On March 12, 2008 a Party Statement was filed involving a dispute between Breckler, Joann, Breckler, Rodrick, and Actuant Corporation, Airgas-Northern California & Nevada, Inc., Air Products And Chemicals, Inc., All Asbestos Defendants, Allied Manufacturing Company, Allied Mfg Co., Inc., Allis-Chalmers Corporation Product Liability Trust, Allsberry Mechanical Corporation, American Conference Of Governmental Industrial Hyg, American Honda Motor Co., Inc., American Plumbing And Heating Supplies, American Plumbing & Heating Supplies, American Standard, Inc., Anderson, Rowe & Buckley, Inc., A.O. Smith Corporation, Asbestos Defendants, Asbestos Manufacturing Company, Auto Friction Corporation, Auto Specialties Manufacturing Company, Baldor Electric Company, Bayer Cropscience, Inc., As Successor To Amchem, B.E.E Industrial Supply, Inc., Bell Asbestos Mines Ltd., Bigge Crane And Rigging Co., Borg-Warner Corporation, Brassbestos Brake Lining Company, Bridgestone Firestone North American Tire, Llc, Bryan Steam Llc, Buckles-Smith Electric Company, Bucyrus International, Inc., Burnham Corporation, Burnham Llc (Fka Burnham Corporation Which Will Do, Burnham Llp F K A Burnham Corporation, Carl N. Swenson Co., Inc., Carrier Corporation, Cbs Corporation, A Delaware Corporation, F K A, Chester C. Lehmann, Co., Inc., Chester C. Lehmann, Co. Inc., Dba Electrical, Chrysler Llc, Clayton Industries, Inc., Cleaver-Brooks, Inc., Consolidated Insulation, Inc., Craftsman Elevators, Inc., Crane Service Corporation, Csk Auto, Inc., Daimlerchrysler Corporation, Dana Corporation, Does 1-8500, Eaton Electrical Inc., Electrical Materials, Inc., Emsco Asbestos Company, Fdcc California, Inc., Fdcc California, Inc.,, Federal-Mogul Asbestos Personal Injury Trust, Fibre & Metal Products Company, Forcee Manufacturing Corporation, Ford Motor Company, Garlock Sealing Technologies, Llc, Gatke Corporation, General Electric Company, General Motors Corporation, Genuine Parts Company, George Rossmann, Inc., Goulds Pumps, Inc., Grinnell Corporation, Grinnell Llc,, Haley Engineering Corporation, Hamilton Sunstrand Corporation, Hanson Permanente Cement, Inc., Hanson Permanente Cement, Inc. Fka Kaiser Cement, Hennessy Industries, Inc., H. Krasne Manufacturing Company, Honda Motor Co., Ltd., Honda North America, Inc., Honda Of America Mfg., Honda Of Canada Mfg., A Division Of, Honda Of South Carolina Mfg., Inc., Hondapower Equipment Manufacturing, Inc., Honda R&D America, Inc., Honda R&D Co., Ltd., Honeywell International Inc., F K A Alliedsignal,, Hurst Boilers, Ingersoll-Rand Company, Jack'S Unlimited, Inc., Jacks Unlimited, Inc., J.T. Thorpe & Son, Inc., Larry Hopkins, Inc., Lasco Brake Products, Lear Siegler Diviersified Holdings Corp., L.J. Miley Company, L.R. Trillo Company, Inc., Madco Welding Supply Co, Inc., Madco Welding Supply Co., Inc., Maremont Corporation, Mcmaster-Carr Supply Company, Medical Counsel Berry & Berry, Metropolitan Life Insurance Company, Molded Industrial Friction Corporation, Morton International, Inc., National Transport Supply, Inc., Nissan Forklift Corporation, Nissan Motor Co., Ltd., Nissan North America, Inc., North America And Nissan Technical Center North, Owens-Illinois, Inc., Pacific Scientific Company, Parker Hannifin Corporation, Peebels Equipment Company, Placerville Auto Parts, Inc., Plant Insulation Company, Pneumo Abex Llc, Pratt & Whitney, Quintec Industries, Inc., Ray L. Hellwig Mechanical Co. Inc., Ray L. Hellwig Plumbing & Heating, Inc., R.E. Cuddie Co., Redwood Plumbing Co., Inc., Riteset Manufacturing Company, Robert Bosch Corporation, Robert Bosch Llc, Rockwell Automation, Inc., Rossendale-Ruboil Company, Rudolph And Sletten, Inc., San Jose Boiler Works, Inc., Sasco, Schneider Electric Usa, Inc., Scott Co. Of California, S. H. Coley Construction Company, Sikorsky Aircraft Corporation, Silver Line Products, Inc, South Bay Electric, Southern Friction Materials Company, S & S Welding, Inc., Standard Motor Products, Inc., Standco, Inc., Stuart-Western, Inc., Super Shops, Inc., The Budd Company, The Jack Dymond Company, The Jack Dymond Company., Toyota Motor Sales U.S.A., Inc., Trane Us Inc. Fka American Standard Inc., Underwriters Laboratories Inc., Union Carbide Corporation, Unique Electronic Transfer And Storage, Inc., Unique Electronic Transfer & Storage, Inc., United Technologies Corporation, Universal Friction Materials Company, U.S. Spring & Bumper Company, Viacom, Inc., Westburne Supply Inc., Westburne Supply, Inc., Wheeling Brake Block Manufacturing Company, W. L. Larsen, Inc., W.L. Larsen, Inc., W.W. Grainger, Inc., York International Corporation, for civil in the District Court of San Francisco County.
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— DO NOT FILE WITH THE COURT — CIV-050 ~ UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE OF CIVIL PROCEDURE § 586 — MAILING ADDRESS: crv anv cons: San Francisco 94102 BRANCHLNAME; PiaintieF: © RODRICK BRECKLER and JOANN BRECKLER DEFENDANT: ASBESTOS DEFENDANTS (BP) “CASE NUMBER: (Personai Injury or Wrongful Death) “STATEMENT OF DAMAGES tae OB 274566 EZ ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address)” FELEPHONENO. nn DAVID R. DONADIO, ES (Bar # 154436) (415) 898-1555 ELECTRONICALLY BRAYTON®PURCELL LLP FAX NO. FILED 222 Rush Landing Road (415) 898-1247 . a Novato, California 94948-6169 Superior Court of California, ATTORNEY FOR (nine): Plaintiff(s) County of San Francisco SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO. ~ | FEB 18 2010 srazer aponess: 400 McAllister Street . pclerk of the Court Deputy Clerk To (name of one defendant only): JACK’S UNLIMITED INC Plaintiff (name of one plaintiff only): JOANN BRECKLER seeks damages in the above-entitied action, as follows: 1, General damages: AMOUNT a. Pain, suffering, and inconvenience b, oO Emotional distress ¢. Loss of consortium d. Oo Loss of society and companionship{wrongful death actions only) 6... ee ee eee $ e oO Other (Specify) eee ene ee tebe ene tenes $ f O Other (specify) oe cece nee ene en ere ern een es $ g. Oo Continued on Attachment 1.g. 2. Special damages a oO Medical expenses ffo dale). eee ccc evveeveliveeveterveenes $ b. Oo Future medical expenses (present value) $ c. O Loss of earnings (fo date) .. $ d. oO Loss of future earning capacity (present value) $ e. 1 property damage cece v cee e ev evee se sceviereeeteeayrevevittsritieevrerieeenrs $ f. LJ Funeral expenses (wrongful death actions only)... 6. cece $ g Oo Future contributions (present value) (wrongful death actions only)... ee $ h OY Value of personal service, advice, or training (wrongful death actions only) . $ « O Qther (specify) $ je O Other (specify) $ k. O Continued on Attachment 2.k. 3. Ri Punitive damages: Plaintiff reserves the right to seek punitive damages in the amount of (specify) ..... . $ _5,000,000.00 when pursuing a judgment in the suit filed against you. Date: FER David R. Donadio 16 2010 > (TYPE OR PRINT NAME) : {SIGNATURE GE PLAINTIFF OR ATTORNEY FOR PLAINTIFF) (Proof of service on reverse) Form Adopted for Mandatory tse STATEMENT OF DAMAGES ode of Givi Procaduno, $5 425,14, 428.115 cw SSD few dancer BOOT] (Personal Injury or Wrongful Death) rine .gow LexisNexis® Automated California Judicial Council Forms