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Home My WebLink About02-3647JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. Da -,d(W 7 t=tv ?£2f+-l CIVIL ACTION - LAW JURY TRIAL DEMANDED P AF IP . FOR WRIT OF SUMMONS TO THE PROTHONOTARY Please issue a Writ of Summons in the above-captioned matter and forward the Writ of Summons to the Sheriff for service on: Myong Nyo Krzykowski 511 North Market Street Duncannon, PA 17020 Date: ?u?y aR ?ooz- /rte! ?r Ronald D. Butler, Esquire Attorney for Plaintif I.D. #09826 500 N. Third St., P.O. Box 1004 Harrisburg, PA 17108-1004 (717) 236-1485 WRIT OF SUMMON TO THE ABOVE-NAMED DEFENDANT: YOU ARE NOTIFIED THAT THE ABOVE-NAMED DEFENDANT HAS COMMENCED AN ACTION AGAINST YOU. 2. Prothonot Dated: *_ ? ? Deputy v V ? C) -' ; C fJ r ? ? i v L., i 1 < -G ca .? SHERIFF'S RETURN - OUT OF COUNTY CASE NO: 2002-03647 P COMMONWEALTH OF PENNSYLVANIA: COUNTY OF CUMBERLAND BURGETT JAMES A AKA JAMES BURG VS KRZYKOWSKI MYONG NYO R. Thomas Kline Sheriff or Deputy Sheriff who being duly sworn according to law, says, that he made a diligent search and and inquiry for the within named DEFENDANT , to wit: KRZYKOWSKI MYONG NYO but was unable to locate Her deputized the sheriff of PERRY serve the within WRIT OF SUMMONS County, Pennsylvania, to On August 14th , 2002 , this office was in receipt of the attached return from PERRY Sheriff's Costs: Docketing 18.00 Out of County 9.00 Surcharge 10.00 Dep Perry Co 41.90 .00 78.90 08/14/2002 BUTLER LAW FIRM So answer y R. Thomas Kline Sheriff of Cumberland County sworn and subscribed to before me this ,lam day of .2rsv Z A.D. Prothonotary in his bailiwick. He therefore f In-The Court of Common Pleas of Cumberland County, Pennsylvania James A. Burgett aka James Burgett vs. Myong Nyo Krzykowski o2 3647 civil SERVE: same No. Now, August 6, 2002 I, SHERIFF OF CUMBERLAND COUNTY, PA, do County to execute this Writ, this hereby deputize the Sheriff of Parry - deputation being made at the request and risk of the Plaintiff. Sheriff of Cumberland County, PA Affidavit of Service Now, August 12, within Writ of summons upon Myong Nyo Krzykowski 20 02, at 6:00 o'clock P M. served the at 511 N. Market St. Duncannon, Pa. 17020 ( Duncannon by handing to Myong Nyo Krzykowski True & Attested a and made known to Her copy of the original Writ of summons the contents thereof. So answers, James T. Bennett Deputy SheriffofB\Perry County, PA Sworn and subscribed before me this 13 thday of August , 20o2 MpROpRE1F.FLICKI GER, AflY t,,. gLODTA r. rLI BORO., PERRYCOUMY A1grAM SSSIOME%PIRESFER.16.2004 COSTS SERVICE $ MILEAGE AFFIDAVIT JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff V. MYONG NYO KRYZKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 02-3647 CIVIL TERM CIVIL ACTION - LAW JURY TRIAL DEMANDED PRAECIPE FOR ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of undersigned counsel on behalf of Defendant Myong Krzykowski. Date: 111,9101" Respectfully submitted, NESTICO, DRUBY DABRAND, LLP By: Vhard B. Druby, EscKre ttorney I.D. No. 61904 840 East Chocolate Avenue Hershey, Pennsylvania 17033 (717) 533-5406 (717) 533-5717 Attorney for Defendant Krzykowski ? ' C__ f ?-? ; i ?:,. `i'_ °- r.-? ;_ ?? ?: c? yy ..: ?,? ??"• JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : No. 2002-03647' : CIVIL ACTION -LAW CERTIFICATE OF SERVICE I hereby certify that I have this day served Plaintiff's Interrogatories and Plaintiff s Request for Production of Documents addressed to Defendant Myong Nyo Krzykowski by first class mail, postage prepaid, addressed to the following person: Richard B. Druby, Esq. Nestico, Druby & Hildabrand 840 East Chocolate Avenue Hershey, PA 17033 CLARAVAL & CLARAVAL Date: 16103 By D U1' Ij6L DENISE I. WILLIAMS, Secretary C-) cr- + ?qq T-1 Oct G JAMES R. BURGETT IN THE COURT OF COMMON PLEAS OF a/k/a JAMES BURGETT CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff V. No. 2002-03647 MYONG NYO KRZYKOWSKI, CIVIL ACTION -LAW Defendant NOTICE - COMPLAINT 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. Cumberland County Referral Service Court Administrator Fourth Floor, Courthouse Carlisle, PA 17013 (717) 240-6200 NOTICIA Le han demandado a usted an la corte. Si usted guiere defenderse de estas demandas expuestas en las paginas siguientes, usted tiene viente (20) dias de plazo al partir de la fecha de la demanda y la notificacion. Usted debe presentar una apariencia escrita o en persona o por abogado y archivar en la corte en forma escrita sus defensas o sus objeciones a las demandas en contra de su persona. Sea avisado gue si usted no se defienda, la corte tomara medidas y puede entrar una orden contra usted sin previo aviso o notificacion y por cualquier gueja o alivio gue es pedido en la peticion de demanda. Usted puede perder dinero o sus propiedades o otros derechos importantes para usted. LLEVE ESTA DEMANDA A UN ABODAGO INMEDIATAMENTE. SI NO TIENE ABOGADO O SI NO TIENE EL DINERO SUFICIENTE DE PAGAR TAL SERVICIO, VAYA EN PERSONA O LLAME POR TELEFONO A LA OFICINA CUYA DIRECCION SE ENCUNENTRA ESCRITA ABAJO PARA AVERIGUAR DONDE SE PUEDE CONSEGUIR ASISTENCIA LEGAL. Cumberland County Referral Service Court Administrator Fourth Floor, Courthouse Carlisle, PA 17013 (717) 240-6200 JAMES R. BURGETT IN THE COURT OF COMMON PLEAS OF a/k/a JAMES BURGETT CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff V. No. 2002-03647 MYONG NYO KRZYKOWSKI, CIVIL ACTION -LAW Defendant COMPLAINT Parties 1. The Plaintiff James R. Burgett is an adult individual who resides at 70 Station Road, Newville, Cumberland County, Pennsylvania. 2. The Defendant Myong Nyo Krzykowski is an adult individual who resides at 511 North Market Street, Duncannon, Perry County, Pennsylvania. Background 3. On Friday, August 11, 2000 at approximately 11:00 p.m., the Plaintiff James Burgett was a driving a 1996 Mercury owned by Rachelle Sybrandt. On that same date the Defendant Myong Nyo Krzykowski was intoxicated and was operating a 1.998 Chevrolet Blazer owned by Timothy Krzykowski. 4. The Plaintiff James Burgett was traveling north on Front Street in Wormleysburg Borough, Cumberland County, Pennsylvania and had properly slowed and then stopped for another vehicle which had stopped in front of Plaintiff because pedestrians were crossing in front of that car. 5. The Defendant Myong Nyo Krzykowski. was also traveling north on Front Street and was behind the Plaintiff James Burgett. 6. The Defendant Myong Nyo Krzykowski was driving at a reckless speed and approached the Plaintiff's car from behind in reckless manner. 7. Without warning the Defendant Myong Nyo Krzykowski caused the Chevrolet Blazer to plow into the rear of the Plaintiff's car, totally demolishing the car. 8. At the moment of impact the Plaintiff James Burgett was subjected to significant force which caused injury to his spine. 9. The force of the impact propelled Plaintiff's car forward into the car that had stopped in front of him. 10. At the time of the crash the Defendant Myong Nyo Krzykowski's blood alcohol was over the legal limit (i.e..10%). Negligence of Defendant Myong Nyo Krzykowski 11. Paragraphs 1-10 are incorporated herein by reference thereto. 12. The collision and all of hereinafter mentioned injuries and damages sustained by the Plaintiff James Burgett, are the direct result of the carelessness, reckless and negligence of the Defendant Myong Nyo Krzykowski as more particularly described as follows: (a) In failing to stop the vehicle she was operating before colliding with the vehicle driven by James Burgett; (b) In failing to keep alert and to maintain a proper lookout for the presence of other motor vehicles, more specifically, the vehicle operated by James Burgett; (c) In failing to keep adequate and proper control over his vehicle to avoid contact with the automobile driven by the Plaintiff James Burgett; (d) In operating her vehicle in a reckless manner and with careless disregard for the rights or safety of others and in operating her vehicle in a manner endangering persons and property in violation of the Motor Vehicle Code of the Commonwealth of Pennsylvania, specifically 75 Pa. C.S.A. §3736; (e) In failing to properly and quickly apply her brakes to prevent his vehicle from colliding with the rear of the vehicle driven be the Plaintiff James Burgett;. (f) In operating a vehicle while under the influence of alcohol; (g) In operating her vehicle while intoxicated in violation of the Motor Vehicle Code of the Commonwealth of Pennsylvania, specifically 75 Pa.C.S.A §3731. 13. Shortly before the time of the crash the Defendant Myong Nyo Krzykowski drank alcohol. 14. The Defendant Myong Nyo Krzykowski knew or should have known that it was illegal to operate a motor vehicle after drinking alcohol to the point where she became intoxicated. 15. The Defendant Myong Nyo Krzykowski became intoxicated from this drinking episode and was legally intoxicated at the time of the crash. 16. Even though the Defendant Myong Nyo Krzykowski knew or should have known she was intoxicated, she proceeded to operate the Blazer thus showing a reckless indifference for other persons, including Plaintiff James Burgett, who was lawfully on the roadway. 17. The Defendant Myong Nyo Krzykowski's action in driving while intoxicated constitutes outrageous and wanton conduct and as such gives rise; to punitive damages to be assessed against the Defendant Myong Nyo Krzykowski. 18. The Defendant Myong Nyo Krzykowski because of her intoxication was unable to properly control her vehicle or apply the brakes in an appropriate fashion. Injuries 19. The force and impact of the collision as caused by the negligence and outrageous conduct of the Defendant Myong Nyo Krzykowski caused serious injury to the Plaintiff James Burgett. 20. The Plaintiff James Burgett suffered the following injuries as a result of the negligence of the Defendant: (a) Persistent and continuous back pain; (b) Aggravation of a pre-existing spine injury; (c) Injury to the discs of his spine; (d) Injury to the nerves radiating to his hand and down his leg, including phantom pain to his amputated left leg; (e) Limitation in his range of motion; (f) Anxiety and depression. 21. By reason of the Plaintiff James Burgett's injuries set forth above he has received medical and chiropractic care, and may in the future be required to receive said care to recover from the injuries he suffered in this crash. 22. As a result of the negligence and gross conduct of the Defendant Myong Nyo Krzykowski as described herein, the Plaintiff James Burgett has suffered and will continue to suffer mental and physical pain, great difficulty in carrying out and engaging in life's activities, a loss of life's pleasures and enjoyment, humiliation and embarrassment. 23. Plaintiff James Burgett has and will in the future sustain a loss of earnings and an impairment to his earning capacity. 24. Plaintiff James Burgett has been forced to expend sums of money for medical services, medication and therapy and related expenses in the past and may be required to continue to do so in the future. 25. All of Plaintiff James Burgett's injuries as herein described are continuing and will continue into the foreseeable future, as will the treatment coasts thereof. 26. The negligence and outrageous conduct of the Defendant Myong Nyo Krzykowski has resulted in the general deterioration of Plaintiff James Burgett's well-being. WHEREFORE, the Plaintiff James R. Burgett demands judgment against the Defendant Myong Nyo Krzykowski in an amount in excess of the compulsory arbitration limits of Cumberland County, together with interest, delay damages if applicable, punitive damages and costs of suit. Date: ?J CLARAVAL & CLARAVAL By Harrisburg, PA 17108-1965 (717) 233-4780 Supreme Court I.D. #19222 Attorneys for Plaintiff P.O. Box 11965 VERIFICATION I hereby certify that I am the Plaintiff in the foregoing action and that the facts set forth in the attached Complaint are based upon information that I have given to counsel and they are true and correct to the best of my knowledge, information, and belief I understand that any false statements herein are made subject to the penalties of 18 Pa. C.S.A. Section 4904, relating to unsworn falsification to authorities. DATED: iX ees Burge t JAMES R. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 CIVIL ACTION - LAW CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the attached Complaint by first class mail, postage prepaid, addressed to the following person: Richard B. Druby, Esq. Nestico, Druby & Hildabrand 840 East Chocolate Avenue Hershey, PA 17033 CLARAVAL & CLARAVAL Date: ( '7 O_ By_ DENISE I. WILLIAMS, Secretary C7 ?? ?, ?? ?? ?Ci?F _._ -?"r-_ £;_t - {?.3 ?.L:1 -?-? ..z r? t . ? - 3 - - ,,` ? ' C '' ;` a V ?? (t ?? " i. , -? JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff V. MYONG NYO KRYZKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 02-3647 CIVIL TERM CIVIL ACTION -LAW JURY TRIAL DEMANDED NOTICE TO PLEAD TO: James A. Burgett c/o Robert F. Claraval, Esquire Claraval & Claraval P.O. Box 11965 Harrisburg, PA 17108-1965 You are hereby notified to plead to the enclosed Defendant's Answer With New Matter within twenty (20) days from service hereof or a default of judgment may be entered against you. NESTICO, DRUB,Y7& HILDABRAND, LLP d Dated: A1,6 By: R}6hard B. Druby, Esq it ,Attorney I.D. No. 61904 840 East Chocolate Avenue Hershey, Pennsylvania 17033 (717) 533-5406 (717) 533-5717 Attorney for Defendant JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff V. MYONG NYO KRYZKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 02-3647 CIVIL TERM CIVIL ACTION -LAW JURY TRIAL DEMANDED DEFENDANT'S ANSWER WITH NEW MATTER 1. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 2. Admitted. 3. Admitted in part and denied in part. It is admitted that on Friday, August 11, 2000 at approximately 11:00 p.m. Defendant was operating a 1998 Chevrolet Blazer owned by Timothy Kryzkowski. It is also admitted, upon information and belief that Plaintiff was driving a 1996 Mercury owned by Rachelle Sybrandt. However, the allegation that Defendant was operating her vehicle "while intoxicated" is denied as a legal conclusion. 4. After reasonable investigation, Defendant is without knowledge of information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 5. Admitted. 6. Conclusion of law, to which no response is required. To the extent a response is required, the allegations of Paragraph 6 are denied pursuant to Pa. R.C.P. 1029 (e). 7. Denied as stated. It is admitted that Defendant struck Plaintiff's vehicle from behind. The remaining averments are denied pursuant to Pa.R.C.P. 1029 (e). 8. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 9. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 10. Conclusion of law, to which no response is required. To the extent a response is required, the allegations of Paragraph 10 are denied pursuant to Pa. R.C.P. 1029 (e). 11. Paragraphs 1 through 10 above are incorporated herein by reference. 12. The allegations of Paragraph 12, including subparagraphs (a) through (g) are conclusions of law, to which no response is required. To the extent a response is deemed to be required, it is admitted that Defendant was negligent for striking the rear of Plaintiff's vehicle. As for the remaining allegations of Paragraph 12, including subparagraphs (a) through (g), they are denied pursuant to Pa. R.C.P. 1029 (e). 13. Denied as stated. Admitted only that Defendant consumed several social drinks in the hours before the accident. 14. Denied as stated. After reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments because the averments are vague and ambiguous, and they are therefore denied. 15. Denied as a conclusion of law. 16. Conclusion of law, to which no response is required. To the extent a response is required, it is denied that Defendant acted with reckless indifference and, further, the allegations of Paragraph 16 are denied pursuant to Pa. R.C.P. 1029 (e). 17. Conclusion of law, to which no response is required. To the extent a response is required, it is denied that Defendant acted in an outrageous and wanton manner and, further, the allegations of Paragraph 17 are denied pursuant to Pa. R.C.P. 1029 (e). 18. Conclusion of law, to which no response is required. To the extent a response is required, the allegations of Paragraph 18 are denied pursuant to Pa. R.C.P. 1029 (e). 19. Conclusion of law, to which no response is required. To the extent a response is required, it is denied that Defendant acted in an outrageous manner and further, the allegations of Paragraph 19 are denied pursuant to Pa. R.C.P. 1029 (e). 20. Conclusion of law, to which no response is required. To the extent a response is required, after reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the allegations contained in subparagraph 20 (a) through 20 (g). As for the remaining allegations of Paragraph 20, they are denied pursuant to Pa. R.C.P. 1029 (e). 21. Conclusion of law, to which no response is required. To the extent a response is required, after reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 22. Conclusion of law, to which no response is required. To the extent a response is required, with regard to the allegation that Plaintiff has suffered and will continue to suffer mental and physical pain, great difficulty in carrying out and engaging in life's activities, a loss of life' pleasures and enjoyment, humiliation and embarrassment, after reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. Further, it is denied that Defendant's conduct was "gross" and further, the remaining allegations of Paragraph 22 are denied pursuant to Pa. R.C.P. 1029 (e). 23. Conclusion of law, to which no response is required. To the extent a response is required, after reasonable investigation Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 24. Conclusion of law, to which no response is required. To the extent a response is required, after reasonable investigation Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 25. Conclusion of law, to which no response is required. To the extent a response is required, after reasonable investigation Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. 26. Conclusion of law, to which no response is required. To the extent a response is required, as for the allegation that there has been a general deterioration of Plaintiff's well being, after reasonable investigation, Defendant is without knowledge or information sufficient to form a belief as to the truth of the averments, and they are therefore denied. Further, it is denied that Defendant acted in an outrageous manner and, further, the allegations of Paragraph 26, they are denied pursuant to Pa. R.C.P. 1029 (e). WHEREFORE, Defendant demands that Plaintiff s Complaint be dismissed with prejudice and that judgment be entered in her favor and against the Plaintiff, plus costs of this action. NEW MATTER 27. Paragraphs 1-26 above are incorporated herein by reference. 28. Plaintiff s claims may be barred, in whole or in part, by the provisions of the Pennsylvania Motor Vehicle Financial Responsibility Law. 29. Plaintiff s claims may be barred, in whole or in part, by the selection of a limited tort option on applicable policies of insurance. 30. Plaintiff may have failed to mitigate his damages. 31. Defenses reserved pursuant to Pa.R.C.P. 1030(b) and all other defenses not required to be pleaded or hereby reserved. 32. Plaintiffs claims may be barred, in whole or in part, by any applicable statute of limitations. 33. If Plaintiff sustained damages as alleged, which is denied and of which strict proof is demanded, the same were caused by conditions for which Defendant is not responsible and/or the damages were not causally related to this accident. WHEREFORE, Defendant demands that Plaintiff's Complaint be dismissed with prejudice and that judgment be entered in her favor and against the Plaintiff, plus costs of this action. /9 NESTICO, DRUBY 0 i;KDABRAND, LLP Date: ?? C1 By: ,, bard B. Druby, Es re Attorney I.D. No. 619 840 East Chocolate Avenue Hershey, Pennsylvania 17033 (717) 533-5406 (717) 533-5717 Attorney for Defendant Krzykowski VERIFICATION I, Myong Nyo Kryzkowski, verify that the statements made in the foregoing document are true and correct to the best of my knowledge, information and belief. I understand that false statements herein are made subject to the penalties of 18 Pa. C.S. §4904 relating to unsworn falsification to authorities. Date: Myong Nyo Kry o ski CERTIFICATE OF SERVICE 1, Richard B. Druby, of the law firm of Nestico, Druby & Hildabrand, LLP, hereby certify that on the 16th day of April, 2003, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: Robert F. Claraval, Esquire Claraval & Claraval P.O. Box 11965 Harrisburg, PA 17108-196? JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 : CIVIL ACTION -LAW PLAINTIFF'S REPLY TO DEFENDANT'S NEW MATTER 27 28 29. 30. 31 32. No answer is required. Denied. Paragraph 28 is a conclusion of law to which no response is required. Denied. It is denied that Plaintiff selected limited tort. Denied. Paragraph 30 is a conclusion of law to which no response is required. Denied. Paragraph 31 is a conclusion of law to which no response is required. Denied. It is denied that the Plaintiff in any way violated any applicable statute of limitations. 33. Denied. The Defendant is solely responsible for the motor vehicle accident and the resulting injuries to the Plaintiff. CLARAVAL & CLARAVAL Date: ?- a3 By ROBERT F. L VAI, P.O. Box 11965 Harrisburg, PA 17108-1965 (717) 233-4780 Supreme Court I.D. #19222 Attorneys for Plaintiff JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 MYONG NYO KRZYKOWSKI, CIVIL ACTION -LAW Defendant CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the attached Plaintiffs Reply to Defendant's New Matter by first class mail, postage prepaid, addressed to the following person: Richard B. Druby, Esq. Nestico, Druby & Hildabrand 840 East Chocolate Avenue Hershey, PA 17033 CLARAVAL & CLARAVAL Date: _ (4 la i- I a -A By ? DENISE I. WILLIAMS, Secretary n c t? -c r JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 CIVIL ACTION - LAW CERTIFICATE OF SERVICE I hereby certify that I have this day served Plaintiffs Response to Defendant's Interrogatories and Request for Production of Documents by first class mail, postage prepaid, addressed to the following persons: Richard B. Druby, Esq. Nestico, Druby & Hildabrand 840 East Chocolate Avenue Hershey, PA 17033 CLARA1VAL & CLA(RIA1VAL Date: By IJQ. W IM?DENISE I. WILLIAMS, Secretary For Robert F. Claraval c ? a m? z c ? T, _;?, v 4' . -C .? ? r ;ir; ? --;. -i(7 ?? S J ??? C . --f IJ JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff V. MYONG NYO KRYZKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 02-3647 CIVIL TERM CIVIL ACTION - LAW JURY TRIAL DEMANDED CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of s subpoena for documents and things pursuant to Rule 4009.22, Defendant certifies that: (1) a notice of intent to serve 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 twenty days notice has expired; and By: chard B. Druby ire Attorney I.D. No. 61 04 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 (717) 533-5717 Date: Attorney for Defendant Kryzkowski (4) the subpoena which will be served is identical to the subpoena which is attached the subpoena. to /?/ the notice of intent to serve COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff V. NO. 02-3647 CIVIL TERM MYONG NYO KRYZKOWSKI, : CIVIL ACTION - LAW Defendant JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Social Security Administration Freedom of Information Staff 3-C-1 Operations Building 6401 Security Boulevard Baltimore, MD 21235 Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Any and all social security records from the beginning of disability to the present, including, but not limited to, social security applications, disability evaluations, report of work injuries, social security disability claims and any and all other information regarding the disability of James A. Burgett (DOB: 7/14/1960, SSN: 208-48-0813). at 840 East Chocolate Avenue, Hershey, PA 17033 You may deliver or mail legible copies of the documents or produce the 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 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: Telephone: Supreme Cot Attorney for: Richard B. Druby, Esquire 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 rt ID #61904 Defendant BY THE COURT: Prothonotary/Clerk, Civil Divisi Date: ??]??/ r 3e 1 of court r ! ? ?1L Deputy (Eff. 7/97) CERTIFICATE OF SERVICE I, Christiana Appleby, of the law firm of Nestico, Druby & H.ildabrand, LLP, hereby certify that on the 301h day of March, 2004, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: Robert F. Claraval, Esquire Claraval & Claraval 500 North Third Street, 2nd Floor Harrisburg, PA 17108-1965 Christiana Appleby t'S o ? r 77 ?C S r7i -um i Fri Ln IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BURGETT Vs. KRZYKOWSKI NO. 200203647 CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena(s) for documents and things pursuant to Rule 4009.22 RICHARD B DRUBY, ESQUIRE certifies that: 1. A Notice of Intent to Serve the Subpoena(s) with a copy of the subpoena(s) attached thereto was mailed or delivered to each party at least twenty days prior to the date on which the subpoena(s) is sought to be served, 2. A copy of the Notice of Intent, including the proposed subpoena(s) is attached to this certificate, 3. No objection to the subpoena(s) has been received, and 4. The subpoena(s) which will be served. is identical to the subpoena(s) which is attached to the Notice of Intent to Serve the Subpoena(s). Date: 04/26/04 File #: R309772 RICHARD B DRUBY, ESQUIRE 840 E CHOCOLATE AVE HERSHEY, PA 17033 717-533-5406 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA PA 19135 (215) 335-3653 By: Susan Tyre IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY BURGETT Vs. KRZYKOWSKI No. 200203647 TO: ROBERT CLARAVAL, ESQ (PLAINTIFF) NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 DEFENDANT intends to serve a subpoena(s) identical to the one(s) 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 no objection is made the subpoena may be served. Date: 04/05/04 RICHARD B DRUBY, ESQUIRE 840 E CHOCOLATE AVE HERSHEY, PA 17033 ATTORNEY FOR DEFENDANT INQUIRIES SHOULD BE ADDRESSED TO: MEDICAL LEGAL REPRODUCTIONS, INC. 4940 DISSTON STREET PHILADELPHIA, PA 19135 (215) 335-3653 By: Susan Tyra Enc(s): Copy of subpoena(s) Counsel return card File #: R309772 OOK40NWEALTH OF PENNSYLVA141A COONPY OF CL14B 3tI M BURGETT Vs. KRZYKOWSKI File No. 200203647 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISOOVERY PURSUANT TO RULE: 4009.22 PAIN MGMT CLINIC OF CARL, 7 SPRINT DR, CARLISLE PA 17013-7696 TO: of Person or Entity Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents 09 WtTA iB-?WFNTM-M -- at - - MEDICAL LEGAL REPROD V-D: PA ------- (Address) You may deliver or mail legible copies of the documents or produce things requested t> this subpoena, together wit!) the certificate of compliance, to the party making thi_ 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 thin, subpoena may seek a court ordei- crnpelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: - R40 R CHOCOLATE AVE ^-PA's033 TELEPHONE: S 3 ZIZ- SUPREME OOURT ID # 215 -3 ATTORNEY FOR DEFENDANT R309772-01 DATE: 12 (W V S 1 of the tour 121 BY THE COURT: leiAM 6 ProthonDtary/cle K civil Division 'EL Deputy (Eff. -1/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: PAIN MGMT CLINIC OF CARL ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO: I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE: I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature for PAIN MGMT CLINIC OF CARL CUMBERLAND R309772-01 * * * SIGN AND RETURN THIS PAGE * * * COMMONWEALTH OF PDMYLVA141A COUNTY OF CUMBERLAND BURGETT Vs. 200203647 File No. KRZYKOWSKI ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 DR PETER PAHAPILL, PHD, C/O DIV OF NEUROSURG, MCH 110 PO BOX 850 TO: HERSHEY PA 17033-0850 of Person or Enti Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents cSftinWTAGHED ???MM M at _._..- TRs?r +-?A------ MEDICAL LEGAL REP 1-fl.L9ST0N ST., (Address) You may deliver or mail legible copies of the documents or produce things requested b> this subpoena, together with the certificate of ompliance, to the party making thi: 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 thin subpoena may seek a court orde cxmpel l ing you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: _ 840 E CHOCOLATE AVE PA =7033 TELEPHONE: SUPREME COURT ID # 215 3ZIZ- ATTORNEY FOR DEFENDANT R309772-02 DATE: D_/ Z J Q1 S l of the Court BY THE COURT: Prothonotary/Clerl, Civil Division Deputy (Eff. 7/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: DR PETER PAHAPILL, PHD ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO.I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or DR PETER PAHAPILL, PHD CUMBERLAND R309772-02 * * * SIGN AND RETURN THIS PAGE * * * QOM4ONWEALTH OF PENNSYLVANIA COUNPY OF COMBER AND BURGETT Vs. KRZYKOWSKI 200203647 File No. ORIGINAL X-RAYS REQUESTED IMICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THIMS FOR DISCOVERY PURSUANT TO RULE 4009.22 DR STEPHEN BECKER, 91 S HIGH ST BOX 39, NIEWVILLE PA 17241-1405 TO: (Name of Person or Ent Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents °S& nW1 B- A?L1T]Y11iTM at MEDICAL LEGAL REPR $$ESSTEM fl4TT A pA (Address) You may deliver or mail legible copies of the documents or produce things requested ti this subpoena, together with the certificate of caTpliance, to the party making thi- request at the address listed above. You have the right to seek in advance the rea.onable 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 thin subpoena may seek a court orde crnpelling you to conply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: _ AID --E CHOCOLATE AVE --PA-17 0 3 3 TELFPHONE: SUPREME OOURT ID # 21 335 32ZZ- ATTORNEY FOR: DEFENDANT R309772-03 DATE: o ?g7 the eal of the Court BY THE COURT: ?A lIz i Prothonotary/Clerk, ivil Division -? Deputy (Eff. 7/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: DR STEPHEN BECKER ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO: I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE: I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or DR STEPHEN BECKER CUMBERLAND R309772-03 *** SIGN AND RETURN THIS PAGE *** COM"MEALTH OF PENNSYLVA141A COUNTY OF CUMBERLAND BURGETT Vs. KRZYKOWSKI File No. 200203647 ORIGINAL X-RAYS REQUESTED :MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISODVERY PURSUANT TO RULE 4009.22 DR WILLIAM RANCK, 3544 N PROGRESS AVE #103, HARRISBURG PA 17110 TO: Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents oginftTAC??)DENDLIAI at _ MEDICAL LEGAL REPRODIICTIO (Address) V-D Fib You may deliver or mail legible copies of the documents or produce things requested b this subpoena, together wit!) the certificate of co-pliance, to the party making thi- 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 sougiht. If you fail to produce the documents or things required by this subpoena within twenty (20) days after its service, the party serving thin subpoena may seek a court orde ompelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: _ 84n F rH0 O TE AVE 033 TELEPHONE: SUPREME OOURT f D# 275--:73-3-5 --21- ATTORNEY FOR: DEFENDANT R309772-04 DATE: Q /A eZoD y' S?the Oourt BY THE COURT: D ?P.r.?otho?notary 1 k, Cdr ivil Division Deputy (Eff. 1/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: DR WILLIAM RANCK ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ l RECORDSAREATTACHEDHERETO. I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or DR WILLIAM RANCK CUMBERLAND R309772-04 *** SIGN AND RETURN THIS PAGE *** COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBEREAND BURGETT Vs. KRZYKOWSKI File No. 200203647 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE: 4009.22 DR HAROLD MCCOY, C/O SPINAL LOGIC, 11417 124TH AVE #102 TO: KIRKLAND WA 98033 Name of Person or Entity) Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the fol lowing documents cSL innTTAGIESD f M £-N M--I -A 4 at _ MEDICAL LEGAL REPROD ?? . FA -- (Address) You may deliver or mail legible copies of the documents or produce things requested t? this subpoena, together with the certificate of caipliance, to the party making thi; request at the address listed above. You have the right to seek in advance the rea^.onable 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 orde Impelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: - R40 E CHOCOLATE AVE ^-??033 TELEPHONE: SUPREME COURT ID # 215 ?- ATTORNEY FOR DEFENDANT R309772-05 DATE: /a o2oo,?- eal of the Court BY THE OOLR2T: Prothonotary/ eidl" dTc, Civil Division _ Deputy (Eff. 7/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: DR HAROLD MCCOY ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ l RECORDS ARE ATTACHED HERETO. I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or DR HAROLD MCCOY CUMBERLAND R309772-05 * * * SIGN AND RETURN THIS PAGE * * * COMMONWEALTH OF PENNSYLVANIA COUNTY OF c UMBERU ID BURGETT Vs. KRZYKOWSKI 200203647 File No. ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE D92b1ENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 WEST SHORE EMERG MED, 503 N 21ST ST, CAMP HILL PA 17011-2204 TO: (Name of Person or Ent Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents cS&n$ffTA£-HED-, Uk MZA at MEDICAL LEGAL E0 SCRON vin • sku" ? , REP ??-- - ----- (Address) You may deliver or mail legible copies of the documents or produce things requested h this subpoena, together with the certificate of compliance, to the party making thi: 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 thin, subpoena may seek a court orde;- cxxrpelling you to ca, ly with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: _ 840 E CHOCOLATE AVE HEIRSHEY, PA 7033 TELEPHONE: # 21 X35-32Z? SUPREME COURT ID ATTORNEY FOR DEFENDANT R309772-06 DATE: leh1 I 02117) y S of the Court BY THE OOURT: Prottwrw:1tary/C1 k Civil Division Deputy (Eff. -1/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: WEST SHORE EMERG MED ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO. I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Aut orize signature or WEST SHORE EMERG MED CUMBERLAND R309772-06 *** SIGN AND RETURN THIS PAGE *** COM10NWFALTH OF PENNSYLVANIA COUNTY OF CMMEZI AM BURGETT Vs. KRZYKOWSKI File No. 200203647 MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISODVERY PURSUANT TO RULE: 4009.22 HOLY SPIRIT HOSP, 503 N 21ST ST, CAMP HILL PA 17011 TO: ATTN: MEDICAL RECORDS DEPT (Name of Person or Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents cS&nAVT -,UMEND1L I at....- MEDICAL LEGAL REP 7CTIDAS; INC-,-49A0 D!SSTeN ST., PHILA., RA (Address) You may deliver or mail legible copies of the documents or produce things requested h this subpoena, together with the certificate of convliance, to the party making thi- request at the address listed above. You have the right to seek in advance the rea.onable 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 thin subpoena may seek a court orde:- ornpelling you to conply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: - R44 E CHOCOLATE AVE rinic?i-icy PA. `033 TELEPHONE: SUPREME OOURT f D # 215 -?_ ATTORNEY FOR DEFENDANT R309772-07 DATE: (.'LJ /-? aay y gea1 of the Oourt BY THE COURT: Prothont>tary/Cle c, ivil Division Deputy (Eff. 7/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: HOLY SPIRIT HOSP ANY AND ALL EMERGENCY ROOM RECORDS AND BILLS. PERTAINING TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 MEDICAL BILLING REQUESTED ALL FEES MUST BE APPROVED PRIOR TO RECORDS BEING FORWARDED. RECORD CUSTODIAN - COMPLETE AND RETURN [ l RECORDS ARE ATTACHED HERETO.I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or HOLY SPIRIT HOSP CUMBERLAND R309772-07 * * * SIGN AND RETURN THIS PAGE * * * COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND BURGETT Vs. KRZYKOWSKI File No. ORIGINAL X-RAYS REQUESTED 200203647 SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 HOLY SPIRIT HOSP-X, 503 N 21ST ST, CAMP HILL PA 17011 TO: ATTN: RADIOLOGY DEPT (Name of Person or Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents °SftnWTAC-HED--1IENlUM __ at MEDICAL LEGAL RSP $?7:°S?C:: T-?A------- (Address) You may deliver or mail legible copies of the documents or produce things requested t? this subpoena, together with the certificate of compliance, to the party making thia 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 thin, subpoena may seek a court orde+- cxnpelling you to cartply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: _ R40 E CHOCOLATE AVE --cif Si1SY;-x''033 TELFPHONE: SUPREME OOURT I D $ 2155 3ZZ? ATTORNEY FOR: DEFENDANT R309772-08 DATE: 2@U S 1 of the art BY THE COURT: Prothorx>tary/Cle I , ivi 1 Division Deputy (Eff. 7/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: HOLY SPIRIT HOSP-X ANY AND ALL EMERGENCY ROOM FILMS. PERTAINING TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED ALL FEES MUST BE APPROVED PRIOR TO RECORDS BEING FORWARDED. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO.I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or HOLY SPIRIT HOSP-X CUMBERLAND R309772-08 * * * SIGN AND RETURN THIS PAGE COMMONWEALTH OF PENNSYLVA141A COUNTY OF COMBE FI AND BURGETT Vs. File No 200203647 KRZYKOWSKI ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE' 4009.22 TO: DR ARUN KAPOOR, 246 PARKER ST BOX 4100, CARLISLE PA 17013 (Name of Person or Ent Within twenty. (20) days after service of this subpoena, you are ordered by the court to produce the following documents of ing k TT -MIDENDLM at MEDICAL LEGAL REPRODUCTIOI u, INC' 494V-D7. . , . , FA (Address) You may deliver or mail legible copies of the documents or produce things requested h this subpoena, together with the certificate of compliance, to the party making thi= 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 orde compelling you to con ply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: _- g4Z F CHO nT ATE AVE TELEPHONE: 033 ? SUPREME OCURT I D# 215 -335-321 ATTORNEY FOR: DEFENDANT R309772-09 DATE: / Z ov Sbal of the Court BY THE COURT: Prot honotarY/Clerk ivi1 Division Deputy (Eff. T/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: DR ARUN KAPOOR ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO:I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Aut orize signature or DR ARUN KAPOOR CUMBERLAND R309772-09 *** SIGN AND RETURN THIS PAGE *** COVCNWII4LTH OF PEtZd LVANIA COUNTY OF Cf14BERLAW BURGETT Vs. KRZYKOWSKI File No. 200203647 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUmENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 PENNS WOOD PHYS THERAPY, 425 STONEHEDGE DR, CARLISLE PA 17013 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 o§&ngs,.;, Mtn l _ at _ F!? -'-- 44940 DIS ., PHI-LA., MEDICAL LEGAL REPRODUCTIONS ,(Atltl IINNC,ress) You may deliver or mail legible copies of the documents or produce things requested h this subpoena, together with the certificate of = pliance, to the party making thi= request at the address listed above. You have the right: to seek in advance the rea.onable cost of preparing the copies or producing the things sought. If you fail to produce the documents or things requiired by this subpoena within twenty (20) days after its service, the party serving thin, subpoena may seek a court orde c=pelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NN1E: RICHARD B DRUBY, ESQ ADDRESS: _ 9 4 g E ciloCAT ATE AVE --PA-c-7 033 TELEPHONE: _ SUPREME COURT ID # 215-335-3212 ATTORNEY FOR R309772-10 DEFENDANT DATE: _I A,,O /=7. -,16o Seal of the Court BY THE COURT: c? 42 40, Prothonotary/C1 rk, Civil Division Deputy (Eff. '7/97) ADDENDUM TO SUBPOENA BURGETT Vs. No. 200203647 KRZYKOWSKI CUSTODIAN OF RECORDS FOR: PENNS WOOD PHYS THERAPY ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ l RECORDS ARE ATTACHED HERETO: I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE: I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or PENNS WOOD PHYS THERAPY CUMBERLAND R309772-10 *** SIGN AND RETURN THIS PAGE *** COM*DNWFALTH OF PENNSYLVANIA COUNPY OF CLDE21a.Am BURGETT Vs. KRZYKOWSKI File No. 200203647 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: PERRY HEALTH CTR, 1100 MONTOUR RD, LOYSVILLE PA 17047-9200 of Person or Entity Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following docxments or ng SEV A'T'TArHLH--7U? -- at NEDICAL LEGAL REPRODUCTIONS,(AWessl940 DISSTON ST., PHILA., PA You may deliver or mail legible copies of the documents or produce things requested t> this subpoena, together with the certificate of ccnpliance, to the party making this request at the address listed above. You have the right: to seek in advance the rea_.onable cost of preparing the copies or producing the things sought. If you fail to produce the docunents or things required by this subpoena within twenty (20) days after its service, the party serving thin subpoena may seek a court order- cxmpelling you to ccnply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: - 8 4 9 R G140CO n mE AVE TELEPHONE: HERSHE ,7033 SUPREME COURT ID $L____215-335-3212 ATTORNEY FOR: DEFENDANT R309772-11 DATE: (24'j 1-2 oZ&f L/ SEal of the Court BY TIE COURT: C(' Lf; o 1. ???. Protho/notary/C , Civil Division Deputy (Eff. 1/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: PERRY HEALTH CTR ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINA}:, X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO.I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or PERRY HEALTH CTR CUMBERLAND R309772-11 * * * SIGN AND RETURN THIS PAGE * * * CONAVDNWFALTH OF PMEYLVANIA COUNTY OF CUMBERLAND BURGETT Vs. KRZYKOWSKI File No. 200203647 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THIWIS FOR DISCOVERY PURSUANT TO RULE' 4009.22 TO: DR JOHN PANTALONE, 267 W MAIN ST, HUMMELS:COWN PA 17036 of Person or Ent Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents oR..tbings.,,,TAICHED-M)H£INDUnR _ at MEDICAL LEGAL REPRODUCTIONS, I1 C, 494 ISSTON . , Fly--"-- (A ress) You may deliver or mail legible copies of the documents or produce things requested t?> this subpoena, together wit!i the certificate of =reliance, to the party making thi_ request at the address listed above. You have the right: to seek in advance the rea,onablE 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 th?im subpoena may seek a court orde• crnpelling you to conply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: - 849 W C8CICOT ATE AVE ->}A--i? 0 3 3 TELEPHONE: SUPREME COURT ID # 215-335-3212 ATTORNEY FOR DEFENDANT R309772-12 DATE: &l of the O u t BY THE COURT: Prot honotary/l k, Civil Division / Deputy (Eff. 7/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: DR JOHN PANTALONE ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO.I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature or DR JOHN PANTALONE CUMBERLAND R309772-12 *** SIGN AND RETURN THIS PAGE *** Q"U94 FALTH OF PENNSYLVANIA COULM OF CUMBERLAND BURGETT Vs. KRZYKOWSKI File No. 200203647 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO. (Name of Person or Ent Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents o§ nA1TA-e??)DENDUA= at ANNETTE DURICA, MA, 79 CEDAR AVE, HERSHEY PA 17033 MEDICAL LEGAL REPRODUCTIONS.(AlINC, 0 D155TON 5T., ., ? You may deliver or mail legible copies of the documents or produce things requested h this subpoena, together witil the certificate of ccfrpliance, to the party making thi; request at the address listed above. You have the right to seek in advance the rea.onable 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 th•ir, subpoena may seek a court orde-- crnpelling you to comply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS: - 84.0 V CHOCOLATE AVE 033 TELEPHONE: _ SUPREME COURT ID # 215-335-3212 ATTORNEY FOR R309772-13 DEFENDANT DATE: aguil 1.2, a20,) N S 1 of the court BY TFE COURT: 2 Prothorotary/ k, Civil Division L:701 Deputy (Eff. 1/97) ADDENDUM TO SUBPOENA BURGETT Vs. KRZYKOWSKI No. 20,3203647 CUSTODIAN OF RECORDS FOR: ANNETTE DURICA, MA ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD NEWVILLE PA DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE AND RETURN [ ] RECORDS ARE ATTACHED HERETO.I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE. I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorized signature for ANNETTE DURICA, MA CUMBERLAND R309772-13 * * * SIGN AND RETURN THIS PAGE * * * COI44* MLTH OF FENNSYLVAN7A COUNPY OF CLAIID BURGETT Vs. KRZYKOWSKI 200203647 File No. ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 DR RODNEY HOUGH, 49 BROOKWOOD AVE, CARLISLE PA 17013 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 domments og_tbings,;,T M.*lnwDjAj at _ yffllilt- MEDICAL LEGAL REPRODUCTIONS,(AWee;ss40 DISSTON •' -? you may deliver or mail legible copies of the documents or produce things requested b> this subpoena, together with the certificate of campliance, to the party making thi_ 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, ompelling you to omply with it. THIS SUBPOENA WAS ISSUED AT THE REQUEST OF THE FOLLOWING PERSON: NAME: RICHARD B DRUBY, ESQ ADDRESS:- 84p g rNOMLATE AVE -P? 0 3 3 TELEPHONE: _ SUPREME OOl1RT ID # 215-335-3212 ATTORNEY FOR: R309772-14 DEFENDANT DATE: /a ?_ eal of the Court BY THE COURT: '- . Prothonotary C erk, Civil Division S;Z ht?cu Deputy (Eff. 7/97) ADDENDUM BURGETT Vs. KRZYKOWSKI No. 200203647 CUSTODIAN OF RECORDS FOR: DR RODNEY HOUGH ANY AND ALL OFFICE RECORDS, INCLUDING NOTES, CORRESPONDENCE, MEMORANDA, X-RAY REPORTS, HISTORY NOTES, INDEX CARDS AND ANY OTHER INFORMATION RELATING TO ANY EXAMINATION OR TREATMENT RENDERED TO: NAME: JAMES BURGETT ADDRESS: 70 STATION RD DATE OF BIRTH: 07/14/60 SSAN: 208480813 ORIGINAL X-RAYS REQUESTED MEDICAL BILLING REQUESTED CERTIFIED PHOTOCOPIES WILL BE ACCEPTED IN LIEU OF YOUR PERSONAL APPEARANCE. RECORD CUSTODIAN - COMPLETE: AND RETURN [ ] RECORDS ARE ATTACHED HERETO:I hereby certify as custodian of records that, to the best of my knowledge, information and belief all documents or things above mentioned have been produced. [ ] NO DOCUMENTS AVAILABLE: I hereby certify that a thorough search has been made and that no record of the following documents have been located (CHECK THE APPROPRIATE BOX): ( ) RECORDS ( ) PATIENT BILLING ( ) X-RAYS ( ) RECORDS / XRAYS have been destroyed Date Authorize DR RODNEY CUMBERLAND R309772-14 TO SUBPOENA NEWVILLE PA * * * SIGN AND RETURN THIS (PAGE * * * S 2 cn r 1_1'1 --c T nl r CO C JAMES A. BURGETT a/k/a.IAMI'S BURGE.'IT, Plaintiff V. MYONG NYO KRYLKOWSKI, Defendant IN Ti IF COURT OF COMMON PLEAS OF CUMBERLAND COUNTY. PENNSYLVANIA NO. 02-3647 CIVIL TERM CIVIL ACTION - LAW .IURY'fRIAL DEMANDED CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE. 4009.22 As a prerequisite to service of subpoena for documents and things pursuant to Rule 4009.22, Defendant certifies that: (1) a notice of intent to serve 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 twenty days notice has expired; and (4) the subpoena which will be served is identical to the subpoena which is attached to the notice of intent to serge the subpoena. VII/ By: L't Wchard B. Druby, Es uir Attorney I.D. No. 619 840 East Chocolate Avenue I lershey, PA 17033 (717) 533-5406 (717) 533-5717 Date: OS Attorney for Defendants Kryzkowski JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff V. MYONG NYO KRYZKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA NO. 02-3647 CIVIL TERM CIVIL ACTION-LAW JURY TRIAL DEMANDED NOTICE OF INTENT TO SERVE A SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.21 Defendant 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 no objection is made, the subpoena may be served. Subpoena is for the following: Shippensburg University Date: Respectfully submitted, NESTICO, DRUBY 4,H,L By: 840 East Chocolate Avenue Hershey, PA 17033 (717) 533-5406 (717) 533-5717 Attorney for Defendants L.L.P. COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND JAMES A. BURGETT a/k/a JAMES BURGETT, Plaintiff MYONG NYO KRYZKOWSKI, : CIVIL ACTION -LAW Defendant ; JURY TRIAL DEMANDED SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Shippensburg University C/o Alana G. Moriarty, Registrar 1871 Old Main Drive Shippensburg, PA 17257 Within twenty (20) days after service of this subpoena, you are ordered by the court to produce the following documents or things: Any and all student record Information from the beginning of enrollment to the present, Including, but not limited to, applications, transfer records, degree requirements, courses, grades, transcripts Including any transfer credits, withdrawals and Incompletes, detailed course schedule for each semester, academic advisors, disciplinary letters, degree anticipation date and any and all other information regarding the education of James A. Burgett (DOB: 7/14/1960, SSN: 208-48.0813), at 840 East Chocolate Avenue, Hershey, PA 17033 You may deliver or mail legible copies of the documents or produce the 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 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: V. ; NO. 02-3647 CIVIL TERM Name: Richard B. Druby. Esquire Address: 840 East Chocolate Avenue Hershey. PA 17033 Telephone: (717) 533-5406 Supreme Court ID #61904 Attorney for: Defendant Date: Seal Of Court BY THE COURT: Prothonotary/Clerk, Civil Division Deputy (EfT. 7/97) CERTIFICATE OF SERVICE 1, Christiana E. Appleby, of the law firm of Nestico, Druby & Hildabrand, L.L.P., hereby certify that on the day of February, 2005, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: Robert F. Claraval, Esquire Claraval & Claraval PO Box 1 1965 Harrisburg, PA 17108-1965 Christiana E. Appleby CERTIFICATE OF SERVICE I, Christiana Appleby, of the law firm of Nestico, Druby & Hildabrand, I1I,P, hereby certify that on the 15th day of March, 2005, a copy of the foregoing document was sent via First Class U.S. Mail, postage paid, to the following: Robert F. Claraval, Fsquire Claraval & Claraval 500 North Third Street, 2od Floor Harrisburg, PA 17108-1965 Christiana Appleby JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 CIVIL ACTION - LAW CERTIFICATE PREREQUISITE TO SERVICE OF A SUBPOENA PURSUANT TO RULE 4009.22 As a prerequisite to service of a subpoena for documents and things pursuant to Rule 4009.22, Plaintiff hereby certifies the following: (I) A Notice of Intent to serve subpoena, with a copy of the subpoena attached thereto, was mailed, or delivered to each party at least 20 day prior to the date on which the subpoena was 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 to be served is identical to the subpoena attached to the Notice of Intent. CLARAVAL & CLARAVAL r Date: Harrisburg, :PA 17101-1167 (717) 233-4780 Supreme Court I.D. #19222 Attorneys for Plaintiff 500 North Third Street, 2nd Floor JAMES A. BURGETT a/k(a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 CIVIL ACTION LAW CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of Plaintiffs Certificate Prerequisite to Service of a Subpoena Pursuant to Rule 4009.22 and Plaintiff's Notice of Intent to Serve Subpoena to Produce Documents and Things for Discovery Pursuant to Rule 4009.21 by first class mail, postage prepaid, addressed to the following person: Richard B. Druby, Esq. Nestico, Druby & Hildabrand 840 East Chocolate Avenue Hershey, PA 17033 CLARAVAL & CLARAVAL Date: 8 10 JOS" By_rWJQ U)j. C nt..a DENISE I. WILLIAMS, Secretary JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 CIVIL ACTION - LAW 17 NOTICE OF INTENT TO SERVE SUBPOENA TO PRODUCE DOCUMENTS AND THINGS FOR DISCOVERY PURSUANT TO RULE 4009.1 Plaintiff intends to serve a subpoena identical to the one attached to this Notice. You have twenty (20) days from the date of this Notice in which to file of record and serve upon the undersigned an objection to the subpoena. If no objection is made the subpoena may be served. CLARAVAL & CLARAVAL Date: -44(!-7J Attorneys for Plaintiff Harrisburg, PA 17108-1965 (717) 233-4780 Supreme Court I.D. #19222 COMMONWEALTH OF PENNSYLVANIA COUNTY OF CUMBERLAND JAMES A. BURGETr a/k/a JAWS BURGEW, Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant Robert F. Claraval, Esq. SUBPOENA TO PRODUCE DOCUMENTS OR THINGS FOR DISCOVERY PURSUANT TO RULE 4009.22 TO: Pennsylvania Department of Transportation (Name of Pcrsoa or Entity) Within twenty (20) days after wryim of this subpoena, you arc ordered by the court to produce the following documents or things: CatQlete driving record of Myong Nyo Krzykowski, Driver No. PA 24 348 151. at 500 North Third Street, 2nd Floor, Harrisburg, PA 17101-1167 (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 fir-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 of 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: 500 North Third St., 2nd Floor Harrisburg, PA 17101-1167 File No. 2002-03647 TELEPHONE : (717) 233-4780 SUPREME COURT )D # 19222 ATTORNEY FOR: Plaintiff DATE Scal of the Court Froth. - 73 By the Court: Prothonotary Deputy o JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff VS. MYONG NYO KRYZKOWSKI Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA NO 2002-03647 CIVIL ACTION - LAW WITHDRAWAL OF APPEARANCE TO THE PROTHONOTARY: Kindly withdraw the appearance of the undersigned as counsel for Defendant, Myong Nyo Kryzkowski, in the above-captioned case. LDABRAND.LLP By: Richard B. Druby, ES uir I.D. 61904 840 East Chocolate Avenue Hershey, PA 17033 ............................................................................... ENTRY OF APPEARANCE TO THE PROTHONOTARY: Kindly enter the appearance of the undersigned as counsel for Defendant, Myong Nyo Kryzkowski, in the above-captioned case. MARSHALL DENNEHEY WARNE EMAN & GOGGIN By: Ch er M. Reeser, Esquire Attorney for Defendant I.D. 73632 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3509 Marshall Dennehey Warner Coleman & Goggin By: Christopher M. Reeser, Esquire ID# 73632 4200 Crams Mill Road, Suite B Harrisburg, PA 17112 717-651-3509 Our File No. 16235-00111 Attorney for Defendant JAMES A. BURGETT a/k/a JAMES BURGETT IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff VS. MYONG NYO KRYZKOWSKI : NO 2002-03647 : CIVIL ACTION - LAW Defendant NOTICE TO PLEAD TO: Robert F. Claraval, Esquire Claraval and Claraval 500 North Third Street, 2nd Floor Harrisburg, PA 17101-1167 Attorney or Plaintiff You are hereby notified to plead to the enclosed Answer with New Matter within twenty (20) days from service hereof or a default judgment may be filed against you. Respectfully submitted, MARSHALL DENNEHEY WARNER EMAN & GOGGIN Dated: November 28, 2006 By: Christopher M. Reeser, Esquire Attorney for Defendant I.D. 73632 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3509 Marshall Dennehey Warner Coleman & Goggin By: Christopher M. Reeser, Esquire ID# 73632 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 717-651-3509 Our File No. 16235-00111 Attorney for Defendant JAMES A. BURGETT a/k/a JAMES BURGETT VS. Plaintiff IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, PENNSYLVANIA : NO 2002-03647 MYONG NYO KRYZKOWSKI Defendant : CIVIL ACTION - LAW DEFENDANT'S AMENDED ANSWER WITH NEW MATTER RE: PIGA OFFSET 34. Paragraphs 1-33 of Defendant's Answer with New Matter filed on or about April 17, 2003 is incorporated herein by reference as if set forth at length. 35. At all relevant times, Defendant Myong Nyo Kryzkowski was insured under a policy issued by Shelby Casualty Insurance Company. 36. Defendant Myong Nyo Kryzkowski has been provided a defense in this case under the same policy of insurance issued by Shelby Casualty. 37. On August 1, 2006, the District Court of Travis County, Texas entered an Order of Liquidation with a finding of insolvency against Shelby Casualty Insurance Company effective August 1, 2006, staying this action for 90 days. 38. A copy of the August 1, 2006 District Court of Travis County, Texas Order is attached hereto as Exhibit A. As a result of the August 1, 2006 Order of Liquidation, the provisions of 40 P.S. §991.1817(a) apply to Plaintiffs claims. 39. Plaintiff is required to exhaust all rights under any insurance policy, including but not limited to claims under accident and health insurance, uninsured motorist, underinsured motorist, worker's compensation, Blue Cross and Blue Shield, and all other coverages except for policies of an insolvent insurer. 40. Upon information and belief, certain of Plaintiffs bills for which recovery is sought in this action were paid or are payable under accident and health insurance, Blue Cross and Blue Shield, worker's compensation insurance, automobile insurance or other insurance. 41. Plaintiffs recovery under all other insurance reduces any amount payable by the Pennsylvania Property and Casualty Insurance Guaranty Association (PIGA) and, to the same extent, Plaintiffs claims against Defendant are also reduced. WHEREFORE, Defendant demands judgment in his favor. MARSHALL DENNEHEY WARN EMAN & GOGGIN By: C ' per M. Reeser, Esquire Attorney for Defendant Lang I.D. 73632 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 Dated: November 28, 2006 (717) 651-3509 EXHI$IT A Page 1 of II 0 001 Cause No. D-1-GN-06-002366 THE TEXAS DEPARTMENT OF INSURANCE Plaintiff V. VESTA FIRE INSURANCE CORPORATION et al., Defendants § IN THE DISTRICT COURT OF U? § TRAVIS COUNTY, TEXAS;O,* § op § dv § 126th JUDICIAL DISTRICT'0 o ORDER APPOINTING LIQUIDATOR AND PERMANENT INJUNCTION c? NMI o m ? ` ..t On this day, the Court heard the Application for Order of Liquidation filed by the Commissioner of Insurance for the State of Texas (the "Commissioner"), in his capacity as Rehabilitator of Defendants. The Application requests an order placing Defendants into liquidation pursuant to TEX. INS. CODE §21A.151 et seq, and appointing the Commissioner as Liquidator (the "Liquidator"). The Application also requests a Permanent Injunction pursuant to TLx. INS, CODE §21 A.A08(a), enjoining Defendants and their agents from conducting Defendants' business, and enjoining other parties from taking any actions against Defendants or their property. The Rehabilitator appeared by and through his counsel of record, and requested that Vesta Fire Insurance Corporation, Shelby Casualty Insurance Company, The Shelby Insurance Company, Texas Select Lloyds Insurance Company and Select Insurance Services, Inc, be placed into liquidation, and that Vesta Insurance Corporation remain in rehabilitation. 1. FINDINGS Having considered the Rehabilitator's Application, the evidence and arguments of counsel, the Court finds as follows: 1.1 The Court has jurisdiction over the parties and the subject matter of this action, http://www.ppeiga.org/vestaorder.html 11/14/2006 Page 2 of II 1.2 Grounds exist to place Vesta Eire Insurance Corporation, Shelby Casualty Insurance Company, The Shelby Insurance Company, Texas Select Lloyds Insurance Company and Select Insurance Services, Inc. (collectively, the "Liquidated Defendants") into liquidation under TEX. INS. CODE §21A.057. These grounds include, but are not limited to, the finding that the Liquidated Defendants are insolvent as defined in TEX. INS. CODE §21A.004(a)(13). 13 Pursuant to TEX. NS. CODE §21A.151, the Commissioner shall be appointed as Liquidator of the Liquidated Defendants. IA Grounds exist to continue the rehabilitation of Vesta Insurance Corporation and the Commissioner's appointment as Rchabilitator of Vesta Insurance Corporation. 1.5 The Commissioner, as itehabilitator or Liquidator, as applicable, is vested by operation of law with title to all of such Defendants' property as defined in TEX, INS. CODE $21A.004(a)(20). Such property shall include property of any kind or nature, whether real, personal, or mixed, including but not limited to money, funds, cash, stock, bonds, account deposits, statutory deposits, special deposits, contents of safe deposit boxes, funds hold in share accounts or trust accounts, retainages and retainers, letters of credit, real estate, fixtures, furniture, equipment, books, records, documents and insurance policies, intellectual property, computer software and systems, information technology, internet domain names, patents and intangible assets, whether owned individually, jointly, or severally, wherever located, and all rights, claims or causes of action belonging to such Defendants, whether asserted or not, including but not limited to accounts receivable, notes, premiums, subrogation, insurance and reinsurance proceeds, and all licenses held by such Defendants (collectively, "Defendants' Propert)"). The title to Defendants' Q 002 http://www.ppciga.org/vestaorder.html 11/14/2006 Page 3ofII Property shall extend to all items owned by Defendants, regardless of the name in which such items are held. 1.6 Defendants and their agents shall be required to cooperate with the Rehabititator or Liquidator, as applicable, pursuant to TEX. INS. CODE §21A.010. 1.7 It is necessary for this Court to issue a permanent injunction pursuant to TEX. INS. COME §21 A.008(a) to carry out the provisions of TEx. Ins. CODE ANN. Chapter 21 A, and prevent irreparable injury, loss and damage to the general public and Defendants' creditors. A necessity exists to enforce the provisions of TFM INS. CODE Chapter 21:A by enjoining Defendants and their agents from conducting Defendants' business, except as authorized by the Rehabilitator or Liquidator, as applicable; enjoining financial institutions or depositories from taking any actions in connection with Defendants' property, except as directed by the Rehabilitator or Liquidator, as applicable; and enjoining all claimants or creditors from asserting claims or causes of action against Defendants, except as permitted by TEX. INS. Coat: ANN. Chapter 21A, 1.8 Pursuant to TEX. INS. CODE §21A,008(c), a stay remains in effect with respect to actions against Defendants or their property. In accordance with TEX. INS. CODF §21 A.008(0, such stay of actions against Defendants is in effect for the duration of this proceeding, and the stay of actions against Defendants' property is in effect for as long as the property belongs to the receivership estate. 1.9 Pursuant to TEX. INS. CODE §21A.008(d), a stay remains in effect with respect to actions against insureds covered under policies of insurance issued by Defendants. Such stay is in effect for 90 days after the date of the Agreed Order Appointing tiehabilitator and Permanent Injunction, or such further time as ordered by this Court. %003 http://www.ppciga.org/vestaorder.html 11/14/2006 Page 4 of II t.10 Defendants have been provided with proper notice of the Rehabilitators' application as provided in TEX. INS. CODE §21 A.007. H. APPOINTMENT OF LTQU(DATUR IT IS ORDERED that the Commissioner is appointed as Liquidator of the Liquidated Defendants, and granted the following duties and powers: 2.1 The Liquidator is granted std given all powers and authority under TEX. INS. CODE Chapter 21 A, and any and all other powers and authority under applicable statutes and the common law of this State. 2.2 The Liquidator is authorized to conduct the Liquidated Defendants' business, administer the Liquidated Defendants' operations, and enter into any contracts necessary to perform the Liquidator'3 duties, at his discretion, pursuant to TEX. INS. CODE §21A.154(a). 2.3 Pursuant to TEX. INS. CODE §21 A.151, title to all of the Liquidated Defendants' Property, including but not limited to all the assets and rights described in this Order Appointing Liquidator and Permanent Injunction, is vested in the Liquidator. The Liquidator is authorized to take control and possession of the Liquidated Defendants' property, wherever located, and remove all such property from such Defendants' prernins, 2.A The Liquidator is vested with all of the Liquidated Defendants' rights as the customer of any bank, financial institutioti or other depository. The Liquidator is authorized to withdraw the Liquidated Defendants' Property from any such entity or any state or federal agency, or continue the operation of any accounts of Defendants, at his discretion. 2.5 Pursuant to TEX. INS. CODE §21A.154, the Liquidator has all the powers of the Liquidated Defendants' directors, officem, and managers, and the authority of such directors, officers, and managers is suspended, except as permitted by the Liquidator. Q004 http://www,ppciga.org/vestaorder.html 11/14/2006 Page 5 of II The Liquidator is authorized to supervise, suspend, terminate, or dismiss any cir all of the directors, officers, managers, ctrtployeex or agents of the Liquidated Defendants, or retain such persons at his discretion, and compensate them as he deans necessary from the Liquidated Defendants' funds. 2-6 The Liquidator is authorized to retain any professional, administrative, and clerical services as he deems necessary pursuant to TEX. INS. CODE §21 A,154. The Liquidator is further authorized to set the compensation of such persons, and pay for such services from the Liquidated Defendants' funds pursuant to TEX INS. CODE §21A.015(e). 2.7 The Liquidator is authorized to receive, collect, control, open and review all mail addressed to or intended for the Liquidated Defendants. 2.8 The Liquidator is authorized to file, prosecute, defend, or settle any action as he deems necessary, including any action to enforce the provisions of this order. 2.9 The Liquidator is authorised to exclude any person from any property owned, ]cased or occupied by the liquidated Defendants, at his discretion. 2.10 The Liquidator is authorized to assume or reject any contracts to which the. Liquidated D6cndants axe a party at his discretion pursuant to TEX. INS. CODE §21A.013. 2.11 The Liquidator is authorized to pay benefits under workers compensation policies as provided in TEX. INS. CODE §21A.302. 2.12 The Liquidator is authorized to take any action to effectuate any transactions that have been initiated by the Rchabilitator to transfer policies of insurance under TFx. INS. Cate Q21 A.102, and may transfer such policies pursuant to TEX. INS. CODE X21 A. 154(h), 2.13 Pursuant to TEX. 114S. CODE §21A.008(m), the Commissioner is not required to file a band. zoos http://www.ppciga,org/vestaorder.html 11/14/2006 Page 6 of II 2. l4 In the event a successor is appointed to be the Commissioner, the successor shall become the Liquidator upon his appointment as Commissioner, and the former Commissioner shall be discharged as Liquidator as a matter of Iaty. lb 008 2.15 The Liquidator has authorized James A. Guillot, Conservator for the Texas Department of insurance, to act on his behalf, A Special Deputy appointed under M. Pw CODE b21A.102(a) shall also have. all the rights and powers of the Liquidator, Subject to any limitations imposed by the Liquidator. 1.11. PERMANENT INJUNCTION It is FURTHER ORDERED that the Clerk of Ns Court shall issue a Permanent 1r unction against the persons and entities named below, with the following force and effect: TC7: Defgndi,nts pd their agents. includiae but not limited to: Defendants and their current and former officers, trustees, directors and underwriters (including but not limited to David W. Lacefiold, C. David Emery, Stephen P. Russell, Russell K, Grouch, Danny E. Laffey, Michael W, Peters, C. Ray Smith, III, Fred H. Wright, Robert J. McLaughlin, Jr., John W. McCullough, George M. Orin, Ronald A. Deep, Martha Etta Joiner, Bobby L. Nolen, Norman W. Gayle, III, and Donald W, Thornton), owners (including but not limitc4 to Vesta Insurance Group, Inc.), affiliates (including but not limited to J. Gordon Gaines, Inc.), managers, employees, agents, servants, representatives, attorneys, adjusters and other persons or entities acting on behalf of the Liquidated Defendants; Financial institutions, including butnotlitnited to: any and all banks, savings and loam msociations; trust companies, credit unions; welfare trusts; or any other financial or depository institutions in the possession of any of Defendants' Property, and iUl other parties. including; but not limited tQ; policyholders, creditors, claimants, reinsurers, intermediaries, attorneys and all other persons, associations, corporations, or any other legal entities asserting claims or causes of action against Defendants, or in possession of any of Defendants' Property, and the United States Postmaster, http://www.ppciga.org/vestaorder.html 11/14/2006 Page 7 of II 11007 Each of you are hereby RESTRAINED and ENJOINED from taking any and all of the following actions: 3.1 Doing, operating, or conducting Defendants' business under any charter, certificate of authority, license, permit, power or privilege belonging to or issued to Defendants, or exercising any direction, control, or influence over Defendants' business, except through the authority of the Rehabilitator or Liquidator, as applicable, or his designees, 3.2 Transacting any business of Defendants in any manner except through the authority of the Rehabilitator or Liquidator, as applicable, or his'designees; 3.3 Using, releasing, transferring, selling, assigning, canceling, hypothecating, withdrawing, allowing to be withdrawn, offsetting. asserting ownership of, or removing from this Court's jurisdiction or from Defendants' place of bus{ness, any of Defendants' property or any other property purchased by Defendants, or any items into which such property has been transferred, deposited or placed, except through the authority of the Rehabilitator or Liquidator, as applicable, or his designees; a A Wasting, disposing of, converting, dissipating, or concealing, in any manner, any of Defendants' Property; 3.5 Doing anything, directly or indirectly, to prevent the Rehabilitator or Liquidator, or.his designees, from gaining access to, acquiring, examining, or investigating any of Defendants` Property or any other property, books, documents, records, or other materials concerning Defendants' business, under whatever name they may be found; 3.6 Obstructing, or interfering in arty way with the conduct of this proceeding or any incidental investigation as prohibited by TFx. INS. CODE §21 A.01 0(b); http://www.ppciga.org/vestaorder.html 11/14/2006 Page 8 of II Z006 3.7 Intervening in this proceeding for the purpose of obtaining a payment from the receivership estate of the Defendants as prohibited by TEX. INS. CODE X21 A.005(i); 3.9 Making any claim, charge or offset, or commencing or prosecuting any action, appeal, or arbitration, including administrative proceedings, or obtaining any preference, judgment, attachment; garnishment, or other lien, or making any levy against Defendants, their property or any part thereof, or against the Rehabilitator or Liquidator, as applicable, except as permitted by TEX. INS. CODE ANN, Chapter 21 A. EACH OF YOU ARE FURTHER ORDERED to make available arad discloso to the Rehabilitator or Liquidator, as applicable, or his designees, the nature, amount, and location of any and all of the items listed above, including but not limited to Defendants' Property, and immediately surrender all such property to the Rehabilitator or Liquidator, as applicable, or his designees. DEFENDANTS AND THEIR AGENTS ARE FURTHER ORDERED to cooperate with the RehaWitator or Liquidator, as applicable, or his designees, as required by TEx INS, CODE ,521 A.010(a). IT 119 FURTHER ORDERED that the United States Postmaster and any other delivery services shall deliver to the R.ehabilitator or Liquidator, as applicable, or his designees, any items addressed to or intended for Defendants. IV. CONTINUATION OF COVERAGE 4.1 All reinsurance contracts by which the Liquidated Defendants have assumed the insurance obligations of another insurer arc canceled upon entry of this order pursuant to TFX. INS, CODE § 21A.252(a). http://www.ppciga.org/vestaorder.html 11/14/2006 Page 9 of II &ae 4.2 Pursuant to TEx. 1NS. CODE § 2 LA.I52(b), ail policies, insurance contracts, surety bonds or surety undertakings of the Liquidated Defendants in effect at the time of issuance this order, other than life insurance, health insurance or annuities, continue in force only until the earlier of (a) the date of the expiration of the policy; (b) the date the insured has replaced or terminated the policy; (c) August 24, 2006 at 12:01 a.m., the date and time of the Rehabilitator's cancellation of policies issued by all of the Defendants under the authority granted in the Agreed Order Appointing Rehabilliator and Permanent Injunction pursuant to TL X. INS. CODE §21A,I 02(b); or (d) the date that the Liquidator has transferred any policies pursuant to M, INS, CODE §21 A.154(h). In this event, such policies will continue in force with respect to the coverage provided by the insurer to which the policies are transferred, V, STAY OF PROCEEDINGS 5.1 An automatic stay remains in effect with respect to actions against Defendants or their property as provided by TEX, INS. CODE §21 A.008(c). In accordance with TEX. INS. CODE §21 A.008(f), such stay of actions against Defendants is in effect for the duration of this proceeding, and the stay of actions against their property is in effect for as long as the property belongs to the receivership estate. 5.2 An automatic stay remains in effect with respect to actions against a person insured by Defendants as provided by TeX. INS. CODE §21A.008(d). Such stay is in effect for 90 http://www,ppciga.org/vestaorder.html 11/14/2006 Page 10 of II days after the entry of the Agreed Order Appointing Rehabititator and Permanent Injunction, unless extended by this Court. 5.3 The stays in effect pursuant to TEx. INS. CODE §21A.008 shall be applicable to any actions described therein commenced either before or after the entry of this order. 'I. o,rHER ORDERS 6.1 Vesta Insurance Corporation shall remain subject to the Agreed Order Appointing Rehabilitator and Permanent Injunction, and such order will continue in full farce and effect with respect to Vesta Insurance Corporation. The Commissioner will continue to act as Rehabilitator of Vesta Insurance Corporation. 62 This Order Appointing Liquidator and Permanent Injunction shall issue and become etTective immediately, and shall continue in full force and effect until the entry of an order by this Court terminating this proceeding under TEX, INS. COD §21 A.352. 6.3 Pursuant to TEX. INS. Corp §21A.055(b), this Order Appointing Liquidator and Permanent Injunction constitutes a final judgment, provided that this Court shall retain jurisdiction to issue further orders pursuant to TEX. Infs. CODE MN. Chapter 2IA. 6A The terms of this Order Appointing Liquidator and Permanent Injunction shall not be construed to infringe upon the authority of any state insurance regulator in connection with any of Defendants' affiliates th4t are domiciled in other states. 6.5 Pursuant to TFx. INS, CODE y21A.009(e), the Liquidator may provide notice of any application in the time periods prescribed in Rule 21 (a) of the 'texas Rules of Civil Procedure if he determines that an expedited hearing is necessary. In accordance witlx Zola llttp://www.ppciga.org/vestaorder.html 11/14/2006 • • Page II of II laotl nx. LAS. CODE §21A.007(d), the Liquidator may provide notice of any application by first class mail, electronic snail, or facsimile transmission, at his discretion. 6.6 The State of Texas and the Attorney General of Texas shall have a claim for reasonable attorneys' fees and court costs pursuant to TEx. Crv. PRAc. & RF,M. CoDL ANN. ?§ 64.051 and 66.003 and TEx. GOVT CODE § 402.006, and the amount and payment of such claim are subject to the provisions of TEX. INS, CODE A.NN, Chapter 21 A. 6.7 Anyone over the age of 18 whom is not a party to nUr interested in the outcome of this suit may serve all citations, writs and notices in this cause. SIGNED at Austin, Travis County, Texas, on this the I day of r ' , 2006, at o'clock M. 4- •, f DISTRICT D E PR-ESID?P'11 SUBM17rED NO HEARING REQUIRED. REGQMMFND?-f SIGNED ON -DAY Q? -r?:' •?5 #1 TOM COLLINS. RECCIVI:'$µits SPECIA 6TER http://www.ppciga.org/vestaorder.htmi 11/14/2006 C? C3? Marshall Dennehey Warner Coleman & Goggin By: Christopher M. Reeser, Esquire ID# 73632 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 717-651-3509 Our File No. 16235-00111 Attorney for Defendant JAMES A. BURGETT a/k/a IN THE COURT OF COMMON PLEAS JAMES BURGETT CUMBERLAND COUNTY, PENNSYLVANIA Plaintiff VS. MYONG NYO KRYZKOWSKI Defendant NO 2002-03647 CIVIL ACTION - LAW STIPULATION The parties do hereby stipulate and agree that Defendant's Answer with New Matter is hereby amended consistent with the document attached hereto. Plaintiff shall have 20 days to file a reply to Defendant's Amended New Matter. AL AN V MARSHALL ENNEHEY WARN C MAN & GOGGIN By: Robert F. aval, squir Christopher M. Reeser, Esquire Attorney for Plaintiff Attorney for Defendant Lang 500 North Third Street, 2nd Floor I.D. 73632 Harrisburg, PA 17101 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 (717) 651-3509 cat C-z Marshall Dennehey Warner Coleman & Goggin By: Christopher M. Reeser, Esquire ID# 73632 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 717-651-3509 Our File No. 16235-00111 Attorney for Defendant JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff VS. MYONG NYO KRYZKOWSKI Defendant IN THE COURT OF COMMON PLEAS CUMBERLAND COUNTY, : PENNSYLVANIA : NO 2002-03647 : CIVIL ACTION - LAW CERTIFICATE OF SERVICE I, Christopher M. Reeser, Esquire, of Marshall, Dennehey, Warner, Coleman & Goggin, do hereby certify that on November 28, 2006, I served a copy of Defendant's Amended Answer with New Matter re: PIGA Offset via First Class United States mail, postage prepaid as follows: Robert F. Claraval, Esquire Claraval and Claraval 500 North Third Street, 2nd Floor Harrisburg, PA 17101-1167 Attorney for Plaintiff Christopher M. Reeser r-> ca p ..? ca ?- I Robert F. Claraval, Esq. CLARAVAL & CLARAVAL 500 North Third Street, 2nd Floor Harrisburg, PA 17101 (717) 2334780 Supreme Court I.D. 19222 Attorney for Plaintiff JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 : CIVIL ACTION -LAW PLAINTIFF'S REPLY TO DEFENDANT'S AMENDED ANSWER WITH NEW MATTER RE: PIGA OFFSET 34. No answer is required. 35. Admitted. 36. Admitted. 37. Admitted. 38. Admitted. 39. Denied. Paragraph 39 is a conclusion of law to which no response is required. 40. It is admitted that certain of Plaintiff James Burgett's bills were paid by other sources. 41. Denied. Paragraph 41 is a conclusion of law to which no response is required. CLARAVAL & CLARAVAL Date: ?v O?o By (C" , )"? OBERT F. ARAVAL 500 North Third Street, 2nd Floor Harrisburg, PA 17101 (717) 233-4780 Supreme Court I.D. #19222 Attorneys for Plaintiff VERIFICATION I, Robert F. Claraval, being duly sworn according to law, depose and state that I am the attorney for the Plaintiff in this action and that the information contained in the foregoing document is true and correct to the best of my knowledge, information, and belief. I understand that any false statements herein are made subject to the penalties of 18 Pa.C.S.A. §4904, relating to unworn falsification to authorities. JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA : No. 2002-03647 : CIVIL ACTION -LAW CERTIFICATE OF SERVICE I hereby certify that I have this day served a true and correct copy of the attached Plaintiff s Reply to Defendant's Amended Answer with New Matter Re: PIGA Offset by first class mail, postage prepaid, addressed to the following person: Christopher M. Reeser, Esq. Marshall, Dennehey, Warner, Coleman & Goggin 4200 Crums Mill Road, Suite B Harrisburg, PA 17112 CLARAVAL & CLARAVAL Date: (v ZOO BY )k ri ?? do no DENISE I. WILLIAMS ??;=:; ? ? ins r?=? -,-; = ?'? c? c° sr .. ? _F?tiJ { (,.t ' t ?? S } ? .-.. ? ?,? t fiJ + ..4 y ,. a ma . .e# ...__ {.rte ? .,,3 "'E. JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant : IN THE COURT OF COMMON PLEAS OF : CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 : CIVIL ACTION -LAW CERTIFICATE OF SERVICE I hereby certify that I have this day served the attached Answers to Interrogatories Directed to Plaintiff James A. Burgett by first class mail, postage prepaid, addressed to the following person: Christopher M. Reeser, Esq. Marshall, Dennehey, Warner, Coleman & Goggin 4200 Cruxes Mill Road, Suite B Harrisburg, PA 17112 CLARAVAL & CLARAVAL Date: Ia119-010-0 By W DENISE I. WILLIAMS ? rIO CD , { ~+.f (J .13 (j) JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant TO THE PROTHONOTARY: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 CIVIL ACTION -LAW PRAECIPE Please mark the above captioned action settled and discontinued. CLARAVAL & CLARAVAL Date: 47 Ir- - By. ROBERT F. VITARAVAL 500 North Third Street, 2"d Floor Harrisburg, PA 17101 (717) 233-4780 Supreme Court I.D. # 19222 Attorneys for Plaintiff C3 ro t,,, + - JAMES A. BURGETT a/k/a JAMES BURGETT Plaintiff V. MYONG NYO KRZYKOWSKI, Defendant TO THE PROTHONOTARY: IN THE COURT OF COMMON PLEAS OF CUMBERLAND COUNTY, PENNSYLVANIA No. 2002-03647 CIVIL ACTION -LAW PRAECIPE Please mark the above captioned action settled and discontinued. CLARAVAL & CLARAVAL Date: '-?).n314 16 r7 By ROBERT F. ARAVAL 500 North Third Street, 2nd Floor Harrisburg, PA 17101 (717) 233-4780 Supreme Court I.D. # 19222 Attorneys for Plaintiff o C? 0 Xm Q