SCHRÖDINGER’S RETIREE
The Evidentiary Record of UCLA Police Officer 341 (Retired?)
15 Chapters; UC’s Inexplicable Record Keeping; One Question UC Cannot Answer.
Chapter 10 of 15
Master Evidence Index and Court Records
Formal Request for Audit and Records Reconciliation

This evidentiary record constitutes a formal demand for audit pursuant to California Government Code § 8546.7, which provides that every contract involving expenditure of public funds exceeding $10,000 “shall be subject to the examination and audit of the California State Auditor.” The Legislature specifically intended this provision to apply to the Regents of the University of California. The contracts at issue — including UC’s systemwide agreements with Anthem Blue Cross, Accolade, and Via Benefits (Willis Towers Watson) — each involve public fund expenditures far exceeding this threshold.

The University of California constitutes a “public trust” under California Constitution, Article IX, Section 9. As a self-insured employer, UC is bound by Cal. Code Regs. Title 8, § 15400.2: claim files where future benefits may be payable “shall not” be destroyed.

A prior formal audit request was submitted November 9, 2021, to Chief Compliance & Audit Officer Alexander Bustamante. UC has never responded. This is the second such demand.





HOW TO USE THIS INDEX

This chapter serves as the master evidence catalog for the entire case documentation package. Every document referenced in Chapters 3 through 9 is inventoried here with its exhibit number, date, description, custodian, file name, and chapter cross-references.

Exhibit Numbering Convention: Each exhibit is assigned a letter-number code corresponding to its evidence category (A = Workers’ Compensation, B = CCW Permits, C = Range Qualifications, D = 1099-R Forms, etc.). The “CH Ref” column identifies which chapter(s) reference that specific document.

Part A contains the Master Evidence Index organized by evidence category in chronological order within each category. Part B contains Court Records documenting three separate legal proceedings involving Harold and/or the University of California. Part C provides a blank template form for adding exhibits not yet cataloged.

Note: This index inventories documents confirmed in the project file as of February 2, 2026. Additional evidence may exist that has not yet been cataloged, including recorded phone calls referenced in Chapter 4 (six recorded calls with UC agents, Accolade representatives, and Medicare representatives from December 2025–January 2026), the original workers’ compensation settlement agreement (which UC claims no record of), and additional UCOP internal correspondence.

PART A: MASTER EVIDENCE INDEX

131 documents across 17 evidence categories, organized chronologically within each category.

Ex. # Date Document Description Source / Custodian File Name Ch. Ref
CATEGORY I: WORKERS’ COMPENSATION / PERMANENT DISABILITY DETERMINATION
A-1 08/08/2001 Octagon Risk Services — Notice Regarding Start & End of Permanent Disability Benefits. Employee: Charles Harold. Employer: UC Los Angeles. Claim #199650445. Date of Injury: 02/16/1996. Permanent and stationary per Dr. Steven Silbart report dated 12/27/1999. Permanent disability rating: 6 ¾%. Benefits: $3,075.98/month tax-free. Octagon Risk Services, Inc. (Claims Administrator for UC Los Angeles) UCLA_Octagon_letter.pdf 3,6,7,8,9
A-2 Undated Verification of Pension — MSS0030005329715. UC Retirement Plan pension verification document. UC Retirement Administration Verification_of_Pension_MSS0030005329715.pdf 3,6,8
CATEGORY II: CCW PERMITS AND RETIREE IDENTIFICATION
B-1 09/06/2002 CCW Permit #1 Issued. Stamped “RETIRED.” Identifies Harold as “Police Officer” of “University of California Police Department.” Authorizes concealed firearm per Penal Code §12027a. Signed by Chief of Police Clarance Chapman. UCLA Police Department 20020906_CCW_Issued.jpg 7,9
B-2 08/29/2013 CCW Permit #2 Issued. States “RETIRED” and “Retired in good standing from service as a Peace Officer of the state of California.” Badge #341, Rank: Officer, Date Retired: 03/01/96, Service Yrs: 8. Signed by Chief James D. Herren. Cites CPC §§25455, 25460 & 25465. Expiration: 08/29/2018. UCLA Police Department 20130829_UCLA_PD_CCW_Issued.pdf 7,9
B-3 08/29/2018 CCW Permit #2 Expired copy. Same permit as B-2, documenting expiration date. UCLA Police Department 20180829_UCLA_PD_CCW_expired_Copy.pdf 7,9
B-4 08/25/2023 CCW Denial / Active Retiree List correspondence. Email RE: CCW UCLA Police Department Active Retiree List. Lt. Chobanian denial letter classifying Harold as “medically separated” receiving “Duty Disability Income,” not retired. UCLA Police Department (Lt. Chobanian) 20230825_Gmail__RE__CCW_UCLA_Police_Department_Active_Retiree_List.pdf 7,9
B-5 Undated UCLA PD Policy 209 — Carry Concealed Weapons policy document. UCLA Police Department Policy_209.pdf 7,9
B-6 01/05/2021 DN 010521 — GO 2102: Retired Officers Carry Concealed Weapons Policy. General Order governing CCW for retired officers. UCLA Police Department DN_010521__GO_2102_Retired_OfficersCarry_Concealed_Weapons_Policy.pdf 7,9
CATEGORY III: CCW RANGE QUALIFICATION CORRESPONDENCE (2011–2017)
C-1 01/31/2011 Harold to Chief Herren — CCW Renewal correspondence. C.A. Harold / UCLA PD 20110131_cah_to_herren_chief_re_ccw_Yahoo_Mail__RE__CCW_Renewal.pdf 9
C-2 01/31/2011 Burbank PD qualifications with attachments — CCW Renewal. C.A. Harold 20110131_Burbank_PD_qualifications_with_attachments_Yahoo_Mail__CCW_Renewal.pdf 9
C-3 01/31/2011 Email attachment re CCW — C. Harold UCPD (image). C.A. Harold / UCLA PD 20110131_email_attachement_re_ccw_C_Harold_UCPD.jpg 9
C-4 01/31/2011 Email attachment re CCW — Chuck Harold (PDF version). C.A. Harold 20110131_email_attachment_re_ccw_Chuck_Harold_2.pdf 9
C-5 03/02/2011 RE: CCW Renewal — 12:09 PM exchange. UCLA PD 20110302_1209_pm_Yahoo_Mail__RE__CCW_Renewal.pdf 9
C-6 03/02/2011 RE: CCW qualifications correspondence. UCLA PD 20110302_re_ccw_qualifications_Yahoo_Mail__RE__CCW_Renewal.pdf 9
C-7 11/03/2011 Renee Granger — Range qualifications correspondance. UCLA PD (Renee Granger) 20111103_Renee_Granger_Rang_qualifications_Yahoo_Mail__Re__CCW.pdf 9
C-8 12/05/2014 Upcoming qualification correspondence. UCLA PD 20141205_ccw_Yahoo_Mail__Re__Upcoming_qualification.pdf 9
C-9 03/11/2015 UCPD range dates — CCW retiree schedule. UCLA PD 20150311_ucpd_range_dates_ccw_Yahoo_Mail__03_01_2015.pdf 9
C-10 02/08/2016 Range qualifications — contact information for Baguio. UCLA PD 20160208_range_qualifications_Yahoo_Mail__contact_information_for_Baguaio.pdf 9
C-11 02/01/2017 Upcoming Range Dates — UCLA PD Retirees. Last known retiree range invitation. UCLA PD 20170201_CCW_Yahoo_Mail__Upcoming_Range_Dates__UCLA_PD_Retirees.pdf 9
C-12 02/12/2024 Re: March 2012 Range dates and directions to Lopez Canyon Shooting Range. Historical range correspondence. UCLA PD Yahoo_20240212_Mail__Re__March_2012_Range_dates_and_directions_to_new_Lopez_Canyon_Shooting_Range.pdf 9
CATEGORY IV: IRS FORM 1099-R — TAX CLASSIFICATION RECORDS (2010–2024)
D-1 Tax Year 2010 1099-R: Distribution Code 3 (Disability). Tax-free disability income. UC / IRS 2010_1099R_.pdf 6
D-2 Tax Year 2011 1099-R: Distribution Code 3 (Disability). Tax-free disability income. UC / IRS 2011_1099R_.pdf 6
D-3 Tax Year 2012 1099-R: Distribution Code 3 (Disability). Tax-free disability income. UC / IRS 2012_1099R_.pdf 6
D-4 Tax Year 2013 1099-R: Distribution Code 3 (Disability). Tax-free disability income. UC / IRS 2013_1099R_.pdf 6
D-5 Tax Year 2014 1099-R: Distribution Code 3 (Disability). Tax-free disability income. Last year of consistent disability classification. UC / IRS 2014_1099R_.pdf 6
D-6 Tax Year 2015 1099-R Version 1: $14,000 amount. Split filing year — first evidence of reclassification. UC / IRS 2015_1099R_14k.pdf 6
D-7 Tax Year 2015 1099-R Version 2: $30,000 amount. Second version issued for same tax year. UC / IRS 2015_1099R_30k.pdf 6
D-8 Tax Year 2015 UCLA 1099 Version 1. Third document for 2015 — multiple conflicting forms. UC / IRS 2015_UCLA_1099_V1.pdf 6
D-9 Tax Year 2015 UCLA 1099 Version 2. Fourth document for 2015. Issuance of four 1099 forms for one tax year evidences internal data confusion. UC / IRS 2015_UCLA_1099_V2.pdf 6
D-10 Tax Year 2016 1099-R: Code 2/7 (Retirement). First full year of retirement classification. 0% tax-free. UC / IRS 2016_1099R_.pdf 6
D-11 Tax Year 2016 1099-R (duplicate/variant filing). UC / IRS 20161099_R.pdf 6
D-12 12/31/2016 1099-R Taxes document. UC / IRS 20161231_1099R_Taxes.pdf 6
D-13 Tax Year 2016 UCLA 1099 — additional 2016 tax document. UC / IRS 2016_UCLA_1099.pdf 6
D-14 Tax Year 2017 1099-R: Code 7 (Normal Distribution/Retirement). UC / IRS 2017_1099R_.pdf 6
D-15 Tax Year 2017 UCLA 1099 — 2017. UC / IRS 2017_UCLA_1099.pdf 6
D-16 Tax Year 2017 UCLA 1099-B — 2017. UC / IRS 2017_UCLA_1099B.pdf 6
D-17 Tax Year 2018 1099-R: Code 7 (Normal Distribution/Retirement). UC / IRS 2018_1099R_.pdf 6
D-18 Tax Year 2019 1099-R: Code 2 (Early distribution, exception applies). UC / IRS 2019_1099R_2.pdf 6
D-19 Tax Year 2020 1099-R: Code 2. UC / IRS 2020_1099R_2.pdf 6
D-20 Tax Year 2020 1099-R: Code 7. UC / IRS 2020_1099R_7.pdf 6
D-21 Tax Year 2021 1099-R: Code 7. UC / IRS 2021_1099R_7.pdf 6
D-22 Tax Year 2021 1099-R: Code 7 (variant/duplicate). UC / IRS 2021_1099R_7_1.pdf 6
D-23 Tax Year 2022 1099-R: Code 7. UC / IRS 2022_1099R_7.pdf 6
D-24 Tax Year 2022 1099-R: Code 7 (variant/duplicate). UC / IRS 2022_1099R_7_1.pdf 6
D-25 Tax Year 2023 1099-R: Code 7. UC / IRS 2023_1099R_7.pdf 6
D-26 Tax Year 2024 1099-R: Code 7. Most recent tax filing. UC / IRS 2024_1099R_7.pdf 6
CATEGORY V: IRS FORM 1095-B — HEALTH INSURANCE VERIFICATION (2016–2024)
E-1 Tax Year 2016 Form 1095-B: Health Coverage verification. UC / IRS 2016_1095B.pdf 3,5
E-2 Tax Year 2017 Form 1095-B: Health Coverage verification. UC / IRS 2017_1095B.pdf 3,5
E-3 Tax Year 2018 Form 1095-B: Health Coverage verification. UC / IRS 2018_1095B.pdf 3,5
E-4 Tax Year 2019 Form 1095-B: Health Coverage verification. UC / IRS 2019_1095B.pdf 3,5
E-5 Tax Year 2020 Form 1095-B: Health Coverage verification. UC / IRS 2020_1095B.pdf 3,5
E-6 Tax Year 2020 Form 1095-B (variant/duplicate). UC / IRS 2020_1095B_1.pdf 3,5
E-7 Tax Year 2021 Form 1095-B: Health Coverage verification. UC / IRS 2021_1095B.pdf 3,5
E-8 Tax Year 2021 Form 1095-B (variant/duplicate). UC / IRS 2021_1095B_1.pdf 3,5
E-9 Tax Year 2022 Form 1095-B: Health Coverage verification. UC / IRS 2022_1095B.pdf 3,5
E-10 Tax Year 2022 Form 1095-B (variant/duplicate). UC / IRS 2022_1095B_1.pdf 3,5
E-11 Tax Year 2023 Form 1095-B: Health Coverage verification. UC / IRS 2023_1095B.pdf 3,5
E-12 Tax Year 2023 Form 1095-B (variant/duplicate). UC / IRS 2023_1095B_1.pdf 3,5
E-13 Tax Year 2024 Form 1095-B: Health Coverage verification. Most recent. UC / IRS 2024_1095B.pdf 3,5
CATEGORY VI: UCOP / THOMAS HERZ SSA CORRESPONDENCE (2009–2010)
F-1 09/29/2009 Thomas Herz (UCOP Retiree Insurance) to Harold — RE: SSA determination. Initial request that Harold apply for Social Security disability benefits. UC Office of the President 20090929_Thomas_Herz_re_SSA_application_Yahoo_Mail__Re__SSA_determination.pdf 7,9
F-2 01/10/2010 Thomas Herz — RE: documents for compliance (12:24 PM). UCOP 20100110_1224_pm_Thomas_Herz_Yahoo_Mail__Re__documents_for_compliance.pdf 7,9
F-3 01/22/2010 Thomas Herz — RE: SSA benefits / documents for compliance. Confirms UC’s “need for a copy from SSA once they determine whether you are or are not eligible for disability benefits.” UCOP 20100122_Thomas_Herz_re_SSA_bebfits_Yahoo_Mail__Re__documents_for_compliance.pdf 7,9
F-4 03/08/2010 Thomas Herz — RE: SSA benefits / Fw: document (6:42 PM). UCOP 20100308_642_pm_Thomas_Herz_Yahoo_Mail__Re__document_.pdf 7,9
F-5 03/08/2010 Thomas Herz — Fw: document (SSA benefits forward). UCOP 20100308_Thomas_Herz_re_SSA_benefits_Yahoo_Mail__Fw__document_.pdf 7,9
F-6 03/29/2010 Thomas Herz — RE: document (2:13 PM). UCOP 20100329_213_pm_Thomas_Herz_Yahoo_Mail__Re__document_.pdf 7,9
F-7 03/29/2010 Thomas Herz — RE: document (3:00 PM). Harold informs Herz of settlement agreement with lifetime medical coverage. Herz responds: “I am not aware of any settlements that UC has made that specifically exempts one individual from the general insurance regulations.” CC’s Bridget Sheehan-Watanabe, UCLA Benefits. UCOP 20100329_300_pm_Thomas_Herz_Yahoo_Mail__Re__document_.pdf 7,9
F-8 03/29/2010 Thomas Herz — Fw: document (3:33 PM). UCOP 20100329_333_pm_Thomas_Herz_Yahoo_Mail__Fw__document_.pdf 7,9
F-9 03/29/2010 Thomas Herz — Fw: document (3:34 PM). UCOP 20100329_334_pm_Thomas_Herz_Yahoo_Mail__Fw__document_.pdf 7,9
F-10 04/06/2010 Thomas Herz — RE: SSA application / documentation. UCOP 20100406_Thomas_Herz_SSA_application_Yahoo_Mail__Re__documentation.pdf 7,9
F-11 04/09/2010 Thomas Herz — RE: documentation (11:43 AM). UCOP 20100409_1143_am_Thomas_Herz_Yahoo_Mail__Re__documentation.pdf 7,9
F-12 04/09/2010 Thomas Herz — SSA documentation (11:43 AM variant). UCOP 20100409_1143_am_Thomas_Herz_Yahoo_Mail_strich_re_SSA_documentation.pdf 7,9
F-13 04/09/2010 Thomas Herz — RE: documentation (12:51 PM). UCOP 20100409_1251_pm_Thomas_Herz_Yahoo_Mail__Re__documentation.pdf 7,9
F-14 04/09/2010 Thomas Herz — RE: documentation (12:51 PM, variant 2). UCOP 20100409_1251_pm_2_Thomas_Herz_Yahoo_Mail__Re__documentation.pdf 7,9
F-15 04/09/2010 Thomas Herz — SSA documentation (additional variant). UCOP 20100409_Thomas_Herz_Yahoo_Mail_strich_re_SSA_documentation.pdf 7,9
F-16 06/08/2010 Thomas Herz — RE: SSA letter (4:44 PM). UCOP 20100608_444_pm_Thomas_Herz_Yahoo_Mail__Re__SSA_letter_.pdf 7,9
F-17 06/08/2010 Thomas Herz to Harold — RE: Retirement and SSA letter. Discusses retirement status and SSA process. UCOP 20100608_Thomas_Herts_to_Chuck_Harold_re_Restirment_and_SSA_letter_Yahoo_Mail__Re__SSA_letter_.pdf 7,9
F-18 09/29/2010 Thomas Herz — RE: SSA determination (6:48 PM). Final SSA-related correspondence in this series. UCOP 20100929_648_pm_Thomas_Herz_Yahoo_Mail__Re__SSA_determination.pdf 7,9
CATEGORY VII: IDA FONG / UCLA BENEFITS CORRESPONDENCE (2021)
G-1 03/12/2021 Email to Ida Fong (1:46 PM). Harold contacts UCLA Benefits regarding status and insurance payments. C.A. Harold to UCLA Benefits (Ida Fong) 20210312_146_PM_EMAIL_TO_IDA_FONG.pdf 3,5,7,8,9
G-2 09/09/2021 Gmail: Ida Fong — My UC Health Insurance Payments. Continuation of correspondence regarding insurance premium deductions. UCLA Benefits (Ida Fong) / C.A. Harold 20210909_Gmail__Ida_Fong_My_UC_Health_Insurance_Payments.pdf 3,7,8,9
G-3 Various Ida Fong Statement document (working draft). C.A. Harold Ida_Fong.docx 3,7,8,9
G-4 Various IDA Fong Statement of Facts — UCLA Data Breach (copy). Documents Ida Fong’s March 18, 2021 admission that UC records were “lost during computer system upgrades” and could not locate workers’ compensation or disability status records. C.A. Harold IDA_Fong_Statement_of_Facts_UCLA_Data_Breach_-_Copy.docx 3,5,7,8,9
CATEGORY VIII: ATTORNEY CORRESPONDENCE — EDGAR SAENZ, ESQ. (2021)
H-1 09/09/2021 Harold to Edgar Saenz — Letter re retirement status. 13-page letter outlining case history, enclosed evidence, and legal theories. C.A. Harold to Edgar Saenz, Esq. Harold_v_UCLA_Disability_Income_Status_Letter_to_Edgar.pdf 7,8
H-2 09/09/2021 Gmail: Letter to Edgar UC about my retirement (email transmittal). C.A. Harold 20210909_Gmail__Letter_to_Edgar_UC_about_my_retirement.pdf 7,8
H-3 Various Harold v UCLA Disability Income Status Letter — SHORT VERSION. C.A. Harold Harold_v_UCLA_Disability_Income_Status_Letter_SHORT_VERSION.docx 7,8
H-4 10/31/2021 Letter to UCLA (Edgar Saenz draft). Attorney’s initial draft letter to UC. Edgar Saenz, Esq. Ltr_to_UCLA_2021_10_31_eas.docx 7,8
H-5 10/31/2021 Gmail: RE: Shorter Letter (Edgar correspondence). Edgar Saenz, Esq. / C.A. Harold 20211031_Edgar_Gmail__Re__Shorter_Letter.pdf 7,8
H-6 11/09/2021 Letter to UCLA from C.A. Harold (final version). C.A. Harold Ltr_to_UCLA_2021_11_09_cah_.docx 7,8
H-7 11/09/2021 Letter to UCLA from Edgar Saenz (final version). Attorney’s formal letter to Alexander Bustamante, Senior VP, Chief Compliance & Audit Officer, UC. Edgar Saenz, Esq. Ltr_to_UCLA_2021_11_09_eas.docx 7,8
H-8 11/09/2021 Edgar Saenz Letter to Bustamante (PDF version). First Formal Audit Request to UC. Edgar Saenz, Esq. 20211109_Edgar_Ltr_to_Bustamante_UC_2021_11_09.pdf 7,8
H-9 11/09/2021 Gmail: C.A. Harold LTR RE Personnel Status Review. Edgar Saenz, Esq. 20211109_Edgar_Gmail__C__A__HAROLD_LTR_RE_PERSONNEL_STATUS_REVIEW.pdf 7,8
H-10 11/09/2021 Gmail: RE: Letter to UC about my retirement (exchange 1). C.A. Harold / Edgar Saenz 20211109_Gmail__Re__Letter_to_UC_about_my_retirement.pdf 7,8
H-11 11/09/2021 Gmail: RE: Letter to UC about my retirement (exchange 2). C.A. Harold / Edgar Saenz 20211109_Gmail__Re__Letter_to_UC_about_my_retirement2.pdf 7,8
CATEGORY IX: UC RASC / RETIREMENT ADMINISTRATION CORRESPONDENCE
I-1 09/02/2020 Gmail: Fwd: A message from the UC Retirement Administration Service. UC RASC / C.A. Harold 2020902_Gmail__Fwd__A_message_from_the_UC_Retirement_Administration_Service.pdf 8
I-2 Undated UC Retirement Center Letter. UC Retirement Center UC_Retirement_Center_Letter.pdf 8
I-3 Undated UCLA Retirement Admin Service Center Letter. UCLA Retirement Admin UCLA_Retirement_Admin_Service_Center_Letter.pdf 8
I-4 Undated UCLA Retirement Estimator sent to Ida (version 1). UC / C.A. Harold UCLA_Retirement_Estimator_sent_to_Ida.pdf 6,8
I-5 Undated UCLA Retirement Estimator sent to Ida (version 2). UC / C.A. Harold UCLA_Retirement_Estimator_sent_to_Ida_1.pdf 6,8
I-6 Various UC RAYS Letter (working document). C.A. Harold UC_Rays_Letter.docx 3,8
I-7 Undated UC RAYS Message screenshot #1. UC RASC / UCRAYS Portal UC_Rays_Message_1.jpg 3,8
I-8 01/29/2026 UC RAYS Message screenshot dated 1/29/26. UC RASC / UCRAYS Portal UC_Rays_Message_1_29_26.jpg 3,8
I-9 Undated Gmail: FW: UC Open Enrollment Starts Soon. UC / C.A. Harold Gmail__Fw__UC_Open_Enrollment_Starts_Soon.pdf 3
CATEGORY X: UCRAYS SYSTEM PORTAL SCREENSHOTS (2026)
J-1 01/30/2026 UCRAYS reply re stoppage of insurance change (screenshot 1). Portal message regarding Harold’s request to hold insurance changes. UCRAYS Portal 20260130_UCRAYS_reply_re_stoppage_of_insurance_change.png 3,8
J-2 01/30/2026 UCRAYS reply re stoppage of insurance change (screenshot 2). UCRAYS Portal 20260130_UCRAYS_reply_re_stoppage_of_insurance_change_2.png 3,8
J-3 02/01/2026 UCRAYS screenshot — 09:26:19 timestamp. UCRAYS Portal Screenshot_20260201092619.png 3
J-4 02/01/2026 UCRAYS screenshot — 09:30:14 timestamp. UCRAYS Portal Screenshot_20260201093014.png 3
J-5 02/01/2026 UCRAYS screenshot — 09:31:31 timestamp. UCRAYS Portal Screenshot_20260201093131.png 3
J-6 02/01/2026 UCRAYS screenshot — 09:31:56 timestamp. UCRAYS Portal Screenshot_20260201093156.png 3
J-7 02/01/2026 UCRAYS screenshot — 09:32:11 timestamp. UCRAYS Portal Screenshot_20260201093211.png 3
J-8 02/01/2026 UCRAYS screenshot — 09:32:22 timestamp. UCRAYS Portal Screenshot_20260201093222.png 3
CATEGORY XI: MEDICARE / BLUE CROSS / INSURANCE RECORDS
K-1 01/05/2025 Medicare Coverage document. CMS / Medicare.gov 20250105_MEDICAR_COVERAGE.pdf 3
K-2 01/05/2026 My Premiums — Medicare premium records. CMS / Medicare.gov 20260105_My_premiums.pdf 3
K-3 01/05/2026 My Preventive Services — Medicare records. CMS / Medicare.gov 20260105_My_preventive_services.pdf 3
K-4 01/06/2026 Insurance Plans from the Past Per Medicare. Historical plan enrollment showing prior coverage. CMS / Medicare.gov 20260106_INSURANCE_PLANS_FROM_THE_PAST_PER_MEDICARE.pdf 3,5
K-5 01/29/2026 Medicare Accounts — Blue Cross Plan History. Shows Blue Cross of California as other insurance, start 1/1/2026. CMS / Medicare.gov 20260129_MEDICARE_ACCOUNTS_Blue_Cross_Plan_history___Medicare.pdf 3
K-6 01/30/2026 Blue Cross Coverage — Jan 2024 no prior coverage. Anthem portal showing no plan records prior to January 1, 2024 despite 20+ years coverage. Anthem Blue Cross Portal 20260130_Blue_Cross_Coverage_Jan_2024_no_prior_coverage.jpg 3,5
K-7 Undated Medicare Coverage screenshot. CMS / Medicare.gov Medicare_Coverage.jpg 3
K-8 Undated Retiree Insurance screenshot (UCRAYS). UCRAYS Portal Retiree_Insurance.jpg 3
K-9 08/07/2022 Current Enrollment document (8/7/22). UC Benefits Current_Enrolement_8_7_22.pdf 3
K-10 Undated Gmail: Good news about your claim. Insurance / C.A. Harold Gmail__Good_news_about_your_claim.pdf 3
CATEGORY XII: IMMEDIATE HOLD REQUEST — MEDICAL COVERAGE
L-1 01/29/2026 Immediate Hold Request on Retiree Medical Coverage Changes (Word version). Formal request to freeze all insurance changes pending cancer surgery Feb 2026. C.A. Harold Immediate_Hold_Request_on_Retiree_Medical_Coverage_Changes.docx 3,8
L-2 01/29/2026 Immediate Hold Request on Retiree Medical Coverage Changes (PDF version). Transmitted via fax to UC RASC. C.A. Harold Immediate_Hold_Request_on_Retiree_Medical_Coverage_Changes.pdf 3,8
CATEGORY XIII: DATA BREACH DOCUMENTATION
M-1 Various UC/UCLA/Anthem Data Breach Chronology Archive. Comprehensive chronological documentation of 25 data breach incidents affecting UC/UCLA and Anthem Blue Cross systems (2005–2026). C.A. Harold (compiled from public regulatory filings) UC_UCLA_Anthem_Data_Breach_Chronology_Archive.docx 5,7
M-2 Various Substitute Notices and Information — Blue Shield of California News Center. Regulatory breach notification documents. Blue Shield of California Substitute_Notices_and_Information___Blue_Shield_of_California___News_Center.pdf 5
M-3 Various Master Statement of Facts — UCLA Data Breach. Harold’s comprehensive narrative of data breach impacts on his records. C.A. Harold Master_Statement_of_Facts_UCLA_Data_Breach.docx 5,7
CATEGORY XIV: TAX WITHHOLDING AND W-9 RECORDS
N-1 Undated Payee Tax Withholding screenshot. Shows current tax withholding configuration from UC pension. UC Benefits / UCRAYS Payee_Tax_Withholding.jpg 6
N-2 06/11/2019 Gmail: 2018 W-9 tax request. UC request for updated tax information. UC / C.A. Harold 20190611_Tax_request_Gmail__2018_W9.pdf 6
CATEGORY XV: UC SYSTEM PORTAL EVIDENCE (HISTORICAL)
O-1 08/07/2022 MAX enrollment status screenshot (8/7/2022). Shows enrollment status in UC system. UC Benefits Portal MAX_enrollment_status_872022.jpg 3
O-2 Undated Migration statement screenshot. Documents system migration affecting records. UC Systems migration_statement.jpg 5
O-3 01/29/2026 Fax confirmation screenshot. Dropbox Fax showing transmission of Immediate Hold Request and other documents to UC RASC at 1-800-792-5178. Dropbox Fax / C.A. Harold fax.jpg 8
CATEGORY XVI: UCLA INSTITUTIONAL HISTORY RESEARCH
P-1 03/2022 History of Racism and the Quest for Racial Justice at UCLA. Published by UCLA Luskin Center for History and Policy. 18-month research project (June 2020–March 2022) by 12+ student researchers supervised by Professors Aomar Boum, Eddie Cole, and David N. Myers. Documents Harold’s case, FLSA lawsuit, and FUPOA founding. Constitutes institutional knowledge and constructive notice. UCLA Luskin Center for History and Policy HistoryofRacismandtheQuestforRacialJusticeatUCLA.pdf 7
CATEGORY XVII: SECOND FORMAL AUDIT REQUEST (2026)
Q-1 01/31/2026 UC RASC Second Formal Audit Request. Formal request for reconciliation of permanent disability determination and current retiree medical premium deductions. Notes first request (11/09/2021) unanswered for 4+ years. Includes medical urgency notice re cancer surgery Feb 2026. C.A. Harold UC_RASC_Second_Formal_Audit_Request_2026-01-31.docx 8

PART B: COURT RECORDS

Three separate legal proceedings document Harold’s history with the University of California and provide the legal framework for the current dispute. These records are evidence.

Case 1 establishes Harold’s role as a successful federal labor litigant against UC. Case 2 establishes the origin of his permanent disability and the continuing tort theory. Case 3 establishes the legal framework distinguishing DDI from retirement under the UCRP — the very distinction UC has inconsistently applied to Harold’s own classification for 30 years.

Field Details
CASE 1: FEDERAL FLSA ACTION — Univ. Police Officers, et al. v. Regents of the Univ., et al.
Case Number 2:96-cv-00396-WDK-AJW
Court United States District Court, Central District of California (Western Division — Los Angeles)
Judge William D. Keller (Presiding); Andrew J. Wistrich (Discovery Referral)
Cause of Action 29 U.S.C. §201 — Fair Labor Standards Act
Nature of Suit 710 Labor: Fair Standards
Date Filed January 19, 1996
Date Terminated January 21, 1998 (case closed May 23, 1997; administrative closure January 1998)
Plaintiffs University Police Officers (collective); Charles A. Harold (individually named, “Los Angeles and all others who file consent forms”). 50 individual consent forms filed February–March 1996.
Defendants Regents of the University of California; University of California Los Angeles Police Department; Clarence R. Chapman (individually)
Plaintiff’s Counsel Curtis S. Leavitt, Kennaday Leavitt PC (formerly Mastagni Holstedt & Chiurazzi), 400 Capitol Mall, Suite 2840, Sacramento, CA 95814. (916) 732-3060.
Defendant’s Counsel Eugene P. Ramirez, Manning and Kass Ellrod Ramirez Trester LLP, 801 South Figueroa Street, 15th Floor, Los Angeles, CA 90017-3012. (213) 624-6900.
Disposition Stipulated Judgment and Order entered April 29, 1997. Regents paid total of $199,126.71 by checks to individual plaintiffs and attorneys. Plaintiffs accepted sum as full satisfaction of FLSA claims. Five individuals (Arsena, Henderson, Tucker, Sells, Morgan) dismissed with prejudice May 22, 1997.
Harold’s Role Individually named plaintiff and founding president of FUPOA. Filed as representative of collective action “and all others who file consent forms.”
Significance to Current Case Establishes Harold’s documented history as a whistleblower and labor organizer who successfully sued UC. Provides foundation for whistleblower retaliation analysis under Cal. Gov’t Code §8547 et seq. Referenced in UCLA Luskin Center institutional history report.
Source Documents FEDERAL_DOCKETDktRpt.pdf (4 pages); FEDERAL_CASE_CM_ECF__California_Central_District.pdf (attorney list); CM_ECF__California_Central_District.pdf (history/documents); 2CM_ECF__California_Central_District.pdf (party list); 3CM_ECF__California_Central_District.pdf (related transactions). All retrieved from PACER on 01/31/2026.
CASE 2: STATE TORT ACTION — Harold v. The Regents of the University of California
Case Name Harold v. The Regents of the University of California
Court California Superior Court (Los Angeles County) — exact case number not available in current project files
Claims Discrimination, whistleblowing, acts against public policy, and related claims arising from employment as UCLA police officer and role as founding president of FUPOA.
Media Coverage Los Angeles Times (February 25, 1993, and additional contemporaneous coverage).
Bankruptcy Seizure During period of unpaid medical leave, Harold filed bankruptcy. Bankruptcy court seized the pending state tort action as an asset. UC settled with bankruptcy court for approximately $50,000 to pay Harold’s creditors. Harold received no money personally from the state tort action.
Settlement Status Harold never signed a settlement agreement in that case, leaving the case technically open for future claims of harassment. Current dispute regarding UC’s failure to honor disability status and medical insurance constitutes a continuing tort arising from the same pattern of institutional conduct.
Significance to Current Case Establishes the origin of Harold’s permanent disability (1996 industrial injury), the pattern of institutional conduct, and the continuing tort theory. The absence of a signed settlement agreement is a critical legal fact.
Source Documents Harold_v_UCLA_Disability_Income_Status_Letter_to_Edgar.pdf; CH_07 (Statement of Facts ¶¶11–12); CH_08 (Section III); UCLA Luskin Center report.
CASE 3: CCW MANDATE ACTION — Jacobs et al. v. The Regents of the University of California
Case Number B268758 (Court of Appeal); BS147764 (Los Angeles County Superior Court)
Court Court of Appeal of the State of California, Second Appellate District, Division Two
Filed / Published Opinion filed May 30, 2017; Certified for Publication June 27, 2017
Judge (Trial Court) Robert H. O’Brien, Superior Court of Los Angeles County
Appellate Panel Ashmann-Gerst, Acting P.J.; Chavez, J.; Goodman, J. (Ret.)
Plaintiffs/Appellants Allison Jacobs (UC Berkeley PD, injured on duty 2010, DDI effective 04/13/2013, medically separated 07/18/2013); Dennis Mueller (UC Santa Barbara PD, injured on duty 1997, DDI effective 07/02/1998, received CCW 1998–2013 then denied renewal); Federated University Police Officers Association (FUPOA) (250+ members, exclusive bargaining representative for nonsupervisory UC peace officers).
Defendant/Respondent The Regents of the University of California
Appellants’ Counsel Castillo Harper; Michael A. Morguess
Respondent’s Counsel Jones & Mayer; Martin J. Mayer, James R. Touchstone, Krista MacNevin Jee
Legal Question Whether disabled members under the UCRP who receive “Duty Disability Income” (DDI) are considered “retired” for purposes of entitlement to a retired identification card and concealed weapons endorsement under Penal Code §16690.
Holding Affirmed trial court denial. DDI recipients are NOT “retired” under the UCRP. The UCRP has no category of “disability retirement.” Under the UCRP, Disabled Members: (1) are not retired; (2) do not receive Retirement Income; and (3) can elect to retire when eligible but are never required to do so.
Key Regents Admission The Regents acknowledged that “its prior policy of issuing retired identification cards and endorsements for concealed weapons to Disabled Members receiving DDI was erroneous, and was properly discontinued.” This admission confirms that UC previously treated DDI recipients as retired for CCW purposes — exactly as Harold was treated from 2002–2017.
Critical FUPOA Connection FUPOA, which Harold founded, was a named plaintiff in this action. The case directly addresses the status contradiction that is central to Harold’s current claims. The court’s distinction between “disabled” and “retired” under UCRP supports Harold’s argument that UC cannot simultaneously treat him as retired (for tax purposes) and not retired (for CCW purposes).
Trial Court Finding re Jacobs Jacobs’s employment records describe the action taken as “Terminat[io]n” with “Reason” specified as “Medical Separation.” Mueller’s employment records “no longer exist.”
Significance to Current Case Establishes binding legal framework for DDI vs. retirement distinction under UCRP. UC’s admission of prior “erroneous” CCW issuance directly parallels Harold’s experience. Mueller’s lost employment records parallel Harold’s lost settlement records. The “Schödinger’s Retiree” contradiction (CH 9) flows directly from this legal framework.
Source Document UCPD_CCW_Case.pdf (16 pages — full published appellate opinion and certification order)

PART C: EXHIBIT TEMPLATE

Use this template to catalog additional evidence items not yet included in the Master Evidence Index above. Assign the next available letter-number code within the appropriate category, or create a new category (R, S, T, etc.) as needed.

Ex. # Date Document Description Source / Custodian File Name CH Ref