Preview
Filing # 138058219 E-Filed 11/08/2021 08:54:47 AM
IN THE CIRCUIT COURT, IN THE
FOURTH JUDICIAL CIRCUIT, IN AND
FOR DUVAL COUNTY, FLORIDA
CASE NO.: 16-2020-CA-005919-XXXX-MA
DIVISION: CV-C
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
as Subrogee of THANH QUANG DANG,
Plaintiff,
vs.
FLORIANGELY RIVERA GARAY, an Individual, AKA FLORIANGELY RIVERA and
RAQUEL GARAY ACOSTA, an Individual, AKA RAQUEL ACOSTA GARAY,
Defendants.
/
PLAINTIFF’S NOTICE OF SERVICE
COMES NOW Plaintiff, by and through its undersigned counsel, and hereby notifies the
Court that the Plaintiff has mailed via certified mail/return receipt requested, Two copies of the
Summons on Amended, Amended Complaint, and Designation of Email Address, addressed to
Defendant, Raquel Garay Acosta AKA Raquel Acosta Garay, 6380 IRONSIDE DR S,
Jacksonville, FL 32244.
I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished
this 1st day of November 2021, by certified U.S. Mail # 9214 8901 9403 8357 9273 42 to
Raquel Garay Acosta AKA Raquel Acosta Garay, 6380 IRONSIDE DR §, Jacksonville, FL
32244.
Hiday & Ricke, P.A.
By: /s/ Jennifer L. Reiss
Jennifer L. Reiss, Esquire
Post Office Box 550858
Jacksonville, FL 32255
(904) 363-2769 Fax: (904) 363-0538
Email: litigation@hidayricke.com
Florida Bar No.: 0122947
File # 201904821
ACCEPTED: DUVAL COUNTY, JODY PHILLIPS, CLERK, 11/09/2021 08:25:15 AM
Filing # 136254547 E-Filed 10/11/2021 07:45:35 AM
IN THE CIRCUIT COURT, IN THE
FOURTH JUDICIAL CIRCUIT, IN AND
FOR DUVAL COUNTY, FLORIDA
CASE NO.: 16-2020-CA-005919-XXXX-MA
DIVISION: CV-C
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY
as Subrogee of THANH QUANG DANG,
Plaintiff,
vs.
FLORIANGELY RIVERA GARAY, an Individual, AKA FLORIANGELY RIVERA
and
RAQUEL GARAY ACOSTA, an Individual, AKA RAQUEL ACOSTA GARAY,
Defendants.
/
SUMMONS ON AMENDED
TO Raquel Garay Acosta AKA Raquel Acosta Garay
c/o Florida Secretary of State Pursuant to Fla. Stat. 48.161-48.171
P.O. Box 6327
Tallahassee, FL 32314
A lawsuit has been filed against you. You have 20 calendar days after this
summons is served on you to file a written response to the attached Complaint in this
Court. A phone call will not protect you; your written response, including the above case
number and named parties, must be filed if you want the Court to hear your case. If you
do not file your response on time, you may lose the case, and your wages, money and
property may thereafter be taken without further warning from the Court. There are other
legal requirements. You may want to call an attomey referral service or a legal aid office
(listed in the phone book). If you choose to file a written response yourself, at the same
time you file your written response to the Court you must also mail or take a carbon copy
or photocopy of your written response to the Plaintiff/Plaintiff's Attorney named below.
ACCEPTED: DUVAL COUNTY, JODY PHILLIPS, CLERK, 10/11/2021 03:47:27 PM
Plaintiff/Plaintiff's Attomey
Hiday & Ricke, P.A.
Post Office Box 550858
Jacksonville, FL 32255
THE STATE OF FLORIDA
TO EACH SHERIFF OF THE STATE: You are commanded to serve this Summons and
a copy of the Complaint in this lawsuit on the above-named Defendant.
DATED ON Oct 11 2021 »20
JODY PHILLIPS
Clerk of the ‘ircuit and
5
County Courts
sods
Ry
i
Duval County, Florida i
py: mao Ge *H
As Deputy Clerk te!
eersst Pie upluggage;
truck, van, minivan, or Sport utility ve~
‘designed primant! ly 10 carry persons: and
OF
vehicle; or *
2. the end of thé 14th calendar day immediately 2: a plekiup tuck, vai, miiv, or epoit uty
following the date the car is delivered to you.
a. while not used for:
If a newly acquired car is not otherwisé afforded ale; or
comprehensive coverage or. collision coverage by a)
this or any other policy, then this poli will pro- Q) !
le Com) ensive
rt Coverage ‘or. llision Cover-
pickup or delivery; sind
age for. that, f
,
acquired car, subject toa
deductibleof $501 : Any ‘coverage provided as .a
result of this paragra| h will apply ly only until the end
b. that has a Gross Vehicle Weight Rating of
a3
lendar y immediately following the
10,000 poundsor less,
of the 5th
date the néwly' acquired car is delivered to you, Reasonable Charge, which includes reasonable
expenise, means an amount determined by us to be
‘No-FaultAce meatis the Florida Motor Vehicle No- reasonable in accordance with the No-Fault Act,
Fault Law and any amen ents. considering one or more of the following: *
Non-Owned Car means. car that is in the lawful L usual and customary charges;
possession of you or any resident relative and that payments accepted by the provider;
neither
1, | is owned by: 3. reim| bursément levels in the community;
4, us federal arid stite medical fee schedules
yous applicable to motor vehicle and other insurance
b any resident relitive, coverages;
any other person who resides primarily in the schedule of maximum charges in thé No-
your household; or ‘ault Act,
bore. 2
an empl er of any pérson described ina,
ove; nor
6. dthér information réleVant to, the reasonable-
ness of the charge for.the service, treatment, or
supply; or
2, has been operated by, rented by, or in the pos- .:
7. licies arid pay ent méth-
session of:
a. yOu; oF
Medicare coding
odologies of the
and.
fed
leral Centers for Medicare
icaid .Services, including applicable
b, any resident relative modifiers,if ‘the. coding policy or payment
during any part of each of the 31 or more con methodology does not constitute a utilization
secutive days immediately prior to the date of imi
the accident or loss. Relative means a relative of any de by blood or
Occupying means in, on, entering, or exiting. marriage who usually makes his or her home in the
‘same family unit, whether or not temporarily living
Our ‘means the Company issuing this policy as elsewhere. *
shown on the Declarations Page.
Resident Relative means persoi, other than jou,
Owned By means: Who resides primarily with the first person shown as a
1. owned by; named insured on thé Declarations ge and who is:
2, registered to; or : or her
1. related to that named insured or his includ.
spouse by blood, marriage, or adoption,
3. leased, if the ledse is written for a period of 6
months or more, to. oi an arried and unemancipated itdof
}
er Who is away at school
$ and otherwise
Pedestrian means a person who is not occupying:. maintains ‘his or ler primary residence with
1. ‘amotor vehicle; or
that named msure: or
Saioa
OCT. 6.2014 {0s %5Ai ADC CENTER NO. 2200 B 6
+
2. a Ward or 4 foster child of that named insured, b, notdesigned to carry persons; and
his or her: spouse, or @ person described -in 1. 6G. whilé not .used as premises for office,
ove, _ store, or display purposes; or
State Farm Companies means one or moté of the 2. a farm implement or farm wagon while being
following: pulled on public roads by a car.
}. State Faith Mutual Automobile Insurance Us. Tieang. the Company issuing this policy as
Company; own on the. Declarations Page.
State Earm Fire and Casualty Company; and We means. the Company issuing this policy as
ubsidiaries
or affiliates of either 1; or 2, above, shown on the Declarations Page.
. -
rary Substitut
i. e Car means a car that is in the You or Your means the named insuréd or named
Taw ul possessit ion of the person operating it and that: ins! shown'on the Declarations Page. If a
named insured shown on the Declarations Page is a
1 replaces your car for a short time while your ers on, then.“9' you". or “your” includes the spouse of
car is out of use due to its:
* preskdown;
fhspouse resides primaril ly with that named
e first person shov Wny ag a named insured if the
insured.
b, Tepair; Your Car nieans the vehicle shown under "YOUR
Cc »” on the clarations Paze. Your Car does not
Ge servicing; include a vehicle that you no Iolonger own or lease.
damage; or J€a car is shown on the Declarations Page under
GQ theft; and “YOUR CAR”, and your ask us to replace it with a
neither you nor the person operating it own or
2, have registered, car newly owited by you, then the car being replaced
will continue to be considered your’ car until the
Ifa car qualifies as both a fon-owned car and a earliest of:
temporary substitute car, the n it is considered a 1. the hd of the 30th calendar day immediately
by you
temporary substitute car only. following the date the car newly owned
Trailer means: is delivered to you;
1. attailer: 2. the date this policyis no loriger it fo or
3. the date you no longer own or the car
a, designed to be pulled by a private passen- being replaced,
ger car;
LIABILITY COVERAGE (Bodily Injury and Property Damage)
This policy vides Liability Coverage if “A” is SP ouisé Who résides primarily with that named
shown under FR‘SYMBOLS"” on the Declarations Page. insured for. the maintenance
te or use of a car that
by an employer. to,
Additional Definition
is owned by, or IST
erson who resides primarily in your housel hi old,
Tnsured means: fiut only. if such car Neither owned by, nor
furnished by an‘employer to, the first person
1. you and resident relatives for: shown as a named insured on the Declarations
a, the ownership, maintenance, or use oft Page or that person's spouse;
(1) your car; 3. any other person for his or her use of:
(2) aneiwly acquired car, Or your car,
(3) adrailer;
and be ‘anewly acquired car;
the maintenance or use of: at orary substitute car; or
(1) anon-owned car, or a a trailer while attached 10 a ear described
(2) a temporary substitute car, ina, b, ore, above,
2. the first person shown as a. named insured on the Such vehi ust be used with your express or
Declarations Page and’ thet named insured’: implied pi 18§ mn; an
9810A,
OCT. 6.2014 10:26AM ADC CENTER No. 2200 27
-
(1) that pait'’o ¢ damages we pay; Or
4
ii the
other. érsoni Or Organization vicaridusly.
le for ¢ use of a vehicle’ by an insured as:
defined in 1. ., OF 3. above, but only for such (2) this polie y's agpliabe Liability Cov-
vicarious liabil ity. This provision applies only erage limi
if the vehicle is neither owned by, nor hired by, b. after a judgment.”
that other person or organization. We have no duty to pay interest that accrues af-
Insured does not include . the United States of ter we deposit in court, pay, or offer to pay, the
merica or any of its agencies. amount due undef.the InsuringA: ement of
Insuring Agreement nodamagesuty
licy’s Liability Coverage. HV also have.
to pay interest that ‘accrues on any
gally list i
1 We will ay damages an insured becomes le- paid or payable by'a party other. than
2 le to pay because of: the insured or us;
a. bodily injury to others; and 4 Premiums for ‘bonds, provided by a company’
b, damage to property chosen by us, required to ap eal a decision ina
lawsuit against an insured. We have no duty to:
caused by an accident that invoives a yehicle a ay for a ‘bond with a face amolint that
for which that insured is provided Liability exceeds this policy's applicable Liability
Coverage by this policy. Coverage limi
2: We have the right to: b fumish or apply. fot any bonds; or
a, investigate, negotiate, and settle any claim
or lawsuit;’ ©, pay premiums for bonds purchased after we
deposit in court, pay, or offer to pay, the
6, defend an insured in any claim or lawsuit, amount due under.the Insuring Agreement
with attorneys chosen by ws; anc of this policy’s Liability Coverage; an
@ appeal aty award or legal decision ‘The following costs and expenses if related to
for damages payablé under this policy’s Liabil- and, . incurre ‘after a lawsuit has been filed
ity Coverage. againstan insured:
Supplementary Payments a Loss of wages of salary, but not other in-
We will pay, in addition to the damages described in ‘Got me; up to $200:for each day an insured
the Insuring Agreement of this policy’s Liability. att end s, at our request;
Coverage, joses ite. ms Jisted below that result from (1) an tion;
such accident: (2) a mediation;
1 Attomey fees for attomeys chosen by us. to (3) atrial ofa lawsuit; and
defend an insured who is sued for such’damag-
es. Ie have no duty to pay attomey fees In- b Reasonable expenses incurred by an in-
curred after we depositin court or pay the Sured at our request other than loss of
amount due under the Insuring Agreement of ‘wages, salary, or other income. °
this policy’s Liability Coverage; The amount of any.of the costs or expenses
Court costs aivarded by the court against an listed “above that ar¢. incurre an insured
insured and resulting from that part of the Law= must be reported to us before we will pay such
sit incurted costs: or expenses.
a, that seeks damages payable under this pol- Limits
icy’s Liability Coverage; ant
b. against which wé defend an irisured with
attorneys chosen by ws.”
TheLi Coverage limits for bodily i it
shown on the Declarations Page under “1
Coverage ~ Bodily ly Injury. Limits = Each’ Person,
tigi
We have no du
ter.we deposit th to pay court costs incurred af
court or pay the amount duo
under the Insuring Agre ement of this policy's
Each Accident,”
‘The limit shown under “Each Person’ is the most
Liability Coverage; “° we will pay for the sum of:
3. Interest the insured Ig legally liable to pay on 1 all dams: ges resulting from bodily injury to ‘any
mages payable under ¢ Insuring Agree- one person injured in any. one accident; an
ment of this policy's Liability Coverage: 2 all damages, including damages for emotional
a before a judgment, but only the interest on tress, Sustained by other persons as 4 direct
the lesser f result of that bodily injury.
980A,
OCT. 6.2014 1 AM ADC CENTER NO. 2200 PB, 8
The limit shown under “Each Accident” is the most BR. BODILY INJURY TO-THAT INSURED S
we will pay, subject to the limit for r “Each Person”, OF THAT
jamages an emotional distress resulting EMPLOYEE'S * This exclu-
sion does not apply to chat dasured’s household
accident.
dante
from boi dil injury to two or more persons Who
sustained Radges ‘or emotional distress in the same employee who is neither cove
Je COV , under ¥
nor require
compens: insure
ance;
The Liability Coverage Y it for dama:
ig shown on the De tons Page under er
fer’ Faas
e. Limit = Each Acci-
5 FOR BODILY INSURE 1‘TO THAT INSURED'S
EELLO
Vera ropes
dent”, elim
e ee is the mostwe will pay for
all damages resulting from damage to property” in SCOPS OF He. OR HER EME
Ou nt resident
any one accident,
These Liabili Coverage limits aré the most 32
This exclusion does not apy
relatives who are legallyJi
employees,
behis coveragi
for Bodily injury.
to fellow em ort
will pay rege less of the numberof: " icy, is tocert inancial responsi ti
1 ‘insureds; 6, R DAMAGES ARISING’ OUT. 0)
2, clainis made OWNERSHIS MAINTENAN i “ist OFOF
A (CLE WHILE IT
3: vehicles insured; or LEASED TO OTHERS BY AN INSURED;
4. vehicles involved in the accident, 1 FOR DAMAGES ARISING OUT OF ‘THE
Nonduplication ANCE ORUSE OF
E ITIS IG USED
We will not pay any damages or expenses under Liabil- GARRY PERSONS FOR A CHARGE This
iy erage: exclusion does not a ply to the use of a‘private
1 that have already been paid as expenses under passenger car ona s! ft are-the-expense basis;
No-Fault Coverage or Medical Payments Coy- ware MAINTAINING OR usn USING A VE-
erage of any policy issued the State Farm CLE IN.-CONNECTION. WITH THA’
Companies to you or any. resident relative; or a URED SE EMPLOYMENT IN OR, ENGAGE.
that have already been paid, under Uninsured A CAR. BUSI-
NESS: Tis exclusion does not only to:
Motor Vehicle Coverage’or Underinsured Mo-
tor Vehicle Covérage of any policy issued-by a yous
the State Farm Companies to you or any rest- bo any resident relative; or
dent relative, ¢ agent employee, or business partner
aby agen
Exclusions
‘THERE IS NO COVERAGE FOR AN INSURED: while ata or using your car, a newly
acquired car,.a temporary substitute cat, OF &
1 WHO INTENTIONALLY CAUSES BODILY trailer owned by you; |
INJURY OR DAMAGE TO PROPERTY;
2. FOR BODILY INJURY 10: 9 wae Feat INSURED IS VALET PARK-
a YOU; 10. WHEE anreaninis OR USING ANY VE-
b RESIDENT RELATIVES; AND Hy 0 IR, ANEWLY
G. ANY OTHER. PERSON. WHO BOTH 4epUR SCAR, A TEMPO! RARY SUBST
SL
RESIDES PRIMARILY es S OR ORCUPATION HSER tH
SURED AND WHO: VALET PARKING, Ths
(1) ISRELATED
TO THAT INSURED BY Salus does’ not
use ofa private passenger
ply to the maintenance or
car,
BLOOD, MARRIAGE, OR ADOP-
TION; OR n, FORDAMAGETO PROPERTY WHILE
IT IS:
(2) IS AWARD OR FOSTER CHILD OF a, OWNED BY;
THAT INS' Di; b RENTED TO;
OR FOR THAT INSURED'S INSURER FOR ¢. USEDBY;
ay OBLIGATION UNDER ANY TYPE OF d. IN THE CARE OF; OR.
WORKERS' COMPENSATION, DISABIL-
ITY, OR SIMILAR LAW; TRANSPORTED BY
9810A
OCT. 6.2014 7 AM ADC CENTER io. 2700 Bg
Ye hy, 2. The Liability Coverage provided by this policy
PERS dN WHO Ie LEGACY TABLE FOR applies as primary coverage for the ownership,
GE, This exclusion does not spply intenance, , oF use of, your car or a trailer at
todamagetoa:’” tached to it,
a motor vehicle owned tho
2 employer of
st
x ou oF any resident 7rel ti Hn ive if such dam-
‘age is caused by:an insured while operat
a If
(1) this is the only.Car Policy issued to
ng another mo vehicle; "you or any resident relative by the
b ‘residence while rented to or leased to an State Farm Companies that provides
insured, or. liability Coverage which applies to the’
private garage while rented to orleased to accident as primary coverage; and
v
i (2) liability coverage provided by one or
i2, FOR LIABILITY ASSUMED UNDER ANY more sources other. than re State
CONTRACT OR AGREEMENT; Farm Companies also applies as pri-
sf
13. WHILE UI! SING A TRAILER ¥ A 10- mary coverage for the same accident,
PROVIDED -LIABILITY..C
CLE IF. THAT INSURED IS Ni then we will pay the proportion of d
THIS POLICY FOR THE USE OF THAT ages payable as-primary that our plica-
MOTOR VEHICLE; ble it bears to the sum of our applicable
limit and the limits of all other liability
14, FOR THE OWNERSHIP, .MAINTEN/ [ANC CE; coverage that apply ‘as primary coverage.
OR USE OF ANY VEHICLE WHILE, STIS:
b Itt
a OFF PUBLIC ROADS AND BEING PRE-
PARED FOR, USED,IN PRACTICE FO] (1) more than ote Car Policy issued: to
OR OFERATED IN ANY RACING CON- you or any resident relative by the
TEST, . SPEED... CONTEST, HILL- State Farm Companies provides lia
CLIMBING CONTEST, JUMPING CON- ity coverage which applies to the
TEST, OR ANY SIMILAR CONTEST: OR | accident ‘primary coverage; and
b ON A TRACK DESIGNED (2) Wabi provided by one or
FOR RACING OR HIGH-SPEED D) 'o more sources other than the State
ING. This exclusion (14.b.) does not spply ie Farm Companies also applies as pri-
the vehicle is being used in connect 1 mary coverage for the same accident,
an activity other. than rac! ing, \-
6 oF any Hype 0 f t compenetitive driving; then the State Farm Comparties will pay the
proportion of damages payable as
15; WHO IS AN EMPLOYEE OF THE UNITED
that the maximum ‘amount that may
by the State Farm Companies as det
teal
S OF AMERICA OR ANY OF ITS in 1.al re béarsto the sum of such amount
AGENCIES, IF THE PROVISIONS OF THE and the limits of all other liability coverage
FEDERAL
TORT CLAIMS ACTAPPLY. ~ that apply as primery coverage.
If Other Liability Coverage Applies
i. Tf liability cov e provided b y this olicy and
one or more other Car Policies issu toyou or
3 Except as provided in 2, above, the Liability
excess cove rovided
ger
by this policy applies as
any resident relative by the State Farm Coim-
Panies applyto the saitie accident, then: a If
a the liability coverage limits of such lis (1) this is the only Car. Policy issued to
cies will not be addéd.together to deter- yout or any ‘resident relative by the
mine the most that may be paid; an State Farm Companies that provides
liability coverage which applies to the
d, je maximum amount that may.be paid accident as excess coverage; and
from all such policies combined is the sin-
gle highest applicable, it. provi yy (2) liability coverage’ provided by one.or
any one o! jolicies. jOOSe We may More sources other than e State
one or more policies from which to make Farm Companies also applies as ex-
payment. cess coverage for the same accident,
Sst0a
OCT. 6.2014 10:26AM ADC CENTER No. 2700 P10
then we will pay the proportion of dam- Required Out-of-Staté Liability Coverage
ages payable as excess that our applicable If
limit bears to the sum of our applicable
limit and the limits of all other liability 1, an Insured is in another state of the United
coverage that apply as excess coverage, States of America, 2 territo or possession
of the: United States of America; ¢ District
b If; of Columbia, or any province or territory of
(1) tiore than ane Car Poliéy issued to you ‘anada, and as a nonresident bei S sul
ject to its motor vehicle co:
ot any resident ‘relative
Farm Companies”
a
vides
the State
liability,
ance’ Ia iW, , financial’ responsi i msur-
law, or
coverage which appliés to the accident similar law, and
8S excess coverage; and this poli les not provide at 1éast the mini-
mum Tiabity coverage required by such law
(2) liability coverage provided by one or for such ne ident,
more sources other than the State then this policy jvill be interpreted to. rovide
Farm: Companies ‘also applies as ex=
cess coverage for the Same accident,
the minimum Ifability coverage required yy such
law.
5
then the State Farm Companies will pay This provision does not apply 16 liability coverage
the proportion of daniazes payable as ex- requited by. law for motor catri, ers of passengers or
cess that the maximum amount that may motor carriersof property.
be paid by the State’-Farm Companies as Financial Responsibility Certification
determined in 1. above bears to e sum of When this policy is certified under any law.as proof
such amount and the limits of all other lia- of future financial responsibility, and while required
bility coverage that apply as excess cover- during the policy period, this Policy will comply
age, with such law to the extent requi ured, *
PROPERTY DAMAGE LIABILITY COVERAGE
This policy provides Property Damage Liability but only if suchcar is neither owned dy, nor
Coverage if “B”.{s shown unde
the Declarations Page.
1 'SYMBOLS” on furnished by an employer to, the first person
shown ‘as 2 named insured on the Decl; larations
Additional Definition Page or that person's spouse;
Insured means: 3. any other person for his or her use oft
1, you and resident relatives for: a Jour car,
a, the ownership, maintenance, or use oft b & newly acquired car;
(1) your car; a a téinporary substitute car; or
(2) anewly acquired car; ot a Q Irailer while attached to a car described
(3) atrailer; and ina, 'b,, or ¢, above.
b, the maintenance or use oft Such vehicle must be used with, your. express or
Preview
Filing # 138058219 E-Filed 11/08/2021 08:54:47 AM IN THE CIRCUIT COURT, IN THE FOURTH JUDICIAL CIRCUIT, IN AND FOR DUVAL COUNTY, FLORIDA CASE NO.: 16-2020-CA-005919-XXXX-MA DIVISION: CV-C STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY as Subrogee of THANH QUANG DANG, Plaintiff, vs. FLORIANGELY RIVERA GARAY, an Individual, AKA FLORIANGELY RIVERA and RAQUEL GARAY ACOSTA, an Individual, AKA RAQUEL ACOSTA GARAY, Defendants. / PLAINTIFF’S NOTICE OF SERVICE COMES NOW Plaintiff, by and through its undersigned counsel, and hereby notifies the Court that the Plaintiff has mailed via certified mail/return receipt requested, Two copies of the Summons on Amended, Amended Complaint, and Designation of Email Address, addressed to Defendant, Raquel Garay Acosta AKA Raquel Acosta Garay, 6380 IRONSIDE DR S, Jacksonville, FL 32244. I HEREBY CERTIFY that a true and correct copy of the foregoing has been furnished this 1st day of November 2021, by certified U.S. Mail # 9214 8901 9403 8357 9273 42 to Raquel Garay Acosta AKA Raquel Acosta Garay, 6380 IRONSIDE DR §, Jacksonville, FL 32244. Hiday & Ricke, P.A. By: /s/ Jennifer L. Reiss Jennifer L. Reiss, Esquire Post Office Box 550858 Jacksonville, FL 32255 (904) 363-2769 Fax: (904) 363-0538 Email: litigation@hidayricke.com Florida Bar No.: 0122947 File # 201904821 ACCEPTED: DUVAL COUNTY, JODY PHILLIPS, CLERK, 11/09/2021 08:25:15 AM Filing # 136254547 E-Filed 10/11/2021 07:45:35 AM IN THE CIRCUIT COURT, IN THE FOURTH JUDICIAL CIRCUIT, IN AND FOR DUVAL COUNTY, FLORIDA CASE NO.: 16-2020-CA-005919-XXXX-MA DIVISION: CV-C STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY as Subrogee of THANH QUANG DANG, Plaintiff, vs. FLORIANGELY RIVERA GARAY, an Individual, AKA FLORIANGELY RIVERA and RAQUEL GARAY ACOSTA, an Individual, AKA RAQUEL ACOSTA GARAY, Defendants. / SUMMONS ON AMENDED TO Raquel Garay Acosta AKA Raquel Acosta Garay c/o Florida Secretary of State Pursuant to Fla. Stat. 48.161-48.171 P.O. Box 6327 Tallahassee, FL 32314 A lawsuit has been filed against you. You have 20 calendar days after this summons is served on you to file a written response to the attached Complaint in this Court. A phone call will not protect you; your written response, including the above case number and named parties, must be filed if you want the Court to hear your case. If you do not file your response on time, you may lose the case, and your wages, money and property may thereafter be taken without further warning from the Court. There are other legal requirements. You may want to call an attomey referral service or a legal aid office (listed in the phone book). If you choose to file a written response yourself, at the same time you file your written response to the Court you must also mail or take a carbon copy or photocopy of your written response to the Plaintiff/Plaintiff's Attorney named below. ACCEPTED: DUVAL COUNTY, JODY PHILLIPS, CLERK, 10/11/2021 03:47:27 PM Plaintiff/Plaintiff's Attomey Hiday & Ricke, P.A. Post Office Box 550858 Jacksonville, FL 32255 THE STATE OF FLORIDA TO EACH SHERIFF OF THE STATE: You are commanded to serve this Summons and a copy of the Complaint in this lawsuit on the above-named Defendant. DATED ON Oct 11 2021 »20 JODY PHILLIPS Clerk of the ‘ircuit and 5 County Courts sods Ry i Duval County, Florida i py: mao Ge *H As Deputy Clerk te! eersst Pie upluggage; truck, van, minivan, or Sport utility ve~ ‘designed primant! ly 10 carry persons: and OF vehicle; or * 2. the end of thé 14th calendar day immediately 2: a plekiup tuck, vai, miiv, or epoit uty following the date the car is delivered to you. a. while not used for: If a newly acquired car is not otherwisé afforded ale; or comprehensive coverage or. collision coverage by a) this or any other policy, then this poli will pro- Q) ! le Com) ensive rt Coverage ‘or. llision Cover- pickup or delivery; sind age for. that, f , acquired car, subject toa deductibleof $501 : Any ‘coverage provided as .a result of this paragra| h will apply ly only until the end b. that has a Gross Vehicle Weight Rating of a3 lendar y immediately following the 10,000 poundsor less, of the 5th date the néwly' acquired car is delivered to you, Reasonable Charge, which includes reasonable expenise, means an amount determined by us to be ‘No-FaultAce meatis the Florida Motor Vehicle No- reasonable in accordance with the No-Fault Act, Fault Law and any amen ents. considering one or more of the following: * Non-Owned Car means. car that is in the lawful L usual and customary charges; possession of you or any resident relative and that payments accepted by the provider; neither 1, | is owned by: 3. reim| bursément levels in the community; 4, us federal arid stite medical fee schedules yous applicable to motor vehicle and other insurance b any resident relitive, coverages; any other person who resides primarily in the schedule of maximum charges in thé No- your household; or ‘ault Act, bore. 2 an empl er of any pérson described ina, ove; nor 6. dthér information réleVant to, the reasonable- ness of the charge for.the service, treatment, or supply; or 2, has been operated by, rented by, or in the pos- .: 7. licies arid pay ent méth- session of: a. yOu; oF Medicare coding odologies of the and. fed leral Centers for Medicare icaid .Services, including applicable b, any resident relative modifiers,if ‘the. coding policy or payment during any part of each of the 31 or more con methodology does not constitute a utilization secutive days immediately prior to the date of imi the accident or loss. Relative means a relative of any de by blood or Occupying means in, on, entering, or exiting. marriage who usually makes his or her home in the ‘same family unit, whether or not temporarily living Our ‘means the Company issuing this policy as elsewhere. * shown on the Declarations Page. Resident Relative means persoi, other than jou, Owned By means: Who resides primarily with the first person shown as a 1. owned by; named insured on thé Declarations ge and who is: 2, registered to; or : or her 1. related to that named insured or his includ. spouse by blood, marriage, or adoption, 3. leased, if the ledse is written for a period of 6 months or more, to. oi an arried and unemancipated itdof } er Who is away at school $ and otherwise Pedestrian means a person who is not occupying:. maintains ‘his or ler primary residence with 1. ‘amotor vehicle; or that named msure: or Saioa OCT. 6.2014 {0s %5Ai ADC CENTER NO. 2200 B 6 + 2. a Ward or 4 foster child of that named insured, b, notdesigned to carry persons; and his or her: spouse, or @ person described -in 1. 6G. whilé not .used as premises for office, ove, _ store, or display purposes; or State Farm Companies means one or moté of the 2. a farm implement or farm wagon while being following: pulled on public roads by a car. }. State Faith Mutual Automobile Insurance Us. Tieang. the Company issuing this policy as Company; own on the. Declarations Page. State Earm Fire and Casualty Company; and We means. the Company issuing this policy as ubsidiaries or affiliates of either 1; or 2, above, shown on the Declarations Page. . - rary Substitut i. e Car means a car that is in the You or Your means the named insuréd or named Taw ul possessit ion of the person operating it and that: ins! shown'on the Declarations Page. If a named insured shown on the Declarations Page is a 1 replaces your car for a short time while your ers on, then.“9' you". or “your” includes the spouse of car is out of use due to its: * preskdown; fhspouse resides primaril ly with that named e first person shov Wny ag a named insured if the insured. b, Tepair; Your Car nieans the vehicle shown under "YOUR Cc »” on the clarations Paze. Your Car does not Ge servicing; include a vehicle that you no Iolonger own or lease. damage; or J€a car is shown on the Declarations Page under GQ theft; and “YOUR CAR”, and your ask us to replace it with a neither you nor the person operating it own or 2, have registered, car newly owited by you, then the car being replaced will continue to be considered your’ car until the Ifa car qualifies as both a fon-owned car and a earliest of: temporary substitute car, the n it is considered a 1. the hd of the 30th calendar day immediately by you temporary substitute car only. following the date the car newly owned Trailer means: is delivered to you; 1. attailer: 2. the date this policyis no loriger it fo or 3. the date you no longer own or the car a, designed to be pulled by a private passen- being replaced, ger car; LIABILITY COVERAGE (Bodily Injury and Property Damage) This policy vides Liability Coverage if “A” is SP ouisé Who résides primarily with that named shown under FR‘SYMBOLS"” on the Declarations Page. insured for. the maintenance te or use of a car that by an employer. to, Additional Definition is owned by, or IST erson who resides primarily in your housel hi old, Tnsured means: fiut only. if such car Neither owned by, nor furnished by an‘employer to, the first person 1. you and resident relatives for: shown as a named insured on the Declarations a, the ownership, maintenance, or use oft Page or that person's spouse; (1) your car; 3. any other person for his or her use of: (2) aneiwly acquired car, Or your car, (3) adrailer; and be ‘anewly acquired car; the maintenance or use of: at orary substitute car; or (1) anon-owned car, or a a trailer while attached 10 a ear described (2) a temporary substitute car, ina, b, ore, above, 2. the first person shown as a. named insured on the Such vehi ust be used with your express or Declarations Page and’ thet named insured’: implied pi 18§ mn; an 9810A, OCT. 6.2014 10:26AM ADC CENTER No. 2200 27 - (1) that pait'’o ¢ damages we pay; Or 4 ii the other. érsoni Or Organization vicaridusly. le for ¢ use of a vehicle’ by an insured as: defined in 1. ., OF 3. above, but only for such (2) this polie y's agpliabe Liability Cov- vicarious liabil ity. This provision applies only erage limi if the vehicle is neither owned by, nor hired by, b. after a judgment.” that other person or organization. We have no duty to pay interest that accrues af- Insured does not include . the United States of ter we deposit in court, pay, or offer to pay, the merica or any of its agencies. amount due undef.the InsuringA: ement of Insuring Agreement nodamagesuty licy’s Liability Coverage. HV also have. to pay interest that ‘accrues on any gally list i 1 We will ay damages an insured becomes le- paid or payable by'a party other. than 2 le to pay because of: the insured or us; a. bodily injury to others; and 4 Premiums for ‘bonds, provided by a company’ b, damage to property chosen by us, required to ap eal a decision ina lawsuit against an insured. We have no duty to: caused by an accident that invoives a yehicle a ay for a ‘bond with a face amolint that for which that insured is provided Liability exceeds this policy's applicable Liability Coverage by this policy. Coverage limi 2: We have the right to: b fumish or apply. fot any bonds; or a, investigate, negotiate, and settle any claim or lawsuit;’ ©, pay premiums for bonds purchased after we deposit in court, pay, or offer to pay, the 6, defend an insured in any claim or lawsuit, amount due under.the Insuring Agreement with attorneys chosen by ws; anc of this policy’s Liability Coverage; an @ appeal aty award or legal decision ‘The following costs and expenses if related to for damages payablé under this policy’s Liabil- and, . incurre ‘after a lawsuit has been filed ity Coverage. againstan insured: Supplementary Payments a Loss of wages of salary, but not other in- We will pay, in addition to the damages described in ‘Got me; up to $200:for each day an insured the Insuring Agreement of this policy’s Liability. att end s, at our request; Coverage, joses ite. ms Jisted below that result from (1) an tion; such accident: (2) a mediation; 1 Attomey fees for attomeys chosen by us. to (3) atrial ofa lawsuit; and defend an insured who is sued for such’damag- es. Ie have no duty to pay attomey fees In- b Reasonable expenses incurred by an in- curred after we depositin court or pay the Sured at our request other than loss of amount due under the Insuring Agreement of ‘wages, salary, or other income. ° this policy’s Liability Coverage; The amount of any.of the costs or expenses Court costs aivarded by the court against an listed “above that ar¢. incurre an insured insured and resulting from that part of the Law= must be reported to us before we will pay such sit incurted costs: or expenses. a, that seeks damages payable under this pol- Limits icy’s Liability Coverage; ant b. against which wé defend an irisured with attorneys chosen by ws.” TheLi Coverage limits for bodily i it shown on the Declarations Page under “1 Coverage ~ Bodily ly Injury. Limits = Each’ Person, tigi We have no du ter.we deposit th to pay court costs incurred af court or pay the amount duo under the Insuring Agre ement of this policy's Each Accident,” ‘The limit shown under “Each Person’ is the most Liability Coverage; “° we will pay for the sum of: 3. Interest the insured Ig legally liable to pay on 1 all dams: ges resulting from bodily injury to ‘any mages payable under ¢ Insuring Agree- one person injured in any. one accident; an ment of this policy's Liability Coverage: 2 all damages, including damages for emotional a before a judgment, but only the interest on tress, Sustained by other persons as 4 direct the lesser f result of that bodily injury. 980A, OCT. 6.2014 1 AM ADC CENTER NO. 2200 PB, 8 The limit shown under “Each Accident” is the most BR. BODILY INJURY TO-THAT INSURED S we will pay, subject to the limit for r “Each Person”, OF THAT jamages an emotional distress resulting EMPLOYEE'S * This exclu- sion does not apply to chat dasured’s household accident. dante from boi dil injury to two or more persons Who sustained Radges ‘or emotional distress in the same employee who is neither cove Je COV , under ¥ nor require compens: insure ance; The Liability Coverage Y it for dama: ig shown on the De tons Page under er fer’ Faas e. Limit = Each Acci- 5 FOR BODILY INSURE 1‘TO THAT INSURED'S EELLO Vera ropes dent”, elim e ee is the mostwe will pay for all damages resulting from damage to property” in SCOPS OF He. OR HER EME Ou nt resident any one accident, These Liabili Coverage limits aré the most 32 This exclusion does not apy relatives who are legallyJi employees, behis coveragi for Bodily injury. to fellow em ort will pay rege less of the numberof: " icy, is tocert inancial responsi ti 1 ‘insureds; 6, R DAMAGES ARISING’ OUT. 0) 2, clainis made OWNERSHIS MAINTENAN i “ist OFOF A (CLE WHILE IT 3: vehicles insured; or LEASED TO OTHERS BY AN INSURED; 4. vehicles involved in the accident, 1 FOR DAMAGES ARISING OUT OF ‘THE Nonduplication ANCE ORUSE OF E ITIS IG USED We will not pay any damages or expenses under Liabil- GARRY PERSONS FOR A CHARGE This iy erage: exclusion does not a ply to the use of a‘private 1 that have already been paid as expenses under passenger car ona s! ft are-the-expense basis; No-Fault Coverage or Medical Payments Coy- ware MAINTAINING OR usn USING A VE- erage of any policy issued the State Farm CLE IN.-CONNECTION. WITH THA’ Companies to you or any. resident relative; or a URED SE EMPLOYMENT IN OR, ENGAGE. that have already been paid, under Uninsured A CAR. BUSI- NESS: Tis exclusion does not only to: Motor Vehicle Coverage’or Underinsured Mo- tor Vehicle Covérage of any policy issued-by a yous the State Farm Companies to you or any rest- bo any resident relative; or dent relative, ¢ agent employee, or business partner aby agen Exclusions ‘THERE IS NO COVERAGE FOR AN INSURED: while ata or using your car, a newly acquired car,.a temporary substitute cat, OF & 1 WHO INTENTIONALLY CAUSES BODILY trailer owned by you; | INJURY OR DAMAGE TO PROPERTY; 2. FOR BODILY INJURY 10: 9 wae Feat INSURED IS VALET PARK- a YOU; 10. WHEE anreaninis OR USING ANY VE- b RESIDENT RELATIVES; AND Hy 0 IR, ANEWLY G. ANY OTHER. PERSON. WHO BOTH 4epUR SCAR, A TEMPO! RARY SUBST SL RESIDES PRIMARILY es S OR ORCUPATION HSER tH SURED AND WHO: VALET PARKING, Ths (1) ISRELATED TO THAT INSURED BY Salus does’ not use ofa private passenger ply to the maintenance or car, BLOOD, MARRIAGE, OR ADOP- TION; OR n, FORDAMAGETO PROPERTY WHILE IT IS: (2) IS AWARD OR FOSTER CHILD OF a, OWNED BY; THAT INS' Di; b RENTED TO; OR FOR THAT INSURED'S INSURER FOR ¢. USEDBY; ay OBLIGATION UNDER ANY TYPE OF d. IN THE CARE OF; OR. WORKERS' COMPENSATION, DISABIL- ITY, OR SIMILAR LAW; TRANSPORTED BY 9810A OCT. 6.2014 7 AM ADC CENTER io. 2700 Bg Ye hy, 2. The Liability Coverage provided by this policy PERS dN WHO Ie LEGACY TABLE FOR applies as primary coverage for the ownership, GE, This exclusion does not spply intenance, , oF use of, your car or a trailer at todamagetoa:’” tached to it, a motor vehicle owned tho 2 employer of st x ou oF any resident 7rel ti Hn ive if such dam- ‘age is caused by:an insured while operat a If (1) this is the only.Car Policy issued to ng another mo vehicle; "you or any resident relative by the b ‘residence while rented to or leased to an State Farm Companies that provides insured, or. liability Coverage which applies to the’ private garage while rented to orleased to accident as primary coverage; and v i (2) liability coverage provided by one or i2, FOR LIABILITY ASSUMED UNDER ANY more sources other. than re State CONTRACT OR AGREEMENT; Farm Companies also applies as pri- sf 13. WHILE UI! SING A TRAILER ¥ A 10- mary coverage for the same accident, PROVIDED -LIABILITY..C CLE IF. THAT INSURED IS Ni then we will pay the proportion of d THIS POLICY FOR THE USE OF THAT ages payable as-primary that our plica- MOTOR VEHICLE; ble it bears to the sum of our applicable limit and the limits of all other liability 14, FOR THE OWNERSHIP, .MAINTEN/ [ANC CE; coverage that apply ‘as primary coverage. OR USE OF ANY VEHICLE WHILE, STIS: b Itt a OFF PUBLIC ROADS AND BEING PRE- PARED FOR, USED,IN PRACTICE FO] (1) more than ote Car Policy issued: to OR OFERATED IN ANY RACING CON- you or any resident relative by the TEST, . SPEED... CONTEST, HILL- State Farm Companies provides lia CLIMBING CONTEST, JUMPING CON- ity coverage which applies to the TEST, OR ANY SIMILAR CONTEST: OR | accident ‘primary coverage; and b ON A TRACK DESIGNED (2) Wabi provided by one or FOR RACING OR HIGH-SPEED D) 'o more sources other than the State ING. This exclusion (14.b.) does not spply ie Farm Companies also applies as pri- the vehicle is being used in connect 1 mary coverage for the same accident, an activity other. than rac! ing, \- 6 oF any Hype 0 f t compenetitive driving; then the State Farm Comparties will pay the proportion of damages payable as 15; WHO IS AN EMPLOYEE OF THE UNITED that the maximum ‘amount that may by the State Farm Companies as det teal S OF AMERICA OR ANY OF ITS in 1.al re béarsto the sum of such amount AGENCIES, IF THE PROVISIONS OF THE and the limits of all other liability coverage FEDERAL TORT CLAIMS ACTAPPLY. ~ that apply as primery coverage. If Other Liability Coverage Applies i. Tf liability cov e provided b y this olicy and one or more other Car Policies issu toyou or 3 Except as provided in 2, above, the Liability excess cove rovided ger by this policy applies as any resident relative by the State Farm Coim- Panies applyto the saitie accident, then: a If a the liability coverage limits of such lis (1) this is the only Car. Policy issued to cies will not be addéd.together to deter- yout or any ‘resident relative by the mine the most that may be paid; an State Farm Companies that provides liability coverage which applies to the d, je maximum amount that may.be paid accident as excess coverage; and from all such policies combined is the sin- gle highest applicable, it. provi yy (2) liability coverage’ provided by one.or any one o! jolicies. jOOSe We may More sources other than e State one or more policies from which to make Farm Companies also applies as ex- payment. cess coverage for the same accident, Sst0a OCT. 6.2014 10:26AM ADC CENTER No. 2700 P10 then we will pay the proportion of dam- Required Out-of-Staté Liability Coverage ages payable as excess that our applicable If limit bears to the sum of our applicable limit and the limits of all other liability 1, an Insured is in another state of the United coverage that apply as excess coverage, States of America, 2 territo or possession of the: United States of America; ¢ District b If; of Columbia, or any province or territory of (1) tiore than ane Car Poliéy issued to you ‘anada, and as a nonresident bei S sul ject to its motor vehicle co: ot any resident ‘relative Farm Companies” a vides the State liability, ance’ Ia iW, , financial’ responsi i msur- law, or coverage which appliés to the accident similar law, and 8S excess coverage; and this poli les not provide at 1éast the mini- mum Tiabity coverage required by such law (2) liability coverage provided by one or for such ne ident, more sources other than the State then this policy jvill be interpreted to. rovide Farm: Companies ‘also applies as ex= cess coverage for the Same accident, the minimum Ifability coverage required yy such law. 5 then the State Farm Companies will pay This provision does not apply 16 liability coverage the proportion of daniazes payable as ex- requited by. law for motor catri, ers of passengers or cess that the maximum amount that may motor carriersof property. be paid by the State’-Farm Companies as Financial Responsibility Certification determined in 1. above bears to e sum of When this policy is certified under any law.as proof such amount and the limits of all other lia- of future financial responsibility, and while required bility coverage that apply as excess cover- during the policy period, this Policy will comply age, with such law to the extent requi ured, * PROPERTY DAMAGE LIABILITY COVERAGE This policy provides Property Damage Liability but only if suchcar is neither owned dy, nor Coverage if “B”.{s shown unde the Declarations Page. 1 'SYMBOLS” on furnished by an employer to, the first person shown ‘as 2 named insured on the Decl; larations Additional Definition Page or that person's spouse; Insured means: 3. any other person for his or her use oft 1, you and resident relatives for: a Jour car, a, the ownership, maintenance, or use oft b & newly acquired car; (1) your car; a a téinporary substitute car; or (2) anewly acquired car; ot a Q Irailer while attached to a car described (3) atrailer; and ina, 'b,, or ¢, above. b, the maintenance or use oft Such vehicle must be used with, your. express or