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HomeMy WebLinkAbout01-06857 ~ ~'i ,,~, "",~,,,,.,.,- "- ,~,~ " 08/29/01 WED 10:50 PAX 570 784 J7lJ ~lMMbX lN~UKANCb AubN~l 01011 C;;LfDLf78 Zimmer Insurance Agency, Inc. 1125 Old Bel"wkk Road BloomsburgPA 17815-2997 Phone 570-784-4988 Fax 570-784-3723 FAX COVER SHEET DATE: August 29, 2001 TO: Rick Williams FAX#: 672-1008 FROM: Molly SUBJECT: Richard A Gross NUMBER OF PAGES, including cover sheet: 1 @ As per our telephone conversation, attached please find the estimate that Mr. Gr ss brought into our office today. Life, Health, Long Term. Cafe, Auto, Home, Business, Bonds, Be1efits I , , I I , I I I Thank you. tc. ~U4 g \ d-tll20D\ {~, :" ~n ,~ " . '~'" '~', ' ",,-, , , ",,~ ,'"' ~",,- ' ',-" oj' ' ""-'-1':',-- " o . * 1. 4 9 8 . 9 7 + 998097_ 500000* o . * "" 0__",7,' ," ,~,,", -- '-"~'--,' -.- _ ~f ';'-,' '" "" ,-'" 19J uUJ.. ',',1,_ ~~,'-,"" =~. ~ _0 fJ~/ ~91 01 ~lMMb~ IN~UKAN~b AubN~X W.tW 10:50 .t'fu\. ::>fV f~4 ;j/.l;j ? .# 0 ;I/ES7c;'754.Y '7 c.?O " No. INVOICE tgJ vv", All3~,r' ANdREZZE NE5 L. c; /J,E'c J'-. Af/;: j:j" /IV J-t Uf'l /1 E-5 fJ-o P.5C~PA /J"3..s- DATE YOUR " ORDER NO. OUR DRDERNo. " '.'h / "TcJ/ ;;';QO/ . / '" " /. ... '" , I , ,," , , r SOLD to: " ,~' ~^:" /,L' . . /9.,p~d, _o<.1..)~ " '<:.I ?-; I /j ~ / f;.,~ ...., 1,(/ );'f4 C'> (d .:: :'- SHiPiO:?!C{ X ~" " ~~-Z:;- I' /JJ--fJ'4 '"' /"' <1 .'V I I I 'A,....P'v..r,-c/~ /. '- , . "7 S-J?-.. Cf(7?~ r F.D.B. \.' TERMS J DATE SHIPPED , SHIPPED VIA . ORDERED .. SHIPPED DESqRIPTlDN. , I' :.L. ,; '/1' ~ /r.5./t ~,;..Sr 'XI O,~ ' .l '/iJA~Y /.i~ I ~7l~ '/~~.lMI C&~, ../.... v~ t' to. ~ / ..J j/__..~7"" ,,//" I ,;i!..;4~ /..t~. ~~)"...c. ~<-,' . 1/ I .-i '. :)., it! , ..... :....~./--!~' ! /.......:,.r.rr;r- /' ...''''W-'''~ ~L~<>:Li /1)"i1-~~)~-.'-/-/1~~ '.',,',...' ..' 2 " SA~ESM "N PRI E .....-\ ~ ':Il~ (1"'",",,"" " " 'c/' n . ..A.. '". ::::>!O-l- ' .' , --j :3 4 5 ,', , ",' , ,. , I I I , 6 , ' .' Il~" ~ / /1 , " , , .. .. " ! I : : , .'.. "" ."1 url-10 IN U.S,A. I , i I HI ~~ , -"-- ,"'--- ~'"", 7 'B ,,/f)r;u--d" /'xr~ ,','" i/ 9 , 10 , "/ IfI1 . A,".-/;~ " ."" 11 /h.;;.;j (f 12, 13 , 14 . 15 " , 16 Tc Ji,. 1:.1 , ' " , .... ..... ..- ';'~':':_"'" ". /~',; /~,ii;c;/ '," ' , .l i; " ;l~, J , .' .I jf ...~'/(..r1'f"''- / " , ! -- ~.~ , "','.1. /.t'. t. .7'7..,,' // -'1 ~ " . '.',J"'!"-,,,~-. , , ,,' . " 17 , " ',' " 18 , " 19 ," , . ' , " 20 , ~.FORM 3811 " , , , " . TF\IPUCATE '~~-,,!1l1if , ,':- ~~"->"'I~ --, , ~r ",.n,k<''''''< 1-,'!.,,~- - """!' '~', <, ~rw 1'-' 1 I , -' " I .........: .., , i , , , I 1 , PER f/ , ' AMOUNT.. 4-.17j. , , . , . C ",' ~\ ["tl't 4A .~~,:l.,.l a:..",. '~'17 ""...., '"1" <K..,..,i " ,,'lr"' '""" '- j , ' h 176 (j , , , " ' , T/-~--o:(j c; . , " ,. " . " ' , " ',,' ,,' , , ',' , ' " . V~(~O/V~ MVp ~~:~~ rAA V(V fO~ Jf~~ SHOP: OWNE~: ADDRESS: CITY STATE: ZIP: L!~uatK l~~Wfuli~~L Aut~~l If!'J uv", ZEISLOFT FORD, INC. 1120 WEST FRONT STREET BERWICK, PA 18603 570-752-2197 FAX: 510-152-3126 CD LOG NO 539-1 DATE 02/26/01 , I 82/26t01 BRET FROMM (570) 52-4085 I , GROSS, RICHARD 313 BOWMAN ST BERWICK, PA 18603- POINT OF IMPACT: 6 LICt: BODY" COLOR: CONDITION: HEP857 BROWN GOOD STATE: DRIVEABLE: Yes INSP DATE: CONTACT: HOME PHONE: VIN: MILEAGE: ACCTNG CTL#: JT2svb2E1K0250356 168,7111 i , , , , VEH. INSP#: *=USER-ENTERED VALUE EU=SALVAGE PART IT=LABOR PARTIAL REPAIR N=ADDNL LABOR OPERATION AA=APPEARANCE ALLOWANCE RI=R&l ASSEMBLY E=NEW PART EP=SEE PX REPORT I=REPAIR/ALIGN!SOBLET P=CHECK RP=RELATED PRIOR DAMAGE EC=ECON MY PART ET=LABO PARTIAL REPLACE L=REFIN SH TE=PART PARTIAL REPLACE UP=UNRE TED PRIOR DAMAGE , , i , APPRAISER LICENSE NUMBER - 136619 -FED. TAX NUMBER - 23259437t 1989 TOYOTA CAMRY LE 4DR SEDAN Y1713B/C OPTNS A/24MYZ I I TWO-STAGE - INTERtOR AUTOMATIC TRANS :~~:: , , , OPTIONS: SURFACES TWO-STAGE - EXTERIOR SURFACES ELEC REMOTE CONTROL MIRRORS TILT STEERING WHEEL OP GDE MC DESCRIPTION I 0103 L 0103 RI 0103 RI 0129 RI 0127 RI 0109 RI 0201 I 0207 E 0209 L 0209 RI 0254 E 0237 L 0237 L 0289 'j1);;,;,-",,_!"1',.. FENDER,FRONT 09 FENDER,FRONT FRONT FENDER R & I MLDG,FENDER SIDE MLDG,FENDER SIDE 01 GUARD, FENDER MUD MLDG,ROCKER PANEL DOOR SHELL, FRONT PNL,FRONT DOOR OUTER PNL,FRONT DOOR DOTER MLDG,FRONT DOOR SIDE HINGE, FRONT DOOR LWR HINGE, FRONT DOOR LWR PNL,REAR DOOR DOTER ,< "".' "",,~, ".",>,>~~",~, '< .~ "''';0"",,,,, MFG. PART NO. AJ% HOURS R LT REPAIR LT REFINISH LT R&I ASSEMBLY L/F R&I ASSEMBLY L/R R&I ASSEMBLY LT R&I ASSEMBLY LT R&I ASSEMBLY LT REPAIR LT 6711232040 LT REFINISH LT R&I ASSEMBLY LT 6874016020 LT REFINISH LT REFINISH 4.0*1 3.6 4 2.3 1 0.2 1 .- 0.2 1 0_2 1 0.3 1 , 1. 0*1 4.9 1 3_1 4 0.2 1 0.2 1 0.4 4 1. 6*4 1"- ',.0- - " 2d.22 I I I I 37,.44 , I I I , I I I I I I , 1 PAGE ,~ . ,,,,, , .' '--'r'~" . ~- " VJ.,/ J.,Vf VJ.. .L'.lV.L' ..l....._-i:J.. Cl1...lll. ....'V '0'* .),,,.., , 1989 TOYOTA CAMRY LE 4DR SEDAN CD LOG NO 539-1 EC M7 ill Ml? I M60 I I EC BLEND FOR COLOR MATCH I?INSTRII?ES-TAPE COVER CAR EXTERIOR HAZARD. WSTE. REM. RUE'F PULL CLEAN ADHESIVE & RETAPE WINDOW VENT SHADES 20 ITEMS LJ.J.UJJJL.l\. J.l'\i:JL'.l'I.1U'\\"J:. t'\\:J.t.l'\i\.,J, IfI:J vV,J ECONOMY PART ADDNL LABOR OPERA SUBLET REPAIR REPAIR SUBLET REPAIR ECONOMY PART 15. 0* 5. 0* 3. 0* 0_5*1* 0.3*1* *4* 1. 5*1 0.6*1 0.5*1 i * 3.~0* - 49.~5* MC MESSAGE(S) 01 CALL DEALER FOR EXACT PART NUMBER / PRICE 09 INCLUDES 0.6 HOURS MAJOR PANEL TWO-STAGE ~LOWANCE FINAL CALCULATIONS & ENTRIES GROSS PARTS OTHER PARTS PAINT MATERIAL PARTS TOTAL TAX ON PARTS & MATERIAL @ LABOR 1-SHEET METAL 2-MECH/ELEC 3-FRAME 4-REFINISH 5-PAINT MATERIAL LABOR TOTAL TAX ON LABOR SUBLET REPAIRS TOWING STORAGE RATE 36.00 43.00 40.00 36.00 17 .50 GROSS TOTAL NET TOTAL 6.00P% 264.66 69.95 152.25 486.86 29.22 REPLACE HRS 9.5 REPAIR H~S 71.4 608.40 8.7 313 _ 20 @ 6.oqO% 921.60 55.29 6.00 - ! 1; ?- 1 ..{ >-~ IS ,/ 1,498.97 "\.,-y' o 1,498.97 ~ CD 02/01 I 09:33:10AM R~_l ADP SHOPLINK U5751 ES CD LOG 539-1 DATE 02/26/01 PXN:N/OO/OO/OO/OO CUM:/// HOST LOG COPYRIGHT 1999, AUTOMATIC DATA PROCESSING, INC. 1.7 HOURS WERE ADDED TO THIS ESTIMATE BASED ON ADP'S TWO-STAG~ REFINISH FORMULA: 20% OF REFINISH HOURS, AFTER OVERLAP, PLUS 0.6 HOURS I FOR THE FIRST MAJOR PANEL, WHERE NOTED_ I ------------~------------------------------------- <:) C[r cf10' ftA,1:",'>,~, ., ~", -F ,'i!'"'(,,, .","_ I'" . "', ~, , ,M ""," '1" - ," " -~, I PAGE 2 , I J .. ~,' , , , "I" , , c'=. , ... SHERIFF'S RETURN - OUT OF COUNTY 'CASE-NO: 2001- 06857 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ERIE INSURANCE EXCHANGE VS GROSS A RICHARD R. Thomas Kline , Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: GROSS RICHARD A but was unable to locate Him in his bailiwick. He therefore deputized the sheriff of COLUMBIA County, Pennsylvania, to serve the within COMPLAINT & NOTICE On January 23rd , 2002 , this office was in receipt of the attached return from COLUMBIA Sheriff's Costs: Docketing Out of County Surcharge Dep Columbia Co 18.00 9.00 10.00 49.00 .00 86.00 01/23/2002 GOLDBERG KATZMAN s~/ ,,' ~ R. omas Klin Sheriff of Cumberland County SHIPMAN Sworn and subscribed to before me this oo'!? day of YU""Y J..()t:J;L A.D. ~Q.~.~ Prothonotary "~-,,,0ll0~~~ "f - . I ,.,.".--.. B~ " ",,' + '.... HARRY A, ROADARMEl, JR. . PH", tS7G)Jl9-HU SHERiff Of COLUMBIA COUNTY COURT HOUSE. P.O. BOX 380 BLooMSBURC, P... 17815 1M: (VO) ,...-o1J1 24 HOUI PHONE (5701'.....100 ERIE INSURANCE EXCHANGE Docket # 6857CFW2001 VS NOTICE RICHARD GROSS SHERIFF'S COST 49 PAID AFFIDAVIT OF SERVICE NOW, TillS FRIDAY, JANUARY 18,2002, AT 12:30 PM, SERVED THE WITlllN NOTICE UPON RICHARD A. GROSS AT 331 BOWMAN STREET, BERWICK BY HANDING TO MIKE, SON, A TRUE AND ATTESTED COPY OF THE ORIGINAL WRIT AND MADE KNOWN TO THEM THE CONTENTS THEREOF. SO ANSWERS, SWORN AND SUBSCRIBED BEFORE ME THIS FRIDAY, JANUARY 18,2002 ~Q.,~~} X SHERIFF HARRY A. ROADARMEL JR. ';...,~ ~fh1 ~<:tf'i\RY~LIC "'-- ", ' \ <-\') '" .,. All .Jl,l,i.'..,.',',WEN,,~ ~,YY, ,"'lIES', TOVER, NGTARY PUB, UAC ": ':'IlLOllMSBURG CGlUM8IA CG. P MtCr1MMISBI0N EXPtRES NOVEMBER G7, 2005 ','-, "":';)m'~ ,<c':;"<,,,.', '-'-1' ~, ~,' " ," " , < . In The Court of Common Pleas of Cumberland County, Pennsylvania Erie Insurance Exchange VS. Richard A. Gross SERVE: Richard A. Gross No. 01 6857 civil Now, January;1, 2002 , I, SHERIFF OF CUMBERLAND COUNTY, P A, do hereby deputize the Sheriff of Columbia County to execute this Writ, this deputation being made at the request and risk of the Plaintiff. ~/? /' ~~~' .r ~"",..c,^f~'~ Sheriff ofCurnberland County, PA Affidavit of Service Now, , 20_, at 0' clock M. served the within upon at by handing to copy of the original a and made known to the contents thereof. So answers, Sheriff of County, PA Sworn and subscribed before me this _ day of ,20_ COSTS SERV1CE MILEAGE AFFIDA V1T $ $ .1~""'M'4i,,,,,_ ',~ , ~_ _e,," ""~ --"'r---"",- ~~,' ' ) "il ,--------"--' "w of (t[Ulltliel'. ~~\\ t~Q(} R. THOMAS KLINE Sheriff q. RONNY R. ANDERSON Chief Deputy EDWARD L. SCHORPP Solicitor OFFICE OF THE SHERIFF PATRICIA A SHATTO Real Estate Deputy One Courthouse Square Carlisle. Pennsylvania 17013 JANUARY 28,2002 o c Dave Raudabaugh J -oFF VS ,f'Tir" ' . 2:'--,.-i- 2F" Stacy Slaybaugh c/o Tabitha Glassc.Q,~, No. 2001-6884 Civil Term ~6 Property Claim Determination ~p ~ ,,' -,- ,---,,^ :3 , Dear Sir, Reference is made to Property Claim dated January 18, 2002 entered by Patricia Glass pertaining to Execution No. 2001-6884 Civil Term, Dave Raudabaugh -vs- Stacy Slaybaugh, c/o Tabitha Glass. R. Thomas Kline, Sheriff, has determined that the claimant, Patricia Glass in the above mentioned property claim, is prima facie the owner of the property set forth therein. J~ ::t S? "\) (n So Answers: ,~~~e R. Thomas Kline, Sheriff a r"0 o "" -"!' ~- )~ ::J:: W o '"' ,',,'~, t~~ ";-)CJ (~3;,:J (~flq' i;! -I-,} -< BY~<1.uAlcvq, ~ cc: Mark Denlinger, Atty for Pltff. Stacy Slaybaugh, Deft. Patricia Glass, Claimant 1."_..",,, -, '-.. , ~", ~^. - ' "r, " ,- --~ ~ .,..,., "! . ; , PROPERT'Y CLAIM Grv~_ 6'~aIJ/1fCrl ~J:bi ,r;vo; O1l<cf_l In the Court of Fomm on Pleas of Cumberland Cqunty, Pennsylvania Writ No. 0/- bf]P!/ I TO THE SHERIFF OF CUMBERLAND COUNTY, PENNSYLVANIA The property listed below and levied upon in this case is not the property of the defendant, but is the property of the llildersigned. A list of the claimed property and the values thereof are: LIST OF PROPERTY VALUE , )17 C1CJ; ;!cF?7tZ, tlL J f -?,;) {j J ? ,.-., ~ ' \'....'-")j Cf' /' /01 ~aJ (1ku~ Clt/h>;>7r/ /~tJf! ,-,? 1.1]/ \ftJtryC:l/J /' d- '---'/JZ~';' c. / , , JPOijJh~~ , ,-,/;j11//t.1rUU> /+ ---J-- ,/" / .J/ -/-/iJ s-jl/' ), 0 ;1r-v- !/CJ' ~l5i~YA1 ,,-;) Ci 00, O'()' / r::;ruo , {} 0' ,3d {J ,{it; 5~oe ,-!20;{"7e ,0 (}{), C-} 6 (, <<) 0, C/O ~fO: c:0 &0tJ: ct:J ''7 c:;:> /)' /-'6 ,'~{--.JU ,v Claimant ~ being duly)',\,orn according to law, deposes and says that the l~L(;a ~ J;t!2V~' /" Claimant ,,,:;;~&,",,,;:,")ll;if,~~_ ,~-,..-~J '~~r"'~~'"' - ~, \'')}/}/I ,(~ .'~/:!,/ ,.,." \,) (Y7''j / (/ U!A,J.<> , ! (){;/dUl '0'1CI<!~ ~N4tJiI aiy/ t~ ,A, ,Th /b~j, ct~~~~< u~/Yc/~ ,/)J'LLAOrJ '7Jj C~ V-U41 dJ'7 . (:;) e-vI jPO/}/l-~) /f', L'AJ/ ; 1 ': Y1 )Jj QYCAJX-.. (9 t'C? ) '/ ~d~.' 0/la p,~, yr ; j/C-::J;,I':.A:" - .~~:b, /;/10A.. ,/ 'i"1' , t--A./ , ........,'~ . b"\ ! 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" 'ij 11 II ,~ '" , :,1 , 'I ':',---~-- "il; I,' '''' -~-----_.- I r , , I 1- .J I :l j ,) ,"" '-'---'-"-"-'''~--'~-'-- -.----.--'.-'-'---- ----,~----,- --.--- ~i ,~,.~T,,__.Ipn~~H'!J;."",~'" _,~,.~~rt:1i;r<W,~f~lI~'fi!?;~j:~~~ff.-W~;-;Ii'\1W~IllI!..{fi'1~';!fr~i~~r,W1;111 , " ,_e__,.._, ',0 '.'" ,,- ". ",.- ..,"',>-, ''".., ",,1..,...-, . ....,~ NOTICE OF APPEAL " " COMMONWEALTH OF PE.NNSYLVANIA COURT OF COMMON ,PLEAS FROM JUDICIAL DISTRICT DI,STRICT JUSTICE JUDGMENT COIiIliION PLl!~S No. <) Ii ... (p'gS7 r " v ~ I NotiCE OF APPEAL l:::k{.. 4,~ 00 I Notice ,is given that the appellant has filed in the above Court of CorTlmon Pleas on 'appea11ram the judgment rendered, by the District Justice on the date and in the case mentiOOed below. ;....a G1"os$ ~-f IN THE C OF (PIairrtiff) E ZF, CODE CV C V CH) C>~ rar,(""-o ( LT , , " , This block will be signedbNLY when this notatiari is required under P , 10088. .,'-'" This Notice of App~I. when received b~, ,t~' ~istrict JustiC~. jw~1I AAl!fote ~s''- ~" SUPERSEDEAS to the Judgment for pa"esSlon In thIS case. '...,..,," .. ' , Signature of Rrothdnotary or Deputy 4 ,,~~~~ /~"', -'."'"_.......~ , ", , {rappellant was, CLAIMANT (see Pa. R.CP.JP. No. (, 1'001 (6) if: aCtion before District Jastice, he MUST " 'iFILEA' CO'MPLAINT within'twenty (20) days after filing his NOTICE of APPEAL. (This section of, form to be used ONLY when appellant was DEFENDANT (see Pa. R.CP.JP. No. IF NOT USED, detach from copy of notice of aPf{'al to be served upon Ii!Pf)eI!ee). PRAECIPE: To Prothonolo, rY~, ~ ',\ V\.!, ~ Enter rule upon- , ~~!I 6 ~, ,<:j Name f appellee{sJ ()\-lll ~ '5'''7- c.;v', I , ,-- , PRAE(IPETO ENlIER RULE TO FILE COMPLAINT AND I'{ULE Td FILE 1001 (7) in action before District Justice. . appellee(s).ta file a complaint in this appeal (Common Pleas No. ) within twenty (20) dayji7;::::;:; or ;41er :;;~~/ non pros. Sigt;lature Of appellant or his attorney or agent \ RULE: TL$, I t ("" \ e.... \ V\ ~ Name of appelJoe(si . appellee(s). (1) You are notified that a, rule is hereby en!elJ!d upon you to file a complaint in ,this appeal within t~1lIy (20) days alter the date of ' service of this rule upon you by personal service or by ceriifie<for,registered'ma,iL (2) ~ you do not file a complaint within this time. a JUDGMENT Of NON PROS WILL BE ENTERED AGAINST YOu. (3) The date of service of this rule if service was by mail is the date a/mailing. ) Date: ~. '-I ;;{a)1 --- Signa/1Jre 0/ Pro~ IY Deputy ( AOPC 312-90 cOUR1flLE "'-::';'~""t~~'I!'<1,,,,,~~~~=,,,~'f-J.\e.,~,,,,,,,,,,,JO_<~ "'''''''''''^r ~II"~~.,,, ~!~" ~^~ .w.~", ; '- ",."J'fi; ,.-;; ~.r4<",,,,,,,,,,,,"~,,,,~"~~.,,,,,,"k"!O~'~~,,,,,._ "'~"'~"''''<=, ",__~,,,~.,~,.,~__,~, - --. . n n - PROOF OF SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT (This proal 01 service MUST BE FILED WITHIN TEN (10) DAYS AFTER filing the notice appeal, Check applicable boxes) COMMONWEALTH OF PENNSYLVANIA COUNTYOF ",CtLc,,(jjJJj);/J. "',.,,~'" __;ss AFFIDAVIT: I hereby swear or affirm that I served a copy of th!, Notice of Appeal, Common Pleas No, _f.liJfJ>.E 7:.,<:,,,:0/ -'I ' upon the District Justice designated therein on (date ot service) -iJ u:' f__lis2.L,.u_,_",' 0 ~ pers9nal serv~ce l0 by (certified) (ragistered) mail, sender's receipt attached hereto, and upon the appellee, (name).-ALc,J?,g...x:oL___A",uu-.6"i:O...Ls:"..u_.u",_' on Lkc"~~,, ,.,),oe t 0 by personal service I:2I by (certitied) (registered) mal(sender's receipt attached herete, o and further that I served the Rule to File a Complaint accon{phnying the above Notice at Appeai upon the appellee(s) to whom the Rule was addressed on . 0 by personai service by (certified) (registered) mail, sender's receipt SIV";'!' ofoirlc~/~;f(;;~~sdaM'~ ___--.-U~"--- /1~A~ -~,v".."Z.i:m~_~"--""'''_..,--'''''''''''-'''--,,,.,' __""""'m~_____""''''''''__''"____ SWORN iAFFIRMEDl SUBSCRIBED BEFORE ME , , THIS DAv OF_"l}r:;",'_",P;"u~'.... 'TitJeoiiiftiC!8IU '"' s;-;'"d';.L. \~~~;!;.s~~:aiyC"pU51tyfC Berwic:k Bore. ColumbIa oun 03 My commissiDn ex~mroJ$siOf!"~~_p'I,r_El_~,,May 8, ~() . Member, Pennsylvania Association of Notanes 0 C;~" (', c: ..,-) ?;:. CJ ""Om P'"f nlfr C"") 2:::u ~~~: c_: r-j'" <,,-,; ----c Pc' Ze' >r!. .. 2: ::2 :::) (;>'l $; -"-'''''','":,:0:-,)-';--; '-'---;'.' ",--l' COMI8\ONWIA~'H OF PENNSYLVANIA COURT OF COMMON PLEAS NOTICE OF APPEAL FROM JUDICIAL DISTRICT DISTRICT JUSTICE JUDGMENT COMMON PLEAS No. () 1- 0; 'gS"f (' :1 ,,;,1 NOTICE OF APPEAL f":>-<-. g, QOO I Notice is given that the appellant has liled in the above Caurt al Camman Pleas an appeallram the judgment rendered by the District Justice an the date and in the case mentianed belew. ,c...h- '" l~ ~OF APPEllANT 3.sl &0JM.a.. DA.1EOF.Il.I:lGMENT 1/ - S-t) OAIM NO zrCODE CV cv LT This black will be signed ONLY when this natatian is required under P 1008B. This Notice 01 Appeal, when received by the District Justice. will operate as a SUPERSEDEAS ta the judgment lor possessian in this case. Gross ~-f-- o Signature of Prothonotary or Deputy If appellant was CLAIMANT (see Pa. R.G.P.J.P. No. 1001 (6) in action before District Justice, he MUST FILE A COMPLAINT within twenty (20) days after filing his NOTICE of APPEAL. PRAECIPE TO ENTER RULE TOFltE COMPLAINT AND RULE TO FILE (This section of loon to be used ONLY when appellant was DEFENDANT (see Pa. R.C.P.J.P. No. IF NOT USED, detach from copy of notioa of apppal to be served upon appellee). P,RAECIPE: To Prothonotary ~~ \~ ~ vS .~ Enlerruleupon_ .-21_. .~.... "v~~ Name of appeJJee(s) () \ -(0 ~ 5""'1 c..; v) 1001(7) in action before District Justice. . appellee(s). ta file a camplaint in this appeal (Comman Pleas No. ) within twenty (20) days a ::Mor;r~lnon~~ Signature of appellant or his attorney or agent , RULE: TO..$/:."\""\ ~ \ \'\. ~ Name of awe/JoeIs) . appellee(s). (1) You are natified that a rule is hereby entered upon you ta file a camplaint in this appeal within twenty (20) days alter the dale 01 service 01 this rule upon you by personal service or by certified or registered maiL (2) II you do nat file a complaint within this time, a JUDGMENT OF NON PROS WILL BE ENTERED AGAINST YOu. (3) The date 01 service 01 this rule il service was by mail is the dale 01 mailing. Signatute of I'roIIIcOOay or Depuly Date: De.c., Lf. WI AOPC 312-90 COURT FILE TO BE FILED WITH PROTHONOTARY "'h~~~,"l ~ r, ......<"~,_,~ """'~~~,_,_ 'I" p, ~.~~-- ~'-, T - ~~ , = " - - , ~- ~ .1 ,~" . ." ~I'" ,r,.,,,!<c'."',,,!,,, 'it,!!"" ""~'''lrr'lI ~ '~~"'"I,',,~.,t"":f:<\'!""'''.~~*(''''-'''''-''''-,,1''''''-'jI'~''""",~'~',4''''~'''''''_'"""".'" ~",,,,,,,\.,,, ,.~ d' .."', " ~"'=,"" _""~,, . _''__~."oc,' ...., ,'. t" .(- .,' , PROOF Of SERVICE OF NOTICE OF APPEAL AND RULE TO FILE COMPLAINT (This proof of service MUST BE FiLED WITHIN TEN/IO) DAYSAFTER filing the notice appeal. Check applicable boxes) COMMONWEALTH OF PENNSYLVANIA COUNTY OF , " "" __.. ",..,~, .m,___ n~",'; S5 AFFIDAVIT: I hereby swear or affirm that I served a copy 01 thEi Notice at Appeal. Common PIEias No, ---,", , (date of service) 0 by personal service rEiceipt attached and upon the appellee, ___.. by personal service by o further that I served thEi Rule to File a Complaint accompanying the above the Rule was addressed on , '..,...... by mail, sender's receipt IhifDislrict Justice designated therein on by (certified) (registered) mail, sender's on maiL sender's receipt attached hereto. Appeal upon the appellee( s) to whom service 0 by (certified) (registered} SWORN (AFFiRMED) AND SUBSCRiBED THiS ME was My commission on (") C;) ~ v C -I": ;-;;: c:J -0 a:; tl-i 52n" " - ::L , :Tl ZC C:J- CI)L: .J::- 5, , -</ ~; !:<o 2:~ :r>c 1, \-':'::(''::1 Zc a 6rfl :r>c z ,:,j :.~} -, :i:i -< f'-0 -< ~~-~ _",tUiili~lt J.,,"]ffiJill.J~~j!l,"1l'ift'~'JI'~II"!\''-1!\':!-'':~~'!$F'''0l'i~~H~~'g!iiffi\i;~!W,:Ji;''f!i;''T'''''''';.!i'+T-'':'. 'F';:'1'9~;:'jf"-,,*'" ~:'",o<;~:i,;f 09-1-01 NOTICE OF JQJd~~1/TRANSCRIPT CIVIL CASE . PLAINTIFF: NAME and ADDRESS I 'ERIE INS PO BOX 2013 MECHANICSBURG, PA 17055 L -.J .COMMONWEAL TH OF PENNSYLVANIA COUNTY OF: CUMBERLAND Mag, Dist No.: DJName: Hon, CHARLES A. CLEMENT, JR. Add,,,,, 1106 CARLISLE ROAD CAMP HILL, PA VS. T"'phoooo (717) 761-4940 17011 DEFENDANT: NAME and ADDRESS !GROSS, RICHARD A 331 BOWMAN STREET BERWICK, PA 18603 L Docket No.: CV- 0000595 - 01 Date Filed: 10/05/01 I RICHARD A. GROSS .; 331 BOWMAN STREET _ BERWICK, PA 18603 / ,,~ l' () 3 11 Cf ~ i qS- -.J THIS IS TO NOTIFY YOU THAT: Judgment: DRFAULT JUDGMID\I'1' PLTF [!] Judgment was entered for: (Name) R1HR TN!! [iJ Judgment was entered against: (Name) GRO!!!!, RTC'HARn A in the amount of $ 1 ,O<;fi <)7 on: (Date of Judgment) (Date & Time) 11/0<;/01 . . o Defendants are jointly and severally liable. o Damages will be assessed on: o This case dismissed without prejudice. Amount of Judgment. Judgment Costs Interest on Judgment Attorney Fees Total $ 998.97 $ 58.00 $ .00 $ .00 $ 1.056.97 O Amount of Judgment Subject to Attachment/Act 5 of 1996 $ Post Judgment Credits Post Judgment Costs $ $ o Levy is stayed for days or 0 generally stayed, ------------ ------------ Certified Judgment Total $ o Objection to levy has been filed and hearing will be heid: Date: Place: Time: ,''''''':'''f" ",.' .. '#'. ANY PARTY HAS THE RIGHT TO APPEAL WITHIN 30 DAYS AFTER THE ENTRY OF JUOGMENT BY FILING A NOTICE OF APPEAL WITH THE PROTHONOTARY/CLERK OF THE COURT OF COMMON PLEAS, c.wrL"oivisION: vbu MUST INCLUDE A COPY OF THIS NOTICE OF JUDG~E~TlTR~T FORM WI~ YOuRNO"tI~~OF A,PPEt NOV 5 - 200tDate ~ . ~, . '. . . ,DlstnctJustICe.: : I certify that this is a true and correct copy of the record of the proceedings cont&iI)ing"the J~dgmerit' ,:., ", .,' Date '...,.."p,i;;Mct'Justice My commission expires first Monday of January, AOPC 315.99 2002 SEAL ""f,E'~~n,"~ ,~, ",,", ~~""", " ~=" <r' ~. ~, '-" ,~~~~~,=."""-".",,,,,, ~ t ..,~ - .~ ~<";>"'->< <~-v'*"<~"'<~"~' ~"",,~,,~, ~ 12 - ~- -J) v..:,) ->..l '-l> ~_~~,,",,,,,~ij~~,~~~Wi~~M,~l~'1%'1lif.t~i,,,~.',,..",,. """'" :;:" r' Vi '-l '-'l ,-,....",,', ..c::. ?'\O 8 (,0-<<> "' ~ l1J Ul o s::; <- vt;:! q.)L; ~C CD -",- -<:;-.c ~::;,;, >~ ,L-:" :.< (> t- .:;,- ~ ,,- .::...- t ~ '" t. r , o '_: -,--- C1 t-'1 :-, ,---,,' ,'-, :~ -, .:r~) r....:' ~ " ""i~- -, ERIE INSURANCE EXCHANGE, Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 6857 CIVIL '1:9 2001 vs. RICHARD A. GROSS, Defendant RULE 1312~1. The Petition for Appointment of Arbitrators shall be substantially in the following form; PETITION FOR APPOINTHENT OF ARBITRATORS TO THE HONORABLE, THE ~UDGES OF SAID COURT: the John R. Ninosky, Esquire above 1- 2. , counsel for the plaintiff~ in action (or actions), respectfully represents that: The above-captioned action (or actions) is (are) at issue. The claim of the' plaintiff in the action is $ 998.97 The counterclaim of the defendant in the action is The following attorneys are interested in wise disqualified to sit as arbitrators: the case(s) as counselor are other- John R. Ninosky, Esquire WHEREFORE, your petitioner prays your Honorable Court to appoint three (3) arbitrators to whom the case shall be submitted. Respectfully submitted, ORDER OF COURT ~ ~~dUire AND NOW''7n~u ' ' ~~~i~ consideration of ~he foregoing petition, ,-ff tJ ~ Esq., ~~ ~' Esq., and~~ :lyIilZ~. ,Esq" are appointed arbitrators in the above-captioned act on (or actions) s prayed for. By the P. J. ::!'%@~i!!V_ ~o _r, ~--' " d_q 1"~~'M~ltillilrll~*-j~~~t!\i,;,,'4i,jili"If;j:,ii"!'-<!M,-if'~"";J;-~~~~.t,ili~''-'" '~~ I ">--'"=:~.rili.("""""=>'""""-~l -~ FllED..OFFiCE "~ l< - ,I:) - Or "c::.".T~"i(,.:r\rl\RY " -,' ., ,~, <: \\, ~\ h.~). J" ('J2. ~l,","\V, . " '"'Icl I' t:"h " \, ,\", I" r" ' fC 1 b r II ';:l '-' \'\" \,t" "\ '"\ ')\ ~ \:~' ~ \, ,,,,,,1,." "" "~' '-. ,\. '4...l"'" <f CUMBEH[j~;\jG COUN1Y ~,. PENNSYLVANIA OF .. .'. .. =M~~~s_, ,,"~, ~~" ~ =~ -, - , --'''~' ~c j- '-.. .. J! .' CERTIFICATE OF SERVICE I HEREBY CERTIFY that I served a ,true and correct copy of the foregoing document upon all parties or counsel of record by depositing a copy of same in the United States Mail at Harr i sburg, ~ day of Pennsylvania, with first-class postage prepaid on the ~ , 2002, addressed to the following: Richard A. Gross 331 Bowman Street Berwick, PA 18603 GOLDBERG, KATZMAN & SHIPMAN, P.C. By JOh5t4ffo~ire P.O. Box 1268 Harrisburg, PA 17108 Attorneys for Plaintiff Telephone: (717) 234-4261 78277.1 i;;,l~k~", '~"-" "~ ",<,K~-~""",,,"''''''''','='''=,"__,.,_M,~ ',,",',',<, .","",:'7'" Of"",,',' ,.", ~_ __"'._ . ,,"'>'- ~~ ". r' \I( -- ~ -tQ. \~ .~ 0 c;> () f;; r'.> !:d 5-" ~ .- ......... c;, vL~,L' ;.:;..;:. )lJ Q)l~,' ,..,~. ~r, "'-- ~,\--, ~ ()oJ -U ~9-; 1::0 G' ,_n '--,-' -- F C.1- f; 0- ~~~: -\:-' , ',~ :i.~' '-7(. ! -:.'. ~;; (~; J >: ~~] i'"Y ,'"-"Ii ~3 ;~ :J.:J ""'" -< "-' ;}5 I21Lt ,~. c~!, ,~" y, "ilf''__pO_''"-, __J'~l("D"""',)7,_,,.'c,~J),,:g, ,,~1;~__,,:'~, -~,'p~~~~~~,:~.u~~1~\i1!~;-.i1~'1J:~~~~,'< I.n.." Offices / O'BR/EN. BARIC & SCHERER 17 West S'H1lh Slreet Carlisle, PemL\\.'II'l7nia /70/3 Robert L. O'Brien Dnvid.4, Baric ;\[ichael A. Scherer (7/7) 2-19-6873 Fax (71 7) 2-19-5755 E-t)1oi/: obs@obslall'.com June 14, 2002 Richard A. Gross. Defendant 331 Bowman Street Berwick, Pennsylvania 18603 Timothy P. Keating, Esquire 1501 North Front Street Harrisburg, Pennsylvania 17108-1268 Rebecca R. Hughes, Esquire Irwin, McKnight & Hughes 60 West Pomfret Street Carlisle, Pennsylvania 17013 John R. Ninosky, Esquire Goldberg, Katzman & Shipman, P.C. 320 Market Street P.O. Box 1268 Harrisburg, Pennsylvania 17108-1268 Re: Erie Insurance Exchange vs. Richard A. Gross No. 01-6857 Dear Mr. Gross: I have been appointed Chairman of the Board of Arbitrators in the above captioned case, (A copy of the Order is enclosed) Enclosed please find schedules for the months of July, August and September. Please cross out the days that you are not available for the arbitration hearing and return the schedules to my office as soon as possible in the envelope provided. Should you have any questions, please feel free to contact me at this office. Very truly yours, O'BRIEN, BARIC & SCHERER ~02.6~ Robert L. O'Brien. Esquire RLOlta Enclosures cc: File ','1'4';~'~~,T'!, ~ !IV i r',~- " "-,. ~ A " June 2002 ISM T W T ~F'-S~i .-,----__4 1 ' 234 567 8 I 9 1011 12 13 14 151 16 17 18 19 20 21 22'1 23 24 25 26 27 28 29 130 _____J July 2002 i I ! I 116-n_--jrr-----118 , , I I I 1 I -l-~ 25 Sun Tue Mon 7 11 '23 ! i I i I I II II i I ; I , I i -1----n-'----r-~---"'-..--- 't- 18 19 110 , ! ! 14 , I ~ 115 1 I __L_, 22 I i 1 I I '23 , , u__._.'~__. __ ._.,. Ln_____ ~24 I I I I I i 21 -j29 30 , i- 131 28 ! i , ' : I I i : I --L ~ I ~_~__~.,~__,_~_.,__.l...-___,__ !:'~~,-,~'" - -' , ~ - '" . ~,' ,~ Wed 4 111 i I --r--- I I Thu I '--j \12 , I -- 'C::- !19 AU us! 2002 IS M t W T F S I 1 2 3 4 5 6 7 8 9 10 111 12 13 14 15 16 171 118 192021 2223241 25 26 27 28 29 30 31 , , , Lnn ..~_____"__,.. m,J Frj Sat 5 6 I \ , J I I 113 I I r I 26 1 I I I I I I ! 1 L--------j 127 I I I I r i I I I I ---'-----1 I I l I ! I~ I I _ """___~____L____~~_ Richard A. Gross Tue Wed Thu Fri Sat ---, -..-----~-- 12 13 I i , i I I , , I I i4-----1s--t16-- , I I I : I . /" Sun Mon '--r-m----on--n,..-., -"'----, ! ' I i I I 4 5 6 r , ! , , I , , , I , , , 11 \12-------V3---- - I I I I I I i I I ___________1_,_ -- 18 19 ,20 I , I ! i I , I I I I i I I 25 '126----127 ----.-- , : i i , , : I i , i i ___L_____,.J___,. '- '~;:J~,...,'!R-1'~~. "t<'.<' " ~ I. "'-I~," August 2002 7 8 SePltember 2002 !SMTWTFS, 11234567'1 ,8 9 10 11 12 13 14 115 16 17 18 192021 I 122 23 24 25 26 27 281 129 30 - I I L________-' 9 10 I I I 117 I I I , I ! ' i i -----124- ___an, I , I I I --I---------b------- " 1-, .. ,21 ,22 ,23 I i r i I I I , -~28"-----~-"-- I , I I ...1____1___ --~ , -, i ,L_,_,,_____~---~ !30 131 : , I I I I I I .1_____1 Richard A. Gross Au ust 2002 .. SMTWTFSI 1 2 3 I i 4 5 6 7 8 9 lOi 11 12 13 14 15 16 171 18 192021 22232411 25 26 27 28 29 30 31 I September 2002 1 Sun Mon Tue Wed --T---~-----~'-----r--- 12 13 14 I I : \ ! l , I is 1 I 1 Thu October 2002 is M T W T F S i : 1 2 3 4 5 i 6 7 8 9 10 11 12 II !13 14 15 16 17 18 19 :2021 2223242526, I I !27_28 29 :~-.J F"ri Sat 6 17 I I I 8 -l_~____, ___1~___ 19 110 I \ I 1 ___L---___,.... i12 ! _L _. 113 I I ,1..,....- ill 1 15 I I I I I I i ----L ' 1 --i 116-'......~117~-~....-!18..m.. 19 22 ...1-__ i23 ! I 126 ! I , :24 125 29 " I ..I~...._..'m___+ -.., 130 : ____, m~__'_ ,.. -1- ____ -__'_'" - - --1- ' I I 120 I " 'n__'..'l-__~_~--I i14 i I I I I I I I I \ I I I 121 i27 I i 128 ! I I , 1 ! 1 I I I 1 i, I I 1 'I ,I 1 ! Ii! --..__..___L____,_..,_"_,..,__....l____"_ __ ,_,_L____............... :"IJ%~'PW-'!1l<ilt~ij ',' __ ,_',~,_-"m '~0 . .,-" r, _, _,", [~' - --1'.- Richard A. Gross ~~.~ John R. Ninosky, Esquire Attorney I. D. No. 78000 GOLDBERG, KATZMAN & SHIPMAN, P.C. 320 Market Street P.O. Box 1268 Harrisburg, PA 17108-1268 Telephone: (717) 234-4161 Attorney for Plaintiff ERIE INSURANCE EXCHANGE P.O. Box 2013 Mechanicsburg, PA 17055 Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW vs. NO. 01-6857 CIVIL TERM RICHARD A. GROSS 331 Bowman Street Berwick, PA 18603 NOTICE TO THE DEFENDANT: YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth in the following pages, you must take action within twenty (20) days after this Complaint and Notice are served, by entering a written appearance personally or by attorney and filing in writing with the Court your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the Court without further notice for any money claimed in the Complaint or for any other claim or relief requested by the Plaintiff. You may lose money or property or other rights important to you. 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. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 Telephone: (717) 249-3166 (800) 990-9108 "~;J~LL, '''''''<''>''f'::t,;''!(1'''''-'J';{?,!"~,_,,:,,,,,r~~;; """_'_; ,_- = 'c. ,_,,..?'",b,,"~ /'-~~',/f-" >::0 ",,""''''':'~ _ ,..,. '"', ','.,-""_J,,,, __ 0 ,,',." ,_,,'-'c ',," _'_"" '. ,,",,'~ "', ",_, ,^ .- ~',' '- ~, -~'" ~t NOTICIA Le han demandado a usted en la corte. Si usted quiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita 0 en persona 0 por abogado y archivar en la corte en forma escrita sus de fens as 0 sus objectiones alas demandas en contra de su persona. Sea adisado que si usted no se defiende, la sin previo aviso 0 notificacion y por cualquier quja 0 puede perder dinero 0 sus propiedades 0 otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABOGADO 1MMED1ATAMENTE. S1 NO TIENE ABOGADO 0 S1 NO T1ENE EL D1NERO SUF1C1ENTE DE PAGAR TAL SERV1C10, VAYA EN PERSONA 0 LLAME POR TELEFONO A LA OF1C1NA CUYA D1RECC10N SE ENCUENTRA ESCR1TA ABAJO PARA AVER1GUAR DONDE SE PUEDE CONSEGU1R AS1STENC1A LEGAL. Cumberland County Bar Association 2 Liberty Avenue Carlisle, PA 17013 Telephone: (717) 249-3166 (800) 990-9108 72657.1 ~t~:Af~L" " :"~'1f"V~0'''YT,:'':~'''''~',< -,-J' > ,", '; "",-",.,,"~;'H"e" ',',"''''''' '''':,0>'' . "~",,:, '~ ':""?'",, , .>",. '~'" "'>", ,~ ",n,o,,,",' '~'_', ,j__~" __ ,,..,' '" "", __ , - . "--~, - if' ~M >'^ ~'. John R. Ninosky, Esquire Attorney I. D. No. 78000 GOLDBERG, KATZMAN & SHIPMAN, p.e. 320 Market Street P.O. Box 1268 Harrisburg, PA 17108-1268 Telephone: (717) 234-4161 Attorney for Plaintiff --------------------------------------------~------------------- ERIE INSURANCE EXCHANGE P.O. Box 2013 Mechanicsburg, PA 17055 Plaintiff IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION - LAW vs. NO. 01-6857 CIVIL TERM RICHARD A. GROSS 331 Bowman Street Berwick, PA 18603 COMPLAINT AND NOW, comes the Plaintiff, Erie Insurance Exchange, by and through its counsel, GOldb,rg, Katzman & Shipman, P.C., who files this Complaint by respectfully stating the following: 1. Plaintiff is a business entity, licensed to issue insurance policies in the Commonwealth of Pennsylvania, and which has a business address of 4901 Louise Drive, P.O. Box 2013, Mechanicsburg, Cumberland County, Pennsylvania, 17055. :i~:~,'2"rf- ~,' ~ ~,'-<''',,' "'"", _""""'"."A,' , ''''-'' ,"","" ,0 -,M,X'_ ,-,',~'h'f""'^',"~_0~e'f'~'~,,,..,.,,,,'~""""''''" ,.","""..,<..,, '''' ',~-- ~,"< '- ~,-,,~-~ "~-'. :~1."'~~'~~'''' ~"'- 2. Defendant is an adult individual who currently resides at 313 Bowman Street, Berwick, Columbia County, Pennsylvania, 18603. 3. On February 16, 2001, Defendant had an insurance policy with Plaintiff which insured a 1989 Toyota Camry automobile with Pennsylvania license place number HEP 857. 4. On February 16, 2001, Defendant was involved in an automobile accident with the subject automobile. 5. Defendant received payment from Plaintiff in the amount of $998.97 to repair damages to the vehicle. 6. Defendant subsequently received an estimate which indicated the total amount of damage to the vehicle was $450. 7. Upon receiving the information that Defendant had an estimate of $450, which was less than the applicable deductible, Plaintiff demanded the repayment of the $998.97. 8. Defendant has refused return the payment of Plaintiff notwithstanding his notice of the overpayment. 9. Defendant is not entitled to the $998.97 which he was paid by Plaintiff. 2 i i i , I Y!i~lj,.> C'_,' ",""",,"'1':'! >:",.,:?, ,r','''';~'' !--!Y"",>~ '_.,,""'. ,C', [",., .",", ,);.0. .,,",,,~,",;,,,.," "':;- <,.c,,,',' """","", _~", _, e, ',;,\, ,. ", __ ,-." ,_,.' " ,,'__,,_ _,-"'F, -," .~, j;""~. WHER~FORE, Plaintiff demands judgment against Defendant in the amount of $998.97, together with interest, delay damages, and costs of suit. Respectfully submitted, GOLDBERG, KATZMAN & SHIPMAN, P. C. DATE: 72657.1 ICJ jJ-l/6 J By ~ j(11~ John . Ninosky, Esqui e Attorney I. D. No. 78000 P.O. Box 1268 Harrisburg, PA 17108-1268 Telephone: (717) 234-4161 Attorneys for Plaintiff 3 )#'~Il~"?:.,, - '''!<OO',<r,n,', ,C:;1,T,_ ,fw"'1'\-'!'.""g",",-_",,<~,,,,,",",,"'h"',Y ,F,,,~,,',,,-_ ,?"",,!,-,,,,,,,,,_.,,,",,,_c~,,,",,,,__,,, ",' ,'',_',_''- ,__" __ M"~""_'"' , - ~." . -, ~~ ~ , ' ;;':f'"'''''''' .',--,,~,'- VERIFICATION I, #f~~ , an authorized representative of the Erie Insurance Exchange, have read the foregoing and hereby affirm that it is true and correct to the best of my personal knowledge, or information and belief. This Verification and statement is made sUbject to the penalties of 18 Pa.C.S. ~4904 relating to unsworn falsification to authorities; I verify that all the statements made in the foregoing are true and correct and that false statements may subject me to the penalties of 18 Pa. e.s. ~4904. ERIE INSURANCE eXCHANGE By~k~ DATE: 72660.1 , ~,"', - -'~ : "''f" '-"I,,~;.~,.;h""""'_'_l-'~Y{'__,''''~0''''', '_'>~'",,,, '"__~,, i -~I,~'-"\0,~ "~,,,o_,.. ~'<""'''"'''',',, ,,' ,,-'.. ,', ,,' "..' ",~ __', ,,',-"",. --, . -- ,,'~ , ",,", ,<- - , -- - -~~ ,,,~, ""~ >.",,~ "" M_.".J!'''J.~,.. ~" ,'""'~, ',' <"', . "'e'" >~~';',,,"^""-""";'="'~~'.; ',,,,"';.."r' -' ',', ~"-~:" )"'-,,"''''''I~'-I- ""~,~""= '~"r:"'J V,,__ , ~IC~'~ o s: -c ~~~ mi" :z: :J:: Zc_" ~:{~ r..:;c) )>:(J !f.::O )>c :z: ::< CJ ~-1 r--;:',l 1-' l':i v~ ~,' -""... ES Sf ~~-~. ~? ,'-' ( '; ~;~ '51. .-.-. ,,, '. .~., ,. ^'- "-c-":: .'~',~-, '__""~',{-.rP1\",,"_"""'~'~:" !''''~-'''~~~~~''-:;-''''''~'__'' ,)l8!:~I~_,~",;_ i'; J,~Jf.!l:~1f" ~, ERIE INSURANCE EXCHANGE : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA V. : 01-6857 CIVIL TERM RICHARD A. GROSS IN RE: ARBITRATION PANEL ORDER OF COURT AND NOW, August 14, 2002, the Court having been informed that Timothy Keating, Esquire, is unavailable for the above-captioned arbitration hearing, Gregory Cutler, Esquire, is appointed in his stead. By the Court, GeO~PJ ~ ~~~~~~~ O'Brien, Esquire -{Y) <j . J '1-0 ~ Court Administrator P.k:s -~fI'~ft,_" "_~"n - ____',_ , " ,- -I" _0'0_ , . ~__ '< ~ , . - " ~ n""'" <if.~~.Mfiij!ffi''PJMJ~lf1.''~!f~*,~'1i'~f;I,W-j'i';&l;vkq'J'i<n:li'i'i'!iE*i~;"~"-"'~.\f.f.~~~MI~t::L"'("'I";f..~..k,,,,'';,; .',\ '--~.!i;~~' :'rM r';;'..T1J.-..." ,LH._,.,~~, .=,T",,,r:'qo..~--,~,N_"~_ "_.".~,= '.""".',. ~ ,~ .. - -~ OF Hi i-'O-(>;CC!('I["' -'[1r'f"';:::;-j.'-:"~.,., I; "_:'I".l 11\" 11flJO'y , -' "....'f"-l 0211UG 1(, "D" ? I ~ :] . ,~' .. _' --i":; CUM!::iEFr ", ,,' "'1'" I' "TY 1-"'1"...... ,--..)\.,-11,\\ PENNSitVf\I\i!AV' , "'-."... "..~ d ,'" ......J r IVS u.n"lAJ('..c:... ExyJ.. ) 2 ) ) ) ) In The Court of Cornm~n Pleas of E,\~ Cumberland County, p1nnSYlVania 'T<\~o..~ (4 9i'oSS :10. 0 \ , <015$7 U ~ OATH We do solemnlv swear (or affirm) that we will support, obey and defend the Constitution of the United States and the ConstitutiQ~ of this Common- wealth and that we will discharge the duties of our office with fidelity. AWARD We, the undersigned arbitrators, having been duly appointed and sworn (or affirmed), make the following award: (Note: If damages for delay are awarded, they shall be separately stated.) ~'" J... \ '^'- .&".-.) oJ' 0 Sf- tk..~ ~ applicable. ) . Arbitrator, dissents. (Insert name if Date of Hearing: Cf I:u> I o":L '9 I ':2-0 I 0'2- Date of Award: NOTICE OF ENTRY OF AWARD Now, the dlo"::: day Of~ award was entered upon the docket and parties or their attorneys. , iIJj;looJ.., at~, 5-.l1., the above notice thereof given by mail to the Arbitrators' compensation to be paid upon appeal: $ ;)t{M/I) By: ~(A-r,.o R,f~ 1/1,.:' Q Pr~thonotary "0 r2 ~ , Deputy 1~.'l~.I..__. ~ c.." .0 . - f!.!l\'M~~ "^ ="-'''''~--'''-'" ,'"""",."",,,", - ~-<"""~"k ""~' '.'''-'- ","-~,< ""'-"'"~ -___'..v~N~ '~~"-IT~-='"~''~--lWf'~'~-rt~:';;;!''''' ~ ~.~a~ q.:u,.V.2. 9- L~e~ f~ eo,""e _ ct /6_1'1-61- /} j--' o f;; :-ufj; !P9:i 6is;: ::< -"". r-B :;f" <8' j;; 5i ~ '~ o .... ~ Rg </.) 1'1'1 "'0 '" o o '1 --/ -r ti-'i:JJ r- -159 S6 (f5:B ;;~ (') csm :i-;! :0 -.:; :b. ..". - '!? .~ i!lf. ","__._,,~~~I~~-tiIt~'PI:Bl"W,fm';""<"'-"")'lf':h;";~'f'\\<-\fP"!"":'::"~"'t"\';':-'if\&~~~,~.w~~;"'~"':;fr.','!';Wlf~~!'sW"H~~~'tfi!1li7:~~~~'*::;;: