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Home My WebLink AboutMINUTES - 06261984 - 1.25 CUUM Bmm or S mmisom or aimm oosm aooN, CAIMMIA BOARD ACTION Claim Against the Canty, or District ) NMICE TO QUUNWp June 26, 1984 governed by the Board of Supervisors, ) The eoPy of7&Ts--d-=--v—en—tm-a-D ed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Cade Section 913 and 915.4. Please note all 'Warnings". Claimant: Katherine L. Blackmon 1785 Ashbury Drive Attorney: Concord, CA 94520 Address: Via County Admini trator Amount: $120 .00 By delivery to clerk on May 21 , 1984 Date Received: May 21 , 1984 By mail, postmarked on I. FROM: Clerk of the Board ot Supervisors County Counsel Attached is a copy of the above-noted claim. Dated: May 21 , 1984 J.R. O2SSON, Clerk, By Deputy T Jolene Edwards II. FROM: County Counsel T0: Clerk of the Board of Supervisors (Check only one) (p) 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. Clerk should return claim ai 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: - By: &90Deputy County Counsel III. FROM: Clerk of the Board 70: (1) C Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD MER By unanimous vote of Supervisors present (X ) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. eeni DuBois Dated: 6- 26- 84 J. R. OLSSON, Clerk, By Deputy Clerk MMUNG (Gov. Code,Section 913) Subject to certain exceptions, you have only six (6) months from the date of this notice was personally served or deposited in the mail to file a court action an 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action onthis claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DATED: 6- 26-84 J. R. CISSON, Clerk, By _ e�� Deputy Clerk cc-. Canty Administrator (2) County Counsel (1) cLM 60, 030 Com[:IM T0: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions •.;o Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. . (Sec. 911. 2 , Govt. Code) 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 (.or mail to P.O. Box 911, Martinez, -CA) . 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 end of this form. RE: Claim by ) Reserved for Clerk' s filing stamps RECEIVED Against the COUNTY OF CONTRA COSTA) i.1 AY t., ;Osp,l or _ DISTRICT) ON (Fill in name) ) CLERK BOARD OF U SUPERVISOR' NT COSTA CO. The undersigned claimant hereby LLakes claim a By.. '" r ' ' ontra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: Wh -- ------------------------------------------------------- d en did the amage or injury occur? (Give exact date and hour) - --- = --- ----------- - -------------------------------------- 2. Where did the damage or injury occur? (Include city and county) W CD i1 N)C-0 J —CDOI R-� �-Pr . — ES-7 t l TTS E�( C� 3. How did the damage or injury occur? (Give full details use extra sheets f required) M� ut, W, o gk� 0,•4 ov-S C - -- -Q---- -�= f I-------------------------- t4. Whaparticular act or omis ion on the part of county or dstrc ' ys officers', servants or employees caused the injur , or damage? (m-p J way-' ,� c,�,._ c � S,,e- � CIA -I-tuLl 3,, —t,, over) . c� Cyt P=0,:I'3 Cl.;0N o.a. '�59&3 Service Order 1701 CXTEA LONIA BLVD. Union Oil CompCalifornia AIpxowE, CA 94509unienL P"4NE 754-1550 "' 52605 I CUSTOMER S AME DATE ADDRESS �. DEuvER TIME CALL CITY,ST ZIP CODE c v✓d a . r LI O. SPEEDOMETER I CHECK SE ES D sov LUBRICATE FITTINGS 1.; 1 I - 1 REPLACE OIL FILTER ELE T I I ' MOTOR NIN fryifff7l A9D OIL j K I I 10 SERVICE TOTAL Y I Q2 MERCHANDISE TOTAL .. I 1 03 SALES TAX 1 O G SOLINE SUPER 76 REGULAR 76 FILL QTY. I I NO. 962 3 5 TOTAL ► /�?1 ouLut—"Un0 l AETER Pp5tING r R v RY WFF srsrEM. rNls DEALER•IF THIS IS A CREDIT SALE ?BANS- ULD BE RFUI o 5x HEYr+EpT FER ITEM 1, 2 IIF.APPLICABLE, 3, a, TO OURGEJS�N EQ_dl REfs INTAINED FOR TN T/Fp SKINWRIGREEo ItAEDwSlF3l R MANAIOVEE. APPROPRIATE SPACES ON CREDIT DE- fMM 3.Mm TREV 6-OD)MWED IN U.S.A. LIVERY TICKET. - • ,� CLAIM BOAR CP SUPERVISORS OF CORM TSTA CODATPY CALIFMIA . BOARD ACTION Claim Against the County, or District ) NMCE TO CLAIMARr June 26, 1984 governed by the Board of Supervisors, ) The copy of th s document mailed to you is your Routing-Endorsements, and Board ) notice of the action taken can your ciaini icy the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Caries ) given pursuant to Government Code Section 913 and 915.4. Please note all "warnings'. Claimant: Abie R. Cooks/Janet Cooks 605 Griffin Drive Cou. iOUfiS21 Attorney: Richmond, CA 94806 MAY 3 0 1984 Address: Martinez, GA 94553 Amount: $1506.26 By delivery to clerk on Date Received: May 30, '1984 By mail, postmarked on May 29, 1984 I. FROM: Clerk of the Board ot Supervisors y Counsel Attached is a copy of the above-noted claim. y►� Dated: May 30, 1984 J.R. OLSSON, Clerk, By 6 Deputy Jolene Edwards II. FROM: County Counsel 40: Clerk of the Board of Supervisors (Check only one) 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. 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: ;3y By: Deputy County Counsel III. FRCM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD By unanimous vote of Supervisors present (X ) This claim is rejected in full. ( ) Other: I -cern y that this is a true and correct copy of the Board's Order entered in its minutes for this date. R eni DuBois Dated: 6- 26- 84 J. R. OLSSON, Clerk, By ��A� ,/ � , Deputy Clerk MANUM (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FSM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DAs: 6-26-84 J. R. CLSSON, Clerk, By , Deputy Clerk cc: County Administrator (2) County Counsel (1) CLAIM 00 ��3 RECEIVED May 25, 1984 �J RY OLSSON CLERKBOARD F UyPE R,,ISORS Dear Board of Supervisors, By IetGS �Depuh ff This is a claim letter for the amount of $1 ,506.26 for damages to my car. My name is Mr. Abie R. Cooks and I live at 605 Griffin Drive, Richmond, CA. On the evening of Saturday, May 12, 1984 at approximately 10:00 p.m. , my car was unoccupied and parked on Griffin Drive in front of my home. Levi (NMN) Allen, foster child of Mr. Lorenza McNair both of 604 Harrison Drive, Richmond, CA, lost control of his motorcycle and hit my car, severely damaging the left front side of the car. Mr. McNair is the legal and/or co-owner of the motorcycle, which either was not insured at the time of the accident, or Mr. McNair would not disclose the affected company since the person respon- sible for the damages was not insured and was then and is now a ward of the State, I am writing you this letter to attempt to recover losses from the aforementioned damages. Enclosed please find a copy of the police report and a copy of two estimates to repair damages to my car. My claim is for lesser estimate. Your immediate attention is appreciated, as this is the only means of transportation for my wife and I to get to work. Sincerely yours, 'OLiCt- DEPT. 07 TRAFrIC COLLISION REPOR_P'C�!ttl"Cj'�-D I o "Ali "ECIALC6ND�7;otS NO INJURE!: RICHMOND 2 NO I-,— cOu'47" IC014TRA COSTA 0 0 71 Y140eff L %TLRSEC710%W,lH S7 ATE-VY RE a71EO 7117" 4_1 I NAME[FiR��I.W. )LE.LAS-, .�,rR S NAVE SAY. A, ARTY Ir A-/tz/ S,TREET ADDRESS e>e�HONE CAVNER 5 ADrRESS rA,!L AS DRIVER 71 2 q:r,N CITY STATE E -'Sl',ESS PHONE DIRE TO OF ON.AG-9,� isTREETC)R^13-NAY: _fED LIMIT ❑ T -PAPKED vr. DPiVERSLICE;;��MBLR 13,R_ S:. -rioN OF VEH,CL ��Y 0 9- 11 At HDA�E I RACE D!Sposi 4�,, v /v/ J /E, VE LICENSE NO STATE VEHICLE DAMAGE V!��:l A CjHt LE'IR MAKE." ODE_C;,_C)P�S: 00 CE'TNT 1 LOCA-K:)N ':'THER r R �. D f rl =MINOR 0 R -T 0 T I OxNLH S NAME PARTY 49/ 2 c STREET ADDRESS HOME PHONE OWNER S A'_DZESS :SAME A5 z DRIV CITY STATF F�;S,NESS PHONE DIRECTION OF REE`. SPEED L-' _S. TRAVEL ,RiAN - 4RKEO OR-VER S LICENSE NUMBER STA7C 6.1147,HC 4 CE DISPOSITION OF VE:-'.CLE EY T___—C-- PA Eq-3r Mo DAY Y, �s EH,'LE YR MAKE,�MODEL CfOR(s) LICENSE NO S7A7E VE�ICL.E DAMAGE 3LA7!C',CHARGED V7;�7CLAS? V - 111,110 2 eMAWIOR 7 Tc-A. ll >_ DES-RIPTION CF DAMAGE LLJ EL OWNFRSNAME AZD;__sS N07-FIEI 0 ES N EXTEN7�:,I.NijRV N_L�QF;:,-AS Ess AGE EX ;A7�L SEVERF Ac"UND O'T I, p S_ -)PAPLAI PAIN DRIVER PA_.� SEX -p1__Yr T Nr OF PA DISIClPF- I F•' —;77 I A I NAM PHC,-,E U) ADDRESS v TAKEN TC(IN)LjRFD ONLY) ELI a,a JJ,e;, ELI7) H 0 1 0 1 C3 1 0 1 0 1 NAME PHC,!.E Ld ADDRESS TAKENTO tINJu4ED ONLY) 0 1 0 1 0 1r ED 0 NAME ADDRESS TAKEN TO(INJURED ONLNJ L A `KETC�_, MI;C)ILL rNEL)iSsTA T. G. OTHER A G 1,1 YI[E T ,%�,,CATE S 4cn %3R7H T. SEC. CRIK CORI. OTHER T F.O.B. ST STATE D. A. ACTION ADM. ISB. C. A. PHYSICAL DESCRIPTION OF NUMBER HAIREYES _1 0 HE'G T 3 WEIGHT J 1962 SGT. ni:vrlv PAGE 710 �r-oq- Sq DAY rR COLL151ON;NA R R 4TIV E tlj-7" cr 12?a2- .12eez-�, ,,�;-------i 73,7L, A1�26--44'= Llu- r I itV. r7la -r-l&-- z ;4/ C7z2 LkEl, IV 42 k�< �7 1 4-i2lK Al-7-7 fl Ae Q,12 L/ v 7-9 PRIMARY COLLISION FAC70P Ric-lw- OF %,BY cl':INn. 2 1 3 1 4 TYPE OF VEHICLE 3i4,1 MOVEMENT PRECEDINL, A VCSETION V;0,A71C)N A COI--rOLS F uNC-,;J.%:NG A PASSENGER CAR tINCLUDI I COLLISION Z ?Z/ -5(D 8 CONTROLS NOT FUNC710N.'NG STATION WAGON) ASTOPPED ]�BOIHER IMPROPER DRWING' I C CONTROLS OBSCURED 8 PASSENGER CAR W/TRAILEP B PROCEEDING STRAIGHT C OTHER THAN DRIVER �T 0 NOC(DN71, I-SPRESENT C RAN 1;�F F ROA 7,7 .D UNKNOWN* TYPE OF COLLISION D PiCKL;-.0R Po�-177: RIGHT TU!RN WZ-ATHER-V� A HEAD_ON E PICKUP OR PANEL TRUCKEMAKING LEFTTURN A I-= .f AFPE WIT RA:LER j_F MAKINGU TURN CLOUDY ._]_,; REAR END IF TRUCK OR TRUCK TRACTOR tt• G ,(; RAINING G TRUCK OR TRUCK TRACTOR H SL_O_W�!=N•G=STOPPIt.c; D SNOiIVING E HIT OBJECT W'/TRAILER(S) I PASSING OTHER VEHICLE ---E_F_Olg. F_OVERTURNED H SCHOOL BUS -1 CHANGINGLANES F OTHER_ G AUTO/PEDESTRIAN I OTHER BUS K PARKING MANEUVER G W1,41) H OTHER*. J EMERGENCY VEHICLE LIGH7iNG I -- ENTERING TRAFFIC FROM K HWY CONST.EOUIPMENT SHOULDER.MEDIAN. 77Z�1�k_q�LIGHT MOTOR VEHICLE I%VOLVEO WITH -T- L BICYCLE L PARKING STRIP OR 51<-DAWN jA NON COLLISION IM OTHER VEHICLE PRIVATE DRIVE C DARK-STREET LIGHTS B PEDESTRIAN IN PEDESTRIAN MOTHER UNSAFE TURNING 10 DARK-NO STREET LIGHTS C OTHER MOTOR VEHICLE O-"OpFD N CROSSED INTO OPPOS-%�- E DARK-STREET LIGHTS NOT 0 MOTOR VEHICLE ON OTHER ROADWAY I OTHER ASSOCIATED FACTOR LANE FUNCTIONING* kB PEDESTRIAN E STR'� -T C 0 TH E R CT' MOTOR R V EHI MOTOR VEHICLE It:i•• I Ic,3 OPARKED IN WWAI'Y--PCAfF IF TRAIN A VC;SECTION VIOLATION P MERGING BICYCLE LE LE 07RAV T-A DR ELING WRONG WAY-' TTTY ,Ai H ANIMAL. B VC SECTION VIOLATION ROTHER C SNOW ICE D SLIPPERY(MUDDY.OILY ETC I I FIXED OBJECT C VC SECTION VIOLATION I k 3 i.4 SOBRIETY-DRUG- PHYSICAL a0ADWAY CONDITIONS(Mar. 1 10 3 iteMS) a-, jA HOLES.DEEP RUTS i OTHER OBJECT :'s D VC SECTION VIOLATION A HAD NOT BEEN U LOOSE-MA7ERIAL ON ROADWAY' B HBD-UNDER INFLUENCE C_OBSTRUCTION ON ROADWAY* I I 1 E VISION OBSCUREMEN7.S C HBD-NOT UNDER D CONSTR UCTION.REPAIR ZONE INFLUENCE' E_ REDUCED_ROADWAY WIDTH PEDESTRIAN'S ACTION F INATTENTION 0 HEID-IMPAIRMENT A NO PEDESTRIAN INVOLVED G STOPS GO_TRAFFIC UNKNOWN' G OTHER 13 CROSSING IN CROSSWALK H ELATE'7'%C;,LEAVING RAMP UNI�ER_p!RUq�INFLUENCE' AT INTERSECTION I PREVIOUS COLLISION F IMP I fAENT-P HYSiCAL' H NO C CROSSING IN CROSSWALK NOT i UNFAMT-IAR WITH ROAD Gl-�PAI MENT NOT KNOWN I _UNUSUAL CONDITIONS rvi -q AT INTERSECTION I j'IHN 7' K DEFECTIVE VEHICLE EOUIP _AP 'APPLICABLE CROSSING-NOT IN CROSSWALK MENT j I SL EEPY,FATp-.j.jEL) F IN ROAD-INCLUDES SHOULDER L UNINVOLVED VEHICLE I L I 31A ;, SdW 0' F NOT IN ROAD M CITHEQ- JA.HM A I k:RI ALS APPROACHING/LEAVING SCHOOL BUS IN NONE APPARENT 8 FIRE INVOLVED' 0 RUNAAAY VEHICLE l C TIRE.11F1111 AILURE' ."'zLol.,AILU I'11 orl 7FVESTI,5ATrD By .•. HILLTOP FORD ESTIMATE OF REPAIR <-=►10mrivM 3280 Auto Plaza Phone 222-4444 SHEET NO. OF Sh RICHMOND, CALIF. 94806 Complete Service All Makes of Cars R.O. NO. Date / Car Owner { �` "/ Address_ : i. /t-7 /� ! %,% Phone�i Make. Year .r Serial No. - •`- �'^ Motor No. Body Style_ Plile+ige .__ - _License No.F `� _-_ Paint No. Trim No. Insurance Co.- c. ` ' Adjuster Phone No,%7 5 ,J File No.. REPfaIR REPLACE ESTIMATE OF REPAIR COST LABOR PARTS MISC. SUBLET _ HOURS ,/' % '. 7 it�� - .•: % /; r- .. 5-7 7. 7.2 , `" `i TOTAL The undersigned agrees to complete the above repairs for $- Labor $ Of this amount the above named insured is to pay Parts = / $ insurance deductible Mise. _ depreciation Sublet $ work not covered by insurance Sales Tax E DA':ASED or WORN parts removed from car will be;unked unless owner instructs us otherwise in writing. It NEW PARTS listed he,e:n or required are NOT available, we reserve the right to REPAIR,such damaged or worn parts.where possible.the CHARGE ESTIMATE TOTAL=,Z s for wh ch will be made on an actual time basis at our previa ling labor rate per hour.The above is an APPROXIh!ATE estimate t.ES of 'eaa rs required. based on the inspection made. ADDITIONAL parts, or labor, may be required after the worF. has started. ADVA^PC S w":-" sere not eviden'on the first inspection. SUCH ADDITIONAL LABOR AND MATERIAL WILL BE CHARGED FOR IN ADDITION TO T-E 'ROVE.PARTS PRICES SUBJECT TO INVOICE. By.^ GRAND TOTAL E E,UGER'S A & N BODY & FRAME SHOP e'r ;wZ),e I W:1 3420 Telegraph Ave. PHOW PHCO* Oakland, CA 94609 (415) 652-3425 Cert. No. AH33871 CL A V 10) CC,'-"L:- KEY: N-New R-Repair Rt-Right C-Center Lr-Lover IU Ni,"W R S—S.J iD I e t. U-Used A-Align Lt-Left Up-Upper Op-open , LEFT SIDE t FIGHT LEFT SIDE RIGHT SIDE in, F Labor K— e T P- L P; Key Parts L-a-t-�---P-a---I— KeyParts Labor I Headlamp _T MIdg/Drill Time ! Headlamp. Door Mirror Scaled Beam/Ret. Handle Focus Headlial,.ts Lock. i Park Light ij...... S;de Lamp Rear Door —7— Wealher Strp Front Fender Ti E 5 i 0 n Glass -iir, ri'l Time Peculator Siripe/TapI.I.Idg./Drill Time e i Handle owl/Dash Lock Instrument Panel Qtr. Panel i Rocker Panel I Extension Rocker MIdg. MIdg./Drill Time Floor/Sill I Qtr. Housing Glass Pillar- Regulator L:Center Post I Gutter I i Rear Fender Front Door Hince Vileather Strip Tail Light Glass _Side Lamp Regulator Su b Total Sub Total M Ke Parts Labor 1 Paint j Key7LP-I— Labor Pa.nt I Key Paris Labor Faint j FrontBumper0%-/ 0.:v Shock I Rear Suspension CI-1 5 0 ri Tie Rod Rear End/Axle bracket Front End Aliq_n Shock R,fi nfor cement Steering Wheel Enc-cy-Absorber Sieering Column—1 Rear Body _Gua-d/Pad Pack Window -Filler Lower Panel V a: .Ce I Frame fAldg./Drill Time Cro�sniernber Gravel Shield FloorGas Tank/Cap —7— T— Grille Windshield Rear Bumper MizL,./Drill Time Windshield Kit Cushion II—G-,.'!e Pane: I fA I d L2Lill Time I 1 I Bracket G r e. Sr. ort M.ir r o r Reinforcement _ Front Seal I E -Absorber Radiator Support4 1Guard/Pad T-1 I Lic. Light/Bulb I -T— Rp.c:a:or I Roof I Filler r. e�ze /Coolant Vinyl Top Valance - ydGravel Shield Ra'::ator Hose/Clamp I Hpper Panel Fa!, F:ace I I i Sac, Glass I MISC, ITEMS Fa.,-- Eie:tfLld ../Drill Time Color Tone Water Pump I I I Special Paints Trunk Lid/T. Gate Him Undercoat 1 Ea::e-v/Cable Coll.!Access Time - J !D r IA Weather Strip Tires/Valve Stems : I Tr;:r:s Linkage Pel.--lator Excessive Clean-Up I Oil Pan lie:..Drill Time I Compound & Wax P:De/l`,.uf./Ext. I I Lock Radio/Antenna Converter Sub Total Sub Total 1 A!C Condenser Parts Prices subject to invoice $ 7 C/3' NOT RESPONSIBLE 1--reon FOR ANY PERS ONAL ITEMS LEFT IN CAR L a b O;belt .11-A!L--Z-h r s. @ &-Y-,,;-' NO- 0932 Paint'Z/ hrs. Cd 92-5.-7� tren, :-,Ihonze the P.7,3�e repair �of6 I' t�-do-e? � Paint Materials the ree sary materials You and ou,em.-!ovees�a. the move wen-ide for pwr-.ses of testing. ,speci�ol 01 e'! Shop Materials-S Time at m, ris� An erpror-s mect-.amc s benis acrn:ez o_ Lc.cw' S--: ort above vehicle to secure !r,e arnoun:ol fena.rs Ihe,el-- Towing not be held tespon sib:--,ior loss or oa.r-age to veh.z,;e c�a lett in eh,c e in case c!!,re.theft.acc,oent or any olne, :z-se beyond your control SIORAGE WILL BE CHARGED C-=7i. Storage EIGHT HOURS AFTER REPAIRS ARE COMPLETEC :1. THE Front Suspemtion EVENT LEGAL ACTION IS NECESSARY 10 ENFOP.rz T61!cz Car Rental Wnec;:!Bal. CONTRACT. I WILL PAY REASONABLE ATTORNEY 5 ;-ES F;;"' Cal:)!WV )eel Cov., I AND COURTCOSTS Misc./Sublet $ HL!t_& Drum Supplement Knuckle-SUP.P-0—rt SIGNED X Sub Total $ Lt. Cont. Arm L!Z) Cont. A r m Terms STRiCTLY GASH 'Jn;ess ArArrangementsMa�:e Tax .. C Sub Total Grand Total 17_,,r 103 't;1983 MITCHELL MANUALS. INC. LITHO IN U.S.A. �.. .W .._:t. .. . .� .w ..- : .... . _:wy s�. y ...... .......... . {.Jd7.L['lp ' ECRED AMO Claim Against the Camty, cr District ) INCE TO CZAINwr June 26 , 1984 governed by the ward of bmpervisors, ) The copy th s t ed to you is yaw Routing a dorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all 'Warnings• Claimant: Wally L. Linski . o�;at� Counsel Attorney: Wm. M. Thon, Esq. �di2 5 1984 Thon & Beck, A.P.C. 94553 Address: 45 S. Hudson Ave. , Penthouse Suite Martinet Pasadena, CA 91101 Amount: $1,500 ,000 .00 By delivery to clerk on Date Received: May 25 , 1984 By mail, postmarked on May 23 , 1984 I. FROM: Clerk of the Board of Supervisors y CoLmsel Attached is a copy of the above-noted claim. Vo4ed2 5 , 1984 J.R. CESSON, Clerk, By Deputy Jo-leng FaWALas II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only one) - (�( ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Secticns 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. 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. - By: Deputy County Counsel III. FROK: Clerk of the Board 70: (1) Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BMM ORD t By unanimous vote of Supervisors present ( )q This claim is rejected in full. ( ) other: I -certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. e e n i DVBois Dated: ---6- 26- 84 J. R. OLSSON, Clerk, By. Deputy Clerk SING (Gov. Cade Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FKX: Clerk of the Board TO: (1) County Camsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a mono thereof has been filed and endorsed an the Board's copy of this Claim in acoordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DAs: 6-26-84 J. R. CS.S.SON, Clerk, By e � , Deputy Clerk cc: Canty Administrator (2) County Camsel (1) 00 0 37 CZA M CLAIM TO; BOARD OF SUPERVISORS OF CONTRA "ft aF&ppiicatlon to: Instructions to ClaimantCleri;of the-Board P.O.Box 911 M rtinez Califomia94553 1 A.-j Ciaims relating to causes of action for death or or injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of 1 action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Strait,'. M .tine=, California 99553. 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 end o —E is form. RE: Claim by )nese ng stamps WALLY L. LINSKI son of =.E IV Fpff) IANE LINSKI , DECEASED. ) ,.,;a.., �� ; 3,, Against the COUNTY OF CONTRA COSTA) . J. R. OLSSON CLERK BOARD OF SUPERVISORS QV I� . I�T ONTRA COSTA CO. (Fill in name ) s ...... ..... . ...........Npu The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 1, 500 ,000 . 00 and in support of this claim represents as follows: -------- t---------- ---------=-------- - --- --- �. -1a'hen � � tfie-damage or �n3ury occur? TGive exact date ani fiourj The specific time and date is presently unknown. The patient, Diane Linski, was transferred from Delta Memorial Hospital on 2/29/84 ,. to Contra Costa County Hospital. Death occurred on 3/8/84 . '�. Wfiere d�� tFie damage or 1n!'ury occur? ZInc�u�e city and countyS At the Contra Costa County Hospital in Martinez , County of Contra Costa. 3. How did the damage or �n�ury occur? ZG�ve �uII deta�is, use extra . Meets if required) Still under investigation, however, it appears that decedent sustained a mechanical tear of the sigmoid colon believed to be caused at Contra Costa County Hospital by the administration of enemas for . im acted bowel. 1 RUE part cular act or om�ss�on on tfie part o county or d�atr�ct officers, servants or employees caused the injury or damage? •. Still under investigation; however, it appears as if the enemas were negligently performed causing a mechanical .tear of the bowel resulting in extensive peritonitis and ultimately death. (over) GAJ 038 5. What are the names of county or district officers, servants or employees causing the damage or injury? Unknpwn at this time. Medical records of Contra Costa County r . "' .Hospital have not yet- been received. This claim is presently filed in order to protect the 100 day statute. a: w�iat damage or �n3ur�es do you cSa�m resuIte�? ZG�veuSS extent of injuries or damages claimed. Attach two estimates for auto damage) Death. -------------------------- ------7 --------------- --------------- --- --- . How was the amount clamed above computed? ?Include the est�-mate�. amount of any prospective injury or damage. ) Estimated value to son from loss of support and society of deceased mother. --------- -- ---------- ---------- -------------- ----------------- �. Names ani addresses of witnesses, doctors and hospitals. Unknown at this time. Witnesses would be all those persons involved in the care and treatment of decedent while' a patient at Contra Costa County Hospital and also at Delta Memorial Hospital from .where decedent was transferred. �. List t5e expen tures you made on account o� this acc��ent or �n�ury: DATE ITEM AMOUNT Redwood Funeral Home Mortuary Expenses Unknown at this time Govt. Code Sec. 910.2 provides: "The claim signed by Me'thalf. " imant SEND NOTICES TO: (Attorney) orb some person on dame and Address of Attorney , Wm. M. Thon, Esq. a an gnature Thon & Bgdk, A.P.C. Wm. M. Thon, Esq'. on behalf 45 South Hudson Ave., Penthouse SuiteAddress Ot Wally L. TinSki, . Pasadena;',.Ca. 91101-2189 son of decedent Telephone No. (818) 795-8333 Telephone No. 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, town, city district, ward or village board or officer, authorized to allow or pay the some if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony." 00 039 CLAIM ' BOARD OF SUPERVISORS OF NIRA OMM C1MNTY, CALIFORNIA BOARD ACTION Claim Against the County, or District ) N TICE TO CLAIMANT June 26 , 1984 governed by the BoarA of Supervisors, ) The copy of this- document,milled to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all 'Warnings'. Claimant: Joseph W. Lyons 847 Brookside Drive County Counsel Attorney: Richmond, California Address: I;iAY 2 4 1984 Amount: $463 . 50 By delivery to clerk on Martina, CA 94553 Date Received: May 23 , 1984 By mail, postmarked on I. FROM: Clerk of the Board ot Supervisors County Counsel Attached is a copy of the above--noted claim. y� Dated: May 23 , 1984 J.R. OLSSON, Clerk, By ADeputy II. FROM: County Counsel M-- Clerk of the Board of Supervisors (Check only one) 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. Clerk should return claim an 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: By: Deputy County Counsel III. FROM: C1er of the Board M: (1) Count amsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD ORDER By unanimous vote of Supervisors present (X ) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. eni DuBois Dated: 6- 26- 84 J. R. OLSSON, Clerk, By.. , Deputy Clerk .. - JING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board M: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a mono thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed tp claimant. DATED: 6- 26-84 J. R. OZSSON, Clerk, By F�r��•� .� , Deputy Clerk cc: County Administrator (2) County Counsel (1) QO 040 (MAIM CLAIM TO: ' BOARD OF SUPERVISORS OF CONTRA COSFTAUrS oR nal application to: Instructions to Claimant Martinez, 94533 A. Claims relating to causes of action for death or t``or injury Californiato person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2 , Govt. Code) 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 , California 945.53. I£ 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. . rte„ Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by ) Reserved for Clerk' s filing stamps Jos� t, RECEIVED Against the COUNTY OF CONTRA COSTA) or _ DISTRICT) J. R. oLuoN (Fill in name) ) CLERK BOARD OF SUPERVISORS NTRA COSTA CO, B .............. The undersigned claimant hereby makes clai .. y of Contra 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) - - - -- .....................-� r ------ 2-.--Where- --di-d-. the--damage or injury occur? (Include city and county) A44Rr.,✓C-z iETeAJr4 r y G oA!TRq Co s 7 A C•o ci r/ r�/ 3. How did the damage or injury occur? (Give full. details, use extra sheets if required) LOJ -5 o)c' /NM47-E pRo ^W /pr7 SPE c 4S/7117*l o a 3 y 8 S a,... .4w ✓-.ra ,,-14q acj o t *0-3 -----------------------�� -------- --- ----------------------------- 4 . What particular act or omission on the--part of county or district officers , servants or employees caused the injury or damage? =c PEPER 7- -47T.4c.AW1 FD 1;>.4G e- 5 � No-ne 0 0 �� , C L 41 M Fa lz r'1 G o SIT i r--i u Pf-air G/ —� �e 0 �,/•� ei Gtr✓ .� q Mgt q /--/ Al-G 2 4 I""x-14 D o+ Ces4-g v}� /hP% e. 4— P" 'A7 �� U•�g b l e. -�-n Lo cam, 4.-- -3 3%1 8 5 N C Iy -a-& v 4% 1 %J.f- o Cor,-F, 01 %, �1 4r_� O -p- 1Core1s100 " c- -C, coo, , �� a ScL, �, . d4 ✓ c tcs�' -�o�.,.. 5 �il � q Werk Fuer l ovg 4 , r•t.� r h .a.� 1 w,-� t c e i r--S cv... CA ✓t c o 'ej S Q0 042 4/so 14pecss , .-,� �,..., /. D , a. olof,macs sus C ,nd /o c,; w7 e-Iy e-4- w/�' r G G t .c A� C ,•a l 00 G. 1. v " 4' 7!.r P".*s s ,e-•7 - v cy a,, 9 { /o c,4 .s e P7 LS 4 op o,r-I d( 00 043 . 7 T1�s. �a' /f a�.a � �� Coy •� s/,�.c � /s a► h+ o acs�' P 7 . Lo's r f��-�. /cam y s Z '� Ac So• C.L6 1, C its l•-- C&.J 7S -- l-G�•�,n s� Ps / o o ,� h Lx l ell 00 044 c -&lam c w s 4 t -v 4A-.4- o l( z n W O ✓ ✓ • v M ! r"C�.S�! -�" 1015.5 a i sl-S s t s w,,,1•�-� 1 t r.G.r,, �- V%A e x 4" wlr. 14- ZJ ( c tern o r% d`r 3 C,,-.. l �°'u. 7 —rw o Lt.�.�+�.�...S r c.K.'T 0.'�"' a,$'�►c.+ tr� r O ts+-�- rv., ann��.. -� too- C-0 o .' GS O. i (Z Q A b +t-4, k'! C- 04- o4- � n A^, dL Le_ �+ r a r er r t.. c z ) j- �d OA3q $ S . Cqs InL/ o �► . g? , Ott c-&,.s W -S Y t t c %j -� G✓� t L p./ Y�G-�v r x -e.44 cam-r.Q c �, c•� - a•ee q ! 1 0�. c..•.. .s �'► �"'I�„ vim'► `f"� � � ��/'4 � E � ( t! Q 00 045 CONTRA COSTA COUNTY SHERIFF - CORONER INMATE PROPERTY RECEIPT 023485 Name: Q(JS J OSqPA BKNG. 1338ate: 41 t S i VALUABLES CLOTHING Cash f Keys Shirt Pants i Jewelry Idescl N1 Coat Shoes j Shorts T Shirt , Watch Idescl Socks Hat Wallet )M Lighter Sweater Gloves Glasse Knife Belt Tie Other Other i a Bookin3')S7 Inmate Officer VerificationX Remarks L( 1J ArZ L. a Ln C =r ... ... .. :. .... .. ... .. - ..ter:;:. _ Rel. By: Received all personal property: Date Inmate: Form M.13 Rev.5.74 IOM 00 04��', county-counsel i. County Counsel MAY a 0 1984 CLAIM BMRD OF SUPENISORS OF COWPA COftY tier 4553 BOARD ACTION Martinez, CA 94553 Claim Against the County, or District ) NMCE TO C[AIHANT June 26 , 19 8 4 governed by the Board of Supervisors, ) The copy of th s document Vaa ed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings'. Claimant: Christina Mavridis/Louis Mitts 555 W. 10th St. , Apt. 15 Attorney: Pittsburg, CA 94565 Address: Amount: $40 . 00 By delivery to clerk on Date Received: May 30 , 1984 By mail, postmarked on May 29 , 1984 I. FRLM: Clerk of the Board at upervisorsCounty Counsel Attached is a copy of the above-noted claim. Dated: May 30 , 1984 J.R. OLSSON, Clerk, By Deputy Jolene Edwards II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only me) �K) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to amply 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. 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: c By: Deputy County Counsel r III. FIM: Clerk of the Board TO: (1) Cot3ltly Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. . BOARD By unanimous vote of Supervisors present ( X) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. • eni DuBois Dated: 6- 26-84 J. R. OISSON, Clerk, By z nw:,4C ;o , Deputy Clerk WARNIM (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FSM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DATED: 6- 26-84 J. R. OLSSON, Clerk, By � ,/� , Deputy Clerk cc: County Administrator (2) County Counsel (1) 00 047 CLAIM CLAIM TO: BOARD OF SUPERVISORS OF CONTRA C(**Q%gXapplicationto: =/ Instructions to ClaimantC!erk of the Board .O.Box 911 Martinez,Califomia 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than. one year after the accrual of the cause of action._ (Sec. 911.2, Govt. Code) 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, California 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 end or his form. RE: Claim by )Reserved for Clerk's filing stamps RECEIVED Against the COUNTY OF CONTRA COSTA) MAY 301984 J.R. OLSSON or DISTRICT) CLERK BOARD OF SUPER ISORS Fill In name ) COSTA O BY Deputy The undersigned claimant hereby makes claim against the oun y f Contra 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) 14i 84 :v�o 2. Where did the damage or injury occur? (Include city and county) . o,•-hem 3. How did the damage or injury occur? (Give ul details, use extra sheets if required) -7 ---------- ---------- -- ------ -- --i------ 4. What part-icu-ar-a--t--o-r-o--m-i-ss--i-o-n-o--n-t-h-e- part-of-county-or-dstrict --- officers, servants or employees caused the injury or damage? V q c',0-f ke, shy , (over) 00 048 'S. What are the names of county or district officers, servants or employees causing the damage or injury? 2 6. What damage or injuries do you claim resulted? ZGive full extent of injuries or damages claimed. wAttach two est imates for auto damage) ------------------------------------------------------ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) [S ShaLS O*p-SSS -------------------- ---------------------------------------------------- 6. Names and addresses of witnesses, doctors and hospitals. YI pul-!s M /7 4-5 sS5 c� 1 U' s+ -10 is `-IS6 5U�z4l,-i AE 09 - -------------------T-------------------------------� _IL 9---------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT i , M Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) orb some person on his behalf. " Name .and Address of Attorney Cla ant s Sign t re SSS LO- I `--`' ---4. IS Address Telephone No. Tel�one NOTICE Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents £or allowance or for payment to any state board or officer, ' or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " 00 049 CLAIM BOARD OF SOPSRVISORS OF COMA OWM O00WY, allMUMIA . . BOARD ACTION Claim Against the Canty, or District ) NMCE TO CEAIMARr June 26 , 1984 governed by the Board of Supervisors, ) The copy of th s document ma ed- YM is Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings'. Claimant: Darnell Norwood Moody County Counsel 2705 Bonita Avenue Attorney: Antioch, CA 94509 MAY 2 5 1984 Address: Martinez, CA 94553 Arrant: $69. 00 By delivery to clerk on Date Received: May 25 , 1984 By mail, postmarked on May 24 , 1984 I. FROM: Clerk of the Board ot Supervisors any Counsel Attached is a copy of the above-noted claim. �5 , 1984 J.R. OISSON, Clerk, By Deputy Jolene Edwards II. FROM: Canty Counsel : Clerk of the Board of Supervisors (Check only one) ( �() This claim complies substantially with Sections 910 and 910.2. (/ ) This claim FAILS to amply 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. Clerk should return claim on grand 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: r-s. y � By: La �„� Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). .o, IV. BOARD By unanimous vote of Supervisors present (X ) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. eni DuBo Dated: g-2 J. R. OLSSON, Clerk, By. Le, Deputy Clerk DING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of this notice was personally served or deposited in the mail to file a court action an 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. V. FROM: Clerk of the Board TO: (1) Canty Counsel,, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. n DATED: 6- 26-84 J. R. CLSSON, Clerk, By :/ p�_� n�J� , Deputy Clerk cc: County Administrator (2) Canty Counsel (1) 00 050 C UM CLAIM TO: BOARD OF SUPERVISORS OF CONTRA CO*FkVApp11Cation to: Instructions to ClaimantClerk cf the Board P.O.Bo:Y 911 M rtinez CalifomiaW53 A. Claims relating to causes of action for death or or Injury to -person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the- cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the rause . nf actioru. (Sec. 911.2, Govt. Code) 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, California 9053. 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. Cee penalty Por fraudulent claims, Penal. Code Sec. 72 at end o� tFiis :�orm. t # R## RR###RR *RBRE: Claim by )Reser tamps EKED(Yj�'; �5 'Against the COUNTY OF CONTRA COSTA) ' ''�`�`��r/ ( ERK BOARD p�SON�� u r >vI5 TRi�T) T suvrRv�soRs COSTA CO. (Filln name ) � The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of and in support of this claim represents as follows: I. When �� the aemage or�n3ury occur? ZGive exact sate ani �iourj --o-X-----------PM --------- ---- n d8ge-o -1-n ury occur? ZnIudty -nd coun 3. Row did the damage or�n�ury occur? ZGiveul� aeta�?s, use extra sheets if required) U o„� o o �r ,�Gores q a��Er,,F, {� oto. p�Feerc P u 13►e t r �fvo e� e-�-j d- P e0PEx4-_, ----"•.---- - ----..M--�-- -- ------- - ----- -------.�--- T--- ----- �. what part�%u�ar art or om�ss�on on tie part o county or aistr�ct officers, servants or employees caused the injury or +Samage? b Fr)e4kny 5, d- e_, 1w-k- e.1 ,•� ��.-i r ,�a� Z.de0-fE ICL � P epf O 3 f 45 '�7 2 p (over) w i�'�• S�a 5 • . 00 05 / 5. What are the names of county or district officers, servants or employees causing the damage or injury? pe*,"o r�3 C e r-AetZ Boo b„,-�-=� cIae k. o C, Vob��NG o P P- cr- D iv Qeop� oe ce P4L 13 a e �r b:"-' ati damage"o'z'In3urles do you clalm resulted?~Ial "e""rnII-extent-"-" of injuries of damages claimed. . Attach two estimates for auto damage) c �r M A n� P � moo+- ��,E�_ �� .�,. } , e a jla4 ,4-,. d wrts 17 How was the"amount"MR-6d-"above computed?"-Zlnclude the estlmated--" amount of any prospective injury or damage.) ""'Jeau� fl�� wf�3 ��c�l�-� � C�w�1.�. i.� C-0ti+c�oe� o •v ---------- ----=--- -- -------- --------------- ------------------ H: Names and"addresses oI �vltnesses,-doctors and hospitals. c v lt-N M n-c 1%qo o DL1 K List the expenditures you made on account oI this accident or In ury: DATE ITEM AMOUNT - c f Govt. rode Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf. " Name and Address of Attorney Claimants nature N J� 276.5 8,c>),j4-',4 -ro Address Telephone No. Telephone No. -776 6 3 ZL-7 •�l�r!**l+�f*:*!!*!:**:*!!*!!!!!!!!�!#!!ll�:�*lt�el�*!*�*:��rRtll��:aef�!!!! NOTICE Section 72 of the Penal Code provides: 'Every peruon who, with intent to defraud, presents for alle-wance or for payment to any state board or officer,*or to any county# town, city district, ward or village board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or xriting, is guilty of a felony.• S J .. ........ .....:.. .. .. . . 00, CZAIM BOARD CP SUPERVISORS OF CORTRA CCDM COUM Y, QU FaMIA . BOARD ACTION Claim Against the County, of District ) NOTICE TO CLAII►VW June 26 , 1984 governed by the Board of Supervisors, ) The copy of th s document ma ed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "W s". counsel Claimant: Barbara A. Purl pully Attorney: Thomas G. McLaughlin 1'►�� 2 4 1984 Sanders , Dodson, Rives & McLaughlin Iqla&el, CA 94553 Address: 2211 Railroad Avenue Pittsburg, CA 94565 ijand-car ied Amount: $75 , 000 . 00 By delivery to crlerk on May 24 , 1984 Date Received: May 24 , 1984 By mail, postmarked on I. FROM: Clerk of the Board ot Supervisors County Counsel Attached is a copy of the above-noted claim. Dated: May 24 , 1984 J.R. CIL.SSCIN, Clerk, By Deputy Jolene Edwards II. FROM: County Counsel TO: Clerk of the Board of Supervisors (Check only me) (�( ) This claim complies substantially with Sections 910 and 910.2. (/ ) This claim FAILS to ocmply 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. 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: - By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County ounsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD Et By unanimous vote of Supervisors present (X ) This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. e n i DuB�DQ i s Dated: 6- 26- 84 J. R. OLSSON, Clerk, By / e - �i Udo , Deputy Clerk NARNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. V. FROM: Clerk of the Board 70: (1) County Counsel, (2) Canty Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of, this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DATED: 6-26-84 J. R. OLSSON, Clerk, By , Deputy Clerk cc: Canty Administrator (2) Canty Counsel (1) CLAIM 00 053 ��r- '�j► •�-� �F.-_.� _, --..tea,. S CLAIM AGAINST CONTRA COSTA COUNTYy «� TO: THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY.-.- BARBARA A. PURL hereby makes a claim against the County of Contra Costa for the sum of $75 , 000 .00, and makes the following statements in support of the claim. 1.. Claimant ' s address is 43 Harbor Drive, West Pittsburg, California. 2 . Notices concerning the claim should be sent to THOMAS G. MCLAUGHLIN, SANDERS, DODSON, RIVES & McLAUGHLIN, 2211 Railroad Avenue, Pittsburg, California, 94565 . 3 . The accident took place on April 6 , 1984 on a sidewalk in front of 73 Harbor Drive in West Pittsburg, which was owned, possessed, maintained and controlled by Contra Costa County. 4 . The circumstances giving rise to this claim are as follows: On or about April 6 , 1984 , claimant was walking along and upon said sidewalk in front of the residence located at 73 Harbor Drive in West Pittsburg, California. At said time and place and prior thereto, said sidewalk was in a dangerous condition which created a substantial risk of injury when said property was used with due care in the manner in which it was reasonably foreseeable it would be used. Said sidewalk was cracked and raised due to a lack of adequate maintenance and repairs rendering the sidewalk dangerous and defective to persons walking thereon. As a proximate result of the dangerous condition of said sidewalk, claimant tripped and fell and incurred injuries. i .i 5 . Claimant injured her head, left leg and hip, right arm and right elbow. Claimant is presently claiming the sum of $75 , 000 .00 . The basis for the computation is as follows: Medical Expense: Unknown at this time. Future Medical Expense: Unknown Impairment to Wage Earning Capacity: Unknown General Damages : $50 , 000 .00 . DATED: May 22, 1984 SANDERS, DODSON, RIVES & McLAUGHLIN THOMAS G. McLAUGHLIN On behalf of Claiman BARBARA A. PURL -2- CLAIM BOARD OF SOR,S OF CORTRA COSTA COUNTY, CALIFC M . BOARD ACTION Claim Against the County, or District ) NOTICE TO CLAIMANTJuly 3 , 1984 n governed by the Board of Supp*vi-wwG, The dopyof th s document-ma ed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below), to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings Claimant: Vickie Klymshyn 516 Lisa Court Attorney: E1 Sobrante , CA 9480:3 Address: Amount: Unspecified By delivery to clerk.on Date Received: May 29 , 1984 By mail, postmarked on May 25 , 1984 I. FROM: Clerk of the Board at upervisors can y Ccunsel Attached is a copy of the above-noted claim. Dated: May 29 , 1984 J.R. OLSSON, Clerk, By Deputy Jolene Edwards II. FROM: County Counsel 70: Clerk of the Board of Supervisors (Check only one) �} This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to amply 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. Clerk should return claim an grand 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: By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1) County Cc nsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD By unanimous vote of Supervisors present (X)o This claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Reeni DuBois Dated: 6- 26-84 J. R. OLSSON, Clerk, By Deputy Clerk MRRNING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of this notice was personally served or deposited in the mail to file a coat 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. V. FROM: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. ( ) . A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. DATED: 6-26-84 J. R. CESSON, Clerk, ByCc�u�� , Deputy Clerk s e cc: County Administrator (2) County Counsel (1) 00 O �' CLAIM f .CLAIM TG.. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions •.:o Claimant A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2, Govt. Code) 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 (or mail to P.O. Box 911, Martinez, _CA) , 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 ent _ty, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims , Penal Code Sec. 72 at end of this form. RE: Cla' by ) Reserved for C erk' s filing stamps Z1VZJ RECEIVED , —Against the COUNTY OF CONTRA COSTA) qq or _ DISTRICT) J. R. oLs`soN (Fill in name) ) CLERK BOARD OF SUPERVISORS TRA COSTA CO. The undersigned claimant hereby Makes claim aga � ntra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: ------------------------------------------------------------------------ d 1. When did the amage or injury occur? (Give exact date and hour) 2. Where did the damag .,lour injury occur? (Includde city and county) _ y_Shit/�� o �•9�r_ � - - --- - --- ----- -------- -------------- --- ------ 3. How did the damage or injury occur? (Give full details, use extra sheets if required) 197 ns�122 i . Wha particular act or omi�ion on the part of county or district officers , servants or employees caused the injury or damage? � ' (over) y � 77 C . .. . ................. `1 - ---/ - - --2 - - -c--_ --_ A,t ---- 03. -- `-?n cmc IC -�- C -----�-- - -------__ 1 -- V • BOARD OF SUPERVISORS OF CIORPRA aosrA aou m. QUZPUMIA . BDARD ACTION Claim Against the County, or District ) (y TO (LAIMAW July 3 , 1984 governed by the Board of Supervisors....) The oopy of-& s document mailed to you is your Routing Endorsements, and Board ) notice of the action taken on your claim by the Action. All Section references are ) Board of Supervisors (Paragraph IV, below),, to California Government Codes ) given pursuant to Government Code Section 913 and 915.4. Please note all "Warnings Claimant: Rosemarie Herke Attorney: James B. Wickersham, Esq. P.O. Box 1058 Address: Alamo, CA 94526 Via C-AO Amount: $51 ,000 .00 By delivery to clerk on May 29 , 1984 Date Received: May 29 , 1984 By mail, postmarked on I. FY04: Clerk of the Board at upervisors W: County Counsel Attached is a copy of the above-noted claim. ev�z�) Dated: May 29, .1984 J.R. C SSON, Clerk, By Deputy VJnLQne Edwards II. FROM: Canty Counsel TO: Clerk of the Board of Supervisors (Check only one) �! ) This claim canplies substantially with Sections 910 and 910.2. ( ) This claim FAILS to damply 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. 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: By: Deputy County Counsel III. FROM: Clerk of the Board TO: (1) Canty Counsel, (2) County Administrator ( ) Claim was returned as untimely with notice to claimant (Section 911.3) . IV. BOARD ORDIIt By unanimous vote of Supervisors present ( X) This claim is rejected in full. ( ) Other: I -cern y that this is a true and correct copy of the Board's Order entered in its minutes for this date. Reeni DuBois Dated: 6- 26-84 J. R. OISSON, Clerk, By. Deputy Clerk SING (Gov. Code Section 913) Subject to certain exceptions, you have only six (6) months from the date of 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. .V. Fit: Clerk of the Board TO: (1) County Counsel, (2) County Administrator Attached are copies of the above claim. We notified the claimant of the Board's action on this claim by mailing a copy of this document, and a memo thereof has been filed and endorsed on the Board's copy of this Claim in aeoordance with Section 29703. ( ) A warning of claimant's right to apply for leave to present a late claim was mailed to claimant. n DATED: 6- 26-84 J. R. MISSON, Clerk, By�� dLc�- 3a_�3? , Deputy Clerk ac: Canty Administrator (2) County Counsel (1) CLAIM 00 055 RECEIVED 1 JAMES B. WICKERSHAM �RY OLSS08N HARBAUGH & WICKERSHAM CLERK BOARD OF SUPERVISORS 2 Attorneyat Law 0 T COSTAc . r+v De►uty 3200A Danville Blvd. , Suite 202 3 P.O. Box 1058 Alamo, CA 94507 4 Telephone: (415 ) 831-1325 Contra Costa Cour,+- RECEZ;1VEE, 5 Attorney for Plaintiffs MAY 2 4 1984 6 Office of 7 Count; Administrator 8 In the Matter of the Claim of ROSEMARIE HERKE 9 VS. 10 11 THE COUNTY OF CONTRA COSTA. 12 13 ROSEMARIE HERKE hereby presents this claim to the 14 County of Contra Costa pursuant to Section 910 of the California 15 Government Code. I 16 The name and post office address of claimant is as 17 � follows : 18 ROSEMARIE HERKE 2978 Ascot Drive 19 San Ramon, CA 20 The post office address to which claimant desires 21 notices of this claim to be sent is: 22 ROSEMARIE HERKE c/o JAMES B. WICKERSHAM, ESQ. 23 P.O. Box 1058 Alamo, CA 94526 24 On or about May 7 , 1984, in the City of San Ramon, 25 California, claimant sustained personal injuries under the 26 following circumstances: 27 Claimant was driving her vehicle northbound on San 28 LAW OFFICES OF HARBAUGH Q WICKERSHAM 610 OAKLAND AVE OAKLAND.CA 94611 14151428-1876 K 1 Ramon Valley Boulevard approximately one-third mile north of 2 Alcosta Boulevard. 3 The names of the government agency employees 4 responsible for the faulty installation of the asphalt surface 5 along said roadway are unknown to claimant at this time. 6 However, it is believed that the agency named above is 7 responsible for the installation and maintenance of the asphalt 8 surface along said roadway. 9 Claimant was in the process of slowing and pulling to 10 -the east curb when the right front wheel of her vehicle dropped 11 off an approximate 6-inch ledge between the asphalt and the 12 roadway. As a result of the wheel ' s dropping off the ledge, the 13 I steering wheel spun suddenly, causing a fracture to claimant' s 14j hand and other physical injuries. 15 i At the gime of presentation of this claim, claimant 16 claims damages for medical bills of approximately $1 ,000 and for 17 � personal injuries in the amount of $50, 000 . 18 Dated: May Zy, 1994 HARBAUGH & WICKERSHAM, 19 by 20 21 Z4GEORG A. MUR Y 22 23 24 25 26 27 28 LAW OFFICES OF HARBALJGH R WICKERSHAM 810 OAKLAND AVE OAKLAND.CA 94811 141514281878 J 1 DECLARATION OF SERVICE BY MAIL 2 I , the undersigned, am a citizen of the United States, over the age of eighteen ( 18 ) and not a party to the within cause or . 3 proceeding; my business address is 3200A Danville Blvd. , Ste 202, P.O. Box 1058, Alamo, California, 94507 . On May 23, 1984 . I. served 4 the within: 5 NOTICE OF CLAIM, pursuant to Section 910 of the California Government. Code i 6 in said action by placirq a true copy thereof enclosed in a sealed y;. 8 envelope with postage thereon fully prepaid, in the United States mail a. at Alamo, Cal fornia , ad4ressed as follows : .. 9 State Board of Control 10 926 J Street, Suie 316 t 11 I Sacramento, CA 95814 12 County Administrator I 'i. I I 651 Pine 13 i Martinez, CA 94553 .' San Ramon City Manager. 14 9 Crow Canyon Court 15 San Ramon, CA 94583 16 k 17 19 20 I declare under penal '.. of perjury that the fore of is true � I )" F - 7 Y 9 p9 21 1 and correct . rL 22 Executed on May 23, 1984 at Alamo., California. 23 CAROL SCH MKE 24 t• g . 25 a 26 R< 27 i `? 28 I SAW OFFICESOF AJGHQ WICKERSHAM .:OA DANVILLE BLVD SUITE 202 :'ST OFFICE BOX 1038 A-AMO.CA 91507 t r .415-e3,.1925