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HomeMy WebLinkAboutMINUTES - 12032002 - C35 CLAIM BOARD OF SUPERVISORS OFCONTBA COSTATY BOARD ACTIONS EMBER 03, 2032 Claim Against the County, or District Governed by } the Board of Supervisors,Routing Endorsements,_ Y _ NOTICE TO CLAIMANT and Board Action. All Section referen e � )j t The copy of this document mailed to you is your California Government Codes. ) ` notice of the action taken on your claim by the {, N=OV {j 4 ;,,:�;� Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and '' I X 915.4. Please note all"Warnings" ,N!AF�T;N Z CALIF. AMOUNT: :,:EXCEED $25,000. - Exceed $10,000. CLAIMANT: KAREN EKLUND ATTORNEY: ROBERT E. GONZALES DATE RECEIVED: NOVEMBER 01, 2002 GONZALES LAW FIRM ADDRESS: 345 FRANKLIN STREET, BY DELIVERY TO CLERK ON: NOVEMBER 01, 2002 SAN FRANCISCO, CA 94102 BY MAIL POSTMARKED: OCTOBER 30, 2002 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETE Dated: NOVEMBER 04, 2002 By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (t is claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with'Sections 910 and 910,2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910,8). ( } Claim is not timely filed. The Clerk,should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911,3). ( ) Other: Dated: �' '-' 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: DECEMBER 03, 2002 ,JOHN SWEETEN,CLERK, ByZi9-44e--- , Deputy Clerk s WARNING(Gov. code ection 13) Subject to certain exceptions, you have only six (6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned,have been a citizen of the United States, over age 18, and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: DECEMBER 04, 2002 JOHN SWEETEN,CLERK.By Deputy Clerk v �y ff6 Y.Yr,., ryl}rye /1 Nav � CLAIM AGAINST CONTRA COSTA COUNTY to tr CLERIK'0 0 T CGT . To: Clerk, Contra Costa County Board of Supervisors 651 Pine Street Martinez, CA 94553 laimant: Karen Eklund c/o Robert E Gonzales GONZALES LAW FIRM 345 Franklin Street San Francisco, CA 94102 415 431 3200/Fax 4313221 Date of Incident: August 1, 2002 Location: 309 -East 9`h Street,Pittsburg, CA Occurrence: On August 1, 2002, law enforcement officers of the Contra Costa County Sheriff's Department, San Joaquin County Sheriff's Department, Lodi Police Department,Pittsburg Police Department and California Highway patrol officers entered claimant's residence while she was asleep in her bedroom, unannounced, without a warrant, without probable cause or exigent circumstances existing, and forcibly and violently arrested and hand cuffed her at gunpoint. This, despite claimant's protests that she did not know what was occurring or was she resisting; and obviously the arresting officers, and other participants, knew that claimant was not the person allegedly being sought. The person allegedly being sought was a female of slight stature(the police had a mugshot and description of the suspect). Claimant is a female approximately 5' 9", 150 lbs. Claimant had not been resisted arrest; and had been asleep in her bed. Person or persons responsible: Police personnel of the Contra Costa Sheriff's Office,who ordered claimant's arrest at gunpoint, detained her in handcuffs, despite her pleas and with the knowledge that they had entered her residence, without a warrant,probable cause, or exigent circumstances, and that claimant was not the person being sought. Inj /ury damages: Claimant was deprived of her right to liberty; and summarily punished for an act she did not commit. She suffered emotional distress and humiliation. Claimant may require future psychological/psychiatric services. Jurisdiction: Damages exceed$25,000. October 30,2002 41 ^e r CLAIMAGAINST CONTRA COSTA COUNTY To: Clerk, Contra Costa County Board of Supervisors 651 Pine Street Martinez, CA 94553 Claimant: Karen Eklund c/o Robert E Gonzales GONZALES LAVA FIRM 345 Franklin Street San Francisco, CA 94102 415 431 3200/Fax 4313221 Date of Incident: August 1, 2002 Location: 309 - East 9`h Street, Pittsburg, CA Occurrence: On August 1, 2002, law enforcement officers of the Contra Costa County Sheriff's Department, San Joaquin County Sheriff's Department, Lodi Police Department,Pittsburg Police Department and California Highway patrol officers entered claimant's residence while she was asleep in her bedroom, unannounced,without a warrant,without probable cause or exigent circumstances existing, and forcibly and violently arrested and hand cuffed her at gunpoint. This, despite claimant's protests that she did not know what was occurring or was she resisting; and obviously the arresting officers, and other participants,knew that claimant was not the person allegedly being sought. The person allegedly being sought was a female of slight stature(the police had a mugshot and description of the suspect). Claimant is a female approximately 5' 9", 150 lbs. Claimant had not been resisted arrest; and had been asleep in her bed. Person or persons responsible: Police personnel of the Contra Costa Sheriff's Office, who ordered claimant's arrest at gunpoint, detained her in handcuffs, despite her pleas and with the knowledge that they had entered her residence,without a warrant,probable cause, or exigent circumstances, and that claimant was not the person being sought. Inyury/damag_es: Claimant was deprived of her right to liberty; and summarily punished for an act she did not commit. She suffered emotional distress and humiliation. Claimant may require future psychological/psychiatric services. Jurisdiction: Damages exceed$25,000. October 30—2002 *bent N. CLAIM AGAINST CONTRA COSTA COUNTY To: California State Controller P.O. Box 942850 Sacramento, CA 94250-5872 Claimant: Karen Eklund c/o Robert E Gonzales GONZALES LAW FIRM 345 Franklin Street San Francisco, CA 94102 415 431 3200/Fax 4313221 Date of Incident: August 1, 2002 Location: 309 - East 9`h Street, Pittsburg, CA Occurrence: On August 1, 2002, law enforcement officers of the Contra Costa County Sheriff s Department, San Joaquin County Sheriff's Department, Lodi Police Department,Pittsburg Police Department and California Highway patrol officers entered claimant's residence, unannounced, without a warrant,without probable cause or_circumstances existing, and forcibly and violently arrested and battered claimant,despite claimant's protest that he did not know what was occurred nor was he resisting, and obviously the arresting officers, and other participants, knew that claimant was not the person allegedly being sought. The person allegedly being sought was a female, of sligth statute. Claimant was battered after he was already on the ground, handcuffed. Claimant had not been resisting arrest. Person or persons responsible: Personnel of the California Highway Patrol,who ordered claimant's arrest, detention and battering, despite his pleas and with the knowledge that they had entered his residence, without a warrant, cause of extigent circumstances. Inj /ury damages: Claimants was deprived of his right to liberty; was similarly punished for an act he did not commit,was battered by police officers causing a nose fracture and deep laceration along the bridge of the nose, requiring 14 stitches to close. Laceration will leave a permanent disfiguring scar along the bridge of the nose, in excess of one inch long and an eighth of an inch wide. Claimant will require future service to repair the fractured nose. Jurisdiction: Damages exceed$25,000. September 12, 2000 APPLI ATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT DECEMBER 03, 2002 Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors (Paragraph III,below), California Government Code.1 ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the"WARNING"below. Claimant: GUILLERMO GONZALEZ, BLANCA GUITERREZ, AND DANIEL GONZALEZ, Deceased Attorney: STEPHEN CLANG, ESQ, Address: 535 MAIN STREET, SOV 0 5 2002 MARTINEZ, CA 94553 COUNTYt1SL Amount: tAARTIN C ry to Clerk on: NOVEMBER 04, 2002 Date Received: NOVEMBER 04 9 2002 By mail,postmarked on:' HAND DELIVERED L FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: NOVEMBER 5, 2002 JOHN SWEETEN,Clerk,By: DEPUTY 11. FROM: County Counsel TO: Cler of the,Board df Supervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). (+ The Board should deny this Application to File Late Claim (Section 911.6). DATED: 16,L-OL SILVANO B.MARCHESI, County Counsel, By: �,� EPUTY III. BOARD ORDER By unanimous vote of Supervisors present (Check one only) ( ) This Application is granted(Section 911.6). ( This Application to File Late Claim is denied(Section 911.6). I certify that this a true and correct copy of the Board's Order entered in its minutes for this date. DATE: DECEMBER 03' JOHN SWEETEN Clerk B 2002 9 y: -- DEPUTY WARNING(Gov. Code §911.8) If you wish to file a court action on this matter,you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4(claims presentation requirement).See Government Code Section 946.6.Such petition must be filed with the court within six(6)months from the date your application for leave to present a late claim was denied. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so immediately. IV. FROM: Clerk of the Board TO: (1) County Counsel (2)County Administrator Attached are copies of the above Application. We notified the applicant of the Board's action on this Application by mailing a copy of this document,and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: DECEMBER 04, 2002 JOHN SWEETEN,Clerk,By: DEPUTY V. FROM: (1)County Counsel (2) County Administrator TO: FlerZ of the pard of Supervisors Received copies of this Application and Board Order. DATED: County Counsel,By: County Administrator,By: APPLICATION TO FILE LATE CLAIM ej;7 THE OFFICES OF CHANG LAW FIRM MARTINEZ ATTORNEY AT LAW WALNUT CREEK 535 Main Srreet,Third Floor 1255 Treat Boulevard,Third Floor Martinez,California 94553 Walnut Creek,California 94597 Tel:(925)372-7779 Tel:(925)838-9369 Fax:(925)372-8181 email:Chang—Law a)hotmail.corn November 04, 2002 Clerk of the Board of Supervisors Contra Costa County LCLERKBOA 200 County Administration Building 651 Pine Street, Room 106 F SUPERVISORSMartinez, CA 94553 COSTA Co. Re Claim Of: Guillermo Gonzalez, Blanca Guiterrez, and Daniel Gonzalez, deceased APPLICATION FOR LEAVE TO PRESENT A LATE CLAIM Dear Board of Supervisors: Please be advised that our office represents the above-referenced claimants in an action against the Contra Costa Regional Medical Center. Pursuant to Government Code § 911.6, this is our written application for leave to present a late claim. We respectfully request that the Board of Supervisors grant our application to present a late claim in this matter for the following reasons: 1. Claimants' failure to present the claim was through mistake and excusable neglect and the Board of Supervisors are not prejudiced in its defense of the claim by the failure to present the claim within the time specified in GC §911.2 a. Claimant Daniel Gonzalez died as a result of the negligent actions of the County Regional Medical Center. Co-Claimants, Guillermo Gonzalez and Blanca Guiterrez, were the parents of Daniel Gonzalez. b. The parties were going through extreme emotional distress and suffering resulting from the death of their child and failed to make a timely claim. c. Claimants were also unaware that they had a claim against the County because the County hospital advised them that there was no negligent conduct on their part. d. The Board would not be prejudiced its defense of the claim because all of the records and facts and witnesses are under the control and custody of the Board. APPLICATION FOR.LEAVE TO PRESENT A LATE CLAIM 2. Pursuant to Government Code §911.6(b)(2), the Board shall grant the application when the person who sustained the alleged injury was a minor during all of the time specified in §911.2 for the presentation of the claim. a. Claimant Daniel Gonzalez was a minor child at the time of the injury and when he died. 3. Pursuant to Government Code §911.6(b)(4), the Board shall grant the application when the person who sustained the injury died before the expiration of time specified in §911.2. In this case, claimant Daniel Gonzalez died three days after the negligent acts of the County. Based on the foregoing facts,the Board of Supervisors must grant our application to present a late claim in this matter. Thank you for your kind consideration of this matter. Sincerely, CHANG LAW FIRM Stephen S. CianESQ. Attorney for Claimants, Guillermo Gonzalez, Blanca Guiterrez, and Daniel Gonzalez, deceased APPLICATION FOR LEAVE TO PRESENT A LATE CLAIM The Board of uperviborsContra ��, -ife,-4 John Sweeten Clerk of the Boarc Count Administration Building f'fit A C+"z'a+ and Y 9 Costa L County Administratcr 651 Pine Street. Room 1{76 Martinez,California 945531293 County {925}335 t9o0 John Glole,1st District �d Gayle S.Ullkerna,2nd District ! Donna Gerber,3rd District Mark DeSaulnier,4th District i� Federal D.Glover,5th District : TO: Stephen Chang, Esq. PQ V CHANG LAW FIRM � 535 Main Street Martinez, CA 94553 Re Claim Of: Guillermo Gonzalez, Blanca Guiterrez, and Daniel Gonzalez NOTICE TO CLAIMANT (Of Late-Filed Claim) (Government Cade Section 911.3) The claim you presented to the Board of Supervisors of Contra Costa County, California, as governing body of the County of Contra Costa on October 30, 2002, has been reviewed by County Counsel and is being returned to you herewith because: X Your claim for an injury to person or personal property was not presented within six months of the event or occurrence as required by law. (See Government Code sections 901 and 911.2) _ Your claim relating to a cause of action other than injury to person, personal property or growing crops was not presented within one year after the event or occurrence as required by law. (See Government Code sections 901 and 911.2) Because the claim was not presented within the time allowed by law, no action was taken on the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code sections 911.4 to 912.2 and 946.6) Under some circumstances leave to present a late claim will be granted. (See Government Code section 911.6) pn [[RD Stephen Chang, Esq. Re: Claim Page Two 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. Date: October 31, 2002 JOHN SWEETEN, Clerk of the Board of Supervisors and County Administrator By: eputy 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. octaber 3I, 2002 Depufy Cldrk t:\TORT\RISK-MGT\CLAIMS\LATE\Gonzalez-Gutierrez.wpd ., CLAIM f BOARDOFSUPERVISORS OF CONTRA COSTA► OUNTY t BOARD ACTION: November 12, 2002 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 OCT 3 0 2002 Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings", COUNTY COUNSEL, AMOUNT: $750,000.00 over $10,0019IARTINEZ CALIF. CLAIMANT: Guillermo Gonzalez, Blanca Gutierrez, and Daniel Gonzalez ATTORNEY: Stephen Chang, ESQ. DATE RECEIVED: October 30. 2002 ADDRESS: 535 Main Street, BY DELIVERY TO CLERK.ON: October 30', 2002 Martinez, CA 94553 BY MAIL POSTMARKED: hand delivered FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE T4r Dated: October 30, 2002 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Superysors ( ) 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). (aim,is not timely filed. The Clerk should return claim on ground that it was,filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). { ) Other: Dated: _ -_ / " L C% --- BY: I ,_ RZLW41�_ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( ) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated.- - JOHN SWEETEN, CLEF., By , Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING _ I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JOHN SWEETEN,CLERK.By Deppty Clerk CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: DECEMBER 03, 2002 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". �3 IRT I a AMOUNT: $5,247.10 ttss 0V 0 4 CLAIMANT: PACIFIC BELL COUNTY COUNSEL %4ART4N4 Z CALi u ATTORNEY: UNKNOWN DATE RECEIVED: NOVEMBER 01, 2002 ADDRESS: 666 FOLSOM, ROOM 920 BY DELIVERY TO CLERK ON: NOVEMBER Q4 2 2002 SAN FRANCISCO, CA 94107 BY MAIL POSTMARKED: OCTOBER 30, 2002 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETE C r Dated: NOVEMBER 04, 2002 By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervis s {t�s 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: Z Z-- —0 2, 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: DECEMBER 03, 2002 JOHN SWEETEN, CLERK, By , Depu Clerk WARNING(Gov. code sectio 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: DECEMBER 04, 2002 JOHN SWEETEN, CLERIC By Deputy Clerk Stacy Riggs SBC Pacific Bell Manager Telephone Company r ����������� Risk Management Services 3235 N.Texas Street >��.�/�-�' 1 Room 200 '' 1C.tXt Fairfield,CA 94533 707.428.2426 Phone 707.428.2427 Fax October 28, 2002 PIEUIVED Case : FACE-CN-200207-OG-0001 NOV 0 1 ?G02 CORK B041gD GOE SC PERVISO S -OW1`HA GCs CLERK BOARD OF SUPERVISORS CONTRA COSTA COUNTY 651 PINE STREET RM 106 MARTINEZ, CA 94553 Ladies/Gentlemen: We are sending you the attached claim notice pursuant to Section 910 o f the Government Code. Sincerely, STACY RIGGS MANAGER RISK MANAGEMENT SERVICE Attachment Page 1 1C.txt CLAIM AGAINST CONTRA COSTA COUNTY Pacific Bell presents a claim for damages against the COUNTY OF CONTRA COSTA as provided in Government Code Section 900 et, seq. CLAIMANT' S ADDRESS: Pacific Bell 666 Folsom, Room 920 San Francisco, CA 94107 DATE OF OCCURRENCE: 6-27-2002 LOCATION: GATEWAY RD 7/10 MILE EAST OF BETHEL ISLAND RD BETHEL ISLAND, CA CIRCUMSTANCES GIVING RISE TO THE CLAIM: EMPLOYEE OF CONTRA COSTA COUNTY DUG UP OUR FACILITIES WITH A B ACKHOE. NO USA FOR THIS LOCATION DESCRIPTION & ITEMIZATION OF DAMAGE: A 200 PAIR PACIFIC BELL CABLE NAME (S) OF PERSON(S) CAUSING DAMAGE: THE COUNTY EMPLOYEE THAT WAS OPERATING THE BACKHOE WAS NOT IDE NTIFIED TO US. Page 2 4!.J C• le- 1C.txt 1C.txt AMOUNT OF CLAIM: $ 5, 47 . 10 DATE OF CLAIM: OCTOBER 27, 2002 PACIFIC BELL CLAIM NUMBER: PACB-CN-200207-OG-0001 ------------------------------------- STACY RIGGS MANAGER RISK MANAGEMENT SERVICES Page 3 Stacy Riggs SBC Pacific Bell l Manager Telephone Company '.�.! Pacific Bell Risk Management Services 3235 N.Texas Street Room 200 Fairfield,CA 94533 Bill For Damm 707.428.2426 Phone 707.428.2427 Fax To: CONTRA COSTA COUNTY OF Date: 9/17/2002 1911 SAN MIGUEL DR., SUITE 200 Page 1 of I WALNUT CREEK,CA 94596 Claim#: PACB-CN-200207-OG-0001 Charge For Damage To: PACIFIC BELL FACILITIES On Or About: 6/27/2002 At: GATEWAY RD 7/10 MILE EAST OF BETHEL ISLAND RD BETHEL ISLAND, CA By: CONTRA COSTA COUNTY While: DIGGING WITH BACKHOE Our Records Indicate: LABOR REPAIRING BURIED CABLE 32.00 REG HRS $3,662.40 LABOR REPAIRING BURIED CABLE 3.00 OVT HRS $343.34 MATERIAL CABLE ANMW 400 PAIR 24 GAUGE 50 QTY $196.56 MATERIAL 3M BURIED CLOSURE 2 QTY $60.82 MATERIAL SPLICING MODULES 64 QTY $71.68 MATERIAL REENTERABLE COMPOUND GAL 2 QTY $52.98 CONTRACTOR IRISH CONSTRUCTION $617.32 LOSS OF USE POTS LOCAL EXCHANGE $242.00 Amount Due: $5,247.10 This bill is clue upon receipt. If payment is not received within 15 days further collection action will be taken. REMIT PAYMENT TO:Pacific Bell Attn:Risk Mgmt. Svcs. ONE BELL CENTER,ROOM 39-N-13 ST.LOUIS,MO 63101 Inquiries call TOLL FREE 1-800-728-4202 Hours:Mon.-Fri. 7:00 am-4:30 pm or DIRECT 1-415-542-0269 FAX 415-542-0111 PACIFIC BELL Pa-ae t of 1 ,,,.._ BREAKDOWN OF CHARGES FOR DAMAGES RUN DATE: 10128/2002 CLAIM NUMBER: PACB-CN-200207-OG-0001 AV T111': DATE OF REG REG OVT OVT DBL DBL EMPLOYEE REPAIR HRS RATE MRS RATE HRS RATE AMOUNT JB 6/27/2002 5.00 114.45 0.50 114.45 $629.47 ED 6/27/2002 3.00 114.45 2.50 114.45 $629.47 AA 6/28/2002 8.00 114.45 $915.60 JB 6/28/2002 8.00 114.45 $915.60 ED 6/28/2002 8.00 114.45 $915.60 LABOR SUB-TOTAL $4.005.74 MATERIAL DESCRIPTION QUANTITY UNIT COST AMOUNT CABLE ANMW 400 PAIR 24 GAUGE 50 $3.93 $196.56 3M BURIED CLOSURE 2 $30.41 $60.82 SPLICING MODULES 64 $1.12 $71.68 REE"NTERABLE COMPOUND GAL 2 $26.49 $52.98 MATERIAL SUB-TOTAL $382.04 CONTRACTOR CONTRACTOR NAME AMOUNT IRISH CONSTRUCTION $617.32 CONTRACTOR.SUB-TOTAL $617.32 LOSS OF USE DESCRIPTION QUANTITY UNIT COST AMOUNT POTS LOCAL EXCHANGE 200 $1.21 $242.00 LOSS OF USE SUB-TOTAL $242.00 OTHER ITEMS DESCRIPTION AMOUNT TOTAL TIME,MATERIAL.CONTRACTOR.LOSS OF USE.OTHER ITEMS $5,247.10 BOARD OF SUPERVISORS OF CONTRA COSTACOUNTY BOARD ACTION: DECD 3, 2002 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 � AMOUNT: $100,000. Exceeds a $1{),000. gmVT ase note all "Warnings". NOV 0 5 2002 CLAIMANT: KEITH DECOSTA COUNTY COUNSEL MARTINEZ CAL i!=. ATTORNEY: STEPHEN CHANG, ESQ DATE RECEIVED: NOVEMBER 4, 2002 ADDRESS: 535 MAIN STREET, BY DELIVERY TO CLERK ON: NOVEMBER 4, 2002 MARTINEZ, CA 94553 BY MAIL POSTMARKED: HAND DELIVERED FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. NOVEMBER 5 JOHN SWEETEN I Dated: _ , 2002 By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (q, 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). (-r0ther: % ► .- L t✓n i r _ ,^, . d'a'l t ° c 'r i { = 7 c/1�. . 7 Dated: 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: (+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. Dated: DECEMBER 03, 2002 JOHN SWEETEN, CLERK, By, , Deputy Clerk WARNING(Gov. code section 9 3) 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: DECEMBER 04, 2002 JOHN SWEETEN, CLERK By Deputy Clerk Claim to: BOARD`% -` SUPERVISORS OF CONTRA C( -;A Ct?ITN'TY INSTR U NS TC! CLQ 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'x'day after the accrual of the cause'ofaction. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.). B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building„ 651 Pine Street,Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors,rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. FLau See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp } KEITH DECOS'TA � } RECEg8UPERV130PM4 Against the County of Contra Costa or ) } NOV 0 District) CLERK BOARD OF(Fill in name) } CON7RA C The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of S 100K and in support of this claim represents as follows: 1. When did the damage or injury occur?(Give exact date and hour) March 29, 2002; and .duly 2002 (Discovery of injury for medical malpractice claim against County Hospital) 2. Where did the damage or injury occur?(Include city and county) Contra Costa Regional Medical Center City of Martinez, Contra Costa County 3. How did the damage or injury occur?(Give full details;use extra paper if required) Medical Malpractice/Professional Negligence during surgical procedure performed at County hospital by County Physician. Physician forgot to place wire in patient's finger as advised and intended resulting in deformed finger with no motion. excee=g tear rnousana nouars(s Iu uw),or by both such imtnisor ment and fine. APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION DECEMBER 037 2002 Application to File Late Claim ) NOTICE TO APPLICANT Against the County, Routing The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to ) the Board of Supervisors(Paragraph III,below), California Government Code.) A given pursuant to Government Code Sections 911.8 and 915.4. Please note the"WARNING"below. i Claimant: SYN FINKLE Attorney: LEEDS DISSTON Address: CASALINA & DISSTON 418 THIRD STMT, Amount: OAKLAND, CA 94807 By delivery to Clerk on: NOVEMBER 01, 2002 $5,000. Date Received: By mail,postmarked on:: HAND DELIVERED BY LEEDS DISSTON 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: NOVEMBER 0 TOS SWEETEN,CIerk,By: DEPUTY II. FROM: County Counsel TO: Clerk of the!Board oftupervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6). (y The Board should deny this Application to File Late Claim (Section 911.6). DATED: - SILVANO B.MARCHESI,County Counsel,By:t22ZEi EPUTY III. BOARD ORDER By unanimous vote of Supervisors present (Check one only) { ) This Application is granted(Section 911.5). (V This Application to File Late Claim is denied (Section 911.5). I certify that this a true and correct copy of the Board's Order entered in its minutes for this date. DATE: DECEMBER 03, 2002 OHN SWEETEN,Clerk,By: DEPUTY WARNING (Gov. Code §911.8) If you wish to file a court action on this matter,you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4(claims presentation requirement).See Government Code Section 945:5.Such petition must be filed with the court within six(5)months from the date your application for leave to present a late claim was denied. 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. IV. FROM: Clerk of the Board TO: (1)County Counsel (2)County Administrator Attached are copies of the above Application. We notified the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: DECEMBER 04, 2002 JOHN SWEETEN,Clerk,By: DEPUTY V. FROM: (1) County Counsel (2) County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel,By: County Administrator,By: APPLICATIQN TO FILE LATE CLAIM CLAIM rail BOARD OF SUPER S NT COSTA 'TY BOARD ACTION: =_. December 2 2002 zoo? Claim Against the County, or District Governed by } '!�' ,4 the Board of Supervisors,Routing Endorsements, } r �..., NOTICE TO CLAIMANT Board Action. All Section references are to � � � � }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: $5,000 CLAIMANT: Evelyn Finkle ATTORNEY: Deeds Disston DATE RECEIVED: November 1,2002 ADDRESS: Casalina & Msston BY DELIVERY TO CLERK ON: November 1 2002 418 Third Street Oakland CA 94807 BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy.of the above-noted claim. JOHN SWE N,Cl ovember 1, 2002 By: Deputy Dated: H. FROM: County Counsel TO: Clerk of the Board of Suo&isors ( } This claim complies substantially with Sections 910 and 914.2. { } 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). ( laim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). { ) Other: Dated: /:- ()2,— 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: JOHN SWEETEN,CLERK.,By ,Deputy Clerk WARNING(Gov.code section 913) Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6.You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so immediately. *For Additional Warnin See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned,have been a citizen of the United States,over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully prepaid a certified copy of this Board Order and Notice to Claimant,addressed to the claimant as shown above. Dated: JOHN SWEETEN,CLERK By Deputy Clerk Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS To CLAnvsArrr A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 10&day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street,Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors,rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. LrAuj. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp oe- z. ) EIS ' .� _ tl. pt Against the County of Contra Costa or District) C S71 ,C.�1RJ (Fill in name) `��-- �J The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of S and in support of this claim represents as follows: 1. When did the damage or injury occur?(Give exact date and hour) 2. Where did the damage or injury occur?(Include city and county) 3. How did the damage or injury occur?(Give full details;use extra paper if required) 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? 5. What are the names of county or district officers, servants, or employees causing the damage or injury? 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) 7. How was the amount claimed above computed?(Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors, and hospitals. 9. List the expenditures you made on account of this accident or injury. DATEAMOUNT ****************************************************************************************** } Gov. Code Sec. 910.2 provides"The claim must be signed by the claimant or by some person on his behalf:" UM NQ33CES TO: (A=M9Y Dame and Address of Attorney ) } } } (Claimant's Signature) } } } {Address} } ) } Telephone No. Telephone No. N0710E Section 72 of the Penal Code provides: Every person who,with intent to defraud,presents for allowance or the payment to any state board or officer,or to any county,city,or district board or officer,authorized to allow or pay the same if genuine,any false or fraudulent claim,bill,account, voucher,or writing,is punishable either by imprisonment in the county jail for a period of not more than one year,by a fine of not exceeding one thousand(S 1,040),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exceeding ten thousand dollars($10,000),or by both such imprisonment and fine. APPLICATION TO FILE LATE CLAIM {Govt. Code §911.4} EVELYN FINKLE, through her counsel, Leeds Disston, CASALINA & DISSTON, hereby petitions the County of contra Costa for leave to file a late claim pursuant to sections 911.2 and 911.4 of the California Government Code. The claim is attached hereto. The claim and this application are presented within one year after the accrual of claimant' s cause of action. The claim was not presented within the time specified in the Government code because claimant was unaware until October 29, 2002 that title to property where the injury occurred was held by the County of Contra Costa and because a police report prepared by the Kensington Police department concluded that the condition of the sidewalk did not constitute a hazard. Applicant requests that the County of contra Costa permit the late filing of her claim. Dated: October 30, 2002 's t Attorney for Claimant Evelyn Finkle g11L AC;A1N`ST =f COUNTY OF .16. TRA COSTA l' CXA.LMANT`S NAME" EVE'LYN FINKLE CLAI'MANT'S ADDRESS-. c/o CASALINA & DISSTON 418 Third Street, Oakland, CA 94607 No Street 7aty State____ zzp SEND NOTICES T0_ Leede Disston Eaq. CASAL,I'NA & DISSTON 4.18 Third ,Street, Inc a At cJx.risy or No. Street Cluy- State p Insurance Agent Representing Oakland, CA 94607 TELEpHONZ NUMBERS.- (5-10) 838-8110 DATE OF BIRTH- 41-16123 DATE OF ACCIDENT CR INCIDENT: -1-1�1�0,1 TIME 8 r.3 U am I?AY Or WM DATE INJURIES, DA MCES OR LOSSES WME DISCOVERED: 71/1/01 LOCATION WHERE INCIDENT OCCURRED 268 Arlington Avenue, Kensington, California Please see Kensington Police re ort sp4ciflc, awagtam on back mid give nearest streeE a&Egsil HOW DID THE ACCID=a OR INCIDENT OCCUR: Tripped and fell on uneven sidewalk paving on Ardmore toad, zRal c, dttawh adzlEi or if necessiay DESCRIBE INJURY OR DAMAGE: Fell on face, hands and knees. Bruises and broken teeth, fi ;FOCIPIC as C6w OCLUS Me snjury or a ya NA14Z OF PUBLIC EMPLOYEE(S) OR DEPARTMENT BL4ZMD, TO BE INVOLVED IN THIS ACCIDENT OR INCIDENT Unknown TATE REPORTED To POLICE DEPARTMENT 11L1310.1 RxpoRT NO. 2001-1385 Kensington PD REPORTED TO OTHER CITY DEPARTMENT (NAME, Kensington pL DATE 11113101 AMOUNT Or CLAIM UNDER $10,000 OR NAME THE APPROPRIATE COURT JURISDICTION (sem Govt. Cede 910(f) ) Damq es within the unlimited jurisdiction of the Superior Court. HOW WAS THIS AMOUNT CALCULATED (please iteMize) $5,000 plus in medical and dentaZ bills and , eneraZ dame es. x atz ac ors care, p oagA I i vO giZ s m t mZ1Z5d1 BTT1_5L0 cute with statue of your conditiob. ) TE: o d 1 to t fo t sof 3 is t!M1 r i r nvcs YrtC+r s e r - and if_re�zbL - =gemont of caw i a ��at tJw� race t. if the accident involvad a vehicle, please trivre the following information, LICENSE NUMBER: NSA MAX9 AND or The information contained in thin fake x. t,°ua, cta +te =plate to the tr-_Zt of my knowledge. Dated .10130/02 orx ca Gfalwant Leeds on (PLEASE RETAIN COPIES FOR YOUR RECORDS) Rev. 3196 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: DECEMBER 3 2002 Claim Against the County, or District Governed by ) the Board of Supervisors,Routing Endorsements, } NOTICE TO CLAIMANT and Board Action. All Section ref TIR ,_, The copy of this document mailed to you is your California Government Codes. II notice of the action taken on your claim by the Board of u ie S p rvisors. (Paragraph IV below), given NOV 0 6 2002 C Pursuant to Government Code Section 913 and COUNTY COUNSEL 915.4. Please note all "Warnings". AMOUNT: $50,690.13 Exceedss OiyCALIF CALIFORNIA STATE AUTOMOBILE ASSOCIATION FOR: CLAIMANT: WILMA MARTIN ATTORNEY: LAW OFFICES OF LESLIE A. LEVY DATE RECEIVED: NOVEMBER 6. 2002 3260 BLUME DRIVE, STE. 410 ADDRESS: RICHMOND, CA. 94808 BY DELIVERY TO CLERK ON: NOVEMBER 6, 2002 BY MAIL POSTMARKED: HAND DELIVERED BY TEDT 5= FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETEN, er Dated: NOVEMBER 6, ,2002 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisors' (vyThis claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). ( } Other: Dated: By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. OARD ORDER: 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. DECEMBER 03 2002 Dated: JOHN SWEETEN, CLERK, By - Depu 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: DECEMBER 04, 2002 JOHN SWEETEN, CLERK By Deputy Clerk CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA BOARD ACTION: DECEMBER 3; 2002 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: $50,690.13 Exceeds $10,000. CALIFORNIA STATE AUTOMOBILE ASSOCIATION FOR: CLAIMANT: WII MA MARTIN ATTORNEY: LAW'OFFICES OF LESLIE A. LES' DATE RECEIVED: NOVEMB.i 60 2002 3260 BLUME DRIVE, STE. 410 ADDRESS: RIND, CA.. 94808 BY DELIVERY TO CLERK ON: NOVEMBER 6, 2002 BY MAIL POSTMARKED: HAND DELIVERED BY FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETEN',ft Dated: NOVEMBER 6. , 2002 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisors ( } This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). ( ) Other: Dated: By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD GIRDER: By unanimous vote of the Supervisors present: ( ) This Claim is rejected in full. ( } Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JOHN SWEETEN, CLERIC, By D uty 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 Shard Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JOHN SWEETEN, CLERK.By Deputy Clerk AUG-15-2002 15:18 CCC RISK MANAGMENT 925 3; 5 1421 P.01r02 Claim to: BOARD OF SUPERVISORS OF C WHA COSTA COUNTY INSTRUCTIONS TO CLADQNT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for-death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 681. Pine Street, Martinez, C.A. 94558. 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. * s AAAAK est AAe # * AAA RB: Claim By Reserved for Clerk's filing stamp L..Y RRE Aga nit the County of MEER staor ) V O� 6 200 Ca 42 UJ4St-eu District) CLERK BOARD OF SUPENVlou F in name CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-ru need District in the sum of $ Vic . ice-..^ and in support of this claim represents as follows: ; tit?�.f Ct�:e.t �"u�.rl 1. When did the e_or injury occur? (Clive exact date and hour) R. Where did the damage or injury occur? (Include city and county) ,. Tm oo'et iz d — `-I ..`6 b(^4XP1+e-; q 4150 3 3. How did the damage or injury occur? (Give fu1.1 details; use extra paper if required) s '3uddw "7 owed pmyvi mac"s ca_u-'�tr)6 4. What particular act or omission on the part of county or district officers, servants Or-employees caused. the.injury or. e? tr( nf'iw1S ►1Gi'"_5Suve or o.C � C � AUG-15-2002 15:19 CCC RISK MANAGMENT 925 335 1421 P.02i02 what are the names of county or district officers, servants or employees causing the damage or injury? c t o m N o. B 11" 15 (- ►� � C r,� � . 'O m t U-)e s t Cau _ s e—,n 1 S 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 9. Names and addresses of witnesses, doctors and hospitals. ( ctr an p4::� resf de4l(�C_ 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT .* a �t *.e a • f * GoV. Code Sec. '910:2 providea: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or im some oerson on his.behalf." Name and Address of Attorney !)� —C:5A C -l);u) O t Gey O C aimant s Signature LesIe- AdLev 4 POex9O '3,-A(PCS f3 lt,,m e D1^. k '4l p Ad ess rylo (I& ; CO- `7 q-&o4 �t c�-5 x'71 c ` Y15 'Telephone No. 6i 0 "off►�A;t & l?t7 Telephone No. 770 �-cR 61— 0/ &0 � * * ee �te 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 imprisoriment in the county Jail-f'or a period of not more than one-year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and finei-or by imprisonment in the state prison, by a fine of not exceeding ten thousand.dollars ($10,000, or by both such imprisonment and fine. TnTAI P_MI CLAIM BOARD OF SUPERVISORS OFONTRA OTA COUNTY Cgs BOAPJD ACTION: DECEMBER 3, 2002 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 T907M Pursuant to Government Code Section 913 and SOV 4 6 2002 915.4. Please note all"Warnings". AMOUNT: $8,047.29 COUNTY COUNSEL MARTINEZ CALIF CLAIMANT: RAND C. SCHAEF'ER ATTORNEY: DATE RECEIVED: _NOVEMBER 5, 2042 SUSAN ALLMER CALIFORNIA STATE AUTOMOBILE ASS. ADDRESS: r G. BOX. 920 BY DELIVERY TO CLERK()N: NOVEMBER 5, 2002 vUZSUN CITY, CA 94585-0924 BY MAIL POSTMARKED: NOVEMBER 4, 2002 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SVVEE N rk Dated: NOVEMBER 5, 2002 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisors (V This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed.. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). ( ) Other: Dated: 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: DECEMBER 03, 2002 JOHN SWEETEN,CLERK., By ,De uty 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: DECEMBER 04, 2002 JOAN SWEETEN,CLERK By Deputy Clerk CatTernia State Automobile Associatien Inter-Insurance Bureau EC P.D.Box 920 Suisun City,CA 94585.0910 November 4, 2002 GLE F1K 80AF0 0 t1PC1 S Ot}�}'CRA C07A C!J. BOARD OF SUPERVISORS.RM 106 COUNTYADMINISTRATION BUILDING 651 PINE S'T'REET MARTINEZ,CA 94553 Re: Insured: Raymond C Or Thelma E Schaefer Claim No.: 03-X57589-6 Date of Loss: 07/23/2002 Driver: Lynn Lopez Vehicle License: E048089 Attached are the itemized bills to substantiatee our subrogation claim. As we have paid this claim,we have a right to recover from you. If you are not insured,please make your check or money order payable to the California State Automobile Association Inter-Insurance Bureau. Repair Bill $6,897.52 Deductible $0,00 Loss-of Use $750.00 Tow/Storage $0.00 Miscellaneous $399.77 -------------------------- TOTAL $8,047.29 Please be advised that any payment in an amount less than that set forth in this letter that is forwarded to.CSAA without its prior authorization as described below will not constitute a full and final settlement and will be accepted as partial payment only. Since payments received in the mail are processed by clerical staff and deposited as a matter of course without examination,unauthorized payments for less than the full amount demanded may be processed inadvertently. Although such payments may be demarked as"payment in full"or have other words of similar meaning written on them, their processing will not constitute an accord and satisfaction,as CSAA has not agreed to acceptance of such payments. Only an authorized Subrogation Specialist may communicate,orally or in writing,CSAA's specific agreement to accept an amount less than that demanded in this letter. If you have insurance,please contact us immediately with your insurance information. A return envelope is enclosed for your convenience. Sincerely, SUBROGATION SPECIALIST 888-222-1839.extension 5039 F2,66K (Apr 2002) OCT-28-2002 17:08 CSAA LV2 702 E343 09/li/02 14 :31 H.A.C.C.C. -4 170786390 rp Maim to: BOARD OF 51.E VMRS OF CONTRA Ct7 TA COIL }} WTRVM0NSjQCLAMMT 1 ' A. claims relating to oaumn of�'tir ort for dcath or for Wwy to perwa or to persoxW CN pmperty or Vowing amps and which eeerue on or befte December 3 t s 1987,must be pruentad not later than the l 00th day after the ecntual of the cause of acdtn. Claimv r4d4 to causes of aotion for death or for hdi"to pew or to p meal property or growing soups and which accrue on or Ow January 1, 1989,mud be prestrud not later than sit months after thin aOMW of the cause of WHOM Claims relating to racy other cause of action must be pmaentod tsot later than ori year afar the m a meal of ft==of action. (Goat.Code 1911.2.) w � > B. Claims ukut be Med whb iiia Cl rk of the BOA VA d Suphrdw x at it*offim in LLI Room 146,County Adminisfttion Buildinro 651 Flue Strep t,Mrtrtul CA 94653,either by=aii or in person. C. if clam is against a dirt gam=ed by the Board of superviNN tath+er than rhe Casty,the natne of the District shoWd be filled in„ D. If the claim is amt more o>aui one public avdty;separate clahm must be filed E, go". See penalty for$went shah^Penal Code Sea.72 at ffie and of this form. ,�,r�.Yi,h,�+rr�i#rift,rrit#�f�tr����r�**�trr#r�tr*phi►f�,rr��i�warvrr1���rf��.�.,k�Y,ki.r�a��*� RB: Claim.BY ) R=wve+d far Claws filing steMP ltaymoad schaef� Agattest the Gauttty-orcoam MRA or The iiausin Authorl of Contra Costa {Diarist) (Fir in n The WAMigned clslm=Ebymal s C . Cotttlty of Coma Cotta or the abar�o-named I3isbrict in the sttm 4 f - and is support of this alalm ruts as fellows: t 1: aaW—or how accm? 0 ve exalt dlir) T) Ad the damage or tWuW oMV i3'RMW4 COW 3, did the d=Ma or Olury `ve faIl da=s reqm ) 4 f 4. Wbg tr"tieular act or ommon on pact of county or dIsMetoffacts, or voployees cataaad the injury or dwaaga7 OCT•-28-2002 17:08 CSAR LV2 70. 09/11/02 10131 H.A.C.C.C. 4 1707863 w Davii+4��or C�ur CM OffiG�l, is employees W w drayage or€nJWY? t O"ras YOU forcilent of WIvies of det>gges Claimed. �Atta bbd two admato for auto .) -- 4ja QM ��L- t 7, was azanunt+� agn to 7 *a Ismnu>at ofany prose Me"irouuy or damage.) times -WIMeaafs, o'N s, st the iWpenMurCs you made on aocomx!of 5S acoid=of t y�j�yJ,��TE do Gov.code sm 910.2 pwvit : "The oWm mug b sipod by 66 dahnsat �NOTICE TO: A ox m� an bis behalf-'s and Addrew of Y ,. Want s r , B(z)cC Tol phatu'No. � r NOTICE Shun 72 of$ba peva!Cade providar; "Evafy PMOR who,with ktwt tO defim4 a>Aca fbr allowor foZ payment to my state board at off ow,or to a>cty W=ty#city or district board of of%cwry sot %iwd the if �,+fY or fimbAc t cisim.bill,a rnt, VoudboCr, to allow or pay ft tilt for r< of Merr w�ti�is aithar by im in tba� nwe thm=e ym,by a 5ne of not cumdiug me dousaud($1,000),or by bath such jMp&0umWt and five,or by impdWWMt in tha state priso%by a fm of DA M"diag tua*QUM d dolbus($10,000)or by both 9=h iMPd==*At end fir". 4 arm I t 1 1TAI P.PIP ..r w.- n w w w• � y..w .is�.w . • • 4 w n n.� + �� n n w w w w ... ow Date: 9/18/2002 5:37:13 pm Estimate ID: A03X57589601 Estimate Version: 0 Committed CV FINAL CQ3 Profile ID: CSAR CV VOR NEAGEN BODY AND PAINT Damage Assessed By KEVIN VORNHAGEN Appraised For: Cinde Casey Condition Code: Fair Type of Loss: Collision Date of Loss: 7/23/2002 Arrival Date: 7/24/2002 mAccident Date: Payer: Q claim Paid: SLI Policy No: Claim Number: A03X57589601 �7 Deductible: WAIVED LLL File Number: None ( Owner. SCBAEFER,RAYMOND �[ Insured: SCHAEFER,RAYMOND Claimant: Address: Telephone: Work Phone:Home Phone: Mitchell Service: 913528 Description 1998 Plymouth Voyager Vehicle Production Date: 8/97 Body Style: Van 113" W8 Drive Train: 3.3L Inj 6 Cyl 2WD License: 3XDX742 CA Mileage: 36,579 OEM/ALT: A Search Code: 088118 Color: LT BLUE MET Options: Air Conditioning,Power Steering,Power Brakas,Power Windows,Power Door Locks, Tilt Steering Wheel,Cruise Control,AM-FM Stareo,Automatic Transmission Line Entry Labor Line Item Part Type/ Dollar Labor CEG, Item Number Type Op Description Part Number Amount units Unit 1 300084 BDY REMOVE/REPLACE R FRT REPLACE DOOR ASSY Qual Recycled Part 825.00 * 1.5 1.5T 2 AUTO RES REFINISH R FRT DOOR C 1.8 i.8 3 AUTO REF REFINISH R FRT ADD FOR JAMBS & INTERIOR C 1.0 1.0 4 300086 BDY REMOVS/REPLACE R FRT DOOR HINGE Qual Recycled Part 0.00 * 0.3 0.3T ESTIMATE RECALL NUMBER: 9/18/2002 17:37:05 A03X57589601 UltraMata is a Trademark of Mitchell International Mitchell Data Version: SEP_02 A Copyright (C) 1994 - 2002 Mitchell international Page 1 of 6 UltraMate Version: 4.8.011 All Rights Reserved Date: 9/18/2002 5:37:13 pm Estimate ID: A03X57589601 Estimate Version: 0 Committed FINAL Profile ID: CSAA 5 300088 BOY REMOVE/REPLACE R FRT-,DOOR LATCH Qual Recycled Part 0.00 * 0.3 0.3T 6 300090 BDY REMOVE/REPLACE R FRT DOOR GLASS Qual Recycled Part 0.00 * 0.6 0.6T 7 300092 BDY MOVE/REPLACE R FRT DOOR REGULATOR Qual Recycled Part 0.00 * 0.3 00.3T 8 *** END OF ATG SECTION *** 9 300439 REF BLEND R FENDER OUTSIDE C 0.8 2.0 10 302458 BDY REMOVE/INSTALL R FENDER MUDGUARD Existing 0.2* 0.2 11 301054 BOY REMOVE/REPLACE R HINGE PILLAR 7.3 07.3 12 AUTO REF REFINISH R HINGE PILLAR C 1.0 1.0 13 301058 BDY REMOVE/REPLACE R DOOR OPENING FRAME ^S 5012414AA 772.33 * INC #12.8T 14 303157 BOY REPAIR FLOOR PANEL Existing 8.0*31.0 15 AUTO REF REFINISH FLOOR PAN ASSY 4.0 4.0 16 303469 BOY REMOVE/REPLACE R ROCKER INNER PANEL -S 5003600AA 69.10 6.5 6.5T 17 302194 BDY REMOVEIREPLACE R FLOOR BRACKET 4716688 11.70 T 16 302196 BOY REMOVE/RSPLACE R FLOOR BRACKET -S 4716322 43.00 0.5 0.5T 19 301087 BOY REMOVE/REPLACE R ROCKER SCUFF PLATE ORDER FROM DEALER 34.85 INC 0.2T 20 301120 BOY REPAIR R SEAT PASSENGER SIDE TRACK Existing 0.5*f0.6 21 301132 BDY REPAIR R SEAT FRONT SEAT RISER Existing 1.040.5 22 320585 BDY REMOVE/REPLACE R FRT DOOR ADHESIVE MOULDING RM26SS8 49.75 0.2 0.2T 23 320607 BDY REMOVE/REPLACE R FRT DOOR TRIM PANEL ASSY Qual Recycled Part INC * 0.0* 0.5T 24 301290 BOY REMOVE/REPLACE R FRT DOOR LATCH STRIKER 4675624 8.25 0.2 0.2T 25 301318 BDY REMOVE/REPLACE R FRT DOOR WEATHERSTRIP 4717328 44.20 0.7 0.7T 26 301322 BDY REMOVE/REPLACE R FRT DOOR OPENING WEATHERSTRIP 4675674 72.35 * 0.3 0.3T 27 301323 BDY REMOVE/REPLACE L FRT DOOR OPENING VEATHERSTRIP 5003600AA 94.00 * 0.5* 0.3T 28 WEATHERSTRIP ON BODY O SLIDER 29 301350 BOY REMOVE/REPLACE R SIDE CARGO DOOR SHELL Qual Recycled Part 690.00 * 4.0* 5.6T 31 AUTO REF REFINISH R ADD FOR OAMBS & INSIDE C 1.0 1.0 32 320668 BOY MOVE/REPLACE R SIDE CARGO DOOR ADHESIVE MLDG SP52SS8 51.60 0.2 0.2T 33 301376 BOY REMOVE/REPLACE R SIDE CARGO DOOR TRIM PANEL Qual Recycled Part INC * 0.5 0.5T 34 301396 BOY REMOVS/REPLACE R SIDE CARGO DOOR STRIKER 4675872 15.35 0.2 0.2T 35 301424 BOY REMOVE/RSPLACE R FRT SIDE CARGO DOOR STRIKER 4675872 15.35 0.2 0.2T 36 301430 BDY REMOVE/REPLACE R SIDE CARGO DOOR STABILIZER 4675516 3.35 0.2 0.2T 37 301444 BDY REMOVE/REPLACE R SIDE CARGO DOOR OPENING WSTAIP 4675674 72.35 0.7 0.7T 38 303619 BOY REPAIR R QUARTER BODY SIDE PANEL Existing 1.5413.0 39 AUTO REF REFINISH R VAN SIDE PANEL OUTSIDE C 2.0 2.4 40 301488 BDY REMOVS/REPLACE R ROCKER OUTER PANEL -S 4674998 29.50 7.0 07.OT 41 AUTO REF REFINISH R ROCKER PANEL C 1.0 1.4 42 301516 BDY REMOVE/REPLACE R CTR PILLAR INNER PANEL -S 4716372 104.00 1.5 1.5T 43 301524 BOY REMOVE/REPLACE R LNR QUARTER TRACK 4716414 18.50 T 44 301526 BOY REMOVE/REPLACS R QUARTER SUPPORT 4716428 28.70 T 45 301528 BOY REMOVE/REPLACE R LWR QUARTER REINFORCEMENT 4883980AA 64.75 T ESTIMATE RECALL NUMBER: 9/18/2002 17:37:05 A03X57589601 UltraMate is a Trademark of Mitchell International Mitchell Data Version: SEP 02 A Copyright (C) 1994 - 2002 Mitchell international Page 2 of 6 UltraMate Version: 4.8.011 All Rights Reserved Date: 9/18/2002 5:37:13 pm Estimate ID: A03X57589601 Estimate version: 0 committed FINAL Profile ID: CSAA 46 936001 ADD'L COST TOWING; 84.00 * T 47 AU'T'O REF ADD'L OPR CLEAR COAT 2.8 48 933018 REF ADD'L OPR MASK FOR OVERSPRAY 5.00 * 0.1* 49 AUTO ADD'L COST PAINT/MATERIALS 404.80 * T 50 AUTO ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00 * * - ,judgement Item M - Labor Note Applies C - Included in Clear Coat Calc Recycler Information Section: Prior Damage LT FENDER DAMAGED Remarks Add'1 Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Bdy-S 0.0 52.00 0.00 0.00 0.00 Parts Adjustments 249.44- Refinish 17.7 52.00 5.00 0.00 925.40 Glass 0.0 52.00 0.00 0.00 0.00 Glass Adjustments @ 0.000 0.00 Mechanical 0.0 52,00 0.00 0.00 0.00 Sales Tex @ 8.250 236.65 Frame 0.0 52.00 0.00 0.00 0.00 @ 8.250 Taxable Labor Non-Taxable Parts Parte Adjustments 0.00 Labor Tax @ 0.000 0.00 Non--Taxable Labor Non-Taxable Labor3,260.,20 Glass Adjustments @ 0.000 0.00 Labor Summary 52.6 3,260.20 Total Replacement Parts Amount 3,105.19 III. Additional Costs IV. Adjustments Amount Taxable Costs 488.80 Insurance Deductible WAIVED Betterment 0.00 ESTIMATE RECALL NUMBER: 9/10/2002 17:37:05 A03X57589601 UltraMate is a Trademark of Mitchell. International Mitchell Data Version: SEP 02 A Copyright (C) 1994 - 2002 Mitchell International Page 3 of 6 U1traMate Version: 4.8.011 All Rights Reserved Date: 9/18/2002 5:37:13 pm Estimate ID: A03X57589601 Estimate Version: 0 Committed FINAL Profile ID: CSAR Sales Tax @ 8.250 40.33 Appearance Allowance 0.00 Related Prior Damage 0.00 Customer Responsibility 0.00 Non-Taxable Costs 3.00 Total Additional Costs 532.13 1. Total Labor: 3,260.20 Ii. Total Replacement Parts: 3,105.19 III. Total Additional Costs: 532.13 Gross Total: 6,897.52 IV. Total Adjustments: 0.00 Net Total: 6,897.52 Related Prior Damage Labor Subtotals Units Rate Totals RL-Body 0.0 52.00 0.00 RL-Refinish 0.0 52.00 0.00 RL Taxable Labor 0.00 GST - E Tax @ 0.000 0.00 Labor Tax @ 0.000 0.00 Labor Tax 0.00 Related Prior Damage Labor Summary 0.0 0.00 Part Replacement Summary Amount RL-Taxable Parts 0.00 GST - E Tax @ 0.000 0.00 Sales Tax @ 8.250 0.00 Sales Tax @ 6.250 0.00 RL-Non-Taxable Parts 0.00 Related Prior Damage Parts Summary 0.00 ESTIMATE RECALL NUMBER: 9/le/2002 17:37:05 A03X57589601 UltraMate is a Trademark of Mitchell International Mitchell Data version: SEP_02 A Copyright (C) 1994 - 2002 Mitchell International Page 4 of 6 UltraMate Version: 4.8.011 All Rights Reserved C.4 �,,, y �, � .. F[ yam+' .. �, �.-, ,, ...; ,. � ,,;�. ;., .� :.. � � .... c__� F�:.. 4,... .� "Y m� —: s, V w, ^`k ��:�h 9YiyyF�y" �.. 1. �'S a. �, ,..., ��� w kt, . " ..1. t.v., v :. �r.�i: ,. �.. ._... CN C'q CHECK NO.: 708 L084873•-3—R m DATE: 09-28-2002 > NAME AND ADDRESS INFORMATION: LU 0 W HERTZ LOCAL EDITION PO BOX 268825 OKLAHOMA CITY OK 73126-8825 INSURED: SCHAEFER,RAYMOND,C;OR T HELMA E PAYMENT INFORMATION/DESCRIPTION: DATE OF LUSS: 07-23-02 CLAIM NO.: 03-X57588-5 CLAIMANT: SCHAEFER,RAYMOND,C;OR THE PAYEE: HERTZ LOCAL EDITION AMOUNT: $750,00 IN PAYMENT OF: INV d'#A18433483 ADJUSTER: COLLEEN WILLIAMS ADJUSTER NO: 32348 KIND OF LUSS: XLU 15510702 DETACH AND RETAIN FOR YOUR RECORDS No. 708 L084873-3•F DATE OF LOSS CLAIMiNSUREO'S NAME DATE 07-23-02 03—X57588-6 SCHAEFER,RAYMOND,C'OR THELMA E 09-28-2002 POLICY TYPE KIND OF LOSS SUFFIX CLAIMANT'S NAME PAY AUTO XLU 02F SCHAEFER RAYMOND C•OR THE $750.00 13.0. AOJLJSTER NO. IN PAYMENT OF BANK OF AMIRICA kk LRK 32348 INV #A18433483 Bar* of America Customer Commotion a bank of America, N.A. TIN: 13-1938558 Atiarwe:, Dekatb Courft,Georgia PAY eSEVEN HUNDRED FIFTY 00/1000 HERTZ LOCAL EDITION This check must be properly endorsed reverse side by all paye TO THE ORDER OF ..,► R YR N!1 R ! R T `R..i f!f'Y N 1 r 1 I R R R w R `� 'F! !Y H R A ,f R • .eii REMIT TO: Rental Agreement No: A18433483 HERTZ LOCAL EDITION Invoice Date: 2002-09-09 PO BOX 268825 Document: 609026266265 OKLAHOMA CITY, OK 73126-8825 LOCAL EDITION Account No. : 099075000614 HCC UNITED STATES Reservation ID: CDP NO. : 1075872 TAX Id: 13-1938568 CDP Name: HLE DSAA - INSURAR o NO. 1 Club: SUSAN ALLMER CSAAJSUISUN CITY . *ATTN CLAIMS DEPT P 0 BOX 920 m SUISUN CITY, CA 94585-0920 w UNITED STATES UJ RENTAL DETAIL; RENTAL CHARGES w Renter: RAYMOND SCHAEFER DAYS 46 @ 23.09 1062.14 Car Description: 4WIB109 SUBTOTAL 1062.14 Group: Charged TAX 87.63 Rented C TOTAL CHARGES 1149.77 USC Reserved C Mm .€ke_ ' nC Pian -___.-___.-. S�AMER..EA.II� Rented On: 2002-07-2 15:59 072621-01 SYCAMORE SQUARE Returned On: 2002-09-06 18:31 07262-01 SYCAMORE SQUARE Miles' In/Out/Driven: 5,432- 2,257 = 3,175 Miles Allowed/Charged: TR-X Miles Driven: BILLING INFORMATION Claim No: 03X575895 Polio No: Date of Loss: 2002/07/23 Type of Loss: D Repair Facility: TOTAL LOSS Authorized Rate: 25.00 Authorized Days: Adjuster: SUSAN ALLMER Insured: SCHAEFER, RAYMOND AMOUNT DUE 750.00 USC THANK YOU FOR RENTING FROM HERTZ Billing Inquiries: Phone: 1-888-777-3700 PAX• dnq-7Rn-r%nnR P16206 poll• 7r-.n nn !1Q! �}.y( �y�q; CLAS QARD OF BOAt,R" ION: December 3, 2002 „ rrrrii i ru�-niirrirr��rr+�nr•r+ww Claim Against the County, or District Governed by } the Board of Supervisors,Routing Endorsements, } t{ TICE "O CLAIMANT and Board Action. All Section.references are to } The copy of this cument trailed to you is your California* Coyernment Codes. ) nptice of the¢cti taken on your claim by the Board of Supervi ors, (Paragraph IV below), given $Ila Pursuant to Gov ent Code Section 913 and. 1"`Warnings", . all AMOUNT: Unknown N 0 ll 1 2 0 2 Michelle Wetsch Y F �w ,�. COUNTY COUNSEL CL�I;111fANT. � .�.� �.. .__�. . MARTINEZ CALIF ATTORNEY: William L. Berg SBN 92095 DATE RECEIVED: November 8, 2002 Michaela Edward Coke SBN 42757 ADDRESS: Law Offices of William Berg & Ass- BY bELIVERY TO CLERK ON: November 8, 2002 2440 Santa Clara. Avenue Alameda, CA 94501 Hand delivered by BY MAIL POSTMARKED: CounLycoungel FROM: Clerk,of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE Irk Dated: ' November 12, 2002 By: Deputy II. FROM County Counsel TO: Clerk of the Board of Supe tsors (,-'This c54m complies substantially with Sections 910 and 910.2. ( ) s Claims FAILS to comply substantially with Sections 9.10 and 910.2, and ix ie are so notifying claimant.The 4 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). (t. —Other: I k C- .'j ) t co `' ,r_ ry)et i r �� t. Dated: �'/- -( - B 4 A, D u 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: {ti 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 thisdate. DECEMBER 03 2002 Dated: JOHN SWEETEN, CLERK,B ,DMuty Clerk WARNING(Gov. code section 913) to certain exceptions, you have only six 6 months from the date this notice waspersonally., erved or deposited, Subjectp , Y Y { } in the mail to file a court action on this claim. See Govemment 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 full prepaid'a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: ECEiBER 04, 2002 JOHN SWEETEN, CLERK,BX D uty Clerk ` d WILLIAM L. BEING SBN 92095 I MICHAEL EDWARD COKE SBN 42757 2 LAW OFFICES OF WILLIAM L. BERG cit. ASSOCIATES 2440 Santa Clara Avenue 3 Alameda, CA 94501 Telephone: (510) 523-3200 4 Facsimile: (510) 523-8851. 5 Attorneys for Claimant, Michelle Wetsch 6 7 Michelle Wetsch, NOTICE OF CLAIM 8 Claimant, 9 vs, RECEIVED 10 Antioch Fairgrounds, County of Contra Costa NOV 0 8 2002 11 City of Antioch, Contra.Costa County Fair, CLARK BOARD F NOFERYlSORB l2 CONTRA COSTA CO. Respondents. 13 14 I 15 PLEASE TAKE NOTICE of the following claim: 16 Name of Claimant: Michelle"Wetsch 17 Claimanfs Address: 3415 Barmouth Drive; Antioch, CA 94509 18 Send All Notices To: Lave Offices of William L. Berg&Associates 19 2440 Santa(Mara Ave.,Alameda, CA 94501 20 mate of Accident: 0512012002 21 Place of Accident: 1201 W. 10n`Street in the City of Antioch, California. 22 On the Antioch Fairgrounds 23 Injuries: Emotional distress 24 Circumstances of Accident: Claimant witnessed her son being struck by a vehicle and 25 seriously injured. 26 27 28 ,V 2 1 Jurisdiction: Superior Court of California County of Contra Costa, 2 Unlimited Jurisdiction 3 4 Dated: November 7, 2002 WILL t. BERG 5 Attorney for Claimant 6 7 8 I have received the above Notice of Claim on behalf of the respondent(s), County of Contra Costa, 9 10 Dated: 11 Name: 12 Title: 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CLAIMI t7O&M OF SUPERVISO p.F,CONTRA COSTA'QuNix , . f BOARD A ON; W. Ia 3. 2002 : Claim Against the County, or District Governed by the Board of Supervisors,Routing Endorsements, ) NOTICE .t.0 CLAIMANT' . and Board Action, All Section.references are to ) The copy of this current mailed to you is your Califorpia Government Codes. ) A''tire of the#cti taken on your claim by the - : Board of Supmi rs. (Paragraph IV below), given Pursuant to Govenrnent Code Section 913 and. Ulm ase noti all"Warnings". AMOUNT: Unknown NOV 1,3 2002 CLAIMANT: Shane O'Roark COUNTY COUNSEL MARTINEZ CALIF. ATTORNEY: William Berg SBN 92095 DATE RECEDED: November_8, 2002 Michael Edward Coke SBN 42757 - ' ADDRESS: Law Offices of William L. Berg & AsB*_ RJERY TO CLERK ON: November 8, .2002 2440 Santa Clara Avenue Alameda, CA 94501 Land delivered by BY MAIL POSTMARKED: ._ FROM: Clerk,of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim.. JOHN SWEETEN, k Dated: November 12. 2002 By. Deputy' ��° H. FROM:, County Counsel TO: Clerk of the Board of Supervisors ( This.1Cim complies substantially with Sections910 and 9.10.2. { ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and vue 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.f lcd late and send warning of claimant's right to apply for leave to present a.late claim (Section 9113). Other: - ' , Dated:•_ //-j -- B : Deputy County Counsel III, FROM: Clerk of the Board TO: County Counsel-(T) County Adininistrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV, ,BOARD ORDER: By unanimous vote of tbe.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. DECEMBER 03 2002 Dated: JOHN SWEETEN, CLERK, B ,D u 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: DECEMBER 04, 2002 JOHN SWEETEN,CLERK By Deputy Clerk ` WILLIAM L. BERG SBN 92095 1 MICHAEL EDWARD COKE SBN 42757 2 LAW OFFICES OF WILLIAM L. BERG& ASSOCIATES 2440 Santa Clara Avenue 3 Alameda, CA 94501 Telephone: (510) 523.3200 4 Facsimile: (510) 523-8851 5 Attorneys for Claimant, Shane O'Roark 6 7 Shane O'Roark, NOTICE OF CLAIM 8 Cl DECEIVED 9 vs. E v 0 S 2002 10 Antioch Fairgrounds, County of Contra Costa CARD O SUPERVISORS 11 City of Antioch, Contra Costa County Fair, CONTRA COSTA CO 12 Respondents. 13 14 15 PLEASE TAKE NOTICE of the fallowing claim: 16 Name of Claimant: Shane O'Roark 17 Claimant's Address: 3415 Barmouth Drive; Antioch, CA 94509 18 Send All Notices To: Law Offices of William L. Berg&Associates 19 2440 Santa Clara Ave., Alameda, CA 94501 20 Date of Accident: 05/20/2002 21 Place of Accident: 1201 W. 10°i Street in the City of Antioch, California. 22 On the Antioch Fairgrounds 23 Injuries: Emotional distress 24 Circumstances of Accident: Claimant witnessed his brother being struck by a vehicle 25 and seriously injured. 26 27 28 1 Jurisdiction: Superior Court of California County of Contra Costa, 2 Unlimited Jurisdiction 3 4 Dated: November 7, 2002 $ L. BERG Attorney for Claimant 6 7 8 1 have received the above Notice of Claim on behalf of the respondents), County of Contra Costa, 9 10 Dated: 11 Name: 12 Title: 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CLAIM BOARD OF SUPERVISOM +' N ''✓ . BOARD FACTION: December 3, 2002 Claim Against the County, or District Governed by the Board of Supervisors,Routing Endorsements, ) 'NOTICE O CLAIMANT and Board Action. All Section,references are to ) The copy of this cument mailed to you is your California Government Codes. ) n9tice of the.#cti taken on your claim by the Board of Supervi rs. (.Paragraph IV below), given Pursuant to Gove>"nrnent Code Section 913 and. t}te all"Warnings". . AMOUNT: Unknown L! tiVr/ YY NOV 1 3. 20V CLAIMANT: Michael R. O'Roark COUNTY COUNSEL hAa TINE2:CALIF ' ATTORNEY: William L. Berg SDN 92095 DATE RECEIVED:< November 8. 2002 Michael Edward Coke SBN 42757 - ADDRESS: Law Of fines of William L. Berg & AsSY DELIVERY TO CLERIC ON:November 8,___2002 2440 Santa Clara Ave. , Alameda, CA 94501 Hand delivered by . BY MAIL POSTMARKED: _-_ ty ,Coun�sel FROM: Clerk,of the Board of Supervisors TO: County Pounsel Attached is a copy of the above-noted claim. Dated:, November 12, 2002 JOHN�SWEEk T By: Deputy -� II. FROM:. County Counsel TO: Clerk of the Board of Supervisors (,rThis clam complies substantially with Sections 910 and 910.1, { ) This Claim.FAILS to comply substantially with Sections 910 and 910.2, and Nueare so notifying claimant, The Board cannot act for 15 days (Section 910.8). ( )'Claim is not timely tiled. 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 (Se©tion 911:3). (r,Kother: "T� e�cue r : ; , t ,- t f -f?X t`n + "Y" V r�a Dated:. 84 q-er� By: "87 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 LSection 9.11,3). IV, .BOARD ORDER: By unanimous vote of the,Supervisors present: This Claim is rejected in full. O Other: .I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated, -DECEMBER 03, 2002 JOHN SWEETEN,CLERIC, B� Dffiut Clerk WARNING(Gov, code section 13) Subject to certain exceptions, you have only six(6)months from the date this notice wasersonall erved or de osited. P Y p in the mail to file a court action on this claim. See Govemment 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.tunes 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: DECEMBER 04, 2002 JOHN SWEETEN, CLERIC BX eputy Clerk I WILLIAM L. BERG SBN 92095 MICHAEL EDWARD CODE SBN 42757 2 LAW OFFICES OF WILLIAM L. BERG&ASSOCIATES 3 .2440 Santa Clara Avenue Alameda, CA 94501 4 Telephone: (510) 5233200 5 Facsimile: (510) 523-8851 6 Attorneys for Claimant, Michael R. O'Roark 7 Michael R. ORoark, NOTICE OF CLAIM 8 9 Claimant, ECLEMB EI'VE'D 10 vs. 8 2002 11 Antioch Fairgrounds, County of Contra Costa r SUPERVISORS12City of Antioch, Contra Costa County Fair, COITA CO. 13 Respondents. 14 / 15 PLEASE TAKE NOTICE of the following claim: 16 Name of Claimant: Michael O'Roark 17 18 Claimant`s Address: 3415 Barmouth Drive; Antioch, CA 94509 19 Send All Notices To: Law Offices of William L. Berg&Associates 2440 Santa Clara Ave., Alameda, CA 94501 20 Date of Accident: 05/2.0/2002 21 22 Place of Accident: 1201 W. 10* Street in the City of Antioch, California. On the Antioch Fairgrounds 23 Injuries: Lacerated spleen, fractured ribs, contusion of pancreas, 24 bruised lungs 25 Circumstances of Accident: Claimant was exiting a bathroom building located near 26 an open gravel parking lot/roadway located on the property of the Antioch Fairgrounds. As the claimant 27 entered the gravel lot he was struck by a vehicle and 28 seriously injured. ,C 1 2 Jurisdiction: Superior Court of California County of Contra Costa, Unlimited Jurisdiction 3 4 Dated: November 7, 2002 � JLG 6 Attorney for Claimant 7 8 I have received the above Notice of Claim on behalf of the respondent(s), 9 County of Contra Costa, 10 11 Dated: 12 Name: Title: 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 CLAIM, BOARD OF 5UPERVIaQU. F!QONTRA COSTA'CQ .DECEMBER 3 2002 .BOA T OIS: s �� IM.�� rb�glOiri.li�l�ai�lr�rr�rl M Claim Against the County,or District Governed by } the Board of Supervisors,Routing Endorsements, } NOTICE "O CLAIMANT and Board Action. All Section,referenciMR The copy of this cement mailed to you is your California Government Codes, t ce of the.#cti taken on your claim by the 2002 Board of Supervi � rs. (Paragraph IV below), given Pursuant to Government Code Section 913 and. COUNTY COUNSEL .915,4, Please note all"Warnings". ' MARTINEZ CALIF. AMOUNT: $10,.000,000, Exceeds $10,000: CLAIMANT: JOSE ORTEGA for: MMANUEL ORTEGA ATTORNEY: JOHN C. STEIN DATE RECEIVED: NOVEMBER 12 , 2092 ADDRESS: THE BOCCARDO LAW FIRM LLPON: NOVEMBER 12 , 2002 111 W. ST. JOHN STREET, STE. 11�C3��•DELIVERY TO CLERK SAN JOSE, CA 95113 BY MAIL POSTMARKED: NOVEMBER 08 , 2902 FROM: Clerk.of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. 7OHN'SWEETE I Dated: NOVEMBER 13 , 2002 By: Deputy H. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 9:10.2. { ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and vae are so notifying claimant. The Board cannot act for 15 days(Section'910.8). { ) Claimis not timely filed. The Clerk should return claim on ground that it.was.fil d late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). { ) Other: Dated:. �' /2i -C -- B : D uty Cour 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 03, 2002 l(} SWEETEN, CLERK_.,By ,De u Clerk WARNING{Gov, code sectio 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 avant to consult an attorney, you should do so ' irnniediatel . *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: DECEMBER 04, 2002 SOHN SWEETEN,CLERK.BX Deputy Clerk 1 EMANUEL ORTEGA, a minor, by and ) through his Guardian ad Litem, ) CLAIM FOR DAMAGES PURSUANT TO 2 JOSE ORTEGA, ) GOVERNMENT CODE SECTIONS 905 AND 910 3 ) RECEIVED Claimants, ) 4 VS . } 5 NOV 12 2002 ) STATE OF CALIFORNIA DEPARTMENT CLERK 60Afiq 0 SL•PEAVIS �?S 6 OF BOATING AND WATERWAYS, a } CONTRAC057AC{7. public entity; COUNTY OF CONTRA ) 7 COSTA, a public entity, et al. , ) 8 Respondents. ) ) 9 ) 10 11 TO ALL PARTIES AND THEIR ATTORNEYS OF RECORD. 12 13 STATE OF CALIFORNIA 14 DEPARTMENT OF BOATING AND WATERWAYS 15 2000 EVERGREEN STREET, SUITE 100 SACRAMENTO, CA 958153888 16 COUNTY OF CONTRA COSTA 17 BOARD OF SUPERVISORS 651 PINE STREET, ROOM 106 18 MARTINEZ, CA 94553 19 Claimant EMANUEL ORTEGA, a minor, by and through his 20 Guardian ad Litem, JOSE ORTEGA presents his claim for damages for 21 personal injuries pursuant to Government Cade Section 905 and 910 as 22 follows . 23 A. NAME AND ADDRESS OF CLAIMANT: 24 EMANUEL ORTEGA, a minor, by and through his Guardian ad Litem, JOSE ORTEGA 25 446 NORTH 9TH STREET 26 SAN JOSE, CA 95112 -1- CLAIM FOR DAMAGES . ....... ........ . � .. . . . . . JUJ mad PaPloo - se■a / / unk / § k k o ` m � § to n % ? n m « > . I-d o n k � � 0 § m § m 11, 7 § A 0 H \ o o " T o Ln 0 & � r / / / O j > > \\ (D _ 1-3 ■ g 2 ; ; n > ■ § � / 0 . � / 2� n? : /9$7 2 ^ � �� \ & �\ � ¢ b� » 2 �« � . . . � . .... ..... .. � �