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Home My WebLink About04-0559 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION ELAINE P. BELBA, and GEORGE BELBA, Plain tiffs : NO. 04 - 5[;9 C!.1~iL~~ v. : CIVIL ACTION - LAW MCDONALD'S STORE #10212 Defendant : JURY TRIAL DEMANDED NOTICE TO DEFEND Pursuant to P A RCP No. 1018.1 YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claims set forth against you 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 default 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, GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW. THIS OFFICE CAN PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER. IF YOU CANNOT AFFORD TO HIRE A LAWYER, THIS OFFICE MAY BE ABLE TO PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THAT MAY OFFER LEGAL SERVICES TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE. Y"""' 1''''''''0",,,,.,'''''''' LAWYER REFERRAL SERVICE OF THE CUMBERLAND COUNTY BAR ASSOCIATION TWO LIBERTY STREET CARLISLE, PENNSYLVANIA 17013 TELEPHONE: 1-800-990-9180 I);\I"-,.I':"'\,'(.'-ICI',:",, '1',(' 1).,l,I': 'r: ,,,,,,"''''1.,,,",. I'.. (' Y"""I',.""""-,,,,, ",..-, EN LA CORTE DE ALEGATOS COMUN DEL CONDADO DE CUMBERLAND, PENNSYLVANIA DIVISION CIVIL ELAINE P. BELBA, and GEORGE BELBA, Plaintiffs : NO. v. : CIVIL ACTION - LAW MCDONALD'S STORE #10212 Defendant : JURY TRIAL DEMANDED AVISO PARA DEFENDER Conforme a PARCP Num. 1018.1 USTED HA SIDO DEMAND ADO EN LA CORTE. Si usted desea defenderse de las quejas expuestas en las paginas siguientes, debe tomar acci6n dentro de veinte (20) dias a partir de la fecha en que recibi6 la demanda y el aviso. Usted debe presentar comparecencia escrita en persona 0 por abogado y presentar en la Corte por escrito sus de fens as 0 sus objeciones alas demandas en su contra. Se Ie avisa que si no se defiende, el caso puede proceder sin usted y la Corte puede decidir en su contra sin mas aviso 0 notificaci6n par cualquier dinero reclamado en la demanda 0 por cualquier otra queja 0 compensaci6n reclamados par el Demandante. USTED PUEDE PERDER DlNERO, 0 PROPRIEDADES U OTROS DERECHOS IMPORT ANTES PARA USTED. USTED DE BE LLEV AR ESTE PAPEL A SU ABOGADO ENSEGUIDA. SI USTED NO TIENE UN ABOGADO, V A Y A 0 LLAME POR TELEFONO LA OFICINA FIJADA AQUl ABAJO. ESTA OFICINA PUEDE PROVEERE CON INFORMACION DE COMO CONSEGUlR UN ABOGADO. Sl USTED NO PUEDE PAGARLE A UN ABOGADO, ESTA OFICINA PUEDE PROVEERE INFORMACION ACERCA AGENCIAS QUE PUEDAN OFRECER SERVICIOUS LEGAL A PERSONAS ELIGIBLE AQ UN HONORARIO REDUCIDO 0 GRATIS. LAWYER REFERRAL SERVICE OF THE CUMBERLAND COUNTY BAR ASSOCIATION TWO LIBERTY STREET CARLISLE, PENNSYLVANIA 17013 TELEPHONE: 1-800-990-9180 ELAINE P. BELBA, and GEORGE BELBA, Plaintiffs IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 04- S'~q C't>J'--r~ v. CIVIL ACTION - LAW MCDONALD'S STORE #10212 Defendant : JURY TRIAL DEMANDED COMPT.ATNT 1. The Plaintiffs, Elaine P. Belba and George Belba, wife and husband, are adult individuals whose mailing address is P.O. Box 130442, Tampa, FL 33681-0442. 2. Defendant, McDonald's Store #10212 is a retail business entity located near the intersection of Trindle Road and York Street in Carlisle, P A. 3. On July 22, 2002 at approximately 9:30 a.m., the Plaintiff, Elaine P. Belba was a business invitee at the aforementioned McDonald's store. 1)'-",1" 4. At that same time and place, Plaintiff, Elaine P. Belba was traversing the floor, when she slipped and fell on a wet area on the floor that had been mopped by an employee of the Defendant resulting in personal injuries to the Plaintiff. 5. At all times relevant hereto, the Defendant acted through its employees, agents, and/or servants and is vicariously liable for the negligence of those individuals. 6. The aforementioned accident OCCUlTed as a result of the negligence of the employees, p, I agents, and/or servants of the Defendant, and was due in no manner to any act or failure to act on I':. .\:'<'''''''.'1''':' """._ 1'"."~",.,,","L' 17'''', the part of the Plaintiff. 1,..\ 1.1', I':. .\S,o.;"'.,,".e:. 1". '(' ."".'''''<'''_,""",w 7. This matter is alleged to exceed the applicable limits of arbitration and a jury trial is hereby demanded. COUNT I ELAINE P. BELBA v. MCDONALDS STORE #10212 8. The allegations contained in paragraphs 1 through 7, inclusive, are incorporated herein as fully as though set forth at length. 9. The negligence of the employees, agents, and/or servants of the Defendant consisted of the following: a) Failing to recognize the special element of harm and danger of a wet floor; b) Failing to utilize that degree of care required for business invitees such as the Plaintiff by not maintaining the premises in a safe and usable condition; c) Failing to warn or protect the Plaintiff from the unsafe and hazardous condition of the wet floor when the Defendant knew or should have known that the Plaintiff might be unable to protect herself; d) Failing to correct the hazardous and dangerous condition that the Defendant knew or should have known existed on its premises; e) Creating or allowing a hazardous condition to exist which the Defendant knew or should have known involved an P."".", I';. ,'\;"C""'J'lCI.', I', {' unreasonable risk of danger to persons such as the Plaintiff who would not know or have reason to know of the unreasonable risk ofhann; f) Failing to warn the Plaintiff of the unsafe and hazardous condition of the wet floor; g) Failing to carry on the Defendant's activities with reasonable care for the safety of the public; and h) Failing to post any warning signs of the unsafe, wet floor in the area of Plaintiffs accident when the Defendant knew, or should have known, that the Plaintiff would be exposed to an unreasonable risk of harm. 10. At all times relevant hereto, the Defendant's employees, agents and/or representatives were acting within the course and scope of their employment with the Defendant, under the Defendant's control, and in furtherance of the Defendant's business interest. 11. The Defendant is vicariously liable for the negligence of its employees, agents, and or representatives. 12. As a result of the aforesaid negligence. the Plaintiff suffered serious and permanent injuries including, but not limited to, right eye hemorrhage, facial contusions, hip and back pain, headaches, neck and shoulder pain, knee pain, fractured tooth, jaw pain, and a severe shock to her nerves and nervous system. 13. As a result of the negligence of the Defendant, the Plaintiff was forced to incur medical bills and expenses for the injuries she has suffered and she will continue to incur medical expenses in the future. 'I'..' I,'" 'I': ;\S.'1"'I;'n,:, I", '(' Y''''.''''''''''-''.",,17''''-, 14. As a result of the negligence of the Defendant, the Plaintiff has suffered, or may suffer, a severe loss of her earnings and impairment of her earning capacity. This loss of income and impairment of earning capacity, and the loss of income and impairment of earning capacity will, or may, continue in the future. 15. As a result of the negligence of the Defendant, the Plaintiff has undergone, and in the future may undergo, great mental and physical pain and suffering, mental anguish and humiliation, loss of life's pleasures, and a severe limitation in her pursuit of daily activities, all to her great loss and detriment. WHEREFORE, Plaintiff respectfully requests This Honorable Court to enter judgment against the Defendant in an amount in excess of the mandatory arbitration limits. COUNT II GEORGE BELBA v. MCDONALD'S STORE #10212 16. The allegations contained in paragraphs 1 through 15, inclusive, are incorporated herein as fully as though set forth at length. 17. Solely as a result of the negligence of the Defendant, and the resulting injury to his spouse, the Plaintiff, George Belba, has been deprived of the assistance, companionship and 1);\ r."..: II':, "'\;><''-\'1'.''''''.1, 'I', .(' . consortium of his wife, all of which has been to his great loss and detriment. Said losses will continue for an unknown time into the future. WHEREFORE, Plaintiff respectfully requests this Honorable Court to enter judgment against I the Defendant in an amount in excess ofthe mandatory arbitration limits. RESPECTFULLY SUBMITTED: LAW OFFICES OF DALE E. ANSTINE, P.c. U j 0)' ~l/ ~~.~-{ Leah B. Graff, Esquir -= I Attorney LD. #29176 Two West Market Street P.O Box 952 York, Pennsylvania 17405 1);\1,.1'1,1':.. ;\,,,,"""';1 S '"" I'. ,(' .. I'''''~''LH_'", "'w, . VRRIF'TCA TION I HEREBY VERIFY that the information set forth in the foregoing Complaint is true and correct to the best of my knowledge, information and belief. I understand that any false statements contained herein <xe subject to ,he penalties of 18 Pa.':.s. 94904, relating te; unsworn falsification to authorities. Date:_ 2/:::S J~LL- -~.::;~~ Llame P. Belba Date: 8/.5' jOc/ ~ u ~ ........ --l::: ~ w ~ o () '" it. "'q. .~ 0- 0 0- () ~ ;V l ~ ~ Q -(: ....~ I"':::.::> C::l 0 or- " :~ ..., M c.:~ , W ...,.., ';,,;' r"-.' -.! 1'11-:'1 r-- '*0;1"' ;"'7" , , -..',' -/, l ,~5~) i"~')hi ;::.-1 8 ,i.,J ...< SHERIFF'S RETURN - REGULAR CASE NO: 2004-00559 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND BELBA ELAINE P ET AL VS MCDONALD'S STORE #10212 RICHARD SMITH , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon MCDONALD'S STORE #10212 the DEFENDANT , at 0815:00 HOURS, on the 12th day of February, 2004 at TRINDLE AND YORK ROADS CARLISLE, PA 17013 by handing to SHARON NACE, MANAGER a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing Her attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge So Answers: 18.00 3.45 .00 10.00 .00 31.45 0~' o;-t:~--' R. Thomas Kline 02/17/2004 DALE E. ANSTINE Sworn and Subscribed to before By: me this "<3""" day of j~ ,,"". A.D. .. pro~L~y+ IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CNIL DNISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CNIL Plaintiffs CNIL ACTION - LA W v. MCDONALD'S STORE #10212, Defendant JURY TRL\L DEMANDED ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of the undersigned on behalf of Defendant, McDonald's Store # I 0212, in the above captioned case. MARSHALL, DENNEHEY, WARNER, COLEMAN & GOGGIN BY: ~ en J. Barcavage, Esquire LD. No. 78867 4200 Crums Mill Road Harrisburg, PA 17112 (717) 651-3506 Attorney for the Defendant DATE: " IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CIVIL DIVISION ELAINE p, BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v, MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVICE I, Angela Zilla, an employee of Marshall, Dennehey, Warner, Coleman & Goggin, do hereby certify that on this2)-~i'-day of February. 2004, I served a copy of the foregoing document via First Class United States mail, postage prepaid as follows: Leah B. Graff, Esquire LAW OFFICES OF DALE E. ASTINE, P,C. Two West Market Street P.O, Box 952 York, PA 17405 ;:;)~ L } dL L/ 11 C- Angela lla ,..., C:-"l C::;:_J .r- .." r'1 OJ :'~) 0"\ -~") '... -~:.- - 9, -I Xll n1r -or!] -'~lV ;-")C ~:+?\ ~7~)i:-~}\ ?-::::; Ul ~ W IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of the undersigned on behalf of Defendant, Levine Enterprises, Inc., d/b/a McDonald's restaurant, improperly named as McDonald's Store #10212, in the above captioned case. MARSHALL, DENNEHEY, WARNER, COLEMAN & GOGGIN BY: en . t?~~ ~ o. 78867 4200 Crums Mill Road Harrisburg,PA 17112 (717) 651-3506 Attorney for the Defendant DATE: IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA. NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVICl~ I, Angela Zilla, an employee of Marshall, Dennehey, Warner, Coleman & Goggin, do hereby certify that on this~y of March, 2004, I served a copy of the foregoing document via First Class United States mail, postage prepaid as follows: Leah B. Graff, Esquire LAW OFFICES OF DALE E. ASTINE, P.C. Two West Market Street P.O. Box 952 York, PA 17405 f1iJf 1 ?" --t~ Angela a (") c i=BP >.~ :- ~~:..:" ~~; ~~~ ~ ~ --.. ....., = = -"" 3: :>>- ;;:0 w o "TI :2 mp;! -om eJ9 -.0 :r:+t ~o Om .-.< ;)0> .:0 -< -0 ::!;: r:! IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED NOTICE TO PLEAD TO: Plaintiffs, Elaine Belba and George Belba c/o Leah Graff, Esquire Law Offices of Dale E. Anstine, P.e. Two West Market Street P.O. Box 952 York, PA 17405 You are hereby notified to plead to the enclosed Answer with New Matter to Plaintiffs' Complaint within twenty (20) days from service hereof or a default judgment may be filed against you. MARSHALL, DENNEHEY, WARNER, COLEMAN & GOGGIN ~-_.. BY: tep en J. Barcavage. Esquire LD. No. 78867 4200 Crums Mill Road Harrisburg, P A 1711 2 (717) 651-3506 DATE: Attorneys for the Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRiAL DEMANDED ANSWER WITH NEW MATTER AND NOW comes Defendant, Levine Enterprises, Inc., d/b/a McDonald's restaurant, improperly named as McDonald's Store # 10212, by and through the undersigned counsel, who answers Plaintiffs' Complaint as follows: 1. Denied. Defendant lacks knowledge sufficient to form a belief as to truth of the allegations contained in Paragraph 1, and therefore, the same are denied with strict proof thereof required at tri al. 2. Denied. It is specifically denied that McDonald's Store #10212 is located near the intersection of Trindle Road and York Street in Carlisle, PA. McDonald's Store #10212 is located on Walnut Bottom Road in Carlisle, PA. 3. Denied. Defendant, after reasonable investigation and inquiry, is without sufficient information to form a belief as to the truth of the allegations, and therefore, such allegations are denied and strict proof thereof is required at trial, if relevant. 4. Denied pursuant to Pa.R.C.P. I029(e). To the extent an answer is required, after reasonable investigation and inquiry, Defendant is without suffkient information to form a belief as to the truth of the allegations, and therefore, such allegations are denied and strict proof thereof is demanded at trial, if relevant. 5. Denied. The allegations contained in this paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. 6. Denied. The allegations contained in this paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. 7. Denied. The allegations contained in this paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. COUNT! ELAINE P. BELBA v. McDONALD'S STORE #10212 8. Defendant hereby incorporates by reference its answers to Paragraphs 1-7 as if fully set forth herein. 9. (a) - (h) Denied. The allegations contained in this paragraph constitute conclusions oflaw, and therefore, no further responsive pleading is required. To the extent an answer is required. Defendant denies that it was negligent in property maintenance in any fashion whatsoever. 10. Denied. The allegations contained in this paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. 2 II. Denied. The allegations contained in this paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. 12. Denied. The allegations contained in paragraph constitute conclusions oflaw, and therefore, no further responsive pleading is required. To the extent an answer is required, after reasonable investigation and inquiry, Defendant is without sufficient information to form a belief as to the truth of the allegations, and therefore, such allegations are denied and strict proof thereof is demanded at trial, ifrelevant. 13. Denied. The allegations contained in paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. To the extent an answer is required, after reasonable investigation and inquiry, Defendant is without sufficient information to form a belief as to the truth of the allegations, and therefore, such allegations are denied and strict proof thereof is demanded at trial, if relevant. 14. Denied. The allegations contained in paragraph constitute conclusions of law. and therefore, no further responsive pleading is required. To the extent an answer is required, after reasonable investigation and inquiry, Defendant is without sufficient information to form a belief as to the truth of the allegations, and therefore, such allegations are denied and strict proof thereof is demanded at trial, if relevant. 15. Denied. The allegations contained in paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. To the extent an answer is required, after reasonable investigation and inquiry, Defendant is without sufficient information to form a belief as to the truth of the allegations, and therefore, such allegations are denied and strict proof thereof is demanded at trial, ifrelevant. 3 WHEREFORE. Defendant, Levine Enterprises, Inc., d/b/a McDonald's restaurant, improperly named as McDonald's Store #10212, respectfully requests judgment in its favor and against the Plaintiffs together with such other costs this Honorable Court deems appropriate. COUNT II GEORGE BELBA v. McDONALD'S STORE #10212 16. Defendant hereby incorporates by reference its answers to Paragraphs 1-15 as if fully set forth herein. 17. Denied. The allegations contained in this paragraph constitute conclusions of law, and therefore, no further responsive pleading is required. WHEREFORE, Defendant, Levine Enterprises, Inc., d/b/a McDonald's restaurant, improperly named as McDonald's Store #10212, respectfully requests judgment in its favor and against the Plaintiffs together with such other costs this Honorable Court deems appropriate. NEW MATTER 18. Defendant hereby incorporates by reference its answers to Paragraphs 1-17 as if fully set forth herein. 19. Plaintiffs' Complaint fails to state a cause of action against Defendant upon which relief can be granted. 4 20. Plaintiffs were contributorily negligent. 21. Plaintiff, Elaine P. Belba, knowingly and voluntarily assumed the risk of her injuries under the circumstances in her Complaint by identifying a dangerous condition, appreciating its dangerous character, and voluntarily proceeding to encounter that condition. 22. If the incident occurred as alleged, a fact specifically denied by Defendant, then Plaintiffs' injuries and/or damages, if any, were caused or substal1tially contributed to by individuals or entities over which Defendant had no control. 23. Plaintiffs' cause of action may be barred or limited by the applicable statute of limitations. 24. The incident, injuries and/or damages alleged to have been sustained by Plaintiffs were not proximately caused by Defendant. 25. Defendant avers that Plaintiffs have failed to take all reasonable and necessary steps to mitigate damages and injuries allegedly suffered in this case. Defendant avers that either some or all of Plaintiffs' alleged injuries, damages and treatment were unrelated to the incident which is the basis for this lawsuit. 26. Defendant breached no duty of care owed to Plaintiffs under the circumstances. 27. Plaintiffs' claims are barred by the Choice of Path Doctrine. 28. Plaintiff, Elaine P. Belba, failed to exercise reasonable care for her own safety under the circumstances described in Plaintiffs' Complaint. 29. Plaintiff's failure to exercise reasonable care for her own safety was a substantial factor in the happening of this incident as described in Plaintiffs' Complaint. 30. Defendant denies each and every allegation and all causes of action not heretofore denied. 5 31. Defendant reserves the right to plead as New Matter any and all additional defenses that become available to it through the course of discovery. WHEREFORE, Defendant, Levine Enterprises, Inc., d/b/a McDonald's restaurant, improperly named as McDonald's Store #10212, respectfully requests judgment in its favor and against the Plaintiffs together with such other costs this Honorable Court deems appropriate. Respectfully submitted, MARSHALL, DENNEHEY, WARNER. COLEMAN & GOGGIN ~7 _" BY: ~-- S\ll1l n J. Barcavage, Esquire X'D: No. 78867 / 4200 Crums Mill Road Harrisburg, PAl 7112 (717) 651-3506 Attorneys for the Defendant DATE: 105_ A ILlABISJBILLPGI144632\ACS\15000\50000 6 VERIFICATION The undersigned hereby verifies that the statements in th(: foregoing Defendant's Answer with New Matter to Plaintiffs' Complaint are based upon information which has been furnished to counsel by me and information which has been gathered by counsel in the preparation of the defense of this lawsuit. The language of the Defendant's Answer with New Matter to Plaintiffs' Complaint is that of counsel and not my own. I have read the Answer with New Matter to Plaintiffs' Complaint, and to the extent that it is based upon information which I have given to counsel, it is true and correct to the best of my knowledge. information and belief. To the extent that the contents of the Defendant's Answer with New Matter to Plaintiffs' Complaint are that of counsel. I have relied upon my counsel in making this verification. The undersigned also understands that the statements therein are mad(: subject to the penalties of I 8 Pa.C.S. Section 4904, relating to unsworn falsification to authorities. LEVINE ENTERPRISES, INC. ::d - "c,' BY: l1\\',-...c:::..)o.....~ "-' Tina Sauter Title: J:AYn~iliA- DATE:-f\II (\A oL I q ~C'>4 -'-'-I: \ -..- -^-<"'--~_...--_._c- IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVICE~ I, Angela Zilla, an employee of Marshall, Dennehey. Warner, Coleman & Goggin, do hereby certify that on this 2(1+'~ay of March, 2004, I served a copy of the foregoing document via First Class United States mail, postage prepaid as follows: Leah B. Graff, Esquire LAW OFFICES OF DALE E. ASTINE, P.C. Two West Market Street P.O. Box 952 York,PA 17405 "' fI ~.".,' . i/-, C LV]~~~:"""",-L. Angela Zil a 0 ...., 0 = c: = .., .t'" s: ::Ii: :eij "T' t-~ ,- :t.:Joo ~-, ::0 / f'" L) ::n \./) O~ r'~ -..<\ ~~(~:' ..", 63 :J:; ~('5 :t- f:! N s~m - );"" ~ =-1.1 -' -< CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS ELAINE & GEORGE BELBA TERM, -VS- CASE NO: 04-559 CIVIL MCDONALD'S RESTAURANT #10212 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 04/26/2004 M~~~ ~ EN J. Attorney B'~E r DEFENDANT DEll-488043 47796 -LO l COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS ELAINE & GEORGE BELBA TERM, -VS- CASE NO: 04 -559 CIVIL MCDONALD'S RESTAURANT #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 PA. STATE POLICE OTHER TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/05/2004 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-261270 47796-COl COMMONWEALTH OF PENNSYL VANIA COUNTY OF CUMBERLAND ELAINE & GEORGE BELBA FileNo. 04-559 CIVIL vs. MCDONALD'S RESTAURANT #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for PA STATE POLICE (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following docwnents or things: .... SEE ATTACHRD RIDER .... at The MCS Grann Ine ]601 Market Street Suite 800 Pbiladelnbia PA ]9103 You may deliver or mail legible copies of the docwnents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance. the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the docwnents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF TIIE FOLLOWING PERSON: NAME: ADDRESS: STEPHEN J. BARCA V AGE. ESO. 4200 CRIJMS MILL ROAD SUITE B HARRISBURG PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ill #: ATTORNEY FOR: Defendant APR 2 6 2004 (YbA.rt... - 3/ ~(Y\r , BY TIIE COURT: (1.diz Prothonotary/Clerk. Civil P 7f1L~r<1 -- 6 /J~ . Deputy Date: Seal of the Court 47796-01 EXPLANATION OF REQUIRED RJECORDS TO: CUSTODIAN OF RECORDS FOR: PA. STATE POLICE 1800 ELMERTON AVE HARRISBURG. PA 17110 RE: 47796 MCDONALD'S RESTAURANT RECORDS AND POLICE REPORTS REGARDING THE INCIDENT THAT OCCURRED ON JULY 22, 2002 INVOLVING ELAINE P. BELBA AND/OR GEORGE BELBA Subject: MCDONALD'S RESTAURANT 905 WALNUT BOTTOM ROAD, CARLISLE, PA 17013 SU1D-497582 47796-LOl o ~ -,....':S.... n-1Uj ;?"rJ';' ~~' ~,"(j ......,.c~ ?; =< .r:- ~ "'" = ,.,.. ".. " ::;0 N \.D ~ :e_ ijg _T1~ 9('~ om ;g ~ ." ::r N " CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 a'D!f") "1 , rf/C:; 1/1;4L IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -vs- CASE NO: 04-559 MCDONALD'S STORE #10212 AS a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 DEll-624762 18124-LOl COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -vs- CASE NO: 04 -559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCllMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/19/2006 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-329807 :1. 8 :1. 2 4 - CO :1. >>> LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS REQUESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TABUS FORT BRAGG, NC MEDICAL CENTER CARLISLE REGIONAL MEDICAL CTR. MACDILL AIR FORCE BASE HOSP. MEDICAL RECORDS k HOSPITAL BILL MEDICAL RECORDS k HOSPITAL BILL MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) X-RAY ONLY X-RAY ONLY DE02-329807 1 B 124 - CO 1 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for CARLISLE REGIONAL MEDICAL CNfR (Name of Person or Entity) Within twenty (20) days after service of this subpoena. you are ordered by the court to produce the following documents or things: **** SEE ATTACHED RIDER **** at The MCS GTO'1P Ino 160] Market Street Suite 800 Philadelnhia PA 191m You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service. the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT TIlE REQUEST OF THE FOLLOWING PERSON: NAME: ADDRESS: STEPHEN J. BARCA V AGE. ESO. 4200 CRUMS MILL ROAD SUITE R HARRISBURG. P A 17110 TELEPHONE: (2 15) 246-0900 SUPREME COURT ill #: ATTORNEY FOR: Defendant MAY 0 9 2005 Date: 4'Vl" ( p.,:J bn Ie Seal of the Court BY TIlE aURT: ~ jr:/ {d.-9 J?" ~~ Prothonotary/Clerk, Civil DiVIS&- ~n~ - P .771iJ~ Deputy '- EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CARLISLE REGIONAL MEDICAL CNTR 246 PARKER STREET CARLISLE, PA 17013 1m: 18124 ELAINE P. BELBA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING DENTAL RECORDS, LAB REPORTS, REPORTS REGARDING X-RAYS,OR OTIIER DIAGNOSTIC TESTING PERFORMED. Please call for prior approval for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Entire hospital medical billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication! prescription records, nurse's notes, doctor's comments, dietary restrictions, and all J;latient consent or refusal of treatment, procedures, tests, and/or medication, lab and diagnostic test results, including any and all such items as may be stored in a computer database or otherwise in electronic form, re~ to any e:umim.tion, consultation, rli'lgJ'Osis, care, trealment, arlmi......1Otl, discharge, or emergency care pertaining to: Dates Requested: op to and including the present. Subject: ELAINE P. BELBA P.O. BOX 130442, TAMPA, FL 33681 SoclaI Security #: XXX-XX-2481 Date of Birth: 03-04-1940 8UlO-617298 18124-LOl CERTIFICATE 08/GIIVAL PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04 -559 MCDONALD'S STORE #10212 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 9 #et#_ 0 ~~~CAVAGE, ES Attorney for DEFENDANT DEll-62476318124-L02 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 NOTICE OF nrrmrr TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL NCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to NCS or by contacting our local NCS office. DATE: 04/19/2006 NCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE NCS GROUP INC. 1601 MARKET STREET #SOO PHILADELPHIA, PA 19103 (215) 246-0900 DE02-329S07 1B124-C01 >>> LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS REQUESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TAROS FORT BRAGG, NC MEDICAL CENTER CARLISLB REGIONAL MEDICAL CTR. MACDILL AIR FORCB BASE HOSP. MEDICAL RECORDS k HOSPITAL BILL MEDICAL RECORDS kHOSPITAL BILL MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY{S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) X-RAY ONLY X-RAY ONLY DB02-32980718124-COl COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for MACDILL AIR FORCE BASE HOSP. (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** SEE ATTACHED RIDER **** at The Mes Groun Ioe ] 601 Market Street Suite 800 Philadelnhia P A ] 91 03 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance. the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: ADDRESS: STEPHEN J. BARCA V AGE. ESO. 4200 CRUMS MIl J ROAD SmTE B HARRISBURG P A 17110 TELEPHONE: (2] 5) 246-0900 SUPREME COURT ID #: ATTORNEY FOR: Defendant Date: f)/~ " l MAY fj 9 2006 (2 ).JY,L I '---- ~n. ~ (:) 7f/u""~ Deputy Seal of the Court EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: MACDILL AIR FORCE BASE HOSP. 8415 BA YSHORE BL YD. MACDILL AFB, FL 33621 RE: 18124 ELAINE P. BELBA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING DENTAL RECORDS, LAB REPORTS, REPORTS REGARDING X-RAYS OR OTHER DIAGNOSTIC TESTING PERFORMED Please call for prior approval for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Entire hospital medical billing file including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medicationl prescription records, nurse's notes, doctor's c(\m1TlP.T1tll, dietary restrictions, and all ~ consent or refusal of treatment, procedures, tests, and/or medicatIon, lab and tliOlrstic test results, including any and all such items as may be stored in a computer database or otherwise in electronic form, re~ to any eYllminOlrinn, consultation, tliOlgnnsis, care, trea1ment, lIiImk51on, discharge, or emergency care perrnining to: Dates R';k~ up to and including the present. Subject: P. BELBA P.O. BOX 130442, TAMPA, FL 33681 Social ~ #: XXX-XX-2481 Date of Birth: 03-M-1940 8U10-617300 lB124-L02 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 a~t: " ' J~; , .' r;(:; II ,,;~:f. IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE. ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate. (3) No objection to the subpoena has been received. and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 ff-~ ~1f~/ ~~~~~E, ES Attorney for DEFENDANT DEl1-624764 ~8~24-L03 . COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL KCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to KCS or by contacting our local KCS office. DATE: 04/19/2006 KCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE KCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-329807 1 B 12 4 - CO 1 >>> LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS REQUESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TANUS FORT BRAGG, NC MEDICAL CENTER CARLISLE REGIONAL MEDICAL CTR. MACDILL AIR FORCE BASE HOSP. MEDICAL RECORDS & HOSPITAL BILL MEDICAL RECORDS & HOSPITAL BILL MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) X-RAY ONLY X-RAY ONLY DE02-329807 18124-C01 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for MACDIT.r, F AMITY MEDICAL PRACT (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **.. SEE A IT ACHED RIDER .**. at The MCS ('>TOlin Ine 160] Market Street Suite 800 Fhiladelnhia FA ]91m You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: ADDRESS: STEPHEN J. BARCA V AGE. ESO. 4200 CRIJMS MILL ROAD SUITE B HARRISBURG. P A 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: AITORNEY FOR: Defendant Date: () n"1 1 I MAY 0 9 2006 1.2, ;~JY,L BY THE 99URT: . r ~ ~~I f.!u:d~ ,/). x~ Pro onotary/Clerk, Civil DivisiDlV '-- ~Q. e> - [J 71e/l/U~ Deputy Seal of the Court EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: MACDILL FAMILY MEDICAL PRACf. CUNIC RE: 18124 ELAINE P. BELBA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING DENTAL RECORDS, LAB REPORTS, REPORTS, MRI'S, Cf SCANS, OR OTHER RADIOLOOICAL TESTING PERFORMED Entire medical, billing, and tfil.gnnstic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, inc~ any and all such items as may be stored in a computer database or othetWl5e in electronic form, relating to any ell':nninarion, COIisultaJ:ion, diagroosis, care or treatmp.nt pertaining to: Dates Requested: up to and including the present. Subject: kLAINE P. BELBA P.O. BOX 130442, TAMPA, FL 33681 Social Security #: XXX-XX-2481 Date of Birth: 03-04-1940 8U10-61730218124-L03 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 OhYGhV4L IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 AS a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE. ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the.notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 1{C} ~e~ 9f:d ~~~C:::~, ES Attorney for DEFENDANT DEl1-624765 ~8~24-L04 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND TH:mGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/19/2006 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-329807 lB124-COl ", LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS REQUESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TANDS FORT BRAGG, NC MEDICAL CENTER CARLISLE REGIONAL MEDICAL CTR. MACDILL AIR FORCE BASE HOSP. MEDICAL RECORDS , HOSPITAL BILL MEDICAL RECORDS , HOSPITAL BILL MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING. AND X-RAY(S) X-RAY ONLY X-RAY ONLY DE02-329807 18124 - CO:1. COMMONWEALTH OF PENNSYL VANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for ROBERT B. WORTHINGTON. LT.COL. (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: .**. SEE A TI ACHED RIDER *u* at The MCS Grnl\P Inc 1601 Market Street Suite ROO Philadelphi. P A 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service. the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: STEPHEN J. BARCA V AGE. ESO. ADDRESS: 4200 CRITMS MIl J ROAD SHITE B HARRISBURG FA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ill #: ATIORNEY FOR: Defendant Date: /JCVLI ( I Seal of the Court MAY 0 9 2006 I ~ I :J.. hl'lt-. BY THE COURT: ~ J~i ;q.,4.,~. J;J ~ l'fo onotary/C1erk, Civil DivisioV ~~€- ,P.~q~ Deputy c EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: ROBERT B. WORTHINGTON, LT. COL. CLINICAL DENlSTRY FLIGHT 6TH AIR MOBILITY WNG MACDILL AFB, FL RE: 18124 ELAINE P. BELDA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING DENTAL RECORDS, LAB REPORTS, REPORTS REGARDIG X-RAYS, MRI'S, cr SCANS, OR ornER DIAGNOSTIC TESTING PERFORMED. Entire medical, billing, and d;agrtnstic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, 1lleIIlOIllIIda handwritten notes, history and physical reports, . medication/prescription records, medical billing and payment records, x-ray films and tests with ~;:;~rts, incl~ any and all such items as may be stored in a computer ase or otheIWlSC in electronic form, relating to any exammarion, COJisultation, diagnosis, care or treatment perta;n;ng to: Dates Requested: up to and including the present. Subject: ELAINE P. BELBA P.O. BOX 130442, TAMPA, FL 33681 Social Sec:urity #: XXX-XX-2481 Date of Birth: 03-M-1940 8U10-6173041B124-L04 CERTIF1CATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 O$6'~ IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 AS a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 DEl1-624766 ~B~24-LOS COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS- CASE NO: 04 -559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSIDINT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL MCS on behalf of STEPHEN J. BARCAVAGE. ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/19/2006 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-329807 1 a 124 - CO 1 >>> LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS REQUESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TANUS FORT BRAGG, NC MEDICAL CENTER CARLISLE REGIONAL MEDICAL CTR. MACDILL AIR FORCE BASE HOSP. MEDICAL RECORDS & HOSPITAL BILL MEDICAL RECORDS & HOSPITAL BILL MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) X-RAY ONLY X-RAY ONLY DE02-329807 18124 - CO 1 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for DR DEBORAH TANlJS (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: ........ SEE A TT Ar.HFD RIDER ........ at The Mrs lrroqI> Tnc 1601 MarKet ~treet Souite ROO Phl1~\(ielphia FA '<)10::;. You may deliver or mail legible copies of the documents or produce things requested by this subpoena. together with the certificate of compliance. to the party making this request at the address listed above. You have the right to seek, in advance. the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: STEPHEN J. BARCA V AGE. ESO. ADDRESS: 4200 CRIJMS MILl. ROAD SUITR B HARRISBURG PA 17110 TELEPHONE: (2] 5) 246-0900 SUPREME COURT ill #: ATTORNEY FOR: Defendant Date: -11pn \ ( MAY 0 9 2006 I~ \ M(J{ft Proth notary/Clerk, Civil Divisi ~,,1i7:J' Y'71zr44~ eputy Seal of the Court EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: DR. DEBORAH TANUS MACDILL AFB, FL 0: 18124 ELAINE P. BELDA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING DENTAL RECORDS, LAB REPORTS, REPORTS REGARDING X-RAYS, MRI'S, CT SCANS OR OTHER DIAGNOSTIC TESTING PERFORMED Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, incl~ any and all such items as may be stored in a computer database or otherwISe in electronic form, relating to any examinllrion, consultation, dillgJIosis, care or treatment pertllining to: Dates Requested: up to and including the present. Subject: ELAINE P. BELBA P.O. BOX 130442, TAMPA, FL 33681 Social Security #: XXX-XX-2481 Date of Birth: 03-M-194O 8U10-617306 18124-LOS CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 O$6/Jtt4/ IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 AS a prerequiSite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 DEll-624767 ). 8 ). 2 4 - L 06 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS- CASE NO: 04 -559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCOMBNTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/19/2006 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-32980718124-COl >>> LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS REQUESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TABUS FORT BRAGG, NC MEDICAL CENTER CARLISLE REGIONAL MEDICAL CTR. MACDILL AIR FORCE BASE HOSP. MEDICAL RECORDS , HOSPITAL BILL MEDICAL RECORDS , HOSPITAL BILL MEDICAL, BILLING, AND X-RAY(Sl MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) X-RAY ONLY X-RAY ONLY DE02-32980718124-COl COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for FORT BRAGG. NC MEDICAL CENTER (Name of Person or Entity) . Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: ..... SEE A 11 ACHED RIDER ...... at The MCS GTOl\P Ine 1601 Market Street Suite ROO Philadelphia PA 19103 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. TIDS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: STEPHEN J. BARCA V AGE. ESO. ADDRESS: 4200 CRUMS MIl.I, ROAD SUITE B HARRISBURG PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ill #: ATTORNEY FOR; Defendant Date: !1."YL1 ( I MAY 0 9 2006 1.:(\ ;;'I l'y)L Pro onotary/Clerk, Civil Divisi ~/M,--Q_ cnz,~ Deputy '-- Seal of the Court .n.""" ^, EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: FORT BRAGG, NC MEDICAL CENTER DEPT OF mE ARMY , NC 28310 RE: 18124 ELAINE P. BELBA Prior approVal is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING DENTAL RECORDS, LAB REPORTS, REPORTS REGARDING X-RAYS, MRI'S, cr SCANS OR OTHER DIAGNOSTIC TESTING PERFORMED Entire medical, billing, and d;'lgTVlstic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda. handwritten notes, history and phrsical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, includinj! any and all such items as may be stored in a computer database or otheIWISe in electronic form, relating to any eJl"lImm'lrion, consultation, d;'lgTIosis, care or treatment pert'lmmg to: DaU;S ReQuested: up to and including the present. SubJect: nAINE P. BELBA P.O. BOX 130442, TAMPA, FL 33681 SoclaI Security #: XXX-XX-2481 Date of Birth: 03-04-1940 8U10-617308 18124-L06 CERTIFICATE PURSUANT TO RULE 4009.22 O$6/~ PREREQUISITE TO SERVICE OF A SUBPOENA IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 AS a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 DEll-62476B 18124-L07 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS - CASE NO: 04-559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL NCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to NCS or by contacting our local NCS office. DATE: 04/19/2006 NCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246 -0900 DE02-329807 18124 - CO 1 >>> LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS RE UESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TANUS FORT BRAGG, NC MEDICAL CENTER CARLISLE REGIONAL MEDICAL CTR. MACDILL AIR FORCE BASE HOSP. MEDICAL RECORDS , HOSPITAL BILL MEDICAL RECORDS , HOSPITAL BILL MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL. BILLING, AND X-RAY(S) X-RAY ONLY X-RAY ONLY DE02-329807 :1. 8 :1. 2 4 - C 0 :1. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for CARLISLE REGIONAL MEDICAL CTR. (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: *..* SEE ATTACHED RIDER ..** at TheMCSGmun IDe 1601 Market Street Suite 800 Philadelphia PA 1910l You may deliver or mail legible copies of the documents or produce things requested by this subpoena. together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. TillS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: ADDRESS: STEPHEN J. BARCAVAGE. ESO. 4200 CRUMS MTT J, ROAD SUITE B HARRISRURG. PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ill #: ATTORNEY FOR: Defendant Date: f)t)>'Ld MAY 0 9 2006 I ). I ~{.::;Ob notary/Clerk, Civil Divisi ~A~t> 9./J{r/JAnU-- eputy Seal of the Court EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: CARUSLE REGIONAL MEDICAL CTR. RADIOLOGY DEPARTMENT 246 PARKER ST. CARLISLE, PA 17013 RE: 18124 ELAINE P. BELBA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING MRJ'S AND CT SCANS Please call for prior approval for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Any and all x-ray films and reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. Subject: ELAINE P. BELBA P.O. BOX 130442, TAMPA, FL 33681 SodaI Security #: XXX-XX-2481 Date of Birth: 03-04-1940 SUI0-617310 18124-L07 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 4~6/Ar4/ IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04 -559 MCDONALD'S STORE #10212 AS a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 05/09/2006 DEll-624769 1. 8 1.:2 4 - L 08 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 [ Note: see enclosed list of locations] TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 04/19/2006 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 DE02-329807 18124-C01 >>> LOCATION LIST <<< PAGE: 1 LOCATION NAME RECORDS REQUESTED CARLISLE REGIONAL MEDICAL CNTR MACDILL AIR FORCE BASE HOSP. MACDILL FAMILY MEDICAL PRACT. ROBERT B. WORTHINGTON, LT.COL. DR. DEBORAH TANDS FORT BRAGG, NC MEDICAL CENTER CARLISLE REGIONAL MEDICAL CTR. MACDILL AIR FORCE BASE HOSP. MEDICAL RECORDS , HOSPITAL BILL MEDICAL RECORDS , HOSPITAL BILL MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) MEDICAL, BILLING, AND X-RAY(S) X-RAY ONLY X-RAY ONLY DE02-329807 J.BJ.24-COJ. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for MACDTT I AIR FORCE BASE HOSP (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** SEE A IT ACHFn RIDER **** at The MCS Grouo Inc ] 601 Market Street Suite ROO Philadelphia P A 19101 You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance. to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. TIllS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: ADDRESS: STEPHEN J. BARCA V AGE. ESO. 4200 CRIJMS MilL ROAD SUITE B HARRISBlIRG. PA 17110 TELEPHONE: (215) 246-0900 SUPREME COURT ID #: A ITORNEY FOR: Defendant Dllte: 9. ;:v, I L . { MAY 0 9 2006 0" &. bd.." BY THE ~URT: ~ 1ft -V?-/-A , ~. ~~ Pro onotary/Clerk, Civil bivisi~ ~k~-q P 7fc~A", tJ--- eputy Seal of the Court 101 "'lA 1"\0 EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: MACDILL AIR FORCE BASE HOSP. RADIOLOGY DEPT. 8415 BAYSHORE BLVD. MACDILL AFB, FL 33621 RE: 18124 ELAINE P. BELBA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. INCLUDING MRI'S & CT SCANS Please call for prior approval for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Any and all x-ray films and reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Da~ Requested: up to and including the present. SubJect: ELAINE P. BELDA P.O. BOX 130442, TAMPA, FL 33681 Social Security #: XXX-XX-2481 Date of Birth: 03-04-1940 8U10-617312 lB124-LOB o ~: ...... = c:-;) c;::.'.^" ~ - ''Z". 1-;:' :,2 <.Jl -:l ~~ ~ ~:lJ f\ 'r: --:JP' ::,1:' OlJ -,..,., :~ :1- (, C> -:;: rn .;..::~ ~ ~ ,s.";-' 1''' -J CERTIFICATE PURSUANT TO RULE 4009.22 /~ LF~~" ~~ PREREQUISITE TO SERVICE OF A SUBPOENA IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, CUMBERLAND -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 AS a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 06/26/2006 ~.~ /~tor::/ ~or ~~~~~~~ . Rl.12 133-H DEll.-0632882 18124-L09 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND IN THE MATTER OF: COURT OF COMMON PLEAS BELBA TERM, -VS- CASE NO: 04-559 MCDONALD'S STORE #10212 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 WOMACK ARMY MEDICAL CENTER MEDICAL RECORDS TO: LEAH B. GRAFF, ESQ., PLAINTIFF COUNSEL MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning. same to MCS or by contacting our local MCS office. DATE: 06/05/2006 MCS on behalf of STEPHEN J. BARCAVAGE, ESQ. Attorney for DEFENDANT CC: STEPHEN J. BARCAVAGE, ESQ. - 07040-01542 Any questions regarding this matter, contact THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.10S 133-H DE02-0333814 18124-COl ... COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BELBA FileNo. 04-559 vs. MCDONALD'S STORE #10212 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for WOMACK ARMY MEDICAL CENTER (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: .... SEE A'IT ACHF.O RIDER .... at The MCS Groun Inc 1601 Market Street Suite 800 Philadelphia PA 19103 You may deliver or mai11egible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance. to the party making this request at the address listed above. You have the right to seek, in advance, the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF mE FOLLOWING PERSON: NAME: ADDRESS: STEPHEN J. BARCA V AGE. ESO. 4200 CRUMS Mil T ROAD SUITE B HARRISBURG. PA ]7110 TELEPHONE: (7] 5) 246-0900 SUPREME COURT ill #: A TIORNEY FOR: Defendant COURT: Ci . Division Date: (Y(;;... I . j I ::Jti>j(j/-, { I Seal of the Court Deputy 18124-09 , EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: WOMACK ARMY MEDICAL CENTER RILEY ROAD FORT BRAGG, NC 28307 RE: 18124 ELAINE P. BELBA Prior approval is required for fees in excess of $100.00 for hospitals, $50.00 for all other providers. Entire medical file, including but not limited to any and all records, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/ prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: Dates Requested: up to and including the present. Subject : ELAINE P. BELBA P.O. BOX 130442, TAMPA, FL 33681 Social Security #: XXX-XX-2481 Date of Birth: 03-04-1940 RL 108 133-H SUIO-0625416 18124-L09 ,; -, 1'--:- ,...,:> C~) Cy.... '-- '- r",) co u) .J:.~~ " "-, ~'i -4 :.r;-:ry rr I.~_ h:.1 \. .. MARSHALL, DENNEHEY, WARNER, COLEMAN & GOGGIN BY: Stephen J. Barcavage, Esquire I.D. No. 78867 4200 Crums Mill Road Harrisburg, PAl 7112 (717) 651-3506 Attorneys for Defendant, Levine Enterprises, Inc., d/b/a McDonald's Restaurant, improperly named as McDonald's Store #10212 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED PETITION FOR STATUS CONFERENCE Defendant, Levine Enterprises, Inc., d/b/a McDonald's Restaurant, improperly named as McDonald's Store #10212, by and through its counsel, Marshall, Dennehey, Warner, Coleman & Goggin, hereby request a Status Conference and in support thereof states the following: 1. Plaintiffs, Elaine P. Belba and George Belba, filed their Complaint in this matter on or about February 9, 2004. 2. According to the Complaint, Plaintiffs allege personal injury to Elaine P. Belba as a result of a slip and fall incident that occurred on July 22, 2002, at Defendant's restaurant. 3. Defendant filed its Answer with New Matter on March 31, 2004. '- .. 4. On April 13, 2004, Defendant forwarded to Plaintiffs' counsel Interrogatories and Request for Production of Documents. 5. Plaintiffs responded to Defendant's formal discovery requests on or about July 13, 2004. 6. Depositions of both Plaintiffs were conducted on September 27,2005. 7. Since January 2006, the parties have unsuccessfully attempted to negotiate a settlement of this lawsuit. 8. Defendant requests a Status Conference in order to discuss resolution of all outstanding issues and to set a deadline for the completion of any outstanding discovery. 9. Counsel for Plaintiff was contacted via telephone and informed of the Petition for a Status Conference; however, no response was given. WHEREFORE, Defendant, Levine Enterprises, Inc., d/b/a McDonald's Restaurant, improperly named as McDonald's Store #10212, requests this Honorable Court to schedule a Status Conference to address the issues raised herein. MARSHALL, DENNEHEY, WARNER, COLEMAN & GOGGIN BY: DATE: EPHEN J. BARCAVAGE, ESQUIRE 4200 Crums Mill Road, Suite B Harrisburg, P A 17112 (717) 651-3506 Attorney for Defendant, Levine Enterprises, Inc., d/b/a McDonald's Restaurant, improperly named as McDonald's Store #10212 \05 _A\LlAB\SJBARCA V AGE\LLPG\239426\TKCOPENHA VER\07040\O 1542 .. MARSHALL, DENNE HEY, WARNER, COLEMAN & GOGGIN BY: Stephen J. Barcavage, Esquire J.D. No. 78867 4200 Crums Mill Road Harrisburg, P A 17112 (717) 651-3506 Attorneys for Defendant, Levine Enterprises, Inc., d/b/a McDonald's Restaurant, improperly named as McDonald's Store #10212 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVICE I, Stephen J. Barcavage, Esquire, do hereby certify that on this ~ day of December, 2006, a copy of the foregoing Petition for Status Conference was served via First Class United States mail, postage prepaid as follows: Leah B. Graff, Esquire LAW OFFICES OF DALE E. ANSTINE, P.C. Two West Market Street, P.O. Box 952 York, P A 17405 (Attorney for Plaintiffs) \OS _A\LlAB\SJBARCA V AGE\LLPG\239426\TKCOPENHA V PHEN J. BARCAVAGE, ESQUIRE (') (,:;:: ~~~. r-,,) c..:> ~ o f"'"1 CJ ~ _u.... ~ ~:o I .. f-- -n~ ~~{~ ~1\ }.r:~ (:2\ c-j) :..:: '2 c.J1 (.n MARSHALL, DENNE HEY, WARNER, COLEMAN & GOGGIN BY: Stephen J. Barcavage, Esquire J.D. No. 78867 4200 Crums Mill Road Harrisburg, . PAl 7112 (717) 651-3506 Attorneys for Defendant, Levine Enterprises, Inc., d/b/a McDonald's Restaurant, improperly named as McDonald's Store #10212 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant DATE OF NOTICE: J'2/1/0f0 JURY TRIAL DEMANDED IMPORT ANT NOTICE YOU ARE IN DEF AUL T BECAUSE YOU HAVE FAILED TO FILE A REPLY TO DEFENDANT'S NEW MA TIER 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 RIGHT TO SUE THE DEFENDANT AND THEREBY LOSE PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS NOTICE TO A LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER OR CANNOT AFFORD ONE, GO TO OR TELEPHONE THE FOLLOWING OFFICE TO FIND OUT WHERE YOU CAN GET LEGAL HELP: CUMBERLAND COUNTY LAWYER REFERRAL SERVICE 32 S. Bedford Street Carlisle, P A 17013 (717) 249-3166 MARSHALL, DENNE HEY, COLEMAN & GOGGIN WARNER, BY: S PHEN 1. BARCA V AGE, ESQUIRE Attorneys for Defendant, Levine Enterprises, Inc., d/b/a McDonald's /"~ Restaurant, improperly named as ). 2 . McDonald's Store #10212 DATE: -- "J \05 A\LIAB\SJBARC A E LPGI239445\TKCOPENHAVER\07040\01542 MARSHALL, DENNEHEY, WARNER, COLEMAN & GOGGIN BY: Stephen J. Barcavage, Esquire J.D. No. 78867 4200 Crums Mill Road Harrisburg, P A 17112 (717) 651-3506 Attorneys for Defendant, Levine Enterprises, Inc., d/b/a McDonald's Restaurant, improperly named as McDonald's Store #10212 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYL VANIA CIVIL DIVISION ELAINE P. BELBA and GEORGE BELBA, NO. 04-559 CIVIL Plaintiffs CIVIL ACTION - LAW v. MCDONALD'S STORE #10212, Defendant JURY TRIAL DEMANDED CERTIFICATE OF SERVICE I, Stephen J. Barcavage, Esquire, do hereby certify that on this'~ day of December, 2006, a copy of the foregoing 10 Day Default Notice was served via Certified Mail, Return Receipt Requested, postage prepaid as follows: Leah B. Graff, Esquire LAW OFFICES OF DALE E. ANSTINE, P.C. Two West Market Street, P.O. Box 952 York, PA 17405 (Attorney for Plaintiffs) \05_ A \LlAB\SJBARCA V AGE\LLPG\239445\TKCOPENH (") G ~':'''''' ,. r..> c,:;;> ~ o f"T1 ("J -- :P"': ~ '2 o --n ~-r'\ rnr -o,rD ,..,0 ;:), c) ',':::~ --rl sj~g ;:;)r\'1 :-,~ ;Z; :Q. {.J'\ (..:n IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ELAINE P. BELBA and GEORGE BELBA NO. 04-559 CIVIL v. CIVIL DIVISION MCDONALD'S STORE #10212, JURY TRIAL DEMANDED REPLY TO NEW MATTER 18-31. Denied. The averments of Defendant's New Matter are legal conclusions and are deemed denied. WHEREFORE, Plaintiffs Elaine P. Belba and George Belba, respectfully request judgment in their favor and against the Defendant together with such other costs as this Honorable Court deems appropriate. Respectfully submitted, ~~~ Leah B. Graff, Esquire Attorney I.D. No. 29176 Two West Market Street P.O. Box 952 York, Pennsylvania 17405 (717) 846-0606 Attorney for Plaintiff DALE E. ANSTINE. P. C. TWO WEST M..F=tKE:r STRt~T POST O;~ICE "OX ..~z YOIUt. PENNl!!IYLVANU. 1740l\. . . . ... VF.RIFICA TION I HEREBY VERIFY that the information set forth in the foregoing Reply to New Matter is true and correct to the best of my knowledge, information and belief. I understand that any false starements contained herem are subject to the penalties of 18 Pa.C.S. S490/.t, relating to unsworn falsification to authorities. Date: _L?):r/QU___ ~~ Elaine P. Belba Date:J?-P r3-lob -!!A- . &II-: ~ I),.'\I,'~J Ji;.:'\l''I'','';~I'I~'''I~:, :1).('. y""I(. )'"..;"syrX.'''I,\ 17.1.(':"; DALE E. ANSTINE. P. C. TWO WEST M"RKln STREET >>OST OFFICE BOX g~.. YOKK, PENlf9Yl'vANlA 1740~ CERTIFICATE OF SERVICE AND NOW, this Ith day of December, 2006, I, Leah B. Graff, Esquire, a member ofthe Law Offices of Dale E. Anstine, P.C., hereby certify that I have this date served a copy of the within Reply to New Matter by first class United States mail, postage pre-paid, addressed to the party or attorney of record as follows: Stephen J. Barcavage, Esq. Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road Harrisburg, PA 17112 LAW OFFICE OF DALE E. ANSTINE, P.C. ~,hd Leah B. Graff, EsqUIre Attorney for Plaintiff 1 (') ~;: ,....., r..,;;;,,, c..;:p cr> o r1 n C) -n :T.!..,., nl-.- r-- ~IF? _...\ (_I ~:-'"1'1 ',1~ (''-)iT1 ,..\ .);~ ~D .< c....) "'u ::'j{,: w D -.j ELAINE P. BELBA and GEORGE BELBA, PLAINTIFFS V. MCDONALD'S STORE #10212, DEFENDANT IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 04-0559 CIVIL ORDER OF COURT AND NOW, this 26th day of December, 2006, the Court having been informed by the Attorney for the Defendant that the above referenced matter has been resolved, IT IS HEREBY ORDERED AND DIRECTED that the Defendant's Petition for Status Conference is deemed WITHDRAWN. kah B. Graff, Esquire Attorney for Plaintiffs ~Phen J. Barcavage, Esquire Attorney for Defendant bas By the Court, \ ." ~'^'n. :) l }' ;{ \ ~, 9;:1 Hd 92 :130%02 Ab'Vll)j\k)HLC:.;d 3Hl :10 3JI::~!()'(BlL:l . . IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYL VANIA ELAINE P. BELBA and GEORGE BELBA NO. 04-559 CIVIL v. CIVIL DIVISION MCDONALD'S STORE #10212, JURY TRIAL DEMANDED PRAECIPE TO SETTLE. DISCONTINUE AND END To The Prothonotary: Please mark the above-captioned action settled, discontinued and ended. Respectfully submitted, /5 r2!~Esq~ V~74JL Attorney J.D. No. 29176 ~ r Two West Market Street P.O. Box 952 York, Pennsylvania 17405 (717) 846-0606 Attorney for Plaintiff DALJ<J J<::. ANHTJlNE. P. (~. TWO WE5T MARKET ST"EE- POST oUICE 80X ",';;2 YORK, PENNSYLVANIA 17,-l,O~ II I '. CERTIFICATE OF SERVICE AND NOW, this 28th day of March, 2007, I, Leah B. Graff, Esquire, a member of the Law Offices of Dale E. Anstine, P.c., hereby certify that I have this date served a copy of the within Praecipe by first class United States mail, postage pre-paid, addressed to the party or attorney of record as follows: Stephen J. Barcavage, Esq. Marshall, Dennehey, Wamer, Coleman & Goggin 4200 Cnuns Mill Road Harrisburg, P A 17112 LAW OFFICE OF DALE E. ANSTINE, P.c. 1;/ ~&~ ~,-;{i2~ Leah . Graff, Esquire /0/ Attorney for Plaintiff ~ DALE E. ANHTINJo:::" I'). ('. YOll:K, PENNSYLVANIA 17..\-01'1 1 0 ~ c => ~ c:;:> <~:. -..l ,'f :::: ~:!J [ ~~ :;;.::1 rn N -0 r,; \.0 ~J:;C? '::::{ (":J -0 -1.- -'-r ( ~ ;.-'):::>':' '7C\ C.: Y? On1 Z --I :~ 0 ~ CO