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HomeMy WebLinkAbout09-6020J. BENJAMIN NEVIUS, ESQUIRE E-mail: Ben.Nevius®zurichna.com Attorney ID No.: 93094 HENDRZAK & LLOYD 3701 Corporate Parkway, Suite 100 Center Valley, Pennsylvania 18034 610.709.8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ? ? err ? 1 ? i R F ND Wp PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN Dq - Cvd a 0 C,?v i ( Term SCHUYLKILL COUNTY COURT OF COMMON PLEAS NO.: S 1017-2008 TRIAL BY JURY OF 12 DEMANDED ORDER AND NOW, this ? day of Aug U 1 t , 2009, upon consideration of the attached Stipulation to Transfer Matter to Cumberland County, being duly executed by counsel for both parties, it is hereby ORDERED and DECREED that the above- captioned action shall be transferred to the Cumberland County Court of Common Pleas. T: e Prothonotary of Schuylkill County is hereby directed to transfer this matter upon payment of the costs of transfer. rV C? 2 _` C Lr ti., r c7 :?= N N BY THE COURT ans 83j DOCKET: S-1017-2008` FILED: 04/10/2008 at 10:14AM OMPLAINT IN CIVIL ACTION LAW ------------------------------ PLAINTIFFS DEFENDANTS ------------------- ----------------------------------------------------------- ADAMS,MICHELLE BUCKMAN,JOSEPH 246 SOUTH LEHIGH AVENUE 127 TEXACO ROAD FRACKVILLE, PA 17931 MECHANICSBURG, PA 17050 ATTY: STEPHEN T. CARPENITO ATTY: J BENJAMIN NEVIUS ------------------- ----------------------------------------------------------- ADAMS JR,RICHARD T..;. PETROLEUM PRODUCTS CORP 246 SOUTH LEHIGH AVENUE 127 TEXACO ROAD FRACKVILLE, PA 17931 MECHANICSBURG, PA 17050 ATTY: STEPHEN T. CARPENITO ATTY: J BENJAMIN NEVIUS ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- FILING ------------------- .------------------------------------------------------------ T & E 404/10/2008 at 10:14AM LAINTIFFS 64.50/PLAINTIFF -------------- ----------------------------------------------------------- STATE TAX (.5d)_ 4 04/10/2008 at,k,0:14AM PLAINTIFFS 0.50/PLAINTIFF -------------------------------------------------------------------------- ATTORNEY 04/10/2008 at 10:14AM PLAINTIFFS 3. 00/PLAINTIFF' L' -------------- ----------------------------------------------------------- SATISFACTION 04/10/2008 at 10:14AM PLAINTIFFS ;t, 16C -------------- 1 7 7.00/PLAINTIFF, ---------------------------------------------------- COMPUTER FUND'` 04/10/2008 at 10:14AM PLAINTIFFS 10.00/PLAINTIFF ----------------------------- AUTOMATION FUND 04/10/2008 at 10:14AM PLAINTIFFS - _, 5.00/PLAINTIFF-' --------------------------- ----------------------------------------------- SHERIFF'S SER CE-SEE FILE 4/23/2008 atV .2:18PM SHF-61_00- ---------------- APPEARANCE FOR'DEFENDANT 05/05/2008 at 12:43PM FRISBIE,MICHAEL F ------------- DOCKET: 5-1017-2008,; FILED: 04/10/2008 at 10:14AM f.. COMPLAINT IN CIVIL ACTION LAW ------------------7------------------------------------------------------------- -r. FILING - .?----------------------------------------------------------- DEMAND --- _ FOR _ JURY TRIAL 05/05/2008 at 12:43PM FRISBIE,MICHAEL F -------------- -7----------------------------------------------------------- AWWER/NEW MAT17ER/CROSSCLAIM/JURY DEMAND ./05/27/2008 at'?0:01AM FRISBIE,MICHAEL F CE TIFICATE OF-SERVICE /27/2008 at 10:01AM FRISBIE,MICHAEL F ANSWER TO NEW MATTER 06/05/2008 at`i0:27AM CARPENITO,STEPHEN T. -------------------------------------------------------------------------- CERTIFICATE OF[SERVICE 06/05/2008 at,10:28AM CARPENITO,STEP'HEN T. ------------- 4 ---------------------------------------------------------- CERTIFICATE OFl`SERVICE 02/04/2009 at '10:29AM FRISBIE,MICHAFL F -------------------------------------------------- PRAECIPE/WITHDkAW APPEARANCE OF COUNSEL 5/22/2009 at ,10:50AM JVFRISBIE,MICHAET F --------------------- STIPULATION 07/21/2009 at' 0:53AM CARPENITO,STEPIAEN T. - ------------------ STIPULATION 07/21/2009 at 0:53AM NEVIUS,J BENJAKIN -------------- CERTIFICATE OF?SERVICE 07/21/2009 at ',0:53AM NEVIUS,J BENJA IN t,. -------------------------------------------- ORDER OF COURT,/COPIES MAILED 08/11/2009 at'g2:12PM DOMALAKES, JOHN,':,E -------------------------------------------------------------- ORDER/TRANSMIT'T`AL OF RECORD 08/11/2009 at Q2:12PM DOMALAKES, JOHN.; K=E --------------- ----------------------------------------------------------- `Jay F , PETER J. SYMOK JR Pwtha wb" JEFFREY MARKOSKY Solidtor FAYE K GUYBSKI First Deputy DEBORAH A. CONWAY Second Deputy OFFICE OF THE PROTHONOTARY SCHUYLIQLL COUNTY COURT HOUSE 401 N 2ND ST POTISVML$, PA 1Ml--25M Telephorm (570) 628-1270 Fax: (570) 628-1261 DA TO WHOM IT MAY CONCERN: We are returning the enclosed item for the following reason(s): DO 1. All transactions directed to this office must include a SELF ADDRESSED ENVELOPE WITH POSTAGE if a return receipt or certificate is desired. 2. Incorrect fee received $ should be $ 3. Need signature d Attorney: ID number 5. Th above matter has been filed but cannot be transmitted to the court without the filing of a ipe. A copy of the praecipe (205.2)(b) is enclosed, please fill out and return to us so we can forward the papers to the courts. 6. 'ainal paperwork not received back from our Sheriffs Office. Please contact Sheriffs O ce. 7. er reasons 41 A COPY OF THIS PAPER SHOULD BE RETURNED WITH ALL CORRESPONDENCE PETER J. SYMONS, JR. PROTHONOTARY Au 4. 4. 2009 3:24PM No. 1116 P. 2 IN THE COURT OF COMMON PLEAS OF SCHUYLKILL COUNTY m,e\,+e& fl&wS JR. No. 1b V-7 zoo8 Plaintiff vs. P:evvwVV% ?c? ducks Cep . Defendant PRAECIPE FOR CERTIFICATION - PROTHONOTARY FORM 205.2(b) TO: PETER J. SYMONS, PROTHONOTARY: Transmit the attached filing to the Court Administrator for Assignment to a Judge, The nature of the filing and requested action is as follows: 0 0 Jury Trial - (Complete Certificate of Readiness.) Non-Jury Trial - o Any matter dispositive of the case e.g.: I> {) Equity Actions; () Tax Appeals; () Summary Appeals; () Name Change Actions; () Permanent Injunctions; () Other (specify) I estimate it will require hours to present the plaintiff sldefendant's case and I will present only the following witnesses for testimony: _= Nnrr;? Petition pursuant to Pa.R.C.P. 206.1 requesting () Issuance of Rule to Show Cause; () Transfer to Court for disposition, no answer having been filed; {) Transfer to Court for disposition, contested matter and fact finding complete or unnecessary; () Other (specify) Issue that can be decided on the record and briefs, being: () Gov't Appeal; ( ) Exceptions; () Judgment on the Pleadings; () Summary Judgment; ( ) Other (specify) Issue that can be assigned for immediate action, being: Stipulation; () Uncontested Motion; () Motion for Appointment; () (uiet Title Motion; Other (specify) Aug, 4. 2004 3:24PM No, 1116 P. 3 ,r , Contested Motion (Memo attached), being: () Discovery Motion; () Other (specify) ( ) Transmit to Custody Officer, Reason: (If hearing is inquired, complete the time and witness portion of this form.) Hearing required/requested: Reason for Hearing: () Special Relief; () Contempt Petition; () Preliminary Injunctions; () Other _ (specify) I estimate it will require hours to present the plaintiff s/defendant's case and I will present only the following witnesses for testimony: Date: Q, ? (. lob For Defendant: ?- 3e ?,"yu vv? ,n (,k u s For Plaintiff: Notice: In matters requiring a non-jury trial or hearing opposing counsel is required to submit a report in WRITING to the Court Administrator within 10 days, (1) listing the names of the witnesses they will use at hearing; and, (2) an estimate of time required to present their case. Revised 7121/04 Y J. BEr [JAMIN NEVIUS, ESQUIRE E-mail: Ben.Nevius®zurichna.com Afton iey ID No.: 93094 HENDRZAK & LLOYD 3701 Corporate Parkway, Suite 100 Center Valley, Pennsylvania 18034 610.739.8705 MICHELLE ADAMS and RIC]IARD T. ADAMS, JR. V. JOS]'PH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN c y c-= N SCHUYLKILL COUNTY c: COURT OF COMMON PLEAS U { w NO.: S 1017-2008 TRIAL BY JURY OF 12 DEMANDED STIPULATION TO TRANSFER MATTER TO CUMBERLAND COUNTY It is hereby stipulated and agreed by and between counsel of record that this matter should be transferred to CUMBERLAND COUNTY, the venue of proper jurisdiction given the location of the subject events, and the residence of the respective parties at all relevant times hereto. This Stipulation may be executed any number of original or facsimiled counterparts, each of which shall be deemed to be an original as against any party whose signature appears thereon, and all of which shall together constitute one and the same instrument. \ Dated: ?- t3-o? Stephen Farpenito, Esquire Counsel for Plaintiff Dated: 1-i6-0S evius, Esquire Hendrzak & Lloyd Counsel for Defendants Joseph Buckman and Petroleum Products Corp. J. BENJAMIN NEVIUS, ESQUIRE E-mail: Ben.Nevius®zurichna.com Attorney ID No.: 93094 HENDRZAK & LLOYD 3701 Corporate Parkway, Suite 100 Center Valley, Pennsylvania 18034 610.709.8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN SCHUYLKILL COUNTY COURT OF COMMON PLEA NO.: S 1017-2008 TRIAL BY JURY OF 12 DEMANIJED STIPULATION OF COUNSEL It is hereby stipulated and agreed by and between counsel of record that: 1. Defendant Joseph Buckman was an employee of Defendant Petroleum Products Corporation and was acting in such a capacity at the time of the subject incident. 2. Defendants Petroleum Products Corporation and Joseph Buckman stipulate to liability in the above-referenced matter. 3. This stipulation is made with regard to liability only; the extent of Plaintiffs' damages/ injuries, if any, and the issue of causation remain in dispute and are a matter for trial. This Stipulation may be executed any number of original or facsimiled counterparts, each of which shall be deemed to be an original as against any party whose signature appears thereon, and all of which shall together constitute one and the same instrument. Dated: 1?y V Stephen arpenito, Esquire el-forz aintiff Dated: - (P - C)C,\. J. Be in s, Esquire H n rzak & Lloyd Counsel for Defendants Joseph Buckman and Petroleum Products Corp. J. BENJAMIN NEVIUS, ESQUIRE E-mail: Ben.Nevius@zurichna.com Attorney ID No.: 93094 HENDRZAK & LLOYD 3701 Corporate Parkway, Suite 100 Center Valley, Pennsylvania 18034 610. 709.8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN SCHUYLKILL COUNTY COURT OF COMMON PLE?P3 NO.: S 1017-2008 TRIAL BY JURY OF 12 DEMARDED CERTIFICATE OF SERVICE %_J I, J. Benjamin Nevius, Esquire hereby certify that a true and correct copy of the fully executed Stipulation of Counsel and Stipulation to Transfer Matter to Cumberland County were sent via First Class United States Mail, postage prepaid to the following parties of record: Stephen Carpenito, Esquire 615 Center Street Ashland, PA 17921 Dated: J. Benjam evius, Esquire Hendrzak & Lloy Counsel for Defendants Joseph Buckman and Petroleum Products Corp. y 4ti '? ? ti?? ? , L. ?C J. BENJAMIN NEVIUS, ESQUIRE E-mail: ben.neviusgzurichna.com Attorney I.D. No.: 93094 HENDRZAK & LLOYD 3701 Corporate Center Parkway, Suite 100 Center Valley, Pennsylvania 18034 (610) 709-8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN SCHUYLKILL COUNTY COURT OF COMMON PLEAS NO.: S 1017-2008 TRIAL BY JURY OF 12 DEMANDED WITHDRAWAL OF APPEARANCE TO THE PROTHONOTARY: Kindly withdraw my appearance in the above captioned matter on behalf of Defendant, PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN. On'A% F71-%- Michael F. isbie, Esquire ENTRY OF APPEARANCE Kindly enter my appearance in the above captioned matter on behalf of Defendant, PETROLEUM PRODUCTS CORP. and JOSEPH BU KMAN. J. Benjami ius, Identification No. 93094 Attorney ndant Dated: -mil ?( ?- _ ????? e IN THE MATTER OF: CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 COURT OF COMMONIPLEAS .5 TERM, SCHUYLKILL _? cl> CASE NO: S 1017-,908 MICHELLE ADAMS AND RICHARD ADAMS -VS- PETROLEUM PRODUCTS CORP., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of MICHAEL FRISBIE, ES certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/02/2009 0 06 33--H MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT DE11-0843037 05383-LO1 COMMONWEALTH OF PENNSYLVANIA COUNTY OF SCHUYLKILL IN THE MATTER OF: MICHELLE ADAMS AND RICHARD ADAMS -VS- PETROLEUM PRODUCTS CORP., ET AL. COURT OF COMMON PLEAS TERM, CASE NO: S 1017-2008 NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 NATIONWIDE INSURANCE COMPANY INSURANCE NATIONWIDE INSURANCE COMPANY INSURANCE NATIONWIDE INSURANCE COMPANY INSURANCE RAYMOND J. KRAYNAK, D.O. MEDICAL, BILLING, AND X-RAY(S) TO: STEPHEN T. CARPENITO, ESQ., PLAINTIFF COUNSEL MCS on behalf of MICHAEL FRISBIE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 01/12/2009 MCS on behalf of MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT CC: MICHAEL FRISBIE, ESQ. - 245249 STEPHEN T. CARPENITO, ESQ. L/O OF STEPHEN CARPENITO 615 CENTRE STREET ASHLAND, PA 17921 THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 R1.80S 133-H DE02-0457726 05383-COl COMMONWEALTH OF PENMOPYNk MICHELLE ADAMS AND RICHARD ADAM vs. , PETROLEUM PRODUCTS CORP., ET AL. File No. S1017-2008 SUBPOENA TO PRODUCE DOCUMENTS OR THNGS FOR DISCOVERY PURSUANT TO RULE 4009.22 Custodian of Records for NATIONWIDE INSURANCE COMPANY TO: (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the **** SEE ATTACHED RIDER **** following documents or things: at The MCS GrouD. Inc.. 1601 Market Street. Suite 800. Philadelohia. PA 19103 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: MICHAEL FRISBIE, ESQ. ADDRESS: 3701 CORPORATE CTR. PKWY, SUITE 100 CENTER VALLEY, PA 18034 TELEPHONE: (215) 246-0900 SUPREME COURT ID # ATTORNEY FOR: Befemda, It FEB 0 2 2009 Date: Seal of the Court BY THE CO T: C-1 F-4 nx;1Ri_n-1 Rev. 4/00) EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: NATIONWIDE INSURANCE COMPANY 1000 NATIONWIDE DRIVE HARRISBURG, PA 17110 RE: 5383 MICHELLE ADAMS Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. POLICY #5837D007324, CLAIM #5837007324D2005110801. Any and all insurance records and PIP files, including but not limited to medical reports and/or records, claims, any and all correspondence, documentation supporting plaintiff's claim, payments including dates of payments, payee and reasons for payments, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. Subject : MICHELLE ADAMS 246 SOUTH LEHIGH AVENUE, FRACKVILLE, PA 17932 Social Security #: XXX-XX-3924 Date of Birth: 10-16-1969 Date of Loss: 07/31/2006 R1.80S 133-H SU10-0767990 05383-LO1 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON PLEAS MICHELLE ADAMS AND RICHARD ADAMS TERM, SCHUYLKILL -VS- PETROLEUM PRODUCTS CORP., ET AL. CASE NO: S 1017-2008 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of MICHAEL FRISBIE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, - (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 02/02/2009 MCS on behalf of MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT R2.06 133-H DE11-0843041 05383-L02 COMMONWEALTH OF PENIS MICHELLE ADAMS AND RICHARD DAM S1017-2008 vs. , PETROLEUM PRODUCTS CORP.,-ET AL. File No. SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 Custodian of Records for NATIONWIDE INSURANCE COMPANY TO: (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the . **** SEE ATTACHED RIDER **** following documents or things: at The MCS GrouD. Inc.. 1601 Market Street. Suite 800. PhiladelDhia. PA 19103 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: MICHAEL FRISBIE, ESQ. ADDRESS: 3701 CORPORATE CTR. PKWY, SUITE 100 CENTER VALLEY, PA 18034 TELEPHONE: (215) 246-0900 SUPREME COURT ID # ATTORNEY FOR: Qefer+Qent FEB 02 2009 Date: Seal of the Court BY THE CO T: C-1 F-4 nRZR? n9 Rev. 4/00) EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: NATIONWIDE INSURANCE COMPANY 1000 NATIONWIDE DRIVE HARRISBURG. PA 17110 RE: 5383 MICHELLE ADAMS Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. POLICY #5837D007324, CLAIM #5837007324D2006063001. Any and all insurance records and PIP files, including but not limited to medical reports and/or records, claims, any and all correspondence, documentation supporting plaintiff's claim, payments including dates of payments, payee and reasons for payments, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. Subject : MICHELLE ADAMS 246 SOUTH LEHIGH AVENUE, FRACKVILLE, PA 17932 Social Security #: XXX-XX-3924 Date of Birth: 10-16-1969 Date of Loss: 07/31/2006 R1.80S 133-H SU10-0767992 05383-LO2 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: MICHELLE ADAMS AND RICHARD ADAMS -VS- PETROLEUM PRODUCTS CORP., ET AL. COURT OF COMMON PLEAS TERM, SCHUYLKILL CASE NO: S 1017-2008 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of MICHAEL FRISBIE, ES certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/02/2009 MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT R2.06 133-H DE11-0843045 05383-L03 COMMONWEALTH OF PENRS 1A COUNTY OF MICHELLE ADAMS AND RICHARD ADAMS S1017-2008 vs. PETROLEUM PRODUCTS CORP.,' ET AL. File No. SUBPOENA TO IRODUCE DOCUMENTS OR T MS FOR DISCOVERY PURSUANT TO RULE 4008.22 Custodian of Records for NATIONWIDE INSURANCE COMPANY TO: (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the **** SEE ATTACHED RIDER **** following documents or things: at The MCS GrouD. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the. right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the partyserving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: MICHAEL FRISBIE, ESQ. ADDRESS: 3701 CORPORATE CTR. PKWY, SUITE 100 CENTER VALLEY, PA 18034 TELEPHONE: (215) 246-0900 SUPREME COURT ID # ATTORNEY FOR: Date: FEB ' 2 2009 Seal of the Court BY THE &COT-. C-1 F-4 n??RA-n A Rev. 4/00) EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: NATIONWIDE INSURANCE COMPANY 1000 NATIONWIDE DRIVE HARRISBURG, PA 17110 RE: 5383 MICHELLE ADAMS Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. POLICY #5837D007324, CLAIM #5837007324D2006073101. Any and all insurance records and PIP files, including but not limited to medical reports and/or records, claims, any and all correspondence, documentation supporting plaintiff's claim, payments including dates of payments, payee and reasons for payments, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. Subject : MICHELLE ADAMS 246 SOUTH LEHIGH AVENUE, FRACKVILLE, PA 17932 Social Security #: XXX-XX-3924 Date of Birth: 10-16-1969 Date of Loss: 07/31/2006 R1.80S 133-H SU10-0767994 05383-LO3 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: MICHELLE ADAMS AND RICHARD ADAMS -VS- PETROLEUM PRODUCTS CORP., ET AL. COURT OF COMMON PLEAS TERM, SCHUYLKILL CASE NO: S 1017-2008 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of MICHAEL FRISBIE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) No objection to the subpoena has been received, and (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. MCS on behalf of DATE: 02/02/2009 MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT R2.06 133-H DE11-0843049 05383-L04 COMMONWEALTH OF PEAWOW)MA COUNTY OF MICHELLE ADAMS AND RICHARD ADAMS S1017-2008 vs. PETROLEUM PRODUCTS CORP., ET AL. File No. SUBPOENA TO PRODUCE DOCUMENTS OR THM OS . FOR DISCOVERY PURSUANT TO RULE 4008.22 Custodian of Records for RAYMOND J. KRAYNAK, D.O. TO: (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: SEE ATTACHED RIDER **** at The MCS GroUD. Inc.. 1601 Market Street. Suite 800. PhiladelDhia. PA 19103 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena, together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: MICHAEL FRISBIE, ESQ. ADDRESS: 3701 CORPORATE CTR. PKWY, SUITE 100 CENTER VALLEY, PA 18034 TELEPHONE: (215) 246-0900 SUPREME COURT ID # ATTORNEY FOR: Defendarn FEB 02 2009 Date: Seal of the Court BY THE CO T: C-1 F-4 nx;?Ri-na Rev. 4100) 4 . ' EXPLANATION OF REQUIRED RECORDS TO: CUSTODIAN OF RECORDS FOR: RAYMOND J. KRAYNAK, D.O. 28 EAST 5TH STREET MOUNT CARMEL, PA 17851 RE: 5383 MICHELLE ADAMS Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical, billing, and diagnostic file, including but not limited to any and all records, correspondence to and from the consulting and/or treating physicians, files, memoranda, handwritten notes, history and physical reports, medication/prescription records, medical billing and payment records, x-ray films and tests with subsequent reports, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, consultation, diagnosis, care or treatment pertaining to: Dates Requested: up to and including the present. subject : MICHELLE ADAMS 246 SOUTH LEHIGH AVENUE, FRACKVILLE, PA 17932 Social Security #: XXX-XX-3924 Date of Birth: 10-16-1969 R1.80S 133-H SU10-0767996 05383-LO4 ? "? Q .._ ?`? ??; a.? 9- ?. LAW OFFICE OF STEPHEN T, CARPENITO BY: STEPHEN T. CARPENITO, ESQUIRE ATTORNEY ID# 68860 615 CENTRE STREET ASHLAND, PA 17921 TELE: (570) 875-3500 COUNSEL FOR PLAINTIFFS MICHELE ADAMS AND RICHARD T. ADAMS, JR., H/W MICHELLE ADAMS and IN THE COURT OF COMMON PLEAS RICHARD T. ADAMS, JR., h/w SCHUYLKILL COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PLAINTIFF DOCKET No: S-1017-2008 VS. roz . r 17 O JOSEPH BUCKMAN and JURY TRIAL DEMANDED= `- . o PETROLEUM PRODUCTS CORP. DEFENDANT; ?v l ANSWER TO NEW MATTER l .-J AND Now, comes the Plaintiffs, Michelle Adams and Richard T. Adams, Jr., h/w, by and through their counsel, Stephen T. Carpenito, Esquire, does file this Answer to New Matter and in support thereof avers as follows: 32. Denied. Plaintiffs' claims are not subject to reduction nor barred by the provisions of the Comparative Negligence Statute of the Commonwealth of Pennsylvania, as Plaintiffs at all time acted in a safe and prudent manner. 33. Denied. There were no emergency situations that would justify the negligent actions of the Defendant. 34. Denied. Plaintiff's injuries were the direct and proximate result of the negligent and careless conduct of the Defendant. Further, at all times Plaintiff acted in a safe an prudent manner. 35. Denied. Plaintiff's injuries were the direct and proximate result of the negligent and careless conduct of the Defendant. Further, at all times Plaintiff acted in a safe and prudent manner. 36. Denied. Plaintiff's injuries were the direct and proximate result of the negligent and careless conduct of the Defendant. Further, at all times Plaintiff acted in a safe an prudent manner. 37. Denied. This is a legal conclusion for which no responsive pleading is necessary. However by way of further answer at all times Plaintiff acted in a safe and prudent manner in the operation of her vehicle and did not violate any Federal statutes, State statutes and/or City Ordinances. 38. Denied. Plaintiffs' Complaint speaks for itself and if the averments therein are proven to be true would support a cause of action. 39. Denied. Plaintiff's injuries were the direct and proximate result of the negligent and careless conduct of the Defendant. 40. Denied. Plaintiff's claims are not barred, nor limited by the Pennsylvania Motor Vehicle Financial Responsibility Act. Further, said Act offers no defenses in this matter. 41. Denied. This is a legal conclusion for which no response is necessary, however, this defense must fail because it has already been addressed by the Supreme Court. 42. Denied. Plaintiff has acted in a safe and prudent manner and has always sought appropriate medical treatment and mitigated her damages. 43. Denied. Defendant has not set forth which specific affirmative defenses to which he is referring. However, by way of further answer Pa.R.C.P. 1030 provides no defense to the Defendant. 44. Denied. Defendant has not set forth which specific affirmative defenses to which he is referring, therefore a proper answer is not possible. By way of further answer, no affirmative defenses provide relief to the Defendant. WHEREFORE, Plaintiffs respectfully seeks this Honorable Court to issue judgement in their favor and against the Defendants, Joseph Buckman and Petroleum Products Corp., in an amount in excess of the arbitration limit, together with costs, attorney fees, punitive damages and interest. Respectfully submitted, DATE: TEPHEN T CA ENITO, ESQUIRE ATTORNEY .468860 COUNSEL FOR PLAINTIFFS I, Michelle Adams, do hereby verify that I have read the hereinabove document and the averments contained herein are true and correct to the best of my knowledge and belief, and the foregoing is a filing before the Schuylkill County Court of Common Pleas, Civil Division. I understand that all statements made therein are made pursuant to the provisions of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. Dated: A 0 _ V44&414Q Michelle Adams I, Richard T. Adams, Jr. do hereby verify that I have read the hereinabove document and the averments contained herein are true and correct to the best of my knowledge and belief, and the foregoing is a filing before the Schuylkill County Court of Common Pleas, Civil Division. I understand that all statements made therein are made pursuant to the provisions of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. Dated: Richard T. Adams, Jr. LAW OFFICE OF STEPHEN T, CARPENITO BY: STEPHEN T. CARPENITO, ESQUIRE ATTORNEY ID# 68860 615 CENTRE STREET ASHLAND, PA 17921 TELE: (570) 875-3500 COUNSEL FOR PLAINTIFFS MICHELE ADAMS AND RICHARD T. ADAMS, JR., H/W MICHELLE ADAMS and IN THE COURT OF COMMON PLEAS RICHARD T. ADAMS, JR., h/w SCHUYLKILL COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PLAINTIFF DOCKET No: S-1017-2008 vs. JOSEPH BUCKMAN and JURY TRIAL DEMANDED PETROLEUM PRODUCTS CORP. DEFENDANT CERTIFICATE OF SERVICE I, Kelly J. Klusman, secretary to Stephen T. Carpenito, Esquire, hereby certify.tihat, on this date, I caused a true and correct copy of Answer to New Matter pursuant to Rule 2252(d), is be served upon the following via the following means: C TYPE OF SERVICE: First Class U.S. Mail, postage prepaid ?? - a - T) COUNSEL FOR DEFENDANTS -? Michael F. Frisbie, Esquire Hendrzak & Lloyd 3701 Corporate Center Parkway, Suite 100 Center Valley, PA 18034 Date: June 4, 2008 LY J. KLUSMAN '?° '"?'1 ?? 4 v 1 To Plaintiffs: You are hereby notified to answer the enclosed Answer, New Matter within twenty (20) days from service hereof r a judgment maybe entered against you. -A ov (r M H L F. FRISBIE, ESQUIRE MICHAEL F. FRISBIE, ESQUIRE Attorney I.D. No.: 79096 HENDRZAK & LLOYD 3701 Corporate Center Parkway, Suite 100 Center Valley, Pennsylvania 18034 (610) 709-8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANTS> PETROLEUM PRODUCTS CORR-bihd JOSEPH BUCKMAN 77 rv r ? SCHUYLKILL COUNTY COURT OF COMMON PLEAS NO: S 1017-2008 TRIAL BY JURY OF 12 DEMANDED ANSWER OF DEFENDANTS, JOSEPH BUCKMAN AND PETROLEUM PRODUCTS CORP. TO PLAINTIFFS' COMPLAINT WITH NEW MATTER CROSSCLAIM Defendants, Joseph Buckman and Petroleum Products Corp., by their counsel, Hendrzak and Lloyd, hereby answer Plaintiffs' Complaint as follows: 1. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 2. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 3. Admitted. 4. Admitted. 5. Admitted. 6. Admitted. 7. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 8. Admitted. 9. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 10. It is admitted only that Defendant Buckman struck the rear of a vehicle in front of him. The remaining allegations are denied pursuant to Pa.R.C.P. 1029(e). 11. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). COUNTI Plaintiffs v. Joseph Buckman 12. Answering Defendants incorporate by reference the answers to paragraphs 1 through 11 inclusive, as fully as though the same were here set forth at length. 13. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 14. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). WHEREFORE, Answering Defendants pray that Plaintiffs' Complaint be dismissed with prejudice or that judgment be rendered wholly in favor of Answering Defendants. COUNT II Plaintiffs v. Petroleum Products Corp. Negligence 15. Answering Defendants incorporate by reference the answers to paragraphs 1 through 14 inclusive, as fully as though the same were here set forth at length. 16. Admitted in part, denied in part. It is admitted that Defendant, Petroleum Products, Corp. employed Defendant, Joseph Buckman. One of Defendant Buckman's job duties involves operating vehicles. The remaining allegations are denied pursuant to Pa.R.C.P. 1029(e). 17. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). WHEREFORE, Answering Defendants pray that Plaintiffs' Complaint be dismissed with prejudice or that judgment be rendered wholly in favor of Answering Defendants. COUNT III Plaintiffs v. Petroleum Products Corp. Respondeat Superior/Agency 19. Answering Defendants incorporate by reference the answers to paragraphs 1 through 18 inclusive, as fully as though the same were here set forth at length. 20. Admitted. 21. Admitted. 22. The allegations in this paragraph are denied pursuant Pa.R.C.P. 1029(e). 23. The allegations in this paragraph are denied pursuant Pa.R.C.P. 1029(e). WHEREFORE, Answering Defendants pray that Plaintiffs' Complaint be dismissed with prejudice or that judgment be rendered wholly in favor of Answering Defendants. COUNT IV Richard T. Adams, Jr. v. Joseph Buckman Loss of Consortium 24, Answering Defendants incorporate by reference the answers to paragraphs 1 through 23 inclusive, as fully as though the same were here set forth at length. 25. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 26. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 27. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). WHEREFORE, Answering Defendants pray that Plaintiffs' Complaint be dismissed with prejudice or that judgment be rendered wholly in favor of Answering Defendants. COUNT V Richard T. Adams, Jr. v. Petroleum Products Corp. Loss of Consortium 28. Answering Defendants incorporate by reference the answers to paragraphs 1 through 27 inclusive, as fully as though the same were here set forth at length. 29. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 30. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). 31. The allegations in this paragraph are denied pursuant to Pa.R.C.P. 1029(e). WHEREFORE, Answering Defendants pray that Plaintiffs' Complaint be dismissed with prejudice or that judgment be rendered wholly in favor of Answering Defendants. NEW MATTER 32. If an accident occurred in the manner alleged by the Plaintiffs, then such accident occurred as a result of the negligence of the Plaintiffs, and under the terms of the Comparative Negligence Act of 1976, 42 Pa. C.S.A. 7102 et seq., the Plaintiffs are not entitled to recover from Answering Defendants or the recovery is to be reduced in accordance with the terms of the aforesaid Act. 33. Answering Defendants assert that at the time and place averred in the Complaint, Answering Defendants, by its agents, servants and/or employees, was in the performance of its duties, responding to an emergency situation; and therefore, Answering Defendants cannot by held liable on the Plaintiffs' cause of action. 75 Pa. C.S.A. § 3105. 34. If it is judicially determined that the Plaintiff suffered any injuries and/or damages as a result of the accident as alleged in Plaintiffs' Complaint then such damages were proximately caused by the negligence of Plaintiff herself. 35. If the Plaintiff suffered any injuries/damages as alleged, they were caused solely and primarily by Plaintiffs own carelessness, recklessness, negligence, or contributory negligence. 36. By the actions at the date, time and place stated in the Plaintifs' Civil Action- Complaint, the Plaintiff assumed the risk of any and all injuries or damages which she is alleged to have suffered. 37. It is further averred that if Plaintiff sustained injuries and damages as alleged in Plaintiffs' Complaint, they were due solely to the fact that Plaintiff violated Federal statutes, State statutes and/or City ordinances. 38. Plaintiffs' Complaint fails to state a cause of action upon which relief can be granted. 39. At all times concerned with this litigation, Answering Defendants acted in a manner which was proper, reasonable, lawful and in the exercise of good faith. 40. Plaintiffs' Complaint in Civil Action avers that Plaintiff sustained personal injuries on July 31, 2006. Answering Defendants claim all of the immunities and defenses provided by the Motor Vehicle Financial Responsibility Law of February 12, 1984. Pursuant to the Motor Vehicle Financial Responsibility Law of February 12, 1984, as amended, 75 Pa. C.S.A. 1701, et seq., Plaintiffs are precluded from pleading or introducing into evidence or recovering the amounts of the coverages set forth. Plaintiffs' action is barred or limited by the limited tort option of the Motor Vehicle Financial Responsibility Law of February 12, 1984, as amended, 75 Pa. C.S.A. 1701, et seg., as Plaintiff has not sustained a serious injury. If applicable, Plaintiff is precluded from recovering any first party benefits, workers compensation benefits or health care benefits under a program, group contract or other arrangement, paid or otherwise payable, in the context of this third party liability claim pursuant to 75 Pa. C.S.A. § 1719. 41. On November 7, 1988 the Pennsylvania Supreme Court promulgated amended Pennsylvania Rule of Civil Procedure 238, hereinafter "Rule 238" with an immediate effective date. Rule 238, on its face and as applied, violates the due process and equal protection clauses of the Fourteenth Amendment to the United States Constitution; 42 U.S.C.A. Section 1983 of the Civil Rights Acts; Article I, Sections 1, 6, 11, 26; and Article IV, Section 10(c) of the Pennsylvania Constitution. If there is a judicial determination that Rule 238 is constitutional, then liability for any interest imposed by this rule should be suspended during the period of time that Plaintiffs fail to convey to the Defendants a settlement demand figure, delays in responding to discovery, delays in producing requests made by the Defendants, and as a result of any delay, the Plaintiffs should be estopped from obtaining interest because of any violation of the discovery rules. 42. Plaintiffs have failed to mitigate their damages. 43. Plaintiffs' claims are barred by all affirmative defenses set forth in Pa.R.C.P. 1030 including, but not limited to accord and satisfaction, arbitration and award, consent, discharge in bankruptcy, duress, estoppel, failure of consideration, fair comment, fraud, illegality, immunity from suit, impossibility of performance, justification, laches, license, payment, privilege, release, res judicata, statute of frauds, statute of limitations, truth and waiver. 44. Plaintiffs' claims are barred by any and all waivable affirmative defenses. WHEREFORE, Answering Defendants pray that Plaintiffs' Complaint be dismissed with prejudice or that judgment be rendered wholly in favor of Answering Defendants. Respectfully Submitted, HENDRZAK & LLOYD W? MICHAEL F. FRISBIE, ESQUIRE Attorney for Defendants VERIFICATION I, JOSEPH BUCKMAN, being duly sworn according to law, depose and say that I am a Defendant in the foregoing action and that the facts set forth in the foregoing Answer and New Matter to Plaintiffs' Complaint with New Matter, are true and correct to the best of my information, knowledge and belief, and that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904, relating to unworn falsification to authorities. J EP BUCKMAN Dated: ? toe Re: Adams v. Buckman, eta] (MFF) MICHAEL F. FRISBIE, ESQUIRE Attorney I.D. No.: 79096 HENDRZAK & LLOYD 3701 Corporate Center Parkway, Suite 100 Center Valley, Pennsylvania 18034 (610) 709-8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANTS, PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN SCHUYLKILL COUNTY COURT OF COMMON PLEAS NO.: S 1017-2008 TRIAL BY JURY OF 12 DEMANDED CERTIFICATION OF SERVICE I, MICHAEL F. FRISBIE, ESQUIRE, hereby certify that a true and correct copy of the foregoing Answer of Defendants to Plaintiffs' Complaint with New Matter, was served by first 2008: class U.S. Mail, postage prepaid, upon the following counsel of record on Mai' W =3 ° C?l - Stephen Carpenito, Esquire r v C _ _ :Ir- 615 Center Street o F 71- -?-' Ashland, PA 17921 C c> a CD z, HENDRZAK & LLOYD r MICHAEL F. FRISB , ESQUIRE Attorney for Defendants, Joseph Buckman and Petroleum Products Corp. ar.', ,,`??; MICHAEL F. FRISBIE, ESQUIRE Attorney I.D. No.: 79096 HENDRZAK & LLOYD 3701 Corporate Center Parkway, Suite 100 Center Valley, Pennsylvania 18034 (610) 709-8705 ADAMS RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN SCHUYLKILL COUNTY COURT OF COMMON PLEAS NO.: S 1017-2008 CIA- cn y TRIAL BY JURY OF 12 DE Ea ? ? QZ cP ? fir' o °? DEMAND FOR JURY TRIAL Twelve (12) members, exclusive of alternates, are hereby demanded by Defend". Joseph Buckman and Petroleum Products Corp., in the above captioned matter. w Respectfully Submitted, HENDRZAK & LLOYD r V MICHAEL FRISBIE, ESQUIRE Attorney for Defendants, Joseph Buckman and Petroleum Products Corp. Qo, MICHAEL F. FRISBIE, ESQLJIRE Attorney I.D. No.: 79096 HENDRZAK & LLOYD 3701 Corporate Center Parkway, Suite 100 Center Valley, Pennsylvania 18034 (610) 709-8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN SCHUYLKILL COUNTY COURT OF COMMON PLEAS NO.: S 1017-2008 TRIAL BY JURY OF 12 DEMANDED 01 ENTRY OF APPEARANCE ? o 2- © Z .Vj TO THE PROTHONOTARY: n° 9 Kindly enter my appearance in the above captioned matter on behalf of Defendants, cn N y Joseph Buckman and Petroleum Products Corp. w Respectfully Submitted, HENDRZAK & LLOYD M A4??jCHAEL F. FRISBIE, QUIRE Attorney for Defendants, Joseph Buckman and Petroleum Products Corp. 1T h ?? M Wed-Apr 23, 2008 12:18PM PLAINTIFF: DEFENDANT: SHERIFF'S DEPARTMENT OF SCHUYLKILL COUNTY SCHUYLKILL COUNTY COURT HOUSE POTTSVILLE, PENNSYLVANIA 17901 (570) 622-5570 ** A F F I D A V I T O F R E T U R N COURT NUMBER S-1017-2008 FILED BY CARPENITO,STEPHEN T. TYPE OF PAPER COMPLAINT IN CIVIL ACTION SERVING NUMBER 51572 PAGE: 1 ATTORNEY: CARPENITO,STEPHEN T. PRO FILE DATE 04/10/2008 EXPIRATION 05/10/2008 615 CENTER STREET SHF RECEIVED 04/10/2008 DEP RETURNED 04/23/2008 ASHLAND, PA 17921 ----------------------------------------------------------------------------------------------------------------------------------- (P E 0 P L E T O B E S E R V E D) NAME ADDRESS 1 ADDRESS 2 CITY ST ZIP DEPUTY -------------------- -------------------- -------------------- --------------------- -- ----- ------------------ Service for BUCKMAN,JOSEPH 127 TEXACO ROAD MECHANICSBURG PA 17050 COUNTY, 0 PETROLEUM PRODUCTS C 127 TEXACO ROAD MECHANICSBURG PA 17050 COUNTY. 0 (A T T E M P T S A T S E R V I C E) SEQ DATE TIME SERVED TO ADDRESS 1 ADDRESS 2 CITY ST ZIP MILES COST --- ---------- ----- -------------------- -------------------- --------------- ---------------- -- ----- ----- ------------ 1 04/14/2008 11:00 JOSEPH BUCKMAN 127 TEXACO ROAD MECHANICSBURG PA 0.00 * REMARKS : SERVICE MADE BY DEPUTY FROM OUT OF COUNTY ------------ Total 0.00 Total Mileage Charge for all Services 0.00 ADAMS,MICHELLE ET AL V S BUCKMAN,JOSEPH ET AL 7 Wed Apr 23, 2008 12:18PM PAGE: 2 SHERIFF'S DEPARTMENT OF SCHUYLKILL COUNTY SCHUYLKILL COUNTY COURT HOUSE POTTSVILLE, PENNSYLVANIA 17901 (570) 622-5570 ** A F F I D A V I T O F R E T U R N ** I hereby CERTIFY and RETURN that service was made by handing a TRUE and ATTESTED COPY to : JOSEPH BUCKMAN (PERSONAL SER) ON 127 TEXACO ROAD 04/14/2008 MECHANICSBURG PA at 11:00 SWORN and subscribed before me this r SO ANSWERS ? t day of O?A (Deputy Sheriff) a ( rothonotary) (Sheriff of Schuylkill County) End - of - Return (S-1017-2008) Wed Apr J?, 2008 12:18PM PAGE: 3 SHERIFF'S DEPARTMENT OF SCHUYLKILL COUNTY SCHUYLKILL COUNTY COURT HOUSE POTTSVILLE, PENNSYLVANIA 17901 (570) 622-5570 ** A F F I D A V I T O F R E T U R N PLAINTIFF: ADAMS,MICHELLE ET AL V S DEFENDANT: BUCKMAN,JOSEPH ET AL COURT NUMBER S-1017-2008 FILED BY CARPENITO,STEPHEN T. TYPE OF PAPER COMPLAINT IN CIVIL ACTION SERVING NUMBER 51572 ATTORNEY: CARPENITO,STEPHEN T. PRO FILE DATE 04/10/2008 EXPIRATION 05/10/2008 615 CENTER STREET SHF RECEIVED 04/10/2008 DEP RETURNED 04/23/2008 ASHLAND, PA 17921 ----------------------------------------------------------------------------------------------------------------------------------- (P E O P L E T O B E S E R V E D) NAME ADDRESS 1 ADDRESS 2 CITY ST ZIP DEPUTY -------------------- -------------------- -------------------- -------------------- -- ----- ------------------ BUCKMAN,JOSEPH 127 TEXACO ROAD MECHANICSBURG PA 17050 COUNTY, 0 Service for PETROLEUM PRODUCTS C 127 TEXACO ROAD MECHANICSBURG PA 17050 COUNTY, 0 (A T T E M P T S A T S E R V I C E) SEQ DATE TIME SERVED TO ADDRESS 1 ADDRESS 2 CITY ST ZIP MILES COST --- ---------- ----- -------------------- -------------------- --------------- --------------- -- ----- ----- ------------ 1 04/14/2008 11:00 JOSEPH BUCKMAN 127 TEXACO ROAD MECHANICSBURG PA 0.00 * REMARKS : SERVICE MADE BY DEPUTY FROM OUT OF COUNTY ------------ Total 0.00 Total Mileage Charge for all Services : 0.00 Wed Apr 23, 2008 12:18PM SHERIFF'S DEPARTMENT OF SCHUYLKILL COUNTY SCHUYLKILL COUNTY COURT HOUSE POTTSVILLE, PENNSYLVANIA 17901 (570) 622-5570 ** A F F I D A V I T O F R E T U R N ** I hereby CERTIFY and RETURN that service was made by handing a TRUE and ATTESTED COPY to : PAGE: 4 JOSEPH BUCKMAN (P.I.C) ON 127 TEXACO ROAD 04/14/2008 MECHANICSBURG PA at 11:00 SWORN and subscribed before me this SO ANSWERS day of Prothonotary) (Deputy Sheriff) (Sheriff of Schuylkill County) ----------------------------------------------------------------------------------------------------------------------------------- End - of - Return (S-1017-2008) Wad Apr 21, 2008 12:18PM SHERIFF'S DEPARTMENT OF SCHUYLKILL COUNTY SCHUYLKILL COUNTY COURT HOUSE POTTSVILLE, PENNSYLVANIA 17901 (570) 622-5570 ** A F F I D A V I T O F R E T U R N S E R V I C E R E T U R N C O M M E N T S 1. SENT TO CUMBERLAND COUNTY FOR SERVICE 2. 100.00 CHECK NO 4428 PAGE: 5 C 0 S T S I N F O R M A T I O N DESCRIPTION PAYMENTS CHARGES BALANCE ---------------------------- ADVANCE COSTS - SERVICE --- --------------- 150.00 --------------- -- ------------- 150.00 R D & R 9.00 141.00 SERVICE 9.00 132.00 ADD SERVICE 6.00 126.00 ATTESTING 8.00 118.00 DEPUTIZING FEE 9.00 109.00 STATE SURCHARGE 20.00 69.00 REFUND 89.00 0.00 Advance Payment 150.00 Cost of Service 61.00 Refund Paid 89.00 ---------------------------------------------- ---------------------- End - of - Return ------------------------ -------- (S-1017-2008) -------------------------------- A C C O U N T S T A T E M E N T O F F I C E O F T H E S H E R I F F O F S C H U Y L K I L L C O U N T Y Case Ref : S-1017-2008 Service ID: 51572 Type : COMPLAINT IN CIVIL ACTION Filed By: STEPHEN T. CARPENITO, ESQ. Address 1 615 CENTER STREET Address 2 . City ASHLAND PA 17921 DATE : 04/23/2008 Advance Payment 150.00 Cost of Service 61.00 Refund 89.00 SHERIFF'S RETURN - REGULAR CASE NO: 2008-00312 T COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND ADAMS MICHELLE ET AL VS BUCKMAN JOSEPH ET AL STEVE BENDER , Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within NOTICE was served upon BUCKMAN JOSEPH , at 0011:00 HOURS, on the 14th day of April , 2008 DEFENDANT at 127 TEXACO ROAD MECHANICSBURG, PA 17050 by handing to JOSEPH BUCKMAN a true and attested copy of NOTICE together with COMPLAINT and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing 18.00 Service 8.00 Affidavit 2.50 POSTAGE .41 Sworn and Subscibed to before me this ?a day of 4 o L . 0)0uU the So Answers: R. Thomas Kline 04/15/2008 STEPHEN CARPENITO By: IJ'eputy Sheriff ,UK A- Pf,' , Carlisle Boro. Cumberland County ly Commission Expires April 4. 2009 A.D. i i SHERIFF'S RETURN - REGULAR -CASE NO: 2008-00312 T COMMONWEALTH OF PENNSY1jVANIA: COUNTY OF CUMBERLAND ADAMS MICHELLE ET AL VS BUCKMAN JOSEPH ET AL STEVE BENDER Sheriff or Deputy Sheriff of Cumberland County,Pennsylvania, who being duly sworn according to law, says, the within NOTICE PETROLEUM PRODUCTS CORP was served upon the DEFENDANT , at 0011:00 HOURS, on the 14th day of April , 2008 at 127 TEXACO ROAD MECHANICSBURG, PA 17050 JOSEPH BUCKMAN a true and attested copy of NOTICE COMPLAINT together with and at the same time directing His attention to the contents thereof. Sheriff's Costs: Docketing Service Affidavit Surcharge 6.00 .00 1.00 .00 So Answers: R. Thomas Kline 04/15/2008 STEPHEN CARPENITO Sworn and Subscibedto before me this 22(c/day of,,. rA A ? L - Re 66 NOTr'kp.ij ?. SEAL CLAUDIA A. BREJVBAKER, NOTARY PUELIC Carlisle Boro. Cumberland County My Commission Expires Aril 1, 2009 By. Z&2L/?z Deputy Sheriff A. D. by handing to SCHUYLKILL COUNTY SHERIFF'S DEPARTMENT ------------------------------------------------------------------------------------------------------------------------- SHERIFF SERVICE PROCESS RECEIPT AND AFFIDAVIT OF RETURN EXPIRATION DATE: 05/10/2008 ------------------------------------------------------------------------------------------------------------------------- TYPE OF SERVICE SERVICE ID COURT NUMBER COMPLAINT IN CIVIL ACTION 51572 5-1017-2008 ------------------------------------------------------------------------------------------------------------------------- PLAINTIFFS DEFENDANTS MICHELLE ADAMS JOSEPH BUCKMAN RICHARD T ADAMS JR PETROLEUM PRODUCTS CORP PERSON TO SERVE ---> JOSEPH BUCKMAN 127 TEXACO ROAD MECHANICSBURG PA 17050 ------------------------------------------------------------------------------------------------------------------------- Now, April 10, 2008, I, SHERIFF OF SCHUYLKILL COUNTY, PA do hereby deputize the Sheriff of CUMBERLAND County, to execute this Writ and make return thereof according to the law. This deputation being made at the request of the Plaintiff. t Sheriff of Schuylkil County ------------------------------------------------------------------------------------------------------------------------ SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE: NOTE ONLY APPLICABLE ON WRIT OF EXECUTION: N.B. WAIVER OF WATCHMEN: Any deputy sheriff levying upon or attaching any property under within writ may leave same -----------------------------------------------------------------? without a watchman, in custody of whomever is ATTORNEY INFORMATION found in possession after notifying person STEPHEN T. CARPENITO, ESQ. of levy or attachment, without liability 615 CENTER STREET on the part of such deputy or the sheriff to ASHLAND PA 17921 any plaintiff herein for any loss, destruction 570-875-3500 or removal of any such property before sheriff's sale thereof. CHECK # 4428 $ 100.00 ------------------------------------------------------------------------------------------------------------------------ SHERIFF'S SERVICE AND RETURN Served and made known to Defendant(s) on the day of at o'clock, AM/PM, at County of Commonwealth of Pennsylvania, in the manner described below: Defendant(s) personally served Adult family member with whom said Defendant(s) reside(s). Relationship is Adult in charge of Defendant's Residence. Manager/Clerk of place of lodging in which Defendant(s) reside(s). Agent or person in charge of Defendant's office or usual place of business Other On the day of at o'clock, AM/PM. Defendant not found because: Moved Unknown No Answer Vacant Other Remarks: Returned: ------------------------------------------------------------------------------------------------------------------------ Affirmed and subscribed to before me this SO ANSWERS, Signature of Deputy Sheriff Date day of Signature of Sheriff Date Notary Public MY COMMISSION EXPIRES: ------------------------------------------------------------------------------------------------------------------------ SCHUYLKILL COUNTY SHERIFF'S DEPARTMENT ------------------------------------------------------------------------------------------------------------------------- SHERIFF SERVICE PROCESS RECEIPT AND AFFIDAVIT OF RETURN EXPIRATION DATE: 05/10/2008 ------------------------------------------------------------------------------------------------------------------------ TYPE OF SERVICE SERVICE ID COURT NUMBER COMPLAINT IN CIVIL ACTION 51572 S-1017-2008 ------------------------------------------------------------------------------------------------------------------------ PLAINTIFFS DEFENDANTS MICHELLE ADAMS JOSEPH BUCKMAN RICHARD T ADAMS JR PETROLEUM PRODUCTS CORP PERSON TO SERVE --> PETROLEUM PRODUCTS CORP 127 TEXACO ROAD MECHANICSBURG PA 17050 ------------------------------------------------------------------------------------------------------------------------ Now, April 10, 2008, I, SHERIFF OF SCHUYLKILL COUNTY, PA do hereby deputize the Sheriff of CUMBERLAND County, to execute this Writ and make return thereof according to the law. This deputation being made at the request of the Plaintiff. 140.44 ?)- Sheriff of Sc ylkil County ------------------------------------------------------------------------------------------------------------------------ SPECIAL INSTRUCTIONS OR OTHER INFORMATION THAT WILL ASSIST IN EXPEDITING SERVICE: I NOTE ONLY APPLICABLE ON WRIT OF EXECUTION: -------------------- ATTORNEY INFORMATION STEPHEN T. CARPENITO, ESQ. 615 CENTER STREET ASHLAND PA 17921 570-875-3500 N.B. WAIVER OF WATCHMEN: Any deputy sheriff levying upon or attaching any property under within writ may leave same without a watchman, in custody of whomever is found in possession after notifying person of levy or attachment, without liability on the part of such deputy or the sheriff to any plaintiff herein for any loss, destruction or removal of any such property before sheriff's sale thereof. CHECK # 4428 $ 100.00 1 ------------------------------------------------------------------------------------------------------------------------- SHERIFF'S SERVICE AND RETURN Served and made known to on the at day of at County of Commonwealth of Pennsylvania, in the manner described below: Defendant(s) personally served Adult family member with whom said Defendant(s) reside(s). Relationship is Adult in charge of Defendant's Residence. Manager/Clerk of place of lodging in which Defendant(s) reside(s). Agent or person in charge of Defendant's office or usual place of business Other On the day of Defendant not found because: Moved Unknown No Answer Vacant Remarks: Returned: at Other o'clock, AM/PM. ------------------------------------------------------------------------------------------------------------------------ Affirmed and subscribed to before me this SO ANSWERS, Signature of Deputy Sheriff Date day of ,Defendant(s) o'clock, AM/PM, Signature of Sheriff Date Notary Public MY COMMISSION EXPIRES: -------------------------------------------------------------------------------------------------------------------------- 4 '$fVFh-eU T. &rFr ifV' ?squlirr *,antq,f ftr Admitted to Practice Pennsylvania, New York, New Jersey Telephone: (570) 875-3500 Facsimile: (570) 875-0699 April 8, 2008 Office of the Sheriff Schuylkill County Courthouse 401 North 2°d Street Pottsville, PA 17901 Re: Michelle Adams, et al. Vs. Joseph Buckman and Petroleum Products Corp. Dear Sheriff: Enclosed please find two (2) copies of a Complaint, along with a draft in the amount of $150.00 to cover the costs associated with service of the same. Upon receipt, I ask that you kindly effectuate service of the Defendant at the following address: Joseph Buckman 127 Texaco Road Mechanicsburg, PA 17050 Petroleum Products Corp. 127 Texaco Road Mechanicsburg, PA 17050 Additionally, enclosed please find a draft made payable to the Cumberland County Sheriff in the amount of $100.00, so that you may deputize them for service of the Complaint. Thank you in advance for your kind attention to this matter and if you should have any questions in regards to the same, please do not hesitate to contact this office. Very truly yours, Stephen T. Carpenito, Esquir STC/kjk Enclosure 615 Centre Street Ashland, Pennsylvania 17921 Vo- 4,, A'7) LAW OFFICE OF STEPHEN T, CARPENITO BY: STEPHEN T. CARPENITO, ESQUIRE ATTORNEY ID# 68860 615 CENTRE STREET ASHLAND, PA 17921 TELE: (570) 875-3500 dl/*"? v COUNSEL FOR PLAINTIFFS y MICHELE ADAMS AND , RICHARD T. ADAMS, JR., H/W' J MICHELLE ADAMS and IN THE COURT OF COMMON PLEAS RICHARD T. ADAMS, JR., h/w SCHUYLKILL COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PLAINTIFF DOCKET O: vs. JOSEPH BUCKMAN and JURY TRIAL DEMANDED PETROLEUM PRODUCTS CORP. DEFENDANT NOTICE You have been sued in court. If you wish to defend against the claims set forth in the following pages, you must take action within twenty [20] days after this complaint and notice are served, by entering a written appearance personally or by attorney and filing in writing with the court, your defenses or objections to the claims set forth against you. You are warned that if you fail to do so the case may proceed without you and a judgment may be entered against you by the court without further notice for any money claimed in the complaint or for any other claim or relief requested by the plaintiff. You may lose money or property or other rights important to you. YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO NOT HAVE A LAWYER [OR CANNOT AFFORD ONE], GO TO OR TELEPHONE THE OFFICE SET FORTH BELOW [TO FIND OUT WHERE YOU CAN GET LEGAL HELP]. 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. PA BAR ASSOC. LAWYER REFERRAL SERVICE 100 STATE STREET P.O. BOX 166 - HARRISBURG, PA 17108 (800)692-7375 LAW OFFICE OF STEPHEN T, CARPENITO BY: STEPHEN T. CARPENITO, ESQUIRE ATTORNEY ID# 68860 615 CENTRE STREET ASHLAND, PA 17921 TELE: (570) 875-3500 COUNSEL FOR PLAINTIFFS MICHELE ADAMS AND RICHARD T. ADAMS, JR., H/W MICHELLE ADAMS and IN THE COURT OF COMMON PLEAS RICHARD T. ADAMS, JR., h/w SCHUYLKILL COUNTY, PENNSYLVANIA CIVIL ACTION - LAW PLAINTIFF , DOCKET No: vs. , JOSEPH BUCKMAN and JURY TRIAL DEMANDED - PETROLEUM PRODUCTS CORP. DEFENDANT COMPLAINT AND Now, comes the Plaintiffs, Michelle Adams and Richard T. Adams, Jr., h/w, by and through their counsel, Stephen T. Carpenito, Esquire, does file this Complaint against Joseph Buckman and Petroleum Products Corp., and in support thereof avers as follows: 1. Plaintiff, Michelle Adams, is an adult individual residing at 246 South Lehigh Avenue Frackville, Pennsylvania. 2. Plaintiff, Richard T. Adams, Jr. is an adult individual residing at 246 South Lehigh Avenue Frackville, Pennsylvania. Plaintiff, Michelle Adams and Richard T. Adams, Jr. at all time relevant hereto are husband and wife. 3. Defendant, Joseph Buckman (hereinafter Buckman), is an adult individual employed by Petroleum Products Corp. . 4. Defendant, Petroleum Products Corp. (hereinafter PPC), is a duly organized business corporation with an office located at 127 Texaco Road, Mechanicsburg, Pennsylvania 17050. 5. On or about July 31, 2006, the Defendant, Buckman, was operating a vehicle owned by Defendant, PPC. 6. Defendant, Buckman, was operating said vehicle in the scope and course of his employment with Defendant, PPC. 7. Plaintiff, Michelle Adams, was operating her vehicle in a lawful and prudent manner. 8. The Defendant, Buckman, was operating the truck owned by the Defendant, PPC, on or about Walnut Street and Main Street in Mechanicsburg, Pennsylvania. 9. Plaintiff was stopped at a red traffic light in a line of traffic at the intersection of Walnut Street and Main Street. 10. The Defendant, Buckman, struck the rear of the vehicle driven by the Plaintiff, Michelle Adams. 11. As a result of the collision the Plaintiff, Michelle Adams, suffered physical, economic and emotional injuries. COUNT I PLAINTIFF v. BUCKMAN 12. Plaintiff incorporates by reference hereto the allegations of paragraphs 1 through 11, as if the same were more fully set forth here at length. 13. The Defendant, operated the truck in a negligent and careless manner as follows; a. Operating the same at an unsafe speed; b. Operating the same without properly observing the roadway; c. Failing to properly observe the roadway and traffic located thereon; d. Failing to properly signal to alert traffic of the intent to change lanes; e. Failing to stop and striking the rear of the Plaintiff's vehicle. 14. As a direct result of the negligence and carelessness of the Defendant the Plaintiff suffered the following injuries and damages: a. Past, present and future physical and emotional injury; b. Past, present and future medical treatment; c. Past, present and future medical expenses; d. Past, present and future out of pocket expenses; e. Past, present and future loss of earnings and earning capacity. WHEREFORE, Plaintiff requests judgment in her favor in an amount in excess of the arbitration limit, together with costs and interest. COUNT II PLAINTIFF V. PETROLEUM PRODUCTS CORP. NEGLIGENCE 15. Plaintiff incorporates by reference hereto the allegations of paragraphs 1 through 14, as if the same were more fully set forth here at length. 16. Defendant, PPC, employed and/or hired the Defendant, Buckman, to operate vehicles upon public roadways. 17. Defendant, PPC, acted in a negligent and careless manner as follows: a. Hiring Buckman, who did not possess the experience and skills necessary to safely operate the truck; b. Permitting Buckman to operate the truck upon the roadway despite the fact that he was unskilled and lacked the experience to safely drive the same; c. Failing to properly ascertain the fact that Buckman did not possess the proper skills and experience to safely drive the truck; d. Failing to keep vehicle in a safe operating condition. 18. As a direct result of the negligence and carelessness of the Defendant the Plaintiff suffered the following injuries and damages; a. Past, present and future physical and emotional injury; b. Past, present and future medical treatment; c. Past, present and future medical expenses; d. Past, present and future out of pocket expenses; e. Past, present and future loss of earnings and earning capacity. WHEREFORE, Plaintiff requests judgment in her favor in an amount in excess of the arbitration limit, together with costs and interest. COUNT III PLAINTIFF V. PETROLEUM PRODUCTS CORP. RESPONDENT SUPERIOR / AGENCY 19. Plaintiff incorporates by reference hereto the allegations of paragraphs 1 through 18, as if the same if were more fully set forth here at length. 20. The Defendant, Buckman, was an employee and/or agent of the Defendant, PPC. 21. The Defendant, Buckman, was operating the truck on July 31, 2006, in the course and scope of his employment and/or agency. 22. The Defendant, PPC, is liable for the negligent and careless acts of the Defendant, Buckman, by and through the theory of respondent superior/agency. 23. As a direct result of the negligence and carelessness of the Defendant the Plaintiff suffered the following injuries and damages; a. Past, present and future physical and emotional injury; b. Past, present and future medical treatment; c. Past, present and future medical expenses; d. Past, present and future out of pocket expenses; e. Past, present and future loss of earnings and earning capacity. WHEREFORE, Plaintiff requests judgment in her favor in an amount in excess of the arbitration limit, together with costs and interest. COUNT IV RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN LOSS OF CONSORTIUM 24. Plaintiff incorporates by reference hereto the allegations of paragraphs 1 through 23, as if the same were more fully set forth here at length. 25. The Plaintiff, Richard T. Adams, Jr., was married to the Plaintiff, Michelle Adams, at all times relevant hereto. 26. On account of the injuries suffered by Michelle Adams, her husband, Richard T. Adams, Jr., has suffered the damages permitted under a theory of the loss of consortium. 27. The Plaintiff, Richard T. Adams, Jr., on account of the negligent of the Defendants suffered the following; a. Loss of emotional and physical companionship of his wife; b. Loss of his wife's normal services and companionship; c. Those damages permitted under the theory of loss of consortium. WHEREFORE, Plaintiff requests judgment in his favor in an amount in excess of the arbitration limit, together with costs and interest. COUNT V RICHARD T. ADAMS, JR. V. PETROLEUM PRODUCTS LOSS OF CONSORTIUM 28. Plaintiff incorporates by reference hereto the allegations of paragraphs 1 through 27, as if the same were more fully set forth here at length. 29. The Plaintiff, Richard T. Adams, Jr., was married to the Plaintiff, Michelle Adams, at all times relevant hereto. 30. On account of the injuries suffered by Michelle Adams, her husband, Richard T. Adams, Jr., has suffered the damages permitted under a theory of the loss of consortium. 31. The Plaintiff, Richard T. Adams, Jr., on account of the negligent of the Defendants suffered the following; a. Loss of emotional and physical companionship of his wife; b. Loss of his wife's normal services and companionship; c. Those damages permitted under the theory of loss of consortium. WHEREFORE, Plaintiffs respectfully seeks this Honorable Court to issue judgement in their favor and against the Defendants, Joseph Buckman and Petroleum Products Corp., in an amount in excess of the arbitration limit, together with costs, attorney fees, punitive damages and interest. DATE: g STEI?21E T. CARPENITO, ESQUIRE ATTORNEY I.D.# 68860 COUNSEL FOR PLAINTIFFS =? =5l ?: _?7'= 16: 3L. 5 7o!?5F{;199 rTEPHEN T i_r=1R°ENliT[ FAGc -fin 1, Michelle Adams, do hereby verify that I have read the hereinabove document and the averrhents contained herein are true and correct to the best of nay knowledge and belief', and the .foregoing is a filing before the Schuylkill County Court of Common Pleas, Civil Division. I understand that all statements made therein are made pursuant to the provisions of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. Dated:LIF kos &X2 1V Aehelle Adams 4= = F S i t :' 1= . _ ?'. 5-P_ S75 0F-j99 -TEEHEhd T +=r??:G'Eh i l _ PAGE 0 l l 0, i., Richard T. Adams, Jr. do hereby verify that I have read thi , hereinabove document and the averments contained herein are true and correct to the best of my knowledge and belief, and the foregoing is a filing before the Schuylkill C-Ounty Court of Common Pleas, 0i6I Division. I underswd that all statements made therein are made pursuant to the provisions of 18 Pa, C.S.A. Section 4404, relating to unworn falsification to authorities. JJ Dated:) rchard T. Adams, r. 2JU, (? r ., _" V i" 1 t i I,,r tr to i1 ? v ? ''_V 08.50 PQ A7-hl C,'Y- I l oo58 i o53 PET OW 153 ,R ., . eal~"~ PRAECIPE FOR LISTING CASE FOR TRIAL (Must be typewritten and submitted in triplicate) TO THE PROTHONOTARY OF CUMBERLAND COUNTY Please list the following case: ^X for JURY trial at the next term of civil court. ^ for trial without a jury. CAPTION OF CASE (entire caption must be stated in full) Michelle Adams and Richard T. Adams, Jr., h/w Q ti ~7 i=- c- j -•-1 -~- ~ I ' r ~ `~ j1 . .: r= {,. ~~ ~= ~ . _ c. ~ w ., ;~ ~ ~'' (check one) ^X Civil Action -Law ^ Appeal from arbitration (other) (Plaintiff) vs. Joseph Buckman and Petroleum Products Corp. vs. (Defendant) The trial list will be called on Aug. 31, 2010 and Sept. 20, 2010 Trials commence on Pretrials will be held on Sept. 8, 2010 (Briefs are due S days before pretrials No. 6020 , 2009 Term Indicate the attorney who will try case for the party who files this praecipe: Stephen T. Carpenito, Esquire, 615 Centre Street, Ashland, PA 17921 Tele. (570) 875-3500 Center Valley, PA 18034 Tele. (610) 709-87 This case is ready for trial. Signed: Indicate trial counsel for other parties if known: J. Benjamin Nevius, Esquire, Hendrazk 8~ Lloyd, 3701 Corporate Center Parkway, Ste. 100 Stephen T. Carpenito, Esquire Print Name: Date: (ol I(Q ~10 Plaintiffs Attorney for: ~~ S`~ ~~~~~~~ ~G~ a~~~ .~ LAW OFFICE OF STEPHEN T, CARPENITO BY: STEPHEN T. CARPENITO, ESQUIRE ATTORNEY ID# 68860 G15 CENTRE STREET ASHLAND, PA 17921 TELE: (570) 875-3500 COUNSEL FOR PLAINTIFFS MICHELE ADAMS AND RICHARD T. ADAMS, JR., H/W MICHELLE ADAMS and IN THE COURT OF COMMON PLEAS RICHARD T. ADAMS, JR., h/w CUMBERLAND COUNTY, PENNSYLVANIA CIVIL ACTION -LAW PLAINTIFF . DOCxET No: 6020 - 2009 vs. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. JURY TRIAL DEMANDED DEFENDANT CERTIFICATE OF SERVICE I, Kelly J. Klusman, secretary to Stephen T. Carpenito, Esquire, hereby certify that, on this date, I caused a true and correct copy of Praecipe for Listing Case for Trial pursuant to Rule 2252(d), to be served upon the following via the following means: TYPE OF SERVICE: First Class U.S. Mail, postage prepaid COUNSEL FOR DEFENDANTS J. Benjamin Nevius, Esquire Hendrzak & Lloyd 3701 Corporate Center Parkway, Suite 100 Center Valley, PA 18034 Date: Resent June 16, 2010 L KLUSMAN MICHAEL F. FRISBIE, ESQUIRE Attorney ID No.: 79096 HENDRZAK & LLOYD 3701 Corporate Parkway, Suite 100 Center Valley, Pennsylvania 18034 610. 709.8705 RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN CUMBERLAND COUNTY COURT OF COMMON PLEAS NO. 09-6020 TRIAL BY JURY OF 12 DEMANDED WITHDRAWAL OF APPEARANCE TO THE PROTHONOTARY: Kindly withdraw my appearance in the above captioned matter on behalf of Defendants, PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN. c.? f'=`i L7 J. Benjamin Nevius, Esquire ' " -° ENTRY OF APPEARANCE Kindly enter my appearance in the above captioned matter on behalf of Defendants, PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN. /x V4 1? Iq Michael F. Frisbie, Esquire Attorney for Defendants T? r Yt` Dated: ?'?l 10 CA MICHAEL F. FRISBIE, ESQUIRE Attorney ID No.: 79096 HENDRZAK & LLOYD 3701 Corporate Parkway, Suite 100 Center Valley, Pennsylvania 18034 610. 709.8705 MICHELLE ADAMS and RICHARD T. ADAMS, JR. ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN CUMBERLAND COUNTY COURT OF COMMON PLEAS v. JOSEPH BUCKMAN and PETROLEUM NO. 09-6020 PRODUCTS CORP. TRIAL BY JURY OF 12 DEMANDED PRAECIPE TO REMOVE CASE FROM THE CIVIL TRIAL LIST Please remove this case from the Civil Trial List for September 2010 upon agreement of Plaintiffs' counsel, Stephen Carpenito, Esquire, and Defendants' counsel, Michael F. Frisbie, ti- c? Esquire. Defendants' counsel will file a Petition for Appointment of Arbitrators shortl ?,. XTI ? ,. ?' N r Z 7 Respectfully Submitted, } 0 t HENDRZAK & LLOYD o o MICHAEL F. FRISBIE, ESQUIRE Attorney for Defendants, Joseph Buckman and Petroleum Products Corp. MICHELLE ADAMS and CUMBERLAND COUNTY RICHARD T. ADAMS, JR. COURT OF COMMON PLEAS V. JOSEPH BUCKMAN and PETROLEUM NO. 09-6020 PRODUCTS CORP. TRIAL BY JURY OF 12 DEMANDED PETITION FOR APPOINTMENT OF ARBITRATORS CZ) TO THE HONORABLE, THE JUDGES OF SAID COURT:, MICHAEL F. FRISBIE, ESQUIRE, counsel for Defendant in the above action resp lyrn represents that: 1. The above-captioned action is at issue. M 2. The claim of the Plaintiff in this action is S ?Ipo? a f 3. The counterclaim of the Defendant is $0.00 5 The following attorneys are interested in the case as counsel or are otherwise disqualified to sit as arbitrators: Michael F. Frisbie, Esquire & Stephen Carpenito, Esquire WHEREFORE, your Petitioner prays your Honorable Court to appoint three (3) arbitrators to whom the case shall be submitted. ?ay 4O?G? Respectfully Su.{b-mitt co !lpoR Dated: ly py?rp V fi _ PO •2518413 Michael 'F. Frisbie, Esquire Hendrzak & Lloyd Attorney ID 93094 Counsel for Defendants Joseph Buckman and Petroleum Products Corp. ORDER OF COURT AND NOW, this day of , 20 , in consideration of the foregoing Petition, , Esq., , Esq. and Esq., are appointed as arbitrators in the above-captioned action as prayed for. BY THE COURT J. 04- Cooao C~~~ i T~-, ~ / CERTIFICATE F1L~D-_aFFICE O~J~ THE P~0 I p~~~OT~~~'RBR$4UISITP! TO SSRVICB OF A SUBPOENA C~~~ ~~-~ ~2 ( ~ ~' ~' ~~ PURSUANT TO RULE 4009.22 ~~~~~ i ~I,itY 1 ~~~9 ~~k~t l IN THE MATTER OF: COURT OF COMMON'-'PLEAS MICHELLE ADAMS AND RICHARD ADAMS TERM, SCHUYLKILL -VS- CASE NO: S 10]~ 2008r ', _,,._ c d PETROLEUM PRODUCTS CORP . , ET AL . ~ ~ ~` ~'p N ~ s-' -:~ ~ -' ~,C~,-;. As a prerequisite to service of a subpoena for documents and things pur~ant ~ ` to Rule 4009.22 s? ~, O N MCS on behalf of MICHAEL FRISBIE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 08/26/2010 R1.97S 116-H MCS on behalf of /S/ ~ichael ~ri~bie, ~~4. MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT JANICE.SANERf~ZURICHNA.COM DE12-0292873 05383-L05 ""' "Sep.. 8. 2010 8:32AM No. 4197 P. 2 ,; . . ,; u~_ ~. .. ~ , • 1601 Markwt Street, suits 800, PhiledaYphia penrisylvanf,a 19103 (215) 2+~6 -0900 Fax Number (2151 S31 -S7a~! 09/26/20x0 ' MYCHELLR ADIII[S MICI~F:7~B AUAMB A~1p RICHARD ADAMS Vs PETROLBiJM pRODOCT3 CORP., 8T AL: . BBNDRBALC 6 LLO'!(D MTCHAEI. FRI$BIE, E9(~. (610) 709-8567 iTe have been raquaseted b~( the above-mentioned counsel to obtain materizl on an '-expeQi,ted basis from the belolt listed custodiari9. Ip order to aoMply with this request we must have your signatu~ce indicating that you waive Ch6 twenty-day notice period provided in Rules 4009.21 sad 4009.22. Ploaee fnsc this fora- Co vs immediately at (215) 531-5754 wig rat atnxr eo that we may comply Bi.th this _, request, • Your COO~~~atiOn would be greatly appreciated. `~ ~} &i.~ncaral,y. ~ C~. ~~ ~7A$iICE MCCA9`FhEY Mote: 5oa Attached LX,st a~ I,OCationa Cownsel: STEFNEI~ T. CARPENI~'O, LSQ. ax: 01 8750699 1 agree to waive waiting pe od ~ Date:T 'i -'~ Copies: Yea W4 ~ I agree to pax the invoice provi-ded with Chs.doe+menta heview Don+~~ta: YQa No Advise of Coat 'I do not agree to waive rule: Date: Bi~,linq Infos • ~ - o~sa~coi Sep. 8. 2010 8:32AM ~ No. 4191 P. 3 LOCA~IOL~ NAME RECORDS RBQUEST&b JONN M_ S~OLLYVRI~. !4D ~ ASBOCB. MeoYCAL RgCORD9 ~--- At!J~ZCAt~ FIDELITY AS~ORADiCffi CO DISABILITY Fug FO1lT DgA[t$ORNB Y.IFE itiS. CO. DISABILITY FILE IWti - 05~~'J-c01 COMMONWEALTH OF PENNSYLVANIA COUNTY OF SCHUYLKILL IN THE MATTER OF: MICHELLE ADAMS AND RICHARD ADAMS -VS- COURT OF COMMON PLEAS TERM, PETROLEUM PRODUCTS CORP., ET AL. CASE NO: S 1017-2008 NOTICE OF INTENT TO SERVE A SIIBPOENA TO PRODIICE DOCIIMENTS AND THINGS FOR DISCOVERY PIIRSIIANT TO RIILE 4009.21 JOHN M. SULLIVAN, MD & ASSOCS. MEDICAL RECORDS AMERICAN FIDELITY ASSURANCE CO DISABILITY FILE FORT DEARBORNE LIFE INS. CO. DISABILITY FILE TO: STEPHEN T. CARPENITO, ESQ., PLAINTIFF COUNSEL MCS on behalf of MICHAEL FRISBIE, ESQ. intends to serve a subpoena identical to the one that is attached to this notice. You have twenty (20) days from the date listed below in which to file of record and serve upon the undersigned an objection to the subpoena. If the twenty day notice period is waived or if no objection is made, then the subpoena may be served. Complete copies of any reproduced records may be ordered at your expense by completing the attached counsel card and returning same to MCS or by contacting our local MCS office. DATE: 08/26/2010 CC: MICHAEL FRISBIE, ESQ. - 245249 STEPHEN T. CARPENITO, ESQ. L/O OF STEPHEN CARPENITO 615 CENTRE STREET MCS on behalf of MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT THE MCS GROUP INC. 1601 MARKET STREET #800 PHILADELPHIA, PA 19103 (215) 246-0900 ASHLAND, PA 17921 R2.33 116-H DS02-0701911 05383-COl COMMONWEALTH OF PENNSYLVANIA COUNTY OF Scher Ikill _ iVtiCHELLE ADAMS AND RICHARD ADAMS S 1017-2Qp8 . vs. • File No. PETROLEUM PRODUCTS CORP., ET AL. • SUBPOENA TO PRODUCE DOCUMENTS OR THINGS - FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for JOHN M. SULLIVAN, MD & ASSOCS. - (Name of Person or Entity) `` Within twenty (20) days sftec service of this subpoena, you ere ordered by the court to produce the following documents or things: **** cG~ eTrer~ucn o;~EP~ **** at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103 (Address) You may deliver or mail legible copies of the documents or produce things requested by this subpoena; together with -the certificate of compliance, to the party making this request at the address-listed above: You have the right to seek in advance the reasonable cost of preparing the copies or produdrig the things sought.. . If you fail o produce the documents or things required by this subpoena within twenty (20) days- after its service, the part~r serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: MICHAFI FRIRRIF~, FSC] ADDRESS: 3701 CORPORATE GTR PKWY, SUITE 100 CENTER VALLEY, PA 18034 TELEPHONE: (215) 246-0900 SUPREl171E COURT ID # ATTORNEY FOR: SEP 0 V 2010 Date: Seal of the Court BY THE COURT: r~ ,,..,a._t..R. - Deputy 05383-05. C-1 F-4 Rev. 4/00) EXPLANATION OF REQUIRED RECORDS T0: CUSTODIAN OF RECORDS FOR: -.JOHN M. SULLIVAN,MD & ASSOCS. 1001 SOUTH. MARKET STREET .SUITE 8 _MECHANICSBURG, PA 17055 RE: 5383 MICHELLE ADAMS Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. Entire medical file, including but not limited to any and all records, correspondence to and from the consulting and treating physicians, files, memoranda, handwritten notes, history and physical reports, medication and prescription records, including any and all such items as may be stored in a computer database or otherwise in electronic form, relating to any examination, diagnosis or treatment pertaining to: Dates xequesteds up to and including the present. `$ubjeCt MICHBLLE ADAMS 246 SOIITH LSHI(3H AVENU$, FRACRVILLI9, PA 17932 Social Security #: a%X-X$-3924 Date of Birth: 10-16-1969 82.33 116-H SII10-0861998 05383 -L05 CSRTIFICATS PRSRSQUISITS TO SSRVICS OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: MICHELLE ADAMS AND RICHARD ADAMS -VS- PETROLEUM PRODUCTS CORP., ET AL. COURT OF COMMON PLEAS TERM, SCHUYLKILL CASE NO: S 1017-2008 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of MICHAEL FRISBIE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE: 08/26/2010 R1.97S 116-H MCS on behalf of /S/ ~ichae~~}ri~bie, ~~~ MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT JANICE.SANER~ZURICHNA.COM DS12-0292876 05383-L06 COMMONWEALTH OF PENNSYLVANIA COUNTY OF Schuylkill _ MICHELLE ADAMS AND RICHARD ADAMS S 1017-2008 vs. , File No. PETROLEUM PRODUCTS CORP., ET AL. SUBPOENA TO PRODUCE DOCUMENTS OR THINQS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO• Custodian of Records for AMERICAN FIDELITY ASSURANCE CO (Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: **** ,gFF n-rrnr~uGn c~nco •*•* at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103 (Address) You may deliver or mail legible Copies of the documents or produce things requested by this subpoena; together with the certificate of compliance, to the party making this request at the address listed above.. You have the right to seek in advance the reasonable cost of preparing the copies or produdng the things sought. If you fail. to produce the documents or things required by this subpoena within.. twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply..-with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: MICHAEL FRISBIF ADDRESS: 3701 CORPORATE CTR_ PIMIY, SUITE 100 CENTER VALLEY, PA 18034 TELEPHONE: (215) 246-0900 SUPREME COURT ID # ATTORNEY FOR: SEP 0 8 2010 Date: Seal of the Court BY THE COURT: 05383-06~ C-1F-4 Rev. 4/00) Deputy EXPLANATION OF REQUIRED RECORDS 'T0: CUSTODIAN OF RECORDS FOR: AMERICAN FIDELITY ASSURANCE CO "-2000 N. CLASSEN BLVD. P:O. BOX 268898 OKLAHOMA CITY. OK 73126 RE: 5383 MICHELLE ADAMS Prior approval is required for fees is excess of $150.00 for hospitals, $100.00 for all other providers. ACCT#733047 Entire disability file, including but not limited to medical reports and /or records, claims, any and all correspondence, documentation supporting plaintiffs claim, applications, payments including dates of payments, payee and reasons for payments, including any and all such items as may be stored in a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to aad iacluding the present. Subject s MICH$LLS ADAMS 246 SOIITH LgHI4H AVSNIIE, P'RACKVILLB, PA 17932 Social Security #: EBE-XX-3924 Date of Birth: 10-16-1969 SII10-0862000 05383-L06 s CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 IN THE MATTER OF: COURT OF COMMON. .PLEAS MICHELLE ADAMS AND RICHARD ADAMS TERM, SCHUYLKILL -VS- CASE NO: S 1017-2008 PETROLEUM PRODUCTS CORP., ET AL. As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22 MCS on behalf of MICHAEL FRISBIE, ESQ. certifies that (1) A notice of intent to serve the subpoena with a copy of the subpoena attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena is sought to be served, (2) A copy of the notice of intent, including the proposed subpoena, is attached to this certificate, (3) The parties have waived the twenty-day notice provided in Rules 4009.21 and 4009.22 and, (4) The subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serve the subpoena. DATE• 08/26/2010 R1.97S 116-H MCS on behalf of / s / ~ic~e~ ~ri~~ie, ~~q. MICHAEL FRISBIE, ESQ. Attorney for DEFENDANT JANICE.SANER~ZURICHNA.COM DS12-0292879 05383-L07 y COMMONWEALTH OF PENNSYLVANIA COUNTY OF Schuylkill MICHELLE ADAMS AND RICHARD ADAMS ' S 1017-2Q08 vs. ' File No. PETROLEUM PRODUCTS CORP., ET AL. SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Custodian of Records for FORT DEARBORNE LIFE INS. CO. (Name of Person or Entity) Within twenty t20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: ****~c~G eTTef~uCn oink «•** at The MCS Group. Inc.. 1601 Market Street. Suite 800. Philadelphia. PA 19103 (Address) You may deliver or mail legible. Copies of the documents or produce things requested by this subpoena; together with the certificate of compliance, to the party making this request at the address listed above. You have the right to seek in advance the reasonable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving this subpoena may seek a court order compelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: ADDRESS: 3701 CORPORATE CTR_ PKWY, SUITE 100 CENTER VALLEY, PA 18034 TELEPHONE: (215) 246-0900 SUPREME COURT ID # ATTORNEY FOR: CEP 0 8 201 . BY THE COURT: .. ~.'_.. Date: . JL..1.:.f _ l ! 1 1.--i u~.!y~-s"_ Seal of the Court / Deputy C-1 F-4 05383-07 Rev. 4/00) r EXPLANATION OF REQUIRED RECORDS T0: CUSTODIAN OF RECORDS FOR: FORT DEARBORNE LIFE INS. CO. :,ADMINISTRATIVE OFFICE ':'20445 EMERALD PKWY CLEVELAND, OH 44135 RE: 5383 MICHELLE ADAMS Prior approval is required for fees in excess of $150.00 for hospitals, $100.00 for all other providers. GROUP NAME: ADAMS CHIROPRACTIC PC :GROUP #MB643637 CLAIM #200611867 Entire disability file, including but not limited to medical reports and /or re`cords,, claims, any and all correspondence, documentation supporting plaintiffs claim, applications, payments including dates of payments, payee and:: reasons for payments, including any and all such items as may be stored in~a computer database or otherwise in electronic form, pertaining to: Dates Requested: up to and including the present. Subject MICHBLLL ADAMS 246 SOUTH LSHICiH AVSNUS, FRACRVILLE, PA 17932 Social Security #: EX%-%E-3924 Date of Birth: 10-16-1969 R2.33 116-H SU10-0862002 05383-L07 .. +•n `,~ c~ .~ Q '' a-~1 a~. '' ~` 1 ~-- MICHELLE ADAMS and RICHARD T. ADAMS, JR., h/w Plaintiff JOSEPH BUCKMAN and PETROLEUM PRODUCTS CORP. In The Court of Common Pleas of Cumberland 04 - 1.6.w County, Pennsyllvania No:11? - 2068 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. S' nature L,4o Y,D R Name (Chairman) La /60 Z 700 C;t ems; IM,C. Address Signature Name R, t?(a G 4 Law Firm c 7 Uj- ?oA.4 Address E Signature Name ' rgm cU-errr,. P.C. La F,wrd'rm V70 o Ve_,..1- jfA kr 3 i vcl . Address McGc" e&6,A ~105a J City, Zip City, Zip City, Zip 3dc?• jo- ? za - Q ys9s /?Awa d =U-aY.S85 a µ It( 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.) We find for Plaintiff Michelle Adams in the amount of $10,000.00 and for Plaintiff Richard T. Adams in the amount of $2,500.00. . Arbitrator, dissents. (Insert name if applicable. Date of Hearing: Date of Award: _ ?? ?? 2-3-11 (Chairman) 2-3-11 2-3-11 Notice of Entry of Award Now, the y(-day of .20, at , P.M., the above award was entered upon the docket and notice thereof ivcfi by mail to the parties or their attorneys. Arbitrators' compensation to be paid upon appeal:y By: Prothonotary 2-3-11 2-3-11 Deputy F1LED-OFFICr OC THE PROTHON TAR'? 2011 FEB -3 PSI 4* 23 CUMBERLAND COUNTY PENNSYLVANIA tik rntw c(- 1 s. GnfetAo l-I MICHAEL F. FRISBIE, ESQUIRE Attorney ID No.: 79096 HENDRZAK & LLOYD 3701 Corporate Parkway, Suite 100 Center Valley, Pennsylvania 1803:4 610.709.8705 1 MICHELLE ADAMS and RICHARD T. ADAMS, JR. V. JOSEPH BUCKMAN and PETR LEUM PRODUCTS CORP. j TO THE PROTHONOTARY: Kindly mark this matter ATTORNEY FOR DEFENDANT(S), PETROLEUM PRODUCTS CORP. and JOSEPH BUCKMAN CUMBERLAND COUNTY COURT OF COMMON PLEAS NO. 09-6020 TRIAL BY JURY OF 12 DEMANDED discontinued and ended upon payment of costs only. ZStephen C enito, Esquire Attorney for Plaintiffs cn r' 7n Cl -<3:> r-= icy - r C3 n ? ?F