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HomeMy WebLinkAboutMINUTES - 10182005 - C10 CLAIM BOARD OF,SUPF VISORS OF CONTRA COSTA COUNTY, BQARD.ACTION: OCTOBER 18, 2005 Claire 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 Cedes. ) 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: UNKNOWN s; CLAIMANT: ROBERT JONESTA lu ATTORNEY: AMRNEYS SERVICES OF CALIFORNIA DATE RECEIVED: SEP'TDIBER 15, 2005 ADDRESS: 2063 MAIN STREET, #222 BY DELIVERY TO CLERK ON: SEPTEMBER 15, 2005" OAKLEY, CA 94561-3302 BY MAIL POSTMARKED: SEPTDIBER 12 2005 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. 3C?HN'SWEET N SEPTEMBER 15 200.5 Dated: x By: Deputy IT OKi: County.Counsel: = TO:Clerk ofth+s Board of Sup sora Complies (This claim I I Ily 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). { ) Claimis 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: 5 G i nr is art� ( +c * d w rn 5 ter r^r.1 C? or etf-_44r March 12-1 .Dated: ` -~ Jr�-O By M av utyunty Couns, III. ;FROM: Clerk o the Board TO:' County Counsel(1) County Administrator(2) { } Claim was returned as untimely with notice to claimant(Section 911.3). IV. ARD 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: V,& BHN SWEETEN, CLERK, ByDeputy Clerk WING(Gov. code section 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or depositt in the mail to file'a court action on this claim. See Govorrnment 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 immediately. *For Additional Warning See Reverse Side of This Notice.>f AFFIDAVIT OF MAILING I declare under penalty of perjury that I arm 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: s� � JOHN SWEETEN, CLERK.ByDepotlerl OFFICE OF THE COUNTY COUNSEL SILVANO B.MARCHES! COUNTY OF CONTRA COSTA COUNTY COUNSEL Administration Building ,_'{ ` SHARON L. ANDERSON 651 Pine Street, 911,Floor Martinez, California 94553-1229 R CHIEF ASSISTANT 5� B fl e GREGORY C. HARVEY (925) 335-1800 ; �3,�;}}t11n ,ri a VALERIE J. RANCHE (925) 646-1078 (fax) v$ Js� ASSISTANTS NOTICE OF UNTIMELINESS AS TO A PORTION OF THE CLAIM TO: Robert Jones 2063 Main Street, #222 Oakley, CA 94561-3302 Please Take Notice as Follows: In regards to the claim you submitted on September 12, 2005,portions of your claim are timely and portions are untimely. The portions of your claim prior to March 12, 2005 that you presented against the County of Contra Costa governed by the Board of Supervisors'fail to comply substantially with the requirements of California Government Code Sections 901 and 911.2,because they were not presented within six months after the event or occurrence as provided by law. Because the portions of the claim prior to March 12, 2005 were not presented within the time allowed by law, no action was taken on those portions of your claim. The claim was forwarded to the Board for action only on the timely portions of the claims. Your only recourse at this time is to apply without delay to the County of Contra Costa governed by the Board of Supervisors for leave to present a late claim as to the claims which are untimely. See Sections 911.4 to 912.2, inclusive, and Section 946.6 of the Government Code. Under some circumstances, leave to present a late claim will be granted. See Section 911.6 of the Government Code. 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. SILVANO B. MARCHESI COUNTY COUNSEL 2 By: Monika L. Cooper Deputy County Counsel Page 1 CERTIFICATE OF(SERVICE BY MAIL (Code Civ.Proc., §§ 1012, 1013x,2015.5;Evid. Code,§§ 641,664) I am a resident of the State of California,over the age of eighteen years,and not a party to the within action. My business addr�e;s is Offi of the County Counsel,651 Pine Street,9th Floor,Martinez, CA 94553-1229. On ° /T20 ,Iserved a true copy of this Notice of Untimeliness as to a Portion of the Claim by plac g the document in a sealed envelope with postage thereon fully prepaid,in the United'States mail at Martinez,California addressed as set forth above. 'I am readily familiar with Office of County Counsel's practice of collection and processing of correspondence for mailing. Under that practice,it would be deposited with the U.S. Postal Service on that same day with postage thereon fully prepaid in the ordinary course of business. I declare under penalty of perjury under the laws of the State of California and the United States of America that the above is true and correct. Executed on 5 - ! _ _ ? , at Martinez,California. Kathleen O'Connell cc: Clerk of the Board'of Supervisors(original) Risk Management Page 2 VF(IA6CR LoSS r . ri ED 1 SLI a k ! sem 3 f )j(rwCcc,9. 7 1-33o. P � . tom_ Yl pi.9I C .)6� r.... ........... 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AMOUNT: $100,000.00 . ..3 CLAIMANT: RICHARD 'BALDWIN SEPTEMBER 15 2005' ATTORNEY: C• BRENI' PATTEN DATE RECEIVED: ' ADDRESS: 1721 ALHAMBRA AVENUE BY DELIVERY TO CLERK ON SEPTEMBER' 15, 2005 MARTINEZ, CA '94553 BY MAIL POSTMARKED, SEPTEMBER 14, 2005 FROM: Clerk of the Board of Supervisors TO County Counsel Attached is a copy ofthe'above-noted claim: SEPTEMBER 15 X305 .. JOHN SW , k Dated: By: Deputy II. FROM: County Counsel. TO:Clerk of tho Board of Sup isors ( 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; 7— By: Deputy County Counst 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 ARD 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: cl'' Iiiv SWEETEN, CLERK, By ,Deputy 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 deposite 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 penury 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:e� Oe4tHN SWEETEN, CLERK By Deputy Clerl BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. A claim relating to a cause of action for death or for injury to person or to personal property or growing crops shall be presented not later than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be presented not later"than once year after the accrual of the cause of action. (Gov. Code § 911.2.) B . Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County AdministrationBuilding, 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 claire 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. rrs�rss�rsasrsr�'rsrr"■ rr�rrsrrsarasssraar'rrsr�rss�■ssrrsr�ssarsss��rs�asaaa RE: Claim By ) Reserved for Clerk's filing stamp a, 4 Richard Baldwin ) X KK .� , Against the County of Contra Costa or ) a } SEP 1 5 L( u District) & _ (Fill in the name) ) "` The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ 100,000 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) March 29,'2005,"@ 7:30 p.m. 2. Where did the damage or injury occur? (Include city and county) East end of Grayson Geek Bridge(Eastbound) on Imhoff Drive} 3. How did the damage or injury occur?(Give fall details, use extra paper if required) Claimant was riding a bicycle to work(to start at 8:00 p.m )and hit a dangerous condition in the bicycle lane and fell. 4. What particular act or omission on the part of county or district officers, servants,or employees caused the'injury'or damage? The asphalt is raised about 3" above the concrete and the bicycle lane abruptly narrows forcing bicyclists'to ride over the transition at an oblique angle. 5. What are the names of county or district officers,„servants,or employees causing the damage or injury? Dangerous road condition not properly'maintained. 6. What damage or injuries do your claire resulted?'(Give'full extent of injuries or damages claimed. Attach two estimates for auto damage.) Right hip fracture required'surgery and''pins. 'Left heel abrasion. Hip'know'causes continued pain and lass of sleep. 7. How was the amount claimed above'computed?(Include the estimated amount of any prospective injury or damage.) Last wages $; 7,500.00 Medical(CCCH) $ 1,692.91 Pain& Suffering $50,807.09 8. Names and addresses of witnesses,doctors, and hospitals: Richard Carter,Joseph Carter,4810 Blum Rd,##3,Martinez, CA' 925-812-1162. Contra Costa County Medical Center, Martinez,CA 94553 9. List the expenditures you made on account'of this accident or injury: DATE TIME AMOUNT August 11,2005 $8.75 Obtain Medical Records rrr�rrr�rrrrrrr�rrr�rrrrrrrr'rrrr'■rrc''■rrr'■rrr'�rrrrrrr�rrrr•rrr`rrrr:rrrr'�rrra ) Gov. Code Sec. 910.2 provides "The claim shall be ) signed by the claimant or by some person on his behalf." SEND NOTICES'TO: (Attorney) ) Name and address of Attorney' C. Brent Patten ) Attorney at Law ) -- 1721'Alhambra Avenue ) (Claimant's'Signature) Martinez,CA 94553 , ) 315 Warren St.,Martinez,CA 94553 (Address) Telephone No. 925-2294568, _ )Telephone No' 925-812-0842 ■r�■rre�rrr■rrr�rrr'■rrr■rrrsrrr�rrr��rrrrrrrarrrw'rrr�'rrr�rrtrr''rrrrrrrr�rrr:■ PUBLIC RECORDS NOTICE: Please be advised that this claim form,or any claim filed with the County under the Tort Claims Act,is subject to public disclosure under the California Public Records Act. (Gov. Code, §§'6500 et seq.)Furthermore,any attachments,addendums,or supplements attached to the claim form; including medical records,are also subject to public disclosure. rrr'arrrrrrsrrrrrrrr'rrrr'arr*rrrr'■rrr�rrrrcrrr�rrrrrrrrrrrr''rrrrrrrr�rrrErrrs NOTICE: Section 72 of the Portal Cade 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 claire, bill, account voucher,or writing, is punishable either by imprisonment in the County jail for a period of not more than one year, by a fine of not exceeding one thousand dollars($1,000.00),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. 1 PROOF OF SER P7CE 4 1 declare that,'I am employed in the County of Contra Costa, State of California. I am over 5 the age of eighteen (18) years and not aparty to the within action; my business address is 1721 6 Alhambra Avenue, Martinez, CA. 7 On September 14, 2005, served the following: 8 TORT CLAIM 9 On the other parties In said action by placing a true copy thereof enclosed in a 'sealed 10 envelope,with postage thereon fully prepaid for first-class mail, in the mail at Martinez, CA,to: 11 Board of Supervisors 12 Room 106, County,Administration Building 651 Pine Street 13 Martinez, CA 94553 14 15 I declare under penalty of perjury that the foregoing is true and correct. 16 Executed on September 14, 2005, at Martinez, California. 17 18 19 20 21 6 Kathy Velasquez 22 23 24 2'5 2'S>•6 27 2'8 CLAIM , BOARD OF SUPERVISORS OF CQNTRA CQS''I'A COUNTY BOARD ACTION: 1IIi 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 documentmailed 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 nate all"Warnings". AMOUNT: AN AMOUNT TO EXC $�5,000 ED .06 ALACIA HENRY, a minor, by and through her CLAIMANT: Guardian Ad''Litem, JAYRA SMITH; JAMAL CARRY, a miner by and through his Guardian Ad Litem ATTORNEY: .JAYRA SMITH., AND JAYRA SMITH._ DATE RECEIVED: SEPTEMBER'16, 2005 JAMES .C. PERLEY ADDRESS: LAW OFFICES'OF JAMES C. PERLEY BY DELIVERY TO CLERK ON; SEPTEMBER 16, 2005 393 CIVIC CENTER DRIVE, SUITE 110 HAND DELIVERED FREMONT, CA 94538. BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET k Dated ' . B SEPTEMBER 16 2005 Y< Deputy p 'Y II. FROM: County Counsel, TO: Clesrk of they Berard of Supervisors (,r This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 311.3). O Other: Dated: J- d � By Deputy County Couns+ 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.,45OARD ORDER: By unanimous vote of the Supervisors present: (V� 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:: 0F4Zty- Zt 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 deposite 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 Waming 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 IS 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: & ��` OOHN SWEETEN, CLERK By Deputy Clert JAMES C. PERLEY,ESQ. (SB#161963) LAW OFFICES OF JAMES C. PERLEY 39300 Civic Center Drive Suite 110 Fremont, California 94538 + ` ' Telephone: (51 j)494-9191 ( Facsimile: 510 797-8434 SEP 6 2005 Attorney for Claimants, Ria°�s �vis ALACIA HENRY, a minor, by and cosi, , ops through her Guardian Ad Litem, JAYRA SMITH; JAMAL GARRY, a minor, by and through his Guardian Ad Litem, JAYRA SMITH; and JAYRA SMITH, In the Matter of the Claim of: ) CLAIM FOR INJURY&DAMAGE AGAINST CENTRAL CONTRA ALACIA HENRY, a minor, by and ) COSTA TRANSIT AUTHORITY aka through her Guardian Ad Litem,JAYRA) COUNTY CONNECTIONS and SMITH,JAMAL GARRY, a minor, by } THE COUNTY OF CONTRA COSTA and through his Guardian Ad Litem, ) JAYRA SMITH; and JAYRA SMITH, ) Claimants, ) } As Against. ) CENTRAL CONTRA COSTA TRANSIT) AUTHORITY aka COUNTY ) CONNECTIONS, and THE COUNTY ) OF CONTRA COSTA ) TO: COUNTY CONNECTION ADMINISTRATIVE OFFICES 2477 Arnold Industrial Way Concord, California 94520 THE COUNTY OF CONTRA COSTA Office of the Clerk of the Board 651 Pine Street Martinez, California 1. Claimants, ALACIA HENRY, a minor,by and through her Guardian Ad Litem, JAYRA SMITH, JAMAL GARRY, a minor, by and through his Guardian Ad Litem, JAYRA 1 SMITH; and JAYRA SMITH,whose address is 2387 Lisa Lane, Apt.No.: 105,Pleasant Hill, California 94523, claim damages from the CENTRAL CONTRA COSTA TRANSIT AUTHORITY aka COUNTY CONNECTIONS and THE COUNTY OF CONTRA COSTA, and/or its agents, employees, and contractors, in AN AMOUNT TO EXCEED$ 25,000.00 for serious injuries sustained to her person on March 17, 2005, in the City of Concord, County of Contra Costa,State of California. 2. Jurisdiction over this claim would rest in Superior Court. 3. This claim is based on the following circumstances: Claimants were riding the County Connections Bus as they usually do. The bus driver negligently, carelessly and recklessly,operated,owned, entrusted,managed and/or maintained,the bus as to cause Claimants to suffer damages all to their loss;past, present, and future. 4. The names of the public agents,employees and contractors,of CENTRAL CONTRA COSTA TRANSIT AUTHORITY aka COUNTY CONNECTIONS,and THE COUNTY OF CONTRA COSTA,that caused, and/or are responsible for Claimants injuries, damage and loss, are not known to Claimants at this time. 5 Injuries of both a physical and emotional nature have been incurred by Claimant, ALACIA HENRY, a minor,by and through her Guardian Ad Ltem, JAYRA SMITH, and Claimant has been forced to seek medical treatment for her injuries,including but not limited to, severe head injury,neck injury,chest injury, and severe emotional distress;past,present and future. These injuries have caused damages general and special in nature. 6. Claimant, JAMAL GARRY, a minor,by and through his Guardian Ad Litem, JAYRA SMITH, was forced to witness the injury to his sister, ALACIA HENRY,thereby 2 suffering, including but not limited to severe emotional distress. 7. Claimant,JAYRA SMITH,was forced to witness the injury to her daughter,A.LACIA HENRY, thereby suffering, including but not limited to, severe emotional distress. 8. All notices and communications concerning,this claim should be sent to: JAMES C. PERLEY, Attorney at Law, 39300 Civic Center Drive, Suite 110, Fremont, California 94538; telephone: (510) 494-9191. Dated: September 15, 2005 LAW OFFICES OF JAMES C. PERLEY By: JAMES C. ERLEY Attorney fo laimants 3 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY • BOARD ACTION:OCTOBER 181 2005 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 IU below), given Pursuant to Government Code Section 913 and 915.4. Please note all"Warnings" AMOUNT: $49780.74 CLAIMANT: ODWALLA, INC BY: CAT1iERTNE KAWACHI ATTORNEY: UNKNOWN DATE RECEIVED: SEPTEMBER 16, 2005 ADDRESS: 120 SffoWl PINE ROAD BY DELIVERY TO CLERK.ON SEPTEMBER 16, 2005 HALF MOON BAY, CA 94019 BY MAIL,POSTMARKED: SEPTEMBER, 15, 2005 FROM: Clerk of the Beard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWE TEN Clerk'.. Dated: SEPTEMBER 16, 2005 By Deputy II. FkOM: County Counsel 'TCI:Clerk of the Award of S ervisors ( his claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 9'10 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 filedlate and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). O Other: Dated; .. r 0 By: Deputy County Counst 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). IV4 .RD 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'copyofthe Board'''s Order entered in its minutes for this date. Dated': A y le, •2 LS...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 deposite 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 full) prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 42Z&7'/ OHN SWEETEN, CLERK By Deputy Clerk BOARD Cid' SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. A claim relating to a cause of action for death or for injury to person or to personal. property or growing crops shall''be presented not later than six months after the accrual of the cause of action. A. claim relating to any other cause of action shall be presented not later than one year after the accrual of the cause of action. (Gov. Cade § 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 Boardof 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. was reraaeeSees*Mae raeaaeeer•arkaeaeae'eeeareaaerKnaa waaaeaseaI RE: Claim By: Reserved for Clerk's filing stamp RECEI VED Against the County of Contra Costa or ) SEP 6 2005 District) CLE t� qR�of StiRE-RV1SORS (Fill in the name) ) c�,'ar;= COSTAccs. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ H l"130, 3:1� and in support of this claim represents as follows: 1. When did the damage or injury occurs (Crave exact date and hour) 2. Where did the damage or injury occur? (Include city and county) 1sn 10��t,1f tick A- I " , 7LfyA CC_7f � 3. How did the damage or injury occur?' (Give folk details;use extra'paper`if required) 4. What particular act or orrussion on the part of county or district t�icers, servants, or employees caused the injury or damage? '54CO.e ->- -p d 04,c�ri�,tt V,,Ca d,t t tVVI d-Alas A4rl� TO v_�- "" , 5 What are the names of county or district officers, servants, or employees causing the damage or injury? '.county Administrator Q1 "c' Risk Management Division Costa 2530 Arnold Drive, Suite 140 Costa Martinez,California 94,553 ��nT\/ Liability Claims (925)335-1440 Fax Number (925)385-1421 �_ -, July 26, 2005 r�coin.. Catherine:Kawaehi Odwalla Truck 120 Stone Pine Rd Half Moon Bay, CA 94019 Re: Claimant: Odwalla Truck Insured: Contra Costa County D/Accident: 46/29/2005 Claim No.: 58744 Dear Ms. Kawachi: ` The above captioned matter has been referred to my office for investigation and handling on behalf of the Contra Costa County Department of Library. I have enclosed a claim form that must be completed in order to file a formal claim against the County. Be advised that you have six months from the accident date to file a formal claim as stated in the California Government Code beginning with Section 900. This also notifies you that you must comply with the claims presentation and timely suit filing requirements of California law in order to preserve your claim. Our investigation of your claim dons not affect your duty to cot ply with time limits set by laver, and by investigating, considering, and discussing your claim with you or your representative, we do not waive our right to assert your failure to comply with those time limits as a complete defense to any claim or action you may bring. Should you have any questions,please do not hesitate to contact the undersigned. Sincerely, Penny Bailey Liability Claims Adjuster 925-3'35-1455 ,STATE OVCALIFORNIA i)EPARTMENT OF CALIFORNIA HIGHWAY PAROL TRAFFIC COLLISION REPORT-PropertyDamage Only CHP 555-03(Rey,9-99) OPI 061 Original to Officer,copy{ies)to involved parfy(ies) SPEOIAL CONDITIONSHTT&RUN CITY JUDICiALOISTRICT NUMBER ,/V9k "� -C!� COUNTY REPORTING DISTRICj, REP INCER !rX COLLISION OCCURRED O y CA/ �� ��� MO. DAY YEAR TIM 400 NCIC OFFICER I.D. Aof AT INTERSECTION WITH : : DAY 'OF:WEEK TOW AWAY STATE HIGHWAY RELATED Or. Fe"Iles Of W �' E] Yes 11 No C3 Yes ❑ No ';' DR suci sJt s,�T`TE cLAss SAFETYEOUIPMENT SHADE (ALLIED AGENCY USE ONLY) ' ro 4CI`A DAMAGED Report taken El Yes ❑ No D NAME(FIRST;MIDDLE.LAS?� AREA Exchange of information 0 Yes ❑ No PED STREETADDRESS _ IYS 10 S- <PK VEH :SEX 61KrHDATE INSURANCE: POLICY NUMBER © QI r CARRI fa &W/y INDICATE g1 i,E DIR.TAVEL'. OX 'SETORHIOHWAYh SPEED LIMIT NORTH. .. (� PARTY OTHER :VEM.& MAM I MODEL I COLOR L��E UMBER � 9� VEO YP i DRIYERS LICENSE NUMBER. STATE CLASS SAFETY EQUIPMENT SHADE ....{ J CA DAMAGED DRIVER NAME(RRST,MtODLE LAS}) AREA o VT pEp STREET ADS SS o H*A41; RGA T P VEH SEK I SiRTHOAT� INSURANCE CARRIER POLICY NUMBER y F 011 F • �o SI f DIR.TRAVEL ON STREET IPJP-^- OR GMNAY "SPEED LIMIT OAPARTY OAR VEH.YEAR MAI OID&ICOLOR LICENSE NUMBER S4:A VEH.?'YP .. oil 614C wom AGE SEX NAME ADDRESS ONE NUMBER PARr�NO. CC 6emL 5 cs i»Pf '1 N Y AR7ll! Z Z5' - (. Z t F. FACiE SEX NAME' AdDRESS HONE NU BER PARTY NO. (—;,- j G O g SNE RD AA Mows" X10 E2. NAME ADDRESS D D PROPERTY 40AI Leff or- .� PRIMARY COLLISION FACTOR } MOVEMENT PRECEDING LIST NUMBER OF PARTY AT FAULT TRAFFIC CONTROL DEVICES # rk TYPE OF VEHICLE +� COLLISION r.....,... ......,.. # A VC SECTION VIOLATED: NI A PASSECA131 916MR.W IN A STOPPED ,--OLS FUNrTIQ 8 COSIRMN91FUNCTIONING 1 113 PASS R PR GHT # B OTHER IMPROPER DRIVING' C CONTROLS OBSCURED G ` PICKUP I A ] A RIGHT TURN C AN Rt ELTR= E MAKI, FT K N I IFTR IF M R E FELL ASLEEP` W GR K ITR R /F 1 GBACKING C H / PIN 1 PASSING VEHICLE..... A Y J CHANGING HIGHWAY MWST.E, IP NT K PAR C RAI I UHIcuI BICYCLE. 1L ENTERINGFI p R VEHICLE I M 01HER AF tN F I PEDESTRIAN X 1 PP N N A NQN-cowsm 10 MOPED 0 PAIROD 8 M t G QjMR MOTOR VEHICLE OTHER ASSOCIATEDFACTORIS) 0 TRA LIN NO w AY HT 1 R MQM.YMICLE ON QjH0 HIGHWAY IMARK 1 TO X ITEMS R R:• DAWN E PAEMED MOTOR AHICLE A VC SECTION VIOLATION: RET LIGHTS 1F TRAIN DA NO SMWLIG-KT B VC SECTION VIOLATION: ' E DARK-STREET LIGHTS NOT H ANIMAL: FUNCTIONING f "+ SOBRIE Y-1 TOUG 2I PHYSICAL <: ROADWAY SURFACE I FIXED OBJECT: A A T ND R 1 T J OTHER OBJECT: S H N iNFLUENO SNOWY-I Y C H -NO UNDER INFLUENCE PEDESTRIAN"SACTIONS F tNIATFENTION` D H IM AI WN`: ROADWAY CONDITION(S) UNDER DRUG F C 'A NO PEDESTRIAN INVOLVED RKiTO37TEMS N I LEMN P i P -PHYSICAL A HOLES,DEEP RUTS- CROSSING IN CROSSWALK AT 1 PREVIO -G IMPAIRMENT T KNOWN 'j LME MLMRIAL 0 ROAQ INTERSECTION i Uutwit.A APPLICABLF. L O CROSSING IN CROSSWALK-NOT AT K DEFECTIVE VEH.EQUIP.: CONSTRUCTION10 -REP R ZONE INTERSECTION W A HAZARDOUS MATERIAL Fr -INC NLQ HER' GI N ROM) PAR H=N A COND1TIONS A-PPROACHING I LA&INGSCH 0 RUNAWAY VEHICLE Destroy previous editions. c5 O DATEOF COLLISION TIME 12400) NCIC'NUMBER OFFICER I.D. NUMBER " a� PAGE MC7, DAY YR. wit i�3gy "Al APPft#t' 0567 .' Why fix ' AT—cktro M A c*" & 2. jq a baj^- jN4 V4A "LL jS 1*$ji F® TOO 0f 4NVA 1.1 g& T' �' �q�t8�1! k't-14 a: W F14 M*_j Prate ►- > a-Z tAd 5. :r 10tt-011FL90 F-1 81 V o UL hS 14ASI als�� Imp" PAts 6. FAU44 #A). 6i>109" WWq d9 lta1rl Tm f 2 1 1 0 ,wft P t-o r 8. f4e 9OAa. or V-J. Amojjmr7 P�, . ' 1 � 6 ► 10. 14N'f gzvvb, APO 4F Nis s:o+c„ii emit 6 il rb 12. Vi6i Ag.— OA#wfrtt V i t1 — Is�dlN!'I' rpripf $C/�'A1 co j)( 13. Y 14. E 'lh. pWo (,0L Aob to 0 Ate 5ft 17. or 24. 4S>Cn brdrd 1 lLi t 21. 22 QAU� P'�1D °��- VJ tT1 7i$�: 2 r�� � � � ', Al�('- lobo ' 23. I�1At� ' PI 89� ' dii if s�""8�'' aA �d'� 4ItJ,^ rb "9 24. ElC l r- a"g M A T06 Aoaps c S PRyi 6ew sa+san —25- lkklAT—kAl VA 26. ll27, 28, PREPARER'S NAME I.D.NUMBER MO. DAY YEARR�EV{E1Nf 'SN ME MO. DAY Orr A14ywe-s Officer Nate McCormack c414°F op„V()A Orinda Police Services P. 0. Brix 2000 . 06nda,CA 94563 aTµ "r Business:925-254-6920 5fl Fax:925-254-9159 Voicemail:925-253-4280 24 Hr. Dispatch: 925-284-5010 From:Mark Mayers Te:TERRY LUCETf Oratec Btl=a Time:t 1:4®.78 AM Page 2 of 2 Western Truck Fabrication, Inc. uotn 1923 West Winton Avenue MANUF C7 RE.S OF rRLICX pate 81/2005 Hayward, CA 94545 BODIESAND E(VIWENr Quote# 21.655 Phone:SID-785-9994 Fax: 510-785-9986 small; www.we9erntnickFab.c= Sates Person:Mark Meyers Cu;totSer Name I Address in'd tls 'e Name Year/Make Isuzu ODWALLA TERRY LUCETT Model 1150 SD(TH STREET W.B. BERKELEY, CA 94710 C.A. Sales Rep Customer Phone 559-wo tatty Descriptions 1 STREET SIDE REAR INSULATED SWNG-OUT DOOR FOR KIDRON 13MY, 1 RAND NOCK Ft DOC 1 F'RNI GIHT AND,CRATE CHARGE ON DOOR 14,5 REMOVE ASO REPLACE REAR DOOR,REPAIR DOOR 3AM5 N. REAR DOOR DECAL DRtc. 'O QUOTE TI-RS jok ,.. Sales lax(5.75' 265.49 P.OA Thm audr is good for tbirty'dayn 7$fJ. '4 Upon accepoan a of is s q tom ,r VINE Stc, # xis",doge and mitial option btx>~s desired **NiNO FISIBN.E P'OR LOST Opt MtSs id qP EH't'*'a CLAIM l ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY •! BOARD ACTION OBER 18, 205 Claim Against the County, or DistrictGoverned 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 Ji i 915.4. Please note all"Warnings". AMOUNT: UNKNOWN CLAIMANT: CALIFORNIA STATE AUTOMOBILE ASSOCIATION BY: STEVEN rWORTVEl)T ATTORNEY: FOR: MIKE/APRIL PERRY DATE RECEIVED; SEPTEMBER 159 2005 UNKNOWN,.' ADDRESS: P.O. BOA 920 BY DELIVERY TO CLERK ON: SEPTEMBER 15, 2005 SUISUN CITY, CA 94585-0920 BY MAIL POSTMARKED: SEPTEMBER 14, 2005 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a coppy'of the'above-noted claim: JOHN SWEETS , Dated. SEPTEMBER 15, 2005 By: Deputy II. FROM: ''County Counsel. " TO: Clerk of the Board of Sup ervi rs ( ) This claim complies substantially with Sections 910 and 910.2. (v his 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: 9 l qo By: rvi Deputy County Couns€ 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. BpAfUJ�ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. { )' Other: I certify that this is a true and correctcopyof the Board's Order entered in its minutes for this date,, Dated: JOHN SWEETEN,CLERK,By ,Deputy Clerk WARNING(Gov. code sec ion 91 ) Subject to certain exceptions, you have only six(6) months from the date this notice was personally served or deposite 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;d'� APP"&00 JOHN SWEETEN, CLERK By Deputy Clerk OFFICE OF THE COUNTY COUNSEL �,;$=Y SILVANO B.MARCHESI COUNTY COUNSEL COUNTY OF CONTRA COSTA Admin Building ri a•':- SHARON L. ANDERSON 651 Pine Street, 91h Floor �a< "� CHIEF ASSISTANT Martinez, California 94553-1229 J e� [ z " GREGORY C. HARVEY (925) 335-1800 VALERIE J. RANCHE (925) 646-1078 (fax) :� ASSISTANTS NOTICE OF INSUFFICIENCY ANIS/OR NON-ACCEPTANCE OF CLAIM TO: Steven Bjortvedt, Claims Representative I1 California State Automobile Association P.O. Box 920 Suisun City, CA 94585-0920 RE: CLAIM OF: CALIFORNIA STATE AUTOMOBILE ASSOCIATION RE: MIKE& APRIL PERRY Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: [X] 1. The claim fails to state the name and post office address of the claimant. [X] 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [X] 3. The claim fails to state the date,place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [X] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation,the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. [ ] 6. The claim is not signed by the claimant or by some person on his or her behalf. [ ] 7. You are required to submit your claim on the proper form, which is enclosed. Please resubmit n Steven Bjortvedt California State Automobile Association Re: Mike& April Perry Page Two your claim on the enclosed form, including all the required information. Gov, Code.. § 910.4. Please be aware that you have only a limited period of time in which to file an amended claim. See Gov. Code, § 910.6. [ ] 8. Other: SILVANO B. MARCHESI COUNTY COUNSEL By: Monika L.L. Cooper Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (Code Civ. Proc., §§ 1012, 1013x, 2015.5; Evid. Code,§§ 641, 664) I am a resident of the State of California, over the age of eighteen years, and not a party to the within action. My business address is Office of the County Counsel, 651 Pine Street, 9th Floor, Martinez, CA 94553-1229. On 205,I served a true copy of this Notice of Insufficiency and/or Non-Acceptance of Claim by p cing the document in a sealed envelope with postage thereon fully prepaid, in the United States mail at Martinez,California addressed as set forth above. I am readily familiar with Office of County Counsel's practice of collection and processing of correspondence for mailing. Under that practice, it would be deposited with the U.S. Postal Service on that same day with postage thereon fully prepaid in the ordinary course of business. I declare under penalty of perjury under the l ws of the State of California and the United States of Arnerica that the above is true and correct. Executed on A°+W ", at Martinez, California. Kathleen O'Connell cc: Clerk of the Board of Supervisors (original) Risk Management Page 2 California State Automobile Association Inter-Insurance Bureau P.O.Box 920 - Suisun City,CA 94585-0920 September 14, 2005 _ SEP I Contra Costa County 651 Pine Street,Room 106 Martinez,CA 94553 RE: Your Insured: Jessrey,Bennett Your Claim No.: County Insd Our Insured: Mike/April Perry Our Claim No.: 01-KW7555-0 Date of Loss: 08/34/2005 Dear Contra Costa County: This is notice of our subrogation interest arising from this loss. We are in the process of settling the claim directly with our insured. We will forward copies of the repair bills as soon as they are available. Sincerely, A z Claims Representative II (888)900-6520 extension 5327 Enclosure F268K(Apr 2)02) I