The URL can be used to link to this page

Home My WebLink AboutMINUTES - 06161987 - 1.18 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Agai.lst the County, cr District governed by) BOARD ACTION the Board Df 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: $1, 180. 00 Section 913 and 915.4. Please note all `Warningeounty COUnsc.11 CLAIMANT: ERIC ROUSE MAY 2 S 1987 71 Ambrose Ave. ATTORNEY: Pittsburg, CA 94565 (via;tinez, CA Date received ADDRESS: BY DELIVERY TO CLERK ON May 18 , 1987 hand del . BY MAIL POSTMARKED: no envelope 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. FFHH DATED: May 27 , 1987 BY1L BATCYELOR, Clerkepu LV// y. 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 910.6). ( ) 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: BY: � �, /'i/ � 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 UN 1 6 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 nabove. Dated: J uN 1 ` BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator CLAIM TO: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY �. 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 LFiis form. ttttttttttAttttttRttt+RtttttttttttttttttttttlttttttttttttttttttttttRtfttt RE: Claim b )Reserved for Clerk's filing stamps 21, Lou S F, ) u�l &Z= ror3[4 (d ; REaj,tra Against the COUNTY OF CONTRA STA; of or Cgvafit �bS� (0U4LI DISTRICT) /�(Fill in name)The undersigned claimant hereby makes claim again Costa or the above-named District in the sum and in support of this claim represents as follows: I. N�ian �1dT the damage or Injury occur? Give exact date ani �iourj wk & o 1 NUre $ t damage or Injury occur? ZInclu�e clay anc-countyS GU1 *Bri-n V\3. How did the damagry cc 0IN IuII 8etall-s, uee extra sheets if r quired) T,. CA k Ortaotl (,J1 a CL t G 4. Nkat particular act or omisslon on the part oI county or &IRUM officers , servants or employees caused the injury or damage? S-C-CO , ,0 LL s (over) 5. What: arei; the names of county or district officers, servants or' employees causing the damage or injury? �pv ACc T............. 6. What 8amage n uries do you clim resulted?--ZGtveuIS extent of injpries or ges claimed. Attach two estimates for auto damage) Ck 7, ow was the amount claimed above computed? (Include the estlmatea amount of any prospective injury or damage. ) LbE3Acs__ _ B: N mea and addresses of witnesses, doctors and ho to s. L4A 0 . n?4r 61V CGA — ---------- ----- -------- — --- �. -L�st the expenditures y ade on account of this accident or in0ury: fad �{ y ITEM (uvEio r. Y30 RAf*t## +!t #•tR##*#*##R*##SSC *t#t#RR*# 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 �.T L U S� C16aim t's Signature Telephone No. Telephone No. tf" o'- ?0 ft#R#*ttR*#tRt##*t*#tt###tR**t#t*tt#R#ttt#Rtt*R*tRtt##Rtt**RRttRtR#tt*t*R# NOTICE Section 72 of the Penal Code provides: 'Every person k-ho, ,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."