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APR ~ 7 1997
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97-024
INRE:
Jeffrey Colpo, a minor,
by and through his parents
and natural guardians,
LTC & Mrs. Michael Colpo,
Petitioners
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IN TIlB COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PBNNSYLVANlA
DOCKET NO. q 7. /7:n' {!,~ ~-
MINOR'S SBTILBMBNT
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PETITION FOR APPROVAL OF COMPROMISJo~ AND SI~TIUMENT
OF MINOR'S ACTION
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TO THE HONORABLE JUDGES OF THIS COURT:
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The undersigned counsel, for Nationwide Insurance Bnterprise, SCOll A. Freeland,
Esquire, respectfully petitions this Honorable Court for an Order approving the compromise
and settlement of the claim of Jeffrey Colpo, a minor, by and through his parents and natural
guardians, LTC & Mrs. Michael Colpo for personal injury and the distribution of the
proceeds therefore, and in support thereof states as follows:
1. LTC & Mrs. Michael Colpo are the parents and natural guardians of Jeffrey
Colpo, a minor. LTC & Mrs. Michael Colpo are adult individuals residing at 112B Forbes
Avenue, Carlisle Barracks, Pennsylvania, 17013.
2. The undersigned counsel is a representalive of Nationwide Insurance Enterprise,
the liability insurance carrier for the alleged lortfcasors, Alfonso & Donna Colpo, and this
Petition has been prepared and filed for the benefit and convenience of the Petitioners.
3. The facts and circumstances which give rise to this Petition occurred on or about
May 20, 1994, at the residence of Alfonso & Donna Colpo, 102 Doyle Road, Sarver, Butler
County, Pennsylvania, grandparents of the Minor Petitioner.
4. At the aforesaid time and place, the Minor Petitioner, Jeffrey Colpo was visiting
his grandparents when he was bitten by a dog owned by Alfonso and Donna Colpo.
5. As a result of the incident, Jeffrey Colpo sustained an injury to the face requiring
medical treatment in the amount of $1,025.50. All medical bills have been paid by
Nationwide Insurance Enterprise.
6. At the time of the incident, Alfonso and Donna Colpo were insured under a
homeowner's liability insurance policy issued by Nationwide Insurance Enterprise.
7. Nationwide Insurance Enterprise, on behalf of their insured, while not admitting
liability, has offered to pay to the Minor Petitioner in settlement of the claim presented and
in amicable resolution of all claims in this matter, the sum of $12,500.00.
8. The tenns and conditions of this agreement are set forth in Exhibit "A".
9. The Minor Petitioner, through his parents and natural guardians, are agreeable to
the proposed settlement and do hereby release and relinquish all rights to compensation or
damages in favor of this compromise settlement and request that the settlement amount set
forth in Exhibit "An be paid in the manner set forth therein.
10. If the Court sees fit to approve this proposed compromise settlement, the release
attached hereto as Exhibit" An and incorporated herein by reference, as executed by the
Petitioner's guardians shall be deemed ratified and confinned in favor of the parties and any
2
other persons, finns, corporations, their heirs, representatives, assigns and any other
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persons, finns or corporations for whose act or conduct they could be liable as a result of the
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accident referred to above.
WHEREFORE, it is respectfully requested that the Court enter an Order approving
the foregoing Compromise Settlement, directing the distribution of proceeds thereof as set
forth above, and authorizing the Petitioner to execute a good and sufficient release to any and
all claims arising from or as a result of the incident referred to above.
Respectfully submitted,
LAW OFFICES OF RUBINATE, JACOBS
& SABA
SC 'IT A. , ESQUIRE
Attorney for Defendants
214 Senate Avenue, Suite 503
Camp Hill, PA 17011
Telephone (717) 731-0988
Identification No. 55663
3
97-024
INRE:
Jeffrey Colpo, a minor,
by and through his parents
and natulal guardians,
LTC & Mrs. Michael Colpo,
Petitioners
IN TIlE COURT OF COMMON PLEAS
CUMBERLAND COUNTY , PENNSYLVANIA
DOCKET NO.
MINOR'S SETILEMENT
VERIFICATION
I, LTC and Mrs. Michael Colpo, verify that the statements made in the foregoing
Petition for Approval of Compromise and Settlement of Minor's Action are true and correct
to the best of my knowledge, infonnation and belief. I understand that false statements
herein are made subject to the penalties of Pa. C.S.A. ~4904, relating to unsworn
falsification to authorities.
26 Mar 97
Date
wJ~
LTC Michael Colpo, as Parent and Natural
Guardian of Jeffrey Colpo, a Minor
26 Mar 97
Date
Mi>>:..li]po~, "" N".,w
Guardian of Jeffrey Colpo, a Minor
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Exhibit A
97-024
Eumberland CountYI
ourt at Common P cns
FOR ~~D IN CONSIDERATION
five hundred dollars and
PARENT/CUARDI~~ RELEASE ~D IND~~~ITY ACRE~~NT
of the paYMent to me/us of the sum of$12,500.00 - Twelve thousand,
no/100--------------------------~--------------------------- Dollars,
the receipt of which is hereby acknowledged, I/we, the undersigned, father and mother and/or
guardian of Minor, Jeffrey Colpo,
a minor of th~ age of , do forever rei~ase, acquit and discharge Alfonso Colpo,
Donna Colpo and Nationwide Insurance Enterprise and his/her/their
heirs, successors and assigns of and irom any and all actions, causes of action, claims, demand
damages, costs, loss of services, expenses and compensation, on account of, or in any way
growing out of, any and all known and unknown personal injuries and property damage which we =,'
or hereafter have as the parents and/or guardian of said minor, and also all claims or rights
of sction for damages which the said minor has or may h~reafter have, either before or aiter
he/she has reached his/her majority, resulting or to result from a certain accident whiCh
occurred on or about the 20th day of May , 19 94 , at or near102 Doyle
Road, Sarver, Butler County, Pennsylvania. ----
FURTHER CONSIDERATION OF THE ABOVE PA\~~;T I/I.t: DO HEREBY ACREE TO IND~~I:1 A:m
HOL~ ~~~ESS THE SAID Alfonso Colpo, Donna Colpo and Nationwide Insurance Enterprise
of and frOM all loss. dama~e and expense by reason of said acc4d~nt should any clal:, Demand
or suit thereiore be brou~ht by or on behalf of said minor child either before or after he/
she has reached his/her cajority.
It is further understood and agreed that this settlement is the compro:ise of a doubtful and
disputed clai:, and that this payment is not to be construed as an admission of liability on
the part of Alfonso Colpo, Donna Colpo and Nationwide Insurance Entp.rprise .
by whem liability is expressly den4ed.
I/~e further state that l/we have carefully read the foregoing release and indecnity agreement
and knl!w the contents,thereof, andl/we sign the saMe as my/our own free act.
hand and seal this
u. n..~
day of
r'l..;
,19!Z.
CA!:TION:
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(Seal)
LTC Michael Colpo, Parent and Natural
Guardian of Jeffrey Colpo, a Minor.
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Mrs. Michael Colpo, Parent
Guardian of Jeffrey Colpo,
(Seal)
and Natural
a Minor.
PF.NNSYLVANIA
CUNBERLAND
26th March 97
On this day of , 19 ___, before
Nichael Colpo and Vera L. Colpo , to me known
wno executed the foregoing Instrument, and aCKnowleDged that they
their free act at d....d. No" ,: ,,:1 ,- \
. Rr",l^- RO''!.,''J>4 . 'V~~'Pt.:t'1iC
Ga" ".~ ~:o.\.'l, Ct, rl" '1' -v. "~:"';':~
l'Iy Commission Expires M~O:H,m"."ob:~'bNO' '.'~'..~~-,-
me personally
to be the person
executed the same
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97.024
INRE:
Jeffrey Colpo, a minor,
by and through his parents
and natural guardians,
LTC & Mrs. Michael Colpo,
Petitioners
IN TIlB COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PBNNSYLV ANIA
DOCKET NO. 97-1758 (Civil)
MINOR'S SETTLEMENT
,
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,
,
ORDER
st
AND NOW, this L day 0
, 1997, upon consideration of the Petition for
Approval of Compromise and Selllement f
inor's Action, it is hereby ordered and directed
that the hearing scheduled for May 2, 1997, concerning such Petition, has been continued for
~
1\lesday. the.l11h.. day of May, 1997, at 4:00 P.M. in Courtroom No. ,-)
(Chambers of ) of the Cumberland County Courthouse.
BY TIlB COURT:
Dated:
J.
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97.024
INRB:
Jeffrey Colpo, a minor,
by and through his parents
and natural guardians,
LTC & Mrs, Michael Colpo,
Petitioners
IN TIlB COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
DOCKET NO. 97-1758 (Civil)
MINOR'S SBTILBMBNT
PRABCIPB
TO TIlE PROTIlONOTARY:
Please mark the above-captioned case settled, discontinued and endr.d,
Respectfully submitted,
Date: /7 u"-'. 9 "7
By: ?i1j 4//r
LTC Michael Colpo, as Parent and Natural
Guardian of Jeffrey Colpo, a Minor.
I'
,
,
Date:~/qq1
BY:~~
Vera Colpo, as Parent and Natural
Guardian of Jeffrey COlpo, a Minor.
-'
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