Complaint,Petition: xxxxxx J . xxxxxxxx vs. DRAEGER'S SUPER MARKETS, et al

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                                PLD·PI-001
       ATTORNF.Y OR PARTY WITHOUT ATTORNEY (Namo, Stnro Bsr number, and acfdross):                                   FOR COURT USE ONLY
     1-M.ichae.l    B.   Ni s hiyama ,     Esq .     SBN    077 588
       LAW    OFFICE     OF   MICHAEL      B.   NISHIYAMA
       39510     Paseo     Padre     Parkway      #300
       Fre mont,      CA   94538

              TELEPHONENO: ( 6 50 ) 8 6 8- 7 0 9 0    FAX NO. (Optional):
      E·MAILADDRESS(Optionai.J: mikenishiyamaSF@gmail . com
        ATIORNEYFORfNam&J: Plaintiff       xxxxxx      J.   xxxxxxxx
      SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN           MATEO
            STREETADORESS: 400   County      Center
            MAILING ADDRESS:
           CITYANDZIPcooe: Redwood      City ,    CA   9 4063
                                                                                                                    4/19/2021
               BRANCH NAME:
                PLAINTIFF: xxxxxx      J . xxxxxxxx


              DEFENDANT: DRAEGER 1 S        SUPER     MARKETS;      and


        W     DOES1 TO     10
       COMPLAINT-Personallnjury, Property Damage, Wrongful Death
           D     AMENDED (Number):
       Type (check all that apply):
        D     MOTOR VEHICLE                [J[l OTHER (specify):     PREMISES       L IABILITY
              0    Property Damage            D     Wrongful Death
              W    Personal Injury            D     Other Damages (specify):

        Jurisdiction (check all that apply):
         0     ACTION IS A LIMITED CIVIL CASE                                                             CASE NUMBER:
               Amount demanded         0     does not exceed $1 0,000
                                       0     exceeds $1 0,000, but does not exceed $25,000                    21-CIV-02230
         W     ACTION IS AN UNLIMITED CIVIL CASE (exceeds $25,000)
         0     ACTION IS RECLASSIFIED by this amended complaint


        1.
              B      from limited to unlimited
                     from unlimited to limited
            Plaintiff (name or names): xxxxxx     J .  xxxxxxxx

            alleges causes of action against defendant (name or names): DRAEGER 1 S        SUPER     MARKETS;       and   DOES     1  to   10
        2. This pleading, including attachments and exhibits, consists of the following number of pages:  four
        3.  Each plaintiff named above is a competent adult
            a. 0     except plaintiff (name):
               (1)  0     a corporation qualified to do business in California
               (2)  0     an unincorporated entity (describe):
               (3)  0     a public entity (describe):
               (4)  0     a minor  0      an adult
                    (a) 0     for whom a guardian or conservator of the estate or a guardian ad litem has been appointed
                    (b) 0     other (specify):
               (5)  0     other (specify):

            b. D      except plaintiff (name):
               (1) D      a corporation qualified to do business in California
               (2) 0      an unincorporated entity (describe):
               (3) 0      a public entity (describe):
               (4)  0     a minor      0      an adult
                     (a) 0    for whom a guardian or conservator of the estate or a guardian ad litem has been appointed
                     (b) 0    other (specify):
                (5) 0     other (specify):


             0     Information about additional plaintiffs who are not competent adults is shown in Attachment 3.
                                                                                                                                        Page 1 of 3
                                                                                                                          Code or Civil P1ocodure, § ~25.12
                                                                                                        soki§~s·
       Form Approved for Opllonal Use
        Judiclnl Council ot Cnlllornla
                                                   COMPLAINT-Personal Injury, Property
      PLO-PI·OO\ (Rev. January \. 20071                     Damage, Wrongful Death
                                                                                                           L