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MINUTES - 07132004 - C.50
CLAIM Y ROARD O SUPE VISQR.S O CON TRA COSTA COUNTY BOARD ACTION: . Y 13., 20 Claim Against the County, or District Governed by } the Board of Supervisors,Routing Endorsements, } NOTICE TO CLAIMANT and Beard Action, All section references are to } The copy of this document mailed to you is your notice of the action taken on your claim by the California Government Codes. �� � Board of Supervisors. (Paragraph IV below), giver Pursuant to Government Code Section 913 and MAY, 4 2,0>;' 915.4. Please note all fM1Warrun s". 8 COUNTY COUNSEL AMOUNT: $5,200.00 MARTINEZ CALIF. CLAIMANT. SLOBODAN DJORD,JEVIC (GEORGE) ATTORNEY: UNKNOWN DATE RECEIVED: MAY 24, 2004 ADDRESS: 425 ROBERTA AVENUE MAY 24 2004 BY DELIVERY TO t..�,ERK t4N: pL A A T HILL. CA 94523 HAND DELIVERED BY BY MAIL POSTMARKED: FROM, Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. . IOI=CN SUET N, Dated: IAY 24, 2004 By: Deputy II, FROM: County Counsel. TO: Clerk of the Beard of Supervisors (; `lis claim complies substantially with Sections 910 and 910.2. M1 ( } This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 914.$), { } 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 e.{ �- By. ' €: f ' Deputy County Couns< 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). I��DARD 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: A& � JOHN SWEETEN, CLERK., By , Deputy Clerk WARNING {Gov. code secti n 913} Subject to certain exceptions, you have only six (6) months from the date this notice was personally served or deposite, 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. *Por 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 deposite ,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: Z44 � JOHN SWEETEN,CLERK By Deputy Clerk Ci.a;iu to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY TY INSTRUCTIONS TO CLAD LA. r 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, 1937, 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, mint be, presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims =st be filed with the Clerk of the ural of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. lf" claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. O. 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 Against the County of Contra Costa ) or } MAY 1 a 904 rig Fill in cry The undersigned claimant hereby makes claim againstthe County of Centra cos or the above-named District in the sum of $ 6�2 and in support of this claim represents ,as follows: 1. When did the doge or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) 3. Hoer did the damage or injury occur? (Give full details; use extra papa if' required) { 4. What particular act or omission on the part of county or district officers, servants or .employees caused_the. injury or damage +prat are the names of county or district officers, servants or employees causing the damage or injury? F M++w✓rw+rnr+is�Y�r�ww�r.wrW.rrwa.�r�rww.a V r.nMwerww+rrrr.r.W�+y..��.y,yanas�a.rrrr..raFarw..wrwY.�+rr.raq.+rsa..rre.aw'nMw+w+r+Pi+Y 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 commuted? (Include the estimated amount of any prospective injury or damage.) tZ 8. Names and addresses of witnesses, doctors and hospitals. —----- 9. List the expenditures you made on account of this accident or injury:�y� DATE I,I . AMOUNT Gov. Cade Sec. '910.2 provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some Person on his. behalf." Name and Address of Attorney (CItMEnts Signature) Address Telephones No. Telephone No491 * Iry Z_Y ( _ Section 72 of the Penall 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 imprisoa-iment, 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 ($10,000, or by bath such imprisonment and fine. Vii, Lia Was Cooley Costa County (92i) 313-2334 ,52559 313-2333 PAX 14 Web 539e.�t��i.C3.earrra casfl�.ces�sJ�gatfl�x� PuoftWorks Department ,o- 255 Giader Dave MartsrAz, CA 54553-4825 x, K. mom go ................ 0... U.. 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FROMref{; P i. p 53 7 856 t'' baa 24 2 ! 910 Gass Or Fremont, W 94539 -11 (SIC) 623-9441 Fax (5103 523-9441 W 58371 Proposal T,a. 9cbcd n Djordjev�c Dam 5/21104 425 kobedm Ave, Am=ON, CA 94523 Was 110PA00nment RadW=d Fame lP, 'ce yard Approxir *Wy 80' aov$ eqd Vt0 wvng It a , = !QA but and Wspose damaged fence 75040 mabrows, 2,0000 r Labe $ 100040 c&be abou work� ¢eted in a sum ntW wor km--, its"e er accordino to atmdapd pmcfte4 Nr t sum pf*ur thc �d thret hundnal g ventV Q4,370) CONTRA COSTA O WORKS DEPARTMENT MICOMPLAIN' FORS Tj-m : °` 2 1 aid NAME: M E: A ®"e`p4s8`�-'w PHONE, l " .a 'OMP*UkINTt. § `f" iG ..yr trod ffa tddsa., �rr ,«arc IF � ,,,� - �,-b-" � ..t"� ��. ah -r�a>,r a .�:`�1�� � x•r"'�tn +�-�„�s��, ^�:� �.,, iii - 74 .. rF. Azs': 't aYLL ka 454 � ti e ° Peer by: � m fe to: s° � -Al.Fleld Inspected by: Nature sof ProWem and, E§uggeste; Action:— ' ion:' omplaia v Contacted Date: 11 4; whys x Work Sc;e a ed Date a or Compieted Date: _- - - .�.. , F ICE USE ONLY Foi�o `up Correspondence: 'yes or no ,Dees: Area: - Category m.:# Parcei No. APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY CALIFORNIA BOARD ACTION Application to File Late Claim NOTICE TO APPLICANT JULY 1.3, 2004 Against the County, Routing } The copy of this document mailed to you is your Endorsements, and Board Action.) notice of the action taken on your application by (All Section References are to } the Board of Supervisors (Paragraph III,below), California Government Code.) } given pursuant to Government Code Sections 911.8 and 915.4. Please note the "WARNING"below. UN y ati s f Claimant: TONY K. MORRIS C - 82013 1-W-115 � '�, Ay Attorney: i UN 0 9 2cjsu)� UNKNOWN COUNTY a rT i�. Address: SAN QUENTIN STATE PRISON M A R,T 1 N E Z CAL; <. SAN QUENTIN, CA 94974 Amount: $1,000,000.00 By delivery to Clerk on: JUNE 092 2004 i Date Received: .JUNE 09, 2004 By mail,postmarked.on: JUKE 08, 2004 I. FROM: Clerk of the Beard of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED: JUNE 09, 2004 JOHN SWEETEN, Clerk,By: DEPUTY 11. FROM: County Counsel TO: Clerk&thetoard o Supervisors { } The Board should grant this Application to File Late Claim (Section 911.6). ( 4---- The Board should deny this Application to.File Late Claim (Section 911.6). DATED: ,i M `%' SILVANO B.MARCHE.SI,County Counsel,By 6* PUTY III. BOARD ORDER By unanimous vote of Supervisors present (Check one only) { ) This Application is granted(Section 911.6). ( This Application to File Late Claim is denied(Section 911.6). I certify that this a true and correct copy of the Board's Order entered in its minutes for this date. DATE. JOAN SWEETEN,Clerk,By: DEPUTY WARNING(Gov. Code §911.8) If you wish to file a court action on this matter,you must first petition the appropriate court for an order relieving you from the provisions of Government Code Section 945.4(claims presentation requirement).See Government Code Section 946.6.Such petition must be filed with the court within six(6)months from the date your application for leave to present a late claim was denied. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so immediately. IV. FROM: Clerk of the Board TO: (1)County Counsel (2)County Administrator Attached are copies of the above Application. We notified the applicant of the Board's action on this Application by mailing a copy of this document,and a memo thereof has been filed and endorsed on the Board's copy of this Claim in accordance with Section 29703. DATED: / JOHN SWEETEN,Clerk,By: DEPUTY V. FKOW (1}County eounsel (2)County Administrator TO: Clerk of the Boarff of Supervisors Received copies of this Application and Board Order. DATED: County Counsel,By: County Administrator,By: APPLICATION TO FILE LATE CLAIM 0 O atc6 c LATe i lL C LA*jtA JON To LLoW ME To _ tom MY UAIM L t--EAV6 MV �AtA LY pj 0 14aivtj5ori "` I :. P,01q fRom 13FimG 6146 At-r fJQ0m TRE PEOPLE IN ml 60mmoo" p%L6 6TH i �`�+'�►6NTAs ►Ni `[T't~ ''r`�i 1 r piT_14E _ )"Al toigT a ` op31—_ WAS CoMPLAj _ J CAiL6 tar ` W R i c k N6 _ A�` fit . O, N APR'iL ! -off 200'Y _ FLEAS NO 6ON—165-1 TO All L U To G1 -rax 1 iTA ?R' SON 1'��i�. � ,��'0q REPLY _ rwt t ►i; Affilk 11 ORWd 50tiN GORR*S __ STATE OF CAUFORNIA DEPARTMENT OF CORRECTIONS INIMATEIPAROLEE APPEALS SCREENING CDC 695(Rev 3/95) TO: (INMATES NAME) Cts NUMBER LOG NUMBER �' t lJ 1`-�#�— C) � cc3 ®C --o t INSTITUTION IUNIT Your appeal is being returned to you for the following reason(s): r - The actionqr decision beim appealedis not within the Jurisdiction of the Department , ll`ISTRUCT- _N;$ ,s v. , C pu t- l vi tc rt-C C La,�a inCr__'> OXO Y, ® 2. You have submitted a duplicate appeal on the same issue. CHECK CINE [_� Your first appeal Is currently under review at the t level. 0 Your first appeal has been completed at the Directors level. 3. You are appealing an action not yet taken. 4. You have not attempted to resolve the problem at the informal level. INSTRUCTIONS EDS. You have not adequately completed the Inmate/Parolee Appeal Form(CDC 602). INSTRUCTIONS ® 6. Documents not attached: --Reasonable Modification or Accommodation Request(COC 1824) --CDC 115 and 115-A --CDC 1030 --CDC 128-G --CDC 128-0 --OTHER INSTRUCTIONS 7., There has been too great a I me lapse between when the action or decisrorr occurred and when you filed your.appeat,with no explanation of why you did not,or could not,file in a timely manner. B. This issue has been appealed by: NAME CDC NUMBER UNIT 9. Abuse of the appeal procedure. INSTRUCTIONS © 10. You may not submit an appeal on behalf of another inmate. 11. The requested action has been granted at the second level of review and no turther action Ts required. APPEALS COORDI A rSSIGNATURE DATE SIGNED MAY 1 4 RECT This screening decision may not be appealed unless you allege that the above reason is inaccurate. In such a case,phase return this form to the Appeals Coordinator with the necessary information _. ............................... The Board of Supervisors ohoSweeten e n' dt County Administration Building Costa County Administrator and 651 Pine Street,Roam 106 Martinez,California 94553-1293 Count (925)335-1900 John Gioia,1 st District Gayle B.Uiikerna,2nd District s,,,. ` .j,._ Donna Gerber,3rd District Mark DeSaulnier,4th District ;; { Federal Glover,5th District co%x TO: Tony K. Morris C-82013 ! 1-W 115 San Quentin State Prison San Quentin, CA 94974 NOTICE TO CLAIMANT (Of Late-Filed Claim) (Government Code Section 911.3) The claim you presented to the Board of Supervisors of Centra Costa County, California, as governing body of the County of Contra Costa on May 24, 2004, has been reviewed by County Counsel and is being returned to you herewith because: X Your claim for an injury to person or personal property%vas not presented within six months of the event or occurrence as required by law. (See Government Code sections 901 and 911.2) _ Your claim relating to a cause of action other than injury to person, personal property or growing crops was not presented within one year after the event or occurrence as required by law. (See Government Code sections 901 and 991.2) Because the claim was not presented within the time allowed by law, no action was taken on the claim. Your only recourse at this time is to apply without delay for leave to present a late claim. (See Government Cade sections 911.4 to 912.2 and 940.6) Under some circumstances leave to present a late claim will be granted. (See Government Code section 911.6) Tony K .Morris Re. Claim Fuge Two You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. Date: MAY 28, 2044 JOHN SWEETEN, Clerk of the Beard of Supervisors and County Administrator By: Deputy Cie Enclosure 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 copy of the above NOTICE TO CLAIMANT (OF LATE-FILED CLAIM), addressed to the claimant as shown above. Date: MAY 281 2004 Deput Clerk I:1Tt3R \RISK-MG'1CLA1MSILA'1EWoms-2.wpd L;1JE..ibtt3�4J`Jl} ,�- t 0,PPnWr T )- BOARD OFPRI SON TERVTS 2NDCOPY-RA COPY-PAROLEE MARC OnC AI}DT CT EVALUATION AT77'T ORTTY 4TH COPY-V_& Q7CT3ttM13Flt NA&M(LA.4T,FRUST,hf1} N BOO DAS Rfi IC523lUk7TS CSTCU-ST C82013 MORRIS, ` of Same II Concord #2 f 71 YES Dfl ARTIEST DATE" ARRESIZNG ACENCY BPTREMMAL& BOOKING-NUMER,AMOK LOCATION 12--2£3--03 Contra Costa Sheriffs DR I lv 2 ATORY 110N-LA DATORY MDF . ARREST CODE *ARREST CODES A F&M STAFF ALONE B LAW EWOKZNMT ACE24CYALONB AS P&CSD ASSISTED BYLAW E14FORMAENT AM4CY 17 LAST/ENRt}RAY'A{fENCYIY3THTtIFORMATIONFftE)3rf1&CSP? MOLD DATE DISCOVERY DATE HOLD M40VED DATE AC I"OF RECORDCONTROI C,ING DTSC93AR,ri B DUCHAR GE REVIEW yy r�yy ry�yy �ryry��}} -I�++�� r^55 R. 7-� }. DAA DA/T$ DISCHARC 12-20- 3 1.L.-20—�} INI/A R. P recto �'�"�'�' �i� � N/A ruarrr..rc s'�arrrnnsc rWA12(=C ANMrnn);e xT_ Absconding (02 i) 4. a. Failure to Register Per PC290 5. 390 REASON FOP-MAL*ONO PAROLS HOLD: PAROLES DANG TO. DA E COPY SENT TO PAROL M ReTIALS OP PERSON SEMI NG ABSCOND = SETS =PROPERTY-OnMS SAFETY-OT.FTM SUPPORTING EVIDENCE: CHAR E 1: On 10--23--01, AOR conducted-a residential--visit-at Subject's residence of Teco. rd:--Subject was-not-_ h-pme at this time: however, AO.R contacted Subject's mother and left instructions for Subjecf to contact ACR on 10-24-01. Subsequently Subject did not report. On 10-24-011 AOR conducted a second residential visit. Subject again was not Dome and contact wasmadewith cam' mph vuh sa. Su q#. ad cr_,tipmAh _pf v ou _rig th ,gibed a11. t}i ct e�s.ansi. t d that someone was trot kill him and e . Subsequently, Subjo.ct's whereabouts became unknown o P CSR. 0n 0®01, AOR submitted a miscellaneous decision recommending Subject's parole. be suspended effective 10-22-01. Can 10-26-01 the Board of Prison Terms suspended Subject's parole effective 10-22-01. CHARGE 2: AOR made an appointment for Subject to register per PC290 on 10-22-01 at gam with the Richmond Police Department. Subsequently Subject failed to report for this,appointment and register. Subject is required by law to register as a sex offender, however there is no indication that Morris has done so. On 12-20-03, Subject was arrested by the Contra Costa County Sheriff's Department for the outstanding Parolee-at-Large warrant. ATTACHMENTS: None KAMER, MORRIS, ToEZ C8 2 01 3 'age 1 Gf-3 PEOPLE V. TONY KING MORRIS NO. 276647-5 PAGE 4 DA NO. X 02 000366-5 SENTENCE FIXING ALLEGATION "THREE STRIKES" CALIFORNIA JUVENILE AnJUDICATION It is further alleged, pursuant to subdivisions (b) through (i) of Penal Cade section 667, and Penal Code section 1170 . 12, that prier to the: commission of the offenses charged herein, on or about March 15, 1979, in the Superior Court of the State of California, in and for.the County--of Contra Costa, the Defendant, TONY KING MORRIS, suffered a juvenile adjudication pursuant to section 602 of the Welfare and Institutions Code for the offense of Rape by Threat/use of Firearm, a serious felony offense which was committed by the Defendant at the time the Defendant was 16 years of age or older, and the. Defendant was adjudged a ward of the juvenile court in the same action for the commission of an offense listed in subdivision (b) of section 707 of the Welfare and Institutions Code. SENT_ NCE FIXING ALLEGATION "TME STRIKES" CALIFORNIA ONENILE ADJUDICATION It is further alleged, pursuant to subdivisions (b) through (i) of Penal Cade section 657, and Penal Cade section 1170 . 12, that prior to the commission of the offenses charged herein, on or about � ��, in the Superior Court of the State of California, in and for the bounty of Centra Costa, the Defendant, NYUF , suffered a juvenile adjudication pursuant to sectionn�f the Welfare and Institutions Code for the offense of e and L . c . ..� .,. .i .- :W..:1. ►, a serious felony offense w is was committed the Defendant at the time the nd 16ye ,arg, of age or older, and the Defendant was ad` a o in the same action for the commi soon of an offense listed in subdivision (b) of section 707 of the Welfare and Institutions' Code. ENHANCEMENT FELONY WITH PRIOR. CALIFpRNIA ORISON CONVICTION It is further alleged, pursuant to Penal Code section 667 . 5 (b) , that prior to the commission of the offenses charged herein, on or about February 29, 1984, in the Superior Court of the State of California, in and for the County of Contra Costa, the Defendant, TONY KING MORRIS, was convicted of Selling Controlled Substance, 2 c6unts, a felony, in violation of Health and Safety Code section 11.379, a crime for which -the Defendant served a separate prison term, and: the Defendant did not remain free for a period of five years of both prison custody and the commission of an offense resulting in a felony conviction. CONTRA. COSTA COUNTY PUBLIC DEFENDER'S {OFFICE INVESTIGATION REPORT RECEIVED JEQ 17 2004 OFFICE OF THE PUBUCC DEFENOEH To; Mark Liss From: Angela Nocera Re: People v. Tony Morris Witness: Sabrina Crenshaw, 5101231-0801 Date of interview: 2/3104, at Bpm On the above listed date and time, I spoke with CRENSHAW on the telephone. Prior to this interview, I identified myself as a Public Defender Investigator, and stated that my office is representing the'above,named individual. The following is a summary of the information provided to me by CRF-NSHAW. CRENSHAW stated that sometime at the beginning of 2003 she was inside her Dome at 1 534 5�h Street in Richmond. CRENSHAW heard a scuffle outside, so she looked out the bedroom window and saw 7-8 guys attacking someone right in front of her yard. CRENSHAW went outside and was yelling at them to stop and get out of the yard. CRENSHAW threatened to call the police at which time the attack. stepped. At that point, CRENSHAW realized that the person being attached was Tony Morris. CRENSHAW stated that she did not hear the men attacking MORRIS say anything during the attack, nor did MORRIS tell her why he thought he was attacked. petition for Tony Morris: To whom it may concern, 1e the people of the Richmond Community feel that Tony K. Morris is not a threat to our community. Name . Age . t 17 C C�cj _ 'f{ � - � I ZL Petition for Tony Morris: To whom it may concern, We the people of the richmond Community feel that Tony K. Morris is not a threat to our community. Name Age J)C��/ J/2,�k— ik ur,� a f C 1 �-A t Wit,, (I - 7u 1 c5 C> �� � C Claim to: BOARD,OF SUPERVISORS OF CONTRA COSTA CO e S'TRUCTIt71�1 S TO CLQ A. Claims relating to causes of action for death or for injury to person or to perso or ' crops and which accrue on or before December 31, 1987,must be presented not later 100 after the accrual of the cause of action. Claims relating to causes of action for death or fo person or to personal property or growing crops and which accrue on or after January 1, 198 , be presented not later than sic 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 Roam 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. EMd. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Reserved for Clerk's filing stamp --Fotj a RRl5 VED C, 5 H E:R i F F br=P l'y ) MAY 2 4 2004 Against the County of Contra Costa or ) _ ) c«R co���°s�����►suss I T. L. A R R E� I3istrict} ('Fill in name) N E WPrRRC_ RLiPF The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$1 C tea ,oo o and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) O C`I'O31EP—i 2001 1\J011GMC35 7Z00Z zo0� 2. Where did the damage or injury occur? (Include city and county) R0b6O, CA C . , C, , 3. How did the damage or injury occur? (Give full details; use extra paper if required) t H 4. 'that particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? L . l�iirJG y NAME . VlOLA1 :0N i End 5. What are tate names of county or district officers, servants, or employees causing the damage or injury? SH RI �� ' ARReiq RUt 6. What damage or injuries do you claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) P P l,4 R,-J b 5 u f F EA,1 tJ6, M 6N`7 A L. Ar t46i l$H 7. How was the amount claimed above computed?(Include the estimated amount of any prospective injury or damage.) :f4,p, alteAeJ + f� • 8. Names and addresses of witnesses, doctors, and hospitals. AA tJGE .A MORIUs 1220 -'R, GG45lZ C`r Ro&-.�60, CA 13ST y ►V ogel% X35 W iLLARD lei t.14MOni+i,► CA MAQIiWd Gt76rJtPjJAW yr? MA1gKF.7 R r CMMOrJ6. e A 9. List the expenditures you trade on account of this accident or injury. DATE } Gov. Code Sec. 910.2 provides"The claim must be } signed by the claimant or by some person on his behalf." SIN—D NOICES TC): (Atter Name and Address of Attorney �7 T69VV } } } (Claimant's Signature) ), ,5AW --Q.u6wT1W 1A Te P RI S IIA1 } (Address) j SAcN 0 r1TW0 CA � '�9 '74 Telephone No. )Telephone No. NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,presents for allowance or the 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,bili,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(S 1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fire of not exceeding ten thousand dollars(S 10,000),or by both such imprisonment and fine. J L i Oivtj t z _ k �- A d c \ H f( iy )�j( a H1 E I I 1 T t= ta THE i Lx E 0 1 N"/-\ S A t HI LL E-6T6-�e,, I \ JI - _ �� I T G ) tRA I Lfi t R b I t H , PENALTY 0 " PE5R SJR, MAA ThE ` � t RJB, QE e i E aryt /r7 eirns-��,.�---fir'-- car r�Y ��- as Grs � /ii�cs a� sa�-� �F' rn/� mo-tht.►%�rc� p-t- o occx t ice-• -rix a4'a4 44tif' iF .Z O&Yrtircctg. -¢n l i Hca. irz -He- iCowte�c�uni-f'y ccJ� Z c<,tas rais�ad, dt�l&d .,chanP avtW /vV (who �-�ow � rd � nom. as o �oafu1�ia✓ �'t r'!d�-r�.es�r;��er —' ha8- � dgS71r-o-ya - 74& - ��t/.sus Q-F►-�trd 4Ae ab ib"4y -fo otiar?,Y4a;� �.rzaa ploYrnen-t- err ✓�cY �rn�/tr� e.,�ill b.2� �'y � c0j-�,'eu 1 f- `q -y4A47 ' -JI&se --Falsealf���a E I i f f i R BOARD OF PRISON TEF STATE OF CALIFORNIA ATTORNEY DETERMINATION DECISION (To be completed by staff) ATTORNEY IS Approved �1 Indigent. Attorney may be appointed at state expense. Not indigent. Attorney to be paid by I/P. (provide name, address and phone number including zip cede and area cede): I Attorney Name Address(including Zip Code) Telephone Number 1 C Denied (state reasons) -7-A'�2- Staff Signa ure Dat TO PRISONER OR PAROLEE: If your request for an attorney was denied, you may appeal to the BPS` (per California Code of Regulations, Title 15, section 2055). If you want this appeal decided before the hearing, you have only five days from the date of this decision to appeal. If you do not meet the five-day limit then the appeal decision could be later than the hearing. You cannot appeal later than 90 days after you receive the written denial of your request for an attorney. I want to appeal the decision to deny my request for an attorney and have asked for help:from the BCPA. I want to appeal the decision to deny my request for an attorney and will mail copies of pages 1 and 2 to the BPT Central Office Calendar. I do not wish to appeal this decision. Prisoner/Parolee Signature Date • Expedited to COC via Name of Deputy telephone/fax Commissioner: ❑ COC decision (1083x) attached Date: Time: ❑ I/P Chooses to mail the BPT 1083 This appeal can be mailed to the BPT at: without help from me. Board of prison Terms 1515 K Street Suite 600 Sacramento, CA 95814 Attention: Central Office Calendar Staff Signature Date NAME CDC NUMBER INET/REGION SPT'083 (Rev.02/02) Page 2 of 2 Distribution: White—C-File TOIAITty of TIuittra Tu!3ta ffi rp Rf 144 Warren E;Rupf Sheriff May 11, 2004 Mr. Tony Morris C-82013 *San Quentin State Prison San Quentin, CA 94974 Mr. Morris, I received your May 2, 2604 letter. The only issue that I could obtain from your letter regarding Office of the Sheriff Personnel was that you believe the disclosure to the public was not appropriate or unlawful. Your complaint is being forwarded to Commander Oble Anderson the Field Operations Bureau for resolution ad/or investigation. The Office of the Sheriff always strives to provide the:highest quality of law enforcement service and appreciates you bringing your complaint forward*.' WARREN E. RUM~, Sheriff By: Lieutenant Mike Casten Professional Standards Unit (925) 335-1519 Post Office Bax 391 • Martinez, califomia 94553-0039 (925) 335-1500 "Community Policing Since 1850... PEOPLE V. TONY KING MORRIS NO. 276647-5 PAGE 6 DA NO. X 02 000366-5 ENHANCEMENT FELONY WITH PRIOR CALIFORNIA PRISON CONVICTION It is further alleged, pursuant to Penal Code section 667 . 5 (b) , that prior to the commission of the offenses charged herein, on or about November 30, 2000, in the Superior Court of the State of California, in and for the County of Contra Costa, the Defendant, TONY KING MORRIS, was convicted of possessing Controlled Substance, a felony, in violation of Health and Safety Code section 11377, a crime for which the Defendant served a separate prison term, and the Defendant did not remain free for a period of five years of both prison custody and the commission of an offense resulting in a felony conviction. ENHANCEMENT FELONY WITH PRIOR CALIFORNIA PRISON CONVICTION It is further alleged, pursuant to Penal Code section 667 . 5 (b) , that prior to the commission of the offenses charged herein , on or about February 01, 1991, in fi:??e Superior Court of the State of California, in and for the County of Contra Costa, the Defendant, TONY KING MORRIS, was convicted of Possessing Controlled Substance for Sale and Selling Controlled Substance, felonies, in violation of Health and Safety Code section 11378 and 1.1379, crimes for which the Defendant served a separate prison term, and the Defendant did not remain free for a period of five years of both prison <:�ustody and the commission of an offense: resulting in a felony conviction. COMPLAINANT REQUESTS THAT DEFENDANT (S) BE DEALT WITH ACCORDING TO LAW. I DECLARE UNDER PENALTY OF PERJURY THAT THE FOREGOING IS TRUE AND CORRECT. DATED: November 1, 2002 AT MARTINEZ, CALIFORNIA DET. L. WARREN COMPLAINANT DARA CASHNiAN DEPUTY DISTRICT ATTORNEY CONTRA COSTA COUNTY SHERIFF CLAIM XV BOARD OF SCJ ERVISORS OF CONTRA COSTA COUNTY BOARD ARD ACTION:Y JUL 132 2004 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 claire by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DJ[ AMOUNT: UNKNOWN AY 2 2004 CLAIMANT: MARGARET DOWLING COUNTY COUNSEL MARTINEZ CALIF, ATTORNEY: TI.MD1W--S. THIMESCH DATE RECEIVED: MAY 24, 2004 ADDRESS: THIMESCH LAW OFFICES BY DELIVERY TO(,LER .ON: MAY 24, 2004 171 FRONT STREET, SUITE 102 DANVILLE, CA 94526-3321 BY MAIL POSTMARKED: MAY 21, 2004 FROM. Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE E lark Dated: MAY 24, 2004 By: Deputy II, PROM County Counsel.. TO: Clerk of the Board of Supervisors (i,,yThis claim complies substantially with Sections 910 and 914.2. { ) 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 910.0. ( ) 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: -' � ' -. +'t Deputy County Counsel Ill, FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) { ) Claim was returned as untimely with notice to claimant(Section 911.3). IVBOARD 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. JOHN SWEETEN, CLEF, By : Deputy Clerk WARNING(Gov. code section 913 Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty ofperjury 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: JOHN SWEETEN, CLERK By Deputy Clerk C'", himesch Cla-w Offices TIMOTHY S. THIMESCH, Esq. (No. 148213) kAY 171 Front Street, Suite 102 els ` `� 2004 Danville, CA 94526-3321 925-855-8235 ��Ra��rsos Attorneys for Claimant MARGRET DOWLING IN THE MATTER OF THE CLAIM OF MARGRET DOWLING, CLAIM AGAINST PUBLIC ENTITIES Claimant, [Government Code § 910] V. SUPERIOR.COURT OF THE STATE OF CALIFORNIA IN AND FOR CONTRA COSTA COUNTY; COUNTY OF CONTRA COSTA; KEN TORRE, COURT EXECUTIVE OFFICER; STATE OF CALIFORNIA; and DOES 1-50, Inclusive, Respondents. To SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR CONTRA COSTA COUNTY; COUNTY OF CONTRA COSTA; KEN TORRE, COURT EXECUTIVE OFFICER; STATE OF CALIFORNIA; and DOES 1-50, Inclusive, hereafter"Respondents": MARGRET DOWLING hereby presents this claim pursuant to section 910 of the California Government Code. 1. The name and address of claimant: MARGRET DOWLING, 426 West 11th Street, Pittsburg, CA 94565. 2. The address to which claimant MARGRET DOWLING desires any and all notices regarding this claim to be sent is as follows: c/o Timothy S. Thimesch, Esq., Thimesch Law Offices, 171 Front Street, Suite 102, Danville, CA 94526. 3. Date, Place and Circumstances: Claimant MARGRET DOWLING has physically limiting disabilities and requires the use of wheelchair for mobility. On a continuous and prospective basis during the six months preceding the filing of this claim, claimant has been CLAIMS AGAINST PUBLIC ENTITY 1 Claimant:MARGARET DOWLING prevented and deterred from utilizing on a full and equal basis the government programs and facilities at the Pittsburg branch of the Contra Costa Superior Court, located 45 Civic Avenue, Pittsburg, California, due to architectural and programmatic barriers to disabled access. The public facilities at this courthouse, including but not limited to its parking, paths of travel from the public right of way,paths of travel to the main entrance, entrance facilities, interior entrances, traffic and small claims courtrooms and service counter, public restrooms, and numerous of other facilities, all fail to provide the"full and equal" access required by Title II of the Americans With Disabilities Act of 1990, Section. 504 of the Rehabilitation Act of 1973, the California Disabled Rights Acts (sections 54 and 54.1 ff Civil Code), and Title 24 of the California Code of Regulations (now known as the California Building Code. During this period, claimant and other disabled members of the general public were denied full and equal access to the aforementioned public facilities owned and operated, controlled and/or maintained by respondents, all in violation of their statutory Civil Rights, as well as their right under the state and federal constitutions to seek due process at the court house. 4. Respondents' actions and inactions, including,but not limited to, the failure to provide access to publicly funded buildings,programs and services, and the failure to identify and implement a transition plan for providing access to the disabled, are in violation of statutory law, including Title II and/or Title III of the Americans With Disabilities Act; Section 504 of The Rehabilitation Act of 1973; California Government Code Sections 4450 et seq. and Section 11135; California Health& Safety Code Sections 19953 an 19955 et seq.; California Civil Code sections 51, 54 and 54.1; California Civil Code sections 54(d) and 54.1(c); and California Code of Regulations.. Title 24. 5. General description of injury or loss: claimant MARGRET DOWLING suffered violation of her Civil Rights,including the right to full and equal access to public facilities, and suffered physical injuries, on the occasions cited above, including exhaustion and injury from attempting to negotiate or accommodate to barriers, and mental and emotional distress, shock, humiliation, embarrassment, a sense of exclusion, loss of autonomy, fear and other injury, all to her damage. CLAIMS AGAINST PUBLIC ENTITY 2 Claimant:MARGARET DOWLING 6. The names of the public employees responsible for damages are unknown at this time. On information and belief, all facilities complained of are owned and operated by respondents, SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR CONTRA COSTA COUNTY; COUNTY OF CONTRA COSTA; KEN TORRE, COURT EXECUTIVE OFFICER; STATE OF CALIFORNIA; and DOES 1-50, Inclusive. Plaintiff is currently ignorant of the capacity and identity of each of the fictitiously named defendants, Does 1-50, and will file an amended goverm-hent claim when and if such identities and capacities are ascertained. ?. Damages are for violation of civil rights, denial of full and equal access to public facilities, and personal injuries, including physical injuries,mental and emotional distress, including statutory and daily damages and attorney fees, all in an amount within the unlimited jurisdiction of the California Superior Court. Dated: May 21, 2004 9himesch 110w Offices TIMOTHY S. THIMESCH C�a li� Attorneys for Claimant MARGRET DOWLING CLAIMS AGAINST PUBLIC ENTITY 3 Claimant: MARGARET DOWLING 1 Certificate or Proof of Service by Mail,Fax or Personal Delivery 2 State of California ss. 3 County of Contra Costa 1,the undersigned,say:I am and was at all times herein mentioned,a citizen of the United States and a resident 4 of the Counties of Contra Costa and/or Alameda,over the age of eighteen(18)years and not a party to the within action or proceeding;that my business address is Thimesch Law Offices, 500 Ygnacio Valley Road,Suite 250, 5 Walnut Creek,California;that on the below date,following normal business practice,I caused to be served the foregoing document(s)described as: 6 GOVERNMENT CLAIM In Re Government Claim of Maggie Dowling 7 on the interested parties in this action,by taking a true copy thereof and conveying as follows: 8 As Indicated: 9 See attached list of respondents and their addresses. 10 Q U.S.Mail andlor Overnight:By depositing true copies thereof,enclosed in a sealed envelope(s)with ostage thereon fully prepaid,marked with the above address(es),and placed in: in First First Class United States Mail ❑ in ❑priority, or❑ standard,overnight mail via Federal Express, 12 1 am readily familiar with our office's practice for collection and processing of correspondence for mailing with the United States Postal Service. In the ordinary course of business, 13 correspondence,including said envelope,will be deposited with the United States Postal Service in Walnut Creek,and designated overnight packages will be timely scheduled for pickup or 14 placed in Federal Express drop boxes or left at drop centers in Walnut Creek. I declare that I am employed in the office of a member of the bar of this court at whose direction the 15 service was made,and that the foregoing is true and correct under penalty of perjury pursuant to the laws of the United States and the state of California.Executed this May 21,2004,in Walnut Creek,California. 16 14 17 By: (Original signed) 18 19 20 21 22 23 24 25 26 27 28 ghimesck qgw Offices 171 FRONT STREET SUITS 102 DAAVILLE, CA 94526 (925) 855-8235 I ATTACHED LIST OF RESPONDENTS AND THEIR ADDRESSES: 2 • SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR CONTRA 3 COSTA COUNTY, c/o: 4 1) Ken Torre, Court Executive Officer, 649 Main St., Martinez, CA 94553. (ORIGINAL COPY.) 5 2) Court Services Administrator, Barbara Cockerharn; 45 Civic Ave, Pittsburg, CA 6 94565. 7 • COUNTY OF CONTRA COSTA, Care of: 8 1) County Auditor-Controller Kenneth J. Corcoran, 625 Court St., Finance Bldg., Martinez, CA 94553. 9 2) County Clerk-Recorder Stephen L. Weir, 524 Main St., Martinez, CA 94553. 10 3) County Counsel Silvano Marchesi, 651 Pine St 9th Fl Martinez, CA 94553. 11 4) County Administrator John Sweeten; 651 Pine St 11th Fl., Martinez, CA 94553. 12 5) Chief Deputy Clerk to the Board of Supervisors, Jane Pennington, 651 Pine St., 6th 13 Fl, Martinez 94553. 14 . KEN TORRE,COUNTY COURT EXECUTIVE OFFICER, 649 Main St Martinez, CA 94553. 15 • STATE OF CALIFORNIA, Care of CLERK OF THE BOARD OF CONTROL, 630 16 K. Street, Sacramento, CA 95814-3300. 17 18 19 20 21 22 23 24 25 26 27 28 nimesch CIA-w Offices 171 FRONT STRsc^T SUITS 102 DAt24I LLE, CA 94526 (925) 855-8235 171 FRONT STREET,SUITE 102 DANVILLE,CA 44526-3321 PHONE 925/855-8235 FAX 925/855-8435 C(gRg���b ANTI# Opp Cod A ��1 0 May 21, 2004 To: Respondents on the Attached List Re: Filing of Government Claim In The Matter of the Claim of Dowling v. Superior Court Of The State Of California In And For Contra Costa County; County Of Contra Costa; Ken Torre, Court Executive Officer; State Of California; and DOES 1-50, Inclusive Dear Government Claims Branch: Please file the enclosed Government Claim and return an endorsed filed face- sheet in the return envelope provided. Also, if you allege that you are not the correct agency for filing this claim as to any of the named entities, please promptly so indicate in writing. Very truly yours, r N1I�r TIMOTHY S. THIMESCH Enc. Victim Compensation and Government Claims Board May 21,2004 Page 2 Attached List of Respondents. • SUPERIOR COURT OF THE STATE OF CALIFORNIA IN AND FOR CONTRA COSTA COUNTY, c/o: 1) Ken Torre, Court Executive Officer, 649 Main St., Martinez, CA 94553. (ORIGINAL COPY.) 2) Court Services Administrator, Barbara Cockerham; 45 Civic Ave, Pittsburg, CA 94565. • COUNTY OF CONTRA COSTA, Care of: 1) County Auditor-Controller Kenneth J. Corcoran, 625 Court St., Finance Bldg., Martinez, CA 94553. 2) County Clerk-Recorder Stephen L. Weir, 524 Main St., Martinez, CA 94553. 3) County Counsel Silvano Marchesi, 651 Pine St 9th Fl Martinez, CA 94553. 4) County Administrator John Sweeten; 651 Pine St 1 Ith Fl., Martinez, CA 94553. 5) Chief Deputy Clerk to the Board of Supervisors, Jane Pennington, 651 Pine St., 6th Fl, Martinez 94553. • KEN TORRE, COUNTY COURT EXECUTIVE OFFICER, 649 Main St Martinez, CA 94553. • STATE OF CALIFORNIA, Care of: CLERK OF THE BOARD OF CONTROL, 630 K. Street, Sacramento, CA 95814-3300. CLAIM B ARD OF SUI' R"VISORS t2F CONTRA COSTA COUNTY BOARD ACTION: ,JULY 1.3, 2004 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), give: Pursuant to Government Code Section 913 and 915.4, Please note all "Warnings". AMOUNT: UNKNOWN Ej!AY 2 5 201,14 COUNTY COUNSEL CLAIMANT: PECGY N WALKER MARTINEZ CALIF ATTORNEY: UNKNOWN DATE RECEIVED: _ MAY 24, 2004 ADDRESS: 4905 FRAY AVENUE BY DELIVERY TO C..LER.K ON: MAY 24, 2004 RICHMOND, CA 94804 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 SWEET , Dated: MAY 24, 2004 By: Deputy II. SROM: County Counsel-. TO: Clerk of the Board ofSupervisofs (t.. his claim complies substantially with Sections 910 and 910.2. { ) This Claim.FAILS to comply substantially with Sections 910 and 910.2, and we are so noti-fying 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: _3--. By: f p Deputy County Counse III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV, BOARD ORDER: By unanimous vote of the Supervisors present: ( This Claire 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. XJOIN SWEETEN, CLERK., B , Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions, you hove 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. Dated. JOHN SWEETEN, CLERK By Deputy Clerk MAR-29-2004 13:39 CCC RISK MANAGMENT 925 335 1421 P.02.'03 Claire to: BOARD OF SUPERVISM OF MNMA MST'A airs y INSTRtIC'T"iONS TO CLAMW A. Claims relating to causes of actio for death or for injury to person or to per- sonal property or growing crops and trhich 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 actio 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 rather cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Cade §911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Rom 106, County Administration Building, 881. Fine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the Coursty, the ase of the District should be filled in. B. 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 REE: Claim By } Reserved for Clerk's filing stamp N , Wak TR::E:C Aga.i.nst the County ofCamra Costa MAY 2 4,. 2004 or } � .f- IF rM* . e undersigned claimant hereby mattes claim against the County of Contra Costa or the above-named District in the sum of and in support of this claim represents -as follows.- 1. ollows:1. When dial the dame-or injury occur? (Give exact date and hour) 2. Where did the damage or injury occur? (Include city and county) CozZ'°Zis�1 3. How did the ��..�._ doge or injury occur? (Give full details; use extra paper if required} pp t r £%+� ........ } S t' tf� > F ' .' ' ^d .£. 1' `'� '' fwkY£i - i'd.. hies{i .. `^' �. 1P c�C..-� �...� !S' tom✓° --�•-',i d-f.. j~ -rr� ` .. wryCr ,r�i r d� €A u.� S C <- r.Y-yam ... d• .4G ., What particular act or camissidn on the part of county district officers, servanta or.employees cru sed. the injury or damage? _ .< -. As/�.,+C_F�.`G'-�-. ��: f�� � $- �•-^'^' � L+".- '•'�,,,�P'{ ' m s'n ,}, ¢ Kk fA e7 ��r';;*-_7' $ I�IRR-29-20@4 1 39 CCC RISK MANPGMENT 925 335 1421 P.03/03 WnaL are the names of county or district officers, servants or employees causing the doge or injury?{ 3�.�i,,,3'Y h't.:a�`« 'a.�t'yr�.„v,�.. ��_ :✓ `"?��,°,'> F'bt,...6',.G 1.+�J`" '`��t..',G^'�"« ✓, r{���" ` �,#g^ {; - ... fr ' "*+� 3�' t/t ,E �G t; ..: S � .'4•. CJ t 47 °-w C t b< What damage or injuries do you Maim resulted? Give full extent of injuries or damages Cl. rated. Attach two estimate4 for auto damage. 7. How eras the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) . Names and addresses of witnesses, doctors and hospitals. Dr, -3_(`kY ID c:�Ctc_, pi. D ' '£ �` 1 P"y 9. List the expenditures you made on account of this accident or injury: DATE . �E. +� * pit, Gvv. Gude Sec. -9101.2 provides: Me claim must be signed by the claimant SEND NOTICES TO; (Attorney) or by sow on his.behalf.' Name and Address of Attorney ' r ` tlClaimantls Signature Address Telephone No. Telephone No. N0TICE Section 72 of the Pena. 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 Name if.genuine, any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisoria=t in the county Jail, for a period of not mrarre than one-year, by a fine of not exceeding one thousand ($1,000), or by both surd imor isonment and fine,or by imprisonment in the state prisons by a fine of not exceeding ten thousand .dohs ($10,000, or by . both such imprisonment and fine. TSTRL P.03 3-0f 1Z, s'�•".Y."Y nre� �nG••�. ����.. _..�y: i '$ F"g ��:" O'L..�C/�^'. \,..^ �... 6f �Yfe^''E,.{.�. .r:.,"F..s°_ Wbf"{„ +^"'Ac'"" :���. 4 '�'.L°�~� L..r �' �`'d '`'�r� 4.rC-d�'.°'._�-` '��r1. �t�.��... ,t" '.r. ..�.X• �>�,.N....f €,s�..-&+7„ �?.3� ."'.����WX�� .,�L.S."_...... r A 4. ;�,, .µ.k_- -- ., I f P £ } f t /. 4 Aq 4M ���-�"iN'�:�`' �k.•' � � .i...... . �D� "'�.'M w3w'�,,,.,E.y�,..r'.� �'C.,r...-"�.4.✓ w'w`fi.....,..,-i�"'��...�`�,.t�$�i � r£g,.r:�-. ciL.' (� -S�rt,LC` t,J C .w.^i,;F �`4+.?w.. ,.- C{ {+'. '. ..'._... .� 4✓ti.."fit,.,-. c"y[ .. '",t..,L'r„`a k'" r ... �,�J� y^^,,:...'&+'' .✓ .1:1.�i..f 4 �`µ���� ""° ✓' .��5.... '4,iy �.,/4M �f �-i.�,t''�..�d. G�"�.�.'L";s' st`....«.�.,! f� l�i,,..S...� # f +��'' "' �. '� L,.3b'*....�,.» �. ! '`..,.f'" -.••_,w,,,�c"✓�f�'t L���✓ ,_.�•��`�`i€"L+t+F��`R"',^^""'��-! �`*+...�...o...»....' F _ #j' �rL - m P Ate Q {• eel { ; P bF:.S..• `�...,. .,.� !' d, � - }�`• *,`yam a r s ,.� r j, i S , t �•g„ h �'�•'v�Vim^"�.✓ ���..-_. i f <„/"" '� � �',�gS� � � ,�` p �`�' �' r u C , /; CLAIM j BOAU OF SUPERVIS RS OF CONTRA COSTA COUNIX ' BOARD ACTION: JULY 13, 2004 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 GsBoard of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and AY 2 5 2 ou D11 915.4. Please note all"Warnings". COUNTY SEL AMOUNT: $1.27,15.5.22 ART ZO ALI CLAIMANT: RANGER INSURANCE COMPANY CIO MS. SUSAN GATTIS ATTORNEY: MICHAM G,_ LONG/DAVID R. JOHNSON LATE RECEIVED: MAY 25, 2004 ADDRESS: WATT, TIEDER, HOIyFAR & FITZGUW D BY DELIVERY TO (_LERK ON: MAY 25, 2004__ #3 PARD PLAZA, SUITE 1500 IRVINE, CA. 92614 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 SWEET , Dated: MAY 25, 2004 By: Deputy II. FROM: County Counsel.. TO: Clerk of the Board of Supervisors ( } This claim complies substantially with Sections 910 and 910.2, i { } This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). (Claim timely filed. cl ( other: ' ,P r a Dated. By: t Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) (t+ Claim was returned as untimely with notice to claimant(Section 911.3). IV, QOARD 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: JOHN SWEETEN, CLERK, By ,Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposited in the mail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. ' For Additional W47iiq See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty ofperjury 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 deposite .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: __ / JOHN SWEETEN, CLERK By Deputy Clerk OFFICE OF THE COUNTY COUNSEL 4 ILVA COg MA uNESI COUNTY OF CONTRA COSTA Administration Building 1 651 Pine Street,9'"Floor t SHARON L. ANDERSON j Martinet, California 84553-1229 " ! CHIEF AS515TAt4T <r GREGORY C.HARVEY (925) 335-180 VALERIE J. RANCHE {925) 646-107$ (fax) ? ' AsstsTANTs STATUTORY WARNING PURSUANT TO GOVERNMENT CODE SECTION 911.3 TO: Michael G. Long David R. Johnson Watt, Tieder, Hoffar&Fitzgerald, L.L.P. 3 Park Plaza, Suite 1500 Irvine, California 92614 RE: Claim of Ranger Insurance Company Please Take Notice as Follows: The claim you presented to the Contra Costa County Board of Supervisors on May 25, 2004 was reviewed by County Counsel. The portion of the claim prior to NTovember 25, 2003 was not presented within six months after the event or occurrence as required by law. Because you allege an ongoing claire, the claim is "timely on its face" and will be reviewed and acted upon by the Board of Supervisors within the statutory time period. To preserve the rights of the County, its departments and employees to challenge the validity of your ongoing claim argument, you are warned pursuant to statute that if your ongoing claim argument is improper,your claim is late, and is being returned because it was not presented within six months after the event or occurrence as required by law. (See Gov. Code, §§ 901, 911.2.) Because the claim may not have been presented within the time allowed by law, we warn you that to preserve your right in the event your claim is determined to be late, your only recourse at this time is to apply without delay to the Contra Costa County Board of Supervisors for leave to present a late claim. (See Gov. Code, §§ 911.4 to 912.2, inclusive, and 946.6.) Under some circumstances, leave to present a late claire will be granted. (See Gov. Code, § 911.6.) Page 1 You may seek the advice of an attorney of your choice in connection with this matter. If you desire to consult an attorney, you should do so immediately. SILVANO B. MARCHER COUNTY COUNSEL By: Monika L. Cooper Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (Cade Civ. frac., §§ 1012, 1013a,2015.5; Evid. Cade, §§ 641,664) 1 am a resident of the State of California,over the age of eighteen years, and not a party to the within action. My business address is Office of the County Counsel,651 fine Street,9th Floor,Martinez,CA 94553-1229. ,I served a true copy of this Notice of Untimeliness as to a Portion of the Claim by placin4he document in a sealed envelope with postage thereon fully prepaid,in the United States mail at Martinez,California addressed as set forth above. I am readily familiar with Office of County Counsel's practice of collection and processing of correspondence for mailing. Under that practice, it would be deposited with the U.S..Postal Service on that same day with postage thereon fully prepaid in the ordinary course of business. I declare under penalty of perjury under the laws of the State of California and the United States of America that the above is true and correct. Executed an 21' '; f`..-'! WATT, TIEDER, HoFFAR sU t1' 500 RTZGERALD, LLP Irvine,California 92614 Telephone:949-852-6700 ATTORNEYS AT LAW , ile:949-261-0771 ww»'.Wthf.corn MAY 25Z0104 May 24, 2004 CLERK O A o A Co� Via Hand Delivery County of Contra Costa c/o Clerk of the Board of Supervisors County Administration Building, Room 106 651 Pine Street Martinez, California 94553 Re: Project: North Richmond Center for Health Contract: No. WH528B Contractor: Clearview Construction, Inc. Surety: Ranger Insurance Company Dear Clerk of the Board of Supervisors: Enclosed please find the claim of Ranger Insurance Company against Contra Costa County, in accordance with Government Code §§900, et seq. Very truly yours, TT, TIEDERr 10 AR & TZGERALDL. . F David Johnso DRJ:hs Enclosure 74565 Post-Ct'M brand fax transmittal memo 7671 #of pages s , Ca. r Co, 0aPt. Phone# s Fax . Fax# McLean,Virginia San Francisca,CA Washington, D.C. Florence, Italy Frankfurt,Germany CLAIM AGAINST PUBLIC ENTITY [government Code §§900 et seq.] TO: County of Contra Costa c/o Clerk of the Board of Supervisors County Administration Building, Room 906 659 Pine Street Martinez, CA 94553 Claimant Ranger Insurance Company ("CLAIMANT"), as assignee and subrogee of Clearview Construction, Inc. ("CLEARVIEW"), hereby asserts this claim against the County of Contra Costa ("COUNTY") pursuant to California Government Code §§900, et §gg., and makes the following statements in support of its claim: 9. The name and Post Office address of CLAIMANT is as follows: Ranger Insurance Company c/o Ms. Susan Gattis TIG Insurances Services, Inc. 5205 North O'Connor Boulevard Irving, Texas 75039 2. The Post Office address to which CLAIMANT desires notices to be sent is as follows: c/o Watt, Tieder, Hoffar& Fitzgerald, L.L.P. Attn: Michael G. Long, Esq./David R. Johnson, Esq. 3 Park Plaza, Suite 9 500 Irvine, California 92694 3. The circumstances of the occurrence giving rise to the claim and a general description of the damage, loss for indebtedness incurred: This claim is ongoing. CLEARVIEW submitted a written bid, based on the bid package, plans and specifications forwarded to it by COUNTY, to construct the work of improvement known as "North Richmond Center for Health, Chesley Avenue and Third Street, Richmond, Budget Line Item No. 6971-4526, Authorization No. 01927 WH528B, in accordance with plans, drawings and specifications, including addenda one through five, prepared by or for the Director of General Services and in accordance with the accepted Bid Proposal" ("PROJECT"). On or about December 16, 1997, COUNTY entered into a contract ("CONTRACT") with CLEARVIEW to construct the PROJECT. Pursuant to the CONTRACT, RANGER, as surety, issued a payment bond and a performance bond on behalf of CLEARVIEW, as principal, and COUNTY, as obligee (collectively, "BONDS"). In general, the BONDS guaranteed to COUNTY that CLEARVIEW would complete the work included within the scope of the CONTRACT and pay its subcontractors for labor and materials on the PROJECT. During the construction of the PROJECT, CLEARVIEW ceased work and failed to pay all of its subcontractors and suppliers, and CLAIMANT was required to perform under the terms of its BONDS. Ultimately, the PROJECT was completed. CLAIMANT incurred lasses of approximately $258,786 in connection with resolving claims against its BONDS. County has not paid all amounts owed under the terms of the CONTRACT. Specifically, CLAIMANT understands that COUNTY is presently in possession of CONTRACT funds in the amount of$127,155.22, based on the following accounting: Original CONTRACT Amount $1,121,000.00 Change Orders 1-8 $_ 33,271.69 Total Adjusted CONTRACT Amount $1,154,271.69 Payments Made By COUNTY ($ 988,502.55) Charges Known To Be Assessed By COUNTY To Date ($ _38,613,92 Total $ 127,155.22 CLAIMANT further understands that COUNTY has assessed/is presently assessing additional charges against the CONTRACT funds (including liquidated damages), but COUNTY has not informed CLAIMANT of the total amount of these charges. 4. CLAIMANT claims damages for COUNTY's breach of contract based on COUNTY's failure to pay all amounts due under the CONTRACT. 5. The names of the public employees, to the extent known, causing the damage or loss: The names of the public employees causing the damage or loss are not specifically known at this time. However, CLAIMANT understands that individuals with knowledge regarding this matter are employed by CQUNTY''s General Services Department. In addition, Deputy County Counsel David Schmidt, Esq. is also believed to have information regarding this matter. 6. The amount which CLAIMANT currently seeks as due and owing as a result of the various acts and/or omissions complained of above exceeds the limits for a limited civil case. Dated: MayZ 20014 1111 TIEDER, HC A FITZGERALD, LLP. r 1 By: MioaqL,6. Long, -q David R. Johnson, Esq. Attorneys for Claimant Ranger Insurance Company, as assignee and subrogee of Clearview Construction, Inc. 74112 CLAIMr ri w� BOARD2F SI�PERVISORS 4F CONTRA COSTA COU TY BOARD ACTION: JULY 13, 204 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 Godes, notice of the action taken on your claim by the !Y26 Board of Supervisors, (Paragraph IV below), gives Pursuant to Government Code Section 913 and Z004 915.4, Please rote all"Warnings". AMOUNT. $250,000-00 COUNTY COUNSEL MARTINEZ CALIF CLAIMANT: JENNIFER DURST, ANTHONY DURST AND ZACHARY DURST ATTORNEY: JONATHAN SAUL DATE RECEIVED: MAY 26, 2004 ADDRESS: NOLEN SAUL BRELSFORD BY DELIVERY TO(.,:C,ERK OM MAY 26, 2QO4 350 UNIVERSITY AVENUE, SUITE 280 SACRAMENTO CA 95825 BY MAIL POSTMARKED: MAY 25, 2004 FROM. Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWE Clerk Dated: MAY 26, 2004 By: Deputy II, MOM: County Counsel.; TO: Clerk of the Board of Su ervis;rs (,-)'This claim complies substantially with Sections 910 and 910.2. i { } This Claim FAILS to comply substantially with Sections 914 and 910.2, and we are so noti4ying claimant. The Board cannot act for 15 days (Section 910.$). { } 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: - $ ''` Deputy County Counse 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. ARD ORDER: By unanimous vote of the Supervisors present: (vr This Claim is rejected in fill. ( } Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JOHN SWEETEN, CLERK, By -, Deputy Clerk WARNING (Gov, code se ion 91 } 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 deposite4.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. JOHN SWEETEN, CLERK By Deputy Clerk Si ?i2004 ? CONTRA COSTA COUNT'S CLERK OF THE 4 9 l J165649991 H0.420 C;,i]. Claim, to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY r,!STRtI'CTIONS10 C G4NT A. Claims relating to causes of action for death or for injury-to person or to personal property or growing craps and which accrue on or before December 31, 1987, must be presented not later than the 1001'clay 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 a xtue 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 oyfaction must be presented not Yater than one year aftrr the accrual of the rause of action, (Crov`t Code 9111.). B. Claims must be filed vAth the Clerk of the Board of Superwhors at its offimin Room 106, County Administration Building, 651 Pine Street,Martinez, CA 945 53. C. If claim is against a district governed by the Board of Supervisors,rather than the +Cour y, 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. Rata . See penalty for fraudulent claims,Penal Code Sec.. 72 at the end of this form. �..�»sys+r�.ss��►�r�*r*�+a�s���r*.►�+ss�w+t�v�r**�rs�s*�►�r»��*�r�«���s�s��*ss�+»s�».*r���x*«�r��s�»:» RR: Claim By Reserve for Clerk's filing stamp Jennifer Durst, Anthony Durst and Zachary Durst ) Against the County of Contra Crista or ) 2 6 2004 ccr K saaf�o District) COA17RA os PrJ? ISftf{3 (Fill in name) ) The undersigned claimant hereby makes claim against the Countir af'Cvntr$ Costa or the above-named district in the sump of$250 ,000 and in support of this claim represents a:,fbllows: t. When did the damaga or injury occur?(Give exact date and hour) 12/24/2003 2. Where did the damage or injury o=r?(Include+city and county)/ Contra Cost:'"Regional Medical Center, 2500 Alhambra Avenue, Martinez GA 3. How did the damage or injury occuO(Give full do,ails;use e.Ktrr,paper if required) Jennifer Durst presented to the emergency room at the Centra Costa Medical Center, thinking she was in labor. After waiting for a few hours, she was told she was not having the baby, and instructed to go horde. Scion after returning hams, Zachary Durst was born. Paramedics arrived on the scene approxinately five minutes after the baby was born, Because Ms. Durst had been sent home., the 'birth was traumatic for bath her and the baby. Zachary Durst was: taken, via ambulance, to John Mair Hospital and stayed in the Neo- natal Intensive Care Unit. n5/17/2004 08:57 CONTRA COSTA COUNTY CLERK OF THE d. What partic=ular act.or OrnissiOn On the pert of county or district officers, servants, or employees caused the injury or damage? The failure-`of the entire medical staff responsible for the care of Jer fifer Durst and:her son, Zachary, caused the damages claimed. The health care providers and staff failed to pay the requisite attention to the patient, (see attached) 5_ What are the names of county or district officers, servants, or cnployeos causing the damage or injury? Contra Costa Regional Medical tenter 6. What damage or injuries dos you claim resulted?((rive full extent of injuries or damages claimed. Attach Emoti�on��.t e t� te�'9°# aif�in and suffering incurred by Jennifer , Anthony and Zachary Durst . The Dursts claim $250 ,000 . 00 plus future medical expenses to care for Zachary' s ailments , caused by the negligence of the health care providers at (attached 7. How was the amount clairned above computed?(Include the estimated amount of any prospective injury or damage.) The above at ants are computed by an evaluation of the darnages suffered by claimants. S. Names and addresses ofwitnesses, doctorsd os it Jermifer Thirst, Anthony Durst, and' .c' s.rst, 4522 St. Charles Place, Concord CA 94521; Contra Costa Regional Medical Center. 9. List the expenditures you made on account of this accident or it jury. IME AM Medical Billr> from John. Moir Hospital liot available at this gime. r,�«*�w#�w*«+►w*#t�#wt*�rwsrt*sip#,t+rrtrr*###�t*#**#rt#t##r*ytwe«r«s#w��r�tt�rt*�*#*s#sww.*�:r:wx«+�«ws«* } Gov. Cade Sec. 910.2 provides "The claim( must be } signed by th s claimant or by some person on his behalf.,. SEND NOTIMS TO: Nacre and ,Address ofAttorne Jonathan Saul., SBN 189251 � N319N SAUL BREMFORD 350 University Avenue, Suite 280 Sacranmto, CA 95825 ; a mart's Signature) } F (Address) (91.6) 5649990 Telephone No. )Telephone Not «ss###swtw#####wa*###sw#f##wase##w#w##tt#rrrr###two*##wratw#tt#(seas##*#wwarw�r#«#«waww««wrw« N 7I7CF, Section 72 of the Pam Code p ovides: Bs'm person who,with inteu to den-dud.presents for klllrri+%nce or the payment to my stmt bawd or officer,or to any ceuwty,city,or district beard or o cct,sut'horir« to allow or pay the same if'g;1(Mane.any rake or fmudu1e t claim,bill,ammat,, voucher,or writing,is ptWshabl#either by imprisoumont in tits county pol far&Fe iod t>3 not metre than one year,by a&at of tx4 "modimg erre thowand t�l, 1.or by both 9wh impriso meat aM S=ic,or by inprisontowt in the trate prison.by a free of xsr� cxcccdiog ten thousand doDam($10,0M),or by both such s`m0sotmtent and fine. 4. Continued: The health care providers and staff failed to pay the requisite attention to the patient, failed to appropriately diagnose and care for the patient, and inappropriately.sent the patient home when she was close to giving birth. 6. Continued. ...caused by the negligence of the health care providers at Contra Costa Regional Medical Center. Permanent damage to the miner child, Zachary Durst, totaling $250,000.00, plus future expenses, expenses already incurred, and interest. 350 UNIVERSITY AVE., SUITE 280 SACRAMENTO, CALIFORNIA 95825 PHONE: (916) 564-9990 PAX; (916) 564-9991 RECEIVED MAY 2 6 2004 U CLERK BOARD of SURVISORS CONTRA COsr�!CC1. May 25, 2004 Clerk of the Board of Supervisors County Administration Building 651 Pine Street, Room 106 Martinez, CA 54553 Re: Claim of Jennifer, Anthony and Zachary Durst Dear Clerk: Enclosed is the original and one copy of the claim of our clients Jennifer, Anthony and Zachary Durst against Contra Costa County. Please direct any and all correspondence to our office. Should you have any questions or comments, please do not hesitate to call. Very truly yours, NCILEN S UL RELSFORD JorYath ul encl. 3 JAS/kc RHUDOLPH NOLEN, JR." JONATHAN A. SAUL" WILLIAM i.. BRELSEORD, JR."" *Member,American Board of Trial Advocates "Also admitted in Nevada CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY • BOARD ACTIQN: JULY 132 2004 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), giver Pursuant to Government Code Section 913 and }, / 2 7 �j p,�S 915.4. Please.note all"Warnings". AMOUNT: $1,000,000 COUNTY COON L MAIRTt E CALIF. CLAIMANT: JEANNIE MEIERS ATTORNEY: STEVEN DUDITCH DATE RECEIVED: MAY 27, 2004 ADDRESS: LAW OFFICES OF STEVEN DLDITCH BY DELIVERY TO (1ERK ON: MAY 27, 2004 1110 LINCOLN AVENUE SAN RAFAEL, CA 94901 BY MAIL POSTMARKED: MAY 26, 2004 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET C Dated: MAY 27, 2004 _ By: Deputy II, FROM: County Counsel.. TO: Clerk of the Board of Supervi ors { his claim complies substantially with Sections 910 and 910.2. 4 { } 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 fled late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). { ) Other: Dated: ' ? By: t_ Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (1) County Administrator(2) { } Claim was returned as untimely with notice to claimant(Section 911.3). IV.,BOARD ORDER: By unanimous vote of the Supervisors present: {✓" This Claim is rejected in full, { ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: 0 JOHN SWEETEN, CLERK, By , Deputy Clerk WARNING(Gov, codes ion 913) Subject to certain exceptions, you hive 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. Dated: OHN SWEETEN, CLERK,By Deputy Clerk 05/19/2004 15.26 CONTRA COSTA COUNTY CLERK OF THE 4 914154576842 N0.444 Dol t, Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSMCTIONS-10-CLAWNU A. Claims relating to causes of action for death or for injury to person or to personal property or grovAng crops and which accrue on or before Mcember 31, l9$?,must be presented not latrs than the 1D&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 prop"or growing craps and which accrete on or after January 1, 1919, must be presented not later than six months aAer the accrual of the cauuse of action.Claims relating to any other cause of action must bac presented not later than one year after the,accrual of the cause of action. (Gov't CC+de 911.2.) R. Claims must be filed with tete Cleric 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 Bawd 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. Emu. See penalty for Fraudulent claims,Penal Code See,72 at the end of this form, RE- Claifn By Reserved for Cler ' filin stamp j RECEI Against the County cf Contra Costa or ) 2004 t;CEFeK 6Aq )OF SUPERVISORS CO) casrA ctt. .,� Ihistrict) (,pili in natr►e) � The undersigned claimant hereby makes claim against the County of Contra Costa or the above-nam dd district in the sum of IL 000 000.and in support of this claim represents as follows: 1. When dict the damage or injury Qmr?(Give exact date and hour) November 30, 2003, at approximately 1 : 20 a.m. 2. Wlere did the dart p or injury occur?(bdudo city tom!county) San Pablo Avenue, approximately 313 feet south of Richmond Parkway, City of Richmond., County of Centra Costa, State of California. 3. Blow did the damage or injury occur?(Give full details;use extra paper if required) See Attachment 4 05/19'2004 15:28 CONTRA COSTA COUNTY CLERK OF THE i 914154576842 NO.444 1902 N. 4, What panicular act Or omission on the part Ofcowry or district officers, servants, Or employees caused the injury or damage? See Attachment 5. What are the names of county or district officers,servants,or employees Causing tho damage or injury? Unkn6wn at this time. 6. What damage or injuries do you dairn resulted?(Give full extent of injuries or dar Cages claimed. Attach two estimates for auto damage.) See Attachment 7. How was the amount claimed above computed?(Include the estimated amount of any prospective injury of damage.) See Attachment S. Names and addresses of witnesses,doctors,and hospitals. See Attachment 9. List the expenditures you made on account of this accident or injury. VATS„ IMM December 5, 2003 Unknown $3 , 794 . 59 ss�l��rrr+e�r��s�t*!a*rt�ts�►es��t+#*i++t��rs��t�r+�rt�+�►il+t+►a�+r+rN+*sisii�t���stti�+���+►firt*+�tt�s+• } Gov.Cad*Sec.910.2 provides"The claim must be signed by the claimant or by some person on his behalf." SMN-0-11CM 10: (Mo Name and Address of Ano ney } Jeannie Meiers I Steven Dud i t ch, Esq. ) (Claimant's Sigttttture) Law Offices of Steven Duditch) 1110 Lincoln Avenue- ) 1,110 L ngoln Avenue San Rafael, CA 94901 } (Address) I San FaZael . CA 94901 I Trdephone No. (415) 456-_-1422 l Telephotk Na t 415 456-3422 +rrssi+►*�r+rrst�s+r*rst�asre�r�+rl�tn��►tai+it+�srr+�ttt/rti�l��t�+i�tsss*rsrs�s+►+1str�s�rrttstsss�r��t�ssrsss• NOT= Section 72 of the Baal Code provider Ivory petsoet who.rritb OwN to dcQrao4 Pruem for Mlo+r►"Ce or tae VVYMM to my nut beard of officer.or to my +amty,city,or Est r rt board car o ffka,aat mizerd to Wow or pay tato$alae if Sew.*w,any woe or fi=dWo of claim,brut,amine, voucW,or w*irq,is prnM*.abk eitba by itiapnimmmuom in do ermttry jau four a period of not mom tb a care year,by a five of not sxt g oae*onuad(Sl.MM,or by both ter impisawrAW and ice,or by impisomwel in the ame piton.by a true of and exceeding to Omindttollan(S1p!,ttM a by both such imprisoetmeoa and An Attachment to Claim of Jeannie Meiers to the Board of Supervisors of Contra Costa County 3. How did the damage or injury occur? Claimant's son, Raymond Olson (then age 22), was a passenger in a car being driven by Marshall Berry southbound on Ban Pablo Avenue in Richmond, California. Due to the negligent driving of Mr. Berry, the automobile went off the roadway where it struck what is believed to be a large concrete drain cover located just off the roadway. The drain cover caused the automobile to catapult into the air, spin in mid-air and turn upside down before landing on the ground. As a result of the accident caused by the existence of the dangerous condition of the large concrete drain cover just off the roadway, claimant's son was ejected from the automobile and died. 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? Although the Claimant is still investigating the nature and extent of the liability of CONTRA COSTA COUNTY, and others, at this time it appears that the County knew, or should have known, of the existence of the dangerous condition, and was further negligent in the manner in which it owned, maintained, controlled, possessed, designed, constructed, managed, operated, repaired, improved, assembled, supervised, entrusted and inspected the concrete drain cover and the surrounding subject area. At this time, it is unclear whether there exist other legal and/or factual bases establishing the County's liability and the claimant does not waive the right to assert such contentions as and when she learns of them. 6. What damage or injuries do you claim resulted? As a result of the negligence of CONTRA COSTA COUNTY and its agents and/or employees, and the existence of the dangerous condition described above, claimant suffered the loss of Raymond Olson's love, companionship, comfort, care, assistance, protection, affection, society, moral support, training and guidance, the financial support that Raymond Olson would have contributed to the family during his life expectancy, the loss of gifts or benefits that claimant would have expected to receive from Raymond Olson, funeral and burial expenses, and the amount reasonably certain to be paid in the future to obtain household services that Raymond Olson would have provided. 7. How was the amount claimed above computed? The basis of computation of the amount claimed as of the presentation of this claim is the damage and losses suffered by the claimant as a result of the acts and omissions of CONTRA COSTA COUNTY, as set forth above, and as to be discovered in the future. 8. Names and addresses of witness, doctors, and hospitals. Marshall Vick Berry 287817 Ih Street Sian Pablo, CA 94806 Robert Dudley Laubach 1530 Swallow Way Hercules, CA 94547 2 Bobur Lamont Sloan 1212 Ohio Avenue Richmond, CA 94804 James Leon Helfer 1212 Karen Drive San Pablo, CA 94806 Officer B. Haupt (1.D. Number 1220) Richmond Police Department 401 27`h Street Richmond, CA 94804 3 I PROOF OF SERVICE BY CERTIFIED MAIL - [C.C.P. SECTION-1-01 3a(3)1 2 Governmental Claim of Jeannie Meiers 3 1, the undersigned, declare that I am employed in the City of San Rafael, County 4 of Marin, State of California; that I am over the age of eighteen years and not a party to 5 the within cause; that my business address is 1114 Lincoln Avenue, San Rafael, CA 6 94941. 7 On May 26, 2444, 1 caused to be served the following document(s): 8 CLAIM AGAINST CONTRA COSTA COUNTY (Government Code Section 910) 9 on the public entity, named below, addressed as follows: 10 Clerk of the Board of Supervisors Contra Costa County 11 Room 146 County Administration Building 12 651 Pine Street Martinez, CA 94553 13 by placing a true copy thereof, enclosed in a sealed envelope with postage thereon fully 14 prepaid, certified mail — return receipt requested, in the outgoing mail box located in my 15 office, in accordance with business practices for deposit with the United States Postal 16 Service in San Rafael, California. I am readily familiar with my office business practice 17 for collection and processing of correspondence for mailing, and the within 18 correspondence will be deposited with the United States Postal Service this date in the 19 ordinary course of business. 20 I declare under penalty of perjury under the laws of the State of California that 21 the foregoing is true and correct. Executed at San Rafael, California on May 26, 2044. 22 23 / heila R. Moore 24 25 26 27 28 LAW OFFICKS OF STEVEN DUDITCH / 1 1 10 LINCOLN AVENUE LCL[ERKK �"p SAN RAFAEL, CALIFORNIA 94801 �€ „j (413) 456-3422 FAX (415) 457-6842 2 7 2004 )QF Sf1PEHUfSf311SA CAST'A CQ. May 26, 2004 CERTIFIED MAIL -- RETURN RECEIPT REQUESTED Board of Supervisors of Contra Costa County County Administration Building 651 fine Street, Room 106 Martinez, CA 94553 Attn: Clerk Re: Governmental Claim of Jeannie Meiers Dear Clerk: Pursuant to California Government Code Section 900 et seq., enclosed please find the governmental claim <)f Jeannie Meiers. Very truly yours, Steven Duditch SD:srm Enclosure(s) CLAIM .� BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION,JULY 13, 2004 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. r--, notice of the action taken on your claim by the GL1 Board of Supervisors. (Paragraph IV below), giver F _ Pursuant to Government Code Section 913 and sAY 7 200 , 915.4. Please note all "Warnings". COUNTY COUNSEL AMOUNT: UNKNOWN MARTINEZ CALIF. CLAIMANT: LIONSOATE DEVELOPMENT CORPORATION KENNETH BARKER ATTORNEY: UNKNOWN DATE RECEIVED: MAy 27, 2004 ADDRESS: P..O. BOX 408 BY DELIVERY TO (_LER.K ON: MAY 27, 2004 ALAMO, CA 94507 HAND DELIVERED BY BY MAIL POSTMARKED: t'S2U€ v cr�tli�t,SFL FROM. Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: MAY 27, 2004 11 JOHN SW!Jt� rk By: Deputy II, FROM: County Counsel, TO: Clerk of the Board of Supefvisors ( } This claim complies substantially with Sections 910 and 910.2.. d ( I his 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: ` .` f By: ' Deputy County Counse 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/. 130ARD 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 date. Dated: AA L4 JOHN SWEETEN, CLERK, By , Deputy Clerk 61 T WARNING (Gov. code section 13) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or depositec 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. *Far 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 depositecl.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: JOHN SWEETEN, CLERK By Deputy Clerk ,r- OFFICE OF THE COUNTY COUNSEL .; <, , SI€.VANO B.MARCHES] COUNTY OF CONTRA COSTA " l y 4S 4 COUNTY COUNSEL Administration Building % sr - h SHARON L.ANDERSON 651 Pine Strut, 9'^Floor r I ' z { CIileF ASSISTANT Martinez, California 94553-1229 ss ri e o < GREGORY C.HARVEY (925) 335-1800 �' , , � ��� VALERIE J. RANCHE {925} 646-1078 (fax) 3; ° ASSISTANTS NOTICE OFIINSt.TFFICIENC ANLIIOR NON-ACCEPTANCE OF CLAIM TO: Lionsgate Development Corporation Kenneth Barker P.U. Box 408 Alamo, CA 94507 RE: CLAIM OF: LIUNSGATE DEVELOPMENT CORPORATION KENNETH BARKER 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 claire 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 claire desires notices to be sent. [X] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the name(s)of the public employee(s) causing the injury, damage, or loss, if known. [ 15. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. [ 16. The claim is not signed by the claimant or by some person on his or her behalf. Page I Lionsgate Development Corporation Kenneth Barker Re: Claim of Lionsgate Development Corporation Kenneth Barker Page Two [ 17. 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. Cade, § 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. [X] S. Other: The attached letter was forwarded to the Board of Supervisors and treated as a government tort claim. We then received your claim on the same matter on May 27, 2004, which was processed as an amended claim. SILVANO B. MARCHESI COtJNTY COLIN SEL fid'r''J 4 f .✓�1 By Monika L. Cooper Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL, (Code Civ.Proc., §§ 1012, 1013x, 2015.5;Evid. Cade, §§ 641,664) 1 am a resident of the State of California,over the age of eighteen years,and not a party to the within action. My business address is Office of the County Counsel, 651 Pine Street, 9th Floor, Martinez, CA 94553-1229. On June 1.2004,1 served a true copy of this Notice of Insufficiency and/or Non-Acceptance of Claim by placing the document in a sealed envelope with postage thereon fully prepaid, in the United States mail at Martinez, California addressed as set forth above. I am readily familiar with Office of County Counsel's practice of collection and processing of correspondence for mailing. Under that practice, it would be deposited with the U.S. Postal Service on that same day with postage thereon fully prepaid in the ordinary course of business. I declare under penalty of perjury under the laws of the State of California and the United States of America that the above is true and correct. Executed on June L 2004, at Martinez,Califgraa a. Kathleen O'Connell cc: Clerk of the Board of Supervisors(original) Risk Management Page 2 LIONSCATE DEVELOPMENT CORPORATION Mailing Address: F. 0.Box 408, Alamo, Califomia 94507 Telephone (925) B 78500 Fax(925)831-8502 VIA ISA�: I)ANU.S. NIAIL t 6Z P7.80 Mr. Dennis Barry, May 11,2004. CONTRA COSTA COUNTY, Director, Community Development Department, 651 Pine Street, a Floor,North Wing, Martinez, CA 94553. RE: IVIS 03-0015 NOTICE OF INTENT TO FILE A CLAIM M AY 1 % 2004 Dear Mr.Barry, Notice is hereby given of Lionsgate's intention to file a claim for damages and delays to the subject minor subdivision caused by the County's repeated failurelrefuW to comply with the County Ordinance Code, applicable taw, and the Constitution of the United States. The County caused damages are estimated to be about$25,000.00 a month and have been ongoing for many months. When the full cost and negative impact are known we shall advise the County of the same. Kindly contact this office if there are any questions. Sincerely, Kenneth Barker, President, Lionsgate Development Corporation. Copy: All Supervisors CLAIM §OARD OF SUPERVISORS !2F CONTRA COSTA COUNT BOARD ACTION:JULY L3, 2004 Claim Against the County, or District Governed by ) the Board of Supervisors,Routing Endorsements, } NOTICE TO CLAIMANT and Board Action. All Section references are to The copy of this document mailed to you is your California Government Cedes, notice of the-action taken on your claim by the Board of Supervisors. (Paragraph IV below), giv Pursuant to Government Code Section 913 and 915.4. Please nate all"Warnings". AMOUNT: UNKNOWN CLAIMANT: LION GATE DEVELOPIW. CORPORATION KENNEL BARKER ATTORNEY: UNKNowN DATE RECEIVED: MAy 27, 2004 ADDRESS: P.:O. BOX 408 BY DELIVERY TO CLERK ON: MAY 27,-,2904 ALAMO, CA 94507 HAND DELIVERED f BY MAIL POSTMARKED: � .M MMS__.SEL FROM: Clerk of the Board of Supervisors TO County Counsel Attached is a copy of the above-noted claim. JOHN SWEVZrk Dated: MAY 27, 2004By: Deputy II, PROM: County Counsel.. TO: Clerk of the Board of Supefvisors ( } This claim complies substantially with Sections 910 and 910.2, A ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). { ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). { ) Other: Dated: By: Deputy County Coun III. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2) { ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( ) This Claim is rejected in.full. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: JOHN SWEETEN, CLERK,By -, Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions, you hove only six(6) months from the date this notice was personally served or deposit 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 deposite '.in the United States Postal Service in Martinez, California, postage .full prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JOHN SWEETEN, CLERK'.By Deputy Clerl LIONSGATE DEVELOPMENT CORPORATION Mailing Address. F. 0.Sox 4018, Alamo, California 94507 Telephone (925) 8 -85013 Fax(925) 831-8502 Mgy272p 04 VIA FAX ANIS U.S. MAIco Va vt�aR� Mr. Dennis Barry, May 11,2004. CONTRA COSTA COUNTY, Director, Community Development Department, 651 Pine Street, 40'Floor,North Wing, Martinez, CA 94553. RE.- MS 03-001.5 NOTICE OF INTENT TO FILE A CLAM MAY i 2 2.004 .Dear 1W Bary, Notice is hereby given.of Lionsgat+e's intention to file a claim for damages and delays to the subject minor subdivision caused by the County's repeated failure/refusal to comply with the County Ordinance Code, applicable law, and the Constitution of the United States. The County caused damages are estimated to be about$25,000.00 a month and have been ongoing for many months. When the full cast and negative impact are Down we shall advise the County of the same. Kindly contact this office if there are any questions. Sincerely, vA Kenneth Barker, President, Lionsgate.Development Corporation. Copy: All. Supervisors Office of the County Counsel Contra Costa County 551 Fine Street, 9th Floor Phone: (925)335-1800 Martinez, CA 94553 Fax: {925}646-1078 Date: May 26, 2004 ` , ` To: Clerk of the Board of Supervisors AY 2 7 Attn: Emy Sharp, Deputy Clerk q COSH pt From: Silvano B. Marchesi, County Counsel By: Monika L. Cooper, Deputy County Counsel Re: New Government Tort Claim by Lionsgate Development Corporation The attached letter should be treated as a new government tort claim. Thank you for your assistance. Please call with any questions. Attachment CON'FID'ENTIAL ATTORNEY CLIENT DOCUMENT CLAIM BOARD OF SUI' RVISORS OF CONTRA COSTA COUNTY BOARD ACTION: ,JULY 1: , 2004 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), give. Pursuant to Government Code Section 913 and 915.4. Please note all"Warnings", r.5 AMOUNT: $1,000,000.00 1 Y 2 7 2D0411 COUNTYCOUNSEL CLAIMANT, RAY OLSON NIARTINEZ CALIF. ATTORNEY. STEVEN DUDITCH DATE RECEIVED: MAY 27, 2004 ADDRESS: LAW OFFICES OF STEVEN DUDITCH BY DELIVERY TO (.:(JERK.ON: MAY 27, 2004 1110 LINCOLN AVENUE SAN RAFAEL, CA 94901 MAY 26, 2004 BY MAIL POSTMARKED: FROM: Clerk of the Beard of Supervisors TO: County Counsel Attached is a copy of the above-noted claim, JOHN SWE T lerk Dated: MAY 27, 2004 By: Deputy II. FROM: County Counsel; TO: Clerk of the Board of Supervisors (L. _T is 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 not-flying claimant. The Board cannot act for 15 days (Section 910,8), { } Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: ' ' 9� Deputy County Counse 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. ARD ORDER: By unanimous vote of the Supervisors present: , (This Claim is rejeccted.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: JOHN SWEETEN,CLERK, By , Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions, you hove 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. *Far Additional Warninj See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of per ury 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 deposite4,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: &=,_:L4OHN SWEETEN, CLERK By Deputy Clerk •• . .11 c Writ I-)i ca "111 MM t..ua!H C: UN#Y LLhitK OF THE 914154576842 NO.444 901 Maim to: BOA"UP SUPERVISORS OF CON`i`1ftA COSTA COUNTY INSIRMIONS 10 CLAWAi A. Claims rtIming to causes ofaction for death or for injury to person or to personal property Or growing crops and which accrue on or before Dace ober 31, 1987,must be presented not lamer than the 10&day after the accrual of the cause of action. Claims relating to ceruses of action for death nr for injury to person or to personal property or growing craps and which accrue on or after 7anuary 1, 1998,must be presented not later than six months after the acctval of the cause of action.Claims relating to any other cause oftaion must be presented rust later than one your after the accrusl of the cause ofaction. (Gov't Code 9111.). D. Claims must be filed with the Clerk ofthe Hoard of Supervisors at its oflrce:ln Room 106, Cory Administration Buddin&651 Piot Street,Martinez,CA 94553. C. If claim is against a district governed by the Hoard 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. Er, rd. See penalty for fmudultnt claims,PerW Code Sec.72 at the end of Ws form. s«««.«««««««««.r««�s«*�«..::�r•r«.«>t..+r«.«.s..*e««.«««+rex.r:r#.««��:..s+r*«««..«��r..:s,�..«*:#. RE: Clairrn By Reserved for Clak's filing stamp I Against the County ofContra Costa or Y 2 7 2OQ4 CLrl �� D cr a#rictj �r� vs a���t''s'��s (,Fill in name) } co. 7U undersipW claimat hereby mdw claim against the County of Contra Costa or the above-named district in the actin of 31 non I QQO lad in support of this claim represents as Wows: 1. 1Jii'heot did the damages or injury q=r?(Give exact date and hour) November 30, 2003, at approximately 1 : 23 a.m.. 2. Wbetn did the da r nage or injury ocoal(Include city and=tnty) San Pablo Avenue, approximately 313 feet south of Richmond Parkway, City of Richmond, County of Contra Costa, State of.-California. 3. Horan did the damage or injury ocam?(Give full details;use extra paper ifrequire d) See Attachment y , WN I KH Wb t H C;LILIN tY CLERK OF THE 914154578842 NO.444 902 n 4. What particular act or omission on the part of county or district officers, servants, Of ernpl0yees caused the injury or damage? See Attachment 5. What are the names of county or district officers,servants,or employees calming the damage or injury? Unknown at this time. 6. What damage or injuries do you claim resulted?(Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) See Attachment 7. now was the&mount claimed above computed?(Ynclude the estimated:amount of any prospective injury or damage.) See Attachment S. ?Names and addresses of witnesses,doctors!, ant!bMitals. See Attachment 9. List the expenditures you made on mount of this accident or injury. DATE Unknown at this time. tt##;####ii#####i###i##i'iiii�Ri+Fii#####iiyif#!+►tai###t#XPi#+ijls#i#####+YM*+Tf#t#i#�F+t##�#d�#M+t#ii+�## Gov.Cad*Sec.9101 provides"The claim trust be signed by the claimant or by some person on his behalf" MM NO= Name and Address of Attormy ) Ray Olson Steven Duditch, Esq. ) (axi ttant's Signature) Law Offices of Steven Duditch ) 1110 Lincoln Avenue 1.11 -0 Linp 4 San Rafael, CA 94901 � (Addresa) San Rafael, CA 94901 Telephone No. ,1�}1. . 4 2. Mepho to Wo.�C 415�4 5 fi-3:42 L._. #####itiiaYi#+t*#tib##rI►#y1taIM#t+1i#�ii#i+i�l #s####!#;##iltf###i ti##i1###i!##t###�tiM#!1#1e#####i• XMICS 5oclkm 72 of the PesW C4*pre+ ilex: wary partoa wbo,wMh intent to drJ'iM4 FtWM for atkyw%oace or tbt myratrrt to my suit board or officer,or to any mwty,city+,of finrict baud or offer,au"ioad to allow of per ttrc saw if pt►turirte,eery false or 6+rat ctaim biA ommumt, voudw.of wrkkv$ is powhable eitber by ww4w is dee muny jail tot a perW of not mart*art orae year,by s Aw of not ceediag one tlrw*=W(x t,tletll,or by bath such jmosowntM and Aoe,or by bnpdwaasM in twat tis pion,by a A=of 2X e.,cftefte tar+lboasad doU=(3100M).w by both sib imprisonmets ad gat. Attachment to Claim of Ray Olson to the Board of Supervisors of Contra Costa County 3. How did the damage or injury occur? Claimant's son, Raymond Olson (then age 22), was a passenger in a car being driven by Marshall Berry southbound on San Pablo Avenue in Richmond, California. Due to the negligent driving of Mr. Berry, the automobile went off the roadway where it struck what is believed to be a large concrete drain cover located just off the roadway. The drain cover caused the automobile to catapult into the air, spin in midair and turn upside down before landing on the ground. As a result of the accident caused by the existence of the dangerous condition of the large concrete drain cover just off the roadway, claimant's son was ejected from the automobile and died. 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? Although the Claimant is still investigating the nature and extent of the liability of CONTRA COSTA COUNTY, and others, at this time it appears that the County knew, or should have known, of the existence of the dangerous condition, and was further negligent in the manner in which it owned, maintained, controlled, possessed, designed, constructed, managed, operated, repaired, improved, assembled, supervised, entrusted and inspected the concrete drain cover and the surrounding subject area. At this time, it is unclear whether there exist other legal and/or factual bases establishing the County's liability and the claimant does not waive the right to assert such contentions as and when he learns of them. 8. What damage or injuries do you claim resulted? As a result of the negligence of CONTRA COSTA COUNTY and its agents and/or employees, and the existence of the dangerous condition described above, claimant suffered the loss of Raymond Olson's love, companionship, comfort, care, assistance, protection, affection, society, moral support, training and guidance, the financial support that Raymond Olson would have contributed to the family during his life expectancy, the loss of gifts or benefits that claimant would have expected to receive from Raymond Olson, funeral and burial expenses, and the amount reasonably certain to be paid in the future to obtain household services that Raymond Olson would have provided. 7. How was the amount claimed above computed? The basis of computation of the amount claimed as of the presentation of this claim is the damage and losses suffered by the claimant as a result of the acts and omissions of CONTRA COSTA COUNTY, as set forth above, and as to be discovered in the future. 8. Names and addresses of witness, doctors, and hospitals. Marshall Vick Berry 287817 Ih Street San Pablo, CA 94806 Robert Dudley Laubach 1530 Swallow'Way Hercules, CA 94547 2 Bobur Lamont Sloan 1212 Ohio Avenue Richmond, CA 94804 James Lean Keifer 1212 Karen Drive San Pablo, CA 94806 Officer E. Haupt (I.D. Number 1220) Richmond Police Department 40127 th Street Richmond, CA 94804 x 3 1 PROOF OF SERVICE BY CERTIFIED MAIL - C.C.P. SECTION 1013a(3)1 2 Governmental Claim of Rey Olson 3 1, the undersigned, declare that I am employed in the City of San Rafael, County 4 of Maria, State of California; that I am over the age of eighteen years and not a party to 5 the within cause; that my business address is 9110 Lincoln Avenue, San Rafael, CA 6 94901. 7 On May 25, 2004, 1 caused to be served the following document(s): 8 Cl-AIM AGAINST CONTRA COSTA COUNT`' (Government Code Section 910) 9 on the public entity, named below, addressed as follows: 10 Clerk of the Board of Supervisors Contra Costa County 11 Rohm 106 County Administration Building 12 651 Pine Street Martinez, CA 94553 13 by placing a true copy thereof, enclosed in a sealed envelope with postage thereon fully 14 prepaid, certified mail —return receipt requested, in the outgoing mail box located in my 15 office, in accordance with business practices for deposit with the United States Postal 16 Service in San Rafael, California. I am readily familiar with my office business practice 17 for collection and processing of correspondence for mailing, and the within 18 correspondence will be deposited with the United States Postal Service this date in the 19 ordinary course of business. 20 1 declare under penalty of perjury under the laws of the State of California that 21 the foregoing is true and correct. Executed at San Rafael, California on May 26, 2004. 22 23IA'ofn(e�*' L"o 0 24 eiia R. oo e 25 26 27 28 LAW OFFICES OF STEVEN lDUDITCH I 1 10 LINCOLN AVENUE SAN RAFAEL, CALIFORNIA 94901 (415) 456-3422 } FAX (415) 457-6E42 AfAy 2 72094 car rt.. oft May 26, 2004 CERTIFIED MAIL -- RETURN RECEIPT REQUESTED Board of Supervisors of Contra Costa County County Administration Building 651 Pine Street, Room 106 Martinez, CA 94553 Attn: Clerk Re: Governmental Claim of Rav Olson Dear Clerk: Pursuant to California Government Code Section 900 et seq., enclosed please find the governmental claim of Ray (Olson. Very truly yours, Steven Duditch SD:srm Enclosure(s) CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JULY 13, 2004 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 J Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all"Warnings". AMOUNT: $3,015,000.00 COUNTY COUNSEL NIARTINEZ CALIF. CLAIMANT: MATT RAMIREZ & KIMBERLY DRESSEL RAMIREZ ATTORNEY: UNKNOWN DATE RECEIVED: MAY 2 , 2004 ADDRESS: 3710 POEMART PLACE BY DELIVERY TO CLERK ON: MAY 2$`, 2004 SAN RAMON, CA 94583 BY MAIL POSTMARKED: HAND DELIVERED .FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. Dated: MAY 28, 2004 By: Deputy JOHN SWEET , II. MOM: County Counsel,. TO: Clerk of the Board of Supero:stirs (This claim complies substantially with Sections 910 and 910.2. t ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days(Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). Deputy County Counse Dated. ,.,. By. yr f; ; :-Y F/-Y r1 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: (b)" 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: 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 depositec 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. Dated: �' JOHN SWEETEN, CLERK By Deputy Cleric Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAPS ANT 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 100`x'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 Berard of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martine, 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 Matt Ramirez& Kimberly Dressel-Ramirez ) > FILED Against the County of Contra Costa or ) MAY Z g 2004 ) District) CLERK BOARD OF SUPERV1SOR3 ) CONTRA COSTA CO. (Fill in name) } The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of S 3,015,000 and in support of this claim represents as follows: I. When did the damage or injury occur?(Give exact date and hour) The death of Haley occurred on December 1, 2003 approximately between the hours of 9:00 a.m. and 11:20 a_m. 2_ Where did the damage or injury occur?(Include city and county) Mauzy School in the City of Alamo,CA,County of Contra Costa 3. How did the damage or injury occur?(Give full details, use extra paper if required) Haley required 24-hour observation by medically trained personnel. On December 1,2003, the employees responsible for observing Haley failed to observe her and her position,thus leaving her alone for a substantial period of time. During this unobserved period,Haley's body was positioned in a manner that restricted her breathing. This restriction of breath led to Haley's death. 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? The supen6sors. nurses and attendants at Mauzy School failed to provide the observation,care and attention required by a chip? in Haley's condition. Haley's condition and requirements were well known by the school and staff prior to December 1, 2003. 5. What are the names of county or district officers, servants, or employees causing the damage or injury? Maricella (her last name is unknown to us), Maryanne Parcel, teacher, two new aides 6, What damage or injuries do you claire resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) Death of Haley Dressel Ramirez 7. How was the amount claimed above computed?(Include the estimated amount of any prospective injury or damage.) Actual out-of-pocket damages and pain and suffering. 8. Names and addresses ofwitnesses, doctors, and hospitals. Walnut Creek Kaiser Hospital and Alamo Fire Department. The Staff at Mauzy School 9. List the expenditures you made on account of this accident or injury. DATE TDA AMOUNT Various medical and transportation $ 5,000.00 Burial Expenses $ 10,000.00 Gov. Code Sec. 910.2 provides "The claim must be } signed he claimant or by some person on his behalf" SEND NOT]CES TO: (Attorney Name and Address of Attorney } } fs } (Claim nt ign re) Kimberly sel Ramirez } 3710 Bocmart Place (Address) San Ramon, CA 94583 Telephone No, )Telephone No. (925) 837-1343 NOTICE SOction 72 of the Penial Code pmvides. Every person who,with intent to defraud,presents for ai OYMMce of the 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 mare than one year,by a fine of not exccexiing one thousand(S 1,000),or by both such imprisorunent and fine,or by imprisonment in the state prison,by a fine of not exceeding tent thousand dollars($10,U00),or by both such imprisonment and fine. Ptd) WMSEf2 @ERMANENTE STATEMENT PAGE l OF 1 Guardian of H RAMIREZ DATE STATEMENT DATE 04/15/04 3710 130CMART PLACE 04/30/04 If you have any questions concerning SAN RAMON CA 94533 this Dill please call: 1-800-201-2123 - Or Write to: Patient Billing Resolurion Crept Guarantor # 11707607 393 East Walnut St Pasadena CA 91 188 ACCOUNT# PATIENT NAME LOC SERV. [SATE ACCOUNT ACTIVITY AMOUNT 7499531 Haley RAMIREZ WCR 12/01/03 Balance Forward 2,939.00 ------------------------------------------------ --------------------------- ------------ i i I i i i i ii l i 01ARBCTI REV 22/11!132p b TOTAL AMOUNT OF ALL,ACCOUNTS $2,930.00 TOTAL BALANCE DUE FROM YOU $2,930.00 Any payments,charges,or adjustments received after the statement date above will appear on your next statement. Your account is seriously past due. In the absence of full payment (by the specified due date) it may be assigned to a collection agency. PLEASE DETACH AT PERFORATION AND RETURN BOTTOM PORTION WITH PAYMENT •�0 Make check payable to Kaiser Permanente I PREFER TO PAY AS FOLLOWS: STATEMENT DATE 04/15/04 IQ MSIR PErW VCNTC ® VISA d MASTERCARD GUARANTOR # DATE DUE EXP.DATE: 11707607 04/30/04 NAME AS IT APPEARS ON CART): BALANCE DUE NT PAITt ACCOUNT NUMBER: [Ia 0 0 00 F1 F1 FIF Fln a[]a $2,9J30.00 SIGNATURE OF CARD HOLDER: DATE: Guardian of H RAMIREZ File 55571 3710 BOCMART PLACE SAN RAMON CA'94583 SAN RAMON VALLEY FIRE PO BOK 269110 SACRAMENTO, CA 95826-9110 FOR BILLING INQUIRIES CALL: 800 772 6552 7750 12/19/03 706.00 IRS NO. 68-0419453 TICKET No. R03006249 � .5:. ��}y WM1y+sp1$y99ji '#Bwl'D p�aNQ 1 c r a.1 ,A, 4wMESRR0300624906# 4000000475 01 00O3 ({t1tte1ttle1ttttIittrrl{ttstlifts tt1iirrtt1}tetitFfiFteritii r10rt=1_ ` t ` t Sr t [ftt tt t(ttt tt 55 ��r�etettit�etfitt�r�tlltt�tlter:tFltrr�l�fittfitil)tertFet�tl HALEY RAMIREZ SAN RAMON VALLEY FIRE PARENT OF PO SOK 269194 3710 BOCMANT PL SACRAMENTO, CA 95826-9110 SAN RAMON, CA 94583-1806 PLEASE RETURN THIS PORTION VIATH YOUR PAYMENT SEE REVERSE SIDE FOR ADDITIONAL INFORMATION INVOICE, ACCOUNT NO. 7750 PATIENT: HALEY RAMIREZ TICKET_ NO. R03006249 Page 1 of 1 SSN#: DATE DESCRIPTION QUANTITY CHARGE PAYMENT BALANCE 12101/03 ALS2 ADVANCED LIFE SUPPORT 1 500.00 500.00 MILEAGE 5 45.00 45.00 OXYGEN 1 40.00 40.00 DEFIB SUPPLIES 1 5.00 5.00 IV KIT WITH NORMAL SALINE 1 50.00 50.00 IV SUPPLIES 1 11.00 11.00 ORALINASAL AIRWAY 1 5.00 5.00 ADVANCED AIRWAY SUPPLIES 1 40.00 40.00 ALS DISPOSABLE SUPPLIES 1 10.00 10.00 This bill ;s .separate from your hospital bill. You are responsible for all charges. Please Inform us of any w insurance coverage, Medicare or MediCal. Este cobro es separado de la cuenta del hospital. Usted es responsable por todas los cargos. Favor de informanos de cualquier seguro, que usted tenga, o Medicare o MediCal. 706.Oft AMBULANCE SERVICE FROM 2964 MIRANDA AVE TO KAISER WALNUT CREEK SAN RAMON VALLEY FIRE PO BOX 265110 SACRAMENTO, CA 95826-9110 FOR BILLING INQUIRIES CALL 800 772 6552 Date of Death: 12)112003 Full Name of Deceased: Haley Ramirez Date of Service:, 12106QQ03 Cemetery/Crematory: Quegn of Heap§n Cgmgt8'.r ♦ IT19 Q Interment Fee $ Professional Services Q Cemetery Equipment $ Basic Services of Funeral Director $ Q Crematory Charges $ and Staff: fr)on-declinable)#fl 0 Final Date Charge $ Embaiming Fees: $ Other Preparation or Cara: Q Clergy Honorarium $ 300.00 $ ] Musician Honorarium 5__ „ -- ❑ Soloist Honorarium $ 150.00 Facilities,Equipment,and Staff: Obituaries: Use of facilities,equipment,and staff $ Q San Jose Mercury. $ 242.31 for Viewing,Visitation,or Wake: Q San Ramon Valley Times - 5 . 118.03 Use of facilities,equipment,and staff Certified Death Certificates: for Funeral Service: $ �] 7 Q $ 14.50 $ 101.50 Use of Staff and/or Equipment for Service Q 0 $3 00 $ in Church or other location or facility: $ Other use of Funeral Home facilities Q Permit $ 13.00 andior Staff(describe:) Q Hairstyling/Barber Charges $ $ Q Florist Charges $ Holiday/Weekend Surcharge: $ Q Transportation(name the carrier:) Automotive Equipment(30 Mile Radius) — $�— Transfer to Funeral Home $ Q Escorts $ Hearse(Funeral Coach): $ Q Other: $ Family Vehicle(s): $ -_ Flower/Other Vehicle: $-- TOTAL OF CASH ADVANCES: Ca 1,072,8 $ We charge for services in obtaining those itams marked with an X, Transportation $_ Any estimated charges will be indicated with an E. Special Charges: +• Cemetery Service by Funeral Home $ •x .,Other: $ Taxable Amount $ 1 2 00 Q Forwarding Remains 0Receiving Remains &250%State $ To/From: $ $ - Service Of Remembrance _•_S .375._0 $_ $ Total Tax: Includes: Basic services of funeral director and staff, $ facilities use for one day of viewing, including two choices of personalization services; facilities and $ equipment use for funeral service,Including one choice TOTAL OF OTHER of personalization service; embalming or other $ 101 05 preparataion of the deceased;transfer of the deceased CHARGES&CREDITS: 00 to the funeral home; funeral coach; limousine end 237500 e s r TOTS�I_"gbl�I§ORVICES: $ ar ,» TOTAL CHARGES&CREDITS(A+B+C): $ 4,773.87 Casket York 3'6"White Lambskin S 975.00 Payment: S_ Prearranpetnent: $ O.B.C.' $ Prearrangement: $ Urn $..�... Casa Discount $� Clothing $. - UNPAID BALANCE(Due by 12/06/2003) $ 4,773.877 Flowers (from Funeral Home) $ 2 0.00 Insurance Assignments or Other Pending Credits: Memorial Monument $ ($ � Tomporary Grave Marker S _ ($ ) Memorial Package $ ($ ) Memorial Register Book $ 50.00 {.tptN QW my mCtves"00"above stutlt 4a P44 W}cw Md..60 days at khs QW Ur ibis oYrs7aet.UDan}aa'iYW✓+t!M at Is"Acknowied Acknowledgement Cards $ I"(3)hays prow w duan rndu Ina any"Woo due..dorIns.e.gnnwn(a)daauDad awva two Mi yet been deal to YOU g prorNasd.you can taquA.OW any w.h unpaid a/IaWN(a)Ot paid by Ire r arra. PAYMENT TERMS'i underAl"tr*no tMantion of area"JW to b dwai a•,d"a cradA dock aixt Yetaaa,61 galea.or a:har conwunaor nada rout*.to OOMMO&Iod by live cabana I nava rr rVN to Qatar payment.1 Any tanwN duo under UIN Canaria.I Memorial Fol tiers/Prayer Cards $ adrae Inc I am personalty taus for payrlant of"appl-016"ones due Koam stove by de dew.todieaw,d Wow SuCts pa"N Other Merchandise: wt bt troaby mt t.y"r"o"aaa gas tone n tide tanbwA.n aadAWn,a tr*cAwryia n the bra ap.ioN.*n peruni(IM)pat annum(or,14"the toyer rale WIVIANd under Wrisrabte low)ail he rherged GM due an Ow unpaid bsionos from Uw dew or $ Iris Cataract Irwuiih th.dour paid.You can.vol pageant of Sha lata ehwrga a you pay It.#mt.balance,ps toll wAlvn(60)days cwt the dale shown here.The is.CASH TRANSACTION,due in his on or Wwo t2'tX1v2= TOTAL OF MERCHANDISE: $ _ 1,2222 r .V5�.�01y0 NOTICE: C3TAL OF SERV.&MERCH.(1 +2), (� ,.J.V VW 5 TO lS yartCoauyre Sea otnor.aa of iNt Conuacp for AONrdn l 7erm4,eaduda,0 t eawhau oi wrravws and P.mk.1—at romade. .that we part of INa wi*wl and as arwrporr*d herrn by rslorame.Co not sign ae annum befogs you road A or 10 aoNain.any .<.•.... Mask space.,you sohnom dy.r.t.0 of.n swot espy r{tae uxdracr.Keep 0-,w w woad to""your w90 tikise Identification and Description of Mandatory Items and Explanation of Embalming Charge: :at(s��ofor Embalming: ID Buyer Name: Matthew Ramirez Expressly Approved U1 Funeral with Public Viewing Address: 3710 Bocm art Plate any lytta,cametary,or crematory requirements have requi ad the purchase of any City: Salt Ramon state:CA ZIP: 9458.3- Date: 'ter it§ms fisted above,the taw or requirement is explained befow: Q Outar burial container required by cemetiary Phone: Relationship: Father Q Other(dascriba): SIGNED: (Signature of Buyer) Ve agree to render the,services and furnish the merchandise indicated above. ACCEPTED for SELLER: Nadine Benz Co-Buyer Name: License Number.- 1976 Address: SIGNED City: State:— ZIP: Date: By: Si nature of Licensed Funeral P7srector Phone: Relationship: Deceased File Numatic Sequence Accounting File Buyer SIGNED: White Copy Yellow Copy Pink Copy Cold Copy (Signature of Co-Buyer) OR MORE INFORMATION ON FUNERAL,CEMETERY,AND CREMATION MATTERS CONTACT: DEPARTMENT OF CONSUMER AFFAIRS,CEMETERYIFUNERAL DIVISION,400 R STREET,SACRAMENTO, CA 95814-6299; TELEPHONE 916322-7737. rm Me R#Y.*d S I'Ou+i 0-006 CLAIM BOARD_ OF S'UPERV"ISOR5 OFC NTRA COSTA COUNTY BOARD ACTION: JULY 13, 2004 Claim Against the County, or District Governed by } the Board of Supervisors,Routing Endorsements, } NOTICE TO CLAMANT 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), giver. Pursuant to Government Code Section 913 and 915.4. Please note all"Warnings". i a� AMOUNT: $12,000-00 COUNTY'C: UNSEL CLAIMANT: THOMAS CASEY COMEN MARTINEZ CALIF, ATTORNEY: BLACKIE BURAK DATE RECEIVED: MAY 28)- 2004 ADDRESS: 500 YGNACIO VALLEY ROAD, SUITE 300 BY DELIVERY TO (..O.ERK.ON: MAY 28, 2004 WALNUT CREEK, CA 94596 HAND DELIVERED BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEE N C k Dated: MAY 28, 2004 By: Deputy 11, MOM: County Counsel. TO: Clerk of the Board of Sup isors (,_).-This claim complies substantially with Sections 910 and 910.2. ( } This Claim FAILS to comply substantially with Sections 9103 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: Deputy Counsel Dated: By, t r zs County 111. FROM: Clerk ofthe 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: JOHN SWEETEN, CLERK., ByA6"%& , Deputy Clerk WARNING(Gov. code sectio 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 seep 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 per ury 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: JOHN SWEETEN, CLERK.By Deputy Clerk Claim to: BOARD OF SUPERVISORS OF CONTRA COS'T'A COUNTY t INSTRUCTIONS TO,CL 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 I Oe day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action trust be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office•in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form. RE: t lain By ,-- - Reserved for Clerk's filing stamp RECEIVED Against the County of Contra Costa w ) MAY 2 8 2004 rr� UPERViSO8g �'_�- District} CLERK BOARD CONTRA COSTA Co. (Fill in name) ) The undersigned cl imant hereby makes claim against the County of Contra Costa or the above-named district in the sura of$ ,4, 1 M and in support of this claim represents as follows: 1. 'W`,htrn did the damage or injury occur?(Give exact date and hour) 2. Where dide da age or in my o9cur?(Include city and county) !fir' d � <,✓ ���J "Y",..� £ y �� fi' "��/ +s- ! ,-,Y»" -� '4"'O -/ 3. How did thte_.damage or injury occur?(Give full details;use extra paper if required) 51 le�s a 4. What particular act or omission can the pa;t of county or district officers, servants, or employees caused the injury or damage? L7''l 5. What are the names of county or district officers, servants, or employees causing the damage or injury? i •.- �'i �f mss"'•. 6, What damage or injuries do you claire resulted?(Give full extent of injuries or damages claimed. Attach two estimates for aorto damage.) "j � ,,, /� , e �y �-. __ _`"Pr �'� ./�y�}y.i.3 s�/e.+ -"'!�"d'"s ..J!' •-c.Jr' J>`l 7- How was the amount claimed above computed?(Include the estimated amount of any prospective injury or g .) damn e t � 8. Names and addresses of witnesses, doctors and hospitals. 4.9. List the expenditures you made on account of this accident or injury. DATE ATvK3I Gov. Code Sec. 910.2 provides"The claim must be } signed by the claimant or by some person on his behalf," SEND NC}TIC S T tt m . Name and Address of Attorney i X` ' j/e� r° ) (C rant's ignature), �. .^•../,, .,...� .�+"I 1777 " Telephone No. :� p Telephone No. NOTICE Section 72 of the Penal Code provides: Every person who,with intent to defraud,prmuts for allowance or the 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 claire,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(S1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fuse of-not exceeding ten thousand dollars($I0,000),or by both such imprisonment and fine. r , r _ d s r .,_.� � ,'r%� �.y'fg� i j0��t tti.. �,,���/ L��C'��'1 ,�'�%"� J•'"j:�'j�'� �'� pdf��� 'r�.' .._ CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JULY 13, 2004 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 15.4. Please note all"Warnings . AMOUNT: a U UNKNOWN CLAIMANT: GEORGE G. PAUNOV COUNTY`u p,)smj.e MARTINEZCALiF ATTORNEY: ALBERT G. STOLL, JR. DATE RECEIVED: JUNE OT, 2004 ADDRESS: LAW OFFICE OF ALBERT G. STOLL, JR. BY DELIVERY TO CLERK.ON: JUNE 01, 2004 SS FRANCISCO STREET, SUITE 403 SAN FRANCISCO;, CA.. 941.33 BY MAIL POSTMARKED: MAY 28, 2004 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JUKE 01, 200 + JOHN SWEET 1 Dated. By: Deputy IT FOROM: County Counsel. TO: Clerk of the Board of Supervisors ( ,)'This claim complies substantially with Sections 910 and 910.2. { ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). { ) Other: Dated: �` .�_ $ iwr,;f,-f,= �; . y: Y ,�f :.. Deputy County C©ansa 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. ©ARD ORDER: By unanimous vote of the Supervisors present: t (# 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: JOHN SWEETEN, CLERK,By Deputy Clerk WARNING(Gov. code sec on 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or depositec 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. Dated: HN SWEETEN, CLERK.By Deputy Clerk ' ALBERT G. STOLL, JR. #164649 2 LAW OFFICE OF ALBERT G. STOLL, JR 55 FRANCISCO STREET, SUITE 403 3 SAN FRANCISCO, CA 94133 TELEPHONE: (415) 576-1500 4 FAX: (415) 576-1501 1 J&/V Attorney for Claimant: GEORGE PAUNOV �' � �(1 PRESENTATION OF GOVERNMENT CLAIM PURSUANT TO CHAPTER 2 8 ARTICLE ONE, SECTION 910 9 GEORGE G. PAUNOV, PLAINTIFF'S GOVERNMENT 10 Claimant, CLAIM I' v [Cal Govn't Code Section 910] 12 CITY OF PITTSBURG, COUNTY OF 13 CONTRA COSTA, 14 Government Entities. 18 16 TO 17 18 Attn.: Claims, Clerk of the Board of Supervisors. Room 106, County Administration 1 9 Building. 651 Pine Street. Martinez, CA. 94553. i 20 CLAIMANT'S NAME AND ADDRESS 21 Claimant is George Paunov. Claimant's address is 2384 Hickory Drive. Concord, CA. 22 94520. 23 ADDRESS TO WHICH NOTICES ARE TO BE SENT 24 Claimant desires notices to be sent to her attorney at Law Office of Albert G. Stoll, Jr., 255 55 Francisco Street, Suite 403, San Francisco, CA 94133, phone 415-576-1500, fax 415-57 26 6- 27 1501. 28 Paunov Government Claim Contra Costa.doc 1 1 2 DATE \LOCATION OF INJURY 3 The incident for which this claim arises occurred on December 25, 2003 shortly after 4 midnight southbound on San Marco near Santa Teresa Drive in the town of Pittsburg, County of 5 Contra Costa, California. 6 HOW DID INJURY OCCUR 7 Claimant was riding his motorcycle on San Marco Boulevard. Claimant passed Saint 8 9 Teresa Drive and without warning came upon a steel cable strung across the public road. He was i 8 unable to avoid striking the thin cable strung across the road. His left ring finger was severed as 11 he struck the wire. He also sustained severe bruising and other injury from being thrown off the 12 motorcycle. The Police Report number for this incident is CO3-11189 and is attached to this 13 claim as exhibit 1. 4 NAME OF PUBLIC EMPLOYEE CAUSING INJURY Claimant does not know the names of the public employee or employees who caused the 16 17 injury. 18 WHAT ACT CAUSED THE DAMAGE 1 The County of Contra Costa created and or was aware of a dangerous condition of public 20 property, i.e. the hanging of an invisible cable across San Marco Boulevard on December 25, 21 2003. The County of Contra Costa had actual and constructive knowledge of the existence of 22 this dangerous condition and took no steps to prevent claimant's injuries or remedy the 23 dangerous condition of public property. 24 25 26 27 28 Paunov Government Claim Contra Costa.doe 2 1 2 DESCRIBE INJURY OR DAMAGE 3 Claimant's left hand ring finger was amputated. As a result there is continuing pain and 4 high sensitivity on the remains of the finger. Furthermore, on his left hand middle finger there is 5 pain in his joints and it cannot fully bend. In his entire hand, there is a loss of grip and power. 6 On top of those injuries,he experienced heavy bruising on his torso, hip, and other 7 regions of his body. He experiences headaches and depression. 8 9 ITEMIZATION OF CLAIM 10 As a result of the subject collision claimant has incurred medical expenses, which are 11 currently being collected, and itemized as claimant's treatment is ongoing. There will be a claim 12 for lost past and future wages, along with a request for compensation for the pain and 13 inconvenience of dealing with a physical injury. Future damages are unknown at this time. 14 Plaintiffs motorcycle was completely totaled in the collision. 15 AMOUNT OF CLAIM 16 17 The claim is an unlimited civil claim. The damages will be proven according to proof. 8 Signed by or on behalf of Claimant this 28 day of May 2004. 19 20 Date: LawOffice G I J 21 22 By: 23 BERT G. STOLL, JR. 24 Attorney for Claimant George G. Paunov 25 26 27 28 Paunov Government Claim Contra Costa.doc 3 1 . TATe Or CALIFORNIA r,RAFFlC-,C0LL1SibN REPORT ##556 Pigg 1 I;RHV.8-97� OR 042 Page� of PECfhL CONDITIONS !NUMl3Ya {wr,mm CITY JUDICIAL DISTRICT LOCAL REPORT NUMBER. Nowa[It llx.i&rtiruexavN COUNTY REPORTING DISTRICT COL ZON OCCURRED ON qMo., OAtV YEAR TIME(.M NGIC w lopPiG „ MILEPOST INFORMATION DAY OF WEEK ITOWAWAY PHOTOGRAPHS BY: ?""j NONE � F£E'TJWLES OF S M S 1 YES E NO I AT INTERSECTION WITH STATE HWY REI. }`� ,' •.. J OR: IT!MIL£fi 4F YEB�. NO AMMODEVOILOR ENSE NUMBS .. DR1V£R`B LICENSE NUMBER � JCLASS'`w+T ` £ Ut 6c,AR +✓ MY�•i-�.F.✓ LiriSiSi"� fCxy E?IYdER NAME(FIAST,Af100(F,LAST) F � � OWNER'S NAME I 1 SAME AS DRIVER PMM STREET ADDRESS 7lSfAN teary OWNER'S ACORES$ f/y SAME A5 DRIVER PARXED GITYISTAT&W UNIX DISPOSITION ORDERS OF. OFFICER t"1 DRIVERE]"`i OTHER S16Y• gpiwx�,tf.� ji NAIR Itysa HEIGHT �}+G�,, WEIGHT BlRTHD 7'E RACE �w+ j PRIOR6tECtiAtdlCtLI7EF£GTS: NOt3EAPf}AREK REFERTONARRATNE 0�1 TOME PHONE BUSINESS PHONE VEHICLE IDENTTPIGATTON NUMBER: CHP USE ONLY DESCRIBE VEHICLE DAMAGE SHADE IN DAMAGES E.AA INSURANCE C,APRIVI `�+�, POLICY NUMBER VEHICLE TYPE UNK F7 NONE �'ArNI+IOR ? + I�MOD. MAJORROLL-OVER DR OF TRAVEL ION STREET OR HkaHWAY SPEED LIMIT CA DOT Ll GAL-T TCPIPBG MCA4Y,_ ,. DARTY DRIVER'S LICENSE.NUMB£RSTArE GL ASS SAFETY V@H.YEAR 1 MA"alOO£L✓COLOR LICENSE NUMBER STATE EQUIP. 2 _j _____�------------------- $RNER NAME(PHUT,MIDDLE,LAv`T} _-_....__ _ __ OWNER`S NAME (-`? SAME AS DERIVER T1iYAtt STREET ADtitESB �,.,r g"""► L� E t9i••di OWNER'S ADORES$ SAME AS DERIVER Pa8XC8 CTTYISTATeVP PEND LJ UE�N-iC # �a SL I! sms DISPOSITION OF VEHICLE ON ORDERS OF: OCT. sex :HAIR iEYEB HEIGHT Q B RACE OFFICER DRIVER Lt"f`(-iER =� I •"'i""I' s A t S,Ro. Day Ye er PRIOR MECHANICAL DEFECTS: NDNe ApFAREN f REFER TO NARRATNE HOME PHONE BUSINESS PHONE VEHICLE IDENTIFICATION NUMBER: L 1 CHP USE ONLY DESCRIBE VEHICLE DAMAGESHADE IN DAMAGED AREA INSURANCE CARRieR POLICY NUMBER VEHICLE TYPE ID UNK [(`'D' NONE t�t I MINOR �4 0 MOD. []MAJOR ROLL-OVER u`� Diff OF TRAVEL ON STREET OR HIGHWAY SPEED LIMIT CA DOT CAL-T TCPtPSC_. __ _ _ ._MC/MK PARTY DRIVER'S LICENSE NUMBER STATE CLASSEOUi51Y VEH.YEAR MAKEAMCDEUCOLOR /"-�p+7'r5' LICENSE NUMBER STATE 6RIV£S +ME(PST,5#lDDLr,1AST) ---------- --- -- ---- - IR . OWNERS NAME j� T__ PECE9- � GAME/AS DRIVER' 004 (r} J/ vw OWNERS ADDRESS Ell j SAME AS DRIVE Uej.lt�[Ell}�;J�t PAAKpp GIMSTATMP . VENlCYE L._..I DISPOSITION OF VEHICLE ON ORDERS OF: L-7— OFFICER E DRIVER 0 OTHER C SEX 'miR EYES :HEr-.w WEIGHT � BIRTHDATE RACE UIT MO. Day Year I _ PRIOR MEOHANiCAL DEFECTS: NONE APPARENT REFER TO NARRATtVB O7NtR HOME PHONEBUSINESS PHONE - VEHICLE IDENTIFICATION NUMBER: ? CRP USE ONLY DESCRIBE VEHICLE 6AMAoE SHADE IN DAMAGED AREA I INSURANCE CARRIER POLICY NUMBER - VEHICLE TYPE E]UNK E NONE E]MINOR E] { '�MOD. �MAJOR�ROLL-OVER MR OF TRAVEL ION STREET'OR HIGHt*iAY I SPEED LIMIT CA DOT I i CAL-T _ TCPIPSC MrWY PREOAREWS NAME DISPATCH N4TCFIED REV R'S N E�, DATE R5 1-w=m +y [25YES NO E N1A �wrc��.+ Z�,W„7 l ATE OF CALIFORNIA _ RAFFIC COLLISION CODING iP 558 P€me:(Psv.8-97)OPI 042 'w or Ip'IY3N k4o. DAY ',"FAR) 7FMEf'x+t4Ki1 ! OfaPICER I.D. NUMBERz : - � - I t76471IER'3IJ.tAiE I LMANEWS ADDRESS NaTIF!ED )AMAGI" nscRlP�Iox €tanuAea YES NO ` ` :� C{ , � ��. moi:' SEATING POSITION SAFETY EQUIPMENT EJECTED FROM VEHICLE DCCUPANTf3 L-AIR SAG DEPLOYED M I C BICYCLE-HELMET 'Si VEHICLE M-AIR BACK NOT DEPLOYED 0-NOT EJECTED ' S-UNKNOWN N-OTHER DRIVER 1.FULLY EJECTED C-IAP BELT USED P-NOT REQUIRED V-NO 2-PARTIALLY EJECTED 0-LAP BELT NOT USED W-YES 3-UNKNOWN I I-DRIVER E-SHOULDER HARNESS USED 5 >3 �2 TO B-PASSENGERS F-SHOULDER HARNESS NOT USED CHILD RESTRAINT PASSENGER 1-S TATiON WAGON REAR G•LAPISHOULDER HARNESS USED 5-IN VEHM77TED X-NO 8-REAR OCC.TRK.OR VAN H:LAPJSHOULDER HARNESS NOT USED' R-IN VEHICLE NOT USED' - Y-YES T 9-POSITION UNKNOWN J PASSIVE RESTRAINT USED S-IN VEHICLE USE UNKNOWN 0.OTHER X-PASSIVE RESTRAINT NOT USED T-IN VEHICLE IMPROPER USE U-NONE IN VEHICLE_.- ITEMS MARKED OF-LOW FOLLOWED BY AN ASTERISK(-)SHOULD BE EXPLAINED IN THE NARRATIVE. ST NiIMBE PRIMARY COLLISIONOF PAM TY AAT FACTOR FAULT TRAFFIC CONTROL DEVICES TYPE OF VEHICLE" �I'�. � + PhOVEMLNT PRECFDINCx 1 3 C LLI$ICIN IAvc aeccncu v aura cr�c YES A CONTROLSFUNCTIONING iA PASSENGER GAR t STATION WAGON A STOPPED i L L. s CONTROLS NOT FUNCTIONING- 113 PASSENGER GAR W t TRAILER S P"D STRAIGHT' OTHER IMPROPER DRIVING" G CONTROLS OBSCURED C MOTORCYCLE i SCOOTER C RAN OFF ROAD C NO CONTROLS PRESENT I FACTOR" f I lD PICKUP OR PANEL TRUCK C3 MAKtNG RIGHT TURN ;c OTHER THAN DRIVER' TYPE OF CLILLI3IONE PICKUP 1 PANEL TRUCK}hJJ TRAILER MAKING I EFT TURN r KNOWN' A DEAD•ON 1 IF TRUCK OR TRUCK TRACTOR F MAKING U TURN IL LASLEEP• a SIDESWIPE I IG TRUCK I TRUCK TRACTOR Wi TRLR. IG SAOKING C REAR SRO I T I H SCHOOL BUB I I SLOWING J STOPPINt) NtEATHER!MARK i 1T)2{ hiS D BROADSIDE I OTHER BUS I PASSING O?HER VEHICLE A CLEAR E HIT OBJECT I J EMERGENCY VEHICLE J CHANGING. S CLOUDY OVERTURNED 1 K HIGHWAY CONST.EQUIPMENT K PARKING MANEUVEFF C RAINING G VEHICLE J PEDESTRIAN I lL BICYCLE L ENTERING TRAFFIC I L9 SNOWING H OTHER-: 1M O i HER VEHICLE i M OTHER UIdSA TURNIN JE FOG I VISIBILITY FT, 1 N PEDESTRIAN N xING INTO OPPCJSIhtG LANE I IF OTHER': MOTOR VEHICLE INVOLVED WITH 10 MOPED O PARKED WIND I A NON-COLLISION P MERGING L1014TING IS PEDESTRIAN TRAVEI1NG WRONG WAY A DAYLIGHT C OTHER MOTOR VEHICLE 02 Z 3 OTHER ggSOCIATED FACTOR{S} R OTHER 'B DUSK-DAWN D MOTOR VEHICLE ON OTHER ROADWAY (hIA K 1 TO 2 ITEMS) C DARK-STREET LIGHTS E PARKED MOTOR VEHICLE A Vo`UCMDN eotAncam: cm I YES DARK-NO STr"dEET L#Gah1"S F TRAIN s E DARK-STREET LIGHTS NOT G BICYCLE ve aecnuN Hcunm: cox= 1 FUNCTIONING" ANIMAL: YES 140 SOBRIETY.DRUG ROADWAY SURFACE C ve e€cnw muu7 are: amn 9 213 PHYSICAL YOI IMARK I TO 2 ITEMS) A DRY I Fix"'O OBJECT: Na ^">3 vVET 1 Cc D d .. A HAD NOT BEEN DRINKING 11 SNOWY-ICY wj OTHER OBJECT: I I E VISION OBSCUREMENT: $ HBO-tfNDEFt INFLUEtdCE IPPERY MUDDY,OILY,ETC, F INATTENTION IC HBQ-NOT UNDER INFLUENCE` ROADWAY TO ITEMS) G STOP&GO TRAFFIC CI HBO-IMPAIRMENT UNKNOWN` {IaIARIf i T."S i ITE{.fS} PEDEBTRIAN'S ACTIONS H ENTERING 1 LEAVING RAMP IE UNDER DRUG INFLUENCE' A HOLES DEEF RUT' A NO PEDESTRIANS INVOLVED I PREVIOUS COLLISION I F IMPAIRMENT-PHYSICAL- 1S LOOSE MATERIAL ON ROADWAY" I S CROSSING IN CROSSWALK t J UNFAMILIAR WITH ROAD IG IMPAIRMENT NOT.KNOWN O_SSTRUCTION ON ROADWAY" I AT INTERSECTION K DEFECTIVE VEH.EOuIP,: CITED H NOT APPLICABLE D CONSTRUCTION-REPAIR ZONE I C CROSSING IN CROSSWALK-NOTi I � I SLEEPY t FATIGUED I I: REDUCED ROADWAY WIDTH AT INTERSECTION YES Nd SPECIAL INPORMATION (F --LOODEO' D CROSSING-NOT IN CROSSWALK L:UNINVOLVED,VEHICLE A HAZARDOUS MATERIAL G OTHER'. E IN ROAD-INCLUDES SHOULDER M OTHER`: 1 1 IH NO UNUSUAL CONDITIONS IF NOT IN ROAD !$ NONE APPARENT 1 G AFPROACH1NCs;LEAVING SCHOOL BUS 0 RUNAWAY VEHICLE (ETCH [* i u MISCELLANEOUS tNSiCASE raaRstl JAN 3{ f . OBP 86 ?,?dt79 PITTSBURG POLICE DEPARTMENT PITTSBURG, CALIFORNIA Case No. ORIGINAL PROPERTWEVIDENCE REPORT Page No. SUPPLEMENT 2a Code Sectonlincident Victim{Last Name First} Suspect's Name Cfc.Booking Property Injug collision NIA Paunov, Geor a S.M. Blazer PROPERTY S—Stolen DISPOSITION ER-Evid. Room PROPERTY V-Victim LEGEND: E—Evidence LEGEND: R-Refrigeration OWNER CODE: S-Suspect F--Found PL-Prepared for Lab W-Witness SK-w Safe Keeping LO-Ret.to or Left with Owner F—Finder R_Recovered 0-tither Property Owner Code Address Horne Phone Business Phone Prop. Est. Disp. Prop. +Sin# Item# Leg. ! Description Value Lea. Code isb ' E CD-R containing digital photographs of scene and injury ER 0 I ? - 1 _ )r f,, t U19 ,xofice Investigating Officer Assisting Cfficeris Processed by Date and Time S.M. Blazer#234 Comments Reviewed by Date and Time Assigned: Patro€ Hjuv. Traffic Copies Patrol Adm. Ser. D.A. father: Inves. to: roves. Chief cif H Case Closed *TATE'OF tA1.JPORNIA WIJRED t WITNESS i PASSENGERS ;,HP 555 EM 3 fRev.8-M OPI 042 Prge ct Alis CPC SIO DAY YEAR, TIM� NCIC i OFFICER IM" N tk'Z— m"anc i PAaSEN alt 1 AMR 'fsex EXTENT OF INJURY("X"ONE) INJURED WAS("X"ONE) PARTY MAT aAFeTY ONLY ONLY ! FATAL i SBVERE BTNBR VISIBLE COMPLAINT _ NtIMSER pos. 50411P. i EJECIL°O I fMdURY iNdURY INJURY BP PAIN DRIVER PASS. PED. 'BICYCLISTI.pTNBR V URE;D BNL TRANBPORTEO EY: TAKEN TO: ltl�RlitlRtE�� ,I VICTIM OF VIOLENT CRIME NOTIFIED ' _# ❑ ❑ ❑ ❑ ❑ � Eld ❑ I ❑ ❑ ❑] AME 1 D.O.E./ADDRESS TELEPHONE NJURED ONLY)TRANSPORTEO EY: TAKEN TO: f �BSCRIBE INJURIES - i VICTIM OF VIOLENT CRIME NOTIFIED ❑ ❑ ❑ ❑ I ❑ El El ❑ ` ❑ IAMB i 0.0,S.1 ADDRESS TELEPHONE INJUR€O ONLY,TRANSFORM BY: TAM TO: )ESCRIBE INJURIES VICTIM OR VIOLENT ORUE NOTIFIED NAME I D.O.B.I ADORE" TELEPHONE UNJURED ONLY)TRANSPORY60 SY: TAKEN TO: I DESCRise iNJURMS VICTIM OF VIOLENT CRIME NOTIFIED � ❑# ❑ ❑ ❑ ❑ ❑ ❑ ❑ ! ❑' ❑ (NAME I D.O.E.i ADDRESS TELBPHON€ i t ONJUREfl ONLY)TRANSFORTM BY: TAKE!TO: DESCRIBE!NJtI#21ES iij,A p�`j CJCU{1 U� �i) 04 �Mitl f lt1S i! 8 wamm,5 g T)FIED ❑ ❑ ❑ ' ❑ ❑ ❑ ❑ ❑ i ❑ ❑ ❑ I i. NAMED.D.S,1ADDRESS TELEPHONE (INJURED ONLY)TRANSPORTED BY: TAKEN TO: DESCRIBE INJURIES � 3 E t i i VICnM OF VIOLENT CRIME.NOTIFIED PREPARERS NAME I I.D.NUMS>:iR MO. AY YEAR i REVIEWER'S NAME MO. DAY YEAR ,TATE OF CALIFORNIA NA F; ATIVE/SUPPLE ENTAL PACE 4 LATE OF INCIDENT � TIME NCIC NUMBER OFFICER 10 NUMBER I '12125I20p3 2500 0708 234 CO3-'1'1'189 "X"ONE "X"ONE TYPE SUPPLEMENTAL("X"APPLICABLE) X 7 Narrative 3t Collision Report BA update [stat Hit and Run update Susi lemental Other. Hazardous matcrials School bus Other: CITY/COUNTY/JUDICIAL DISTRICT DISTRICT I BEAT OITA TION NUMBER PittsburgI Contra Costa t Delta 4 LOCATION I SUBJECT STATE HIGHWAY RELATED i San Marco Blvd/Santa Teresa Drive Yes x No 1 FACTS 2 3 Notification 4 5 1 received this injury collision call at 0409 hours. Responding from Range Road and 6 West Leland Road, l arrived on scene at 0416 hours. Officer M. Keefe had arrived prior 7 to me and had contacted D-Paunov at the intersection of'Willow Pass load and Evora 8 Road, approximately 1 mile from the collision scene. D-Paunov was being attended to 9 by medical personnel. All times, speeds and measurements in this investigation are 10 approximate. Measurements were taken with a rola-tape. 11 12 Summary 13 14 D-Paunov was riding V-KAWASAKI southbound on Salk Marco Blvd at an unknown 15 speed well in excess of the posted 45-MPH limit. 16 17 The roadway south of Santa Teresa Drive was closed due to ongoing construction of 18 the housing development and school in the area and the roadway ends south of this 19 intersection several hundred feet away. The roadway was chased by the use of several 24 5 foot tali and 4-foot diameter solid concrete barricades which were marked with 21 standard sued yellow reflective diamonds. From one barricade to another was a 22 string of approximately % inch steel spun wire connecting the barricades together. 23 The wire had (4) standard sized yellow reflective diamonds hung on it at regular 24 intervals. The roadway was clearly closed to traffic. 25 26 D-Paunov failed to see the clearly closed roadway and continued southbound through 27 the intersection. D-Paunov struck the wire with the front end and fairing of V. 28 KAWASAKI causing damage to both the motorcycle and steel wire.. The force of the 29 impact toppled one of the concrete barricades (approximately I ton in weight) and 30 caused D-Paunov to lose control of V-KAWASAKI. D-Paunov was thrown from the 31 motorcycle, which began.to topple end over end. D-Paunov and V-KAWASAKI came to 32 rest approximately 175 feet south of the initial area of impact. 33 34 3 C �d"w"; L�it?t �Jlvlci 'R FARER'S tANLEI.Q. NUM I ER IRATE REVIEWER'S NA&4 t.,i{id S.M. Blazer X34 1212 1{33 ATE OF CALIFORNIA NARRATIVE/SUPPLEMENTAL PAGE 5 DATE OF INCIDENT TIME NCIC NUMBER OFFICER ID NUMBER 1212512003 2500 0708 234 CO3-11189 "X"ONE TYPE SUPPLEMENTAL(°X"APPLICABLE) X Nar ative 1 x i Coilislnn Report i BA update Fatal HIt and Run update sunt3lemental 1 1 dither: Hazardous materials Schaal bus Other: CITY t COUNTY/JUDICIAL DISTRICT DISTRICT f BEATCITATION IUUMEER Pittsburg / Contra Costa I Delta 4 --- LOCATION J SUBJECT STATE HIGHWAY RELATED San Marco Blvd/Santa Teresa Drive Yes No 1 During this collision, D-Paunov suffered a severed left ring finger. He began to walk 2 about the area for several hours in an attempt to flag down passing motorists, but 3 failed to attempt to telephone help at any of the residences within the housing 4 development where this collision occurred. 5 6 At the time D-Paunov was contacted, he stated that he had consumed (2) beers earlier 7 in the evening. He clearly had been drinking but was not deemed under the influence. 8 It is unknown if he was under the influence of an alcoholic beverage at the time of the collision based on his delay in reporting this incident. 10 11 Area of lm act 12 13 AOI was determined to be 18' south of the south curb line prolongation of Santa 14 Teresa Drive and 8' east of the west curb line of San Marco Boulevard. AOI was 15 determined by vehicle debris, D-Paunov's statement and damage to the wire and 16 barricades. 17 18 CAUSE 19 20 D-Paunov caused this collision by being in violation of VC 22350 Unsafe speed for 21 conditions (Road Closed). This is based on the fact that D-Paunov was traveling at a 22 speed greater than that which would have allowed him to adequately recognize and 3 react to the present danger caused by.the road being closed and clearly marked in 24 front of him. 25 26 RECOMMENDATIONS 27 28 None 29 30 31 32 CCn�r `1 CC LDC?CL'MENT 33 34 �;ll ` 2004 35 {1IL�i7t;r�; a{tll�t'LIuIJiIIiIE�I:i PREPAEER'S NAIv4E I.D. NUMBER DATE REVIEWER'S NAME BATE i S.M. Blazer 234 12/25/03 Cc lamro � t c�► 7 LTJ{#� STATE OF CALIFORNIA DEPARTIMNT OF CALIFORNIA Hlpt-'AY PATROL � '+#O'r'E: CHP 480 IS FURNISHED TO ALL PEACE 'VEHICLE`�cEPO'i*'T �>T" ".k* FF#CERS BY THE CALIFORNIA H113HWAY PATROL CHP 180(Rev.2-99) OPI 061 �3��o �a "-:W REP DEPARTMENT [LOCATION CODE ATE 1 T#ME OF REPORT NOTICE OF STORED VEHICLE FILE NO,�y it { t`} 7`�r DELIVERED PERSONALLY 0 t>4! ." 1 t dS LOCATION T OWED I STOLFN FEF M + i ODOMETER READING VIN CLEAR IN SVS? YES No DATE!TIME D# PATCH NOTIFIED !LOG NO. LIC.CLEAR IN SVS7, YES El NO YEA`R� MAKE" MODEL ry �y BODY TYPE COLOR L#CEENNSrE NOj ONE I MVONTH/YEAR I STATE� 4r''"' � �+"l+�';.� ..�1 / L. 'lir I"-` '�—° (-"''��"•3 1"'`J J�4�4'� ! TWi7 �G-�rJ� � `i.."„a�" VEHICLEIDENTIFICATION NO, ENGINE NO, VALUATION SY [SOFFICER []OM'ER TIV C) ( \ ![]0.300 %341-4000 E]4001. C._1I — REGISTERED OWNER LEGAL OWNER SAME AS R/0 STORED IMPOUNDED "r'u'ff L1*C jUV P �RECOVERS -VEHICLE t COMPONENT TOWING I STORAGE CONCERN(NAME,ADDRESS,PHONE) STORAGE AUTHORITY I REASON Vis ., t t " ` "�" ! " 3` -rte c. TOWEL}TO 1 STORES!AT AIRBAG? D�RIVEABLE? VIN SWITCHED? YES NO [:] 1 2 l ]YES XNO E]JUNK ([]UNK E]YES ;?NO - CONomom YE5 1 NO ITEMS YES ' NO ITEMS YES 1 401 ITEMS YES ,NO TIRES 1 WHEELS CONDITION WRcCt<ED SEAT(FRONT) REGISTRATION CAMPER LEFT FRONT BURNED HULK per 431(G)VC i SEAT(REAR) ALT./GENERATOR VESSEL AS LOAD RIGHT FRONT -.--" VANDALIZED RADIO BATTERY FIREARMS LEFT REAR ,, �,.,�• ENGi !TRANS.STRIP TAPE DECK DIFFERENTIAL OTHER RIGHT REAR ] MISC.PARTS STRIP Al TAPES ( TRANSMISSION SPARE BODY METAL STRIP OTHER RADIO ( AUTOMATIC HUB CAPS SURGICAL STRIP par431(b)VC A iGNITION KEY Fe� MANUAL SPECIAL WHEELS R E VEHICLE T0: RIO OR AGENT (D AGENCY HOLD 22850 s.3 VC GARAGE PRINC i A ENT ST TNG VEHICLE 1S1i3A} 7IlR DA 1 TI E ef � � E OF PERSON 1 AGENCY AUTHORZING RELEASE I I.D.NO. DATE }CERTIFICATION: 1,THE UNDERSIGNED,00 HEREBY CERTIFY THAT I AM LEGALLY � �f AUTHORIZED AND ENTITLED TO TAKE POSSESSION OF THE ABOVE DESCRIBED VEHICLE, F SI AT RE OF PER UTHRIZIN RELEASE NATURE SON TA SESSION STOLEN VEHICLE f COMPONENT ❑ EN! EZ?.1.ED VEHICLE rLA . Sj REPORT 3 r n DATE I TIME OF OCCURRENCE DATE!TIME REPORTED NAME OF REPORTING PARTY(RIP) .wMSE NO./STATE Lt.. DRIVER OF VEHICLE DATE 1 TIME ADDRESS OF RIP r a 41 NE OF RIP I CERTIFY OR DECLARE UNDER PENALTY OF PERJURY UNDER THE LAV115 OF SIGNATURE OF PERSON MAKING REPORT t i6 ie L THE STATE OF CALIFORNIA THAT THE FOREGOING IS TRUE AND CORRECT. REMARKS [LIST PROPERTY.TOOLS,VEHICLE DAMAGE,ARRESTS] DRIVER'S NAME ARRESTED 1 SECTION? REPORTED BY i CARGO t TYPE? ;VALUES_ c, J El YES 1j NO ❑YES a NO ;Cj Bf'.L OF LADING AT'T'ACHED u .st-i —t,-.-> ' r +eG � �C.. �"/ +' �..�..- {yL,r'r.d� L✓�J� __.+ ��..,,,y ^'� t ...�`'t 1 V`�'"C'.',,.p '�Ldf w"s. F r FRONT LEFT 3108 RIGHT 3#D$ REAR TOP SIGNATURE OF FFI R TAKING REPORT SUPERVISOR REQUIRED NOTICES SENT TO RED YES C??A ENO #FLED f AND LEGAL OWN1 RS PER 2%8 2 V 7 NO ( C J 05. B9 r67 �:j _ e180 238.trp rw+x. ALBERT G. STOLL, JR. #164649 2 LAW OFFICE OF ALBERT G. STOLL, JR 55 FRANCISCO STREET, SUITE 403 3 SAN FRANCISCO, CA 94133 TELEPHONE: (415) 576-1500 4 FAX: (415) 576-1501 Attorney for Claimant: GEORGE PAUNOV 6 PRESENTATION OF GOVERNMENT CLAIM 7 PURSUANT TO CHAPTER 2 8 ARTICLE ONE, SECTION 910 g GEORGE G. PAUNOV, PLAINTIFF'S GOVERNMENT 10 Claimant, CLAIM 11 v [Cal Govn't Code Section 910] 12 CITY OF PITTSBURG, COUNTY OF 13 CONTRA COSTA, 14 Government Entities. 15 16 TO 17 18 Attn.: Claims, Clerk of the Board of Supervisors. Room 106, County Administration 19 Building. 651 Pine Street. Martinez, CA, 94553. 20 CLAIMANT'S NAME AND ADDRESS 21 Claimant is George Paunov. Claimant's address is 2384 Hickory Drive. Concord, CA. 22 94520. 23 ADDRESS TO WHICH NOTICES ARE TO BE SENT 24 Claimant desires notices to be sent to her attorney at Law Office of Albert G. Stoll, Jr., 25 26 55 Francisco Street, Suite 403, San Francisco, CA 94133, phone 415-576-1500, fax 415-576- 1501. 27 28 Paunov Government Claim Contra Costa.doc 2 DATE t LOCATION OF INJURY 3 The incident for which this claim arises occurred on December 25, 2003 shortly after 4 midnight southbound on San Marco near Santa Teresa Drive in the town of Pittsburg, County of 5 Contra Costa, California. 6 HOW DID INJURY OCCUR 7 Claimant was riding his motorcycle on San Marco Boulevard. Claimant passed Saint 8 9 Teresa Drive and without warning came upon a steel cable strung across the public road. He was 10 unable to avoid striking the thin cable strung across the road. His left ring finger was severed as 11 he struck the wire. Ile also sustained severe bruising and other injury from being thrown off the 12 motorcycle. The Police Report number for this incident is CO3-11189 and is attached to this 13 claim as exhibit 1. 14 NAME OF PUBLIC EMPLOYEE CAUSING INJURY 15 Claimant does not know the names of the public employee or employees who caused the 16 17 injury. 18 WHAT ACT CAUSED THE DAMAGE 19 The County of Contra Costa created and or was aware of a dangerous condition of public 20 property, i.e. the hanging of an invisible cable across San Marco Boulevard on December 25, 21 2003. The County of Contra Costa had actual and constructive knowledge of the existence of 22 this dangerous condition and took no steps to prevent claimant's injuries or remedy the 23 dangerous condition of public property. 24 25 26 27 28 Paunov Government Maim Contra Costa.doc 2 1 2 DESCRIBE INJURY OR DAMAGE 3 Claimant's left hand ring finger was amputated. As a result there is continuing pain and 4 high sensitivity on the remains of the finger. Furthermore, on his left hand middle finger there is 5 pain in his joints and it cannot fully bend. In his entire hand, there is a loss of grip and power. 6 On top of those injuries, he experienced heavy bruising on his torso, hip, and other 7 regions of his body. He experiences headaches and depression. 8 9 ITEMIZATION OF CLAIM 10 As a result of the subject collision claimant has incurred medical expenses, which are 11 currently being collected, and itemized as claimant's treatment is ongoing. There will be a claim 12 for lost past and future wages, along with a request for compensation for the pain and 18 inconvenience of dealing with a physical injury. Future damages are unknown at this time. 14 Plaintiffs motorcycle was completely totaled in the collision. 15 AMOUNT OF CLAIM 16 17 The claim is an unlimited civil claim. The damages will be proven according to proof. 18 Signed by or on behalf of Claimant this 28 day of May 2004. 19 20 1 Date: y ;- Law Office ;{G 1 J 21 22 By r 23 f , BERT G. STOLL, JR. 24 Attorney for Claimant George G. Paunov 25 26 27 28 Paunov Government Claim Contra Costa.doc 3 1 . Meagan Cavanaugh ATTORNEY AT LAW TELEPHONE LegalAssistant 55 FRANCISCO STREET,SUITE 403 (415)576-1500 SAN FRANCISCO,CALIFORNIA 94133 FACSIMILE www.stoll-law.com (415) 57$-1501 Friday, May 28, 2004 Claims + r, Clerk of the Board of Supervisors �w9 Room 106 County Administration Building E(p� , 651 Pine Street. CSN caoTA C��rio ns Martinez, CA 94553 Re: Georme Paunov v. City of Pittsburg, County of Contra Costa J{f Dear Clerk, Cou , ryT� COS, C'R Please find enclosed_1_copy and_1_original of Plaintiff's Government Claim. _X Please file the original. X Please return file-endorsed stamped copy to our office. _X_Self-addressed stamped copy enclosed. Thank you for your assistance in this matter. Regards, l EDF Mea n °.. ;vanaugh M1., CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY (,+_• BOARD ACTION: JULY I3, 2004 Claim Against the County, or District Governed by ) the.Beard of Supervisors,Routing Endorsements, ) NOTICE TO CLAIMANT and Beard Action. All Section references are to ) The copy of this document mailed to you is your California Government Codes. ) notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given l � '; rsuant to Government Code Section 913 and 5.4. Please nate all"Warnings". AMOUNT: UNKNOWN s'•if 4 ` CLAIMANT: ELISABETH MOm'GOMERY 1,AAPT!tgEz;:$ALiR ATTORNEY. UNKNOWN DATE RECEIVED: JUNE 04, 2004 ADDRESS: 4004 CREEKSIDE COURT BY DELIVERY TO CLERK ON: JUNE 04, 2004 OAKLEY, CA 94561 RECEIVED THRU INTEF BY MAIL POSTMARKED: OFFICE MAIL FROM PENNY BAILEY FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SW�TClerk Dated: JME_ 04, 2004 By: Deputy II. NOW County Counsel TO: Clerk of the Board of Su ervisors ( ,°".Phis claim complies substantially with Sections 910 and 910.2. 4 ( ) This Claim FAILS to comply substantially with Sections 910 and 9-10.2, and we are so notifying claimant. The Board cannot act for IS days(Section 910.8). { ) Claim is not timely filed. The Clerk should return 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 Counse 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). IVOARD ORDER.: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. ( ) Other: 1 I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Date �1_59JOIN SWEETEN, CLERK,By , Deputy Clerk WARNING(Gov. code secti n 913) Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposite in the mail to file a court action on this claire. 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 fu113 prepaid a certified copy of this Board Order and,Notice to Claimant, addressed to the claimant as shown above. Dated: JOIN SWEETEN, CLERK By Deputy Clerk FRO11 i : .Mon°t gcmer j Sweeping Service PHO E NO. 925 G-25 3304 Jun. 02 2004 04:19PM P5 CCC R:Sk h4p"Ar'"ENT" 325 s35 1421 YP.O Clagett to: BOM OF XPERMMS OF C3M C=A MRM INS MCI`IOM To CLQ Dour A. Clam relating to causes of action for death or for In jury to Person cr to per- sonal property or growing craps and which accrue can or before December 31, 1587, mint be presented not later tMn the 100th day after the accrual of the cauwe of action. C3Aim relating to cawes 6f actica fardeath or fez` Jewry to pVson or to persot l property or,grmdng cxta's`wid which 10=-M on cc A"WJk L, 3.988, =at be presented not later thia aix mond after tht gtcr or the M, a of a,4tt.ion. Claims relating to airy other+,.fie cif antion must be presented t~o.1 }.ater� tt n c ae Year .afterthe sccrual,or thecause c►f action.' (r.:ovt.� e 591,.2.) 8. Claims must be feed With; the Clerk of � o*f.St,tp rvis= at,lts office in $oc}m 106, 00=ty Administratl.on Building, 651 Fire Street, Martinei, C 94553: C. If alaim is against a district ,gov*med by the Board of Supervisors, rather than: the County, the name of the District should be filled in. D. If the claim is against eve fta one public entityt neparate cUivs tt><:st by Mad aga3.rast each pdblit entity. F_ Fraud. Sec PerZlty for fmudaent claims, POnll.God" Sec. 72 at the end of ttL's RE- Claim 8p � Reserved for Clerk's Mias sta* RECEIVED,4 aina t e Couzlty c tea. sta ° MBOAR o!` CLERKOF, R5 , Disr.rlot The undersigned cla iz=t h Y Aces 01&" agalnst the C�cn3rtty off ContaaCostaf' r t}ae above-r=ad District in the sus of � ts 1 When did the dg ar WurY =It'- {Ciera exact data azzd hour} i a=trf? (jncj, d z pity WId �tmty) Where did tie dw age a-" ,� x�.zr' (Give ins. de ails; usON � e patter if 3. �� did �rw � or � f f� pal.,�- 0 C>� S Vis' act tit` cR!$ SUk1 Kira the 3+0"" 'of County or district f ce:"Sr k. t patio used. ,injU Y cr.UmnVI servants sir FROM Montgomery Sweeping Service PHONE NO. : 325 625 3304 MAY-20-2004 08:44 CCC RISK MANpcMENT J'un. 02 2004 04:i7PM P5 525 3Z5 1421 P.03 Wnat are the narae5 of county or .distri.ot officers, servants or eaplOyees Musing the doge or injury? 5. What doge or injuries do you kain reted? {Give full extent `0f in j=ies or dames claimed. Attach two estimates for auto dai s. LI 7. Hour was the arBox=0aimed above died?. (include the timstted 2motrit of any prospective ti.ve injury or da.mi ae=.) Nis and addresse3 of. writ=es eel doctors and hosplta.I3. g. List the mid i ttrnes you made can accauat of this accident or injury: DATE ! iF #e lE !C 1k y Gorr '. Code Sec. "93,11: grov4des= "The clAim mast be signed by the cl.2i=nt N=CES TO: (&tc+rr )" or �.f nem hI&be .r' Name and Address of Att.or:ey 's Signa u ,' 1 A &esa Telephone No. Telephone go. 6" : stat aaaasa �3a * N0TICE S "tirxi 7Z of the Feral. Cade provides.- "Every persons who, with intent to def rpt, present3 for allowenoe or for Aalmeznt to any, state board or officer, or to aM co=ty, city or district board o:" . officers authorized to allow or pay the --am if' .genuine, any false or fraudulent 03.nim, bill, a=t7'C1nt, vowhar, or writing, in 7inizhsable ,elther Ergo imprlswment n the 1=u tty jail for a period of riot more thttxt one.year, * a fim'of not.e=eedIng one tb*au=d ($l.,CW), c r by}boas such St r scr t and tine,:"car by impri sor'iment in the state prise, by a fig of not exeeeding ten thousand"doLl2rs ($10,000, or by. both st.sch tmpri.sorAwt and rine. TarAtf P.03 FROM Montgomery Sweeping Service PHONE NO. "� 5 62 3304 jun. 02 2004 04`.17PM P4 06/02/2004 at 02.59 FM Job Number: "73659 PRELIMINARY ESTIMATE 2001 CHEV K1500 4X4 St8URBAN LIT 8-5.3L-FI 4n UTV SLACK Estimate based on MOTOR CWH ESTIMATING GUIDE. Unless otherwise noted all items are derived from the G'aide DAlGA00 Database Date 5/2004 and the parte selected are OEM-parts manufactured by the vehicles original Equipment. Manufacturer. Asterisk (") or Double Asteria}; (**) indicates that the parte 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, Qual Rapi Parts or Camp Repi Parts which atands for Competitivc Replacemont Partss. used parts ar6 described as LKQ, Qual Reay Parte, RCY, or USED. Peroftaitioned parts are described as necon. Recored parts are describers as Recore. v,AGS Part Numbers and Prices are provided from National Auto Glass 9pecitications, Inc, Pound sign (#) items indicate manual entries, Pathways - A product of CCC Information Services Inc. 3 FROM Mcn tgomer,.4 Sweeping Service PHONE NO. 925 625 3304 Jun. 02 2004 04:i6PM P3 06/02/2044 at 02:59 PM .lob Number: ?3659 PRELIMINARY ESTIXATE 2001 CHEV K1500 4X4 SUBURBAN LT 8-5.37.E-FI 40 UTV BLACK NO. OP. DESCRIPTION QTY EXT. PRIG LABOR FAINT ------------------------------------------------------------------------------- 6 Add for Clear Coat 1.3 9# COTTER CAR 1 10.00 T 0.2 10## HAZARDOUS WASTE REMOVAL 1 5.60 X 11# TINT COLOR 1 0.5 Subcotal.s ==> 70.72 6.1 4.8 Part: 55.71 Body Labor 6.1 hrs ( a 68.00/hr 414.80 Paint Labor 4.8 hrs 0 $ 68.00/hr 326.40 Faint Supplies 4.8 hrs @ S 30.00/hr 144.00 Sublet/Misc. 15.00 ---------------------------------------------------- SUBTOTAL $ 955.91 Sales Tax $ 209.71 0 8.2500% 17.30 GRAND TOTAL $ 973.21 ADJUSTMENTS: Deductible 0.00 ---------------------------------------------------- CUSTOMER PAY $ 0.00 INSURANCE PAY $ 973.21 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=APPROXIMA'TE PRICE LABOR TYPES: S=BODY LABOR. D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=CLASS M=MECHANICAL P=PAINT LABOR S=STRUCTURAL T=TAXED MISCELLA142OUS XmNOU TAXED MISCELLANEOUS PATHWAYS: ADJ=ADJACENT ALGN=ALIGN A/M=AF'T'ER.MARKET BLND=,BL.END CAPAwCERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT E'ST=ESTIMATE EXT. P.RICEuUNIT PRICE MULTIPLIED BY THE QUANTITY INCdL=INCLUDED MI SC=MISCELLANEOUS NAGS=NATIONAL AUTO GLASS SPECIFICATIONS NOR-ADJ=NON ADJACENT O/H=OVERHAUL OP=OPERATION NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED FART QUAL REPL=QUALITY REPLACEMENT PART COMP REPL PARTS=COMP,ETTTIVE REPLACEMENT PARTS RECOND=IREC'ONDITION REFN-R.EPINISE REPL:REPLACE R&I=REMOVE AND INSTALL R&R=RSMOVE AND REPLACE RPR=R.EPAIR RT=RIG.T SECT=SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT is/_=WITR/w SYMBOLS: ##=MANUA.L LINE ENTRY =OTHER [IE. .MOTCORS DATABASE INFORMATION WXS CHANGED) **=TSATAk3ASE LINE WITH AFTEFttMARKnT N=14 7'T`ES ATTACHED TO LINE. MOVP=KAIIUFACTURER'S QUALIFICATION AND VALIDATION PROGR-AM. 2 FPCM P!nntgomery Sweeping Service PHONE- NO. 925 525 3304 Jun. 02 2004 04:16PM P2 46/42/2004 at 02:59 PM Job Number: '71659 BRENTWOOD AUTOBODY Federal ID ¢#:942958593 4535 0114ara Avenue Brentwood, CA 94513 (925)634-6366 Fax: (925)634-2553 PRELIMINARY ESTIMATE Written Byl: Lynda. Hinds Adjuster: Insured: TPM MONTGOMERY, I claim 0 Ownert TOM EuSflN=MERY Policy # Addresst 4004 CREEKSIDE CT. Deductible: OAKLEY, CA 94551. Dates of Loss: Other- (925)625-8069 Type of Lose! Point of Impact: 7. Left Rear Inspect BRENTWOOD AUTOBODY Businesez (925) 634-6566 Locations 4535.0ts lara Avenue Brentwood,., CA 94513 Insurance 3RD PARTY Company: Bays to Repair 2001 CHEW X1504 4X4 SUBURBAN LT 8-5.3L-Fl 4D UTV BLACK VIM! IGNFK16TSIJ291545 Lic: 4UJM416 CA Prod Date: 05/2001 Odometer: 45000 Air Conditioning Rear Defogger Tilt Wheel Cruise Control Intermittent Wipers Keyless Entry T'hef't Deterrent./,Alarm Dual Air Condition Rear Wiper Body Side Moldings Dual Mirrors Privacy Glass .Roof Console Luggage/Roof Rack Electric Glass Sunroof California Emissions Fog Vamps Clear Coat Paint Power Steering Power Brakes Power Windows Power hocks Power Driver Seat Tower Passenger Seat Power Mirrors AM Radia FM Radio Stereos Cassette Search/Seek CD player Anti-Lock Brakes t4? Driver Air Hag Passenger Air Barg Front Side Impact Air Bag 4 wheel. Disc Brakes Leather Seats Bucket Seats Heated Seats 3rd Seat Rear Step Bumper Trailering Package Automatic Transmission 4 Wheel Drive Overdrive Aluminum/Alloy Wheels NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT 1 REAR BUMPER 2 R&I R&I bumper astsy 1.0 3 Repl LT Step pad outer 1 55.71 0.3 4 REAR LAMPS 5 R&I LT Combo lamp assy 0.3 6 QUARTER. PANEL 7w R.pr LT Quarter panel 4.00 3.3 1 FROM : Montgomery Sweeping Service FHONe NO925 525 3304 Jun. 02 2004 04:16pM PI Tb e A r 1 air ROTI 1ont comer+ weeping Serer i c PHONE NO. 925 625 3304 Sun, 02 2004 04:21PM P3 1 .!! 4 (;� ,.J j. !.•e,. til', 1� 4 9.:i,i. 1 '�' ; � ` n..r ..; c#a .. +t .. .. a i . ... w. •1 v r r .. !9 fri+.r a q..\.Yy T i\•ti Fk.+ • .. x o'r A t I .. w `.l FROM Nontgomer+j SweeP i ng Service PHONE NO. : 925 G25 3304 Jun. 02 2004 04:20PM P2 06/02/2004 at 02 : 14 PM Job Number: 17153 Ppama .Y ESTTE 2001 CHEV K1500 4X9 SUBURBAN LT 8-5 . 3L-El 4L3 UTV BLACK Int: THE 'FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE; USED TO DESCRIBE PORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR ABBREVIATIONS/SYMBOLS: D=DISCONTINUE:D PART A=A.PPROXIMATE PRICE LABOR TYPES: B=BODY LABOR D=DIAGNOSTIC E,ELBCTRICAL F=FRAME G=GLASS M=ME;CHANICAL ?=PAINT LABOR S=ST'RU'CTURAL T=TAXED MISCELLANEOUS X=Nf, N TAXED MISCELLANEOUS PATHWAYS: AUG=ADJAACENT ALGN=ALIGN A/M-AFTERMA,RKET BLND BLEND CAPK-CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R-DISCONNECT AND RECONNECT EST-ESTIMATE EXT. PRICE=UNIT .PRICE MULTIPLIED BY THE QUANTITY SNCL=INCLUDED MISC=MISCELLANEOUS NAGS-NATIONAL AUTO GLASS SPECIFICATIONS NON-ADJ=N'ON ,ADJACENT OIH=OVERHAUL OP=OPERA'TION Nth-LINE SLUMBER. QTY-QUANTITY QUAL RECY QUALITY RECYCLED PART QUAL REPT+=QUALIT"Y REPLACEMENT PART COMA' REPL PARTS=COMPETITIVE REPLACEMENT PARTS 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. .MOTOR5 DATABASE INFORMATION WAS CHANGED] **=DATABASE LINE WITH AFTERMARKET N=NOTES ATTACHED TO LINE. MQVP=M.ANUFACTURER'S QUALIFICATION AND "VALIDATION PROGRAM. E:.:t:imate based on MOTOR CRASH ESTIMATING GUIDE. Unless otherwise noted all items axe derived from the Guide DRIG.A00 Database Date 5/2004 and the parts selected are <5Bm--parrs+ 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. 'Tilde ;ign (w) ,items indicate MOTOR Not-included Labor operations. Non-o.tiginal Squipment Manufacturer aftermarket parts are: described as AM, dual Rept 'Parts or Coreg Repl Ports which stands for Competitive Replacement Parr,,. used parts are described as LKO, Qual Recyr Parts, RC1 , or USED. Reconditioned paxts are describod as Recon. Recored parts arc described as Recoxe. NAGS Part Numbers and Prices are provided from National Auto Glass Specifications, Xnc. Pound sign (#) items indicate manual entries. Pathways - A product of CCC information services Inc. 3 FfiDt,t : r,°tontgomer{j Sweeping Service PHONG NO. 92 625 3304 Jun. 02 2004 04:20PM P1 06102/2004 at 02 :14 PM .lob Number: 17163 MLIM1N RY ESTXb&TE 2001 CHEV K1500 4X9 SUBURBAN LT 4D UTV BLACK Int: ------------------------------------------------------------------------------- NO. op. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 124 Hazardous Waste Removal 1 2 . 50 ------------------------------------------------------------------------------- Subtotals r= 63.21 6.3 2.1 Parts 58 .21. Body Labor 6.3 hra @ 70. 001hr 441.00 Paint Labor 2 . 2 hrs @ S 70.00/hr 247.00 Faint supplies 2 . 1 hrs @ $ 30.00/hr 63. 00 Sublet/Misc. 5.00 ---------------------------------------------------- SUBTOTAL $ 714.21 Sales Tax $ 126.21 @ 8 .2500% 1.0.41 ---------------------------------------------------- GRAND TOTAL $ 724. 62 ADJUSTMENTS: Deductible 0 .00 ---------------------------------------------------- CUSTOMER PAS.' $ 0.00 INSURANCE PAY $ 724.62 This is just an estimate of repairs, if on futher inspection, additional parts or repairs are needed, you will be contacted for authorization. We are not responsible for loss or damage from fare, theft accidents or causes beyond our control to your vehicle. Storage charges will occur 48 hours after customer is not i.fied that vehicle is completed. Casey's Auto Body guarantees all repairs performed on your vehicle including parts, workmanship and refinishing for a period of not less than one year from the time of completion of repairs. Defects in craftmanship or refinishing are warranteed for as lona as you own, your vehicle. Failure to present an Insurance estimate at time of repairs may result in additional costs to you. 2 FROM r1ont,,amerV Sweeping Service PHONE NO. : 925 625 3304 Jun. 02 2004 04:19PM P? 06/02/2004 at 02 : 14 PM Job Number: 17163 CASEY'S AUTO BODY INC. License #:AB220391 Federal ID #: 30-001613 Quality is our Number I concern 4515 O'Hara Brentwood, CA 94513 (925) 634-2211 Fax: (925) 634-7257 PRELIbaNARY EsTndATE Written by: John Mancuso # Adjuster: Insured: TOM MONTGOMERY Claim # Owner: TOM MONTGOMERY Policy # 4ci�re9s: 4004 CREEKS IDE CT Deductible. OAKLEY, CA 94561 Date of Loss: Day. (925) 679-8068 Type of Loss: Point of Impact: 7 . Left Rear Inspect CASEY'S AUTO BODY INC. Business: (925) 634-2211 Locatlon, 4515 O'Hara Brentwood, CA 94513 Insurance Company: Days to Repair 2001 CHEF K1500 4X4 SUBURBAN LT 8-5.3L-FI 4D UTV BLACK Int: VIV: IGNFK16TSIJ291545 Lie: 4UJM146 CA Prod Date.* Odomter; Air Conditioning Rear Defogger Tilt Wheel Cruise Control Intermittent Wipers Keyless Entry Theft Deterrent/Alarm Dual Air Condition Body Side Moldings Dual. Mirrors Privacy Glass Roof console Luggage/Roof Rack Fog Lamps Clear Coat Paint Power Steering Power Brakes Power windows Power Locks Power Driver Seat Power Passenger Seat Power Mirrors Anti-Lock Brakes (4) Driver Air Bag Passenger Air Bag Front Side impact Air Bag 4 Wheel Disc Brakes Leather Seats Bucket Seats Heated Seats 3rd Seat Rear Step Bumper Aluminum/Alloy Wheels -------------------------------------- --------------------------------------- mo� OP. DESCRIPTION -- QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 1 QUARTER PANEL 2* Rpr LT Quarter panel 4 .0 1.5 3 Add for Clear coat, 0.6 4# KEEP PAINT AND BODYWORK LOW 1 5 REAR LAMPS 6 R41 LT Combo lamp assy 7 REAR BUMPER 0.3 8 R41 R&I bumper assy 1 .0 9 Repl. LT Step pad outer 1 55 .71 0. 3 104 Cover Car 1 5.00 T 0.2 Color Tint I O.S CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JULY 13, 2004 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 t Supervisors. (Paragraph ) given ' Pursuant to Government CodeSe tion 913 and St f �. 915.4. Please note all"Warnings„ AMOUNT: $1,859.75 -OUN '° COUNSEL CLAIMANT: ELIZ<ABEI'H G. MAULDIN ATTORNEY: UNKNOWN DATE RECEIVED: .TUNE 08, 2404 ADDRESS: 4353 DRIONES VALLEY ROAD, BY DELIVERY TO CLERK ON: .JUNE 08, 2044 BREN'IV00D, CA 94.513 BY MAIL POSTMARKED: JU NE 07, 2004 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEET Dated: .TUNE 08 2004 By: Deputy II. FROM: County Counsel, TO: Clerk of the Board of Supervisors {0,'Thhis claim complies substantially with Sections 910 and 910.2. { ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant.The Board cannot act for 15 days (Section 910.8). { ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim(Section 911.3). ( ) Other: Dated �: ;� By. -` ) , r `` Deputy County Counse 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: (v'} 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. Date ' ' JOHN SWEETEN, CLERK.,By , Deputy Clerk WARNING(Gov. code se on 9 ) Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposite, 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. Dated. JOHN SWEETEN,CLERK By Deputy Clerk Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA CIO= INSTRUCTIONS TO CLAPiANr A. Claims relating to causes of action for death or for injury to person or to per- sonal property or -growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for -death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims roust be filed with the Clem 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 shoved be filled in. D. If the claim is against more than one public entity, separate claims must b-- filed efiled 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 3 RECEIVED �N 0�82 0 C 4]} Against"the County of Contra Costa } or ) CLERK BOARD OF UP!E sc�s CONTRA COSI�CO. .District) Fil1 in name) ) The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sun of $ r; _7 and in support of this claim represents -as follows: 1. When raid the damage or injury occur? (Give exact date and hour) TH C 'f ci_4 f .,..._....._...._ �_ .:.. .. .� w.._r__..__.._ 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) .7-/J & L Y 1yc C t e d , ' 4. What particular act or omission on the part of county or district officers, servants or .employees caused.the. injury or. damage 7-1-f L j�_cat I k-� F �. wnat are the names of county or district officers, servants or employees cau3ing the damage or injury? D What damage or injuries do you claim resulted? (Give full extent of injuries or damages Attach two C....estimates for auto damage^. ., &C- 'TCD' e-q e/ r _t, Yra' C+ f D.' J 4,,,. 7. How was the amount claimed above computed': (Include the estimated amount of any prospective injury or damage.) " 3. ?dames and addresses of witnesses, doctors and hospitals. � £� 9. List the expenditures you made on account of :his accident or injury: DATE AMUNT Goi. Code Sec. 910: provides: "The claim must be signed by the claimant SEND NOTICES TO: (Attorney) or by some person on his.behalf." Name and Address of Attorney :9 Q f-,�\-(Clain2nt W Signature ` Address Tele hone No. e No. J /6 F Telephon.. ,� �:. /6J / 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 o-- officer, ^officer, authorized to allow or pay the same if -genuine, any false or fraudulent claim, bill, account, vouche_^, or writing, is punishable either by imprisonment in the county jail for a period of not more than erne.year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine;- or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($109000, or by both such imprisonment and fine. Date: 614104 02:28 PM Estimate ID: 533 Estimate Version: 0 Prelirninary Profile ID: FLEET ACC. PSE SkION PAINT & COLLISION 1932 ARNOLD INDUSTRIAL.PLACE CONCORD,CA 94520 (S25)608-8585 Fax: (925)609.9407 Tax ID: 68-0022860 BAR#: AJ112956 EPA#: CAD981388739 Damage Assessed By: Frank Mercado Deductible: Owner PACE DRYWALL INC. Address: P O BOX 573 CONCORD,CA Telephone: Work Prone: (926)682-0900 Home Phone: (925)802.0900 Mitchell Service: 914624 Description: 2004 Ford Pickup F260 XL Body Style: 4D PkupCrw 7'Sed 156"WS Drive Train: 6AL in;8 Cyl 4WD VIN: 1 FTNW 21 S94EA9197 Options: 4WD OR AWD Line Entry Labor Line Item Part Type/ Dollar Labor Item Number Type Operation Description Part Number Amount Units STRIPE TAPE 1 402730 BDY REMOVEIREPL.ACE L STRIPE.TAPE BODY SIDE F81Z 2520001 ASO 87.35 PICKUP BED 2 401477 BDY REMOVEiREPL.ACE L PICKUP BELL SIDE PANEL F81Z 9827841 EA 363.73 15.0 # 3 REF REFINISH L BED OUTER PANEL C 3.8 4 4016617 SDY REPAIR L PICKUP BED WHEELHOUSE PANEL Existing 1.0*# 5 403142 BOY REMOVE/REPLACE L PICKUP BED DECAL YC3Z 9825622 BAS 22.68 0.2 6 REF ADD L UPR TWO TONE 1.8 ADDITIONAL OPERATIONS 7 REF ADD`L OPR CLEAR COAT 1.4 8 ADIYL COST PAINTIMATERIALS 156.40* 9 ADD'L COST HAZARDOUS WASTE DISPOSAL 3.00' -Judgement tern #-Labor Note Applies C-included in Two Tone t Clear Coat Calc Add'] Labor Sublet 1. Labor Subtotals Units Rate Amount Amount Totals 11. Part Replacement Summary Amount Body 16.2 52.00 0.00 0.00 842.40 Taxable Parts 453.76 Refinish 6.8 52.00 0.00 0X0 353.80 Sales Tax @ 8.2500A 37.44 Non-Taxable Labor 1,196.00 Total Replacement Parts Amount 491.20 Labor Summary 23.0 1,198 00 ESTIMATE RECALL NUMBER: 61410414:28:25 633 UltraMate is a Trademark of Mitchell International Mitchell Data Version: MAY 04 A Copyright(C)1004-2003 Mitchell International Page 1 of 2 UltraMate Version: 5.0.021 All Rights Reserved Date: 614104 02:28 PM Estimate:ID: 533 Estimate Version: 0 Preliminary Profile ID: FLEET ACC. Itl. Additional Costs Anxmunt IV. Adjustments Amount Taxable Costs 158.40 Customer Responsibility 0.00 Sales Tax 8.260° '13.16 Total Additional Costs 172.56 1. Total Labor: 1,196.00 It. Total Replacement Parts: 481.20 III. Total Additional Costs: 172.55 Gross Total: 1,859.76 IV. Total Adjustments: 0.00 NO Total: 1,859.76 This is a 13reliminaLy estimate. Additional chancres to the estimate maybe retluired for the actual repair. ESTIMATE RECALL NUMBER: 6t 410414:28:26 633 UttraMate is a Trademark of Mitchell International Mitchell Data Version. MAY 04 A Copyright(C)1"4-2803 Mitchell International Page 2 of 2 LlltraMate Version: 6.0.021 All Rights Reserved CLAIM BOARD OF SUPERVISORS t7F CONTRA COSTA COUNTY * BOARDACTION: JULY 1.:3,, 2004 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 f� < ; Pursuant to Government Code Section 913 and� ;J �� i 915.4. Please note all"Warnings". AMOUNT. UNLIMITED CLAIMANT: YYONGGIN WANG WIRTINEZ CAUR ATTORNEY: MARK J. ZANO.BINI, ESQ. DATE RECEIVED: JUNE 095 2004 ADDRESS: ROUDA, FEDER, TIETJEN & ZANOBINI BY DELIVERY TO CLERK ON: JUNE 09, 2004 44 MONTGOMERY STREET, SUITE 4000 SAN FRANCISCO, CA. 94104 BY MAIL POSTMARKED: JUNE 08, 2004 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETEN, C Dated: JUNE 09,__2004 By: Deputy II. FkOM: County Counsel TO: Clerk of the Board of Supervi.Kors ( 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: f - f��`: By: ' g: Deputy County Counse III. FROM: Clerk of the Board TO: County Counsel(1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant(Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. { ) Other: r I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Bate 0. JOHN SWEETEN, CLERK, By , Deputy Clerk WARNING(Gov. code sectio 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or deposite( 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 per ury 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: JOHN SWEETEN, CLERK By Deputy Clerk 06/0?x'2004 12:34 CONTRA COSTA COUNTY CLERK UR THE 9141539081G9 N0.504 901 Claim to. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY H INSTRUtrTl'ONS TOCLA AA ` 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 3l, 19'8'7, rnusl be presented not later than the 100''day aflcr 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 ether 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 officeJn,Room 106, County Administration Building, 651 Pint Street,Martinez, CA 94553. C. If claim is against a district govemed by the Board of Supervisors,rather than the County, the name of the District should be filled ire, D. If the claim is against more than one public entity, separate claims must be Med against each public entity. . R. Frau . Sec penalty for fraudulent claims,Penal Code Sec. 72 at the end of this farm. #iiiii#iiiiiiitic��►�t1rtRlii!#ilii##i�l#iii*ii�Ysfrlrlri#itiitiifiwi�iYii�ii'i#i###**#*##i##+i1*�►#i# RE. Claim By Reserved for Clerk's filing stamp YONGQIN WANG Against the County of Contra Costa or ) IV 9 2004 (Fill in name District) ctK BOAR cr s ) c(7jVrRn S U'peRVISORS Co, The undersigned claimant hereby makes claim against the County of Contra Co to or the above-named district, in the stem of S UNLIMITEDmd in support of this claim represents as follows: see Attached. 1. When did the damage or injury n=r7(Give exact date and hour) See Attached. 2. Where did the damage or injury ncrau?(Include city wW County) See Attached. 3. How did the damage or injury occur?(Give full details;use extra paper if mired) See Attached. 06.'07 '2004 1 :34 CONTRA COSTA COUNTY CLERK OF THE 3 914153906169 NO.504 902 i 4. What particular act or omission on the part otcounty or district officers, servants, or employees caused the injury or damage? See Attached. S. 'Khat are the names of county or district officers, servants,or employees causing the damage or injury? Unknown. 6_ What damage or injuries do you claim resulted?(give full extent of injuries or damages claimed. Attach two estimates for auto damage,) See Attached. 7. How was the amount claimed above computed?(Include the estimated amount of any Prospective injury or damage.) Unknown. 8. Names anif addresses of witnesses, doctors, and hospitals. John Muir, Alta Bates, etc.- 9. List the expenditures you made on account of this accident or injury. lD vtC3tJ1vT See Attached. s#sss#ssss+�*sssr#�r�r�►sss#+rts�rs*s*s#t**ss+►+�t*s*s#s**s*ase+assts*s*s#*qhs##*#**�tsss:**s�e�rsrssss } Com, Code gee. 9)i1.2 provides"'The claim must be signed by the claimant or by some person on his behalf" N Name and Address of Attorney Mark J. Zanobini Rouda, Feder, Tietjen W566-9 ` & Zanobini igatstue) 44 Montgomery, Suite 4000 San Francisco, CA 94104 ). 723 Moraga Read (Address) Moraga, CA 94556 Telephone No. -C4 ) 3 9 8-5 3 9 8 Telephone No. .(9 2 5) 631-1337 NancE v Section 72 et the PtsW Co4a provides: Evtry perm arbor Witb it nU to ddh4 punts for allm=m or Me payment to any"tS board or vMcar,or to any cauutY,6ty,or distrid boaA or o crr.autbodzed to auow or Pay tb*same if gcauink any false or baudulew c#aaim bila B ur t, voucher,or w-rittns,is puoist abla aid=by stnprisomm*in tbo county jail for ai paivd of not marc itian wit Year,by a tue of n% c=4ag one thwCan d(5 t, O),or by beth such imprismamt aad fine,ar by ImpisomDW in the.state prison,by a AM of ext 0=odin8 tru thoumd do11 (SIO.000),orby"both sorb iwp:iso=ent and fte. CLAIM FOR DAMAGES AGAINST THE-COUNTY-OF CONTRA COSTA T4 Clerk of the Board of Supervisors Room 106 County Administration Building 851 rine Street Martinez, CA 94553 Claimant's Names Yonggin Wang Claimants' Address 723 Moraga Road Moraga, CA 94558 Claimants' Telephone 925.831 .1337 Address to Which Mark J. Zanobini, Esti. Notice is to Be Sent Rouda, Feder, Tietjen & Zanobini 44 Montgomery Street, Suite 4000 San Francisco, CA 94104 V415-398-5398 <mzano@rftlaw.com> Date of Occurrence december 19,2003 Time of Occurrence Approximately 8:45 p.m. Place of Occurrence Intersection of Moraga Road and Corliss Drive Moraga, CA Description of On the above date, 73-year-old Yongqin Wang Occurrence was crossing walking in the eastbound direction across Moraga Road in a marked crosswalk at the intersection with Corliss Drive. Mr. Wang was ten feet into the street when he was violently struck by a black 1999 Daewoo Sedan. The vehicle was traveling south on Moraga Road at approximately 35 mph at the time of contact. Due to the weather and darkness, Mr. Wang did not see the car approaching with time to move and was thrown onto the front passenger side of the windshield. His injured body was propelled into the air and onto the asphalt until he slid to rest over 80 feet from the point of impact. The impact caused massive head trauma and other severe injuries requiring extensive reconstructive surgery for which he still has permanent scars. Claim Against the County of Contra Costa Re: Yongain Wang June 7, 2404 Page 2 Claimant has recently become informed and believes that defendant County of Contra Costa was the owner, occupier and maintainer of the premises where Mr. Wang suffered his severe injuries. Claimant contends that the County of Contra Costa (1) maintained a dangerous condition of public property which it created, or had actual or constructive notice of such dangerous condition, in time to have taken protective measures to have prevented the subject accident from occurring, (2) was negligent in hiring contractors and/or subcontractors to maintain the premises, thereby creating or allowing to be created the dangerous conditions of public property above described, thereby breaching the County of Contra Costa's nondelegable duty to maintain its premises in a safe condition; (3) was negligent in either leasing the premises to others, or permitting others to occupy the premises and create the dangerous conditions of public property above-described, thereby breaching the County of Contra Costa's nondelegable duty to maintain its premises in a safe condition; t4? negligently designed and/or authorized or permitted the negligent design of the subject premises so as to create the street, slope, sidewalk sign post location, lighting and signage which combined to allow plaintiff to be struck by a vehicle while lawfully in the crosswalk; (5) negligently failed to discharge mandatory duties imposed upon the County of Contra Costa that were designed to protect against the risk of injuries suffered by Mr. Wang; and (6) through its employees and agents, the County of Contra Costa acted negligently in inspecting, supervising, maintaining, controlling, and owning its premises, thus causing the subject accident. Specifically, the subject roadway, intersection and crosswalk was in a dangerous condition and deficient in a number of respects. The crosswalk and intersection was poorly lit leading to difficulty for motorists to perceive pedestrians. There was inadequate pedestrian crosswalk signage for southbound Moraga Road in the crosswalk area or in close proximity thereof. There was very limited sight distance both for pedestrians looking for southbound traffic and for drivers traveling southbound since there was no lamp post near the intersection so vision was significantly impaired at night. There were also no warning beacons or flashing lights indicating pedestrian crossings. Claimant contends that his severe and permanent injuries were proximately caused by the above-described negligent conduct and dangerous conditions of the property of the County of Contra Costa. Claim Against the County of Contra Costa Re: Y'onggin Wang June 7, 2004 Page 3 The names of the public employees causing Claimant's injuries, damages and loss are unknown at this time. Claimant further contends that he has been generally damaged by the injuries and severe pain that he has suffered. He has incurred hundreds of thousands of dollars in medical, hospital, and reconstructive surgery expenses and will continue to incur medical, hospital, and reconstructive surgery expenses well into the future. The amount of damages claimed in connection with this accident far exceeds the unlimited jurisdiction of the Superior Court of the State of California. DATED: June 7, 2004 MARK J. 1 Attorney r ant PROOF 4F SERVICE BY CERTIFIED MAIL C.C.P. Suctions 1 13(a) and 2015.5- 1 declare that I am employed in the City and County of San Francisca, California. I am over the age of eighteen years and not a party to the within entitled cause; my business address is 44 Montgomery Street, Suite 4000, San Francisco, California, 94104. Can .lune 7, 2004, 1 caused Claimant's Claim Against the County of Contra Costa to be served on all parties listed below in said cause by placing a true copy thereof enclosed in a sealed envelope with postage thereon fully prepaid, with a certified, return-receipt attached, in the United States mail at 44 Montgomery Street, San Francisca, California, 94104, addressed as follows: Clerk of the Board of Supervisors Room 106 County Administration Building 651 Pine Street Martinez, CA 94553 1 declare under penalty of perjury that the foregoing is true and correct, and that this declaration was executed on June" 004 at San Francisco, California. LYANNETTE LUNA CLAIM � BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION. T a 2004 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 3j Y Board of Supervisors. (Paragraph IV below), given 5 Pursuant to Government Code Section 913 and � y _€ r q ,- ,t; 915.4. Please note all"Warnings'. AMOUNT: $100,000.00 CS..,sUNTY C,o4 N EL CLAIMANT: LIONISGATE DEVELOPMENT CORPORATION ATTORNEY: UNKNOWN DATE RECEIVED: JUNE 09, 2004 ADDRESS: P.O. BOX 408 BY DELIVERY TO CLERK.ON: JUNE 09, 2004 ALAMO, CA 94507 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 SWEET , Cle Dated: JUNE 09, 2004 By: Deputy II. FROM: County Counsel. TO: Clerk of the Board of Supervis rs (f�his claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 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. C,'Ci f ey-,, € J t r o y 6 9,_r{V14 0 f S y _ i i;".¢'1:.. c f6% ,- Dated: By: -�`- ter. Deputy County Counse III. FROM: Clerk ofthe 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. JOHN SWEETEN, CLERK, By , Deputy Clerk WARNING(Gov. code section 913) Subject to certain exceptions, you have only six(6)months from the date this notice was personally served or deposite4 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. Dated: JOHN SWEETEN, CLERK By Deputy Clerk Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLQ 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 I Oe day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Gov't Code 911.2.). B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building., 651 Pine Street,Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors,rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. . E. Fraud. See penalty for fraudulent claims,Penal Code Sec. 72 at the end of this form. RE: CIairrr By Reserved for Clerk's filing stamp Against the County of Contra Costa or ) JUN 0 9 2004 District) (Fill in name) ) c�Ear say 0€tr STA Is es �i } cONTf€C#�a�` Cil. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of S and in support ofthis claim represents as follows e r ' F .7-'GO x f a't 4 . 1. When did the damage or injury occur?(Give exact_date and hour) '..` 1 �-� ' 9/ �"..,1."� d,S G.�4 ,�. i �} � �. �is q�,S i +z::✓"t it L.. 2. Where did the damage or injury occur?(Include city and county) : 7 v _ �:. `?' {,..:: { jtd �.c .✓ 1...... :- :''s..,.,; �+.... i, s '-1 z„s�.rt 3a... ti.« ...o ','_ .,... ,..... y,... '>.-.._ _..�F 3. How did the damage or injury occur?(Give full details;use extra paper if required) x - _ s S 4. 'What particular act or omission on the part of county or district officers, servants, or employees caused the injury ordamage? ill. 7V-1 5. What are the names of county or district officers, servants, or employees causing the damage or injury? r :✓` ' '" .... :''f r 3,.,_j''` ti,_,z: .a .�X'" S i � :''f +... ,.,� .; �. ��f /;may:-:f 6. What damage or injuries do you claim resulted?(Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) ,r 7. How was the amount claimed above computed?(Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors, and hospitals. It. . 9. List the expenditures you made on account of this accident or injury. DATE T1 AMt)LTN"I' ****************************************************************************************** } Gov. Code Sec. 911.2 provides"The claim must be } signed by the claimant or by some person on his behalf." NOUCES IQ: (Attorna Name and Address of Attorney (Claimant's Signature) Y(Address) t Z } Telephone No. }Telephone No. NOME Section 72 of the Penal Code provides: Every person who,with intent to defraud,presents for allowance or the 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 qty jail for a period of not more than one year,by a fine of not exceeding one thousand(S 1,000),or by both such imprisonment and fine,or by imprisonment in the state prison,by a fine of not exuding ten thousand dollars(S 10.000),or by both such imprisonment and fine_ L NSGATE DEVELOPMENT CORPORATION Mailing Address.. F 0.Box 408, Aiarno, California 94507 Telephone (925) 831-8500 Fax(925) 831-8502 VU CERTIF'.IED MAIL RETURN RECEIPT REQUESTED No. 7003 0500 0000 4264 3907 Mr. Maurice Shiu June-8,2004. CONTRA COSTA COUNTY, Public Warks Director, 255 Glacier Drive, Martinez, CA. 94553-4525. RE :MS 03-0015- 2501 Warren Road,Walnut Creek-County Letter of June1,2004. Bear Mr. Shui, Receipt of the above referenced County letter is acknowledged. Similar.to.severM previous County determinations regarding MS 03-0015, it is noted that the County continues to erroneously assert that the adjoining property sections of Las Trampas Creek (i.e. the Looney,and Shaw/Ryan properties) are unimproved, and therefore, yet another study is now allegedly needed ".....to determine if any basis exists for supporting an exception to the creek structure set back requirements of the Ordinance Code for this (allegedly) unimproved portion of Las Trampas Creek. " The County is in grass error, and notice is given as follows: 1) The adjacent channel sections of Las Trampas Creek channel have been materially unproved, and reams of documents including plans, permits,construction inspection records, photographs, correspondence, and numerous other records are in the County files which confirm these improvements. 2)The belated further request hydraulic studies of Las Trampas Creek and site soils/geological studies and reports have already been performed, and reams of pertinent reports and studies are also in the County files. For your use, we shall shortly:send you a further copy of these reports via separate correspondence. The County's latest requirements are seen as a woeful last ditch attempt to try and cover up its ongoing gross negligence. This simply farther high lights the wide spread serious mismanagement within the County Public Works Department. Page No, 2-Letter to Maurice Shiu 3) Contrary to the County's determination, creek set backs per Ordinance Code Section 914-14.012 are inapposite, because they are not required by the Ordinance.-Cede. Unquestionably, Ordinance Code Sections 1010-6.014; 1010-6.026 and 914-14.006 apply, and the County's continuing willful violations of these sections of the Ordinance Code has caused damages to Lionsgate Development Corporation. 4) The County's refusal to comply with its own Ordinance Code constitutes the inverse condemnation of the subject property. 5)The County' refusal to comply with its own Ordinance Code has resulted in Lionsgate's private property, being seized by the County for public use, without just compensation. This is a violation of the Constitution of the United States. 6)Delay damages are estimated at approx. $25,000.00 per month(not including the cost of any further studies/reports etc. required by the County) are being incurred from the above noted County violations of the Ordinance Code and law. Additionally, the cost of all further County reports/studies etc., allegedly required by the County "... to determine if any basis exists for supporting an exception to the creek setback requirements of the Ordinance Code for this unimproved portion of Las Txampas Creek." will also be charged to the County, along with costs for other work not required by the Ordinance Code. 7)A formal claim will shortly be filed with the County Legal Department.for the damages and extra costs that will surely flow from the County's latest erroneous and unlawful determinations and directives as set forth in the County letter of June 1, 2004. Please contact this office if there are any questions. Sincerely, z .Kenneth barker, President, Lionsgate Development Corporation. Copy : All County Supervisors. A DED -- CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JULY 13, 2004 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), give Pursuant to Government Code Section 913 and s"." 915.4. Please note all"Warnings". g �F s 2B 2 i 04 AMOUNT: UNKNOWN cOUINTY COUNSEL CLAIMANT: GEORGE G. pAUNOV MARTINEZ CALIF. ATTORNEY: ALBERT G. STOLL, JR. DATE RECEIVED: JUNE 18, 2004 ADDRESS: LAW OFFICE OF ALBERT G. STOLL, JR. BY DELIVERY TO CLERK ON: JUNE 18, 2004 55 FRANCISCO STREET; SUITE 40.3 SAN FRANCISCO, CA 9413.3 BY MAIL POSTMARKED: JUNE 17, 2004 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN SWEETIr Dated: JUNE 18, 2004 By: Deputy II. FROM: County Counsel. TO: Clerk of the Board of Supervis rs (-'This 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 9111.8). ( } 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:`" � 9" ' ' Deputy County Couns 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: (I 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: JOHN SWEETEN, CLERK., By , Deputy Clerk WARNING(Gov. code recti 913) Subject to certain exceptions,you have only six(6)months from the date this notice was personally served or deposits 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 full prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: JOHN SWEETEN, CLERK By Deputy Clef I ALBERT G. STOLL, JR. #164649 LAW OFFICE OF ALBERT G. STOLL, JR 2 55 FRANTCISCO STREET, SUITE 403 ��� � 8 ���� 3 SAN FRANCISCO, CA 94133 CLERK BOARD OF SUPERVISORS TELEPHONE: (415) 576-1500 CONTRA easrA CO. 4 FAX: (415) 576-1501 Attorney for Claimant: GEORGE PAUNOV 5 PRESENTATION OF GOVERNMENT CLAIM 6 PURSUANT TO CHAPTER 2 7 ARTICLE ONE, SECTION 910 8 GEORGE G. PAUNOV, PAUNOV'S SUPPLEMENTAL GOVERNMENT CLAIM 9 Claimant, [Cal Govn't Code Section 910] 10 V. 11 CITY OF PITTSBURG, COUNTY OF 2 CONTRA COSTA, 13 Government Entities. 14 15 WHAT ACT CAUSED THE DAMAGE 16 Further, the County of Contra Costa did not advise the developers I contractors of proper 17 18 safeguards for safe installations of road barriers and other blockades to prevent traffic from using 19 the road in question. The County failed to instruct developers /contractors of laws and 20 regulations and other requirements governing proper safeguards for safe road barrier installation. 21 The County failed to insure that said safeguards were carried out and or implemented. Said 22 failure proximately caused plaintiff's injuries. /I 23 24 Date: '/f S' Law Of c f b 25 By-., ALBERT G. STOLL, JR. 26 Attorney for Claimant George G. Paunov 27 1 28 Paunov Government Claim Contra Costa Supplemental.doc 1 ALBEIT G. STOLL, JR. (#164649 2 LAS'OFFICE OF ALBERT G. STOLL, JR 55 FRANCISCO STREET, SUITE 403 3 SAN FRANCISCO, CA 94133 TELEPHONE: (415) 576-1500 4 FAX: (415) 576-1501 Attorney for Claimant: GEORGE PAUNOV 5 PRESENTATION OF GOVERNMENT CLAIM 6 PURSUANT TO CHAPTER 2 7 ARTICLE ONE, SECTION 910 8 GEORGE G. PAUNOV, PAUNOV'S SUPPLEMENTAL GOVERNMENT CLAIM 9 Claimant, 10 [Cal Govn't Code Section 910] V. 11 CITY OF PITTSBURG, COUNTY OF 12 CONTRA COSTA, 13 Government Entities. 14 15 �''^ WHAT ACT CAUSED THE DAMAGE 16 17 Further, the County of Contra Costa did not advise the developers I contractors of proper safeguards for safe installations of road barriers and other blockades to prevent traffic from using 9 the road in question. The County failed to instruct developers J contractors of laws and 20 regulations and other requirements governing proper safeguards for safe road barrier installation. 21 The County failed to insure that said safeguards were carried out and or implemented. Said 22 failure proximately caused plaintiff's injuries. 23 24 Date: Law Of c f b 25 By- ALBERT G. STOLL,3R.. 26 Attorney for Claimant George G. Paunov 27 7 28 Paunov Government Claim Contra Costa Supplemental.doe Meagan Cavanaugh ATTORNEY AT LAW TELEPHONE Legal Assistant 55 FRANCISCO STREET, SUITE 403 (41 S) 576-1500 SAN FRANCISCO,CALIFORNIA 44133 FACSIMILE www.st0I1-Iaw.C*M (415) 576-1501 Thursday, June 17, 2004 Claims Clerk of the Board of Supervisors ' 1 Room 106 JffN County Administration Building ctFxgQ 651 Pine Street. � � , A�;a �� Martinez, CA � �,1 Cd 180ft 94553 Re: George Paunov v. City of Pittsburg, County of Contra Costa Dear Clerk, Please find enclosed_1_copy and_1_original of Plaintiff s Supplemental Government Claim. _X_Please file the original. X Please return file-endorsed stamped copy to our office. _X Self-addressed stamped copy enclosed. Thank you for your assistance in this matter. Regards, , Me anj vanaugh t `I