Preview
Filing #78643517 E-Filed 10/01/2018 10:30:08 AM
VERIFIED RETURN OF SERVICE
State of Florida County of HILLSBOROUGH Circuit Court
Case Number: 18-CA-001480 Court Date: 10/10/2018 9:30 am
Plaintiff:
LYLAN NGUYEN
vs.
Defendant:
CITY OF TAMPA
For:
ROBIN HORTON SILVERMAN
OFFICE OF THE CITY ATTORNEY
315 E. KENNEDY BLVD
5TH FLOOR
Tampa, FL 33602
Received by CHOICE PROCESS - TAMPA on the 17th day of September, 2018 at 12:43 pm to be served
on INJURY AND ACCIDENT CLINIC A/K/A INJURY ACCIDENT CLINIC ATTN: RECORDS CUSTODIAN,
136 EAST COLONIAL DRIVE, ORLANDO, FL 32801.
|, RICHARD W. GOLDEN, do hereby affirm that on the 19th day of September, 2018 at 12:30 pm, I:
AUTHORIZED: served by delivering a true copy of the SUBPOENA DUCES TECUM WITHOUT
DEPOSITION with the date and hour of service endorsed thereon by me, to: PAULA IRRAZARY as
RECEPTIONIST, who stated they are authorized to accept service for: INJURY AND ACCIDENT CLINIC
AIK/A INJURY ACCIDENT CLINIC ATTN: RECORDS CUSTODIAN at the address of: 136 EAST
COLONIAL DRIVE, ORLANDO, FL 32801, and informed said person of the contents therein, in
compliance with state statutes.
| certify that | am over the age of 18 and have no interest in the above action and | am in good standing in
the judicial circuit in which the process was served. Under penalty of perjury, | declare that | have read the
foregoing and that the facts stated in it are true.
RICHARD W. GOLDEN
0163
CHOICE PROCESS - TAMPA
Attn: Process Accounting
P.O. Box 1215
Tampa, FL 33601
(813) 229-1444
Our Job Serial Number: CPS-2018011595
Copyright © 1£92-2018 Database Services, Inc, - Process Server's Toolbox V7.2p
10/1/2018 10:30 AM Electronically Filed: Hillsborough County/13thJ udicial Circuit Page 1
3) ORIGINAL
IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT
IN AND FOR THE STATE OF FLORIDA
GENERAL CIVIL DIVISION
LYLAN NGUYEN,
Plaintiff, CASE NO. 18-CA-001480
v, DIVISION: C
CITY OF TAMPA,
Defendant.
/
SUBPOENA DUCES TECUM WITHOUT DEPOSITION
THE STATE OF FLORIDA
TO: Injury and Accident Clinic
A/K/A Injury Accident Clinic
Attn: Custodian of Records
136 East Colonial Drive
Orlando, Florida 32801
YOU ARE COMMANDED to appear at the Office of the City Attorney, 315 E, Kennedy Blvd., in
Tampa, Florida 33602, on October 10, 2018 at 9:30 a.m. and to have with you at that time and place the
following:
Any and all records in vour possession pertaining to —
neluding but not limited to the entire chart, cover to
cover, including any and all medical records, notes, bills, diagnostic films, MRI's. X-rays,
tests and reports, patient information sheets, lab reports, progress reports, work sheets,
Insurance forms, statements, photographs, miscellaneous correspondence to attorneys or
miscellaneous correspondence to physicians contained in your file.
These items will be inspected and may be copied at that time. You will not be required to surrender
the original items. You may comply with this Subpoena by providing legible copies of the items to b:
produced to the attorney whose name appears on this Subpoena on or before the scheduled date of
production, You may condition the preparation of the copies upon payment in advance of the reasonable
cost of preparation. You may mail or deliver the copies to the attorney whose name appears on this
Subpoena and thereby eliminate your appearance at the time and place specified above. You have the right
to object to the production pursuant to their Subpoena at any time before production by giving written notice
to the attorney whose name appears on this Subpoena. THIS WILL NOT BE A DEPOSITION. NO
TESTIMONY WILL BE TAKEN.
Defendant, City of Tampa, as the requesting party has complied with Florida Rule of Civil
Procedure 1.351. This subpoena was issued Fifteen (15) days after the Plaintiff was served with notice
of the City’s intent to obtain these records via subpoena and the Plaintiff has not served any objection
thereto.
10/1/2018 10:30 AM Electronically Filed: Hillsborough County/13thJ udicial Circuit Page 2
If you fail to:
Q) appear as specified;
@) furnish the records instead of appearing as provided above; or
(3) object to this subpoena,
you may be in contempt of court. You are subpoenaed by the attorney whose name appears on this
Subpoena and unless excused from this subpoena by the attorney or the court, you shall respond to this
subpoena as directed,
Pursuant to the Health Insurance Portability and Accountability Act, Sections 164.512(a)(1) and
164.512(e)(1)(ii)(A), of the Code of Federal Regulations, you are advised that the individual who is the
subject of the requested records has been given notice of this request for the information described herein,
the notice included sufficient information about the litigation in which this information is required to
permit the individual to raise an objection to the court, and the time for the individual to raise any
objection to this request has elapsed and no objection was filed.
DATED on
SEP 13 2018
SALVATORE TERRITO, CITY ATTORNEY
CITY OF TAMPA
/s/ Robin Horton Silverman.
Robin Horton Silverman
Assistant City Attorney
Florida Bar No. 0027934
Sth Floor, Old City Hall
315 E. Kennedy Blvd.
‘Tampa, Florida 33602
Telephone: (813) 274-8996
Facsimile: (813) 274-8894
E-Mail: Robin. Horton-Silverman@tampagov.net
Attomey for Defendant, City of Tampa
THIS SUBPOENA IS VALID THROUGHOUT THE DURATION OF THIS LITIGATION. WE RESERVE THE
RIGHT TO REQUEST SUPPLEMENTAL/UPDATED RECORDS THROUGHOUT THIS LITIGATION
PURSUANT TO THIS SUBPOENA.
IMPORTANT NOTE TO THE WITNESS REGARDING COPYING COSTS
IN THE EVENT THAT PHOTOCOPYING COSTS ARE EXPECTED TO EXCEED $50.00, PLEASE CONTACT
THE OFFICE OF THE UNDERSIGNED ATTORNEY AT (813) 274-8996 AND ADVISE OF SAME PRIOR TO
COMPLYING WITH THIS SUBPOENA. SAID ATTORNEY RESERVES THE RIGHT TO CONTEST ANY
BILLINGS FOR RECORDS SENT JN EXCESS OF $50.00 IF PRIOR APPROVAL NOT AUTHORIZED.
If you are a person with a disability who needs any accommodation in order to respond to this subpoena, you
may request such assistance by contacting the attomey at the address and number above upon the receipt of this
subpoena; if you are hearing impaired, call 711.
10/1/2018 10:30 AM Electronically Filed: Hillsborough County/13thJ udicial Circuit Page 3
Preview
Filing #78643517 E-Filed 10/01/2018 10:30:08 AM VERIFIED RETURN OF SERVICE State of Florida County of HILLSBOROUGH Circuit Court Case Number: 18-CA-001480 Court Date: 10/10/2018 9:30 am Plaintiff: LYLAN NGUYEN vs. Defendant: CITY OF TAMPA For: ROBIN HORTON SILVERMAN OFFICE OF THE CITY ATTORNEY 315 E. KENNEDY BLVD 5TH FLOOR Tampa, FL 33602 Received by CHOICE PROCESS - TAMPA on the 17th day of September, 2018 at 12:43 pm to be served on INJURY AND ACCIDENT CLINIC A/K/A INJURY ACCIDENT CLINIC ATTN: RECORDS CUSTODIAN, 136 EAST COLONIAL DRIVE, ORLANDO, FL 32801. |, RICHARD W. GOLDEN, do hereby affirm that on the 19th day of September, 2018 at 12:30 pm, I: AUTHORIZED: served by delivering a true copy of the SUBPOENA DUCES TECUM WITHOUT DEPOSITION with the date and hour of service endorsed thereon by me, to: PAULA IRRAZARY as RECEPTIONIST, who stated they are authorized to accept service for: INJURY AND ACCIDENT CLINIC AIK/A INJURY ACCIDENT CLINIC ATTN: RECORDS CUSTODIAN at the address of: 136 EAST COLONIAL DRIVE, ORLANDO, FL 32801, and informed said person of the contents therein, in compliance with state statutes. | certify that | am over the age of 18 and have no interest in the above action and | am in good standing in the judicial circuit in which the process was served. Under penalty of perjury, | declare that | have read the foregoing and that the facts stated in it are true. RICHARD W. GOLDEN 0163 CHOICE PROCESS - TAMPA Attn: Process Accounting P.O. Box 1215 Tampa, FL 33601 (813) 229-1444 Our Job Serial Number: CPS-2018011595 Copyright © 1£92-2018 Database Services, Inc, - Process Server's Toolbox V7.2p 10/1/2018 10:30 AM Electronically Filed: Hillsborough County/13thJ udicial Circuit Page 1 3) ORIGINAL IN THE CIRCUIT COURT OF THE THIRTEENTH JUDICIAL CIRCUIT IN AND FOR THE STATE OF FLORIDA GENERAL CIVIL DIVISION LYLAN NGUYEN, Plaintiff, CASE NO. 18-CA-001480 v, DIVISION: C CITY OF TAMPA, Defendant. / SUBPOENA DUCES TECUM WITHOUT DEPOSITION THE STATE OF FLORIDA TO: Injury and Accident Clinic A/K/A Injury Accident Clinic Attn: Custodian of Records 136 East Colonial Drive Orlando, Florida 32801 YOU ARE COMMANDED to appear at the Office of the City Attorney, 315 E, Kennedy Blvd., in Tampa, Florida 33602, on October 10, 2018 at 9:30 a.m. and to have with you at that time and place the following: Any and all records in vour possession pertaining to — neluding but not limited to the entire chart, cover to cover, including any and all medical records, notes, bills, diagnostic films, MRI's. X-rays, tests and reports, patient information sheets, lab reports, progress reports, work sheets, Insurance forms, statements, photographs, miscellaneous correspondence to attorneys or miscellaneous correspondence to physicians contained in your file. These items will be inspected and may be copied at that time. You will not be required to surrender the original items. You may comply with this Subpoena by providing legible copies of the items to b: produced to the attorney whose name appears on this Subpoena on or before the scheduled date of production, You may condition the preparation of the copies upon payment in advance of the reasonable cost of preparation. You may mail or deliver the copies to the attorney whose name appears on this Subpoena and thereby eliminate your appearance at the time and place specified above. You have the right to object to the production pursuant to their Subpoena at any time before production by giving written notice to the attorney whose name appears on this Subpoena. THIS WILL NOT BE A DEPOSITION. NO TESTIMONY WILL BE TAKEN. Defendant, City of Tampa, as the requesting party has complied with Florida Rule of Civil Procedure 1.351. This subpoena was issued Fifteen (15) days after the Plaintiff was served with notice of the City’s intent to obtain these records via subpoena and the Plaintiff has not served any objection thereto. 10/1/2018 10:30 AM Electronically Filed: Hillsborough County/13thJ udicial Circuit Page 2 If you fail to: Q) appear as specified; @) furnish the records instead of appearing as provided above; or (3) object to this subpoena, you may be in contempt of court. You are subpoenaed by the attorney whose name appears on this Subpoena and unless excused from this subpoena by the attorney or the court, you shall respond to this subpoena as directed, Pursuant to the Health Insurance Portability and Accountability Act, Sections 164.512(a)(1) and 164.512(e)(1)(ii)(A), of the Code of Federal Regulations, you are advised that the individual who is the subject of the requested records has been given notice of this request for the information described herein, the notice included sufficient information about the litigation in which this information is required to permit the individual to raise an objection to the court, and the time for the individual to raise any objection to this request has elapsed and no objection was filed. DATED on SEP 13 2018 SALVATORE TERRITO, CITY ATTORNEY CITY OF TAMPA /s/ Robin Horton Silverman. Robin Horton Silverman Assistant City Attorney Florida Bar No. 0027934 Sth Floor, Old City Hall 315 E. Kennedy Blvd. ‘Tampa, Florida 33602 Telephone: (813) 274-8996 Facsimile: (813) 274-8894 E-Mail: Robin. Horton-Silverman@tampagov.net Attomey for Defendant, City of Tampa THIS SUBPOENA IS VALID THROUGHOUT THE DURATION OF THIS LITIGATION. WE RESERVE THE RIGHT TO REQUEST SUPPLEMENTAL/UPDATED RECORDS THROUGHOUT THIS LITIGATION PURSUANT TO THIS SUBPOENA. IMPORTANT NOTE TO THE WITNESS REGARDING COPYING COSTS IN THE EVENT THAT PHOTOCOPYING COSTS ARE EXPECTED TO EXCEED $50.00, PLEASE CONTACT THE OFFICE OF THE UNDERSIGNED ATTORNEY AT (813) 274-8996 AND ADVISE OF SAME PRIOR TO COMPLYING WITH THIS SUBPOENA. SAID ATTORNEY RESERVES THE RIGHT TO CONTEST ANY BILLINGS FOR RECORDS SENT JN EXCESS OF $50.00 IF PRIOR APPROVAL NOT AUTHORIZED. If you are a person with a disability who needs any accommodation in order to respond to this subpoena, you may request such assistance by contacting the attomey at the address and number above upon the receipt of this subpoena; if you are hearing impaired, call 711. 10/1/2018 10:30 AM Electronically Filed: Hillsborough County/13thJ udicial Circuit Page 3