col style="width: 50%;"> IN THE COUNTY COURT AT [insert] Claim No: [insert claim number] BETWEEN MR A B Claimant -and- C D LIMITED Defendant _____________________________________________________________________________ PARTICULARS OF CLAIM _____________________________________________________________________________ 1 All material times the Defendant owned and/or operated a business [description of business, eg collecting and processing refuse]. 2 At all material times the Claimant was employed by the Defendant as a [job title eg dustbin lorry driver and loader]. Details of Incident 3 At around [time] on [date] the Claimant was [description of work activities being undertaken] at [location] in the course of their employment. 4 The Claimant was wearing liveried clothing and personal protective equipment issued to them by the Defendant. This consisted of [details of equipment, eg Type 1 gloves, which extended approximately three centimetres up the Claimant’s forearm above his wrist, and a short-sleeved company-branded T-shirt]. 5 As the Claimant was [description of the incident, eg collecting loose rubbish sacks, they felt a sharp prick on the exposed portion of their forearm, approximately two centimetres above the glove line]. 6 The Claimant discovered upon inspection that [description of the cause, eg they had been pricked by a needle,