SHORENSTEIN REALTY SERVICES, L.P. v. ACE AMERICAN INSURANCE COMPANY Complaint

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    Nicholas L. Dazer, OSB 002403kinetic law group IIp121 S.W. Morrison Street, Suite 475Portland, OR 97204Telephone: (503) 953-1043Facsimile: (503) 953-1039Email: [email protected] for Plaintiff

    UNITED STATES DISTRICT COURTDISTRICT OF OREGONPORTLAND DIVISION

    SHORENSTEIN REALTY SERVICES, CV'11-704 ACL.P., a Delaware limited partnership, Civil Case No.Plaintiff, COMPLAINT

    v. Declaratory Judgment (28 U.S.C. 1332and 28 U.S.C. 2201)ACE AMERICAN INSURANCECOMPANY, a Pennsylvania corporation, Demand for Jury TrialDefendant.

    PARTIES1. Plaintiff Shorenstein Realty Services, L.P. ("Shorenstein") is a Delaware

    limited partnership engaged in the business of office real estate ownership and operation.Shorenstein's principal place of business is in San Francisco, California.

    2. Defendant Ace American Insurance Company ("Ace") is a Pennsylvaniacorporation engaged in the business of insurance. Ace's principal place of business is inPhiladelphia, Pennsylvania.

    kinetic law group lipPage 1 - COMPLAINT FOR DECLARATORY JUDGMENT 121 SW Morrison St., Ste. 475Portland, Oregon 97204Telephone: (503) 953-1040Facsimile: (503) 953-1039

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    mailto:[email protected]:[email protected]:[email protected]:[email protected]
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    JURISDICTION AND VENUE 3. Plaintiff Shorenstein is presently defending claims made by Jessica N. Morrow

    and Kimberly Ferrara in the matter of Jessica N Morrow and Kimberly Ferrara v.Shorenstein Realty Services, L.P., Multnomah County Circuit Court Case No. 1004-06285(the "Underlying Lawsuit"), and Shorenstein seeks a declaration that Shorenstein is anadditional insured under the Ace insurance policy issued to Shorenstein's landscapecontractor, Northwest Landscape Services of Oregon, a Division of the Brickman Group Ltd,LLC ("Northwest Landscape"). The Underlying Lawsuit seeks damages in excess of$2,900,000 and the amount in controversy in the instant matter exceeds $75,000.

    4. This court has jurisdiction pursuant to 28 U.S.c. 1332 (Diversity ofCitizenship) and 28 U.S.c. 2201 (Declaratory Judgment).

    5. Venue in the District of Oregon, Portland Division, is proper under 28 U.S.c.1391 and Local Rule 3.4 because Ace is deemed to reside in this District and a substantialpart ofthe events or omissions giving rise to the claims allegedly occurred in this District.

    6. An actual controversy exists among the parties regarding Shorenstein's statusas an additional insured under the Ace policy of insurance with respect to the UnderlyingLawsuit.

    ALLEGATIONS IN UNDERLYING COMPLAINT7. The Underlying Complaint in the lawsuit alleges that a diseased fir tree located

    on Shorenstein's property near the intersection of Meadows Road and Kruse Way in or nearLake Oswego, Oregon blew down in a moderate breeze on or about January 17, 2009,striking a pickup truck in which the plaintiffs were passengers, thereby causing the plaintiffssevere personal injuries. The Underlying Complaint is attached as Exhibit A.

    8. The Underlying Complaint alleges that Shorenstein is liable in negligence forfailing to properly maintain the fir tree in the following particulars:

    Page 2 - COMPLAINT FOR DECLARATORY JUDGMENT kinetic law group lip121 SW Morrison St., Ste. 475Portland, Oregon 97204Telephone: (503) 953-1040Facsimile: (503) 953-1039

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    (a) In failing to have or develop a reasonable plan fo r assessing thesafety of its forest land and trees when defendant knew, or inthe exercise of reasonable care should have known, of the riskof harm to the public from hazardous trees on defendant's land.(b) In failing to follow a reasonable plan fo r assessing the safety ofits forest land and trees when defendant knew, or in theexercise of reasonable care should have known, of the risk ofharm to the public from hazardous trees on defendant's land.(c) In failing to remove trees that posed an unreasonable risk ofharm to the public when defendant knew, or in the exercise ofreasonable care should have known, of the risk of harm to the

    public from hazardous trees on defendant's land.(d) In failing to treat the trees adjacent to public roadways fo r[disease], including the tree that struck plaintiffs, when

    defendant knew, or in the exercise of reasonable care shouldhave known, of the risk of harm to the public from hazardoustrees on defendant's land.(e) In failing to warn the public, including plaintiffs, of hazardposed by its forest land and trees, when defendant knew, or in

    the exercise of reasonable care should have known, of the riskof harm to the public from hazardous trees on defendant's land.(f) In failing to prevent or treat the disease of Laminated Root Rotwhen defendant knew, or in the exercise of reasonable careshould have known, that this particular Douglas Fir tree and

    others near it were diseased and creating a hazard to passersby, including plaintiffs.9. The Underlying Complaint alleges that plaintiff Morrow sustained $307,439 in

    economic damages and $1,500,000 in non-economic damages and that plaintiff Ferrarasustained $107,000 in economic damages and $1,000,000 in non-economic damages as aresult of their personal injuries.

    SHORENSTEIN'S CONTRACT WITH NORTHWEST LANDSCAPE10 . At all material times, Northwest Landscape contracted with Shorenstein to

    provide exterior landscape services for properties managed by Shorenstein, including thelocation from which the tree at issue in the lawsuit fell. These exterior landscape services

    Page 3 - COMPLAINT FOR DECLARATORY JUDGMENT kinetic law group Up121 SW Morrison St., Ste. 475Portland, Oregon 97204Telep hone: (503) 953-1040Facsimile: (503) 953-1039

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    included, but were not limited to, maintaining and monitoring all trees over 12 feet in height,including monitoring such trees for disease.

    11. The contract further required Northwest Landscape to indemnify and holdShorenstein harmless from any claims arising out of Northwest Landscape's work andrequired Northwest Landscape to carry commercial general liability insurance with limits ofnot less than $1,000,000, and to name Shorenstein as an additional insured under such policyor policies. The contract further provided that the liability coverage that NorthwestLandscape was to procure for Shorenstein would be "primary to any liability insurancecarried" by Shorenstein. Northwest Landscape provided to Shorenstein the Certificate ofLiability Insurance attached hereto as Exhibit B, describing that Shorenstein was named asan additional insured under Northwest Landscape's policy issued by Ace.

    THE ACE COMMERCIAL GENERAL LIABILITY POLICY12. Ace issued insurance policy number XSL G23725356 to Northwest

    Landscape effective July 1, 2008 to July 1, 2009 (the "Policy"). Relevant portions of thePolicy are attached hereto as Exhibit C. The Policy contains an Additional InsuredEndorsement that contains the following pertinent provisions:

    ADDITIONAL INSURED - OWNERS, LESSEES OR CONTRACTORS(FORM B)***

    THIS ENDORSEMENT CHANGES THE POLICY, PLEASE READ IT CAREFULLY. This endorsement modifies insurance provided under the following:

    EXCESS GENERAL LIABILITY COVERAGE FORMSCHEDULE

    Name of Person or Organization:

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    Any person or organization that you have agreed to include as anadditional insured under CG 2010(11/85) or equivalent by contract oragreement.RE: All OperationsIT IS AGREED THAT SUCH INSURANCE AS IS AFFORDED BY THISPOLICY FOR THE BENEFIT OF THE ADDITONAL INSURED SHALL BEPRIMARY INSURANCE, BUT ONLY AS RESPECTS LlABLITY ARISINGOUT OF YOUR ACTIVE NEGLIGENCE AND RESULTING FROM "YOURWORK" FOR THAT INSURED BY OR FOR YOU, AND ANYINSURANCE MAINTAINED BY THE ADDITIONAL INSURED SHALL BEEXCESS AND NON-CONTRIBUTING. THIS APPLIES ONLY IFREQUESTED BY WRITTEN CONTRACT.***WHO IS AN INSURED (Section II) is amended to include as an Insuredthe person or organization shown in the Schedule, but only withrespect to liability arising out of "your work" fo r that insured by or foryou.

    DECLARATORY JUDGMENT - CLAIM ONE(Recognition of Shorenstein as Additional Insured)

    13. Shorenstein restates and realleges Paragraphs I through 12 herein.14. Pursuant to the express provisions in the Ace policy, Ace owes a duty to

    recognize Shorenstein as an additional insured with respect to the Underlying Lawsuit as a"primary" liability insurer.

    15. Shorenstein has repeatedly tendered the Underlying Lawsuit to Ace anddemanded that Shorenstein be recognized as an additional insured with respect to theUnderlying Lawsuit, but Ace has refused to do so.

    DECLARATORY JUDGMENT - CLAIM TWO(Duty to Indemnify)

    16. Shorenstein restates and realleges Paragraphs I through 12 herein.17. Pursuant to the express provisions in the Ace policy, Ace owes a duty to

    indemnify Shorenstein in the Underlying Lawsuit as a "primary" liability insurer.

    Page 5 - COMPLAINT FOR DECLARATORY JUDGMENT kinetic law group lip121 SW Morrison St., Ste. 475Portland, Oregon 97204Telephone: (503) 953-1040Facsimile: (503) 953-1039

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    18. Shorenstein has repeatedly demanded that Ace agree to indemnify Shorensteinin the Underlying Lawsuit, but Ace has refused to do so.

    ATTORNEY FEES - CLAIM THREE(Attorney Fees- ORS 742.061)

    19. Shorenstein restates and realleges Paragraphs 1 through 12 herein.20. Shorenstein is entitled to an award of its attorney fees in this action, pursuant

    to ORS 742.061.PRAYER

    WHEREFORE, Shorenstein prays for judgment as follows:1. Under Claim One for a declaration that Ace is an additional insured under the

    Ace Policy;2. Under Claim Two for a declaration that Ace has a duty to indemnify

    Shorenstein in connection with the lawsuit;3. Under Claim Three, for an award of Shorenstein's attorney fees incurred

    herein;4. For Shorenstein's costs and disbursements incurred herein; and5. For such other relief as the Court deems just and proper.

    DATED this 10lh day of June 2011. kinetic law group IIp

    Page 6 - COMPLAINT FOR DECLARATORY JUDGMENT kinetic law group lip121 SW Mor rison St., Ste. 475Portland, Oregon 97204Telephone: (503) 953-1040facs imil e: (503) 953-1039

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    1 ORIGINAL2 ' ~ ' ; ; ; : ; ~ r r : ~ I r ' ~ ' ""'-"''''''1

    . \: .. . . ... .3 4 l ~ p n 2 2UiO f ,

    I ~ E G l t : T l ' : H 13'( I ' ~ O P I~ " :1I""uz " , . ~ ' ~ ~ " " " I ' l ' : f I l " ' ' ' - ' 6 7 8 IN THE CIRCUIT COURT OF THE STATE OF OREGON 9 IN AND FOR THE COUNTY OF MULTNOMAH

    0 6 2 q ~ { ' ~ JESSICA N. MORROW; and 1004-0628511 KlMBERL Y FERRARA, Case No. ...:

    12 Plaintiffs, COMPLAINT AND DEMAND FORJURy TRIAL (Personal Injury, Negligence)13 VS. Damages Claimed Over $10,000 14 SHORENSTEIN REALTY SERVICES, L.P., a Delaware Limited Partnership, Claim Not Subject to Mandatory Arbitration Defendant. 16 Total Damages Claimed: $2,914,439.00 1718 1. 19 This is a personal injury case against the owner of real property that failed to safely

    maintain the condition oflrees adjacent to a roadway. As a result ofdefendanl's negligent21 conduct, a tree fell on the truck in which plaintiffg were riding, causing severe and pennanent22 personal injuries as sct forth more fully below.23 2. 24 Plaintiffs are, and at all material times were, residents of Oregon.

    I I I26. II I

    Page I - COMPLAINT AND DEMAND FOR JURY TRIAL (Negligence)

    David Paul PC520 SW 61h Ave Sle 920, Portland OR 97204

    Ph 5032246602 I Fx 5032242764www.davidpaullalY.com

    EXHIBIT A - Page 1 of 7

    Case 3:11-cv-00704-AC Document 1-1 Filed 06/10/11 Page 1 of 7 Page ID#: 7

    http:///reader/full/2,914,439.00http:///reader/full/www.davidpaullalY.comhttp:///reader/full/2,914,439.00http:///reader/full/www.davidpaullalY.com
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    1 3. 2 Defendant Shorenstcin Realty Services, L.P . is nduly authorized Delaware limited 3 palinership, authorized to do business, and doing substantial and sustained business, ill 4 Multnomah County. Defendant Shorenstein Realty Services, L. P. holds and maintains, buys,

    I5 sells, and leases real estate holdings throughout Oregon.6 4. 7 On or about Jalluury 17,2009, plaintiffs were passengers in a pickup trllck as it passed by 8 the intersection of Meadows Road and Kruse Way in or near Lake Oswego, Oregon. 9 S. 10 At the same lime and place, a diseased Douglas Fir tree owned, maintained, and located 11 I 011 real estate owned by defendant Shorenstein blew down in moderate breeze and landed 12 I squarely on the top of the pickup truck, destroying the truck in which plaintiffs were riding and 13 pilming down its occupants, including plaintiffs. The truck was knocked off the roadway and 14 came to rest in the wooded area near the intersection in question. Plaintiffs were both trapped 15 inside the truck and both suffered severe and permanent physical and emotional injuries as 16 detailed below. 17 6. 18 The personal injuries in question, and plaintiffs' economic and non-economic damages, 19 were caused by the negligence of the defendant in one or more of the following particulars: 20 (a) In failing to have or develop a reasonable plan for assessing the safety of its forest 21 land and trees when defendant knew, or in the exercise of reasonable care should 22 have known, of the risk of harm to the public from hazardous trees on defendant's 23 land. 24 (b) In failing to follow a reasonable plan for assessing tht: safety of its forest land and 25 trees when defendant knew, or in the exercise of reasonable care should have known, 26 of the risk of harm to the public from hazardous trees OIl defendant's land.

    Page 2 - COMPLAINT AND DEMAND FOR JURY TRIAL (Negligence)

    David Paul PC520 5W 61h Ave Sle 920, Portland OR 9720QPh 503224.6602 I Fx 50322Q2764 /III 1"1ww w.davldp

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    1 (c) In failing to remove trees that posed an unreasonable risk of harm to the public when2 defendant knew, or ill the exercise of reasonable care should ]u\ve known, of the risk3 of harm to the public from hazardous trees on defendant's land.4 Cd) In failing to trel\! the trees adjacenl to public roadways for [disease], including the.5 tree that struck plaintiffs, when defendant knew, 01' in the exercise of reasonable care6 should have known, of the risk of harm to the public from hazardous trees on7 defendant's land.8 (e) In failing to warn the public, including plaintiffs, of tile hazard posed by its forest9 : land and trees, when defendant knew, or in the exercise of reasonable care should10 have known, ofthe risk of harm to the public fioln hazardous trees on defendant's11 land.12 Cf) In failing lo prevent or treat the disease of Laminated Root Rot when defendant knew,13 or in the exercise of reasonable care should have known, that this particulor Duuglas14 Fir tree and others neal' it were diseased and creating a hazard to passers-by, including15 plaintiffs.16 CLAIM FO R RELIEF17 Jess ica Mol'l'oW18 7.19 As a result of defendant's negligence, plaintiff Jessica Morrow was nearly killed while in20 the cab of the truck and properly wearing seatbelts. She rcql1ired resuscitation at the scene.21 After emergency evacuation ioto the trauma center at Oregon Health Science University she was22 diagnosed with multiple iI\iuries, including, a fractured spine that was reconstructed surgically at23 four vertebral kvels, a collapsed lung, as well as cuts to her face, ear, abrasions, and bl'l1ising.24 As a result of the scriotlsness of the accident, Ms. Morrow has suffered from the effects of25 Post-Traumatic Stress Disorder. Ms. Morrow has incurred objectively verifiable economic loss26 in the form of medical, ambulallce, X-ray, diagnostic, surgical, pharmacy, rehabilitative,

    Page 3 - COMPLAINT AND DEMAND FOR JURY TRIAL (Negligence)

    David Paul PC520 SW 6th Ave S(e 920, Portland OR 97204 /h 503-2246G02 I Fx S 0 3 - 2 2 4 2 7 6 ~ q ' " IYww.davidpaullaw.com J "

    EXHIBIT A - Page 3 of 7

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    1 therapeutic, and counseling medical bills in the amount of $237,439.00to date. Plaintiff Jcssica2 Morrow's injuries are permfment, progressive, and disabling. The expenses for her futlll'e3 medical care are continuing and ongoing, as is her medic,,1 care. Such expenses will be updated4 At or nenr the time of trial.5 8.6 Ms. Morrow also suffered loss of her wages and benefits and a reduction or loss of7 earning capacity. Al the time of this injury, Ms . Morrow was earning $23 .00 per hour in full8 time work plus benefits and has further suffered fmtller economic losses in the forlll of lost9 wages, lost benefits and lost earning capacity in the amount of $70,000.00 to date, and said10 amount is continuing and ongoing. The economic damages set forth in this portion of the 11 Complaint will be updated and amended at the time oftrial to reflect information that develops 12 I after the date of filing. 13 9. 14 As a further restllt of defendnnt' s negligence, Ms . Morrow has ~ u f f e r e d , and will continue 15 to suffer in the future, a significant array of non-economic damages such as pain, anxiety, 16 Post-Traumatic Stress Disorder, loss of enjoyment of life, hyper-vigilance while traveling, 17 depression, weight gain, loss of stamina, restricted mobility, and increased fatigue. Plaintifrs 18 nOll-economic damages are to be cOllsidel'ed by the jury and are alleged here at an amount not to 19 exceed $1,500,000.00.20 CLAIM FOR RELIEF21 Kimberly FerJ'1\1'1t22 10.23 As a result of defendant's negligence, plaintiff Kimberly Fel1'ara also slistained a24 crushing injmj' while riding as a passenger in the cah of the truck and appropriately seal belted.25 She too had to be extricated from the car. Ms. Ferrara's thoracic vertebrae WflS fraclll1'ed and this26 hilS left her weak and significantly weakened by ongoing and p ~ r m a n e n t pain. Ms. Ferrara

    Page 4 - COMPLAINT AND DEMAND FO R ,JURY TRIAL (Negligence)

    David Paul PC520 SW 6th Ave Ste 920, Portland OR 97204 /Ph 50:1-2245502 I Fx 503-224-2764 www.davidpaullaw. com t -

    EXHIBIT A - Page 4 of 7

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    http:///reader/full/237,439.00http:///reader/full/70,000.00http://www.davidpaullaw/http:///reader/full/237,439.00http:///reader/full/70,000.00http://www.davidpaullaw/
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    1 c. Por plaintiffs' c o s t ~ and disbursements incurred herein; and2 d. For slich other relief as the court deems just.3 4 DATED this 29th day of April] 2010.

    Respectfully submitted,6 7

    B y : = - ~ ~ ~ ~ ~ ~ ____ 8 David Pall. 0 IN . 86260 DAVID PAUL, PC 9 520 S.W. Sixth Ave., Ste. 920 P0l1land] Oregon 97204 Phone: (503) 224-6602 Fax: (503) 224-2764 11 E-Mail: [email protected] Attorneys for Plaintiff.c; 12 13 Plaintiffs demand ajul'Y trial.14 DATED this 29th day of April, 2010.

    DAVID PAUL, PC16

    B y : = - ~ ~ ~ ~ ~ ____17 David Pau" o. 86260 DAVID PAUL, PC 18 520 S.W. Sixth Ave., Ste. 920 POitland, Oregon 97204 19 Phone: (503) 224-6602 Fax: (503) 224-2761) E-Mail: [email protected] Attorneys tor Plaintiffs and Trial Attorney 21

    22 23 24

    26 Page 6 - COMPLAINT AND DEMAND FOR JURY TRIAL (Negligence)

    David Paul PC I20 SW 6th Ave Ste 920, Portland OR 97204 Ph 5032246602 I F)( 5032242761

    WWIV .davldpaullaw.com EXHIBIT A - Page 6 of 7

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    mailto:[email protected]:[email protected]:[email protected]:[email protected]
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    1 CERTIFICATE OF SERVICE 2 I hereby certify that I served a true copy of the foregoing SHORENSTEINREALTY SERVICES, L.P.'S FIRST AMENDED THIRDPARTY COMPLAINT on the3 following attorneys on the date noted below via the following method:4 David Paul Frank MoscatoDavid Paul PC Aaron T. 8als520 SW 6th Ave., Ste 920Portland, OR 97204 Harrang Long Gary Rudnick PC1001 SW 5th Avenue 16th FI6 Portland, OR 972047 OfAttorneys for Plaintiffs Of Attorneys for Brickman Group8 Ltd, LLC9

    Method: US Mail, postage prepaidD Facsimile11 D Hand DeliveryD Overnight Delivery12

    Dated this 22nd day of November, 2010.1314

    EW ';;1j : v, aSsN';, 974423Email: [email protected] Heathe . Bowman, OSS No.: 073257Email: [email protected] Phone: (503) 243-1022Fax: (503) 243-201918Attorneys for DefendantfThird-Party Plaintiff19

    21222324

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    Page 1 - CERTIFICATE OF SERVICE BODYFELT MOUNT LLPAttorneys At Law707 SW Washington Street, Suite 1100Portland OR 972053528h:lcllentOleslmorrow-(:ouslnI8188Ipld!l6Icomplalnt. 3rd party amended.doc Phone: 5032431022 Fax: 5032432019

    EXHIBIT A - Page 7 of 7

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    mailto:[email protected]:[email protected]:[email protected]:[email protected]
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    Porter & Curtis, LLC "?5 State Road

    :dia, PA 19063 (610) 891-9850INSURED NORTHWEST LANDSCAPE SERVICES OF

    OREGON, A DIVISION OF BRICKMAN THE BRICKMAN GROUP LTD. l lC GAITHERSBURG MD 20879 Certificate Number: 7 5 6 9 ~ I Branch:

    POLICY NUMBER POLICY EFFECTIVE POLICY EXPIRATIONDATE (MMIDONY DATE (MMIOONY LIP\AITS

    LIABILITYPRODUCTSCOMPIOP AGG : 2.000,000I GENERAL lIA8lUTYPERSONAL & ADV INJURY $ 1,000,000

    A EACH OCCURANCEXSL G23725356 0710112008 0710112009 $ 1,000,000C o ~ a g e Incf\.,ld(!dX FIRE DAMAGE (Any One Fire) $ 500,000

    MED EXP (Any One Po

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    ADDITrONM. INSURED - OWNERS, LESSEES OR CON'1.'RACTORS (FORM B)~ ; " : - : . W t = : - e d " - - - : ' l ' I " ' l ~ l i t ic}c/tlan G ~ o U p L ! ! d ' - . - : : L - : : : r . . - = C : - - - - ~ - - - - - - - - - - - - r ; ; E i ' > d j ) ( $ e n i G i i I Number

    2rnpo-:i,-=,C""y " " S y n - : : : - > b o ; : - : : - ; I - r - . ; I P ; : - O I ; ; " ~ ~ Y " " ' " N ; - : - : ' u - : ; : ; ~ - - r ; ; l P C . ~ c l i ~ Date 01 Endoniementm : ; : - \ j G : C r o " " ' i c y : - - , p " ' e r " " , , ' O - d : - - - - - - - ~ - - - - - - - - - - - - h - E XSL G23725356 01/0l!200a to 07/01/2009 07/01/2000:TsiU

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

    RW,IDI0 ,JUH 7111 ]:4t:IJSDC-ORP~ I S 44 (Rev. 12/07) CIVIL COVER SHEETTh e JS 44 civil cover sheet an d the information contained herein neither replace nor supplement th e filing and service of pleadings or other papers as required by law, except as pro vide dby local rules of court. This form , appro ved by the Judicial Conference of the United States in September 1974 , is required for th e use of the Clerk of Co uri for the purpose of initialingIhe civil dockel sheet. (SEE tNSTRUCTIONS ON THE REVERSE OF THE FORM)I. (a) P L A I N T l F F S D E F E N D A N T S

    SHORENSTEIN SERVICES, L.P., a Delaware limited partnership ACE AMERICAN INSURANCE COMPANY, a Pennsylvaniacorporation, a(b) County of Residence of Firsl Lisled PlainlitT San Francisco County o f Residence ofFirSI Lisled Defendant Philadelphia

    (EXCEPT tN u.s. PLAINTIFF CASES) (IN u.S. PLAINTIFF CASES ONLY)NOTE: IN LA ND CONDEMNATION CASES. USE THE LOC ATION OF THELAND INVOLVED.

    (c) Attorney ' s (F inn Name, Address, and Telephone Number) Attorneys ( l C V ~ 1 - 7 0 4 : " ; ACkinetic law group lip, 121 SW Morrison Street, Suite 475Portland, OR 97204II . B A S I S O F J U R I S D I C T I O N (Place an 'X " in One Box Only) I I I . C I T I Z E N S H I P O F P R I N C I P A L PARTIES(Place an "X" in One Box for PlaintilT

    (For Diversity Cases Only) and One Box for Defendant)o t U.S. Government o 3 Federal Quest ion PTF DEF PTF DEFPlaintilT (U.S. Government Not a Party) Citizen of This State 0 I o I Incorporated or Principal Place 0 4 0 4of Business In This State

    o 2 U.S. Government I!!I 4 Diversity Citizen of Another State o 2 0 2 Incorporated and Principal PlaceDefendant (Indicate Citizenship of Panies in Item III) of Business In Another Stateo 3 0 3 Foreign Nation o 6 0 6

    IV N A T U R E O F S U IT (Place an "X " in One Box Only)CONrRACT T()RTS F() RFEITURElPENALTY BANKRVP'I CY OiliER S' rAl1 rESt to Insurance PERSONAL INJURY PERSONAL INJURY o 610 Agricu Iture o 422 Appeal 28 USC t 58 0 400 State Reapportionmento 120 Marine 0 3 lOA irplane 0 362 Personal Injury - o 620 Other Food & Drug o 423 Withdrawal 0 410 Antitrusto 130 Miller Act 0 315 Airplane Product Med. Malpractice o 625 Drug Related Seizure 28 USC 15 7 0 430 Banks and Bankingo 140 Negotiab le Instrument Liability 0 365 Personal Injury - of Properry 21 USC 88 1 0 450 Co mmerceo 150 Recovery of Overpayment 0 320 Assault. Libel & Product Liability o 630 Liquor Laws PROPERTY RJGHTS ::J 460 Deponation& Enforcement of Judgment Slander 0 368 Asbestos Personal o 640 R.R. & Truck o 820 Copyrights 0 470 Racketeer InOuenced ando 151 Medicare Act 0 330 Federal Employers' Injury Product o 650 Airline Regs . o 830 Patent Co rrupt Organizationso 152 Recovery of Defaulted Liability Liability o 660 Occupational o 840 Trademark 0 480 Consumer CreditStudenl Loans 0 340 Marine PERSONAL PROP[RTY SafetylHealth 0 490 CablelSat TV(ExcL Velerans) 0 345 Marine Product .:J 370 Other Fraud o 690 Other 0 810 Setective Serviceo 153 Recovery of Overpayment Liability 0 37 I Tru.h in Lending .ABOR SOC IAL SE' :URJTY 0 850 SecuritiesiCommodi.iesl

    ofVeteran's Benefits 0 350 MOlOr Vehicle .:J 380 Other Personal o 7 10 Fair Labor Standards o 86 1 HIA (I 395ft) Ex changeo 160 Stockholders' Suits 0 355 MOlOr Ve h cle Property Damage Act o 862 Black Lung (923) 0 875 Cus.omer Challengeo 190 Other Contract Product Liability 0 385 Properry Damage o 720 Labo r/MgJnI . Relat ions o 863 DIWClD IWW (405(g 12 USC 341013 195 Contract Product Liability 0 360 Other Personal Produc. Liability o 730 Labor/Mgmt.Reponing o 8MSS IDTitleXVI 0 890 Other Statutory Ac.ionso 196 Franchise In ury & Di sclosure Act o 865 RSI (405(g 0 891 Agricultural ActsREAL PROPERTY CIVIL RJGHTS PRJSONER PETITIONS 'J 740 Railway Labor Act FEDERAL TAX SUITS 0 892 Economic Stabilizarion Act0210 LandCondemnalion 0 441 Voting 0 5 10 Malions 10 Vacate o 790 Other Labor Lillgalion o 870 Ta.es (U. S. PlaintilT 0 893 En vironmen.al Matlerso no oredosure 0 442 Employment Sentence o 79 I Empl . Ret. Inc. or Defendant) 0 894 Energy Allocation ActCJ 230 Rent Lease & Ejectlnent 0 443 Housing! Habeas Corpus: Security Act o 871 IRS-Third Party 0 895 Freedom of Infonnation:I 240 Tons to Land Accommodat ions 0 530 General 26 USC 7609 ActCJ 245 To n Product Liability 0 444 Welfare 0 535 Death Penalty IMJ\.IIGRATlON 0 900Appeal of Fee Detenninationo 290 All Other Real Property 0 445 Amer. w/Disabihlies - 0 540 Mandamus & Other o 462 Naturalization Application Under Equal Access

    Employment 0 550 CiVil Righ.s o 463 Habeas Corpus- to Justice0 446 A mer. w/Disabilities- 0 555 Prison Condition Alien Detainee 0 950 Consritutionality ofOther o 465 Other Immigration S.ate Statutes0 440 Other Civil Rights ActionsAppeal to DistriciJudge fromV_ O R I G I N (Place an .'X" in One So . Only)I Original o 2 Removed from 0 3 Remanded from o 4 Reinstaled or 0 5 Transferred from 0 6 Multidistrict o 7 MagistrateReopened another dtstnct Litigations ec i Ju d mentroceeding Slate Courl Appellate Courl

    V I. C A U S E O F A C T I O N 1--- - - - - - - - - - - - - - -- - - - - - - - - - -- - - - - - - Brief description of cause:~ e e k i n g declaration that plaintit1 ~ h o r e n s t e l n is an additional InsuredVII . R E Q U E S T E D IN CJ CHECK IF THIS IS A CLASS ACTION DEMAND $ CHECK YES only if demanded in complaint:

    C O M P L A I N T : UNDER F.R.C.P. 23 Over $ 7 5 , 000 JURY DEMAND: lilf Ye s 0 NoV II I . R E L A T E D C A S E ( S ) (See instructions):IF ANY JUDGE DOCKET NUMBERDATE D06/10/2011

    FOR OFFICE USE ONLYRECEIPT # AMOU NT JUDGE MAG. JUDGE--------- - - - - - - - - - - - - - - '

    Case 3:11-cv-00704-AC Document 1-3 Filed 06/10/11 Page 1 of 1 Page ID#: 16

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