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Home My WebLink AboutMINUTES - 01242006 - C.8 (3) TO: BOARD OF SUPERVISORS �' Q �7 FROM: John Sweeten, County Administrator Contra.:_. DATE: January 24, 2006 t a = COS a SUBJECT: Perley/Berkowitz v. Contra Costa County � Superior Court No. 7CO2-02624 A��o�K Count y SPECIFIC REQUEST(S)OR RECOMMENDATION(S)&BACKGROUND AND JUSTIFICATION RECOMMENDATION: AUTHORIZE payment in the amount of$721,066.24 from the General Liability Trust Fund to the CSAC Excess Insurance Authority. BACKGROUND/REASONS FOR RECOMMENDATION: Pete Edrington, defense counsel for the County, has advised the County Administrator that within authorization, an agreement has been reached settling the general liability claim of Perley/Berkowitz v. Contra Costa County. The payment represents the County's portion of the $1 million self-insured retention, less attorney's fees and costs of$287,933.76 and will be made to reimburse CSAC, which paid the settlement. In closed session on December 14, 2004, the Board heard the facts of the case and authorized payment of the County's $1 million self-insured retention. CONTINUED ON ATTACHMENT: YES SIGNATURE: RECOMMENDATION OF COUNTY ADMINISTRATOR RECOMMENDATION OF RD COMMITTEE ,/'APPROVE OTHER SIGNATURE(S): ACTION OF BOA D N , u.Cri APPROVED AS RECOMMENDED 11OTHER VOTE OF SUPERVISORS I HEREBY CERTIFY THAT THIS IS A TRUE AND CORRECT COPY OF AN ACTION TAKEN '/ AND ENTERED ON THE MINUTES OF THE BOARD UNANIMOUS (ABSENT OF SUPERVISORS ON THE DATE SHOWN. AYES: NOES: ABSENT: ABSTAIN: nn l, / ATTESTED �G�GGG7�y � j 675, \\fs-riskm2k3\u9ers$\jgricius\My Documents\Board Orders\602006\BO- JOHN SWEETEN, RK OF THE BOARD OF PerBerkGL.doc SUPERVISORS AND COUNTY ADMINISTRATOR Contact: Ron Harvey (335-1443) cc: CAO,Risk Management Auditor-Controller BY DEPUTY CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JANUARY 24/06 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 091 UM Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and DEC 19 2005 - 915.4. Please note all "Warnings". AMOUNT: $749.81 COUNTY COUNSEL MIARTINEZ CALIF CLAIMANT: THE INYO COUNTY.SHERIFF'S DEPARTMENT BY: DAN LUCAS ATTORNEY: UNKNOWN DATE RECEIVED: DECEMBER 19/05 ADDRESS: 550 SOUTH CITY STREET, BY DELIVERY TO CLERK ON. DECEMBER 19/05 P.O. BOX "S" INDEPENDENCE, CA. .93526 BY MAIL POSTMARKED: DECEMBER 15/05 FROM: Clerk of the Board of Supervisors TO: 'County Counsel Attached is a copy of the above-noted claim. JOHN SWEET erk Dated: DECEMBER 19, 2005 By: Deputy II. FROM: .County Counsel TO: Clerk of the Board of Supervisors ( his claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with.Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). O Other: Dated: l l�1-'a 3� By: Deputy County Counse 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: 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:-AW6C,ct y Q JOHN SWEETEN, CLERK, By _, Deputy Clerk WARNING(Gov. code sec ion 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 fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: Ar?"y 45- �.�, JOHN SWEETEN, CLERK By Deputy Clerk xq ` k This warning does not apply to claims which ;are not subject to the California Tort Claims Act,-such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or Federal Civil` Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the. separate limitations periods that may apply.The limitations period within which suit must.be filed may be shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particularclaim. The, Cci `- f~Contra Costa does not waive any of.its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable to actions not subject to the California Torn Claims Act. _ 1 k .dry Ad' AiY ��•. ' -1 M," ''' � w , RECEIVED Sher ff A,.- artment DEC 1 9 2005 ".County'of,Inyo CLERK BOARD OF SUPERVISORS 55Q Ohthi'Clay Street CONTRA COSTA CO. - PDQ°Box"S'" Independence California 93526 DAN LUCAS Sheriff ADMINISTRATIVE CENTER (760)878-0383 FAX(760)878-0389 Date 12/13/05 NORTHERN PATROL DIVISION BISHOP SUBSTATION Case# 05-10-010 301 W.Line St. Suite F Bishop,CA 93514 Clerk of The Board of Supervisors (760)873-7887 County of Contra Costa FAX(760)873-6515 651 Pine Street BIO PINE SUBSTATION 180 N.Main St. Martinez, CA 94553 Big Pine,CA 93513 (760)938-2359 (760)938-2917 Dear Clerk of The Board of Supervisors: SOUTHERN PATROL DIVISION LONE PINE SUBSTATION The following claim is being presented to you under authority of 21ON.Washington St. California Government Code Section 26614.5 (Search and Rescue P.O.Boxprompt attention regarding this matter will be Lone Pine,, Expenses).CA 93545 Your i p p g g (760)876-5606 appreciated. FAX(760)876-5977 INDEPENDENCE RESIDENT POST 550 S.Clay St. Victim#1: Stephen L. Tom P.o.Box"S" 6515 Alta Vista Drive Independence,CA 93526 (760)878-0395 El Cerrito, CA 94530 OLANCHA RESIDENT POST P.o.Box 2 Dates of S&R: 10/03/05 Olancha,CA 93549 (760)764-2313 DEATH VALLEY RESIDENT POST Area of S&R: Mount Whitney P.O.Box 131 Death Valley,CA 92328 (760)786-2238 Deputies and other paid personnel: $496.54 FAX(760)786-2217 Sgt. Randy Nixon SHOSHONE RESIDENT POST P.O.Box 187 Shoshone,CA 92384 (760)852-4313 FAX(760)852-4231 Helicopter used in S&R: $ CUSTODY DIVISION INYO COUNTY JAIL 550 S.Clay St. P.O.Box"S" Independence,CA 93526 (760)878-0370 FAX(760)878-0404 ✓ r j a Ja - _ °!., ,��` ,. .• �' � � f J s t i 7 dam$'e'1\ ff '.l t�,I c i',>�r ltd a°�?•�r'j/��1\ti}�1.�q'*,-,�� "�\� � ^,, J'/1t�5� '�i'� "` '/- ✓�\alt ``ria:. r .�, t t \r. � )`ti;.�� , a.��a .:a.�s�.,'t '.�,� "r ,� +°`°`r�`..r�y# l�bt�...k `k.., ;..'n4,��.'�.*�" .�-•Y�-,y �_._.-��, ,: \.. v Vehicles and Mileage: Unit#,. Total Miles 252 @.69 $173.88 -81-27 126 @.72. $ 90.72 Meals and Food for S&R Personnel: $ 88.67 Sierra Caf6, Lone Pine Equipment and Personnel Rental: Other Supplies and Items used in S&R: Sub Total: $849.81 Less CGC 26614.5 $100.00 Amount Due: $749.81 Please make your check payable to The Inyo County Sheriff's Department. Very Truly Yours, Dan Lucas She 'f Sergeant Randy N on S.A.R. Coordinator INYO COUNTY SHERIFF'S DEPARTMENT 550 SOUTH CLAY STREET CASE # CRIME OR INCIDENT REPORT INDEPENDENCE, CA 93526 (760)878-0383 05-10-010 DATE/TIME REPORTED ON-SIGHT DATE/TIME OCCURRED INVEST. AREA FROM 10/03/2005 - 1230 ❑ DATE: 10/03/2005 TIME: 1 130 o TE: 10/04/2005 TIME: 1200 ❑ 491 CRIME CODE CODE/SECTION DESCRIPTION CRIME CODE CODE/SECTION DESCRIPTION Search and Rescue z Hiking fatality M DOMESTIC TYPE FIREARM ❑ OTHER DANG.WPN ❑ DV-INF ❑ VICTIM/ CHILD DOJ ELDER OFFICER GANG DRUG HATE PC 293 VIOLENCE WEAPONWITNESS ABUSE FORM ABUSE ASSAULT RELATED RELATED CRIME ❑YES F-1 USED: KNIFE E] HANDS/FEET/ETC. ❑ DV-PRIOR ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ Cl NO LOCATION OF OCCURRENCE NUMBER DIR I STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE r O n LOCATION OF OCCURRENCE DESCRIPTION O Ice chute just east of Trail Crest, Mount Whitney. z CODE: V-VICTIM BV-BUSINESS W-WITNESS C-CONTACT RP-REPORTING PARTY P-PARENT SU-SUBJECT OI-OFFICER INVOLVED CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE V Tom, Stephen Leonard O M 45 09/07/19601 B6128254 CDL NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZiP CODE 6515 Alta Vista DR EI Cerrito - CA 94530- c� EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE RP Rishany, Dan (707) 838-7572 z M NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY .STATE I ZIP CODE N in EMPLOYER/SCHOOL/ADDRESS WORK PHONE S-SUSPECT IL-INVESTIGATIVE LEAD BKD CIT JUV I CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH HEIGHT WEIGHT HAIR EYES ❑ ❑ ❑ NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE BOOKING/CITATION# SS# DL#AND STATE HOME PHONE WORK PHONE EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA ADDITIONAL INFORMATION CONTINUED: fn C W V BKD CIT JUV CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH HEIGHT WEIGHT HAIR EYES m C.) NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE BOOKING/CITATION# SS# DL#AND STATE HOME PHONE -T WORK PHONE EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA ADDITIONAL INFORMATION CONTINUED: SUSPECT VEHICLE ST LICENSE# COLOR YEAR MAKE MODEL STYLE ADDITIONAL INFORMATION C M x SYNOPSIS On October 3, 2005 at around 1130 hours, victim Tom attempted to glissade down the ice chute east of Trail Crest, off the main trail on Mount Whitney. Tom lost control, accelerated and impacted boulders at the bottom of the 1100'+ slide. It z appeared from his injuries that he died instantly. Recovery was completed on October 4, 2005 and his remains were turned 0 over to Deputy Coroner Frank at the Lone Pine airport. U) TTS: AFS ❑ ENT NCIC ❑ ENT SPS❑ ENT SVS ❑ ENT WPS [:J ENT OTHER ❑ ENT BCST ❑ ENT [] CAN ❑ CAN ❑CAN ❑ CAN ❑ CAN AGENCY ❑ CAN CAN COPIES ❑ DET [:1 BPD ❑ MLPD ❑ ADULT PROB. ❑ DA'S OFFICE ADDITIONAL PAGES ATTACHED: ❑ ADDITIONAL NARRATIVE E] OTHER TO: F-1INETElKCSO ❑ CPS ElJUV. PROB. El BRIEFING ❑ ADD.NAMES/SUSPECTS ❑ ADDITIONAL PROPERTY ❑ COMPLAINT REQUEST ❑ CHP ❑ MCSO ROLE OTHER_(OronAr ❑ DRUG INFLUENCE ❑ P.C.DECLARATION ❑ VEHICLE REPORT REPORTING OFFICER: ID# APPROVED BY: ID# DATE: ASSIGNED TO: Sgt. R. Nixo INYO SHERIFF CRMRPTI(R. /98)RG INYO COUNTY SHERIFF'S DEPARTMENT 550 SOUTH CLAY STREET CASE # INDEPENDENCE, CA 93526 ADDITIONAL NAMES (760)878-0383 105-10-010 CODE: V-VICTIM BV-BUSINESS W-WITNESS C-CONTACT RP-REPORTING PARTY P-PARENT SU-SUBJECT -01-OFFICER INVOLVED CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE C Rowland, Bertram W M 75 06/26/1930 (650) 344-4674 NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE 1420 S Down RD Hillsburro CA 94010 EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE: NAME(LAST,FIRST,MIDDLE) RINIT SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE W Vonhoff, John M (209) 825-6036 NUMBER DIR STREET NAME TYPEUNIT ID CITY STATE I ZIP CODE EMPLOYERISCHOOL/ADDRESS WORK PHONE Alameda County Paramedic CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE 0 C Kramer, Mark W M (415) 515-8248 =4 NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE 9 Oakland CA EMPLOYER/SCHOOL/ADDRESS WORK PHONE Z M cn CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE N C Kramer, James F. W M 44 11/03/1960 C4647034 CDL (650) 556-1000 NUMBER DIR I STREET NAME - TYPE UNIT UNIT ID CITY STATE I ZIP CODE 141 Wellesley CR Apt 305 Redwood City CA 94062- EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE C Morehead, Michael M 45 02/29/1960 (707) 538-1098 NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE I ZIP CODE 4836 Glencanyon Santa Rosa CA 95495- EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE:S-SUSPECT IL-INVESTIGATIVE LEAD BKD CIT JUV CODE: NAME(LAST,FIRST MIDDLE) RACE SEX AGE DATE OF BIRTH HEIGHT WEIGHT HAIR EYES ❑ ❑ ❑ NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE BOOKING/CITATION# SS# DL#AND STATE HOME PHONE WORK PHONE EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA ADDITIONAL INFORMATION CONTINUED: BKD CIT JUV CODE: NAME(LAST,FIRST MIDDLE) UNIT RACE SEX AGE DATE OF BIRTH HEIGHT WEIGHT HAIR EYES 111:11:1 NUMBER DIR STREET NAME TYPE UNIT ID CITY STATE ZIP CODE N CAC BOOKING/CITATION# SS# OL#AND STATE HOME PHONE WORK PHONE m 0 EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA -q CA ADDITIONAL INFORMATION CONTINUED: BKD CIT JUVCODE: NAME(LAST,FIRST MIDDLE) RACE SEX AGE DATE OF BIRTH HEIGHT WEIGHT HAIR EYES NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE BOOKING/CITATION# SS# DL#AND STATE HOME PHONE WORK PHONE EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA ADDITIONAL INFORMATION CONTINUED: REPORTING OFFICER �.) D# Sgt. R. Nixon IDL_617 PAGE 2 Inyo County Sheriff AddNames(R. 4/00)RG INYO COUNTY SHERIFF'S DEPARTMENT 550 SOUTH CLAY STREET CASE # ADDITIONAL NAMES INDEPENDENCE,CA 93526 (760)878-0383 05-10-010 CODE: V-VICTIM BV-BUSINESS W-WITNESS C-CONTACT RP-REPORTING PARTY P-PARENT SU-SUBJECT 11-OFFICER INVOLVED CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE W McEntee, Michael W M 1 44 07/01/1961 (650) 966-5282 NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE I ZIP CODE 832 Running Wood CI Mountain View CA 94040- EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE W Sanderson, Jake W M 31 03/10/1974 A4501566 CDL (707)479-3342 NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE I ZIP CODE 3614 Sleepy Hollow DR Santa Rosa CA 95404- EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX I AGE I DATE OF BIRTH ID NUMBER AND TYPE PHONE C7 NUMBER DIR STREET NAME TYPE UNIT UNIT ID I CITY- STATE I—TV-dO—DE EMPLOYER/SCHOOL/ADDRESS WORK PHONE Z m Cn CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE N NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE J EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE: NAME(LAST,FIRST,MIDDLE) RACE SEX AGE DATE OF BIRTH ID NUMBER AND TYPE PHONE NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE I ZIP CODE EMPLOYER/SCHOOL/ADDRESS WORK PHONE CODE:S-SUSPECT IL-INVESTIGATIVE LEAD BKD CIT JUV CODE: NAME(LAST,FIRST MIDDLE) RACE SEX AGE DATE OF BIRTH I HEIGHT WEIGHT HAIR EYES NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE BOOKING/CITATION# SS# DL#AND STATE HOME PHONE WORK PHONE EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA ADDITIONAL INFORMATION CONTINUED: BKD CIT JUV CODE: NAME(LAST,FIRST MIDDLE) RACE SEX AGE DATE OF BIRTH HEIGHT WEIGHT HAIR EYES NUMBER DIR STREET NAME TYPE UNIT UNIT ID CITY STATE ZIP CODE CA C BOOKING/CITATION# SS# DL#ANO STATE HHONE WORK PHONE Cn OME P m n EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA Ch ADDITIONAL INFORMATION CONTINUED: BKD CIT JUVCODE: NAME(LAST,FIRST MIDDLE) RACE SEX AGE DATE OF BIRTH HEIGHT WEIGHT HAIR EYES ❑ ❑ ❑ NUMBER DIR STREET NAME TYPE I UNIT UNIT ID CITY STATE ZIP CODE BOOKING/CITATION# SS# DL#AND STATE HOME PHONE WORK PHONE EMPLOYER&ADDRESS/SCHOOL&GRADE/PLACE OF BIRTH/ADDITIONAL DESCRIPTION/AKA ADDITIONAL INFORMATION CONTINUED: REPORTING OFFICER 21"7 # Sgt. R. Nixon PAGE 3 Inyo County Sheriff AddNames( .04/00)RG INYO COUNTY SHERIFF'S DEPARTMENT F ASE # ADDITIONAL NARRATIVE 5-10-010 Iniuries: Victim Tom slid an estimated 1100' plus down a hard icy slope of over 35 degrees. He impacted large rocks at the bottom of the run-out. Upon arrival I observed Tom's torso to be twisted and contorted, with arms extended and legs slightly bent. It did not.appear that he had moved at all after coming to rest. There was a large amount of blood in his facial area and the frontal portion of his skull was deformed. Evidence: We took numerous photos of the victim and the scene. They are saved on CD and will be retained in the SAR file for seven years. Details: On October 3, 2005 at around 1230 hours I was notified there was a possibly injury on Mount Whitney. Dispatch gave me the name of Dan Rishavy. He told me that he received a text message from a friend, Jake Sanderson. The message read, "I'm O.K. but injured person below trail crest, call 911". Rishavy said he did not know any details about Sandersons trip, or his companions. He said he was unable to determine the exact date and time that the message was sent. I tried calling Sanderson's cell phone numerous times but I was unsuccessful. I contacted both the U.S. Forest Service and National Park Service, Sequoia/Kings. I learned there were no wilderness rangers in the area to investigate. I called CHP Fresno and asked if they could fly the area and look for a potential victim and they responded. When they reached the crest they were unable to descend down the east side because of 50-60 knot winds blowing over the crest. They returned to Fresno. I learned that two Forest Service Wilderness rangers were leaving the Portal and enroute to Trail Camp, and they would investigate. I also paged out the Inyo SAR team and 8 members responded. They began a hike in with medical equipment and established a command post at the Whitney Portal trailhead. At around 1430 Morehead telephoned in after having run down the trail until he obtained cellular service. He reported that a hiker had slid down the large ice chute below Trail Crest and was not moving. He said that other hikers were going to check the victim. At around 1530 hours I received information from Wilderness Ranger 42, that Vonhoff, an Alameda County paramedic, had reached the victim, and he determined the victim was deceased due to major trauma. I also learned that two other members of the victim's party had been located at Outpost Camp. They were Mark Kramer and Bert Rowland. Still missing was Mark Kramer's cousin, Jim Kramer, who had been hiking with the victim Stephen Tom. At about 1630 hours Wilderness 42 located Jim Kramer near Trail Camp. He escorted him down the trail and was to pass him on to another ranger who would see him to Lone Pine. Kramer had not been with Tom when the accident occurred. The ranger spoke to witnesses who said that Tom had attempted to glissade the large ice chute without having an iceaxe or any other equipment to self arrest. They said he lost control and impacted the rocks below. From the trail they could see that he was not moving. In speaking with one of his hiking companions, Bert Rowland, I learned that Tom did not have any experience in snow and ice conditions. On October 4, 2005 1 met CHP H-40 at Lone Pine. Two SAR members assisted me by flying into the scene. We recovered Tom's remains at 1130 hours and flew him to the Lone Pine airport. Deputy Coroner Bob Frank took possession of the body at the airport. Interview James Kramer: James Kramer told me that he and Steve Tom left their other companions at Outpost Camp and headed for the summit of Mount Whitney. While on the 99 switchbacks they met up with Michael McEntee whom they had met the night before while camped at Outpost Camp. The three hiker together because Mike's girlfriend had gone ahead towards the summit. They did not like the ice conditions beyond the cables. They had seen one subject glissade down the large chute closer to Trail Crest and discussed the possibility of glissading in order to save time during the descent. When the three reached Trail Crest they rested and McEntee and Tom had enough of the ice conditions and wanted to descend from that point and not summit. Kramer tried to get them to go with him to the summit but they decided to go down. He left'and made the summit. Later that day during his descent he reached the ice chute and decided to glissade down. He had a hard time during the glissade and did loose control near the bottom. He tumbled and hit small rocks but came to a stop without major injury. When he looked up he saw Tom's body below him on the slope. He became distressed and checked, but found that Tom was deceased. He became disoriented and wandered off. Eventually he was found by Wilderness 42 on a ledge above Trail Camp. REPORTING OFFICER: ID# Sgt. R. Nixon 617 PAGE 4 Inyo Sheriff Add Narr(R. I w98)RG INYO COUNTY SHERIFF'S DEPARTMENT CASE # ADDITIONAL NARRATIVE 105-10-010 Interview Michael McEntee: Michael McEntee met the Tom Party on October 2, 2005 when they were camped together at Outpost Camp. On October 3, 2005 he and his girlfriend Brenda left camp enroute to the summit. Brenda went on ahead and Stephen Tom and James Kramer caught up with Mike on the switchbacks. They did not have crampons, iceaxe or any protection. They carefully manuvered along the icy trail from Trail Camp to Trail Crest: He said the trail was concerning, and both he and Tom decided they did not want to continue to the summit. They did not want to have to descend the trail later, with daylight waning, and being more tired from the climb. Kramer tried to get them to continue but they declined and seperated at Trail Crest. They discussed glissading down from the switchbacks and which area would be the best. As he and Tom were descending they decided to go down the large chute. Tom had two walking poles and Mike had a large wooden "branch". They started down, Mike first. There was about six inches of soft snow covering the ice on about the upper 1/4 of the chute. He said they had to make an effort to scoot down because of the friction. As they got out of the soft snow and into more ice, they were able to slide easier. Tom was on his butt with both poles extended under h is right armpit. He was using them as a rudder and brake. Mike was using the branch, but going slower. Soon, Tom began:to speed up and he was unable to break with the poles. Mike said he was amazed how quickly Tom sped up and out of control. Tom slid, and he rolled over onto his stomach, legs downhill, and arms extended uphill. His walking poles were dragging behind him. He slid down the slope at an extremely high rate of speed. When he reached the bottom where the run-out was Mike expected him to start to slow, but he kept sliding across the lower area and into some boulders. Mike said he could hear the impact and believes some of the rocks moved from the impact. Tom was laucnched an estimated twenty feet in the air and he came to rest just beyond the rocks. Tom did not move after sliding to a stop. Mike tried to slide down to Tom but he felt he was loosing control of his slide also. Mike had a short class two years prior at Mount Shasta that taught snow and icy skills. He remembered the "self arrest' and used his branch to successfully stop. He worked his way off to the side of the chute and into some rocks. He called for help and a short time later two women descended the slope and rescued him. They climbed back to the trail and hiked down from there. Other hikers worked their way down to Tom about an hour later. They received word that Tom had died. REPORTING OFFICER: ID# Sgt. R. Nixon 617 PAGE 5 Inyo Sheriff Add Narr(R.11/98)RG INYO COUNTY SHERIFF'S DEPARTMENT CASE # ADDITIONAL NARRATIVE 05-10-010 COSTS Manpower: Sgt. R. Nixon 8 hrs ST @ 29.21 233.68 6 hrs OT @ 43.81 262.86 496.54 SAR volunteers 8 X 2hrs 16 hrs. 3 X 11 hrs 33 hrs. N/C U.S. Forest Service Rangers 2 X 12 hours N/C Air Support: CHP H-40 Fresno 7 hrs N/C N/C Mileage: Unit#8147 252 miles @ .69 173.88 Unit#8127 126 miles @ .72 90.72 264.60 Meals: Sierra Cafe, Lone Pine 88.67 Misc: -0- Total $849.81 REPORTING OFFICER: ID# Sgt. R. NixonV�L 617 PAGE-6 Inyo Sherif Add Narr(R.11/98)RG N ° r 4 W rte"' C�d Y v d U M w V m ZOO a l� � �3 �__� ``�-". I i f CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY C� BOARD ACTION: JANUARY 24/06 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), give► NOTE: CLAIM AGAINST CONTRA COSTA COUNTY Pursuant to Government Code Section 913 and "- 915.4. Please note all "Warnings". � AMOUNT: $1007000.00 91M WE DEC 2 1 2005 CLAIMANT: DANIEL ROSE ' COUNT'COUNSEL MARTINEZ CALIF DECEMBER 20 2005 ATTORNEY: PAUL J. SMOOT DATE RECEIVED: ANDERLINI, FINKELSTEIN, EMERICK & SMOOT DECEMBER 20 2005 ADDRESS: BY DELIVERY TO CLERK ON: 400 SOUTH EL CAMINO REAL, :.STE. 700 HAND DELIVERED SAN MATEO, CA 94402 BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET N rk Dated: DECEMBER. 20, 2005 By: Deputy II. FkOM: County Counsel. TO: Clerk of the Board of Supe 2sors (vrThis claim complies substantially with Sections 910 and 910.2. O 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: 1- -06 By: Deputy County Coun: 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: (tK 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:c%k»444r2.0 D JOHN SWEETEN, CLERK, By —, Deputy Clerk WARNING(Gov. code secti n 913) Subject to certain exceptions,you have only six (6) months from the date this notice was personally served or deposit 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: Vie"k.4�r � a,4OHN SWEETEN, CLERK By Deputy Clet This -w.arning" does not apply to claims which are not subject.to the California Toru Claims Act-such as actions in inverse condemnation, actions for. specific relief such as mandamus or .injunction, or Federal Civil ;Rights :. claims. The above list is not exhaustive and legal,: consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter :or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular;claim.•: ' The County of°Contra Costa does not waive an ty y of its rights under California Tort Claims Act nor does it waive rights, under the" statutes of .limitations applicable to actions not subject to the California Tort Claims Act. , r , , i JSTRUCTIONS 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, Code § 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street,Martinez, CA 94553. C. If claim is against a district governed by the Board of.Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By: Reserved for Clerk's filing stamp Daniel Rose ) RECEIVED Against the County of Contra Costa or ) 'DEC Z U 2005 District) CLERK BOARD OF SUPERVISORS CONTRA COSTA Co. (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) Please see Exhibit A 2. Where did the damage or injury occur? (Include city and county) San Ramon, Blackhawk please see Exhibit A 3. How did the damage or injury occur? (Give full details; use extra paper if required) Please see Exhibit A 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? Please see Exhibit A 5 What are the names of county or district officers, servants, or employees causing the damage or injury? Please see. Exhibit A -6. What damage or injuric_ -do your claim resulted? (Give full int of injuries or damages claimed. Attach two estimates for auto damage.) Please see Exhibit A 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Please see Exhibit A 8. Names and addresses of witnesses, doctors, and hospitals: Please see Exhibit A 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT Please see Exhibit A ) 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 ��// Old )IS Paul J. Smoot ) Anderlini, Finkelstein, (Cl ant's Signature) Emerick & Smoot ) rlini in lstein, Emerick & Smoot, 400 South E1 400 South El Camino Real ) Camino u an Mateo, CA 94402 Suite 700 San Mateo, CA 94402 ) Telephone No. 650/348-010? ) ephone No. 6 iW 348-0102 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. NOTICE: Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account voucher, or writing, is punishable either by imprisonment in the County jail for a period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), 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. Claimant: Daniel Rose 5332 Cypress Hawk Court, San Ramon, CA 94506 (925) 735-3644 Respondents: 1. County of Contra Costa Board of Supervisors 2. County of Contra Costa Sheriff's Department 3. City of San Ranson 4. San Ramon Police Department Claimant presents this claim in conformity with California Government Code 5 5 904,et seq. against the above public entities. CLAIM AMOUNT: Exceeds the jurisdictional limits of Unlimited Jurisdiction Superior Court, i.e., S100,000+ LOCATION OF VIOLATION 5332 Cypress Hawk Court, San Ramon, CA FACTUAL BACKGROUND On 6-20-05 Claimant Daniel Rose attended a "Buddy Night" event for the Hox's swim team at Blackhawk, a swim team for which his three children swim.This was a team event where alcohol was served as a fund raiser. ' Claimant arrived at the party at approximately 6:30 PM. Claimant purchased and consumed only one drink that evening. Sabryna Hughes, a friend of claimant's estranged wife, Diana Rose, saw him with a drink in hand at the event. At approximately 7:55 PM, when claimant was leaving the fundraiser,Ms.Hughes called claimant's estranged wife's cell phone and reported that claimant was leaving the party with the kids, and that lie was "Rip Roaring Drunk." Claimant arrived home with his children at approximately 8:01 PM. Upon arrival, he instructed his children to go change into their pajamas. Claimant then had a two glasses of Grand Marnier to unwind. Page 1 of 5 At 8:30 PM claimant's estranged wife,.a San Ramon police officer,claimant's father-in-law, Henry Schultzel, and three other officers came appeared in claimant's home. [As of this filing, Respondents have refused to provide the identity of two officers, a San Ramon Police Officer and a Deputy Sheriff of Contra Costa County.The two officers who have been identified are San Ramon Police Officer Echelmeier and Contra Costa County Deputy Sheriff Gray.] The San Ramon police officer stated that Diana had let him in, and he was there because a report had been made that claimant was drinking and driving with his three children in the car. The officer directed claimant to go the front of the house and did DUI testing. The officer asked-if claimant had anything to drink when claimant arrived home, and claimant responded that he had a few belts of Grand Mariner. The officer then asked to see the bottle of alcohol. Claimant walked the officer to the liquor drawer, but the bottle was gone. The officer said he didn't believe claimant and arrested claimant for DUI. Because of the contentious custody battle, claimant told the officer lie suspected lie was being set up and explained the circumstance to the officer and requested the officer search the house. At not time did the officer even seem the least bit concerned about claimant's three children and their safety and well-being, nor did he ever inquire, as confirmed in Diana Rose's deposition. That night claimant was booked on three counts of felony child endangerment and a DUI, bail was set at $300,000, and he was imprisoned in Martinez..After claimant was able to post bail, he returned home, and to his surprise the Grand Marnier bottle was in the liquor drawer. The police then made statements at claimant's Department of Motor Vehicle hearing that a complete search of the house did not uncover the Grand Marnier bottle from which claimant claimed to be drinking. The San Ramon police/Contra Costa County Sheriff have either told the District Attorney's Page 2 of 5 office,or have elected to conceal the information,but,claimant continues to be charged based upon concealment of facts known to the police and their co-conspirators. According to statements made on October 27, 2005, upon examination of claimant's estranged wife,claimant's estranged wife and in-laws and the police/sheriff's department concealed the following information at the instruction and direction of the police/sheriff's department: 1. After receiving the call claimant's estranged wife told her father, Henry SchultZCI, what Sabryna Hughes had said, and then he called the police. Claimant's father-in-law, in possession of this third hand information, called 911 and the reported that claimant was driving DUI with children in the car. 2. Pursuant to deposition testimony from claimant's estranged wife, Diana, she and her father were instructed by the San Ramon police to meet them at the end of claimant's street. 3. Arriving in separate cars, they met with the police at the end of claimant's street at approximately 8:30 PM. The San Ramon police instructed claimant's estranged wife,Diana , to go to the house and let them in so they could determine if claimant was intoxicated. (in May 2005,claimant filed for divorce,lie and Diana had become legally separated.The house they lived in is large, 7000 sq ft., so claimant moved out of the master suite and into the lower east wing, separated from the main living quarters of his estranged wife, an apartment setting, such as an au pair apartment.) The San Ramon police instructed Diana let them in this entrance to that part of the house. 4. Diana.,Schultze],and unknown San Ramon police officer and unknown Contra Costa County deputy sheriff searched claimant's home, and as she testified in her deposition, she and the officers did find the open bottle of Grand Marnier in claimant's liquor draw that night during the search. Page 3 of 5 5. Claimant has made numerous discoveryrequests through his defense counsel identifying the two unknown officers,but claimants have refused to identify the unknown officers who were with Diana Rose and accompanied her in discovering the open bottle of Grand Marnier that was concealed, based upon officer Echelmeier's testimony. ISSUES AND CONCERNS Respondents invaded claimant's home and privacy based upon third-hand, hearsay Information. Respondents conspired to illegally gain entrance to claimant's defacto apartment/"personal space" through someone, estranged spouse, without authority, real or ostensible, based upon the facts and circumstances. Respondents acted in violation of the law in that there existed no probable cause, no exigent circumstances, no citizen's arrest, no citizen's arrest papers, or other cause than conspiring to deprive claimant of his rights as a citizen and a parent. Respondents never checked on the children to determine the children's degree of well-being. Respondent was arrested for felony child endangerment, yet, respondents failed to advise him of his rights. Respondent was falsely arrested and imprisoned for felony child endangerment and drum: driving. Respondents' knowingly,and intentionally and with malice conspired to and did conceal the open Grand Marnier bottle,exculpatory evidence,and subsequently testified said bottle did not exist to the prejudice of claimant and his rights. Respondents' false testimony and concealment of exculpatory evidence,and false imprisonment has negatively and detrimentally impacted claimant's driving privileges, work/employment, living circumstance and has caused him to be held in false light in the community subject.to humiliation and derision. Page 4 of 5 Respondents' pattern and practice, through training, instruction, direction and/or conduct, permits, authorizes and condones police officers to violate rights guaranteed by the California and United States Constitutions, and did so with Claimant. Claimant's civil rights were violated under color of law by the City of San Ramon, Contra Costa County, the San Ramon Police Department, Contra Costa County Sheriff's Department and District Attorney's Office. WITNESSES: Officer Echelmeier, S.R.P.D. Unknown Officer, S.R.P.D. Dep. Sheriff Gray, Contra Costa County Unknown Dep. Sheriff, Contra Costa County Daniel Rose, Claimant Diana Rose, Claimant's estranged wife Henry Schultzel, Claimant's father-in-law Sabryna Hughes Page 5 of 5 .. , CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY C BOARD ACTION:JANUARY 24/06 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 NOTE:. CLAIM AGAINST THE SHERIFF'S DEPARTMENT 915.4. Please note all "Warnings". AMOUNT: $100,000.00 CLAIMANT: DANIEL ROSE IFD O E C 2 1 ZQ05 ATTORNEY: PAUL J. SMOOT COUNTY OOUNSEL DATE RECEIVED:" DECEMBER 20, 2005 RAIARTINEZ CALIF ANDERLINI, FINKELSTEIN,� DECEMBER 20 2005 ADDRESS: EMERICK & SMOOT BY DELIVERY TO CLERK ON: 400 SOUTH EL CAMINO REAL,' STE. 700 SAN MATEO, CA 94402 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 SW k Dated: DECEMBER 20, 2005 By: Deputy II. FkOM: County Counsel. TO:"Clerk of the Board of Supe isors 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 isnot 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: 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. „ARD ORDER: By unanimous vote of the Supervisors present: (V�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: JOHN a 4 JOHN SWEETEN, CLERK, By , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim, See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. .*For Additional Warning See Reverse Side of This"Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: Van o2�sr JOHN SWEETEN, CLERK By Deputy Clerk z This warning' does not apply to�claims. which are not.. . subject to the.California Tort Claims Act•such as actions, in inverse condemnation, actions for specific relief such As. mandamus or injunction•,,. or, Civil Rights claims: The above, list is not exhaustive and legal. consultation •is essential to.understand all the separate limitations periods that may apply. The limitations period within which suit must be 'filed may be shorter or longer depending on the nature of the,claim. Consult the specific statutes and cases applicable to your particular claim. The County of~,Contra Costa does not waive. any of it rights under California Tort Claims Act nor doea it waive rights under the statutes of limitations applicable, to t actions not subject to the 'California Tort Claims Act _ s • y u s &A V 1\V 1 V %i"^JUT it'll\1 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. 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 4553.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. RE: Claim By: Reserved for Clerk's filing stamp Daniel Rose RECEIVED Against the County of Contra Costa or ) DEC z U 2005 Sheriff Department District) CIERKBOARD OFSUPERVISORS CONTRA COSTA CO. (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) Please see Exhibit , A 2. Where did the damage or injury occur? (Include city and county) San Ramon, Blackhawk please see Exhibit A 3, How did the damage or injury occur? (Give full details; use extra paper if required) Please see Exhibit A 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? Please see Exhibit A 5 What are the names of county or district officers, servants, or employees causing the damage or injury? Please see Exhibit A 6. What damage or injuria -3o your claim resulted? (Give full int of injuries. or damages claimed. Attach two estimates for auto damage.) Please see Exhibit A 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Please see Exhibit A 8. Names and addresses of witnesses, doctors, and hospitals: Please see Exhibit A 9. List the expenditures you made on account of this accident or injury: DATE TIlv1E AMOUNT Please see Exhibit A am a%seems as amen ass 0 am amass women a Gauss a a a on goo on ass as gasses ago amass@ a a am a an"sea a am 0 a a I ) 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) ) i Name and address of Attorney Paul J. Smoot ) Anderlini, Finkelstein, (C1 ant's Signature) Emerick & Smoot ) r Fin lstein, Emerick & Smoot, 400 South E1 400 South E1 Camino Real ) ino Re San Mateo, CA 94402 Suite 700 San Mateo, CA 94402 SST— Telephone S Telephone No. 650/348-0102 ) 4eZe o. 0/348-0102 •M..................see..ago..............Mono........•.................... ..all son ■ ■l 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. NOTICE: Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account voucher, or writing, is punishable either by imprisonment in the County jail for a period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), 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. Claimant: Daniel Rose 5332 Cypress Hawk Court, San Ramon, CA 94506 (925) 735-3644 Respondents: I. County of Contra Costa Board of Supervisors 2. County of Contra Costa Sheriff's Department 3. City of San Ramon 4. San Ramon Police Department Claimant presents this claim in conformity with California Government Code 904,el seq. against the above public entities. CLAIM AMOUNT: Exceeds the jurisdictional limits of Unlimited Jurisdiction Superior Court, i.e., $100,000+ LOCATION OF VIOLATION 5332 Cypress Hawk Court, San Ramon, CA FACTUAL 13ACKGROUND On 6-20-05 Claimant Daniel Rose attended a "Buddy Night" event for the Hox's swim team at Blackhawk, a swim team for which his three children swim. This was a team event where alcohol was served as a fund raiser. Claimant arrived at the party at approximately 6:30 PM. Claimant purchased and consumed only one drink that evening. Sabryna Hughes, a friend of claimant's estranged wife, Diana Rose, saw him with a drink in hand at the event. At approximately 7:55 PM, when claimant was leaving the fundraiser, Ms. Hughes called claima»t's estranged wife's cell phone and reported that claimant was leaving the party with the,kids, and that he was "Rip Roaring Drunk." Claimant arrived home with his children at approximately 8:01 PN/1. Upon arrival, he instructed his children to go change into their pajamas. Claimant then had a two glasses of Grand Marnier to unwind. Page 1 of 5 At 8:30 PM claimant's estranged wife,a San Ramon police officer,cIaunant's father-in-law, Henry Schultze], and three other officers came appeared in claimant's home. [As of this filing, Respondents have refused to provide the identity of two officers, a San Ramon Police Officer and a Deputy Sheriff of Contra Costa County.The two officers who have been identi pied are San Ramon Police Officer Echelmeier and Contra Costa County Deputy Sheriff Gray.] The San Ramon police officer stated that Diana had let him in, and he was there because a report had been made that claimant was drinking and driving with his three children in the car. The officer directed claimant to go the front of the house and did DUI testing.The officer asked if claimant had anything to drink when claimant arrived home, and claimant responded that he had a few belts of Grand Mariner. The officer then asked to seethe.bottle of alcohol. Claimant walked the officer to the liquor drawer, but the bottle was gone. The officer said he didn't believe claimant and arrested claimant for DUI. Because of the contentious custody battle, claimant told the officer lie suspected he was being set up and explained the circumstance to the officer and requested the officer search the house. At not time did the officer even seem the least bit concerned about claimant's.three children and their safety and well-being, nor did lie ever inquire, as confirmed in Diana Rose's deposition. That night claimant was booked on three counts of felony child endangerment and a DUI, bail.was set at $300,000, and he was imprisoned in Martinez. After claimant was able to post bail, he returned home, and to his surprise the Grand Marnier bottle was in the liquor drawer. The police then made statements at claimant's Department of Motor Vehicle hearing that a complete search of the house did-not uncover the Grand Marnier bottle from which claimant clalmed to be drinking. The San Ramon police/Contra Costa County Sheriff have either told the District Attorney's Page 2 of 5 office,or have elected to conceal the information,but,claimant continues to be charged based upon concealment of facts known to the police and their co-conspirators. According to statements made on October 27, 2005, upon examination of claimant's estranged wife,claimant's estranged wife and in-laws and the police/sheriff's department concealed the following information at the instruction and direction of the police/sheriff's department: 1. After receiving the call claimant's estranged wife told her father, Henry SChLI1tZel, what Sabryna Hughes had said, and then he called the police. Claimant's father-in-law, in possession of this third hand information, called 911 and the reported that claimant was driving DUI with children in the car. 2. Pursuant to deposition testimony from claimant's estranged wife, Diana, she and her father were instructed by the San Ramon police to meet them at the end of claimant's street. 3. Arriving in separate cars, they met with the police at the end of claimant's street at approximately 8:30 PM. The San Ramon police instructed claimant's estranged wife,Diana, to go to the house and let them in so they could determine if claimant was intoxicated. (In May 2005,claimant filed for divorce,he and Diana had become legally separated.The house they lived in is large, 7000 sq ft., so claimant moved out of the master suite and into the lower east wing, separated from the main living quarters of his estranged wife, aii apartment setting, such as an au pair apartment.) The San Ramon police instructed Diana let them in this entrance to that part of the house. 4. Diana,Schultzel,and unknown San Ramon police officer and unknown Contra Costa County deputy sheriff searched claimant's home, and as she testified in her deposition, she and the officers did find the open bottle of Grand Marnier in claimant's liquor draw that night during the search. Page 3 of 5 5. Claimant has made numerous discovery requests through his defense counsel identifying the two unknown officers,but claimants have refused to identify the unknown officers who were with Diana Rose and accompanied her in discovering the open bottle of Grand Marnier that was concealed, based upon officer Echelmeier's testimony. ISSUES AND CONCERNS Respondents invaded claimant's home and privacy based upon third-hand, hearsay information. Respondents conspired to illegally gain entrance to claimant's defacto apartment/"personal space" through someone, estranged spouse, without authority, real or ostensible, based upon the facts and circumstances. Respondents acted in violation of the law in that there existed no probable cause, no exigent circumstances, no citizen's arrest, no citizen's arrest papers, or other cause than conspiring to deprive claimant of his rights as a citizen and a parent. Respondents neverchecked on the children to determine the children's degree of well-being. Respondent was arrested for felony child endangerment, yet, respondents failed to advise him of his rights. Respondent was falsely arrested and imprisoned for felony child endangerment and drunk driving. Respondents' knowingly and intentionally and with malice conspired to and did conceal the open Grand Marnier bottle,exculpatory evidence,and subsequently testified said bottle did not exist to the prejudice of claimant and his rights. Respondents' false testimony and concealment of exculpatory evidence,and false imprisonment has negatively and detrimentally impacted claimant's driving privileges, work/employment, living circumstance and has caused him to be held in false light in the community subject to humiliation and derision. Page 4 of 5 Respondents' pattern and practice, through training, instruction, direction and/or conduct, permits, authorizes and condones police officers to violate rights guaranteed by the California and United States Constitutions, and did so with Claimant. Claimant's civil rights were violated under color of law by the City of San Ramon, Contra Costa County, the San Ramon Police Department, Contra Costa County Sheriffs Department and District Attorney's Office. WITNESSES: Officer Echelneier, S.R.P.D. Unknown Officer, S.R.P.D. Dep. Sheriff Gray, Contra Costa County Unknown Dep. Sheriff, Contra Costa County Daniel Rose, Claimant Diana Rose, Claimant's estranged wife Henry Schultzel, Claimant's father-in-law Sabryna Hughes Page 5 of 5 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA'COUNTY 4. O BOARD ACTION: JANUARY 24/06 Claim Against the County, or District Governed by ) (lie 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 t Board of Supervisors. (Paragraph IV below), giv Pursuant to Government Code Section 913 and C DEC 2 1 2005 915.4.Please note all "Warnings". AMOUNT: $900,000.09 COUNTY COUNSEL MARTINEZ CALIF CLAIMANT: FRANCISCO DOMINGUEZ BK N0. 2003026991 DECEMBER 21/05 ATTORNEY: UNKNOWN DATE RECEIVED: . ADDRESS: 901 COURT STREET, BY DELIVERY TO CLERK ON: DECEMBER 21/05 MARTINEZ, CA 94553-1700 BY MAIL POSTMARKED; DECEMBER 19/05 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE k Dated: DECEMBER 21, 2005.. By: Deputy II. FkOM: County Counsel. TO: Clerk of the Board of Supe tsors W)0- P y (This clainnNcrai •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). mai { C4- (Claim is-H4 timely filed. f+esent-a late eltrint (Se tion 9 11 3) 1 _ Other: �� l e-1 ct� (fpv r (b u yi*,e I e /-d i 44, v, o ur5uaj 460V. Codd 113. e O n -6- CO CO3"-A00h-7 ' / 4-_7 Dated: By: Deputy County Cou: 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. BSJARD 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 141a a D JOHN SWEETEN, CLERK, By , Deputy Clerk ' WARNING (Gov. code sec on 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or depos in the mail to file a court action oil this claim. See Government Code Section 945.6. You may seek the advice of all attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Waiving 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 Unite( States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fu prepaid a certified copy of this Board Order acid Notice to Claimant, addressed to the claimant as shown above. Dated:'AW7 •2tq' D OHN SWEETEN, CLERK By Deputy CIS i This warning does not apply to claims which are not subject to the California Tort Claims Act-such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, or rt Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply..The limitations period within which suit must be filed maybe shorter or longer depending on the nature of the claim. Consult the specific. statutes and,cases applicable to your particular claim. The County of Contra'Costa does not waive.any of'its rights under California Tort Claims Act nor does it waive rights under the- statutes of limitations applicable to . actions not subject to the California Tort Claims Act. .t •a OFFICE OF THE COUNTY COUNSEL SILVANO B.MARCHESI COUNTY OF CONTRA COSTA .j► - ''_0�+ COUNTY COUNSEL Administration Building �,•'� - SHARON L. ANDERSON 651 Pine Street, 9 Floor a Martinez, California 94553-1229 Q' _ _ CHIEF ASSISTANT GREGORY C. HARVEY (925) 335-1800 ®� _r ;j111\\1\ =-, '�iz VALERIE J. RANCHE (925) 646-1078 (f ax) ® ' �n AssisrArrrs 0013 s't l✓ STATUTORY WARNING PURSUANT TO GOVERNMENT CODE SECTION 911.3 TO: Francisco Dominguez Martinez Detention Facility Booking No. 2003-026991 901 Court Street Martinez, CA 94553 RE: Claim of Francisco Dominguez Please Take Notice as Follows: The claim you presented to the Contra Costa County Board of Supervisors on December 19, 2005 was reviewed by County Counsel. The portion of the claim prior to June 19, 2005 was not presented within six months after the event or occurrence as required by law. Because you allege a continuing violation, the claim is "timely on its face" and will be reviewed and acted upon by the Board of Supervisors within the statutory time period. To preserve the rights of the County, its departments and employees to challenge the validity of your continuing violation claim, you are warned pursuant to statute that if your continuing violation argument is improper, your claim is late, and is being returned because it was not presented within six months after the event or occurrence as required by law. (See Gov. Code, §§ 901, 911.2.) Because the claim may not have been presented within the time allowed by law, we warn you that to preserve your right in the event your claim is determined to be late, your only recourse at this time is to apply without delay to the Contra Costa County Board of Supervisors for leave to present a late claim. (See Gov. Code, §§ 911.4 to 912.2, inclusive, and 946.6.) Under some circumstances, leave to present a late claim will be granted. (See Gov. Code, § 911.6.) Page 1 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. MARCHER COUNTY COUNSEL Monika L. Cooper Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (Code Civ. Proc., §§ 1012, 1013a, 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. I served a true copy of this Statutory Warning Pursuant to Government Code S�eti n� y placing the document in a sealed envelope with postage thereon fully prepaid, in the United States mail at Martinez, California addressed to Francisco Dominguez,Martinez Detention Facility,Booking No. 2003-026991, 901 Court Street,Martinez, CA 94553, 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/ at Martinez, California. Kathleen O'Connell cc: Clerk of the Board of Supervisors (original) Risk Management Page 2 t. 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 one 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 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 FRASC-1560 DOMINGu64- ) ) RECEIVED Against the County of Contra Costa or ) DEC 2 1 2005 EtpurX S FIERI FF J• u�Ih , District) CLERK BOARD Of SUPERVISORS (Fill in the name) ) CONTRA COSTA co. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ a0 Q,000-W and in support of this claim represents as follows: . 1. When did the damage or injury occur? (Give exact date and hour) Fri 'Peb s, zooy +�rov0tI $-A- 4resc iI 7f-, 2. Where did the damage orinjury occur? (Include city and county) AT Ma,+ i✓fez, Deml! 4jo- I Fac J1 -1 ltlay4itie-z, Ck 3. How did the damage or injury occur? (Give full details; use extra paper if required) By be►nj depr►w.� o� 4- Foals reeled 4-o frePave >M1,1 derma, a,J ®b alvt >.^y �rQe�.ow. 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? See. A-- acke, , 5 What are the names of county or district officers, servants, or employees causing the damage or injury? apAy SherIrv- 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) .see. A4?,c, cd 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) awlbu--;� o� 8. Names and addresses of witnesses, doctors, and hospitals: None 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT FROM TR& DAY OF My 1 Nc 4RcE RA no-N Td roe, PRESENT. go N Much 1-5 I CIO WORTH Tyg zxPENDI7°URd' MAZE ON VHS l-N.SvRy Is N1H FRbEDOM, ■.......................s...■o■eaaeeme■o........■e....■.......................OWN..NMI ) 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 ) PrD Cee ) (Claimant's Signature) om I 0,0,� <s4yecl (Address) Telephone No. Telephone No. ft 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 Acta(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. .................Noun.................................■.anon..a..e...........aamNone# NOTICE: Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account voucher, or writing; is punishable either by imprisonment in the County jail for a period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), 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. 80AR. r) OF SUPERNISOK5 OF CD N M i+ CM T14 CSL `! IN S T-R U c TJONS C LA-1_NA a L6�1�2r�� L a'y1 o� M z i�►V}a � z �(I�A �� 3 A ex Ica d 1' r►�a�le-� o �1¢�__o��L l�n�l-tel e4e� , m��, l. bgC2&lSc- Je42rivalitii o-� ja ea d unnesecmnc/� _YAQ- a v7Cnb� --71,law los O dad- I ll� 1 C�iY► y �Ge unmaio re� CA ,_ Ll 8,j k V„W • -'Qet o' N �O .�Xil�U[t z° t 0 1 61 ma CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY of BOARD ACTION: JANUARY 24/06 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), giv Tra L?a / Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DEC 2 3 2005 AMOUNT: $948.19 COUNTY COUNSEL MARTINEZ CALIF. CLAIMANT: PAUL.u. SEQUEIRA ATTORNEY: UNKNOWN DATE RECEIVED: DECEMBER 22/05 ADDRESS: 4th FLOOR COURTHOUSE, BY DELIVERY TO CLERK ON: DECEMBER 22/05 OFFICE OF DISTRICT ATTORNEY MARTINEZ, CA 94553. BY MAIL POSTMARKED: DECEMBER 22/05 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. . JOHN SW T Jerk Dated: DECEMBER 22, 2005 By: Deputy II. FROM: County Counsel. TO: Clerk of the Board of Supervisors (/This claim complies substantially with Sections 910 and 910.2. O 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). O 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: By: Deputy County Cou. 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: (� This Claim is rejected in full. O Other: I certify that this is a true and correctcopy of the Board's Order entered in its minutes for this date. Dated:\4V7 0-, o2 6 OHN 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 depos 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 1 declare wider penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the Unitec States, over age 18; mid that today I deposited in the United States Postal Service in Martinez, California, postage fu prepaid a certified copy of this Board Order and Notice to Claimant; addressed to the claimant as shown above. Dated:4-n w±Ay SWEETEN, CLERK By Deputy CIS 1 . This warning does not apply to claims which are not subject to the California Tort Claims Act-such as actions in inverse condemnation, actions for. specific relief such as mandamus or injunction, orf Federal Civil Rights claims. The above list is not exhaustive and legal. consultation is essential to understand all the separate limitations periods that may apply.The limitations period wjthin which suit must be filed may be.shorter or longer depending on the nature of the claim. Consult the specific statutes and cases applicable to your particular'claim. The County of Contra Costa does not waive.any of its rights under California Tort Claims Act nor does it waive'` rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act. t 1 t BOARD OF SUPERVISORS OF CONTRA COS'T'A 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. Code § 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street,Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. ■saesa ®a®eae®aata®aea■aaases.roneea.aeacaaaaa.ao.. ....■......aoe¢eaaaeaaeece ®t RE: Clain By,- Reserved for Clerk's filing stamp RECEIVED DEC 2 2005 Against the County of Contra Costa or ) CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. District) (Fill in the name) ) The undersigned claim reb makes claim against the County of Contra Costa or the above-named district in the sum of$ and in support of this claim represents as follows: 1. When did r/Z;n7or injury occur? (Give exact date and hour) � 2. �Wln�re did the damage �injury occur? (In nude cit�T nd�tS,) U ( AV ow did th d nage or injury occ ? (Give full e , u e aperi 4 What partic ar act or omission e p of coon 1 district ers servants o 10 s c used he 'ury or a 4W - . .e Gni l/fo ! S What are the names of co or district off ers, servant , mployees causing th damage or injury? )r)', 6. What damage or injuries do your claim resulted? ((:Jive full extent of injuries or damages claimed. ttach two estimates for auto damage.) �—� 7. How was the he t claiuned above co puted? (Include the estimated amount of any prospective injury or damage. 8. Naives and addresses ofvtTitiie es, doctors, and hospitals: 1 � /a' 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT amammaaammaanammamasRamona aasaamoaa■■aa■mmmaa■maaaa■a¢¢aaamamamaaeeasaaas aaaamaammami ) .Gov. Code Sec. 910.2 provides "The claim shall be ) signed by the claim by some person on his behalf." SEND NOTICES TO: (Attorney) 1 Name and address of Attorney4.4 ) (U1WhanVS1gnA0e Is AI } (Address) ) S� ) Telephone No. ) Telephone No. ■aaaa®maaaa9aamaaaavaaaaaaaamaaamaaavaaaaaaaaeeaaaaaamsaaaaamaaaaaaaamaaaaaaaaaaama.. 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. saaa¢aaaaamaaaaaaamamaa0aaaaa■aaaa5a8aa0aaaaaaaaaa2aaaaaaaa0aa0a■aaaaaaaaaaaa0aaa9aaI NOTICE: Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account voucher, or writing, is punishable either by imprisonment in the County jail for a ,period of not more than one year, by a fine of not exceedu1g one thousand dollars ($1,000.00), or by both such imprisomnent and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000), or by both such iinprisorunent and fine. 12./21/2005 at 04 :29 PM Job Number: • 74446 G & C AUTOBODY License #:AC220804 ..Federal ID #: 680271452 896 Lakeville St. Petaluma, CA 94952 (707) 762-7556 Fax.: (707) 762-2910 PRELIMINARY ESTIMATE Written By: DAN FLORES Adjuster: Insured: PAUL SEQUEIRA Claim # Owner: PAUL SEQUEIRA Policy # Address: 233 METZ LN Deductible: PETALUMA, CA 94952 Date of Loss: Business: (925) 957-2220 Type of Loss: Point of Impact: 11.. Left Front Inspect G & C AUTOBODY Business: (707) 762-.7556 Location: 896 Lakeville St. R Petaluma, CA 94952 Insurance Company: Days to Repair 1994 INFI Q45 8-4 . 5L-FI 4D SED BLACK Int : VIN: JNKNG01D6RM251533 Lic: 4CUV966 CA Prod Date: Odometer: UNK Air Conditioning Rear Defogger Tilt Wheel Cruise Control Telescopic Wheel Intermittent Wipers Climate Control Keyless Entry Theft Deterrent/Alarm Tinted Glass Body Side Moldings Dual Mirrors Electric Glass Sunroof Clear Coat Paint Power Steering Power Brakes Power Windows Power Locks Power Driver Seat Power Passenger Seat Power Antenna Power Mirrors Power Trunk/Tailgate AM Radio FM Radio Stereo Cassette Search/Seek Equalizer BOSE Radio Anti-Lock Brakes (4) Driver Air Bag Passenger Air Bag 4 Wheel Disc Brakes Positraction Leather Seats Bucket Seats Recline/Lounge Seats Automatic Transmission Overdrive Aluminum/Alloy Wheels ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 1 FRONT BUMPER 2* Rpr Bumper cover (Spot & Blend) 1 . 0 2 . 2 3* Add for Clear Coat 1 . 0 4 O/H front bumper 3 . 0 5 Repl Molding from 1/94 1 103 . 71 Incl . 6 R&I License bracket 0 .2 7# Rpr Color tint 0 .5 8# Subl Hazardous waste 1 10 . 00 X 9# Repl Flex Additive 1 7 . 95 T i 1 i 12/21/2005 at 04 :29 PM Job Number: 74446 PRELIMINARY ESTIMATE 1994 INFI Q45 8-4 .5L-FI 4D SED BLACK Int: ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 10# Rpr De-nib & Polish 0 . 5 ------------------------------------------------------------------------------- Subtotals =_> 121.66 5 .2 3 . 2 Parts 103 .71 Body Labor 5 .2 hrs @ $ 83 . 00/hr 431.60 Paint Labor 3 .2 hrs @ $ 83 . 00/hr 265 . 60 Paint Supplies 3 .2 hrs @ $ 35 . 00/hr 112 . 00 Sublet/Misc. 17 . 95 ---------------------------------------------------- SUBTOTAL $ 930 . 86 Sales Tax $ 223 .66 @ 7 .7500% 17 .33 ---------------------------------------------------- GRAND TOTAL $ 948 . 19 FOR YOUR PROTECTION CALIFORNIA LAW REQUIRES THE FOLLOWING TO APPEAR ON THIS FORM: ANY PERSON WHO KNOWINGLY PRESENTS FALSE OR FRAUDULENT CLAIM FOR THE PAYMENT OF A LOSS IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN STATE PRISON. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES: B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS: ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT O/H=OVERHAUL OP=OPERATION NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY REPLACEMENT PART COMP REPL PARTS=COMPETITIVE REPLACEMENT PARTS RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT W/_=WITH/_ SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE. .MOTORS DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NOTES ATTACHED TO LINE. MQVP=MANUFACTURER- S QUALIFICATION AND VALIDATION PROGRAM. OPT OEM=ORIGINAL EQUIPMENT MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR -OTHERWISE PROVIDED WITH SOME UNIQUE PRICING OR DISCOUNT. 2 12/21/2005 at 04 :29 PM Job Number: 74446 PRELIMINARY ESTIMATE 1994 INFI Q45 8-4 . 5L-FI 4D SED BLACK Int: Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the Guide AEA3815 Database Date 12/2005, CCC Data Date 12/2005, and the parts selected are OEM-parts manufactured by the vehicles Original Equipment Manufacturer. OEM parts are available at OE/Vehicle dealerships. OPT OEM (Optional OEM) parts are OEM parts that may be provided by or through alternate sources other than the OE/Vehicle dealerships. OPT OEM parts may reflect some specific, special, or unique pricing or discount. Asterisk (*) or Double Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have been modified or may have come from an alternate data source. Tilde sign (-) items indicate MOTOR Not-Included Labor operations. Non-Original Equipment Manufacturer aftermarket parts are described as AM, Qual Repl Parts or Comp Repl Parts which stands for Competitive Replacement Parts. Used parts are described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recon. Recored parts are described as Recore. NAGS Part Numbers and Prices are provided by National Auto Glass Specifications, Inc. Pound sign M items indicate manual entries. Some 2006 vehicles contain minor changes from the previous year. For those vehicles, prior to receiving updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The Pathways estimator has a complete list of applicable vehicles. Parts numbers and prices should be confirmed with the local dealership. CCC Pathways - A product of CCC Information Services Inc. 3 12/21/2005 at 04 :29 PM Job Number: '74446 PRELIMINARY ESTIMATE 1994 INFI Q45 8-4 . 5L-FI 4D SED BLACK Int : ALTERNATE PARTS USAGE AFTERMARKET PARTS Aftermarket Selection Method: Manually List No. of times user was notified that an Aftermarket part was available: 1 No. of Aftermarket parts that appear in the final estimate: 0 4 a CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JANUARY 24/06" 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), giv Pursuant to Government Code Section 913 and DEC 2 3 2005 915.4. Please note all "Warnings". ANIOUNT: $2,266.48 COUNTY COUNSEL IVIARTINEZ CALIF. CLAIMANT: CRYSTAL BISCAY ATTORNEY: UNKNOWN DATE RECEIVED: DECEMBER 23/05 ADDRESS: 2055 NOIkE DRIVE, APT. 15 BY DELIVERY TO CLERK ON: DECEMBER 23/05 PLEASANT HILL, CA 94523 RECEIVED FROM RIS! BY MAIL POSTMARKED: MANAGEMENT FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DECEMBER 23 2005.. JOHN SWEETS C er Dated: ' By: Deputy II. FkOM: County Counsel. . TO: Clerk of the Board of Supervisors O This claim complies substantially with Sections 910 and 910.2. (VYThis 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). O 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: 1 --t9 By: Deputy County Cou. 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. 3OARD ORDER: By unanimous vote of the Supervisors present: (tef 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: -X 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 depos in the mail to 61e 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 Unite( States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fu prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. 57 Dated: r��' °� O JOHN SWEETEN, CLERK By Deputy CIS , This warning' does not apply to claims which are not subject to the California Tort Claims Act-such as actions in inverse condemnation, actions for specific relief such as mandamus or injunction, orf Federal Civil Rights claims. The above list is not exhaustive and legal consultation is essential to understand all the separate limitations periods that may apply. The limitations period within which suit must be filed may be shorter or longer depending on the nature of the claim. Consult the specific. statutes. and.,cases applicable to your particular'claim. The County of Contra Costa does not waive.any of its rights under California Tort Claims Act nor does it waive rights under the statutes of limitations applicable • to actions not subject to the California Tort Claims Act. k •� '"ry h •Kik 3 b`,'4:i ' ` •••y �' ' AI . jrr_.} ` . i.J til -.':L. OFFICE OF THE COUNTY COUNSEL 6E L SILVANO B. MARCHESI COUNTY OF CONTRA COSTACOUNTY COUNSEL Administration Building % -_ .� 651 Pine Street, 9th Floor _ ^ SHARON L. ANDERSON Martinez, California 94553-1229 A: + CHIEF ASSISTANT --_ n� �a d111,"� �:4 GREGORY C. HARVEY (925) 335-1800 VALERIE J. RANCHE (925) 646-1078 (fax) ASSISTANTS .... a O COS7A_COlu V� NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Crystal Biscay 2055 Norse Drive, Apt. 15 Pleasant Hill, CA 94523 RE: CLAIM OF: CRYSTAL BISCAY 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 Govermnent Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: [ ] I. The claim fails to state the name and post office address of the claimant. [ ] 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [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. [ ] 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 ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. [ ] 6. The claim is not signed by the claimant or by some person on his or her behalf. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. A claim relating to a cause of action for death or for injury to person or to personal property or growing crops shall be presented not later than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be presented not later than one year . after the accrual of the cause of action. (Gov. Code § 911.2.) B. Claims must be filed with the Cleric of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street,Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the naive of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. ■■ssrsu ssssasaaaasssssssaassssassssassssassssone sssaaasa-ssssasesssassIatastssa RE: Clain By: Reserved for Clerk's filing stamp Ctc cl RECEIVED Against the County of Contra Costa or ) DEC Z 3 2005 District) ill in the name CLERK BOARD OF SUPERVISORS ) ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ 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? �v 0X\ IAo cu'c. 5 What are the names of county or district officers, servants, or employees causing the damage or injury? 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages claiined. 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: DATE TIIVM AMOUNT .........................................................................mown.......I ) .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 ) - (Cl ' is Signature) �5dr (Address) Telephone No. }Telephone No. �2Z ....................mom...............mom was...........nos man....a.......man........i 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.) Furthennore, any attachments,addendums, or supplements attached to the claim form, including medical records, are also subject to public disclosure. ■ ■..................mown ..■a.■.....■■................■■...........t......... .mom momek NOTICE: Section 72 of the Penal Code provides: Every person who, with intent to defraud,presents for allowance or for payment to any state board or officer, or to any county, city, or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account voucher, or writing, is punishable either by imprisonment in the County jail for a period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), 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. ea(- uO09, (No{ Swo ov\ W� opt- havj s1k) , Tv\,-t k,%14 Com A-C VO A sA-Or. I Mc- kPt'-C b c� �� due , end K� ,-- uy-ec- � ;r, iK OY�" -L A& G)MV �n ujwv� VIII(c ay\j 411 4y- �XL Wt, f�tW N6f t-D Date: 12112/05 11:37 AM Estimate ID: 3787 Estimate Version: 0 Preliminary _ Profile ID: PACIFIC r: PACIFIC BODY W®RXIE"S 760 SAN PABLO AVENUERINOLE,CA 94564 (510)724-8482 Fax: (510)724-6732 BAR#: AA115196 EPA#: CAD981445943 Damage Assessed By: CLAY KUNTZ Deductible: UNKNOWN Owner CRYSTAL BISCAY Address: 16401 SAN PABLO AVE SP 129 SAN PABLO,CA 94806 Telephone: Work Phone: (925)629-4249 Home Phone: (925)429-2533 Mitchell Service: 910101 Description: 1997 Saturn SC2 Vehicle Production Date: 3197 Body Style: 2D Cpe Drive Train: 1.9L Inj 4 Cyl A VIN: 1GBZH1270VZ325275 License: 3VOT205 CA Options: ALUM/ALLOY WHEELS,AIR CONDITIONING,POWER STEERING,POWER WINDOWS -POWER DOOR LOCKS,TILT STEERING WHEEL,CRUISE CONTROL,ELECTRIC DEFOGGER AUTOMATIC TRANSMISSION,AM-FM STEREO/CDPLAYER(SINGLE) ALL CRASH PARTS ON THIS ESTIMATE ARE "NEW" ORIGINAL EQUIPMENT MANUFACTURER PARTS, UNLESS OTHERWISE SPECIFIED. PARTS DESCRIBED AS RECHROMED, RECORED, REMANUFACTURED OR RECONDITIONED ARE CONSIDERED "REBUILT" PARTS. CRASH PARTS DESCRIBED AS "QUALITY REPLACEMENT PART" ARE NON—ORIGINAL EQUIPMENT MANUFACTURER AFTERMARKET NEW PARTS. Line Entry Labor Line Item Part Type/ Dollar "'•1:abor Item -dumber -Type Operation Description Part Number Amount ?Units 1 000012 BDY REMOVEIINSTALL FRT BUMPER ASSY ,;'1:0"# 2 000034 BDY REMOVE/INSTALL R FRT COMBINATION LAMP INC # 3 000147 BDY REPAIR R FENDER PANEL Existing 1.0*# 4 AUTO REF REFINISH R FENDER OUTSIDE C 2.5 5 000149 BDY REMOVEIINSTALL R FENDER EMBLEM Existing 0.2*# 6 000281 BDY REMOVE/REPLACE WHEEL 21013039 268.83 0.3 7 900500 BDY* ALIGN FRT SUSP Sublet 69.95* 0.0* 8 000667 BDY REMOVE/INSTALL R FRT DOOR OUTER PANEL 0.9 # 9 000671 BDY REPAIR R FRT DOOR REPAIR PANEL Existing 2.5*# 10 AUTO REF REFINISH R FRT DOOR OUTSIDE C 2.0 11 000681 BDY REMOVE/INSTALL R FRT OTR BELT MOULDING INC # 12 000683 BDY REMOVE/INSTALL R FRT REAR VIEW MIRROR INC 13 001402 BDY REPAIR R QUARTER PANEL Existing 1.5*# 14 AUTO REF REFINISH R QUARTER PANEL OUTSIDE C 1.9 15 001126 BDY REMOVE(INSTALL R REAR COMBINATION LAMP 0.3 16 001152 BDY REMOVE/INSTALL REAR BUMPER COVER 0.6 17 001155 BDY REPAIR REAR BUMPER COVER Existing 1.0* 18 AUTO REF REFINISH REAR BUMPER COVER C 2.5 ESTIMATE RECALL NUMBER: 1211210511:37:07 3787 UltraMate is a Trademark of Mitchell International Mitchell Data Version: NOV_05—A Copyright(C)1994-2003 Mitchell International Page 1 of 2 UltraMate Version: 5.0.212 All Rights Reserved Date: 12/12/05 11:37 AM -Estimate-ld: 3787 Estimate Version: 0 Preliminary Profile ID: PACIFIC 19 436012 ADD'L COST HAZARDOUS WASTE DISPOSAL 5.00' -20 ,f AUTO REF ADD'L OPR CLEAR COAT 2.3 21 ,, 933017 REF ADD'L OPR COLOR SAND&BUFF 1.5* 22 933018 REF ADD'L OPR MASK FOR OVERSPRAY 5.00* 0.2* 23 AUTO ADD'L COST_ __. _ PAINTlMATERIALS 336.00* * -Judgement Item #-Labor Note Applies C-Included in Clear Coat Calc Add'I Labor Sublet I. Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 9.3 69.00 0.00 59.95 711.65 Taxable Parts 268.83 Refinish 12.9 69.00 5.00 0.00 895.10 Sales Tax @ 8.250% 22.18 Non-Taxable Labor 1,606.75 Total Replacement Parts Amount 291.01 Labor Summary 22.2 1,606.75 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 336.00 Customer Responsibility 0.00 Sales Tax @ 8.250% 27.72 Non-Taxable Costs 5.00 Total Additional Costs 368.72 1. Total Labor: 1,606.75 U. Total Replacement Parts: 291101 III. Total Additional Costs: 368.72 Gross Total: 2,266.48 IV. Total Adjustments: - '0.00 Net Total: 2,266.48 This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair. ESTIMATE RECALL NUMBER: 1211210511:37:07 3787 UltraMate is a Trademark of Mitchell International Mitchell Data Version: NOV_05_A Copyright(C)1994-2003 Mitchell International Page 2 of 2 UltraMate Version: 5.0.212 All Rights Reserved