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HomeMy WebLinkAboutMINUTES - 06172008 - C.46 (2). • _, CLAIM BOARD OF SUPE11VISORS OF CONTRA COSTA COUNTY BOARD ACTION: 'Ur& Claim Against the County, or District Governed by )" the Boai•d of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes.: ' D MAY 0 8 2008 AMOUNT: OXO' °O CLAIMANT: 'Tre4l 'gt(tl COUNTY COUNSEL MARTINEZ CALIF. L, l�r ms ATTORNEY: 1316-,klar1,l Bost r ADDRESS: r20(�v C �5 FROM: Clerk of the Board of Supervisors Dated: i NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your clairn.by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DATE RECEIVED: 944 7, � BY DELIVERY TO CLERK ON: BY MAIL POSTMARKED: �lq T0: County Counsel Attached is a copy of the above -noted claim. JOHN CULLEN Clerk By: .Deputy n: yl Sseo II. FROM: dounty Counsel TO: Clerk of the Board of Supervisors (411'111s 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 Boai-d cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should retum claim on. ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: Deputy County Counsel 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). I.V.. BOARD ORDER: 'By unanimous vote of the Supervis&rs present: This Claim is rejected in full. () Other: Dated: I certify that this is a true and correct copy of the Board's Order.entered in its minutes for . this date. JOHN CULLEN, CLERK, B Clerk WARNING (Gov. code section 913) Subject to certain exceptiais, you have only six (6) months from the ate this notice was personally served or deposited in the nail to file a court action on this cNim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection wide this matter. 1.1' 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 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 .1 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 cla!uaikt shown above. Dated: d2"�o� io JOHN CULLEN, CLERK By Deputy Clerk C LAI.IN'I BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government. Codes. ) AMOUNT: �=O. 00 CLAIMANT: "Tr¢v1i que �rrrs ATTORNEY: 1316 - ADDRESS: FROM: Clerk of the Board of Supervisors Dated: I.I. FROM.: Counsel BOARD ACTION: tJA&...-/0,_',2Cr� NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your claim by the Board of . Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DATE RECEIVED: BY DELIVERY TO CLERK ON: BY MAIL POSTMARKED: X�4 T0: County Counsel Attached. is a copy of the above -noted claim. JOHN CULLEN Clerk By: Deputy_ nL�>ILqss(�2 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 warping of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: Deputy County Counsel III. FROM.: Clerk of the Board TO: County Counsel (1) County Administrator (2) () Claim was returned as untimely with notice to claimant (Section 91 l .3). IV. 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 coirect copy of the Board's Order entered in its minutes for. this date. Dated: 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 chum. See Government Code Section 945.6. You may seek the advice of'an attorney of your choice in connectioi with this matter. 41'you want to consult an attorney, you should do so immediately. *Fo.r AdditioReverse ial Warning See Revee Side ofThis Notice. AFFIDAVIT OF MAILING I. declare under penalty of per jury that i am now, and at all times herein mentioned, have been a citizen of the United States, over age 1.8; and that today 1 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: JOFIN CULLEN, CLERK By Deputy Clerk CLAiM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: �VlY1rR. 1�:f Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes. D � �mv� Mai 0. s 2008 AMOUNT: 2Lt'jQ' o0 CLAIMANT: rT✓eni quer COUNTY COUNSEL MARTINEZ CALIF. ATTORNEY: 1316- ADDRESS: 120 v I ,vt. FROM: Clerk of the Board of Supervisors Dated: i II. FROM. ty Counsel NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DATE RECEIVED: 9", �f � BY DELIVERY TO CLERK ON: AIJ BY MAIL POSTMARKED: klq TO; County Counsel Attached isa copy of the above -noted claim. JOIN CULLEN Clerk By: Deputy n;- "5 TO: Clerk of the Board of Supervisors i (✓This claim complies substantially with Sections 910 and 910.2. ( ) This Claim. FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 days (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: ,5- 12 OK By: /1171� County Counsel i1f. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) () Claim was returned as untimely with notice to claimant (Section 911.3). W. BOARD ORDER: By unanimous vote of the Supervis6rs present: () This Claim is rejected in full. () Other: I certify that this is a true and con-ect copy of the Board's Order entered in its minutes for. this date. Dated: JOIN CULLEN, CLERK, By Deputy Clerk WARNING (Gov. code section 913). Subject to ceitain exceptions, you have only six (6) months from the date this notice was personally served or deposited in the n-40 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 Addidaial Warning See Reverse Side ofThis 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 1.8; 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 P-1 Claim to: BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CLAIMANT A. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or before December 31, 1987, must be presented not later than the 100th day after the accrual of the cause of action. Claims relating to causes of action for death or for injury to person or to personal property or growing crops and which accrue on or after January 1, 1988, must be presented not later than six months after the accrual of the cause of action. Claims relating to any other cause of action must be presented not later than one year after the accrual of the cause of action. (Govt. Code §911.2.) B. Claims must be filed with Jane Pennington, Clerk of the Board at its office in Room 106, County Administration Building, 651 Pine Street, Martinez, CA 94553, either by mail or in person. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the name of the District should be filled in. D. If the claim is against more than one public entity; separate claims must be filed against each public entity. E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. RE: Claim By Trenique L. Minis Against the County of Contra Costa or Reserved for Clerk's tiling stamp The housing Authority of Contra Costa (District) (Fill in name) RF MAY 0 "j L u G. CLERK BOARD OF SUPERVISORS CONTRA COSTA CO. The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named District in the sum of 214 and in support of this claim represents as follows: 1. When did the damage or injury occur? (G,ive exact date and hour) 2. Where did the damage or injury occur? (Include city and county) 1�_o cL,4,0 Co 3. flow did the damage or injury occur? (Give full details; use extra paper if required) C_A+GL_Ck+L .0 `v O UCS V -,Q—p o� 4. What particular act or omission on the part of county or district officers, servants or employees caused the injury or damage? , r vim- D b -v -� w �s � �e. � �-rte- ►v►� � �n:�t/VL��S . ci ntbrm M What are the names of county or district officers, servants or employees causing the damage or injury? 6. What damage or injuries do you claim resulted? (Give fill extent of injuries or damages claimed. Attached two estimates for auto damage.) • , e. ,-� .UJ-ev 7. How was the amount claimed above computed? (Include the estimated amount of any prospective iniury or damage.)t Z' LT-" 8. Names and addresses of witnesses, doctors and hospitals. 9. List the expenditures you made on account of this accident or injury: DATE ITEM AMOUNT 12--(zs-f0-7 To s"c- 1 c-� 5 k ; v-Lro. Gov. Code Sec. 910.2 provides: "The claim must be signed by the claimant SEND NOTICE TO: (Attorney) or by someRerson on his behalf." Name and Address of Attorney Telephone No. (Claimant's Signature) (Address) Telephone No. t�2�" )—j Z� 07 NOTICE Section 72 of the Penal Code provides: "Every person who, with intent to defraud, presents for allowance or for payment to any state board or officer, or to any county, city or district board or officer, authorized to allow or pay the same if genuine. any false or fraudulent claim, bill, account, voucher, or writing, is punishable either by imprisonment in the county jail for a period of not more than one year, by a fine of not exceeding one thousand ($1,000), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of not exceeding ten thousand dollars ($10,000) or by both such imprisonment and fine." clmforrm Canon - PIXMA All -In -One Photo Printer/ Copier/ Scanner - MP210 • R Page 1 of 1 Best -Buy > Computers > Printers,_ Scanners _& Fax > Printers > All -in -one Ink et > Product Info Canon - PIXMA All -In -One Photo Printer, l i Copier/ Scanner Model: MP210 SKU: 8470013 Shipping: Usually leaves our warehouse in 1 business Reg. Price: day Estimate arrival time. Can Sale Nrt Store Pickup: Available at most stores Select See price in ca preferred store availability Add to Special Offers: On Sale Add to Wish $39-$70 Off Select Printers: See How http://www.bestbtly.com/site/ol spage.j sp9skuld=8470013&st=cannon+all+in+one+photo+p... 5/6/2008 19 Face Page CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Beal 1 D Co ntinualion ❑ Supplemental P.O. Box 391, Martinez, California 84557.01138 ❑ D.V. ❑ HRO ❑ Arrest [:)SI I. DR No. '2. City Code 3. CrimaiClassification 4. Detail 1. 459R 5. More 08-2624 Bey 20 Burglary - Residential (459R') 2 Persons 6. Day i Date i Time of Occurrence 7. Date i Time Reported8: Employee No. Friday/2-1-08/0700 hrs - Saturday/2-2-0811800 hrs 214/08 11014 hours 67033 9.Redassi- 10. Address 1 Location of Occurrencefialion ❑ 1315 Mariposa Street #878, Rodeo 11: PP.I Dg VIC u WIT M5P Ll RJN SLI;LEAD OTHER 12. Name (L F. Ml l3. Race; Sex I Age 14. DOB t 5. Driver License No. Mims, Trenique, Lizette B / F 130 3/23/1977 B5776005 16. Address (Zip Code] 17. Home Phone 1315 Mariposa Street #878, Rodeo 925-727-5639 18. Employed y or School 19. Work Phone Unemployed NIA 20. Hair 21. Eyes 22. Hl. 23. Wt. 24: AKA I Maiden Name 25. Social Security No. BL.K BRO 5'08" 1 210 N/A Unk 26. Further Description (Scars, Tattoos. Mannedsms, Clothing, Etc.l 27. Booking or Cite No. N/A None 28. 1 1 PRI VIC WIT 1.1sP Ll RUN D40 Sus LEAD Lj OTHER 29. Name (L. F. Ml 29. Race 1 Sex? Age 30. DOB 31. Driver License No. Unknown Suspect(s) / / 32. Address (Zip Codel 33. Home Phone 34. Employed By or School 35. Work Phone 36. Hair 37. Eyes 1 38. HI.. 39. Wt. 40. AKA I Maiden Name 41. Scc el Security No. 42. Further Description (Scars. Tattoos. Mannerisms. Clothing, Etc.1 43. Booking or Cite No. 44. LJ PP.I LJ VIC Lj Wli LJ 1.1sP U MN LJ sus U LEAD OTHER 45. Name (L, F. Ml 46. Race )' Sex 1 Age 47. DOB 48. Driver License No. Sisk, Harece, Jr B /M /30 11/27/1977 B4554284 49. Address (Zip Code] 50. Home Phone 1315 Mariposa Street #878, Rodeo 925-727-5639 51. Employed By or School '52. Work Phone Unemployed N/A 53. Hair 54. Eyes 55. HI. 56. Wt. 57. AKA I !.laiden Name 58. Social Severity No. BRO BRC) 1 5'07" 185 N/A Unk 59. Further Description (Scars, Tattoos. Mannerisms, Clothing, Etc.l 60. Booking or Cite No. N/A N/A 62. Veh; Ves 63. Lic No. (State) 64. Year 65. Make 66: Model 67. Body Style 66. Color Top ❑ S Cl Viol Bottom 69. Status 70. Registered Owner 71. R.O. Address ❑ Left ❑ Impound 72. Towed to or Released to 73. Who has Keys? ❑ Stored 74. Evid 75. F1 P 76. Dispo of Evidence 77. Missing 78. Damaged O 'yes r No O Yes ON. N/A. $2,000.00 N/A 79. B'let Synopsis of Incident Unknown suspect(s) entered Pri-V-Mims residence and stole a Toshiba lap top computer, serial number X7352112K and a Canon printer, serial number JJT622641. Mims was with friends and at Kaiser hospital between the times she last saw the lap top computer and printer in the upstairs bedroom of her residence. I canvassed the area for suspects, leads and witnes�g�TRw LE- negative results. CUMENT Office of the Sheriff Contra Costa County 80. Distribution 81'. Additional Routing ❑ B ❑ C ❑ DA ❑ DE ❑ L ❑ 0 ❑ SR ❑ V ® Investigation ❑ Vice ❑ Narcotics ❑ Juv ❑ coroner 82. Reporting Deputy (Print) 83. DaterTime Written 84. Dispo ❑ Property Ck. ® ACS ❑ Intell. ❑ R.O. ❑ SHC J. Brown 2-4-08/1056 hours REF 95. Approving Supe (Print) 86: Supv No. 87. Date 1 4 ❑ Patrol Captain ❑ Compl.Olc. ❑ Marine Patrol ❑ DV Unit ❑ Other Sgt. Haggard 53423 2/5/2008 of J51 12 11-94 Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT.CA0070000 P.O. Box 391, Martinez,. CA, 94553-0039 Beat 13 Supplemental ❑D. V. ❑ HRO ❑Arrest. ❑SI t, DR.No. 2. CllyCode . rimeClassification a ail 1. 459R: 5. Redassi 08,2624 Bay 20 Burglary - Residential (459W) 2.. ri a6on . rim ante t .. ate' rg. Report 777=7-70, ❑ Mims. Trenique, Lizette 2/4/08 67033 9. Address + aca un at ocurrenceSuspect 1315 Mariposa Street #878, Rodeo Name iL. , I Unknown'Suspect(s) 1 i. Property escnpoon: Impounded. Recovered. Found, Lost: Stolen - Item Number. Article, Ouaririry, Brandi Makell.fanufacturer's Model Number.,Seiia( Number, Miscellaneous Description, Lecatbri Where Taken. Value, Include 1. Total Loss -LIST IN FOLLOWING ORDER: Al.Currenc : Notes: B) Jevrelr ; C) Furs; D) Vehicles;. El Office.E uipment; F) Radio. TVs etc.: G1 Firearms. H) Household Goods: h Mise, 12. Recovered Property S 13. Narrative i Statements On 2/4108, at approximately 1014 hours, I eras dispatched.to a grand:theft report at 1315. Mariposa street, #878, Rodeo.. .I ar..rived and contacted Pri-V.-Mims, who told me the following in summarv: Minis left her residence on 2/1108, at approximately 0700 hours and spent t -he .;treekend with -friends and. at Kaiser Hospital Richmond. Mims was not sure if she returned home on 2%2/0.8 or 2/3/08, finally saying she returned on'Saturday;.2/2/0.8 at approximately 1800 hours. When she arrived home, she noticed her Toshiba Satellite lap top computer and.. Canon Pix-na PQ210 .printer missing from an upstairs bed -room'. I asked Hirris why she left her residence on 2/1/08, and Mims told me she had an argument with her husband O=Sisk and. wanted .to get away from liim for a d'ay or two. I asked: Mims if her husband may have taken her items and she said °no". I checked the residence for signs of forced entry, with negative results. I asked Mims if she had touched the area where the items were located and: she said she 'did. Mims told me she had touched all the exterior doorknobs to the residence and: the door .knobs on the interior of the residence, .several. times, since she returned over the weekend. I was unable to dust for fingerprints due to all areas being repeatedly -touched by Mims. I canvassed the area for suspects, leads and witnesses; -with negative results. I reviewed the incident history,of Rodeo, bleat 1, over the weekend and found several calls at Mims residence, including several calls for a missing adult, suspicious circumstances and one W&I 5150 call. NFI Stolen Items ESV 1. One copper colored Toshiba Satellite lap top computer, serial $1,000 W3.52112K 2. One.black and white colored Canon Pikma MP210.Printer, serial $1,000 JJTTB22641 cow f"' -i thDOCUME Contra NT Total;: 000. Costo Ghent _$2., Mq 2Do� Bit approximately 12.16 hours, I spoke to $isk and, asked }iirn. what ,lie k he missing ]:a1) ton computer -and.printer. Sisk told me the followin in sumrnarv: 14: Distribulinn 15. Additbrial Routing E] 13 0 [I DA [I DE ❑L ❑ O ❑SR - ❑V IR Investigation ❑ Vice ❑ Narcotics ❑ Juv ❑ Coroner ❑ Properri Ck. ® ACS ❑ Intell. ❑ R.O. ❑' SHC 16.ReportingDeputy (Print) .: ater ime Written t spo 2=4=08/1056 hours REF ❑ Patrol Captain ❑ Compl.Olc:. ❑ Marina Patrol ❑ OV Unitupv ( rint) pv o. ': a e, age ❑ Other ard;, 53423 2/5/2008' 2 of .4 36112 11+94 Continuation CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 Supplemental P.O. Box 391, Martinez, CA 94553-0039 ❑ Beat 1 ❑D.V. ❑ HRO ❑ Arrest ❑SI 1. DR No. 2.CityGode rime., Classification 4. Detai 1 1. 459R 5. Reclassi 08-2624 Bay 20 Burglary - Residential (459R') 2.. lcafion ICm arae (L, ale Ong. Report 8. Employee No. ❑ Mims; Trenique, Lizette 2/4108 67033 fess 1 o:a nn o ocurrence Suspect's Name ( .. t 1315 Mariposa Street #878, Rodeo Unknown Suspect(s) I I. PropertyDescription: impounded, Recovered. Fourd• Lost, Stolen • Item Number, Article, Ouantity. Brand-MakeiManuf3cturer's Model Number. Serial Number. Miscellaneous Description. Location Where Taken, Vafue. Include Total Loss - LIST IN FOLLOWING ORDER: Al Currency, Notes: B! Jevvelr ; C) Furs; 01 Vehicles: El Office Equipment; F1 Radio, TVs etc.: G1 Firearms; H) Household Goods: Il mi - 12. Recovered Property $ 13. Narrative i Statements Sisk was hospitalized for W&I 5150 on Fridav, February 1. He returned home on 2/2,/08 and found the computer and printer missing. Sisk does not recall if the front door was locked when he returned home. CONTq Off; �Z[Fp CU ORtra C MIN)" slpL ��l qY � 2pp 14. Distribution 15. Additi rial Routing ❑B ❑C El DA El DE ❑L ❑ D 0 s El ® Irmestgation ❑ vice ❑ Narcotics ❑ Juv ❑ Coroner Deputy (Print) ❑ Property Ck. ® ACS ❑ Intell. ❑ R.O. ❑ SHC 1 .. atee ima Written 1 cpo 2-4-0811056 hours EBrown Patrol Captain❑ REF ❑ Compl.Olc. ❑MarinaParrot ❑ DV Unit bupv ( rint) . au pv o. are age Other gard 53423 215!2008 3 of 4 36112 11194 I ` CONTRA COSTA COUNTY SHERIFF'S DEPARTMENT CA0070000 P.O. Box 391, Martinez, California 94553-0039 1. DR No. 2. CrimerClaasifi=ion 3. Detail code 1. 459R 4. 08-2624 Burglary - Residential (459R') 2 H Felony ❑Mild. ❑Arrest ❑Cite 5. Victim Name (L.F) 6. Address! Location of Occurrence 7. Employee No. Mims, Trenique, Lizette 1315 Mariposa Street #878, Rodeo 67033 S. Gang Activity O Yes 0 No OF ❑ Other Prints ❑ PS ❑ Paint Samples AL PH ❑ Photos 9. Name of Gang PJ ❑ Projectile -'Casing Blood RK ❑ Rape Kit 10. MEANS OF ATTACK ST ❑ Semen B ❑ Boole SK ❑ Sketches C ❑ CIuG'Stick TT ❑ Tire Casting. F ❑ Firearm TL ❑ Tool Marks G ❑ Handgun VH ❑ Vehicle K ❑ Knife WP ❑ Weapon N ❑ Martial Arts Weapon HA ❑ P ❑ Plirsical (Hands) R ❑ Rdle.Shotgun 13. METHOD OF ENTRY MS A ❑ Attempt S ❑ Shoes+Feet T ❑ Threats D ❑ Bodily Force V ❑ Vehicle G ❑ Bolt CutterwSaw E [:1 Common Cei ling;Wall 0 El Other L ❑ Cut C ❑ Hid in Building 11. PROPERTY ATTACKED O ❑ Lockbox ❑ NSFE ARG ❑ Agriculture B F El Pry ANT ❑ Antiques I E] Slim Jim -Coat Hanger ART ❑ Atiquetirys H E]SmashZreaklPunch AUT El Auto Parts BYC ElBicycle- BOT ❑ Boats ELM ❑ Bui:ding Materials 14. POINT OF ENTRY CAM ❑ Cameras+Projectors Window Entry CLO ❑ Clothing WC ❑ Crank CRC ❑ Credit -ATM Cards WD ❑ Louvered CUR ❑ Currency WA ❑ Non-movable NRC ❑ Drugs WB ❑ Sliding Door Entry FIR ❑ Firearms DG ❑ Double Swing FRN ❑ Fuiniture DI ❑ Garage (overhead) APP ❑ Household Appliarceo DF ❑ Single Swing IND ❑ Industrial Equipment DH ❑ Sliding JEW ❑ Jewelry DJ 19 Other Unknown LIO ❑ Liquor Other Entry LIV ❑ Livestock OP ❑ Basement MED Medical Equipment OK ❑ Floor MIS Miscellaneous CC ❑ Ground Level MOT ❑ McdorcyclevMiniti kes ON ❑ O1 Premises MUS ❑ Musical Instruments OL ❑ Rooi OFE ❑ Office Equipment OR ❑ Upper Level FUR ❑ Purses'Wallets OM ❑ Wall RAD ❑ Radio7Sterea CO X Unknown COL ❑ Rare Coins SLV ❑ Silverware 15. ENTRY LOCATION SPD ❑ Sporting Goods F ❑ Front TEL ❑ Telavision(VCRs R ❑ Rear TOB ❑ Tohao=o Products S ❑ Side TOL ❑ Tools 0 lK Other Unknown VEH ❑ Vehicles(not motorcycles) 16. NUMBER OF SUSPECTS Unknown 12. PHYSICAL EVIDENCE AC ❑ Accelerants AL ❑ Alcohol 17. HOW WEAPON WAS USED BL ❑ Blood COATP ❑ Coat Pocket CL ❑ Clothing COVER ❑ Covered DC ❑ Documents PROPK ❑ Front Pocket DR ❑ Drugs PANPK ❑ Hand in Pocket FP ❑ Firgerpr ints HIPHO ❑ Hip Holster GL ❑ Class Fragments LEFTH ❑ Left Hand HA ❑ Hair MS ❑ Mud+Soil ❑ B ❑ C ❑ DA ❑ DE ❑ L ❑ 0 ❑ Sk Cl V IN Investigation ❑ Vice ❑ Narcotics ❑ Juv ❑ Coroner ❑ Prcpefry Ck. ® ACS ❑ Intell. ❑ R.O. ❑ SHC ❑ Patrol Captain ❑ Compl.Ofc. ❑ Marine Patrol ❑ DV Unit ❑ Other LEGHO ❑ Leg Holster PISWIP❑ Pistol Whipped PURSE ❑ Purse RERPK ❑ Rear Pocket RIGHH ❑ Right Hard PSACK ❑ F duBag SHOTS ❑ Shots Fired SHLHO ❑ Shoulder Holsler WAIST ❑ Waistbard 18, Circumstances R ❑ Raciul7Religuous7Ethnic 19. ALARM N N None A ❑ Activated P ❑ Bypassed D ❑ Disabled TRK ❑ Trucking Company TVS ❑ TV, -Stereo Sales)Repair WHS ❑ Warehouse OTH ❑ Other 21. SUSPECTS ACTIONS APPFF ❑ Approach from Front APPFR ❑ Approach from Renu ATEDR ❑ AWDrank BLIND ❑ Blindfolded Victim BOGAG ❑ Boun:FGagged COW F ❑ Covered Victim's Face DEFEC ❑ Defecated DEMON[-] Demanded Money DISAL ❑ Disabled Alarm DISPH ❑ Disabled Phone DISPO ❑ Disabled Power DISRO ❑ Disrcbed Victim 20. WHERE OCCURRED FIRED ❑ Fire] Weapon APO ❑ ApartmenllCondo FOLVM ❑ Followed Victim APT ❑ Aulo+Tire Stores FVMTM ❑ Forced Victim to Move BNK ❑ Bank Savings 6 Loan FDISR ❑ Fully Disrobed(suspect) BAR ❑ BanLungerTavern HBD ❑ Had Been D rinking CAB ❑ Cahn?axi HITCH ❑ Hitchhiking CWA ❑ Car Wash IMPOT ❑ Impersonated Other CHU ❑ Church INJIN ❑ Inflicted Injury CLN ❑ Cleaners JUMPC ❑ Jumped Counter CLO ❑ Clothing Store KLOCA ❑ Knew Location of Cash CDC ❑ Construction Company LGRET ❑ Lilted Cash Register Tray COS ❑ Construction Site MADPR ❑ Made Purchase CON ❑ Convenience Store MTHRT ❑ Made Threats DPT ❑ Department Store MASTU ❑ Masturbated MDO ❑ Doctor' Dentist Office MOLES ❑ Molested Victim DRG EJ Drug Store MULTI ❑ Muhiple Suspects DWY ❑ Driveway OCCUP ❑ Occupied Building 2P ® DuplexlFourplex OFVFD ❑ Offered Victim Food0rink FFS ❑ Fast Food ORALC ❑ Oral Copulation Inv. GAD ❑ Garage Detached PDISR ❑ Partially Disrobed (Suspect) GAS f-1 Gas Station PKLOT ❑ Parking Lot GVT ❑ Government Facility PRPEX ❑ Prepared Exit SMS ❑ Grocery -Small Store PP PAG ❑ Put Property in Bag MKT ❑ Grocery-Supermarkel RAINS ❑ Ransacked HWY❑ Highway+StreeVRoad RIPCL ❑ Ripped Clothing HOS ❑ Hospital SELEC ® Selective in Lool HTO ❑ HoteVNIatel Office SMOKE ❑ smoked on Premises HTR ❑ Hote[Wotel Roam SARM ❑ Suspect Armed JEW ❑ Jewelry Store THRET ❑ Threatened Retaliation LAU ❑ Laundromat TCONC ❑ Tack Concealables LID ❑ Liquor Store TDRUG❑ Tock Diugs'Naroti---s MAL ❑ Mall TSTTV ❑ Took TV. -Stereo Only MFG ❑ Manufacturing Firm TVMCL ❑ Tock Victim s Clothes MAR ❑ klarine+DodiWaterfro m UID ❑ Under Influence Drugs MOV ❑ Movie+Playhouse UNOCC❑ Unoccupied Building BKS ❑ Office SupprBooklStat. ODORS❑ Unusual Odors OIL ❑ Oil Company UDEMN ❑ Used Demand Note PPK ❑ Park+Playground ULODR ❑ Used Lookout LOT ❑ Parking Lot MATCH ❑ Used Matches RAL ❑ Railroad USVEH ❑ Used Stolen Vehicle RAP ❑ Rapid TransitlBART UVNAM ❑ Used Victim's Name RES E] Residential House UVTOO❑ Used Victim's Tools RST ❑ Restaurant VANDL ❑ Vandalized SAL ❑ SaJvage.Wfecking YrEj VEU-IND❑ Vehicle Needed SCH ❑ School Q �RQ��� SPT C] Sporting Goods StoreC1, C D Ofy C. P p _ OS/O i 6 4? 23. Additional Routing 24. Reporting Deputy IPnnt) J. Brown 27. Approving Supv (Print) Sat. Haaaard hours I REF 2e. Eiu pv No. 29. Date 53423 2/5/2008 Toshiba - Satellite Laptop with Intel(R) Centrino® Processor Technology - Flare Carmine ... Page l of 1 Best Buy > Computers > Laptops > Garning > Product Info Toshiba - Satellite Laptop with Intel® Ce Processor Technology - Flare Carmine .. .;::: .. -SU5 SKU: 8780688 Model: X205 Backordered: Usually leaves our warehouse within 1- Our race. 2 weeks Estimate arrival time. '. F - Store Pickup:Available at most stores Select Add to preferred store availability -►. Ads! to Wish E I'M r,,, Special offers: $39-$70 Off Select Printers: See How $99 Vista Ultimate SPI Upgrade: See How QuickBooks Pro for $99: Find Out How Financing: Get Great Financing http://www.bestbuy.com/site/olspage.jsp"skuld=8780688&st=toshiba+laptop&lp=10&type... 5/6/2008 CLAIM HOARD OF SUPERV.i.SORS OF CONTRA COSTA COUNTY 1 BOARD ACTION: Claim .Against the County, or. District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes. MAY 19 2008 AMOUNT: n�o CLAIMANT: Sanegr& ATTORNEY: COUNTY COUNSEL MARTINEZ CALIF. 1-4! 1.,t // aMS ADDRESS: 2v iV� et; btu Aw, Pilils*bVI, a fy65 FROM: Clerk of the Board of Supervisors Dated:I.I. FROM: County eounsi NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the'action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DATE RECEIVED: �Q /671 sue BY DELIVERY TO CLERK ON: /�'�Cl BY MAIL POSTMARKED: T0: County Counsel Attached is a copy of the above -noted claim. JOHN CULLEN, Ci�}k By: Deputy (_— wf TO: Clerk of the Board of Supervisors ( ei 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 wasfiled late and send warning of claimant's right to apply for leave to present.a late claim (Section 911.3). O Other: Dated: 5 �"By: /Y1 Deputy County Counsel 1.11. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) () Claim was returned as untimely with notice to claimant (Section 911.3). . IV. BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for. this date. Dated: JOHN CULLEN, CLERK, By - Deputy Clerk WARNING Gov"code section 913) Subject to certain exceptions, you leave only six (6) months from the date this notice was personalty 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. 1,fyou want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side ofTl-iis Notice. AFFIDAVIT OF MAILING I declareunder penalty of perjury that I air now, and at all times herein mentioned, have been a citizen of the United States, over age 1.8; and that today I deposited in the United States Postal Service in Nfartinez,, California, postage fully prepaid a certified. copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: OV,,L Log' JOHN CULLEN, CLERK B Deputy Clerk CLAiM BOAi21) OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION: .�. Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes. EMAY 1 9 2008 COUNTY COUNSEL AMOUNT: nC MARTINEZ CALIF. CLAIMANT: SG(,hN►'�(, (�1'�l /QI%%s NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on .your claim by the Board. of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". ATTORNEY: DATE RECEIVED: k4 16 �4•V ADDRESS: (fill bt> ' BY DELIVERY TO CLERK ON: Ath .2 BY MAIL POSTMARKED: /7 y FROM: Clerk of tlne Board of Supervisors T0: County Counsel Attached is a copy of the above -noted claim. JOHN CULLEN, C11 k Dated: _ �•�/t/y By: Deputy i.I. FROM.: County eounsel TO: Clerk of the Board of Supervisors (This claire complies substantially with Sections 910 and 910.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant_ The Board cannot act for 15 days. (Section 910.8). ( ) Claim is not timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: 5 By: /Y1 Deputy County Counsel III.. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) () Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOARD ORDER: By unanimous vote of the Supervisors present: () This Claim is rejected in full. () Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for. this date. Dated: 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 niail to file a court.aWoii 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. 4f you want to consult an attorney, you should do so frnrnediately. *For Addi6oial War nirxg See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of perjury that.[ am now, and at all times herein mentioned, have been a citizen of the United States, over age 1.8; 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 A1%1 CN D.r D CL.AIAI BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION:�1�,(,i`i�i Claim Against the County, or District Governed by,) the Board of'Supervisors, Routing Endorsements, ) . and Board Action. All Section referq���Lcz ���i� California Government Codes. ( m MAY 2 3 2008 COUNTY COUNSEL. MAFITINEZ CALIF AMOUNT: Uf),"W CLAIMANT: /1A I (,k a -p -L 5Ka j ATTORNEY j— Michel/ 6rtwn ADDRESS: 6510 3(,QjVb 0M --45 �eFon, c�P.�c a`I NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DATE R.ECF.IVED. BY DELIVERY TO CLERK ON: a%3� BY MAIL POSTMARKED: r FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above -noted claim. JOHN CUL I, Clerk Dated: o2 a�g By: Deput It FROM( Cotint_y Counsel T0: Clerk of the Board of Supervisors ( f'his claim complies substantially with Sections 910 and 9.10.2. ( ) This Claim FAILS to comply substantially with Sections 910 and 910.2, and we are so notifying claimant. The Board cannot act for 15 clays (Section 910.8). O Claim is not timely filed. The Clerk should return claire on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 91.1.3). O Other. Dated: 5� �7� O� By: 6/IC: 67v� Deputy County Coulrsel III. FROM: Clerk ol'the Board TO: County Counsel (1) County Administrator (2) O Claim was returned as untimely with notice. to claimant (Section 911.3). IV, BOARD ORDER: By unanimous vote ol'the Supervisors present: ( '.Chis Claim is rejected in lull. 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:/�&_ JOHN CUL.LEN, CLERK, By eputy Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) months from the ate this notice was personalty seuved or deposited in the mail to file a cowl action on this claim. See Goveninuent 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 atlorley, you should do so immediately. "For Additional Warning See Reverse Side of bis Notice. AFFIDAVIT OF MAILING 1 declare under penalty of pet jury thatI 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 I\Iartinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant., addressed to the ch ' n:n.`t as slimvii above. Dated: 6 JU11N CI_!L.LEN, C.I.-ERK BY _ _ Deputy Clerk AMENDED CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Claire Against the County, or District Governed by ) the Board of -Supervisors, .Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes. ) A A/I O U NT : CLAIMANT: N�, i dj cteL sal? rrj ATTORNEN': j . m tchd" OKCY(vo ADDRESS: CD to-,3ajvb I BOARD ACTION.,,A(,(je. ­ 7L `,4- tP NOTICE TO CLAIMANT.' `.1'he copy of this document mailed to. you is your notice of the action taken on your claim by the Board of. Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DATE RECEIVED: � �- c� ► !�' � BY DELIVERY TO CLERK ON: IR BY .1vlAlL POSTMARKED: i ) 1,1.1,01VI.: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above -noted claim. .JOHN CUL N, Clerk By: Deputyt ll. FRONT.(,_ County Counsel T0: Clerk of the Board of Supervisors ( ) This claim complies substantially xvith Sections 910 and 910.2. ( ) 4"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 riot timely filed. The Clerk should return claim on ground that it was filed late and send warning of claimant's right to apply for leave to present a late claim (Section 911.3). ( ) Other: Dated: By: Deputy County Counsel III. FROM.:. Clerk of the Board TO: County Counsel (1) County Administrator (2) O Claim was returned as untimely with notice to claimant (Section 911.3). 1V. BOARD ORDER: By unanimous vote of the Supervisors present: ( ) This Claim is rejected in full. ( ) . Other: Dated. I certify that this is a true and correct copy of the Beard's Order entered in its minutes for this elate. JOHN CULLEN, CLERK, By Deputy Clerk WARNING (Gov. code section 913) Subject to cenlain exceptions, you have only six (0) months frim the date this notice was personally served or deposited in the maul to file a court action on this claim. See Government Code Section 948.6. You may seek the advice ohm attorney of your choice in connection with this matter. If you want to consult an altvnrey, you shoult.l do so inurretiialely. *For- Additional Warning See Reverse Side of Tlris Notice. AFI (DAVIT OF MAILING 1 declare tiller penalty of perjury (hat.l. ani uow,-antl at all times herein mentioned, have been a citizen of the United States, over age 18; and that today 1 deposited in the United Stales 1'ostsil Service in Martinez, California, postage fully prepaid a certified copy of this 1.3oard Ordc:r ar►d Notice: Lo Claimant, addressed to the clain►ant as shor}'n above. Dated: .1014N C1►1_,LER CLERK By, Deputy Clerk LAW OFFICE OF I. MICHAEL BROWN Tel: (925) 484-2200 Fax: (925) 484-2208 jmb®mbrown-law.com May 22, 2008 Clerk of the Board of Supervisors County of Contra Costa 651 Pine Street Martinez, CA 94553 Re: Skarry v County of Contra Costa Gentlepersons: 5510 Sunol Boulevard Suite 5 Pleasanton, CA 94566 - -RECEIVE® MAY 2 3 2008 ERK BOARD OF SUPERVISORS Enclosed are an original and one copy of a claim on behalf of my client, Michael Skarry, against the County of Contra Costa and my check for the $25.00 Cling fee. Please stamp the copy to indicate it has been received by your office and return the copy to the person who delivers this claim to you. Thank you for your ass Very truly yours J. 1V11 Encl. LAW OFFICE OF ). MICHAEL BROWN Tel: (925) 484-2200 5510 Sunol Boulevard Fax: (925) 484-2208 Suite 5 jmb@mbrown-law.com May 16, 2008 Pleasanton, CA 94566 CLAIM. PURSUANT TO THE CALIFORNIA TORT CLAIMS ACT DEFENDANT ENTITIES: COUNTY OF CONTRA COSTA WARREN RUPF, SHERIFF OF THE COUNTY OF CONTRA COSTA DEPUTIES DOE ONE THROUGH TWENTY, DEPUTY SHERIFFS OF THE COUNTY OF CONTRA COSTA CLAIMANT: MICHAEL SKARRY CLAIMANT'S ADDRESS: C/O J. MICHAEL BROWN LAW OFFICE OF J. MICHAEL BROWN 5510 SUNOL BLVD., SUITE 5 PLEASANTON, CA 94566 ATTORNEY FOR CLAIMANT: J. MICHAEL BROWN LAW OFFICE OF J. MICHAEL BROWN 5510 SUNOL BLVD., SUITE 5 PLEASANTON, CA 94566 (925) 484-2200 DATE OF OCCURRENCE: DECEMBER 1, 2007 PLACE OF OCCURRENCE: BRADFORD ISLAND, CONTRA COSTA COUNTY CALIFORNIA At all times relevant herein Warren Rupf, was the Sheriff of the County of Contra Costa. This claim is against him individually and in his capacity as the Sheriff at the time of the incident which is the subject of this lawsuit. At all times relevant herein Deputies Doe One through Twenty were and are deputy sheriffs of the County of Contra Costa. This claim is against them in their individual capacities and in their capacities as deputy sheriffs. The true names of Deputies Doe One through Twenty are unknown to claimant because at all times Claim Against County of Contra Costa - Page 1 of 5 herein the County of Contra Costa has refused to divulge their identities. CIRCUMSTANCES OF OCCURRENCE: On or about December 1, 2007, Deputy Sheriffs Doe One through Twenty of the County of Contra Costa, police officers Doe Twenty One through Forty of the City of Antioch, and agents, wardens and officers Doe Forty One through Sixty of the State of California Department of Fish and Game, while making an illegal arrest of claimant did so negligently, carelessly and deliberately attack, assault and beat claimant, spray claimant with pepper spray after claimant was in custody and cause a police dog to attack and repeatedly bite claimant after claimant was in custody. As a direct result of the acts and conduct of said persons claimant suffered severe and debilitating physical injuries. Claimant is informed and believes that the office of the Sheriff of the County of Contra Costa received a report of a disturbance on .Bradford Island in the County of Contra Costa. In response to that report of a disturbance supervisors of the office of the Sheriff of Contra Costa and deputy sheriffs, including Deputy Sheriffs Does One through Twenty, organized a task force of law enforcement officers including Antioch Police Officers Does Twenty One through Forty and California Department of Fish and Game Agents or Wardens Forty One through Sixty to respond to that report of a disturbance. At all times relevant herein all of the members of the task force of law enforcement officers were dressed in SWAT camouflage uniforms which concealed their identities. At all times relevant herein all of the members of the law enforcement task force were acting within the course and scope of their employment of their employing agencies and were under the supervision of the Sheriff and deputy sheriffs of the County of Contra Costa, including deputy sheriffs One through Twenty and were acting in concert with each other and each of them conspired with each of the other members of the law enforcement task force in the acts described herein. While claimant was on the property on which he resided members of the law enforcement task force assaulted and grabbed plaintiff and with great force pulled claimant from a ladder and threw claimant to the surface of a dock with such force that claimant landed on his back and struck his head against the hard surface of the clock causing claimant to suffer severe personal injuries. Thereafter members of the law enforcement task force took claimant into custody and removed claimant to the levee road adjacent to the claimants home and while Claim Against County of Contra Costa - Page 2 of 5 claimant was in custody and offering no resistance they did cause a police dog to attack claimant without 'provocation by claimant causing claimant to received multiple dog bites and wounds on claimant's head, neck, arms, legs and body. Thereafter, and while claimant was in custody and offering no resistance, members of the law enforcement task force began to beat claimant with police batons by using their police batons as clubs in a manner inconsistent with and in violation of proper police practices for the use of police batons thereby causing injuries to claimant's body. Thereafter, and while claimant was in custody and offering no resistance, members of the law enforcement task force began to spray claimant with mace or pepper spray to claimant's face and eyes in a manner inconsistent with and in violation of proper police practices for the use of mace or pepper spray thereby causing injuries to claimant's body. Thereafter while claimant. was in custody, injured and bleeding, members of the law enforcement task force forced claimant to walk approximately one mile to the Bradford Island ferry dock, notwithstanding that there were police boats at the location where claimant was assaulted and beaten which could have transported claimant to the ferry dock or to the main land where police vehicles were parked. By forcing claimant to walk while suffering from his injuries the members of the law enforcement task force subjected claimant to cruel and unusual punishment. After claimant was transported to the main land claimant was denied medical care and treatment even though there were paramedical personnel present. Thereafter claimant was transportedto jail and held in custody and although claimant.was in need of medical care for his injuries claimant was denied medical care. Thereafter but only after several hours during which claimant remained in' custody did members of the law enforcement task force finally take claimant to the Contra County Hospital for emergency care and treatment. Claimant was kept in custody for four days without being charged with any crime before being released. Claimant has not been charged with any crime arising out , of the events described herein. The conduct of the members of the law enforcement task force was malicious, wanton and oppressive and said members of the law enforcement task force acted out of a deliberate and intentional desire and willingness to harm and to injure Claim Against County of Contra Costa - Page 3 of 5 claimant and such conduct justifies an award of punitive and exemplary damages and plaintiff is therefore entitled to punitive and exemplary damages against said members of the law enforcement task force. At all times mentioned herein, members of the law enforcement task force were subject to a duty of care to avoid causing unnecessary physical harm and duress to citizens in the exercise of police powers and functions. The County of Contra Costa and Warren Rupf, Sheriff of the County of Contra Costa, had a duty to employ, train, supervise and discipline deputy sheriffs employed by the County of Contra Costa. Sheriff Rupf so carelessly and negligently did employ, train, supervise and discipline deputy sheriffs employed by the County of Contra Costa as to cause the members of the law enforcement task force to be unfit to perform ,the duties upon which they engaged. The members of the law enforcement task force failed to properly evaluate the situation existing at the time to determine whether extreme and potentially deadly force was required to investigate the reports of a disturbance and to question claimant or to take claimant in to custody. The members of the law enforcement task force further failed to attempt to resolve the matter peacefully but instead assaulted, battered and beat claimant as described herein thereby causing severe and disabling physical injuries and unlawful arrest and confinement without probable cause. The members of the law enforcement task force acted in a hasty, disorganized and unwarranted manner without properly assessing any potential threat claimant may or could have posed to any persons present. In doing the acts and in the conduct described herein -above treated the situation as one involving a suspect resisting and interfering with law enforcement officers when that was not true and in so doing escalated the existing situation unnecessarily and unreasonably. The conduct of the Sheriff of the County of Contra Costa and the members of the law enforcement task force breached said standard of care .and did not comply with the standard of care required . to be exercised by reasonable law enforcement authorities and officers. In addition to violating generally accepted police standards and procedures, the actions of members of the law enforcement task force were in violation of established County of Contra Costa Sheriff's Department procedures and policies. The conduct of the Sheriff of Contra Costa County in failing to properly train and supervise the members of the law enforcement task force have caused claimant to suffer severe personal injuries, severe emotional and physical distress and loss of earning capacity. Claim Against County of Contra Costa - Page 4 of 5 The act and conduct of all persons named were in violation of claimant's rights as a citizen of the State of California and the United States of America and did interfere with and deprive claimant of rights, privileges, or immunities secured or protected by the Constitution or laws of the United States or by the Constitution or laws of California. DAMAGES: Claimants damages are expenses for medical care and treatment in an amount to be determined; loss of earning capacity in an amount to be determined; general non- economic damages in the amount of $2,500,000 and exemplary and punitive damages in the amount of $5,000,000.00. f' MIOIAEL BR Attorney for Clai Claim Against County of Contra Costa - Page 5 of 5 AM -ENDED CLAIM. BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTIONJUAe� Z+ 24M8 Claim Against the County, or District Governed by the Board of•Supervisors, Routing findorsements, ) NOTICE TO CLAIMANT and Board Action. All Section references are to ) The copy of this document mailed to California Government Codes. x!!11 ng(rm dC7mmyou is your notice of the action taken mon your claim by the Board of MAY 2 22008 Supervisors. (Paragraph IV below), COUNTY COUNSEL given Pursuant to Government Code MARTINEZ CALIF. Section 913 and 915.4. Please note all AMOUNT: ��� — �. r "Warnings". CLAIMANT: con ; �. f1"i' I OR1�TE�': qo,) ADD RES S :,5I 5t . k. Watpj � qq�s 3 DATE RECEIVED: W`1 BY DELIVERY TO CLERK ON:: r 2�zj BY MAIL .POSTMARKED _ 0 FROM: Clerk of the Board of Suljervisors TO: County Counsel Attached is a copy of the above -noted claire. JOHN CUL, N• Clei;k y ~ Dated: oZ•�.� By: Deputy,_ Il. FROM- Wounty Counsel TO: Clerk of the Board of Supervisors (0'lrhis claiie complies substantially with Sections 910 and 910.2. ( ) This Claire .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 latae and send warnin; of claimant's right to apply for leave to present a late claim (Section 911.3). ( ✓r,_Othei-: ..0 i MG'r'4 r1e-Z. l5 P� ( -iron � Cam -� t/���Cx7 Dated: _ 5'��'�� By: m Deputy County Counsel 11.1. FROM: Clerk of the Board TO: County Counsel (1) County Administrator (2) O Claim was returned as untimely with notice to claimant (Section 911.3). IV. BOA.R.D ORDER: By unanimous vote of the Supervisors present: ( This Claim is rejected in full. . () Other: 1 certify that this is a tare and correct copy of the Board's Order- entered in its minutes for this date. Dated: (P JOHN CULLEN, CLERK, By. Deputy Clerk WA.RNIN (Gov. code section 91 3) Subject to certain exceptions, you have only six (6) months from the date this notice was personally sewed or deposited in the mail to fde a coml action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your choice in connection with this matter. If you want to consult an attorney, you should do so immediately. *For Additional Warning See Reverse Side of This Notice . AFFIDAVIT OF MAILING I declare under penalty of perjury that I am now, and at all times herein mentioned,.have been a citizen of the United States, over age 18; and that today.1 deposited in the United Slates .l.'ostal Service in Ntartinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claimant as shown above. Dated: _� �fl��. IO1=1:N CULLEN, CLERK By — -- — Deputy Clerk AMENDED CLAIM. BOARD OF SUPERVISORS Ol+ CONTRA COSTA COUNT'Y Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes. ) " 0 ATTORNEY: kP ADDRESS lil��� CCc(- BOARD ACTION.JLRe NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". DATE RECEIVED: �AAa , o2( d ()0C BY DELIVERY TO CLERK ON: ?`�v BY NIAIL POSTMARKED: I��\(f �((,: ��D FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above -noted claim. JOHN CU.LN Clerk bated: �� �✓ c�-.� .: �i�j By: Deputy:. ail 11. f ROM: County Counsel TO: C'Jerk 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). ( j ('laim 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 tier leave to present a late claim (Section 91.1.3). ( ) Other: -- ------ — — - Dated: Bv: Deputy County Counsel 11.1. FRONT Clerk of the .Board 'TO: County Counsel (1) County Administrator (2) () Claim was returned as untimely with notice to claimant (Section 911.3). BOARD ORDER: By unanimous vote of the Supervisors present: 'Flus Claim is rejected in full. Other: 1 certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. Dated: _ _ JOHN CU_.LLEN, 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 art attottirey, you should do so iuuue liately. hor Additional War•rting See Reverse Side of'Ilds .Notice AFFIDAVIT OF MAILING 1 declare under penalty of penury 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 rostal seuvice. in I\.tartinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimairt., addressed to the claimant as shown above. Dated: - _--- -- -- .-. __—. _ J01 -IN l'l.!I_:LI N, l.'J_FRK 13y --- Deputy 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, Pan al Ccd? See. 72 at the end of this forth. Noun 131111 was DREMMUMMMUMMEMOMMERMUMMas RE: Claim By: Against the County of Contra Costa or ) A2T \ 14 E-Z�_ District) (Fill in the name) ) Reserved for Clerk's filing stamp RECEIVED . LMAY2 1 2008 CLERK BOARD OF SUPERV!SORS The undersigned claimant hereby makes claim against the County of Contra Costa or the above-named district in •the sum of $250 — 2 60 and in support of this claim represents as follows: 1. When did the damage or injury occur? (Give exact date and hour) rEQ). ICrri , Zao .S to, -%AS •Ann 2. Where did the damage or injury occur? (Include city and county). rA aZ'C k N EZ VA- C�S� A c.oU NVf 3. How did the damage or injury occur? (Give full details; use extra paper if required) A '! T V_EET Utt' ?Ale `.-3TZCE"i" FLI F.461NG RcG� fVEp_`% 'Wtte--C 0105%Nrc • DAMRG9- -M M•te VE1iiGveo 4. What particular act or -omission on the part of county or district officers, servants, or employees caused the injury or damage? CS l�� MY .-STzETraGi10E, =��So i�AUF .1JO DR:a,\ivS O� 51 OE-.1uA CICS C N M.Y S'CtG�� 5 o A 57eC-C� Su>EC-�E"� NAS nes P cs SNFs5. �H ErZE. 5 What are the names of county or district officers, servants, or employees causing the damage or injury. ql�?� 0_i` IAAvC- � fit♦ M`{ STR'�E'\ s fi. What damage or injuries do your claim. resulted? (Give full extent of injuries or damag ,- &.,7 (OC claimed.. Attach two estimates for auto damage.) `jt; Va « oN Orr G•pok_ p -m'9. a,aiNaSwfc�LO ; �rNGS t�.l ��MS ea.Nb P�� i CArZ �2`<`� �Ga6�6D `� �T q�90 i7� �wS�b`c \►Et�tGl� AS -4kc- W-,1,bDcir3 WEt'C- ce^c-ket, 7. How was the amount claimed above computed? (Include the estimated amount of any oft prospec:five injury or damage.) i s�ov c� ��-� Z a LSo S�okc- W l'Ck1 6N1'. l lstJ E (,ALS p<<J�O pETF�1L} NE SA,r9 NE t�RS acv oceGc�l�.r L..>RH ti'oU. 6C�t S"StM•R'iE� �-���-H EO. 8. Names and addresses of witnesses, doctors, and hospitals: E a List the; expenditures you made on account of this accident or injury: DATE TIME AMOUNT ■ Nam man MEN rWagon Emmaus rrrrrrrraarrrrraarrraarrrrrrrraaarag ) Gov. Code Sec. 910.2 provides "lhe claim shall be ) signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attorney) ) Name and address of Attorney ) CI ' ant's Signature) (Address) CA, "141&S3 Telephone No. ) Telephone No. < I LS, `-19 7 -'S Q -7 7 BONNE rrrrrrrMonosson rrrarrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrrBoom rrrrrrrrrrrrrrrael 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 supplernents attached to the claim form, including medical records, are also subject to public disclosure. ■■m a a on aaraaamarrarrrrrrrrrrrarrrrrrrrarrarrrarrrrrrrrraraarrrirrrrrrrarrr0rrraarrarl 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 ($10,000), or by both such imprisonment and fine. City of. Martinez STREET SWEEPING SCHEDULE & ROUTES — — City Limit Boundary i MARINA •••"•• Roadways <• Fr eewa ys .o \ • �USANA ST � North t• , SHELL 61. X. ce ..�yq ¢ W • `•� J • m \ ,meq .d •t '•m •�� • `� --� - °o •; off'• ♦' •1 ` eti��` : �° • • i ELDER. �•� � BENNAN •'•' • � '� 1 MAY JUNE JULY AUGUST 2008 STREET SWEEPING SCHEDULE Hours 5:00 a.m. To 1:00 p.m. Sunday Monday Tuesday Wednesday Thursday Friday Saturda 1 2 3 5 4 5 6 7 8 9 10 8 2 10 11 12 13 14 15 16 17 .9 3 Islands Islands 18 19 20 21 22 23 24 6 4 Parking Lots 25 26 27 28 29 30 31 _. .. H®LIDAY. 1 2 3 4 5 6 7 8 2 5 8 9 10 11 12 13 14 9 3 10 15 16 17 18 19 20 21 6 4 Islands Islands 22 23 24 25 26 27 28 7 1 Parking Lots 29 30 1 2 3 4 5 2 5 HOLIDAY 6 7 8 9 10 11 12 8 3 10 13 14 15 16 17 18 19 9 4 Islands Islands 20 21 . _.. , ,.. _ .. 22-• . 23 . 24-,25, -_ . _ 26.: . 6 1 Parking Lots 27 28 29 30 31 1 2 7 3 4 5 6 7 8 9 8 2 5 10 1 2 3 14 16 9 3 10 17 18 19 20 21 22 23 6 4 Islands Islands 24 25 26 27 28 29 30 7 1 Parking Lots chis Information can also be found on our website at: www.cityofmartinez.org ..... .......... 7. �zn CV- 2Pr'. Pik .......... Kill "R 7 E3. .� J. C -0 0 M fD M Dj -0 0 M 3 -0 'V (D Ln ID Co (D ll� 0 �r-t' L:E (D =$ 03 q =3 3 t —f M CD M - C D .rt L, s. -r 'a) lo ul D -0 (D M ul 0 LO -o W r) M 3 0 En M rt m Us _0 -(D -X 0 LA 3 0- M M :r rD 3 -1 m (D rD 'Cl o 3 =rDr X M C: rD jw rD =3 - - 6 Di. tn M. CL D) =r o I LA 'ED 1� - -3 m x o 0 rt -0 070 A 0 —'0 "., -Z n 0_ rD c ni =3 m (D -r 3 0 I ---"o ai 0 10) rZ C) �:* 0 — V C �< :3 -1 r -r 0 3 cy 'SL 1 U*) 0) (D 3 T. 3 D =) rD 3 B) -L CL X. Ln M 0 CL Ui. ZT Ln Ln 3 M r) M 0 M < =3 fu D r -r 0 3 to 3 OL fa aj M 0 0 X Ln 0, =3 r) �1) rD -, `a) c LO r) a) M. 0 -7 C: C: q < Ln - M (n (D rt C: X C) (n (D a) Di -1 (.) -< r,+j =T --h O DJ4 C7 Cr,!(D m UJ MC C) DJ r -r al C: :7 ,:37 — a) (D 11 j 1 03 0 Z; -0 M rr --, U) --I -3 -0 - L6 'D Ln 3-- 0 ol r (D 0 00 Ln -7 Z. 4, (D U' At U) C) X M (n ,r-,_�� U) E, cL 0 fD- < -m- rr Q (D aj rt Z3 Ln ul -0 :3— C:) (c D cLO 3 FT Ln 07 _0 0 -.1 C: 0 ai M Di Ln ..... .......... 7. �zn CV- 2Pr'. Pik .......... Kill "R 7 E3. .� J. c vi o c E i6 c C_ U C c w m N O N (n .0. C En O O U N O 7 (0 U t— m0 O ON N� m —a,� a) C: L � U U 0 o N 0 U 02" «O N N rn Ir `m 7N _O) Q IL` ;:�'2rli.,: .:;1'2". 4y ^8., i.sy .s.•%7.1 ,.�, r--_. •y E9{��"s„� �Y� i ais y 0 x 73, E E A .i" CL V/ CL :�" . ,.1•i:: Mo-.. / � /•L �: ,'.g L � „�+j . !Rva'�rr... Fs'•:i 'b, '' '.� ^, V 0 • .,aji I�S g w Ln J *W Ln C O 0 'L h �.•' N uj ; w V ;� �, ` o � 1 0� to •� l O O• v ®M GJ o olet Cq Ln N N OO �I, N Ia _ `•O0 al 1 00 Y Ln vco M •- �° N 00 00 U If ? a) a a) CL io CL is 06 O I mOO O C) O O O O O a) p Ln O N', "TT O O O m O to O in O U.) O O " O LO O N (D N + — N in t` 00 tl-— tl N N m O N t.- -'TO M 69 69 69 1 6=} 169 69 69 69 69 69 69 69 69 69 69 69- 69 69 69 69 0 (6 O J L C _ O O O fd C ` In a) N N C K O co >0 E LL o o o U c n o U m3 U I m o ,� N Q : 1 0 c� o N o x cn (n a) E Z a> m E fn a) a) w 0) N `� o o2S 2 C -0 > O L x o X c N co N 7 2 a) a) U N U C: a) O O m Z L Q) () s atS L) O CO (n O C 3 E N L -O � O (6 _ fA > 0 O 0 ca M N O C_ c ca U d O O + I C X + i N (0 'p O N N O C O O O � U) U Q y ti w Q M cn U m 0 CL CL o > m = Q AI's Auto Detail 209 Berrellesa St Martinez, Ca 94553 Tel.: (925)370-6033 Fax: (925)370-3540 COREY STANLEY 3131 CATALPA ST MARTINEZ, CA 94553 Estimate CUSTOMER ORDER NO. DATE PAGE 1.00 03 CADILLAC CTS PLATE#5MFE837 $260.00 $260.00 VIN#1391 1.00 COMPLETE DETAIL IN & OUT SIGNATURE DATE SUBTOTAL TAX $260.00 $0.00 TOTAL AMOUNT $260.00 SIGNATURE DATE co C= CQ vi 4 d 1-n O � baa 2 N �S�d co C= CQ CLAiM BOARD OF SUPERV.i.SO.RS OF CONTRA COSTA COUNTY BOARD ACTION<,1 Qe- 241 � 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 D � ����� on your claim by the Board of Supervisors. (Paragraph IV below), MAY 2 0 2008 given Pursuant to Government Code AMOUNT:Section 913 and 915.4. Please note all COUNTY COUNSEL "Warnings". ' r MARTINEZ CALIF. CLAIMANT: �Yf V ATTORNEY: 1A../01.1 DATE RECEIVED: f4t1ij Z ADDRESS:Tip BY DELIVERY TO CLERK ON: PcnBY MAIL POSTMARKED: G - g FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above -noted claim. JOHN CUL N Clerk Dated: MA, � By: Deputy al 4l r" u-[i(.�G� II. FROM: gounty 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 retum claim on ground that it was fled late and send waming of claimant's right to apply for leave to present a late claim (Section 911.3). {) Other: Dated: 97,0 By: Me��;,,! Deputy County Counsel III. FROM.: Clerk of the Board TO: County Counsel (1) County Administrator (2) () Claini was returned as untimely with notice to claimant (Section 911.3). 1V BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. {) Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for this date. DatedC.tQjj.c:) 6 JOHN CULLEN, CLERK, B Clerk WARN1.NCi (Gov. code section 913). . Subject to certain exceptions, you have only six (6) months linin the elate this notice was personally served or deposited in the mail to file a courtaction 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 immetliately. *For Addidolal Wan-niiig 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 .1 deposited in the United States Postal Service in INi.artinez, California, postage fully prepaid a certified copy of this Board Order and Notice to Claimant, addressed to the claim. it . shown above. Dated: 10 JOHN CULLEN, CLERK . By Deputy Clerk C LA I.IVI BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes. ) AMOUNT: CLAIMANT: Z l lit%CCf���i� BOARD ACTION:IJUgC'. 2.4, C•Z''�� NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your clai►n.by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". ATTORNEY:. 11.%CC = DATE RECEIVED: Matf ADDRESSA41-rAou ReLCcc., BY DELIVERY TO CLERK ON: h C�-;1 ft -to - - r BY MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above -noted claim. JOHN CULIN .Clerk Dated: ��� `�i< c� By: Deputy,(Y1lGtitC/ i.I. FROM.: unty 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. Tile Board cannot act for 15 days (Section 910.8). O 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 1.11. FROM.: Clerk of the Board TO: County Counsel (1) County Administrator (2) () Claim was returned as untimely with notice to claimant (Section 911.3).. IV. BOARD ORDER: By unanimous vote of the Supervisors present: () This Claim is rejected in full. (1 Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for. this date. Dated: JOHN CULLEN, CLERK, By Deputy Clerk WARNING (Gov. code section 913). Subject to certain exceptions, you have only six (6) months h-oul 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 widi this matter. Il'you want to consultaii attorney, you should do so immediately. *For Additimal 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 beenma citizen of the United States, over age 18; and that today .1 deposited in the United States Postal Service in Nlartinez, 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 �b BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY INSTRUCTIONS TO CL_ MkNT 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,6:5) 1 Pine Street, Martinez, CA 94553. C. If claim is against a district governed by the Board of Supervisors, rather than the County, the nine 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. V E. Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the end of this form. MEMO NEMNEREZROWERM so i i i i i i i i■ i i i i i i i i f i■[ i i t i i i t i i MORE RXUREEM i i t i t i i■ [iii i i■ 21 RE: Claim By: 16zrlye 1/a.-.9as j Against the County of Contra Costa or ) District) (Fill in the name) ) Reserved for Clerk's filing stamp RECEIVED MAY 202008 CLERK BOARD OF SUP,RVISORS CONTRA COSTA CO. The undersigned claimant hereby Lakes claim against the County of Contra Costa or the above-named district in the sum of $ Z© 16. 2 z and in support of this claim represents as follows: )When did the damage or injoccur? (Give exact date and hour) 170.m 2. Where did the damage or injury occur? (Include city and county) d J�anlon X(//4Ce 3. How did the damage or injury occur? (Give full details; use ex-tra paper if required) .S%eP int' s �a�rQ� c�,.^ `]loar palAe� epi; 4. What particular act or omission on the part of county or ;district officers, servants, or employees caused the injury or damage? / �1 —A e Ga may e// {✓eA i Ge /J Wa 5 Ail' eya7�ro� car 5 What are the names of county or district officers, servants, or employees causing the damage or injury? p -��' &„ � 15 l.' . 00. (p sbot n eZ, as ci `1 � 3 `� 1 i�as) !o C 6 - R 6. What damage or injuries do your claim resulted? (Give full extent of injuries or damages claimed. /Attach two estimates forautodamage.) '026,13 - Z, D 1�, z V7_, O Z 6 , /3 7. How was the amount claimed above computed? (Include the estimated amount of any prosp;.ctive injury or damage.) u� A l 304 � rc 0 8. Names and addresses of witnesses, doctors, and hospitals: /Ae, iildlGlr/eeJ pv;1. e5SE62Ad GicGidenL, 9. List the expenditures you made on account of this accident or injury: DATE TIME AMOUNT 6_s4;.,nt+7eS a jbchev ■■ a a a a a a a BORROW mango ONIONS a e a a a a Q a e t a a a a t e a a a a a a Romeo a a e a a a a a i t a a r a a t a a OR no a e r o a a a a e l .Gov. Code Sec. 910.2 provides "The claim shall be signed by the claimant or by some person on his behalf." SEND NOTICES TO: (Attornev) ) Name and address of Attorney ) (Claiman s Signa LFlo (Address) Telephone No. Telephone No. _ 1 �3 & % (fir �� ■■ a t s e m a e a a a a e e Magnusson Sam on Mason KERNMERNKRO muss teat no a a a a a a Samoan mammon NEEKEEMBEREP 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. ■ SEEN a a a a a a a m t e a a t a Osman ■ t ass a r a i e a r a a a a a a a! a a a e a t e a a a r a a a a a a a a r a a t a t a e a Oman a a a a a a r a i NOTICE: Section 712 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. 0.,/:30/2008 at 04:15 PM 227, . 9 MIKE ROSE'S AUTO BODY OF PITTSBURG Fec-.Ieral !D !i:`,12621349 COUNTS, WHIERE Q-)U�k-:1:''i — 300' NORTH PPP.7<. (: 25)4 �9 22 `; ) 4 3 �2` - 799 �10)F�aa-- i' ':J'7 51 }/-J9 Insured: !RENE VARGAS Owner: TRENE VARGAS Address: 46 HANLON PL. -PITTSBURG, CA 945E -3 - Other: (925)567-645,-) Business: (9 2 5) 26 7-4-3105 PRELIMINARY ESTIMATE a E, u .=jVs=� Claim # Policy # Deductible: Date of Loss: Type of Loss: Point of Impact: Inspect MIKE ROSE'S P�T-70 BODY OF PIETTSBU Business 92 5 ) 4 2 - - - Location: 3001. NlORTH PARK BLVD PITTSBURG, CA 94565. Insurance Company: Days 'L -.o Repail, 1'.9 . FORD EXPLORER 4X4 6 -4.0L -FI 4D UTV -3-LA--E� :111 t : GR VIN: '17MDFJJ34E8VUD08`23 Lic: VQO Prod Date: O 1 7 Odometer: condition: Good Condt1ol ` 1- lg r; e -rm i t t e n t ipers -)U" Mi-rors a.r ;_,ae Pa in z -Owp- St- in a Pow r -L .M R1�6io SL--,-eo Brakes (4) Dr-ve- Air Baa Passenger A -'r Eaq Disc Bi -tikes BUCKet =ats ALiLo:--'Lai-ic Tre . L s 10 ti "IV e - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -- - - - - - - - - - -- - -- - -- - -- - - - - - - - - - - - - - - - - OP. D E S C P-1. -D IJ -11 N. Q111,11 I`X-1:1. P.` I LVA -1-1. '..'.i`1 --------------------------------------------------------------------------------- 1 FRONT BUMPER O/H bum.per aQsy Repl Bumper cover ch----ome -18 9 1n c I- J. p 1 Pad assy gra,.--)'.,!it r; GRILLE Repl Grille assy w/o I,9 n i chrome/ a --,- g en t FRONT LAMPS Repl LT Headlamp assy T n f- I 9 Airr, 1--teadiamps 0 11. 00 D 10 Repl L' -r Park/marker lamp 1 47.54 -r.cl. %i FENDER 7.Z. Repl LT Fender w/o Edaie Baue--, Limited j Add for C' iear Coat 0. 0n 1 04./30/2008 at 04:15 PM 22792 Job Nu:r.;oer: PRELIMINARY ESTIMATE 1997 FORD EXPLORER 4X4 6-4.CL-FI 4D UTV BLACK Int:GRE' ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 14 Add for Edging 0 0.00 0.0 0.5 15 Add for Clear Coat 0 0.00 0.0 0.1 16 STRIPE TAPE 17 Repl LT Stripe tape side kit 1 70.20 0.0 0.0 18# Repl COVER CAR 1 7.50 T 0.2 0.0 19 Repl CORROSION PRO"E'CTION 1 10.00 _ J.3 0.0 20+ Repl FLEX ADDITIVE 1 8.00 T 0.0 0.0 21t Subl HAZARDOUS WASTE 1. 5.00 z",0.0 0.0 221; TINT COLOR 1 0.00 1/ 0.5 0.0 23# XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 1 0.00 0.0 0.0 XXXXXXXXXXXX v"` _l X X X v XIIIIXIVXX 244 ESTIMATE OPEN PENDING TEARDOWN 1 0.00 0.0 0.0 254 INNER STRUCTURE OPEN 1 0.00 0.0 0.0 264 XXXXXXXXXXXXXXXXXXXXXXXXXX::XXX - 0.00 ( j.0 0.0 XXXXXXXXXXXXXXXXXXXXXXXXXXXXX>: ------------------------------------------------------------------------------- SubtoLals =_> 969.51 5 Parts 939.01 Body Labor 5.8 h.s @ $ 82.')0/hr_ 4.75.60 Paint Labor 4.1 'r-ir_s @ $ 32.00/hr 336.20 Paint Supplies 4.1 hrs @ 35.00/h 143.50 Sub 1e /X"sc. ---------------------------------------------------- SUBTOTAL % 1.924..81 Sales Tax $ 1:x.08.01 @ 8.2500'`s 91.41 GRAND TOTAL $ 2016.22 ADJUSTMENTS: Deduczi.;le 0.00 ---------------------------------------------------- CUS''_'OMER PAY $ 0.00 INSURANCE PAY 201.6.22 THIS IS A PRELIMINARY ESTIMATE AND ADDITIONAL CHARGES MA`1 BE REQUIRED FOR 'NNE, ACTUAL REPAIR. I 0A /30'/008 at 04: 15 PM 2 2 1 9 2' Job Nu -s --Der: PRELIMINARY ESTIMATE 1997 FORD E2'PLOFER 4z',"4 6-4 UL 4D UTV BLACK _[i- i- : (_1'RE1` FOR YOJR PROTECTION CALIFORNIA ':.,AW REQUiRFS _1_-'OL.-L,OWINCl T'O ISPPTEap. Cil ANY PE'RSON WHO KNOWINGLY PRESENTS _'rTA_"'_-E CR DULENT CLAIM F,1 -)R THF D'V�.'rjH­.T OF FRAU V CZrjB',L-­ rrr� 71-t,' L_ - -I- IN IS GUILTY OF A CRIME AND RE L I S A'- D C 0 I'd E- S T T E P P. I S 0' T H`i F 0 L L C-) W T N G: =S A LIST 0 F A B B P�, 7- V I A T1 0 t,' S 0 M3" 0 !IS HA. BE U==.D '.I`Ci 7 REPLACED: MOTk",'-_-, ':_RED 0 R WORK. TO BE DONJIE OR PAR7S TO BF AB BRE.VIAT70N Q Sy'D\/]Bo— S: D=D_;SCON-IN� D -':,\I R T A=, "PRI;'-PPROv. MITE PRI;'- L=_OR :PES : D Y LABOR D = D 1 AG 0 S T I C E E T ECT-RICAL F=FPAMEG=G- -,-"�MECA':'\-;I'_'AL -I '�-PP.: 7\ S S .H T _. r 'I D L— C � TL-ANECUS 1,ABOP. S=STRUCTURAL -_=TAXED '\/qISCELLA.rjEOUS 'A' _L I S 2L\1_',J=,,D__ACENT AL(--;N=A7Lj IGN A/N—AFTERMARKE'll 3- D = 7ND CA = CER F, T D 12, J;r M 0 1 V E-7 'po, T, S S or, I A -7 1 ON' D&R=D_ONN7CT AND P\ECO'\-'--"T _-,ST--;;'STIM,",.TE Il:P. T,,-, E L -Cr I CE IPT !ED BY THE QUANT\T7` T1'\1 C L I'. C- m-MC�M_-.Tn;i ,DEDISIS'ELLA�4 I I =.JTO LAI SPECFI ATIO1JS NC[,]-AE,J=NON ADJA:­EHT 0/"i-OVER"AUL 0-= '-_7�',­ Ni:MBER QTY=_UANT1T"1QUAL R E C`i = Q:_- A L T ___ PEC"LCL-D PART PT QUAL R E L !';Lir PART COMP REPL PARTS=COMPETITIVE REPLAC'E'v17."\1,T PI \ RT S REFN1=REt'1N1__r_'-"-, 7-17._"_)::j='.EPLAC'E R&__=RE_'v1OVE AND .'ND REPLACE PPR=P\EPTAIR RT=RIGHT Sr__'-=S::"ECT_'OH SUBL=SUBL;"r1' E F T oUC.1- W/ _WTTH/ SYMBOLS: #=MANTJAL LIME E',\ITR",' —F Oq'O R D AT A B TSF I L\j_' i "IF wi 1 -TES `'':TTS" TO -R' Za Ar'.F'.<ET N-11' I J 'A" ED -.1\TTON WAS CHNGED'I "=D"BA-:E L-1 -1 LT'\Jl',. ";QVP=MANUFACTURER'S QU"A T 1 1. C AT__ 0 1\j IND VA_'-1UPT1O1'j PPIUGP.A�Pj. "D P-1 EQUIPMENT MANUFAC-UREP. PARTS L L C,-,7, T: T C� L. %�j TT -7lj p 1 7 ID T:1 0 V IDED WI"T'H SOME UNIQUE PRIICIT'\jj(-'R DISCO -NT. i PROC�RAM. t: t, e i: %A Otl t -r' L J L v j.. "'131) fa - 1. Ire f f.'[U" ja� e S S s, --J - a 01A_.el' T:'r EE T. I_`_, S C cl 1. 1--' L: 1-: ID -_l: .I:' 'JI �j . 171 S 1 L. L TID:_i c; 1 1, �'I tm'an:.11_::''..;-'.uro'­ T .i:_ 1. P 1 S L7 ia p e a l:':_.. -: 0- L c ci as P. c" SSE r) 1 t i- r 1. 0a 1 , �3 ]:'f-: E, 7 1'T t i i g. ci 0 U 1-. d S.i.,-.'% (4.-1 Cl Is inc" c a 'I:a­)Jal ._;":r -e 2n n s r,, 1 "c:L :.rIe p I e v c" u s -"oar. EF D f t- - c; ::r v.1)d.i_'1e_s' pr1c.-I.. d L �..'.h e ve, anci par'ls frci:t v-_.az- 1,.:e usec. 1 De vi El 'vS '-.3 a Of i. U 1: LO .3 -1 fl'� r i cc ::3 U Cc , - c 71 04/30/2008 at 04:40 PM 31033 Job Number: ANTIOCH AUTO BODY, INC. License #:37962 Federal ID #:680336031 1.401 VERNE ROBERTS CIRCLE ANTIOCH, CA 94509-7915 (925)757-3586 Fax: (925)757-5246 PRELIMINARY ESTIMATE Written By: RICK RINNA Adjuster: Insured: IRENE VARGAS .Owner: IRENE VARGAS Address: 46 HANLON PL PITTSBURG, CA 94565 Day: (925)267-4305 Inspect ANTIOCH AUTO BODY, INC. Location: 1401 VERNE ROBERTS CIRCLE ANTIOCH, CA 94509-7915 Insurance Company: Claim # Policy # Deductible: Date of Loss: Type of Loss: Point. of Impact: 1997 FORD EXPLORER 4X4 6-4.OL-FI 4D UTV Int: Business: (925)757-3586 Days to Repair VIN: 1FMDU34E8VUD08123 Lic: 4QQ097 OR Prod Date: 05/1997 Odometer: 191027 Air. Conditioning Intermittent Wipers Dual Mirrors Clear Coat Paint Power Steering Power Brakes AM Radio FM Radio Stereo Anti -Lock Brakes (4) Driver Air Bag Passenger Air Bag 4 Wheel Disc Brakes Bucket Seats 5 Speed Transmission Overdrive ------------------------------------------------------------------------------- NO. OP. DESCRIPTION QTY EXT. PRICE LABOR PAINT ------------------------------------------------------------------------------- 1 FRONT BUMPER - 0/H front bumper 1.5 3 Repl Bumper cover chrome 1 248.99 Incl. 4* Repl Pad assy titanium 1 81.88 Incl. 0.0 5 GRILLE 6* Repl Grille assy w/o Limited 1 177.69 Incl. 0.0 chrome/argent 7 FRONT LAMPS 8 Repl LT Park/marker lamp 1 47.54 Incl. 9 FENDER 10 Repl LT Fender w/o Eddie Bauer, 1 202.43 2.8 2.5 Limited 11 Add for Clear Coat 1.0 12 Add for Edging 0.5 13 PILLARS, ROCKER & FLOOR 14 R&I LT Running board 4 door, 0.5 XL-XLT-Limited board only 1 04/30/2008 at 04:40 PM 31033 Job Number: PRELIMINARY ESTIMATE 1997 FORD EXPLORER 4X4 6-4.OL-FI 4D UTV Int: ----------------------- NO. ------------------------------------------------------------------------------- OP. ----------------------------- DESCRIPTION =-------------------------- QTY EXT. PRICE LABOR PAINT 15# Refn COLOR MATCH 0.5 16# HAZARDOUS WASTE 1 3.00 X 17# Repl CORROSION PROTECTION 1 10.00 T 0.2 18# Repl COVER VEHICLE FOR OVERSPRAY: 1 7.50 0.3 19 STRIPE TAPE 20* Repl LT Stripe tape side kit 1 52.33 0.2 21# ----=------------------7--------------------=---------------------------------- Rpr GRILLE FILLER PANEL 1.0 1.0 Subtotals =_> 831.36 6.5 5.5 Parts 818.36 Body Labor 6.5 hrs @ $ 77.00/hr 500.50 Paint Labor 5.5 hrs @ $ 77.00/hr 423.50 Paint Supplies 5.5 hrs @ $ 34.00/hr 187.00 Sublet/Misc. 13.00 ---------------------------------------------------- SUBTOTAL $ 1942.36 Sales Tax $ 1015.36 @ 8.25000 83.77 GRAND TOTAL $ 2026.13 ADJUSTMENTS: Deductible 0.00 ---------------------------------------------------- CUSTOMER PAY $ 0.00 INSURANCE PAY $ 2026.13 2 04/30/2008 at 04:40 PM 31033 Job Number: PRELIMINARY ESTIMATE 1997 FORD EXPLORER 4X4 6-4.OL-FI 4D UTV Int: FOR YOUR PRO'T'ECTION CALIFORNIA LAW REQUIRES THE FOLLOWING TO APPEAR ON THIS FORM: ANY 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. THE FOLLOWING IS A LIST OF ABBREVIATIONS OR SYMBOLS THAT MAY BE USED TO DESCRIBE WORK TO BE DONE OR PARTS TO BE REPAIRED OR REPLACED: MOTOR ABBREVIATIONS/SYMBOLS: D=DISCONTINUED PART A=APPROXIMATE PRICE LABOR TYPES: B=BODY LABOR D=DIAGNOSTIC E=ELECTRICAL F=FRAME G=GLASS M=MECHANICAL P=PAINT LABOR S=STRUCTURAL T=TAXED MISCELLANEOUS X=NON TAXED MISCELLANEOUS PATHWAYS: ADJ=ADJACENT ALGN=ALIGN A/M=AFTERMARKET BLND=BLEND CAPA=CERTIFIED AUTOMOTIVE PARTS ASSOCIATION D&R=DISCONNECT AND RECONNECT EST=ESTIMATE EXT. PRICE=UNIT PRICE MULTIPLIED BY THE QUANTITY INCL=INCLUDED MISC=MISCELLANEOUS NAGS=NATIONAL AUTO GLASS SPECIFICATIONS NON-ADJ=NON ADJACENT 0/H=OVERHAUL OP=OPERATION NO=LINE NUMBER QTY=QUANTITY QUAL RECY=QUALITY RECYCLED PART QUAL REPL=QUALITY REPLACEMENT PART COMP REPL PARTS=COMPETITIVE REPLACEMENT PARTS RECOND=RECONDITION REFN=REFINISH REPL=REPLACE R&I=REMOVE AND INSTALL R&R=REMOVE AND REPLACE RPR=REPAIR RT=RIGHT SECT=SECTION SUBL=SUBLET LT=LEFT W/O=WITHOUT W/ =WITH/_ SYMBOLS: #=MANUAL• LINE ENTRY *=OTHER [IE..MOTORS 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 OTHERWISE PROVIDED WITH SOME UNIQUE PRICING OR DISCOUNT. NWCPP=NATIONWIDE CRASH PARTS PROGRAM. : stim.a:to based on MOTOR CRA;i_! ES-TMATING GUIDE. Unless otherwise noted all items are derived from he Gui_ue DE2MF95, CCC Data Date 04/01/2008, and the parts selected are OEM -parts manufactured by t- ve:•:icles Original Equipment Manufacturer. OEM parts are available at OF../Vehicle dealerships. OPT OEM (Optional OEM) or ALT OEM (:alternative OEM) parts are OEM parts that m.ay be provided by or throuoh alternate sources other than the OEM vehicle dealerships. OPT OEM or ALT OEM parts may re=l:ct some specific, special, or unique pricing or discount. OPT OEM or ALT OEM parts may inc:i,.do "7"emi.shed" parts provided by OE'M's through OEM vehicle dealerships. Astc:eri.9 (*; or Doub.''e Asterisk (**) .ridicatc:, that'the parks and/or labor information provided by MOTOR may have belen modified or may have come from an alternate data source. Tilde sign (-) items indicate MOTOR. Not-;ricl.uded Labor operations. Non --Original Equipment Manufacturer aftermarket parts are described as AM, Qual Repl Parts or Comp Rep' Parts which stands for Competitive Replacement Parts. Used parts are described as LKQ, Qua]. Recy Parts, RCY, or USED. Reconditioned parts are described as Rec.ond. Recored parts are described as Recore. NAGS Part Numbers and Benchmark Prices are provided ;y National Auto Glass Specifications. Labor operation times listed on the line with the NAGS .nformation are MOTOR suggested labor operation times. NAGS labor operation times are not included. Pend sign (#) iteral indicate manual entries. Some 2006 vehicles contain minor changes from the previous year. Fo.r those vehicles, prior to receivir_g updated data from the vehicle manufacturer, labor and parts data from the previous year may be used. The Pathways estimator has a =:pl.ete list of applicable vehicles. Parts numbers and prices should be•confirmed with the local dealershi-o. C:C Pathways - A product of CCC Information Services Inc. 9 <. S. RST CLA IOREVER' cc O - " ILS.A FIRST-CLASS FOREVER ; + Yob /Fxiof a O 000 Y DAVID RAYMOND 3001 NORTH PARK BLVD. • PITTSBURG, CA 94565 FAX (925) 432-9936 draymond@mautobody.Com • WWW.MAUTOBODY.COM PV. aim --furm fl. �'A cc O (� �� CO o (n rx. 0 a O LL G J I CLAIM BOARD OF SUPERVISORS OF CONTRA COSTA COUNTY BOARD ACTION:(, e, Z4 ZW I Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to ) California Government Codes.6,g 13� MAY 2 3 2008 ff __rr,, COUNTY COUNSEL . AMOUNT: l� - 2, MARTINEZ CALIF. NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your claim by the Board of Supervisors. (Paragraph IV below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings". . CLAIMANT: Sf Q. WtM ATTORNEY: DATE RECEIVED: ADDRESS BY DELIVERY TO..CLI`ERK ON: e BY MAIL POSTMARKED: ✓ FROM: Clerk of the Board of Supervisors T0: County Counsel Attached is a copy of the above -noted claim. JOHN CUL EN, Clerk Dated: By: Deput �. II. FROM.: tounty Counsel TO: Clerk of the Board of upervisors ( 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). O 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: Jr' �� —0 By: tV 1 Deputy County Counsel 1.11. 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. BOARD ORDER: By unanimous vote of the Supervisors present: This Claim is rejected in full. () Other: I certify that this is a true and correct copy of the Board's Order entered in its minutes for. this date. /1 Dated: (O Zoe JOHN CULLEN, CLERK, By Clerk WARNING (Gov. code section 913) Subject to certain exceptions, you have only six (6) nrontlrs from the date this notice. was personally served or deposited in the n><ail to file a court action on this claim. See Government Code Section 945.6. You may seek the advice of an attorney of your chore in connection widr this matter. {f you want to consult an attorney, you should do so immediately. *For Additimal Warning See Reverse Side of This Notice. AFFIDAVIT OF MAILING I declare under penalty of per jury 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 claimar as own above. G Dated: JOHN CULLEN, CLERK By y Clerk CLAiM BOARD OF SUPERVI.SO.RS OF CONTRA COSTA COUNTY Claim Against the County, or District Governed by ) the Board of Supervisors, Routing Endorsements, ) and Board Action. All Section references are to' ) California Government Codes. ) AMOUNT: BOARD ACTION:C,(•. ric NOTICE TO CLAIMANT The copy of this document mailed to you is your notice of the action taken on your claim by the Board of .Supervisors. (Paragraph 1V below), given Pursuant to Government Code Section 913 and 915.4. Please note all "Warnings" . CLAIMANT: re... (�V rt1 -%1 ce- ATTORNEY: DATE RECEIVED: V �l� -�J� Cc _fit ADDRESS: , s 1 BY DELIVERY TO,CLERKON: 11,t6[ S Z>> .26, 0 k jLa;u 'i j� BY.MAIL POSTMARKED: FROM: Clerk of the Board of Supervisors TO: County Counsel Attached is a copy of the above -noted claim. JOHN CUL�E.N, Clerk Dated: Bv: Deuut�(J(1�"1'i`�.i,LLi? 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). O 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: ZZ Deputy County Counsel 1.11. FROM.: Clerk of the Board TO: County Counsel (1) County Administrator (2) O Claim was returned as untimely with notice to claimant (Section 911.3): IV. BOARD ORDER: By unanimous vote of the Supervisors present: () This Claim is rejected in full. O Other: I certify that this is a ti`ue and correct copy of the Board's Order entered in its minutes for. this date. Dated: 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 oe 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 attoMey of your choice in connectim with this matter. I1'you want to consult an attorney, you should do so immediately. *ho.r Additional Warning See Reverse Side ol'This No.tim 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 ill 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 r State Farm Insurance Companies # 6 VW/ May 13, 2008 Certified Mail -Return Receipt Requested County Administrators Office County Administration Building 651 Pine Street, 11th Floor Martinez, CA 94553 RE: Claim Number: Our Insured: Date of Loss: Your Insured: Your Insured Driver: Your Claim Number: Your Policy Number: Dear Penny Bailey: 05-BO62-505 Constance Windmiller March 4, 2008 Contra County Don D Parker CLM# 64488 STATE FARM aw INSURANCE O State Farm Insurance Subrogation Services PO Box 2371 Bloomington, IL 61702-2371 MAY 2 3 2008 CLERK BOARD OF SUPERVISORS CONTRA _OSTA CO. It is our understanding that you are self insured. Our investigation indicates you are responsible for this claim. Therefore, we are seeking recovery from you. This letter is to notify you of our subrogation claim and request your cooperation in settling this matter. To assist you in your review, here is a breakdown of the amounts State Farm paid by Cause of Loss: 041/045 - Uninsured Motorist BI $ 042 - Uninsured Motorist PD $ 300 series/400 - Comp/Collision $99.23 501 - Rental/Loss of Use $50.00 600-050 - Med Pay/PIP $ Other $ Salvage Recovery $ Amount State Farm Paid 1 $149.23 Insured Deductible $500.00 Total Claim Amount $649.23 Based on the assessment of liability between the parties, State Farm Mutual Automobile Insurance Company is seeking 1000 of the Total Claim Amount listed above. The amount payable to State Farm Mutual Automobile Insurance Company for this loss is $649.23. HOME OFFICES: BLOOMINGTON, ILLINOIS 61710-0001 f =t Page 2 May 13, 2008 Please remit payment of this claim and include our claim number on the payment. If you have any questions, please call 877-457-8276 and any member of Team ##60 may assist you. Thank you for your cooperation. In order to assist you in evaluating and processing the subrogation claim we are asserting, we may provide nonpublic personal information about our customer. We are sharing this information to effect, administer, or enforce a transaction authorized by the consumer. However, you are neither authorized nor permitted to: (1) use the customer information we provided for any purpose other than to evaluate and process the subrogation claim, or (2) disclose or share the customer information we provide for any purpose other than to evaluate and process the subrogation claim. Sincerely, Stacey L. Van's egraf t ' Claim Processor (877) 457-8276, Team 60 State Farm Mutual Automobile Insurance Company Enclosure (s) PS: There is a $251.89 supplement payment pending. •••� RBZ0006Z date: 05-13-08 =°•,Nw r..... .:tc S:teve : I c lar: STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY AUTO PAYMENTS BY COL cla m nWnber named insured w=NIDM =LLER , CONS TAN C E COL 4 O O page: 1 policy number date of loss 03-04—OS C denotes consolidated payment E denotes EFT payment P denotes previous data COL: 400 indemnity: 99.23 dir rcov: 0.00 expense: 0.00 payment number payee amount status COL pay cd rsn reporting party 102054993Q CONSTANCE WINDM 99.23 PAID 400 1 Named Insu COL 5 O J- C denotes consolidated payment E denotes EFT payment P denotes previous data COL: 501 indemnit: 5 0. 0 0 di r rcov: 0.00 expense: 0.00 payment number payee amount status COL pay cd rsn reporting party 102624051) CONSTANCE WINDM 50.00 PAID 501 1 Named Insu E ........... .............................. .................................. route. t;e : < Lb lar; ;:;; ::Steve eve ....... ...................................................................................... ............................................ c:1a:;m .............ui RBZ00032 date: 05-13-08 time: 12:26 PM STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY VEHICLE DAMAGE REPORT date of loss 03-04-08 Zk -k- Estimate Vehicle Info Vehicle Owner: WINDMILLER, CONSTANCE �c Vehicle Description: 06 Toyota Tundra 4D PkupX silver -E 3c -jc -ic -:c -ic -Ac -rc -.k -�k -Ar �k tk -ZAC -Zk 'Zk 'Zk -c -JC -JC -JL- -JC -lc -jc -jc -jc -jc -.c tk tk tk -jE -.Ar -:Ar tk tk -Ac -E -ic �c Damage Assessed By: JOE BRAZ Supplemented By: JOE BRAZ Supplement Fax: 866-638-6498 Type of Loss: Collision (Spec) Date of Loss: 3/4/2008 Deductible: 500.00 Claim Number: 05-BO62-50501 State Farm Insurance Companies 1475 66TH STREET EMERYVILLE, CA'94608 (510) 985-6200 Fax: (866) 638-6498 Appraised For: 1TEAM PROCESSOR (800) 440-6175 Date: 5/12/2008 04:16 PM Estimate ID: 05-BO62-50501 Estimate Version: 2 Supplement: 1(F) 5/12/2008 04:10:33 PM Profile ID: Pleasant Hill Insured: CONSTANCE WINDMILLER Owner: CONSTANCE WINDMILLER Address: 1910 RAINIER DR, MARTINEZ, CA 94553-4927 Telephone: Work Phone: (510) 934-9339 Home Phone: (925) 335-0113 Mitchell Service: 911752 Description: 2006 Toyota Tundra SR5 Body Style: 4D PkupXCb 6' Bed 128" WB Drive Train: 4.71. Inj 8 Cyt 2WD VIN: 5TBRT341162476369 License: 8A03380 CA Mileage: 11,760 OEM/ALT: A Search Code: B1PP Color: silver Options: ALUM/ALLOY WHEELS, AIR CONDITIONING, POWER STEERING, POWER BRAKES, POWER WINDOWS, POWER DOOR LOCKS, TILT STEERING WHEEL, AUTOMATIC TRANSMISSION, STEP BUMPER, DEEP TINTED GLASS, BED LINER, TRAILER TOWING PKG., PASSENGER -FRONT AIR BAG, 4 -DOOR PICKUP, DRIVER -FRONT AIR BAG Line Entry Labor Item Number Type Operation 1 AUTO BDY OVERHAUL S1 2 102467 BDY REMOVE/REPLACE 3 102470 BDY REMOVE/REPLACE 4 900500 BDY* ADD L. LABOR OP S1 5 900500 BDS* ADD L. LABOR OP S1 6 * - Judgement Item Line Item Description REAR BUMPER ASSY REAR BUMPER STEP TYPE BAR L REAR OTR BUMPER STEP PAD DRILL OUT HOLES FOR REAR PARKING SENSORS REMOVE AND THEN REINSTALL PARK SENSORS CAMPWAYS 228-9310 Part Type/ Dollar Labor Part Number Amount Units ESTIMATE RECALL NUMBER: 3/25/2008 10:20:45 05-8062-50501 Mitchell Data Version: OEM: APR _08_V0507 UltraMate is a Trademark of Mitchell International Copyright (C5 1994 - 2008 Mitchell International UltraMate Version: 6.5.017 All Rights Reserved Page 1 of 3 1.7 52151-00O21 430.58 INC 52164-00010 25.98 INC Existing 1.0 * Sublet 162.50* 0.0 * ESTIMATE RECALL NUMBER: 3/25/2008 10:20:45 05-8062-50501 Mitchell Data Version: OEM: APR _08_V0507 UltraMate is a Trademark of Mitchell International Copyright (C5 1994 - 2008 Mitchell International UltraMate Version: 6.5.017 All Rights Reserved Page 1 of 3 Date: 5/12/2008 04:16 PM Estimate ID: 05-8062-50501 Estimate Version: 2 Supplement: 1(F) 5/12/2008 04:10:33 PM Profile ID: Pleasant Hill Estimate Totals P oint(s) of Impact 6 Rear Center (P) ESTIMATE RECALL NUMBER: 3/25/2008 10:20:45 05-8062-50501 Mitchell Data Version: OEM: APR 08 VO507 UltraMate is a Trademark of Mitchell International. Copyright (C) 1994 - 2008 Mitchell International Page 2 of 3 UltraMate Version: 6.5.017 All Rights Reserved Add't Labor Sublet I . Labor Subtotals Units Rate Amount Amount Totals II. Part Replacement Summary Amount Body 2.7 72.00 0.00 0.00 194.40 Taxable Parts 456.56 Bdy-S 0.0 72.00 0.00 162.50 162.50 Sales Tax a 8.250% 37.67 Non -Taxable Labor 356.90 Total Replacement Parts Amount 494.23 Labor Summary 2.7 356.90 III. Additional Costs Amount IV. Adjustments Amount Total Additional Costs 0.00 Insurance Deductible 500.00 - Customer Responsibility 500.00- 1. Total Labor: 356.90 II. Total Replacement Parts: 494.23 III. Total Additional Costs: 0.00 Gross Total: 851.13 IV. Total Adjustments: 500.00 - Net Total: 351.13 Less Original Net Total: 99.23 Net Supplement Amount: 251.90 S1: JOE BRAZ 251.90 P oint(s) of Impact 6 Rear Center (P) ESTIMATE RECALL NUMBER: 3/25/2008 10:20:45 05-8062-50501 Mitchell Data Version: OEM: APR 08 VO507 UltraMate is a Trademark of Mitchell International. Copyright (C) 1994 - 2008 Mitchell International Page 2 of 3 UltraMate Version: 6.5.017 All Rights Reserved Date: 5/12/2008 04:16 PM Estimate ID: 05-BO62-50501 Estimate Version: 2 Supplement: 1(F) 5/12/2008 04:10:33 PM Profile ID: Pleasant Hill Inspection Site: Elite A/b 2180 MARKET ST.Concord.94 Address: Elite A/b 2180 MARKET ST.Conco rd.94520.925-687-3117 Inspection Date: 3/25/2008 Body Shop: ELITE AUTO BODY & COLLISION CENTER Address: 2180 MARKET STREET CONCORD, CA 94520 Telephone: (925) 687-3117 Fax phone: (925) 687-4747 wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww For your protection California Law requires the following to appear on this form: Any person who knowingly presents a false or fraudulent claim for payment of a loss is quilty of a crime and may be subject to fines and confinement in state prison This is an estimate. Repair facilities must inspect the vehicle to determine if any repairs not listed are required, and to contact State Farm before making such repairs. Repairer also is responsible for conducting any necessary inspection and safety checkes prior to and after completing repairs. wwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwwww . ESTIMATE RECALL NUMBER: 3/25/2008 10:20:45 05-6062-50501 Mitchell Data Version: OEM: APR_08_VO507 UltraMate is a Trademark of Mitchell International Copyright (C) 1994 - 2008 Mitchell International Page 3 of 3 UltraMate Version: 6.5.017 All Rights Reserved lwl� "T - - - - - - - - - - - - - 2710312008 - 11 Z7'� tr � _ � . .-.-�P +�F � a1��yQ-.5.. 4 � 4� �� "� pit.,, �s� y� �"`� rkYt�a�fC '�,- pitt.. � �� �, .rf .ye. r � � :t r �� �- `�s��"^,E Y� a � � � �.. �- t�.�- , 1 Y .,.. .� �-- „a.,,. � � � �.. �- t�.�- , 1 Y .,.. .� �-- „a.,,. 1 Y .,.. .� �-- „a.,,. Y,kRk RA � �_` �,� � j T J Mr' ` h• y.. � 4'dL F' ���;�f.�_ A , s$ �n wy , Y f tl ' i �• � � - .ren. , 7777 .I� 4T a> C7 w a o r f lye F , _ -rt § 4 � ` k l t.5 S v i , ..,.`C.��.n�k�,'r""��`.. ..: i?:f ...z_Y...,... ,._.. ..� ...... � ._ ..:cif:.'..• is f � r' 1 c � jr I ri- _ - Y fha AS C IT 4�`Th7�1¢Pa7"�3'1A�fFY` " 03/07/2008 16:52 FAX 9256710309 STATE4ARM BOARD OF SUPERVISORS OF CONTRA COSTA CO UNTY mS UMONS TO CLAIMANT _ Q001 . vcea.5 05 A. AC . jaim rebating 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 tb , accrual of the cause of actior:L A claim relating to any other cause of action shall be pmsen ed 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 E t its office in Room 105, County Administration Building, 651 Pine Street, Martinez, CA 9455: . C• If claim; is against a district governed by the Board of Supervisors. i ather 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 muss be filed against each. public entity. F, Fraud. See penalty for fraudulent claims, Penal Code Sec. 72 at the a id of this forts RE: Claim By: Reserved for Cle rk's filing stamp eeY�Q. • t ' � 4J` Against the County of Contra Costa or j District) (Fill in the name) ) The undersigned claimant hereby makes claim against the County of Conga Costa a above-named district in the sum of $ and in support of this claim represer is asMows: 1. When did the damage or injury occur? (Give exact date and hour) 1 51. 1? I Y�Q_ S} . VAS N n e' -F_ I cA Ct , 3a A. 31 'i (dQ* 2. RThere did the damage or injury occur? (include city and county) loS 1 �ii12. S�• occur? (Give full details; use extra l aper if required) 3. -How did the damage or injury ur Ca Jr�4.I QMp b��Pi Noa-cyRd...%n-ko fcp'y'%r6vre65 VQht64• 4. What particular act or omission on the part of county or district o 5cers, servants, or emp�loyeees caused the injury or damage? yOVf (a m0o�ejz' �CVPa 'in' o 00 r' ►n5 \�/' 5 What are the names of county or district officers, servants, or =pogees causing the damage or -injury? r�255 CA o� OUx i YlSurec�S 03/07/2008 16:52 FAX 9256710309 STATE -FARM ll002 b. W,et dzmage or injuries do your claim resulted? (Give full extei.t of injuries or damages claimed. Auar h two estimates for auto damage.) YIL 7. How was the amount claimed above computed? (Include the i ztimated amount of any prospective injury or damage.) 8. Nmnes.and addresses of witnesses, doctors, and hospitals: AWE - 9. List the expenditures you made on account of this accident or injury: DATE TIME AMQUN' amass End son ...............won9.aa111161111,■a..■aa.■a■■x..•61166111 .Gov. Code Sec. 910.2 provides "T1.e claim shall be signed by the claimant or by some 1 erson on his behalf." SEND NOTICES TO: (.Alto ey) Name anis address of Attorney ) (Clai_man 's Sigtlate re) Win d pr) ► 1e ) (Address) Telephone No. ) Telephone No.CO - `i�0 ` roi Ann 1 ■ a a. a Of 1 a a a .. *6 - W I A ■. a a 6 f a. a a 11 11. ONE at a9 a a a a a 6 a 6 a a a a f a Ads . a a a. Ina Asa It r 6 415 a a•■. I -a 1 a 6 IF 1 PUBLIC RECORDS NOTICE: Please be advised that this claim form. or any claim filed with the County under tl ':e Tort Claims Act, is subject to public disclosure under the California Public Records Act. (Gov. Code, §§ X500 et seq.) Furthermore, any attachments, addendums,or supplements attached to the claim form, including me dical records, are also subject to public disclosure. a asaaa.a used ■.a6.a■■.•aaan0..I aava••.a11.a.aa6 mae.* saass6 as. as .faaa.assaax afa mass■.sal NOTICE: Section 72 of the Penal Code provides: Every person who, with intent to defraud, presents for allowance or for paytnea: to any state boardor offoer, or to any county, city, or district board or offer, authorized to allow or pay tt s same if genuine, any false or fraudulent claim, bili, account voucher, or writing, is punishable either by impr scament in the Couaty jail for a period of not more than one year, by a fine of not exceeding one thousand dol ars (S1,D00.00), or by both such imprisonment and fine, or by imprisonment in the state prison, by a fine of nc t exceeding tsn thousand dollars ($10,000), or by both such imprisonment and fine. 03/07/2008 16:52 F.4X 9256710309 STATE -FARM 2003 is -337 t c�jS Contra Doug Parker -Sr CoSta lead SmUonary Englneer County (g25) 313.7052 t=Ax dpark* gsd.co.contra-costa.oa.u9 General Services Department Statbnary Engineers Division 2467 waterbird Way Martlnez, CA 94653 .. 3 6 6 ce 1� 03/07/2008 16:52 FAX 9236710309 STATE -FART! 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