On September 15, 2023 a
Affidavit of Facts
was filed
involving a dispute between
Unitedhealthcare Of New York, Inc.,
and
Bender Contracting L.L.C.,
for Commercial - Insurance
in the District Court of Lewis County.
Preview
FILED: LEWIS COUNTY CLERK 11/30/2023 02:32 PM INDEX NO. EFCA2023-000320
NYSCEF DOC. NO. 6 RECEIVED NYSCEF: 11/30/2023
STATE OF NEW YORK
SUPREME COURT COUNTY OF LEWIS
UNITEDHEALTHCARE OF NEW YORK, INC.
P.O. BOX 94017 Index #EFCA2023-000320
PALATINE, IL 60094
Plaintiff, AFFIDAVIT OF FACTS
CONSTITUTING
THE CLAIM
-vs- THE DEFAULT AND THE
AMOUNT DUE
BENDER CONTRACTING L.L.C.
5523 SHADY AVE
LOWVILLE, NEW YORK 13367
Defendant(s),
STATE OF NEW YORK, COUNTY OF MONROE ss:
Joseph M. Shur, being duly sworn, deposes and says: that the deponent is one of the
attorneys for the plaintiff in the within action; this action was commenced by service of the
summons and complaint upon defendant(s) and is an action.
*
Contract.
Notice of default (a copy of the summons and complaint) was mailed to defendant on
October 10, 2023 is at least 20 days prior to entry of this judgment and proof of service thereof is
annexed.
Wherefore deponent demands judgment against the defendant(s) in the sum of $8,284.29,
with interest from November 22, 2022 together with costs and disbursements of this action.
Joseph M. Shur
Sworn to before me on
November 22, 2023
. DANIELLE BARNEY
Notary Public. State of New York
62 98 7
NOTARY PUBLIC Commission Expires April 5, 20
Residence and trade or profession of Defendant: Residence address of Plaintiff:
5523 SHADY AVE P.O. BOX 94017
LOWVILLE, NEW YORK 13367 PALATINE, IL 60094
1 of 1
Document Filed Date
November 30, 2023
Case Filing Date
September 15, 2023
Category
Commercial - Insurance
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FILED: LEWIS COUNTY CLERK 11/30/2023 02:32 PM INDEX NO. EFCA2023-000320 NYSCEF DOC. NO. 6 RECEIVED NYSCEF: 11/30/2023 STATE OF NEW YORK SUPREME COURT COUNTY OF LEWIS UNITEDHEALTHCARE OF NEW YORK, INC. P.O. BOX 94017 Index #EFCA2023-000320 PALATINE, IL 60094 Plaintiff, AFFIDAVIT OF FACTS CONSTITUTING THE CLAIM -vs- THE DEFAULT AND THE AMOUNT DUE BENDER CONTRACTING L.L.C. 5523 SHADY AVE LOWVILLE, NEW YORK 13367 Defendant(s), STATE OF NEW YORK, COUNTY OF MONROE ss: Joseph M. Shur, being duly sworn, deposes and says: that the deponent is one of the attorneys for the plaintiff in the within action; this action was commenced by service of the summons and complaint upon defendant(s) and is an action. * Contract. Notice of default (a copy of the summons and complaint) was mailed to defendant on October 10, 2023 is at least 20 days prior to entry of this judgment and proof of service thereof is annexed. Wherefore deponent demands judgment against the defendant(s) in the sum of $8,284.29, with interest from November 22, 2022 together with costs and disbursements of this action. Joseph M. Shur Sworn to before me on November 22, 2023 . DANIELLE BARNEY Notary Public. State of New York 62 98 7 NOTARY PUBLIC Commission Expires April 5, 20 Residence and trade or profession of Defendant: Residence address of Plaintiff: 5523 SHADY AVE P.O. BOX 94017 LOWVILLE, NEW YORK 13367 PALATINE, IL 60094 1 of 1