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  • 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 — TELEPHONE NO. ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): DAVID R. DONADIO, ESQ. (Bar # 154436) (415) 898-1555 BRAYTON*®PURCELL LL FAX NO. 222 Rush Landing Road (415) 898-1247 ELECTRONICALLY Novato, California 94948-6169 ATTORNEY FOR (ame): Plaintiff(s) SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO street appress: 400 McAllister Street MAILING ADDRESS: cry anozpcops. San Francisco 94102 BRANCH NAME: PLAINTIFF: | ROBERT ROSS and JEAN ROSS DEFENDANT: C.C. MOORE & CO. ENGINEERS, et al. STATEMENT OF DAMAGES (Personal Injury or Wrongful Death) To (name of one defendant only): S F L, INC. Plaintiff (name of one plaintiff only): JEAN ROSS seeks damages in the above-entitled action, as follows: FILED Superior Court of California, County of San Francisco APR 06 2012 Clerk of the Court BY: EDNALEEN JAVIER Deputy Clerk CASE NUMBER: CGC-10-275731 1. General damages AMOUNT a. o Pain, suffering, and inconvenience ..........--.. 0.2 eee eee cette $ b. O1 Emotional distress c. Bl Loss of consortium d Oo Loss of society and companionship(wrongful death actions only) $ e. O1 other (specity) $ t OD other (specify) 20. ooo c cence tee tet ete tee tenses $ Q. Oo Continued on Attachment 1.g. 2. Special damages a. [1 Medical expenses (fo date} 0... occ cece cece cence eee e eee e eee e eee eees $ b. oO Future medical expenses (present value} 2... 0. ett eens $ c O toss of eamings (fo date} $ d. Oo Loss of future earning capacity (present value) $ e C1 propertydamage 6.0 c eet bce bebe ce cet ebeeeeeeees $ f. Oo Funeral expenses (wrongful death actions only)... 2.2.00. 0 02 ee $ g. oO Future contributions (present value) (wrongful death actions only) $ h. Oo Value of personal service, advice, or training (wrongful death actions only) $ i CD otter (specify) o.oo eee cence cee e eect cent eee ee tees tenet este ee nes $ i. TF otter (specify)... eee eee cece eect teen cette teeter eeeeeee es $ k. oO Continued on Attachment 2.k. 3, 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: November 21, 2011 David R. Donadio > Che & {TYPE OR PRINT NAME} . (SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF) (Proof of service on reverse) Form Adopted for Mandatory Use STATEMENT OF DAMAGES Code of Civil Procadure, §§ 425.11, 425.115 ‘Judicial Council of California ‘www. courtinfu.ca gov. CiV-050 (Rev. January 1, 2007] (Personai Injury or Wrongful Death) LexisNexis® Automated California Judicial Council Forms