HomeMy WebLinkAboutMINUTES - 10072008 - C.12 • CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
BOAR 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 to ) C ' The copy of this document mailed to
California Government Codes. you is your notice of the action taken
gagon your claim.by the Board of
Supervisors. (Paragraph IV below),
SEP 0 4 2008 given Pursuant to Government Code
AMOUNT: $91.99 Section 913 and 915.4. Please note all
COUNTY COUNSEL
MARTINEZ CALIF, "Warnings".
CLAIMANT: KIMBERLY MILLER
ATTORNEY: UNKNOWN DATE RECEIVED: SEPT. 04, 2008
ADDRESS: 1149 HARRIS COURT BY DELIVERY TO CLERK ON: SEPT. 04, 2008
MARTINEZ, CA 94553
BY MAIL POSTMARKED: HAND DELIVERY
FROM: Clerk of the Board of Supervisors T0: County Counsel
Attached is a copy of the above-noted claim.
SEPTEMBER 04,: 2008 JOHN CULLEN, C
Dated: By: Deputy rL�
'i1. FROM: County Counsel TO: Clerk of the Board of Supervisors
( 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).
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).
O Other:
Dated: �� B By: Deputy County Counsel
III. FROM: Clerk of the Board . TO: County Counsel (]) 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:
(vf 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.
DatedAX-4+0yo eg 01A0J6HN CULLEN, 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 oflhis 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 1 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 clainhant as shown above.
Dated.&V'0602"Bd; *F''00kJ`OHN CULLEN, CLERK By �/ Deputy Clerk
i
This warnMIr, doe finot apply to claims which
are not subject toW e California Tort Claims
Act such as acti�ons.in I atue> a o'ndemnation,
. _.
actions for specEfl elief s ;)mandamus or
injunction, or Federal C, i' g fs'claims. The
above list is not exhaustive and legal
consultation is essential, toiu lVe-stand 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
i
claim.
The County of Contra Costa does not waive any
of its rights under California Tort Claims Act
I nor does it waive rights under the statutes of
limitations applicable to actions not subject to
the California Tort Claims Act
i
i
I
i
BOARD OF SUPERVISORS 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 properly 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.
as asman masaaaa■■a■ms■m aama•MEN mat es ams as taasasIts■amass saaasa a ai am NNW a rise a a e a,
RE; Claim By: Reserved for Clerk's filing stamp
h1N Ler X� V )
}
Against the County of Contra Costa or ) SEP 0 4 2008
}
District) CLERK BOARD OF SUPERVISORS
(Fill in the name) )' CONTRA COSTA CO.
}
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named
district in the sum of$ q I -99 and in support of this claim represents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
37kAy 2q , zao8 , 3. o s Fes' .
2. Where did the damage or injury occur? (Include city and county) Fm�b _ z moo A%a r%6'"'
Cc.CCL`M Ft►vn�` r�Acvt(. U1ca5. 0.2 D's"'L L gko'L'h� 5eacc �h
Marl•tr,eZ Cord& C,)s�K Cou.n+`( .
3. How did the damage or injury occur? (Give full details;use extra paper if required)
Metal reVkv- S1-%aKiw` ttIJ Frovn Ctnlln�{Arl4%ny buv.%ptr, cau5h4 bo rs�
Cavy�cy vk, A -Fury M Ve—(ircLe - J
4. What particular act or omission on the part of county or district officers, servants, or employees
caused the injury or damage? M2�a1 rrl�� Sl ict<�.:� k���ou� fro✓
3r' about bur,,tWr SWLk-
5 What are the names of county or district officers,servants,or employees causing the
damage or injury? Shcr.ff 0.q& j lotrer4s.' tis onsikQ Cin,A -F•aIC- �N'c\4A tts. aj
Car l5Dr CMA ocl� +o Si)f a wJ �w4ruc4c(C Z C'o-nLf MatnkanoL Wo✓kcys -R-�
CAA 1re�niu�,+,cQ�✓ oF'LAhaAYC'arr*X) (y-on,
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6. W� a damage or injuries do your claim resulted? (Give full extent of injuries or damages
claimed. Attach two estimates for auto damage.) UvtdlwCurrif' v ekiL(R WG
oFF by ma�reS� rtbGr. ><� o
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injuryor damage,) To x(01-w c✓e rv�CR %4eyp4• rec,( —
8. Names and addresses of witnesses,doctors, and hospitals:
Ke1C� Mi11er llyq Narr►'s Ct. MTZ CA gIf5S3
9. List the expenditures you made on account of this accident or injury:
DATE TIME AMOUNT
7-26- o8 91 59
Srarre+rearaala■rrrr agErrrrr Er rrr+rErErE/ragerrrrtEeee■ae+ace reEag agErrtrrrrl Seau err
.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
(Claim is Signature)
1/91 y4rrn'S CT
(Address)
Mad iheZ , CA 9Y553
Telephone No. )Telephone No. q12 cy- Z8&-7898
a*map reerrrr■wit Wage+SEEN rr+leer[rlr ere aeagr[Eagrarrnr reran ear agar+carr Kann Sa r rage rent
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.
■!/!Ir■Isle+Erre+[aa E/anrrrrE■rlre+evilIra■Eli■1a/rrlrll■!1111 rrer■■r+■/■rannusaeE■al
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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i d� o * ij S� i S'*S' � .,Y.'Y � E V s r A+ :a.0 }i s• '�{'�2\d 14°
MARTIINEZI,28, 78980 ltsz7FF 'v , ;A If 1q` yYgi J ? 4 y DG 1J` 0 t V4
HOME 925 ` E ApUIS01 5396` MATT M4LAREIN TAR
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OS081D20794AX �ryr 1plV QATE
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1< p 001" GASH 26JUL08
01SEP07. :` > ,> L7 00` 26JULD8> ` 27aZC248065 AXL F
r�&tfsTs�N t NO PIED OPTIONs STK 81020794
D ENG i
O.c�P roEO R 1)AUT4�ARE PCU3 3 7
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OS�i'41. 26JUL08..'=09:48 ,26JUU08 LIST
NET TOTAL
LINE OPCODE TECH TYPE HOURS
A;INSTALL ,.SOPL?NDERCARRIGE ".COVER . SOP IS ,IN PARTS p `06 0
00
9 ADJ'USTMkrS/REPAIRS 71 48
5464 C4 71.48; 7148"
1 5],441 1227��aCOVER, ENGINE 'UNDER � ,270; 2,,7p 13 50
5 9046f7 071.64 CLIP 0 00 > p 00 TONAL LINE A
84 98;
PARTS 84 '98 LABOR
69REPLACED UMERCARRAGE COVOR
EST ""z9d 00 26JUI,08 08 41 SA 5396
' THANK YOU ;FOR }CaWSu3G CONCQRD TO`10�A'S
SERVICE DEPARTMENT FOR YOUR °VICLES SERVICE ^
�, p 1TENANCE
NEEDS SEE YOU zAT YOUR NEXT�T
SERVICE INTERVAL , A.O.,
B �A.R. #AJ201392 E.PA. #CAD982048878.
SERVICE DEPT• HOUAS MON FRI •7AM TO7PM
WE ARE ALSO OPEN SAT[JRDAYS 8AM TO 5PM
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TERMINAL 1240011 REVISEDPARTS AMOUNT 84 9A
ESTIMATE: $ p pp
11F,103�IN1�31 {ONE# AUTHORIZED ADDITIONAL REVISED GAS,OIL.LUBE 0.0()
I�,� �7 AMOUNT TOTAL SUBLET AMOUNT
07126,2r)O� 13: 0: 0.00
MISC.CHARGES 84 98
TOTAL CHARGES
X KXXXXxxNxXXX666S ADJU57MENTS
flltrFl. TR�,J\N. 10. 16,82088_?7`24920: 7.01
INUDICE
700k.-- HI H19, SALES TAX
HIJTk't. f+(JLIE (:�l e:I..+��`"�y iDVAL IACKNO EDGE RECEIPT OF HI LE ANOI HAVE
ATE PRICE. RECENED A COPY OF THIS'VOICE. PLEASE PAY
$A_F TCITRL 'I' 7. " ' THIS AMOUNT ��`•��
BAR#AJ20t392EPA#CAD982048878
CU.`_,TCt�ER f"Opy CUSTOMER COY INITIALED
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�I ^ace Page CONTRA COSTA HEALTH SERVICES SECURITY UNIT i
❑ Continuation CONTRA CO.STA 2500 Alhambra Ave., Martinez, CA 94553
❑ Supplemental '.H:F AA.LT,H K RV'IC15 .,
1.Report No. 2.Report Area 3.Classification 4.Code(s) 1. 1744 5.More
CCRMC SERVICE TO CITIZEN 2. Persons
6.Day/Date/Time of Occurrence 7.Dale/Time Reported 8.Employee No. ❑
Thur. 07/24/08 at 1515 Hrs. 07/24/08 at 1515 Hrs 55485
9.Address/Location of Occurrence
2500 ALHAMBRA AVE., MARTINEZ
10. ®PRI ❑VIC# ❑WIT# ❑SUS# ❑LEAD# [:]OTHER
11. Name(L,F,M) 12. Race/Sex/Age 13. DOB 14.Driver License No.
MILLER, KIMBERLY C. / / 08/29/63
15.Address (Zip Code) 16.Cell Phone
925 286-7898
17.Employed By or School 18.Home Phone
19.Hair 20.Eyes 21.Ht. 22.Wt. 23.AKA/Malden Name 24.Social Security No.
25.Further Description (Scars,Tattoos.Mannerisms,Clothing,Etc.) 26.Booking or Cite No.
27. ❑PRI ❑VIC# ❑WIT# ❑SUS# ❑LEAD# ❑Other
28. Name(L,F,M) 29. Race/Sex I Age 30. DOB 31.Driver License No.
32.Address (Zip Code) 33.Home Phone
34.Employed By of School 35.Home Phone
36.Hair 37.Eyes 38.Ht. 39.Wt. 40.AKA/Maiden Name 41.Social Security No.
42.Furter Description (Scars,Tattoos.Mannerisms,Clothing,Etc.) 43.Booking or Cite No.
44. ❑PRI ❑VIC# ❑WIT# ❑SUS# ❑LEAD# ❑Other
45. Name(L,F,M) 46. Race/Sex/Age 47. DOB 48.Driver License No.
49.Address (Zip Code) 50.Home Phone
51.Employed By or School 52.Home Phone
53.Hair 54,Eyes 55.Ht. 56.Wt. 57.AKA/Maiden Name 58.Social Security No.
59.Further Description (Scars,Tattoos,Mannerisms.Clothing,Etc.) 60.Booking or Cite No.
61.Van./Ves. 62.Lic.No. (State) 63.Year 64.Make 65.Model 66,Body Style 67.Color Top SILVER
❑6 ❑via 0046JDP CA 2008 TOTOYA SCION XB UT Bottom
68. Status 69.Registered Owner 70. R.O.Address
❑ Lee KIMBERLY MILLER
❑ Impound 71.Towed to or Released to 72.Who has Keys?
❑ Stored
73. Bdef Synopsls of Incident
Report is a Service to Citizen. At approximately 1515 on 07/24/08, Sheriff Ranger Morant and I responded to
Parking Lot D after PR-MILLER called to report damage to her vehicle. Miller told me she pulled into a
parking space in front of Building 1 and drove up to a concrete wheel stop embedded in the pavement in the
stall. Miller said that when she later backed out of the stall, a metal rebar, that was protruding up from the top
of the wheel stop, caught a piece of protective plastic underneath the vehicle's engine and tore it from the
vehicle. Miller felt it was unsafe for the rebar to protrude higher than the wheel stop and believed that [the
County] is responsible for the damage to her vehicle.
Facility Administrator L. Carlson came onscene and spoke to Miller about her concerns.
74.Distribution 75.Additional Routing
❑ Chief
❑ Building Manager L79.
Reporting Officer(Print) 77. Employee Number 78.Date/Time Written
. PARENTI 55485 07/24/08 at 1630 Hrs.
❑ Other. Approving Supv. (Print) 80.Supv.No. 81.Date 82. Page
c%•• G. /Ko,,Cc f4Se-Ire-9 ��d a8 1 of 'f
I continuation CONTRA COSTA COUNTY HEALTH SERVICES SECURITY UNIT a "
CON'j:J CU5-1A; r1^-,i�.`•..
❑Supplemental H F A LT H 51,WI-C l s 2500 Alhambra AvI Martinez, CA 94553
1.Report No. 2.Report Area 3.Classification 4.Codes) 1.
CCRMC SERVICE TO CITIZEN 2.
5.Victim Name(L,F,M) 6,Date Orig.Report T.Employee No.
55485
8.Address/Location of Occurrence 9.Suspect's Name(L,F,M)
10. Narrative/Statements:
1 Ill I Jill 1,
4 ray
Sl
k
.2.
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3
it
L
Fr
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s
11.Distribution 12.Additional Routing
❑ Chief
❑ Building Manager 13,Reporting Officer(Print) 14. Employee Number 15.DateRme Written
M. PARENTI 55485 07/24/08 at 1630 Hrs.
❑ Other. _ 16.Approving Supv. 17.Supv.No. 18.Date 19. Page
5319 dd a 2 of
• ®Continuation CONTRA COSTA COUNTY HEALTH SERVICES SECURITY UNIT
CON fHA CU11 A. a'4'y��_',
DSupplemental :HEAI.T fi SsERvrc'e3 2500 Alhambra Ave., Martinez,CA 94553
1.Report No. 2.Report Area 3.Classification 4.Code(s) 1. 1744
CCRMC SERVICE TO CITIZEN 2.
S.Victim Name(L,F,M) 6.Date Orig.Report 7.Employee No.
55485
6.Address/Location of Occurrence 9.Suspect's Name(L,F,M)
10. Narrative/Statements:
a,
i
cin
,• ,2 ,-.,.,,,i rs"F k-'� '6°h• ids+,' '
a'rw.
11.Distribution 12.Additional Routing
❑ Chief
❑ Building Manager 13.Reporting Officer(Print) 14. Employee Number 15.DateMme Written
M. PARENTI 55485 07/24/08 at 1630 Hrs.
❑ Other. 16.Approving Supv. 17.Supv.No. 16.Date 19. Page
of eye
®Continuation CONTRA COSTA COUNTY HEALTH SERVICES SECURITY UNIT ,'
CONTRACU s-rA;,..
❑Supplemental HF.A:IT'6 sr,uVICia 2500 Alhambra Ave., Martinez, CA 94553
1.Report No. 2.Report Area 3.Classification 4.Code(s) 1.
CCRMC SERVICE TO CITIZEN 2.
5.Victim Name(L,F,M) 6.Date Ong,Report 7.Employee No.
55485
8.Address/Location of Occurrence 9.Suspect's Name(L,F,M)
10. Narrative/Statements;
I
n"t a.4
N;
11 F.
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1 ^K?� cif
K•YvkY M�
S
r�Y, t rr"�^ +Ltissf-h,1^ i.;
11.Distribution 12.Additional Routing
❑ Chief
❑ Building Manager 13.Reporting Officer(Print) 14, Employee Number 15.DateMme Written
M. PARENTI 55485 07/24/08 at 1630 Hrs.
❑ Other. 16.Approving Supv. n 17,Supv.No. 18.Date 19. Page
of