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Filing # 141153808 E-Filed 12/30/2021 03:35:19 PM
RETURN OF SERVICE
State of Florida County of Palm Beach Circuit Court
Case Number: 50-2021-CA-010108
Piaintiff,:
MARION J. YOUNG BUTERA and THOMAS BUTERA, her spouse
vs.
Defendants,:
EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA and THE
BRIGHT VIEW LANDSCAPES, LLC
For:
David J. Majcak, Esq.
Goldberg Segalla, LLP
222 Lakeview Avenue
Suite 800
West Paim Beach, FL 33401
Received by Williams Process Service, Inc. on the 16th day of December, 2021 at 9:00 am to be served on Records
Custodian: Woolbvright Physical Therpay Re: Marion J. Young Butera, 2015 Ocean Drive, Suite 1, Boynton
Beach, FL 33435.
|, Pennie Atwell, do hereby affirm that on the 20th day of December, 2021 at 2:00 pm, I:
served a CORPORATION by delivering a true copy of the Subpoena Duces Tecum Without Deposition and
Notice of Production from Non-Party with the date and hour of service endorsed thereon by me, to: Lydia Colton
as Records Custodian for Woolbvright Physical Therpay, at the address of: 2015 Ocean Drive, Suite 1, Boynton
Beach, FL 33435, and informed said person of the contents therein, in compliance with state statutes.
Description of Person Served: Age: 50, Sex: F, Race/Skin Color: White, Height: 5'6*, Weight: 160, Hair: Dark
Brown, Glasses: N
Under penaities of perjury, | declare that | have read the foregoing and that the facts stated in it are true. | am over
the age of eighteen, have no interest in the above action and am a Certified Process Server in good standing in the
circuit in which service was effected in accordance with State Statutes.
ds/ Pennie Atwell
Pennie Atwell
C.P.S.# 931
Williams Process Service, Inc.
721 US Highway 1
Suite 121
North Palm Beach, FL 33408
(561) 881-1442
Our Job Serial Number: WPS-2021023358
Ref: 16214.0040
‘Copyright © 1992-2021 Database Services, Ine, - Process Servers Tootbox VB.25
*** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 12/30/2021 03:35:19 PM ***21358
IN THE CIRCUIT COURT OF THE [5th
JUDICIAL CIRCUIT IN AND FOR PALM
BEACH COUNTY, FLORIDA
MARION J. YOUNG BUTERA
AND THOMAS BUTERA, her spouse,
Plaintiffs, CASE NO: 50-2021-CA-010108
ve
EDENS LIMITED PARTNERSHIP d/b/a
SUNSHINE SQUARE PLAZA and THE
BRIGHTVIEW LANDSCAPES, LLC,
Defendants.
EDENS LIMITED PARTNERSHIP d/b/a
SUNSHINE SQUARE PLAZA,
Cross-Plaintiff,
v.
THE BRIGHTVIEW LANDSCAPES, LLC,
Cross-Defendants.
SUBPOEN, CES TECUM WIT! 'T DEPOSITIO:
To: Records Custodian:
Woolbright Physical Therapy
2015 Ocean Dr., Suite 1
Boynton Beach, FL 83426 23435"
HIPAA NOTICE: In accordance with the provisions of 45 C.P.R. 164,512(3)(1), we have previously
notified Plaintiff's counsel of our request for the above-referenced information pursuant to a Notice of Production
from Non-Party dated the 2nd day of December, 2021. This Notice included sufficient information about the above-
captioned matter to provide an opportunity for the Plaintiff to raise an objection with the Court. The time for the
Plaintiff to raise objections has tapsed and no objections were filed or all objections filed have becn resolved by this
Court.
YOU ARE COMMANDED TO EMAIL TO THE BELOW EMAIL ADDRESSES or MAIL
TO: David Majcak, Esquire, Goldberg Segalla, LLP, at our central mail address: P.O, Box 787, Buffalo, NY 14201,
within ten (10) days of service hereof, the following:
Any and all medical records, including but not limited to reports of physical examination, films, x- ~
rays, x-ray reports, copies of CT scans, CT scan reports, copies of MRI's, MRI reports, admission records,
notes on attendance and/or treatment, memoranda, telephone memorandum slips, laboratory studies,
records of physical therapy, reports of physical therapy, medication records, consultation records, medical
bills, ledgers, balance ledger, payment ledger, financial transaction listing, hospital records, liens and/or
31234993.vtletters of protection, and any all records whatsoever you may have in your possession or control for the
following:
NAME OF PATIENT : MARION J. YOUNG BUTERA
DATE OF BIRTH z
SOCIAL SECURITY NO :
INAI IR AY: LY DISCREPANCH| LI
IN AN EFFORT TO AVOID ANY DISCREPANCIES AND DUPLICATION OF RECORDS,
If IS HEREBY REQUESTED THAT A COPY OF THIS SUBPOENA BE ATTACHED TO.
YOUR RECORDS.
‘You must produce each and every piece of paper contained in your files regarding the patient, whether or not
prepared by you {i.e., including letters or records sent to you from other healthcare providers).
Pursuant to Florida Statutes 456.057(17) and Florida Administrative Code § 64-B8-10.003, a fee of
$1.00 per page for the first twenty-five (25) pages and $0.25 cents per page for each additional page will be paid
for the photocopying of said records. IF THE FEE FOR PHOTOCOPYING EXCEEDS FIFTY ($50.00)
DOLLARS, PLEASE CONTACT THE UNDERSIGNED IN ADVANCE OF THE COPYING FOR
AUTHORIZATION TO DO SO. IC it is necessary to have the fee paid in advance or if the records cannot be
gathered by the appointed date, please contact the undersigned on or before the date on the Subpoena and
arrangements will be made.
You have the right to object to the production pursuant to this Subpoena at any time before production by
giving written notice to the attorney whose name appears on this Subpoena. THIS WILL NOT BE A DEPOSITION,
NO TESTIMONY WILL BE TAKEN.
Ifyou fail to: (1) furnish the records; or (2) object to this Subpoena, you may be in contempt of Court. You
are subpoenaed by the attorney whose name appears on this Subpoena and unless excused from this Subpoena by the
attorney whose name appears on this Subpoena or the court, you shall respond to this subpoena as directed,
DATED this 12th day of December, 2021
DAVID MAJCAK
For the Court
Jsi David Majcak.
GOLDBERG SEGALLA, LLP
David J. Majeak, Esquire
Florida Bar No. 0073883
222 Lakeview Avenue, Suite 800
West Palm Beach, FL 33401
(561) 618-4469 Office
(561) 618-4549 Fax
email designations:
dmaical Ha.
dharrison@goldbergsegalia.com
31234993.v1
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Filing # 141153808 E-Filed 12/30/2021 03:35:19 PM RETURN OF SERVICE State of Florida County of Palm Beach Circuit Court Case Number: 50-2021-CA-010108 Piaintiff,: MARION J. YOUNG BUTERA and THOMAS BUTERA, her spouse vs. Defendants,: EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA and THE BRIGHT VIEW LANDSCAPES, LLC For: David J. Majcak, Esq. Goldberg Segalla, LLP 222 Lakeview Avenue Suite 800 West Paim Beach, FL 33401 Received by Williams Process Service, Inc. on the 16th day of December, 2021 at 9:00 am to be served on Records Custodian: Woolbvright Physical Therpay Re: Marion J. Young Butera, 2015 Ocean Drive, Suite 1, Boynton Beach, FL 33435. |, Pennie Atwell, do hereby affirm that on the 20th day of December, 2021 at 2:00 pm, I: served a CORPORATION by delivering a true copy of the Subpoena Duces Tecum Without Deposition and Notice of Production from Non-Party with the date and hour of service endorsed thereon by me, to: Lydia Colton as Records Custodian for Woolbvright Physical Therpay, at the address of: 2015 Ocean Drive, Suite 1, Boynton Beach, FL 33435, and informed said person of the contents therein, in compliance with state statutes. Description of Person Served: Age: 50, Sex: F, Race/Skin Color: White, Height: 5'6*, Weight: 160, Hair: Dark Brown, Glasses: N Under penaities of perjury, | declare that | have read the foregoing and that the facts stated in it are true. | am over the age of eighteen, have no interest in the above action and am a Certified Process Server in good standing in the circuit in which service was effected in accordance with State Statutes. ds/ Pennie Atwell Pennie Atwell C.P.S.# 931 Williams Process Service, Inc. 721 US Highway 1 Suite 121 North Palm Beach, FL 33408 (561) 881-1442 Our Job Serial Number: WPS-2021023358 Ref: 16214.0040 ‘Copyright © 1992-2021 Database Services, Ine, - Process Servers Tootbox VB.25 *** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 12/30/2021 03:35:19 PM ***21358 IN THE CIRCUIT COURT OF THE [5th JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA MARION J. YOUNG BUTERA AND THOMAS BUTERA, her spouse, Plaintiffs, CASE NO: 50-2021-CA-010108 ve EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA and THE BRIGHTVIEW LANDSCAPES, LLC, Defendants. EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA, Cross-Plaintiff, v. THE BRIGHTVIEW LANDSCAPES, LLC, Cross-Defendants. SUBPOEN, CES TECUM WIT! 'T DEPOSITIO: To: Records Custodian: Woolbright Physical Therapy 2015 Ocean Dr., Suite 1 Boynton Beach, FL 83426 23435" HIPAA NOTICE: In accordance with the provisions of 45 C.P.R. 164,512(3)(1), we have previously notified Plaintiff's counsel of our request for the above-referenced information pursuant to a Notice of Production from Non-Party dated the 2nd day of December, 2021. This Notice included sufficient information about the above- captioned matter to provide an opportunity for the Plaintiff to raise an objection with the Court. The time for the Plaintiff to raise objections has tapsed and no objections were filed or all objections filed have becn resolved by this Court. YOU ARE COMMANDED TO EMAIL TO THE BELOW EMAIL ADDRESSES or MAIL TO: David Majcak, Esquire, Goldberg Segalla, LLP, at our central mail address: P.O, Box 787, Buffalo, NY 14201, within ten (10) days of service hereof, the following: Any and all medical records, including but not limited to reports of physical examination, films, x- ~ rays, x-ray reports, copies of CT scans, CT scan reports, copies of MRI's, MRI reports, admission records, notes on attendance and/or treatment, memoranda, telephone memorandum slips, laboratory studies, records of physical therapy, reports of physical therapy, medication records, consultation records, medical bills, ledgers, balance ledger, payment ledger, financial transaction listing, hospital records, liens and/or 31234993.vtletters of protection, and any all records whatsoever you may have in your possession or control for the following: NAME OF PATIENT : MARION J. YOUNG BUTERA DATE OF BIRTH z SOCIAL SECURITY NO : INAI IR AY: LY DISCREPANCH| LI IN AN EFFORT TO AVOID ANY DISCREPANCIES AND DUPLICATION OF RECORDS, If IS HEREBY REQUESTED THAT A COPY OF THIS SUBPOENA BE ATTACHED TO. YOUR RECORDS. ‘You must produce each and every piece of paper contained in your files regarding the patient, whether or not prepared by you {i.e., including letters or records sent to you from other healthcare providers). Pursuant to Florida Statutes 456.057(17) and Florida Administrative Code § 64-B8-10.003, a fee of $1.00 per page for the first twenty-five (25) pages and $0.25 cents per page for each additional page will be paid for the photocopying of said records. IF THE FEE FOR PHOTOCOPYING EXCEEDS FIFTY ($50.00) DOLLARS, PLEASE CONTACT THE UNDERSIGNED IN ADVANCE OF THE COPYING FOR AUTHORIZATION TO DO SO. IC it is necessary to have the fee paid in advance or if the records cannot be gathered by the appointed date, please contact the undersigned on or before the date on the Subpoena and arrangements will be made. You have the right to object to the production pursuant to this Subpoena at any time before production by giving written notice to the attorney whose name appears on this Subpoena. THIS WILL NOT BE A DEPOSITION, NO TESTIMONY WILL BE TAKEN. Ifyou fail to: (1) furnish the records; or (2) object to this Subpoena, you may be in contempt of Court. You are subpoenaed by the attorney whose name appears on this Subpoena and unless excused from this Subpoena by the attorney whose name appears on this Subpoena or the court, you shall respond to this subpoena as directed, DATED this 12th day of December, 2021 DAVID MAJCAK For the Court Jsi David Majcak. GOLDBERG SEGALLA, LLP David J. Majeak, Esquire Florida Bar No. 0073883 222 Lakeview Avenue, Suite 800 West Palm Beach, FL 33401 (561) 618-4469 Office (561) 618-4549 Fax email designations: dmaical Ha. dharrison@goldbergsegalia.com 31234993.v1