arrow left
arrow right
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
  • BCV-20-10047323-CV Other PI/PD/WD - Civil Unlimited document preview
						
                                

Preview

ELECTRONICALLY FILED 1 PATRICK M. QUIGLEY [Bar No.: 148448] 2/14/2020 12:48 PM E-mail: pquigley@mfrlegal.com Kern County Superior Court 2 MORALES, FIERRO & REEVES By Rebecca Saldivar, Deputy 2151 Salvio Street, Suite 280 3 Concord, California 94520 Telephone: (925) 288-1776 4 Facsimile: (925) 288-1856 5 Attorneys for Plaintiff, ZURICH AMERICAN INSURANCE COMPANY 6 7 8 SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF KERN 10 11 ZURICH AMERICAN INSURANCE CASE NO.: BCV-20-100473 COMPANY, 12 COMPLAINT FOR DAMAGES MORALES, FIERRO & REEVES Plaintiff, CONCORD, CALIFORNIA 94520 13 2151 SALVIO STREET vs. Suite 280 14 DOES 1 through 50, inclusive, 15 Defendants. 16 17 Plaintiff, ZURICH AMERICAN INSURANCE COMPANY, (“Plaintiff”) alleges: 18 GENERAL ALLEGATIONS 19 1. At all times relevant herein, plaintiff Zurich American Insurance Company 20 (“Zurich”) was, and now is, a corporation organized and existing under the laws of the State of 21 New York and authorized to, and doing, business within the State of California. Under the laws of 22 the State of California, Plaintiff is licensed and authorized to write Workers’ Compensation 23 insurance and insured Kern Glass & Aluminum Company (“KGAC”) against liability to its 24 employees for compensation benefits under the Workers’ Compensation Act of the State of 25 California. 26 2. The true names and capacities, whether individual, corporate, associate or 27 otherwise, of Defendants herein designated as DOES 1 through 50 inclusive, are unknown to the 28 Plaintiff at this time, who therefore sue said Defendants by such fictitious names. Plaintiff is 1 COMPLAINT FOR DAMAGES CASE NO.: 1 informed and believes and thereon alleges that each of said Defendants are responsible in some 2 manner for the events and happenings and proximately caused the injuries and damages herein 3 alleged. Plaintiff will seek leave to amend this Complaint to allege their true names and capacities 4 as they are ascertained. 5 3. At all times mentioned, each of the Defendants were the representatives, agents or 6 employees of each of the other Defendants and in doing the things alleged herein were acting 7 within the scope of their authority as agents or employees. 8 FIRST CAUSE OF ACTION (Negligence Against All Defendants) 9 10 4. Plaintiff incorporates by reference each and every allegation contained in 11 Paragraphs 1 through 3 as though fully set forth herein. 12 5. At all times herein mentioned, KGAC was the employer of Hugo O. Gomez MORALES, FIERRO & REEVES CONCORD, CALIFORNIA 94520 13 (“Gomez”). 2151 SALVIO STREET Suite 280 14 6. On or about February 21, 2018, Gomez was working within the course and scope 15 of his employment with KGAC at or near the property located at 5151 Knudson Drive, 16 Bakersfiled, California (“Transitional Care of Bakersfield Project”). Plaintiff is informed and 17 believes Does 1 to 30 were engaged in a construction project at the Transitional Care of 18 Bakersfield Project at the time of the incidents described herein. Plaintiff is informed and believes 19 that Does 31 to 50, owned, maintained, controlled, and/or managed the property at the Transitional 20 Care of Bakersfield Project. 21 7. On or about February 21, 2018, Gomez was walking at Transitional Care of 22 Bakersfield Project when he tripped on an unmarked pipe sticking out of the ground (“Accident”). 23 8. Plaintiff is informed and believes the pipe, was owned, built, constructed, 24 maintained, designed and/or repaired by Defendants, and each of them. 25 9. At and before the time of the Accident, the Defendants, and each of them, so 26 carelessly, recklessly and negligently owned, operated, maintained, constructed, designed and 27 controlled the subject property, as to cause it to be in an unsafe condition at the time of the 28 Accident. 2 COMPLAINT FOR DAMAGES CASE NO.: 10. By reason of the negligence and carelessness of Defendants, and each 0f them, Gomez did sustain physical injuries arising from the Accident. AWN 11. As a proximate result of the negligence of Defendants, and each of them, and of the resulting injuries sustained by Gomez, Plaintiff has been obligated to pay workers’ compensation benefits to, and 0n behalf 0f, Gomez. 12. Marquez’s Workers’ Compensation claim is stillongoing. Plaintiff will be required to pay further disability benefits and sums for medical care and treatment for an indefinite \DOOVQUI time in the future. Pursuant to Labor Code § 3852 Plaintiff is entitled to recover in this action all sums ithas paid to, and on behalf of, Gomez in Workers’ Compensation benefits, as well as all 10 amounts for which itwill become liable as Workers’ Compensation benefits. To date, Plaintiff 11 has paid in excess 0f $67,000 in Workers’ Compensation benefits. 12 WHEREFORE, Plaintiff prays for judgment against Defendants as follows: REEVES 13 For amounts to compensate Plaintiff for past Workers’ Compensation benefits paid 94520 (1) & STRET 280 14 in connection with Gomez’s claim an amount according CALIFORNIA FIERRO Suite SALVIO in to proof; 2151 15 CONCORD, (2) For amounts t0 compensate Plaintiff for liability for future Workers’ Compensation MORALEs, 16 benefits to be paid in connection with Gomez’s claim in an amount according to 17 proof; 18 (3) Interest on amounts paid for Workers’ Compensation benefits; 19 (4) Costs of suit herein; and 20 (5) For all other relief the Court deems just and proper. 21 DATED: February 14, 2020 MORALES, FIERRO & REEVES 22 23 24 PATRICK M. QUIGLEf / Attorneys for Plaintiff, URI i AMERICAN 25 INSURANCE COMPANY 26 27 28 3 COMPLAINT FOR DAMAGES CASE No.: ELECTRONICALLY FILED 1 PATRICK M. QUIGLEY [Bar No.: 148448] 6/22/2020 3:01 PM E-mail: pquigley@mfrlegal.com Kern County Superior Court 2 CANON T. YOUNG [Bar No.: 189142] By Vanesa Jackson, Deputy E-mail: cyoung@mfrlegal.com 3 MORALES, FIERRO & REEVES 2151 Salvio Street, Suite 280 4 Concord, California 94520 Telephone: (925) 288-1776 5 Facsimile: (925) 288-1856 6 Attorneys for Plaintiff, ZURICH AMERICAN INSURANCE COMPANY 7 8 SUPERIOR COURT OF THE STATE OF CALIFORNIA 9 IN AND FOR THE COUNTY OF KERN 10 11 ZURICH AMERICAN INSURANCE CASE NO.: BCV-20-100473 COMPANY, 12 FIRST AMENDED COMPLAINT FOR MORALES, FIERRO & REEVES Plaintiff, DAMAGES CONCORD, CALIFORNIA 94520 13 2151 SALVIO STREET vs. Suite 280 14 PAVLETICH ELECTRIC & 15 COMMUNICATIONS, INC. and DOES 1 through 50, inclusive, 16 Defendants. 17 18 19 Plaintiff, ZURICH AMERICAN INSURANCE COMPANY, (“Plaintiff”) alleges: 20 GENERAL ALLEGATIONS 21 1. At all times relevant herein, plaintiff Zurich American Insurance Company 22 (“Zurich”) was, and now is, a corporation organized and existing under the laws of the State of 23 New York and authorized to, and doing, business within the State of California. Under the laws of 24 the State of California, Plaintiff is licensed and authorized to write Workers’ Compensation 25 insurance and insured Kern Glass & Aluminum Company (“KGAC”) against liability to its 26 employees for compensation benefits under the Workers’ Compensation Act of the State of 27 California. 28 1 FIRST AMENDED COMPLAINT FOR DAMAGES CASE NO.: BCV-20-100473 1 2. Defendant PAVLETICH ELECTRIC & COMMUNICATIONS, INC. 2 (“PAVLETICH”), based on information and belief, was and is at all times herein mentioned a 3 California corporation authorized to do business in California. 4 3. The true names and capacities, whether individual, corporate, associate or 5 otherwise, of Defendants herein designated as DOES 1 through 50 inclusive, are unknown to the 6 Plaintiff at this time, who therefore sue said Defendants by such fictitious names. Plaintiff is 7 informed and believes and thereon alleges that each of said Defendants are responsible in some 8 manner for the events and happenings and proximately caused the injuries and damages herein 9 alleged. Plaintiff will seek leave to amend this Complaint to allege their true names and capacities 10 as they are ascertained. 11 4. At all times mentioned, each of the Defendants were the representatives, agents or 12 employees of each of the other Defendants and in doing the things alleged herein were acting MORALES, FIERRO & REEVES CONCORD, CALIFORNIA 94520 13 within the scope of their authority as agents or employees. 2151 SALVIO STREET Suite 280 14 FIRST CAUSE OF ACTION (Negligence Against All Defendants) 15 16 5. Plaintiff incorporates by reference each and every allegation contained in 17 Paragraphs 1 through 4 as though fully set forth herein. 18 6. At all times herein mentioned, KGAC was the employer of Hugo O. Gomez 19 (“Gomez”). 20 7. On or about February 21, 2018, Gomez was working within the course and scope 21 of his employment with KGAC at or near the property located at 5151 Knudson Drive, 22 Bakersfiled, California (“Transitional Care of Bakersfield Project”). Plaintiff is informed and 23 believes PAVLETICH and Does 1 to 30 were engaged in a construction project at the Transitional 24 Care of Bakersfield Project at the time of the incidents described herein. Plaintiff is informed and 25 believes that Does 31 to 50, owned, maintained, controlled, and/or managed the property at the 26 Transitional Care of Bakersfield Project. 27 28 2 FIRST AMENDED COMPLAINT FOR DAMAGES CASE NO.: BCV-20-100473 1 8. On or about February 21, 2018, Gomez was walking at Transitional Care of 2 Bakersfield Project when he tripped on an unmarked piece of plumbing, piping or conduit sticking 3 out of the ground (“Accident”). 4 9. Plaintiff is informed and believes the plumbing, piping or conduit, was owned, 5 built, constructed, installed, maintained, designed and/or repaired by Defendants, and each of 6 them. 7 10. At and before the time of the Accident, Defendants, and each of them, so 8 carelessly, recklessly and negligently owned, operated, maintained, constructed, installed designed 9 and controlled the subject property and/or the plumbing, piping or conduit, as to cause it to be in 10 an unsafe condition at the time of the Accident. 11 11. By reason of the negligence and carelessness of Defendants, and each of them, 12 Gomez did sustain physical injuries arising from the Accident. MORALES, FIERRO & REEVES CONCORD, CALIFORNIA 94520 13 12. As a proximate result of the negligence of Defendants, and each of them, and of the 2151 SALVIO STREET Suite 280 14 resulting injuries sustained by Gomez, Plaintiff has been obligated to pay workers’ compensation 15 benefits to, and on behalf of, Gomez. 16 13. Gomez’s Workers’ Compensation claim is still ongoing. Plaintiff will be required 17 to pay further disability benefits and sums for medical care and treatment for an indefinite time in 18 the future. Pursuant to Labor Code § 3852 Plaintiff is entitled to recover in this action all sums it 19 has paid to, and on behalf of, Gomez in Workers’ Compensation benefits, as well as all amounts 20 for which it will become liable as Workers’ Compensation benefits. To date, Plaintiff has paid in 21 excess of $67,000 in Workers’ Compensation benefits. 22 WHEREFORE, Plaintiff prays for judgment against Defendants as follows: 23 (1) For amounts to compensate Plaintiff for past Workers’ Compensation benefits paid 24 in connection with Gomez’s claim in an amount according to proof; 25 (2) For amounts to compensate Plaintiff for liability for future Workers’ Compensation 26 benefits to be paid in connection with Gomez’s claim in an amount according to 27 proof; 28 (3) Interest on amounts paid for Workers’ Compensation benefits; 3 FIRST AMENDED COMPLAINT FOR DAMAGES CASE NO.: BCV-20-100473 1 (4) Costs of suit herein; and 2 (5) For all other relief the Court deems just and proper. 3 DATED: June 21, 2020 MORALES, FIERRO & REEVES 4 5 6 By:__________________________________ PATRICK M. QUIGLEY 7 CANON T. YOUNG 8 Attorneys for Plaintiff, ZURICH AMERICAN INSURANCE COMPANY 9 10 11 12 MORALES, FIERRO & REEVES CONCORD, CALIFORNIA 94520 13 2151 SALVIO STREET Suite 280 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 4 FIRST AMENDED COMPLAINT FOR DAMAGES CASE NO.: BCV-20-100473 CIV-110 ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NO: 36623 FOR COURT USE ONLY NAME: ERNEST A. VARGAS, ESQ. FIRM NAME: LAW OFFICES OF VARGAS & VARGAS STREET ADDRESS:301 NORTH LAKE AVENUE, SUITE 120 ELECTRONICALLY FILED CITY:PASADENA, STATE:CA ZIPCODE: 91101-4108 8/16/2021 1:08 PM TELEPHONE NO.:(626) 440-1111 FAX NO. : (626) 440-9456 E-MAIL ADDREss: ernest@vargasandvargas.com Kern County Superior Court ATTORNEY FOR (Name): PLAINTIFF-IN-INTERVENTION HUGO GOMEZ By Maribel Villalon, Deputy SUPERIOR COURT OF CALIFORNIA, COUNTY OF KERN STREETADDRESS:1415 TRUXTUN AVENUE MAILING ADDRESS: CITYANDZIPCODE:BAKERSFIELD, CALIFORNIA 93301 BRANCH NAME: BAKERSFIELD Plaintiff/Petitioner: HUGO GOMEZ [PLAINTIFF-IN-INTERVENTION] Defendant/Respondent:PAVLETICH ELECTRIC & COMMUNICATIONS, INC. CASE NUMBER: REQUEST FOR DISMISSAL BCV201 00473 A conformed copy will not be returned by the clerk unless method of return is provided with the document. This form may not be used for dismissal of a derivative action or a class action or of any party or cause of action in a class action. (Cal. Rules of Court, rules 3.760 and 3.770.) 1. TO THE CLERK: Please dism1ss this act1on as follows: a. (1) [KJ With prejudice (2) [:J Without prejudice b. (1) [KJ Complaint (2) [:J Petition (3) [:J Cross-complaint filed by (name): on (date): (4) [:J Cross-complaint filed by (name): on {date): (5) [:J Entire action of all parties and all causes of action (6) [KJ Other (specify):* Onlv as to defendant ARCO CONSTRUCTION CO .. INC. served as DOE 1 2. (Complete in all cases except family law cases.) The court c:::Jdid [2] did not waive court fees and costs for a party n this cas. {Thi clerk. If court fees and costs were waived, the declaration on the back of th1 rrn mu Date: AUGUST 16. 2021 ITJ (TYPE OR PRINT NAME OF ATTORNEY c:::J PARTY WITHOUT ATTORNEY) *If dismissal requested is of specified parties only of specified causes of action only, or of specified cross-complaints only, so state and identify the parties, causes of ant/Respondent action, or cross-complaints to be dismissed. 3. TO THE CLERK: Consent to the above dismissal is hereby given.** Date: c:::J (TYPE OR PRINT NAME OF ATTORNEY [:J PARTY WITHOUT ATTORNEY) (SIGNATURE) Attorney or party without attorney for: ** If a cross-complaint -or Response (Family Law) seeking affirmative c:::J relief- is on file. the attomey for cross-complainant (respondent) must sign Plaintiff/Petitioner this consent if required by Code of Civil Procedure section 581 (i) or (j). c:::J Defendant/Respondent c:::J Cross Complainant {To be completed by clerk) 4. c::::J Dismissal entered as requested on (date): 5 xx c:::JDismissal entered on (date): 8/16/21 as to only (name): as to Arco Construction Co., Inc. 6. c:::JDismissal not entered as requested for the following reasons (specify):from the Complaint-In-Intervention, with prejudice 7. a. c:::J xx 8/16/21 Attorney or party without attorney notified on {date): b. c:::J Attorney or party without attorney not notified. Filing party failed to provide c:::J a copy to be conformed c:::J means to return conformed copy TAMARAH HARBER-PICKENS Date: 8/16/21 Clerk, by , Deputy Page 1 of2 Fonn Adopted for Mandatory Use REQUEST FOR DISMISSAL Maribel Villalon Code of Civil Procedure, § 581 et seq.: Gov. Code, Judicial Council of Csfifomia § 68637(c): Csl. Rules of Court. rule 3.1390 CIV-11 0 [Rev. Jan. 1, 2013) www.courls.ca.gov CIV-110 CASE NUMBER: Plaintiff/Petitioner: DefendanURespondent: COURT'S RECOVERY OF WAIVED COURT FEES AND COSTS If a party whose court fees and costs were initially waived has recovered or will recover $10,000 or more in value by way of settlement, compromise, arbitration award, mediation settlement, or other means, the court has a statutory lien on that recovery . The cou rt may refuse to dismiss the case until the lien is satisfied. (Gov. Code,§ 68637. ) Declaration Concerning Waived Court Fees 1. The cou rt waived court fees and costs in th is action for (name): 2. The person named in item 1 is (check one below): a. 0 not recovering anything of value by this action. b. D recovering less than $10,000 in value by this action. c. D recovering $10,000 or more in value by this action. (If item 2c is checked, item 3 must be completed.) 3. D All court fees and court costs that were waived in this action have been paid to the court (check one): Yes No I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: D (TYPE OR PRINT NAME OF ATTORNEY D PARTY MAKING DECLARATION) (SIGNATURE) CIV-110 {Rev. January 1, 2013) REQUEST FOR DISMISSAL Page 2 of 2 For you r protectio n and privacy, please press the Clear This Form b utto n after yo u have printed the form. IIPrint this form II Save this form I I Clear tliis form I PROOF OF SERVICE 2 3 STATE OF CALIFORNIA ) ) ss. 4 COUNTY OF LOS ANGELES ) 5 I am employed in the County of Los Angeles, State of California. I am over the age of 18 and not a party to the within action. My business address is 30 1 North Lake Avenue, Suite 6 120, Pasadena, California 91101-4108 . 7 On August 16, 2021, I served the foregoing documents described as: REO UEST FOR DISMISSAL ONLY AS TO DEFENDANT ARCO CONSTRUCTION CO., INC. [SERVED 8 AS DOE 1] , on all interested parties in said action by: 9 [x] BY EMAIL OR ELECTRONIC TRANSMISSION: Based on a Court Order of an agreement of the parties to accept service by email or electronic transmission, I caused the documents 10 to be sent to the person(s) at the email address(es) listed above. I did not receive, within a reasonable time after the transmission, any electronic message or other ind ication that the transmission was II unsuccessful. [Rules of Court Rule 2056(a)(4). 12 Ms Patricia J. Wolfe, Esq. Attorneys for Defendant Pavletich Electric & patricia@pobrienlaw.com Communications, Inc. 13 tania@pobrienlaw.com O'BRJEN LAW, PC 14 765 Baywood Drive, Suite 185 Petaluma, California 94954 15 Mr. Canon Young, Esq. Attorneys for Plai ntiff Zurich American International 16 Cvoung@mfrlegal.com Company pquigley@ mfrlegal.com 17 Sbird@mfrlegal.com Morales, Fierro & Reeves 18 2151 Salvio Street, Suite 280 Concord, California 94520 19 Mr. Michael McC lain, Esq. Attorneys for Arco Construction Co. , Inc. 20 Michael.McClain@ lewisbrisbois.com Lewis Brisbois Bisgaard & Smith 21 633 West 51h Street. Suite 4000 Los An geles, California 90071 22 23 (X) STATE- I declare under penalty and perjury under the laws of the State of California that the foregoing is true and correct. 24 25 26 27 28 CIV-1 1 0 ATrORNEY 0R PARTY wrrHour ArrORNEY: STATE BAR N0:36623 Fan count use omv NAME: Ernest A. Vargas, Esq. FIRM NAME:Law Ofices of Vargas & Valgas smEErADDREss: 301 North Lake Avenue. Suite 120 cm; Pasadena STATE:CA ZP CODE: 91 101 TELEPHONE no.2626-440-1 1 1 1 FAX N0. : 626-440-9456 ELECTRONICALLY FILED EMAILADDREss: emest@vargasandvargas.com 7/28/2022 12:08 PM ArroRNEY Foname): HUGO GOMEZ Plaintiff-in-Intervention, SUPERIOR COURT OF CALIFORNIA, COUNTY OF KERN Kern County Superior Court smear ADDRESS: 121 5 Truxtun Avenue 121 5 Truxtun Avenue MAILING ADDRESS: AND ZIP cone Bakersfield. CITY CA 93301 By Leslie Dickey, Deputy BRANCH NAME: Bakersfield Courthouse Zurich PlaintifflPetitionen American Insurance Company Defendanthespondent: DOES 1 through 50, Inclusive CASE NUMER: REQUEST FOR DISMISSAL BCV-20-1 00473 A conformed copy wlll not be returned by the clerk unless a method of return Is provided with the document. This form may not be used for dismissal of a derivative action or a class action or of any party or cause of action In a class action. (Cal. Rules of Court, rules 3.760 and 3.770.) 1. a. (1) E T0 THE CLERK: Please dismiss E With prejudice (2) D this action as follows: E Without prejudice D b. (1) Complaint (2) Petition E (3) Cross-complaint filed by (name): on (date): E (4) Cross-complaintfiled by (name): on (date): E (5) and Entire action of all parties allcauses of action As to Defendant—in-lntervention, Sunset Mechanical & Construction, Inc. -ONLY W (6) Other (specify):* 2. (Complete The court D coun‘ did fees and E in all cases except family law cases.) costs did not were waive court fees and costs for a party in thi waived, the declaration on the back of this for' case. must n may be obtained from the ) clerk. If Date: July £21., 2022 ’/ E Ernest A. Vargas, Esq. (TYPE 0R PRINT NAME 0F ArronNEY E PARTY wrrHOU‘r ATTORNEY) ’ ‘-/ 'It is action. ot cmss-complalnts to be dlsmissad. E Attorney or party with of specified patties only oi specified causes of action only. dismissal requested E or of specified cross-complatms only. so state and Identify the parties, causa of plainfiff/peflfion Cross comp'ainant E ut attorney ‘ r: efendanuRespondent 3. TO THE CLERK: Consent to the above dismissal ishereby given.“ Date: 1 (TYPE 0R PRINT NAME 0F E A'rrORNEY E PARTY wrmou‘r ArroRNEY) ’ (SIGNATURE) D D “ a cross-complatnt - or Response (Family Law) seeking affirmative If Attorney Or party without attomey for: E - ls on flle. the attorney for cross-oornplalnam (respondent) must sign DefendanuRespondem relief plainfiff/Petmoner consent this if Code of CMI Procedure requlred by sectlon 581or (j). (l) Cross Complainant 4. E (To be completed by clerk) D X Dismissal entered as requested on 7/28/2022 12:08 PM (date): E 5 Dismissal entered on (date): as to only (name): 6. Dismissal not entered as requested for the following reasons (specify): 7. a.EX D Attomey or party without attorney notified on 7/28/2022 (date): b. Date: 7/28/22 E a copy to be conformed TAMARAH HARBER-PICKENS E Clerk, means to by return wnflwrfi t’ I £4 vide Attorney or party without attorney not notified. Filing party failed to _ Z7 . DOPUty Page 1 of: CodofCl ° Pmed 5B1 .:Go.Cod, F Ad tedforM Jflmmé'immcflnom d Us ° REQUEST FOR DISM|SSAL ssgammiflim c?mwgaaas?) CIV-110 [Ram Jan. 1.201 3] www.magov CIV-1 1 0 .. CASE NUMBER: . . . Zunch Amencan Insurance.Company . , PlamtnfflPetItIoner. BCV_20_100473 Defendant/Respondent: DOES 1through 50, Incluswe COURT'S RECOVERY OF WAIVED COURT FEES AND COSTS Ifa party whose court fees and costs were waived has recovered or will recover $1 0.000 or more initially in value by way of settlement, compromise, arbitrationaward, mediation settlement. or other means, the court has a statutory lien on that recovery. The court may refuse to dismiss the case the until lien is satisfied. (Gov.Code, § 68637.) Declaration Concerning Waived Court Fees 1. The court waived court feesand costs action for (name): in this E 2. The person named initem 1 is(check one below): E a. not recovering anything of value by this action. D b. recovering less than $10,000 in value by this action. D c. recovering $1 0,000 ormore invalue by this action.(If item2c is checked, item 3 must be completed.) 3. Allcourt feesand court costs that were waived action in this have been paid to the court (check one): Yes No Ideclare under penalty of peljury under the laws of the State of California that the information above istrue and correct. Date: } (TYPE0R PRINT NAME 0FD ATTORNEY D PARTY MAKING DECLARATION) (S'GNATURE) ClV-110 (Rev. January 2013] 1. REQUEST FOR DISMISSAL Page 2 of 2 PROOF OF SERVICE 1 ZURICH AMERICAN INSURANCE COMPANY v. DOES 1 through 50, inclusive Case No. BCV-20-100473 2 3 I am over the age of eighteen years and not a party to this action. My business address is: Law Offices of John A. Hauser, One Pointe Drive, 6th Fl, Brea, CA 92821; email address: 4 Karen.Woodhead@thehartford.com. 5 On July 28, 2022, I served a true and correct copy of the following document(s), on the 6 interested party/parties identified on the attached Service List: 7 REQUEST FOR DISMISSAL OF COMPLAINT-IN-INTERVENTION AS TO 8 DEFENDANT-IN-INTERVENTION SUNSET MECHANICAL & CONSTRUCTION, INC. ONLY (WITH PREJUDICE) 9 Based on applicable law or statute, including California Rule of Court 2.251(C)(3) and/or 10 Code of Civil Procedure § 1010.6), or an agreement of the parties to accept service by electronic 11 transmission, I electronically served the document(s) on the interested party/parties on the attached Service List. 12 I declare under penalty of perjury under the laws of the State of California that the above 13 is true and correct. 14 Date: July 28, 2022 15 16 17 __________________________________ 18 KAREN WOODHEAD 19 20 For purposes of serving documents on the Law Offices of John A. Hauser, please use 21 the email address for the attorney of record (amy.pennington@thehartford.com) and 22 LawOfficesHauser@thehartford.com. 23