HomeMy WebLinkAbout96-02284
~
I' ~ I
I
'. 1
i I
!
I
I
I
.
I
I
I'
~
~
"
"
"-
>"
I,
I,
i
"
...
/,'
J
J
/
.
C_WI"UN or 'INNIYLYANIA
- coui, or c_N-,iiAI
NOTlCI 0' APPIAL
fROM
lUDlCIAL DlIY.ICY
DISTRICT JUSTICI JUDGMINT
Noli:. I. given thot tho appeIlanl ho. filed in the above CaUft of Cammon Pleo> an appeal fram tho judgment r.nd~.d by lhe Oi.trid Ju,'iu an tho
date and In the co.. mentioned belov<
COMMON 'LlAI N. % - 22 8lf t~ r VIAtv I
. . ----- I
NOTICE O' APPEAL !
~
I
I,
r
~_.._--,. .-.-,..-.---.,.,---,.
RIWo~u.. H F,~€ EI)
ADE.mOP """'LlAN' _.---.- .--~-.-. .---.-...---- .
f.S<I fA} N~wtoN Ru€..
-sw~~~' 9;--..~~=Q~~;~~;';~ ...
QAlMNO.
. -iii;,;'n-h",j}--~--' -..---. -.. -.---
Il/rjf Sp<('la 1151~ ]~':.. f!;jND~L' II Fret'cl
[!iGNA\UiI .ll' ""lirANI(il'~ ',lfiliiNlH,'-A<:.Ifll'" --.------, ------
~~II:~M_"~ ," <)~ ... .. _ ~,~dtt~~,.?!~!~~_~'.!.._.._m' ____,.
Thi. block will be IiynId ONLY when Ihi. notohan " ,oquirod Undlf Po. R,CP.JP, Nc> /I appellant was CLAIMANT (see Po, R.G.P,JP, No,
lOOn.
Thia Nolie. 01 A_ai, when received by tho Di.tri<.t Ju.tico, w,1I opll'OIo 0. a 1001 (6) in actIon before District Justice, he MUST
SlJPERSEOfAS to tho judgment lor po.....i"" in thi. ca... FILE A COMPLAINT wIthin twenty (20) days alter
filing his NOTICE of APPEAL,
0'"'
t:;:rt't'l/'s bl.<,-',
.[""'il'billH1l'OlIol'Ml1>lbi'- .,-,.... -.--
~/",r V I'JJllil/U'vF
. '...".,1.... .-...- ..m.._... -'--T~
P/I /r,,<, I
------------ --S,fjlilrlire (Jj 'Prothl)(lIjiiuy 1)( Ot.'fJ(Jly
_n ___________.___ ...._ _ _ ----- ~- -.----~---
PRAECIPI TO ENTlR RULI TO FiLl COMPLAINT AND RULE TO FiLl
fThis see/ion 0/ foon to be used ONLY when appel/lmt Wol5 DEFENDANT (se'" Pa HCPJP No. 1001(7) /n nCI/OIl be/ore D/strICt Jus//ce,
IF NOT USf'D, detach /rom copy of nol/cL' 0/ appeol 10 be serve<l upon appollcc},
PRAECIPEL To Prothonolory
En... ruIo upon __,JJ.&>L',o"s.L.!!Jt,L ;5e.f~!~!HI.r....!.t! ~_n.__m ____ ,oppell..,(.), to fil. a camploint in thi. ~
Nlln'IfJ 0' .1t.lJfJ/lt'I>(.'i!
(Cammon Plea. Nc> ~ - 2- 2. f3 :f....~ T ~~ within twenty (20) day. oftet ...vic. of rule or .ul entry 0.1 judgment 01 noo pm.
,,;J
RULE, To~S"~<ll/tt! /l/6r ;t.":l,~'~~"(nnn{A.'_~,oppell..{tI.
Natno 01 ~sJ
~ a'~
. 4' - Sq1aI'lXe 01 a,:veIJWJt 01 rns aNomey 01 ~
Il-~N-"j2li 0,)
8'36 - 8-3 ':rs- (Iv)
( 1) You en no~fiod rhot 0 rule i. hIIeby en"".d upon you 10. file a comploint in thi. owool within twenly 1201 cloy. aft.. the dote 01
IIIviee of tN. rule upon you by p."onol .lfvie. '" by certified '" regi.,entd moiL
(2) H you do not file 0 comploinl within thi. ~mo, a JUOGMfNT Of NON PROS WILL BE ENrERED AGAINST YOU,
(3) The dote of ....vic. 01 tN. Me if ....,ke we. by moil i. tho dote 01 maiN"",
lloIe: 1'-~9 ,19tk, [Jt-~.!t:L d, n[U~,;,,!!!:.c.~t1t'i-,
~J'l"
COllR'f FILE TO BE FILED WITH PROTHONOTARY
.-
--...,........---......
.
PROOF OF SERVICE OF NOTICE OF A~PEAL AND RULE TO Fll,E COMPLAINT
COMMONWEAL TH OF PENNSYLVANIA
I TlII~ pllJdf IJltJllfY/1"I] MUS! tJE riLl; () Wlli'fIN TeN f ItJllJA '1'.'; A' I en '"lllfJ fill} .')11(11 rJ IJI jlPO~jll CflOl;~ tIPlJI'!.-iltJlu IJOAl}lil
COUNTY OF ; II
AFFIDAVIT: I hHel1y Sw.w m 1I111f'" '1101 I "'".<J
{ 1 .I t . ;p~ I)' 1/11' NIJIIU~ l.:f App.:.ll ClJIlIIIIO/l Ph!IHi No _.. , Ilpl," lhtcl DHHtlct .Jw;ttCP. Iftlhlgn;thHll/wl pm I)"
II/iiltln' ,~I/'Vh;l}) 1'~ . _,.. [1 1)1' PI!' ~~l)'lil! til'rVh,:H CJ h'y (CIHllfl~d) (t~UIl'iICIl.H1) 111.111, :jl.!tldt."'~
t11Cf~lpl t3ll/h:htHI hl1/1ilr), IJnll lJpnf1 ltw ;1PI)l1111111, (n.""'J) ._.___.01\
. .... ....,-- ,IU. - - ::lliy ptq,,'~tldl ',I'I'.ll;l: 1. '/lly (,~l(trldll)(Jj IUJ'Jj~;II:,tl.ldi 1111111. !:i1J/hh.'f') f(!U1IPI HIIIH:tHid h~r(!tQ
[] ,II'" 1..'11"., 11,,,11 ''''IV''') II", 1'1,,,,, I" I"".. C",,'I"""" ", "''''1'1111, ""I"'" ,iI".)v., No''''" 'JI/\pp",ll "pOllllle "l'poilc,Hi) 10 Who,"
IIIP nlll,' W,l:i Hddll:'SH'd 0'1 In ,fJ 1)'II.ll~':',')/I.11 ~;l"\lI(fl ['J hy' (((~lllllnt1) (roan)!11rpd)
tllll'l, 'it~nI1t,Ir'r; m':ldpt nllil~hl.ld IWIIJI'J1
SWORN (AFFII1MEDI AND SUll~iCnIIlU) IlIJOHE ML
THIS__
DAY OF
.HI
SIQnllllll1l (II ,)1/". "jl /:/1/'", 1~"!)nI ,II/II/II,,, l'ril!; mil'l11
-----------_._...._._-~._-_._..__.._...
71"'0101116'1
'.
My COmmil'tijlon '~)lpHt!!I on ___.__________...__. IU'____.
SI~f/;Jtu,11 of U!fI;Jnl
~
..1b. r,;"...t::. ,00,
4: .~ '"'
~ c::. I:" " .l
C )
~ "', " ."
;>,
.,.\ ~~ J
"I
~
...? ,,,
. ,~
~~ (~
~4
':f:.."
t
v-> V)
-J.....
o()lt'
).>
~
I~,J
I
I
I,
,
i
I
I
f
,
f
r
i,
I
It
II
i
I'"
;
COMMONWEALTH OF PENNSYLVANIA
COUNTY OF: CUMBERLAND
- . -----.,---_..-------
---------
"'10 ()1It Nu
09-1-02
OJ Name hon
ROBERT V. MANLOVE
1901 STATE STREET
CAMP HILL, PA
r_, (717) 761-0583
""d_
17011-0000
RANDALL FREED
654 W. NEWTON AVE.
GREENSBURG, PA 15601
NOTICE OF JUDGMENT/TRANSCRIPT
PLAINTIFf' N^~I:' MntI,Al)[)HI "II
rxNSURANCE MGT. SPECIALISTS, INC.
2114 MARKET BTREET
P.O. BOX 192
~AMP HILL, PA 17011
DEFENDANT VS.
r;; NAME Ilnd Af.)()f'f 56
FREED, RANDALL
654 W. NEWTON AVE.
GREENSBURG, PA 15601
L
Docket No,: CV-0000040-96
Date Flied: 2/08/96
THIS IS TO NOTIFY YOU THAT:
Judgment:
00 Judgment was entered for: (Name)
[!] Judgment was en'ered against: (Name)
In the emount of $ 7,692.34
D Judgment was entered against
Landlordrrenant action In the amount of $ on
The amount of rent per month, as established by the District Justice, Is $
D Damages will be assessed on: (Date & Time)
DEFAULT JUDGMENT PLTF
INSURANCE MGT. SPECIALISTS. IN
FREED, RANDALL
on: (Date or Judgment)
D n,ls case dismissed without prejudice,
o Possession granted,
D Possession granted ~ money judgment Is not
satisfied by time of eviction,
o
D
D Objection to levy has been lIIed and hearing will be held:
IO~
Time:
Possession not gianted,
Levy Is stayed lor _ days or D generally stayed,
J:"
~4/96
Ina
(Dale of Judgment)
Rent In arrears $ __,
Damages Unjust Detention $
Damages to Property
Residential Lease: $
Less Amt Due Defendant - $
Amount of Judgment = $
Judgment Costs $
Intllrest on Judgment $
Attorney Fees $
7.603.34
8.~.....QQ
.00
.00
7 ,69b..ll
TOTAL
$
]
ANY PARTY HAS rHE RIGHT TO APPEAL A JUDGMENT INVOLVING A RESIDENTIAL LEASE AND AFFECT/NO THE
DELNERY OF POSSFSSION OF REAL PROPERTY WITHIN 10 DAYS OF THE DArE OF JUDGMENT BY FILING A
"I II"
NOTICE OF APPEAL WITH THE PROTHONATARY/CLERK OF THE COURT OF COMMQtJ P!-fA~PlVlt'J;?IVISION
ANY PARTY AGGRIEVED BY A JUDj:I T FOR, 0 Y OR A JUDGMENT INVOLVING A Nci'lRE IPE~w.. l.EASE
MAY APPEAL WITHIN 30 DAYS OfEI ~'T DGMENT BY FILING A NOTICE Oft~PPeAl I'TH,JHE
PROli 0 OTARY/CLERK OF T ~ ~ 0 ON PLEAS, CIVil. DIVISION, . '
{p Date " ' .~ l _____,___,__,__,__~__'___, ~,,~tnct Just',ce
I ~~1'pt ~~'_ Ihl Is :t~u_e_ an 'U rr /~J~rec:r~_~~:~:~e~di~~~ con:~~~~:~~:~t~~~J:~~;'~e
~ss'on expires f,rst Monday 01 r;~ry, 2000 ' BEAL
_,ope 31~9t5
, ,_NWIAUN Of "NNlnYANIA
r--COU.' O' COMMON'LIAI
1_ JUDICIAL DllnlCY
"
,b-,--=-=:=:=-=--::::::-.=-,:,: -- - -
NOTICE O' APPEAL
fllOM
DISTRICT JUSTICE JUDGMENT
COMMOMmAIN.. % - 22 8'1 c;..,![(/lA.v
NOTICE Of APPEAL
Nolie. II 91_ that the appellant h." filed in ,he above Court 0' Common Pie". an appeal from Ihe judgmenl rendered by 'he Q;,lrict JUllic. on the
dole and In the co.. mentioned below,
...... or ....""'" ,-'----- d'___ _,_ 1"..0 bill-NO OitlA..IOIlli- ___d_ -------
i.1///::';:; tL F(;! U~~~I(Y l/i,;,"r;,~\;___~_i!~!'/~"_"~IOCOOl
t.S'-I Iv /JEuJ/Of<) J4L1t., C;rNI/"$ hvrr- P/I IS,," 0 1
Qln;~:r 1'/(, '-'d~~7u~~'~~i;'~- I,~_f .s,XL,/~-,,~t~-'l~'.. ---;.i~~~~.-:-dl;:i''''F(;;c/ --,---
-~ \;::=~:~~:-~ ..r~:::;'Z~::,~= ......--
Thi. block wiU be oIgned ONLY wn...lhil "o'ohen i, required und.. Po, R,CP.J.P, No. If appellant was CLAIMANT (see Pa, R.C'p,J,P, No,
10088.
Thl. Notk. of Appeal, when received by lhe Oi,lrict Ju,lico. will operoto '" 0 1001(6) in act/on before District Justice, he MUST
SUPERSEDEAS to the judgment fo< po"."i"" in thi, cm.. FILE A COMPLAINT within twenty (20) days after
filing hiS NOTICE of APPEAL.
~---_.~'SliiniJItJrf!"iIPriith;)nor.lrY oioiiXit:Y-- -
----~._--_.---- ,-- ._-,--_..--- ,.
(This section 01 loon 10 00 used ONLY when appellant was DEFENDANT Iscc Pa, HCPJP No, 1001(7) /n aCr/UlI belore D/slllcl Justice,
IF NOT USED, detach from copy 01 nol/ce 01 appeal /0 00 serv",1 upon appellee)
'RAECIPE, To Prothonotory
En... ruI. upon .III.!. 1/ n. ",U!,..~itL_ c':;tl!: ~ IQjl}f~_J.!:!...l,.",_,___--,_" oppel""'("" toflle'JcllmP\s>Iil.,in ~I. ~
NiJilH1o/ll{.VCl!etJ(S) .l' ' j" .
(Common PIoo, No. qh- 2. 2 g'1..t.,~ifI~ within lwenty (201 day' ofler ,..vice 0'-'''' 0< Ivf';" ~~y,,,,.iurJ9';'ent of non pro'
, /
i't;'~K L!ru/--; I~~;~<
, SiQl1lJtUfe 01 awellant 01 hIS alforney 01 agent
'-'-'RAECfPETO ENTER RULE TO FILE COMPLAfN'(ANDiiliiTo-'iLE
RULE. To JIfI:;c.iIQn~(' ,/Ilf" -Yffl..,41"t ZlIl,._,oppell.o(I),
Nome oIll/,"f)OIW.'i}
(1) y"" en no~fied thot a rule i, hereby entered upon you 10 fil. a comploint in thi, oppool within twenly (20) day. ofler the dote of
...vic. of thi. ,"Ie upon you by p."onoll..vke '" by c..tified 0< regi'tered moil.
(2) W you do not file a complainl within Ihi. time, 0 JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOU,
Date:
r-J.'I
(3) The date 01 ...vlc. of this rule if ...vice wo, by moil i, lhe <late of moiling.
(1,// . I...
I )~ tldli:r,
, 19't.f_,
{J, ) ~,ft {!~;" :ftt.:::-~
1JC#IC 31:1.14
.....-.~._-~..-----,...._._..._.--..._-,~ __._.__.......____.__VMj...~___..._._.._._..__...__._..........r__.._....__
PROOF OF SERVICE OF NOTICE OF APPEAL AND flULE TO FilE COMPLAINT
(Thl... (Jluof Il( ,~"/V;,,/l MU';' hI- Ou U V\ill ,'/IN llN i /,]1 (.lli \",; AlI'tf{ Iflill~/ tllr' ,'I,dll'li (If lIP/JlJ,JI ChtJd.. i/(lfJ/H..Jlill' L'<JlllJ~)
COMMONWEAL TH OF PENNSYLVANIA
COUNTY OF
,II
AFFIDAVIT: I h"'1""', ',,","M ," """111 Ihol1 .",,",.1
I~, ";', '" II)" ~J"'",, ,,'/1/1"" C'''''II1,'I> l'loi,i', No) .lt~',i/!''tj'1~N~,'~,~)[ Il";III" ,11I'i'I>'" ,1o'",~ln"I,"I/"""", '0"
rdilfl/oJ(')/Jllllt,'li) '1- 29 III 9<.. " I' Jll11'1 Ird 'jl ". I'\.11((,,,rll'I..oJl(lotUI'(l'IPdjI11dil ',"llh~t"\
rr~(,l'lp( ~lla(~~ld IH~'tqJ), I~d IJP.nn till' iqqH'I'", (11',II'HII, Z"':;"t'H';(f me;,r S:ftn~fa.J,s'- +Nl!_ 'ill
-.. . W.. J. 7,-... , If!.1.t 1 J Iii pl1j')Ojfl.l1 :,1'1 \" '.~r,I" ,'1111t1 r." ""1'.1 " '1'1"', I,', "1[:1 ,llt.!1 11,.01 h.,(~,t,)
V;:nol I'll U'j'! II ht!I'I'l \;1 ,j !tHo I'IJI. I., r.I,' ,j ( ,:;):1:111" "1 'J '1 ..' o. 11<.' "'I J ,.,ji IJj I II" dJJ!.'vl!t.)Ij\.} 10 Whl)f!l
IIII' nidI' 'J,iil', Hdojl,.,,~,.;d "II 'I. .,.2 9 0 ~ " I", I' X' I" f'I'''lt1'(q!ll!t~(.lI~""pd)
llldt!, ';I'nd.','" Il'OI'I'lpl ;lIl,whl'd tH:lntn
SWORN IAFI'II1MlcIJ) ANI, '.,1 ;11.','
THIS ./4/, .I)AV()F
I
Jill!!. 1.1 r~(' r (lHt
I J ~+-";
ME
1'l 9~
~fWL ~JA~ d__,__
. S'IlI1/JltUfj of "ffldnt
,
0:' ( 1uL-
5,,;,,;7,,,, 'II",,,.' liVI'''i ~bt~"lI,.S'.~rt .,' ,; d. I
~~,~ C!",,,, Nolary Public
-(;N';;,;"; .r~"'~ j .M1COmml:io~\"~~;;:'~~~. ~~~~~
My c"mnl'~Jl\IlI'~'1lIa or. '.",,, "l. --lL$:
(~' ',,; ..,J
'~J' I ,
-")i! ,
f.1};, , i;J
, '. ""9
c' ' i':-
,
r; , ' ~: ':'''1
,::]
j~: :1 :"":)
\()I' -)l1l
I
r.- :\1
,,-<. ~"..,
P 337 '115 283
P 33? US 284
US Poalul 511~ICij
Receipt for Certified Mall
No InlSUranco CO'i(oril(jo PflwltJed
DQ nol U61) ~2!~!).!!llo~~U~.~~j!l~!:,~-'LI}1:1/,'jIJL
II h) - .-..
'" &m., i#"!l..5f,u.,;':. ,_.1 /J_,,-__
Ie mbe,
,)/10/. J}Ja'~"'-JLiY!<_e9.l..
rO~"':lCr"'IU
,u,u 11 ,1?C,'f.__
P""U' .____ ~__,_ J~__
Cltr11~~~____ -L~._LQ~.__
5pf)alllOllllveryFr",
US PI)/jlllt Sllr\'IC'
Receipt for Certified Mall
No 111'5Uf.lfl(1J C')..,.HrUljtl P'llVh11Jl1
'~!) ~ ~~ll~Y_! ~~ U' !!~ ~!:'!~ ,r! !!l~.jl!_.~j .1,1.1.0 !~t! !.!!!:'!1-~~1
'~ljJ
. '2i:!fN,.t...V,I!!.~A-'''-c'',(Ir€~
;9.~ A _11':~~lft" S' f" m+_u__
iz.;J1~ ",;;" D,r'~';';~~;-;;"~
--, HLlLl?! '...,..,_ (J
$"..J..a,~
j.j_ 0 _..,_
P('i,II\\JI!
r"Htltwdf'"o
'3PIl<111ItJtlll,IU~ h'"
.-[_~J ~ __
--.'.--.----.- ------"..-
8!
RIt&lnc1~Oellvl.I,.".FQl)
-c
HfH,tJld.~1 DIIII"'!!}' rou
III __
3J jil't;;;;l'~fl~';';ISi;'J~~hl-
,": !y!l,:m&U;lIIlDfllrvfltnd
ii fl"I;;;;;fl:;I~~~";i~;~I~;i;;Y;;;;~.
..{ OII!l'AMtllf<\Wf'iA, ,
g
~ P1lbtmmtlm
S
,.
ii.
L L~_~=
~. ~O
..-"'_n___n__;.~ _. _....
I
!
~
"
II r
".J
,
'. ',.
,
I
"
,
J
V
I
I
.
INIURANCI MANAGIKlNT I.ICIALIITI,
INC.,
I IN THI COURT or COMMON .LIAI or
J CUKlIRLAND COUNTY, .IHNIYLVANIA
J
I
I NO. 96-2284
I
.
. CIVIL TIRK - LAW
'laintUf
Y.
RANDALL rUID,
Defendant
_OTICI
YOU HAVI 811N 8UED IN COURT. If you wi.h to defend againet the
claim. set forth in the following pag.., you mu.t take action within twenty
(20) day. aftar thi. complain~ .nd Notice ar. .erved by entering a written
.ppearanc. per.onally or by attorn.y and filing in writing with the Court your
defen.e. or objection. to the claim. eet forth again.t you. YOU are warned
that if you fail to do .0 the ca.e may proceed without you and a judgment may
be entered again.t you by the court without further notice for any money
claimad in the Complaint or for any other claim or relief requa.tad by tha
Plaintiff. You may loe. money or property or other right. important to you.
YOU IHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. II' YOU DO NOT
HAVE A LAWYIR OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE OFFICE lET FORTH
IELOW TO FIND OUT WHiRl YOU CAN GET LEGAL HELP.
COURT ADMINISTRATOR
4TH FLOOR
CUKlIRLAND COUNTY COURTHOUSE
CARLISLE, PA 17013
TELEPHONE. (717) 240-6200
,
IN8URAHCB MAHAGBKlNT 8.BCIALI8TS,
INC.,
IN TNII COURT or COKKON .LBA8 or
CUIIBIlIlLAlfD COUNTY, PBWSYLVANIA
naintiff
v.
NO. 96-2284
IlAIIDALL rUIID,
Defendant
CIVIL TIIRM - LAW
COIIPLAIIIT
AND NOW, comea the 'laintiff, Inlurance Nanagement specialiata,
Inc., by ita attorneYI, Ronald D. Butler, P.c., and relpectfully avera the
follovin!II
1. The Pla~ntiff at all time. herein mentioned va. a corporation
organi.ed and exi.ting under the lawl of the commonw.alth of .ennlylvania,
with it. principal pl.ace of bulinell at 2114 Narket street, CUlp Hill,
cumberland county, pennlylvania 17011.
2. The Defendant, Randall Freed, il an adult individual re.iding
at &54 weet Newton Avenue, Greenlburg, We.tmoreland county, ,enn.ylvania
15&01.
3.
The .laintiff i. an inlurance agency.
,I
I,
~ '
"
4. The Defendant i. an independent contractor working for
.laintiff aa an inaurance agent.
.2-
l,
t
I
, '
5. Defendant entered into a written Independent Agent Agree~nt
~'
l
t
I: '
. '
with plaintiff dated Auguet 15, 1994. A aopy of Agreement i. attached hereto
I ~
,
marked Ixhibit "A" and made a part hereof.
I
I
6. The inauranae i. written by Defendant for penn Treaty Life
In.urance company. The Defendant wrote certain policie. and retained a
portion of the premium a. hi. commi..ion. Some or all of the policie. were
not i..ued by penn Treaty Life In.urance company. The premium on the.e
policie. were .ub.equently refunded by Penn Treaty Life In.urance company to
the individual purcha.er.. Penn Treaty Life In.urance company thereafter
recovered the commi..ion. from plaintiff.
7. Defendant i. oblig.ted to reimbur.e Plaintiff for $7,603.34
repre.enting the commie.ion overpayment. through october 31, 1995.
.1,
8. plaintiff ha. frequently demanded payment from Defendant, but
Defendant ha. refu..d and neglected to pay the entire belance due and owing to
plaintiff in the amount of $7,603.34 or any part thereof, ae more
particularly .et forth on Exhibit "B".
9. The entire balance i. pa.t due and pre.ently owing a. e.t forth
on J:xhibit "B".
\
-3-
WBlftlrOftl, Plaintiff demande judgement againlt Defendant in tha lua
of '7,'03,34 plul inte~elt and the cOlte of thi1 luit.
Reapectfully submitted,
;!i! (j;Jrecr-
Ronald D. .utle~, .aqui~e
Atto~ney fo~ Plaintiff
I.D. 10982'
300 No~th slcond st~eet
P.O. Box 430
Har~i.burg, PA 17108-0430
(717) 236-1485
\
-4-
t
INSUH^NCE M^NM;EMEN'l' SPECI^I.!:,'l'S
1l1,1 MMlKl,'I' ~;'I'HEr:'1' C^MP 1111.1., P^ 17011
J
I NJ)l': I' 1,:N l) 1,:N'l' ,\ C 1,:N'l' ^ (; IU,:EM 1':N'l'
I N.';lIl0\NCE M!IN^GfMEN'r SPECIflLIS'l'S ,ITS SUIIS! IliA Il I ES AND AFFII.I,\TES, (lIEREINAFTEIlIU':FElllWIl TO AS '1'111'
',1\ _ I ,,'~\ '\" (lit .JOINTI,\' AS "WI-:", "OI)1l '011 "1I!,"), ANIl 'I'm: INIlEI'I':NllEN'l' ,\(;ENT NAMEIl IIFltEIN, (l1f':11EINM"I'I':1l
I 1.1 I 1:I;I,1l1 () ,IS "\'llll", "YlIlIH" Oil ","OUIlS") INll':NilIN(; 'IU liE JllllINIlIlEIIEJlI', Al;IU,:I,: AS Hll.IllWS,
/<','Id I, Illll'h\' i1l'POIl1l\ you II) ~()II(.1t ilPpli(illIlJll~ lor alllorlll~ of 1.lre illld Ilc,dlh IIl!\lllnnCl.' ,..oycrnIIIY 11\l~ "gll~l'1l1l'll! Ill!
II" i (lllll',ltll'\ \', hl~ Ii till' l\gCll()' l\ ,Illtholl/l'd to I l'jll 1'.'\l'll I alHllo 1IIlIlS:\t:I b\l',llll'~'l jl\ 1l~'lcillalll:1 ~,t.'t 1\lIlh, 111\11111111'- ll'III'" ilnd
"", ,iI IIlI', /\!'I~'l'lllCllt '''"'lll11tllhl' Stille '11 TI'ltJlI.H)' 11\ wllil..11 ~'llll ,lie lhily Illl'I\\cd III sull<,:il ~,lld\ 11\~;III.lIHl' 1\)11 \h,1I11I11I h'
I, 1'1'11",\ III ,\11'" olher 111'dllilll(l'l.lllll\llllJIO ~J1 alll'lIll~:'> ,,,,hde 11\l~ l\gll'l'l!lt'IIII~' IIll'1fl'(t, \~'illlu\li Ihl" 1'^pH'~", .ul'I:ltll.l.:, WillI!;,
" 'I III Illi' /q',L'llI..:.'
il (1'1111(/1 Y I', filii il""q~lIl'd I' ~dU~I\'d)' 10 yuu and till' "\~!l'lll~Y npfc~!)l)' rl'~\!f\'I::, Iq 1l\l'I! 1111: nl~hlll) ilJlllUlfll WIIIIII1 ~,i1ld II'IIIIIH~' I"
,;',.1 l(t ';1111 h:IJllul y, t)tlll~1 11l'1~()11" <II \lll',illlll.illllJlI\ 10 ill:! 011 It~ l).,:half lIH'ICJll.
" ","1 q' ,jllOII Ill,'" h~ l!lad.... ;\\ 10 YOlll ,:11:11 tll.'lt:r, l~l'nCI ill H'Plllilliilll, p~l~tlll;ll dial ill'II'll.'>II1':~, Ill'"lIh illld lllllth: III II'''II\!'. I nfollll,llH:I',
,I 'I:~ :.ll\ II 1I11111111' 110m: I" 11\i\tk, IS av,ldable tu YUllllpOIl wlitlt'll IL"PIC\1.
I~! I SJ IONSIIII' OF '1'1110: l'AllTIES
11'\1 ,ll,dl hr f'l',l',lu 1",I~ICI~,C YUill (JWI111\lkpel\dL:IlI"J~ldgl1\e111 a~ lu the tlIllC, placc ilnd ItlilllllCr III wlndl )'llll Pl'IIOlIl\ tile.' !'it'IYIl'l",
,,,\1,"11:1,..1 1IIIlkr lIu,\ A~~ll'ClllCllt :'>llhl\~U 10 illl)' lUlc~ illHlrL'gl1latlolls Il1al we Ilia)' 'ldopl fl'OlIlllIllC In 1I111L' f.'t1I\Cl:lIllll)' {l.l~ ('01\11l1L'1 0111"
"t!" ' , I 1,\'1'11, (l III H'lli ;llld 11\11 I nil:! It:lllll'", Will! )'l":'1I1 Ill'cd0l11 llr a(IHlIl You wllll;c all lIHkpL'IHll'nl (.llllll adlll ,lIld 1100hlllg I.:UIII;III\\,I
'I II,d\ tl" ({)I\\lll\t',l as Lll'illlng tile Idalll)Il~;hlp 01 cllll'lnYL'1 and clllplu)'\.~c hctWC~'11 ynu Illld "'I I'm any IIUII'\O~1' Yllll willlHlI I"~
',,',1' ,i .1\ ,1I11:t1lpl\f~'n' lor ;lll)' lI'il"UIl, II\eludlllg fell plllpIJ5l:~ of the.' 1,'cdL'lnllll~lJrall(:f.' Cllf\llllHlliollS ^cl (1:IC:\), Il1r SU~'I:J1 Srnll'lt) '\l"l,
,,',j,illll\l'Il'pl(l~ 111,"111 TiP, '\((, Of IIILlllllC. Tax \VilhllOhling Yml :ibidl hI.: 1l.::'POllsible lor "lid pa)' ;111)' :lllll illll'\Ill'I1Sr.:~ illl'Ulll'd I"
" IIII~' 11\1',1111 ',', 1Ilh.kl' Ih,: Il'l \\l$ llrtlll~ '\I.',If.,'ClllCtll You ill'(, flul clll'.\bk 10 PMlt(lp:IlC ;11 ,IllY llilll',l' h..: fll.: I II Ill\)!'I;II1)\ \PClIlSUI~d h~' \f',
,;: llllphl)'I'l',
:II~ t"'llnll\l;IIllI' lit' ,)I\Y ilJid all or )'11111 obhgilllons ;1llU l!\ttll':l heIL~\lIHkl', YOll ~hall l;...; nclillll (Ill YOIIl own ~'f,:l1,lll alld nUl .1\,
\ I, Ilil ,'1;(, P:lfllll'f tH d\\uc,:lall' 01 lh~ ^gCIICY, Illld YIHI ~lJallllol huld YU\II'5t:lIllll1 ill i111Y C;\IH1Clly uther Illall an 1Il1kl'l'lldcnt "l!CIlllll ,':
,\iill' (,Irlll.:f, 1\11' ',', hl~ 11 YOII IIle ;lllllwI I/.CO by ~llt,h c:arIlCI, ILl solicit ilpplkillHlI1~ fur Ide and health 111\11I';\110:.:1.:. Yml ulldf..'I~taIHI al'\:
liLlt )'\1\1 ill~:;1 full linK Llk ilnd HClllth 11I.\llrall('c ^l',Clll ;lnd :Wf..q>l thl.'.IC";p\lfl~i1brlIIIC:i 01 all irul('.pCI1~kllll,'IIl'II.11hU'
"t I, r',II)!\IFj\T~i
illl, /\:!~II(> ~11,1111l1.'1 l)t~ llGlIlld I))' ilny PIllillltif.;, :'l:ln:IlICIlI, \11l\kl~liHldjng or IcprCS~:llli\tion herelofule 01 hCIl,:dlt.:1 IIl.HIc 1I1111.'~' II,
:, II1;"k hy ,III In:;lfLHIlCIlI III Wrllllll~, ~;q~llcd hy an ulriC! or IhL' I\gcm:y, winch c'(prc~~L'_s hy il~ Il.'nn~ ,11\ 1111\'111101110 11l(llI;f~' dll"
i 11,:111
I I_J;\,I,\'IIS.I;({)I~S
1:11' \, l'lll \ '-!I,illl',I~', '.Iii'll'! I III ,dllhl_ h'llllS ;11111 \ 111\\1111111., (II 11\l',l.'Ulltlil\ I ;Ind UIII~' whlk lhl'. COlIll,1t I I', illl:lII'\1 illlll\lIlll1 III II
" ',',III,lllllIL t lllllllll'~,j\)!l~ 1l1l1'1l:lll111l1lS "IIIH'. 1':'10 .'l'I 11111\1 III 11\l' ~Cp.Ili\ll' ;;cllcd\lk Ill' C\J1lllll1S:II()n~ \Ignl'llll'f 1111 11\t11t(ull.l~d (Hill \'1
I, 11!:1\' Ill' 1,,:,(I,d, dlld ;1', III dfn:l, fllill\ II I Ill' III 1111lL" II)' Ihe "\l',L'fU,y illld \\'11Il.:h I' hy t\w; IdL'I'C/\l't.: '''ilde a P:III ht'felll, un pICI1I1\llll'
,. III III" I\""f~",' lill Illdl\)' fIJl'111', 1I h~l', Ilad 1',,~\Il'd pUISILII\1 It) aJlpll\'i1I11IIl~ I'llJlIlIl'd by YelU unci IWill'lll,l. Yll\ll ll;\llll~, alld )'011 ,11,.11
, I I', III \ '1Ill' III', '1111\'1 ,IS '"Ili] \1..' fl"illlnll 111 lid 1 II 11 ,ll~' Sl'l \'Ill", pL't IllfIlI\'d ;Illd lil! all ~':I, 1\I'II"c'\ ilK III I I'll hy ypu Y. 'II! l'1,lIll1ll1:\SIIlIl,..11 ,i I
I',' <I III! tldtlll'ilfq!
i,l) 111'l Y\"lI 1,ljl,llllll'I'IIUIl', '1Illl:,L IICI\.VII!,I}~L', 01 It)!" 1'11'1111\1111 Ill! 1111': rll~II'ollL)' Yeilr ;l~ :\IIIIWllll1lhl.' ~il'lll'\llll~flr:
( 'l.nlfli:~,SlnI1S
11..1 I,'" III \' ,1\ I "1'1111111',',11111.', lhll"C Ill.' f I ('Ill ,Ire'; ,1', ..Illl\',' 1\ III tIll' SI.:Ill'dllk ld Cllll\llll',~"(lIlS, which illl' pl'l r;l'nlll)tt':,
I 'f 1111 Illll"\'"d pll:II\JUIIl~ [III Ilw ~.I't III III }',',ll .llld 1!IfLHI~',h 111l' Ilk Ii! Ihe polICY pil)'i1hk il'j the l\gl'III")' It'U.'IV"~1
1111' I.Ulllllll'I,,,nll Ofl Ihat polll'Y ',' ',.'
1,1.';1'1 'I'll. I'L" '11111"1 IH~tU:tlliq',l'" ..~, "IIIIWII III lhl' ,';,IIL:dtlk 11t' ClHlltlll~"dllW" whic.:lI,\1L' pcn:ClIlill',t..S ulllu,~ n..:m:wO\t
1111'11111'111' l'll \lli' ',1',1")1\11 ye,l! dllll 111:lHII'h 11f!' [Ifl' 1IIIIw I'ldlCY II:lYilhk ;\:~ Ih(~ ^1.',~'.nt:Y Il'n'I\'l'llhl' ~tlllllll1~~ipn
(,'\\111: i',il )'
I il) II11 ;\1'1 II' ',' ',h,dl ,<llrl dill" Il,IVl III\:
"1,
"-IIIH"I'
II.f:" ,', .d, ,II', [
,1'1\'1'
Ill',II! ,II, ,IllY llll\l', III If I' 11',\',e III lilt \l:,l'.l' 1111: I;lll: III III '.t
1\1 ,\,1' ,\I,) ,'1"\ ,1111,\1111 II' ',(lId lhll>\Ij,11 II1l' '\!'.l'l\r)"
yr.1I nltllllll~"UIII'\
\ C"'I.......pr lor rcncwu!l.:UIIIIIIISSlill1.\ llc~~rihed bclll\\', thc Agclll "ihulllllll Ill' l~IlIIIIl'd to illlY Ulllll>cmlllioll 1'10111 tile' Av.CI1l:Y' I,tlcr lhls I
'\}tIl'ClIlclltIS tl'rminalcd hy l'ithcr party. Any SUIIIS, whcther dl'\!.:nbcd i1~ l)~'ellldl.', !JtlllU\, profits, 1I1l.':Clltl \'l' IlilYlIll.'llI!I, 01 utherwIse, will
IIl\ly he paid!'i() IOIl,b'. us this Agrcement is in rurCl.~. The date 011 wllll.:h the Agcllc.:y 1l't.:el\lC~ the rCl1cwlIl <':l)lllllli~~ioll\ 111111 nul the dute the
1t.:J1cwlIl premium Wll'i duc shall he the dllle used rllr vl'still~ of rencwul"'tllllllll~si(Jl\s
\'FSTING OFHENEWAI.S
'),1 I\ftcr ICrllllnalillll ufttlls <.:ontr:ll..:t hy elllwr palty, Ihl' Agcllq will (UlllllHlC 10 P;IY ll'nl.'Willl.:OIIlIIlISsi~)I\., 10 YOII un the adjusted VUIUllIl'
\11 all imllvldual heallh and life in~ural\l.:c writtell hl'rellllt.lcr, "lid 011 wllll.:h llie Agc/II:)' h rCl.:el\'llI~ rCllc\\'all.:Ollll1\IS!lIOnS, provided thilt
:;')\1.\11;111 ha\'l' pcrforI1H~I' undcr alll'fOvisiuJls oltlll'l L'onlliK! SUl'h H.Ill'....all'Olllllli\~illllS !)hall be Iwid tu you flll It pcrlud cquul to the
1lllllll)cr of l.:1l1l\J1let'~d 'ietUs uf !)erVICC Wlllllhc ^gl'11CY, pro\'Hlell thallhi~ lOlltr iIl:t has beelllll force clHltlnuuusly fllr II pc-dou uf nut Ic~'
tll:.Il\ __"._______.__.__ _lIlonths,
lih. The \ervke fecs us shown unucr Parllgraph 71:. "Scrvil.:c Fcc" arc pay,\h1c ulIl)' while lhb contract is in force 1I1Il! you UTe nctive wilh
1I1C I\gcncy.
'I, )'llll :'Illal!, subJl'l.:t 10 Paragrnph 9;\, have n VESTED interest ill renewal clllnlllissilJll~; us provided hcreill so long U!'i the "rencwal
,",ili"lilSSIOIlS" remain Ill} less than $200.00 a Illonth rM thr~e 0) l.'Ollsccutivc mOllths: l.Jlherwisc nil pa)'U1l'llts will be tCrlllitHlleu.
'Id In the cvcnt of your deilth llr total di'lahility whilc this rOlltr:!!.:t is 111 h1rl:.e, yuur heirs or Icgalleprescllt:lllVCS shall, except ;l'l
i.l"rClllill'tl'l provided in this Clllltra\..'t, rccl~i\'L' '.Olllllli:\SlllIlS IhJl i!l.,.;..;ruc \lJuk'r thl.: pHlvI~ion' of this (\)Jllr,Il':l. SUl.:'h rCl\cwilll'Ollllllis!'IIlIJl
II.dlll'll1l\llate Wh~ll the total (llnllllis!);OIl~ ~o pa)'abll' ;uc lc!)~ than ~2(KI.()O 11111011111 for lllr~c (,\) l'Oll:-.Cc.:utl\'l.' Illonths
I () 't'lHI shall not be allowed illl)' (OlllmlSsillllS UPOII any applil..'illIlHI dcchl1l'd or rCJcl'ted by the ^g..:n<.:y ur all Insurance COIllP,IIl:t
!"11ICSCllll'd hy Ihe ^r.Clll:Y: or upon any un~i1rned pmtJollllf nil)' pollq c.:alll'l'lIt.:ll hy or ,lttlie ICt!UCSI of the lnsul~d If ilny cOInlnis!'Ilon
\,r other l'l.lIrJIWll'iiltlllll, indulllllg all)' al!villIl:.ct.ll.:llllllllISSll.llIS or luans hI whldl you ,lfL' nul entilled undt'!' lhc lerlllS of IhlS Agrccnll':llt IS
Ill' \ l'rlhch;ss allowed or p.lld to or rcl:Jllled by you, yuu il~rcl: to pay lhc :-',lII1C to thc l\l!CIIl..')' upon dClllillj(J. If dClllilnd is IllUUC YO\l must
,-It'ar )our ill<kbtcdlless ",,"hin 90 days oj sllch t.lcmand or thereaftcr he ill viulatlorl ollhis contract. COlllrnis'ii(H\!'I shallllol be .lilowl'd
lq>llll allY pull\..')' wl1ic.:h IS rl'instaled thirty-one n I) days m morc after the date of .my IlIlIH.IIlI prcllliulI1, unless the application for
It'ln'ltatell\ent is Sl'l:UTCd :\olcl)' lhrough your instrulllcntallty,
ACCOllNT STATED
II. You hereby agrce that Ihe kugl.:r ac.:l:.ounts 01 thc I\~cn'y shall be l'(lrJllK'tCllt and ~ufli\..'iclll prillla filcic evid':Ill;C uf the state of
,l((ll\lnts bl.:twcen the pilnic'i hereto; and your fHillln.' t~) IHHlfy Agcncy of allY l'\Ceplllln taken, in wntllll! wllh ~Ul.;h notice rcccivctl hy
..\ l~ ....n.... Y withi II lhlrt Y (30) \..'alcnuar days from the dOltl.: 'Iu.:h stall,.'.lllcnt of ac.:c.:llll n t 1:-. I \lrlll~;hcd ~hall r~nder SlI<.: h statelTlc nt a c..:orrcctIH':l;O\\ lIt
Ill'twcen YOll and Agcn\..'y
LIENS AND OFFSETS AGAINST CO~IMISSIONS
12. The Agl.:flCY lIlay Orhel agamst any clalln ror l'OIllIlIlSSlons hereunder, ;Ill)' t1dll now due ur which may hecollll.: due thc Agenc)' fr(llll
)\lU. and such debts slJ;lll he a lirsllien ilgi.linst any l:.(Jrnrni~~loll duc YUII hl'n:lJNkT Any ,uh'anccs tIl.'\lJt.: to you hy the Agency shall be
(ullsldcred as an IndcbleJncs.s hy you to the Agcncy If t!usAgrccmenlls tCrlll1l1alc.'.j for any rcason or cause, m WlthOUl cause, and iflhcrl.:
l'i any outstanding lllt.lebledncss of yours 10 the Agcn\..')', such illlkhlcdness shall bccome lJlIC and p:'lyahlc oil thl.: date or tcrrmllatiOI1 of
!1I1~ Agrl'ClIlcnl ;lIld lr nl>l su paid, thcn IlItl.:rCsl ;H the raIl' {)( fiftccn pcrl.clll (151;-;,) p~r .lI1num, C(llI1POUIHJcd allnually rrom dille of
termination of this Agreement until. c.!;\te uf payment of the acculIlulated indcbtednl.:ss, ~hall be adlJcd 19 and made pan (If the inc.Jebledne.\s
;llld YOll shilll he liablc fm allY e:~pc/lsc:') whklllhl' Agcl\q !'Ihall ill....ur llll'olln.ting thc :\u':lllllulatcd IIHkhtedrll~!'IS, including attmllcy\
I ccs and Cuurt \..'usts
('OI.I.ECTION AND HE~IITT,\NCE OF I'HE~llllMS
1.1 'lOll shall pll.lIrlplly rt.:llll( toJ\gcnc.:)' illI)' dlHI alllllUIlIC~ ICl.:eIWd by you Oil bchall of ^gt.:Il\..')' all full vr partial pa)'ll1cnt of first year or
rcnewal prclllillll1:-', Such lIIUlllC.') shall be held hy YOll In trust ror thl' bl'lH:flt of the Agency, shall rwt he intermingled with personal ami
llthcr funds. ;lIHI \....h,.:1I rClllllh:d sh.1l1 be applit:d tl) (he relevant roli!.:)' ilt:COc.I/H
Ma:NC\' HE<;lJl,,\TIONS
I,\. Yeu ~hilll contoflll lollle ['ules illId tq:uliltiom of the I\~~ellcy nllW or herelll'lt" tll hec.:olt\c in force, whidl rlJll.:s "IlU rcgulutions shall
tOIl'dltute a pan ollhis Agrl'cmcnt. Thi:-. pruvl\io/l ~,hillll1(,( he l'ull.~lrlJt.:d In altl'r [he Illdcpentlt.-nt Clllltractur slatus of the parllC'l il'l
Iql>\o'Idl'~1 in "I{datlollshlp {If thc Pi\IIIC~" paragr;\l'h ,i hen.:ot'.
I")' );1)1I a~rec Illat Ylltl shalllHIl. III illlY lillle. indu(c 1111)' of tile.' Ilulil'yhuldt I~ 11l\IIIl'd tllluugh lhe l'UIJ\p:tI\I~'~ thallhc.' AY,~'llI,:y fl'IHCSCIlI'l,
1" ll'il'le to l'lltry lhl'lf il\!)lJfatl~'e wilh ~aid t.:OlllIJllHY. 01' Inducc III 1l1l~'ll1ptlq IlIduu' :lIlY ,\penl \vl1o I~ (Olltnll'tl'd II1IlHIgh the Agcrlf.:y II'
,t',l.~l' 11I'I/lIl'l u'l'l~)(nlllon wllh 1111..' Ag(.'/Il':Y; or SllblJlll, dlll,\tl)' III IfIdiICl.:ll)', to lIlher u"IIJ1;lnll..'~J IllOflo:ial:) III ilpplll.III()1lS lor in ,UrlIlKe, 01
\ lolall' allY o"ll1l' 1.1ws or rq',ulnltol\\ vuvclllllq~ !lISUtIlIlCl' \i1ll'~ ltllhe ~t"IC 01 ...Ialc'l In Wllldl you nrc lin.Il\f....d In lilt.' t.'ycnllhat you
\ Il'd;ltl" lltly llllhcse obliKatiull'i, 1I0IWllh\IUIIlIIIIl! al1ylhlll~ 10 lhe l'ontrilr)' herclll, your Inll'IC'l111l renCWall'lJllIllIl\\lllll\ under 11m ^IUcc,
rlll'III...Il;dlllllllledl,lldv (ca\e: and Il.'nlHIIlIlC Till.' Plll\'I'.Hltl sll:llllltll hllllt Illl' Ilght\llIll.ltll'dll'\ uflhc A1!l'IIl")' tlll d;lIl\ai',C\ (II uthcr relil'!,
Illl'JlJdlll~ IIl)lllll"tIYl' fl'lIef, ~1'lIlIilY hI..' pcnlllttl'd by la\\'.
t t) )'IlU ilgrl'C Ihal )'lllJ \\'lIll1ot be 1tl:~II~cd It) 1\.'llIe\efll any l:lllllpan)' lllher tl1;1ll lilc llt'CS r~"plchenh'u lliroujth IIH' A~'cllcy YlJU nhn 1I1~fl'e
trlat yuu wtllllllt MIIII"lt UIlY 1"...urilllL:C lor llll)' l'lllllll:lll)' or Ilrgalll/atltlll olhn 111alllllrllugh the Agenc)', unk:is wlllIen I'UlI~ellt has bCl'n
. ....pre'l~t.'d by lllc Agl'lll:)' Till: Agency shull not unlc;\~Ilnahly wilhhlllJ ~udl 1.1l1l~Cllt fllr you 10 leprC~l'lIt other lll\UI:lrIl'C carriers that
<llll'r it pllldlKt that h nul ~ltI\lIar llf l'Oll1petlllg III llatull', With the p/lldUd~ of 1/1\Ur,IIH,;e UlllicfS IIppuillled tllfllugh the ^gcm.:y, All
Icqunl'i III tCprl'~t'tl! (1ltler IIl~lJrall(C (arfll:rh 11111'il hl' ~uhlllltled III wlillll~' to, .HIJ approved ill \""rltlng by, ;llloflilTr of the Age!lcy prnn
III Y'Jur l"l'pre~cIllilll! llr sulKiling lIpplit.:illlOWi t'm hudl C;lrIlcr.
I'l II 1\ undcI\hJlHI and agrced thal ellher pany mny ll'mllllilte llii~ l\grcclIlclll at any lilllC by giving 10 11l,~ ull1l'l 15 day~ prillr wriucll
Illlll(l' ollis dcsJlc 10 dll sn, anYlhing hClein contalncd tu the t"l)lllrnry 1\lltwllh:itnIHLng. Tcnrllllatiol1 fur L:alJ~e dut.' 10 1Illethu.:nl ClJlIdll(.( lir
~"qlllr;l,,"1 Violations ~Il;dl not n.'~luirc SUdl IHlll(e
I:~ I'(IlJ lJllder\land :Jnd ;It:knowledgc Ihat ull of the lolluWII1l'. I.:omlitule tri\d~ s~',rcl~ and propriclary lurorlllillHlIlUf tllc ugcllcy: (a) illl
111 111l:1l'\. nplr.IIHlll~ and IUlcrl'sh thl.'fClll: (II) all Cushllllcr ha~c li~t~ uf the agt.'IlI.'Y wllll.:h i/ldll~lt.'s: lists of ();Isl ilud pH'st.'1l1 policylloltlCI~
,1\ \\dl ,I'" 11\1\ (II k:IJS or [lHlSpl.'CtlVe LlIt.'nIS, III any Ill! III whalsot.'\'cr. and howevcr and hy \\,:lilllllcver altlle itJ.!C.'lll.:Y lhey were acq1llrcd
Ill' Jt:\~'llll'cd. (l'J all polrl'Y forms, filtt.' buuh, ~upplll.'\, IC\..'~Hds ;11111 tllh~~r pl'll11cd lIlallcr Ilr JOClJf1lt.'IlI~ of till' .\gClll")', or ll~ l'ilfrI(.'IS, III
! l\IJr pO~"C:i~lon or l:olllrol.lI1d (d) lhc nillllCS, lIddrcs~l's, pfellliulll~, duc dah.'s, e'plfiltiol\ datcs anu similar InloflnallOIl, YlHlllndcrst:llld
11):11 all <if till.' forl'},WllIg, induJllIg IIny lIotes or tfallslurtll;lll~lIl llf such itlforrll<ItJOll, or in ;l11Y form what~oe'''n, ;111.', dllll ~ihall rCIIl:lln, Ihl'
I'IOpCrty l)f the ^l.:CIH:Y and ~llall be 1IIlIIlCdt<lIc1y aCUHHlI('d for and \lllrCndl'rcd ()\'l'r tu tile Agency \JfhHl tt.:IJIlIO;lll11!l (Ir ~h:lIlalld hy the:
:\gI'IICY. Yf.JU l:Xpll.::i~ly agrce III hold ull MICh infunn;lllllll III conl1d":lll'C bolh dllring, and afl!.:r lerrnin:Jli0/l of thl~ ^~rCCl1lellt. You agrt:l'
Ill.lt llpllll nllY I11I~approprtatl{)1l of Iht.'se rtt.:IIIS, or Ufl('11 dIVlll~ltI!! dll!'.l.'Olllld....lltJallnlorlll:HHlIl 10 othl.'''~, or UPOIl ll~llIg ~alllc fur agl'nt....
\ll'I'lllll:lIl1l'lh:fll otl1n Ih;1Il for Writing aUlhOlll.ed inSllt;llll;C Ihlml~h lhc agcllt.:y, ur upon failing [0 11I1Illclllatl'Iy ~uIH'lhlcr sallie Uplll\
.ll'lllill\d. thell you :-hall hI.' 11~lblc 10 the t\gcm:y for ;lilY auorney Ice.'...., I.:I!Sts and l'.\pen'il.'S, III addillCJIl to dalllugn and illlY olher rl.'lIlCdll'S
.1'..:lll.lblo.: hy 1;lw 10 lhe t\~',CIH:Y, illL:urred as:J rl.'~ul1 tl1':ll'OI', iIlL'hllilngh\lt not liflllleJ 10 ilttllllleys fet.'s alld l'O'lts IlllUffed III scck looblalll
:1 l\:a\l.' anJ lksist Order, or other rdic!'. to Slop vlobl!<)1I'l of tllt~ paril!!raph.
Il) You ...hilll be respoll'>lhll.' for ilnd Shilllltlaillt;1l1l i1ppropflalc Jll\U1:UKL' Of (\(L:llpalioll:d ll(;en\e~ I1C\,C",II"\' 111 !lrdt:r to pt.'lforlll III
,1,"(1I1dall\.'C \'.'Ith thiS 1\ grl'l.' filL' Il 1
..'0 )\llJ ;1t!lee Ihat aftcr ICrITlIllation or this l,;untract Y\llJ \1,1I111{)1 call UIl, IIIl'c1 With, corlcsp(lIul wilh or otlll~rWI\C ha\'C con wet willi Ilwsl..'
p'1lil.'yhnlJcrs for a pcriod ~)r two years thereafter for llle purpose of. m havlllg tile r~:\1I11 of, rcwrlting, t.:.ltl(cllln}!, l,q):\ltlg or rcplacllI!!
(how pOIII.:IC~ wHit allY llllll.'r "uli..:y of ;\11)' \..'lJl1lpilllY You lully 111l\kt~talld ;llld a~rCl' 11';lt ~tI\lr ri!!lJt to rCI.:C:Vl'l'Olllllll\SIOIlS jlil)':dllc. II
.lll\', 01\ It;neWilh or llthcl'l\'ISL:, afler ICnllllliltlUtl IS (llllllll~l'IH upon )IlIJr UltltllHJIIl~ l\ll'lllllply fully wllh thl' IcrnlS IIl~rc~d' i111l11hJt, Up~111
\ Idlall\)1\ uf ;ltly prOYISIOn hcreof. you ~l1all bc dl~l.'rn\.:d III have l'orlcllcd Of S\l1 rl'l\dcrl:d 'llLh future t.:OlllI1lJ..'IOll fll:III.., If allY,
:1 Wlldc this 1\ g rl.' I.' 1111: 11 I IS ill for(l.', and for Ill..: Itllllll.'dJiltl' 2.\ lI11Hllh Ill'flod nltcl Il.'rll\ill.Hl\11J of tllis A~r,,'t:lll~1I1, It IS further 1Il1dcrstoud
.tlld al!rceJ th;lt If you do, lhrectly or inJtn:I'lly, L~IU'le or iI''>lSI III GHJSIIl},C l.lp'llll~. ITWlltlllg, ur rCplal.'lllJ:! jln~' pullcll.'s, Ih;lt II b~:llll'
dlllll;\l!t 10 dClcrrnllle the ,\~cnry's aL:lual d,lIl1age wllll 111atlu:III:lIKid prc\..'isitJll, YOIl a!Hl.'e thal dalllagl.'s III thl.' '\!~CIH,:y \hall be (lilt.' and
(jilt: 11.lIt (I 1/1) tl1lleS lhc anllual flll:ltllUlll ~Jr~ucll polllll'\ wnltl'l\ 11\1(1111111 Ill\.' "\~l.'IK~', ..\Ill'" thl..' .!lltl\'l' 2.t I1\lJlllh \1l'rrod has CXplrl.'(l,lhl'
Llill,l~l'~ l(llh..: :\gclll:Y ..11;111 h~ un~ (I) tllllCS Il1e ;lllllua! rrc III III 111.... 01 slJL:h pOlll'I~'"
DISPUTES ANI> l.ITlGATION
n If allY dl~p\ltl.' shall illISt.' hctw~:l.'l\ you, ;\lld ;lilY uthcr Indepl'ndent ..\gelll Ill' tht' 1\~'C'1I.'Y, or any appll\;;lIlt tll m pllhcyholder III tht'
I\F_l'tll.,)", Uplll\ any 1Ilatter what.'locycr fl:lallllg tl) tile bll\llle~S ut" the Agl.'Il',:y, c.Udl dl.~putl.: ...h,lIl be subllllltl:d III till' ^gCJley ~I'l arbllratm
Ih'~I't:()f and Its d':I..'I<;JtHl shall be !inal You ....h,lll lIulllllgall.' allY slIdl (11"'lllllC WIlh'Hlt thl.: wrltlell t:~lIl....ent of the A!:'.cllc)' IlIlhe cvcnt 01
'>lH.h llllgillllltllhe l.'ntlfc l'.;"pclIse ilnd dillTl,I~Cl shall be borllc by you, If any k1!i\l al..:tl(Jl1 i:i bruught ag.ullst clther pimy herelo, ~Jr a~i1ln"
holh f1:lrl]l.:~ Jllllllly, hy rl'ilSllll of Hill' allegcd act, fault or ralllllC III yours III l'IJIIIlCl,tioll with your aClivitk\ ItclclllUlL'r, Ihe A~'.cncy may
rrqutrl' Y')~l III ddend ~lIl:h lIL'liUIl, or at Il:i ~,ulL' uptlun IlldY (kfcnd thercin and t."llCIHI sudl SlIll1:i a.s iliaI' be nl'l'C,i\OlI ~ tlll'rdore, illl:llldlnl~
,1ll(llnI.'Y'~ lec'., and Y'Hl s11.IIII)t.' cllar~~cahk therewith ii', wdl as wllh allY i1111011111 WllldllllilY be rl.'cuycred i1~.i1Jlht the At!.e.'IIl:Y 011 dcm:uld,
"~ll'plltl Ihusl' ~";l',l"; when III the .'\Ok Jlalglllenlof the ^gelll.'y, th;ll YO\l ha\l' 1lllllx'l'Il at faull and should IltlllH~ Itl~hl rl.'~pollslh1.:.
\,
. .
: '1';ll(ll'ill;aill::c 1..11' Ill.:gku 011 lhl..' pari ullhl..' Agcllt.:y 10 ItlSI\llIflon l:Utllpli,III(1..' hy you Wllh the tCnll'i "lid PIl'''ISiuIlS of this 1\~rL'CIIIl'ld'
Illd lllks .lll{! fl:l!lIJilIIUII\ ollh~ Agcnl:)' shalllllll hI..' l.:l)l\slrul..'d as lII' 'l~IlSlllulc it Wlll\iCI thereof.
AllIlJ'l'llATI()N
.',1 I! I') .11..'Iced lhat the 11IWS of tile CC.HIIIlHll\wcallh III PCIIII')ylvullla will gl)\lCllllhc l.'ollsllut.:lion uf this t.:~ll\lrill.:t ;Iud "II thS[1UICS \l,'llh
"'1'.11,,1 It) llll' \"'01111"11..:1, III illI)' p.1I1 thereof'. or lhe 111.:,1'01 t1l<II\1.:C hy cillH:r llf 11\(,' parlll'S, \lllles.\ the pilllln tlll'lIl\chl:S t.:all scuk !'Iudl
,1;'1'\111."\ illllll..al1lv, IlIllY, at the :'lolL' dlSl:lcthllluf the l\gl'lh':Y, I,I.' sullll1ll1cd 10 aillllr,Hiol1 ill 111\,' dOlHiclk ll"lhc^~l'I1\.') III._________.~_.
( lllllll)'. Pl'IHH;)'1 \'illl Iii, YUlIugrl'e that should a dl!'lpule a,'bl' ulHll'r this COIllnu.:t, the Agenc)' shall hl' entitled to 1111 1I1JuIlClion In preserve
Illl' '.1,11\1" \jllO pendlllg the OUll'IlII1t: of Illigiltll.lI1 or mhllr;\lilll1, upon ex parte applicillIllll to 1I coull or COIJI!ll'ICI\[ jLHlsllictlOIl, without
11<;1,11' Till.' p,\lth:~ il,~fl't: 10 Illl' ,'lulflcielH:Y ()f all illjUlllr.:tllllllhlllll\.lf Olll' IlllIulrcd Dollars ($IO<UX)), H the J\g~l1l')' I'ICVllih ill 11I1)' c.:mlll
1111\, l'l'dlll.','l 1.11 ,II hllratnlll i1g11ltl!'l1 you, )'lHI agree In pil~ illIl'tlsts Icasonabl)' e;,pl.~lllkd hy Ihe Agency, Including Il'asonablc illlmncy \
I,\'\
,:()VFIlNINI; I.AW AND VFNlJE
1'-, TIlI~ t\Frl.'l.'llll.'l\I IS ~ulJp':d tllllntlls III hc Intclpreted ill ill.'COldal'l.:c w1th Ille laws of lh~ COlllll1UIlWCillth of Pellll'iylvunia, VellUl.,~ 101
,III\' ,ILtlllll, ",Ult III tllller P/l)l'I.'cding, 1111.:ludlllg 111J1l.COllll';lCI disputes, shall be ill ____________.._____ CUUllt)', Pl.'llflsylvarllll Thc p.HIlC~
~".h.'ld \\iU....L. 110) ullll':l ....Clllll.' lll\k~s ngrccd hllU ill.h.'ill\(l' by Ihe- partil'~ l(lllll~ Aglccmellt.
11':I(~IlNATION OF PIlEVIOUS AGIlEEMENTS
'II TIII~ i\'~ll'l'1l1l.:111ICnlllljilll.'~ Hnd supcrscdc~ llll)' alld all pliOI' il~n"CII\Cllts hl'I\\'CClllhc pallie\ hcrl:IO n~l;.lIlnL! 10 Ihe SUIIl.:ltilll01l of 1~11l'~
,I Ilj\Ur;lll'd' nJ\'l'H..'d by [he /\1!ll'cllleIlL
.\I;I(I':I':~IE"'T NON,,\SSI(;NAIlI.E
"-,1 NCllhcr Ihi~ t\l~rl'Cllll~llt nor illIY of the lll.:nCrllS lu ",.:nue hercunder Shilll he as:ilgncd lIr trnnsfcrrcd, eilher ill Wlhllc or ill pmt. WillHHIl
',\lltll'lll'1.11l~enllil till' Agell(:)', cHepl i1S ~Iilted in SCI.:'lolllJd hcrelll,
2:-\ It is Ilt:rcu)' agrl'cd 1I1:1t any l.'olllpens:J.tiolllhat may ill.:cr\lC under this conlracl is pny.ihk by tile ^~CllCY,
t:IlHOI(S AND O~t1SSI0NS
,!'J j.llr lhl.' ^gcIlI..'Y\ ilnd YOUI' protcl.'lIon, you shul1l..arry Errors .\lId OIIlISSIOIl\ Ii>rhility inslJrnnce co\'ering you alld the Agency III illl
,lllhlllnl 1101 Ins Il1all $1 OO,tlOO pIa m:l.:urrcncc llnd shall provide (0 the Agcncy. within sixly (60) Jays from tile d,ne of this ngrccllIl'lll.
lllnol of such (m'l'rage. a~ required for tile AgclI(;Y's n:l,:orus, If ~Udl proof ufco\'eragc is not providcu Iu the I\gency WIthin Ih.: lillle 1 illl II
.1'; .,t;\l.:d ;dlll"'l', ~'1)1I helell)' allthmizc Ihe /\gl;I\l.'Y [1.1. ;ltllllhe Agl'tlCY l1lil~' ill its discretlon, ,'il~CllrC SlIdl crror'l ilnd ()lIIis~ioIlS 1I0lhllll~'
\ 1'\l'I;I~'L' llll' YlHI. .llld 10 dcduLt the prClllllJI1\ IlflHlllnls 110m 111..: 1..lll1lllli~.'110nS dLlI' you If allY.
SEVERABILITY
HI 1l' .11l) IHUVj~ll)ns of tIllS J\grl'clllclIl ilre, for ilny rC.I'IOI1, IIl.'ld 10 he lll\'alHI. It \\1111111.11 in\alid.uc illl)' (.Jlllc!' Plll\'I'l11.1I1'\ of thIS ^greel11L'1I1
,,\ h II,: 11 are \tllhcl1lsclvl.'s valid, /101' will It invalidate lht: rroVl."ions uf .11l)' othcr agn:l.!lIlcllt bl't\'-'cclItl\e partlcs hl.'rc\l) , I{albl'r. sl.'ch in\'i1I111
IllOVI'i'UII ~hall he l.'I.lIl~[r\lcu SO:lS III giv~ ilthc maXll11um cffC1:l alluwed by appll(ilhk law,
x I. /'~,
IJ__li1.W~':-!:.., __.L.:L.!,!_,,!,~_':::.."~~_
\VlIlles"
nY.~l' ;
I)"Il'
'J:,~d(tfl_2iJ;;(v/ '
tlldcjlt:lhknt /\J.!l'lIt .
. . - "
, , '.
'- \ "' , '..
y~~~";;:~;';;c~i:,,;
i)/
i,
Datl'
,',
X /.1' /,t, i' "-~
.. .., _,...~. L I t~. _ ~_
\Vlllll'S'"
.'. I ^
E:1.,~I'l'-"'-_..__,__,-L__'- "
Dilt\.'
"I,
~ . 1 '
wa:rPleA'!IOII
I, Margaret D. Miner, hereby certify that the fact. set forth
in the foregoing Compleint are true and correct according to the be.t of
my knowledge, info~ation and belief.
I underatand that any fal.. atatem.nt. herein ar.e made aubject to
p.nalti.. of 18 Pa. C.S. 54904 relating to un.worn faleification to
authoriti...
~' ,) /
...:....' ;-",:., ~' If /'. I ;A. l..,,,,_ \
. ,_, garet D. Hin.r
Dated.
May 17. 1996
-5.
,
I"
. ,
,.
.
"
,
I
,I
",~
"
--,
m~
~~ .... .,
~~ .... l:: U i !
~:> '... III
~ ..... 'tl ~
z:>- l:: l:: ~
om '... ill ~~I ii a
~~ E-< III ""' !;
Z "'" ill
o~ ~ .~ (.:I 3 1-' :> a
U~ ::i: .
~ ~u ~i,pll
~ . t.!lZ ~
0:>- ~..... .
E-< Z Cl
E-<Z ~ui i:.:! ~~I ~i
;:J;:J.., i:.:!
~0c:Q::i: E-< ~
OUN~ i:.:!Ul ~
U "Ii:.:! U..... Z I ~
Z IE-< Z...1 . ...1 ~ ~
~...'" ~~ :> ...1
:c :c 0'\...1 ~..... ~
E-<~ ..... ;:JU Cl
;:J .:> Uli:.:! ~
Z~ 0'" Z~
.. .Q..
.. .'
..'
.
"
INSURANCE MANAGEMENT SPECIALISTS. I IN THE COURT OF COMMON PLEAS
INC.. Plaintiff I CUNBERLAND COUNTY, PENNSYLVANIA
I
VB, I NO, 96-2284
I
RANDALL FREED, I CIVIL ACTION - LAW
Defendant I
IMPORTANT NOTICE
TOI Randall Fr~ed
(Defendant)
DATE OF NOTICEI June 17, 1996
YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO
TAKE ACTION REQUIRED OF YOU IN THIS CASE. UNLESS
YOU ACT WITHIN TEN (10) DAYS FROM THE DATE OF THIS
NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU
WITHOUT A HEARING, AND YOU MAY' LOSE YOUR PROPERTY
OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS
PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE
A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE
THE OFFICE SET FORTH BELOW TO FIND OUT WHERE YOU
CAN GET LEGAL HELP.
COURT ADMINISTRATOR
4TH FLOOR
CUMBERLAND COUNTY COURTHOUSE
CARLISLE, PA 17013
TELEPHONE: (717) 240-6200
NOTICIA IMPORTANTE
AI Randall Freed
(Demandado)
FECHA DE NOTICIAI June 17, 1996
USTED NO HA COMPLIDO CON EL AVISO ANTERIOR
PORQUE HA FALTADO EN TOMAR MEDIDAS REQUERIDAS
RESPECTO A ESTE CASO. SI USTED NO ACTUA DENTRO DE
DIEZ (10) DIAS DESDE LA FEeHA DE ESTA NOTICI~, ES
POSIBLE QUE UN FALLO SERIA REGISTRADO CONTRA USTED
SIN UNA AUDIENCIA Y US TED PODRIA PERDER SU
DCBA-200-Rul.4.7-4/3/81-M
'-'
INSURANCE MANAGEMENT SPECIALISTS,
INC. , P ll.llll t 1 ff
I N 'rilE COUI\1' Of' COMMON PLE^S
CUMBERLANllCOUtlT'i. PttlNS'iLV^t1X ^
vo,
RANDALL FREED,
110 C IJllclllll t
CIVIL ^C'l'lOtl - LAW
NO. 96-2284
'1'0
Randa 11 Freed
, I)ofondllnt(u)
'iou lIro lwruby Ilotlfiuc.l that on
!.1-. 1996, tho fol10"'ln')
TJiiOglllunt~ hgsfnlt:1'i"onturull agaillst you
cap t 10no,1 ~lIij'e.
Insurance Management Sp!,c iallsts. Inc. v. Randall Freed
in the amount of $7 ,603.34 Ius interest and os ,s of suit.
J)^TI~ I
7- r f~ _ _ "".'
rrotl. n tory
hoaroby cartity thllt,~; I~l and
poroon(u) to rocolvo thl0,.:totlco
Randa 11 Freed
tl t t, '.~
I
provo r
/
oddrosD 0 thu
i u I
654 Wes t Newtol1. Avenue
Greensbur2. PA 15601
^
Randa 11 Freed
Ilcfentlldo/n
Dc fendirJos/as
Por eut,e lIIe<.lio RC Ie ostn notlficando 'lue 01
do ,leI 1996 . oi/li1 ulgulollte
.~bx~laltiiiilbiiTc. (r.~ llo)/~I'~d9tadfltllnoto<l0 on conlri\
sl.1yn on 01 CIISO ,n'ilncionodo <f;{ 0'1 il'I'lgrafo.
~
'.
n:<:I1^r
iirownotilr 10
Cartlnco 'Iun J..~ nl,')lIlontc dlra<.:clon 00 I.. del
dofondldo/o sagun lllcHcoua an 01 cartH lcado do
r os Idoncla I
i
I
,
'i
Randa 11 Fret!d
654 West Newton Avenue
Greensbur", PA 15601
^bOCJildo II,! 1 [JOIII~I\(l oJ II t 0
OCBA.4QO-Rule 236(a)(2)-8/1/89