HomeMy WebLinkAbout02-3863
CHRISTINE ANDELA, Administratrix of the
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
CIVIL ACTION - LAW
v.
JAMES E. PRUITT;
COVENANT TRANSPORT, INC.; and
SOUTHERN REFRIGERATED
TRANSPORT,
NO. IJ.,),- 3.1'(.3 ~J f.tA-
Defendants
JURY TRIAL DEMANDED
NOTICE TO DEFEND
You have been sued in court, If you wish to defend against the claims set forth in the following pages. you
must take action within twenty (20) days after this Complaint and Notice are served, by entering a written
appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims
set forth against you, You are warned that if you fail to do so the case may proceed without you and a judgment
may be entered against you by the Court without further notice for any money claimed in the Complaint or for any
other claim or relief requested by the Plaintiff, You may lose money or property or other rights important to you,
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A
LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO
FIND OUT WHERE YOU CAN GET LEGAL HELP,
COURT ADMINISTRATOR
4th Fl., Cumberland County Courthouse
Carlisle, Pennsylvania 1710 I
(717) 240-6200
NOTICIA
Le han demandado a usted en la corte, Si usted quiere defenderse de estas demandas expuestas en las
paginas sugnuientes, usted tiene viente (20) dias de plazo al partir de Ia fecha de la demanda y la notificacion. Usted
debe presentar una apariencia escrita 0 en persona 0 por abogado y archivar en la corte en forma escrita sus defensas
o sus objeciones alas demandas en contra de su persona. Sea avisado que si listed no se defiende, la corte tomara
medidas y puede entrar una orden contra usted sin previo aviso 0 notificacion y por cualquier queja 0 alivio que es
pedido en la peticion de demanda, Usted puede perder dinero 0 sus propiedades 0 otros derechos importantes para
usted,
LLEVE ESTA DEMANDA A UN ABOGADO IMMEDIATEMENTE, SI NO TIENE ABOGADO 0 SI
NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR
TELEFONO A LA OFICINA CUYA D1RECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR
DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL.
COURT ADMINISTRATOR
4th Fl., Cumberland County Courthouse
Carlisle, Pennsylvania 17101
(717) 240-6200
ORIGINAL
237860.1 IMTGILC3
CHRISTINE ANDELA, Administratrix of the
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
CIVIL ACTION - LAW
v.
JAMES E. PRUITT;
COVENANT TRANSPORT, INC.; and
SOUTHERN REFRIGERATED
TRANSPORT,
NO. 0:1. 3.1'(...3 ~ T u--<----
Defendants
JURY TRIAL DEMANDED
COMPLAINT
1. Plaintiff Christine Andela is an adult individual and a citizen of the
Commonwealth of Pennsylvania who resides in Lebanon, Lebanon County, Pennsylvania. Ms.
Andela was appointed as the Administratrix of the Estate of John D. Andela on July 16,2001, by
the Register of Wills of York County, Pennsylvania.
2. Decedent, John D. Andela, was a citizen of York County, Pennsylvania. The
Decedent was born on February 10, 1966, and died on June 26,2001.
3. Defendant James E. Pruitt is an adult individual who resides at One Ives Drive,
North Little Rock, Arkansas 72117.
4. Defendant Covenant Transport, Inc. (hereinafter Covenant) is a corporation with a
principal place of business located at 400 Birmingham Highway, Chattanooga, Tennessee
37419-2346.
5. Defendant Southern Refrigerated Transport (hereinafter Southern) is a corporation
with a principal place of business located at 210 Highway #71 North, Ashdown, Little River
County, Arkansas 71822.
237860.1\MTG\LC3
6. On or about June 26, 2001, Decedent John D. Andela was operating a delivery
truck in the course and scope of his employment with Schenk's Pastry Shoppe. Mr. Andela was
traveling in an eastbound direction on Trindle Road (SR 641), Cumberland County,
Pennsylvania.
7. At the same time, Defendant James E. Pruitt was acting in the course and scope of
his employment and/or as an agent of Defendant Southern and/or Defendant Covenant, and was
operating a tractor-trailer owned by Defendant Covenant in an eastbound direction on Trindle
Road.
8. Defendant Pruitt was attempting to locate the Ralston Purina business and became
lost.
9. Defendant Pruitt stopped his tractor-trailer in front of a railroad bridge near the
5000 block of Trindle Road in Hampden Township, Cumberland County because he feared that
his truck would not fit under the thirteen-foot six-inch (13' 6") bridge.
10. Defendant Pruitt did not place appropriate warning signs and/or signals around his
stopped tractor-trailer.
11. Mr. Andela stopped his delivery van behind Defendant Pruitt's tractor-trailer as it
was blocking the eastbound lane, and in essence, was disabled.
12. Defendant Pruitt approached Mr. Andela, asked for directions to Ralston Purina,
and asked whether Mr. Andela thought the tractor-trailer would fit under the bridge. After a
discussion, Mr. Andela offered to stand near the tractor-trailer and watch the top of the tractor-
trailer as Defendant Pruitt drove under the bridge.
13. Due to the size and noise of the tractor-trailer, Mr. Andela had to stand on the left
side of the tractor-trailer to assist Defendant Pruitt,
237860.llMTGILC3
2
14. While Mr. Andela was guiding Defendant Pruitt under the bridge, Heather
Frampton was operating a Nissan Sentra in a westbound direction on Trindle Road.
15. As Ms. Frampton drove under the railroad bridge, she caused the front of her
vehicle to strike Mr. Ande1a and pushed him approximately eighty-eight feet (88').
16. Mr. Andela died as a result of the impact.
COUNT I
Christine Andela. Administratrix of the Estate of John D. Andela, Decedent v. James E. Pruitt.
Covenant Transport, Inc.. and Southern Refrigerated Transport
17. Paragraph I through 16 of the Complaint are incorporated herein by reference.
18. The foregoing accident and all of the injuries and damages set forth hereinafter
are the direct and proximate results of the negligent, careless, wanton, and reckless manner in
which Defendant James Pruitt, while an employee and/or agent of Defendant Covenant
Transport, Inc., and/or Southern Refrigerated Transport and operated his tractor-trailer as
follows:
(a) failure to know the height of his tractor-trailer;
(b) failure to properly plan his route to avoid becoming lost and to avoid
potentially low bridges;
(c) failure to place appropriate warning signs or signals around his stopped
tractor-trailer in accordance with 75 Pa.C.S.A. g4530 and 45 CFR 393.95;
(d) negligently creating a dangerous situation which led to the foreseeable death
of Mr. Andela; and
(e) stopping his vehicle upon the highway in a manner endangering persons and
property and in a reckless manner with careless disregard to the rights and
safety of others and in violation of the Motor Vehicle Code of the
Commonwealth of Pennsylvania.
237860,1\MTGILC3
3
CLAIM I - SURVIVAL ACTION
19. Paragraphs I through 18 of the Complaint are incorporated herein by reference.
20. Plaintiff, Christine Andela, Personal Representative of the Estate of John D.
Andela, deceased, brings this action on behalf of the Estate of John D. Andela under and by
virtue of the Act of 1976, July 9, P.L. 586, No. 142, ~2, 42 Pa.C.S.A. ~8302.
WHEREFORE, Plaintiff demands judgment against Defendants James E. Pruitt,
Covenant Transport, Inc., and Southern Refrigerated Transport in an amount in excess of
Twenty-five Thousand ($25,000.00) Dollars, exclusive of interest and costs and in excess of any
jurisdictional amount requiring compulsory arbitration.
Date: Cb~ ()~
ANGINO & ROVNER, P.C.
~
1.D. No. 35956
4503 N, Front Street
Harrisburg, PA 17110
(717) 238-6791
Attorney for Plaintiff
237860.1\MTG\LC3
4
VERIFICATION
I Christine Andela, Plaintiff, have read the foregoing COMPLAINT and do hereby swear
or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge,
information and belief. I understand that this Verification is made subject to the penalties of 18
Pa,C,S.A. S 4904, relating to unsworn falsification to authorities.
WITNESS:
~ /)f .-7
l/rv'LLUhrJ
Christine Andela
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Dated: if'/ I) '1- 0 J-
237860, I\MTGILC3
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CHRISTINE ANDELA, Administratrix of the
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
CIVIL ACTION - LAW
v.
JAMES E. PRUITT;
COVENANT TRANSPORT, INC.; and
SOUTHERN REFRIGERATED
TRANSPORT,
NO. 02-3863 Civil Term
Defendants
JURY TRIAL DEMANDED
PETITION FOR APPROVAL OF A COMPROMISE SETTLEMENT AND DISTRIBUTION
OF PROCEEDS PURSUANT TO Pa.R.C.P. 2206
The Petitioner, Christine Andela, Administratrix of the Estate of John D. Andela,
deceased, by and through her attorneys, Angino & Rovner, P.e., hereby avers as follows:
1. Your Petitioner is the Administratrix of the Estate of John D. Andela, deceased,
by Letters of Administration granted to her by the Register of Wills of York County,
Commonwealth of Pennsylvania. The Letters of Administration were granted on July 16,2001,
and attached as Exhibit A is a copy of the Grant of Letters,
2. The decedent, John D. Andela, was the husband of the Petitioner, Christine
Andela. The decedent was born on February 12, 1966, and died on June 26, 2001, as a result of
a motor vehicle accident occurring in Cumberland County, Pennsylvania.
3, Immediately before the subject fatal motor vehicle accident on June 26, 2001, the
decedent was operating a delivery truck while in the scope of his employment with Schenk's
Pastry Shoppe. The decedent, Mr. John Andela, was operating a delivery truck owned by
Schenk's Pastry Shoppe and was travelling in an eastbound direction on Trindle Road,
Cumberland County, Pennsylvania.
250208,1 IDLL\MTG
4. Defendant James R. Pruitt had been operating a tractor-trailer in an eastbound
direction on Trindle Road and had stopped his tractor-trailer on the west end of a railroad bridge
near the 500 block of Toodle Road in Hampden Township. It is believed that Defendant Pruitt
stopped his truck because he thought that the truck and trailer would not fit under the 13' 6"
clearance of the bridge.
5, Given the stopped tractor-trailer on Trindle Road, the decedent stopped the
Schenk's delivery van behind Pruitt's trailer and it is assumed that Defendant Pruitt asked the
decedent whether he thought the tractor-trailer would fit under the bridge. After discussion, the
decedent offered to stand beside the tractor-trailer and watch the top of the tractor-trailer as
Defendant Pruitt drove under the bridge.
6. While the decedent was guiding Defendant Pruitt and the tractor-trailer under the
bridge, Heather K. Frampton was operating a Nissan Sentra, traveling westbound on Trindle
Road.
7. As Ms. Frampton drove under the railroad bridge, the front of her vehicle struck
the decedent. John D. Andela died as a result of the motor vehicle accident. Attached as
Exhibit B is the Hampden Township Police Accident report.
8. State Farm Insurance Company provided liability insurance coverage to Heather
K, Frampton relevant to the subject fatal motor vehicle accident.
9. Although disputing liability for the fatal motor vehicle accident, State Farm
agreed to pay and compromise the disputed claim arising from the subject motor vehicle accident
and offer $80,000.00 of its policy limits of $100,000.00.
10. Your Honorable Court approved the third-party settlement and attached as
Exhibit C is Your Court's May 9, 2002, Order approving the settlement.
2S0208,IIDLL\MTG
2
1\
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11. In addition to making a third-party claim, Petitioner, by and through counsel,
Angino & Rovner, filed a Claim Petition for worker's compensation benefits,
12. The employer filed an Answer and thereafter the parties filed a Stipulation of
Undisputed Facts Claim Petition.
13. Essentially, the dispute presented before worker's compensation Judge Christina
Tarantelli was whether the decedent's son, Brandon Andela, was a dependent of the decedent
and entitled to death benefits.
14. After a hearing before Judge Tarantelli on February 6, 2002, and before a second
hearing was scheduled, the parties reached an amicable resolution, pending approval of Your
Honorable Court,
15 . Your Honorable Court approved the worker's compensation settlement and
attached hereto as Exhibit D is Your Court's July 24, 2002, Order approving the compromise
and release.
16. The Petitioner initiated the present action against the Defendants in the Court of
Common Pleas of Cumberland County. Attached as Exhibit E is a copy of the Complaint.
17. Thereafter, the Defendants offered to settle the present action for the
consideration of $25,000.00, pending approval by Your Honorable Court. Attached as Exhibit F
is the proposed Release to settle the above-captioned action,
18. The Petitioner retained the law firm of Angino & Rovner to prosecute this action.
19. Angino & Rovner seeks to recover 30% or $7,500.00 of the $25,000.00 settlement
for attorney's fees.
250208.1\DLLIMTG
3
20. Additionally, Angino & Rovner, P.C., has spent more than $325.00 in out-of-
pocket expenses. Attached hereto as Exhibit G is a computer print-out of incurred out-of-pocket
expenses.
21. Petitioner's counsel has received approval of the allocation between the Wrongful
Death Action and Survival Action from the Department of Revenue. See, Paul Dibert's
September 6, 2002, letter from the Department of Revenue, attached as Exhibit H.
22. Petitioner believes that a fair, just, and equitable distribution would be as follows:
(a)
Estate of John D. Andela, deceased, under
the Survival Action
$ 3,435,00
(b)
Estate of John D. Andela, deceased, under
the Wrongful Death Action
$13,740.00
(c)
Angino & Rovner, P.C" professional fees
based on 30% of the gross amount recovered
(d)
Angino & Rovner, P.C., out-of-pocket expenses
$ 7,500.00
$ 325.00
$25,000.00
TOTAL PRESENT DISTRIBUTION
23. Distribution of the net proceeds of $54,972.00 from the third-party settlement
payable to the Estate of John Andela should have been distributed as follows:
$54,972.00 - Net proceeds
$30.000.00 - To surviving spouse, Christine Andela
$24,972.00 - Balance
$12,486.00 - To surviving spouse, Christine Andela
$12,486.00 - To surviving minor child, Brandon Andela
However, Your Petitioner, Christine Andela, Administratrix of the Estate of John D.
Andela, expended the $12,486.00 proceeds that should have been paid into an account for
Brandon Ande1a to purchase a new home and furniture. Therefore, all of the net proceeds of
250208.1 IDLLIMTG
4
~
$17,175.00 due to the Estate of John D. Andela from the $25,000.00 settlement from the
Defendants herein, should be deposited into an account for Brandon Ande1a in the First Union
Bank.
WHEREFORE, Petitioner prays Your Honorable Court to enter an Order approving said
compromised settlement, directing the distribution of the proceeds in accordance with the
averments of this Petition and permit Christine Andela, Administratrix of the Estate of John D.
Andela, to execute the proposed Release.
Date:
\~ ~~\O'l
ANGINa & ROVNER, P.C.
~
David L. Lutz
J.D. No. 35956
4503 N. Front Street
Harrisburg, P A 1711 0
(717) 238-6791
Attorney for Plaintiff/Petitioner
250208,l\DLLIMTG
5
VERIFICATION
I, Christine Andela, Administratrix of the Estate of John D. Andela, deceased, Plaintiff,
hereby verify that the facts set forth in the foregoing document are true and correct to the best of my
knowledge, information and belief, I understand that any false statements therein are made subject
to the penalties of 18 Pa,C,S.A. ~4904, relating to unsworn falsification to authorities.
WllNESS:
~
(~h~~ flanr1P1CL
Christine Andela, Administratrix of the
Estate of John D. Andela
Date: ((~ f-cJd-
2S0208,1\DLLIMTG
Exhibit A
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Exhibit B
Police Agency Patrol Zone
CiliIilQEJ ITIJ
Investigation Date (MM-DD-VYYY)
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Approval Date (MM-DD-yyyY)
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Dav 0' Week
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No Injured No Killed (If > 00. a Mon a Fri
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School Zone Related PennDOT Property
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FI MI Telephone Number
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Model Year Vehicle Make.
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Reg. State Travel Speed
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N\wUAL-117Z8 15Sb-Aoz.-3841-r17-7bb_ileq
Towed To Towed By Tow Agency Phone
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Model Year Vehicle Make.
ID DID CD
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Policy No
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Towed By
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POLICE CRASH REPORTING' . -,RM
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Agency Name
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Dispatch Time (mm Arrival Time (mil)
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County County Name
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Reportable Crash
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Crash Number
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o legally Parked a Non - Motorized
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a Phantom Vehicle
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.Refer to li5t on
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Unit Number Trailina Unit(s) Tv"e of Unit 5=Camper ~OTagNO I I Tag I
[Q]J] Number [Q] t=Towing Passenger Veh 6= Trailer ] Tag 0
2=Towing Truck 7=5emi-Trailer Year Slale
of Trailing 3=Towing Utility Trailer 8=0lher ~ 0 Tag No I I Tag I 1
Units: Tag 0
4=Mobile or Modular Home 9=Unknown Year State
Vehicle Color IDI"2-1 Vehicle Tv"e ~ ~ 10101
01=81ue ~ 12=Commercial
02=Red 08=Gold 01=Automobile, 11=EarmJ:,quip,__ , 22=Horse and Buggy OO=Not Applicable Passenger Carrier
03=White 09=Brown 02=Motorcycle 12=Construction Equip 23=Horse and Rider 01=Fire Veh - 13=Taxj- ,-
04=Green 10=Orange 03=Bus lB=Other Type Special Veh 24= Train 02=Ambulance 21=Tractor Trailer
05=81ack II=Purple 04=Small Truck 19=Unknown Type Special Veh 25= Trolley 03=Police 22=Twin Trailer
06=Yellow 12=Other OS=Large Truck 20=Unicycle, Bicycle. Tricyc", 98=Other 08=Other Emergency 23=Triple Trailer
07 =Silver 99=Unknown 10=Snowmobile 21 =Other Pedalcycle 99=Unknown Vehicle 31=Modified Veh
1 I=Pupil Transport 99-Unknown
Initial/moact Point [ill] Damaae Indicator ~ Vehicle Role [0 Vehicle P05it;on [QIIJ
'~' O=None OO=Not Applicable
OO=Non-Collision I=Minor (Driveablel O=Non-Collision 01=Right Lane (Curbl
2=Functional t=Striking 02=Right Turn Lane OB=L!ft of Trafficway
(Moderate Damage, 2=Struck 03=Left Lane 09=R'ght of Trafficway
09 03 13=Top 3=Both Striking 04=left Turn Lane 10=HOV Lane
14=Undercarriage May Not be Driveable) 05=2-Direction 11=Shoulder Right
08 04 15=Towed Unit 3=Disabling (Severe - and Struck Center Turn Lane 12=Shoulder Left
07 06 05 Not Driveable) 06=Other Forward 13=One Lane Road
99=Unknown 9=Unknown Moving lane 9B=Other
07=Oncoming Traffic Lane 99=Unknown
Direction of ~ Movement [Q[IJ 07 Entering a Parked 14 Backing Up !imOOJ1 ITJ
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01=Going Straight 08= Trying to Avoid Animal. or Merging 4=5ag/Bottom of Hill
N=North 02=510wing/Stopping in Lane Ped, Object. Veh, etc 16=Negotiating 1=Level Roadway 5=Crest/Top of Hill
S=South 03=Stopped in Traffic Lane 09= Turning Right on Red Curve - Right 2=Uphill 9=Unknown
E=East 04=Passing/Overtaking Veil to= Turning Right 17=Negotiating
W=West 11=Turning Left on Red Curve - Left Alionment OJ l=Straight H
U=Unknown 05=leaving a Parked Position 12=Turning Left 91l=0ther 2=Curved
06=Parked
13=Making a U-Turn 99=Unknown 9=Unknown
Unit Number Trailino Unit(s) TVDe of Unit 5 Camper ~D Tag No I
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2=Towing Truck 7=Semi.Trailer Year State
of Trailing 3=Towing Utility Trailer 8=Other ~D Tag No I I Tag I I I
Units: Tag L-=:J
4-Mobile or Modular Home 9=Unknown Year State
Vehicle C%r [JJ Vehicle TVDe IT] ~ CD
01 =Blue ~ t2=Commercial
02=Red 08=Gold 01=Automobile 11=Farm Equip 22=Horse and Buggy OO=Not Applicable Passenger Ca trier.
03=Wllite 09=Brown 02=Motorcycle 12=Construction Equip 23=Horse and Rider 01=Fire Veh 13=Taxi
04::::;Green 10:0range 03=Bus 18=Other Type Special Veil 24=Train 02=Ambulance 21=Tractor Trailer
05=Black 11 =Purple 04=Small Truck 19=Unknown Type Special Veh 25= Trolley 03=Police 22= Twin Trailer
06=Yellow 12=Other 05=Large Truck 20=Unicycle. Bicycle. Tricycle 98=Other 08=Other Emergency 23:Triple Trailer
07=Silver 99=Unknown 10=Snowmobile 21=Other Pedalcycle 99=Unknown Vehicle 31=Modified Veh
11=Pupil Transport 99 Unknown
InitiallmDact Point IT] Damaae Indicator 0 Vehicle Role D Vehicle. Position rn
'~ O=None OO=Not Applicable
OO=Non-Collision I=Minor (Drive able) O=Non-Collision 01=Right Lane (Curb)
2=Functional 1=Striking 02=Right Turn Lane OB=L!ft of Trafficway
03=Left Lane
09 03 13=Top (Moderate Damage. 2=Struck 04=Left Turn Lane 09=R'ght of Trafficway
May Not be Driveable) 3=Both Striking 10=HOV Lane
14=Undercarriage 05=2-Direction II=Shoulder Right
08 04 3=Disabling (Severe - and Struck Center Turn lane
15=Towed Unit 12=Shoulder Left
07 06 OS 99=Unknown Not Driveable) 06=Other Forward 13=One Lane Road
9=Unknown Moving lane 98=Other
07=Oncoming Traffic lane 99-Unknown
Direction of D Movement CD 07-Entering a Parked 14-Backing Up 0
T ra vel Position 15=Cllanging Lanes Gradient 3=Downhill
01=Going Straight 08= Trying to Avoid Animal. or Merging 4=Sag/Bottom of Hill
N=North 02=Slowing/Stopping in Lane ped. Object. Veh. elc 16=Negotiating 1=level Roadway S=CreSt!Top of Hill
5=Soutll 03=Stopped in Traffic Lane 09=Turning Right on Red Curve. Right 2=Uphill 9=Unknown
E=East 04=Passing/Overtaking Veil 10=Turning Right 17=Negotiating
W=West 11=Turning Left on Red Curve. Left Alianment 0 l=Straight
U:;;Unknown 05=Leaving a Parked Position 12=Turning Left 9B=Other 2=Curved
06=Parked
13=Making a U-Turn 99=Unknown 9:;;Unknown
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COMMONWEALTH OF PENNSYLVANIA
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license Number
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_ No
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Alcohol Test Type
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o Blood
Alcohol Test Results
o Illegal Drugs
o Alcohol and Drugs
o Medication
o Unknown
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Pedestrian Sirmal at Scene of Cram
o No Pedestrian Signal
o Pedestrian Signal
Pedestrian Location
o Not at Intersection
Driver or Pedestrian Phvsical Condition
_Apparently 0 Illegal Drug
Normal Use
,--., Ha.d ~een 0 Sick
'---' Drlnkong
o Fatigue
o Asleep
,0 Medication
o Unknown
O I R dO" to Feet
Marked Crosswalks n oa way Off Road
o at Intersection 0 Not in Roadway
o > 10 Feet
o At Intersection. No 0 Median' Off Road
Crosswalks 0
o Island Outside Trafficway
o Non-Intersection 0 Shared Pathsl
Crosswalks 0 Shoulder Trails
o Driveway Access 0 Sidewalk 0 Unknown
Vehicle Code lis~ any Vehicle Cod~ Section this driver has Charged with
VIolated and mark If they were charged. Violation'
I lOves ~ No
I lOves 0 No
[QICIJ
0 Breath 0 Other r
0 Urine 0 Unknown if 0
Test Given c
..
Unknown .;:
0 Test Refused 0 ...
..
Results ..
0 Test Given. "II
..
Contaminated Results ...
Owner/Driver
Code
101-z.1
OO-Not Applicable
01 =Private Vehicle Ownedl
leased by Driver
02=Priva1e Vehicle Not
Ownedlleased by Driver
last Name
03 Rented Vehicle
04=State Police Vehicle
05=PennOOT Vehicle
06=Other State Gov Vehicle
07=Municipal Police Vehicle
OB-Other Municipal
Government Vehicle
09=Federal Gov Vehicle
98=Other
99=Unknown
Driver Presence
f\I 1=Driver Operated 3=Oriver Fled Scene
L!..J Vehicle 4=Hit and Run
2=No Driver 9=Unknown
Alcohol Test Results
Unit Number
10121
Address State Zip
I ?'3b5 6 (CoSS'TOuJN R-D IIW€LLS\1 ILLt I []!] ~
l~nsz..e Nu:err> I C- -, 8 (~1 A I
~ C=> -. c::::> tC- _ r If License Number is unknown or
driver is not Iicensed~ see manual
Alcohol/DruQs Suspected g Pedestrian Sienal at Scene of Crash
.. No 0 Illegal Drugs 0 Medication ':;; 0 No Pedestrian Signal
o Alcohol 0 Alcohol and Drugs 0 Unknown ~ 0 Pedestrian Signal
Alcohol Test Type ] Pedestrian Location
- In Roadway 0 "10 Feet
.. Test Not Given 0 Breath 0 Other 0 Marked Crosswalks Off Road
,--., Blood 0 Urine 0 Unknown if 6 at Intersection 0 Not in Roadway 0 > 10 Feet
'---' Test Given cOAt Intersection. No 0 Median Off Road
.. Crosswalks 0
:s Non-Intersection 0 Island Olltside Trafficway
~ 0 Crosswalks 0 Shoulder 0 f~';:f;d hthsl
~ 0 Driveway Acc~ss 0 Sidewalk 0 Unknown
Vehicle Code list any Vehicle Cod~ Section this driver has Charged with
VIolated and mark If they were charged. Violation?
FI MI Telephone Number
[f]WI
.. Not at Intersection
[Q].CIJ
o
o
Test Refused
Test Given,
Contaminated Results
o
Unknown
Results
Driver or Pedestrian Physical Condition
C) Apparently 0 Illegal Drug
Normal Use
C) Had Been 0 Sick
Drinking
C)
C)
Fatigue
o
.
Medication
I
I
o
Yes
o
No
Asleep
Unknown
o
Yes
o
No
Owner/Driver
Code
/0101
00 Not Applicable
01=Private Vehicle Ownedl
Leased by Driver
02=?rivate Vehicle Not
Owned/leased by Driver
03-Rented Vehicle
04=State Police Vehicle
05=PennDOT Vehicle
06=Other State Gov Vehicle
07=Municipal Police Vehicle
OB=Other Municipal
Government Vehicle
09=Federal Gov Vehicle
9B=Other
99=Unknown
Driver Presence
o
1:::0river Operated 3=Oriver Fled Scene
Vehicle 4=Hit and Run
2:::No Driver 9=Unknown
FORM it AA.4$ (01101)
Pl=Nt\lnnT rnDV
r
COMMONWEALTH OF PENI\IC;YLVANIA
PbLlCE CRASH REPORTING JRM
Crash Number
. New
)0140974
-,
AA 45 4 1
Page: 10/0 I tJ.!
o Change/
Continuation
Person TVRJ:; Seat Positio..n: Safetv Eauioment One: Eiection:
A 1_Driver D OO=Not A Passenger/Occupant E OO-None Used / Not AJ'plicable G O=Not Applicable
2=passenger 01 =Driver. All Vehicles 01=Shoulder Belt Use 1 =Not Eiected
7=Pedestrian 02=Front Seat Middle Position 02=lap Belt Used 2=Total Yi Ejected
8=Other 03=Front Seat Right Side 03=lap And Shoulder 8elt Used 3=Partia Iy Ejected
9=Unknown 04=Second Row - left Side Or 04=Child Safety Seat Used 9=Unknown
Motorcycle Passenf/er 05=Motorcycle Helmet Used
05=Second Row - Midd e Position 06=Bi'(.c1e Helmet Used Eiection Path:
Sex: 06=Second Row - Right Side 10=Sa ety 8elt Used Improperly H O-Not Ejecte~ I Not Applicable
B F ,=female 07=Third Row Or Greater. 11 =Child Safety Seat Used Improperly '"
- left Side 12=l-Ielmet Useatmproperly- -, -- 1= Through SIde Door Opening
M=Male 08=Third Row Or Greater- 90=Restraint Used, Type Unknown 2= Through Side Window
U =Unknown Middle Position 99=Unknown 3= Through Windshield
09=Third Row Or Greater- 4= Through 8ack Door
Right Side F Safetv Eauioment Two: 5= Through Back Door Tailgate Openi ng
IniuN Severitv: 10=Sleeper Section Of Truckcab OO=None Used / Not Applicable 6=Through Roof Opening (Sunroof/
11=ln Other Enclosed 01=Front Air Bag Oef.loyed (For This Seat) Convertible Top Down)
CO-Not Injured Passenger Or Cargo Area 02=Side Air Bag Dep oyed (For This Seat) 7=Through Roof Opening (Convertible
l=Killed 03=Other Type Air Bag Oeployed Top Up)
2=Major Injury 12=ln Open Area 9=Unknown t-
3=Moderate (Back Of Pickup, Etc.) 04=Multiple Air Bags Deployed
Injury 13=Trailing Unit 05=Motorcycle Eye Protection
4=Minor,lnjury 14=Riding On Vehicle Exterior 06=Bi~c1ist Wearing Elbow/Kneel E~l'atiDn.
15=Bus Passenger Ot er Pads
9=Unknown 10=Air Bag Not Deployed, Switch On I 0= ot Appl,cable
98=Other l=Not Extricated
99=Unknown 11=Air Bag Not Deployed. Switch Off 2=Extricated By Mechanical Means
12=Air Bag Not Deployed. ' 3=Freed By Non - Mechanical Means
Unk Switch Settin8 8=Other
13=Air Bag Removed Prior To Crash) 9=Unknown
19=Unknown If Air Bag Deployed
99=Unknown
'tNo Person No Date of Birth (MM-DD-VYYY) ABC 0 E F G H I
ill] [Q]IJ D~te? [iliJ-lo Is I-~ITJ[E]~~[Q@]I 0 10 1[QJ~eJ
ne / Address / Phone S e, S ,'rA I EMSTransport
i E A'T'""t-l1S\'L K:A~ ~a.A-lY\ PToI-l) -+01 . I\crimoRE )\..~~w;.~ 110lQ a Yes . No
itNo Person No Date of Birth (MM-DD-YVYV) ABC 0 E F G H I
~ 'Z-/,[QJJJ D~te? [Qli]-CLlQ] -~ GJ ~ ITJI~ Ie/I ala I f010l @~!Q]
11e / Address / Phone I EMS Transport
ol{~ ""D. AN b 6Lo '3'Ob'56 ((.o~S.TO\.9)tJ Q.b I I W EU..S \H LU:;:: '\1\ lJ~S a Yes . No
tNo Person No Date of Birth (MM-OO-YVYY) ABC 0 E F G H I
IJ CIJ D~te? CIJ-CIJ -CLIIJDDDrnrn mOOD
ne I Address / Phone
1 EMS Transport
a Yes aNo
tNo Person No Date of Birth (MM-DD-YYYY) ABC 0 E F G H I
IJ CIJ D~te? CIJ-CIJ -CLIIJDDornrn mOOD
11e / Address / Phone
J EMS Transport
a Yes aNo
tNo Person No Delete? Date of Birth (MM-DD-YYYY) ABC D E F G H I
IJ CIJ 0 CO-CO-CIIIJOOornrnCOOOO
ne I Address I Phone EMS Transport
1 o Yes 0 No
tNo Person No Date of Birth (MM-DD-YYYY) ABC D E F G H J
IJ CIJ D~te? CO-CO -CIIIJ Ooornrn CO 000
ne I Address / Phone EMS Transport
1 o Yes o No
:JRM )j AA.45 (01101)
.,.......0...............,.. ...................,.
J
COMMONWEALTH OF PENN<;YlVANIA
POLICE CFlA!5H REPORTING ,~M
_New
AA 45 5 1
Page: I 0 I 0 /s I
o Change
o "Y" Intersection 0 Off Ramp Special Location
Traffic Circle! 0 . Not Applicable 0 Bridge 0 Cross Over Related
o Crossover
Round About 0 Underpass 0 Tunnel 0 DrivewaYIParking lot
O Multi-leg 0 Railroad Crossing 0 Ramp 0 Toll Booth 0 R &.
Intersection amp Bridge
o On Ramp 0 Other (If 'Ramp' is indicated, please see manual) 0 Unknown
Complete the Principal Road Section for all type of crashes. For crashes at intersections, enter information in the Intersecting Road Section or the GPS
Section. ILy_ou _have a mid block crash, you should enter information in_ the_'Oistance from landmark' Section, the GPS Section. or the House-Number'
Section in the Princi al Road area.
County Route Number Segment (Optional) Travel lanes
[?JJJ CQ&EDJ o=rTI 1012/
Street Name
Intersection Type
-
o
o
Midblock
4 Way Intersection
"T" Intersection
Speed limit
ffiQJ
Street Ending
[lli]
Route SiClninq
r--'\ Interstate 0 Turnpike 0 Turnpike .. State
L...I (Not Turnpike) (East/West) Spur Highway
:(l County Route Number Segment (Optional) Travel lanes
~ [I] ITITICIIIJ ITJ
.0 Street Name
~
~
..
.s
~
.e
..
~
....,u.)" 1''1\'''''''''1:1
0140974
-,
o North
J. 0 South
o East
@ West
o Unknown
House Number (if applicable)
r:rr=ITfJ
0 County 0 local Road o Private C) Other!
Road or Street Road Unknown
Speed limit o North
CD J o South f-
Street Ending o East
CD o West
o Unknown
o State 0 County 0 local Road 0 Private
Highway Road or Street Road
-"
~ ~
.. E
'"' '0
S Please c
Enter .:l
'lS Information
.!;!
<Q for BOTH
~ landmarks
lE if Using N
~
.e This Option ~
.
.. E
~ '0
C
.
~
C) Other!
Unknown
10 North
o South
St Ending 0 E" ast
~ 0 West
Feet
Ur13E1?J
Or Miles
ITJ.O
Intersecting Rt Num Or Mile Post 1
~ ITII 0 o North
~~. o South
Or Intersecting Street Name St Ending 0 East
~YH==-8IIIIITIIJ [IE] o West
Degrees
Latitude: c=cJ
Traffic Control Device
Minutes Seconds
[TI:ITJ.rn
Distance From Crash
Scene to Landmark 1
(For Crash between
Landmark 1 and
Landmark 2)
Longitude:
Degrees Minutes Se<onds
ITIJ CD:CD.rn
o
o
o
o
Passive RR
Crossing Controls
Police Officer or
Flagman
Other Type TCD
Unknown
o
C)
o
Stop Sign
Yield Sign
Active RR Crossing
Controls
-
o
o
Not Applicable
Flashing Traffic
Signal
Traffic Signal
TeD FunctioninQ
. No Controls
o Device Not
Functioning
o
o
Device Functioning
Improperly
Device Functioning
Properly
o Emergency
Preemptive Signal
o Unknown
- Not a Work Zone Work Zone Location
0 Construction 0 Transition Area
0 0 Before 1st Work 0 Activity Area
Maintenance Zone Warning Sign
0 Utility Company 0 Advance Warning 0 Termination Area
0 Other Area 0 Other
Type of Work Zone (If "Not a Work Zone", skip rest of Work Zone section) Work Zone (Mark all that apply)
o Lane Closure 0 Work on Shoulder
O Road Closed with 0 or Median
Detour Intermittent or
Mavin Work
Lane Closed (If "Not Applicable". skip rest of the Lane Closure section)
~ 0 Not Applicable 0 Partially &I Fully 0 Unknown
~
0: Lane Closure Direction
* C) North
~ C) South
"
o East
o West
o North and South
& East and West
ORM il AA-45 (OH01)
Work Zone
Speed Limit
co
Traffic Detoured
Estimated Time Closed
o < 30 Minutes
o 30-60 Minutes
n~;l,I"II""l""""T ,-..,-.,,..."',
o Flagger Control
o Other
Workers
Present
DYes 0 No
o Unknown
.'Yes 0 No
III ,.3 hours
o 3-6 hours
o 6-9 hours
o 9-12 hours
o > 12 hours
o Unknown
Crash Number
J
GOMMON~EALTH OFPH'-'SYLVANIA
POLICE CRASH REPORTIN,- .'ORM
P0140974
. New
-,
Page: [iliill' o Changel
AA 45 6 1 Continuation
0 O=Non-Collision 2-Head On 4=Angle 6=Sideswipe 8-Hit Pedestrian
Crash Descriotion 1=Rear End 3=Rear to Rear 5=Sideswffie (Opposite Direction)
(Backing) (Same irection) 7=Hit Fixed Object 9=Other/Unknown
3
v [[] 1=On Travel lanes 3-Medlan S-Outside Trafficway 7 -Gore (Ramp Intersection)
v
~ Relation to Roadwav 2=Shoulder 4=Roadside 6=ln Parking lane 9=Unknown
~
- [?J 1-0aylight 3 Dark - Street S=Dawn 8=Other
3 Illumination 2=Oark - No lights 6=Dark - Unknown '
Street lights 4-Dusk Roadway lighting
5 1 No Adverse
~ OJ 3=Sleet (Hail) S_Fog 7=Sleet & Fog 9=Unknown
,. Weather Conditions Conditions 4=Snow 6=Rain & Fog 8=Other
v 2_Rain
5 2 Sand. Mud. Dirt, 4-Slush 6=lce Patches 8-0ther
E @] O=Ory Oil 7=Water - Standing
- Road Surface Conditions 1=Wet 3=Snow Covered 5=lce or Mavin
Harm Event LIR Most?
[QgJ 0 0
Unit No
[2I[] 2 ITJ 0 0
Please Put 3ITJ 0 0
Events in
Sequential
Order 4ITJ 0 0
Harm Event L/R Most7
1 ITID 0 0
Unit No
IOI2-/2ITJ 0 0
Please Put 3ITJ 0 0
Events in
Sequential
Order 4ITJ 0 0
Mlm
Harmful
Event in
the Crash
00 not repeat this In'orm~tion on multiple pageol
2LU 3IT]
E.iu.t.
Harmful
Event in
the Crash
Unit No Harm Event
[QIT] [2E]
Environmental / Roadwav
Poten tial Factors (EIR)
OO=None
01=Windy Conditions
02=Sudden Weather Conditions
03=Other Weather Conditions
04=Oeer in Roadway
05=Obstacle On Roadway
06=Other Animal In Roadway
07=Glare
08 Work Zone Related
Unit No Harm Event
IT] IT]
Harmful Events (Harm Event) 30-Hit Fence Or Wall
01_Hit Unit 1 31=Hit Building
02=Hit Unit 2 32=Hit Culvert
03=Hit Unit 3 33=Hit Bridge Pier Or Abutment
04=Hit Unit 4 34=Hit Parapet End
OS=Hit Unit 5 35=Hit Bridge Rail
06=Hit Other Traffic Unit 36=Hit 80ulder Or Obstacle
07=Hit Oeer On Roadway
08=Hit Other Animal 37=Hit Impact Attenuator
09=Collision With Other Non 38=Hit Fire Hydrant
Fixed Object 39=Hit Roadway Equipment
11=Struck By Unit 1 40=Hit Mail Box
12=Struck By Unit 2 41=Hit Traffic Island
13=Struck By Unit 3 42=Hit Snow Bank
14=5truck By Unit 4 43=Hit Temporary ConstrU<lion
IS=Struck By Unit 5 Barrier
16=Struck By Other Traffic Unit 48=Hit Other Fixed Object
21=Hit Tree Or ShrUbbery 49=Hit Unknown Fixed Object
22=Hit Embankment ' 50=0vertumIRoII Over
23=Hit UtiJ!!y Pole 51=Struck By Thrown Or Falling
24=Hit TraffiC S~n Object
2S=Hit Guard Rail 52=Pot Holes Or Other
26=Hit Guard Rail End Pavement Irregularities
27=Hit Curb S3=Jacknife
2ll=Hit Concrete Or S4=Fi~ In Vehicle
longitudinal Barrier 5ll=Other Non-Collision
29=Hit Ditch 99=Unknown Harmful Event
Left/1/ioht (1/11) l=left R-Right O=Other U=Unknown
Driver Action (D) 16_Driving The Wrong Way
On 1-Way Street
OO=No Contributing Action t7=Careless Or Illegal
01=Oriver Was Oistracted Backing On Roadway
02=Oriving Using Hand Held Phone 1ll=Oriving On The Wron9
03=Oriving Using Hands Free Phone Side of Road
04=Making Illegal U-Turn 19=Making Improper
OS=lmproper/Careless Turning Entrance to Hi9hway
06=Turning From Wrong Lane 20=Making Improper Exit
07=Proceeding W/O From Highway
Clearance After Stop 21=Careless Parklng/Unparking
08=Running Stop Sign 22=Over/Under
09=Running Red light Compensation At Curve
1ll=FaiJure To Respond To 23=Speeding
Other Traffic Control Device 24=Driving Too Fast For Conditions
11=Tailgating 2S=Failure To Maintain Proper Speed
12=Sudden 510wing/Stopping 26=Driver Fleeing Police
13=lIIegally Stopped On Road (Police Chase)
14=Care'ess Passing Or lane 27=Driver Inexperienced
Change 28=Failure To Use Specialized Equip
15=Passing In No Passing Zone 98=Other Improper Drivin9 Actions
~~itm 1m 2IT] 3 IT] 4Q]
1m 2IT] 3m
t-
1 [Q]QJ
11=Slippery Road Conditions (Ice/Snow)
12=Substance On Roadway
13=Potholes
14=Broken Or Cracked Pavement
1S=TCO Obstructed
16=Soft Shoulder Or Shoulder Drop Off
28=Other Roadway Factor
99=Unknown
Possible Vehicle Failures (V)
OO=None' 06:Exhau.st
01=Tires 07=H.eadltghts
02=Brake System 08=Slgnal l.'ghts
03=Steering System 09=Other lights
04=Suspension 10=H,?rn
05=Power Train 11=Mlrrors
~~it [Q]QJ 1 CD 2 [I]
~~it CD 1 CD 2 [I]
Indicated Prime Factor
Do not I""epeat this information on
multiple pages
12_Wipers
13=Oriver SeatinglControl
14=Body, Doors, Hood, Etc
1S=Trailer Hitch
16=Wheels
17=Airbags
18=Trailer Overloaded
19=Unsecure/Shifted
Trailer load
20=lmproper Towing
21=Obstructed Windshield
99:Unknown
Unit m
No
4Q]
Pede,trian Action (P)
OO=None
01=Entering Or Crossing At
Specified location
02=Walking. Running, Jogging,
Playing, Or Cycling
03=Working
04=Pushing Vehicle
OS=Approaching Or leaving Vehicle
06=Playing Or Working On Vehicle
07=Slanding
9B=Other
Unit No Factor Code
1012110171
EIR
C)
v
C)
D
o
P
-
If E/R ;s the Prime Factor
Type. leave Unit No blank
...E.O.B.M lLAA,~S_IQ'''''()Jl
U~it No ~
[ili]
Unit No IT] rn
J
COMMONWEALTH OF PE"'''!.'iYLVANIA
POLICE CR'ASH REPORTlN, ORM
. New
o Changel
Continuation
AA 45 7
Page: /0 10/7/
o Delete Page
.;.....
,,~:~JD:,
....i
...,
.....
.....n.~. "
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.~J!L
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-. ......-.... -. .. ... ..~........~.... -....~ .....
, ,
. '.
: . . . -
. ..- ...-~........ r'" .... ~.... .....~....-....:....
. : . . ... . .. ~. -- . . .. . :'
. . . .
..:........:........:........:.
....:.... ,-.. ..:.....-...~ .....
, ,
....;........!........i.........!.........!........;....
.... i.. ..... -!....... -i..-..... i........~......
, , ,
. ,
. . ,
.....................................
, . .
. . .
. , ,
, , .
, , ,
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...'..'I....:::1::::::r...'
~
...:........:-... .....;........ ~_..... ...~. ......... ........ .. ':.>00"
...."",..,',....,..,, '....f;;;~?'..,~\:~~:':',..,..,'
,,-,",,..;' '.... ....,...,
---:-
.......~~.~~"...
....,
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..... -...~.......
;r
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"-...
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JD..,..~
......, ....'.s
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........,~,
VJ
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a ~
'''J' ..0
';) 'Z
,,:I!..,~
V)I
.....!
....i
FORM :I AA.45 (01101)
nC:"I.J.If"\"""""" ........"'.....,..
l.rasn Numoer
?0140975
j
...~....... .:
,,1"\
~
.......~.........
....... ................
.......:................ .. .....
- - - -.~ ~
. . .
, . ,
................ . .
. . . . .' ....r.......r......T.......
....... r' ......;........:-....... T........r... ....f... ..... ~........ ~........
....~ u~.1.:.~r~..~.:,~:....~.,.:~~'.'.,
, , ,
, , ,
....-................-...
, , ,
, ,
. .-........-........;-..
"L
'T
.0..~ ;,..~~-F~ITL~L(+....
..... .... r..... .'[........t-...... ...................
....:.. ......~ ....... -... ....~h..... '~n... ...?.. .....i........ ~........
,..,p..;. , i...~+:-E'I,.......!........I-..,...
;:-r~.jf,Ff
....~.........i........+....~._....t........;........;........~......"
. :--: ; ;- . ; :
..-(....')......"+"..,+-..,..;...""'!,...."'[",.."'!.,.,....
"ii)'
::to
. .....~........~....
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.... ~.........;.........~........~..~... .....~........1........
. . . .
. . . .
. . . .
fA-rt:~..<:>~.."i....."
..'r'....!......'i....,..;......,,~r!\~t
, , '
......-........-........;....
....;.........~........;.......
~
Place emergency transport, witness, and other information here. It is not required to restate information from the form.
Responding EMS Agency: HAMflJeJ """TwP, Medical Facility: NcN~
loWb"'I'L ALD=N 1W~
Witness 1: -:r-f'rrYt e;:, o , '~vi1f Address: !J~~~':>Li~ ArZ. 1"2..1\1 Phone: (S'fO) ., 8"3 - 4 7'5
Witness 2: . ----- Address: Phone: "
Narrative: SElS All A: e...\- t b'!'> ~ () l$1\l D Q 1Y\
,
,
- ---1
J
C.OMMONVVEAlTH OF PEf\J"'SYlVANIA
POLICE CRASH REPORTIN, ORM
AA 45 8 1
Page: 1010/8/
ORM .. AA-45 (01/01)
,....-10....11.....,...,.... ,...,..........,.
Lrasn NumOer
. New
o Changel
Continuation
o Delete Page
P0140974
J
Road Surface Tvpe 0 Brick or Block 0 Dirt Special Jurisdiction a Military o Other Federal Sites
CJ Concrete 0 Slag, Gravel or 0 Other . No Speda I a Indian Reservation o Other
.. Stone 0 Unknown Jurisdiction
Blacktop 0 National Park a College/University o Unknown
Campus
.ase complete Unit Information for each unit involved in a fatal crash. Do not repeat the information in the fields above on multiple pages.
Unit Number Principle Impact Point
C2IiJ o Non-Collision e 0 0
- , .., '" ",' - " D'~'D -
Driver Restrictions 0 Restrictions 0 Not a Pennsylvania o Top
Compliance Complied With Driver
No Restrictions/ 0 Restrictions Not o Unknown a Undercarriage a 09 03 0
@ Complied With Compliance
Not Applicable Compliance a Towed Unit 008 040
0 Unknown 07 06 05
Driver Endorsement 0 Required - o Not a Pennsylvania a Unknown a 0
Compliance Complied With Driver 0
Required - Non Unknown Avoidance Maneuver
C!1l None Required 0 Compliance o Compliance
. No Avoidance
0 Required - Maneuver a Braking - Other o Other Avoidance
Compliance Unknown Evidence Maneuver
Driver License 0 Not Required for 0 Unk if COlor a Braking - Skid a Steering - Evidence o Inconclusive
Marks Evident
Compliance Vehicle Class CDl Required or Driver Stated
0 No Valid license 0 Not a Pennsylvania Braking - No Skid a Steering and Braking o Unknown
0 Not licensed for Class Driver a Marks, Driver Evidence or Stated
Stated
~ Valid license for 0 Unknown
Class Under Ride'lndicator
Druq Test Tvpe 0 o Other a No Underride or Underride, No
Blood a Compartment o Override, Other
., o Unknown if T""t Override Intrusion Vehicle
None 0 Urine
Given Underride, Underride,
Unknown if
Druq Test Results - (Up to Four Results) ~[QJ [QJ o Compartment o Compartment o Underride or
Intrusion Intrusion Unknown Override
o = No Test Given 5 = Amphetamines
1 = No Drug Reported 6 = PCP EmerQencv Use
2 = Marijuana 8 = Other ~ [QJ a lights Flashing o B.oth lights and
3 = Cocaine 9 = Unknown Test . Not in Emergency Siren
4 = Opiates Results Use o Siren Sounding o Unknown
Unit Number Princi,,'e Imoacr Point
CD a Non-Collision 0 0 0 t-
D'~'D
Driver Restrictions 0 Restrictions o Not a Pennsylvania aTop
Como/lance Complied With Driver
No Restrictions! 0 Restrictions Not o Unknown o Undercarriage a 09 03 0
0 Complied With Compliance
Not Applicable Compliance a Towed Unit o 0 04a
0 Unknown 07 06 05
I Driver Endorsement 0 Required - a Not a Pennsylvania a Unknown o 0 a
Comollance Complied With Oriver
0 Required - Non a Unknown Avoidance Maneuver
0 None Required Compliance Compliance a No Avoidance
0 Required - a Braking - Other a Other Avoidance
Compliance Unknown Maneuver Evidence
"- Maneuver
Driver License 0 Not Required for a Unk if COlor a Braking - Skid a Steering - Evidence b Inconclusive
Comollance Vehicle Class CDl Required Marks Evident or Driver Stated
0 No Valid license a Not a Pennsylvania Braking - No Skid a Steering and Braking
0 Not Licensed for Class Driver a Marks. Driver a Unknown
Valid license for Stated Evidence or Stated
0 a Unknown
Class Under Ride Indicator
DruQ Test Tvoe 0 Blood a Other a No Underride or a Underride, No Override, Other
0 a Unknown if Test Override Compartment a Vehide
None 0 Urine Intrusion
Given
a Underride Underride, Unknown if
Druq Test Results - (Up to Four Results) ~D D Compart,,{ent a Compartment a Underride Or
Intrusion Intrusion Unknown Override
'0 = No Test Given 5 = Amphetamines
1 = No Drug Reported 6 = PCP
2 = Marijuana 8 = Other D D Emerqenev Use a lights Flashing a 80th lights and
3 :::: Cocaine 9 = Unknown Test a Not in Emergency Siren
4 = Opiates Results Use a Siren Sounding a Unknown
=OAM .'1 AA.4SF (01101)
J
LUIVIIVIUNVVI:ALIH UI" t"I:NI'oI:'YLVANIA
POLICE GRASH REPORTINf 'JRM
AA 45 F 1
Page: /01019/
PENNDOT COpy
. New
J
o Change/
Continuation
Page 1
Accident # 97-0 I
June 26, 2001
(Fatal)
PtIm. Shaun A. Felty
At 0428 this officer was disp-atchedto the 5000 BIk ofTrindle Rd, for a struck
pedestrian. I arrived on the scene at 0433 to find a tractor trailer stopped in the eastbound
lane with the tractor under the navy railroad bridge overpass. Standing by the tractor was
James E. Pruitt who identified himself as the driver of the tractor trailer. The tractor
trailer did have it's headlights on upon my arrival.
Also on the scene were Susan'Mayernick and Randall Keebaugh who identified
themselves as the individuals who called 911.
The body of John Andela was in the westbound lane between the tractor trailer and a
Shenks Pastry truck. West Shore ALS had arrived on the scene at the same time this
officer arrived and paramedic had detennined that Andela was already dead.
Susan Mayernick, 31 Mayernick Dr., Mechanicsburg Pa 17055 ,(717) 691-9705 stated
that she did not see the accident but had come upon it in her travel and called 911.
Randall Keebaugh, 5340 Oxford Circle, Apt 39, Mechanicsburg Pa 17055,
(H)(717) 791-1276 (W)(717) 605-7301 stated that he was driving eastbound on Trind1e
Rd. and was approaching the accident scene when he saw a car of unknown description
traveling westbound on Toodle Rd. away from the scene. Keebaugh did not see the
accident but did call 911.
James E. Pruitt, 1 Ives Dr., N Little Rock AR 72117 stated that he was lost and was
looking for Ralston Purina when he was traveling eastbound on Trindle Rd. and came to
the raiItoa.d bridge overpass. He saw the sign that stated the bridge was a heighthf 13' 6"
and wasn't sure ifhis trailer would fit under the bridge, He pulled his tractor forward and
under the bridge and exited his truck to see uhis trailer would clear when a truck pulled
up behind him and stopped. He went back to the truck (Shenks Pastry) and spoke with the
driver who was John Andela. Pruitt asked Andela for directions to Ralston Purina and
then asked Andela if he thought the trailer would clear the bridge. Andela told him he did
think that the trailer would clear the bridge and asked Pruitt ifhe would like him CAndela)
to watch the bridge while he drove under it. Pruitt then tried to drive his tractor trailer
lll1der the bridge. Pruitt saw Andela standing in the westbound lane ofTrindle Rd. next to
Pruitt's tractor. Pruitt was looking back and forth between Andela and the bridge when a
red" blur" went past and Andela was gone.
It was at this time that this officer was informed by a Lower Allen Twp. EMT that a
young woman had arrived on the scene stating that she had been in an accident and that
something had bit her car.
This officer found Heather K. Frampton by a red Nissan Sentra with Pa registration
BSM3413. The Sentra had minor :front end damage to the driver side Comer and had a
large whole in the windshield by the P A inspection sticker. The windsheild wipers were
in the up position. The car was located on the east side of the accident scene behind this
officers patrol car.
Heather K. Frampton stated that she was on her way home :from Country Meadows,
where she works. She was driving westbound on Trindle Rd. and approaching the
Page 2
railroad overpass and saw a tractor trailer stopped with it's lights on. She slowed down
and when she drove past the truck something hit her car. She drove down the street and
turned around in a business parking lot. She then drove back towards the accident scene
and saw that the truck wasstill stopped in the eastbound lane anrldrJlY.edOwn1he right
hand side of the truck; usmg the shoulder. Frampton drove back to Country Meadows to
call her mother.
During my initial encounter with Frampton she appeared calm and never mentioned
that she had struck someone. Frampton was not told by myself or Officer Kopko who was
also present with her that she had struck a individual. Frampton was also not in a position
to see John Andela's body.
I then attempted to 0 btain more information from Pruitt who was with the Lower
Allen Twp. EMTs. Pruitt appeared distraught and blamed ~self for the accident_ Pruitt
was not injured but was transported by Lower Allen Twp Ambulance to Holy Spirit to
speak with a crisis worker.
Frampton's mother, Mary Shreve, arrived on the scene and it was at this time that
Frampton was informed by this officer that she had struck and killed a individual, This
officer noticed that Frampton began to cry and shake,
Frampton was requested to follow Officer Kopko back to ow- station so that we could
get a written statement as to what occurred. Frampton and her mother did go to the
station and Frampton did provide a written statement to Officer Kopko.
A review of the accident scene showed that there were no gouges or scratches in the
roadway to indicate a point of impact. From statements that Pruitt made the area of
impact is believed to be, .close to but behind the tractor driver door. Small particals of
glass were seen on the roadway between the area of impact and Andela's final resting
place. The glass could onIy be seen by shinning a flashlight over the road surface. There
is a overhead light in the area which is 43 feet from the railroad bridge abutment on the
westbound side ofthe roadway. The overhead light sits on a telephone pole at a height
above the bottom ofthe railroad bridge and the light is obscured by a tree which sits
between the light and the railroad bridge. Lighting under the railroad bridge is poor. The
area of impact is believed to be 45 feet east of bridge abutment on the westbound side of
the roadway. The body was 43 feet from the railroad bridge abutment on the westbound
side of the roadway.
Frampton's vehicle was transported to the Hampden Township Police Station by
Roadside Auto Rescue.
Photo graphs and videotape ofthe accident scene were taken by Dennis Brown,
Hampden Twp. Fire Dept photographer.
After clearing the scene this officer returned to the station and breifly spoke with
Frampton who had already provided a written statement. Frampton was asked if she knew
what the speed limit was (40 MPH), which she did. Frampton was asked how fast she
thought she was going to which she replied that she didn't know but that she had slowed
down when she saw the stopped tractor trailer:
This officer also interviewed Pruitt at the station on the morning of June 26th after he
left Holy Spirit Hospital.
Page 3
Pruitt stated that he had become lost and was approaching the railroad bridge when he
saw the sign that indicated the bridge height was 13'6". He pulled his tractor forward
under the bridge and exited the truck to see ifhis trailer would clear. He saw a truck pull
. ---up-behind-andwent back to the truck to asked the-drivertAndela) for directions, Andela
provided directions to Ralston Purina a~d Pruitt asked Andela ifhe thought his trailer
would clear the bridge. Andela told PruItt that he thought the trailer would clear the
bridge and then asked Pruitt ifhe would like him (Andela) to watch while Pruitt drove
under the bridge. Pruitt went and started his truck and Andela was standing in the
westbound lane looking up at the bridge. Pruitt was pulling forward and Andela was
telling him to keep going he has 8 more feet. Pruitt was looking between Andela and the
bridge when saw a red blur go by and heard a crunch. Pruitt exited his tractor and saw a
car traveling westbound and that it appeared to be driving onto the westbound shoulder.
At this time two cars pulling up and he told them to call 911. Pruitt could not say if the
red" blur" was the color of a car or the taillights of a car. Pruitt never saw the car
approaching prior to collision since he was looking from the bridge to Andela Pruitt
could not say at what speed he thought the red" blur" may have been traveling. Pruitt
did not believe that Andela saw the vehicle coming since he did not say anything to
impact nor did he say anything afterwards.
Pruitt provided this officer with a written statement.
In a attempt to determine how Andela traveled off the Nissan Sentra the vehicle was
processed using Luminal and Ultra Violet lighting. During this process no blood was
found to be on the exterior of the vehicle. Scuffmarks were found on the front driver side
quarter panel. Additional photographs were taken of the Nissan Sentra by this officer.
On 27 June 2001 this officer interviewed Patricia Franks, 4902 Delbrook Rei,
Mechanicsburg Pa 17050, (H) 763-5716. Franks stated that she has worked with
Frampton for I -2 months at Country Meadows. On the morning of the accident
Frampton was suppose to get off work at 0400. There was nothing unusual about the
shift. Frampton did not appear in a hurry nor did she say anything about being in a hurry.
Franks was present at Country Meadows when Frampton returned there after the
accident. Frampton stated to Franks that something had just hit her car. Frampton called
her mother and stated" Mom you have to come get me something hit me ". Frampton
was upset and Franks got her calmed down and they noticed the emergency vehicles
driving past Country Meadows towards the accident scene. Franks told Frampton that she
should return to the scene. It was Franks opinion that Frampton was not aware that she
had struck someone.
Mike Norris, Cumberland County Coroner, has stated that injuries sustained by
Andela are consistent with those of a individual who has been struck by a vehicle
traveling less than 30 MPH.
Page 4
DriverNehicle Information (not involved in coJIision)
Driver - James E. Pruitt, 1 Ives Dr, N Little Rock, AR 72117, AR/227279679
Vehicle - 2001 FRHT, TN/58924HY, VIN IFUYDSEB9WP96779, white. Registered
owner, Covenant Transport Inc., 400 Binningham Hwy, Chattanooga 1N
37419-2346. Pruitt works for Southern Refrigerated Transport,
(888) 778-7670. Tractor was towing a: 53 ft trailer, white, empty.
Vehicle - 1999 Ford PAlZS34675, VIN 1FDXF46F1XED43960 white, Registered
owner, Schenks Pastry Shoppe INC., 5303 E. Toodle Rd., Mechanicsburg Pa
17050. This vehicle had been driven by John Andela and was left parked
behind the above tractor trailer during the accident.
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Exhibit C
!VlAY (1 'r 20tlt 3>
IN RE: PETITION OF CHRISTINE
ANDELA, ADMINISTRATRIX OF THE
ESTATE OF JOHN D. ANDELA,
DECEDENT,
NO. O;;l. - ~;t~
Cu'~(~ J~~
Petitioner
ORDER
AND NOW, this q :.t/..... day of
,') I a.~_ , 2002, upon consideration of the
Petition for Approval of a Compromise Settlement and Distribution of Proceeds Pursuant to
Pa.R.C.P. 2206, IT IS HEREBY ORDERED THAT:
(1) The settlement of Christine Andela, Administratrix of the Estate of John D.
Andela, is hereby approved and the proceeds will be allocated as follows:
(a)
Estate of John D. Andela, deceased, under
the Survival Action
$10,994.40
(b)
Estate of John D, Andela, deceased, under
the Wrongful Death Action
$43,977.60
(c)
Angino & Rovner, P.C., professional fees
based on 30% ofthe gross amount recovered
$24,000.00
$ 1.028.00
$80,000.00
(d)
Reimbursement of out-of-pocket expenses
TOTAL PRESENT DISTRIBUTION
BY THE COURT:
/5/ ,2j.,'" '-2J .', c!.'. '*n...., J.
TRt~... Ct.......'v '.."''''~,., ".,,'..........R-O
,}~. ".,."' ~ /.,,,,,...-,,, "".' ~''';'^'~ "., "
..~ "'''';:.,... fl'~"1.'I't ll~:,Jt'" ".
!n T:~mlmoIiY W"')(l;Xd.. ! i.gtft W:!/)';;01 ;;~y h;Jnd
and thl' attll (;t ::~;d ',;;Xgt at G;liH,;ie, loa
rhis..'1jL .uay, or, ' -'~+44, '_2~(':L
. '.if" U. ?!./-, f'l/'.1 uY7'
L'jJ-~J-' ~~,'lf;,"t, \~,
, tfFV1fH J L..
244672,l\DLL\MTG
Exhibit D
JUl 0 8 2002 ~
IN RE: PETITION OF CHRISTINE
ANDELA, ADMINISTRATRIX OF THE
ESTATE OF JOHN D. ANDELA,
DECEDENT,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNA.
Petitioner
NO. 02:'2222Tivil Term
AND NOW, this ,,(~+h day of
, 2002, upon consideration of the
Petition for Approval of a Compromise Settlement d Distribution of Proceeds Pursuant to
Pa.R.C.p. 2206, IT IS HEREBY ORDERED THAT:
(1) The settlement of Christine Andela, Administratrix of the Estate of John D,
Andela, is hereby approved and the proceeds will be allocated as follows:
(a) Estate of John D. Andela, deceased, under
the Survival Action
$ 6,400.00
(b) Estate of John D, Andela, deceased, under
the Wrongful Death Action
$ 1,600,00
(c) Angino & Rovner, P.C., professional fees
based on 20% of the gross amount recovered
$ 2.000.00
$10,000.00
TOTAL PRESENT DISTRIBUTION
BY THE COURT:
J.
245852,l\DLLIMTG
Exhibit E
CHRISTINE ANDELA, Administratrix of the
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
CIVIL ACTION - LAW
v.
JAMES E. PRUITT;
COVENANT TRANSPORT; INC.; lirld
SOUTHERN REFRIGERATED
TRANSPORT,
NO.
Defendants
JURY TRIAL DEMANDED
NOTICE TO DEFEND
You have been sued in court. If you wish to defend against the claims set forth in the following pages, you
must take action within twenty (20) days after this Complaint and Notice are served, by entering a written
appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims
set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment
may be entered against you by the Court without further notice for any money claimed in the Complaint or for any
other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A
LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW TO
FIND OUT WHERE YOU CAN GET LEGAL HELP.
COURT ADMINISTRATOR
4th FI., Cumberland County Courthouse
Carlisle, Pennsylvania 17101
(717) 240-6200
NOTICIA
Le han demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las
paginas sugnuientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted
debe presentar una apariencia escrita 0 en persona 0 por abogado y archivar en la corte en foma escrita $US defensas
o sus objeciones a las demandas en contra de su persona. Sea avisado que si usted no se defiende, la corte tomara
medidas y puede entrar una orden contra usted sin previo aviso 0 notificacion y por cualquier queja 0 alivio que es
pedido en la peticion de demanda. Usted puede perder dinero 0 sus propiedades 0 otros derechos importantes para
usted.
LLEVE EST A DEMANDA A UN ABOGADO IMMEDIA TEMENTE. SI NO TIENE ABOGADO 0 SI
NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA 0 LLAME POR
TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUENTRA ESCRITA ABAJO PARA AVERIGUAR
DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL.
COURT ADMINISTRATOR
4th Fl., Cumberland County Courthouse
Carlisle, Pennsylvania 17101
(717) 240-6200
237860,l\MTGlLC3
6M,{;cT E
CHRISTINE ANDELA, Administratrix ofthe
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
CIVIL ACTION - LAW
v.
JURY TRIAL DEMANDED
g
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q)c~
~;E
~t~_:
~~::
s:; (=
z
~
9,
//
JAMES E. PRUITT;
COVENANT TRANSPORT, INC,; and
SOUTHERN REFRIGERATED
TRANSPORT,
NO. 0.2; 39t,5~7i-
o
I"
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c.~\
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Defendants
"'C'
::,,'1:
COMPLAINT
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1. Plaintiff Christine Andela is an adult individual and a citizen of the
Commonwealth of Pennsylvania who resides in Lebanon, Lebanon County, Pennsylvania. Ms.
Andela was appointed as the Administratrix of the Estate of John D. Andela on July 16,2001, by
the Register of Wills of York County, Pennsylvania.
2. Decedent, John D. Andela, was a citizen of York County, Pennsylvania, The
Decedent was born on February 10, 1966, and died on June 26, 2001.
3. Defendant James E. Pruitt is an adult individual who resides at One Ives Drive,
North Little Rock, Arkansas 72117.
4.
Defendant Covenant"
'''ort, Inc. (hereinafter Covenant) is a corporation with a
principal place of business located at 400 Birmingham Highway, Chattanooga, Tennessee
37419-2346.
5. Defendant Southern Refrigerated Transport (hereinafter Southern) is a corporation
with a principal place of business located at 210 Highway #71 North, Ashdown, Little River
County, Arkansas 71822.
237860.1\MTGlLC3
6. On or about June 26, 2001, Decedent John D. Andela was operating a delivery
truck in the course and scope of his employment with Schenk's Pastry Shoppe. Mr. Andela was
traveling in an eastbound direction on Trindle Road (SR 641), Cumberland County,
Pennsylvania.
7. At the same time, Defendant James E. Pruitt was acting in the course and scope of
his employment and/or as an agent of Defendant Southern and/or Defendant Covenant, and was
operating a tractor-trailer owned by Defendant Covenant in an eastbound direction on Trindle
Road.
8. Defendant Pruitt was attempting to locate the Ralston Purina business and became
lost.
9. Defendant Pruitt stopped his tractor-trailer in front of a railroad bridge near the
5000 block of Trindle Road in Hampden Township, Cumberland County because he feared that
his truck would not fit under the thirteen-foot six-inch (13' 6") bridge.
10. Defendant Pruitt did not place appropriate warning signs and/or signals around his,
stopped tractor-trailer.
11. Mr. Andela stopped his delivery van behind Defendant Pruitt's tractor-trailer as it
was blocking the eastbound lane, and in essence, was disabled.
12. Defendant Pruitt approached Mr. Andela, asked for directions to Ralston Purina,
and asked whether Mr. Andela thought the tractor-trailer would fit under the bridge, After a
discussion, Mr. Andela offered to stand near the tractor-trailer and watch the top of the tractor-
trailer as Defendant Pruitt drove under the bridge.
13. Due to the size and noise of the tractor-trailer, Mr. Andela had to stand on the left
side of the tractor-trailer to assist Defendant Pruitt.
237860,IIMTGILC3
2
14. While Mr. Andela was guiding Defendant Pruitt under the bridge, Heather
Frampton was operating a Nissan Sentra in a westbound direction on Trindle Road.
15. As Ms. Frampton drove under the railroad bridge, she caused the front of her
vehicle to strike Mr. Andela and pllshed him aeproximately eighty-eight feet (88').
16. Mr. Andela died as a result of the impact.
COUNT I
Christine Andela. Administratrix of the Estate of John D. Andela. Decedent v. James E. Pruitt.
Covenant Transport. Inc.. and Southern Refril!:erated TransPOrt
17. Paragraph I through 16 of the Complaint are incorporated herein by reference.
18. The foregoing accident and all of the injuries and damages set forth hereinafter
are the direct and proximate results of the negligent, careless, wanton, and reckless manner in
which Defendant James Pruitt, while an employee and/or agent of Defendant Covenant
Transport, Inc., and/or Southern Refrigerated Transport and operated his tractor-trailer as
follows:
(a) failure to know the height of his tractor-trailer;
(b) failure to properly plan his route to avoid becoming lost and to avoid
potentially low bridges;
(c) failure to place appropriate warning signs or signals around his stopped
tractor-trailer in accordance with 75 Pa.C.S.A. ~4530 and 45 CFR 393.95;
(d) negligently creating a dangerous situation which led to the foreseeable death
of Mr. Andela; and
(e) stopping his vehicle upon the highway in a manner endangering persons and
property and in a reckless manner with careless disregard to the rights and
safety of others and in violation of the Motor Vehicle Code of the
Commonwealth of Pennsylvania.
237860,1 IMTG\LC3
3
CLAIM I - SURVIVAL ACTION
19. Paragraphs I through 18 of the Complaint are incorporated herein by reference.
20. Plaintiff, Christine Andela, Personal Representative of the Estate of John D.
Andela, deceased, brings this action on behalf of the Estate of John D. Andela under aIldJ)y
virtue of the Act of 1976, July 9, P.L. 586, No. 142, ~2, 42 Pa.C.S.A. ~8302.
WHEREFORE, Plaintiff demands judgment against Defendants James E. Pruitt,
Covenant Transport, Inc., and Southern Refrigerated Transport in an amount in excess of
Twenty-five Thousand ($25,000.00) Dollars, exclusive of interest and costs and in excess of any
jurisdictional amount requiring compulsory arbitration.
<;:'f..1\ ('\)
Date: l) '\"0 (
ANGINa & ROVNER, P.C.
~
I.D, No, 35956
4503 N. Front Street
Harrisburg, P A 1711 0
(717) 238-6791
Attorney for Plaintiff
237860,IIMTGILC3
4
VERIFICATION
I Christine Andela, Plaintiff, have read the foregoing COMPLAINT and do hereby swear
or affirm that the facts set forth in the foregoing are true and correct to the best of my knowledge,
. iilformlitioii-anab6lief.' I understand that this VerificationU is made-subject to the penalties of 18
Pa.C.S.A. g 4904, relating to unsworn falsification to authorities.
WITNESS:
~ (~!t<L,J..~tihj
Christine Andela
. i ,..,.
Ul n<>:u / ,(
Dated: if - i)' '1- () J-
237860,1 IMTGlLC3
Exhibit F
...'---,-"'-"..,.,....~.",-,~...-
CHRISTINE ANDElA, Administratrix
of the Estate of John D. Andela, Decedent,:
Plaintiff
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNA.
vs.
No. 02-3863
JAMES E. PRUITT, COVENANT
TRANSPORT, INC.; and SOUTHERN
REFRIGERA TED TRANSPORT,
CIVIL ACTION -LAW
GENERAL RELEASE AGREEMENT
KNOW ALL MEN BY THESE PRESENTS that I, CHRISTINE ANDElA, Administratrix of
the Estate of John D. Andela, Decedent, for the sole consideration of Twenty-Five Thousand
Dollars ($25,000.00), paid by JAMES F. PRUITT and COVENANT TRANSPORT, INC., Payers,
the receipt whereof is hereby acknowledged, has released and discharged, and by these
presents does for myself, my heirs, executors, administrators and assigns release and forever
discharge the said Payers, their insurance companies and all other persons, firms and
corporations, both known and unknown, their heirs, executors, administrators, affiliates,
successors and assigns, of and from any and all claims, demands, damages, actions, causes of
action, or suits at law or equity, of whatsoever kind or nature, for or because of any matter or
thing done, omitted or suffered to be done by anyone prior to and including the date thereof
on account of known or unknown injuries, losses and damages allegedly sustained by the
Plaintiff,Christtne Andela, individually and as Administratrix of the Estate of John D. Andela,
arising out of a motor vehicle accident which occurred on or about June 26, 2001, which is
the subject of fOllowing lawsuit in the Cumber/and County Court of Common Pleas:
EM,}/r- F
Covenant Trans rt fne and Southern Refri erated Trans ort Defendants, Docket No. 02-
3863 Civil.
We understand that Payers, by reason of agreeing to this compromise payment, neither
admit nor deny liability of any sort, and said Payers have made no agreement or promise to
do or omit to do any act or thing not herein set forth and we further understand that this
Release is made as a compromise to avoid expense and to terminate all controversy and/or
claims for injuries or damages of whatsoever nature, known or unknown, including future
developments thereof, in any way growing out of or connected with said incident.
We admit that no representation of fact or opinion has been made by the said Payers
or anyone on their behalf to induce this compromise with respect to the extent or nature of
"damages and that the sum paid is solely by way of Compromise of a disputed claim, and that
it is specifically agreed that this Release shall be a complete bar to all claims, suits, and/or
recoveries for losses of whatever nature resulting or to result from said incident, including
subsequent litigation relating to the above-described incident or matters.
It is further understood and agreed that this is the complete Release Agreement and
that there are no written or oral understandings or agreements, directly or indirectly,
connected with this Release and settlement which are not incorporated herein. This
Agreement shall be binding Upon and inure to the successors, assigns, heirs, executors,
administrators and legal representatives of the respective parties hereto, including the Plaintiff,
Christine Andela, AdminiSftatrixofthe Estate of John D. Andela, Decedent.
It is further understood and agreed and made a part hereof that neither the
undersigned, Christine AndeJa, Administratrix of the Estate of John D. Andela, Decendent, or
any of her attorneys, agents or other representatives, will in any way divulge to any person
what;oeve, 0' pubUdze 0' ",",e to be pubUdzed ;n any new, '" commun;cat;on, med;~
including but not limited to, newspapers, magazines, journals, radio or television, the facts,
terms or conditions of this Release and settlement. All parties to this Agreement expressly
agree to decline comment on any aspect of the Release and settlement to any member of the
news media. This paragraph is intended to become part of the consideration for the
settlement of this claim,
It is further understood and agreed that we, the undersigned, are responsible for the
payment of any lien or charges against this settlement sum. Should any person or entity make
a claim for payment of any liens or charges against Payors, their attorneys, agents, servants,
and/or employees, , hereby agree to indemnify and hold harmless Payors, their attorneys,
agents; servants, and/or employees from any and all liens, charges; .fees, costs, interest,
demands, and any and all other sums, including payment of all costs and attorneys fees,
The undersigned hereby declares for herself that the terms of this settlement have been
completely read, fully understood, and voluntarily accepted for the purpose of making a full
and final compromise, adjustment and settlement of any and all claims on account of the
injuries and damages mentioned above, and for the express purpose of precluding forever any
further or additional suits arising out of the aforesaid claims.
'."~"---'-<-'-"""-'
IN WITNESS WHEREOF, I have hereunto set my hand this
,2002.
day of
CAUTION: READ BEFORE SIGNING
In the presence of:
Witness
Christine Ande/a, Executrix of the
Estate of John D. Andela, Decedent
Address
Sworn to and subscribed
before me this
day
of
,2002.
Notary Public
My Commission Expires:
Exhibit G
Angina. Rovner, P.C.
** CASB/.ICCOtnrn:HG RBGISmR **
PILE HtOGDDl............. 01172
PREPARED. 9/10/2002
PAGIl.
1
CLIBH'1'.................. ARDBLA, B~ aI JOSH
~ IB OFFICB.......... 7/13/2001
TYPB or CASB............ H
DIlPBIIIllIIIT ( S) . .. .. . . .. . .. III!lmIIIIl KAY PIWlP'l'OB
~RItBY IN CBAR.GB...... DLL
PO~............... RANDY I~MBRM~, BSQUXRB
~................
SPBCDL IfO'J!Il(S)......... P<lRIIllIlDBR'S PBB - 1/3
DBSCRIPTIOII
CRBDI'l' PROM PRIOR lIKTrLIIIIIIII'
BXPBIISB TDB ~. CIlBDI'l' PROM PIUOR sm"J:L1IIIBII'
PAX CIWIGBS (PBR PAGIl)
PAX CIIARGIlS (PBR PAGIl)
PAX CIIARGIlS (PBR PJlGIl)
PAX CIIARGIlS (PBR PJlGIl)
PAX CIlIlRGBS (PBR PJlGIl)
BDBIISB nPB 'l'OBL, PAX CIWIGIIS (PER PAGIl)
IXVlISTIGM!IOB TIMB BllPIlIISB
IIIVIIllTIcwrIOH TIMB IIllPBIISB
IXVlISTIGM!IOB TIMB BllPIIIISB
IIIVIIllTIGM!IOB TIMB IIllPBIISB
IXVlISTIGM!IOB TIMB BDIIIISB
BDIIIISB nPB 'l'OBL. IIIVIlSTIGM!IOII 'rIHB IlXPBIISB
DI.L - IlXPBIISBS
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BXPBRSB TYPE '1'O'J!U.. LONG DISTARCB
*** PILB BXPBlISBS ***
~ QUJIII'rI'rr UBr.r/PJtJ:CB
'/28/2002
8/21/2001
11/01/2001
1/22/2002
2/01/2002
4/22/2002
7/17/2001
7/18/2001
7/20/2001
7/23/2001
11/0'/2001
8/08/2001
4/17/2002
'/1'/2002
4/04/2002
1,00
2.00
4.00
4,00
2,00
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1,028.00-*
1.00 1.00
1.00 2.00
1.00 4.00
1.00 4.00
1.00 2,00
--------
13.00 *
70.00 105.00 !WI
70.00 52.'0 !WI
70,00 52.50 !WI
70.00 52.50 !WI
70.00 70,00 !WI
----------
332.50 .
46.80
16.00
19.20
-----------
82.00 .
20.00
20.00 *
e~I'h;t G
Angino . Rovner, P. C,
.. CASB/ACCOUH'l'ING RBGISTBR ..
PRBPARBD. 9/10/2002
PILB HDMBBR...........,' 01172
PAGB.
2
CLIlDiI"1'.................1 ARDBLA, BSTAD OF JOB
JWI - HILIWlB
7/17/2001
7,68
BXPDD TYPB TOTAL. Mn.EAGB
7.68 ...
PBO'l'OCOPIBS
PBorocOPIBS
PBO'l'OCOPIBS
P&a.I!OCOPIBS
4/04/2002
4/04/2002
9/09/2002
9/10/2002
838.00
40,00
150.00
437.00
.25
,25
.25
.25
209.50
10,00
37.50
109.25
BllPBRSB TlPB 'l'ODL. PIIO'.L'OCOPIBS
366.25 .
POlITAGB
POlI'rAGB
POS'DGB
POlI'rAGB
4/05/2002
5/13/2002
9/09/2002
9/10/2002
46.13
1.36
1.11
38.90
BllPBRSB TlPB 'l'ODL, POSTAGH
87.50 .
StJB-TCl'.rAL
119.. 07-**
... CIIIIC1ItllllPBRSBS ...
DBSCRIP'fiOR DM'Jl CBBClt' AIIOUII'.r
DMPDBJI T01lIISBIP VOL, nRB co, 7/25/2001 49297 208.00
RBGI_ OP IRLLS 7/25/2001 910728 45,00
IIIT1lIlIIAL RBVBIItIII SBR.v:ICB 8/07/2001 49422 138,00
C01lllllllftCllll GRAPBICS . copy 11/20/2001 5075a 9.54
COllllCllllBALft RllP~1IG 3/13/2002 52026 59.55
PR.C7.rIl OF CUJIBBRLARJ) COURT!' 5/03/2002 52811 45.50
PRarJI OP ClIHIIIIRLAIlD COUIlTr S/09/2002 53741 50.50
StJB-'l'ODL
556.09 ..
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11/29/2001
AIIOUII'.r
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RBCBIP'l'S TCl'.rAL
115.00 ...
----------------------------------------------------------------------------------------------------
. OUTSTAHDIHG IRVOJ:CBS .
CU8'rolD!R HAMIl
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----------------------------------------------------------------------------------------------------
.. BHD OF PILa *.
Exhibit H
.
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF REVENUE
BUREAU OF INDIVIDUAL TAXES
DEPARTMENT 280601
HARRISBURG, PA 17128-0601
Telephone
09-06-2002
717-783-0972
David L Lutz, Esquire
Angino & Rovner
4503 North Front Street
Harrisburg, P A 17110-1708
Re: Estate of John D Andela
File Number: 6701-1027
Court Number: Cumberland-
Dear Mr. Lutz:
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 35 year old decedent died as a result of a motor vehicle-pedestrian accident.
Decedent is survived by .
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 gross proceeds of this action, $ 20,000.00 to the wrongful death claim and
$ 5,000.00 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,reEstate ofMenyman.. 669 A.2d
1059 (pa. Cmw1th. 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. Finally, the approval of this allocation is limited to this estate and does not reflect the position that the
Department may take in any other proposed distribution of proceeds of a wrongful death / survival action.
Sincerely, ~
~
Inheritance Tax Division
Bureau ofIndividua1 Taxes
E>fh; b,f- H---
11
.
CERTIFICATE OF SERVICE
I, Mary T. Geraets, an employee of the law firm of Angino & Rovner, P.C., do hereby
certify that I am this day serving a true and correct copy of the PETITION FOR APPROVAL OF A
COMPROMISE SETILEMENT AND DISTRIBUTION OF PROCEEDS PURSUANT TO
Pa.R.C.P. 2206 upon all counsel of record via postage prepaid :first class United States mail
addressed as follows:
Frank Marshall, Esquire
20 South 36th Street
Camp Hill, PA 17011
Attorney for Defendants
Dated: \ D /ifb-Od
247786,l\DLL\MTG
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OCT 2 5 200? ~
CHRISTINE ANDELA, Administratrix of the
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
CIVIL ACTION - LAW
v.
JAMES E. PRUITT;
COVENANT TRANSPORT, INC.; and
SOUTHERN REFRIGERATED
TRANSPORT,
NO. 02-3863 Civil Term
Defendants
JURY TRIAL DEMANDED
W\ 0
AND NOW, this r day of
, 2002, upon consideration of the
Petition for Approval of a Compromise Settlement and Distribution of Proceeds Pursuant to
Pa.R.C.P. 2206, IT IS HEREBY ORDERED THAT:
(1) The settlement of Christine Andela, Administratrix of the Estate of John D.
Andela, is hereby approved and the proceeds will be allocated as follows:
(a)
Estate of John D. Andela, deceased, under
the Survival Action
$ 3,435.00
(b)
Estate of John D. Andela, deceased, under
the Wrongful Death Action
$13,740,00
(c)
Angino & Rovner, P.C., professional fet:s
based on 30% of the gross amount recovered
$ 7,500.00
(d) Angino & Rovner, P.C., out-of-pocket expenses $ 325.00
TOTAL PRESENT DISTRIBUTION
$25,000.00
250208,lIDLL\MTG
'II
"
(2) The net proceeds of $17,175.00 due to the Estate of John D. Andela shall be
deposited to the First Union Bank, in an account for the sole benefit of Brandon Andela and no
withdrawal shall be made therefrom until minor reaches majority age of 18, absent Court Order.
BY THE COURT:
P. J.
L~~
JJ-1-0~ l ~
CO "
~tS3itSo.4 RovJe.i\, PC.
250208.1 IDLLIMTG
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CHRISTINE ANDELA, Administratrix of the
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
v.
CIVIL ACTION - LA W
JAMES E. PRUITT;
COVENANT TRANSPORT, INC.; and
SOUTHERN REFRIGERATED
TRANSPORT,
NO. 02-3863 Civil Term
Defendants
JURY TRIAL DEMANDED
PROOF OF DEPOSIT
In accordance with Pennsylvania Ru1e of Civil Procedure 2039, attached is a photocopy of a
Brokerage Services Deposit Ticket in the amount of $17,176.28, as proof of deposit of the
settlement proceeds. Per Your Court's November 7, 2002, Order, no withdrawal can be made from
any such account until the Minor attains majority, except as authorized by a prior Order of Court.
Date: ,_~\)~?
ANGINO & ROVNER, P.C.
~LU~
I.D, No. 35956
4503 N. Front Street
Harrisburg, P A 17110
(717) 238-6791
Attorney for Plaintiff
255806.1\DLL\MTG
Wachovia Securities is the trade name under which Wachovia Corporation provides brokerage ~ervices through two registered broker-dealers, which
are non-bank afflliates'of Wachovia Corporation: Wachovia Securities, Inc" member NYSE/SIPC, and Wachovia Securities Financial Network, Inc., member
NASD/SIPC. Accounts carried by First Clearing Corporation, member NYSE/SIPC.
"W"ACHOVIA
SECURITIES
BROKERAGE SERVICES DEPOSIT TICKET
Depositing Bank Name
Depositing Branch Name
Depositing Branch Number Employee ID Number Time
85474 A3~9036 0'-lG-Ol 14'13
n, T PALMYRA
Completed By
Cust~TS'T'TNE A ANDF:I,A CIF
Nam~NDON M ANDF.LA UTMA
Addr~~ PALM CJTY PARK
ANNVILLE PA 17003-9730
Tax 10 Nu~,p+f) 9 f~ ~'.'~ Cj LJ
Brokerage Account Number 11 4 7 4 4 3 ']
Cash Deposit
1) Check Deposit
$17.176.28
2) Check Deposit
3) Check Deposit
Deposit Total Amount
$'17.176.28
0000536743 (50/pkg Rev 05)
CUSTOMER RECEIPT
CERTIFICATE OF SERVICE
I, Mary T. Geraets, an employee of the law firm of Angino & Rovner, P.c., do hereby
certify that I am this day serving a true and correct copy of the PROOF OF DEPOSIT upon all
counsel of record via postage prepaid first class United States mail addressed as follows:
Frank Marshall, Esquire
20 South 36th Street
Camp Hill, PA 17011
Attorney for Defendants
Dated: \,-(}'\J -\) ')
255806.1\DLL\MTG
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CHRISTINE ANDELA, Administratrix of the
Estate of JOHN D. ANDELA, Decedent,
Plaintiff,
v.
JAMES E. PRUITT;
COVENANT TRANSPORT, INC.; and
SOUTHERN REFRIGERATED
TRANSPORT,
Defendants
IN THE COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PA
CIVIL ACTION - LAW
NO. 02-3863 Civil Term
JURY TRIAL DEMANDED
PRAECIPE
To the Prothonotary of Cumberland County:
Please mark the above-captioned action settled, satisfied, and discontinued.
Date:
l-o~ -a?;;
249537,l\DLL\MTG
AN~OVNERP.C.
David L. Lutz
J.D. No. 35956
4503 N. Front Street
Harrisburg, PA 17110
(717) 238-6791
Attorney for Plaintiff
II
CERTIFICATE OF SERVICE
I, Mary T. Geraets, an employee of the law firm of Angino & Rovner, P.C., do hereby
certify that I am this day serving a true and correct copy of the PRAECIPE upon all counsel of
record via postage prepaid first class United States mail addressed as follows:
Frank Marshall, Esquire
20 South 36th Street
Camp Hill, P A 17011
Attorney for Defendants
Dated: t ~ ~3 -07
249537,I\DLL\MTG
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