On March 20, 2019 a
Summons
was filed
involving a dispute between
Perez, Esperanza,
and
Brown, Tawna,
Bruun, Tawna,
Does 1 Through 50,
Kaiser Foundation Health Plan Inc A California Corporation,
Kaiser Foundation Hospitals A California Corporation,
Southern California Permanente Medical Group Inc., A Caifornia Corporation,
for Wrongful Termination Unlimited
in the District Court of San Bernardino County.
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Electronicatiy F ILED by Superiar Court of Caiifomia County of as Rngetes an 0412312419 03 39 PM Sherri R Carter Executive OfficeriGlerk of Caurt by S Bolden deputy Gierk
x
aq
POS 010
ATTOi2NEV OR PARTY WlTHOUT AT70RNEY Name Sfate 8atnumbet and address FOR COURT USE ONLY
LAW FFICE flF TWILA S WHTTE
Twila S White S N 207424
6433 West Century Boulevard Suite 810
Los Angeles California 90045
TELEPHpNE NO 7 J j 87 FAX NO
PpfionaQ j 3 I 8799
E MAIL ADpRESS OpUona
arroRNsv FOR roame Plaintiff ESPEi2ANZA PEREZ
SUPERIOR CdURT OF NEW JEF2SEY couNrr aF LOS ANGELES
sraEeTnaoRess 111 North HiIC Street
MAILING ADDRESS
CITYANDZIPCOOE
S ArI e IE S California 90012
BRANCtt htAME
P wTiFFiaEriTioN R E5PERANZA PEREZ A
a FENaANriR sPorvo rvr KAISER FOUNDATION HOSPITALS etc et al
Ref No or File No
PROOF OF ERVICE OF SUMMCINS
1695378YF
Separate proofaf senrice is required for each party seroed
1
At the time of service I was at least 18 years of age and not a party to this action
2 i served copies of
a 0 summons
6
0 complaint
c Alternative Dispute Resolution ADR package
d 0 Civi1 Case Cover Sheet served in complex cases only
e cross camplaint
Amended Summons First Amended Gomplaint Notice af Case Assignment tJnlimited Civil
f
0 ather speeify documents Case Voluntary Efficient Litigation Stipulations Packet
3 a Party served specify name of party as shown an documents senredj
KAiSER FOLINDATiON HEALTH PLAN iNC a Caiifarnia Corporation
b
Person other than the party in item 3a served an behalf af an errtity or as an au horized agent and not a person
under item 5b on whom substituted serviCe was made specify name and relatianship to the party named in item 3a
CSC Lawyers Incorporating Service A ent for service by serving Becky Degearge Receptianist
4 Address where the party was served
2710 Gateway Oaks Drive Suite 150N Sacramento California 45 14
5 f served the party check proper bax
a 0 by personat service I personally delivered the documents listed in item 2 to the party or person authorized to
receive service oE process the party date 041 212019 2 time
or an a
3 4 p rn
b 0 by substituted service On dafe at time i left the documents listed in item 2 with or
in the presence of name and fifle or relafionship ta person indicated in item 3
1 business a person at least 18 years of age apparently in cnarge at the office or usual place of business
of the persnn to be served I informed him or her of the generai na ure of the papers
2 homeJ a competen member of the household at least 18 yeass ot age et the dwelling house or usuaf
place of abode of the party I in ormed him or fier of fhe ganeral nature of the papers
physical address unknown a person at Ieast 18 years of age apparently in charge at the usual mailing
address af tfie person ta be served other than a United States Posta3 Service past office box i informed
him or her of the general nature of the papers
4 0 1 thereafter mailed by first class pastage prepaici copies of fhe cfocuments ta the person ta be served
at the place wherethe copies were left Code Civ Proc 415 I maifed the documents on
date fram citY1 or a declaration of mailing is attached
5 C attach a deciaration of diligence stating aetions aken first fo attempt personai service
Page 1 ot 2
Fo n naopiearo asa at yu5 coaeorG raea e a r zo
Judiciai Council of Ca ifomie t ROOF UE SERVICE OF SUMMCINS
American I egalNel In
POS 0 0 Rev t
January 2007j www formsWorkl pw com
PLAINTIFFIRETITIONER SPERANZA PEREZ caser un eErz
19STCV0967q
DEFENDANTlRESPONDENT KAISER FOUNDATION HOSPITALS etC et aI
5 0 by mail and acknowiedgment of receipt of service I mailed the documents listed in item 2 to the party to the
address shawn in item 4 by certified mail postage prepaid wifh atticle number 7Q14349000Q104562994
1 on date 2 from city
0 with iwo copies of the Notice and Acknowledgment of Receipt and a postage paid retum envelope addressed
to me Atfach completed Notice and Acknpwledgement of Receipt Code Civ Prqc 415 30
4 to an address ouEside Californ sa with retum recsipt requested Code Civ Prac 415 40
by other means specify means of service and authorizing code sectionJ
Q Additionai page describing service is attached
6 The Notice to the Person 8enred on the summans was cornpleted as foitows
a 0 as an individuai defendant
b
as the person sued under the fictitiaus name of specify
0 as occupant
d
qn behalf of specify KAISER FOUNDATION HEALTH PLAN INC a California Cor ao ation
under the following Code of Civil Arocedure sectian
416 10 carporatian 415 95 business organization form unknown
416 20 defunct corporation 416 Bp minor
C 416 30 joint stock company association 0 416 70 ward or conservatee
0 416 4Q associatian ar partnership 416 9t1 aufhorized person
416 50 public en i y 415 46 pccupant
other
7 Person wha served papers
a Name Todd Lewis Ace Attorney Service Inc
b Address 4Q1 F Street Suite 150 Sacramento Caiifornia 95 l4
c Telephone number 916 44 4000
d The fee for service was 15l 84
e I am
1 not a registered Califarnia process server
2 exempt fram registratian under Business and Professions Code sectian 22350 tr
3 a registered California process server
i
0 owner employee independent con ractor
iij Registra ion No
iii Gounty
8 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and co rect
4
9 I am a California sheriff or marshal and I certify that the foregoing is true and correct
Date Aprii 3 2019
TODD LEWTS
NAME OF PERSON WHO SERVED PAPERS MERIFF OR MARSHAI IGNATU
PpS 070 Rev Januaryt z PSg 2 z
PROOF tJF SERViCE OF SUMMC NS
Document Filed Date
April 23, 2019
Case Filing Date
March 20, 2019
Category
Wrongful Termination Unlimited
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Preview
Electronicatiy F ILED by Superiar Court of Caiifomia County of as Rngetes an 0412312419 03 39 PM Sherri R Carter Executive OfficeriGlerk of Caurt by S Bolden deputy Gierk x aq POS 010 ATTOi2NEV OR PARTY WlTHOUT AT70RNEY Name Sfate 8atnumbet and address FOR COURT USE ONLY LAW FFICE flF TWILA S WHTTE Twila S White S N 207424 6433 West Century Boulevard Suite 810 Los Angeles California 90045 TELEPHpNE NO 7 J j 87 FAX NO PpfionaQ j 3 I 8799 E MAIL ADpRESS OpUona arroRNsv FOR roame Plaintiff ESPEi2ANZA PEREZ SUPERIOR CdURT OF NEW JEF2SEY couNrr aF LOS ANGELES sraEeTnaoRess 111 North HiIC Street MAILING ADDRESS CITYANDZIPCOOE S ArI e IE S California 90012 BRANCtt htAME P wTiFFiaEriTioN R E5PERANZA PEREZ A a FENaANriR sPorvo rvr KAISER FOUNDATION HOSPITALS etc et al Ref No or File No PROOF OF ERVICE OF SUMMCINS 1695378YF Separate proofaf senrice is required for each party seroed 1 At the time of service I was at least 18 years of age and not a party to this action 2 i served copies of a 0 summons 6 0 complaint c Alternative Dispute Resolution ADR package d 0 Civi1 Case Cover Sheet served in complex cases only e cross camplaint Amended Summons First Amended Gomplaint Notice af Case Assignment tJnlimited Civil f 0 ather speeify documents Case Voluntary Efficient Litigation Stipulations Packet 3 a Party served specify name of party as shown an documents senredj KAiSER FOLINDATiON HEALTH PLAN iNC a Caiifarnia Corporation b Person other than the party in item 3a served an behalf af an errtity or as an au horized agent and not a person under item 5b on whom substituted serviCe was made specify name and relatianship to the party named in item 3a CSC Lawyers Incorporating Service A ent for service by serving Becky Degearge Receptianist 4 Address where the party was served 2710 Gateway Oaks Drive Suite 150N Sacramento California 45 14 5 f served the party check proper bax a 0 by personat service I personally delivered the documents listed in item 2 to the party or person authorized to receive service oE process the party date 041 212019 2 time or an a 3 4 p rn b 0 by substituted service On dafe at time i left the documents listed in item 2 with or in the presence of name and fifle or relafionship ta person indicated in item 3 1 business a person at least 18 years of age apparently in cnarge at the office or usual place of business of the persnn to be served I informed him or her of the generai na ure of the papers 2 homeJ a competen member of the household at least 18 yeass ot age et the dwelling house or usuaf place of abode of the party I in ormed him or fier of fhe ganeral nature of the papers physical address unknown a person at Ieast 18 years of age apparently in charge at the usual mailing address af tfie person ta be served other than a United States Posta3 Service past office box i informed him or her of the general nature of the papers 4 0 1 thereafter mailed by first class pastage prepaici copies of fhe cfocuments ta the person ta be served at the place wherethe copies were left Code Civ Proc 415 I maifed the documents on date fram citY1 or a declaration of mailing is attached 5 C attach a deciaration of diligence stating aetions aken first fo attempt personai service Page 1 ot 2 Fo n naopiearo asa at yu5 coaeorG raea e a r zo Judiciai Council of Ca ifomie t ROOF UE SERVICE OF SUMMCINS American I egalNel In POS 0 0 Rev t January 2007j www formsWorkl pw com PLAINTIFFIRETITIONER SPERANZA PEREZ caser un eErz 19STCV0967q DEFENDANTlRESPONDENT KAISER FOUNDATION HOSPITALS etC et aI 5 0 by mail and acknowiedgment of receipt of service I mailed the documents listed in item 2 to the party to the address shawn in item 4 by certified mail postage prepaid wifh atticle number 7Q14349000Q104562994 1 on date 2 from city 0 with iwo copies of the Notice and Acknowledgment of Receipt and a postage paid retum envelope addressed to me Atfach completed Notice and Acknpwledgement of Receipt Code Civ Prqc 415 30 4 to an address ouEside Californ sa with retum recsipt requested Code Civ Prac 415 40 by other means specify means of service and authorizing code sectionJ Q Additionai page describing service is attached 6 The Notice to the Person 8enred on the summans was cornpleted as foitows a 0 as an individuai defendant b as the person sued under the fictitiaus name of specify 0 as occupant d qn behalf of specify KAISER FOUNDATION HEALTH PLAN INC a California Cor ao ation under the following Code of Civil Arocedure sectian 416 10 carporatian 415 95 business organization form unknown 416 20 defunct corporation 416 Bp minor C 416 30 joint stock company association 0 416 70 ward or conservatee 0 416 4Q associatian ar partnership 416 9t1 aufhorized person 416 50 public en i y 415 46 pccupant other 7 Person wha served papers a Name Todd Lewis Ace Attorney Service Inc b Address 4Q1 F Street Suite 150 Sacramento Caiifornia 95 l4 c Telephone number 916 44 4000 d The fee for service was 15l 84 e I am 1 not a registered Califarnia process server 2 exempt fram registratian under Business and Professions Code sectian 22350 tr 3 a registered California process server i 0 owner employee independent con ractor iij Registra ion No iii Gounty 8 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and co rect 4 9 I am a California sheriff or marshal and I certify that the foregoing is true and correct Date Aprii 3 2019 TODD LEWTS NAME OF PERSON WHO SERVED PAPERS MERIFF OR MARSHAI IGNATU PpS 070 Rev Januaryt z PSg 2 z PROOF tJF SERViCE OF SUMMC NS