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HomeMy WebLinkAboutMINUTES - 03071989 - 1.28 CLAIM /.,2S BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA C1ai,;v,Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March 7 1989 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: $103 , 000 . 00 Section 913 and 915.4. Please note all "Warnings" County Counsel CLAIMANT: CRAIG JAMES ROCK 2810 Merle Avenue FEB 03 1989 ATTORNEY: Martinez , CA 94553 Date received Martinez, CA 9455 ADDRESS: BY DELIVERY TO CLERK ON February 2 , 1989 hand del . BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: Y February 3 1989 HHIL BATCHELOR, Clerk : 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: — p� BY: eputy County Counsel i III. FROM: Clerk of the Board TO: County Counsel (1) -aunty Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present IV 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. np Ap Dated: AR 7 1900 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: MAR 8 1989 BY: PHIL BATCHELOR by ZClerk 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 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 f r Clerk's f'kling amp Craig g ,lames B nk ) Against the County of Contra Costa or ) F E3 2 1988 District) P Fill in name ) aA CL_ U r_: ARD STP VISCY.IJ { W louty The undersigned claimant hereby makes claim against t B' _ .. .�. _ on ra Costa or the above-named District in the sum of $ 1 n rn n 0 and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) On or about September 14 , 1988 and possibly other occassion5still unknown. ------------------------------------------------------------------------------------ 2. Where did the damage or injury occur? (Include city and county) San Quentin Prison ------------------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details; use extra paper if required) Jack Rauch, Deputy Public Defender, told his client, John Sapp that while I was employed as a defense investigator on his case that I "withdrew enough (money) from (his ) defense fund to buy a new house. " Rauch' s tone suggested graft on my part. ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Slander, reckless endangerment of life (over) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA :Claim Against the County, or District governed by) BOARD ACTION the P,oard of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March 7 , 1989 and Board Action. All Section references are to ) The copy of this document mailed to you is your no ice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $325 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SHEILA PIARIE BEEM County Counsel 71 Belinda Drive ATTORNEY: Pleasant Hill , CA 94523 FEB 03 1989 Date received r�InP-,� q 94553 ADDRESS: BY DELIVERY TO CLERK ON Februa ,t , —C9 � BY MAIL POSTMARKED: January 25 , 1959 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. February 3 1989 HHIL ATCHELOR, Clerk DATED: Y BPpY: 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: o� ' 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 AThis 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. MAR 7 1989 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: MAR 8 1989 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator TO,: BOARD OF SUPERVISOPS OF CONTRA CoVeiurOTU application to-, Instructions to Claimant Clerk of the Board �( P.O.Box 911 laims relating to causes of actin n for death or rtinez,Calift�ra�l 94533 g �or ire 3 ury �o . person` or to personal property or crowing 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 1-ater than one year after theaccrual accrual of the cause. .of action. (Sec. 911. 2, Govt. Cc-.)de) P. Claims must be filed with the Clerk of the Board of Supervisors at. its office in Room 106 , County Administ'ratiolz Building, 651 Pine Street, Martinez, California 94553. C. 7f 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. !f the claim is against more than one public entity, separate claims mast be filed against each publico entity. E. Fraud. See penalty for fraudulent claims, Perial Code Sec. 72 at eind of this form. RE: Claim by /1�, � ) Reserved .,Q" a s s amps � . k,.tj 'PD Against-. the COUNTS' OF CONTRA-, CCv9TA) ' - 1 1989 or PAZA��d (, DISTRICT) _i (Fill in name) ) - 'Phe undersigned claimant hereby makes claim agains the Countv of Contra Costa or the above-named District in .the sum --of- $ and in support of this claim represents as foll;)ws : �� ------------------------------------.:.----------------------------- 5,------ 1. • hen did the gdamage or injury oc.pur? (Give exact da and hour).L i 0 _4 9--- - G -�---- -- re_e did the damage or i jury c�r��(Inclu_ de city and country) -._.,.__- ------------- ------------------- --------------•------`------- 3. liow did the damage or injury occur- (Give full details use qxtrra sheet>> if required) %t`E f7t 6. (YO , .�, ,�� a=te 4 . What particular act or omission on - the part_of u, y or distr:.ict officers , servants or employees caused the injury or damage? P P (over) the...names of count;�' or district officers; servants or employeFs:: causing th d.amag.; or injury" -E-damage - -__ ` - -- w _ _ A4_ v What damage or injuries-do :ou--c-laim resulted? rGive full extent of injuriep or damages�clainied. Attach two estimates for :nut damage) dAZ -. ----- ------ - �, - ---_ 7. -How was the amount claimed m - ove computed? (Irolude ' : esti << amount of any prospective irury or damage. ) I 8. Name na addresses of wltne>sess doctors and hos i.ta s P ---- -----------_ -------- -- ----------------- ---------- �__ -- --- . 9 just the• _expenditures you maiF on account of this accident or-injury: i 'DP.TE, I'T'EM AML`ANT **its:***ic,�•tr*'#'**+*'ik�E•**********ic******!c*****x**********�';*********.t*�c***•k***�•,:•� , Govt. Code Sec. 97.0 . 2 provides : `l "The cla�i_�1 signed by the clai.mai ; SENO NOTICES TO:, (Attorney)___. or by some person on his behalf. ' Name and Address of Attorney �`^� t^— Claimant s Signature Addreps Telephone No., Q- Telephone No. S Q NOTICE Section 72 of the PenEJ Code pzo-�ides: . "Every person who, with intent to defraud., presents for allowance o.�. for payment to any state board or officer , or to any county, t6wn; %city district, ward or village board or officer, authorized to allow of pay the same if genuine, any false or fraudulent claim, hill , account , vouc'Ye.r_ ' or writing, is guilty of a felony." / r COi\i1'FiA COSTA C®IJNfiY� `" RACK# MJD DATE: l/ 2`Y MCDF I CLN BOX I TIME: PROP.BOX WFC WCJC NAME: 11=0` SI�E` Ct�` OTHER BOOKIN&-NBR , CASH: $ ` SHIRT/BLOUSE ❑ D ESX - ❑ TI fCARF COAT/JACKET ❑ SHORTSMANTIES ❑ JEWELRY - ['] SOCKS/NYLONS �f �❑ SWEATERISWT.SHIRT WATCH r[❑ BELT ❑ PANTS/SKIRT [] SHOES/BOOTS ALLET [] T-SHIRT/BRA ❑ KEYS [�GLASSES } .❑ :KNIFE - �❑ OTHER i �BK6-OFC:�/f _ X - - - INMATE SIGNATURE Fi" have received all of my pew' sonal property and clothing. -� D'AT E X ,REL OpC: _- -1.� .--- D w t CONTRA COSTA DETENTION FACILITY PROPERTY RECEIPT DATE: 1 3 ,,L$ REC: ' , t' ! TIME: I1:dlk: FACILITY: ,I NAME: 2"H11�. HEd,:f A a�,f I e-, BOOKING NBR ITEM UNDER COUNTER ly X012` N CASH: $ �W 6 �R k . 1 JEWELRY: �`� DESC�`< '' f mm WATCH: DESC. LIGHTER: 3 9 WALLET/PURSE: KEYS: GLASSES: BELT: i . KNIFE: OTHER: rad BKG OFC: xl:?to a wx?r s d INMATE SIGNATURE S DATE: I HAVE RECEIVED ALL OF MY PERSONAL PROPERTY. REL OFC: '` ' U 'i 1 4 r CLAIM / `� 4r BOARD OF•SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA i Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March 7 1 9 R 9 and Board Action. All Section references are to ) The copy of this document mailed o you is your no ice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $70 . 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: DONALD KELLY County Counsel 6360 Silverado Trail. ATTORNEY: Napa, CA 94558 FL U 3 i989 Date received A 9�5aL ADDRESS: BY DELIVERY TO CLERK ON Febr_uary J1 Apr Iq�q, BY MAIL POSTMARKED: January 23 , 1989 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Februar 3 1989 HHIL BATCHELOR, Clerk DATED: y Y: Deputy k. 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 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 A) 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: MAR 7 1989 PHIL BATCHELOR, Clerk, By I 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: MAR 8 1989 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator P ^LAIM •TC? BOARD OF SUPERVISORS OF CONTRA COe�'urR2RiU application to: Instructions to Claimant Clerk of the Board - P.O. Box 911 Martinez,Californlik 94533 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 f must be filed against each public entity. i I E. Fraud. See penalty for fraudulent claims, Penal ode Sec. 72 at end of this form. RE: Claim by ) ReserveeE4-'- stamps e LI-I/ RCEIN7 D i > E B. 119899 Against the COUNTY OF CONTRA COSTA) 7 f ` LERK(NT F VI +( or DISTRICT)(Fill in name) ) s ..... ... ................. I . The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ , and in support of this claim represents as follows : ------------------------------------------------------------------------ 1. When did the damage or injury occur? (Give exact date and hour) --------------------------o-r--in-j - ---ury----occur?-------(Include-----------citya---nd------county)------- 2. Where did the damage ------------------------------------------------------------------------ 3. How did the damage or injury occur? (Give full details , use extra sheets if required) W�e-,v _Z .d � 4VS ,qAG 100 f ---------------------------------------------------------------------t-- 4 . What particular act or omission on the part of county or distric officers , servants or employees caused the injury or damage? W�IeAJ �iti� r� a5ed �rorn �/'�i3 IG /—�—b'9 CCGa�/�oi✓ /�L�. M,�/ /�•2�.o j��N�S UV�3^e 3-��v r6f/�GL� —GX G 2�`)'- /'TAY �y (over) _ u r� .,v.� .tF t • '.R'i t J.. ray.J.>.. a rONTRA COSTA DETENTION FACILITY i • :._... s 1 1 LOTHING RECEIPT ,v DATE: REC: "i •1 is a i •• � TIME: 1 :1 :: FACILITY: NAME (L, F, M): F.A D.O.B.: • = • BOOKING NBR: SHIRT/BLOUSE PANTS/SKIRT 0 COAT/JACKET HOES/BOOTS 'SHORTS/PANTIES T-SHIRT/BRA �OCKS/NYLONS 0 HAT/PURSE Q SWEATER/SWT: SHIRT Q DRESS E OTHER Zx I� - � BKG OFC: INMATt S GNATUR DATE: I HAVE RECEIVED ALL OF MY CLOTHING. REL OFC: X �. INMATE SIGNATURE ' '" ant Y AA r,1 Zzz C• 1 ............... t ° O:)vIsoDVal NOD saosm3dns i0 osvo9)ia31:) 8013H:)1v9 1iHd 68R i e t �\14 t 1 � � CLAIM 42 ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Clay.m Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Ma-r c h_ .71989, _. 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: $325 , 0 0 Section 913 and 915.4. Please note all "Warnings". County Counsel CLAIMANT: .DENNIS HAWKINS 930 So, 43rd Street FEB 03 1989 ATTORNEY: Richmond, CA 9.430.4 Date received Martinez, CA 9455 ADDRESS: BY DELIVERY TO CLERK ON February 2 , 1989 hand del , BY MAIL POSTMARKED: no envelor)e I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. �aILeputOR, Clerk DATED: February 3 , 1939_ y L Nall II. FROhy: 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: O� �"' U 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 (y) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. e Dated: NAR 1989 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: MAR 8 1989 BY: PHIL BATCHELOR by ty Clerk CC: County Counsel County Administrator i Clam�t�: 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, 19872 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 19 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 ) Reser 's i 'n tamp , L5 C Co11&- r,sTa Z),C Tia Tam Against the County of Contra Costa j [ 3 2 198 CLE ( P B T HE OR District) NT F S7J ISG tiS Fill in name ) By The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 2 5. and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ---- c.! __/-�y�-------- `-=�--11/1 a- ---A^ZI ------------------------- 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) ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) t 5. What are the names of county or district officers, servants or employees causing~ the damage or injury? ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above compu ed? (Include the estimated amount of any prospective injury or damage.) __________ ______�___-_ ..___-____ __� _�.._-.--__-_-_-_,.__ 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 someperson on his behalf." Name and Address of Attorney, � � J Claimant's Signature Address Telephone No. Telephone No. .-11 3 --2 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. U CONTRA COSTA DETENTION FACILITY :.�I�IIi jC OTHIIVG R`ECUIP-T 0' ' DATE: 12/14,-'10 14 . REC 152734 i TIME: 112 FACILITY. . MDF NAME (L, F, M): „A'WK INS DE:dNIv D.0.B.: BOOKING NBR:. '� INTAKE H /BLOUSE SKIRT , COAT/JACKET OOTS PANTIES F--JT-SHIRT/BRA YLONS HAT/PURSE SWEATER �I HDRESS F OTHER EIKG OFC: WMAVE SIGnTURE t f� RELEASE y............ . . .r. s x : ::: .:: :::... . : DATE: I HAVE RECEIVED ALL' �`/ �} i qE: J :d R A }may. HIN . L T G. x, r, .............. ........... ...... . REL OFC. ka .. _................:... ..................._.. :..................................... ., ........ .................:.......................... 1 ................ X T I INMATE SIGNATURE ii!r' ..........................;. :i:' '• ' .............. ........... ........... ............................... ............ ........... ................................................. ::::: "I"'.'.",.*.,.,.,.,.,.'.'.'.,.*.* Y ' i 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 March 7 , 198 9 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 . 00 Section 913 and 915.4. Please note all 16rnQ1iMt11C0Un 6J CLAIMANT: CAROL LYNN LFMUS 27467 Manon Avenue #27 F- E B 03 1989 ATTORNEY: Hayward, CA 94544 Martinez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON February 1, 1989 BY MAIL POSTMARKED: January 26 , 1989 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: February 3 , 1989 gyIL BAATCHELOR, Clerk put 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: n. Dated: °3 iJ l 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 (x) This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: MAR 7 1989 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 claimantasshown above. Dated: MAR 8 1989 BY: PHIL BATCHELOR by Depty Clerk CC: County Counsel County Administrator CLAIM)TO- BOARD OF SUPERVISORS OF CONTRA CO c� v -� e urs 2ql lwi appHaatlen to: Instructions to Claimant Clerk of the Board ' J l P. 0. Box 911 A. Claims relating to causes of action for death or fare incur rnf 94533 to person or to personal property y en p p p y or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to, any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911. 2 , Govt. Code) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106 , County Administration Building, 651 Pine Street, Martinez , California 94553. C. If claim is against a district governed by the Board of Supervisors , rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by ) Reserved for C s CA<oL. L-Ynin) LCM u-:�- �c� - I RECEI' ' i Against the COUNTY OF CONTRA COSTA) ( `�' F 1 .1989 or DISTRICT) K 0 ua a ,o kr ill in name) ) , -$ - .. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of and in support of this claim represents as follows : ---------------------------------- 1. When did the damage or injury� y occur? (Give exact date and hour) - --------------------------------------- ---- -------------- ------ ------- 2. Where did the damage or ,injury occur? (Include city anal county) ----------------------------------------------------------------------- 3. How did the damage or injury occur? (Give full details , use extra -. sheets- if required) ✓�!�ZL� L^' ��`c t/P(i��G Ta it/� /Vi CGo T�IA4) , --------�---------------------------------------------------------------- 4 . What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? (love r '.:5..:,:•� zat: ar.e.:th.e.:names of county or district officers , servants rQ - employees;causing the /Ddamage or injur ? ' ----------------------------------------------------------lull Whatdamage or injuries do you claim resulted? (Give extent---- of injuries or damages cl imed. Attach two estimates for autp damage) 'v J e-7 �-o. - - �.S1 �ic --------------------------------------------------------------------------- 7 . How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) - --------------------------------•------------------------------------- 8-. --Names and addresses of witnesses , doctors and hospitals. ------------------------------------------------ --- - 9 . .. t.. sthe expenditures you made on account of-this--acci----dent-----or---in- '-ur-y- : b --DP.TE k ITEM AMOUNT XI Govt. erode Sec. 910 . 2 provides : "The claim signed by the .claimant SEND NOTICES TO: (Attorney) r by some son on his behalf. " Name and Address of Attorney Clai ' s Sig tur Ve 2'7 Address Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer , or to any county, town, city district, ward or village board or officer, authorized to allow or pay the same if genuine , any false or fraudulent claim, bill , account , voucher, or writing , is guilty of a felony. " � V Qr cr� C) 19 AO C� 00 �c� CLAIM f. BNRD 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 March_ 7 19.89.=_ and Board Action. All Section references are to ) The copy of this document mailed to you is your noticeof California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $300$ 00, 00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: CAROLYN NELSON County Counsel c/o Larkin H.- Chan, Esq, ATTORNEY: Law Offices of Arnold Laub FEB 03 1989 43 Panoramic Way Date received ADDRESS: Walnut Creek, CA 9.459.5 BY DELIVERY TO CLERK ON February rte1i9,g,gGA 94553 BY MAIL POSTMARKED: February 1, 1989 Certified P 577 9.39. 672 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: February 3 1989, ppHHIL BATCHELOR, Clerk a 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: Al Dated: 3 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 rder entered in its minutes for this date.. e Dated: MAR 7 1989 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 claimantas shown above. Dated: MAR 8 1989 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LAW OFFICES OF ARNOLD LAUB A PROFWIONAL CORPORATION 43 PANORAMIC WAY•WALNUT CREEK,CA 94595 • 415/938-4400 1970 BROADWAY•SUITE 1140.OAKLAND,CA 94612•415/839-7136 1652 WEST TEXAS STREET•SUITE 110,ROOM 1•FAIRFIELD,CA 94533.707/425-9334 REPLY TO WALNUT CREEK: TV Ev ': .., r c�_B 3.1989 CERTIFIED MAIL PHIL 9ATCHELOR ct'UK 4QpQQ Of SUPERVISORS CCOSTA CO. De ua i February 1, 1989 Clerk of the Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 Re: Carolyn Neslon - Filing of Claim for Damages against Contra Costa County Accident of 10-22-88 Dear Sir/ Madam: Enclosed please find an original and two (2) copies of a Claim for Damages Against the County of Contra Costa for injuries sustained by Carolyn Nelson in an accident that occurred on the above referenced date. Please file the original and endorse the two copies and return the endorsed copies to this office in the enclosed self-addressed postage paid envelope. If there are any problems or questions in regard to this matter, please feel free to call me a1415) 9.33- 4YCC t and I will do my best to accommodate you. (I_ Yours .Truly, By: Y LAW OFFICES: CiprianoJ. Salazar Fairfield Law Clerk Fresno cc: file, client Modesto encl. Oakland Redwood City Sacramento San Francisco San Jose San Mateo Santa Rosa South Lake Tahoe Stockton Walnut Creek RECEIVED 1 LARKIN H. CHAN, Esq. 2 LAW OFFICES OF ARNOLD LAUB 43 Panoramic Way T -LOR 3 Walnut Creek, CA 94595 cue-, tJT •Y 4 (415) 938-4400 aY 5 Attorney for Claimant CAROLYN NELSON 6 7 In the Matter of the Claim of: 8 CAROLYN NELSON CLAIM FOR DAMAGES AGAINST 9 THE COUNTY OF CONTRA COSTA Claimant, Pursuant to Government 10 Code Sections 910 to 911.2 z v. o 11 H a " ¢ 12 COUNTY OF CONTRA COSTA. 0 ,< z 3 R8 C) u P 13 00z0zW4 / � z �- Uv 14 � Claimant hereby presents a claim to the COUNTY OF o04 30. 15 CONTRA COSTA pursuant to Section 910 of the California 16 Government Code. 17 18 1. The name and address of the claimant is: 19 Carolyn Nelson 20 3232 Estates Pinole, CA 94564 21 22 2 . The address to which claimant desires notice of the claim to be sent is as follows: 23 Larkin H. Chan, Esq. 24 Law Offices of Arnold Laub 43 Panoramic Way 25 Walnut Creek, CA 94595 26 1 3 . On or about October 22 , 1988, Claimant, CAROLYN 2 NELSON was a volunteer for the Montara Bay Community Center 3 who, along with 8 to 10 other volunteers, was assisting in 4 the harvest of pumpkins for the community center's 5 Halloween celebration in a number of pumpkin patches located 6 in Tracy, California. Claimant and the other volunteers 7 were riding on the bed of a truck that was being driven by 8 Paula Christensen, the Director of the Montara Bay 9 Community Center. The truck was being used for the sole 10 purpose of the pumpkin harvest. While being transported �Z 11 r ¢ from one pumpkin patch to another, the truck drove over a �D o z � u ° g 12 trench, ditch, or an embankment that caused the truck to w O .. wQj U � 13 3 O o °zaW jerk, bounce or suddenly fall with such force that Claimant, � z � �- Uv 14 in an attempt to prevent falling, reached out and grabbed � 0 3 15 the side of the truck while she fell. Although she did not 16 fall off the truck, Claimant suffered serious physical 17 injuries, including but not limited to, a fractures to her 18 fingers and hand. 19 20 4. Ms. Erin Murphy was a witness of the incident. 21 Her address is 758 1st Street, Rodeo, CA. Telephone number 22 at this time is unknown. 23 24 5. Claimant, CAROLYN NELSON, suffered serious bodily 25 injury to her right hand. The full extent of the Claimant's 26 injuries are unknown at the present time. r- 1 6. The full amount of the Claimant's damages are not 2 yet known, but prospective damages based on pain and 3 suffering and prospective special damages of medical bills 4 total not less than $300, 00. 00. 5 Dated: ' 6 7 LARKIN H. CHAN 8 Attorney for Claimant, CAROLYN NELSON 9 10 z " o a 11 H � 0 0 1W-1 8 12 Wao :, � P. j rn 13 30o ° W " ; zN � U � 14 z 15 3 16 17 18 19 20 21 22 23 24 25 26 y A sF t.4r C �. �p 3 ri vA }�,��.A 'V V1 v rU �jrA Q0 ` N y{ O O ro co� rA Cd 4 W O � C1 UIQ m a � � r to a �' Dou ,n u w O vw 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 March 7 , 1989 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: $7 9. 5 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: DANA M. PAINTER COunty counsal . 596 Pomona Street ATTORNEY: Crockett, C:,A 94525 FEB 03 1989 Date received ADDRESS: BY DELIVERY TO CLERK ON FebruarU �l3t9 � ,}�., BY MAIL POSTMARKED: February 2 , 1989 ' I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PPHHIL BATCHELOR, Clerk BY: Deput DATED: February 3 , 1989 y L, Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors (✓ ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning .of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: V` l '$ 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 (X) This Claim is rejected in full. ( \) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: MAR 7 1989 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 tice to Claimant, addressed to the claimant as shown above. Dated: MAR 8 1989 BY: PHIL BATCHELOR by �/�Dy Clerk CC: County Counsel County Administrator Claim to: yam" 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 on- 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 1069 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 See. 72 at the end of this form. RE: Claim By ) Reserve k' f' amp LRCEI'�' ' . Against the County of Contra Costa ) B 3 1989 or ) H!! BATCHELOR District) ARD OF SUP;RVISORS :ACO.Fill in name The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ '79, 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) S em- bc--\C ���-�� Se ��e s �' I-E- or) prop . ------------------------------------------------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? bay orq+C) (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? ------------------------------------------------------------------------------------ ' 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. � 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 5te, D V �)'Y'\, Pa-+C 0 ( LAD 0 Y- 0 CC- C, E��a&,,e -------------- _�_ - ------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. C roc �.. ------------ 9. List the expenditures you made on account of this accident or injury: (� DATE ITEM AMOUNT I Ear-��Q P � Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant ,SEND NOTI{MS,_TO: ` (Attorney) or by someperson on his behalf." Name and Address of Attorney Clai is Signature 57(, P n14/76 -�- Address Telephone No. Telephone No. o l f 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. D O O 0 C m U) 0O i K o a ❑❑ m Do O V -Z 0 m 7 0 v ` y m O I� Q C W Z V =i in a m N Z U) r O < z D my O D r '^ 3 0 < n -A 0 � Z Z m n D O w "^' _ v O m m>�❑ f>❑ O CD O m C mc ok O m D yin 0 '. Q1 CO 0 r 0 in D m r ti; M : O o O❑ Z 1 m O m n D m ^� a (rig < m D in rw ,0 � Q`vv z D 311 ud Z m O rm QQ❑ ❑ -•1 0 =O ^� � m m o m v �00 o (, D � mm )- ~ r L D S Z D U7 I P z Z D_ C) VV I Z f� D r r O O a u v { 0 D cn --4'D -Am cn cn K m w 0 0000 � (n ko�m �� m my P � oc n� pm D O m C M n m a o D 1 m p v m D y D cn m n c; n -Di C D x r (n z a -, ry, Z x D > \V C z v 1 m v p m� m • ❑0❑❑ w Dm � � I m r O Q O c p N m .�i. rorr(n \ m Fa m o N m _N Z 1 m m Z 0 a y cn D u O ��0 'o w -a g no sum oe ? O .....� o ❑ 11,O 31 A 7 7 w C N - 'O (n 1 0 m N m <t (D 3 0 is N Co m w w o w Q C Z Nm �.7n 0 3 _ 3 tnan� rD- O D 3 —.� m a m 7 f co a m m / \�, cr - ;4 m . o f ,r ❑m ❑cai �cmi �u n Z m �Nw �. ao � w � � ma..m n � �.l f �a' O z' x Er D r- u �.� 30 p < a o a m ° p 3 o d 7 r-- cpi (i /'� O m r m w w 0 m v x D O n N (D' 0 a ^_.K x 7 ] o m c.) �. o CD h w ? F m wam � aw70 v') (D .-.. _woo c�CC C } o pT pp -D N.r_(p < x.C (D 7 O7 7 7 �N.N N m I 'w m V O O a m u) -6 C, 3 r, o m � � o m z , V/ y (( � a ip 7) c (D C o f 0 _� C) f n. w O O w ^ n (D ° c w a 7 Ano t U m m m m <; < w w o_ o w n —(o o w oow h C �11�\ ❑o ❑i D c D 7 7 in ID (n CM" m J ]0 i a' r � ctw rD o 3 am N u3i c dK \ �` Na �� C) m � > C< w0 m.p w 7 3 o a m m y tTii w I��' v m. n a y D ,1 m (D 7 -" 'y.7 < (D (D O'O A Cr N n to 'J ,.�� " N �+ 7c Z m m a < m a m eo r '" o s 7 c7�wov� CD Qfm �_ 7c co _OD �T so �r Z ; .,: o � =w� �; cC: cK m mC* nm 7~09 0 1 Ln xn N F 7 0 ° a ' w N (n ::rOe C C T �Os D /f 7 LD w c = a C m 7 �. 7 S o o N 3 oe 2: ♦/� �J o c cnm n '(A mai O O A m W o m m Z Y n co 3 w o x _ n g y ...may (� < a w tO (D 7 ±:N c (O Q N O N w Q m (D (D 7 N 90 white customer yellow-payroll pink-zip/customer file ' goldenrod-numerical s AI 0 'Zr Z t i� 4 } CLAIM cy �• BOARD° OF SUF#ERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March, 7 1989 and Board Action. All Section references are to ) The copy of this document mailed to you is you.e 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: JULIE MAZZANMUTO County Counsel 2315 Pacheco Blvd, FEB 10 1989 ATTORNEY: Martinez, CA 94553 Date received Martinez, CA 94553 ADDRESS: BY DELIVERY TO CLERK ON February 6, 1989_ trans , BY MAIL POSTMARKED: no envelolae I. .FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: February10, 19.89. ppHH1L BY10, Clerk BY: D puty L, Hall I1. 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: 2f(3 I 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. MAR '7 1999 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: MAR 8 1989 BY: PHIL BATCHELOR by /_/Deppty Clerk CC: County Counsel County Administrator -� �.�,u �. r''` �� y':. �_ �.. � ,, �— �.; -- sP �;'.° i �� :..� h ��� ( � � ( ,� � �j y'ta �; �.-.."� ,� �. i-�-�^�._f - -- N,-. Y,Y �_� ��_ Claim to: BOARD OF SUPERVISORS-QF 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 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 ) Resery P, 's ling stamp �.)ul 1'6 Z2&Mu o JLKILS �. Against the County of Contra Costa ) ' or District !6RK 130,. R(()QF SUPERVISORS Fill in name ) o 1A CasT, CO. The undersigned claimant hereby. makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: ------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) A 199 2. Where did the damage or injury occur? (Include city and county) 1_ %-� ir�e z �o _ ora_ ley ---- ----- ----- ---- ---- 3. How did the damage or injury occur? (Give full details; use extra paper if required) -740-1,5 dry rll ,ail aalle y .fid, Goo,'k,"e,-s ac e-re. ,oa,��f•�� e We;le, ee r- 11i7e, eW Xhe, 7`he �i-�ce�e.r� 1.�.�e�re a1) �-he leaf hQ�d Sr i d� �h� roQ�, r u>Qs el) 1--I.?A?- hr-. ha.d 'fd G�/'i✓� ✓e�y G1/OSQ � t/�e, Shocctder- ,� i.� ��de� `f-D Q�loeu . 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? lydA all cujil7 Je one- sla 4Ze'e0/'e Ojos dC<'n 5 a/1 'M(f '0/ 0/7 spa-/- I<JA-S- e7`' �e r(5hf side beep Ct /lowed . `>LD" G /'y . �e�6GcC�Se- l�d (over) Seg e/oSc 7`O the 5G1oc�lder Z- /an e9vim' MC, W17 416 a 4 /Oa_117t �of 0/7 year 5. What are the names of county or district.-bfficers, servants or employees causing the damage or injury? Z i` �e da�a5 L ------------------------------------------------------------------------------------ 5. What damage or injuries do you claim resulted? (Give Hall extent of injuries .or damages claimed. Attach two estimates for auto damage. ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) ------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. 0v1// Z�° ------------------------------------------------------------------------------------- 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 U —(Claimant' 'gnature Address ' s� Telephone No. Telephone No. 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. ESTIMATE OR REPAIR ORDER R.O. No. 0657 NAM DATE ~�4 d BUS.PHONE ADDRESSjj)4dl ZIP ', PHONE RES.V YEAR MAKE MODEL I.D.NO. PAINT CODE PROD.DATE TRIM MILEAGE LICENSE NO. WRITTEN BY INS.CO. FILE NO. CLAIM NO. P.O.NO. ADJUSTER LIC.NO PHONE Deductible/Betterment Line Re- Re- DESCRIPTION OF DAMAGE PARTS LABOR PAINT No. pair place f 1 2 3 4 5 gra SRS/ 6 7r�% 8 9 10 c 11, 12 13 , G I. s°IO 14 15 16 17 18 TOTALS "THIS CONTRACT LIMITS OUR LIABILITY,READ IT" I hereby authorize the above repair work to be done along with the necessary materials.You and your employees may operate vehicle for purposes of testing,Inspection or delivery at "The estimate,based on our inspection,does not Include any addl• my risk.An express mechanic's lien is acknowledged on vehicle to secure the amount of ttonel parte or labor that may be required after the work has been PARTS,PRICES repairs thereto.You will not be held responsible for loss or damage to vehicle or articles left started, occasionally, after work has been started, damaged or SUBJECT TO In vehicle In case of fire,theft,accident or any other cause beyond your control. broken parts are found which were not evident on the first Inspec- CHANGE tion.Because of this,the prices are not guaranteed." SIGNED ADVANCE AUTO BODY PARTS $ LABOR hrs @ $ "Quality Since 1960" PAINT hrs@$ $ Paint Supplies $ COMPLETE COLLISION SERVICE Towing/Storage $ 917 HOWE ROAD Sublet/Miscellaneous $ MARTINEZ, CA 94553 SUBTOTAL $ (415) 370-7789 TAX $ RAY TRESKO RICK COLLINS TOTAL ESTIMATE $ ALL DEDUCTIBLES MUST BE PAID IN FULL BAR REGISTRATION # AB137501 BEFORE CAR WILL BE RELEASED ' Dote to Address y M SK SS'l t � J •; i 1 Cl-..AIM ~ BOARD OF SUPERVISORS 'OF COMMA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March 7 , 1989 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: *338 , 50 Section 913 and 915.4. Please note all "Warnings". CLAIMANT.: PHILLIP SCOTT JOHNSON County Counsel c/o Charles Hoehn III FEB10 1989 ATTORNEY: 3015 'B1SSeli Avenue Richmond, CA 94805 Date received Februar 10 , Niyez, CA 94553 ADDRESS: BY DELIVERY TO CLERK ON y BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gg DATED: February 10, 1989 RYIL 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: 2213 � 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 (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. �J p(� Dated: MAR j 19M 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 14AILING 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. 1 Dated: MAR 8 989 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator BOARD OF SUPERVISORS OF CONTRA CO!38Te�ut.R2WlylW�appl,cetionta, Instructions to Claimant Clerk of the Board P.Q.E30X 911 Marez, � A. Claims relating to causes of action for death or morn inCallforn9 Dury o4533 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 f'iled 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 ent-ity. .- E. Fraud. See penalty for fraudulent claims, Penal de Sec. 72 at end of this form. RE: Claim by ) Reserved f-c-- CEIVEer s I n tamps M s&� 67- 64Z& elt' FEB 1 0 1989 Against the COUNTY OF CONTRA COSTA) CL[VTC dLOR , c;OA A., ER or L _�61STRICT) corp-. M .-ty (Fill in name) . The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support -of this claim represents as follows : ------------------- -7 7�;__n ainjury------------------------------------------ 7did the damage or occur? (Give exact date and hour) ----------------r--r--- ------ ----------- -- --- ----- 2_. Wh_e_r_e__d_i'_d_the damage or injury-occur?- (Include city-and-count ) LJT51t -- ---- ----- K­How-dill the damage-or injury occur--.1 rull details ,mouse-extra__ sheets if required) 13 eAyIdIc 0�_ ----------- --- - - - ------------------------ - - - --- particular-act- or-omission-on the part of county or-district officers , servants or employees caused the injury or damage? (over) , zat; are,..the..names of county or district officers , servaxzts 'ter " employees::causing --the damage or injury? plp(e- ------------------------------------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) ------------------------------------------------------------------------- 7 . How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage. ) ------'cC-------r-s -s of witne ��---tors a-------------------------- 8. Names and addresses of witness �s tors and hospitals. Mf- ------=-----=------------------------------------------------------------ 9 , List the expenditures you made on account of this accident or injury: DATE !TEM AMOUNT ©qZ?! A/AV r Ikue 4P,41 �1 901400IJr1,T,c �fJe/TS X los o d W141-re SNo93 "HI-re- -:roe r-3so 2 5 O Govt. Code Sec. 910 .2 provides : "The claim signed by the claiman- SEND NOTICES TO: (Attorney) or by some person on his 'behalf. Name and Address of Attorney 6&1,016-1 CWRs ��� yCiaim�a4t' s Signature Address Telephone No.� �4 � 3a "S ��5� Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, prese,it-s 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. !` f'7l :. Cl N�? y tv `r,,,ry1e V �4 4 V t i 4 i OD*ViSO?VK:NOD SdOSln43dns jo avOJ kn31? S01314JlVJ YHJ Y 686t 0 t UJ Gaal DaU CLAIM A�f t ABOARD DF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA a Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March 7 , 1989 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: $10, 000 , 00+ Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PHYLLIS RIDDELL County Counsel c/o Stuart M. Kopel, Esta . ATTORNEY: Law Offices of Arnold Laub FEB 10 1989 43 Panoramic Way Date received rtj , CA 94553 ADDRESS: Walnut Creek, CA 94595 BY DELIVERY TO CLERK ON February, n19�9 BY MAIL POSTMARKED: February 6 , 1989 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. February 10 1989 PPHHIL BATCHELOR, Clerk DATED: y + 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). 1 ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filled late and send warning of claimant's right to apply for leave to present a late claim (Section 9111.3). I ( ) Other: I l Dated: 2 / 13 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 (X) This Claim is rejected in full. (� �) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. n 7 19W Dated: ~� PHIL BATCHELOR, Clerk, By 6eyfeputy 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: MAR 8 198 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LAW-OFFICES OF ARNOLD LAUB A PROFESSIONAL CORPORATION 43 PANORAMIC WAY•WALNUT CREEK,CA 94595 •415/938-4400 1970 BROADWAY•SUITE 1140•OAKLAND,CA 94612•415/839-7136 1652 WEST TEXAS STREET•SUITE 110,ROOM 1•FAIRFIELD,CA 94533•707/425-9334 REPLY TO WALNUT CREEK: M]l E TRANSMITTAL MEMO Rh 9 ISORS. Deu DATE: February 6, 1989 TO: Clerk of the Board Contra Costa County Board of Supervisors 651 Pine Street - Room 106 Martinez, CA 94553 SUBJECT: Phyllis Riddell - Government Claim .ENCLOSURES: Acknowledgement of Receipt and Claim ACTION: Please endorse/file the original and copy, returning the properly endorsed/filed copy to our office in the enclosed return envelope along with the signed Acknowledgement of Receipt. Very truly yours, LAW OFFICES OF ARNOLD LAUB LAW OFFICES: . Fairfield STUART M. KO PE L Fresno SMK:j ks Modesto Encl. Oakland Redwood City Sacramento San Francisco San Jose San Mateo Santa Rosa South Lake Tahoe Stockton Walnut Creek CLAIM AGAINST: COUNTY OF CONTRA COSTAKECEI ., � NAME AND POST OFFICE ADDRESS OF CLAIMANT: FEB 7 19� PHYLLIS RIDDELL P SAT L ; 1840 Yolanda Circle ��cP T� B O Clayton, CA 94517 y POST OFFICE ADDRESS TO WHICH CLAIMANT DESIRES NOTICES TO BE SENT: Stuart M. Kopel, Esq. LAW OFFICES OF ARNOLD LAUB 43 Panoramic Way Walnut Creek, CA 94595 THE DATE, PLACE AND OTHER CIRCUMSTANCES OF THE OCCURRENCE OR TRANSACTION WHICH GAVE RISE TO THE CLAIM ASSERTED: The accident occurred on August 27, 1988 in Contra Costa County. Ms. Riddell was injured in an automobile accident when the vehicle she was driving collided with another vehicle at the intersection of Concord Boulevard and Kirker Pass Road in Concord, California. This collision occurred as a result of dangerous conditions on public property, including, but not limited to, the absence of a signalled left hand turn lane and inadequate speed controls, limits or warnings. The public property on which the dangerous conditions existed was owned, maintained , managed, operated, supervised and/or created by said public entity named above. These dangerous conditions caused the other vehicle to collide with Ms. Riddell 's vehicle resulting in her injuries. A GENERAL DESCRIPTION OF THE INDEBTEDNESS, OBLIGATION, INJURY, DAMAGE OR LOSS INCURRED SO FAR AS IT MAY BE KNOWN AT THE TIME OF PRESENTATION OF THE CLAIM: As a result of the accident, Ms. Riddell has incurred costs for medical treatment in the amount of approximately $25, 214 . 07 , with treatment continuing. Ms. Riddell has suffered lost wages in the amount of approximately $15, 000. 00 to date and still accumulating. Ms. Riddell has suffered general damages in an unspecified amount. Ms. Riddell sustained fractured ribs, a punctured lung, a ruptured and removed spleen and neck and back injuries. THE NAME OR NAMES OF THE PUBLIC EMPLOYEES CAUSING THE INJURY, DAMAGE OR LOSS IF KNOWN: Unknown. AMOUNT CLAIMED IF UNDER $10,000.00, OR STATE WHETHER JURISDICTION LIES IN MUNICIPAL OR SUPERIOR COURT. Jurisdiction lies in the Superior Court of California. DATED: 2-A - Signature ;Z—J— k AP-11 - - A Al wart M. Kopel, sq. ttorney for Plaintiff(s) * Claim must be presented within six months of incident in accordance with Government Code Sections. ?MM 4�Ftlattua4i�x � 1r1 1 � LO 0 N It `\\•• m0 20 EEk N Lo rn d � Q z o O < o � u U ) oLn u >i �4a -�T Pi � i 0 0 > -P MU �4 Q) KC N N U - t/� 3 X! 4-) �$ 4J +1 U) U) U) U 4-4 U 4.4 Q) N O O z N ' w N fO -iI 4 IIII Q r-I O O LO (0 o UUPU � � ' CLAIM /,,?f BOARD OF SUPF^'VISORS- OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Bo.::rd of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT r[ar ch 7 , 1989 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: Unspeclfied Section 913 and 915.4. Please note all "CudmV.Counse) CLAIMANT: WILLIAM MICHAEL ROGERS 501 West 10th. Street FEB 10 1989 ATTORNEY: Antioch, CA 94509 Martinez, CA 94553 Date received February 9 , 1989 CC ADDRESS: BY DELIVERY TO CLERK ON BY MAIL POSTMARKED: January 28 , 1989 ' Certified P731 703 855 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Februar 10 1989 PPHHIL BATCHELOR, Clerk DATED: y , 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: 2/ 1� / �� BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County 'strator (2) i ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (J�) 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. n r� nQ Dated: MAR E 1989 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: MAR 8 1�'Q9 BY: PHIL BATCHELOR by D y Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Willi Michael Rogers 501 Wes 0th Street Antioch, C 94509 Re: Claim of WILL 3CHAEL ROGERS Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1 . The claim fails to state the name and post office address of the claimant. -2.. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. 3. The claim fails to state the circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. X 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel By: 1 Deputy County ns 1 CERTIFICATE OF SERVICE BY MAIL C.C.P. §§ 1012, 1013a, 2015 .5; Evid. C. 59 641, 664 ) My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s) having delivery service by U.S. Mail) , which envelope(s) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the, foregoing is true and correct. Dated: \ at Martinez, California. cc: Clerk of the Board of Supervisors (or final) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910. 2, 920.4, 910. 8) 15 .. rithew County Coun,._, emorial FEB 198 �r�J a[3DO` &L AND CLINICS hfiartinez, GA 9466:-3 To: Office of County Counsel Date: February 1, 1989 Contra Costa County From: Mark Fi nucane �,� LA--�n Subject: CLAIM (Notice of Intent) Health Services 9rector William Michael Rogers Record #136786-1 The attached claim (notice of intent) , regarding the above named patient, was received by Merrithew Memorial Hospital on February 1, 1989. This is our first knowledge of any claim for damages by this patient. SP Attachment cc: Ron Harvey, Liability Claims Officer a�-•-- .,-_...oma x. -¢ Contra Costa County SrA COUN'� A-301B (3/87) William Michael Rogers 501 West 10th Street Antioch, California 94509 January 30, 1989 _ CERTIFIED -- a - s l 'vif 3 Return Receipt Requested k �� � y Hospital Administrator Merrithew Memorial Hospital FEB 9 1989 2500 Alhambra Martinez , CA 94553 CLERK IR T O 'TF, C RO By RE : William Michael Rogers — :. ..:_ _.... DPPur Dear Sir : Pursuant to Code of Civil Procedure Section 364 (a) , I am hereby giving notice of my intention to commence action for professional negligence against the hospital as a result of the care and treatment rendered to me from September 12 , 1988 September 20, 1988 . Said improper treatment, which included use of an improper bed, resulted in my subsequent injuries which include a breakdown of my right buttocks . . You are requested, pursuant to Evidence Code Section 1158, to provide, at my cost, all medical . records , pertaining to my care at your facility. Please refer this letter to your liability insurance carrier and your attorney. Please direct all inquiries with respect to this matter to the undersigned. Very truly yours, A�m mir- WILLT_AM MICHAEL RO ERS 05892 CLAIM BOARD OF SUPERVL'::;. S OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against .the County, or District governed by) BOARD ACTION the Board of,�6upervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March 7 1989 and Board Acti6w,, 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: $500. 00 Section 913 and 915.4. Please note all "Wtffily Counsel` CLAIMANT: RAMON DELGADO P, O. Box 1472 FEB 101989 ATTORNEY: Oakley, CA 94561 Martinez, CA 94553 Date received ADDRESS: BY DELIVERY TO CLERK ON February 10 , 1989 hand del . BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. February 10 1989 PpHHIL BATCHELOR, Clerk DATED: ' BY: Deputy L, Hall II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: '� ! 13 � 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: MAR 7 1989 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: MAR 8 1989 BY: PHIL BATCHELOR byk,1�4�Lty Clerk CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Ramon gado P.O. Box 2 Oakley, CA 9 1 Re: Claim of RAMON DELG 0 Please Take Notice As Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code section 910 and 910 . 2, or is otherwise insufficient for the reasons checked below: 1. The claim fails to state the name and post office address of the claimant. 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. 3 . The claim fails to state the circumstances of the occurrence or transaction which gave rise to the claim asserted. 4 . The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. X 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000) . If the claim totals less than ten thousand dollars ($10,000) , the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000) , the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. 6 . The claim is not signed by the claimant or by some person on his behalf . 7 . Other: VICTOR J. WESTMAN, County Counsel By: Deputy County CERTIFICATE OF SERVICE BY MAIL C.C.P. SS 1012, 1013a, 2015.5; Evid. C. 69 641, 664 ) My business address is the County Counsel's Office of Contra Costa County, Co. Admin. Bldg. , P.O. Box 69, Martinez, California, 94553, and I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non Acceptance of Claim by placing it in an envelope(s) addressed as shown above (which is/are place(s) having delivery service by U.S. Mail) , which envelope(s) was then sealed and postage fully prepaid thereon, and thereafter was, on this day deposited in the U.S. Mail at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: ��� , at Martinez, California. cc: Clerk of the Board of Supervisors (original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910. 2, 920 .4, 910. 8) vsd�•� , �.y re cn Y, V„ fP rn o r lk ji cv � is 0) ON 0 )A 0 Lo oi Dy0 CA ., A :i ---gr VD O Cp \Vr/ r y � A N � G 4 " 0 cis m �N s c CQ � G Z 1 ^_LAIMV T0, . BOARD OF SUPERVISORS OF CONTRA CO TAt a urRg R�X� appllaatlen to: Instructions to Claimant Clerk of the Board P.O.Box 911 Martinez,Calitornl 94533 A. Claims relating to causes of action for death or =or injury o 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 1ict later than ane - 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 , Cou,,�y Administrati ._Pine Street, Martinez , Californi 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. f E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at end of this form. RE: Claim by ) Reserved g s Ps I1 AION .06f GSD 0REC} 9 Against the COUNTY OF CONTRA COSTA) FFEB 10 1989 l��p or DISTRICT) 4 (Fill in name) ) CLERK P ELo S P A • The undersigned claimant hereby makes claim again ...T�. ...'rPUt Contra Costa or the above-named District in the sum of $ SOO. 0 0 _ and in support of this claim represents as follows : ------------------------------------------------------------------------ 1. When did the damage or injury occur? (Give exact date and hour) -------------------------- -----=--------------------y and ----------- 2. Where did the damage or-_`injury occur? (Include city and county) - ----------------------- ------------------------------------------------- 3. How did the damage or injury ,3ccur? (Give full details , use extra - sheets if required) L 0S% ------------------------------------------------------------------------- 4 . What particular act or omission on the part of county or district officers , servants or employees caused the injury or damage? I (over) y n14 3 :5..:,:•l zat" are.-,the,..:names of county -or .,district officers , servants o_r ,-,, employees causing the damage or injury? • What dama e or in 'uries do you ------------- 6 -------- ------ ----- g � y claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage) ------------------------------------------------------------------------- 7 . How was the amount claimed above computed? (Include the estimated amount of any ,prospective injury or damage. ) ------------------------------------------------------------------------- 8 . Names and addresses of witnesses , doctors and hospitals . ------------------"------------------------------------------------------- 9 . List the expenditures you made on account of this accident or injury: DATE ITEM AAIOUiv'T YM IN-3- IYOO 12,w e_ S to nes 1 L-m Govt. Code Sec. 910 . 2 provides : "The claim signed by the claiman- SEND NOTICES TO:< (Attorney) or by some person on his behalf. Name and Address of Attorney ���� , �, �,e\2CL&0 Claimant' s Signature Address _ pAkLey za 94561 Telephone No. v ;y Telephone No. NOTICE Section 72 of the Penal Code provides: "Every person who, with intent tt 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 r: Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT March 7 , 1989 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 5 , 3 0 9 , 8 0 (Paragraph IV below), given pursuant to Government Code Amount:_ $ Section 913 and 915.4. Please note all "Warnings". CLAIMANT:LAPORCHE WALTON c/o Michael L, Alderson, Pelletreau, Moses , Larson, Alderson etal ATTORNEY: 2090 23rd Street San Pablo, CA_ 94806 Date received ADDRESS: BY DELIVERY TO CLERK ON February 7 , 1989 hand del . BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. H Bg DATED: February 10, 1989 EyIL 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 filedlateand send warning of claimant's right to apply for leave to present a late claim (Section 911®lYtI$Y C®Lli1Sel ( ) Other: FEB 101989 Martinez, CA 94553 Dated: 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. q p� Dated: MAR 719�J 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. l Dated: MAR 8 1989 BY: PHIL BATCHELOR by_kZF& Deputy Clerk CC: County Counsel County Administrator i� OT FEB 7 1989 p P YL R •HEL CLE.." A ISC?� 1 CLAIM AGAINST THE COUNTY OF CONTRA CO A, 2 TO: THE CONTRA COSTA COUNTY BOARD OF SUPERVISORS: _ Deputy 0 3 Claimant herein presents her claim for damages against 4 the above named governmental entity and in compliance with N W 5 Section 910 of the California Government Code sets forth in 0 6 detail the following information: ICU 7 A. The name and post office address of the claimant J Q 8 is : LaPorche Walton, c/o Michael L. Alderson, Pelletreau, Moses, Q U ,, 9 Larson, Alderson, Jacobsmeyer, Cabral & Vandersloot, 2090 - 23rd Z 0 o yW, Mm 10 Street, P. 0. Box 35, San Pablo, CA 94806 . W a X n 00 m $ 11 B. The post office address to which notices in m J � OU oaa � 12 connection with this claim are to be sent is: Michael L. Q N rn m Z 0 N 13 Alderson, Pelletreau, Moses, Larson, Alderson, Jacobsmeyer, 0 a a 62 WO 0 < 14 Cabral & Vandersloot, 2090 - 23rd Street, P. 0. Box 35 , San a � a QZON 15 Pablo, California, 94806. z a " 16 C. The date, place and circumstances of the 0 u a 17 occurrence which give rise to the claim are as follows: Q � 18 -j Claimant is a dependent child of the Contra Costa County Juvenile (nn 19 Court. Claimant was placed by County personnel in the home of O � 20 j Earl and Cora Porter, 830 Sonoma Street, Richmond, Contra Costa W 21 County, California, on September 11 , 1987, and resided there Ir F- � 22 continuously through approximately August 8 , 1988 . On or about J (L 23 August 8 , 1988 , while claimant was playing in the backyard of her 24 foster parents ' home, she was attacked and bitten by one or more 25 of the family dogs. Claimant bases her claim against the County 26 of Contra Costa on the negligent placement of claimant in the -1- I Porters' home without adequate investigation to ensure a 'safe 2 environment for claimant. Among other omissions, the County of 0 3 Contra Costa placed claimant in a home where several dogs of 4 uncertain temperament were being kept as family pets, thereby W 5 exposing claimant to attack by said dogs and to serious personal 0 6 injury. J 7 D. A general description of the injuries and the loss Q m 8 incurred, so far as is known at the present time, is as follows: Q U , 9 Claimant sustained extensive lacerations to her scalp, right Z 02 w01 Ln 10 upper and lower eyelid lacerations , right superior and inferior a x Ln ° °sg 11 canalicular lacerations, ear lacerations, thigh lacerations, OU oa , 2 12 cosmetic deficit and severe emotional distress due to dog bites. Q N m m - waQ z & WU " 13 E. The name of the public employee causing the injury a N O ^ UJ o� aQ 14 is: Contra Costa County Social Services Department. QZoa 15 F. The amount claimed as of the date of the z Q " 16 presentation of this claim is: O Q 17 1 . Medical Specials to Date . . . . . . . . . . . . . . . . . . . . . . . . $ 5 ,309. 80 Q J 18 2 . Future Medicals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . unknown U) 19 3 . Permanent Disability . . . . . . . . . . . . . . . . . . . . . . . . . . . . unknown 0 � 20 j4 . General Damages . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . unknown w 21 Total . . . . . . . . . . . . . . . . . . $ 5 ,309.80 H � 22 Dated: February 6 , 1989. J w 23 d PELLETREAU, S, LARSON, ALDERSON, 24 JAC ' S EY , CAP & VANDERSLOOT 25 By 26 MICHAE L., LDERSON, Attorneys for Claimant, LA PORCHE WALTON Acting for and on Behalf of Claimant, LA PORCHE WALTON -2- i ; CLAIM /o?i' BOARD rF 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 March 7 , 1989 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: VIRGINIA SMITH c/o Louis M. Bernstein ATTORNEY: Attorney at Law 1440 Broadway 3x`-810 Date received ADDRESS: Oakland, CA 94612 BY DELIVERY TO CLERK ON February 5 , 1989 hand del . BY MAIL POSTMARKED: no envelope I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. February 10 1989 PpHHIL BATCHELOR, Clerk DATED: y , 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 fil 1 warning of claimant's right to apply for leave to present a late claim (Section 911 UrWldc ' el F E 8 10 1989 ( ) Other: year +aAoy rl! 4 $ Dated: 2 X13 ' 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: MAR 1989 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.l Dated: MAR 8 1989 BY: PHIL BATCHELOR by ,_Z9i&6e,Mty Clerk CC: County Counsel County Administrator Fai .y .. f 1 CLAIM AGAINST COUNTY OF CONTRA COSTA 2 (Government Code, §910) 3 A. Name and post office address of the claimant: 4 Virginia Smith 1100 Bailey Road 5 Pittsburg, CA 94565 6 B. The post office address to which the per on 7 presenting the claim desires notices to be en E P, 8 Louis M. Bernstein Attorney at Law FE -B 1440 Broadway, Suite 810 ; FE 19$9 Oakland, CA 94612 10 PHIL BATCHiELOn 1��r, CLE-IK BOARD Or SUPERVISO ,,_, 11 C. The date, place and other circumst �-. °a?lity 12 occurrence or transaction which gave rise to the claim: 13 For a prolonged period of time, including the present 14 date, Contra Costa.- County and its agents and employees have 15 negligently and wrongfully maintained Bailey Road, 16 Pittsburg, California and the drainage system thereof so as to 17 cause claimant' s property to erode at or about 1100 Bailey 18 Road and to cause a great deal of debris to run onto claimant's 19 property and the destruction of the bulkhead on claimant' s 20 property requiring the removal of debris and rebuilding of 21 said bulkhead with new material, said damage having been 22 caused by water flow and/or seepage. 23 D. The damage incurred so to date is loss of bulkhead 24 and accumulation of debris on claimant's property. 25 E. The name and address of the public employee or 26 employees causing the in��'Y or damage is presently unknown. 27 28 LOUIS M. BERNSTEIN ATTORNEY AT LAW - 1440 BROADWAY,SUITE 810 l� OAKLAND.CALIFORNIA 94612 TELEPHONE 14151 832-5460 1 F. The total amount of the claim is within the 2 jurisdictional amount of the Superior Court -of CAlifornia. 3 DATED: / 4 5 6 7 uis M. Bernstein, Attorney for Claimant 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 -2-