Proof of Service: Wayne Van Amburgh, Judith Van Amburgh v. Amchem Products, Inc., N/K/A Rhone Poulenc Ag Company, N/K/A Bayer Cropscience Inc.,, General Electric Company, Goulds Pumps Llc, Grinnell Llc, Honeywell International, Inc., F/K/A Allied Signal, Inc. / Bendix,, Imo Industries, Inc.,,, Itt Llc., Individually And As Successor To Bell & Gossett And As Successor To Kennedy Valve Manufacturing Co., Inc.,, Jenkins Bros, Neles-Jamesbury Inc.,, Pfizer, Inc. (Pfizer),, Redco Corporation F/K/A Crane Co.,, Spirax Sarco, Inc. Individually And As Successor To Sarco Company,, U.S. Rubber Company (Uniroyal),, Union Carbide Corporation,, Carrier Corporation, Warren Pumps Llc

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                                FILED: RENSSELAER COUNTY CLERK 10/19/2023 02:51 PM                                                      INDEX NO. EF2023-275073
NYSCEF DOC. NO. 21                                                                                RECEIVED NYSCEF: 10/19/2023




             SUPREME COURT OF THE STATE OF
                      NEW YORK
                  County of Rensselaer                        I IIII II Ill I Ill I Ill I Ill 111111111111111
                     AFFIDAVIT OF SERVICE
                                                                                               Index no :EF2023-275073


            Wayne Van Amburgh, et al
                           Plaintiff(s),
            vs.
            Amchem Products, Inc., et al
                           Defendant(s).
            _ _ _ _ ___________./
            STATE OF CONNECTICUT
                                               ss: East Hartford
            HARTFORD COUNTY
            Theresa Barnes, the undersigned, being duly sworn, deposes and says that I was at the time of service
            over the age of eighteen and not a party to this action. I reside in the State of Connecticut.
            On 10/17/2023 at 12:35 PM, I served the within Notice of Commencement of Action Subject to
            Mandatory Electronic Filing, Summons, Verified Complaint and Plaintiff Demands Trial by Jury
            on ITT LLC, Individually and as successor to Bell & Gossett and as successor to Kennedy Valve
            Manufacturing Co., Inc. at 187 Danbury Road, Ste. 2D, Wilton, CT 06897 in the manner indicated
            below:
            CORPORATE SERVICE: By delivering a true copy of each to Marie Altieri, Authorized Agent of the
            above named corporation. The undersigned asked the recipient if he/she is authorized to accept service on
            behalf of ITT LLC, Individually and as successor to Bell & Gossett and as successor to Kennedy
            Valve Manufacturing Co., Inc., and the recipient responded in the affirmative.

            A description of the Recipient, or other person served on behalf of the Recipient is as follows:

                       Sex          Color of skin/race     Color of hair     A e      Hei ht
                       Female       White                  Brown             40       5'3"        155




            Sworn to and subscribed before me on                       =-------
                                                                   x�cl5
            October 18, 2023                                       Theresa Barnes
            by an affiant who is personally known to               Nicoletti & Harris Inc.
            me or produced identification.                         101 A venue of the Americas, 9th Floor
                                                                   New York, NY 10013
                                                                   J-212-267-6448
                                                                   Atty File#:
            NOT�YPUB]I'
            My Commission E, pires:___ _ _ _
                                           _


              AMY J, CHANTRY
                  NOTARY PU13UC
            My Cammlulen hplru Mar, 31, 2028



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