Loading...
HomeMy WebLinkAboutMINUTES - 05241988 - 1.14 ' 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 24, 1988 and Board Action. All Section references are to ) The copy of this document mailed to you Mns 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: -2, 250 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SUSAN R. LEVINE c/o Richard F. Hill ATTORNEY: 2168 Shattuck Ave. #300 Berkeley, CA 94704 Date received ADDRESS: C_--unty C0uml BY DELIVERY TO CLERK ON April 26, 1988 APR,2 7 1988 BY MAIL POSTMARKED: April 25 , 1988 DUA*Aee PA 94558 I. FROM: Clerk of the Board o Supervisbrs TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: April 27 , 1988 ��: Deputy L. Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. (V) 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: Ql ��? � /�' � BY: ZiL4,f eputy County Counsel ! '-o 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 2 4 1988 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. MAY 2 5 1988 Dated: BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator , IRICHAI3D F. HILL EIV ATTORNEY AT LAW REED FI 2166 SHATTUCK AVENUE,SUITE 300 hpRTR.,0917E(415)54 0356 BERKELEY, CALIFORNIA 94704 �1 / f{ ISORS CLAIM AGAINST PUBLIC ENTIT CLEa .. epuly 13Y TO: CLERK, BOARD OF SUPERVISORS, CONTRA COSTA COUNTY SUSAN R. LEVINE ("Claimant") hereby makes claim against CONTRA COSTA COUNTY for the sum of Two Thousand Two Hundred Fifty Dollars ($2,250. 00) and makes the following statements in support of the Claim: 1. Claimant's post office address is 419 Kentucky Avenue, Berkeley, California 94707. 2 . Notices concerning the Claim should be sent to Richard F. Hill, 2168 Shattuck Avenue, Suite 300, Berkeley, California 94704 . 3 . The date and place of the. occurrence giving rise to this Claim are January 18, 1988, junction between Parking Lot 4 and Access Road 2, Kensington Youth Hut, Kensington, California. 4. The circumstances giving rise to this Claim are as follows: at the above 'time and place, Claimant was walking around her car which she had parked properly and stepped into a pothole, causing serious injuries. 5. Claimant's injuries are torn ligaments of right ankle. 6. The names of the public employees causing the Claimant's injuries are unknown. 7. Claimant's claim as of the date of this Claim is $2,250. 00. 8. The basis of computation of the above amount is as follows: Medical expenses incurred to date : $ 250. 00 Estimated future medical expenses : unknown General damages $2 , 000. 00 TOTAL $2,250. 00 Dated: April 25, 1988 . RICHARD F. HILL, on behalf of Claimant 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 24, 1988 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: $3 , 500. 00 Section 913 and 915.4. Pleases ree-igtj, "Warnings". CLAIMANT: RICHARD HARRISON 2751 Monument Blvd. #286 ATTORNEY: Concord, CA 94520 Date received tb�?UrE''April 27 , 1988 hand del . ADDRESS: BY DELIVERY TO CLERK ON 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. ATED: May 4, 1988 EaIL BATCtELOR, Clerk D p y L. Hall 11. 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: J��7` BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. 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 2 4 1988 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. MAY 2 5 1988 Dated: BY: PHIL BATCHELOR byVV­I�eruty Clerk CC: County Counsel County Administrator 6 Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY �i INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months 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. (Govt. Code §911.2.) 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." C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp i�►�.i..In.cZD l-�d�isv rel ) RECEIVED Against the County of Contra Costa ) or APR-27 19.8.8 ) District) PHIL BATCHELOR CLERK BOARD OF RVISOR,g Fill in name ) B �coNTRA Co. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ �fQ(�,� and in support of this claim represents as follows: ------------------------------------------------------------------------------------- l. When did the damage or injury occur? (Give exact date and hour) ------22P�--4,_L q_a ­-� ---------------------------------- 2. Where did the damage or injury occur? (Include city and county) , 3. How did the damage or i jury occur? (Give IV11 details; use extra paper if 9 rods )^ I Q/7J11oY = Q , � -i4lc V(a&zel� ca.A.0 ---------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 40,� L41-0Q)r-fna*-�, �yn -tL -,CL CIP-A (over) 5. What are the names of county or district officers, servants or employees causing ' the damage or injury? 5. What damage or injuries do youaim resulted? (Give full extent of injuries or damages c ai ed. At ch wo estimates for auto damage., G�Q/J/� CJ71Qyrpc3 /(D✓.L?� �Zrexsal L�.fYlp� �Cb✓ay d-' [�C ---gyp - = -=----=------------------- ------- --------------------------- ----- 7. How wasle amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) r Re+ c.�em� pavr� w� c � uc' c 0. !!�D �r dlt ys� /CAIC- ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. --------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT , Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney < Clai tis Signature (Address) q ZC Telephone No. Telephone No. fY/5 (0$2-9?0�,( N 0 T I C E 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, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Y Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 24, 1988 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 GovernmeCt,Code Amount: $250 ,000- 00 Section 913 and 915.4. Please note all "Warnings". �jr qp 0 CLAIMANT: KENNETH M. ROBEY �,r s 0/) �� c/o Johanna A. Bernstein, Taylor & Meadows 7, ATTORNEY: 2121 N. California Blvd. #865 `9BB Walnut Creek, CA 94596 Date received '9 9 ADDRESS; BY DELIVERY TO CLERK ON April 25 , 1988 BY MAIL POSTMARKED: April 23 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ��IL eATCHELOR, Clerk DATED: April 25, 1988 : Deputy L. Hall 11. 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: ,l BY: '� A 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 (V) 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 24 1988 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 5 1988 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator c 1 t 2REG EIVED 3 AP R, 4 2 519$ 5 DPMI ATFon SGR3 CLEP 6 T n4outy 6 ey i .c. _• . 7 THE MATTER OF THE CLAIM OF KENNETH M. ROBEY, AGAINST 8 THE COUNTY OF CONTRA COSTA 9 CLAIM FOR PERSONAL 10 INJURY AND EMOTIONAL DISTRESS (GOVERNMENT 11 CODE SECTION 910) 12 TO THE BOARD OF SUPERVISORS: 13 Claimant, KENNETH M. ROBEY, presents a claim for damages 14 in the amount of $250,000, estimated as of the date of 15 presentation of this claim. The following statements are 16 made in reference to this claim: 17 1. Notices concerning this claim should be sent to 18 JOHANNA A. BERNSTEIN, TAYLOR & MEADOWS, 2121 N. California 19 Blvd., Suite 865, Walnut Creek, California 94596. 20 2'. The occurrence giving rise to this claim �o;t place 21 on or about January 24, 1988 at or near the City of Concord, 22 California. The circumstances of the occurrence are as 23 follows: County employees and Sheriff's Deputies committed 24 upon claimant trespass, false imprisonment, physical abuse, 25 infliction of physical injury, pain, suffering, and emotional 26 distress. 27 3. The names of the public employees causing or 28 contributing to the injuries, damage, and loss for which this LAW OFFICES OF claim is made are unknown. TAYLOR&MEADOWS r _ 1 2 4. The injuries, damage, and loss for which this claim 3 is made, so far as now known, consist of those described in 4 paragraph 2 above. 5 5. The basis of computation for the amount for these .6 injuries, as now known and prospectively estimated, is as 7 follows: 8 a) Medical Expense: $100,000 9 b) Lost Income: 50,000 10 c) General Damage: 200,000 11 TOTAL: $350,000 12 13 DATE: _ April 22, 1988 1415 AX / 1_�-- / HANNA A. BERNSTEIN 16 f� ATTORNEY FOR CLAIMANT 17 18 19 20 21 22 23 24 25 26 27 28 LAW OFFICES OF TAYLOR&MEADOWS w r I PROOF OF SERVICE BY MAIL 2 I declare that: 3 I am a citizen of the United States , I am employed in the 4 County of Contra Costa, State of California, I am over the 5 age of eighteen years , and I am not a party to the within cause . 6 My business address is 2121 North California Boulevard, Suite 865 , 7 Walnut Creek, California , 94596 . 8 On April 22 , 1988 , I served the within 9 Claim for Personal Injury and Emotional Distress 10 (Government Code Section 910) 11 12 13 on the parties in said cause, by placing a true an correct copy 14 thereof enclosed in a sealed envelope with postage thereon fully 15 prepaid, in the United States mail at Walnut Creek, California, 16 addressed as follows : 17 Board of Supervisors 651 Pine Street 18 Martinez , CA 94553 19 Attn: Clerk of the Board 20 Contra Costa County Sheriff 1000 Ward Street 21 Martinez , CA 94553 22 23 24 I certify and declare under penalty of perjury that the 25 foregoing is true and correct and that this declaration was 26 executed on 4/22 , 1988 at nut Creel<' Califo ' a . 27 28 A R E kICHOL LAW OFFICES OF TAYLOR&MEADOWS CLAIM C 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 24, 1988 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 "War"S'. CLAIMANT: KENNETH M. ROBEY c/o Johanna. A. Bernstein, Taylor & Meadows IriN`1 ATTORNEY: 2121 N. California Blvd. #865 Walnut Creek, CA 94596 Date received ADDRESS: BY DELIVERY TO CLERK ON April 28 , 1988 BY MAIL POSTMARKED: April 23 , 1988 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached. is a copy of the above-noted claim. May 4, 1988 pHIL BATCHELOR, Clerk > DATED: y BY: Deputy L. Hall 11. 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: Lj - BY: — Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. 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 2 4 1988 PHIL BATCHELOR, Clerk, By -�C—_. 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 5 1988 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator 1 2 1�ED PE(;E 3 APR.2 8 �9ag, 4 P A7 E POR ORS CLE TR pU 6 7 THE MATTER OF THE CLAI_4 OF KENNETH M. ROBEY, AGAINST 8 THE COUNTY OF CONTRA COSTA 9 CLAIM FOR PERSONAL 10 INJURY AND EMOTIONAL .DISTRESS (GOVERNMENT 11 CODE SECTION 910) 12 TO THE BOARD OF SUPERVISORS: 13 Claimant, KENNETH M. ROBEY, presents a claim for damages 14 in the amount of $250,000, estimated as of the date of 15 Presentation of this claim. The following statements are 16 made in reference to this claim: 17 1. Notices concerning this claim should be sent to 18 JOHANNA A. BERNSTEIN, TAYLOR & MEADOWS, 2121 N. California 19 Blvd., Suite 865, Walnut Creek, California 94596. 20 2. The occurrence giving rise to this claim took place 21 on or about January 24, 1988 at or near the City of Concord, 22 California. The circumstances of the occurrence are as 23 follows: County employees and Sheriff's Deputies committed 24 upon claimant trespass, false imprisonment, physical abuse, 25 infliction of physical injury, pain, suffering, and emotional 26 distress. 27 3• The names of the public employees causing or 28 contributing to the injuries, damage, and loss for which this LAW OFFICES OF claim is made are unknown. TAYLOR&MEADOWS 1 2 4. The injuries, damage, and loss for which this claim 3 is made, so far as now known, consist of those described in 4 paragraph 2 above. 5 5. The basis of computation for the amount for these 6 injuries, as now known and prospectively estimated, is as 7 follows: 8 a) Medical Expense: $100,000 9 b) Lost Income: 50,000 10 c) General Damage: 200,000 11 TOTAL: $350,000 12 13 DATE: April 22, 1988 1415 % TOHANNA A. BERNSTEIN 16 /ATTORNEY FOR CLAIMANT 17 18 19 20 21 22 23 24 25 26 27 28 LAW OFFICES OF TAYLOR&MEADOWS I PROOF OF SERVICE BY MAIL 2 I declare that: 3 I am a citizen: of the United States , I am employed in the 4 County -'of Contra Costa, State of California, I am over the 5 age of eighteen years , and I am not a party to the within cause . 6 My business address is 2121 north California Boulevard, Suite 865 , 7 Walnut Creek, California, 94596 . 8 On April 22 , 1988 , I served the within 9 Claim for Personal Injury and Emotional Distress 10 (Government Code Section 910) 11 12 13 on the parties in said cause, by placing a true an correct copy 14 thereof enclosed in a sealed envelope with postage thereon fully 15 prepaid, in the United States mail at Walnut Creek, California, 16 addressed as follcas: 17 Board of Supervisors 651. Pine Street 18 Martinez , CA 94553 19 Attn: Clerk of the Board 20 Contra Costa County Sheriff 1000 Ward Street 21 Martinez , CA 94553 22 23 24 I certify and declare under penalty of perjury that the 25 foregoing is true and correct and that this declaration was 26 executed on. 4/22 1988 at nut Creek Califo a . I � 27 28 AftN/ RTE ti.TCHOL LAW OFFICES OF TAYLOR&MEADOWS CLAIM BOARD 'OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA r ,> Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May +4,, 1988 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: Unspecified Section 913 and 915.4. Please note all "Warnings". CLAIMANT: RALPH HERNANDEZ P. O. Box 8251 ATTORNEY: Pittsburg, CA 94565 Date received ADDRESS: COUClty Counsel BY DELIVERY TO CLERK ON April 21 , 1988 hand del . APR,2 5 1988 BY MAIL POSTMARKED: no envelope l.Aa r 1. FROM: Clerk of the Board of Supervisors TO: County.Counsel Attached is a copy of the above-noted claim. April 25 , 1988 PpHHIL BATCHELOR, Clerk DATED: P 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: �� �(� BY: eputy 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 (V) 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 2 4 1988 PHIL BATCHELOR, Clerk, By c 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. 57 01 Dated: MAY 2 5 1988 BY: PHIL BATCHELOR by puty Clerk CC: County Counsel County Administrator `SOC O NELOAOISp;7� 4� CLE ` B J S " �`� f� Cf�i--tFc�(21Uf/ C�UfvT`{ c�NrfZR cC G� C(TI DIP . b acv,�.�� �-o � �_ v-�-Q�►.�. �s.-v� .��.�.ra�- . w ��,p .ter 4 c � I csF 3 4c, � Wc--t, b� cry 4t� -iL�Nt� a,.,& a d6 4-4 &A-t awns, iA-- -�; C&61c� 64(j ��-� ..tea--�►�.� o��J . . � . r Doo • _ 3. ul ; r. Dc e 0 F o, Eox 8251 , Tb� Ck Cq%5 ?' 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 24, 1988 and Board Action. All Section rPferencps 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 Suptvisors (Paragraph IV below), given pursuant to Government O de Amount: $772 .44 Section 913 and 915.4. Please note all '*-rnir*. ��e, CLAIMANT: ALBERT G. MCMANUS � c� �0 2735 Ryan Road `Sj �s ATTORNEY: Concord, CA 94518 C,4 E2 Date received dQ ADDRESS: BY DELIVERY TO CLERK ON April 20, 1988 s BY MAIL POSTMARKED: April 19 , 1988 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH gg DATED: April 25 , 1988 BYIL DeputyLOR, Clerk 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: /,� -��s(� BY: �/[ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( his 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 2 4 19884 Dated: PHIL BATCHELOR, Clerk, By ,V( ,/ 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 5 1988 BY: PHIL BATCHELOR by VeDeputy Clerk CC: County Counsel County Administrator ^laim t6s­i 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 per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months 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. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Roam 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this Tom—. RE: Claim By ) Reserved for Clerk's filing stamp �.6En — 61. A7 RECEIVED Against the County of Contra Costa ) AP R,2 0.SK or ) District) O1ER Rs Fill in name- ) eY oop�v The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ '77a. 174-4- and in support of this claim represents as follows: ----------------•--------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ----- ---------- ---- -------- ----------------------------------------------------- 2. Where -did the damage or injury occur? (Include city and county) ----------------- ------ 3. How did the damage or injury occur? (Give .full details; use extra paper if required) 1�-M/�[>c �'ti �. y �E fj�/'774-c_rf•�U N�C2.�i-� �- • ----------------------------------------------------------------------------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 6�lc ZUi4izi C NJT7l L1C/7 c.tJ C A- j JC, �f�c, : r3E �.uf� /TrV,U S L 17/E aor t47tfLL vr"v`X ACS Ez�t >c1J i�//t arc E �•c: J71Z� 51>Lt�T �t 89 2r c:}[)✓ �c,.2 rc S;�D ,t� ,,.„c.S f� A ��c�: ✓c7vi �c,.6uct..�-y. 2Zl�fLJ (over) . 5. What are the names of county or district officers, servants or employees causing the damage or injury? ------------------------------------------------------------------------------- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. lJcn%c�cc y. J ��--------------------------- i 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) l�c,z,.��r�� � ;Z Cn S;-.s /7-zr ��r�i� 2 L:i'L�)��i L.., 77fL= ��-f i�l'-D /'.971�.� (•%�'C'3E �r7��:7C�7�/ �/�v r i3 r�7) �C-i7t',.t; /) i�c :� I7�L� /4--:141 c iY iZ /A�S PCC-?z�i, iifi �Nln2� �fa 8. Names and addresses of witnesses, doctors and hospitals. t vL'C•.�c 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT `{-/G+�5.. .,. ' �l'7�� •�.�Y ;�+I�L�. �t�.rfEc7 '� 77a . �CL, r Y Y Y 4 Gov. Code Sec. 910.2 provides: F "The claim must be signed by the claimant SEND NOTICES TO: (Attorne ) . . or by some person on his behalf." Name and A dress'of Attorney Claimant's Signature — 7A ess Telephone No. Telephone No. 6d i L 3 * * * * * V V Ir * * * * * * * * 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, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine. of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. 4 ------------ ,64L-et--I*- ------------ ------ Z:41/ At 1 14"TT7 �10 127-� 1/5�11 -zfv 44.4 Le Z-Xe 4va ------------ Yl-en- .mac'."-�—cs et'.-L_e. 2--1._G, ,C/"G���� .!y-c_t��c � Lx-� ,� L2-z-v_.s2✓ i J L i I - I - - Q �O 4 olo ----------- - — — ----- - --------- --------------------------- ---------------- _ 4i, • -- 140 v s� dig m �° NO CCAC aR � o �,� �, `gyp �m i 6 CD Dx ��� m + j'Q 2 co>3 Z 12I OA �3 � �£ m I v I f L' A.. NWS n �;C,-y9 l , '� z n ozc m ! i 0 good sI ,. m O lz �z K I I I IS I C,) c ow£ s <R 1 Nv 't 29 CA se=R= ryerm ^ m f r \ • a > i m m r • g • c : m 7,11 m • .. m 1 '7 -- .. .. .. r N (� _ f'1 O 7C m O 1 FrZn 4=m OOrn C rn m O c I w > A-�C m rn m �7 oD cin N3L- c � [� f z cZz nuc = o N c -� c- � ooD ccn < i m Z m c o C v, m Ln cn •r Z V c • m 2 j . � `� t�,ax ice.. a$-t -. „.�.', x� .:. a � � .:j �2F' � a' r�'. :'•r - "�+. " Yh-t d 'J fn � ��� •cY � �j, .a �,.a � o- �� .�.���- t,t•"fit. • s "-'yam' i,:` u''�-,"�' - 4 r�6K':.' 7 4 C.. '4'f l'.• ,Y _.� +Tit. �� co NY. 4,�3 -t ' r"k � `� •= L - r r. 4, T. ar...: �.'',�p`' �u. Jai m- l�S�t' .•".y �r^�d�s .ry � "� ?��,-y •r"-z �v � : i•° �r:.-.r yw` rS'�J��� j�l •r�,r i�. rt x'it•; . _t h•_ 7�Y` �,,, w?'s _ti. u •''ra• +' T ,�'',�r �-r t` ^"-t"•7 S s •t' �-.1-..' -� .+aFa.., � r�'r 'P�C•�s'�n(. . -a '�•} � 7e. x - r-•� '' -' k."»•-.-+*.y�SF v.. .,r ._ n.. 1 I. s P-np O Oiw tc. r ;> �Rr{J .'> ....•y tllm ti A — ru a H O ul� CAO ru vLn c r rn R r J O _ ru- z E..r �rcc ^' n co 00 _ •� .4,y"�.t:_V'�`�.Y�• Q S - _.'L S,1'r 4• ?.s�-'fir +i'-`r' i�. ::.t'::'.. Z -•tJ 3n,S�-td^4.�.:�'a- -*� .r.` ..si._s v:z .�k's."-.^¢:gyp'•• ..,. tk ,.."k .� _ -Sl.i�.-.� >':� ',:r'{i'�� .�..,- _._. ... .. .. :a.:"%•. .. •:.!.::.. =. M. ;:. u" ', '4 _.•'e. .: �C'�` kA�`�`T'`.+�.r.'-- ;�k+,•Yr ;r:�,.s #fl ,w�r}„•sn�y4§'�+.,ptw t s«�.. a. ;nsN.,yizt�.,y,� -.w.......a v+..ry-_ - �•w:ut�:-..�.,.. .. -. - .• . 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 24, 1988 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 Sup6�isors (Paragraph IV below), given pursuant to Government Cdllll�f Amount: $100 , 000. 00 Section 913 and 915.4. Please note all " nin� ?y 'p-� 0G CLAIMANT: ROSE JOHNSON c/o Coker, Tays & Ramirez ? l9 ATTORNEY: 509 Railroad Ave. 0-9 (9E19 Pittsburg, CA 94565 Date received `9�s ADDRESS: BY DELIVERY TO CLERK ON April 20 , 1988 BY MAIL POSTMARKED: April 19 , 1988 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: April 25 , 1988 PpHHIL BATCHELOR, Clerk BY: Deputy L 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: ���J 2� Jae BY: � Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOY) This DER: By unanimous vote of the Supervisors present ( 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 2 4 1%8 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 5 19IMS BY: PHIL BATCHELOR by • /44 �t y• Clerk CC: County Counsel County Administrator ' e RECEIVL;D APR.2 019MI, CLAIM AGAINST THE COUNTY OF CONTRA CO ERK T R CRS R� er .2 c.. ..... ..... Dew+b ROSE JOHNSON presents a claim for damages against the County of. Contra Costa. Address of Claimant: 418 W. 9th Street, Pittsburg, CA 94565 Address to Which Notices are to be Sent: Coker, Tays & Ramirez 509 Railroad Avenue, Pittsburg, CA 94565 Date, Place and Circumstances of Occurrence: On March 8, 1988, Claimant was entering the Contra Costa County Courthouse located at 725 Court Street in the City of Martinez , County of Contra Costa, State of California. Due to faulty construction and/or a foreign substance, Claimant slipped and fell on the steps while entering the building. Amount of Claim: $ 100,000.00 Claimant suffered injuries to her right foot, knee, hip and back. Damages are based on treatment expenses, and lost school time. i Dated: April , 1988. K PEREZ TAXSf Attorney for C aimant ROSE JOHNSON 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 24, 1988 and Board Action. All Section references are to ) The copy of this document mailed to you is your nda" Fe of California Government Codes. ) the action taken on your claim by the Board of Super$�Vp�s (Paragraph IV below), given pursuant to Gov/��rnm!! jr de Cc, Amount: $1 , 500, 000 - 00 Section 913 and 915.4. Please note all "W�I�1' s"//. IMP 4 hS� g� � i CLAIMANT: THOMAS LUPHER AND ANGELA LUPHER nem' C,9 1%) c/o Philip R. Weltin 9 ATTORNEY: 444 Market Street #930 yS60 San Francisco , CA 94111 Date received ADDRESS: BY DELIVERY TO CLERK ON April 25 , 1988 Sheriff' s BY MAIL POSTMARKED: April 22 , 1988 Certified P 627 546 981 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppH gg , 2V DATED: April 25 , 1988 BIL DeputyLOR, 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:' �, S /��{� BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. 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 2 4 1988 � Dated: PHIL BATCHELOR, Clerk, By eputy 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 2.5 1988 BY: PHIL BATCHELOR byV. , _,Z�t�eputy Clerk CC: County Counsel County Administrator 1 Philip R. Weltin, Esq. RECEIVE® 2 WELTIN, VAN DAM & FLORES 444 Market St. , #930 APR,2 5 l9j San Francisco, CA 94111 3 Telephone: (415) 433-4500 CLEA Pqq HELOR 4a ison; Attorneys for Claimants. By r � THOMAS LUPHER and ANGELA LUPHER 5 6 TO: COUNTY OF CONTRA COSTA, CONTRA COSTA COUNTY SHERIFF' S 7 OFFICE, DEPUTY GARY CAMPBELL AND DEPUTY W.R. CUNNINGHAM: 8 THOMAS LUPHER and ANGELA LUPHER hereby make claims against 9 the COUNTY OF COSTRA COSTA, CONTRA COSTA COUNTY SHERIFF' S OFFICE 10 and DEPUTYS ' W.R. CUNNINGHAM AND GARY CAMPBELL for the sum of 11 $6,000 ,000 and make the following statements, in support of the 12 claim: 13 1. Claimants ' post office address is 245 North Point, #308 , 14 San Francisco, California. 15 2 . Notices concerning the claim should be sent to Philip R. 16 Weltin, Weltin, Van Dam & Flores , 444 Market Street , Suite 930 , 17 San Francisco, California 94111 . 18 3 . The date andlace of the occurrence p giving rise to this 19 claim are February 4, 1988 on Port Chicago Highway west of 20 Nichols Road in Contra Costa County. 21 4 . The circumstances giving rise to this claim are as 22 follows: 23 At the above time and place, claimants were traveling 24 westbound on the highway, a county road. Deputys' Cunningham and 25 Campbell were pursuing a suspect in another vehicle in an 26 eastbound direction. Port Chicago Highway, a county road, was in 27 a dangerous condition due to insufficient width and insufficient 28 shoulders. As a result of the dangerous condition of the highway DJV -1- lupher r� 1 and the pursuit of the suspect by the Sheriff ' s officers, without 2 lights or siren, claimants were involved in accident with the 3 pursued vehicle, causing them serious injuries. Claimant Thomas 4 Lupher' s injuries were multiple, including but not limited to, a 5 fractured femur, a fractured pelvis , major chest trauma and knee 6 injuries. Claimant Augela Lupher ' s injuries were multiple, 7 including but not limited to, chest trauma and wrist fracture and 8 dislocation. 9 5. The names of the public employees causing the claimant' s 10 injuries are G. CAMPBELL, W.R. CUNNINGHAM, and other unknown 11 employees. 12 6 . Thomas Lupher ' s claim as of the date of this claim is 13 $4,500, 000, which includes amounts for medical expenses both 14 incurred to date and in the future, loss of wages and general 15 damages. 16 7. Angela Lupher ' s claim as of the date of this claim is 17 $1, 500, 000, which includes medical expenses both incurred to date 18 and in the future, loss of wages and general damages. 19 DATED: April 22, 1988 20 21 22 Ph ip R. Weltin, Esq. On behalf of Claimants , 23 THOMAS LUPHER and ANGELA LUPHER 24 25 26 27 28 Div -2- lupher • CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C1aim,Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT May 24, 1988 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: $3 , 686 . 40 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ELIZABETH GRAVL 2140 Pomona Avenue ATTORNEY: Martinez , CA 94553 County Counsel Date received 1988 hand del . ADDRESS: BY DELIVERY TO CLERK ON April 22 , APR,2 5 1988 BY MAIL POSTMARKED: no envelope Martinez, CA 94553 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. April 25 , 1988 EVIL BATCHELOR, Clerk DATED: P BY: Deputy ' L. Hall 11. 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: d" ,f oO BY: A~ 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 OR ER: 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 2 4 1988 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. MAY 2 5 1988 �--- Dated: BY: PHIL BATCHELOR by • eputy Clerk CC: County Counsel County Administrator C12AmAc,3 . 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 per- sonal property or growing crops and which accrue on or before December 31, 19879 must be presented not later than the 100th day after the accrual of the cause of . action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months 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. (Govt. Code §911.2.) 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• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RE: Claim By ) Reserved for Clerk's filing stamp Z 0A GTS 4/0 'o02oAI c ) RECEIVED Against the County of Contra Costa ) or ) APR.2 2 MR.., •3:30 r. District) PHIL BATCHELOR Fill in name ) CL /jK B N RA C SAS 0 IPCO�SOIi, By //•ADeputy The undersigned claimant hereby makes claiLa agai st t e County of Contra Costa or the above-named District in the sum of $SZk and in support of this claim represents as follows: -----------------I-------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) 14-, 19 " ------------------------------------------------------------------------------------ 2. Where did the damage or injury, occur? (Include city a d county) �`.`� ON W14QZ) S>+I #)AP\l irEz , C� �1�.+c���en p rh6unlgra /Q ��. �- eGu'a -------------------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details; use extra paper if required) GuC� dr Vin an (,)arct -owa.rd Alham,(2.V4 A 6ob�c ka word �if ova o-C -the �e��-gar dep� _ Cieav) do lob atl6 h. 4 rh �, ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Oard d;,d lrL; �� 0�`�. l , ' loo 0,1 - c,61, 4a4'; c (over) 5. `What are the names of county or district officers, servants or employees causing the damage or injury? rd---=----------------------------------------- 5. What damage or injuries do you claim resulted? (Give full extent of Injuries or damages claimed. Attach two estimates for auto damage. ML jL tl tC&v' door 5ma ,�,L,-: , Mo►dI nc, -;gMa:5h6d,, 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) I I ``^I/ 1 ^ ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES Tb: (Attorney) ` or by some person on his behalf." Name and Address of Attorney26L: - Claimant's Signature 4 0 PO roc 40P J&vE. Address Telephone No. Telephone No. — a -7 3 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,' city or district board or officer, authorized to allow or pay the same if genuine., any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. Q e44 4rt4 V644 Ise, CUSTOM AUTO PAINTING TELEPHONE 689-6117 252'0 MONUMENT BOULEVARD - CONCORD, CALIFORNIA 94520 Date 19 NAME `2 -4y� ADDRESS CITY PHONEa�19y� 73 Make Year Serial No. 1 f bo ry/i�/3 SOi6 OG y S Mileage License No.�'T X l� LQ Body Style Prod.Date REPAIR REPLACE ESTIMATE OF REPAIR LABOR HRS. PARTS SUBLET /J Lz 37. /1 100 t Z o • 7 T 6 ff ? v -'An s ? IL '" „ � <��- 4-1 �T Z 2 D TOTAL REMARKS: t2noA I ',, ,,/s ©���� O��''] HRS.OF LABOR @ S&[/ PER HR.$ /477 �O PARTS$ 3162 7y PAINT MATERIALS$ 0 S INSURANCE DEDUCTIBLE SUBLET$ SALES TAX$ Z BY: THIS ESTIMATE IS BASED ON OUR INSPECTION AND DOES NOT COVER ADDITIONAL PARTS ESTIMATE TOTAL$ OR LABOR WHICH MAY BE REQUIRED AFTER THE WORK HAS BEEN STARTED.AFTER THE ADVANCE CHARGES$ WORK HAS STARTED,WORN OR DAMAGED PARTS WHICH ARE NOT EVIDENT ON FIRST IN- SPECTION MAY BE DISCOVERED. NATURALLY, THIS ESTIMATE CANNOT COVER SUCH — 76. /D CONTINGENCIES.PARTS PRICES SUBJE:CTTOCHANGE WITHOUT NOTICE.THIS ESTIMATE IS GRAND TOTAL$ FOR IMMEDIATE ACCEPTANCE. ' THIS WORK AUTHORIZED BY r�",RES'Iff CARDS ACCEPTED. -- MIKE ROSE'S AUTO BODY INC. DBA DATE/ F Am� � MAKE Y � � : OD MILEAGE eCEY SERIAL NO. 686 -1739 INSURANCE COMPANY CLAIM# 2001 FREMONT ST.CONCORD,CALIF.94520 A COMPLETE QUALITY PAINTING& REPAIRING SERVICE ADJUSTER PHONE (OWING. FRAME STRAIGHTENING - EXPERT COLOR MATCHING NAME L I HOME#� :''��i WORK# REPAIR REPLACE ESTIMATE:OF REPAIR COSTS PAINT BODY PARTS SUBLET co v ZL - O Z =s C 2 3 d r7$ 30 S PD 3T w.. i e r,. PARTS PRICE9--SUJBJECT TO I ICE �. 9 (I4- ! O G• HRS. @ $Y'7 Per Hr. $ ALIGNMENT PARTS $ •21 CHARGE AIC PAINT MATERIALS S c� a • AIM HIL SUBLET•IPARTS $ (.. O SUBLET•LABOR $ STRIPE COLOR MATCH j STORAGE/TOW $ SALES TAX $ 4� l TWO TONE TWO STAGE Q� G RAND TOTAL ROCK GUARD THIS ESTIMATE IS BASED ON OUR INSPECTION AND DOES NOT COVER ADDITIONAL PARTS OR LABOR WHICH MAY BE REQUIRED AFTER THE WORK HAS BEEN STARTED. AFTER THE WORK HAS BEEN STARTED, WORN OR DAMAGED PARTS WHICH ARE NOT EVIDENT ON FIRST INSPECTION MAY BE ` DISCOVERED NATURALLY THIS ESTIMATE CANNOT COVER SUCH CONTINGENCIES. PARTS PRICES TOTAL I CLAIM E:3ARD 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 24, 1988 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: $200. 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT. TANYA CHANMEL WOODS 214 West 9th Street ATTORNEY: Pittsburg, CA 94565 County Counsel Date received April 21 1988 hand del . ADDRESS: BY DELIVERY TO CLERK ON P APR,2 7 1988 BY MAIL POSTMARKED. no envelope Martinez, CA 94553 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. April 27 1988 pH IL BATCHELOR, Clerk DATED: P 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: BY: %` `i,�+ +c / Deputy County Counsel J 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 0 DER: 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 2 4 1988 PHIL BATCHELOR, Clerk, By puty 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 5 1988 BY: PHIL BATCHELOR by -/16_ Clerk CC: County Counsel County Administrator TO: BOARD OF SUPERVISORS OF CONTRA COR-;.�OyrF4? }'applIcationto• Instructions to ClaimantVerk of the Board .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 Su�gerY�sots 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 Distr4ctushould 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 Co3e' ec:72 at end `' o his form. RE: C1 im by )nese ' ing stamps ECEIVED . . Against the COUNTY OF CON COSTA) aPR'2119�$ Oz ) PHIL BATCHELOR DISTRICT; c�ERK TF8 QF TM �sonJ_- (Fill in name a � c �_ The undersigned claimant hereby makes claim against the County of Contra : Costa or the above-named District in the sum of $_' p/) and in support of this claim represents as follows: When did the damage or injury occur? (Give exact date and hour] -- --- •rte•-- --•�---------T—•T---------�•---�...---•�---T------ ----........—�-- . ..,:dl ,- • .�. W�iere id t, e damage or in3ur'y occur? (_Include city and county _ 3. How did the m daage or injury occur? (Give N11 details, use extra sheets if required) 4. What particular act or omission on the part of county oz district' officers, servants or employees caused the injury or damage? :;:;,►�;::: •,... pep (over) .( 4 v What are the names of county or district officers, servants or employees causing the damage or injury? 6.�lWhat damage or�njuriesldo youlclaim iesultea? lZGive-full extent of injuries of damages claimed. - Attach two estimates for auto damage? _ ..�!!N!lN_�!!!-!!!!!-e!!!�-!!!!!!!J//�!/�.11...�l�.l rl.�—l�.�.!!��!ll�._M!ll�..w!!!!! 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) :•Sly,.: !ll�r�ll !!! !l����!!N!!!!!!!�!!�!�!!!!!!!!!��!!!!!!�!!��l i-!l---N-lam! 8. Names and addresses of witnesses, doctors and hospitals. .,�r , .w!l�.T ! +..exr..w• .ill�....----..�.--------�....�...���..�..����------1 lT.�.� �. Inst th•e- penditures fou made on account of this accident or injury: `;�: s DXT ITEM AMOUNT ��,1� � ,S/r►`r�� Pane 3.S•t�1� �+ •' . . ».. a .. ,.. .. .: .. . F Govt. Code Sec. 914.2 provides: ._h "The claim signed by the claimant ' SEND NOTICES TO: (Attorney) __ arhy some person on his behalf.^_.y •moi Name and -Address of AttorneyXl X12 r aiman s SlanatuEe .. .... . . ess Telephone No. 4elephon o. J� NOTICE lection 72 of the Penal Code provides: "Every person who, With intent to defraud, presents for allowance or or payment to any state board or officer, * or to any county, town, city "+ istrict, ward or village board or officer; authorized to allow or pay ie same if genuine, any false or fraudulent claim,. bill, account, voucher,,'.'.! • writing, is guilty of a felony." v..:.-..-�_.�:.:ca:.,4 .3a�t �+-,i..:•..+i:.+e::..-•:.ii.:.+..i .::.:.:..-...!-.rc...,.r�• .t�::i�.:,•::.K..