HomeMy WebLinkAboutMINUTES - 06161992 - 1.2 (2) MAY 2
CLAIM 8 �99
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MART1A1WqUNSE1
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 16 , 1992
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim-by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: Unspecified Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: STRANGE, Jay
ATTORNEY: c/o Law Office of Jay Chafetz
1375 Creekside Drive Date received
ADDRESS: Walnut Creek, CA 94596 BY DELIVERY TO CLERK ON May 26 , 1992
BY MAIL POSTMARKED: May 22, 1992
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: JAIL BATCtELOR, Cler a
Ma)r 2.87 1 AA2. P y100:
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
'fes ) 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: 7 BY:� �' Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2)
( ) Claim was returned as untimely with notice to claimant (Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present
(✓) This Claim is rejected in full.
( ) Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for
this date_.}
lm
Dated: "IRT 1 PHIL BATCHELOR, Clerk, B 4W 01 0 Deputy Clerk
-nit
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 andNo ice to Claimant, addressed to
the claimant as shown above.
1
Dated: JUN 6 1992 BY: PHIL BATCHELOR byC D Deputy Clerk
CC: County Counsel County Administrator
JAY CHAFETZ RECE, �®
ATTORNEY AT LAW
1375 CREEKSIDE DRIVE MAY WALNUT CREEK,CALIFORNIA 94596 2 61992
510 933-5890
CLER COl AR0 OF_" "
A COSTA Cp SORB
May 22, 1992
CONTRA COSTA COUNTY BOARD OF SUPERVISORS
CLERK'S OFFICE
651 Pine Street, Room 106
Martinez, CA 94553
Dear Sir or Madam:
Please find enclosed a claim submitted pursuant to Government
Code section 910. Also, I am enclosing an extra copy and request
that you stamp this copy as received and return it in the enclosed
return envelope.
Thank you for your courtesy.
Very truly yours,
P4
Jay Chafetz
JC:rfm
Encl: Government Claim (original and one copy)
Return envelope.
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RECEIVED-
MAY 2 61992
GOVERNMENT CLAIM CLERK BOARD OF SUPERV
CONTRA COSTA CO,
TO: CONTRA COSTA COUNTY, CONTRA COSTA COUNTY SHERIFF'S
DEPARTMENT, AND CONTRA COSTA COUNTY SHERIFF'S
WORK ALTERNATIVE PROGRAM
Attention: Board of Supervisors
The following claim is submitted pursuant to Government Code
section 910.
1. Claimant's name and address:
Jay Strange
c/o Law Office of Jay Chafetz
1375 Creekside Drive
Walnut Creek, CA 94596
2. Send Notices To:
Law Office of Jay Chafetz
1375 Creekside Drive
Walnut Creek, CA 94596
3 . The Occurrence:
a. Date: 12/15/91
b. Place: In or about an abandoned industrial
building in the vicinity of Hall and Harbour Way in Richmond,
California, the probable address being 1422 Harbour Boulevard,
Richmond, California.
c. Circumstances: Claimant Jay Strange was assigned
to work at the Port of Richmond harbor or marina on December 15,
1991 pursuant to the Contra Costa County Sheriff's Work
Alternative Program.
When claimant reported to work on December 15, 1991,
Marina assistant Bill Henry told claimant to go with assistant
harbormaster Tracy Cullen. In violation of claimant's
constitutional and civil rights and the work alternative program
contract and regulations, Cullen maliciously, despicably, and
with deliberate intent to inflict injury drove claimant away from
the work alternative program site to an abandoned industrial
building which was clearly marked, and which Cullen knew, was
uninhabitable, hazardous to human life, and filled with asbestos.
Cullen deliberately and maliciously locked claimant in the
industrial building for several hours.
As a consequence of Cullen's conduct, claimant received
a prolonged and significant exposure to asbestos and suffered
emotional distress. Asbestos fibers entered his lungs, where
they will serve as a possible future source of asbestosis, lung
cancer, or other diseases related to exposure to asbestos.
Claimant believes Contra Costa and -its agents and
employees were negligent in their setting up and monitoring of
the Work Alternative Program, negligent in their selection and
monitoring of the Port, Marina, or Harbor of Richmond and its
agents and employees, and hired an incompetent entity or persons
to have charge over claimant in the Work Alternative Program.
The acts done to claimant constitute assault and
battery and/or a willful and unprovoked physical act of
aggression of Cullen, Henry, and Woods and/or a willful physical
assault of the City of Richmond, City of Richmond Harbor, City of
Richmond Marina, Port of Richmond, Contra Costa County, Contra
Costa County Sheriff's Department, and Contra Costa County
Sheriff's. Work Alternative Program.
Claimant intends to assert all possible causes of
action and theories arising out of the above circumstances,
including but not limited to violation of constitutional and
civil rights, various rights under the penal code including but
not limited to being free from cruel and unusual punishment,
negligence, intentional and negligent infliction of emotional
distress, dangerous condition of public property, assault and
battery, prior authorization of the acts alleged, ratification of
the acts alleged, negligent supervision, training, and hiring of
agents and employees, and negligent and unconstitutional customs
and practices.
4. General Description of indebtedness, obligation, injury,
damage or loss:
Exposure to asbestos. Probable future lung cancer,
other asbestos-related injury, and death; related medical
expenses and wage losses; loss of earning capacity; shortened
life expectancy; anxiety; emotional distress and pain and
suffering; violation of constitutional and civil rights.
5. Names of government employee(s) causing the loss:
Assistant Harbormaster Tracy Cullen and Marina
Assistant Bill Henry. Possibly Harbormaster Sharon Woods.
Unknown employees of Contra Costa County who were in charge of
setting up and monitoring the Work Alternative Program.
6. Amount Claimed: The amount claimed would fall within
the jurisdiction of the superior court.
Dated: May 15, 1992
JChafettt
Attorney for Claimant
CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA �
®8199
Claim Against the County, or District governed by) BOARD ACTIO 0141y
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 16, 1992",Ncou, I
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: $100,000.00+ Section 913 and 915.4. Please note all 'Warnings".
CLAIMANT:MATH ERS, Thomas and Jeanie
ATTORNEY:Harold W. Tobin, Esq.
3240 Lone Tree Way, Suite 103 Date received
ADDRESS: Antioch, CA 94509 BY DELIVERY TO CLERK ON MAY 28, 1992
BY MAIL POSTMARKED: May 27, - 1992
CERT P 790 272 932
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
DATED: June 1, 1992 VIL LATTCHtyLOR, Clerk L4Ua
I1. FROM: County Counsel TO: Clerk of the Board of Supervisors
�N ) 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: X1 1 12,- BY: Deputy County Counsel
T
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
(✓) 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: U� -6 1992 PHIL BATCHELOR. Clerk, By ° , Deputy Clerk
NARNING (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 NAILING
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 a to Claimant, addressed to
'the claimant as shown above.
Dated: JUN, 1.6 19
92 BY: PHIL BATCHELOR by 0 � Deputy Clerk
CC: County Counsel County Administrator
' ll
Harold W. Tobin
Attorney at Law
3240 Lone Tree Way, Suite 103
(415) 737-9400 Antioch, California 94309
RECEIVED
Date: May 21 , 1992 MAY 2 8.1992 „;
To: Contra Costa County . CLERK BOARD OF SUPERVISORS
Risk Management CONTRA COSTA CO.
651 Pine Street i
Martinez, CA 94553 t
f
be: Thomas Mathers and Jeanie Mathers j
Enclosures: Claim Against County of Contra Costa
These are furnished for the purpose designated below:
( ) Your signing and returning the enclosures to the
undersigned in the enclosed return envelope.
(xxxxx) Filing and return of the endorsed-filed copies to the
undersigned (Envelope and copy/ies enclosed) .
( ) Signature of the Court, filing of original, and return
of the endorsed-filed copies to the undersigned (en-
velope and copy/ies enclosed) .
( ) Recording and return to the undersigned (copy/ies and
envelope enclosed) .
( ) For your records and information
( ) Also, enclosed is our check in the amount of $
to cover the fee.
o her.
V u y yours,
I
T N
torney at Law
HWT/cm
I "
RECEIVED
VIN 2 R
CLERKS Of SUPER�SORS
CLE CCOSTA
CLAIM AGAINST COUNTY OF CONTRA COSTA
TO: CONTRA COSTA COUNTY
Risk Management
651 Pine Street
Martinez, CA 94553
CLAIMANT° Thomas Mathers and Jeanie Mathers
ADDRESS: 5 East Madill Court, Antioch, CA 94509
TELEPHONE NO. : (510) 757-9400
SEND NOTICES TO: Harold W. Tobin, Esc . , 3240 Lone Tree Way, Suite
103, Antioch, CA 94509
DATE AND TIME OF OCCURRENCE: 04/24/92, 05.4.5.
EXACT PLACE
OF OCCURRENCE: Deer Valley Road .4 mi. N of Empire Mine Road.
DESCRIBE IN FULL DETAIN HOW THE INJURY OR DAMAGE OCCURRED:
Claimants were driving on the roadway and hit loose gravel causing their
vehicle to slide off the road and hit the embankment and drop into a ditch
on the side of the road. Failure to give advanced warning of loose gravel
and leaving the roadway in an unsafe condition was the cause of this accident.
PARTICULAR ACT OR OMISSION BY EMPLOYEE, OFFICER OR AGENT CAUSING
THE INJURY OR DAMAGE° , Failure to regulate and failure to clear
gravel from public road.
NAME(S) OF F fIPLQYEX,CSUNTYF-TCE W8RKGENT CAUSING THE INJ-URYr
OR DAMAGE: CVSTROAD
Page two CONTRA COSTA COUNTY
Claim against
DESCRIBE FULL EXTENT OF INJURIES AND DAMAGE CLAIMED: Thomas
Mathers : Acute moderate/traumatic cervical and lumbosacral sprain/
strain with cervicalgia; Jeanie klathers: Acute moderate/traumatic
TOTAL AMOUNT CLAIMED: $100, 000 . 00 -- BASIS OF COMPUTA-
TION OF TOTAL AMOUNT:
$100, 000•. 00 general damages plus unknown special damages .
NAMES, ADDRESSES, AND TELEPHONE NUMBERS OF WITNESSES, DOCTORS,
HOSPITAL, AND ANY PERSON WHO CAN SUBSTANTIATE YOUR CLAIM OR THE
AMOUNT CLAIMED: Kaiser, 200 Muir Road, Martinez, CA 94553 ;
L. D. Frigard, D.C. , 501 W. Third Street, Antioch, CA 94509
I declare under penalty of perjury that the forgoing is true
and correct under the laws of the State of California and that
this was executed on this I& day of `" --n ,
1992 , at Antioch, California.
17
-ITTIOMAS MATHERS
C�
MATHE RS
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'• CLAIM AIAV
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA '�8 199
Claim Against the County, or District governed by) BOARD ACTION
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 16 , 1992
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: Unspecified Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: LIGMAN, Greg
ATTORNEY:
Date received
ADDRESS: 6251 Hillinont BY DELIVERY TO CLERK ON May 27 , 1992
Oakland, CA 9460.5 .
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.
PpHHIL BATCHELOR, Clerk 0�44JL,
DATED: M,a, 2,q L}2.� 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: qZ BY: ` _ �, 6 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. �1 C
0
Dated: JUN 16 1992 PHIL BATCHELOR, Clerk, By OL ° , Deputy Clerk
$lit -
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'ce to Claimant, addressed to
the claimant as shown above.
Dated: JUN 16 1992 BY: PHIL BATCHELOR b Al o Deputy Clerk
CC: County Counsel County Administrator
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Greg Li gman
6251 Hillmont
Oakland, CA 94605
Re: Claim of Greg Ligman
Please Take Notice As Follows :
The claim you presented against the County of Contra Costa or District
governed by the Board of Supervisors fails to comply substantially
with the requirements of California Government Code section 910 and
910. 2, or is otherwise insufficient for the reasons checked below:
1 . The claim fails to state the name and post office address of
the claimant.
2. The claim fails to state the post office address to which
the person presenting the claim desires notices to be sent.
3 . The claim fails to state the date, place or other
circumstances of the occurrence or transaction which gave
rise to the claim asserted.
4 . The claim fails to state the name(s) of the public
employee(s ) causing the injury, damage, or loss, if known.
XX 5 . The claim fails to state whether the amount claimed exceeds
ten thousand dollars ($10400). 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. WEST , County Counsel
By: �7
Deputy ounty Coun el
CERTIFICATE OF SERVICE BY MAIL
C.C.P. 95 1012 , 1013a, 2015 .5; Evid.. C. SS 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: May 29, 1992 . at Martinez California.
cc: Clerk of the Board cf Supervisors (o. -iginal)
Risk Management
(NOTICE 'OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910 . 2, 920 .4; 910 . 8 )
Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA OOUNTY
I10MCTIONS TO CLADUM
A.,- .Claims relating to causes of action for death or for injury to person or to per-
_ conal 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 5911.2.)
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 9 +553.
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.
AE: Claim By ) Reser ed fo erk's iling stamp
)
Against the County of Contra Costa ) MAY 2 7 I
or )
District) CLERK BOARD OF SUPERVISORS
Fill in name ) CONTRA COSTA CO.
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of-$ and in support of
this claim represents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
t� ag qJ
-30
2.
Q"^
2. Where did the damage or injury occur? (Include city and county)
n"� �icNNonCCoQ �
D �a� �, �
3. How did the damage or in jury oec ? (Give full details; use extra paper i-fl
required)
-&v, des(3 v% a,� t���d S
V e Ua s f4i. LJ-e f-b�7 c�
4. What particular act or emission on the part of county or district officers,
servants or employees caused the injury -or damage?
(over)
5. What are the names of county or district officers, servants or employees. causing
the. damage or injury?
6. what damage or injuries do-you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
SJ e V r6' e;-- awe S w i �.�i'� S KuLL '�"' r� �}� I��1J�V e t .S'
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. (
1
P �
9. List the expenditures you made on account of this accident or injury:
DATE FL AMOUNT
053
41 It IF
Gov. Code Sec. 910.2 provides:
03
s"I' a: "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's Signature
(Address)
pA(Z- A C�
a
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 than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such imprisonment and fine.
CLAIM MAY
• BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA COU . 8 1992
MART/ roUMg�
Claim°Against the County, or District governed by) BOARD ACTION Gc�F
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 16 , 1992
and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of
California Government Codes. ) the action taken on your claim by the Board of Supervisors
(Paragraph IV below), given pursuant to Government Code
Amount: $200 ,000. 00 Section 913 and 915.4. Please note all "Warnings".
CLAIMANT: KING, Margaret Katherine
ATTORNEY: Stanley Pedder, Esq.
Pedder, Stover &. Hesseltine Date received
ADDRESS: 3445 Golden Gate Way BY DELIVERY TO CLERK ON May 26, 1992
P .O: Box 479
Lafayette , CA 94549 BY MAIL POSTMARKED: May 22, 1992
I. FROM: Clerk of the Board of.Supervisors TO: .County Counsel
Attached is a copy of.the above-noted claim.
DATED: May 28 , 1992 EVIL DeputX_ Clerk 2-
11.
FROM: County Counsel TO: Clerk of the Board of Supervisors
____44 ) 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: CJ lii BY: ��" Deputy County Counsel
1I1. 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: JUN 16 1992 PHIL BATCHELOR, Clerk, By 0 ° , 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.
1 16 19 ,
Dated: JUN 1 92 BY: PHIL BATCHELOR by0a Deputy Clerk
CC: County Counsel County Administrator
REDDER, STOVER, HESSELTINE & WALKER
• ATTORNEYS AT LAW
STANLEY PEDDER
3445 GOLDEN GATE WAY
RICHARD A. MALOTT
JOHN A. STOVER (RETIRED)
W. G. HESSELTINE POST OFFICE BOX 479
TIMOTHY B. WALKER
LAFAYETTE, CALIFORNIA 94549-0479
ROBERT R. HALL (SIO) 283-6816C Ee,.I E®
STEWART W. LENZ fi\A p(Eem,.Bfl
FAX (510) 283-3683
MAY 2 61992
May 22, 1992
CLERK BOARD OF SUPERVISORS
CONTRA COSTA CO.
Clerk of the Board of Supervisors
Room 106, County Administration Building
651 Pine Street
Martinez, CA 94553
Re: Margaret Katherine King against County of Contra Costa
Gentlemen:
Enclosed please find original and copy of Claim. Please file
same and return an endorsed filed copy to me in the enclosed, self-
addressed return envelope.
Thank you.
Very truly yours,
PEDDER, STOVER, HESSELTINE &
WALKER
�k-I ,k
ANNE M. KEITH, Secretary to
STANLEY PEDDER
AMK
Enclosures
92 : 094
CC: Greg Harvey, Esq.
Mr. Ron Harvey
Clair,: 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,ofthe 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. W
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 dlerk's filing stamp
)
MARGARET KATHERINE KING ) RECEIVE®
Against the County of Contra Costa ) MAY 2 61992
or )
District) CLERK BOARD OF SUPERVISORS
Fill in name ) -CONTRA-COSTA CO.
The undersigned-claimant"hereby makes claim against the County of Contra Costa or
the above-named District in the sum of $ 200 . 000 .0 0 and in support of
this claim represents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
5/6/92 at 10 : 30 a.m.
----N---_--_--__�eo_N��_------N�N�:--N-------------------_------_------
2. Where did-the damage or injury occur? (Include city and county)
Alhambra Avenue, intersection with ".C" Street,
Martinez , County of Contra Costa, State of California.
---Y---------------_0_N_aN__NNN_MND__-___N_NCN-N__M__-___-_.�____�.+_+_-__
3. How did the damage or injury occur? (Give full details; use extra paper if
required)
Claimant was run down in . crosswa.lk by motor vehicle.
-------------------=------ ---------------------------
----
U. What particular act or omission on the part of county or district officers,
servants or .employees caused. the injury or damage?
Motor vehicle was operated by county employee, to wit: hospital
administrator, Hariette Jeanne Fisher, while in the course and scope
of her employment with the county; in the. county. hospital. At said
time and place said Fisher was inattentive and negligent in running
into claimant who was legally and lawfully walking in the crosswalk at
the intersection of Alhambra Avenue & C Street, (over)
Martinez.;. California.
7. Wnat are the names of county or district officers, servants or employees causiing
the damage or injury?
See 4 .
------------------------------------------------------------------------------------
6. What damage or- injuries do you claim resulted? (Give full extent 'of injuries or
damages claimed. Attach two estimates for auto damage. '
Head trauma, left clavicle.. fracture, right arm fracture, rib fracture,
knee fracture, _ leg fracture .
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
Estimated pain : and .suf.fesing and medical expense
------------------------------------------------------------------------------------
8. Names and addresses of witnesses, doctors and hospitals.
John Merson, M.D. , 2121 Ygnacio Valley Road, Walnut Creek, CA
John Muir Memorial Hospital, 1601 . Ygnacio Valley Rd. , Walnut Creek, CA
Lafayette Convalescent Hospital, 1034 2nd St. , Lafayette, CA
---- ---- -----------------------------
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
No bills have yet been received, no cost computed, injuries continue
to be treated, continual hospital and convalescent home. Stay is
-continual.
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
STANLEY PEDDER, ESQ. Claimant's Signature
PEDDER, . STOVER &' HESSELINTE MARGARET K,. KING .
3445 Golden -Gate Way c o PEDDER STOVER HESSELT-INE & WALKER
P. O. Box 479- - Address
Lafayette, CA 94549 P. O'. - Box 479
Lafa ette. CA 94549
Telephone No. (510) 283-6816 Telephone No. 510/283-6816
9 1 F # # # * # # # # # # �t
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 ($10,000, or by
both such imprisonment and fine.
1 DECLARATION OF SERVICE BY MAIL
2 I, the undersigned, a citizen of the United States, employed
3 in the County of Contra Costa, over the age of eighteen (18)
4 years, whose business address and place of employment is 3445
5 Golden Gate Way, Lafayette, California 94549, declare that I am
6 not a party to the within action; that on May 22 , 1992, I
7 deposited a true copy of the attached document entitled CLAIM BY:
8 MARGARET KATHERINE KINV AGAINST THE COUNTY OF CONTRA COSTA in the
9 United- States Mail., Box,. . in . the . City of Lafayette,, County of
10 Contra Costa, State of California, by placing it in a sealed
11 envelope, with postage thereon fully prepaid and addressed as
12 follows:
13 GREG HARVEY, ESQ.
OFFICE OF THE COUNTY COUNSEL
14 COUNTY OF CONTRA COSTRA
P. 0. Box 69
15 Martinez, CA 94553
16 RON HARVEY, LIABILITY CLAIMS MGR.
RISK MANAGEMENT DIVISION
17 OFFICE OF THE COUNTY ADMINISTRATOR
651 Pine Street, 6th Floor
18 Martinez, CA 94553
19 I declare under penalty of perjury at Lafayette, California,
20 on the date shown below, that the foregoing is true and correct.
21 Dated: May 22, 1992
22
23 �
24 ANNE M. KEITH
25
26
27
28
ULOTT,PEDDER,STOVER
& HESSELTINE
ATTORNEYS AT LAW
.3445 GOLDEN GATE WAY
L.AFAYETTE
CALIFORNIA 9454$
AREA CODE 415
283-6816
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