HomeMy WebLinkAboutMINUTES - 10072008 - C.12 (14) � e
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
BOARD ACTION: OCTOBER 07, 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 toAp
The copy of this document mailed to
California Government Codes. you is your notice of the action taken
on.your claim by the Board of
Supervisors. (Paragraph IV below),
given Pursuant to Government Code
AMOUNT: $4,458.64 SEP Q $ 208 Section 913 and 915.4. Please note all
"Warnings".
CLAIMANT: ROY ALLEN GROVES UNTY COUNSEL
MARTINEZ CAUR
ATTORNEY: UNKNOWN DATE RECEIVED: SEPT. 08, 2008
ADDRESS: 11 HANLON,
BY DELIVERY TO CLERK ON: SEPT. 08, 2008
PITTSBURG, CA 94565 HAND DELIVERED
BY MAIL POSTMARKED:
FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
SEPTEMBER 08, 2008 DAVID TWA, Cler
Dated: By: Deputy
Il. FROM: County Counsel TO: Clerk of the Board of Su rvisors
(�is 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: 61-0 a By: , �� 1�� Deputy County Counsel
I1I. 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. .WARD 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 ,/lD c,~ID TWA, 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
1 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:A rAv hew 90 4a944CIKID TWA, CLERK, By eputy Clerk
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY (OC_I& 2 2'
INSTRUCTIONS TO CLAIMANT
A. A.claim relating to a cause of action for death or for injury to person or to personal propertyor
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.
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REE: Claim By: Reserved for Clerk's filing stamp
►1CK-A r�`D2O �� R
ECEIVED
ii
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Against the County of Contra Costa or )
_-tAA District)
(Fill in the namt)L-T- � )
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named
district in the sum of$ W.58 .!w Mand in support of this claim represents as follows:
i. When did the damage or injury occur? (Give exact date and hour) 3-10 -0e
2. Where did the damage or injuryoccur? (Include city'and county) i`_f HAW 1pnl P1,++S)9UPJ,04-
/�
3. How did the damage or injury occur? (Give full details; use extra paper if required)
Sze-/ atLIZ�--
4. What particular act or omission on the part of county or district officer's, servants, or employees
caused the injury or damage? J� 4 ¢%a eJA--;1 1Qa4.dc Yj-., cl-vl �
O1,ty cc/
/IJJUU ,vt �.
5 What are then es ofcountyr distnc' t officers, s� tis o -re ployees causing the
damage or injury?
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6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages
claimed. Attach two estimates for auto damage.) T{� „ c p C�.�
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7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.) 0,,,k 04-�-ac�
AAVkc)
S. Names and addresses of witnesses, doctors, and hospitals:
9. List the expenditures you made on account of this accident or injury:
DATE TIME y,,dal;�? AMOUNT
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) .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) 1
Name and address of Attorney )
)
} (Claimant's
Signature)
(Address)
Telephone No. )Telephone No,
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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.
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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.
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09/05/2008 at 03 :22 PM Job Number:
17163
CASEY'S AUTO BODY INC.
License #:AB220391 Federal ID # : 300016136
QUALITY IS OUR #1 CONCERN
4515 O'Hara Ave.
Brentwood, CA 94513
(925) 634-2211 Fax: (925) 634-7257
PRELIMINARY ESTIMATE
Written By: Mark Casey
Adjuster:
Insured: ROY GROVES Claim #
Owner: ROY GROVES Policy #
Address: Deductible:
Date of Loss:
Day: (925) 318-4352 Type of Loss-
Point of Impact: 11 . Left Front
Inspect CASEY' S AUTO BODY INC. Business: (925) 634-2211
Location: 4515 O'Hara Ave .
Brentwood, CA 94513
Insurance
Company: Days to Repair
1972 CHEV C10 4X2 6 2D SHORT WHITE Int :
VIN: UNK Lic: Prod Date: Odometer:
Clear Coat Paint
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
1# Repl FRONT BUMPER LKQ 1 350 : 00 1 . 4
2# Repl GRILLE 1 300 . 00 0 . 8
3# Repl LT . FENDER 1 400 . 00 2 . 0 2 . 0
4# Repl LT.SIDE MARKER 1 45 . 00 0 .2
5# Repl RT .DOOR 1 550 . 00 3 .2 2 . 8
6# Algn HOOD 1 . 0
7# Rpr FRAME 6 . 0
8# Subl Two Wheel Alignment 1 85 . 00 X
9# Set and Measure 1 2 . 0 F
10# Repl Cover car 1 8 . 00 0.2
11# Rpr Pull Lt frt rail 2 .5 F
12# Rpr Rough pull 2 . 0 F
13# Hazardous Waste Removal 1 4 . 00
14# STEERING BOX OPEN FOR 1
INSPECTION
15# ADD FOR CLEARCOAT 1 2 . 0
-------------------------------------------------------------------------------
Subtotals =_> 1742 . 00 21. 3 6 .8
1
09/05/2008 at 03 : 22 PM Job Number :
17163
PRELIMINARY ESTIMATE
1972 CHEV C10 4X2 6 2D SHORT WHITE Int:
Parts 1657 . 00
Body Labor 14 . 8 hrs @ $ 78 . 00/hr 1154 . 40
Paint Labor 6 . 8 hrs @ $ 78 . 00/hr 530 . 40
Frame Labor 6 . 5 hrs @ $ 85 . 00/hr 552 . 50
Paint Supplies 6 . 8 hrs @ $ 35 . 00/hr 238 . 00
Sublet/Misc. 85 . 00
----------------------------------------------------
SUBTOTAL $ 4217 . 30
Sales Tax $ 1895 . 00 @ 8 . 25000 156 . 34
----------------------------------------------------
GRAND TOTAL $ 4373 . 64
ADJUSTMENTS:
Deductible 0 . 00
----------------------------------------------------
CUSTOMER PAY $ 0 . 00
INSURANCE PAY $ 4373 . 64
This is just an estimate, upon further inspection or teardown, if additional
parts or labor is needed, you will be notified.
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. NWCPP=NATIONWIDE CRASH
PARTS PROGRAM.
CCC Pathways - A product of CCC Information Services Inc.
2
Coi:nty Administrator Contra V
Risk Management Division Costa
2530 Arnold Drive,Suite 140 County '
Martinez, California 94553 Cou I{ I Fax Number (925)335-1421
-FAX MESSAGE
BATE, 3 —GD -
T0: C X71 Fax: q Q9'O,
FROM. enn 5%t j Fax: (925) 335-1421
G DT; Phone:
SUBJECT Clainww.. r >_. 6 I/G._-7
Clainz# - %�`-
Date of L 055! 3 -10, 09
Number of pages including this cover page:
Message:
PLEASE NOTE:
The nlfortnariotl conrailled in this facsimile message nicN be confidential 077d1or legally privileged nrformatro77 intended
onrTv for the use of the individual or.entity named pbove. If the reader- of this• message is nor the intended recipient, yocr
Ole hereby not fired that the copying, diSSentil70rio7Z or distribution of con fdentiol irrfornunion is strictly prohibited.
If you ha1le not received all of rhe pages in this message,please contact me at the above phone ntunber.
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STATE OF CALIFORNIA /
TRAFFIC COLLISION REPORT _2 s t
t
CHP 555 CARS P. 1 (REV 11-06)OPI 065 °` PAGE 1 OF T
SPECIALVONDIIIDNS NUMBER NR6RUN CITY JUDICIAL DISTRICT LOCA PORT
ON-DUt:'EMERGENCY VEHICLEREo FELONY
{ 0 PITTSBURG DELTA
NUMBER KILLEo MI D ME COUNTY REPORTING DISTRICT BEAT DAY OF WEEK TOW AWAY
MISDEMEANOR RUN NOR
0 CONTRA'COSTA 901 MONDAY YES O
_- --- --COLLISION OCCURRED ON: -- ..-- - -_ ....... . . . . .. ___.___-_---_M0--..DAY-- YEAR TIME(2400) - -._. _NCIC p _...._. ._ ..OFFICER I.D.
T'
Z HANLON CT 03/10/2008 0115
0 MILEPOST INFORMATION: GPS COORDINATES PHOTOGRAPHS BY: ❑NONE
ULATITUDE LONGITUDE
AT INTERSECTION WITH: STATE HWY REL
71 OR: 50 FEET EAST OF BALCLUTHA WAY YES NO
PARTY DRIVER'S LICENSE NUMBER STATE CLASS AIR BAG SAFETY EQUIP. VEH.YEAR MAKE/MODEL/COLOR LICENSE NUMBER STATE
1 1972 CHEV PICKUP WHT 7T36431 CA
DRIVER NAMEIFIRST,MIDDLE,LAST) -
OWNER'S NAME ❑SAME AS DRIVER
PEDES- STREET ADDRESS ALLEN ROY GROVES
TRIAN
1-1 OWNER'S ADDRESS ❑SAME AS DRIVER
PARKED CITY/STATE/ZIP
VEHICLEI1 HANLON PL-PITTSBURG CA 94565
DISPOSITION OF VEHICLE ON ORDERS OF: OFFICER X DRIVER OTHER
BICY- SEX HAIR EYES HEIGHT WEIGHTBIRTHDATE RACE PARKED AT SCENE
CLIST MO DAY YEAR
PRIOR MECH.DEFECTS X NONE APP. REFER TO NARRATIVE
OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER:
VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA
PDXLPiRUCK•T0P
INSURANCE CARRIER POLICY NUMBER UNKNONE MINOR
- 22 X MOD MAJOR ROLL-OVER
DIR OF TRAVE ON STREET OR HIGHWAY SPEED LIMIT
CA OOT
CAL-T TCP/PSC MC/MX
PARTY DRIVER'S LICENSE NUMBERSTATE CLASS AIR BAG SAFETY EQUIP. VEH.YEAR MAKE/MODEL/COLOR LICENSE NUMBER STATE
2 D1452013 CA C M G 2004 FORD CROWN C WHT 1073815 CA
DRIVER NAMEIFIRST,MIDDLE,LAST) ON DUTY EMERGENCY VEHICLE
FXJ CHRISTIAN GUZMAN OWNER'S NAME n SAME AS DRIVER
PEDES- STREET ADDRESS CONTRA COSTA(QNTYSHERIFF'S OFFICE
TRIAN
651 PINE ST OWNER'S ADDRESS SAME AS DRIVER
PARKED CITY/STATE/ZIP
VEHICLE MARTINEZ CA 94553
F-IDISPOSITION OF VEHICLE ON ORDERS OF: ❑OFFICER L!jDRIVER OTHER
BICY- SEX HAIR EYES HEIGHT WEIGHT BIRTHDATE RACE DRIVEN FROM SCENE
CLIST
M BLK BRN 5-09 180 M12/16/1982 YEAR H PRIOR MECHANICAL DEFECTS X NONE APP. REFER TO NARRATIVE
OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER:
(925315-2500 VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA
9OW/•iW
INSURANCE CARRIER POLICY NUMBER UNKNONE MINOR
CONTRA COSTA RISK MANAGEMENT 01 1( MOD MAJOR ROLL-OVER
DIR OF TRAVE ON STREET OR HIGHWAY SPEED LIMIT
CA DOT
W HANLON CT W/B 25 CAL-T TCP/PSC mc/mx -
PARTY DRIVER'S LICENSE NUMBER STATE CLASS AIRBAG SAFETY EQUIP. VEH.YEAR MAKE/MODEL I COLOR LICENSE NUMBER STATE
3
DRIVER NAME(FIRST,MIDDLE,LAST)
❑ OWNER'S NAME ❑SAME AS DRIVER
PEDES- STREET ADDRESS
TRIAN
OWNER'S ADDRESS El SAME AS DRIVER
PARKED CITY/STATE/ZIP
VEHICLE
DISPOSITION OF VEHICLE ON ORDERS OF: Ll OFFICER1-1 DRIVER DOTHER
BICY- NEC,SE% HAIR EVES HEIGHT WEIGHT BIRTHDATE RACE
CLIST DAY YEAR
PRIOR MECHANCIAL DEFECTS NONE APP. REFER TO NARRATIVE
OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER:
❑ VEHICLE TYPE DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGED AREA
INSURANCE CARRIER POLICY NUMBER ❑UNK ❑NONE ❑MINOR
MOO nMAJOR ROLL-OVER
\ - DER OF TRAVE ON STREET OR HIGHWAY SPEED LIMIT CA DOT
CAL-T TCP/PSC MC/MX
-CARER'S NAME DISPATCH NOTIFIED REV ER'SN DATE REVIEWED
iYSTROM 018706 YES NO N/AG*f LE
STATEOF CALIFORNIA
TRAFFIC COLLISION CODING
CHP 856 CARS PAGE2(REV.11-06)OPI 065 1 PAGE 2' OF7
DATE OF COLU41ZN(MO.DAY YEAR) TIME(2400) NCIC 0 ' OFFICER I.D. 14 NUMBER
03/10/2.108 0115 9320 018706
OWNER OWNER ADDRESS NOTIFIED
PROPER []YES[]NO
DAMAGE DESCRIPTION OF DAMAGE
SEATING POSITION SAFETY EQUIPMENT INATTENTION CODES
OCCUPANTS L-AIR BAG DEPLOYED M/C BICYCLE-HELMET
_ A-NONE IN VEHICLE M-AIR BAG NOT DEPLOYED DRIVER PASSENGER A-CELL PHONE HANDHELD
B-UNKNOWN N-OTHER V-NO X-NO B-CELL PHONE HANDSFREE
C-LAP BELT USED P-NOT REQUIRED W-YES Y-YES C-ELECTRONIC EQUIPMENT
D-RADIO/CD
1 2 3 1-DRIVER D•LAP BELT NOT USED E-SMOKING
E-SHOULDER HARNESS USED
2 TO 6•PASSENGERS CHILD RESTRAINTF•EATING
4 5 6 7-STA WGN REAR F-SHOULDER HARNESS NOT USED Q-IN VEHICLE USED EJECTED FROM VEHICLE
0-NOT EJECTED G-CHILDREN
G-LAP/SHOULDER-HARNESS USED
8•RR.OCC TRK.OR VAN R-IN VEHICLE NOT USED N-ANIMALS
H-LAP/SHOULDER HARNESS NOT USED 1-FULLY EJECTED
9-POSITION UNKNOWN S-IN VEHICLE USE UNKNOWN I- PERSONAL HYGIENE
J 0-OTHER J-PASSIVE RESTRAINT USED T-IN VEHICLE IMPROPER USE 2-PARTIALLY EJECTED J. READING
K-PASSIVE RESTRAINT NOT USED U-NONE IN VEHICLE 3-UNKNOWN K-OTHER
ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(')SHOULD BE EXPLAINED IN THE NARRATIVE.
PRIMARY COLLISION FACTOR MOVEMENT PRECEDING
LIST NUMBER(9)OF PARTY AT FAULT TRAFFIC CONTROL DEVICES ] 2 3 SPECIAL INFORMATION ] 2 3 COLLISION
2 A VC SECTION VIOLATED: CITED®YE A CONTROLS FUNCTIONING A HAZARDOUS MATERIAL A STOPPED
22107 NO B CONTROLS NOT FUNCTIONING' B CELL PHONE HANDHELD IN USE B PROCEEDING STRAIGHT
B OTHER IMPROPER DRIVING' C CONTROLS OBSCURED C CELL PHONE HANDSFREE IN USE C RAN OFF ROAD
D NO CONTROLS PRESENT I FACTOR* D CELL PHONE NOT IN USE D MAKING RIGHT TURN
C OTHER THAN DRIVER' TYPE OF COLLISION E SCHOOL BUS RELATED E MAKING LEFT TURN
D UNKNOWN' A HEAD-ON F 7S FT MOTORTRUCK COMBO I IF MAKING U TURN
B SIDE SWIPE G 32 FT TRAILER COMBO G BACKING
C REAR END H H..SLOWING/.STOPPING
WEATHER (MARK 1 TO 21TEMS) D BROADSIDE I I PASSING OTHER VEHICLE
X A CLEAR E HIT OBJECT J J CHANGING LANES
B CLOUDY F OVERTURNED IK K PARKING MANEUVER
C RAINING G VEHICLE/PEDESTRIAN IL L ENTERING TRAFFIC
D SNOWING H OTHER': M M OTHER UNSAFE TURNING
E FOG/VISIBILITY FT. i N N XING INTO OPPOSING LANE
F OTHER:' MOTOR VEHICLE INVOLVED WITH O XO PARKED
G WIND A NON-COLLISION P P MERGING
LIGHTING B PEDESTRIAN Q Q TRAVELING WRONG WAY
A DAYLIGHT X C OTHER MOTOR VEHICLE OTHER ASSOCIATED FACTORS R OTHER':
B DUSK-DAWN D MOTOR VEHICLE ON OTHER ROADWAY I 2 3 (MARK 1 TO 21TEMS)
X C DARK-STREETLIGHTS E PARKED MOTOR VEHICLE A WSECTgNVOIATED: CITEDBYES
D DARK-NO STREET LIGHTS F TRAIN No
E DARK-STREET LIGHTS NOT G BICYCLE B YCSECTIMV101ATE0: CITED BNo
FUNCTIONING'
H ANIMAL: SOBRIETY-DRUG
ROADWAY SURFACE - C VC SECTION VIOUITED: GRED BYES PHYSICAL
X A DRY i FIXED OBJECT: _
NO 12 3 (MARK 1 TO 21TEMS)
B WET 1 X JA HAD NOT BEEN DRINKING
C SNOWY-ICY J OTHER OBJECT: I E VISION OBSCUREMENT: B HBO-UNDER INFLUENCE
D SLIPPERY(MUDDY,OILY,ETC.) I IF INATTENTION': C HBO-NOT UNDER INFLUENCE'
ROADWAY CONDITION(S) I G STOP B GO TRAFFIC D HBD-IMPAIRMENT UNKNOWN'
(MARK 1 TO 21TEMS) PEDESTRIAN'S ACTIONS IH ENTERING/LEAVING RAMP E UNDER DRUG INFLUENCE'
A HOLES,DEEP RUT' _jj A NO PEDESTRIANS INVOLVED I PREVIOUS COLLISION F IMPAIRMENT-PHYSICAL*
B LOOSE MATERIAL ON ROADWAY' B CROSSING IN CROSSWALK J UNFAMILIAR WITH ROAD G IMPAIRMENT NOT KNOWN
C OBSTRUCTION ON ROADWAY' AT INTERSECTION K DEFECTIVE VEH.EQUIP.: CITED X H NOT APPLICABLE
D CONSTRUCTION-REPAIR ZONE C CROSSING IN CROSSWALK-NOT YES I SLEEPY/FATIGUED
E REDUCED ROADWAY WIDTH AT INTERSECTION No
F FLOODED' D CROSSING-NOT IN CROSSWALK L UNINVOLVED VEHICLE
G OTHER-: E IN ROAD-INCLUDES SHOULDER M OTHER':
X H NO UNUSUAL CONDITIONS F NOT IN ROAD X X IN NONE APPARENT
G APPROACHING/LEAVING SCHOOL BUS O RUNAWAY VEHICLE
SKETCH FOR SKETCH DIAGRAM,SEE PAGE 3 0 .MISCELLANEOUS
DOT
INDICATE NORTH pp
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_T1�C CNP
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OTHER -
STATE O&CALIFORNIA
SKETCH DIAGRAM
CHP 555 Page 4(Rev.8-97) OP1042 PAG E 3 OF 7
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
03/10/2008 0115 9320 018706
ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED(SCALE= )
2 Hanlon Court
11 Hanlon Court
V-
1
12 ft
Baclutha ft 12ft
1!12 ft—t 12 ft�r
PREPARED BY I.D. NUMBER DATE REVIEWER'S NAME DATE
LEIF YSTROM 018706 03/10/2008
STATE 04F CALIFORNIA
FACTUAL DIAGRAM
CHP 555 Page 4(Rev.8-97) OPI 042 PAGE 4 OF 7
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
03/10/2008 10115 9320 018706
ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED(SCALE= )
Hanlon Court
N
11 Hanlon Court
12ft
4
;'Balc�lutha Way 12k
I
J�!i2 ft !12ft
PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE
LEIF YSTROM 018706 1 03/10/2008
STATE O�-CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 5 OF 7
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
03/10/2008 0115 9320 018706
- _
1 FACTS:
2
3 NOTIFICATION: I was dispatched to a call of a non-injury collision at 0130 hours. 1
4 responded from Willow Pass Rd at Bailey Rd and arrived on scene at 0135 hours. All times,
5 speeds and measurements in this investigation are approximate. Measurements were taken
6 by rollmeter, except where otherwise indicated.
7
8 SCENE: At the scene of this collision, Hanlon Ct is an eastbound/westbound residential
9 court. The roadway is straight and level. The surface is composed primarily of asphalt.
10
11 PARTIES:
12
13 VEHICLE #1 CHEVROLET PICK UP. Damage to V-1 was moderate including a dented
14 front bumper.
15
16 PARTY # 2 (Guzman) was located at 0155 hours on scene. Party Guzman was identified by
17 a valid California driver's license. Guzman was placed as a party by the following items:
18
19 - Driver statements
20
21 FORD CROWN VICTORIA Driver# 2's vehicle, was located on its wheels as shown on the
22 diagram. Vehicle damage was moderate to the passenger side including dented front and
23 rear door panels and broken window glass.
24
25
26
27
28
PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE
LEIF YSTROM 018706 03/10/2008
STATE ON CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 6 OF 7
DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
03/10/2008 0115 9320 018706
1 PHYSICAL EVIDENCE. Resting points of vehicle.
2
3 V-2: Right Front: 6 feet 2 inches right of the driveway of 11 Hanlon Court and 34 feet 5
4 inches east of Balclutha Way.
5 Right Rear: on curb edge of the driveway of 11 Hanlon Court and 37 feet east of
6 Balclutha Way.
7
8
9 STATEMENTS:
10
11 PARTY # 2 ( Guzman)
12 1 was driving my patrol car backwards at about 35 mph. I started to lose control so I hit my brakes
13 and then felt the car start to spin. Then I collided with the truck parked in the driveway.
14
15 OPINIONS AND CONCLUSIONS:
16
17 SUMMARY: V-1 was parked in the driveway of 11 Hanlon Court. P-2 was driving V-2 in
18 reverse on Hanlon Court w/b at 35 mph. P-2 turned the wheel of V-2 and lost control of V-2.
19 V-2 spun sideways and struck the side of V-1. V-1 remained parked in the driveway of 11
20 Hanlon Court. V-2 came to rest facing a southeasterly direction in front of 11 Hanlon Court.
21
22 AREA OF IMPACT: The area of impact (V-2 vs V-1) was determined to be 5 feet north of the
23 north roadway edge of Hanlon Court and 35 feet east of the east roadway edge prolongation
24 of Balclutha Way.
25
26 CAUSE: P-2 caused this collision by driving in violation of California Vehicle Code section
27 22107 which states in part that no person shall turn a vehicle from a direct course of travel
28 upon a roadway until such movement can be made with reasonable safety.
PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE
LEIF YSTROM 018706 03/10/2008
STATE C7F CALIFORNIA
NARRATIVE/SUPPLEMENTAL PAGE 7 OF 7
" DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER
03/10/2008 0115 9320 018706
----
1 CAUSE CONTINUED
2
3 P-2 turned the wheel of V-2 which caused him to lose control of the vehicle. V-2
4 subsequently collided with V-1.
5
6
7 RECOMMENDATIONS:
8
9 None.
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PREPARED BY I.D.NUMBER DATE REVIEWER'S NAME DATE
LEIF YSTROM 018706 03/10/2008
County Administrator Contras
CostaRisk Management Division v7
2530 Arnold Drive,Suite County Liability Claims
Martinez, California 945533 (925)335-1440
Fax Number (925)335.1421
EAL
1'
April 15, 2008
�p
:Allen Groves 1`O �� ' G yz'clU
nP .
Pittsburg, CA 94565
Re: Claimant: Allen Grove
Insured: Contra Costa Cc i hw—' — -
D/Accident: 03/10/2008
Claim No.: 64672
Dear Mr. Grove:
The above captioned matter has been referred to my office for investigation and handling
on behalf of the Contra Costa County Department of Sheriff/Coroner.
I have enclosed a claim form that must be completed in order to file a formal_ claim
against the County. Be advised that you have six months from the accident date to file a
formal claim as stated in the California Govennnent Code beginning with Section 900.
This also notifies you that you must comply with the claims presentation and timely suit
filing requirements of California law in order to preserve your claim. Our investigation
of your claim does not affect your duty to comply with time limits set by law, and by
investigating, considering, and discussing your claim with you or your representative, we
do not waive our right to assert your failure to comply with those time limits as a
complete defense to any claim or action you may bring.
Should you have any questions, please do not hesitate to contact the undersigned.
Sincerely,
Penny Bailey
Liability Claims Adj aster
(925) 335-1455 . /1"
Enclosure