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HomeMy WebLinkAbout08-6767 ROBERT D. KODAK, ESQUIRE KODAK & IMBLUM, P.C. 407 N FRONT STREET, PO BOX 11848 HARRISBURG, PA 17108-1848 (717) 238-7159 Attorney for Plaintiff SELECTIVE INSURANCE COMPANY OF AMERICA Plaintiff v IN THE COURT OF COMMON PLEAS OF Cumberland COUNTY, PENNSYLVANIA NO. ?S -?'IG7 •v? lF1L RICHARD L. BARR and ANN D. BARR CIVIL ACTION - LAW each individually and trading as RLB Services Defendant(s) NOTICE YOU HAVE BEEN SUED IN COURT. If you wish to defend against the claim 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, 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. CUMBERLAND COUNTY BAR ASSOCIATION TWO LIBERTY AVENUE CARLISLE PA 17013 717-249-3166 AVISO USTED HA SIDO DEMANDADO/A EN CORTE. Si usted desea defenderse de las demandas que se presentan mas adelante en las siguientes paginas, debe tomar accion dentro de los proximos veinte (20) dias despues de la notificacion de esta Demanda y Aviso radicando personalmente o por medio de un abogado una comparencencia escrita y radicando en la Corte por escrito sus defensas de, y objecciones a, las demandas presentadas aqui en contra suya. Se le advierte de que si usted falla de tomar accion como se describe anteriormente, el caso puede proceder sin usted y un fallo por cualquier suma de dinero reclamada en la demanda o cualquier otra reclamacion o remedio solicitado por el demandante puede ser dictado en contra suya por la Corte sin mas aviso adicional. Usted puede perder dinero o propiedad u otros derechos importantes para usted. USTED DEBE LLEVAR ESTE DOCUMENTO A SU ABOGADO INMEDIATAMENTE. SI USTED NO TIENE UN ABOGADO, LLAME O VAYA A LA SIGUIENTE OFICINA. ESTA OFICINA PUEDE PROVEERLE INFORMACION A CERCA DE COMO CONSEGUIR UN ABOGADO. SI USTED NO PUEDE PAGAR POR LOS SERVICIOS DE UN ABOGADO, ES POSIBLE QUE ESTA OFICINA LE PUEDA PROVEER INFORMACION SOBRE AGENCIAS QUE OFREZCAN SERVICIOS LEGALES SIN CARGO 0 BAJO COSTO A PERSONAS QUE CUALIFICAN. CUMBERLAND COUNTY BAR ASSOCIATION TWO LIBERTY AVENUE CARLISLE PA 17013 717-249-3166 SELECTIVE INSURANCE COMPANY IN THE COURT OF COMMON PLEAS OF OF AMERICA Cumberland COUNTY, PENNSYLVANIA Plaintiff NO. O ?• G 7 L l.(?• v RICHARD L. BARR and ANN D. BARR CIVIL ACTION - LAW each individually and trading as RLB Services Defendant(s) COMPLAINT The Plaintiff, SELECTIVE INSURANCE COMPANY OF AMERICA, by its attorneys, KODAK & IMBLUM, P.C., brings this action of Assumpsit against the Defendants to recover the sum of SIX THOUSAND TWO HUNDRED EIGHTY-TWO DOLLARS ($6,282.00), along with interest thereon at the statutory rate from April 3, 2008, upon a cause of action of which the following is a statement: 1. The Plaintiff, SELECTIVE INSURANCE COMPANY OF AMERICA, is a corporation organized and existing under the laws of the State of New Jersey, having a principal office and place of business at 40 Wantage Avenue, Brachville, NJ 07890. 2. The Defendant, RICHARD L. BARR, individually and trading as RLB Services, a sole proprietorship, is an adult individual residing at 6996 Wertzville Road, Mechanicsburg, Cumberland County, Pennsylvania 17050-1540. 3. The Defendant, ANN D. BARR, individually and trading as RLB Services, a sole F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\SELECTIVE INS 34681.wpd 2 proprietorship, is an adult individual residing at 6996 Wertzville Road, Mechanicsburg, Cumberland County, Pennsylvania 17050-1540. 4. An application for insurance was submitted by Defendants' agent, on behalf of Defendants, to Plaintiff thereby creating the Contract in question. COUNT I - POLICY #S1577408 EFFECTIVE 02/12/06 - SICSC 5. Plaintiff incorporates by reference the averments of Paragraphs 1 through 4 above the same as if fully set forth at length herein. 6. Plaintiff, at Defendants' request, did provide Commercial Package insurance for the benefit of Defendants for the period February 12, 2006 through February 12, 2007 for the total amount of Five Thousand Nine Hundred Seventy-Nine Dollars ($5,979.00). A true and correct copy of the Policy Declaration Page is attached hereto, marked Exhibit "A" and made a part hereof. 7. The prices charged for said insurance coverage provided was just and reasonable, was the legal and market prices therefor, and was the price which the Defendants promised and agreed to pay Plaintiff. 8. Said policy was cancelled on or about March 13, 2008 at 12:01 a.m. F:\USER\ROBIN\CCP&D] CMPS\CCP COMPLAINTS\SELECTIVE INS 34681.wpd 3 9. The total policy premium was Nine Thousand One Hundred Seven Dollars ($9,107.00) against which Defendants paid and/or received credits in the amount of Six Thousand Six Hundred Sixty Dollars ($6,660.00), thereby leaving a balance due and owing by Defendants to Plaintiff in the amount of Two Thousand Four Hundred Forty-Seven Dollars ($2,447.00), as appears by Plaintiffs Billing Inquiry statement attached hereto, marked as Exhibit "B" and made a part hereof. 10. The balance due and owing by Defendants to Plaintiff is the sum of Two Thousand Four Hundred Forty-Seven Dollars ($2,447.00) as appears by Plaintiffs March 13, 2008 Statement of Account, a true and correct copy of which is attached hereto, marked Exhibit "C" and made'a part hereof. 11. Plaintiffs complete policies and audits are not attached to this pleading due to the voluminous nature of same and have previously been provided to Defendants. 12. Plaintiff frequently demanded payment from Defendants of said amount due and owing as aforesaid, but Defendants refused and neglected and still refuse and neglect to pay said amount or any part thereof. WHEREFORE, Plaintiff brings this suit to recover from Defendants the sum of TWO THOUSAND FOUR HUNDRED FORTY-SEVEN DOLLARS ($2,447.00), together with interest as set forth herein. F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\SELECTIVE INS 34681.wpd 4 COUNT II - POLICY #S1577408 - EFFECTIVE 02/12/07 - SICSC 13. Plaintiff incorporates by reference the averments of Paragraphs 1 through 12 above the same as if fully set forth at length herein. 14. Plaintiff, at Defendants' request, did provide commercial package insurance for the benefit of Defendants for the period February 12, 2007 through February 12, 2008 for the total amount of Seven Thousand Four Hundred Sixty-Two Dollars ($7,462.00). A true and correct copy of the Policy Declaration Page is attached hereto, marked Exhibit "D" and made a part hereof. 15. The prices charged for said insurance coverage provided was just and reasonable, was the legal and market prices therefor, and was the price which the Defendants promised and agreed to pay Plaintiff. 16. Said policy was cancelled on or about March 13, 2008 at 12:01 a.m. 17. The total policy premium was Twelve Thousand Sixty-One Dollars ($12,061.00) against which Defendants paid and/or received credits in the amount of Nine Thousand Eight Hundred Fifty-Seven Dollars ($9,857.00),thereby leaving a balance due and owing by Defendants to Plaintiff in the amount of Two Thousand Two Hundred Four Dollars ($2,204.00), as appears by Plaintiffs Billing Inquiry statement attached hereto, marked as Exhibit "E" and made a part hereof. F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\SELECfIVE INS 34681.wpd 5 18. The balance due and owing by Defendants to Plaintiff is the sum of Two Thousand Two Hundred Four Dollars ($2,204.00) as appears by Plaintiffs March 13, 2008 Statement of Account, a true and correct copy of which is attached hereto, marked Exhibit "C" and made a part hereof. 19. Plaintiffs complete policies and audits are not attached to this pleading due to the voluminous nature of same and have previously been provided to Defendants. 20. Plaintiff frequently demanded payment from Defendants of said amount due and owing as aforesaid, but Defendants refused and neglected and still refuse and neglect to pay said amount or any part thereof. WHEREFORE, Plaintiff brings this suitto recoverfrom Defendants the sum of TWO THOUSAND TWO HUNDRED FOUR DOLLARS ($2,204.00), togetherwith interest as set forth herein. COUNT III - POLICY #WC 7246916 - EFFECTIVE 02/12/06 - SICA 21. Plaintiff incorporates by reference the averments of Paragraphs 1 through 20 above the same as if fully set forth at length herein. 22. Plaintiff, at Defendants' request, did provide workers Compensation insurance for F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\SELECTIVE INS 34681.wpd , 6 the benefit of Defendants for the period February 12, 2006 through February 12, 2007 for the total amount of Four Thousand Two Hundred Forty-Seven Dollars ($4,247.00). A true and correct copy of the Policy Information Pages are attached hereto, collectively marked Exhibit "F" and made a part hereof. 23. The prices charged for said insurance coverage provided was just and reasonable, was the legal and market prices therefor, and was the price which the Defendants promised and agreed to pay Plaintiff. 24. Said policy was cancelled on or about March 13, 2008 at 12:01 a.m. 25. The total policy premium was Five Thousand Seventy-Two Dollars ($5,072.00) against which Defendants paid and/or received credits in the amount of Four Thousand Two Hundred Thirty-Eight Dollars ($4,238.00), thereby leaving a balance due and owing by Defendants to Plaintiff in the amount of Eight Hundred Thirty-Four Dollars ($834.00) as appears by Plaintiffs Billing Inquiry statement attached hereto, marked as Exhibit "G" and made a part hereof. 26. The balance due and owing by Defendants to Plaintiff is the sum of Eight Hundred Thirty-Four Dollars ($834.00) as appears by Plaintiff's March 13, 2008 Statement of Account, a true and correct copy of which is attached hereto, marked Exhibit "C" and made a part hereof. F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\SELECTIVE INS 34681.wpd 27. Plaintiffs complete policies and audits are not attached to this pleading due to the voluminous nature of same and have previously been provided to Defendants. 28. Plaintiff frequently demanded payment from Defendants of said amount due and owing as aforesaid, but Defendants refused and neglected and still refuse and neglect to pay said amount or any part thereof. WHEREFORE, Plaintiff brings this suit to recover from Defendants the sum of EIGHT HUNDRED THIRTY-FOUR DOLLARS ($834.00), togetherwith interest as setforth herein. COUNT IV - POLICY #WC 7246916 - EFFECTIVE 02/12/07 - SICA 29. Plaintiff incorporates by reference the averments of Paragraphs 1 through 28 above the same as if fully set forth at length herein. 30. Plaintiff, at Defendants' request, did provide workers Compensation insurance for the benefit of Defendants for the period February 12, 2007 through February 12, 2008 for the total amount of Four Thousand Eighty-Eight Dollars ($4,088.00). A true and correct copy of the Policy Information Page is attached hereto, marked Exhibit "H" and made a part hereof. 31. The prices charged for said insurance coverage provided was just and reasonable, F:\USER\ROBIN\CCP&D] CMPS\CCP COMPLAINTS\SELECTIVE INS 34681.wpd 8 was the legal and market prices therefor, and was the price which the Defendants promised and agreed to pay Plaintiff. 32. Said policy was cancelled on or about March 13, 2008 at 12:01 a.m. 33. The total policy premium was Four Thousand Eight Hundred Seventy-Nine Dollars ($4,879.00) against which Defendants paid and/or received credits in the amount of Four Thousand Eighty-Eight Dollars ($4,088.00), thereby leaving a balance due and owing by Defendants to Plaintiff in the amount of Seven Hundred Ninety-One Dollars ($791.00) as appears by Plaintiffs Billing Inquiry statement attached hereto, marked as Exhibit "I" and made a part hereof. 34. The balance due and owing by Defendants to Plaintiff is the sum of Seven Hundred Ninety-One Dollars ($791.00) as appears by Plaintiffs March 13, 2008 Statement of Account, a true and correct copy of which is attached hereto, marked Exhibit "C" and made a part hereof. 35. Plaintiffs complete policies and audits are not attached to this pleading due to the voluminous nature of same and have previously been provided to Defendants. 36. Plaintiff frequently demanded payment from Defendants of said amount due and owing as aforesaid, but Defendants refused and neglected and still refuse and neglect to pay said amount or any part thereof. F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\SELECTIVE INS 34681.wpd 9 WHEREFORE, Plaintiff brings this suit to recover from Defendants the sums: A. Count I: Two Thousand Four Hundred Forty-Seven Dollars ($2,447.00); and B. Count II: Two Thousand Two Hundred Four Dollars ($2,204.00); and C. Count III: Eight Hundred Thirty-Four Dollars ($834.00); and D. Count IV: Seven Hundred Ninety-One Dollars ($791.00); and For a total balance due and owing to Plaintiff by Defendants in the amount of SIX THOUSAND TWO HUNDRED EIGHTY-TWO DOLLARS ($6,282.00) plus interest as set forth herein. Respectfully submitted, KODAK & IMBLUM, P.C. Robert D. Kodak, squire 407 North Front Street Post Office Box #11848 Harrisburg, PA 17108-1848 (717) 238-7159 Attorney ID No. 18041 Attorney for Plaintiff F:\USER\ROBIN\CCP&DJ CMPS\CCP COMPLAINTS\SELECTIVE INS 34681,wpd 10 Issued by The Stock Insurance Company Policy Number LS 1577408 SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA 3420 TORINGDON WAY, CHARLOTTE, NC 28277 l:V1V11V1L' KIaAL YOLICY COMMON DECLAR ATION Named Insured and Address Policy Period RICHARD BARR AND ANN BARR From: FEBRUARY 12, 2006 6996 WERTZVILLE RD MECHANICSBURG, PA 17050-1540 To: FEBRUARY 12, 2007 12:01 A.M Standard Time At Location of Designated Premises. Named Insured is: Producer Number: INDIVIDUAL 00-02963-00000 Producer: KNOLL INSURANCE AGENCY INC PENNSYLVANIA Schedule of Coverage COMMERCIAL PROPERTY COVERAGE COMMERCIAL GENERAL LIABILITY COVERAGE COMMERCIAL AUTOMOBILE COVERAGE COMMERCIAL INLAND MARINE COVERAGE REFER TO THE ATTACHED IMPORTANT NOTICE CA7048 FOR INFORMATION REGARDING COLLISION COVERAGE ON RENTAL VEHICLEk' PREMIUM INCLUDES TERRORISM COVERAGE $123.00 In return for payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance indicated in the schedule above. Insurance is provided only for those coverages for which a specific limit is shown on the attached coverage declaration(s). PAYMENT METHOD Total Policy Premium $5,979.00 D/B - 10 (This premium may be subject to adjustment.) Date Issued: FEBRUARY 27, 2006 Issuing Office: PENNSYLVANIA REGION Authorized Representative EXHIBIT "A" Policy Number S 1577408 SCHEDULE OF LOCATIONS Policy Effective Date: FEBRUARY 12, 2006 Schedule Effective Date: FEBRUARY 12, 2006 No. Location 1 6996 WERTZVILLE RD MECHANICSBURG, PA 17050 Bldg. No. Occupancy 1 STORAGE IL-7036 (01/93) INSURED'S COPY SELECTME Policy Summary Insured Name: RICHARD BARR AND ANN BARR RLB SERVICES D/B/A Address: 6996 WERTZVILLE RD MECHANICSBURG PA 17050-1540 Policy #: S 1577408 Status: LEGAL Total Premium Premium 9,107.00 - Paid 6,660.00 Remaining Balance 2,447.00 Effective Date: 02/12/2006 Pay Plan: 10 Pay Policy is in external collections as of 04/28/2008 Type Transaction Transaction Process Eff Date Amount Date NEW POLICY PREMIUM 02/12/2006 5,979.00 02/27/2006 ENDORSEMENT 05/17/2006 382.00 05/17/2006 ENDORSEMENT 06/23/2006 22.00 06/30/2006 ENDORSEMENT 08/15/2006 74.00 09/06/2006 ENDORSEMENT 09/25/2006 223.00 09/26/2006 ENDORSEMENT 02/12/2006 229.00 01/29/2007 ENDORSEMENT 02/12/2006 -249.00 01/30/2007 AUDIT 02/12/2006 2,447.00 02/07/2008 9,107.00 EXHIBIT "B" KNOLL INSURANCE AGENCY INC 704 BRIDGE ST NEW CUMBERLAND, PA 17070-1623 Phone No. 717-774-8128 March 13, 2008 S EL ECT1V-E Page l j/JJgJYlJfCB . RICHARD BARR AND ANN BARR RLB SERVICES D 6996 WERTZVILLE RD MECHANICSBURG PA 17050-1540 Iuilllu?Ilhudd?Runulld?ln6dlln?lduelhuihll ACCOUNT 614-422-086 SUMMARY Previous Amount Due ................... $ 9,836.00 Payment Received 03/05/08 Thank You $ -9,836.00 Minimum Amount Due By 04/03/08 $ 6,282.00 See back for details IMPORTANT MESSAGES Save Time In Your Day, Use Seleditynw Log onto www.selective.com or call 1-888-974-7400 to pay your bill, Cancel pending on policy S 1577408. Full payment of $ 2,562.00 must be received by 03/30/08. A separate cancellation notice has been issued on this policy. Full payment must be received prior to the cancellation due date. Contact your agent for the status or for additional information regarding this policy. Cancel pending on policy WC 7246916. Full payment of $ 930.00 must be received by 03/30108. A separate cancellation notice has been issued on this policy. Full payment must be received prior to the cancellation due date. Contact your agent for the status or for additional information regarding this policy. Detach and return this portion with your payment. Please write your account number on your check. ----------------------------------------------------------- - Name on Account Account Number Account Balance Minimum Amt. Due Due Date Amount Enclosed RICHARD BARR AND A 614-422-086 S 24,403.00 $ 6,282.00 1 04/03/08 $ ware a-neck rayaDie to Sejective insurance Company of America Mail Payment To: Selective Insurance Company of America Box 371468 Pittsburgh PA 15250-7468 i?ulhl?hnhhlddlndnd?luhlhrhdnllnlohluhl 16144220860313200800006282nnnnnauun-2nnnnnnn D840 (07!06) EXHIBIT "C" 2963-00000 614-422-086 DETAILS FOR M 614-422.086 /?1 S 1577408 Effective 02/12/06 SICK (? 1 l7? Commercial Package RICHARD BARR AND ANN BARR RLB SERVICES D S 1577408 Effective 02/12107 SICSC $ Commercial Package RICHARD BARR AND ANN BARR RLB SERVICES D S 1577408 Effective 02/12/08 SICSC Cancel Pending Commercial Package RICHARD BARR AND ANN BARR RLB SERVICES D - WC 7246916 Effective 02/12/06 SICA (z) $ Workers Compensation RICHARD BARR AND ANN BARR RLB SERVICES D WC 7246916 Effective 02/12/07 SICA $ Ck' Workers Compensation RICHARD BARR AND ANN BARR RLB SER ICES D WC 7246916 Effective 02/12/08 SICA Cancel Pending Workers Compensation RICHARD BARR AND ANN BARR RLB SERVICES D Installment Fee 2,447.00 Page 2 RECENT ACCOUNT ACTIVITY Prior Account Balance S 1577408 Eff. 02/12106 $ 2,447.00 S 1577408 Eff. 02/12/07 $ 2,204.00 S 1577408 Eff. 02/12/08 $ 13, 843.00 2,204-00 WC 724,6916 Eff. 02/12/06 $ 834.00 WC 7246916 Eff. 02/12/07 $ 791.00 WC 7246916 Eff. 02/12/08 $ 4,695.00 Total $ 25, 014.00 Payments and Adjustments S 1577408 Eff. 02/12/06 $ -2,447.00 S 1577408 Eff. 02/12/07 $ -2,204.00 834.00 S 1577408 Eff. 02/12/08 $ -2,630.00 WC 7246916 Eff. 02/12/06 $ -834.00 WC 7246916 Eff. 02/12/07 $ -791.00 WC 7246916 Eff. 02/12/08 $ -930.00 791.00 Total $ -9,836.00 Refunds Returned Payment $ 9,836.00 Total $ 91836.00 Policy Changes S 1577408 Eff. 02/12/08 $ -611.00 Installment Fee $ 6.00 6.00 Total $ -605.00 MIN. AMOUNT DUE BY 04/03/08 $ 6,282.00 When you provide a check as payment, you authorize us either to use information from your check to make a one-time electronic fund transfer from your account or to process the payment as a check transaction. When we use information from your check to make an electronic fund transfer, funds may be withdrawn from your account as soon as the same day we receive your payment, and you will not receive your check back from your financial institution. ONE OR MORE OF SELECTIVE INSURANCE GROUP, INC.'S MEMBER INSURERS WHICH INCLUDE SELECTIVE INSURANCE COMPANY OF AMERICA (SICA), SELECTIVE WAY INSURANCE COMPANY (SWIC), SELECTIVE INSURANCE COMPANY OF SOUTH CAROLINA (SICSC), SELECTIVE INSURANCE COMPANY OF THE SOUTHEAST (SICSE), SELECTIVE INSURANCE COMPANY OF NEW YORK (SICNY), SELECTIVE INSURANCE COMPANY OF NEW ENGLAND (SICNE), AND SELECTIVE AUTO INSURANCE COMPANY OF NEW JERSEY (SAICNJ) HAVE ISSUED YOUR POLICY TO WHICH THIS PREMIUM BILL PERTAINS. CONTINUED ON NEXT PAGE DB-47 (07106) Page 3 BILL ACCOUNT 614-422-086 DB-48 (07.'06) RECENT ACCOUNT ACTIVITY continued Current Account Balance S 1577408 Eff. 02/12/06 $ 2, 447.00 S 1577408 Eff. 02/12/07 $ 2,204.00 S 1577408 Eff. 02/12/08 $ 13, 232.00 WC 7246916 Eff. 02/12/06 $ 834.00 WC 7246916 Eff. 02112/07 $ 791.00 WC 7246916 Eff. 02/12/08 $ 4,895.00 Installment Fee $ 6.00 Total $ 24,409.00 Issued by The Stock Insurance Company =1-977408*c umberSELECTIVE INSURANCE COMPANY OF SOUTH CAROLI 3426 TORINGDON WAY, CHARLOTTE, NC 28277 COMMERCIAL POLICY COMMON DF.C1,ARATION Named Insured and Address Policy Period RICHARD BARR AND ANN BARR RLB SERVICES D/B/A From: FEBRUARY 12, 2007 6996 WERTZVILLE RD To: FEBRUARY 12, 2008 MECHANICSBURG, PA 17050-1540 12:01 A.M Standard Time At Location of Designated Premises. Named Insured is: Producer Number: INDIVIDUAL 00-02963-00000 Producer: KNOLL INSURANCE AGENCY INC PENNSYLVANIA Schedule of Coverage COMMERCIAL PROPERTY COVERAGE COMMERCIAL GENERAL LIABILITY COVERAGE COMMERCIAL AUTOMOBILE COVERAGE COMMERCIAL INLAND MARINE COVERAGE REFER TO THE ATTACHED IMPORTANT NOTICE CA7048 FOR INFORMATION REGARDING COLLISION COVERAGE ON RENTAL VEHICLEk' PREMIUM INCLUDES TERRORISM COVERAGE $153.00 In return for payment of the premium, and subject to all the terms of this policy, we agree with you to provide the insurance indicated in the schedule above. Insurance is provided only for those coverages for which a specific limit is shown on the attached coverage declaration(s). PAYMENT METHOD Total Policy Premium $7,462.00 D/B - 10 (This premium may be subject to adjustment.) Date Issued: DECEMBER 7, 2006 Issuing Office: PENNSYLVANIA REGION Authorized Representative EXHIBIT "D" . I Policy Number S 1577408 SCHEDULE OF LOCATIONS Policy Effective Date: FEBRUARY 12, 2007 Schedule Effective Date: FEBRUARY 12, 2007 Prem. Bldg. No. Location No. Occupancy 1 6996 WERTZVILLE RD 1 OFFICE MECHANICSBURG, PA 17050 2 54 E MAIN STREET (REAR) 1 CNTR STORAGE NEW KINGSTOWN, PA 17072 IL-7036 (01/93) INSURED'S COPY SELECTIVE Policy Summary Insured Name: RICHARD BARR AND ANN BARR RLB SERVICES D/B/A Address: 6996 WERTZVILLE RD MECHANICSBURG PA 17050-1540 Policy #: S 1577408 Effective Date: 02/12/2007 Total Premium Premium 12,061.00 - Paid 9,857.00 Remaining Balance 2,204.00 Status: LEGAL Pay Plan: 10 Pay Policy is in external collections as of 04/28/2008 Type RENEWAL POLICY PREMIUM ENDORSEMENT ENDORSEMENT ENDORSEMENT ENDORSEMENT ENDORSEMENT ENDORSEMENT ENDORSEMENT ENDORSEMENT Transaction Transaction Process Eff Date Amount Date 02/12/2007 7,462.00 12/07/2006 02/12/2007 240.00 01/29/2007 02/12/2007 -265.00 01/30/2007 03/05/2007 -64.00 03/13/2007 03/07/2007 792.00 03/22/2007 05/11/2007 123.00 05/23/2007 08/27/2007 1,698.00 09/19/2007 11/13/2007 -129.00 11/20/2007 02/12/2007 2,204.00 02/07/2008 .vv -,--v EXHIBIT E Issued by The Stock Insurance Company WC 00 00 01 A POLICY NUMBER PREVIOUS POLICY NUMBER WC 7246916 NEW SELECTIVE INSURANCE COMPANY OF AMERICA 40 WANTAGE AVE, BRANCHVILLE, NJ 07890 INFORMATION PAGE NCCI COMPANY NO. 11169 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ITEM 1. NAME OF INSURED & MAILING ADDRESS PRODUCER'S NAME AND MAILING ADDRESS RICHARD BARR AND ANN BARR KNOLL INSURANCE AGENCY INC 6996 WERTZVILLE RD 704 BRIDGE ST MECHANICSBURG, PA 17050--154 NEW CUMBERLAND, PA 17070-1623 INSURED IS: INDIVIDUAL FED ID NO. 251851763 AGENT NUMBER: 09-00-02963-00000 ITEM 2. POLICY PERIOD The Policy Period is from FEBRUARY 12, 2006 To FEBRUARY 12, 2007 12:01 A.M., standard time at the insured's mailing address. ITEM 3. COVERAGE A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation law of the states listed here: PA B. Employers Liability Insurance: Part Two of the policy applies to work in each stated listed in Item 3.A. The limits of our liability under Part Two are: Bodily Injury By Accident $100,000 each accident Bodily Injury By Disease $100,000 each employee Bodily Injury By Disease $500,000 policy limit C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND,OH,WA,WV & WY. ITEM 4. PREMIUM: The premium for this policy will be determined by our manuals of rules, classifications, rates and rating plans. All information required below is subject to verification and change by audit. Code Premium Basis Rate Per Estimated CLASSIFICATION No. Total Estimated $100 of Annual Annual Remuneration Remuneration Premium SEE ATTACHED SCHEDULE(S) EXPENSE CONSTANT 0900 230 FOREIGN TERRORISM -PA $.040 9740 29 DOM TER, EARTH & CAT IND ACC- PA $.020 9741 15 PA EMPLOYER ASSESSMENT ( 1.91%) 0938 80 Minimum Premium $1,247 PENNSYLVANIA Total Estimated Cost $4,247 If indicated below, interim adjustments of premium shall be made: Semi-Annually I I Quarterly Monthly Deposit Premium $4,247 This policy includes these endorsements and schedules: REFER TO WC-52 D/B - 10 - 614422086 Issue Date: FEBRUARY 28, 2006 Issuing Office: PENNSYLVANIA REGION, 18002-5333 Authorized Representative Form-64 (11/88) Copyright 1987 National Council on Compensation Insurance. EXHIBIT F Attached to and Forming Part of Policy Number WC 7246916 Name of Company Policy Effective Date 02/12/06 SELECTIVE INSURANCE COMPANY OF AMERICA FED ID NO. 251851763 NCCI COMPANY NO. 11169 BUREAU FILE NO. 3037192 SCHEDULE OF OPERATIONS Extension of Item Nn 4 of the Tnfnrmat;nn P.- wr_no-nn nt A Location of Operations Insured's Name and State Location RICHARD BARR AND ANN BARR PENNSYLVANIA Producer KNOLL INSURANCE AGENCY INC 09-00-02963-00000 Classification of Operations Code No. Estimated Total Remuneration Rate Per $100 of remuneration Estimated Premium 7C Annual 3 Year ]I Annual Ll 3 Year LOCATION # 001 EXCAVATION NOC (00) 0609 55,200 10.17 5,614 CLERICAL OFFICE EMPLOYEES (00) 0953 18,200 .48 87 ESTIMATED ANNUAL PREMIUM 5,701 PREMIUM FOR INCREASED LIMITS PART TWO NONE DEDUCTIBLE CREDIT (9664) NONE PREMIUM SUBJECTED TO EXPERIENCE MODIFICATION 5,701 APPLICABLE EXPERIENCE MODIFICATION .843 PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION (9898) 4,806 SCHEDULE MODIFICATION 19.00% (9887) ( 913) CERTIFIED SAFETY COMMITTEE CREDIT (9890) NONE CONSTRUCTION CREDIT (9046) NONE PER CAPITA PREMIUM NONE POLICY MINIMUM PREMIUM CHARGE (0990) NONE TOTAL ESTIMATED STANDARD PREMIUM 3,893 PREMIUM DISCOUNT (0063) NONE LARGE DEDUCTIBLE CREDIT NONE PREMIUM SUBTOTAL 3,893 Issue Date: FEBRUARY 28, 2006 PA Authorized Representative Form-63 (1 P88) INSURED'S COPY SCHEDULE OF LOCATIONS Policy Number WC 7246916 Policy Effective Date: FEBRUARY 12, 2006 Schedule Effective Date: FEBRUARY 12, 2006 EXTENSION OF INFORMATION PAGE ITEM 1. LOCATIONS OF THE INSURED LOCATION NUMBER ADDRESS 001 6996 WERTZVILLE RD MECHANICSBURG, PA 17050 WC-54 (03/99) INSURED'S COPY SELECTIVE Policy Summary Insured Name: RICHARD BARR AND ANN BARR RLB SERVICES D/B/A Address: 6996 WERTZVILLE RD MECHANICSBURG PA 17050-1540 Policy #: WC 7246916 Status: LEGAL Effective Date: 02/12/2006 Pay Plan: 10 Pay Policy is in external collections as of 04/28/2008 Type Transaction Transaction Process Eff Date Amount Date NEW POLICY PREMIUM 02/12/2006 4,247.00 02/27/2006 ENDORSEMENT 02/12/2006 -9.00 05/18/2006 AUDIT 02/12/2006 834.00 02/07/2008 5,072.00 EXHIBIT r Issued by The Stock Insurance Company WC 00 00 01 A POLICY NUMBER PREVIOUS POLICY NUMBER WC 7246916 WC 7246916 SELECTIVE INSURANCE COMPANY OF AMERICA 40 WANTAGE AVE, BRANCHVILLE, NJ 07890 INFORMATION PAGE NCCI COMPANY NO. 11169 WORKERS COMPENSATION AND EMPLOYERS LIABILITY INSURANCE POLICY ITEM 1. NAME OF INSURED & MAILING ADDRESS PRODUCER'S NAME AND MAILING ADDRESS RICHARD BARR AND ANN BARR RLB SERVICES KNOLL INSURANCE AGENCY INC D/B/A 704 BRIDGE ST 6996 WERTZVILLE RD NEW CUMBERLAND, PA 17070-1623 MECHANICSBURG, PA 17050-1540 INSURED IS: INDIVIDUAL FED ID NO. 251851763 AGENT NUMBER: 09-00-02963-00000 ITEM 2. POLICY PERIOD The Policy Period is from FEBRUARY 12, 2007 To FEBRUARY 12, 2008 12:01 A.M., standard time at the insured's mailing address. ITEM 3. COVERAGE A. Workers Compensation Insurance: Part One of the policy applies to the Workers Compensation law of the states listed here: PA B. Employers Liability Insurance: Part Two of the policy applies to work in each stated listed in Item 3.A. The limits ofour liability under Part Two are: Bodily Injury By Accident $100,000 each accident Bodily Injury By Disease $100,000 each employee Bodily Injury By Disease $500,000 policy limit C. Other States Insurance: Part Three of the policy applies to the states, if any, listed here: ALL STATES EXCEPT ND,OH,WA,WV & WY. ITEM 4. PREMIUM: The premium for this policy will be detennined by our manuals of rules, classifications, rates and rating plans. All information required below is subject to verification and change by audit. Code Premium Basis Rate Per Estimated CLASSIFICATION No. Total Estimated $100 of Annual Annual Remuneration Remuneration Premium SEE ATTACHED SCHEDULE(S) EXPENSE CONSTANT 0900 230 FOREIGN TERRORISM -PA $.050 9740 37 DOM TER, EARTH & CAT IND ACC- PA $.020 9741 15 PA EMPLOYER ASSESSMENT ( 1.98%) 0938 79 Minimum Premium $1,199 PENNSYLVANIA Total Estimated Cost $4,088 If indicated below, interim adjustments of premium shall be made: Semi-Annually I I Quarterly Monthly Deposit Premium $4,088 This policy includes these endorsements and schedules: REFER TO WC-52 D/B - 10 - 614422086 Issue Date: DECEMBER 19, 2006 Issuing Off-ice: PENNSYLVANIA REGION, 18002-5333 Authorized Representative Form-64 (11/88) Copyright 1987 National Council on Compensation Insurance. EXHIBIT ?_ ib 0 Attached to and Forming Part of Policy Number WC 7246916 Name of Company Policy Effective Date 02 / 12 / 07 SELECTIVE INSURANCE COMPANY OF AMERICA FED ID NO. 251851763 NCCICOMPANY NO. 11169 BUREAU FILE NO. 3037192 SCHEDULE OF OPERATIONS F.xtencinn of Tt- Nn d of tho Tnf -+;-- to- mr nn nn ni e Location of Operations Insured's Name and State Location RICHARD BARR AND ANN BARR PENNSYLVANIA Producer KNOLL INSURANCE AGENCY INC 09-00-02963-00000 Classification of Operations Code NO. Estimated Total Remuneration Rate Per S 100 of remuneration Estimated Premium Annual 3 Year 7C' Annual 3 Year LOCATION # 001 EXCAVATION NOC (00) 0609 55,200 9.69 5,349 CLERICAL OFFICE EMPLOYEES (00) 0953 18,200 .49 89 ESTIMATED ANNUAL PREMIUM 5,438 PREMIUM FOR INCREASED LIMITS PART TWO NONE DEDUCTIBLE CREDIT (9664) NONE PREMIUM SUBJECTED TO EXPERIENCE MODIFICATION 5,438 APPLICABLE EXPERIENCE MODIFICATION .846 PREMIUM ADJUSTED BY APPLICATION OF EXPERIENCE MODIFICATION (9898) 4,601 SCHEDULE MODIFICATION 19.00% (9887) ( 874) CERTIFIED SAFETY COMMITTEE CREDIT (9890) NONE CONSTRUCTION CREDIT (9046) NONE PER CAPITA PREMIUM NONE POLICY MINIMUM PREMIUM CHARGE (0990) NONE TOTAL ESTIMATED STANDARD PREMIUM 3,727 PREMIUM DISCOUNT (0063) NONE LARGE DEDUCTIBLE CREDIT NONE PREMIUM SUBTOTAL 3,727 Issue Date: DECEMBER 19, 2006 PA Authorized Representative f=orm-63 (11/84) INSURED'S COPY SCHEDULE OF LOCATIONS Policy Number WC 7246916 Policy Effective Date: FEBRUARY 12, 2007 Schedule Effective Date: FEBRUARY 12, 2007 EXTENSION OF INFORMATION PAGE ITEM 1. LOCATIONS OF THE INSURED LOCATION NUMBER ADDRESS 001 6996 WERTZVILLE RD MECHANICSBURG, PA 17050 WC-54 (03/99) INSURED'S COPY ? 4 e + SELECTIVE Policy Summary Insured Name: RICHARD BARR AND ANN BARR RLB SERVICES D/B/A Address: 6996 WERTZVILLE RD MECHANICSBURG PA 17050-1540 Policy #: WC 7246916 Effective Date: 02/12/2007 Total Premium Premium 4,879.00 - Paid 4,088.00 Remaining Balance 791.00 Status: LEGAL Pay Plan: 10 Pay Policy is in external collections as of 04/28/2008 Transaction Transaction Process Type Eff Date Amount Date RENEWAL POLICY PREMIUM 02/12/2007 4,088.00 12/19/2006 ENDORSEMENT 02/12/2007 791.00 02/07/2008 4,879.00 EXHIBIT -3-: ?. CD F O ii / .. il a • µ w ?? 10(/3 SHERIFF'S RETURN - REGULAR CASE NO: 2008-06767 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SELELCTIVE INSURANCE COMPANY VS BARR RICHARD L ET AL MARK CONKLIN Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon BARR RICHARD L the DEFENDANT , at 2100:00 HOURS, on the 18th day of November , 2008 at 6996 WERTZVILLE ROAD MECHANICSBURG, PA 17050-1540 by handing to RICHARD BARR a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 11.00 Postage .76 Surcharge 10.00 .00 ifoS?DB?. 39.76 Sworn and Subscibed to before me this day So Answers: R. Thomas Kline 11/19/2008 KODAK & IMBLUM s.. By: eput Sheriff of A. D. SHERIFF'S RETURN - REGULAR CASE NO: 2008-06767 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SELELCTIVE INSURANCE COMPANY VS BARR RICHARD L ET AL MARK CONKLIN , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon BARR RICHARD L TRADING AS RLB SERVICES the DEFENDANT , at 2100:00 HOURS, on the 18th day of November , 2008 at 6996 WERTZVILLE ROAD MECHANICSBURG, PA 17050-1540 by handing to RICHARD BARR a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 6.00 .00 .00 10.00 .00 16.00 Sworn and Subscibed to before me this of day So Answers: R. Thomas Kline 11/19/2008 KODAK & IMBLUM By: Deputy Sheriff A. D. r CASE NO: 2008-06767 P SHERIFF'S RETURN - REGULAR COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SELELCTIVE INSURANCE COMPANY VS BARR RICHARD L ET AL MARK CONKLIN , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon RAPP ANN n the DEFENDANT , at 2100:00 HOURS, on the 18th day of November-, 2008 at 6996 WERTZVILLE ROAD MECHANICSBURG, PA 17050-1540 by handing to RICHARD BARR, HUSBAND a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge f?/o5/o f 6.00 .00 .00 10.00 .00 16.00 Sworn and Subscibed to before me this of day So Answers: R. Thomas Kline 11/19/2008 KODAK & IMBLUM 000, By: eput Sheriff A. D. ' CASE NO: 2008-06767 P SHERIFF'S RETURN - REGULAR COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND SELELCTIVE INSURANCE COMPANY VS BARR RICHARD L ET AL MARK CONKLIN , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within COMPLAINT & NOTICE was served upon BARR ANN D TRADING AS RLB SERVICES the DEFENDANT , at 2100:00 HOURS, on the 18th day of November-, 2008 at 6996 WERTZVILLE ROAD MECHANICSBURG, PA 17050 RICHARD BARR, ANN'S HUSBAND by handing to a true and attested copy of COMPLAINT & NOTICE together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing 6.00 Service .00 Affidavit .00 Surcharge 10.00 i?/OswB ;,. .00 1 Sworn and Subscibed to before me this day of , So Answers: R. Thomas Kline 11/19/2008 KODAK & IMBLUM By: De uty /Seriff A. D. SELECTIVE INSURANCE COMPANY OF AMERICA : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA v. NO. 2008-6767 CIVIL RICHARD L. BARR and ANN D. BARR each : CIVIL ACTION - LAW individually and trading s RLB Services Defendants TO: PROTHONOTARY, COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA PRAECIPE FOR DEFAULT JUDGMENT Please enter judgment in favor of Plaintiff and against Defendant(s) RICHARD L. BARR and ANN D. BARR each individually and trading s RLB Services, named for failure to file within the required time an Answer to the Complaint in the above-captioned case and assess the Plaintiff's damages as follows: Amount claimed in Plaintiffs Complaint for all counts $6,282.00 Interest at the statutory rate of 6% per annum from Ap 3, 2008 282.69 Total = $6,564.69 I hereby certify that a written Important Notice of the intent to file this Praecipe was mailed or delivered to the Defendant(s) and/or his/her Attorney of Record, if any, after the default occurred and at least ben (10) days prior to the date of the filing of this Praecipe and a copy of the notice(s) is/ are attached. KODAK & IMBL , P.C. By Robert D. Kodak, Attorney for Plaintiff DATED: Judgment entered and dam ges assessed as above. 41. ? - othonota LAW OFFICES OF KODAK & IMBLUM, P.C. CAMERON MANSION Telephone Robert D. Kodak 407 NORTH FRONT STREET 717.238. Gary J. Imblum POST OFFICE BOX 11848 Facsimile HARRISBURG, PA 17108-1848 717.238.7158 www.kodak-imbl um.com December 12, 2008 RICHARD L BARR IATA RLB SERVICES 6996 WERTZVILLE RD MECHANICSBURG PA 17050-1540 RE: Selective Insurance Company of America FILE copy VS: Richard L. Barr and Ann D. Barr a/i/a/t/a RLB Services Our File No. 34681 No. 08-6767 Civil, Court of Common Pleas Cumberland County, Pennsylvania Dear Mr. Barr: In accordance with Pennsylvania Rules of Civil Procedure 237.1, we are enclosing herewith a Notice of a Praecipe for Entry of Default Judgment. According to the records as they are found in the Office of the Prothonotary of Cumberland County, you have not filed responsive pleadings to the Complaint filed against you to the above term and number, nor has any attorney entered an appearance on your behalf. Accordingly, we are forwarding to you the enclosed Notice which indicates that if you do not take action as set forth in this Notice, we, at the expiration of time indicated therein, will request the Office of the Prothonotary of Cumberland County, Pennsylvania, to enter Judgment against you in the amount as set forth in said Complaint. Very truly yours, RDK/ bjh enclosure KODAK & IMBLUM, P.C. Robert D. Kodak Tobert.kodak@kodak-imblum.com THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. THIS COMMUNICATION IS FROM A DEBT COLLECTOR. cc FRANK VECCHIO THE COMMERCIAL COLLECTION CORP OF NY PO BOX 288 TONAWANDA NY 14150 533765/533767/533766/533784 SELECTIVE INSURANCE COMPANY OF AMERICA Plaintiff V. IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO. 08-6767 CIVIL RICHARD L. BARR and ANN D. BARR each individually : CIVIL ACTION - LAW and trading s RLB Services Defendants IMPORTANT NOTICE FILE COPY TO: RICHARD L. BARR I A T ARLBSERVICES Defendants DATE OF NOTICE: December 12, 2008 YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER, 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. CUMBERLAND COUNTY BAR ASSOCIATION TWO LIBERTY AVENUE CARLISLE PA 17013 717-249-3166 LAW OFFICES OF KODAK & IMBLUM, P.C. CAMERON MANSION Telephone Robert D. Kodak 407 NORTH FRONT STREET 717.238. Gary J. Imblum POST OFFICE BOX 11848 Facsimile le HARRISBURG, PA 17108-1848 717.238.7158 www.kodak-imblum.com December 12, 2008 FILE COPY ANN D BARR IATA RLB SERVICES 6996 WERTZVILLE RD MECHANICSBURG PA 17050-1540 RE: Selective Insurance Company of America VS: Richard L. Barr and Ann D. Barr a/i/a/t/a RLB Services Our File No. 34681 No. 08-6767 Civil, Court of Common Pleas Cumberland County, Pennsylvania Dear Ms. Barr: In accordance with Pennsylvania Rules of Civil Procedure 237.1, we are enclosing herewith a Notice of a Praecipe for Entry of Default Judgment. According to the records as they are found in the Office of the Prothonotary of Cumberland County, you have not filed responsive pleadings to the Complaint filed against you to the above term and number, nor has any attorney entered an appearance on your behalf. Accordingly, we are forwarding to you the enclosed Notice which indicates that if you do not take action as set forth in this Notice, we, at the expiration of time indicated therein, will request the Office of the Prothonotary of Cumberland County, Pennsylvania, to enter judgment against you in the amount as set forth in said Complaint. Very truly yours, RDK/ bjh enclosure KODAK & IMBLUM, P.C. Robert D. Kodak robert.kodak@kodak-imblum.com THIS IS AN ATTEMPT TO COLLECT A DEBT. ANY INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE. THIS COMMUNICATION IS FROM A DEBT COLLECTOR. cc FRANK VECCHIO THE COMMERCIAL COLLECTION CORP OF NY PO BOX 288 TONAWANDA NY 14150 533765/533767/533766/533784 SELECTIVE INSURANCE COMPANY OF AMERICA : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. NO. 08-6767 CIVIL RICHARD L. BARR and ANN D. BARR each individually : CIVIL ACTION - LAW and trading s RLB Services Defendants IMPORTANT NOTICE TO: ANN D. BARR I/ A/ T/ A RLB SERVICES, Defendant(s) DATE OF NOTICE: December 12, 2008 FILE COPY YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN APPEARANCE PERSONALLY OR BY ATTORNEY AND FILE IN WRITING WITH THE COURT YOUR DEFENSES OR OBJECTIONS TO THE CLAIMS SET FORTH AGAINST YOU. UNLESS YOU ACT WITHIN TEN DAYS FROM THE DATE OF THIS NOTICE, A JUDGMENT MAY BE ENTERED AGAINST YOU WITHOUT A HEARING AND YOU MAY LOSE YOUR PROPERTY OR OTHER IMPORTANT RIGHTS. YOU SHOULD TAKE TUIS 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. CUMBERLAND COUNTY BAR ASSOCIATION TWO LIBERTY AVENUE CARLISLE PA 17013 717-249-3166 144 p ? O (n D ?7 ^J P - F-7 SELECTIVE INSURANCE COMPANY OF AMERICA : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 20084767 CIVIL RICHARD L. BARR and ANN D. BARR each : CIVIL ACTION -LAW individually and trading s RLB Services Defendants TO: RICHARD L. BARR I/AJT/A RLB SERVICES, Defendant(s) You are hereby notified that on Jill 5 , 20pj the following (judgment) has been entered against you in the above-captioned case. Tndgment entered in the amount of $6.,%C 9 DATE: othon I hereby certify that the name and address of the proper person(s) to receive this notice is: RICHARD L BARR IATA RLB SERVICES 69% WERTZVILLE RD MECHANICSBURG PA 17050-1540 SELECTIVE INSURANCE COMPANY OF AMERICA : IN THE COURT OF COMMON PLEAS Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA V. : NO. 2008-6767 CIVIL RICHARD L. BARR and ANN D. BARR each : CIVIL ACTION -LAW individually and trading s RLB Services Defendants TO: ANN D BARR I J A/T/ A RLB SERVICES, Defendant(s) You are hereby notified that on %?Ckn 5 , 20-0 the following (judgment) has been entered against you in the above-captioned case. Tudgment entered in the amount of $6,564.69 DATE: thou ry I hereby certify that the name and address of the proper person(s) to receive this notice is: ANN D BARR IATA RLB SERVICES 69% WERTZVILLE RD MECHANICSBURG PA 17050-1540 _. 4 PRAECIPE FOR WRIT OF EXECUTION - (MONEY JUDGMENTS) P.R.C.P. 3101 to 3149 Selective Insurance Company of America IN THE COURT OF COMMON PLEAS OF 40 Wantage Ave, Brachville NJ 07890 Cumberland COUNTY, PENNSYLVANIA Plaintiff Writ No. Term 20 vs No. 08-6767 Term 2008 Amount Due Richard L. Barr and Ann D. Barr each ind 1/26/09 jdmt ............. & t/ a RLB Services 6996 Wertzville Road Mechanicsburg PA 17050 DEFENDANT(S) First National Bank of Pennsylvania Garnishee Interest from 1/5/09-1/26/09 1.06 per diem .............. Attby's Commission 5/0 ...................... Costs (to be determined) $ 6,564.69 $ 22.32 $ 328.24 TO THE PROTHONOTARY OF SAID COURT: ISSUE WRIT OF EXECUTION IN THE ABOVE MATTER, (1) Directed to the Sheriff of CUMBERLAND . Cour(ty, Pennsylvania (2) against Richard L Barr and Ann D Barr each i/ a/ t/ a RLB Services e en ants ; (3) and against Garnishee s ; (4) and index this writ (a) against Richard L Barr and Ann D Barr each i/ a/ t/ a RLB Services Defendant(s) and (b) against arrusneeks), as a lis pendens against the real property of the defendant(s) in the name of the Garnishee(s) as follows: (Specifically describe property and note any specific direction to Sheriff) Furnish 4 copies for real estate levy): LEVY UPON ALL PERSONAL PROPERTY OF THE ABOVE-LISTED DEFENDANT(S) AT THE ABOVE ADDRESS IN CUMBERLAND COUNTY, INCLUDING BUT NOT LIMITED TO FURNITURE, JEWELRY, ELECTRONICS, SUPPLIES, ETC., (5) Exemption has (not) been waived. Robert D. Kodak, Esquire PO Box 11848 Harrisburg, PA 17108 (717) 238-7159 Dated 12 3 08 Attorney For Plaintiff(s) (o)1701 E a1n21 aaS pansap si suapuad siI a se Oucxapui pue payaeuu sf a3gsfwe9 aqI jo aweu ayl of ? vpdoid temp nluo p oldwoa aq pI nogs (q)(q) gdeideJed (q)bOl £ a1n21 aaS Sielouoylo?d ayl Cq punoa leyl w as?noa 3o se pannba? sf ?uixapui Aunoa iayioue of sanssi liL" aqi uayM '(e)b0l £ a1nE 6q pazuoyine se pansap si `aouujnssi jo ?4unoa ayi ui suorinoaxa aqi;o 8uixapui;l ? luo paialdwoo aq plnoys (e)(b) ydeaSeied (ufm aqi w papnpu! aq of si aogsiwe2 paweu e w ? Iuo palaldwoa aq plnoys anoge) (£) gdUlBeled panssi yoiym u) 64unoo aql jo jluags ayi of fluo palaanp aq , uw luowSpnC pa.ua;sueil a uo panssi lum a (a)£0l £ a1n?l lapu fl paleoipui aq plnoys fiunoo oq1 `(q)£ol£ a1n21 !q pozuoglne se niunoa Ja410ue3o;;Ja4s ayi of paioanp si 1µm aqi uaym (1) gdeiSuad iapun UON O N E f. F-? W O O N v lL) •? Z7 C7N _ N C_) V V c? C o V ¢ 4J C U .ri V z ? O D Q ? \ W 4 M W Q u r • \ r V V V V r v 'Zi ?crJth4ri v f $ ? -l? V t`I of r V Gee WRIT OF EXECUTION and/or ATTACHMENT - 4 COMMONWEALTH OF PENNSYLVANIA) NO 08-6767 Civil COUNTY OF CUMBERLAND) CIVIL ACTION - LAW TO THE SHERIFF OF CUMBERLAND COUNTY: To satisfy the debt, interest and costs due SELECTIVE INSURANCE COMPANY OF AMERICA, Plaintiff (s) From RICHARD L. BARR AND ANN D. BARR EACH IND. & T/A RLB SERVICES, 6996 WERTZVILLE ROAD, MECHANICSBURG, PA 17050 (1) You are directed to levy upon the property of the defendant (s)and to sell LEVY UPON ALL PERSONAL PROPERTY OF THE ABOVE-LISTED DEFENDANT(S) AT THE ABOVE ADDRESS IN CUMBERLAND COUNTY, INCLUDING BUT NOT LIMITED TO FURNITURE, JEWELRY, ELECTRONICS, SUPPLIES, ETC. . (2) You are also directed to attach the property of the defendant(s) not levied upon in the possession of GARNISHEE(S) as follows: and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant (s) or otherwise disposing thereof; (3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a garnishee and is enjoined as above stated. Amount Due $6,564.69 L.L. $.50 Interest FROM 1/5/09-1/26/09 1.06 PER DIEM -- $22.32 Atty's Comm5 % $328.24 Due Prothy $2.00 Atty Paid $206.76 Other Costs Plaintiff Paid Date: JANUARY 27, 2009 (Seal) Curtis R. Long, Prothonotary By: Deputy REQUESTING PARTY: Name ROBERT D. KODAK, ESQUIRE Address: PO BOX 11848 HARRISBURG, PA 17108 Attorney for: PLAINTIFF Telephone: 717-238-7151 Supreme Court ID No. 18041 r S 7t i, .. &Thomas Kline, Sheriff, who being duly sworn according to law, states r?is writ is returned STAYED, per request from attorney. 'Sheriff's Costs: Advance Costs: 150.00 Sheriff's Costs: 136.17 Docketing Poundage Advertising Law Library Prothonotary Mileage Surcharge Levy Certified Mail Postpone Sale Garnishee Postage TOTAL 18.00 13.83 2.67 10.00 .50 2.00, Refunded to Atty on 04/14/09 18.00 50.00 20.00 15.00 $ 136.17 ? y Jt4 So Answers; R. Thomas Kline, Sheriff z • By Sharon R. Lantz ? . n ? b c?!a ""_ =t7 Rj?7 -A. !Sir t_ J23 f; { m 'iii Co 5v ih1Ggo6 WRIT OF EXECUTION and/or ATTACHMENT COMMONWEALTH OF PENNSYLVANIA) COUNTY OF CUMBERLAND) NO 08-6767 Civil CIVIL ACTION - LAW TO THE SHERIFF OF CUMBERLAND COUNTY: To satisfy the debt, interest and costs due SELECTIVE INSURANCE COMPANY OF AMERICA, Plaintiff (s) From RICHARD L. BARR AND ANN D. BARR EACH IND. & T/A RLB SERVICES, 6996 WERTZVILLE ROAD, MECHANICSBURG, PA 17050 (1) You are directed to levy upon the property of the defendant (s)and to sell LEVY UPON ALL PERSONAL PROPERTY OF THE ABOVE-LISTED DEFENDANT(S) AT THE ABOVE ADDRESS IN CUMBERLAND COUNTY, INCLUDING BUT NOT LIMITED TO FURNITURE, JEWELRY, ELECTRONICS, SUPPLIES, ETC. . (2) You are also directed to attach the property of the defendant(s) not levied upon in the possession of GARNISHEE(S) as follows: and to notify the garnishee(s) that: (a) an attachment has been issued; (b) the garnishee(s) is enjoined from paying any debt to or for the account of the defendant (s) and from delivering any property of the defendant (s) or otherwise disposing thereof; (3) If property of the defendant(s) not levied upon an subject to attachment is found in the possession of anyone other than a named garnishee, you are directed to notify him/her that he/she has been added as a garnishee and is enjoined as above stated. Amount Due $6,564.69 L.L. $.50 Interest FROM 1/5/09-1/26/09 1.06 PER DIEM --$22.32 Atty's Comm5 % $328.24 Due Prothy $2.00 Atty Paid $206.76 Other Costs Plaintiff Paid Date: JANUARY 27, 2009 (Seal) REQUESTING PARTY: Name ROBERT D. KODAK, ESQUIRE Address: PO BOX 11848 HARRISBURG, PA 17108 Attorney for: PLAINTIFF Telephone: 717-238-7151 Curtis R. Long, Prothonotary By: Deputy Supreme Court ID No. 18041