The URL can be used to link to this page

Home My WebLink AboutMINUTES - 01082008 - C.25 (9) r CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY • BOARD ACTION: JANUARY 08, 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 ��r�' (� on your claim by the Board of �+k`J � Supervisors. (Paragraph IV below), V given Pursuant to Government Code AMOUNT: UNKNOWN 07 0 4 20072P Section 913 and 915.4. Please note all COUNTY COUNSEL "Warnings". CLAIMANT: DELORIS TOOLE MARTINEZ CALIF. ATTORNEY: UNKNOWN DATE RECEIVED: DECEMBER 04, 2007 ADDRESS: 1026 WELDON LANE BY DELIVERY TO CLERK ON: DECEMBER 04, 2007 PITTSBURG, CA 94565 RECEIVED FROM RISK BY MAIL POSTMARKED: MANAGEMENT FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DECEMBER 04, 2007 JOHN CULLEN, r Dated: By: Deputy I1. FROM: County Counsel TO: Clerk of the Board of S pervisors ( �iis 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: /2-7-v By: m 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. JaOARD 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. Date d40 44tHN CULLEN, CLERK, By Deputy Clerk WARKING (GA. 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 nail 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 Warring 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. Date B o�O�JOHN CULLEN, CLERK By Deputy 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 reliet'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 tiled 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 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT, A claim relating to a cause of action for death or for injury to person or to personal proeity 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 1,ear after the accrual of the cause of action. (Gov. Code § 10 11.2.) Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street,Martinez, 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 fiaudulent claims, Penal Code Sec. 72 at the end of this form. ■!!!![!!![[t![[!l[><!!■ ■1 t i!!E t!i Ci[C[![!!![1[■[[!G G G G C G G G!.[[[[!R■i![[[!![[[[[1 ;E: Claim By: Reserved for Clerk's filing stamp Penny Bailey RECEIVED DEC 0 3 2007 against the County of Contra Costa or j 01 ti District) CLL=SU:PERVISORS CONTRA COSTA CO. Fill in the name) Y 'he undersigned claimant hereby makes cla1m against the County of Contra Costa or the above-named district in the sum of$ and in support of this claim represents as follows: When did the damage or injury occur? (Give exact date and hour) C) 114 1s" (43- t _ Where did the damage or injury occur? (Include city and county) n ; ]slow did the damage or inj occur? ( ave full etails;use extra p per if req ed) t — �.,��-c��Z�Z �. What particular act or omission on the past of county or 'strict o cers, se ants, or. gees caused the injury or damage? �,� � GAN— i What arc.the names of county or district.officers, s �ants�mploye�mg the ,Z damage or injury? 1410,� tk 6. What damage or injuries do your clam resulted? (Give full extent of injuries or damages "claimed. -Attach two estimates for auto damage.) R�ev� CAP- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ?Dc2 jj� S. N an addr ss o witnesses, octo s,'and hs itals: 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUN I Run t e t Ism[tat as t L e e t Nor e t t[a t costs t Is IRS tee INK [Exxon t e■t a t t t t[■■e t[[e e[[■e t t e t a [ l .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 ) (Claimant's Signature) (Address) 6A4l Telephone No. ) Telephone No. ` F — sr �� ■ e e t t e t e e t a t l e t■ tet RENERN e ■ zones e KRINXENNEKKK[t t[[i t t e t t t t e t i■tet[t t t t e t t e t t t tet a t e t l PUBLIC RECORDS NOTICE: Please be advised that this claim form; or any claim filed with the County under the Tort Clams 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. ■ l t t e e t[e[l t t l e t e[e t e t t ME MENt [e[e■t[tee■elate[1■t e[t e[e e t e t e e t t[l■t t e t e t e [t t e t t[tet[1 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 count3,, 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 prisonent and fnie, or by imprisonment prisoent in the state prison, by a fine of not exceeding ten thousand dollars ($10,000), or by both such imprisoiunent and fine.