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CLAIM
BOARD OF WULVISQAS OF CONTRA COSTA COUNTY
BOARD ACTIONfAY I;3, ;2003
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
7 -
-'= Board of Supervisors. (Paragraph IV below),given
G4—paql �Tj Pursuant to Government Code Section 913 and
P R 0 7 2 0H-113 DI 915.4. Please note all"Warnings".
AMOUNT: $2,500,000. COUNTYCOUNSEL,
� .ARTR4EZ CAUF.
CLAIMANT: CHARLES EDWARD JOHNSON
ATTORNEY: LAUREEN A. BEMARDS DATE RECEIVED: APRIL 07, 2003
ADDRESS: LAW OFFICES OF LAUREEN A. BEIHARDSBY DELIVERY TO CLERK ON: APRIL 07, 2003
P.O. BOX 12815
BERKELEY, CA 94712-3815 BY MAIL POSTMARKED: APRTI1 030 2003
FROM; Clerk ofthe Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
JOHN SWEETEN C
Dated: APRIL 07, 2003 By: Deputy................
II. FROM: CountyCounsel TO:Clerk of the Board of Supervis&rs
Pa(41AIN
(This claim Jbst substantially.,,�omplies s an , y with Sections 910 and 910.2.
This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The
Board cannot act for 15 days(Section 910.8).
Claim is not timely Bled. 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: 4-7--o L/ By: Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2)
Claim was returned as untimely with notice to claimant(Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present:
(X) This Claim is rejected in fall.
Other:
I certify that this is a true and correct'copy of the Board's Order entered in its minutes for this date,
Dated: MAY 13, 2003 JOHN SWEETEN,CLERK,By Z 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 actionon 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 LV�armn See Reverse Side of This Notice.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now,and at all times herein mentioned,have been a citizen of the United
States,over age 18;and.that today I deposited in the United States Postal Service in Martinez, California,postage fully
prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.
Dated: MAY 14, 2003 JOHN SWEETEN, CLERK By 7 Deputy Clerk
........ ........
......... .......... ..... ....
"OFFICE OF THE COUNTY COUNSEL 6E,�1L SILVANO B.MARCHESI
COUNTY COUNSEL
COUNTY OF CONTRA COSTA ;�
Administration Building *,•`- �,�
651 Pine Street, Stn Floor 1 - �- ;♦ SHARON L.ANDERSON
Martinez, California 84553-1229 CHIEF ASSISTANT
t
1
t ° GREGORY C. HARVEY
(925) 335-1800
(925) 646-1078 (fax) VALERIE J. RANCHE
�' - ' i" ASSISTANTS
nosr�µcovr� "c
NOTICE OF UNTIMELINESS
AS TO A PORTION OF THE CLAIM
TO: Laureen A. Bethards
Attorney at Law
P.O. Box 12815
Berkeley, CA 94712
RE: CLAIM OF: CHARLES EDWARD JOHNSON
Please Take Notice as Follows:
In regards to the claim you mailed on April 3, 2003, on behalf of Charles Edward Johnson,
portions of the claim are timely and portions are untimely. The portions of the claim prior to October 3,
2002 that you presented against the County of Contra Costa governed by the Board of Supervisors fail to
comply substantially with the requirements of California Government Code Sections 901 and 911.2,
because they were not presented within six months after the event or occurrence as provided by law.
Because the portions of the claim prior to October 3, 2002 were not presented within the time allowed by
law, no action was taken on those portions of your claim. The claim was forwarded to the Board for
action only on the timely portions of the claims.
The only recourse at this time is to apply without delay to the County of Contra Costa governed
by the Board of Supervisors for leave to present a late claim as to the claims which are untimely. See
Sections 911.4 to 912.2, inclusive, and Section 946.6 of the Government Code. Under some
circumstances, leave to present a late claim will be granted. See Section 911.6 of the Government Code.
SILVANO B. MARCHESI
COUNTY COUNSEL
By: � CJI
Monika L. Cooper
Deputy County Counsel
Page 1
....................................................
CER IEICATE 4F SMVICE>BY MAIL
(C.C.P. §§ 1012, 1013a,2015,5;Evidence Code§§641,664)
i declare that my business address is the County Counsel's Office of Centra Costa County,651 Pine Street;Martinez,,California 94553,l
am a citizen of the United States,over IS years of age,employed in Contra Costa County,and not a party to this action. I served a true
copy of this NOTICE OF UNTIMELINESS AS TO A PORTION OF THE CLAIM by placing it in an envelope addressed as shown
above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California.
I certify ender penalty of perjury that the foregoing.is true and correct. Executed in Martinez,California.
Dated: April 14,.2003 /
f 'f'
Kathy O'Co6hell _
cc: Clerk of to Berard of Supervisors(original)
Risk Management
Page 2
...................................................................................................................................................
..................................................................................
LAW OFFICES OF
LAUREEN A. BETHARDS
P. O. Box 12815
Berkeley, CA 94712 lip C..
Telephone: (510) 525-1001
Facsimile : (510) 525-6001 Op 0 7 2003
April 4, 2003
BOARD OF SUPERVISORS
CLAIMS DIVISION
651 Pine St .
Martinez, CA 94553
Re : JOHNSON, CHARLES EDWARD v. CONTRA COSTA COUNTY,
CONTRA COSTA COUNTY SUPERIOR COURT, CONTRA COSTA
COUNTY PUBLIC DEFENDER' S OFFICE, et al
Dear Sirs/Madam:
Enclosed please find the original claim form in the above-
referenced matter, a copy of which was faxed to your offices
today.
Please return an acknowledged copy in the enclosed self-
addressed, stamped envelope .
Your attention to this matter is appreciated.
Very trulyryn-Ur-s,
Laureen A. Be�thard
LAB:emp
Parr 26 03 11a49a Clerk of the Board 925 335 1913 p. 2
r
Claim to'. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTI QNS TO .CLAZW '
A. Claims relating to causes of action for death or for injury to person or to personal property or grooving
crops and which accrue on or before December 31, 1987, must be presented not later than the IWIh day
after the accrual of the cause of action. Claims relating to causes of action for death or for injury to
person or to personal property or growing crops and which accrue on or after January 1, 1988, must be
presented not later than six months after the accrual of the cause of action. Claims relating to any other
cause of action must be presented not later than one year after the accrual of the cause of action.
(Gov't Code 911.2.).
B. Claims must be filed with the Clerk of the Board of Supervisors at its officc-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. Fru , See penalty for fraudulent claims,Penal Code See.72 at the end of this form.
+f##t#####I#k####i#MY##k##M####1tM#R####t######►####tt####+K#####k#####+Y##i###k#*####►##*######
RE: Claim By Reserved for Clerk's filing stamp
}
Against the County of Contra Costa or ) Q1 Pp
R & 7
2003
District)
(Fill in name) C
aRA � ri S
c�
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district
in the sum of S2_, 5 00, 0 0(And in support of this claim represents as follows.
1. When did the damage or injury occur?(Give exact date and hour)
October 4, 2000 continuing to December 12, 2002,
2. Where did the damage or injury occur?(Include city and county)
Napa State Hospital , Napa CA and in Martinez , CA, Contra Costa County
3. How did the damage or injury occurs(Give full details,use extra paper ifrequired)
Claimant was "recommitted" for two years based on the signature of a
stranger. Claimant was not brought to court , nor was he interviewed by
his attorney. The alleged waiver was obtained by a social worker rather
than claimant ' s attorney. All proceedings relating to the recommitment were
had in absentia.
26 03 11. 49a Clerk of the Hoard
925 335 1919 P• 1
Y 4. What particular act or ornission on the part of county or district officers, servants, or emlo ees caused the
injuryordamage? Having proceedings in absentia, not compete t ya social
client , allowing a waiver of constitutional rights to be taken by
worker , the court ' s failure to determine the voluntariness of the waiver or
ascertain the identity of the defendant resulting in denial of all rights 5. What are the names of county car district officers, servants,or employees musing the damage or injury? including
Judge Minney, D.P .D. Thomas F . Oehrlein, D.D.A. S . Grassini right to
attorney
to be
6. What damage or injuries do youclaim resulted?(Give full extent of injuries or damages claimed. Attaehpresent
two estimates for auto damage.) to a jury
Two years of unlawful confinement in State Mental Hospital trial.
7. How was the amount claimed above computed?(Include the estimated antat:nt of any prospective in or
damage.)
value of two years of life
8. Dames and addresses of witnesses,doctors, and hospitals.
Judge Minney, D .P .D. Thomas Oehrlein, D.P .D. Dan Clark, D.D.A. S .
Grassini , L. C. S .W. Karen Ellison.
9. List the expenditures you made on account of this accident or inj
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CLAIM
B-OAR QF§KURVISORS OF ONTRAOTA CC1U TY L
BUARD ACTIQN,T. MAY 13, 2003
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
�` u ` '��— 15.4. Please note all"Warnings".
AMOUNT: $1,357.60 APR 1 021,f00
}
CLAIMANT: ROBERT/JULIANA BOLES trtAR NEZ CALIF
ATTORNEY: UNKNOWN DATE RECEIVED: APRIL 10, 2003
ADDRESS: CANDY S. BAILEY BY DELIVERY TO CLERK ON: APRIL 10, 2003
AMEX ASSURANCE COMPANY
P.O. BOX 19018 BY MAIL POSTMARKED HAND DELIVERED BY
GREEN BAY, ,W1 54307-9018
RISK MANAGEMENT
FROM: Clerk of the Board of Supervisors TO: County Counsel
Attached is a copy of the above-noted claim.
APRIL 10 2003 JOHN SWEETEN, er
Dated: By Deputy
H. FROM: County Counsel TO: Clerk of the:Board of Supervise
( ) This claim complies substantially with Sections 910 and 910.2.
( This Claim FAILS to comply substantially with Sections 910 and 910,2,and we are so notifying claimant. The
Board cannot act for 15 days(Section 910.8).
( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of
claimant's right to apply for leave to present a late claim(Section 911.3).
( ) Other:
Dated: 0 By: Deputy County Counsel
EL 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 CINDER.: 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: MAY 13, 2003 JOHN SWEETEN,CLERK,By ,Deputy Clerk
WARMING(Gov. cede section 913)
Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposited
in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an
attorney of your choice in connection with this natter.If you want to consult an attorney, you should do so
immediately. *For Additional Warnitig See Reverse Side of This Notice,
AFFIDAVIT OF MAILING
I declare under penalty of peury that I am now, and at all times herein mentioned,have been a citizen of the United
States,over age 18; and that today I deposited in the United States Postal Service in Martinez, California,postage fully
prepaid a certified copy of this Board Order and Notice to Claimant,addressed to the claimant as shown above.
Elated: MAY 14, 2043 JOHN SWEETEN,CLERK By Deputy Clerk
OFFICE OF THE COUNTY COUNSEL SEAL SILVANO B.MARCHESI
COUNTY OF CONTRA COSTA ,S1',� �?�e, COUNTY COUNSEL
Administration Building
651 Pine Street, 911 Floor r �: SHARON L. ANDERSON
Martinez, California 94553-1229 •`r, '� '+* CHIEF AssisTANT
(925) 335-1800 Q; � .- -<f GREGORY C. HARVEY
` r VALERIE J. RANCHE
(925) 646-1078 (fax) t -
, A5515TANT5
s r
♦ r�
covr�'�`t
NOTICE OF INSUFFICIENCY
AND/OR
NON-ACCEPTANCE OF CLAIM
TO: Candy S. Bailey
AMEX Assurance Company
P.O. Box 19018
Green Bay, VVI 54307-9018
RE: CLAIM OF ROBERT I JULIANA BOLES
Please Take Notice as Follows:
The claim you presented against the County of Contra Costa or District governed by the Board of
Supervisors fails to comply substantially with the requirements of California Government Code Section
910 and 910.2, or is otherwise insufficient for the reasons checked below:
[ ]
I. The claim fails to state the name and post office address of the claimant.
[ ] 2. The claim fails to state the post office address to which the person presenting the claim desires
notices to be sent.
[X] 3. The claim fails to state the date,place or other circumstances of the occurrence or transaction
which gave rise to the claim asserted.
[X] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or
loss, if known.
[ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000).
If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount
claimed as of the date of presentation, the estimated amount of any prospective injury,
damage or loss so far as known, or the basis of computation of the amount claimed.
[ ] b. The claim is not signed by the claimant or by some person on his or her behalf.
Page 1
Candy S. Bailey
AMEX Assurance Company
Re: Claims of Robert J Juliana Boles
Page Two
[X] 7. You are required to submit your claim on the proper form, which is enclosed. Please resubmit
your claim on the enclosed form., including all the required information. Gov. Code, § 910.4.
Please be aware that you have only a limited period of time in which to file an amended claim.
See Gov. Code, § 910.6.
[ ] 8. tither:
S'ILVANO B. MARCHESI
COUNTY COUNSEL
By: .
MONIKA L. COOPER
Deputy County Counsel
CERTIFICATE OF SERVICE BY MAIL
(C.C.P.§§ 1012, I413a,2015.5;Evidence Code§§641,664)
I declare that my business address is the County Counsel's Office of Contra Costa County,651 Pine Street,Martinez,California
94553;1 am a citizen of the United States,over 18 years of age,employed in Contra Costa County,and not a party to this action. I
served a true copy of this Notice of Insufficiency and/or Non-acceptance of Maim by placing it in an envelope addressed as shown
above,sealed and postage fully prepaid thereon,and thereafter was,deposited this day in the U.S.Mail at Martinez,California.
I certify under penalty of perjury that the foregoing is true and correct.
Dated: J�at Martinez,California.
Kathy O'C 11
cc: Cleric of the Board of Supervisors(original)
Risk Management
(NOTICE OF INSUFFICIENCY OF CLAIM:GOVT.CODE§§910,910.2.920.4,910.8)
Page 2
AThe American Express
April 3, 2003 Penny Batley Property Casualty companies
3500 Packeriand Qrive
'p
PR Q 7200 De Pere,W4 54115-9034
MS PENNY BAILEY
CONTRA COSTA COUNTY AMEX Assurance Company
RISK MANAGEMENT DIV ins Property Casualty
insurance Company
2530 ARNOLD DR STE 140
MARTINEZ CA 94553
4p�, ►
RE: OUR CLAIM NO.: 372292 KIOI 0
OUR INSURED: ROBERT/JULIANA BOLE R Nr °°Fs 200?
DATE OF LOSS: 10/23/02 c 'p
YOUR FILE NO.: 51836
YOUR INSURED: CONTRA COSTA COUNTY
Dear Ms. Bailey:
Our investigation of the above dated loss has disclosed that your insured is 30°x`0
responsible for the damages incurred;by our insured.
We are hereby notifying you of our total damage in the amount of$4,525.33
Property Damage $4,025.33
Deductible $ 500.00
Please forward payment in the amount of$1,357.60 (30%)to Amex Assurance
Company,PO Box 19018,Green Bay WI 54307-9018.
Please call us with any questions at 1.800.872.5246 and refer to our claim number when
calling.
Sincerely,
At—
Candy S. Bailey, AIC
Senior Subrogation Representative
Ext. 5179
Amex Assurance Company
Enc.
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...........................-........................................................................................................................................................................
............................................................
11/17/2002 at 09:46 PM File ID: 386570
70571
SCA APPRAISAL COMPANY
Northern California Dvision
For Supplements: 510-282-9622, Fax 510-530-6815
P 0 Box 1455
Burbank, CA 91507
(818) 845-7621
Written by: SIMON LEE # 11/17/2002 09:48 PM
For: AMERICAN EXPRESS PROPERTY AND CASUAL
Adjuster: HEATHER LEITNER #
SUPPLEMENT OF RECORD 2 WITH SUMMARY
Insured: ROBERT BOLES Claim #3722926214-I
Owner: ROBERT BOLES Policy #
Address: 349 BRIGHTON ST. Date of Loss: 10/23/2002
HERCULES, CA 94547 Type of Loss: Collision
Evening- (510) 245-3903 Point of Impact: 5. Right Rear
Inspect BILL'S NELSON OLDSMOBILE Business: (510) 222-2070
Location: 3233 AUTO PLAZA REPAIR—SHOP
RICHMOND, CA 94806
Repair BILL'S NELSON OLDSMOBILE Business: (510) 222-2070
Facility: 3233 AUTO PLAZA 7 Days to Repair
RICHMOND, CA 94806 License # 94-1699426
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Tnt:GRAY
VIN: 1GHDT13S722127146 Lic: 4TUS625 CA Prod Date: 03/2001 Odometer: 18817
Air Conditioning Rear Defogger Tilt Wheel
Cruise Control Intermittent Wipers Climate Control
Keyless Entry Theft Deterrent/Alarm Auto Level
Rear Wiper Steering Wheel Controls Body Side Moldings
Dual Mirrors Privacy Glass Luggage/Roof Rack
California Emissions Fog Lamps Clear Coat Paint
Power Steering Power Brakes Power Windows
Power Locks Power Driver Seat Power Passenger Seat
Power Mirrors AM Radio FM Radio
Stereo Cassette Search/Seek
CD Player Anti-Lock Brakes (4) Driver Air Bag
Passenger Air Bag Front Side Impact Air Bag 4 Wheel Disc Brakes
Positraction Leather Seats Bucket Seats
Automatic Transmission Overdrive Aluminum/Alloy Wheels
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
1 REAR BUMPER
2 O/H rear bumper 1.8
3 Repl Bumper cover Oldsmobile 1 395.49 Incl. 2 . 8
4 Add for Clear Coat 1. 1
5 REAR LAMPS
6 Repl RT Tail lamp assy Oldsmobile 1 112. 40 0.3
7 LIFT GATE
1
11/17/2002 at 09: 48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
8* Rpr Lift gate 2.0 2.1
9 Add for Clear Coat 0.8
10 R&I Handle Oldsmobile w/o gold orn 0.4
ll* S02 Rept Nameplate "OLDSMOBILE" chrome 1 6.01
12* S02 Rept Nameplate "BRAVADA" chrome 1 16. 48
13* S02 Repl Emblem chrome 1 5.29
14* R&I Glass GM w/rear defogger 1.0
w/deep tint
15 R&I R&I trim panel upper 0.3
16 R&I Wiper arm 0. 3
17 QUARTER PANEL
18* S02 Repl RT Liner 1 37.62
19 R&I RT Qtr glass GM w/o G.P.S. 2.0
w/deep tint
20 Blnd LT Quarter panel 1 . 3
21 R&I LT Qtr glass GM w/o G. P.S. 2.0
w/deep tint
22 REAR LAMPS
23 R&I LT Tail lamp assy Oldsmobile 0.3
24 REAR DOOR
25 Blnd RT Door shell short wheel 1.2
base GMC .& Olds
26 R&I RT Belt w' strip short wheel 0. 3
base
27 R&I RT Side molding 0. 5
28 R&I RT Handle, outside w/short 0. 4
wheel base, Oldsmobile
29 R&I R&I trim panel 0. 6
30* S01 Rpr RT QUARTER PANE/LOWER PORTION 7.0 2.5
31 Overlap Major Adj . Panel -0.4
32 Add for Clear Coat 0. 4
33 EXHAUST SYSTEM
34* S02 Repl Muffler w/tpipe 1 577.08 m 0. 7
35* S02 Repl Heat shield rear 1 36. 73
36* S02 Rep! Heat shield center 1 24. 78
37# COLOR MATCH 1 0 . 5
38# HAZ WASTE DISPOSAL 1 3. 00
39# COVER VEHICLE FOR OVERSPRAY 1 5.00
40# FLEX ADDITIVE 1 8.00
4"-# Subl FOUR WHEEL ALIGNMET 1 79. 99 X
42# SET UP AND MEASURE 1 1. 5
43# Repl PULL AND SQUARE 1 2. 0
44# S01 Subl Check for leak and Repair 1 15.00 X
45# S02 Subl TOW BILL 1 130.00 X
46# SO2 Repl NEW TIRE- 1 363.00
47 S02 WHEELS
48* S02 Repl Valve stem & weight 1 6. 38
49 S02 REAR BODY & FLOOR
2
... ....... ....... .........
_...
11/17/2002 at 09:48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
--------------------------------------------------------------------------------
50 S02 Repl Winch 1 91. 96
51 S02 REAR LAMPS
52 S02 Repl RT Reflector Oldsmobile 1 6.00
53# S02 Subl over night fedex/shipping 1 16.70 X
-------------------------------------------------------------------------------
Subtotals =_> 1936. 91 23. 9 11.8
Parts 1695.22
Body Labor 23. 9 hrs @ $ 60.00/hr 1434 .00
Paint Labor 11. 8 hrs @ $ 60.00/hr 708.00
Paint Supplies 11. 8 hrs @ $ 24.00/hr 283.20
Sublet/Mise. 241. 69
----------------------------------------------------
SUBTOTAL $ 4362. 11
Sales Tax $ 1978 . 42 @ 8.25000 163.22
----------------------------------------------------
TOTAL COST OF REPAIRS $ 4525. 33
ADJUSTMENTS:
Deductible 0.00
----------------------------------------------------
TOTAL ADJUSTMENTS $ 0. 00
NET COST OF REPAIRS $ 4525. 33
3
11/17/2002 at 09: 48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
Attention vehicle owner and repair facility.
Do not repair this vehicle until all guidelines are acknowledged and
accepted.
THIS ESTIMATE IS SUBJECT TO INSURANCE COMPANY AND/OR SCA AUDIT AND
APPROVAL. CONFIRM APPROVED ESTIMATE AMOUNT WITH VEHICLE OWNER AND CARRIER PRIOR
TO STARTING REPAIRS
By accepting the repair from the owner of this vehicle, the shop must agree to
the following guidelines if payment is expected from the Insurance Company. If
the guidelines are not followed, the shop Nearby acknowledges that the
Insurance Company and or SCA Appraisal will not be liable for repairs exceeding
80% of the vehicles actual cash value and / or unauthorized supplements.
Under California Bureau of Automotive Repairs laws, the shop must present a
written estimate prior to starting repairs or accept the Insurance Appraisers
estimate. This applies to all supplements as well. The shop must tear down the
vehicle and calculate a supplement which must be authorized by the appraiser
before any work is started. This means estimates, multiple supplements and / or
supplements that exceed 80% of the vehicles actual cash value and will deem the
vehicle a total loss, which is the limit of the Insurance Companies Liability.
SCA will not be held responsible for any repair cost due to the fact that we
are not the Insurer. The repair facility agrees to limit the repair cost to 800
of the vehicles actual cash value, if repaired under this claim. Average market
Actual Cash Value of this vehicle.
THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO
DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR
ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES:
B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT
LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS:
ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLVD=BLEND CAPA=CERTIFIED AUTOMOTIVE
PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT
PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL
AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT 0/H=OVERHAUL OP=OPERATION
NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY
REPLACEMENT PART RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND
INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET
LT=LEFT W/O=WITHOUT W/ =WITH/ SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE. .MOTORS
DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NOTES
ATTACHED TO LINE.
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived
from the Guide DR1GN02 Database Date 11/2002 and the parts selected are OEM-parts
manufactured by the vehicles Original Equipment Manufacturer. Asterisk (*) or Double
Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have
been modified or may have come from an alternate data source. Non-Original Equipment
Manufacturer aftermarket parts are described as AM or Qua1 Repl Parts. Used parts are
described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recon.
Recored parts are described as Recore. NAGS Part Numbers and Prices are provided from
National Auto Glass Specifications, Inc. Pound sign (#) items indicate manual entries.
4
....................................................................... ........
...................................... .
11/17/2002 at 09: 48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
Pathways - A product of CCC Information Services Inc.
11/1712002 at 09:48 PM File ID: 386570
70571
SUPPLEMENT OF RECON 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-•4 .2L-FI 4D UTV SILVER Int:GRAY
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT, PRICE LABOR PAINT
-------------------------------------------------------------_----------------_
------- CHANGED ITEMS -------
11 Repl Nameplate "OLDSMOBILE" chrome 1 -5.90
ll* S02 Repl Nameplate "OLDSMOBILE" chrome 1 6.01
12 Repl Nameplate "BRAVADA" chrome 1 -16. 17
12* S02 Repl Nameplate "BRAVADA" chrome 1 16. 48
13 Repl Emblem chrome 1 -5. 19
13* S02 Repl Emblem chrome 1 5.29
18 Repl RT Liner 1 -36. 92
18* S02 Reel RT Liner 1 37. 62
34 Repl Muffler w/tpipe 1 -566. 32 m -0.7
34* S02 Repl Muffler w/tpipe 1 577.08 m 0.7
35 Repl Heat shield rear 1 -36.05
35* S02 Repl Heat shield rear 1 36.73
36 Rept Heat shield center 1 -24.32
36* S02 Repl Heat shield center 1 24. 78
------- ADDED ITEMS -------
45# S02 Subl TOW BILL 1 130.00 X
46# S02 Repl NEW TIRE- 1 363.00
47 S02 WHEELS
48* S02 Repl Valve stem & weight 1 6. 38
49 S02 REAR BODY & FLOOR
50 S02 Repl Winch 1 91. 96
51 S02 REAR LAMPS
52 S02 Repl RT Reflector Oldsmobile 1 6.00
53# S02 Subl over night Fedex/shipping 1 16.70 X
-_-__-----------------------------------_-_------_--------------------------------
Subtotals ==> 627. 16 0. 0 0.0
Parts 480.46
Sublet/Misc. 146.70
----------------------------------------------------
SUB`T`OTAL $ 627.16
Sales Tax $ 480. 46 @ 8.2500% 39. 64
----__--_--_-----_-------------------------_------___-
TOTAL SUPPLEMENT AMOUNT $ 666.80
NET COST OF SUPPLEMENT $ 666.80
Estimate 3603. 53 SIMON LEE
Supplement S1 255.00 SIMON LEE
Supplement S2 666. 80 SIMON LEE
-------- TOTAL ADJUSTMENTS $ 0. 00
Workfile Total $ 4525. 33 NET COST OF REPAIRS $ 4525. 33
6
11/17/2002 at 09:48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
Attention vehicle owner and repair facility.
Do not repair this vehicle until all guidelines are acknowledged and
accepted.
THIS ESTIMATE IS SUBJECT TO INSURANCE COMPANY AND/OR SCA AUDIT AND
APPROVAL. CONFIRM APPROVED ESTIMATE AMOUNT WITH VEHICLE OWNER AND CARRIER PRIOR
TO STARTING REPAIRS
By accepting the repair from the owner of this vehicle, the shop must agree to
the following guidelines if payment is expected from the Insurance Company. If
the guidelines are not followed, the shop hearby acknowledges that the
Insurance Company and or SCA Appraisal will not be liable for repairs exceeding
80% of the vehicles actual cash value and / or unauthorized supplements.
Under California Bureau of Automotive Repairs laws, the shop must present a
written estimate prior to starting repairs or accept the Insurance Appraisers
estimate. This applies to all supplements as well. The shop must tear down the
vehicle and calculate a supplement which must be authorized by the appraiser
before any work is started. This means estimates, multiple supplements and / or
supplements that exceed 80% of the vehicles actual cash value and will deem the
vehicle a total loss, which is the limit of the Insurance Companies Liability.
SCA will not be held responsible for any repair cost due to the fact that we
are not the Insurer. The repair facility agrees to limit the repair cost to 80%
of the vehicles actual cash value, if repaired under this claim. Average market
Actual Cash Value of this vehicle.
THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO
DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR
ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES:
B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT
LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS:
ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE
PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT
PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL
AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT O/H=OVERHAUL OP=OPERATION
NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY
REPLACEMENT PART RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND
INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET
LT=LEFT W/O=WITHOUT W/ =WITH/ SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE. .MOTORS
DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NOTES
ATTACHED TO LINE.
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived
from the Guide DRlGN02 Database Date 11/2002 and the parts selected are OEM-parts
manufactured by the vehicles Original Equipment Manufacturer. Asterisk (*) or Double
Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have
been modified or may have come from an alternate data source. Non-Original Equipment
Manufacturer aftermarket parts are described as AM or Qual Repl Parts. Used parts are
described as LKQ, Qual Racy Parts, RCY, or USED. Reconditioned parts are described as Recon.
Recored parts are described as Recore. NAGS Part Numbers and Prices are provided from
National Auto Glass Specifications, Inc. Pound sign (#) items indicate manual entries.
7
__.
c
11/17/2002 at 09:48 PM File ID: 386570
7057"
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA ASND 6-4.2L-FI 4D UTV SILVER Int:GRAY
Pathways -- A product of CCC Information Services Inc.
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CLAIM
B!2"R OF&UB3MRS OQE CQNT&&COSTA COUNTY
BOARD ACTION: 003,
_N: W 13� 2
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: $765.00
Ai' 2Q
CLAIMANT: DONNA FOX
VAI
ATTORNEY: UNKNOWN DATE RECEIVED: APRIL 10, 2003
ADDRESS: 5335 CHEROKEE WAY BY DELIVERY TO CLERK ON: APRIL 10 2003
ANTIOCH, CA 94531
BY MAIL POSTMARKED: RECEIVED FROM RISK
MANAGEMENT THROUGH INTER OFFICE
FROM; Clerk of the Board of Supemisors TO: County Counsel MAIL
Attached is a copy of the above-noted claim.
JOHN SWEETEN Cl
Dated: APRIL 10, 2003 By: Deputy
II. FROM: County Counsel. TO: Clerk of the Board of Supervisor's
Gyfhis claim complies substantially with Sections 910 and 910.2.
This Claim FALLS 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).
O Other:
Dated: By: Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2)
Claim was returned as untimely with notice to claimant(Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present:
9 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: MAY 1 13, 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 W!M!Rg See Reverse Side of This Notice.
AFFIDAVIT OF MAILING
I declare under penalty ofperjury that I am now,and at all times hereinmentioned,have been a citizen of the United
States,over age 18; and that today Ideposited in the United States Postal Service in Martinez,California,postage fully
prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.
Dated: MAY 14, 2003 JOHN SWEETEN2 CLERK By Deputy Clerk
.......... .......
...........................................
•MAR-06-2003 13.40 CCC RISK M"GMENT 925 335 1421 P.01
Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA C?t3M
INS't"RfICT ONS TO C LADAW
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,
mast be presented not later than the 100th day after the accrual of the cause of
action. Claims relating to causes of action for death or for injury to person
or to personal property or growing crops and which accrue on or after January 1,
1988, must be presented not later than six months after the accrual of the cause
of action. Claims relating to any other cause of action must be presented not
later than one year after the accrue of the cause of action. (Govt. Code §91.1.2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in
Room 3-06, County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather t'=
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"bee
fled against each public entity.
E. ' Fraud.; See penalty for fraudulent claims, Penal. Code Sec. 72 at the end of thl is
form.
RE: Claim By } Reserved for Clerk's filing s�
}
3
H A 110 N t, f+sE •�
Agai.rgt 'the Ciaunty of Contra. Costa ) ���o
or APR o � d
� w
District} 1.
'i 11 : name fl G
The undersigned claimant hereby mattes claim agai t the County of Contra Costa.
the above-namd District in the sum of � and in support of
this claim represents as follows:
1. When did the damage or injury occur? (Give exact date and hour)
2. Where did the damage or injury oomvwx (Include city and county)
�. � �?r
3. H w dict the damage or injury occur? (Give a r if
_ Parte
r
4- What particular act or emission an the part of county or district o fivers,
se.*waats or .e'mployees caused.the injury or damage?
MAR-06-2003 13:40 CCC RISK MANN&ENT 925 335 1421 P.02
5. gnat are the names of county or district officers, servants or employees causing
the damage or injury? CE. ��..�s,,.,�, � 4�`
k�
5. What damage or injuries do you claim resulted? (Give full extent of injuries or
damages Claimed. Attach two estimates for auto damage.
7. How was the amount claimed above computed? (Include the estimated%amount of any
prospective injury or darmage.
.� � �
13. !dames and addresses of witnesses, doctors and hospitals.
�� .
9. List the expenditti-es you made on account of this accident or injury:
DATE 1TEII MINT
Gov. Code Sec. 910;2 Provides:
"The claim must be signed by the claimant
SM X=CES TO; (Attorne ) or some o�n
me a his.behalf."
MiAddress of Attorney
aT3532'tt t S SigI3atur'@
Telephone No. Telephone No.
* * IFIN Ir"' * �t
NOTICE
Section 72 of the Penial. 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 ordistrictboard or
officer, authorized to allow or pay the same if.genuine, any false or fraudulent
claim, bill, account, voucher, or writing, is punishable either by imprisonment in
the county Jail.,for a period of not more than one year, by a fine of not exceeding
one thousand ($1,000), or by 'both such U30ri=hment and fine; or by imprisormaent: in
the state prison, by a fine of not exceeding ten thousand dollars ($10,000, or by
both such iMprisonMent and fine.
TOTAL P.02
To Whom It May Concern,
On 02-14-431 was taking my mother Connie Lawrence for a
Doctors Appointment. When parking in the Handicapped parking space in front
of the Clinic,my front bumper got caught on some mbar that was sticking up
at least 4 inches out of the parking barrier that stops your tire. When trying,to
back out it of the space it ripped my front bumper off'of the car.I immediately
ately
went inside and filed a claim. Attached is a copy of an estimate to fix the
Damage.
Donna Fox
5335 Cherokee Way
Antioch,Ca 94531
Hm#925-755-3595
Wk#925-224-3018
.........................I.........................................................................................................................
..........I................I............................................................................
03/18/2003 at 04:21 PM Job Number:
20216
JIM'S CALIFORNIA AUTO BODY, INC.
License #:AH134092 Federal ID #:94-222722
EST. 1962
1615 W. 10TH STREET
Antioch, CA 94509
(925)754-7600 Fax: (925)754-3614
PRELIMINARY ESTIMATE
Written by: MARK AZEVEDO #
Adjuster:
Insured: GARY HORNE Claim #
Owner: GARY HORNE Policy #
Address: 5335 CHEROKEE WAY Deductible:
ANTIOCH, CA 94531 Date of Loss:
Business: (925)824-0267 Type of Loss:
Evening: (925)755-3595 Point of Impact: 12• Front
Inspect JIM'S CALIFORNIA AUTO BODY, INC. Business: (925)754-7600
Location: 1615 W. 10TH STREET
Antioch, CA 94509
Insurance
Company: Days to Repair
1999 VW NEW JETTA GLS VR6 6-2.8L-FI 4D SED Int:
VIN: 3VWSE29.M.8XM069096 Lic: 4FRN846 CA Prod Date: Odometer:
Air---C6ditioning Rear Defogger Tilt Wheel
Cruise Control Telescopic Wheel Intermittent Wipers
Keyless Entry Theft Deterrent/Alarm Body Side Moldings
Dual Mirrors Clear Coat Paint Power Steering
Power Brakes Power Windows Power Locks
Power Mirrors Anti-Lock Brakes (4) Driver Air Bag
Passenger Air Bag Front Side Impact Air Bag 4 Wheel Disc Brakes
Cloth Seats Bucket Seats Automatic Transmission
-------------------------------------------------------w-----------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-----------------------w-------------------------------------------------------
1 FRONT BUMPER
1
03118/2003 at 04:21 PM Job Number:
20216
PRELIMINARY ESTIMATE
1999 VW NEW JETTA GLS VR6 6-2.8L-FI 4D SED Int:
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
2 Repl Bumper cover 1 252.90 1.2 2.4
3 Add for Clear Coat 1.0
4 FENDER
5 Repl RT Splash shield 1 39.75 0.3
6# 'DINT COLOR TO BATCH 1 0.5
7# FLEX ADDITVE 1 8.00
-------------------------------------------------------------------------------
Subtotals ==> 300.65 2.0 3.4
Parts 300.65
Body Labor 2.0 hrs B * 63.00/hr 126.00
Paint Labor 3.4 hrs B S 63.00/hr 214.20
Paint Supplies 3.4 hrs B S 27.00/hr 91.80
----------------------------------------------------
SUBTOTAL * 732.65
Sales Tax $ 392.45 B 8.2500% 32.38
----------------------------------------------------
GRAND TOTAL $ 765.03
ADJUSTMENTS:
Deductible 0.00
----------------------------------------------------
CUSTOMER PAY $ 0.00
INSURANCE PAY * 765.03
2
_
^ ^
^ ~
03/18/2003 at 04:21 PM Job Number:
20216
PRELIMINARY ESTIMATE
1999 VW NEW JE7?A CLS VK6 6-2.8L-FI 4D SED Int;
AUTHORIZED AND ACCEPTED: You are hereby authorized to make the above specified
repairs, I understand that payment in full will be due upon release of vehicle,
including additional supplemental damage charges, and hereby grant you/or your
employees, permission to operate the car, truck or vehicle herein described on
streets` highways or elsewhere for the purpose of testing and/or inspection. An
expressed mechanic's lien is acknowledged on above car` truck or vehicle equal
to the amount of repairs thereto` You will not be responsible for loss or
damage to vehicle or articles lost in vehicle in case of fire, theft, accident
or any other cause beyond your control.
ALL OLD/DAMAGED PARTS REMOVED FROM VEHICLE WILL BE DISPOSED OF UNLESS
REQUESTED OTHERWISE PRIOR TO REPAIRS.
NO {K[DI? CARDS ACCEPTED ****************
REPAIRS AUTHORIZED BY DATE
THE FOLLOWING IS k LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO
DESCRIBE WORK TO BE DON[ OR PARTS TO BE REPAIRED OR REPLACED: MOTOR
ABBREVIATIONS/SYMBOLS: D=DISC0N?INU[0 PART A=APPROXIMA?[ PRICE LABOR TYPES:
8=BVDY LABOR D=DIAGN0S7I[ E=ELE[?RICAL F=FRAME G=GLAS3 M=M[[HANICAL P=PAIN7
LABOR S= TRUCTURAL 7=7AX[D MISCELLANEOUS X=NON ?AXED MISCELLANEOUS PATHWAYS:
ADJ=ADJA[ENT ALGN=ALI&N A/M=AF7ERMARKE? 8LND=8L[ND CAPA=[[R?IFIE0 AUTOMOTIVE
PARTS ASSOCIATION D&R=0IS[0NNE[? AND RECONNECT ES?=[S?IMA7[ [X?^ PRI[E=UNIT
PRICE MULTIPLIED BY THE QUANTITY IN[L=TN[LUD[D MIS[=MIS[ELLAN[OUS NAG%=NA?IONAL
AUTO GLASS SPECIFICATIONS NON-ADJ=N0N ADJACENT O/H=OVEMHAUL 0P=0PERA?I0N
NO=LINE NUMBER Q?Y=&UAN?I?Y QUAL RE[Y=QUALI?Y RECYCLED PAR? QUAL R[PL=QUALITY
REPLACEMENT PART R[{0ND=R[{ONDI?ION REFN=MEFINISH R[PL=REPLA[E R&I=R[MOVE AND
INSTALL R&R=R[M0VE AND REPLACE RPR=REPAZR RT=RZGH7 %E[T=3E[TT0N SUBL=SU8L[7
L?=L[FT N/O=WI7HOUT N/_=NITH/_ SYMBOLS: #=MANUAL LIN[ ENTRY *=OTHER EIE^ ^MOTOR%
DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NO?ES
ATTACHED TO LINE~
_
y
03/18/2003 at 04:21 PM Job Number:
20216
PRELIMINARY ESTIMATE
1999 VWNEW JETTA GLS VR6 6-2.8L-FI 4D SED Int:
Estimate', based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived from
the Guide ERA9277 Database Date 212003 and the parts selected are OEM-parts manufactured by the
vehicles',Original Equipment Manufacturer. Asterisk (*) or Double Asterisk (**) indicates that the
parts and/or labor information provided by MOTOR may have been modified or may have come from an
alternate data source. Non-Original Equipment Manufacturer aftermarket parts are described as AM
or Qual Repl Parts. Used parts are described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned
parts are described as Recon. Recored parts are described as Recore• NAGS Part Numbers and Prices
are provided from National Auto Glass Specifications, Inc. Pound sign (#) items indicate manual
entries.
Pathways - A product of CCC Information Services Inc.
4
c
— 4
---l''..,...I....................................................................................................-........
................. ...
CLAIM
B9_AR OF SUP RVISORS OF CONTRA CQSTA COINTY a.
BOARD ACTION:.. MAY. 13j: 2003
ClaimAgainst 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. $1,570.64
APR 1 0 2003
CLAIMANT: JAMES MODKINS
COUNrf-11
MARTINEZ CAUR
ATTORNEY: UNKNOWN DATE RECEIVED- APRIL 10, 2003
ADDRESS: 1.212 TULLIBEE ROAD BY DELIVERY TO CLERK I ON: APRIL 10, 2003
RODED, CA 94572
BY MAIL POSTMARKED: RECEIVED FROM RISK
MANAGEMENTTHROUGH INTER OFFICE MAI
FROM; Clerk of the Board of Supervisors TO County Counsel
Attached is a copy of the above-noted claim.
JOHN SWEETEN2&,,,,___
Dated: APRIL 10, 2003 By: Deputy— 0
H. FROM: County Counsel TO: Clark of the Board of Supervisofs
(W<.S 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: LLL
By: Deputy County Counsel
_! .4
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:
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: MAY 13, 2003 JOHN SWEETEN,CLERK,By a e_ 'Deputy Clerk
WARNING(Gov. code section 913) - 01
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
*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 hereinmentioned,have been a citizen of the United
States,over age 18;land that today I deposited in the United States Postal Service in Martinez, California,postage fully
prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.
Dated. MAY 14, 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 Pers n
property or growing crops and which accrue on or before December 31, 19
be presented not later than the I 00th day after the accrual of the cause of
Claims relating to causes of action for death or for injury to person or to pe
property or growing crops and which accrue on or after January 1, 1988, st b
presented not later than six months after the accrual of the cause of action. Claims
As
relating to any other cause of action must be presented not later than one year after the
accrual of the cause of action. (Govt. Code §911.2.)
B. Claims must be filed with the Housing Authority of the County of Contra Costs
at its office at 3133 Estudiflo Street,Martinez,CA 94553, either by mail or in
person.
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 R e for Clerk's filing stamp
James Modkins
Against the County of Contra Costa 0,910
1?00,?
or
The Housing Authority of Contra Costa (District)
(Fill in name)
The undersigned claimant hereby makes claim against Pie County of Contra Costa or the
above-named District in the sum of$ -71>- to t-f and in support of this claim
represents follows:
9 0,::�
1. When did the damage or injury jecur? (Give exact date and hour)
Ru4eo . P /��f
2. Where did the dAmage or injury occur? (Include city and county)
-fit -
tmth mil oat "Aad Aq
3. How did the age or injury occur?-(Give full details; usUxtra papet if required)
F%-,
4. What particular act or omission on the part of county or district officers, servants or
employees caused the injury or damage?
cimform
5. What are the names of county r di,tr ct officers, servants or employees causing the
damage or injury?
and &d U-) &i &LS
IRI&I
6. W a damage or injuries do you claim resulted? (Give full extent of injuries or
damages claimed. Attached two estimates for auto damage.)
7. How was the amount claimed above computed? (Include the estimated amount of any
prospective injury or damage.)
C4'4--Ifx W 19,9
8. Names and adUresses of withess s, doctors and hospitals.
9. List the expenditures you made on account of this accident or injury:
DATE ITEM AMOUNT
Gov. Code Sec. 910.2 provides:
"The claim must be signed by the claimant
SEND NOTICE TO: (Attorney) or by some person on his behalf."
Name and Address of Attorney
X96
(Claimafif s Signature)
(Address)
Ace) _ q(-P5-).
Telephone No. Telephone No. 057
NOTICE
Section 72 of the Penal Code provides:
"Every person who,with intent to defraud,presents for allowance or for payment
to any state board or officer,or to any county,city or district board or officer,authorized
to allow or pay the same if genuine,any false or fraudulent claim,bill, account, voucher,
or writing,is punishable either by imprisonment in the county jail for a period of not
more than one year, by a fine of not exceeding one thousand($1,000), or by both such
imprisonment and fine, or by imprisonment in the state prison,by a fine of not exceeding
ten thousand dollars($10,000)or by both:such imprisonment and fine."
ctmform
Date: 2124103 09:17 AM 4
Estimate ID: 1434
Estimate Version: 0
Preliminary
Profile ID: Mitchell
BILL NELSON CHEVROLET, Inc.
3233 Auto Plana Richmond,CA 94606-1994
{514)222-2070
Fax: {610)2234641
Tax ID: 94-108426 BAR#: AB00700i ERA M CA981997S68
Damage Assessed By: Chris Hoglund
Type of Loss: Collision
Deductible: UNKNOWN
Insured: JAMES>MODKINS
Address: 1212 TULLISEE RD RODEO,CA 94572
Telephone: Home Phone: (510)313.0466
Mitchell Service: 910471
Description: 1986 Chevrolet Cavalier
Body Style: 4D Sed Drive Train: 2.81-In)6 Cy)3A
VIN: 1GiJO69P4LK165827
Mileage: 11036
OEMIALT: O Search Code: None
Color: WHITE
"ALL CRASH PARTS ON THIS ESTIMATE ARE "NEW" ORIGINAL EQUIPMENT
MANUFACTURER PARTS, UNLESS OTHERWISE SPECIFIER. PARTS DESCRIBED AS
RECHROMEI7,RECORED,R 4RNUFACTURED OR, RECONDITIONED ARE CONSIDERED
"REBUILT" PARTS.CRASH PARTS DESCRIBED AS "QUALITY REPLACEMENT PARTS"
ARE NON 'ORIGINAL EQUIPMENT MANUFACTURER AFTEPIOMCET NEW PARTS.
THOSE LISTED AS „LRQ" LIKE: RIND AND QUALITY PARTS ARE USED PARTS.
Line Entry Labor Line Item Part Typef Dollar Labor
Item Number Type_ Operation _ Description — -— Part Number Amount Units
I_...__ 400130 BOY REMOVEIREPLAC€ L FRT REPLACE DOOR ASSY Qual Recycled Part --550.00• 4.6*
2 AUTO REF REFINISH L FRT DOOR C 1.6
3 AUTO REF REFINISH L FRT ADD FOR JAMBS ii INTERIOR C 1.0
4 ***END OF ATG SECTION
5 008800 REF BLEND L FENDER OUTSIDE 1.3*
6 025230 BOY REMOVEIREPLACE L FRT DOOR ADHESIVE MOULDING ORDER FROM DEALER B1.24 0.2
7 026470 REF BLEND L REAR DOOR OUTSIDE 1.1
8 000031 BOY REMOVEMSTALL L REAR DOOR TRIM PANEL 0.4
9 029570 SDY REMOVEIINSTALL L REAR DOOR OUTSIDE HANDLE Existing 0.2*#
10 AUTO REF ADD*LOPR CLEAR COAT 1.0
11 933005 BOY ADO'L OPR RESTORE CORROSION PROTECTION 10.000 0.3*
12 933018 BDY* ADD'L OPR MASK FOR OVERSPRAY 5.00* 0.3*
13 AUTO ADMCOST PAINTIMATERIALS 144.00*
14 AUTO ADDT COST HAZARDOUS WASTE DISPOSAL 2.25
ESTIMATE RECALL NUMBER: 2124103 09:17:00 1434
UltraMste is a Trademark of Mitchell international
Mitchell Data Version: FEBf03_A Copyright(C)1994-2002 Mitchell International Page i of 2
UltraMste Version: 4.8.012 All Rights Reserved
........... ------
`%O/
Date: 2124103 0917 AM
Estimate ID: 1434 -
Estimate Version: 0
Preliminary
Profile 0: Mitchell
Judgement Item
#-Labor Note Applies
C-included In Clear Cost Calc
Add`1
Labor Sublet
1. Labor Subtotals Units Rate Amount Amount Totals H. Part Replacement Summary Amount
Body 6.8 80.0!1 IS-00 -
T Taxable Parts 631.24
— —--i-00—
Refinish 6.0 $0.00 0.00 0.00 360.00 T Sales Tax @ 8.250% 62.08
Taxable Labor 729.00 Total Replacement Parts Amount 683.32
Labor Summary 11.9 720.00
111. Additional Costs Amount IV. Adjustments Amount
Taxable Costs 146.25 Customer Responsibility 0.00
Sales Tax @ 8.250% 12.07
Total Additional Costs 158.32
1. Total Labor. 72940
N. Total Replacement Parts: 683.32
In. Total Additional Costs. 168.32
Gross Total: 1,570.64
IV. Total Adjustments. 0.00
Not Total: 1,5711.e4
This Is,a gMWWnm estimate.
&ORIonal clLanami to the 291—ma-ft may be rmired for the actual reR111r.
SPECIAL PARTS NOMALL CRASH PARTS ON THIS ESTIMATE, ARE "NEW"
PARTS (OEM) UMZSS OTHFXXISZ SPECIFIED. PARTS DESCRIBED AS
RECHROMD, RECORZD, OR RMamurACTURED ARS EITHER "RECOWITIONED-
PARTS OR "REBUILT" PARTS. CRASH PARTS DESCRIBED AS QUAL REPL,
PART,, ARE NON 01124 AFTEP24ARKET PARTS
Drop off Date. 2"03 Repair Dates:
Promise,Data. 2124103 Start Date: 2124103
wARNWG-. Accidents!airbag deployment to possible. Personal k1jury may result; Avoid area near steering wheel
and Instrument panel even H sk bags have deployed. Dual-stage,air bag modul"may be present Out could
contain an undeployed stage. Whan disposing of a deployed dualstage air bag,always treat It as a"live"module.
See appropriate MITC14ELLO AIR SAO SERVICE&REPAIR MANUAL,or OEM Informallom
ESTIMATE RECALL NUMBER: 2124103 0907:00 4434
U**Msft Is a Trademark of Mitchell International
Mftheti Data Version: FEEL-O _A Copyright(C)1994-2002 M*dw#tntemadonal Page 2 of 2
UkraMsW Version: 4.8.012 Alt Rights Reserved
CLAIM {�
BOARD OF SUPERYISURS OF CONTRA COSTA COUNTY l
BOARD ACTION; MAY 13, 2003
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 N below), given
Pursuant to Government Code Section 913 and
915.4. Please note all"Warnings".
AMOUNT: $924.92 APR .14 2003 -01�
CLAIMANT: LISA GREGO COUNTY COUNSEL
MARTINEZ CALIF.
ATTORNEY: UNKNOWN DATE RECEIVED: APRIL 11, 2003
ADDRESS: 2504 PRINCETON LANE BY DELIVERY TO CLERK,ON:gBIL 11, 2003
ANTIOCH, CA 94509
BY MAIL POSTMARKED: HAND DELIVERED
FROM; Clerk of the Board of Supervisors TO, County Counsel
Attached is a copy of the above-noted claim.
JOHN SWEETEN,2er
Dated: APRIL 14, 2003 By: Deputy '
H. FROM: County Counsel: TO: Clerk of the Berard of Superviso
(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 914.8).
( ) Claim is not timely filed.The Clerk should return claim on ground that it was filed late and send warning of
claimant's right to apply for leave to present a late claim(Section 911.3).
( } Other:
Dated: '� By Deputy County Counsel
III. FROM: Clerk of the Board TO: County Counsel(1) 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: t
ft 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: MAY 13, 2003 JOHN SWEETEN,CLERK,By ,Deputy Clerk
WARNING(Gov.code section 9.1 )
Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposited
in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an
attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so
immediately. *For Additional Warning See Reverse Side of This Notice.
AFFIDAVIT OF MAILING
I declare under penalty of perjury that I am now, and at all times herein mentioned,have been a citizen of the United
States,over age 18, and that today I deposited in the United States Postal Service in Martinez, California,postage fully
prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.
MAY 14 2003
Dated: JOHN SWEETEN,CLERK By Deputy Clerk
' rY
Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
t•
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 10&day
after the accrual of the cause of action. Claims relating to causes of action for death or for injury to
person or to personal property or growing crops and which accrue on or after January 1, 1988, must be
presented not later than six months after the accrual of the cause of action. Claims relating to any other
cause of action must be presented not tater 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 claire is against more than one public entity, separate claims must be filed against each public
entity. .
E. raud. See penalty for fraudulent claims,Penal Code Sec.72 at the end ofthis form.
RE: Claim By Reserved for Clerk's filing stamp
Against the County of Contra Costa or }
} A PR 1 12003
District} cC Arc sc�ARJ)0,C St
(.Pill in name) } c �s
The undersigned claimant hereby makes claim against the County of Contra Costa or the above--named district
in the sum cif - and in support of this claim represents as follows:
1. When did the damage or injury ca ur?(Give enact date and hour)
ry)wch 3$1315 Polk
2. Where did the damage or injury occur?(Include city and county)
3. How did the damage or injury,occur?(Give full details;use extra paper if required)
l Are. cid
4. 'What particular act or ornission on the part of county or district officers, servants, or employees caused the
injury or damage" — Ob ce0c� 4 JcD
Ca"tof
5. What are the names of county or district officers, servants, or employees causing the damage or injury?
6. What damage or injuries do you claim resulted?(Give full extent of injuries or damages claimed. Attach
two estimates for auto damage.)
&f W hD A-tJ&bj9,jz tb
T. How was the amount claimed above computed?(Include the estimated amount of any prospective injury or
8. Names and addresses of witnesses,doctors,and hospi s.
An:-tioc� CA j ( BCD
9. List the expenditures you made on account of this accident or injury.
MATE IM AMttiNT
pr
) Gov. Code Sec. 910.2 provides"The claim must be
) signed by the claimant or by some person on his behalf."
Name and Address of Attorney )
}
(Claimant's 1gnatu re)
} (Address)
}
)
Telephone No. )Telephone No. 2�`229-, 9/96
#��*s**s:*���*Asa*��*��#*�s*s****s�*«#ss*•#��r�***s*�*sss#��*�a*���**ss*������#.��*#*#*s**
No=
Section 72 of the Penal Code provides:
Every person wbo.with iartcxit to defrsuck prts m for allo%awe or the paywzm to any gate board or officer,or to my
county,city.or district board or offim,audwriz ed to allow or pay the lame if get Woe,my false or fraudulent Chinn,bill,wcoum,
voccber,or,writing is punishable either by imprisownent in the=wty jafl for a period of not afore than one year,by>a fine of not
exsxeftg;out tbousand I,00 k sir by both ssreh iu psisotunn v and fine,or by haprisonment in the state priwn,by a Sm of not
exmeding len thousand d (SIOAM).or by be ttb such imprisorrmea and fm e.
2T4174 a s MI kN ANTIOCH NISSAN
1801 SOMI_RSVILLE ROAD
ANTIOCH, CA 94509
*INVOICE* 925-755-2600
I X GREGO www.antiochautocenter.com
2-4 PRINCETON LN.
1TIOCH, CA 94509 PAGE 1
HOME: 925-778-7180 BUS: 408-0024
SERVICE ADVISOR 29 JOSE DEL CID
L L i Ai'
WHITE 02 NISSAN MAXIMA JN1DA31DX2T417440 6XHW937 10072/10072 T531
£ t3kt '!8{�I� :�dAI�
..:.. ..,...:.:. .:.
OIJAN2002, , 17:00 19MAR03 0.00 CASH LlMAR2003
OPTIONS: EIdCs:3.5 Liter GrXS
10..28 >19MAR03 13:09 21MAR03
LINE OPCODE TECH TYPE HOURS LIST NET TOTAL
A INSPECT FOR VEHICLE VIBRATION ON FREEWAY
99 MISCL'
5405 ISER (NIC)'
RIGHT FRONT WHEEL BENT, TIRE HAS 'BULGE HAS SPACE SAVER TIRE
B CHECK AND ADVISE CUSTOMER REPORTS SEAT SWITCH NOT WORKING PROPERLY
WILL CONTINUE TO MOVE BACK OR FOWARD ONCE SWITCH RELEASED
CAUSE: SWITCH STICKS, REPLACED
99 MISCL
5405 WN (NIC)
1 87066-2Y020 SWITCH ASM (NIC)
C BECK AND .ADVISE CUSTOMER STATES THUMP NOISE OVER BUMPS
99 MISCL
5405 ISER (NIC)
UNABLE TO DUPLICATE, ROAD TESTED WITH CUASTOMER TIGHTEN SUSPENSION AND
LUNE
I t
eme ------ Cw cif
FINAL.
ORIGINAL REVISED LABOR AMOUNT 0.00
ESTIMATE$ ESTIMATE 6 PARTS:AMOUNT 0.00
--. DATE TIME PHONE# AUTHORIZED ADDIAMOUNT TOTAL GAS,OIL,LUBE 0.00
�r
SUBLET AMOUNT 0.00
1MI � � HAZARDOUS MATERIALS 0,.00
TOTAL CHARGES 0.00
ADJUSTMENTS 0.00
I ACKNOWLEDGE NOTICE AND URAL APPROVALj ACKNOWLEDGE RECEIPT OF V9 CLE AND I SALES TAX a.00
OF AN HVCREA5E 3N THE ORIGINAL ESTIMATE IA VERECEIVEDACOP76F TMS INVOICE
PRICE. PLEASE PAY
THIS AMOUNT
ALL PARTS ARE NEW UNLESS SPECIFIED OTHERWISE.
BAR#AA2032$5 EPA#TAL000212209
CUSTOMER COPY
April 10,2003
board of Supervisors
Contra Costa n+q,)%arfinear CA
To whom it na!j concern,
I work in` racq, CA for the Tri-Va e!j Otralti Ntwspaptr, and travel the
Saha+,romft to work tvtr!jda:!j. The pothole that 1 encountered on
Concord Avenin.,the morning ofMarch IT",came to a shock to me as rn!j
vehicle crossed its'path. The impact was frightening,loud and
+int*pected. L lit t said a6ov , 1 drive this same route,twerp morning on
mg wad to work in Tracy, CA from Antioch.
4 was ironic that when 1 returned from word,drag home the same wag,
road
transportation (Cal-Trans?) were hard of work pawing the thole.
`fie time was 2ahouf 100 loam.
The reason I'm telling you this is 16tcause the photos that rve enclosed
with this claim were taken at noon to same dad. This would t*plain why
the photos "a freshly tarred pothole.
should!)ON have ani questions,p+1tase call me at VS-778-7180. Could
the coWntg please fry to e*pedite this clairza'x' I've ajrea y been driving
m!) "new" car,with a hent rim& 6166led tire for fhe past 3 weeds now,
and it'sJust not safe. I need nab car Ned ImmOiat 1q, 16ecause rve keen
told that the damage could intensifg and camse other front-end damage,
should`Icontinue to drive on this Lent riga and Aged tire.
Lisa,M.Grego
2W4 Princeton Lane
Antioch,CA g4SOq
NII SA-N ANTIOCH NISSAN
2T417440 2 9 7 3 8 1801 SOMERSVILLE ROAD
ANTIOCH, CA 94609
*INVOICE* 925-755-28130
1;7^A GREGO www.antiochautocenter.com
4 PRINCETON LN.
ANTIOCH, CA 94509 PAGE 1
Ham: 925-778-7180 BUS: 408--0024
SERVICE ADVISOR 90 BOB WOOD
WHITE 02 NISSAN MAXIMA JN1DA31DX2T417440 6XH 937 10072/10072'; PRtE E7AtE A3P _ . ... 'I3M1 .. t0 '_ RAYIr1NT lN1l;.CAIR. . ...
01,7AN200217:00 09APR03 0.00 CASH 09APR2003
RIO .:: OPTIONS: ENG:3 .5 Liter Gas
10:28 09APR03 0:30 09APR03
LINE OPCODE TECH TYPEHOURS LIST NET TOTAL
A ESTIMATE FOR REPLACING RIGHT FRONT WHEEL AND TIRE. WHEEL IS BENT ANIS
TIRE HAS A BULGE
02 SUSPENSION
99 ISER (N/C)
TIRE $300.00 WHEEL $577.30 TAX $47.62 TOTA L 924.92
tr x r1 t
cv 1c"
FINAL ESpIIWTiIt TG?TAL"s"
ORIGINAL REVISED LABOR AMOUNT �,.���
ESTIMATE$ ESTIMATE$ PARTS AMOUNT 0.00
DATE TIME PHONE# AUTHORIZED 0.00}00
AMOUNT TOTAL GAS,OIL,LUSS
SUBLET AMOUNT 0.00
NISSAN HAZARDOUS MATERIALS
0.00
® TOTAL CHARGES 0.00
ADJUSTMENTS 0.00
3 ACKNOWLEDGEE NOTICE AND ORAL APPROVAL I ACKNOWLEDGE RECEIPT OF VEMCLE AND I SALES TAX 0.00
OF AN fNCREA$E IN THE ORIGINAL ESTIMATE NAVE RECEIVED A COPY OF THIS INVOICE.
PRICE. PLEASE PAY
TfIS AMOUNT
ALL PARTS ARE NEW UNLESS SPECIFIED OTHERWISE. $AR 9 AA203286 EPA TAL000212209
CUSTOMER COPY
y r A
e
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AMEND -- CLAIM
FS]Vr
&QAU gj ZM§=OF QUM CgSTA C
B0 gpoN: MAY 13, 2003
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
W Pursuant to Government Code SectiWi.913 and
is
APR 915.4.Please note all"Warnings".
AMOUNT: $4,525-33 COUNTY
CLAIMANT: AMEX ASS'Ok�' COMPANYI
ROBERT/jULIANABOILES,
ATTORNEY:. =Now
DATE IkEMMW: APRIL 23, 2003
CANDY BAILEY '
ADDRESS: P.O. BOX19013BY DELIVERY TO CLERK ON: APRIL 23, 2003
GREEN BAY� -
WI 59307-§618
BY MAIL POSTMARKED: HAND DELIVERED
FROM: Clerk of the Board'd Supir' 'SON
TO: C6W)ty Counsel
Attached is a copy of the abbvenoted cla,=, ,
Dated: APRIL 23, 21003 JOHN S
WEE lark
By: Deputy
H. FROM: Coun;yCounsel TO:Clark of the Board of Supeivrisors
claim complies substantially with Sections 910 and 910.2.
This Claim FAILS to comply substantially with Sections 910 and 9102, 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 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: LA—2-3-al
By.'11'�r kda Deputy County Counsel
III. FROM: Clerk of the Board TO:, County Counsel(1) County Administrator(2)
Claim was returned as untimely with notice to claimant(Section 911.3).
IV. BOARD ORDER: By unanimous vote of the,Supervisors present:
0 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 ate,
Dated: MAY 13, 2003 JOHN SWEETEN,CLERK,By 22uty Clerk
WARNING(Gov.code section 9,13)
Subject to certain exceptions,you have only six{o)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 Wan= See Reverse Side of This Notice,
AFFIDAVIT OF MAZING
I declare under penalty ofperjury that I am now,and at all times horein,mentioned,have been a citizen of the United
States,over age 18; and that today I deposited in the United States Postal Service in Martinez,California,postage fully'
prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.
Dated: n
JOHN SWEETEN,CLERK By 2!!�.r Clark
.................... ..........................................
............
Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIQNS TO CLAZIANT
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 10&day
after the accrual of the cause of action. Claims relating to causes of action for death or for injury to
person or to personal property or growing crops and which accrue on or after January 1, 1988,must be
presented not later than six<months after the accrual of the cause of action. Claims relating to any other
cause of action must be presented not later than one year after the accrual of the cause of action.
(Gov't Code 911.2.).
B. Claims must be filed with the Clerk of the Board of Supervisors at its office-in Room 106, County
Administration Building, 651 Pint 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
- - t
RECEIVED' ~ ~~m g
9fbOf~.
Against the County of Contra Costa or ) APR 2"3 2003
}
District) CLERK 8€IARD OF NPERVISORS
(Fill in name) ) CONTRA COSTA CR' ~
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-gMtd.district
in the sum of$q,5,k 5.3� and in support of this claim represents as follows: •"a 9
y
~ ~ 0
14~ l 4t
I. When did the damage or injury occur?(Give exact date and hour)
WkN 103., 13,`o rtcuaA
2. Where did the damage or injury occur?(Include city and county)
3. How did the damage or injury occur?(Give full details;use extra paper ifrequired)
%ul►�-- s�-� Q ,c r Q kt.�3 n t rc7 h� Cbl
s�-.sem. �-�.r �!C�c�yS ..�r,, !►t.�.�,.:r ,1.,,.. s"t��C -�,s.'rt oc�j rn.-�t�'E"�la_t"�`n�,�,*'�,. t,,%�.2-rl. �S
ja—r �+.rr. icCa �t ii eJ.t }rte'
4. What particular act or omission on the part of county or district officers, servants, or employees caused the
injury or damage? r� !
tp�a w3 h , s� fZk �tL
is:ua— ;/ tsc &".(41 +c'
AX
5. What are the names of county or district officers, servants,or employees causing the damage or injury?
f iol-f Prtir�
6. What damage or injuries do you claim resulted?(Give full extent of injuries or damages claimed. Attach
two estimates for auto damage.) _
7. How was the amount claimed above computed?(Include the estimated amount of any prospective injury or
damage.)
8. Names and addresses okg
nesse doctors, and hospitals.
D,r..v;,L t nom. a, 51'C>---7't1- 07al
9. List the expenditures you made on account of this accident or injury.
w
Gov.Code Sec. 510.2 provides"The claim must be
#***,PP
signed by the claimant or by some persorr on lits behalf.,'
SEND E 'I' �a#
4 'A'
Name and Address of Attorney �
�yyl(C, 1lj nt°s+Signature) a # M
9th k'IC Q4,, L;,- . 'fit_.7-4c1
(Address)
Telephone No. )Telepb=No.
NMCE
Section 72 of the Penal Code provides:
Evuy person wbo,with u t ut to defraud,presents for anm2noe or the payment to any state board or omcer,or to any
County,tatty,or district board or officer,authorized to allow or pay the same ifgenuine,any false or fmuduknt claim,bill,account,
voucher,or writing,is punishable either by imprisonment in the county jail for a period of not more than one year,by a fine of not
exceeding one thousand 01,440),or by both such imprisonment and fine,or by finprisontuent in the state prison,by a fine of not
exceeding to thousanddollars(S ltf,000),or by both such imprisonment and foe.
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. . ........................................................ ...........-.......-
11/17/2002 at 09:48 PM File ID: 386570
70571
SCA APPRAISAL COMPANY
Northern California Dvision
For Supplements: 510-282-9622, Fax 510-530-6815
P 0 Box 1455
Burbank, CA 91507
(818) 845-7621
Written by: SIMON LEE # 11/17/2002 09:48 PM
�+ )t.
For: AMERICAN EXPRESS PROPERTY AND CASUAL
Adjuster: HEATHER LEITNER #
SUPPLEMENT OF RECORD 2 WITH SUMMARY
Insured: ROBERT BOLES Claim #3722926214-I
Owner: ROBERT BOLES Policy # -
Address: 349 BRIGHTON ST. Date of Loss: 10/23/2002
HERCULES, CA 94547 Type of Loss: Collision
Evening: (510) 245-3903 Point of Impact: 5. Right Rear
Inspect BILL' S NELSON OLDSMOBILE Business: (510) 222-2070
Location: 3233 AUTO PLAZA REPAIR-SHOP
RICHMOND, CA 94806
Repair BILL'S NELSON OLDSMOBILE Business: (510) 222-2070
Facility: 3233 AUTO PLAZA 7 Days to Repair
RICHMOND, CA 94806 License # 94-1699426
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
VIN: IGHDT13S722127146 Lic: 4TUS625 CA Prod Date: 03/2001 Odometer: 18817
Air Conditioning Rear Defogger Tilt Wheel
Cruise Control Intermittent Wipers Climate Control
Keyless Entry Theft Deterrent/Alarm Auto Level
Rear Wiper Steering Wheel Controls Body Side Moldings
Dual Mirrors Privacy Glass Luggage/Roof Rack
California Emissions Fog Lamps Clear Coat Paint
Power Steering Power Brakes Power Windows
Power Locks Power Driver Seat Power Passenger Seat
Power Mirrors AM Radio FM Radio
Stereo Cassette Search/Seek
CD Player Anti-Lock Brakes (4) Driver Air Bag
Passenger Air Bag Front Side Impact Air Bag 4 Wheel Disc Brakes
Positraction Leather Seats Bucket Seats
Automatic Transmission Overdrive Aluminum/Alloy Wheels
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
1 REAR BUMPER
2 O/H rear bumper 1.8
3 Repl Bumper cover Oldsmobile 1 393.49 Incl. 2. 8
4 Add for Clear Coat 1 . 1
5 REAR LAMPS
6 Repl RT Tail lamp asst' Oldsmobile 1 112. 40 0.3
7 LIFT GATE
VI
11/17/2002 at 09: 48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
--------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
8* Rpr Lift gate 2.0 2. 1
9 Add for Clear Coat 0.8
10 R&I Handle Oldsmobile w/o gold orn 0. 4
11* S02 Repl Nameplate "OLDSMOBILE" chrome 1 6.01
12* S02 Repl Nameplate "BRAVADA" chrome 1 16.48
13* S02 Repl Emblem chrome 1 5.29
14* R&I Glass GM w/rear defogger 1.0
w/deep tint
15 R&I R&I trim panel upper 0.3
16 R&I Wiper arm - 0. 3
17 QUARTER PANEL
18* S02 Repl RT Liner 1 37. 62
19 R&I RT Qtr glass GM w/o G. P.S. 2.0
w/deep tint
20 Blnd LT Quarter panel 1.3
21 R&T LT Qtr glass GM w/o G.P.S. 2. 0
w/deep tint
22 REAR LAMPS
23 R&I LT Tail lamp assy Oldsmobile 0. 3
24 REAR DOOR
25 Blnd RT Door shell short wheel 1.2
base GMC & Olds
26 R&I RT Belt w' strip short wheel 0.3
base
27 R&I RT Side molding 0. 5
28 R&I RT Handle, outside w/short 0. 4
wheel base, Oldsmobile
29 R&I R&I trim panel 0. 6
30* S01 Rpr RT QUARTER PANE/LOWER PORTION 7.0 2. 5
31 Overlap Major Adj . Panel -0.4
32 Add for Clear Coat 0. 4
33 EXHAUST SYSTEM
34* S02 Repl Muffler w/tpipe 1 577.08 m 0.7
35* S02 Repl Heat shield rear 1 36. 73
36* SO2 Repl Heat shield center 1 24.78
37## COLOR MATCH 1 0.5
38# HAZ WASTE DISPOSAL 1 3.00
39# COVER VEHICLE FOR OVERSPRAY 1 5.00
40# FLEX ADDITIVE 1 8.00
41# Subl FOUR WHEEL ALIGNMET 1 79. 99 X
42# SET UP AND MEASURE 1 1. 5
43# Repl PULL AND SQUARE 1 2.0
44# S01 Subl Check for leak and Repair 1 15.00 X
45# S02 Subl TOW BILL 1 130.00 X
46# S02 Repl NEW TIRE- 1 363.00
47 S02 WHEELS
48* S02 Repl Valve stem & weight 1 6. 38
49 S02 REAR BODY & FLOOR
2
11/17/2002 at 09:48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4.2L-FI 4D UTV SILVER Int:GRAY
-------------------------------------------------------------------------------
ATO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
50 S02 Repl Winch 1 91. 96
51 S02 REAR LAMPS
52 S02 Repl RT Reflector Oldsmobile 1 6.00
53# S02 Subl over night Fedex/shipping 1 16.70 X
-------------------------------------------------------------------------------
Subtotals ==> 1936. 91 23.9 11.8
Parts 1695.22
Body Labor 23. 9 hrs @- $ 60.00/hr 1434.00
Paint Labor 11.8 hrs @ $ 60.00/hr 708.00
Paint Supplies 11.8 hrs @ $ 24. 00/hr 283.20
Sublet/Misc. 241. 69
----------------------------------------------------
SUBTOTAL $ 4362. 11.
Sales Tax $ 1978.42 @ 8.25000 163.22
----------------------------------------------------
TOTAL COST OF REPAIRS $ 4525.33
ADJUSTMENTS:
Deductible 0.00
----------------------------------------------------
TOTAL ADJUSTMENTS $ 0.00
NET COST OF REPAIRS $ 4525.33
3
11/17/2002 at 09:48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
Attention vehicle owner and repair facility.
Do not repair this vehicle until all guidelines are acknowledged and
accepted.
THIS ESTIMATE IS SUBJECT TO INSURANCE COMPANY AND/OR SCA AUDIT AND
APPROVAL. CONFIRM APPROVED ESTIMATE AMOUNT WITH VEHICLE OWNER AND CARRIER PRIOR
TO STARTING REPAIRS
By accepting the repair from the owner of this vehicle, the shop must agree to
the following guidelines if payment is expected from the Insurance Company. If
the guidelines are not followed, the shop Nearby acknowledges that the
Insurance Company and or SCA Appraisal will not be liable for repairs exceeding
80% of the vehicles actual cash value and / or unauthorized- supplements.
Under California Bureau of Automotive Repairs laws, the shop must present a
written estimate prior to starting repairs or accept the Insurance Appraisers
estimate. This applies to all supplements as well. The shop must tear down the
vehicle and calculate a supplement which must be authorized by the appraiser
before any work is started. This means estimates, multiple supplements and / or
supplements that exceed 80% of the vehicles actual cash value and will deem the
vehicle a total loss, which is the limit of the Insurance Companies Liability.
SCA will not be held responsible for any repair cost due to the fact that we
are not the Insurer. The repair facility agrees to limit the repair cost to 80%
of the vehicles actual cash value, if repaired under this claim. Average market.
Actual Cash Value of this vehicle.
THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO
DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR
ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES:
B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT
LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS:
ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE
PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT
PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL
AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT O/H=OVERHAUL OP=OPERATION
NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY
REPLACEMENT PART RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND
INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET
LT=LEFT W/O=WITHOUT W/ =WITH/ SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE. .MOTORS
DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NOTES
ATTACHED TO LINE.
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived
from the Guide DRIGN02 Database Date 11/2002 and the parts selected are OEM-parts
manufactured by the vehicles Original Equipment Manufacturer. Asterisk (*) or Double
Asterisk (**) .indicates that the parts and/or labor information provided by MOTOR may have
been modified or may have come from an alternate data source. Non-Original Equipment
Manufacturer aftermarket parts are described as AM or Qual Repl Parts. Used parts are
described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recon.
Recored parts are described as Recore. NAGS Part Numbers and Prices are provided from
National Auto Glass Specifications, Inc. Pound sign #) items indicate manual entries.
4
11/17/2002 at 09: 48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
Pathways - A product of CCC Information Services Inc.
5
11/17/2002 at 09:48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 . 2L-FI 4D UTV SILVER Int:GRAY
-------------------------------------------------------------------------------
NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT
-------------------------------------------------------------------------------
------- CHANGED ITEMS -------
11 Repl Nameplate "OLDSMOBILE" chrome 1 -5. 90
11* S02 Repl Nameplate "OLDSMOBILE" chrome 1 6.01
12 Repl Nameplate "BRAVADA" chrome 1 -16. 17
12* S02 Repl Nameplate "BRAVADA" chrome 1 16.48
13 Repl Emblem chrome 1 -5. 19
13* S02 Repl Emblem chrome 1 5.29
18 Repl RT Liner 1 -36. 92
18* S02 Repl RT Liner 1 37.62
34 Repl Muffler w/tpipe 1 -566. 32- m -0.7
34* S02 Repl Muffler w/tpipe 1 577 .08 m 0.7
35 Repl Heat shield rear 1 -36.05
35* S02 Repl Heat shield rear 1 36.73
36 Repl Heat shield center 1 -24 .32
36* S02 Repl Heat shield center 1 24 .78
------- ADDED ITEMS -------
45# S02 Subl TOW BILL 1 130.00 X
46# S02 Repl NEW TIRE- 1 363.00
47 S02 WHEELS
48* S02 Repl Valve stem & weight 1 6. 38
49 S02 REAR BODY & FLOOR
50 S02 Repl Winch 1 91. 96
51 S02 REAR LAMPS
52 S02 Repl RT Reflector Oldsmobile 1 6.00
53# S02 Subl over night fedex/shipping 1 16. 70 X
---------_----------------------------------------------------------------------
Subtotals =_> 627. 16 0. 0 0.0
Parts 480. 46
Sublet/Misc. 146. 70
----------------------------------------------------
SUBTOTAL $ 627.16
Sales Tax $ 480. 46 @ 8.2500° 39. 64
----------------------------------------------------
TOTAL SUPPLEMENT AMOUNT $ 666.80
NET COST OF SUPPLEMENT $ 666.80
Estimate 3603. 53 SIMON LEE
Supplement Sl 255. 00 SIMON LEE
Supplement S2 666. 80 SIMON LEE
--------- TOTAL ADJUSTMENTS $ 0.00
Workfile Total $ 4525.33 NET COST OF REPAIRS $ 4525.33
6
__
.......................,...,._........,.......... .......
11/17/2002 at 09:48 PM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-Fl 4D UTV SILVER Int:GRAY
Attention vehicle owner and repair facility.
Do not repair this vehicle until all guidelines are acknowledged and
accepted.
THIS ESTIMATE IS SUBJECT TO INSURANCE COMPANY AND/OR SCA AUDIT AND
APPROVAL. CONFIRM APPROVED ESTIMATE AMOUNT WITH VEHICLE OWNER AND CARRIER PRIOR
TO STARTING REPAIRS
By accepting the repair from the owner of this vehicle, the shop must agree to
the following guidelines if payment is expected from the Insurance Company. If
the guidelines are not followed, the shop hearby acknowledges that the
Insurance Company and or SCA Appraisal will not be liable for repairs exceeding
800 of the vehicles actual cash value and / or unauthorized- supplements.
Under California Bureau of Automotive Repairs laws, the shop must present a
written estimate prior to starting repairs or accept the Insurance Appraisers
estimate. This applies to all supplements as well. The shop must tear down the
vehicle and calculate a supplement which must be authorized by the appraiser
before any work is started. This means estimates, multiple supplements and / or
supplements that exceed 80% of the vehicles actual cash value and will deem the
vehicle a total loss, which is the limit of the Insurance Companies Liability.
SCA will not be held responsible for any repair cost due to the fact that we
are not the Insurer. The repair facility agrees to limit the repair cost to 80%
of the vehicles actual cash value, if repaired under this claim. Average market
Actual. Cash Value of this vehicle.
THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO
DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR
ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES:
B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT
LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS:
ADJ=ADJACENT ALGN=AL T GN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE
PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT
PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL
AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT O/H=OVERHAUL OP=OPERATION
NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY
REPLACEMENT PART RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND
INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET
LT=LEFT W/O=WITHOUT W/ =WITH/ SYMBOLS: #=MANUAL LINE ENTRY *=OTHER [IE. .MOTORS
DATABASE INFORMATION WAS CHANGED) -*=DATABASE LINE WITH AFTERMARKET N=NOTES
ATTACHED TO LINE.
Estimate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items are derived
from the Guide DRlGN02 Database Date 11/2002 and the parts selected are OEM-parts
manufactured by the vehicles Original Equipment Manufacturer. Asterisk (*) or Double
Asterisk (**) indicates that the parts and/or labor information provided by MOTOR may have
been modified or may have come from an alternate data source. Non-original Equipment
Manufacturer aftermarket parts are described as AM or Qual Repl Parts. Used parts are
described as LKQ, Qual Recy Parts, RCY, or USED. Reconditioned parts are described as Recon.
Recored parts are described as Recore. NAGS Par', Numbers and Prices are provided from
National Auto Glass Specifications, Inc. Pound sign (ft) items indicate manual entries.
7
11/17/2002 at 09:48 RM File ID: 386570
70571
SUPPLEMENT OF RECORD 2 WITH SUMMARY
2002 OLDS BRAVADA AWD 6-4 .2L-FI 4D UTV SILVER Int:GRAY
Pathways - A product of CCC Information Services Inc.
8
......................................................
. .....................................................................
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.....................................................................................................................................................................................................
CLAIM
NAM
FS gZ CqJUA COM COUNTY
BOARD ACTIQN_: MAY 13, 2003
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 Sectir.913 and
A P R915.4..Please note all"Warnings
AMOUNT: UNKNOWN 00 UN Ty ll U N SE L
MARTINEZ CAUIR
CLAIMANT: CHARLES.`6WARD7JOHNSON
ATTORNEY:. LAUREE9 'A'xBETHARDS DATE RECEIVED: APRIL 23, 2003
ADDRESS-. LAW OFFICES., OF, IAUREF14 A.. , BEITIARDEBy DELIVERY To CLERK ON. APRIL 23, 2003
P.O. BOX 12815
BERKELEY., 'CA, 94712 '
BY MAIL.POSTMARKED'. HAND DELIVERED
FROM; Clark of the Bowd of Supervisors TO:, County counsel,
Attached is acopy of the abbi4not6d claim.
JOHN SWEETEN,
Dated:
APRIL 23. 2003
ByEut
11. FROM: County.Counsel TO: Clerk of the Board of Supervisove
(%4/This claim co mplies 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 apt 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:-SJillr
-Deputy County Counsel
Ill. FROM: Clerk of the Board TO:. County Counsel(1) County Administrator(2)
Claim was returned as MWInely with notice to claimant(Section 911.3).
IV. BOARD ORDER: By unanimous vote of the Supervisors present:
(y) 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: MAY 13, 2003, JOHN SWEETEN, CLERK,By
_Tuty Clerk
WARNING(Gov. code sect ion§.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.actioi 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 Earning See Reverse Side of This Notice,
AFFIDAVIT OF MAILING
I declare under penalty ofperjury that I'am now,and at all times hereinmentioned,have been a citizen of the United
States,over age 18;.and that today I deposited in the United States Postal Service in Martinez,California,postage fully'
prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.
Dated. MAY 14, 2003 JOHN SWEETEN,CLERK BX 45 J
Deputy Clerk
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LAW OFFICES OF
LAUR'EEN A. BETHARDS
P. O. Box 12815
Berkeley,CA 94712
Telephone: (510) 525-1001
Facsimile : (510) 525-6001
April 22, 2003
CLERIC OF THE BOARD
BOARD OF SUPERVISORS
CLAIMS DIVISION
651 Pine St .
Martinez, CA 94553
Via Fax Transmission
(925) 335-1913
Re: JOHNSON, CHARLES EDWARD v. CONTRA COSTA COUNTY,
CONTRA COSTA COUNTY SUPERIOR COURT, CONTRA COSTA
COUNTY PUBLIC DEFENDER' S OFFICE, et al
Dear Sirs/Madam:
This letter is intended to supplement Mr. Johnson' s claim in
order to explain why he is entitled to damages for a period
extending beyond 6 months .
Mr. Johnson has a delayed discovery, continuing injury type
claim. Mr. Oerlein and the Contra Costa Public Defender' s office
were Mr. Johnson' s attorney throughout the period of time
indicated on the continuing claim. Mr. Johnson' s attorney never
advised him of their malpractice, or of the circumstances giving
rise to this claim. Mr. Johnson did not become aware of the
legal malpractice and the violation of his civil rights until
advised by his present attorney shortly after her substitution
as counsel and first appearance on October 29, 2002 . So the
basis for damages extending from the period of his confinement
until the time of his release include:
(1) Delayed discovery;
(2) Failure to advise claimant of his rights (concealed
injury) ;
(3) continued representation by an attorney who did not
disclose the legal error and violation;
(4) continuous injury,
(5) equitable and legal estoppel; and
(6) legal tolling due to confinement .
I hope this letter satisfactorily explains claimant' s
position. Please advise if you find any deficiencies.
Very truly
Lau en A. Bethards
LAW OFFICES DP
LAUREE'N A. RETNARDS
P.0.Box 12815
Berkeley,
Teleptione (510)525 1001
Facsimile : (510)525-6001
April 22, 2003 APR 2 3 2003
CLERK OF THE BOARD CLEffK80AffDdFslip
BOARD OF SUPERVISORS
CtfNlffA CQ$A C01/fStJfls
CLAIMS DIVISION
651 Pine St.
Martinez, CA 94553
via Fax Transmission
(925) 335-1913
Re: JOHNSON, CHARLES EDWARD v. CONTRA COSTA COUNTY,
CONTRA COSTA COUNTY SUPERIOR COURT, CONTRA COSTA
COUNTY PUBLIC DEFENDER'S OFFICE, et al
Dear Sirs/Madam:
This letter is intended to supplement Mr. Johnson' s claim in
order to explain why he is entitled to damages for a period
extending beyond 6 months.
Mr. Johnson has a delayed discovery, continuing injury type
claim. Mr. Oerlein and the Contra Costa Public Defender's office
were Mr. Johnson's attorney throughout the period of time
indicated on the continuing claim. Mr. Johnson's attorney never
advised him of their malpractice, or of the circumstances giving
rise to this claim. Mr. Johnson did not became aware of the
legal malpractice and the violation of his civil rights until
advised by his present attorney shortly after her substitution
as counsel and first appearance on October 29, 2002. So the
basis for damages extending from the period of his confinement
until the time of his release include:
(1) Delayed discovery;
(2) Failure to advise claimant of his rights (concealed
injury) ;
(3) continued representation by an attorney who did not
disclose the legal error and violation;
(4) continuous injury;
(5) equitable and legal estoppel; and
(6) legal tolling due to confinement.
I hope this letter satisfactorily explains claimant's
position. Please advise it you find any deficiencies.
ve y truly
La n Vii. Bethards
I •d Wd91 :2 E002 22 add