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MINUTES - 03281995 - 1.12
CLAIM BOARD OF SUPERVISOWOF _CONNA COSTA COUNTY, CALIFORNIA � March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT. and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $5,000,000.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT:Paul Vincent Ziogas M1��[a o K F.fl y ATTORNEY:James R. Chiosso, Esq. — MAR Date received COUNTYcaUIIscL, ADDRESS: 1999 Harrison St. , Ste. 1600 BY DELIVERY TO CLERK ON March 1. 199�IARTINEZCALIF. P.O. Box 2079 Oakland CA 94604-2079 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. 9g 6 DATED: March 2, 1995 ga1L DeputylOR, Clerk I1. FROM: ,�County Counsel TO: Clerk of the Board of Supervisors ('l�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 5 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). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a -true and correct copy of the Board's Order entered in its minutes for this date. Q Dated: 2 8 2% PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately, AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant. addressed to the claimant as shown above. Dated: MAR 2 8 9 BY: PHIL BATCHELOR by4J4 AJ4 eputy Clerk CC: County Counsel County Administrator RECEIVE® CLAIM AGAINST COUNTY OF CONTRA COSTA �� - >DOF 199 CLER CONTRA COSTA CO.SUPERV�SORS (a) NAME AND ADDRESS OF CLAIMANT: Paul Vincent Ziogas Address: 737 Palm Avenue Martinez, CA 94553 Telephone: Home 510/372-5669 (b) SEND ALL NOTICES TO: Gwilliam, Ivary, Chiosso, Cavalli & Brewer 1999 Harrison Street, Ste. 1600 P.O. Box 2079 Oakland, CA 94604-2079 Attn: James R. Chiosso, Esq. Phone: 510/832-5411 (c) DATE OF OCCURRENCE: 9/2/94 at approximately 9: 30 p.m. PLACE OF OCCURRENCE: 108 ' west of Peach Street on Pacheco Boulevard CIRCUMSTANCES OF OCCURRENCE: On the above day and place, claimant, Paul Vincent Ziogas, was a pedestrian crossing Pacheco Boulevard when a vehicle travelling eastbound on Pacheco Boulevard struck him. Claimant alleges that this section of Pacheco Boulevard where this accident occurred constituted a dangerous condition of public property under the laws of the State of California due to inadequate lighting, defective lighting and poor visibility and that the County of Contra Costa, its agents and assigns, failed to inspect, service, maintain, repair and operate the street lighting for this accident site and/or to see that it was properly serviced maintained, repaired, inspected and operated. Claimant reserves the right to amend this claim upon discovery of additional information. (d) GENERAL DESCRIPTION OF INJURY, DAMAGE OR LOSS INCURRED: Claimant suffered severe injuries including, but not limited to, massive chest injuries with multiple rib fractures, tension hemopneumothorax, acute tear of the left diaphragm with intra- abdominal contents of the left chest, lacerated spleen and liver, left pelvic fracture with retro peritoneal hematoma and left legs, head concussion with laceration of forehead and scalp and developed ARDS. Medical Damages currently in excess of $240, 000. 00 Emotional and mental anguish. Loss of income and/or earning capacity. �i Claim Against County of Contra Costa Re: Claimant: Paul Vincent Ziogas Page Two (e) NAMES OF EYEWITNESS (ES) : Laurie Lynn Schneider Erica N. Schneider 1524 Willow Street Martinez, CA 94553 Phone: 510/372-0794 Michael R. Richardson Sharon R. Richardson 1795 Sharon Drive Concord, CA Phone: 510/687-4671 (e) AMOUNT OF CLAIM AND BASIS OF COMPUTATION: General damages: $5, 000, 000 Special damages: Loss of income/earning capacity according to proof within the jurisdiction of the Superior Court. Interest as allowed by law. Attorneys' fees as allowed by law. JURISDICTION: Superior Court I declare under penalty of perjury, that the above is true and correct. Signed by or on behalf of claim is Dated: February 27, 1995 , Ja s R. Chiosso, Esq. Receipt of a copy of the within claim is hereby acknowledged this day of February, 1995. _,CLAIM 1. r BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $250.00 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Anthony H. Siino ATTORNEY: c AR Date received COUNT'YC6��tf�4�=! ADDRESS: 153 Encinal Place BY DELIVERY TO CLERK ON Marrrh 9 1995 MARTINE-Zc:er Pittsburg, CA 94565 BY MAIL POSTMARKED: Hand Delivered via: Risk Mgmt_ 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Pp gg DATED: March 2, 1995 B�1L DeputyLOR, Cler Il. FROM: /unty Counsel TO: Clerk of the Board of Supervisors ( This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: j j 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. BOARDS 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: R 2 81995 PHIL BATCHELOR, Clerk, B , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant asc�Shown above. Dated: 2 8 �0,_r4e�,�Deputy BY: PHIL BATCHELOR b Clerk CC: County Counsel County Administrator Cla 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 91553• 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 ECEIVEAgainst the County of Contra Costa ) MAR - 2 1995 or ) District) CLERK BOARD OF SUP VISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ %', O 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) 178 4- .I ULI 10 /I MM f961 l n_ c• r.�STl 1 M___------___ 3. How did the damage or injury occur? (Give full details; use extra paper if required) 'kUKk /�'l t% I 4. What particular act or. omission on the part of county or district officers, servants or employees caused the injury or damage? ro2Cj13� � k �� �aRn}!`� 1 Qu���& y�ry�2�c��' _FF, 71--nJts �n/lLn ►z, rNVT� t� j- j��)n� ove� D. wnat are the names of county or district officers, servants or employees causing the da-m-age or injury? -------- -'1 f—L s=L=5 —------------------------- 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. C ---- -�r�--4' 'L ?{ o 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 71- $. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT d�yS (�)dvi, Lead f1 rI ev; - X10`=., � 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 d lk tC aimant's Signature A5 ECt 04 L. (� Address Telephone No. Telephone No. � /a 3 • � .3 * * * * 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. I � .. _ } •`SSL§�e i �� l {t�,f:s� N�.xsi �s v t +v v CLAIM t BOARD OF SUPERVISORSOFCONTRA COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $1,000,000.00 Section 913 and 915.4. Please note all "Warnings-1k, CLAIMANT: Romelo and Ascuncion Riemedio - FEB 2 ATTORNEY: Timothy Jaress _ COUNTY Cb UNI-.1L Date received 24 9951TINEZCALIF. ADDRESS: 1426 FillFebruary St. , Ste 213 BY DELIVERY TO CLERK ON Y 1 San Francisco CA 94115 Hand Delivered via: Risk M t. BY MAIL POSTMARKED: � 3. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppH�{1L BATCHELOR, Clerk DATED February 27, 1995 BY: Deputy I1. FROM: County Counsel TO: Clerk of the Board of Supervisors (--I'—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: oZ 'a? BY: AiZA==/4____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). IV. BOARDD 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: 2 8 1995 PHIL BATCHELOR, Clerk, BydL&44 .B®, Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 2 8 1995 BY: PHIL BATCHELOR b (',,,,,J&,eputy Clerk CC: County Counsel County Administrator l Ron Harvey FEB 2 41995 O �4 rI .(..1 {1 M Ln LO OcDc� •r•r 90 O F:4 U N N - ap Or: H �.j co Q U 0— t~n O O o H J.Z J Q ?yi 0 LLz Lr Iv., � N z c < WAPIr ? SUPERVISORS OF CONTRA COSTA INSTRUCTIONS TO CLAIMANT k. Clam 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 acarus 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 roust be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be tiled with the Clerk of the Hoard of Supervisors at its office in Room 106, County Administration Building, 651 Pigs Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the Mme 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 Seo. 72 at the end of this f0m. !F 11 �11F # �Fl� # g91 � # It � 1f � it � A �F * �F � ItiFi �F � � � 1111 � � 9k � iFlFlt � �l � � REs aSiM EV ROMELO' RIEMEDIO AND ) Reserved for Q.erk's filing stamp ASCU ION RIEMEDIO ) 571 NATOMIA ST. SF, CA 94103 ) RECEIVES ~' Again the County of tra Costa ) LCLERK Eg 2 4 1995 CHILDREN 'S HOME Or FOUNDATION OF ) ANTIOCH District) �fVT�,AARD OF S13P CDSTA Co..ISORS Fi in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 1,000 ,000 .00 and in support of this claim represents as followss ww 1, When the damage or injury 000ur? '(Give exact date and hour) September 6 , 1994 to September 9 , 1994 2. Where did the damage or injury occur? (Include city and county) Children' s Home Foundation, 1714 San Jose Dr . , Antioch, CA 94509 county of Contra Costa ..ww....w�w�w•.Mww �wvwMw-� + ww 3. How did the damage or inj%L y occur? (Give full details; use extra paper if required) Children' s Home Foundation onSeptember 9 , 1994 accepted minor child of claimants , Skylette Riemedio, without the proper facilities , or knowledge to properly administer to the special care and equipment, ` staff (PLEASE SEE .OTHER SIDE) ......��..-mow«.... u. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? , The director of the Children' s Home Foundation, Lenny Ladesic, misrepresented that his facility had adquate medical personnel and equipment to properly provide medical care for the speciai needs of claimant' s minor child who was admitted suffering from cerebral palsy and an acute respiratory condition. Their failure to properly administer care to the claimants ' 3 . (CONTINUED) < needs of the child, or to properly monitor her care, and which failures and omissions led to child' s death. Claimants suffered severe emotionai distress and anguish, and loss of love and affection as a result. 4 . (CONTINUED) child and to monitor her condition led to her death . n 0 #GINAL . i. wnaL are the ru ws of county or district officers, servants or employees causing th^ t3-.11ge or jury? Lenny Ladesic, director of Childrens Home Foundation of Antioch and it' s employees ,, staff, .,-and as .yet- unknown �.-r..r.--------- -r- --- •.-O.w�.�.. 5. What damage or injuries do you claim resulted? (Give Hill extent of injuries or damages claimed. Attach two estimates for auto damage. Severe emotional distress and anguish and loss of love and affection on behalf of claimants ���r1r�..��.•.r�•+r��rt.���.�- 7• How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) Reasonable value of •loss . of affection,' love and_ the suffering_, of __severe emotional distress and anguish from the wrongful death of a minor child. OPO•r���w.wo��Mrrrrrrr.r rr.. $. Names and addresses of witnesses, dootors and hospitals. . Medical Personnel (others yet to be Lenny Ladesic determined' Children Home Foundation of Antioch Kaiser Permanente Hosp. 1714 San Jose Dr. , Antioch, CA 94509 350-St. Joseph St. S .F. , CA 94115 9. List the expenditures you made on aawunt of this accident or inJurya DATE ITEM .r. To be determined # r1 � {f a * a � � .a i M !F M i! ! * * -� *.a f ! i IF a � � • # � � M � � � * * IF � !F � Gov. Code Sec. 910:2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney)_ or bV some person on his behalf." Me and Address of Attorney TIMOTHY JARESS LAW OFFICE 1426 FILLMORE ST. iSTE 213 Claimant s Signature SAN FRANCISCO, CA 94115 TIMOTH JARES5, Attorney at L-aw, behalf. of ROMELO RIEMEDIO AND 'ASCUNCION RIEMEDIO .. .(Address) 1426 Fmore St.. $te 213 , SF�, CA 94115 Telephone No. (415) 346-3552 Telephone No. (415) ea * e: ae: a ertaar► eea aaa 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 Sail 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 ($10,0009 or by both such irprison mnt and fine. TOTAL F.03 CLAIM BOARD OF SUDERVI5O, S OF CONTRA COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $25,000.00 Section 913 and 915.4. Please note all ."Warnings". CLAIMANT: Lia Ojendyk ATTORNEY:' FES s� �•y`;a Date received COUNTY , ADDRESS: 60 Kenneth Court BY DELIVERY TO CLERK ON Febnialz� 9.4, 1�3�3 1NrEZCALIF. Bay EQji3t CA 94565 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. EVIL gATCHELOR, Cler DATED: February 27, 1995 : Deputy I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( ,.V�his 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: o�— a'1 - Cj� BY: Deputy County Counsel II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARDD 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: MAR28 1995 PHIL BATCHELOR, Clerk, By JA 4Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: e ° BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator l 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, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 1069 County Administration Building, 651 Pine Street, Martinez, CA 94553• C. If claim is against a district governed by the Board of Supervisors, rather than - the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By ) Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa ) or ) FEB 2 41995 District) CLERK BOARD OF SUPERVISORS Fill 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 $ and in support of this claim represents as follows: -------------------------------------------- 1. When did the damage or injury occur? (Give exact date and hour) ---------- -- - �--°1-._-`� --`'. -------------------------------- 2. Where did t e damage or injulry occur? (Include city and county) --� _ 1 _�UL�.-- -- ,' '— -------------------------------- Ho� the dams a or in occur? (Give full details; use extra r if 3 g jury paper required) ---------------------------- -2,11 ------------------------- 4.NWhat particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? y-N&D � 1�"vti 1�0, GD-Jo Vr,D _ i i -_ 1, F V '� \A0, S (over) 5. What are the names of county or district officers, servants or employees causing thedamage or injury? vy� - -------- -------------------------------------------------------------- S. What damage"4 injuries do you claim resulted? (Give full extent of in'uries or amage�s pclaimed.�+ Attach estifm`a�tes� for auto damage. [—'0, U111) V\,Q— 1 7. How was the amount claimed above computed? (I clud the estimated amo o any prospective injury or damage.) .v,� �o rvv\- ` 9, W6 O uo U\T 8. ,Names and address s of witnesses, ntors and hospitals. CZ C - ---------- -- - --------------------------------��----------------------- 9. List the enditures 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) 4 or by some person on his behalf." Name and Address of Attorney (Claibant' S gnature (Address) LO 1 Telephone No. Teleph ne No. Vy 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 ($10,000, or by both such imprisonment and fine. J � t ol R� tag ' � --�,�.,�•_.. _ �� ^vim---� ��'���� r � ,,��,�t:� �ino 00 • ; . `� ��' ��-�-�''r, �p(�i•". lam' 1v�, `� OvQ "V4 A h 40D �Ujat'�' _-0) • tA. Cb 05 LkD yvo ctzl A-Q) Wwv �-+_ szws S Uj I-H.a) 1011 - ,; q c'AD An, u CiD "YA V k� vc Z- L Jr �c) ;.Q(: C7V) A) P, AID c - k 4 cev,�)u T�f V-Q ft'�- t -v--A Cts av Q,.— COY �-2- g (k-s CxA D�kkA G",r u� A OR ASV A� y AV +6 w CLAIM ' BOARD OF SUPER.VI SORS_OF CONTRA COSTA COUNTY, CALIFORNIA March 28 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $ $50,000.00 Section 913 and 915.4. Please note all 't,Warnings;.:;P 1,}, CLAIMANT:Aina Ojendyk y P ATTORNEY: c:S?URITY CC�Z:fd ! Date received MAR iNEZCALiF:. ADDRESS: 60 Kenneth Ct. BY DELIVERY TO CLERK ON February 24, 1995 Bay Point CA 94565 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. DATED: February 27, 1995 JAIL BATTCHELOR, Clerk 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: a' - S BY: /��-�.. Deputy County Counsel II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD(ORDER: By unanimous vote of the Supervisors present ( V) This Claim is rejected in full. ( ) Other: I certify that this is a -true and correct copy of the Board's Order entered in its minutes for this date. _ Dated: IMIJAAR 2 8 9 PHIL BATCHELOR, Clerk, By,44'4 _, Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING 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: MAR 2 8 1M BY: PHIL BATCHELOR bj". &d,& Deputy Clerk CC: County Counsel County Administrator Cl" "in 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, 19870 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 ) Re ved for erk's iling stamp WI nC RECEIVE® ) Against the County of Contra Costa ) FEB 2 41995 or ) p4.,... District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. z The undersigned claimant hereby makes claim against the County of Contra Costa or the, above-named District in the sum of $ S O�,©t)(p 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"Y+rA� ----------------- 3. How diA&e damage or injury occur? (Give fu13'details; use extra paper if required) N --------------------------- ------------------------------------------ 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? ti , (over) . 5. What are the names of county or district officers, servants or employees causing . the damage or injury? r 01- 7-7 ---------------------------- ------------------------------ 6. What damage injuries do you claim resulted. (Give full extent of injuries or damages claimed. ,ttac4estimate for auto d e. Gy Ni -- - �� 7. How was th amount claimed above computed? (IncNIude the estimated amount(_�f prospective 1,,njury or e.) 8 Names and addre seof w the s doc o s and hospitals. '� � 01- too-------- -- -- - - - - -----------List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Seca 910.2 provides: "The claim must be signed by the claimant SEND NXICES T0: (Attorney) or by some person on h14 behalf." Name and Address of Attorney , Cla is i tune Address k '\r','%1\ Telephone No. Telephone No._L[O� vs� —L7 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. Ll VA- t o V --- - --- --- A` - _ - -- - `� T - == - - ----- ----- 5--- - - ' - ` ►� �1�Y�.1 C�S :DCC-i�,ar'P:� _ ��- '�- C"�n.-g �N"—�� 1 � � - sx 4�4 ov T ' 4f . V\-Q - CD - _ _ i I cCO Lk-V-\-\� loack .. ®r, X N tv VVA- h - - 1 `- - - A Mv� 41�k tv VN� v I V�x ---�,(OA _OAO - ( �< 46 Y 1� KJ a dp t t� _CQ1 W im, Ad A I vv-\- og, -A�� Id 1 01 ca TA Awi,\�uj k,� v--�o 0-�C�GS C � ,� , co �'\) pv� ItJ r ! OW . I f " r 4• t ' r CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $457.09 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Marc Mackey ATTORNEY: MAR Date received COUNTYCOUNSEL ADDRESS: 5311 Ridgeview Circle #5 BY DELIVERY TO CLERK ON March 3, 1995 nOaatrnrr-mac al IM El Soberante, CA 94806 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. DATED: March 3, 1995 JYll �eputyLOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( his 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 _ 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). IV. BOARDD 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: MR.2 8 19% PHIL BATCHELOR, Clerk, By,h A , Deputy Clerk WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 16; 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: MR 2 8 199% BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator V. Claim 'to: BOARD OF SUPERVISORS OF CONTRA COSTA COMM IRSTRDCTIONS TO A. Claims relating to causes of action for death or for injury •�o person or to per- sonal property or growing crops and which accrue cn 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, 19889 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. 'n IP the claim is a—inst =re than one - b..c entity, se,--rate alai- =xst be 0_ filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this a • • � � � � ! • � f i � • � • a f i f i f • f • a f � i a • a a i • � • f i • • � � RE: Claim By ; Reserved for Clerk's filing stamp MARC RECEIVE® 531 I Rk -0i Gr 5 EL Sobran�-�j Il�!�c, ,D AgainsV the County of Contra. Costa T) ' 31995 or ) CLERK�NTi;A COSTA COARD OF SUPERVISORS District) Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 4o-7.0 g and in support of this claim represents as follows: + 50, 00 4, U so -1-1Y-t•5 To 1.-; 457,0� I. When did the damage or injury occur? (Give exact date and hour) -�Yr--NY-N--Y- 2. Where did the damage or injury occur? (Include city and county) Le.mu Swn Ul �,Yi tv'W �1�� ��wQ�h R�1 �abQr� M;I�Qrs 5+ 3. How did the damage or injury oc ur? (Give full details; use extra paper if _110required), nnd�, a SrY14�N� ��Ye. 11eq�e� kouJpr�, h�1� 0^ vJ�n� Lt-4 V '46 �0,��,e.c �h a 90+ Y1ole wkSen ,n �-Du) RIS 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? (over) 5. What•are the names of county or district officers, servants or employees causing the damage or injury? 5. What damage or injuries do you claim salted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. / Neek,q -refnftrar�- 771re-3157 d-°e na7. How was the amount above computed? (Include the tI ed unt of any prospective injury or damage.) y 7 C e B. Names and addresses of Witnesses, doctors and hospitals. --"�N Ar S ern yrs 9. List the expenditures you made on account of this accident or injury: D` ITEM AMOUNT T�rnQb 5 0.00 2��f1S 0i Gov. Code Sec. 910.2 provides: "The claim must signed by the claimant SEND NOTICES TO: (Attorney)•, or by isome perWon his behalf." Name and Address of Attorney P WW A�atAL'('V Cla 's Si tore 5311 1� tviev) T'\YAt ' 5 (Address) �L Sa�Rav� eA . (S/9) -75 -mss A7 1C1C}7'�i�itiC alp. � iCic}�iaucyc a�G. iii • iiiIr iiiiiiii �T�TZ T'TTT� iii 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 01090009 or by both such imprisonment and fine. Dam - i SO j Y �Jr�2.� sd Y►n� ern ora e� Ir25 i �.d• U �or U re"s I 1 I � I Ivan Schuplinsky - ---- --- -- ---- - - -- - - ---- 700 Belmont Way f Pinole,CA 94564 ! ! (510)114-9444 j• I I �� Ito o Tires,• Wheels•Shocks•Brakes•Alignment•SYiuts -- — — '14D TORE ICHMO t; 1608 Mark6f Ave. SAN PABLO, CA 94806 .57` `� 5 95N T (510) 27.212 ".09 . 95 + CUSTOMER'S ORDER NO. PHONE DATE �/m NAME f ADDRESS z,� p2 NQS 90 Xf llJ� +�le� 61• .j j n 8e 25% iaCFtpRGE rAC T'17' RETD:`PAID OUT x m ` 16 - 99* 222089 + ............ I ............... .. ....._.._....._.___.............. .................................................. ._:.................. ..._._....__._...._...._.:._...._._. i �-- _._........._.._._.....__.._._._.._.:......_......:.._....._._... _..._... .. :....... .............................. _...__...__..._�._...__...:.... 1, ( TAXA W(K 129 . c� + 1 ��� SOLD BY RECEIVED BY i r{ TOTAL e,-Z)_, r 9- 18 e 1 5" -F 9 All claims and returned goods MUST be I accompanied by this bill. l ( 10326 `ThankYo` u f PRODUCT 609�Inc.Groton,Mau.01471. . . . 4796 AS LISTED FOR LABOR AND MATERIAS ESTIMATE ®F R E PAIRS VER AL AGREEMENTS NOT BINDING L STIMATES FREE OWNER ,ny DATE f, ADDRESS PHONE EST. NO. INSURANCE CO. ORDER NO. ADDRESS PHONE LICENSE NUMBER y� � /Z�� YEAR-MgKE �� / MODEL MILEAGE MOTOR NO. SERIAL NO. "` /Lla'Z�f 2OOV �'�•� N/1(1F/! �®�8r2�3 I.z s 3 §P,ARTS PRI;CES BASED ON STANOARII CATALOG PROCUREMENT PRIDE LISTS SUBJECT 70 CHANGEtWIT,HOUT NOTICE ' TOTAL J PROCUREMENT AN0 DELIVERY CHARGES MAY BE AOIIEO fDR SPEC IALSERV,(CE,ON ITEMSNOT-A AILABL'E LOCALLY< MATERIAL O�D PARTS REMDVStI FROM CARSWILL��E JUNKED UNIfSS OTHERWISE INSTRUCTfD`tN WRi7l{G � � TOTAL LABOR GSC T,HE ABOVE IS"fiiV E571RRRTE"BASED ON OUR=INSPECTION ANLL DOES 1VOT',COVER"ADQIT.IONi4L PARTS'OR,-LABOR WHI `BE,REQtilIREQ",AFTER THE WOR K,HAS BEEN OPENED Up.OGCR �SIONALLVAFTER WORK HA STARTEQ WORN PARTS ARE DiSCOVEREQ WHICH ARE`NOT Evl TOTAL MATERIAL QENT ON FIRST INSPECTIO :BECAU E OF THIS THE ABOVE PRICES ARE,NOT GUAitANTEEp x � a ,r ra.rte r ¢ ESTIMATE ,x TAX ES`,i'IM?TEO BY;• RPP,FOVED;Bf( ��•.; AUTHaR'IZEp AIVD AGGEPTEQ k PAIDOUT-TOW&STORAGE ^ : 6 e �" 4 SUBLET REPAIRS BY,OWNERk r �$ A� OR_AGENT - a >, x DATE 4H 429 P99F!M. �j -- CLAIM BOARD OF SUPERVISORS OF CONT%A COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: S94.25 Section 913 and 915.4. Please note all "Warni p s" _. 06, i CLAIMANT: Timothy Hannibal ' � 6a ATTORNEY: Date received GOUNTY COUNSEL MARTtNEZt;AIIF. ADDRESS: 908 Sylvaner Ct. BY DELIVERY TO CLERK ON February 28, 1995 Clayton CA 94517 BY MAIL POSTMARKED: February 23, 1995 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. IL gATCHELOR, Clerk DATED: February 28, 1995 ��: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors ( by0ooThis 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: P—7—T e [ s BY:'�� Deputy County Counsel 311. 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. A� Dated: MAR 2 8 1995 PHIL BATCHELOR, Clerk, By , , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited i6 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 yshgown above. Dated: A b M BY: PHIL BATCHELOR b Al. Deputy Clerk CC: County Counsel County Administrator 1 Js o �� tp �*ci w Cr7 ~ C" r � Ilk LIM r co c" zo �v CD co a O } Cia='' 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 RECEIVED Against the County of Contra Costa ) or ) 2 81995 -t .- -.m.... District) CLE K1. "- RS Fill in name ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ and in support of this claim represents as follows: 1. When 'did the damage or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) IrA .� .. � - Y � � - c& a _u8C / L 3. How did the damage or injury occur? (Give full details; use extra paper if required) u. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage?. �cvcr D. 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. 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) $. Names and addresses of witnesses, doctors and hospitals. ------------------------------ 9• List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Aim Gov. Code Sec. 910:2 provides: "The claim must be signed by the claimant SEND NOTICES TO: I(AttorneyJ. or byvome, person on hisbehalf." Name and Address"6f o'f Attorney (Claimant's i tore foe SyfeIAJa-- Ad ess Telephone No. Telephone No. Sy 73 1CS p * V W N 0 T I C E Section 72 of the Penal Code provides: - - "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonr.�ent and fine. Al El LJ hl H>. Z —c:3 T E lm!-r R F=-F +�� �• n �t fr 2 ��NCt)F.DCLCAj (510)687-8000, BAR REGI AE146651, EPR I.D. 70755 -' (.�;;T,`lell AVTC)_EFVaC I tit'•!C3 I C--EE01 /12/ TERR. 5175 PAGE: 01 COPY: 01 NONSiG: 905175 f=-3-r ? MATE fL4C3F,:t-=. C3F-%DIt.Ft--ni3 NO-r F-AV-X- BILL TO: T.IM HANNIBAL ! 908,SYLVANER CT. ~ r CLAYTpN,'*"CA 94517 i PHONE 1 . . . . . . . (510 )673-9558 VEH YEAR/MAKE. PHONE 2. . . . . . . ( ) - VEHICLE MODEL. DATE REQUESTED OT-71271 - VEHICLE COLOR. TIME REQUESTED AM/PM LICENSE/STATE. RETURN PARTS. . IM _ ODOMETR IN/OUT SALESMAN. . . .. . 003 / 003 VEHICLE INFO. . ACCOUNT i COB TC CUSTI 517500001 2 01 13598 I INSTRUCTIONS. . . . _ ------ --------- ----•.••_.1 SLSN TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR/EXCISE LINE TOTAL CO3 393-000-031-0 R 1 Pc'IS/75R15 HANKOOK 635 TUWS 55.95 .00 55.95 l� 003 ~_ _-_ _~ 040-223 R 1 TIRE DISPOSAL-CHAR6E-_ 1.00 .00 1.00 ` 003 w 041-263 R 1 NEN VALVE $TEN 2.75 .00 2.75 003 044-263 R I WHEEL BALANCE - COMPUTER SPIN 2.50 7.25 9.75 j _ I ..� THANK YOU FOR YOUR BUSINESS, PLEASE CONE AGAIN. EPA ID NUMBER — CA000024131 G I i s Tax 5.30 SALE , _ 17!sC U RI EED TH REPAIRS " a: .,Y"� aF:. R STRATI .. QTY _-- / ID _ QTY _ V I,D QTY / ID QTY W_ 1 ID FALL SPEC RJU. BALL SPEC R/L. BALL SPEC L/U. BALL SPEC L/L. _ BALL ACTL R/U. BALL ACTL R/L, BALL ACTL L/U. BALL ACTL LIL. AUTHORIZED BY. RUTH REC'D BY. MANNER REC'D.. AUTH PHONE.... T=—r— RUTH DATE..... ��7 "' AUTH TIME .. REVISED TOTAL. _ . _ ADD'L AMIOToAIR$ DESC �• j!f TREAD lif....► !32 Mn. y d d 1�'' •lt .S7��� ' RI��t Wd LIN ,-8 77 ........... c__0 1: F:Z X -c:3 E: E3 LJ F:.-' I E3_T_ F�, O RD 2 2gee ATCLt T -:94 1 I.D. 70755 (510)687-8000, EAI EPA Cf AijTo SER 001 1 06 02 PM 06: 17 F 23 6a E3 I':?Es TERR: 5175 PAGE: 01 NONSIG: 905175 BILL TO: TIM HANNIBAL 908 SYLVANER CT. CLAYTON, CA 94517 RHONE I . . . . . . . (510)673-9558 VEH YEAR/MAKE. , VEHICLE MODEL. PHONE 2. . . . . . . DATE REQUESTED 01 /12/95 VEHICLE COLOR. TIME REQUESTED LICENSE/STATE. RETURN PARTS. . NO ODOMETR IN/OUT SALESMAN. . . . . . (103 / 003 ACCOUNT # COD IC CUS71 TYPE/STATE AUTHORIZATION CREDIT CARD NOB 517500005 Y 01 13598 0 CA 054408 4625485570002591 SLSM TECH PRODUCT CODE BC QTY DESCRIPTION PARTS LBR/EXCISE LINE TOTAL 003 393-000-031-0 R i Pmnso HANKOOK 835 TUWS 55.95 .00 55.95 003 057 040-223 R I TIRE DISPOSAL CHARGE 1.00 .00 1.00 003 057 041-263 R I NEW VALVE STEM 2.75 .00 2.75 003 057 044-263 R I WHEEL BALANCE - CONFUTER SPIN 2.50 7.25 9.75 THANK YOU FOR YOUR BUSINESS, PLEASE COKE AGAIN. EPA ID NUMBER - CA0000E4131 STORE HOURS MONDAY-FRIDAY 7:30AN TO 6t30PMjSATURDAY BAN TO SPM NOW OPEN SUNDAYS 9AM TO 4M IF APPLICABLE. I ACKNOWLEDGE NOTICE AND ORAL APPROVAL OF AN INCREASE IN THE ORIGINAL ESTIMATE PRICE. ~PARTS'TOTAL........ 62.20 CHARGED AMOUNT 74.75 LABOR TOTAL........ 7.25 25 SUB TOTAL.......... 69-45 ITATE11RE FEE 601 F AMOUNT 6 1.20 SALES TAX.......... 5.05 10 R 4ii Wiii� CUSTOMS UT RIZATION FOR TOTAL AUTHORIZED BY. TIM AUTH REC-0 BY ,BRUCE D $AWNER REE'D.. IN STORE AUTH PHONE.... 1000)000-0000 AUTH DATE..' AUTH TIME..... 0600 AN REVISED TOTAL. 69.70 ADD'L AMOUNT.. 51.95 REPAIRS DESC.. TIRE 9 F%-r AN-r S;Ot��IE_r V 'aF E F:Z F-7-V, F_:� K- A E Ll 4' -s w ki hs, #:;:i+i._I 1+x.11=` x + -r I:rq i �=ti x S.- C31:C i J G YC{ CONCORD,:;'£A :,94 21 (510)667-8000, RAR RM;AE 1'46651. EFA I.D. 70755 4•"� ' i �� '"ERTiFlED , i..�4•'C") 101 /21 /95 01 /21 i s+ ;a;urvl�e>;vrce i 11 :23 AN 04: 10 F.M�:_�::; TERR: 5175 PAGE: ri 1 NONS I G: 905175 . j BILL TO: TIM HANNIBAL 90$ SYLVANER CT. j CLAYTON, CA 94517 1 PHONE 1 . . . . . . . (510 )673--9558 VE H YEAH/MAt-E. PHONE c.. . . . . . . VC=HILL-E mODE'L.. DOTE REQUESTED 01 /21 /95 VE H I CL..E COL-OR. "F I ME REQUESTED L_I CENSE /STATE. RETURN PARTS. . NO ODONIETR IN/OLJT SAL-E:SHAN. . . . . . 004 / 0031 PRIOR INV©ICE:. 08699 - , ACCOUNT I COB TC COST# TYPE/STATE PAYMENT METHOD 517500001 2 01 13598 0 CA CHECK � SLSM TECH PRODUCT CODE BC ATY DESCRIPTION PARTS LBR/EXCISE LINE TOTAL 004 055 049-100 R i CHECK BENT WHEEL/REPAIR IF POSSIBLE .00 19.50 '.9.50 THANK YOU FOR YOUR BUSINESS, PLEASE COME AGAIN. EPA 1D NUMBER - CA000024131 STORE HOURS MONDAY-FRIDAY 7;30AM TO 6:30PM,SATURDAY BAM TO 5PM NOW OPEN SUNDAYS 9AM TO 4PM I i i i. I i i i PARTS TOTAL........ ,00 LABOR TOTAL........ 19.50 HECK AMOUNT....... 19.50 SUB TOTAL.......... 19.50 TA�(ABLE AMOUNT .00 SALES TAX.. 00 OSE, U RIZATION FOR TOTAL �1I*�:1.� :' .. �.a 1 E:a C E- t.:�I-=v E�I 3 E3 1 II F'.' 1-y"0'F`�•` dl ftil t !Ce f-�!''+!I. M I i'wl I� C3 F;:t-1 r-4* 1 1f 7 tit .?,,AV 14�7� L M� r Plea.e te,!our sio�e`n1aTager.Wi vafua Your opinign'4 nhrchAQ Yout ro � . fdtlR r� I(ouf SY a s i 3 •r: sSTOA;EiT A4SI57AN�PAM, � a � t X21 t t 80013 .. . ° � vg � CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $10,000,000.00 + Section 913 and 915.4. Please note af19 "WaFnings" CLAIMANT: Karen Greathouse, Rachel Sitea, Joseph Robledo and Deborah Roble o. . ATTORNEY: Michael J. Staskus, Esq: Date received ADDRESS: 160 W. Santa Clara Street, 12th Fl.BY DELIVERY TO CLERK ON March 6. 1995 San Jose CA 95113 BY MAIL POSTMARKED: Airborne Express I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. PpH�{ 9g DATED: March 6, 1995 BTIL BATCHELOR. Clerkeputy • ]I FROM: County Counsel TO: Clerk of the Board of Supervisors (W'*r 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). ( wOther.r (—A1AA IS ACCt►PML A'S "r0 E Vt#07 5 0tCQ0*irJ (r 61.1 AN 0 A;;'Tk P 54L PTreA t_2 3. 1901 W . F00- A L�L— 't^24 t4- DAM, t.-er A TO P R&SIN i A L.811 L' t.A i ref M U5 T :R� SOUty-HT:41' 41 42 Dated: 9 S 8Y:�ti ' 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). �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. n o 2 0 0 Dated: MAR 1995 PHIL BATCHELOR, Clerk, By. �+ Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to- 'consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in' the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: 9"tlAR 2 8 19j 8Y: PHIL BATCHELOR by�J Deputy Clerk , CC: County Counsel County Administrator TO: Michael J. Staskus 160 W. Santa Clara Street, 12th Floor San Jose, CA 95113 NOTICE TO CLAIMANT (Of Late-Filed Claim) (Government Code Section 911 . 3) The claim you presented to the Board of Supervisors of Contra Costa County, California, as governing body of the County of Contra Costa on March 6 . 1995 has been reviewed by County Counsel and is being partially returned to you herewith because: Your claim for an injury to person or personal property which arose on or after January 1, 1988 was not presented within six months of the event or occurrence as required by law. (See Government Code sections 901 and 911 .2) According to your claim, some of the acts or omissions complained of occurred more than six months before the filing of the claim. As to those acts or omissions, and any resulting damages and injuries therefrom, application for leave to present a late claim must be applied for. Because the claim was not presented within the time allowed by law, no action was taken on the claim, or those portions which are untimely. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Code sections 911 . 4 to 912 .2 and 946 . 6) Under some circumstances leave to present a late claim will be granted. (See Government Code section 911 . 6) You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. PHIL BATCHELOR, Clerk of the Board of Supervisors and County Administrator By: De F16ty Clerk Dated: 16 Z 99S Enclosure 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 copy of the above Notice to Claimant (of Late Submitted Claim) , addressed to the claimant as shown above. Date: �3-,/D - 9,5 By Phil Batchelor by i Deputy C� rk a KAREN GREATHOUSE, RACHEL SITEA, ] CLAIM FOR DAMAGES JOSEPH ROBLEDO and DEBORAH ] ROBLEDO, ] Claimants, ] VS. ] [Govt. Code §835, 910, ] 911.2] ] COUNTY OF CONTRA COSTA, CITY OF ] MARTINEZ, BAY AREA QUALITY MANAGEMENT DISTRICT, and DOES 1 ] - ; RECEIVE® through 100, inclusive. ] ] I4R - Respondents. ] 61995 CLER'1810ARD F SUPERVISORS TO: COUNTY OF CONTRA COSTA CONTRA COSTA CO. BOARD OF SUPERVISORS CLERK OF THE BOARD 651 PINE STREET, ROOM 106 MARTINEZ, CA 94553 CITY OF MARTINEZ CITY CLERK 525 HENRIETTA STREET MARTINEZ, CA 94553 BAY AREA QUALITY MANAGEMENT DISTRICT TOXICS SECTION 939 ELLIS STREET SAN FRANCISCO, CA 94109 YOU ARE HEREBY NOTIFIED that Claimants, KAREN GREATHOUSE, RACHEL SITEA, JOSEPH ROBLEDO AND DEBORAH ROBLEDO, and their attorney, Michael J. Staskus, Esq. , of THE STASKUS LAW FIRM, hereby present their claim for damages and personal injuries pursuant to Government Code Sections 905 and 910 against the County of Contra Costa, City of Martinez, and Bay Area Quality Management District and Does 1 through 100, and allege as follows: A. NAME AND ADDRESS OF CLAIMANT: Karen Greathouse 557 Winslow Street Crockett, CA 94525 (510) 78.7-1045 1 Rachel Sitea 557 Winslow Street Crockett, CA 94525 (510) 787-1045 Joseph Robledo 5840 East Avenue, #131 Livermore, CA 94104 (510) 606-6348 Deborah Robledo 5840 East Avenue, #131 Livermore, CA 94104 (510) 606-6348 B. ADDRESS OF PERSON TO WHOM NOTICES ARE TO BE SENT: Michael J. Staskus, Esq. THE STASKUS LAW FIRM 160 W. Santa Clara Street, 12th Floor San Jose, CA 95113 (408) 295-7227 C. DATE, PLACE AND CIRCUMSTANCES OF THE OCCURRENCE: This claim is based on personal injuries sustained by claimants on or about August 22, 1994 up to and including September 15, 1994. The Shell Oil Company Petroleum Refinery Facility located at Marina Vista, in the City of Martinez, County of Contra Costa, controlled by Bay Area Quality Management District released harmful toxic chemical contaminants which were exposed to claimants for which they seek damages for personal injuries sustained by each and every one of them. As such, claimants are informed, believe and thereon allege that the County of Contra Costa, the City of Martinez, and the Bay Area Quality Management District, its agents, servants, and employees, and each of them, were negligent in and about, but not limited to, the facts alleged below: a. The negligent, careless, and/or wrongful acts of 2 respondents, their agents, servants and employees were done within the course and scope of said agencies, services or employment. b. That as a direct result of the negligence and carelessness of respondents, their agents, servants, and employees, and each of them, as aforesaid, claimant was caused to sustain severe and permanent personal injuries. Respondents failed (1) to warn the citizenry of the existence of these harmful chemical toxins and had ample opportunity and notice to do so prior to claimants' injuries; (2) to evacuate claimants and others from their homes and communities until the chemical substances were cleaned up; (3) to exercise ordinary care in order to avoid exposing claimants and others to a foreseeable and unreasonable risk of harm; (4) to restrict or limit access to the area or to take further action which constituted a breach of their contractual and ministerial duties by agents, servants and/or employees of the County of Contra Costa, City of Martinez, and the Bay Area Quality Management District. Respondents, its agents, servants and employees, and each of them, should have reasonably foreseen that a dangerous condition existed and the likelihood that potential injuries, such as the ones sustained by these claimants as alleged herein, would occur, if the aforementioned conditions were not corrected. Respondents failed and neglected to correct this situation even though foreseen and/or foreseeable. D. GENERAL DESCRIPTION OF DAMAGE, INJURY OR LOSS INCURRED: As of the date of- this claim, injuries known include 3 severe mental anguish and emotional distress, as well as nausea, vomiting, internal symptoms, loss of vision, fever, general deterioration of health, damages to personal property, real property, severe short-term and long-term detriment to animals, loss of consortium, medical and related expenses, loss of earnings associated with diminished earning capacity and vocational rehabilitation, earning potential due to work missed, opportunities and other benefits of employment, all in an amount to be established at trial. E. NAMES OF THE PUBLIC EMPLOYEES RESPONSIBLE: The names, identities and capacities of the agents, servants, employees of Respondents County of Contra Costa, City of Martinez, and Bay Area Quality Management District causing claimants' injuries under the described circumstances are currently unknown, wherefore, Claimants pray leave to . amend this claim to insert the same when said names, identities and capacities are ascertained. F. AMOUNT OF CLAIM AND BASIS FOR COMPUTATION: As a result, claimants have incurred and will continue to incur in the future special damages pertaining to but not limited to property loss, past, present and future medical expenses associated with medical treatment, hospital care, rehabilitation and other related healthcare services, loss of companionship, support, comfort, and consortium. Claimants have also suffered and will continue to suffer in the future a substantial loss of income, as well as diminished 4 earning capacity and will require vocational rehabilitation training. As a result, claimants' special damages are in excess of ten million dollars ($10,000,000.00) according to proof. Claimants have also suffered and will continue to suffer in the future general damages in an amount which would rest in the jurisdiction of the Superior Court of the State of California pertaining to the severe psychological disorders they have experienced and will continue to experience as well as the severe mental and emotional distress and anxiety they experience on a daily basis and will continue to experience in the future. Dated: March 2, 1995 THE ST7S LAW FIRM B �GB Y� Michael J kus Attorne or Plaintiff(s) 5 PROOF OF SERVICE BY MAIL I, TRACEY CAPPELLAZZO, declare: I am a resident of the County of Santa Clara; over the age of eighteen years and not a party to the above-entitled action; my business address is 160 West Santa Clara Street, 12th Floor, San Jose, California :95113. I served the CLAIM FOR DAMAGES (Govt. Code §835, 910, 911.2] on the interested parties in the within action by following ordinary business practices and placing for collection and mailing at San Jose, California, on March 1 , 1995, by placing a true copy of the above-referenced document(s) enclosed in a sealed AIRBORNE EXPRESS envelope addressed as shown below; in the ordinary course of business, correspondence so deposited will be placed in an AIRBORNE EXPRESS depository the same day. That there is delivery service by AIRBORNE EXPRESS at the place so addressed and/or there is a regular communication by mail between the place of mailing and the place so addressed. I declare under penalty of perjury that the foregoing is true and correct, and that this document was executed on March O� , 1995 at San Jose, California. Trace Cappe Jazz ///// NAMES AND ADDRESSES: COUNTY OF CONTRA COSTA BOARD OF SUPERVISORS CLERK OF THE BOARD 651 '-PINE STREET, ROOM 106 MARTINEZ, CA 94553 CITY OF MARTINEZ CITY CLERK 525 HENRIETTA STREET MARTINEZ, CA 94553 BAY AREA QUALITY MANAGEMENT DISTRICT TOXICS SECTION 939 ELLIS STREET SAN FRANCISCO, CA 94109 LAW OFFICES OF MICHAEL J. STASKUS 160 WEST SANTA CI-ARA STREET 12TH FLOOR SAN JOSE,CALIFORNIA 95113 TELEPHONE(408)295-7227 FACSIMILE(408)295.2728 March 2, 1995 VIA AIRBORNE EXPRESS AIRBILL NUMBER: 6601289376 COUNTY OF CONTRA COSTA BOARD OF SUPERVISORS CLERK OF THE BOARD 651 PINE STREET, ROOM 106 MARTINEZ, CA 94553 RE: GREATHOUSE, ET AL. v. COUNTY OF CONTRA COSTA, ET AL. Enclosures: CLAIM FOR DAMAGES Dear Clerk of the Board: Enclosed herewith please find four claims. Please retain those copies necessary for your files and records and return at least one (1) copy STAMPED RECEIVED. Please stamp said documents reflective of the date, MARCH 61 1995. A self-addressed, pre-paid envelope has been provided for your convenience. Should you have any questions regarding the above, please do not hesitate to contact the undersigned. Thank you in advance for your professional courtesies extended in this matter. Very truly yours, THE STASKUS LAW FIRM gy, Tracey bn Capp azzo Paralegc&I to Michael J. Staskus, Esq. :tc Encl. S ul LU uj LU Lu- LU Lu L#j Lzu g LU 0W 2 Seo a 1 (. -0 -0 b. ( r- m m m to cc ru ru O C3 I y uj { Z ❑ sy O O E > N ' it E6a Z\ 14 g` N C"3 b3 co 0 10L ui Uz sW W V . I � i j � ❑ >x2 d J aI) mz . LU e O 0t U III ¢� . 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B aaoca uo oaa- ca °J J � � E n � � . ;Zeoca 4/fw �° a � oauE `o �• - -x - CLAIM ( I BOARD OF SUPERVISORS OF- CEibTRA COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $750 000.00 + Section 913 and 915.4. Please note all "Warnings" CLAIMANT:Linda Joyce Fite 3 . ATTORNEY:Richard J. Alexander MAR Date received COUNTYCOUNSEL ADDRESS: 137 Park Place BY DELIVERY TO CLERK ON March 14 1995 MARTINEZCALIF. Pt. Richmond, CA 94801 BY MAIL POSTMARKED: February 28, 1995 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. + ppHHll ATCHELOR, Clerk DATED: March 2, 1995 BY: Deputy 11. FROM: County Counsel TO: Clerk of the Board of Supervisors ( - This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 3- 3 - `7 s- 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). IV. 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: MAR 2 g 1% PHIL BATCHELOR, Clerk, By - , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAR 2 R 195 BY: PHIL BATCHELOR by eputy Clerk CC: County Counsel County Administrator r. :.., RECEVED i CLAIM AGAINST PUBLIC ENTITY MAR ^ 1 X995 To: Clerk of the Board of Supervisors CLERIC BOARD OF 5tit'ERiltSORS 651 Pine Street, Room 106 CONTRA COS- 1 D Martinez, CA 94553 Linda Joyce Fite hereby makes claim against Merrithew Memorial Hospital, Denis Mahar, M.D. , Ogo S. Mbanugo, M.D. , Edwin 0. Carlson, M.D. , and Does 1 through 20, and makes the following statements in support of the claim: 1. Claimant' s post office address is care of Law Offices of Richard J. Alexander, 137 Park Place, Pt. Richmond, CA 94801. 2. Notices "concerning the claim should be sent to Richard J. Alexander, Esq. , Law Offices of Richard J. Alexander, 137 Park Place, Pt. Richmond, CA 94801. 3. The date and place of the occurrence giving rise to this claim are on or about November 7, 1994 at Merrithew Memorial Hospital, 2500 Alhambra Avenue, Martinez, CA 94553. 4. The circumstances which gives rise to this claim are the medical negligence of Merrithew Memorial Hospital, Denis Mahar, M.D. , Ogo S. Mbanugo, M.D. and/or Edwin 0. Carlson, M.D. , and Does 1 through 20, in ( 1 ) performing elective surgery on claimant which exceeded the scope of consent obtained; i.e. , the impermissible removal of her ovaries while performing surgical removal of fibroid tissue located in claimant' s uterus, (2) the failure to use due care in reviewing her medical records and consent form prior to performance of the surgical procedure, (3 ) the performance of a treatment which was substantially different from that for which the consent was obtained, (4) the lack of appropriate follow-up treatment for the patient, ( 5) failure to supervise appropriately the treatment of claimant, and ( 6) such other and further claims as may become discovered as time passes, and the extent and type of long-term harm to claimant are more fully ascertained. 5. Claimant' s injuries are the loss of both ovaries and loss of attendant hormones, enezymes and other chemical substances produced, in whole or in part, by her ovaries which are necessary for the continued health and wellbeing of claimant. 6. The names of the public employees causing the claimant' s injuries are Denis Mahar, M.D. , Ogo S. Mbanugo, M.D. , Edwin 0. Carlson, M.D. , Does 1 through 20, and such others as further discovery may identify. Claimant' s claim as of the date of this claim is in an amount that would .place it within the jurisdiction of the Superior Court. The claim is based on injury, damages, and/or loss in an amount to be proved later, but which includes,' non-economic damages in an amount not to exceed $250,000.00 and such expenses and damages for future medical treatment for claimant Clerk of the Board of Supervisors February 28, 1995 Page Two as a result of the wrongful removal of her ovaries in an amount to be determined as her life progresses and her physical condition deteriorates, to be proven at trial, currently estimated to exceed $750, 000.00. Dated: February 28, 1995 RICHARD J EXANDER Attorney for Claimant Amended CLAIM I . BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA ' — March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $8,500.00 Section 913 and 915.4. Please note al "Wa in§i-,�'.�Q,, CLAIMANT: Booker 'TC Carloss, II FEE E3 COUNTY C4sUNSE1, ATTORNEY: MARTINEZ INEZ CALIF. Date received ADDRESS: ANZ 800 33 West 4A BY DELIVERY TO CLERK ON February 24, 1995 5.325 Broder Blvd. Dublin CA 94568 BY MAIL POSTMARKED: Hand 1)P1 l VPYP[1 xzi a_• slant-* Counsel 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. ppHH gg DATED: February 27, 1995 BTiI DepuiyLOR, Clerk I1. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY:- il�. —� Deputy County Counsel II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present ( This Claim is rejected in full. ( ) Other: I certify that this is a -true and correct copy of the Board's Order entered in its minutes for this date. . MAR 2 8 1 ' Dated: PHIL BATCHELOR, Clerk, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. �� Dated: MAR 8 19`�`� BY: PHIL BATCHELOR by _ eputy Clerk CC: County Counsel County Administrator O N C1 iD =3 C) V) — 4– E 00 O M 'l7 CL' Ltd - 5_ LC) O +;C71 CO N Cll CU L < C 4-J U }� Lo C? C= q1 C yC CL w L 4-) O 00 O C i O U -o c 0 E Qf u Z3 c c p tL • m v N Q • -0 r3 �C • C7 J L. V M • Ca iZ ,._ . CL O • -� ck- `n ,s --1 �,46 L JTS N >N e o '� o AAI� a 7 r z Dep-L*) CGUNSEL - - 149ARTINEZ CALIF. _TCL - - . . - -RECEI\/ED *- Clot�, • C�4�w. t Zebk-e-� -( - Czoe li- -- - FEB 2 4 1995 I CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. C0LM3e& 6pk%lbv% (IN raV id�ed__ -t om re c�est�d je��ck� ohm— -0t- 14,iQ ret& tAperibt- 17 41-ct etn'f" frcQ� Uiato+ed n,L 6* Aw,*vJ&wQo-+ kt-Rk+ `O"fb Asise(� r liSt�5 Se toe- Rose cif r ne t dn�ss' .Acer w + wee _ (616) 7(a3- gs3s_ la'5peC4�lu c5325 t�rad.Qr Dubf� C asp z v. Su�Ovh �-N1 +��fv =fie ore a 'u 1 `g Soo °° C e G► `f f sc�v&' ;be•. 'kta t4-rt;t -dwlar2). _'Al - 'tial is .OQ CCepfc�Ole n�egs� rrc-asroi it Oke- GZ-�d'�wt��o�.ed adrlleQS, T�,R^ xv a OFFICE OF COUNTY COUNSEL DEPUTIES: CONTRA COSTA COUNTY PHILLIP S. ALTHOFF SHARON L. ANDERSON ~� BRANDON D. BAUM COUNTY ADMINISTRATION BUILDING ANDREA W. CASSIDY VICKIE L. DAWES P.O. BOX 69 MARKE S. ESTIS VICTOR J.WESTMAN MARTINEZ, CALIFORNIA MICHAEL D. FARR WUNTY COUNSEL 94553-0116 LILLIAN T. FUJII DENNIS C. GRAVES SILVANO B.MARCHESI TELEPHONE (510) 646-2041 GREGORY C. HARVEY ARTHUR W.WALENTA,JR. FAX (510) 646-1078 KEVIN T. KERR ASSN AKM EDWARD V.:, LANE, JR. MARY ANN M. MASON PAUL R: *MIZ January 30, 1995 VALERIE J. RANCHE DAVID F. SCHMIDT DIANA J. SILVER VICTORIA T. WILLIAMS NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Booker T. Carloss ANZ800 4A7 NCJ 550 6th Street Oakland, CA 94607 RE: CLAIM OF: Booker T. Carloss Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: [] 1 . The claim fails to state the name and post office address of the claimant. [] 2 . The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [x] 3 . The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [] 4 . The claim fails to state the name (s) of the public employee (s) causing the injury, damage, or loss, if known. [] 5 . The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10, 000) . If the claim totals less than ten thousand dollars ($10, 000) , the claim fails to state the UNION gum �Y r"N71,77, t t t1 amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10, 000) , the claim fails -to state whether jurisdiction over the claim would rest in municipal or superior court. [] 6 . The claim is not signed by the claimant or by some person on is behalf . [x] 7 . Other: We must treat your letter of January 26, 1995 as an amended claim against the County. In that regard it .-is insufficient for the above-noted reason(s) . Please also be advised that the statement "This claim substantially complies with Sections 910 and 910,2" is not a comment on the merits of the claim. It is merely a statement that the claim contains all of the necessary information so that it may be. processed _ I', by the Board of Supervisors. I believe the Board rejected the PrU6 reclaim on the merits. The Office of County Counsel has no ohv } authority to advise the Probation Department to release a � Q cow hgW on a"l-trunk probationer. Oobationer. VICTOR J. WESTMAN, County Counsel Deputy County tounsel CERTIFICATE OF SERVICE BY MAIL (c.C.P. §§ 1012, 1013a, 2015.5; Evidence Code §§ 641, 664) I declare that my business address is the County Counsel's Office of Contra Costa County, 651 Pine Street, Martinez, California 94553; I am a citizen of the United States, over 18 years of age, employed in Contra Costa County, and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above, sealed and postage fully prepaid thereon, and thereafter was, deposited this day in the U.S. Mail at. Martinez, California. I certify under penalty of perjury that the foregoing is true and correct. Dated: January 30, 1995 at Martinez, California. i 1 { CC: Clerk of the Board of Supervisors (original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM: GOVT. CODE §§ 910, 910.2, 920.4, 910.8) / r S` I • !C/ cla1M BOARD OF SUPERVI SORE' OF' CONTRA COSTA COUNTY, CALIFORNIA March 28, 1995" Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: $368.39 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: 4 i Alejandro R. Canaday � _ - ATTORNEY: FE"' rt�' Date received COUNTYCr_�i ADDRESS: 325 Maine Ave. BY DELIVERY TO CLERK ON F bnja''�' 2.7 -- ,- Richmond CA 94804 BY MAIL POSTMARKED: February 24, 1995 . 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. p gg DATED: February 27, 1995 B�jIL DeputyLOR, Clerk 11. FROM: County Counsel TO: Clerk of the Board of Supervisors .This claim complies substantially with Sections 910 and 910.2. { ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 2 - a 7 — S 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). IV. BOARD ORDER: By unanimous vote of the Supervisors present V This Claim is rejected in full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: MAR 2 8 1995 PHIL BATCHELOR, Clerk, By I , Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: MAR 2 R 19% BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator (n `f Cla-;- 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 5911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should-bee-f-iw 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 �e undue �ar,c u� j RECEIVED OA, 7 I'0 JL ) Against the County of Contra Costa ) FEB 2 7 1995 orSu BOARD_ PF ) (Nn_�a &54t, l.DGcti District) CLER CONTRAOCOSTA CO ISORS Fill in name ) The undersigned claimant hereby makes claim n t the County of Contra Costa or the above-named District in the sum of $ 6$'.39 and in support of this claim represents as follows: P cwre S�Q,, a 9 u � c� • 1. When did the damage or i fury occur? (Give exact date and hour) T� c�o�0, r,M t S 0.,.d.fires wee_ o r\ - Rbn"-\l '7, N9S, o,- G;CYofd. 2. Where did the damage or injury occur? (Include city and county) _rkt- dct^ fie. was 0.z 4*.e-- kQC6Zt40:\ 0-F T4-ard. S- i A �OY441. _RiCA+W4, � -Tk#- d&V23C was IS-M -R4S 5+",e'- Aar—S 6CRIM _BM0k F4R-S-f M�-- 3• How did the damage or injury occur? (Give full details; use extra paper if required) -rkc dlstw:ck9e o r red dA,,°,kg - •-�,,-(' 1�:s rude(. .2 was d r1, ,�3 ups ro -{$ 9�-Fo �,_kz,rL. T4s � rpa,�,.T�'ue an d0,�age� s of sir w►�,cJ,� eeu%,ed, �� -fv wu� �t 1s a -E,ires on very; -------------- ------- ------------------- - 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? T c act" of W k" wO-S ops o te- dl`d r,P-F cew.�le e o` "e-- LJk,'Ck WC,,% f1uytIAPA oY\ u�.un®� 4ko- mad dF �a a� JggS.. SCwi2-�•t+Ha- th �t•�T /�av�'�-� , w��o�Y.S E.l.�.ve_ �r� � an �f�, , -D'VIT cd S�- ,-,30.dr40- rba. _ jus - beAr-e reacl�i,,� [ � �Si� :sF.;Over) 4 D. wnat are the na-jes of county or district officers, servants or employees,causing the Cama-ge or injury? T�t2 0►�(� - i� cnuJ are— o� r-e, �r-3 C_o C, - . 5. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage. d a.,ages `✓►• c laav►��v�g a.� yw�i uil �-�s o�,�{�res 6A ca-; - a3� Y'eS��" ��' �.-�d,Arno,ai� d.�. tln �rrt�. S-� • ..�_._......__ __, 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) a.,ou,1�- _w! alked lw� 740 �a d,���- a.•ea a� �ocQ�Yb,� 'Ike- ,�� �( eo�o� �3 �'-�-�s�( -- w------a AFd�------ -doWA B. :names and addresses- of witnesses, doctors- and hospitals. 4 ��r8lud= t'3�cl ted, CA- 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code Sec. 910:2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his behalf." Name and Address of Attorney ClaimantIs Signa Address _COl 70a - r a37-lo-36%W4"k) Telephone No. Telephone No. * �r 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. t Z� � ILI �� �.? ✓ W � � Com./ �. W _ n f o � b , r vs � f p - • n h r � � / 0 O f -00111 .L C � c t f , ! v 0 0 J Y __ c l�n ��^rte` ~�t�i7., Y ' }• a: •a •T - , a v r �.r.rwr.■.r,. s t S , 1 r. Z r wq„ 6 1 , u- o 0 �L C Yr" o lop 01 d ol 400 C d . � a 'r'"'r ) Wheel Center (510) 895-8150 U QOTE Date: � Salesp s _ PRICE EM DESCRIPTION Q EACH TOTAL TIRES`Ot S _ 5 fS / qqlo P, � W �w c,5 �WHEELS 3� LbCKS LUGS STUDS $1.50 WASHERS CAPS STEMS CHROME-RUBBER $2.50 CHROME $3.30 WRENCH KNOCKOFFS SET OF FOUR CHIPS SMALL $12.00 LARGE $15.95 TAX TRADE IN MOUNT REGULAR T:5-0 WIRES& BRUSHES 0.00 BALANCE HIDDEN WEIGHTS $10.50 CHROME WEIGHTS REGULAR T7.50 TIRE DISPOSAL $2.00 ea TIRE ROAD HAZARD WARRANTY 10% OF TIRE PRICE AVAILABILITY AND PRICE SUBJECT TO CHAN r *a-7 `sem _ • CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA March 28, 1995' _. Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to you is your notice of California Government Codes. ) the action taken on your claim by the Board of Supervisors (Paragraph IV below), given pursuant to Government Code Amount: $10,045.50 Section 913 and 915.4. Please note all "Warnings". CLAIMANT: California State Auto Assoc./ Manuel & Mary Cambra c/o Mary Hubert Claim # HO-02-546619-8 ; ATTORNEY: ��s� Date received COUNTYCi�u�� e �, ADDRESS: 1700 Somersville Road BY DELIVERY TO CLERK ON 3-3-95 MART'INEZCALIF. Antioch CA 94509-0951 BY MAIL POSTMARKED: 371-95 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: March 6, 1995 JAIL BATCHELOR, Clerk ' I1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( his claim complies substantially with Sections 910 and 910.2. { ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 8Y: puty County Counsel I11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Superviscrs 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. Dated: MAR 2 $ 19� PHIL BATCHELOR, Clerk, B Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: PEAR 2 8 195 BY: PHIL BATCHELOR by Deputy Clerk CC: County Counsel County Administrator rLl t y ,•+.�+ D� s `n �N m a 2 ��uy4 s U O10 O O p� a 2Q a C=aim 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 tin 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 R£: Claim By ) Reserved for Clerk's filing stamp RECEIVE® Y Iy Against the County of Contra Costa ) R - 1995 or ) 3 ,. District) CLERK BOARD OF SUPERVISORS Fill in name ) CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of $ 10,045.50 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) During road construction, September & October 1994 2. Where did the damage or injury occur? (Include city and county) 1931 Laurel Road, Oakley, CA 94561 3. How did the damage or injury occur? (Give full details; use extra paper if required) Vibration. during construction of the road in front of house caused the underlayment to buckle, the computer hard drive to malfunction and the spa to catch fire. ------ ------ --------------------------- --- - 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? ;over) D. wnat are the names of county or district officers, servants or employees causing the da:-age 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. Spa repair $2,503.17 20 hours of labor to repair driveway at $50/hr. $1,000.00 Linoleum replacement $6,449.97 Computer-repair $92.36 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) See attached estimates 6. :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 imam's Signature (� Address t�►'l'�'1 c�ct� C� ..��'�O� Telephone No. Telephone No. f-510* * * * +t NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. --- - I SEARSCharge Account Number: 48 80554 33575F3) I - - P.O. BOX 5 Billing date: December 4, 1994 - -- " - BOISE ID 83707 - ACCOUNT SUMMARY Previous balance $0.00 `- Total payments - 0.00 Total charges + 92.36 _ _ II�I���l��I�IeI��IL���eILLl�IL��lLofl�r�i�fl����IIL��II � Tota!credits - 0.00 ' - - - - FINANCE CHARGE + 0.00 - ---- •� MANUEL CAMBRA New balance $92.36 .." _. _ 1931 LAUREL RD OAKLEY CA 94561-2660 Scheduled payment: $10.00 --- _ Minimum due: $10.00 Due date: January 3,1995 TRANSACTIONS HELPFUL INFORMATION Nov 14 MAINTENANCE AGREEMENTS.................... $92.36 Available Credit: $10,059 If the amount of Available Credit is not TIMELY OFFERS FROM SEARS! sufficient,or you have a question,call: �— Order your Masterpiece Fruitcakes now! A Sears holiday 1-800-877-8691 tradition for over 30 years,they're delivered anywhere in the U. M-F 9-9,SAT 9-6 MT _S.with your personal greeting. 2 Ib.cake with 73%fruit and Mail any billing error notices to: nuts,only$17.95 plus$4.50 shipping. Call 1-800-637-5390 for P.O. BOX 8 details. BOISE ID 83707-0008 — -- - Please include your account --- number with any correspondence. SEARSCHARGE BONUS CLUB -- Great News! Now the SearsCharge - —"-- Bonus Club pays you back in --- -- money-saving certificates every time - --- your SearsCharge purchases build up -- -- to$200 or more. You need only --------- $107.64 more in charges to earn your - ----- bonus. It pays to shop at Sears! �______"-• FINANCE CHARGE Average ANNUAL Monthly Average FINANCE SCHEDULE Daily PERCENTAGE Periodic Daily CHARGE �- --'- - Balance RATE Rate Balance - -- -All over$0.00 19.2% 1.6% -------• _ Total $0.00 NOTE:See other side for important information •CARPET•HARDWOOD•LINOLEUM•CARPIT,HARDWOOD•LINOLEUM•CARPET•HARDWOOD•LINO L. ,::`.. .;ET•HARDWOOD•LINOLEUM•CAR PET-HARDWOOD•LINO LEU M•CARPET•HARDW00= D O a oP 306 Oak Street o - McCurley Brentwood, CA 94513 a W (800) 865-9991 0 Floor Covering (510) 634-0888 "The Floorologist" Fax (510) 516-3330 D a o m z -1 p D O a January 4, 1995 0 w Z 6 C r Q C 0 3 0 O D 3 Re: Mary Cambia C 1931 Laurel Road o Oakley, CA 94561 g 510-625-9516 z a o Z 0 3 o a o To whom it may concern, C 2 2 P c In a discussion with Mary Cambra, she told me about construction to the road in o front of her house. She described how for months her house would shake as the o Ems ground was being packed as the roadbed was being raised several feet in front o z of her house. 3 � 3 She showed me the seams in the underlayment,in her house. They were D buckled badly through the house and very unattractive. Mary told me that she D didn't have this problem until the construction began on the road in front of her Y o f W Mary asked me if this damage could be a result of the construction shaking z of her house over a long period of time. Having seen and repaired many 3 3 floors damaged by earthquakes, I told her, in my opinion, it was possible that a the shaking could cause the damage to her floor. _ a W vo` C G Q [) Y O < O w D Z Si erely, - _ g a 3 0 Leonard McCu tz z c O Q Y 3 a 0 m z � p D o v 3 0 0 C Q -CARPET-H AR DWOOD•LINO LEUM•CAR PET-HARDWOOD-LI NOLEUM-CARPET-HARDWOOD-LINOLEUM-CARPET HAR D WOO D•Ll NOLE UM•CARPET•HARDWOOD•LINO LEU M-CA RPET•HAR D WOOD• M C1 c '^ -0-0 N-.d ,o $ �,E -c°,`d�� vwt� Pr P- C L. ZD C C r� .V A � N a'�i• W� �+ G CI� W p E - �� N$ p L,iO 7S a 2+ of a of� ° a•G.-e c F-rn c�E E 2 W �. �dV n' .+ L ° an aiN d 12 612 2 W O q�g H H H H H H `� Nq� o a o o Zcc u a C rc^� E� �" L.°' � 7 m J — U_ N b �«�+cmaai� >a° '^ ��n �-Ela Q ,J IC LU Q _o. ; N� B's cc Nomad �° a8E`E,EE k i Z • Q u CC rn p Cl CCy g� W p W �—L N A dUJL LU W 12 Ecc 41 y� �( O E ;, O U OM-0-avc a NNOf V c� N M p Q. '� 5� a F- "G W '� z ��Nt'«°'r�or« c� o Q Q W p8"g ui 9.2 R R L .q E 'MHV cZc J m .V E u H =. O 0 m g Q� a'o��8, " '> � °Nom°' AM fe CML C O W ce uj M. @l cc uj a Q � o v wi 10, co Z o_Go co vz_ M� M •• O • W A�; • Ii. %D ."Z• 4 '' Q W z ` cz cr- ui >+m • m i4.1 O. z 41 CA V ; Z' fj .. f N W �. W � cT . ¢ W oC GG D m m 0 Q Z ¢ u � � ` ` aa; Z Z' ¢ E- g • "<w vfy,.:m,', m "m 'ca 'M . z. _. CALIFORNIA SP SERVICE CA CONTRACTOR 1-1 . 4412391 L REPAIRS • UPGRADES 4, 01 EEKLY SERVICE 1347 EI Curtola Blvd. LAFAYETT , CALIFOR iA 54549 (S10) 935.3 8 ADDRESS �TY �Pi,4M E-------• I MAf"E— — rAJDEL 5E !A.L NO• r C.O.D- --- D CHARGE / PRoWSEU / 2 _- 4. f LK TilTAL MATERIALS KWlC TECHRViCE �.- �/7 f� -X , SERVICE moi-' TAX Z. DAYS COMPLEYEb �� j �TCCHrII.IAN - CASH TOTAL COMPLEMN WORK-----b- TOTAL K-----�'- 111K] Si vna�ico performed ccnsGt4tes aces nce Of above CCrJ� '�J((v^ 5ervicn Performed es beine eat ectory — anC � �L that equipment has been left In oud condition. I� 3 5 V Q See rover side for Gua f. ------------------- --- --------- --- -----= ------------------------- �-- 1�9 CLAIM . BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA March 28, 1995 Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT 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: Unknown Section 913 and 915.4. Please note all "Warnings". CLAIMANT: Barnett Raymond Alston ATTORNEY Date received COUNTYcOUNkSpl, ADDRESS: West County Detention Facility BY DELIVERY TO CLERK ON February 14, 1MITINEZCALIF. 5535 Giant Highway Richmond, CA 94806 BY MAIL POSTMARKED: February 11, 1995 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: February 27, 1995 gall BATCYELOR, Clerk epuI1. FROM: County Counsel TO: Clerk of the Board of Supervisors ( yrThis claim complies substantially with Sections 910 and 910.2. { ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: BY: Deputy County Counsel II1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARDD 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: PAR 2 9 19% PHIL BATCHELOR, Clerk, ByAA Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. AFFIDAVIT OF MAILING I declare under penalty of perjury that 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 United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimantasshown above. Dated: BY: PHIL BATCHELOR b Deputy Clerk CC: County Counsel County Administrator Mr. Barnett Raymond Alston Jr. WEST COUNTY DETENTION FACILITY 5535 Giant Highway Richmond, California. 94806. . »zy 13, 1995 3RECEIVE® Mr. Phil Batchelor FEB 1 41995 Clerk, of the Board Of Supervisors and County Administrator CLERK BOARD OF SUPERVISORS 911 Pine Street. Cores ACOSZF c0. Martinez, Calif 94553 RE: Barnett Raymond Alston 90 Day Letter. Mr. P. Batchelor, Clerk Of the Board of Supervisors: Please be advised that it is my intention to file a Civil Action for legal Malpractice against Mr. David Headley and the Contra Costa County Alternate Defenders Office, for Defamation of Character (SLander) , Negligence and Malfeasance in the handling of my legal matters in Delta Judicial District Municipal Court (November 3 ,1994) . Docket Number #89424-6. . The filing of this action of damages will occur within ninety (90) day's of the date of this letter. Please tender this matter to your professional errors and omission insurance carriers so that settlement negotiations can be initiated. RESPECTFULLY SUBMITTED MR. Barnett Raymond Alston Jr. Mr. Barnett Raymond Alston Jr. West County Detention Facility 5535 Giant Highway Richmond, Calif. 94806 APPENDIX.1 1 On or about the 3rd of November 1994 at approximately 9:30am, 2 while in Delta Judicial District Court holding cell awaiting 3 preliminary hearing to begin in Department 4. I was visited by 4 my Attorney David Headley, He at that time indicated that the 5 plea Bargain agreement offered by the District Attorneys office 6 was available to me, and that in his opinion the offer was a 7 reasonable offer. I informed Mr. Headley that I was not 8 interested in the District Attorneys offer, and that my position 9 of innocence should by now, be' crystal clear to him, for I have 10 indicated to him on numerous occasions that I was totally it prepared to go to trial in order to prove my innocence. Mr. . 12 Headleys response was that he would inform the Courts of my 13 decision prior to the bearing. 14 15 Approximately thirty (30) minutes later I was escorted into the 16 court room, at which time Judge Allen asked if all parties were 17 ready to proceed, the District Attorney indicated "Yes" as did 18 Mr. Headley, however Mr. Headley informed the court that he would 19 like to make a statement for the record. From the onset of Mr. 20 Headleys' statement, he began to make malicious reference to 21 psychotic behaviors he said I possess. In addition, I was .� 1 I accused of being suicidal and incompetent to stand trial. After 2 much considerations, I realize that Mr. Headley is not a member 3 of a medical staff and was out of line professionally in passing 4 such judgement. During this court proceeding I was totally 5 mortified by the statements made by Mr. Headley in reference to 6 my mental capabilities. 7 8 Mr. Headley went on to further state that he didn't feel that I 9 stood any chance what-so-ever at winning my case, this was pre 10 judgmental, considering the fact that the case is still in 11 litigation. These are the kinds of statement to which I feel 12 could have had a detrimental effect on my situation. This is why 13 I have been forced to seek retribution for defamation of my 14 character and mental stability. 15 I would like for the Courts to take into consideration the 16 proceedings from the transcripts dated November 3, 1994 in 17 Department #4 of the Municipal Courts of Pittsburg, CA. Judge 18 Allen presiding, at which time the aforementioned dialogue took 19 place. 20 21 I declare under the penalty of perjury that the foregoing is true 22 and correct and understand that a false statement herein may 23 result in the dismissal of my claim. 24 25 26 27 28 29 30 31 t��lJ 32 DAT 3IGMTURE KSAICANF 2 CONFIDENTIAL COUNTY COUNSEL'S OFFICE CONTRA COSTA COUNTY MARTINEZ, CALIFORNIA MEMORANDUM Date: February 17, 1995 TO: Jeanne Maglio, Clerk of the Board of Supervisors FROM: Victor J. Westman, County Counsel By: Gregory C. Harvey, Deputy Count Couns 1 RE: Claim of Raymond Bennett Alston, Junior Please treat the attached correspondence as a claim. Thanks . 7 Barnett Raymond Alston Jr. vs :,SERVICE ADVICE FORM Contra Costa County Office of Clerk of the Board 90 Day Letter (Name of Action) , IU (Court) FFB 15 1995 (Number) COUNTY COUNSEL 1) Service was made by: MARTINEZCALIF. Personal Service [ ] Name of Server: Mail [ X ] Did you sign acknowledgment and return it to Plaintiff's Attorney? Yes [ No [X] 2) Date of Service 2/14/95 Time of Service p.m. 3) Were you served as an individual? Yes [ ] No [X ] 4) Were you served as an official of the County? Yes j ] No [X ] B) Was service made on the Clerk of the Board? Yes [X ] No [ ] 6) If service was made in person, then please give the name of the person who received service: Name Title Deputy Clerk Department Clerk of the Board Office Address 651 Pine St. , Rm. 106, Martinez INSTRUCTIONS: The Summons and Complaint (and other legal documents) should be referred immediately to County Counsel. TO: COUNTY COUNSEL/ Received the documentation pertinent to the above referenced Action this i 5th day of February , 1995. Barnett Raymond Alston Jr. vs ZERVICE ADVICE FORM Contra Costa County Office of Clerk of the Board 90 Dap Letter (Name of Action) k � (court) FE B 15 1995 (Number) COUNTY COUNSEL 1) Service was made by: MARTINEZ CALIF. Personal Service [ ] Name of Server: Mail Ex ] Did you sign acknowledgment and return it to Plaintiff's Attorney? Yes [ ] No [X] 2) Date of Service 2/14/95 Time of Service p.m. 3) Were you served as an individual? Yes [ ] No [X ] 4) Were you served as an official of the County? Yes [ ] No [X ] 5) Was service made on the Clerk of the Board? Yes [X ] No [ ] f) If service was made in person, then please give the name of the person who received service: Name Title DeDULV Clerk Department Clerk of the Board Office Address 651 Pine St. , Rm. 106, Martinez INSTRUCTIONS: The Summons and Complaint (and other legal documents) should be referred Immediately to County Counsel. TO: COUNTY COUNSEL Received the documentation pertinent to the above referenced Action this 15th day of February , 1995. Mr. Barnett Raymond Alston Jr. WEST COUNTY DETENTION FACILITY 5535 Giant Highway Richmond, California. 94806. . �� 13, 1995 RECEIVED Mr. Phil Batchelor FEB1 41995 Clerk, of the Board Of Supervisors and County Administrator CLERK BOARD OF SUPERVISORS Pine Street. CONTRN CQSTF, CO. Martinez, Calif 94553 RE: Barnett Raymond Alston 90 Day Letter. Mr. P. Batchelor, Clerk Of the Hoard of Supervisors: Please be advised that it is my intention to file a Civil Action for legal Malpractice against Mr. David Headley and the Contra Costa County Alternate Defenders Office, for Defamation of Character (SLander) , Negligence and Malfeasance in the handling of my legal matters in Delta Judicial District Municipal Court (November 3,1994) . Docket Number #89424-6. The filing of this action of damages will occur within ninety (90) day's of the date of this letter. Please tender this matter to your professional errors and omission insurance carriers so that settlement negotiations can be initiated. RESPECTFULLY SUBMITTED MR. Barnett Raymond Alston Jr. i Mr. Barnett Raymond Alston Jr. West County Detention Facility 5535 Giant Highway Richmond, Calif. 94806 APPENDIX.1 1 On or about the 3rd of November 1994 at approximately 9:30am, 2 while in Delta Judicial District Court holding cell awaiting 3 preliminary hearing to begin in Department 4. I was visited by 4 my Attorney David Headley, He at that time indicated that the 5 plea Bargain agreement offered by the District Attorneys office 6 was available to me, and that in his opinion the offer was a 7 reasonable offer. I informed Mr. Headley that I was not 8 interested in the District Attorneys offer, and that my position 9 of innocence should by now, be crystal clear to him, for I have 10 indicated to him on numerous occasions that I was totally 11 prepared to go to trial in order to prove my innocence. Mr. 12 Headleys response was that he would inform the Courts of my 13 decision prior to the hearing. 14 15 Approximately thirty (30) minutes later I was escorted into the 16 court room, at which time Judge Allen asked if all parties were 17 ready to proceed, the District Attorney indicated "Yes" as did 18 Mr. Headley, however Mr. Headley informed the court that he would 19 like to make a statement for the record. From the onset of Mr. 20 Headleys' statement, he began to make malicious reference to 21 psychotic behaviors he said I possess. In addition, I was 1 I accused of being suicidal and incompetent to stand trial. After 2 much considerations, I realize that Mr. Headley is not a member 3 of a medical staff and was out of line professionally in passing 4 such Judgement. During this court proceeding I was totally 5 mortified by the statements made by Mr. Headley in reference to 6 my mental capabilities. 7 8 Mr. Headley went on to further state that he didn't feel that I 9 stood any chance what-so-ever at winning my case, this was pre 10 Judgmental, considering the fact that the case is still in 11 litigation. These are the kinds of statement to which I feel 12 could have hada detrimental effect on my situation. This is why 13 1 have been forced to seek retribution for defamation. of my 14 character and mental stability. 15 I would like for the Courts to take into consideration the 16 proceedings from the transcripts dated November 3, 1994 in 17 Department #4 of the Municipal Courts of Pittsburg, CA. Judge 18 Allen presiding, at which time the aforementioned dialogue took 19 place. 20 21 I declare under the penalty of perjury that the foregoing is true 22 and correct and understand that a false statement herein may 23 result in the dismissal of my claim. 24 25 26 27 28 29 30 31 32 DATLK SIMMTUM O APPLIC t 2 d e `.n d -�