Preview
INDEX NO. 650313/2017
(FILED: NEW YORK COUNTY CLERK 0171972017 11:09 AM
NYSCEF DOC. NO. RECEIVED NYSCEF: 01/19/2017
REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only:
Ucs-240 (712012) TAS Entry Date
SUPREME COURT, COUNTY OF. NEW YORK
Tudge Aselgned
Index No: Date Index Issued: IJ I
Enter the complete case caption, Do not use et al or et ano. If more space Is required, Rar Date
CAPTION: attach a caption rider sheet.
PROGRESSIVE SELECT INSURANCE COMPANY
as subrogee of ARSHMAN AHMED, RABIA RIAZ and ROBANA RIAZ,
Plaintiff{s)/Petitioner(s)
ragainst-
CITY OF NEW YORK,
Defendant(s)/Respondent(s)
NATURE OF ACTION OR PROCEEDING: Check ONE box only and specify where indicated.
MATRIMONIAL, COMMERCIAL
Contested CT Business Entity (Including corporations, partnerships, LLCs, etc.)
NOTE: For ail Matrimonial actions where the parties have children under C1 Contract
the age of 18, complete and attach the MATRIMONIAL RJI Addendum. C1 Insurance (where insurer Is a party, except arbitration)
For Uncontested Matrimonial actions, use Rul form UD-13, [1 UCC (inetuding sates, negotiable instruments)
TORTS C1 Other Commercial:
LT Asbestos (pacify)
CO Breast implant NOTE: For Commercial Division assignment requests [22 NYCRR §
1 Environmental: 202.70(d)}, complete and attach the COMMERCIAL DIV RJi Addendum,
(specify) REAL PROPERTY: How many properties does the application inclide?
1] Medical, Dental, or Podiatric Malpractice 1 Condemnation
1 Motor Vehicle OD Mortgage Foreclosure (speciiy): O Residential C1 commercial
1 Products Liability: Property Address:
(specify) NOTE: For Mortgage Foreclosure actions involving a one- to four-tamily,
OC other Negligence:, owner-occupied, residential property, or an owner-occupied
Gspectty) condominium, compiete and attach the FORECLOSURE RJI Addendum.
CI Other Professional Malpractice: CO Tax Certiorari - Section: Block: Lot:
(specify) CO Tax Foreclosure
C1 Other Tort: O other Reat Property;
¢specify) (epeciny
OTHER MATTERS SPECIAL PROCEEDINGS
Ty Gentificate of Incorporation/Dissolution [see NOTE under Commercial] Tx] CPLR Article 75 (Arbitration) [see NOTE under Commercial}
C Emergency Medical Treatment C1 CPLR Article 78 (Body or Officer)
C1 Habeas Corpus 0 Election Law
CO Locat Court Appeal OO MeL Article 9.80 (Kendra's Law)
C1 Mechanic's Lien 1 ML Article 10 (Sex Offender Confinement-Initial}
C1 Name Change [1 MHL Article 10 (Sex Offender Confinement-Review)
1 Pistol Permit Revocation Hearing 1 MHL Article 81 (Guardianship)
(1 Sate or Finance of Religious/Not-for-Profit Property C1 Other Mental Hygiene:,
C1 other: (epeaiy)
‘(evecifyy CO other Special Proceeding:
STATUS OF ACTION OR PROCEEDING: Answer YES ar NO for EVERY question AND enter additional information where indicated.
YES NO
Has a summons and complaint or summons winotice been filed? Ifyes, date filed:
Oo wW fe
Has a summons and complaint or summons winotica been served? O 8 Ityes, date served:
Is this actlon/proceeding being filed post-judgment? Oo 8 Ifyes, judgment date: L L
1 of 2
NATURE OF JUDICIAL INTERVENTION: Check ONE box only AND enter additional information where indicated,
Infant's Compromise
Note of Issue and/or Certificate of Readiness
Notice of Mecical, Dental, or Podiatric Malpractice Date Issue Joined: i___ fi
Nolice of Motion Relief Sought: Retum Date: i
15,
Notice of Petition Relief Sought; Confirm arbitration award Retum Date: _3 I v oT 2017
Order to Show Cause Relief Sought: Retum Date: I i
Other Ex Parte Application Relief Sought:
Poor Person Application
Request for Preliminary Conference
Residential Mortgage Foreclosure Settlement Conference
writ of Habeas Corpus
Other (specify):
RELATED CASES: List any related actions. Far Matrimonial actions, include any related criminal and/or Family Court cases.
If additional space is required, complete and attach the RJI Addendum. If none, leave blank.
Case Title IndexiCase No. Court Judge (ifassigned) Relationship to Instant Case
PARTIES: For parties without an attorney, check "Un-Rep" box AND enter party address, phone number and e-mail address in space provided.
if additional space is required, complete and attach the RJl Addendum,
Parties: Attorneys and/or Unrepresented Litigants:
Issue
Un- List parties in caption order and Provide attorney name, firm name, business address, phone number and e-mail Joined Insurance Carrier(s):
Rep indicate party role(s) (e.g. defendant, address of all attorneys that have appeared in the case. For unrepresented (YIN):
3rd-party plaintiff). litigants, provide address, phone number and e-mail address.
Name: progressive Select Feldman & Feldman, LLP Progressive Max
Insurance Company 811 West Jericho Turnpike, Suite 201W O Yes
Role(s}: Petitioner Smithtown, New York 11787 Insurance Company
(631) 979-1200 (631) 979-1264 C1No
Ghaesler@feldmanandfeldmanlaw.com.
NameCity of New York 100 Church Street O Yes
New York, New York 10007
Role(s): Respondent
ONO
Name:
O yes
Role(s):
ONo
Name:
Cl Yes
Role(s}:
CNo
Name:
O YES
Oo Rola(s):
ONO
T 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.
12 2017
Dated: 1 b __.—__ /
SIGNATURE
2619211 Gwenn E. Haesler
ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME
2 of 2
Preview
INDEX NO. 650313/2017 (FILED: NEW YORK COUNTY CLERK 0171972017 11:09 AM NYSCEF DOC. NO. RECEIVED NYSCEF: 01/19/2017 REQUEST FOR JUDICIAL INTERVENTION For Court Clerk Use Only: Ucs-240 (712012) TAS Entry Date SUPREME COURT, COUNTY OF. NEW YORK Tudge Aselgned Index No: Date Index Issued: IJ I Enter the complete case caption, Do not use et al or et ano. If more space Is required, Rar Date CAPTION: attach a caption rider sheet. PROGRESSIVE SELECT INSURANCE COMPANY as subrogee of ARSHMAN AHMED, RABIA RIAZ and ROBANA RIAZ, Plaintiff{s)/Petitioner(s) ragainst- CITY OF NEW YORK, Defendant(s)/Respondent(s) NATURE OF ACTION OR PROCEEDING: Check ONE box only and specify where indicated. MATRIMONIAL, COMMERCIAL Contested CT Business Entity (Including corporations, partnerships, LLCs, etc.) NOTE: For ail Matrimonial actions where the parties have children under C1 Contract the age of 18, complete and attach the MATRIMONIAL RJI Addendum. C1 Insurance (where insurer Is a party, except arbitration) For Uncontested Matrimonial actions, use Rul form UD-13, [1 UCC (inetuding sates, negotiable instruments) TORTS C1 Other Commercial: LT Asbestos (pacify) CO Breast implant NOTE: For Commercial Division assignment requests [22 NYCRR § 1 Environmental: 202.70(d)}, complete and attach the COMMERCIAL DIV RJi Addendum, (specify) REAL PROPERTY: How many properties does the application inclide? 1] Medical, Dental, or Podiatric Malpractice 1 Condemnation 1 Motor Vehicle OD Mortgage Foreclosure (speciiy): O Residential C1 commercial 1 Products Liability: Property Address: (specify) NOTE: For Mortgage Foreclosure actions involving a one- to four-tamily, OC other Negligence:, owner-occupied, residential property, or an owner-occupied Gspectty) condominium, compiete and attach the FORECLOSURE RJI Addendum. CI Other Professional Malpractice: CO Tax Certiorari - Section: Block: Lot: (specify) CO Tax Foreclosure C1 Other Tort: O other Reat Property; ¢specify) (epeciny OTHER MATTERS SPECIAL PROCEEDINGS Ty Gentificate of Incorporation/Dissolution [see NOTE under Commercial] Tx] CPLR Article 75 (Arbitration) [see NOTE under Commercial} C Emergency Medical Treatment C1 CPLR Article 78 (Body or Officer) C1 Habeas Corpus 0 Election Law CO Locat Court Appeal OO MeL Article 9.80 (Kendra's Law) C1 Mechanic's Lien 1 ML Article 10 (Sex Offender Confinement-Initial} C1 Name Change [1 MHL Article 10 (Sex Offender Confinement-Review) 1 Pistol Permit Revocation Hearing 1 MHL Article 81 (Guardianship) (1 Sate or Finance of Religious/Not-for-Profit Property C1 Other Mental Hygiene:, C1 other: (epeaiy) ‘(evecifyy CO other Special Proceeding: STATUS OF ACTION OR PROCEEDING: Answer YES ar NO for EVERY question AND enter additional information where indicated. YES NO Has a summons and complaint or summons winotice been filed? Ifyes, date filed: Oo wW fe Has a summons and complaint or summons winotica been served? O 8 Ityes, date served: Is this actlon/proceeding being filed post-judgment? Oo 8 Ifyes, judgment date: L L 1 of 2 NATURE OF JUDICIAL INTERVENTION: Check ONE box only AND enter additional information where indicated, Infant's Compromise Note of Issue and/or Certificate of Readiness Notice of Mecical, Dental, or Podiatric Malpractice Date Issue Joined: i___ fi Nolice of Motion Relief Sought: Retum Date: i 15, Notice of Petition Relief Sought; Confirm arbitration award Retum Date: _3 I v oT 2017 Order to Show Cause Relief Sought: Retum Date: I i Other Ex Parte Application Relief Sought: Poor Person Application Request for Preliminary Conference Residential Mortgage Foreclosure Settlement Conference writ of Habeas Corpus Other (specify): RELATED CASES: List any related actions. Far Matrimonial actions, include any related criminal and/or Family Court cases. If additional space is required, complete and attach the RJI Addendum. If none, leave blank. Case Title IndexiCase No. Court Judge (ifassigned) Relationship to Instant Case PARTIES: For parties without an attorney, check "Un-Rep" box AND enter party address, phone number and e-mail address in space provided. if additional space is required, complete and attach the RJl Addendum, Parties: Attorneys and/or Unrepresented Litigants: Issue Un- List parties in caption order and Provide attorney name, firm name, business address, phone number and e-mail Joined Insurance Carrier(s): Rep indicate party role(s) (e.g. defendant, address of all attorneys that have appeared in the case. For unrepresented (YIN): 3rd-party plaintiff). litigants, provide address, phone number and e-mail address. Name: progressive Select Feldman & Feldman, LLP Progressive Max Insurance Company 811 West Jericho Turnpike, Suite 201W O Yes Role(s}: Petitioner Smithtown, New York 11787 Insurance Company (631) 979-1200 (631) 979-1264 C1No Ghaesler@feldmanandfeldmanlaw.com. NameCity of New York 100 Church Street O Yes New York, New York 10007 Role(s): Respondent ONO Name: O yes Role(s): ONo Name: Cl Yes Role(s}: CNo Name: O YES Oo Rola(s): ONO T 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. 12 2017 Dated: 1 b __.—__ / SIGNATURE 2619211 Gwenn E. Haesler ATTORNEY REGISTRATION NUMBER PRINT OR TYPE NAME 2 of 2