The URL can be used to link to this page

Home My WebLink AboutMINUTES - 01152008 - C.10 (5) CORRETED'COPY1 PLEASE DESTROY CLAIM PREVIOUS ISSUE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY C . BOARD ACTION: JANUARY 15, 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 3 on your claim by the Board of W1DEC 0, 2007 Supervisors. (Paragraph IV below), given Pursuant to Government Code AMOUNT: $3,105.21 COUNTY COUNSEL Section 913 and 915.4. Please note all MARTINEZ CALIF. "Warnings". RIP SUP CHUNG or CLAIMANT: RI SUP CHUNG ATTORNEY: UNKNOWN *14 DA rE RECEIVED: DECEMBER 10, 2007 ADDRESS: 251 3 th STREET, #706 BY DELIVERY TO CLERK ON: DECEMBER L0, 2007 OAKLAND, CA 94611 BY MAIL POSTMARKED: DECEMBER 07, 2007 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DECEMBER 10, 2007 JOHN CULLEN, le k Dated: By: Deputy II. FROM: County Counsel TO: Clerk of the Board of p_ervisors (0 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). O Other: Dated: By: eputy 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. BOARD 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 �code HN CULLEN, CLERK, By Deputy Clerk WAR I.NG ( 913) — 7 Subject to certain exceptions,you have only six(6) months from the date this notice was personally served or deposited in the ni-ail 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. lf'you want to consult an attorney,you should do so immediately. *For Additional Warning See Reverse Side ofThis Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that f 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" JOHN CULLEN, CLERK By Deputy Clerk 1 61 DATED:y _ .Z.Z, Zd0� BY: Deputy Clerk _ CCC RISK MANAGEMENT VISORS 'TRA COLS-TAA COUNTY BO OF SCJFFRRF r STRUC nONS To C'1-4IlUI`1T �. f4 claim relating to a cause of action for death ax far injunJ to person or to personal property Or gro-V-ing crops shall be presented not later !an six months ;:after the accrasl of the cE-'a e of action. A claim relating to any Othex cause of action shall be Presented nOt later than one yvar mer the accrual of the cause of action. (GeV. Code § 911.2.) B. Claims must be filed Zxirh the Clerk of `she Board of Supervisors at its office in Room 106, County:administration Duilditlg, 551 fine Street.1_Viaitinez, C_4�L 94553- C. If clam is against a district governed by the Board of Supervisors, rather than the County, the rt�ie of the District should be filled in. If the cls nst is agaimore f,= one public entity, se parate claims Must be filed agate each pubiio mtity- Fraud. See pen t-for fraudulent claims,penal Code Sec. 72 at 6e end of this faun. [son■rRNR■■kMENWRYtaKnows WREMs.xxWkKxzw1RRW Russ RMINKiik/i■ �i RE: Claim By: Reserved for Clerk's filing stamp RECEIVED Aga st the COUnt37 of Contra Costa or ) DEC i 0 2007 Distract) CLERK BOARD OF SUPERVISORS (Fi%1 in tli8 ram e) )' CONTRA;COSTA CO. 'Fca und6xsigned claimant hereby ides claim aQai.st the County of Contra Costa or the above-named district in the suxo. of S 17,1 OS 1 and irz support of this claim represents as fallo��s' 1. When did the damage or injury occur? (Give exaot date and hour) v e IA 0—f- `-, c � Zoo �7 C,, 2. there did the damage or injury occur? (Include city and county) 3. Hou did the damage or injury accUr? (Clive full details;use ef,:tm paper if req Ted) 4. What parldcular Edt or omission on the pW, of county or t OfftC�rS�Servzs�ts, or employees caul e�d the injuy or damage? 0 okk k, T qc c �,..� �nc-E 10c,k-� 5 What axe The names of county or district,officers, servants; or employees causiing t e damage OT injury`? j i,, , ( �S- 3/3 - �n� Ltou1�� Vv ' 1( ' a s L' ``e- f"a') y21S= 335= IW�Z Oe-WCIE : F-D -J 7awrls ( Go.rfra C°S{-a ac,, ) LT-case Pi-� �f //2�i$S Y _ : 39`'M :CC RISK MANAGEMENT N0, 334 6. �Nrhat damage or injufies do your claim. resulted? (Give fjali extent of injuxies or damages / claimed. Attszh two estimates for auto damage.) cavrv�cc c./ bpm � 7. Flow was the amount claimed above computed? (Include the estimated amount of any zospecti53e injury or damage,) rnmss{ Cbo, 6,4 -4r- S. Nvrames land addresses of Wi=esses, doctors, and hospitals: 9. List the expenditures you made on account of this accident or iajury: DATE TIME _�M A AAW{acct MIAANYAIVAN KAREN ss lass sassssArsss■A■to eA■A ass■A won AAAss■■sass■s s A A SA■tes+=� .Gov. Code Sec. 910,2 provides"The claim shall be signed by`le claimant or by some person on his 1 bel�lf.'. SEND NOTICES TO: lAttomev1 ) NTamte and address of Attorney (Claiant's t�at�re) ) (Address} ) No. 1 1 lhone No, t70 T�C1Cp110nC Ngo. e _ e r y A KENN f o i A s A ARTt its■A A A A A A.S s!A A K"m RANA A MR era%V A A A A Y=a S Y f A A v a L s a A A A A as f as a ■A 1 Agal A A h I a PUBLIC RECORDS N OTIM. Please be advised that tais claim fora, or any claim.51zd with the County Tinder the Tort Claims Act= is subject to public disclosure under the California Public Records Act. (Gov. Code, s§ 6500 et sea.) Furthermom, anY ar,.achments,addmduzms, or supplements attached to the claim form, medical re=rds, are also subject to Public disclosure, Y b A e A a A s s l a a f■ A A A A A A A A.•A A A A If A L A A A A A A A[A 5 A A s A A■■s s s s s R t s r t A s s s A A A A A A a{e A A A A A a A A A A A C NOTICE: ,Section. %' of the.Pena-7 Code provides: BN,er' pennon who, with intent to deLnaud, presents for allowance or for payment to any state board or officer, or to any county-, city, or dissaict board or oinoer, authorized to a11ow or pay the same if genuine, any false or fraudulent claim_ bill, account voucher, or�Triting, is p= shable 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 (51,000.00), or by both such imprisonment and fine, or by imprisorsment in the state prison:, by a fine of not exceeding ten thousand dollars (S10;000)_ or by both such imprisonment and f tL Date: 12/4/2007 10:53 AM 2 R Estimate ID: 11219 C �!0Estimate Version: 0 a Preliminary Profile ID: Mitchell QUALITY BODY & FENDER 2510 MARTIN LUTHER KING JR WAY,OAKLAND,CA 94612 (510)839-0122 Fax: (510)839-1726 Tax ID: 94-2769852 Damage Assessed By: John Ponce Appraised For: OWNER Type of Loss: Collision Payer: Customer Deductible: 0.00 Claim Number: 11219 Owner: RO CHUNG Address: 251 28TH ST#706,OAKLAND,CA 94611 Telephone: Home Phone: (510)529-6194 Mitchell Service: 912121 Description: 2006 Honda CR-V LX Vehicle Production Date: 6/06 Body Style: 4D Ut Drive Train: 2.41-Inj 4 Cyl 2WD VIN: JHLRD685X6C014075 License: 5UGB100 CA OEM/ALT: O Search Code: None Color: SILVER Options: AUTOMATIC TRANSMISSION Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units 1 200008 BDY REMOVE/INSTALL FRT BUMPER ASSY INC # 2 203442 BDY REMOVE/INSTALL L FRT COMBINATION LAMP 1.3 # 3 200176 REF BLEND L FENDER OUTSIDE C 0.9 4 200194 BDY REMOVE/INSTALL L FENDER WHEEL OPENING MLDG 0.2 5 200196 BDY REMOVE/INSTALL L FENDER MUDGUARD 0.2 6 201057 BDY REMOVE/REPLACE L FRT DOOR SHELL 67060S9A-A90ZZ 578.00 5.0 # 7 AUTO REF REFINISH L FRT DOOR OUTSIDE C 2.4 8 AUTO REF REFINISH L FRT ADD FOR JAMBS&INSIDE C 1.0 9 203156 BDY REMOVE/REPLACE L FRT DOOR ADHESIVE MOULDING 75322-S9A-013 55.47 0.1 10 201079 BDY REMOVE/REPLACE L FRT LWR DOOR GARNISH MOULDING 75332S9A-003 50.03 INC 11 201085 BDY REMOVE/REPLACE L FRT DOOR REAR BLACKOUT TAPE 67326S9A-003 17.03 0.2 12 201228 BDY REPAIR L REAR DOOR SHELL Existing 1.0" 13 AUTO REF REFINISH L REAR DOOR OUTSIDE C 1.9 14 201232 BDY REMOVE/INSTALL L REAR OTR BELT MOULDING 0.6 # 15 201234 BDY REMOVE/INSTALL L REAR LWR DOOR GARNISH 0.2 16 202446 BDY REMOVE/INSTALL L REAR DOOR CLADDING 0.4 17 201284 BDY REMOVE/INSTALL L REAR OTR DOOR HANDLE 0.4 # 18 900500 BDY Y ADD'L LABOR OP NIB SAND&POLISH Existing 1.5' 19 936012 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00' 20 AUTO REF ADD'L OPR CLEAR COAT 1.9 21 933003 REF ADD'L OPR TINT COLOR 0.5' 22 933005 BDY ADD'L OPR RESTORE CORROSION PROTECTION 12.00' 0.3' 23 933018 REF ADD'L OPR MASK FOR OVERSPRAY 5.00` 0.3' 24 AUTO ADD'L COST PAINT 258.00' ESTIMATE RECALL NUMBER: 12/04/2007 10:53:27 11219 UltraMate is a Trademark of Mitchell International Mitchell Data Version: OCT_07_V Copyright(C) 1994-2005 Mitchell International Page 1 of 3 UltraMate Version: 6.0.028 All Rights Reserved Date: 12/4/2007 10:53 AM Estimate ID: 11219 Estimate Version: 0 Preliminary Profile ID: Mitchell " -Judgment 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 11.4 76.00 12.00 0.00 878.40 Taxable Parts 700.53 Refinish 8.9 76.00 5.00 0.00 681.40 Sales Tax @ 8.750% 61.30 Non-Taxable Labor 1,559.80 Total Replacement Parts Amount 761.83 Labor Summary 20.3 1,559.80 III. Additional Costs Amount IV. Adjustments Amount Taxable Costs 258.00 Insurance Deductible 0.00 Sales Tax @ 8.750% 22.58 Customer Responsibility 0.00 Non-Taxable Costs 3.00 Total Additional Costs 283.58 I. Total Labor: 1,559.80 II. Total Replacement Parts: 761.83 III. Total Additional Costs: 283.58 Gross Total: 2,605.21 IV. Total Adjustments: 0.00 Net Total: 2,605.21 This is a preliminary estimate. Additional changes to the estimate may be required for the actual repair. Insurance Co: Owner To Pay Authorized and Accepted: I hereby authorize to make the specified repairs from attached Estimate. I understand that payment in full for the repairs will be due upon release of vehicle, including additional supplemental damage charges. I hereby grant Quality Body & Fender' s employees permission to operate the vehicle on streets, highways, or elsewhere for the purpose of testing and or inspecting vehicle. .An express lien is hereby acknowledged on the vehicle to secure the amount of the repairs. Owner of the vehicle will not be held responsible for loss or damage to the vehicle due to fire, theft, and. accident while in custody of Quality Body & Fender. Quality Body, & Fender will not be responsible for any lost or missing articles or items left in the car. Once customer is notified of vehicle repair completion, vehicle must be picked up within two business days, otherwise storage charge will accrue at $40.00 a day, as of the second business day completed. I ESTIMATE RECALL NUMBER: 12/04/2007 10:53:27 11219 UltraMate is a Trademark of Mitchell International Mitchell Data Version: OCT_07_V Copyright(C)1994-2005 Mitchell International Page 2 of 3 UltraMate Version: 6.0.028 All Rights Reserved Date: 12/4/2007 10:53 AM Estimate ID: 11219 Estimate Version: 0 Preliminary Profile ID: Mitchell hereby consent a verbal authorization for the original repairs, or an increase from the original repairs specified to me. All parts removed from the vehicle will be junked unless otherwise instructed and specified by owner of the vehicle in a timely manner. Signing this document acknowledges receipt of the final repair order and will put in effect the Guaranty given by Quality Body & Fender after completion of repairs on the vehicle. All unibody/Structural Repair specified on final repair order is guaranteed lifetime as long as you own the vehicle. All paintwork specified on final repair order is guaranteed 60 months (5 years) , against peeling, cracking, or checking. All mechanical repairs specified on final repair order are Manufacturer Warranty for 1 year. All Guaranty work for the vehicle specified on hte repair order should be brought back to Quality Body & Fender, in order to fufill the Guaranty. If vehicle is taken elsewhere, the guaranty is automatically revoked.. No exceptions. Authorizing Signature Date Insurance Coverage Confirmed: Yes NO Owner to Pay: Yes NO Repairs Inspected By: Date ESTIMATE RECALL NUMBER: 12/04/2007 10:53:27 11219 Ultra Mate is a Trademark of Mitchell International Mitchell Data Version: OCT_07_V Copyright(C)1994-2005 Mitchell International Page 3 of 3 Ultra Mate Version: 6.0.028 All Rights Reserved V a U aLU w rl V) v n V'f L� W CD CD CD 0{J J ; o WU IWI ®aw O .y(� r—i 'D coo �U W W V1 O