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HomeMy WebLinkAboutMINUTES - 03151994 - 1.17 AMENDED `I CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors,.Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15—, 7777— and 5and 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%'Supertiso�s I� h ' (Paragraph IV below), given pu n 1nt�tocoj t_Cod l Amount: $1 0 0 0 0. 0 0 + Section 913 and 915.4. Please no a aTl 'Yarnin s'. t! CLAIMANT: LARSEN, Alice ATTORNEY: Date received ADDRESS: 2742 Oak Road, No . 179 BY DELIVERY TO CLERK ON February 28, 1994 Walnut Creek, CA 94596 BY MAIL POSTMARKED: Nand T1n1 i�rororl 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED• (�IL �eTCHEIOR, Clerk A .11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( 4 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: (w'� 8Y: 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: fT 9 2c�PHIL BATCHELOR. Clerk. By ,,,,I_�_� ., D a.�• Deputy Clerk If 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. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING 7 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 Unitedtates sial 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:=id&L lggxl BY: PHIL BATCHELOR by� �a 1 ��� Deputy Clerk CC: County Counsel County Administrator RECEIVED AMENDMENT TO JANUARY 28, 1994 CLAIM FOR DAMAGES FEB 2 8 1994 To Person or Property CLERK BOARD OF SUPERVISORS TO: CLERK OF THE BOARD OF SUPERVISORS _ ONTf A COSTA CO. Name of Claimant LARSEN, Alice Date of Birth: 2/4/42 Address/Telephone No. : 2742 oak Road, No. 179, Walnut Creek, California 94596 Ph: 1-510-932-5020 Send All Notices and/or Communications Regarding This Claim To The Claimant. Accident Description and Location: Assault and Battery at the Homeless Shelter, 847 Brookside Drive, Richmond, California. on July 30, 1993, at approximately 1:00 p.m., the claimant was found at her work site located at the Homeless Shelter, 847 Brookside Drive, Richmond, California. The claimant was taken to Brookside Hospital, San Pablo, and was airlifted to the John Muir Trauma Center, Walnut Creek. The Richmond Police Department has been assiuned to the case; report no. 93-17607 and the investigator assigned to the case is officer Jenkins. The Richmond PD Bay Station Rape Crisis Unit is also involved and officer John celestrie is assigned to the case. The claimant was found by Danna Hannon, another person who works for the Rubicon program. What particular ACT or OMISSION caused the Injuries or Damages? It is claimant s contention that Contra Costa County, the Contra Costa County School Board of Education, and the City of Richmond had a duty and breached that duty to the claimant to provide a safe and secure working environment and either by act, omission, or both breached that duty to the claimant proximately causing claimants injuries and damages. What AMOUNT is claimed? Claimant continues under active medical and is not aware of the exact amount of her damages and any other claims for damages and injuries to be claimed incident to this claim on account of each item of prospective injuries or damages. It is the claimant's contention based on information and belief that her claim has a value in excess of $10,000.00 and jurisdiction rests in the superior court. [Gov.C. §910(f) ] Insurance Payments and Or Payments of Any Benefits Received: Claimant is unaware of the exact amount of benefits received to date. sandy Inman, claims Examiner, Claims Management Inc., P. o. Box 3042, Sacramento, California 95812-3042 (916) 631-1250 Claim No. : 2029066 Damages and Injuries: Traumatic deformities of the left eyelids and orbit with left enophtalmos, left globe ptosis, left medial canthal deformity, left orbital floor fracture; need for piasLic surgery to undertake repair of the orbital floor fracture and repositioning of the left medial canthus; multiple lacerations on the face, multiple maxillofacial fractures, blunt chest trauma; Lefort II-type fracture of the maxilla, depressed fracture of the left infraorbital rim, depressed fracture of the nose; psyche and central nervous system -- entire body. Full nature and extent currently under investigation. Names and Addresses of Medical Facilities: John Muir Hospital, 1601 Ygnacio valley Road, Walnut Creek, CA 94598; Neuro Scan, 115 La Casa Via, Walnut Creek, CA 94598 (510) 933-9440; Calstar, California shock/Trauma Air Rescue, 20876 corsair Blvd., Hayward, CA 94545; J. Earl Rathbun, M.D., F.A.C.S., 100 Brookwood Ave., Sta. Rosa, CA 95404; David Ulmer, M.D., 95 Montgomery Drive, Ste. 118, Sta. Rosa, CA 95404; Susan Taylor, M.A., M.F.C.C., Rose Street Center, 368 Rose, Danville, CA 94526 (510) 820-6575; Istvan Borocz, M.D., 2121 Ygnacio valley Rd., Bldg. E, No. 103, Walnut Creek, CA 94598 La Casa De La Luz, 939 Janet Lane, Lafayette, California 94549 (510) 284-5715; \ Date: 2/22/93 ALICE LARSEN/CLAIMANT CLAIM ` BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15 , 1994 and Board Action. All Section references are to ) The copy of this document mailed to you isyouu��oticejof California Government Codes. ) the action taken on your claim by he BLL 0 of�Superwisors (Paragraph IV below), given pursuant to-Government Code; Section 913 and 9154. Please note„a11 *Warning . Amount: Unknown CLAIMANT: State Farm Insuance Co . on behalf of Julie L. Lowe, Claim Number 05-0969.-088 ATTORNEY: Date received ADDRESS: P.O. Box 20577 BY DELIVERY TO CLERK ON February 2 1994 E1 Sobrante , CA 94820 BY ISA1l POSTMARKED: Feb uagy 25 . 1994 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted claim. IV IL BBATCHELOR, Clerk �R DATED• B�: Deputy(„__ I1. FRO/M• County Counsel TO; Clerk of the Board of Supervisors (,V) 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 910.0. { ) 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: Alf Dated: 1l�'[4�c �, �� /4,/ BY: Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (1) County inistrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 3V. BOARD ORDER: By unanimous vote of the Supervisors present (v' This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. , BATCHELOR. Clerk, Byaced: � Deputy Clerk �. YARNING (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. *for additional warning see reverse side of this notice. 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 1$; and that today I deposited in the }Unitedfates stat 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. r' Hated. /zo BY: PHIL BATCHELOR ,d,, Qj21,,LDeputy Clerk LC: County Counsel County Administrator STATE FARM State Farm Insurance Companies -M- State February 25, 199 4 HILLTOP SERVICE CENTER RRc�� D 2920 Hilltop Mall Road !� Richmond,CA 94806-1902 P.O.Box 20577 _ Z8 EI Sobrante,CA 94820-0577 Phone: (510)2624900 County of Contra Costa 651 Pone Street #106 CLERK BOAp 0 QS q SORS CO. Martinez, CA 94553 CONj' ' RE: Claim Number 05-0969-088 Date of Loss January 24, 1994 Our Insured Julie L. Lowe Attention Claims Department: State Farm Insurance Company on behalf of Subrogee, Julie L. Lowe hereby makes claim for $9, 069. 18 and makes the following statements in support of claim: 1. Notices concerning this claim should be sent to State Farm Insurance Companies, P.O. Box 20577 E1 Sobrante, CA 94820. 2 . The date and place of the accident giving rise to this claim are; on January 24, 1994 at Hwy 4 by Bailey Rd. Pittsburg, CA. 3 . The circumstances giving rise to this claim are as follows: Cause: The cause was determined to be other than driver due to the roadway and weather conditions. It was not possible for P-1 to perceive and react to the flooded section of road while it was raining. (Please see police report page 5, lines 7-12 and page 7, lines 1-4) . 4. The injuries reported consisted of neck and chest pain. 5. Our total claim is as follows: Company's Net Payment Property Damage $8,569. 18 - not final figures and Medical Payment Coverage to be determined. Insured's Deductible $500. 00 Interest Total Property Damage To be determined,. documents to follow. HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001 NOTICE: This form is to provide notice of our claim for damages in accordance with the six (6) month statute. If this form is not acceptable for compliance with the statute, please rush the necessary form to my attention for proper filing. DATED: `7 `1 BY: De ora . Dominguez Claim Representative / (510) 262-4921 State Farm Mutual Automobile Insurance Company DD/af Encl: Supporting Documents cc: Ben Llovera 05-2731 STATED ;LIFOR A . FEB 0 R 1994 TRAFFIC COLLISION REPORT PAGE or 7 SPECIAL CONDITIONS NUMBER HIT f RW CRY JUDICIAL DISTRICT LOCAL REPORT NUMBER a INJURED .EO NIRIBlR HITT RW COUNTY REPORTING DISTRICT , BEAT ROLLED MY /ESV t..[YL//� 7Q �4Z K.J OLLMRED ON MO. DAY YEAR TIME(2400) OFRCE Z S, 1OCCU �/ey y� asps .��� 4 --- DAY or wccR TOW AW Hs Br: MILEPOST NPORMATION y 5 wBr I Eel E or .Z�•l3 S gA T W T F S l9Ya pta p STATE HWr REL. ~ ❑AT IWTEREECTION WITH "ETIHILTS E OF /Lc _ 1 0YCS 0HO - NDI4 PARTY oava"ucrosc NUMBER STATE CLASS SAFETY v[K YEAR MME/-ODELf COL011 ENSE Hunal STATE 1 G' 3653l.Z Z ea L' `G �i"1— �Y�-la41Sccc..o� ?.cW 944 3 86-.92-1 DRIVER NAME(FIRST,MIDDLE.LAST) PEDES- STRUT ADDRESS OWNER'S NAME ®f AME AS DAIVl4 p .2 Z 4AA) 6r Aor A rARKco arr/sTAnl a1" OWIIERS ADDRESS sAY!AS DRIVu VEHICLE .-. BICY. Sac HMR EYcs NE .r W..ff BIRTHDAYS. YEAR RACE DRSPOSITIONOFVlNCLEONORDERSO► OFFICER DRIVER., OTHa `o ew Bw s'7''' ass i s� ;62 T�►os �.� s(� �s�w ... . ❑...;:... .;...; OTHER NOME PHONE BUSINESS PHONE PRIOR MECHANICAL DEFECTS: NONEAPPARENT® RfPaETO NAMATRRp ❑ .(5i0 ) -2"- 9 S ii'S ( '�J 1 b) 7S-q-1"3 CHP USE ONLYEO70, VEHICLE DAMAGE SHADE INDA M GED AREA vweumE = INSURANCE CAMER POLICY NUMBER 01 OWN" MAJOR _..._ DRL Gr ON STREET OR N Ar !PEED PCP RCC Q TRAVEL LIMIT puca PARTY DRIVER'S LICENSE NUMBER STAT! Cues SAFETY VEK YEAR -AMI MODEL I COLOR UCIM, "UHSu... STATE 2 lour. _ ONVER NAME(FIRST.WOOLS.LAST) .- . .- . PEDEL STREET ADDRESS - OMIN[R1 NAY! PAYE AB BRIVAR TRIAN PARKEDCITY I STATEI IIP 0104[11"{ADORESS p$Am AS DRIVER . VEHICLE ❑ INCY• SEX HAIR EYb NOG/TT WaONf YO. �SI1 0�ATEI YEA RACE DISPOSITION OF VEHICLE ON ORDERS or: �OrRCER pONVER POTHER CLgT u 13 i OTHER HOME PHONE BUSINESS►Nloru PRIOR MECHANICAL 09FIC71: NONE APPARENT El RIM TO HARRATTIRo ❑ ( ( , CHP USEO4lr DEE.^.RIB!VIDSCL!DAYAO! SHADE INDAMAOED AREA INSURANCE CARRIER POLICY NUMBER vofucTrn - - , pWIL PHONE pYDgR . i O1400. p EEA.IOR pTOTAL - OIR.OF ON STREET OR HIGHWAY f E7 PCP ICC Q TRAVEL PUC Q CHI Q PARTY DRIVE"LICENSE NUMBER STATE CLASS SAFETY VSK YEAR MA"IMODEL/COIoR LICENSENUMBER STATE cow. 3 .. DRIVER NAME(FIRST,WOOLE.LAST) PE❑DM STREET ADDRESS OWNER'S NAM! pSAME AS DRIVER TMAN PARKED CITY I STATE 1 D► OWNER'S ADOREfi p SAM!Af DRIVER VEHICLE NC❑Y• SEX HAIR EYES HEIGHT wriow BIRTHDATE RACE DISPOSITION OF VEHICLE ON ORD IRf OF: OFFICER pDR1VER [—]OTHER eLHr Mo w1" YEAR 3 OTHER HOME►HON! BUSINESS PHONE PRIOR MECHANICAL DEPSCTB: NONE APPARENT p RlPfRTO HMIRATRIE p ❑ CH►Uss ONLY DESCRIBEVEHICLl DAMAGE SHADC IN DAMAGED AREA -. INSURANCE CARRIER POLICY Nunn VEHICLE TYPE pWRL 0ND1rt 01.NGR pMGD. p-A+OR 1:1 ' OMOII IONfTREETORHIGHWAYarEEO ►eP ICCQ TRAv[i LIMY► PUC Q ew Q rREPARER'S WM& DISPATCH NOTIFIED REVIEW ER�NAME t ' DATE REVIEWED _ , STATE OF CALIFORMA � TRAFFIC COLLISION CODING ACE - - DATE OF COLLISION THE(]'DDC) NCyC NWS[RRIG ? OEN L D MIYS[R MO. / DAY"II YEAR OSIS ✓� /O��`^ OWNERY NAM[I ADDREU NOTIFIED -PROPERTY NO •,,.DA6IAGE DESCMF noN OF DAMAGS _ ... . . SEATING POSITION SAFETY EQUIPMENT EJECTED.FROM.VEHICLE L-AIR BAG DEPLOYED M/C BICYCLE-HELMET OCCUPANTS 0-NOT EJECTED _ A-NONE IN VEHICLE M-AIR BAG NOT DEPLOYED DRIVER - 1-FULLY EJECTED"- ... B-UNKNOWN N-OTHER V_No 2.PARTIALLY EJECTED C-LAP BELT USED P-NOT REQUIRED W_YES 3-UNKNOWN I-DRIVER D-LAP BELT NOT USED 1 2 3 2 TO 6-PASSENGERS E-SHOULDER HARNESS USED PASSENGER Q S G 7•STATION WAGON REAR F-SHOULDER HARNESS NOT USED CHILD RESTRAINT X-No G K. 8-REAR OCTROR VAN G-LAP/SHOULDER HARNESS USED O-IN VEHICLE USED Y-YES 0-POSITION UNKNOWN H:LAP/SHOULDER HARNESS NOT USED R-IN VEHICLE NOT USED J PASSIVE RESTRAINT US8-IN CLE USE UNKNOWN 7 0-OTHER K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U-NONE IN VEHICLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(•)SHOULD BE EXPLAINED IN THE NARRATIVE PRIMARY COLLISION FACTORTRAFAC CONTROL DEVICES 2131 TYPE OF VEHICLE 2 3 MOVEMENT PRECEDING UST NUMBER (E) OF PARTY AT FAULT COLLISION [ AVC SECTION 1ROLATED: L1YaRJAMEAD-Old CONTR'JLS FUNCTIONING APASSEMGER CAR/STATION W ASTOPPED NO CONTROLS NOT FUNCTIONING• B PASSENGER CAR W I TRAI B PROCEEDING STRAIGHT -- S. B OTHER IMPROPER DRIVING•: CONTROLS OBSCURED C MOTORCYCLE/SCOO RAN OFF ROAD NO CONTROLS PRESENT/FACTOR• D PICKUP OR PANEL T CK D MAKING RIGHT TURN C OTHER THAN DRIVER• TYPE OF COLLISION E PICKUP/PANEL TR K W/TRAILER MAKING LEFT TURN D UNKNOWN• F TRUCK OR TRUCK IRACTOR FMAKING U TURN E E FELL ASLEEP 113 SIDESWIPE GTRUCK/TRUCK T CTOR W/TRLR. GBACKING - - REAR END H SCHOOL BUS HSLOWING/STOPPING WEATHER( MARK I TO 21TEMS) ID BROADSIDE I OTHER BUS 1 PASSING OTHER VEHICLE ACLEAR E HIT OBJECT I j EMERGENCY VfHICLE J CHANGING LANES CLOUDY OVERTURNED I K HIGHWAY CO t EQUIPMENT PARKING MANEUVER C RAINING VEHICLE/PEDESTRIAN I L BICYCLE L ENTERING TRAFFIC .. D SHOWING OTHER•: MOT EHICLE OTHER UNSAFE TURNING, E FEE/VISIBILITY FT. MOTOR VEHICLE INVOLVED WITH DESTMAN XING INTO OPPOSING LANE F OTHER•: . ANON-COLLISION MOPED PARKED JGWIND PEDESTRIAN P MERGING LIGHTING OTHER MOTOR VEHICLE TRAVELING WRONG WAY A DAYLIGHT D MOTOR VEHICLE ON OTHER ROADWAY OTHER ASSOCIATED FACTOR(S) OTHER•: B DUSK-DAWN. E PARKED MOTOR VEHICLE 2 3 (MARK 1 TO2 REMB C DARK-STREET LIGHTS F TRAIN Avc a v'OLATaN: pop prs DARK-NO STREET LIGHTS BICYCLE p»p STREET UGHTS NOT ANIMAL: vc[[craw vIOLATaN: GTSD DARK.FUNCTIONING• B Ova SOBRIETY-DRUG AOR�ROADWAYSURFACE IFIXEDOBJECT) VCS[ VIOLATION. Ooa 1 2 3 (YANKTTO2REMS) B WET J OTHER OBJECT: D p� HAD NOT BEEN DRINKING SNOWY-ICY B HBO-UNDER INFLUENCE D SLIPPERY(MUDDY,dLY,ETC ) E VISION OBSCUREMENT: ►IgD-MOT UNDER INFLUENCE F INATTENTION•: HBO.IMPAIRMENT UNKNOWN ROADWAY CONDITION(S) G STOP i CO TRAFFIC (MARK t TO 2 ITEMS) PEDESTRIANS INVOLVED H ENTERING/LEAVING RAMP E UNDER DRUG INFLUENCE A NO PEDESTRIAN INVOLVED I PREVIOUS COLLISION FIMPAIRMENT-PHYSICAL A HOLES,DEEP RUT• B CROSSING IN CROSSWALK UNFAMUAR IMPAIRMENT NOT KNOWN jj WITH ROAD B LOOSE MATERIAL ON ROADWAY' AT INTERSECTION NOT APPLICABLE C OBSTRUCTION ON ROADWAY• 1C DEFECTIVE VEIL EQUIP.: perp CROSSING IN CROSSWALK-NOT pYa I SLEEPY/FATIGUED D CONSTRUCTION-REPAIR ZONE AT INTERSECTION SPECIAL INFORMATION E REDUCED ROADWAY WIDTH IDCROSSING-NOT IN CROSSWALK I IL UNINVOLVED VEHICLE I I JANAZARDOUS MATERIAL FLOODED• IN ROAD-INCLUDES SHOULDER OTHER E ]UNUSUAL ER•: NOT IN ROAD NONE APPARENT H CONDITIONS- APPROACHING/LEAVING SCHOOL BUS O RUNAWAY VEHICLE i SKETCH �At� "SC US _ I ... .. .. ASPueLT /2DI-.T� . .. lOCATt MDIeTN , } DOT /z CR CNR 4V. 19C CHP DA RU/SO STATE OF CAUFORM V INJURED / WITNESSES / PASSENGERS PAOE-3 DATE OF COLUSION TIME 924MNCIC NUMBER OFFICER LD. NUMBER osz5 432.0 /0?;- WITNESS PASSENGEREXTENT OF INJURY( "X" ONE) INJURED WAS( "X"'ONE) PARTY TEAT SAFETY EJECTED ONLY ONLY AOE BEI -ar NUMBER POS. EQUIP. FATAL SEVERE .OTHER VtSiBLE COMPLAINTWURY ILIUM IilUl1Y OFPAM DRIVERPASS. FED. BICYCLIST� OTHER ❑ ❑ 3Z F ❑ ❑ ❑ ❑ ❑ Cl 10 TELE NAME/O.O.B.I ADDRESS IURED OIaY)TRANSPORTED BY: TAKEN TO: . )TT , DESCRIBE INJURIES - - `: • �tilo�.aar o r. pe;..J. . ,J -r. . . . . .._. S/C. ❑ VICTIM OF VIOLENT CRIME NOTIFI[p NAME 10 OJL l ADDRESS 4: C�/Q� TELEPHONE Av Seo 6U85-� QNURED ONLY)TRANSPORTED BY: TAKEN TO: i✓C SID, �]73' / A./ .. DESCRIBE WURIEE a VICTIM Of YIOI.EP/T CIBYENOTNFKp' ❑� ❑ ❑ ❑ ❑ ❑ 010101 ❑ ❑ NAME I D.O.L I ADDRESS TELEPHONE ONJURED ONLY)TRANSPORTED BY. TAKEN TO: .. DESCRIBE INJURIES ..._ .. _ _.�. .....:......... _.._ ... ., .. _ _ i . .. .'.. `.•, ....-.. - ".,.. -.._.•.. . .... ❑ VICTIM OF VIOLENT ptYE NOTIFIED NAME 10.011 ADORESt TELEPHONE . ONJURRD ONLY)TRANSPORTED BY: TAKEN TO. DESCRIBE INJURIES - ❑ VICTIM Of VIOLENT CRIME NOTIREM: M 1 a ❑ ° ,❑ o` a ❑ ❑ ❑ ❑ ❑ NAME I D.O.B.I ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: - DESCRIBE INJURIES .. - ❑ VICTIM OF VIOLENT CRIME NOTIFIED ❑ .. _ o ❑ - ❑ ❑ ❑ ❑ ❑ ❑ ❑ o NAME 10.011 ADDRESS _ - TELEPHONE . ONJURED ONLY)TRANSPORTED BY: TAKEN TO, . DESCRIBE INJURIES . ❑ VICTIM Of VIOLENT CRIME NOTIRED ►REPMER't /) V 40YO Y AR REVIEWERS NAME MO. 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CHP 555—Page 4 (Rev II.85) OPI 042 STATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL CHP 556(Rev 7-90)OPI 042 Page s DATE OF INCIDENVOCCURRENCE TIME(2400) NCIC NUMBER OFFICER I.D.NUMBER 14UMBER .X.ONE 'X'ONE TYPE SUPPLEMENTAL rX-APPL"LE) Narrative �2 Collision report ❑BA update ❑Fatal ❑Hit and run upd�p ❑Supplemental ED Other: ❑Hazardous materials ❑School bus ❑Other: Ca CITY/COUNTY/JUDICIAL DISTRICT REPORTING DISTR T T�CR BER LOCATION/SUBJECT STATE HIGHWAY RELATED( ❑Yes ❑No 2. / )OT 1 FICA 77o.J: 1 �E� E� ,Fa ! G4� b� G'D(:u 51 GJ��� �!v D�T•t fit,$ 3. /9T 5.34 4. AA25 .4.9o.Pb !MATE'. 5. c GE AAZT- 6. 8. T dkJ.4 �75e4)64 T AS, ? OLS 1 T / Q T w 4-5 10. K QO/Ll.Qc 7-C. Ae& 4S. <is 4,e=4 /S �1lTL Lha - 11. Go T'•FuGTr ati1 LJltJ - ,.v ..i r4n� QAi27' r,G4C� T �IlsI,1 T 13. 14. 15. 4c-',Q,0 7-;Z/ d 14 �,Z AA I J4:-= . ✓ lis 7'41nJ 16. / T )*a,.,T - 17. 18. - prNFQ �! t/E!�/c - Saa. G,.J rN i:-- AAcn444-.... /4a 19. /cam�I �.e� L,4 7 c'e 20. 21. ,C [s✓h0Qw9T/vim - / 4.5 �L- , /nom 1/- /�J�•� i4�P�Y�4L. 22. IS -7-4;67 '� - _ V,,4L 01 C01 L 4.L,4 4 S A[44SO 23. ,:�� /✓= - ✓ ► LY,c1,J 24. 5'T4 7tF - , . 25. I 26. 27. 28. 29. -rte 30. 31. PREPARER'S NAME AN .D.NUMBER DATE �✓.� REVIEWERS NAME DATE Use previous editions until depleted. 90 57541 STATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL CHP 556(Rev 7-90)OPI 042 Page 6 DATE OF INCIDENVOCCURRENCE TIME(2400) NCIC NUMBS OFFICER I.D.NUMBER 75,M-7 ' /-.zy_sy OSIS 3 16,q2-41, z97 'X'ONE ")r ONE TYPE SUPPLEMENTAL rX-APPLrABLE) Narrative Collision report ❑BA update ❑Fatal ❑Hit and run update Supplemental ❑Other: ❑Hazardous materials ❑School bus ❑Other: CITriCOUNTY/JUDICIAL DISTRICT REPORTING OISTRICTBEAT' ORATION NWBER LOCATIOWSUBJECT STATE HIGHWAY RELATED ❑Yes ❑No_ 1. ST.q, M S - 2. le- / STA 7Z� A &)A S 6.J THE. 3. )67- 1.4n1= T 161+144, :5/4!F q) l-,'A -.J $f ZT T 1= 4. / T `1i--e�U1 ;-4> 5. N i T ..56.1E-7-4 ✓G- J, ^J ST>AZ, 6. 7. W1 r AIV rq r i.✓ E 5 — T��S►T He �✓a S_::._ E = Oma/ S.Q .8. .Iv TyG '/,4o A/G s.94./ 4 /YOd47-_ AJ 6-- 9. T_LL GcJ�/G� LA�J� T �.v�- /n/ 1,�.�E�/ /T ,Si4i•✓ G1cw r {�-� Nl r .•10. /''Mir Zve-4�0-> >L 0... T�1 c LES r A�-O T�•r E�✓ CAm e,qC4 Tv 7-WE: 11. 416,-w7- /n/ E La .J E. ,r / )z 12. ¢/..L.a.,J — .4 ,Q.��,aoac.,Ea -/, � 414S 13. T�/E �c FT. / — V- I wNc� A :56C6,0L'vLL�S)ts„J Glc 22EJL 15. 17. 18. a,J 4:5;g- tJ /�� �.✓ 7:4 E �� L4ti1— , '-Z::7- 19. rT- 20: /� iUi.T. �=Lam? Q— r �is20X ��/77idir' /Q �'ST 21. 1,/- / 5.4Z-...J 75ST,PuCC 22. 7i/E _vc 4A/L /A/ i Nc= CE.�/r )S)✓J1)E:e, !l / e4111E TU .ecST' 23. 24. 25. �o�•JT F 26. �!,/ s/Ga r'�// - - 4,.A b-,4 � r�io.�a �i1.�gTEL 27. ..25���- >' /tee /G .4AnFr 'v�iF' �� �✓� 28. El8, 29. . 30. 31. . PREPARERE D I.D.NUMBER DATE REVIEWER'S NAME DATE �(/ Use previous editions until depleted. 90 57UI STATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL CHP 556(Rev 7-90)OPI 042 Page DATE OF INCIDENT/OCCURRENCE TIME(?I00) NCIC NUMBER OFFICER I.D.NUMBER /-,Zy-9� h d5�5 93� /o�i�,6 [NUMBER 1=297 -r ONE 'X'ONE TYPE SUPPLEMENTAL(-X'APPLICABLE) p ZNarrative Collision report El BA update ❑Fatal ❑Hit and run/")e. O �99y J Supplemental ❑Other: ❑Hazardous materials ❑School bus ❑Other. '--roo CITY/COUNTYIJUDICIALDISTRICT •• REPORTINGDISTRICT/BEAT Crr Cxum ER.. _ LOCATION/SUBJECT STATE HIGHWAY RELATED.-, ❑Yes ❑No' 2. LV..V,!T _ 3. —K,1 F�1�C- - TD 2�Fiti c� . .QCiQc Tp /y �ZL1Da _ _ . - .. ..,......_.._ ,. ,_.. .. .-,._...,......... ...................,. ..._..:...,.. S :-tet+ a. S. i 1 8. 9 10. 11. 12• 13. 14. 16. 17. . Z 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. .. 29. 30. 31. PREPARER'SvNAAMME A19 I.D.NUMBER DATE / REVIEWER'S NAME DATE Use previous editions until depleted. 90 57U, STATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL CHP 556(Rev 7-90)0151042 Page DATE OF INCIDENT/OCCURRENCE TIME(2400) NCIC NUMBER OFFICER I.D.NUMBER NUM8ER A •X.ONE 'X'ONE TYPE SUPPLEMENTAL r'X-APPLICABLE) ❑Narrative ❑Collision report ❑BA update ❑Fatal ❑Hit and run update ❑Supplemental 0 Other. • ❑Hazardous materials . ❑School bus ❑Other. CITY/COUNTY/JUDICIAL DISTRICT REPORTING DIST51CT/B T CITATION NUMBER ' LOCATION/SUBJECT - - STATE HIGHWAY RELATED Yes—,_ _.._. _ .-- ❑No 3. 4. ;. 6 ...»... Y` h.. 7. 8. 10. .._. ... ................ ..,.�....,.>.. .:, .-..,_..:� .r.-,,-._, rota. ... 12. 13. _. ._... .. ._... _,._... . n 14. 15. 16. 17. 18. 20. 21 22. 23. 24. _ 25. 26. 27. 28. 29. 30. 31. PREPARERS NAME AND I.D.NUMBER DATE REVIEWER'S NAME DATE Use previous editions until depleted. 90 57u, a O\ + k �} ® � Oj § C a \ � � � \ � � 0 � cc % 'k w a o t • . � 60) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County. or District governed by) BOAR_D ACTION the Board of Supervisors. Routing Endorsements. ) NOTICE TO CLAIMANT MARCH 15 , 1994 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: $140 . 50 Section 913 and 915.4. Please note all •warnings•. CLAIMANT: SILVA, Stephen J. ATTORNEY: Date received ADDRESS: 25318 Second St . BY DELIVERY TO CLERK ON Marrrh 1 AAIB Hayward, CA 94541 BY MAIL POSTMARKED: Nand l)al ivarPd via : Risk Mgmt . 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. a ll BBeputyLOR. Clerk DATED: _0� .11. FROMM: County Counsel TO: Clerk of the Board of Supervisors (V) 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: &,Z,4 c� I S 9 q BY: Deputy County Counsel II1. FROM: Clerk of the Board 70: County Counsel (1) County Admin 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: 1 certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, 6y \J ,,e ,y a , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. 1f you want to consult an attorney, you should do so immediately. *For additional warning see reverse side of this notice. 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 Sftates stal 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 9 9BY: PHIL BATCHELOR b422 Deputy Clerk CC: County Counsel County Administrator .... ...... ............... K5 x*i :xgx- ...... ............ ....... ........ .................. .................. .. ............ ... ................... .......... 115. ............. .......... ......................... ... ............... .............. ------- ... ............ ............... ....... ............. ................. ....................... ... .... ......... ............. ........... ................ ................... ................................. ............... .................... K;Si................... iii,K ..................... ...... ............. ............... ........... ---------- ............ "RK �Z?`.Z,�K-' --SK K:K 2 ......... ........ ............... ................ .......... 'o'K iiissiiii:::�i ........... ......... ...... . .. ..... w ...... .................. . . .................... . ................ i7l a xF X .......... ........... ................ ...... .......... ........................ ............................. .......... ........... ................... .................. a .............. ..... ..... i.-.K K E OK ............... -NO-N.............I.... X" ................... M 111..1 .......... so ..............11... Xn� 'Xg: K:Bc�tK MO ................. ---------- I.,......l.---k...,--....M.0 ...........M...............M cK., -kX. ................................... ............ ... ...... ........................... X .................... .................... x. m......x ........................... .............. ...................... .................................... ............... .............. ...................... .......... ............ ............. ........ .......... ......................................... X.: .............. .....xx ........... xx x . ............. ........................ .................................... ............................ ................ .......... .......... .......... .......... .........%..%.......... ........ .............. .. ....................... ...................... ........... ...........%....... ............................ .......... .......... .......... .......... ............. 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 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 Piled 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 forClerk`s filing staa}p STEPHEN J. SILVA ) RECEIVE® ) Against the County of Contra Costa ) MAR 1994 or ) District) CLERK 60AF,G OF R5 ,: CO. Fill in name p The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 140.50 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) TUESDAY, FEBRUARY 22, 1994 -APPROXIMATELY 3:00 P.M. 2. Where did the damage or injury occur? (Include city and county) SAN RAMON CITY LIMITS / CONTRA COSTA COUNTY 3. How did the damage or injury occur? (Give full details; use extra paper if required) I WAS TRAVELING (NORTHEAST?) ON NORRIS CANYON ROAD FROM CASTRO VALLEY TOWARDS SAN RAMON WHEN I STRUCK A POT HOLE IN THE MIDDLE OF THE ROAD. THE POT HOLE CAUSED MY ALUMINUM RIM TO BEND.� POTS'.HO19�4Sy'MPROXIMATEL'Y 100 YARDS PRIOR TO THE INTERSECTIONS OF NORRIS CANYON AND BOLLINGER CANYON ROADS. ----------------------------wa.. ..-.. .»---------------------------------------.- 4. What particular actor omission on the part of county or district officers, servants or employees caused the injury or damage? POOR MAINTENANCE OF PUBLIC ROAD CONDITIONS. 5. wnat are the names of county or district officers, servants or employees causing the damage or injury? ----------------------------------.. ---------------------------------------- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. ALUMINUM WHEEL WAS BENT AS A RESULT OF STRIKING -THE, POT HOLE. (FRONT WHEEL PASSENGER SIDE) I WAS INSTRUCTED BY MR. RON HARVEY TO OBTAIN ONLY ONE ESTIMATE FOR REPAIR 7. How was the amountclaimedabove computed? (Include the estimated amount of any prospective injury or damage.) COST FOR INSPECTION OF SUSPENSION - $35.50 FRONT, END ALIGNMENT•WILL TELL IF THERE IS COST TO REPAIR WHEEL - $40.00 ANY DAMAGE THAT IS NOT READILY VISIBLE. ALIGN FRONT END TO MEET SPECS - $65.00 —>TOTAL = $140.50 $. Names and addresses of witnesses, doctors.-and hospitals. LORI LAMR11A 14636 JULIETTA STREET SAN LEANDRO, CA. 94578 -------------------------------i-- -��.. ..-..-M..-----.,---�.---- -------..------ 9. List the expenditures you made on 'account of this accident or injury: DATE ITEM AMOUNT 2-25-94 SUSPENSION INSPECTION $35.50 WHEEL REPAIR & ALIGNMENT HAVE NOT YET BEEN DONE. y Gov. Code Sec. 910:2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some oerson on his behalf." Name and Address of Attorney �.tice- Clai 's Signature 25318 SECOND STREET, HAYWARD, CA. 94541 Address (510) 886-4497 - Telephone No. Telephone No. WORK # (510) 581-2488 N O 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. � '•' MITSUBISHI •�• MOTOPS-- -a-� _ - • • VEHICLE IDENTIFICATIONNO. • ' • • a • • TIME ••Y YEAR MAKE&I III •� • • LABR RATE aPAY / 09 : 46 90 MITSUBISHI .ECLIPSE 886-4497� ' • • MISCELLANEOUS COMMENT/ • • J.:. sp IlJM �jj1 • 1 .AIM �, • .AJM `1 FIS .it'• FIS —tan , FIL Nev 4, JM F'�Wv wta• :. ' FI;. wta• . ' FIS fs'�� .. f�-t��.: JM �, ♦ �A JM �j1 • ♦, �AJM �l! ..�, jv'- a:..l�-~�.orytf••-t •'►{-'�- - )C FI'= ��a■ f' FIS ��a■EE � �.+t-�"'■�.. _ F•I •e • Q— ORIGINAL•JFI `T+ •,�..�iarJ•��T�->�♦ :,.t.I1'' '�.-..i4lfaJ•1T FI W..RYIIr-, ! -•�.14R I/-Z- :r�.V q Ire 11.,!01 It-=,i SUBLET AMOUNT1 4 00: ®®®® r 0, MEANS OF CONTA TING MISC.CHARGES 04 E Wit!■ FIS Nt!• FI:: .;t!■ FtLESS / 0*00 90919aw.low"14-ma 00, m"aiao;', also a nowledge and approve all repairs as itemized below, Ntv .AJM �1 .AJMAM. A " �1 . J �1 I : J• - PAY THIS AMO .1 1•. s j fa. . / LINT �' Rl� 'La' '`" Fle taf FI:_ ta■ FI �Wf • W�f W ( •' WT // AJM' , ♦ �AJM �1 ♦ �AJM � ♦ MAIM 7rr,C'i Tr. fW. "` ;SRI` ,aa■ �'' -FIL• [ta■ ,;, RI` .._.L•• FI W. - ♦' iJ, i I ' �-� CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15, 1994 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 bJ the-BoaTrd-of-Supeevi"sor._s-- 01 r5 a IS �I V�� (Paragraph IV below), given purs�'Ua't Lo Government.,Code �tl Mount: $21,000.00 Section 913 and 915.4. Please note all •Warnings". ' 9 tLAIMANT: ROE, Russell M. FM& General Aviation Pilots Assoc. + 8 -d!i I ATTORNEY: James F. Beiden COUNTY COUNSEL MARTINEZ,CALIF Date received - - ADDRESS: 1134 Alhambra Ave. BY DELIVERY TO CLERK ON February 15, 1994 Martinez, CA 94553 BY MAIL POSTMARKED: Hand Deldivered I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. QQN BB DATED �1,&A&A�,.a 11v . N 9 B IL DepuLyLOR, Clerk �2 .II. FROM: County Counsel TO: Clerk of the board of Supervisors Wf 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: ,,9�1 BY: Deputy County Counsel U 61 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: 1 certify that this is a true and correct Copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk. 8y 0/1 ��a1Y1/�,-� 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. *for additional warnino see reverse side of this notice. 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 Unitedtates stat 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. Dat IVY 1�.,, Q !9 � BY: PHIL BATCHELOR byL'a puty Clerk CC: County Counsel County Administrator Claim lo: 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, 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 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) or ) FEB 5 ! District) CLERK WARD OF SUPERVISORS 'I Fill In name ) CON�NA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ _91,CC0 ,00 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) C om__ Cs+ -. (00_n (1 _ 3. How did the damage or injury occur? (Give full details; use extra paper if required)-?uSS-e k1 ry) •-Rae-- O_n j- y i 15i� waS - &r" -b s-�op UVP_rce+ior)S a3 a Cbz yec_4 reSCLi-l- Df- +N DC 4-he a O -e 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? GA i cz+1 DV)3 f o� Ck- 1 aS-e G�k �O��COrcl Cc.i r Y�- I YIGI I,Cc�i GL C �l r�f. uc i n4c_ • s -- -.-pCos'e c�te.� ttW k-o jon S D-C Y�r� - m,s r-e p Y-e n+ h c ar ` h1f pVP?,r-+1 � (over) . 5. What are the names of county or district officers, servants or employees c&i.-§Jn& the damage or injury? W-o-D la � - UO 1*!5 h-V--D f CL Jq Werl ((A S -�- 0-I I CPCte-( U0 J�j-j -Oaf-A\,1 PLUAit6w-,5� rOK) AndC,ror) -1)6RDyC-e- bif I I Ph] r)-) Ks w(T-co-L 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates f to damage. .9r au -4 I)-n-1 ;�cco -00 in CtC-+(kCU I(des clu-c" -to EF-),) -00VCe,4- +c-) ow 6U +VV CC-Ln�l -L-L)r+ 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. nc)+ -—------ —-------- 9. List the expenditures you made on account of this accident or injury: DAM ITEM AMOUNT Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (M ,orniey) or by some person on his behalf." Name and Address of Attorney f(I-e V) (Claimant's Signature) 0456� (Address Mcklk+� rycz- Co INSS-3 Telephone No. Telephone No.L51 C)) D,-;q -C)133 Ir 4 * * * * * * * V* I I I I I I * * * 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 ($109000, or by both such imprisonment and fine. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15, 1994 and Board Action. All Section references are to The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your clafmZ e(( oar� �f� `$upprvi'Tso s ri (Paragraph IV below), given pr a to Gtve' nme'nt�rCo.de , Amount: $25 000.00 Section 913 and 915.4. Please oteeaall 'Warnings'. 14 �g 16 ��'; CLAIMANT: ROE, Russell M. & General Aviation Pilots Assoc. j ATTORNEY: James F. Beiden CO1PJYuCOLeaSEL Date received NiPRiIPlt� CfatlF. ADDRESS: 1134 Alhambra Ave. BY DELIVERY TO CLERK ON FPhrna" 15, 1994 Martinez, CA 94553 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. H gg DATED: �1iL DeputyLOR, Clerk Il. FROM: County Counsel TO: Clerk of the Board of Supervisors (lf 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: c7` u 6 (q 9 Y BY: Deputy County Counsel 111. 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 ( Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: PHIL BATCHELOR, Clerk, By �J2 _ n �, Deputy Clerk J 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. *For additional warnina see reverse side of this notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: BY: PHIL BATCHELOR by s jDeputy Clerk CC: County Counsel County Administrator Claim -to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or,growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * RE: Claim By eu!�-6e(( n'1 (�De j Reserved for Clerk's filing stamp 01-c WIP� RECEIVE® Against the County of Contra Costa ) LF8 15 W4 or ) District) LCLERKOARD OF SUPERVISORS F'ill in name ) NTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ )S)COC) •UO 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) Conal L� 4i-r c rf . eDr*- Co_ os+n _ea, n 3. How did the damage or injury occur? (Give full details; use extra paper if required) p-) - eC( C, CLnd �'��1'� rC� A 1 OJi0" P+•1 0tf G+ p C) r'G__JI U-)S Get- CflnCo r'c Air S GZ. �l t_r�G-f- !`�Sl e (f f -1 I'�Q Gt�k-r'cDr�`� no GlCf7.OhS DF GZ L� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? r -ear of p roc r-ess t Cre hou-osSne n l- by Coca n� U �.c�•a l"� CMJ CA_ -C'ncL( d�`rzC i bar ►m +D Cease_ cape r-a- ion S 0-+ +VW_ (over) 5. What are the names of county or district officers, servants or employees causing the damage or injury? ZjilodY1+.'C.h0e I WC CD tJ �CCCLO �f - T>e Dye -be Th i' 1 +3ach-elp � - n, r, . Pc Pecs k 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for autodamage. '-S/A ,CDC)•oo 1' )---) ac+i.i 0-( tlT'� `n btn' -Co h ecl 4c) (Def-KaffonC-, o-+ +ht-- W-t,-n+V cu�-IM2- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT 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 4W Claimant's Signature H 3 I hce r� brC� 14v e �►a (,�c�1 S�• Address MCf A rha e /4 c/4ss 3 Telephone No. Telephone No. L51c�) 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. 6, CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY. CALIFORNIA Claim Against the County. or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15, 1994 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_Supe.r._visors (Paragraph IV below), given pureK't fo GovvFr "nth,' rl 11 Ln Amount: $40,000.00 Section 913 and 915.4. Please note a11a•llarnings".! � ; U!� a CLAIMANT: ROE, Russell M. FEB 16 W4 4 __� ATTORNEY: James F. Beiden COUNTYL'OtlidSEL 1134 Alhambra Ave. Date received MART1NEZ,CALIF. ADDRESS: Martinez, CA 94553 BY DELIVERY TO CLERK ON Fehrnare 15, 1994 BY MAIL POSTMARKED: Nand DPl iyPred 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: eVIl BATCHELOR, Clerk eputy n .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: Les�u BY: �. Deputy County Counsel 11I. 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 (vf 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: q9�PHIL BATCHELOR. Clerk, By �. Deputy Clerk YARNING (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. *For additional warning see reverse side of this notice. 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 unitedtotes stat Service in Martinez. California. postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: BY: PHIL BATCHELOR by T _,� ( pia 1 �, � peputy Clerk CC: County Counsel County Administrator Claim 'to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and,which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp USS-2(( (�"1 • ��`� ) � �.n„ _ _ � RECEIVED Against the County of Contra Costa ) or ) FEB 15 District) CLERK BOARD OF SUPERVISORS Fill in name) , CONT..a COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ yO,oCaD •tX- 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) 0 0 neo rj_ 0,'r IC�- CD144-0- CV5+0 O_W_n 3. How did the damage or injury occur? (Give full details; use extra paper if required) W o _� n� b� C�►- ►-Gt� CL Q Ccs► f y D ci (� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? ba Cc =1--h h S n 4-6ce-S+-- b(--e- 14►� r-4- (over) 5. What are the names of county or district officers, servants or employees causing. the damage or injury? N_C( .i'C h 'v "C.L r 1 ocn I U-S — S �-�i cher-e( lc�Gz l�'o r� - ��,e-r-��y A u.d.� �r- �►-�a.ron �n�-�.�v� - �(�o �� �e 1 ► - Ph�' 1 �tc��lo rN�rs . f��ea�l� __ 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. �j t.�j pDb •U(� 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Coni pee,-a+i&-e- ccsf tc h a ,5e r, c-A-- wx&� J_ aj r ja r+ 8. Names and addresses of witnesses, doctors and hospitals. r)ol- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT yy +- Gov. Code Sec. 910.2 provides: ~ "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney } { Claimant's Signature 113 ( 41 ha n L4Al - r�1GZ r-H 11-C—z—Xq 11 gSS3 Address Y),-)ar+-i ne-z. C4 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 ($109000, or by both such imprisonment and fine. CONFIDENTIAL COUNTY COUNSEL'S OFFICE CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA MEMORANDUM Date: March 11, 1994 To: Jeanne Maglio, Clerk of the Board of upervisors FROM: Victor J. Westman, County Counsel ` r By: Gregory C. Harvey, Deputy CountyCounse RE: Russell Roe Claim Please treat the attached document as a claim. FEB-15-1994 1334 FROM CCC BUCHANAN AIRPORT TO COUNTY COUNSEL P.01 CONTRA COSTA COUNTY.AMPORTS 550*Sally Ride Drive Telephone (510) ""MZ Concord,CA 94.520-5550 Telecopler (510) 6+16% 1.. • Te1ccopie3r Tranamittul Record Number of pages: (Wdading thb steed) To: From: W ' JAN Company: Date: Z-15-1 q Time: 01 Subject: Remarks: zor , Telecopier No: ❑ As we discussed ❑ Please expedite ❑ As you requested 0 Revisions ❑ For your information ❑ Replacements For your review and comment p Preliminary draft for review ❑ Please call regarding the attached Original to follow O I YdH call yon regarding the attached to Please provide information requested If there are problems with the transmission, Please call 646-5722 FEB-15-1994 13.32 510 646 5731 P.001 FEB-15-1994 1334 FROM CCC BUCHANAN AIRPORT TO COUNTY COUNSEL P.02 l laiai 'to. M= OF:WPERPI=.OF CGN'irAA =TjL SNUTRQCUONS 70 CEJLTrjm. A. Claims relating to causes of action for death or far injury to person or to per- sonal. property ar growing crops am whian accrue an or before December .31, 1987, must be presented not later than the 100th day after the accrual of the cause' of f action. Claim relating to causes of action for death or for injury to person or to per=zl property or.growing crops and'Which accrue on ar aster January 3, 1988, must be presented not later than six moths 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. Cede 9911.2.) B. Claims must be. filed with the Clerk of the Board of Supe.rvisora at its office in Roam 1.06, 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 haled 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 Seo. 72 at the end of this orm. RAE: M ed m By eu--cGe l( (n Qc' Reserved for Clerk's filing stamp 4- &e-r ra., 4 1JI G�.. OYl the um y of Contra Costa ) • or ) District) M32 in name The undersigned claimant hereby makes claim against the County of Contra Costa or the above-n2med District in the sum of $ no 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) Cont'..Ur A4-)- r-+ Cot-if Cas#- ... 3. Hoowwddidthe damage car injury occur? (Give full details; use extra paper if -arc &puv--hcr,)s cc.- W-f—Di8t r cz dt ree: -'r-e�ce.c D� nCA4& l.> Mn ANf Dns D�a. Z*-e– 4. What particular act or omission on the part of county or distriat'offieers, servants or euployees caused the Injury or damage? au- V--Caps ofp resS 6-e.. ha-r ssn-e.ni-- b� Co c:r4-y C�nd a -�'nCL( c�jr,-cj C-e by 4h-e-rM -o C•eceS-c opc i-a-fianS 0-+ (over) : .. FEB-15-1994 13:32 510 646 5731 P.002 FEB-15-1994 1334 FROM CCC BUCHANAN AIRPORT TO COUNTY COUNSEL P.03 5. 4What are the names of 0O urty or district officers= servants or employees causing the damage or injury? HCLrCW E .. UZj-hf — -P(C L ry chs,t1 \,•Jca.t�o tj-�{. fo r - 5-al j)r� A► ..tin _ Ph,' I Bch- o�- - m VS . PC Pf&-k 6. what damage or injuries do you claim resulted? (give full extent of injuries or damages claimed. Attach two estimates for auto damage. 4 x,60-oo C1k4 Lka-( LC& <4- � -tn bd;• 4©rCe4-1 4c OLL4 c, .ra•ffonS of +hc ccv-h+k/ W r 7. How was the amalmt claimed above computes!? (Include the estimated amount of any prospective injury or damage.) $. Names and addresses of witnesses, doctors and hospitals. 9. List he expenditures made on account of this accident or injury: DATE AMOUN Gov. Code Sec. 910.2 providest "The claim must be signed by the claimant SEND NMICE3 T0: (Attornerr) or by some person on his behalf." Name and Address of Attorney lir j F �d C'Y? C awn m3 )"...'" 5�. Andress Telephone No. 1 Telephone No.L'51 s e e e f f e # e e e e e e af—* 11411445"�'�"# s e NOTICE Section 72 of the Fenal 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 Pine 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 ('$1.0,000, or by both such imprisonment and fine. FEB-15-1994 13:33 510 646 5731. P.003 FEB-15-1994 1335 FROM CCC BUCHANAN AIRPORT To COUNTY COUNSEL P.04 Clai'rzi Itot ABABA OF OF CON= tX= CODE= A. Claims relating to causes of action for death or for injury to person or to per- s==1 property-or growins crops and which acarm on or before December 31, 1987, mist be presented not later U= the 200th day afterthe accrual of the cause of ' action, Maims relating to causes of action for death or for injury to person or to pw"-onal property or growing crops acid wbieh accrue on or after January I, 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 orae year after the aoomml of the cause of action. (Govt. Code $911..2.) B. Clailris must be filed with the Clerk of the Board of Supervisors at its. office in Rosa 106, County Administratiau Building,,651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board; of Supervisors, rather than the CQ=ty, the name of the District should be filled in. D. If the claim is against mwe than cne public entity, separate claila.s must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sea. 72 at the end of this form. RE: Claim By 3 Reserved for Clerk's filing stamp Against he Qounty of Contra Costa } y or ) Vt District) Pill in nam)) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ �(���i�7 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 owu r? (Give full, details; use extra pa if required) �c ' . " .c _ e +*0 ._ cL!s a t r"t i�uct. 4.. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Za� Tj�t..4.h r 1C�9ja_+0 y?5 ' a 1_f 0 S p U4 W r,GOrJ Gt,i r p01 - inicIciAt CL. C (rC+ cV1 (n YeS4-- -Q(sf e -4, 0-fer��r,i's G.C.. k-cficnS c4' , (aver) FEB-15-1994 13:33 510 646 5731 P.004 FEB-15-1994 1336 FROM CCC BUCHANAN AIRPORT TO COUNTY COUNSEL P.05 w *Wk at are the nr-mes of county or district officers, serv=ts or euP-Wyees tuuour8 . tiae die, or inJury? HCc ro la 'E • W E!�ht'Di Ct )1I,.oeri i L6 - . o 1 iaxzef "'... 6. What damage or injuries do you claim resulted? (Give full extent Of inJuries Or , damages claimed. Attach two estimates f auto dames. t C .00 in act-acLf icsses. L tr�.r �b vceA _{t:;) elk 4 n5 04 4+v GCun o i i-po r 7. Haw was the amount al.2timed above computed? (Include the estimated amount of any prospective injury or damage.) aired bi 1lei-, GZ..r-k4 8. Names and addre3ae3 of witnesses, doctors and hospitals. noi 9. List the expenditures You mado on account of this r de t or injury; AMMeee * ssees � � f " * ws � se " ssese � e �ter} f � ee � f * ee * f � Gov. Code Sea. 910.2 provides: "The claim must be signed by the claimant WM NOTICES TO; (Attorney) or by some porson on his behalf." ame and Address of Attorney 50-n-wS t7"��.f'�7 E�� ►�l� ��� � Addre� Telephone No. Telephone Bess of � 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, cr writing, is punishable either by imprisonment in the county jail for a period of not more than the year, by a fine of not,exceading ane thousand 0190003, or by bath such fmpriscmwt and fine, or by imprisormMt in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. FEB-15-i994 13:34 510 646 5731 P.005 FEB-15-1994 13:36 FROM CCC BUCHANAN AIRPORT TO COUNTY COUNSEL, P.06 elaim1to:' BOM OF SUPFZV C=A =MX A&AW T�CftMAN A. Claims relating to causes of action for death or for injury to person or to per- sonal. Property Cr grog APs and uhich accrue on or before Aeeember 311, 1987, must be presented not later then 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 aconic on or after January 11, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of actio mast be presented not latex than one year after the accrual of the cause of action. (Govt. Cade 5911.2.) B. Claim must be filed with the Clerk of the Board of Supervisors at its office in Rooth 106, County Admiatstration Building, 6511 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the Countyt the name of the DSstrict 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, renal Cade Sec. 72 at the end of this MR. •fit #� +� � * �tltttittEe �Fi� etFe � ctees� eect �te � � e � eeee �tit * eeeeee RE: Claim By ) Reserved for Clerkf s filing stamp } Wnst Me e3unty of Contra Costa or District) Fill f.n s�rse } She 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) 2. Where did the damage or injury occur? (Include city and county) 3. Howldid the damage or injury occur? (Give full details; use extra paper if required) -V-A,7ar)J CCr- CCU's Y O�Pcf cxcS 4. What particular aot or omission on the part of county or district officers, servants or employees oaused the injury cr damage? G7 � e - . � bl-EL ; ��� _n € rC - � � �i (aver) FEB-15-1994 13:34 510 646 5731 P.006 FEB-15-1994 1337 FROM CCC BUCHANAN AIRPORT TO COUNTY COUNSEL P.07 •w f �Wftt we,the names of county or district officers, dervants Or employees causing the damage .or inJury? 1+cf.rou C , l t) 1��? ' -=L�+ C�. -r)i uS �s Gt(�rcl ^fir_ c'(�-moron rs 6. What• damage or injuries do you claim resulted? {Give full extent of injuries or damages alaimed. Attach two estimates for auto damage. .35 q0)OC�G CSC; 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) iA0-1') Ct�- Ill(.®�c� GLi ► ( 1'�' B.. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or in,jurys D.� I'B'S + C(. CL( Gov. Code Sec. 91.0.2 provides: • "The claim must be Signed by the Claimant SAID NOTICES TOs (AttoMe ) or ky some son cn his behalf." Name Arid Address of Attorney ,moi' zd•E� Claimant Is Signature' t Y)Ld n 1 ►E.n ► �", lei. (Address) Telephone No. Telephone No. 5 Il;1 o i f iF f iF M NT I T I T T T W W NOTICE Section 72 of the Peml.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 saltie 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 Me state prison, by a fine of not exceeding ten thousand dollars {$10,000, or by both such imprisonment and fine. TOTAL P.07 FEB-15-1994 13.35 510 646 5731 P.007 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15, 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-.dSuperv-itsors—I e 9�f�J 2�ldl°GigtA� (Paragraph IV below), given pursant to Governmentl�Code Amount: $4,000,000.00 Section 913 and 915.4. Please note X11 "Warnings". CLAIMANT: CRESPO, Juan Pablo IL ATTORNEY: ! ;'r�1_ 4 . Date received � s� _. y ADDRESS: 110 Stony ridge Place BY DELIVERY TO CLERK ON February 15, 1994 Walnut Creek, CA 94596 BY MAIL POSTMARKED: Hand Delivered 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. � Q pIL ggepuLLOR, Clerk DATED: y .I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( D'f 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: !,[ a BY: Deputy County Counsel 111. 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: 1 certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DatedAgel HIL BATCHELOR, Clerk, 6y �.Q.�L1��.� 1 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 an this claim. See Government Code Section 945.6. Tou 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. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING 1 declare under penalty of perjury that 1 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 Unitedtotes stat 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. n Doled: _9G BY: PHIL BATCHELOR byputy Clerk CC: County Counsel County Administrator Claim 'to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against..._each pub3if8 entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp "ucgv\ N%a o c re-5 Q 4 ) �, RECEIVED Against the County of Contra Costa ) or ) [:FEMB 151994 1-5 w1"-:;c G/ !'�� Strlet) CLERK BOARD OF SUPERVISORS Fill in name ) CONTPA COSTA CO. The undersigned claimant hereby makes claim against the C unty of Contra Costa or the above-named District in the sum of $ Alga Cb11a1,S_ 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) 1AA QoXxA-e-L (,Q c nvf o, cas4s% 3. How did the damage or injury occur? (Give full details; use extra paper if required) 4. What particular act or omission on the part of couni'vy 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? a vrzA� (0tJr4 Cada ------------- 1 � -'Cs__ �� _ e l'_ r r ti --- r 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for au tq damage. I —e Yt,retY F-r!r --�r-r-rrrrr-rr- -- ----r -----r rr- +-eIi�y 7. How was the amount claimed abov computed? (Include the estimated amount of any prospective injury or damage.) V,) GVH`" �l S T 11M. ---- --------------------------- 8. Names and addresses of witnesses, doctors and hospita . r 6V V\ \V\A k)x VA-t� UCA (-t t,4-e Y 41, ---------------------------------------------- ----/---------------------------------- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT CU a/4(-S 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 �w v\ k�aO0 C reS 0 Claimant's Signat llD S 014 fi/ �,1 UO)'lle-e Ad ss v�laln Wil-('17-e , rA - Telephone No. Telephone No. 'g/0 - 9L� IoZdS * * * * * * * * * * * * * * * * * * * * 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. Q CLAIM I ' 1D' BOARD OF SUDERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15 , 1994 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: $4775 .41 Section 913 and 915.4. Please note all 'Ilarnings CLAIMANT: COLEY, Kelly ATTORNEY: Date received ADDRESS: 221 Nor.thgate Place BY DELIVERY TO CLERK ON FPhriinrs�. 1 9 34 Oakley, CA 94561 BY MAIL POSTMARKED: Hants Dpl i VPrp-d via : Risk Mgmt . 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pNIL pepuLylOR, ClerkDATED: 594- , .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: 3 9 y BY: Deputy County Counsel 11I. 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. D Dated: PHIL BATCHELOR. Clerk, ey Oaf_ _ 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 94S.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. *For additional warning see reverse side of this notice. 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 16; and that today I deposited in the United tates stat 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. Date J qenLBY: PHIL BATCHELOR by �, , p Q„ Deputy Clerk .CC: County Counsel County Administrator Clair to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Clams relating to causes of action fordeath 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 t1har, one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp ) RECEIVED ) Against the County of Contra Costa ) FB 2 3 M or ) District) CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. Fill in name ) The undersigned claimant hereby makes claim agai t theoCounty of Contra Costa or the above-named District in the sum ofd�] . $ y.1 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) U--)"U--)" +M,\JeA , �1 1 - (DbD a- a-PP-ro�(_ ID-15 mph ------------_ .. � - �� --- 1 ------------- 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? Mbc�e, an unsafe_ Ian ,e �h rover) WnaL are tne names of county or district officers, servants or employees causing the damage or injury? aAAe�_17�3 6. ----- ------------------------------—------------------------------------------- What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach-t-wo--estimates for auto damage. NO rico DtC,y in 0 ;��+o e 4 els b�,CL__t-eSU1C_tk1_- 7. How was the amount claimed above computed? (Include the estimated amount of any prospective" injury or damage._) see" LCL�D es _M_________!__M-------------- S. Names and addresses of witnesse.,p*,-doctors arid- hospitals. W�+_ )Zss e-n n IRNCY�,,e_ D)P�BLA -I C)I M+ bgal V8 - (ALA CbkA q 9. List the expenditures you made on account of this accident or injury-. DATE ITEM AMOUNT (0 46 ' k -e, Gov. Code Sec. 910-02 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney)_ or by somepersonon his behalf." Name and Address of Attorney ta (C�aimant I s 'gnature lum+- t1 kAddreiss) Telephone No. Telephone No. 61 (6-1c T T 11 V V I V I I I V I V WT I NOTICE Section 72 of the Penal Code provides:. "Every person who, with intent to defraud, presents for allowance or for paymentto 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 ($19000), 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. Hca rnri -.)Ao- ("n Please see full prescribing information on last pages. Contra Costa County RECEIVED FEB 22 1994 isk Meria0ment et,j. �! 'j�{�:rr," .re{•-.1,. ,•.!"''!' y�"`�" LA '1'Y ��1:�1�1 4i VOLVO )t 1791 N tit MAI Street + Wnlnut Creek,Cnlliurttln 94596 + 11Itutte(415)939_3333 ,u�►, , ;,,, R'Ai.p�J. WO i, Cx rx is c INS molm I" r► ..! Ct'MIi . ...... mlsT n[t � -'sc:auvj rwm L�ctW- /'L'�.. [t��, ,x�'iL. . � !Ci Y �a,©-0 ff)JA Oro ner r ..:. aw 5 a ��. �nr3 f � 0 ALL LAu. KATL Ion k CS?.li,� illlGli. -_ ___ - ... .. LABR. TIMC ' .4?`_ t� ic I t ' 3 ,-. �b NO'T'ES. � (_�_ _ _...1 TOTAL .�....! ! t ESTIMATE OF REPAIRS -57 =OAS LISTED FOR LABOR AND MATERIALS-VERBAL AGREEMENTS NOT BINDING-ESTIMATES FREE 31-571- OWNER WNER _�..__- -T/ DATE ADDRESS PHONE EST.NO. ;�lD5 l -eno'is LX[yf� An 6q gtTg- 3828 INSURANCE CO. - ORDER NO. /�A^ ADDRESS PHONE LICENSE NUMBER YEAR, K - MODU ILEAGE MOTOR NO. SERIAL NO. QUAN. DESCRIPTIOWOF LABOR OR MATERIAL WAM90. ' MATERIAL LABOR G r� Daz 42—. ILA J Ir �� 17 15,00 3 r e f N Q ,vo':' } 3 r- e;- DID — -- - �U 0LUPI 190 mm ge-P i.- bo du � t 00 PARTS PRICES BASED ON STANDARD CATALOG PROCUREMENT PRICE LISTS SUBJECT TO CHANGE WITHOUT NOTICE. TOTAL PROCUREMENT AND DELIVERY CHARGES MAY BE ADDED FOR SPECIAL SERVICE ON ITEMS NOT AVAILABLE LOCALLY. MATERIAL OLD PARTS REMOVED FROM CARS WILL BE JUNKED UNLESS OTHERWISE INSTRUCTED IN WRITING. THE ABOVE IS AN ESTIMATE BASED ON OUR INSPECTION AND DOES NOT COVER ADDITIONAL PARTS OR LABOR WHICH �+ TOTAL LABOR o MAY BE REQUIRED AFTER THE WORK HAS BEEN OPENED UP.OCCASIONALLY AFTER WORK HAS STARTED WORN PARTS ARE DISCOVEREDWHICH AA/R�E/'}N�OT EVIDENT ONN�FIRST INSPECTION.BECAUSE OF THIS THE ABOVE PRICES ARE NOT GUARANTEED. TOTAL MATERIAL ' 1250 Contra Costa Blvd. �aa�CA 94y23 ESTIMATE TAX ESTIM APPROVED BY AUTHORIZED AND ACCEPTED PAID OUT-TOW&STORAGE SUBL REPAIRS BY OWNER . TOTAL OR AGENT DATE REIXFCRM. 411.429 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15 , 1994 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`tAe-BoaTdrof Supery,isors Y i a 11. �? , 1r, L� n (Paragraph IV below), given pursuant to�6ove,cnalent_CO"6 Amount: $1 , 000,000.00 + Section 913 and 915.4. Please noLe��il •Warnings". t �fl� CLAIMANT: MAUS, Debra Ann G ATTORNEY: Stan Casper COUNTY COUNSEL ` Casper , Meadows & Schwartz Date received MARTINZ,CP1IF� ADDRESS: 1320 Willow Pass Rd, . Ste 500BY DELIVERY TO CLERK ON February 23 , 1994 Concord, CA 94520 BY MAIL POSTMARKED: Fevruary 22, 1994 Certified Mail P 394 356 015 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IVIL BATCHELOR' Clerk DATED. . 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: /9 21 BY: �, Deputy County Counsel 111. FROM: Clerk of the Board 70: County Counsel (1) County AdnUistrator (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. ( I Other: 1 certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated A.�Q� I S. l cm PHIL BATCHELOR, Clerk. By 4L, PA �0 d_� Deputy Clerk HARNING (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. *For additional warning see reverse side of this notice. AFFIDAVIT OF MAILING T 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 fates sial 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. 00 — Dated: BY: PHIL BATCHELOR by,,�A,n1 pQ, _> Deputy Clerk CC: County Counsel County Administrator / ! � . , . _ �Ul � a L 8 co ON cts ¥ A « U2 n � . . o C - . \ , N . � . » � \ i � 7 , � J \ � } � W � � V I STAN CASPER RECEIVED CASPER., MEADOWS & SCHWARTZ 2 A Professional Corporation One Corporate Centre FEB 2 3 M4 3 1320 Willow Pass Road, Suite 500 .�._ Concord, California 94520 CLERK BOARD OF SUPERVISORS 4 Telephone: (415) 827-0556 CONTRACOSTACO. 5 Attorneys for Claimant, DEBRA ANN MAUS 6 7 8 9 10 DEBRA ANN MAUS, CLAIM FOR PERSONAL INJURIES (Government Code 5 910) 11 VS . 12 COUNTY OF CONTRA COSTA. 13 14 TO: Clerk of the Board of Supervisors 15 County of Contra Costa 651 Pine Street 16 Martinez, CA 94553 17 YOU ARE HEREBY NOTIFIED that Debra Ann Maus, whose 18 address is P. 0. Box 841, Martinez, California 94553, claims 19 damages from the County of Contra Costa in an amount within the 20 jurisdiction of the Superior Court. 21 This claim is based on personal injuries sustained by 22 claimant on or about November 5, 1993, in Richmond, California. �3 Claimant Debra Ann Maus was, at the time, a prisoner and inmate 24 of the Contra Costa County Sheriff's Department's Detention 25 Center located at 5555 Giant Highway, Richmond, California 26 (otherwise known- as West County Detention Facility; i.e. WCDF) . 27 As an inmate in the custody of the Contra Costa County 28 Sheriff's Department, claimant was both expressly and impliedly CASPER,MEADOWS &SCHWARTZ A Professional Corporation ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)627.0556 I promised that she would be kept safe while in custody. On 2 November 5, 1993, claimant was escorted to the West County 3 Detention Facility medical office by Deputy Sheriffs K. Wilson 4 and B. Collins . On the way to the medical facility male 5 inmates were observed leering and making remarks about claimant 6 who is a female. In full view of the aforementioned male 7 inmates, the deputies who had escorted claimant left her alone 8 in the medical office waiting room without locking the door 9 that separated her from the male inmates and leaving her to 10 fend for herself. 11 After the deputy sheriffs left claimant in this 12 vulnerable and unprotected position, two male inmates entered 13 the medical office and sexually assaulted claimant. Said 14 assault included rape and rape by penetration by foreign 15 object. 16 The conduct by the aforementioned officers and other 17 WCDF staff exhibited a callous disregard for claimant's safety 18 resulting in the assault by male prisoners. After the assault 19 claimant made repeated requests to be seen and treated by an 20 appropriate medical practitioner. She was denied this request 21 by unknown employees of the Sheriff's Department, who 22 demonstrated a deliberate indifference to claimant's serious �3 medical needs. This failure to summon appropriate medical care 24 caused further physical and mental injury to claimant. 25 The injuries sustained by claimant, as far as known, as 26 of the date of presentation of this claim, consist of vaginal 2; and urinary tract infections and severe emotional distress . 28 CASPER.MEADOWS &SCHWARTZ A Professional Corporation 'Z _ ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 Concord,California 94520 (510)627.0556 I The amount claimed, as of the date of presentation of 2 this claim, is computed as follows: 3 A. General Damages Incurred To Date: $1,000,000 . 00 4 B. Future Expenses For Medical Care: Unknown at this 5 time. G C. Prospective General Damages : Unknown at this time. 7 Jurisdiction over the claim would rest in the Superior 8 Court of the State of California, Contra Costa County. 9 All notices or other communications with regard to this 10 claim should be sent to claimant at the following address: 11 Stan Casper Casper, Meadows & Schwartz 12 A Professional Corporation 1320 Willow Pass Road, Suite 500 13 Concord, California 94520 14 Dated: February 22, 1994 15 CASPER, MEADOWS & SCHWARTZ 16 A Professional Corporation 17 18 STAN CAOER 19 Attorneys r Claimant 20 21 22 23 24 25 26 27 28 CASPER.MEADOWS &SCHWARTZ A Professional Corporation _ 3 ONE CORPORATE CENTRE 1320 Willow Pass Road Suite 500 Concord.California 94520 MIA1[19]_!1944 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT MARCH 15 1994 and Board Action. All Section references are to ) The copy of this document wailed to you-is your notice of California Government Codes. ) the action taken on your claim by thefBoard2 of�Su"per#visors ''- (Paragraph IV below), given pursuant,'�6overnment�Code� N Fnl, Amount: Section 913 and 915.4. Please note `Warn N - Unknown ings . N U� CLAIMANT: ! MIRANDA, Boy & Erns • �i COUNTY COWNS�L ATTORREY • Jeffrey R. Siegel if Lg1111t9lstzz,-f-I_�_�r "moi Law Offices Of Jeffrey Siegel Date received ADDRESS: 1910 Olympic Blvd. , Ste . 220 BY DELIVERY TO CLERK ON February 28 , 1994 Walnut Creek, CA 94596 February 24 1994 _ BY MAIL POSTMARKED: Y , Certified Mail P 299 954 623 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. p BB DATED: Tall DepuLyLOR, Clerk (1 A O Q .I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( 1/) 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: Nalt& 0 9 8Y: 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 i ✓) 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 f�M aA o AJ 15 191' PHIL BATCHELOR, Clerk, By_�l r e , 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. *For additional warning see reverse side of this notice. 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 fates stat Service in Marttnes. California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the Claimant as shown above. Dated: "� �1d /(e ggAL BY: PHIL BATCHELOR byOeputy Clerk -CC: County Counsel County Administrator 00 o.o r� r Q1 Ul U1 0 F"' tj fict ►—' K ti mo • 00 ru t. NOtDt++ f►' a (� ctOD G d fi C 0 Ul En N Q _ � w p � 1 cax ltd w C y _ *#RA��r.kR x�i•Rk� LAW OFFICE OF JEFFREY R. SIEGEL BE EIVED JEFFREY R. SIEGEL, ESQ. S.B.#112061 1910 Olympic Blvd. , Suite 220 Walnut Creek, CA 94596 28 Telephone: (510) 274-9800 Fax: (510) 930-7595 CLERK CORAC OS A CO.ISORS NT Attorneys for Claimant C L A I M PUBLIC ENTITY: County of Contra Costa Sheriffs-Coroner's Office 1. Name and Address of Claimant: Boy and Ems Miranda 707 Turquoise Drive hercules, CA 94557 2. All notices should be sent to: Jeffrey R. Siegel, Esq. LAW OFFICES OF JEFFREY R. SIEGEL 1910 Olympic Blvd. Suite 220 Walnut Creek, CA 94596 (510) 274-9800 3. The date, place and other circumstances of the occurrence or transaction which gave rise to this Claim are as follows: On or about October 9, 1993, claimants' daughter, Maylaneeh Miranda, was involved in a fatal automobile accident. During the Coroner's investigation, Sergeant Floyd Snodgrass, brought the remains to the claimants' residence, at which time he requested, and claimant Ems Miranda did, view the body. i i GOVERNMENTAL ENTITY CLAIM I PAGE -2- 4. A general description of the indebtedness, obligation, injury, damage or loss incurred so far as it may be known at the time of presentation of the Claim it as follows: The nature of the damages is serious emotional, mental and psychological injury to claimant Ems Miranda and loss of consortium for Boys Miranda. The acts constituted negligence and intentional infliction of emotional stress in that Contra Costa County Sheriff Coroner's Office failed to . institute, and follow appropriate procedures for notification and identification of remains. The method of identification in this instance has been expressly forbidden by the Sheriff-Coroner's Department since the date of the incident. I 5. The name and names of the public employee or employees causing the injury, damage, or loss, if known are as follows: Sergeant Floyd Snodgrass, Captain John C. Hart. i 6. The amount claimed as of the date of presentation of this Claim, including the estimated amount of any prospective injury, damage, or loss, insofar as it may be known at the time of the presentation of this Claim, together with the basis of computation of the amount claimed •is as follows: Within the jurisdiction of the Superior Court. DATED: / LAW OF C OF JEFFREY R. SIEGEL i I By: JEF REY R. IEG L Att rney fo Claimant I Jeffrey R. Siegel REE® Attorney at Law 1910 Olympic Boulevard Suite 220 El 1994 Walnut Creek, California 94596 510-274-9800 CLERK BOAF.0 0 FAX: 510-930-7595 VIA CERTIFIED/RETURN RECEE"REQUESTED FIRST CLASS U.S. POST February 24, 1994 Clerk of the Board Board of Supervisors 651 Pine Street 1st Floor Martinez, CA 94553 Re: Boy and Ems Miranda Dear Clerk of the Board: Enclosed herewith is an original claim and one copy. Please stamp the copy received and return it to me in the envelope provided. Thank you for your attention to this request. Very truly yours, JE FREY IECEL JRS/pt A:CLERK.1 Enclosures