Loading...
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. •,f i A �ry o- Y �„ lot J cri cn +i1 O L Q `ave�� J BZW LQ a �J 0 Q 4 rn Q Q� Q� It r Z a w 0 N p U 3 He, w � Wa , w w dyW� 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 �\ . \ \ VIA4 \ _ �® jj� � * ! \ \ @ » � * � 0 \ C �'« « a � « . # « � a 9 A � � o2Q '• 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 l 8 4 00 �� •�`� ao Li \Y Y l}d•Y 0 t� 10 Cr i u. N F, f-A a A � �ov t, l � Q a. o rn ? g W x o Q 2 p U vo (L 0 p r 7 Q a r� � 7 U1 4. W O d