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  • PAUL VAN DEGRIFT VS. ASBESTOS DEFENDANTS (BP) AS REFLECTED ON EXHIBITS et al ASBESTOS document preview
  • PAUL VAN DEGRIFT VS. ASBESTOS DEFENDANTS (BP) AS REFLECTED ON EXHIBITS et al ASBESTOS document preview 
						
                                
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                                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
BRAYTONS PURCELL LLP 415) aie "0, 7 ELECTRONICALLY
US! nding Koa -124
Novato, California, 94948-6169 ( FILED
ATTORNEY FOR (mame) Plaintiff(s) Superior Court of California,
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN FRANCISCO County of San Francisco
street aporess; 400 McAllister Street , FEB 18 2010
MAILING ADDRESS: Clerk of the Court
civ anpzecoor: San Francisco 94102 By: RAYMUNDA MABAET
BRANCH NAME Deputy Clerk
PLAINTIFF: PAUL VAN DEGRIFT
DEFENDANT: ASBESTOS DEFENDANTS (B“P)
CASE NUMBER:
STATEMENT OF DAMAGES 6GC-07-275076
(Personal Injury or Wrengful Death)

To (name of one defendant only): COLTEC INDUSTRIES, INC.

Plaintiff (name of one plaintiff only): PAUL VAN DEGRIFT
seeks damages in the above-entitled action, as follows:

1. General damages AMOUNT
a Pain, suffering, and inconvenience 0.0... cece eee eee eee e een n eee $ _ 250,000.00
b. BR emotional distress oo... cece se eceevesevesseesenseeucteuvetecetereeevetsess $ ___ 50,000.00
c oO Loss ofconsortium 2... ee nett tee e te ee $
d Oo Loss of society and companienship(wrongful death actions only) $
e OO otter (SPOGIY) cece eee $
f. Oo Other (specify) 2.0. te eee $
g. Oo Continued on Attachment 1.g.
2. Special damages
a, w Medical expenses (fo dale) 6. eee eee eee $ 10,000.00
b. & Future medical expenses (present value)........ Dec eee cece eee cee eeeeeeeeee $ 50,000.00
c. oO Loss of eamings (fo dafe) ..... 0.6... eee $
d. Oo Loss of future earning capacity (present value) $
e, QO Property damage .......... $
f QO Funeral expenses (wrongful death actions only) $
g. O Future contributions (present value) (wrongful death actions only) ©... 00.2. eee $
h. 0 Value of personal service, advice, or training (wrongful death actions only)... 6. eee $
i. Other (specify) LOSS OF HOUSEHOLD SERVICES 20.20.00... ccc cece eee e eee $ ___50,000,00
i Oo Other (specify) $
k, oO Continued on Atlachment 2.k.
3, x 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:
FEB 1 6 2010
David R Donadio > Or. gir,
{TYPE OR PRINT NAME) {SIGNATURE OF PLAINTIFF OR ATTORNEY FOR PLAINTIFF)
(Proof of service on reverse)
Form Adopt for Mandatory Ua STATEMENT OF DAMAGES Gode of Givi Procedure, 65 425.4: 426.118

GIV-050 Rev, January 1, 2007) (Personal Injury or Wrongful Death)

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