Preview
FILED:
[FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08719/2019 02:15
10:15 PM
AMI
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
THOMAS F. DELANEY INC.
Lic. Private Investigators
Phone (914) 761-6367
Fax (914) 761-6368
AFFIDAVITOFSERVICE
Supreme Court of the State of New York; County of New York
LIBERTY MUTUAL INSURANCE COMPANY and
LM GENERAL INSURANCE COMPANY,
Plaintiffs, INDEX NO.: 654092/19
- vs.-
KENDON THOMAS,
("Individual Defendants")
and
AMRO CARE PT, P.C., LAWRENCE CHIROPRACTIC DIAGNOSTIC SERVICE,
NORTH SHORE HOME CARE SERVICES, INC., AVA CUSTOM SUPPLY, INC.,
OPUS PSYCHOLOGICAL SERVICES, P.C., SI ACUPUNCTURE, P.C., METRO
PAIN SPECIALISTS PROFESSIONAL CORPORATION, PROSPECT
CHIROPRACTIC, PLLC, CITIMEDICAL I,PLLC, MAURO CHIROPRACTIC, P.C.,
HARBOR MEDICAL GROUP, P.C., ACUTUS RX, LLC, AK GLOBAL SUPPLY CORP.,
("Medical Provider Defendants")
Collectively the Defendants,
State of New York, County of Kings ss:
ROBERT BRACKEN, being duly sworn, deposes and says that deponent isover 18 years ofage and not a party tothisaction; thaton
10"'
the day of AUGUST of the year 2019 at approximately 4:06 p.m. at 145-21 TUSKEGGE AIRMEN WAY, JAMA!CA, N.Y. 11435
depenent served theannexed SUMMONS & VERIFIED COMPLAINT on KENDON THOMAS in the followingmanner:
Responsible to and with OMARI MCFARLANE - NEPHEW OF KENDON a true
[X] By delivering leaving THOMAS,
copy thereof, a person of suitable age and discretion. Said premises being the recipient's dwelling place
within the state.
[X] Mail A true copy thereof was also deposited in a postpaid, properly addressed envelope, to the above
address in an officialdepository under the exclusive care and custody of the US Postal Service.
Description Deponent describes the individual served as follows: [X] male [ ] female
5'9"-6'O"
[X] black skin [X] black hair [ ) glasses [X] [X] 161-200 lbs. [X] 21-35 years
Sworn to me on August 12, 2019
SUZANNEG. BRACKEN
Notary b c t e ew York
ROBERT BRACKEN
Qualified inPutnam
minission
County NYCDCA #: 1430550
Expires April 20, 2023
TFD AGENCY #: 1427277
TFD LICENSE NO. 11000031079
1 of 14
FILED:
[FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08719/2019 02:15
10:15 PM
AM|
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
Attorney(s) Thomas F. Delaney, Inc.
Index # 654092/2019
Purchased/Filed: July 17, 2019
State ofNew York
Court: Supreme
County: New York
AFFIDAVIT OF SERVICE - SECRETARY OF STATE
Liberty Mutual Insurance Company
Plaintiff(s)
against
Kendon Thomas, et al
Defendant(s)
STATE OF NEW YORK ) DESCRiPTiON OF PERSON SERVED: Approx. Age: 55 Yrs.
COUNTYOF ALBANY )SS
CITY OF ALBANY 5'0"
) Weight: 120 Lbs. Height: Sex: Female Color of skin: White
Hair color: Blonde Other:
Robert Guyette , being duly sworn, deposes and says: deponent isover
the age of eighteen (18) years; isnot a party to thisaction, and resides inthe State of NY, and that on
August 7, 2019 , at 1:35 PM , atthe officeof the Secretary of State of the State of NY,
located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served:
Summons and VerifiedComplaint with Notice ofElectronic Filing
on
Amro Care PT, P.C.
,
the Defendant in thisaction, by delivering to and leaving with Sue Zouky
AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the
Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of
making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service
was made pursuant to Section BUSINESS CORPORATION LAW §306.
Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office
of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said
defendant.
Sworn to before me on this
7th day of August 2019
FAlTH OZZ Robert Guyette
NOTARY PUBUC, f Ne Y
No. 01C06158874, Albany Invoice-Work Order # 1932081
Commission Expires Jan 8, 2023
Attorney File # Liberty Mutual
2 of 14
FILED:
FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08719/2019 02:15
10:15 PM
AM|
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
Attorney(s) Thomas F. Delaney, Inc.
Index # 654092/2019
Purchased/Filed: July 17, 2019
State ofNew York
Court: Supreme
County: New York
AFFIDAVIT OF SERVICE - SECRETARY OF STATE
Liberty Mutual Insurance Company
Plaintiff(s)
against
Kendon Thomas, et al
Defendant(s)
STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs.
COUNTY OF ALBANY )SS
CITY OF ALBANY 5' 0"
) Weight: 120 Lbs. Height: Sex: Female Color of skin: White
Hair color: Blonde Other:
Robert Guyette , being duly sworn, deposes and says: deponent isover
the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on
August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY,
located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served:
Summons and VerifiedComplaint with Notice ofElectronic Filing
on
Lawrence Chiropractic Diagnostic Services, P.C.
the Defendant in this action, by delivering to and leaving with Sue Zouky
AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the
Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of
making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service
was made pursuant to Section BUSINESS CORPORATION LAW §306.
Deponent further says thatdeponent knew the person so served as aforesaid to be the agent in the Office
of the Secretary of State of the State of New York, duly authoriZed to accept such service on behalf of said
defendant.
Sworn to before me on this
7th day of August 2019
FAITH ZZY Robert Guyette
NOTARY PUBLIC, f N w Y rk
No. 01C06158874, Albany nty Invoice-Work Order # 1932086
Commission Expires Jan 8, 2023
Attorney File # Liberty Mutual
3 of 14
FILED:
FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08/19/2019 02:15
10:15 PM
AM1
INDEX
INDEX NO.
NO. 654092/2019
654092 /2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
Attorney(s) Thomas F. Delaney, Inc.
Index # 654092/2019
Purchased/Filed: July 17, 2019
Stateof New York
Court: Supreme
County: New York
AFFIDAVIT OF SERVICE - SECRETARY OF STATE
Liberty Mutual Insurance Company
Plaintiff(s)
against
Kendon Thomas, et al
Defendant(s)
STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs.
COUNTYOF ALBANY )SS
CITY OF ALBANY 5' 0"
) Weight: 120 Lbs. Height: Sex: Female Color of skin: White
Hair color: Blonde Other:
Robert Guyette , being duly sworn, deposes and says: deponent isover
the age of eighteen (18) years; isnot a party to thisaction, and resides in the State of NY, and that on
August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY,
located at 99 Washington Ave, 6th Fl,Albany, New York 12231 deponent served:
Summons and VerifiedComplaint with Notice ofElectronic Filing
North Shore Home Care Services, Inc.
the Defendant in thisaction, by delivering to and leaving with Sue Zouky
AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, peis,0ñally at the
Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of
making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service
was made pursuant to Section BUSINESS CORPORATION LAW §306.
Deponent further says that depeñent knew the person so served as aforesaid to be the agent in the Office
of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said
defendant.
Sworn to before me on this
7th day of August 2019
FAITH COZZ Robert Guyette
NOTARY PUBLIC, State of or
No. 01CO6158874, Albany County InvoiCEWark Order # 1932087
Comrnission Expires Jan 8, 2023
Attorney File # Liberty Mutual
4 of 14
FILED:
FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08/19/2019 02:15
10:15 PM
AM|
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
Attorney(s) Thomas F. Delaney, Inc.
Index # 654092/2019
Purchased/Filed: July 17, 2019
State ofNew York
Court: Supreme
County: New York
AFFIDAVIT OF SERVICE - SECRETARY OF STATE
Liberty Mutual Insurance Company
Plaintiff(s)
against
Kendon Thomas, et al
Defendant(s)
STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs.
COUNTYOF ALBANY )SS
CITY OF ALBANY 5' 0"
) Weight: 120 Lbs. Height: Sex: Female Color of skin: White
Hair color: Blonde Other:
Robert Guyette , being duly sworn, deposes and says: deponent isover
the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on
August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY,
located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served:
Summons and VerifiedCGmplaint with Notice of ElectronicFiling
on
AVA Custom Supply Inc.
the Defendant in thisaction, by delivering to and leaving with Sue Zouky
AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the
Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of
making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service
was made pursuant to Section BUSINESS CORPORATION LAW §306.
Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office
of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said
defendant.
Sworn to before me on this
7th day of August 2019
FAlTH CO Robert Guyette
NOTARY PUBLIC, Stat Yor
No. 01CO6158874, Albany Coun inVOlCe-Work Order # 1932088
Commission Expires Jan 8, 2023
Attorney File # Liberty Mutual
5 of 14
FILED:
[FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08719/2019 02:15
10:15 PM
AM|
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
Attorney(s) Thomas É Delaney, Inc.
Index # 654092/2019
Purchased/Filed: July 17, 2019
State ofNew York
Court: Supreme
County: New York
AFFIDAVIT OF SERVICE - SECRETARY OF STATE
Liberty Mutual Insurance Company
Plaintiff(s)
against
Kendon Thomas, et al
Defendant(s)
STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs.
COUNTY OF ALBANY )SS
CITY OF ALBANY 5' 0"
) Weight: 120 Lbs. Height: Sex: Female Color of skin: White
Hair color: Blonde Other:
Robert Guyette , being duly sworn, deposes and says: deponent isover
the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on
August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY,
located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served:
Summons and VerifiedComplaint with Notice of ElectronicFiling
on
Opus Psychology Services P.C.
the Defendant in thisaction, by delivering to and leaving with Sue Zouky
AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the
Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of
making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service
was made pursuant to Section BUSINESS CORPORATION LAW §306.
Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office
of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said
defendant.
Sworn to before me on this
7th day of August 2019
FAITH CO Robert Guyette
NOTARY PUBUC, State w Yo
No. 01C06158874, Albany Coun Invoice-Work Order # 1932090
Commission Expires Jan 8, 2023
Attorney File # Liberty Mutual
6 of 14
FILED:
FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08/19/2019 02:15
10:15 PM
AM)
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
THOMAS F. DELANEY INC.
Lic. Private Investigators
Phone (914) 761-6367
Fax (914) 761-6368
AFFIDAVITOFSERVICE
Supreme Court of the State of New York; County of New York
LIBERTY MUTUAL INSURANCE COMPANY and
LM GENERAL INSURANCE COMPANY,
Plaintiffs, INDEX NO.: 654092/19
-vs. -
KENDON THOMAS,
("IndMdual Defendants")
and
AMRO CARE PT, P.C., LAWRENCE CHIROPRACTIC DIAGNOSTIC SERVICE,
NORTH SHORE HOME CARE SERVICES, INC., AVA CUSTOM SUPPLY, INC.,
OPUS PSYCHOLOGICAL SERVICES, P.C., SI ACUPUNCTURE, P.C., METRO
PAIN SPECIALISTS PROFESSIONAL CORPORATION, PROSPECT
CHIROPRACTIC, PLLC, CITIMEDICAL 1, PLLC, MAURO CHIROPRACTIC, P.C.,
HARBOR MEDICAL GROUP, P.C., ACUTUS RX, LLC, AK GLOBAL SUPPLY CORP.,
("Medical Provider Defendants")
Collectively the Defendants,
State of New York, County of Nassau ss:
ROBERT BRACKEN, being duly sworn, deposes and says that depoñent isover 18 years ofage and not a partyto thisaction;that on
29*
the day ofJULY ofthe year 2019 at approximately 11:10 a.m. at 3 DAKOTA DRIVE, SUITE 300, NEW HYDE PARK, N.Y. 11042
deponent served theannexed SUMMONS & VERIFIED COMPLAINT on SI ACUPUNCTURE in the followingmanner:
Corporate to and with ELMER MARTINEZ - PARALEGAL - a true who stated
[X] By delivering leaving copy thereof,
that he was authorized toaccept on behalf of said corporation.
[ ]Mail A true copy thereof was also deposited in a postpeid, properly addressed envelope, to the above
address in an officialdepository under the exclusive care and custody of the US Postal Service.
Description Deponent describes the individual served as follows: [X] male [ ] female
5'9"-6'0"
[X] brown skin [X] black hair [ ] glasses [X] [X] 161-200 Ibs. [X] 21-35 years
Sworn to me on July 29, 2019
SUZANNE G. BRACKEN /
State
ROBERT BR CKEN
Notary Public, of New York
No. 01BR6323491 NYCDCA #: 1430550
Qualified inPutnam Coun
Commission Expires April
TFD AGENCY #: 1427277
20, 023
TFD LICENSE NO. 11000031079
7 of 14
FILED:
FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08/19/2019 02:15
10:15 PM
AM1
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
Attorney(s) Thomas Å Delaney, Inc.
Index # 654092/2019
Purchased/Filed: July 17, 2019
State ofNew York
Court: Supreme
County: New York
AFFIDAVIT OF SERVICE - SECRETARY OF STATE
Liberty Mutual Insurance Company
Plaintiff(s)
against
Kendon Thomas, et al
Defendant(s)
STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs.
COUNTY OFALBANY )SS
CITY OF ALBANY 5' 0"
) Weight: 120 Lbs. Height: Sex: Female Color of skin: White
Hair color: Blonde Other:
Robert Guyette , being duly sworn, deposes and says: deponent isover
the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on
August 7, 2019 , at 1:35 PM , atthe officeof the Secretary of State of the State of NY,
located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served:
Summons and Verified Complaint with Notice of ElectronicFiling
on
Metro Pain Specialists Professional Corporation
the Defendant in thisaction, by delivering to and leaving with Sue Zouky
AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the
Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of
making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service
was made pursuant to Section BUSINESS CORPORATION LAW §306.
Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office
of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said
defendant.
Sworn to before me on this
7th August 2019
FAITH COZZŸ Obert Guyette
NOTARY PUBLIC, state rk
No. 01C06158874, Albany County Invoice-Work Order # 1932091
Commission Expires Jan 8, 2023
Attorney File # Liberty Mutual
8 of 14
FILED:
FILED: NEW
NEW YORK
YORK COUNTY
COUNTY CLERK
CLERK 07/14/2020
08719/2019 02:15
10:15 PM
AM|
INDEX
INDEX NO.
NO. 654092/2019
654092/2019
NYSCEF
NYSCEF DOC.
DOC. NO.
NO. 13
3 RECEIVED
RECEIVED NYSCEF:
NYSCEF: 07/14/2020
08/19/2019
Attorney(s) Thomas F. Delaney, Inc.
Index # 654092/2019
Purchased/Filed: July 17, 2019
State ofNew York
Court: Supreme
County: New York
AFFIDAVIT OF SERVICE - SECRETARY OF STATE
Liberty Mutual Insurance Company
Plaintiff(s)
against
Kendon Thomas, et al
Defendant(s)
STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs.
COUNTYOF ALBANY )SS
CITY OF ALBANY 5' 0"
) Weight: 120 Lbs. Height: Sex: Female Color of skin: White
Hair color: Blonde Other:
Robert Guyette , being duly sworn, deposes and says: deponent isover
the age of eighteen (18) years; is not a party to this action, and resides in the State of NY, and that on
August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY,
located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served:
Summons and VerifiedComplaint with Notice ofElectronic Filing
on
Prospect Chiropractic PLLC
,
the Defendant in this action, by delivering to and leaving with Sue Zouky
AUTHORIZED AGENT in theOffice of the Secretary of State, of the State of New York, personally at the
Office of the Secretary of State of the State of New York, two (2) truecopies thereof and that at the time of
making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service
was made pursuant to Section LIMITED LIABILITY COMPANY LAW §303.
Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office
of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said
defendant.
Sworn to before me on this
7th day of August 2019
FArrH CO Robert Guyette
NOTARY PUBLIC, State of New Yor
No. 01CO6158874, Albany County Invoice-Work Order # 1932092
Commission Expires Jan 8, 2023
Attorney File # Liberty Mutual
9 of 14
FILED:
FILED: NEW
NEW
Preview
FILED: [FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08719/2019 02:15 10:15 PM AMI INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 THOMAS F. DELANEY INC. Lic. Private Investigators Phone (914) 761-6367 Fax (914) 761-6368 AFFIDAVITOFSERVICE Supreme Court of the State of New York; County of New York LIBERTY MUTUAL INSURANCE COMPANY and LM GENERAL INSURANCE COMPANY, Plaintiffs, INDEX NO.: 654092/19 - vs.- KENDON THOMAS, ("Individual Defendants") and AMRO CARE PT, P.C., LAWRENCE CHIROPRACTIC DIAGNOSTIC SERVICE, NORTH SHORE HOME CARE SERVICES, INC., AVA CUSTOM SUPPLY, INC., OPUS PSYCHOLOGICAL SERVICES, P.C., SI ACUPUNCTURE, P.C., METRO PAIN SPECIALISTS PROFESSIONAL CORPORATION, PROSPECT CHIROPRACTIC, PLLC, CITIMEDICAL I,PLLC, MAURO CHIROPRACTIC, P.C., HARBOR MEDICAL GROUP, P.C., ACUTUS RX, LLC, AK GLOBAL SUPPLY CORP., ("Medical Provider Defendants") Collectively the Defendants, State of New York, County of Kings ss: ROBERT BRACKEN, being duly sworn, deposes and says that deponent isover 18 years ofage and not a party tothisaction; thaton 10"' the day of AUGUST of the year 2019 at approximately 4:06 p.m. at 145-21 TUSKEGGE AIRMEN WAY, JAMA!CA, N.Y. 11435 depenent served theannexed SUMMONS & VERIFIED COMPLAINT on KENDON THOMAS in the followingmanner: Responsible to and with OMARI MCFARLANE - NEPHEW OF KENDON a true [X] By delivering leaving THOMAS, copy thereof, a person of suitable age and discretion. Said premises being the recipient's dwelling place within the state. [X] Mail A true copy thereof was also deposited in a postpaid, properly addressed envelope, to the above address in an officialdepository under the exclusive care and custody of the US Postal Service. Description Deponent describes the individual served as follows: [X] male [ ] female 5'9"-6'O" [X] black skin [X] black hair [ ) glasses [X] [X] 161-200 lbs. [X] 21-35 years Sworn to me on August 12, 2019 SUZANNEG. BRACKEN Notary b c t e ew York ROBERT BRACKEN Qualified inPutnam minission County NYCDCA #: 1430550 Expires April 20, 2023 TFD AGENCY #: 1427277 TFD LICENSE NO. 11000031079 1 of 14 FILED: [FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08719/2019 02:15 10:15 PM AM| INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 Attorney(s) Thomas F. Delaney, Inc. Index # 654092/2019 Purchased/Filed: July 17, 2019 State ofNew York Court: Supreme County: New York AFFIDAVIT OF SERVICE - SECRETARY OF STATE Liberty Mutual Insurance Company Plaintiff(s) against Kendon Thomas, et al Defendant(s) STATE OF NEW YORK ) DESCRiPTiON OF PERSON SERVED: Approx. Age: 55 Yrs. COUNTYOF ALBANY )SS CITY OF ALBANY 5'0" ) Weight: 120 Lbs. Height: Sex: Female Color of skin: White Hair color: Blonde Other: Robert Guyette , being duly sworn, deposes and says: deponent isover the age of eighteen (18) years; isnot a party to thisaction, and resides inthe State of NY, and that on August 7, 2019 , at 1:35 PM , atthe officeof the Secretary of State of the State of NY, located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served: Summons and VerifiedComplaint with Notice ofElectronic Filing on Amro Care PT, P.C. , the Defendant in thisaction, by delivering to and leaving with Sue Zouky AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service was made pursuant to Section BUSINESS CORPORATION LAW §306. Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said defendant. Sworn to before me on this 7th day of August 2019 FAlTH OZZ Robert Guyette NOTARY PUBUC, f Ne Y No. 01C06158874, Albany Invoice-Work Order # 1932081 Commission Expires Jan 8, 2023 Attorney File # Liberty Mutual 2 of 14 FILED: FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08719/2019 02:15 10:15 PM AM| INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 Attorney(s) Thomas F. Delaney, Inc. Index # 654092/2019 Purchased/Filed: July 17, 2019 State ofNew York Court: Supreme County: New York AFFIDAVIT OF SERVICE - SECRETARY OF STATE Liberty Mutual Insurance Company Plaintiff(s) against Kendon Thomas, et al Defendant(s) STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs. COUNTY OF ALBANY )SS CITY OF ALBANY 5' 0" ) Weight: 120 Lbs. Height: Sex: Female Color of skin: White Hair color: Blonde Other: Robert Guyette , being duly sworn, deposes and says: deponent isover the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY, located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served: Summons and VerifiedComplaint with Notice ofElectronic Filing on Lawrence Chiropractic Diagnostic Services, P.C. the Defendant in this action, by delivering to and leaving with Sue Zouky AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service was made pursuant to Section BUSINESS CORPORATION LAW §306. Deponent further says thatdeponent knew the person so served as aforesaid to be the agent in the Office of the Secretary of State of the State of New York, duly authoriZed to accept such service on behalf of said defendant. Sworn to before me on this 7th day of August 2019 FAITH ZZY Robert Guyette NOTARY PUBLIC, f N w Y rk No. 01C06158874, Albany nty Invoice-Work Order # 1932086 Commission Expires Jan 8, 2023 Attorney File # Liberty Mutual 3 of 14 FILED: FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08/19/2019 02:15 10:15 PM AM1 INDEX INDEX NO. NO. 654092/2019 654092 /2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 Attorney(s) Thomas F. Delaney, Inc. Index # 654092/2019 Purchased/Filed: July 17, 2019 Stateof New York Court: Supreme County: New York AFFIDAVIT OF SERVICE - SECRETARY OF STATE Liberty Mutual Insurance Company Plaintiff(s) against Kendon Thomas, et al Defendant(s) STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs. COUNTYOF ALBANY )SS CITY OF ALBANY 5' 0" ) Weight: 120 Lbs. Height: Sex: Female Color of skin: White Hair color: Blonde Other: Robert Guyette , being duly sworn, deposes and says: deponent isover the age of eighteen (18) years; isnot a party to thisaction, and resides in the State of NY, and that on August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY, located at 99 Washington Ave, 6th Fl,Albany, New York 12231 deponent served: Summons and VerifiedComplaint with Notice ofElectronic Filing North Shore Home Care Services, Inc. the Defendant in thisaction, by delivering to and leaving with Sue Zouky AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, peis,0ñally at the Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service was made pursuant to Section BUSINESS CORPORATION LAW §306. Deponent further says that depeñent knew the person so served as aforesaid to be the agent in the Office of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said defendant. Sworn to before me on this 7th day of August 2019 FAITH COZZ Robert Guyette NOTARY PUBLIC, State of or No. 01CO6158874, Albany County InvoiCEWark Order # 1932087 Comrnission Expires Jan 8, 2023 Attorney File # Liberty Mutual 4 of 14 FILED: FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08/19/2019 02:15 10:15 PM AM| INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 Attorney(s) Thomas F. Delaney, Inc. Index # 654092/2019 Purchased/Filed: July 17, 2019 State ofNew York Court: Supreme County: New York AFFIDAVIT OF SERVICE - SECRETARY OF STATE Liberty Mutual Insurance Company Plaintiff(s) against Kendon Thomas, et al Defendant(s) STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs. COUNTYOF ALBANY )SS CITY OF ALBANY 5' 0" ) Weight: 120 Lbs. Height: Sex: Female Color of skin: White Hair color: Blonde Other: Robert Guyette , being duly sworn, deposes and says: deponent isover the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY, located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served: Summons and VerifiedCGmplaint with Notice of ElectronicFiling on AVA Custom Supply Inc. the Defendant in thisaction, by delivering to and leaving with Sue Zouky AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service was made pursuant to Section BUSINESS CORPORATION LAW §306. Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said defendant. Sworn to before me on this 7th day of August 2019 FAlTH CO Robert Guyette NOTARY PUBLIC, Stat Yor No. 01CO6158874, Albany Coun inVOlCe-Work Order # 1932088 Commission Expires Jan 8, 2023 Attorney File # Liberty Mutual 5 of 14 FILED: [FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08719/2019 02:15 10:15 PM AM| INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 Attorney(s) Thomas É Delaney, Inc. Index # 654092/2019 Purchased/Filed: July 17, 2019 State ofNew York Court: Supreme County: New York AFFIDAVIT OF SERVICE - SECRETARY OF STATE Liberty Mutual Insurance Company Plaintiff(s) against Kendon Thomas, et al Defendant(s) STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs. COUNTY OF ALBANY )SS CITY OF ALBANY 5' 0" ) Weight: 120 Lbs. Height: Sex: Female Color of skin: White Hair color: Blonde Other: Robert Guyette , being duly sworn, deposes and says: deponent isover the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY, located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served: Summons and VerifiedComplaint with Notice of ElectronicFiling on Opus Psychology Services P.C. the Defendant in thisaction, by delivering to and leaving with Sue Zouky AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service was made pursuant to Section BUSINESS CORPORATION LAW §306. Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said defendant. Sworn to before me on this 7th day of August 2019 FAITH CO Robert Guyette NOTARY PUBUC, State w Yo No. 01C06158874, Albany Coun Invoice-Work Order # 1932090 Commission Expires Jan 8, 2023 Attorney File # Liberty Mutual 6 of 14 FILED: FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08/19/2019 02:15 10:15 PM AM) INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 THOMAS F. DELANEY INC. Lic. Private Investigators Phone (914) 761-6367 Fax (914) 761-6368 AFFIDAVITOFSERVICE Supreme Court of the State of New York; County of New York LIBERTY MUTUAL INSURANCE COMPANY and LM GENERAL INSURANCE COMPANY, Plaintiffs, INDEX NO.: 654092/19 -vs. - KENDON THOMAS, ("IndMdual Defendants") and AMRO CARE PT, P.C., LAWRENCE CHIROPRACTIC DIAGNOSTIC SERVICE, NORTH SHORE HOME CARE SERVICES, INC., AVA CUSTOM SUPPLY, INC., OPUS PSYCHOLOGICAL SERVICES, P.C., SI ACUPUNCTURE, P.C., METRO PAIN SPECIALISTS PROFESSIONAL CORPORATION, PROSPECT CHIROPRACTIC, PLLC, CITIMEDICAL 1, PLLC, MAURO CHIROPRACTIC, P.C., HARBOR MEDICAL GROUP, P.C., ACUTUS RX, LLC, AK GLOBAL SUPPLY CORP., ("Medical Provider Defendants") Collectively the Defendants, State of New York, County of Nassau ss: ROBERT BRACKEN, being duly sworn, deposes and says that depoñent isover 18 years ofage and not a partyto thisaction;that on 29* the day ofJULY ofthe year 2019 at approximately 11:10 a.m. at 3 DAKOTA DRIVE, SUITE 300, NEW HYDE PARK, N.Y. 11042 deponent served theannexed SUMMONS & VERIFIED COMPLAINT on SI ACUPUNCTURE in the followingmanner: Corporate to and with ELMER MARTINEZ - PARALEGAL - a true who stated [X] By delivering leaving copy thereof, that he was authorized toaccept on behalf of said corporation. [ ]Mail A true copy thereof was also deposited in a postpeid, properly addressed envelope, to the above address in an officialdepository under the exclusive care and custody of the US Postal Service. Description Deponent describes the individual served as follows: [X] male [ ] female 5'9"-6'0" [X] brown skin [X] black hair [ ] glasses [X] [X] 161-200 Ibs. [X] 21-35 years Sworn to me on July 29, 2019 SUZANNE G. BRACKEN / State ROBERT BR CKEN Notary Public, of New York No. 01BR6323491 NYCDCA #: 1430550 Qualified inPutnam Coun Commission Expires April TFD AGENCY #: 1427277 20, 023 TFD LICENSE NO. 11000031079 7 of 14 FILED: FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08/19/2019 02:15 10:15 PM AM1 INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 Attorney(s) Thomas Å Delaney, Inc. Index # 654092/2019 Purchased/Filed: July 17, 2019 State ofNew York Court: Supreme County: New York AFFIDAVIT OF SERVICE - SECRETARY OF STATE Liberty Mutual Insurance Company Plaintiff(s) against Kendon Thomas, et al Defendant(s) STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs. COUNTY OFALBANY )SS CITY OF ALBANY 5' 0" ) Weight: 120 Lbs. Height: Sex: Female Color of skin: White Hair color: Blonde Other: Robert Guyette , being duly sworn, deposes and says: deponent isover the age of eighteen (18) years; is not a party to thisaction, and resides in the State of NY, and that on August 7, 2019 , at 1:35 PM , atthe officeof the Secretary of State of the State of NY, located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served: Summons and Verified Complaint with Notice of ElectronicFiling on Metro Pain Specialists Professional Corporation the Defendant in thisaction, by delivering to and leaving with Sue Zouky AUTHORIZED AGENT in the Office of the Secretary of State, of the State of New York, personally at the Office of the Secretary of State of the State of New York, two (2) true copies thereof and that at the time of making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service was made pursuant to Section BUSINESS CORPORATION LAW §306. Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said defendant. Sworn to before me on this 7th August 2019 FAITH COZZŸ Obert Guyette NOTARY PUBLIC, state rk No. 01C06158874, Albany County Invoice-Work Order # 1932091 Commission Expires Jan 8, 2023 Attorney File # Liberty Mutual 8 of 14 FILED: FILED: NEW NEW YORK YORK COUNTY COUNTY CLERK CLERK 07/14/2020 08719/2019 02:15 10:15 PM AM| INDEX INDEX NO. NO. 654092/2019 654092/2019 NYSCEF NYSCEF DOC. DOC. NO. NO. 13 3 RECEIVED RECEIVED NYSCEF: NYSCEF: 07/14/2020 08/19/2019 Attorney(s) Thomas F. Delaney, Inc. Index # 654092/2019 Purchased/Filed: July 17, 2019 State ofNew York Court: Supreme County: New York AFFIDAVIT OF SERVICE - SECRETARY OF STATE Liberty Mutual Insurance Company Plaintiff(s) against Kendon Thomas, et al Defendant(s) STATE OF NEW YORK ) DESCRIPTION OF PERSON SERVED: Approx. Age: 55 Yrs. COUNTYOF ALBANY )SS CITY OF ALBANY 5' 0" ) Weight: 120 Lbs. Height: Sex: Female Color of skin: White Hair color: Blonde Other: Robert Guyette , being duly sworn, deposes and says: deponent isover the age of eighteen (18) years; is not a party to this action, and resides in the State of NY, and that on August 7, 2019 , at 1:35 PM , atthe office of the Secretary of State of the State of NY, located at 99 Washington Ave, 6th FI,Albany, New York 12231 deponent served: Summons and VerifiedComplaint with Notice ofElectronic Filing on Prospect Chiropractic PLLC , the Defendant in this action, by delivering to and leaving with Sue Zouky AUTHORIZED AGENT in theOffice of the Secretary of State, of the State of New York, personally at the Office of the Secretary of State of the State of New York, two (2) truecopies thereof and that at the time of making such service, deponent paid said Secretary of State a fee of $40 dollars; That said service was made pursuant to Section LIMITED LIABILITY COMPANY LAW §303. Deponent further says that deponent knew the person so served as aforesaid to be the agent in the Office of the Secretary of State of the State of New York, duly authorized to accept such service on behalf of said defendant. Sworn to before me on this 7th day of August 2019 FArrH CO Robert Guyette NOTARY PUBLIC, State of New Yor No. 01CO6158874, Albany County Invoice-Work Order # 1932092 Commission Expires Jan 8, 2023 Attorney File # Liberty Mutual 9 of 14 FILED: FILED: NEW NEW