HomeMy WebLinkAboutMINUTES - 04281992 - 1.9 116,19
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 April 28, 1992
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: $89 .00 Section 913 and 915.4. Please note all "Warnings".
a CEIVED
CLAIMANT: BINETTI , Ray APR 81992
ATTORNEY:
DCOUNTY COUNSEL
Date received
MARTINEZ, CALIF.
ADDRESS: 1221 Detroit Avenue 465 BY DELIVERY TO CLERK ON April 6, 1992
Concord, CA 94520
BY MAIL POSTMARKED: Hand delivered
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
April 8 1992 PpHHIL BATCHELOR, Clerk
DATED: BY: Deputy
__ omm.�dd�4 I-)
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantially with Sections 910 and 910.2.
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
claimant. The Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send
warning of claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: 4 4 2 BY: 'l Deputy County Counsel
\",rj - - ,
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).
1V. BOARD ORDER: By unanimous vote of the Supervisors present
(ve� 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: APR 2 8 1992„ PHIL BATCHELOR, Clerk, By 01 ° 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.
0
Dated: A 9 8 1992 BY: PHIL BATCHELOR by a Deputy Clerk
CC: County Counsel County Administrator
Claim .to: BOARD OF SUPERVISORS OF CONTRA COSTA COUM
4 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,�llater 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 a9district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72, at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
RECEIVED
Against the County of Contra Costa APR 61�2
or ) /./:
00 r.A"
District) CLERIC BOARD OF SUPERVISORS
Fill in name ) L 92NTRA COSTA CQ-
The undersigned claimant hereby makes claim inst the County of Contra Costa or
the above-named District 'in the sum of $ 4`,9C and in support of
this claim represents as ";follows:
1. When did the damage or injury occur? (Give exact date and hour)
----------�?=-,� 4'�_---�_---_.---------------------------------------
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? -� ;I
rL �o v w, ���- cry. 5'Ec—,
(over)
_
_� o
I�;C54�-
ZUNI ti tllj - - -
Y-0-0 .R__
__ ___. _ ISI _ = -1,_� � ��� I __o► _� ___do Pl_ ,_
ID
_-�-_ - - ---- -: ��CL.-.-- �cy►v��-- v�_C�� fJ . �L� o rte_ m.�- - .
rA
----
I
�Uvw _ -
4
- --- ---_
C�jE13P
----
i .
- \ Qp V %_
__tin_
_ 2-
ll
�Qtyl y ti
b's go
�I
149,10-
0__ bac>
tic o �- Q �4
Avl�
L 71
4�1i AOS. YVL
a�
it
i
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY,v CALIFORNIA
Claim g Against the District governed by) BOARD ACTION
the Board of Su"WU �� g
II
ylirutin Endorsements ) NOTICE TO CLAIMANT April 28, 1992
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 j! Section 913 and 915.4. Please note all "Warnings".
L' .
CLAIMANT: CLARKE, Keith and PHILLIPS, Teresa
ATTORNEY: j
Date received
ADDRESS: 561 Captains Court BY .DELIVERY TO CLERK ON April 1 , 1992
Pittsburg, CA 94565 March 31 , 1992
j BY MAIL POSTMARKED:
III
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
1 pH IL ATCHELOR, Clerk
DATED: April 2 , Igo?, I BY: Deputy
I
i
11.
�FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantially with Sections 910 and 910.2.
�I
( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying
11
claimant. The Board cannot act for 15 days (Section 910.8).
i
i
( ) 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:
l
i'
j
Dated: 4 /1112 BY: 2UL / &_U Deputy County Counsel
ii
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
l
( ) 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 iin full.
( ) Other:
• ji
' 1!
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
Dated: 2 1992 PHIL BATCHELOR, Clerk, By G Deputy Clerk
i'
i 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 al certified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
0
Dated:_ APR 2 8 1999 BY: PHIL BATCHELOR by b Deputy Clerk
i
CC: County Counsel I County Administrator
j
u
(j
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 thari -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's 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 'againsta 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 aga�inst_,more thanone public entity, separate claims must be,.
filed against each ;public entity.:
y , p
E. Fraud. See penalty ifor fraudulent claims, Penal. Code Sec. 7.2 at the-:dnd of this.
form.
RE: ClaimBy ) Reserved for Clerk's filing stamp
RECEI\IED
--rE P_ra A -Pi4 f t,(,I pS j
Against the County',!of Contra Costa )
or APR
I! )
DfStriCt) CLER BOARD OF SUPERVISORS
) - - CONTRA COSTA CO.
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:
1. When did the damage or injury occur? (Give exact date and 'hour)
ii
Nov_ t 3�� � Ci
-L-- ---------N----N-..---__-_-_
2. Where did the damage or injury occur? (Include city and county)
3. How did the damage,� or injury.-,occur?. (Give full details;.iuse extra.paper..if. .
required) �.
U - o(►1 i e ►n G� C; '{'o f� ct, t G� .
-----
-----------
-- -------- -..-.w--r_ ---------------------------
4.
--- - --- ---4. What particular act or omission on the part of county or district officers,
seryants• or employees caused the injury or damage?
tat(.(;r wll S �r0 (orcL�Jl rio'�' ��� �,n(�
7. What are the names of county or district officers, servants or employees causing .
the damage or injuryll
P("lg.Y .i i.J r-i E�IY�' 1�eC��`
---------- .------- --------------------------- ------ ------- -------------
. 6. What damage or.,injuries do you claim resulted?- ,(Give full extent of injuries or `
damages claimed. Attach two estimates for auto damage.
J �' 'f0 L:_awerr lun1 acLr r r
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or .damage.).
Sino P: clomp :C" �5�1
--------
8. Names and addresses=--------------------------------------- --------------- - -
-- �, of witnesses, doctors and hospitals.
------------
9. List .the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT -
II
Gov. Code Sec. 910:2 provides: -
"The claim must be signed by the claimant
SEND NOTICES TO: (Atte+erne ) or by, some person on his behalf."
Name and Address of Attorney LIX l
fiece
(Claimant'.1 Signature f
ICS C�c� .k,� Ili n PSG 6 Fa1/I
5(0( CA A lA S C:,+-. (Address
in
Telephone No. ._ �� ( 8oSly Telephone No. 5 ( k6
NOTICE _
Section 72 of the Penal Code provides: - -
"Every person who, with intent "to defraud, presents for allowance or for.,:
payment to any state,:*6'ard or officer, or. to any county, city or district board or , `
officer,, authorized It 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 a1�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 ($10,000, or by
both such imprisonment and: fine.
�i
Visible ,.Damage Quotation 47.5457
DAT
P-7
NAME YEAR y7MAKE MODEL
ADDRESS_�L `�,u 1 R� C LICENSE NO. ` v / MILEAGE
CITY L\` "`"' STATE S'21P 5 VIN NO.
H.PHON W.PHONII PROD.DATE - BODY CODE PAINT TRIM
1
INS.CO. ADDRESS DATE OF LOSS CLAIM NO.
�I
ADJUSTER PHONE LIC.NO. FILE NO. D.D.
LINE RE- RE- DETAILS OF REPAIR 1 PARTSINDEX LABOR HOURS
NO. PAIR PLACE R=Repair S=Straighten A=Aftermarket N=New PI PARTS SUBLET/MISC. .
R/C=Recycle/Rechrome/Recore U=Used R=Rebuilt BODY PAINT FRAME MECH
1 I
2 l _
3 ll o (S
4 ail
5 'll
6Alzi VAC-7
7
8 - 11 O
9 ll
10 Ill
'11 I
12 II
13 II
14 )
15 ll
16 III
17 II
18 ill
19 II
20 ll
21 Il
`22 III
23
I
24 I)
25 ll
26 )
27
OLD PARTS WILL BE DISCARDED UNLESS OTHERWISE INSTRUCTED TOTALS b
SOMETIMES AFTER THE WORK HAS BEEN STARTED,ADDI ZONALLY DAMAGED OR WORN PARTS ARE DISCOVERED
WHICH WERE NOT EVIDENT ON FIRST INSPECTION.THIS DAMAGE REPORT DOES NOT COVER OR INCLUDE ANY ADDI- L BODhrs.
TIONAL PARTS OR LABOR WHICH MAY BE REQUIRED.ALLIIPARTS PRICES ARE SUBJECT TO INVOICE.
A PAINT- hrs.
I hereby authorize the above work and acknowledge receipt of copy. 0
FRAME hrs.@
Signed X I Date R MECH hrs.@
1MPARTS Prices subject to invoice
11 SUBLET/MISCELLANEOUS -
BEST AUTO BODY & PAINT Paint Supplies—hrs.@ ^
III Body Supplies—hrs.@
1932 Arnold Industrial Place Towing/Storage
EPA/ Charge
Concord, California 94520
Phone (51. )l 825-1518
( )'1825-1519 Sub TOTAL ..............
510
FAX #
TA) %-on$—
WRITTEN BY 70TAL
'�I @1988 I/D/E/A inc. Form No.1023 I/D/E/A inc.,One I/D/E/A Way,Caldwell,ID 83605-6900 o CALL TOLL FREE 1-800-635-9261 -
P 7
E?, A Ra L.I C,'E 1�.1 E I1[*) A�A 12
WE REF"'ATIR AL.L. JlAl,,:'ES ','I, III[I J)E L.S
1260 Diaminncl 'Way
['cinc.-crcJ,, CA.-94-5'w2()
V 1,
S. U 4111A I A')�,'u dlrulim C.';# ime Ell 4-t 0 t, zim.t 1 c3l u h 44n.1, IP:,"?"T.,5 b Tf:)M
17,-'r
i lu IN
J C; 8 t.v 1. 11, 11'
4
Adj S."'.
i::, TT i f :;:f:t'
Pztirvt
Prrid, Dziteu C,I a i in 4t f)-L
C RID 1,C)F11 F�,a t m c:C)d S Pi t-11 11.)S,.t r- d
VIN.: `:V'i:�:1 5-24.
M J.I e a 9 e A (3,
# Labor Op Descrigtion pries LAhpf Paint LAhu EfEu E F i E&k&j__
A T'.I
I RMY!PEP YEAR BUMPER !EXCHANSE' 2.0* �:�
NE-1
2 RMVIREP '224 REAR RUMOPER GUARDS I,_, -I n
0 0!1 N E 111
Z RMV!REP REAR BODY LOWER PANEL 85.'•''1=1 i%*!t 1.51 BODY NEE'!
4 REPAIR FRAME 0.00 1 t I",:! B 15 1)V
R CE FL 9 01 R 01 1 iris
f:,o , CI A
GAS CAP clit s1 0 PODY IiE
7 RMY!RErP REAR Lir. DZETT,
E4
...............
...............................•............. ........................................................................""........•.•",.".........,."..................................,..,."..,.",......,...•...•........."...,„w,,..,...::,".".....................
B 0 Y @
I PIE 1,11 T
.7 0-E)0, P A I N T M A I E R VA L!S T
REFINISH 1,5:@ 510.,fm)
r
.......... .................................................................. ....................
i I JID (N I
7 C',
I)v 11";IV
............. ................................ ................................
C.5 r D-11 co I"c.T t 4:44 31' 151.1
ltttt Parts P,ices Subject to luo;ce ttt t t S j Er N 1 F 1 E S F ES T 114 A T-3 RE J;U D f F M E N T
D A
A U T H C1 R I ZLELD AN' MCCEPTE11- Y-,,! are heretiv A!thori-ed tc make the abcve c5pecifled repairs. 11 understa-d {hat pavmsn- in f�.,ll will be
I � u -_:I i 11 1
due oprn release cf -vehicle, juluding ad itional 5opplemental damage fhUg_es, and grant you 2nd.1v your erjp1j.-,2Ps.,
cp: -,o h-
perTission 4o c -Fate the caF, tr:,Ek, or vehicle herein described �n ctreets, high;-,ays, ,lr �15ewher,. fu �h�e P�:FF-se o_ -st rm
Uuck, u vehicle '10 se'rure the amount r.-f
and/or inspurticn,. An express s is heFeb--J.; acknowledged en the abc-'e :-ar, T1 "
repairs thuetn. You ;vill not be held responsible for loss or damar,2 to th'- _-ThiCle Or art;Z!,05 left in in Case 04 fir413
theft, ;7cid2nt or any other cause beyond your control.
OLP PARTS REMOVED FROM CAR WILL DIE jU UNLESS 19THERHISE T NSrDTRUCTE
I - . u,
----------------------------------------- -----------------------------------------------------------------------------7------------
A
Authorized by ......................
------——---------- ------------
T
yo:j for C2fflin
,g tC SUN YA
hanl� ALLEY PODY SHOP' We -�PPreciztle y o;1 r b u s i P,e s
11
6�
C1
r
ld
s.
x~'
o
i
IA
CLAIM
�PR 3 19(3' BOARID OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Claim Vgainst the ugyft�jUoWistrict governed by) BOARD ACTION
the Board of Sup 5,OMNing Endorsements, ) NOTICE TO CLAIMANT April 28, 1992
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: $80,000.00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: DeBUONO, Carrie Francis
ATTORNEY: Michael Peter Semansky
Semansky Law Firm Date received
ADDRESS: 535 Main Street, Third Floor BY DELIVERY TO CLERK ON April 3, 1992
Martinez, CA 94553
BY MAIL POSTMARKED: Hand delivered
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: Apri 1 3, 1992 1 JAIL BAATTCYELOR, Clerk
epu11. FROM: County Counsel TO: Clerk of the Board of Supervisors
I
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).
�I
( ) 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: q � BY: ) Deputy County Counsel
--r
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).
1V. BOARD ORDER: By unanimous vote of the Supervisors present
( V)( This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.®
Dated: Mr $ 192 PHIL BATCHELOR, Clerk, By JA 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: , R 1992 BY: PHIL BATCHELOR by u Deputy Clerk
CC: County Counsel County Administrator
` .C]aimrto: HOARD OF SOPS fISORS OF CONTRA COSTA COUNTY
IIaTRUCTTONS To CLAimpm
A.; yClaims 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 notllater 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 aifter the accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed ,�rith 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 again Ist 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
orm.
RE: Claim By ) Res ved f erk's iling stamp
CARRIE FRANCIS DeBU0N0 �r !
II E �� D
Against the County of Contra Costa )
or ) APR 31992
g;o� �:
District) CLERK BOARD OF SUPERVISORS
Fill in name II 1 CONTRA COSTA CO.
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ 80,060.00 and in support of
this claim represents as:follows:
1. When did the damage or injury occur? (Give exact date and hour)
October 16, 1991 at 2:30 p.m.
2. Where did the damage+or injury occur? (Include city and county)
Crockett Community Playground - Crockett —Contra Costa County
II
3. How did the damage or injury occur? (Give full details; use extra paper if�N
required) Claimant was swinging at Crockett Community Playground and the
swing gave way causing claimant to fall abruptly to 'the ground.
4. What particular act or omission on the part of county or district officers,
servants or employees caused the injury or damage?
Failure to maintain playground equipment in a safe and operable condition,
defective and dangerous condition of public property to wit:
playground swing.
I
(over)
P
II
5. What are the names of county or district officers, servants or employees causing
the damage or injury?l Unknown at present.
�I
jl
------------------- -----------------------------------------------------
6. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage. Injury to right hip,
right shoulder and right side of head. Claimant has a right torn rotator
cuff which requires slurgery. Surgery is scheduled for March 24, 1992.
7. How was the amount ciaimed above computed? (Include the estimated amount of any
prospective injury or damage.)
Medical to date - $5,000 approximately and continuing
Wage Loss to date - $2,000 and continuing
8. Names and addresses of witnesses, doctors and hospitals. -
Margaret Lopez Faria ' Linda Niles Elizabeth McKinney
c/o Crockett Community Center 16401 San Pablo Avenue, Sp. 347
850 Pomona Avenue, PO. Box 374 San Pablo, CA 94806
Crockett, CA 94525 Rodeo, CA
---------------------- ---------------------------------------------------
9. List the expenditures .you made on account of this accident or injury:
DATE ITEM AMOUNT
Dr. R. Snyder
Contra Costa Health Clinic $2,000 and continuing
11/25/91 ?Joseph A. Matan, M.D.
04/92 Surgery,(pending hospital) Unknown
Gov. Code Sec. 910.2 provides:
IfThe clAim must'be signed by the claimant
SEND NOTICES TO: (Attorre ) or b om o on-his behalf
Name and Address of Attorney
MICHAEL PETER SEMANSKY
SEMANSKY LAW FIRM I Claimant's ig' na e
535 Main Street, Third Floor MICHAEL PETER SEMANSKY
Martinez, CA 94553 535 Main Street, 3rd Floor
Address
Martinez, CA 94553 ,
Telephone No.
p (510) 372-8766 Telephone No.(510) 372-8766
V V V V V V V
11
NOTICE
Section 72 of the Penal .i Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
rs:. APR 3199
Claim Against the County, orajstrillct governed by) BOARD ACTION
the Board of SuperfO,ng Endorsements, ) NOTICE TO CLAIMANT April 28, 1992
and Board Action. ection 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: DE CROOY, Roberti E.
ATTORNEY: Michael A. King
Attorney at Law Date received
ADDRESS: 3675 Mt. Diablo �iBlvd. BY DELIVERY TO CLERK ON April 1 , 1992
Suite 200 Hand delivered
P.O. Box 367 BY MAIL POSTMARKED:
Lafayette, CA 194549
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: April 2, 1992 PpHHIL BATCHELOR, Clerk
BY: Deputy
a444
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
i
This claim complies subsitantially with Sections 910 and 910.2.
( ) This claim FAILS to comp i�y 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
11
warning of claimant's right to apply for leave to present,a late claim (Section 911.3).
( ) Other:
II�
' I
Dated: /3 l�2 BY:_ `' - Deputy County Counsel
III
�I
III. FROM: Clerk of the Board 11 TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD DER: By uinanimous vote of the Supervisors present
( ) This Claim is rejected lin full.
( ) Other:
i
E
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
p I
Dated: ��R 2 8 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk
if
I
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.
f�
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 alcertified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated: R 2 8 1992• BY: PHIL BATCHELOR by CL. RJ A.J ° Deputy Clerk
CC: County Counsel County Administrator
ii
o
MICHAEL A. KING
Attorney at Lazy
3675 Mt. Diablo Blvd. , Suite 200
Lafayette, California 94549
M a 1 1 1 n 9 A d d r e s s
T e l e p h o n e
P 0 B o x 3 6 7
( 5 1 0 2 8 4—5 1 8 0 l a f a v e t t e . C A 9 4 5 4 9—0 3 6 7
April 1, 1992 RECEIVED
r I
APR 1 1992
HAND-DELIVERED CLERK BOARD-OF—SUPERVISORS
CONTRA COSTA CO.
i
Board of Supervisors
Contra Costa County
651 Pine Street
Martinez, CA 94553
RE: Government Claim (Govt. Code §910)
CLAIMANT: Robert ' E. de Crooy, 155 Kingswood Circle,
Danville, CA 94526
NOTICE ADDRESS: Michael A. King, Attorney at Law, 3675 Mt.
Diablo Blvd. , Suite 200, P.O. Box 367, Lafayette, CA 94549
DATE AND CIRCUMSTANCES: 10-3-91; Center Street between Crow
Canyon and Tassajara Ranch, Danville, California. Defective and
dangerous condition in street design, paving, and maintenance,
directly caused serious personal injury to claimant.
INJURY AND DAMAGES Fractured ankle and significant soft
tissue injuries resulting in medical specials, wage loss, pain
and suffering and" other damages according to proof.
PUBLIC EMPLOYEE CAUSING INJURY: Names unknown, but Building
Department, Public Works, Street Maintenance Department, or
other similarly placed employees.
AMOUNT CLAIMED: In excess of jurisdictional limits of the
Superior Court, State of California.
DATED: April 1, 1992
i
r
MI A A. KING
AT ORNEY FOR CLAIMANT
ROBERT E—de CROOY
^ O O
a
y � H
?� �0 O
O
!D n h
N ro 0
N
� yOo
-s
P roro5
ul LA
0
Ln
` CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA
Cla�fAgai,nst the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT April 28, 1992
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: $1169 . 11 Section 913 and 915.4. Please note all "Warnings".
i
CLAIMANT:FOLTZ, William ,° ��I �
I
ATTORNEY: APR 81992
Date received rr,,
ADDRESS: 4892 Stoneridge Court BY DELIVERY TO �TbWU"ril 7, 1992
Nom' �iR
Fairfield, CA 94585
BY MAIL POSTMARKED:
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: April 8, 1992 JVIL BAATputyLOR, Clerk
i
II. FROM: County Counsel i 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).
I
'I
( ) 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).
I
( ) Other:
Dated: 4 q 2 ; BY: Ir'�t 5� Deputy County Counsel
I
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).
i
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.
I
Dated: r'"PR 2 8 1992 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: APR 2 8 1992 i BY: PHIL BATCHELOR by Deputy Clerk
A. P y
P.s..
CC: County Counsel County Administrator
Clair,: to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
L
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.)
�I
B. Claims must be filed with the Clerk of the Board of Supervisors at its office. in
Room 106; Countq Administretion Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against,,a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be_ ,
filed against each public entity.
E. Fraud. See penalty, for fraudulent claims, Penal. Code Sec. 72 at -the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
1f
l��//�c�m �-�! Fri Z- ) • , ...:RECEIVED
4o " �
C 29'8 7U
Against he t of Contra Costa ) OR - 7 1
or JI )
District) CLERK BOARD OF SUPERVISORS
Fill in name ) CONTRA COSTA CO.
�' -
The undersigned-claimant, hereby makes claim against the County of Contra Costa or
the above-named District in the sum of 4Z69,11 and in support of
this claim represents% s follows:
1. When did the damage or injury occur? (Give exact date and hour)
i
7/q 2 0; Ss' 1�aurS
N-eeea-_e__eeNe-NeNe_--_e-e--------_--N_-e-Ni_----e----
2. Where did,,the ,damage or_i ury,00eur? (Innludo city and ��ur�t
�JB,Qc ,cam M`�o�u. �c�L ty Go �ar� caerk f��D
--AOW Gua" 15)7t" clas-Tom
Nee_-_----N---e--
3. How did the geior injury occur? (Give full details; use extra paper if
required) TP�ee cuas 8 4 c'47f /1b t k IC yelle J 6e rcjep,) ?2u>o •neles
gtin tea- _ w��r o&t,s>� a.�cy c`cw/// )ut- -Ae llghf
��y �itiry the: ',v�ngfer avd he aN&.off -144 ��vn-►�f�.s of o M,?Cc9�4-
4. What particular acct or omission on the part of county or district officers,
servants or .employees caused the injury or damage?
4C t: -Selo&ra i✓y 3�vo 4 j//nd*T AUr«v &ACA
i
���. I�oC�O aao o�✓� v�' melte: ��fP,� :^de:Jt��.. �
EW rn
(over)
1
what are the names of county or district officers servants or employees causing ., .
the damage or injury? `, f � J '�'ORW
'
-----------------------..__-___--------__M-_______--- __________________-____
5. 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.)eas';�jrt? - c57n 4G1/oe� -
—-------
----
B. Names and addresses of witnesses, doctors and hospitals.
J
__.�_______—__—___ -----
List
__ .List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
} tl1Er
Isr
M* # # 16 Y;;l !F �t iE #. iF iF # i� �4 W 0
a Gov. Code Sec. 910:2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: '(Attorney) __ or b some e on on'his.behalf,"
Name and Address of Attorney
Claimant's Signatur
Address)
Telephone No. Telephone NC70 7 CY+
d •.t .<: aw,. ; NT y7
'q
Section 72 of the Penal Code provides:
Every`"ers'on`who,,,Ywith`'rintent to defraud, presents�'for'allowance or for
-payment tany,;-state?board+or,. officer, -or to'"any;county,` city or``district ' or
officer, authorized tol allow or pay the same,-if .genuine', any fa2.se�'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)1, or by both such imprisonment and fine, or by imprisonment in
the state,prison',�'by�-a; f`he"of`riat exceeding ten .thousand dollars ($10,000, or- by
both such. imprisgnmentz,4nnd. fine. NV- • 'v` -
Estimate-Report, F
y_
NAME LJ / r II/ /// � -DATE /Z BUS.PHONE N O 00240
..
G/9 z/2 Sri �j 7L�^ ,_ 5 �''
ADDRESS �/P CITY' `�'�r��/� STATE �� ZIP�•` ��'S PHONE s?���
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-
No. pair place DESCRIPTION OF DAMAGE PARTS LABOR PAINT SUBLET
2 j �-7 c 5 (3100 b 3
4 . .
5 $0 i 2
�I
6
7 �S vtr /cj �Z6q O
I�
8
,i
9
I'
10 J
11
12 G
13
14
15
16
17 �I
18
J19
20
TOTALS c7
it
I hereby authorize the above work and acknowledge receipt of copy signed X.
O
MARK CU,3ACK PARTS Prices subject to invoice $ `� 3
OWNER B.Labor J. j'"hrs.@ y� $ sy
R Labor �.9 hrs.@ Y o`?� $
Materials _/S'S. -
Towing/Storage $
Sublet/Miscellaneous $
od SUB TOTAL $
M&T AUTOBODY&PAINT, INC. db/d Tax $
FOR ESTIMATE CALL(510)685-2294 FAX(510)685-7295 TOTAL ESTIMATE
2291-M VIA DE MERCADOS,CONCORD,CA 94520
4z
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 April 28, 1992
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: Approx. $350.00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: MUKES, Charles M.
APR 91992
ATTORNEY:
Date received COUNTY COUNSEL
ADDRESS: 2045 Sutter Street Apt. 101—A BY DELIVERY TO CLERK ONApril 9-, JAAI�EZ, CALIF.
San Francisco, CA 94115 Hand delivered via.Risk Mgmt.
BY MAIL POSTMARKED:
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of thi above-noted claim.
DATED: April 9, 1992 PpHHIL BATCHELOR, Clerk
BY: Deputy
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 compily substantially with Sections 910 and 910.2, and we are so -notifying
claimant. The Board cannot act for 15 days (Section 910.8).
j
( ) 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:
i
i
f
{
Dated: 106z BY: A Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
(✓ ) This Claim is rejected in full.
i
( ) Other:
I
i
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date.
i 1 0
n� q ,�
Dated: A'« R 2 ` PHIL BATCHELOR, Clerk, By ° Deputy Clerk
i
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 ajcertified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
Dated: R R �qq� BY: PHIL BATCHELOR byQc Deputy Clerk
CC: County Counsel County Administrator
i
i
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Charles M. Mukes
2045 Sutter Street Apt. 101-A
San Francisco, CA 94115
Re: Claim of Charles Mukes
Please Take Notice As Follows :
The claim you presented against the County of Contra Costa or District
governed by the Bbard 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.
XX 3 . The claim fails to state the date, place or other
. circumstances of the occurrence or transaction which gave
rise tolthe claim asserted.
XX 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
over the claim would rest in municipal or superior court.
XX 6 . The claim is not signed by the claimant or by some person on
his behalf .
7 . Other:
VICTOR J.� TMAN,. County Counsel
Y
B : 5-
_
Deputy unty Couns
CERTIFICATE OF SERVICE BY MAIL
C.C.P. SS 1012, 1013a, 2015 .5; Evid. C. 99 641, 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: D' q , at Martinez, California.
cc: Clerk of the Board cf Supervisors (ori i al)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 .41 910 . 8)
s � a
Sheriff-Coroner • Richard K.Rainey
'Conga Costa County SHERIFF-CORONER
Warren E.Rupf
3pl1 Willow Pass Road Assistant Sheriff
Concord,California 94519 Gerald T.Mitosinka
(415)646- 4672 Assistant Sheriff
Rodger L.Davis
Assistant Sheriff
To: Ron Harvey Date: April 1 , 1992
Liability Claims Officer
From: Subject:
Chief Deputy L. Ard � � Lost Property
Wm. Shinn, Captain
Ry Mike Rutledap
Director of Support Services
In accordance with Detention ,% Fac lity, Regulatwion 2-6 of 11/1/90, I am
forwarding Charles aM :"Makes ' " lost°",property," claim with supporting
. �.
information. Based 'onmy� researcli,.�I consider; the claim to be:
!_! valid cl,a m-W ich- should-'be paid. in full
!A valid claim which `"should.,receivepartial "payment ( see
'comments
4 °
!_1 invalid claim for `some reason ,(-see `,comments)
Comments . "Loss ; directlY. related �to "released` inmat�e Larry Dorrough as
documented by Incident Report ""x#92=1252d ',; Since the claim
value` will apparently ?exc`eed $250. 00;` ,recommend Risk
Management ,c°oducTt further research .to�-determine ultimate
County �,labi_1°ity, if" any.
_ . RECEIVED",
y
APR 91992
t� f
CLERK BOARD OF SUPERVISORS
As CONTRA COSTA CO.
AN EQUAL OPPORTUNITY EMPLOYER
1.
' Contra Costa County Detention Facilities
INMATE REQUEST FOR PERSONAL PROPERTY REIMBURSEMENT
C4;MCDF MDF ❑ WCDF ❑ WFF
THIS SECTION IS TO BE COMPLETED BY INMATE/CLAIMANT: :
NAME:
ADDRESS:
TELEPHONE: (HOME) f`f 1- S� T (WORK) N d,!
How did the loss �,or damage occur?
DESCRIPTION OF LAST OR DAMAGED PROPERTY:
Item (Describe fully) Original Purchase Price` and
Date of Purchase
f 7-
.41 Al
Sip(,
Wow
4
t MAW-t ,
Distribution: Original-Director of Support Services
Yellow -inmate
DET 071:FRM Rev. 2/22/91
yr •
ZNM - �` RSONAI, PROPERTY REIMBURESEMENT Page 2
( /J This request for reimbursement is approved by authority of
California 'Government Code ' Section #26640 and Detention
Division Policy Chapter #2-6' for the following reasons.
k�U,14 C41
_.S ado no e ind approval -of -tbi-s zequest because it does
• .,:.-not meet. the criteria for reimbursement outlined in the above
cited authority _and policy for the following reasons.
[ I authorize payment to t e Inmate/Claimant in the amount of
„.� S.do not .auth, J ze ayment.
f �� j/ if l f/
Signature Date
' k
n0
_ m
w �` 2N
0
tl 03
ho m
NN
T'm N
oc
c
U1
N
O
rs�
ri ui
n
Ul
.K4. 4
-p 2CP0
9b
6
s
s �
�Ef1V CLAIM /
OF SUPERVISORS OF CONTRA COSTA COUNTY,CALIFORNIA
Claih Against the CoA, or D8'SS��r tS t governed by) BOARD ACTION
the Board of Supervisor3quJ n 4 dorsements, ) NOTICE TO CLAIMANT April 28, 1992
and Board Action. All tion 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: In excess of approx. $26,000.00 Section 913 and 915.4. Please note all ."Warnings".
CLAIMANT: SMITH, Kimberly
ATTORNEY: Stanley T. Grydyk, ', Esq.
4006 Macdonald Avenue Date received
ADDRESS: Richmond, CA 94805 BY DELIVERY TO CLERK ON April 2, 1992
BY MAIL POSTMARKED: April 1, 1992
j CERT P 671 679 892
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
April 3, 1992 EpVHIL BATCHELOR, Clerk
DATED: BY: Deputy
qi
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: f 1 12 _ BY: IJ" S 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. o
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date. D Q '.
Dated: APR 8 1992 PHIL BATCHELOR, Clerk, By4L O 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: APR 2 8 1992 BY: PHIL BATCHELOR by Deputy Clerk
CC: County Counsel County Administrator
I
In the Matter of the Claim of
KIMBERLY A. SMITH, Claimant, RECEIVED 4
VS .
1992
BOARD OF SUPERVISORS , -CONTRA COSTA APR - -
COUNTY, and CONTRA COSTA COUNTY
DEPARTMENT OF AGRICULTURE, ANIMAL CLERK BOARD OF SUPERVISORS
CONTROL DIVISION CONTRA COSTA CO.
KIMBERLY A. SMITH hereby presents this claim to the Board
of Supervisors , Contra Costa County, and Contra Costa County Depart-
ment of Agriculture, Animal Control Division, pursuant to Section
910 of the California Government Code.
1 . The name and post-office address of KIMBERLY A. SMITH
is as follows : 2905 Hillsdale Drive, Pleasant Hill , CA 94523 .
2 . The post-office address to which KIMBERLY A. SMITH
desires notice of this . claim to be sent is as follows : Stanley
T. Grydyk , Esq. , 4006 Macdonald Avenue, Richmond , CA 94805 .
3 . On March 9 , 1992 , at Contra Costa Veterinary Emergency
Clinic, 1410 Monument Blvd . , Concord, California, claimant received
personal injuries under the following circumstances :
A Contra Costa County Animal Control truck delivered
an injured dog, about 70 pounds , to the Contra Costa Veterinary
Emergency Clinic and the lone driver of: the vehicle requested Claimant
to help carry the dog in a gurney into the veterinary clinic.
4 . The . dog bit the Claimant on her right wrist and right
fingers . The wound required stitches at the Mt . Diablo Medical
Center by Dr . Nourollah G. .Ghorbani of Walnut Creek . The wound
thereafter became infected and required further opening and restitching.
Attached is a copy of a report entitled "Interim Bite
Report" completed by an employee of the Animal Control Division
of the Contra Costa County Department of Agriculture and made a
part hereof . Claimant is informed and believes that there will
be a permanent injury involving loss of grip of the right hand and
permanent scar above the right thumb.
5 . The name of the employee who drove the vehicle is
unknown.
6 . KIMBERLY A. SMITH estimates that the medical costs
will be approximately $1 ,000 .00, pain and suffering is estimated
at $10 ,0.00.00, and prospective injuries and damages consisting of
loss of grip and scar are estimated as an additional $15 ,000 .00 ,
which total damages are in excess of approximately $26 ,000 .00 .
7 . The jurisdiction of this claim would rest in the Superior
Court of Contra Costa County, California.
Dated : April 1 , 1992 .
STANLEYT. GRYDYK,et;eorney
for KIMB RLY A. SMH
-2-
ra
b
d ,A
O0 ev
e. 0
CD N�
N (D O N
Ul
ul
1
1
i
r
4
/off
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 April 28, 1992
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $250,000.00 Section 913 and 915.4. Please note all "Warn.iwns".
CLAIMANT: VEGA, Martha the Heirs of APR 9 1 �
ATTORNEY: C/o John Diaz Coker COUNTY COUNSEL
Coker & Ramirez Date received A ri 1 MARTINEZ,
ALIF
ADDRESS: 525 Marina Boulevard BY DELIVERY TO CLERK ON p
Pittsburg, CA 94565
BY MAIL POSTMARKED: Unreadable
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: April 9, 1992 PpHHIL BATCHELOR, Clerk
p
BY: Deputy
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).
`i
( ) Other:
Dated: /to 2- BY: I✓�� �. � Deputy County Counsel
J
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
( VI This Claim is rejected in full.
( ) Other:
i
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date. �2 1
PR
Dated: 9'16 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 acertified copy of this Board Order and Notice to Claimant, addressed to
the claimant as shown above.
0
Dated:— APR 2 it 1992 BY: PHIL BATCHELOR b a Deputy Clerk
CC: County Counsel County Administrator
• COKER & RAMIREZ
ATTORNEYS-ABOGADOS
RECEIVEDER
AO RACEHN L RAMIREZ
RHONDA WILSON RICE
APR - 81992
CLERK BOARD OF SUPERVISORS
Clerk, Board of Supervisors CONTRA COSTA CO.
Contra Costa County
651 Pine Street
Martinez, CA 94553
April 7, 1992
RE: Request for Administrative Investigation
And Government Code Section 910 Claim
Dear Clerk,
Please retain the original of the above referenced document
and return the copy, marked with your receipt stamp, to our
office in the attached, self-addressed, stamped envelope.
Thank you.
Sincerely,
V U4_
Secret2
me
Enclosures
525 MARINA BOULEVARD • PITTSBURG, CALIFORNIA 94565 • (510)432-7373
448
9
REQUEST FOR ADMINISTRATIVE INVESTIGATION
AND GOVERNMENT CODE SECTION 910 CLAIM
Claimants are the heirs of Martha Vega, 88 Breaker Drive, West
Pittsburg, CA 94565.
Address to which Responses are to be sent: RECEIVED
Martha Vega, c/o John Diaz Coker APR - 81992
COKER & RAMIREZ
525 Marina Boulevard CLERK BOARD OF SUPERVISORS
Pittsburg, CA 94565 CONTRA COSTA CO.
Parties Responsible: Martha Vega did not know the names of the
employees responsible. She lived in the area within the
jurisdiction of the Sheriff of the County of Contra Costa at the
above address. The people who are complained of herein, seven or
more officers, wore county sheriff's uniforms and one officer
wore a blue uniform.
Date of Incident: Saturday, March 14, 1992.
Date of Death: . March 25, 1992.
Description of Events Complained of: On the above date,
Mrs. Vega received a telephone call where the caller identified
himself as police instructing her to walk out into the middle of
the street. Mrs. Vega was not dressed to go out of her house,
had a very serious foot infection which was especially dangerous
because she was a diabetic and was in danger of losing her foot.
She had surgery scheduled in the next week for her dangerous foot
condition. She did not want to go out of the house and told the
caller that she was not dressed. The caller ordered her to get
dressed immediately and come out.
When she went to the door she was confronted by three
officers. Two of them in sheriff's uniforms. They were holding
guns pointed at her. Mrs. Vega was a 64-year old woman who was
five feet tall and in poor health. These officers kept their
apparently loaded guns trained on her and ordered her to go out
of her house because they were looking for her son. She tried to
assure them that her son was not in the house, but they would not
listen. In fact, her son was not in the house. Mrs. Vega did
not want to go out onto the front lawn because she was not
supposed to get her foot dirty or wet. On that day it was
raining and she was not dressed to go out into the rain. Despite
the fact that it was raining and despite the fact that she was
complaining about the danger of getting the medical dressing on
her foot wet by going out, she was nevertheless ordered to go out
and stand in the grass, in the rain. She complained to the
officers because she was cold and shivering and they ignored her
complaints.
The officers went through her house, apparently looking for
her son. This went on for about two hours. Officers went
• i
r ,
through rooms, throwing clothes out of closets and drawers and'
leaving the clothes in disarray as they left. Nothing was put
back where they found it despite the fact that they were there
two hours without finding anyone.
Finally, they allowed her to reenter her house only after
Mrs. Vega's daughter arrived on the scene and reminded the
officers that Mrs. Vega was outside shivering and that she was in
very poor health. Thus, after two hours outside she was allowed
to reenter henhouse.
Mrs. Vega: had never had an incident where anyone had treated
her so disrespectfully in her life. She was terrified at the
guns pointed at her, the angry commands that were shouted at her,
the apparent disrespect for her as a person, the callousness to
her personal comfort and health during the apparent police
business. There were at least six police cars on the scene.
There were many officers and a helicopter. The notion that she
posed such a threat to the officers' safety that she had to be
left standing outside with her bandages in the rain in order to
protect the of is untenable and mean-spirited.
Injuries ;Suffered: This police behavior made her sick,
complicating her health care and surgery and contributing, to her
death on March 25, 1992 . In addition to the other consequences
mentioned above, Mrs. Vega had fear when she saw any uniformed
police officer. She felt less comfortable about her own house
and realized that she was a person of no consequence in the eyes
of the police and that she had no rights. She knew that this was
connected with'. her being a person .of Mexican-American ancestry as
well as her being a person who is poor and without social or
political connections in the area in which she lived. She felt
unequal with `other citizens and knew that the treatment she
received is evidence of that. She also knew that she was not
realistically entitled to protection by government officials
because she knew they saw her as unimportant and powerless.
Damages: As of this moment it is not known whether the
infection was ' made worse by the incident and how much the
incident contributed to her death. Thus, damages are requested
in the amount s, of $250, 000.00 for the above-described emotional
and physical conditions and death.
Request for Investigation: By this joint claim and request
for investigation I request that the officers' conduct in this
matter be investigated and that the appropriate personnel
complaint procedure be initiated. I request an opportunity to
speak with the', investigating officer.
Dated: April 6, 1992 .
1'
OHN DIAZ OKER
On Behalf of the Heirs of MARTHA VEGA
-o
�N o
nZ �
p 9
co
� G m
u�
a,
Ln
ON
Q ,
Ct td ti �
N N Q Q
00
i" (D0 Y h }
W ro