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HomeMy WebLinkAboutMINUTES - 06052007 - C.22 i I CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY VV BOARD ACTION: J mc, 51 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. D j (��j� you is your notice of the action taken on your claim by the Board of APR 3 0 2007 �f Supervisors. (Paragraph IV below), given Pursuant to Government Code COUNTY COUNSEL Section 913 and 915.4. Please note all AMOUNT: Ltf)k/r�oW n MARTINEZ CALIF. "Warnings". CLAIMANT:Am:irI•(.ft.r1 e' V40- Grp. a ATTORNEY: DATE RECEIVED: q ADDRESS: �2FM4 �t BY DELIVERY TO CLERK ON: � zt6 C©notiaA itUnsas 3� BY MAIL POSTMARKED:�j (� ZCj� 7 FROM: Clerk of the Board of Supervisors' T0: County Counsel Attached is a copy of the above-noted claim. JOHN CU LLE .le'k Dated: By: Deputy Cif/L II. FRONf. 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: 5- 1 By: mC.e ems: Deputy County Counsel 111. 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: (yJ This Claim is rejected in full. O Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:VO-we- � ��JOHN CULLEN, CLERK, By eputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions,you have only six(6) months trom the date this notice was personally served or deposited in the nail to file a covet 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 attontey,you should do so immediately. *For Additional Warning See Reverse Side of bis 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. Dated:�'��'� �, ��� JOHN CULLEN, CLERK By _ puty Clerk OFFICE OF THE COUNTY COUNSEL SILVANO B. MARCHESI COUNTY OF CONTRA COSTA Q,+ �'"=� -�,� COUNTY COUNSEL Administration Building 651 Pine Street, 91" Floor _ — ,• SHARON L. ANDERSON Martinez, California 94553-1229 �; ;, CHIEF ASSISTANT O; _ j111t " i^ GREGORY C. HARVEY (925) 335-1800 VALERIE J. RANCHE (925) 646-1078 (fax) a " �.,._ �---- ,�O AssISTANrS �OSr� co p4 NOTICE OF INSUFFICIENCY AND/OR NON-ACCEPTANCE OF CLAIM TO: Sharon Munro, Recovery Specialist American Management Corporation 824 Front Street P.O. Box 2020 Conway, Arkansas 72033 RE: CLAIM OF AMERICAN MANAGEMENT CORPORATION 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: [ ] L 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. [ ] 3. The claim fails to state the date, place or other circumstances of the occurrence or transaction which gave rise to the claim asserted. [ ] 4. The claim fails to state the name(s) of the public employee(s) causing the injury, damage, or loss, if known. [X] 5. The claim fails to state whether the amount claimed exceeds ten thousand dollars ($10,000). If the claim totals less than ten thousand dollars ($10,000), the claim fails to state the amount claimed as of the date of presentation, the estimated amount of any prospective injury, damage or loss so far as known, or the basis of computation of the amount claimed. r Sharon Munro, Recovery Specialist Re: Claim of American Management Corporation Page Two [ ] 6. 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 your claim on the enclosed form, including all the required information. Gov. Code, § 910.4. Please be aware that you have only a limited period of time in which to file an amended claim. See Gov. Code, § 910.6. [ ] 8. Other: SIL,VANO B. MARCHESI COUNTY COUNSEL By: I 6�G� Monika L. Cooper Deputy County Counsel CERTIFICATE OF SERVICE BY MAIL (Code Civ. Proc., §§ 1012, 1013a, 2015.5; Evid. Code, §§ 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 ddress is Office of the County Counsel, 651 Pine Street, 9th Floor,Martinez, CA 94553-1229. On '0 I 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 Sharon Munro,Recovery Specialist,American Management Corporation, 824 Front Street,P.O. Box 2020, Conway,Arkansas 72033, as set forth above. I am readily familiar with Office of County Counsel's practice of collection and processing of correspondence for mailing. Under that practice, it would be deposited with the U.S. Postal Service on that same day with postage thereon fully prepaid in the ordinary course of business. I declare under penalty of perjury under the laws of the State of California and the United States of America that the above is true and correct. Executed on 7 , at Martinez, California. Kateen O'Connell cc: Clerk of the Board of Supervisors (original) Risk Management Page 2 A M E R I C A N MANAGEMENT CORPORATION INSURANCE SERVICES RECEIVE® APR 3 0 2007 CLERK BOARD OF SUPERVISORS April 24,2007 CONTRACOST.ACO. Board of Supervisors Attn: Clerk 651 Pine St,Room 106 Martinez CA 94553 RE: Our Client: Shell Oil Our Claim#: 97717435 Driver Scott Badler Vehicle: Ford Taurus 283697 Date of Loss: 3-15-07 Description of Loss Damage to Dispenser Amount of Loss: Pending Location Loss: Shell Station @ 2876 El Portal Dr, San Pablo,CA To Whom It May Concern: This letter is to put you on notice of our recovery rights in reference to the above captioned accident. In our investigation,we have found that your client is the responsible party. We will be seeking recovery when we received final payment invoice from the station. If you had insurance at the time of this accident,please forward a copy of this to them IMMEDIATLEY. If you did not have insurance at the time of this accident,please call me IMMEDIATLEY to discuss payment options. Please do not send any information or payments to the Shell Station. If you have any questions,please feel free to give me a call at 1-800-777-3462 ext. 6820. Sincerely, Sharon Munro Recovery Specialist 824 Front Street P.O.Box 2020 ^ Conway,Arkansas 72033 (501) 450-7400 a (800) 233-2398 a Fax(501)450-6970 a www.amcinsurance.com Z00 asEd VOW-% -W0Jd 94 51 !0-JZ-JEW PGAIG086 BOARD OF SUPERVISORS OF CONTRA.COSTLA.COUNTY INSTRUCTIONS TO G`1,AIlYL4I�I It L A claim relating to a cause of action for death or for injury to person or peiso 3al property r` growing crops shall be presented not later than six moatbs after the crual the cause f action. A claim relating to any other cause of action shall be.presented i of later thea one y after the acemal,of the cause of action. ' (Croy. Code 9 911.2.) I. 3. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 16, County Administration Building, 651 Pine Street;Marrtianw,CA 94553. If claim is against a district governed by the Board of Supervisors, ratter than 1115 County, 110 :name of the District should.be filled in- D7 If the claim is against more thm one public entity, separate claimsm be fLl d against b, public entity. E. Fraud. See penalty for fraudulent claim5y Penal Code Sec. 72 at the end of this f '' zzzz zzz zzzzzzzzzzz}zz;RaMxxgkKb zxzzz C zzzKPzzzzz zzz4 P.ko"MCCzz zxxixx zz■Rzzzzzz z� RB; Claim By: Reserved for Clerk'sfiling stamp Against the County of Contra Costa or ) APR District) CLERK BOARD OF SU RVISO (Fill in,the name) ) CONTRA COSTA CO. 'ire umde,sigaed cl��,' exaby makes claim IagainA the Co�tSr of Contra Co or aabove- ed district in the sum of$ PfAlbla and in support of this claim represents.as Illows 1. When did the damage or injury occur? (Give exact date and hour) -q-/ �eI 1,4:3o 2. Where did the damage or in � 9►�occur.? (Include city and cou�ety) a 87 cA N A�� A. How did the damage or ipjtuy occur? (Give full details,use paper' ed) �'�rT Q�AL� Df2ove ,4�.�y wiTri os� �� / i 416 'I 4. Whaf`pancmlar act or omission on the pant of county or district officers,servants, or eMP103 tes caused the injury or dame-gs? g1 MSS L s what are the names of county or district oft m,servants, or employees usince the damage or m9 ? SW7-7 /3,1Z) LEP- I 1 � I —.—Z 'd 18t 'ON 1N3W39dM YSH 303. I WdSS:61 LOOZ •LZ VA _ . Fr e00 good VMV-01 -tun 14 9:91 10-12—J8}y pan1939y 6. What damage, or injuries do your claim resulted? (Give full enwt of Mimi or s .,Maime(L '.Attach two estimates-for auto damage.) :Pe)0P-a!lV I! i� 7. How was the amount claimed above computed? (Include the es6m d unt of Rhy prospective iu7ury or dazl agra.) F?,eV 1) l hl 8. Names,aud addresses of witnesses, doctors, and hospitals; A1117 9. List the expenditures you m de•on account of'this accident or injury: DATE Tn iV IylpV Aux as NumYr*NaaanaataU*manna MUMOR*R*Nnn Ka M*U tutu RSa*tn ata Nu;RnRaN Milli Nunn ;a Mantua* Rat .Gov.Code Sec. 910.2 provides"Me cWm be }stand by-the claimant or by some pens I on his SE SD NO2LCES TO: (Atloxney'1 Mame and address of Attomey ) (Claim=es Slpature) ; ) �m�,etEt�N/��3nN8�MeN7 � �!l 20220 , (Address) 917�. S TelephoneNo. }Telephone No. 7 7? J (�3244 N,aa Li maau[an[ua;YaU*Nanta UlRaa*Rana PLa*a Yulaa Ralfaa MaA■Ui*UUPL I[tua Cita PLUM tax lean■ gnat •, PUBLIC RECORDS NOTICE: Please be advised that this claim f6 m,or any claim filed with the County under the P Acta is to public disclosure under the Ca'lif'ornia Public Records Act. Pov. Codp, 55 6500 et seq. Fur hereto , any ; attachments,addendums,or supplements attached to' ie claim form,including medical rem are also nab eat to public disclosure. RNRua Mtn■NMNNu as UNamaN nit a a mac*Ya PLNa UR M7l�MryR�U rU�l''7a'�m+lu Ula Rn[ap UUUMRU an NFNU NOXX2MUUt nRRl1 , • NOTICE: i ,lection 73 ofPhe Penal Code provides. Every person who,with intent to defraud, presents for allowazoe or for payment to . stat board or cer, or to any Cotmt3, City, or di,%r t board or ofneer, authorized to allow or pay the mme if wine, any a or fraudulent claim,bill, account voucher, or writing,is punishable either by imprisonment in a county j ' for a period of not mare than one year, by a flue of not aweding one thousand dollars $1,000 0), or by b such imprisammcnt and fine, or by ire priso=ent in the state prisch, by a e,of not e i ng n thous aa dollar C$10.000),or by both such imprison mens and fine. i $ d I$l ON 1N3W30VNVW NSILA DD) , Wd95:Z1 cooZ 'LZ 'U8dW AMERICAN ` , MANAGEMENT CORPORATION 824 FRONT STREET P.O. BOX 2020 RIRErOEINJE® CONWAY, AR 72033 APR g 0 2001 CLERK BOARD OF SUPERVISORS CONTRACOSTACO. i i-` f w i I i t FIRST CLASS ^` IIFRRST QLASS . :. . Hasler cn o f$} o V $ ' Q = N c.n .-I - b) 1 O D N poW 0-4) 0 W V 10 � rf1 N CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY . 2 C BOARD ACTION: JUNE 05, 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 CLAIM AGAINST COUNTY COUNSEL Supervisors. (Paragraph IV below), given Pursuant to Government Code MINIMUM SUPERIOR C TF TIO Section 913 and 915.4. Please note all AMOUNT: OF SUPERIOR CO Tj � "Warnings". CLAIMANT: RAY MUHAMMAD 91 MAY 0 1 2007 ATTORNEY: UNKNOWN COUNTY C-, RECEIVED; APRIL 30, 2007 MARTINEZ C A W. ADDRESS: P.O. BOX_ 191 BY DELIVERY TO CLERK ON: MAY 01, 2007 RICHMOND, CA 94808 BY MAIL POSTMARKED: HAND DELIVERED FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above-noted claim. MAY 01, 2007 JOHN CULLEN, Cl k Dated: By: Deputy 11. FROM.: County Counsel TO: Clerk of the Board of Sup rvisors ( 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 warming of claimant's right to apply for leave to present a late claim (Section 911.3). O Other: Dated: `�—�' By: Deputy County Counsel III. FROM. : Clerk of the Board TO: County Counsel (1) County Administrator(2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). . 1V.,J3OARD ORDER: By unanimous vote of the Supervisors present: (v' This Claim is rejected in full. O Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: a2010 AM CULLEN, CLERK, Byy Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions,you have only six(6) months irom the date this notice was personally served or deposited in the mail to file a court action on this claim.See Government Code Section 945.6.You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney,you should do so immediately. *For Additional Warring See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of,perjury that 1. 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 clainran.t as shown above. Dated: ✓tet- 4P 01,e��� JOHN CULLEN, CLERK By eputy Clerk r BOARD OF SUPERVISORS OF CONTRA COSTA 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 than six months after the accrual of the cause of action. A"claim relating to ahy other cause of action shall be presented not later than one year after the accrual of the cause of action. (Gov. Code § 911.2:) w B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By: Reserved for Clerk's filing stamp RECEIVED ) Against the County of Contra Costa or ) APR .3. 0 2007 CLERK BOARD OF SUPERVISORS C� C�U M s e 1 District) CONTRA COSTA CO. (Fill in the )51 h/ecoo 'M /, ) The undersigned claim t 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) PCB ase e CCffC(c&Per1 2.,.. ,.Where did the damage or injury occur? (Include city and county) 3. How did the damage or injury occur? (Give full details; use extra paper if required) 4. What particular 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? 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. Attach two estimates for auto damage.) �% IJ 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) l � 8. Names and addresses of witnesses, doctors, and hospitals: ff 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT ■..................................a...a.e n..e e.........................mono■ ■ .WERE•K Gov. Code Sec. 910.2 provides"The claim shall be signed by the claimant or by some person on his } behalf." SEND NOTICES TO: (Attorney) ) Name and address of Attorney ) (Claimant's Signature) (Address) Telephone No. )Telephone No.( No Monosson EEnEEEEE■■EEE■5 R N aEEE.■n E E E W a a a W an E E E E E R E a••■•R E m E E n E a m E E W E■09 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. 0MMWOWEEEO EW nEEEWEEEonEWEWEEWnE OWES Boom EEn nn EaE■............................. .......� 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. I RECEIVED COUNTY OF CONTRA COSTA APR 3 .0 2007 Clerk of the Board of Supervisors CLERK BOARD OF SUPERVISORS 651 Pine Street, Room 106 CONTRA COSTA CO. Martinez, California 94553 CLAIM AGAINST COUNTY OF CONTRA COSTA, et al. Claimant's Name: RAY MUHAMMAD Person(s) Against Whom Claim is Made: County of Contra Costa; County Counsel Silvano B. Marchesi Deputy County Counsel Melinda Frey Claimant's address: Ray Muhammad P. 0. Box 191 Richmond, CA 94808 (510) 215-7663 Address to Which Notices to be Sent: Claimant's address above Date(s) of Occurrence: October 30, 2006 November 2, 2006 Place of Occurrence: Martinez, California CLAIM ARISES FROM THE FOLLOWING CIRCUMSTANCE(S): 1. County counsel made frivolous challenges to the validity of the assessment administered by the expert witness. 2. County counsel made frivolous objections to the opinion of the expert witness. 3. County counsel made frivolous objections to the testimony of the expert witness. 4. County counsel consistently advised the court to strike testimony that disputed the allegations. 5. County counsel advised the court that evidence contesting allegations are irrelevant at disposition. 6. County counsel opposed providing services to the father without proper cause. 7. County counsel objected to allowing testimony that could clarify questions and concerns. CLAIMANT'S DAMAGES: 1 Claimant's damages are the direct and proximate result of the conduct of Reid, et al., and include general, actual, and special damages. Claimant is entitled to punitive and/or exemplary damages together with attorney's fees for civil rights violations. AMOUNT OF CLAIM: Minimum Unlimited Jurisdiction of Superior Court CLAIMANT'S COMPLAINT MAY INCLUDE THE FOLLOWING CAUSES OF ACTION: Title 42 U.S.C. Section 1983, the 4th 5th 8th and 14th Amendments to the United States Constitution, Negligence: Negligence Supervision. Dated: April 30, 2007 IAV�- --Z RAY AMMAD 2 a A CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY , BOARD ACTION: JUNE 05, 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 CLAIM AGAINST CHILDREN AND FAMILY SERVICES , on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code MINIMUM UNLIMITED JURISDI1 MOUNT: OF SUPERIOR COURIJ1TION Section 913 and 915.4. Please note all AMOUNT: OF SUPERIOR COUR D 1 6 Warnings". CLAIMANT: RAY MUHAMMAD AY 0 1 2007 ATTORNEY: UNKNOWN COUNTYGf)^A%TEaRECEIVED: APRIL 30, 2007 MARTINEZ CALIF. ADDRESS: P.O. BOX. 191 BY DELIVERY TO CLERK ON: MAY 01, 2007 RICHMOND, CA 94808 BY MAIL POSTMARKED: HAND DELIVERED FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above-noted claim. MAY 01 2007 JOHN CULLEN r Dated: By: Deputy C7 -.e.crlt I.I. 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: ��7��� By: m 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). I.V. BOARD ORDER: By unanimous vote of the Supervisors present: (✓ This Claim is rejected in full. O Other: I certify that this is a true and con-ect4copy of the Board's Order entered in its minutes for this date. Dated:✓�-07r�, 0,r: OHN 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 covet action on this claiin.See Government Code Section 945.6.You may seek the advice of an attorney of your choice in connection wide this►natter. [f you want to consult an attorney,you should do so immediately. *For Additional Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that I. am now, and at all times herein mentioned, have been a citizen of the United States, over age 18; and that today I deposited in the United States Postal Service in Martinez, California, postage.fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated:\&72e CJG �� JOHN CULLEN, CLERK By �Deputy Clerk 1. M BOARD OF SUPERVISORS OF CONTRA COSTA 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 than six months after the accrual of the cause of action. A claim relating to any other cause of action shall be presented not later than one year after the accrual of the cause of action. (Gov. Code § 911.2.) B. Claims must be filed with the Clerk of the Board of Supervisors at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity, separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By: Reserved for Clerk's filing stamp RECEIVED e c e } Against the County of Contra Costa or ) APR 3 0 2001 c f Id _r �� f G � ) CLERK BOARD OF SUPEflVISORS h r I U(e tl /k 1X Jel Utr�SDistrict) CONTRA COSTA CO. (Fill in the name) ) Opnna Fe4e46 `, 5w q it klee ) 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•exxtdate and hour) m gea#eceyl�1e� 2. Where did the damage or injury occur? (Include city and county) i� 3. How did the damage or injury occur? (Give full details; use extra paper if required) 4. What particular act or omission on the part of county 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? � 7 � 6. 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.) 8. Names and addresses of witnesses, doctors, and hospitals: 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT soonunnonaNn■NNNNn■rN••■NNuuununNun nu nnn Nn Nnnnunnnuuu•an ON Sam ONE Noun Noun Nunn. N ■nnun ES Gov. Code Sec. 910.2 provides "The claim shall be } signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attorney) ) Name and address of Attorney ) (Claimant's Signature) 171 (Address) Telephone No. ) Telephone No.(✓�1 D� oZ / 5— 74e�'t� 3 ■NNNNrun■• ■•■■■NnNnNun■nNnnr■N•■N■■nnnN•NN•■nrnnunnon■■nnunnru NNa■■■■a■NunnN ■un NnnnI 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. ......0u0N0nn0.a0N0aN000 n n n N N n r n n n n a N 0 NN u nn n n n N a N a a n 0 u N u n a 0 r•■n r N■■■■N N u u N N n n u n u n a 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. y •1 RECEOVED APR _3,p 2007 COUNTY OF CONTRA COSTA Clerk of the Board of Supervisors OF SUPERVISORS p CLERKCpNRRACOSTACO. 651 Pine Street, Room 106 Martinez, California 94553 CLAIM AGAINST COUNTY OF CONTRA COSTA, et al. Claimant's Name: RAY MUHAMMAD Person(s) Against Whom Claim is Made: County of Contra Costa; Children and Family Services Donna Fabella, Director Sonia Reveco, Social Casework Specialist II Claimant's address: Ray Muhammad P. O. Box 191 Richmond, CA 94808 (510) 215-7663 Address to Which Notices to be Sent: Claimant's address above Date(s) of Occurrence: October 30, 2006 Place of Occurrence: Martinez, California CLAIM ARISES FROM THE FOLLOWING CIRCUMSTANCE(S): 1. Information was deliberately withheld from the court. 2. Information was deliberately withheld from therapists assigned to the case. 3. The court was given false information. 4. The therapists were not sufficiently consulted about matters concerning the case. 5. Request for supervised visitation was improperly denied. 6. Recommendations given to the court were unreasonable and unfounded. 7. 1 was not provided with reasonable services. 8. Matters critical to the case were not investigated or fully investigated. CLAIMANT'S DAMAGES: Claimant's damages are the direct and proximate result of the conduct of Reid, et al., and include general, actual, and special damages. Claimant is entitled to punitive and/or exemplary damages together with attorney's fees for civil rights violations. 1 L f AMOUNT OF CLAIM: Minimum Unlimited Jurisdiction of Superior Court CLAIMANT'S COMPLAINT MAY INCLUDE THE FOLLOWING CAUSES OF ACTION: Title 42 U.S.C. Section 1983, the 4th 5th 8 I and 14th Amendments to the United States Constitution, Negligence: Negligence Supervision. Dated: April 30, 2007 RAYbOWAMMAD 2 CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: JUNE 05, 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 Supervisors. (Paragraph IV below), given Pursuant to Government Code AMOUNT: $390.00 MAY 0 8 2007 Section 913 and 915.4. Please note all COUNTY COUNSEL "Warnings". CLAIMANT: VALARIE C. SEVEY MARTINEZ CALIF. ATTORNEY: UNKNOWN DATE RECEIVED: MAY 08, 2007 ADDRESS: 7251 BRENTWOOD BLVD. , X6266 BY DELIVERY TO CLERK ON; MAY 08, 2007 BRENTWOOD, CA 94513 – 2085 1 POSTMARKED MISSING BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above-noted claim. MAY 08, 2007 JOHN CULLEN, r Dated: By: Deputy II. FROM.: County Counsel TO: Clerk of the Board of S pervisors ( his claim complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). O Other: Dated: —���� By: Deputy County Counsel------ 111. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) ( ) Claim was returned as untimely with notice to claimant (Section 911.3). IV. OARD ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. O Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated:•✓w»v � P&VAFIN CULLEN, CLERK, By Deputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions,you have only six(6) months trom the date this notice was personally served or deposited in the mail to file a court action oil 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 au attorney,you should do so immediately. *For Additional Warning See Reverse Side ofTltis 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: Vance 0G,, JOHN CULLEN, CLERK By eputy Clerk BOARD OF SUPERVISORS OF CONTRA COSTA 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 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. anal auaaaaataeaaua aua ■ataaauaeaeaaaaaeeueeacua ataanncaateueia■■■aaaaeee acal RE: Claim By: Reserved for Clerk's filing stamp RECEIVE® Against the County of Contra Costa or ) MAY 0 8 2007 District) CLERK BOARD OF SUPERVISORS (Fill in the name) ) CONTRA COSTA CO. The undersigned claimant hereb�makes claim against the County of Contra Costa or the above-named district in the sum of$ �qD. and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) 19 ,.Zo o-2 50Po 2. Where did the damage or injury occur? (Include city and county) C C . Cat ?-t Cosh. 3. How did the damage or injuryoccur? (Give full details;use extra paper if required) L R -kTCMtD� 4. What particular act or omission on the part of county or district officers, servants, or employees caused the injury or damage? k D�1 eD �b 4 Ut'IEiuev vpmeS 6k+ TV- 5 What ar-e-lbe names o county or district officers,servants, or employees causing the damageorinjury? e. COn Ra Cosh ov, t3k� �12 PC), I N 6--PTwC'C-n Se11e�S a.no Btx01e2. I 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages -claimed. Attach-two estimates for auto damage.) CPAS�eRS+FFCtyPgS kTT- OOD) 7. How was the amount claimed above computed? (Include the estimated amount of any prospective injury or damage.) 8. Names and addresses of witnesses, doctors, and hospitals: 9. List the expenditures you rnada on account of this accident or injury: DATE TIME AMOUNT ■ aaaalSSmaEmma■■e amaeaSm■ a Ungava aetxeaeaaaEXm■mama■■■EES■man saaeeattS!■■a talatatsal El ) .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 ) j-7251 bFenAeOOO E)LVO. 4 2(o(0 (Address) ) ° Crb , gy513 - M35 Telephone No. )Telephone No. (P3� -(pb7-4 ■SaX■■tmlat■tamlEaEamm)XX■ aXmXSXXSXEmmmlaslma a sun alXmt!!Xl■lt Xtetaeml tela■EmaamSmmall 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, §9 6500 et seq.) Furthermore, any attachments,addendums, or supplements attached to the claim form, including medical records, are also subject to public disclosure. ■tons ONE■muaXaEXS■ESSEX a AZE■■SSemummE■ualXSmaXSa■m XEmeslmEslmEtluau■■mSSaaS"NEI NOTICE: Section 71 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. I # 3. I,Valarie C.jevey,was driving with my daughter, 2,and my son, 5 months on Balfour Rd.from our home in Brentwood , on our way to my husbandsjob site in Disco gay. I was driving the speed limit when Ijust Past `fellers Rd.when my front passenger tire hit a pothole at least 3 to 4 inches deep . M.9 car made the loudest cracking sound then tugged us from left to right. I wasn't sure if my tire blew so I didn't hit the brakes, but my car was driving even more rugged then the road before , so, knew it was more serious . I slowly hit the brakes anyway because we were driving too fast on a two lane road with only three worlcingtire5 . 1 pulled us to the right side of the road as far as we can go without unleveling the car. I got out of my car to see the damage and it appeared as if the tire was pulled a little to the right,apart from its rim , but I knew we weren't going anywhere .After I called my husband I immediately dialed 41 1 to call the city of pisco gay which whom then told me I was on a county road , after deeply apologizing he then gave me the number to pave harper. He wasn't in the office so I left him two detailed messages 10 minutes apart and we waited on the side of the road about 40 minutes with no assistance what so ever, not knowing the true damage that had been done . After that time my husband and three of his friends came to help and got nowhere without the correct tools .Then I finally got an apologetic tail back from Dave Harper, as two very kind gentlemen from the Brentwood yard pulled over to kelp, they said theyjust patched a pothole about 10 minutes ago and assumed it was my " Beautiful shiny rim theyjust picked up from the huge pothole theyjust filled " . He then handed my husband the correct tool to take off my wheel when from inside my car i hear all six men shout"Qhh Man ". I then described to Dave Harperwho was still on the phone at the time " the true damage ". He then gives me the number to Penny Daily telling me I needed to file a claim. M� 20" rim was ripped apart and is completely damaged . I have also attached two self explanatory pictures,and the possible potholes which were hard to identify the exact one being that there are so many patched potholes on Balfour KJ . , also attached is two pictures of the driver and passenger side of my full vehicle . ar.'L"x! �"'� may,f`j, �'t'�, » "�'��-"'�, g�aen4� F .�'n.i r u.. " .� p 'lea.✓�,; gr ,..�`rah.9 '�"-„2�,g5 d r � g �, �,tT.sa�•%"* �- c..,��Yr�.s` 3 -ti +`�'vi�-2' .^ > `$s' .+r '� t 7tR�'� 4 }s �♦�P'Y wU`'� d _ �1 ?� x lr� �” �1t.3" K$ �... '�,'� khq+„��Y �F s vx.� §w5 - r z says•'~ x'tx +4�3 � q"r'n �.� ��iz-s s�tls 1`` A�S ��}'Tsz �„rv,.f v:,, 4.,.i. 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''f�'J "J'%f^��lV�i a_�.'/ f.J '..F;_ � ✓ r: "1W� 1� ? �6 �F ��'�t t! - +�' ri J W ' , _ J •' r tit STATE A aTYf7 / t t CAR MAKE&'MODEL', a"'LICENSE NO MILEAGE *'1 1 s � Y DESCRIPTION •; 1.•,iel -�,; A , , ,ala'.. Ise - 4 J , - { q y, SUw xaP': Warrantee ❑ B=TOTAL' z, Tighten lugnuts "' SALES LrAX = after first 25 miles+ Road Hazard NO Warrantee LABOR Yr .xfY�.:. No warrantee on, Treadwear ❑ TOTAL Warrantee a« g Wire WHeels . x ;5 DEPOSIT . ' NO Wariantee (11BALANCE CUSTOMER SIGNATURE F ALL SALESFINAL NO REFUNDS 25%;CAN CELATION FEE ON ANY ORDER _ad.as�'..c'�y„?_y, �rY:�r. r�G .i n. .: ' rz„ � ��'�,.r=�'..r.4.�'�.�a�',.....�a *t`, Air fry.:•' :�.,1r,+,. �.ytiry i ��" A —----------- 1stStop Auto Wheels & Tires 7935 Brentwood Blvd. - Brentwood, CA 94513 Phone: (925) 634-0818 ® (925) 634-4281 �NAME) DATE� ADDRESS rrffPHONE CITY STATE CAR MAKE&MODEL LICENSE NO. MILEAGE QTY DESCRIPTION AMOUNT v Warrantee SUB-TOTAL 3 Tighten lugnuts SALES TAX after first 25 miles Road Hazard NO Warrantee LABOR No warrantee an Treadwear 0 TOTAL$ Wire Wheels Warrantee iDEPOSIT 1 NO Warrantee. 01 IBALANCE I CUSTOMER SIGNATURE: ALL SALES FINAL-NO REFUNDS•25%CANCELATION FEE ON ANY ORDER 1-1, 7R -7. ,a ' CAR:.STEREOS••MOBILE.VIDEO-ALARMS-NAVIGATION SYSTEMS-RIMS &TIRES-ACCESSORIES OPEN 7 DAYS 10am-7pm Tel. 925 6744 060 ELECTRONICS DATE YEAR 1309 Galindo Street Concorl CA 94521 1-1 NAME _ LICENSE No. MAKE Qu Gt L ADDRESS A'�j �� y��� �lU� ODOMETER MODEL C }ter STATES t2 ZIPq,/5 j RES. PHONE SOLD CASH CHARGE BALANCE DUE CELL. QUANTITY DESCRIPTION PRICE AMOUNT /7 • Customer must dnedc the vehicle and equipmart Installed or purchased at the time that BALANCE DUE 2 r the fob is completed.Any problems or matters should be brought up to the management's attention at that time. SALES TAX I 37 • Customer must make sure the warranly rearms and boxes are given to them arta complelim of the job. LABOR • GM ELECTRONICS warrants the equipment that was purchased ham Q R and has no liability customer..on equipment that was purchased elsewhere a that TOTAL 7L./ v belonged to customer.. ✓✓ DEPOSIT ' a 30 days alae warrantyon as car audio8 accessories,NO MONEY BACK Exchange or store credit only,customer must have all pads in original packages. - There will be 25%fee on as parts or padrages that are missing. BALANCE DUE Also, there will be 25%restocMrg fee on as special orders that are cancelled. GP • Customers assume all responssbtitty for as audio and video equipment that they request to be installed and a modified in Meir vehicle. ° GM ELECTRONICS does not provide any kind of warranty on tires. Rims have a factory warranty any. . • The customer is respor"for to balancing of thek rims&tires. • / therefci GM ELECTRONICS Is not responsible for any warteny on Me micro 6 ares. \ • No realms on mounted dins 8 tlrea. \ CUSTOMER'S SIGNATURE 1 hereby aulhodm you to perform On servioe end famish the necessary maledals.I understand my cost quated,heretofore is an estimate only. REGARDING ENGINE Your emgoyaas may operate vehicle for inspecting,and daAve y at my risk You will not be respamilNe for loss or damage to vehicles or articles STATIC: left ink I agree to pay reasonable storage on veMda tell more than 48 hours after mAficatial that repalis are rampleted. Auto stereo sound products are susceptible to I AGREE THAT YOU HAVE AN ERRETS�LIEN ON THE DESCRIBED VEHICLE FOR THE CHARGES FOR PARTS AND LABOR FURNISHED UNDER THIS REPAIR reproducing various noises generated by the ORDER INCLUDING THOSE FROM AN1 PRIOR REPAIR ORDERS ON THE VEHICLE.IF I FALL TO PAY SUCH CHARGES,I AGREE THAT THE VEHICLE MAYBE eutanoble's Ignition and slectkal systems. HELD UNTILALL THE CHARGESARE PAID M FULI.IN THE EVENT OF LEGAL ACTION TO COLLECTION AND FEES INCLUDING REASONABLE ATTORNEY FEES, GM Eleebonk:s Ingest an main static suppressor. ., mak, --E--�/Ir A ^ \ Any static not egmmeted by an m-Ime suppressor X /lY""' L"/7 J is considered abnormpled for and suppression of '+'[� it will be attempted fa en additional charge s requested. ,75 -" Ji Cl D t7 M O Om Q < _ co __ 1 q cr cr G O o O - o wv < ` SV CL< �. cv00 O a w � < J V OL C-c G-7 LD r� r nL�-