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HomeMy WebLinkAboutMINUTES - 10142008 - C.12 (19) J CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: OCTOBER 14, 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 on your claim by the Board of p Supervisors. (Paragraph IV below), EP given Pursuant to Government Code SEP 1 1 2008 999111 Section 913 and 915.4. Please note all AMOUNT: UNKNOWN "Warnings". COUNTY COUNSEL CLAIMANT: CONNIE LEUNG MARTINEZ CALIF. ATTORNEY: UNKNOWN DATE RECEIVED: SEPTEMBER 11, 2008 ADDRESS: 242 CORONADO STREET, BY DELIVERY TO CLERK ON: SEPTEMBER 11, 2008 HERCULES, CA 94547 RECEIVED FROM BY MAIL POSTMARKED: RISK MANAGEMENT FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. SEPTEMBER 11, 2008 DAVID TWA, Clerk Dated: By: Deputy. II. FROM: County Counsel TO: Clerk of the Board of Sup isors ( "'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: 61— By: /?I 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. O Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 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 I declare under penalty of perjury that 1 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: d #.AWN- ZtWeAVID TWA, CLERK, By Deputy Clerk This warning dohs not apply to claims which are not subject to'tlie California Tort Claims Act such as actions'in inverse condemnation, actions for specific,relief �such•jas%mandamus or i. I �' Iq� ,. injunction, or Federal-Civil Rights claims. The above list is not ezh'austiveiand'legal'x' consultation is essential to understand all the separate limitations periods.tlat=,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 BOARD OF SUPE*SORS OF CONTRA COSTA COU ENTSTRUCTIONS TO CLAHAANT A. A claim relating to a cause of action for death or for injury to person or to personal property-or- growing ropertyofgrowing 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 eacb. public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. MEN Noss anaman■■■aanaansea aaa■•aas■a■■a*0a Iask ama a■■■■■■■m a a ate a■■■a a*IRK am aa■■l RE: Claim By: Reserved for Clerk's filing stamp Cohh,`e RECEIVED C TRA COSTA COUNTY Against the County of Contra Costa or ) RECEIVED JULDistrict) UL 2 8 2OnA (Fill in the name) . ) -RISK MANAGEMEIV I- The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ o«h, and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) l 71-6 <m a e J Ih �4v/ DGC�cvi �� Or-., CJu�-, d- oZoaO q �!� .' �..�GZ .is-� 2. Where did the damage orinjuryoccur? (Include city/and county) / l�� + � /J ` :/ 3. How //did the damage or injury/ occur? (Give full details; use extra paper if required) p441V /,/y C'uvS-hi/Jpc�o7 �t f�I/,? y,l.�vT S•`j'../-7� �iG[�`� /.v On Cv.. //'/tib/,, �/'�r /1,'c n '3 ��f�P .� &ePd r,`/.G� �'� %'i i�i�✓�ai,�. (J4/C�i i3',-n.� �4Y�ii c77 4. What particular act or omission on the part of county or district officers, sZants, or employees C4 0, caused the injury or damage? 1 /p Ca u°d t,I 5 V /�P ( on7va� C bS7� ( 0a y l/e/�ri.�it�.,� of ��JC.L ���Pi�s� at .d �Iur�ial 5 What are the names of county or district officers, servants, or employees causing the A/ �✓ damage or injury? 6. Want damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) p 4,5Z//u.,�s - � _' re 4,L Qol c„( Ars us 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, hospitals: \y J, LJo4 p ✓e,a, �v- 9. List the expen tures you made on account of this accident or injury: DATE TIME AMOUNT ■ UK man man auats.mas a■■aa as■ams■■a aaa NaaN amu aaa au as amaaamNua■maDa■a■ 0 a a■m aaaaaaal .Gov. Code Sec. 910.2 provides"The claim shall be signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attomey) 1 In Name and address of Attorney ) (Claimant's Signature) g �o �'7�-et,� (Address) Telephone No. ) Telephone No. M am.a a aala■S a a E E.E a..a s a..N...Bass 9NESHESENEN■MRSam HEa■■ESSEN■SNNNSS■am■a an 02 ENDS aENI 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. assaN asN a a s a a a a a■aa a a a as ■ as a s aa.aaasaaaaaaaaaaaasaaa■aa a a a a a a a a a a an■■a.a. a. a a a a a a a■■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 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 ($10,000), or by both such imprisonment and fine. � _S z ? � BOARD OF SUPERVISORS OF CONTRA COSTA COUl-T"f INSTRUCTIONS TO CL kRVL4NT A. A claim relating to a cause of action for death or for injury to person or to personal property or growing crops shall be presented not later than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be presented not later than one year after the accrual of the cause of action- (Gov. Code § 911 2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street,Martinez, CA 94»3. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each. public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. ■¢¢¢¢¢¢¢¢¢¢¢¢¢aaaa¢a¢aa¢a¢¢ea¢a¢aaaaeaa ea as aa¢s¢aa¢¢eeaa¢■a a¢a s a¢a a a 9 c a a a a e a M RE: Claim By: Reserved for Clerk's filing stamp J ) RECEIVED Against the County of Contra Costa or ) LSEP1 9 2008 District) CLERK BOARD OF SUPEMISORS CO. (Fitt in the name) ) CONTRA COSTA The undersigned claimant Hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ ly,; /, , o /, . and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 71-L. (�c/a� :i('C .� !/e � ..rte/ .:'CC .-Gri - .,( Cis. t /�+,f-- �t���. T .le /�Lt 2. Where did the damage or injury occur? (Include city and county) 7/C..a Cxc:,�. '1L .1 ih ��Ur ` C1�C c:vr, ' •� 7 l.:' 3. Ho//w did the damage or in/ occur? (Give full details;use ek-tra paper if required) � s1z'iJ:":,'! L �!r I.[1'.! S'.`r._. '�l �J✓2i �/.1� I,i CSG... �44 i A �-[!q/-' t�••<� /`<'iJ.-l•t;l '�'' �br� .j�c'.� t IE�G4n..-+..-� %'''r,�,. ,-� .T� �1 •.-� �,7��� yf/I/`: 4. What particular/act/or omission on the part of county or district officers, sef�vants, or employees caused the injury or damage? /4 7el 7 11, 5 What are the names of county or district officers, servants, or employees causing the damage or injury? SHARON HYMES-OFFORD SEP 1 7 2008 5_ )WL-Et damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) (,L/G�.i.�� -'/•�C 1�J1�/7 G7 >C; sj .1UY -'baa% (_:��/ j".7 v L..' L. - 7. Hover was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 9. ,_Na\/mes and addresses of viritnesses,J/doctors, and hospitals: tti 9. List the es penhrtures you made on account of this accided or injury: - z DATE M4E AMOUNT �a% S T� ?P✓ Cid [ [aatl[[aa •e[[[s[[[a[[[[[[ ■ a a a Ron a■aa■■a■aaa■■■aa aaaaa■■■■■a■• aaaa■a•Run ■aaa■aa•aa•■■l .Gov. Code Sec. 910.2 provides "The claim shall be signed by the claimant or by some person on his behalf." SDgD NOTICES TO: (Attomev) 1 j Name and address of Attorney ) 4 (Claimant's Signature) (Address) Telephone No. ) Telephone No. G 6 a a a a a a WE a a.a ata ■a t a a as an a a a a a a a a a[[an or I a a to a a RE on ad a a a or a a a a t a a ala a a.WE a t a a a a[s at RE l 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, §9 6500 et seq.) Furthermore, any attachments, addendums, or supplements attached to the claim form, including medical records, are also subject to public disclosure. a a R a a a a a a a a a a a a a a a a a a a a . ..................... ........................... ... ......... NOTICE: Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents for alloNvance or for payment to any state board or officer, or to anv county, city, or district board or ofFcer, 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 exceeaing ten thousand dollars ($10;000), or by both such imprisonment and fine.