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)

gracie@epcontainer.com EP Container Corp ✔

800-211-0311 ✔

✘

✔

Claim Number: 1556

Case: 19-30088 Doc# 3541-1 Filed: 08/14/19 Entered: 08/14/19 08:57:27 Page 1

of 5
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 

First name Middle name Last name 

Title 

Company 

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

Address 

Number Street 

City State ZIP Code 

Contact phone Email 

Signature:

Email:

Gracie Marek (Mar 19, 2019)

Gracie Marek

✔

CA 90701 8002110311 gracie@epcontainer.com Accounts Receivable/Customer Service Manager 983.84 17115 Jersey Ave Artesia 01/08/2019 gracie@epcontainer.com Gracie Marek EP Container Corp

Case: 19-30088 Doc# 3541-1 Filed: 08/14/19 Entered: 08/14/19 08:57:27 Page 2

of 5
Attach Supporting Documentation (limited to a single PDF attachment that is less than 5 megabytes in size and under 100 pages):

❐I have supporting documentation. ❐I do not have supporting documentation.

(attach below)

PLEASE REVIEW YOUR PROOF OF CLAIM AND SUPPORTING DOCUMENTS AND REDACT

ACCORDINGLY PRIOR TO UPLOADING THEM. PROOFS OF CLAIM AND ATTACHMENTS

ARE PUBLIC DOCUMENTS THAT WILL BE AVAILABLE FOR ANYONE TO VIEW ONLINE.

IMPORTANT NOTE REGARDING REDACTING YOUR PROOF OF CLAIM AND SUPPORTING

DOCUMENTATION When you submit a proof of claim and any supporting documentation you must show

only the last four digits of any social-security, individual’s tax-identification, or financial-account number,

only the initials of a minor’s name, and only the year of any person’s date of birth. If the claim is based on

the delivery of health care goods or services, limit the disclosure of the goods or services so as to avoid

embarrassment or the disclosure of confidential health care information.

A document has been redacted when the person filing it has masked, edited out, or otherwise deleted, certain

information. The responsibility for redacting personal data identifiers (as defined in Federal Rule of

Bankruptcy Procedure 9037) rests solely with the party submitting the documentation and their counsel.

Prime Clerk and the Clerk of the Court will not review any document for redaction or compliance with this 

Rule and you hereby release and agree to hold harmless Prime Clerk and the Clerk of the Court from the

disclosure of any personal data identifiers included in your submission. In the event Prime Clerk or the Clerk

of the Court discover that personal identifier data or information concerning a minor individual has been 

included in a pleading, Prime Clerk and the Clerk of the Court are authorized, in their sole discretion, to 

redact all such information from the text of the filing and make an entry indicating the correction.

Attachment

✘

Case: 19-30088 Doc# 3541-1 Filed: 08/14/19 Entered: 08/14/19 08:57:27 Page 3

of 5
Invoice 17115 Jersey Ave.

Artesia, CA 90701

(562) 282-1882

Sold To: Ship To:

PG & E Diablo Canyon

Materials Facility

4340 Old Santa Fe Road

San Luis Obispo, CA 93401

Pacific Gas & Electric Inc

Diablo Canyon Materials

Attn: Accounts Payable

P.O. Box 7760

San Francisco, CA 94177

Page: 1

Invoice Number:

Invoice Date:

Salesperson:

Customer Number:

0001

20-PG&EDI

1/8/2019

0303843-IN

Order Number:

Order Date

0154950

12/18/2018

EP Container Corporation

http://www.epcontainer.com

Confirm To: Steve Reed

Customer P.O.

3501186692

Ship VIA

ESTES PPD

F.O.B.

ORIGIN

Terms

Net 30 Days

Item Code Unit Price Amount Ordered Shipped Back Ordered

DMG500FIT

Whse: 010 753.70 EACH 10 10 0 75.370

55g Steel O/T Drum, Bolt & Rin

Net Invoice: 753.70

Less Discount: 0.00

Freight: 175.50

Sales Tax: 54.64

Invoice Total: 983.84

Closure instructions available online at: www.epcontainer.com

Title to the materials shall pass directly from the seller the buyer at the shipping point prior to

shipment. Seller shall set out and deduct freight charges prior to computing sales or use taxCase: 19-30088 Doc# 3541-1 Filed: 08/14/19 Entered: 08/14/19 08:57:27 Page 4

of 5
Electronic Proof of Claim

Final Audit Report 2019-03-19

Created: 2019-03-19

By: Prime Clerk E-Filing (efiling@primeclerk.com)

Status: Signed

Transaction ID: CBJCHBCAABAAlwcPEgy1iVlG-71XUac7D-AVPDIg7CD7

"Electronic Proof of Claim" History

Widget created by Prime Clerk E-Filing (efiling@primeclerk.com)

2019-03-19 - 6:00:49 PM GMT

Gracie Marek (gracie@epcontainer.com) uploaded the following supporting documents:

Attachment

2019-03-19 - 6:03:52 PM GMT

Widget filled in by Gracie Marek (gracie@epcontainer.com)

2019-03-19 - 6:03:52 PM GMT- IP address: 96.229.127.113

(User email address provided through API User-Agent: Mozilla/5.0 (Windows NT 10.0; Win64; x64)

AppleWebKit/537.36 (KHTML, like Gecko) Chrome/72.0.3626.121 Safari/537.36)

2019-03-19 - 6:03:54 PM GMT- IP address: 96.229.127.113

Signed document emailed to Gracie Marek (gracie@epcontainer.com) and Prime Clerk E-Filing

(efiling@primeclerk.com)

2019-03-19 - 6:03:54 PM GMT

Case: 19-30088 Doc# 3541-1 Filed: 08/14/19 Entered: 08/14/19 08:57:27 Page 5

of 5