HomeMy WebLinkAbout06-6290
KELLY HOME CARE SERVICES, INC.
Plaintiff
v
DORTHEA PHELABAUM, by her attorney in fact,
PAUL H. PHELABAUM, JR. and PAUL H.
PHELABAUM, JR., personal guarantor for
DORTHEA PHELABAUM
Defendant
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.
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. Ot- - ~~'1D C.;u~ll~
CIVIL ACTION - LAW
AVISO
USTED HASIDO DEMANDADO/AEN 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 0 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 Ie
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 0 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 0 propiedad u
otros derechos importantes para usted.
USTED DEBE LLEVAR ESTE DOCUMENTO
A SU ABOGADO INMEDIATAMENTE. 51 USTED NO
TIENE UN ABOGADO, LLAME 0 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
EST A OFICINA LE PUEDA PROVEER INFORMACION
SOBRE AGENCIAS QUE OFREZCAN SERVICIOS
LEGALES SIN CARGO 0 BAJO COSTO A
PERSONAS QUE CUALlFICAN.
CUMBERLAND COUNTY BAR ASSOCIATION
TWO LIBERTY AVENUE
CARLISLE PA 17013
(717) 249-3166
v
IN THE COURT OF COMMON PLEAS OF
CUMBERLAND COUNTY, PENNSYLVANIA
NO. ()I.. - ft,,;;9o Clo;"L '-r~'"'\,
KELLY HOME CARE SERVICES, INC.
Plaintiff
DORTHEA PHELABAUM, by her attorney in
fact, PAUL H. PHELABAUM, JR. and PAUL
H. PHELABAUM, JR., personal guarantor for
DORTHEA PHELABAUM
CIVIL ACTION - LAW
Defendant
COMPLAINT
The Plaintiff, KELLY HOME CARE SERVICES, by its attorneys, KODAK & IMBLUM, P.C., brings
this action of Assumpsit against the Defendant to recover the sum of SEVEN THOUSAND FOUR
HUNDRED SIXTY-SIX DOLLARS AND NINETY CENTS ($7,466.90), along with interest thereon at the
statutory rate from May 26, 2006, upon a cause of action of which the following is a statement:
1. The Plaintiff, KELLY HOME CARE SERVICES, is a corporation organized and existing under the
laws of the Commonwealth of Pennsylvania, having its principal office and place of business at PO
Box 828739, Philadelphia, Pennsylvania 19182.
2. The Defendant, DORTHEA PHELABAUM, is an adult individual residing at Country Meadows in
Hershey, Pennsylvania, by her Attorney In Fact, PAUL H. PHELABAUM, JR., who resides at 626
Park Avenue, New Cumberland, Cumberland County, Pennsylvania 17070.
3. The Defendant, PAUL H. PHELABAUM, JR., personal guarantor for DORTHEA PHELABAUM, is
an adult individual residing at 626 Park Avenue, New Cumberland, Cumberland County,
Pennsylvania 17070.
F:\ USER\ROBIN\ CCP&DJ CMPS\ CCP COMPLAINTS\KELL Y HOME CARE.32665.wpd
4. On or about February 25, 2005, Defendants entered into a Service Agreement and Personal
Guaranty, a true and correct copy of which is attached hereto, marked Exhibit "A" and made a
part hereof.
5. On the dates, in the amounts, and for the prices set forth in the true and correct copies of Plaintiffs
Invoics hereto attached, collectively marked Exhibit "B" and made a part hereof, Plaintiff, at the
special instance and oral request of the Defendants, provided services of the description set forth
on said exhibit.
6. The prices charged for said labor performed and services provided were just and reasonable, were
the legal and market prices therefor and were the prices which the Defendant orally promised and
agreed to pay to Plaintiff.
7. The balance due and owing by Defendants to Plaintiff is the sum of Six Thousand Three Hundred
Seven Dollars ($6,307.00), as appears by Plaintiffs Statement of Account hereto attached, marked
as Exhibit "e" and made a part hereof.
8. Due to the default of Defendant, and pursuant to the terms and conditions of the Service
Agreement executed by Defendant and attached hereto as Exhibit "A", attorney's fees in the total
amount of One Thousand One Hundred Fifty-Nine Dollars and Ninety Cents ($1,159.90) have been
added to said account.
9. 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 SEVEN THOUSAND
F:\ USER\ROBIN\ CCP&DJ CMPS\ CCP COMPLAINTS\KELL Y HOME CARE.32665.wpd
FOUR HUNDRED SIXTY-SIX DOLLARS AND NINETY CENTS ($7,466.90), along with interest thereon
at the statutory rate from May 26, 2006.
Respectfully submitted,
Rob rt D. Kodak, Esquire
407 North Front Street
Post Office Box #11848
Harrisburg, PA 17108-1848
(717) 238-7151
Attorney ID No. 18041
Attorney for Plaintiff
F:\ USER\ROBIN\ CCP&DJ CMPS\ CCP COMPLAINTS\KELL Y HOME CARE.32665.wpd
ILKeily Home Care
I.IVII:II:.-
SERVICE AGREEMENT
AntldfNlbld 5erviC8
.... LMII
.... HeelIh All>> $
o P-.I c.r. All>> $
o H-'-r $
1;1 ~ NUIN $
o L11*,," ,..IaalJ $
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$ 1'1.1.1. tJt)
.
$
$
.
$
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......... ..... T...I
The (numberl
following Activities of Daily Living m,15t be pravided In order for your Insul'lnce to consider payment:
., ~"e<;~~~t~t~~;:~,t,rt;3~ .
t6...Onrtlme ~rtjme is billed at one and one "alf times lhe bill rale. Overtime worked on holldays billed at three limes the bill rate.
r ~ida,.. will be billed at one and Me half times the hourly or dally bill rate (whichever is applicable). Holidays inclucle: New Year's
Day, Memorial Day. Independence Day, Labor Day, Thanksgivin8< Chrlttrnas M (5 p.m. to 8 a.m.), ChriilmaS Day and New Year's
Eve (5 p.m. to & a.m.l. Mlleqe is billed to the client when the employee transports the client in !he employee's vehicle;ll I ~f)~
~nu per mile.
~Visit Services Vi>>i1s ire provided by Specialized Care Services; billing is per visit and Includes time for tr.lIVel and documentation
Iw-tn Stnlcu Mnimum number of toor consecutive ~s, Client musl. meet estabIi,11ed critefia for live-in
servi<<:es. Empoyee works 8 hours; sleeps 8 hours; and hu 8 hours of leisu~ time I n each 24-hour period (except
in Pennsylvania and Wilconsjn).
UKement FftI The Client and/or Guarantor agAi!e, j( he/she hires a KHCS caregiver within thlft months
I after oompletlOl' of client setvice5, to pay KHCS as liquidated damases the sum of $5,000 for HM, HHa. PCa
and/or S8,OOO for RN, LPN. LVN.
tle.power ServKn Employee works ill the homE! CJVernillht and requires at least I) houri of sleep. _ ~
~.
ORt6/NAL-C1lflnt RecanI
YELLOW-Cl/lttlt
Page 1 of 2
PINK~
C.2OOl! Kllly Home car. 5eMc:e1, Inc,
~ EXHIBrr
!A
PrInted In U.S.A. 818 R2Jl)2
'=- K21ly Home Care
S! .\'1 1;1..
SERVICE AGREEMENT
CliMe tY ilulhorll<<l ~Mriltill1!. p/_ liB" briow. GUilr.nror must .Iso sl," if /he r;f/fnt Is not me J>>JIef $Pllra'.
kI KHC5 GUIIIIItee KHCS guarantees lhat Ihe KHCS employee shall satisfactorily pedorm the services ordered. Wilhin 30 days of
~ice from the client. KHCS will cancel charges for unsatisfactory service. A refund will be issued for any oYel'plyrtlf!nt made when
service has been di500ntinued under these circumslance..
~..celatlon or srplfkanl ReclIuclloM of 5enIlces yO'.! will receive Reasonable notice (see ~ific dient Rights & Responsj-
r-bililies forml prior 10 termination of services. If l<HCS employees' saIety is in danger, notice will be Biven to the elden! that is pr.Ictical.
~mtII' to Pay The Oienl or Guarantor iglft to pay KHCS for all services provided upon R!a!lpt of invoice($) regardr~5 of
rW.~ the servk:es lire reimbuf50lble by insulilOce Dr other third party payer sourceW. 11 your Insurance requires a certain number
of ,\ctj"i'ies of Daily living and t!'lose activities are .!!!i1! performed, then you will be responsible for paymenc.
~~ fGr .el.... of Int'armation I hereby authorize kHCS to release .nd/or receive any past and/or ~
present health Information as may be necessary for the coordination of my cat!! 10 other S1I!rvice providers and ~ I f~
tQ all thl,d party payers liS required 10 receiw paymen, and for quality aswrance activities. ~ Initials
~e"l for Trutment ./or Home ea,.. Service. I nezeby authorize KHCS and il$ ilgents tc provide me ~
.th home care service$, trealments and proceGures as requesaed by me and ordenId by my phyIIcMn when
applicable. The nature, nquenc)' and purpmr of the service and any side effects or hazatds have been explained. 'nllials
tome.
ifprfrrraN euar..... If the diem is unable to sign the KHCS caregl\lt!l"S time card, t authorize KHCS bJanch ~aff to verify hours
~ worked and I gualilntee payment for 5erviCe5 rendered.
'f( Kelly provides LCNls-Ter.. Care Setvices which are not a betlefil unde, Medicare Conditions of P,lItidpatiOfl. ~
I'Medicare CO"'l!B shol'l-lem\ intennittent seMCes and muM meet additional criteria, thereto"" 5efV1ces ~rovided
by KHCS cannot be billed to Medicare. Initials
~llIinll Methud The estimated charges (see page 1) are based on Ihe services orisinally requested. Billing is based on actual time
l~rlted. (IJI' 1<Isl(5 perlormed dLlring "visits"), by KHCS' caregivell is evidenced by empfoyee time cards. Since services may vary as
c1ient's requests and needs change, the amount may differ from the estimated servtca on page 1. Client hilS receilled and understands
the explarwtion of lhe method of billing and received a copy of $4Imple Invoice brochure.
'icollKlian PnIf:2N T~ Payer source will reutlvv pasl due notiCl!S al 30 diIYS. 60 days and 90 days (final notice). If roe i1ccounl
{~remaj05 unpaid. further collection efforts are pursued. which may include turning the accourt O'M 10 the Collection Department.
The c1iem and/or guarantor agrees thill if KHCS nKeSArtly Incurs any 1-.1 fees and related eXpl!I'Ilft in collectIon efbls, then the
dlent and/or guarantor shari be responsible for payinfl KHCS the legal fees and related ellpeftSeS incurred.
~Credit RtpOI't The Client and Guarantor aulhorize KHCS to obtain credit reports relating to tnem befor~ beginning service.
)sf Rdund Procea The client is directed to use his/her credll memos against f~ iOllOlces. KHCS reimburses ~
rIlle client when overpayment l1as caused a credit balance to remain after discharBe.
In ilia Is
~A'i~t~
/ lienl/Authoilzed Represenralivl!
-
1-:1~
OIlJalNAL....cu.nt Recotd
YEUow-cllent
Page 2 or 2
;;;Nnc;;;;;:;,;=- ~~~;n~p Tod~l
Addre!S . Social Security IJ
o 2OCI2 ~ly Home c.. SeNic... roo.
PrlrUd In u.s..... 876 R2I02
I:. Kelly Home Care
.. !lI':RVICt! s'.
KELLY HOME CARE SERVICES, INC.
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND, PA 17070
SEND
PAY.NT
TO
KELLY HOME CARE SERVICES, INC,
P.O. BO)( 828739
PHILADELPHIA, PA 19182-8739
CLIENT NAME
POLICY OR P.O. NO.
INSURED'S NAME
INSURED'S S.S. NO
PLEA5E RETAIN 1HIS PAIH fDR .'OUR RECOIlOS
CliENT COPY
DORTHEA PHELABAUM
0000
DORTHEA PHELABAUM
192-14-54-45
19 PENNSYLVANIA
412-937-8191
DISTRICT LOCATION
DISTRICT PHONE NO.
CLIENT NO.
19000144-01
FRACTIONS OF AN HOUR ARE SHOWN IN DECIMALS
AS fOl.lOWS, .25.15 M"~ .50.30 MIN.; .75-45 "'".
EMPLDYEE
B STONE
N BRANCH
N BRANCH
N BRANCH
C JACKSON
C JACKSON
C JACKSON
B STONE
CDRPORA1E TAX I.D.. 38-2110841
SE VICE
DESCRIPTION
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
DATE HOURS RATE HOURS RATE AMOUNT
07/17 12.00 17.00 204.00
07/ 18 12.00 17.00 204.00
07/19 12.00 17.00 204.00
07/20 12.00 17.00 204.00
07/21 11 .00 17.00 187.00
07/22 11.00 17.00 187.00
07/23 12.00 17.00 204.00
07/24 12.00 17.00 204.00
WTHANK YOU FOR YOUR BUSINESS.
..CORRECTED CLAIM.. INCLUDES ADJUSTMENTS TO PRIOR CLAIM(S), REPLACING THOSE
CLAIM(SI. DOES NOT INCLUDE PAYMENTS MADE AGAINST THOSE PRIOR CLAIM(S).
TERNS: PAYABLE UPON RECEIPT
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REllJRN COPY WITH PAYMENT
.. ......... ..____.......__d......... ..-,' .-.--.-.-.-.-,-.'--. .:;.'{.:(ll;'~i..:~g;,:.;.~l;J.
OAT E a. I ENT ....IEIt ....... ".........'jM#II..'......'
/;r~fV:;;Mt~;:,:::~.:~::-:;~~::::::~':::~~1:;.::;;\>:='~~.~:::<:) ~~.
0 9 / 0 6 / 0 5 1 9 0 0 0 7 4 4 . 0 1 1 9 0 0 0 7 4 4 0 1 0 9 0 6 0 5 $ 1 . 5 98 0 0
CORPORATE TAX lD. 38- ~ 11084'
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND, PA 17070
.....................................................................~...............
'r;.i~.....'..'.;.!ili......!.;:;~.i.m."~__li::;!,.......~.;:.~",f
KELLY HOME CARE SERVICES. INC.
P.O. BOX 828739
PHILADELPHIA. PA 19182-8739
.......,...
I
!-B-
6050000010110001598005
.. Kelly Home Care
.. S,.V1Cli"
KELLY HOME CARE SERVICES, INC.
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND. PA 17070
CLIENT NAME
POLICY OR P.O. NO.
INSURED'S NAME
INSURED'S 5.5. NO.
CORPORATE TAX lD.
EMPLOYEE
N BRANCH
N BRANCH
N BRANCH
C JACKSON
C JACKSON
C JACKSON
N BRANCH
N BRANCH
DORTHEA PHELABAUM
0000
DORTHEA PHELABAUM
192-14-5445
38-2110841
S VICE
DESCRIPTION
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA OVERTIME
HHA HOURLY
'F':tiiitii(i( ... ..:::;;.::
1900074401090805
SEND
PAVlENT
TO
KELLY HOME CARE SERVICES, INC.
P.O. BOX 828739
PHILADELPHIA, PA 19182-8739
PLEASE RETAIN THIS PART FOR ~OUR RECORDS
CLIENT COPY
DISTRICT LOCATION
DISTRICT PHONE NO.
19 PENNSYLVANIA
412-937-8791
CLIENT NO.
19000744.01
V
DATE
08/29
08130
08/31
09/01
09/02
09/03
09/04
09/04
FRACTIONS OF AN HOUR "liE SHOWN IN DECIMALS
"'S FOllO.....S, .25.15 MIN.: .50-30 M;N.; .75.45 MIN.
GULAR OVERTIME
HOURS RATE HOURS RATE
12.0017.00
12.0017.00
12.00 17.00
11 .00 17 . 00
11 .00 17 . 00
1 2 . 00 17 . 00
AMOUNT
204.00
204.00
204.00
187.00
187.00
204.00
153.00
68.00
6.00
25.50
4.00
17.00
"THANK YOU FOR YOUR BUSINESS.
TERNS: PAYABLE UPON RECEIPT
RPOD-D0028
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CLIENT NJNIER
19000744-01
09/08/05
CO"PORATE TAX lD., 38- 2110841
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND, PA 17070
TUTM A'J10UNT
1,411.00
$
.-
RETURN Copy WITH PAYMENT
;:'l~Ii~,~8ij"i~:1?i!nn: tm:'~~~'~~,~n...j
1900074401090805
$
1,411 00
i~11~::I;ill.'U'1u::m_'A'\ltltlf'*'~l1\;ii~~r!'~~')';.!.i~
KELLY HOME CARE SERVICES, INC.
P.O. BOX 828739
PHILADELPHIA, PA 19182-8739
19000744010908050000010110001411007
,. Kelly Home Care_
It:. V Ie [s:
KELLY HOME CARE SERVICES, INC.
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND, PA 17070
CLIENT NAME
POLICY OR P.O. NO.
INSURED'S NAME
INSURED'S 5.5. NO.
CORPORATE TAX 1.0.
DPLDYEE
N BRANCH
N BRANCH
N BRANCH
C JACKSON
C JACKSON
C JACKSON
N BRANCH
N BRANCH
SEfe)
PAYMENT
TO
KELLY HOME CARE SERVICES, INC.
P.O. BOX 828739
PHILADELPHIA, PA 19182-8739
PLEAS[ RETAI~ THIS PART fOR YOUR RECORDS
CLIENT COPY
DORTHEA PHELABAUM
0000
DORTHEA PHELABAUM
192-14-5445
19 PENNSYLVANIA
412-937~8791
DISTRICT LOCATION
DISTRICT PHONE NO.
i
CLIENT NO.
19000744- 0 1
38-2110841
SERVICE
DESCRIPTION
HHA OVERTIME
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA OVERTIME
FRACTIONS Of AN HOUR ARE SHOWN III OEC..AlS
AS FOLLOWS, .2&-15 Mill., .SD-30 11111.,1&.45 M'N.
LAR OVERTIME
RATE HOURS RATE
12.00 25.50
SERVICE
DATE
09/05
09/06
09/07
09/08
09/09
0911 0
09111
09/11
R
HOURS
AMOUNT
306.00
204.00
204.00
187.00
187.00
204.00
68.00
204.00
12.00
12.00
11.00
11 .00
12.00
4.00
17.00
17.00
17.00
17.00
17.00
17.00
8.00
25.50
"THANK YOU FOR YOUR BUSINESS.
TERMS: PAYABLE UPON RII!CEIPT
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REnJRN copy WITH PAYMENT
.;.-.:.-,. ,-" ..:.--><..'y.....y.:'~':'::;':'~::..:.:.: :.',: '.~ :. ,'~...'.', ".',','," ......... ......."....-.'-.,.....,--.--.,.
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0 9 / 1 4 / 0 5 1 9 0 0 0 7 4 4 - 0 1 1 9 0 0 0 7 4 4 0 1 0 9 1 4 0 5 $ 1 , 5 6 4 0 0
CORPORATE TAX lO.' 3B-211()841
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND, PA 17070
:i(j.~Ii.l;~~'I[I:[im_!l..
KELLY HOME CARE SERVICES, INC.
P.O. BO)( 828739
PHILADELPHIA, PA 19182-8739
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~ Kelly Home Care..
S'ltV1CES
KELLY HOME CARE SERVICES, INC,
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND. PA 17070
CLIENT NAME
POLICY OR P.O. NO.
INSURED'S NAME
INSURED'S S S. NO.
DORTHEA PHELABAUM
0000
DORTHEA PHELABAUM
192-14-5445
CORPORATE TAX I.D.
38-2110841
SERVICE
DESCRIPTION
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
EMPLOYEE
N BRANCH
N BRANCH
N BRANCH
C JACKSON
C JACKSON
C JACKSON
o WAGNER
SEND
PAYMENT
TO
KELLY HOME CARE SERVICES, INC.
P.O.. BO)( 828739
PHILADELPHIA, PA 19182-8739
PLEAn: RETAIN THIS PART FO~ YOUR RECORDS
CLIENT COpy
DISTRICT LOCATION
DISTRICT PHONE NO.
19 PENNSYLVANIA
412-937':8791
CLIENT NO.
19000744' 0'
SERVICE
DATE
09/12
09/13
09/14
09/15
09/16
09/17
09/18
FRACTIONS OF AN HOUR AIlE SIlOWN 'N DECIMALS
AS FOLLOWS, .25-15 MIH~ .60.30 MIN.; .75.45 fIlIN.
REGULAR OVERT ME
HOURS RATE HOURS RATE
12.0017.00
12.00 17.00
12.00 17.00
11.00 17.00
11.00 17.00
12 . 00 1 7 . 00
1 2 .00 1 7 .00
AMOUNT
204.00
204.00
204.00
187.00
187.00
204.00
204.00
'THANK YOU FOR YOUR BUSINESS"
TERIIS: PAYABLE UPON IlECfJPT
TOT AL A:,1CiU~J I
1.394.00
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KELLY HOME CARE SERVICES. INC.
P.O. BOX 828739
PHILADELPHIA, PA 19182-8739
19000744010921050000010110001394008
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St:.VICIES.
KELL V HOME CARE SERVICES, INC.
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND. PA 17070
CLIENT NAME
POLICY OR P.O_ NO.
INSURED'S NAME
INSURED'S S S. NO.
COIlPORAiE lAx Le.
EMPLOYEE
N BRANCH
N BRANCH
N BRANCH
C JACKSON
C JACKSON
C JACKSON
Z WHITE
DORTHEA PHELABAUM
0000
DORTHEA PHELABAUM
192-14-5445
38-2110841
SERVIC
DESCRIPTIQN
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
HHA HOURLY
SEND
PAYMENT
TO
KELLY HOME CARE SERVICES, INC.
P.O. BOX 828739
PHILADELPHIA, PA 19182-8739
PLEASE M:TAI~ lHIS PART FOR vQUl RECORDS
CLIENT Copy
DISTRICT LOCATION 19 PENNSYLVANIA
DISTRICT PHONE NO. 412-937-:e791
CLIENT NO. 1900074~-01
SERVICE
DATE
09/19
09/20
09/21
09/22
09/23
09/24
09/25
FRACTIONS OF AN HOUI\ Aile SHOWN IN DECiMAlS
AS FOllOWS, .25"5 MIN,; .50.30 MIN.; .75.45 MIN.
REGULAR OVERTIME
HOURS RATE HOURS RATE
12.00 17.00
12 . 00 17 .00
12.00 17.00
11 .00 1 7 . 00
11 .00 17.00
12.00 17.00
12.00 17.00
"THANK YOU FOR YOUR BUSINESS.
TEMS: PAYABLE UPON !tEe!!PT
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204.00
204.00
204.00
187.00
187.00
204.00
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DATE
CLIENT NtMIER
09/28/05
19000744-01
COIlPOIlATE TAX W.' 38-2110841
PAUL PHELABAUM
626 PARK AVENUE
NEW CUMBERLAND, PA 17070
RETURN COPY WITH PAYMENT
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1900074401092805 $ 1,394 00
KELLY HOME CARE SERVICES. INC.
P.O. BOX 828739
PHILADELPHIA, PA 19182-8739
19000744010928050000010110001394003
Accounts Receivable File
IAccount Information
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CustomerPHElABAUM,DORTHEA
Name:
Branch Number 19
City Group:
Customer 19000744
Number:
Account Status: Open
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STATEMENT
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KELLY HOME CARE SERVICES, INC.
t,,/81JJ I/Jv
a. '?J'p
Dorthea Phelabaum
Room 317 (Third Floor)
Mechanicsbura, PA 17050
Client:Dorthea Phelabaum
PAYMI!NTTERMS: DUE UPON RECEIPT
INVOICE NUMBER a DA: CHECK NUMBER CD
19000744 0910612005 ClM
19000744 09/0812005 ClM
19000744 09/14/2005 CLM
360 PMT
19000744 09/21/2005 ClM
19000744 09/2812005 eLM
SUB-TOTALS
BRANCH NO
CUSTOMER NO.
5180
Kell Home Care Services, loc..
P.O. Box 828739
Philadel hia Pa. 19182-8739
Billed to :Dorthea Phelabaum
CURReNT
$0.00
This STATEMENT is submitted as a convenience to you so that you may verify open items.
If we have billed your insurance company, you may be responsible for charges not covered.
If payment has been made after the statement date indicated, please disregard. Thank you.
~
!
EXHIBIT
c.
. ' . QCT-17-2006 16: 49
KNUPP KODAK & IMBLUM
717 238 7158 P.06
VERIFICATION
31.~..J ~hhJ
(name) I
~ / Ie /t?.J ;1J fit
(title)
I,
of KELLY HOME CARE SERVICES, INC., verify that the statements made in the aforegoing
document are true and correct. I understand that false statements herein are made subject to the
penalties of 18 Pa. C. S. ~4904, relating to unsworn falsification to authorities.
S, INC.
By:
~{~
Title:
(?/;:(1I?J ~71)
Dated:
/0 It tw
32665
TOTAL P.06
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KEU Y HOMll CAJU! SEIlVlCllll, INe. : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
.
: NO. 06-6290 CIVIL TEltM
v
DORTHEA PHELABAUM, by her attorneY in
fact, PAUL H. PHELABAUM, JL attd PAUL H.
PHELABAUM, JIt., personal guarantor for
DORTHEA PHELABAUM
Defendants
.
.
: OVIL ACUON - LAW
TO: PROTHONOfARY, COURT OF COMMON PLEAS
CUMBERLAND COUNTY, PENNSYLVANIA
PRAEOPE FOR DEFAULT TUDGMENT
Enter judgment in favor of plaintiff and againstDefendanl(s) DORTHEA PHELABAUM.
by her attorneY in fact, PAUL H. PHELABAUM. JR. and PAUL H. PHELABAUM, JR.,
personal guarantor for DORTHEA PHELABAUM. 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 Plaintiff's Complaint less payment
Interest from May 26, 2006 at the statutory rate of 6% per annum
Total
$7,366.90
S748.60
$7,615.50
IUs hereby certified thata writtennolice of inIenIiOn to file tbis Praecipe was mailed to the
Defendant(s) and his attorney of record, after the default occurred and at least ten (10)
days prior to the date of the filing of this Praecipe. See Exhibits A & B attached.
By
Robert D. Kodak, Attorney for Plaintiff
DATED: Uec. .:2 Or 200 (.. Judgment entered and damages assessed as above.
~o:S7
-
Robert D. Kodak
Gary J. Imblum
LAW OFFICES OF
KODAK & IMBLUM, P.C.
CAMERON MANSION
4(Y1 NORTH FRONT STREET
POST OFFICE BOX 11848
HARlUSBURG, P A 171OS-1848
kki.laW@verizon.net
website: kki-law.com
fILE~~J.
Facsimile
717.238.7158
November 29, 2006
DORTHEA PHELABAUM
626 P ARK AVENUE
NEW CUMBERLAND PA 17070
RE: Kelly Home Care Services, Inc.
VS: Dorthea Phelabaum, ET AL.
No. 06-6290 Civil, Court of Common Pleas
Cumberland County, Commonwealth of Pennsylvania
Our File No. 32665
Dear Ms. Phelabaum:
In accordance with Pennsylvania Rules of Civil Procedure 237.1(a)(2), we are
enclosing hereWith a Notice of a Praecipe for Entry of Default Judgment According IxJ
the records as they are found in the Office of the ProthonotarY of Cumberland County,
you have not filed responsive pleadings IxJ the Complaint fi1ed against you IxJ 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
;ndkated Iherein, will request the Office of the Prothonotary of Cumberland County IxJ
enter Judgment against you in the amount as set forth in said Complaint
Very truly yours,
KODAK & IMBLUM, P.e.
Robert D. Kodak
THIS LETIER IS AN ATTEMPt TO COLLECT A DEBT AND ANY
INFORMATION OBTAINED WILL BE USED FOR THAT PURPOSE
RDK/kqb
enclosure
cc: GARY HUTCHINSON
HUTCHINSON WARREN & ASSOC
PO BOX 8018
STERLING HEIGHTS MI48311-8018
#076861
rILE COpy.
KELLY HOME CARE SERVICFS, INC. : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
v : NO. 06-6290 CIVIL TERM
DORTHEA PHELABAUM, by her attorney in fact,
PAUL H. PHELABAUM, JR. and PAUL H. : CIVIL ACTION - LAW
PHELABAUM, JR.~ personal guarantor for
DORTHEA PHELABAUM
Defendants
IMPORTANT NOTICE
TO: DORTHEA Pl:lELABAUM, Defendant(s)
DATE OF NOTICE: NOVEMBER 29,2006
YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITl'EN
APPEARANCE PERSONALLY OR BY ATfORNEY AND FILE IN WRITING WITH THE COURT
YOUR DEFENSES OR OBJECI'lONS TO THECLAIMSSET FORTH AGAINST yOU. UNLESS YOU
ACf WITHIN TEN (10) DAYS FROM THE DATE OF TIllS NOTICE, A ~MENT MAY BE
ENTERED AGAINST yOU WITHOUT A HEARING, AND YOU MAY LOSE YOUR PROPERTY OR
OTHER IMPORTANT RIGHTS.
YOU SHOULD TAKE TIllS PAPER TO YOUR LAWYER AT ONCE. IF YOU 00 Nor HAVE
A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FOKfH BELOW. TIllS oFFICE CAN
PROVIDE YOU WITH INFORMATION ABOUT HIRING A LAWYER.
IF YOU CANNor AFFORD TO HIRE A LAWYER, TIllS OFFICE MAY BE ABLE TO
PROVIDE YOU WITH INFORMATION ABOUT AGENCIES THATMA Y OFFER LEGALSERVICFS
TO ELIGffiLE PERSONS AT A REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
TWO LffiERTY AVENUE
CARLISLE P A 17013
(717) 249-3166
Robert D. Kodak
Gary J. Imblum
LAW OFFICES OF
KODAK & IMBLUM, P.C.
CAMERON MANSION
4(Y1 NORTH FRONT STREET
POST OFFICE BOX 11848
HAlUUSBURG, P A 17108-1848
kld.1aw@verizon.net
website: kId-law.com
FILF;~Y
Facsimile
717.238.7158
November 29, 2006
PAUL H PHELABAUM JR
626 P ARK AVENUE
NEWCUMBERLAND PA 17070
RE: Kelly Home Care Services, Inc.
VS: Dorthea Phelabaum, ET AL.
No. 06-6290 Civil, Court of Common Pleas
Cumberland County, Commonwealth of pennsylvania
Our File No. 32665
Dear Mr. Phelabaum:
In accordance with Pennsylvania Rules of Civil Procedure 237.1(a)(2), 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 to
enter Judgment against you in the amount as set forth in said Complaint
Very truly yours,
KODAK & IMBLUM, P.C.
Robert D. Kodak
THIS LETTER IS AN ATTEMYf TO COLLECT A DEBT AND ANY
INFORMATION OBTAINED WILL BE USED FOR THAT pURPOSE
RDK/kqb
enclosure
cc: GARY HUTCHINSON
HUTCHINSON WARREN & ASSOC
PO BOX 8018
STERLING HEIGlITS MI48311-8018
#076861
. .'
FILE COr~;
KELLY HOME CARE SERVICES, INC. : IN THE COURT OF COMMON PLEAS OF
Plaintiff : CUMBERLAND COUNTY, PENNSYLVANIA
v : NO. 06-6290 CIVIL TERM
DORTHEA PHELABAUM, by her attorney in fact,
PAUL H. PHELABAUM, JR. and PAUL H. : CIVIL ACflON - LAW
PHELABAUM, JR., personal guarantor for
DORTHEA PHELABAUM
Defendants
IMPORTANT NOTICE
TO: PAUL H. PHELABAUM, TR'J Defendant(s)
DATE OF NOTICE: NOVEMBER 29,2006
YOU ARE IN DEFAULT BECAUSE YOU HAVE FAILED TO ENTER A WRITTEN
APPEARANCE PERSONALLY OR BY A TIORNEY AND FILE IN WRITING WITH THE COURT
YOUR DEFENSES OR oBJECI1ONS TO THE tLAIMSSEf FOlU'H AGAINSf YOU. UNLESS YOU
ACf WITHIN TEN (10) DAYS FROM THE DATE OF THIS NOTICE, A JUQC;!MENT MAY BE
ENTERED AGAINSfYOUWITHOUT A HEARING, AND YOU MAY LOSE YOUR PROPERTY OR
OTHER IMPORTANT RlGHfS.
YOU SHOULD TAKE THIS PAPER TO YOUR LAWYER AT ONCE. IF YOU DO Nor HAVE
A LAWYER, GO TO OR TELEPHONE THE OFFICE SET FORTH BEWW. 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 LEGALSERVlCES
TO ELIGIBLE PERSONS AT A REDUCED FEE OR NO FEE.
CUMBERLAND COUNTY BAR ASSOCIATION
TWO LIBERTY AVENUE
CARLISLE P A 17013
(717) 249-3166
C IV i ~
tl :{)
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KELLY HOME CARE SERVICES, INC.
Plaintiff
v
OORTHEA PHELABAUM, by her attorney
in fact, PAUL H. PHELABAOM, JR. and
PAUL H. PHELABAUM, JR, ~al
guarantor for OORTHEA PHELABAUM
Defendants
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY,
: PENNSYLVANIA
: NO. 06-6290 CIVIL TERM
: CIVIL ACtION - LAW
TO: OORTHEA PHELABAUM J Defendant(s)
You are hereby notified that on \) ~ L,; ..:2 C> J 2~the following
audgment) has been entered against you in the above-captioned case.
JudllRent entered in the amount of $7,615.50.
DATE:
/;..1 'J.C> f (~
1~
I hereby certify that the name and address of the proper person(s) to receive this
notice is:
DORTHEA PHELABAUM
626 P ARK AVENUE
NEW CUMBERLAND P A 17070
-
. ,.. .
KELLY HOME CARE SERVICES, INC.
Plaintiff
: IN THE COURT OF COMMON PLEAS OF
: CUMBERLAND COUNTY,
: PENNSYLVANIA
: NO. 06-6290 CIVIL TERM
v
DORTHEA PHELABAUM, by her attorney
in fact, PAUL H. PHELABAUM, JR. and
PAUL H. PHELABAUM, JR., ~al
guarantor for DORTHEA PHELABAUM
Defendants
: CIVIL ACTION - LAW
TO: PAUL H. PHELABAUM, fR. J Defendant(s)
You are hereby notified that on.=:u" (" 2 () J 20~e following
oudgment) has been entered against you in the above-captioned case.
Judzment entered in the amount of $7,615.50.
DATE:
I J.. / J 6/ Dh
f I
~~
I hereby certify that the name and address of the proper person(s) to receive this
notice is:
PAUL H. PHELABAUM, JR.
626 P ARK AVENUE
NEW CUMBERLAND P A 17070
SHERIFF'S RETURN - REGULAR
.. '..
CASE NO: 2006-06290 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
KELLY HOME CARE SERVICES INC
VS
PHELABAUM DORTHEA ET AL
BRIAN BARRICK
, Sheriff or Deputy Sheriff of
Cumberland County, Pennsylvania, who being duly sworn according to law,
says, the within COMPLAINT & NOTICE
was served upon
PHELABAUM DORTHEA
the
DEFENDANT
, at 1908:00 HOURS, on the 2nd day of November I 2006
at 626 PARK AVENUE
NEW CUMBERLAND, PA 17070
by handing to
LINDA PHELABAUM,
DAUGHTER IN LAW
a true and attested copy of COMPLAINT & NOTICE
together with
and at the same time directing Her attention to the conten~s thereof.
Sheriff's Costs:
Docketing
Service
Postage
Surcharge
18.00
14.96
.39
10.00
.00
43.35,/ 11/06/2006 A J.
toCJ.,.. iJ/O"/iXKODAK B:: IMBLUM ~ fII, ~
day Deputy Sheriff
So Answers:
r-~~~d
R. Thomas Kline
Sworn and Subscibed
before me this
of
A.D.
SHERIFF'S RETURN - REGULAR
. '..
CASE NO: 2006-06290 P
COMMONWEALTH OF PENNSYLVANIA:
COUNTY OF CUMBERLAND
KELLY HOME CARE SERVICES INC
VS
PHELABAUM DORTHEA ET AL
BRIAN BARRICK
, Sheriff or Deputy Sheriff of
Cumberland County,Pennsylvania, who being duly sworn according to law,
says, the within COMPLAINT & NOTICE
was served upon
PHELABAUM PAUL H JR
the
DEFENDANT
, at 1908:00 HOURS, on the 2nd day of November, 2006
at 626 PARK AVENUE
NEW CUMBERLAND, PA 17070
by handing to
LINDA PHELABAUM, WIfE
a true and attested copy of COMPLAINT & NOTICE
together with
and at the same time directing Her attention to the contents thereof.
Sheriff's Costs:
Docketing
Service
Affidavit
Surcharge
So Answers:
Sworn and
6.00
.00
.00
10.00
.00
16.00 -:/ 11/06/2006
SUbSCibe~t~~Jo"10" KODAKB::IMBLUM ~/t~
.-~(?~/ //
-1 ~~~~
R. Thomas Kline
Deputy Sheriff
day
before me this
of
A.D.