Pablo v. ServiceMaster Global Holdings, Inc. et al

Filing 371

VERDICT FORMS (October 28, 2011) (SI, COURT STAFF) (Filed on 10/28/2011)

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IN THE UNITED STATES DISTRICT COURT

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FOR THE NORTHERN DISTRICT OF CALIFORNIA

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RUBEN PABLO, BONNIE COURSEY and
JOHN BAHR,

No. C 08-3894 SI

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United States District Court
For the Northern District of California

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VERDICT FORMS
Plaintiffs,
v.
SERVICEMASTER GLOBAL HOLDINGS,
INC., et al.,
Defendants.

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Instructions: Three verdict forms are below, one for each plaintiff. Please read the questions
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carefully. After answering each question, read the directions directly following the question to
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find out whether to proceed to the next question, or to skip to a question later in the form.
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Verdict Form for Plaintiff John Bahr

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1. Did defendants prove, by a preponderance of the evidence, that plaintiff John Bahr customarily
and regularly worked more than half the working time away from the defendants’ place of business
selling tangible or intangible items or obtaining orders or contracts for products, services or use of
facilities?
[ ]Yes

[ ] No

If Yes, skip to Question 14.
If No, proceed to Question 2.

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Overtime Claim

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2. Did plaintiff John Bahr prove, by a preponderance of the evidence, that he worked over 8 hours
on any day or 40 hours in any week?

United States District Court
For the Northern District of California

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[ ] Yes

[ ] No

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If Yes, proceed to Question 3.
If No, skip to Question 4.

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3. What is the amount of overtime wages owed to plaintiff John Bahr by defendants?

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$__________
Proceed to Question 4.

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Meal and Rest Break Claim
4. Did plaintiff John Bahr prove, by a preponderance of the evidence, that defendants failed to
provide him with one or more 30 minute duty-free meal periods during any 5-hour work period?
[ ] Yes

[ ] No

If Yes, proceed to Question 5.
If No, skip to Question 6.
5. What is the number of times that plaintiff John Bahr was not provided with a meal period that he
was owed?
__________

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Proceed to Question 6.

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6. What was plaintiff John Bahr’s average hourly wage rate during his employ with defendants?

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$_________
Proceed to Question 7.
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7. Did plaintiff John Bahr prove, by a preponderance of the evidence, that defendants failed to
provide him with one or more duty-free rest periods during any four-hour work period?

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[ ] Yes

[ ] No

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If Yes, proceed to Question 8.
If No, skip to Question 9.

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8. What is the number of times that plaintiff John Bahr was not provided with a rest period that he
was owed?

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__________
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Proceed to Question 9.
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United States District Court
For the Northern District of California

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Itemized Wage Statement Claim
9. Did plaintiff John Bahr prove, by a preponderance of the evidence, that defendants knowingly
and intentionally failed to furnish to him with one or more accurate itemized statements in writing
showing the total hours he worked?
[ ] Yes

[ ] No

If Yes, proceed to question 10.
If No, skip to question 11.
10. How many pay periods did defendants fail to furnish plaintiff John Bahr with accurate itemized
statements in writing showing the total hours he worked?
__________
Proceed to Question 11.

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Waiting Time Penalties
11. Did plaintiff John Bahr prove, by a preponderance of the evidence, that defendants willfully
failed to pay him the amount of wages due to him at the time his employment with defendants
ended?
[ ] Yes

[ ] No

If Yes, proceed to question 12.
If No, skip to question 14.
12. For how many calender days, not to exceed 30, following plaintiff John Bahr’s last day of
employment did defendants willfully fail to pay the full amount of his wages?
__________
13. What was plaintiff John Bahr’s daily wage rate at the time his employment ended?
$__________ per day.
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Reimbursement for Necessary Work Expenditures Claim

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14. Did plaintiff John Bahr prove, by a preponderance of the evidence, that defendants failed to
reimburse him for necessary work expenditures that he incurred?

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[ ] Yes

[ ] No

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If Yes, proceed to question 15.
If No, skip to the signature line.

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15. What is the amount of necessary business expenditures for which plaintiff John Bahr was not
reimbursed?

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$__________

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United States District Court
For the Northern District of California

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You are now finished with plaintiff John Bahr’s verdict form. Please have the presiding juror sign
on the line below and proceed to the next verdict form.

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Dated: __________
__________________
Presiding Juror

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Verdict Form for Plaintiff Ruben Pablo

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1. Did defendants prove, by a preponderance of the evidence, that plaintiff Ruben Pablo customarily
and regularly worked more than half the working time away from the defendants’ place of business
selling tangible or intangible items or obtaining orders or contracts for products, services or use of
facilities?
[ ]Yes

[ ] No

If Yes, skip to Question 14.
If No, proceed to Question 2.

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Overtime Claim

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2. Did plaintiff Ruben Pablo prove, by a preponderance of the evidence, that he worked over 8
hours on any day or 40 hours in any week?

United States District Court
For the Northern District of California

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[ ] Yes

[ ] No

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If Yes, proceed to Question 3.
If No, skip to Question 4.

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3. What is the amount of overtime wages owed to plaintiff Ruben Pablo by defendants?

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$__________
Proceed to Question 4.

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Meal and Rest Break Claim

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4. Did plaintiff Ruben Pablo prove, by a preponderance of the evidence, that defendants failed to
provide him with one or more 30 minute duty-free meal periods during any 5-hour work period?

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[ ] Yes

[ ] No

If Yes, proceed to Question 5.
If No, skip to Question 6.

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5. What is the number of times that plaintiff Ruben Pablo was not provided with a meal period that
he was owed?
__________

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Proceed to Question 6.

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6. What was plaintiff Ruben Pablo’s average hourly wage rate during his employ with defendants?

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$_________
Proceed to Question 7.
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7. Did plaintiff Ruben Pablo prove, by a preponderance of the evidence, that defendants failed to
provide him with one or more duty-free rest periods during any four-hour work period?

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[ ] Yes

[ ] No

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If Yes, proceed to Question 8.
If No, skip to Question 9.

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8. What is the number of times that plaintiff Ruben Pablo was not provided with a rest period that
he was owed?1

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__________
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Proceed to Question 9.
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United States District Court
For the Northern District of California

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Itemized Wage Statement Claim
9. Did plaintiff Ruben Pablo prove, by a preponderance of the evidence, that defendants knowingly
and intentionally failed to furnish to him with one or more accurate itemized statements in writing
showing the total hours he worked?
[ ] Yes

[ ] No

If Yes, proceed to question 10.
If No, skip to question 11.

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10. How many pay periods did defendants fail to furnish plaintiff Ruben Pablo with accurate
itemized statements in writing showing the total hours he worked?
__________
Proceed to Question 11.

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Waiting Time Penalties

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11. Did plaintiff Ruben Pablo prove, by a preponderance of the evidence, that defendants willfully
failed to pay him the amount of wages due to him at the time his employment with defendants
ended?

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[ ] Yes

[ ] No

If Yes, proceed to question 12.
If No, skip to question 14.
12. For how many calender days, not to exceed 30, following plaintiff Ruben Pablo’s last day of
employment did defendants willfully fail to pay the full amount of his wages?
__________

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13. What was plaintiff Ruben Pablo’s daily wage rate at the time his employment ended?
$__________ per day.

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Reimbursement for Necessary Work Expenditures Claim

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14. Did plaintiff Ruben Pablo prove, by a preponderance of the evidence, that defendants failed to
reimburse him for necessary work expenditures that he incurred?

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[ ] Yes

[ ] No

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If Yes, proceed to question 15.
If No, skip to the signature line.

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15. What is the amount of necessary business expenditures for which plaintiff Ruben Pablo was not
reimbursed?

United States District Court
For the Northern District of California

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$__________

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You are now finished with plaintiff Ruben Pablo’s verdict form. Please have the presiding juror
sign on the line below and proceed to the next verdict form.

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Dated: __________
__________________
Presiding Juror

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Verdict Form for Plaintiff Bonnie Coursey

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1. Did defendants prove, by a preponderance of the evidence, that plaintiff Bonnie Coursey
customarily and regularly worked more than half the working time away from the defendants’ place
of business selling tangible or intangible items or obtaining orders or contracts for products, services
or use of facilities?
[ ]Yes

[ ] No

If Yes, skip to Question 14.
If No, proceed to Question 2.

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Overtime Claim

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2. Did plaintiff Bonnie Coursey prove, by a preponderance of the evidence, that he worked over 8
hours on any day or 40 hours in any week?

United States District Court
For the Northern District of California

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[ ] Yes

[ ] No

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If Yes, proceed to Question 3.
If No, skip to Question 4.

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3. What is the amount of overtime wages owed to plaintiff Bonnie Coursey by defendants?

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$__________
Proceed to Question 4.

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Meal and Rest Break Claim

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4. Did plaintiff Bonnie Coursey prove, by a preponderance of the evidence, that defendants failed to
provide him with one or more 30 minute duty-free meal periods during any 5-hour work period?

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[ ] Yes

[ ] No

If Yes, proceed to Question 5.
If No, skip to Question 6.
5. What is the number of times that plaintiff Bonnie Coursey was not provided with a meal period
that he was owed?
__________
Proceed to Question 6.
6. What was plaintiff Bonnie Coursey’s average hourly wage rate during his employ with
defendants?
$_________
Proceed to Question 7.
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7. Did plaintiff Bonnie Coursey prove, by a preponderance of the evidence, that defendants failed to
provide him with one or more duty-free rest periods during any four-hour work period?

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[ ] Yes

[ ] No

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If Yes, proceed to Question 8.
If No, skip to Question 9.

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8. What is the number of times that plaintiff Bonnie Coursey was not provided with a rest period
that he was owed?

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Proceed to Question 9.
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United States District Court
For the Northern District of California

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Itemized Wage Statement Claim

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9. Did plaintiff Bonnie Coursey prove, by a preponderance of the evidence, that defendants
knowingly and intentionally failed to furnish to him with one or more accurate itemized statements
in writing showing the total hours he worked?

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[ ] Yes

[ ] No

If Yes, proceed to question 10.
If No, skip to question 11.
10. How many pay periods did defendants fail to furnish plaintiff Bonnie Coursey with accurate
itemized statements in writing showing the total hours he worked?
__________
Proceed to Question 11.

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Waiting Time Penalties
11. Did plaintiff Bonnie Coursey prove, by a preponderance of the evidence, that defendants
willfully failed to pay him the amount of wages due to him at the time his employment with
defendants ended?
[ ] Yes

[ ] No

If Yes, proceed to question 12.
If No, skip to question 14.
12. For how many calender days, not to exceed 30, following plaintiff Bonnie Coursey’s last day of
employment did defendants willfully fail to pay the full amount of his wages?
__________

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13. What was plaintiff Bonnie Coursey’s daily wage rate at the time his employment ended?
$__________ per day.

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Reimbursement for Necessary Work Expenditures Claim
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United States District Court
For the Northern District of California

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14. Did plaintiff Bonnie Coursey prove, by a preponderance of the evidence, that defendants failed
to reimburse him for necessary work expenditures that he incurred?
[ ] Yes

[ ] No

If Yes, proceed to question 15.
If No, skip to the signature line.
15. What is the amount of necessary business expenditures for which plaintiff Bonnie Coursey was
not reimbursed?

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$__________

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You are now finished with all of the verdict forms. Please have the presiding juror sign on the line
below and contact the courtroom deputy.

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Dated: __________
__________________
Presiding Juror

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