Proof of

503(b)(9) Claim

page 1

Part 1:

Proof of 503(b)(9) Claim

Read the instructions before filling out this form. This form is for asserting claims entitled to administrative priority pursuant to 11 U.S.C. § 

503(b)(9) against one of the above Debtors arising on or after January 9, 2019 through and including January 28, 2019. Do not use this form 

to assert any other pre-petition claim(s). Assert such claims on Form 410. 

11 U.S.C. § 503(b)(9) applies only to claims arising from the value of any goods received by the Debtor within 20 days before the date of 

commencement of the above case, in which the goods have been sold to the Debtor in the ordinary course of the Debtor's business. Attach 

documentation supporting such claim. 

Filers must leave out or redact information that is entitled to privacy on this form or on any attached documents. Attach redacted copies of 

any documents that support the claim, such as promissory notes, purchase orders, invoices, itemized statements of running accounts,

contracts, judgments, mortgages, and security agreements. Do not send original documents; they may be destroyed after scanning. If the

documents are not available, explain in an attachment.

A person who files a fraudulent claim could be fined up to $500,000, imprisoned for up to 5 years, or both. 18 U.S.C. §§ 152, 157, and 3571. 

Fill in all the information about the claim as of the date the case was filed. 

Identify the Claim 

1. Who is the current

creditor?

Name of the current creditor (the person or entity to be paid for this claim) 

Other names the creditor used with the debtor 

2. Has this claim been

acquired from

someone else?

 No

 Yes. From whom?

3. Where should notices

and payments to the

Where should notices to the creditor be sent? Where should payments to the creditor be sent? (if

different)

creditor be sent?

Federal Rule of

Bankruptcy Procedure

(FRBP) 2002(g)

Contact phone 

Contact email 

Contact phone 

Contact email 

4. Does this claim amend

one already filed?

 No

 Yes. Claim number on court claims registry (if known) Filed on MM / DD / YYYY 

5. Do you know if anyone

else has filed a proof

of claim for this claim?

 No

 Yes. Who made the earlier filing?

United States Bankruptcy Court, Northern District of California

PG&E Corporation (19-30088)

Pacific Gas and Electric Company (19-30089)

C.H. Reynolds Electric, Inc. n/a ✔

C.H. Reynolds Electric, Inc.

1281 Wayne Avenue

San Jose Ca 95131

408-217-2211 pauld@chreynolds.com ✔ 2639 04/22/2019 ✔

X

EXHIBIT A 

Case: 19-30088 Doc# 3324 Filed: 07/31/19 Entered: 07/31/19 16:50:12 Page 1 of

3
Proof of

503(b)(9) Claim page 2

Part 2: Give Information About the Claim as of the Date the Case Was Filed 

6. On what date (or dates)

were the goods

delivered? (if known) (mm/dd/yyyy) 

7. How much is the claim?

$ 

Note: 11 U.S.C. § 503(b)(9) applies only to claims arising from the value of any goods received by the Debtor within 20 

days before the date of commencement of the above case, in which the goods have been sold to the Debtor in the 

ordinary course of the Debtor's business. Do not include in the above amount the value of goods received by the 

Debtor outside of that period, or the value of any other services performed. Assert such claims on Form 410. 

8. What is the description

of the goods provided

in the claim?

Part 3: Sign Below 

The person completing

this proof of claim must

sign and date it.

FRBP 9011(b).

If you file this claim

electronically, FRBP

5005(a)(2) authorizes courts

to establish local rules

specifying what a signature

is. 

A person who files a

fraudulent claim could be

fined up to $500,000,

imprisoned for up to 5

years, or both.

18 U.S.C. §§ 152, 157, and

3571.

Check the appropriate box:

 I am the creditor.

 I am the creditor’s attorney or authorized agent.

 I am the trustee, or the debtor, or their authorized agent. Bankruptcy Rule 3004.

 I am a guarantor, surety, endorser, or other codebtor. Bankruptcy Rule 3005.

I understand that an authorized signature on this Proof of Claim serves as an acknowledgment that when calculating the

amount of the claim, the creditor gave the debtor credit for any payments received toward the debt. 

I have examined the information in this Proof of Claim and have a reasonable belief that the information is true

and correct. 

I declare under penalty of perjury that the foregoing is true and correct. 

Signature 

Print the name of the person who is completing and signing this claim:

Name 

Last name 

Title 

Company 

Identify the corporate servicer as the company if the authorized agent is a servicer. 

Address 

Number Street 

State 

Contact phone Email 

Executed on date (mm/dd/yyyy) 

43,313.39

Electrical Services by a licensed Electrical Contractor in California, C-10

License #450477

✔

07/24/2019 /s/ Paul DeraniaPaul Derania

\

C.H. Reynolds Electric, Inc. 1281 Wayne Avenue San Jose CA 95131

CFO & In-House General Counsel

Cit

408-217-2211 pauld@chreynolds.com

EXHIBIT A 

Case: 19-30088 Doc# 3324 Filed: 07/31/19 Entered: 07/31/19 16:50:12 Page 2 of

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Case: 19-30088 Doc# 3324 Filed: 07/31/19 Entered: 07/31/19 16:50:12 Page 3 of

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