In Re: Monsanto Class Action Settlement

City of Long Beach, et al. v. Monsanto Company, et al.

United States District Court, Central District of California - Western Division

Case No. 2:16-cv-03493-FMO-AS

All Settlement Class Members received a mailed copy of the Notice of Pendency of Class-Action Proposed Settlement and Court-Approved Hearing. This mailing included a unique User ID and Confirmation Code which you will need to access this Application. Please refer that mailing for your login credentials and contact the Settlement Administrator if you require confirmation of credentials.

Please enter the User ID and Confirmation Code exactly as it appears on the Notice:

OR

If you did not receive a personalized Notice in the mail or via email, click below to complete a Claim Form.

Sediment Sites Fund - Allocation Application



Instructions and Information
Please fill out this Sediment Sites Allocation Application to the best of your knowledge and the knowledge of the qualifying Class Member. Please submit your completed application no later than 65 days after the Final Approval Order or by January 23, 2023. Late applications will not be considered by the Special Master. Qualifying Class Members that do not return a completed application or that return a late application will receive an allocation by the Special Master based on the good faith, best efforts of the Allocation Experts to complete an application for the qualifying class member. Qualifying Class Members that do not return a completed application or that return a late application will forfeit the right to the one (1) appeal to the Special Master but will not forfeit the receipt of Reserve Funds distributed pro-rata after all Appeals are exhausted and decided by the Special Master.
Please attach no more than twenty-five (25) pages of supporting documentation and evidence of your summary description, past and future costs and expenses, and other important factors and information that may be relevant to the Special Master’s allocation. Only the first 25 pages submitted will be considered by the Special Master.
For any questions about this application or process, you may contact Lead Class Counsel Scott Summy, John Fiske, or Carla Burke of Baron & Budd, P.C., at PCBClassAction@BaronBudd.com. For technical questions related to this application, please contact the Settlement Administrator at info@pcbclassaction.com.


1. SETTLEMENT CLASS MEMBER INFORMATION (REQUIRED*)

2. SEDIMENT SITE INFORMATION

2.1. Qualifying Sediment Site Entity (must be one of 12 Qualifying Sediment Site Entities; only one qualifying Sediment Site per Application; refer to the Notice for a list of Qualifying Sediment Sites):


2.2. Please provide an initial summary description of the Class Member’s role, involvement, or responsibility in the qualifying Sediment Site, focusing on the regulatory or legal responsibility, and the costs or expenses related to and caused by PCB contamination, specific to the Class Member. The Class Member may continue this summary by uploading no more than two (2) pages typed, 14-point font, entitled “Sediment Sites Fund—Initial Summary Description.” (limit 2,500 characters)


2.3. Upload related documentation

Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

File List: No Files Selected


    3. SEDIMENT SITE DAMAGES

    Please provide known total amounts in dollars for the following categories of damages (undocumented totals will be considered speculative or inapplicable):

    3.1. Total past costs/expenses spent for PCB-caused remediation of the Sediment Site:

    3.2. Total past costs/expenses spent for PCB-caused mitigation required due to the Sediment Site:

    3.3. Total future costs/expenses, as documented and evidenced, for PCB-caused remediation of the Sediment Site:

    3.4. Total future costs/expenses, as documented and evidenced, for PCB-caused mitigation due to the Sediment Site:


    4. ADDITIONAL INFORMATION

    4.1. Please provide a summary description of any other important factors or information that may be relevant to the Special Master’s allocation, focusing on the regulatory or legal responsibility, and the costs or expenses related to and caused by PCB contamination, specific to the Class Member. The Class Member may continue this summary by uploading no more than two (2) pages typed, 14-point font entitled “Sediment Sites Fund—Other Important Factors and Information.” (limit 2,500 characters)


    4.2. Upload related documentation

    Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

    File List: No Files Selected


      5. RESPONSIBLE PARTIES

      5.1. Please provide a summary description of other relevant named Responsible Parties, and what impact, if any, those other relevant named Responsible Parties will have on the information provided above, including cost-sharing or cost reduction for the Class Member. Please continue this summary by uploading no more than two (2) page typed, 14-point font entitled “Sediment Sites Fund—Other Responsible Parties.” (limit 2,500 characters)


      5.2. Upload related documentation

      Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

      File List: No Files Selected


        6. SEDIMENT SITE FUND REQUEST

        6.1. Please provide a total Sediment Site Fund award requested by the Class Member:

        7. DECLARATION

        I hereby declare under penalty of perjury under the laws of the state of that the information within this application and its attachments are true and correct to the best of my knowledge.





        8. Supplemental Documentation Upload

        Accepted file types are: PDF, TIF, JPG, GIF, PNG. Other file types will be rejected. Please confirm in the grid below that your file has been successfully uploaded.

        File List: No Files Selected

          Your Claim Form has been submitted successfully.

          HOWEVER, it appears one or more of the documents you uploaded were not successfully received. Please see below for which file(s) had errors and log back in to your existing Claim online to re-upload your document(s). Alternatively, you can send your documents with your Submitted Claim ID to the Settlement Administrator by email to: info@HannaSettlement.com.

          Please print this page for your records.

          Your Claim Details

          Submitted Claim ID:
          Confirmation Code:
          You will need the above Submitted Claim ID and Confirmation Code if you would like to edit your Claim at a later time, so please print this page for your records.
          CLAIM INFORMATION
          Class Member
          Contact person
          Phone
          Email
          Signature
          Signed By
          Signed At
          Date

          If you have any questions regarding your Claim, please provide the Submitted Claim ID listed above and email us at info@pcbclassaction.com

          Click here to edit your Claim.

          Your Claim Form has been saved successfully.


          Click here to edit your Claim.