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Home My WebLink AboutMINUTES - 12162008 - C.30 (5) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: DECEMBER,16, 2008 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 California Government Codes. ) you is your notice of the action taken All on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code AMOUNT: $670.00 �6 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: RONALD DABNEY N0V 2 5 2008 COUNTMUNSEL ATTORNEY: UNKNOWN NOVEMBER 25, 2008 MpFtTINEZ��$RECEIVED:. ADDRESS: 4331 REEDLAND CIRCLE BY DELIVERY TO CLERK ON; NOVEMBER 25, 2008 ,SAN RAMON, CA 94582 <7 BY MAIL POSTMARKED: RECEIVED FROM.RISK FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DAVID TWA, Cler Dated: NOVEMBER 25, 2008 By: Deputy Il, FROM: County Counsel TO: Clerk of the Board of Sup isors (V)"This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). ( ) Other: Dated: 12" 1 "�� By: M g::_ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim4 returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated.-Aa DAVID TWA, CLERK, By eputy Clerk WARNING (66. code section 913) Subject to certain exceptions,you have only sic(6)months from the date this notice was personally served or deposited in the mairto lite 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%�-, DAVID TWA, CLERK, By -Heputy Clerk 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 legalrr consultation is essentia.l,to understaiid all the separate limitations periods that'`inay apply, The limitations period within which suit must be filed may be shorter or lon'ger.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 -->,�.w�knor'•dpes it waive rights under the statutes of limitations applicable to actions not subject to the California Tort Claims Act I ,R BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAMANT A claim relating to a cause of action for death or for injury to person or to personal Property or gro-wing 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.) Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street•,Marrdnnez, CA 94553. 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- If the claim is against more than one public entity, separate claims must be filed against each. public entity. Fraud. See penalty for fraudulent claims,Penal Code Sec.72 at the end of this form. ■rlrr/rrlrrlr[[[[It[ C Q EQr C[r[rr[rr(■rrrir[l[[[[[t E: Claim By: Reserved for Clerk's filing stamp PE? Qb 0 nLD Lo fta�N Cz1! ) Nov 2 yeai/�,y RECEiVE0 4 20 9 ,,gainst the County of Contra Costa or ) NOV 2 5 2008 CLERK BOA- 11D CONTRA COs A CoVISO Fill in.the name) ) Rs rhe undersigned claimant hereby makes claim against the County of Contra Costa or the above-named 3istriet in the sum of$ L-7 c). O Q and in support of this claim represents as follows: L When did the damage or injury occur? (Give inct date and hour) 2. Where did the damage or injury occur? (include city and county) kgk' Cb J f IZ_y M'IR-(ZT i�► f� �� 3. How did the damage or injury occur? (Give full details;use extra paper if required) Ccs SNSI.c� O vAT v F 17�e c V�rLY ��uSfi, RR�C� 1G LOT Y-N-NO VA-i' 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? ►� eoe,\-Ns�-Lo Q V�)r l OtsC-CA rz&y N0�.s`z 5 What are the names of county or district officers, servants,, or employees causing the damage or injury? What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed 'Attach-two estimates for auto damage,) o�-OTMED I&LC,4tis(Zo f P4s,TL A How was the amount claimed above computed? (Include the estimated amount of any prospective injury or daagage.) Names and addresses of witnesses, doctors, and hospitals: U ��1011 (0, i-r. oc)fA OKi�l >\tG- t �fz cdv` i.�TY �1F�1� �. List the expenditures you made on account of this accident or injury: kS CO t(�1�� d�$ILI DATE ME •AMOUNT 8 3 - ��- �� vm '�Z5 6o Ia,aaaaaeea,aeaoil oil eaaaasa aaa!,a aaaau aateaaaaaa a■aaaaasaaa■Kattaaaata■aaataa■aaeaaal .Gov. Code Sec. 910.2 provides"The claim shall be signed by the claimant or by some person on his behalLn ,SEND NOTICES TO: (Attorney) Name and address of Attorney (Claimant's Si ) } (Address �f 331 zv;� ,,\C�N o C,i YLCLr 5gtit fzA om e�V�- C1u9 R2- Telephone No. )Telephone No. �(Z�' �7�.1 - L133'7 Kanas as we taatasaalfa■s a ca o f as a a a a ttaaaERE aa a a a as t o ata a as a a a a as a s at as s IF amp as t It s as ass 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, s"§ 6500 et seq.) Furthermore, any attachments,addendums, or supplernents attached to the claim form, including medical records, are also subject to public disclosure. ■ ■aataaaaaa■aaaaataaaatataask aKaata■aaaaaaaaaataaaaataa■a■man tataaaaaaaasataaaaaaaan NOTICE: Section 71 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 distdi t 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 tine County jail for a period of not more than one year, by a fine of not exceeding one thousand dollars ($1,00D.00), or by both sucb imprisonment and fine, or by imprisonment in the state prison, by a fine of not exca-eding ten thousand dollars or by both such imprisonment and fine. T' :Z: --_..�-may [. c : c,-u r...;' F '+ ♦ -�._,r•-;H.c_,_�... a. _. c -_r--� F._ a_'�... ,..-.. F.._ ,�—y F'j-'cr,°%. s. .,.•...,.F .,_r. ...� ,.i Commay Auto Bod NAME • ..�j I REPAIR ORDER ,ann cgs n - t CITY n STATE zap WORK PHONE EST.COMPLETION DATE ESTIMATE DATE14L44SC, Y wruKooEl _ jC' ll. .IL ESTIMATOR UCENSHSTOCK NO. STATE NN 875 Howe Road - DATE M DATE° ❑ INS O �E 6 OWARRAN Y Martinez, CA 94553PAIN LD , RF _ For Tow:Jesus For Auto Body:Jorge MIS IN: OUT: Cell(925)366-4922 Cell(925)231-5614 SURFACE PREPARATION ESIDE AL PAINT SFf VICES T �I,r ;t � � Pte,o7 PROTECTION PACKAGES AAg NAL CHARGES �-f er, ✓ OTHER PAINT OPTIONS .PAINT COMMENTS - SURFACE - RECONDITIONIEa N - - 1 �&i�;b d a ESH Certifie - ' CUSTOMER'S OWN BODYWORK NO WARRANTY t! -.2' �A/NTaBODY Craig Rowley F— ;h 2' Te 1: Manager 925-609-7780 Fax: 925-609-7781 2130 Market Street Concord, CA 94320 O.OD / .0.00 0.00 0.00 �' ✓�l �� j 0.00 O'Neal's ,. Body Shop ES T. Cbl( JEFF HUNTLEY g owner 895 Howe Rd. H Martinez, CA 94553 I Phone(925)228-6410 FAX #(925) 228-6505 I A Full spectrum Of Service And Experience - I s 0 DISCOVERY HO?.ISE _ 4645 PACHECO -.'SID. ; MARTINEZ, CA 34553-3625 MAILING ADDRESS QV P BOX 1109011 MARTINEZ, CA. 94553-0110 cq P7 (�c, Contra Gounty Administrator Costa Risk Management Division 2530 Arnold Drive,Suite 140County Liability Claims (925)335-1440 Martinez,California 94553 Fax Nu sr t,„`,,.,,<� (932%ry5) - 421 EA S�•i. ]�UEIVED Q REGE@VED ~ NOV 2 5 2008 LNV 2 5 2:0�8 1, s CLEW BOARD 0FSUPERVIS0RS CONTRA COSTA CO. CLERK 80kilD OF SUPERVISORS CONTRA COSTA CO. Penny Bailey MEMORANDUM NOV 2 4 2008 TO: EMY SHARP, CLERK OF THE BOARD FROM: CAO/RISK MANAGEMENT DIVISION - LIABILITY UNIT ATTACHED MAIL RECEIVED AT RISK MANAGEMENT DIVISION: VIA MAIL ( ) VIA FAX ( ) DROPPED OFF WITH RECEPTIONIST )