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Home My WebLink About08-4337 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. No. - 4227 ctoc ?! 68 C COMPLAINT IN CIVIL ACTION SANDY L MYERS Defendant FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: WILLIAM T. MOLCZAN, Esquire PA I.D. #47437 WELTMAN, WEINBERG & REIS CO., L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 WWR#06432955 IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff VS. Civil Action No. 6? - I / 3 3 7 cNr SANDY L MYERS Defendant COMPLAINT AND NOTICE TO DEFEND 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 an 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 LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717) 249-3166 COMPLAINT 1. Plaintiff is a corporation with offices at 7465 N.W. 49TH ST, LAUDERHILLE, FL 33319- 0000. 2. Defendant is an adult individual residing at 639 GRAHAMS WOOD RD, NEWVILLE,PA 17241. 3. At the specific instance and request of Defendant, Carlisle Regional Medical Center, provided certain medical services to Defendant. 4. This obligation was subsequently assigned to Plaintiff for value. 5. Defendant, SANDY L MYERS, received and accepted the aforementioned medical services which were provided by Plaintiff's assignor 6. The prices charged by Plaintiff's assignor were the prices that Defendant, SANDY L MYERS, agreed to pay. 7. Plaintiff avers that there is a balance due and owing from Defendant, SANDY L MYERS, in the amount of $1,636.02 as of MAY 23, 2008. 8. Plaintiff claims interest at the legal rate of six (6%) percent per annum from MAY 23, 2008. 9. Although repeatedly requested to do so by Plaintiff, Defendant has willfully failed and/or refused to pay the aforementioned balance, or any part thereof to Plaintiff. WHEREFORE, Plaintiff demands Judgment in its favor and against Defendant, SANDY L MYERS, in the amount of $1,636.02 with continuing interest thereon at the rate of 6% per annum from MAY 23, 2008 and costs. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED SHALL BE USED FOR THAT PURPOSE. WELTMAN, WEINBERG & REIS, CO., L.P.A. WIL IAM T. LCZAN, Esquire PA I.D. #47437 WELTMAN, WEINBERG & REIS CO., L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 WWR#:06432955 05/09/08 PAGE 001 HEALTH DA17 COID: 858 AS OF 05/08/08 CARLISLE REGIONAL pp 17015 PHONE (717) 960-1680 361 ALEXANDER SPRING RD CARLISLE , -------------- ___ -------- ---------------------------- PATIENT: MYERS, SANDY L F/C: P P/T: I A/C: ADMISSION: 12/22/04 9299613 DSC CODE: 07 DISCHARGE: 12/22/04 TO: MYERS, SANDY L 425 STEELSTOWN ROAD NEWVILLE PA 17241 POL ID: 171685682 INS CD: 950/PHC BENEFIT PLANNERS GROUP A M O U N T DE PARTMENT 650.00 280.43 308.75 304.75 505.92 2,239.12 949.69 178.10 2,308.35 4,544.07- ADJUS'I'mm.rb. _ 3,181.04- ----------------- ---------------- ---------------------- -- --------------- TOTAL ------ 0.00 * * SELECT: REV= * DEPT= CHGCD= DATE/MDCY= TO/MDCY= * 8=BACKWARD, ENTER=FORWARD 7=RETURN CMD:I=DAR,2=PAT 4=DETAIL ? , EXHIBIT ,The undersigned does hereby verify subject to the penalties of 18 PA.C.S. 14904 ? ?z x ?xr?rtrrFR('?SSt) relating to unsworn falsifications to authorities, that she is - (Name) - tRE M of l?t`l` NA?'IU1 Al p()R'f 0I.1 ? I1NG., plaintiff (Title) (Company) herein, that she is duly authorized to make this Verification, and that the facts set forth in the foregoes Complaint in Civil Action are true and correct to the best of her kno ge> information and belief. WR TC? ? 1 V MM rnW W _ C7 "? t.? m co V rj c lD •C 0 SHERIFF'S RETURN - REGULAR CASE NO: 2008-04337 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND INTERNATIONAL PORTFOLIO INC VS MYERS SANDY L JODY SMITH Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon MYERS SANDY L the DEFENDANT , at 0009:28 HOURS, on the 11th day of August , 2008 at 1 COURTHOUSE SQUARE CARLISLE, PA 17013 SANDY L MYERS DEFENDANT by handing to a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing Her attention to the contents thereof. Additional Comments PAPER WAS SERVED AT THE SHERIFF'S OFFICE. Sheriff's Costs: Docketing ? 18.00 Service 12.00 Affidavit Owg .00 Surcharge 10.00 ^n -ZV . Val Sworn and Subscibed to before me this day So Answers: R. 'Thomas Kline 08/11/2008 WELTMAN WEINBERG & REIS By: Deput Sheriff of , A. D. BAUMGARTNER - POHLMAN, PLC Scott W. Pohlman, Esq. 10482 Armstrong Street Fairfax, Virginia 22030 Telephone 703-273-1188 Facsimile 703-352-4282 Email Scott ;lawvirginia.com Attorneys for the Defendant Sandy L. Myers IN THE COURT OF COMMON PLEASE OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. SANDY L. MYERS Defendant Docket No. 2008-4337 CV Civil Action - Law ANSWER AND NOW comes Defendant Sandy L. Myers, by and through her attorneys, Baumgartner Pohlman, PLC, to file the within answers to the Complaint of International Portfolio Inc. and in support thereof, states the following: 1. The Defendant is without sufficient information to admit or deny the averment in paragraph 1, proof thereof is demand. 2. Admitted. 3. Admitted only that the Defendant received medical services at the Carlisle Regional Medical Center, the Defendant is without information to admit or deny whether she received the specific services referenced in the Complaint. Accordingly, the same is denied and strict proof thereof, if admissible, is demanded at time of trial. 4. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth or falsity of the averments in paragraph four (4). Accordingly, the averments in paragraph four (4) are denied and strict proof thereof, if admissible, is demanded at time of trial. 5. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth or falsity of the averments in paragraph five (5). Accordingly, the averments in paragraph five (5) are denied and strict proof thereof, if admissible, is demanded at time of trial. By way of further answer the attached invoice does not identify the services rendered. 6. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth or falsity of the averments in paragraph six (6). Accordingly, the averments in paragraph six (6) are denied and strict proof thereof, if admissible, is demanded at time of trial. Denied. 7. Denied 8. Denied. A 9. Denied. By way of further answer the Defendant has not been contacted by the Plaintiff or any other parties regarding the balance. WHEREFORE, Defendant Sandy L. Myers respectfully requests that this Honorable Court enter judgment in her favor and against Plaintiff, International Portfolio Inc. , dismissing Plaintiff, International Portfolio, Inc's Complaint against Defendant, Sandy L. Myers, with prejudice and further award Sandy L. Myers all such other relief as is proper and just. Respectfully submitted, BAUMGARTNER - POHLMAN, PLC Dated: August 27, 2008 By: Scott . P man, Esquire Iden ' cation No. 78004 10482 Armstrong Street Fairfax, Virginia 22030 Telephone: 703-273-1188 Facsimile: 703-352-4282 Email: scott@lawvirginia.com Attorneys for Additional Defendant Sandy L. Myers AW VERIFICATION The undersigned hereby verifies that the facts averred in the foregoing document are true and correct to the best of her knowledge, information, and belief. This verification is made subject to the penalties of 18 Pa. C.S.A. § 4904 relating to unsworn falsification to authorities. Dated:.. BY SANDY,. S IN THE COURT OF COMMON PLEASE OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant CERTIFICATE OF SERVICE I, Scott W. Pohlman, Esquire, of the law firm of BAUMGARTNER - POHLMAN, PLC, hereby certify that I served a true and correct copy of the foregoing ANSWER by first-class United States mail, to the following counsel for Defendant: William T. Molczan, Esquire Weltman, Weinberg & Reis CO.,L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 412-434-7955 WWR#06432955 BAUMGAR - P HLMAN, PLC Dated: August 27, 2008 By: Scott W. P man, Esquire Iden cation No. 78004 10482 Armstrong Street Fairfax, Virginia 22030 Telephone: 703-273-1188 Facsimile: 703-352-4282 Email: scott@lawvirginia.com Attorneys for Additional Defendant Sandy L. Myers t? "?I"t ?„_ ? ?? °r" p A .r- r?: ?` IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO, INC, Plaintiff, vs. SANDY L. MYERS, Defendant. Case No.: 2008-4337-CV MOTION FOR SUMMARY JUDGMENT FILED ON BEHALF OF: Plaintiff COUNSEL OF RECORD OF THIS PARTY: Benjamin R. Bibler,Esquire PA ID# 93598 Weltman,Weinberg & Reis CO L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 WWR No. 6432955 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO, INC, Plaintiff, Case No.: 2008-4337-CV VS. MOTION FOR SUMMARY JUDGMENT SANDY L. MYERS, Defendant. MOTION FOR SUMMARY JUDGMENT AND NOW COMES, Plaintiff, by and through its counsel, Weltman, Weinberg & Reis, Co., L.P.A., and hereby files this Motion for Summary Judgment against the Defendant. In support thereof, Plaintiff avers as follows: 1. Plaintiff filed a Complaint against Defendant seeking judgment in the amount of $1,636.02 with interest at the interest rate of 6.000% per annum from May 23, 2008, and costs. A true and correct copy of the Complaint is attached hereto as Exhibit "A" and made a part hereof. 2. Attached to the Complaint was Verification from an authorized representative of Plaintiff verifying the accuracy of the amount sought. See Exhibit "A". 3. Defendant filed an Answer to Plaintiffs Complaint. A true and correct copy of the Answer is attached hereto as Exhibit "B" and made a part hereof. 4. On or around January 9, 2009, Plaintiff served upon Defendant a set of requests for admissions and requests for production of documents. A true and correct copy of the same is attached hereto as Exhibit "C" and made a part hereof. 5. No response to the discovery demands has been received from the Defendant. 6. The requests for admissions are now deemed admitted under Pennsylvania Rule of Civil Procedure 4014(b). Thus Defendant has admitted that on or about December 22, 2004, she received and accepted health care services and materials provided by Carlisle Regional Medical Center; at the time of W WR No. 6432955 receiving the aforementioned materials and services, Defendant agreed to be responsible for payment required for those health care services and materials not covered by applicable insurance; and that Defendant has not submitted any written dispute to Carlisle Regional Medical Center as to the charges for any of the goods and services provided to her. 7. By way of her Answer, the documents attached to this Motion, and the Requests for Admissions, deemed admitted under Pa.R.C.P. 4014(b), the Defendant has admitted all facts material to this matter and verified the amount owed. 8. There are no meritorious defenses against this action and Plaintiff is entitled to summary judgment as a matter of Law against defendant. WHEREFORE, Plaintiff respectfully requests that this Honorable Court grant summary judgment in favor of Plaintiff and against Defendant for $1,636.02 with interest at the legal interest rate of 6.000% per annum from May 23, 2008, and costs. Respectfully Submitted: By: PA ID# 35 Weltman, emberg & Reis CO L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 WWR No. 6432955 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff VS. SANDY L MYERS Defendant No. COMPLAINT IN CIVIL ACTION FILED ON BEHALF OF Plaintiff COUNSEL OF RECORD OF THIS PARTY: WILLIAM T. MOLCZAN, Esquire PA I.D. 947437 WELTMAN, WEINBERG & REIS CO., L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 WWR#06432955 N ---_T )A.._....? IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. Civil Action No. SANDY L. MYERS Defendant COMPLAINT AND NOTICE TO DEFEND 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 an 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 funther 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 LAWYER REFERRAL SERVICE CUMBERLAND COUNTY BAR ASSOCIATION 32 SOUTH BEDFORD STREET CARLISLE, PA 17013 (717) 249-3166 COMPLAINT Plaintiff is a corporation with offices at 7465 N.W. 49TH ST, LAUDERIMLE, FL 33319- 0000. 2. Defendant is an adult individual residing at 639 GRAHAMS WOOD RD, NEWVILLE,PA 17241. 3. At the specific instance and request of Defendant, Carlisle Regional Medical Center, provided certain medical services to Defendant. 4. This obligation was subsequently assigned to Plaintiff for value. 5. Defendant, SANDY L MYERS, received and accepted the aforementioned medical services which were provided by Plaintiff's assignor 6. The prices charged by Plaintiff's assignor were the prices that Defendant, SANDY L MYERS, agreed to pay. 7. Plaintiff avers that there is a balance due and owing from Defendant, SANDY L MYERS, in the amount of $1,636.02 as of MAY 23, 2008. 8. Plaintiff claims interest at the legal rate of six (6%) percent per annum from MAY 23, 2008 9. Although repeatedly requested to do so by Plaintiff, Defendant has willfully failed and/or refused to pay the aforementioned balance, or any part thereof to Plaintiff. WHEREFORE, Plaintiff demands Judgment in its favor and against Defendant, SANDY L MYERS, in the amount of $1,636.02 with continuing interest thereon at the rate of 6% per annum from MAY 23, 2008 and costs. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED SHALL BE USED FOR THAT PURPOSE. WELTMAN, WEINBERG & REIS, CO., L.P.A. WIL IAM T. LCZAN, Esquire PA I.D. #47437 WELTMAN, WEINBERG & REIS CO., L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 (412) 434-7955 WWR#:06432955 W709/09 PAGE 0C1 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CTR AS OF 05/08/08 311 ALEXANDER SPRING RD CARLISLE PA 17015 PHONE (717) 960-1680 ---- ------- ------------------------------------------------------------------ PATIE]AT: MYERS, SANDY L TO: NY?RS, SANDY L 425 STEELSTOWN ROAD NEWVILLE INS CD: 950/PHC BENEFIT PLANNERS DE PARTME-NT ADJUSTMENTS F/C: P P/T: I A/C: ADMISSION: 12/22/04 PA 17241 GROUP 9299613 DSC CODE: 07 DISCHARGE: 12/22/04 POL ID: 171685682 A M O U N T 650.00 280.43 308.75 304.75 505.92 2,239.12 949.69 178.10 2,308.35 4,544.07- 3,181.04- ----------------------------------------------------------------------------- TOTAL 0.00 SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= * TO/MDCY= CMD:I=DAR,?=PAT VDETAIL 7=RETURN,8=BACKWARD, ENTER=FORWARD EXHIBIT The undersigned does hereby verify subject to the penalties of 19 PA.C.S. 14904 relating to unsworn falsifications to authorities, that she is MINA MONTEROSSO (Nme) NICE PRESIDENT OF OPERATIONS of 2MMAIIQNAL POR'T'EW INC., plaintiff (Title) (Comfy) herein, that she is duly authorized to make this Verification, and that the facts set forth in the foregoing Complaint M* Civil Action are true and comet to the best other knowledge, information and belief BAUMGARTNER - POHLMAN, PLC COUNSELORS AT LAW "THE INNS OF COURT" 10482 ARMSTRONG STREET FAIRFAX, VA 22030 TELEPHONE: (703) 273-1 188 TELEFAX: (703) 352.4282 WWW.LAwVIRGINIA.COM ROBERT B. BAUMGARTNER RBB@LAWVIRGINIA.COM VIA: US Certified Mail August 27, 2008 Weltman, Weinberg & Reis CO.,L.P.A. c/o William T. Molczan, Esquire 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 RE: International Portfolio, Inc. v. Sandy L. Myers Docket Number: 08-4337 Civil Term Dear Mr. Molczan: SCOTT W. POHLMAN SCOTT@LAWVIRGINIA.COM /N/?, Enclosed please find a copy of the Answer in the above referenced matter. Please contact me if you have any questions. Thank you, BAIT)MMGARTNER - POHLMAN, PLC Y Scott W. Pohlman S WP/vsm Enclosures Cc: Sandy L. Myers r,U?aQ SS BAUMGARTNER - POHLMAN, PLC Scott W. Pohlman, Esq. 10482 Armstrong Street Fairfax, Virginia 22030 Telephone 703-273-1188 Facsimile 703-352-4282 Email scott@lawvirginia.com Attorneys for the Defendant Sandy L. Myers IN THE COURT OF COMMON PLEASE OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant ANSWER AND NOW comes Defendant Sandy L. Myers, by and through her attorneys, Baumgartner Pohlman, PLC, to file the within answers to the Complaint of Intemational Portfolio Inc. and in support thereof, states the following: 1. The Defendant is without sufficient information to admit or deny the averment in paragraph 1, proof thereof is demand. 2. Admitted. 3. Admitted only that the Defendant received medical services at the Carlisle Regional Medical Center, the Defendant is without information to admit or deny whether she received the specific services referenced in the Complaint. Accordingly, the same is denied and strict proof thereof, if admissible, is demanded at time of trial. 4. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth or falsity of the averments in paragraph four (4). Accordingly, the averments in paragraph four (4) are denied and strict proof thereof, if admissible, is demanded at time of trial. 5. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth or falsity of the averments in paragraph five (5). Accordingly, the averments in paragraph five (5) are denied and strict proof thereof, if admissible, is demanded at time of trial. By way of further answer the attached invoice does not identify the services rendered. 6. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth or falsity of the averments in paragraph six (6). Accordingly, the averments in paragraph six (6) are denied and strict proof thereof, if admissible, is demanded at time of trial. Denied. 7. Denied 8. Denied. 9. Denied. By way of further answer the Defendant has not been contacted by the Plaintiff or any other parties regarding the balance. WHEREFORE, Defendant Sandy L. Myers respectfully requests that this Honorable Court enter judgment in her favor and against Plaintiff, International Portfolio Inc. , dismissing Plaintiff, International Portfolio, Inc's Complaint against Defendant, Sandy L. Myers, with prejudice and further award Sandy L. Myers all such other relief as is proper and just. Respectfully submitted, BAUMGARTNER - POHLMAN, PLC Dated: August 27, 2008 By: Scott . ,;/P *man, Esquire Iden ' cation No. 78004 10482 Armstrong Street Fairfax, Virginia 22030 Telephone: 703-273-1188 Facsimile: 703-3524282 Email: scoff@lawvirginia.com Attorneys for Additional Defendant Sandy L. Myers VERIFICATION The undersigned hereby verifies that the facts averred in the foregoing document are true and correct to The best of tier knowledge. information, and belief. This verification is made sul jject to the penalties of 18 Pa. C.S.A. § 4904 relating to unsworn falsification to authorities. 1n Dated: J?{ 13Y SANDY MXl? S IN THE COURT OF COMMON PLEASE OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff VS. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant CERTIFICATE OF SERVICE I, Scott W. Pohlman, Esquire, of the law firm of BAUMGARTNER - POHLMAN, PLC, hereby certify that I served a true and correct copy of the foregoing ANSWER by first-class United States mail, to the following counsel for Defendant: William T. Molczan, Esquire Weltman, Weinberg & Reis CO.,L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 412-434-7955 WWR#06432955 BAUMGAR P HLMAN, PLC Dated: August 27, 2008 By: Scott W Esquire Iden cation No. 78004 10482 Armstrong Street Fairfax, Virginia 22030 Telephone: 703-273-1188 Facsimile: 703-352-4282 Email: scoff@lawvirginia.com Attorneys for Additional Defendant Sandy L. Myers IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION INTERNATIONAL PORTFOLIO, INC, Plaintiff, V. SANDY L. MYERS, Defendant. NO.: 2008-4337-CV PLAINTIFF'S FIRST REQUEST FOR ADMISSIONS AND REQUEST FOR PRODUCTION OF DOCUMENTS Plaintiff demands that the defendant answer and respond to the following Request for Production of Documents under oath pursuant to the Pennsylvania Rules of Civil Procedure within 30 days from the date of service hereof. Plaintiff also demands that defendant answer and respond to the following Request for Admissions pursuant to Pa. Rules of Civil Procedure 4014. You are requested to admit the truth of each of the statements of fact hereinafter stated. You are instructed that: 1. These requests are made under Pennsylvania Rules of Civil Procedure 4001, et seq., and each of these matters of which an admission is requested shall be deemed admitted unless your sworn statement in compliance with such Rules is timely made. 2. If you do not admit each of such statements, you must specifically deny each one not admitted or set forth in detail the reasons why you cannot truthfully either admit or deny each such matter. 3. Your answer, signed and properly verified, must be delivered to the undersigned attorney of record for the Plaintiff within thirty (30) days after delivery hereof. 4. If you fail or refuse to admit the truth of any such statement of fact and the Plaintiff thereafter proves the truth thereof, you may be required to pay the reasonable expenses incurred in making such proof, including attorneys' fees, witness expenses, etc. 5. If, in response to any of the following statements of fact, it is your position that the statement is true in part or as to some items, but not true in full or as to all items, then answer separately as to each part or item. 6. If you have been sued in more than one capacity or if your answers would be different if answered in any different capacity, such as partner, agent, corporate officer or director EXHO!! C or the like, then you are requested to answer separately in each such capacity. Failure to do so constitutes an admission in any such capacity. 7. In these Requests for Admissions: A. The word " rson s " means all entities, and, without limiting the generality of the foregoing, includes natural persons, joint owners, associations, companies, partnerships, joint ventures, trusts, and estates; B. The word "document(s)" means all written, printed, recorded, graphic, or photographic matter, or, sound reproductions, however produced or reproduced, pertaining to any manner to the subject matter indicated; C. The words "identity", "identify", "identification" when used with respect to a person(s) means to state the full name and present or last known address and business address of such rson s and, if an actual person, his present or last known job title, and the name and address of his present or last known employers; D. The words "identity", "identify" "identification", when used with respect to a date, subject matter, name(s) or person(s) that wrote, signed initialed, dictated or otherwise participated in the creation of the same, the name(s) of the addressee or addressees if any and the name(s) and address(es) of each person who have possession, custody, and control of said document(s). If any such document was, but is no longer in your possession, custody, or control, or in existence, state the date and manner of its disposition; and E. The word "identi when used with respect to an act (including an alleged offense), occurrence, statement, or conduct (hereinafter collectively called "act"), means to (1) describe the substance of the event or events constituting such an act, and to state the date when such act occurred; (2) identify each and every person(s) participating in such an act; (3) ident' all other person(s) (if any) present when such act occurred; (4) state whether any minutes, notes, memoranda, or other record of such act was made; (5) state whether such record now exists; and (6) identi the person(s) presently having possession, custody or control of such record. 8. Unless otherwise indicated, all Requests herein relate to those certain events, persons, and period of time more fully described in the pleading in this case. 9. These requests are of a continuous nature. These Requests for Production of Documents shall be deemed continuing so as to require supplemental answers and documents if any information of documents are acquired subsequent to the filing of responses hereto, which information or documents would have been included in the answers and documents produced had it been known or available at the time the answers and the documents provided pursuant hereto were produced. Defendant shall supply such information and documents by supplemental answers and production of documents as soon as such information becomes known or available and in all events, prior to trial of this action. If objection is made to any requests for production of documents, it is demanded that the requests for which there is no objection be answered and furnished within the aforesaid period. All documents identified in response hereto shall be organized and labeled to correspond with the request to which it pertains. For all documents produced, list the individual and his or her job title and department from whose files it was produced and the current custodian of said document. If a document called for is believed to exist or is known to exist, but is in the possession, custody or control of another person or party, the existence of the document, the identity of the possessor, custodian and one in control of such documents shall be provided along with any applicable common description or citation utilized by the publisher, possessor, custodian or disseminator of such document. If any document called for by this request is withheld on the basis of any claim of privilege or any similar claim, identify that document as follows: author; addressee; indicated or blind copies, date, subject matter, number of pages; attachments or appendices; all persons to whom distributed, shown or explained; present custodian; and nature of the privilege or similar claim asserted. REQUEST FOR PRODUCTION OF DOCUMENTS 1: Produce any and all documents evidencing proof of all payments on the subject debt referenced in the Complaint, including, but not limited to, cancelled checks, receipts, coupons, statements, accountings, memoranda, invoices, financial statements, accounting entries, diaries, charts, lists, phone records, data compilations etc. REQUEST FOR PRODUCTION OF DOCUMENTS 2: Produce any and all documents you intend to introduce and/or provide testimony on as evidence at the time of trial. REQUEST FOR ADMISSION NO. 1 On or about December 22, 2004, Defendant received and accepted health care services and materials provided by Carlisle Regional Medical Center. Admitted Denied If the answer to Request for Admissions No. I is "denied", then supply specific written documentation supporting the denial. REOUEST FOR ADMISSION NO. 2: On or about December 22, 2004, Defendant received health care services and materials from Carlisle Regional Medical Center as specified in: Exhibit "A" attached hereto. Admitted Denied If the answer to Request for Admissions No. 2 is "denied", then supply specific written documentation supporting the denial. REQUEST FOR ADMISSION NO. 3: At the time of the providing of the health care services and materials provided by Carlisle Regional Medical Center Defendant agreed to be responsible for payment of those health care services and materials. Admitted Denied If the answer to Request for Admissions No. 3 is "denied", supply specific written documentation supporting the denial. REQUEST FOR ADMISSION NO. 4: At the time of the providing of the health care services and materials provided by Carlisle Regional Medical Center Defendant agreed to be responsible for payment of those health care services and materials in the amount that payment of such materials and services were not covered by any applicable insurance. Admitted Denied If the answer to Request for Admissions No. 4 is "denied", then supply specific written documentation supporting the denial. REQUEST FOR ADMISSION NO. 5: Defendant has not submitted any written dispute to Carlisle Regional Medical Center as to the charges of any of the goods and services provided to her. Admitted Denied If the answer to the Request for Admissions No. 5 is "denied", then supply proof of any written dispute of said charges. THIS IS AN ATTEMPT TO COLLECT A DEBT AND ANY INFORMATION OBTAINED SHALL BE USED FOR THAT PURPOSE. ?-gZv-L jk&v"6-t WOO a W-&-'--- Patrick Thomas Woodman, Esquire Weltman, Weinberg & Reis 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219-9517 WWR:#6432955 )9/03/08 PAGE 001 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CTR AS OF 09/02/08 361 ALEXANDER SPRING RD CARLISLE PA 17015 PHONE (717) 960-1680 ---- ------- --------- PATIENT: MYERS, SANDY L P0: MYERS, SANDY L 425 STEELSTOWN ROAD NEWVILLE INS CD: 950/PHC BENEFIT PLANNERS D E P A R T M E N T 310 NURSING - MED/SURG 2ND F 412 PHARMACY 416 IV THERAPY 418 SUPPLIES - MEDICAL 428 RADIOLOGY - DIAGNOSTIC 429. RADIOLOGY - CT SCAN 436 LAB 450 ONCOLOGY 480 EMERGENCY ROOM PAYMENTS ADJUSTMENTS F/C: P P/T: I A/C: ADMISSION: 12/22/04 PA 17241 GROUP 9299613 DSC CODE: 07 DISCHARGE: 12/22/04 POL ID: 171685682 A M O U N T 650.00 280.43 308.75 304.75 505.92 2,239.12 949.69 178.10 2,308.35 4,544.07- 3,181.04- ----------------------------------------------- ----------------------------- TOTAL 0.00 SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= * TO/MDCY= CMD:I=DAR,2=PAT 4=DETAIL 7=RETURN,8=BACKWARD, ENTER=FORWARD EX 101T VERIFICATION 1, , (please print) under penalty of perjury and subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities verify that the foregoing Responses are true and correct to the best of my knowledge, information and belief. Date Signature CERTIFICATE OF SERVICE A true and correct copy of Plaintiffs First Request for Production of Documents and Request for Admissions has been served by U.S. Mail, on the ?rN day of 4kNK4i2Y , 200 °r , upon the following: SCOTT W. POHLMAN, ESQUIRE BAUMGARTNER POHLMAN, PLC 10482 ARMSTRONG STREET FAIRFAX, VA 22030 Patrick Thomas Woodman, Esquire VERIFICATION The undersigned does hereby verify subject to the penalties of 18 Pa.C.S. Section 4904 relating to unsworn falsification to authorities, he is an attorney for the Plaintiff herein; makes this Verification based upon the facts as supplied to him by the Plaintiff and/or its agents and because the Plaintiff is outside the jurisdiction of the court and the Plaintiff's Verification cannot be obtained within the time allowed for filing of this Motion, and that the facts set forth in the foregoing Motion are true and correct to the best of his knowledge, information and belief. WWR No. 6432955 CERTIFICATE OF SERVICE A true and correct copy of the within Plaintiff's Motion for Summary Judgment and Brief in Support has been served by U.S. Mail, Postage Pre-Paid, on day of AX&f 2009 upon the following: Scott Pohlman, Esq. The Inns Of Court 10482 Armstrong Street Fairfax, Va 22030 By: PA ID# 3598 Weltman, emberg & Reis CO L.P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 WWR No. 6432955 P i =r U -- f - CD C-1 - F-3 PRAECIPE FOR LISTING CASE FOR ARGUMENT (Must be typewritten and submitted in duplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY: Please list the within matter for the next Argument Court. CAPTION OF CASE (entire caption must be stated in frill) I AM?OAa? ?V440 , cnC - (Plaintiff ) V5. (Defendant) Zpp? No. Civil 40-51N 1. State matter to be argued (i.e., plaintiff's motion for new trial, defendant's demurrer to c aplaint, etc.): M0j(-XCX\' -Ctr SVWVxvq 11?vdyyn4-- 2. Identify counsel who will argue case: UQ.it1 Ct.?(YL?v? (a) for plaintiff: q, Svt Address: ?5a1? Pik Opt (b) for defendant : S CC)*- ndt .JA 'f 5C Address: 3. I will notify all parties in writing within two days that this case has been listed for argument. 4. Argument Court Date: ucw- ?jrr? ` 7" FILED-OfF11 E 2009 APR 20 Fri 2: 36 , b 3 ? 1 . 7 U in1+. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant PETITION OF COUNSEL FOR LEAVE TO WITHDRAW APPEARANCE The Petition of Scott W. Pohlman, Esq., respectfully represents: 1. During August, 2008, Petitioner, the law firm of Hale Carlson Baumgartner, PLC, which law firm was formed after a merger with Baumgartner Pohlman PLC agreed to represent the Defendant, Sandy L. Myers. 2. The address of the Defendant Sandy L. Myers is: 639 Grahams Woods Road, Newville, Pennsylvania, 17241. 3. On or about August 28, 2008, Petitioner filed an answer to the Complaint of the Plaintiff. 4. Thereafter, on or about February 19, 2009, during the course of representing the Defendant in this litigation through answers and formal discovery responses the Defendant decided to no longer engage the services of the Petitioner and to pursue her own defense. 5. The Defendant concurs to the request of the Petitioner to withdraw from this case. 6. Plaintiff's counsel has been notified via phone message and no objection to Petitioner's withdrawal has been received. WHEREFORE, petitioner requests that this Court grant petitioner leave to withdraw his appearance for Defendant in this action. Respectfully submitted, HALE CARLSON BAUMGARTNER, PLC b/m BAU TN - POHLAN, PLC Dated: May , 2009 By: Scott gation an, Esquire Ident No. 78004 10511 Judicial Drive Fairfax, Virginia 22030 Telephone: 703-591-4900 x 1308 Facsimile: 703-591-5082 Email: spohlman@valawyers.com Attorneys for Additional Defendant Sandy L. Myers I, Sandy L. Myers, the Defendant have seen the foregoing request and petition and consent and agree to the Petitioner's withdrawal Sandy L. Myers Date: WI IEREFORE, petitioner requests that this Court grant petitioner leave to withdraw his appearance for Defendant in this action. Respectfully submitted, HALE CARLSON BAUNIGARTNER, PLC b/m BAUNIGART'NI R -PC4HLAN. PLC Dated: May 2009 By: Scott W. Pohlman, Esquire Identification No. 78004 10511 Judicial Drive Fairfax. Virginia 22030 1Celephone: 703-591-4900 x 1308 Facsimile: 703-591--5082 Email: spohlmant'ti-D.valawyers.com Attornc*v5.16r Additional Defendant Sandi, L, Xfvers 1, Sandy L. Myers, the Defendant have seen the foregoing request and petition and consent and agree to the Petitioner's withdrawal S1 ye Date: _, VERIFICATION I verify that the statements made in the foregoing document, of which I have direct knowledge, are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. Sec. 4904, relating to unsworn falsification to authorities. Dated: S (0 cot W. Pohlman, Esquire IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant Certificate of Service I, Scott W. Pohlman, hereby certify that on this day I served a copy of the foregoing PETITION OF COUNSEL FOR LEAVE TO WITHDRAW APPEARANCE upon the person(s) indicated below by depositing a copy of the same in the United States Mail, postage prepaid, at Fairfax, Virginia, and addressed as follows: Sandy L. Myers 639 Grahams Woods Road Newville, PA 17241 Benjamin R. Bibler, Esquire Weltman, Weinberg & Reis, Co., L.P.A. 4367 1h Avenue Pittsburgh, PA 15219 Date: W. Pohlman, Attorney FiLf;C ?F THE PPS, 71,E ,;:?r; v 2009 MAY -S AM I I uM:.; . ?; IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff vs. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant AMENDED PETITION OF COUNSEL FOR LEAVE TO WITHDRAW APPEARANCE The Petition of Scott W. Pohlman, Esq., respectfully represents: 1. During August, 2008, Petitioner, the law firm of Hale Carlson Baumgartner, PLC, which law firm was formed after a merger with Baumgartner Pohlman PLC agreed to represent the Defendant, Sandy L. Myers. 2. The address of the Defendant Sandy L. Myers is: 639 Grahams Woods Road, Newville, Pennsylvania, 17241. 3. On or about August 28, 2008, Petitioner filed an answer to the Complaint of the Plaintiff. 4. Thereafter, on or about February 19, 2009, during the course of representing the Defendant in this litigation through answers and formal discovery responses the Defendant decided to no longer engage the services of the Petitioner and to pursue her own defense. 5. The Defendant concurs to the request of the Petitioner to withdraw from this case. 6. Plaintiff's counsel has been consulted and has no objection to the Petitioner's withdrawal from this case. 7. To the Petitioner's knowledge there have been no judicial rulings in this matter. WHEREFORE, petitioner requests that this Court grant petitioner leave to withdraw his appearance for Defendant in this action. Respectfully submitted, F1ALE CARLSON BAUMGAR`1 NER, PL.C b/m 13AU TN POHLAN. PLC Dated: May I , 2009 By: ' Scott P himan, squire._._.__._?._...._.__._. Identification No. 78004 10511 Judicial Drive Fairfax, Virginia 22030 Telephone: 703-591-4900 x 1308 Facsimile: 703-591-5082 Email: spohlman(a?valawvers.com Atiornevs lbrAdclitional 1)0f,ndant Sandy L Myers I, Sandy L. Myers, the Defendant have seen the foregoing request and petition and I consent and agree to the .Petitioner's withdrawal. San • L. W.e.?.. Date: VERIFICATION I verify, that the statements made in the foregoing document, of which I have direct knowledge, are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa.C.S.A. Sec. 4904, relating to unworn falsification to authorities. Dated: w. roniman, Esquire IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff' vs. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant : Certificate of Service I, Scott W. Pohlman, hereby certify that on this day I served a copy of the foregoing AMENDED PETITION OF COUNSEL FOR LEAVE TO WITHDRAW APPEARANCE upon the person(s) indicated below by depositing a copy of the same in the United States Mail, postage prepaid, at Fairfax, Virginia, and addressed as follows: Sandy L. Myers 639 Grahams Woods Road Newville, PA 17241 Benjamin R. Bibler, Esquire Weltman, Weinberg & Reis, Co., L.P.A. 436 7th Avenue Pittsburgh, PA 15219 Date: cott W. Pohlman, Attorney FU-1T OF THE f TARY ?nty ? „,°I ,^u tv3! li'i it J ,i 01 HALE CARLSON BAUMGARTNER, PLC f/k/a BAUMGARTNER - POHLMAN, PLC Scott W. Pohlman, Esq. 10511 Judicial Drive Fairfax, Virginia 22030 Telephone 703-591-4900 x 1308 Facsimile 703-591-5082 Email spohlman@valawyers.com Attorneys for the Defendant Sandy L. Myers IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA CIVIL DIVISION INTERNATIONAL PORTFOLIO INC. Plaintiff VS. Docket No. 2008-4337 CV SANDY L. MYERS Civil Action - Law Defendant ORDER AND NOW, this 'PIA'd-ay of , 2009, upon consideration of the av f?A9;Z-,% verified Petition of Defendant's Counsel for Leave to Withdraw, it is hereby ORDERED and :DECREED that said petition is GRANTED and that petitioner, Scott W. Pohlman; Esquire, and the law firm of HALE CARLSON BAUMGARNTER, PCL, be permitted to withdraw their appearance of record for the Defendant in the above J. i A?? INTERNATIONAL IN THE COURT OF COMMON PLEAS OF PORTFOLIO, INC., CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff V. SANDY L. MYERS, NO. 2008 - 4337 CIVIL TERM Defendant IN RE: PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT BEFORE OLER AND GUIDO, JJ. ORDER OF COURT AND NOW, this 22ND day of JUNE, 2009, it appearing that there are substantial issues of fact that may be in dispute, the Plaintiff's Motion for Summary Judgment is DENIED without prejudice to refile after discovery has been completed. Edward E. Guido, J. Benjamin R. Bibler, Esquire 1400 Koppers Building 436 Seventh Ave. Pittsburgh, Pa. 15215 Sandy L. Myers 639 Grahams Wood Rd. Newville, Pa. 17241 4- -aef /'-- Co K41/ w',oWn;d qzz - 02,-, "~` ' 22 n ( (l TOA IN THE COURT OF COMMON PLEAS OF Y? 1 ,v`1 l CUMBERLAND COUNTY, PENNSYLVANIA \If? NO. 20 San RULE 1312-1 The Petition for Appointment of Arbitrators shall be substantially in the Following form: PETITION FOR APPOINTMENT OF ARBITRATORS TO THE HONORABLE, THE JUDGES OF SAID COURT: I1r _-pAb\_C(' , counsel for the lainti defendant in the above action (or actions), respectfully represents that: 1. The above-captioned action (or actions) is (are) at issue. 2. The claim of plaintiff in the action is $ ? 1 (.0 3 (P • O Z' The counterclaim of the defendant in the action is The following attorneys are interested in the case(s) as counsel or are otherwise disqualified to sit as arbitrators: der ,amI r Z WHEREFORE, your petitioner prays your Honorable Court to appoint three (3) arbitrators to whom the case shall be submitted. Respectfully submitted, ORDER OF COURT AND NOW, 200 , in consideration of the foregoing petition, Esq., and Esq., and Esq., are appointed arbitrators in the above captioned action (or actions) as prayed for. By the Court, EDGAR B. BAYLEY CERTIFICATE OF SERVICE A true and correct copy of the within Petition for Appointment of Arbitrators was served by U. S. Mail, postage prepaid, this "h_ day of, &02n? 2009, upon the following: Sandy L Myers 639 Grahams Wood Rd Newville, Pa 17241 r r By: Be jam<R.' er,Esquire PA ID# 93598 Weltman, Weinberg & Reis CO L. P.A. 1400 Koppers Building 436 Seventh Avenue Pittsburgh, PA 15219 OF THE P'. -TARP 2009 SEP 16 PM f : 2 3 LrLt?Yt?:? . *, ? •.?, -*a4.oo Pao AITY c?* N 17 054 ? a3ocaso r' IN THE COURT OF COMMON PLEAS OF Y? 1 "' ` ,` ^ J ?'^^ CUMBERLAND COUNTY, PENNSYLVANIA V s . No. 20 o g RULE 1312-1 The Petition for Appointment of Arbitrators shall be substantially in the Following form: PETITION FOR AI'POINTMEI' r OF ARBITRATORS TO THE HONORABLE, THE JUDGES OF SAID COURT: ?n rnlr counsel for the lainti defendant in the above action (or ac ions), respectfully represents that: 1. The above-captioned action (or actions) is (are) at issue. 2. The claim of plaintiff in the action is S 1 i o 3 o . Q The counterclaim of the defendant in the action is The following attorneys are interested in the case(s) as counsel or are otherwise disqualified to sit as arbitrators: ?2C1?C?lrlrur B??\-e? WHEREFORE, your petitioner prays your Honorable Court to appoint three (3) arbitrators to whom the case shall be submitted. Respectfully submitted, ORDER OF COURT Vactionoractions) 200 q in consideration of the foregoing petition, Esq., and Esq., and Esq., are appo• d arbitrators in the above captioneas prayed for. B th Co?i rt / / EDGAR B. BAYLEY f aLE 2009 SEP 24 PIN (: ? o ? fs rri,?.r 44?7 R. a,•b(z__ S. rnye".s IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA INTERNATIONAL PORTFOLIO, INC., Plaintiff, CIVIL DIVISION NO: 4337 CIVIL 2008 V. SANDY L. MYERS, Defendant. NOTICE OF INTENT TO OFFER DOCUMENTS INTO EVIDENCE PURSUANT TO RULE 1305 FILED ON BEHALF OF: Plaintiff COUNSEL OF RECORD OF THIS PARTY: Lyndsay E. Rowland, Esquire Pa. I.D. # 205520 WELTMAN, WEINBERG, & REIS CO., L.P.A. 436 Seventh Avenue, Suite 1400 Pittsburgh, PA 15219 Phone: (412) 434 - 7955 Fax: (412) 338 - 7130 WWR# 6432955 IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA INTERNATIONAL PORTFOLIO, INC., CIVIL DIVISION Plaintiff, NO: 4337 CIVIL 2008 V. SANDY L. MYERS, Defendant. NOTICE OF INTENT TO OFFER DOCUMENTS INTO EVIDENCE PURSUANT TO RULE 1305 AND NOW, comes the Plaintiff, International Portfolio, Inc., whom intends to offer the documents attached hereto at the arbitration of the above referenced matter, in the manner provided by Rule of Civil Procedure 1305. The following documents are attached: 1. Screen prints from Health Management Associates detailing the charges incurred by the Defendant for treatment aA Carlisle Regional Medical Center. z_ topectfully Submitted,: L ndsay E. Zland,Esquire P I.D. # 20 5 WELTMAN, WEINBERG, & REIS CO., L.P.A. 436 Seventh Avenue, Suite 1400 Pittsburgh, PA 15219 Phone: (412) 434 - 7955 Fax: (412) 338 - 7130 WWR# 6432955 b/ug[vd PAGE UUl HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CTR AS OF 05/08/08 - 361 ALEXANDER SPRING RD CARLISLE --- PA 17015 ---------------- PHONE (717) 960-1680 ------------------- - - --- ------- ----------------------- PATIENT: MYERS, SANDY L F/C: P P/T: I A/C: 9299613 DSC CODE: 07 0: MYERS, SANDY L ADMISSION: 12/22/04 DISCHARGE: 12/22/04 25 STEELSTOWN ROAD NEWVILLE PA 17241 NS CD: 950/PHC BENEFIT PLANNERS GROUP POL ID: 171685682 D E P A R T M E-N T A M O U N T 650.00 280.43 308.75 304.75 505.92 2,239.12 949.69 178.10 2,308.35 4,544.07- ADJUSTMENTS ---- --------------- 3,181.04- ---------------------- ----------------------------------- TOTAL 0.00 ELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= * TO/MDCY= AD:I=DAR,2=PAT 4=DETAIL 7=RETURN,8=BACKWARD, ENTER=FORWARD EXHIBIT l 09/03/08 PAGE 001 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CTR AS OF 09/02/08 361 ALEXANDER SPRING RD CARLISLE PA 17015 PHONE (717) 960-1680 PATIENT: MYERS, SANDY L TO: MYERS, SANDY L 425 STEELSTOWN ROAD NEWVILLE INS CD: 950/PHC BENEFIT PLANNERS D E P A R T M E N T 310 NURSING - MED/SURG 2ND F 412 PHARMACY 416 IV THERAPY 418 SUPPLIES - MEDICAL 428 RADIOLOGY - DIAGNOSTIC 429 RADIOLOGY - CT SCAN 436 LAB 450 ONCOLOGY 480 EMERGENCY ROOM PAYMENTS ADJUSTMENTS F/C: P P/T: I A/C: ADMISSION: 12/22/04 PA 17241 GROUP 9299613 DSC CODE: 07 DISCHARGE: 12/22/04 POL ID: 171685682 A M O U N T 650.00 280.43 308.75 304.75 505.92 2,239.12 949.69 178.10 2,308.35 4,544.07- 3,181.04- ----------------------------------------------------------------------------- TOTAL 0.00 SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= * TO/MDCY= CMD:I=DAR,2=PAT 4=DETAIL 7=RETURN,8=BACKWARD, ENTER=FORWARD 09/03/08 HEALTH MANAGEMENT kSSOCIATES DA09 COID: 858 .ACCOUNT #: 9299613 PAYMENT HISTORY TOT PAY + ADJ : 7,725.11- PAT NAME : MYERS, SANDY L F/C: 9 BALANCE: .00 PAY PAYMENT PAYMENT PROCESS PAY PAYMENT PAYMENT PROCESS CD DATE AMOUNT DATE CD DATE AMOUNT DATE 978 12/25/05 1,636.02- 12/25/05 950 05/10/05 4,544.07 - 05/10/05 967 05/10/05 1,545.02- 05/10/05 CMD:I=DAR,2=PAT,3=GAR,4=INS,5=UB,7=RTN,8=CMTI,9=CMTU,I0=BAL,II=LOG 10/20/09 HEALTH MANAGEMENT ASSOCIATES ACCOUNT #: 9299613 PATIENT RECORD NAME: MYERS, SANDY L SSN: -5682 STREET: 425 STEELSTOWN ROAD DOB: 06/28/74 ADDR-2: COUNTY: COMB CITY: NEWVILLE PA 17241 COUNTRY: US PHONE: (717) 776-4743 TOTAL CHARGE: EMPLOYER: WINEMILLER COMM TOTAL PAY: PHONE: (717) 241-4400 TOTAL ADJUST: ADMIT DATE: 12/22/04 ACC HR: 00 TIME: 09:20 CLERK: CAR DIAG: EXACERBATION OF CROHN'S DISEA ROOM: 0000 DISCH DATE: 12/22/04 TIME: 17:00 CD: 07 MOTHER/BABY XREF: 0 0 PAT DAYS QTY: 0001 CHARGE QTY: 044 ADJUST QTY: 000 DRG NBR: 179 DOCTOR: 1062 OTHER DR: 1015 LAST CHARGE: 12/22/04 LAST PAY: 00/00/00 LAST ACT: 12/22/04 DA05 COID: 858 MED REC #: 0000319703 RELIGION: TYPE: I1 PROGRAM: NS SEX: 4 REL: GAR REL : G 7,725.11 .00 ADMIT TYPE: 1 .00 SOURCE: 7 ACCTS RECV: BILL: ALERT: A VA ELIG: RACE: 1 M/C ELIG: N MEDREC TYP: ER ADMIT: Y DAR TRANSFER: 12/30/04 INTERIM FROM: 00/00/00 ACCOUNT TRANSFERED TO: 0000000 TO: 00/00/00 CMD:I=DAR,3=GAR,4=INS,5=UB,6=HIS,7=RTN,8=CMTI,9=CMTU,IO=DET,II=LOG 10/20/09 HEALTH MANAGEMENT ASSOCIATES DA06 COID: 858 ACCOUNT #: 9299613 GUARANTOR RECORD RESP PARTY: DOB: 06/28/74 PAT NAME: MYERS, SANDY L GAR NAME: MYERS, SANDY L EMPLOYER: WINEMILLER COMM STREET: 425 STEELSTOWN ROAD STREET: 99 GARDEN PARKWAY ADDR-2: ADDR-2: CITY: NEWVILLE PA 17241 CITY: CARLISLE PA 17013 PHONE: (717) 776-4743 COUNTRY: US PHONE: (717) 241-4400 COUNTRY: SSN: 5682 SEX: F OCCUPATION: ACCOUNTS PAYAB RELATIONSHIP TO PATIENT: G OTHER RESP: DOB: 03/23/71 GAR NAME: MYERS, JUSTIN D EMPLOYER: SELF EMPLOYED STREET: 425 STEELTOWN RD ADDR-2: CITY: NEWVILLE PA 17241 PHONE: (717) 776-4743 COUNTRY: PHONE: (717) 991-3182 SSN: -4027 SEX: M OCCUPATION: MECHANIC RELATIONSHIP TO PATIENT: S NEXT OF KIN NAME: COULSON, AUDREY CITY: ..STREET: PHONE: (800) 334-7633 COUNTRY: ADDR-2: RELATIONSHIP TO PATIENT: FRIEND WK CMD:I=DAR,2=PAT,4=INS,5=UB,6=HIS,7=RTN,8=CMTI,9=CMTU,I0=BAL,II=LOG 10/20/09 HEALTH MANAGEMENT ASSOCIATES DA07 COLD: 858 ACCOUNT #: 9299613 INS ORDER: 1 INSURANCE RECORD MYERS, SANDY L PAYOR/PLAN:"950 PHC PROVIDER #: 251587146 BENEFIT PLANNERS INS NAME MYERS, SANDY L PO BOX 690450 DOB 06/28/74 INSREL: 18 PHONE (866) 868-6491 SEX : F SAN ANTONIO TX 782690450 STATUS: 00/00/00 GRP # GRP NAME: POLICY 171685682 PAT ID . PRECERT #: THRU : 00/00/00 VER CONT : PHONE: ( ) - 0 DATE: 00/00/00 CERT CONT: BY: CLIN FAX CLINICAL PHONE: COVERAGE EFF: 00/00/00 YR DEDUCTIBLE IND: BEN IN-NETWORK % PART A EFF INDIVIDUAL REMAIN: BEN OUT-NETWORK: PART B EFF YR DEDUCTIBLE FAM: MCD DAYS REMAIN: ANNUAL DED FAMILY REMAIN ANNUAL MET PER CONF DED ER COPAY OUT/POCKET MAX IN COPAY INCLUDES DED OP COPAY LIFETIME MAX CMD:I=DAR,2=PAT,3=GAR,5=UB,6=HIS,7=RTN,8=CMTI,9=CMTU,10=BAL,II=LOG 10/20/09 HEALTH MANAGEMENT ASSOCIATES DA09 COID: 858 ACCOUNT #: 9299613 PAYMENT HISTORY TOT PAY + ADJ : 7,725.11- PAT NAME : MYERS, SANDY L F/C: 9 BALANCE: 0.00 PAY PLAN PAYMENT PAYMENT PROCESS PAY PLAN PAYMENT PAYMENT PROCESS CD CD DATE AMOUNT DATE CD CD DATE AMOUNT DATE 978 12/25/05 1,636.02- 12/25/05 950 PHC 05/10/05 4,544.07- 05/10/05 967 05/10/05 1,545.02- 05/10/05 CMD:I=DAR,2=PAT,3=GAR,4=INS,5=UB,7=RTN,8=CMTI,9=CMTU,I0=BAL,II=LOG 10/20/09 PAGE 001 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CTR AS OF 10/19/09 PATIENT: MYERS, SANDY L F/C: P P/T: I DSC CODE: 07 A/C: 9299613 ADMISSION: 12/22/04 DISCHARGE: 12/22/04 CHG DATE DPT REV BAT# HCPC M1M2M3M4 CHGCD DESCRIPTION QTY AMOUNT -------------------------------------------------------=-------------------- 12/22/04 310 120 4 00018 12/22/04 412 250 5203 10166 12/22/04 412 250 5203 10166 12/22/04 412 250 5203 10166 12/22/04 412 250 5203 24020 12/22/04 412 250 5203 34630 12/22/04 416 258 5400 02820 12/22/04 416 258 5203 10078 12/22/04 416 258 5203 10078 12/22/04 416 258 5203 33887 12/22/04 416 258 5203 33887 12/22/04 418 270 5400 00493 12/22/04 418 270 5400 00493 12/22/04 418 270 5400 00493 0000 SEMI PRIVAT LEVOFLOXACIN 500 LEVOFLOXACIN 500 LEVOFLOXACIN 500 METOCLOPRAMIDE 5 SODIUM CHLORIDE SODIUM CHLORIDE D5W 0.9% NS 20ME D5W 0.9% NS 20ME SODIUM CHLORIDE SODIUM CHLORIDE SET CONTINU FLO SET CONTINU FLO SET CONTINU FLO 1 650.00 1 227.70 1 227.70 1- 227.70- 1 17.08 1 10.97 1 71.03 1 118.86 1 118.86 1 109.90 1- 109.90- 1 37.97 1 37.97 1 37.97 CONTINUED ... TO/MDCY= * ENTE R=FORWARD SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= CMD:I=DAR-S=PAT. =SUMMARY, =TOP,6=END,7=RETURN,$=BACKWARD 10/20/09 PAGE 002 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CT R AS OF 10/1 9/09 PATIENT: MYERS, SANDY L F/C: P P/T: I DSC CODE: 07 A/C: 9299613 ------------ ---- ------ ----- ---- ADMISS - - ION: 12/22/04 DISCHARGE: 12/22/04 CHG DATE --------- DPT --- REV ---- BAT# ------ -- HCPC M1M2M ----- - --- ---- 3M4 CHGCD ----------------- DESCRIPTION --------- QTY --------- AMOUNT 12/22/04 418 270 5400 - ---- --------- 04141 ----------------- SLIPPERS TERRY S --------- 1 --------- 16.88 12/22/04 418 270 5 14205 MEDRAD TRIPACK 1 48.52 12/22/04 418 270 5400 33801 TOOTHBRUSH 1 10.56 12/22/04 418 270 5400 33900 TOOTHPASTE 1 10.56 12/22/04 428 320 8 74022 74022 ABDOMEN ACUTE W/ 1 505.92 12/22/04 429 352 8 72193 72193 CT PELVIS W/CONT 1 1,119.56 12/22/04 429 352 8 74160 74160 CT ABDOMEN W/CON 1 1,119.56 12/22/04 436 301 30 80053 10607 COMPREHENSIVE ME 1 78.90 12/22/04 436 307 30 81001 10819 URINALYSIS AUTO 1 38.44 12/22/04 436 306 30 87040 20132 CULTURE BLOOD 1 214.87 12/22/04 436 306 30 87040 20132 CULTURE BLOOD 1 214.87 12/22/04 436 300 30 G0001 36111 VENIPUNCTURE ROU 1 9.00 12/22/04 436 30.0 30 G0001 36111 VENIPUNCTURE ROU 1 9.00 12/22/04 436 300 30 G0001 36111 VENIPUNCTURE ROU 1 9.00 CONTINUE D... SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= * TO/MDCY= * CMD:I=DAR,2-=PAT 4=SUMMARY75:-:TOP ,6=END, =RN,?=BACKWARD ENTER=FORWARD 10/20/09 PAGE 003 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CT R AS OF 10/19/09 PATIENT: MYERS, SANDY L F/C: P P/T: I DSC CODE: 07 A/C: 9299613 ADMISS ION: 12/22/04 DISCHARGE: 12/22/04 CHG DATE DPT REV BAT# HCPC M1M2M3M4 CHGCD DESCRIPTION -------- QTY -------- AMOUNT ---------- --------- 12/22/04 ---- 436 ---- 301 ----- 30 ------ 82150 -------------- 82150 --------- AMYLASE 1 54.16 12/22/04 436 301 30 83690 83690 LIPASE 1 181.68 12/22/04 436 301 30 83735 83735 MAGNESIUM 1 82.11 12/22/04 436 305 30 85025 85028 CBC COMPLETE AUT 1 57.66 12/22/04 450 636 5203 J1745 10056 INFLIXIMAB 100MG 3 9,735.33 12/22/04 450 636 5203 J1745 10056 INFLIXIMAB 100MG 3- 9,735.33- 12/22/04 412 250 5202 00060 ACETAMINOPHEN 16 2 7.60. 12/22/04 412 250 5202 24020 METOCLOPRAMIDE 5 1 17.08 12/22/04 450 250 5202 48555 ONDANSETRON 2MG/ 1 178.10 12/22/04 418 272 5 03430 KIT IV START 1 57.89 12/22/04 418 270 5 28187 CONTAINER TRANS 1 16.88 12/22/04 418 272 5 31258 SET IV ADMIN EXT 1 29.55. 12/22/04 480 450 5 99285 00520 ER DEPT MAJOR VI 1 981.08 12/22/04 480 260 5 Q0081 13161 INFUSION THERAPY 1 815.05 CONTINUED... SELECT: REV= * DEPT= * C HGCD= * DATE/MDCY= * TO/MDCY= CMD:I=DARK=PAT 4=SUMMARY7 3= 0 ,6=END,7=RETURN,-?=BACKWARD ENTER=FORWARD 10/20/09 PAGE 004 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CTR AS OF 10/19/09 PATIENT: MYERS, SANDY L F/C: P P/T: I DSC CODE: 07 A/C: 9299 613 ADMISSION: 12/22/04 -- - DISCHARGE: 12/22/04 ---- - --------- CHG DATE -------- DPT REV ----- BAT# ------------------------- HCPC M1M2M3M4 CHGCD - --- ---- DESCRIPTION - ------------- QTY AMOUNT --------- 12/22/04 -------- 480 450 ----- 5 ------------------------- 90784 97501 INJ ------- ---- THER/DX IV ------------------- 1 256.11 12/22/04 480 450 5 90784 97501 INJ THER/DX IV 1 256.11 ----------------------------------------------------------------------------- TOTAL CHARGES 7,725.11 TOTAL: CASH> 4,544.07- ADJUSTMENTS> 3,181.04- BAILANCE> '0.00 SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= * TO/MDCY= * CMD: I=DAR, =PAT 4=SUMMARY 5--TOP, 6=END, 7=RETURN, $= BACKWARD ENTER=FORWARD 10/20/09 PAGE 001 HEALTH MANAGEMENT ASSOCIATES DA17 COID: 858 CARLISLE REGIONAL MEDICAL CTR AS OF 10/19/09 361 ALEXANDER SPRING RD CARLISLE PA 17015 PHONE (717) 960-1680 ---- ------- ---------------------------------------------i-------------------- PATIENT: MYERS, SANDY L TO: MYERS, SANDY L 425 STEELSTOWN ROAD NEWVILLE INS CD: 950/PHC BENEFIT PLANNERS D E P A R T M E N T 310 NURSING - MED/SURG 2ND F 412 PHARMACY 416 IV THERAPY 418 SUPPLIES - MEDICAL 428 RADIOLOGY - DIAGNOSTIC 429 RADIOLOGY - CT SCAN 436 LAB 450 ONCOLOGY 480 EMERGENCY ROOM PAYMENTS ADJUSTMENTS F/C: P P/T: I A/C: ADMISSION: 12/22/04 PA 17241 GROUP 9299613 DSC CODE: 07 DISCHARGE: 12/22/04 POL ID: 171685682 A M O U N T 650.00 280.43 308.75 304.75 505.92 2,239.12 949.69 178.10 2,308.35 4,544.07- 3,181.04- ----------------------------------------------------------------------------- TOTAL 0.00 SELECT: REV= * DEPT= * CHGCD= * DATE/MDCY= * TO/MDCY= CMD:I=DARPATTAIL =RET RN, =BACKWARD, ENTER=FORWARD CERTIFICATE OF SERVICE The undersigned hereby certifies that a true and correct copy of the within 1305 Notice has been sent to the following parties by first class, U.S. Mail, postage prepaid, this G? day of bpE, 2009, as follows: Sandy L. Myers 639 Grahams Wood Road Newville, Pa 17241 WELTMAN, WEINBERG, & REIS CO., L.P.A. 436 Seventh Avenue, Suite 1400 Pittsburgh, PA 15219 Phone: (412) 434 - 7955 Fax: (412) 338 - 7130 WWR# 6432955 249Nu?'?' ? ?:{?C -1- In The Court of Common Pleas of Cumberland Plaintiff County, Pennsylvania No. --,7 `?i? y f r t y Defendant Civil Action - Law. Oath We do solemnly swear (or affirm) that we will support, obey and defend the Constitution of the United States and the Constitution of this Commonwealth and that we will discharge the duties of our office with fidelity C1 k 'fiLV'7,) Signature 1 Signa 91patu* WEE1."i E . MCAI I/1J Name Name ( ) Name Law Firm /b W, ( 1G-H ZT Address city, zip Z661 MAR T s'T - Address MWNlu- 1,1011 City, zip Address Ca, Pry i 7ai3 City, Zip ) 0 ID # IMaa -Xoo? 05 TD 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.) Date of Hearing: ) 1 / I Wo Date of Award: l 1 ?Rc-Ac4c? Q ' d? ry4plc,s Law Firm Law Firm Notice of Entry of Award dissents. (Insert name if applicable (Chairman.) Now, the day of 20 09 , at 10:gq , A .M., the above award was entered upon the docket and notice thereof given by mail to the parties or their attorneys. Arbitr4tors' compensation to be paid upon appeal: $ 30.00 By: Prothonotary Deputy FtLEI)-QKFI OF THE PR(Pl, NARY 2003 NOV 23 AM 10: 4 4 PENN YNWA orb r