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Filing # 150041392 E-Filed 05/20/2022 04:42:04 PM
IN THE CIRCUIT COURT OF THE FIFTH
JUDICIAL CIRCUIT IN AND FOR LAKE
COUNTY, FLORIDA
ERLENE FEDRICK,
Plaintiff,
vs.
CASE NO: 2022-CA-754
PATRICK DONALD HENES and ARCH CIVIL DIVISION
INSURANCE COMPANY, a Foreign Profit
Corporation,
Defendants
/
NOTICE OF SERVICE OF MOTOR VEHICLE NEGLIGENCE
INTERROGATORIES TO PLAINTIFF, ERLENE FEDRICK
The Plaintiff, ERLENE FEDRICK, is hereby requested to and required to answer the
attached Motor Vehicle Negligence Interrogatories propounded by the Defendant, PATRICK
DONALD HENES, under oath, and further, in accordance with the Florida Rules of Civil
Procedure 1.340.
CERTIFICATE OF SERVICE
I] HEREBY CERTIFY that a true and correct copy of the above and foregoing has been
furnished via E-Mail on May 20, 2022 to Devry R. Kelley, Esquire, Dan Newlin & Partners
(Orlando), Attorney for Plaintiff, Erlene Fedrick,
Devry.pleadings@newlinlaw.com;Devry.Kelley@newlinlaw.com;Patricia.Croc@newlinlaw.com
, B21) 234-3859/(863) 225-9853 (F).
Law Office of Terryl Blackmon Walker
Attorneys for Defendant
901 N. Lake Destiny Rd., Suite 105
Maitland, FL 32751
(407) 618-8935 (Asst.)/(407) 949-3450 (Direct)
Fax: (866) 516-8617
SERVICE DESIGNATIONS:
Primary: NOFLBI@progressive.com
Secondary: akapsall@progressive.com
FILED: LAKE COUNTY, GARY J. COONEY, CLERK, 05/23/2022 09:16:00 AM
Case No: 2022-CA-754
“Yl Kapsates
By:
AYDA KAPSALES, ESQUIRE
Florida Bar No. 98224
“Salaried Employees of Progressive Casualty Insurance Company”
Case No: 2022-CA-754
MOTOR VEHICLE NEGLIGENCE INTERROGATORIES TO PLAINTIFF
ERLENE FEDRICK
Please insert your answer in the space provided following each question. If additional
space is needed, so indicate in the space provided; prepare your answer on a separate paper and
attach.
What is the name and address of the person answering these Interrogatories, and, if
applicable, the person's official position or relationship with the party to whom the
interrogatories are directed?
List the names, business addresses, dates of employment and rates of pay regarding all
employers, including self-employment, for whom you have worked in the past ten (10)
years.
If you were employed at the time of the accident which is the subject of this case,
describe your job and its responsibilities.
If you returned to work since the incident described in the Complaint, state the date
of your return and if you are doing the same work you did before this incident
Case No: 2022-CA-754
List all former names and when you were known by those names. State all addresses where
you have lived for the past ten (10) years, the dates you lived at each address, your social
security number, your date of birth, and if you are or have ever been married, the name of
your spouse or spouses.
Have you ever been convicted of a crime, other than any juvenile adjudication, which under
the law under which you were convicted was punishable by death or imprisonment in
excess of one year, or that involved dishonesty or a false statement regardless of the
punishment? If so, state as to each conviction, the specific crime, the date and the place of
conviction.
Were you suffering from physical infirmity, disability, or sickness at the time of the
incident described in the Complaint? If so, what was the nature of the infirmity, disability,
or sickness?
Case No: 2022-CA-754
Did you consume any alcoholic beverages or take any drugs or medication within twelve
(12) hours before the time of the incident described in the complaint? If so, state the type
and amount of alcoholic beverages, drugs or medication which were consumed and when
and where you consumed them.
Describe in detail how the incident described in the complaint happened, including all
actions taken by you to prevent the incident.
Describe in detail each act or omission on the part of any party to this lawsuit that you
contend constituted negligence that was a contributing legal cause of the incident in
question.
Case No: 2022-CA-754
Were you charged with any violation of law (including any regulations or ordinances)
arising out of the incident described in the Complaint? If so, what was the nature of the
charge; what plea, or answer, if any, did you enter to the charge; what court or agency
heard the charge; was any written report prepared by anyone regarding this charge, and if
so, what is the name and address of the person or entity that prepared the report; do you
have a copy of the report; and was the testimony at any trial, hearing, or other proceeding
on the charge recorded in any manner, and, if so, what was the name and address of the
person who recorded the testimony?
10. Describe each injury for which you are claiming damages in this case, specifying the part
of your body that was injured, the nature of the injury, and as to any injuries you contend
are permanent, the effects on you that you claim are permanent.
11 List each item of expense or damage, other than loss of income or earning capacity, that
you claim to have incurred as a result of the incident described in the Complaint, giving
for each item the date incurred, the name and business address to whom each was paid or
is owed, and the goods or services for which each was incurred.
Case No: 2022-CA-754
12 Do you contend that you have lost any income, benefits, or earning capacity in the past or
future as a result of the incident described in the Complaint? If so, state the nature of the
income, benefits, or earning capacity, and the amount and the method that you used in
computing the amount.
13. Has anything been paid or is anything payable from any third party for the damages listed
in your answers to these Interrogatories? If so, state the amounts paid or payable, the name
and business address of the person or entity who paid or owes said amounts, and which of
those third parties have or claim a right of subrogation.
14 List the names and business addresses of each physician who has treated or examined you,
and each medical facility where you have received any treatment or examination for the
injuries for which you seek damages in this case; and state as to each the date of treatment
or examination and the injury or condition for which you were examined or treated.
Case No: 2022-CA-754
15. List the names and business addresses of all other physicians, medical facilities or other
health care providers by whom or at which you have been examined or treated in the past
ten (10) years; and state as to each the dates of examination or treatment and the condition
or injury for which you were examined or treated.
16. List the names and addresses of all persons who are believed or known by you, your agents
or attorneys to have any knowledge concerning any of the issues in this lawsuit; and specify
the subject matter about which the witness has knowledge.
17. Have you heard or do you know about any statement or remark made by or on behalf of
any party to this lawsuit, other than yourself, concerning any issue in this lawsuit? If so,
state the name and address of each person who made the statement or statements, the name
and address of each person who heard it, and the date, time, place and substance of each
statement.
Case No: 2022-CA-754
18 State the name and address of every person known to you, your agents, or attorneys, who
has knowledge about, or possession, custody or control of any model, plat, map, drawing,
motion picture, video tape, or photograph pertaining to any fact or issue involved in this
controversy; and describe as to each, what such person has, the name and address of the
person who took or prepared it, and the date it was taken or prepared.
19 Do you intend to call any expert witnesses at the trial of this case? If so, state as to each
such witness the name and business address of the witness, the witness's qualifications as
an expert, the subject matter upon which the witness is expected to testify, the substance
of the facts and opinions to which the witness is expected to testify, and a summary of the
grounds for each opinion.
20. Have you made an agreement with anyone that would limit that party's liability to anyone
for any of the damages sued upon in this case? If so, state the terms of the agreement and
the parties to it.
Case No: 2022-CA-754
21. Please state if you have ever been a party, either plaintiff or defendant, in a lawsuit other
than the present matter and if so, state whether you were plaintiff or defendant, the nature
of the action, and the date and court in which such suit was filed.
22. At the time of the incident described in the Complaint, were you wearing a seat belt? If
not, please state why not; where you were seated in the vehicle; and whether the vehicle
was equipped with a seat belt that was operational and available for your use.
23. Did any mechanical defect in the motor vehicle in which you were riding at the time of the
incident described in the Complaint contribute to the incident? If so, describe the nature
of the defect and how it contributed to the incident.
Case No: 2022-CA-754
24 Please identify by date, location and nature (type of accident) all accidents in which you
were involved before and after the incident involved in this lawsuit, regardless of whether
or not you were injured. ("Accidents" covers all types of incidents, and includes, but is not
limited to motor vehicle accidents).
25 As to each accident identified in response to question 24, please state whether or not you
were injured, and if injured, state the nature of the injury, if it was permanent, and the full
name and address of all physicians and medical/chiropractic providers by whom you were
treated.
26 Please identify all claims made by you for personal injuries with any insurance company
or individual (excluding court (cases) including the date of the claim, the nature of the
claim, and the name and address of the individual or business entity against whom the
claim was made or filed.
Case No: 2022-CA-754
27 Please state whether or not you have filed a claim for worker's compensation,
unemployment compensation, or social security disability benefits within the past 10 years.
If so, please state the date of each claim, the name and address of the individual/agency
with whom the claim was made, and the amount of benefits received.
28 With regard to any and all cell phones you had access to on the date of the accident
described in the Complaint, please state:
a. The name and address of the carrier/provider for each cell phone.
b The telephone number, including the area code for each cell phone.
The billing account number for each cell phone.
The name and address of the account holder for each cell phone.
29 List the name, business address, telephone number, named insured, policy number, (both
group and individual number) and applicable dates of coverage for all health insurance
companies, life insurance companies and disability insurance companies, who have
provided coverage for you in the past ten (10) years.
Case No: 2022-CA-754
30. Identify all social/professional networking websites that Plaintiff is registered with
currently (such as Facebook, LinkedIn, Tinder, MyLife, etc.).
BY:
Name: ERLENE FEDRICK
STATE OF FLORIDA }
} ss
COUNTYOF_
Sworn to (or affirmed) and subscribed before me by means of 0 physical presence or 0 online
notarization, this day of 20 by
who is personally known to me (or has produced as identification)
and did/did not take an oath.
BY:
Name:
NOTARY PUBLIC STATE OF FLORIDA
Commission Expires/Serial No./Seal
Preview
Filing # 150041392 E-Filed 05/20/2022 04:42:04 PM IN THE CIRCUIT COURT OF THE FIFTH JUDICIAL CIRCUIT IN AND FOR LAKE COUNTY, FLORIDA ERLENE FEDRICK, Plaintiff, vs. CASE NO: 2022-CA-754 PATRICK DONALD HENES and ARCH CIVIL DIVISION INSURANCE COMPANY, a Foreign Profit Corporation, Defendants / NOTICE OF SERVICE OF MOTOR VEHICLE NEGLIGENCE INTERROGATORIES TO PLAINTIFF, ERLENE FEDRICK The Plaintiff, ERLENE FEDRICK, is hereby requested to and required to answer the attached Motor Vehicle Negligence Interrogatories propounded by the Defendant, PATRICK DONALD HENES, under oath, and further, in accordance with the Florida Rules of Civil Procedure 1.340. CERTIFICATE OF SERVICE I] HEREBY CERTIFY that a true and correct copy of the above and foregoing has been furnished via E-Mail on May 20, 2022 to Devry R. Kelley, Esquire, Dan Newlin & Partners (Orlando), Attorney for Plaintiff, Erlene Fedrick, Devry.pleadings@newlinlaw.com;Devry.Kelley@newlinlaw.com;Patricia.Croc@newlinlaw.com , B21) 234-3859/(863) 225-9853 (F). Law Office of Terryl Blackmon Walker Attorneys for Defendant 901 N. Lake Destiny Rd., Suite 105 Maitland, FL 32751 (407) 618-8935 (Asst.)/(407) 949-3450 (Direct) Fax: (866) 516-8617 SERVICE DESIGNATIONS: Primary: NOFLBI@progressive.com Secondary: akapsall@progressive.com FILED: LAKE COUNTY, GARY J. COONEY, CLERK, 05/23/2022 09:16:00 AM Case No: 2022-CA-754 “Yl Kapsates By: AYDA KAPSALES, ESQUIRE Florida Bar No. 98224 “Salaried Employees of Progressive Casualty Insurance Company” Case No: 2022-CA-754 MOTOR VEHICLE NEGLIGENCE INTERROGATORIES TO PLAINTIFF ERLENE FEDRICK Please insert your answer in the space provided following each question. If additional space is needed, so indicate in the space provided; prepare your answer on a separate paper and attach. What is the name and address of the person answering these Interrogatories, and, if applicable, the person's official position or relationship with the party to whom the interrogatories are directed? List the names, business addresses, dates of employment and rates of pay regarding all employers, including self-employment, for whom you have worked in the past ten (10) years. If you were employed at the time of the accident which is the subject of this case, describe your job and its responsibilities. If you returned to work since the incident described in the Complaint, state the date of your return and if you are doing the same work you did before this incident Case No: 2022-CA-754 List all former names and when you were known by those names. State all addresses where you have lived for the past ten (10) years, the dates you lived at each address, your social security number, your date of birth, and if you are or have ever been married, the name of your spouse or spouses. Have you ever been convicted of a crime, other than any juvenile adjudication, which under the law under which you were convicted was punishable by death or imprisonment in excess of one year, or that involved dishonesty or a false statement regardless of the punishment? If so, state as to each conviction, the specific crime, the date and the place of conviction. Were you suffering from physical infirmity, disability, or sickness at the time of the incident described in the Complaint? If so, what was the nature of the infirmity, disability, or sickness? Case No: 2022-CA-754 Did you consume any alcoholic beverages or take any drugs or medication within twelve (12) hours before the time of the incident described in the complaint? If so, state the type and amount of alcoholic beverages, drugs or medication which were consumed and when and where you consumed them. Describe in detail how the incident described in the complaint happened, including all actions taken by you to prevent the incident. Describe in detail each act or omission on the part of any party to this lawsuit that you contend constituted negligence that was a contributing legal cause of the incident in question. Case No: 2022-CA-754 Were you charged with any violation of law (including any regulations or ordinances) arising out of the incident described in the Complaint? If so, what was the nature of the charge; what plea, or answer, if any, did you enter to the charge; what court or agency heard the charge; was any written report prepared by anyone regarding this charge, and if so, what is the name and address of the person or entity that prepared the report; do you have a copy of the report; and was the testimony at any trial, hearing, or other proceeding on the charge recorded in any manner, and, if so, what was the name and address of the person who recorded the testimony? 10. Describe each injury for which you are claiming damages in this case, specifying the part of your body that was injured, the nature of the injury, and as to any injuries you contend are permanent, the effects on you that you claim are permanent. 11 List each item of expense or damage, other than loss of income or earning capacity, that you claim to have incurred as a result of the incident described in the Complaint, giving for each item the date incurred, the name and business address to whom each was paid or is owed, and the goods or services for which each was incurred. Case No: 2022-CA-754 12 Do you contend that you have lost any income, benefits, or earning capacity in the past or future as a result of the incident described in the Complaint? If so, state the nature of the income, benefits, or earning capacity, and the amount and the method that you used in computing the amount. 13. Has anything been paid or is anything payable from any third party for the damages listed in your answers to these Interrogatories? If so, state the amounts paid or payable, the name and business address of the person or entity who paid or owes said amounts, and which of those third parties have or claim a right of subrogation. 14 List the names and business addresses of each physician who has treated or examined you, and each medical facility where you have received any treatment or examination for the injuries for which you seek damages in this case; and state as to each the date of treatment or examination and the injury or condition for which you were examined or treated. Case No: 2022-CA-754 15. List the names and business addresses of all other physicians, medical facilities or other health care providers by whom or at which you have been examined or treated in the past ten (10) years; and state as to each the dates of examination or treatment and the condition or injury for which you were examined or treated. 16. List the names and addresses of all persons who are believed or known by you, your agents or attorneys to have any knowledge concerning any of the issues in this lawsuit; and specify the subject matter about which the witness has knowledge. 17. Have you heard or do you know about any statement or remark made by or on behalf of any party to this lawsuit, other than yourself, concerning any issue in this lawsuit? If so, state the name and address of each person who made the statement or statements, the name and address of each person who heard it, and the date, time, place and substance of each statement. Case No: 2022-CA-754 18 State the name and address of every person known to you, your agents, or attorneys, who has knowledge about, or possession, custody or control of any model, plat, map, drawing, motion picture, video tape, or photograph pertaining to any fact or issue involved in this controversy; and describe as to each, what such person has, the name and address of the person who took or prepared it, and the date it was taken or prepared. 19 Do you intend to call any expert witnesses at the trial of this case? If so, state as to each such witness the name and business address of the witness, the witness's qualifications as an expert, the subject matter upon which the witness is expected to testify, the substance of the facts and opinions to which the witness is expected to testify, and a summary of the grounds for each opinion. 20. Have you made an agreement with anyone that would limit that party's liability to anyone for any of the damages sued upon in this case? If so, state the terms of the agreement and the parties to it. Case No: 2022-CA-754 21. Please state if you have ever been a party, either plaintiff or defendant, in a lawsuit other than the present matter and if so, state whether you were plaintiff or defendant, the nature of the action, and the date and court in which such suit was filed. 22. At the time of the incident described in the Complaint, were you wearing a seat belt? If not, please state why not; where you were seated in the vehicle; and whether the vehicle was equipped with a seat belt that was operational and available for your use. 23. Did any mechanical defect in the motor vehicle in which you were riding at the time of the incident described in the Complaint contribute to the incident? If so, describe the nature of the defect and how it contributed to the incident. Case No: 2022-CA-754 24 Please identify by date, location and nature (type of accident) all accidents in which you were involved before and after the incident involved in this lawsuit, regardless of whether or not you were injured. ("Accidents" covers all types of incidents, and includes, but is not limited to motor vehicle accidents). 25 As to each accident identified in response to question 24, please state whether or not you were injured, and if injured, state the nature of the injury, if it was permanent, and the full name and address of all physicians and medical/chiropractic providers by whom you were treated. 26 Please identify all claims made by you for personal injuries with any insurance company or individual (excluding court (cases) including the date of the claim, the nature of the claim, and the name and address of the individual or business entity against whom the claim was made or filed. Case No: 2022-CA-754 27 Please state whether or not you have filed a claim for worker's compensation, unemployment compensation, or social security disability benefits within the past 10 years. If so, please state the date of each claim, the name and address of the individual/agency with whom the claim was made, and the amount of benefits received. 28 With regard to any and all cell phones you had access to on the date of the accident described in the Complaint, please state: a. The name and address of the carrier/provider for each cell phone. b The telephone number, including the area code for each cell phone. The billing account number for each cell phone. The name and address of the account holder for each cell phone. 29 List the name, business address, telephone number, named insured, policy number, (both group and individual number) and applicable dates of coverage for all health insurance companies, life insurance companies and disability insurance companies, who have provided coverage for you in the past ten (10) years. Case No: 2022-CA-754 30. Identify all social/professional networking websites that Plaintiff is registered with currently (such as Facebook, LinkedIn, Tinder, MyLife, etc.). BY: Name: ERLENE FEDRICK STATE OF FLORIDA } } ss COUNTYOF_ Sworn to (or affirmed) and subscribed before me by means of 0 physical presence or 0 online notarization, this day of 20 by who is personally known to me (or has produced as identification) and did/did not take an oath. BY: Name: NOTARY PUBLIC STATE OF FLORIDA Commission Expires/Serial No./Seal