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HomeMy WebLinkAboutMINUTES - 12092008 - C21 (8) ' CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: DECEMBER 09, 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 Calif rnia Government Codes. 12 a you is your notice of the action taken on your claim by the Board of NOV 0 q 2Q08 Supervisors. (Paragraph IV below), . given Pursuant to Government Code COUNTY COUNSEL Section 913 and 915.4. Please note all AMOUNT: $500,000.00 MARTINEZ CALIF, "Warnings". CLAIMANT' DEBRA A. ZAVALA ATTORNEY: MARGARET L. KIRBY DATE RECEIVED:. NOVEMBER, 06, 2008 KIRBY, KIRBY AND KIRBY` NOVEMBER 06, 2008 AD�RESS: 2614 ARTESIA BOULEVARD BY DELIVERY TO CLERK ON: REWNW BEACH, ca 90278 NOVEMBER 03; 2008 BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO.- County Counsel Attached is a copy.of the above-noted claim. DAVID TWA, Cler Dat d: NOVEMBER 06, 2008 . By: Deputy II. PROM: County Counsel TO: Clerk of the Board of Sup&visois ( s claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply. substantially with Sections 910 and 910.2, and we are so notifying claimant. , 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). (Other: The/ C D o yi+4 ©� C co rl -r C—0&..+ZzL J oeSY104- W r-). C. O/ 4?1-e f 0 / /1)Q 1✓1�C/// DW4 M- 9ad By: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) O Claim'was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. m��AVID TWA, CLERK, By _ Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptiones,you have only six(6)months from the date this notice was personally served or eposited in the mail to file a court action on this claim.See Government Code Section 945.6.You may s the advice of an attorney of your choice in-connection with this matter.If you want to consult an a ey,you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AF IDAVIT OF MAILING I d Clare under penalty of perjury that I am now, and at all times herein mentioned, have bee a citizen of the United States, over age 18; and that today I deposited in the United Sta es 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. Dat eod&,P,6&� .o .?i3OPAVID TWA, CLERK, By Deputy Clerk y f This warning does riot apply to claims which are not subject to the California Tort Claims Act such as actions-ininverse condemnation, actions for specific relief such as=mandamus or injunction, or Federal;CivilRights 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 I - '•`•S;" ",i 'c.-11.1+ `i .\C,�C :•,.�%r'�ti� BOARD OF StPER'VISORS 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. Boor rrrrrrrrrur■■rrru urrr■rr rrrrrrrr■r■rru urrrrr■a rrr■rrrrrrrr rrr■ ru rr r� RE: Claim By: Reserved for Clerk's filing stamp Debra A. Zavala ) RECEIVE® Against the County of Contra Costa or ) District) NOV O 6 2008 (Fill in the name) ) CLERK BOk8D 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) May 24, 2008 11:15 a.m. 2. Where did the damage or injury occur? (Include city and county) Highway 4 E/B at or near Port Chicago Exit, Concord, California 3. How did the damage or injury occur? (Give full details; use extra paper if required) plaintiff's motor- cycle tire became embedded in a divet which was created when. the #1 lane was paved but the left fog line was several inches to the left of the unpaved area. 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? The fog line should not have been painted to the left of pavement creating a divet and giving the motorist the false sense of security in believing that the roadway was paved all the way up to the painted fog line. 5 What are the names of county or district officers, servants, or employees causing the damage or injury? . Unknown at .this time, however, the Department charged with the responsibility of roadway repair and maintenance in this area. 6: What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) fracture in left ankle, fractured right wrist, right shoulder injury, neck injury and damage to motorcycle. 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 TIME AMOUNT 5-28-08 $1,273.19 Ambulance Bill t 5-28-08 Hospital Bill me on NOR a%aaara No ao'Cg a 0 Y COGGC00009a9isao aG-0Oa aao Clea G9a aG9sooasaG Gras CaCr■Ga r IN G■aaooa,al 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 addressAttorney ) n� Margaret L. Kirby, Al �, Attorney ) A-/ Kirby, Kirby & Kirby ) (Claimant's Signature) 2614 Artesia Boulevard ) Redondo Beach, CA 90278 ) 406 Chateau La Salle (Address) San Jose, CA 95111 • Telephone No. 310/372-8429 ) Telephone No. ■aasssoaasNo aaaaaaaaaaaaaaaaaaaaaaa a sass■sass■oaasoaaaaaasoaa as aaasoaaaa■a a as monsoon@ 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 Califcmia Public Records Act (Gov. Code, s5 5500 et seq_) Furthermore, any attachments, addendums,or supplements attached to the claim form, including medical records, are also subject to public disclosure. among■■■9asom"o■so■■aaaso■on■uroraa■bansom■■a on rr.uo.ot 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. Law Offices KIRBY KIRBY & KIRBY Margaret L.Kirby 2614 Artesia Boulevard Telephone (310)372-8429 Steven C.Kirby Redondo Beach,California 90278-3312 Fax (310)372-7660 Aimee E.Kirby* K Licensed in CA,AZ and NV ,fie mlkirby@kirbyandkirby.com ;.� RECEIVED www.kirbyandkirby.com uU November 3, 2008 N0V U b ?008 CEERK BOARD G _ ?VISORS CONTAA,. ;0, Clerk of the Board of Supervisors Contra Costa County 651 Pine Street Martinez, California 94553 Re My Client: Debra A. Zavala Date of Accident May 24, 2008 Dear Sirs: Enclosed is a Governmental Claim Form on behalf of my client who was -injured in a motorcycle accident on May 24, 2008. A self-addressed envelope is included for you to return a conformed copy to my office. Sincerely, KIRBY, KIRBY & KIRBY Margaret L. Kirby Attorney at Law N [� pLu r' 0 Cl a� xa ` r Y at` � 0 o-? rN goo s S ,. Ona! m U Ln f d w T j O �y O ✓ O 0 CO Ul 14 Lo m ?a�I to Eti „D Cl _•� Ul N C:3 r . co r N O T ' 9 y O x 4 C D � N