Loading...
HomeMy WebLinkAbout96-01167 .. ~ I, !~ ... ~~ Pl~ ~j It ~ , ~ ' ~ ; .g ~ ~ J . ~ \, ) ~ '.:"- ~ ./ ........ .' if -:B ~ (~ -" - - ) .i . - .. .;,") . ,j ,~ L. . I ,~\ r-1- n .J (~ 1 .. '..J '\ ~ I" -- k:i lL: ~; l.ji \~i :, , , r.-: Ie) ,.~ ,.. G~ u. ~ . lrJ < ::t r(~ c<' r- ,. -;, 14 ' , ~ t: ~ ... 'L . ..J ,. " ~, .:.J '.' ;,1 ~~ ; lQ ~~ ~ g ~ ~Q ~ '" - " ~ 3 j i j! ~~ . ro~ ; .... I\. ~~ QI <r.. H ~~~~~ ~ ~~ CI) rc I !l 41 CJ ~ > j 1lI ~< ~ w I ce .~ el~ o IH CIl~ ~ 5 ~ o CJ~ H'ri rn~1lI llil roCJ ~ Q =~ ~ ] 0 ~ < ~ ; ~r · r.. 0.... ~Q4I 8 ... 0 III I\.~~ ro u t) r.. ,.-I . ~~ <. W~ > ~ ~ ,a ~~s rn roiS j~ > ,t) ~ z ~~ z '....0 ~ . . WAYNe F. SHADe 4. On March 29, 1995, the third party claims were settled in the amount of the policy limits of $50,000. 5. The first party automobile medical expense coverage was in the amount of $100,000. 6. The medical expenses for Rebecca A. Orris to date are in excess of $500,000 and are continuing to accrue. 7. The family health insurance coverage insuring against the medical expenses of Rebecca A. Orris in excess of the first party automobile medical expense coverage is through Defendant by virtue of the employment of Plaintiff James E. Orris with Preston Trucking Company. 8. In spite of repeated written requests for a complete copy of the Central Pennsylvania Teamsters Health and Welfare Fund Plan applicable to the injuries sustained by Rebecca A. Orris on November 18, 1994, the Fund has failed to provide us with anything more than Amendment No. 20 to Plan No. 13 which is attached hereto as Exhibit "A" and incorporated herein by reference as though fully set forth. 9. In addition to the foregoing medical expense coverages, Plaintiffs have under insured motorist coverages through Erie Insurance Company in the combined stacked amount of $3,300,000. -2- party recovery from the party who was responsible for the injuries to Rebecca A. Orris. 15. In order to move forward with payment of the mounting medical expenses, the parties negotiated an undated interim agreoment in which they preserved their respective claims regarding subrogation with the understanding that any party hereto could proceed to resolution of the subrogation issues when ready to do so. A copy of said undated interim agreement is attached hereto as Exhibit "B" and incorporated herein by reference as though fully set forth. 16. Plaintiffs believe and therefore aver that the compensatory damages for the severe brain injuries to Rebecca A. Orris will exceed $3,350,000 for the severe injuries for which she remains under expensive treatment and from which she will suffer for the remainder of her life. 17. Plaintiffs contend that, whether or not the damages for the injuries to Rebecca A. orris are ultimately determined to be in excess of $3,300,000, Defendants are only entitled under the language of Exhibit "A" hereto to subrogation from the third party recovery and not from the first party automobile under insured motorist recovery for which Plaintiffs have paid separate premiums. WAYNE F. SKADE ,,_ ..LAw llW"'_"'_ CadIoIo, _...... 17011 WHEREFORE, Plaintiffs demand judgment declaring that the subrogation claims of Defendant for payment of medical expenses -4- ".?,t ~ . .'," . ." . . C!;N'1'RAL PENNSYLVANIA TilANS'l'i:aS HEALTH AND WEL9'ARE FUND pLAN NO. 13 (AS RESTATED JANOAR~ 1, 1989) AHENPKEHT NO. 20 , WHEREAS, the central Pennsylvania Teamsters Health and welfare .. Fund _ plan No. 13, hereinafter referred to. as the "Plan" was created on December 19, 1999, effective January 1, 1989; and WHEREAS, Ar~iclEl XXVI of the Plan provides that the TrusteeS may amand the Plan, in a manner consistent with the central Pennsylvania Teams~ers Health and Welfare Declaration of Trust and applicabl~ law, by resolution of the Trustees; and WHEREAS, Article XXVI of the plan provides that amendments to the Plan be in writing; and WHEREAS, the 7rust;ees ..,ish to amend t.he plan in order to clarify and restate the Subrogation provisions of the plan, NOW, THEREFORE, in" consideration of the premises and by the unanimous Written consent of the Trustees, t.he Plan shall ba amended as follows: 1. Art;icle XIX, ent;it;led "SUBROGATION" shall be amended by the delet;ion of the former provisions of the Article and the addition of t;he following new provisions which read as follows: "SUBROGATION Section 19.1. Fecoverv of Benefits Paia. A. Upon payment under this Plan and as Eecurity for the Fund's right; to reimbursement to the extent of its payments, the Fund will be subrogated to t;ns rights of recovery of each Participant, Dependent and/or Beneficiary of a Participant against any third party which caused the injury or sickness for which the claim is made or which is otherwise liable for the expenses incurred as a result of such injury or sickness. Participant, Dependents and/or Beneficiaries of Participants may noe act to prejudice the rights of the Fund to subrogation and may be required to sign a subrogation agreement in a torm prescribed by the Fund EXHIBIT "A" ""I't ~ t . . . , ;' . before the rclea:;c of benefit:;,. In the event of any payment under this plan on behalf of a Participant, Dependent and/or Beneficiary of Participa.nt the Fund shall be subrogated to all the rights of recovery therefore against any person or organization. Participants, Dependento and/or Beneficiaries of Participants shall execute and deliver instruments and papers, shall furnish. the Fund with such notice and information, and shall do whatever else is necessary to secure such rights, including but not limited to the right of the Fund to sue in the name of such Participants, Dependents and/or Beneficiaries of participants, Participants, Dependents and/or Beneficiarie~ of Participants shall do nothing after a loss, or otherwise, to prejudice the Fund's subrogation rights. The receipt of any payment by any Participant, Dependent and/or Beneficiary of a Participant shall be specifically conditioned upon an agreement by such individual acknowledging this subrogation provision, its terms and conditions and the agreement of such individual to repay any sums expended in full B. The Fund shall be entitled to reimbursement from the first dollars to be paid or to be received by a Participant, Dependent and/or Beneficiary of a Participant from a,. settlement or judgment from a third party, The Fund shall be first reimbursed fully to the extent' of benefite paid from the monies paid by any person or pexsons, party or parties, insurance company, firm, corporation, government agency, or other entity, and the balance of monies, if any, then remaining from such subsequent recovery shall be retained by or on bahalf of tha Participant, Dependent and/or Beneficiary of such Participant. C. The Fund'lI su.Orogation rights 651t"blished by this Plan shall not be diminished to any extent by the failure of a Participant, De~endent and/or Beneficiary of such participant to sign an agreement as provided in paragraph A, herein. D, The Fund shall have the right to take all appropriate actions necessary to enforce its subrogation rights in the event that a Participant, Dependent and/or Benef iciary of a Participant refuses to sign a subrogation agreement, refuses to reimburse the Fund in accordance with the ~und's subrogation rightH, or takes any other action inconsistent '"ith the Fund's subrogation rights. In such situatione, the Fund' 9 options shall -;1- I. . , AGUDDIT This Agraement between James B. Orris ("Mr. Orris") anc1 Charloete Orris ("Ms. Orris") and the Central Pennsylvania Teamstars Health and well!are Punc1 ("Punc1") is basad on ehe tollowing taces, 1. Mr. Orris is a participant of the Fund, 2. Ms, Orris is the spouse of Mr, Orris. 3, Mr. Orris and Ms. Orris are ehe parente and naeural guardians of Rebecca Orr1s, a minor. 4. On or about November IB, 1994, Rebecca Orris suttared serious injuries in an automobila accident. As a result ot her injuries, Rebecca Orrie has incurred various bills tor medical carel it'. is aneicipated that her need for medical care for injuries arising from ehe accident will continue on a long- term basis, 5. As a pareicipant of the Fund, Mr. Orris is eligible to raceive benefits trom the Fund to help Mr. Orris and Ms. Orris to pay for Rebecca Orris' medical bills. The amount and duraeion of these benefits will be determined in accordance with the Pund's governing documents and the appliCable law. 6, The Fund has taken ehe pOSition that its obligation to pay these benefits does not commence until Mr. Orris signs the EXHIBIT "B" Fund'. standard Subr~gation Agreement, a copy ot which is attached hereto a8 Exhibit A. 1. Mr. Orris and Ms. Orris, conversely, have taken the position that they have no obligation to sign the Subrogation Agreement as set forth in Exhibit A. a. The Fund, Mr. Orris, and Ms. Orris wish to reach an interim settlemant ot this dispute concerning the Settlement Agreement. Such an interim settlement would be mutually beneticial. Mr. Orris and Ms. Orris would benetit, because an interim settlement would facilitate paymant ot bills incurred for the treatment of Rebecca Orris. The Fund would benefit, because the interim settlement would pre.erve the Fund's right to claim subrogation at a later time. WHEREFORE, in consideration ot the promises eXChanged herein. and intending to be legally bound, the undersigned agree that: (a) Upon receipt of a fully-executed copy of this Agreement, tha Fund will pay bills submitted tor the medical treatment ot Rebecca Orris on the aame terms that would apply if Mr. Orris had signed the Subrogation Agreement. Nothing in this Agreement will require the Fund to pay all or any portion ot . benefit thae is not provided by the Fund's governing documents or by the appliCable law. -2- . , (bl Mr. Orris and Me_ Orris recognize that the Fund claims the right to subrogation in accordance with it$ governing documents. The Fund's right to aaaQrt all subrogation claims is expressly reserved by this Agreement. (c) Mr. Orris and Ms. Orris will keep the Fund appri..d o~ the status ot all eftorts to recover .ume which, in the view ot the Fund, are covered by the Fund's subrogation rights. In the event that Mr. Orris, Ms. Orris, Rebecca Orris. or anyone acting on the behalt ot any ot them, recoverS any sum covered by the Fund's subrogation claims, then the Fund will receive prompt written notice of the recovery and the recovered sum will be escrowed until the Fund', claims are resolved by agr.ement, arbitration, or litigation. Cd) There already exists an escrowed account, under Court supervision, which consists of $37,500 recovered on behalf of Rebecca Orris. The Fund claims that this entire sum is subject :0 its subrogation rights. Mr. Orris and Ms. Orris claim that all or 80me of this amount may be used tor other purpoeee. such as paying medical bills for Rebecca Orr!e, which are not covered by the Fund'e governing documents. It is agreed that this amount will remain in escrow until the competing claims of the Fund, Mr. Orris, Ms. Orrie, Rebecca Orris, or anyone acting on behalf of any ot them are resolve~ by agreement, arbitration, or litigation. -3- III ~------_._--------------~-------- EXPUN.\110fl or SI1llROGATtON POLICY --------------------------.------ The Tru.tns of the Central Pannsylvanh r...amsters Hulth ~nd Wellara Fund ("Fund") have established the following Subrogation Policy' If a Member incurs any medical upense or lost tlme axpense resulting lrom bodiLy injury or sickness. for which he or she may have any right of recovery against a third party. any benefits paid by tb6 Fund tor such expense shall be made on tbe condition that th.. 'und will be reimbursed therefor by' the Kember and his or her Cependents. The .,und will be reimbUrsed tor the full amount recdved by the Member and hb or her Cependent. from such third p~rty by way of .ettlement or in satisfaction for any judament. As security for the 'und's riahts to such reimbursement, the 'und .hall be subrogated to all right. of recovery of the Member and his or her Cependents against 'uch third party to the extent of any benefit paid by the Fund with respect to such expense. The Member and his or her Cependents .hall do whatever is necessary to fully secure and to protect, and nothing to prejudice. the riahts of the Fund to such subrogatIon. IMPORTANT, PLease note that the AssIgnment and SubrogatIon Agreemant must be witnessed. ----~-------...-_.~-_._------------ ASSIGNMEIIT AIlD SUBROGATION AGREDtENT --------------------------------~-- WHEalAS, tha undersigned (heralnafter called "Claimant") may ba or has been furnlshad benefits in connect.lon with tha above claim under a benefit. plan with the Central Pennsylvania T.umstars Health and Welfare Fund (hereinafter called "the Fund") and the C05t of such benafits may ba recov.red by the Claimant from a party liable to Claimant or to a Depandent or Beneficiary of Claimant. NOW. THEREFORE. Claimant intending to be legally bound, a8r..$ to assign and does hereby assign to the Fund any amounts recoverad from any party to the extent of the benefits furnished or to he furnished by the Fund to or on behalf of Clalmant, ur a Dependent or Beneficiary of Claimant. EXHIBIT "A" '<1g. 2 Exp14nat!~-2!-!ubroR~tlon Policy and A'4i~~nt/SubrOI&tion AgreQmdn! Claimant. iIlso agrll"s tt..1t. when Clalm.1nt or a DlIpend.nt or aendici..ry ot Cla1m.1nt shall have any tights to r\lcove!:' trom any person or persons tor benetLts tu~ished under the agreement. thll fund .hatl be subro,ared to such riahts t.o the extant ot th" benlltit.s so furnished. ClaLmant agrees to re1mburs. the Fund from anll recovery Claimant or a Dependant or Beneficiary of Claimant obtains from a third party to the extent of any benefits the Fund pays on account of the accident or iLlness living rise to this cLaim. ClaImant shall lll\llllldiauty infot'lll the fund of any legal action or settlement which arises subsequent to the payment of beneUU hereunder. In addition, Claimant shall do nothinll to p:'ejudice such rights of the Fund. Clalmant authorizes the Fund to claim and receive any amounts hereby assianed or to which the Fund is subrogated hereby. directly from any party Uable to tile Claimant or a Dependent or Benaticiary of Claimant and hereby direcU luch pany to make such payment dinctly to the 'und u-pon presentation of a p.~anent copy of this Assignment and subrogation Allreement. Claimant warrants that no settlement has been made by the undersigned with any perSon or ~Qrporation against whom a ~laAm may lie, and no nleasa has been given to anyonQ responsible for the lou, and that no such nttlamant will be aade nor release given by the undersigned without prior noeice and the written consent of the Fund. Nature of Illness or Injury Claimant (Member) - Print Date Illness or Injury Occurred Claimant (Mambar) - Social Security' Employer at Time of Occurrence Claimant (Member) - Signature OiU.~: IIi tn~5S - S 19nature lJ.ne: SCHNADER HARRISON SEGAL &. LEWIS Auorney of Record: Frank C. Sabatino Auorney for Central Pennsylvania Teamsters Health and Welfare Fund PA Auorney 10 No. 30147 1600 Market Street, Suite 3600 philadelphia, PA 19103 2IS-" 1-2288 JAMES E. ORRIS and CHARLaITE R. ORRIS, as parents and natural guardia:lS o! REBECCA A. ORRIS, a Minor, COURT OF COMMON PLEAS CUMBERLAND COUNTY CIVIL TERM Plaintiffs, NO. 96-1167 v. CIVIL ACTION - LAW CENTRAL PENNSYLVANIA TEAMSTERS HEALTH AND WELFARE FUND Defendants. NOTICE OF FILING OF DEFENDANT'S NOTICE OF REMOVAL I ~ 4. . On Ma~ch 29, 1995, the third party olai.. vere .et~led in the amount or the policy li.its ot $50,000. 5. The first party automobile .edical expen.. aoveraqe vaa in the ~ount of $100,000. 6. The medical expenses for aebeaoa A. o~ris to date are in exce.s ot $500,000 and are continuing to accrue. 7. The family health insurance coveraqe insuring against the medical expenses ot Rebecca A. Orris in excess of the first party automobile medical expense coverage is through Defendant by virtue ot tha e~ployment of Plaintiff James E. Orris with Preston Trucking company. 8. In spite of repea~ed written requests for a complete copy of the Central Pennsylvania Teamsters Health and Welfare Fund Plan applicable tG the injuries sustained by aebecoa A. Orris on November 18, 1994, the Fund has failed to provide us with anything more than Amendment No. 20 to Plan No. 13 which is attached hereto as Exhibit "A" and incorporated herein by reference as though fully set forth. 9. In addition to the foregoing medical expense coverages, PlaintiffS have under insured motorist coverages through Erie Insurance Company in the combined stacked amount of $3,300,000. - .' 10. Plaintiffs' rights of recovery under the first party autoaobil8 underins~8d motorist coverages are not speculative but. are absolutely certain u indicated by the fact. that. the automobile carrier has taken the unusual st.ep at the request. of 'laint.iff. t.o advance fundS aqainst. the under insured motorist cO'/eraeJes for the payaent of ..dJ,cal expenses whieb ue not covered wuler the Plan of Defendant. 11. Aftar exhaust.ion of the first party medical expense coverage under the orris family automobile insurance pOlicy, Plaintiffs submitted the medical expense claims to Defendant, U. Defendant initially declined to honor the claims for medical expenses unless plaintiffs executed a form subrogation aqreemant wbich would have been broad enough to have encompassed Plaintiffs' first party automobile underins~ance coverages for whieb Plaintiffs had paid separate premiums to their automobile underinsurance carrier. 13. Defendants based their claims on the language of Exhibit ~A. hereto. 14. c On the basis of the language at Exhibit "A" hereto which provides for subrogation from third party recoveries, PlaintiffS declined to recognize a subrogation obligation beyond their third . ....... ., .... ., party recovery from the party vho vas responsible for the injuries to Rebecca A. Orris. 15. " In order to move forward vith payment of tbe mounting medical expenses, the parties negotiated an undatad tnteria a<:jreement in vhich they preserved their respective clai_ . regarding subroqation with the undarstandinq that ~ny party hareto could proceed to resolution of the subroqation issues vhen ready to do so. A copy of said undated-interi_ a<:jraeDent is attached hereto as Exhibit liB" and incorporated herein by reterence as thouqh fully .et forth. 16. PlaintiffS believe and therefore avar that the compensatory da~qes for the severe brain injuries to Rebecca A. orris will exceed $3,350,000 for tbe severe injuries for which she remains under expensive treatment and from which she will suffer for the remainder of her life. . '. 17. Plaintiffs contend that, whether or not the damaqes for the injuries to Rebecca A. Orris are ultimately determined to be in excess of $3,300,000, Defendants are only entitled under the lanquaqe of Exhibit "A" hereto to subrogation from the third party recovery and not from the first party automobile under insured motorist recovery for which plaintiffs have paid separate premiums. WAnaI P. SIwla _ oIlooo DW"__ ~ ~,f--A WHEREFORE, P13intirts demand judgment declaring that the subrogation claims of Defendant for payment of medical expenses ,. _4..... . .. -.-..-:-:--- - t" ! , .. t . . -, . cu....a.u. l'ENN$n.~A ~s BEAL'm AND NZLl'AlU: FUND l'LlUI XO. 1.3 (M RSSTAT15D JANTJ1.Jl'l 1. UU) ~ NO. 2Q WJ[ElU:M, the Cea.tral PellAaylvania TeanlStel:'S Jlealth and Welfare -, I'UI1d _ &llan No. 13, hereUaIter rele%%ec1 to. as the -Planll was created an December 19, 1988, effective January 1, 1989; and .........."~. Article XXI1X of the Plan provides that the TrUsteeS lQaY amend. the Plan. 1n a manner cqn.sistent with the central l'e1U1Sylvania Teamstars Health and Welfare Declaration of TrUst. and applicable law. by resolution of the TrUstees; and WH:BREJ\S, Article XXVI of the plan provides that. iUIlendmentll to the plan be in writing; and WKEllEAS, the TrUstees wish to amend the plan in order t.o clarify and restate the Subrogation provisions of the Plan, NOW, THEREFORE,. in- consideration of the premi.ses ~ by the unaniJucus ~itten consent. of the Trustees, t.he Plan shall 1:10 amended as follows: 1. JU'ticle XIX, entitled -SUBROGATION" shall be amended by the dclet.ion of the fOruler prcvi3ions of t.he Article and the addit.ion of the following new provisions which read as follows: "S'OBROGATION Section 19.1. Becoverv of Benefits Paid, A. Upon payment under t;his Plan and as security for the Fund's right to reimbursement to the excent of ics payments, the Fund will be subrogated to the rights of recovery of each participant., Dependent and/or. senefidary of a Participant against any third party whicb caused the injury or sickness far which the claim is made or wh1ch is ochentil'le liable for the e"Penaes incurred a~ a result o~ such injury or sickness. Participant, Dependents and/or Benefi,ciaries of Participants may not. act. to prejudice the rights of the Fund t.o subrogation and may be required to sign a 9ubrogat~on agreement in a form prescribed bv the f~d . . t . . ~ . . ):)efcure the 1:8181..& of benefits." In ehe event of any ..paYment Wldet: this Plao. on behalf of a Parcicipanc:, Dependant. andlor: senetic:iuy of 'udc:.ipaJSt the Fun4 shill be subr:ogat.<<d 1:.0 all the dghts o~ Z'ac:ave:'Y th.~.tore against any peraon or organizacioa. partieipiLl\ts, Dependents lAd/or BenefiCliariu of pal:'ticipant8 shall .~ecut.s and delivaI' 1AStJ:UmectS aad papers, shall furnish cbs J'Imd with INch noeiee a.ad 1nlorl\loltion, and sball do whatever elae 1s lUIee.sa:ry t.o ..cur. such rights, including but not: limited to th. right o~ the Fw1cl to sua in the -.. ot! ~h lIart.icipants, Dependents ~/or: BelWlJ.c:iaries of participant.. Participants, DepeDdence L~d/or '. Sea& f ic:.i.ar1eft of ParI:. icipants shall do I1Otl1iug atter .. loss, or otherwise, to pJ:ejudice the Fund's eu):)rogation rights. The nceipt of any paY1Mnt by any participant, Dependent. and/ol:' Ben.lidaJOY of a PU'tic:ipant lJh.all be specifically conditioned upon an agreement by lI\Icb individual acJcncwledging this subrogation provision, its te1:'TllS and conditions and the agreement of such indivi.dual to repay any aulIIS expanded in full B. The Fund shall be encitled to rtdlllbu::.ement IrCl1ll the firse dolla,:s to be paid or to be rec:e1ved ):)y a 'an:ic:ipan~, Dependent aAd/or Benefic:iary at a Participant f~om a-s.tt.lemene or jydgment:: from a t.hird party. The Fund shall be first reilllbuned tully to lLhe extent: of benefits paicl trolll ttle 1IIOcies paid by any person or persons, party or parties, ~urance company, firm, co~oration, government. agency, or other entity, and che bala.nce of 1IIOnies, if any, then remaining frolll suc::&. eubsliIquent recovery shall be recai.ned t:y or on behalf of the Participant, Dependent and/or Beneticiary ot such participant. c. The Fund's sWlrog.tion righ1:8 established by t.his I'l.ul. shall not. be dillli4i,hed to any extent by the failure of a part.icipant, De,endent and/or Beneficiary of such Parc.icipant: to sign an agreelllilnt as provided in paragraph .A. herein. I I .1 , D. The F\md shall have the right to take all appropriate actions neceSllary to enforce it::6 subroqation rights in the event that. Participant, Dependent and/or Benet iciary of a Participant refuse9 to sign a subrogation agreement, refuses to reimburse the FUnd in accor~nce with the Fund's sUbroqation righes, or tax~B any ocher action inconsistent '"ith the Fund' 8 lJub~ogat.ion rights. In such situations, the rund'll options ghall '. ~ Th;i.a A.g:rtl..ft1:. l:let-~ J...- .. OlM:1, (RM~. oni.R) lUl4 dl,arlotte On18 (RM8. Om,R) aSI4 tbe Central ,~ylvanilo TeamsterS Health 1J1l111el!u. r=a (Ri'\UIdR) h 1:Iaa.4 0" the '. fol.low!r.g fac:U: '. ], . M1:'. Orri. ill a paJ:tlcipaZlt ot thl 1'WId. 2 . M8. orda 15 the lIpCN8e ot M1:'. orris. 3. Mr. Oml and Ma. ern- are \:.he puentl and nat~al guardians of Rel:leCea orrill, a minor. 4. . on or about November 18. 1994. Rel:lecca Onb luttered se~lou. lnj~le. in aft automobile accident. .AS a result of her 1nju~iee. Rel:lec:ca orril has inc:urre4 various !:lills for medical care, it il anticipated tbat her need for medical caxe fo]," iAjuriea arising from the ilcc:ident wu'l continue OIl a lcmg- - . tens l:laeis. 5. As a part1cipant ot the i'UnC1. Mr. On-is is eligible to receive genetits from t~e Fund to help Mr. orri8 and Ms. oni. to pay for ReDecca ern.' medical tlills. The amount and c1uration of these benefit. vill be de1:.ermined in accordance with the FW:1d'. governing doc:ument:8 a.nd \::he applicable law. ,. The Fund ha. taken the position that ita Obligation to pay tbase benefits does not commence until Hr. Orris signs the EXHIBIT "a" FUnd'. .~~darc! subrogal:10A ~ePlenl:, & ccpy of which ia al:l:Ac:hed hereto all ExhUlit A. " 7. Mr. on:ill iU1I1 Me. 0"18, conversely, have taken the podl:1on that they \1&v. QO c!Jliga.tio~ to 81gn the SubrOlPt1.on AgreelllCnt as sot tOrth in 2Xh;lJ:li~ A. ., 8. The J'unc!, Hr. oni., and Ma. oni. wi lib to nacb iIA " int.rim lIettlement ot thill dispute concerning the se~t1..-nt JLg1:8ement. such an interi!\\ .ettlelll8J1t would be llIUtua11y benetieial. Hr. oni& and M8. 0"18 would. benefit, hec:&\&&. an interim settlement would. facilital:& payment of ~ills incurre4 rol:' the treatment or Rebecca orris. The Fund would benefit, because the interim settlement would preserve the fw14' B right to clai\l\ subrogation at a later time. ~1:'FOIU:, in consideration of tbe prami.es exchanged herein, and intending to be legally bound, tho undersigned agree chat: (al upon receipt ot a fully-executed copy of th~' Agreement, the rund ~ill pay bills submitte~ tor the medical treatmenl: of RebeCca OrriB on the same terma that would apply if Mr. orris had signed l:he Subrogation Agreement. Nothing in ~i' Agreement will require the Fund to pay all or any portion ot a benefit that ie not provided by the FUnd's governing documents or by the appliCable la~. -2- (1:1) H1:', O:n:U and Ma. O",d. recognJ.ae tb.at the run4 claJ.1DlI t.he right eo .w::.:r:oqaeJ.OA iA acc:o~. wit.h 11:.. goveni.llg 4oc~Ae.. The Fun4'. rlgAt: eo ....re .11 aub1:og&tiOA cl.1m1 1a ~:e.al~ reae~ by ~1a ~re~e. (el M:r:. Os-da aM "e. 01rd' win k...p tAe ~ app:1ae4 of t.Da et&t.~' of all .ffO~. to ..eave:r: ~ wbicb, in 1tha rlew of ehe ND4. ue cove:J:'e4 bY ellA 1'WUi'. .~s-0'3ation dght.. 14 the e'lene elsAlt M%', ors-b. .~.. os-de, J.cbeC:~ oni8, " OJ: aJ1YOne ac:~1Dg Oft the behl.lf: ot dY ot ehem. ..covers any IUllI covered by the I'\I.Dd'. .u!)~e1oA clailllll, theA the JWl,d will receive pr~t ~it.te4 QDeiC8 of the :ecovery an4 ebe recovered e~ will 1:Ie ..czowed until the rund'e clailllll are :e.olved by asre.~e, arbitration, oX' litigation. C~) There alreadY exietl &n escrowed account., under court 8upervi.ion, wbleb coneile. of $11,500 recovered on tlchalf ot lleaecca o1'1'il. 'l'b.. f\UId claim ~e th18 ant:!.r. S\IlIl ill Iutljece to its sUbrogation rights. Mr. O:n:il and Ms. or:r:1. clai~ that all or .ema of ell1. amount may be uled foX' other purpose., luch aa paying medical bill. tor Rebecca orr1., which are not covered ay ene run4" governillIJ 4oc:~U' It'. ia agreed tnat tDiI amount will remain in escrow until the competing claims of tJ18 f'UXld. Mr. Orr1s. JlIa. orril. ll.eDecc:a orris, 01: anyone acting' on behalf of any of ~nem are resolved by agreement, ar~itrat1on. or l:i.tigat10n. -)# . u &UUlA1'1al ar SGlIOc.t.Tlall rot.IC'I ..... '. n. 1~Uas 01 the CIAUU ..nt\Jylvanh 1eUln.~I ~.&lth aliA "dfaA rlll'ld C"J'wI4") ha"e e,tabUslad ue fOl1oviuI S~fQ.aUaa 'aUC:1: If a "811III011 lncurs ., ..dleal. upense or lost. tu. utlease nS1l1dll& bOIl 1104111 ll\jlUY or 11...1. fat vIL1ch lie GI' sluI ., 11~'" allY dpt. of c.cQYUJ acaJ.IIJ1: a tldri pat\l. 1IA'1 lIeadiu ~.14 ~ tile J'\IIld fo1' sudl up...e sball lie Ucla . tII. lUlIIlUdllll wt. ue ~ rill 11_ tdallU'. theeafol' W' the lIaIIet .4 lais Ot hor 1)opnr:lao.'s, n& .IUII4 "Ul lie nJ.lIbllrseol lal' the fIa11 2IIIOlII\t <<ceheel by the )lUlbe.,UIA. Il.i.S or hor Depandenu fCd sv.dl third. prey 111 va:r of uu.l_t. ot in .adsf"dCID lot lID" jupel\l:.. As sOC1lod':r lar ue fluIol'S dpu 'a such n~bursallUlllt., &!l. 'mol .h.U bo slSllrolau4 t.o all ,labU 01 nc:ovary of the tlelDbu and ILl.s or her llepu4ellt.s e'lI1Jln I\Idl third patty la the ellUllf. of atL'f 11I1D"!t. ,aU b1 tile r\lllol with respect. co sw:Il POlansa. Tlle )I_ba.. and his or h..- De,udellU shall do wbat,a.,... is lleeeSury to f\&111 secure and to protect. iIlcl lIOehlnl to ptejlUlic:e, the ripu of the flllld ta such subeoladon. Dl1'OllTAIl'rI neue lIa,e that the Ass1&f\IIWI' md Subrasadon A.re~a' ~Sl be witnessed. ~- ~ ~... ASSIGH1l1B't ~ SUllIOGA:nON AGuntElIT WHlllEAS. the undetsianlld (henlROllt.e.. called .CIU111an'.) u1 be or bas been furnisbed bellefits 1a coanec:daa with the above cldJIl w:,,1" a benefi' plan "ith tha C.nt~.t feAa"lvanii Teamsters Re.l1~ and Welfare fund (heniaaEtll(' called -the FWld-) and tha c:C:SI of ,uch bandits IN'f 'Oc recovered by the Claimint f,~ ~ party liable to Clii~ant or to a Dependen~ 0" aeneficiary of Claiaant. NOW, THEREFORE. Claimant intending to be le8~11y bound. aSrees to us Iln and dOliS h.~eby usi.an 10 tbe fund any amounts rllcav..,ad fcom any pacty to the extant of Ihe benefits furnislud or to b. furnisbed by the Fund to or on lIl1.hatf of cuilllllnt. 0' a Oependent or Bendici.ary of Clawnt, EXHIBIT "A" . u,a Z Illft.s&lon of SuI"'J .se!'" ..,Ue _Ii ,Ud Cb.L1lant:. aJ,u alfe.. ebat. .,ftaft C:l.~t or: . D.p..,4.,,& or 'cnafiduy of Cl.dlNlll: shaU Ila'" allY fiPt..s \0 recovn h.... adY pelrSOO Olr pUSlJII' fo"C' benallu IUn\J.lhd 11II4.. the alfUlleat. ue I\IIId .I\.au, lie sUfolcaul! to .udl wi!h'" u t.lle I:lIUllt 0' elIa lI.n.IiU 10 IUtlli.bad. Cli.i.Jlallt I&ru. 1:0 natlUta llhe hn4 Irlllll lAY rlCJnary Claillomf. .. . Dapcn48Dt. o. acnefieiary of Cl~t. olltal~ 'lrlllll . thifd parcy \0 elIe utalt. of .'OJ badiu the 'lIdd. ,ay, 01\ .c~t. of elIe &l:c14alt. or Uln... 11vil\1 dse' 1:0 this da1.lll. ch1liaAt .baU __dhul, iAfoqa t.Iae ruaA of 111' lal&1 .c:t.ioft 011 saul_C ..10m ado.as subsa",,'" &0 &he paJMl't. of lI81\11I1U llaulll\d&r. In addit.J.on. Clalllant. .hall '0 1I0u1Aa t.o plrljlllUc:a sudI dpts 01 the fuJI'. Chlaa01: nthod.u the f\IrI4 t.o da.i.a and nc.i"a allY _U ~r.by a..lanad. or to Vb1ch tha ,~ i. subrOI&t:.ad befell,. 41re.:l:.l, Iro. allY part.y thbl. co ua Clailun' Of a Dlpen'ent. u le".tl.cbcy of Cbilllilot. aIId. helrlby .lfll<:.\5 .uch puty t.o lUke .uch paylllllllt clincHy t.o the hnd QPcm plrue1ItadOll of a pafllWlent. tall' of t.A1. Asdltllll8nt and. SUbfOIa.d01l ".r.....ne.. ClaWu& varnnU that. no settlPllDt has beal IUd. by tha ~1i.fsLlOed with lAY p.rson or corporation alainst:. whom a c:lata .., 11.. aft4 1.0 raleas. hu beea livlIn t.o any 0". r.sponsibl. for th. Iou. anll that. ,,0 wch nul....lInt. will II. llladll nor nllu. livan by the IJIllilltsianlld vitho~t:. pdOf notte. lAc! Ult wit.un conSlIn\ of tha funcl. .atute of Illness o~ tnjucy Cla~' (Ma.bar) - reint Data 111".5$ or Injury Occurrlld Claimant (Membat) - Social s.curit1 · Employer ~t. Time of Occurrenee Claimadt (M~ber) ~ Siln~t.ut. D~ta: Witd~5S - Sl&n2eUre Date: f:: ..,. C': r-. f.1..1':"'" (:', (~) < -..: p::~. () .. c.. L..', G::I . .,":' I 1,_. ,. .. ", . . . "'-. ...~ ~ ~ ~ " ,j ~ .~ ~ ~ ~ ~ ~ f"l . . , ~ .~ ~t ~ " . i ~ . , . l SOUTHAMPTON TOWNSHIP, CUMBERLAND COUNTY. PENNSYL VANIA IN TilE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYL VANIA v. MUNICIPAL LIEN DOCKET PAUL BARRY KILLINGER, SR., and CA KILLINGER NO. 98-1168 MLD PRAECIPE TO SATISFY To the Prothonotary: Please satisfy the above-captioned Municipal Claim, as the case has been paid in full. SOUTHAMPTON TOWNSHIP CUMBERLAND COUNTY. PENNSYL VANIA Dated: ) (ll/o y /1../~. --:--/ By: Richard L. Webber, Jr., Esquire Solicitor for Southampton Township, Cumberland County, Pennsylvania 126 East King Street Shippensburg, PA 17257 717-532-7388 'J\J~l'.".I:.~. ,"".,'~{]c!,"r".-' Pc Arr'JIHH'.....;,\f Li\-,'i ','., ',\",f 1~lrl" -,IH~_I;.r '.~HPPENCjHUHl:i. PA Il~'!i7.t397 ~ '" )- <~ .~ ~ ~~ <'"' -2 ~ Lo' c.."J. ~ "..... \)~ >~ '\ ~ -.' '--'. " ." i,_ ,', ;- 1_") ~ ,t \"[", ~ C1'... 1 ... UJ'-'. " ~ ~.d II J '!.. -," ..,.: . i-" _T \i'j Le, e.1 ...', .......J ...J - <,. ,.. G07ISQ.OOOIIIJIeb....., 6, !996IIRDIDIUJ50333 STIPULATION AGAINST LIENS VICI'OIUA GLEN ASSOCIATES, IN THE COURT or COMMON PLEAS OP CUMBERLAND COUNTY, PENNSYLVANIA o.w- Y. NO. MLD qt..- Ill, 9 .'" fit u) LEON E. WINfEIlMYU, INC., Contractor WHEIlEAS, VlCfORlA GLEN ASSOCIATES, hll'einafter ~a1led .Owner., hu Illec:uted a ContrllA:t wilb LEON E. WINTEIlMYER, INC., a domllti~ corporation, hll'elnafter called .Contractor. , for site work in connection with a residential development situale in Hampden Township, Cumberland County, Pennsylvania, known u Pbaso I, Tumberry U, whidl said silO work shallln~lude excavation, erOlion and sedimentation control, installation of sanitary sower colloc:tion system, installation of storm water colloc:tion and lIIIDIIement facilitilll, installation of elec:tri~ linlll IIId pavinl of streeta within said Pbaso I, Turnborry II. SaId silO work shall be done upon land situate In Hampden Township, Cumberland County, PlllDlyivania, beinl more particularly bounded and described on Exhibit. A. attacl1ed hereto IIId made part hereof. NOW TIlEREFORE, nus AGREEMENT WITNESSETH: That Ibe said Contractor, for and in consideration of Ibe sum of One ($1.00) Dollar 1.0 Contracl.Or in hand paid by Owner, lbe receipt whereof is hereby acltnowledlled, and Ibe further consideration mentioned in lbe contract aforesaid, for itself and its subcontractors, and all partloa llA:tinl throulh or under Contractor and its subl:ontractors, covenant and IIree lbullO mechanl~'s liens or clalllll shall be med or maintained by Ibom or any of lbem lIainstlbe land dlllcrlbed In Exhibit. A. for or on IICcount of any work done or materials furnished by Ibom or any of Ibem under said contract or olberwise, for, towards, in, ot aboutlbe site work on Ibe land des~ribed in Exhibit. A. and said Contractor, for itself, ill sulN:ontractors and olbers under Ibom hereby Illpressly waive and relinquish Ibe ript 1.0 have, flle, and maintain any mechanl~'s lien or ~Ialm apinst Ibe land described in Exhibit . A. and IIree Ibat Ibis Instrullklnt, waivinl Ibe rllht of lien, shall be an Independent covenant. . QO'7IjG.OOOt IIFobJUUy 6. 1996IJRD/DKU50333 EXHIBIT "A" ALL THOSE CERTAIN tr_ or par~~ls of real estate siwace in Hounpden Townahip, Cumberland County, Pennaylvania, beinl more particularly bounded and dll8cribed as follows: BEGINNING III . point on the northern lellal riJlht-1lf-way line of Aldecslate Circle at the southeast corner of Lot No. 1M OD the bereinafter deacribed Final-Phase I, Turnbetty; thence South 02 delrees 01 minutea 17 seconds East a distance of ~ feee to a point on 'he southern lelal riJlht-1lf-way Hnll of Alderslate Circle; thence a10nl the southern lelal rIJlht-1lf-way line of A1d<<sla1e Circle South 87 dellrees 28 minutes ~3 seconds West a distance of 20 feet, mort or leu, to a point; tltence South 02 delreea 0 I minutes 17 seconds East a distance of ~ feet, more or leu, 10 . point; thence South 81 deareel ~8 minutes 34 S<lCllndJ West a distance of 236.~2 feet 10 . point; thence by a C1IfVe 10 tlteleft bavin" radius of "0 feet a distance of 174.22 feet 10 a point; thence continuin, by a cllrvelO tlte left bavln, a radius of 41 feet a distance of 96.9'l feet to a point on the eastern lelal ri&bt-1lf-way line of Jerusalem Road; thence a10nl the eastern lelal rI&bt~f-way liM of Jerusalem Road North 19 depees 13 minuteS West a distance of 111.~8 feet to a point; thence contlnuinl a10nl tlte same by a curve to the ri,ht havinl a radius of 3,970 feet a distance of 48.76 feet 10 a point; thence continuin, a10nl the same North 46 de,rees 36 minutes ~9 Joconds West a distance of 6$4.10 feet 10 a point at the southwest corner of lands now or formerly of &I,ar F. SwartI and Vlr,inla It. SWartI; thence a10111 the southern line of the same North 72 dllllreea 24 minutes 33 seconds East a distance of 626.40 feet; thllllClt a1on, the western line of other landa of Victoria Glen Associates South 55 dellrees ~~ minutea 31 seconds East a distance of 314.~ feet to a point; thence continuin, a1on, tlte southern IiM of other lands of Victoria Glen Associatel South 21 de,rees 24 minutes 01 seconds West a distance of 34.1$ feet to a point; thence a1on, the southern line of other lands of Victoria Glen Auoclalell South 62 delreea 29 minutes 01 seconds East a distance of 150.00 feet to . point on the southern lelal rlaht-1lf-way line of Oalkeith Drive; thence a10nl the southern lelal riaht-1lf-way line of the same South 21 delrees 30 minutea ~9 seconds West a distance of 28 feet to a point at the northern comer of Lot No. 103, FInaI- Phase 1, Turnberry U; thllllClt a10nl the northern line of said Lot No. 103 South 62 delreel 29 minutea 01 seconds East a distance of 11".02 feet to . point at lhil eastern comer of said Lot No.3; thence a101ll the eastern line of said Lot No.3 South 23 dearees -'6 minutea 24 seconds West. distance of 77.as feet to a point on the eastern side of a 20 foot dralnaie easement; thence continuinll a10nl the eastern sid" of mil 20 foot drainaae easement South 23 dlllrees -'6 minuteS 24 seconds West a distance of77.8" feet; South 04 delrees 49 minutes ~2 seconds West a distance of 6-'.23 feet and South 02 depees 01 minuteS 17 se<:onds East a distance of 143.19 feet to a point on the northern 11IIa! rlpl- of-way line of A1derslate Circle; thence continuinl throuah the lelal rilbt-of-way line of AlderSIa1e Circle South 02 dearees 01 minuteS 17 seconds East a disllDce of ~ feet to a point on the southern lellal rlpt-1lf-way line of A1derslate Circle, the point and place of BEGINNING. The above described lellal description includes Lot No. 103, Lot No. 104, Lot No. 1M, Loc No. 110, Loc No. Ill, Lot No. 112, Lot No. 113, Loc No. 114, Lot No. 11~, Lot No. 116, Lot No. 117, Lot No. 118, Lot No. 119, Lot No. 120, Loc No. 121, Lot No. 122, Lot No. 123, Lot No. 124, Lot No. 12S, Lot No. 126, Lot No. 121, Lot No. 129 and Loc No. no, tolether with the legal ri&blS-1lf-way for BoMyriU Court (Road 08"), Dalkeith Drive (Road "CO) and Aldersllale Circle (Road 000) all as :!hown on Final-Phase I, Turnbetty II, dated S~_!....:1.1 ,1995, lasl revised ~ .....~ U ,1996, recordoild in the Office of the Recorder of Deeds of Cumberland County Ia Plan Book:1.L, Pile ~. In addition, said land also includes me following tract: BEGINNING at a point on the northern legal right-1lf-way line of Silvercreek Drive (ellisti.n&) at the southeast corner of lands now or formerly of Central Conference of United Methodist Churches; thence a10Dl the eastern line of Janda now or formerly of Central Pennaylvania Conference of United Methodisl Churches North 07 degrees 14 minutes 4' ~IIIP.NU')' 6, 1996I1R>>/DtU.l503JJ S8l:Oada Wilt a diatance of 100 feet 10 , poine; thence coDtinuinl lIonl thtlli/Dll North 19 delr_ 02 miRlltea 03 lec9lllll W.t a diltance of 40.07 felt 10 a poine; thenca a10nl the south<<n IiIM of other landa of Vldoria 01.. A.I6ociatel the IOlIowina foIIr COIIlItlI and diatlncllI: (I) North 19 dear_ 3~ minutea ~~ aeo;onda E>>t a diltallCe of 161.34 f.1O a point; (2) North 12 dear-.~ minutea U S8l:Onda Eut a dlSWICe of 1-'6.00 Ieee; (3) North 67 dear- 22 ml-.tea 1. aeo;onda Eut, dialmc. of 161.2. feet; and (.) South 71 delr_ 36 miRlltea 30 S8l:Onda EIIc ,dialaDl:a of 79.1. ,.. 10 a poine; thence lIonl die wtllltll'llline of other landa of VielOri, Olen A.I6oci... Soudl 07 dear- 1. milllltel ~ uconda Eat a distance of 136.11 feet to a point on the oorthern lelll rlpt-of-way line of Silvltcr.k Drlva; thence a10nl the northern lela! rlpt-of-way line of Silvercr. Drive South 12 deareea .~ miOlltel I' lecoada Wilt a diatanc:e of ~38.00 feet to a point allhe northeast comer of landa now or IOrmerly of Centra! Pennaylvania Conferene. of United Mtlthodi.t Churchill, lhe point and place of BEGIN NINO. The above deI"illed parcel containa Lot No. I, Lot No.2, Lot No.3, Lot No. ., Lot No. S, Lot No.6 and Lot No. 7, final-Phan I, Tumberry II, dattld Septllmbet 21, 1995, last reviaed Janllll}' 26, 1996, recorded in die OffIu of the Recorder of Deeds of ClIIIIbetland COIInty in Plan Book 11, Paae 123. The land IIpOII wbldl the work II to be done sball allO speclficllly lnclllde Lot No. 10 and Lot No. 128, Final-Phan I. TIIt1Iberry II, dated Septamber 21, I99S, last revised January 26. 1996. recorded in the OffIc. of th.llecorder of Deeds of ClIDIberland County in Plan Book 71, Pile 123, which said Lot No. 10 and Lot No. 128 ar. more particularly bound and described u IOlIows: 1.At HOe 10: BEGINNING aI a point on the northern lelal rlpt-of-way line of Silvercr_ Drive which said point ia North 82 delreea ~ mlnutea U HCOnda EIIc of lhe southwest comer of Lot No.7, flnal-Phan I, Tumberry D; Ibeoce 11011I Ibe northern lela! ript-of-way line of Silvtltcreek Drive (aiatinl) South 82 dear_ ., minutea IS uconda Wilt a diatanc:e of 103.606 feet 10 a point; thence contlnuinl alonl the oorthern lella! ript-of-way line of SUvercreek Drive and the weatern I.a! rlaJIt-of-way line of Good Hope Road (S.l. lOll) by a curve to th.lelt bavina a radiua of 20 f. a diatanu of 30.606 feet \'0 a point; thence continuinl a!onl the wolltern lela! rlpt-of-way of Good Hope Road (S.R. 1013) North 05 delr_ 01 minulllS 19 seconda WolIt a distance of l00.S8 feet to a point; thence &1011I the southern line of other landa of Victoria Glen Al50ClateI South lW d.reea 58 minutlll .Iseconda West a distance of 17..1 feet 10 a poine; thence continulnl alonl the eastllrn line of other lands of Victoria Olen Auociatea South 2' delr_ 59 minulllll 53 seconds WllIt a distance of 75.03 feet to a point; thence continuinl a!onl the same South 07 dear_ 1. minutes .5 seconds West a distance of 8.5 feet to a point on the northern lela! rlpt-of-way line of Silvercr_ Drive. the point and place of BEOINNINO. lnt No. 111: BEGVfflJNG aI a point on the lOuthern lelll rilht-i)f.way line of Silvercreek Drive aI the northeast comer of Inv_ Drive; thence alolII the southern lelll ..ipt-of-way line of Silvercr_ Drive by a curve to the rlaJIt bavilll a radiua of 10 feet a distance of 9.36 feet 10 a point; thence continuini alonl the southern lela! ript-of-way line of Silv,"reek Drive North 12 delr_..5 minutes 1.5 seconds Eat a distance of238.81 feet 10 a point; thence contlnuinl a10nl the southern lela! ript-of-way line of Silvercreek Drive and continuinl to the wllltern leial rlpt-of-way line of Good Hope Drive (S.R. lOll) by a curve to the rilht havinl a radiua of 25 feet a distance of 22..7 feet 10 a point; thence contlnulni alonl the wllItern lellal rlpt-of-way line of Oood Hope load (S.R. lOll) South <46 dear- 37 minutea 56 seconds Eut a distance of 3.66 feet 10 a point; thence South .2 delreea 19 minutlll .5 seconds WolIt a distance of 7..02 feet to a poinl; dlence South S2 degrees .2 minutes 22 seconds West a distance of 116.31 feet to a poine; thenu North 58 delr_ .7 minutes 59 seconds West a distance of 21.87 feet to a point; thence North I. delr_ 23 minutes 39 seconds WolIt a distance of 27.88 feet 10 a poinl; lhence North 60 delr_ 53 minutes 35 seconds III Ii :)7 Ii I", t \\ ;j .:.1' t, I I,,'I! 11,11 ,\ lill, 'III I ._l ,oRN ,9A 6/90 l.lPl t....-J '31" ~ ,'". ll~,..lr;.. '4'1' f C'}l,1 t 11100111 DI~PIfI~T I)' III 'fH-;Y' '~AllIA 1:.1,""., "'U,.,,,,: 'J/,J.t1/l1.;.lH.JW,1 "JTI(!:. "I l'I''''~l..n~OH Ui r.\r.F 1..1l(1('1 CWAI'[(>l ,. Ul fllF 9..../n'itllq':r CI.Jf, MU,II"'ti or (llllll '1)11-;, ^HO IltlHlo al UAI"'i (lr'ld 1" "h,:1I i~r' J1I1'" C1!.'l,JtLr ij" .I',',,'! !".-I"': J In rc: (,....~ II' UcOtOI'1 BRUNI. UIUUI f. 0.' I . . J:tJN$nllr.llfHl . !tOMI IHf'A'JlfLMINf C" BRUNI. UFltllHAIl L- 0.' II " \I CQtt:iINUCT [,iN . 110,.; lIo4P~.:'''1 ~j:ij' l,;1l ~....t, ,'"', ;"l f 'I I'll! 11'1' ( g. ~ CNlI,I 'il ~, l'JA- 1-/0U O,'I,tM '.j'.' ").-" .' I.. III IIIn', ~.' l; .. r I.": 14/.to 1,.1-;;-F;1~..J- hll-, 2'1. 1'J'16 i 1 '.'ilo!: .'IJU.JIi' .'/,'1 FIN. It/A AdlJrlf~'::""': A,~II" 'J' II,,. ("'l~ ", I'.' 1i..l""~I,P',l~ f.UI'" ~.o. an. ~fl" .'.III \jl.llilllJT ~IlIL~ I 1tA-1I14/S.VIlI" I'. 1110".\MJU ...... ;It'td Act.tr""" a' AI run",." jor f)",hl"r IOWAI'O U" NAAKfR. 1i~.U. 1 W. "IC~H SI.. 'AIIMf:N~i tRUST 'UOli. CAAI.ISLi. Il''' l/Ul3 J.lll,.wltU.., Hl.lle-.', (/111 l'oI.IUl;H N.,,1OI1 ..ncJ "'ddl"~:. ul '11l'.tI"U l.AUJ!IHn ij. lllANIo:, "..0. bUl NmUII ~FCO"l1l 'iTAFP' ItAURI\lIl1Hli. PA \)'10.-" I~d Pplllll'U' 'hilt...'. (711) .UI, 1.;.','. DATt, fllt(E AHO lOl.;AflON C)l "t-Erl~r. Ol- cwtO[Il1If!i S.....h>ftN1' 6, 199h. '):30 ".14., u.s. !IUJ';JFF III;Alllljfi ~o.." ,'/T~ fL.lN'j HAM~I.' SJ,CU1l .\6ill !if. l"I;f^Nl.J1IItU(L~A U 1 ';l'il^;ll;f OF I)ll!~', HIJ"t.""'" ". I')'.... I", I"..: O",nll In!'! Iv "," II (.,."..I.flr'\1 I'Jl t'" , It'''' I" Uu..(li....~"tll'lto: lit r"~Ol.'r.,I",. \.Ir tu OI'I,.rmlr'\': CI",lt"r'J"nl.'lj,ry." C"'ll."r'\ T,:.to:. ,,11,..:'1:. AT TNIS TlHE mER! APPEAR Ta .. 110 A:.;SUS .VAIIAJUI flU1H wlllt:lt PATMI-NT KAV 11'- /ItAl)' 10 UN'i(tURCO CllfDlrOAS. nil NOr 'Il.~" PACKlf Of CUlM UNflL lOO AICEIVE NOrlCi ru OIJ sO. (!>>tMEMCEMfN' 0' CASI:. A peri'",,,\ fur tltflJld.1liOf' Ilfld",,. c"Qnl.~r , 0' .~" H.Vlkl''4Ilf'tl r.rwtr. n",.. 1,,'rM fill...J I" rni., t"'M'" bv ur ag.ainst th. ptfSon _ or plr:\OflS fWINtd JbQvv ..~ the dt:l.llIJl. $ld IlIn III dVI I~.. 1"'" i " r "11': h..... '''''1'1 ,~" ,,,., "'" I \ ""r r ~: 0: .... "1't I r.: 0/411 docUJllnU 'Ited in thiS c:a,.. All doc\lllenU tiltd with Uur c;otJrr. lm:tl..dlng li~t~ u' '"" lJ\:btlll'" 1cI1'UJ,Wny, c;S.:l.It$. ,1nd pr.-,ty cl.llillltd IS ."l.~' .ar. .",..il.\bl. fo" inspectl!)., ~Ir U,,, I)lflJ:'v 0' rtlc cltPilr of th. h.lllkryptr., ..II\Jrt. CRIOITOItS MAr Nor TAK! CUIAIN aCtIONS. a .;1";1 tor h IIny.'N'lt' to -.flU'. rhe lJulHnr own nU'l'V or ~rUJlf'l"Y. UI04't'r rrHI'I.."Irl'I4)tl.:)' Code, th. d,btor Is gromred cert.ln E)rottKliOn a40insr ~rC'dltor,. CutlrftOn c"'iJIflJlr'.J ot pruftlbl~crd u.rum:i b'f ,..l..llru,':;' \111' c:oRtlCl'nv fI'Ill abUr to delnard 'ltpilymenC. Ulci"'l olccinn .tjoJinsr ~hiP dlDfor III r.ollf!Ct ftlnll'Y oved tu c.r~1 tur~ III' 10 Uk. property Df thlt dtbtor, Mtd sturtlng or c:ontlnulng 'QrvdO'lurlt aC'ti'JIlI. rt-r",.,U..J\lOllS. 01' Wol'.1n d~I'1 IlIns. If l"lo,"rhorq,.d actions .r. ulten by. c.rod1tor Igolilnn . debtur, tile CQUn my pe,,:,IIW '".It ",.""htor. A C'roditor whtJ loi. r.tJf\~id"rtn!l IlIkinq Ktian ageinst the debtor or the praptrf"l of V'IB ditbtl1f' snQuld relllltlf 1 1/)2 I1t thIP lI.mkroptc:'f tlMt" ,lnfJ mu'f 10111010 to ~ttl11c '''9;11 .ldYlclt. 'he Itaff of the ct.r" of th. banlLruptcy court I~ not pVI'1fti ttcct 10 lJivl." t"!Ial 1MJ\l'IC'. MIITlNG OF CltEDIfO_S. rh. debtilr (born h",s~n:t M"d "If. ill. ,011'" Cot'.!.,) l!i I'tQr..dl.d to IptNdf tit the: !l1Ct'f1t\lJ or ~'I.'ttl1or!t UII u,. dill. ..-1d It ChII' pllK. set furrh olhove tor thfl' purpo~fl' II' IWlrtl] uumilll",' Lt'\dt:". ",.rh. lUtlt,,,lllfl"'~ hy C'1'!:di r.,,~ II:' till' .....t In'l II ...,c:~, bloIc not rll'QlJirCl'd. 41 rh_ tlCetinw. rh.. cr~'f.litlll" I'l'l.ty elel'l ., '''1I~'~t." flfhpl' InUlI th.. \If'~ nU.llt,.1 ,.j".vc. ,,:1'" f., ,..-.. .llt.. Q' crlchlon, .......In. UI. d.htor, M'Id trllfw<..cf such oth.!( blJsinl/$~ .... m.:JV ~ICJjll.'rly (QI!fll.' l.....Ir.r,. 11'1: "M.,"l""'. "",.' lW""'III"J ..y be conrirlUld Of ~JourJWd trOll tlllllt to Ilmr by noticft At the ",,'1"9, Wllhuu1' ftJrlher wl'i",," null'" tll r.1.~.t(,lJ"', LIQUIOAflOH 0' lItt DEarORIS P"OPEATT. 'hit tru5t~f vB\ colllfct Ih. d"blllr'S proplL',.tv .v'Id r",,'11 AllY rhi'lL i:f nut uc:qJl into lIDO,.,. At 'hi, ti.., however. ir 1PPt:8rs trail rhe ,ct'l9llJIH 0# lI"r ch.-htor' Iholt th.r. are flU :'j1UI:l ,,'unt "hleh UflY tliUl'lbul.illfl GM\ bt IMld '10 credllor.. If ~t. l.t.r dotle It .pp4.1'1 char th.r. Ire DSSOlI~. '1011 ..rllen .Ilhstrlbuliun ""lY ~ puid. tI,,~ C'rfodil'l1r!l will be ~tl"ed Ind giv.n an opportuoiry 10 fill ,tAims. lXVII" PROPfRn. Und.r statlf .,-,d 'I'dtral law. thtl' debtur i\ ....r""lt~ Co Ic.,~p cc:,.tai" money or prulJ"'rt'f'~ .-u",.,r. It 111'....1110'" b1fti.v" th~t an lI'.~tion 0' ~v or pru~rfy is nat eulh:- IZed by tdM. Iht cr~ltor ~y file .l" Obje~tiun. Nl ~icttlon ~5t be 'Il~ "ot I.t",. rh:tn ]0 Goiya. ~fUI' the r:ur\t;IU:;lor1 II' ,'1.. ~~tl":l I." r.r~It<:lr'i OISCKAIGI 0# DUT$. fhe dltDtor i. udllnIJ . di"ch.uge ot l.Jt!UH. A dllll:ht,lryct /fItO.lnS thlH l.;",rl.1111 ch;lJl'.. .f'" lNlUe ..It....lllnr(~ul.ll".. qeinlr the dtbtor pO'rsonally. Cutillors who", ".iQ\S ~9(1inst Ihl debtur ore dlsch.1rgcrd NY nev~" fille,. olelilJfl uq.t1"fU lhv d,.IHl1l' 10 collect the disch.rgad debts. " . cr.d.tol' bclilvu tho'lr tft. d.bflll ~ho....ld I"Ut receivI ,,''f rtI5c""r'1~ 11' Mbl~ yndp, ~ rl7 u, I". Bar.kruptcy CO'dt or tt'let . dtbt owtd to th. c:rt'ditor "Mt dl:sch..r~Qabll" ur'dtrr t 5lHII)(l), (4), 0" (6) of rh. .""It'llptCY Code. ti_lYlction ftJ!:t bet ukll" In th'! bankruptcy court by thlt d'.1dlll", 'ut forth ItxJIW In rhc: UoJl l,~blhod "0i!iI'''M9l" uf DebU." Crwd'ltors con.idtPrlng ull.lng $ur.h .\i':non N., ",i<)h to seek \~~d' o1dvlc~" To order coplt'$. sCf'd r.qu..ar: ..,,,h c.h.cll poIy..ble tU "OUI(\IJIl':j copy ItillvlCE" wlrh 0 'u~lf .:K1dre"norJ ',rnq'.11 cflvI..lolI" I'll 'Ih. ~lI'SS of c\.I'V: of court ahc"'e. ClJ!;I.t 11 1.'10 p4fr Pd9lL Schedule~ of [rf"tji tur~'~ f1;:'9C"t, ~lI1'lr", pllti l im' ~: p.J'JI.''J. DO NOI Fill A PRom 0' Ct.AI.- IIIHl~~i you 1Il;.C1 IVI A (OORl fill I II.' Tc. OU ',11 '4r th. Caurt: ___-.-- ____._.JIlIII!:S;!~ftr_~_,'i_~I.'.L_. _ Clltrk 11 tn. lIanll'"'411r.y (Of,Jrt _A\JIj"''it ",!l,.....J'n6 nufll III l.) \17 I ~ I" I \ \ ; l; -.: I: It, I ~, I 11,1\ 1 \. \I~ h'. . III I. / I,ll I lINTTP.D f,'I'A'I'~!:i IIANKR1TT"I'CY COIlIlT F'O~ 'I'IIE M 111l1l,t>. DI5TRI C1' 01' PRNNSY1,VAN I A IN 'I'HE MJ\'I"I'ER OF GL~:NN E. arHlN'l' t/tI/tl/.. fl , Fl CONSTRUCTION , HOME lMPIlOVEMENT COMPANY nod DEIJOIlAII I,. HIHlN1'. t./d/b/" U '" 0 CON;,TRUC'l'lllN b 110m: tMPtWV~:M~:N'I' . CA~;F NO. 1-%-0204J CIIJ\F'TER 7 I).' III (\ r!:: AMP.NDHEH'l' '1'0 scm:lJlIl.F. " - CREDI'l'OIlf, AOT,OTNG UN:;EClIll~:1l ~-'-N()NPi( [0[( 1'l'Y CLA lMS-:-piilUaJAN.T. '('0 IWI.I;:" 1 nO'I' COMES NOW, the above Dehtors ilnd tiles lhc fDII.D\o/I.n~ /'JIlandmant to Schedule f' - C",:,clitor!l HoldinC} Un'J<:,c'lIu,,1 Nonpri(lCi I 'i Claims. CREDITOR NAME AND ADDIlE!>" DATE CLAiM WAS INCURRED CONs!orfRA'r lON ~'OH -Cr.},:tM ---. C J.~ I M IIMrll INT LeRoy Deputy, Jr. and Roxanne Deputy 828 Baltimore pike Gardners, PA 17324 $35,441.. 4) 1995 construction Marcus A. McKnight, IiI, Esquire IRWIN HcKN1GRT & HUGHES 60 West Pomfret Street Carlisle, PA 17013 REPRESEN'l'lNl.; - LerDY 1.l('l"ull~', ,I' WE HEREBY CERTiFY IInder the penalty of perjury that the within amendment is trlln anJ corrnct. .~~. Q::2 E. Bruflt: Dnte: q. ]Ll rY-i Date: L) _. \ L\ .. q-~ l~~~<\t~:-. Jl.~.k Dcuor"h J.. I1r"" I.