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DISC-001 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, State Bar number, and address): FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): SUPERIOR COURT OF CALIFORNIA, COUNTY OF SHORT TITLE OF CASE: CASE NUMBER: FORM INTERROGATORIES—GENERAL Asking Party: Answering Party: Set No.: (c) Each answer must be as complete and straightforward as the information reasonably available to you, including the information possessed by your atto rneys or agents, permits. If an interrogatory cannot be answered completely, answer it to the extent possible. Sec. 1. Instructions to All Parties (a) Interrogatories are written questions prepared by a party to an action that are sent to any other party in the action to be answered under oath. The interrogatories below are form interrogatories approved for use in civil cases. (b) For time limitations, requirements for service on other parties, and other details, see Code of Civil Procedure sections 2030.010–2030.410 and t he cases construing those sections. (d) If you do not have enough personal knowledge to fully answer an interrogatory, say so, but make a reasonable and good faith effort to get the info rmation by asking other persons or organizations, unless the information is equally available to the asking party. (c) These form interrogatories do not change existing law relating to interrogatories nor do they affect an answering party’s right to assert any pr ivilege or make any objection. (e) Whenever an interrogatory may be answered by referring to a document, the document may be attached as an exhibit to the response and referred to in the response. If the document has more than one page, refer to the page and section where the answer to the interrogatory can be found. Sec. 2. Instructions to the Asking Party (a) These interrogatories are designed for optional use by parties in unlimited civil ca ses where the amount demanded exceeds $25,000. Separate interrogatories, Form Interrogatories—Limited Civil Cases (Economic Litigation) (form DISC-004), which have no subparts, are designed for use in limited civil cases w here the amount demanded is $25,000 or less; however, those interrogatories may also be used in unlimited civil cases. (f) Whenever an address and telephone number for the same person are requested in more than one interrogatory, you are required to furnish them in answering only the first interrogatory asking for that information. (g) If you are asserting a privilege or making an objection to an interrogatory, you must specif ically assert the privilege or state the objection in your written response. (b) Check the box next to each interrogatory that you want the answering party to answer. Use care in choosing those interrogatories that are applicable to the case. (h) Your answers to these in terrogatories must be verified, dated, and signed. You may wish to use the following form at the end of your answers: (c) You may insert your own definition of INCIDENT in Section 4, but only where the ac tion arises from a course of conduct or a series of events oc curring over a period of time. I declare under penalty of perjury under the laws of the State of California that the foregoing answers are true and correct. (d) The interrogatories in section 16.0, Defendant’s Contentions–Personal Injury, should not be used until the defendant has had a reasonable opportunity to conduct an investigation or discovery of plaintiff’s injuries and damages. (DATE) (SIGNATURE) (e) Additional interrogatories may be attached. Sec. 4. Definitions Sec. 3. Instructions to the Answering Party Words in BOLDFACE CAPITALS in these interrogatories (a) An answer or other appropriate response must be given to each interrogatory checked by the asking party. are defined as follows: (a) (Check one of the following): (b) As a general rule, within 30 days after you are served with these interrogatories, you must serve your responses on the asking party and serve copies of your responses on all other parties to the action w ho have appeared. See Code of Civil Procedure sections 2030.260–2030.270 for details. (1) INCIDENT includes the circumstances and events surrounding the alleged accident, injury, or other occurrence or breach of contract giving rise to this action or proceeding. Page 1 of 8 Code of Civil Procedure, §§ 2030.010-2030.410, 2033.710 Form Approved for Optional Use Judicial Council of California DISC-001 [Rev. January 1, 2008] FORM INTERROGATORIES—GENERAL TELEPHONE NO.: 1.0 Identity of Persons Answering These Interrogatories (2) INCIDENT means (insert your definition here or on a separate, attached sheet labeled “Sec. 4(a)(2)”): 1.1 State the name, ADDRESS, telephone number, and relationship to you of each PERSON who prepared or assisted in the preparation of the responses to these interrogatories. (Do not identify anyone who simply typed or reproduced the responses.) 2.0 General Background Information—individual (b) YOU OR ANYONE ACTING ON YOUR BEHALF includes you, your agents, your employees, your insurance companies, their agents, their employees, your attorneys, your accountants, your investigators, and anyone else acting on your behalf. 2.1 State: (a) your name; (b) every name you have used in the past; and (c) the dates you used each name. 2.2 State the date and place of your birth. (c) PERSON includes a natural person, firm, association, organization, partnership, business, trust, limited liability company, corporation, or public entity. 2.3 At the time of the INCIDENT, did you have a driver's license? If so state: (a) the state or other issuing entity; (b) the license number and type; (c) the date of issuance; and (d) all restrictions. (d) DOCUMENT means a writing, as defined in Evidence Code section 250, and includes the original or a copy of handwriting, typewriting, printing, photostats, photographs, electronically stored information, and every other means of recording upon any tangible thing and form of communicating or representation, including letters, words, pictures, sounds, or symbols, or combinations of them. 2.4 At the time of the INCIDENT, did you have any other permit or license for the operation of a motor vehicle? If so, state: (e) HEALTH CARE PROVIDER includes any PERSON referred to in Code of Civil Procedure section 667.7(e)(3).(a) the state or other issuing entity; (b) the license number and type; (c) the date of issuance; and (d) all restrictions. (f) ADDRESS means the street address, including the city, state, and zip code. 2.5 State: Sec. 5. Interrogatories (a) your present residence ADDRESS; (b) your residence ADDRESSES for the past five years; and (c) the dates you lived at each ADDRESS. The following interrogatories have been approved by the Judicial Council under Code of Civil Procedure section 2033.710: CONTENTS 2.6 State: (a) the name, ADDRESS, and telephone number of your present employer or place of self-employment; and 1.0 Identity of Persons Answering These Interrogatories 2.0 General Background Information—Individual 3.0 General Background Information—Business Entity 4.0 Insurance 5.0 [Reserved] 6.0 Physical, Mental, or Emotional Injuries 7.0 Property Damage 8.0 Loss of Income or Earning Capacity 9.0 Other Damages(b) the name, ADDRESS, dates of employment, job title, and nature of work for each employer or self-employment you have had from five years before the INCIDENT until today. 2.7 State: 10.0 Medical History 11.0 Other Claims and Previous Claims 12.0 Investigation—General 13.0 Investigation—Surveillance 14.0 Statutory or Regulatory Violations 15.0 Denials and Special or Affirmative Defenses 16.0 Defendant’s Contentions Personal Injury 17.0 Responses to Request for Admissions 18.0 [Reserved] 19.0 [Reserved] 20.0 How the Incident Occurred—Motor Vehicle 25.0 [Reserved] 30.0 [Reserved] 40.0 [Reserved] 50.0 Contract 60.0 [Reserved](b) the dates you attended; (c) the highest grade level you have completed; and (d) the degrees received. 2.10 Can you read and write English with ease? If not, what language and dialect do you normally use? 70.0 Unlawful Detainer [See separate form DISC-003] 101.0 Economic Litigation [See separate form DISC-004] 200.0 Employment Law [See separate form DISC-002] Family Law [See separate form FL-145] DISC-001 [Rev. January 1, 2008] FORM INTERROGATORIES—GENERAL Page 2 of 8 2.9 Can you speak English with ease? If not, what language and dialect do you normally use? (a) the name and ADDRESS of each school or other academic or vocational institution you have attended, beginning with high school; 2.8 Have you ever been convicted of a felony? If so, for each conviction state: (a) the city and state where you were convicted; (b) the date of conviction; (c) the offense; and (d) the court and case number. DISC-001 3.4 Are you a joint venture? If so, state: 2.11 At the time of the INCIDENT were you acting as an (a) the current joint venture name; agent or employee for any PERSON? If so, state: (b) all other names used by the joint venture during the (a) the name, ADDRESS, and telephone number of that PERSON: and past 10 years and the dates each was used; (c) the name and ADDRESS of each joint venturer; and (d) the ADDRESS of the principal place of business. (b) a description of your duties. 2.12 At the time of the INCIDENT did you or any other 3.5 Are you an unincorporated association? person have any physical, emotional, or mental disability or condition that may have contributed to the occurrence of the INCIDENT? If so, for each person state:If so, state: (a) the current unincorporated association name; (b) all other names used by the unincorporated association (a) the name, ADDRESS, and telephone number; (b) the nature of the disability or condition; and (c) the manner in which the disability or condition contributed to the occurrence of the INCIDENT.during the past 10 years and the dates each was used; and (c) the ADDRESS of the principal place of business. 3.6 Have you done business under a fictitious name during 2.13 Within 24 hours before the INCIDENT did you or any the past 10 years? If so, for each fictitious name state: person involved in the INCIDENT use or take any of the following substances: alcoholic beverage, marijuana, or other drug or medication of any kind (prescription or not)? If so, for each person state:(a) the name; (b) the dates each was used; (c) the state and county of each fictitious name filing; and (d) the ADDRESS of the principal place of business. (a) the name, ADDRESS, and telephone number; (b) the nature or description of each substance; (c) the quantity of each substance used or taken; 3.7 Within the past five years has any public entity regis- (d) the date and time of day when each substance was used tered or licensed your business? If so, for each license or registration: or taken; (e) the ADDRESS where each substance was used or (a) identify the license or registration; (b) state the name of the public entity; and (c) state the dates of issuance and expiration. taken; (f) the name, ADDRESS, and telephone number of each person who was present when each substance was used or taken; and 4.0 Insurance (g) the name, ADDRESS, and telephone number of any HEALTH CARE PROVIDER who prescribed or furnished the substance and the condition for which it was prescribed or furnished. 4.1 At the time of the INCIDENT, was there in effect any policy of insurance through which you were or might be insured in any manner (for example, primary, pro-rata, or excess liability coverage or medical expense coverage) for the damages, claims, or actions that have arisen out of the INCIDENT? If so, for each policy state: 3.0 General Background Information—Business Entity 3.1 Are you a corporation? If so, state: (a) the name stated in the current articles of incorporation; (a) the kind of coverage; (b) the name and ADDRESS of the insurance company; (b) all other names used by the corporation during the past 10 years and the dates each was used; (c) the name, ADDRESS, and telephone number of each (c) the date and place of incorporation; named insured; (d) the ADDRESS of the principal place of business; and (e) whether you are qualified to do business in California.(d) the policy number; (e) the limits of coverage for each type of coverage con- tained in the policy; 3.2 Are you a partnership? If so, state: (f) whether any reservation of rights or controversy or (a) the current partnership name; coverage dispute exists between you and the insurance company; and (b) all other names used by the partnership during the past 10 years and the dates each was used; (g) the name, ADDRESS, and telephone number of the custodian of the policy. (c) whether you are a limited partnership and, if so, under the laws of what jurisdiction; (d) the name and ADDRESS of each general partner; and (e) the ADDRESS of the principal place of business. 3.3 Are you a limited liability company? If so, state: 5.0 [Reserved] (a) the name stated in the current articles of organization; (b) all other names used by the company during the past 10 6.0 Physical, Mental, or Emotional Injuries years and the date each was used; (c) the date and place of filing of the articles of organization; (d) the ADDRESS of the principal place of business; and (e) whether you are qualified to do business in California. 6.2 Identify each injury you attribute to the INCIDENT and the area of your body affected. DISC-001 [Rev. January 1, 2008] FORM INTERROGATORIES—GENERAL Page 3 of 8 6.1 Do you attribute any physical, mental, or emotional injuries to the INCIDENT? (If your answer is “no,” do not answer interrogatories 6.2 through 6.7). 4.2 Are you self-insured under any statute for the damages, claims, or actions that have arisen out of the INCIDENT? If so, specify the statute. DISC-001 (c) state the amount of damage you are claiming for each 6.3 Do you still have any complaints that you attribute to the INCIDENT? If so, for each complaint state: item of property and how the amount was calculated; and (d) if the property was sold, state the name, ADDRESS, and (a) a description; (b) whether the complaint is subsiding, remaining the same, telephone number of the seller, the date of sale, and the sale price. or becoming worse; and (c) the frequency and duration. 6.4 Did you receive any consultation or examination (except from expert witnesses covered by Code of Civil Procedure sections 2034.210–2034.310) or treatment from a HEALTH CARE PROVIDER for any injury you attribute to the INCIDENT? If so, for each HEALTH CARE PROVIDER state:7.2 Has a written estimate or evaluation been made for any item of property referred to in your answer to the preceding interrogatory? If so, for each estimate or evaluation state: (a) the name, ADDRESS, and telephone number of the PERSON who prepared it and the date prepared; (b) the name, ADDRESS, and telephone number of each PERSON who has a copy of it; and (c) the amount of damage stated. (a) the name, ADDRESS, and telephone number; (b) the type of consultation, examination, or treatment provided; (c) the dates you received consultation, examination, or treatment; and 7.3 Has any item of property referred to in your answer to interrogatory 7.1 been repaired? If so, for each item state: (a) the date repaired; (b) a description of the repair; (d) the charges to date. (c) the repair cost; 6.5 Have you taken any medication, prescribed or not, as a result of injuries that you attribute to the INCIDENT? If so, for each medication state:(d) the name, ADDRESS, and telephone number of the PERSON who repaired it; (a) the name; (e) the name, ADDRESS, and telephone number of the PERSON who paid for the repair. (b) the PERSON who prescribed or furnished it; (c) the date it was prescribed or furnished; (d) the dates you began and stopped taking it; and (e) the cost to date.8.0 Loss of Income or Earning Capacity 8.1 Do you attribute any loss of income or earning capacity to the INCIDENT? (If your answer is “no,” do not answer interrogatories 8.2 through 8.8). 6.6 Are there any other medical services necessitated by the injuries that you attribute to the INCIDENT that were not previously listed (for example, ambulance, nursing, prosthetics)? If so, for each service state: (a) the nature; (b) the date; 8.2 State: (a) the nature of your work; (b) your job title at the time of the INCIDENT; and (c) the date your employment began. (c) the cost; and (d) the name, ADDRESS, and telephone number of each provider. 8.3 State the last date before the INCIDENT that you worked for compensation. 8.4 State your monthly income at the time of the INCIDENT and how the amount was calculated. 6.7 Has any HEALTH CARE PROVIDER advised that you may require future or additional treatment for any injuries that you attribute to the INCIDENT? If so, for each injury state: 8.5 State the date you returned to work at each place of employment following the INCIDENT. (b) the complaints for which the treatment was advised; and (c) the nature, duration, and estimated cost of the treatment. 8.6 State the dates you did not work and for which you lost income as a result of the INCIDENT. 7.0 Property Damage 8.7 State the total income you have lost to date as a result of the INCIDENT and how the amount was calculated. 7.1 Do you attribute any loss of or damage to a vehicle or other property to the INCIDENT? If so, for each item of property: 8.8 Will you lose income in the future as a result of the INCIDENT? If so, state: (a) the facts upon which you base this contention; (a) describe the property; (b) describe the nature and location of the damage to the property;(b) an estimate of the amount; (c) an estimate of how long you will be unable to work; and (d) how the claim for future income is calculated. DISC-001 [Rev. January 1, 2008] Page 4 of 8 FORM INTERROGATORIES—GENERAL (a) the name and ADDRESS of each HEALTH CARE PROVIDER; DISC-001 9.0 Other Damages (c) the court, names of the parties, and case number of any action filed; (d) the name, ADDRESS, and telephone number of any attorney representing you; (e) whether the claim or action has been resolved or is (b) the date it occurred; pending; and (c) the amount; and (f) a description of the injury. (d) the name, ADDRESS, and telephone number of each PERSON to whom an obligation was incurred. (a) the date, time, and place of the INCIDENT giving rise to 9.2 Do any DOCUMENTS support the existence or amount of any item of damages claimed in interrogatory 9.1? If so, describe each document and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT.the claim; (b) the name, ADDRESS, and telephone number of your employer at the time of the injury; (c) the name, ADDRESS, and telephone number of the workers’ compensation insurer and the claim number; 10.0 Medical History (d) the period of time during which you received workers’ compensation benefits; (e) a description of the injury; (f) the name, ADDRESS, and telephone number of any HEALTH CARE PROVIDER who provided services; and (g) the case number at the Workers’ Compensation Appeals Board. (a) a description of the complaint or injury; (b) the dates it began and ended; and (c) the name, ADDRESS, and telephone number of each 12.0 Investigation—General HEALTH CARE PROVIDER whom you consulted or who examined or treated you. 12.1 State the name, ADDRESS, and telephone number of each individual: (a) who witnessed the INCIDENT or the events occurring 10.2 List all physical, mental, and emotional disabilities you had immediately before the INCIDENT. (You may omit mental or emotional disabilities unless you attribute any mental or emotional injury to the INCIDENT.) immediately before or after the INCIDENT; (b) who made any statement at the scene of the INCIDENT; (c) who heard any statements made about the INCIDENT by any individual at the scene; and (d) who YOU OR ANYONE ACTING ON YOUR BEHALF claim has knowledge of the INCIDENT (except for expert witnesses covered by Code of Civil Procedure section 2034). (a) the date and the place it occurred; (b) the name, ADDRESS, and telephone number of any other PERSON involved;12.2 Have YOU OR ANYONE ACTING ON YOUR BEHALF interviewed any individual concerning the INCIDENT? If so, for each individual state: (c) the nature of any injuries you sustained; (d) the name, ADDRESS, and telephone number of each (a) the name, ADDRESS, and telephone number of the individual interviewed; (b) the date of the interview; and (e) the nature of the treatment and its duration. (c) the name, ADDRESS, and telephone number of the PERSON who conducted the interview. 11.0 Other Claims and Previous Claims (a) the date, time, and place and location (closest street (a) the name, ADDRESS, and telephone number of the individual from whom the statement was obtained; ADDRESS or intersection) of the INCIDENT giving rise to the action, claim, or demand; (b) the name, ADDRESS, and telephone number of the individual who obtained the statement; (b) the name, ADDRESS, and telephone number of each PERSON against whom the claim or demand was made or the action filed;(c) the date the statement was obtained; and (d) the name, ADDRESS, and telephone number of each PERSON who has the original statement or a copy. DISC-001 [Rev. January 1, 2008] Page 5 of 8 FORM INTERROGATORIES—GENERAL 10.1 At any time before the INCIDENT did you have com- plaints or injuries that involved the same part of your body claimed to have been injured in the INCIDENT? If so, for each state: 11.1 Except for this action, in the past 10 years have you filed an action or made a written claim or demand for compensation for your personal injuries? If so, for each action, claim, or demand state:HEALTH CARE PROVIDER who you consulted or who examined or treated you; and 12.3 Have YOU OR ANYONE ACTING ON YOUR BEHALF obtained a written or recorded statement from any individual concerning the INCIDENT? If so, for each statement state: 11.2 In the past 10 years have you made a written claim or demand for workers' compensation benefits? If so, for each claim or demand state: 10.3 At any time after the INCIDENT, did you sustain injuries of the kind for which you are now claiming damages? If so, for each incident giving rise to an injury state: 9.1 Are there any other damages that you attribute to the INCIDENT? If so, for each item of damage state: (a) the nature; DISC-001 13.2 Has a written report been prepared on the surveillance? If so, for each written report state: (a) the title; (b) the date; 12.4 Do YOU OR ANYONE ACTING ON YOUR BEHALF know of any photographs, films, or videotapes depicting any place, object, or individual concerning the INCIDENT or plaintiff's injuries? If so, state: (a) the number of photographs or feet of film or videotape; (b) the places, objects, or persons photographed, filmed, or videotaped;(d) the name, ADDRESS, and telephone number of each PERSON who has the original or a copy. (c) the date the photographs, films, or videotapes were taken; 14.0 Statutory or Regulatory Violations (d) the name, ADDRESS, and telephone number of the 14.1 Do YOU OR ANYONE ACTING ON YOUR BEHALF contend that any PERSON involved in the INCIDENT violated any statute, ordinance, or regulation and that the violation was a legal (proximate) cause of the INCIDENT? If so, identify the name, ADDRESS, and telephone number of each PERSON and the statute, ordinance, or regulation that was violated. (e) the name, ADDRESS, and telephone number of each PERSON who has the original or a copy of the photographs, films, or videotapes. 12.5 Do YOU OR ANYONE ACTING ON YOUR BEHALF know of any diagram, reproduction, or model of any place or thing (except for items developed by expert witnesses covered by Code of Civil Procedure sections 2034.210– 2034.310) concerning the INCIDENT? If so, for each item state: 14.2 Was any PERSON cited or charged with a violation of any statute, ordinance, or regulation as a result of this INCIDENT? If so, for each PERSON state: (a) the name, ADDRESS, and telephone number of the PERSON; (b) the statute, ordinance, or regulation allegedly violated; (c) whether the PERSON entered a plea in response to the (c) the name, ADDRESS, and telephone number of each PERSON who has it.citation or charge and, if so, the plea entered; and (d) the name and ADDRESS of the court or administrative agency, names of the parties, and case number. 12.6 Was a report made by any PERSON concerning the INCIDENT? If so, state: 15.0 Denials and Special or Affirmative Defenses (a) the name, title, identification number, and employer of the PERSON who made the report; 15.1 Identify each denial of a material allegation and each (b) the date and type of report made;special or affirmative defense in your pleadings and for each: (c) the name, ADDRESS, and telephone number of the PERSON for whom the report was made; and(a) state all facts upon which you base the denial or special (d) the name, ADDRESS, and telephone number of each PERSON who has the original or a copy of the report.or affirmative defense; (b) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of those facts; and (c) identify all DOCUMENTS and other tangible things that 12.7 Have YOU OR ANYONE ACTING ON YOUR BEHALF inspected the scene of the INCIDENT? If so, for each inspection state:support your denial or special or affirmative defense, and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT. (a) the name, ADDRESS, and telephone number of the individual making the inspection (except for expert witnesses covered by Code of Civil Procedure sections 2034.210–2034.310); and16.0 Defendant’s Contentions—Personal Injury (b) the date of the inspection. 13.0 Investigation—Surveillance (a) state the name, ADDRESS, and telephone number of the PERSON; 13.1 Have YOU OR ANYONE ACTING ON YOUR BEHALF conducted surveillance of any individual involved in the INCIDENT or any party to this action? If so, for each sur- veillance state:(b) state all facts upon which you base your contention; (c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and (a) the name, ADDRESS, and telephone number of the individual or party;(d) identify all DOCUMENTS and other tangible things that support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing. (b) the time, date, and place of the surveillance; (c) the name, ADDRESS, and telephone number of the individual who conducted the surveillance; and (d) the name, ADDRESS, and telephone number of each PERSON who has the original or a copy of any surveillance photograph, film, or videotape. (c) identify all DOCUMENTS and other tangible things that support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing. DISC-001 [Rev. January 1, 2008] Page 6 of 8 FORM INTERROGATORIES—GENERAL individual taking the photographs, films, or videotapes; and (a) the type (i.e., diagram, reproduction, or model); (b) the subject matter; and 16.2 Do you contend that plaintiff was not injured in the INCIDENT? If so: (a) state all facts upon which you base your contention; (b) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and 16.1 Do you contend that any PERSON, other than you or plaintiff, contributed to the occurrence of the INCIDENT or the injuries or damages claimed by plaintiff? If so, for each PERSON:(c) the name, ADDRESS, and telephone number of the individual who prepared the report; and DISC-001 16.8 Do you contend that any of the costs of repairing the property damage claimed by plaintiff in discovery proceedings thus far in this case were unreasonable? If so: (a) identify each cost item; (a) identify it; (b) state all facts upon which you base your contention; (c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and(b) state all facts upon which you base your contention; (c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and (d) identify all DOCUMENTS and other tangible things that (d) identify all DOCUMENTS and other tangible things that support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing. support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing. (a) identify each service; (b) state all facts upon which you base your contention; (c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and(a) the source of each DOCUMENT; (b) the date each claim arose; (c) the nature of each claim; and (d) the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT. (d) identify all DOCUMENTS and other tangible things that support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing. 16.10 Do YOU OR ANYONE ACTING ON YOUR BEHALF have any DOCUMENT concerning the past or present physical, mental, or emotional condition of any plaintiff in this case from a HEALTH CARE PROVIDER not previously identified (except for expert witnesses covered by Code of Civil Procedure sections 2034.210–2034.310)? If so, for each plaintiff state: (a) identify each cost; (a) the name, ADDRESS, and telephone number of each HEALTH CARE PROVIDER; (b) state all facts upon which you base your contention; (c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and(b) a description of each DOCUMENT; and (c) the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT. (d) identify all DOCUMENTS and other tangible things that support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing.17.0 Responses to Request for Admissions 17.1 Is your response to each request for admission served with these interrogatories an unqualified admission? If not, for each response that is not an unqualified admission: (a) state the number of the request; (b) state all facts upon which you base your response; (a) identify each part of the loss; (b) state all facts upon which you base your contention; (c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and(c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of those facts; and (d) identify all DOCUMENTS and other tangible things that support your response and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing. (d) identify all DOCUMENTS and other tangible things that support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing. 18.0 [Reserved] 19.0 [Reserved] 16.7 Do you contend that any of the property damage claimed by plaintiff in discovery Proceedings thus far in this case was not caused by the INCIDENT? If so: 20.0 How the Incident Occurred—Motor Vehicle (a) identify each item of property damage; 20.1 State the date, time, and place of the INCIDENT (b) state all facts upon which you base your contention; (c) state the names, ADDRESSES, and telephone numbers of all PERSONS who have knowledge of the facts; and(closest street ADDRESS or intersection). (d) identify all DOCUMENTS and other tangible things that20.2 For each vehicle involved in the INCIDENT, state: support your contention and state the name, ADDRESS, and telephone number of the PERSON who has each DOCUMENT or thing.(a) the year, make, model, and license number; (b) the name, ADDRESS, and telephone number of the driver; DISC-001 [Rev. January 1, 2008] Page 7 of 8 FORM INTERROGATORIES—GENERAL 16.3 Do you contend that the injuries or the extent of the injuries claimed by plaintiff as disclosed in discovery proceedings thus far in this case were not caused by the INCIDENT? If so, for each injury: 16.4 Do you contend that any of the services furnished by any HEALTH CARE PROVIDER claimed by plaintiff in discovery proceedings thus far in this case were not due to the INCIDENT? If so: 16.5 Do you contend that any of the costs of services furnished by any HEALTH CARE PROVIDER claimed as damages by plaintiff in discovery proceedings thus far in this case were not necessary or unreasonable? If so: 16.6 Do you contend that any part of the loss of earnings or income claimed by plaintiff in discovery proceedings thus far in this case was unreasonable or was not caused by the INCIDENT? If so:16.9 Do YOU OR ANYONE ACTING ON YOUR BEHALF have any DOCUMENT (for example, insurance bureau index reports) concerning claims for personal injuries made before or after the INCIDENT by a plaintiff in this case? If so, for each plaintiff state: DISC-001 (d) state the name, ADDRESS, and telephone number of each PERSON who has custody of each defective part. (c) the name, ADDRESS, and telephone number of each occupant other than the driver; (d) the name, ADDRESS, and telephone number of each registered owner; 20.11 State the name, ADDRESS, and telephone number of each owner and each PERSON who has had possession since the INCIDENT of each vehicle involved in the INCIDENT. (e) the name, ADDRESS, and telephone number of each lessee; (f) the name, ADDRESS, and telephone number of each 25.0 [Reserved] (g) the name of each owner who gave permission or consent to the driver to operate the vehicle.30.0 [Reserved] 40.0 [Reserved] 50.0 Contract 50.1 For each agreement alleged in the pleadings: (a) identify each DOCUMENT that is part of the agreement and for each state the name, ADDRESS, and telephone number of each PERSON who has the DOCUMENT; (b) state each part of the agreement not in writing, the (c) identify all DOCUMENTS that evidence any part of the agreement not in writing and for each state the name, ADDRESS, and telephone number of each PERSON who has the DOCUMENT; (d) identify all DOCUMENTS that are part of any modification to the agreement, and for each state the name, ADDRESS, and telephone number of each PERSON who has the DOCUMENT; 20.7 Was there a traffic signal facing you at the time of the INCIDENT? If so, state: (a) your location when you first saw it; (e) state each modification not in writing, the date, and the (b) the color; name, ADDRESS, and telephone number of each PERSON agreeing to the modification, and the date the modification was made; (c) the number of seconds it had been that color; and (d) whether the color changed between the time you first saw it and the INCIDENT. (f) identify all DOCUMENTS that evidence any modification of the agreement not in writing and for each state the name, ADDRESS, and telephone number of each PERSON who has the DOCUMENT. 20.8 State how the INCIDENT occurred, giving the speed, direction, and location of each vehicle involved: (a) just before the INCIDENT; (b) at the time of the INCIDENT; and (c) just after the INCIDENT. (a) identify the vehicle; (b) identify each malfunction or defect; (c) state the name, ADDRESS, and telephone number of (d) state the name, ADDRESS, and telephone number of each PERSON who has custody of each defective part. (a) identify the vehicle; (b) identify each malfunction or defect; (c) state the name, ADDRESS, and telephone number of each PERSON who is a witness to or has information about each malfunction or defect; and60.0 [Reserved] DISC-001 [Rev. January 1, 2008] Page 8 of 8 FORM INTERROGATORIES—GENERAL 20.9 Do you have information that a malfunction or defect in a vehicle caused the INCIDENT? If so: 20.10 Do you have information that any malfunction or defect in a vehicle contributed to the injuries sustained in the INCIDENT? If so: 20.6 Did the INCIDENT occur at an intersection? If so, describe all traffic control devices, signals, or signs at the intersection. 20.5 State the name of the street or roadway, the lane of travel, and the direction of travel of each vehicle involved in the INCIDENT for the 500 feet of travel before the INCIDENT. 20.4 Describe the route that you followed from the beginning of your trip to the location of the INCIDENT, and state the location of each stop, other than routine traffic stops, during the trip leading up to the INCIDENT. 20.3 State the ADDRESS and location where your trip began and the ADDRESS and location of your destination. owner other than the registered owner or lien holder; and 50.6 Is any agreement alleged in the pleadings ambiguous? If so, identify each ambiguous agreement and state why it is ambiguous. 50.5 Is any agreement alleged in the pleadings unenforce- able? If so, identify each unenforceable agreement and state why it is unenforceable. 50.4 Was any agreement alleged in the pleadings terminated by mutual agreement, release, accord and satisfaction, or novation? If so, identify each agreement terminated, the date of termination, and the basis of the termination. 50.3 Was performance of any agreement alleged in the pleadings excused? If so, identify each agreement excused and state why performance was excused. 50.2 Was there a breach of any agreement alleged in the pleadings? If so, for each breach describe and give the date of every act or omission that you claim is the breach of the agreement.name, ADDRESS, and telephone number of each PERSON agreeing to that provision, and the date that part of the agreement was made; each PERSON who is a witness to or has information about each malfunction or defect; and DISC-001

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How to Sign a PDF Online How to Sign a PDF Online

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How to Sign a PDF in Gmail How to Sign a PDF in Gmail How to Sign a PDF in Gmail

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How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device How to Sign a PDF on a Mobile Device

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How to Sign a PDF on iPhone How to Sign a PDF on iPhone

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How to Sign a PDF on Android How to Sign a PDF on Android

How to complete and sign forms on Android

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