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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 end Adorass): TELEPHONE NO. DAVID R. DONADIO, ESQ, # 154436 415 = BRAYTON@ PURCELL ire | ) (415) 898-1555 ELECTRONICALLY US! ~ Novato, California 94948-6169 (415) 898-1247 FILED ATTORNEY FOR (was): Plaintiff(s) Superior Court of California, County of San Francisco SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO srarerappress) 400 McAllister Street NOV 03 2010 MAILING ADDRESS lerk of the Court crv aaroine San Francisco 94102 ease pepuly Clerk PLAINTIFF: LAURANCE HAGEN DEFENDANT: CROWN CORK & SEAL COMPANY, INC., et al. STATEMENT OF DAMAGES SENET (Personal Injury or Wrongful Death) CGC-10-275582 To (name of one defendant only): SF L, INC. Plaintiff (name of one plaintiff only); LAURANCE HAGEN seeks damages in the above-entitled action, as follows: 1. General damages ‘ AMOUNT a B pain, suffering, and inconvenience 2.0.0.0... cece cece cece eevee eee eee eee $ __ 250,000.00 pb. J Emotional distress $ ____ 50,000.00 ce. © Loss of consortium $ d Oo Loss of society and companionship(wrongful death actions orily) 6. ee $ e O other (SPECI) crt cee teen tnt e enter etd r net eten rues $ « 11 other (specityy $ g. o Continued on Attachment 1.9. 2. Special damages a. Bl medical expenses (to date) 0.0 eee een ee $ ] 00 b. fw Future medical expenses (present value)... 2... teen eee $ $0,000.00 Cc. Oo Loss of earnings (fo date) 6... eee tees $ d. Oo Loss of future earning capacity (present value)... 6. eee § e O Propertydamage 0. crete ee eevee nee n centres $ f. Oo Funerat expenses (wrongful death actions only) ..0. 000 eee $ g. Oo Future contributions (present value) (wrongful death actions only)... 2.620 eee $ h. oO Value of personal service, advice, or training (wrongful death actions only)... 6... ee $n i BL other (specify) LOSS OF HOUSEHOLD SERVICES 20s $___ 50,000.00 j DD Other (specify) occ b bbe teens $ x. [1 Continued on Attachment 2.k. » 3 BD 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. Pate: OCT 1 2.2010 David R. Donadio r Che Oe (TYPE OR PRINT NAME) {SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF) (Proof of service on reverse) ‘ Form Adapted for Mandatory Use STATEMENT OF DAMAGES Code of Civit Procedure, $§ 426.11, 425.115 ciRDEO Rav tanuny 1 2007) (Personal Injury or Wrongful Death) wroncournf ca gov LexisNexis® Automated California Judicial Council Forms