Preview
FILED: ORANGE COUNTY CLERK 05/23/2018 03:04 PM INDEX NO. EF008376-2017
NYSCEF DOC. NO. 16 RECEIVED NYSCEF: 05/23/2018
REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only:
ucs-840 (7/2012)
IAS EntryDate
Orange Supreme COURT, COUNTY OF Orange
Judge Assigned
index No: EF008376-2017 Date index issued: 10/17/2017
Enter the complete case caption. Do not use et al or et ano. If more space is required, RJI Date
CAPTION: attach a caption rider sheet.
Property & Casualty Insurance Company of HartfordalsloJoan Cassidy
Plaintiff(s)/Petitioner(s)
-aqainst-
-a
Culligan Water, Culligan of Newburgh, Culligan ofHudson Valley,Culligan Water Conditioning of Newburgh, CulliganDutchess-Putnam
Water Conditioning Incorporated, Culligan Northeast
Defendant(s)/Respondent(s)
NATURE OF ACTION OR PROCEEDING: CheckONEbox o ily and specify where indicated.
MATRIMONIAL COMMERCIAL
Contested O BusinessEntity (including corporations, partnerships, LLCs,etc.)
U Contract
NOTE: For all Matrimonial actions where the parties have children under the
age of 18, complete and attach the MATRIMONIAL RJIAddendum.
For
UncontestedMatrimonial actions, use RJIform UD-13. Insurance(where insurer is a party, except arbitration)
UCC(including sales, negotiable instruments)
TORTS
Other Commercial:
Asbestos
NOTE: For CommercialDivision assignment requests [22 NYCRR§ 202.70(D)],
Breast Implant complete and attach the COMMERCIALDIV RJIAddendum.
REAL PROPERTY: How many properties doesthe application include?
P Environmental:
Condemnation
Medical,Dental, or Podiatric Malpractice
Mortgage Foreclosure: O Residential U Commercial
MotorVehicle Property Address:
NOTE: For Mortgage Foreclosureactions involving a one- to four-family, owner-
ProductsLiability:
occupied, residential property, or an owner-occupiedcondominium, complete and
attach the FORECLOSURERJIAddendum.
X Other Negligence:
Property Damage
Tax Certiorari - Section: Block: Lot:
Other ProfessionalMalpractice:
Tax Foreclosure
Other Tort: Other Real Property:
OTHER MATTERS SPECIAL PROCEEDINGS
Certificate of Incorporation/Dissolution
[see NOTEunder Commercial] CPLRArticle 75 (Arbitration)
[see NOTE under Commercial]
EmergencyMedicalTreatment CPLRArticle 78 (Body or Officer)
HabeasCorpus Election Law
LocalCourt Appeal MHLArticle 9.60 (Kendra's Law)
Mechanic'sLien MHLArticle 10 (Sex Offender Confinement-Initial)
NameChange MHLArticle 10 (Sex Offender Confinement-Review)
PistolPermit Revocation Hearing MHLArticle 81 (Guardianship)
Saleor Financeof Religious/Not-for-ProfitProperty Other Mental Hygiene:
Other: Other Special Proceeding:
STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor EVERYquestion ANDenter additional information where indicated.
YES NO
Hasa summonsand complaint or summonsw/notice been filed? X If yes, date filed:
10/17/2017
Hasa summonsand complaint or summonsw/notice been served? X If yes, date served:
10/19/2017
Isthis action/proceeding being filed post-judgment? X If yes, judgment date:
Filedin Orange County 05/23/2018 03:04:12 PM $95.00 1
Bk: of
51262 Pg: 1904 Index: 0 EF008376-2017 Clerk: JM
FILED: ORANGE COUNTY CLERK 05/23/2018 03:04 PM INDEX NO. EF008376-2017
NYSCEF
NATURE DOC.OF NO. 16
JUDICIAL INTERVENTION: RECEIVED NYSCEF:
CheckONEbox only ANDenter additional information where indicated. 05/23/2018
Infant's Compromise
Note of Issueand/or Certificate of Readiness
Notice of Medical, Dental, or Podiatric Malpractice
Date IssueJoined:
X Notice of Motion Judgment - Default
ReliefSought: Return Date: 06/27/2018
Notice of Petition ReliefSought: Return Date:
Order to Show Cause ReliefSought: Return Date:
Other Ex ParteApplication ReliefSought:
PoorPersonApplication
Requestfor Preliminary Conference
ResidentialMortgage ForeclosureSettlement Conference
Writ of HabeasCorpus
Other:
RELATED CASES: List any
relatedactions.For Matrimonial include
actions, any relatedcriminal
and/or FamiyCourt cases.If
additional
space is required,
complete and attachthe RJI Addendum. If none,
leaveblank.
Case Title Index/Case No. Court Judge (ifassigned) Relationship to Instant Case
For parties
withoutan attorney,
check "Un-Rep" box AND enter phone number and e-mail
PARTIES: partyaddress,
address in space
provided.If additional
space is required,
complete and attachtheRJl Addendum.
Parties: Attorneys Litigants:
and/or Unrepresented
Un. List parties in caption order and indicate ISSUe
Provide attorney name, firm name, business address, phone number and e- Carrier(S).
lnSUFBnCe
mail address of all attorneys that have appeared in the case.
party role(s) (e.g., defendant; 3rd-party For Joined
Rep plaintiff). unrepresented litigants, provide address, phone number and e-mail address.
(Y/N):
Name: Property 8 Casualty Insurance PAUL NEUGEBAUER, Law Office of Stewart H. Friedman, 401 Franklin The Hartford
Company of Hartford a/s/o Joan C··· Avenue Suite 314, Garden City, NY
11530, 516-365-9191,
lawofficesfriedman@thehartford.com YES
Role(s): Plaintiff/Petitioner
Name: Culligan Water 131 Little Britain Road, Newburgh, NY
12550
X NO
Role(s): Defendant/Respondent
Name: Culligan of Newburgh 131 Little Britain Road, Newburgh, NY
12550
X NO
Role(s): Defendant/Respondent
Name: Culligan of Hudson Valley 131 Little Britain Road, Newburgh, NY
12550
X NO
Role(s): Defendant/Respondent
Name: Culligan Water Conditioning of131 Little Britain Road, Newburgh, NY
12550
Newburgh
X NO
Role(s): Defendant/Respondent
I AFFIRM UNDER THE PENALTY OF PERJURY THAT, TO MY KNOWLEDGE, OTHER THAN AS NOTED ABOVE, THERE
ARE AND HAVE BEEN NO RELATED ACTIONS OR PROCEEDINGS, NOR HAS A REQUEST FOR JUDICIAL
INTERVENTION PREVIOUSLY BEEN FILED IN THIS ACTION OR PROCEEDING.
Dated: 05/23/2018 PAUL L. NEUGEBAUER
SIGNATURE
2371573 PAUL L. NEUGEBAUER
ATrORNEY REGISTRATION NUMBER PRINT OR TYPE NAME
This form was generated by NYSCEF
2 of 2
Preview
FILED: ORANGE COUNTY CLERK 05/23/2018 03:04 PM INDEX NO. EF008376-2017 NYSCEF DOC. NO. 16 RECEIVED NYSCEF: 05/23/2018 REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only: ucs-840 (7/2012) IAS EntryDate Orange Supreme COURT, COUNTY OF Orange Judge Assigned index No: EF008376-2017 Date index issued: 10/17/2017 Enter the complete case caption. Do not use et al or et ano. If more space is required, RJI Date CAPTION: attach a caption rider sheet. Property & Casualty Insurance Company of HartfordalsloJoan Cassidy Plaintiff(s)/Petitioner(s) -aqainst- -a Culligan Water, Culligan of Newburgh, Culligan ofHudson Valley,Culligan Water Conditioning of Newburgh, CulliganDutchess-Putnam Water Conditioning Incorporated, Culligan Northeast Defendant(s)/Respondent(s) NATURE OF ACTION OR PROCEEDING: CheckONEbox o ily and specify where indicated. MATRIMONIAL COMMERCIAL Contested O BusinessEntity (including corporations, partnerships, LLCs,etc.) U Contract NOTE: For all Matrimonial actions where the parties have children under the age of 18, complete and attach the MATRIMONIAL RJIAddendum. For UncontestedMatrimonial actions, use RJIform UD-13. Insurance(where insurer is a party, except arbitration) UCC(including sales, negotiable instruments) TORTS Other Commercial: Asbestos NOTE: For CommercialDivision assignment requests [22 NYCRR§ 202.70(D)], Breast Implant complete and attach the COMMERCIALDIV RJIAddendum. REAL PROPERTY: How many properties doesthe application include? P Environmental: Condemnation Medical,Dental, or Podiatric Malpractice Mortgage Foreclosure: O Residential U Commercial MotorVehicle Property Address: NOTE: For Mortgage Foreclosureactions involving a one- to four-family, owner- ProductsLiability: occupied, residential property, or an owner-occupiedcondominium, complete and attach the FORECLOSURERJIAddendum. X Other Negligence: Property Damage Tax Certiorari - Section: Block: Lot: Other ProfessionalMalpractice: Tax Foreclosure Other Tort: Other Real Property: OTHER MATTERS SPECIAL PROCEEDINGS Certificate of Incorporation/Dissolution [see NOTEunder Commercial] CPLRArticle 75 (Arbitration) [see NOTE under Commercial] EmergencyMedicalTreatment CPLRArticle 78 (Body or Officer) HabeasCorpus Election Law LocalCourt Appeal MHLArticle 9.60 (Kendra's Law) Mechanic'sLien MHLArticle 10 (Sex Offender Confinement-Initial) NameChange MHLArticle 10 (Sex Offender Confinement-Review) PistolPermit Revocation Hearing MHLArticle 81 (Guardianship) Saleor Financeof Religious/Not-for-ProfitProperty Other Mental Hygiene: Other: Other Special Proceeding: STATUS OF ACTION OR PROCEEDING: AnswerYESor NOfor EVERYquestion ANDenter additional information where indicated. YES NO Hasa summonsand complaint or summonsw/notice been filed? X If yes, date filed: 10/17/2017 Hasa summonsand complaint or summonsw/notice been served? X If yes, date served: 10/19/2017 Isthis action/proceeding being filed post-judgment? X If yes, judgment date: Filedin Orange County 05/23/2018 03:04:12 PM $95.00 1 Bk: of 51262 Pg: 1904 Index: 0 EF008376-2017 Clerk: JM FILED: ORANGE COUNTY CLERK 05/23/2018 03:04 PM INDEX NO. EF008376-2017 NYSCEF NATURE DOC.OF NO. 16 JUDICIAL INTERVENTION: RECEIVED NYSCEF: CheckONEbox only ANDenter additional information where indicated. 05/23/2018 Infant's Compromise Note of Issueand/or Certificate of Readiness Notice of Medical, Dental, or Podiatric Malpractice Date IssueJoined: X Notice of Motion Judgment - Default ReliefSought: Return Date: 06/27/2018 Notice of Petition ReliefSought: Return Date: Order to Show Cause ReliefSought: Return Date: Other Ex ParteApplication ReliefSought: PoorPersonApplication Requestfor Preliminary Conference ResidentialMortgage ForeclosureSettlement Conference Writ of HabeasCorpus Other: RELATED CASES: List any relatedactions.For Matrimonial include actions, any relatedcriminal and/or FamiyCourt cases.If additional space is required, complete and attachthe RJI Addendum. If none, leaveblank. Case Title Index/Case No. Court Judge (ifassigned) Relationship to Instant Case For parties withoutan attorney, check "Un-Rep" box AND enter phone number and e-mail PARTIES: partyaddress, address in space provided.If additional space is required, complete and attachtheRJl Addendum. Parties: Attorneys Litigants: and/or Unrepresented Un. List parties in caption order and indicate ISSUe Provide attorney name, firm name, business address, phone number and e- Carrier(S). lnSUFBnCe mail address of all attorneys that have appeared in the case. party role(s) (e.g., defendant; 3rd-party For Joined Rep plaintiff). unrepresented litigants, provide address, phone number and e-mail address. (Y/N): Name: Property 8 Casualty Insurance PAUL NEUGEBAUER, Law Office of Stewart H. Friedman, 401 Franklin The Hartford Company of Hartford a/s/o Joan C··· Avenue Suite 314, Garden City, NY 11530, 516-365-9191, lawofficesfriedman@thehartford.com YES Role(s): Plaintiff/Petitioner Name: Culligan Water 131 Little Britain Road, Newburgh, NY 12550 X NO Role(s): Defendant/Respondent Name: Culligan of Newburgh 131 Little Britain Road, Newburgh, NY 12550 X NO Role(s): Defendant/Respondent Name: Culligan of Hudson Valley 131 Little Britain Road, Newburgh, NY 12550 X NO Role(s): Defendant/Respondent Name: Culligan Water Conditioning of131 Little Britain Road, Newburgh, NY 12550 Newburgh X NO Role(s): Defendant/Respondent I AFFIRM UNDER THE PENALTY OF PERJURY THAT, TO MY KNOWLEDGE, OTHER THAN AS NOTED ABOVE, THERE ARE AND HAVE BEEN NO RELATED ACTIONS OR PROCEEDINGS, NOR HAS A REQUEST FOR JUDICIAL INTERVENTION PREVIOUSLY BEEN FILED IN THIS ACTION OR PROCEEDING. Dated: 05/23/2018 PAUL L. NEUGEBAUER SIGNATURE 2371573 PAUL L. NEUGEBAUER ATrORNEY REGISTRATION NUMBER PRINT OR TYPE NAME This form was generated by NYSCEF 2 of 2