arrow left
arrow right
  • ROBERT ROSS et al VS. C.C. MOORE & CO. ENGINEERS ASBESTOS document preview
  • ROBERT ROSS et al VS. C.C. MOORE & CO. ENGINEERS ASBESTOS document preview
						
                                

Preview

CiV-050 — DO NOT FILE WITH THE COURT — — UNLESS YOU ARE APPLYING FOR A DEFAULT JUDGMENT UNDER CODE OF CIVIL PROCEDURE § 585 — ATTORNEY OR PARTY WITHOUT ATTORNEY {Name and Address): TELEPHONE NO, DAVID R. DONADIO, ES' (Bar # 154436) (415) 898-1555 BRAYTON@PURCELL LU) FAK NO. Rush Landing Ri (415) 898-1247 Novato, California SiS 8.6169 ATTORNEY FOR (same): Plaintifi(s) SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO street appress:; 400 McAllister Street MAILING ADDRESS: city axpzipcos: San Francisco 94102 BRANCH NAME: Plaintiff: | ROBERT ROSS and JEAN ROSS DEFENDANT: C.C. MOORE & CO. ENGINEERS, et al. STATEMENT OF DAMAGES CASENUMBER coc1027573 To (name of one defendant only): FULLER FLOORS Plaintiff (name of one plaintiff only): JEAN ROSS seeks damages in the above-entitled action, as follows: ELECTRONICALLY FILED Superior Court of California, County of San Francisco SEP 07 2012 Clerk of the Court BY: EDNALEEN JAVIER Deputy Clerk 1. General damages AMOUNT a. 1 Pain, sutfering, and inconvenience b. 1 Emotional distress c. EX Loss ofconsortium 0.0.0.0... cece eect eee erent nett eee ete e teen eens nenes d 0 Loss of society and companionship(wrongful death actions only) .$§ ec. C1 other (specity) 0.0.00. c cece cece cece cece cece tee sees beaten eeeaeteeeeenees $ § [1 otter (specity) ooo ccc cece eee eens eee ede ene eee eee e ne eneeneene $ g. o Continued on Attachment 1.9. 2. Special damages a. C1 Medical expenses (to date) $ b. oO Future medical expenses (present value) . . $ c. [1 Loss of eamings (to date) $ d. © toss of future earning capacity (present value) $ e. oO Property damage $ ¢ (1 Funeral expenses (wrongful death actions only) $ g. [1 Future contributions (present value} (wrongful death actions only) $ h Q Value of personal service, advice, or training (wrongful death actions only) $ i OD other (specify) o.oo cece cece cece eeeeeeneeeneeeeee bee ceeecteutensevesues $ j OO otter (specify) o.oo ccc cece cece eect e eee eee e eer ne ener een ees $ x. (1 Continued on Attachment 2.k. 3. Oo Punitive damages: Plaintiff reserves the right to seek punitive damages in the amount of (specify) ...... $ when pursuing a judgment in the sult filed against you. Date: May 16, 2012 David R. Donadio » (TYPE OR PRINT NAME) {SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF) (Proof of service on reverse) aso (Porsonal Injury or Wrongful Dest) sonore See LexisNexis® Automated California Judicial Council Forms