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HomeMy WebLinkAboutMINUTES - 03182003 - C7 CLAIM S, P RVI RS OFQQNIR A Q2STA CO (r+r BOARD Ag:noN: mar eh IB,. 2043 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 below), given Pursuant to Government Code Section 913 and 915.4.Please note all"Warnings". AMOUNT: $776,396. FEB 13 2003 CLAIMANT: NANCY BRE6 STII2 MARTINEZ COUNTY COUNSEL T INE.Z CALIF. ATTORNEY: RICHARD A. FRANKEL DATE RECEIVED: FEBRUARY 12, 2003 ADDRESS. 375 DIABLO ROAD, SUITE 200 BY DELIVERY TO CLERK ON: FEBRUARY 12 2043 DANVILLE, CA. 94526 BY MAIL POSTMARKED: HADD DELIVERED FROM. Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. FEBRUARY 13, 2043 JOHN SWEETEN C Dated: By De u � , 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 91{1.8). ( ) 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. L. 1 De uty 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: a) This Claim is rejected in full. { ) Ot�rer: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: MLRCH 18, 2003 JOHN SWEETEN,CLERK,By , Deputy Clerk WARNING(Gov. code section 91 Subject to certain exceptions,you have only six(6)mobths 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 clamant as shown above. Dated: MARCH 19, 2003 JOHN SWEETEN,CLERK,B , ' Deputy Clerk Office of the County Counsel Contra Costa County 651 Pine Street, gth Floor Phone: 335-1800 Martinez, CA $4553 Fax: 646-1078 RECEIVED Date: February 12, 2043 FEB 12 2003 To: Clerk of the Board of Supervisors , CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. From: Silvano B. Marchesi, County Counsel , By: Gregory C. Harvey, Assistant County Counsel Subj: Claim of Nancy Brewster Attached please find a letter from Richard Frankel to me dated August 6, 2002, After receipt of this letter, I wrote to Mr. Frankel indicating that if he wished, I would treat the letter as a claim and send it to the Cleric of the Board to be treated as a claim dated August 6, 2002. On September 4, 2002, Mr. Frankel wrote to our office requesting that we treat the August 6, letter as Ms. Brewster's claim. Apparently, due to an oversight, Mr. Frankel's of August 6, 2002 was not sent to the Board as agreed. Because of our error, the letter of August 6, 2002 should be treated as a claim with an effective filing date of August 6, 2002 as agreed by the parties. All objections as to timely filing of this claim as to matters arising more than six months prior to the effective fling date (August 6, 2002) of the claim are reserved. Please put the claire on the agenda for board action and handle in the usual manner. Suit has already been already filed. cc: Monika Cooper, Deputy County Counsel Sharon Hymes-Offord, Assistant Risk Manager Richard Frankel, Esq. 1:1TORTICASESIFORMS%MEMOIMEM-STND,WPD L (I k !A W O F F I C E 51 FRANKE F L 0 u D '`A j F L P I ?IC 1 RD A.FRANKEL Of Counsel THOivIAS E.l IENZE :`.T-'r-.:.LLE R.FFRBER IRSTFI'.?E•RATrI Br'.fikANTl RICHARD A.F'RANKEL frankel@danvillelaw.com x16 August 6, 2002 CONFIDENTIAL Via Certifted Mail Return Receipt Requested Silvana Marchesi,Esq. ContraCosta County County Counsel 651 Pine Street, 9th Floor Martinez,Califoniia 94553 Re. Nancy Brewster Dear Mr. Marchesi: We represent Nancy Brewster, a Contra Costa County"contract employee,"in evaluating her status with Contra Costa County. Ms. Brewster has been classified as a"contract employee" since her return to Contra Costa County, In 1992,Ms. Brewster left her position and took an early retirement. In 1993, at the request of the County,Ms. Brewster returned to her prior position as a mental health administrator,but as a"contract employee." Ms. Brewster never converted from a"contract employee"to a Contra Costa employee because she was told she would forfeit her previously earned retirement benefits. We believe that Ms. Brewster's status as a contract employee is contrary to case law and California's Civil Service Mandate,which prohibits private contracting, if those services are of the kind the person selected through the civil service system could perform competently and adequately. State Camp. Ins. Fund v. Riley(1937) 9 Cal.2d 126. Ms. Brewster is the only senior level person holding management responsibilities in her division who is not a Contra Costa County employee receiving benefits that are provided to other senior level managers. Instead of receiving a form 1099, Ms. Brewster receives a W2 form,which reflects the mandatory withholding for federal,state and social security taxes like all other Contra Costa County employees. In addition, Ms. Brewster's paycheck reflects that Contra Costa County is covering her under their workers' compensation insurance plan, although Contra Costa County classifies -C.:.I�' j 831-C155 E-t�!:<_IL;franl:el�danvt11F1z.,:coir: Silvan Marchesi August 6, 2002 Page 2 her as a contractor. Finally, at the direction of her supervisor, Ms. Brewster was required to draft a job description for her replacement,which will be classified as a regular Contra Costa County employee. These items demonstrate she has been improperly classified and that she should be an employee receiving appropriate benefits rather than a contractor. Ms. Brewster has suffered a significant economic loss related to her status as a contract employee. We have attached a forensic analysis that sets forth her substantial economic loss to date. Please contact me after you have reviewed this information. Ms. Brewster is willing to discuss an appropriate financial resolution that avoids litigation. Thank you for responding to me no later than August 30, 2002. Very truly yours, Richard A. Frankel RAF/pc Enclosure cc: client 1ABrewster,Nancy\Ltr County Counsel re NB.doc i 16-May-02 NANCY BREWSTER - ECONOMIC LOSS SPECTRUM Case H Date of Birth: 03-Jan-42 Start Date of Loss: 15-Feb-93 Earninys with Emyloyee Status Earnings with Contractor Status Fringe Fringe Present Year Mo Wspes Benefits Total Wages Benefits Total Difference 'Value Past 1993 $62,153 $4,161 $66,314 $37,552 $2,328 $39,880 $26,434 $26,434 1994 74,624 4,387 79,011 46,896 2,908 49,804 29,208 29,208 1995 78,695 4,499 83,194 38,430 2,383 40,813 42,381 42,381 1996 81,996 4,592 86,588 51,663 3,203 54,866 31,722 31,722 1997 83,6_24 4,880 88,504 77,582 4,055 81,637 6,867 6,867 1998 85,615 5,066 90,681 86,514 4,241 90,755 (74) (74) 1999 88,941 5,414 94,354 93,093 4,701 97,794 (3,439) (3,439) 2000 92,927 . 5,557 98,483 82,941 4,724 87,666 10,818 10,818 2001 95,952 5,817 101,769 90,939 4,985 95,924 5,845 5,845 2002 5 41,167 2,899 44,067 39,750 2,465 42,215 1,852 $1,852 Future 2002 7 57,634 $2,121 $59,756 $55,650 $1,814 $57,464 $2,292 $2,260 2003 98,802 6,096 104,898 95,400 5,264 100,664 4,234 4,072 2004 1 8,233 570 8,804 7,950 493 8,443 361 347 Past Earnings Loss: $151,614 Future Earnings Loss(PV): $6,678 Total Earnings Loss(PV): $158,292 Past Pension Loss: ($55,401) Future Pension Loss(PV): $673,505 Total Pension Loss(PV): $618,104 Pre-Judgment Interest: $74,892 TOTAL ECONOMIC LOSS(P'): $776,396 SPECTRUM ECONOMICS INC . 201 San Antonio Circle,Suite A-105-Mountain View,CA 94040-(650)949_9590-Fax(650)949-2201 website:wwwspececon.com Comments and Assumptions Case II Earnings with Employee Status 1. New employment on February 15,1993 2. Entry wage rate equal to$32.31 per hour and wage rate effective on October 1,2000 equal to$44.55,per information provided by Ms.Brewster 3. Interim wage rates estimated for 1993 through 1995 and based on actual C©LA.adjustments approved by the Contra Costa County Board of Supervisors thereafter: 7/i/96 3.0% 10/1/99 5.0% 10/1/97 2.0 10/1/00 3.0 10/1198 3.5 10/1/01 4.0 4. Wages also include Management Longevity Pay,equal to 2.5 percent of base wage rate,based on Board of Supervisors Resolution 5. Fringe benefits considered include employer's contribution to Deferred Compensation plan,Professional Development Reimbursement,and Social Security b. Employer's contributions to Deferred Compensation and Professional Development Reimbursement based on terms of Board of Supervisors Resolutions 7. No account of Annual Management Administrative Leave 8. Retirement at age 62 9. Net discount rate equal to 2.5 percent,used to compute the present value of future earnings,is equal to the average historic difference between the interest rate on three-year U.S.Treasury bonds and the average increase in U.S.worker compensation Earnings without Employee Status 10. Earnings in 1993 through 2001 from W2 earnings statements from County of Contra Costa 11. Earnings in 2002 on based on payment limit shown in Contract between Ms.Brewster and the County of Contra Costa,effective July 1,2001 and June 30,2002 12. Fringe benefits limited to County's contribution to Social Security 13. Retirement as described in comment seven,listed above 14. Net discount rate as described in comment eight,listed above Pension with Employee Status 15. Pension commencing February 1,2004 based on terms of Tier III CCERA 16. Account is taken ofyears of service prior to February 15, 1993 in calculation of expected pension 17. Duration of future pension payments based on Ms.Brewster's statistical life expectancy of 23 years,from "Vital Statistics ofthe United States 1998",published in the Statistical Abstract of the United States.2001 18. Net discount rate of 2.5 percent,used to calculate the present value of firture pension payments from not tow date of retirement,as described in comment eight,listed above 19. Net discount rate of 2.9 percent,used to compute the present value of future pension payments from date of pension receipt on,is equal to the average historic difference between the interest rate on three-year U.S. Treasury bonds and the average increase in Consumer Price Index Pension without Employee Status 20. Pension payments equal to$426.45 per month,from CCERA pay stub,plus annual COLA adjustments in April 21. Duration of payments through January 2004 22. Net discount rate of 2.9 percent,used to compute the present value of future pension payments,is equal to the average historic difference between the interest rate,on three-year U.S.Treasury bonds and the average increase in Consumer Price Index General 23. All future figures shown in current dollars 24. No account of possible additional out of pocket expenses for medical and dental insurance 25. Pre judgment interest computed on past earnings losses minus past pension payments received using ten percent simple interest rate ti CLAIM#- COQUR . T + BDA„ AMC?„N: �, � flrrl I��w�i.�1rI�Irii�W IAM■Y.ha 4 x 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.Governmont 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 s�W�gsr� AMOUNT: $50,000. 2gyp 915.4. SEB .1 3 2003 CLAIMANT: WALTER L. HILL COUNTY COUNS i, - ATTORNEY: PETER C. PAPPAS 1tsSAR'CtPdEZ CALIF. DATE RECEIVED- FEBRUARY 13, 2003 ADDRESS: LASS OFFICE OF PETERC. PAPPAS BY DELIVERY TO CLERK ON: FEBRUARY 13, 2003 2400 SYCAMORE DRIVE, SUITE 40' ANTIOCH, CA 94509 HADD DELIVERED BY NAIL POSTMARKED: FROM•. Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETENl94 Dated: FEBRUARY 13, 2003By: De uty H. FROM: County Counsel TO Clerk of the Board of Supervisors (v�This claim complies substantially with Sections 910 and 910.2. { } This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant.The Board cannot act for 15 clays(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: '/ y By- DMut Counsel M. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2) { } Claire was returned as untixnel with notice to claimant(Section 911.3), IV. BOARD ORDER: By unanimous vote of the Supervisors present. {X} This Claim is rejected in full. { } Other: I certify that this is a true and convect copy of the Board's Order entered in its minutes for this date. Dated: MARCH 18, 2003 JOHN SWEETEN,CLERK,By Deputy Clerk WARNING{Gov.code section 91 Subject to certain exceptions,you have only six{h}motiths from the date this notice was personally served or deposited in the snail 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 ixnmediatel . *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF FAILING 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 clamant as shown above. Dated: MARSH 1922003 JOHN SWEEM,CLERK By Clerk Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO 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 1 a4Ls 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 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 106, County Administration Building,651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors,rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp --WALTER L. HILL } } EE - . Against the County of Centra Costa or ) =13District) CLOF SUPt'iV?SORs (Fill in name) CONTPA COSTA CO, } The undersigned claimant hereby snakes claim against the County of Contra Costa or the above-named district in the sum of S -5 9 r 900. and in support of this claim represents as follows- 1. When did the damage or injury occur?(Give exact date and hour) October 30, 2002 at 6:00 P.M. 2. Where.did the damage or injury occur?(Include city and county) Marsh Creek Road, Brentwood, Contra Costa/Delta unincorporated 3. How did the damage or injury occur?(Give full details;use extra paper if required) Hill was driving on west bound March Creek Road. Roadway castruction was in the area and a pile of asphalt and gravel were in the west bound traffic lane. No .signs directing traffic, or indicating change in roadway, were posted. Hill collided into the pile of asphalt. H-a 4. N4 hat particular act or omission on the part of county or district officers, servants, or employees caused the injurer or damage? Failure to post signs, cones and notice of road construction. 5. What are the names of county or district officers, servants,or employees causing the damage or injury? Contra Costa County Road Works 6. What damage or injuries do you claim resulted?(Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) Property damage $6,600. Ambulance $846. Mount Diablo $ 1 , 167. Injuries to Hill ' s back, neck and nervous system. Lost wages $ 2, 500. 7. How was the amount claimed above computed?(Include the estimated amount of any prospective injury or damage.)' Medical billings and propety damages estimates. 8. Names and addresses of witnesses, doctors, and hospitals. Mt Diablo Medical. Center, Concord, Ca Jack Townsend, 46644 Rishell Court, #1 , Concord, CA 94521 9. List the expenditures you made on account of this accident or injury. DAM 11E AMQIM 11 /02 Lost wages $ 2,500. 11 /0,2 medical $ 2,013. 11 /02 property damage $ 6,600. ) Gov. Code Sec. 914.2 provides"The claim must be ) signed by the claimant or by some person on his behalf." N—D NQBCES IQ: Name and Address of Attorney ) PETER C. PAPPAS LAW OFFICE OF PETER C. PAPPAS 2440 Sycamore give, Suite 40 ) (Claimant's S ` ature-) Antioch, CA 94509 ) PETER C. PAPPAS for WALTER L. HILL 2400 Sycamore Drive, Suite 40 Antioch, CA 944 yens) (925" 754-0772 Telephone No. ( 925) 754-0772 Telephone No. ;925 754-7183 facs N0710E Section 72 of the Penal Code prwAdes: Every person who,with intent to defiraud,presents for allommoe or the payment to any state board or officer,onto any county,city,or district board or officer,authorized to allow or pay the same if genuine,any false or fraudulent cbim bill,account, voucher,or writing,is punishable either by imprisontt nt in the county jail for a period of not more than one<year,by a fine of not exceeding one thousand(S1,0 00),or by both such irnpr soumcnt and ire,or by imprisonment in the starts prison,,by a fine of not exceeding tan thousand dollars($10,000),or by both such imprisonment and fine. A=R Arnedean Med€cal Response W :ST PATIENT NAME �A 22 77 0^' ACCT# 0t��6 €4 9 J DATE OF SERVICE 10�f A L T c k L. � . L AMOUNT DUE / /? �„+'� • C C,. 1 4 y DUE DATE 4.A L T t n i L REMIT PAYMENT TO: PLEASE CHARGE My: 0 VISA n MASTERCARt7 ACCOUNT EXPIRATION DATE SIGNATURE PLEASE DETACH AND RETURN THIS PORTION LEYOURPAYMENT AS ENTER AMOUNT T PAID: PATIENT NAME ACCOUNT NO. TRIP NO. INVOICE DATE AALTiR L. BILL 'nr 47' R {. F r'• c� _: L L 4 t. -�YYt 4 T i w Y HATE OF SERVICE SERVICE FROM I, w 4 SERVICE TU e L. V it 43 hli TY OPJT4 i - IMPORTANT MESSAGES CODE DESCRIPTION UNITS UNIT CHARGE ! FTOTAL CHARGE A ALa9 � --4FREY FiCek"r, : U A1 �r�L5 AajEa.. y T `rL ? .7 7 ,2. 7 13 .,07 TO AL CHARGES DUE CALL rt�:iJDy 9 a :u5 t nt1 IAuRvSiS. M � 1 c1C SEE REVERSE SIDE FOR INSURANCE INFORMATION AND CUSTOMER SERVICE INFORMATION H :" TAX 1C.- 77,3'47-3c Keep This portion for your records. ...T. "y s. r ..... .... ..... .... .. .. .. PAGE P *vd wam tscn on 7Yfi*E C opt 140 r11 w"Wd*for credit card payMwtg r .f7 PATIENEll ? .,r. PATIENT ACCOUNT NO; AL'MISStC)N LIATE ISCHARGE HATE B#!##t+l�#OAT& QUARANTOR ?�,A v }'.S r y a , i 7 } ,.x . INSURANCE COVERAGE a Y N 4 w„.? r r: POLICY Af12, T?fxl .. t r„, •..a r r.�5 11 ” SERVICE DATE SVC.CODE DESCRIPTION CPT Cooi--1 OTY AMOUNT tx I,.�s {1 r.•C"'I'"":. �"''"' i � f "{ is 1d 7 .Pr. T. D1ABLO MEDICAL CENTER ff`�tYiti:4 i { t I 77715(1141) • RETURN TOP PORTION WITH YOUR Rl MITTANCE, TOTAL INCLUDE PATIENT ACCOUNT NUMBER ON YOUR CHECK TOTAL CREDITS * RETAIN BOTTOM PORTION FOR YOUR RECt?RAS, TOTAL DUE ESTIMATED INSURANCE COVERAGE i ! � 7 n c FOR LABORATORY SERVICE+SE+R,CRIPTION Ft"7LtOWED BY A LETTER,SEE REVERSE MME OF BILL FOR # � 7 ,�f� IDENTIFICATION OF�ERENCE LAOS,REFERENCE LAB TESTS INCLUDE A HANDLING FEE OF 82300/LAS. iEH- -2003 12:13 FROM: Tp:9257547183 P.001 0tl2 l C Auto Pr"h" w9h Contra C WA Blvd.Suitt E Plewat E6111,CA 9457 (92"MS78 Pax-(925f "579 ARDN AF1.79726 astaiaer: waiter Hili Serviea Writer: C.BACIGALUPI sfdr+acs: Service Tach: C.BACIGALVPI 4y,Statti f?UWANT ALL,CA 94523 sy Phone VW'. phoet. iKitrW: Waste Ref:1009 atw Itebruary 03,3.003 arae: 09:58 AM Miele: 1992 Chavrolet Lumina V6-1913.IL "criptim Part#/Labor Rate Qty Priedrimt Extwdad 41 Pan M Fan 24504719 t 93.05 93.05 &*]we(13) LAbor 85.001 hr 1 3.40 289.00 ki Pan Castro Oil Pan calke 10/51654 1 23.95 23.95 )a piper Cki Wtv 251..71377 1 5.23 5.28 Price rar Estiraathq Purrpmes 0*. ;xc�etor With AC With 4 Speed Trsas With XD Cooling 52460747 1 354.81 354.81 Aran Frans(C) Labor 85.001 hr 1 1.70 144.50 :croft Pao Motor rw M61ur JU& 22134671 1 65.74 65.74 Price for Eatineatin8 FUIVMS On y. Left 22/37318 1 9592 95.92 Price for 95*utthtg Purposes Only. Replace t Dual Pan Both Sides(B) Labor 85.001 hr 1 1.00 85.00 tadistor go" Lower Radiator Hose 10228349 1 19.74 19.74 Replece Lower(;C) Labor 85.901 fir 1 0,80 69.00 Note Vft A.I.R.Pump,Add(C) Labor 85.001 hr 1 0.30 25,50 :o0ww System service ar Chau(C) Labor 85.001 hr i 11120 102:00 1` dudes:Press Tft System for Leaks,Check Derr mstat And,Hester Operation„Chace All Bft,Drano Aiad 13 9h System And Add Coolant. "Awdeusw HVAC Condeftor 52452050 1 239.89 239.89 Price for Z timsting Furpow only, R"lue Aute Trans(B) Labor 85.001 hr 1 2.00 170.00 Does Not.T.nchtde.Ra fteraui Rftovery()r Evacme& Rear wge AC Syatt ........................... ...................................... ):ES-03-2M 1Fa13 FROM: TO.9257547163 P.002/w2 wing wul Air Conditioning, Fw3h(3) Labor 93.00/hr 1 0.30 25.50 To as Used las Cost uwtlon With Comfit Rep#s+fcxa tent Which Could Cantaminato System Don Not Include: Evacuate&Reclmp System.Many Vehieki Are Now Using R134 Re**wt wt Ina The At System Extra Gina Mot Be f3l*rod When Sarum Tbia Type Of System.R12 Refffi$vrant MUST NOT Ba Uaed.See Manufacturers SwAco Manual For Specific Rqmk Proc edurea.With Any Opsrsttion Regt*ft A RoffigWaut Lim Disoonnem,,Add AC Service, LE.Evamam Red"And,,rest For Lealm Add Fon Refrigeru t Coen.Ensure Proper Rufrigarant Is Used to Vehicle S41vicei Evacuat&?=hwV Evacaate&Radwse Syste(a) Labor 85.00/hr 1 1,40 119.04 harry Vehicles Are Now UftR 134 Ra igcrant in no AC System..Raftiaw ut Typic Must Be Verified:Prior To SerulciuS System. R12Rafterzat 14#W 140T Be Used In Any Systan Equipped WA 8134 amara.See M&rwlhe tum Servim Mwid For Specaflc Repan' Procedures.Wath Any OpwaOft RoquW%A Rofrige ram Lift t?Wonnecte Add AC SwAw,I.E.Evecsrate, Rechup And Test For Leaks.Add For 1itffiguant. Recover('9) Labor 85.00 i hr 1 0.40 34.00 To Be Used In Conjunction V th Component Repla=nt WIsieh Could Conaftnats Systaft Does Not Ittctu%: Btitacttato&RrOWV System.Add For Wfterant Coat. Bowl*Prppet Re Brant Ts Us">1n Vehicle Serviced. :ron-maker Rear suspension Support 10062954 1 274.77 274.77 RVIACO --Prout(A) Labor 85.40 r hr 1 +4.30 352.50 ►1*=M Align Front Whorls Alis *ant(B) Labor 65.40 t hr 1 1.20 78.00 W4umutator HVAC' Accumulator 2724686 1 101.09 101.09 Prier for Istimades purp►oees to*' Front COP (used] 1 1200.00 1200.00 Labor Labor 85.401 hr 1 8.00 680.00 PAINT 1 1740.00 1700.00 Labor Total 2203.00 .Parts Total 2474.24 Nott-RIAble Total 1700.00 Sub-ToW 6377.24 farts Tax &25% 204.13 Total $6591,37 'funk You foot Choosing Auto Pro-Shoot All.Estimates aro Goat!for 30 Days: w 1� r { '�y +"•' h '� ,f'f' t t r. f ry ,n ��� �� , :aS S.' > is . r r 3�• .,b.�y }'a.�,, Yyt p •vvi i s n�}+j / {n 5 �S =.'c .lam y 5 ,,t.f �. �'� r rf 3'7 b• r,.{ �` �a 6��cw � ,� . r O r r.,/ � Y �'i<'{,.wq �� 9 � f �4� T•_y24fr�``'Ailr 'r+T'^Yt �far.,>�i+} • It t " ahs ;. � �: ass, .• �4� „ q;<f cr5`f �kN45•,M a�j 1 r�"'^'S` _ � fh"c � sr e .� ��h{ q y��'`''tom ••� Zrr�"'t"11rlY v r Y{. � ..;;. f br x,c�? +3,4br < � I 5 {ba✓ � r F � " _. ...,... .d �....,.,,vna�6ti6ic.nn,.,ow,..,:M,..,.,..,��.,. tai.}.n...,�i Lo-,car%ftre !�A'9,e x✓'- 3. Fav.f , ADDITIONAL AUTHORiZED SERVICE fi r r,. ,. d .... >GI 3`f f? �}•�c3�G�8��-A�n'n' ri'>n ��. �,'��, �Z. �'r°'� '��2 � # I7 � �j'a`{��f{���,k ,e�•f,'. y S � f:. t ''}}.. . +=Y.. .. _ cR�55CCOLLISION REPORTA1a I 42page Iof 10 SPECIAL CONDITIONS. .. +"T+' CITY JUDICIAL DISTRICT LOCAL REPORT MAWR :. facet 1 UNTNCORPORATED DELTA 1XI MIXAZO M yron COUNTY REPORTING DISTRICT BEAT 10408 ' 0 CONTRA COSTA 77 COLLISION OCCURRED ON: MD DAY YEAR TIME 12400) NCIC a O"KER 1.0, Z MARSH CREEK ROAD 1013012002 1800 4320 015454 0 MILEPOST ROORMATKSN:. DAY OF WEEK TOW AWAY PHOTOGRAPHS BY: �� .NONE WEDNESDAY X YES NO _. X:AT INTERSECTION WITH: M .. STATE KWY REL PINE LANE tf 0✓ YES X ND PARTY DRIVER'S LICENSE NUMBER STATE CLASS. SAFETY =YEAR /MODELlCOLOR tICENSE MIMBER STATE A1343372 CA C G LUMINA GRY -- 3AQH403 .._ CA_. . DRIVER NAME(FIRST.MOVLE.LAST) X WALTER LADELL HILLX OWNER'S NAME ^`SAME AS DRIVER PEDES STREET ADDRESS �. 31.2 HERON DR. OWNERS ADDRESS :SAME AS DRIVER. .. PARKED CTM I STATE.I LP VE)DCLE PITTSBURG CA 94565 DISPOSITION OF VEHICLE ON ORDERS OF: OFFICER :DRIVER OTHER 4CU$F SEX JR4M EYES HEIGHT wEIGtiT e1RT TE Ywr RACE ETtANKS TOW'(925)689-9540 -^+ PRIOR MECH.DEFECTS NONE APP. i J REFER TOmARRATIVE M BLK IBRN 6-03 22.5. OI12411933 X OTHER NOME PHONE _ BUSINESS PHONE VEHICLE.W&,rr FICATION NUMSM (925)427-4055 (425)672-5700 CNP USE ONLY DESCRIBE VEHICLE DAMAGE SHADE W DAMAGED AREA INSURANCE CARRIER POLICY NUMBER VEHICLE TYPE UW —NONE X MINOR npvxY PROGRESSIVE 61620554-4 01 MOD _. MAJOR ROLL-OVER (! Om OF TRA - ON STREET OR HIGHWAY SPEED LIMIT { � DOT W MARSH CREEK ROAD 35 CAL•T TCPIPSC MCNX +PARTY DRIVERS LICENSE NUMBER STATE CLASS SAFETY :VEH.YEAR MAKE I MODEL 17M LICENSE NUMBER STATE l . ... . .. .... . ........... ---------- ---- - - 'DRIVER NAmifFIRST.MIDDLE.LAST) - OWNERS NAME SAME AS DRIVER iP£OES. .STREET ADDRESS i ..__ OWNERS ADDRESS _... SAME AS DRIVER !'ARKEO Cry I STATE ZIP VE!tCLE DISPOSITION OF VEHICLE ON ORDERS OF..: —_OFFICER —'DRIVER .OTHER ! BICY• $E.it -IR JEYES HEIGHT WEIGHT StRTHOATE RACE ._._ ..... .-.�- CUS-t,T Mo Day Yfas PRIOR M'ECHANICALOEFECTS :NONE^PP. Ii FtEFERTO.NARRATIVE OTHER NOBLE PHONE BUSINESS.PHONE VEHIG'£E IDENTIFICATION-NUMBER' i ' CNP USS ONLY. JOESCRIBE VEHICLE DAMAGE," SHAVE W OAMAOEO AREA t, INSURANCE CARRIER POLICY NUMBER VEHICLE TYPE tj)I 1 NOW .MINOR - IMOO MAJOR ROLL-OVER DIFt.OF TRAVEL ON STREET OR HIGHWAY SPEEO LIMIT CA .DOT - - CAL-T - 7OPVP3c MCmu PARTY DRIVER'S LICENSE NUMBER STATE CLASS SAFETY VEH.YEAR MAKE.I MODEL I COLOR UCENSE NUMBER STATE { .... .. . . . . ... .. . .... .. ... . . DRIVER NAMEtFIRST..MIDOLE.LAST) OWNER'S NAME SAME AS DRIVER =EDESS 'STREET ADDRESS 7RIAN OWNER'S ADDRESS SAME AS DRIVER ?ARXED CITY I STAT4l XJP �. .'EWCLE DISPOSITION OF VEHICLE ON ORDERS OF: OFFICER• DRIVER OTHER C6 S" HAIR EYES .HEIGHT. WEIGHT BIRTH 7E Yew PRIOR .Y W PRIORMECHANCIAL DEFECTS ....NONE.APP. ..REFER TO NARRATIVE OTHER HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER: CHP USE ONLY DESCRISE VEHICLE DAMAGE SHADE IN DAMAGED AREA ' INSURANCE CARRIER POLICY NUMBER VEHICLE TYPE SUNK NONE ...i.MINOR MODMAJORROLLOVER (([ OIR OF TRAVEL ON STREET OR HIG14WAY SPEED LIMIT CA, DOT k CAL.T TCPIPSC MCAMX I PREPARERS 44AME DISPATCH NOTIFIED REVIEWER'S NAME DATE REwEWED {. �• i D. E.11ICCAAi1J 015459 1 1 )X'YES No NIA _.:. ....... ... . TRAFFIC COLLISION CODING CNP 555 CARS Pa e2 8/98)Off 042 Pace 2;-a I9 DATE OF COLLISION(MO.DAY YEAR)..... YIM£12400).._. faClCr OFFIC€RLD.... NUAI6ER •... . 10/3012002 1800 9320 015459 14r408 OWNER OWNER ADDRESS. PROPERLY =%Y6 DAMAGE DESC PMON OF DAMkGE SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE OCCUPANTS MIC BICYCLE.HELMET Ak L-AIR BAG DEPLOYED 0-NOT EJECTED A-NONE IN VEHICLE M-AIR BAG NOT DEPLOYED F.FULLY EJECTED B-UNKNOWN N-OTHER DRIVER 2•PARTIALLY EJECTED C-LAP BELT USED P.NOT REQUIRED V-NO 1 2 3 4.DRIVER D-LAP BELT NOT USED 3•UNKNOWN 2 TO 6•PASSENGERS E-SHOULDER HARNESS USED CHILD RESTRAINT YES 4 7-STA.W GN REAR F-SHOULDER HARNESS NOT USED O-IN VEHICLE ED PASSENGER 8-RR OCC TRK.OR VAN G-LAPISHOULOER HARNESS USED R-IN VEHICLE NOT USED X-NO 7 9-POSITION UNKNOWN H-LAPISHOULDER HARNESS NOT USED S•!N VEHICLE USE UNKNOWN Y-YES 0.OTHER J•PASSIVE RESTRAINT USED T-IN VEHICLE IMPROPER USE K-PASSIVE RESTRAINT LOT USED U-NONE IN VEHICLE ITEMS MARKED BELOW FOLLOWED BY AN AS FRISK r)SHOULD BE EXPLAINED IN THE NARRATIVE. PRIMARY COLLISION FACTOR T LIST NUMBER RAFFK CONTROL DEVICES OF PARTY AT FAULT I 2 3 TYPE OF VEHICLE ; 2 3 MOVEMENT COLUSM VC SECTpNNOtATED. tfPEO A r- S A CONTROLS FUNCTIONING A PASSENGER CAR I STATION WAGD A STOPPED NO H CONTROLS NOT FUC-TIONING• B PASSENGER CAR W!TRAILER B PROCEEDING STRAIGHT B OTHER IMPROPER DRIVING` C CONTROLS OBSCURED C MOTORCYCLE I SCOOTER �+ RAN OFF ROAD X D NO CONTROLS PRESENT 1 FACTOR- D PICKUP OR PANEL TRUCK D MAKING RIGHT TURN X D OTHER THAN DRIVER' TYPE _c COLLISION E PICKUP 1 PANEL TRUCK WJ TRAH ER E WAKING LEFT TURN D UNKN01^tN' A HEAD-ON F TRUCK OR TRUCK TRACTOR F MAKING U TURN E FELL ASLEEP B SIDE SWIPE D TRUCK/TRUCK TRACTOR Wt TRLP_ G BACKING C REAR END H SCHOOL aUS H SLOWING/STOPPING WEATHER (MARK I TO 2ITEMS) D BROADSIDE �lfll OTHER BUS I PASSINR OTHER VEHICLE X A CLEAR X E HIT OBJECT J EMERGENCY VEHICLE J CHANGING LANES B CLOUDY F OVERTURNEDI JK HIGHWAY CONST.EQUIPMENT K PARKING MANEUVER D RAINING G VEHICLE/PEDESTRIAN L BICYCLE L ENTERING TRAFFIC SNOWING H OTHER': M OTHER VEHICLE M COTTER UNSAFE TURNING 1 VISIBltJTY FT. N PEDESTRIAN N }LING INTOOPPOSING LANE F OTHER:- MOTOR VEHICLE INVOLVED WITH O MOPED O PARKED G WIND A NON-COLLISION P LIGHTING PEDESTRIAN $ PEDESTRIAN Q TRAVELING WRONG WAY A DAYLIGHT Ic OTHER MOTOR VEHICLE 1 2 3 OTHER ASSOCIATED FACTORS R OTHER: B DUSK-DAWN D MOTOR VEHICLE ON OTHER ROADWAY {MARK 1 TO 2ITEMS) _ X C DARK-STREET LIGHTS £ PARKED MOTOR VEHICLE A VC SECT N VIOLATED: uTEo YES D DARK-NO STREET LIGHTS F TRAIN wNO E DARK-STREET LIGHTS NOT G BICYCLE B VC SICTKW VIOLATED cam VES FUNCTIONING- H ANIMAL: No ROADWAY SURFACE VOSECTgNVNYATW urea YES 1 2 3 SOBS AUG IXIA DAY 1 FIXED OBJECT:, `NEg MARK 1 TO 2 ffam$I 8;WET D X A bIAD NOT BEEhF�t1NfC O SNOWY-ICY )( J OTHER OBJECT: E VISION OBSCUREMENT B HBD•tlhlpEHt»CE Ds SLIPPERY(MUDDY.OILY.ETD.) PILE OF ASPHALT F INATTENTION' C NOT UNi)ER/NFL ROADWAY CONDIT(C&4{SI G STOP E GOT. : D HBO•(MPRtRTBENT IJAiKNO4Y (MARK 1 TO 21TEMS) PELOES7RLhNS ACTIONS H ENTERI4 I LEAVING RAMP E DRUG LtLUENCE" �wx .DE€P RUT' X A NO PEDESTRIANS INVOLVED I PREVIOUS ISIONF ;IMPAIRMENTp H#V31G L'OBSTRUCTION MATERIAL QN ADWARoADY- B CROSSING IN CROSSWALK J 'UNFAMILIAR WITH ROAD G iMPA(RmF_NT NOT KNOWN X C OBSTRUCTION ON ROADWAY AT INTERSECTION K DEFECTIVE VEH.EQUIP.: CITED H NOT APPILZABLE X 0CONSTRUCTION-:REPAIR ZONE C CROSSING IN CROSSWALK:NOT YES I :>SLEEPY tFATIEiUED:... E REDUCED ROADWAY WIDTH AT INTERSECTION No SPECIAL INFORMATION F FLOODED' D CROSSING-NOT I3 CROSSWALK I I IL UNINVOLVED VEHIICLE A y S 2AROUgpMATE i G OTHER': E IN ROAD-INCLUDES SHOULDER M OTHER': 13 CELL PHONE IN USE H NO UNUSUAL CONDITIONS f NOT IN ROAD X N NONE APPARENT X C CELL PHONE NOT#i USE G APPROACHING/LEAVING SCHOOL BUS O' PRUNRWAY VEHICLE D E€Ll PHONE NONEIl3NKNCOW SKETCH FOR SKETCH DIAGRAM,SEE PAGE MISCELLANEOUS 0 CONSTRUCTION COMPANY: DOT BRUCE CARONE GRINDING L_LHO CAT£NDRT" AND PAVING.INC. CR CRNR OdO COMMERCIAL CTR. 7y* CONCORD,CA 94520 i9C CHP (925)691-2030 i DA FD/S0 ._.____CT OTHER ., �. ... . ..... STATE Oi ALIFORN3A . �: INJURED I WITNESSES I PASSENGERS Pape 3 of C.iip 555 CARS,Pa Rev 8108 OP-1 44 DATE OF COLLISION IMO. DAY YEAR) TUE(2400) tJCIC>K OFFICER I.D. NUMBER 1013012402 1800 9320 015459 10-408 wss; P NGFA AGE SEX EXTENT'O INJ11RYCX'ONE) INJURED WAS('3C ONE) P g R SPAT SAFETY e�EcsE 4 y ONLY PATAL SEVERE OTHER VISIALE COk1PlAINT PCS. EC�UUIP. Ar♦1{AtY MARY IFLANZY OF PAIN OfRNER - PASS. PEO. 81q.YCi137 t7TNER 69 NAME 1 D.O.8./ADDRESS TELEPHONE WALTER LADELL HILL (0111411933) 312 HERON DR. PITTSBURG CA 94565 (925)427-4055 (INJURED ONLY)TRANSPORTED BY: TAKEN TO: AMR MOUNT DIABLO HOSPITAL DESCRIBE INJURIES: COMPLAINT OF PAIN TO LOWER BACK VICTIM OF VIOLENT CRIME NOTIFIED xi# I ❑ 59 M ❑ ❑ ❑ ❑ ❑ ❑ ❑ I� NAME I D.O.B,I ADDRESS TELEPHONE JACK TOWNSEND LOS/30/19431. 4644-I RISHELL CT. CONCORD GA 94521 (925)686-6620 (INJURED ONLY)TRANSPORTED BY: TAKEN TO: i DESCRIBE INJURIES: VICTIM OF VIOLENT CRIME NOTIFIED # Eli L i 1— f� _J Lj NAME 1 D.O.B,I ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES: VICTIM OF VIOLENT CRIME NO IED -i NAME I D.O.B.I ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY, TAKEN TO: DESCRIBE INJURIES 7 VICTIM OF VIOLENT CRIME NOTIFIED NAME!D.O.B.!ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES: VICTIM OF VIOLENT CRIME NOTIFIED NAME!D.O.S.i ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: 1 DESCRIBE INJURIES: -- VlCTtM OF VIOLENT CRIME NOTIFIED PREPARER'S NAME I.D.NUMBER MO. DAY YEAR REVIEWER'S NAME MO. DAY YE D. E.MCCANN 015459 10/30/2 STATE OF CALIFORNIA SKETCH DIAGRAM CHP 555 Pa e 4 Rev.8-971 OPi 042 PAGE 4 O l0 1DATE OF INCIQENT TIME NCIC,NUMBER OFFICER 1.0. NUMBER 10/30/2002 1800 9320 015459 10-408 ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED(SCALE � Mars Creek Road (;N) Road Edge §i- TCH E-1 W-1 Asphalt Edge (Not To Scale) Solid White Luse White Dashed Lines Solid White Line Dirt/Gravel Construction Area Pile of Asphalt/ Pine-Lane j n. Gravel V-9 _- p�o 'b Orange Construction Cane Road Edge Asphalt Asphalt Lanes Lanes 12 ft. 12 fL PREPAREII$Y I.D.NUMBER DATE REVIEWER'S NAME DATE D. E, MCCANN 015459 10/30/2002 ... ..... ..... ..... ........ ...... S TE OF CALIFORNIA FACTUALDIAGRAM Q. 555 Pa v.x-97 OPi 042 PAGE 5 OF 10 FDA—TE-0-F�INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 0130/20 11800 9320 1015459 10-408 ALL MEASUREMENTS ARE APPROXIMATE AND NOT TO SCALE UNLESS STATED(SCALE= } Marsh Creek Road � Rosa Edge Factual Diagram E-1 W-1 Asphalt Edge (Not To Scale) Solid 1Nhite Line White Dashed ones Solid White Line Dirt/Gravel Construction Area 3 Pile of Asphalt/ Pine;Lane Gravel cn 0 Orange Construction Cone Road Edge Asphalt Asphalt Lanes Lanes 12 ft. 12 ft. PREPAREQ BY I.D.NUMBER DATE REVIEWER'S NAME DATE C :ANN 015459 10/30/2002 ......... .. ... STATE OF CALIFORNIAf ' NARRATIVE/SUPPLEMENTAL PAGE 6 elo GATE OF INCIDENT; TIME NCIC NUMBER OFFICER I.D, NUMBER 10/30/2002 1800 9320 0154590468 1 FACTUAL DIAGRAM LEGEND 2 3 VEHICLE POINTS OF REST.''' 4 5 V-1 f Left/Front Wheel„-was located approx. 15 ft. W/of the West road edge of Pine Lane and 6 approx. 7 feet S/of the North road edge. 7 8 V-1(Left/Rear/Wheel}-was located approx. 10 ft. W/of the West road edge of Pine Lane and 9 approx. 7 feet S/of the North road edge. 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 AREpARED BY k.t3.NiJMBER DATE REVIEWER'S NAME DATE C}. E. MCCANN 015459 10/30/2002 N. w.t... ............ ..::., .::::::. I.........................................................................-..... ........................................... %-'ATE OF CALIFORNIA NARRATIVE/SU PP LEM ENTAL PAGE-7 OF 10 -------------- bATE OF INCUDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 1013012002 1800 9320 015459 10-408 1 FACTS: 2 3 NOTIFICATION: I was dispatched to a call of a minor injury traffic collision at 1807 hours. 4 1 responded from Neroly Road at Oakley Road and arrived on scene at 1831 hours. 5 Clayton Police Department was on scene and related that the driver was already 6 transported with minor injuries to Mount Diablo Hospital, All times, speeds and 7 measurements in this investigation are approximate. Measurements were taken by 8 rollmeter, except where otherwise indicated. 9 10 SCENE: At the scene of this collision, Marsh Creek Road is an eastbound/westbound 11 roadway consisting of two lanes. The roadway is straight and level. The surface is 12 composed primarily of asphalt. There was roadway construction that was taking place 13 primarily in the City of Clayton but did extend into county area at Pine Lane. There was 14 limited cones and road markings to advise drivers of the changed conditions ahead. It is 15 believed that some of the cones may have been knocked down prior to this collision but 16 was clearly not properly marked with warning signs. The pile of asphalt debris and gravel 17 was left directly in the path normally traveled for westbound traffic and was not visible to 8,..,.... .......... approaching traffic. There are street lights at this location but do not illuminate the hazards ........ ..... 19 i the roaddue to construction taking place See di agram. ............ ................... 20. 21 PARTIES: 22 23 Party# I -(Hill) was contacted by phone at approx. 2120 hours. Party Hill was identified 24 verbally and had been released from Mt. Diablo Hospital prior to my arrival. Hill was placed 25 as a party by the following items: 26 27 - personal statements 28 - injuries 29 - being registered owner PREPARED BY J.D.NUMBER DATE REVIEWER'S NAME DATE D. E. MCCANN 015459 10/30/2002 ..... ......... ..... ....................................... STATE OF CALIFORNIA ` NARRATIVE/SUPPLEMENTAL PAGE 8 OF 10 DATE OF INC#DENTTIEvt NCIC NUMBER OFFICER I.D. i UCNBER 10/30/2002 1800 9320 015459 10-408 1 Chevrolet Lumina, Driver# 1's vehicle, was located on its wheels as shown on the 2 diagram. V-1 sustained minor front end damage including a right/front flat tire and 3 scratches to the front bumper area. No previous damage was noted or claimed. 4 5 PHYSICAL EVIDENCE: 6 7 _None. S 9 STATEMENTS; 10 11 Statements are not verbatim and are written in summary form. The statements were 12 related back to the involved parties for verification. 13 14 Party## 1 (Hill) related that he was driving V-1 on W/b Marsh Creek Road, E/of Pine Lane 15 at approx. 35 m.p.h. P-1 related that other vehicles were approaching from the opposite 16 direction with their headlights on and he was having a hard time seeing the roadway. P-1 17 related that he did not,see any traffic cones or signs advising of the approaching roadway 18 construction area. P-1 related that he suddenly went off of the asphalt'roadway and 19 collided into the pile of asphalt and gravel that was left in his direction of travel. 20 21 Witness (Townsend)was contacted by phone on 11-02-02 at approx. 1715 hours. 22 Townsend related that he was driving his vehicle on W/b Marsh Creek, E/of Pine Lane at 23 approx, 25-30 m.p.h. and 3-4 car lengths behind V-1. Townsend related that he did not 24 see any roads signs or construction cones prior to the roadway construction. Townsend 25 related that V-1 suddenly collided into the pile of asphalt and jumped over the pile. 26 Townsend related that if V-1 hadn't hit the pile of asphalt that he most likely.would have 27 because of a lack of cones or flashers. Townsend related that after the collision he only 28 observed a few cones standing and that a previous vehicle may have knocked the cones 29 down. PREPAREt3 BY LD.NUMBER DATE REVIEWER'$NAME DATE D. E. MCCANN 015459 10/30/2002 STATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL PAGE 9 OF Ifs DATE OF INCIDENT TIME NCIC NUMBER OFFICER I.D. NUMBER 1013012002 1800 9320 015459 10-408 I OPINIONS AND CONCLUSIONS 2 3 The SUMMARY, A01, and CAUSE are based on vehicle damage, statements and my 4 observations at the scene. 5 6 SUMMARY: 7 8 P-1 was driving V-1 on W/b Marsh Creek Road, E/of Pine Lane at approx. 35 m.p.h. There 9 was roadway construction in the area and a pile of asphalt and gravel in the westbound 10 traffic lane. There were construction cones and limited roadway markings with'a detour 11 around the westbound lane. P-1 did not see any cones or signs,advising of the 12 construction zone ahead. V-1 collided into the pile of asphalt and came to rest on the west 13 side of the pile. 14 15 AREA OF IMPACT: 16 17 The A01 &-1 vs. Pile of Asphalt and Gravel) was located approx. 2 feet W/of the East 18 ', roadway edge of Pine Lane and approx. 6 feet S/of the North road edge of Marsh Creek 19 Road. 20 21 CAUSE: 22 23 The cause of this collision is other than driver. Due to the lack of signs and cones advising 24 of the road construction ahead, it is unreasonable to expect P-1 to have been able to avoid 25 this collision. The pile of asphalt debris and gravel was left directly in the path usually 26 driven for westbound traffic. 27 28 29 PRI=PARED BY I.D.Nt1MBEFt DATE REVIEWER'S NAME DATE D. E. MCCANN 015459 10/30/2002 .................................................................. ....... ........ .... STATE OF CALIFORNIA NARRATIVEIS U PP LE IMENTAL • PAGI loo] i d ©ATE OF INC113ENT TIME NCI C NUMBER OFF#CBR I.D. NUMBER #0130/20tJ2 1800 9320 015459 10-408 1 RECOMMENDATIONS 2 3 None. P'KtPARED BY I.D.NUMBER LATE REVIEWER'S NAME7 DATE D. E. MCCANN 015459 10/30/2002 4i.litidM /� r AQAR F SUPXRnaQ1§ QF COL COUNT UABR AC=;MARCH 1118 2003 �Y# # IIIIrII IYY1iIYYI�#IY Claim Against the County, or District Governed by ) the Board of Supervisors,Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references arc 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"Warnings". AMOUNT: $300,000. EB 13 2003 CLAIMANT: ERIC I ToLIVER GOUNTY COUNSEL MARTINEZ CALIF. ATTORNEY: IRA LESHIN DATE RECEIVED: FEBRUARY 13, 2043 ADDRESS: LESHIN & UINCEL BY DELIVERY TO CLERK ON: FEBRUARY 13, 2003 AM IRA LESHIN 2201 SANSOME ST- , 6th FLOOR DELIVERED FRANCISCO, CA 941.44 BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the.above-noted claim. JOIN SWEETEN C e Dated. FEBRUARY 13,, 2043 By: Amt-y- H. FROM: County Counsel TO: Clerk of the Board of Supervisors 0"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 IS days(Section 910.8). ( } Claim is not timely filed.The Clerk should return claire 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). (o)" Other: .7 he 0cit-0t. k LJ c• � Dated: By, De uty County Counsel M. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2) { } Claim was returned as untime€ with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (K4 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: tIARCH 1$1 2443 JOHN SWEETEN,CLERK,By .� . ,De uty Clerk WARMING(Gov. code section 913) Subject to certain exceptions, you have only six(6)motths 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 943,6. 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 clamant as shown above. Dated: LARCH 19 003JOHN SWEETEN,CLERK By Deputy Clerk CA 9q6 9 l Mikes _€ C-tAILAA ............... .................. ................... b RECEIVED FEB 13 2003 CLERIC BOARD WJE 5UPERViS{7 is Claim tax BOOM OF SRERYISM Of t'�ti'i'U CMA C>�titt't'Y C(7t�FF?AG£?3TACQ. XtiSI`R4JC'P CENS TO C�.14"Ls'AHT �'/�' c� Z y9. ---7 A. Claims relating to causes of action for death or "w injury to person or to ;ior- SOM1 'Ar*Wty or grsswing crops Lrd which accrt s an or bel ore December 31., 1987, must be presented not later than the 100th slay after the accrual of the ca-,we o: action. Maim relating to ca-ans of ac:tian for. th or for injury to person Or tO peors0na2 pMPerty or groaning *r'op and which score oo or after January 1, 19889, must be presented not later than sisc months atter the accrual o" the cause of action. Claims ^elating to MY other cause of action must be pmm-rated not later tbm oar year after the acwn al. of the causo or action. (Govt. Code S911.2.) B. Clams =at be filed With the C1Wk of the herd Or S T6Miaors at Its csffiee in ROOM 106r COMty Administraatim Building, 651 First Street, Martinez, CA 94553. C. If claim is agai-nst a district governed by the Board of S;rper isors, rather than the Comty, that name of the District should be filled in. D. If the t:Uim is agairw.st than one public er:tity, separate claim oust ba- filed apirs..s't each public 'amity. B. Fraud. See persa!ty for fraudulant claims, PorAL. Cosme Seo. 07,7 at the er.d 76 . ee rleaaEaF �teatalar �re • aaeaaeae +� * aast �t * eea� staaeeaort * reit : +r REx Claim By � �} Reserved for Clerk's filing stamp 3 r F-sT o, RE or ) a District) 'The =e.*rs{grant aliLlmant hereby =kw olaim a pinst the County, of C=tra Costa or the Oove-wm:d €istrict to the sa of � 2iC00.00 and in support ref` +h this alm mptreawts.as fol l wss �.... •. " 1. When did the die or irsjury **c"—? (Give exact slate and hour) C(.00 A.M. 2. Whero slid 'tt s 440489 or injury Maur? (Include city and csraursty) 3. Flow diol the d4zw car to 00* r7' tvit�a ft4 detaa ai we extra paper if re i:� Dix4ip L..-40t. tv� QWtI SIA'SP INV6 CJA� OA�k� 15 Lri� btu 0ex 1 5 a.'tu ffGl �t++t�k+"�"u A L' wto» �arcc+nntnr�tco�i ncrt�ei k5tiane � �� t: ��sa�o�a{(,�C �TAe Ll � a �Mo��`►„t't►��tW a��-u��o�n E�n �s�a�'S TN.�►7 �wscs��t�r rns �c�a aa.+ �tPn�! 4�iu:til CH 7v ,i�j3 u�tsc�Lp Cra) .{"ll .SuiLi ,aw S#.t1tci #� Ap ti4'tssdt'!` tM��t�M►+ . d �s'+ �' u#1A40.v1� f ii,fSf7 A#�Sc'.Lk 'tJ`O7'Y N A$AIIGA 'CLAIM A A rld6r tA\Q.,SUi.l.WAn fo+z %)f%Vern#h?o .iA ee- �r+w.rwrwreiw�w+.+rwnrsw.+rwr. . t paz" 4loan r aot or emission on the part of *=ty Or district officers, 2#"Mt$ CV. al*Y caused r the in." a- damage?? 5. gnat sre tnt rams of count, or d1strlct o#'ticxrs, servants the lo=gs or injury? or emplopees ceusing mat . #n ri s Y'3u c141rn resulted (? el e t ,.` or � e►ia�ad. Attaah two e�ttsmstrrs rc sofa ice 7. Now 143 the amounta ae i=d atboVer PUW? ( nClude t♦he estimated Arvsl�activIl injury or Vie.) amaur�t rat any • HUM $Ad addresses of witnesses, , tore and ;loaj3ft ♦►Ni ( l ihlt►TLi## M1 ;1*"#% UAI 9 A 4 VQ, PtiMtyt G?iJA1.E A-JfxV 9, ittlo"14*-%CM� 6't: 4 944 tVi�TAWAA,c-A 94Ya 90A, dA R456 It q&4 5AVI M1WEL VQ♦# 304,o A 9, List tho *Mend itu �""'� .�..........._...__ 20- �� made CIO acootwt of this W10M t or injury; 1A mRD "' t bt s provides, an I r t t legs by the c4 t r Aft y , E5 1 t1lcc- rrcl•. MR A J-F-S 14 + . a205A(450MC fir► FLaOa titre SAO fwan66wj CA gi4toy f aiv IF us Ao q Tele�d Ncr. yt�.3��.'3�5{3 s s e s s e e a +�Telej*=eeno" F40-r 5 . (03 1 e � e N0TICL Section fit of th* Penal Conde Provides.. P"or, who, with intent to defraud P'tYMM t tO at y stAta bm-d , t Fats fCt� Io cc cu• for Cjf iWo authwizf►d. to ,��,q�,*0�r4♦ r Pay ry,y, ar�yto appy cont t city c� w4nee of foe. .^.xx 10141MY mill, �+.Qwau;� +�i+bwe� Pay Mi3Q r�Ftli� i# th* my Jill �� ae "u e'iod ,onotr l''49, is Pim ble ei . by Z*Wift* any false J t'�t�Z�Ett� t cs�Nt S.�) CP by b0t4 Met-t than oxer ' -"r by a rim$irc�a�riso ,nt both ststO r` s ► it first t 1 !iow it t �.I And flmi' or by :"t zos{!au'lt in 3• a4ti10kr:t and 2'irre. 10M, Cor' by CLAIM BOAR OF SUEERVISORS OF C NTRA OTA CO 'TY BOARD&CTI��/.�.A���/.N� x BCH .8, 2003 M Y...Y�YYi�ll YYYY1 Yf�.11gillYl...Ylfi YYYpi�Yy.YY./}I.i. YYiI.Y 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 below), given Pursuant to Government Code Section 913 and 915.4. Please note all"Warnings". AMOUNT: $2,000,000- f EB 13 203 CLAIMANT: MARTA TOLEDO COUNTY COUNSEL MARTINEZ CALIF. ATTORNEY: ALFRED H. BUWA DATE RECEIVED: FEBRUARY 13, 2003 ADDRESS: THE 'LAW OFFICE OF BUCHTA BY DELIVERY TO CLERK ON: FEBRUARY 13, 2003 P.O. BOX 1070 DAN ILLE, CA 94526-1070 BY MAIL POSTMARKED: FEBRUARY 12, 2003 FROM, Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETEN C &,.. Dated: FEBRUARY 13, 200-3 By: Deputy II. FROM: County Counsel TO Clerk of the Board of Supervisors {(),his claim complies substantially with Sections 9'10 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: ;} . y Deputy County Counsel 17 IIT. 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. BOARDORDER.: 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: MARCH 18,- 2003 JOHN SWEETEN, CLERK, By ,Deputy Clerk. WARNING(Gov. code section 13) 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 clamant as shown above. Dated: MARCH_19. 2003 JOHN SWEETEN,CLERK By Deputy Clerk VW49 w vaittvtt:ta Submit completed otedm toitn and three copies to: BOW of C0001 STATE BOARD OF CONTROL GOVERNMENT CLAIM GOVERNMENT CLAWS BRANCH P0.Box 3035 SBOC•OC-0002(Rev 4"Rwem Saner fft,CA 55812.3035 Has the claim for the alleged damagelinjury been filed Poky Nt>Ttw :i T nenur nber(rtA&areaaxte) or will it be filed with your insurance carrier? f lyes .j No Mat'tingAddressCity State zip cede Name of insurancecarrier Mount of Deductible Are you the registered owner? J Yes J No , .� PfMake:___ __ Ntodet: Year. IUarrreofASotdit`. byttattt#iortedr Tetepti�e�r(r edea ax" -tq 74 MaingAWress city swe ' 0. a X /o7c Section 72 of the Penal Co&pmvides that every person ft wdh intent to dehaud,presets for atbwance or for payment to any State Board a Office(Of to any county,town,eatp,district,ward,a v4 ,board or officer,authaited 10 allow of pay the same if gentane,My false or fraudulent claim,bill,account.voucher,or writir;g,is guilty of a felony., Sfgrratureo(Claimant t?ab Signature o€A,#tmeyeRepr Date 'fes /�J r a 410 o,ru iVe W .+''.e -rsd".' , ���•[+�{�y'j .ar�i lets. q`�` :o-i � '�4*zt,.�t t ., t. PlaametlfC�artt . .. - '�,• '��lMill7e[(rr#ufeareu�aie MaitingAftm qb-rife au-O*r-4 c�6Wi any p,�V,11,= ste eA- ZipCode S6 X y p s al a�f Y f f � S j tA .:..5 ��... ,, '3, + `�f{tfir' } Is the daim filed on b ehaffof a minor?UYes XNo If yes,Please indicate,Relationship to the minor gate o€girth of the minor Name J kA9%lcy a which this claim is filed Incident Date UoifarArnount of Claim . Ccs,,c Rft s r 4 COL",/).J T f Month g Day!2 Yr. ;Z-co a OrR,a Pcrp e---MAc c ,6zk- if the amount exceeds$10,000,indicate type of cM rase: Explain how Me dollwarnouritclaimed was computed. d LimKed CtACase IBNon-Limited Civil Case ! ( offesVparfir doammvrAationforUv amcxrntdaimedwrittthisform.) N1edt,C f/ (roc> DescAbe the spwAc damage or injury incurred as a result of , ,�5� A 4'. L, the incident. 14 - s Locafio n of the ir,4dent{# it) ttide street 2KSdresS,City ts l±� E ►" t o��..a 11 a2_ t d n1 _ orhomWantw podn*r rrat erandd yottravel.) TY45� 1+r2C�,�LQS T2 �{ ,�o� t 1�—�------- L--t>n2'T'f�rk �.t�✓.3-�.Q E70,c.-.)—1 `70, AtA'44D�'S2 �'�.A I'a-1✓~, • �1 v L� G-U wt i� �.�'_.f1.S SL�.S _� ___ �/- L3'7 Q•4c` CletlC+crSSt linl} VCT a 7— CE3�J c!C s r o�1 9fo sz t PrefersedHeatingttUt7n{ltanappesrancesr,eom-ay). �c-�7 OSaawwnto CI t_as Ameles �• — - 7"� B doe) n W C-b, c R---(• l r S i C�Oakland USanDiego Explain the circumstances that led to the alleged damage or injury.State ail facts that supportyourdalm against the State of California,and why you believe tttfsState is resporo-to for the alleged damage,or".if known,provide the names)of the State employee(s)who allegedlycaused fheir*tny,damagetxkoss.(If momspace is needed.Fleaseattach a(iri'Rionalsheets.) / 39 QS 7 .f 0t/r • 7r — - e {-�v 2sre7 r , Cax cn tr1� tnoo C� ,4 ..k .�" S. "E7 Ln ! m o --" D10.) c' _ ci C:) .. . 0 ml -�---- si L, o n v b ffC�y p{N ��^^ LTI C W� V ,aCD a/� CD ,� �s c� > v m . CLAIM B0ARI7 F§EEMVISOQF C_OET—RA!90§TA QQKN Y BOARD AMON: MARCH 18, 2003 AMON:rrwwrrirr �r� rrw,rrrrn wr rw Claim Against the County, or District Governed by } the Board of Supervisors, Routine 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 below), given Pursuant to Government Code Section 913 and ' 15.4. Please note all"Warnings". AMOUNT: MORE UM $25,00 B . $ 2003 CLAIMANT: DOUGLAS C. YOU CE COUNTY COUNSEL MARTINEZ CALIF ATTORNEY: JEFFREY NADRICH ESP. DATE RECEIVED: F MARY 18, 2003 ADDRESS: NADRICH & ASSOCIATES BY DELIVERY TO CLERK ON: FEBRUARY 18,_2003 12400 WILSHIRE BLVD., FIFTEEN FLOOR' BY MAIL POSTMARKED: FEBRUARY 13,E 2043 LOS ANGELES, CA 90025 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETE , Dated: FEBRUARY 18, 2003 Ry: Deputy IT. FROM: County Counsel TO: Clerk of the Board of Supervisors ('� is claim complies substantially with Sections 910 and 910.2. ( } This Claire FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days{Section 310.8}. { } Claim is not timely filed.The Cleric 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). (t,y Other: 'Qvtl-& c eS �90t % C�/ r Gte�t r^ 9 Dated: 2I f By: Deputy County Counsel III. FROM: Clerk of the Beard TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). CV. BOARD ORDER By unanimous vote of the Supervisors present: ;X) 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. Sated: MARCH 18, 2003 ,TORN SWEETEN, CLERK,By Deputy Clerk WARNING(Gov.code section 913) Rubject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposited a the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an ttorney of your choice in connection with this matter. If you want to consult an attorney,you should do so nmediately. *For Additional WmLm See Reverse Side of This Notice. AFFIDAVIT OF MAILING declare under penalty of perjury that I am now, and at all tunes herein mentioned, have been a citizen of the United Cates,over age 18; and that today I deposited in the United States Postal Service in Martinez,California,postage fully repaid a certified copy of this'Board Order and Notice to Claimant, addressed to the claimant as shown above. fated: MARCH 19, 2003 JOHN SWEETEN,CLERK.B Deputy Clerk LAW ORICES NADRICH & ASSOCIATES Jeffrey Nadrich Randal Neal Cohen Martin A. Eine 12400 WILSHIRE BOULEVARD FIFTEENTH FLOOR LOS ANGELES,CALIFORNIA 90025-1030 TELEPHONE: (310)826-8082 FACSIMILE: (310)826-x682 EMAIL jnadrich@personalinjurylawcal.com www.personatinjurylawca I.com Lawrence R.Jordan Legal Administrator Nancy Youngblood Sylvia M.Munoz Paralegals February 13, 2003 Via Certified Mail/Return Receipt Requested 7002 0510 0002 4851 4207 EFEB 11 8 f1jJ03 Clerk of the Board of Supervisors CLERK soar CONTRA COSTA COUNTY4";�=.,.1. - s L7- Room 106, County Administration Building 651 Pine Street Martinez, Ca. 94553 Re: Our Client : Douglas Younce Date of Loss : August 27, 2002 Dear Gentlepersons: We hereby submit a copy, along with the original of Mr. Younce's Claim Form in compliance with al'I appropriate codes. Please immediately forward us a conformed copy of the claim for our records in the self addressed stamped envelope provided. Should additional information be necessary, please feel free to contact this office. Also attached is a copy of the police report and bill for auto repair. Medical records and bills will be submitted in their entirety when they are received from the providers. l:l'ovncs,DouplContraCongCou+vvCq+u.wpf ............................................................................................ CONTRA COSTA COUNTY Clerk, Board of Supervisors February 13, 2003 Page 2 Thank you for your professional courtesy in this matter. Sincerely, NAD & OCIAT JEFFREY NADRICH JN/ny enclosures ............................... ............... j Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY s �TRU 'l{) S TO-CLADIANI 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 1 Oe 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 awual ofthe cause of action.Claims relating to any other cause of actions must be presented not later than one year iter 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 officeIn Room 106,County Administration Building, 651 Pine Street,Martinez, CA 94553. C. if'claim is against a district governed by the Board of Supervisors,rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. %See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp DOUGLAS C. YOUNCE RECEIVED Against the County of Contra Costa or ) CEN'T'RAL JUDICIAL F€B1 $ 2003 District) (Fill in name) CLARK� ROD 77 SUPE v s Ps GO Ra rA co. The undersignsa n tal ereby makes claim against the County of Contra Costa or the above-named district in the suxn of S 2 5.0 0 Q and in support of this claim represents as follows: 1. When did the damage or injury occur?(Give exact date and hour) 8/27/02 at 0808 hours 2. Where dict the damage or injury occur?(Includecity and county) Main Street intersection with "C". Street, City of Hayward, County of Alameda 3. How did the damage or injury occur?(Give Wl details;use extra paper if required) I was driving Southbound on Main at the intersection of "C" St. , when a bus traveling eastbound on "C" St. ran the red Light and broadsided my car. 4. What particular act or omission on the part of aunty or district officers, servants, or employees caused the injury or damage? The driver of the bus negligently ran a red light, which is a violation of the California Vehicle Cade. The driver of the� bus is an employee of the County. 5. What are the names of county or district officers,servants, or employees causing the damage or injury? Dollie Ann Reed, AC Transit. 6. What damage or injuries do you claim resulted?(Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) _ Extensive property damage to my Infinity 130T in excess of $14 ,000. Extent of physical injuries still unknown - experiencing headaches, sore back and neck. 7. Hove was the amount claimed above computed?(Include the estimated amount of any prospective injury or damage.) Physical injuries still unknown. To date, I have incurred $1 ,869. 30 in medical costs and $34,642,49 in the repair of auto damage caused by accident. ' S. Names and addresses of witnesses,doctors, and hospitals. San Ramon Medical Center P. 0. Box 2517, Santa Ana, Ca. 92707 San 'Ramon Emergency Physicians, P. U. Box 2267, Chatsworth, Ca. 91313 Danville Medical Group, 903 San Ramon Valley .Blvd. , # 122, Danville, Ca. f`fili es in Im in in P p. B 111%, LaFayette, Ca. 94549 9. List€ ie expen' res you mal on`�ecc fit of this accident or injury. ]DATE TUVWAIVi.£1I��NT To date I have incurred $1. ,69. 30 in medical costs and. $14 ,642. 49 in the ',repair of auto damage caused by accident. ) Gov. Code Sec:910.2 provides"The claim must be ) signed by the claimant or by some person on his behalf:" SEND NOnCES TO: LAUQn= Hume and Address of Attorney ) JEFFREY NADRICH:, ESQ. NADRICH & ASSOCIATES ) ( mant's Signature) 1 Blvd. Fifteenth Floor . NADRICH & ASSOCIATES Los Angeles, Ca. 90025 � " ` Fifteenm Floor Telephone No. 310 826-8082 OS rageles UA UV 02 0-1 )Telephone No. %_t,o 2 4^ o fi 2 *****��*«***#******:**��►****w**s+**�****s#****s*s�►t*sss***s#t*�***�*:s*****s****:***�***** NoncE Section 72:of the Penal Code ptuuides. Evoy person who.with intent to defraud,pants*for allowanoe or the paynieent to any state board or officar,or to any wwy,city,or district board or offic a,authorized to allow or pay the same if genuine,any false or fraaudulew claim,bill,amt, voucher,or writing,is punishableeidw by imptisomnent in tb e,m linty jail for a period of no more than enc year,by a fine of m exceeding one 9musand($1,000),or by bath such impisoment and fie,or by impr soninew in the state prison,by a fine of not exceeding in thousand dollars($10,0W),or by both such imp6sonmeat and fins:. STA, C tCALWORNIA TRAFFIC COLLISION REPORT 64 Q,.�i��C CHP 555 PA90 1{Rev, i- ?};OPJ 042 SPEOAL CONDITIONS : Nuta%R MYt.Ruk CITY Ptgi r%{ ' Imi"to €itow 3UO=AL DISTRICT LOCAL REPORT42UM£ER upz aLMs� %o T Rom 'COUNTY REPORTING DISTRICT SEAT COLLISION OCCt1RRED ON MO. DAY YEAR 'TtME a4m NCIG K OFFICER W. 5 7" I ; MILEPOST INFORMATION /04, i !!�tdz DAY OF WEERTOW•WhY PHOTOGRAPN39Y: ,() : FEET,'MItEB OF S IN "T t+J 'lE^aEl NO AT INTERSECTION WITH '�Y/r / � G.,' !v✓ 'STATE hN Y REL OR: : FECTRMLES OP YES . NO + �+Fa� PARTY DRIVER'LICENSE NUMBER STATE CL433 SAFETY VEIL TEAR 'MAt E AtOggLOR :. ,,.Z. LICENSE NUMBER// 4SNER NAME{FIRS T;MtdOIE;.LAST) . i 4� — G L.� _ V`< t oW aER S nuME •.['"FRAME AS DRIVER v aI`E STREET f ADORE (J =•;RXE I crWIfER9AQDRE58 . '4(Nt�%"E4 GtYYiBTATFIZ:P ME AS DRIVER �.J kIf DISPOS4TR3N OP VEltlGLe ON ORDIREOF: 0t%ri SEX HAIR EYES HE OHT WEIGHT B RTP%MTE PACO OFFICER DRIVER U OTHER LYt6T 1Lt !}}L Mo. DSY YS2c j P.tDRMECNANI FEC78: NONE APPARENT REFER TO NARRATIVE CTNJA SOW"ONE �}/3 6 3 J IBL ,SS t i V" L GGT{ CHP UNTIP-mLy-N NUMB'SRt J I£ CHP ti$E YiNLY DESCRIBE VEHkCLE DAMAGE SHADE W dAMAGEb AREA t ;HCARRfER POLICY NUMBER DItCYNUMBERV€HtGlETYPI (`1.UNK .NONE ]MINOR �! Se--7 OERO � �.., OtR OF TRAVEL ON STREET OR HIGHVYAY SPEED LIMtT _/�,,,. t 5` CA OOT I�"T j �.J CAL�7 „i7GPJPCC APARTY ORWER'S LICEN NjUMMER(�,,r} ;STATE CLASS WE7Y VEH YEAR MMCElfAOOE1ICOLOR LiCFN3E NUMBER 'STATE Cl- . MM4 NAME IPMST:Af1DDLP,LAST) .._. --_---_ - �,L1 ���-- I t - - � E hJ �,.'!r✓. OWNE . .NAME Y� SAMEASDR4VER 3^� STREE XDQR}ES9 1 ,r WE ; Afr SAME AS DRDRNER Pti%ED CITYMIATW4r Ia Ytslt%lE �/yJ ��,, E..A 01500VTIONOF VE31s4;LE ON ORDERS OF. �OFfICER,�.DRIVER ®OTHER u%r• SEX HAIR EYES HVCHY Y4,B04T RiRTHOA�E RACE t�—� PRK1R MECHANICAL OEFEG73 NONEAPPAREi3T REF.R TO NARRATIVE ants HOME PHON'L' s$U6II#38 PHONE VEHICLE IDENTIFICATION NUMBER: CHPUS91ONLY DESCRIBE VEHICLE CAMAG£ SHADE 1.4 DAMAOED AREA INSURANCE CARRIER PrXtCr P#iM3ER AmwAE 7YPE ©4JNiCNONEMINOR 11 T~` DCI. D MAJOR El ROLL-OYER DfR O/F: �VEL ON STREET OR H16 I.BPE£Q LlM1T_,,.r+ T.. .YG�.—i :CANT .,... _TCPA-SC 1111_.,..,,,,_,,.,.,,.,,,., PARTY DR7VER5 WCENSE NtJMflPlt ISTATE11CLASS SAFETY -VEH.YEAR NAK&NODELICOLOR •LICENSE NUMBER STATE aARDDLF.LA&TJ -------- ---------- - -� O 3 HAW � SAME AS DRIVER MAN B,TtiEETi•DDRE96 TPIAY OWNERS ADDRESS El SAME AS DRIVER PAW D CITI'jSTA7E2tP : ie,i - rL.Jt =POSITION sR VIEWC11 ONORDERS OF: u OFFICER DRIVER Fj OTHER EiCY• SFX HAIR (EXES HE4GNT 'W£tGkT EtRTHGATE ItiACE tt,IST t7j Mo, OST Yief IE..M34 PRIOR USCHM ICAL DEFECTS; NONE APPARENT RIFER TO NARRATIVE OrHIA :HOME PHONE. BUSWESa PHONE VEHICLE VENTIFICA71ON NUMSER: J CMP Us&ONLY DESCRIBE VENCtE DAMAGE 4HA06 IN OVAA6CO MGA INSURANCE CA"I€R pOLaCY N49ASER VEHtGLE TYPE QLSNkNONE ®MINOR t E MOD. []MAJOR ROLL-OVER I Q1R OF YRAVEL ON 57REE7 OR HIGHWAY SPEED LIMIT CA DOT CAI•T 7CPR+SC MClM% (PREPARBA'S NAk£ DISPATCH NOTIFIED REVIEWER'S NAME TO r- WA,r �' ��--�+I •{. Age ck ,{• k,',YES L.]NO 1tern ...::: ........: _. t STATE O'CALIFORNIA TRAFFIC COLLISION CODING CHP 555 Page 2 Rev:8-97 OPI 042 DATE Of OOLOSION(MO. DAY YL'IRY:... TIME(+7+064 INC.N J o6Y�CER t.a NUMBER i ovnaEki`S.x+AnE oWNEI;S AOORSSS NOTWIfio PROPERTY s YES NO DAMAGE DFBCRIPPON Of DAMAGE SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE OCCUPANTS L-AIR BAG'DEPLOYED M if C$$CYCLE-HELMET A A-N J $N FHICLE M-AIR BAG NOT`bEPLOYED C-NOT EJECTED / � B-UNKNOWN N-OTHER DRivER #-FULLY EJECTED C-LAP BELT USED P-NOT REQUIRED V-NO 2-PARTIALLY EJECTED D-LAP BELT NOT USED W-YES 3-UNKNOWN 1 2 3 t-DRIVER E-SHOULDER HARNESS USED 4 2 TO S-PASSENGERS F-SHOULDER HARNESS NOT USED CHILD RESTRAINT PASSENGER 7.STATION WAGON REAR G-LAP/SHOULDER HARNESS USED -INV MEM Mo X-Na S-REAR OCC--RK OR VAN H-LAPISHOULDER HARNESS NOT USED R-1N VEHICLE NOT USED Y-YES p-POSITION UNKNOWN d-PASSIVE RESTRAINT USED S-IN VEHICiE USE UNKNOWN 7 K-PASSIVE RESTRAINT NOT USED T-IN VEHICLE!MPROPER USE 0-OTHER v-NONE.IN VEHICLE ITEMS MARKED BELOW FOLLOWED SY AN ASTERISK(')SHOULD BE EXPLA)NED IN 714E NARRATIVE, PRIMARY COLLISION FACTOR MOVEMENT PRECEDING LIST NU#BER 3 V QF¢ARTY AT FAULT TRAFFIC CONTROL DEVICES 1 2 3� TYPE OF VEHICLE 1 2 3 CY3L IS ae a:anon d;oWeo � A CONTROLS FUNCTIONING k I IA PASSENGER CAR t STATION WAGON f1 STOPPED i } E3 CONTROLS NOT FUNCTIONING:' 8 PASSENGER CAR W i TRAILER 8 PR CEEDI STRAIGHT CTHER$MPROPER DRIVING': C CONTROLS OBSCURED C MOTOt4CYCLE t SCOOTER I IC RAN OFf ROAO I Q..NO CONTROLS PRESENT r FACTOR* 0 PIC)WP OR PANEL TRUCK 10 MAKING RIGHT TURN a C OTHER THAN t)RtVER- TYPE OF COLLISION E PICKUP I PANEL TRUCK Wr TRAILER FBA KING LEFT TURN D StNKN_CiyNI' A HEAT}-aN ' TRUCK OR TRUCK TRAC7ttf2 FKING U xURN i 'ELL ASLEEP SIDE SWIPE IGT TRUCK I TRUCK TRACTOR WITRLR. I `GK,N' IC REAR END i H SCHOOL BUS #{ SLOWING i STOPPING WEATHER ARX T TO 2ITEMS RRaADSIDE OTHER BUS PASSING OTHER VEHICLE_ A CLEAR 1'E HIT OBJECT EMERGENCY VEHICLE li CH NGWG LANES $CLOUDY F OVERTURNED I KC HIGHWAY CONST.EQUIPMENT K< PARKIN MANEUVER !C RAtNIt10 Ca V€HICLE i PEDESTRIAN1 L BICYCLE I ENTERINGTRAF$ D SNOWING H OTHER^ OTHER VEHICLE MOTHER UNSAFE TURNING F FOO+v1-1-3141Y �_ FT. !N P£DE.STRIAN N )ONG INTO OPPOSING LAN. F O?HER' MOTOR VEHICLE INVOLVED WITH E}MOPED iO PARKED W_m I AA�-NON-COLLISION R M€RPit. LIGHTING ,Y i2S P€iT€STrttAN i Q TRAVELING WRONG WAY A DAYLkONT C O7HfR MO?OR VEHICLE 2 OTHER ASSOCIATED FACTOR(S) R OTHER'. B OU SK-OAS_ MOTOR VEHICLE ON OTHER RO&DWAY thfARK r 7O 2 IremS) �e%4=n -GAr�ow cluo - l:DARK-STREET LIGHTS E PARKED MOTOR VEHICLE pk A YES i I)DARK-ilT STREET EIGHTS 'F TRAIN E WX-STREET LIGHTS NOT tra BICYCLE +euaTiry�°`° FUNCTIONING* YES �ANIMAL: - No SOBRIETY-DRUG } 3 vc:ec;wnwxArwt: carx6 PHYSICAL ROADWAY SURFACE f �C �IYEs 1 2!� I A aRY F,xED OBJECT: # NO (AAt�SK i TO 21T£At5) FA ; D ! iA HAD NOT BEEN DRINKING FT' u J OTHEROBJ€CT. VAS$aN OBSCUREMENT: 8 ttSO-UNDERINFLUSNCE DOY.0!1 ETC ! *ATTENTION•: C HBD-NOT UNDER INFLUENCE' NDIMNIS) $TOP b ca TRAFFIC D HBO-IMPAIRMENT UNKNOWN' 2 ITEMS] PEDESTRIAN'S ACTIONSH ENTERING i LEVANG RAMP r UNDER DRUG INFLU€NCE' R T• Na PEDESTRtANs IF3vaI vED I PREVIOUS COLLISION F IMPAIRAdENT-PHY'sICAL' iAtaN RIIADWAY" (..CRaSSINC,kN CROSSWALKUNFAMIL AR WITH ROAD Cs IMAIRENT NOTKNaWN.ONROADWAY- I AT INTERSECTION K( DEFECTIVE VES,EOUIP.: CITED H NOT APPLICABLE3N-REPAIR ZONE (C CROSSING IN CROSSWALK•NOT �j YEsEEPY I FATTCU8i1AOWAt WIDTH AT INTERSECTION _ _[j wd SPECIAL INFORMATION DED• D>CROSSING-NOT IN CROSSWALK> (L UNI LVED VEHICLE A HAZAaiaUS MATERIAL C HER E IN ROAD-INCLUDES SHOULDER 11I OTHER` 3 H NO UNUSUAL CONBIF$CNS i F NOT IN ROAD I IN NONE APPARENT APPROACHING f LEAVING SCHOOL BUS 1 10 RUNAWAY VEHICLE SKETCH MISCELLANEOUS :• � +9 I WA}f AlAl 1r . [j r-,[,J�. WMAT$NORTH �f 1 t .._.—._.._...>.....--. - MR osP as 1700s .. . _.. __ .._:: �:: :: STATE Of CALIFORNIA TRAFFIC COLLISION CODING CHP 555 Pa e 2 Rev:8-97) OPI 042 PaQa of DATE Of COLLtSl VAOI� fixtE(:�� NdC y � �OFFICER 10. OltvNER S NAME tOWNER'S ADDRESS NOTIFIED I i PROPERTYYEScl NO DAMAGE DES:RtPTiCtd OF DAMAGE I SEATING POSITION SAFETY EQUIPMENT i EJECTED FROM VEHICLE OCCUPANTS L-AIR SAG DEPLOYED M t C BICYCLE-HELMET A-N N :N VEHICLE M•AIR SAG NOTDEPLOYaD C•NOT EJECTED B•UNxHOWN N-OTHER DRIVER I-FULLY EJECTED C-LAP BELT USED P-NOT REQUIRED V-NO 2-PARTIALLY EJECTED D-LAP SECT NOT USED W-YES 3•UNKNOWN l 2 3 1-DRIVER E-SHOULDER HARNESS USED. f 4 E 2 TO S•PASSENGERS F-SHOULDER HARNESS NOT USED CYNLD RESTRAINT PASSENGER 1 7-STATION WAGON REAR 10•LA,FISKOULCER HARNESS USED IN V€H? l ll ED X-NO 8-REAR OCC TRK OR VAN#H•LAPtSHOUL:ER 4ARNE9S NOT USED R-fN VEHICLE NOT USED Y-YES 7 9-POSITION UNKNOWN -PASSIVE RESTr"NT USED S-fN VEHICLE USE UNKNOWN. D-OTHER K•PASSIVE RESTRAINT NOT USED T•IN VEHICLE IMPROPER USE U NONE IN VEMCLE ITEMS MARKED BELOW FOLLOWED BY AN ASTERISK(')SHOULD BE EXPLAINED IN THE NARRATIVE. { PRIMARY CGLiU S?ON FACTOR ? 1 k I :.,ST?.UMBERY 4101=PAR AT FAULT TRAFFIC CONTROL DEVICES j 2,:.3 TYPE OF VEHICLE { MOVEMENT PRECEDING 1 ;2 13 ! COLLISION su:aaxvx:usio. c•rca , E5 .4:CCSV'ROLS:FC;I^1CTIOftiNG t IA PASSENGER CAR;STATION WAGON I ASTOPPED •' :E CONTROLS NOTFUNO'tONING` I { PASSSNGERCAR'N/TRAILER $ pRO^.EEDING STRAIGHT: $OTh€F',IMPROPER C CONTROLS OBSCURED _ 1 j t C MOTORCYCLE t SCOOTER ! t C RAN OFF ROAD Q NC CONTROLS PRESENT I FACTOR' r I D PtCKUP OR PANEL TRUCK1 � D MAKINGRIGHT T' R N { i C OTH6RTHAN DRIVER' TYPE OF COLLISION I I E PICKUP I PANEL TRUCKW1`RAILER f E MAKING LE.=T TURN 10 UNKNOWN k A AD•Civ IF TRL?CK OR TRUCK TRACTOR I F MAKING U TURN I r-E�FELL —ASLEEP- - - I •B S:DESWIPE IG TRUCK ITRUCK?RAC-OR WT7RLR. } Ga BACKING t 1 i :.PEAR END i i H SCHOOL BUS WE ER,'MARX 1 70 2 t7EMSI -- I I SLAV INC t STOPPING f)BROADSIDE I I OTHER BUS I PASSING OTHER VIE HICLE ( 1 _.A'CLEAR E±?t7 05JEC� J EMERGENCY V£MiC E - ! J CHANGING LANES S CLGUOY _ I F �Rr�+vED rc H?cHwmY coNS7 ECU?Fa ENT K PARKING MANEUVER 1 • c C RAINING ...._ T G.VEHICLE t PEDESTRIAN I. HICYOLE I L ENTERING TRAFFIC �I}3 SNOWING _ - t {H DTHER' I MOTHER VEHICLE i M OTHER UNSAFE TURNING E FDG i VIStSif ITY F? 1 i l IN PEDESTRIAN N XfNG INTO GPPfi.52NGLANE I F OTHER': MC VEHICLE kNYOLVE*J WITH i i()MOPED f 10 PARKED: wa 1 to NoN-CCLUS/ON P MERGING I PEDESTRIAN �I { ( Q TRAVELING WRONG WAY A DAYLIGHT :C'OTHER MOTOR VEHICLE I Z I # OTHER ASSOCIATED FACTORS) i R OTHEtt i E,'DU$X DAWN :MOTOR VEICCLE ON OTHER ROADWAY r f {MAe7x!7O:f ITEMS) f . !C DARK•STREET UGH-S AARKED MOTOR VEHICLE J `Y A vc xennc.vvo t-44, xea YEs D:DARK•NO;STREETTORTS I F.BRAIN I_ DARK-STREET LIGHTS NOT I G SIGYCLE 7 E a secma ww.•nae Cat a FUNCTIONING_ YES H �'�#ANIMAL. s aD SOBRIETY DRUG ROADWAY SURFACE C vaatasuxr� LArl■t "Teo± r •YES 2 i 3 PHYSICAL A DRY i i FIXEEDCB;ECT ti :'' % 'NO (.MARX t TO ZITEMS) 8 V,lET t [} _'•* i * . e:.; le,v I A HAD NOT BEEN DRINKING C SNOWY ICY _ i j OTt'ER OB,ECT ? IE VISION:OBSCUREMENT: I I $f4m•UNDER INFLUENCE 0 SLIAPERY;MUDIIY OIL- TC-t _2 F INATTENTION- I C HBO•NOT UNDER iNFLUENC°'[ ROADWAY CONDIT?ONISITr7AfFIC Q HBO•IM?AIAMENT UNKNOWN- ROADWAY ARX;?'O 2 17E31S1 Pe.O£STMAN'S ACTIONS fH ENTERNG i LEAVING RAMP UNOER DRUG 3NFS:UENCE' IA HOLES,DEEP RUT` ;A NoPEDES'•R?aN3INVDLVED I I PREvous COLLISION I - r IMPAMMENT•PHYSICAL' . IS LOOS£MATERIAL ON RCAO VAY' :g CROSSING fN CROSSWALK ! I U UNFAMILIAR WITH ROAD L G IMPAIRMENT NOTMNOWN OBSTRUCTIQNONROADWAY` F N ERRSECT10N lK DEFECTIVEVEH EQUIP C?TED H NOT APPLICABLE �f Q CONSTRUCTION.REPAIR ZONE _ { GROSSING L'V CROSSWALK-NOT I i_jygs t I SLEEPY l FATIGUJEO ------ I f S REDUrED•._ROADWAY IMOTti AT tN3ERSEC.ION I t � !�r`10 SPECIAL.INFORMATION FL,^.00EO' --_ 'Q:.CROSS•NG-NOT tN.CROSSWALK —! !L UNINVOLVED VEHICLE !A HAZARL?QUS MATERIAL 1G OTHER'' V LE ''W ROAD-9NCLi1DfS:5HOULDER _ ' f IM OTHER.•. i -' ]KEN `UNUSU:AL CONDMONS �1 F NOT IN ROAD ! I NNONE APRARENT _•..._.. .. _r . 3� --i APPRGAGkifhO t; I .EAVtNG SCHOOL SUS CS RUNAYYAY'J£HICL€ �Y ! SK£7Cti I i rAj .�. MISCELLANEOUS I LISP J�i I I tNOICATt±I.CRT:i I I I i I ................................................................................................................-....-I..'','''', .......................................................................................................................................... . ................................................................................... ....................... STATE OF CALIFORNIA INJURED I WITNESS I PASSENGERS cHp 555 Pae 3(Rev,8-97 OPi 042 page 3 a DATE OF COLLISION IMO, DAY Y" TIME(2400) WCIC t OppCeR Lo. NuwlR aL2 EXTENT OF INJURY("X"ONE) INJURED WA3 I-X"ONE) AGE six ONLY PARTY SEAT SAFETYONLY FATAL SEVERE Oot1 COMPLAINT NJURy N�y INiuzOFPAIR DRIVER PAW PED, JMMYOUST R N . . Z' � ❑ - - I El cl NAME 10.0.S.1 ADORP-03 (mUgeo ONLY)TRANSPORTED BY: TAKEN TO. DESCRIBE INJURIES VICTIM Of VIOLENT CRIME NOMIED El NAME 10.O.0.1ACOR£85 TELEPHONE f�5�4� Stag 5 2. ONAURgDONLY/TRANSPOATEDBY TAKEN TO: MCWHINAIRIES VICTIM OF VIOLENT CRIME NOTIP19D L-j DIE] I ol NAME I D.0.S.I AWREW TELEPHONE 14,� t V QANQQ gujuxgo ONLY)TRANSPORTED ar, TAKEN TO: DESCRIBE tiviuRiEs VICTIM OF VIOLENT CRUZ NOTIFIED I I It NAME.?DO.B.1 AMR939 YgLIPHIONE f D-7,11,2 (fNAIRED ONLY)TRANSPORTED BY. f TAKEN TO.' OFSCRIBE INJURIES Eli I o I st El VICTIM oFyoLgHTCRIMENOTIRED, El NAMEJO.O.B.I ADDRESS TELEPHONE -7D (04,pmfoom;yI TRANSPOATEDay, TAKEN TO: DESCRIBE INJURIES VICTIM Or VIOLENT CRIME NOTIFIED I J NAME 10.0,8-i'AVORESE TELEPHONE {INJURED ONLY)TRANSPOR-MOty: TAKEN TO: vicTim oP VJ40XLfNT GRIME NOTtRED PREPARER'S NAME tS7..NUOAM MQ DAY YEAR mgmvftptls NAME MO, DAY YEAR ..........................I..,......-........ ...................................................... STATE.OF CALtFOOKA FACTUAL DIAGRAM CNP 555 Pace 4Rev.8-97)-OP!042 DATE flP cowltON W. DAY YEAR! ;,nme a4w) �MC1Ct OpPrEft 1.0, �,/ !MWJtltR ALL MIASUREMV[S ARE APP'TtOXWA TT AND NOT TO KALK UNLOSS STATED(SCALE< ? ,94M„Ts 13 �yf t t t 1 r d9 Si tt, Fy2 17 NARRATIVE/SUPPLEMENTAL A f GNP 558(Rev 7-90)t3Pt 042 Page DATE OF 3NClDtciVT10GCURAENCE TIME fZ4W) NCIC NUMBER 771 LO,NMB #NUMBER "X'ONE W ONE TYPE SUPPLEMENTAL rX'AF Pf CABLE) Narrative Corlision report (1 SA update Q Fatal 17 Hit and runt update i SupplementalC Other: ❑Hazardous materials Q School bus C3 Other: CtTYlCOUNTYMUDiCtAL DISTRICT REPORTING tNSTR1CTtBEAT CtTATK}N N1 SER LOCATIOMSUSJECT STATE Hi WAY RELATED d Yes NO 4, 5. 6, 12. 14. E 15, 7. 5' ir4 19. 20. 22. -r11 ?' /Lr'G 23. G ISN. 24. 25. 1*41 26, LAS"Z' s/' 127 28. 30, 31. PREPARER'S,.�N'iAME AND I.Q.NUMBER HATE REVIEWER'S NAME DATE = Use previous editions until depleted. fa osP 98 ,scan STATE OF CALIFORNIA NARRAT{VEISUPPLEMENTAL CHP 550(Rev 7.90)GPS 042 CATE or INCfDEN?:OCCURRENCE TfME 12400) NC}C NUMBER OFCER I.D.NUMBER NUMBER �x"ONE %'ONE --r TYPE SUPPLEMENTAL rX`APPL"a) Z Narrative koliision report C3 SA update !Fatal 7 Hit and Tun update 4C1 supplemental 11C Other: O-J at p, J Hazardous m er:als School bas C7ther. C,"WCCUNT)%JUDFCIAL OISTRiCT REPURTiNGVS3R iBEA7 I C7TATfitJNNUA#StA LXATI0.WSU8JECT t/1 STATE HiGHWAY RELATED Yes No 1. i fG 2. 3 4. f3 'w 14. 16. --/ Gtr •�� .' .41 S� .� 4 . , 17, z) �+c- �y } i 19. ..G./' + Gr us. .CY �.L V' '�". r"td wf'L z l)'' t 20, j '.» .� ' -Vii' . Z/L' / r4;+ 22. 42 23.,: 24. 29. T rF"" ' '"Y, ,,+ r•°'sftsl�G�tifi't Y'r .,�J" ,.'Y+oC C,. „r J""'7" 29. cit I 3" S yA�.ic`a.NO 1?;.ut:iss a_.,......._._.._.....Y._..�.._._.._..__. ,.__...� ......__,..�.....I c. C.l fic 1 E4V 8`..ittE'� r Jse rrevt4Ls edmons urtti depiecec. ..... ., ......... ........ ......... TRANSIT CRASH WITNESS STATi—&ENT I,Michael White,was a passenger on an AC Transit bus at approximately 8:05 a.m. on the morning of August 27, 2002 when it collided with a passenger car at the intersection of Main and C Streets in downtown Hayward, CA. I noticed that the bus driver was talking on the speaker when the bus entered the intersection against the red light traveling east bound on"C"St. The bus struck the vehicle traveling south on Main St. As a consequence of the impact,I slid off my seat in the bus. � IJL,, Michael White Date Address: 2307 Havenscourt Oakland, CA 94607 --I.-,....................................................................................................................................................................................................................... ... ............................................... AC TRANSIT CRASH WITNESS STATEMENT JJ 1, Roosevelt Wilkerson, was a passenger on an AC Transit bus at approximately 8:05 a.m. on the morning of August 27, 2002 when it collided with a passenger car at the intersection of Main and C Streets in downtown Hayward, CA. I noticed that the bus driver was talking on the speaker when the bus entered the intersection against the red light traveling east bound on"C" St. The bus struck the vehicle traveling south on Main Roosevelt Wilkerson Date Address: 1600 Franklin St. Oakland,CA 94612 .....................- ....................................... .............I...................................................................................................................................................... .................................................................................................... �C' 'TRANSIT CRASH WITNESS STAT,-JENTr �r I, Patricia Wallace,was a passenger on an AC Transit bus at approximately 8:05 a.m. on the morning of August 27, 2002 when it collided with a passenger car at the intersection of Main and C Streets in downtown Hayward, CA. I was seated in the front of the bus on the left hand side. I saw that the traffic light was red when the bus entered the intersection traveling east bound on"C" St. At the time, the bus driver was talking on the speaker, entered the intersection against the red light and struck the vehicle traveling south on Main St. Patricia Wallace Date Address: 736 Memorial Way#7 Hayward,CA 94 ............................................-........................ ......... ...... .... ....._- SR 1 IREV"I) FINANCIAL RESPONSIBILITY REPORT OF *** OFtRAFFICACCIDENT*k i SECTION VSE ONL r SEE INSTRUCTIONS ON BACK MAIL THIS I*PORT TO DEPARTMENT OF MOTOR VE141CLES— FINANCIAL RESPONSIBILITY P.O.BOX 942884,SACRAMENTO.CALIFORNIA 94284-0401 PLUSE PRI)VT (916)657.6421 oATE OF ACCIYIEMT.i'" * +oua Month O R G.- Year Cl A.M. OP.M. PLACE LOCATION OF ACCIDENT CITY COUNTY PRWATE PROPERTYtJO.VEHICLES IN ACCIDENT CAj e;` ,I v oq-1z T e ❑Yes YOUR VEHICLE.- (Also, plea complete Insurance Information stub below) §Aqppo In Traffic Ing 0 LParked © Pedestrian 0 Bicycle DRIVER'S NAME(FIRST.MIDDLE,LAST) DRIVER LICENSE NO.AND STATE DATE OF R H(MONTP,�AY,YEAR) DRIVER ADDRESS M.AND ,e�STREET) (,r CITY J STATE ZIP'CODE TEL Ot O�_^��/� 7,9 OWNER OF VEHICLEJOU WERE DRIVING(FIRST,MIDDLE,LAST) ADDRESS(NO.AND STREET) CITY STATE ZIP CODE VEHICLE YOU WERE DRIVING(YEAR ANI)MASE) BODY TYPE VEHICLE LICENSE OR 10,NO.AND STATE ESTIMAT CAST OF REPAIRS WERE YOU DRIVING A VEHICLE IF,YES EMPLOYER'S NAME AND ADDRESS OWNED BY YOUR EMPLOYER AND WITH PERMISSION? Yes OTHER VEHICLE I 0 Sopped In "traffic vinq C3 Legally Parked 13Pedestrian 3 {�''} Bicycle DRIVER'S NAME(FIRST,MIDDLE.LAST) DRIVER LICEW NO.AND STATE DATEOF 8 T (MONTH.DAY,YEAR) DRIVER ADDRM ANDS '') CITY STATE ZIP CO�TELEP - ENO: '46411111,g, -- Work: Horne: OWNER OF OT4141 VEHICLE(FIRST,MIDDLE.LAT) r ADORE (NO.AND ST11 CITY STATE ZIP CODE VEHICLE{Y RAND MAKE} BODY TY VE#IICLE LICENSE OR#.D.N AND STA ESTIMAT D COST Of REPAIRS IVC2r ,603 7 t WAS HEISHE DRIVING AIF YES,E P YER:'S NAME AND ADDRESS VEHICLE OWNED 9Y AN EMP%OY AND WITH PERMISSION? Yes ( NO DAMAGE TO OTHER OOPERTY ESTIMATED COST TO REPAIR DAMAGE NATURE OF DAMAGES OWNER'S NAME AND ADDRESS INJUMES AND DEATHS CAUSED BY THE ACCIDENT NAMEJAODRESS TYPE OF INJURY —AGE 0 Driver 0 In Your Vehicle ©Bk-Olst a Fatal ❑Passenger ❑to Other Vehicle Q Pedestrian NAMVADDRESS TYPE OF INJURY AGE 0 Driver 0 In Your Vehicle C3 acwjsI ©Fatal Passenger 0 In Other Vehicle ©Pedestnan Was a policy of LIABILITY insurance or a bond covering the operation of YOUR vehicle in effeC at time of accident? 0 Yes t'1 Nn tsars AAW tri US .gdep OZ fit 411M JUDWI iieidea em 01 peuln1et F +arq jentu,m 'polio ul ;ou 89,M puog/ft*ilod e%a 1041 404imliul'01 p04tew $I UUof slyl if ole() �llt3. asnleu6tS _ J -01---- Ol WO4 pO90d pU08 xa ;340d JagwnN puoq Jo&x1od iO3JJ5 N1 ION SVM ❑ 105:1:13 NI SYM :1Uapt3aT petiodal aql of loadsaJ L4tm '-0'n 9909L '09S ut t4lAol )as sltwtt wrTUJtutw aLtl sat#stles yoi" `apes asigAw atll UD papodej puoq Jo Aottod atll 1egj sesi pe Auedwoo pau t lepun eq j too()-b8zb6 e11.110lt1e0 `O)uaweloeg `b98Ztr6 xog -O-d ',titltgtsuodsai} jetOU1VU!-4--S6iOt40A JOIOVY P 1UGUAJedB`G :01 .............. . ... _ _ 07 : 43 J aU 7()b Murber : 6459 B & S HACIENDA AUTO BOD' License # :AC1614 60 Federal ID 4 : 9442464`167 Quality isn' t expensive it ' s pri _pass 3687 OLD SANTA RITA RD #7 `LEASANTON, CA 94388 (925) 847-8789 Fax: (925) 947-x804 PRELIMINAIRY SUPPLEMENT 1 WITH SUMMARY Written by: Lisa Hanrahan 4 A<--'-i aster . Doug W_` Iburn Jr ±sed: Douq rJuT Chi (`t3i:Il .7ner: Doug YOu:'?ce P014 c- d cess: 70 North Oak Ct Deductible: _OCr . 00 Deville, CA 94506 Date of Lass: ( 5' 0j 76-1064 Type of Loss: _,rsning: ( 923) 736-3937 Point of' Impact: Req _ Qt_ Pos: ,-zpect B & S HACIE 3rA A'1JTO BODY Business: 92 '_7-8 789 ,:)cvcion: 3697 OLD SANTA RI`'A RC #7 ?Lz,zSANIM, CA 94338 �ronce c y.RM7R- .,—::,anv: �'j I30T 6-3 . OT 77 J tiC D E_a'�. _..� -A -2- 3387 Lic: 4,, 221 CA Prod Date: " . ._ 1" odometer: 30511 ondon ng Rear Defogger T-4 -t :,]heel _ ? Control i terms t_e:-.t W4 0ers _i'rate Control Entry Theft reterrent/r.?ar... "—'a a M---' Controls _.in Dua_ Mirrors Class Sunroer i3tlrc Clear Co- az Pain.. ;'rl=_ 7p=er ng �__"le ."',ear p1wer PPS__viae Se aOr L Era'res (#) Dri,,e Air Eau Ar Ba�- 3 y : ide 1moact Air Bac Posit�3�t:^i7 r lca Seats =.t Seats AIumi r,um/Ai 11 o Wheeis ------------------------------------------------------------------------------ Or . DE:SCRw +T10 O, L �7 1 ✓ _ T LA2OR PAINT ------------------------------------------------------------------------------ W7-NDSHIELD R&I Ui:�ber molding ;Y one`. 0 . 8 RESTRAINT SYSTEMS „^ Rep! RT Side bad m 0 . 7 P7 System diag,ncsis m 0 . 5 N] SEATS & TR .C[{S r Repl RT Pad backrest 220 R:OO E SOI BInd Rooms panes 1 . 5 R.&I RT Drip Ws�rio 0. 3 _ R&= LT Drip W s`r rs 0 . 3 PILLARS, RC,1_K7;z. __._. .......... ..._._ ..___ T.__.. f 0202 C7 : 43 APS? Number : 6459 _ _ .._ PRELIMINARY SUPPLEMENT 1 WITH SUbJMARY 2000 INTI 130T 6--3 . OL--FI 4D SED Black int : ------------------------------------------------------------------------------ . OP. DESCRIPTION TTY EXT . 'R ICZ LABCR PAINT ________-__________-_________w_________-___________-_________________________- x ,`0 Rep! RT Rocker molding black ;. } . J 1 . 3 210i Add for Clear Coat 0 . 3 301 R&I LT Rocker mc_d,ng black 0. 5 FRONT DOOR Bind RT Outer peel 1 . 2 1. R&I RT Belt w' strp 0 . 3 Rep, R"_' Body side mldg black ?. 6P . '37 0 . 3 Incl . R&I RT Mirror assy w/o heat 0 . 4 &I RT Handle, outside black 0 . 4 F. 1I R&1 trim, panel 0 . 4 REAP. (SOCK eal R moor she:._ 4 . 5 3 . _ T I . - SO 1 deduct time ,., incl . '* SO! Rep! R`y" Body side m_dg black ? 56 . 63 0 . 3 Incl . k SO! Reel LT Handle, :outside black 1 27 , 17 0 .4 Incl R&I R&= trim panel Incl . Rep! RT Applique 1 4 . 90 0 . 2 BACK GLASS R&I Back glass I.nf_niti w/o Incl . communicanion Rep! Reveal ""C__.int' 7n , :5 incl. QUARTER P"NZI R pl R'_" Quarter panel w/T package 1 30 . 82 17 .0 3. 0 Overlap Mayor Ad-, . Pane' -0. 4 Sol Add for Clear Coat 0 . 5 Bind LT Quarter panel w/T package 1 . 1 -^R33epl RT Wheelhouse outer l 134'. . ?. 3 . 0 Rep!ept RT Inner pilar 1 6- S3 2 . 0 TRUNK LID k Bind Trunk lid 1 . 2 Rept Nameplate "130 t'" 4. !t. 0. 2 Peal E:�blem.. 0 . 2 La SO! Rep! Acruacor 0. 15 SO! R&I Rai spode:. . v� 7 REAR LAMPS Rep 1 RT . 17: " �J . . li h R&_ LT Tail lamp assy 0. 6 R&I RT Tai._ lamp assy incl . R&I LT Tail lamp assy incl . .A ?epi RT Tail lamp harness i 7� . _ ut Rep! Rear Combo base C/H rear a ser c . 2 Deduct for Rear Bumper R&I --1. 2 501 Rep! R ' Marker lamp assy 05 . 17Incl . SO! Rep! LT Marker lamp assy i. . _ . incl . . REAR. .`..C..M F E-:, t n L r s ......... _ 6439 P:tELIri4INARY SUPPLEMENT 1 WlTn SVfig�ARY 2rJ0r IIS_ r3r-T 6-3 . OL-FE1 4D SED _- 0P , DEsCP.T_PTICNT' E`. ',:P-CE LABOR PAINT * �:1 Cover wcSV n incl. 2 . 8 Add f,�r-C �a:.- Coag_ 1 . 1 flex coat C?ciu" 1 1 ? r Color s r.d 'o is : 2 . 4 ;F _cr Frame se, iir c, gware 1 . 5 E # �C_ y Pull Lo saua_� 4 . 0 r �cI Energy ati�:��� __ ^^ Incl . FT Cover azzy s" de tracke --'o,1old . ? i iI.C1 . 0 . 3 =PI RT Cower a; _'1 '".Jun br c k e Incl . °P H .1 S s.l I RT/Reay W ee , a,IIG';i .7 ,:77 M 0 . 3 M "r PeI 25f� rr "' B:.-u'jestone -35° .. r _•%1 _ Panel Ce.:.cw ?_•_: 3 . o i J overlac ma;:,�r act; . Pane_ -0 . 4 Add L _ ,•,.t mar Coat 0 . 2 mI PT Ex:e n Z _.. 1 . 5 SCI RT W .eelhc!---e --ner . In . 5�1r Packa-2 .,y P.r_ s_ _caer 3 . 0 1 . 0 REAFF. P -pl A<t1e tee= :,;/T cacka-e :r 3 . 2 NI a01 Sla 1 4 W H AL1ME1 T vril Reol Seam S---=-1 _t. ] i i. . 0 !t 301 Rent Underooa--in I. !_ . J � 0 . 3 , i Pain: suppLl--3 r t' av1 Tr 1-n Assy,A_r Bag .`ter:^.sot's, i C--E CHARGES r sto ue _ . ------------------------------------------------------------------------------- subtotals _ . . _ J7 1 20 . 2 r r _. _.. _. _.._ ......... .' ..._.........._.. ... ............._......._ ........ .................. 002 at 01 . 43 AM h Number: 6459 PRELI111NARY SUPPLEMENT 1 WIT:: SUM1 Y 2000 !NF1 130T 6-3 . OL-_ 1 4D SEI Blac._ int : Parts 5533 . 57 Endy Labor 16 . 0 hrn Q 0 61 . 00/hr 3048 . 50 taint Labor . _: _._ - &5 . 00/hr 1313 . 00 Hochanical Labor I C 25 . 00/hr 399. 50 ame Labor ,: , 81 . 00/hr 467 . 50 _.4.. a±-/Mi.cc . 3145 . 3:: Other Charges 275 . 00 ----------------------------------------------------- CUBT07AL $14182 . 42 Sales Ta . ,. . i7 r 8 . 23CC% 460 . 07 ---------------------------------------------------- G P N D TOTAL $14642 . 49 ADJUSTMENTS: _educzi2l,E; 10G0 . 00 RT Pat hackresm EIV 36. 43 ---------------------------------------------------- ..rT' NE? PX: J 1036. 43 INSURANCE PA'Z $13606 . 06 work is guaranteed _ _ _ year . We warranty workmanship and paint . 2) 3) ALI sub lez repai_z are war_anceer for _ ,e-_ ,, ei al_gments have a (var .y". 4 ) Damage :?ve tc Improper care on7ire will void MGI ke ._ .:r'W:NG _TS A L ST OF .`_3ERE71A70NS G.Z. 5 MECLZ THAT MIT USE 1 TO _. _SE WORK TO BE DONE OR PARTS TO BE RE2A:RE0 OR v EFLACED: MOTOR 22_".:V:ATI0n S/SYMEOLS . D=0:CCC i'T_`dUF,_ PART A=APP.. X:MAT- __:CE LABOR TYPES : LABOR D=DIAGNOSTIC E ELECTR_CAL F=_ . AME G- 3LAZZ M=MECNANICAL P=PAINT _STRUC_.T,UR,,. T=TAXED M:SCE_L `IEGUS =NCN T.-..:E2 _ :__ __: EOf'S PATHWAYS i A .:CENmALGN=AL_GN A/M=me 'TERMA KET RLN =E__..'1_ 7AE .-=T:FIED AUTOMOTIVE _ . A GCCIAT..I N C&R=DI_ _'. NE T AND n^V _ENE;_,r, _ _ =..... _ _'.:-.__ Z77 , PR ICE=UNI i UL_ : LED BY THE Y,r1ZN7:=Y :NCL.=1:•C:17DE .1 �J___ � 5 NAGS=MATIONAL - ,A23 SPECIFICATIGNS . -AD N?H A .AGEN'i __NE NUMBER QTY=QUANT:""_ _-L RE Y=QU L:i_ _ E _L-,I :ART QUAL REPL=QUALITY L .CEMENT FART RECOND=REVN::T10N F.E_N=F w?' 1S RE.:I r__ LASE R&I=REMOVE AND : .. _..LL R&R=REMOVE AND RE?LAZE R>R=REPA1_. . _=RIG T Z1CT=3ZCT10N STEL=SUBLET _ WMW�T�OUT W/ -�va_T SIMBOLS . -'.'II 1'Jr_L Li_i _- ! -OTHER [ IE . .^40TOR5 _- LASE INFORMATION WES CHANTED] *-=DATABASE LIMZ W=_.. -_T;wMARKET N=NOTES 7--- 'HEO TO LINE. d 4 . .-.-.-- ....,.... ......._ t V 002 ai 07 . 43 AM j"h mumber . 6459 PRELIMINARY SUPPLEMENT 1 WITH SUN!MARY 2000 OF: 130 6- .QL-F! 4D SED Black :nt . .ti:r__te based on MC}TOR CRASS EST:MRTING GUIDE, Unless othein0se nctn:2 ;ill items are derived from r,.f.: qu de AR.A3821 Database Date 6/200:1 and the parts selected are 0Ef-parts manufactured by the _ s original Equipment Ma=fa__arer. Asterisk ( ) or Double As a___Jx 1 ) indicates that the andlor labor information provided by MOTOR may have been modify.-id or may have come from an _ mats data source. Non-Original Equipment. Manufacturer *i= ...rnary rort,s are described as AM Rep Parts. Used part, gar_ .'escribe'd ,ac LXX Qual F' ,_-7_-.d ' _ . '?"E.u. Recon, it�oned ! ;:irs .r bed aS ? f}l. T?r-. s Iti n, rt.. :'trc 1G ..'L C? i _, E'Y,L Numbers and Prices -idem 0om National Autrc _.....: in ,. gin& »:,"` indicate manual -zit':._-.. . c J '0002 at 07 . 4: A,, [on t umner . 6459 PRELIMINARY SUPPLEMENT 1 WITH SLfi_n.RY 2000 InFI 130T 6-3 . 01-FI 4D SEE Black int: --------------------------------------------_---------------------------------- CP . DESUIP':`:U QTY EZT . ?RICE LABOR PAINT ----------------------------------------------------------------------------- ------ C-.__ GID 17.,AC ------- Repl RT Side air bag 2 m -1 . 7 901 Rep! RT Side air tag : ' : e m 0 . 7 M Sys em diagnosis M -0 . 5 .0i System ala,, .tsiz Plnd Roos pareL -1 . 4 S01 Sind Roof panel _ . 5 Rep! RT Rocker moldLny black i in-! . Incl Incl SO1 Rep! RT Racker mcldi.g black 0. 5 1 . 3 R&I LT Rocker mc,ld_r.y black incl . molding 901 R&I LT Rocker blacl: 0 . 5 F:_id or C1 �-;t t .at 5 Acid . ;C deduct times _ 0 . 4 u .SOI deduct time Inc" . R Rl RT Body site T_ou black incl . Inc_ 301 Rep! RT Body sits ..._ g black 'M Incl Pepl LT Handle, cu s de black A7 , 17 i cl incl . SO! Rep! LT Handle, auzsLde black 7 0 . 4 Incl A.-...d f _ :_ C,--a7 6 :701 Add for S_ _ __ -oat 0 . 5 (7.ep! LCT Ma:ker ?imp assy .,.^.c1 . 701 Ru✓.J'! RT Marker _amp a zy - T * Rep! LT Farker lamp _ss' 0_ Rep! LT :`fla=ke:. -_mp a . I _ _ incl . Aid f C.:at -0 . 5 u1 Add far Cl __._ 1 . 1 Pull zo sonare -2 . 0 F -,o l Pull o quare k Rep- RT/Rear Wheel, alloy 17.:7 ncl .:01 Repl RT/Rear Wheel, alloy 170 n 177 , 2: m 0 . 3 M xpr Panel below lip -') 5 -1 . 5 ` Sol Rpr Panel below _Id 370 0 1 . 3 Rpr Package _ '' _ side _ . Q of Pp>_ Package ,_u_ _ ,;; ,- i 1 O y .zl�,l 4Wi EZI ; IE. _ 4 Rep! Seam Sea- 4 Sol Repl Seam Sea! Y za T 1 . 0 4 Rep! Undercoa__n-_; i Inc' # SO! Repl Undercoat_. = i T 0 . 3 ------ DELETED __EMS ------- s deduct time -1 . deduct tL -ii 1 . 2 r dee!a . t-_.._ a,a _m _ . 8 0. 4 it deduct .._...- _ , an 07 . 4 . AM 7, P Number: 6439 PR.ELIi I—MARY SUPPLZI EMNT 1 7417a S n-V-11R 2000 1Nc 1 1307 6-3 . OL-Fl U NEi -a.._. _h _ ?` . ------------------------------------------------------------------------------- . OP. E'3CRIPTI0N n"Y EXT. ?RICE LABOR PAINT ------------------------------------------------------------------------------ ------ AL=: !TEMS ------- ol Add for Clean. Coag 0 . 3 SO_ Rep, Actuator 0 . 5 Sol R&I R&I spoiler 0 . 7 1 001 Rep! 225/50vr/11 Iritaes-cne .I_ _V U 501 Mount and C 00 Shop Suppl_ _s +A '. - U SO! Subl Infiniti m -_iaa__nton re *2 0 301 Trim Assy, Air Say Sensors, --_---------------------------------------------------------------------------- Subtotals -- > d05 . 1 : 8 . 2 2 . 7 Warts 1506 . 0;', 20dy Labor 1 , 7 hr _ 1 , 13 . 00/hr 30:5 . 50 Painn Labor . . , hr 65 . 00/hr 175 . 00 _ohanicttal Labor K .,r._ V S5 . 00/hr 1�2'J7^1 . 50 i .c:me Labor � t ho I f 5 . 00/hr 110 . 00 _' blet/Misc . 2793 . 23 ----------------------------------------------------- ales Tax @ 8 .2500O 126 . 72 ---------------------------------------------------- TOTAL SJPPLEMENT Pi**4OUN7T $$^ 5204 . 43 COST OS O SUPPL'L L'1..EN 5204 . 45 9438 . 04 E_..mi:-_-ee S.inc-:ez ------ ,CT,Di%'EP DA` $ 1036 . 43 _. Wotal $14642 . 49 73UR.ANCE PAY $135C6 . 06 11 work is guaranteed for 1 year. We warranty workmanship and paint . 2) ime guarantee on our Z S=age Pains and 5 ( five) :<'? - on Single Stage 3) All sublet repairs are warranteed for 1 year, _el aligments have a y warranty. 4 j Dm age due to improper care oract nature 'v ill T, Ci. v u I7ee . EPA # O00000134 . ted by ._ fes:_. _ Make Model l _. riwation to begin repairs f t ?? AM Tt.%L 6,139 PRELIMINARY SUPPLEMENT 1 WITH SUIIMAR':: 200JO INFI Tyr,- 6-? . Qom- _ 8D, SES -iTLO;rJING IS A LIST OF F.T:3RE`JI?ATIOPiS )R SYME," THAT P4AY ?E USED TO - : -EE C-R TO 3E DONE Of, wAR S TO -_ ..E-A L -'F", E.EL'L__TED: MOTOR _: _ .ATI i i SYMLOLS : D=DICOP?TINUED =_a_- x=a ` - _r ir. _ .ICE LA30R TYPES _. LF.30R. D=DIAGNOSTIC E=7' 7.' IO .J _=,AME =3�A:�: 7 :I rCHA IICAL P=PAIn1T _ _.. =STRU' TUBAL T=FAXED C17"CEI,L.�IJEGUti ..-r.IOP: T= .�D _ _LLANEOUS PATHWAYS : 'JA-7N"' AT GN=A=IGN A/'-I=AE^_'ERMARE(E7 E,LtN0I 5a? iC L _= EP.TIFiED AUTOMCT;VE _ SSCC TIG'ty D&R-C7ISCCittN ECI AND, R.ECONNEC EXT . PRICE=UNIT - - ,tC;L'T�> IEL� 3Y THE QUA 1^IT4' T_ d L=I 3C :UDERt t`1I ' =M, E+:LAEEOUS NAGS=NATI(DNA7 �A-S SP-CIFICA TONS NOP?-AL% s=ni0t3 AL!JACE?IT i `)J;�t it:UL OP=OPER.ATION NE NUMBER Q"TY=QUA�iTITY -,,,'JAL RECY='v :- L!TY ?ES r T_ t:.D -':�RT QUAL RE?L=QUALITY _.�vlENT PART RECOND=RECONDI�IOP] �EE`1=�.F`INI.;i� ''EL L =FZ-C'LAITE R. -=REIOVE AND .L R,&F= EI?0VE AND REP-AC- V?R.=R�? �:- RT=RIl�ri :�E` T _ � _fON SUBI=S J3L7GT _ W/ O --T- :C UT W/_=W!�L I-�i/ .5 M=:0�.., , ==^^_AN-JAL. t\I:,-: EN1 r'.': k=n ' ��R [ IE . .MOTORJ INF'RmL AT.L0N WAS CHAFGEDI k k=DA'T,.-'A.SE LINE WITI? ..iIE?.MAR_#E_ N=NCTES ' INE. MCToR CRASH -.f. __ 1 L _ !1.' . r5 a dcritiFd irnm _ I A?.r .12 Database Date .'l c _ .._'.. S?i? _ .t 3r_ -1_ a!- .., Ma: ;___ _ l ECU1DTEl LIc lLlf ctu—fir. `.- _:•. ' "1 :_.;�: } -..^.i{ ::a7: s t.i at the 1LOr CidtlOSl pr T.t, ! .^.3, -"ome from an "data so'urCP_. 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