HomeMy WebLinkAboutMINUTES - 02052002 - C8 CLAIM ' y
BOARD OF SUPERVISORS;OF CONTRA COSTA COUNTY"
BOARD ACTION: :. Feb 5, 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
91$ 4 Pnete all`�Wrnngs"
AMOUNT: Unknown
CLAIMANT: Edward L. Turner t
ATTORNEY: DATE RECEIVED: January 8,2002
ADDRESS: 901 Court St BY DELIVERY TO CLERK ON: _ January 8,2002
Martinez, CA 94553
BY MAIL'POSTMARKED: January 2002
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a,copy of the above-noted claim.
JOHN SWEETEN- k
Dated January 9,2002 By: Deputy. ` £ `} '}
II. FROM: County Counsel TO: Clerk of the Board of Supervisors \1
L eis claire 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):
O Other:
Dated; .—f - 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:
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: G `t, ' JOHN SWEETEN, CLERK B `.1
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
Z 14Deputy Clerk
Clairn,to: BOARD £1F SUPERVISORS OF CONTRA COSTA COUNTY"
-INSTRUCTIONS TO CLAD
A. Claims relating to causes of action for deathor 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 Beard 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
FREr
IVE
7RAgainst the+county of Contra Costa or )Destruct) � s
ON
e.FJ.
(1~111 in name)
The undersigned claimant hereby'makes claim against the County of Contra Costa or the above-named district
in the sum of S and in support of this claim represents as follows: -
r
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 slid the did or injury occur?(Give full details; use extra paper if requ;a ed)
4 What particular act or omission on the part of county or district officers, servants, or employees caused the
injury or damage? , Ali 0All
r
5. What are the names of county or district officers, servants, or employees causing the damage or 1nJury�
K Al Ri
Piiw
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6. What damage or injuries do you claim resulted? (Give full extent of'anjuries or damages claimed. Attach
two estimates for auto damage.)
Or
o
7. How was the amount claimed above computed? (include the estimated amount of any prospective injury or
damage.)
.t
8 Names and addresses of witnesses, doctors, and hospitals.
rl
9. List the expenditures you made on account of this accident or injury.
DATE TIlviE AMOUNT
Gov. Code Sec. 9113.2 provides "The claim must be
signed by the claimant or by some person on his behalf;"
SEND NOTICES TQ: (Attorney
Name and Address of Attorney )
(Claimant's Signature)
(Address)
g
Telephone No. )Telephone No.
NOTICE
Section 72 of the Penal Code provides:
Every person who,with intent to defraud,presents for allowance or the payment to any state board or officer,or to any
county,city,or district board or officer,authorized to allow or pay the same if genuine,any false or fraudulent claim,bill,account,
voucher,or writing,is punishable either by imprisonment in the county jail for a period of not more than one year,by a fine of not
exceeding one thousand(S 1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by'a fine of not
exceeding ten thousand dollars(S 10,000),or by both such imprisonment and fine.
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