Preview
At an IAS Term of the Supr.eme
Court of the State of New York,
County of Orange, 285 Mai11 St,
Goshen, NY 10924, on the
day of , 2020
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF ORANGE
B.F., Jr. by his Father and Natural
Guardian BARON FAISON Sr. and
BARON FAISON Sr., Individually, INFANT'S COMPROMISE
ORDER
Plaintiffs,
-against- Index No.: EF000882-2019
OLUWAFOLAK FERNANDEZ and
OLUKAYODE A. FERNANDEZ,
Defendants.
-------------- -----------------------X
Upon reading and filing the Petition of BARON FAISON Sr, parent and natural guardian
of the infant B. F. Jr., duly sworn on January 29, 2020, the Affirmanon of Sheila S. Rosenrauch,
Esq. dated February 20, 2020, the Affirmation of Dr. Amarjit Gill, dated November 13, 2019 and
the exhibits submitted herewitli, and the Infant having been examined by the Court, and it
appearing that the best interests of the infant will be served by compromising the action in the
amount of Five Thousand Dollars ($5,000.00);
Now, on the application of Sobo & Sobo, LLP, attorneys for the Plaintiffs, it ishereby
ORDERED, that BARON FAISON Sr, as parent and natural guardian of B. F. Jr., an infant
under the age of fourteen (14), be and is hereby authorized to enter into a compromise of B. F.
Jr.'s personal injury claim against the Defendants upon the within terms, and itis further
Filedin Orange County 02/25/2020 02:34:22 PM $45.00 Bk: 5134 Pg: 1654 Index: # EF000882-2019 Clerk: SW
ORDERED, that the claim brought on behalf of the infant B. F. Jr., against the
Defendants, OLUWAFOLAK FERNANDEZ and OLUKAYODE A. FERNANDEZ, be and the
same is hereby settled for the sum of Five Thousand Dollars ($5,000 00), and it isfurther
ORDERED, that the Defendants or their insurance carrier, Geico Insurance, pay the sum
of Five Thousand Dollars ($5,000.00), in full settlement of the Infant's claim against them as
follows;
attorneys'
1. $1,666.67 to Sobo & Sobo, LLP for fees;
2. $318.67 to Sobo & Sobo, LLP as reimbursement for expenses and disbursements;
and,
3. $3,015.16 to BARON FAISON SR., as parent and natural guardian of B.F Jr., for
the sole use and benefit of said infant, jointly with an officer of Hudson Valley Federal Credit
Union, tocated at 40 Lloyds Ln, Middletown, NY 10940, to be deposited pursuant to CPLR §
1206(c) in one or more insured savings accounts and/or high interest yield accounts such as an
certificate" market"
insurance "savings or an insured "money account, and/or in one or-more
insured or guaranteed United States treasury or municipal bills, notes or bonds, until the infant
reaches the age of eighteen (18) years, and itis further
ORDERED, that the aforesaid accounts shall be continuously rcnewed upon maturity at
the highest rate of interest available, except that the date of maturity shall not extend beyond the
infant's eighteenth birthday; and is in further
ORDERED, that said bank shall pay out of the infant's account(s) such sums as may
from time to time become due and payable for.Federal and New York 5tate income taxes, or any
other state or local income taxes for which the infant's account(s), including penalties or interest
thereon, in such sums as may be certified to the bank by a qualified tax preparer retained or
employed on behalf of the infant by the infant's parent and natural guardian, together with
reasonable fees for the preparation thereof,.upon presentation to the bank. of proper bills and
copies ofthe infant's incoine tax returns showing the balances due; and itis further
ORDERED, that except as provided herein, there shall be no right of withdrawal from
any of the aforesaid accounts, until the infant's eighteenth birthday, except upon further order of
the Court, which shall be certified by the Clerk of the Court; and it isfurther
ORDERED, that said bank shall, upon the infant's demand thereof, and without further
Court order, pay over to.BLF.Jr., when he reaches the age of eighteen (18), all monies held for his
benefit in his account upon presentation of proper proof of age to said bank; and it isfurther
ORDERED, that in the event the infant shall die before reaching the age of eighteen (18),
the balance of the monies held in his account shall be paid to his estate; and it isfurther
ORDERED, that the Plaintiff shall hold the Defendants, OLUWAFOLAK FERNANDEZ
and OLUKAYODE A.. FERNANDEZ, and their insurance carrier, Geico Insurance, harmless
front any liens;. and it is.further
ORDERED, that upon compliance with the tenns ofthe Order, BARON FAISON SR., as
parent and natural guardian, is hereby authorized and empowered to execute a General Release
and any other documents necessary to effectuate the settlement; and itis further
ORDERED, that the making and filing of a bond is hereby waived; and itis further
ORDERED, that the Guardian shall within thirty (30) days of the deposit of the money
due the infant herein, in the above designated bank, submit to the Clerk's office, Room
a copy of the Certification of Deposit issued by said bank.
ENTER:
Hon.
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF ORANGE
----------------------····----------------- ---- -----X
B.F., Jr.by his Father and Natural
Guardian BARON FAISON Sr. and
BARON FAISON Sr., Individually,
GUARDIAN'S PETITION
Plaintiffs, TO COMPROMISE
INFANT'S CLAIM
-against-
Index No.: EF000882-2019
OLUWAFOLAK FERNANDEZ and
OLUKAYODE A. FERNANDEZ,
Defendants.
___.._____________--
--------------X
Baron Faison, Sr., as Petitioner herein, alleges as follows:
1. I am the father and natural guardian of the infant B.F. Jr. We reside at 72
Mottntaindale 1, Greenfield Park, New York 12435.
2. B.F. Jr. was eight (8) years old at the time of the motor vehicle accident, having
been born in 2008.
3. This accident occurred on December 16, 2016, in a parking lot in the Town of
Wallkill, New York, at approxhñately 6:26pm. At that tiine, B.F. Jr. was a rear seat passêñger
seated in a child restraint in my vehicle when we were struck on the front bumper by a car that
backed out of a parking space and leftthe scene. A copy ofthe police report is annexed as Exhibit-
"1". The police later identified the owner and the driver of the other vehicle.
4. As a result of the accident, my son complained of injuries to his lower back. His
firsttreatment was on January 16, 2017, at Ellenville Regional Hospital. The diagnosis was low
back pain. His symptoms were noted to be very mild. He was discharged after one hour with the
diagnosis of sprain, back pain. A copy of thehospital records is annexed as Exhibit "2".
5. The next time my son was seen by a medical provider was.April 10, 2017 when he
was examined at ChiroCare Chiropractic, 201 Dolson Avenue, Middletown, New York. At that
time, he was cotnplaining of neck pain, mid-back pain and low back pain. He. underwent
treatment with the chiropractor consisting of sixteen visits from April 10,2017 until July 3, 2017.
"3"
A copy of the records and the patient ledger are aññéxed as Exhibit
6. He received no further treatment for his neck or back. He did not undergo any MRIs
or diagnostie testing.
7. Despite some records to the contrary, he was not treated at Orange Regional
Medical Center on the date of the accident. A copy of the response for records from ORMC is
annexed as Exhibit "4".
8. In compliance with CPLR 1208, I wish to advise the Court that my son did not
suffer a prolonged and/or perrsâñent disability as a result of the motor vehicle accident. He was
not employed at the time and did not sustain any wage loss. He did not miss any time from school
as a result of the accident. He is presently able to participate in the normal activities that he
enjoyed prior to the date of the accident, without restrictions or complaint.
9. B.F. Jr. does not suffer from any illness or disability. In my opinion as parent, he is
a normal, active, eleven (11) year old boy who has fully recovered from the injuries.he sustained
as a result of the motor vehicle accident of June 28, 2016.
10, Following the accident, I retained the Law Offices of Sobo & Sobo, LLP,. pursuant
to agreement, whereby the attorneys are to be paid 33.33% of any recovery and would be.fully
reimbursed for all expenses and disbursements incurred by the firm. A copy of the retainer
agreement is annexed as Exhibit "5".
11.. The defendants were insured by GEICO Insurance with policy limits of 100/300.
The Verification of Coverage page confirming the limits are annexed as Exhibit "6".
12. I have been advised attorneys that the Deferhtc have offered the sum of
by my
FIVE THOUSAND DOLLARS ($5,000) in full settlement of my child's claim against them. I
believe that the sani offered is the highest amount that the Defendants would pay under any
circumstances to settle this claim. I further believe that this settlement offer is fair and equitable
and should be accepted in the best interest of B.F. Jr. I agree to the settlement offer, subject to
the approval of the Court.
13. 1 respectfully waive any and all claims I may have or may have had for loss of
services. I believe that allthe medical bills were paid by New York Central Mutual through the
PIP (No Fault) coverage except for one visit to Ellenville Regional Hospital on January 16, 2017.
I4. There was an additional PIP lien of $28.68, that was waived by NYCM. A copy of
the PIP Ledger and the emails containing the waiver are annexed as Exhibit "7". The New York
State Medicaid program is asserting a lien for $221.09 which consists of a capitation payment to
MVP Health Plan for the month of January 2017 and covers the January 16, 2017 visit to
Ellenville Hospital. I am advised that my attorneys have asked Medicaid to waive the lien, but
that they have not done so. A copy of the correspondence with Medicaid, their response, the lien
and the payment ledger are armered as Exhibit "8".
15. I have reviewed and approved the expenses incurred by the law firm, which total
$318.17. A copy of the disbursement list is annexed as Exhibit "9". I respectfully request that a
total of $318.17 in expenses be awarded to our attorney.
attorneys'
16. I am advised that the fees are $1,666.67.
17. The final settlement to B.F. Jr., is as follows:
i
a. Total Recovery; $5,000
b. Minus Attorney's Fees $1,666.67
c. Minus Disbursements $318..67
d. Minus Medicaid Lien $221..09
e. Net Settlement $2,794.07
If the Medicaid lien is vacated the Net Settlement will be $3,015.16.
18. I respectfully .request that the total net settlement proceeds be paid to me as his father and
natural guardian together with an officer of Hudson Valley Federal Credit Union, located
at 40 Lloyds Ln, Middletown, NY 10940, to be deposited in a trust account to be held for
B.F. Jr's benefit, in an accountpaying the highest rate of interest available, subject to CPLR
§ .1206(c) and § 1210(d) and to the further Order of the Court.
19. I am not aware of any outstanding medical bills or any liens against the proceeds of my
son's settlement other than the Medicaid lien. I request that the court vacate
respectfully
the Medicaid lien in the interest of justice, insofar as my son is only receiving a small
settlement.
20. I agree to hold the defendants and their insurance carrier, GEICO insurance, harmless from
any claimant liens, known and unknown.
21. No otheractions or proceedings have been enmmenced on behalfof B.F.Jr. or on my behalf
as a result of my child's injuries other than the claims asserted in this proceeding.
22, I have no interest in any respect adverse to that of my child, nor have I become concerned
or interested herein at the request of the opposing. party, directly or indirectly. No previous
application to compromise this matter has been made to this or any other Court.
Dated: dgn A¶ , 2020
Middletown, New York
Baron Faison, Sr.
ROSENRAUCll
SHElLA S NEW YORK
STATE OF
PUBLfR 02RO5037990
NOTARY
Na
Registration
Rocyand County
in
Qualified ho
a
Expires
Commission
My
SUPREME COURT OF THE STATE OF NEW YORK
COUNTY OF ORANGE
___ __------- ---- -----------X
B.F., Jr. by his Father and Natural
Guardian BARON FAISON Sr. and
BARON FAISON Sr., Individually,
ATTORNEY
AFFIRMATION
Plaintiffs,
-against- Index No.: EF000882-2019
OLUWAFOLAK FERNANDEZ and
OLUKAYODE A. FERNANDEZ,
Defendants.
___--.....---________-......____- -- -----------------X
Sheila S. Rosenrauch, an attorney duly adinitted to practice law b.efore the Courts of New
York, affirms the following under the penalties or perjury and pursuant to CPLR §2106:
1. I am associated with the law firm of Sobo Bc Sobo, LLP, attorneys for the Phintiffs.
As such, I am fully familiar with this matter based on review of the legal filemajntained by this
office.
2. This affirmation is submitted in support of the application to compromise and settle
the infant Plaintiff's claims agains.t the natned defendants which claims arose out of a motor
vehicle accident that occurred on December 16, 2016, and resulted in injuries to the child.
3. This accident occurred on December 16, 2016, in a parking lot in the Town of
Wallkill, New York, at approximately 6t26pm. At that time, B.F. Jr.was a rear seat passenger
seated in a child restraint in his father's vehicle when they were struck on the fro.nt bumper by a
car that backed out of a parking space and leftthe scene. A copy of the police report is annexed as
Exhibit "I". The police later identified the owner and the driver of the other vehicle.
4. As a result of the accident, the child complained of injuries to his lower back. His
first treatment was on January 16, 2017, at Ellenville Regional Hospital. The diagnosis was low
back pain. His symptoms were noted to be very mild. He was discharged after one.hour with the
diagnosis of sprain, back pain. A copy of the hospital records is atmexed as Exhibit "2".
5. The next time the child was seen by a medical provider was April 10, 2017, when
he was examined at ChiroCare Chiropractic, 201 Dolson Avenue, Middletown, New fork. At that
time, he was complaining of neck pain, mid-back pain and low backpain. He underwent treatntent
with the chiropractor consisting of sixteen visits from Aprii 10, 2017 until July 3, 2017. A copy of
Exhibit"3"
the records and the patient ledger are annexed as
6. He received no further treatment for his neck or back. He did not undergo any MRIs
or diagnostic testing.
7. Despite some records indicating to the contrary, he was not treated at Orange
Regional Medical Center on the date of the accident. A copy of the response for records from
ORMC is annexed as Exhibit "4".
8. On September 23, 2019 the child was examined by his regular pediatrician, Dr.
Amarjit Gill, and he was found to be fully recovered from all injuries related to this incident. A
copy of Dr. Gill's affirmation and records is annexed as Exhibit "5".
9. The Plaintiff retained Sobo & Sobo LLP as counsel. A copy of the Retainer is
annexed as E3dtibit "6". A lawsuit was commenced on December 21, 2017. A copy of the
Summons and Verified Complaint is annexed as Exhibit "7". A Bill of Particulars, Responses to
Defendants'
demands and discovery demands were served on May 14, 2019, along with medical
records and provider authorizations. A copy is annexed as Exhibit "8". We also received and
defendants'
reviewed responses.
10. Before depositions were conducted, the matter was negotiated with Geico
Insurance. A final settlemcñt offer of Five Thousand Dollars ($5,000) was extended, which offer
was accepted by B.F.Jr's father, pending Court approval.
11. Given the minor impact, minima treatment and the infant's full recovery, the
amount offered of Five Thousand Dollars ($5,000) appears reasonable and sufficient and is the
highest amount that the Defendant's carrier would pay under any clroumstañces to settle this claim,
12. Sobo & Sobo LLP has expended Three Hundred Eighteen Dollars and Sixty Seven
cents ($318.67) on the infant's behalf, for which itis entitled to be reirnbursed.
13. Upon conformation and belief, all medical bills have been paid by New York
Central Mutual Insurance except for the January 16, 2017, visit to Ellenville Hospital, which was
paid hy Medicaid. There was an additional APIP lien of $28.68 that was waived by NYCM. A
copy of the PIP payment ledger and the email containing the waiver are annexed as Exhibit "9".
14.. The New York State Medicaid program is asserting a lien for $221.09, which
consists of a capitation paymcat to MVP Health Plan for the month of January 2017 and covers
the January 16, 2017 visit to Ellenville Hospital. Our office asked Medicaid to waive the lien, but
they have not done so. A copy of the correspondence with Medicaid, their response, the lien and
the paymeñt ledger are annexed as Exhibit "10''.
15. We respectfully request that the Court vacate the Medicaid lien in the interests of
justice.. We have served HMS with a copy of this petition. The affidavit of service is annexed as
Exhibit "11".
16. We are unaware of any unpaid reedled bills or any other liens.
17. H is respectfully requested that the Court approve the settlement as put faith in the
Petition and permit.Baron Faison Sr.,as parent and natural guardian, to sign a General Release and
any and all other documents required to effectuate the settlement.
18.. No prior application for this relief nor lien made in this or any other Court.
19. Wherefore itIs respectfully requested that the Court grant allrelief requested in the
written petition.
Dateds , 2020
febcoag
Middletown, New York
Respectfully,
$OBO & SOBO LL.P.
/Sheila S. Rosenrau h, Esq.
Attorneys for Plaintiff
One Dolson Avenue.
Middletown, New York 10940
(845) 343-7626
EX.HIBIT 1
Page i of 2 Paqer New York StateDepartment of MotorVehicles
Loca C des
POLICE ACCIDENT REPORT
WP-33051-16 1
MV-f04A (3/04) -
9HWP88 6 F7NGK O AMENDED REPORT
AccidentDate Day of Week No. of
Military Time No.InjuredNo. K ledNot IryéEg-t-.4 at Scene Left Scene Police Photos
Month Day Year Vehides
12 16 2016 Friday 18:26 2 1 O AccidentReconstructed Oves 2No 20
VEHICLE 1 VEHICLE 2 ]BICYCLIST OPEDESTRIAN OTHER PEDESTRIAN
VEHICLE1 - brIver State of Llc.VEHICLE2 - Driver State of Llc.
ucense ID Number 512985219 NY UcenseID Number
FAISON, BARON nNad n li LSA
Address(Indude 19urnberand Street) Apt. No. Address(Indude Number and Street) Apt. No.
PO BOX 92
OVor Town State Zip Cod City or Town State Zip Code 22
-
WHITE LAKE NY 127860000
1 Dateof Birth Sex Unlicensed No. of Occupants PublicDateof Birth Sex Uniloensed No.of Occupants Pubile
Day Year PropertY Month Day tear Property
M 02 Damaged U 02 mmaged 23
5
Name- on registration Sex Dateof Birth Name - exaçtly as printed on registration
Sex. Dateof Birth
Month Day Year Month Day Year
4 FAISON, BARON M LSA U
ss (Indude Numberand Street) Apt No Haz. Released Address(Include Nurnberand Street) Apt. No Haz. | Released
[-
-
72 MOUNTAIN DALE 1 | O
Cty or Town State. Zip Code City or Town State Zip Code
s GREENFIELD PAR NY 12435
1 Stateof Reg.. ehicleYear & FlakeehRleType Ins. Code PlateNumber
PlateNumbef tate of Reg. Vehide.Year8t MakeVehicleType Inst Code
HDH7608 NY 2002 MAZD 4DSD 071 UNKNOWN 000
Tidset/Arrest Tid(et/Arrest 1
Numbers(s)
1 Violation Violation
Sectionfo Sectinn(s)
Checkif involvedvehide is: Check.ifinvolvedvehide is: Circlethe diagram belowthat describerthe ãccident,or drawyour own
morethan 95 ini±es wide; more than 95 incheswide; diagramIn space#9. Numberthe vehicles.
V morethan 34 feet long; V alore than 34 feet long; RearEnd Left Turn HeadOn
Right Angle Righl;Turn 15
operateclwith.an exchaiubt
permit; 4-+
operated with an.overweight permit; -+ 4=
I operatedv/lth an overdimensiongermjt.operated with an overdimensionpermlt. 1. 7. 5. 7.
CI VEHICLE1 DAMAGECODES C VEHICLE2 DAMAGECODES Sideswipe 1.eftTurn =+ RightTurnSideswipe
L Box.1- Pointof Impact 1 2 L Boz 1 - Point of Impact 1 2 (same rection)4.- +• (apposandirection)2
E Bok2 -Most Darnage 1 1 E Box 2-Most Damage
Enter up to three 4 S Enter up to three 3 4 5
2 DIAG
A1CCIDENT M
more damagecodes more darnage codes_
ed To: d To See the lastpage Of MV-104A forthe acciclent
4 6 diagram.
VEHIO.EDAMAGECODING: 3
1-13SEEDIAGRAMCN RIGHT. 9.
2 13
14. UNDERCARRIAGE17. DEMOLISHED Costof repairs to any one vehide will be more than $1,000.
15. TRAILER 18. NO DAMAGE I 9 Unknown/0nableto deterfnine Yes No
16. OVERTURNED 19. OTHER 12 11 10
Coordinates(If Where
Plars
available) AccidentOrrnrred: 29
ReferenceMarkel' County .Orange City Village Town of WALLKILL -
Roadon which accidentoccurred .Pa.mGhG LOT 470 ROUTE 211 E
(RouteNumberor Street.Namej
at nIntersecNndstreer
Longitude/Easting: (RouteNumberor StreetName)
or 2) N 2S
500 of EXIT 120 E ON.RAMP
feet miles E W (Mileoost,Nearestintersectina Route Numberor Street Name)
AccidentDescription/Offter's notes
OPERATOROF VERICLE 1 STATES. THAT WHILE OPERATING 5/B IN THE PARKING 10T OF WALMART,-VEHICLE 2 BACKED.-0.UT OF A
PARKING SPACE AND STRUCKVEHICLE 1 ON THE PRONT BUMPER OPERATOROF VEHICLE 1 FURTHER STATED THAT VERICLE 2 THEN
LEFT THE 5CENE OF THE ACCIDENT VEEICLE 2 IEFT SCENE OF ACCIDENT. OPERATOROF VEHICLE 1 TRAN$PORTEDTO ÔBMCBY
TOWVAC193 .
11 O G 14 15 17 RV TO in Namecnf a9 Involverl Datp:-rfThath Only
A A 1 1 4 1 47 1 6 12 6 10866EV 3503 FAISON, BARON
B 1 6 5 1 1 - - - BM F
c
Qmcer'sRank NCICNo.
Badoa/fd No. Precinct/Posttat:cn/Ucat g Officer Date/TimeReviewed
E and Sionature Fo Troop/Zone Sector
ASHWORTH, 1/6/2017
a mig D WARD 71 03578 88 4 3ULIA 19:42
00000001 LastMod: 1/6/2017 7:42 PM ht e //=au.crashiogic;com
Page 2. of 2 Pages New York 5tateDepartment of MotorVehtcles
Ilocal
Cddes POLICE ACCIDENT REPORT
WP-35051-16
MV-104A (3/04)
9HWP886F7NGK D AMENDED REPORT
Acddent Date Day of Week Military Time
(Aof No. Injured
No. IGiled
Not Irwestigated
at Scene Left scene
Police Photos
Month Day Year les
12 16 2016 Friday 18:26 2 1 0 AccidentReconstructed Yes 2 No
470ROUTE2t1EAST
WALMART
Officer'sRank Badae/Id No.
NCC No. lyecinct/Post
Station/BeatReviewinaOfficer Date/nme Reviewed
anrl Siormhire ·
PO Troop/Zone Sector
ASHWORTH, 1/6/ 2017
ÃŽnÃŽn D WARD 71 03578 88 4 JULIA 19:42
00000001 LastMod: 1]6[2017 7:42 PM https://WWW.Crashlogic.com
PEr m½MSICYCUSTIOTHER PFDESTRiAN LOCATIO†l APPARENT CONTRIBUTENGFACTORS
L PedestriarvBrcyclistfotberPadastrian at interseconHuman Vehicufar
- 2 Pedestrian/8tycEstfolber
Pedestrian at
t$ol Intersection 2.Alcohol
Involvement Vehicl
4L AcceleratorDefedive 19
PEDESTRIANJBICYCUST) 1 BacidngUnsafs[y 42. Grakes Defective
OTHERPEDESTRIANACTION A Driver inattentfowDistractiorc
43-Hastaights
Defective
1/Crossing, With Signat B. Going tolFèorsStopped S. Driver Inexpedenoe' 44. O:her LightinoDefacts
2. Crossing.Aoalnst Slanal School Bus & Drugs (lllegaQ 45- OversizedVahlete
3. Crossing, Nõ Signal Marked
9, Getting OnfOff Vehicle 7. Fallure loYield Right-of-Way46, Steering Faibra V4Mde
Crosswalk Other Than School Bus 8- Fall Asleep 47. Tire Fallurefinadeqtiate
4. Crossing, No Signal es in
1 L WorkingRoadstay 9. FoBauingToo Cloself -
48. Tow Hitch Defecjive
Cosswalk 12. Playing In Roadway 10. fliness
, 49. Windshieki Inadequak
|
13, Other Actions in Roadway"
5. Ridin&Walking/SkatingAlong 11.
LostDonaclousness 50. DriveIdeswRunawayVehicts
HighwayWimTraffic t4. Notin Roadway (Indicate)'
, 12. Passenger Distractbn 61. Tinted Windows
e. RidlogWalking SlsatingAfoog 13. Passing ortune UsageImproper60_..Other VeWoular
HighwayAgainst Traffic 14. Pedestrian/B1cyclist/Other 21
L from
Emerging inFront
off gn gg
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BEhindParkedVehicle
TRAFFic coNTROL
15. PhyrJestchability
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1. None & RR Crossing Sign 13, Malnfenance 175rama Control Disregarded ' Inadequata
'9. RR Crossina
2. Traflic Signal WorteArse 18. Tumlag Impro
fly VeNde
g4. ObstructionfDebds.
. 3 Stop Sign Rashing Ug-bt 14 UE1y WortArea la Unsafe 8 65. Pavemc-MDeedive 2
10-
C Flashing Light RR CrossmgGafan 15. PolicafFne 20. Llmsfe_LaneChanging 66. Pavement SIlppery
. 5 Y1skiSign TL Stopped Bus-
School 2L FallguedfDrowey
Erragency GL hulders Defective
6. Officer/Guard Red taghts Flashin9
16. SchootZons 21 Cell Phone hand41ekÛ improper
7. No Passhg 11 Constructiort GOLOther 21 Ce11Phone hands-fame) 68. TradieControl
Device
7_one Work Aree 24. Olber Electronic Devlon" I o erJNon4Ycddag V8MCld
21 Outside Car Distradion' ag. vio bbstructed/Umwed
UChiT M 11"W$ New York State 21 ReactioninUninvohd Vehide 1
L Davnght 27...Failureto Keep RMht DIRECTION
2- n Department of Motor Vehicles sa Apive WRoad OF
Reg .
POUCE ACCtDENT REPORT
pÊad up
5. Dark-RoadUnlIghted