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HomeMy WebLinkAboutMINUTES - 04071992 - 1.41 AMENDED CLAIM I� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA RECEIVE® Claim 'Against the County, or District governed by) BOARD ACI%AIR 9 1992 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT April 7, 1� 2 and.'Board Action. All Section references are to ) The copy of this document mailed to you is your` 'wgQ ISEI MA TINEIIF. California Government Codes. ) the action taken on your claim by the Board of Supervi's EA (Paragraph IV below), given pursuant to Government Code Amount: $150,000.00 minimum Section 913 and 915.4. Please note all "Warnings". CLAIMANT: COLLINS, Bobbie and Adele ATTORNEY: Kim R. Mayor Law Offices of Jon-Marc Dobrin Date received ADDRESS: A Professional Corporation BY DELIVERY TO CLERK ON March 6, 1992 685 Market Street, #360 San Francisco, CA 94105 BY MAIL POSTMARKED. Unreadable I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: March 9, 1992 ' ��: Deputy (Imn L kz II1.. 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 q X1z BY: �- Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) CountyA ministrator (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. �f Dated: APR 0 7 199E PHIL BATCHELOR, Clerk, By d 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: AP R 0 6 ry1992 JZ BY: PHIL BATCHELOR by ° Deputy Clerk CC: County Counsel County Administrator LAW OFFICES OF JON-MARC DOBRIN A PROFESSIONAL CORPORATION SON-MARC DOBRIN 685 MARKET STREET, SUITE 360 LOS ANGELES OFFICE FRANK E. HAGIE, JR. 12400 WILSHIRE BOULEVARD. SUITE 400 LYNN S. SAMUELS SAN FRANCISCO, CALIFORNIA 94105 LOS ANGELES,CALIFORNIA 90025 ANTONIO A. CELAYA TELEPHONE (415) 512-0307 • (415) 956-7151 TELEPHONE(213)520-6511 EUGENE N. STUART III FAX (415) 512-0327 FAX(213)826-0840 DOUGLAS A. SHAW' PLEASE REPLY TO SAN FRANCISCO OFFICE *OF COUNSEL MECE8p ® March 5, 1992 - MAR - 61992 Clerk of the Board of Supervisors CLERK BOARD OFSUPERV Room 106 CONTRA COSTA CO. County Administration Building 651 Pine Street martinez, CA 94553 Re: Bobbie and Adele Collins 4241 Elario Drive, Concord, CA Amended Claim for damages against Contra Costa County Dear Sir or Madam: Enclosed is an original and two copies of an amended claim made against Contra Costa County by Adele and Bobbie Collins regarding damages at 4241 Elario Drive, Concord, CA. The original claim named Robert Collins instead of Bobbie Collins. Please return one copy marked received and/or filed in the enclosed self addressed envelope. We were informed by your office that there is no filing fee required. Please notify me if any further information is required and also notify me of any action by the Contra Costa County with respect to this claim. Very truly yours, LAW OFFICES OF JON-MARC DOBRIN A Professional Corporation Fy ` Kim R. Mayor KRM/tn L600001K.J14. A M E N D E D clam 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 for Clerk's filing stamp Bobbie- Collins and ) RECE1��/E_D Adele Collins ) . Against the County of Contra Costa ) MAR - 6 W2 or ) District) CLERK BOARD OF SUPERVIS Fill in name ) CONTRA COS Tq Co The undersigned claimant hereby makes claim against the County of Con Costa or the above-named District in the sum of $ 150,000.00 (m inimum)and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) May 19 , 1991 at 10 :00 a.m. 2. Where didthedamage or injury occur? (Include city and county) 4241 Elario Drive , Concord, CA. 3. How did the damage or injury occur? (Give full details; use extra paper If required) dere was water pipe leak as a result of a split pipe, which pipehad been improperly installed and intaineckhe water leaked for same 8 months before discovered, causing extensive damage.; the improper laying , repai taped up improperly and rii and installation of the pipe constituted a dangerous condition; actions _ at Ono _Xee I _�ropertX_owned by claimants +Iuisdnce . --- 4. What particular act or omission on the part of countyordistrict officers, servants or employees caused the IVu oho pr �yeg i Water pipe; failure to properl Installation of a cracked pipe; repair water pipe; failure to properly cover water pipe; failure to properly bed cracked pipe; and failure to properly install new pipe; inverse condemnation of real property (over) LfIc names of coi v or district officers, servant, r employees causing 't')e �arn3ge or inur '? Persons/ emplayjeesy/agents of county, who installed crackea pipes; persons/employees/ agents of county who repaired the pipe and failed to properly repair and install pipe. - ---.--------------------------------------------------------------------------------- 5. What damage or. injuries do you claim resulted? (Give full extent of iniuries or damages claimed. Attach two estimates for auto damage. In excess of$150 ,000-foundation and slab movement resulted in cracks to fo tion, wa1� sidewa s, <.:,� tant moisture it basement, rotting, cracks in driveway, ro Von, on house, split sf,.'-; rock, and a 'ncT----------------------------------- ------ ------------------__- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Foundation and slap movement and cracks in excess' Of $50 ,000 .00 Cracks in sidewalks , driveway and other concrete areas in excess of $50 ,000 .00 and moisture and water in basement and under house in excess of$50 ,000 .00 - - - -----r—.._ —---- --�----------------- --------------- _ 8. Names and addresses of witnesses, doctors and hospitals. Collins, 4241 Elario Drive, Concord, Ca. Adele Collins, 4241 Elario Drive, Concord, CA. --------------------------------—---—----------------------------- -- -- ---------------------------------------------------------- 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 Kim R. Mayor Law Offices of Jon-Marc Dcbrin LM OFFICES OF JON-MARC DOBRIN, A Professional Corporation laimant's signature 685 Market St. , #(360 San Francisco, CA 94105 Kim R. Mayor Attorney for Claimant Telephone No. (415) 512-0307 Telephone No. (415) 512-0307 * * 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. 7". C6 . §\ g � / Q cr vs 4-) LI) 44 (o Ln 0 Q 4-) 4-) CN ro ri) 0 Q) �4 Q) (a 41�4 CQ em 4-) �Z 4-; Q) 0 Q a % 0 0 LO % 0 cn CL > U ui Lo z z 0 2 LU cOD w cc V-u c LL PQ o z LU 0 0. to LO 0 tr 0 W po t.: u w u w 4 L—L u -<, w u 0 LL q z U) 0 2 w, u Y) < w a: z 2.L LO CO Z Ul CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA RoCEIVE® Claim Against the County, or District governed by) BOARD AMM ;) 1992 the' Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT April 7, and Board Action. All Section references are to ) The copy of this document mailed to you is you&OWELF. California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $150,000.00 (Minimum) Section 913 and 915.4. Please note all "Warnings". CLAIMANT: COLLINS, Robert and COLLINS, Adele ATTORNEY: Kim R. Mayor Law Offices of Jon-Marc Dobrin Date received ADDRESS: A Professional Corporation BY DELIVERY TO CLERK ON March 4, 1992 685 Market Street, #,360 San Francisco, CA 94104 BY MAIL POSTMARKED: March 3, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. March 5, 1992 ppHHIL BATCHELOR, Clerk DATED: 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). ( ) Other: Dated: 192 BY: 1 }�r, / 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: 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: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LAW OFFICES OF JON-MARC DOBRIN A PROFESSIONAL CORPORATION JON-MARC DOBRIN 685 MARKET STREET, SUITE 360 LOS ANGELES OFFICE FRANK E. HAGIE, JR. SAN FRANCISCO, CALIFORNIA 94105 12400 WILSHIRE BLVD., SUITE 400 EUGENE N. STUART III LOS ANGELES. CALIFORNIA 90025 KIM R. MAYOR TELEPHONE (415) 512-0307 • (415) 956-7151 TELEPHONE (310) 820-6511 DOUGLAS A. SHAW' FAX (415) 512-0327 FAX (310) 826-0840 "OF COUNSEL PLEASE REPLY TO SAN FRANCISCO OFFICE March 2 , 1992 Clerk of the Board of Supervisors RECEIVED Room 106 County Administration Building MAR - 41992 651 Pine Street martinez, CA 94553 CLERK 13 0 UPPRy Re: Robert and Adele Collins co 4241' Elario Drive, Concord, CA Claim for damages against Contra Costa County Dear Sir or Madam: Enclosed is an original and two copies of a claim made against Contra Costa County by Adele and Robert Collins regarding damages at 4241 Elario Drive, Concord, CA. Please return one copy marked received and/or filed in the enclosed self addressed envelope. We were informed by your office that there is no filing fee required. Please notify me if any further information is required and also notify me of any action by the Contra Costa County with respect to this claim. Very truly yours, LAW OFFICES OF JON-MARC DOBRIN A Professional Corporation 'e'- , —1p _. Kim R. Mayor KRM/tn cc: Mr. Robert Collins L600001 K.J 14. 01aim 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 musC. 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 Robert Collins and ) C C `p ED Adele Collins ) . Against the County of Contra Costa ) MAR - 4 1992 or ) District) CKgOAR0 PERM Fill in name5 CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra or the above-named District in the sum of $ 1.50,000.00 (minimum)and in support of this claim represents as follows: --- -------------------------- 1. When did the damage or injury occur? (Give exact date and hour) May 19 , 1991 at 10 :00 a.m. - - 2. Where did the damage or injury occur? (Include city and county) 4241 Elario Drive , Concord, CA- - -------——- A.------------ 3. How did the damage or injury occur? (Give full details; use extra paper ;f. required) There was water pipe leak as a result of a split pippee, whi&. .pipehhadobe n r some taped up improperly and improperly installed and. amintainec�he water leaakk ed 8 months before discovered, causing extensive damagQ.; the improper laying , repairing and installation of the pipe constituted a dangerous condition; actions � �t�of_� l�ropert -owned by claimants; and a _""Z'�'titZt�rteei-- mac -eye-.crzd __ ____________nuisance . 4. What particular act or omission on the part of county or district officers, servants or employees caused• the iinii o egli in Installation of a cracked pipe; fai n pprr l'�Y water pipe; failure to properly repair water pipe; failure to properly cover water pipe; failure to properly bed cracked pipe; and failure to properly install new pipe; inverse condemnation of real property (over) e,'lat,_ar•c -cne names of co or district officers, servant employees causing t1,e .-damage or in ur � A `.Persons/ employj :e /agents of county, who installed crack pipes; persons/employees/ . agents of county who repaired the pipe and failed to properly repair and install pipe. 5. What damage orinjuriesdo you claim resulted? (Give full extent of iriiuries or damages claimed. Attach two estimates for auto damage. In excess of$150',0'00-foundation and slab movement resulted in cracks .to fo t.on, walk, sidewalks, c.., tantt moistdure in basement, rotting, cracks in driveway, ro _Liding on Buse, sp it sYiee ro , an __ crack?na---------------------------------------------�...._----------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Foundation' and slap' movernerit. and cracks `in.: excess of. ,000 .00 Cracks in sidewalks , driveway=-and other concrete areas in excess of $50,000 .00 and moisture and water in basement and under house in excess of$50 ,000 .00.. . ;- --��..��__-_. ------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. Rcabert Collins, 4241 Elario Drive, Concord, Ca. Adele Collins, 4241 Elario Drive, Concord: CA. -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 Kim R. Mayor Law offices of Jon-Marc Dcbrin 1,41 OFFICES OF JON-MARC DCBRIN, Claimant's Signature A Professional Corporation ��/% 685 Market St. , #360 ' San Francisco, CA 94105 i Kim R.. Mayor . Attorney for Claimant Telephone No. (415) 512-0307 Telephone No. (415) 512-0307 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. � / §! ) � \ \ � � V4 / \ r-k cA VII CG 0 CD .,A A -rA �d rA A-) 00 C%4 LU M 9L LU k\ m LU <P 0 0Z cc 0 0 0 0 0 0 / A . o V- u 0 CLAIM R�16 LVID � z / BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MAR 4 1992 Claim Against the County, or District governed by) BO44Qj.A J WN EL the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Apr WARYigt` tlF. 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: TO exceed $10,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: DYER, Eleanor C. ATTORNEY: Seymour M. Rose, Esq. 1655 North Main Street, #260 Date received ADDRESS: Walnut Creek, CA 94596 BY DELIVERY TO CLERK ON March 3, 1992 BY MAIL POSTMARKED: March 2, 1992 Certified P 708 411 510 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. March 4, 1992 &pHHIL BATCHELOR, Clerk \ DATED: BY: Deputy 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ) This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 3��j /�Z BY: Deputy County Counsel I11. 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. rI Dated: APR + PHIL BATCHELOR, Clerk, By ODeputy 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 Noti to Claimant, addressed to the claimant as shown above. CL Dated: APR 0 7 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator LAW OFFICES OF SEYMOUR M. ROSE 1655 NORTH MAIN STREET, SUITE 260 WALNUT CREEK, CA 94596 FAX 415/930-0759 415/930-7707 SEYMOUR M. ROSE DANIEL A. PORTILLO Certified Family Law Specialist r! � DATE:. 3/2/92 3 1992 #r TRANSMITTAL fRK g TRANSMITTAL MEMO C 01VJRAOF$OpFRvf COSTq CO �r TO: Contra Costa County SUBJECT: Dyer v County of Contra Costa ENCLOSURE(S) : Claim (2) REOUESTED ACTION: For processing and return of the second copy dated received by County of Contra Costa THANK YOU, CAROL RUSSELL, Secretary Oakland Office 415/763-1780 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 ?Orm. BE: Claim By ) Reserved for Clerk's filing stamp ELEANOR C. DYER ) i RECEIVED ) Against the County of Contra Costa ) - 3 or ) CLERK BOARD 0 UPERVI District) CONTRA COSTA CO y Fill in name ) The.undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ To exceed $10 ,000 .fifid in support of this claimrepresents as follows:!This ma er7. a s in e jurisdictiom of the -----5UTIE U -C-Q1J1=--------- 1. When did the damage or injury occur? (Give exact date and hour) On December 14 , 1991 at approximately 9 : 30 a.m. 2. Where did the damage or injury occur? (Include city and county) N 888 Castle Rock Road, Walnut Creek, CA -- —-------- 3. -3. How did the damage or injury occur? (Give full details; use extra paper if required) See attached Exhibit "A 4. What particular act or omission on the part of county or district officers, N servants or employees caused the injury or damage? See attached Exhibit "A" . (over) 5. What are the names of county or district officers, servants or employees causing -, the damage or injury? DEPUTY MICHAEL DAHLSTROM, CO:`TTRz, COSTA COUNTY SHERIFF ' S DEPARTMENI,* (Warking Linder contract for the City of Sari Ramon 'Police Ser,;-ices) ------------------------------------------------------------------------------------ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. See attached- Exhibit "A" ------------------------------------------------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) S�e attached Ex'lib it -------------------------------------------------------------------------------------- 8. Names and addresses of.witnesses, doctors and hospitals. Dennis Cote 2123 Oak Grove Rd. , Su:it:e 110 Walnut Cree':, Cts Richard Milstier 2125 Oak Greve Rd. , Suite 110 Walnut Creek , "A Robert J. Ramia 88E Castle Rock Rc . , Walnut Creek , CA -----------------------------------------•-------------------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gee attached E.x6ibit "A" Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by so a person_pn his behalf." Name and Address of Attorney Attorney .'.or SEYMOUR M. ROSE , ESQ W Clgt�ls_=.Siamiture) Cltaimant . 1655 North Main St. , #260 . . Walnut Creek, CA 94596 888 Castle Rock Rd. . Address Walnut c,re� , Telephone No. 510/930-7707 Telephone No. 51.0/% 34- 2287 !F * * * * * V V V 4 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. ATTACHMENT TO CLAIM AGAINST COUNTY OF CONTA COSTA EXHIBIT "A" On December 14, 1991 at approximately 9: 30 a.m. Deputy Michael Dahlstrom, Contra Costa County Sheriff's Department working under contract for the San Ramon Police Services and Dennis Cote went to Claimant, Eleanor Dyer's home located at 888 Castle Rock Road, Walnut Creek, California. Claimant's son Robert J. Ramia went to the front door to see who was calling. Deputy Dahlstrom displayed his Sheriff's badge and indicated he was there on police business. He asked for Claimant, Eleanor Dyer. Mr. Ramia called for his mother who came to the door to respond to Deputy Dahlstrom. Upon claimant's coming to the front door Deputy Dahlstrom again displayed his badge and explained to claimant he was there on police business. He then told claimant he and Mr. Cote were there to take claimant's automobile, a 1991 BMW, license no. 2XEZ466. Deputy Dahlstrom stated to claimant that the car had been sold and they were there to "take it. " Both Deputy Dahlstrom and Mr. Cote indicated that they were working for Richard Milsner. Deputy Dahlstrom under color or authority ordered claimant to give him the keys to the automobile and to remove her personal property from the vehicle. Claimant complied to the officer's demand. At all times herein mentioned claimant was entitled to the use and possession of said automobile and has an equitable interest in said vehicle. At all times mentioned herein Michael Dahlstrom was employed by the Contra Costa Sheriff Department and worked under contract for the City of San Ramon in the San Ramon Police Services. Attached hereto as Exhibit "B" and incorporated herein is a letter to claimant from Ovid C. Holmes, of the San Ramon Police Services, Chief of Police, wherein he confirmed that "Deputy Dahlstrom did violate police department procedures with inappropriate use of his authority during off duty time". DAMAGES Claimant, ELEANOR DYER, has suffered the following damages as a result of the unlawful conduct of Deputy Michael Dahlstrom, acting under the authority of the City of San Ramon Police Services. 1. Loss of use of claimant's automobile. 2 . Loss of personal property contained n the automobile and not returned. 3 . Loss of claimant's equitable interests in the subject automobile. 4. Severe and extreme emotional distress including fright, coercion, trauma and anxiety. 5. Future medical damages to be assessed according to proof. 6. Exemplary damages. 7. Alternate transportation expenses. 8. Other damages according to proof. Said claim for damages exceeds the jurisdictional limits of the Municipal Court and are subject to the jurisdiction of the Superior Court. r, cri ior v� e OLUrs tt ct:V LU ta O n M tit LO d' q� ON C2 0 0 4 © O Q 1 +n E., t a W � ia)�"„ tU .r e ,I�EU•�,� ww � ZO W cd . r- r1. s 'W n, .l s w-+ r l� in t� CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA 3, MA BOR� ACT��-2 Claim ,gainst the County, or District governed by) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT ' and Board Action. All Section references are to ) The copy of this document mailed to VI�o�tice 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: GRIFFEY, Patty ATTORNEY: Date received ADDRESS: 136 Figtree Lane A-1 BY DELIVERY TO CLERK ON March 2, 1992 Martinez, CA 94553 BY MAIL POSTMARKED: February 28, 1992 Certified P 865 135 004 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. March 4, 19.92 PpHHIL BATCHELOR, Clerk La DATED: BY: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors ""IN- ) 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: 31/ 1/� 52- - BY: � 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). 1V. 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. A. Dated: APR 0 7 1992 PHIL BATCHELOR, Clerk, Byza�4 - 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 1 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 pas shown above. Dated: R BY: PHIL BATCHELOR by a Deputy Clerk CC: County Counsel County Administrator y qy � � t Kai, Alp u f Al ,, 644 OA G rn dz 9 •� � nnmw... tet.}as.�ri�a.u. it SKS S 11, II rr�� I 1-3 i� it 3 I � jl I� I� i - 'i 'I II 'I h _ _ i i �I LAJ CQ LIJ z LLJ p t "t V) Ul CS r r, Yq 4 J no t `l i' r^ i V i W } CLAIM RECEIVED BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA y" C1a;J.Ayainst the County, or District governed by) BOAROMfA�RR ACTIO� 1992 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT April 7oQ�92couNsEL and Board Action. All Section references are to ) The copy of this document mailed to you is RITINUiCALW California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $3,215.93 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: JOSEPH, Lynda ATTORNEY: Date received ADDRESS: 1387 Karen Road BY DELIVERY TO CLERK ON March 5. 1992 San Pablo, CA 94806 March 4, 1992 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk Lo DATED: March 5, 1992 �d: Deputy 1I. 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 A /fZ BY: S , �' Deputy County Counsel II1. 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. 0 Dated: APR 0 71992 PHIL BATCHELOR, Clerk, By CLDeputy 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 ithe claimant as shown above. APR 07 1992 Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator Claim -to: BOARD OF SUPERVISORS OF CONTRA =A 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 a r ' 5. What are the names of county or district officers, servants or employees caaising• the damage or injury? L•'61use TO GtVc /N� iDE,vzI��-y%�✓ %f{z�!Sc�v",�I, o�GY I- Td S'.r, C71e p-9Y 'HirdG /3c YPIJ-PZ-C-O 7?167--6 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. PA-m6 c Oanve 7-rr 647 aOoR S, �ocKs 5%✓i9TGlf OF�� C�rEs 6.d"PLE7-6::-�y• � sd•��t� �sc��.��el ti�S i . i � i i I i i i ; i l ; i i , � i li ii i I � i i I , ii II it it i ij i � II iiI I ij I I it . i . i I it li � I ' i ij it i I I ; I I i i � I I I i � ; I i i � i i i ii i I i ii i ! I : i � I I i ii li it li I, i it i i . i i 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 for Clerk's filing stamp L_�(AJ 0 A J osep RECEIVED - Against the County of Contra Costa > - 5 X992 or ) District) CLERK BOARD OF SUPERVI CONTRA COSTA CO. Fill in name ) , The undersigned claimant hereby makes claim against t County of Co ra Costa or the above-named District in the sum of $ /2; and in support of this claim represents as follows: -------------------------------------------------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) /-7 � � 9,'�S-i°n'' ---------------------------- --- ..------------------------------------------ 2. Where did the damage or injury occur? Unclude city and county) .3 9 7 r,-4 A-V �.jf� PA-6 L.6 C BON"I Rte-- Cd y 7,f- C_c�,_v i 3. How did the damage or injury occur? (Give full details; use extra paper ifN required) s L`2✓EO o "J ,��.�.,,� rsc-5 I VrgC°�Mr !- r TOC 7fOA C-) ;'& 916- 371/.3Vd - 51Pv'&O ?-' Z/ S cc) Pd 2),U r3 cls/-19-L.i ------------------------N-------- --------------------- -------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? X22 e .sPd-,-✓Sf'6 r /, (over) r 5. What are the names of county- or district officers, servants or employees ca,.ising• the damage or injury? C S Q FC=u s c0 Ta G,v c ,�,,� ,d�,v-r�r✓yn r� i sc�v�r, o��y 5;*-1 IV t,7-1 G cfe .g-1 i;q ?aS'. /�n/� �l/C 2 Y rf�.✓G c✓O uG0 t3 C 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. D onlC 7-ri 0117" aoo,e S, '10c.res 46 ,5.1'1^ rC.1fED or-e=, S GoIPG.�TFc y• � se) "? dti�G/ A)6-S zv'�O .J,✓ ��UT,/�'LS�c L ti iv E �y Loc.:}T%^rE � P,Yt 2 U:= /3.2ci K't=.tJ E"-1�'F�•�ssc-s /f-LSc, . -----------------------------------------•-------------------------------------------- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 5,, -E AGO St5o CC-C,Cz7-4-RrS. -------------------------------------------------------------------------------------- 8. Names and addresses of witnesses, doctors and hospitals. SAS i .,HCl S Lv �'d Z,i C p T< �r✓`7' ~��S-d u r a -------------------------------------------------------------------------------------- 9• List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT If 3 d''S UQ (�Oa 12.S �.QG•LGS, �>/ /�� C---TC . 9a "2, /J'0 93 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 itClaifoant's Signature Address f-6, CYE Telephone No. Telephone No.r-'-317 3,0-0 6,-7 02.12-.;2-.5 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. 9103058 u AIM AGAINST THE CITY AND COUNTY OF SAN FRANCISCO Before completing this form,please read the instructions on the back.You have only 6 months from the date of incident to submit this form and supporting documentation to the Controller or the Clerk of the Board of Supervisors. 1.Claimant's Name and Home Address(Please Print) 2.Send Official Notices and Correspondence to: Cit S N �, '!� LD zip9y��� Cit N P L� Zi d 3.Date of Birth 4.Daytime Telephone S.Social Security Number 6.Date of Incident 7.Time of Incident 2��6v ��� J'()q7� i3 ' 11_a1— 9(e 9,. Pic. 8.Location of Incident or Accident 9.License Plate Number,Claimant Vehicle 10.Basis of Claim (State in detail, the known facts and circumstances attending the incident identifying persons and City departments and property involved,and the cause thereof.Use additional pages I necessary and attach photos if available. See Instructions.) _12002 s le,c�EO OF�,e nu BSc S . D"T�cr'�J T,4 Ti b ,effy_^r g vrp O)u C-m i EJ' L/ Ar Im C-) ro 54*c,41. A6 /d — 3 v3 Name,, 1_D. Number and Department Type of City Vehicle Vehicle License Number and Vehicle Number 11.Description of the Claimants damage,injury,or loss 12.Value of Claimant's Loss or Injury and method of computation (See Instructions) ---Dov,eS ZV-c,� GAi f- G -7-2.�X r ITE MS i.-4)A6 zG F r d a1� TOTAL A OL NT.�4tj.6o 4 /.�d- $e'1`&S.lb 3- t � ' l2cPLf}CC- CourtJuris ion:�llunicipal_O� Superior •fTv 13.Witnesses(if any) Name Address Telephone 2. 174,1r-iJDCIP-Scl1 /tr39�.-11-1 i 9-0 I understand that if my claim is successful, any monies owed me may be offset by any Do Not Wr e4n This' :4ac, monies I may owe the City and County of San Francisco,for such items as traffic tickets, f S.F.General Hospital unpaid bills,welfare reimbursements or overpayments,etc. 1 t aim 14.Signature of Claimant or Representative 15.Date of CRIM NAL PENAL FOR PRESENTING A FRAUDULENT CLAIM OR MAKING A FALSE STATEMENT IS IMPRISONMENT FOR NOT MORE THAN 5 YEARS OR FINE OF moorm 2.8M 4� NOT MORE THAN$25,000.00,OR BOTH. COMPLETED CLAIMS AND RELATED DOCUMENTATION MUST BE FILED WITH THE: s CONTROLLER'S OFFICE,ROOM 109,CITY HALL,SAN FRANCISCO,CA 94102,ATTN:CLAIMS DIVISION. INSTRUCTIONS FOR FILING A CLAIM Failure to complete all sections of the Claim form could delay the processing of your claim. The following provides specific instructions for completing each:section of the claim form: 1. Claimant's Name and Home Address-State the full name and home address of the person(s)claiming damage or injury. Include the street,city,state and zip code. 2. Official Notices and Correspondence-Provide the name and mailing address including zip code of the person to whom all official notices and other correspondence should be sent,if other than claimant.This official contact person can be the claimant or a representative of the claimant. If this section is completed,nothing will be sent to the claimant. 3. Date of Birth-State claimant's date of birth including month„day,and year. 4. Daytime Telephone-State the daytime telephone number of the claimant or official representative. Include the area code if outside the (415)area. 5. Social Security Number-State the claimant's social security number. 6. Day and Date of Incident-State the exact month,day,and year of the incident which caused the alleged damage or injury. 7. Time of Incident-State the exact time, including A.M.or P.M.,of the Incident which caused the alleged damage or injury. S. Location of Incident or Accident-Include the city,and street address or intersection streets where the damage or injury allegedly occurred. 9. Claimant Vehicle License Plate Number-Please show your vehicle license plate number. 10.Basis of Claim-Provide in full detail the circumstances that led up to the incident. State all facts which support the claim. In the boxes provided for the information,show the name, I.D.number and Department of City employee(s)who allegedly caused the damage;the type of City vehicle and the license numberr or City vehicle number. 11. Description of Damage or Injury-Provide in full detail a description of the damage or injury that allegedly resulted from the incident. If claimant's vehicle was involved,provide make, model,and year. 12. Value of Loss and Method of Computation-State the total amount you are claiming as a result of the alleged damage or injury. Provide a breakdown of how the total amount that you are claiming was computed.You may declare expenses incurred and/or future,anticipated expenses. If available,attach to your claim,copies of all bills,payment receipts,and R an automobile accident, we would appreciate your including two repair estimates. The Government Code requires that if the claim is for lessthan$10,000.00,the amount of claim shall be shown. If the claim is for more than$10,000.00, no dollar amount need be shown,but the claim shall indicate whether jurisdiction of the claim would rest with Municipal or Superior Court. Municipal Court limits are under$25,000.00;Superior Court over that amount. 13. Witnesses-State the names,addresses,and daytime phone,numbers of any persons who witnessed the incident. 14. Signature of Claimant or Representative-The claim must be signed by the claimant or by the official representative of the claimant.The Controller will notaccept the claim without a signature. 15. Date of Claim-The date you are filing this claim. Claims for death or injury to persons or personal property must be filed within six months after the incident causing the claim to be made.Any other claim must be filed within one year. Personal service of claims can be accomplished during regular business hours,Monday through Friday(excluding County holidays). N you want a time stamped copy of your claim returned to you,please present an original and copy of the claim,and include a self- addressed stamped envelope. For information on the status of your claim,please call the correct,number listed below. If your claim is against the: WATER DEPARTMENT Call 923-2540 MUNICIPAL RAILWAY Call 923-6018 PORT OF SAN FRANCISCO Call 391-8000 S.F. INTERNATIONAL AIRPORT Call 876-2156 OTHER DEPARTMENTS Call 554-3893 COMPLETED CLAIMS AND RELATED DOCUMENTATION MUST BE FILED WITH THE: CONTROLLER'S OFFICE,ROOM 109,CITY HALL,SAN FRANCISCO,CA 94102,ATTN:CLAIMS DIVISION. a ,CLAIM AGAINST THE CITY AND COUNTY OF SAN FRANCISCO Before completing this form,please read the instructions on the back.You have only 6 months from the date of incident to submit this form and supporting documentation to the Controller or the Clerk of the Board of Supervisors. 1.'Claimant's Name and Home Address(Please Print) 2.Send Official Notices and Correspondence to: `/Al IDA je)S 1:r: l-j ,fit//U 0A JI) JF-f4 1397 ROAD Ca 5 ,A l�i4-gto zip 9yfe,4, cit .(% pA134,c) z d 3.Date of Birth 4.Daytime Telephone S.Social Security Number 6.Date of Incident 7.Time of Incident L5-1o)4Aa�, d o / 2 9� S.Location of Incident or Accident 9.License Plate Number,Claimant Vehicle 10.Basis of Claim (State in detail, the known fads and circumstances attending the incident identifying persons and City departments and property involved,and the cause thereof.Use additional pages lf necessary and attach photos if available. See Instructions.) _�l702 S ,Ci,�iCEO N �gT �� n Gdr.�s iPP�D erg' AF ,e tsEs . B icreJ cevE,� bti Eiu� Er e' -.�-N? ,,4r (ImE) ro 5el�cev• egSE A6 /O — 37y.3 ,9- 6�TK__ 7� ?"d ?�O Srlv"4 14 E0 Name, I. Number and De artment Type of City Vehicle Vehicle License Number and Vehicle Number 11.Description of the Claimants damage,injury,or loss 12.Value of Claimant's Loss or Injury and method of computation (See Instructions) Dao,e S C,47-f_ tikt7^2 I T E M S i s ,t $ C`'C C L r1 STNS ��k.'�•.r EN� l,/f Z:l� '�r%�f.s _.... . . ;v_F-C�1 r4/'C. Z-tF 7-6 TOTAL A UNT��lcS�'o -f Court Juri un icipal..A "Superior 13.Witnesses(if any) Name Address Telephone 1. 4 A t Z.4 mac'-n►1D6�e so nJ /1 ,e -2.f.J 02 +0. 2. E•n�rr�� /j�i�D�esc�1 /31-7 I understand that if my claim is successful, any monies owed me may be offset by any Do Not Write.tP Thi* monies 1 may owe the City and County of San Francisco,for such items as traffic tickets, _Z S.F.General Hospital unpaid bills,welfare reimbursements or overpayments,etc. ;� = 14.Signature of Claimant or Representative 15.Da, of im /j ( vim CRIMINAL PENALfY FOR PRESENTING A FRAUDULENT CLAIM OR MAKING A FALSE STATEMENT IS IMPRISONMENT FOR NOT MORE THAN 5 YEARS OR FINE OF moo,,,,a 6W 4 O NOT MORE THAN$25,000.00,OR BOTH. ' �CLPdCl/J� �i:7i�2�1i �E'OZP/J�Q�fi �G�:?�/J42�Ci�G�J� P.O. BOX 1325 EL CERRITO, CALIFORNIA 94530 (415) 237-9700 CALIFORNIA STATE LIC. #351522 i CAESAR SMITH GENERAL CONTRAVt t B AM MOM UG°t�DE yyyyyyxx . 333 5 (8 00) t�-7488A 4 • 11:A%G..1, Lic. #351522 A US OMER'S ORDER NO. PHONE MECHANIC HELPER STARTING DATE /�«�..� 11 /22 /91 Ci 0 BILL TO ORDER TAKEN BY ��� . 1 r4s. Henderson ADDRESS Q 1387 Karen Rd. E] DAYWORK 7TY i CONTRACT iSan Pablo, CA C7 EXTRA 1 JOB NAME AND LOCATION i � � ~� Repair p__ _ at same address _J D SCRIP ION OF WORN:. Removed and replaced damaged doors, jams and locks, also inrlLirla�i rp-il rt�mFt�t nT damaged emirit" crrFTn at ear_' $1580.01 TOTAL MATERIALS ! TOTALLABOR TAX ® I --.DATE COMPLETED WORK ORDERED BI 2?080 00 TOTAL AMOUNT $ V � t � .. ♦ r Q► _0 J. D A 0 0 1 off Q 0 1-0 0 C 0 Co D -3 c -5 J ------------------ 10 0 4 a 3c D D 3 300' 3 3ES D D 0 0 300 gr - 10 1 - )SO Dso COI : ' . 0-0 4, 3 3. 0 3 0 3 3 0 V 3 D D 10 0 ..Jo-•0� w D 0 0 ------------ city and county of ban i-ranclsco: VTTICe OT LAly AtiOrney 2c coUlvj' Louise H. Renne, Y a City Attorney Ray King Chief, Bureau of Claims (415) 554-3865 February 04, 1992 LYNDA ANDERSON-JOSEPH 1387 KAREN RD. SAN PABLO, CA 94806 RE: Claim of JOSEPH , LYNDA Incident Date: 11/21/91 Claim Filed : 01/15/92 NOTICE OF ACTION UPON CLAIM PLEASE TAKE NOTICE THAT An investigation of your claim filed with the City and County of San Francisco has revealed no indication of liability on the part of the City and County. Accordingly , your claim is 'denied . WARNING Subject to certain exceptions, you have only six (6 ) months from the date this notice was personally delivered 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 desire to consult an attorney, you should do so immediately. Ray ng (415) 554-3900 Fox Plaza, 1390 Market Street, Suite 250 San Francisco 94102-5404 Claim of:- JOSEPH Claim filed: 01/15/92 LYNDA I, Elizabeth Bullard say: I am a citizen of the United States, over eighteen years of age, and not a party to the within action; that my business address is 1390 Market Street, Suite 250, San Francisco, CA 94102. That on February 04, 1992 I served: Notice of Action Upon Claim by placing a true copy thereof in an envelope addressed to: LYNDA ANDERSON-JOSEPH 1387 KAREN RD. SAN PABLO, CA 94806 and by then sealing and depositing said envelope with postage thereon fully prepaid, in the United States mail at San Francisco, California. That there is delivery service by the United States Mail at the place so addressed or regular communication by United States Mail between the place of mailing and the place so addressed. I declare under penalty of perjury that the foregoing is true and correct. Executed on February 04, 1992 at San Francisco, California. zat BUTI ar DECLARATION OF SERVICE BY MAIL J l- `rd O ?�cs� c� Gm City and County of San Francisco: Office of City Attorney Louise H. Renne, b City Attorney R a y King Chief, Bureau of Claims 9'.0�5`' (415) 554-3865 February 04, 1992 LYNDA ANDERSON-JOSEPH 1387 KAREN RD. SAN PABLO, CA 94806 RE: Claim of JOSEPH , LYNDA Incident Date : 11/21/91 Claim Filed : 01/15/92 NOTICE OF ACTION UPON CLAIM PLEASE TAKE NOTICE THAT An investigation of your claim filed with the City and County of San Francisco has revealed no indication of liability on the part of the City and County. Accordingly , your claim is denied . WARNING Subject to certain . exceptions , you have only six (6 ) months from the date this notice was personally delivered 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 desire to consult an attorney, you should do so immediately.. Ray ng (415) 554-3900 Fox Plaza, 1390 Market Street, Suite 250 San Francisco 94102-5404 Claim of: " JOSEPH Claim filed: 01/15/92 LYNDA I, Elizabeth Bullard say: I am a citizen of the United States, over eighteen years of age, and not a party to the within action; that my business address is 1390 Market Street, Suite 250, San Francisco, CA 94102. That on February 04, 1992 I served: Notice of Action Upon Claim by placing a true copy thereof in an envelope addressed to: LYNDA ANDERSON-JOSEPH 1387 KAREN RD. SAN PABLO, CA 94806 and by then sealing and depositing said envelope with postage thereon fully prepaid, in the United States mail at San Francisco, California. That there is delivery service by the United States Mail at the place so addressed or regular communication by United States Mail between the place of mailing and the place so addressed. I declare under penalty of perjury that the foregoing is true and correct. Executed on February 04, 1992 at San Francisco, California. ( /�7 Eti zat BuTl arcr DECLARATION OF SERVICE BY MAIL _ CLAIM f BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA RECEIVE® ��ryrynnpp Claim ?gainst the County, or District governed by) MAR A'C1TIOa992 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT A ri1COZyTY1 ? and Board Action. All Section references are to ) The copy of this document mailed to youMARIWIZ C &ce of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $7,500,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: MC CLELLAND, Fred J. Individually, and as Natural Guardian of Elizabeth McClelland, a Minor ATTORNEY: Date received ADDRESS: 6325 Highland Avenue BY DELIVERY TO CLERK ON March 5, 1992 Richmond, CA 94805 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. ppN IL BATCHELOR, Clerk DATED: M;;rrh 5, lggp BY: Deputy OL I. 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 �5 / 2 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). 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'� 1992 Dated: W R """ PHIL BATCHELOR, Clerk, By OAAm 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, 4 Dated: �p R 0 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator TO: THE BOARD OF SUPERVISORS OF THE COUNTY OF CONTRA COSTA The following claim for damages is hereby made by and on behalf of Elizabeth McClelland, a minor, acting through her natural guardian, Fred J. McClelland, and by Fred J. McClelland, individually, the particulars of the claim being as follows: A. Name and Mailing Address of the Claimants: Mr. Fred J. McClelland, Individually RECEIVED and as Natural Guardian of Elizabeth McClelland, a Minor O 5 1992 B. Address to Which Notices Are to be Sent: CLERK BOARD OF CONTRA COQ 6325 Highland Avenue Richmond, CA 94805 C. Date, Place and Other Circumstances Which Give Rise to this Claim: 1. The accident which is the subject matter of this claim occurred on or about September 11, 1991, at or about 8: 00 p.m. in unincorporated Contra Costa County, and the details of the occurrence are set forth below. 2 . At all relevant times, Bernhard Avenue within unincorporated Contra Costa County, at or near its intersection with Felix Avenue, was and is a roadway developed, improved, designed, maintained and supervised by the County of Contra Costa, acting by and through its Department of Public Works and other Departments and Divisions. 3 . At approximately 8:00 p.m. on the above date, the minor claimant was struck by a vehicle being operated by Daniel F. Dimatteo. The minor claimant's father, Fred J. McClelland, was then and there present, and observed the injury to his daughter, contemporaneously and simultaneously experiencing her injury while being in close proximity thereto. At the time of the accident, claimants allege that the subject roadway, including its lighting, signing (and lack thereof) , speed limit, controls (and lack thereof) were such that the highway was in a dangerous and defective and hazardous condition as those terms are utilized in the California Government Code, and such dangerous, defective and hazardous condition of public property was a legal cause of the injuries and damages hereinabove incurred. The nature of the dangerous and deceptive and defective condition of public property existing on Bernhard Avenue within one mile in either direction of the point of impact was that the Page 2 subject roadway was a trap for pedestrians such as the minor plaintiff by reason of the absence of adequate lighting, speed control, mandatory signing, pavement marking, lane striping, and vehicle speed limits, when said factors were considered in light of the traffic patterns, traffic flows, accident history, visibility and posted speed, such that the roadway was a trap for pedestrians and motorists who were using the roadway and its abutting sidewalks in a foreseeable manner. The dangerous and defective nature of the roadway was created by said public entity, or at a minimum, was known or should have been known to the public entity through correspondence from citizenry, police agencies, data collection, reasonable inspection, maintenance and supervision policies and practices. The hazardous condition above described and the defective nature of the roadway created a substantial risk of injury of the very type which befell the minor claimant, and her father, on September 11, 1991. D. Description of Iniury and Damage: As a direct, concurrent and legal cause of the negligence and carelessness of the public entity above described, and its employees, as well as the dangerous and defective condition of public roadway, the happening of the accident detailed in California State Highway Patrol Report, Local Report No. 9-095, occurred. As a result thereof the minor claimant sustained massive injuries including a broken leg, a fractured hip, a fractured pelvis, lacerations to the liver, internal bleeding, and organic brain damage which has rendered her comatose and in a vegetative state, requiring 24 hour attendant care, and eliminating her future earning capacity in its entirety. In addition, the adult claimant, Fred J. McClelland, sustained compensable emotional distress recoverable pursuant to Dillon v. Legg (1968) 68 C.2d 728. In addition, as a single parent charged with the responsibility for the care, nuturing and upbringing of his daughter, the adult claimant, Fred McClelland, suffered injury as a "direct victim" compensable under the holding in Molien v. Kaiser Foundation Hospitals (1980) 27 C. 3d 916. The precise nature and extent of any residual injuries, other than as described above, is at this time unknown as both claimants continue to suffer from the signs and symptoms of their injuries. The minor claimant continues to be under ongoing medical care and in need of 24 hour a day attendant and nursing care. V Page 3 E. Names and Addresses of Public Employees Causing Injury and Damage: The names and addresses of those agents or employees of the County of Contra Costa, or its various departments or agencies, which said employees were responsible for the matters herein alleged are not now known to these claimants. F. Amounts Claimed: On behalf of the minor claimant, Elizabeth McClelland, her father as her natural guardian makes claim at this time in compensation for both special and general damage, from Contra Costa County, in the sum of $7, 000, 000. 00. Claimant, Fred J. McClelland, on behalf of himself in his individual capacity, claims damages for both general and special damage from respondent County of Contra Costa in the amount of $500, 000. 00. Dated: March , 1992 By: 4"Y'C'-T Fred J. McClelland, Individually, and as Father and Natural Guardian on Behalf of His Daughter, Elizabeth McClelland, a Minor RKEIVED CLAIM ' BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MAR 4 1992 a• C1aim,Actinst the County, or District governed by) BOA!E 4WX 010UNSEL the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Ap ri I 'rK11Tq1q'ZCALIF 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: MILLER, Gail ATTORNEY: Wendy Alfsen-Cleveland Cleveland Law Offices Date received ADDRESS: 230 Grand Avenue, Suite 301 BY DELIVERY TO CLERK ON March 2, 1992 Oakland, CA 94610 BY MAIL POSTMARKED:February 28, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpHHIL BATCHELOR, Clerk DATED: rC� 4,. 7qq� ' BY: Deputy FROM: County Counsel TO: Clerk of the Board of Supervisors A--y ti�cC1 ThiJ,\cldA m 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: /'� Z. BY: � �--1 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 ( VJ'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. 0 Dated: ,qp R 0 7 1992 PHIL BATCHELOR, Clerk, By ° , Deputy Clerk WARNING (Gov. code section 913) M:;bject 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 Orde and No ice to Claimant, addressed to the claimant as shown l above. Dated: APR 4 4 +�a� BY: PHIL BATCHELOR by q Deputy Clerk 44.M CC: County Counsel County Administrator • CLEVELAND LAW OFFICES 230 Grand Avenue, Suite 301 6020 c:onunerce Boulevard, Suite 128 Oakland, CA 94610 Rohnert Park, CA 94928 (510) 893-2141 (707) 575-7477 Fax (510) 893-2172 RECEIVED (707) 584-2980 Wendy Alfsen-Cleveland MAR - 21992 CLERK BOARD 0 UPE�tV CONTRA COSTA CO. Ann Curulli February 27, 1992 Deputy Clerk Phil Batchelor Clerk of the Board and County Administrator Contra Costa County County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 Re: Jgaii Dear Ms. Curulli: I received your Notice to Claimant dated February 18, 1992 returning the claim as not presented within six months of the date of personal injury. However, this claim is one relating to a cause of action other than injury to person, personal property or growing crops and is one for which there is a one year claim presentation requirement under Government Code Sections 901 and 911.2 . The claim is resubmitted to you for your re-examination as it is a breach of contract claim for breach of Section 14 . 5 (e) of the Contra Costa County Employees Association Memorandum of Understanding entitling the claimant to one year salary continuation pay. The grounds for interruption and cessation of salary continuation pay were resolved on February 20, 1991 and thereafter the claimant submitted and renewed her claim for the balance o� the salary continuation payments due her but that claim has not been satisfied. Whereforelthe claimant presented her claim against public entity received by you on February 18, 1992 . Please review the matter presented as to claim relating to cause of action other than injury to person, personal property or growing crops, that is a cause of action for breach of contract presented within one year after the occurence. Thank you for your prompt attention to this matter. Sincerely, Wendy Alf&en-6tleveland NO ff �- N • 1� C-Na�•1 4 vT,• FU CL LU N t t1C '�y N N o0 LU ¢� ul m c� U M W r 0 pa. � a .e� Q Z U. awwo a z do O 'S a4 � 0 Wo a N U CLAIM RECEIVED s BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MAR 4 1992 Claim Against the County, or District governed by) BOARD ACTION "the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Apr iF. 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: $201.02 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PAULL, Michael W. ATTORNEY: Date received ADDRESS: 2081 Olivera Road #D BY DELIVERY TO CLERK ON March 3, 1992 Concord, CA 94520 Unreadable BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PPHHIL BATCHELOR, Clerk a DATED: March 4, 1992 BY: Deputy _ (1,54Q 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: �j `� /9 2 BY: � - az, Deputy County Counsel V II1. 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: APR 0 7 1992 PHIL BATCHELOR, Clerk, ByAA-ILDeputy 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 show�n above. r Dated: APR 0 ( 992 BY: PHIL BATCHELOR by0/ D Deputy Clerk CC: County Counsel County Administrator • NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Michael W. Paull 2081 Olivera Road #D Concord, CALIFORNIA 94520 Re: Claim of Michael W. Paull 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 . XX 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 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. ;WESTM7AN, ounty Counsel By: Deputy Vunty Counsel CERTIFICATE OF SERVICE BY MAIL C.C.P. §9 1012, 1013a, 2015 . 5; Evid. C. 95 641 , 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: March 5, 1992 , at Martinez, lifornia. cc: Clerk of the Board cf Supervisors (or' inal ) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C .SS 910, 910 . 2, 920 . 41 910 . 8 ) 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 aedrue 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 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 Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp ���� • c� ) FECEIVED co•yt(yay'� C A. 45 zoAgainst the County ofd Contra Costa ) W 3W orDistrict) DO. Fill in name ) NTRA COSTA C, The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of -tZ5`�G and in support of this claim represents as follows: MxZ C�, p ZOu C ------------------------------------- -------------------------------------------- 1. When did the damage or in ury occur? (Give exact date and hour) G� -------------------�.,�_� —_ ------------------------- ------- 2. Where did the damage or in ury occur? (Include city and county) P 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 emplo ees caused the ijury or 9 n .9 - (149 V c bo (OPW S fix•Z t) r) , �, ll 5. What are the names of county or district officers, �,/servants or employees causing .k o.b-Qthe damaw-GWrn i uryk - Td� Ne(,061 C4jrtk Tkoq or 1�d. _mi a I�at ke/son - --------- - --- ----- - 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Att ch 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 ee Z5 00 'c NO C ;A5 Cow e Gov. Code Sec. 910.2 provides: rIT] e claim must be signed by the claimant SEND NOTICES T0: (At't'orney) or by somo persqn onhibe lf." Name and Address of Attorney A C al- -ane,'s S gnature Address _ 60r)lc&V C4 ° cr�5-Z� Telephone No. Telephone No. 60 F-26 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 bothsuch 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. ' ' ' . ^mMuir Road Off' ~ . .f District Attorney Contra m= " . ���j ,o (415) ��4C Gary T Yancey Costa ( ADMINISTRATION District Attorney �,�x � COLLECTIONS F�,//ySuppo� 0v�km County ( ) LEGAL L Douglas Pipes Senior Deputy District Attorney Director \ - --- ' D�tS \ ! K]{� \ � \ \ cl-V-9 A ----'~^ In response to your inquiry da please be advised of the following iofo ~ �J re����1ng ybur child support ~ case: ' 1 : ( > Your child support payment was sent on . ^ ' 2 ( ) No child support payment was received. We are taking action � to secure payments. ^ . ' 3' ( ) The absent parent is employed. We are taking action to se- cure payments. ` ' 4. ( ) Current employer for absent parent is unknown at this time. Please advise in writing if name, address and phone number of current employer is known to you. 5. ( ) Notice of your address change has been received and pro- cessed. ` 6 Other: ('O_°__ ' ~~ `^O-°__ Y[(�� ) ' � ` V\ \ -�-�-� (` ` --- Colls ~Officer - �/ _'�^�-~ ,_G \ v v \J FS-52 ( REV 2/88 ) New #F3-199 ylDepartment o the Treasury Date of this notice: QPR. 1, 1991 Internal Revenue Service Taxpayer Identifying Number: 520-62-1993 OGDEN, UT 84201 Form: Tax Period: DEC. 31, 1990 FOR ASSISTANCE FROM THE AGENCY TH'. REFERRED YOUR DEBT TO US , YOU MAY WRITE T0: CHILD SUPPORT ENFORCEMENT ADMIN. MICHAEL W & JERI L PAULL TAX REFUND INTERCEPT PROJECT 2081 OLIVERA RD APT D P.O. BOX 34309 CONCORD CA 94520-5443 PHOENIX AZ 85067 _A\_0909 55 (602) 255-4711 LOCAL 1 (IRS NUMBERS ARE LISTED BELOW) OVERPAID TAX APPLIED TO PA Tr—DUE OBLIGATION NAFDC AZ WE HAVE APPLIED ALL OR PART OF YOUR REFUND TO FULLY OR PARTIALLY SATISFY A PAST—DUE OBLIGATION REFERRED TO US BY ANOTHER GOVERNMENT AGENCY. THIS ACTION IS REQUIRED BY SECTION 64C2(C) OR (D) OF THE INTERNAL REVENUE CODE. FOR QUESTIONS ABOUT THE OBLIGATION, OR IF YOU BELIEVE THE AMOUNT IS IN ERROR, CONTACT THE AGENCY AT THE ADDRESS OR TELEPHONE NUMBER SHOWN IN THE UPPER RIGHT CORNER OF THIS NOTICE. IF YOU ARE MARRIED, FILING A JOINT RETURN, AND INCURRED THIS DEBT SEPARATELY FROM YOUR SPOUSE WHO HAS NO LEGAL RESPONSIBILITY FOR THE DEBT, BUT WHO HAS INCOME, WITHHOLDING AND/OR ESTIMATED TAX PAYMENTS, YOUR SPOUSE MAY BE ENTITLED TO HIS OR HER SHARE OF THE JOINT REFUND. YOUR SPOUSE MAY RECEIVE THE SHARE OF THE JOINT REFUND BY FILING FORM 8379, INJURED SPOUSE CLAIM AND ALLOCATION. INSTRUCTIONS FOR FILING THE INJURED SPOUSE CLAIM MAYBE FOUND ON THE BACK OF THE FORM 8379. FIRS WILL FIGURE AND ISSUE THE INJURED SPOUSE PORTION OF THE JOINT REFUND. IN COMMtlNITY PROPERTY STATES, THE JOINT REFUND MUST BE DIVIDED ACCORDING TO STATE LAW. THE (COMMUNITY PROPERTY STATES ARE ARIZONA, CALIFORNIA, IDAHO, LOUISIANA, NEVADA, NEW -MEXICO, TEXAS, WASHINGTON AND WISCONSIN. GENERALLY, INJURED SPOUSE CLAIMS FROM CALIFORNIA, IDAHO, LOUISIANA AND TEXAS WILL BE DENIED. THE LAWS OF YOUR STATE OF DOMICILE DETERMINE WHETHER YOU HAVE COMMUNITY PROPERTY AND COMMUNITY INCOME. IF YOU HAVE QUESTIONS ABOUT THE INJURED SPOUSE CLAIM OR NEED HELP IN COMPLETING THE FORM, PLEASE CALL YOUR LOCAL IRS OFFICE AT THE TELEPHONE NUMBER IN THE LOWER LEFT CORNER. OBLIGOR'S SSN: 520-62-1993 TAX STATEMENT REFUND ON INCOME TAX RETURN . . . . . . . . . . . . . . . . . $1,014.65 AMOUNT OF REFUND APPLIED TO THE AGENCY DEBT= . $1,.014 .65 AMOUNT TO BE APPLIED TO OTHER OBLIGATIONS, REFUNDED, OR APPLIED TO YOUR ESTIMATED TAX: . . S.00 (IF THERE IS AN AMOUNT TO BE REFUNDED, BY IRS, INTEREST DUE YOU WILL BE ADDED. ) FOR REFUND INFORMATION CALL= 1-800-829-1040 ST. OF CA y� Form 8581 (10-em ARIZONA DEPARTMENT OF ECONOMIC SECURITY CHILD SUPPORT ENFORCEMENT ADMINISTRATION Fife Symington 2222 W. ENCANTO P.O. BOX 36978 Linda Moore-Cannon Governor PHOENIX, ARIZONA 85067 Director /15 19 i/ ACKNOWLEDGEMENT ( ) Your request for an Administrative Review of your case has been forwarded to: ' ( We are in receipt of your correspondence--da-t -: We will be contacting you as soon as your case has been processed. ( ) We are in receipt of your correspondence dated: Your request was not accompanied by supporting documentation as requested. Without this documentation we are unable to proceed: ( ) Other : Performance Assurance Review Unit Child Support Enforcement Administration FF ARIZONA DEPARTMENT OF ECONOMIC SECURITY a1 ' CHILD SUPPORT ENFORCEMENT ADMINISTRATION Fife Symington 2222 W. ENCANTO P.O. BOX 40458 Linda Moore-Cannon Governor PHOENIX, ARIZONA 85067 Director August 22,_ 1991 r Office of the District Attorney 40 Muir Road Martinez , Ca. 94553 ATTN: Naomi Griffin RE: Michael W. Paull Dear Ms . Griffin, We have reviewed Mr . Paull ' s case file. Our records indicate that he still owes $11 . 98 . Your memo states that he is still owes $611 . 98 . Per our telephone conversation, your arrearage figure $6 , 385 . 00 , but we were showing $5 ,78`5 . 00 , which is the $600 . 00 difference. I am enclosing the document showing this amount as due and owing as of + 6/23/89 . It is signed by the custodial parent and notarized. I have also enclosed our computation and payment history. Please adjust your records accordingly. Our office is holding Mr . Paull ' s IRS refund of $1,014 . 65.' Since it is a joint return, we hold it for six months. This refund will be returned to Mr . Paull because the child is . .I emancipated. To expedite this process, we can release the refund upon receipt of a notarized Affidavit from Mrs . Paull stating she has not, and will not, file the "Injured Spouse" claim. When we determine that the $11 . 98 has been paid to the custodial parent, we will close this case file . If you have any questions regarding this matter, you may contact me at ( 602) 252-0236. Sincerely, Alba D. Doane Performance Assurance Review Unit Child Support Enforcement Administration .L ARIZONA DEPARTMENT OF ECONOMIC SECURITY CHILD SUPPORT ENFORCEMENT ADMINISTRATION Fife Symington 2222 W. ENCANTO P.O. BOX 40458 Linda Moore-Cannon Governor PHOENIX, ARIZONA 85067 Director • December ��., 4.9 91 Office of the District Attorney Contra Costa County 40 Muir Road Martinez, Ca. 94553 ATTN: Naomi Griffin RE: Michael W. Paull Your No. DR633811; Our NO. DR89-03285 Dear Ms. Griffin, tWe are in receipt of your correspondence dated 12/26/91. The payments were not sent to this office, but went directly to the Clerk of Court. They sent them directly to the custodial parent the same day. So we will be unable to return any money to the Defendant, Mr. Paull, who has also written about this money. Enclosed is a copy of payment history from Maricopa County. We will forward a copy of this letter to Mr. Paull in answer to his inquiry. If you have any questions regarding this matter, you may contact me at (602) 252-0236. Sincerely, Alba D. Doane Administrative Review Unit Child Support Enforcement Administration Lr. rr; Ji Q cz C2 is cm C. o ci i 3 1 k-.M ice o., District Attorney � ontra1"i""' California 94553 6,��fl 510)M(X'M 646- 4883 GaGary T..Yance Costa District Att6.rney ( I ADMINISTRATION IX I COLLECTIONS Family Support Division County I I LEGAL L. Douglas Pipes WELFARE FRAUD Senior Deputy District Attorney Director December 26 , 1991 CSEA P. 0. Box 40458 Phoenix , AZ 85067 ATTN: Alba Doane RE: UNIFORM RECIPRDCAL aTFORCEynM OF SUPPORT ACT Case: Linda K . Paull vs . Michael Paull Our No: DR633811 Your No-))989-03285 An Order to Show Cause has been issued requiring the Respondent to appear in our Court on providing that service is effective. An order against the Respondent has been filed in this case. Attached please find three copies of same. We cannot find the Respondent with the information given. If you can furnish additional information on 1-Lis whereabouts in this County, please advise us within 90 days or the above action will be dismissed. A Civil/Criminal Contempt action has been filed against the Respondent. The court date is tentatively set for The above action has been continued/transferred to Other: Please advised that we have forwarded $176 . 02 on to you in error . Those dollars should be refunded to the Defendant as overpayment . Weare closing our case . GARY T. YANCEY District Attorney N. Gri Collections Officer NG/vm �7> 69 FS-281R f <; Office of District Attorney Contra �...�,aiz Gary T. Yancey Family Support Division 40 Muir Road Costa ;::� ^;;. ' . District Attorney L. Douglas Pipes Martinez,California 94553 County �P Senior Deputy District Attorney FAX:646-1322 -+`i`OU �� 4883 Director Phone:646- December 26, 1991 ,A Michael Paull 2081 Olivera #D Concord, CA 94520 RE: Linda K. Paull vs. Michael Paull; DR# 633811 Dear Mr. Paull: This is to advise you we are closing your case this date, as all arrears are paid in full.. i3nfortunately, the first delete we did on your Unemployment ntercept did .not take. This resulted in $176 . 02 being forwarded o._Arizona_ in error. ', We have notified Arizona to refund the money to you and have contacted Enemployment to confirm your deletion. We have also deleted you from all other intercepts. However,. sometimes intercepts on taxes do occur at tax time. Please contact .us immediately if this happens so we can rectify. Thank you for your cooperation throughout this case. Sincerely, GARY T. YANCEY District Attorney N. Gri f n Collections Office NG/vm ARIZONA DEPARTMENT OF ECONOMIC SECURITY CHILD SUPPORT ENFORCEMENT ADMINISTRATION Fife Symington 2222 W. ENCANTO P.O. BOX 40458 Linda Moore-Cannon Governor PHOENIX, ARIZONA 85067 Director November 21, 1991 Michael W. Paull 2081 Olivera Rd. , Apt. D Concord, Ca. 94520-5443 RE: Tax Intercept Dear Mr. Paull, Our office just completed a review of your case as requested by the Office of the District Attorney in Martinez, Ca. A copy of that letter is enclosed for your records. The IRS Refund of $1, 014 . 00 should have been returned to you + by .now. Please advise if you have not received it. Your name has already been removed from our tax intercept program,... " If you have any questions regarding this matter, you may contact me (602) 252-0236. Sincerely, Alba D. Doane Administration Review Unit Child .Support Enforcement Administration ARIZONA DEPARTMENT OF ECONOMIC SECURITY CHILD SUPPORT ENFORCEMENT ADMINISTRATION Fife Symington 2222 W. ENCANTO P.O. BOX 40458 Linda Moore-Cannon Governor PHOENIX, ARIZONA 85067 Director December 31, 1991 ` Michael W. Paull 2081 Olivera Rd. , Apt. D Concord, Ca. 94520-5443 Dear Mr. Pal-ill., Your letter was received on the same day we received correspondence from the District Attorney's Office in Martinez, Ca. There were two payments sent to the Maricopa County Clerk's "Office in November. However, they were immediately sent out to the custodial parent, Linda. See attached copy of the payment history, the correspondence from Calif. , and our letter to them. Your balance due of $11. 98 has been paid now, and your case has been processed for closure. If you have any questions regarding this matter, you may contact me, or the District Attorney's Office as shown on the attached correspondence. 1 Sincerely, Alba D. Doane Administrative Review Unit Child Support Enforcement Administration r• a, /� 4 '7424' .. ` e� ��, �► Z sod M� Ck at, ZOA ,11 �nEP m ot k6 W VvCCAL ' EVA vc a, d l q m T � 4� Lr) SMR <r °! �� �' 3/992 or OST pFq�j A � rro �� �• .,. +� 1 " ' :+� ;,�;, CLAIM / �,• BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA RECEIVE® Claim°Aga*nst the County, or District governed by) BOARD ACTION the Boafd of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT April 7, 1W 9 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 Zif"sa (Paragraph IV below), given pursuant to Government Code G4IF. Amount: In excess of $25,000.00 each Section 913 and 915.4. Please note all "Warnings". CLAIMANT: ROGERS, JamesLand Marjorie A. ATTORNEY: c/o Paul M. Curry 1401 Lakeside Drive Suite 700 Date received ADDRESS: Oakland, CA 94612 BY DELIVERY TO CLERK ON March 6, 1992 BY MAIL POSTMARKED: Federal Express I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: P1arrh 9, 1992 gJIL BepuAATTCYELOR, C1er J 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: r. Dated: 3 /q (� 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 ( VThis 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 0 7 1992 PHIL BATCHELOR, Clerk, By °&..e__11 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 Not i a to Claimant, addressed to the claimant as shown above. .Dated: APR 0 7 1992 BY: PHIL BATCHELOR byI�Peputy Clerk CC: County Counsel County Administrator 1 PAUL M. CURRY REC IVED � 1401 Lakeside Drive 2 Suite 700 MAR 61992 Oakland, CA 94612 3 Telephone: (510) 452-1608 CLERK BOARD OF SUPERV 4 CONTRA COSTA Atty for Claimants, 5 James L. Rogers and Marjorie A. Rogers 6 Claim of 7 CLAIMS FOR PERSONAL INJURY JAMES L. ROGERS and DAMAGES (Section 91.0 of the i 8I MARJORIE A. ROGERS Gov't Code) 9 �I vs. 101 THE CITY AND COUNTY OF SAN FRANCISCO, THE COUNTY OF 111 CONTRA COSTA, AND THE CITIES OF WALNUT CREEK AND MARTINEZ. 12 I 13 TO: THE BOARDS OF SUPERVISORS FOR THE CITY AND COUNTY OF SAN FRANCISCO AND CONTRA COSTA COUNTY, AND THE CITY MANAGERS FOR 141 THE CITIES OF WALNUT CREEK AND MARTINEZ: 15 You are hereby notified that JAMES L. ROGERS and MARJORIE A. 16ROGERS, whose address is 1303 Spyglass Parkway, Vallejo, i 17 California, claim damages from the above-named public entities in 1 18f the aggregate amount, computed as of the date of the presentation 19 of this claim in excess of Municipal Court jurisdiction (ie. , in i 20 excess of $25, 000. 00 each) . 21 These claims are based on personal injuries sustained by 22 Claimants as the result of an incident occurring on or about j 23 September 14 , 1991, in the City of Walnut Creek, under the 24 following circumstances: 25 On or about said date, as Claimant JAMES L. ROGERS was 26 proceeding to work in his automobile, officers of the Walnut 27 28 1 PAUL M. CURRY ATTORNEY AT LAW AXE SIDE PLAZA.SUITE 700 1.01 LAKESIDE DRIVE OAKLAND.CA 94612 (415) 452-1608 1 Creek Police Department stopped him for an alleged traffic P 2 violation. During the course of- said stop, said police officers j 3 ran a warrant check and discovered in the PIN system a purported ! I 4outstanding bench warrant issued by a San Francisco Magistrate. 5 Solely on the basis of this warrant, and apparent 6confirmation provided by City and County of San Francisco 1 ( 7 employees, said police officers arrested Claimant JAMES L. ` 8I ROGERS. At the time of his arrest, Claimant vehemently protested I 9that no valid outstanding bench warrant against him could then II I 101 have existed. i 11 Prior to the date of this incident, in May 1982, Claimant 12 ` JAMES L. ROGERS had been found guilty of a .misdemeanor criminal 13 offense (San Francisco Municipal Court no. 501217) . However, he 14 had successfully completed probation by May, 1985; and the 15 probation department knew of his whereabouts at all times. 16 During said case and thereafter, Claimant neither knew or had 17reason to know that the court had issued a bench warrant against 18 him. Accordingly, said bench warrant was negligently and 19 erroneously both issued and retained in the PIN (or similar) l� 20 system by employees of the City and County of San Francisco. I I 21 Thereafter, Claimant JAMES L. ROGERS was incarcerated at the � 22 Walnut Creek City Jail. Contemporaneous with his arrest and 231 incarceration, Claimant MARJORIE A. ROGERS, who is the lawful 24 spouse of Claimant JAMES L. ROGERS,,. learned of and observed her 25 husband's shock and injury. 26 Subsequently, Claimant JAMES L. ROGERS was brought to the 27 2 28 PAUL M. CURRY ATTORNEY AT LAW LAKESIDE PLAZA.SUITE 700 1.101 LAKESIDE DRIVE CIAKLAND.CA 94612 (415) 452-1606 1 central detention facility in Martinez, Contra Costa County. 2i Claimant remained incarcerated in said facility for a total of 6 3 (six) days before being brought before a local magistrate. At 4 that point, said Magistrate ordered Claimant to be transferred to 5 San Francisco Municipal Court jurisdiction, to answer to the 6 bench warrant issued by said court. 7I On or about September 19, 1991, Claimant was brought to the 8i Hall of Justice Jail, San Francisco. After reviewing Municipal i i 9 � case number 501217, the Magistrate found no legal basis i 10 whatsoever for Claimant's arrest and imprisonment and ordered him 11 to be released forthwith. 12i At all times subsequent to his wrongful arrest and during 13 I { his unlawful detention, Claimant JAMES L. ROGERS protested that I i 14 there was no valid bench warrant for his arrest; and demanded to i 15 be taken before a magistrate. Notwithstanding his demands, 16 employees of the County of Contra Costa, and the Cities of Walnut 17 Creek and Martinez negligently and erroneously confirmed the 18 existence of the bench warrant and continued his incarceration. 19 Subsequent to his release, Claimant JAMES L. ROGERS was 20 terminated from his employment as the Business Manager for I 21I Anderson Oldsmobile-Jeep-Eagle car dealership, Walnut Creek. 22 Thereafter, despite his concerted efforts in excess of 4 months 23i � n finding other similar work in the industry, he was unable to 24 obtain same--all to his financial detriment. 25 The injuries sustained by Claimant JAMES L. ROGERS, as far 26 as known, as of the date of presentation of this claim, consist 27 28 3 PAUL M. CURRY ATTORNEY AT LAW _AKESIDE PLAZA.SUITE 700 1401 LAKESIDE DRIVE OAKLAND.CA 94612 (415) 452.1608 1 of great humiliation, mental anguish, anxiety, loss of I 2 ( consortium, and severe emotional and physical distress. Also, 3 Claimant has sustained a past and future earnings loss, and other 4 direct economic harm, in an -unknown amount. 5 The injuries sustained by Claimant MARJORIE A. ROGERS, as 6 far as known, as of the date of presentation of this claim, 7 consist of embarrassment, -anxiety, mental anguish, severe 8 emotional and physical distress and loss of consortium. Also, i 9 Claimant has suffered a .loss of earnings as a direct result of 10i the conduct alleged -above. 111 The names of the public -employees causing Claimants' 12 injuries under the descr.ibed .circumstances are not known to 13 Claimants. However, in doing the things alleged above, were 14 acting within the course and .scope of their employment. 1 15 By their above described actions, the employees of each of i 16 the named public entities, and each of them, initiated, 17 corroborated, ratified and approved of the actions of each and I 18 all of the other entities and its employees. 19 Jurisdiction over the above claims and each of them would 20 rest in the Superior Court. 21 All notices or other communications with regard to this 22 claim should be sent to Claimants c/o PAUL M. CURRY, 1401 23 Lakeside Drive Suite, 700, Oakland CA 94612. I 24 ' 25 26 Dated: March 5, 1992 . j PAdL M. CURRY i Att rney for Claimants 27 28 4 I PAUL M. CURRY ATTORNEY AT LAW I AKESIDE PLAZA.SUITE 700 1401 LAKESIDE DRIVE OAKLAND.CA 94612 (4151 452-1608 $ - sl o csp g VVYit� 3 f� i s 0, d a ceN LU y s 0 I N g z. m 'w > � � ❑. n cn Z.. C W a ' - . o w i m . W LL S J W� � fid � �o. 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': f:.G[ N tD tNi_s A p7jW �0 O,tqd i '4.d 7:N�N7 GON(D dw t0 a03 m O 6 d w.O wy � G i�.in N O N G w �w a .���T 9 0� y =oz ocS ^t In m �3° "�nco _ $(u v 'v_ , �Q oon�, s L Cs Gey y03N$ xD 700 d' n b ?ON N�20 f �9"•�-O w jin y t N V� NR=T NO 3 O' O mn-<0O d G5Ct1 w O G.Od "N rsd mcz.m S'o cu:) m`s m'aFto� o a c ;iG 9 anu• _c gm " fv omoo T o ? sn3wwq o = p r,3°o�'1tw'^ v 7�<0 G W. 7 - ��_ x5 m_T Ff o O tG�9 U� om,9$o w.G ccraa3<F..� N Z[-� -` w xO t�ttt�� 'O OC b�-, rG rl� O=4. Q, .:3 9.N'p'`s Vd"ypN i�• d OG[PO (0 oaa N VO-DN C.1 �' `« (0 •=1 W m'0 (.:, 'p N r3 7 F) �-G��'•4 N O� 6 Cs`Pa C" `��y O t N Q O 7�.N�t` �'�G i E) F'�.G .=1 Q D C•3 N :' d�0 f.N N�G w D,}G"L�-� p6p NC @ w `.a 10 0 @� � ,- FG Ot'9 y. <jN'9 s �in3v?.e 'o aga.P R d3mo°- oG3 °'w7tPZ y 93 d-O =' o'o£'o owdFMa- OOQ iCj �?":> Np F, y 60 K�3 �G N G .O C Gv �� tRc c3 0� du+tc < Ot�P �� O�9^ �RN 4� tD O •-(•CJ Op 7 a�'�-,� b3 a 0 K O �„G 7�N 3 y t0 :. CLAIM Cle BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA QI'kzf� � L'laim Against the County, or District governed by) BOARD AR 1 2 1992 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Apr! , and Board Action. All Section references are to ) The copy of this document mailed to you is WUNTMOMUNSIB.f California Government Codes. ) the action taken on your claim by the Board WT t�pA�%rs (Paragraph IV below), given pursuant to Government Code Amount: In excess of $10,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SERZOW, Tanya E. ATTORNEY: John J. Farrell , Esq. Hildebrand, McLeod & Nelson, Inc. Date received March 3, 1992 ADDRESS: 414 Thirteenth Street, Sixth Floor BY DELIVERY TO CLERK ON Oakland, CA 94612-2603 BY MAIL POSTMARKED: March 2, 1992 Certified P 317 673 559 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. gg DATED: March 4, 1992 JVIL DepuiyLOR, Clerk 1. F _ (1w ROM: 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: 8Y: I✓ ,.. Deputy County Counsel II1. 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. 0Dated: APR O 7 i90 PHIL BATCHELOR, Clerk, Byg,�01 G 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 O 7 1992 BY: PHIL BATCHELOR by ° i Deputy Clerk CC: County Counsel County Administrator HILDEBRAND, MCLEOD & NELSON, INC. • ATTORNEYS AT LAW SIXTH FLOOR CLIFTON HILDEBRAND 414 THIRTEENTH STREET (1899.1977) C..HARLES C M,LEOD OAKLAND. CALIFORNIA 94612-2603 CALIF 1.800-48-7575 (1910-1991) (510) 451.6732 U. S. A.1.800.447.7500 FREDERICK L. NELSON QAC SIM'LE DAVID B DRAHEIM JOHN J. FARRERE ' a ANTHONY S. PETRU �� March 2 , 1992 WR - 31Q CLERK8 0 CON tRq UPERV COSTA C Clerk, Board of Supervisors County of Contra Costa 651 Pine Street, Room 106 Martinez , CA 94553 Re: Claim of Tanya Serzow Dear Sir or Madam: Enclosed please find an original plus one copy of the Claim of Tanya Serzow against the County of Contra Costa. Upon receipt, please stamp the enclosed copy "Received" and return it to our office in the enclosed postage-paid envelope. Thank you for your courtesy and cooperation in this matter. If you have any questions, please feel free to call. Sincerely yours, HILDEBRAND, McLEOD & NELSON, INC. qO& ELL JJF/eaa Certified Mail Return Receipt Requested No. P 317 673 559 JOHN J. FARRELL, ESQ. HILDEBRAND, McLEOD & NELSON, INC. 414 Thirteenth Street, Sixth Floor Oakland, CA 94612-2603 Telephone: (510) 451-6732 RECEIVED Attorneys for Claimant TANYA E. SERZOW MAR - 3192 FIK SOARD OF SUPERV :'7EJTRA COSTA C ?yy� In the Matter of the Claim of ) TANYA E. SERZOW, Claimant ) VS . ) COUNTY OF CONTRA COSTA. ) CLAIMANT, TANYA SERZOW, hereby presents this Claim to the County of Contra Costa pursuant to Section 910 of the California Government Code: 1) NAME AND ADDRESS OF CLAIMANT: Tanya E. Serzow 20 Irwin Way, Apt. 712 Orinda, CA 94563 2) ADDRESS TO WHICH NOTICES ARE TO BE SENT: John J. Farrell, Esq. HILDEBRAND, McLEOD & NELSON, INC. 414 Thirteenth Street, Sixth Floor Oakland, CA 94612-2603 3) DATE, PLACE AND CIRCUMSTANCES OF OCCURRENCE: At approximately 1: 00 p.m. on September 19, 1991, at, about or near 895 Moraga Road, Lafayette, California, an employee/driver of a County Connection bus assisted claimant to said County Connection bus, placed her in front of the vehicle door and asked her to wait while he opened it. As the employee/driver opened the bus door, the door flew open and knocked claimant backwards over a cement parking block. 4) DESCRIPTION OF INJURIES, DAMAGES AND LOSS: Severe physical and emotional injuries including, but not limited to, injury and reinjury to claimant' s back and hips, injury to head. 5) NAMES OF EMPLOYEES CAUSING INJURY AND DAMAGE: Officers , agents, servants and employees of the County of Contra Costa, California. 6) AMOUNT OF DAMAGES CLAIMED: In excess of $10 , 000 . Jurisdiction over this claim will rest in the Superior Court of the County of Contra Costa. DATED: March 2 1992 HILDEBRAND, McLEOD & NELSON, INC. BY: (;�6 RELL A ORNE FOR CLAIMANT O Q0 U} O .14 r{ - P 4-) Q) u1 O 0 u Ln Ln rti --T w �4 .4.i M O 4-) N 't3Ou � U -NV O Cq O N N � 4} I pp- CLAIM RECEIVE® BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MAR ) I� � `� 1992 Claim Against the County, or District governed by) BOA%,QT�014 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT April 7, N1��IEZ. CgL,F 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: $5,000 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: TORRES, Charlene J. ATTORNEY: Date received1992 ADDRESS: 2765 Wailea Circle BY DELIVERY TO CLERK ON March 5, Fairfield, CA 94533 BY MAIL POSTMARKED: Hand delivered via Risk Mgmt. I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted.claim. DATED: P1arch 5, 1992 PpHHIL ATCHELOR, Clerk BY: Deputy 011 AAJ 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: Gated: _ �r) 2 BY: — Q� / f Deputy County Counsel U ' 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. 0 0 6 Dated: APR 0 7 1992 PHIL BATCHELOR, Clerk, By a 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: ATR 0 7 1992 BY: PHIL BATCHELOR byLD .Peputy Clerk CC: County Counsel County Administrator I i Clain: to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for in.jury 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. �t iE �I iE * * iF ;i ;♦ it iE iF ;!i * * If iE * iF RE: Claim By ) Resery d fo 3k's fi s p \ ) RECEIVE® Against the County of Contra Costa ) MAR 51992 or ) District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. atj The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 'T o O U and in support of this claim represents.,as.,follows: 1. When did the damage or injury occur?~(Give exact date and hour) --------I vo v e"D C RP -------- 2. ' Where did the damage or•- injury occur? (Include city and 'county) Ke i _N C 2 n±r a C o S?g.. C t�a✓i� ----------------- N__N___ 3. How did the damage or injury ``occur? (Give full details; use extra paper if _SS required) V0. Ikin q On Sidewalk 'L �o,,4 S etl v._per NiS� Sc�cai Fr,oTi�a�� Jamie , _14 vas c`0., K a nA own 4 rlre'in J on a �cic o`h �1ze S(jewalk mcross Ae_ S}recA -Vro*% the WiS� Sc.�ool near +ne- park - ------------------------------------------------------------- --- --- ---- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? W11 01 o ��e Sic'etvo- 1K on (��iP� S�ree� : r�1is is neS l +pence On pa.r-� o-� caun41 workers ho� 4-o rtfea r 6JQWailC , There arc ma,�r �„ iea on ,,; _% 'J fwa lle- (over) �. Wnat are the names of county or district officers, servants or employees causing the damage or injury? ------ -------------­ - ----------------------------- ---------------- 5. What damage or injuries do you' claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. aruWen 0n Kle Corn. uSi6m5 on +he knee Torn S /cCLA Su-; 4 Shoe, Wren Kecl � ------------------------------------------------------------------------------------- 7• How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) C�ar jr..,e s v;�erej q. S e v ere. b ro ken cxeA t e- %OAIC� nee(�eck to Days 3Weeks Spl;+7+- 0/2 6. eas4 wA� cry+chef 3 wevW5 � J. c;.;r SPGR . F`uu 15s4l1) 5woHen . Cars`,fce)sc-Aicn -�cr ►pis �e�-� 4in,e � Pain (qna S _ e�►�J--� Go--- T�e aa�ve o� �er ��wc�}_su t cr.�nc1 ceS00. -- ----------- — —1--------- ----------------------- 8. Names and addresses of witnesses, doctors and hospitals. ` GC r,J to Recs ( iJ�sbe�d � 47GS VOL1 ea Ccr'c1e: 1 Sevt�a l evPte r�ecl I Fa1��•ie�U CA IT4p; 33 P GaQ.� �aQ►'eS Son) 1CC9 14carn Arc 5�,}. Roses ea -6 `ass A+ Clna,lene C6 P0.+ne�v, Pe�alu�ra CR 9y `) S� w1,e., Sie cell i E Ann Dellari ( \ �►eceSsar� T cu. 3e+ ---- - K Sb = Noy ice}u \ � i I e 0 ----SCI�GI s C-- h e j.��k llv-`b e 1l------------- 1 ti e,r n e.m es. --- --- - -- --- -- -- ----------- 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 _ � . Claimant' _ ignature 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, 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 thai' 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 � s - _� _ � , �i - - '� � -6 - .__ e :- . -�� II " ' � `. � ,��' � � 1 1y 1,- 0 t'; r y i T � y �. � , r . ,�� i�;fs,` (1 1_ ��F` _ _...M.�l ' ��1'( _ � /.++III �f � /'V :,`�•. �; 4 VkA N FROM M,EM Gary j Torres Battalion Chief Communication Center TO' �a v,.t C 0 n C R A., rt (L 4 �tJ C- 6 R E> C� ble C Y- IbS 42 v 0 are