Loading...
HomeMy WebLinkAboutMINUTES - 05141991 - 1.21 (4) AMENDED CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MAY 14•, 1991 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: $510.40 Section 913 and 915.4. Please note all "Warning 11 CLAIMANT: CONNELL, John MAY q p 1(901 1570 Willow Pass Road, #7 1 ATTORNEY: Pittsburg, CA 94565 COUNTY COUNSEL Date received MARTINEZ, CALIF. ADDRESS: BY DELIVERY TO CLERK ON May 7, 1991 BY MAIL POSTMARKED: May 6, 1991 1. FROM: Clerk of the Board of Supervisors TO:. County Counsel Attached is a copy of the above-noted claim. May 10 199 1 HIL BATCHELOR, Clerk DATED: y 1�: Deputy 1 FROM: County Counsel TO: Clerk of the Board of Supervisors (�! ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: S 13 191 BY: Deputy County Counsel 1I1. FROM: Clerk of the Board TO: County Counsel (1) County Admin' trator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present �This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: MAY 14 1991 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code sec 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAY 17 M91 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LOST PROPERTY CLAIM Return original application to: Clerk of the Board PO Box 911 Martinez, CA 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must. be filed with -the Clerk of the Board of Supervisors at it's 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 - 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 of officer, authorized to allow or pay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, is g6ilty of a felony. " c-:c:c:c•�k-n�;c;c:c-k4c-�:<;c:e:c:c°e:c:csc:e:::c:::c:c9csc4c:c ;c:c:c-.°.�-::'c-.°.:c„x:r.°.:':k�:::�•:::e�cx:c4c:::c4e':��'.c;c�s:��th'c�:�Tx�s:'k'.c�� RE: Claim By Reserved for Clerk's.-.filing stamps RECEIVE® _MAY - 71991 Against the COUNTY OF CONTRA COS CLERK BOARD OF SUPERVIS or _ DIST-RICT- ` CONTRA COSTA C') (Fill in name) 9 The undersigned claimant hereby makes claim agai st the County of Contra. Costa or the above-named District in the sum of $ dl and in support ofthis claim re presents as follows: 1, When did the damage or injury occur? (Give exact. date and hour) cs2 - oP_ 2. Where did the damage or �� injury occur: (In�clude/� city and county.) ,// f Com?- G(.�c•-�./ •, .. 3. How did the dam or injury occu ive full det ls• use extra sheets , n if required.) � /ACy � 4. What particular act or omission on the art f county or district officers, servants, or employees caused the injury or damage? over - 5. What are the names or county or district officers, servants, or~ employees causing the damage or injury?, LX� 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.) 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 Govt. Code Sec. 910.2 provides: "The claim signed by the claimant or by so e person on his behalf." SEND NOTICES TO (Attorney) . Name and Address of Attorney JW& Claiman s ignatur as% G /X a I / Telephone Number: Telephone Number: �z a IX 040 00 i 0. a2 r moo G > * INCIDENT REPORT - CONTRA COSTA COUNTY SHERIFF 'S DEPARTMENT INCIDENT: LOST PROPERTYMCDF INCIDENT FACILITY: REPORT ,- : DATE/TIME DATE/TIME SAME LOCATION: OFFICE OCCURRED: REPORTED: @ 0800 REPORTED: CONNELL JOHN JOSEPH 90-24303) HOUSING N/A INMATE: BOOKING - : ASSIGNMENT: Last First Middle WITNESS(ES) -- LIST -- Name - Address If an inmate, give booking r : SYNOPSIS: CONNELL'S WALLET AND HAT WERE NOT RETURNED TO HIM WHEN HE WAS RELEASED. NARRATIVE: INMATE CONNELL WAS RELEASED THIS MORNING FROM THE MCDF AT 0600 HRS. WHEN HE GOT TO CONCORD BART AND GOT OFF THE BUS, THE DEPUTY DID NOT HAVE A PERSONAL PROPERTY BAG TO GIVE HIM, SO CONNELL CALLED ME. I CHECKED CONNELL'S BOOKING, WHICH WAS STILL AT MCDF. THE INMATE PROPERTY SLIPS INDICATED THAT CONNELL HAD A WALLET, A HAT, A COMB, AN ADDRESS BOOK, AND A CARTON OF CIGARETTES WITH HIM WHEN HE WAS BOOKED. CONNELL SAID THAT HE HAD RECEIVED THE COMB, ADDRESS BOOK, AND CIGARETTES AT THE MDF, BEFORE HE WAS SENT TO MCDF. (SEE THE ENCLOSED COPIES OF THE PROPERTY SLIPS). CONNELL WAS SENT BACK TO THE MDF ON 2-11-91 FOR MEDICAL REASONS. HE RETURNED TO MCDF ON 2-12-91. OUR INCOMING RECEIPT FOR THE TOWN RUN ON 2-12-91 INDICATES THAT INMATE CONNELL CAME BACK WITH HIS CLOTHING ONLY. NO PROPERTY BAG WAS SENT. WITH HIM. SEE THE ENCLOSED COPY OF THE TOWN RUN SHEET. - I CONTACTED THE MDF RELEASE CLERK, BUT SHE WAS UNABLE TO LOCATE CONNELL'S PROPERTY BAG. I TOLD INMATE CONNELL THAT I WOULD SEND HIM A COPY OF MY REPORT AND A COUNTY CLAIM FORM. ACTION TAKEN/RECOMMENDED: COPY OF REPORT AND CLAIM FORM MAILED TO INMATE. YM. MEAD 39473 REPORTING EMPLOYEE # SUPERVISOR OPERATIONS DIRECTOR .9 O.D. ROUTING INSTRUCTIONS: White to Facility Manager - Yellnw to Bnnking File - Go.ldenrnd to inmate By: Pink to BAS Page one of 1 Rev. 3/85 ^ . . ` LJ 1833A ACTIVE INMATE INFORMATION AS OF 04/04/91 AT 00: 11 PAGE 01 BK NBR: 90024303J ID-NBR: 070002512 CClN NBR: 070002512 NAME: CONNELL JOHN JOSEPH DOB: 07/03/34 AKAS: KEYS JOHN LACEY DICK RICHARD LACEY JOHN RICE JOHN JOSEPH ADDR: 1570 WILLOW PASS RD CITY: WEST PITTSBURG ST: CA ZIP: PHONE: 415-432-1566 POB: MA SEX: M RACE: W HOT: 509 WGT: 165 HAIR: BRO EYES: BRO SKIN: MED GLASSES: N PREVIOUS CITY OF RESlDENSE: W PITTSBURG DR LIC NBR: V8O88367 ST: CA SSN: 460-46-7996 MEDICAL :: CII NBR: 799221 FB[ NBR: 479377B AFlS NBR: 070002512 PFN NBR: HZD CODE: HZD CODE DESC: CASH: .00 ADMINISTRATION VERIFY: Y PROPERTY BOX: 15E RETURNED TO: FAC: RHC MOD/SECT: G ROOM: 17 CUSTODIAL STATUS: TEMP RELEASE: O DATE PREBOOKED: 09/14/90 TIME OF PREBOOK: 1O:06 PREBOOKED BY : 41153 ' DATE BOOKED: 09/14/90 TIME BOOKED: 1O:23 BOOKED BY: 28320 CLASSlQCATlON: A FINGERPRINT BY: PHOTO BY: WORK DETAIL: N ` 851 .5 ADV: Y 851 . 5 COMP: Y 851 .5 DECLINED: N � ' [/ �� ---t- 141+ 7— - ' /4 /+ 7-- . EMPLOYMENT INFORMATION OCCUPATION: UNEMPLOYED EMPLOYER: UNEMPLOYED * � c� EMP ADD: ' CITY: EMP PHONE : ' . /L~ /7-An y/ EMERGENCY CONTACT lNFORMATlON NAME: MARGE COLE (MOTHER-[N LAW) ADDR: 711 ANTHONY ST CITY: MODESTO ST: CA ZIP: HOME PHONE: 209-524-8456 BUS PHONE: UPDATED ON HISTORY: Y CAL ID VER: Y PIN COMPL: CLETS COMPL: CHARGE NBR: C01 OFF: PC 484/666 F SENT 1 YEAR . NO CREDIT T/S N ' / ARREST REPORT INFORMATION AGENCY: 20 DATE: 09/14/90 TIME: 08:45 ! � TYPE ARR: C ARREST RPT NBR: WAR/DKT NBR: / DATE COMPLAINT FILED: COMPLAINT NBR:- COURT BR:COURT APPEARANCE INFORMATION ! COURT: DEPTv DATE: TIME: ROC: DOCKET MBR: 901065-3 ' SENTENCE DATE: 09/14/49 PROJECTED DATE OF RELEASE: 04/04191. - - BAIL 4/04/91 'BAlL AMOUNT: _ NOj3AlL� FINE AMOUNT: RELEASE lNFORMATlON ^ ' RELEASE TYPE: P RELEASE CODE: 7 DATE:04/04/91 TIME: 00: 10 BY: 36042 BAIL BOND NBR: APPEAL BOND NBR: BONDING COMPANY: PAYMENT TYPE: PAYMENT REF ID: PAID AMT: .00 PAYMENT RECEIVED FROM: RECEIPT NBR: COURT RELEASE TYPE: COURT: DEPT: DATE OF COURT RELEASE: AGENCY RELEASED TO: OFFICER RELEASED TO: OTHER RELEASE TYPE: STATE RELEASE TYPE: TYPE OF DEATH: PROPERTY RELEASED: [ FINAL RELEASE BY: 36042 FOR RECORDS USE ONLY: TIME SERVED WARRANT NBR DlSPO CHECK NBR COURT PD DATE .......................... ------- ------- -..................... ............................ ------- ' . . , - LJ1933A ACTIVE INMATE INFORMATION AS OF 04/04/91 AT 00: 11 PAGE 02 ` BK NBR: 90024303J }D-NBR: 070002512 CClN NBR: 070002512 CHARGE NBR: CO2 OFF: CVC 21453A M CVC 40508A M ARREST REPORT INFORMATION AGENCY: 20 DATE: 01/23/91 TIME: 17:05 TYPE ARR: R ARREST RPT NBR: WAR/DKT NBR: DATE COMPLAINT FILED: COMPLAINT NBR: COURT APPEARAN'CE INFORMATION COURT: DEPT: DATE: TIME,. ROC: DOCKET NBR: 698244-1 SENTENCE DATE: PROJECTED DATE OF RELEASE: BAIL AMOUNT: COURTESY FINE AMOUNT: RELEASE INFORMATION _ RELEASE TYPE: P RELEASE CODE: 5 DATE:01/28/91 TIME: 21 :24 BY: 46971 BAIL BOND NBQ. APPEAL BOND NBR: BONDING COMPAM. PAYMENT TYPE: _ PAYMENT REF ID: PAID AMT: AO PAYMENT RECEIVED FROM: RECEIPT NBR: COURT RELEASE TYPE: 4 COURT: 4 DEPT: DATE OF COURT RELEASE: 01/28/91 AGENCY RELEASED TO: OFFICER RELEASED TO: OTHER RELEASE TYPE: STATE RELEASE TYPE: TYPE OF DEATH: PROPERTY RELEASED: FINAL RELEASEBY: FOR RECORDS USE ONLY: COURT ORDER ` WARRANT NBR DlSPO CHECK NBR COURT PD DATE ...................-.... ------- ------- ------- ------- ----- '- DESTINATION DATE TIME FLAG ***** NO DATA ***** TEMPORARY RELEASES RELEASE CHG DATE OF TIME OF ENTERED DATE OF TIME OF TYPE NBR RELEASE RELEASE BY RETURN RETURN AGENCY ***** NO DATA ***** ================================================================================ .I NMATE NAME: CON NELL JOHN JOSEP .I BOOKlNG NBR: pO024301J - ' � MDF { OO 09/14/90 10:06 � MDF Q 47A D 09/14/90 14 : 19 MDF l 00 09/15/90 16:04 RHC B 14 09/15/90 19:47 RHC E 63 09/18/90 13:51 RHC C 38 09/27/90 12:24 RHC G 60 09/28/90 13:23 RHC F 23 10/10/90 16: 18 RHC G 17 01/14/91 13:48 RHC M 17 01/28/91 05:09 RHC G 17 01/28/91 18: 10 RHC S 04 02/11/91 18:33 MDF l OO 02/11/91 21 :27 MDF Q 18A D 02/12/91 01 :08 MDF l OO 02/12/91 16:OO RHC B- 65 12/12/91 2014 RHC G 17 Q02/13/91 � / 13:46 ================================================================================ PROPERTY/CLOTHING RECEIPT R 0.69092 CONTR._)COSTA COUNTY �{ } DATE: RACK# MDF ' TIME: CLH BOX MCDF I - PROP.BOX WFC i NAME: � X/�(/FLL f ' yc�/�iJ .1 WCJC � BOOKING NSR: OTHER ♦ I CASH: S- 0 • U ❑ SHIM/BLOUSE DRESS L�-ea, "/JACKET ❑ TIE/SCARF E�I SHORTS/PAVTTES7 -E] JEWELRY ❑-SOCKS/N'etMS ❑ SWEATER/SWT.SHIRT WATCH V 1; ❑yBELT �l LJ PANTS/9*14i-T } } L SHOES/BMOTS E4--T SH I RT L'�.WALLET - 1 ❑ KEYS ❑ KNIFE E:1 GLASSES i 0'tS HER ` ( f ) rA.=ZTt,til ►,IAP-1 bu2w C I S . BKG OFC: f� //J(>RT X INMATE SIGNATURE have received all of my 4NAper- DATE: sonal property and clothing. I REL OFC: X INMATE SIGNATURE �ONTRA COSTA DETENTION FACILITY CLOTHkIN RECEIPT LJIS11 .:_ . .DATE:— 09/14/90 ....:_.. REC: 202535 TIME: -`-1013 FACILITY: .. .MUF NAME (L, F, M):_':` CONNELL JOHN JO D.0.B.: . BOOKING NBR:. :;._J0 ..-. . _ j 024303) • - I SHIRT/BLOUSE PANTS/SKIRT COAT/JACKET SHOES/BOOTS JEJ SHORTS/PANTIES i F—jT-SHIRT/BRA SOCKS/NYLONS HAT/PURSE Q SWEATER/SWT. SHIRT' DRESS OTHER BKG OFC y h X INMATE SIGNATURE DATEHAVE RECEIVED ALL OF MYC', x � �-CLOTHING `� �_ �<t� s REL OFC v a e c;t� - X f r hi " INMATE SIGNATURE I ONTRA COSTA DETENTION FACILITY­- PROPERTY ACILITY--PROPERTY RECEIPT DATE: . ..09/14/90 REC 202535' r TIME: ., 1013 FACILITY: MDF ` NAME: CQNNELL JOHN JOSEPH D.O.B.. -• :• i BOOKING IBR: 90024303) _. .:_. ITEM UNDER. COUNTER: Y OR N ! CASH:-$--- -19 0.6 8 F JEWELRY: N : :...D ESC• i ! WATCH: N DESC: ._.�_ -- LIGHTER: WALLET/PURSE:. .:-N' KEYS:. - GLASSES. N . BELT: ':,N:, . I. K - :,, . OTHER: - ONE BAG .SEALED PROPERTY S `BKG OFC 41153 k y } _ � z I - ' t hi INMATE SIGNATURE y f S DATE 1 I HAVE RECEIVED ALL OF:MY`. _ PERSONAL.PROPERTY • REL OFC ! IINMATE SIGNATURE • I FES - - 9 1 TUE f F' Aco � Tr1:1 F= PROPERTY INVENTORY LIST CONTRA COSTA COUNTY DETENTION FACILITY INMATES TRANSFERRED TO: YY1 C �' —' IN's q T t- O)q r i DATE: . -- INSTRUCTIONS -- Please total the money and place it*into one envelope. Proper credit can be made from this inventory. NAME LAST FIRST MIDDLE BOOKING # MONIES PROPERTY -3 b 77:x' X3.51 �- �z - 7 3 (?4. N Ns o 95. q - 3 o G 0N4 P6. z 1 -3 71 y l G Y. qs. 13 l o �i v 3b d� C 99. 4�1 0. 12:moi, s.1 S 1371 1 3 D :Cz2e 14. TOTAL $ RELEASED BY: ACCEPTED BY: APPROVED BY: AGENCY: t _ TRANSPORTED BY: DATE: �� i + l i' \� l xh�> �� "tiy.� L 0 r r� O a� f nrn � v � no 00 v T7 *krAARtAAARA i. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION r the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MAyi 1 4 1 9 9 1 and Board Action. All Section references are to ) The copy of this document mailed to you is you P notice of California Government Codes. ) the action taken on your claim by the Board�ff Supervisors $5 09 . 00 (Paragraph IV below), given pursuant to Go�fernment Code Amount: Section 913 and 915.4. PleZ Warnings". tdEdEIVED CLAIMANT: CONNELL, John 1570 Willow Pass Road, #7 APR 16 1991 ATTORNEY: Pittsburg, CA 94565 COUNTYDate received �TIN� CCI& ADDRESS: BY DELIVERY TO CLERK ON A991 BY MAIL POSTMARKED: ,April 9, 1991 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. l April 12 1991 HHIL BATCHELOR, Clerk DATED: P Y: Deput/y/ II. FROM: County Counsel TO: Clerk of th Board of Supervisors ( ) This claim complies substantially with Sections 910 and 910.2. �(J ) 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 applyfor leave to present a late claim (Section 911.3). ( ) Other: / l Dated: f 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 nanimous 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: 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. 1 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 asl shown above. Dated: BY: PHIL BATCHELOR by Deputy Clerk I CC: County Counsel County Administrator NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM John Connell T0: 1570 Willow Pass Road #7 Pittsburg, California 94565 Re: Claim of JOHN CONNELL 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 date, place or other 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. 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 X 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: I �L Deputy Cobhty Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P . SS 1012, 1013a, 2015 . 5; Evid. C. S9 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. Maid at Martinez/Concord, Contra Costa County, California. I certify under penalty of perjury that the foregoing is true and correct . Dated: "/-/7- fl , at Martinez California. i cc: Clerk of the Board of Supervisors ( ginal ) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 . 4 , 910 . 8) LOST PROPERTY CLAIM Return original application to: Clerk of the Board PO Box 911 Martinez, CA 94553 A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Sec. 911.2, Govt. Code) B. Claims must. be filed with the Clerk of the Board of Supervisors at it's office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claic 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,.7 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 of officer, authorized to alloworpay the same if genuine, any false of fradulent claim, bill, account, voucher, or writing, lis guilty of a felony." �n•�C i,JC iC Jif k'.0 iC iC�;J..4J J J.J J.J J.J.J.J.J J.J..4 J.J .J.J.J.J. .V J.J.J..4 J..L.4. .k iC• 4•k k� J J r n•�� n n � n RE: Claim By Reserved for Clerk's--.filing stamps ti RECEIVED 0, ,.n 02 Against the COUNTY OF CONTRA COSTA - I ( ' or _ DISTRICT- `- CLERK BOARD OF SUPERnra. CCsta (Fill in name) CONTRA COSTA CO The undersigned claimant hereby makes cla�_X,40.oandin inst the County of or the above-named District in th sum of $ support of this claim re- presents as follows: 1. When did the damage or i jury occur. Give exact. date and hour) 2. [there did the damage or injur;7occur: (Inc ude city and county.) How did the eaJa;e or injury occur? (Give full details ; use extra sheets if required. 4. What particular act or omission on the part of county or district offi e , servants, or employees caused the injury or damage? over 5. What are the names or county or district-officers, servants, or employees-,14 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 amountlc aimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and adcfresses of witnesses, doctors, and ospitals: 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Govt. Code Sec. 910.2 provides: "The claim signed by the claimant. or by some person_ on his behalf." SEND NOTICES TO (Attorney) Name and Address of Attorney _ Claimants Signature Address Telephone Number: - ' Telephone Number: * INCIDENT REPORT CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT INCIDENT INCIDENT: LOST PROPERTY FACILITY- MCDF REPORT OFFICE DATE/TIME 4-4-91 @ 0800 DATE/TIME SAME LOCATION: OCCURRED: REPORTED: 90-24303J HOUSING N/A INMATE: CONNELL, JOHN JOSEPH BOOKING ASSIGNMENT: Last First Middle WITNESSES) -- LIST .— Name - Address If an inmate, give booking r : SYNOPSIS: CONNELL'S WALLET AND HAT WERE NOT RETURNED TO HIM WHEN HE WAS RELEASED. NARRATIVE: INMATE CONNELL WAS RELEASED THIS MORNING FROM THE MCDF AT 0600 HRS. WHEN HE GOT TO CONCORD BART AND GOT OFF THE BUS, THE DEPUTY DID NOT HAVE A PERSONAL PROPERTY BAG TO GIVE HIM, SO CONNELL CALLED ME. I CHECKED CONNELL'S BOOKING, WHICH WAS STILL AT MCDF. THE INMATE PROPERTY SLIPS INDICATED THAT CONNELL HAD A WALLET, A HAT, A COMB, AN ADDRESS BOOK, AND A CARTON OF CIGARETTES WITH HIM WHEN HE WAS BOOKED. CONNELL SAID THAT HE HAD RECEIVED THE COMB, ADDRESS BOOK, AND CIGARETTES AT THE MDF, BEFORE HE WAS SENT TO MCDF. (SEE THE i ENCLOSED COPIES OF THE PROPERTY SLIPS). CONNELL WAS SENT BACK TO THE MDF ON 2-11-91 FOR MEDICAL REASONS. HE RETURNED TO.MCDF ON 2-12-91. OUR .INCOMING RECEIPT FOR THE TOWN RUN i i ON 2-12-91 INDICATES THAT INMATE CONNELL CAME BACK WITH HIS CLOTHING ONLY. NO PROPERTY BAG WAS SENT. WITH HIM. SEE THE ENCLOSED COPY OF THE TOWN RUN SHEET. I CONTACTED THE MDF i RELEASE CLERK, BUT SHE WAS UNABLE TO LOCATE CONNELL'S PROPERTY BAG. i I TOLD INMATE CONNELL THAT I WOULD SEND HIM A COPY OF MY REPORT AND A COUNTY CLAIM FORM. ACTION TAKEN/RECOMMENDED: COPY OF REPORT AND CLAIM FORM MAILED TO INMATE. YM. MEAD 39473 REPORTING EMPLOYEE # SUPERVISOR OPERATIONS DIRECTOR O.D. ROUTING INSTRUCTIONS: White to Facility Manager - Yellnw to Bonking Fi. le - G(dden:-nd tc Tmmmte By: Pink to BAS Page one of 1 Rev. 3/85 - ' LJlS33A ACTIVE INMATE INFORMATION AS OF 04/04/91 AT 00: 11 PAGE 01 BK NBR: 90024303J lD-NBR: 070002512 CClN NBR: 070002512 NAME: CONNELL JOHN JOSEPH DOB: 07/03/34 AKAS: KEYS JOHN LACEY DICK RICHARD LACEY JOHN RICE JOHN JOSEPH ADDR: 1570 WILLOW PASS RD CITY: WEST PITTSBURG ST: CA ZIP;: PHONE: 415-432-1566 POB: MA SEX: M RACE: W HGT: 509 WGT : 165 HAIR: BRO EYES: BRO SKIN: MED GLASSES: N � PREVIOUS CITY OF RESlDENSE: W PITTSBURG DR LIC NBR: V8088367 ST: CA SSN: 460-46-7996 MEDICAL: CII NBR: 799221 FB[ NBR: 479377B AFlS NBR: 070002512 PFN NBR: HZD CODE: HZD CODE DESC: CASH: .00 ADMlNISTRAr[ON VERIFY: Y PROPERTY BOX: 15E RETURNED TO: FAC: RHC MOD/SECT: G ROOM: 17 CUSTODIAL STATUS: TEMP RELEASE: 0 DATE PREBOOKED: 09/14/9O TIME OF PREBOOK: 10: 06 PREBOOKED BY : 41153 DATE BOOKED: 09/14/90 TIME BOOKED: 10:23 BOOKED `BY: 28320 CLASSIFICATION: A FINGERPRINT BY: PHOTO BY: WORK DETAIL: N � 851 .5 ADV: Y 851 . 5 COMP: Y 851 .5 DECLINED: N � --f- ' /�� T-- . EMPLOYMENT INFORMATION ' ' OCCUPATION: UNEMPLOYED EMPLOYER: UNEMPLOYED ' EMP ADD: CITY: EMP PHONE : . v�1`� /L~ /�-/��Y \' / . � EMERGENCY CONTACT INFORMATION NAME: MARGE COLE (MOTHER-[N LAW) ' ADDR: 711 ANTHONY ST CITY: MODESTO ST: CA ZlP: HOME PHONE: 209-524-8456 BUS PHONE: UPDATED ON HISTORY: Y CAL ID VER: Y PIN COMPL: CLETS COMPL: CHARGE NBR: C01 OFF: PC 484/666 F SENT 1 YEAR N NO CREDIT T/S N ARREST REPORT INFORMATION AGENCY: 20 DATE: 09/14/90 TIME: 08:45 TYPE ARR: C ARREST RPT NBR: WAR/DKT NBR: DATE COMPLAINT FILED: COMPLAINT NBR: COURT APPEARANCE INFORMATION COURT: DEPT: DATE:` - TIME: RON _ _ DOCKET NBR: 901065-3 SENTENCE DATE: .09/14/49 PROJECTED DATE OF RELEASE: 04/04/911 BAIL AMOUNT: NO BAIL FINE AMOUNT: RELEASE lNFORMATl ON RELEASE TYPE: P RELEASE CODE: 7 DATE:04/04/91 TIME: OO: 1O BY: 36042 BAIL BOND NBR: APPEAL BOND NBR: ` BONDING COMPANY: PAYMENT TYPE: PAYMENT REF ID- PAID AMT: .00 PAYMENT RECEIVED FROM: RECEIPT NBR: COURT RELEASE TYPE: COURT: DEPT: DATE OF COURT RELEASE: AGENCY RELEASED TO: OFFICER RELEASED TO: ` OTHER 'RELEASE TYPE: STATE RELEASE TYPE: TYPE OF DEATH: PROPERTY RELEASED: l FINAL RELEASE BY: 36042 ` FOR RECORDS USE ONLY: TIME SERVED WARRANT NBR DlSPO CHECK NBR COURT PD DATE ------- ------- ------- -...................... ........................... ------- ' ` . 'L' lS33A ACTIVE INMATE INFORMATION AS OF 04/04/91 AT 00: 11 PAGE 02 , BK NBR: 90024303J ID-NBR: 070002512 CClN NBR: 070002512 CHARGE NBR: CO2 OFF: CVC 21453A M CVC 40508A M ARREST REPORT INFORMATION AGENCY: 20 DATE: 01/23/91 TIME: 17:05 TYPE ARR: R ARREST RPT NBR: WAR/DKT NBR: DATE COMPLAINT FILED: COMPLAINT NBR: COURT APPEARANCE INFORMATION COURT: DEPT: DATE: TIME: ROC: DOCKET NBR: 698244-1 SENTENCE DATE: PROJECTED DATE OF RELEASE: BAIL AMOUNT: COURTESY FINE AMOUNT: RELEASE INFORMATION _ RELEASE TYPE: P RELEASE CODE: 5 DATE:01/28/91 TIME: 21 : 24 BY: 46971 BAIL BOND NBR: APPEAL BOND NBR: BONDING COMPANY: PAYMENT TYPE: PAYMENT REF lD: _ PAID AMT: .00 PAYMENT RECEIVED FROM: RECEIPT NBR: COURT RELEASE TYPE: 4 COURT: 4 DEPT: DATE OF COURT RELEASE: 01/28/91 AGENCY RELEASED TO: OFFICER RELEASED TO: OTHER RELEASE TYPE: STN E RELEASE TYPE: TYPE OF DEATH: PROPERTY RELEASED: FINAL RELEASEBY: FOR RECORDS USE ONLY: COURT ORDER WARRANT NBR DlSPO CHECK NBR COURT PD DATE ....................-.... ------- ------- ------- ------- ----- '- ==z============================================================================= DESTlNATlON DATE TIME FLAG ***** NO DATA ***** TEMPORARY RELEASES ' RELEASE CHG DATE OF TIME OF ENTERED DATE OF TIME OF TYPE NBR RELEASE RELEASE BY RETURN RETURN AGENCY ***** NO DATA ***** INMATE NAME: CONNELL JOHN JOSEPH, BOOK[NG NBR: /9002430�J . MDF l OO 09/14/90 10:06 ' MDF Q 47A D 09/14/90 14 : 19 ' MDF l 00 09/15/90 16:04 0 / RHC B 14 9 15/90 19:47 RHC E 63 09/18/90 13:51 RHC C 38 09/27/90 12:24 RHC G 60 09/28/90 13: 23 RHC F 23 10/10/90 16: 18 RHC G 17 01/14/91 13:48 RHC M 17 01/28/91 05:O9 RHC G 17 01/28/91 18: 10 RHC S 04 02/11/91 18:33 MDF l 00 02/11/91 21 :27 MDF Q 18A D 02/12/91 O1 =8 MDF l 00 02/12/91 16:00 RHC B 65 12/12/91 2O: 14 � - - - 602/13/91�� ��_ - � � � RHC G 17 13 :46 ================================================================================ PROPERTY/CLOTHING RECEIPT CONTa-_)COSTA COUNTY RE( 0.69092 DATE:'A0 �/41 ancKA MDF CLH BOX MCDF TIME: PROP,BOX WFC NAME:�OX/�(/FLL- ' .1c�/�iJ .1 WCJC BOOKING NBR: OTHER CASH: S_L_ C� • U j PS IRT/BLOUSE �❑ DRESS -eae�/JACKET TIE/SCARF . SHORTS/pAvTTESr JEWELRY (1 ❑SOCKS/N'r�S SWEATER/SWT.-SHIRT ❑ WATCH V �S BELT I E yPANTS/S'fHfi"T 1 E]-_SHOES/BOOTS-M//k//S,—,-,� E?' SHIRT)q � EB ALLET p- G-A ❑ KEYS I ❑ KNIFE ❑GLASSES ( I ) rA t Z-1Z, —I P,,1 A P- R C I I' S . I BKG OFC: - ///01zT�t_, X �^ f INMATE SIGNATURE . . . If have received all of my per- DATE: sonal property and clothing. REL OFC: X INMATE SIGNATURE f nNTRA COSTA DETENTION FACILITY _..L'JISll ._ CLOTHIIyG RECEIPT .DATE:--09/14/90 REC: 202535 TIME: FACILITY: - ' 1013 ..:,._.... , . .. . h1DF NAME (l, F, M):--,. CONNELL JOHN JO D.O.B.: • : • BOOKING NBR: ::..J 0 .... . 0 3 J 'L 0243 ' 1 SHIRT/BLOUSE _ PANTS/SKIRT COAT/JACKET ? SHOES/BOOTS SHORTS/PANTIES Q T-SHIRT/BRA SOCKS/NYLONS HAT/PURSE Q SWEATER/SWT. SHIRT' DRESS OTHER l� X r INMATE SIGNATURERELEASE _ Ay DATE 1 I HAVE RECEIVED ALL OF MY fl} F I E Li OFC w r} INMATE SIGNATURE { _ t ONTRA COSTA DETENTION FACILITY PROPERTY RECEIPT DATE: 09/14/90 202535 . REC• _.TIME: .: .1013 FACILITY: MDF ... .. L . NAME: CQNNELL JOHN JOSEPH D.O.B. _ BOOKING MBR: - 90024303) ITEM UNDER COUNTER: Y OR N1101111 oil 11111 CASH: JEWELRY: N ..... .:.,_D ESC: •', i WATCH:—' N _DESC: LIGHTER: WALLET/PURSE:. j KEYS: ---- GLASSES. �{ BELT: . I. ,.,N. KNIFE: ' N _. OTHER:;. ONE BAG .SEALED PROPERTY s -BKG O17C:741153 INMATE SIGNATURE ? a RELEASE DATE I HAVE RECEIVED ALL OF MY. PERSONAL:PROPERTY. REL OFC X- INMATE SIGNATURE TUE 1 1 L-1 F-4 z GL1GTF O 1I �1F jjj 7 r PROPERTY INVENTORY LIST CONTRA COSTA COUNTY DETENTION FACILITY INMATES TRANSFERRED TO: YY1 —' I � q--rt-(- -t-1 OVA M , DATE: Z - i-l^Q -- INSTRUCTIONS -- Please total the money and place iI'*into one envelope. Proper credit can be made from this inventory. NAME LAST FIRST MIDDLE BOOKING # MONIES PROPERTY �i.S�'r �s i► 91 3 b 3 �' � C � 2. q1-3b77,1 a- r . Q3.S C- z - 7q 3 i 2. 94Z0 �-p z�i303� CZ� 95• oq1-2 k97 3 ?7. PL:7orf, Ci 4 Q1 1 -3719 3' C C . © V4 • Q8• o vTO 3 b d C Q b C owl 0. c C s -2L10 -1 2 7 C 12..0 rC.p i:�_ c (Z- 1-371 l 3 D 14. 15. it-S C TOTAL $ RELEASED BY: ACCEPTED BY: r` APPROVED BY: AGENCY: : I E TRANSPORTED BY: DATE: �• ^°a�" ' r� o Cl «� Cluj � cn > C%j �o Lia -- n U � Q� LU 0 0 W �V r r 1 J � 1 a -� _ . _ __ .. � �, .� - �i� .�. • . l ,. � � �. i , 1 -' \ t f 1 .. r Cr) ;5 s , yj © 00 ' 00 0 , 00 0 :4