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HomeMy WebLinkAboutMINUTES - 04242007 - C.9 CLAIMe. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY o BOARD ACTION: 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 California Government Codes. ) you is your notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), MAR 19 2007 given Pursuant to Government Code AMOUNT: (,,Q, Kmu)n Section 913 and 915.4. Please note all COUNTY COUNSEL "Warnings". ^,,dw,�MARTINEZ CALIF. CLAIMANT:81-M 14 d ATTORNEYAMt6 `t't DATE RECEIVED: L?j-1q-01 ADDRESS: �wlp' �� as afit;, 6+C,1000 Y DELIVERY TO CLERK ON: BY MAIL POSTMARKED: 3 - 1b-07 FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above-noted claim. r� JOHN CULLEN, l -k Dated: �� I By: Deputy W Ak�. iI. FROM: County Counsel TO: Clerk of the Board of Supervisors Fn,--h a//, ( T-his claim`complies 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: Ilie— Aor-7h a n 5 0,( -(-{1-e, cd a i rn pr I or- -D 9 - �to_0C;1 Gam, ynA rrnedq Q✓td re4,u%r-e_ Q fa,�= Glurm , ( 110v CDJ-eS 0111,3) See l e lam-- Cour,- 7�,, Dated: �J 3-�^1 By: rn 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: (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. 01 Dated /!ri!a -9�zz JOHN CULLEN, 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 ofan attorney of your choice.in connection with this matter. If'you want to consult an attorney,you should do so immediately. *For Additional Warding 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. a Dated: Ap��� JOHN CULLEN, CLERK By a/ Deputy Clerk OFFICE OF THE COUNTY COUNSEL E L SILVANO B. MARCHESI COUNTY OF CONTRA COSTA �'► -_; �;'=-ti 0.�, COUNTY COUNSEL Administration Building ,�.� "-_==-'•° 1351 Pine Street, 911, Floor �! �'�` - SHARON L. ANDERSON (Martinez, California 94553-1229 CHIEF ASSISTANT (925) 335-1800 _ GREGORY C. HARVEY ®: ":a';;i�`'` <� , VALERIE J. RANCHE 925) 646-1078 (fax) ASSISTANTS A �coiir+ NOTICE OF UNTIMELINESS AS TO A PORTION OF THE CLAIM TO: Pamela Pitt Law Office of Pamela Pitt 22 Battery Street, Suite 1000 San Francisco, CA 94111 RE: CLAIM OF: Elma Bauder Please Take Notice as Follows: In regards to the claim you submitted on March 16, 2007, on behalf of Elma Bauder, portions of the claim are timely and portions are untimely. The portions of the claim prior to September 16, 2006 that you presented against the County of Contra Costa governed by the Board of Supervisors fail to comply substantially with the requirements of California Government Code Sections 901 and 911.2, because they were not presented within six months atter the event or occurrence as provided by law. Because the portions of the claim prior to September 1.6, 2006 were not presented within the time allowed by law, no action was taken on those portions of your claim. The claim was forwarded to the Board for action only on the timely portions of the claims. The only recourse at this time is to apply without delay to the County of Contra Costa governed by the Board of Supervisors for leave to present a late claim as to the claims which are untimely. (See Gov. Code, tiff 911.4 to 912.2, inclusive, and 946.6.) Under some circumstances, leave to present a late Claim will be granted. (See Gov. Code, 5 911.6.) SILVANO B. MARCHESI COUNTY COUNSEL B : y (--w' Monika L. Cooper Deputy County Counsel Page I CERTIFICATE OF SERVICE BY MAIL (Code Civ. Proc., §§ 1012, 1013a, 2015.5; Evid. Code, §S 641, 664) 1 ani 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 3 .23 -07 , I served a true copy of this Notice of Untimeliness as to a Portion of the Claim by placing the document in a sealed envelope with postage thereon fully prepaid, in the United States mail at Martinez, California addressed to Parnela Pitt, Law Office of Pamela Pitt, 22 Battery Street, Suite 1000, San Francisco, CA 9411 1, as set lorth above. I and readily familiar with Office of County Counsel's practice of .collection and processing of correspondence for mailing. Unifier 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 x-23 07 ! at Martinez, California. Kathleen O'Connell cc: Clerk of the Board of'Suj)ervisors (original) Risk INLIMIgcnlcnt Page 2 Law Office of Pamela Pitt 22 Battery tit.,Suite 1000•San Francisco,CA 94111 •Phone:415 291.9251 •Fax:415.274.5770 E-mail:attorney((i'hamelapitt.com•Nvwx .pamclapittcom Eil111 ® March 16, 2007 MAR 1 9 2001 CLERK BOARD OF SUPERVISORS Contra Costa County Board of Supervisors CONTf;ACOSTACO. County Administration Building 651 Pine Street Martinez, CA 94553 Re: Elma Bauder Government Tort Claim and Application to Accept Late Filed Tort Claim Dear Contra Costa County Board of Supervisors: Enclosed please find a Government Tort Claim addressed to the County Administrator which I am sending to you for filing and on behalf of Elma Bauder. Most recently, Ms. Bauder was terminated from leer temporary job with Contra Costa County through EASTBAY Works on December 29, 2006. Prior to this Ms. Bauder had been raped on August 13, 20.06 by Mr. Benjamin Mosley, One-Stop Operator Consortium.Assistant Administrator, for EASTBAY Works. }le was the manager of her direct supervisor, Richard Cox. The rape occurred when Mr. Mosley invited Ms. Bauder to his home to discuss matters dealing with the office. Mr. Mosley threatened to have Ms. Bander terminated if she disclosed the rape. She therefore was afraid and did not come forward earlier. After.Ms. Bauder confided in a cu-worker in November,she was terminated in December. T'hl-(:D-worker:is a iurlg dine colleague of Mr. Mosley. Now that she has been terminated, Ms. Badder is filing a claim for sexual battery as well as other tort claims. 111 the event that you determine that the sexual battery tort claim is not timely filed,we submit this application for acceptance of any part of her tort claim which you may Been; late filed. Please let us know as soon as possible if you find any deficiencies in this tort claim or if a tiling fee needs to be pav . fhank Y0111 rcr your acitlt�iurl i� i ii5 it,dC ci. Very truly yours, Pamela Pitt Cc: Ms. Elina Bauder Mi.John Cullen, County Administrator 1:7ma 19audcr 1.938 Cavallo Road, No. 112 Antioch, CA 9150.9 (.92.5) 778-.52.91 March 16, 2007 Contra Costa County Attn:John Cullen, County Administrator County Administration Building 651 Pine Street 111h Floor Martinez,CA 94553 Re: Eima Bauder Government Tort Claim Dear Mr.Cullen: I hereby make and file a government tort claim against Contra Costa County,Workforce Development Board of Contra Costa County, EASTBAY Works One Stop Centers,and Benjamin Mosley for sexual battery,failure to provide a safe workplace, false imprisonment, fraud, retaliation in violation of public policy,wrongful termination in violation of public policy,and violation of Civil Code 51.7. I make a further claim against Contra Costa County,Workforce Development Board and EASTBAY Works for the negligent hiring,supervision and retention of Benjamin Mosley. I am also making claims against Contra Costa County and Benjamin Mosley under the California Fair Employment and Housing Act("FEHA") for sexual harassment,gender discrimination, national origin discrimination, race discrimination, and retaliation. The FEHA claims are also being filed with the Department of Fair Employment and Housing. 1 will be asking for an immediate right to sue letter in order to pursue my claims in the Superior Court, Unlimited Jurisdiction. I was employed by Contra Costa County through Venturi Staffing Agency starting July 27, 2004. 1 originally worked in the Welfare Department. Around November 10, 2005 1 went to work in EASTBAY Works in Contra Costa County. My supervisor was Richard Cox,Coordinator. His manager was Benjamin Mosley. Mr. Mosley is One-Stop Operator Consortium Assistant Administrator, for EASTBAY Works. Mr. Mosley came to our office about twice a month. He met with us as a group and individually. On Saturday,August 12, 2006 Mr. Mosley called me and I told him about some of the problems at work. He told me to come to his house on Sunday to discuss the problems at the office. I thought he was having a gathering of a number of people. I took BART to his home on Sunday after I went to Church Sunday morning. When i arrived I discovered Mr. Mosley's wife was not at his house, nor was anyone else. He would not discuss the office with me. Instead, he raped me. I called my uncle and talked to him about what happened and he told me not to trust anyone else. I will not go into the details here of what occurred in his home,but I have furnished this to the Elma Bauder Government Tort Claim March 16, 2007 Richmond Police Department,Case NO.0724218. They are investigating my claim and will interview Mr. Mosley. After the incident at Mr. Mosley's house,he instructed me not to tell anyone. He told me 1 was a temporary worker and could be fired. I called Mr. Mosley on Monday. He told me to go find another job. He told me to find a permanent job. He told me to act natural in the office. However, in October, 2006, Mr. Mosley told me,while we were talking about work,that"I want to play with you every night." As instructed by Mr. Mosley, I did not say anything to anyone,other than my initial phone call to my uncle. I felt that Mr. Mosley had taken advantage of me because he knows that I am a single mother and really need to work. This is especially distressing because I was working at EASTBAY Works which Contra Costa County supports to assist women like me. I was a very good worker and my supervisor, Mr.Cox,told me I would never be terminated. In November, 2006 I received a phone call from Karen Daniels, a long time Contra Costa County employee who had worked with Mr.Mosley for about 11 years. She wanted to meet me for lunch. She spoke to me at length about Mr. Mosley. She made negative comments about him and told me he has a girlfriend in every office. Still, I did not tell her what happened because I was afraid of Mr. Mosley and he had told me not to tell what happened or I would lose my long-term temporary job. The next day I went to dinner with Ms. Daniels. After reflecting on what Ms. Daniels had told me about Mr. Mosley,while we were having dinner, I told Ms. Daniels that I had been raped by Mr. Mosley. Ms. Daniels told me not to tell my supervisor, Mr. Cox. She said to never tell anyone since Mr. Mosley is a powerful man. In December 2006 when Mr. Mosley came to the office he would barely speak to me. He was cold when he spoke to me on the phone or in the office. He and Mr.Cox encouraged me to find a permanent job. Yet,when I went on an interview for a permanent job,they made it difficult for me to make up my time that I missed when I went for the interview. First I was told by Mr. Cox I could make up the time,and then I was told by Mr.Cox I could not make up the time. Stephen Baiter,Administrator Contra Costa One Stop Consortium and Mr. Moseley's boss, came to the office on December 26, 2006. He called a meeting and spoke about teamwork. He said not to complain about things. Mr.Cox began to criticize me for things that he did not criticize other people for. He accused me of things that were not true. At ten to 5:00 on December 29,2006,Venturi Staffing called me and told me that my assignment was over and not to return to Contra Costa County offices. To make matters worse, Mr. Cox called Venturi and told them some negative things about me,so that I have been unable to get another assignment from them. I used to be a happy person before the incident with Mr. Mosley. Since then I have been extremely depressed, have trouble sleeping and have chest pain from stress. I became suicidal in the fall not long after the rape and continue to have trouble with suicidal thoughts. I have contacted the Rape Crisis Center in an attempt to get some assistance with this. Please let me know if I need to do anything further to submit my claim. All notices should be sent to my attorney, Pamela Pitt, Esq.; LAW OFFICES OF PAMELA PITT, 22 Battery Street,Suite Elma Bauder Government Tort Claim March 16,2007 1000,San Francisco,CA 94111 (415) 291-9251. She is also available to answer any of your questions regarding this matter. Very truly yours, 'Elma Bauder i ' * * * EMPLOYMENT COMPLAINT OF DISCRIMINATION UNDER DFEH # THE PROVISIONS OF THE CALIFORNIA DFEH USE ONLY F=AIR EMPLOYMENT AND HOUSING ACT CALIFORNIA DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING YOUR NAME(indicate Mr.or Ms.) TELEPHONE NUMBER(INCLUDE AREA CODE) _Elma Bauder 925 778-5291 ADDRESS _ 1938 Cavallo Road,No. B2 CITY/STATE/ZIP Antioch,CA 94509 COUNTY COUNTY CODE _ Contra Costa NAMED IS THE EMPLOYER, PERSON, LABOR ORGANIZATION, EMPLOYMENT AGENCY, APPRENTICESHIP COMMITTEE, OR STATE OR LOCAL GOVERNMENT AGENCY WHO DISCRIMINATED AGAINST ME: (NAME TELEPHONE NUMBER(Include Area Code) _EASTBAY Works,Inc.,dba EASTBAY Works One-Stop Centers Benjamin Mosley 925 439-4875 ADDRESS DFEH USE ONLY _1212 Broadway St.,Suite 300 4071 Port Chicago Hwy.,Suite 250 CITY/STATE/ZIP COUNTY COUNTY CODE Oakland,CA 94612 Concord,CA 94520 Contra Costa NO.OF EMPLOYEES/MEMBERS(if known) DATE MOST RECENT OR CONTINUING DISCRIMINATION RESPONDENT CODE 25+ TOOK PLACE(month,day,and year) December 29,2006 THE PARTICULARS ARE: On December 29,2006 1 Was ✓ tired denied employment _detiedfamily ormedical leave ✓ laid oft _denied prmrotion _dened pegnancy leave -demoted _derded transfer _denied equal pay harassed _denied aomnttgtlation _denied right to wear pants genetic characteristics testing -impermissible non-job-related inquiry _denied pregnancy accommodaticn _forced to quit ✓other(specify) retaliated against for comolaining of harass&discrim by Venturi Staffing Partners,Inc. on behalf of Contra Costa County and EASTBAY Works Name of Person Job Title(supervisor/manager/personnel director/etc.) because of my: sex ✓ nationalongir/ancestry iphysical disability _cancer ✓ (Circle one)filing; _age _marital status _mental disability genetic characteristic Protesting;participating in _religion sexual orientation investigation(retaliation for) ✓ race/color _association V other(specify) protesting harassment and discrim the reason given by Venturi Staffing Partners, Inc.on behalf of Contra Costa County and EASTBAY Works Name of Person and Job Title Was because 1 was told my assignment was over. On August 13,2006 I was raped by Benjamin Mosley, Contra Costa County of[please state what One-Stop Consortium. Mosley threatened to take away my temporary iob if I told. In November 2006 I confided you believe to be reason(s)] in Karen Daniels,an associate of Mosley. I was terminated on 12/29/06 after being told I would never be fired. wish to pursue this matter in court. I hereby request that the Department of Fair Employment and Housing provide a right-to-sue notice. I understand that if I want a federal notice of right-to-sue, I must visit the U.S. Equal Employment Opportunity Commission(EEOC)to file a complaint within 30 days of receipt of the DFEH"Notice of Case Closure,"or within 300 days of the alleged discriminatory act,whichever is earlier. I have not been coerced into making this request,nor do I make it based on fear of retaliation if I do not do so. I understand it is the Department of Fair Employment and Housing's policy to not process or reopen a complaint once the complaint has been closed on the basis of"Complainant Elected Court Action." I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct of my own knowledge except as to matters :stated on my information and belief,and as to those matters I believe it to be true. Dated March 16,2007 COMPLAINANT'S SIGNATURE At San Francisco,CA 94111 City DATE FILED DFEH-300-03(01/05) DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING STATE OF CALIFORNIA RIGHT-TO-SUE COMPLAINT INFORMATION SHEET DFEH needs a separate signed complaint for each employer, person, labor organization, employment agency, apprenticeship committee, state or local government agency you wish to file against. If you are filing against both a company and an individual(s), please complete separate complaint forms naming the company or an individual in the appropriate area. Please complete the following so that DFEH can process your complaint and for DFEH for statistical purposes, and return with your signed complaint(s): YOUR RACE:/ETHNICITY (Check one) YOUR GENDER: ✓ Female _ Male _ African-American African - Other YOUR OCCUPATION: ✓ Asian/Pacific Islander(specify) Filipino ✓ Clerical Caucasian (Non-Hispanic) _ Craft _ Native American _ Equipment Operator Hispanic(specify) _ Laborer _ Manager YOUR PRIMARY LANGUAGE (specify) _ Paraprofessional English _ Professional _ Sales YOUR AGE: 43_ _ Service _ Supervisor IF FILING BECAUSE OF YOUR NATIONAL _ Technician ORIGIN/ANCESTRY, YOUR NATIONAL ORIGIN/ANCESTRY (specify) HOW YOU HEARD ABOUT DFEH: Phillipines _ Attorney IF FILING BECAUSE OF DISABILITY _ Bus/BART Advertisement YOUR DISABILITY: _ Community Organization _ AIDS _ EEOC _ Blood/Circulation EDD _ Brain/Nerves/Muscles ✓ Friend _ Digestive/Urinary/Reproduction _ Human Relations Commission _ Hearing _ Labor Standards Enforcement _ Heart _ Local Government Agency _ Limbs (Arms/Legs) _ Poster _ Mental _ Prior Contact with DFEH Sight _ Radio Speech/Respiratory _ Telephone Book Spinal/Back — TV DFEH Web Site IF FILING BECAUSE OF MARITAL STATUS. YOUR MARITAL STATUS: (Check one) DO YOU HAVE AN ATTORNEY WHO HAS AGREED _ Cohabitation TO REPRESENT YOU ON YOUR EMPLOYMENT _ Divorced DISCRIMINATION CLAIMS IN COURT? IF YOU CHECK _ Married "YES YOU WILL BE RESPONSIBLE FOR HAVING _ Single YOUR ATTORNEY SERVE THIS DFEH COMPLAINT. IF FILING BECAUSE OF RELIGION, (Yes _No YOUR RELIGION: (specify) PLEASE PROVIDE YOUR ATTORNEY'S NAME, ADDRESS AND PHONE NUMBER: IF FILING BECAUSE OF SEX, THE REASON: ✓ Harassment Pamela Pitt 415 291-9251 _ Orientation _ Pregnancy _ Denied Right to Wear Pants 22 Battery Street, Suite 1000, San Francisco _ Other Allegations (List) DFEH-300-03-1 (01/05) Aursignature Date Department of Fair Employment and Housing State of California * * * EMPLOYMENT * * * COMPLAINT OF DISCRIMINATION UNDER DFEH # THE PROVISIONS OF THE CALIFORNIA DFEH USE ONLY _F=AIR EMPLOYMENT AND HOUSING ACT CALIFORNIA DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING YOUR NAME(indicate Mr.or Ms.) TELEPHONE NUMBER(INCLUDE AREA CODE) Elma Bauder 925 778-5291 ADDRESS 1938 Cavallo Road,No. B2 CITY/STATE/ZIP Antioch,CA 94509 COUNTY COUNTY CODE _ Contra Costa NAMED IS THE EMPLOYER, PERSON, LABOR ORGANIZATION, EMPLOYMENT AGENCY, APPRENTICESHIP COMMITTEE, OR STATE OR LOCAL GOVERNMENT AGENCY WHO DISCRIMINATED AGAINST ME: NAME TELEPHONE NUMBER(Include Area Code) _Contra Costa County; Workforce Dev. Bd of Contra Costa Co ADDRESS DFEH USE ONLY _651 Pine Street, 11th Floor 2425 Bisso Lane,Suite 100 (925 646-5239) CITY/STATE/ZIP COUNTY COUNTY CODE Martinez CA 94553 Concord CA 94520 NO.OF EMPLOYEES/MEMBERS(if known) DATE MOST RECENT OR CONTINUING DISCRIMINATION ;RESPONDENT CODE 25+ TOOK PLACE(month,day,and year) December 29,2006 THE PARTICULARS ARE: I was ✓ trfed denied es ed employ -denied family or medical leave On December 29,2006 lad ofl _denied pronation _denied pregnancy leave _danoted _denied transfer -denied equal pay ✓ harassed _denied accommodation denied right to wear pants _genetic g characteristics testing _impermissible norrjob4alated inquiry denied preaaccommodation rcy accoodation _rorcedtoquit ✓ other(spe*)retaliated against for comnlaining of harass&discrim by Venturi Staffing Partners,Inc.on behalf of Contra Costa County and EASTBAY Works Name of Person Job Title(supervisor/manager/personnel director/etc.) because of my: sex ✓ nationalodgin/ancestry _physical disability _cancer ✓ (Circle one)filing; _age _mental status _mental disability _genetic characteristic Protesting;participating in _religion _sexual onentauon investigation(retaliation for) ✓ race/color _association otw(spedfy) protesting harassment and discrim the reason given by Venturi Staffing Partners, Inc.on behalf of Contra Costa County and EASTBAY Works Name of Person and Job Title Was because I was told my assignment was over. On August 13,2006 l was raped by Benjamin Mosley, Contra Costa County of[please O state what m Cine-Stop Consortium. Mosley threatened to take away my temporary iob if I told. In November 2006 1 confided you believe to be reason(s)] in Karen Daniels,an associate of Mosley. I was terminated on 12/29/06 after beiniz told I would never be fired. I wish to pursue this matter in court. I hereby request that the Department of Fair Employment and Housing provide a right-to-sue notice. I understand that if I want a federal notice of right-to-sue, I must visit the U.S. Equal Employment Opportunity Commission(EEOC)to file a complaint within 30 days of receipt of the DFEH"Notice of Case Closure,"or within 300 days of the alleged discriminatory act,whichever is earlier. I have not been coerced into making this request,nor do I make it based on fear of retaliation if I do not do so. I understand it is the Department of Fair E=mployment and Housing's policy to not process or reopen a complaint once the complaint has been closed on the basis of"Complainant Elected Court Action." I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct of my own knowledge except as to matters :stated on my information and belief,and as to those matters I believe it to be true. Dated March 16,2007 AA��� COMPLAINANT'S SIGNATURE At San Francisco,CA 94111 City DATE FILED: DFEH-300-03(01/05) DEPARTMENT OF FAIR EMPLOYMENT AND HOUSING STATE OF CALIFORNIA RIGHT-TO-SUE COMPLAINT INFORMATION SHEET DFEH needs a separate signed complaint for each employer, person, labor organization, employment agency, apprenticeship committee, state or local government agency you wish to file against. If you are filing against both a company and an individual(s), please complete separate complaint forms naming the company or an individual in the appropriate area. Please complete the following so that DFEH can process your complaint and for DFEH for statistical purposes, and return with your signed complaint(s): YOUR RACEJETHNICITY (Check one) YOUR GENDER: ✓ Female _ Male _ African-American African -Other YOUR OCCUPATION: ✓ Asian/Pacific Islander(specify) Filipino ✓ Clerical _ Caucasian (Non-Hispanic) _ Craft Native American — Equipment Operator Hispanic(specify) Laborer — Manager YOUR PRIMARY LANGUAGE (specify) _ Paraprofessional English _ Professional _ Sales YOUR AGE: 43 _ Service _ Supervisor IF FILING BECAUSE OF YOUR NATIONAL _ Technician ORIGIN/ANCESTRY, YOUR NATIONAL ORIGIN/ANCESTRY (specify) HOW YOU HEARD ABOUT DFEH: Phillipines _ Attorney IF FILING BECAUSE OF DISABILITY. _ Bus/BART Advertisement YOUR DISABILITY: _ Community Organization _ AIDS _ EEOC _ Blood/Circulation EDD _ Brain/Nerves/Muscles ✓ Friend _ Digestive/Urinary/Reproduction __ Human Relations Commission _ Hearing _ Labor Standards Enforcement _ Heart _ Local Government Agency _ Limbs (Arms/Legs) _ Poster _ Mental _ Prior Contact with DFEH Sight _ Radio Speech/Respiratory _ Telephone Book Spinal/Back — TV _ DFEH Web Site IF FILING BECAUSE OF MARITAL STATUS. YOUR MARITAL STATUS: (Check one) DO YOU HAVE AN ATTORNEY WHO HAS AGREED Cohabitation TO REPRESENT YOU ON YOUR EMPLOYMENT _ Divorced DISCRIMINATION CLAIMS IN COURT? IF YOU CHECK _ Married "YES". YOU WILL BE RESPONSIBLE FOR HAVING Single YOUR ATTORNEY SERVE THIS DFEH COMPLAINT. IF FILING BECAUSE OF RELIGION. ,L Yes _No YOUR RELIGION: (specify) PLEASE PROVIDE YOUR ATTORNEY'S NAME ADDRESS AND PHONE NUMBER: IF FILING BECAUSE OF SEX, THE REASON: ✓ Harassment Pamela Pitt 415 291-9251 _ Orientation _ Pregnancy Denied Right to Wear Pants 22 Battery Street, Suite 1000, San Francisco Other Allegations (List) DFEH-300-03-1 (01105) ?&d Signature Date Department of Fair Employment and Housing State of California o 7 tP r Q; .Y n pv Ln i 4 tea Oj 33.p tw1 n ©cS _- Fs !p Ln Ln LU W r C - O =-G m G� in CD om. 1 c� w co, 9c+ � m - 0 aN M CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: q ( ILA p-j- Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorserne tits, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to California Government Codes. 61 1 EE �c) you is your notice of the action taken on your claim by the Board of rL�F�;:�OIAR 1 ;ir 2Q07 Supervisors. (Paragraph IV below), given Pursuant to Government Code (pq qq COUNTY COUNSEL Section 913 and 915.4. Please note all AMOUNT: J(?, MARTINEZ CALIF "Warnings". CLAIMANT: l—Y2 JOCLl IILWO�\K) p- ATTORNEY: DATE RECEIVED: glut{ ADDRESS: 5430 0-4 1ER-I LLD S LA)- BY DELIVERY TO CLERK ON: `-1.�C1�► Ia r�W� a, p,1 t BY MAIL POSTMARKED: ach FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claire. ` JOHN CULLEN, Ciee-k Dated: 1 t1� VC k� r By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Supervisors (4This 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). O Other: Dated: By: 11 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. ( ) Other: I certify that this is a true and cor7-ect copy of the Board's Order entered in its minutes for this date. e' Dated:i /- a-9,AW,,2JOHN CULLEN, 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 wail 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 widr 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 1.. 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. a Dated-4?--//4f,- JOHN CULLEN, CLERK By Deputy Clerk COVER LETTER TO Attn: Clerk of Board of Supervisors Room 106 County Administration Building RECEIVED 651 Pine Street, Martinez , CA 94553 FROM MAR 1 9 2001 Gregory Kushner 5430 Cabrillo Sur CLERKCC,j-F,,COSTACO.�SORS El Sobrante,CA 94803 (cell)510-501-9596 This package include the following: 1. Filled Instraction to Claimant 2. Additional Sheet "A" : How did damage occur 3. Additional Sheet `B" : Full extent of damages 4. Copy of Hertz rental bill 5. Copy of Car expanses 6. Copy of Insurance settlement 7. Copy of Insurance payment for car rental 8. Copy of Insurance payment for car total loss 9. Copy of replacement car registration 1 e i J �� 6 -0 BOARD OF SUPERVISORS OF CONTRA.COSTA COUNTY INSTRUCTIONS TO CLAIMANT 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.) 4. 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. 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. �. 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. ■1111 sun a■■■1a11111 a a M;Is ■■■a l a a. mata■■a laatlalalit■1l as lal■1 ama1 RE: Claim By: Reserved for Clerk's filing stamp R E® Against the County of Contra Costa or ) EMAR 9 2007 CLERK BOAT' ''GRVISORS District) CONT;... .....:CO. (Fill is the name) ) The:undersigned claimant hereby makes 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. When did the damage or injury occur? (Give exact date and hour) At��ttir� S7A AM 2. Where did the damage or injury occur? (Include city and county) Sh-�J PA-1'1>L,0 DA-M (LOA D ) C,OtAT� 3. How did the damage or injury occur? (Give full details;use extra paper if required) � r 4. Whatparticular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? 5 What are the names of county or district officers,servants, or employees causing the damage or injury? CCC Pu��r � WOCIL DC-Ph What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. -Attach two estimates for auto damage.) 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) « r, 8. Names and addresses of witnesses,doctors, and hospitals: Nom r - 9. List the expenditures you made on account of this accident or injury: DATE TIlv1/Ey��� AMOUNT J 1. i...r_�, Ia"RA✓K S.�Y'7/1 _� J� 0.-) -7 llz-1 iV-o�] 7 i2�oo� 7 �2,SZo-7 ciM'L p✓�'cGv�s'a�•- ,,S^�'�� •'rk���e6 - � > 1178�5g 7C/NL ►v�.4�,�T/�//Micc- �r _i.oss � 2�v-7 > 4�� :7�Nsvr�� P✓�-u�,�►+., �3 �� ■ ■Y t t t amp t Exam■■[as an■■■■ ■ t;Al■■[■■[Ina is t It■t■■■■■t MEN t■ass■Ina t[■t[■t■■ass l[t■■[t[t t[■1 } .Gov. Code Sec. 910.2 provides "The claim shall be signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attomev) ) Name and address of Attorney ) (Claimant's Signature) (Address) } S 0h r/-7 51t,12 -- -L12 Telephone No. )Telephone No. t,■MEN■1[■[t■laws SEES■■all[■ ■ name■■![[[■t[[[[■t[[[ltt[[[[■t■■■[t[■[[■t[man■MILK Runs l[Mal 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. ■ wave was■■■■■[■■■t■masks■ ■Mal ails Susan■■■[■f!■t[[[[[t■[[■[t t[[[[[[[t[[[\[t us t Mason East NOTICE: Section 72 of die 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. FULL EXTENT OF DAMAGES - SHEET "B" 1. TOTAL LOSS OF CAR ( Infinity , I30, 1997,Car value($6972) - $500 deductable = payment $6472). Value lost : $6972.00 Insurance payment: $6472.00 Loss: $500.00 2. Rent of car till bought of replacement car(insurance payment) Value lost : $387.00 Insurance payment: $387.00 Loss: $ 0.00 3. Insurance payment $6472 , was not enough to buy reliable replacement car. I was forced to buy more expansive replacement( Infinity I35, 2004). I could not find the same age car with good service history. Value lost : $ 17,800.00 Tax: $1492 Insurance payment: $6472.00 Loss: $ 12,820 4. I bought Infinity I30,1997 at 4/2000. It had 11,300 mileage. Each year I paid for service, so I can have a reliable car. For example, in 2006 , I spent $1378.99 for service. All this was lost. Value lost : $ 1,378.99 Insurance payment: $0.00 Loss: $ 1,378.99 5. Due to this accident, my insurance will go up. At present time , I have good driver discount. I never had an accident due to my fault. My estimate that my insurance might go up as high as $800 a year for many years. At present time , I pay $1126/year. Expected future lost : $4000 Insurance payment: $0.00 Expected future lost : $ 4000 TOTAL DAMAGES $18,698.99 HOW DID DAMAGE OCCUR - SHEET "A" Attn: Contra Costa County, CA,USA From Gregory Kushner 5430 Cabrillo Sur EI Sobrante,CA 94803 (cell) 510-501-9596 Every morning, to avoid traffic, I leave my house around 5:35am and go to work. First, I drive from my house to gym, exercise, take shower and second, go to work. My work is in Fremont, Ca. My gym is located about 7 minutes from my work. I drove from my house, made left on Castro Ranch Road, and made left on San Pablo Dam Road and went in direction of Orinda. This San Pablo Dam Road becomes Camino Pablo Road. After I made a left On San Pablo Road, I saw fog, so I slowed down and drove at speed between 30 and 40 mph. Speed limit on that road is 50mph. After I drove about eight minutes, my car went into a spin and I hit the fence on the road. After I hit the fence, I slowly (5mpr) drove to Safeway parking lot( safe place). This car could not drive faster , because wheel was not working properly. Next , I called to AAA. AAA agent , Petrisha, gave me claim number and made a reservation to car rental. After , I got a rental car, I needed to do the following 1) Transfer my car to body shop 2) Take shower and go to work. I drove back home, took shower and went back the same road that I drove at 5:40am. At loam, I saw many "ICY" signs on Camino Pablo/San Pablo Dam Road . This sign was not on the road when I drove at 5:40am. I lived in that house since 1989 and I never seen ice on any road in this area. Conclusions: I)In spite of the fact that I drove car below speed limit, my car went into a spin on icy road. 2)If Contra Costa County had "ICY" road sign , this collusion will never happen. I know how to drive on icy road, because I go to Lake Tahoe to ski and I never had an accident. I have very good driving record. I never had an accident due to my fault. At present time I have good driver discount. Q� V Hertz #01 RN RR 168176631 GREGORY KUSHNER GC VEHICLE 0129811295559 Q CLS.0 07NCOA LIC:CA 5UJVY897 FUEL: 8/8 OUT 818 IN as 1� CDP:XXXXXXX RES D53118097421MCLW /C - PREPARED BY: 4321/CABLE01 COMPLETED BY:4321/CABLE01 RENTED: 01117107 08:13 BERKELEY RETURN:02101107 16:22 MILE-ALBANY N PLAN IN: MCLW RATE CLASS: C PLAN OUT: MCLW MILEAGE IN 8932 TR-X MILES �- kA MILEAGE OUT 7410 MILES ALLOWED 0 MILES DRIVEN 1522 MILES CHARGED WEEKS 2 @$ 179.99/WEEK $ 359.98 EX DAYS 2@S 35.00 1 DAY $ 72.00 SUBTOTAL 1 $ 431.93 J DISCOUNT- R 10% $ 43.20 J — - SUBTOTAL2 T$ 388.78 .�� LDW DECLINED LIS DECLINED Q PAI,PEC DECLINED TAX 8.750°k ON TAXABLE TTL OF$ 388.78 $ 34.02 MISCELLANEOUS ADJUSTMENTS $- 35.00 CHARGED ON VISA )0O00CX)DOO=9630 S 387.80 t RENT FP VISA XXXXXXXXXXXX9680 HOW WAS YOUR EXPERIENCE? WE'D LIKE YOUR FEEDBACK. 1) Call 1-800-278-1595,or Visit WWW.HERTZSURVEY.COM 2) Enter Access Code:07281 3) Take Brief 4 Question Survey STATEMENT OF CHARGES- NOT VALID FOR RENTAL ATTN: Contra Costa County From Gregory Kushner 5430 Cabrillo Sur El Sobrante, CA 94803 (cell) 510-501-9596 My car expenses for 2006: 1) Factory service: $505.99 2) Repair (Speedo): $406.99 3) Engine Diagnostics: $78.00 4) Replaced Battery Terminlas: $48.04 5) Replaced Battery: $89.97 6) Car cervice: $250.00 All total: $1378.99 I N F I N I T INVOICE - CUSTOMER • • This form is an itemized list of repairs and is Peninsula Infiniti part of the original Repair Order. This Repair Order Continuation is subject to all of the terms 386 Convention Way and conditions of the original Repair Order. Redwood City, CA 94063-1405 Page 1 Continued on next pag Phone: 650-369-4000 :.:.:..........gar..l:. r................................ Fax: 650-569-4235 00204 :..........................:................................:•. It is the goal of everyone at Peninsula Infiniti v GREGORY KUSHNER to achieve a passing grade.We strive to provide v 5430 CABRILLO SUR you the best possible service.If you feel we have g RICHMOND CA 948033872 excelled in our goal,we would welcome your input. a U If you feel we have failed to reach our goal, u Thank a .:....::.::::::....... •::.::.::.::::..:::::..::.::.:::::::::::.:: :�:y:.::::::::::::.:.::..::..:::::::::.:.:::..:::.:::::::::....:.::::::..:..:.:.....: .: :....:..................::.::................:.::.::............:::::.:...:::::.:::.:::•::....:::::::::: .>iI�B�:•:��. � ..:..,,:� 3WIiSB.�IS.•:.�. ...... F..::•: '}'�13Y.:. •:.;;?;;:•. :�::,:-;:.:'�� �:: •.:::.:::::�r,•::. .......�:y.,.,y.,: � :..:. »: Mt2 W :............................... :....4n! ................. ............. ...................:::.:::::::::::::::.::........ ...... �:5::;>;';::::;iS:;::?;:£2;::: I�i;a'+.�.P.�Fa:�:�::•::.•.���.�.•I�.�.A..•t�.SFf:?:i:::::: a IN 130 97 158,193 Bei g JNKCA21D4VT 507639 2/28/97 .... :s:«:>:::>::»: >':: >::::.::::..:.. alb::iia::::::::::::»:':::»:>::: : ISA.... a KUSH01 KUSHNER GREGORY 510-771-2226 0000 510-262-9596 0000 a .;:.;::.::::::.. ............ :: :;.;:.:::#,fin: .�� .t.�t�:. �msce..�,.:t 1i3 �•::itiaEE:�z:: ::?:::>::>:::>>::>?:::>:>:>::?:':?: >`:<:<: : .. >;»»>:.............� .......... . ...!Edi''. ...,......! ?!::9P ...�........... � .....................................:dei�a..e...:......a..s�:::.:.:::.:.;:;;:.;:.;:.::::::::::;;:<.;:.;:.;;;:;.::::::;:4?�►>1:: ..................:...... ......:::::............. .:::. ...:... .. .:.......... ....., .... .................... :......... r::wor9r»• �;tess': i;ktn:.3 ::dsflre a BRADLEY NORMAN REID o, ;:.:::::::.,..::::::.:.::::.:.:::::::::::::::::::.:::::::................:.......:..::.....:...................... :;::.:%':';`;i:::;'�`..::: :; ;:;::`?i:":?::.: •?'•::':.:83 :;:> :..:::::: ..::::••:.':: O': ?<�: . ate:;::;;;.<.:;. •;:•r::::•::•:: :. :::::.>;:.;.: ;• :..:..::.............. ...:............ ..:.........: :............ ....:....:.... ......................... .................... ::.I*s •.:... "ar .;;<>:.1IIrk:..:................:Eaik+�....:.::: foe::: . 3044 No Yes 4/05/06 4/05/06 17:00 4/06/06 01 30000 MILE FACTORY SERV PERFORMED 30K SERVICE AS PER ATTACHED SCHEDULE. Add-On? Tech Labor 30000 MILE FACTORY SERV-FM030 No DKANJI 289.37 Customer Includes:PERFORM SERVICE PER MENU-FPI38 Oil & Filter Disposal Fee-9HAZ1 TRANS. FLUID DISPOSAL FEE•9HAZ2 Parts Qty Each Parts WASHER-DRAIN-11026-01MO2 ASR 2 1.08 2.16 Customer FILTER OIL-15208.9E000 ASR 1 6.95 6.95 Customer ELEMENT ASSY-AIR-16546-OZ000 ASR 1 16.95 16.95 Customer MOC FUEL INJ CLEANER-01061 1 5.95 5.95 Customer PARTS CLEANER-10081 1 2.95 2.95 Customer MOC W/S WASHER FLUID-61131 1 1.49 1.49 Customer 5W30 QUAKER STATE 0-001 4 1.99 7.96 Customer QUAKER-STATE MV-ATF-002 4 2.59 10.36 Customer Expenses Expense Oil & Filter Disposal Fee-WOF 1.30 Customer Transmission Fluid Waste Disposal Fee-WTF 1.04 Customer 02 LOAN CAR RETURN EXPENSE Add-On? Tech Labor LOAN CAR RETURN EXPENSE-LOAN No No Charge Customer Includes:Late Fee @ $95.00 per Day-LATE .r 03 DETAIL DEPARTMENT SERVICE I.L Add-On? Tech Labor DETAIL DEPARTMENT SERVICE-Y9999 No No Charge Customer 04 LOANER CLEANING/REFUELING N Add-On? Tech Labor qlp CLEANING/REFUELING $5.00-FUEL No No Charge Customer ExCLEANING/RE-FUELING enses 5A� .00 Customer Expense FUELI�` VEEP�S �i,� 05 CLIENT STATES THESE LIGHT IS ON. CK AND ADVISE. FOUND OPEN CIRCUI THE SPEED SENSOR WIRING IN THE SPEEDO h t-T eIr HEAD. ESTIMATE IS $406.99 PLUS TAX. CLIENT DECLINED. Add-On? Tech Labor Diag-Check Engine Light-EI145 No DKANJI 150.00 Customer Page 1 Continued on next page SERVICE DEPARTMENT HOURS:7 AM TO 6 PM PARTS DEPARTMENT HOURS:7:30 AM TO 5 PM STORAGE CHARGES COMMENCE 48 HOURS AFTER REPAIRS ARE COMPLETED. Original Estimate Total Revised Estimate I acknowledge notice and oral approval of an increase in Customer acknowledges receipt thereof. the original estimated price. $ $ CUSTOMER SIGNATURE x X CUSTOMER SIGNATURE InvCCZEEE (9)2092 Wom Ono mltirmwica.Inc. Invnlrl..FFF AZI N F I N I T INVOICE CUSTONIER • • This form is an itemized list of repairs and is Peninsula Infiniti part of the original Repair Order. This Repair Order Continuation is subject to all of the terms 386 Convention Way and conditions of the original Repair Order. Redwood City, CA 94063-1405 Page 2 Continued on next pag Phone: 650-369-4000 ;:;:;<;;;:;;::.::.;:.;:.;:....:..::;:.:::., .::::r,::;.;.::..:::;:»»::>::>::::»::::::» :: Fax: 650-569-4235 00204 It is the goal f everyone at Peninsula Infini• o GREGORY KUSHNER to achieve a passing grade.We strive to provide a 5430 CABRILLO SUR you the best possible service. If you feel we have o RICHMOND CA 948033872 excelled in our goal,we would welcome your input. If you feel we have failed to reach our goal, a .....:::.:::a. ::....:::: ::::::.:::::..:::::.::.:::::::::::::..:. . :.:. .:..:..::::..::::..:::.:::.::.::...:..:::::.:::::.::. ..Ale.......... ............... ................. .............k.ThanYou .... .........:::.:.::................... :.:.II ::Y 3es•::•::..: ::No :: atea eta:::<::::,.. ; " ::: ............ W ar:<.;:....:....................I s .......,.............. .:. io <.;... Iia.: ::>::>:::::»::>:::::::>:::::>:»::>rr ar< :.. cc IN 130 97 158,193 JNKCA21D4VT 507639 --7.777.......................:.:...........:................................. ..........::::::::::.:...................:.::. ..::........ ....::::.:. ;:.:;;+Ott.....+ .. ................................. Qt:;; :<.....:;.;;;:.:>:::.;;:.;;;:::.>:.... . tai•:>;;;;.;:.;.; :.. : :........... ................::>:: ......::::::.:::.,:.............:..::::::.::.:............:.::.:::.................................... a KUSHNER GREGORY 510-771-2226 0000 510-262-9596 0000 a ::.::::.::::::::. :::::..::.::..::::....:::::.::•:..::::::::::::.:::.:::•::::::::::::::::::..::::::::::::.:.:::......... ..........:...:................:::....:........ ...........:................... .... ... :. .. ..:.:.:. 1. ::.. stszu: ........�tt4i '..::...:f:f ...........:::�.......:::..... .........:..... ...... :. a BRADLEY NORMAN REID e:woFsa;ei m :..................:::..:..::::::::::::::::.::::::::::..v...........................:..:...:::..........:........... 06 FORNISH ESTIMATE ON REPAINTING FRONT BUMPER AND REPLACING THE LEFT FOG LIGHT ASSY. ESTIMATE IS $502.52 PLUS TAX. CLIENT DECLINED. Add-On? Tech Labor MISC REPAIR ON VEHICLE-Y1000 No DKANJI ***** Dealer X 07 WE RECOMEND REPLACING THE FUEL FILTER. ESTIMATE IS $125.98 PLUS TAX. CLIENT DECLINED. Add-On? Tech Labor Client Declined Repairs-D Yes ***** Dealer 08 WE RECOMEND REPLACING ALL 4 STRUTS. ESTIMATE IS $1365.25 PLUS TAX. THIS INCLUDES AN ALIGNMENT. CLIENT DECLINED. Add-On? Tech Labor Client Declined Repairs-D Yes ***** Dealer 09 WE RECOMEND PERFORMING A FUEL SYSTEM CLEANING. ESTIMATE IS $139.88. CLIENT DECLINED. Add-On? Tech Labor Client Declined Repairs-D Yes ***** Dealer ^ 10 WE RECOMEND PERFORMING A POWER STEERING FLUSH. ESTIMATE IS $89.88 PLUS TAX. CLIENT DECLINED. Add-On? Tech Labor Client Declined Repairs-D Yes ***** Dealer 01 PERFORMED 30K SERVICE FRONT BRAKES 7MM, REAR BRAKES ` �0 8MM, TIRE TREAD DPTH, FRbNT TIRES 4/32, REAR TIRES 8/32, LL 1►) SET TIRE PRESSURE TO 32 PSI, ROTATED & BALANCED THE TIRES, TORpUED WHEELS TO 85 LBS TESTED THE BATTERY TO 14.25 VOLTS, TESTED THE AC SYSTEM TO 45 DEGREES REPLACED THE TRANS FLUID, REPLACED THE AIR FILTER, LURED DOOR HINGES, tA WINDOW SEALS, SUNROOF SEAL ROAD TEST THE CAR IS VERY [f � BOUNCY, RECOMMEND REPLACING FRONT & REtAR STRUTS & BOOTS, THE OIL PRESSURE SWITCH IS LEAKING, THE WIPER INSERTS NEED REPLACING, RECOMMEND FUEL, POWER STEERING & BRAKE FLUSHES CHECKED FOR THE CODE HAD CODEP0500 FOR THE SPEED SENSOR, TESTED THE SPEED SENSOR, THE SPEEDO HEAD NEED REPLACING Page 2 Continued on next page SERVICE DEPARTMENT HOURS:7 AM TO 6 PM PARTS DEPARTMENT HOURS:7:30 AM TO 5 PM STORAGE CHARGES COMMENCE 48 HOURS AFTER REPAIRS ARE COMPLETED. Original Estimate Total Revised Estimate I acknowledge notice and oral approval of an increase in Customer acknowledges receipt thereof. the original estimated price. $ $ CUSTOMER SIGNATURE x X CUSTOMER SIGNATURE InvCC2.EFE 0 1999 Moore North America,Inc. InVnIrI..FFF I N F I N I T INVOICE - CUSTOMER COPY Thisform is an itemized list of repairs and is Peninsula Infiniti part of the original Repair Order. This Repair Order Continuation 1s subject to all of the terms 386 Convention Way and conditions of the original Repair Order. Redwood City, CA 94063-1405 Page 3 Last Page Phone: 650-369-4000 ;::::::«.;;::;:.::;:.;:.;::.;:::...;:: Fax: 650-569-4235 00204 _ f ....::................ It is the oal of everyone at Peninsula Infiniti v GREGORY KUSHNER to achieve a passing grade.We strive to provide 5430 CABRILLO SUR you the best possible service.If you feel we have o RICHMOND CA 948033872 excelled in our goal,we would welcome your input. cal If you feel we have failed to reach our goal, a 501 ..:::: .;....::•:::. :....:::: ........................................... .......0 .....a.k.Y .I a ;; ;;.. ................ :•:.. ::.::•> #;lit ::� :;:: ;. IN 130 97 158,193 JNKCA2164VT 507639 :::�3 :.1ata�.: ;:; ::;.; ...............................::.:.............. ........... .:::. �::: a KUSHNER GREGORY 510-771 2226 0000 510-262-9596 0000 a .::::•::::.::::• o...::.:::::::.:::::::::.:::::::::::::.:::::::::.::.:::::::::.:.:::.::::.:.. . ........... ::;:::;:;::::,:�AIiHQQ::.. fti!<t�::::::::::::::::::::: ;<::::::::;;::R::;:;:;:;:;:;:;s:::::2::::::::;;t;:> ;: :::::::...........::::.::::::: ::.::.::::.::::::::::::::.,:::::::::......::::::.:::...::..:...::::::::,....................:..:.................::.::::::::....... ..:......:........;. ..: :........ ..... ...... ..:........:.......... .t#m�;ior..>�oyr:;wn�k><�!p►;:ii�dr:::�!'$�::z�Y.:3�!�ra�O!s::#>�;:!.s.!er@:sx�r::!ess:: a BRADLEY NORMAN R E I D tsies: eii +aF ::; : : m * Totals Amount * Labor......... 439.37 * Parts.. .. ... 54.77 * Expenses.... .. 7.34 * Tax.. ...... 4.51 * Total. 505.99 Customer Page 3 Last Page -117 PENQISlLt 1:1-47=1 REEWOO 7 941063:=lt:�ll lei i?L 210! 7i' Q /t;6r''G'9Gh 7.-44? 4-- lf; 1 :. TRANS. 1G. 1764:967c?C�9� 1:1 :J1 '_CE ()0r. I4E1. Iq@2 .:, 6: Sf- :'US s Os 1ER COPY SERVICE DEPARTMENT HOURS:7 AM TO 6 PM PARTS DEPARTMENT HOURS:7:30 AM TO 5 PM STORAGE CHARGES COMMENCE 48 HOURS AFTER REPAIRS ARE COMPLETED. Original Estimate Total Revised Estimate I acknowledge notice and oral approval of an increase in Customer acknowledges receipt thereof. the original estimated price. $ $ CUSTOMER SIGNATURE x x CUSTOMER SIGNATURE InvCC2.EFE 0 1999 Moore North America,Inc. InvDIrL.EFE I N F 1 N I T I INVOICE - CUSTOMER • • This form is an itemized list of repairs and is Peninsula Infiniti part of the original Repair Order. This Repair Order Continuation is subject to all of the terms 386 Convention Way and conditions of the original Repair Order. Redwood City, CA 94063-1405 Page 1 Last Page Phone: 650-369-4000 4iiY:i::iS:4i:'+i:itriY:: '::i::iiR::::.Y.l ?is{:'::11•]•iFY:::airy^:::}i'.:':::'::::::::: Fax: 650-569-4235 00538 Reprint >: Itis the goal of everyone at Peninsula Infiniti o GREGORY KUSHNER a 5430 CABRILLO SUR to achieve a passing grade.We strive to provide v you the best possible service.If you feel we have oRICHMOND CA 948033872 excelled in our goal,we would welcome your input. J U If you feel we have failed to reach our goal, *` please con -4 .Thank You! a .,...:.:•:•:,:.................................:...:.:................................................................................................:. ............:..................................:.:::....................:.:..:.:::: ::::::..::: LU 1 ............Bar: tc«::...... co v IN 130 97 158,648 Beig JNKCA21 D4VT 507639 2/28/97 t>: >:::<: ;<;>::::>::::;:>:«:<:::>::::>::::>:<:::;»:>::>: ::>:<:::>:::;:::>::>?>::::i >::>::::>::>::;:>::? 7;>::>?:<:.......: ........:::rIO'.>:::»::::»::::i::>::::<E......sio`::>:::<>: ue..,......::: ......�.N'.: <:< :>:'::> .xtei�si [Y:'::::>: Na.::::::::......:::.:..............:.... IAe....................:........xteM.....n:::.:.................... ::Plick...................:..:::...............:..:.:::. . ..:.::..................:.:............... a KUSH01 KUSHNER GREGORY 510-771-2226 0000 510-262-9596 0000 i::{.:�::i'.�:::::::::.:- ............: .......{. .... .:::y'::.:}'.;;.}::::::::ii.....i::::::.viiiii:4ii:itiv: ......} :....:::.:::.:'ii^ii;::: .. .;``.�...... �,:♦♦ ..:.. .... .,.1. ,y �y yy :::;;:# i6:tih3r. $:t7t '.�JIOJI �.:.C::tktE:Ern�i}fii:X.i:F , : .wiiU:J.:' .:.:::.:::...:::::::::::.�::..: CXif.ECB.:.....rt6ti1E8E1>f:::::::::.:::...::::::: ..::::::::::::::::.:.:: i9bDI;:)f .:::::.:::::.:.:�:: :...�: ..::.�:•..:.::�::!? .....•.:::::,.::::::•......::.: .............:. :.. .................. ma ¢ ac3uef;;tans:;Eor;yofir:wnEtr..::..:.t.:o......gss.:: Y;3her..:.:: a BRADLEY NORMAN REID ► :??e:auar:>i'ra:a+akd::arallaF:tgay:s? eateti::gii?4? Qs>>:>?:» m .....::.::::::::::::::::::::::::::::.::.::::::::::.::::::::::::,.......:::::::..:..... :..::::::::.......... ::::...:.::.:.:.:.:.:. '....... ...... .....:........:.....:....:.:.:.::.:..:..:.:.:.:::.....:.:.:.:.:.:.:..::..:::.::'..:.:::. : : : # -W. k ....................:3149 > . 4/18/06 4/18/06 17:00 4/21/06 01 REPLACE THE SPEEDO HEAD TO CORRECT THE SES LIGHT. $406.99 CALIBRATE SPEEDO. REPLACED SPEEDO HEAD AND CLEARED CODE. RETEST. PASS. NOX CODE NOW APPEARS. CLIENT IS AWARE OF CODE. Add-On? Tech Labor Diag-Check Engine Light-EI145 No DKANJI 168.70 Customer Parts Oty Each Parts SPEEDOMETER ASSY-24820-40000 1 211.99 211.99 Customer Expenses Expense Oil & Filter Disposal Fee-WOF 1.30 Customer CALIBRATE ODOMETER-510 30.00 Customer 01 REPLACED THE SPEEDOMETER & RECHECKED, THERE EXISTS A KNOCK SENSOR CODE THAT THE CLIENT IS AWARE OF AS IT WAS PRESENT DURING A TEST MADE AT AN OUTSIDE REPAIR FACILITY AT C� THE CLIENTS REQUEST AFTER WE HAD DETERMINED THE SPEED SENSOR Q (SPEEDOMETER HEAD ASSY) NEEDED REPLACEMENT. THE SPEEDOMETER HEAD REPLACEMENT CORRECTED FOR THE "SERVICE ENGINE SOON" LIGHT BEING ON. A KNOCK SENSOR CODE WILL NOT CAUSE THE "SERVICE ENGINE SOON" LIGHT TO COME ON. ( E * Totals Amount * Labor. . . .....: 168.70 * �� * Parts. .......: 211.99 * �✓ * Expenses... .. . 31.30 * v + * Tax. . ..... 17.49 * Total.... .. : 429.48 Customer PFNINSJLl' INFIN..-ii :;86 CO`dENT701'' Y r l.iA {Fi_1fJllOC1 CITY, CF:' c.4;9C,3 j';s,\kx •'' '� Otf4/27/Z;V10V5 13J:/23:SE�f � INVOICE @@2 tiUTtl, til e:: x'-1.1:l SALE TLT AL :>;!;:::'.`.::1 .. {•!is j CLI.STO-'.1ER CII ?' CE DEPARTMENT HOURS: 7 AM TO 6 PM DEPARTMENT HOURS: 7:30 AM TO 5 PM :OMMENCE 48 HOURS AFTER REPAIRS ARE COMPLETED. fledge notice and oral approval of an increase in Customer acknowledges receipt thereof. ial estimated price. x I SIGNATURE x CUSTOMER SIGNATURE InvCCZEEE d 2909 wagm awttwwinwrica,Inc. InvDIrL.EFE AUTO CARE 2000 3405 Clayton Road INVOICE Concord, CA. 94519 49580 Phone-925-288-1500 Fax-925-687-3088 Org. Est.#012061 AE227698 QUICK CONVENIENT SERVICE! EPA#CAL000287865 INVOICE Print Date : 04/11/2006 1997 Infiniti - 130 Kushner,Gregory 5430 Cabrillo Sur Lic# : 4LNU996 Odometer In : 158360 EI Sobrante, CA 94803 Unit#: Home 510-501-9596 Vin#: Cust ID : 3426 Hat# : Ref#: Part Description /Number Qty Sale Extended Labor Description Extended Engine Performance/driveability failure diagnosis 78.00 (Check Engine Light On).We Scan an on board computer(If equipped)and run program to recieve codes from your vehicle's ECM.Diagnos system(s) from codes detected. Labor Upon Analysis due to check engine light or service �- enigne soon light,codes found&detected to be RIT- C(RE 20t;.) PO500 Knock Sensor, 0325 Vehicle Speed Sensor, E'4t95 CLRY T 0'd RI CbmcoI:i., CA 91-:'519 &P0600 Transmission Circuit Problem Ti-:iRMIMIL 0142.109- F,mal Ordered Part from dealer customer will call to 35E M41;E2E; replace parts or not. 04/_11/20CII3 ].3:11;:25 iiUTH. Tr is:i\IS. lU 09i10i7:��796;;76 01voir_E i)1-1T[,'. COX 02F;2/i•I l SALE 1 OTAL $7B CI.JS T O;,ER COPY v [T'echnicians:Emal, ; Amine-Jaan, ] Org.Estimate $78.00 Revisions $0.00 Current Estimate $78.00 Additional Cost Revised Estimate Labor: $78.00 Parts: $0.00 Sublet: $0.00 Sub: $78.00 Tax: $0.00 Total: $78.00 Payments-Visa-$78.00] 1 Bal Due: $0.00 FOR ALL YOUR AUTO NEEDS! I hereby authorize the above repair work to be done along with the necessary material and hereby grant you and/or your employees permission to operate the car or truck herein described on street,highways or elsewhere for the purpose to testing and/or inspection. An express mechanic's lien is hereby acknowledged on above car or truck to secure the amount of repairs thereto. Warranty work has to be performed in our shop only&cannot exceed the original cost of repair. AUTO CARE 2000 3405 Clayton Road INVOICE Concord, CA. 94519 53881 Phone-925-288-1500 Fax-925-687-3088 QUICK CONVENIENT SERVICE! Org. Est. #021247 AE227698 EPA#CAL000287865 INVOICE Print Date : 12/09/2006 1997 Infiniti - 130 Kushner, Gregory 54.30 Cabrillo Sur Lic#: 4LNU996 Odometer In : 173154 EI Sobrante, CA 94803 Unit# : Home 510-501-9596 Vin#: Cust ID : 3426 Ref#: Hat# : $48.04 Part Description/Number Qty Sale Extended Labor Description Extended TWO NEW BATTERY TERMINALS REMOVE&REPLACE BOTH BATTERY 20.00 AC2-786786 2.00 12.95 25.90 TERMINALS LABOR s t"'t I....I. ;,_ti E..l t"c i" €i]}" i CA-R£ 2,300 241114. i;Ayr;i.ie RD . Y;XXX''X°:X':XX9620 up 1 � /� N — Cl STUNirR [Technicians:Shahpoor, ] _Org.Estimate $48.04 Revisions $0.00 Current Estimate $48.04 Additional Cost Revised Estimate Labor: $20.00 Parts: $25.90 Sublet: $0.00 Sub: $45.90 Tax: $2.14 Total: $48.04 [Payments-Visa-$48.04] _ Bal Due: $0.001 FOR ALL YOUR AUTO NEEDS! I hereby authorize the above repair work to be done along with the necessary material and hereby grant you and/or your employees permission to operate the car or truck herein described on street,highways or elsewhere for the purpose to testing and/or inspection. An express mechanic's lien is hereby acknowledged on above car or truck to secure the amount of repairs thereto. Warranty work has to be performed in our shop only&cannot exceed the original cost of repair. Written By: shop au o _ accessories anytirr CUSTOMER INFORMATION I[r TAG N YPICI,EJ ff,QRMATION _yE MAKE,(MODEL .. INITIAL ESTIMATE REVISED ESTIMATE CREATED BY NAME: • r'1-•!'r':�F'.. JfiS,":L7:.I _tl if••!�t� i��� ... :"�ii.r ..:`:� Chi r. t. 7e•u:�L G•.''it s.ir.:'y'.i r. " :r. ADDRESS: LICEN$EA COLOR PARTS _ -. 'Gel::si?': .i ji�i .._ ��1;_:! x'11.•�': CITY/ST/ZIF r; � LABOR HOME PHONE'•". " 7" V.I.N. :LOCATION j(i INVOICED BY ^; OTHER ST gP INFAEI1�PT10N TIME IN r TAX TIME OUT if s: ;1 . .. :: . ° �,:.ti_ -. � r :i ., t,a.• •y r, ;.., wi!�. :c::.:i .:`: .=.!? t�.+'.:. ,ri;iLi TOTAL I. _ ODOMETER IN ODOMETER OUT IC."'.T�d t• DATE/TIME OF ESTIMATE DATE/TIME OF REVISED PAYMENT TYPE CASH ER :fist".Jyi' j. +� - CREDIT • CHECK +'r,I !:-!+; !•;)t-'" .,;;ir5:r:: _:•-�Ir�•= TIRE INSTALLATION INSTRUCTIONS LOCKS PHONE AUTHORIZATION❑ PHONE NUMBER CALL its `'SC' LF --------FRF SP BW l� !'r�i :.:;N I I ROWL CONTACTED BY DATE TIME Y:r;: SAVE _ i_.__ TLR ----- RR OLD Y ` l N 'C._ TIRES u CUSTOMER COMMENTS n.,(tIFjPAf-SSLURE F.11 /-REAR See reverse for important warranty terms and other information. }; F1L.`OROUESPECIFICATION T4p,•5t:',VJ i�li:�l?;''I;;f7 QTY .t L _'t::.�� J`Y J� r' Ti::!1' L:: •d'T!, r_ ION TECH. t. iY,: f ^ ^i_U:a sxi l :I&.,' _ ESjQd SIA M: v. a R"_ yy` r 4 IAIV110, _,`1. v 3 C`:r:�' S:"_� iiTE _,•. v ._. a tW^ _ _ t ---------------------------------- ALL ..r .,.. .,,..ALL NEW,NON-OEM PARTS UNLESS OTHERWISE SPECIFIED. _ .. IC ITEM/WARRANTY INFORMATION/CSA COMMENTS/TECHNICIAN COMMENTS "a, ltEt:sE. .:L.-II, fly.4 �l+ �'rR ` rl•'.,' r.11---rr '+ +ms's' y,,_!••.. _ y.1:,::l' .. i:� E r,.ly Iq :.tt7 .. ;t_:75 : _ :ltiK r i'• iii rsS-.. :'N:' T„ tY4: rt:~� Be !L�S::::'u: :t1� !-f_r_,_.,. _ '•.h^' ��:�' .l `i .. :iJ .___.._ ':tii' s.... _.....- _..3_ r........._. �.... ._:rl~•'• I':�in _ '" ^ili -�i•� r'P'. _ rti C: �_ _ .'r; _ _ r!.L T,.',.. - � P,r'•`+ rKh`4 dlj k. 'ilii .�': T-; _ ..! T:?.Y11 Y :F,;-, _ _ � ^`1.'_ _ f.1'.�_ _e-!'.. _. _uf owr 'i 3_ h P1 ,( T LN.-URE: RE: .. A,, E't >; - rI �lY7eTr lJ'iii L U. 7!i iL. itt.. !iL'� ;•i: il SLI`.•.•td'!k`, :.C. -�3L:ly lei.. Citi tl[r:. 1r;:AT_tn=Tp:� r•1: CRAPS,7ta„ ,.T f. ^•�:1=S'.� _ T- vr�li nFr: r�7Yti�={Jr.•(:x; ��.S.r. [ >.r!:• - • LE:-r•13±' '31 AT1�SI6 t4l t ",.APS,, NERVIM ALJLJ! .�•tL9b It Clf t!vl..r.:a i_'t l��,l iai•5 � ''�I:affL LIY' t�[JTLIIe IG�Ti: �1J:�it'.(1s•1Ll _(.���t�ec,f: ��•1lI::tL.:.✓L•.''.�l S��'i�f_Y {{ T:'•i" f: 'J,1 !`::�,•!• ti TA' �; iy.d .I. INS'i ��� P3. _.sIF 11� i:f ��iYi i.?:•;.r.�, -`:,.lf_��,.^ e fl•l^� fl_L•riLhi. i:LEHii C rr ENEPS, .:.Wt F .C!.s;ltr_. .�.10 iJ.' i ...ti TE � .. :i_Sr_Li. _ .l _ 1.� d .;M6 �1:•. >_r.: Gem Irl :Z�,r1LIl'il QP Fu''. _ _ RMhE iWIL "ter..lri 1:*^rj 1:'�'. URN --------------- Thank you forthe opportunity to serve you. - << ;i:':,, Our goal is to provide Fast, Expert Service. me cohand stecl<ing Fee may apply on returned Please keep us in mind for your future automotive needs. A 15%Cancellation Fee may apply on Special Ordered merchandise cancelled after 24 hours See Salesperson for clt4 s r„I_[l PAR'S"C-C. Id: 'OU ARE ENTITLED TO RECEIVE REPLACED AND REMOVED PARTS,OTHER THAN EXCHANGED OR WARRANTED PARTS WHICH WILL BE AVAILABLE FOR YOUR INSPECTI01 '0 OBTAIN FULL WARRANTY BENEFITS,YOU MUST PRESENT YOUR RECEIPT AND THE DEFECTIVE PRODUCT OR THE VEHICLE ON WHICH THE SERVICE WAS PERFORMEI 7451-National(Rev.10/05) r,'.ri n ir ' G ;.,_'1 �I.::,:lll '�hPY AUTO CARE 2000 3405 Clayton Road INVOICE Concord, CA. 94519 49598 Phone-925-288-1500 Fax-925-687-3088 Org. Est. 4 012093 AE227698 QUICK CONVENIENT SERVICE! EPA#CAL000287865 INVOICE Print Date : 04/12/2006 1997 Infiniti- 130 Kushner, Gregory 5430 Cabrillo Sur Lic#: 4LNU996 Odometer In : 158407 EI Sobrante, CA 94803 Unit# : Home 510-501-9596 Vin# : Cust ID : 3426 Hat# : Ref# : Pert Description/ Number Qty Sale Extended Labor Description Extended Fuel Filter Replace fuel filter 35.95 PEP-PYT-F43178 1.00 36.95 36.95 Remove and replace fuel filter. Inspect for leaks. High Proformance BG Power Steering 100%Power Steering Fluid Flush,We check the fluid 69.95 Fluid meeting OEM specs. level,inspect system for leakage.Our BG Machine PS Fluid(BG) 1.00 24.95 24.95 will throughly flush and break down all carbon build 3 Part cleaning system chemicals for fuel in its power steering lines,pump,rack and pinion, and intake cleaner and or gear box if required. BG 3 Part Chemical 1.00 59.95 59.95 100%Fuel Injection System 3 part fuel injector,BG 60.00 Fluid chemical and intake cleaning service.Clean gum and soft carbon deposit from fuel delivery components,throttle body unit,intake valves and inside combustion chamber. Labor This type of service has been improved to provide 0 ' even better clean-up in critical areas of the fuel and exhaust systems. These features gives your vehicle significantly improved performance,smoother RPM,cleaner operation and reduced maintenance costs. We help to keep your vehicle running strobger and longer. AUTO CA;E 2&4 ***Discount*** L;l :,Il $47.80 off labor alkoFC1, Y-A 9451-5 "s5��57✓�'4 j�8�? I + T!4'-IJ. LL': `rJTi I,,!i`OI-_'_ 00 k::1- +: sAI_f= TOT(-IL AUTO CARE 2000 3405 Clayton Road INVOICE Concord, CA. 94519 49598 Phone-925-288-1500 Fax-925-687-3088 Org.Est.#012093 AE227698 QUICK CONVENIENT SERVICE! EPA#CAL000287865 INVOICE Print Date : 04/12/2006 1997 Infiniti -130 Kushner, Gregory 5430 Cabrillo Sur Lic#: 4LNU996 Odometer In : 158407 EI Sobrante, CA 94803 Unit#: Home 510-501-9596 Vin# : Cust ID : 3426 Hat# : Ref#: Part Description/Number Qty Sale Extended Labor Description Extended [Technicians:Amine-Jaan, ; Shahpoor, ; Sayed, ; Emal, ] Org. Estimate $250.00 Revisions $0.00 Current Estimate $250.00 Additional Cost Revised Estimate Labor: $165.90 Parts: $121.85 Sublet: $0.00 Sub: $287.75 Discount: $47.80 Tax: $10.05 Total: $250.00 [Payments-Visa-$250.00 1 Bal Due: $0.00 FOR ALL YOUR AUTO NEEDS! I hereby authorize the above repair work to be done along with the necessary material and hereby grant you and/or your employees permission to operate the car or truck herein described on street,highways or elsewhere for the purpose to testing and/or inspection. An express mechanic's lien is hereby acknowledged on above car or truck to secure the amount of repairs thereto.Warranty work has to be performed in our shop only&cannot exceed the original cost of repair. V 1 California State Automobile Association Inter-Insurance Bureau PO Box 920 Suisun City, CA 94585-0920 January 26, 2007 Gregory Kushner 5430 Cabrillo Sur EI Sobrante, CA, 94803RE: Insured: (:iD Claim NumbeDate Of LossVIN: 3/x/0 7 Dear Gregory Kushner: This will confirm our recent settlement discussions regarding your claim arising from the loss identified above. As we explained, your vehicle has been declared a total loss because the-cost of repairs, in addition to the salvage value, exceeds the vehicle's actual cash value as it existed just before the accident. Because the cost of repairs would exceed the replacement value of your vehicle, the following settlement is based on the replacement value of a comparable automobile. In arriving at the Actual Cash Value of your vehicle we consulted with a computerized automobile valuation service that determines fair market values of comparable automobiles within your geographic area. A comparable automobile is defined in California as one of like kind and quality, made by the same manufacturer, of the same or newer model year, of the same model type, of a similar body type, and with similar options and mileage. Where differences exist between vehicles surveyed in the marketplace and your vehicle, value adjustments are made to account for such differences. Copies of the documentation used to establish the Actual Cash Value of your vehicle are available upon request. The following is a breakdown on the settlement of your claim, starting with Actual Cash Value described above: Actual Cash Value + $6,377.00 Tax + $526.10 DMV Fees + $69.00 Gross Settlement Amount: $6,972.10 Salvage - $0.00 . Deductible- $500.00 Net Settlement Amount $6,472.10 To Lienholder $0.00 To Registered Owner $6,472.10 Please note, this vehicle had 175616 miles on the odometer when it was declared a total loss. Please note, if you are currently in a rental vehicle, it must be turned in by 2/1/2007. This is our final settlement offer. Under the Fair Claims Settlement Practices Regulations, 10 CCR Section 2695.8(c), if you notify us within thirty-five (35)days of your receipt of this letter that you cannot purchase a vehicle for the gross settlement amount listed above, we will reopen our claim file. However, if you do not notify us within that time,.we will be under no obligation to reopen our file, and the settlement amount shall be final. Please only sign in the spaces marked with "Sign Here" indicators. It is not necessary for you to complete any other sections on the forms. Please return the forms in the postage paid envelope provided. If you have any questions, please call me at the number below. We also wish to advise you that since your claim is being settled as a total loss, please contact either your local district office or the member service center to discuss removing or maintaining coverage on the total loss vehicle. In some instances the removal of a vehicle from your policy may produce a return premium. However, there may be important reasons for maintaining coverage on the total loss vehicle and your sales representative or member service representative can assist you with that decision. To speak to your sales representative or an insurance associate please telephone your local district office or telephone 800-922-8228 to speak to a member service representative for assistance. If you have any questions or concerns regarding the settlement of your claim, please do not hesitate to contact me. Sincerely Sarah Powers Total.Loss Specialist 888-900-6520 ext 6041 (1) m Lit 71 'p, C7- (n 0 50 - -0 0 m C) pn -- W- C) M c) -n E �o Q C) 1") CD m rn 0 W m r, m 0 0 ryl 0 W0 U) 0 0 0 I 03 40 C= 7 rn (n Cl) 'r C) C: (p 7K 0 �o a: C: 00 0 m -a -n 70 T m z S.0 (31 CD :) 0 0 '00 m )> m 0 -4 00 C) - (A) C) CD �o 5 7Z :13 010 rn ?; 110, cmc C) Z 0 0 LM C) C) rn Z 0 C:) rri U) C) 0 si Ul si 1 D DD _0 n o z o C) D D o Z O z D z i r r D m cCl� cCi� C m m 70 r .A m m m \ Om m m z z -n m0 cn Cl) Cm)i D o z r m O O o z Z .. r ao n 70 0 i O z O D m fA O O Z — � � � 0 N < m r cn r x 0 0 c ci o m m -i r- m FD n w cn (a N m A O (AD O rn m c C31c -4o r CD rn D_ D J� cmi x ago � x 00 (7 T Ln w r N m m Ln �I m D O o c °a O O •G m o 70 7D g cn o n M rn 0 m cn c m 1 o D cn m ao m w O 2 G7 m z o o z m m m x < 2 n` o — D m (7 %D D r Ln = m 03 D o 0 0 m m D Z T O 0 O C m m n O O D -1 { D F. r m z O z Qn T In p O n D 1 m z x_ o n m m n C 0 o 0n z U m ti m N a 'CHIS VALIDATED REGISTRATION CARD OR A FACSIMILE COPY IS TO BE KEPT WITH THE VEHICLE FOR WHICH IT IS ISSUED. THIS REQUIREMENT DOES NOT APPLY WHEN THE VEHICLE IS LEFT UNATTENDED. IT NEED NOT BE DISPLAYED. PRESENT IT TO ANY PEACE OFFICER UPON DEMAND. IF YOU DO NOT RECEIVE A RENEWAL NOTICE, USE THIS FORM TO PAY YOUR RENEWAL FEES OR NOTIFY THE DEPARTMENT OF MOTOR VEHICLES OF THE PLANNED NON-OPERATIONAL STATUS (PNO) OF A STORED VEHICLE. RENEWAL FEES MUST BE PAID ON OR BEFORE THE REGISTRATION EXPIRATION DATE OR PENALTIES WILL BE DUE PURSUANT TO CALIFORNIA VEHICLE CODE SECTIONS 9552 - 9554 . EVIDENCE OF LIABILITY INSURANCE FROM YOUR INSURANCE COMPANY MUST BE PROVIDED TO THE DEPARTMENT WITH THE PAYMENT OF RENEWAL FEES . EVIDENCE OF LIABILITY INSURANCE IS NOT REQUIRED WITH REGISTRATION RENEWAL OF OFF-HIGHWAY VEHICLES, TRAILERS, VESSELS, OR IF YOU FILE A PNO ON THE VEHICLE. WHEN WRITING TO DMV, ALWAYS GIVE YOUR FULL NAME, PRESENT ADDRESS, AND THE VEHICLE MAKE, LICENSE, AND IDENTIFICATION NUMBERS . ************** DO NOT DETACH - REGISTERED OWNER INFORMATION ************** REGISTRATION CARD VALID FROM: 11/24/2006 TO: 11/24/2007 MAKE YR MODEL YR 1ST SOLD VLF CLASS *YR TYPE VEH TYPE LIC LICENSE NUMBER INFI 2004 2004 EC 2007 120 11 5LBR752 BODY TYPE MODEL MP MO VEHICLE ID 'NUMBER 4D G NN JNKDA31A44T212765 TYPE VEHICLE USE DATE =SSUED CC/ALCO DT FEE RECVD PIC USE TAX AUTOMOBILE 02/16/07 07 02/16/07 3 1469 PR EXP DATE: 11/24/2007 REGISTERED OWNER AMOUNT PAID KUSHNER GREGORY $ 1492 . 00 5430 CABRILLO SUR AMOUNT DUE AMOUN F RECVD $ 1492 . 00 CASH CHCK 1492 . 00 EL SOBRANTE CRDT CA 94803 LIENHOLDER F00 B47 6A 0149200 0009 CS F00 021607 11 5LBR752 765 A 0 r- r- P4 0 00 ai (NN CN WW H 0 W 4 K4 Eq E-q 9 fzl Ln ko cn (N a4 a4 W 0 U) 0 rX4 lx3Hx 'I W -,4 Z 0 r-I N M '44 U 4 E-4 4 (Y) 9I-q Q CT, WW Z 0 W rT4 04 > rT4 to > w H cf) 0 0 4 :3: w W U) >1 rX4 04 E-4 F:4 0 r- P4 I co P4 w z ri) 0 W z > O*A 0 > z U W a4 000 H 000 0 w * z W 00 Lt rn r14 r-11A � T-i HrJ4 til z Ho u pq P4 O E-4 r14 m E-4 44 0 � W. 0 W 2: U) E-4 H ri) E-i t:) rX4 Z W W r- OD al 0 H N m dim w G4 r14 IttP NOR Ln ° � to • � o 4 �•D � Q r 0 ` o 0 0 o � o a �o v o a a. a> o Q V-A J d — � 9 � o CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION.- Claim CTION: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 ) California Government Codes. The copy of this document mailed to D � Dtl) you is your notice of the action taken on your claim by the Board of MAR 2 0 2007 Supervisors. (Paragraph IV below), given Pursuant to Government Code AMOUNT: $A16aC)' OZ7 COUNTY COUNSEL Section 913 and 915.4. Please note all MARTINEZ CALIF. "Warnings". CLAIMANT: L Te_t'on Se ATTORNEY: / /a-) DATE RECEIVED: 3'(9-0 CO ADDRESS: I Q 2q f6tI b000d BY DELIVERY TO CLERK ON: Arr o&k CiAt BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. r� JOHN CULLEN, le'k Dated: ! By: Deputy 11. FROM.: County Counsel TO: Clerk of the Board of Supervisors (v)This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we ai-e 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: .. - U'"��� By: ( Deputy County Counsel III. FROM:: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. OARD 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. DateOHN CULLEN, 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 Additiaial Warning See Reverse Side of Tliis Notice. AFFIDAVIT OF MAILING I declare under penalty of per jury that f. ani 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.-h,P//°9'." JOHN CULLEN, CLERK By Deputy Clerk 3 I OF TIF R R'CURT) OFS12F VISORS OF CONTR-A COST--x COL TY' UN"WIRUCTIONS TO CLAIMAN'T ited not !a--Let th-arl six month,�, atw-r flie ac 114a% of tk­ Caus� ;wuo n. A !o :-'aly 01-ter cmusc 0C action Shall be:� presel% iaer tb?17 One year aver the ac.17t:I (if rh,-! of a�iicn, 'C C,6.C t'.*_41;i,ms ravis! he .lied ,viij, the : Q- tile Board of Supen-,sors at :1-7, of icF in P.00m- 106. Cc•miry Ad-ministuation 65 t4artffle7_, CA 94553. Tf c1laim ;.i �- bY 1,*np, Board of slrmn-vlsors. rather Tj)a-: 1,1- thu- Aled D. L, .1t claLml is aevns:t naore iliun one uubilc 5d••AT�Ile must. be filed r. Erx:,,! Set- 0Em%.!vv flot clai.ms. P?ma-;� Codt ;ec. 72 at end of �-,n -6.1ws mn, Res'em-ad fur oiling 6 u-)x-\ REBUT[) A='zs',the Counzy :.-,,:'Cortra Coslii�:Ir MAR 2 0 2007 CLERK BOARD OF SUPERVISORS the aame CONTRA COSTA CO. cla4rn a-'amr.",bt C,c7uiaky of Cr_­m Col�ia or ibe ,,,hove-named strict 1!1 dv, Sum of$Z)_A_q_0X and ai. ;-,,pper4eftri:5 c:A=' as folm-,vs; The dpznage occur'! icr ve exac� dalp-Md 1-01"-.t 0,(N C7,r 4q 2. %'htre cid L!"w &,magt: or iijjuni occur? linclula zo,1 ,Y,,-d coanv.y 9KYk� 1:6 lh- d4m-ap Or�rqj%v; ozc-i'a", Z.'("!i%­ f11, :I-i uv'exuI i paper].t'raqjuiuc) Covy-'wk-t- AD 0_1 mw rta�- .31-colanty o-, C115:': v: St"'LilPtz. 67 ar"1771"'I'­-, caused Inme ol- Qlarna­c? v Y)K_ 0r) a-VelLNW\ ©C 0._ or Jivxic,o.ffic'ns,5 in th, b c v 66VI COY\, -5. 17 -1 JT I H I.AJ-11 w.'— THE '97-514,7E.F17 i i7P c I 6, Vilm damargt Or Iqix-7.45 do. yc-,z ciamn; '(0i-ve fall exter'y cf Mjuxi--s or 'Alar J MUCII 11kic eslima�cs for wito dammoge:` -P-0-- Ok�c vva V,,,pQ CL �`�`\ � V� L PJ- Ho`F' "vas rhe xr.cum.1 clail-ried abovc C.omputed? iULit the c�,Urxiated aamou-tv- ofl' 111V !3et.. LVA, S. Names suld add-xsses. 011%viulesscs, u0c.tors, mid, -cs y: zom-� cr i.ri�urv: List L�e expenclivu: ..3u inacie 3n 2c -rly r I MF &N-T-01 1,11 LIT ) Gov. -a't-Sec, 910.2 prcvd-i"71 rU.? sb,01 be ) signed by the LIasimarit Ur by sore Pen.c.". cri Lis 'behalf, _J'yqomey'I Nw-Ile aad address O."Aummevti WXW,A-- Oou-)A ri✓lei a: . s Si mdwre � YI [rtiCtLlTeS ? Telephor-c! No. 4aq i Tele. 'hout No. @moo 10108 1461131940t,t u wo loar."o 9. 9 0 a a 6 A a%a 9P a 0 a a 0 4 J 0 0 9 a.M.a a d a a a 0.a is I F.w t;11 q;0 a a 0 1. 4 R a 0 b i PUBLIC RECORDS NOUCE, Pleze be advised vlat this chilm,form, r any claim fied w::th the Ccwu-�;uridorr t i,?To-, ACT, miS Sobjecr m pub;ic disc.lo!;jr, uridCr I.,vjC Cal"fem;a Public Rec�or3S A.-m e4 St...q , :I! rm rr;, al.1111 e public,disclalure, C oval A 68BRI6486as w"m 600.1,99 LIMIG Odd*R mall tPtWas 0.a NOTICE Sec-hon 72 qj Ev!ry person who, w;di ;mttm to defraud, Pr-a-.,ents fer allowa,mc- or or !i.,;,ymenT So any$uta- or low cr pox, t)e SP n� if 6- -t % i�uy. c:- Jistvict or of flzutt�r.. uthoTizad- to nd r; 3r!'} .'mise or "Any k"oun. ,ru mlent claim, bill, anc"-m-ni vou,,Ii-r, or writin'-, is punishable either L-y Th,-. ccunf); ;:J; f4r a Dvricd of-,ior• mor.- Ij-4an one year7 h- a i5n- of noimcceiing one thous.,mJ dollars of 1---y both S11cl2 Hmpri.;onmem Fir-J" fine, or by impri-z-ximent i-. zh.L'. Suw prison.. by P fine of rot excee.-ding teii ti-imisanid LI(Aiars '.$I 0,00M), 01 b'V bUtIlk&i;" irLpTIq0InITi8nt JAIA fiT.E. GREG&ALMA TOWNSEND 1029 BUR WOOD WAY ANTIOCH, CA 94509 (925) 778-7424 March 12, 2007 Via Facsimile (925) 335-1222 Contra Costa County Community Development Re: Billing Account #30156 ZI0510673 & ZC0500668 Donna Allen & Bob Drake: I have reviewed the billing for the Tallent parcel, which includes a request for determination and a request for certificate of compliance. It appears that your office has decided to bill the certificate of compliance file for work Donna did on the determination of the legality of the parcel, apparently because I jumped ahead and paid and filed the application for certificate of compliance in anticipation of the determination being in my favor, and prior to your office rendering the decision. We both know the request for determination was at that time a flat fee of$400.00. Donna correctly billed the determination file on 6/15/05 $236.93; on 11/15/05 $416.50; and on 11/30/05 $1,487.50, then later reversed these charges and billed them to the certificate of compliance file. My position is that you cannot.bill me for time spent on.preparing my certificate of compliance before the determination of the legality of the parcel has been decided. In the meantime, there are other files which I am due a refund. I am requesting that you release these refunds to me immediately because we all know that anything involving Donna Allen is going to take a very long time, given that she is retired and only works once in a while; and these other files are irrelevant to any issues involving the Tallent parcel. March 12, 2007 Bob Drake Donna Allen Please call me upon receipt of this fax to let me know whether or not I can pick up a check tomorrow on the other files. Ai TOS SEND \J GREG&ALMA TOWNSEND 1029 BUR WOOD WAY ANTIOCH, CA 94509 (925) 778-7424 March 12, 2007 Via Facsimile (925) 335-1222 Contra Costa County Community Development Re: Billing Account #30156 ZC0500668 & ZI0510673 To Whom It May Concern: The above-mentioned file has long ago been completed and closed.. Attached is the January 2007 billing statement for your reference. I have been in contact with Victoria in accounting attempting to obtain the refund due me, to no avail. Demand is hereby made for the sum of$246.90. Please let me know when I can pick up a check for this amount. WNS cc: Bob Drake Mary Piepho, Supervisor, District 3 Contra Costa County ' Community Development/Public Works Department 255 Gladier Drive Martinez, California 94553-4897 Page 1 BILLING ACCOUNT# 30156 Statement Print Date: 01/12/2007 ACCOUNT ACTIVITY THROUGH: 12/31/2006 Statement r=: 53495 ALMA&CHRIS TOWNSEND 1029 BURWOOD WY ANTIOCH,CA 94509 i CURRENT STATEMENT PERIOD Account Balance as of 11/30/2006:$ 246.90CR Total PW Charges this statement period: S 0.00 I Total CD Charges this statement period: $ 0.00 Total payments received this statement period: 5 0.00 i Totai deposits received this statement period: S 0.00 1 Less Deposit Administrative Fees: $ 0.00 Net Deposit this statement period: S 0.00 1 1 Permits covered by this billing statement: Available Balance-Do Not Pay: $ 246.90CR ZC0500668, Z10510673 ACCOUNT HISTORY i Total Account Activity to date: Revenue Charges Deposits- aX—— -s Administrative i�a_s_—_ PW.�h.a�es.._ CD Chafes_ 1.000.00 0.00 753.10 Cash Bond Held: $0.00 Fixed Fees Payments: 800.00 DISTRIBUTION LIST: Community Development 925-335-1282 Public Works 925-313-2374 (PW)PROJECT ENGINEER (CD)PLANNER Please return bottom portion with payment to insure proper credit: ---------------------------------------------------------------------^-----^------------------------------------------------------------------------- Send Payment to: Date: 01/12/2007 Contra Costa County Payment Coupon Statement: 53495 Public Works Department 255 Glacier Drive Martinez, California 94553-4897 No Payment Due Amount Paid: Billing Account: 30156 Permit: ZC0500668, Z10510673 ALMA&CHRIS TOWNSEND 1029 BURWOOD WY ANTIOCH, CA 94509 GREG&ALMA TOWNSEND 1029 BUR WOOD WAY ANTIOCH, CA 94509 (925) 778-7424 March 12, 2007 Via Facsimile (925) 335-1222 Contra Costa County Community Development Re: Billing Account #33242 VR06-1066 To Whom It May Concern: The above-mentioned application has been withdrawn by me, and I received a letter dated January 17, 2007 from Debi Foley, the assigned planner, acknowledging same . I have been in contact with Victoria in accounting attempting to obtain the refund due me, to no avail. Demand is hereby made for the sum of$331.52. Please let me know when I can pick up a check for this amount. .A�A SEND cc: Bob Drake Mary Piepho, Supervisor, District 3 I'IMi;,, ;-.�_.Ji _�i.?r''I _.,�. I"_'ty..11. il_?h:r:.� !+•. . ____ i'. L • Contra Costa County C inz' Uri;;'CevslapmentlPublic Worn: I;elarMent 255(3laCier Drive ltartfnez,Ca!ifern!r.5455 -489' page 1 B&LING Eu:,CO;jNT 9 33242 ACCOUNT ACTt"Y THROUG Staremert Print QZ1219:2077 c;2c t�Cf:fi9rITTM. S3'S$� ALMA G CHRII- TO W NS F NG -J" ,02 9 8URW00D VVY A,NTIOCH,CA 94509 CURRENT SA-EMENT PERIOD _ _-------- � A.countbalancezks,,fIZ3t12006:3 36S.50CR i Tota!PW Charges:hie Er.-tamcnt r±utioa S 0.00 Tata;CD Chargn this 5wi-pitl:t period: 57.38 . TOtf/lp:y7"!A1I£ft:CBIVEC I.hi.Bteyemelt rrfnOd: � O..'O `ct*l depa°iz rxciv9,thIc 9`.BtbJt';E!:T period: 5 Less DfipoO AxninisttatvE•Fees' 0.C. t a;Drr.:'t this smomont perfod, 3 0.00 !"hv purmtt cnversd ayrru> hil!irtg stSi.';T414!fi lu' Avat!aittg 6rld,u.6-rlo Not Pay: s - 331.52CP. VRC5601066 e - -— - ACCOUNT HISTORY Total Account Activity to date: Revenue Charges ales i 668.45 C >:t worn:' He1c: $0.00 Fixed Fees Pae-r!erts:6S.C.0 PL7.)F UT!..)k I_iST: Communky Deyefors ten' 33S:2e2 Pubk-W'or4 s .9.,r-31n,2374 (PVV)FRC.,ECT E•dGINeER (C6-%dL!'VNER __ Piaese 'etur't at.:urI portion with payment tc insure proper credit: wYMrr rrrdrY+.nr�.�rrrrr rMrrrrOMerrr 4Yrn....�.--�-�reirrr�Mr rYY�rrr�.a.-rrrrrnr..rrr rYYrrrrrrrr--r,.�,r...�rww.rwsrr wrrrarwrr_-.,�..-��wrw� Send Payment to: Date: 02109.7007 --Contra Cos+.a County Payment Coupon tBtement: 55509 ?uofic Woks Depal wnani 7.55 G:acier Drive Martinez California 94554-4897 No Payment Due Amount Paid: Billing Account: 3?.242-, -- 11�ermit' VR06010GO ALMA&CHRIS TOWNS tNU t029 SUP.W000 WY ANTIOCH,CSA 04509 GREG&ALMA TOWNSEND 1029 BUR WOOD WAY ANTIOCH, CA 94509 (925) 778-7424 March 12, 2007 Via Facsimile (925) 335-1222 Contra Costa County Community Development Re: Billing Account #33844 RZ063188 To Whom It May Concern: The above-mentioned application has been withdrawn by me, and I received a letter dated January 9, 2007, from David Schwartz, the assigned planner, acknowledging same. I have been in contact with Victoria in accounting attempting to obtain the refund due me, to no avail. Demand is hereby made for the sum A14�"_n�69. Please let me know when I can pick up a check for this amount. SEND cc: Bob Drake Mary Piepho, Supervisor, District 3 • Contra 0o;tn. County Community Uevetopment/Pub is Works Department 255(Racier Drive Martinez.California 94555-48017 Patin 1 BILLING ACCOrUNT# 33344 =–-—�.` scarer-ent Prin:mare:c3?o9i2007 ACCOUNT ACTIVITti'THROUGH: i2/ 8!2007 --• 1 Stutes:er•t4: TU!;_3 ALMA Jj CHP.4 TOWNSIZIN1] 1.028 5UKTV0QD WY ANTIO,'-;H.,CA 14509 ,--- --- �CURRENT STATEMENT PEPJOD ;,xeurt Hal�ne?a of o1 rs1.,2UC7. 1,438.69OR Tota Fv:'chir4as this statement pericd: $ v,00 Total CD(hauea'1iS et.'a'.errsrt n8nc1. S 0.00 I Total payf enn received this 5t3tErnwir pfrnc' $ x,00 i Total aepoNz receNed fi;S stau4 ant neriu4- Lesa DepositAjmirizt-at�+e�ocx S 0.00 Ne Cepvtd is statalr:rn. The parmlt s--rored bythis blaing statornent Is. Avaitable Balance-Go Not Pgy; b 1,438.690Pt IRZ0603188 ACCOUNT HISTORY I Total Account A,tMlyto date: j Revenue C 4 iL4�L'eYt[Lsi1l:5.—_ �,ci^ruy n_4 Rh: F C FIN Ch;iMPS— — CIJ^v!'c3�gts ! . 2,550,00 0.00 1 " 11,31 .;,,vim �n— t:•ash bond Held: $0,001 ,-fixed Fees Poyments:83.00 DIr;!"Al8UTI0TI LIST; Com rn.,okrDevelopment 025335-1232 Puble works 925-313.2W .WV;PROJECT ENGINEER (CO)PLANNER Plante retum bottom portion with payment to inure proper credit; fff affYlfi�OYt'IYfJMrYCfWrYr\r Wr.rrY.Yal�wlr.r�orrrrr ^r\IM•�rNA �M!YMrAt//IVIsMIfffM!•u/f9llf.....f4nffffflurlP• Send Pavm,�,it to: Dam: 03/0912009 Contra Costa G)urt� P2�n�el.tCouparf S�tatenent .5745% Public Works Decartment 2"55 Glacier DrNe Martinez, Californ,a 94553.4897 No Payment Due Amount Paid: Billing Account 33844 Permft: RZO6031F3F ALMA&CNRiS TOWN SEND 1028 SURWOOD Wr ANTIOCK CA 214509 GREG&ALMA TOWNSEND 1029 BUR WOOD WAY ANTIOCH, CA 94509 (925) 778-7424 March 12, 2007 Via Facsimile (925) 335-1222 Contra Costa County Community Development Re: Billing Account #31354 VR0501120 To Whom It May Concern: The above-mentioned file has long ago been completed and closed.. Attached is the January 2007 billing statement for your reference. I have been in contact with Victoria in accounting attempting to obtain the refund due me, to no avail. Demand is hereby made for the sum of$73.16. Please let me know when I can pick up a check for this amount. AL T SEND cc: Bob Drake Mary Piepho, Supervisor, District 3 r Contra Costa County Community Development/Public Works Department 255 Glacier Drive Martinez, California 94553-4897 Page 1 BILLING ACCOUNT# 31354 ACCOUNT ACTIVITY THROUGH: 12/31/2006 Statement Print Date: 2007 53693 Statement#: 53693 ALMA&CHRIS TOWNSEND 1029 BURWOOD WY AN T IOCH, CA 94509 CURRENT STATEMENT PERIOD Account Balance as of 11/30/2006:$ 73.16CR Total PW Charges this statement period: $ 0.00 Total CD Charges this statement period: $ 0.00 i Total payments received this statement period: $ 0.00 i j Total deposits received this statement period: S 0.00 Less Deposit Administrative Fees: S 0.00 i Net Deposit this statement period: $ 0.00 i ;The permit covered by this billing statement is: Available Balance-Do Not Pay: $ � 73.16CR VR0501120 ACCOUNT HISTORY Total Account Activity to date: Revenue Charges Dep CD-Adm.irt�trative Fees PW Charges CD Charges i'000.00 0.00 926.84 Cash Bond Held: $0.00 Fixed Fees Payments: 63.00 DISTRIBUTION LIST: Community Development 925-335-1282 Public Works 925-313-2374 (PW)PROJECT ENGINEER (CD)PLANNER Please return bottom portion with payment to insure proper credit: Send Payment to: Date: 01/12/2007 Contra Costa County Payment Coupon Statement: 53693 Public Works Department 255 Glacier Drive Martinez, California 94553-4897 No Payment Due Amount Paid: Billing Account: 31354 Permit: VR0501120 ALMA&CHRIS TOWNSEND 1029 BURWOOD WY ANTIOCH, CA 94509 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY 1 s BOARD ACTION: 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 California Government Codes. you is your notice of the action taken on your claim by the Board of MAR 2 0 2007 Supervisors. (Paragraph IV below), given Pursuant to Government Code AMOUNT: �3�J�• COUNTY COUNSEL Section 913 and 915.4. Please note all MARTINEZ CALIF. "Warnings". CLAIMANT: , T net Simpson rm.pson ATTORNEY: DATE RECEIVED: 3—d-0 -07 ADDRESS: plod— 4Ida, AV&fl LV BY DELIVERY TO CLERK ON: SaA v064-1 C1 BY MAIL POSTMARKED: !Oli 610301 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. JOHN CULLEN, Clgrly I Dated: 6_oX rD7 By: Deputy Cs 11. FROM: County Counsel TO: Clerk of the Board of Supervisors (,,)-?'This claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911-3). O Other: Dated: _3) By: ` l 1 �.�,%J 1� Deputy County Counsel III. FROM: Clerk of the Board TO: County Counsel (]) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). 1V. OARD 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: ///-e Z-V HN CULLEN, 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 wide this matter. If you want to consult an attorney,you should do so immediately. *For Additional Warning See Reverse Side ofThis Notice. AFFIDAVIT OF MAILING I declare under penalty of pei jury 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 CULLEN, CLERK By Deputy Clerk BOARD OF SUPERVISORS OF CONTRA COS'T'A COUNTY INSTRUCTIONS TO CLAIMANT A. 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 thaii 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 fiaudulent claims, Penal Code Sec. 72 at the end of this form. ■■mmmmmanmammamemmmsemmmgmmmmmmmmsmmmmeamameammmmmmammmmmmmmmmammmmaamommammmat RE: Claim By: Reserved for Clerk's filing stamp At ) RECEIVED Against the County of Contra Costa or ) MAR 2 0 2007 _ District) CLERK BOARD Of SUPERVISORS (Fill in the name) ) CONTRA COSTA Co. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ and in support of this Clain represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) N� V F F7Iq-4-R Z� 2 i�rqo Uti`J i1:-30 A?/`J 2. Where did the damage or inj ury occur? (Include city and county) -27oz fribA � Y��/ uE s/�.�J �losF ci9 9s�� z - �3a 3 ,L'o U� � >. How did the damage or in occuf? (Give full details; use extra paper if required) /?C k/V'�Jw'y — ifs ieoi, <c v A i T- saA96,V e., ry 4. 'WThat particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? '5W1t04C /.W7 5c'q W'4RR4,V= WrF_t? , "T- 5 What are the names of count), or district officers, servants, or employees causing the damage or injury? beTv'c iyv 5ci/iRo rl,�'� i{iSy>� 6. Wllat damage or injuries do your claim resulted? (Give full extent of injuries or damages clairrred. Attach two estimates for auto damage.) 7. How was the amount claimed above computed? (haclude the estimated amount of any prospective injury or damage.) R c i v A 1.. Cas 8. Naives and addresses of witnesses, doctors, and hospitals: 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT 's P!, 0 f a a a a am a a am a a a a am an an am a a an on a am a a m m a a a s m a a Ranson m a a s a mems s a m a m a s■a a a a MKS a a a a m a a a a a a at .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 ) (Claimants Signature) �- 0 T (Address) .S' os i CFS `I-.5-1 a ;I- - c 3 i ) Telephone No. ) Telephone No. o y - ;2 - V 9 3 Ina a as a a a an a an a sits a am on a am am an ass on it am a ad a a s a a as ads m a a a a a It a a a m a Sams an It an a an a t a ass cam s 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. a■aasasasassaaaaaaaaSams aSUN onto aOman aaaaaaaaaMEN Nunn Bonn saaaaaaaaaamaMan asaaaasaasa1 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 imprisoiunent and fine, or by imprisotunent in the state prison,by a fine of not exceeding ten thousand dollars ($10,000), or by both such imprisonment and fine. z ----- ----- ----------- -----I- ---------- -- 0 ----- ----- ------------ ---- ---- ----- ----- ----- LT uj U) Lu iLl o 0 < Ld 0 LLI ui I X (0 Lu < LL m z uj 0 Z Lu cy-- r<_ C) 0 1 z C- oU) ri) L) < (n M Lu F- w LLI d I�- z� O N Cl) Lz Lo F- Ir LLI U) C) Q) LL, LLI O LL) Lij >: co Cl) F- j Z) UJ co C\J (') -v -���Cor- co 0) am DON SIMPSON 90-8188/1211 225 INEZ SIMPSON 713094019 2702 AIDA AVE. SAN JOSE, CA 95122-1303 I $ jL WWVO R L S AV I N G 229OTullyD Road Sari Jose,California 95122 w�.worldsavingsxom --- ------- 1: 12.1 18 L8661:0 2 2 S 7 130940 19111 THE COUNTY OF hV CONTRA COSTA Card /a'17F-it =SC&W her -WF CAll Detective5es5 t4 1980 Muir Road hivestigation Division Martine-, CA 94553-4800 (925)313-2623 WARREN E.RUPF Fax(925)646-1389 Sheriff CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: APRIL 24, 2007 Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) NOTICE TO CLAIMANT and Board Action. All Section nefer��MAR FO l ` � The copy of this document mailed to California Government Cod es. ��) you is your notice of the action taken 2 y 2007 on your claim.by the Board of Supervisors. (Paragraph IV below),. COUNTY COUNSEL given Pursuant to Government Code MARTINEZ CALIF. Section 913 and 915.4. Please note all AMOUNT: UNKNOWN AT THIS TIME "Warnings". JASMINE SORIANO. through her father CLAIMANT: LUCIO SORIANO, LUCIO SORIANO, DORA GOMEZ ATTORNEY: MARC L. TERBEEK DATE RECEIVED: MARCH 21. 2007 MEHLMAN':;TERBEEK, LLP ADDRESS: 2125 OAK GROVE ROAD, SUITEBI2I)ELIVERY TO CLERK ON: MARCH 21, 2007 WALNUT CREEK, CA 94598-2406 BY MAIL POSTMARKED: RECEIVED FROM nnrrnrry rnilnTC�'T FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. MARCH 21, 2007 JOHN CULLEN, Ci -k Dated: By: Deputy II. FROM.: County Counsel TO: Clerk of the Board of Sup visors ( ) This claim complies substantially with Sections 910 and 910.2. ( 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: 3By: Deputy 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). IV. BOARD ORDER: By unanimous vote of the Supervisors present: (VThis 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. b Dated.- JOOROHN CULLEN, 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 ofan attorney of your choice in connection wide this matter. If you want to consult an attorney,you should do so immediately. *For Additional Warming See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that i. ani 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. d Dated:. !!K02O0 JOHN CULLEN, CLERK ByDeputy Clerk OFFICE OF THE COUNTY COUNSEL SILVANO B. MARCHESI COUNTY OF CONTRA COSTACOUNTY COUNSEL Administration Building ._. 651 Pine Street, 91" Floor ° C ��`" — SHARON L. ANDERSON Martinez, California 94553-1229 CHIEF ASSISTANT GREGORY C. HARVEY (925) 335-1800 ®• , VALERIE J. RANCHE (925) 646-1078 (fax) ASSISTANTS '4 COUP NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Steven J. Mehlnlan Marc L. Terbeek MEHLMAN & TERBEEK 2125 Oak Grove Road, Suite 125 Walnut Creek, California 94598 R.E: CLAIM OF: JASMINE SORIANO, through her father, Lucio Soriano, LUCIO SORIANO, DORA GOMEZ Please Take Notice as Follows: The claim you presented against the County of Contra Costa or District governed by the Board of Supervisors fails to comply substantially with the requirements of California Government Code Section 910 and 910.2, or is otherwise insufficient for the reasons checked below: ] I. The claim fails to state the name and post office address of the claimant. ] 2. The claim fails to state the post office address to which the person presenting the claim desires notices to be sent. [X] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the nanle(s) of the public employee(s) causing the injury, damage, or loss, if known. [ ] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than tell thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated alll01.111t 01`ally prospective Injury, damage or loss so far as known, or the basis of computation of the amount claimed. [ ] C. The claim is not signed by the claimant or by some person on his or her behalf. ] 7. You are required to submit your claim on the proper form, which is enclosed. Please. resubmit You]-claim on the enclosed form, including all the required information. Gov. Code, § 91.0.4. Please be aware that you have only a limited period of time in which to file an amended claim. See Gov. Code, S 910.6. [X] 8. Other: Please provide specific dates for the allegations in the claim that "[a]t various dates and times . . . Claimant Jasmine Soriano . . . was molested at the Los Medanos Elementary School. . . ." SILVANO B. MARCHESI COUNTY COUNSEL By: Monika L. Cooper Deputy County Counsel CERTIFICATE OF SERVICE BY MAiL (Code Civ. 11roc., §5 1012, 1013x, 2015.5; Evid. Code, y§ 641, 664) i 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 3�23.0"7 , 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 to Steven J. Mehlnan, Marc L. Terbeek, MEHLMAN & TERBEEK, 2125 Oak Grove Road, Suite 125, Walnut Creek, California 94598, 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 pei jury under the laws of the State of California and the United States of America that the above is true and correct. Executed on 3 23- O at Martinez, California. L4g"u�k,- ,jw KA thleen O'Connell cc: Clerk of the Board of Supervisors (original) Risk Management Page 2 -; LLI ►sl STEVEN J. MEHLMAN CSB #95881 !�; 1,0 • " MARC L. TERBEEK CSB #166098 Re G n U2 MEHLMAN❖TERBEEK LLP ��® ® t. W:r s 2125 Oak Grove Road, Suite 125 l tt �4 >-- 3 Walnut Creek, California 94598-2406 MAR 2,1 TUU/ W Telephone (925) 935-3575 CLERK BOARD a4 Facsimile (925) 935-1789 coNrRA°os Ap�ov1scRs ry U A-21 5 Attorneys for Claimants 6 7 SUPERIOR COURT OF THE STATE OF CALIFORNIA 8 COUNTY OF CONTRA COSTA 9 JASMINE SORIANO, through her father, Case No: None Assigned 10 LUCIO SORIANO, LUCIO SORIANO, DORA GOMEZ, CLAIM AGAINST GOVERNMENT ENTITY 1 I FOR LOSS-- GOVERNMENT CODE Claimants, SECTION 910 ET SEQ. 12 vs. 13 COUNTY OF CONTRA COSTA; ANGELA S. STEVENSON, KAREN 14 GOODSHAW, FRANK ABANO, REED MCLAUGHLIN, LOS MEDANOS 15 ELEMENTARY SCHOOL, PITTSBURG UNIFIED SCHOOL DISTRICT; DOES 16 ONE THROUGH ONE HUNDRED 17 Respondents. 18 TO THE ENTITIES AND PERSONS IDENTIFIED IN THE ATTACHED PROOF 19 OF SERVICE: 20 You are hereby notified that Claimants Jasmine Soriano (through her father, Lucio 21 Soriano), Lucio Soriano and Dora Gomez claim damages as set forth in the attached Exhibit A: 22 "CLAIMAGAINST GOVERNMENT ENTITY FOR LOSS-- GOVERNMENT CODE 23 SECTION 910 ET SE . ' Additional information concerning this claim is disclosed in the 24 attached Exhibit A. 25 Dated:.March.14, 2007 MEHLMAN❖TERBEEK LLP 26 27 By: 28 Marc L. TerBeek Attorneys for Claimants Notice of Ton Claim ' CLAIMAGAINST GOVERNMENT ENTITY FOR LOSS— GOVERNMENT CODE SECTION 910 ET SEO. A. Claimant Information Claimants: Jasmine Soriano [SSN: 609-04-6414; DOB:1/06/98], through her father Lucio Soriano [SSN: 564-08-6527; DOB: 3/6/70], and Dora Gomez [SSN:552-97-7536; DOB: 7/30/70]. Mailing Address: 210 Orangevale Street, Pittsburg, California 94565 Telephone No: (925) 497-3885 B. Names of Public Entities/Employees Against Whom Claim Asserted Angela S. Stevenson Karen Goodshaw Frank Abano Reed McLaughlin Los Medanos Elementary School Pittsburg Unified School District County of Contra Costa C. incident Date & Location Various dates prior to December 5, 2006, but only discovered on December 5, 2006, at Los Medanos Elementary School, Pittsburg, California. D. Amount of Claim This is an Unlimited Jurisdiction Claim for tort damages exceeding the $25,000 jurisdictional limits of the Superior Court, the exact amount of which is unknown at this time. E. General Statement of Factual Circumstances Underlying Claim At various dates and tunes prior to December 5, 2006, Claimant Jasmine Soriano, a developmentally disabled minor student especially vulnerable to predation, was molested at the Los Medanos Elementary School after being permitted to travel unaccompanied and alone in violation of applicable school policies and general standards of care applicable to students suffering disabilities of the type Claimant Jasmine Soriano experiences. Lucio Soriano and Dora Gomez first discovered the molestation on December 5, 2006. As a result of Defendants' negligence, all Claimants have suffered severe emotional distress and out-of-pocket expenses associated with treating Claimant Jasmine Soriano for her injuries, and for treating Claimants Lucio Sorinao and Dora Gomez for their emotional distress. As a further result of Defendants' negligence, all Claimants have suffered a diminution of earnings or earning capacity. F. Nature of Claimed Loss This claim is in the nature of a tort claim, which includes losses for general and special damages such as emotional distress, mental suffering, loss of earnings, loss of earning capacity, medical expense, and other expense not yet known. 1. Gov't Tort Claim— Soriano v Stevenson et al. EX 1131T G. List of Persons/Entities Served With This Notice 1. County of Contra Costa: Stephen L. Weir, County Clerk-Recorder John Cullen, County Administrator Silvano Marchesi, County Counsel 651 Pine Street, 11`" Floor Martinez, California 94553 2. Angela S. Stevenson, Principal, Los Medanos Elementary School 610 Crowley Avenue Pittsburg, California 94565 3. Karen Goodshaw, Vice-Principal, Los Medanos Elementary School 610 Crowley Avenue Pittsburg, California 94565 4. Frank Abano, Instructor, Los Medanos Elementary School 610 Crowley Avenue Pittsburg, California 94565 5. Los Medanos Elementary School Angela S. Stevenson, Principal Karen Goodshaw, Vice Principal 610 Crowley Avenue Pittsburg, California 94565 6. Pittsburg Unified School District Reed McLaughlin, Superintendent 2000 Railroad Avenue Pittsburg, California 94565 7. Reed McLaughlin, Superintendent, Pittsburg Unified School District 2000 Railroad Avenue Pittsburg, California 94565 H. Address for Service of Rclated Notices or Communications All notices or communications regarding this claim should be sent to the following address: MEHLIMAN•:' .rERBEEK LLP Attention: Marc L. TerBeek Attorneys for Claimants Jasmine Soriano, Lucio Soriano and Dora Gomez 2125 Oak Grove Road, Suite 125 Walnut Creek, California 94598-2406 "Telephone (925) 935-3575 Facsimile (925) 935-1789 Date: March 14, 2007 MEHLMAN❖TERBEEK LLP By: Marc L. TerBeek Attorneys for Claimants 2. Gov't Tort Claim—Soriano v Stevenson et al. 1 PROOF OF SERVICE [C.C.P. §§ 1011, 10.12, 1013] 2 Re: Jasmine Soriano, et al and County of Contra Costa County, et al 3 I, Phyllis L. Thomas, am a citizen of the United States and employed in Contra Costa 4 County, California. I am over the age of eighteen years and not a party to the within action. My business address is 2125 Oak Grove Road, Suite 125, Walnut Creek, CA 94598. On October 17, 5 2006, 1 served the following documents: 6 CLAIMAGAINS T GOVERNMENT ENTITY FOR LOSS-- GOVERNMENT CODE SECTION 910 ET SEQ. 7 8 X By HAND DELIVERY as follows: by causing a true copy thereof enclosed in a sealed envelope and hand delivered on this date as set forth below upon 9 said person. 10 _ by MAIL as follows: by causing a true copy thereof enclosed in a sealed envelope,with postage thereon fully prepaid, to be placed in 11 the United States Post Office mail box at Walnut Creek, California, addressed as indicated below. (I am readily familiar with this 12 business' practice of collecting and processing correspondence for mailing. It is deposited with the U.S. Postal Service on the same day 13 in the ordinary course of business). 14 _ by OVERNIGHT MAIL causing a true copy thereof to be placed in FEDERAL EXPRESS MAIL on Oak Grove Road, in Walnut Creek, 15 CA before the final collection time, addressed as indicated below following ordinary business practice, said practice being that in the 16 ordinary course of business, correspondence is deposited in the Federal Express Depository on the same day as it is placed for 17 processing. 18 _ by FACSIMILE as follows: I caused the said document(s) to be transmitted by facsimile machine to the addressee at their fax 19 numbers indicated below, at approximately 1:OOPM. The facsimile machine I used complied with Rule 2003(3) and no error was 20 reported by the machine. Pursuant to Rule 2005(i), I caused the machine to print a transmission record of the transmission. 21 22 See Attached Mailing List 23 24 25 1 declare, under penalty of perjury, under the laws oft St to of California, that the foregoing is true and correct. 26 MF BEEK ❖ Dated: March 15, 2007 TEI2BGLK LLP 27 2125 Oak Grove Phykfs L. T O as Road 28 Suite 125 Walnut Creek,CA 94598 PROOF OF SERVICE (925)935-3575 Jasmine Soriano, et al. and County of Contra Costa, et al. MAILING LIST 1. County of Contra Costa: Stephen L. Weir, County Clerk-Recorder John Cullen, County Administrator Silvano Marchesi, County Counsel 651 Pine Street, I1`h Floor Martinez, California 94553 2. Angela S. Stevenson, Principal, Los Medanos Elementary School 610 Crowley Avenue Pittsburg, California 94565 3. Karen Goodshaw, Vice-Principal, Los Medanos Elementary School 610 Crowley Avenue Pittsburg, California 94565 4. Frank Abano, Instructor, Los Medanos Elementary School 610 Crowley Avenue Pittsburg, California 94565 5. Los Medanos Elementary School Angela S. Stevenson, Principal Karen Goodshaw, Vice Principal 610 Crowley Avenue Pittsburg, California 94565 6. Pittsburg Unified School District Reed McLaughlin, Superintendent 2000 Railroad Avenue Pittsburg, California 94565 7. Reed McLaughlin, Superintendent, Pittsburg Unified School District 2000 Railroad Avenue Pittsburg, California 94565 w o, uJ fl- `` L!. .s in cd .. "!•. W o O >, cs tc9 "- +—• a" p , c2ti _ W H w ri C 7N CJ wQCW QW � F o o uj } ® � C3 a� Q0 e4 U. _ CT31{Pltx O ox 'cY O r,. r• N O Ln = H cM 0 o T U �•.. � �= t-4 c=� }t VolN w ) w ryF� co CA xtY y ct�G 0 G� � ` - `yNti a N � W � o Lns in CG Ln y � r-3 �+ © Ln © t� t f C � v N d - ° r . cr- U y�'► d � r � ci CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: APRIL 24, 2007 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 California Government Codes. ) you is your notice of the action taken on your claim by the Board of 1;04Supervisors. (Paragraph IV below), AR 2 1 2007 given Pursuant to Government Code Section 913 and 915.4. Please note all AMOUNT: UNLIMITED COUNTY COUNSEL "Warnings MARTINEZ CALIF. CLAIMANT: NADI:. AMAIN AND MOHAMED EISA ATTORNEY: MARK J. ZANOBINI DATE RECEIVED: MARCH 21, 2007 JOHN M. FEDER. ADDRESS: ROUDA, FEDER, TIETJEN & BY DELIVERY TO CLERK ON:MARCH 21, 2007 ZANOBINI 44 MONTGOMERY STREET, STE. BVWAIL POSTMARKED: MARCH 20, 2007 SAN FRANCISCO, CA 94104 FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. MARCH. 21, 2007 JOHN CULLEN, er Dated: By: Deputy II. FROM: County Counsel TO: Clerk of the Board of Su ervisors ( 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 warding of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: J' d''� `Z)7 By: Ol C��c Deputy County Counsel 111. FROM: Clerk of the Board TO: County Counsel (]) 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. ( ) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. ,� a Dated:lY//�`,_.2W?-JOHN CULLEN, 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 connectiar with this matter. If you want to consult an attorney,you should do so immediately. *For Additional Wareing See Reverse Side ofTliis 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:/ �'i� } JOHN CULLEN, CLERK By Deputy Clerk 03/19/2007 , 15:37 CONTRA COSTA COUNTY CLERK OF THE 4 914153988169 N0.184 P02 BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLA.I..M.ANT A. 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 § 91.1.2.) 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.' saw mop=No emsessessew pampa we Wells a seaseentemoso 5 M1011ft Wolfson a goospenumpt..166 Vermont RE: Claim By: Reserved for Clerk's filing stamp Nadia Amin and ) —)tilohaamed Ti ca � RECEIVED Against the County of Contra Costa or ) MAR 2 1 2001 District) CLERK BOARD OF SUPERVISORS -- — ) CONTRACOSTACO. (I7 i.11 in the name) Th.e tmdersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ -UNLIMITED and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) See attached 2. Where did the damage or injury occur? (Include city and county) See attached 3. How did the damage or injury occur? (Give full details; use extra paper if required) See attached 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? See attached 5 What are the names of county or district officers, servants, or employees causing the damage or injury? See attached 03i19/2007 15:37 CONTRA COSTA COUNTY CLERK OF THE 4 914153988169 N0. 1e4 D03 r ¢.. What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) See attached 7. How was t]ie amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) See attached 8. Names and addresses of witnesses, doctors, and hospitals: See attached 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT See attached ..r..ONE■■•r■■.NEWS■■.•r.•o..@asaaamabob a■ama W0 arr Sun r■-■■■■■■■■-■■.■■ONE 1■1asp 11 ass 1 ) 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)____1 Name and address of Attorney ) John M. Feder, Esq. ) M:ark. J. Zanobini , Esq. ) ow) Attorney for Claimants Rouda, Feddr,Tietjen & ) 780 Oak Grov ad Zanobini ) 44 Montgomery St. , #4000 ) (Address) San Francisco, CA 94104 ) Concord, CA 94518 Telephone N0415-398-5398 ) Telephone No. 925-609-9964 .....rr.■...■■■■■..■-......arm..■■■.■■■■■................................ ........... , PUBLIC RECORDS NOTICE: ?lease be advised That this claim form, or any claim filed with the County under the Tori Claims Act, is subject to c--01;?c disclosure under the California Public Records Act. (Gov. Code, §§ 6500 et seq.) f=urthermore, any 11ri'acahments, addendums,or supplements attached to the claim fonn, including medical records, are also subject to cvblic disclosure. NOTICE: act on 72 of the Penal Code provides. FVt]'Y person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to my 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 apt more than one year, by a fine of not exceeding one thousand dollars ($1,DDO.DO), or by both such imprisonmeit and fine, or by imprisonment in the state prison, by a fine of not exceeding teal thousand dollars ($10,000), c by both such imprisonment and fine. CLAIM FOR DAMAGES AGAINST THE COUNTY OF CONTRA COSTA TO The Clerk of the Board of Supervisors Room 106, County Administration Building 651 Pine Street Martinez, CA 94553 Claimants' Names : Nadia Amin Mohamed Eisa Claimants' Address 780 Oak Grove Road Concord, CA 94518 Claimants' Telephone 925-609-9964 Address to Which John M. Feder, Esq. Notice to be Sent Mark J. Zanobini, Esq. Rouda, Feder, Tietjen & Zanobini 44 Montgomery Street, Suite 4000 San Francisco, CA 94104 x415-398-5398 Email: ifeder@ rftzlaw.com mzano@rftzlaw.com Date of Occurrence September 22, 2006 Time of Occurrence Approximately 10:45 a.m. Place of Occurrence Locust Street at intersection with Mt. Diablo Blvd., Walnut Creek, CA Description of On the above date,49-year-old Nadia Amin was walking Occurrence in the southbound direction across Mt. Diablo Blvd. in a marked crosswalk at the intersection with Locust Street. Ms. Amin was past the center line into the street when she was struck by a black 2006 Hummer H3. The vehicle was traveling westbound on Mt. Diablo Blvd., waiting to take a left turn. The driver of the vehicle started a left turn and struck Ms. Amin who was still on the crosswalk. The force of the collision knocked her to the ground causing serious injuries. Claimants have recently become informed and believe that defendant County of Contra Costa was the owner, occupier and maintainer of the premises where Ms. Amin suffered her severe injuries. Claimants contend that the County of Contra Costa (1) maintained a dangerous condition of public property which it created, or had actual or constructive notice Claim Against the County of Contra Costa Re: Nadia Amin & Mohamed Eisa March 20, 2007 Page 2 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; (4) 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 Ms. Amin; 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 controlled for left turns leading to difficulty for motorists to perceive pedestrians. There was inadequate pedestrian crosswalk signage in the crosswalk area or in close proximity thereof. There was very limited sight distance both for pedestrians looking for traffic and for drivers. There were also no warning beacons or flashing lights indicating pedestrian crossings. Claimants contend that their severe and permanent injuries were proximately caused by the above-descr':ibed negligent conduct and dangerous conditions of the property of the County of Contra Costa. The names of the public employees causing Claimant's injuries, damages and loss are unknown at this time. Claimants further contend that they have been generally damaged by the injuries and severe pain that he has suffered. Claimant Nadia Amin has incurred 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. Mohamed Eisa has a related loss of consortium claim. Claim Against the County of Contra Costa Re: Nadia Amin & Mohamed Eisa March 20, 2007 Page 3 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: March 20, 2007 JOHH M. F E MARK J. ZANOKINI Attorneys for Claimants PROOF OF SERVICE BY CERTIFIED MAIL C.C.P. Sections 1013(a) and 2015.5 1 declare that I am employed in the City and County of San Francisco, 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. On March 20, 2007, 1 caused Claimants' 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 Francisco, California, 94104, addressed as follows: The 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 March 20, 2007 at San Francisco, California. 61ut't \ NELEEN MOITOSO RECEIVED LAW OFFICES ROUDA, FEDER, TIETJEN & ZANOBINI MAR 2 1 2007 44 MONTGOMERY STREET,SUITE 4000 SAN FRANCISCO,CALIFORNIA 94104 CLERK BOARD Or SUPERRS VISO CONTRA COSTA CO. (415)398-5398 -RONALD H.ROUDA *PROFESSIONAL CORPORATION JOHN M. FEDER FAX(415)398-8169 TIMOTHY G.TIETJEN MARK J.ZANOBINI JUNE P.BASHANT March 20, 2007 CERTIFIED MAIL - RETURN RECEIPT REQUESTED TO: The Clerk of the Board of Supervisors Room 106, County Administration Building 651 Pine Street Martinez, CA 94553 RE: Amin/Eisa v. County of Contra Costa ENCLOSURES: CLAIM FOR DAMAGES AGAINST THE COUNTY OF CONTRA COSTA BY NA.DIA AMIN and MOHAMED EISA [XX] For Filing. [XX] Please return file endorsed copy(ies) [XX] Self-addressed/stamped envelope enclosed. Very truly yours, Neleen Moitoso Assistant to Mark J. Zanobini :nm Encs. 0 O c< 8 ' C i O5 il G cx W � G as r1 i c5 Ln ON ° tC �. U �, U U) N Alm 'ilio o r H ul 00 140 Ln 7 o W � a tt't N Z W � o � a Aaa c`- W N V y� U � N 0U N Z F� Z U. (QUI 2 4 4 0 - c:::) �G O a� N 00 r-4NOW �O .1 �V c C5Q Q � C� o�d H L&A - m0 @v W cc: cr � � N H r S431tNn ca0crj W O . a r V' w H o � ua 45 �. ON r p .16U N _ O N � o W �u rto 1 Ln(p Ul O W lull o W N U Y oda Q N CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: APRIL 24, 2007 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 California Government Codes. � Lau� you is your notice of the action taken on your claim by the Board of MA�c 2 2 LG07 • Supervisors. (Paragraph IV below), given Pursuant to Government Code AMOUNT: TO BE DETERMINED COUNTY COUNSEL Section 913 and 915.4. Please note all MARTINEZ CALIF, "Warnings". CLAIMANT: MATS AND GRETCHEN SCHEID ATTORNEY: UNKNOWN DATE RECEIVED: MARCH 22, 2007 ADDRESS: 516 CHIPMUNK COURT BY DELIVERY TO CLERK ON:MARCH 22, 2007 SANTA ROSA, CA 95401 BY MAIL POSTMARKED: HAND DELIVERED FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. MARCH 22, 2007 JOHN CULLEN, C Dated: By: Deputy 11, FROM.: County Counsel TO: Clerk of the Board of Sup visors his claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we ai•e 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 9l 1.3). ( ) Other: Dated: .3' a ;2-(D 7 By: �I' 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: (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 fol- this orthis date. Dated: 73OHN CULLEN, 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. ff you want to consult an attorney,you should do so immediately. *For Additional Warring 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. • J Dated: JOHN CULLEN, CLERK By Deputy Clerk 1/ B -ARD CSF SLTPFIRVISORS OF CONTR., C6S to COUNTY INSTRUCTIONS TO CLAXYLAINT A claim relating to a cause of act on for death or for injury to person or to persoaal 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 aeon shall be.presented not later than one year - after the accrual of the cause of action. (Gov. Cade § 911.2) 3. Claims must be filled with the Clerk of the Board of Supervisors at its office in. Room 1.06, County A.dmib stration Building, 651 Fine Street,Martinez, CA 945 53. If claim is against a district governed by the Board of Slipervisors, rather than the County, the mane of the District should be filled in. I If the claim is against niore than one public entity; separate claims must be filed against each, public entity. _ E, Fraud. See:penaltyfdr fraudulent claims$Pedal Gide Sec:72°af the ehd ofthis fozm sums Q Q Q Q A 6 R A Q R@ Q 8 Q FE a IT m A ram Una II' Zen C[ RE: Claim Y_: _ ���.__.._� Reserved for Clerk's filing stamp Matthew & Gretchen Scheid } _T6 Chipmuh.k Ct Santa Rosa.C%.95401 REC Against the County of Contra-Costa or MAR. 2 /Uu/ District) CLf RK r, SOgAp Fill 1n the name) CON7AA COST�'SAF OU VO0. ISOAS w � q The undersigned claimiant hereb y males claim against the County of Contra Costa or the abo-k e-namad ! cd.str'icl in the sum of ''""` and in support of this claim represents as follows: 1 men did the damage or i'�jUry ( � ) g. ] � occur? Gig=.�exact dare and hair , 12/26/2006 @ 2. br The Damage occurred at the stop light at Marina Vista and the Northbound 1-680 off ramp in the'r•ight hand south Morand lane. 3. How did the danla�e or inLttr�occur? (Give full details:use extra paper if required) While stopped'at a red light the stop light to the right of the vehicle blew over iaa :heavy winds and landed on the right-front corner of the vehicle.The vehicle is *`2004 Nissan Maxima. 4 t-particular act or omissionfin on e part of c0uni-y Or district offic . � ers, servants; or employees '. causedthe injury or damage? fr. Stop flights should be secured in a manner that prevents them from lilo*ing over. r.- '} 5 What are the names of county or'district officers,servants, or ezuployees causing the damage or inju�-y? 6. What .damage- or Wurios do your claim resulted? (Give full extent of injuries or damages cla1ne .es+imatos-for_auto_da�nag We request the City of Martinez or responsible agency pay to have our vehicle repaired at the facility of our choice. 7. How was Ahe amount .claimed above._coroputed? (Include the estimated amount of any prospective injury or da'mazi - See attached. 8. Names and addresses of v Tgesses,doctois�and_hospi Jessica Beaty 516 Chipmunk Ct. Santa Rosa Ca.95401 (passenger) Matthew Scheid 516 Chipmunk Ct. Santa Rosa,Ca. 95401 (driver) 9. List the expenditures you made-on account of this accident or injury: DATE TLP AMOUNT G6'QB�Q:E•QBS`Q':3=8"Q".8'.c,Q;l}'.^_:!e;E4:D;s.R.o.n.e,u'B¢:S:Ui 6:6;2.^-9.S1..9?3a 8';.0 Q Q.Q.B.B.A.B S Q Q_u Q Q_S 0 8 0 8 Q Q 3 Q A&013 f[ E 6E Q Q 1 Goa. Code Sec: 910.2P rdvides "Tlie claiiim sliall be signed by ihb claimant or by some person on lis behalsr' SEND NOTICES TO: GkatomeV' 1 Name and address of Attorney } } (Claunant's i� e) } 516`Chipmunk Ct. Santa Rosa Ca. 95401 (Address) } 'Telephone No. }Telephone No. 707-799-9178 or 925-323-7450 Q QL+4000 C+Q B 6 a Z U 1186Qt39 SC UE;a a a aunt!QQQSIIQ QQCCRUIan U3QQ Q8t1G 8 OIIQQf:aa a9.©8.1[98H Q6L Q QQ8 Q8Q8 QW BaI PUBLIC RWORDS NOTICE: Please be advised that this claim farmm.f ,-or any clailed with the.County under the Tort Claims Ac.,is subject to % ... public disclosure under ttie:`California'Pubiia Records Act: (Gov.:Code; §§ ,65`00 of>seq) Furthermore,::any attachrnents,addendums, or supplemeiits attached to the claim form, including medical records are:also subject to public disclosure. Q QL•68lima OQ888 Q9Q aQ3 RMR, 5 r ?M91RQtiQG8C88HCB=E A 3 Q Q II B IS u M Q?S 88 Q 28 Q8 QIIG U 85 F 5Q C1E8 H98 EH a 8 A u 9Ct NOTICE: Section i2 of rhe Penal Code provides: Every person tvho, with intent to defraud, presents for allowance or for payment to any state board or oLicer, 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 exceedbig one thousand dollars (2,000.00), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceedhag ten thousand dollars ($10,000), or by both such imprisonment and fine. s ,. .._,... ., . .,... ;u. s._. .. r. .. .. \- �. .....,.. . : ..._ .. .. ate:—''21 4/200704.44 743 ..... .::'...::..;:::.':.;::,_�.'::;::::•:.,::,;:.,- '-:::..::Est - .. .-...... .. _ Estimate,Version� 'p.. f Preliminary:'. -. Profile ID SYMMONS. . SYMMONS BODY & FENDER INC. 509 SAN RAMON VALLEY'.8LVD.DANVILLE,CA 94526 (925).820-3317 Faic..(9M..820=8897 Tax iD:..9.4-2536583`.BAR 9: AE070127-553102 EPA#::77 294 . ... es a ... , . . Ass ..... .. .. ...:... ......:.._.:. .. _. .:� - a e " Deductible: UNKNOWN Claimant: GRETCHEN SCHEID Address: 747 SAN'LULS C.T.CONCORD,CA 94518 Telephone: Borne Phone: (925)323-7450.::: : Mitchell:Service: ":910099. .:. :.:. .. Description:,::200.4 Nissan:Maxima. L:..: :: Vehicle Production Date: 310 }:' Body:Style: 4D Sed : C N4BA41 E94C.900848 Drive Train: ,`3:5L.Inj 6`Cy14A.FW 1 . Mileage:_:,,582;216' License. .5J.BL860 A !. olor:;-,PEARL . ... Options: ALUMIALLOY WHEELS,.. R'CONDITIONING;POWER STEERING;POWER.WINDOWS { PQINER DOOR LOCKS,TILT STEERING WHEEL,CRUISE CONTROL;ELECTRIC DEFOGGER < :AU TOMATIC:TRANSMISSION;AM-F'M-STEREOICDPLAYER(SINGLE) LDinecirtiemtion. ...... .:....•:<,:. :: el::::. Dollarri;':-; ::,:;:.Lbor'.:.: tsUniLan. :...:�::. It .,.. ..T. e,,.... .O era o ....__ >.. ..:::.: ....... ..._.::._.-::.,.:-:....:,....,.:: .. em.......Number,... P................P.. 1 00187'1`-:..'BDY':`:' OV.ERHAUL :7.:' : .' F.RT BUMPER COVER;;ASSY' 2 001950 BDY REMOVEIREPLACE - FRT BUMPER COVER . 62022-7Y0402.6 235.68 INC # 3 AUTO REF 'REFINISH FRT BUMPER COVER.'. C 4 000037 BDY REMOVEIREPLACE .. GRILLE 62070-7Y000 192.73 0.1 5 000038 BDY REMOVElREPLACE GRILLE ADHESIVE EMBLEM 62890-TY000 20.40 0.1 6 001787 BDY REMOVEIINSTALL L FRT COMBINATION LAMP 0.2 # 7 000041 BDY REMOVE.IREPLACE R FRONT COMBINATION LAMP ASSEMBLY 26010-ZA90A 873.91 0.2 8 AUTO BDY CHECKIADJUST HEADLAMPS 0.4 9 000079 BDY REMOVEIREPLACE HOOD PANEL 65100-7Y030 396.08 1.0 10 AUTO: REF REFINISH HOOD OUTSIDE C 2.6 C 1.3 11 AUTO .-'..REF:.::....:REFINISH. HOOD UNDERSIDE 12 001910.' REF' BLEND R FENDER.OUTSIDE C 0:8_ C 0.8 13 .001911 REF BLEND . L FENDER OUTSIDE . 14 003225 BDY REMOVE/INSTALL R.FENDER MUDGUARD 0 2 15 003226 BDY REMOVEIINSTALL L FENDER MUDGUARD 0.2 16 000188 BDY REMOVEIREPLACE -4 FRONT BODY RADIATOR SUPPORT 62500-7Y000 348.03 2.8 # 17 . 936012.... ADD'!COST_ HAZARDOUS WASTE DISPD�SAL 2.00 r...: T OP :.•:.:::::..: .:::. . .-:...,•.,,,:;.::. 19 .THREE STAGE:.:REF :`. ;ADD'L OPR ''4:4: 20 933017 . BDY" ADD'L OPR FINISH SAND AND BUFF " 1.7• 21 933018 BDY' ADD'L OPR MASK'.FOR OVERSPRAY . 6:00" 22 AUTO ADD'L COST PAINT/MATERIALS 375.00" ESTIMATE RECALL NUMBER: 216/2007 16:44:32 743 UltraMate is a Trademark of Mitchell International Mitchell Data Version: JAN_07_V Copyright(C)1994-2003 Mitchell International Page 1 of 2 UltraMate Version: 5.0.215 All Rights Reserved ... .t.. ..r... ., .:. ... r .:.r _ .. .i .. :,...: t•Fy i•iR. ..+};,`i ::.;:.,., .. .):- •..ti:yy�;:• .. ... ... .. -....... ... ..... ...a.... ,-.... .. .,. ........ , _.. ..g,..._-'r%}`:�}:.�.....'o::..:.^7.,...=-'.:"i'9:;{;i:;...A rr.y... Es ''PreliminaY Profile'ID: SYM 0 * -Judgement Item #-Labor Note Applies C -included in Three Stage.Calc : I _ : .. ..... . . . ..... ..... .. . Add .. . -•--.::-...,.:,:..:..: .-: rte..:, ...,�...+.. ,.:::-::.,,.. - -...... '- -- -:', �.: . .;.:::. :.: - - ent Summ Amount ^I_:_ fbor Subtotals =rr. •s=Umts .-- 'Rate' Amount Amount Totals 11. Part Replacem ary _ Body 9.4 73.00 6.00 0.00 692.20 Taxable Parts 2,066.83 Refinish 12.5 73.00 0.00 0.00 912.50 Sales Tax @ 8.250% 170.51 Non-Taxable Labor9,604.70 Total Replacement Parts.Amount 2,237.34 - Labor Summary : 21..9.' : ..::Ill. Additional.Costs" . Adjustments _ ty A Taxable'Costs 'oD ustomenResponsibili 000 :. Sales Tax @ 8:250%:: ...3. 1:10: Total Additional Costs . .408:10::.::.: I:. Total Labor:: 1,604.70. If. Total Replacement Parts: 2,237.34 I III, Total Additional Costs: 408.10 Gross Total: 4,250.14 .::.. ...... .. ._,r. :,.:...... ' ._.:.. .-:...-, .:,:: . ..._ .: . :.. ...: i.::...:'..;-:.•...",:...:.; _0­ . 4250.14tal. - ) .......:.... . a This is a,preliminary estimate. Additional chancres to the estimate may be required for the actual repair. I hereby authorize Symmons. Body & Fender Inc. to make -the above' repairs. The Body Shop. Will not be responsible. for loss or damage to vehicle or. articles'.left.-.in-.vehicle :in case of .F3.re.,. ..Theft Or Accident:.. ,l X COPY OF ESTIMATE TO OWNER ADDITIONAL':.DAAGE. IS. :FOUND:'_;QR" SUP'PLENA9ENT':APPROVAL IS.:NEEDEp; ;E1ROM" I. . . . `I INSURANCE -.COMPANY DELAY IN FINISH 'DATE BY 'OCCUR ESTIMATE RECALL NUMBER: 216/200716:44:32 743 UltraMate is a Trademark of Mitchell.international Mitchell Data Version: JAN_07_V Copyright(C)1994 2003 Mitchell International Page 2 of 2 UltraMate Version: 5.0.215 All Rights Reserved . .02/231 /2007 at 8 : M 0 55 A yob. Number: ! 40462 MIKE ROSE"'S' AUTO .BODY= .INC: ,- VDM License #:BAR# AG18474 Federal. ID # : 942621349 EPA# CAR 000004317 i ,WHERE 'QUALITY COUNTS 2260 VIA DE MERCADOS CONCORD, CA 94520-4920 .' "(925) 689-1739 Fax: (925) 689-099.1 PRELIMINARY ESTIMATE 'Y _��� _..(>r�'3�.,_.'„ma=r_ �=iRd' o ;.w . . .. .. ... .:. ... ..... .r.. ,. ....., ..... ... ... L.”_ :[iii' ?��" - a.. v Insured;: GRETCHEN SCHE'ID':: Claim # Owner:. GRETCHEN: :SCHEID, Policy # Address: 74.7 ,.SAN LUIS CT Deductible:. , CONCORD,. CA 94518 Date of Loss: Evening: (925-) 429-2766.,,.. Type of Loss: Business: (925),:323 ,745.0; Point of Impact.: 12 , Front Inspect MIKE.:'ROSEt,S AUTO: BODY INC. - VDM Business : {925} 689-1739 Location: WHERE-:QUALITY COUNTS 226,0 VIA DE MERCADOS CONCOR.D, :CA'. 94520-4920 Insurance Company: 5' Days to,: -Repair 2004 HISS MAXIMA 'SL 6-3 . 5L-FI 4D SED, PEARL.: I'nt : VIN: 1N4BA41E94C900848 Lic: 5JBL860 CA Prod Date: Odometer: . Air Conditioning Rear Defogger Tilt Wheel Cruise Control Telescopic Wheel Intermittent Wipers` ' . Keyless Entry Theft Deterrent/Alarm Steering Wheel Controls >..;...-;.?.aK Mirror _ ,soy r Roof — - amps ....•.:__..-t...- ....+G.G .•_.. ._...__..L..i.. ....:.::..:... .. .. � 'Yit,. 'l•'S'1 `LAG .. ..., ..:: ,... .a,....... ,,... _.C}E+C._... ...Cr-._c::`_ :,\;:i `'ref.: ..... .�. ..... .,.... .. .:....:.<.,-.t... . .._. .>. d•:'' �F:`I P.:�i•. .......... .. ..... ... ,:, .,-.. -..,,.-. ,.._. ,:.. ... n.. _ .16 . ,. ..,_.. . .... ..:. ..:.r... ...... :. A. ... :--, :L •kp ,_ Pov�er 'Mirrors 9 , e r; S Power Trunk/Tailgat %e::,.>.:;' <;. 'AM .Radio- ; FM Radio Stereo:' ,.. Cassette f Search/Seek Equalizer CD Changer/Stacker ? `ROSE Radio Anti,='Lock Brakes (4) Driver Air Bag Passenger Air Bag Front Side Impact Air Bag 4 Wheel Disc Brakes Leather Seats Recline/Lounge Seats Heated Seats Automa-tic Transmission Overdrive Aluminum/Alloy Wheels - - - - -- -- - ------ - - - - - --- - -- - - - - 77 7.7 ` NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT --- - -- - - - - - - - - - - - - - - - - -- -- - - - - - - - - - - - - - - - - - - 1 FRONT BUMPER 2 O/H bumper asst' 0 0 . 00 2 .2 0 . 0 3 Repl Bumper cover 1 235 . 68 Incl . 2 . 6 4 " Add for Th :... :.:. 0 0 . 00. 0 :•0 1 . 8 5 FRONT LAMPS 6 R&I LT, .Headlamp assy. 0 0 . 00 0 .4 0 . 0 7 RT Re l' Headlamp P ass Y. � ' 342 . 52 0 .4 0 . 0 Z ' 02/21/2007 at 08:; 55 ESM Job Number: 40462 PRE'LIMINAR.Y;. ESTIMATE 2004 NISS MAXIMA SL 6-3 . 5L-FI 4D SED PEARL Int NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT - - - - - - - -- - - - - - - - - - -- -- -- -- -- - - - - - - - - ----- -- - - - - - - -- - - - - - - - - - - - -- - - - Aim headlamps. 0 0.. 00 0 .:5 ._ 0 . 0 9 :. .. HOOD 10 Repl . Hood 1 396 . 08 1 . 1 2 . 8 11_ Add for Three Stage 01 0 . 00 0 . 0 2 . 0 12 02/21/2007: at 08 : 55 AM Job Number: 40462 PRELIMINARY ESTIMATE 2004 NISS "MAXIMA SL 6-3 :'SL-FI 4D 'SED PEARL• Int : FOR YOUR PROTECTION CALIFORNIA LA?r) '`REQUIRES THE FOLLOWING TO APPEAR ON THIS FORM: F,NY PERSON WHO KNOWINGLY PRESENTS FALSE OR 'FRAUDULENT CLAIM FOR THE PAYMENT OF A LOSS IS GUILTY OF A CRIME AND MAY BE SUBJECT TO FINES AND CONFINEMENT IN STATE PRISON. i -OT•r:OWTNi(- TS A i,IS'+ CF ABBREV-IATIONS On. SYMBOLS 'T='AT MAY BE USED TO ::._ - — l�.E�CI3�. nrOxtC..,,_O...b-.-:. DO2�t.�..OR .PA�R_.S.....i0°''".. R�_.A_RED:�;•:O:R';::a. : .T , :':.:::..::z_i. . -: 13BBRrVIATION.S/SYMBO_,S:., :D. �ISGONT:INUED::..PART':A-AP•PROXIMATE: PRI:CE<`Z)AB:OR ;.T.YPES '_;;`` B=BODY LABOR D=DIAGNOSTIC .E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT ,LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS : ADJ=ADJACENT' ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT O/H=OVERHAUL OP=OPERATION NO=LINE `NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY REPLACEMENT PART COMP -REPL PARTS=COMPETITIVE REPLACEMENT PkRTS 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=LE'F'TW/O=WITHOUT W/ =WITH/_ SYMBOLS :. #=MANTUAL LINE ENTRY *=OTHER [IE . .MO'TORS DATABASE INFORMATION WAS CHANGED) **=DATABASE LINE WITH AFTERMARKET. N=NOTES ATTACHED TO LINE. MQVP=MANUFACTURER'S QUALIFICATION AND VALIDATION PROGRAM, OPT OEM=ORIGINAL EQUIPMENT MANUFACTURER PARTS EITHER OPTIONALLY SOURCED OR OTHERW I'SE. .PROVIDED.IXIITH SOME UNIQUE .PRICING OR DISCOUNT. NWCPI=NATIONTq.TDE• CRASH :. ... PARTS PROGRAM: . : Estimate based on MOTOR CRASH EST MIATING 'GUIDS. Unless cti_er-wise noted all items are derlved from the Guide ARFF3750 Database Date, 01/2007, CCS Data Date 01/2007, and the parts selected are i OEM-parts manufactured by the vehicles' Original Equipment Manufacturer. OEM parts are available at 0=/Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEP•1 (Alterna=xve OEM) parts are OFM parts -ha: may be provided by or through alternate sources or-h than t?ie V=?i ,en: is r�`�'�rSi;i Vic. 1 - - - _ .m,$:. a� r,...E._..C_ •SQ .:aDeC�.•t•_C:;::..-SD _a _G ..rr:1 Ii! �!J... _ Ora � `GG_._ .:OSN:`O { :.�, (.; ALT OEN..pa:�s mGv .�ncluae ein_shed." parts:.provided-'Sv.:OEM':s"tHrougt`i.,0�'-r,;.Ten.;`:aTe�d eaIershins,' I Asterisk (*) or'Double Asterisk (**) indicare's that the:%+parts aria/or labor information provided by MOTOR may have been modified or may have come from an alternate data source: Tilde sign (-) items indicate MOTOR Not-Included Labor opera Non-Original Equipment Manufacturer aftermarket �. P 9 I., parts are described as AM, Qual- Repl Parts or Comp Rep! Parts which stands for Competitive if Replacement Parts. Used parts are described as L•K o ^- ,e ne { Q; Qual Recy _ants, RAY., or..US^J. .. corditxc__ d parts are described as Recond. Recored parts are descr-ibed as Recor . NAGSPart Numbers and 4 Benchmark Prices are provided by National Auto Glass Specifications. Labor operation times listed on the line with the NAGS information are MOTOR suggested labor operation times. NAGS labor I+ operation times are not included. Pound sign (r) items indicate manual entries. Some 2006 i;. vehicles contain minor charges from the previous year. For those vehicles, prior to receiving F !lQdated data from the vehicle manufacturer, labor and parts data from t�?e previous year ma;.' be tiS�.d. �''1 Pat-l'•ii:'ay= estimator hds 'a complete list of applicable =lei?Kies. Parts numbers and prlce� . should be c o n f i rmed 4i_th Che local dealership. . CCC Path:'a}'S - .n product. of CCC l;?lei mat:on Services Inc.. 3 r:':'.. . .y MARTINEZ POLICE DEPARTMENT PRrfm Page 1 CAD INCIDENT REPORT:`.. .;:.:.::::. ...::::"::. 061226056. . . 3/22/2007 Location Cross Streets I City MARINA VISTA/1 680 1 680 MARTINEZ Incident Type Call'faker Dispatcher 20002 - HIT AND RUN JOHNSEN,KAREN JOHNSEN,KAREN Date Priority Primary Unit Beat Fire Zone Area Map Source 12/26/2006 2 L108 1 139 TELEPHONE CALL Caller Name Caller Address Caller Phone Dispositions Weapon Alm Level Case Number Outside Assist 06-5744 Vehicles Associated Incidents Incident Times Special Circumstances Received 15:28:16 Created 15:29:52 -- -- Dispatched 15:39:47 Persons En Route 15:40:08 On Scene 15:44:50 Closed 16:00:42 Rcvd-Closed 32:26 Unit Times Officer Dispatched Enroute On Scene Clear Disp-On Scene On Scene-Clear Disp-Clear L64 Vandermeulen,Jeff 15:39:47 15:40:07 15:40:16 N/A N/A 00:29 L108 Schnabel,Craig 15:40:10 15:40:14 15:44:49 16:00:42 04:39 15:53 20:32 L64 Vandermeulen,Jeff 15:42:05 15:42:13 15:46:04 N/A N/A 03:59 L64 Vandcrmculen,Jeff 15:52:28 15:52:30 15:59:40 N/A N/A 07:12 Incident Comments DOWNED SIGNAL LIGHT AT THIS 20.MAKING 21 TO CAL TRANS,PER COUNTY SIGNALS NOT THEIRS. DR CANCELLED,CHP HANDLING TIME:...::'::;.:.: H,EVENT :.'::::::: . :':' ::: 15:29:52 Incident initiated at Marina Vista/I 680,Martinez 15:30:34 Incident comments changed 15:31:58 CAL TRANS ADVISED AT 415-330-6500 15:33:50 CHP CALLING ABOUT THE DOWN LIGHT 15:36:12 2ND CALLER SAID SIGNAL FELL ON HIS VEH,BUT HE ALREADY LEFT AREA DUE TO 15:36:12 TRAFFIC BACKING UP.ADV IF REPORT NEEDED TO COME TO PD AT HIS 15:36:12 CONVENIENCE 15:36:35 Incident comments changed 15:39:47 L64 DISP. Marina Vista/I 680,Martinez ib 15:40:07 L64 10-49. 15:40:10 L108 DISP. Marina Vista/I 680,Martinez 15:40:14 L 108 10-49. _ Q� 15:40:16 L64 10-8. ® � 15:42:05 L64 DISP.Marina Vista/I 680,Martinez Cl �b � 1542:13 L64 10-49. V 15:44:49 L108 10-97. 15:46:02 L108 ADV CAL TRANS IS 97 MVI AS ®3'1108-LNOO 15:46:04 L64 10-8. SONVI iSS13H 80 NOUV'C lIdna 15:48:23 L 108 Case number 06-5744 assigned to 061226056 15:48:36 Incident type changed from MIST to 20002 15:52:28 L64 DISP.Marina Vista/I 680,Martinez 15:52:30 L64 10-49. 15:52:48 L64 10-49. 15:59:40 L64 10-8. �AI)Incident 061226056. Page 2 .:.. ..:. - .. TIME EVENT.:. 16:00:27 L108 ADV STANDING BY FOR CHP,22 THE DR# 16:00:42 L108 10-8.CAL TRANS ON SCEEN,CHP TO HANDLE. 16:00:43 L108 Closed-Disposition OS 16:01:32 Incident comments changed I APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION APRIL 24. 2007 Application to File. Late Claim ) NOTICE TO APPLICANT 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. t Claimant: JOSEPH TIEDJE � HD111�Attorney: UNKNOWN MAR 2 6 2007 Address: 805 SUMMER CIRCLE COUNTY COUNSEL . BRENTWOOD, CA 94513 MARTINEZ CALIF. MARCH 26. 2007 Amount: $830.00 By delivery to Clerk on: ; I Date Received: MARCH 26, 2007 By mail,postmarked on:' HAND DELIVERED 1. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. ' DATED: MARCH 26. 2007 .IOH.N CULLE N, Clerk, By: DEPUTY II. FROM: County Counsel TO: Cler of thejBoard of Apervisors ( ) The Board should grant this Application to File Late Claim (Section 911.6) (v�The Board should deny this Application to File Late Claim (Section 911.6). DATED: -7-- o-7 SILVANO B. MARCHESI, County Counsel, By: DEPUTY III. BOARD ORDER By unanimous vote of Supervlsors present (Check one only) 1 ( ) 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. u DATE: Aeyi/-Zz, 2,&w? JOHN CULLEN, Clerk, By: �j�� 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 apRocation 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 riled and endorsed on the Board's copy of this Claim in accordance with Section 29703. d d DATED: 461' JOHN CULLEN', Clerk,By: DEPUTY V. FRONI: (1) County Counsel (2) County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By: County Administrator, By: APPLICATION TO FILE LATE CLAIM Zex)-7 4;rlrur- ;r z— (,Oce"o .&7 '42 A BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY �p INSTRUCTIONS TO CLARVL NT A. 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. ■a an a a a a a t a a a a a a a MR tun Isms■n a l a a a a a a a t a a a l a l a x a a t a ON mama a a a a a t a o a a Una a a a a a a an MR RE: Claim By: Reserved for Clerk's filing stamp RECEIVE® Against the County of Contra Costa or )1 MAR 6 cuui J CLERK BOARD OF SUPERVISORS _ District) CONTRA COSTA Co. (Fill in the name) Y The undersigned cl ' t hereby makes claim against the County of Contra Costa or the above-named district in the sum of$ ecko and in support of this claim represents as follows: 1. When did the damage o injury occur? (Give exact date and hour) �x)(:� ' 7 �/*"' 2. Where did the damage or injury occur? (Include city and county) 3. How did the a or in' occur? Give full details•use extra paper if required) dame . Jm'Y ( � PaP 4 ) 4. What particular act or omission on the part of county or distract officers, servants, or employees caused the injury or damage? 7�. J7tJ 5 What are the names of county or district officers, servants, or employees causing the damage or injury? 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages - ..claimed. -Attach-two estimates for auto damage.) vAef . 7. How was the amount claimed above computed? (Include the estimated ainount of any prospective injury or damage.) 8. Names and addresses of witnesses,doctors, and hospitals: 9. List the expenditures you made-on account of this accident or injury: DATE T IVM AMOUNT Z 200 (0 . X,2�)Dxv am a a BANKS a exams NIS as a a ass a air it IAN a a ass BEV at MEN BE ME on It IF a a a Elias am as Bills ass us a A a a a a Ina Nos I ) .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) 1 Name and address of Attorney ) (Claimant's Signature (Address) Q Telephone No. )Telephone No. ( Al—'�%zZ— 0 2'3 ■11■i a t a!a R t t[a a!ata Maxus a in ■t a a t t■a t t■t a t t t Stana![a a!a t t a t a a s t a t a!a a SUNa mass Nunn Am Est 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, s§ 6500 et seq.) Furthermore, any attachments,addendums, or supplements attached to the claim form, including medical records, are also subject to public disclosure. ■ sonNASA a s t/!t■■a a a a s a a a a ■1 t a a!a!!a!t a a R a■■Emit Iaa!a!!a[t!a a a a a a[a t!!i i Una a a t a a t!a a Mal 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. ATr CONTRA COSTA COUNTY =' Office ®f the District Attorney k Roberti. Xochly District.attorney TO: Whom It May Concern FROM: Tom Kensok, Misdemeanor Team Supervisor SUBJECT: Joseph David Tiedje DOB: 03/16/1966 DATE: 0112312007 A review of our records show no criminal complaint was issued against the above noted individual based on the incident described in Sheriffs Office Report Number 06-17178, occurring on 07/01/2006. Tom Kensok, Misdem or Team Supervisor/tb Central-Eastern Operations (92 5) 646-2 62 5 10 Douglas Drive, Suite 130 FAX (925) 646-2524 Martinez, California 94553-4078 Ap RELEASE AND PROMISE TO APPEAR LIBERTAD Y PROMESA A PRESENTARSE DE FROM CONTRA COSTA COUNTY DETENTION LA FACILIDAD DE DETENC16N DEL CONTADO FACILITY DE CONTRA COSTA (Penal Code Section 853) (Codigo Penal Seccion 853) The People of the State of California ) y t 7' '`; La Gente del Estado de California ) . vs. en contra de Booking No. ;is :?i rsC` ' � No. de Registro(Bkg. No.) Warrant No.'s No. de Coprobante(s)(Wrnt. No.'s) In consideration of being released from custody, 1 hereby agree: En consideracif5n de ser libertado, yo estoy de acuerdo de: 1. That I will appear at the: 1. Yo me presentare al ❑ Walnut Creek Superior Court located at 640 ❑ Juzgado Superior de Walnut Creek,640 Ygnacio Ygnacio Valley Road,Walnut Creek Valley Road,Walnut Creek ❑ Bay Superior Court located at 100'-37th Street, ❑ Juzgado Superior de Bay, 100'-37th Street, Richmond Richmond LlMt. Diablo Superior Court located at 1010 Ward Ll Juzgado Superior de Mt. Diablo, 1010. Ward . Street, Martinez Street, Martinez ]f Delta Superior Court located at 45 Civic Avenue, ❑ Juzgado Superior de Delta, 45 Civic Drive, Pittsburg Pittsburg 4 Cl Court: C1 Otro Corte: :a v., DATE TIME FECHA TIEMPO on the charge of violating Section(s) i r s en el cargo de violando seccion(s) (p s t 1,? of the•California-PenaW.ehicle.Code: del Codigo Penal/del Camino f de California. 2. That if I fail to appear and am apprehended outside the State of California, I waive extradition. 2. Si yo fallo de presentarme y me aprenden afuera .del Estado de California, yo renuncio a una extradicidn. 3. 1 understand that any court or magistrate of competent jurisdiction may revoke this order of release and either 3. Yo comprendo que cualquier corte o majistrado de return me to custody or require that I give bail or other jurisdicci6n competente puede renoquar esta orden de assurance for my appearance. libertad, y puende regresarme a custodia o requirir que yo . . de fianza o orta seguridad para mi presentaci6n. 41. 1 further understand that if I fail to appear when required to do so that I may be charged with the additional crime of 4. Yo tal vez comprendo que si yo fallo de presentarme a misdemeanor under Section 1320A of the California Penal cuando requiren, que me pueden cobrar con el crimen adicional de un delito menor bajo la Seccihn 1320a del Code. Codigo Penal de California. DEFENDANT (signature) DEMANDADO Date—-7 - � Address'=� - � ' (Firma) 5 i 3't t , ''t,t. . Fecha Direccion City&Phone Q': ,.i Ciudad y Telefono FORM COMPLETED BY ! =: l: EMPLOYEE FORM COMPLETED BY EMPLOYEE# White-Court:Canary-Arresting Agency;Pink-Defendant;Goldenrod-Booking White-Court;Canary-Arresting Agency;Pink-Defendant;Goldenrod-Booking. DET 010:FRM Rev.329101 DET 010:FRM Rev.3129/01 o VESSEL ASSIST Boat U.S. ao mcisco Yachting Specialties, Inc. (WTI 0638) Fax(925)684-2184- P.O. Box 2169, Bethel Island, CA 94511-2169 - Ph. (925)684-2183 i Disabled Boat Information ;TowKe # Date of Service: t -... . How Contacte ❑ Name of Power ❑ Sail ❑ d:'p VHF ❑ Phone CG I Vessel: ❑ Visual ❑ BUS Disatch ❑ Other , Make: Length: Color: Nature of #POB: Distress: Reg./Doc.#: .i Weather&Sea Contitions: i Disabled boat's location' Owner 1 Operator i Disabled boat's : _ /j:Na,me: Destination:.. —-........... -'- - r Address: -.Time ETA: contacted: Cit.y:. ?" State: Zip:: '1)Time towboat 2)Time on...,, : - Out: scene: Home Phome: Work Phome: Cell Phone: !3)Time 4)Time Tow i - : in tow:.--• t completed � -= Card holder's Signiture: i 5) Time towboat._,.. f,,6)'Total time,, °itCard holder's Name:(print) i I at base i` billed j Towing Captain: , 'T n Cat ` .. ' Credit Card#:' i '::'' ' ... Exp. Date: `'Towboat Used: _ . 4 Vessel Assist-BOatU.S, Service Exp. Towboat's Location Member#: `� Level: Date: when contacted: DECRIPTION OF SERVICES BASIS-FOR CHARGES (RATES,TIME SPENT,ETC.) — AMOUNT J _ -- .�_— f , C7.Towing: hours x rate ❑ Dock to Dock: hours x rate ❑ Ungrounding: — rate x feet ❑ Diving hours x rate ❑Salvage . I — --- ----- --------- --. --....__—__.._......_... ----......—........... . - - - -- - - .......- - ...— --- i l Notes: I ' r=.tj =, 3 t;id f ; st:Release of liability I - Invoice I s I/N'c hereby agree to waive andrrele se any apd al�claims of any kind of nature whatsoever,including without limitation,claims for damage to the vessel,its np{'�urtenances,famishing andJlher ankles of anY nature and for personal injury or death,against Yachting Specialties,Inc.,noatU.S.and/or its ofliccrs, Subtotal din:etom.employees,shareholders,arriliates,agents and contractors related in any manner to the services provided hereunder. In consideration of the 1 i : related charges,either for membership or otherwise,the(liability of Yachting Specialties,Inc.nr BoatU.S.,for such loss,damage,injury or death,shall in + Membership all events be limited to S2,5(X).(X)for death,personal injury and/or,property damage. Ilwc agree to indemnify,hold hanulcss,and defend Yachting SI,,cewltics, i Inc.against all claims made by perwms aboard the vessel for properly damage or 4xs,personal injury,and for death which otherwise would lx waived,released I—J'__Urehase or limited hereunder if brought by me/us. I/We further agree to pay for all services prir,ided for hereunder,without offset of deduction,at the time of billing regardless of the result or outcome of services provided. If I/We fail to pay any invoice when due,Ilwe agree to pay a late charge of 1.5%per month(1819 per I i ...oror the nuuimum charge allowed by law,which ever is less,and additionally agree toany attorneys fees and costs related w any cuntroversy or claim .I arising of or mtin lag to necessaryarrestor this Agreement,and in the event it becomes to arreor otherwise seize said vessel.the undersigned agrees to pay all custs Total of such arrest. Cuntrovcrsy or claims that miry arise from.but not limited to this agreement shall be settled by The Maritime Ar6tration Association of the Amount billed United States in accordance with its rules,and judgment on the award may be entered in any court having jurisdiction thereof.The parties understand that e+ Thev are waiving any right to trial by Jury. I to BoatU.S. BALANCE PAID: ❑Cash-Rcvd. By ❑ Check# 0 Credit Card Balance Billed Boat Owner 1-1O erator❑ to Boater ------...- ---e - - -.. --- - - ---------..---- g -- -- - - -- . r Si nature Date -- Comments: : .. White to billing service--Yellow to-- Contractor--Pink to boat Owner/operator l -- --.._.__ . PARKER - STANBURY LLP ATTORNEYS AT LAW DOUGLASS H.MORI ALAN O.SEIMS MICHAEL COMPTON GLENN M.HABAS JOHN D.BARRETT.JR.• YVONNE E.MARTINEZ MARY SOUTH FLOWER STREET MARY V.ASSAD GEORGANN CARMAN ROBERT W.LOPRESTI• GEORGE A.HUNLOCK NINETEENTH FLOOR MICHAEL J.FRIEDMAN CHRISTOPHER J.THOMAS RONALD L.SMITH CHRISTOPHER R.KELLEY DANA C.GIOVINE MART N. ARELLA TIMOTHY D.LUCASALEX L.SHIA LOS ANGELES,CA 90071-2901 MATHEW L-MAY MICHAELCJ.CRUSH J.LUIS GARCIA B.PETER LEE PATRICK M.HEVESY VALERIE L.HANNA MICHAEL E.MCCABE TAMARA A.HAGGSTROM TELEPHONE!2 t 3)622.5124 CHRISTOPHER I.MERRILL WILLIAM M.PAO MARY ANNE FORAN MARCUS BASTIDA ALAN B.SHEATS REGINO M.VALENZUELA MATTHEW T.SALABEN ANTHONY W.JANSING FAX(2 13)622-4858 ALLA TENINA ARMANDO M.GALVAN CHRISTOPHER M.MOEN EDWARD C.JACOBS II FELICIA EDELMAN JOEL O.MARTINEZ MATTHEW W.DAVIS MARK E.STENSON E-MAIL'LA@PARKSTAN.COM ELIZABETH UNRATH TIEN H.LE REYNALDO C.SANTOS THERESA J.CARROLL JOHN E.REDO MICHAEL S.KANG MOJDEH ZAMANI ROSEMARIE MERRILL MANAGING PARTNER MARK A.GORDON BENJAMIN J.JESUDASSON JOYCE D.KIM DAVID C.LANE NELSON J.SCHWARTZ MICHAEL D.EVNIN DAVID E.COWAN TAMARA R.DENNIS ROBERT W.LOPRESTI JEFFH.GREEN ANTONIOT.HICKS MICHAEL O.ROUNTREE DONALD G.FURNESS KRISTEN J.LIEU MEMBER OF AMERICAN BOARD OF TRIAL ADVOCATES January 30, 200/ THOMAS L.WADDELL.OF COUNSEL HARRY D.PARKER(1891-1976) RAYMOND G.STANBURY(1904196M Contra Costa County Sheriff 210 O'Hara Avenue Oakley, CA 94561 Vessel Assist Yachting Specialties, Inc. P.O. Box 2169 Bethel Island, CA 94511-2169 To Whom It May Concern: Re: Joseph David Tiedje Refund Demand Tow Date: 07/01/2006 Sheriffs Office Report #: 06-17178 Our File No.: 1729195 Please be advised that Mr. Joseph 'Tiedje has contacted our law offices in connection with the unlawful towing of his jet ski, and the unnecessary and excessive fees he had to pay for the release of his jet ski. We have reviewed the facts and have advised Mr. Tiedje of his legal rights and remedies. This letter serves as Mr. Tiedje's good faith attempt to resolve this mater amicably and to avoid formal legal actions. According to Mr. Tiedje, on July 1, 2006, he was wrongfully accused of Boating Under the influence (BUI). Mr. Tiedje has always denied the allegations and has maintained his innocence. Without proper investigation into this mater, Mr. Tiedje's Jet Ski was towed away by Vessel Assist and per Sheriff instruction. Mr. Tiedje had to pay $830.00 to get his jet ski released to him (see attached). It turns out no criminal charges were ever brought against Mr. Tiedje for the alleged "BUI." This confirms the fact that Mr. Tiedje was innocent and that the allegations against him were false, and unfounded. His Jet Ski should never have been towed away and the amount of money charged by Vessel Assist was unreasonably high when in fact, the Jet Ski should never have been towed at all. ,This incident violates Mr. Tiedje's constitutional rights and is deemed an unlawful taking. ORANGE COUNTY SAN BERNARDINO SAN DIEGO SACRAMENTO 200 WEST SANTA ANA BOULEVARD 306 WEST SECOND STREET 3131 CAMINO DEL RIO NORTH 777 CAMPUS COMMONS ROAD SANTA ANA 92701.7502 SAN BERNARDINO 92401.1805 SAN DIEGO 92108.5706 SACRAMENTO 958258309 (714)547.7103 (909)8841256 (619)528.1259 (916)5657651 FAX(714)5473428 FAX(909)88&7876 FAX(6 19)5211.1419 FAX(916)929-0448 \\pssmt:r2\data$\_wpd_\Attorneys\Moji Zan)ani\LE'1-1.1:R r13MIJI.A'1'I:S-USI:\my form letter.doc j January 30, 2007 Page 2 With this letter, demand is hereby made that this matter be properly investigated and that a full and complete refund be issued to Mr. Tiedje for the entire amount of tow and storage cost charged for this matter. The towing of this Jet Ski was not only unconstitutional, but was done maliciously and in bad faith and the fees for the release of the property were highly excessive. We hereby give you full permission to contact Mr. Tiedje directly to resolve this matter informally. Mr. Tiedje may be reached at 805 Summer Cir., Brentwood, CA 94513 Nothing in this letter should be construed as a waiver of any of Mr. Tiedje's rights or remedies in this matter, all of which he expressly reserves. Please be advised that this letter is written pursuant to California Evidence Code § 1152, and any and all information and documentation submitted herein is for the purposes of settlement only, and nothing contained herein may be utilized in the subject proceeding. Thank you for your anticipated cooperation Very truly yours, PARKER • STANBURY LLP By MODJEH ZAMANT-, cc: Joseph Tiedje Enclosure \\psserver2\data$\_wpd_\Attorneys\Moji Lamani\L.E'I-I'ER'I'EMI'LA'I'L'•S-USE\my torm letter.doc\me Page i of 2 Subj: SFGate:.Going.to Canada?Check your past/Tourh is with minor criminal records turned back at border Date: 2/26/2007 8:09:13 P.M. Pacific Standard Time From: atiedje@yahoo.com To: jdtiedje@_ga om This article was sent to you by someone who found it on SFGate. The original article can be found on SFGate.com here: http:/Avww.sfgate.comJcgi-bin/article.egi?file=/rJa/2007/02/23/MNGCAO9NSB1.DTL Friday, February 23, 2007(SF Chronicle) Going to Canada?Check your past/Tourists with minor criminal records turned back at boater C.W. Nevius There was a time not long ago when a trip across the border from-the United States to Canada was accomplished with a wink and a wave of a driver's license.Those days are over. Take the case of 55-year-old Lake Tahoe resident Greg Felsch. Stopped at the border in Vancouver this month at the start of a planned five-day ski trip, he was sent back to the United States because of a DUI conviction seven years ago. Not that he had any idea what was going on when he was told at customs: "Your next stop is immigration." Felsch was ushered into a room. 'There must have been 75 people in line," he says."We were there for three hours. One woman was in tears.A guy was sent back for having a medical marijuana card. 1 felt like a felon with an ankle bracelet" Or ask the well-to-do East Bay couple who flew to British Columbia this month for an eight-day ski vacation at the famed Whistler Chateau, where rooms run to$500 a night They'd made the trip manytimes, but were surprised at the border to be told that the husband would have to report to"secondary"immigration. There, in a room he estimates was filled with 60 other concerned travelers, he was told he was"a person who was inadmissible to Canada." The problem?A conviction for marijuana possession. In 1975. Welcome to the new world of border security. Unsuspecting Americans are turning up at the Canadian border expecting clear sailing, only to find that their past—sometimes their distant past—is suddenly an issue. While Canada officially has barred travelers convicted of criminal offenses for years, attorneys say post-9/11 information-gathering, combined with a sweeping agreement between Canada and the United States to, share data, has resulted in a spike in phone calls from concerned travelers. They are shocked to hear that the sins of their youth might keep them out of Canada. But what they don't know is that this is just the beginning. Soon other nations will be able to look into your past when you want to travel there. "It's completely ridiculous,"said Chris Cannon,an attorney representing the East Bay couple,who asked that their names not be used because they don't want their kids to know about the pot rap."Irs a disaster. I mean, who didn't smoke pot in the 70s?" We're about to find out And don't think you are in the clear if you never inhaled. Ever get nabbed for a DUI?How about shoplifting?Tum around. You aren't getting in. "From the time that you tum 18,everything is in the system,"says Lucy Pefillo,whose Canada Border Crossing Service in Winnipeg,Manitoba,helps Americans get into the country. Canadian attorney David Lesperance, an expert on customs and immigration, says he hada dient who was ihvoWd in a fratemity prank 20 years ago. HA%vas on a scavenger hunt, and the assignment was to steal something from ;g.g� Wgg€y supermarket- He got caught, paid a small fine and was A4onday,tFcbnimy 26,:200y: i :�:.:y g- - Page 2 of 2 'r 6rd6red to sweep the police station parking lot. tie thought it was all forgotten.And it was, until he tried to cross the border. The official word from the Canadian Border Services Agency is that this is nothing more than business as usual. Spokesman Derek Mellon gets a little huffy when asked why the border has become so strict. "I think it is important to understand that you are entering another country," Mellon says. "You are not crossing the street." OK, but something changed here, didn't it? "People say, 'I've been going to Canada for 20 years and never had a problem,"" Lesperance says. "It's classic. I say, 'Well, you've been getting away with it for 20 years.'" A prior record has always made it difficult to cross the border. What you probably didn't know was that, as the Canadian Consulate's Web site says, "Driving while under the influence of alcohol is regarded as an extremely serious offense in Canada." So it isn't as if rules have stiffened. But what has changed is the way the information is gathered. In the wake of 9/11, Canada and the United States formed a partnership that has dramatically increased what Lesperance calls"the data mining"system at the border. The Smart Border Action Plan, as it is known, combines Canadian intelligence with extensive U.S. Homeland Security information. The partnership began in 2002, but it wasn't until recently that the system was refined. "They can call up anything that your state trooper in Iowa can," Lesperance says. "As Canadians and Americans have begun cooperating, all those indiscretions from the'60s are going to come back and haunt us." Now, there's a scary thought. But the irony of the East Bay couple's situation is inescapable. Since their rowdy days in the'70s, they have created and sold a publishing company, purchased extensive real estate holdings and own a$3 million getaway home in Lake Tahoe. "We've done pretty well since those days,"she says. "But what I wonder is hour many other people might be affected." The Canadian Border Services Agency says its statistics don't show an increase in the number of travelers turned back. But Cannon says that's because the"data mining"has just begun to pick up momentum. "It is too new to say,"he says. "Put it this way. I am one lawyer in San Francisco, and I've had four of these cases in the last two years, two since January.And remember, a lot of people don't want to talk about it (because of embarrassment)." Asked if there were more cases, attorney Lesperance was emphatic. "Oh, yeah," he says. "Just the number of calls I get has gone up. If we factor in the greater ability to discover these cases, it is just mathematically logical that we are going to see more." The lesson, the attorneys say, is that if you must travel to Canada, you should apply for"a Minister's Approval of Rehabilitation"to wipe the record clear. Oh, and by the way, if you don't need to travel to Canada, don't think you won't need to clear your record. Lesperance says it is just a matter of time before agreements are signed with governments in destinations like Japan, Indonesia and Europe. "This," Lesperance says, "is just the edge of the wedge." Who would have thought a single, crazy night in college would follow you around the world? Rules for getting into Canada For more information on offenses that prohibit entry to Canada, go to the Canadian Consulate's Web site at geo.international.gc.ca/can-am/seattle/visas/inadmissible-en.asp. For more information on visiting Canada, go to cic.gc.ca. C.W. Nevius'column appears regularly. His blog, C.W. Nevius.blog, can be found at SFGate.com. E-mail him at cwnevius@sfchronicle.com. ---------------_ __ _ __ ___—_—_ Copyright 2007 SF Chronicle Monday,February 26, 2007 America Online: JDTiedje APPLICATION TO FILE LATE CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY, CALIFORNIA BOARD ACTION Application to File Late Claim ) NOTICE TO APPLICANT APRIL 24, 2007 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.) ) giuen_puzsuantto Government Code Sections 911.8 kannd 91151.4t'Please note the"WARNING"below. Claimant: ELMA BADDER MAR 2 8 2007 Attorney: PAMELA PITT COUNTY COUNSEL MARTINEZ CALIF. LAW OFFICE OF PAMELA PITT Address: 22 BATTERY STREET, S TE. 1000 SAN FRANCISCO, CAI.94111 MARCH 28, 2007 Amount: UNKNOWN By delivery to Clerk on: I Date Received: MARCH 28, 2007 By mail,postmarked on: RECEIVED FROM COUNTY COUNSEL I. FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above noted Application to File Late Claim. DATED; MARCH 28. 2001-.INC[ .I,I�EN Clerk,By: DEPUTY I1. FROM: County Counsel TO: Clerk of thejBoard of Supervisors ( } The Board should grant this Application to File Late Claim (Section 911.6)i i 0 The Board should deny this Application to File Late Claim (Section 911.6). DATED: J DC7 -0 7 SILVANO B. MARCHESI, County Counsel,By: Mcc�� DEPUTY 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. a D.ATE:h X11.2 Z'"3 .101IN CULLE.N, 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 ap-Ocation 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. 1 d DATED: lr&Y/l o _ aALIP,,?- JOIIN CULLEN" Clerk, By: DEPUTY V. FROM: (1) County Counsel (2) County Administrator TO: Clerk of the Board of Supervisors Received copies of this Application and Board Order. DATED: County Counsel, By: County Administrator, By: APPLICATION TO FILE LATE CLAIM MLC 1 Pamela Pitt (SBN: 156395) —I -LAW OFFICE OF PAMELA PITT REc , 22 Battery Street, Suite 1000 ED C= z San Francisco, CA 94111 Telephone: 415 291-9251 MAR 2 8 [uui 00 acsimile: 415 274-8770 CLERK BOARD OF SUPERVISONS ttorney for Claimant, Elma Bauder C NTRACOSTA Co. 6 7 8 Elma Bauder, APPLICATION FOR ITO PRESENT 9 PARE CLS Claimant, AIM ION PURSUANT TO GOVERNMENT CODE 10 vs. §911.6(b)(1) and (b)(3) 11 Contra Costa County, 12 Defendant. 13 14 15 TO.! CONTRA COSTA 000NTY and its CLERK OF ITS BOARD: 16 Application is hereby made for permission to present the attached claim [Exhibit 1]-after 17 expiration of the time limit provided in Government Code §911.2. 18 1. As stated in the attached claim, claimant's cause of action arises out of a 19 sexual assault against claimant, Ms. Elma Bauder, perpetrated by Contra Costa County 20 agent and employee, Mr. Benjamin Mosley, One-Stop Operator Consortium Assistant 21 Administrator, for EASTBAY Works, and occurred on or about August 13, 2006. 22 2. The time to present a timely claim under Government Code §911.2 23 expired on or about February 12, 2007. 24 3. . The reason for the failure to present the claim within a timely manner is 25 because Mr. Mosley threatened to terminate Ms. Bauder from her employment if she. 26 reported to anyone.that she.had,been sexually�assaulted.._, Ms. Bauderwas afraid to 27 make a report because she is a single mother with two children and needed her job. 28 After she finally told a co-worker in November 2006 about the sexual assault, she was - 1 — Application for Permission to Present a Late Claim Pursuant to 911.6(b)(1)&(3) 1 terminated in December 2006. She was under duress not to make a claim. The board 2 should accept Ms. Bauder's claim pursuant to §911.6(b)(1) because of excusable 3 neglect: 4 §911.6(b) The board shall grant the application where one or more of the 5 following is applicable: (1)The failure to present the claim was through mistake, 6 inadvertence, surprise or excusable neglect and the public entity was not 7 prejudiced in its defense of the claim by the failure to present the claim within the 8 time specified in Section 911.2. 9 4. Ms. Bauder also failed to make a claim because of mental incapacity. Ms 10 Bauder has informed me that her medical provider has diagnosed her with Post 11 Traumatic Stress Disorder due to the sexual assault and battery. The board should 12 accept Ms. Bauder's claim pursuant to §911.6(b)(3): 13 §911.6(b) The board shall grant the application where one or more of the 14 following is applicable. . . (3) The person who sustained the alleged injury, 15 damage or loss was physically or mentally incapacitated during all of the time 16 specified in Section 911.2 for the presentation of the claim and by reason of such 17 disability failed to present a claim during such time. 18 19 1 declare under penalty of perjury under the laws of the State of California that 20 the forgoing is true and correct. 21 22 March 27, 2007 LAW FFICE OF PAMELA PITS' 23 24 25 By: Pamela Pitt, Attorney for 26 Elma Bauder 27 28 - 2 — Application for Permission to Present a Late Claim Pursuant to 911.6(b)(1)&(3) 1 PROOF OF SERVICE 2 3 1, Pamela Pitt, declare, I am over the age of 18 years and am employed in the 4 County of San Francisco, California. My business address is 22 Battery Street, Suite 5 1000, San Francisco, California 94111. On March 27, 2007 1 served copies of the 6 following documents: 7 8 Application for Permission to Present Late Claim Pursuant to §911.6(b)(1) and (b)(3) 9 By putting it in the United States mail to: 10 Clerk of the Board 11 Contra Costa County Board of Supervisors 12 651 Pine Street, 9th Floor 13 Martinez, CA 94553-1229 14 15 Monika L. Cooper, Esq. 16 Deputy County Counsel 17 651 Pine Street, 9th Floor 18 Martinez, CA 94553-1229 19 20 1 declare under penalty of perjury under the laws of the State of California that 21 the foregoing is true and correct, and th his declaration was exe ted on March 27, 22 2007 at San Francisco, California. 23 24 Pamela Pitt 25 26 27 28 - 3 — Application for Permission to Present a Late Claim Pursuant to 911.6(b)(1)&(3) .�-- ,, _. .. c ` ��., M .. ..,� ., ' ,�: ...._ �: •t ...�= p �. y'W, F ._ �� S_ 1 �� Y �� � o N 'r v: w s :.: 6' � y � cy� C 6'` �` �- � � d, v G � t�I3 ca X" � �v' t�i � � '� U `.�'. �: t .: 1,,�. Cfs �_ � � '� J J. JL `s- O f �u J n 3� ,.� ���� �Y �� ML VI iz-� ON C5, Ln L:-3 CTJ ACJ P WJ 1 Pamela Pitt (SBN: 156395) LAW OFFICE OF PAMELA PITT 2 22 Battery Street, Suite 1000 San Francisco, CA 94111 3 Telephone: 415 291-9251 Facsimile: 415 274-8770 4 Attorney for Claimant, Elma Bauder 5 6 7 8 Elma Bauder, APPLICATION FOR PERMISSION TO PRESENT 9 Claimant, LATE CLAIM PURSUANT TO GOVERNMENT CODE 10 vs. §911.6(b)(1) and (b)(3) 11 Contra Costa County, RECEIVED 12 Defendant. MAR 2 9 2001 13 CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. 14 15 TO: CONTRA COSTA COUNTY and its CLERK OF ITS BOARD: 16 Application is hereby made for permission to present the attached claim [Exhibit 1] after 17 expiration of the time limit provided in Government Code §911.2. 18 1. As stated in the attached claim, claimant's cause of action arises out of a 19 sexual assault against claimant, Ms. Elma Bauder, perpetrated by Contra Costa County 20 agent and employee, Mr. Benjamin Mosley, One-Stop Operator Consortium Assistant 21 Administrator, for EASTBAY Works, and occurred on or about August 13, 2006. 22 2. The time to present a timely claim under Government Code §911.2 23 expired on or about February 12, 2007. 24 3. The reason for the failure to present the claim within a timely manner is 25 because Mr. Mosley threatened to terminate Ms. Bauder from her employment if she 26 reported.to anyone that she had been sexually assaulted. 'Ms. Bauder was afraid to 27 make a report because she is a single mother with two children and needed her job. 28 After she finally told a co-worker in November 2006 about the sexual assault, she was - 1 — Application for Permission to Present a Late Claim Pursuant to 911.6(b)(1)&(3) 1 terminated in December 2006. She was under duress not to make a claim. The board 2 should accept Ms. Bauder's claim pursuant to §911.6(b)(1) because of excusable 3 neglect: 4 §911.6(b) The board shall grant the application where one or more of the 5 following is applicable: (1)The failure to present the claim was through mistake, 6 inadvertence, surprise or excusable neglect and the public entity was not 7 prejudiced in its defense of the claim by the failure to present the claim within the 8 time specified in Section 911.2. 9 4. Ms. Bauder also failed to make a claim because of mental incapacity. Ms 10 Bauder has informed me that her medical provider has diagnosed her with Post 11 Traumatic Stress Disorder due to the sexual assault and battery. The board should 12 accept Ms. Bauder's claim pursuant to §911.6(b)(3): 13 §911.6(b) The board shall grant the application where one or more of the 14 following is applicable. . . (3) The person who sustained the alleged injury, 15 damage or loss was physically or mentally incapacitated during all of the time 16 specified in Section 911.2 for the presentation of the claim and by reason of such 17 disability failed to present a claim during such time. 18 19 1 declare under penalty of perjury under the laws of the State of California that 20 the forgoing is true and correct. 21 22 March 27, 2007 LAW FFICE OF PAMELA PITT 23 24 25 By: Pamela Pitt, Attorney for 26 Elma Bauder 27 28 - 2 — Application for Permission to Present a Late Claim Pursuant to 911.6(b)(1)&(3) 1 PROOF OF SERVICE 2 3 I, Pamela Pitt, declare, I am over the age of 18 years and am employed in the 4 County of San Francisco, California. My business address is 22 Battery Street, Suite 5 1000, San Francisco, California 94111. On March 27, 2007 1 served copies of the 6 following documents: 7 8 Application for Permission to Present Late Claim Pursuant to §911.6(b)(1) and (b)(3) 9 By putting it in the United States mail to: 10 Clerk of the Board 11 Contra Costa County Board of Supervisors 12 651 Pine Street, 9th Floor 13 Martinez, CA 94553-1229 14 15 Monika L. Cooper, Esq. 16 Deputy County Counsel 17 651 Pine Street, 9t" Floor 18 Martinez, CA 94553-1229 19 20 1 declare under penalty of perjury under the laws of the State of California that 21 the foregoing is true and correct, and th 91 his declaration was exe ted on March 27, 22 2007 at San Francisco, California. 23 24 Pamela Pitt 25 26 27 28 - 3 — Application for Permission to Present a Late Claim Pursuant to 911.6(b)(1)&(3) C-7) rw 44; RD (;C;0 wy cU O Ll. LO Kr -Z 0' Lr) <U 0 G cu C SC SCl. 4-J- r— o Ln a. 0 U) O C=) C--4 LLJ CrCL Cr F- 00 CO