On February 04, 2021 a
Exhibit,Appendix
was filed
involving a dispute between
Matthew Mullett,
and
Camellia Bellis,
Jane Doe,
Phoenix Insurance Company,
Travco Insurance Company,
for Commercial - Insurance
in the District Court of Niagara County.
Preview
FILED: NIAGARA COUNTY CLERK 01/11/2022 03:56 PM INDEX NO. E174138/2021
NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 01/11/2022
EXHIBIT A
SUPREME COURT OF THE STATE OF NEW
YORK, COUNTY OF NIAGARA
MATTHEW MULLETT,
Index No. E174138/2021
Plaintiff,
-against- CONFIDENTIALITY
AGREEMENT AND
PHOENIX INSURANCE COMPANY and TRAVCO PROTECTIVE ORDER
INSURANCE COMPANY,
Defendants,
-and-
JANE DOE 1, JANE DOE 2, and CAMELLIA BELLIS,
Nominal Defendants,
-------------------------------------------------------------------x
I, , being duly sworn, state that:
1. My address is __________________________________________.
2. My present employer is and the
address of my present employer is ____
3. My present occupation or job description is _
4. I have carefully read and understand the provisions of the Confidentiality Agreement
and Protective Order ("Order") in the above-captioned Action ("Action") entered by the Court,
and I will comply with all provisions of the Order.
5. I will hold in confidence and not disclose to anyone not qualified under the Order any
Confidential Material or any words, summaries, abstracts or indices of Confidential Material
FILED: NIAGARA COUNTY CLERK 01/11/2022 03:56 PM INDEX NO. E174138/2021
NYSCEF DOC. NO. 17 RECEIVED NYSCEF: 01/11/2022
disclosed to me.
6. I will limit use of the Confidential Material disclosed to me solely for purposes of this
Action.
7. No later than the final conclusion of this Action, I will return all Confidential Material
and all summaries, abstracts or indices thereof that come into my possession, custody or control,
and documents or things that I have prepared relating thereto, to counsel for the party for whom I
was employed or retained.
8. I declare under penalty of perjury that the foregoing is true and correct.
Dated: __________________ (sign)
(name) _________
Document Filed Date
January 11, 2022
Case Filing Date
February 04, 2021
Category
Commercial - Insurance
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