Jury Verdict Form - Colorado Court Forms (Page 2 of 3) in pdf

Jury Verdict Form - Colorado Court Forms Page 2

Case 1:03-cv-00118-REB-BNB

Document 73-2

Filed 01/26/2006

Page 2 of 3

[Note: If you answered No to both Question No. 1 and Question No. 2, you

need not answer the remaining questions on this form and should skip to the signature

block at the end of this form.]

That the acts or omissions of Defendant Dever were the proximate or legal

cause of damages sustained by Plaintiff Gambina?

Answer:

______ Yes

______ No

If you answered yes to Question 3, should Plaintiff Gambina be awarded

damages to compensate him for physical or emotional pain or mental anguish?

Answer:

______ Yes

______ No

If you answered Yes, in what amount? $__________

That the acts or omissions of Defendant Chavarria were the proximate or

legal cause of damages sustained by Plaintiff Gambina?

Answer:

______ Yes

______ No

If you answered yes to Question 5, should Plaintiff Gambina be awarded

damages to compensate him for physical or emotional pain or mental anguish?

Answer:

______ Yes

______ No

Jury Verdict Form - Colorado Court Forms Page 2