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HomeMy WebLinkAboutMINUTES - 04211998 - C13 ..............I............................................................................................................. ...................................................................................................................................................................... APPLICATION TO DILE LATE CLAIM BOARD OF SUPERVISDRS OF CONTRA COSTA COMY, CALIFORNIA, MARD ACTION Application to File Late Claim NOTICE TO APPLICANT APRIL 2A, 1998 Against the County,, Routing The copy of thiia6c-urmnE malle3 E6 you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References areto the Board of Supervisors (Paragraph 111, below), California Government Code.) given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNINV below. Claimant: KATHERINE DANGERFIELD Attorneys MAR 2 b 1998 Addresst 4421 PAMPAS CIRCLE COUNTY COUNSEL ANTIOCH CA 94509 By delivery to Clerk on MASTINEZ CAUF, Amount: $10,000 Date Received: By mil, Postmarked On MARCH 25, 1998 Clerk of -tFe BcerTof Supervisors 'TO: County CounsWl Attached is a copy of the above noted AppliCati to File We Claim. DATED: MARCH 25. 1228 PHIL BATCHWt. Clerk, BY Puty II. M: County Counsel L/ TO: Clerk of the SR7wd -0? Supervisors The Board should grant this Application to File Late Claim (Section 911.6). The Boardrshould deny this Application to File Late Claim (Section 911-6). L DATED: VICTOR WESTMAN, County Counsel, By jtA4t, Depulty Iff B—ox WE By MOmous VoEg o? supervIsom present (Check one only) This Application is granted (Section 911.6). (1/;/ Tis Application to Fjle Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATEt r P I. BATCF=R, Clerk, By puty Jr, WARN= (Gov. Code 1911.8) If you wish to file a court action an this matter, you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4 (claim presentation requirement). See Govenuent Code Section 946.6. Such petition ont be filed with the court within six (6) months from the date your application for leave to present a late claim was denied. You may seek the advise of any attorney of your ohoioe in oonnection with this matter. If M want to oonsult an atjgM, TM should do so imm&4teiz. - — V. FROM: Clerk of the 96w--q TOt (1) County Counsel (2) County AdminiWaGF Attached are copies of the above Application. We notifed the applicant of the Board's action on this Application by mailing a copy of this document:, and a memo there0ft has ben filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED:aZ PHIL BAT CHEOR, Clerkq By Deputy Boara V. FROM: (i) Uaunty d6aiig (2) County Administrator 70 U17EZk- 0 the of Supervisors Received copies of this Application and Board Order. DATEDt County Counsel, By County Administrator, APPLICATION TO FILE LATE CLAIM -. r frmaa. mss, v REE ` .... ry To: The Board of Supervisors, 49% Contra Costa County = �c �-c pt��rytt-5; '�>.1t�tRD 4F+➢sJTG('�ildfFSQFe From: Katherine Dangerfield Date: March 23, 1998 Re: Leave to present a tate claim Per instructions ftom the County Administrator cleric and Ron Harvey from Risk Management, I have prepared a document describing the occurences dating from May 1994 to the present to the best of my recilection to show evidence for considerancelgranting my claim. May 5, 1994, while working on the swing shift at Merrithew Memorial Hospital, I was experiencing some discomfort from a ismall corn, on the third toe, of my left foot. I signed in with the Triage Nurse who determined 1 should be seen in the Fast Track Clinic. Dr. Dan Lively was working the clinic that night. We entered the treatment room as I was expressing some discomfort €was experiencing with a smallcorn that was farming on my third toe and how I had attempted to remove it by using an application of Dr. Scholl's corn remover and that I had been wearing a corn pad to protect the toe from being irritated by my shoe. Dr. Lively began to examine my toe and stated "Yeah you've got a small corn I can remove that with a little Liquid Nitrogen although it may take more than one application to completely remove it. I was delighted to hear that the small corn could be removed because of the discomfort it was causing and because I love water sports and sandals and having the corn was causing me to become quite self concious, Dr. Lively looked around the room and said "they don't have any swabs in here" he then began to describe that he has an instrument with a straw like tube that allows you to place the drops of Liquid Nitrogen in a precise spot but that it was at the other clinic he was working;at and said " I'll just pour a little drop on the corn". While attempting to pour the Liquid Nitrogen on my toe it spashed from my third toe onto my fourth toe running in-between my third and fourth toes. Dr. Lively attempted to absorb the spilled Nitrogen with paper towels from the dispenser in the room as I began to express a tingling burning sensation, Dr. Lively assured me that this was normal and that I would experience some discomfort while the Liquid Nitrogen penetrated through the layers of skin on the corn. Dr. Lively stated" the Liquid Nitrogen will penetrate the layers of skin on the corn, and as the base of the skin heals from the inside out, the top layer of skin containing the corn will be deadened and the corn will dry-up and eventually fall off', He also reiterated that it may take more than one application of Liquid Nitrogen to accomplish this. Upon leaving the treatment room, I asked Dr. Lively how long was this burning sensation expected to last? And he stated"people heal at different times and it may take!a while for the skin to heal and the corn to fall off . I was given a paper post-op slipper because my foot was too painful to put my shoe track on and I was instructed to elevate my foot when possible to help reduce the expected swelling and to come back if necessary. A week or so later, I noticed that my third and fourth toes and in-between them were swelling immensely and that airy type blisters were farming. While on duty, I again signed-up at Triage seeking treatment for the painful blisters and swelling that had formed because lwalking had become very painful. While sitting at Triage, the nurse asked me"why are you wearing a paper surgery slipper?" I explained that I had been treated about a week ago by Dr. Lively using a Liquid Nitrogen Treatment to remove a corn and that the substance had spilled while he was trying to pour it on my toes and formed these blisters and that I couldn't wear a shoe. The Triage Nurse repeated pour Liquid Nitrogen?And shook her head in disapproval. She then asked why wasn't I given a post-op orthopedic shoe? I had no response. She then asked was I keeping my foot elevated to help reduce the swelling? I told her that while I'm at work I sit registering patients with my foot on top of a upside down waste basket. She then stated"you're at work with your foot all swollen like this?"I said yes, Dr. Lively sent me back on duty. The Triage Nurse shook her head and proceeded to send me to the Emergency Room. Inside the ER, I was told not to pop the blisters that the blisters would dry up by them self, if any sign of infection occurred to return immediately and to elevate the foot as much as possible. I was already awaiting a follow-up appointment with Dr. Lively so it wasn't necessary to make one. The following week the blisters did begin to dry-up but the skin on my third toe was completely gone, my toe looked like a pink sore that even the air blowing across it aggravate it. My fourth toe and in-between the third and fourth toes was dark with loose wrinkle skin attached. The next week was my appointment with Dr Lively. I entered the treatment room and immediately questioned Dr. Lively asking him: 1. Why didn't he give me an orthopedic shoe after my initial treatment instead of sending me back on duty wearing a paper slipper walking on a hard uncarpeted floor? 2. If it was vital for me to keep my foot elevated to minis-ize swelling why didn't he release me from work? "Dr. Lively stated he didn't realize that my foot was going to swell that much from the treatment or that I was going to get blisters from the spilled Nitrogen". He also stated"he didn't realize that I was on duty or returning to duty". (My treatment record clearly stated to call me at extension when ready for me and Dr. Lively didn't release me from work so where else would I be going but returning to work. As we continued the examination I expressed my concern about the appearance of my toes the fourth one and in-between being dark in color and the third toe beim extremely painful, raw, and pink. Dr. Lively nonchalantly stated " the loose skin from the blisters will fall off and the pigmintation will eventually return. I asked Dr. Lively any idea how long I'll have these ugly toes? and he stated "I really can't say;just be patient healing takes time". I returned to see Dr. Lively for another visit approximately a week later and the dead wrinkled skin on my fourth toes and in-betwen was still dark, but the blisters had completely dried-up. There was really no change in my third toe except it didn't still have that slimy bloody look. it was still tender, sensitive and pink. Dr. Lively didn't seem concerned and made no impressions of anything being abnormal about the healing progress of my toe especially since Dr. Lively didn't request any more treatments or follow-up appointments and the closure statement of my treatment was to be patient it will take time for my toes to heal. As I passed Dr. Lively in the corridors at work or spoke with him in the cafeteria as long as four months after my Liquid Nitrogen treatment, I sometimes asked',him how much longer? and he would state"I don't know but it takes time to heal"., or he would inquire " how's that foot doing? (It was obvious my toes weren't healed because I was still wearing an orthopedic shoe), and I would state my toe still hurts and it's still pink. Dr. Lively would give me the same response to hang in there it takes time and go on his way, so why would I think there was a delay in the healing process? The year prior to this Liquid Nitrogen treatment, I had been sick for about three weeks with a cold and developed Pneumonia. I was tested for everything for weeks because no one could figure out what was wrong with me until I discovereda small lesion near my rib cage that my doctor did a biopsy on, and diagnosed me with Sarcoidosis. The damage the Pneumonia did to my lungs kept me off of work and on 60 miligrams of Prednisone per day, for three months. Following that, I had an Ectopic Pregnancy that required surgery for a partial removal of a tube that kept me off of work for a month, I was taught through these incidents that my immune system was comprimised, and I had learned to trust my physicians and if they weren't concerned neither was I. I also learned to follow their instructions which at that time my instructions were to patiently wait. Approximately one week before Thanksgiving 1994 I had finally found a boat that I could wear that didn't aggravate my toes. I wear a size 9 shoe and bought this soft suede boot in a size 10, large enough for me to wear guaze on my toes and a thick sock. It was a flat boot and was as comfortable as I had been in the last six months. I wore this boot daily for a couple of months. I moved into a new home and transitioned into a new position working at the RHC, February 14, 1995. It was at the RHC that for the first time someone implied that I was not having a normal healing; process. It was approximately March of 1995, while working at the RIAC I was still having problems with my toes being sensitive to cold and getting painful cramps underneath the toes causing; problems with bending them so I went to the Ortho clinic requesting a new orthopedic shoe. I was explaining how I had had this Liquid Nitrogen treatment and that € had been wearing a boot that was maybe beginning to aggrivate my toes. I was asked how long ago I had had this procedure? I stated last May and 1 was told that my toes should have been healed by now. Because of that conversation I had with the ortho tech, I called the Advice Nurse to express my concern for my healing process and to get advice. I told her about the Liquid Nitrogen procedure, the boot I was wearing, what the ortho tech stated and asked if maybe my foot wasn't ready for a shoe yet. The Advice Nurse said that perhaps the shoe had irritated the tissue on my toes and that it sounded like the pain with moving my toes was from the scar tissue forming on my toes as it was healing and suggested I notify Dr Lively if my condition worsened. (As far as I was concerned I had heard the key words (scar tissue forming from healing;). So I continued to wait with some concern. After speaking candidly with a few other physician's it became obvious that Dr. Lively had.- 1. Improperly applied Liquid Nitrogen ie , (poured). 2. Discharged me without the proper durable medical equipment ie., (an orthopedic shoe and perhaps Motrin for inflamation). 3. Did not release me from work to elevate the foot propely ie., Oeapordized and prolonged a safe and healthy healing process). 4. Completed closure on treatments as though his practices were in order. ie.,suggested there was no need for further treatments. It was now approximately April 1995, and after hearing these statements from other physicians I phoned Risk Management to find out how to submit a claim for this injury. I was told that because the initial treatment was for the removal of a corn that 1 was not eligible to submit a claim. I wasn't informed of any other procedure for submitting a claim for this injury, so I was forced to continue working, and pampering these toes as I waited for them to heal. As the skin thickened on my third toe, over the months the pain lessened because the skin wasn't raw and so sensitive to touch. I took that as the signs of healing and waited for the large lump on my toe to fall off as Dr. Lively stated it would. By December of 1995, the pain had become manageable and tolerable as long as I wore a corn pad on the third toe and I carefully shopped for shoes that didn't fit snug. I had Dr. Lively paged because the lump had'nt fallen off and I was ready to wear shoes for the holiday season. When I spoke to Dr. Lively he wasn't concerned about how long it was taking for this toe to completely heal, taking no responsibility for his malpractice, but instead he reminded me of haw he had told me at the initial visit that it may take more than one Liquid Nitrogen application to remove this corn. (After what I had been through for the past year I thought you must be kidding and refused the suggestion to have the second application). I didn't go see another doctor for my foot because I thought my problem was caused by the Liquid Nitrogen being spilled but that it was still the only way to remove the lump/corn and I had just been through too much I wasn't ready for round two. So I suffered and pampered these toes especially the third toe for as long as I could then in October or September of 19971 started to experience spasm like crippling pain on the same toes. The pain was so bad I was forced to make a podiatry appointment. I knew by the pain I was experiencing while walking that I needed to see a specialist not just any doctor. That's when I went to see Dr, Ted Tanaka, Podiatrist. When I arrived to see Dr. Tanaka I was wearing the same boot that I had been wearing off and on for a year and a half: While removing it I was having some pain and we began talking about the construction of the boot, when I explained bow it was one of my most comfortable shoes. I removed my sock and Dr. Tanaka said "ouch" looking at the large pink lump on my third toe and asked me how did you get that? I explainedthe whale saga of the Liquid Nitrogen treatment and how it seemed like it never really healed. I told him how long I had suffered with it and He explained that the Nitrogen had left residual scarring and that it appeared that I was suffering from chronic inflamation and severe hammertoe. As he examined my toes he said that it appeared to need correction through surgery. Dr. Tanaka explained the difference between cutting tendons to relax the tees versus removing gone and stated it appeared that I would need to have some bone removed and that the hammertoe had progressed past cutting tendons and suggested that I get a second oppinion and have an x-ray at Pinole Radiology. My x-ray's confirmed what he had stated about the severe hammertoe needing to be corrected surgically. I asked Dr. Tanaka, if Dr. Lively had been more concerned after the Liquid Nitrogen had splashed on my toes and because I continually complained about my toes being raw and painful could this need for surgery have been avoided? He stated " because the Liquid Nitrogen was improperly administered and any time a patient persistently complains of pain you should be concerned." I then asked is that how I got this hammertoe? and he stated" hammertoe is usually hereditary, but that the scar tissue that was causing all of the pain he could confidently say was caused by the Liquid Nitrogen. I then asked if the burning and scarring could have excelerated the need for tendons to be cut or for surgery? and Dr. Tanaka stated "that lots of people have hammertoes and never have tendons cut or surgery". Needless to say I was infuriated with Dr. Lively's negligence and malpractice and phoned Risk.Management again and spoke with John Elliott. I explained'what had taken place and Mr. Elliott stated the same thing that I was told When I tried to submit a claim that because the initial visit was for the removal of a darn he would not honor the claim as being work related but offered no recourse. I was speaking with my boss regarding the four to six weeks I would need to recover from surgery. I was really concerned about having enough time off but now the pain was justbecoming unbearable. I explained the Liquid Nitrogen;treatment that led up to this point, and explained how I had been discouraged twice from submitting a claim. She said they can't deny you the right to submit a claim and made a phone call. The person she called was Judy Burns. Ms. Burns wanted to know who I had spoken with that was discouraging me from submitting a claim? When I told her I didn't get the name of the first person I had spoken with , but that John Elliott was the second person I had spoken with, and she said oh that's a different department. This was the day I learned of a department that handled claims other than work related ones. In October 1997. As I explained my situation to Ms. Burns who patiently listened,I was informed that John Elliott works primarily with warp related claims, and what he and the previous person I had spoken with stated was correct, that my initial visit to remove a cern was not work related. Now my question was, if I was calling the wrong department, after explaining what had occured, why didn't either of the people I had spoken with refer or transfer me to the proper department to file my claim? I obviously would not have been calling the wrong office to submit a claim if I wasn't interested in filing a claim? Ms. Burns continued to listen as I expessed haw I was very discouraged when John Elliott stated "There's no need for you to submit the claim because treatment for a corn removal is not work related and the claim will be denied" The idea of filing a claim was over as far as I was concerned, because I'had no knowledge of another department to call and I believed the only resolution for me was with an outside malpractice lawyer, which I could'nt afford? I submitted my., claim with Ms. Burns giving light details dyer the phone and she instructed me to fax her a consent to request my medical records and she asked me what was I seeking as restitution? I stated "to be compensated for my recovery time off from my surgery. When I spoke with Ms. Burns again she informed me that my chart had very little information regarding the treatment of my toes. I requested to view my medical records and could'nt believe how incomplete my medical records were. far. Lively didn't complete Blue Progress Notes some of my treatment visits were missing I don't recall the words Liquid Nitrogen being spelled-out on any of the paperwork and my treatment copies looked like a bunch of scribble. Ms. Burns had referred me to Ron Harvey who contacted me and explained the restitution procedures of my claim. Mr. Harvey explained the amount that he was allotted to compensate me for my time off which was fine at the time, it was just a little less than my one months salary and I was expected to be off for four weeks. By the time I filed my claim I had been off of work for seven weeks and had exceeded the allotted amount that was discussed with Mr. Harvey. This was the reason I had changed the amount of restitution. I knew I would not get the amount that I was requesting and after seeing the before surgery pictures of my toes and looking at them after surgery I was really angry about all the time I lost doing things I enjoyed because of being in pain, all of the money I had spent to accomodate the painful toes, how the people in a position to assist me in filing my claim didn't Delp me and how three years later I was still in pain partially from the same Liquid Nitrogen treatment and incapacitated. Three years later, here I am as of todays date March 23, 1998, I had been off work eight weeks, still in a orthopedic shoe, spending my time doing an appeal and still talking about these toes. Now that my foot is just about healed and I am almost ready to wear a shoe, I am still seeking my original restitution which is to be compensated for my time off of work which is eight weeks. At this point I just want to get on with my life. I cannot believe after seeing the photograph I enclosed of my toe prior to surgery, knowing the work history that I have come to learn about Dr. Lively, his work ethics and work habits that my claim was denied because it was not filed in time. I suffered for three years before stumbling across someone in a system that I am employed with, before obtaining the proper assistance for correcting something that I was not responsible for. I'm penalized and Dr. Lively gets ofscott free, not because he's innocent but because noone helped me with the proper channels in time. I don't know what code of loyalty is taught amongst the medical personel, but it's really sad to see people so unwilling to get involved. To know f worked in a professional medical setting and not one physician thought it was odd seeing me everyday for months in an orthopedic shoe. It took an Ortho tech to stand up and say that this was an extensive healing period and somethings not right. f X 1 1,• h TC I�1 YY�•T= _ T�y4R`f f"7' 44 Y } / F � S u > APPLICATION TO FILE LATE CLAIM BOARD OF SUP VISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim } NOTICE 70 APPLICANT APRIL 21, 1998 Against the County, Routing The copy of this document mailed to you is your Endorsments, and Board Action.) notice of the action taken on your application by (All Section References we to the Board of Supervisors (Paragraph III, below), California Goverment Code.) } given pursuant to Government Cade Sections 911.8 and 915.4. Please note the 'WARN' " below. Claimant! JULIA NORMAN alfa `7M) Attorney: GERALD LYNN ROSS, ESQ. APR 0 9 1998 ROSS F ASSOCIATES LLP Address! 436 14TH STREET STE 1415 CC3UNT'YCOUNSEL OAKLAND CA 94622 MARTINEZ CALIF. Amount: $ By delivery to Clerk on Date Received: APRIL 9, 1998 BY nail, postmarked on APRIL 8, 1998 Clerk of the '�d of Supervisors z Coytmty Counsel Attached is a oopy of the above noted Applicaatioxs to File La Claim. I3ATII)S_ APRIL, g- 1998, �ML 8ATt1.AR, Clerk By 17 Deputy . "FROM: Couo y Counse _ : Clerk of the: ar of Su erviiors ( The Heard should grant this Application to File Late Claim (Section 911.6). The Board should deny this Application to File Late Claim (Section 911.6). DATED: VICTOR WESTMAN, County Counsel, By _ &e44Deputy I. B—OW ORDER By urian mous vo a of Supervisors present (Check one only) { This Application is granted (Section 911.6)• (� This Application to Fjle Late Claim is denied (Section 911.6). I certify that this is a true and correct dopy of the ward's Order entered in its minutes for this date. BATE: „PHIL BATCM.OR, Clerk, BY putt WARN:CNG (Gov. Cala 5911.8) If you wish to file a court action an this matter, you must first petition the appropriate +tet for an order relieving you from they pcovisiorns of QOVWTAent Cade section 945.4 (claims mentation requirement). See Oovernmmt Code 3ection 946.6• Such petition not be tiled with the court within Six (6) months from the date your appl.i ation for leave to present a late claim was denied. You may week the advise of any attorrneey of your choice in conneo:tion with this matter. If M Leant to oronsult an attorn+e should do so Immediately. V. : ClerkOf : County y 'A*01nistra EFF Attached are copies of the above Application. We notified the applicant of the Dowd'se action on this Application by mailing a copy of this document, and a Memo thereof has bon filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: PHIL BAT(HUDR, Clerk, By Deputy V. : 1 MWEy Counsel (25 County A nistrator TO: fferk o t of ,Supervisors Reoeived copies of this Application and Board Order. DATED! County Counsel, By County Administrator, By APPLICATION 'f"Q FILE LATE CLAIM ......... ......... ......... ......... ......... ......... .._..............._._..... ......... ......... .._...... ......... ......... ......... ......... ...._.... _. _........ ......... ......... ......... RECEIVED Ross&Associates LLP 436 141' Street, Suite 1415 APR 9 1998 Oakland, CA 94612 Telephone. 510-496-0160 CLERK ONT COSTA-CO.J��s Facsimile: 510-496-0164 April 4, 1998 Re. Julia Norman, Claim for Personal Injuries (re. Alleged Notice of Late Filed Claims) The Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553-1293 Dear Mr. Batchelor: Notice is provided herein that the claims as presented are not late-filed as under Accardi v. Superior Court, under cases of discrimination a claimant is entitled to present all claims regardless of a statutory bar to provide circumstantial evidence for those claims that fall within the statutory period. Nonetheless, Ms. Norman asserts that no claims fall outside the statutory period, but submits this alleged late filed claim pursuant to Govt Code §911 etseq. Thank you for your prompt attention to this matter in advance. Dated: April 4, 199$ .,)--""�"`" J a C. Norman Direct any inquiries related to this response to the County's late-filed claims to Ross&Associates LLP at the address and telephone numbers above and specifically to Gerald Lynn Ross and Bruce H. Nicholson of our firm. Further, the County had stated that it is willing to meet so as to discuss settlement at our offices. Please call to arrange a meeting at our downtown Oakland office at a mutually;convenient date/time. Bet regard ... raid Lynn , Es . Attorneys for J' Orman GRlglr Art t- C7 } ui to �r 'Cp w � 4 LA) •1 P1V 0) L{ VrtJ W0 N✓"' d rF j 2f Mr� i i' i Ross&Associates LLP RECEIVED 436 14ffi Street, Suite 1415 APR9 199$ Oakland, CA 94612 ` ` ' C ;;Q Telephone: 510-496-0160 CBOARD OSaA6 0. Facsimile: 510-496-0164 April 4, 1998 Re. Julia Norman, Claim for Personal Injuries (re. Alleged Notice of Late Filed Claims) The Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553-1293 Dear Mr. Batchelor: Notice is provided herein that the claims as presented are not late-filed as under Accardi v. Superior Court, under cases of discrimination a claimant is entitled to present all claims regardless of a statutory bar to provide circumstantial evidence for those claims that fall within the statutory period. Nonetheless, Ms. Norman asserts that no claims fall outside the statutory period, but submits this alleged late filed claim pursuant to Govt Code §911 et seq. Thank you for your prompt attention to this matter in advance. Dated: April 4, 1998 , ------ J a C. Norman Direct any inquiries related to this response to the County's late-filed claims to Ross&Associates LLP at the address and telephone numbers above and specifically to Gerald Lynn Ross and Bruce H. Nicholson of our firm. Further, the County had stated that it is willing to meet so as to discuss settlement at our offices. Please call to arrange a meeting at our downtown Oakland office at a mutually'convenient date/time. A arLynn6, EAttorneys for Jman GR/glr APPLICATION TO BILE LATE CLAIM BOARD OF SUPERLSORS OF a*MRA: COSTA 6}997—Y CALIFORNIA BARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT ARIL 21 , :1998 Against the County, Routing } The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to } the Board of Supervisors (Paragraph III, below), California Government Code.) } given pursuant to Government Code Sections 911.8 and 915.4. Flame note the "WARNING" Claimant: MELONIE JACKSON MAR .2 6 1998 Attorneys COUNTY COUNSEL MARTINEZ CALIF, Address: 1460 PLEASANTTRA HILLOSTA CA HLVD 94523117 Amounts $8 , 000 By delivery to Clerk on MARCH 25 , 1998 Date Received: MARCH 25 , 1998 By mail, postmarked on : Uerk c the Board of Supervisors r5t County Counsel Attached is a copy of the above noted Applicat to File to Cla m. DATED: MARCH 25 , 1998 FM BAT CHEIM�, Clerk, By ty : Couxrty Cbumi TO: Clerk of the Board o Supervisors { } The Board should grant this Application to File Late Claim (Section 911.6), { r} The Board should deny this Application to File Late Claim (Section 911.6). DATED: jf"a Ll ''�ICTCJR WE,S'tl i+fi, Cc►t�ntp Counsel, Bye � Deputy I. BROW WER EY MZgo—us vote o Supe+^visors present (Cheek one only) ( ,} This Application is granted (Section 911.6). W) This Application to Flie Late Claim is denied (Section 911.6). I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DATE: aACPHIL BAMMOR, Clerk, By Deputy WARNING (Gov. Coda 1911.8) If you wish to file: a oourt action an this matter, ym must first petition the Wropriate pourt for an order relieving you trem the provisions of Government Code Suction 945.4 (claims presentation requirement).. see Government Code Section 946.6. Such petition must be riled with the court within nix (6) months from the date your application for leave to present a late claim was denied. You mai* seek the advise of ang attor aey of your choice in oonnwtion with this matter. It 7W want to consult an ata should do so i=eediartel . FROM: Clerko : 1 oun Xe>, County A s ra or Attached are copies of the above Application. We noticed the applicant of the Board's action on this Application by mailing a copy of this documt, and a memo thereof has ben tiled and endorsed on the Board's copy of this Claim in accordance with Section 297'03. DATEDt PHIL BAT(MM# Clerk, By Deputy V. FRCMs 1 M—ty Counsee 2 County A ni; for : Clexrk of -tFe Boar Received copies of this Application and 'Board Order. of Supervisors DATEas County Counsel, By County Administrator, By APPLICATION TO FILE LATE CLA114 ''I'll''...-......I..........................................................................................................................................................................- ............................................................................ REC ,EIVED M 2 41998 DUSUPERVISORS 1 CONTRA COSTA CO. Application To File Late Claim Against Public Entity In the Matter of the Application for Permission to File Late Claim of MElowe, MLksc�m VS . KMt1kF-W COurg-V VA COSI COU Sonhereby applies to the (-Oq I qTY , for leave to present a claim against said M- CrxnjEy, pursuant to Section 911 .4 of the California Government Code. tAos"PiTpilt 1. The cause of action of 15EII)AIE- aC�N as set forth in her proposed claim attached hereto , accrued on ' -Y MAY 1996, a period within one year from the filing of this application. 3. y. , . q KCV-S-ot.1 s reason for the dealy in presenting her claim against tjggL-Off Cb\)qjy is as follows : VVMPOA \ \t4cA. Pc\TN-C*D Z�kNW�MG --OK -VW'rC 51 P��s�art Date: 3/24/98 6z CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT APRIL 21, 1998 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 Supervisrrs (Paragraph IV below), given pursuant to Government Code Amount: $7,211 Section 913 and 915.4. Please note all "Warnings% CLAIMANT: STATE FARM INSURANCE COMPANIES ATTORNEY: Date received ADDRESS: NORTH COAST OFFICE BY DELIVERY TO CLERK ON MARCH 26, 1998 6400 STATE FARM DRIVE ROHNERT PARK CA 94926-0001 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: 2zr�9.� ' q?L eeputyLOR, clerk II. FROM: County Counsel TO: Clerk of the Board of Supervisors { } This claim complies substantially with Sections 910 and 910.2. This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: .rt'�° BY: LGA-' 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. Dated: PHIL BATCHELOR, Clerk, Rv putt' Clerk ll 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 wail to file a court action on this claim. See Government Code Section 945.5. 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. t For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18, and that today I deposited in the united States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: / BY: PHIL BATCHELOR by _ --Deputy Clerk CC: County Counsel County Administrator VICTOR J.WESTMAN /� DEPUTIES: COUNTY COUNSEL CONTRA COSTA COUNTY PHILIP S.ALTHOFF AMENTA OFFICE OF THE COUNTY COUNSEL SHARON L ANDERSON ARTHUR W.WALENTA,JR. ANDREA W.CASSIDY COUNTY ADMINISTRATION BUILDINGVlCKIE L.DAWES ASSISTANT COUNTY COUNSEL 651'PINE STREET,9#h FLOOR MARKS ICHAEL .F RR MARTINEZ,CALI FORNIA 94563-1229 LILLANTFUJI1 SILVANO B.MARCHESI DENNIS C.GRAVES ASSISTANT COUNTY COUNSEL GREGORY c.HARVEY JANET L.HOLMES KEVIN T.KERR GAYLE MUGGLI BERNARD L.KNAPP OFFICE MANAGER EDWARD V.LANE,JR. (�['�Q MARY ANN MASON PHONE(925)335-1800 April 1 1770 PHILIP)Nd GAARD FAX(926)646-1078 VALERIE J.RANCHE DAVID F.scHMIDr DIANA J.SILVER BARBARA N.SUTLIFFE JACQUELINE Y WOODS NOTICE OF INSUFFICIENCY A D NON-ACCEPTANCE OF CLAIM TO: State Farm Insurance Companies RE: CLAIM OF: North Coast Office - State Farm Insurance Companies 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: [ ] L 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. [ X 14. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. Page 1 2, 13 [ ] 6. The claim is not signed by the claimant or by some person on his behalf. [ 7. Other: The claim fails to describe any duty or obligation of the public entity and any action giving rise to the claim. VICTOR J. WESTMAN, County Counsel Andrea W. Cassidy Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (C.C.P. §§ 1012, 1013a,2015.5;Evidence Code§§641,664) 1 declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California 94553;1 am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. I served a true copy of this Notice of Insufficiency and/or Non-acceptance of Claim by placing it in an envelope addressed as shown above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California. I certify under penalty of perjury that the foregoing is true and correct. Dated: April 1, 1998,at Martinez,California. cc: Clerk of the Board of Supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE§§910,910.2,920.4,910.$) Page 2 d'Iz STATE FARM State Farm Insurance Companies fN5URANtE RECEIVE- D--March 20 1998 619%1ttC North Coast Office 6400 State Farm Drive Rohnert Park,California 94526-0001 CLER OARD CONTRA GQS - CO.SE}t�S Lafayette Police Dept. 'b m� 3675 Mt. Diable Blvd. Lafayette, CA 94549 Re: Claim Number: 05-A519-325 Our Insured: Steven P. and Novelle R. Lathrop Loss Location: 1 White Oak Dr, Lafayette CA Date of Loss: 01-21-98 Dear Sirs: We are writing to you with reference to damage which occurred on 01-21-98 to the property at the above location. The property is .insured by our Company and the damage was in the amount of $7,211. 00. our investigation indicates you are responsible for this damage, and we are therefore, looking to you for reimbursement. If you have insurance, please refer this letter to your insurance company for discharge of your obligation, and inform us as to your insurance company name, address, and your policy number. If you do not have insurance, please forward your remittance in the above amount. Please use the enclosed self-addressed envelope when replying so that your payment will receive prompt acknowledgement. S' erely, Debbie Wymer Claim Specialist State Farm General Insurance Company (707) 588-6331 pg\suba HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001 COLILINE aIwOUNT TRANS PAY caoE REPORTING PARTY - �° i ) PAY ID(WC ONLY) EXP.(FLOOD ONL r REMARKS: CAT CODE STATE 5 0 2Q A, X56 Q D AN ...,, ,.» NORTH COAST OFFICE RL7HNERT PARK,CALIFORNIA copy FILE COPY. COPY-NOT NEGOTIABLE CLAIM 502 0409,56 0 NUMBER /? ? ` {G�7 �j DATE / NAMEOF OFLOSS�-_/ tNSLfftED %`f ISSUED PAY TO THE ---ED f J i.F 3 t DATE f ORDER OF �E've o, I V Q 1 ' j JJ/y / iPV!� f�LJ 5G A Y p /^ I DOLLARS " ., Q STATE FARM GENERAL INSURANCE COMPANY � } ❑ STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS ❑ STATE FARM FIRE AND CASUALTY COMPANY fI � JJJ ❑ STATE FARM LLOYDS �� AUTH.IC A�U7Na�iEO St3ATUpE Gr 13 CLAIM NO 05-A519-325 POLICY NO 57-CA2161-7 LOSS DATE 1/21/1998 PAYMENT NO 1 02 011180 J Coverage Description Amount COL/Line- Cd DATE 2/11/1998 Theft of Bui Lding Prop - On Premises 54,897.81 55/001 1 AMOUNT $4,897.81 TIN ENTERED BY ESCOBAR, LETICIA AUTHORIZED BY RUPPE, JOSEPH PHONE (510) 674-4335 REMARKS STATE FARM GENERAL INSURANCE COMPANY 1 .:02 011180 J NORTH COAST OFFICE BANK OF AMERICA NT & SA 11-35/1210 2/11/1998 fNYtlItANCt ROHNERT PARK, CA CONCORD, CA 8 PLEAS HILL FIRE 02-501 L044 �t INSURED LATHROP, STEVEN CLAIM NO �5=A19 X25 FLOSS DATE 1/21/1998 rawwww*w**ww*ww**w***v*t*wt*twrrw***x EXACTLY I�tSktR Tt#Oi�SAND EIGHT..�IUNDRED #lNET'fY$��1Et1 AND 81I100 DOLLARS Pay to they Order of. STEVEN P. L ,OP kNONELLE Fi LAcT14 OP 1 WHITE OA-4. `<";. LAFAYETTE CA 94549.3333 APPROVED BY COLtLiNE AMOUNT TRANS CODE REPORTING PARTY PAY 10(WC ONLY) EXP.{FLOOD ONL` /� (� t CAT CCOE STAT@ T.I.N. REMARKS. 502 040929 {� Li•I... NORTH COAST OFFICE CLAIM FELE COPY. ROHNERT PARK,CAUFORNIA COPY-NOT NEGOTIABLE 502 040929 CLAIMDATENAME OF NUMBER_ L - r- -„ y OF LOSS1_ "/{� -^1J INSUREDISSUSURED S % ll DATE PAY TO F y/ r - "� AJ'4 ORDER OF 3: � �'`J} {,ji^. e2 e �. DOLLARS STATE FARM GENERAL INSURANCE COMPANY STATE FARM COUNTY MUTUAL INSURANCE COMPANY OF TEXAS STATE FARM FIRE AND CASUALTY COMPANY f e STATE FARM LLOYDS AUTHORIZED SI AT E { _ 0002 - 03/11/98 WED 13:17 t s Zg36758 , t3 h1ar-11-9e 09:23A D- S- ,.,.AXL.EY COMPANY s>�o - 71 �95� P.02 BAXLEY COW PROPOSAL 7711ia yftoOlt COVERING SPrCIALt5TS DATE PROPOSAL X :*35Z Rr r4o:h Clr..Civer�zv4#-t.A %44551-tW_...._ {{I{ 3111I9t3 73 �,> 1`k1 r$to�3�g�3sasv r�,x sstcsa•}�:-�t�5.t $ { CUSTOMER PROJECT NOVELLE E L ATH P #1 LtMITE OAK L AFAYETT'E. CA NOVELLE LATHROP-til 4Yt#Tff t3AKAAFAYErM ATTN: NJVEL.LE,L.ATHROP .� JOBS We offer the following gvotadon'for your`cons?!'eraW*'I ; �SUPPLY&INSrALL ALOOR COVJci'MTIWG t=NISH&S TOTAL CARPET-CORoNETIREGAL SP N R +' X „ .fj 4,GM-01 LABOR 241.00 DEMO �41.Cttl TbTAL PRICE 7 1. 'Tier.payment tc:MW of for ahovr prupmMI are as foilo-s; WMF1-ULLkDXFXCI ':QF 10"9'1M 2. 'j'hc ptopnxal sioll expire in AU AIM and shall he of no farce acid c0ect therestfrer unless it has butt acctrpwd prev lously'by cusvomcr. 3. A scrvicae chargc of 11/2"/a per mouth will be charged an detiuyue..nc unpaid batawes. A. A.min morn handling charge of:!WA will he nuuIc an all retumcd marchaAd se- No rerurnt d merchurtWac acceyrt:ti witboov written Nrmission. 5. All wink to lar perllomied by D.S.Baxley Company will!+e dn,te daring no-t-ntal working hours,tttticss uthcr•wift stated, 6. All ehataiges must be in tic fora-t of writwn r-hartgc urdcrs agrftd to anti sigucd by ytVQ a td D.S.Baxley Company. 7. Any itu:reasics in costs of nierchantlisc,and/or s3ny addittoml work requ rt to he pesformcd by Ta, 5,' }taaicy Cninpatt7 as the result of amrorner Cain djob Ways.shall be pari for by cuvtrtnwt at d=ent price::andtor D.S.'Baxley Cotni�auy`s prc-ailiag man haur rates;at Char rirlw work is rwrrorrru:d. 8Tole prizing itu:ludes all material,hibor&applkabic sales tax. 9, TRF..rRUPOSAL PR.IC F F.XCLtlDES ALL p't.C3OR PREP C0911S. . .. Kat, ._.,.� ..........�._._. .�_ •.ty+tfi'.7c Tns MIA:t.tfaatl£S-t."i.^W rt•at.tP*#MfA Olbf,i*Ctvtt. i0i Er.S:$I AOV t-t)t+Z'ItT tCiC1It.SiNit'�M€T7a+G['fG,'1Kt.iRa.�FT.M- 1410►ri MA 016 arT004 r*votw WHO Mr.f`tit k"V*o%T Yiarr a trorLltl'r 0tF2`j$CM*T r^10 Mnk ttt.'t aitQjW DitSusrt.tss.PC% ritx 191071-1"M Kmroftct A fitAUA•r.40(s r Y us+x riSt7f Xicr r.TOW I-Mms,t1t+'r&o tett x i V#:tc7 x>iAR�rc�riti*rltq b�Rts t::rom aK-SOLO)Y A-:4m v t+Wri K"to I ist >t+ot°Rittsa*WTiff aAtXar tnTp3nttatlrsitr, t+iYttsDiN}«vx 7liltic -+iif4►1mavettsler,ittNAVRI"Atb,rrwirOR114asne•tFTIM tilit4 t i:+i'rp.�Cr+tiL t.4t1011$p1.0{i;Ct7#Pi.{t:tt tttl4itt+:C t#rPlttt/�. We Thank you for the opportunity of submitting this proposal and Crust we may have the privilege of serving you. tf acceptatble. please sign and return one copy. Accepted by_ _ _ D. S. BAAXI KY COMPANY Date .. - BY 511.litsr.xl9Y+ . 03111/88 WED 14:19 I TTUR-C NO 60801 01002 vim, i t va n 1s:ais r'AA 5102890759 »: ,.:17f 199 22.19 ;;. 528-846-7; 4+5t yy taUKt- 003::::.... . CtiU1C, C!d TtMATED 3T r 8F7itVICL"S IWT To Xr p y 8hlpporr, SITM. LArHRop F"`Tr:. ('-A 525-0700 ta700 ,�'+„tray ,`TATE OR. DUEL palrA tte+tt LOCAL 7RtANffP lRT;,Tl%j Bc LABOR.- S Y�f tLt .. ./+:`{•t x.71 1r�.VO 0 !7.SD hour � 1�.F+�.4Ct B�'iIPMT VALU�Obi (w 14,000); LOCAL CNARogs fit. 1240.!1 Ct # e} �r t M ,. Dj#R CIAi' ti.:. s f. VALUE '' Per Pound �st~ �srtiic!a? . . .9. FULL r1LWa5' rh�1N 'JAI.UP a14,d4V) I,.. .,FL�L-�S q�••• . """oo 2. to 250 MnAt ;0 Eye;. A4 4M oe 00M �• '�C.. e. 09111/98 WED 14:19 [TX/RX NO 6080) Z003 f �/3 Pi to No. LccationN ew tock Photo No. ' �%QS+ f� pays fH Location �iiii"fY f {N YJ r L f J/ 5rr�•k{.r J y vy. :1 X L } ? y L 4 View J{ L, t D c ct' 7'Z�r, � y f f r f: Date/Time By JOE AU.PPE . re-yd 38o-Y2'i qw, f d.' f+nniad++ 8 (tlEilGE� { J >r cs s 3'{ } 4r it y '�r4fr t IMITTAL ,iii .fit tax y�r� is Gt.AtM Photo N© Lpcation/View ..cca�r Photo No. Loi;ationNiew Photo No. Location/View I DateM me f 9 r By JOE E j recycled paper 560.23;1 itw.1-d" PnnIW in yy:..w.y 46 MNSM " `ti"AL :..:> ...... �. :.... .. a ( mNO . 1` �Y f '���f$ fihot No. Location /view r IL w i .... Photo No. Location/Vier Photo No. LocatlonNiew t ©ate/Time /yy of By J E RUPPE recy S11Q-22:1 ftw.1.87 Gnr�tw:n:.f a. 1�JRttd (` TRANSMITTAL Y ' (35nun) CLAIM NO 7 2 R Photo No. Location/View m� 0m C Photo No. Location/View ll�t�-e� G-Gzs err fl..�. 74;L 074 Ute' ���cy-�/I• Photo No. Location/View i Date/TimeBy JQF=j--z9- PE recycled paper' S60-22'1 Row.1-d: PnntW;n:.5 (OM X. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT APRIL 2 1 , 1998 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 Section 913 and 915.4. Please note a �` JLWM) CLAIMANT: DENISE RUSSELL ON BEHALF OF MAR 70 2 6 1998 STEVEN RUSSELL L ATTORNEY: coUNTY MUNSEL Date received MARTINEZ CAUF. ADDRESS: 38-B N. BROADWAY AVE BY DELIVERY TO CLERK ON MARCH 26, 1998' BAY POINT CA 94565 BY MAIL POSTMARKED: 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. MARCH 26, py IL BATCHELOR, Cler DATED: 1998 BY: Deputy i 71 1I. FROM County Counsel TO: Clerk of the Board 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: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) v 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 {�'j This Claim is rejected in full. C } Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date,. , Dated: lr +. , s ' PMit BATCHELOR, Clerk, By , eputy 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. Ste Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF !+!AILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 1$: and that today I deposited in the 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. t Dated: BY: PHIL BATCHELOR by uty Clerk CC: County Counsel County Administrator Pn TAM cla.ino relating to causes of action for death or far injury to psrsan or to T raonaal property or growing crops and which accrue on or before carbcr z1, 1037, nua t be prosy"ntad not later than the .100th clay after tho accrual of the cause of action. claims relating to causes caw action for death or for injury to person or to pQrso Beal property 0"- gTowi.ng crops and which accrue on or after January 1, 1988* must pros ant,Gd not later than six months after this accrual of the cause cif action. Claaims relating to any other cause of action nuat bo proseaa od zot later than one year after than accrual of the cauca of action. (Gov°t Code 911.2. ) a laai as mu€at bo Filed with the clerk of t4%o Eo and of Ouparvieorm at its 022iFco in p�oom i0o, County Z-Aminictration Building, 651 Pi O StrOQt, rlart na""., Gni D4553. : 12 clai.n Jo Qgainast as district gcvatmod by the Board is as or a n ao County, twc mane of the District abou,.& be f i l l Od i n. D. 22 the claim is against Mara than one public entity'$ acparata claahia3 not be filed against each public ontity. Sao pa;naalty for froudul.ont claaims, Penaal. Code Sac. 72 at the and of this farm, }�t����3Q���c��fs�t�{'zQ�tQ{�ftbt'Yc3G�t?s�tltlt4#bs��tA�rt�flQ�;�aQ�t4��c"tt'�Gtl�is3c:ri5s��t+[t�i4dts?tiQQc��tQ�t�rfsifiQ�tkL Pro* Clain 13y 161oservad for Clerk's filing sta p glmven KusselI RECEIVED Lgaai.nst the dountif..of Contra Costa) R 2 5 1998, (Pill in name) CONTRA COSTA CE7. The undorsi.gnad claimant hereby makes claim against the C=aunty of Contra Costa or he above-named District in the rnuz of and in support of this claim ropreasoaata as folloWs o . Cion Cid Uha Camago or i.n ju 1 e,-»cur? (Giga c bac c a.te and hour) ,31,a5lqY, (hour unknown ) pOSS,b)q 6JWee1-1 ;�',q5+-3'30pM LL'i}$a V did $ho damage o injury occur? (Incl V+Ce city and county)-_ oti nt )- dna qNM4WM Marti ne.-z.. * 'YarK . MCU dial the danago or i n ury occur? (Give full atai la s uea a cera paper if ra ire ) n ' l ` 'is r 04 held nnq sons nes bait - - aii-e-de '-VTAen�s on +�)e new approved qs-lem . r 6 Uhat particular act or omiuci.on on the part of county ar district o9 ice aa, corvanta or employees caused the injury or damage? bf - ern ray al1� Ktnappko, lc � m; withheU mq unem&4ment Chea..; CaUSeO mq _..._. ......... ......... ......... ......... ........ . . ...... ...........__.......... .......... ......... ...._.... .._...... ......... ......... ......... ................ . _.. ..... .... ......... ......... . ........ ......... ­ 3. What are thea names of county or district officers,; t3ezvants or amployeas causing the damage or injury? The 3L)dIC t01 1 SL4S m.. G. fuhat damage or injuries do you claim resulted? (Givo lull oxtent of injuries or damages claimed. Attach two aatirnata3 for auto SS) CtIr\" de + - to�1c�rc ; hcacarnn -; -c� c� 1 pt1C �nv'ast ?. thou was the amount claimed abwva computed? (Encludd the ooti.mate-d amount of any prospective injury or damage.) them r5 no omount- on Ii-Fe+ime, dare , 0. Names and addresses of witnesses, doctors and Ia=L-pitnlo. coor) o tor)% CoG�O, cane. ,rnL� t QS ernp l beer-, The-- Sf4e' 9. List the expenditures you nage on account of this ' accidont or injury. > I N A- f �datrQt?�t��tst�flAs3s�s#+��4tht?fld64Qal1Y�34t���i€r�rf}C3As�{�6+RsRtt0t3�dtYt�Q�u��t�Cit^��+�f��c��ti3�af3t} Gov. Code Sec. DIO.2 provides 'The chain mint be signed by tha A claimant or by Como pars on on hia .bane and Address of Attorney 9 t Cl ai.man°y a a Signa turO j. olophone No. .� telephone v®aV�..& L � L'It1i�fl�?C�t'IL'f�L'�L'IE�QL'?�L�'cBL'tQQ3f}Q4'1L14".S:tEiOsa�ii'��QC?a�t{3i�t�i tc'�t�'t�Ji�i Qt�Qi:1.�.i3QCTL}CJ''.Situ'1f�G�i�4�il'Q'F1L'15'3C'�'{dG7 Soction 72 of t a penal. Coda provides: vary person who, with intent to Oafroud, proconts f'or nllo ln'=3 o., for payment to tiny state board or off'icar, or to ory county, cl ty or district board or officer, author zad to allow or logy the same if genuine, any fa:1so .or fraudulent claim, bill, account, voucher, or t7riting, ira punishable either by imprisonment in the county jail for a period of not more than one year, by a ging of not ancooaing one thousand ($1,000) , or by bath ouch impriaos ant and fine, or by imprisonment in the state prison* by ea fine of not e scaading ten thousand dollars ($10,000, or by bogs ouch imprisommont and fine. a CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT APRIL 2 1, 1998 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: $250 , 000 Section 913 and 915.4. Please note ail gi CLAIMANT: DENISE RUSSELL MAR 2 3 1998 ATT ORN_Y: MAR NT COUNSEL Date received MARTINEZ CALIF. ADDRESS: BAY 38—B N _ NBROAEW Y AVE BY DELIVERY TO CLERK ON MARCH 23 , 1998 65 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. A4ARCH 23 , 1998 IVIL BATCHELOR, Clerk DATED: BY: Deputy II. FROM- County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAIL$ to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.6)• ( } 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: c{1f Dated: fl BY: ! Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD OROS : 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: 5 � r II1`4F_HIL BATCHELOR, Clerk, $ puty Clerk e 1� 41 WARNING (Gov, code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 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: .P.�' BY: PHIL BATCHELOR hV ut Clerk CC: County Counsel County Administrator S o C !'1 T9- GUMM100=1 ra � a r•-s S'i y, ^x,sj :s o 1:.� c:...- r'a ' 1ti`#ia ' 1: r t;�t a rtlt C WI 1. A. Clams relating to causes of action for death or a®r injury to porno a or to 1 arcanal pr aparty or roving craps and which accrue on or bre Zara Docanbar 32.0 1037, Dust be presented not later than the •1ootba dr.y Moz the accrual of the cause aa2 action. Claims relating to causes g action far death or for injury to person or t© >personal proper , � roving craps and which accrue ®n or after January 1, 19sa y must b3 presented not later than six monthsafter the accrual of this cause L✓ a2 action. Claims relating to any other cause cat action nuat, be pzoso atad Haat hater than one year after the accrual of the cause aZ action. ( ovOt Code 911.2.) Clair-S nest be Mod with U10 Clare of the Board of Supervi ors a it.s 09fica In Baan a0G, County Uninictraation Building, 551 Pine Strast, 12 " &has, 'a, 04353. :Q ZZ claim is against a district gcvcr ed by the Board oZ 'Supervisorc, Toth pan n, a CotLit yl the nano of the Dictrict ahouid b, f!-! 13d in. ')o Zf the slain to against more than one public cantity, caparate clains nuct be filed to cinst oach public antity. 13. PT ,u SOO p halt for froUdUlOnt Claims, PQnaal Code Sec. 72 a t the and of this form, . ti3��°�� s��{1���}{}QfrL"��it3t'r�3QQQf3QQc��lt?�rEidt3s�i3Qfat�t�sStiC3t��2QiSt}tS�aK�ik�3C#s�£a✓��fl�rfli�QE?t�t��tfsist3Ct�e1 zr Clain By r:aaerved Zar Cl aeV s filing stamp RECEIVED -, 2�gn not taeonnt �t of Contra Costa) M ictr .ct C LIE i�€'lARD t3 SU ' RV3SEi ORS; s("ill in nano) I CONTRA COSTA'`0 The nnderei nod claimant hereby makes claim against the County of Contra Costa or the above-named District in the alm, c:Z $aA.L0D_A_0C) and in support c� this claim r€aprouentc as 2cllowso' 1. Me an did the damage or Anjurear ra r7 (Give exact date and hour) 31glq�' ( hour unKnown � 2. �Zhtora dic t1ha dnuaga or 1njnznJ occur? cinclude city and Cee �a a(A� re.7-a Confra Cos+a a ow did U1e daama o or injury 0"nr? (Give full datailc ua€a Q=a a ear i rairad� 1Cf1C � sen 4 o Mot part.4cular act or omi cion on the part: of county or district 029icors, servants or amploycea caused the injury or damage? (over) 5.,maat are the names of county or district officarst o arvants or employees causing the daazage or injury? G. what damage or injuries do you claim rosultaU (Give cull axtent of injuries, or damages claimod. attach two octinztes� gor auto damage.) mag •)CJsio m� son .cis i-e+al iat on- cnea+- n an nv . e r Q i d n to v temp a��err�.c�rAi Uf?t (' ' e Uoti was the amount claimed above compastcad? =0t of aaany proinj=7 or damzare.} Chi'N � Pal bil S �X P� CClem " bas l" wVProblems Cry loq We los� 0 ISNO'r loss O-, mec�Ica tle- r .ij IOLU Nanes ted add re seen of witnese=0, dost ray and ��oc�i�alc uf ier be Med,�a�Cern ter~ CA Cmc f- `Phtgs- (Dr.J`kKzn) �;-�'j a 3 9 o 1 I.-one +r ee, v+�y (kPo! t�MM Ins bt: P. . j 3 C la s t o "izt tae Qxpanditure s you mads: on account of this accident or injury. 3 11-g 8 NJA 35" a Mqg IVIA 51 .573 atsf flik i k rte u i`ss Cs tt'szzL'tQ as"sFts tfit7f 0t}t'tpsfi�stz£3t'rp��tt3�tcrfl�?c��Vit?��zp��rF's�r1�;00�c"as3�'5e;+�wt3 Gov. Code. Sac. 10 a 2 provides "The Clain must be signed by tha claimant or by ac a raison on his Naue and Address cZ Attorney (Claiman 3 Signature) W�t::1IDt1 �ic�iid Te2ephonca No. Telephone , Section 72 of the pcanal Coda prwAdon a ainj p rt3on vho, with intent to defraud, pxosontn for nllcn"ansa; or for payment to any atatea board or officer, cr to any county, city or district board or officer, authorized to allow or pay the same if Vanuine, any false or fraudulent claim, bill, account, voucher, or uri.ting, is punishabla either by i.mprizormant in tho Oount7 jail for a period of net near* than one year, by o Line cif not oncooding one thousand (ZI,000) , or by both ouch impriconmont and find, cr by imprisonment onment in the ctaate pricon, by a Zino of not c2cceaedinU ion ts%ouzand dollars t$10,000, or by both ouch in riccnnent rand find. CLAIM G'�1.3 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT APRIL 2 1 1998 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 Superviscrs (Paragraph IV below), given pursuant to Government Code Amount: S16 , 167 . Section 913 and 915.4. Please note all Ir n C � c CLAIMANT: PAUL M. OGLE h q ATTORNEY: PAUL T . KLOBAS MAR 2 3 1998 4515 SAN PABLO DAM ROAD Date received OOUN YCOUNUL ADDRESS: PO BOX 20030 BY DELIVERY TO CLERK ON MARTINEZ OALIF. EL SOBRANTE CA 94820-0030 BY MAIL POSTMARKED: MARCH 23 , 1998 I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED• MARCH 23 , 1998 IVIL L BgA�TCHELOR, Clerk $Y: Deputy ,c, a.,.. II. FROM County Counsel TO: Clerk of the Board of Supervisors X) 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 910.6). 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: ' G ' � Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present (tef 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: IL BATCHELOR, Clerk, By Deputy Clerk YARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING 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. op Dated: . '� —,7,1 / �r'r.!' i BY: PHIL BATCHELOR be�o e:7�A� Deputy Clerk CC: County Counsel County Administrator VAR 2 Z _ Clain of Paul M. Ogle CLAIM FOR DAMAGE TO REAL P'ROPERT'Y against COUNIX QE CONUA COM To Contra Costa County: 1. Claimant, Paul M. Ogle, individually and as Trustee of the Paul M. Ogle Family Trust.dated January 14, 1989,. whose address is care of: Pauli T. Ilobas, Esq., P.O. Box 20030, El Sobrante, California 94820-0030,030, claims damages from the County of Contra Costa in the estimated amount of $16,167.00 to date for damage to real Property Domed by claimant. 2. Jurisdiction over this claim would rest in municipal court. 3. This claim is based on the actions of county employees, and contractors, subcontractors and agents employed by the County of Contra Costa who on or about April/May, 1997 constructed a black wall on claimant's real property and made certain improvements and repairs to claimant's driveway thereon. The property site is the Appian Triangle, project number O662-684051 -95. The Countywas responsible for construction of said block wall Pursuant to that certain Full and Final Settlement Agreement and Release dated September 18, 199+6 by and between the County of Contra Costa and Paul M. Ogle, Trustee of the Paul M. Ogle Family Trust dated 1/14/99. In addition to the terms of said agreement, the County orally agreed to make certain repairs and improvements to the driveway of said property and did make certain repairs and improvements thereon. 4. Claimant does not know tate names of the public employees, contractors, subcontractors and agents who caused claimant's loss. 5. The loss sustained by claimant consists of damages for the cast to correct defective planning, engineering, construction, building, application and workmanship in the construction of the block wall thereby causing a portion of the wall to collapse and in the repair of and improvements to the asphalt driveway causing the asphalt to crack, subside and deteriorate. 6. There'; is no known future loss anticipated at this time. 7. All notices and communications concerning this claim should be sent to: Paul T. Klobas, Esq., P.O. Boa 20030, El Sobrante:, California 94820-0030, telephone: (510) 223-5073. Date: ~zz) - PAUL. T. KLOBAS Attorney at Lave 4515 San Pablo Dam Road P.O. Box 200301 El Scrante, California 94820-0030 Telephone. (510) 223-5073 2 r e N a u> Lm a Lmrd a RM $ a x N .,.. .o Cz ru a $ I w 0 w CLAIM BOARL OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA Claim Against the County, or District governed by) BOARD ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT : APRIL 21 , 1998 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 , 413 Section 913 and 915.4. Please note allVW*1411W113) CLAIMANT: AMY COLLEEN MOLLIFY MAR 2 3 1998 ATTORNEY: CSO JULIE MOLLOYY COUNTY COUNSEL Date received MARTINEZ CALIF. ADDRESS. 189 ELMINYA DRIVE BY DELIVERY TO CLERK ON MARr_H �� , 1X798 PACHECO CA 94553 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. pp�tIL BgATCHELOR, Clerk � DATED: MARCH 23 , 1998 g : Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( ) This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated �0 BY: °r,G• :�( ' Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present This Claim is rejected in full. J, ( } 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 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. * For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United 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. t Dated: BY: PHIL BATCHELOR by Deputy Clerk CC: Country Counsel County Administrator Claim to. BOAM OF SUPERVISORS OF CONTRA COSM COUNTY INS'T'RUMONS TO CL ADOM A. Claims relating to causes of action for death or for injury to person or to per- sonal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than' the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing craps and uh1di accrue on or after January 1, 198$, mint 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. trade S911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, Sal Pine Street, mwtinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the rte= of the District should be filled in. D. If the claim is against more than one public entity, separate claims trust be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Cade See. 72 at the end of this .r0FM. RE: Claim By Reserved for Clerk's filing stamp ni CAI= RECEIVED gas the O�j County of Mt-m— Rta ) or WEs�' District) Cl.l.R�C sc�ARp 1 PEFtVIuQ�{� ...�(Fill M name .. �. CSM l -A CC?S1A . The undersigned claimant hereby maces claim against the County of Contra Costa or the above--named District in the sum of $ 1 ql --� , _ and in support of this claim represents as follows: 1. When did the dae.or injury occur? (Give exact date and hour) aLi 12a-) 2. Where did the damage or injury occur? (Include city and county) cc*144 3. How did the damage or injury occur? (Give full deta ls; use I @xtm paper if required) m S;'5� i s.. ux- /31 4. ;What particular act or omission,.on.the part of county or district officers, serves or, loyees caused.the injury or.Vie? ' .. (oven) -5. what are the names of county or district officers, servants or employees causing the damage or injury? c4 RM kole- bi, � 'S. I 5. What damage or injuries do you claim resulted? (Give Hill 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.) .._........._..�_...r..�...._...._ $. Names and addresses of wiViesses, doctors and hospitals. III f5ly"WYA of'. W , 9�lS5 U..)1e)0+ 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT Gov. Code See. 910;2 provides: "The claim must be signed by the claimant SEND NOTICES::TOt..,. 1 or by some 22ESM on.his.behalf." Name and Address of Attorney �- la s tore (Ad es Telephone No. Telephone No. a * 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 fora period of not more than one-year, by <a fine of not exceeding one thousand ($1,000), or by -both such -imprisonment and fine; �or`by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($109000, or by both such imprisonment and fine. STOP *V The following pages are medical records. Do not print or distribute without written consent from County Counsel. Abundant Life Chiropractic Ctr 2150 Civic Zr. , Ste. 200 Walnut Creak CA 94395 510-939-7778 ID#: 68-0394454 Thursday .Tanua=y 29, 1998 Itemized Statement for 12/10/1997 - 01/20/1998 Patient Insured Employer Amy Molloy 189 Elminya dr. Pacheco, CA 94553 DOB: 10/03/1983 DOB: Onset date: Policy#: ----------- ------------------------------------------------------------------------------------- Date -Description----__-- -_--v_--_--___- Amount 12/10/9? C $ 124.00 12/10/97 72050 SVW CERV $ 189.00 12/12/97 99213 EXTD OV $ 50.00 12/13/97 99213 EXTD OV $ 50.00 12/15/97 99213 EXTD OV $ 50.00 12/17/97 99213 EXTD OV $ 50.00 12/20/97 99213 EXTD OV $ 50.00 12/22/97 99213 EXTD OV $ 50.00 12/29/97 99213 EXTD OV $ 50.00 12/29/97 97122 MAN TRACT $ 30.00 12/30/97 99213 EXTD OV $ 50.00 12/30/97 97122 MAN TRACT $ 30.00 01/05/98 99213 EXTD OV $ 50.00 01/05/98 97122 MAN TRACT $ 30.00 01/06/98 99213 EXTD OV $ 50.00 01/06/98 97122 MAN TRACT $ 30.00 01/07/98 99213 EXTD OV $ 50.00 01/07/98 97122 MAN TRACT $ 30.00 01/06/98 99213 EXTD OV $ 50.00 01/08/98 97122 MAN TRACT $ 30.00 01/09/98 99213 EXTD OV $ 50.00 01/09/98 97122 MAN TRACT $ 30.00 01/12/98 99213 EXTD OV $ 50.00 01/12/98 97122 MAGI TRACT $ 30.00 01/13/98 99213 EXTD OV $ 50.00 01/13/98 97122 MAN TRACT $ 30.00 01/19/98 99213 EXTD OV $ 50.00 01/19/98 97122 MAN TRACT $ 30.00 ---------------------------------------------------------------------------------------------------- Totals Based On Above Search: Total Services $ 1413.00 Total Sales Tax : $ 0.00 Total Tate Charges $ 0.00 Total Interest Charges $ 0.00 Total Pat Pymts-Csh $ 0.00 Total Pat Pymts-Chk : $ 0 .00 Total Pat Pymts-CC $ 0.00 Total Insurance Pymts $ 0.00 Total Adjustments $ 0 .00 Balance (search range) $ 1413.00 Total Case Balance $ 1413.00 _....... . ......... ......... ......... ......... ......... ......... ..........-_.._. . ........ ............._............. __...._.. .._..._.........._.._.. ......._.. ......... ......... ....._.. ......... ......... 1 13 December 15, 1997 Re: Molloy, Amy , Date of Injury/Onset: 12/9197 On December 14, 1997, Amy Malloy presented with symptoms arising from a motor vehicle accident which occurred on December 9, 1997. DESCRIPTION OF INJURYION SET: The patient reported, "while riding on the back of a scooter, my sister (the driver), ran over a huge hale in the road. I was jerked back violently. Then I had a headache and my back and neck hurt." The patient reported wearing a motorcycle helmet during the injury. INITIAL COMPLAINTS: Frequent dizziness; frequent, moderate headaches; difficulty sleeping; constant, moderatre neck pain and stiffness; difficulty breathing; occasional moderate low back pain. GENERAL PHYSICAL EXAMINATION: An antalgic spine tilt on the right side was apparent when the patient stood upright. Gait: On ambulation, the patient revealed an antalgic gait, apparently favoring the left side. X-RAY STUDIES; Date of Study: December 10, 1997 The following films were available for review: Cervical Spine: Davis Series RaEdloaraahic_Analysiis: There is no evidence of fracture present. . ... ..................................................................................................................................................................................................................... ....... .......... .......... ......._..._.._........................... ......._................. ...._.... ......_....... _.......... ..._.._..... .......... CO Motion Studies: The relative movements of the vertebrae were evaluated utilizing extension and flexion radiographs. There was moderately deficient movement in extension at 05,6,7. There was apparent aberrant movement (opposite the gross movement) of 05,6 in extension. There was moderately deficient movement in flexion at 05,6,7. There was moderately aberrant movement in flexion, which was opposite to the gross movement, at C6,7. Additional X-Ray Information: Lateral cervical view discloses a moderate loss of the lordotic curve, and minimal anterior translation of the head. CURRENT SIGNS AND SYMPTOMS: An assessment was performed on Molloy to determine the currant signs and symptoms presenting at the time of this examination. The current primary symptom is sharp, shooting and spastic pain in the neck bilaterally. Amy reported that this symptom radiates into the head on the left side and both shoulders. It occurs between three fourths and all of awake time, and causes serious diminution in capacity to carry out daily activities. Amy further indicated the symptom is brought on by bending to the left, sneezing and by lifting. also stated the symptom is aggravated by bending forward, bending backward, bending to the right, twisting to the left and by twisting to the right. Amy Molloy also reported a second symptom which is dull, aching and spastic pain in the low back bilaterally. It occurs between one fourth and one half of the patient's awake time, and causes moderate diminution in capacity to carry out daily activities. MANGE OF 'MOTION STUDIES: The following joint range of motion calculations and analyses are based upon the methodologies and tables found in the A.M.A. Guides to the Evaluation of Permanent Impairment. Cervical Swine: Angle Anaivsis Flexion 40 degrees Mild restriction: normal is 50 degrees. Extension 45 degrees Mild restriction: normal is 60 degrees. Left Lateral Flexion 40 degrees Mild restriction: normal is 45 degrees. Right Lateral Flexion 32 degrees Mild restriction: normal is 45 degrees. Left Rotation 50 degrees Mild restriction: normal is 80 degrees. Right Rotation 75 degrees Slight restriction: normal is 80 degrees. ----.............I....................................................................................................................I........................... .................................................................................. KINESIOLOGICAL STUDIES: The following muscles were tested to determine if there were any nerve related motor impairments. This evaluation was based on the Muscle Rating Scale found in Chapter 3, of the A.M.A. Guides. Grip Strenath Evaluation: The following measurements were obtained using a Jamar Dynamometer. Three readings of the involved hand are averaged and compared to those of the opposite hand, which is usually normal. If both extremities are involved, the strength measurements are compared to the average normal strengths listed ini Tables 31 and 32 on pages 64 and 65 of the A.M.A. Guides to the Evaluation of Permanent Impairment. Left Hand: 12, 12, 12 Avg: 12. kilograms. Right Hand: 24, 16, 14 Avg: 18. kilograms. Utilizing the A.M.A. Guides"Strength Loss Index' Formula from page 65, Mich is Normal Strength minus Abnormal Strength divided by Normal Strength equals % Strength Loss Index: Left Hand: (46.3 - 12.) divided by 46.3 = 74.1% Strength Loss Index. Right Hand: (46.3 - 18.) divided by 46.3 = 61.1% Strength Loss Index. ORTHOPEDIC EVALUATION: Cervical Lesion Tests: The Jackson Compression Test was positive bilaterally. In this test, the patient, sifting upright, attempts to laterally flex the neck and head toward the affected shoulder. Then the examiner exerts downward pressure with clasped hands on top of the patient's head. The test is positive if this action exacerbates the patient's cervical and/or radicular pain indicating nerve root compression. The Maximum Cervical Compression Test was positive bilaterally. In this test, the patient, sifting upright, attempts to laterally flex the neck and head toward the affected shoulder. Then the examiner directs the patient to bring the chin as close as possible to the shoulder. The test may be repeated passively if there is no response When the patient does the action actively. The test is positive when the action causes radicular pain on the side of the flexion and rotation. A positive test reveals cervical nerve root compression in that the action narrows the diameters of the intervertebral foramina as much as anatomically possible. �1 f� The Shoulder Depression Test was positive on the left side. This test is done with the patientsupine. The examiner standing at the head of the patient, flexes the neck to the side opposite to the shoulder being tested while pushing the shoulder caudadward. Then, while maintaining the depression of the shoulder, the head is rotated, again to the side opposite to the shoulder being tested. If radicular pain is either produced or aggravated the first action and then confirmed by the second, the test is considered positive. A positive test indicates adhesions of the dural sleeves, the spinal roots, or the adjacent structures of the joint capsule on the side of the shoulder being depressed. Soto-Hall Test was positive. With the patient supine and the examiner exerting pressure on the sternum to prevent either lumbar or thoracic flexion, the examiner places the other hand'under the patient's occiput and flexes the head and neck slowly and forcibly upon the sternum. This causes more and more of a pull on the posterior spinous ligaments, starting at the Ligamentum Nuchae, moving downward until it reaches the spinous process of the involved vertebra. There the pull acts as a lever compressing the vertebral body, thus causing localized pain. This test is mainly used to diagnose and localize vertebral bony disease and injuries, particularly of the compression type. This patient's pain was localized at C7. Sacroiliac Lesion Tests: The lilac Compression Test positive on the left side. This test is performed with the patient lying on the side on a padded table. The examiner with both hands over the superior innominate bone applies strong downward pressure. When this maneuver elicits pain from the pelvis, the test is considered positive, indicating a sacroiliac lesion. Yeoman's Test was positive. This test is done with the patient in a prone position. The examiner exerts downward pressure over the suspected sacroiliac joint, while maximally flexing the ipsilateral knee. Then the thigh is hyperextended while holding down the pelvis. The test is positive when deep pain in both sacroiliac joints is causes from the above action, indicating a strain of the anterior sacroiliac ligaments. Intervertebral Disc Syndromes: Kemp's Test was positive on the left side. This test can be done with the patient standing or sitting. While stabilizing the pelvis, the patient's shoulder if firmly forced obliquely backward, downward and medialward. The idea is to put the lower spine on the opposite side to the one being tested, into a combined position of rotation, lateral bending, and extension. The test is considered positive when low back pain radiates into the lower extremity, indicating facet syndrome, fracture or disc involvement. PALPATION EVALUATION: Palpation, which is an examination using the hands, was performed to evaluate the patient's response to pressure and to examine tissue consistency. Parasg nal Studies: Palpation of the paracervical muscles revealed moderate pain and tenderness. The left paracervical muscles disclosed moderate myotonia, and significant edema. The right paracervical muscles demonstrated mild myotonia, and mild edema. In the low back, the iliolumbar muscle groups revealed moderate pain and tenderness. The left iliolumbar group disclosed moderate myotonia, and mild edema. The iliolumbar midline structures demonstrated significant edema. The right iliolumbar group revealed mild myotonia. DIAGNOSIS: E815.1; 738.2; 839.0; 847.0; 784.0; 847.2; 724,5 PROGNOSIS: Exellent. Patient's age and prior condition should contribute to a favorable response to recovery with chiropractic care. CLOSING COMMENTS: The injury sustained, along with clinical findings, support that of a flexion/extension (whiplash) injury. It is probable that the weight of the helmet worn at the time of injury is a factor in this incident. f Dr. Brian Thomason Abundant Life Chiropractic Center 1150 Civic Drive Suite 200 Walnut Creek, CA 94596 (510)939-77' 8 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA c 13 Clair, Against the County, or District governed by) SOARO ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT APRIL ,1 998 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 Supervisrrs (paragraph IV below), given Government Code Amount: $5000 Section 913 and 915.4. Avg*I CLAIMANT: NEAL BORDENAVE MAR 2 7 1998 ATTORNEY• COUNTY COUNSEL MARTINEZ CALIF. Date received ADDRESS: 3546 WREN AVENUE BY DELIVERY TO CLERK ON MARCH 27, 1998 CONCORD CA 94519 BY MAIL POSTMARKED: I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. DATED: MARCH 27, 1998 IViL BATTCHELOR, 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: B Y: _ 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. Dated: HIL BATCHELOR, Clerk, B t,� �puty 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 fife a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times htrein 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: t� BY: PHIL SATCHEL OR by De uty Clerk CC: County Counsel County Administrator . 13 VICTOR J.WESTMAN DEPUTIES. COUNTY COUNSEL CONTRA COSTA COUNTY PHILIP S.ALTHOFF OFFICE OF THE COUNTY COUNSEL SHARON L.ANDERSON ARTHUR W.WALENTA,JR. ANDREA W CASSIDY COUNTY ADMINISTRATION BUILDING VICKIE L.DAWES ASSISTANT COUNTY COUNSEL 651 PINE STREET,'9FI'1 IFLOOR MARKE S.ESTtS MICHAEL D.FARR MARTINEZ,CALIFORNIA 94553-1229 LILLIAN T.FUJII SILVANO B.MARCHESI DENNIS 0.GRAVES ASSISTANT COUNTY COUNSEL GREGORY C.HARVEY JANET L.HOLMES KEVIN T.KER( GAYLE MUGGLI BERNARD L,KNAPP OFFICE MANAGER EDWARD V.LANE,JR. MARY ANN MASON PAUL R.MUNIZ PHONE(925)335-1800 PHILIP J.NORGAARD FAX(925)646-1078 VALERIE J.RANCHE DAVID F SCHMIDT DIANA J.SILVER BARBARA N.SUTLIFFE JACQUELINE Y WOODS NOTICE OF INSUFFICIENCY ANEIZOR NON-ACCEPTANCE OF CLAIM TO: Neal Bordenave 3546 Wren Avenue Concord, CA 94519 RE: CLAIM OF: Neal Bordenave 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: [ ] L 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. [ 15. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation,the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. If the amount claimed exceeds ten thousand dollars ($10,000), the claim fails to state whether jurisdiction over the claim would rest in municipal or superior court. Page 1 N [ 7. Other: The claim fails to describe any duty or obligation of the public entity and any action giving rise to the claim. VICTOR J. WESTMAN, County Counsel By: Andrea W. Cassidy Deputy County Counsel E, TIFICATE OF SERVICE;BY MAIL (C.CT. §§ 1012, 1013a,2015.5,Evidence Code§§641,664) 1 declare that my business address is the County Counsel's Office of Contra Costa County,651 fine Street,Martinez,California 94553;1 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. Bated, March 30, 1998,at Martinez,California. t cc: Clerk of the Board of supervisors(original) Risk Management (NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE§§910,910.2,920.4,910.8) Page 2 <J,3 4. Neal Bordenuve 3546 Wren Avenue Concord, CA 94519 (514) 680-4215 March 16, 1998 Michael G. Ross, Director Animal Services.Department 1 4849 Imhoff Place Martinez,CA 94553 Re: Notice of Demand for Wronctul Death Dear Mr. Ross: This letter is a fort-nal demand for the sum of$5,000.00 for the wrongful acts of your department in leading to the surrender and unnecessary destruction of my dreg. If I have not been paid the sura of$5,000.00 on or before April 17, 19981 will proceed with civil action against Centra Costa County, Lt. Gamez, and you as the Director of Animal Services. Please recognize that the sum of$5,000.00 is an amount that I will agree to settle this matter for and that any civil action may seep significantly higher compensatory and punitive damages,as well as, all court costs and legal fees. I invite your efforts to resolve this matter without litigation. Regardsrenave:� RECEIVE W 2 71998 N al Boa K €3OF SUPERVWRS Ct 14 M COSTA CO. CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA ' Claim Against the County, or District governed by} BOAR, D ACTION the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT APRIL 11 21, 1998 and Board Action, All Section references are to ) The copy of this dotument mailed to you is your notice of California Gcvernment Codes. } the action taken on your Claim by the Board of Supervist�rs (Paragraph IV below), given pursuant to Government Code Amount: $1300 Section 913 and 925.4. Please note! osevz q) CLAIMANT: ROBERT PIZZAGRANI MAR 2 7 1998 ATI ORNE Y: COUNTY COUNSEL Date received MARTINEZ CALIF. ADDRESS: 901 COURT STREET BY DELIVERY TO CLERK ON .MARTINEZ CA 94553 BY MAIL POSTMARKED: MARCH ,2.6, 199—Z- 1. 997I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted claim. MARCH 27, .1998 B pp IL ggATCHEIOR, r W DATED: Deputy II. 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 I5 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). f } Other: Dated: . BY: Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER. By unanimous vote of the Supervisors present ( is Claim is rtjected 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. oe Dated: e //�' PHIL BATCHELOR, Clerk, By Deputy Clerk Or WARNING (Gov. code section 913) Subject to certain exceptions, you have only six {b} months from the data this notice was personally served or deposited in the mail to file a Court action on this claim. See Government Code Section 045.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side of This Notice. AffIDAYIT OF %AILING 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 a5 shown above. Dated: C� i • �?7 /�? �" BY: PHIL BATCHELOR by puty Clerk CC: County Counsel County Administrator ...I.................................................................I.............................I..................................................................... .............................................................................. ..... claim to: BOARD OF 5UP2RVX8ORS OF CONTRA COSTA COVNTY 6), XNATRUCTION6 20 CLAIM W A. 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 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. (Gov*t Code 911.2. ) B. claims must be filed with the Clerk of the Board of Supervisors at its office in Room 1061 County Administration Building, 651 Pine Street, Nartinez,, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the ne-me 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. rraNd. Ste 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 MAP 2 7 1998 District} BOARD C, 4-tims _ CONTRA 6 Z3 io�t,;O. (Fill in name) The undersigned claimant hereby makes claim against the ounty of Contra Costa or the above-named District in the sun of and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 2. Whore didthe damageor in*ry occur? (Include city and county) 3. Now did the damage or injury occur? (Give full do ails; use extra paper if required) > 14 A 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? 7 n rc J (over) .............I................................. 5. What are the names of county or district officers, servants or employees causing the damage or inju r ? e 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto -V�1. damage. 'r"7-�C,/-'et-- ! </ fAn e <7- r�o lc� co ev e'C A -• J dc 7. How was the amount claimed above computed? (Include the estimated amount of any prospective 3ury or damage. )60 ))Ocjp-,- r'-r- 0 'te' r re-1 S. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury. AMOUNT X" Gov. Code Sec. 910.2 provides "The claim must be signed by the claimant or by some person on his SZKD NOTICES TO: JAttorney) I beha Name and Address of Attorney r74- (Claimant I"iOature) (Address) Telephone No. Telephone No. NOTICE Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer,, or to any county,, city or district board or officer, authorized to allow or pay the same if genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine, of not exceeding one thousand ($1,000) , or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by both such imprisonment and fine. i' 1,,3 JUN- G c t )INMATE EQU Sf FOR INFORMA N { )MEDICAL REQUEST T ' rc� /44 06 9�'g) Late: -- Z/ Housing Assl_gnment ?6; Check One: { )ph"Jest XGdevance t )APPeal ( )Other RequestQ1 :Z-+ 7- 1 if .wa4Wig Jlw t ,�+�"' ..�"" J�'"� !'��`+�,t .�� fit.-�'"?:;.t,,.� ,,r, '�,•? k I Date Recd: Reed 8 z ! Flouted To: { )APPROVED { )DENIED-(state reason) 1 3 i zd r BY. j Mink: by inmate YeHow Re*to inmate Date:— � o crt+: ter JIMI White:7o Booking i r s�e ec W e ,o..r,f,,c^� ,(�.iC..'r�._ '}r'1,..�F _��'.."'� � ...'l�Cy�:I"�...'� ?r� .,�,,ice'-"-_IZ..�pef'I C✓..�L"i ..."�.s��y'J'��!��w� ./�i,'r�.ry .+L.c'T �� .__..... y ��-1-.,..,....?�'-:...:�:� '.,.tl;,!,{��'}�.,;�'S,� .. .1���;^^^"._ I�'�{���'�e�;.+!"_-.. .+�'....{� z ,'.�it:._.�r'.F. C..�...+..✓ f� ,..r�, .� „✓vt,.- i f 'C w'{ �'_�i. .l..._�(��C .G"r✓" f, 'J�...+�� "'f"" f�"v' +�.6.,4.iL!" �r;��.. ./4!'�r#//r"ti" �f .:.. _�f�Y.__ .. ✓"!''�'.-. f .1....C...���� .d..,._._.L.S✓�{-�il,,..F-_..._. .,::.f.'-..... +�'+."w..'�f"� .a'�..:"i'�L.����''I �. 1 .� ..//,,y�' J�' +:.. -"�'`��.�."�.w.:s"f'"�}L,.'" SL.� . ......,,.-�;'4«-. .. .r�l'wG,.� w,+/jj� {'�' ��*� - �� `'«"!.`w+�.,,,....-/',/t"r� f�_"�-".__ti,.- ..+.•T..:." Y_�.t'.ir. t Ir1 Ci- "]I y �A" " ,.�:,�` t•f-T;;,'�� •'"7f,.�'�1 C�.�.+Y,/�"�-Y!'��' sw' `��"•�?' �` `�1.r'" .>it'..-�' �_'`*'�"` /'" , „ �,�""'"tib'-� 7 p ' 4 Al —64/ 1 .00 00* f ^'3..�..-d•`�:...._.e!��_L.:�_..-..5...-_{`r_'�-� .,�-t_'`«�/L.G:-'"Y-,'.��. :�e�'�..�.+/G..✓! ':``,'£ �'� -�/'C. %/�J ,�`�� Lr;.� -•..y{ �r�I _ � ti. �-� .«'S�.�'. � /y"".....Sti-- /f1�.�f-��. .'_-....Z-_.dLr'[/-4tw;r4._. �•.'` t°°°''/ /� ani Ira i zc ,c''�,t' ..:_'L._..�'�`�....._.,:="'s: _te.•�� __ -'- �-'%'r�:L_... ..__ �_�..__�''%� _'.: ..d��'..:__C`�''_�E ,. �./�t+y,�'f7 y,.�f��r -;�,47 7-- 777 .. 1 r r /�`�, .....�L,...� of _ f t'1��'�.rw,..:-�,_!_.'..._ �._ — .�sW.G.'a�+M1i,��"'- (......,wr'Sm•."�i.�..{x..Ci,�-." ,.--4.wq�c,„+�'1...,,c.....L---�wf��arW*+-'�.. 13 - f . a� o CLAIM i BOARn, OF SUPERVISORS OF CONTRA COSTA COONTY, CALI€ORNI,A Claim Against the County, or District governed by) BOAR the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT APREIe; 21, 1398 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--r-,-t Amount: $41,900 + Section 913 and 915.4. Please note al rnniingssl. CLAIMANT: PHUOC LY MAR 2 6 198 COUNTY OOUNSEL ATTORNEY, THEODORE O. BERRY MARTINEZ CALIF, 77 8TH STREET STE 203 Date received ADDRESS; OAKLAND CA 94607 BY DELIVERY TO CLERK ON MARCH 26, 1998 BY MAIL POSTMARKED; 1. FROM. Clerk of the Board of Supervisors TO: County Counsel Attached is a ropy of the above-Hated claim. pp�#iL BATCHELOR, Clerk GATED: . ' BY: eputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors This claim complies substantially with Sections 910 and 910.2. ( t 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 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. i 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 t" mail to file a court action on this claim. See Government Code Section 345.5. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. * For Additional Warning See Reverse Side Of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claift nt as shown above. Gated: BY: PHIL BATCHELOR by,44/" Clerk CC; County Counsel County Administrator CLAIM AND NOTICE OF CLAIM 1. NAME OF CLAIMANT: Phuoc Ly 2.ADDRESS OF CLAIMANT: 39»222 North Broadway,Bay Point,California. 3. ADDRESS WHERE NOTICES ARE TO BE SENT: LAW OFFICE OF THEODORE O. BERRY,77-8th Street, Suite 203,Oakland,Ca 94667 4.DAY TIME PHONE NUMBER: (510)653-2554 5. DATE AND 71ME OF OCCURRENCE: November 5, 1997,daylight hours 7.CIRCUMSTANCES OF OCCURRENCE.-I am claiming the sum of$41,900 which was taken by Ted Todd/Edward Todd and/or employees and agents of the County of Contra Costa from my sister's residence at 41 Ids Court,Bay Point,California, pursuant to a search warrant Issued on October 30, 1997,by a,fudge of the Superior Court,State of California,County of Contra Costa. The entire$41,900 in cash Is my personalproperty,acquired solely by me as set forth In the attached declaration made under penalty of perjury. 8. DESCRIPTION OF INJURY: Personal property In the form of$►41,900 cash which was in the constructive possession of my sister,Uong Ly,at 41 Ida Court,Bay Point, Califora,which I have been deprived of the use of since November 5, 1997. 9. NAME OF CITY EMPLOYEE CAUSING INJURY:Ted Todd/Edward Todd andlor employees and agents of the County of Contra Costa: 10.TOTAL AMOUNT CLAIMED: $41,900 plus interest at the rateof ten percent per annum. DATED. SIGNED: EEIVED X26 CLERK BOARD OF SUPERMORS TRA Z. 1TA CO } 2 3 4 5 6 7 8 IN THE MATTER OF THIS CLAIM OF PHUOC LY 9 1. My name is Phuoc Ly and I live at 39-222 Forth Broadway, Bay Point, California. 10 2. hely sister is Uong Ly and she is married to Nhoc Danh; they live at 41 Ida Court, Bay I 1 Point, California. 12 3. Since 1986, I have been employed in various jobs. Prior to, 1986, I was enrolled in the 13 Jobs Corps Center in San Marcos, Texas. 14 4. My jobs have included the following: 15a)Wrinkler Flexible Products, .Houston, Texas, ((b) Thai Market, Oakland, California; 16 (c) Good Luck Market, Oakland, California; (d)Khanh Phan Market, Oakland, California, 17 e) Underground Construction,Bencia, California; �f) Shore Acres Auto Repair, Bay Point,California; 18 (g)R& A Auto Repair, Martinez, California. 19 5. During all of the years that I have worked,I have set aside a portion of my earnings in the 24 form of cash savings. 21 6. Approximately two and one-half years ago, I became concerned that my savings could be 22 stolen from me because the place where I lived had no one else thereto safeguard property and 23 while I was at work,it would be possible for someone to break in to my place and steal my money. 24 7. Because my sister did not work and was at home most of the time taking care of her 25 children, I decided to take my cash to my sister's house and leave it in a safe plane. I did not tell 26 anyone what I was going to do,but I only asked my sister,Uong Ly, if I could leave some things in 27 her closet. 29 8. 1 don't know exactly how much money I had when I first took it to my sister's house at 41 C,13 1 Ida Court in Bay Paint, but it was contained in two suitcases. My best estimate is that I tank the suitcases to 41 Ida Court in June, 1995, and that at that time they contained approximately $38,000 3 in cash. 4 9. After initially taming the suitcases to 41 Isla.Court,I would periodically add cash to them 5 as it accumulated from my earnings in the form of savings. My visits to add cash were irregular, but 6 usually I would add some money to the suitcases at least once every month. 7 10. None of the money found by Edward Todd on November 5, 1997, in the suitcases in the 8 closet upstairs at 41 Ida Court was money which my sister, Uong Ly,or her husband,Nhoc'Danh, 9 or any other member of their household knew about. Nor did any of the money belong to anyone 10 other than myself. The approximately $41,900 which was found in the suitcases consists entirely 11 of swings which I retained from my earnings. 12 I declare under penalty of perjury under the laws of the State of California that the foregoing 13 is true. 14 Dated: 15 P u oc Ly 16 17 18 19 20 21 22 23 24 25 26 27 28