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  • LAURANCE HAGEN VS. ASSOCIATED INSULATION OF CALIFORNIA ASBESTOS document preview
  • LAURANCE HAGEN VS. ASSOCIATED INSULATION OF CALIFORNIA ASBESTOS document preview
						
                                

Preview

ClV-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, ESQ. (Bar # 154436) (415) 898-1555 BRAY TON@PURCELL. LD 415) eek 17 ELECTRONICALLY ush Landing Ro: 5 Novato, California 94948-6169 FILED ATTORNEY FOR (same): Plaintiff(s) Superior Court of California, SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO County of San Francisco smusxasouss: 400 McAllister Street OCT 14 2010 MAILING ADDRESS: Clerk of the Court city anpzipcope. San Francisco 94102 BY: EDNALEEN JAVIER BRANCH NAME: Deputy Clerk PLAINTIFF: LAURANCE HAGEN DEFENDANT: CROWN CORK & SEAL COMPANY, INC., et al. STATEMENT OF DAMAGES oaenes (Personal Injury or Wrongful Death) CGC-10-275582 To (name of one defendant only): BARNES CONSTRUCTION CO. Plaintiff (name of one plaintiff only): LAURANCE HAGEN seeks damages in the above-entitled action, as follows: 1. General damages AMOUNT a Ww Pain, suffering, and inconvenience 2.0.2... 00.2 c eee eee eee eee $ __250.000.00 b, PS Emotional distess 2.00.00 e eect eerste ete rtenee erence ened $___ 50,000.00 ce. DF Lossofconsortium 6.6... cece ceed eee e ee ee bette ne ete debate bn ea nies $ d. oO Loss of society and companionship(wrangful death actions only) $ e. O other (SPECI) ccc cence nee eee e tee tented tebe nee n en eebnene $ £ DD other (specify) oe eee cence ee beeen tne e bene e terete ees a $ g. oO Continued on Attachment 1.g. 2. Special damages a. I Medical expenses (to date) 6... cece eee eee ener nee etna $ 10.000.00 b, BX Future medical expenses (present value)... 0.00. cc cece c cee eevecevateueeeveeevene $ 50,000.00 c. C1 Loss of earings (to date) oo... ccc ccc eds cee eg veeevueeveeevatteeeeerenniees $ d oO Loss of future eaming capacity (present value) 0.0. cece renee $ e, oO Property damage $ f. oO Funeral expenses (wrongful death actions only) .. . $ g. oO Future contributions (present value) (wrongful death actions only) $ h Oo Value of personal service, advice, or training (wrongful death actions only) ...... 0.6 eee $ i BX other (specify) LOSS OF HOUSEHOLD SERVICES $ 50,000.00 j D2 other (specify) $ «. [1 Continued on attachment 2k. 3. © punitive damages: Plaintiff reserves the right to seek punitive damages in the amount of (specify)... ... $ _2,500,000.00 when pursuing a judgment in the suit filed against you. Date: OCT 1 2 2010 David R. Donadio > Ohne i (Ye (TYPE OR PRINT NAME) (SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF} . (Proof of service an reverse) Form Adopted for Mandatory Usa : STATEMENT OF DAMAGES Coda of Civil Procedure, §§ 225.14, 426.115 “uaa Counell of Cmtra civ580 [Rev January. 2007) (Personal Injury or Wrongful Death) ‘www.courtinio.ca.gov. LexisNexis® Automated California Judicial Council Forms