HomeMy WebLinkAboutMINUTES - 06161987 - 1.16 14
APPLIZATION TO FILE LATE CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
BOARD ACTION
Application to File Late Claim ) NOTICE TO APPLICANT dune 16, 1987
Against the County, Routing ) The copy of this document mailed to you is your
Endorsements, and Board Action.) notice of the action taken on your application by
(All Section References are to the Board of Supervisors (paragraph III, below),
California Government Code.) ). given pursuant to Government Code Sections 911.8 and
915.4. please note the ffWARNING" below.
Claimant: MICHELLE BUNDY County Counsel
c;o Charles 0. Prickett MAY.2 8 1987
Attorney: Attorney at Law
1440 Broadway #700 Martinez, CA 9455;
Address: Oakland, CA 94612
Amount: $100,000. 00 By delivery to Clerk on May 22 , 1987
Date Received: May 22 , 1987 By mail, postmarked on May 21 , 1987
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above noted Applicationt File Late Claim.
DATED: May 27, 1987 PHIL BATCHELOR, Clerk, By Deputy
a
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
( ) The Board should grant this Application to File Late Claim (Section 911.6).
The Board should deny this Application to File Late Claim (Section 911.6).
DATED: L1,2W (9 VICTOR WE.STMAN, County Counsel, By49—DeWty
III. BOARD ORDER By unanimous vote of Supervisors present
(Check one only)
( ) This Application is granted (Section 911.6).
(X) This Application to File Late Claim is denied (Section 911.6).
I certify that this is a true and correct copy of the Board's Order entered in its
minutes for this date.
DATE: JUN 16 1987 PHIL BATCHELOR, Clerk, By. �ar 1 Deputy
WARNING (Gov. Code 5911.8)
If you Trish 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 connection with this
matter. It M want to consult an attorne you should do so immediately.
V. FROM: Clerk o the Board TO: 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: JUN 17 1987 PHIL BATCHELOR, Clerk, By Deputy
V. FROM: 1 County Counsel 2 County Administrator TO: Clerk of the Board
of Supervisors
Received copies of this Application and Board Order,
DATED: County Counsel, By
County Administrator, By
APPLICATION TO FILE LATE CLAIM
1 CHARLES O. PRICKETT, ESQ.
1440 Broadway, Ste. 700
2 Oaklnad, California 94612
415/893-2552
3 � ECEIVED
�Q v�
4 MAY eZZ1987
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8 In The Matter of The Claim of APPLICATION FOR LEAVE TO
PRESENT LATE CLAIM
9 MICHELLE BUNDY
10 Against
11 CONTRA COSTA COUNTY
12 /
13 TO CONTRA COSTA COUNTY :
14 1. Application is hereby made for leave to present a
15 late claim under section 911.4 of the Government Code. The
16 claim is founded on a cause of action for negligence, breach of
17 fiduciary duty and wrongful discharge, which accrued on
18 June 18, 1986, and for which a claim was not timely presented.
19 For additional circumstances relating to the cause of action,
20 reference is made to the proposed claim attached hereto as
21 Exhibit A and made a part hereof.
22 2. The reason for the delay in presenting this claim
23 is the mistake, inadvertance, surprise, and excusable neglect
24 of the claimant and her attorney, Charles 0. Prickett, as more
25 particularly shown in the declaration of Michelle Bundy
26 attached hereto as Exhibit B and made a part hereof.
27 3. This application is presented within a reasonable
28 time after the accrual of the cause of action as shown by the
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1 declaration of Michelle Bundy attached hereto as Exhibit B and
2 made a part hereof.
3 WHEREFORE, it is respectfully requested that this
4 application be granted and that the attached claim be received
5 and acted upon in accordance with sections 912.4 - 912.8 of the
6 Government Code.
7
LARLES
8 Dated: ( � , 1987 /OIAVPRI T
9 Attorney for Claimant
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I CHARLES 0. PRICKETT RECEIVED
Attorney At Law i987
2 1440 Broadway MAR .23,
Suite 700
PkftBATCHELOR
3 Oakland, CA 94612 Bo of SU ISORS
TEL: 415-893-2552 AST
4 er DOW
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5 _SUPERIOR COURT OF CALIFORNIA, COUNTY OF CONTRA COSTA
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7 MICHELLE BUNDY Case No .
Plaintiff
8 Vs. NOTICE OF CLAIM AGAINST PUBLIC
ENTITY
9 CONTRA COSTA COUNTY
Defendant
10 /
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12 TO CONTRA COSTA COUNTY:
13 MICHELLE BUNDY hereby makes claim against CONTRA COSTA
14 COUNTY for the sum of $ 100,000 . and makes the following state-
15 ments in support of the claim:
16 1 . The claimant°s post office address is 3209 Eccleston
17 Ave. , Walnut Creek , California .
18 2 . Notices concerning the claim should be sent to CHARLES
19 0. PRICKETT, Attorney at Law, 1440 Broadway, Suite 700, Oakland,
20 CA 94612 .
21 3 . The date and place of the Wrongful Discharge giving rise .
22 to this claim are June 18 , 1986 , at 2401 Stanwell Dr . , Concord,
23 CA 94524 .
24 4 . The circumstances giving rise to this claim are as fol-
25 lows : Plaintiff was an employee of Contra Costa County as a
26 social services case worker and was wrongfully discharged .
27 5 . Claimant's injuries are loss of wages , loss of benefits ,
28 loss of employment , severe emotional distress , and include but
I are not limited to, wages, benefits, retirement benefits, and all
2 benefits associated with her employment .
3 6 . The names of the public employees causing the claimant°s
4 injuries are Louise Aiello, and R.E . Jornlin.
5 7 . My claim as of the date of March 20, 1987 is $ 100,000 .00
6 8 . The basis of the computation of the above amount is as
7 follows :
8 Medical Expenses incurred to date : $
9 Estimated Future Medical Expenses : $
10 Loss of Wages : $ 50, 000
11 GEneral Damages: $ 50, 000
12 Total : $ 100,000 . 00
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14 Dated : March 20, 1987
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17 CHARLES O. PRICKETT,
Attorney for Plaintiff
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PROOF OF SERVICE BY MAIL
2 I declare that I am employed in the City of Oakland,
3 County of Alameda, State of California, and am over the age of
4 eighteen years and not a party to the within entitled cause; my
5 business address is 1440 Broadway, Suite 700, Oakland, California,
6 94612 . On March 20 19 87 , I served the within
7 NOTICE OF CLAIM AGAINST PUBLIC ENTITY
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11 on the parties of said action, by placing a true copy thereof
12 enclosed in a sealed envelope with postage thereon fully prepaid,
13 in the United States mail in Oakland, California, addressed as
14 follows : County of Contra Costa
Administration Bldg.
15 651 Pine St .
16 Martinez , CA 94553
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26 I declare under penalty of perjury that the foregoing is .
27 true and correct and that this declaration is made this 20th day
28 of March 1986, at Oakland Californi .
1 CHARLES 0. PRICKETT, ESQ.
1440 Broadway, Suite 700
2 Oakland, California 94612
415/8932552
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11 In Re The Matter of The Claim of DECLARATION IN SUPPORT
OF APPLICATION FOR LEAVE
12 MICHELLE BUNDY TO PRESENT LATE CLAIM
13 Against
14 CONTRA COSTA COUNTY
15 /
16 I, MICHELLE BUNDY, am the claimant herein. This
17 declaration is made under penalty of perjury under the laws
18 of the State of California. On or about November 41 1986 until
19 December 15, 1986 I was employed as a temporary employee with
20 duties as a case worker. On December 15, 1986 I was offered a
21 full time permanent position of Social Case Worker II by Linda
22 Canan, my supervisor.
23 On or about January 28, 1986, I was struck by a truck
24 while driving a county vehicle. I was diagnosed as having a
25 cervical sprain and as a result of this injury I was unable to
26 continue my duties for Contra Costa County.
27 On April 3 , 1986, I returned to work.
28 On or about June 8, 1986, I had a meeting with
1
1 supervisor Linda Waddington and personnel assistant Judy
2 Dellareule at the Antioch office. At this meeting I was
3 handed a Copy of a termination letter and told that I was
4 rejected from my probationary period because of a significant
5 period of time that I was off ill at my former job with
6 Alameda County.
7 I have filed Workmen's Compensation claims for physical
8 and psychological trauma through my attorney Raymond Frost in
9 Fremont, California.
10 Because of the physical and psychological trauma I have
11 undergone, I have been unable to file a timely claim against
12 the County of Contra Costa.
13 Therefore, I ask for leave to present a late claim
14 under section 911.4 of the Government Code.
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16 Dated: May J L , 1987
MI�E BUNDY, C1 nt
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1 I PROOF OF SERVICE BY MAIL
2 I declare that I am employed in the City of Oakland,
3 County of Alameda, State of California, and am over the age of
4 eighteen years and not a party to the within entitled cause; my
5 business address is 1440 Broadway, Suite 700 , Oakland, California,
6 94612. On Mao 20 0 19 A7 , I served the within
7 APPT TrATTON FOR LEAVE TO PRESENT LATE CLAIM? NOTICE OF CLAIM.
8 AaATygx PrTRT.Tr FNTTTv., nF(-T.ARATIO.N IDT SUPPORT C1F APPLICATION
9 FOR LEAVE TO PRESENT LATE CLAIM
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11 on the parties of said action, by placing a true copy thereof
12 enclosed in a sealed envelope with postage thereon fully prepaid,
13 in the United States mail in Oakland, California, addressed as
14 follows :
15 COUNTY OF CONTRA COSTA
16 ADMINISTRATION BLDG.
17 651 PINE ST.
18 MARTINEZ, CA 94553
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26 I declare under penalty of perjury that the foregoing is
27 true and correct and that this declaration is made this 20th day
28 of May 1987, at Oaklan , lifo ia.
t,AMENDED
s"--° 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 June 16 , 1987
anvi 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: $30, 725. 00 Section 913 and 915.4. Please note all °Warip-ORo ytY C�U7S4,
CLAIMANT: ROYAL INSURANCE CO. , SUBROGEE OF JOHN J. SCHOMfER MAV
c/o Law Offices of Rinella & Kami Ma2 c 1981
ATTORNEY. 11e, #300tlne2'
Concord, CA9452ODate received r CA 94
ADDRESS: BY DELIVERY TO CLERK ON May 20, 1987
BY MAIL POSTMARKED: May 19 , 1987
I. FROM: Clerk of the Board of Supervisors TO: • County Counsel
Attached is a copy of the above-noted claim.
May 27, 1987 PFH�{IL BATCHELOR, Clerk
DATED: y 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: Iliad BY: Mad Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
As Amc �
M
( 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.
�UI� 161981 `//
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: JUN 1.7 1987 BY: PHIL BATCHELOR by eputy Clerk
CC: County Counsel County Administrator
Law Offices of
RINELLA & KAMI
2401 Stanwell Drive w
Suite 300
Concord, CAA
94520
(415) 682-1977
May 19, 1987PY
The Board of Supervisors
P.O.BOX 911
Martinez, Ca 94553
Attention: Phil Batchelor
n Claim of : nOY L INSURANCE COMPANY, Subrogee of
JOHN J . SCHOMMER
Location: 43 Estabueno Drive, Orinda, California .
Dear Mr. Batchelor:
We hereby resubmit this claim based on paragraph A. , Claims
relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. "
This claim is based on landmovement and damage to real property.
Please submit the attached claim to the board for their review.
Thank you for your courtesy and cooperation in this matter .
Very truly yours,
M RK C. KAMI
MCK:k
Enclosure
CZ AIN;1TO: 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 ROYAL INSURANCE CO. , ) Reserve stamps
Subrogee of JOHN J. SCHOMMER ) �`�T�LT%
V�tiill/j♦ L4-JWr
Against the COUNTY OF CONTRA COSTA) ARV/ 087
or DISTRICT)
(Fill in name) )
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District in the sum of $ 30 , 725 . 00
and in support of this claim represents as follows :
---- -------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
Royal Insurance Company' s insured sustained landslide damage between
June 28 , 1984 and January 23 , 1987. Royal Insurance Company paid
its insured on or about January 23 , 1987 .
------------ --------------------------- ---------------------------
2. Where did the damage or injury occur? (Include city and county)
43 Estabueno Drive,
Orinda, California
Contra Costa County
-------------------------------------------------- ---------------------
3. How did the damage or injury occur? (Give full details, use extra
sheets if required) Royal ' s insured' s real property sustained damage
due to earth movement. Earth movements were caused by poorly compacted
and leaking culverts and stream bank erosion.
4 . What particular act or omission on the part of county or district
officers , servants or employees caused the injury or damage?
Omissions- failure to properly install, maintain and repair the culverts .
Failure to properly install, maintain and repair the grouted rip-rap
along the stream bank. Negligence in diverting the stream from its
original water course.
(over)
5,. What are the names of county or district officers, _.:servants•rszr�
: employees causing the damage or injury?
UNKNOWN
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6. ----- - -------------------- ------
What damage or nures do you claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage) Earth movement damage to the insured' s land and structures,
specifically driveway and garage foundation are cracking & sinking.
-------------------------------------------------------------------------
7. How was the amount claimed above computed? (Include the estimated
amount of any prospective injury or damage. )
Computed as to cost to repair damage to structures and cost to
stabilize the land.
-------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
Mr. Louis Tams , GAB Business Services, Inc. , P.O.BOX 6788
Oakland, CA 94603. Paul Seidelman, Seidelman Associates , Inc. ,
90 Devon Ave. , Pleasant Hill, CA 94523
-- - --------------------------------------------------------
9. is res you made on account of this accident or injury:
GH V"'a 1R ITEM AMOUNT
1-23-87 22 , 466 . 50
11Z-$-86 R(l) 8 , 008 . 50
Insured de'
e $250 . 00
Lam
Govt. Code Sec. 910.2 provides :
"The claim signed by the claimant
SEND NOTICES TO: (Attorney) b some person pn h' behalf. "
Name and Address of Attorney
LAW OFFICES OF RINELLA & KAMI Clai ant' s Si ature
2401 Stanwell Dr. , Suite 300 `�D/ ,S A".,W-
Concord, CA 94520 Address
0
Telephone No. ( 415 ) 682-1977 Telephone No. G
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
L I aim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 16 , 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: $7 , 000- 00 Section 913 and 915.4. Please note all °WaoijUNty COL!snSal
CLAIMANT: JAMES R. THOMPSON MAY
54 Tunnel Road 2 8 1987
ATTORNEY: Berkeley, CA 94705 N!arflnoz GA 0413} ..11
Date received
ADDRESS: BY DELIVERY TO CLERK ON May 21, .1987
BY MAIL POSTMARKED: May 20, 1987
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PpHHIL BATCHELOR, Clerk
DATED: May 27 , 1987 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: &4,/./2 BY: d,4,� 422f,,!�J 4ZZ Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
((() 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:'
,JUN 16 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
1 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.
JUN 171987
Dated: BY: PHIL BATCHELOR b -(.�.—,.BgPut Clerk
Y
CC: County Counsel County Administrator
, y
CLAIM OF JAMES R. THOMPSON ) CLAIM FOR PROPERTY DAMAGE
v ) (PURSUANT TOFj�1FNT I
COUNTY OF CONTRA COSTA ) �i(v��
-----------------------------)
MAY,9/ 1987
To the Board of Supervisors, Contra Costa County:
You are hereby notified that James R. Thompson, whos
54 Tunnel Road, Berkeley Ca. 94705, claims damages f
Contra Costa in the amount, estimated as of the date of presentation
of this claim, of $7,000. (seven thousand dollars) .
This claim is based on the property damage sustained by claimant on
or about May 11 , 1987 in the vicinity of 54 Tunnel Road, Berkeley
under the following circumstances:
Police officers of Orinda chased Robert Eichelberger from
Orinda to Berkeley at speeds at or exceeding 70 MPH. This chase
was conducted on extremely busy public highways, especially
Tunnel Road in Berkeley. The basis of this chase was apparently
petty theft. This chase was conducted in a negligent manner,
and ended with Eichelberger crashing into claimant' s garage
and landscaping, doing severe damage. The officers involved were
actually Contra Costa County Sheriff employees, following (or not
following) County policies.
The names of the public employees causing these injuries are
not fully known to me because I was not present when this incident
occured and because when I later phoned the Orinda police department
I was denied access to any reports. Officer Sylvia stated he prepared
a report on the incident and had participated in the chase, and
I therefore believe that officer was negligent and responsible.
The amount claimed, as of the date of presentation of this claim,
is for:
Removal of debris
Reconstruction of foundation to deck, and of deck: itself
Reconstruction of garage
Replacement of ivy and shrubbery
Replacement of frame and bamboo matting
Prospective general damages
Total . . . . . . . . . . . . . . . . . . . . . . . . .$7000.
I attempted to learn if there were any local requirements involved
in the filing of this claim by phoning Ms. Finucane of the County
Counsel office. She did not mention any local requirements.
All notices or other communications with regard to this claim
should be sent to the claimant at
54 Tunnel Road
Berkeley Ca 94705
(415) 548 764 '
Dated: May 1791987
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mes R. Thompson
Claimant
CERTIFICATE OF SERVICE BY MAIL
I am a citizen of the United States and employed in
the County of San Francisco, California. My business address
is 505 Sansome Street, Suite 1600, San Francisco 94111 . I am
over the age of eighteen years. On May A , 1987 I served
the foregoing Claim of James R. Thompson by placing a true
copy thereof , enclosed in a sealed envelope with postage
thereon fully prepaid, in the United States Postal System
at San Francisco, California, addressed as follows:
CONTRA C65T4 COUNT4
CLERK F�OhI2D GF 5uPEaV156R5
(c51 A-4E STREsr
MkR'r1NEz, c4 9'f553
I , Anne M. Bevington, declare under penalty of perjury
that the foregoing is true and correct.
Executed on May 1987, at San Francisco, California.
Anne M. Bevington
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 June 16 , 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: $67 . 50 Section 913 and 915.4. Please note all `Warnings".
CLAIMANT: HELEN BAILEY County Co,n ,3,
1015 East Meadow Avenue f�AY � 1987
ATTORNEY: Pinole, CA 94564
Date received /Vt,
ADDRESS: BY DELIVERY TO CLERK ON May 19 , 197nez CA
BY MAIL POSTMARKED: May 18 , 1987
I. FROM: Clerk of the Board of Supervisors TO:', County Counsel
Attached is a copy of the above-noted claim, gg
DATED: May 27, 1987 gYpH IL DepuiyLOR, Clerk
L. Hall
11. FROM: County Counsel TO: Clerk of the Board of Supervisors
(Xj 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: Iq ff BY: Deputy County Counsel
II1. 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: JUN 16 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.
JUN 17 1987
Dated: BY: PHIL BATCHELOR by r GC 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 or tamps
e Le..i 2.2/ kz ' RECEIVED
io/s 46psr �� �� ) MAYf�1987
'
Against the COUNTY OF CONTRA COSTA)
or DISTRICT)
Fill in name) )
The undersigned claimant hereby makes claim against the County of Contra
Costa or the above-named District in the sum of $ 6 7. 41-0
and in support of this claim represents as follows:
------------------------------------------------------------------------
1. When did the damage or injury occur? (Give exact date and hour)
172 87 J:3S .�
-----------
---------------------
--------------------------
2. Wher/e did the damage or injury occur? (Inclu/de city and county)
nV�e4l- '549~6 G< zcL
---------------------
3. How did the damage or injury occur? (Give full details, use extr
sheets if required)
7//, eJ On/ �A✓
----------------------------------------------------------------------
4 . What particular act or omission on the part of county or district
officers , servants or employees caused the linjury or damage?
1'jo S is A4!1 or' `61-ocx pr s �arE Pos �ecC .'lc V1 Z-c
v+.l. Ot i M¢. 6AlArk
(over)
5. What are the names of county or district off icers,.,servants ate:.
I employees causing the damage or injury?
__ Worms
- -- ------------------ -------------------
6-.--Wh damage or -in--j-uries-----do----you---claim resulted? (Give full extent
of injuries or damages claimed. Attach two estimates for auto
damage) -r,(VS L,,arC F3 Coalac( +�. ra�rrux ..a / " af" T/O- .6W/
roc.-e, 1 CDu[ti or 7//7� Jv� Z6ih/A5� cJ/XM+, Tlj 1�AJ \f/J//J{i
/ / / 1 /CK /l7uw/
c_d_i3_jlco nn_._c_d b __Lvsa.a,.u_ �O��ee rT• .�l[IfKa_�� Co,
7. How was the amount claimed above computed (Include tfie estimated
amount of any prospective injury or damagL. )
---_— =`1.-------------------------
8. Names and addresses of,witnesses, doctors and hospitals.
L-k V4,) +A
9ures you made on accountofthis accident or injury:
ITEM AMOUNT
67 so
711A N'
T res.
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 �l
Claimant' s Sigrifture
/0/5 E,az r 1,72 a d,�) ,..c_
Address
',vole 9y�s�y
Telephone No. Telephone No. Te2y- yv
**************************************************************************
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. "
r
P
i
• Y
Q[111 -
a
.Horne of the Tire Doctor!'
(41 5) 724-TIRE
730 SAN PABLO AVE., PINOLE, CA. 94564
jl�7
Ll
(41-5) 23[•93;i e�.0.� �f•fi�/� �
101�)
SOLD BV DATE
NAME
ADDRESS
n�°a oa�: ,�ncaex;3�,cccT. rti � "� � l�v� d � — � ��► � r
st,
,mac•. .? .5i tr ti. �. r
L,lersi u . G.... . ?�
Lub,ir-a;i^n
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,
ECEIVED BY
iO C
p al�A�OI!
claims and returned goods MUST be accompanied by this bill.
First Class Car Service
Specializing in RETAIL
WHOLESALE Plus 1 and Plus 2 &
Suspension Combination DR. "D"
90 Days Same As Cash