On January 04, 2021 a
Miscellaneous
was filed
involving a dispute between
and
for COUNTY CIVIL (15,001 to 30,000)
in the District Court of Gadsden County.
Preview
Filing # 118966256 E-Filed 01/04/2021 09:40:07 AM
BI INTHE COUNTY COURT IN AND FOR GADSDEN COUNTY, FLORIDA
DIVISION CASE NUMBER
& civit
CIVIL COVER SHEET
PLAINTIFF VS. DEFENDANT
CLOCK IN
FOREMOST INSURANCE
COMPANY GRAND RAPIDS,
MICHIGAN
CHARLES PRESIDENT
‘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 with the Clerk of Court for the purpose of
reporting uniform data pursuant to section 25.075, Florida Statutes. (See instructions for completion.)
AMOUNT OF CLAIM in excess of $8,000, but not exceeding $30,000
This action is for non-monetary declaratory relief, but for jurisdictional purposes only, the value of the
alleged loss involved herein is set forth above, exclusive of interest, court costs and attorneys fees.
TYPE OF CASE (If the case fits more than one type of case, select the most definitive category.) If the most descriptive label is a
subcategory (is indented under a broader category), place an x in both the main category and subcategory boxes.
COUNTY CIVIL
O Condominium Other
C1 Contracts and indebtedness (© Antitrust/Trade Regulation
O Eminent Domain O Business Transactions
O Auto Negligence 1 Constitutional Challenge - Statute or Ordinance
ONegligence - Other 1 Constitutional Challenge - Proposed Amendment
© Business Governance O Corporate Trust
© Business Torts O Discrimination - Employment or Other
O Environmental/Toxin Torts & Insurance Claims
(1 Third Party Indemnification 0 Intellectual Property
O Construction Defect 0) Libel/Slander
O Mass Tort O Shareholder Derivative Action
1 Negligent Security F Securities Litigation
O Nursing Home Negligence C1 Trade Secrets
Ci Premises Liability - Commercial O Trust Litigation
O Premises L:iability - Residential
© Products Liability COUNTY CIVIL
O Real Property/Mortgage Foreclosure
(1 Commercial Foreclosure X Civil
Cl Homestead Residential Foreclosure O Replevins
(2 Other Real Property Actions O Evictions
( Professional Malpractice C1 Other civil (non-monetary)
© Malpractice - Business
(© Malpractice - Medical
O Malpractice - Other Professional
(1 Insurance ClaimsREMEDIES SOUGHT
O monetary;
& non-monetary declaratory or injunctive relief
O punitive
NUMBER OF CAUSES OF ACTION: [ 1 ]
(specify) Declaratory Relief
IS THIS A CLASS ACTION LAWSUIT?
O Yes
& No
HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
No
O Yes IfYes”, list all related cases by name, case number and court.
IS JURY TRIAL DEMANDED IN COMPLAINT?
8 Yes
ONo
1CERTIFY that the information I have provided in this cover sheet is accurate to the best of my
knowledge and belief.
Signature: __Kenneth R. Duboff Florida Bar # _ 218261
Attorney for Plaintiff(s)/Petitioner(s)
Kenneth R. Duboff, Esq. Date: __ December 30, 2020
Document Filed Date
January 04, 2021
Case Filing Date
January 04, 2021
Category
COUNTY CIVIL (15,001 to 30,000)
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Filing # 118966256 E-Filed 01/04/2021 09:40:07 AM BI INTHE COUNTY COURT IN AND FOR GADSDEN COUNTY, FLORIDA DIVISION CASE NUMBER & civit CIVIL COVER SHEET PLAINTIFF VS. DEFENDANT CLOCK IN FOREMOST INSURANCE COMPANY GRAND RAPIDS, MICHIGAN CHARLES PRESIDENT ‘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 with the Clerk of Court for the purpose of reporting uniform data pursuant to section 25.075, Florida Statutes. (See instructions for completion.) AMOUNT OF CLAIM in excess of $8,000, but not exceeding $30,000 This action is for non-monetary declaratory relief, but for jurisdictional purposes only, the value of the alleged loss involved herein is set forth above, exclusive of interest, court costs and attorneys fees. TYPE OF CASE (If the case fits more than one type of case, select the most definitive category.) If the most descriptive label is a subcategory (is indented under a broader category), place an x in both the main category and subcategory boxes. COUNTY CIVIL O Condominium Other C1 Contracts and indebtedness (© Antitrust/Trade Regulation O Eminent Domain O Business Transactions O Auto Negligence 1 Constitutional Challenge - Statute or Ordinance ONegligence - Other 1 Constitutional Challenge - Proposed Amendment © Business Governance O Corporate Trust © Business Torts O Discrimination - Employment or Other O Environmental/Toxin Torts & Insurance Claims (1 Third Party Indemnification 0 Intellectual Property O Construction Defect 0) Libel/Slander O Mass Tort O Shareholder Derivative Action 1 Negligent Security F Securities Litigation O Nursing Home Negligence C1 Trade Secrets Ci Premises Liability - Commercial O Trust Litigation O Premises L:iability - Residential © Products Liability COUNTY CIVIL O Real Property/Mortgage Foreclosure (1 Commercial Foreclosure X Civil Cl Homestead Residential Foreclosure O Replevins (2 Other Real Property Actions O Evictions ( Professional Malpractice C1 Other civil (non-monetary) © Malpractice - Business (© Malpractice - Medical O Malpractice - Other Professional (1 Insurance ClaimsREMEDIES SOUGHT O monetary; & non-monetary declaratory or injunctive relief O punitive NUMBER OF CAUSES OF ACTION: [ 1 ] (specify) Declaratory Relief IS THIS A CLASS ACTION LAWSUIT? O Yes & No HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED? No O Yes IfYes”, list all related cases by name, case number and court. IS JURY TRIAL DEMANDED IN COMPLAINT? 8 Yes ONo 1CERTIFY that the information I have provided in this cover sheet is accurate to the best of my knowledge and belief. Signature: __Kenneth R. Duboff Florida Bar # _ 218261 Attorney for Plaintiff(s)/Petitioner(s) Kenneth R. Duboff, Esq. Date: __ December 30, 2020