HomeMy WebLinkAboutMINUTES - 03082005 - C22 CLAIM
BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
BOARD ACTION: MARCH 08, 2005
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), given
Pursuant to Government Code Section 913 and
915.4. Please note all "warnings".
AMOUNT: $39424,68 L'3Y ai F �.3- 0
CLAIMANT: KAREN RENO
ATTORNEY; UNKNOWN DATE RECEIVED$ EBRUARY 03.,� 2005
ADDRESS: 3891 VISTA OAKS DRIVE, #207 BY DELIVERY TO CLERK ON: FEBRUARY 03, 2005
MARTINEZ, CA 94553
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 S WEE E
Bated: FEBRUARY 03, 2005 --: B Deputy
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II, FROM: Count Counsel:. ; TO: Clerk of theBoard of Su e isors
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(&or'This claim complies substantially with Sections 910 and 910.2.
{ ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The
Board cannot act for 15 days (Section 910.8).
Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of
claimant's right to apply for leave to present a late claim(Section 911.3).
{ ) Other:
Dated: By:Y 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. OARD ORDER: By unanimous vote of the Supervisors present:
( This Claim is rejected in full.
O Other:
I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date.
Dated: MO. 6V000. JOHN SWEETEN CLERK By 06.00 Deputy clerk
WARNING(Gov. code seCtion 913)
Subject to certain exceptions,you Have only six(d)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. Ifou want to consult an attorney, you should do so
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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, osta e full
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prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above.
Dated: a�40%6 did V0'0 JOHN SWEETEN CLERK By Deputy Clerk
This warning does not apply to claims which are not
subject to the California Tort Claims Act-such as actions
in inverse condemnation, actions for specific relief such
as mandamus or injunction, or Federal Civil Rights
claims. The above list is not exhaustive and legal
consultation is essential to understand all the separate
limitations periods that may apply. The limitations period
within which suit must be filed may be shorter or longer
depending on the nature of the claim. Consult the specific
statutes and cases applicable to your particular claim.
The County- of Contra Costa does not waive any of its
rights under California Tort Claims Act nor does-it waive
rights under the. statutes of limitations applicable to
actions not subject to the California Tort Claims -Act.
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BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY
INSTRUCTIONS TO CLAIMANT
As A claim relating to a cause of action for death or for injury to person or to personal property or
growing crops shall be presented not later than six months after the accrual of the cause of
action. A claim relating to any other cause of action shall be presented not later than one year
after the accrual of the cause of action.
(Gov. Code § 911-2.)
B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106,
County Administration Building, 651 Pine Street, Martinez, CA 94553.
C. If claim is against a district governed by the Board of Supervisors, rather than the County, the
name of the District should be filled in.
D. If the claim is against more than one public entity, separate claims must be filed against each
public entity.
E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form.
RE Claim By: Reserved for Clerk's filing stamp
F)
Against the County of CAiraCosta or }'
I FEB 0 3 cPek5_'
District) I -_
CLERK BOARD OF SUPE
RVISORVC
r%nNITO A(%nqTA ro,
(Fill 'in the name)
The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named
district in the sum of$ LL44 A and in support of this claim represents as follows:
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1. When did the damage or 'in'ury occur? (Give exact date and hour)
2. Where did the damage or 'injury occur? (Include city and county)
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3. How did the damage or injury occur? (Give full details; use extra paper if required)
4. What particular act or omission on the part of county r district officers, servants, or employees
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caused the injury or damage?
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5 What are the names of county or district officers, servants, or employees causing the
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6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages
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claimed. Atta%_.h two estimates for auto damage.) CC4,90A44_,�,� t_0 XA-e 4?4
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7. How was t�hec:J�� ount claimed above computed? (Include the estimated amount of any
prospective injury o damage.)
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8. Names and addresses of witnesses, doctors, and hospitals:
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9. List tie expen Mures you made on account of this accident or injury.
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DATE TIME AMOUNT
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Gov. Code Sec. 910.2 provides "The claim shall be
signed by the claimant or by some person on his
behalf
SEND NOTICES TO: (Attorney)
Name and address of Attorney ........................
(Claimant's Signature)
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(Address)
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Telephone No. Telephone No. _?Z� 7/
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PUBLIC RECORDS NOTICE:
Please be advised that this claim form, or any claim filed with the County under the Tort Claims Act, is subject to
public disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) Furthermore, any
attachments, addendums, or supplements attached to the claim form, including medical records, are also subject to
public disclosure.
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NOTICE:
Section 72 of the Penal Code provides:
Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or
to any county, city, or district board or officer,, authorized to allow or pay the same if genuine, any false or
fraudulent claim, bill, account voucher, or writing, is punishable either by imprisonment in the County jail for a
period of not more than one year, by a fine of not exceeding one thousand dollars ($1,000.00), or by both such
imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars
($10,000),or by both such imprisonment and fine.
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