Attorney or Party without Attorney (Name/Address) FOR COURT USE ONLY Telephone: State Bar No.: Attorney for: SUPERIOR COURT OF CALIFORNIA COUNTY OF SAN MATEO 400 COUNTY CENTER REDWOOD CITY, CA 94063 Plaintiff Defendant Certificate Re Complex Case Designation Case Number This certificate must be completed and filed with your Civil Case Cover Sheet if you have checked a Complex Case designation or Counter-Designation 1. In the attached Civil Case Cover Sheet, this case is being designated or counter-designated as a complex case [or as not a complex case] because at least one or more of the following boxes has been checked: Box 1 ­ Case type that is best described as being [or not being] provisionally complex civil litigation (i.e., antitrust or trade regulation claims, construction defect claims involving many parties or structures, securities claims or investment losses involving many parties, environmental or toxic tort claims involving many parties, claims involving mass torts, or insurance coverage claims arising out of any of the foregoing claims). Box 2 ­ Complex [or not complex] due to factors requiring exceptional judicial management Box 5 ­ Is [or is not] a class action suit. 2. This case is being so designated based upon the following supporting information [including, without limitation, a brief description of the following factors as they pertain to this particular case: (1) management of a large number of separately represented parties; (2) complexity of anticipated factual and/or legal issues; (3) numerous pretrial motions that will be time-consuming to resolve; (4) management of a large number of witnesses or a substantial amount of documentary evidence; (5) coordination with related actions CV-59 [Rev. 1/06] www.sanmateocourt.org American LegalNet, Inc. www.USCourtForms.com pending in one or more courts in other counties, states or countries or in a federal court; (6) whether or not certification of a putative class action will in fact be pursued; and (7) substantial post-judgment judicial supervision]: (attach additional pages if necessary) 3. Based on the above-stated supporting information, there is a reasonable basis for the complex case designation or counter-designation [or noncomplex case counter-designation] being made in the attached Civil Case Cover Sheet. ***** I, the undersigned counsel or self-represented party, hereby certify that the above is true and correct and that I make this certification subject to the applicable provisions of California Code of Civil Procedure, Section 128.7 and/or California Rules of Professional Conduct, Rule 5-200 (B) and San Mateo County Superior Court Local Rules, Local Rule 2.30. Dated: ___________________ ________________________________ [Type or Print Name] ______________________________________ [Signature of Party or Attorney For Party] CV-59 [Rev. 1/06] www.sanmateocourt.org American LegalNet, Inc. www.USCourtForms.com