HomeMy WebLinkAboutMINUTES - 05121998 - C14 CI AIM
BOAM OF SUPERY O DE CONTRA QQSIAA CO2NTV CALEE NI
WMD AO I, 1Z 1998
Claim Against the County, or District Governed by 1
the Board of Supervisors, Routing Endorsements, ) NOTICETO CLAIMANT
and Board Action. All Section references are to ) The copy of this document mailed to you is your
California Government Codes. ) notice of the action taken on your claim by the
Board of Supervisors. paragraph IV below), given
pursuant to Government Code Section 913 and
915.4. Please note all "volilallw
AMOUNT: $400ZEM)
APR 2 0 1998
CLAIMANT: Maria Ellison OOUNTY C4UNS�L
MARTINEZ CAUF.
ATTORNEY: DATE RECEIVED:
ADDRESS: 3016 Baywood Lane BY DELIVERY TO CLERK ON: April 17, 1998
San Pablo CA 94206
BY MAIL POSTMARKED:
1. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PHIL BATC OR, Clerk
Dated: April 17, 1998 By: Deputy
Il. FROM- County Counsel TO: Clerk of the Board o upervisors
,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: iDI` ,J By: 6.
� f Deputy County Counsel
IM 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 en ed in its miputes for this date.
Dated: � , i, '�' PHIL BATCHELOR, Clerk, By '� - puty Clerk
WARNING (Gov. code sdefion 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.
AF DAVff 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 PosW Service in Martinez, California, postage fully
prepaid a certified coley of this Board Order and Notice to Claimant,,Aressed to the claimant as shown above.
Dated: ''� By: PHIL BATCHELOR By e uty Clerk
CC: County Counsel County Administrator
Clam to; BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing craps 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 rause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code 5911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at itsofficein
Room 106, County Administration Building,, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal, Code Sec, 72 at the end of this
form.
aa * � a �ta � � aa � � aaaaa * artrtaa � aa � * * a � a * a � � � aa � � �
BE: Claim By ? Reserved for Clerk's filing stamp
.i RECEIVED
Against _W County of Contra Costa AFIR1 7 X98
or ,
�.
District) Rx s °
In n3Tie __ CC's". _ `TA C",;
The undersigned claimant hereby makes claim against the County of 'Contra Costa or
the above-named District in the sum of $ _ and in support of
this claim represents-as fellows:
1. When did the damage or injury occur? (Give exact date and hour)
....w...w.wr .r .0 .�.Yw...y..+.war....r«...,,..r..r......e,..........•....w�.
2. Where did the damage or injury occur? (Include city and county)
i'S AT� G-J
3. How did the damage or injury recur? (Give full details; use extra paper if
required) i C�a r" d - `� ;_tDt Agm, .
f
4-u_:. fes. �•. �-'.z- r
n
4. What particular act or omission on the part of county or district officers,
servants or ,employees caused. the injury or.damage?
J � � LAj t "
(over)
'. wnat are the names of county or district officers, servants or employees causing
the damage or injury?
V17 I
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
7. Hoer was the amount claimed above computed? (include the estimated amount of any
prospective injury or damage.)
Loq
R. Names and addresses of witnesses, doctors and hospitals.
UA
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
� �E iE !F IF � �F 1F,-�F ssiE � !F * � �F � -�F �.� � � �f !! � � •* � � !k !t * * � � * � � � iF
Gov. Code Sec. 910:2 provides:
_. .. _ "The claim must be signed by the claimant
SEND NOTICES TO : (Attorne or some erson on his-behalf."
Name and Address of Attorneys'
Claimant's Signature
D111,7
Address .
lei
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 imprisonmermt and fine,-or by imprisonment in
the state prison, by a fine of not exceeding ten thousand .doll.ars ($10,000, or by
both such imprisonment and fine.
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Rr-,SUB. T OTAt -344.
SUB"TOTAL
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TOTAL I-SWATC: _ 92
THIS IS_AWRIT N' QUr'TF ONLY
tsar-20 9a 11 14,A Mas n MI—cO iffiR PPM RQalty 510 75E �S Fa' Pof Gyj
faumL
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DATES
FROM: _
F&x NUIVOIER:
.NU'&19ER OF FACES INCLiU't IMG COVER
CONYT5:
A/a r
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CLAIM �
BOARD OF SUY' RyI ORR ( CONTRA 0051A CCI:ITNTY CA
BOAR.A00t� iii 1 , 1
Claim Against the County, or District Governed by ?
the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT
and Board Action. All 'Section references are to ) The copy of this document mailed to you is your
California Government Codes. ) notice of the action taken on your claim by ,the
Board of Supervisors, (Paragraph IV belov4, coven
pursuant to Government Code Section 913 and
915.4. Please note all
AMOUNT: $286.68
APR 15 1998
CLAIMANT: Christopher Gotsill 0OUN.r,+�COUNSEL
MART NEZ CALIF.
ATTORNEY: DATE RECEIVED:
ADDRESS: 4374 Dorset Court BY DELIVERY TO CLERK ON:
Concord CA 94521
BY MAIL POSTMARKED: April 13, 1998
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PHIL BATCHEL R, Clerk
Dated: April 15, 1998 By: Deputy �---'
H. FROM: County Counsel TO: Clerk of the Board of Supervisors
} This claim complies substantially with Sections 910 and 910.2.
( This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The
Board cannot act for 15 days (Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of
claimant's right to apply for leave to present a late claim (Section 911.3).
( ) Other:
Dated: � By: Deputy County Counsel
III. FRONL 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 tered in its minutes for this date.
Dated: ^, PHIL BATCHELOR, Clerk, By . / 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 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 MAH ING
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, ddressed to the claimant as shown above.
Dated: t. By: PHIL BATCHELOR By `" 1 Deputy Clerk
CC: County Counsel County Administrator
Claire to: BOARD OF SUPERVISORS OF CONTRA COSTA COU M
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action.. Claims relating to causes of action for death or for injury to person ;
or to personal property or growing craps and which accrue on or after January 19
1988, must be presented not later than sax months after the accrual of the Muse
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause of action. (Govt. Code 5911.2.)
B. Claims must be filed with the Clerk of the Beard of Supervisory at its office in
Room 106t County Administration Building, 651 Pine Street, Martinez, CA 94553•
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity,
E. Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this
form.
RE: Claim By ) Reserved for Clerk's filing stamp
EGET of
Against the County of Contra Costa ) APR 14 1998
or )
District)
MIT n name )
The undersigned claimant hereby makes claire against the County of Contra Costa or
the above-named District in the sum of $ -961 Q5 and in support of
this claim represents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
2. Where did the damage or injury occur: (Include city and county)
Y 7
3. How did the damage or injury occur? (Give full details; use extra paper if
required) '
�;rze 1 e 1(-f 0&1V �&� �>0 Frav7 ire &l04v, e&,' Atki-.T h4 �
ecl7 vlll OF `Twle_,1ny rl9hf Fitz T lli #S ev7 Dv a Sva��c �nrc�rC,�1-.�r�n lcssl
Sd 4V lou }# 41rre rvef rr3nyrpiilG �n �t►e rorgn ktlS f, «'jvf f Qin
.... .....air....u..........._...r............i...�...w._..rr..r.r _ .....,.,..ri_........w..:r..w,.....,....�.......,.�...�,r_��_...��rt,r�5,/�'',
4. What'partioular act or omission on the part of county or district officers,
servants ter ,eloyees caused the Injury or damage?
(aver)
�. wnat are the names of county or district officers, servants or employees causing
the damage or injury?
_ ------ --------- -------.r --r.r- r_. ------.r.rrr.f.+w.rr.r+ ---__.---
b. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
ZV;Alyd Wh-ce1, $Z6Wrg6 Rrf Aiew TC X7 rrvA:; Onmei5e t�N.7?t/ f�r1/tpfi�fcr6lL,.
rV'ec9-eO [ViCk ' ZilW,—,I t,5411'9 CALF of PVgl-),y OC06r–),
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.) Zb f�,q6 ---� v.-Aiey15 toO Qer neA,,
jZr NACJ~ fv7d'S ca4 4v pvi- •nc�/t7.d+,
JA4S kW- (Itjy PlIfeec �9-Ry-tUjc, mvcti CY n r i^cQr wr;;c-#h Gli ;-,
Names and addresses of witnesses, doctors and hospitals.
l iv rZa 64 `7ZISZ j
--_------- -----_.._____________.�._-......__..__��____..�.....___...._�.w..._....__-,.__...._..._..___
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT F/owl
.gZgfW 4�,(jV i-7"raivrrr t%v r;-.r) wh ee i I'M 7 S Z-A�8"9 b elvC l46evi%
$
;n5i�o-it,gripx> - f yob b� }at�tU
Gov. Code Sec. 910:2 provides:
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or b someperson on his.behalf."
Name and Address of Attorney ►
-� 'imantlb Signature
�37Y Da��:r Ct�vrr"
Address
C8`V(01,(1 e# OL15 2 f
Telephone No. Telephone No. 177-5 7cI'S'-12_,`71
* i
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if .genuine, any false or fraudulent
claim, bill, account, 'voucher, or writing, is punishable either by imprisonment in
the county jail for a period of not more than one-year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine,- or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars {$1090000 or by
both such imprisonment and fine.
.............................................................................................................................................................................
.. . .. .................................. .. . .... ....................................................
>
44
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rs
cz
4c, V3
�. CIAIM
BOARD ACTT 199
Claim Against the County, or District Governed by }
the Board of Supervisors, Routing Endorsements, NOTICE TO CLAIMANT
and Board Action. All Section references are to } The copy of this document mailed to you is your
California Government Cedes. 1 notice of the action taken on your claim by the
Board of Supervisors. (Paragraph IV below), given
pursuant to Government Code Section 913 and
915.4. Please note all "vima
AMOUNT: $15,000 (?)
wl%
APR 15 1998
CLAIMANT: Paul Hupp COUNTY COUNSEL
ATTORNEY: DATE RECEDED: MARTINET CALIF.
ADDRESS: PO Box 1046 BY DELIVERY TO CLERK ON: April 14, 1998
Alamo CA 94507
BY MAIL POSTMARKED:
I. FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PHIL BATCHELOR, Jerk
Dated. April 15, 1998 By: Deputy
H. FROM-. County Counsel TO: Clerk of the Board of Supervisors`
( This claim complies substantially with Sections 910 and 910.2. i
( ) 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 warring of
claimant's right to apply for leave to present a late claim (Section 911.3).
{ ) Other:
Dated: ` Z 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 9113).
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 e tered in its minutes for this date.
Dated: .'t o PHIL BATCHELOR, Clerk, By -,,-Deputy Clerk
WARNING (Gov. code sec ion 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, a0dressed to,the claimant as shown above.
Dated: By: PHIL BATCHELOR By - --....Deputy Clerk
CC: County Counsel County Administrator
Claim to: BOARD OF SUPERVISORS OF CMU COSTA CC)UM
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to person or to per-
sonal property or growing craps and which accrue on or before December 31, 1987,
mast be presented not later than the 140th 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 aeerual of the cause of action. (Govt. Cade §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 136, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims rust be
filed against each public entity.
E., Fraud. See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of this
farm.
RE: Claim By ) Reserved for Clerk's filing stamp
RECEIVED
AM 14 1P3
Against the ty of Contra Costa ) 119
or
CLERK BOARD OF v`_:
District] I SL0_N R-: ccs
71r3- in name
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above-named District in the sum of 1 ,. .._- and in support of
this claim represents as follows:
1. When did the damage-or injury occur? (Give exact date and hour)
2. Where did the damage or injury occur? (Include city and county)
�` 4„„ ��,✓ "*�..1 i�'`f �`/�,.,.3�.�r"<� ,� a . �, ,`' _,: , .. .-,"-:;.,,a`
lM.�YIi.MM.lWYaY.Mw6NMiMM� {rfaFlYY �.1l�ilitlY�Y'/i+�.iWa'..i�+�sMY+irMrwOa+l.N
3. How did the damage or injury occur? (Give full details; use extra paper if
required)
4. What particular act or omission on the part of county or district officers,
Servants oremplgoyees caused.- the injury or damage?
" 4-J et: i >', 3_jar !S
(over)
.................................
.... ......... .........
_._..... ............... ... _
........ ......... .........
..............................................................
.. ........................
�. wrnat are the names of county or district officers, servants or employees causing
the damage or injury?
� (� f i
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attach two estimates for auto damage.
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
8. Names and addresses of witnesses, doctors and hospitals.
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
*
_ >
Gov. Code Sec. 910:2 provides:
j "The claim must be signed by the claimant
SEND NOTICES TO: (Attorne ) - or by awe person on,his.behalf."
Name and Address of Attorney
Clai s Signature
Address
Cil A
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�for a period of not more than one year, by a fine of not exceeding
one thousand ($1.,000)1, 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..........I.....................................I................1.11'..,.........
........................................................
CLAIM aliy
BOA D- SORS OF CONTRA—COSTA COUNTY, CA IFO NIA
BOARD: AM M8y:.1Z::199&:
Claim Against the County, or District Governed by
the Board of Supervisors, Routing Endorsements, NOTICE TO CLAIMANT
and Board Action. All Section references are to The copy of this document mailed to you is your
California Government Codes. l notice of the action taken on your claim by the
Board of Supervisors. (Paragraph IV below), Oven
pursuant to Government Code Section 913 and
915.4. Please note all "Warnings".
AMOUNT: $51.30
CLAIMANT: Diana N. Jones APR 15 1998
COUNTYCOUNSEL
ATTORNEY: DATE RECEIVED: MARTINEZ CALIF.
ADDRESS- 2401 Glenlock Street BY DELIVERY TO CLERK ON: —April 14,1998_
San Pablo CA 94806
BY MAIL POSTMARKED:
L FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PHIL BATCHEk R, Clerk
Dated:–April 14, 1998 By: Deputy-<7 Y,",–
H. FROM: County Counsel TO: Clerk of the Board of Supervisors
This claim complies substantially with Sections 910 and 910.2.
This claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The
Board cannot act for 15 days (Section 910.8).
Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of
claimant's right to apply for leave to present a late claim (Section 911.3).
) Other:
Dated: By: 4A-WA� Deputy County Counsel
UL 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. 13OARD 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 e ered in its minutes for this date.
Dated- � PHIL BATCHELOR, Clerk, By eputt' Clerk
WARNING (Gov. code sec ion 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 MAU-ING
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: 0/
r-'By: PHIL BATCHELOR B Deputy Clerk
CC: County Counsel County Administrator
.................. ............
_. _. . ..._.... .............._.. .
......................................_...................... ... ...._. _...... _
_. ...._..._. ......... ...._.............
.........................................................
Claim tot BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAD ANT
A. Claims relating to causes of action for death or, for injury to person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for-death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrual of the cause: of action. (Govt. Cade §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its .office in
Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than
the County, the name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be
filed against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal. Code Seo. 72 at the end of this
form.
BE: Claim By ) Reserved for Clerk's filing stamp
} RECEIVED__
Against ER County of Contra Costa )
or ) WWWOimp W
;
District)
(pill rn name )
The undersigned claimant hereby mattes claim against the County of Contra Costa or
the above-named District in the sum of $ 6' and in support of
this claim represents -as follows:
1. When did the damage or injury occur? (Give exact date and hour)
17 Fx
2. Where did the damage or injury occur? (Include city and county)
",-)/o C_ k- -i -, - )"L 7,x-v Co
3. Flow did the damage or injury occur? (Give full details; use extra paper if
required)
�- A -
r
e 7— 4.41 LZe eL4Lt-
4. What partite act or omission on the part of county or district officers
servants or -employees caused.the.injury or.damage?
,x,/13
(over)
.........................................................................
..................................I........
.....................
Wnar, are tne names of county or district officers, servants or employees causing
the damage or injury?
Jarcd le
6. What damage Or injuries do you claim resulted? (Give full extent of injuries or
damages-claimed. Attach two estimates for auto damage.
/*
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
8. Names and addresses of witnesses, doctors and hospitals.
–—---------——----—
9. List the expenditures you made on account of this acAMOcidentUNT or injury:
DATE ITEM
_4
Gov. Code See. 910.2 provides-.
"The claim must be signed by the claimant
SEX) or b some Lwxson on his behalf."
_y
Name
Claimant' Si tore
. -(Address)!
i 4a III zl"'
Telephone No. --- Telephone No.
4* T-1 I V FN V W N I I
NOTICE
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, Or to any county, city or district board or
offieerp authorized to allow or pay the same if _genuinev any false Or fraudulent
claim, bill,, accountt voucher, or writing, ispunishableeither by imprisoriment In
the county jail-for a period of not more than one.yearg by a fine of not exceeding
one thousand ($1too0)1, or by both such imprisonment and fine-9or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000t or by
both such imprisonment and fine-
..........................
..........
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TIRE E&ESS 835 A Street 160 Concord Ave
rn.petMMn oats »rhe cs^ Hayward,GA Concord,CA 94520 NUMBER
(510)561-6020 (510)691-1400
FAX(510)581-2308 FAX(510)609-1605 PAGE
31 Pitt imeiy DATE
Rlcbmors1,EA SALES AS
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FAX(510)222-216P
1 Pitt Way
:1 Spb an e, CA 94803
SHIP To:
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CLAIM
BOAR ID OF SUPER SORS Of CONTRA Q051A COUNTY, CAI LEORNIA
BQMD ACTit t^May 12, 199$
Claim Against the County, or District Governed by
the Board of Supervisors, Routing Endorsements, NOTICE TO CLAIMANT
and Board Action. All Section references are to The copy of this document mailed to you is your
California Government Codes. l notice of the action taken on your claim by the
Board of Supervisors. (Paragraph IV below), given
pursuant to Government Code Section 913 and
915.4. Please note all "Warnings".
Et*7 1,
AMOUNT: $4348 t.r)R 31998
CLAIMANT: Bertha & Chester Sims COUNS��L
ATTORNEY: DATE RECEIVED: V N 4T11 YN Iff C A L
ADDRESS: 888 Carpino BY DELIVERY TO CLERK ON:
Pittsburg CA 94565 BY MAIL POSTMARKED: April 11, 1998
L FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
PHIL BATCHEL ' Clerk
Dated: April 13, 1998 By: Deputy
H. FROM: County Counsel TO: Clerk of the Board of SuWrvisors
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: �/Jy ____By: Deputy County Counsel
M. 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:
brC This Claim is rejected in full.
Other:
I certify that this is a true and correct copy of the Board's Order en 'red in its minutes for this date.
Dated.
PHIL BATCHELOR, Clerk, By
;Deputy Clerk
WARNING (Gov. code section 913)
Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposited
in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an
attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so
immediately. *For Additional Warning See Reverse Side of This Notice.
AFFIDAVIT OF MAMING
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
...............................
Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMA� N
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 I40th day after the accrual of the cause of action.
Claims relating to causes of action for death or for injury to person or to personal
property or growing crops and which accrue on or after January 1, 1988, must be
presented not later than six months after the accrual of the cause of action. Claims
relating to any other cause of action must be presented not later than one year after the
accrual of the cause of action. (Govt. Cade §911.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room
106,County Administration Building, 651 fine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors,rather than the
County,the name of the District should be filled in.
D. If the claim is against more than one public entity; separate claims must be filed
against each public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form.
RB: Claim By } Reserved for Clerk's filing stamp
}
Bertha&Chester Sims :}
} t 4
Against the County of Contra Costa
t3f' �d# :
or � �4f �
The Housing Authority of Contra Costa (District)
(Fill in name)
The undersigned claimant hereby makes claim against the County of Contra Costa or the
above-named District in the sum of _ ` V9, 02 and in support'ofthis claim
represents as follows:
} L "' a > 97
1. When did the damage or injury occur? (Give exact date and hour)
f t
2. Where did the age or injury occur? Onclude city and county)
3. How did the damage or injury occur? (Give full details; use extra paper if required)
,�
4.1 What particular act or omission on the part of county 6f distri t officers, servants or
employees caused the injury or damage? 10p,6-/-fi w zff3abie 4-b resc>j
clmform ,
5. ghat are the names of county or district officers,servants or employees causing the
damage or in�j�ury?( .--7 row r' V,f���
tt1Gt' C:lL` c ^ ? /al t trI7�
b. What damage or injuries do you claim resulted? Give full extent of injuries or
damages claimed. Attached two estimates for auto damage.)
eC ! -1 ' t2.a i � v u.s T! ske 9s Medea' Grl /-Erz�,
fd , � � ri 12r
j1A
7. How as the amount claimed abo computed`? (Include the estimated amount of any
prospective injury or damage,)
le4e
R r f } {lLf2 aCk /7LL �G`-tom rj�'..y"GG'
0.
8. Names and addresses of witnesses,doctors and h spitals.
9. List the expenditures you made on account of this accident or inj
DATE ITEM AMQUNT
Gov. Code Sec. 910.2 provides.
"The claim must be signed by the claimant
SEND NOTICE TO: (Attorney) or by some person on his behalf."
Name and Address of Attorney n
A --i
W��,,1��,�G✓�''L'� '
(Claimant's Signature
(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 for 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."
Omform
} «off"
City of Pittsburg
Civic Center • P.O. Box 1518 • Pittsburg,California 94565
Community Development Department
Engineering Division
'hone(510) 439-4930
FAX(510)439-0527
December 9, 1997
Chester Sim
Resident
888 Carpino Ave..
Pittsburg, California 94565
RE: Water inundation
Dear Mr. Sims:
In response to Councilman Federal Glover's request of December 1, 1997; the Pittsburg
Engineering Division investigated the water inundation at the sports field located at 875 El Pueblo
Ave. which you and your neighbors reported out of concern for the damage it could cause.
We found that: (1) the inundation was due to a County water pipe;leakage; (2) that the
County's Housing Authority Department was aware of the damage; and (3)that steps were being
taken to repair it.
We hope that the information we were able to gather addresses your concern. If you have
any further questions concerting this matter,please call the County's Housing Authority Department
at the following telephone number: (510) 372-0795 Ex. 40, the contact person at this departmennt
is Ron Gu'`Iden.
Sin r ,
riser Shirazi r.,.
Community Dev llq meat Department/City Engineer
xc: Federal Glover,Councilman
leffxr-ey Kolin,City Manager
Wallace E.Girard,Assistant.City Engineer
Alfredo Hurtado,Assistant Civil Engineer
b:\Glover\sims
California Healthy Cities Project ^A�A,
National Center for Public Productivity Exemplary Award- 1993
City of New Horizons
Y
Residential and Commercial
Installation & Renovations
Irrigation Specialist with 18 Years of Experience
License #732212
Office: 432-9247 Pager: 753-7159
MR.SIMS
888 CARP'INU AVE
PITTSBURG,CA 94565
FEBRUARY, 19 1995
This is a bid proposal to do the following work at your property:
Located at this address»888 CARPING AVE,PITTSBURG,CA
Remove existing fence in back yard and replace with new fence
also install a (2"x12"x50 ' )retaining wall to prevent; water run
off from housing authority park.
Install (3"x2OO ' )corrugated pipe french drain to control further
flood problems in back yard.instail at least (4 )four' catch basins
along back area run pipe all the way to walk way in front by
street.this is needed for controlling future flooding in back
yard.
all of the wood used to perform this job will be treated wood
will need at least two yards landscape sail for retaining wall
and also for garden area to replace what was lost with flood.
also will need about one and a half yard drain gravel for french
drain to function propertly.
Will perforin all of the above work which includes,labor,materials
and dump fees.for the sum of.$1848.00 one thousand eight hundred
forty eight dollars.
TERMS must pay one third before work is to be started.
ACCEPTANCE OF PROPOSAL.
AUTHORIZEDSIGNATURE. . . . . . . . . . . . . . . . . . . . . . .DATE. . . . . . . . . . . . .
FRED GUTIERREZ/OWNER/DELTA LANDSCAPING.
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