SUPREME COURT OF THE STATE OF NEW YORK

COUNTY OF QUEENS
---------------------------------------------------------------------X
Index No.
-against-

Demand for Verified Bill

of Particulars

-----------------------------------------------------------------------X
COUNSELOR(S):
PLEASE TAKE NOTICE THAT ______________ ASSOCIATES, P.C. attorneys for the
defendant, demands that a verified bill of particulars be served upon them with the
following information within thirty (30) days:
1.

Age of Plaintiff(s), date of birth, place and social security number.

2.

Date of incident.

3.

Time of incident.

4.

Address of the premises where the incident occurred.

5.

Describe the exact location of the premises in which it is claimed the subject

incident occurred, with sufficient detail as to allow the defendant to identify the particular
area and distinguish it from other areas of the premises. Plaintiff may narratively
describe the area in terms of compass points, size, shape, proximity to other fixed objects,
exits or structural landmarks, or in any sufficiently detailed description which will permit
identification.
6.

Is it claimed that the alleged incident was occasioned by virtue of slippery and/or

improper steps or walkways? If so:

(a) describe the steps or walkway, including direction of the steps, rises, tread,
etc.; and
(b) what caused it to be slippery and/or improper.
7.

Is it claimed that there were any debris or foreign substance for foreign object(s)

at the location which caused or contributed to the happening of the alleged incident?

8.

If the answer to the above question is in the affirmative, describe each item of

debris and substance and foreign object(s) which plaintiff will claim caused or
contributed to the happening of the alleged incident.
9.

Set forth each and every act or omission of negligence on the part of the

defendant which plaintiff will claim caused or contributed to the alleged occurrence.
10.

If actual notice is alleged:

(a) person or persons to whom given;
(b) place or places where given;
(c) date or dates when given.

11.

If constructive notice is claimed:

(a) duration of condition (in minutes, hours, days or otherwise), with the date and

time of inception, to date and time of constructive notice will be claimed to be given
defendant(s).
12.

Statement of permanent injuries claimed.

13.

State of other injuries claimed.

14.

Loss of earnings claimed, including:

(a) name and address of employer;
(b) number of days incapacitated, setting forth the dates;
(c) daily, weekly or monthly earnings;
(d) total amount of loss claimed.

15.

If plaintiff was a student at the time of the alleged incident:

(a) name and address of school;
(b) dates student failed to attend school as a result of incident.

16.

If confined to a hospital:
(a) length of time confined, giving dates;
(b) names and address of hospital.

17.

If confined to bed or home:

(a) length of time;
(b) length of time confined to home, giving dates

18.

Statement of amount of money actually expended for:

(a) hospitals and dates of visits (name hospitals);

(b) physicians and dates of visits;

(c) nurses and dates of visits;
(d) medicines and dates obtained.
19.

A verified statement setting forth the residence and post office address of the

plaintiff.
20.

If any statutes, laws or rules are claimed to have been violated by the defendant,

set forth the title of any such law and the section or sections and subsections claimed to
have been violated.
21.

Set forth all statements made by the defendant in writing with respect to the

occurrence.
22.

State whether or not plaintiff(s) have been reimbursed for the claims of economic

loss from any collateral source.

23.

If the answer to the foregoing is in the affirmative, state:

(a) which of such claims plaintiff(s) have been reimbursed, the amount of

reimbursement received and the name of the person, firm or organization who made such
reimbursement;
(b) If such reimbursement was made by an insurance company, state the number
of the policy under which it was paid;
(c) state whether or not plaintiff(s) has made a claim for reimbursement for
economic loss to any collateral source and which has not as yet been paid;
(d) if the answer to 24 (c) is in the affirmative, state the name of the person, firm
or organization to whom such claim was presented, the date of presentation, and the
amount claimed.
24.

Set forth whether plaintiff is claiming a reduced life expectancy, and if so, the

extent of same.
25.

Set forth whether the plaintiff(s) is claiming a reduced work expectancy, and if so

the extent of same.

26.

Set forth the total amount claimed as special damages for the following, and in

each instance set forth the date(s) that care is alleged to have been rendered and the
name(s) and address(es) of the provider(s):
(a) Physicians services;

(b) Medical Supplies;

(c) X-rays;
(d) Hospital expenses;
(e) Nurses services, together with the name(s) and address(es) to whom paid;
(f) All other expenses, damages and injuries which will be claimed by plaintiff(s),
including by not limited to, household expenses, together with the name(s) and
address(es) of the recipient thereof.
27.

Set forth each occurrence prior to the occurrence alleged in the complaint, in

which the plaintiff(s) sustained an injury to the bodily portion alleged to have been
injured during the occurrence alleged in the complaint, whether or not medical care was
obtained. If medical care was obtained, set forth the name(s) and address(es) of each and
every health care facility / physician / therapist who treated or examined the plaintiff(s)
for such prior injury.
28.

State whether the occurrence alleged in the complaint was reported to the

defendant, _____________________________, or anyone on the said defendants behalf.

(a) if the occurrence was reported, state the date(s), time(s) and place(s) the
occurrence was reported and the name(s) of the person(s) on behalf of said defendant it
was reported to.
(b) State whether the report was in writing or verbal each time it was reported to
the said defendant.
29.

If the occurrence alleged in the complaint is claimed to have happened as a result

of plaintiffs slip, trip or fall on or upon a stoop. Walkway, step(s), stairway, remap,
hallway, landing, room as a result of debris, liquid or any substance then, set forth where
applicable as follows:
(a) The location stating without limitation, between what floors situated, counting
the ground floor as the first floor.
(b) The particular step on which the plaintiff(s) slipped, tripped or fell, counting
form the bottom or top stair;
(c) The location of the hallway stating without limitation, on what floor situated,
counting the ground floor as the first floor;

(d) The location in the hallway where the occurrence, alleged in the complaint
occurred;
(e) The location of the ramp, walkway, landing, room, including the location of
any alleged debris, liquid or substance;
(f) A description of the ramp, landing, room, debris, liquid or substance;
(g) The manner in which the alleged slip, trip or fall in, or upon a stoop, a step(s),
walkway, stairway, ramp, hallway, landing, room, debris, liquid or any substance caused
or contributed to the injuries alleged in the complaint.
30.

If the occurrence alleged in the complaint is claimed to have happened due to

improper or inadequate supervision then set forth in detail;

(a) The period of time during which said supervision was improper prior to the
occurrence alleged in the complaint;
(b) The manner in which said supervision was improper and/or inadequate;
(c) Identify the specific location within the premises at which the supervision was
inadequate so as to cause the occurrence alleged in the complaint;
(d) The acts and/or omissions constituting the improper or inadequate supervision;
(e) Whether defendant, __________________________________, was advised at
any time prior to the occurrence ) alleged by the plaintiff(s) or any person on behalf of or
known to plaintiff(s) that the supervision was inadequate and/or improper, stating the
person(s) on behalf of said defendant who was/were so informed, the person(s) so
informing said defendant and the time(s) and date(s) of said informing.
(f) State the manner in which the alleged improper or inadequate supervision
caused or contributed to the occurrence and injuries alleged in the complaint.
31.

In the occurrence alleged in the complaint is claimed to have happened due to

carelessness and/or negligence in the construction, maintenance or repair of certain

premises, then set forth in detail;
(a) The manner in which said construction or maintenance was careless and/or
negligent;
(b) Identify the specific location within the premised at which the construction of
maintenance was careless or negligent;

(c) The specific carelessness or negligence in connection with the construction

with or maintenance which it is alleged existed;
(d) whether defendant, ____________________________________, was advised
anytime prior to the occurrence (alleged in the complaint) by the plaintiff(s) or any
person(s) on behalf of or known to plaintiff(s) that said construction or maintenance was
careless and/or negligent stating the person(s) on behalf of said defendant who was/were
so informed, the person(s) so informing said defendant and the time and date(s) of said
informing.
(e) The manner in which the alleged negligent construction, maintenance or repair
of the premises caused or contributed to the occurrence and injuries alleged in the
complaint.
32.

If the occurrence alleged in the complaint is claimed to have happened due to

improper or inadequate lighting provisions then set forth in detail:

(a) The manner in which said lighting condition was improper or inadequate;
(b) Identify the specific location within the premises where the lighting condition
was inadequate or improper;
(c) The manner in which defendant was carelessness or negligence in regard to the
lighting condition;
(d) whether defendant, ____________________________________, was advised
anytime prior to the occurrence (alleged in the complaint) by the plaintiff(s) or any
person(s) on behalf of or known to plaintiff(s) that said lighting condition was improper
or inadequate stating the person(s) on behalf of said defendant who was/were so
informed, the person(s) so informing said defendant and the time and date(s) of said
informing.
(e) The manner in which the alleged improper or inadequate lighting condition of
the premises caused or contributed to the occurrence and injuries alleged in the
complaint.
33.

If the complaint alleges loss of services, society, companionship and/or

consortium, set forth the nature, extent and duration thereof.

34.

If the complaint alleges loss of services, then with regarding to any spouse who is

a party to this action, set forth the plaintiff(s) relationship now and at the time of the

occurrence alleged in the complaint. If plaintiff(s) was /were married at the time of the
occurrence and /or up to the present, state the date(s) and place(s) of marriage.
35.

Set forth the date of birth of plaintiffs spouse.

36.

With respect to the plaintiffs spouse set forth:

(a) type of business occupation.
(b) if self-employed name of business and address
(c) if not self-employed name and address of employer.

37.

If a sidewalk, walkway, pathway, window, parking lot or playground is to be

involved in the occurrence alleged in the complaint, state the following:

(a) In what respects plaintiff(s) claim(s) that the sidewalk, walkway, pathway,
window, parking lot or playground was in a/an dangerous, defective and/or improper
condition;
(b) The location of the occurrence on the sidewalk, pathway, walkway, parking lot
or playground by distances from the nearest intersection and corner and curb and building
(or other fixed and described point), stating the address of the building;
(c) If the condition and/or activity involved a hole, depression and/or raising,
please state the dimensions thereof;
(d) The manner in which the sidewalk, pathway, walkway, window, parking lot or
playground caused or contributed to the occurrence of the injuries alleged in the
complaint.
38.

If the occurrence alleged in the complaint is claimed to have happened on or in an

elevator or elevator shaft, set forth the following:

(a) the exact location of the elevator, noting the elevator number and noting at or
between which floors the elevator was situated (counting the ground floor as the first
floor) at the time of the occurrence alleged in the complaint;
(b) Whether the elevator was ascending or descending or stationary at any time of
the occurrence alleged in the complaint;
(c) Any and all claims of malfunction regarding the elevator;
(d) The manner in which the occurrence alleged in the complaint allegedly
occurred;

(e) A description of the elevator, giving its size, height, floor material makeup,
type of door action (whether the same was a sliding door, push door or otherwise);
(f) The manner which the elevator was allegedly improperly maintained, if
alleged:
(g) The manner in which the elevator was allegedly improperly repaired, if
alleged:
(h) The manner in which the elevator was improperly serviced, if alleged:
(i) The manner in which the elevator closed upon the plaintiff(s) if alleged:
(j) The manner in which the occurrence referable to the elevator and/or elevator
shaft caused or contributed to the injuries alleged in the complaint.
39.

State whether the plaintiff(s) claim they sustained any property damage or

loss as a result of the incident alleged in the complaint.

40.

If the answer to the proceeding demand is in the affirmative, then state

separately the following with respect to each plaintiff:

(a) the name of the plaintiff who claims such property damage or loss;
(b) state separately each item of property claimed.
Dated:

Jamaica, N.Y.
_____________________
By:
_______________ Associates, P.C.
123 main st

TO: