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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 — ATTORNEY OR PARTY WITHOUT ATTORNEY {Name and Address): TELEPHONE NO. . DAVID R DONADIO. ESR (Bar # 154436) (415) 898-1535 ELECTRONICALLY 222 Rush Landing Road (415) 898-1247 FILED Novato, California 94948-6169 ATTORNEY FOR (name): Plaintifi(s) SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO 400 McAllister Street STREET ADDRESS: MAILING ADDRESS: csryannze cove: 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) Superior Court of California, County of San Francisco AUG 03 2011 Clerk of the Court BY: EDNALEEN JAVIER Deputy Clerk ‘CASE NUMBER: CGC-10-275731 To (name of one defendant only): CINCINNATI VALVE COMPANY Plaintiff (name of one plaintiff only): ROBERT ROSS seeks damages in the above-entitied action, as follows: 1. General damages a. Pain, suffering, and inconvenience 2.02.00 0. ee eee b. BR Emotional distress 00.02. e eect eee ences G CI Loss of consortium da o Loss of society and companionship(wrongful death actions arty) e, CD other specify) ooo ccc eee c ees eveeeteveeeeesed £ CD other (speci o.oo cece ne ee ceen es eees a [1 Continued on Attachment 4.9. 2. Special damages a. Medical expenses (to date) 66ers b. & Future medical expenses {present value) a o Loss of earnings (fo date)... eee eee tees d & Loss of future earning capacity (present vaiue) @ 0 Property damage f Oo Funeral expenses (wrongful death actions only) g. CO Future contributions (present value) (wrongful death actiaris anly) 6.66... h. 0 Value of personal service, advice, or training (wrongful death actions arly) . i Other (specify) LOSS OF HOUSEHOLD SERVICES ............ po ED omer fspecifyy occ ccc ccc eee evceeteeveees k. C1 Continued on Attachment 2.k. 3. Punitive damages: Plaintiff reserves the right fo seek punitive damages in the amount of (specify) when pursuing a judgment in the suit filed against you. Date: David R, Donadio“¥6 0 3 201 > (TYPE OR PRINT NAME} {Proof of service on reverse) Form Adopted for Mandatory Use STATEMENT OF DAMAGES ‘Judicial Council of California. CIV-050 (Rav, January 1, 2067} {Personal Injury or Wrongful Death) AMOUNT Leste ete eee $ __500.000,00 bbe eee eee ee $ __250,000,00 $ $ cette eens $ eben ener ene ee $ (SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF) Code of Sivil Procedure, §§ 425.41, 425.145 ‘wry. courtingo.ca. gov LexisNexis® Automated California Judicial Council Forms