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Home My WebLink AboutMINUTES - 05191987 - 1.21 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Clilim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 19 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code 300 . 00 Section 913 and 915.4. Please no�jmt' "$ Amount: $1, �''� e} CLAIMANT: HOWARD HARVEY APR,2 7 1987 2839 Rheem Ave. ATTORNEY: Richmond, GA 94804 Martinez, CA 94553 Date received 1887 ADDRESS: BY DELIVERY TO CLERK ON April 21 , BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. AprilBY: BATCHELOR,23 , 1987 ppNNIL BATCHELOR, Clerk y DATED: L. Hal II. FROM: County Counsel TO: Clerk of the Board of Supervisors {k') This claim complies substantially with Sections 910 and 910.2. {� �} This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: CL j BY:`t,/ L (� \/ �'�`��!'.t�C--lefty County Counsel r III. FROM: Clerk of the Board TO: County Counsel (i) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 1V. BOA�R/D' ORDER: By unanimous vote of the 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. Dated: MAY 19 1987 // PHIL BATCHELOR, Clerk, By GC --��1� , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. 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 a Notice to Claimant, addressed to the claimant as shown above. Dated: MAY 2 0 1987 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLA_I M ,TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY ' = 1 Instructions to Claimant Return original application to Clerk of the Board 651 Pine St., Room 106 Martinez, CA 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 of this form. RE: Claim by )Rese ing stamps UCEIVED ) FU, 7�Again�s,trthe COU .TY. OF CONTRA COSTA) APR al 198 oz eli, rt�z!u . 2rzz�4' kDISTRICT) (Fill in names ) IT The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ AMMON fes," _r? and in support of this claim represents as follows: I: ee ee .reeeeeeeeeeee ecce Zeeeeeeeeeeee eeeeeeerweeeeeeee a eoee .oee e wFien did the damage or Injury occur? (Give exact date and fiure j 1eWUxeedidetfieedamageeorelnjury occuac?e (Include cityeandecountyT eee LA c� 0 _ IZ141 _ _ --------------eere eeeeeeeeeee 3. Howdid the damage or injury occur? Give full details, use extra sheets if required) , eee..e ee eeerrTee eeeeeeseee� Teeeeee.reeeeeeeee of eeeeeecountyee ordisteee .'eeer1eecte ee i�lhat particular act or omission on the part officers, servants or employees caused the injury or damage? CSG ��4-e�,t�C�''1 9��c�c'�'�C•- `� 7 -�'G��.�L�`�t'`rU�•�-�2_,k "�t� ��2�� (over) 5. What are the names of county or district officers, servants or' employees causing the damage or injury? 6. What damage or injuries do you claim resulted? �G�ve full extent of injuries or damages claimed. Attach two estimates for auto damage) --------------------------------------------------------------------- -- 7. How was the amount claimed above computed? (Include the estimate amount of any prospective injury or damage. ) '1 ------------- 8.- Names and addresses of witnesses, doctors and hospitals. --T----- TJc. --- ------------------------------------------ 3 -------------------------------- - 3.- List th expgfldf't�es— ade on account of this accident or injury: DAIrIE Q�I x ITEM AMOUNT Govt. Code Sec. 910.2 provides: "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some personon his behalf. " Name and Address of Attorney G �� Claimant s Signature ddr ss Telephone No. 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 same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " CLAIM BOARD OF SUPE:�'iISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Bozrd of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 19 , 1987 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $25 ,000. 00 Section 913 and 915.4. Please note all "WarnG4upt Y COUnSel CLAIMANT: ANNETTE KITTRELL c/o Ronald P. Rives , Esq. APR`2 71987 ATTORNEY: Sanders , Dodson, Rives , McLaughlinDi&eP egnim Martine,,, CA 94553 2211 Railroad Avenue ADDRESS: Pittsburg, CA 94.565 BY DELIVERY TO CLERK ON April 16 , 1987 hand del . BY MAIL POSTMARKED. no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. April 23 , 1987 PpHHIL BATCHELOR, Clerk DATED: BY: Deputy ' L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: // Dated: ,bL X�, BY:`K7 c,C .1 t t,(_C�Gc�� ty 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 (�) 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. / MAY 19 1987 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAY .2 0 1987 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator c 17 i. 1 NOTICE OF CLAIM AGAINST CONTRA COSTA COUN 2 TO THE BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY: 3 ANNETTE KITTRELL, by and through her attorneys, the Law " 4 Offices of SANDERS, DODSON, RIVES, McLAUGHLIN & PEGNIM, herewith 5 presents a claim against Contra Costa County, California, in the 6 sum of $25, 000 . 00 for personal injuries, medical expenses , and 7 general damages. 8 1. Claimant' s address: 2347 Peachtree Circle, Antioch, z . 9 California 94509 . z 10 2. Address to which claimant desires notice to be sent: a x N 11 Ronald P. Rives , Esq. , SANDERS, DODSON, RIVES, McLAUGHLIN & 4 ' � W < N 12 PEGNIM, 2211 Railroad Avenue, Pittsburg, California 94565 LL o Q 13 (415) 432-3511. U � (Y a a ° 14 3. Place occurred: California Avenue at its intersection J z N m " H 15 with Loveridge Road, City of Pittsburg, County of Contra Costa, Q a Q 16 State of California. a w 17 4. Said claim arises from the following circumstances: z 18 On March 24, 1987, claimant was a passenger in a vehicle stopped 19 on California Avenue at its intersection with Loveridge Road 20 when said vehicle was struck from the rear by a Contra Costa 21 County Sheriff ' s patrol vehicle driven by Deputy Sheriff S. 22 Trojanowski. 23 5. Public employee responsible for accident: S. Trojanowski. 24 6. Nature -and extent of damages or injuries: As a result 25 of this accident, claimant suffered neck and back injuries; and 26 aggravation of a pre-existing back condition. Claimant has 1 received medical treatment at Los Medanos Community Hospital, 2 James I. Scarborough, M.D. , and has received physical therapy. . 3 7". Claimant' s claim as of the date of this claim is .-,in the 1 4 amount of $25, 000 . 00 . The basis of computation of the above 5 amount is as follows: Medical expenses incurred and general 6 damages. 7 8 DATED: April 14 , 1987 z 9 SANDERS, D�DSON, RIVES, McLAUGHLIN & PEGNIM z 10 :a L Ln d Z Q U. W z _ 12 RO ALD P. RIVE , ESQ. O LL O d a 13 2: U O > � Q p; rc l a_ 14 J z N m Xgg " H 15 Q a 16 c w 17 z" 18 19 20 21 22 23 24 25 26 -2- ♦ CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 1 Claim A§ainst the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 19, 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $250 ,000. 00 Section 913 and 915.4. Please note all "Warnings". ntY Counsel CLAIMANT: RODNEY N. LOQUTAO C°u c/o Ronald �M. Schwartz AP8`2 7 1987 ATTORNEY: 140 Mayhew ,.Way #100B ma )@ Pleasant Hill, CA 94523 Date received A ril 22 1981' Cq 94553 ADDRESS: BY DELIVERY TO CLERK ON P BY MAIL POSTMARKED: April 21 , 1987 Certified P 003 825 904 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. 23 , 1987 April 1 PeHHIL BATCHELOR, Clerk DATED: P BY: Deputy L. Hall I1. FROM: County Counsel,. TO: Clerk of the Board of Supervisors (x) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ' i yYf� BY• i1{'/_1A_ 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 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. , MAY 19 1987 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately, 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 1,8; 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. MAY 2 0 1987 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLAIM r against RECEIVED County of Contra Costa APR,?�1981 (Government Code, sec. 910) DAITZ: 4/21.;/87 Gentlemen: The undersigned hereby presents 'the following claim against the County of Contra Costa . I. Date of Accident or occurrence: January 15, 1987 2. name and Address of Claimant: Rodney N. Loquiao, c/o Ronald M. Schwartz, 140 Mayhew Way, Suite 100B, Pleasant Hill , CA 94523 3. Description and Place of the Accident or Occurrence : Automobile accident occurring on Mt . Diablo Blvd . at or near its intersection with Moraga Rd . 4 . Names of employees involved , and type, make and number of Equipment , if applicable and if known : Unknown , but the traffic signals at the southern intersection werenotoperating at the time of the subject accident and this forms the basis of this claim against the County of Contra Costa . 5. Description of the kind and value of damage : Mr . Loquiao sustained personal injuries and property damage . 6. Cost estimates or bills (are) (are not) attached. 7 . Amount of Claim: Special damages unknown at this time , general damages in the amount of $250,000 .00. gnature of Claimant Ronald M. Schwartz , Attorney for Claimant Rodney Loquiao CLAIM O1 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA ,qo o hty 004n Claim Against the County, or District governed by) BOARD 7�9 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 1 9 , 8� 8� and Board Action. All Section references are to ) The copy of this document mailed to you is your notice California Government Codes. ) the action taken on your claim by the Board of Supervisors 911% (Paragraph IV below), given pursuant to Government Code Amount: $10, 000. 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PEGGY LEE BAXTER AND STEPHANIE BAXTER, A MINOR, BY AND THROUGH HER NATURAL MOTHER AND GUARDIAN AIDLITEM PEGGY LEE BAXTER ATTORNEY: 21 Crestview Terrace Orinda, CA 94563 Date received ADDRESS: BY DELIVERY TO CLERK ON April 16, 1987 BY MAIL POSTMARKED: April 15 , 1987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: P B April 23 ,,' 1987 PpYHHIL BATCHELOR, Clerk : Deputy Gt L. Hall II. FROM: County Counsel' TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: (�,��i <� �'X� , / yy'� BY:-I�c-c ,c_ " 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 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. Dated: MAY 19 1987 PHIL BATCHELOR, Clerk, By cze� , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAY .2 O 19$7 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator PEGGY LEE BAXTER 21 Crestview Terrace Orinda, California 94563 ixEGEIVED April 10, 1987 aPR � t9s7 Clerk Board of Supervisors County of Contra Costa County Administration Building 651 Pine Street Martinez, CA 94553 Re: Claim Pursuant to Government Code 910 Claimant: Peggy Lee Baxter and Stephanie Baxter, a minor, by and through her natural mother and guardian ad litem Peggy Lee Baxter (a) Name and post office address of Claimant: Peggy Lee Baxter and Stephanie Baxter, 21 Crestview Terrace, Orinda, California 94563 . (b) Post office address to which the person presenting this claim desires notices to be sent: Peggy Lee Baxter, 21 Crestview Terrace, Orinda, California 94563 . (c) Date, place and other circumstances of the occurrence or transaction which gave rise to the claim asserted: January 13, 1987 at 7 : 30 a.m. on eastbound Crestview Drive adjacent to 31 Crestview, City, of Orinda, County of Contra Costa, State of California. ' On said date, a water line and/or sewer line was leaking liquid substances presumed to be water which coated por- tions of Crestview Drive and were otherwise not observable to oncoming traffic. Said liquid and/or water was caused to freeze and thus created a dangerous and defective driving condition, claimant Baxter' s 1985 Volvo station wagon was caused to drive over said icy portion of Crestview causing the vehicle to lose control and drive into the ditch. (d) General description of the indebtedness, obligation, injury, damage or loss incurred sofaras it may be -known at the time of presentation of the . claim: As to both claimants personal injuries the nature and extent to which are unknown. As to claimant Peggy Lee Baxter, her 1985 Volvo station wagon has received extensive property damage and the exact amount of cost of repairs and future repairs is unknown at this time but esti- mated to be $2 ,500.00 . Additionally, if the claim is not pro- perly settled, claimant Baxter will suffer and continue to suffer loss of use. ` S County of Contra Costa Board of Supervisors April 10 , 1987 Page Two (e) Name or names of the public employee or employees causing the injury, damage, or loss, if known: Unknown, but County of Contra Costa workers during the last 12 months may have made repairs to the water and/or sewer lines . (f) Amount claimed as of the date of presentation of the claim, including the estimated amount of any prospective injury, damage, or loss , insofaras it may be known at the time of the presen- tation of the claim, together with the basis of computation of the amount claimed: Claimant Peggy Lee Baxter claims $5 ,000 .00. Claimant Stephanie Baxter claims $5 ,000 .00 . If the contents of this claim are deficient in any respect, we ask that you notify the undersigned immediately and we will attempt to remedy the same. If this claim is to be denied, we ask that it be done so expeditiously. V truly y urs , David1Md2se Hammond DMH:smn • CERTIFICATE OF MAILING I, the undersigned, declare under penalty of perjury: That I am a citizen of the United States , over the age of 18 and not a party to the within cause of proceeding; that I am an employee of David Morse Hammond, Attorney at Law, and my business address is 405 - 14th Street, llth Floor, Oakland, California; that I served a true copy of: Claim Pursuant to Government Code 910 by placing said, copy in an envelope addressed to: Clerk Board of Supervisors County of Contra Costa County Administration Building 651 Pine Street Martinez , CA 94553 which envelope was then sealed and postage fully prepaid thereon, and thereafter, on the date set forth below, deposited in the United States mail at Oakland, California. (That there is delivery service by United States mail at the place so addressed, or regular communication by United States mail between the place of mailing and the place so addressed) . Executed and mailed at Oakland, California on April 1987 . Suzalma N. Mueller CLAIM /_ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 'Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 19 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $100, 000. 00 Section 913 and 915.4. Please note all "Warnings". County Couns:; CLAIMANT: KI14BERLY NOEL c/o Mitchell A. Stevens APR`2 7 1987 ATTORNEY: Andersen & Bonnifield Marti 1355 Willow Way x[255 Date received April 16, lq%e�, CA 945;,.1 ADDRESS: Concord, CA 94520 BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: April 15 , 1987 P 066 892 390 I. FROM: Clerk of the Board of Supervisors TO: County Counsel . Attached is a copy of the above-noted claim. DATED: April 23 , 1987 gyiL Deputy OR, Clerk L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (� This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: C ��'� '�- ' BY ��c `� \: /�-«-�' - L�P�ty County Counsel —T ,r 4V 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 (�) 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. Dated: MAY 19 1987 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAY 2 O 1987 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator F \ I/CLAItjl TO:, BOARD OF SUPERVISORS OF CONTRA CoggA A%RYa ppli cation to: Y Instructions to ClaiTrantC!erk of the Board P.O. Box 911 Martinez,California 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 ofthisform. RE: Claim by )Reserved for Clerk's filing stamps KIMBERLY NOEL nCX1VVT,% Against the COUNTY OF CONTRA COSTA) QAPR 1987 or DISTRICT) (Fill in name) The undersigned claimant hereby makes claim agal - My VT Contra Costa or the above-named District in the sum of 100, 000.00 and in support of this claim represents as follows: 1. Wfien did the damage or injury occur? (Give exact_date_and hour) January 28 , 1987 at approximately 3:05 p.m. ----------------------------------- 2, h'here drd the damage or injury (Include city and county) Contra Costa County Health Services Merrithew Memorial Hospital 2500 Alhambra AvenVe MrA artinez lifn-rniA -9-4.553-W-6ntr-a- Cn--i-a-Coui2. ------------------ 5-*.--How did the- damage or injury occur? (Give A�1-1-Keta-ils, use -extra sheets if required) In the process of removing Claimant's four impacted wisdom teeth, Dr. Jerry Mattka, oral surgeon employed by the County of Contra Costa, severed Claimant's nerve which has caused. permanent injury to the tongue with attendant humiliation and embarrassment_ due to the resulting speech impair 4.- ---------------------------------------- ------------------------ K_-W-hat particular act or omission on the part of county or district ment officers, servants or employees caused the injury or damage? Medical negligence. (over) S. What are the names of, county• or district oiiicers, sex-vanv5 uL A 2mplpyees causing the damage or injury? County Employee Dr. Jerry Mattka. ---------------- - -------- --- --- ------ ------------------ 6 . What damage or-injuries do-you-claim resulted?-_Iaive full extent of injuries or damages claimed. Attach two estimates for auto, damage) Severed nerve which has caused .permanent -injury to Claimant's tongue with attendant humiliation and embarrassment as the resulting speech impariment. ---H-o-w-w--a-s--tb--e--a-m-o-u-ni--cia-7i-m-e�--aT)-o�-e--c-o-mp-u-t-e--d-?---(I-n--c-lu--d-e-t-h-e--e--si3-*j-n;ie"a- 7. amount of any prospective injury or damage. ) My attorney computed. �.---Rl-a-m-e-s-a--na-��a-r�-s-s-es---oi-w-i7i-ne--s-s-es-,--d--o-c-t-o-r-s--an--d-h--o-s-pi--ta--I-s-------------- Dr. Jerry Mattka Merrithew Memorial ' Hospital Other witnesses unknown. §.---L71s-ie -is--e--xp--en--d-i-t-u-r-e-syou made onun ------a--c-c-o---tfthis accident orin j : DATE ITEM AMOUNT None to date. Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or bqq(eypp ron jqnis behalf. " Name and Address of Attorney MITCHELL A. STEVENS KIMB NOEL by MITCHELL SITCHEiqnaturt ' LL A. STEVENS ANDERSEN & BONNIFIELD 1355 Willow way, #255 Address Concord, CA 94520 c/o 1224-Patty Leht- nLa ipn B bel Telephone No. (415) 825-5100 Te1ePCf?8ggr4b.CA 3T520 (415) 67.6-100:1 NOTICE Section 72 of the Penal Code provides: ".Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, . or to any county, 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. " CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 19 , 1987 and Roard Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: 070. 0 0 Section 913 and 915.4. Please note all "Warnings" CLAIMANT: DAVID V. CARLSON County Counsel 35607 Newark Blvd. APR ,2 7 1987 ATTORNEY: Newark, CA 94560 Date received Martinez, CA 9455: ADDRESS: BY DELIVERY TO CLERK ON April 15 , 1987 BY MAIL POSTMARKED: April 14, 1987 I. FROM: Clerk of the Board of Supervisors TO: .County Counsel Attached is a copy of the above-noted claim. April 23, 1987 PpHHIL BATCHELOR, Clerk DATED: P BY: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (x) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: L/��-�- aZ /q� L— BV: �-� y �%L/..�! t�lti �-�ty 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. BOAX RDD ORDER: By unanimous vote of the Supervisors present ( 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. Dated: MAY 19 1987 PHIL BATCHELOR, Clerk, By_ Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAY 2 0 1987 BY: PHIL BATCHELOR byY_&(_�/ �eputY Clerk CC: County Counsel County Administrator I `CLAIM TO: BOARD OF SUPERVISORS OF CONTRA CON ��applicationto: Instructions to Claimant0erk of the Board .O.Box 811 Martinez,Califomla 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 claimAs agoznst a. district governed by the Board of Supervisors, rather thar .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 ' )Reserved for Clerk's filing stamps 3 0�? � � ) 10100`IVED Against the COUNTY OF CONTRA COSTA) APR k-5-'M7 or DISTRICT) n namet The undersigned claimant hereby makes claim againsta out�)of ContraCosta or the above-named District in the sum of � _ and in support of this claim represents as follows: i. When did the-damage r 1n3ury occur? exact date and hour �: -Wher lid t e a age or Mury occulL!d ity an cNNty. ____ -------_-- - - - - - �-u - - -- owaiathe damage or injury occur? {Gieta�.is, se ext sh e s if required) tv 4. ha Wt particular act or omIsszon on the part of county or district officers, servants or employ ju pr g P ♦/ �' cr► � g� Gos o !(et Ke `f 1(� c r 0 (over) + 5. What are the names of county or district officers, servants or empl y e ca the amag o jur • Y 6. What damage or inj les-do BF-C! resulted? ZGive dull extent- off injuries of damages claimed. - Attach two estimates for auto amag _-iii---------- ---_i- ---__-----i--------------------i--i---- -- 7. How was the amount cla' ed above computed? (Include the estimated- amo t of any pr spective injury or damage.) • f� )�o� (`i r�. l��1 a N od`� �t�S'4 (1eA (Uly ',J CNS f ?U.vv4� � d^�r PeAJ&&' -AJ)'Ll k6d� as-ecc� L �.� � �it.t z. �------------------------------- ----------------- - ------- ----------------------- \is. aures and "addresses of witnesses, doctors and hospitals. iw.-+�--------_--i'-T_ --�m--T-T---- �. Zt' e hex a �Tr^-r youimade on account of th1s accident or injury: ITEM o LINT Govt. Code 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 Ca ' ' tsSgn ur Ad espo Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: •Every► person who, with intent to defraud, +resents 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 same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony." CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA •Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 1 9 , 1987 and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $1, 928. 78 Section 913 and 915.4. Please note all rnings". CLAIMANT: JOSEPH ALLEN JR. ounty Counsel c/o Peter Golden APR, ATTORNEY: 515 16th Street 1 X987 a rti Oakland, CA 94612 Date received April 9 ,M198� Z' C'4 945;,3 ADDRESS: BY DELIVERY TO CLERK ON P BY MAIL POSTMARKED: April 8 , 1987 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: April 13, 1987 gaIL BATTCYELOR, Clerk epu )�_ V, �X//w_, /t// - L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. (X) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: uty 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 ( ) 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. MAY 19 1987 Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of' an attorney of your choice in connection with this matter. if you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: •11'AY 2 BY: PHIL BATCHELOR by G2�C�C_�Deputy Clerk CC: County Counsel County Administrator CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Instructions to 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 CleQ' s g stamps � �. , A\1�,,,�. ; JDA09 Against the COUNTY OF CONTRA COSTA) APR ? 1987 or DISTRICT) (Fill in name)_ The undersigned claimant hereby makes claim against the Count uAConn tra Costa or the above-named District in the sum of $(_hXes4 -7 and in support of this claim represents as follows:' i-.--When-did-the--damage--o-r--i-n-D'-u-r--occur.-----5----(Give exac-------t--date-----and------------- hour) 2. ama or ,ZfqyfieNe_a"1ra_EK;-a--------- 7 occu and county) H1, X RJ(�60v) lid /Mbp Ile east , COV\�C(A 3. -How-ala"the - -------------- -------ll- a;mage or injury occur? (G�- 1,51,+ 4e, q,e fua;Eg,1 is,---us----extra------- sheets if required) Lwto CAPP! 11�1 L w Hi\re(A a y s�opped, -�e 4 A t i ce ns k(3kcd rear L/I C vy rn i I'ro r,- 5.',t1-/ 090ii CAVII VCCW,( teCArC,1 � _ ,0PCtJ ,'V1 • liga"I iota QA11A L/C '5rt k<n ac id -T-3. LA C 47 ro 4 . What particular act Y-0 or-omission-on the part-of county or district officers , servants or employees caused the injury or damage? /-P, WN V00 VY\ Gvrc bccju Lk .5,0t e, tt (over) P� '73 5. _What are the names of county or district officers,-. servantsY rz. , -B. ::r�'� I employees causing the damage or injury? -------------- -- ---------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) ----- ------------ ---- C,CA V--------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. )/-5j /a—apt - 11-c.,nse-A dy ---------- - --- ----------- - ------ ---------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. ( rr1 S YY tr(' u L-� 3 S � V1 �! l�o r G. �t u�1�� ,Ow5 3`J Duke s.cue, �lr eln�mv��,C , (1,760 r04,W /31vd— ��uL�.. ►�,�h�mPs�� , m, ��CS" U v) 16 13t AL� 2, - ---------- ------ ------- Cly ►_. ��---------- ----- ----- ---- ---- ----- Y - - J Y� 9. es ou made on account of this accident or injury: ��rrII�� ITEM AMOUNT Ua %')Hf Govt. Code Sec. 910.2 provides : "The claim signed by the claimant SEND NOTICES TO: (Attorney) or by some(�p`ec `rson on his behalf. " Name and Address of Attorney k� - 'Claimant s Signature 5 Ad -� CJ 4 �j h dr s s Y,(1) Telephone No. l f� 0�� 7 / 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 same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is guilty of a felony. " DATE IN / ESTIMATED COMPLETION DATE NAME TRADE ❑ Collision ADDRESS CITY STATE Specialists, HOME PH # BUSINESS PH # YR./MAKE/MODEL OF CAR LICENSE 11 Inc. COLOR TOP P. O. Box 726 CODE BOTTOM 110 East 14th Street San Leandro, California 94577 FREE ESTIMATE THIS IS NOT AN INVOICE 415 /638"0212 NO GUARANTEE ON RUST WORK. NOT RESPONSIBLE FOR CRACKING OF BODY PLASTIC FROM PREVIOUS REPAIRS, OR_ RUST COMING THROUGH FROM BENEATH THE METAL. PARTS LABOR AMOUNT %i-'• :../ <. : y��.. ' i/J✓c" PAINT DEPT. SPOT PAINT. L BODY DEPT. LABOR SUPPLIES BODY DEPT. PARTS OTHER GR. SALES TAX TOTAL . z nom. NO PERSO AL CHECKS REMARKS SERVICE AUTHORIZATION 1 HEREBY AUTHORIZE THE REPAI R WORK TO BE DONE ALONG WITH THE NECESS- ARY MATERIALS,AND GRANT YOU AND/OR YOUR EMPLOYEES PERMISSION TO OPERATE THE VEHICLE HERE- IN DESCRIBED FOR THE PUR- POSE OF REPAIR AND OR INSPECTION. I ALSO AGREE THAT NO OTHER WORK IS TO BE DONE EXCEPT THAT WHICH IS LISTED,UN- LESS AUTHORIZED BY PHONE OR IN PERSON. PAINT I UNDERSTAND THAT COLLISION SPECIALISTS WILL NOT BE RES- TOTAL PONSIBLE FOR MECHANICAL OR ELECTRICAL FAILURE OR FOR LOSS OR DAMAGE TO CARS OR SUBCONTRACT ARTICLES LEFT IN CARS IN CASE OF FIRE,THEFT,ACCID- ENT,FREEZING,AND/OR OTHER CAUSE BEYOND THEIR CONTROL. AN EXPRESSED MECHANICS LEIN IS ACKNOW LEDGED FOR THE PURPOSE OF SECURING AMOUNT OF REPAIRS HERETO: 00 A53ENGER FRONT„ vEqs REAR IDE IDE SIGNATURE 1i O 0 . I APPOINTMENT DATE: TIME: 7833 E. 14th Street Oakland, CA W21— Superior Auto Body 568-5617 568-7375 NAME /tom DATE /��BX5, ADDRESS INSURANCEfcz e,-- CITY !CITY �'� PHONE� yGBf ADJUSTER MAKE �� MODEL SERIAL MILEAGE LICENSE "bol FRONT Labor S. lobe,Hr►. Paris SFrwbol LEFT Labor ►ober Mrs. pert► Symbol RIGHT Or Su Diei Or Sublet Y Or Sumet Leber Mn. Perot Bumper(U)Ex-New Fender,Frt.&Ext. Fender,Frt.6 Eat Bumper(1)Ex•hlew Fender Shield Fender Shield Bumper Britt. Fender Mldg. Fender Mldg. tamper Gd. Hoodlemp Headlamp Frt.System Heodlomp Door Headlamp Door From* Sealed Boom M-Ovt Sealed B*om in-Out Cross Member Cowl-Post Cowl-Post Sto6iliaer Windshield Mldg. Windshield Mldg. Wheel Door,Frons Door,Front Hub Cap-SM-Age. Door Mi Door Hing* Hub i Drum Door Glass Door Gloss Vent Gloss Vont Gloss Knuckle Svp. Door Midg. Door Mldg. Lr.Cent.Arm Door Handle Door Handle lr.Cont.Shah Center Post Center Post Up.Cont.AIM Door Raor Door Rear Up.Cont.Shah Door Glass T-Cl. Door Gloss T-CI. Shock Deer Mldg. Door Mldg. Tie Rod-Ends Rocker Panel Rocker Panel Savoring Geer Rocker Midg. Rocker Mldg. 5ftering Wheel Floor Floor worn Rine Ouor,Inner Const. Oster.Inner Const. Grovel Shield Ouor.-Eat Guor.-Ent. Pork,tigm Ouor.Panel Upper Outer.Panel Upper iJ .Red.Grille,Ctr. Over.kowar Guar.Penal lower Red.Grille,Side Oster.Mldgs. Over.Panel Mid s. Griller AAW9. Gvor.-Glosi T-CI. Guar.-Gloss T-CI. RBAR MISC. Bust r Ea.-Now _iGgialm Inst.Panel Bum er Britt. Front Seat Hera bumper Gd. Front Soot Tracks Wflo,Side Growl Shield Rear Soot Baffle,lover lower Penal y OD • •Q Headlining Baffle,Upper jFloor Te Lock Plate,L►. Trunk lid Tire %Worn Lock Platte,Up. Trunk Lid-Nin Trim Meed Top Trunk Mondt* Belle Hoed Min • Toil Light Point t Motorial Mood Midg. Toil Pi -Muffler Ofnomeod Bock U Light Antenno Rod.Stop. Frame•Cfotsmember .0 Rod.Caro Gas Tank Windshield T-CL Nub 6 Drum _Rod.Mows 1 Axle-Housing fen Bledo Spring Pon Belt Control-Arms Water Pum -Pull* 4' A-ALIGN N-NEW OM-OVERHAUL EX-EXCHANGE Mntor Mot. RC-RECHROME U-USED S-STRAIGHTEN OR REPAIR Trans.Linke • SUMMARY/1 /saljr O Labor Mrs. 7 $ z _e O Para INCLUDES ALL PARTS AND LABOR.IF ON CLOSER ANALYSIS IT IS FOUND THAT ADDI— TIONAL REPAIRS ARE NECESSARY,YOU WILL BE CONTACTED FOR AUTHORIZATION. _ 2�.o D Tax PHONE REVISED AMOUNT Sublet ! Date TIME PERSON CONTACTED = 1 HAVE READ AND UNDERSTAND THE ABOVE ESTIMATE AND TERMS. I I AUTHORIZE SERVICE TO BE PERFORMED,INCLUDING SUBLET WORK,AND ACKNOWLEDGE RECEIPT OF THIS ESTIMATE. Total $ OWNER DATE County Counsel v APPLICATION TO FILE LATE CLAIM APR`2 7 1987 HOARD OF SUPERVISORS OF CONTRA COSTA COUNTY. CALIFORNaninA1M Application to File Late Claim } NOTICE TO APPLICANT May 19 , 1987 Against the County, Routing ) The copy of this document mailed to you is your Endorsements, and Hoard Action.) notice of the action taken on your application by (All Section References are to } the Hoard of Supervisors (Paragraph III, below), California Government Code.) ) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING" below. Claimant: MAURICE HARRIS, BY HIS GUARDIAN AD LITEM, HAZEL HUNN, AND THE CLAI11 OF HAZEL NUNN Attorney: c I o Hazel Nunn 2860 Clearland Circle Address: Pittsburg; CA 94565 Amount: $1, 000, 000. 00 By delivery to Clerk on April . 20, 1987 hand del . Date Received: April 20, 1987 By mail, postmarked on no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Applicationo Fie Late Claim. DATED:, Ap r i 1 23, 19 8 7 PHIL BATCHELOR, Clerk, By Deputy L. Hal II. FROM: County Counsel TO: Clerk of the Board of Supervisors 61 �,/i(.-�t.�,c.�-fYc.a, ()•) The Hoard should grant this Application to File Late Clain gSecti 944.6). {" ) The Board should deny this Application to File Late C1aiSeeti 911/. /Vu . DATED: j '', ? VICTOR WESTMAN Count Counsel By ,/ ,. s Y c C ..�_ c �-� - ''Gc �.�f:pllty III. HOARD ORDER By unanimous .vote of Supervisors present (Check one only) on behalf of Maurice 'Harris . (x ) This Application is granted A(Section 911.6). on behalf of Hazel Nunn. %) This Application to File Late Claim is denied"(Section 911.6). I certify that this is a true and correct copy of the Boardfs Order entered in its minutes for this date. DATE: MAY 19 1987 PHIL BATCHELOR, Clerk, By Deputy WARNING (Gov. Code $911.8) If you wish to file a court action on this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claims presentation requirement). See Government Code Section 946.6. Such Petition must be filed With the court within six (6) months from the date your application for leave to present a late claim Was denied. You may seek the advise of any attorney of your choice in oonneetion with this matter. If you want to consult an attorne u should do so immediately. V. FROM: Clerk of the Board 70: 1 County counsel 2 County A nis ra or Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document, and a memo thereof. has ben filed and endorsed on the Board's copy of this Claim in accordance With Section 29703. DATED: MAY 2 0 1987 PHIL BATCHELOR, Clerk, By r Deputy V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board Received copies of this Application and Board Order. of Supervisors DATED: County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLAIM ' 4 1 MAURICE HARRIS HAZEL NUNN IN PRO PER DIVE i�.i.CE 2 2860 Clearland Circle ��1 L 3 Pittsburg, CA 94565 (415) 458-3644 APR A0 4 ep:ao P.M 5 CW " 8 In the Matter of the Claim of: 9 MAURICE HARRIS, by his Guardian ad litem, HAZEL NUNN, and the 10 Claim of HAZEL NUNN; APPLICATION FOR LEAVE 11 In The Claim Against TO PRESENT LATE CLAIM 12 DR. ERIC GILLETTE, M.D. , MERRIHEW HOSPITAL, and 13 CONTRA COSTA COUNTY, 14 TO: CONTRA COSTA COUNTY BOARD OF SUPERVISORS and CONTRA COSTA COUNTY 15 16 1. Application is hereby made for leave to present a late 17 claim under Section 911.4 of the Government Code. The claim is founded on a cause of action for wrongful death, which occurred 18 19 on April 26, 1986, and for which a claim was not timely 20 presented. For additional circumstances relating to the cause 21 of action, reference is made to the proposed claim attached 22 hereto as Exhibit A and made a part hereof. 23 2. .The reason for the delay in presenting this claim is 24 that Maurice Harris, the claimant, was a minor during all the 25 period when the claim should have been presented as shown by the 26 declaration of Hazel Nunn attached hereto as Exhibit B and made 27 a part hereof. 28 1 1 3. Claimant Hazel Nunn did not present her claim in a 2 timely manner because she was mentally incapacitated during all 3 the period when the claim should have been presented and by 4 reason of the disability, failed to timely present the claim as 5 shown by the declaration of Hazel Nunn attached hereto as 6 Exhibit B and made a part hereof. 7 4. This application is presented within a reasonable time 8 after the accrual of the cause of action as shown by the 9 declaration of Hazel Nunn attached hereto as Exhibit B and made 10 a part hereof. 11 WHEREFORE, it is respectfully requested that this 12 application be granted and the attached claim be received and 13 acted upon , in accordance with Sections 912.4 to 912.8 of the Government Code. 14 15 DATED: 1987. 16 17 18 HAZER, Individually 19 eewz HA L NUNN, on behalf of 20 MAURICE HARRIS, a minor 21 22 23 24 25 26 27 28 2 EXHIBIT A MAURICE HARRIS 1 HAZEL NUNN 2 IN PRO PER 2860 Clearland Circle 3 Pittsburg, CA 94565 (415) 458-3644 4 5 6 7 In the Matter of the Claim of: 8 MAURICE HARRIS, by his Guardian 9 ad litem, HAZEL NUNN, and the Claim of HAZEL NUNN; 10 CLAIM AGAINST PUBLIC In The Claim Against ENTITY 11 DR. ERIC GILLETTE, M.D. , MERRIHEW HOSPITAL, and 12 CONTRA COSTA COUNTY, 13 TO: CONTRA COSTA COUNTY BOARD OF SUPERVISORS and CONTRA COSTA 14 COUNTY: 15 Hazel Nunn, individually, and on behalf of Maurice Harris, 16 a minor, hereby makes claim against Contra Costa County, 17 Merrihew Hospital , and Dr. Eric Gillette for the sum of 18 $1,000,000.00 and makes the following statements in support of 19 the claim: ' 20 1 . Claimant' s post office address is 2860 Clearland 21 Circle, Pittsburg, California 94565. 22 2. Notices concerning the claim should be sent to Hazel 23 Nunn, 2860 Clearland Circle, Pittsburg, California 94565. 24 3. The date and place of the occurrence giving rise to 25 this claim are 2860 Clearland Circle, Pittsburg, California 26 94565, April 26, 1986. 27 4. The circumstances giving rise to this claim are as 28 follows: Dr. Eric Gillette was an employee of Contra Costa 1 - RXNTRTT A 1 County working in the East County Neighborhood Clinic. Over a 2 period of time, Dr. Eric Gillette prescribed a number of 3 medications for Ramona Nunn. These included Imipramine, 4 Desipramine, and Trifloperazine. The combined medications 5 caused Ramona Nunn to die. There was no evidence of any 6 overdosing. Ms. Ramona Nunn was prescribed too many medications 7 over a prolonged period of time. The drugs caused Ms. Nunn's 8 heart to stop. 9 5. Claimant' s injuries on the part of Maurice Harris is 10 loss of his mother. Maurice Harris has lost the care, support 11 and affection of his mother. Likewise, Hazel Nunn has lost the 12 care, support and affection of her daughter. 13 6 . The names of the public employees causing the 14 claimant ' s injuries are Dr . Eric Gillette . The other individuals are unknown at this time. 15 16 7 . Our claim as of the date of this claim is 17 $1,000,000.00. 18 8. The basis of computation of the above amount is as follows: 19 20 (a) Expenses: $ 2,000.00 21 (b) Loss of Support: $ 100,000.00 22 (c) General Damages: $ 898,000.00 23 TOTAL: $1,000,000.00 DATED: ` 1987. 24 ' 25 26 H Z W NUNN, Individually 27 �7za HAZE NUNN as Guardian Ad 28 Litem for MAURICE HARRIS 2 • EXHIBIT B 1 MAURICE HARRIS HAZEL NUNN 2 IN PRO PER 2860 Clearland Circle 3 Pittsburg, CA 94565 (415) 458-3644 4 5 6 7 8 In the Matter of the Claim of: MAURICE HARRIS, by his Guardian 9 ad litem, HAZEL NUNN, and the Claim of HAZEL NUNN; 10 DECLARATION OF 11 In The Claim Against HAZEL NUNN DR. ERIC GILLETTE, M.D. , 12 MERRIHEW HOSPITAL, and 13 CONTRA COSTA COUNTY, � 14 15 I, Hazel Nunn, declare: 16 I am the mother of Ramona Nunn. Ramona Nunn died on April 17 26, 1986. Prior to her death, she was treated by Dr. Eric 18 Gillette, who worked for the East County Neighborhood Clinic in 19 Pittsburg, California. The East County Neighborhood Clinic was 20 a Contra Costa County neighborhood clinic. 21 Dr. Eric Gillette prescribed a number of anti-depressant 22 medications and tranquilizers for Ramona Nunn. The combination 23 of these drugs caused Ramona Nunn's death. At the time of her 24 death, Ramona Nunn was 29 years old. She was survived by her 25 son ;Maurice Harris who is now 10 years old. She was also 26 survived by myself, Hazel Nunn, who is her mother. 27 Maurice Harris was incompetent to file a claim against 28 Contra Costa County due to his age. I did not file on my own 1 P.XHTRTT R 1 behalf within the one hundred day statute of limitation because 2 I have been mentally distraught over the death of my daughter. 3 I have been barely able to take care of my grandson, Maurice Harris, and care for myself due to the extreme mental and 4 5 emotional shock I suffered over the death of my daughter Ramona 6 Nunn. 7 I ask that the County permit me to file a late claim on 8 the basis of my mental disability. I ask the County to permit 9 me to file a late claim on behalf of Maurice Harris on the basis 10 that he was a minor from the time of his mother's death to the 11 present. 12 I declare under penalty of perjury under the laws of the 13 State. of California that the foregoing is true and correct. 14 Executed at Davis, California. DATED: �Q 1987. 15 16 17 18 HAZE NN 19 20 21 22 23 24 25 26 27 28 2