making an unsafe turning movement(i.e.,he turned 4 V-1 to the left and collided with V-2)which is a violation of 22107 VC. An associated factor in this 5 collision was D-I fleeing from the-Contra Costa Chanty Sheriff's Department at the-time of collision, fi which is a violation of 2800.1(a)VC. The cause was based on the statements and-tile vehicle damages. 7 , 8 g lIMC31 MATIONS 10 11 I recommend a_copy of this report be forwarded to the Contra Costa County Sheriff's Department for review 12 and subsequent prosecution of 1;t4(Covarrubias)for 20002(aY VC-hit and run; 12-50D(a)VC_-unci 13 driver;and, 16028(c)VC-failure to provide pmo£of' sat the scene_of.a.collision. j PWAAWS NAME I.D.NUMBER DATE REVIEWER'S NAME DATE I M15 11/1/00— CILAIM r WARD OF SUffJMSORS OF CONIRA COSTA CO[NTY. CA�,UDMIA BOARD AC11JANUARY 1(n, 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: Exceeding $10,000.00 CUAlTy, t NE-'Z CAUO CLAIMANT: Ndubuisi Chimara ATTORNEY: c/o Beatrice Priscilla Barr DATE RECEIVED: December 11, 2000 Attorney at Law ADDRESS: 805 Fourth Street, Ste 11 BY DELIVERY TO CLERK ON: December 11, 2000 San Rafael CA 94901 BY MAIL POS'T'MARKED: December 9, 2000 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: December 12, 2000 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of upervisors : C41 a [q (i.� This claim complies stabstantially 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: C-1611 rY1 a�b CCS + C5CGe=,P�,n nr, 000 c ry QV)h V-Ylel4 ta/) -O t 0 In 0rf-- c of ,�,�✓1. Dated: /0�-I,-CA-11 By:�6 ' - 6 ______Deputy County Counsel II[. FROM- Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). TV� BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By it , Deputy Clerk 10 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 NLAH NG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: ) By: PHIL BATCHELOR By Q . /l Deputy Clerk tZ CC: County Counsel County Administrator VICTOR 1 WESTMAN DEPUTIES: c6UNTY COUNSEL ' ° PHILLIPS.ALTHOFF JANICE L.AMENTA NORA G.BARLOW B.REBECCA BYRNES SILVANO B.MACOU A C S� UNTY MONIANDRKA L COOPER CH IEF ASSISTANT COUNTYNTY COUNSEL �* VICKIE L.DAWES OFFIC�Jq /� J N �` MARKES.ESTIS SHARON L.ANDERSON � MICHAELD.FARR ASSISTANT COUNTY COUNSEL INIBTi## d'SII1 {NCS ? LILLIANT.FUJII DENNIS C.GRAVES JANET L.HOLMES GREGORY C.HARVEY MARZ,CALIF e29 KEVINT.KERR BERNARD L.KNAPP ASSISTANT COUNTY COUNSEL EDWARD V LANE,JR. � BEATRICE OLI GAYLE MUCaCaLI MARY ANN MASON k PAUL R.VALERIE J.RAiNCHE OFFICE MANAGER STEVEN P RETTIG DAVID F.SCHMIDT PHONE(925)335-1890 NOTICE OF UNTIMELINESS JACQUELINEY.WOODS FAX(925)846-1078 AS TO A PORTION OF THE CLAIM TO: Beatrice Priscilla Barr, Esq. 805 Fourth Street, Suite 11 San Rafael, CA 94901 RE: CLAIM OF: NDUBUISI CHIMARA Please Take Notice as Follows: In regards to the claim you submitted and postmarked on December 9, 2000 on behalf of claimant, Ndubuisi Chimara, portions of the claim are timely and portions are untimely. The portions of the claim prior to June 9, 2000 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 by law. Because the portions of the claim prior to June 9, 2000 were not presented within the time allowed by law, no action was taken on those portions of the claim. The claim was forwarded to the Board for action only on the timely portions of the claim. Ms. Chimara's 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. VICTOR J. WESTMAN COUNTY COUNSEL By: Monika L. Cooper Deputy County Counsel Page 1 CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5;Evidence Code§§641,664) t 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. I 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,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. Executed in Martinez,California. Dated: December 13,2000 f f Kathleen O'Connell cc: Clerk of the Board of Supervisors(original) Risk Management Page 2 BEATRICE PRISCILLA BARR WED Atra,r q sa Law 805 Fourth Street, Suite I I San Rafael,California 94901 DEC 1 12000 415-482-6116 CLERIC ie AK,n SU ER4'iSORS C NT'A,' OS1ACO, November 8, 2000 Clerk of the Board of Supervisors Room 106 County Administration Building 651 Pine Street Martinez, California 94553 Re: Claim of Ndubuisi Chimara pursuant to California Tort Claim Act Dear Sir or Madam: A claim is hereby made for damages exceeding $10,000 by Ndubuisi Chimara, whose postal address is 109 Hawk Court, Hercules, California 94547. The contact address and address for service of notices relating to this claim is: B. Priscilla Barr, Esq., 805 Fourth Street, Suite 11, San Rafael, California 94901. This claim is for recovery of damages for national origin and race discrimination, harassment, retaliatory treatment, breach of contract,an accounting, common counts, intentional and negligent infliction of emotional distress, earned and unpaid wages,civil penalties, declaratory relief, and punitive damages. The circumstances giving rise to this claim are cumulative, began in or around November 1998 and continue to date. These circumstances occurred and continue to occur at 151 Linus Pauling Drive, Hercules, California 94547, also known as the Children's and Family Services Division of the County of Contra County Department of Employment and Human Services. A general description of the broken obligations, damages, and loss is attached hereto and incorporated by this reference as Exhibit A: Letter to Delores De Baca, Affirmative Action and Diversity Coordinator for Contra Costa County Social Services, Employment and Human Services Department. Yours very truly, B. Priscilla Barr, Esq. Enclosure I, Ndubuisi Chimara,am,a resident of the County of Contra County, am of majority age, and am of sound mind. I hereby swear under penalty of perjury under the laws of the State of California that the facts as set forth in Exhibit A hereto are true and correct,except as to that matter which is stated on information and belief,and as to that matter, I am informed and do believe it to be true. Date: )I cl—0 — - --- ---- DECLARANT k & � � ■ A � » � \ $ f k � . 7 � � § � � CLAS . G BOARD OF SUFUMSORS OF CONTRA COSTA CQUilYs-CALUUMIA BOARD A0 JAMARY 16, 2000 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, } NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". ivio AMOUNT: $161.00 COU N,YCOUNSEL ARTINEZ CALIF. CLAIMANT: RAPHAEL DOUGLAS ATTORNEY: DATE RECEIVED: DECEMBER 14, 2000 ADDRESS: 1751 GIARAMITA STREET BY DELIVERY TO CLERK ON: DECEMBER 14 P 2000 RICHMOND CA 94$01 BY MAIL POSTMARKED: NAND-DELIVERED�FROM_RISK �. L FRONT: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECMER 14, 2000 By: Deputy IL FROONL• County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. { L is 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 310.8). ( ) 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 311.3). ( ) Other: Dated: lr -� By: Deputy County Counsel III. FROM- Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER; By unanimous vote of the Supervisors present: ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: ! PHIL BATCHELOR, Clerk, By , 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 NIAILING 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:50,v G By: PHIL BATCHELOR By Deputy Clerk CC: County Counsel County Administrator VICTQR J.WESTMAN D PLUnS.ALTHOFF COUNTY COUNSEL JANICEL.AMENTA NORA G.BARLOW B.REBECCA BYRNES SILVANO B.MARCHESI T ANDREA W.CASSIDY CH IEF ASSISTANT COUNTY COUNSEL �CQNTRA C0$f, TY MONIKA L.COOPER OFFICe C�!FTH U V NSEL MAR VICKELDAWES MARKS S.ES71S SHARON L.ANDERSON cFARR STR 4� I.Nla'k�} MICHAEL D.1L l , LILLIANTFUJI1 JII ASSISTANT COUNTY COUNSEL �I T'' a DENNISC,GRAVES yg JANET L.HOLMES GREGORY C.HARVEY MAR'i"I # Z,CAL1F ^9`�29 KEVINTKERR BERNARD L.KNAPP ASSISTANT COUNTY COUNSEL EDWARD V.LANE,JR. BEATRICE LIU MARY ANN MASON GAYLE MUGGLI PAUL R.MUh11Z VALERIE J.RANCHE OFFICE MANAGER NOTICE OF UFFTCIENCY STEVEN P.RETTIG DAVID F.SCHMIDT PHONE(925)335.1800 AMD/OR DIANA J.SILVER JACOUELlNE Y WOODS FAX(925)646-1078 NON-ACCEPTANCE OF CLAIM TO: Raphael Douglas 1751 Giaramita Street Richmond, CA 94801 RE: CLAIM OF: Raphael Douglas 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: [XX] 1. The claim fails to state the name and post office address of the claimant. [XX] 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [ ] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. [XX] 6. The claim is not signed by the claimant or by some person on his or her behalf. [XX] 7. Other: You may submit the additional information in a letter referencing your initial claim. Page 1 VICTOR J. WESTMAN COUNTY COUNSEL B V12"', 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. 19 4p Dated: December J9,2000,at Martinez,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE§§410,910.2,920.4,910.8) Page 2 Claim to; BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 140'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 penalty for fraudulent claims, penal Code Sec. 72 at the end of this form. RE: Claim by. ) Reserved for Clerk's Filing Stamp %JED Against the County of Contra Costa A h �. 1 or CLERIC BoAr F a:�PEi3VISQR$ ��:.. CONTRA District} Co (Fill in Name) `'7 The undersigned claimant hereby makes claim against the County of Contra Costa or the above named�� District in the sum of$ 1L�-and in support of this claim represents as follows. 1. Wh n.did the damage or injury occur? (Give exact Date and Hour IL Z5 wyZ 6"N,44 1� . L Qr%�14.�1 lis irk �Uvi\ t -------------------�------------------------------------- e ----------------------------- - 's" t�-�S - l -`Coi = S �ul�rof 2. Where did the damage or injury occur? (Include city and county 'T t'5Q--mIJvt p� �� WW\ow -� IN Q-A alf\Vk A p. 1 i 7 Uf* ----------- _ m it - _V,r- 4, 3. How did the damage or injury occur? (Give fiili details;use extra paper if required)",):L `[o h A ,�`G �t�w lv v C�' -\\)CL Vt 1: 4 Whit particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? -11�& Pry - mr -Jug pur luauuuosudxui Bans gloq Sq xo QOO`OIS) snrltop pursnoq� ual 2uipaaaxo jou jo aug r {q 'uosud aluls aull ui}uauuuosudwI Sq xo'aulj pur luauuuosuduut gaps gloq Sq .to ( OOWIS) s-uullop puusnogl auo 2uipaaaxa lou;o au!)u Sq 'aVas auo ural woun lou,lo pouad u .uol tier nlunoa aql at luauuuosuduci Sq.uaglia alqugsiund si'21upi"i ao°uaganoe`lunoaar 11pq'uurela lualnpnvaj xo 991191 gur 'auinuat.ti auurs aql Sud xo nolle of pazuoq#nr'aa:)Wo xo pxuoq iaulsip xo Sita 'Slunoa nur of.uo'iaoWo.io pirog alrls nut of luauusrd uoj.uo aaau.%ollr.io;sluosa ud'pnuxjap o;tumor fp!M°ogn+uos.1ad glaAa, :sappmid apo Iniad agl jo ZL uotlaaS M M M M M M M M M M M M M M M M M M M M M M MM M M M M M M M M M M M M M M M � M M M M M M M M M M M M a M M -oNI auogdalay -oK auogdalas (ssa uppy) (a.xnlru2Is siluruiiula} gau uou-r,lo ssa.uppv par auurN 4,-jIugaq sig uo uoszad autos tiq ao (Iauxouy) :py saxi.OK(was luruirela agl Sq pautis aq lsnut wirla agy„ :saplAoid Z`0I6'30S 3 .Aoo t r 0 ..a all s.�cr 'A" W _ --------------------------------------------------� (.unfui ao luaprear sigl jo luaoaau uo apuuu nosaueuipuadxa agl lst'l 5 _---_ _ _ 14 } r � t t � .�, .�ca� ,�ux, so pur'sxolaop'sassaulin+jo sassaxppr pur saruVil ag (•a2suusp Jo ian[uf aagaadsead d o 3unouue pa3empsa otp apnpul) 4paindmoa 4anoalu'pau7[uP a QAogr aql SUM.NOR __ ----------------------------------------- ,tom -, I � -> 01 1 Q 4'"�J -assump ohne xoi 503euxpsa ON4 ti{as33V 'pauttop saseu[ap Jo sawful jo 3ualxa Ig aA D) Zpallnsal auela nod op sounfui i sa rturp lvgm '9 ouau ;2Unful jo aSrump aql 2uusnr3 soanoldma unoa Jo saumu agl we 1rgm 's c7- tx.1 Vic; y�✓ �'"f � (8„1 C CLAIM t✓ Bmp ACi10l1t JANUARY 16, 2001 Claim Against the County, or District Governed by the Board of Supervisors, Routing Endorsernents, ) NOTICE TO CLAIMANT and Board Action. All Section references are to 1 The copy of this document mailed to you is your California Government Codes. l 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: $750,000.00 s..a 4fiI . � .CA CLAIMANT: JAMES C. FAGAN ,� �, ATTORNEY: DATE RECEIVED: DECEMBER 13, 2000 ADDRESS: 3886 MULBERRY DRIVE, #B4 BY DELIVERY TO CLERK ON: DECEMBER 13, 2000 CONCORD CA 9451.8 BY MAIL POSTMARKED: HAND-DELIVERED 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk. Dated: DECEMBER 13, 2000 By: Deputy ,) H. FROM: County Counsel TO: Clerk of the Board of 96pervisors { ; 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: 13-,00 By: Deputy County Counsel M. FROM Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: a9l-oOZ_ PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAH.ING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: By: PHIL BATCHELOR By --l7eputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIQNS TO CL 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. (Gov't Code 911.2.) B. Claims must be filed with the Clerk of the Hoard 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. See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp - .Tames C Fagan ) RECEIVED Against the County of Contra Costa or ) D E C 13 2000 _J District) 9 � (Fill in name) ) CLERK BOAR C OF SUPERVISORS ' CONTRA C05TA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-name district in the sum of.'S? 0 000. and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) ' 6/21/00 ?tate of surgery 2. Where did the damage or injury occur?(Include city and county) Merrithew Memorial Hospital Martinez, Ca. 3. How did the damage or injury occur? (Give full details;use extra paper if required) Alleged Malpractice, agents of Merrithew Hospital 4. JVhat particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? Details 'unknown, but alleged malpractice resulting iih left leg two inches longer, after surgery. n 5. What are the names of county or district officers, servants, or employees causing the damage or injury? John Burton M.D. and others unknown. 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) Dain and suffering, permanent disability from two inch difference . 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Wage loss,present and future. Medical expense, present and future . other special and general damage, present and 'future. 8. Names and addresses of witnesses, doctors, and hospitals. John Burton M.D. , claiment and consultant Merrithew Memorial Hospital Martinez, Ca. 9. List the expenditures you made on account of this accident or injury. DATE .None yet incured Gov. Code Sec. 910.2 provides""The claim must be signed by the claimant or by some person on his behalf." Name and Address of Attorney ) (Claimant's gfglta V)- L0921o. } (Address) ) } Telephone No. }Telephone No NOTICE Section 72 of the Penal Code provides: Every person who,with intent to deftw4 is for allowance or the payment to any state board or officer,or to any county,city,or district board or offierx,authorized to allow or pay the same if sanuint,any false or f udulent claim,bill,account, voucher,or writing,is punishable either by imprisonment in the county jail for a period of not more than am year,by a fine of not oweeding o (S 1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not oweeding tm dousand dollars($10,000),or by both such imprisonment and fine. cLAnvl BOARD AG' O JANUARY 16, 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 ti:sa "� ,J s'y 915.4. Please note all "Warnings". AMOUNT: $301.52 co ITY COUNSEL Ali€EECALIF. CLAIMANT: A. Galica ATTORNEY: DATE RECEIVED: DECEMBER 13, 2000 ADDRESS: 102 Wawona Circle BY DELIVERY TO CLERK. ON: DECEMBER 13, 2000 Martinez CA 94553 BY MAIL POSTMARKED: HAND-DELIVERED L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECEMBER 13, 2000 By: Deputy IL FROM: County Counsel TO: Clerk of the Board of'Supervisors ( k-r"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 Bled. 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: /d BY Fd Deputy County Counsel IIT. FROn- 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: PHCL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MATIING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: By: PHIL BATCHELOR By Deputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or grooving crops and which accrue on or before December 31, 1987, must be presented not later than the 1006 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.4ccrue 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 ilii i l this fbrin. RE: Claim by, } Resorved for Clerk's Filing Stamp El---w- Against the County of Contra Costa or DEC 1 3.`w 000 CLERK BOARD 0 ,UpERVISOR5 District) CONI RA C4S7A C(, I+'ill in Naiue)�., , The undersigned claimant hereby makes claim against the County of Contra Costa or the above named District in the sum of S-Sfl 1•S and in support of this claim represents as follows: I. .?Wheii did the am a pr;injury occur? {Give exact Date and Tour) � - rr.. rr�rr w ---------------------- rrrwrw r....rrrrrr rr..rrr_r wr...r .. (� • s 2. 'Where did the damage or injury occur? (include City and county) rkw F.., .�•• !C•.. ?wi .,. a.r, #. r.,r ! f�:. r ...,.,,,� '------------------------ 3. Hove A tl}e daqWe or in�jur-$.occur? JOY o ttat dot u�e �tr��a�er 'eey�rea) r r r a w a w c r r r r a r } . $ w wr r r r w.r',:rw rrr r r rrr rr r r r ra s rr w v rr r rwr } ..,.urrrrr.rwr 4. lial cular-aft dr<omrsionn tb dart o county or district.isffiGers, serahts, or employees caused the injury or damage? € , (Over) -aulj pur juautuosuditt gans gloq Sq xo `(000101$} sxrllop puusnogl ual Sutpaaaxa jou jo aug r Sq 'uosud ajrjs aqj ut juatuuosudwt eq xo Haug pun juaumosudutt gans gloq Sq xo t( 000115) sxrllop punsnogj auo Autpmixa jou jo auU r gq Ixrag auo ump axow jou,lo pouad r xoj llrf Sjunoa aqj ut juautuosuditt Sq xaglp algrgstund st 12upum xo£taganoe';unoaas {lllq lwmla jualnpnex; to aslr;Sur °autnua%p autos agj Sud xo mollr of pazuogjnr lxaaU;o xo pxroq jat tjstp xo alta `Sjunoa Sur 01.10 Ixaau;o xo pxroq ajrjs Sur of juatuSed xoj jo aaurmollr xol sluasaxd fpnra;ap o;ldalut tlltnc°ogAt uouad iWAa, :saptnoxd apoj lrua,d atp jo EL uotjaaS aDlIORt auogdalal, oK auogdalay (ssaxppv) t M (axnlrulitS s fjurtutrlj) ' Sauxolly1;o ssaxppv Pur awrK ;,',llrgaq stq uo uosxad autos iq xo (Sauxotl'v) -OL S33I LON (IK3s jurtutrla aql Sq paints aq Isnot uttrla agy„ ssappoxd Z-016 'aaS apoJ 'AOD 7`t 3f 'f yR A� A� A� 'R � id * M M M %d A� yR �' 3� dR �F * M X � M M M M of aR � >R i2 at �t•* L� yF A� M * M A� �K � M 3a � K 3F aF � M M ka-75 alva Sxnfut xo juaptaar stgj,la Iunoaar uo apjtu�tog_;sainjtpuadxa aqj jst"T 6 ;�,_.. �cis '�►�. � , . '� 5.32 11.x'1 32b -- 'slrltdsoq pur,Isxojaoprsassaujim jo sassaippr pur-saUMK _rg ------------ ----------------------------- --------------- ____ ____»__--_ ,�~o lE., S'"�v-� -�:� t ► � ` ""'�wa�-�;,�"+r�� tom►... '. �vat.LbWt.�.S. � o?SSi1nlS xrs. "tCtScn A i4i�r"i '1ton ( aaurep xa{xnfuc an��adsoxd due lir�unowu pa3su� sa a apntaul j ;pajnduttJa junoutr paittrla anogr agl Sri ,uog L ------------------------------------------------------- fit xof salsulpsa OM4 ipguv Pauqvp salsutsp to saunful jo;ua4xa nN-10) Zpallnsax uttep nog op sapnfut xo sallrutrp jggm � ------------------------------------- _' ._- .• -. �1 "' '--_ ZSxnCut xo arurep aqj dutsnra saagolduta xa rsjirn tas°sxaat, lo jaujstp xo gjinoaa sauzri agj axr jrg� S CIAIM BOARD OF SUPERVISORS-OF CONTRA COSIA COUNTYs !CALIFORNIA BOARD AM JANUARY 16, 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 1a_e. pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". COUNTY COUNSEL AMOUNT: EXCEEDS $10,000.00 MARTINEZ CALIF, CLAIMANT: DIANA GARRETT, AS INDIVIDUALLY AND AS ATTORNEY: GUARDIAN FOR THE MINOR CHILDREID�%N AARON GARRETT, AND KATHRYN GARRETT, AND JUSTIN GARRETT DECEMBER 14, 2000 ADDRESS: c/o RICHARD J. SIMONS, ESQ. BY DELIVERY TO CLERK ON: ___ DEC ER 14 2000 FURTADO, JASPOVICE & SIMONS A LAW CORPORATION BY MAIL POSTMARKED: HAND-DELIVERED 22274 MAIN STREET HAYWARD CA 94541 L FRONL• Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECEMBER 14, 2000 By: Deputy Cj It. FROM County Counsel TO: Clerk of the .Board o6Supervisors (`X"T"his clai ,F complies Ybstantially 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 , iclaimant's right to apply for leave to present a late claim (Section 911.3). , ( V7 tither: G IM! 1 ) Allt16 `IV e a L,6 .06CUI'` fA7 e vim'et 19e ' 321/e./tt` .2cw 4iA r t l- -To I�' Cir. a)11/ neW dC ; V ate; Dated: �. / '� By: Deputy County Counsel IIT. FROM- Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 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- / PHIL BATCHELOR, Clerk, By , Deputy Clerk WARMING (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 NLkUlNG 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: 14, 9CO / By: PHIL BATCHELOR By eputy Clerk CC: County Counsel County Administrator VI&OR J.WESTMAN DEPUTIES: COUNTY COUNSEL JANICEL AMEvTAF NORAG.BARLOW B.REBECCA BYRNES SIt_VANO B.MARCHES1 CONTRA COSTA t ANDREA W.CASSIDY 1' T MONIKA L.COOPER CH IEF ASSISTANT COUNTY COUNSEL �r+� i �y�w (y c c VICKIE L.DAWES V��I �t 6./�r THR. `+Q W +�EL MARKE S.ESTIS SHARON L.ANDERSON MICHAEL D.FARR Q I,STRiY►��1kA'VII.DlN3 " LILLIAN TFUJII ASSISTANT COUNTY COUNSEL DENNIS C.GRAVES TREET, f' JANET L.HOLMES GREGORY C.HARVEY MAR=`�Z, CALiF "1s �9 KEVIN T.KERR BERNARD L.KNAPP ASSISTANT COUNTY COUNSEL EDWARD V.LANE,JR. p BEATRICE LIU MARGAYLE MUGGLI PAULYR.MUN ZANN SON OFFICE MANAGER VALERIE J.RANCHE P. ETTIG STEVEN RETTIG DAVID F.SCHMIDT PHONE(925)535.1800 NOTICE OF UNTIMELINESS DIANAJ.S14VER FAX(925)646-1078 JACOUELINE Y.WOODS AS TO A PORTION OF THE CLAIM TO: Richard J. Simons, Esq. Furtado, Jaspovice &Simons A Law Corporation 22274 Main Street Hayward, CA 94541 RE: CLAIM OF: DIANA GARRETT, INDIVIDUALLY AND AS GUARDIAN FOR THE MINOR CHILDREN SEAN GARRETT, AARON GARRETT, AND KATHRYN GARRETT, AND JUSTIN GARRETT Please Take Notice as Follows: In regards to the claim you submitted on December 14, 2000, on behalf of the above named clients, portions of the claim are timely and portions are untimely. The portions of your claim prior to June 14, 2000 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 by law. Because the portions of the claim prior to June 14, 2000 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. VICTOR J. WESTMAN COUNTY COUNSEL By. Monika L. Cooper Deputy County Counsel Page 1 CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5;Evidence Code§§641,664) 1 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 UNTIMELINESS AS TO A PORTION OF THE 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. Executed in Martinez,California. !q i49-16 Dated: December tf,2000 cc: Clerk of the Board of Supervisors(original) Risk Management Page 2 1 RICHARD J. SIMONS, ESQ. State Bar No. 072676 2 FURTADO, JASPOVICE &SIMONS A Law Corporation 3 22274 Main Street Hayward, CA 94541 4 (510) 582-1080 Telephone 5 (510) 582-8254 Facsimile g Attorneys for Claimant p ' DIANA GARRETT 8 9 BEFORE THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA COSTA 10 AND THE CONTRA COSTA COUNTY DEPARTMENT OF HEALTH 11 12 13 DIANA GARRETT, individually and as Guardian for the Minor children SEAN 14 GARRETT, AARON GARRETT, and KATHRYN GARRETT, and JUSTIN 15 GARRETT, NOTICE OF CLAIM (Government Code §910) 16 Claimants, l 17 18 TO THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA COSTA, THE 19 CONTRA COSTA COUNTY DEPARTMENT OF HEALTH, AND TO THE CLERK AND SECRETARY 20 THEREOF: 21 Claimants DIANA GARRETT, individually and as Guardian for the Minor children 22 SEAN GARRETT, AARON GARRETT, and KATHRYN GARRETT, and JUSTIN GARRETT, present 23 the following claim: 24 25 26 1 NOTICE OF CLAIM FURTADO,JASPOVIC€ R SIMONS A LAW CORPORATION -41010- 1 1. The name and post office address of claimants are as follows: DIANA 2 GARRETT, individually and as Guardian for the Minor children SEAN GARRETT, AARON 3 GARRETT, and KATHRYN GARRETT, and JUSTIN GARRETT, c/o Furtado, Jaspovice & 4 5 Simons, A Law Corporation, 22274 Main Street, Hayward, CA 94541. 6 2. All notices regarding this claim should be sent to the address set forth 7 above. 8 3. The occurrences which give rise to this claim occurred between April 1, 9 2000, and May 28, 2000. The cause of action accrued on June 17, 2000, the date of 10 death of Robert Wright Garrett. 11 12 4. Decedent Robert Wright Garrett was born on November 1, 1942, and 13 died on June 17, 2000. Claimant Diana Garrett is the surviving spouse of decedent, 14 and claimants Sean Garrett, Aaron Garrett, Kathryn Garrett, and Justin Garrett are the 15 surviving children. Between April 1, 2000, and May 29, 2000, decedent was under the 16 medical care of Dr. Milton VonRydingsvard, and other employees and agents of the 17 County of Contra Costa, receiving medical care at the Concord Health Clinic, 3052 18 Willow Pass Road, Concord, Contra Costa County. At all times herein there existed a 19 20 patient/physician relationship between decedent and the County of Contra Costa, 21 acting through the Contra Costa County Health Center and its employees and agents. 22 5. This claim arises from the professional negligence of the employees and 23 agents of the County of Contra Costa at the Contra Costa County Health Center 24 acting in the course and scope of their agency and employment. Said professional 25 negligence occurred during the course of care and treatment of decedent, and 26 2 FURTADO,JASPUVICE NOTICE OF CLAIM & SIMONS A LAW CORPORATION s 1 includes negligent failure to diagnose gastrointestinal disease, negligent failure to 2 perform proper monitoring and testing of gastrointestinal disorder, negligent failure to 3 perform appropriate, reasonable, and required medical tests and diagnostic 4 5 procedures, negligent failure to perform appropriate follow-up services, and negligent 6 failure to prescribe appropriate medications, procedures, and care for gastrointestinal 7 disorder. As a result of said professional negligence in the care, diagnosis, and 8 treatment of decedent, he was caused to pass away from respiratory failure, due to 9 aspiration pneumonia, secondary to gastrointestinal disease and complications 10 thereof, on June 17, 2000. 11 6. Claimants, and each of them, have suffered the loss of the comfort, 12 13 society, and protection of decedent, the economic lass of his personal services, and 14 the loss of his economic support, and incurred funeral and burial expenses as a result of 15 the negligence of respondents causing his death. The amount of this claim exceeds 16 $10,000.00 and jurisdiction of this claim would rest in the Superior Court. 17 7. This claim is submitted pursuant to Government Code §910. Further, 18 notice is hereby given of claimants' intention to commence legal against you within 90 19 days based upon these matters, pursuant to C.C.P. §364. 20 Dated. December 11, 2000 FURTADO, JASPOVICE &SIMONS 21 A w Co oration 22 23 By 24 RICHARD J.SIMONS 25 Attorneys for Claimants 26 3 NOTICE OF CLAIM pURTADO.JASPOVICE 3 SIMONS A LAW CORPORATION r CLAIM , O�RI� OF SUPERVISORS OF CQNTRA COSTA COUNTY, CALROHYYA BOARD ACTT JANt1ARY 16, 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 railed to you is your California Government Codes. ) notice of the action taken on your claim by the 1T Board of Supervisors. (Paragraph IV below), given pursuant to Government Code Section 913 and C 0 tj 915.4. Please note all "Warnings". AMOUNT: $500,000 COUNTYCQU,41r CLAIMANT: TIM MAHANEY ATTORNEY: c/o PHILIP C. GALLAGHER DATE RECEIVED: DECEMBER 7, 2000 SCRANTON LAW FIRM ADDRESS: 1200 CONCORD AVENUE STE 260 BY DELIVERY TO CLERK ON: DECEMBER 7, 2000 CONCORD CA 94520 BY MAIL POSTMARKED: DECEMBER 5, 2000 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECEMBER 7, 2000 By: Deputy QDY� 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 12—e 0C) By: Deputy County Counsel M. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of the Supervisors present: ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: !!!�- /4- "may O,, PHIL BATCHELOR, Clerk, By % c 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: e< By: PHIL BATCHELOR By eputy Clerk CC: County Counsel County Administrator Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100'h day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988,must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code§911.2. ) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building,651 Pine Street,Martinez,CA 94553. C. If Claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. 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 TIM MAHANEY ) Against the County of Contra Costa or CONTRA COSTA COUNTY DEPT. OF PUBLIC WORKS 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 5 0 0 ,0 0 0. and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact Date and Hour) _25,- 2000@_3_25- •m-------------------------------------------------- 2. Where did the damage or injury occur? (Include City and County) 680 North near Livorna Road in unincorporated area of Walnut Creek, Contra Costa County, State of California ------------------------------------------------------------------------------------- 3. How did the damage or injury occur? (Give fun details;use extra paper if required) Driver Mark Duckett changed lanes into Tim Mahaney` s vehicle in an unsafe manner. ------------------------------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? Failure to make a sAfe lane change. Failure to operate vehicle in a safe manner. (Over) 5. What are the names of county or district officers,servants,or employees causing the damage or injury? Mark Duckett 6. What damages or injuries do you claim resulted' (Give fun extent of injuries or damages claimed. Attach two estimates for auto damage.} Soft tissue injuries to the neck., back, and shoulder area - extent unknown at this time. ------------------------------------------------------------------------------------- 7. How was the above claimed amount computed? (Include the estimated amount of any prospective injury or damage.) Unavailable at this time. 8. Names and addresses of witnesses,doctors,and hospitals. Vacaville, CA 95687 Fairfield, CA 94533 1000 Nut 'Free Road 1100 Missouri St. North Bay Hospital Don Eilert, D.C. ------------------------------------------------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMt3UN 7-26-00 North. Bay Hospital $892. 70 (7-27-00 to present) Don Eilert, D.C. Unknown at present Gov. Code Set. 914.2 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 SCRANTON LAW FIRM Tim Mahaney 1200 Concord Ave. , #260 (Claimant's Signature) Concord, CA 94520 307 Woodside Circle (Address) Vacaville, CA 95688 Telephone No. 925-602-2727 Telephone No. 707-451-4005 * * * * * * a * * * * Bann * * as * * * a * * * aa * a * * n * a * * * td * * a * * * aa 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 ($1,444), or by both such imprisonment and fine,or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,444), or by both such imprisonment and fine. -I�ANTON LAW FIS RECEIVED December 5, 2000 DEC ` 7 2000 CLERK 80ARD OF SUPERVISORS CONTRA COSTA CO. Clerk of the Beard of Supervisors County Administration Building 651 Pine Street Rm. #106 Martinez, CA 94553 RE: Our Client Tim Mahaney Date of Accident 7-25-2000 Their Insured Contra Costa County Department of Public Works Claim No. 45337 Dear Sir/Madam: Enclosed please find the proper public entity claim farm regarding::our client's automobile accident referenced above:' Very truly yours, SCRANTON LAW FIRM KARL A. BACH Legal Assist to PHILIPC. GALLAGHER Attorney at Law KAW:pa Enclosure: public entity claim form Michael C.Scranton,A Professional Corporation (1-800) �O�—o/ LI1 Main Office: 1200 Concord Ave.,Suite 260,Concord,CA 94520 FAX'(925) 676-9999 ..o c r r.y � H 3� c� 1.0 ' 010 LM ru 1 CLAIM BOARD OF SLIP MSORS OF CONTRA COT COUNTY,C UEORNIA BOARD..Au1011t JANUARY 16, 20; Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to 1 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: NONE STATED CLAIMANT: RUDy MC CONAHEY ATTORNEY: DATE RECEIVED: DECEMBER 14, 2000 ADDRESS: M-2-F-9-LOW BY DELIVERY TO CLERK ON: DECEMBER 14, 2000 MULE CREEK STATE PRISONNOVEM[3ER 27 2000 (previously OX 409000 BY MAIL POSTMARKED. NOVEMBER P �' P 0 B IONS OX 09000-9000 went to the Superior urClerko ice L FRONL Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECEMBER 14, 2000 By: DeputyQc 'f IL FROM County Counsel TO: Clerk of the Board o Supervisors { ) This claim complies substantially with Sections 910 and 910.2. { ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). { ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: Deputy County Counsel M. FROM Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV., BOARD ORDER. By unanimous vote of the Supervisors present: This Claim is rejected in full. { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: jj — f PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (b) 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. AFFMAAVFT OF NIAILJNG 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: h. l / By: PHIL BATCHELOR By eputy Clerk CC: County Counsel County Administrator RECEIVED DEC 14 Zo00 SUPERIOR COURT C!SPK BOAF?C OF SUPERVlSt7RS CONTRA COSTA COUNTY COWRT ACOSTACO. 725 Court St. Martinez, , Ca. 94553 On Feb. 22, 2000 I sent in the attached civil claim against the Pittsburg Police department, to the board of sgpervisors, of contra Costa County. My claim was denied due to being late. Due to the fact that I was injured, incarcerated, unable to receive proper legal representation, and lack of availity to legal material concerning and about civil mat- ters, I was un able to send my claim out on time. I would also like this court to note that I was taking medication before and during the time of the incident and inadver-- ently taken off my medication, which resulted in pain. Please note also I was dealing with a death in my family. As a result of the injuryes I recieved from the attack by the Pittsburg police and their dog, I was and I still am phisicalyand mentally incapasacitated. I ask the court to recognise that I am a lay-man of the law and d4lpsot understand civil procedue or tort actions. I pray the court accepts my claim so justice may be served, and I can put this matter behind me. I am currently incarcerated at MULE CREEK STATE PRISON with an estimated parole date of April 15, 2001 , at which time I intend to obtain proper legal consul . sincerely, Rudy McConahey P71976 M. C. S. P. M2 F 9Low P.O.Box 409000 Ione, Ca. 95640-9000 CALIP'QANIA � "� SEPTEM6Eit 19, 2000 „ BOARD OF SUP BOARD ACTION Application to Fila Later Clair ) "� A?lLICANT Against the County, Routing ) The copy of thismu a i�isosa you is your, Endorsawnts, and board Action.) notice of the action taken on your application by (All Section References ars to the Dowd of Supervisors ((Paragraph III, below) California dovernarnt Code.) ) given pursuant to Government Code Sections 911.6 and !i 915.4. Fleas note the eWAN(DW below. Claimants RLy MC =4AM 1 dttorneye!`'; Address P-71976 CG-133-L Amounts � 0,000,000.00 By delivery to Clark on. August 9. 2000 Date]te*ai�vede 8-09-2000 By sail, postmarked an AUGUST 7. 2000 eClerk a of SVeRtsors, e County Attached is a copy of the above noted Application to Fila Let* Claim. DATEDe Al1GUST 10, 2000 PHIL BATCHUM, Clark, Bya Deputy II. ea5my Tot Clarko per- aors ( ) The Board should grant this Application to File Late Claim (Section 911.6). { tlJ'�Th#i Board should deny this Application to File.Late 1 Claim (Sao�ion 11.6). DATEDe G VICTOR tiF4117AN, County Counsel, sy� LL'f _ Deputy III. DJARD UNDER mous vote or Fupervisors presen (Chleok one,only) ( ). Tht's Application is granted (Section 911.6). { ) This Application to File Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Rcard's Order entered in its minutes for this date. [[ DATE,, ,4—ML BATMAR, Clerk, Bii `— •^� JC{'T �. Deputy WARNING (Oov. Code 6911.8) If you wish to fila a court action on this matter, you gust first petition the appropriate court for an order relievin� you frac the pr altos of tiovernment Code Section 945.4 (claims Po seaitation rsquirasept). ayes M wuaent Code aactiom 946.6. duoh petition out be filed with the oourt within six (6) s itths ftma the date your application for leave to presant a late claim was denied. You my seek the Adiise of an 3ttceWy at choice in oonn.otson with this t le a r ar e 7 y A421nismor Attached are copies of the above Applioation. we notated the applicant of the Board's action on this Xpplicaticn by mailing a copy of this document, and a mama thereof !i has ben filed and endorsed an the Boardis copy of this Claim in acoordatm with Section 29T03- DATED2Q 70-':'PHIL HIL DATC 1181M. Mork, Br puty • it y rAdministrator Tot Clark or ER Received copies of this Application end Board Order. of Supa dswe } DATFiie County Counsel, By County Administrator, A_M ICATION T17 FUS LATE CLAIM ! i 'I i f , ` 5„C ur -t SSE fib Whom if Aq/ o wye-e.rt`1 / M oT 7'l o—;r_ p--cj_. oy jnc,Gs[ 't Gam.+ tJl 3:4LAXS }'rpt rc. .s"tr•A/tj s _ s re,s�li of YA,'s a ht�r"�t'e,�c� � �._rp—C js P.Veol Seri o"S Solo af.A,.T__ f'N�i ��� � �� s4tffq- "l,H _ t _ J'Nlo.Nd /V cb. r'N.�,c?/'t�P�' .r lg _ _ /. '._yo III /vee�o( /40 _ 111 tie,rip-/,,� a b , Apar r'+tti. '2,600 I be Reard of 3ttfltae v'tor's Coif1104 'r.'dmilw511,13(ion 6111 tilllo! h I Flt fl'-- i�.f F?e: t_;�,:,•,.w t+� l r nrri I_atr f:t in 3i r v.. The, t:tainj ► }rG?ffntr?:1 #+� t)te 13oal-I ,)t' Suppr�,r00rt � of Contrs tYrtxt�3 f`tt�ttTt+1, t' litnrnia, bt3 Gollrtttx iaowv3el and r0urii d i-4 tile! Lwf_+Jtjse, :, you t`efe-1 "arta=3 Mt P F,3ei ted 'urlt.hih thp, ti me ti reit s;, reoui red by low, berebai: 1, ptyjy P- t+,Corahey '.pply for LEAVE TO PRESENT A LATE CLAIM �Sce Exhibit A, t:overiirnetti €-10 °echo" 91 44ve been ilt custo(1y :girtce 81142/99 And ri+)°d lervitiy a seer pmwt term, whir-ft rrlak:es me eligible to oprily for re-filing the enclosed rleim. Respectful i'I 5ubmittptS, Pudti P? 1°'lc:Ctli)ehetj P71976 P. 0. Box 40+000 tone.k'.A '45640-9000 f(idevit of Hatlina I declare under penalt of perjury that I am now, and at all threes here mentioned, have been a 6tizen of the United 'tater, over sge IS, and that today I doposited in the united States Postal Service in lone,t ali forma, postage fully prepaid,,a copy of the above LEA E TO PRESENT A LA'a CLAIM, addr-e:s gid as shown above_ Date: 04/2 7M LA Pudy R. Mc-Conshey f il Safthelor I VOW Clark sm, tcrr �, tri tho Board and i't k a. staCounty Administrator 6t Pr s# Ca26)33S-t90p rr *,Nr ,N�ttiDori"Obrbi 34D mil kWWI# .�Gf�e'rrfflii��t�l�!teCtl'ir� f ?R `O; Ludy R: McConahey M&1ft r'eZ Ddtentlon Facility 9p1 Court Street, C-29 lllfartine�, CA 94553 NQJIC.,�E TQ QL A1MAiUT (Of Late-Filed Claim) (Government Cade Section 911.3) 'The claim you presented to the Board of Supervisors of Contra Costa County, Calif* as governing body of the County of Contra Caste on October 271, 1999, has been reviewed by County Counsel and Is being returned to you herewith because. Your claim for an injury to person or personal property which arose on or before Oecembor 3'1, 1987 was not presented within 100 days after the event or occurrence as required *!law. (See Government Cade sections 901 and 911,2) J Your.claim for an Injury to person or personal property which arose on or after itinuary 1 1088 was not presented within six months of the event or occurrence as required by law= (See"Governmint Code sections 901 and 911.2) Your claim relating to a cause of action other than Injury to person, personal propdrty orgrowing crops was not presented within one year after the event or occurrence as required by.WW. (See Government Code sections 901 and 911.2) Dscsruse the claim was not presented within the time allowed by law„no action was takenn tie rlalrn. �s A Your-bblyrecourse at this time Is to apply without delay for leave to present a late claim. (See'Government Gude sections911.4 to 912.2 and 948.6) Under some d r+cum nbs leave to present a late claim will be granted. (See Government Code section r �xa�r��idtr»trica�srrs�rarlets gory.W� u> 911.6} You may seek the advice of an attorney of your choice In connection with this matter. If you desire to consult an attorney, you should do so immediately. t uc c7,0 Date: � � PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administrator By. AL puty Clerk Enclosure Affidavit of Mailing *** I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18, and that today I deposited in the United States Postal Service In Martinez, California, postage fully prepaid, a copy of the above NOTICE TO CLAIMANT (OF LATE-FILED CLAIM), addressed to the claimant as shown above. Date: t -' puty Clerk Tict 4 I:\TORT\R t SK-MC,T\C'LAIMS\LATE\1 Fortn,wpci r Claim to. BOARD.OF SUPERVISORS OF CONTRA COSTA COUNTY � INS CT �►N_s S2 C BM A. Claim relating to causes ofaction 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 tf�'�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 accrues on or after January 1, 1988,num be presented not later than six months after the accrual of the cause of action. Claims relating to any ether 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. B. FIAW. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp 0 RECEIVED Against the County of Contra Costa or ) FEB 2 2 2000 District) ill in name CLERK BOARD Or 911PERVtSOR5 CP00KTR gQSTA 0, The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the surra of o/t1,000yM,rnand in suprort of this claim represents as follows; 1. When did the damage or injury occur?(Give exact date and hour) i 2. Where did the damage or injury occur? (Include city and county) 3. How did thett damage or injury occur? (Give full details;use extra paper if required) 7A pal l i ce 6 5 �e,. - L. 0 M4,1 - ern.►' crib /qr yd44. ;stat particular actor omission can the part of county or district officers, servants, or employees caused the y ,.,ajury or damage? LVa 5 /11/1 S. Wh(ajt are the names of county/or district officers, servants, or employees causing the damages or injury? i �. + (i h', a C1! 1 i��C1►v, , ,r! '�t �'' r' i �v s l/rc' �k { , � 7t: yt✓ �r''"L N 11 -I' PO4S 44 i . {. What damage or injuries dt ou claim resulted?Ave full extent of injuries dr damages claimed. Attach two estimates for auto damage.) // O t aa, a NSI /r Q11y'tA1111'v1 11?1 a '' 'c /r t r '�r'�, irV r,•IX71." t � 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or dama*ge.).._, 4, , J 7 C PiC l (l ✓ l !ff� ll�i7 �}3 t � ,jL'(7� f?irit��/,r,-�r/ } rS ; �/ ue .Pr✓ iJvj % Zpt tf+ ,��"f1r."r+r�r1'`i;"►/a.� r�,�Ycr�/�l/�`k���`+� Ai S. Names and addresses of witnesses, doctors, and hospitals. 04?v r o M ('tyV4,<0V S 41—t r Idt' /lr fi IC >t t tJ 1110 6`, 71VIt//tr,14 yk . '3r^/ / Ir 9, List the'expenditures you,made on ac+dount of this accident or injury. DATE AMOM Gov, Code Sec. 910.2 provides"The claim must be } signed by the claimant or by some person on his behalf." Name and Address of Attorney' ) )ra } (CI imant's Signature) M A),44W-L~ I)44.e. ,,Vtv rA e/rr',� ) t sf-, (-- 0*� (Address) Telephone No. )Telephone No. NOTICE Section 72 of the Penal Cade 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,ac , 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 suite prison,by a fine of not exceeding ten thousand dollars($10,000),or by both such imprisonment and tine. po . t t r 44 41 NJ " �"7 �� 4 ....y-.... +"1 Imo"" �,-' a��� l\� .. ,+"' tiHw✓' w i .. �� � ;� t. _.. ... t .� ' �� �� � � ...w....�. r'^" �} ..w �. fLL.. � ,� I P` r «�.tom.. >_ '�• tail � �, ... l � �* t,,. ,.� � "�. ;� �--- �...� ��' l"''ti, �', .... .... _ '" t �.- �`- -...j. r"".. �. { ��,,. .. �, ..^� t^" *.max ��� � � #: � ., �ooIX i'.�: �'� �a O.o....y � � xf w ...�.. �V.. � � S �J � �. ; � ' .� �.; '� `� ��� r j�,�` � t ' r�� W� `• t cn :� G � .. :w y :.- K- , � s�5� ::`• �, � � yrs y fir.� � , �� CLAIM 1 BOAOF SUPERVISORS OF CONTRA COSTA COUNTS CAI 1A BOARD A00JANUARY 16, 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 i}�� ..�_� pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". sa E�1 ,. AMOUNT. In Excess of $10,000.00 CCS' COUNSEL MARTINEZ CALIFt CLAIMANT. ALLEN M. PROWS ATTORNEY: c/o P. M. DAVIS, ESQ. DATE RECEIVED: DECEMBER 13, 2000 LAW OFFICES OF PAUL M. DAVIS ADDRESS: P. O. Box 5230 BY DELIVERY TO CLERK ON: DECEMBER 13, 2000 SAN MATEO CA 94402-0230 BY MAIL POSTMARKED: DECEMBER 12, 2000 L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECEMBER 13, 2000 By: Deputy ZZ IL FROM County Counsel TO: Clerk of the Board of Supervisors { This claim complies substantially with Sections 910 and 910.2. { ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.$). ( ) 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: t ew By: Deputy County Counsel M. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER By unanimous vote of the Supervisors present: ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: gjZ= 16, ' 1 PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF NLAIr ING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States,over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified /copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 5LOd/ By: PHIL BATCHELOR By 1 &,Deputy Clerk CC: County Counsel County Administrator LAW OFFICES OF PAUL M. DAVIS POST OFFICE BOX 5230 SAN MATEO,CALIFORNIA 94402-0230 TELEPHONE: [650]349-0700 MEMORANDUM TO Clark, Board of Supervisors FROM Paul M. Davis, Esq. E D SUBJECT Claim for Damages DEC 1 3 2000 CLERK 8�7.°,6t 7 ul° ;�PERVIsOIs DATE 12/12/2000 c�v l.wa cosiA CO. Enclosed for filing is a form of CLAIM, along with a copy of the same. Kindly file the original, and stamp and return to me the copy. Thank you. S I P. M. Davis, Esq. (Bar No. 147985) 2 LAW OFFICES OF PAUL M. DAVIS Post Office Box 5230 3 San Mateo, California 94402-0230 4 Telephone: (650) 349-0700 5 Attorneys for Claimant 6 7 8 BEFORE THE BOARD OF SUPERVISORS OF THE 9 COUNTY OF CONTRA COSTA, STATE OF CALIFORNIA 10 11 ALLEN M. PROWS, ) ) 12 Claimant, ) Claim No. ) 13 -vs- ) 14 COUNTY OF CONTRA COSTA, OFFICE ) CLAIM FOR DAMAGES OF THE DISTRICT ATTORNEY, GARY ) 15 YANCEY, as District Attorney ) (Gov.Cd. §900, et seq. ) 16 Respondents . ) 17 ) 18 ) 19 20 21 Claimant Allan M. Prows claims damages from the County of 22 Contra Costa, the Office of the District Attorney of the County 23 of Contra Costa, and Gary Yancey as District Attorney of the 24 County of Contra Costa, as follows : 25 1 . The claimant is Allen M. Prows. Claimant' s post office 26 address is in care of his counsel identified above. 27 2 . Claimant requests that all notices regarding this claim 28 be sent to him in the care of his counsel as set forth above. - 1 - L3-301 1 3 . The date on which the incident giving rise to this claim 2 occurred on or about September 13 , 2000, and following, at, in, 3 or near the City of Daly City, County of San Mateo, State of 4 California. 5 The circumstances giving rise to the claim are that on and 6 September 13, 2000, the wages of claimant, a public employee and 7 police officer of the City of Daly City, were wrongfully, 8 unlawfully, carelessly, negligently, and maliciously garnished 9 and attached by an invalid and outdated wage and earnings 10 withholding notice, by continuing to overcollect child support 11 from claimant' s wages by way of such invalid notice purporting to 12 be valid legal process of the Superior Court of the County of 13 Contra Costa. Respondents knew that such legal process was 14 invalid and of no force or effect because the underlying child 15 support order was modified on September 13, 2000, but respondents 16 nevertheless negligently, carelessly, or intentionally failed and 17 refused to prepare and serve upon claimant' s employer a modified 18 earnings withholding notice to conform to the new court order. 19 Additionally, respondents carelessly, negligently and/or 20 intentionally paid the funds they wrongfully and unlawfully 21 extracted from claimant' s paychecks to claimant' s former spouse 22 who has no legitimate right, title or interest in the same. As a 23 proximate result of respondent' s invalid legal process, 24 claimant' s wages were seized and attached in an amount in excess 25 of the court order made on September 13 , 2000, and such 26 overwithholding from claimant' s wages continues to the date of 27 this claim. 28 2 - L5-301 1 Additionally, respondents have violated claimant' s civil 2 rights as set forth in Title 42 United States Code §1983 by 3 persisting in pursuing a vendetta and campaign of harassment 4 against claimant by disparate treatment and wrongful attachments 5 and seizures without lawful right, under the color of state 6 authority, solely because claimant is a male. 7 4 . The general description of the injury suffered by 8 claimant is that claimant suffered, among other things, the loss 9 of money, financial hardship, and emotional distress. 10 5 . The names and addresses of the public employees causing 11 the injury are Gary Yancey, Gayle Graham, and others whose 12 identities are unknown. 13 6 . The amount of this claim exceeds $10, 000 . 00, and 14 judicial jurisdiction of this claim is in the unlimited 15 jurisdiction of the Superior Court . 16 DATED: December 12, 2000 17 18 19 LAW OFFICES SW PAUL, M. is 20 2 0 21 By: 22 ;VA Q. Fiihe f Claimant 23 24 25 26 27 28 3 - LS-301 1 2 Abbreviated Case Title: Prows vs. County of Contra Costa 3 4 ATTORNEY' S CERTIFICATE OF SERVICE 5 [Code of Civil. Procedure S1013a(2) 6 I, the undersigned, am an active member of the State Bar of 7 California, not a party to the within action, and employed at the 8 address shown on the face page of this document; 9 That on the date shown below I served on RESPONDENT COUNTY 10 OF CONTRA COSTA the original of the attached NOTICE OF CLAIM by 11 placing the same in a sealed envelope with first-class postage 12 thereon fully prepaid, and, on the same day, deposited such 13 envelope in the United States Mail at San Mateo, California, 14 addressed as follows: 15 Clerk of the Board of Supervisors County of Contra Costa 16 651 Pine Street, Room 106 Martinez, CA 94553-1293 17 DATED: December 12, 2000 18 19 20 /P'1111M AVIS "" f 21 22 23 24 25 26 27 28 LS-301 x At `pp� o '•. y %0 ton 0% p p © rn '' v ` CA t7 NDN CLAIMBOARD OF SUPERVISORS QF-CDN1RA QQ51A COUNTY,- CALIFORNIA G`-1 BOMB AM1011t—JANUARY 16,- 2001 Claim Against the County, or District Governed by ► the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your California Government Codes. 1 notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below, given Al pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". AMOUNT: AMOUNT NOT STATED CIOUNTY COUNSEL MARTINEZ CALIF. CLAIMANT: THOMAS SPENCER ATTORNEY: C/o STEVEN W WELTY DATE RECEIVED: DECEMBER 19, 2000 MASTAGNI, HOLSTEDT, CHIURAZZI DECEMBER 19 2000 ADDRESS: & AMICK BY DELIVERY TO CLERK. ON: , 1912 1 STREET SACRAMENTO CA 95814 BY MAIL POSTMARKED: DECEMBER 18, 2000 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: DECEMBER 19, 2000 By: Deputy ^• IL FROM: County Counsel TO: Clerk of the Board of Supervisors ( VI'This claim complies substantially with Sections 910 and 910.2. ( ) This claim TAILS 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: r 2---'.2-0-06 By: - �-�-....Deputy County Counsel M. FROM- Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: C rD/ PHIL BATCHELOR, Clerk, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF AIAHANG 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: t9-80 By: PHIL BATCHELOR By9�� Deputy Clerk Ll CC: County Counsel County Administrator MASTAGNI, HOLSTEDT, CHIURAZZI & AMICK A PROFESSIONAL CHARLES H.BRIGGS,III DAVID P.MASTAGNI CHICO:895-3536 JOHN R.HOLSTEDT CORPORATION STC7CKTON:948-6155 J. 1912JSTREET STEVEN H MIAER RICHARDD AMICK77.I SACRAMENTO,CALIFORNIA SAN JOSE: 6-55802 AMANDAUEIRJ{AMIVSER MICHAEL D..JACO 95814 FRESNO:456-5580 BRADFORD A.WARREN BARBARA M. RGRA E 914 44n3 MICHAEL J.FERGUSON DENNIS W.HARORAVE FAX(916)447 4614 STUART C.WOO KASEY CHRISTOPHER CLARK I.R.S.#942478460 TIMOTHY C.McNEILL BRIAN A.DIXON CRAIG E.JOHNSEN DAVID E.MASTAGNI GEORGE FAGHI I MICHAEL KELLY PAT STAFFORD CHRISTOPHER W.MILLER CYNTHIA M.BOSCO JENNIFER A.HABER GREGORY S.EMERY ROGER A-TOLMAN,JR PAUL T.ESTRADA December 18, 2000 VIA CERTIFIED MAIL#Z 548 951 428 RECEIVED Clerk of the Board of Supervisors DEC 1 Contra Costa County 651 Pine St. (ARK BOARD OF SUPERVISORS Martinez, CA 94553 ONTRA COSTA CO. Re: Claim Dear Clerk of the Board of Supervisors for Contra Costa County: Enclosed you will find a Claim to be filed on behalf of Tom Spencer. Please file the original and return a stamped endorsed copy in the envelope which has been provided. Sincerely, MASTAGNI,HOLSTEDT & CHIURAZZI STEVEN W. WELTY Attorney at Law RJC:ao cc: Tom Spencer 1 STEVEN W. WELTY (SBN 192092) STAGNI,HOLSTEDT, CHIURAZZI & AMICK 2 1912 I Street Sacramento, California, 95814 3Telephone: (916) 446-4692 Attorney for Claimant NOMAS SPENCER RE 5 EIVED 6 101" 7 CLERK BOAR � �� THOMAS SPENCER ) g Claimant, } CLAIM AGAINST PUBLIC V. ) ENTI'T'Y la COUNTY OF CONTRA COSTA and ) [Govt. Code Section 910 et seq.] 11 CONTRA COSTA SHERIFF'S DEPARTMENT, 12 ) Respondents. } 13 ) ) 14 ) } 15 ) } 16 O: THE CLERK OF THE BOARD OF SUPERVISORS FOR THE COUNTY OF 17 CONTRA COSTA; 18 Claimant, Thomas Spencer,hereby requests compensation and damages as 19 follows: 20 1. Claimant's name is Thomas Spencer. Claimant's mailing address is 510 21 West Railroad Avenue, Cotati, California 94931. 22 Claimant is represented by the Law Firm of Mastagni,Holstedt, Chiurazzi 23 & Amick and all correspondence concerning this claim should be sent directly to 24 Steven W. Welty, Esq., 1912 I Street, Sacramento, California 95814, Telephone: 25 (916) 446-4692. 26 3. This is a claim for back pay and benefits filed by Thomas Spencer. Since 27 Thomas Spencer was denied disability retirement benefits,he is entitled to be 28 CLAIM AGAINST PUBLIC ENTITY 1 MASTAGNI,NOLSTEDT 6 CNIURA72f A PRCIEESSIONAL CORP0RATi I N 19121 STREET,SUITE 102 SACRAMENTO,CA 95814 28 4 1 reinstated to his previous position and to receive a full award of back pay and 2 benefits for the period of time that he was on unpaid administrative leave. (See 3 Phillips v. County ofFresno , (1990) 225 Cal. App. 3d 1240;McGriffv. Countv 4 of Los Angeles, (1973) 33 Cal. App. 3d 394; Leili v. Countyof Los Angeles, 5 (1983) 148 Cal.App. 3d 985, Tapiay. County of San Bernardino, (1994) 29 Cal. 6 App. 41375; Raygoza v. Count off Los Angeles, (1993) 17 Cal. App. 4th 1240; 7 California Government Code § 31725. 8 4. Claimant was a deputy sheriff employed by the County of Contra Costa. 9 While performing his job,he was injured to such a degree that the County of 10 Contra Costa paid Thomas Spencer benefits pursuant to Labor Code § 4850 for 11 the statutory period of one year. Thomas Spencer exhausted his § 4850 benefit on 12 February 10, 1998. At that time he was placed on administrative leave without 13 pay. His employer filed an Application for Disability Retirement with the Contra 14 Costa County Employees Retirement Association, alleging Claimant was 15 substantially unable to perform his duties as a deputy sheriff. This application 16 was filed October 6, 1997. 17 5. Thomas Spencer requested reinstatement to his position pursuant to his 18 treating doctor concluding that Claimant was able to perform the duties of deputy 19 sheriff. 20 6. Thomas Spencer requested reinstatement to his position on February 23, 21 1998, and again on February 25, 1998. 22 7. The employer refused Thomas Spencer's request for reinstatement or that 23 he be placed on paid administrative leave while the retirement application filed by 24 the employer was processed. 25 8. A hearing was conducted before an Administrative Law Judge to determine 26 whether Thomas Spencer qualified for disability retirement. The Administrative 27 Law Judge heard the evidence,received closing briefs, and issued a decision on or 28 CLAIM AGAINST PUBLIC ENTITY 2 MASTAGNI,FIOLSTEDT &CMIURAZZI A PROFESSIONAL CORPORATI 19121 STREET,SUITE 102 SACRAMENTO,CA 95814 2g a a I about August 10, 2000. The Application for Disability Retirement was denied. 2 On or about September 12,2000, the proposed decision of the Administrative 3 Law Judge was adopted by the Contra Costa County Employees Retirement 4 Association. 5 9. The County of Contra Costa reinstated Thomas Spencer to his previous 6 position as Deputy Sheriff on September 13,2000. 7 10. On or about September 13, 2000 Thomas Spencer requested back pay and 8 benefits during the time that he was on administrative leave without pay. The 9 County refused to pay any back pay or benefits during the period of time that 10 Thomas Spencer was on administrative leave without pay. 11 11. Thomas Spencer first became aware that a cause of action existed on 12 September 13, 2000. The filing of this claim on December 12,2000, is within the 13 six month period prescribed by § 911.2 of the Government Code. 14 12. Thomas Spencer requests back wages and benefits from February 10, 1998 15 through September 12, 2000. Jurisdiction is with the Superior Court. 16 ATED: December 14, 20010 17 18 MASTAGNI,HOLSTEDT, CHIURAZZI & AMICK 19 20 STEVEN W. Attorney for PI a iff 21 22 23 24 25 26 27 28 CLAIM AGAINST PUBLIC ENTITY 3 MASTAGNI,HOLSTEDT &CHIURAZZI A PROFESSIONAL CORPORATI 1912 1 STREET,SUITE 182 SACRAMENTO,CA 95814 AW 26 Z 548 951 428 s ri, t h ,ZZI&AMICK F_ Clerk of the Board of Supervisors Contra Costa County 651 Pine St. Martinez, CA 94553 ,; J yA'.. AH ENDED CLAIM `? BOARD OF SUPEBMS RS OF CONTRA COSTA +CQTINTY, CALWAMNIA__ BOARD ACT1011t JANUARY 16, 200 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 13 L9 k''0 pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". MARTINEZ TINEZ CALIF AMOUNT: JURISDICTION OF SUPERIOR COURT CLAIMANT: ELVIS B. WILLIAMS ATTORNEY: c/o The Law Office of Roberta DATE RECEIVED: DECEMBER 21, 2000 Brooks DECEMBER 21 2000 ADDRESS: 1001 Second St. , Ste. 345 BY DELIVERY TO CLERK ON. Napa CA 94559 HAND-DELIVERED BY MAIL POSTMARKED. L FRONL• Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL B HELOR rk DECEMBER 22, 2000 B Dated: y: Deput,p y IL FROM• County Counsel TO: Clerk of the Board of Slupervisors 6,'This claim complies iibstantially 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.$). ( ) 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). { -T-h- -e---. Other: 1rhe— r'''`+1,t n!5 b - Q wt` VQQr- C JCL 1 rn et-470r 4o JfiJ r\e- 0 e.70 O r-e Dated: 1 '' '" By: y County Counsel ffi. FRONL Clerk of the Board TO. County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD GIRDER: By unanimous vote of the Supervisors present: ()4 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: /& 'OOD/ PHIL BATCHELOR, Clerk, By , Deputy Clerk —9 4; 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 N!A>[LING 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: 10 J By: PHIL BATCHELOR By Deputy Clerk CC: County Counsel County Administrator `7) Vii* 114 C LiAwOnria OF ROBERTA. BROOKS 1001 Second Street, Suite 345 Telephone: (707) 252-7637 Napa, CA 94559 Facsimile: (707) 257-5399 December 14, 2000 Monika L. Cooper, Esq. �} DIs all '.. Y I Contra Costa Count 1� Office of the County Counsel r DEC 15 2000 County Administration Building 651 Pine Street, 9`h Floor '7 �r COUNTY CUUN6'L Martinez, CA 94553-1229 CLE h �� �"g ' � MARTINEZ, CALIF K - Re: Elvis B. Williams vs. Contra Costa Sheriffs Department, et al. Dear Ms. Cooper: As we discussed on December 8, Mr. Williams' allegations of discrimination and hostile work environment are based on the series of events described on pages 1-2, lines 26-28, lines 1- 8. Each event is but a link in the chain of evidence leading to Mr. Williams' allegation of discrimination and hostile work environment. While I understand the County's desire to look at each event as a separate occurrence,the legal nature of each makes it impossible to sort an alleged event into a separate, stand-alone category constituting discrimination or hostile work environment. As we also discussed this letter is an amendment to the Claim filed on December 5, 2000, in the above referenced matter. The sentence on page 1, lines 26-28 and continued on page 2, lines 1-8 should read"On or about March 13, 2000 and continuing through September 2000, Claimant's supervisor discriminated against Claimant and subjected him to a racially hostile work environment by using the word"nigger,"by referring to Claimant as "boy,"by changing the scope of Claimant's work to include work originally assigned to Caucasian employees, by assigning Claimant job tasks outside the scope of his regularly assigned duties, by changing the Department's work schedule so that Claimant, who had Saturday as a scheduled day off for two years, was then assigned to work Saturdays, while a Caucasian employee originally assigned to the Saturday schedule was given Saturday as his day off, by threatening Claimant with termination, by telling him he was a buck and a day late, by telling inmates and Claimant's co-workers that Claimant was on a leave of absence due to stress, by trailing Claimant endlessly while Claimant performed his assigned tasks, and by refusing to sive Claimant his final paycheck upon Claimant's resignation on September 12. Williams vs. County of Contra Costa et al. —Amendment Page 2 Add to page 2 after line 26 the following: In or about the month of April 2000, defendant Choate changed the department's work schedule so that Claimant no longer had Saturdays as a day off. Claimant lost his Saturday day off to a Caucasian employee who was originally assigned to work Saturdays. Add to page 3 after line 10 the following: In or about the month of July 2000, Claimant asked for and received a medical leave of absence based on job-related stress. During his absence, defendant Choate-had several conversations with Claimant's co-workers as well as inmates concerning Claimant's mental health. Claimant is informed and believes that defendant Choate told one inmate that" I thought we were getting alone fine,he didn't go out because of me." Upon his return in July 2000, Claimant was embarrassed to learn that his co-workers knew the reasons for his medical leave. Of most concern to Claimant, however, was the fact that the inmates knew that Claimant's leave of absence was related to on-the-job stress. Claimant informed defendant Choate that she had placed Claimant's personal safety at risk by revealing to inmates the reasons for his leave. Claimant also discovered upon his return that he was still being assigned much of the work that was originally assigned to Caucasian employees. Claimant was also dismayed to discover that his supervisor continued to scrutinize his work and not the work performed by Caucasian employees. Moreover, Claimant was dismay to hear that defendant Choate planned to have him terminated. On or about September 12, 2000, Claimant resigned his position as a detention service worker. In accordance with California law, Claimant was to receive a final paycheck upon completion of his last day of work. However, defendants refused to pay Claimant stating that he failed to return county property. Yet, as Claimant went through the check out process on his last day of work with the county, no one informed him, either verbally or in writing, that the county believed Claimant to be in possession of county property and that he needed to return the property before the county could give him his final check. Moreover, Claimant is informed and believes that defendant Choate, who told a number of people that she was not going to pay Claimant, made up the story regarding Claimant's possession of county property. Claimant absolutely denies possessing county property. In late November 2000, Claimant's check mysteriously appeared. Claimant is informed and believes that not until word of Claimant's pending lawsuit reached defendants did defendants forward Claimant's paycheck to him. Any issue regarding Claimant's alleged possession of county property was dropped. This concludes the current amendments to Mr. Williams claim. As is the case with most lawsuits, evidence often appears as a case proceeds requiring yet another amendment. Should that be the case here, I will contact you immediately. Williams vs. County of Contra Costa et al. —Amendment Page 3 Should you have any questions, please feel free to contact me at the above-listed address. In the meanwhile, as stated in my earlier letter, please forward any correspondence to Mr. Williams to my office. Sincerely, Roberta Brooks cc: Elvis B. Williams CLAIM BQARD OF SUP,EMSM OF CONTRA-COSTA COUNTY, CALIFORNIA BOARD ACMOAt .JANUARY 16, 2001 Claim Against the County, or District Governed by 1 the Board of Supervisors, Routing Endorsements, 1 NOTICE TO CLAIMANT and Board Action. All Section references are to 1 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 IOU ;.�" 0 6 pursuant to Government Code Section 913 and COUNTY COUNSEL 915.4. Please note all "Warnings". MARTINE-Z CALIF. AMOUNT: Jurisdiction of Superior Court CLAIMANT: ELVIS B WILLIAMS ATTORNEY: DATE RECEIVED: December 6, 2000 ADDRESS: c/o The Law Office of Roberta BY DELIVERY TO CLERK. ON: December 6, 2000 1001 Second St. , Ste 345 Brooks Napa CA 94559 BY MAIL POSTMARKED: December 5, 2000 L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PHIL BATCHELOR, Clerk Dated: December 6, 2000 By: Deputy II. FROM: County Counsel TO: Clerk of the Board Supervisors { ✓)" This claiMA 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). { 0 Other: Tit i!5 C is+gym i s on IL, -h me-tu �-_5 -6pe-� �_ _c�C L r—r�r r 0 n::� _[ aid w i t1 e.- Dated: A?41—A) By: �� - Deputy County Counsel Ill. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By , 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. AFMAVTT OF N14II NG I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: By: PHIL BATCHELOR By Deputy Clerk `� rr. Cnimty CnitncPl f+�imty AA—iniot,a?n lI VlClrOR J.WESTMAN DEPUTIES: PHILLIPSCOUNTY COUNSEL JANICE L.L.ALTHOFF ANICAMENTA NORA G.BARLOW B.REBECCA BYRNES LSILVANO B.MARCHESIANDREA W CASSIDY CH IEF ASSISTANT COUNTY COUNSEL �°'�'?'` A MONIKA L.COOPER VICKIE L.DAWES OFFICE,' FTH C 7tJ 4NSEL MARKES.ESTIS SHARON L.ANDERSONMICHAEL D.FARR iSTfEIIL {(yi LILLIAN T.FUJiI ASSISTANT COUNTY COUNSEL fEE�' yr DENNISC.GRAVES F EZ CALl JANET L. HOLMES MAEERH BERNARD L. GREGORY C.HARVEY L.K r� �� t„ BKNAPP ASSISTANT COUNTY COUNSEL EDWARD V.LANE,JR. BEATRICE LIU MARY ANN MASON GAYLE MUGGLI PAUL R.MU94IZ VALERIE J.RANCHE OFFICE MANAGER STEVEN P.RETTIG DAVID F.SCHMIDT DIANAPHONE(925)335-1800 NOTICE OF UNTIMELINESS JACQUELINE R FAX(925)646-1078 JACOUELINEYWOOO$ AS TO A PORTION OF THE CLAIM TO: Elvis B. Williams c/o Ms. Roberta Brooks Attorney at Law 1001 Second Street, Suite 345 Napa, CA 94559 Please Take Notice as Follows: In regards to the claim you submitted on December 6, 2000 on behalf of claimant, Elvis B. Williams,portions of your claim are timely and portions are untimely. The portions of your claim prior to June 5, 2000 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 by law. Because the portions of the claim prior to June 5, 2000 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. Mr. Williams' 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. VICTOR J. WESTMAN COUNTY COUNSEL By. < d' Monika L. Cooper Deputy County Counsel Page 1 CERTIFICATE OF SERVICE BY MAIL (C.C.P.§§ 1012, 1013a,2015.5;Evidence Code§§641,664) 1 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. I served a true copy of this NOTICE OF UNTIMELINESS AS TO A PORTION OF TIME 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. Executed in Martinez,California. Dated: December 7,2000 j G Kathy 0' ell �a cc: Clerk of the Board of Supervisors(original) Risk Management Page 2 LA,w OrrICE OF ROBERTABROOK$ 1001 Second Street, Suite 345 Telephone: (707)252-7637 Napa,CA 94559 Facsimile: (707) 257-5399 RECEIVED- December 5,2000 p E C _ 6 2000 CLERK BOAS OF NPERVISORS Clerk of the Board CONTRA COSTA CO. County Administration Building 651 Pine Street,Room 106 Martinez, CA 94553 Re: Notification of Governmental Claim—Williams vs.Contra Costa Sheriff's Departments et al. Dear Gentleperson: This claim is being filed pursuant to Government Code section 900 et seq. for damages sustained by Elvis B. Williams,who was employed by the Contra Costa Sheriff s Department in Richmond, California from October 1996 to September 2000. The facts which constitute Mr. Williams' claim are contained in the enclosed Claim for Personal Injuries. This claim is being submitted to exhaust Mr. Williams' administrative remedies. I look forward to your response. Please address any and all correspondence regarding this matter to Elvis B. Williams c/o The Law Office of Roberta Brooks 1001 Second Street, Suite 345 Napa, CA 94559 Sincerely, Roberta Brooks cc: Elvis B. Williams I Roberta Brooks; SBN 203536 LAW OFFICE OF ROBERTA BROOKS 2 1001 Second Street, Suite 345 Napa, CA 94559 3 (707)252-7637 4 Beverly Saxon Leonard; SBN 153105 THE LAW FIRM OF BEVERLY SAXON LEONARD 5 1001 Second Street,Suite 345 Napa,CA 94559 6 (707)257-5378 7 Attorneys for Plaintiff ELVIS B.WILLIAMS 8 9 10 ELVIS B.WILLIAMS CLAIM FOR PERSONAL INJ[JRIES (SECTION 910 OF THE GOVERNMENT 11 Plaintiff, CODE) VS. 12 � CONTRA COSTA SHERIFF'S 13 DEPARTMENT; SHERIFF WARREN E. RUFF; JEFF VICKERS; WILMA 14 CHOATE AND DOES 1 -25 inclusive. ) 15 Defendant. 16 TO THE COUNTY ADMINISTRATOR OF CONTRA COSTA COUNTY. 17 You are hereby notified that Elvis B. Williams,whose address is 132 Byron Street,Vallejo, 18 California 94590, claims damages from the Contra Costa Sheriff s Department, Sheriff Warren E. 19 Rupf, and Jeff Vickers, and Wilma Choate. 20 This claim is based on personal injuries sustained by claimant beginning in the month of 21 March 2000, and continuing until his resignation in September 2000, at the Contra Costa Sheriff's 22 Department Correctional Facility, located in Richmond, California,under the following 23 circumstances. 24 Claimant was employed by Contra Costa Sheriff's Department as a detention service worker. 25 He was supervised by Wilma Choate. In about March 2000 forward through September 2000, 26 Claimant was subjected to racial discrimination as well as a racially hostile work environment. On 27 or about March 13, 2000, Claimant's supervisor discriminated against Claimant and subjected him 28 to a racially hostile work environment by using the word"nigger,"by referring to Claimant as 1 Claim for Personal Injuries 1 "boy,"by changing the scope of Claimant's work to include work originally assigned to Caucasian 2 employees,by assigning Claimant job tasks outside the scope of his regularly assigned duties,by 3 changing the Department's work schedule so that Claimant,who had Saturday as a scheduled day 4 off for two years,was then assigned to work Saturdays,while a Caucasian employee originally 5 assigned to the Saturday schedule was given Saturday as his day off,by threatening Claimant with 6 termination,by telling him he was a buck and a day late, by telling inmates and Claimant's co- 1 workers that Claimant was on a leave of absence due to stress, and by trailing Claimant endlessly 8 while Claimant performed his assigned tasks. In addition, Sheriff Rupf told Claimant during a 9 Skelly hearing that Claimant was a"big black guy"who intimidated his Caucasian supervisor. 10 In or about March 2000, Claimant complained to Sergeant Larry Aulich that Choate was 11 treating African-American employees differently than Caucasian employees by assigning African- 12 American employees work that was originally assigned to Caucasian employees. Later on or about 13 March 15, 2000, Claimant complained to his supervisor, Choate, about Choate's use of racial 14 epithets and about Choate's treatment of African-American under Choate's supervision. The 15 conversation between Claimant and Choate escalated with Choate telling Claimant"wait until we 16 get new post orders" and"you better look for a new job." Claimant responded to Choate by telling 17 her he was going to the union and the Equal Employment Opportunity Commission. Later that day 18 Claimant filed an internal complaint. 19 The next day, Jeff Vickers,the Director of Food Services and Choate's manager, filed a 20 Cause of Action against Claimant claiming that Claimant had lunged at Choate. Vickers 21 recommended terminating Claimant. An internal investigation of the matter by Sergeant John Dodd 22 of Internal Affairs revealed that Vickers failed to complete a thorough investigation of the matter. 23 Vickers neglected to contact witnesses suggested by Claimant. Moreover,Vickers' investigation 24 found that Choate did not use the"N"word, in spite of Choate's admission that she had. 25 Nonetheless,the Department's Affirmative Action Coordinator advised Claimant on April 26,2000, 26 that his allegations of race discrimination were "unsuccessfully resolved." 27 Cance the Department felt its investigation of Claimant's allegations was complete, it held a 28 Skelly hearing on or about June 7, 2000,to settle the March 15,2000 incident between Claimant and 2 Claim for Personal Injuries 1 Choate. During that meeting, Sheriff Rupf told Claimant that he doubted Claimant had actually 2 lunged at Choate,but that Claimant was a"big,black guy"who was probably angry and as a result 3 intimidated Choate. Claimant absolutely denies lunging at Choate. As a result of the hearing, 4 Claimant was not terminated,but had his pay reduced by five percent for three months,beginning 5 July 1,2000. However,to add insult to injury, Claimant's paycheck was not simply reduced. 6 Attached to his check was a salutation which read"Congratulations" and"Good Luck in your new 7 job." Claimant's pay check congratulated Claimant on his new job,while informing him that in 8 "conjunction with disciplinary action his pay was being reduced." Needless to say,Claimant felt 9 utterly demoralized at the County's complete lack of sensitivity and continued perpetuation of a 10 racially hostile work environment. 11 As Claimant's employer,the Sheriff s Department owed Claimant a special duty to protect 12 him from danger, including protection from racial discrimination and a racially hostile work 13 environment. Defendants, and each of them, failed to comply with this duty thereby exposing them 14 to damages. 15 The personal injuries complained of include,but are not limited to intentional/negligent 16 infliction of emotional distress, negligence training and/or retention of an unfit employee,racial 17 discrimination,racially hostile work environment, and retaliation. 18 The injuries sustained by Claimant, as far as known, as of the date of presentation of this 19 claim,consist of loss of income, loss of earning capacity,medical bills, and pain and suffering. 20 Based on the foregoing, Claimant hereby makes claim against Defendants, and each of them, 21 in the amount of$500,000. 22 Jurisdiction over this claim would rest in Superior Court. 23 All notices or other communication with regard to this claim should be sent to The Law 24 Office of Roberta Brooks, 1001 Second Street, Suite 345,Napa, California 94559. 25 Dated: December 5, 2000 THE LAW OFFICE OF ROBERTA BROOKS 26 27 ' Roberta Brooks,Attorney for Claimant 28 ELVIS B. 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