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Home My WebLink AboutMINUTES - 01132009 - C.09 (9) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JANUARY 13, 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 vv on your claim by the Board of n Supervisors. (Paragraph IV below), v 911) given Pursuant to Government Code DEC 1 1 2008 Section 913 and 915.4. Please note all AMOUNT: UNKNOWN "Warnings". CLAIMANT: PETRA GARCIA COUNTY MARTINEZ CALIFCOUNSEL CALIFL . ATTORNEY: UNKNOWN DATE RECEIVED: DECEMBER 11, 2008 ADDRESS: 3330 WALLER AVENUE BY DELIVERY TO CLERK ON; DECEMBER 11, 2008 RICHMOND, CA 94804 RECEIVED FROM RISK BY MAIL POSTMARKED: MANAGEMEt11r FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DAVID TWA, CI Dated: DECEMBER 11, 2008 By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Su ervisors O This claim complies substantially with Sections 910 and 910.2. ( his 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). ( ) Other: Dated: ��3 i" �� By: 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. XARD 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. Date 3 %4 S7GID TWA, CLERK, By eputy Clerk OL 9 WA ING (Go . 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. Date .��OID TWA, CLERK, By eputy Clerk This warning doenot apply to claims which are not subject toithe C31ifornia Tort Claims Act such as actions in in;verse condemnation, actions for specific relief-such-as mandamus or ,[(s 1 =:i :'".•"f dig � ;s�Fq`ai injunction, or Federal C.vilR19' is claims. The above list is not exhaustiye;and legal -lr consultation is essential tounderstandall the separate limitations per'iod's.that:m_a',Y apply. The limitations period within4hich'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`'doesit waive rights under the statutes of :hmi ations.applicable to actions not subject to the California Tort Claims Act r -._f�� 'JF,`i vh, �+ af�' h:J �.'•.' �'•.11x+.?'7nsa:".'�+�� r e e... OFFICE OF THE COUNTY COUNSELgE___L SILVANO B. MARCHESI COUNTY OF CONTRA COSTA � ' Off' COUNTY COUNSEL Administration Building ,;i- 651 Pine Street,9t'Floor _ - • SHARON L. ANDERSON �� _� Martinez,California 94553-1229 - ' �- ', CHIEF ASSISTANT (925)335-1800M1 GREGORY C. HARVEY npt t}iY\l11 , (925)646-1078 (fax) �' �' �p VALERIE J. RANCHEASSISTANTS rA COUK� NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM January 5, 2009 TO: Petra Garcia 3330 Waller Avenue Richmond, CA 94804 RE: CLAIM OF PETRA GARCIA 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. [X] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [X] 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. [ ] 6. The claim is not signed by the claimant or by some person on his or her behalf. ♦/ -& Petra Garcia Re: Claim of Petra Garcia January 2, 2009 Page Two [ ] 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. j 18. Other: SILVANO B. MARCHESI COUNTY COUNSEL i By: 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 January 5, 2009,I 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 Petra Garcia, 3330 Waller Avenue, Richmond, CA 94804, 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 on 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 S Zda 2 , at Martinez, California. Kathleen O'Connell cc: Clerk of the Board of Supervisors (original) Risk Management b � y � � BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Il\TSTRUCTIONS TO CLAMANT 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 ,p 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.) O,9 B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, ��Og 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. "u[[[[[[u[[u[[[[[ a[u[[[[[■[ae[a[[[[[[[au■■■u[[[[[[Q[au[[[[[[[[[[[[[[[[a� RE: Claim By: Reserved for Clerk's filing stamp } Against the County of Contra Costa or District) m, (Fill in the name) ) 99�'p S, 110d A Tyco9Gs s The undersigned claimant hereby makes claim against the County of Con Costa or the above-named district in the sum of$ and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) / c Qaviw(�"�� 39 5l 'ti��t�►�z Cly Cl'�� 3. How did the damage or injury occur? (Give full details;use extra pa er if required) �� L b s IAC Ca.r rnlc�2 aK I v u� yn� 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? 5 What are the names of county or district officers, servants, or employees causing the damage or injury? ` 6. damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) 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, and hospitals: 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT ■ aaIRE■a.an a s to a a a at as as a s aaaaa■an*as t o ass a a a as a s am a a a a a.■a.■■was Eno ass■■ata[[an as ass ) .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. aaaaa■■aaa■■[.a........■■ .. ..awt.■a.a[i.alaaw ata9 a..aa■■wtaa[aa■aaaa ass a ■.■a..a■most 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. ■ awas■a■mass.■tRome■town a ata.tta[.aaa...a.etaaat mammas man■aa wa attaa■■ no a■a[atwa.l NOTICE: Section 71 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. VN i b a a 10 mUEFA mU7OA m A QQ'.15 r+i CA W4 WM 2S�n C �d ot a s N o iEI�p �� m c N m cn o o x 3 3 �5' Ics+ Q 12/06/2008 at 01 : 48 PM Job Number: 98473 �' CARLOS AUTO BODY SHOP CARLOS AUTO BODY SHOP 221 24th Street Richmond, CA 94804 (510) 307-1544 Fax: (510) 307-1507 PRELIMINARY ESTIMATE Written By: Carlos Carbajal Adjuster: Insured: PETRA GARdIA Claim # Owner: PETRA GARCIA Policy # Address: 3330 WALL ER AV Deductible: RICHMOND, CA 94804 Date of Loss: Day: (510) 965-9243 Type of Loss: Point of Impact: 6. Rear Inspect CARLOS AUTO BODY SHOP Business: (510) 307-1544 Location: 221 24th Street Richmond, CA 94804 Insurance Company: Days to . Repair 1983 HOND ACCORD 4-1. 81, 4D SED Int: VIN: JHMSZ7425DC159523 Lie: Prod Date: odometer: 194579 Rear Defogger Cruise Control Intermittent Wipers Body Side Moldings Power Steering Power Brakes Bucket Seats Recline/Lounge Seats 5 Speed Transmission ----------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT --'----------------------------------------------------------------------------- 1 REAR BUMPER 2 O/H bumper assy 1 .7 3 O Repl Face bar 1 289.38 Incl. 4 Repl LT Energy absorber ` 1 98 .28 0. 3 5# Repl 1 6 REAR LAMPS 7* 0 Repl USED LT Tail lamp assy 4 door 1 100 . 00 0 .5 -------=----------------------------------------------------------------------- Subtotals . ==> 487 . 66 2 .5 0. 0 Parts 487 . 66 Body Labor 2 . 5 hrs @ $ 60 . 00/hr 150 . 00 ---------------------------------------------------- SUBTOTAL $ 637 . 66 Sales Tax $ 487 . 66 @ 8 .2500% 40 . 23 ---------------------------------------------------- GRAND TOTAL $ 677 .89 ADJUSTMENTS: Deductible 0 . 00 1 F7--- X t�01: 48 PM Job Number: PRELIMINARY ESTIMATE 1983 HOND ACCORD 4-1 . 8L 4D SED Int: ---------------------------------------------------- CUSTOMER PAY .$ 0 . 00 INSURANCE PAY $ 677 .89 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' SQUALIFICATION 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. 2 t w QY— ,\ ny mks NY � ��- �V pkpp� (VQ' fee I.� iT CT 4 . + r a� U _ )e $ 25 �Clo r Q} n tj1 to V l ,