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Home My WebLink AboutMINUTES - 11182008 - C.12 (22) r ., CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: NOVEMBER 18, 2008 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) OTICE TO CLAIMANT and Board Action. All Section references are to ) he 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), OCT 6 2008 given Pursuant to Government Code COUNTY COUNSEL Section 913 and 915.4. Please note all AMOUNT: $1 MILLION MARTINEZ CALIF. 'Warnings". CLAIMANT: ADELMIRO VALENTINE GIRON ATTORNEY: GEORGE D. OLIVER DATE RECEIVED: OCTOBER_109, 2008 ADDRESS: 42 HICKORY ROAD BY DELIVERY TO CLERK ON: OCTOBER 09, 2008 FAIRFAX, CA 94930 BY MAIL POSTMARKED: HAND DELIVERED FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DAVID TWA, Clerk Dated: OCTOBER 09, 2008 By: Deputy ka%4�� 11. 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). ( ) 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: �. 30L BCounsel III. FROM: Clerk ofthe Board TO: County Counsel (1) County Administrator(2) O Claim was returned as untimely with notice to claimant (Section 9113). IV, ROARD 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. Datecj44r/+°iirl db� Pa. AVID 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 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,10`1&1"�6ey� AVID TWA, CLERK By ,Deputy Clerk 1 , This warning foes not apply to claims which are not subject to the;California Tort Claims Act such as actions;iniinverse/`cond'e_mnation actions for specific relief such.as mandamus or injunction, or Federal'.CivilfRghtsclaims. The above list is not exhaustive,andAjegal ', ....,+i��4 i�iTn consultation is essential�to understand all the separate limitations periods that 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 DUAKV Ur JurrnVlavl-,Zur '.VIN I MA t—sua 1A %_VV1V11 INSTRUCTIONS TO CLAIMANT 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 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 forma ■ee■ o■emoms ■■ ■eeeeel RE: Claim By: Reserved for Clerk's filing stamp Aba-mi u \/kIN-D WE GROW) � R�C Against the County of Contra Costa or ) OCT ... 9 E�VE 2008 District) CCE (Fill in the name) ) co of KBN RACOSgp S ER C VIS RS r o 0 The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ V, and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) N-�1r1 ` \ 0 12008 2. Where did the damage or injury occur? (Include city and county) lid_\MovXdk / Coniy_a Cos-�a CoUV�h.1 Tal I 3. How did the damage or injury occur? (Give full details; use extra paper if required) 2 WAS %V- 0,-DVt -_T WAS 1oc)c� -eal '%V.+o t\,\e- Cgorgva coS}� CouA� Jo.( I . Eves, tHovc�L. b ay.1G kACd� o 5ea(ePP� e-1i hS�s iz,llgC3 't1 �2 @,ioP bu 1cP Sive 4�5 y hea 4. What particular,act or omission on the par of county or district officers, servants, or employees St o ider, caused the injury or damage? See KNG�kI� M^e �v COn 4 5 What are the names of county or district officers, servants, or employees causing the damage or injury? ?C A I(_e ASA CoY-\AY& CosA-t;^, Cbuv-,.� V 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.)Seve re he-id ACheS JOSS of vhe w v� �vinw�eol��4e l-� CNFier -- \C okci Al hi-i co 11 ct✓ b o h� p er;�o u+/ 1112 '1 v\C i� CLA— ev\ the i�F s� P, Ck ineaclt vts��V. � S �ggyl lecl ST- C -v V\, 1' �Jurt S . 7. How was the amount claimed above computed? (Include the estimated arnount of any prospective injury or damage.)EL \t C 8. Names and addresses of witnesses, doctors, and hospitals: i�6c+z��s Me& C�J Ceh�er, 2-000 VO12 po�1/ Sa��al�lo ,Cf� 9. List the expenditures you made on account of this accident or injury: `Aq, 3 O� DATE TIME AMOUNT ��F'roXim��e�� 1Oj000 . 00 ■.......... ....... ....Bonn nonage..sessom.........,..■■..........■■.....rson■■mennowl ) 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 ) C)CovGe D. O 11 velem ) J ) (Claimant's Signature) �zoS C1u6 (Address) \ ) R�c1�►�o�d , LA 9S% 63 Telephone Telephone No. t]Z�o (a .......o.................................agog........■.............Down onus.........i 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. 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.