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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 fivame end Aduress): ‘TELEPHONE NO. DAVID R. DONADIO, ESQ Bar # 154436 415) 898-1555 BAe tan Ee ELECTRONICALLY ush Landing Roa - Novato, California 94948-6169 FILED ATTORNEY FOR (name: Plaintifi(s) Superior Court of California, SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO ocr: 14 2010 srrerrappeess. 400 McAllister Street - MAILING ADDRESS Clerk of the Court cityanp2e cone San Francisco 94102 BY: EDNALEEN SAVIN Clerk BRANCH NAME: epuly Cler! praintiFe, LAURANCE HAGEN DEFENDANT; CROWN CORK & SEAL COMPANY, INC., etal. STATEMENT OF DAMAGES oer a {Personal Injury or Wrongful Death) CGC-10-275582 To (name of one defendant only): FOLEY-PML, INC. Piaintiff (name of one plaintiff only}: LAURANCE HAGEN seeks damages in the above-entitled action, as follows: 4. General damages AMOUNT a & Pain, suffering, and inconvenience . Lecce bees . .. $__ 250,000.00 pb. Bl emotional distress 2.0 c eee de eee euteseeeceerenenes $ __ 50,000.00 ce. CD Loss ofconsortium o.oo e cei c cette tebe e nett b tne eben es $ d, a Loss of society and companionship(wrongful death actions only) 6... 6. eee es $ e. C1 other (specify) ooo. occ cece ccc ccc eves teveeeucseuvereurteeveecveeevees $ t ED other (specify) 00. coco eve ccc ce eececveeeueeeverevtecvttevereevecevees §$ g. 0 Continued on Attachment 1.9. 2. Special damages a Medical expenses (fo date) ene ene ben tener eben ene $ 19,000.00 p. BS Future medical expenses {present vaiue) $ 50,000.00 c. o Loss of earnings (to date) $ da. C1 toss of future earning capacity (present value} $ e. 0 Property damage eee ee eee eee ene ene $ f. o Funeral expenses {wrongful death actions ory} . . feet n eter rere eee eee ee eee $ g. Oo Future contributions (present value) (wrongful death actions only) ©... 0... Levene eens $ A o Value of personal service, advice, or training (wrongful death actions only)... 0... 02. see $ i Botner {specify) LOSS OF HOUSEHOLD SERVICES $ 50,000.00 3 OF other (speciyy $ x. (1 Continued on Attachment 2k. 3. Bl 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: OCT1 2200 David R. Donadio Che Ri 2, {TYPE OR PRINT NAME) (SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF) (Proof of service on reverse) Form Adopted for Mandatory Use . . STATEMENT OF DAMAGES Code of Civil Procedure, a SS as ae a caaecenaceraa (Personal Injury or Wrongful Death) wee coustinis 68.gov LexisNexis® Automated California Judicial Council Forms