HomeMy WebLinkAboutMINUTES - 01062009 - C.13 CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
BOARD ACTION: JANUARY 06, 2009
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
Supervisors. (Paragraph IV below),
given Pursuant to Government Code
AMOUNT: $1)279.05 DEC 0 3' ZOOg Section 913 and 915.4. Please note all
'Warnings".
CLAIMANT: EDNA WDNER GOVBT 0 CpL FL
tVIAR
ATTORNEY: UNKNOWN DATE RECEIVED:. DECEMBER 02, 2008
ADDRESS: 4525 SILVERCREST WAY BY DELIVERY TO CLERK ON: DECEMBER 02, 2008
ANTIOCH, CA 94531 RECEIVED 'FROM RISK
BY MAIL POSTMARKED: MANArENR rr
FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DAVID TWA, Cl
Dated: DECEMBER 03_;.,.2008 By: Deputy
II. FROM: County Counsel TO: Clerk of the Board of Su ervisors ,
(eis claim complies substantially with Sections 910 and 910.2.
,,,fgThis. 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).
( ) Other:
Dated: 2— By: m Deputy 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:
(1 j 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 a deo DAVID TWA, CLERK, By Deputy Clerk
WARNING(GVv. code section 913)
Subject to certain exceptions,you have only six(6)months from the date this noticewas 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 choke in.connection with this matter.If you want to consult an
attorney,you should do so immediately. *For Additional Warning See Reveiee 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.
Date • 2 DAVID TWA,CLERK, By Deputy Clerk
This warning doe`$ not.not ,pply to claims which
are not subject to the California Tort Claims
Act such as actions,in inverse condemnation,
actions fors ecific'reliefi& asmandamus or
injunction, or Fed'er'al Civil Rights,elaims. The
above list is not exhaustive and legal`.'
consultation is essential,tounderstand all the
separate.limitations periods'•th:at`m'ay 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
t
OFFICE OF THE COUNTY COUNSEL gEL SILVANO B. MARCHESI
COUNTY OF CONTRA COSTA 1� ''- _ - +s' COUNTY COUNSEL
Administration Building - SHARON L. ANDERSON
651 Pine Street,9'"Floor
Martinez, California 94553-1229 - - :_ _. ;• CHIEF ASSISTANT
.. .Y-.'i't. ,1\l�h :r,:.,.. GREGORY C. HARVEY
(925)335-1800 Ot f j �lr
VALERIE J. RANCHE
(925)646-1078(fax) �� a e�� AssisTANTs
r"� COUK�
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
December 23, 2008
TO: Edna Gardner
4525 Silvercrest Way
Antioch, CA 94531
RE: CLAIM OF EDNA GARDNER
Please Take Notice as Follows:
The claim you presented against the County of Contra Costa or District governed by the Board of
Supervisors fails to comply substantially with the requirements of California Government Code Section
910 and 910.2, or is otherwise insufficient for the reasons checked below:
[ ] 1. The claim fails to state the name and post office address of the claimant.
[ ] 2. The claim fails to state the post office address to which the person presenting the claim desires
notices to be sent.
[ ] 3. The claim fails to state the date,place or other circumstances of the occurrenc.e.or transaction_ -
- which gave rise to the claim asserted.
[ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or
loss, if known.
[ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000).
If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount
claimed as of the date of presentation, the estimated amount of any prospective injury, damage
or loss so far as known, or the basis of computation of the amount claimed.
Edna Gardner
Re: Claim of Edna Gardner
December 23, 2008
Page Two
[ ] 6. The claim is not signed by the claimant or by some person on his or her behalf.
[ ] 7. You are required to submit your claim on the proper form, which is enclosed. Please resubmit
your claim on the enclosed form, including all the required information. Gov. Code, § 910.4.
Please be aware that you have only a limited period of time in which to file an amended claim.
See Gov. Code, § 910,6.
[X] 8. Other: Please provide the year of the incident.
SILVANO B. MARCHER
COUNTY COUNSEL
B � . r �
y:
Monika L. Cooper
Deputy County Counsel
CERTIFICATE OF SERVICE BY MAIL _
(Code Civ. Proc., §§ 1012, 1013a,2015.5; Evid. Code, §§ 641, 664)
I am a resident of the State of California, over the age of eighteen years,and not a party to the within action. My
business address is Office of the County Counsel, 651 Pine Street,9th Floor,Martinez, CA 94553-1229. On
December 23,2008,1 served a true copy of this Notice of Insufficiency and/or Non-Acceptance of Claim by
placing the document in a sealed envelope with postage thereon fully prepaid,in the United States mail at
Martinez,California addressed to Edna Gardner,4525 Silvercrest Way, Antioch,CA 94531, as set forth above. I
am readily familiar with Office of County Counsel's practice of collection and processing of correspondence for
mailing. Under that practice,it would be deposited with the U.S.Postal Service o_n_that_same day_ with postage
-thereon fully prepaid in the ordinary course of business.
I declare under penalty of perjury under the laws of the State of California and the United States of America that
the above is true and correct. Executed on�nZ&l��'3R_ at Martinez,California.
Kathleen O'Connell
cc: Clerk of the Board of Supervisors(original)
Risk Management
Nov ,26 08 '03: 55p S i cF' 'peed Inc 510 �—'9 9569 p. 2
BOARD OF SL-PEIRV'ISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIIVLANT
A. �A claim relating to a cause of action for death or for injury'to person or to personal property or
gro-wing 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 a?ainst each. .
public entity. A
e
E. Fraud. See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form. N0I,//�hYea f
a■■•■N■WEf■a••■■!■ f ���-f■1i��[■fitl[[■BRURINBad■■AtNI■■RMIRK2■K',l{•■new` •K LO ,�+
RE: Claim By. „ Reserved for Clerk's filing stamp
_ ) Cis UE i 72 E..
Against the County of Contra Costa or
k' BOARD OF SUPcR`iISOR5,
District) _ Do^I?RA COSTA CO.
(Fill in the name) )
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named
district in the sum.of$—I and in support of this claim represents as follows:
1. "%an did the damage or injury occur? (Give exact date and hour)
14i5P
2. Where did'the damage or injury occur? (Include city and county)
3. How did the damage or injur1y ccur? (Give full details: use extra paper if required) r
�etl'L"E� .:'F <( -B.. �i-�S JfA 'p, yw, (O:ngtoy�..C;r, c Ov r✓l/N2
jr U;tXf ry
i-.+- �� f.AY
.a c
4. What particular act or omission on the part of county or district officers, servants, or employees
caused the injury or damage? — ,W:c k n Po"` A-u� ; U O r r� r N S 4en di a
C4w4rNY jus Cti,- � CV.-,il� rni�Z vti , n/2. t4-e v9a .nAJ�-e,o
�(f5 rx154-�+J�, -d' APvtJ5, Zax
5 What are the names of county or district officers, servants, or employees catling the
damage or injury? R;? Lx
Nov • 26 08 03: 56p Sig(_ Speed Inc 510 r 9 9569 p. 3
6. V1qat damage or injuries do your claim resulted? (Give full extent of injuries or damages
claimed. Attach two estimates for auto damage.) -�,�-�- }���-ti�z.� c`fl� ekfeo� R L-i L e r-
��{,,.i.,..��, s _- t2 •t �, .�L��ro= 'd la ka.•,.� _ �1,:_.n-f- cic:w„^a�c{ _. s c:-����I ---
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury"or damage.) -7u)n '� a c�-I c w �4� 4� c�c
wn-+-
8. Names and addresses of witnesses, doctors, and hospitals: —
CA-r..�S, Rl w'/h_Oly. – Lf,CZ2 S i(ve`—rr 1 (A/ y A-"-�i--�v c i.. C om-
(,�nr�cH-. vl�113
2_10 l y�wi l..Sf �4-&J`x fc. Crf .
9. . List the expenditures you made on account of this accident or injury:
DATE TINS AMOUNT
/�✓!✓� �c� GCS C S }"f s".��Y-�I ��i9-...
aaa eaa ata as■eataleeiftf[setae■aa■at[aaaea[a[ata[l[[[a[te[tat■taa■aaea[a eeataa[t.[[ fal
.Gov. Code Sec. 910.2 provides "The claim shall be-
signed
esigned by the claimant or by some person on his
behalf."
:SEND NOTICES TO: (Attorney) 1
Name and address of Attorney )
} (Claimant's Signature)
j "/s2 S S!lyerc,u,LT L�
(Address)
)
Telephone No. ) Telephone No. S lv
a ■a t....■a a.■tat■a■Remain a■a....a a[a■[1 1 1!a■t t t a:[t a■ an [...l a■t t■a a a a a aMen stageReal 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, §§ 6500 et seq.) Furthermore, any
attachments, addendums, or supplements attached to the claim form, including medical records, are also subj cot to
public disclosure.
a e am wagesa a a Ka t e t a t.............■[t a a t a a a RUN.a t t t t t...[.... RE Kilt an t a a I
NOTICE:
Section 173 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 disfaict 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.
Nov. 26 08 03: 56p sign ipeed Inc 510 r`9 9569 ! p. 4 ,
11)20/2008 at 04 : 56. PM_ 1:;b `Number:
22792
MIKE ROSE'S AUTO BODY OF PITTSBURG
Federal ID 4 : 942621349
WHERE QUALITY COUNTS
3001 NORTH PARK BLVD
PITTSBURG, CA 94565
(925) 432-9910 Fax: ( 925; 432-9936
PRELIMINARY ESTIMATE
Written By: MARTY KIKK.ERT
Adjus-c.er :
Insured: EDNA GARDNER claim #
Owner: EDNA GARNER Policy #
Address: 4525 SILVERCRE.ST WAY Deductible:
ANTIOCH, CA 94531 Date of Loss:
Modem: (510) 302-9147 Type of Loss:
Business: (510) 302-5987 Point of Impact: 12 .
Inspect MIKE ROSE' S AUTO BODY OF PITTSBC Business: ( 925) 432-9910
Location: .3001 NORTH PARK BLVD
PITTSBURG, CA 94565
Insurance
Company: Days r.o R-pa . r
2006 CHRY PACIFICA 4X2 TOURING 6-3 . 5L-FI 4D JTV SI=..VER
VIN: 2A4G1,168446R787668 Lic: 058 WTC AZ Prod Date: 0_1i?Ci `i Odometer: 80538
A-r Conditioning Rear Defogger ^i: t Wheel
_... ..ise Cor_trcI Interm-` t-ent 'Wipers
-_heft Deterrent/Alarm Rear window Wiper _�teerirnc W*,�ei ..on refs
Massage Center Body Side: Moldings D;i,,1 i•-:__ c:.r:
Console/Storage Overhead Console T. . r�gaclr/Roo.; Rack
Clear Coat Paint Metallic Paini Pov:cr z.-erinq
Power Braces Power Windows Pnw(�er. �_c,:.ks
Power Driver Seat Power. Passenger Seat rowe_ liirr.crs
Heater h,_rrors AM Radio L'h1 Rad
Ste neo Search/Seek ."r,
Anti-Lock Brakes (4 ) Driver A ' -- Bac r •,~ :�k
Jy:^eel Disc Brakes Cloth seats l3ur •::: t: at.:
Automatic Transmission Aluminum/Alloy Wheels
--------------------------------------------------------------------------------
NC. OP. DESCRIPTION QTY EXT . PRICE 1 ABOR PAII:T
--------------------------------------------------------- ----------------------
1 FRONT BUMPER
2 Repl Bumper cover upper w/Tour, 1 296 . 00 ? . 0 2 . 4
Lmtd
3 Add for Clear Coat 0 i .Ci0 0 . C 0
4 Repl License bracket 1 7,11
54 Repl S, :-MPEP. COVER L06)F2 1. 0
6 Repl RT Reflector ? _ ' . .55 incl . 0 .0
7# Repl FLEX ADD-TIVE _ B . Oc 0 0. 0
8# Sub' HAZAR=)S WASTE 1 00 ., 0. C. C , G
1
26 08 03: 55p Sig Speed Inc 510 ( 9 9569 p. 1
Fax
To: Joan
From: Edna Gardner
Fax: 925-335-1421
Voice: 925-335-1440
Ref: Claim # 65834
Pages 9
Nov• 26 08 03: 56p Sigh. Speed Inc 510 ( 9 9569 p. 5
1-/20/2008 at 04 : 56 PM Job Number:
2
c?9 G
PRELIMINARY ESTIMATE
20067C4RY PACIF=CA 4X2 TOURING 6-3 . 5L-F= 4D 'J'I V
-------------------------------------------------------------------------------
NO. OP. DESCR--PTION QTY EXT . _'PTC:E LABOR FAINT
-------------------------------------------------------------------------------
9# TINT COLOR 1 . 0C J .
10# XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 1 i; . 0C 1 . 0 0 .0
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
11# ESTIMATE OPEN PENDING TEARDOWN 1 0 . 00 0. 0 0. 0
12# XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 1 'J . C:O ii . 0 0. 0
XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
--------------------------------------------------------- ----------------------
Subtotals =_> 593 . •0 =. 6 3. 4
Parts 580 . 30'
Body Labor 2 . 8 hrb @ s2 . 0 h- 22: . 60
Paint Labor 3 . 4 hr: ? c2 . C10/hr 278 . 8C
Pa_n- Suppl_es 3 . 4 hr:: ? 5 . 00;hr _19 . 00
S-able-11N1isc . 13 . 00
----------------------------------------------------
SJBTOTA! $ ' `2_2C . 70.
Sales Tax ?i...' . . ( . . 35C;,- �5
GRAND TC^_AL 1279 . 05
THIS LS A PRELIMINARY ESTIMATE AND ADDITIONAL CHARGES MA')' BE REQUIRED FO*3 TH1
ACTUAL REPAIR.
Nov- 26 08 03: 56p Sight Speed Inc 510 649 9569 p . 6
11/2C/2008 at 04 : 56 PM -oh :-,lumbar:
22%92
PRELIMINARY ESTIMATE
2006 CHRY PACI F ICA 4X2 TOURING 6-3 . 51,-FI 4D U„v SI',.V E: n_
_ FOR YOUR PROTECTION CALIFORNIA LAP, REQUIRES THE FOLLOWIN(! TO APPEAR Oh' TH-S
FORM:
ANY PERSON WHO KNOWINGLY PRESENTS FALSE OR FRAUDULENT ::1, E1P! I-CP, '1nE PAYMENT OF
A LOSS IS GUILTY OF A CRIME AND MAY BE SJBJECT TO FINE.:-', i':f•1C r1F I : i h:r'I: 1:'•J
.STATE PRISON.
THE FOLLOWING 'IS A LIST OF ABBREVIATIONS OR S'Y'MBOLS THAT MAV, BE l::ED TO
DFSCR.IBE WORK TO BE DONE. OR PARTS. TO BE REPAIRED OR REP1,=•=.1:EG:
ABBREVIATIONS/,,SYMBOLS : D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES:
B=BODY LABOR D=DIAGNOSTIC E=EIECTRICA! F=FRAME G=GLASS M=HECHANICAL P=PAINT
LABOR S=STRUCTURAL T=TAXED MISCELIANEOJS X=NON TAXED MI6CELLANEOJS PATI-7WAYS :
ADJ=ADJACENT ALGN=ALIGN A/NI=AFTE3MARKET BLND=BLEND CAPA=CEHTIF'IED AUTOMOTIVE
PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMAT EXT . PRICE=Ut�I,r
PRICE MULTIPLIED BY” THE QCANTIT`' INCL=INCLUDED MISC=MISCi:LLA--1FJJS KAGS=NA:'ICNAL
AUTO GLASS SPECIFICAT=ONS NON-ADJ=NOP: ADJACENT O/H=n-VERFiAC_. 013=0PERATION
NO=LINE NUMBER QTY=QUANTI^_Y QUAL RELY=QUAL-TY RECYCLED PARI' ',IUAL REPL=QCAL-TY
REPLACEMENT PART COMP REP! PARTS=COMPETI"IVE REPLACEMENT PA!.TS
RECOND=RECONDITION REFN=REF=NISH REPL=REPLACE R&I=REMOVE r.ND I1::3'rA.L R&R=REMOVE
AND REPLACE RPR=REPAIR' R^=RIGHT SECT=SEC"ION SUBL=SUBLET LT=LEFT ,^1/0=WITH0UT
W/ =WITH/ SYMBOLS : #=MANUAL LINE ENTRY —OTHER [IE . .F�-OTORS DATABASE
INFORMATION WAS CHANGED] **=DA'-ABASE LINE WITH AFTERMARSL'1 N =NC-TE:= ATTACHED ^O
LINE. MQVP=MANUFACTURER' S QUALIFICATION AND VAL=DAT-CN PP.00P.PIm. OL-,r
OEM=ORIGINAL EQUIPMENT PANUFACTGRER PAR_'S EITHER OPTIOn A,L -UU[:_:EC OR
OTHERWISE PROVIDED tWITH SOME JNIQJE PRICING OR DISC:OUN'_ . !:'r'dC;'P NA'i::Nloj_D-- CFASH
FARTS PROGRAM.
• -west:- eased o'1 P40'fCR CRASH ESTI>9A1'I`dC'; GUTPY. miesN rEnerwiar, n ,i 1 .. M:. at':- '.ie?-iveri from
- , l.C..- ',:wide DR3004r VLIr _•StS LdT.!; 0:/ 0 c.:::,)JS, [Ii.'.: :.1:':v ::'1=i'._ ;iEla::i.C:w .. .. .. .. ........ _a W,... ...
the vehicles Original Equipment. Manufacturer. CEM par7s are avai-::nio : A- . _ . .. . .,:. :; :>.
027 OEM (Optional SEMI or ALT OEM (.Alternative OEM) parts axe OEM pa: `:S VhAt way he pr.nc'ded by or
,.....ocgh alternate sources other than -he OEM veh_'cle dealerships. W. ;trai :r . ._ :>Rrl p, lrtz flay
_reflect some specific, special, or unique pricing or diseowriL. C•L'I ai A.L7 OEM parts may
Include 'Blemished" parts orcv_ded by OEM's inrougn G&M cen_ule ,ie., : - : ;: '1:.:. Am7elish , or
Double Asterisk f*") indicates that the parts and/or labor inF;rca-tn: ora - . n; MOTOR may have
had
modified or may have C:gIT,P_ from an alternate data source- 'li_v:a tjr , . -. L,ris ii:c.iazie ;<l:?'f(?3
Kai-Included Labor operations. Non-Cricina' Equipment Kanufacture: .JL ' ::r:::::: 1 "alto are dek_iked
.as ::_ISS, Qua- Rep_ Parts or Coop Rept Parts 'which stanbs for Costpeti.-'. .. P. 1� n_.;,nL Parma . Used
Parts are described as LK, , Qua! Recy Petr-s, RC:Y, nr I:SED. kecnn"i7 %r:"r1 .Ar N .,re resp ified As
Recondi Reccred parts are described as Rec ce. NAGS =are Numbi rt no! !•,_.I. .. Prices arc.
pruvi.ded. by 'National A1tc. ,las: Spec:=ications. Laino_ operation -..ime 1 ; : th^ ' ' no w i :. I h,>
NAGS information are MOOR sugaes Led Labor _upe_.:ttion tines. NAGS .L-., c no ali•on t i meN ore not
f:tJ_ild@:C.
. Pound sign (0)items indicate manual cnt.rics. Some 203, v, •:!.v. :. ,gin: n& min:::. ahange
l_cir the previous year. ' For those Vehicles, arior to receiving 17:?,t• ynd jai li-cm. the .,.f:.l.a L,
manufacturer, labor and pests as Cd Iron the pievicis ,-« may, be ..son. L F'::. hways r_1;t7:;i;,L'JI has
o complete list of applicable aehiglr.,. I•,,rts numbers and pricer, .,.. :a_ . nantirmen with ;.hr
CCC P"Chwdys - A plo uci ;_ L_.nrua.. .....
3
Nov. 26 08 03: 56p Sig Speed Inc 510 49 9569 p. 7
11/20/2008 at 04 : 19 PM Job Number:
31033
ANTIOCH AUTO BODY, INC.
License # : 37962 Federal ID # : 680336031
1401 VERNE ROBERTS CIRCLE
ANTIOCH, CP_ 94509-7915
(925)_757-3586 Fax: (925) 757-5246
PRELIMINARY ESTIMATE
Written By: SERGIO GONZALEZ
Adjuster:
Insured: Ernest Gardner J Claim #
Owner: Ernest Gardner Policy #
Address: 4525 silvercrest way Deductible:
antioch, CA 94531 Date of Loss:
Day: (510) 302-9147 Type of Loss:
Day: (510) 302-5987 Point of Impact: 12 . Front
Inspect
Location:
Insurance
Company: Days to Repair
2006 C3RY PACIFICA 4X2 LIMITED 6-3 . 5L-FI 4D UTV silver Int:
VIN: 2A4GK68446R787668 Lic: 058wtc AZ Prod Date: Odometer: 80535
Air Conditioning Rear Defogger Tilt Wheel
Cruise Control Intermittent Wipers Keyless Entry
Theft Dezerrent/Alarm Rear Window Wiper Steering Wheel Controls
Memory Package Message Center Body Side Mol dings
Dual Mirrors Console/Storage Overhead Console
Luggage/Roof Rack Electric Glass Sunroof Clear Coat Pa int
Power Steering Power Brakes Power Windows
Power Locks Power Driver Seat Power Passenger Seat
Power Mirrors Heated Mirrors AM Radio
FM Radio Stereo Cassette
Search/Seek CD Player Premium Radio
Anti-Lock Brakes (4) Driver Air Bag Passenger Air Bag
Head/Curtain Air Bags Front Side Impact Air Bag Rear Side Impact Air Bags
4 Wheel Disc Brakes Leather Seats Bucket Seats
Seated Seats Automatic Transmission Aluminum/Allo y Wheels
-------------------------------------------------------------------------------
NO. OP . DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
1 FRONT BUMPER
2 Repl RT Reflector 1 18 . 10 Incl -
3 Repl License bracket 1 38 . 40" 0 . 3
4 Repl Bumper cover upper w/Tour, 1 252 . 00 2 . 0 2 . 4
Lmtd
5 Add for Clear Coat 1 . 0
6* Repl Bumper cover lower blue 1 279 . 00 Incl . 0 . 0
7# Repl FLEX ADDITIVE 1 10 . 00 T
8# HAZARDOUS WASTE 1 5 . 00 X
1
Nov. 2G 08 03: 57p- Sigh Speed Inc 510 !. .9 95GS p. 8
11/20/2008 at 04 : 19 PM Job Number :
31033
PRELIMINARY ESTIMATE
- 2006 CHRY PACIFICA 4X2 LIMITED 6-3 . 5L-FI 4D UTV silver Int:
-------------------------------------------------------------------------------
NO. OP . DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
9# Refn COLOR MATCH 0 . 5
-------------------------------------------------------------------------------
Subtotals =_> 602 . 50 2 . 3 3 . 9
Parts 587 . 50
Body Labor 2 . 3 hrs @ $ 77 . 00/hr. 117 . 10
Paint Labor 3 . 9 hrs @ $ 77 . 00/hr 300 . 30
Paint Supplies 3 . 9 hrs -@ $ 34 . 00/hr 132 . 60
Sublet/Misc . 15. 00
----------------------------------------------------
SUBTOTAL $ 1212 . 50
Sales Tax $ 730. 10 @ 8 . 2500% 60 . 23
--------------------------------------.--------------
GRAND TOTAL $ 1272 . 73
ADJUSTMENTS :
Deductible 0 . 00
CUSTOMER PAY $ 0 . 00
INSURANCE PAY $ 1272 . 73
2
Contra
County Administrator Costa Sta
Risk Management Division v
2530 Arnold Drive,Suite 140 C O U n ty Liability Claims (925)335-1440
Martinez,California 94553 Fax Number (925)335-1421
Penny Bailey
MEMORANDUM DEC 0.1,.2008
TO: EMY SHARP CLERK OF THE BOARD
FROM: CAO/RISK MANAGEMENT DIVISION - LIABILITY UNIT
DEQ; 0 2000 1
Ci_ER{<BOARDOf-'9:;Fc'vl°OR'_>�
ATTACHED MAIL RECEIVED AT RISK MANAGEMENT DIVISION: CO'NTPA CO TA 00.
VIA MAIL ( )
VIA FAX
DROPPED OFF WITH RECEPTIONIST ( )