Sample Complaint for Negligence and Premises Liability in ...



ANY NAME

Any STREE

Any Town, CA 55555

ANY PHONE

UNITED STATES DISTRICT COURT

CENTRAL DISTRICT OF CALIFORNIA

|ANY PLAINTIFF, |) |Case No. |

|Plaintiff, |) | |

|vs. |) |SUPPLEMENTAL COMPLAINT FOR: |

|AND DEFENDANT, and DOES 1 through 10, inclusive, |) | |

|Defendants. |) |WRONGFUL DISCHARGE IN VIOLATON OF PUBLIC POLICY |

| |) |COMPLAINT FOR CIVIL RIGHTS |

| |) |FRAUD – EXHIBIT ‘‘F” |

| |) |NEGLIGENT MISREPRESENTATION |

| |) |CIVIL CONSPIRACY |

| |) |DUE PROCESS VIOLATION UNDER |

| |) | |

| |) |DEMAND FOR JURY TRIAL |

| |) | |

| |) | |

FIRST SUPPLEMENTAL AMENDED COMPLAINT

PURSUANT TO RULE 1F

Plaintiff, ____________________ (“Plaintiff”) for their complaint against Defendants, _________________________________________________________ , alleges:

JURISDICTION AND VENUE

1. This Court has jurisdiction over the subject matter of this action pursuant to the Federal Tort Claims Act (June 25, 1946, ch. 646, Title IV, 60 Stat. 812, "28 U.S.C. Pt.VI Ch.171" and 28 U.S.C. § 1346(b) ("FTCA").

2. This Court has personal jurisdiction over all the Defendants by virtue of their transacting, doing, and soliciting business in this District, and because a substantial part of the relevant events occurred in this District.

THE PARTIES

3. Plaintiff JOHN DO is individual residing in the City of

County of LOS ANGLES, State of CALIFORNIA

4. On information and belief, defendant UNITED STATES POSTAL SERVICE (“USPS”) is an independent establishment of the executive branch of the Government of the United States under 39 U.S.C. § 201 and is headquartered at 475 L'Enfant Plaza SW, Washington, D.C. 20260.

5. On information and belief, _______________, (“_________”) is an individual doing business under the name of _____________ in the City of ____________, County of _________, State of ___________. Defendant does business as a ____________________________.

6. On information and belief, defendant ______________________., a ____________ Corporation, (“_____________”) is a Corporation duly organized and existing under the laws of the State of ____________, with its principal place of business located in the City of ____________, County of ____________, State of ________. Defendant is a ________________________. Plaintiff further alleges that defendant ____________ is owned by defendants _________ and __________.

7. The true names and capacities, whether individual, corporate, or otherwise, of the

Defendants sued as Does 1 through 100 are unknown to Plaintiff, who, therefore, sues them by such fictitious names. At such time as their true names and capacities have been ascertained, Plaintiff will seek leave of Court to amend this Complaint accordingly. On information and belief, Plaintiff alleges that each of Does 1 through 100 was the agent, representative, or employee of each of the

other Defendants and was acting at all times within the scope of his/her agency or representative capacity, with the knowledge and consent of the other Defendants, and that each of Does 1

through 100 are liable to Plaintiff in connection with one or more of the claims sued upon here and are responsible in some manner for the wrongful acts and conduct alleged here.

EXHAUSTION OF REMEDIES

8. Plaintiff has complied with the provisions of the FTCA in that on or about _________, Plaintiff duly submitted a completed Standard Form 95 administrative claim for damages of $_________ on Defendant, USPS on or about ______, which date was less than two years from the date that the claims alleged in this case arose. A true and correct copy of said administrative claim is attached hereto as exhibit “1” and incorporated herein by reference.

On or about _____________________, Defendant USPS rejected the administrative claim submitted by Plaintiff.

It has been more than six months since Plaintiff submitted their administrative claim on Defendant, USPS and Plaintiff has not received any response whatsoever.

///

FIRST CLAIM FOR RELIEF

(WRONGFUL TERMINATION IN VIOLATION OF PUBLIC POLICY)

9. Plaintiff incorporates by reference all the allegations of paragraphs 1 through 8, and the FRAUD claim inclusive of this complaint as though set forth herein in full.

10. On or about ___________, Plaintiff visited the Post Office operated by Defendant, USPS located in ____________________________ to purchase some stamps.

11. While at the Post Office on or about ________________, Plaintiff was injured when a portion of the roof fell on them causing them to suffer injuries such as DESCRIBE INJURIES SUFFERED IN DETAIL resulting in damages including medical expenses, lost wages, pain and suffering, and physical injuries.

12. Defendant, USPS had a duty to maintain and operate their Post Office location in such as a manner as to avoid causing injury to another person. They failed to do so.

13. Due to the failure of Defendant, USPS to maintain and operate their Post Office location in such as a manner as to avoid causing injury to another person, Plaintiff suffered injuries.

14. But for the negligence of Defendant, USPS, Plaintiff would not have suffered injuries.

15. The negligence of Defendant, USPS was a proximate cause of the injuries suffered by Plaintiff.

16. As a direct and proximate result of the negligence of Defendant, USPS Plaintiff has been damaged in the sum of $___________________.

SECOND CLAIM FOR RELIEF

(FRAUD)

17. Plaintiff incorporates by reference all the allegations of paragraphs 1 through 16, inclusive of this complaint as though set forth herein in full.

18. At all times mentioned in this complaint, Defendant, USPS operated the Post Office located at __________________. Defendant, USPS invited the general public, including Plaintiff, to enter the premises of the Post Office and to purchase various stamps and other services from Defendant, USPS.

19. While at the Post Office on or about ________________, Plaintiff was injured when a portion of the roof fell on them causing them to suffer injuries such as DESCRIBE INJURIES SUFFERED IN DETAIL.

20. Defendant, USPS as the operators of the Post Office located at __________________ negligently:

a. Failed to maintain the roof of the Post Office in a reasonably safe condition;

b. Allowed the roof of the Post Office to remain in such a dilapidated condition when defendant knew, or in the exercise of reasonable care should have known, that the dilapidated condition of the roof created an unreasonable risk of harm to customers and visitors coming to the Post Office;

c. Failed to warn plaintiff of the danger presented by the dilapidated condition of the roof of the Post Office, and

d. Failed to otherwise exercise due care with respect to the matters alleged in this complaint.

21. As a direct and proximate result of the negligence of Defendant, USPS, on or about ________________, Plaintiff was injured when a portion of the roof of the Post Office fell on them causing them to suffer injuries such as DESCRIBE INJURIES SUFFERED IN DETAIL resulting in damages including medical expenses, lost wages, pain and suffering, and physical injuries.

Be sure to modify these paragraphs to suit your individual situation. Do NOT just use the wording here unless it definitely applies to your particular situation.

PRAYER FOR RELIEF

THEREFORE, Plaintiff prays for judgment against Defendants and each of them as follows:

FIRST CLAIM FOR RELIEF:

1. For general damages in the amount of $______________;

2. For special damages for medical and related expenses in the amount of $_________;

3. For damages for loss earnings in the amount of $_________;

4 For interest on said damages from ____________, at 10% per annum from and after _______________;

5 Costs of suit herein incurred; and

6 Such other and further relief as the court may deem just and proper.

SECOND CLAIM FOR RELIEF:

1. For general damages in the amount of $______________;

2. For special damages for medical and related expenses in the amount of $_________;

3. For damages for loss earnings in the amount of $_________;

4 For interest on said damages from ____________, at 10% per annum from and after _______________;

5 Costs of suit herein incurred; and

6 Such other and further relief as the court may deem just and proper.

Remember that you have to prepare a Summons, and a Cover Sheet when you file the complaint. Some courts have a local cover sheet as well. Check your local rules with the District Court.

Dated:_____________________ __________________________________________

ANY ATTORNEY OR PARTY

LITIGATION REQUIRED TO GET THE MOST OF THE CASE:

[ ] FILE MOTION FOR SECOND SUPPLEMENTAL COMPLAINT, KEEPING THE SAME CLAIMS OF RECORD ALONG WITH THE NEW CLAIMS.

A. WRONGFUL TERMINATION AGAINST PUBLIC POLICY

B. FRAUD

C. CIVIL CONSPIRACY

D. NEGLIGENT MISREPRESENTATION

THE MOTION SHOULD BE BASED UPON THE BOARD OF NURSING LETTER DATED 12/17/2019 COMPLAINT

[ ] ATTACH A COPY OF THE AMENDED COMPLAINT AND EXHIBITS TO THE MOTION

[ ] FILE THE COMPLAINT

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LETTER TO LAWYER

----------------------------------------------------------

Dear Ms. Glazer:

This is my request to you to file a second Amended Supplemental complaint in my case based on NEW EVIDENCE received from the Board of Nursing which has become available as of December 17, 2019.

Wrongful Termination Claim: (Retailiation)

According to the facts in my case, which can be proven beyond the shadow of a doubt I was Wrongfully Terminated from my employment by fraudulent means.

Firstly, the VA purportedly terminated my employment on May 17, 2017 for (expired nursing license) when I received a letter regarding my FINAL TERMINATION (no appeal rights) from the VA. (See Exhibit "A")

However that was a lie and material misrepresentation based on the undisputed fact that according to the Nursing Board, my license was indeed in tact and in good standing. (See Exhibit "B" - letter from the Nursing Board - SMOKING GUN).

Thus the VA committed FRAUD, and wrongfully terminated my employment apparently based upon my prior complaints against them.

I would like to keep the current claims in tact but need to supplement the complaint to add my fraud claim and wrongful termination clai

I would like to meet with you to further discuss these matters so that the complaint can be amended with the new facts and evidence according to what actually happened.

Moreover, I was terminated against public policy while I was on Worker's compensation.

I demand a jury trial on the issues.

Thank you

Marilyn Gladle

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