On May 06, 2019 a Summons was filed involving a dispute between Anthony L Perez, Successor-In-Interest To The Estate Of Jordan Lee Perez, Perez, Anthony L, Perez, Sandra L, Sandra L Perez, Successor-In-Interest To The Estate Of Jordan Lee Perez, and Abongwa M.D., Chenue, Barcega M.D., Besh R, Bravo M.D, Thomas P, Brown M.D., Lance A, Collins M.D., Chelsea L, Does 2-200, Inclusive, Fteeh M.D., Gamil, Kheradpour M.D., Albert, Kim M.D., Tommy Y, Klooster M.D., Marquelle J, Kong, P.A., Yuthana, Li M.D., Natasha Y, Loma Linda University Children'S Hospital A Nonprofit Corporation, Loma Linda University Health A Nonprofit Corporation, Loma Linda University Medical Center A Nonprofit Corporation, Mehta M.D., Khyati P, Peterson M.D., Sarah C, Pichon M.D., Pilar D, Richter, David, Sadanand M.D., Venkatraman, Suterwala M.D., Batul, Thorp M.D., Andrea W, Zimmerman M.D, Kimberly R, Zouros M.D., Alexander, for Complaint for Medical Malpractice in the District Court of San Bernardino County.
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p POS 010 ATTORNEY OR PARTY WITHOUT ATTORNEY Name Stafe Bar number and address FOR COURT USE ONLY Anthony L Perez Sandra L Perez 14322 Arae St Hesperia CA 92344 SUPERIO R R gERNARDI COUNTY OF SAN D STRIC BERNARDINO 1 SAN TELEPHONE NO 7S 1 S 15 3371 FAX NO Optionel E MAILADDRESS OpNonaQ SIpSIp Q 1V0 COTT1 AUG 2 9 O J ATTORNEY FOR Name Ill PTO Pe1 SUPERIOR COURT OF CA COUNTY OF S3ri BOrilaT dll O j x STREET ADDRESS 24 WeSt 3rd St BY Maiurv aooRess 247 West 3rd St BREI DA MATSUMURA DEPUTY cirv alloziPcooe San Bernal dino 92415 eRnNCH NnME San Bernardino District Civil Division PLAINTIFF PETITIONER PeYeZ CASE NUMBER Q CIVDS 1913814 DEFENDANT RESPONDENT LOffi1 Llrid1 Uri1VeIS11 7 Med1CS1 CCriteP et al ORef No or File No PROOF OF SERVICE OF SUMMONS Separate proof of service is required for each parfy seived J1 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 b complaint c Altemative Dispute Resolution ADR package d Civil Case Cover Sheet served in comp ex cases only e cross complaint f otner speci y documents Declaration of Anthony L Perez Sandra L Perez pursuant to CCP337 32 3 a Party served specify name of party as shown on documents served Marquelle J Klooster M D an individual b 0 Person other than the party in item 3a served on behalf of an entity or as an authorized agent and not a person under item 5b on whom substituted service was made specify name and relationship to the party named in item 3a y 4 Address where the party was served 24890 Tulip Ave Loma Linda CA 92354 5 I served the party check proper box a Q by personal service I personally delivered the documents listed in item 2 to the party or person authorized to receive service of process for the party 1 on date 2 at time b by substituted service On date 08 19 2019 at time 9 00 ari1 I left the documents listed in item 2 with or in the presence of name and title or relationship to person indicated in item 3 Pamela Munz for Kent Hansen agent of service for LLUH and their employees 1 business a person at least 18 years of age apparently in charge at the office or usual place of business of the person to be served I informed him or her of the general nature of the papers 2 0 home a competent member of the household at least 18 years of age at the dwelling house or usual place of abode of the party i informed him or her of the general nature of the papers 3 0 physical address unknown a person at least 18 years of age apparently in charge at the usual mailing address of the person to be served other than a United States Postal Service post office box I informed him or her of the general nature of the papers 4 I thereafter mailed by first class postage prepaid copies of the documents to the person to be served at the place where the copies were left Code Civ Proc 415 20 I mailed the documents on date from city or a declaration of mailing is attached 5 I attach a declaration of diligence stating actions taken first to attempt personal service Page 1 of 2 Form Adopted for Mendetory Use Cade of Civil Procedure 417 10 Judidal Coundl of Califomia PROOF OF SERVICE OF SUMMONS POS 010 Rev 1 2007 January CASE NUMBER PLAINTIFF PETITIONER P0Y0Z CIVDS1913814 DEFENDANT RESPONDENT LO1T11 L1Tld1 Uri1VeI Sl MCC 1C11 CeriteP et al 5 c 0 by mail and acknowledgment of receipt of service I mailed the documents listed in item 2 to the party to the address shown in item 4 by first class mail postage prepaid 1 on date 2 from city 3 0 with two copies of the Notice and Acknowledgment of Receipt and a postage paid retum envelope addressed to me Attach comp eted Notice and Acknowledgement of Receipt Code Civ Proc 415 30 4 0 to an address outside California with return receipt requested Code Civ Proc 415 40 d by other means specify means of service and authorizing code section Additional page describing service is attached 6 The Notice to the Person Served on the summons was completed as follows a 0 as an individual defendant b 0 as the person sued under the fictitious name of specify 0 as occupant d 0 On behalf of specify under the following Code of Civil Procedure section 416 10 corporation C7 415 95 business organization form unknown 416 20 defunct corporation 0 416 60 minor 0 416 30 joint stock company association 416 70 ward or conservatee 0 416 40 association or partnership 416 90 authorized person 416 50 public 415 46 occupant entity 0 other 7 Person who served papers a Name Windsor Salcido b Address 11294 Heathclif Dr Riverside CA 92506 c Telephone number 951 318 6996 d The fee for service was 0 e I am 1 0 not a registered California process server 2 Q exempt from registration under Business and Professions Code section 22350 b 3 a registered Califomia process server owner employee independent contractor ii Registration No iii County I declare under penalty of perjury under the laws of the State of Califomia that the foregoing is true and correct or 9 I am a California sheriff or marshal and I certify that the foregoing is true and correct ate 08 21 2019 Windsor Salcido NAME OF PERSON WHO SERVED PAPERS SHERIFF OR MARSHAL SIGNATURE POS 010 Rev January 1 2007J Pe9e z or z pROOF OF SERVICE OF SUMMONS