Miscellaneous: WATSON, WANDA vs AMERICAN INTEGRITY INSURANCE C

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                                Filing # 86569573 E-Filed 03/18/2019 04:22:28 PM

FORM 1.997. CIVIL COVER SHEET

The civil cover sheet and the information contained in it neither replace nor supplement the filing and service of pleadings
or other documents as required by law. This form must be filed by the plaintiff or petitioner for the use of the Clerk of
Court for the purpose of reporting judicial workload data pursuant to section 25.075, Florida Statutes. (See instructions for

completion.)
I CASE STYLE
IN THE CIRCUIT COURT OF THE THIRD JUDICIAL CIRCUIT,
IN AND FOR MADISON COUNTY, FLORIDA
Case No..:
Judge:
Wanda Watson
Plaintiff
vs.
American Integrity Insurance Company of Florida
Defendant
I. TYPE OF CASE
O - Non-homestead residential foreclosure
OD Condominium $250,00 or more
| Contracts and indebtedness G Other real property actions $0 - $50,000
Eminent domain O _ Other real property actions $50,001 - $249,999
D Auto negligence 0 Other real property actions $250,000 or more
O Negligence — other | |
OO Business governance O Professional malpractice
Business torts QO Malpractice — business
OG  Environmental/Toxic tort O Malpractice — medical
Ol Third party indemnification OQ Malpractice — other professional
O Construction defect O Other
OO Mass tort QO  Antitrust/Trade Regulation
go Negligent security Q Business Transaction
ga Nursing home negligence O Circuit Civil - Not Applicable
g Premises liability — commercial a Constitutional challenge-statute or
Premises liability — residential ordinance
O Prod liabili © Constitutional challenge-proposed
OO Products liability amendment
0 Real Property/Mortgage foreclosure g Corporate Trusts
G Commercial foreclosure $0 - $50,000 od Discrimination-employment or other
QO Commercial foreclosure $50,001 - $249,999 1 insurance claims
O Commercial foreclosure $250,000 or more Intellectual property
O Homestead residential foreclosure $0 — 50,000 a Libel/Slander
a ooresea residential foreclosure $50,001 - 1 Shareholder derivative action
OO _ Homestead residential foreclosure $250,000 or O Securities litigation
more oO Trade secrets
© Non-homestead residential foreclosure $0 - O Trust litigation
$50,000
O _Non-homestead residential foreclosure

$50,001 - $249,999

Electronically Filed Madison Case # 19000023CAAXMX 03/18/2019 04:22:28 PMCOMPLEX BUSINESS COURT

This action is appropriate for assignment to Complex Business Court as delineated and mandated by the
Administrative Order. Yes | No

mM. REMEDIES SOUGHT (check all that apply):
Monetary;
O Non-monetary declaratory or injunctive relief;
OD Punitive

lV. NUMBER OF CAUSES OF ACTION: (__)
(Specify)

L

Vv. IS THIS CASE A CLASS ACTION LAWSUIT?
O Yes
No

Vi. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
No
O Yes - If “yes” list all related cases by name, case number and court:

vil. IS JURY TRIAL DEMANDED IN COMPLAINT?
Yes
G No

| CERTIFY that the information | have provided in this cover sheet is accurate to the best of my knowledge and belief, and
that | have read and will comply with the requirements of Florida Rule of Judicial Administration 2.425.

Signature s/ Robert L Ehrhardt FL Bar No.: 10381
Attorney or party (Bar number, if attorney)

Robert L Ehrhardt 03/18/2019
(Type or print name) Date