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  • Gonzalez, Christopher vs. Colon, Jose et al Motor Vehicle Negligence - Personal Injury / Property Damage document preview
  • Gonzalez, Christopher vs. Colon, Jose et al Motor Vehicle Negligence - Personal Injury / Property Damage document preview
						
                                

Preview

Za DOCKET NUMBER Trial Court of Massachusetts = CIVIL ACTION COVER SHEET Qo 4 Hb Th - e Superior Court PLAINTIFF(S): Christopher Gonzalez COUNTY Worcester ADDRESS: 7 Cotting Street, Medford, MA 02155 DEFENDANT(S): Jose Colon Tufis University ATTORNEY: H. Luke Mitcheson ADDRESS: 1 State Street, Suite 1050, Boston, Massachusetts 02109 ADDRESS: 449 Boston Avenue, Medford MA 02155 Tufts University Medford, MA 02155 BBO: 876386 TYPE OF ACTION AND TRACK DESIGNATION (see reverse side) CODE NO. TYPE OF ACTION (specify) TRACK HAS A JURY CLAIM BEEN MADE? BO3 Motor Vehicle Negligence-Personal Injury F oO NO. “If "Other" please describe: STATEMENT OF DAMAGES PURSUANT TO GL. c, 212, § 3A. [The following is a full, itemized and detailed statement of the facts on which the undersigned plaintiff or plaintiff counsel relies to determine money damages. For this form, disregard double or treble damage claims; indicate single damages only. ‘ORT CLAIMS (attach additional sheets as necessary) |A. Documented medical expenses to date: 4. Total hospital expenses 2. Total doctor expenses .. 3. Total chiropractic expenses 4. Total physical therapy expenses 5. Total other expenses (describe below) .. B. Documented lost wages and compensation to date IC. Documented property damages to dated D. Reasonably anticipated future medical and hospital expenses . E. Reasonably anticipated lost wages .. IF. Other documented items of damages (describe below] PARAAA BHRBAA IG. Briefly describe plaintif’'s injury, including the nature and extent of injury: Fractured Spine : TOTAL (A-F):$ — >$50,000 CONTRACT CLAIMS (attach additional sheets as necessary) Provide a detailed description of claims(s): TOTAL: $ Signature of Attorney/Pro Se Plaintiff: X lyfe Date: af: 3 / 20 IRELATED ACTIONS: Please provide the w/a Via name, ang/county of any related actions pending in the Superior Court. * CERTIFICATION PURSUANT TO SJC RULE 1:18 || hereby certify that | have complied with requirements of Rule 5 of the Supreme Judicial Court Uniform Rules on Dispute Resolution (SJC Rule 1:18) requiring that | provide my clients with information about court-connected [dispute resolution services and discuss with them the ladvantages and disadvantages of the As of disp CN. Signature of Attorney of Record: X Date: 2f a Jf 20)