Fill and Sign the Injury Property Form

––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––––– ––– –– ––––– ––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––––– ––– –– ––– –– ––––– ––––– ––– –– ––––– ––– –– ––– –– ––––– ––– –– ––––– ––– –– ––– –– ––– –– ––– –– ––––– ––– –– ––––– ––– –– –––––––––– ––––– ––––– P L D-P I - 002ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, state bar number, and address): FOR COURT USE ONLY TELEPHONE NO FAX NO. (Optional): E-MAIL ADDRESS (Optional): ATTORNEY FOR (Name): NAME OF COURT STREET ADDRESS: MAILING ADDRESS: CITY AND ZIP CODE BRANCH NAME: SHORT TITLE: CROSS-COMPLAINANT: CROSS- DEFENDANT: DOES 1 TO CROSS-COMPLAINT-Personal Injury, Property Damage, Wrongful Death AMENDED (Number): Causes of Action (check all that apply. Apportionment of Fault Indemnification Declaratory Relief Other (specify): Jurisdiction (check all that apply): CASE NUMBER ACTION IS A LIMITED CIVIL CASE ($25,000 or less) ACTION IS AN UNLIMITED CIVIL CASE (exceeds $25,000) I t i s is not reclassified as unlimited by this cross-complaint 1. CROSS-COMPLAINANT (name): alleges causes of action against CROSS-DEFENDANT (name): 2. This pleading, including exhibits and attachments, consists of the following number of pages: 3. Each cross-complainant named above is a competent adult a . except cross-complainant (name): ( 1 ) ( 2 )( 3 ) a corporation qualified to do business in California an unincorporated entity (describe): a public entity (describe): ( 4 ) a minor an adult ( a )( b ) for whom a guardian or conservator of the estate or a guardian ad litem has been appointed other (specify): ( 5 ) other (specify): Information about additional cross-complainants who are not competent adults is contained in Cross-Complaint-Attachment 3. (Continued on reverse) Page one of three Form Approved for Optional Use Judicial Council of California PLD-PI-002 [Rev. January 1, 2007] CROSS-COMPLAINT-Personal Injury, Property Damage, Wrongful Death Code of Civil Procedure, § 425.12electronic form ã 2000-7 WWW.LawCA.com Law Publishers ––––– ––––– –– ––– ––––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– ––––– ––––– –– ––– –– ––– ––––– ––––– –– ––– –– ––– ––––– ––––– –– ––– –– ––– –– ––– –– ––– ––––– –– ––– ––––– –– –––––SHORT TITLE: CASE NUMBER: 4. Each cross-defendant named above is a natural person a . except cross-defendant (name): b . except cross-defendant (name): ( 1 ) a business organization, form unknown ( 1 ) a business organization, form unknown ( 2 ) a corporation ( 2 ) a corporation ( 3 ) an unincorporated entity (describe): ( 3 ) an unincorporated entity (describe): ( 4 ) a public entity (describe): ( 4 ) a public entity (describe): ( 5 ) other (specify): ( 5 ) other (specify): Information about additional cross-defendants who are not natural persons is contained in Cross-Complaint- Attachment 4. 5. The true names and capacities of cross-defendants sued as Does are unknown to cross-complainant. 6 . Cross-complainant is required to comply with a claims statute, and a . b . has complied with applicable claims statutes, or is excused from complying because (specify): 7 . Cause of Action-indemnification (NUMBE R) a. Cross-defendants were the agents, employees, co-venturers, partners, or in some manner agents or principals, or both, for each other and were acting within the course and scope of their agency or employment. b. The principal action alleges, among other things, conduct entitling plaintiff to compensatory damages against me. 1 contend that I am not liable for events and occurrences described in plaintiffs complaint. C. If i am found in some manner responsible to plaintiff or to anyone else as a result of the incidents and occurrences described in plaintiffs complaint, my liability would be based solely upon a derivative form of liability not resulting from my conduct, but only from an obligation imposed upon me by law; therefore, I would be entitled to complete indemnity from each cross-defendant. 8 . Cause of Action-Apportionment of Fault (NUMBE R) a. Each cross-defendant was responsible, in whole or in part, for the injuries, if any, suffered by plaintiff. b. If 1 am judged liable to plaintiff, each cross-defendant should be required: (1) to pay a share of plaintiffs judgment which is in proportion to the comparative negligence of that cross-defendant in causing plaintiffs damages; and (2) to reimburse me for any payments I make to plaintiff in excess of my proportional share of all cross-defendants' negligence. (Continued on page three) PLD-PI-002 [Rev. January 1, 2007] CROSS-COMPLAINT-Personal Injury, Property Damage, Wrongful Death Page two of threeP L D-P I - 002 ––––– ––––– –– ––– ––––– –– ––– ––––– –– ––– ––––– ––––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– ––––– ––––– –– ––– –– ––– –– ––– –– ––– –– ––– –– ––– ––––– –– ––– ––––– –– ––– ––––– ––––– –––––SHORT TITLE: CASE NUMBER: 9 . Cause of Action-Declaratory Relief (NUMBE R) An actual controversy exists between the parties concerning their respective rights and duties because cross-complainant contends and cross-defendant disputes as specified in Cross-Complaint-Attachment 9 as follows: 1 0 . Cause of Action-(specify): (NUMBE R) 1 1 . The following additional causes of action are attached and the statements below apply to each (in each of the attachments, ''plaintiff "means ''cross-complainant'' and ''defendant "means cross-defendant"): a . Motor Vehicle b . General Negligence c . Intentional Tort d . Products Liability e . Premises Liability f . Other (specify): 12. CROSS-COMPLAINANT PRAYS for judgment for costs of suit; for such relief as is fair, just, and equitable; and for a . total and complete indemnity for any judgments rendered against me. b . judgment in a proportionate share from each cross-defendant. c . d . a judicial determination that cross-defendants were the legal cause of any injuries and damages sustained by plaintiff and that cross-defendants indemnify me, either completely or partially, for any sums of money which may be recovered against me by plaintiff. compensatory damages ( 1 )( 2 ) (unlimited civil cases) according to proof. (limited civil cases) in the amount of. $ e . other (specify): 1 3 . The paragraphs of this cross-complaint alleged on information and belief are as follows (specify paragraph numbers): Dat e: (TYPE OR PRINT NAME) (SIGNATURE OF CROSS-COMPLAINANT OR ATTORNEY) PLD-PI-002 [Rev. January 1, 2007] C RO S S - CO M P L A I NT- P e r s o n a l I n j u r y, Property Damage, Wrongful Death Page three of three P L D-P I - 002