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NOT FOR PUBLICATION
UNITED STATES COURT OF APPEALS
FOR THE NINTH CIRCUIT
MULTICARE HEALTH SYSTEM, d/b/a
MultiCare Good Samaritan Hospital,
Plaintiff - Appellant,
v.
LEXINGTON INSURANCE COMPANY,
a Delaware corporation; et al.,
Defendants - Appellees.
No. 12-35436
D.C. No. 3:12-cv-05043-BHS
MEMORANDUM*
Appeal from the United States District Court
for the Western District of Washington
Benjamin H. Settle, District Judge, Presiding
Argued and Submitted July 12, 2013
Seattle, Washington
Before: KLEINFELD, M. SMITH, and N.R. SMITH, Circuit Judges.
Medical Staffing Network contracted with Multicare Health System (“the
hospital”) to provide the hospital with temporary nursing staff. Pursuant to that
FILED
AUG 28 2013
MOLLY C. DWYER, CLERK
U.S. COURT OF APPEALS
*
This disposition is not appropriate for publication and is not precedent
except as provided by 9th Cir. R. 36-3.
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contract, Medical Staffing gave the hospital a Certificate of Liability Insurance
issued on behalf of Lexington Insurance Company (“Lexington”), by USI
Insurance Services, LLC, and USI Holdings (collectively “USI”). The Certificate
stated that Medical Staffing had a professional liability insurance policy that
provided up to $5 million of coverage. It did not state, however, that the
professional liability policy was subject to a $1 million self-insured retention.
The hospital sued Lexington and USI, alleging that the failure to include the
$1 million self-insured retention on the Certificate was a material
misrepresentation on which the hospital relied to its detriment. The hospital
became liable for a $785,000 malpractice award, that resulted from a 2008 suit
against a Medical Staffing nurse on contract with the hospital. The award was
within Medical Staffing’s self-insured retention, but Medical Staffing went
bankrupt and did not pay it.
The district court dismissed the hospital’s claims, but allowed supplemental
briefing on whether the hospital should be given leave to amend its complaint.
After reviewing that briefing, the district court dismissed the complaint with
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prejudice, concluding that “any amendment would be futile.” The hospital appeals.
I.
We review de novo the district court’s grant of a motion to dismiss, and may
affirm on any ground supported by the record. Davis v. HSBC Bank Nevada,
N.A., 691 F.3d 1152, 1159 (9th Cir. 2012). We consider only the complaint itself
and the Certificate of Insurance Liability, which was attached to the complaint as
an exhibit. See Manzarek v. St. Paul Fire & Marine Ins. Co., 519 F.3d 1025,
1030–31 (9th Cir. 2008). “To survive a motion to dismiss, a complaint must
contain sufficient factual matter, accepted as true, to state a claim to relief that is
plausible on its face. A claim has facial plausibility when the plaintiff pleads
factual content that allows the court to draw the reasonable inference that the
defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662,
678 (2009) (citations and internal quotation marks omitted).
The hospital’s complaint alleges that defendants harmed the hospital when
they breached their duty “to not misrepresent the terms of an insurance policy” and
“made [a] material misrepresentation by not including the $1 Million [self-insured
retention] on the Certificate of Insurance.” Under Washington law, a defendant is
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liable for negligent misrepresentation when it 1) makes an affirmative
misrepresentation or 2) negligently fails to disclose information when it has a duty
to do so. Van Dinter v. Orr, 138 P.3d 608, 609–10 (Wash. 2006).
The complaint does not contain sufficient facts to state a claim for
affirmative misrepresentation. It does not claim that any information contained in
the Certificate is false; it simply alleges that the self-insured retention should have
been included and was not.
Nor does the complaint contain sufficient facts to state a claim for negligent
failure to disclose information. Under Washington law, a duty to disclose
information arises “if imposed by a fiduciary relationship or other similar
relationship of trust or confidence or if necessary to prevent a partial or ambiguous
statement of facts from being misleading.” Van Dinter, 138 P.3d at 610. “The
existence of a duty is a question of law.” Colonial Imports, Inc. v. Carlton
Northwest, Inc., 853 P.2d 913, 916 (Wash. 1993).
Here, defendants were not in a fiduciary or quasi-fiduciary relationship with
the hospital. They were not in any relationship with the hospital at all. They
-4-
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issued a Certificate of Liability Insurance to Medical Staffing, not the hospital.
Medical Staffing gave the Certificate to the hospital as proof that it had insurance.
The complaint alleges no facts indicating that including the self-insured retention
on the Certificate was necessary to prevent a partial statement of facts from being
misleading. “We need not accept as true conclusory allegations that are
contradicted by documents referred to in the complaint.” Manzarek, 519 F.3d at
1031. The Certificate is a one-page form document, the heart of which is a table
summarizing Medical Staffing’s insurance policies by listing in separate columns
each policy’s insurance type, policy number, policy effective date, policy
expiration date, and policy limits. There is no column for retention amount or
deductible. Anyone with medical, auto, homeowners, commercial or other liability
or casualty insurance knows that many policies have deductibles and self-insured
floors below which there is no coverage. The Certificate expressly states that “the
insurance afforded by the policies described herein is subject to all the terms,
exclusions and conditions of such policies” and that the Certificate is “issued as a
matter of information only.”
We do not believe that the Washington Supreme Court would find a duty to
disclose a self-insured retention amount on a certificate that summarizes insurance
-5-
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policies and does not contain a column for retention or deductible amounts. This is
especially true in light of the fact that the hospital could have asked Medical
Staffing for a copy of its insurance policy. See Van Dinter, 138 P.3d at 610
(explaining that the duty to disclose arises “when the facts are peculiarly within the
knowledge of one person and could not be readily obtained by the other; or where,
by the lack of business experience of one of the parties, the other takes advantage
of the situation by remaining silent.”); Austin v. Ettl, 286 P.3d 85, 90–91 (Wash.
Ct. App. 2012) (affirming a trial court’s dismissal of a negligent failure to disclose
claim in part because the “information was easily discoverable by [plaintiff] and, in
addition, [defendants] did not have any kind of special or fiduciary relationship to
[plaintiff].”); see also Travelers Prop. Cas. Co. of Am. v. Superior Court, 155 Cal.
Rptr. 3d 459, 477 (Ct. App. 2013) (“A certificate of insurance is merely evidence
that a policy has been issued; it identifies the types of policies issued, the dates of
coverage and the dollar limits of coverage. The document is not intended to
inform the certificate holder of every, or any, limitation on or exclusion from
coverage, and no broker can be liable for failing to include such information in a
certificate of insurance.”) (footnote omitted); Benjamin Shapiro Realty Co. v.
Kemper Nat’l Ins. Cos., 756 N.Y.S.2d 45, 46 (App. Div. 2003) (“[W]here, as here,
certificates of insurance contain disclaimers that they are for information only, they
-6-
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may not be used as predicates for a claim of negligent misrepresentation.”). If
defendants had a duty to disclose retentions, exclusions, and all policy terms that a
third party could conceivably rely upon when issuing a certificate of insurance,
certificates would essentially be transformed into copies of insurance policies, and
would lose their value as succinct statements of the existence of insurance. See
Postlewait Constr., Inc. v. Great Am. Ins. Cos., 720 P.2d 805, 807 (Wash. 1986)
(“[T]he purpose of issuing a certificate of insurance is to inform the recipient
thereof that insurance has been obtained; the certificate itself, however, is not the
equivalent of an insurance policy.”).
For the reasons stated above, the district court was correct to dismiss the
hospital’s misrepresentation claim. The hospital’s other claims for bad faith,
violations of Washington insurance regulations, and violation of Washington’s
Consumer Protection Act, were dependent upon its misrepresentation claim, so the
district court was correct to dismiss those claims as well. The hospital’s breach of
the duty of care claim is essentially a restatement of its negligent misrepresentation
claim. Even if the independent duty doctrine as articulated in Affiliated FM
Insurance Co. v. LTK Consulting Services, Inc., 243 P.3d 521 (Wash. 2010)
applies, the only duty arising out of “ordinary tort principles,” and the only duty
-7-
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argued by the hospital in its brief on appeal, is the same duty at issue in the
hospital’s negligent misrepresentation claim – the duty to disclose information.
There was no misrepresentation, no fiduciary duty, no privity, and no other basis
pleaded for a duty to disclose the self-insured retention provisions of the policy, so
we need not reach the question of whether reliance was unreasonable as a matter of
law. Cf. Barnes v. Cornerstone Invs., Inc., 773 P.2d 884, 886 (Wash. Ct. App.
1989).
II.
“Dismissal with prejudice and without leave to amend is not appropriate
unless it is clear on de novo review that the complaint could not be saved by
amendment.” Eminence Capital, LLC v. Aspeon, Inc., 316 F.3d 1048, 1052 (9th
Cir. 2003). The hospital argues that it can amend its complaint to state sufficient
facts and theories to make out a negligent misrepresentation claim. But none of the
new facts or theories pressed by the hospital plausibly state or allow us to infer that
it justifiably relied on the Certificate or that the defendants had a duty to include
the self-insured retention amount to keep the Certificate from being misleading.
-8-
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We do not see how the complaint could plead a claim even with the amendments
the hospital might make.
The hospital says that if it were allowed leave to amend, it would claim that
the defendants made an affirmative misrepresentation, because they should have
put Medical Staffing’s professional liability policy into the “excess/umbrella
liability” row on the Certificate. This row includes a blank for retention amount,
and the hospital claims that the defendants should have used this blank to state that
the professional liability policy was subject to a $1 million self-insured retention.
Medical Staffing already had an excess liability policy listed on its Certificate, but
the professional liability policy at issue was not an excess or umbrella policy. It
provided the first layer of coverage. Excess and umbrella policies provide layers
of coverage on top of the first layer. The self-insured retention is not a first layer
of insurance. See Bordeaux, Inc. v. Am. Safety Ins. Co., 186 P.3d 1188, 1192
(Wash. Ct. App. 2008) (“Washington courts have rejected the argument that self-
insurance constitutes ‘insurance.’”).
The hospital says that industry standards control here, rather than
Washington law, and points us to a declaration from an insurance consultant.
-9-
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However, the consultant merely offers conclusory statements, unsupported by any
facts or examples. See Pillsbury, Madison & Sutro v. Lerner, 31 F.3d 924, 928
(9th Cir. 1994) (“[C]onclusory allegations without more are insufficient to defeat a
motion to dismiss for failure to state a claim.” (quoting McGlinchy v. Shell Chem.
Co., 845 F.2d 802, 810 (9th Cir. 1988))); see also Iqbal, 556 U.S. at 679–81. Nor
does the expert’s declaration address the question of whether the hospital was
justified in relying upon the Certificate rather than asking for a copy of Medical
Staffing’s professional liability policy.
We respectfully disagree with our dissenting colleague’s view that the self-
insured retention endorsement might be pleaded as an “exclusion” that should have
been in the “description of operations/locations/vehicles/exclusions added by
endorsement/special provisions” box. Kyrkos v. State Farm Mutual Automobile
Insurance Co., 852 P.2d 1078, 1081 (Wash. 1993) addressed exclusions in
uninsured motorist coverage, not endorsements adding deductibles or self-insured
retentions. The endorsement itself states that it amends the policy by replacing the
section entitled “Deductible” with the self-insured retention provision.
-10-
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The hospital also attempts to bolster its negligent failure to disclose claim by
saying that if it were allowed leave to amend, it would claim that third parties
frequently rely upon certificates of insurance in the course of their business
transactions with insureds without asking to see the underlying policies, that
defendants knew that a $1 million self-insured retention is unusually high in the
nurse staffing business, and that certificate issuers should know that certificate
recipients rely upon certificates. These claims, though, would not establish a duty
under Washington law to disclose a self-insured retention on a one-page certificate
that has no column in which to include retention or deductible amounts.
The hospital has not put forward any argument that would save its complaint
from dismissal. The district court’s orders dismissing the hospital’s claims and
denying leave to amend are AFFIRMED.
-11-
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Multicare Health v. Lexington Ins. Co., 12-35436
N.R. SMITH, Circuit Judge, concurring in part and dissenting in part:
I only write to address the negligent misrepresentation by omission claim.
This claim was insufficiently pleaded in the hospital’s original complaint.
However, amendment of this claim would not be futile, because the hospital’s
proposed amendments allege sufficient facts to state a claim. Accordingly, the
district court abused its discretion in denying leave to amend and dismissing this
claim with prejudice. See Manzarek v. St. Paul Fire & Marine Ins. Co., 519 F.3d
1025, 1031 (9th Cir. 2008). Otherwise, the majority “got it right.”
Under Washington law, a plaintiff may state a negligent misrepresentation
by omission claim based on a duty to disclose where disclosure is “necessary to
prevent a partial or ambiguous statement of facts from being misleading.” Van
Dinter v. Orr, 138 P.3d 608, 610 (Wash. 2006).1
First, the district court
improperly conflated the question of whether the disclosure of the self-insured
retention was necessary to prevent a partial or ambiguous statement of fact with
whether information about the self-insured retention was easily obtainable. These
FILED
AUG 28 2013
MOLLY C. DWYER, CLERK
U.S. COURT OF APPEALS
1
Although the district court cited the “clear, cogent, and convincing”
evidentiary standard for negligent misrepresentation claims, I note that the proper
question for resolving a motion to dismiss is whether the hospital alleged sufficient
facts to state a claim plausible on its face. Bell Atl. Corp. v. Twombly, 550 U.S.
544, 570 (2007).
1
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are distinct theories under which a plaintiff may allege a duty to disclose, one does
not preclude the other. See id.
Second, in noting that disclosure of the $5 million limit of liability was not a
partial or ambiguous statement, the district court misconstrued the nature of the
hospital’s claim. The hospital’s negligent representation by omission claim alleges
that the $1 million self-insured retention should have been disclosed on the face of
the insurance certificate (not that the $5 million liability limit was somehow
erroneous). Specifically, the hospital alleges that, because the self-insured
retention was added to the policy by an endorsement, it should have been disclosed
in the space designated for “Exclusions Added by Endorsement / Special
Provisions.” See also Kyrkos v. St. Farm Mut. Auto. Ins. Co., 852 P.2d 1078, 1081
(Wash. 1993) (describing self-insured retention provision as an “exclusion”). The
hospital further alleges that this omission “violated industry standards and
misrepresented the coverage offered under the Lexington policy by failing to
indicate the self-insured retention which was, under the terms of the policy, an
‘exclusion added by endorsement’ and/or a ‘special provision.’”
I am mindful of the broad disclaimers contained on the front and back of the
certificate. While the disclaimers indicate that there are applicable terms and
conditions not found on the insurance certificate, the disclaimers do not suggest
2
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that a holder of the certificate cannot assume the accuracy of the standardized
information that is provided (e.g., the existence of an insurance policy, the stated
amount of liability coverage). The same should be true where space for a
standardized term is left blank. For example, if the “Automobile Liability” box is
blank, the holder of the certificate would assume the covered party has no
automobile liability insurance.
As the majority notes, an insurance certificate and its corresponding limited
disclosure space surely cannot be expected to list every term and condition of
every policy. See Mem. Dispo. at 7. However, where the form standardizes the
information to be disclosed and a standardized disclosure is omitted, it seems
plausible that this type of partial or ambiguous statement of fact could become
misleading. The majority rejects the hospital’s use of this theory based on the
assumption that the insurance certificate “has no column in which to include
retention or deductible amounts.” Mem. Dispo. at 10-11. If, however, the
industry practice is to include the amount of a self-insured retention in the space
designated for “Exclusions Added by Endorsement / Special Provisions,” then the
majority’s assumption is incorrect.
Therefore, a factual question exists at this stage of the proceedings regarding
whether industry standards mandate that a $1 million self-insured retention added
3
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by endorsement should appear in the space designated for “Exclusions Added by
Endorsement / Special Provisions.” Because the hospital so alleges in its proposed
amended allegations, and because factual allegations are to be taken as true at the
motion to dismiss stage, I would allow the hospital to proceed on its negligent
misrepresentation by omission claim under this theory.
Of course, if Defendants can show that industry practice is to the contrary
(i.e., this box is not used in such a manner, or a self-insured retention is never so
disclosed), then the hospital’s claim may not survive summary judgment. At this
early stage, however, the hospital need only provide plausible factual allegations,
not evidence to prove the merits of its claim. See Twombly, 550 U.S. at 570.
The district court dismissed the bad faith, Consumer Protection Act,
statutory claims, and the independent duty doctrine claim as a result of its holding
that the hospital failed to allege a negligent misrepresentation claim. Because I
find that the negligent misrepresentation by omission claim would be sufficiently
pleaded as amended, I would allow amendment and remand consideration of these
claims to the district court for further proceedings. On remand, the district court
could also address standing in the first instance.
4
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United States Court of Appeals for the Ninth Circuit
Office of the Clerk
95 Seventh Street
San Francisco, CA 94103
Information Regarding Judgment and Post-Judgment Proceedings
Judgment
• This Court has filed and entered the attached judgment in your case.
Fed. R. App. P. 36. Please note the filed date on the attached
decision because all of the dates described below run from that date,
not from the date you receive this notice.
Mandate (Fed. R. App. P. 41; 9th Cir. R. 41-1 & -2)
• The mandate will issue 7 days after the expiration of the time for
filing a petition for rehearing or 7 days from the denial of a petition
for rehearing, unless the Court directs otherwise. To file a motion to
stay the mandate, file it electronically via the appellate ECF system
or, if you are a pro se litigant or an attorney with an exemption from
using appellate ECF, file one original motion on paper.
Petition for Panel Rehearing (Fed. R. App. P. 40; 9th Cir. R. 40-1)
Petition for Rehearing En Banc (Fed. R. App. P. 35; 9th Cir. R. 35-1 to -3)
(1) A. Purpose (Panel Rehearing):
• A party should seek panel rehearing only if one or more of the following
grounds exist:
► A material point of fact or law was overlooked in the decision;
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► An apparent conflict with another decision of the Court was not
addressed in the opinion.
• Do not file a petition for panel rehearing merely to reargue the case.
B. Purpose (Rehearing En Banc)
• A party should seek en banc rehearing only if one or more of the following
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Post Judgment Form - Rev. 08/2013 1
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► Consideration by the full Court is necessary to secure or maintain
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► The proceeding involves a question of exceptional importance; or
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rule of national application in which there is an overriding need for
national uniformity.
(2) Deadlines for Filing:
• A petition for rehearing may be filed within 14 days after entry of
judgment. Fed. R. App. P. 40(a)(1).
• If the United States or an agency or officer thereof is a party in a civil case,
the time for filing a petition for rehearing is 45 days after entry of
judgment. Fed. R. App. P. 40(a)(1).
• If the mandate has issued, the petition for rehearing should be
accompanied by a motion to recall the mandate.
• See Advisory Note to 9th Cir. R. 40-1 (petitions must be received on the
due date).
• An order to publish a previously unpublished memorandum disposition
extends the time to file a petition for rehearing to 14 days after the date of
the order of publication or, in all civil cases in which the United States or
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(3) Statement of Counsel
• A petition should contain an introduction stating that, in counsel’s
judgment, one or more of the situations described in the “purpose” section
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(4) Form & Number of Copies (9th Cir. R. 40-1; Fed. R. App. P. 32(c)(2))
• The petition shall not exceed 15 pages unless it complies with the
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• If a pro se litigant elects to file a form brief pursuant to Circuit Rule 28-1, a
petition for panel rehearing or for rehearing en banc need not comply with
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Post Judgment Form - Rev. 08/2013 2
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• The petition or answer must be accompanied by a Certificate of
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• You may file a petition electronically via the appellate ECF system. No
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pro se litigant or an attorney exempted from using the appellate ECF
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required unless the Court orders otherwise.
Bill of Costs (Fed. R. App. P. 39, 9th Cir. R. 39-1)
• The Bill of Costs must be filed within 14 days after entry of judgment.
• See Form 10 for additional information, available on our website at
www.ca9.uscourts.gov under Forms.
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• Ninth Circuit Rule 39-1 describes the content and due dates for attorneys
fees applications.
• All relevant forms are available on our website at www.ca9.uscourts.gov
under Forms or by telephoning (415) 355-7806.
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Post Judgment Form - Rev. 08/2013 3
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Form 10. Bill of Costs ................................................................................................................................(Rev. 12-1-09)
United States Court of Appeals for the Ninth Circuit
BILL OF COSTS
Note: If you wish to file a bill of costs, it MUST be submitted on this form and filed, with the clerk, with proof of
service, within 14 days of the date of entry of judgment, and in accordance with 9th Circuit Rule 39-1. A
late bill of costs must be accompanied by a motion showing good cause. Please refer to FRAP 39, 28
U.S.C. § 1920, and 9th Circuit Rule 39-1 when preparing your bill of costs.
v. 9th Cir. No.
The Clerk is requested to tax the following costs against:
Cost Taxable
under FRAP 39,
28 U.S.C. § 1920,
9th Cir. R. 39-1
REQUESTED
Each Column Must Be Completed
ALLOWED
To Be Completed by the Clerk
No. of
Docs.
Pages per
Doc.
Cost per
Page*
TOTAL
COST
TOTAL
COST
Pages per
Doc.
No. of
Docs.
Excerpt of Record
Opening Brief
Reply Brief
$
$
$
$
$
$
$ $
Other**
Answering Brief
$ $
$
$
$
$
$
$
$
$
$
$
$ $TOTAL: TOTAL:
* Costs per page may not exceed .10 or actual cost, whichever is less. 9th Circuit Rule 39-1.
Cost per
Page*
Any other requests must be accompanied by a statement explaining why the item(s) should be taxed
pursuant to 9th Circuit Rule 39-1. Additional items without such supporting statements will not be
considered.
Attorneys' fees cannot be requested on this form.
** Other:
Continue to next page.
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Form 10. Bill of Costs - Continued
I, , swear under penalty of perjury that the services for which costs are taxed
were actually and necessarily performed, and that the requested costs were actually expended as listed.
Signature
Date
Name of Counsel:
Attorney for:
Date Costs are taxed in the amount of $
Clerk of Court
By: , Deputy Clerk
(To Be Completed by the Clerk)
("s/" plus attorney's name if submitted electronically)
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Multi care health system v. lexington ins. co.

  • 1. NOT FOR PUBLICATION UNITED STATES COURT OF APPEALS FOR THE NINTH CIRCUIT MULTICARE HEALTH SYSTEM, d/b/a MultiCare Good Samaritan Hospital, Plaintiff - Appellant, v. LEXINGTON INSURANCE COMPANY, a Delaware corporation; et al., Defendants - Appellees. No. 12-35436 D.C. No. 3:12-cv-05043-BHS MEMORANDUM* Appeal from the United States District Court for the Western District of Washington Benjamin H. Settle, District Judge, Presiding Argued and Submitted July 12, 2013 Seattle, Washington Before: KLEINFELD, M. SMITH, and N.R. SMITH, Circuit Judges. Medical Staffing Network contracted with Multicare Health System (“the hospital”) to provide the hospital with temporary nursing staff. Pursuant to that FILED AUG 28 2013 MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS * This disposition is not appropriate for publication and is not precedent except as provided by 9th Cir. R. 36-3. Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 1 of 11 (1 of 20)
  • 2. contract, Medical Staffing gave the hospital a Certificate of Liability Insurance issued on behalf of Lexington Insurance Company (“Lexington”), by USI Insurance Services, LLC, and USI Holdings (collectively “USI”). The Certificate stated that Medical Staffing had a professional liability insurance policy that provided up to $5 million of coverage. It did not state, however, that the professional liability policy was subject to a $1 million self-insured retention. The hospital sued Lexington and USI, alleging that the failure to include the $1 million self-insured retention on the Certificate was a material misrepresentation on which the hospital relied to its detriment. The hospital became liable for a $785,000 malpractice award, that resulted from a 2008 suit against a Medical Staffing nurse on contract with the hospital. The award was within Medical Staffing’s self-insured retention, but Medical Staffing went bankrupt and did not pay it. The district court dismissed the hospital’s claims, but allowed supplemental briefing on whether the hospital should be given leave to amend its complaint. After reviewing that briefing, the district court dismissed the complaint with -2- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 2 of 11 (2 of 20)
  • 3. prejudice, concluding that “any amendment would be futile.” The hospital appeals. I. We review de novo the district court’s grant of a motion to dismiss, and may affirm on any ground supported by the record. Davis v. HSBC Bank Nevada, N.A., 691 F.3d 1152, 1159 (9th Cir. 2012). We consider only the complaint itself and the Certificate of Insurance Liability, which was attached to the complaint as an exhibit. See Manzarek v. St. Paul Fire & Marine Ins. Co., 519 F.3d 1025, 1030–31 (9th Cir. 2008). “To survive a motion to dismiss, a complaint must contain sufficient factual matter, accepted as true, to state a claim to relief that is plausible on its face. A claim has facial plausibility when the plaintiff pleads factual content that allows the court to draw the reasonable inference that the defendant is liable for the misconduct alleged.” Ashcroft v. Iqbal, 556 U.S. 662, 678 (2009) (citations and internal quotation marks omitted). The hospital’s complaint alleges that defendants harmed the hospital when they breached their duty “to not misrepresent the terms of an insurance policy” and “made [a] material misrepresentation by not including the $1 Million [self-insured retention] on the Certificate of Insurance.” Under Washington law, a defendant is -3- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 3 of 11 (3 of 20)
  • 4. liable for negligent misrepresentation when it 1) makes an affirmative misrepresentation or 2) negligently fails to disclose information when it has a duty to do so. Van Dinter v. Orr, 138 P.3d 608, 609–10 (Wash. 2006). The complaint does not contain sufficient facts to state a claim for affirmative misrepresentation. It does not claim that any information contained in the Certificate is false; it simply alleges that the self-insured retention should have been included and was not. Nor does the complaint contain sufficient facts to state a claim for negligent failure to disclose information. Under Washington law, a duty to disclose information arises “if imposed by a fiduciary relationship or other similar relationship of trust or confidence or if necessary to prevent a partial or ambiguous statement of facts from being misleading.” Van Dinter, 138 P.3d at 610. “The existence of a duty is a question of law.” Colonial Imports, Inc. v. Carlton Northwest, Inc., 853 P.2d 913, 916 (Wash. 1993). Here, defendants were not in a fiduciary or quasi-fiduciary relationship with the hospital. They were not in any relationship with the hospital at all. They -4- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 4 of 11 (4 of 20)
  • 5. issued a Certificate of Liability Insurance to Medical Staffing, not the hospital. Medical Staffing gave the Certificate to the hospital as proof that it had insurance. The complaint alleges no facts indicating that including the self-insured retention on the Certificate was necessary to prevent a partial statement of facts from being misleading. “We need not accept as true conclusory allegations that are contradicted by documents referred to in the complaint.” Manzarek, 519 F.3d at 1031. The Certificate is a one-page form document, the heart of which is a table summarizing Medical Staffing’s insurance policies by listing in separate columns each policy’s insurance type, policy number, policy effective date, policy expiration date, and policy limits. There is no column for retention amount or deductible. Anyone with medical, auto, homeowners, commercial or other liability or casualty insurance knows that many policies have deductibles and self-insured floors below which there is no coverage. The Certificate expressly states that “the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies” and that the Certificate is “issued as a matter of information only.” We do not believe that the Washington Supreme Court would find a duty to disclose a self-insured retention amount on a certificate that summarizes insurance -5- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 5 of 11 (5 of 20)
  • 6. policies and does not contain a column for retention or deductible amounts. This is especially true in light of the fact that the hospital could have asked Medical Staffing for a copy of its insurance policy. See Van Dinter, 138 P.3d at 610 (explaining that the duty to disclose arises “when the facts are peculiarly within the knowledge of one person and could not be readily obtained by the other; or where, by the lack of business experience of one of the parties, the other takes advantage of the situation by remaining silent.”); Austin v. Ettl, 286 P.3d 85, 90–91 (Wash. Ct. App. 2012) (affirming a trial court’s dismissal of a negligent failure to disclose claim in part because the “information was easily discoverable by [plaintiff] and, in addition, [defendants] did not have any kind of special or fiduciary relationship to [plaintiff].”); see also Travelers Prop. Cas. Co. of Am. v. Superior Court, 155 Cal. Rptr. 3d 459, 477 (Ct. App. 2013) (“A certificate of insurance is merely evidence that a policy has been issued; it identifies the types of policies issued, the dates of coverage and the dollar limits of coverage. The document is not intended to inform the certificate holder of every, or any, limitation on or exclusion from coverage, and no broker can be liable for failing to include such information in a certificate of insurance.”) (footnote omitted); Benjamin Shapiro Realty Co. v. Kemper Nat’l Ins. Cos., 756 N.Y.S.2d 45, 46 (App. Div. 2003) (“[W]here, as here, certificates of insurance contain disclaimers that they are for information only, they -6- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 6 of 11 (6 of 20)
  • 7. may not be used as predicates for a claim of negligent misrepresentation.”). If defendants had a duty to disclose retentions, exclusions, and all policy terms that a third party could conceivably rely upon when issuing a certificate of insurance, certificates would essentially be transformed into copies of insurance policies, and would lose their value as succinct statements of the existence of insurance. See Postlewait Constr., Inc. v. Great Am. Ins. Cos., 720 P.2d 805, 807 (Wash. 1986) (“[T]he purpose of issuing a certificate of insurance is to inform the recipient thereof that insurance has been obtained; the certificate itself, however, is not the equivalent of an insurance policy.”). For the reasons stated above, the district court was correct to dismiss the hospital’s misrepresentation claim. The hospital’s other claims for bad faith, violations of Washington insurance regulations, and violation of Washington’s Consumer Protection Act, were dependent upon its misrepresentation claim, so the district court was correct to dismiss those claims as well. The hospital’s breach of the duty of care claim is essentially a restatement of its negligent misrepresentation claim. Even if the independent duty doctrine as articulated in Affiliated FM Insurance Co. v. LTK Consulting Services, Inc., 243 P.3d 521 (Wash. 2010) applies, the only duty arising out of “ordinary tort principles,” and the only duty -7- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 7 of 11 (7 of 20)
  • 8. argued by the hospital in its brief on appeal, is the same duty at issue in the hospital’s negligent misrepresentation claim – the duty to disclose information. There was no misrepresentation, no fiduciary duty, no privity, and no other basis pleaded for a duty to disclose the self-insured retention provisions of the policy, so we need not reach the question of whether reliance was unreasonable as a matter of law. Cf. Barnes v. Cornerstone Invs., Inc., 773 P.2d 884, 886 (Wash. Ct. App. 1989). II. “Dismissal with prejudice and without leave to amend is not appropriate unless it is clear on de novo review that the complaint could not be saved by amendment.” Eminence Capital, LLC v. Aspeon, Inc., 316 F.3d 1048, 1052 (9th Cir. 2003). The hospital argues that it can amend its complaint to state sufficient facts and theories to make out a negligent misrepresentation claim. But none of the new facts or theories pressed by the hospital plausibly state or allow us to infer that it justifiably relied on the Certificate or that the defendants had a duty to include the self-insured retention amount to keep the Certificate from being misleading. -8- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 8 of 11 (8 of 20)
  • 9. We do not see how the complaint could plead a claim even with the amendments the hospital might make. The hospital says that if it were allowed leave to amend, it would claim that the defendants made an affirmative misrepresentation, because they should have put Medical Staffing’s professional liability policy into the “excess/umbrella liability” row on the Certificate. This row includes a blank for retention amount, and the hospital claims that the defendants should have used this blank to state that the professional liability policy was subject to a $1 million self-insured retention. Medical Staffing already had an excess liability policy listed on its Certificate, but the professional liability policy at issue was not an excess or umbrella policy. It provided the first layer of coverage. Excess and umbrella policies provide layers of coverage on top of the first layer. The self-insured retention is not a first layer of insurance. See Bordeaux, Inc. v. Am. Safety Ins. Co., 186 P.3d 1188, 1192 (Wash. Ct. App. 2008) (“Washington courts have rejected the argument that self- insurance constitutes ‘insurance.’”). The hospital says that industry standards control here, rather than Washington law, and points us to a declaration from an insurance consultant. -9- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 9 of 11 (9 of 20)
  • 10. However, the consultant merely offers conclusory statements, unsupported by any facts or examples. See Pillsbury, Madison & Sutro v. Lerner, 31 F.3d 924, 928 (9th Cir. 1994) (“[C]onclusory allegations without more are insufficient to defeat a motion to dismiss for failure to state a claim.” (quoting McGlinchy v. Shell Chem. Co., 845 F.2d 802, 810 (9th Cir. 1988))); see also Iqbal, 556 U.S. at 679–81. Nor does the expert’s declaration address the question of whether the hospital was justified in relying upon the Certificate rather than asking for a copy of Medical Staffing’s professional liability policy. We respectfully disagree with our dissenting colleague’s view that the self- insured retention endorsement might be pleaded as an “exclusion” that should have been in the “description of operations/locations/vehicles/exclusions added by endorsement/special provisions” box. Kyrkos v. State Farm Mutual Automobile Insurance Co., 852 P.2d 1078, 1081 (Wash. 1993) addressed exclusions in uninsured motorist coverage, not endorsements adding deductibles or self-insured retentions. The endorsement itself states that it amends the policy by replacing the section entitled “Deductible” with the self-insured retention provision. -10- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 10 of 11 (10 of 20)
  • 11. The hospital also attempts to bolster its negligent failure to disclose claim by saying that if it were allowed leave to amend, it would claim that third parties frequently rely upon certificates of insurance in the course of their business transactions with insureds without asking to see the underlying policies, that defendants knew that a $1 million self-insured retention is unusually high in the nurse staffing business, and that certificate issuers should know that certificate recipients rely upon certificates. These claims, though, would not establish a duty under Washington law to disclose a self-insured retention on a one-page certificate that has no column in which to include retention or deductible amounts. The hospital has not put forward any argument that would save its complaint from dismissal. The district court’s orders dismissing the hospital’s claims and denying leave to amend are AFFIRMED. -11- Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-1 Page: 11 of 11 (11 of 20)
  • 12. Multicare Health v. Lexington Ins. Co., 12-35436 N.R. SMITH, Circuit Judge, concurring in part and dissenting in part: I only write to address the negligent misrepresentation by omission claim. This claim was insufficiently pleaded in the hospital’s original complaint. However, amendment of this claim would not be futile, because the hospital’s proposed amendments allege sufficient facts to state a claim. Accordingly, the district court abused its discretion in denying leave to amend and dismissing this claim with prejudice. See Manzarek v. St. Paul Fire & Marine Ins. Co., 519 F.3d 1025, 1031 (9th Cir. 2008). Otherwise, the majority “got it right.” Under Washington law, a plaintiff may state a negligent misrepresentation by omission claim based on a duty to disclose where disclosure is “necessary to prevent a partial or ambiguous statement of facts from being misleading.” Van Dinter v. Orr, 138 P.3d 608, 610 (Wash. 2006).1 First, the district court improperly conflated the question of whether the disclosure of the self-insured retention was necessary to prevent a partial or ambiguous statement of fact with whether information about the self-insured retention was easily obtainable. These FILED AUG 28 2013 MOLLY C. DWYER, CLERK U.S. COURT OF APPEALS 1 Although the district court cited the “clear, cogent, and convincing” evidentiary standard for negligent misrepresentation claims, I note that the proper question for resolving a motion to dismiss is whether the hospital alleged sufficient facts to state a claim plausible on its face. Bell Atl. Corp. v. Twombly, 550 U.S. 544, 570 (2007). 1 Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-2 Page: 1 of 4 (12 of 20)
  • 13. are distinct theories under which a plaintiff may allege a duty to disclose, one does not preclude the other. See id. Second, in noting that disclosure of the $5 million limit of liability was not a partial or ambiguous statement, the district court misconstrued the nature of the hospital’s claim. The hospital’s negligent representation by omission claim alleges that the $1 million self-insured retention should have been disclosed on the face of the insurance certificate (not that the $5 million liability limit was somehow erroneous). Specifically, the hospital alleges that, because the self-insured retention was added to the policy by an endorsement, it should have been disclosed in the space designated for “Exclusions Added by Endorsement / Special Provisions.” See also Kyrkos v. St. Farm Mut. Auto. Ins. Co., 852 P.2d 1078, 1081 (Wash. 1993) (describing self-insured retention provision as an “exclusion”). The hospital further alleges that this omission “violated industry standards and misrepresented the coverage offered under the Lexington policy by failing to indicate the self-insured retention which was, under the terms of the policy, an ‘exclusion added by endorsement’ and/or a ‘special provision.’” I am mindful of the broad disclaimers contained on the front and back of the certificate. While the disclaimers indicate that there are applicable terms and conditions not found on the insurance certificate, the disclaimers do not suggest 2 Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-2 Page: 2 of 4 (13 of 20)
  • 14. that a holder of the certificate cannot assume the accuracy of the standardized information that is provided (e.g., the existence of an insurance policy, the stated amount of liability coverage). The same should be true where space for a standardized term is left blank. For example, if the “Automobile Liability” box is blank, the holder of the certificate would assume the covered party has no automobile liability insurance. As the majority notes, an insurance certificate and its corresponding limited disclosure space surely cannot be expected to list every term and condition of every policy. See Mem. Dispo. at 7. However, where the form standardizes the information to be disclosed and a standardized disclosure is omitted, it seems plausible that this type of partial or ambiguous statement of fact could become misleading. The majority rejects the hospital’s use of this theory based on the assumption that the insurance certificate “has no column in which to include retention or deductible amounts.” Mem. Dispo. at 10-11. If, however, the industry practice is to include the amount of a self-insured retention in the space designated for “Exclusions Added by Endorsement / Special Provisions,” then the majority’s assumption is incorrect. Therefore, a factual question exists at this stage of the proceedings regarding whether industry standards mandate that a $1 million self-insured retention added 3 Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-2 Page: 3 of 4 (14 of 20)
  • 15. by endorsement should appear in the space designated for “Exclusions Added by Endorsement / Special Provisions.” Because the hospital so alleges in its proposed amended allegations, and because factual allegations are to be taken as true at the motion to dismiss stage, I would allow the hospital to proceed on its negligent misrepresentation by omission claim under this theory. Of course, if Defendants can show that industry practice is to the contrary (i.e., this box is not used in such a manner, or a self-insured retention is never so disclosed), then the hospital’s claim may not survive summary judgment. At this early stage, however, the hospital need only provide plausible factual allegations, not evidence to prove the merits of its claim. See Twombly, 550 U.S. at 570. The district court dismissed the bad faith, Consumer Protection Act, statutory claims, and the independent duty doctrine claim as a result of its holding that the hospital failed to allege a negligent misrepresentation claim. Because I find that the negligent misrepresentation by omission claim would be sufficiently pleaded as amended, I would allow amendment and remand consideration of these claims to the district court for further proceedings. On remand, the district court could also address standing in the first instance. 4 Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-2 Page: 4 of 4 (15 of 20)
  • 16. United States Court of Appeals for the Ninth Circuit Office of the Clerk 95 Seventh Street San Francisco, CA 94103 Information Regarding Judgment and Post-Judgment Proceedings Judgment • This Court has filed and entered the attached judgment in your case. Fed. R. App. P. 36. Please note the filed date on the attached decision because all of the dates described below run from that date, not from the date you receive this notice. Mandate (Fed. R. App. P. 41; 9th Cir. R. 41-1 & -2) • The mandate will issue 7 days after the expiration of the time for filing a petition for rehearing or 7 days from the denial of a petition for rehearing, unless the Court directs otherwise. To file a motion to stay the mandate, file it electronically via the appellate ECF system or, if you are a pro se litigant or an attorney with an exemption from using appellate ECF, file one original motion on paper. Petition for Panel Rehearing (Fed. R. App. P. 40; 9th Cir. R. 40-1) Petition for Rehearing En Banc (Fed. R. App. P. 35; 9th Cir. R. 35-1 to -3) (1) A. Purpose (Panel Rehearing): • A party should seek panel rehearing only if one or more of the following grounds exist: ► A material point of fact or law was overlooked in the decision; ► A change in the law occurred after the case was submitted which appears to have been overlooked by the panel; or ► An apparent conflict with another decision of the Court was not addressed in the opinion. • Do not file a petition for panel rehearing merely to reargue the case. B. Purpose (Rehearing En Banc) • A party should seek en banc rehearing only if one or more of the following grounds exist: Post Judgment Form - Rev. 08/2013 1 Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-3 Page: 1 of 5 (16 of 20)
  • 17. ► Consideration by the full Court is necessary to secure or maintain uniformity of the Court’s decisions; or ► The proceeding involves a question of exceptional importance; or ► The opinion directly conflicts with an existing opinion by another court of appeals or the Supreme Court and substantially affects a rule of national application in which there is an overriding need for national uniformity. (2) Deadlines for Filing: • A petition for rehearing may be filed within 14 days after entry of judgment. Fed. R. App. P. 40(a)(1). • If the United States or an agency or officer thereof is a party in a civil case, the time for filing a petition for rehearing is 45 days after entry of judgment. Fed. R. App. P. 40(a)(1). • If the mandate has issued, the petition for rehearing should be accompanied by a motion to recall the mandate. • See Advisory Note to 9th Cir. R. 40-1 (petitions must be received on the due date). • An order to publish a previously unpublished memorandum disposition extends the time to file a petition for rehearing to 14 days after the date of the order of publication or, in all civil cases in which the United States or an agency or officer thereof is a party, 45 days after the date of the order of publication. 9th Cir. R. 40-2. (3) Statement of Counsel • A petition should contain an introduction stating that, in counsel’s judgment, one or more of the situations described in the “purpose” section above exist. The points to be raised must be stated clearly. (4) Form & Number of Copies (9th Cir. R. 40-1; Fed. R. App. P. 32(c)(2)) • The petition shall not exceed 15 pages unless it complies with the alternative length limitations of 4,200 words or 390 lines of text. • The petition must be accompanied by a copy of the panel’s decision being challenged. • An answer, when ordered by the Court, shall comply with the same length limitations as the petition. • If a pro se litigant elects to file a form brief pursuant to Circuit Rule 28-1, a petition for panel rehearing or for rehearing en banc need not comply with Fed. R. App. P. 32. Post Judgment Form - Rev. 08/2013 2 Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-3 Page: 2 of 5 (17 of 20)
  • 18. • The petition or answer must be accompanied by a Certificate of Compliance found at Form 11, available on our website at www.ca9.uscourts.gov under Forms. • You may file a petition electronically via the appellate ECF system. No paper copies are required unless the Court orders otherwise. If you are a pro se litigant or an attorney exempted from using the appellate ECF system, file one original petition on paper. No additional paper copies are required unless the Court orders otherwise. Bill of Costs (Fed. R. App. P. 39, 9th Cir. R. 39-1) • The Bill of Costs must be filed within 14 days after entry of judgment. • See Form 10 for additional information, available on our website at www.ca9.uscourts.gov under Forms. Attorneys Fees • Ninth Circuit Rule 39-1 describes the content and due dates for attorneys fees applications. • All relevant forms are available on our website at www.ca9.uscourts.gov under Forms or by telephoning (415) 355-7806. Petition for a Writ of Certiorari • Please refer to the Rules of the United States Supreme Court at www.supremecourt.gov Counsel Listing in Published Opinions • Please check counsel listing on the attached decision. • If there are any errors in a published opinion, please send a letter in writing within 10 days to: ► Thomson Reuters; 610 Opperman Drive; PO Box 64526; St. Paul, MN 55164-0526 (Attn: Jean Green, Senior Publications Coordinator); ► and electronically file a copy of the letter via the appellate ECF system by using "File Correspondence to Court," or if you are an attorney exempted from using the appellate ECF system, mail the Court one copy of the letter. Post Judgment Form - Rev. 08/2013 3 Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-3 Page: 3 of 5 (18 of 20)
  • 19. Form 10. Bill of Costs ................................................................................................................................(Rev. 12-1-09) United States Court of Appeals for the Ninth Circuit BILL OF COSTS Note: If you wish to file a bill of costs, it MUST be submitted on this form and filed, with the clerk, with proof of service, within 14 days of the date of entry of judgment, and in accordance with 9th Circuit Rule 39-1. A late bill of costs must be accompanied by a motion showing good cause. Please refer to FRAP 39, 28 U.S.C. § 1920, and 9th Circuit Rule 39-1 when preparing your bill of costs. v. 9th Cir. No. The Clerk is requested to tax the following costs against: Cost Taxable under FRAP 39, 28 U.S.C. § 1920, 9th Cir. R. 39-1 REQUESTED Each Column Must Be Completed ALLOWED To Be Completed by the Clerk No. of Docs. Pages per Doc. Cost per Page* TOTAL COST TOTAL COST Pages per Doc. No. of Docs. Excerpt of Record Opening Brief Reply Brief $ $ $ $ $ $ $ $ Other** Answering Brief $ $ $ $ $ $ $ $ $ $ $ $ $ $TOTAL: TOTAL: * Costs per page may not exceed .10 or actual cost, whichever is less. 9th Circuit Rule 39-1. Cost per Page* Any other requests must be accompanied by a statement explaining why the item(s) should be taxed pursuant to 9th Circuit Rule 39-1. Additional items without such supporting statements will not be considered. Attorneys' fees cannot be requested on this form. ** Other: Continue to next page. Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-3 Page: 4 of 5 (19 of 20)
  • 20. Form 10. Bill of Costs - Continued I, , swear under penalty of perjury that the services for which costs are taxed were actually and necessarily performed, and that the requested costs were actually expended as listed. Signature Date Name of Counsel: Attorney for: Date Costs are taxed in the amount of $ Clerk of Court By: , Deputy Clerk (To Be Completed by the Clerk) ("s/" plus attorney's name if submitted electronically) Case: 12-35436 08/28/2013 ID: 8759870 DktEntry: 55-3 Page: 5 of 5 (20 of 20)