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HomeMy WebLinkAboutMINUTES - 06021992 - 1.35 DATE �� -�-� o� ITEM NUMBER THE ORIGINAL CLAIMS ARE FILED IN THE MINUTE FILE. CLAIMS FOR JUNE 2, 1992 ^y DENY CLAIMS OF: CNA/W.&R. HOLDEN, T. DEMPSTER, B. GRAVES/,B. MCGLOUD, C. LEAL, A.' MOUSSA, M: MC CUAIG, D. PFLUM, R. SIKES CLAIM RhVED BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MAY 0 11992 Claim Agni• the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT Ilk"M June 2; 19.92 and Board Action. All Section references are to ) The copy of this document mailed to you is y h ice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $50,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT:CNA/HOLDEN, Wilfred and Ruth Claim No. 13-434175 T8 ATTORNEY: Date received ADDRESS: P.O. Box 7430 BY DELIVERY TO CLERK ON May 1, 1992 San Francisco, CA 94120 7430 BY MAIL POSTMARKED: April 20, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: May 1, 1992 ggIL BAATTCepuYELOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors \( ) This claim complies substantially with Sections 910 and 910.2. '(v ) 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: / 9 L 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.JU0 N UN e 2 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING 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 No ice to Claimant, addressed to the claimant as shown above. CL Dated: JUN e 2 1992 BY: PHIL BATCHELOR by v 0 LDeputy Clerk 11t. CC: County Counsel County Administrator •tl NOTICE OF INSUFFICIENCY AND OR NON-ACCEPTANCE OF CLAIM TO: Wilfred & Ruth Holden P.O. Box 7430 San Francisco, CA. 94120-7430 Re: Claim of Wilfred & Ruth Holden 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 . XX3 . 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. WESTMANntyCounsel By: Deputy o my Counsel CERTIFICATE OF SERVICE BY MAIL; C.C.P. 99 1012 , 1013a, 2015. 5 ; Evid. C. 96. 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 4, 1992 , at Martinez, California cc: Clerk of the Board cf Supervisors ( ginal) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOV.C.§§ 910, 910. 21 920: 4, 910 . 8 ) CNA San Box 7430 San Francisco CA 94120 7430 Public Defenders Office April 10, 1992 200 37th Street Richmond CA 94530 Claim No: 13-434175 T8 Insured: Wilfred & Ruth Holden � � F���,-tea Date of Loss: 12-16-91 Amount of Loss: $50,000 Type of Loss: Fire To Whom It May Concern: We are writing to you with reference to damage to building located at 200 37th Street, Richmond which occurred on 12-16-91. This property is owned by Wilfred and Ruth Holden and is insured by our company. The damage sustained was in the amount of $50,000. 6uf–investigation indicates that you are responsible for this damage, and we are therefore, looking to you for reimbursement. If you have insurance, please refer this letter to your insurance company and inform us as to your insurance company's name and address, and your policy number. If you do not have insurance, please forward your remittance for the above amount. Please use the enclosed self-addressed envelope when replying so that your payment will receive prompt acknowledgment. Very truly yours, , Christine Hoyt ` — Claim Specialist Continental Casualty Comp y APR 1 1L (415) 872-5641 ------------ ANCH CL220/c117e10.518/82 ECE V ® �` J OR 'UBL;C DEFENDER CONTF , Cfi4TA COUNTY MAY 11992 �~ CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. CNATranscontinental Technical Services, Inc. For All the Commitments You MakO oz x c A A 3 � ?p ✓e.� n @ � N N HG o G w o w A_ N O v a w 0 S : —41 NAA .Y' r �♦ 't 1 aP c I , 0 r+• CLAIM REE®t�SJ BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTIO.Y 1 4 1992 the Boar.1 of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 22, 1 NN��NsEl and Board Action. All Section references are to ) The copy of this document mailed to you is your notice ofltrF California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $250,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: DEMPSTER, Teresa Uri b e ATTORNEY: Eric Goldman, Esq. Goldman and Goldman Date received ADDRESS: 1910 Olympic Blvd. Suite 220 BY DELIVERY TO CLERK ON May 13, 1992 Walnut Creek, CA 94596 BY MAIL POSTMARKED: May 12, 1992 CERT P 387 376 891 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. May 14, 1992 PpHHIL BATCHELOR, Clerk a DATED: B`f: Deputy 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: F1 Z 1'i J �• �1 BY; � �"• Deputy County Counsel V III. FROM: Clerk of the Board TO: County Counsel (1) County Adm rator (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 e 2 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk '►jai -- - ----- 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 9456. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. 0 Dated: JUN ' 2 1992 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator • '+ GOLDMAN @ GOLDMAN RECEIVED ATTORNEYS AT LAW 1492 1910 OLYMPIC BOULEVARD MA`y'1 �D SUITE 220 WALNUT CREEK, CALIFORNIA 94596 CLERK ROARD OF SUPERVISORS (510) 939-6629 CONTRA COSTA CO. May 12, 1992 Contra Costa County Room 106 County Administration Building 651 Pine Street Martinez , CA 94553 Re: Claim by Teresa Uribe Dempster Dear County: Please file the enclosed claim on behalf of Teresa Uribe Dempster against the county and conform the copy of the claim and return it to me in the enclosed SASE. Thank you. Yours very truly, Eric Goldman Claim- to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS 110 CI.ADOM 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 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 file] arainst each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this Toren. RE: Claim By ) Reserved for Clerk's filing stamp TL:'Z.LSA U1:I13h L)ENIPSTER ) RECEIVED MAY 1 31992 Against the County of Contra Costa ) Or ) CLERK BOARD OF SUPERVISORS MgRRITHEW MEMORIAL HOSP. District) CONTRA COSTA CO. Fill in name ) The undersigned claimant•hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 250 , 000 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) February 10, 1992 . 2. Where did the damage or injury occur? (Include city and county) - - --"-- " - — Merrithew Memorial Hospital, Martinez, CA, County of Contra Costa . 3. How did the damage or injury occur? (Give full details; use extra paper ifMN re red) Claima i went in for surgery to remove a lump fr)om her leg. The surgeon operated on the wrong part of her body and took out "a generous portion" of tissue. When the mistake was discovered, claimant was returned for see ara _surgery. --- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? The doctor operated in the wrong place and caused injury. (over) 5. What are the names of county or district officers, servants or employees causing' the damage or injury? Dr. Stephen D. Weiss, surgery clinic, Merrithew Memorial Hospital . 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. The surgeon made a large, deep incisi6n. through subcutaneous tissue and removed a large mass of healthy tissue. Pain, infection, large ugly scar . 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Pain and suffering, unnecessary surgery, permanent large rough scar. 8. Names and addresses of witnesses, doctors and hog itals. Hospital staff, nurses, doctors at Merrithew. M�morial Hospital . ------------------------------------------------------------------------------------- 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 oA his beha ." Name and Address of Attorney Eric Goldman, Esq. Claimant's Signature Goldman & Goldman 1910 Olympic Blvd. , Suite 220 By Eric Goldman Walnut Creek, CA 94596 Attorney for Teresa Uribe Dempster Address PF 7 _ Telephone No. ( 51 0 ) 939-6629 Tele hone No. N 0 T I C E 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. � 0 .• m N ; 2 � � L l ' as° � p \ • leA- W �Y• �G ,..,- .y 5 Ml CLAIM RECEIVED . Jq BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA MAY 14 1992 Claim"Against the County, or District governed by) BOARD ACTIO A� N1y the Hoard of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 2, 1992 rr�� 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: $10,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: GRAVES, Barry by and through hi.s Guardian Ad Litem Belinda McCloud ATTORNEY: Judith A. Pascoe, Esq. Moss & Hough Law Office Date received May 13, 1992 ADDRESS: 755 Sansome Street, Suite 350 BY DELIVERY TO CLERK ON San Francisco, CA 94111 BY MAIL POSTMARKED: Unreadable 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pH gg DATED: BYIL DeputyLOR, Clerk o 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: 1z• 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). 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 N — 2 1992 PHIL BATCHELOR, Clerk, By ° Deputy Clerk filo — --- — 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. 0 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 1 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: JUN — 2 1992 BY: PHIL BATCHELOR by01 1Deputy Clerk CC: County Counsel County Administrator ---� E D MOSS & HOUGH MAY 131992 Attorneys at Law 755 Sansome Street,Suite 350,San Francisco,California 941bCLERK BOARD OF SUPERV! CONTRA COSTA CO SORB Telephone 415 399-1110 / Telefax 415 399-1552 Gary E.Moss Mary Patricia Hough May 12 , 1992 Judith A.Pascoe Board of Supervisors Room 106 --County Administration Building 651 Pine Street Martinez, CA 94553 Re: McGloud v. Contra Costa County Dear Clerk: Please file the enclosed claim form and return to us a filed endorsed copy. Thank you for your courtesy and cooperation. Very truly yours, /Kelly g ClAim to: BOARD OF SUPERVISORS OF CONTRA COSTA OOUNTY % INSTROCTIONS 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, 19879 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 rqi F,-.•laterj,than one .year after the- accrual of the cause of action. (Govt. Code §911.2.) 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 .�p3�..+^�-* eanh public entity. E. Fraud. See penalty for fraudulent claims, Penal Code See. 72 at the end of this Toren. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RE: Claim By ) Reserved for Clerk's filing stamp Barry Graves by and through hisRECEIVED ) Guardian Ad Litem Belinda McCloud ) Against the County of Contra Costa ) MAY. -I 31992 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 $ 10,000.00 and in support of this claim-represents as follows: -------------------------- -- --- 1. When did the damage or injury occur? (Give exact date and hour) Nom=ke U, 1221 at nppr is r p 3� A•�� �� __ ��� -- 2. Where did the damage or injury occur? (Include city and county) Qen{{- al .Toni nr H;uh Srhn�� Pittsburg«Contra Costa County. S.rr _ ��aa_ r:�-s:.'t•.a-ate w...w—i<�a.ta...�.a.�— 3. How did the damage or injury occur? (Give full details; use extra paper if required) A s.tudent attending Central Jr. High brought a gun to class. He shot Barry Graves with the gun. 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? The school failed to ensure Barry Graves safety by allowing the student, Alonzo Smith, to bring a gun to school. The school should have known of Alonzo Smith's dangerous propensities. (over) at 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. Barry Graves suffered a hematoma and swelling to right eye. His vision is blurred and may havePermanent eye injuries. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Medical expenses-incurred unknown at this time Future medical expenses-unknown at this time. 8. ZaosseMendosaoopsgal of witnessUA Foansrscand bssf1Hospital Emergency Dept. 2200 O'Farrell Street 2311 Loveridge Road San Francisco, CA 94115 Pittsburge, .CA 94565 Dr. Sing - Orthopedic Dept. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT To Be Ascertained: Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his half." Name and Address of Attorney Judith A. Pascoe, Esq. _ Signature) MOSS & HOUGH LAW OFFICE -- 755 Sansome Street, Suite 350 Attorney . or Claimant San Francisco, CA 94111 (415) 399-1110 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 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. :... PROOF OF SERVICE - - 3 I am a citizen of the United States and am employed in 4 the County of San Francisco. I am over the age of 18 years and am 5 not a party to the within action. My business address is 755 6 Sansome Street, Suite 350, San Francisco, California 94111. 7 On May 12, 1992, I served the following: 8 Claim to Board of Supervisors of Contra Costa County 9 by placing it in a sealed envelope with postage thereon fully 10 prepaid, in the United States mail at San Francisco, California, 11 addressed as follows: 12 Board of Supervisors 13 Room 106 County Administration Building 14 651 Pine Street Martinez, CA 94553 15 16 I declare under penalty of perjury that the foregoing is 17 true and correct, and that this declaration was executedlon 18 May 12, 1992, at San Francisco, California. 19 20 Kelly�P g 21 22 23 24 25 26 MOSS X HOUGH Attorneys at Law 755 Sansone Sl:ee;,Sure 350 San Franc..sco.caldornia 94111 Telephone 415 399.1110 Telclas 415 399-1552 C . � \ \ � \ � } 1 � } \ . \ . \ 0 » \ * � o \ 7 / k o { & % y O Ct V, CT � . ¥444 , ` . t �> . . . � 33• � �y � ! \ CLAIM ►a BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA �AY � 1 J X99 Clam Against the County, or District governed by) BOARD ACTIQ��My 2 the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 2, 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: LEAL, Christina Marie, a Minor, by and through her Guardians ad Litem Angelina Marie Leal and Raymond J. Leal ATTORNEY: Bayard J. Miller, Esq. Miller & Partridge Date received May 8, 1992 ADDRESS: 3708 Mt. Diablo Blvd. Suite 210 BY DELIVERY TO CLERK ON y Lafayette, CA 94549 Hand delivered BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. May 11, 1992 EV!L BATCHELOR, Cler p 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: BY: lJ� J . 4 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 (✓DO) 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 ® 2 1992 PHIL BATCHELOR, Clerk, By v 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 No 'ce to Claimant, addressed to the claimant as shown above. Dated: JUN- 2 1992 BY: PHIL BATCHELOR by a Deputy Clerk CC: County Counsel County Administrator V Claim.to: BOARD OF SUPERVISORS OF CONTRA OOSTA OOUNTY INSTRUCTIONS 70 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, 19879 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 orm. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RE: Claim By CHRISTINA MTRiE LEF:L, a ; Reserved for Clerk's filing stamp Minor, by and through .h.er:::: G.uardiaiisi.ad:oLiitem ANGELINA MARIA TEAL and RAYMOND J. LEAL ) RECEIVE® Against the County of Contra Costa ) [NAY ` 8 IM or ) V : 15 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: **See Addendum A attached hereto. 1. When did the damage or injury occur? (Give exact date and hour) Please see Addendum 1 attached hereto. 2. Where did the damage or injury occur? (Include city and county) Please see Addendum 2 attached hereto. 3. How did the damage or injury occur? (Give full details; use extra paper if required) Please see Addendum 3 attached hereto. 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Please see Addendum 4 attached hereto. (over) �I 5. What are the names of county or district officers, servants or employees causing the damage or injury? Please see Addendum 5 attached hereto. ------------------------------------------------------------------------- 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. Please see Addendum 6 attached hereto. 7.. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Please see Addendum 7 attached hereto. 8. Names and addresses of witnesses, doctors and hospitals. Please see Addendum 8 attached hereto. -------------------------------------! List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Please see Ad'deAai'ii=9 attached hereto. N Gov. Code See. 910.2 provides: "The must be Ogne4, by the claimant SEND NOTICES TO: (Attorney)� '`{ a persohisbehalf." Name and Address of Attorney Bayard J. Miller, Esq. MILLER & PARTRIDGE 's Signature 3708 Mt. Diablo Blvd. B Y MILLER Suite 210" tt n y for Claimant Lafayette, CA 94549 Address (510) 284-6130 MILLER & PARTRIDGE 3708 Mt. Diablo Blvd. , Suite 210 Lafayette, CA 94549 Telephone No. I Telephone No. _(510) 284-6130 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)0 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. .F ADDENDUM A In excess of $1, 000, 000 and within the jurisdiction of the Superior Court of the State of California, County of Contra Costa. ADDENDUM 1 December 13 , 1991 at the hour of 2350 ADDENDUM 2 Alhambra Valley Road, .4 miles west of Reliez Valley Road, County Costa County (unincorporated - Mt. Diablo Judicial District) , State of California ADDENDUM 3 At said time and place, claimant/minor CHRISTINA MARIE LEAL was a passenger in a vehicle identified as a 1982 Nissan pick up truck, California License Number 2D93501, owned by Robert Daugherty and then being operated by Christopher Daugherty. Christopher Daughter operated said vehicle eastbound on Alhambra Valley Road approaching Reliez Valley Road when he lost control of said vehicle striking bushes and a fence adjacent to the pavement of the roadway. ADDENDUM 4 Claimant contends that the responsible County parties allowed a dangerous and defective condition to exist which caused the incident to occur. Specifically, and without prejudice to assert further acts and omissions as they become known, claimant contends that the County: a. Failed to properly grade the roadway. b. Failed to provide for a proper shoulder. C. Failed to clear the adjacent property from encroaching bushes, trees and shrubs. d. Allowed a permanent and dangerous structure (the fence) to exist adjacent to the pavement of the roadway. ADDENDUM 5 County of Contra Costa Department of Highways and Roadways and maintenance department; others may be responsible whose identities are unknown to claimant at this time. ADDENDUM 6 As a result of the incident, CHRISTINA MARIE LEAL sustained severe and permanent injuries to her right arm (brachial plexus injury) , nerve damage, laceration and separation of right arm, laceration to face and multiple abrasions. Claimant's right arm remains flaccid. Based thereon, claimant's damages include, but are not limited to: 1. Past, present and future medical care and treatment. 2 . Loss of earning capacity. 3 . Loss of scholastic ability. 4. General damages. ADDENDUM 7 Claimant's injury is both permanent and totally disabling. Medical probability of claimant ever having any sensitivity in her right arm or ever to be able to use her entire right arm and hand are extremely remote. See medical expenses below set forth in Addendum 8. ADDENDUM 8 1. John Muir Medical Center 1601 Ygnacio Valley Road Walnut Creek, CA Dr. Robert W. Burns Dr. Lynn Schafer Dr. Cavitt Robert Dr. James L. Pincock Dr. Edward M. Miller Dr. William Hoddick 2 . UC San Francisco Medical Center 505 Parnassus Avenue San Francisco, CA Dr. Nicholas Barbaro 3 . Kaiser Permanente Medical Center 200 Muir Road Martinez, CA Dr. Ryst Dr. Ikeda Dr. Casey Barton ADDENDUM 9 Medical bills to date are in excess of $42, 000 John Muir Medical Center $ 33, 201.25 Dr. Edward Miller 2, 250.00 Dr. Lynn Schafer 1, 549.25 Dr. Robert Burns 1, 049.25 Dr. Cavitt Robert 925.00 Dr. William Hoddick 1,721.00 Dr. James L. Pincock 1,985. 00 1 PROOF OF SERVICE BY HAND 2 I, BAYARD J. MILLER, declare under penalty of perjury that 3 the following facts are true and correct: 4 I am a citizen of the United States, over the age of 18 5 years, and not a party to or interested in the within action. I 6 am an employee of MILLER & PARTRIDGE, and my business address is 7 3708 Mt. Diablo Boulevard, Suite 210, Lafayette, California 8 94549. 9 On May 8, 1992, I personally served the following document: 10 CLAIM [Government Code Section 910. et seg. ] , in said action by 11 placing a true and correct copy thereof, enclosed in a sealed 12 envelope, addressed as follows: 13 Clerk, Board of Supervisors COUNTY OF CONTRA COSTA 14 County Administration Building, Room 106 651 Pine Street 15 Martinez, CA 94553 16 and personally delivering the envelope to the above-stated 17 address. 18 Executed on May 8, 1992, at Lafayette, California. 19 20 21 1001 J77 ER 22 23 24 / 25 26 27 28 CLAIM / BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Rg�FN�o Claim 'Agai►.I►t the County, or District governed by) BOARD ACT,OAY j 1 199 the Board of'Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 2, 1992 W QNry 2 and Board Action. All Section references are to ) The copy of this document mailed to you is your no�f",W&� California Government Codes. ) the action taken on your claim by the Board of Supervisor1119 (Paragraph IV below), given pursuant to Government Code Amount: In excess of $25,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PIOUSSA, Amal Ms. ATTORNEY: Barry Balamuth, Esq. Gus Guinan, Esq. Date received ADDRESS: Law Offices of Barry Balamuth BY DELIVERY TO CLERK ON May 8. 1992 140 Brookwood Road, Second Floor Orinda, CA 94563 BY MAIL POSTMARKED: Play 7. 1992 CERT P 910 209 624 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: May 11, 1992 JVIL BATCYELOR, Clerk epuaym 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: BY: 12 �,/SXJDeputy County Counsel 0- \U 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. O Dated: JUN v 2 1992 PHIL BATCHELOR, Clerk, By Deputy Clerk lili _ __-• WARNING (Gov. Lode 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: JUN - 2 1qq? BY: PHIL BATCHELOR by ° Deputy Clerk CC: County Counsel County Administrator RECEIVE® 1 Barry Balamuth, Esq. (Bar No. 50058) MAY,, LAW OFFICES OF BARRY BALAMUTH S 1992 i 2 140 Brookwood Road CLERKBOARD Orinda, California 94563 OARDOFSUP 3 Telephone: (510) 254-1234 _ CONTRA COSTACo ISORS 4 Attorneys for Claimant 5 6 In the Matter of the Claim of: ) Ms. Amal Moussa ) CLAIM FOR DAMAGES 7 ) (Government Code § 910) 8 ) 9 To the Board of Supervisors of the County of Contra Costa: 10 You are hereby notified that Amal Moussa claims damages from 11 Merrithew Hospital and- others in an amount in excess of $25,000. 12 1. NAME AND ADDRESS OF CLAIMANT: 13 Ms. Amal Moussa 4860 Clayton Road, #25 14 Concord, CA 94521 15 2 . NOTICES/COMMUNICATIONS REGARDING CLAIM TO BE SENT TO: 16 Barry Balamuth, Esq. Gus Guinan, Esq. 17 Law Offices of Barry Balamuth 140 Brookwood Road, Second Floor 18 Orinda, CA 94563 (510) 254-1234 19 3 . DATE AND LOCATION OF INJURY/DAMAGES: 20 On or about November 16, 1991, at Merrithew Hospital, 21 Martinez, California. 22 4 . NAME OF PUBLIC EMPLOYEES CAUSING CLAIMANT'S INJURIES: 23 Unknown to claimant at this time; when the names of these 24 employees are learned, claimant reserves the right to amend this claim 25 to add their names. 26 27 28 1 5. INJURIES SUSTAINED BY CLAIMANT: 2 Loss of ability to bear children; ruptured uterus; other 3 physical injuries; severe emotional and mental distress; pain and 4 suffering; loss of consortium; and, reduction in quality of life. 5 6. AMOUNT OF CLAIM• 6 7 In excess of $25, 000; jurisdiction will rest in the superior court. 8 7 . CIRCUMSTANCES GIVING RISE TO CLAIM: 9 10 On or about November 16, 1991, claimant, Amal Moussa, gave birth to her daughter at defendant's hospital in Martinez, California. 11 Defendants, and each of them, were negligent in the diagnosis, care 12 and treatment of claimant, prior to and during the birth and delivery. 13 14 Defendants, and each of them, were also negligent in the hiring, training and supervision of defendants' employees involved in the 15 diagnosis, treatment and care of claimant during said birth and 16 17 delivery. As a direct and proximate result of defendants' negligence, 18 claimant suffered severe physical and emotional/mental injuries and 19 damages, including, but not limited to, the loss of her ability to bear children, as more fully stated in paragraph five, above. 20 DATED: May 7, 1992 . 21 22 LAW BA TH 23 By: 24 ;rryy amuth 25 26 27 28 a ti - x 'J J � 7 G -p� O 7 r; .o s � c -0 10 0 ct t 0 y «A C7. ti V--h M C3 (p ('t _!] c1- Cr" t l _ N Ln 0 Yi t U) U1 lot py r � - nl �aaQa CLAIM kftVIVED BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIAMq r 14 , C1,im,Against the County, or District governed by) BOARD ACTI UN y '9�4? the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 2, 1992 "Aft?-' 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: See Estimates Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PIC CUAIG, Michael Arthur ATTORNEY: Date received ADDRESS: 1828 Walnut Grove Court BY DELIVERY TO CLERK ON P1av 12, 1992 Oakley, CA 94561 BY MAIL POSTMARKED: May 11, 1992 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: May 14, 1992 gaIL BATCYELOR, Clerk epuII. 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: C I ? BY:��_ J• 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: Jul, - Z 153Z 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 Noti a to Clai ant, addressed to the claimant as shown above. Dated: JUN 2 1992 BY: PHIL BATCHELOR byQAAA^ Deputy Clerk CC: County Counsel County Administrator 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 dayafter 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 claim's, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp Ackon J2 1-1+L'r2 ,moi C- cze_14 � ..,RECEIVED Against the County of- Contra Costa ) MAY 12 1992 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 $ SGS ateS and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Where did-the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) &ele Laete_ +j-. c>eAvV ©"LA, OAKS-EflZ °t Sy- e_-e_o ,,k_t \ 4. What particular act or omission/on the part of county or district officers, servants or .employees caused the injury .or damage? n c- Get-,. v 1 cL 4-tfe- 04- (over) �. wnat are the names of county or district officers, servants or employees causing the damrage or injury? - -______________-_----_r__-_-_-__-_-__-_r._-_--_M._-_---.ti__-_____-__-_Yr_____-_ 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) _ ic.___�s.�l w1c� ? _ ct� Go a�•�l E_s �. Names and addresses of witnesses, doctors and hospitals. _ w ls. g = .. __ --------------- 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 GC, v Claimant's Signat 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 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. ADDENDUM To THE CLAIM OF rrjc-�,,otj A jL-7[1yj-z (Print your full name) ( 1) Do you use the roadway as part of a daily commute? Yes No ( 2) Were you aware that construction would be commencing on the roadway? Yes No ( 3) Was an alternate route available? ,. Yes No ( 4) Did you read about .the impending resurfacing in the local newspaper') Yes No ( 5) Did you see warning signs advising of loose gravel and a 25 mile per hour advisory sign.) Yes G% No ( 6) Did the damage result from another vehicle exceeding the 25 mile per hour advisory? ' Yes No (7) Did a vehicle traveling in the same direction' -and exceeding the -25 mile per hour advisory sign attempt to pass you? Yes No (8) Did a vehicle coming from the opposite direction cause gravel to be thrown onto your car? Yes. No (9) Was the vehicle located directly in front of you- exceeding the speed advisory? Yes No ( 10) Did you travel the .roadway more than once during the resurfacing prior to the damage sustained to your car? Yes ( ) No ( .� ( 11) Did you obtain the identity of the car relating to questions . 6 thru 9? Yes ( ) No If yes,, please provide identification below: ( 12) Please describe in your own words how the gravel caused damage to your vehicle and the angle the gravel was thrown onto the car, along with the specific damaged parts on your vehicle. o o►9a -tip L=4, OF � o C re-o- LoLp IL vL ( 13) Were you aware that using the road during the chip seal process might result in damage to your car? =Yes ( ) No I declare that the above information is true and correct under the penalty of perjury. ( signature) . (Date) G. HOSE & SONS 230 Chestnut Street JOB WORK ORDER Brentwood, California 94513 DATE OF ORDER 634-5609 5-- _ CUSTOMER'S ORDER NO. PHONE STARTING DATN 3�S BILL TO ORDER TAKEN BY ADDRESS L.01 ❑ DAY WORK ❑ CONTRACT CITU ❑ EXTRA JOB NAME AND LOCATION DESCRIPTION OF WORK JOB PHONE 4 42 sian jr, x4v TOTAL MATERIALS ® vO TOTAL LABOR TALE DATE COMPLETED WORK ORDERED BY / TOTAL AMOUNT $ 1125-167 1 hereby acknowledge the satisfactory completion of the above described work O No one home ❑Total amount due ❑ Total billing to e for above work or be mailed when lob finished tiqnature TERMS 30 DAYS Any portion of theprevious balance remaining unpaid 30 days after the end of the month follow- ing purchase will be subject to a finance charge of 1 and one-half percent.(18 percent per annum). INVOICE ❑ 1177 BOULEVARD WAY • WALNUT CREEK, CA 94595 - (415) 933-2940 61251 --,.VALLEY T' GLASS •COMPANY'! - 216625 BRENTWOOD BOULEVARD • BRENTWOOD, CA 94513 (415) 634-5155 SOLD TO SHIP TO D TE YOUR ORDER NO. PHONE NUMBER PHONE FIRST JOBDATE INSTALLED BY SIZE DESCRIPTION LIST DISC. TOTAL X X X x x x x , OD x �- x �.: x PLEASE PAY FROM THIS INVOICE-STATEMENT SENT ONLY UPON REQUEST.TERMS-PAYABLE UPON .REQUEST-FINANCE CHARGE OF 1 '/z% PER MONTH(ANNUAL RATE: 18%)CHARGED ON PAST DUE BALANCE. IN'THE EVENT LEGAL ACTION IS REQUIRED FOR COLLECTION CUSTOMER AGREES TO PAY ALL COLLECTION COSTS AND REASONABLE ATTORNEY FEES. CUSTOMER ORIGINAL COPY S C S ('1 � ro 7 C Q cn t CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA M^r Clai;i Against the County, or District governed by) BOARD ACTIO�UN 4 1992 iy the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 2, 19 RrrNE?�IJNse and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of4tIF California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $131.25 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: PFLUM, David ATTORNEY: Gordon A. Berke Date received May 12, 1992 ADDRESS: 111 Civic Drive Suite 290 BY DELIVERY TO CLERK ON Y Walnut Creek, CA 94596 BY MAIL POSTMARKED. April 27, 1992 632 W. Bertrand 66536 I. FROM: Clerk of t e Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL BATCHELOR, Clerk DATED: May 14. 1992 ��: Deputy _ rL 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: 5 19 97— BYDeputy 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 (v1J' 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 - 2 1992 PHIL BATCHELOR, Clerk, BJA AAA fi 40j 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 asI shown above. Dated: V UN ' �� BY: PHIL BATCHELOR b � Deputy Clerk CC: County Counsel County Administrator 710 ,�z -A�7;6-- _ 0— RECEIVE . -R CEIVED -- - M ! `2. 1992 RD_O.F Cc 3,A y7113 - .. APP-10`32 FR I a9:0Q I D:PH EXEC CTR TES NO'.415 53-4-01E7, 97e:� P02 INATBUCTIONS TQ VICT Dater March 20, 1992 TO; Gf f i,oe of the Sheriff Centra Costa County, California RE: Cass Court & Number s Mcn-jab}�rii #7n7l0 Date Complaint Filed: A�-1 1/2y Cass Title t _—P l um va Dan ie 1 a Pleas* serve WRIT OP BXSCUTION (Possession of Real Property) on Defendants NORMAN G. DANIELS and EARL ROMITI Location of Promises t 1750_, Diane Court, Apartment 7,, Concord, California Mane of person who will mesa Deputy l on promises at tine of evictions G„ ward train GOR A. 8- Mg--Phone is 212-1700 Att?rnay for Judgment creditor Address: 140 Marti, w Wim' 1111 Civic Drive, Suite 290 P, f¢,mnt_ H CAS Walnut Greek, California 94596 510-939-6776 M ARMS EVICTION DATE: W/74w,� TIME:______ n . O e' 1 J ' � �J � G 4� �'m ws N �. . , NAo m rnZ� � �� r � i N V"� t. -.,.,. 1 1�_ ' � S .rw�w�. ••"'\ h1 t r�� �� ,', �V •�� �. � �1 �� � . �. '� � +a � � � � � � �?-'� #:� i'ki;•�,�v• � � a n '+ CLAIM �S BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Q F/1 iFp Claim Aga ir t the County, or District governed by) BOARD ACTIONhIq k I the Beard of S;!pervisors, Routing Endorsements, ) NOTICE TO CLAIMANT June 2 , 1� ', rr / 79 and Board Action. All Section references are to ) The copy of this document mailed to you is your no e California Government Codes. ) the action taken on your claim by the Board of Supervisors,Te? (Paragraph IV below), given pursuant to Government Code Amount: $100,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: SIKES, Regina ATTORNEY: Harold W. Tobin 3240 Lone Tree Way Suite 103 Date received ADDRESS: Antioch, CA. 94509 BY DELIVERY TO CLERK ON May 8, 1992 BY MAIL POSTMARKED: May 7, 1992 CERT P 790 272 931 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: May 11, 1992 JVIL BATCepuYELOR, Clerk a L d441Z 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: / r Dated: Tt / T* 1I /52 BY: ( ) , Deputy County Counsel I1I. 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 ( 1.4/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.U Nlnl Dated: y - 2 1992 PHIL BATCHELOR, Clerk, By_Q5W 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' a to Claimant, addressed to the claimant as shown above. Dated: JUN e 2 1992 BY: PHIL BATCHELOR by Deputy Clerk — oi.. a---CC: County Counsel County Administrator 'Harold W1• Tobin Attorney at Law 3240 Lone Tree Way, Suite 103 (415) 757-9400 Antioch, California 94509 RECEIVED Date: May 7, 1992 MAY 81992 TO: Contra Costa County CLERK BOARD OF SUPERVISORS Risk Management CONTRA COSTA Co. 651 Pine Street Martinez, ,CA 94553 Re: Regina Sikes Enclosures: Claim Against Contra Costa County These are furnished for the purpose designated below: Your signing and returning the enclosures to the undersigned in the enclosed return envelope. ox x x 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. other: /7ftW trultTOBT Attorney at Law HWT/cm CLAIM AGAINST CONTRA COSTA COUNTY RECEIVE® 4; TO• Contra Costa County MAY - 8 1992 Risk Management 651 Pine Street Martinez, CA 94553 CLERK TROFSTISORSOAACO CLAINANTL : REGINA SIKES ADDRESS: C/O HAROLD W. TOBIN, 3240 Lone Tree Way, Ste. 103 Antioch, CA TELEPHONE NO. : ( 510) 757-9400 • SEND NOTICES TO: HAROLD W. TOBIN 3240 Lone Tree Way, Suite 103, Antioch OA 94509 DATE AND TIME OF OCCURANCE: January 10, 1992 6 : 50 a .m. EXACT PLACE OF OCCURANCE: Deer Valley Road , Antioch, CA DESCRIBE IN FULL DETAIL HOW THE INJURY OR DAMAGE OCCURRED: Large amounts of mud were on the road . Total failure to •' warn or protect drivers using Deer Valley Road , Antioch, CA. i PARTICULAR ACT OR OMISSION BY EMPLOYEE, OFFICER OR AGENT CAUSING THE INJURY OR DAMAGE: Failure to regulate and failure to clear mud from public road . j NAME(S) OF THE EMPLOYEE, OR OFFICER OR AGENT CAUSING THE INJURY OR DAMAGE: City of Antioch, Department of Public Works . I i i I Page 2 Claim against CONTRA COSTA COUNTY DESCRIBE FULL EXTENT OF INJURIES AND DAMAGE CLAIMED: Car skidded and turned over seriously injugilIq and Eright-ening glalmpnt Acutp. traumatic/severe cervical sprain Zstrain with pprvj (-a1c1Ja ., f-bnraai.c sprain/strain with lumbalgia and lumbosacral sprain/strain. TOTAL AMOUNT CLAIMED: $100, 000-00 -- BASIS OF COMPUTATION OF TOTAL AROUNT: $100, 000 - 00 General damacres n1us unXnawn Sparial dama�Q9_- NAMES, ADDRESSES, AND TELEPHONE NUMBERS OF WITNESSES, DOCTORS, HOSPITAL, AND ANY PERSON WHO CAN SUBSTANTIATE YOUR CLIAM OR THE AMOUNT CLAIMED: Dr. Frigard , D .C . , 501 W. Third Street, Antioch , CA - ()49ng (510) 754-1441 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 day of -1-InjaAA 19? at Antioch, California. � 7 � 20 2 � � - \ � s � o . � � D . � / . 9 � $ $ y / \ O � �` A & ® o ` . . � > \ �� � a f .. / L51 - \� I � . \\ • � � �.