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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

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, ESQ. (Bar # 154436) (415) 898-1555 BRAYTON@PURCELL te ats) a7 ELECTRONICALLY ush Landing Roa ~ Novato, California 94948-6169 FILED ATTORNEY FOR (name): Plaintiff(s) Superior Court of California, if Fr is SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO ocr 14 2010 street appress: 400 McAllister Street MATLING ADDRESS Clerk of the Court crv anparcovs: San Francisco 94102 BY: EDNALEEN JAVIER eputy Clerk BRANCH NAME: PLAINTIFF: LAURANCE HAGEN DEFENDANT: CROWN CORK & SEAL COMPANY, INC., et al. STATEMENT OF DAMAGES CSE NENAER: (Personal Injury or Wrongful Death) CGC-10-275582 To (name of one defendant only): ALADDIN HEATING CORPORATION Plaintiff (name of one plaintiff only); LAURANCE HAGEN seeks damages in the above-entitled action, as follows: 1. General damages AMOUNT a Pain, suffering, and inconvenience ................. ened eee eee $_ 250,000.00 b. BL Emotional distress 0006.5 ee eee $___50.000.00 c. LD Loss ofconsortium 60.0. e bebe tenes $ d oO Loss of society and campanionship(wrongful death actions only) oo. eee $ e 11 other (speci) 8 t 1 otner (specity $ g. o Continued on Attachment 1.9. 2. Special damages a. Bl Medical expenses (to date) $ 10,000.00 b. & Future medical expenses (present value) ............. $ 50,000.00 c [1 Loss of earings (fo date)... cence vette eens $ d. oO Loss of future earning capacity (present value)... 66 ee es $ e O Propertydamage .............- bec e eee ee beeees $ t 1 Funeral expenses (wrongful death actions only) . . . $ g. QO Future contributions (present value) (wrongful death actions only) «6.6.0. eee $ h. O Value of personal service, advice, or training (wrongful death actions only)... 00.0. eee $ i Bl other (specityy LOSS OF HOUSEHOLD SERVICES 2.2.0.0... 0. ccc cece cece $ 50.000.00 L 1 other (Specity) ccc teeter tee eens -... $ k. O Continued on Attachment 2.k. 3. & punitive damages: Plaintiff reserves the right fo seek punitive damages in the amount of (specify) ...... § 2.500.000.0060 when pursuing a judgment in the suit filed against you. Date: OCT 2.2010 Orne Dayid R. Donadio > i G2 {TYPE OR PRINT NAME) {SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF) (Proof of service on reverse) Form Adaptad for Mandatory Use STATEMENT OF DAMAGES Code of Civit Procedure, §§ 425.11, 425.115 Judicial Council of California. ‘www.courtinto.ca.gov CIV-050 [Rae, January 1, 2007] (Personal Injury or Wrongful Death) ‘LexisNexis® Automated California Judicial Council Farms