HomeMy WebLinkAboutMINUTES - 03042003 - C16-C17 ARD CSFITPER S RS OF-COO C) T
BOAR,,ACTff3N MARCH 04, 2003
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. ;-� 7 notice of the,action taken on your claim by the
i 3 ' Board of Supervisors. (Paragraph IV below), given
Pursuant to Government Code Section 913 and
N 2 9 915.4.Please note all"Tunings".
AMOUNT: UNKNOWN COUNTY t : INII$P
CLAIMANT: MARIA CHRISTINA ALirAREZ
ATTORNEY: UNKNOWN DATE RECEIVED: MiJAU 29, 2QQ3
ADDRESS: 2930 CLEARLAND CIRCLE BY DELIVERY TO CLERK.ON: JANUARY 29, 2003
BAY POINT, CA. 94565
BY MAIL POSTMARKED: JANUARY 28, 2003
FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
JOHN SWEE ,
Dated: JANUARY 29, 2003 By: Deputy
II. FROM: County Counsel TO: Clerk of the Board of Supervisors
(LeKs claim complies substantially with Sections 914 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. De a County Counsel
" G " B '"- tY
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:
(X) This Claim is rejected in full.
{ } Otger.
I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date.
Dated: MARCH 04, 2003 JOHN SWEETEN, CLERK,By ,Deputy Clerk
"WARNING(Gov. code section 913)
Subject to certain exceptions,you have only six(6)mouths 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
immediatel , '"For Additional Warning See Reverse Side of This Notice.
AFFIDAVIT OF MAILING
C 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
)repaid a certified copy,of this Board Carder and Notice to Claimant, addressed to the claimant as shown above.
)aced: MARCH 05, 2003 JOHN SWEETEN,CLERK By Deputy Clerk
Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
A. Claims relating to causes of action for death or for injury to ;person or to per-
sonal property or growing crops and which accrue on or before December 31, 1987,
must be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating: to any other .cause ofaction must be presented. not
later than one year after the accrual of the cause of action. (Govt. Code §911..2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 106, County Administration Building, 651 pine Street, Martinez, CA 94553.
C. If vlalm, is against a district governed by the Board of Supervisors, rather then
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 Se--. 72 at the end of this
fore.
RE. Claim By ) Reserved for Clerk's; filing stamp
)
FaERK
CEIVED
Against the County
' of Contra Costa } N 2 9 2003
or )
District) RD 0�SUPE�iViSORS
CONTRA COSTA CO.
7110377-n name }
The undersigned claimant hereby makes claim against the County of Contra Costa or
the above--named District in the sun of $ C _ and in support of
this claim represents as follows: , uL�t
Oi4l, IL
1. When did the damage.or injury occur? (Give exact date and hour) .
2. Where did the damage or injury occur? (Include city and county)
t)G2..G' "712.,4 i.fF6L'`/ E:._r''�-' �✓ �� �✓�^ C._G�2f 7Gx- `a3 ,j
3. How,/did the damage or injury occur? (Give full details; use extra paper if
required) r
} 7"r'�`j
�r c:Atm. L cz� :�1�d�.r<>r't�..,. �- ��.� �:-r.1'�/'�, �e.�''' do -�`�� �,��•t...z�.�.._
4. What particular act or omission on the part of county or district officers,
servants or .employees caused. the injury or damage?
veA
f r ? r� r (�i �i` [ �r' l t ./x G'3` c��✓ �t ���J `! L _ f� �b`lBj'
(over)
wnat are the names of county or district officers, servants or employees causing
the damage or injury?
emCot
5. "What damage or injuries do you claim resulted? (Give Hill extent of injuries or,
damages claimed. Attach two estimates for auto damage. $d4,x fiJ a6z.wv
7. How was the amount claimed above comrpute :? (Include the estimated amount of any
prospective injury or damage.) �kAjst", C—d
$. �Names wand�addresse;s of witnesses, doors and hospitals.��'�'`� = L+�� '��' q
As''�r'��T/"•c.."3i F '�.'r.�1,..�.-. i�.,c'.,}4 ,�.1,% � �I �� .j� `'-..jd iG's-.ill-Jj�' i..-,.j+�, t'.� (,,���'� ! � �Cl.�t,�� ,
q. List the expenditures you made on account of this accident or injury s:yig. 5&1f
DATE ITEM AMOUNT
-M � -iF iF �E � •� �.# iF iF � it iF 1E � � � iE � � � �k �E iF #F � ik,,,� ���:�rl�
Gov. Code Sec. 910;2 provides-,
"The claim must be signed by the claimant
SEND NOTICES TO: (Attorney) or by some ensu lf."
Name and Address of Attorney
Claimant's Signature
. t
Address
Telephone No. Telephone No. S 5 q
N O T I C E
Section 72 of the Penal Code provides:
"Every person who, with intent to defraud, presents for allowance or for
payment to any state board or officer, or to any county, city or district board or
officer, authorized to allow or pay the same if .genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county ,fail for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by both such imprisonment and fine;- or by imprisonment in
the state prison, by a fine of not exceeding ten thousand dollars ($10tOOO, or by
both such imprisonment and fine.
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