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HomeMy WebLinkAbout10-0439(a { ?{E i ilvT. Y ti.JT? ~ S 2fifI yara .. , ,;;? LO Fi' i I: v r IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA In re: Estate of Stuart A. Bingham, Jr. CIVIL ACTION - LAW NO. 10 - 4S9 a-'v; I Term PETITION FOR APPROVAL AND SETTLEMENT OF WRONGFUL DEATH AND SURVIVAL ACTIONS NOW COMES Petitioner, Stuart A. Bingham, Sr., by and through Christopher J. Marzzacco, Esquire, of Colgan Marzzacco, LLC, his Attorney, and as Administrator of the Estate of Stuart A. Bingham, Jr., deceased, and hereby respectfully sets forth the following: 1. Stuart A. Bingham, Sr., is the natural parent of the decedent and was appointed Administrator of the Estate of the decedent by Letters of Administration dated August 27, 2009. (See Exhibit "A"). 2. The Decedent was a resident of Cumberland County, Pennsylvania. 3. Richard W. Jones, Respondent, is the driver and owner of the automobile which struck Decedent's vehicle and resulted in the death of Stuart A. Bingham, Jr. 4. The insurance companies involved herein are Nationwide Insurance Company (the third-party carrier) and State Farm Insurance Company (Decedent's first- party insurance carrier). Said companies are duly registered corporations which conduct business, including the issuance of automobile insurance policies, within the Commonwealth of Pennsylvania. $ga.oo Po A7TY 0011 30!85 a3L. 5a? 5. The Administrator's address for purposes of this petition is 130 West Church Street, Suite 100, Dillsburg, Pennsylvania 17019. 6. Respondent is represented by his insurance company, Nationwide. Nationwide's address for the purpose of this petition is P.O. Box 10405, NESRO Class Claims, Des Moines, IA 50306-9475. 7. On or about August 2, 2009, at approximately 5:43 PM, Respondent was driving a 2002 Ford Ranger bearing Pennsylvania registration plate number 130RFA, on Wertzville Road (SR 0944), at the intersection with Center Street (SR 1015) in Enola, East Pennsboro Township, Cumberland County, Pennsylvania, while driving under the influence of alcohol. Respondent drove through a red light, striking Decedent's vehicle as Decedent was lawfully crossing through the intersection. (See the police accident report attached hereto as Exhibit "B"). 8. As a result of the above-referenced collision, Decedent died from multiple blunt-force trauma. (See Certificate of Death attached hereto as Exhibit "C"). 9. Petitioner was twenty-two (22) years of age at the time of the collision and his date of birth was March 27, 1987. 10. The Decedent was survived by his parents, Stuart A. Bingham, Sr., and Renee Bingham. 11. At the time of the accident, the Decedent did not have a lawful Last Will and Testament. 12. The following is a list of the names and addresses of all possible beneficiaries to this action: a. Stuart A. Bingham, Sr., 3588 Golfview Drive, Mechanicsburg, PA 17050. b. Renee Bingham, 4156 Kittatiny Drive, Mechanicsburg, PA 17050. 13. Respondent's automobile insurance policy through Nationwide provided $100,000.00 of coverage for bodily injury and/or death. 14. The third-party, Nationwide Insurance, has been represented by Tyler Hauck, a claims adjustor for said entity with offices in Harrisburg, Pennsylvania. 15. Stuart A. Bingham, Sr., as Administrator of the Estate of Stuart A. Bingham, Jr., has accepted a settlement offer of full policy limits of $100,000.00 made by Nationwide Insurance for the release of its insured, Richard W. Jones. (See Exhibit «D„ 16. Prior to his death, Decedent resided with his father, Stuart A. Bingham, Sr., and was covered by an automobile insurance policy underwritten by State Farm. After reviewing said policy and all underinsured refusal forms, undersigned counsel confirmed that said policy did not provide underinsured motorist coverage. 17. Counsel has done an extensive investigation and has determined that all applicable automobile liability and other insurance policies have been identified and reviewed. Moreover, reasonable investigation has also determined that no other defendants exist in this claim. 18. Attached as Exhibit "E" is a release of all claims to be executed by Stuart A. Bingham, Sr., Administrator of the Estate, which releases Richard W. Jones and Nationwide Insurance Company. 19. Petitioner's counsel respectfully requests that this Honorable Court enter the proposed Order approving the settlement and distributing counsel fees, expenses and placing the proceeds of the Estate in escrow for future distribution through the Estate administration. 20. The enclosed billing statement (attached as Exhibit "F") shows that undersigned counsel has incurred the following expenses for which reimbursement is sought: Accident Report Fee $ 15.00 Postage $ 47.98 Notary Fees $ 5.00 Court Filing Fee $ 92.00 Investigation Fee $ 1,520.00 TOTAL $ 1,679.98 21. Counsel requests attorney's fees in the amount of $30,000.00 representing thirty (30%) percent of the gross proceeds of the settlement. (See Exhibit «G„ 22. The estate administration is being handled separately by David W. Reager, Esquire, of Reager & Adler, PC, in Camp Hill, Pennsylvania. 23. As a result of the aforementioned automobile collision, the Estate has incurred the following expenses: Funeral costs: $6,727.22 Crypt expense: $2,050.00 Mausoleum: $ 495.00 Pastor: 200.00 TOTAL: $9,472.22 24. All medical expenses were paid by State Farm. No outstanding medical bills exist. WHEREFORE, Petitioner requests that he be permitted to enter into a settlement as described above and that the Court enter an Order of Distribution as follows: (a) Pennsylvania Wrongful Death Statute, 42 Pa. C.S.A. Section 8301: $ 28,400.00 (b) Pennsylvania Survival Act; 42 Pa. C.S.A. Section 8302: $39,920.02 (c) Colgan Marzzacco Counsel Fees $30,000.00 (d) Colgan Marzzacco (Costs) 1,679.98 $100,000.00 25. The Department of Revenue has been contacted regarding the allocation of the proceeds to the estate. The Department has approved the above-referenced allocation, for estate tax purposes. (See Exhibit "H"). 26. Stuart A. Bingham, Sr., Administrator of the Estate, believes it is in the best interest of the Estate to accept the aforementioned settlement offer as all potential insurance proceeds have been identified and policy limits have been tendered. 27. All actual damages of the Estate caused by the aforementioned automobile collision have been accounted for in this Petition. Any other estate debts will be paid via the separate administration thereof. 28. It is believed and, therefore, averred that representatives from Nationwide Insurance Company do not object to this Honorable Court approving the instant Petition without a formal hearing. 29. Approving the instant Petition without a hearing would prevent the Decedent's family from painful testimony and provide closure in this tragic case. WHEREFORE, the Petitioner respectfully requests the following: That this Court authorize and empower the Petitioner to settle the above- captioned matter on behalf of the Estate of Stuart A. Bingham, Jr., as set forth in the proposed Order of Court and Release. 2. That the Court approve the payment of the sum identified in this Petition and Release as fully set forth in the attached document. Respectfully submitted, COLGAN MARZZACCO, LLC y by: Chri t her J. arzza o, Esquire ID No.: 78262 130 West Church Street Suite 100 Dillsburg, PA 17019 (717) 502-5000 VERIFICATION The undersigned, Stuart A. Bingham, Sr., verify that the statements made in this document are true and correct to the best of my knowledge, information, and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unsworn falsification to authorities. Respectfully submitted, Stuart A. Bingham, Sr. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA In re: Estate of Stuart A. Bingham, Jr. CIVIL ACTION - LAW NO. CERTIFICATE OF SERVICE I, Christopher J. Marzzacco, Esquire, hereby certify that I am this / 7 day of January, 2010, serving a copy of the foregoing document upon the person(s) and in the manner indicated below, which service satisfies the requirements of the Pennsylvania Rules of Civil Procedure, by first-class mail delivery, to: Tyler Hauck Nationwide Insurance Co. P.O. Box 10405 NESRO Class Claims Des Moines, IA 50306-9475 Respectfully submitted, COLGAN MARZZACCO, LLC by: Chris o er J. Marzzacco, Esquire ID No.: 78262 130 West Church Street, Suite 100 Dillsburg, PA 17019 (717) 502-5000 Exhibit it A" COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND I, SHORT CERTIFICATE I STRASBAUGH U Register for the Probate of Wills and Granting Letters of Administration in and for CUMBERLAND County, do hereby certify that on the 27th day of August, Two Thousand and Nine, Letters of ADMINISTRATION in common form were granted by the Register of said County, on the estate of STUART A BINGHAM JR late of EAST PENNSBORO TOWNSHIP Oat, Middle, Last) in said county, deceased, to STUART A BINGHAM SR (First, Middle, Last) and that same has not since been revoked. IN TESTIMONY WHEREOF, I have hereunto set my hand and affixed the seal of said office at CARLISLE, PENNSYLVANIA, this 27th day of August Two Thousand and Nine. File No. PA File No. Date of Death S.S. # 2009- 00805 21- 09- 0805 810212009 178-72-9467 C" t'vk' - C?-- NOT VALID WITHOUT ORIGINAL SIGNATURE AND IMPRESSED SEAL Exhibit It B" Prn* CRS w4119845 _J POLICE C RASH POPENNSYLVANIA {II{? IIN INII I III{ case Closed Reportable Crash W0119845 AA 500 1 a Ygs 0 No 0 Yes Q No 1 Page 1 of 9 Crash Number Incident Number Police Agency Patrol Zone 2009080032 21101 E2 A env Name P i t I y rec nc nvestigation DAM (MM-DD-YYYY) East Pennsboro Township ENOLA 08 m 02 a 2009 t Dispatch Time (mil) Arrival Time (mil) Investigator Badge Number 8 1743 1744 DENELLE E. CRAUL 1626 Reviewer Bad a Number Approval Date (MM-DD-YYYY) Coun unty Name Municipality Munici ali Dav of p 1 umberland 11101 ast Pennsboro Township 0 Sun Q Thu C e Crash Date (MM-DD-YYYY) Crash Time (mi! No of Units le Injured Killed' •i{ > 00 0 Mon Q Fri 08 02 2009 1743 2 3 1 1 ? O p Wed Q Unk Workzone meSlbiCoSemcpGOn 29) 0 Yes No Relaatteld?s O Yes No School OAe Q Yes 0 No N.=,r0 Yes 0 No t /nt"action Tvne Q 4 Way Intersection Q 'Y' Intersection Q Multi-Leg Q Off Ra mp Q Railroad Crossing 0 Midblock Traffic Circle/ Intersection " " 00 7 Intersection O Round About 0 On Ramp Q Crossover 0 Other e Sea Ov?r la?? Route Hum ment (Optional) Travel Lanes ?mk O Nth ` 0944 02 35 House Number (if a 1'Kable) 0 O South e' l Street Name Street Ending 0 East o For Mid-block crashes only. use l H t N b k d us O West WERTZVILLE PETI O O U k Pos a ouse um er an ma e sure P l Roadway Street Name is e n nown lied in fled in if using this option Route 0 Interstate Turnpike Turnpike State County Local Road Private Other/ (Not Turnpike) 0 (EasUWest) 0 Spur - Highway 0 Road O or Street 0 Road 0 Unknown $ _ Route Number nt (Optional) Travel Lanes Speed Link Q North ~ 1015 02 25 ? O South q LJ Street Name Street Ending 0 East I 0 west ICENTER ST Q Unknown g Di 8 0 interstate O Turnpike 0 Turnpike - State 0 County 0 Local Road O Private O Other/ (Not Turnpike) (EastANest) Spur Kighway Road or Street Road Unknown roc ,? i _ Intersect! Rt Hum Or Mile Post Or 7nt Marker .? O m Or Inte ti t N St O North th O South Feet V Please rsec ng ree ame St Endi O East Enter Information .3 E CCD) West Or Miles °v for BOTH • ? Landmarks 'g if Using This Option Intersecting Rt Hum Or Mile Post Or Segment Marker C 0 North Distance From Crash S L d k a 2 O South cene to an mar 1 F r C (f r h b Or Intersectin Street Name 9 St Endin 0 East o o ras etween 0 West 7 and Landmark 2) Degrees Minutes Seconds Degrees Minutes Seconds Latitude: Longitude: Traffic [onbw Devine O Yield Sign Q Police Officer or 0 Not Applicable Traffic Signal 0 Active Crossing 0 Flagman Other Type TCD O No Controls O Device Improperly Functioning Emergency O Preemptive t- Flashing Traffic Controls ls O Signal O Stop Sign O Passive RR Unknown Crossing Controls O Signal 0 Device Not . Device Functioning 0 Unknown Functioning Properly (aW_Gk=d Of "Not Applicable", skip rest of the Lane Closure section) {NaL O North O East Q North and South 0 All v Q Not Applicable O Partially Fully O Unknown AkUdW Q South O West (N,S,E,W) O East and West c c ? UYesnknown No O Q Et 0 < 30 Min. Q 30.60 Min. 0 1-3 hrs Q 3-6 hrs Q 6-9 hrs 0 > 9 hours 0 Unknown Q1348d 9 FORM a AA4500 (17/02) PENNDOT COPY http://www.dot6. state.pa.uslcrsappIPrintlmageslXmIFiles/20090775 5820090809122004204.... 8/9/2009 Pr;,lt CRS WO, 119845 _ 1 POLICE CRASH TING FORM OF PENNSYLVANIA Papa: AA 500 2 POlke Use Only .LL_j. W0119845 Page 2 of 9 Crash Number 7 c Motor Vehicle in Hit & Run Vehicle Q Illegally Parked Q Le l Parked TYAe Transport O 9a ti Q Non -Motorized Commercial Vehicle ro ?, UnJt Pedestrian on Skates, Disabled From Q Pedestrian Q O Train Q Phantom Vehicle Q No Q Yes No in Wheelchair, etc Previous Crash (If Yes, Complete Form C) (!f 'Pedestrian' or 'Pedestrian on Skates, in Wheelchair, etc', Com lete Form M, Section 28) Unit No First Name MI Date of Birth (MM-DD-YYYY) O1 I RICHARD W? 04 21 1957 Delete? Last Name Tel hone Number Q JONES 5187013408 1 Address / C' / State Zip 157 S ENOLA DR, APT A ENOLA PA 17025 Driver License Number State Gass 102BB8556 C AlcoMMMas Suspected Driver or Pedestrian Physical Condition 1 No Q Illegal Drugs Q Medication Q CD Use al Drug Q Q Q Fatigue Q Medication Q Alcohol 0 Alcohol and Drugs Q Unknown Had Been O Sick Q Asleep Q Unknown D rinkin p Alcohol Test Type Q Test Not Given Q Breath Q Other lMrmary Vehre Code VafsUOn Charged? -e, a Blood Q Urine Q T wif HOMICIDE BY VEHICLE Yes O No C y Alcohol Test Results Q Test Refused Unknown Results Driver Operated Presence 1=Driver 3=Driver Fled Scene - Test Given, M i d R C t t lt Vehicle 4=Hit and Run 1 na on am e esu s . 2=No Driver 9=Unknown OwnenDriver 00=Not Applicable 02=Private Vehicle Not 04=State Police Vehicle 07=Municipal Police Veh 09=Federal Gov Veh 01=Private Vehicle Owned/ Owned/Leased by Driver 05=PENNDOT Vehicle 08=Other Municipal 98=Other 01 Leased by Driver 03=Rented Vehicle 06--Other State Gov Veh Government Vehicle 99=Unknown Same as Owner First Name Owner Last Name or Business Name Of Pedestrian, ski this Section) Driver Q I RICHARD W. JONES Address / C' / State / Zip Vehicle Make *Make Code 1 157 S ENOLA DR, APT A ENOLA PA 17025 Ford 12 VIN Model Year Vehicle Model (see overlay) I 1FTZR45E42PA36602 2002 RANGER License Plate Reg. State Est Speed Vehicle Towed Towed B 130RFA 999 W Yes O No MAGARO'S TOWING Insurance Insurance Company Policy No ° Un- a Yes Q No O kn own ALLIED INSURANCE -J PPGM16242889 Uri Ii T 1=Towing Pass. Veh 4=Mobile/Modular Home 7=Semi-Trailer Tag No Tag Year Tag St un?t No, of y 2=Towing Truck 5=tamper 8=Other a ? ? v Trailing 3=Towin Utility Trailer 6=Full Trailer 9=Unknown Units: g y Direction F] *Vehicle Position O1 *Movement 01 *See Soccdal Usage y Vehicle Color Vehlde hoe 05=Large Truck 20=Unicycle, Bicycle, 00 12=Commercial Passenger 06=Yellow OS 07=Silver 01=Automobile 06-SUV Tricycle 04 02=Motorcycle 07=Van 21=Other Pedalcycle 7 00=Not Applicable Carrier Fi V h 13 01 T i 08=Gold 01=Blue 09=Brown - 03=Bus 10=Snowmobile 22=Horse & Buggy 04=Small Truck 11 =Farm Equip 23=Horse & Rider = re e = ax 02=Ambulance 21=Tractor Trailer 02=Red I O=Orange (!f "02' Complete Form 12=Construction Equip 24-Train 03=Police 22=Twin Trailer 08=Other Emergency 23=Triple Trailer 03=White 11=Purple 04=Green 12=Other M, Section 26) 13=AN 25=Trolley 18=Other 7 Spec Veh 98=Other Complete '20" or "2 1 (x y Vehicle 31 =Modified Veh 11=Pupil Transport 99=Unknown 05=Black 99=Unknown , M, Section tio 27) 19=Unk. T pes SpVeh 99=Unknown form M, S Initial l?ntlact Point Damage indicator Gradient 3=Downhill Road Allanmeot 12 00=Non-Collision 14=Undercarriage 01-12=Clock Points 15=Towed Unit O=None 2=Functional 1=Minor 3=Disabling 4=Bottom of Hill 1=Level 5-To of Hill 1=Straight a 2=Curved 9=Unknown 2=Uphill 13=Top 99=Unknown 9=Unknown 9=Unknown FORM r AA-500 (12112) PENNDOT COPY http://www.dot6. state.pa.uslcrsappIPrintlmageslXmIFilesl2009077 55 820090809122004204.... 8/9/2009 Prin± CRS W9119845 R6A -J POLICE AREPORTING FORM I?II?IIII?I Page: AA 500 2 Pala use ooiv 3 W0119845 Page 3 of 9 Crash Number - Motor Vehicle in O Hit & Run Vehicle 0 Illegally Parked 0 legally Parked Q Non - Motorized Type Transport Commerdal Vehicle o ;y Unit Pedestrian on Skates, Disabled From 0 Pedestrian O 0 Train 0 Phantom Vehicle Q Q Yes 0 No a in Wheelchair, etc Previous Crash (If Yes, Complete Form C) (if 'Pedestrian' or "Pedestrian on Skates, in Wheelchair, etc", Com lete Form M, Section 18) Unit No First Name MI Date of Birth (MM-DD-YYYY) 02 STUART A? 03 27 1987 Delete? Last Name Telephone Number - 0 BINGHAM JR. ? Address 1 Ci / State Zi ° 4156 KITTATINY DR. MECHANICSBURG PA 17050 Driver License Number State class 12842676 PA s Alcohol/Drugs Suspected Driver or Pedestrian Physical Condition No 0 Illegal Drugs 0 Medication Apparently Illegal Drug Q Fatigue 0 Medication Normal Q Use Q Alcohol 0 Alcohol and Drugs 0 Unknown Had Been O Sick Q Asleep Q Unknown Drinking g p Akolrol Test Tvpe a Test Not Given 0 Breath 0 Other Primary Vehiple Code Violation Charged? ' 0 Blood 0 Urine 0 Unknown if O Yes O No Test Given Alcohol Test Results 0 Test Refused 0 Unknown Results Drfver Presence 1=Driver Operated 3=Driver Fled Scene O Test Given, l d R C t i M Vehicle 4=Hit and Run E esu ts on am nate . 2=No Driver 9=Unknown OwnerlDrfver 00=Not Applicable 02=Private Vehicle Not 04=State Police Vehicle 07=Municipal Police Veh 09-Federal Gov Veh 01 =Private Vehicle Owned/ Owned/Leased by Driver 05=PENNDOT Vehicle 08=Other Municipal 98=Other 02 Leased by Driver 03=Rented Vehicle 06=Other State Gov Veh Government Vehicle 99=Unknown Same Owner First Name Owner Last Name or Business Name Of Pedestrian, ski this Section) Driver Q STUART A. BINGHAM Address ! City / State / Zip Vehicle Make *Mak* Code 1 3588 GOLFVIEW DR. MECHANICSBURG PA 17050 Ford 12 VIN Model Year Vehicle Model (see overlay) 1FALP13P7VW233617 111997 ESCORT License Plate Reg. State Est. Speed Vehicle Towed Towed B I FWF4763 PA 999 a Yes 0 No MAGARO'S TOWING Insurance Insurance Company Policy No Yes p No O Un- known STATE FARM MUTUAL 1443902-F22-38B Trailing T 1=Towing Pass, Veh 4=Mobile/Modular Home 7=Semi-Trailer Tag No Tag Year Tag St Unit T No. i of 2=Towing Truck 5=Camper 8=Other a El let 1:1 v v r a 3=Towing Utility Trailer 6=Full Trailer 9=Unknown Unit-. y Direction of N "Vehicle Position 1 -Movement F am i 2 -See Special Us,,, r Overlay Vehicle Color Vehide Type 05=Large Truck 20=Unicyde, Bicycle, 12=Commercial Passenger 06=Yellow 03 07=Silver 01=Automobile 06=5UV Tricycle 01 02=Motorcyde 07=Van 21 =Other Pedalcycle 00=Not Applicable Carrier 01=Fire Veh 13=Taxi 08=Gold 01=Blue 09=Brown 03=Bus 10=Snowmobile 22=Horse & Buggy 04=Small Truck I I=Farm Equip 23=Horse & Rider 02=Ambulance 21=Tractor Trailer 02=Red 10=Orange Of '01', Complete Form 12=Construction Equip 24=Train 03=Police 22=Twin Trailer 08-Other Emergency 23=Triple Trailer 03=White 11=Purple M, Section 26) 13=ATV 25=Trolley Vehicle 31 -Modified Veh 04=Green 12=Other 05=81ack 99=Unknown (if 20' or '11 , Complete 18=Other Type Spec Veh 98=0ther Form M, Section 27) 19=Unk. Type Spec Veh 99=Unknown t t=pupil Transport 99=Unknown Initial Imeact Point Damaoe lndtvtor Gradient 3=Downhill Road ARonment 00=Non-Collision 14=Undercarriage 09 01 12 k P t T Cl i 15 i d U 0=None 2=Functional F1 1=Minor 3=Disabling 4=Bottom of Hill E11=Level 5=Top of Hill 1=Straight ? 2=Curved - = oc o n s = owe n 9 k U 2=Uphill 13=Top 99=Unknown - n nown 9=Unknown 9=Unknown FORM N AA-SW (12M) PENNDOT COPY http://www.dot6. state.pa.uslcrsappIPrintImageslXmIFiles/20090775 5820090809122004204.... 8/9/2009 , rrn . ?" ZS Vrd(jl; '9845 COMM PENNSYLV -? POUI E®RA FIR PORTING FORFflANIA Page 111001211111 -1 L_J AA 500 3 Police Use Only W0119845 Page 4 of 9 Crash Number Person Tyoea A 1=Driver 2 P Seat i'osibm D 00=Not A Passenger/Occupant 01 D i All V hi l Safely Egyjpnfent One: E oD=None Used ! Not Applicable G O=Not Applicable h l = assenger 7=Pedestrian = r ver - e c es 02=Front Seat Middle Position 01=S ou der Belt Used 1--Not Ejected 02=Lap Belt Used 2=Totally Ejected 8=Other 9=Unknown 03=Front Seat Right Side 04=Second Row - Left Side Or 03=Lap And Shoulder Belt Used 3=Partially Ejected 04=Child Safety Seat Used 9=Unknown Motorcycle Passenger 05=Motorcycle Helmet Used 05=Second Row - Middle Position 06--Bicycle Helmet Used H &eam Path: d F?=Female B 06=Secon Row - Right Side 07=Third Row Or Greater - I O=Safery Belt Used Improperly 11 =Child Safety Seat Used Improperly O=Not Ejected / Not Applicable 1 Th h S D i d O a M=Male U =Unknown Left Side 08=Third Row Or Greater - roug e oor pen ng i 12=Helmet Used Im ropedy 90=Restraint Used, YpT e Unknown 2=Through Side Window n Middle Position 09=Third Row Or Greater - 99=Unknown 3=Through Windshield 4=Through Back Door o c- d njuly Severity; Right Side 10=Steeper Section of Truckcab 5=Through Back Door Tail to Openin g Roof Openin g Sunroof/ F 00=None /Not Applicable 6--Through Top Down) e ® C 0--Not Injured 1=Killed 11=1n Other Enclosed Passenger Or Cargo Area 01-Front Air Bag Deployed (For This Seat) 7=Through Roof Opening (Convertible 02=Side Air Bag Deployed (For This Seat) Up) Top 2=Major injury 3=Moderate 12=In Open Area (Back Of Pickup, Etc.) 03=Other Type Air Bag De oyed 9=Unknown 04=Multiple Air Bags Deplpk>yed Injury 4=Minor Injury 8=Injury, Unk 13=Trailing Unit 14=Riding On Vehicle Exterior 1 S=Bus Passenger 05=Motorcycle Eye Protection 06=Bicyclist Wearing Elbow/Knee/Pads Extrication 10=Air Bag Not Deployed, Switch on ( 0 Applicable Severity 9=Unknown if 98=Other 99=Unknown 11=Air Bag Not Deployed, Switch Off 1=Not Extricated 12=Air Bag Not Deployed, 2=Extricated By Mechanical Means Injury Unk Switch 3=Freed By Non - Mechanical Means 13=Air Bag RemSetU oved?Prior To Crash) 8=Other 19=Unknown If Air Bag Deployed 9=Unknown 99=Unknown EMS Agency: EAST PENNSBORO EMS Medkal Facility: HOLY SPIRIT HOSPITAL Unit No Person No O1 O1 Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I p ?- 21 - 1957 110 1 O1 99 Ol 000 Name / Address / Phone EMS Transport C1 same as JONES RICHARD W 157 S ENOLA DR, APT A ENOLA PA 17025 51 Operator ' O Yes 0 No Unit No Person No 02 01 Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I p 03 - 27 - 1987 I 1 ? M? 1 J01 03 O 1 0? Iq IT] Name / Address / Phone EMS T t ranspor 0 same as BINGHAM JR., STUART A 4156 KITTATINY DR. MECHANICSBURG P Operator O Yes i No Unit No Person No 02 02 Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I p 02 - 28 -11988 EJF? 71 03 99 O1 0 0I 0? Name I Address / Phone EARS Transport Oprerator EMRICK, KELLI L 109 BOYER ST PO BOX 417 SUMMERDALE PA 17 0 Yes O No Unit No Person No as Date of Birth (MM-DD-YYYY) A B C D E F G H I ?o-cam- ?oaooooa? Name / Address / Phone EMS Transport Same as Operator O Yes O No Unit No Person No Delete? Date of Birth (MM-DD-YYYY) A B C D E F G H I Name / Address / Phone EMS Transport Same as Operator O Yes O No Unit No Person No L-? Delete? Date of Birth (MM-DD-YYYY) AA }} 8 C D E F G H I O -?-LJ???FT? Name / Address / Phone EMS Transport Same as Operator F_ I O Yes (::)No FORM R AA-5W (17102) PENNDOT COPY http: //www.dot6. state.pa.uslersappIPrintImageslXmIFilesl200907755820090809122004204.... 8/9/2009 Print CRS W01 19845 COMMONWEALTH OF POLICE CRASH IREPORTING?FORM ?Wlf? Page 110 1111 AA 500 Poke Use Only W0119845 Page 5 of 9 Crash Number 7 Crash Description O=Non-Coftion 2=Head On 4=Angle "idmwlpe 8--Hft Pedestrian (OPPe Direction) R E R 5 c ear = a 1= ear nd 3= to (Same - (Backing) girection) 7--M Fixed Object 9--Oftr/Unknown c Relation fo RoadWav 1 1=0n Travel lanes 3=Median 5--Outside Tmffieway 7-6ore (Ramp Intersection) ?- 2-Shoulder 4=Road8ide 6=ln Paridng Lane 9=Unknown - g ' o n 1=Daylight 3=Da Street 5=08111M 8.iher g v ' W& 2=Street Lioghts 4=Dusk Roadway _ ---- -- -- - - - - - - Weather Conditions 1' jiorm.0 3=Sleet (Hail) 5=Fog -7=Sleet 5 Fog - 9--Unknown 2=Rain 44oow 6=FWn $ Fog a=Other - = O=Dty 2 , Mud, Dirt, 4=Slush Woe Patches -- t.Other - Road Surface Conditions Standing 0 7=Water ? 1=Wet 3=Snow Covered 5=1oe or Moving Harts Event L/R Most' Uti Pole Number Harmfa/ Events (Harm Event) 30--Hit Fence Or Wail 1 02 ? 01=Hit Unit 1 31=Hit Building it 2 32=Hit Culvert 02 Hn U Unit No = n 03=Hit Unit 3 33=Hit Bridge Pier Or Abutment O 1 2 F-1 O 04=Hit Unit 4 34=HR BParapet ri End 05=Hn Unit 5 35=Hit Bri dge Red 06=Hit Other Traffic Unit 36=Hit Boulder Or Obstacle Put PleaseEvents fn 3 ? O 07=Hit Deer On Roadway 08--Hit Other Anmal 37=flit Impact Attenuator Sequential 09=Collision With Other Non 38=Hit Fire Hydrant Fixed Object 39=Hit Roadway Equipment Order 4 ? O 11=Struck By Unit 1 40=Hit Mail Box 2 41=:Hit Traffic Island 12 k B i U y n =5tnx t 13=Struck By Unit 3 42=Hit Snow Bank Harm Event L/R Most7 Utility Pole Number 14=Struck By Unit 4 43=Hit Temporary Construction rrier B C c ' 11 a 15=Struck 8 Unit 5 11 Struck By Other Traffic Unit 48=Hit Other Fixed Object ' 49=Hit Unknown Fixed Ob ect 21 Hi T Sh bb O iv u Unit No = ree r ru ery t j 22=Flit Embankment 50-OvertumrRo110ver s N 02 2 0 Z3=Hn Utility Pole 51=Struck By Thrown Or Falling n Object Hn Traffic Si 24- Please Put 3 O g - 25=Hit Guard Rail 52=Pot Holes Or Other 26-HO Guard Rail End Pavement Irregularities 2 Curb 53=lack n Events in Sequential Order 2"k Concrete Or 54=fire In Vehicle r n u anal Barrier ' ? 4 O Harmf l ch Harmful Event 99-Unknown 29=Hit First Unit No Harm Event Afort Unit No Harm Event Driver Action (D) 17=Careless Or Illegal - f ul in POTPO 1 02 ven in m O 1 02 00=No Contributing Acton Backing On Roadway 01=Driver Was Distracted 18=Driving On The Wrong rash?ra Do not rWeat this inion- ion on "Kkipk page V 02=Driving Using Hand Held Phone Side Of Road 03=Driving Using Hands Free Phone 19=Making Improper Envkonmental /ROadwav 00 2 3 1 R f E 04--Making Illegal U-Turn Entrance To Highway 05?mproper/Careless Turning 20=Makkty Improper Exit hwa Lane From Hi m Wron 06 Tu F actors ( ) A Poem" g y g = rning ro 07=Proceeding W/O 21=Careless Par%g/Unparking 00=None 11=Sli Road Conditions (ice/Snow) pery 01=WIndy Conditions 12=Su Lance On Roadway 02=Sudden Weather Conditions 13-Potholes Clearance After Stop 22=Over/Under 08=Running Stop Sign Compensation At Curve mg Red h g nn 03=Other Weather Conditions 14=Broken Or Cracked Pavement t?ailure To Respond To 24 Too Fast For C nditions D 04--Deer In Roadway 15=TCD Obstructed = o Other Traffic Control Device 25=Failure To Maintain Proper Speed 05=Obstacle On Roadway 16=Soft Shoulder Or Shoulder Drop Off 06=Other Animal In Roadway 28=Other Roadway Factor i 1=Tai mg 26=Driver Fleeing Police (Poll Chase) 12=Sudden SlowingiStopping 27=Driver Inexperienced Q 07=Glare 29=Other Environmental Factor 08=Work Zone Related 99-Unknown 13=Illegally Stopped On Road 28=Failure To Use Specialized Equip 14_=Careless Passing Or Lane 92-Affected By Physical Condition e Chan Possible Vehide Failures (I0 12 Wipers g 15 =Passing In No Passing Zone 98=Other Improper Driving Actions 99=Unknown 00=None 06-Exhaust 13=Driver Seating/Control 01=Tires 07=Headlights 14=Body, Doors, Hood, Etc t6=Driving The Wrong Way On 1•Way Street CA 15=Trailer Hitch 02=Brake System OB=Other Lights 03=Steering System 09=Other lights 16=Wheel Unit . O 1 1 09 2 3 4 04=Suspension 10=Hom 17=Airbags 0S=Power Train 11=Mirrors 18=Traiier Overloaded c 19=U o/Shifted Unit Trailer ailer Load No 01 1 00 2 20=Improper Towing Unit No 02 9 00 2 3 4 21=Obstructed Windshield Usk 99-Unknown 02 t 00 2 No PodIestrian Action (P) 03=Working 04=Pushin Vehicle 00=None 9 roachin Or Leavin Vehicle 05=A pp g g 01=Entering Or Crossing At Specified Location 06=Working On Vehicle lodketed Prime Factor Unit No Factor Code .prep = this inrorrnation on 01 09 02=Walking, Running, Jogging, gg=0thering Or Playing 99=Unknown E/ R V D P Unit No 0] Unit No 02 O O 0 O If EIR is the Prime Factor Type, leave Unit No blank FOAM • AA-500 (12ft) PEPIPIDOT COPY http://www.dot6.state.pa.uslcrsappIPrintlmageslXmIFiles/20090775 5 820090809122004204.... 8/9/2009 Pn*nt CRS WO, ' 9845 POLICE 1 :RASH REPORTING FORMANIA Page '? ???III M 5005 RdFce Use Only 6 W0119845 Page 6 of 9 Crash Number 0 MCQUISTON, STEPH 316 S ENOLA DR ENOLA PA 17025 7177322159 Z RYAN, WILLIAM 114 WAYNE AVE ENOLA PA 17025 7177323763 I Narrative and additional witnesses: Accident Investigation Nott kation Issued? 0 Property Damage O 1 z w On August 2, 2009 at 1743 hours, officers from East Pennsboro Township Police Department were dispatched to a crash on Wertzville Road at Center Street. Upon arrival, Officer Epting located a male, standing next to the truck (Unit 1), identified as Jones, the driver of Unit 1. Unit 1's front, passenger side tire was shredded off to the rim. Officer Epting then observed a male, identified as Stuart A. Bingham, Jr., still in the driver's seat of the sedan (Unit 2). Bingham was not breathing or moving, no first aid was attempted due to EMS personnel being on scene. It was later determined that the driver of Unit 2, Bingham was deceased and the Cumberland County Corner was requested to the scene. Kelli Emrick was then located next to Unit 2, and advised she was a passenger in Unit 2. Emrick explained that they were waiting at the traffic light on Center Street at the intersection with Wertzville Road. Their traffic light then turned green, and they entered the intersection. Unit 1 was travelling east on Wertzville Road and did not stop, impacting with the driver's side of Unit 2. Officer Epting then returned to speak with the driver of Unit 1, Jones. Jones advised that his traffic light was green. Officer Epting's observations, he was determined to be DUI of alcohol and drugs and was transported to Harrisburg Hospital for legal blood. Officer Diehl then spoke with wittnesses. A witness, Timothy McOuiston, FORM N AA-M (IMM PENNDOT COPY http://wwNv.dot6. state.pa.uslcrsappIPrintImageslXmIFiles/20090775 5820090809122004204.... 8/9/2009 ;'Tint CRS WO; 19845 CC RQ®%MMALVt11 OF PENN5YLVANOA II INIIIIIIII MACE CRASH QtEPGKMG FORM ?9e O New W0119845 AA 500 N rd ce use oar O amwi c w tkm x Page 7 of 9 Narrative and additional witnesses: advised he was the first vehicle behind the striking vehicle. He stated the traffic signal turned to a steady red indication for Unit 1 who failed to stop, striking Unit 2. Stephanie McQuiston who was with her husband, Timothy, in the first vehicle behind Unit 1, observed a tire lying in the roadway in the area of Wertzville Road and Technology Drive in Hampden Township. As they continued to follow Unit 1, she continued to see chunks of tire along the road. When they arrived in the area of Wertzville Road and Southmont Drive, she realized that Unit 1 was the vehicle leaving all of the tire debris behind. When the approached the intersection of Wertzville Road and Center Street, she observed the traffic light turn to red. She then said out loud, 'That truck is not going to stop!" Officer Diehl then spoke with William Ryan. Ryan advised he was the first vehicle behind Unit 2 on Center Street. He advised upon approach of the traffic light for Center Street, it was red. Both he and Unit 2 had stopped at the traffic light. When the light turned to green, Unit 2 pulled into the intersection being struck by Unit 1. Sarah Steigerwalt was the front seat passenger in Ryan's vehicle. She advised they were stopped at the red light on Center Street. When the light turned green, Unit 2 proceeded into the intersection and was struck by Unit 1 on the driver's side. t it, 9 FORE/ f AAiBODI ? PENNOOT COPY http://www.dot6. state.pa.uslcrsappIPrintlmageslXmIFilesl200907755820090809122004204.... 8/9/2009 Prtip± CRS W01119845 Page 8 of 9 -? FOUCE MASN IRtMUM M ?$ff I?lat4 Page 0 Now 11111111111111 Crloh NuffdM AA 500 F r°M" teOnly W0119845 [_ 0 Co on 14oac1 S?xfaae Teller =- Q Brick or Block p Dirt SpeW BOA O military O Other Federal Sites 24 (_) Concrete O Gravel or Q Other ? No Special Ju isdi ti Q Indian Reservation O Other IN Blacktop Q Unknown r c on O National Park O""? O Unknown Please complete Unit Information for om* unit involved in a fob/ crash. Do not repeat the information in the fields above on multiple pages. Unit ft [)? Prkxh le inroad Psbet O Non-Collision O 0 12 1 1 O Q Restriction 10 02 O D fp s s O Com lied With Not a Pennsylvania D i O Top p Cenbtlar she PASUICtIOM mplied With O No Restrictions( O Co Not A licable r ver Q Compc?an e Undercarriage 09 O 0 z 03 O 4 7 pp O Towed Unit O ? O . 0 6 Dd erEndsrsdnent Required - O a Not : Pennsylvania O Unknown O O O Complied With Dr O Required - Non O Unknown Am@Mp ce A/aneuner _ 25 O None Required Compliance O Compliance No Avoidance O Maneuver Eraki Other O Other Avoidance Compliance Unkno wn Maneuver G?? O Not Required for Unk If CDL or O Braking - Skid Marks Evident Steen Evidence or Driver Q "g " Stated O Inconclusive Vehicle Class CDL Required No Valld License O for Class Not a Pennsylvania Driver Braking - No Skid O Ma Driver dew 0 5Bn9 O Unknown O E O Not Licensed O Valid License for O Unknown s, tated v Class Under RA* b?dlator Ong Test Type 0 Blood O Other - No Underride or Underride, No Override, O Compartment O O None Q Urine O Unknown if Test Override Vehicle intrusion Garen U d id U k U id d If Om Test llera is - fUb 0 = No Test Given to Four lteserks) 5 a Amphetamines F I F1 n err e, Q Compartment Intrusion n n nown err e, O Compartment O Underride or Intrusion Unknown Override 1 ° No Drug Reported 6 =PCP 2 = Mari uana 3 = Cocaine 9 = Unknown Test ? ? Erg use Not in Emer enc Q Lights Flashing O Si Both Lights and 4 = Opiates Results g y Use O Siren Sounding Q Unknown Unit No 02 1 Prick h"Dad point O Non-Collision O O 12 1 0 O Restrictions P l 1 02 O Driver Ratilrkdoru O Complied With ennsy vania O D irot a O Top N Re arictiosl O Restriction Not O Complied With Unknown OCompliance O Undercarriage 09 03 Q Applicable 0 =apta - O Towed Unit O 08 04O U n 07 05 weent En O Required - O Not a Pennsylvania Q Unknown 06 O O O LIM n Complied With Driver Q Required - Non Compliance O Unknown AvoMam Maneuver n x 0 None Required O Required - Compliance No Avoidance Maneuver O Braking -Other O Other Avoidance Compliance Unknown Evidence Maneuver Darth1w ' Not R iced for O Not e?Gas Unk if CDL or O Braking - Skid Q Marks Evident Steering - Evidence O inconclusive Q or Driver Stated Lanounoe CD L Required No Valid License O for Class Not a Pennsylvania O Driver Braking - No Skid O Marks, Driver ?ng Q Unknown O E or SB de c Q Not Licensed Valid License for ? G O Unknown Stated t vi n e ass Under hide kickat" Drug Test TYS+e O Blood O Other NNor derride or Underride, No ' a her O Compartment O None O Urine O Unknown if Test Override ehK Intrusion Given Underride Underride Unknown if Orm Test Riess is - (Up to Fuca Iksu? [9 F] , O Compartment Intrusion , O Compartment O Underride or Intrusion Unknown Override 0 = No Test Given 5 = Amphetamines 1 = No Drug Reported 6 = PCP 2 = Marijuana B - Other 3 = Cocaine 9 = Unknown Test Emeraerecv Use Both Lights and Q Lights Flashing O Siren 4 = Opiates Results Not in Emergency Use O Siren Sounding O Unknown PENNDOT COPY http://www.dot6. state.pa.uslersappIPrintImageslXmIFiles/200907755 820090809122004204.... 8/9/2009 Pr;n` C;ZS WQ; '9845 Page 9 of 9 Crash Number; W0119845 Incident Number: 2009080032 I1 Center Street (SR 1015) gE ?o m a m CL c V®? J IfiC73" 7-0 http://www.dot6. state.pa.uslcrsappIPrintlmageslXmlFiles/200907755 820090809122004204.... 8/9/2009 Exhibit "C" ... -_1 'Fv.kxmq T his is to certify that this is a true copy of the record which is on file in the Pennsylvania Department of Health, in accordance with the Vital Statistics Law of 1953, as amended. WARNING: It is illegal to duplicate this copy by photostat or photograph. 5145398 No. a, ee" % Linda A. Caniglia State Registrar OCT 16 2009 Date 105.1" REV 112005 COMMONWEALTH OF PENNSYLVANIA, DEPARTMENT OF HEALTH a VITAL RECORDS PEl s 079911 PONAW CORONER'S CERTIFICATE OF DEATH (See Instructions and examples on reverse) #32-073 STATE FILE NUMEIER 1.*0olDo wt(Fnl,midde,KV* 2. sex 3.sxwSK"Maaw 4.DWof 094QWm dq,yw) Stuart A Bingham, Jr. Male 178 - 72 - 8467 August 2, 2009 s.AP(lad30*1 Undw1 Udwk &DWdeaapb,d 7, MOND (04 end*0or 10* OMM eLRVd0eAPckmyab) 22 YM A101i1 °'rd rous .mw March 27, 1987 Harristairg, PA Noepbk ?bpded ?ffilwi m ?WA Oaec ?MedrgHma ?Fbeidwwe j4w-** Bb.C"dDean 3c.Cay, Try Dash 3d.F8dryWNpndkdkin9keskedeM 3. Was DecdwadHspWCOW IX No ?Yes 10. Paz Mwkmwxa %CKW6.at. Cumberland East Pennsboro Wertzville Road @ Center Street ("y"''0'0i M' (Sp,d11 mmm,PaabHaA0.) White 11. DxWoO Uad WmWm (ft of "t( hm dft mold wmft Ia Do rd *6 52 Way Deeded eve 'Into 13. Deoedm's ft' dai (Sbedly 0* fYglbat Fade conp legd) 1e. Mmkd UW Mm" Newer MWW, K Swv r q Spo use (I rake,"mWom area) KxddWak IWof&* slk4s" U.S.PmadFaces? Ele-fty/Seaardery(0.12) Coapa(1.4 ) Wdoe+d,DaaadlSPao?11 1 S?vilae State Coverr>rnent ?yn Erb 3 Never Married 10. ftWO'e M*gAddam PaK *1 bw, f. dp coda) DoWmfs oM DaudW 9de Pennsylvania Weiia 17o ?YeADMWWU.din EaSt Pennsbolro T Ada RoWwn 17a 3588 Golf View Drive . . aP. Toro*? Mechanicsburg, PA 17050 ? 17L Cunberland nd No Dendaa uwd wln #"Lkid 0y/B= A FaM Mena Fat red k bet aft) 13. Ww's Nwm ftK ff ft MWM MM) Stuart A. Bingham Renee Leuer ft k*mwft Mme (type / Prka) 206. Wamad'e M09A*= RnK dY/WA ft 10 axb) Stuart A. B' 3588 Golf View Drive, Mechanicsburg, PA 17050 21aMdWdDYpD&lm ?Cmmr1 ?Dmdm 21ADebdoiapoalimPmt4day, yw4 21o.PletadDbpadkmpwdmwmy,,awmayor dhwpin) 21d.1 aaI (Clylbnapb,aipada) ®? awnaedkaa3mb i W0 am?r: r ' "&d?*0* August 7, 2009 Chestnut Hill Cemetery Mechanicsburg, Ph 22L 3kpYe $MMOe ? ) 22b. UW W Naha 22& NM XW Aft=d NA 8 Market Plaza Way ? 6 FU-138630 1 Mal zi Fwwal Hone Mechanicshirg, PA 17055 23aemywlrm ML To isbeddny QUk* deelmrWdfkkddewdp1mwAftlanad6) ZQlianwMmbr 2kOW?FrdPMKd1%y* bnaarrb6bdaae b aaeya.eddadr. h02428mWbeoanpbledbypwem 24.TkmofN NO 25.DWPwwnoedDadpmhdry, year) 2s. Was ROMW13MddExmwwlCamwkraPaesmOdwtoCwn0mor Dmdm? wMPawereadda 6:06 P. M. August 2, 2009 ?No CAUSE OF DEATH Is« twasKaona rd axempbe) , Ammiw www: Pwt & Edw ctw 23. OW ft= We 026M b Deli? Im27.Pa1kEewMyy?.a.ES -6aarea,iguiee„aoarplowfaw-MddndyawdneaedADONOTenlwMnakwlerwdawxnaeaaUeceaesl, i Omdboeart Uramagingam0ftcuetwnPatt ?Yea ?Pmhahy apkday arrest arawkUwaeldm wega ahaAnpae Wba• Ud sky a. awe m as h. r r ? No ? Uawam a Multiple Blunt Force Trauma 25.1FareM: ? Dub(aaeaaxeapwadk HdM0ddnPdyW woadlaa Iwy b. Motor Vehicle Crash ; k ? Pmgwddanaaaeea 4L DAZ(or asawwwaoo: i ?NdpgwakApmgnataeln42dip irerbmaatp'n? c r MwkemwxnYn adeaa Dueblaasaoawagwrced): i ?Na(P4M1PAPpW3&p%oIyw d. bdW did ? IMowmlPgwtwaitlaNdYew 3o?Wbm/dbpey 3CDMweWopry ftft '' 3t•YwawdDalh 3ZaDaMdY}aY(kbrirdewral 32ADaaaelbwkr.ylyaxaad Belted operator, struck w.PbadbpFHmFomShKFab% P«armem kAlftwa I OMOIDDdboDCa d ? " "" ' ?"°' de August 2 2009 broadside by vehicle that ran red light OeGeBod?d'np° Road ? N. ND ? Wa Ns t ? , ?. O.A."' ?p?,gMao. 3TETbmdY?wy A ft4gdWbdR 321.1TtrVMVMY?rfl 32planNmdklu7l ldllbwAdwa) ?&M ?`aotabBDN1n1nid kL 5 35 P ?Yo (W ? ? Wertzville Road, Enola, PA . 89e.carMw(drrAMyan) b Pl d e 336. Chief Deputy w,a a?yYyp ydd.,l yd ybg,aa,dd„6,d,w,end,,,pnpidmk.pmrwwaddwhwdapwadkm2? -------------------------------- ? Coroner ' tsar.Nk MW00"Pk0R]mQhMidnbdpidgn4 ig6dimd="bandded4 W T l k k d d d ' a + ? ftUkwaMmbw 33d0a1s9(FwdAkaMAdwlYwl e a a .y ae eye, e raeana d.e rr, kadpaokmWftsbft==M admmaditL----------------- ' NdWF aitla/Cmw Oelakaebdb..Yrlaraadiff, alga Inof00 ok60aaowIMA Aft adp.a,ad6obl.ammodwmanr¦e 0_0 August 5, 2009 b . ? aPwsmW6kCaipYMOCmdW apmT/) 701PM Z 1 1 k6A? a Todd C. Eckenrode, Chief Deputy Coroner 6375 Basehore Road Suite ,,`, Io I I I II q DbpoeeenPe k 0389576 EXh?bit "ID 11 7174125049 nationwide Nationwide Insurance pa wonw0 2 how-we ANAdhWROM N&do wA&AwdWmIMN T11ae NWXMM Qn 1bw $W Vkwk IKwaaw P.O. Box 10405 ' NESAO Class Claims ' Des Moines, IA 50306-9475 December 1, 2009 The Law Offices of Colgan Marzmcco, LLC 130 West Church St Suite 100 Dillsburg, PA 17019 OUR INSURED : Richard W. Jones OUR CLAN NUMIBER : 72 14 20 074702 08022009 01 DATE OF LOSS : 08-02-2009 YOUR CLIENT : Estate of Stuart Bingham Jr Dear Christopher Marzzaoco: 04:57:04 p.m. 12-01-2009 2/4 This letter is to confirm our offer of $100,000.00 in settlement of your clients claim against our insured for the above accident. Thank you for your cooperation in this matter and your prompt response. Sincerely, Nationwide Agribusiness Insurance Company Tyler Hauck Claims Department (717)651-5436 Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such a person to criminal and civil penalties. Exhibit it E" 7174125049 nationwide Nationwide insurance 04:57:41 p.m. 12-01-2009 4/4 RELEASE OF ALL CLAIMS CLAIM NUMBER: 72 14 20 074702 08022009 01 FOR AND IN CONSIDERATION OF the payment to m&%w the Sum of ($100,000.00) dollars. and other good and vaiuable consideration, I/we, being of lawful age, have released and discharged, and by these presents do for myseN/ourselves, my/our heirs, executors, administrators and assigns, release, acquit and forever discharge Richard W. Janes, Nationwide Insurance Company and any and all other persons, firms and corporations, whether herein named or referred to or not, of and from any and all past, present and future acyons, causes of action, claims, demands, damages, coats, loss of services, expenses, compensation, third party actions, suits at law or in equity, including daims or suits for contribution andlor indemnity, of whatever nature, and all consequential damage on account of, or in any way growing out of any and all known and unknown personal injuries, death, ardor property damage resulting or to result from an accident that occurred on or about 08-02.2009 at or near CENTRE/WERTZVILL ENOLA PA17025CUMBERLAND. I/we hereby declare and represent that the injuries sustained may be permanent and progressive and that recovery therefrom is uncertain and indefinite, and in making this release and agreement it Is understood and agreed that Uwe rely wholly upon my/our own judgment, belief and knowledge of the nature, extent and duration of said injuries, and that Uwe have not been influenced to any extent whatever in making this release by any representations or statements regarding said injuries, or regarding any other matters, made by the persons, firms or corporatiom who are hereby released, or by any person or persons representing him or them, or by any physician or surgeon by him or them employed. Vwe understand that this settlement is the compromise of a doubtful and disputed claim, and that the payment is not to be construed as an admission of liability on the part of the persons, firms and corporations hereby released by whom liability is expressly denied. It is further understood and agreed that I am responsible for the payment of any Ilan or charges against the settlement sum, including but not limited to Worker's Compensation liens, liens of the Department of Public Welfare or low arising out of any other form of public assistance. Should any person or entity drake a claim for payment of any liens or charges against the released parties, I hereby agree to indemnty and hold harmless the released parties, from any and all liens, charges, fees, attorney's fees, cost, interest and other sums. It is agreed that distribution of the above sum shall be made as follows: one IUmp sum made payable as the court outlines. This release contains the ENTIRE AGREEMENT between the parties hereto, and the terms of this release are contractual and not a more recital. Uwe further state that I/we have carefuily read the foregoing release and know the contents thereof, and Uwe sign the same as my/our own tree act. WITNESS In the presence of: Name Address Name Address State of , County of hand and seal this _ day of , 20 CAUTIONI READ BEFORE SIGNING Your Signature (SEAL) Your Signature (SEAL) On this day of , 20 Before me personally appeared to me known to be the person... described herein, and who executed the foregoing instrument and he/she acknowledged that he/she voluntarily executed the same. My tern expires , 20 Notary Public Any person who knowingly and with intent to defraud any insurance company or other person files an application for insurance or statement of claim containing any materially false information or conceals for the purpose of misleading, information concerning any fact material thereto commits a fraudulent insurance act, which is a crime and subjects such a person to criminal and civil penalties. EXh0 0 t 66f:ll Colgan Marzzacco, LLC 130 West Church Street Suite 100 Dillsburg, PA 17019 To: Stuart A. Bingham, Jr. 417 Delancey Ct. Mechanicsburg, PA 17055 Statement Date 1/19/2010 Amount Due Amount Enc. $1,679.98 Date Transaction Amount Balance 04/30/2009 Balance forward 0.00 09/30/2009 INV # 143. 19.74 19.74 11/25/2009 INV #230. 19.04 38.78 11/25/2009 INV #231. VOID: 0.00 38.78 11/25/2009 INV #233. 5.00 43.78 12/11/2009 INV #239. 1,520.00 1,563.78 12/11/2009 INV #240. 24.20 1,587.98 01/19/2010 INV #250. 92.00 1,679.98 CURRENT 1-30 DAYS PAST 31-60 DAYS PAST 61-90 DAYS PAST OVER 90 DAYS Amount Due DUE DUE DUE PAST DUE 92.00 0.00 1,568.24 0.00 19.74 $1,679.98 Colgan Marzzacco, LLC 130 West Church Street Suite 100 Dillsburg, PA 17019 Bill To Stuart A. Bingham 3588 Golfview Dr. Mechanicsburg, PA 17050 Invoice Date Invoice # 9/30/2009 143 Terms Date Description Attorney Time Rate Amount 8/20/2009 Cost to obtain accident report Postage for 3rd Quarter, 2009. Marzzacco 15.00 15.00 4.74 Total $19.74 Colgan Marzzacco, LLC 130 West Church Street Suite 100 Dillsburg, PA 17019 Bill To Stuart A. Bingham 3588 Golfview Dr. Mechanicsburg, PA 17050 Invoice Date Invoice # 11/25/2009 230 Terms Date Description Attorney Time Rate Amount 11/9/2009 Postage through conclusion of case Marzzacco 19.04 19.04 Total $19.04 Colgan Marzzacco, LLC 130 West Church Street Suite 100 Dillsburg, PA 17019 Bill To Stuart A. Bingham 3588 Golfview Dr. Mechanicsburg, PA 17050 Invoice Date Invoice # 1112512009 233 Terms Date Description Attorney Time Rate Amount 11/25/2009 Notary Fee - Nationwide Release Marzzacco 5.00 5.00 Total $5.00 Colgan Marzzacco, LLC 130 West Church Street Suite 100 Dillsburg, PA 17019 Bill To Stuart A. Bingham 3588 Golfview Dr. Mechanicsburg, PA 17050 Invoice Date Invoice # 12/11/2009 239 Terms Date Description Attorney Time Rate Amount 12/10/2009 Investigative work by Applied Forensic Solutions Marzzacco 1,520.00 1,520.00 Total $1,520.00 Colgan Marzzacco, LLC 130 West Church Street Suite 100 Dillsburg, PA 17019 Bill To Stuart A. Bingham 3588 Golfview Dr. Mechanicsburg, PA 17050 Invoice Date Invoice # 12/11/2009 240 Terms Date Description Attorney Time Rate Amount 12/11/2009 12/11/2009 Postage (Petition for Approval filing) Postage (finalization of case) Marzzacco Marzzacco 19.80 4.40 19.80 4.40 Total $24.20 Colgan Marzzacco, LLC 130 West Church Street Suite 100 Dillsburg, PA 17019 Bill To Stuart A. Bingham, Jr. 417 Delancey Ct. Mechanicsburg, PA 17055 Invoice Date Invoice # 1/19/2010 250 Terms Date Description Attorney Time Rate Amount 1/19/2010 Cost to file Petition for Court Approval Marzzacco 92.00 92.00 Total $92.00 ejktilbit fifiG 11 0 THE LAW OFFICES OF COLGAN MARZZACCO LLC Timothy J. Colgan Christopher J. Marzzacco David E. Hershey Thomas M. Clark Shawn M. Curry AUTHORITY TO REPRESENT ON A CONTINGENT FEE BASIS I do hereby retain and employ CHRISTOPHER J. MARZZACCO, Esquire, as my,4ttorpey to represept me in my claim against firm, or cor ration liable therefor resultin f or about tW4j,C&,2 , .? Pennsylvaniaj- or against any other person, rom an,gccidenYinci?ent which occurred on in lam o-- gA J County, FEE: IPA I agree to pay CHRISTOPHER J. MARZ 6?8 from the proceeds of any recovery by settlement or verdict, as follows: Thirty- ' percent -7 of any amounts recovered from any available source in this case. The legal fee i `earned" when my Attorney receives 'a settlement offer from another party or as per the terms contained in the "Termination" paragraph below. If my Attorney does not make a recovery on my behalf, I understand that I do not owe him a legal fee. COSTS: I understand and agree that all costs in this matter will be advanced by my attorney, but will remain my responsibility if no recovery is made on my behalf. If a recovery is made, all advanced costs will be deducted from my portion of said recovery. I hereby agree that "costs" include, but are not limited to, the costs of investigation, preparation, research, experts, court costs and other incidentals such as copying, and postage, and if necessary, my attorney's transportation, accommodation and meal expenses if travel to another jurisdiction is necessary to pursue my claim. AUTHORITY TO ACT: I hereby expressly give my Attorney the authority to execute all checks, releases, health insurance lien documentation forms, Medicare/Medicaid forms, financial forms, medical authorizations and all other documents necessary to pursue and settle my claim or claims, as if I were personally signing the same. In cases of a settlement on my behalf, upon receipt of a release, my Attorney may sign the same for me, after explanation of the terms contained therein and request payment from the responsible party or company. Upon receipt of the settlement check, my Attorney is permitted to sign the same on my behalf, deduct legal fees, costs, expenses and all lien amounts and to send me a check via mail. This paragraph is intended to expedite settlement for me and to facilitate payment of legal fees, costs and expenses once the same have been earned. 130 W. Church Street, Suite 100 • Dillsburg, PA 17019 • P: 717-502-5000 • F: 717-502-5050 • Toll Free: 1-800-615-0115 • www.cmlawl.com Where Every Client Mailters Offices in Dilisburg, York, Harrisburg, Scranton Area TERMINATION: Should I terminate this contract before payment of an outstanding settlement offer or verdict is received by my Attorney, I understand that my attorney is entitled to payment for his time at his hourly rate of $250.00, or 35% of any existing settlement offer negotiated by him, plus advanced costs, as of that date. I also understand that my attorney may terminate this contract at any time, if after a reasonable investigation, he determines that the case lacks merit and would not be successful if litigated. If my Attorney terminates this contract before a settlement offer is paid, I understand that I do not owe him a legal fee. Therefore, having read this document and discussed any concerns regarding the same with my attorney, hereby sign this document and agree to be bound by its terms. Dated this day of , f r., /n ATTORN LIENT ' [end of document] Exhibit 11 H" v-sy pennsylvania DEPARTMENT OF REVENUE December 31, 2009 Christopher J. Marzzacco Law office of Colgan Marzzacco 130 W. Church Street, Suite 100 Dillsburg, PA 17019 Re: Estate of Stuart Bingham, Jr. File Number 2109-0805 Court of Common Pleas Cumberland County Dear Mr. Marzzacco: The Department of Revenue has received the Petition for Approval of Settlement Claim to be filed on behalf of the above-referenced Estate in regard to a wrongful death and survival action. It has been forwarded to this Bureau for the Commonwealth's approval of the allocation of the proceeds paid to settle the actions. Pursuant to the Petition, the 22 year old decedent died as a result of a motor vehicle accident. Decedent is survived by his parents. Please be advised that, based upon these facts and for inheritance tax purposes only, this Department has no objection to the proposed allocation of the net proceeds of this action, $28,400.00 to the wrongful death claim and $ 39,3933.52 to the survival claim. Proceeds of a survival action are an asset included in the decedent's estate and are subject to the imposition of Pennsylvania inheritance tax. 42 Pa.C.S.A. §8302; 72 P.S. §9106, 9107. Costs and fees must be deducted in the same percentages as the proceeds are allocated. In re Estate of Merryman, 669 A.2d 1059 (Pa. Cmwlth. 1995). I trust that this letter is a sufficient representation of the Department's position on this matter. As the Department has no objections to the Petition, an attorney from the Department of Revenue will not be attending any hearing regarding it. Please contact me if you or the Court has any questions or requires anything additional from this Bureau. S14crely, C-. I vj?zu $hannon E. Baker Trust Valuation Specialist Inheritance Tax Division Bureau of Individual Taxes Bureau of Individual Taxes PO Box 280601 1 Harrisburg, PA 17128 1717.783.5824 1 shabaker@state.pa.us s. i FILE 'FE ,.. 2010 JAN 25 FK 2: 35 JAN 212010 ri M1? 1 F. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA In re: Estate of Stuart A. Bingham, Jr. CIVIL ACTION - LAW NO. 10 - 4SI.. 0'tvit --r?rM ORDER AND NOW this day of 20, having reviewed the enclosed Petition for Approval and Settlement of Wrongful Death and Survival Actions with concurrences from all parties involved, it is hereby Ordered and decreed that: 1. Petitioner, Stuart A. Bingham, Sr., as Administrator of the Estate, is authorized and empowered to settle the above-captioned matter on behalf of the Estate of Stuart A. Bingham, Jr., by accepting the sum of one hundred thousand dollars ($100,000.00) for the claims referenced within said Petition. 2. The amount of one hundred thousand dollars ($100,000.00) is hereby approved and may be accepted by the representative of the Estate and distributed • pursuant to the laws of this Commonwealth as follows: (a) Pennsylvania Wrongful Death Statute, 42 Pa. C.S.A. Section 8301: $ 28,400.00 (b) Pennsylvania Survival Act; 42 Pa. C.S.A. Section 8302: $39,920.02 (c) Colgan Marzzacco Counsel Fees $30,000.00 (d) Colgan Marzzacco (Costs) $ 1.679.98 $100,000.00 DISTRIBUTION: ? 1'4- ristopher J. Marzzacco, Esquire, 130 W. Church Street, Suite 100, Dillsburg, PA 17019 Shannon E. Baker: Business and Trust Valuation Manager, Inheritance Tax Division, PA Dept. of Revenue Bureau of Individual Taxes, Department 28061, Harrisburg, Pennsylvania 17128-0601 Viler Hauck: Nationwide Insurance Company, P.O. Box 10405, NESRO Class Claims, Des Moines, IA 50306-9475 ?? t?ES' M.ci.l BY THE COURT: