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Tamarah Harber-Pickens SUPERIOR COURT
Clerk of the Superior Court aor Telephone 661-868-5393
eS
1415 Truxtun Avenue
Sr ps Bakersfield CA 93301
ass Zo
Justin Carino Date : 3/17/2021
Case No.: BCV-20-102879
RETURNED VIA EFILE Case Name: CARINO VS ADVENTIST HEALTH
JEREMY BOLLINGER DELANO
Document: PROOF OF SERVICE
The attached papers are being returned for the following reason(s): 1 Check # Returned
This pleading does not appear to be for Superior Court, Kern County.
The attached document is an improper ex-parte communication and has not been considered by the Court.
Fee of S, required or a Request to Waive Court Fees must be submitted.
Application for Waiver of Fees missing attachment(s):
(J Last three (3) paystubs, if employed.
LJ Certified Copy of Statement of Account for previous six (6) months certified by Dept. of Corrections
OO Trust Account Withdrawal Order form (CDC form 193) completed by the Dept. of Corrections
indicating $3.00 fee to Dept. of Corrections has been paid or insufficient funds in the account to cover.
Does not conform to Rule 2.100-2.119, California Rules of Court, as to form and format.
Superior Court case number is wrong, incomplete, or missing.
Consolidated matter: All consolidated case numbers must be listed in the heading with the lead case listed
first.
Consolidated matter:
Title is incorrect or missing parties.
Summons does not conform to complaint/cross-complaint/petition.
Not an original. Copies are not acceptable.
Copies must be provided if endorsed copies are requested. Submit one original plus copy(ies).
Does not conform to Kern County Local Rule/Code:
Must use Mandatory Judicial Council form.
ts not eligible for filing. Reason:
Item(s) # incomplete.
Missing required forms/attachment:
Original Will must be presented at the time of filing petition.
Signature missing:
Date and place of execution not completed.
Document(s) must be verified.
Show date, timc, and location of hearing pursuant to California Rules of Court.
The date you have noticed this matter is a Court holiday/weekend.
Acknowledgement of Receipt/Citation must be attached to the completed proof of service.
Attach Proof of Service on opposing party.
Correct Proof of Service: Second Rejection. No changes made. Party does not conform to the
Complaint. Party must match word for word. Please review the Complaint.
Not appraised by the Probate Referee.
oO Order/Judgment does not conform to the Court minutes.
Oo Order page docs not contain enough information regarding case; need at least three lines of text with
identifying information for order and case (short title case and case number).
Oo Dismissal cannot be entered for the following reasons:
oO Other:
Tamarah Harber-Pickens
CLERK OF THE SUPERIOR COURT
By: _Leslie Dickey, Deputy Clerk
ANY CORRESPONDENCE REQUIRING AN ANSWER FROM THE COURT MUST BE
ACCOMPANIED BY A SELF-ADDRESSED STAMPED ENVELOPE LARGE ENOUGH TO RETURN DOCUMENTS
WII?
POS-010
[ATTORNEY OR PARTY WITHOUT ATTORNEY (NName, State Bar number, and address):
Jeremy Bollinger, SBN 240132 FOR COURT USE ONLY
Moss Bollinger LLP
15300 Ventura Boulevard, Suite 207
Sherman Oaks, CA 91403
TELEPHONE NO: 310-982-2984 FAX NO. (Optional): 818-963-5954
E-MAIL ADDRESS (Optional): jeremy@mossbollinger.com
ATTORNEY FOR (Name): Plaintiff Justin Carino
SUPERIOR COURT OF CALIFORNIA, COUNTY OF SAN BERNARDINO
STREET ADDRESS: 1415 Truxtun Avenue
MAILING ADDRESS:
cry AND zip cove: Bakersfield, CA 93301
BRANCH NAME:
PLAINTIFF/PETITIONER: Justin Carino CASE NUMBER:
DEFENDANT/RESPONDENT: Adventist Health Delano dba Delano Regional Medical Center BCV-20-102879
Ref. No. or File No.
PROOF OF SERVICE OF SUMMONS
(Separate proof of service is required for each party served.)
1 At the time of service | was at least 18 years of age and not a party to this action.
2. | served copies of:
a. [Ge] summons
b, . [6] complaint
c. . [__] Alternative Dispute Resolution (ADR) package
d. . [3] Civil Case Cover Sheet (served in complex cases only)
(] cross-complaint
lotice o}
‘specify documents): nt, Order to Show Cause and Case Management Conference;
First Amended Complaint
Party served (specify name of party as shown on documents served):
Adventist Health Delano dba Di ino Regional Medical Center
Person (other than the party lem 3a) served on behalf of an entity or as an authorized agent (and not a person
:)- (specify name and relationship to the party named in item 3a):
Address where the party was served:
Zimmer & Melton, LLP, 11601 Bolthouse Dr., Suite 100, Bakersfield, CA 93311
5. | served the party (check proper box)
a. [_] by personal service. | 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): at (time): 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):
(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. | informed him or her of the general nature of the papers.
(2) [_] (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. | informed him or her of the general nature of the papers.
(3) _] (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. | informed
him or her of the general nature of the papers.
(4) [_]| 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). | mailed the documents on
(date): from (city): or[__] a declaration of mailing is attached.
(5) [_] | attach a declaration of diligence stating actions taken first to attempt personal service.
Page 1 of 2
Form Adopted for Mandatory Use PROOF OF SERVICE OF SUMMONS Code of Civil Procedure, § 417.10
Judicial Council of California
POS-010 [Rev. January1, 2007]
POS-010
PLAINTIFF/PETITIONER: Justin Carino CASE NUMBER:
DEFENDANT/RESPONDENT: Adventist Health Delano dba Delano Regional Medical Center BCV-20-102879
5. c. [3] by mail and acknowledgment of receipt of service. | 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): 12/24/2020 (2) from (city): Los Angeles, CA
(3) [4] with two copies of the Notice and Acknowledgment of Receipt and a postage-paid return envelope addressed
to me. (Attach completed Notice and Acknowledgement of Receipt.) (Code Civ. Proc., § 415.30.)
(4) [_]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.
The "Notice to the Person Served" (on the summons) was completed as follows:
a. . [__] as an individual defendant.
b. . [-_] as the person sued under the fictitious name of (specify):
c. - [) as occupant.
d |. [_] On behalf of (specify):
under the following Code of Civil Procedure section:
[) 416.10 (corporation) [] 415.95 (business organization, form unknown)
[) 416.20 (defunct corporation) [—) 416.60 (minor)
[) 416.30 (joint stock company/association) () 416.70 (ward or conservatee)
[) 416.40 (association or partnership) [) 416.90 (authorized person)
() 416.50 (public entity) () 415.46 (occupant)
[)) other:
Person who served papers
a. Name: Lea Garbe
b. Address: 15300 Ventura Boulevard, Suite 207, Sherman Oaks, CA 91403
c, Telephone number: 310-982-2984
d The fee for service was: $ 0.00
lam:
(1) [4] not a registered California process server.
(2) (-] exempt from registration under Business and Professions Code section 22350(b).
(3) [) a registered California process server:
[[) owner [J employee [) independent contractor.
(i) Registration No.:
(iii) County:
8. [4] I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.
or
9. [-_] lam a California sheriff or marshal and | certify that the foregoing is true and correct.
Date: 1/20/2021
Lea Garbe > Lea gube
(NAME OF PERSON WHO SERVED PAPERS/SHERIFF OR MARSHAL) (SIGNATURE)
POS-010 [Rev. January 1, 2007) PROOF OF SERVICE OF SUMMONS Page
2 of 2
ae
ee
[ Print this form Save this form |
POS-015
| ATTORNEY OR PARTY WITHOUT ATTORNEY: STATE BAR NO: 240132 FOR COURT USE ONLY
NAME: Jeremy Bollinger
FIRM NAME: Moss Bollinger LLP
STREET ADDRESS: 15300 Ventura Boulevard, Suite 207
city: Sherman Oaks state: CA ZIP CODE: 91403
TELEPHONE NO.: 310-982-2984 FAXNO.: 818-963-5954
E-MAIL ADDRESS: jeremy@mossbollinger.com
ATTORNEY FOR (Name): Plaintiff Justin Carino
SUPERIOR COURT OF CALIFORNIA, COUNTY OF Kern
STREET ADDRESS, 1415 Truxtun Avenue
MAILING ADDRESS:
CITY AND ZIP CODE Bakersfield, CA 93301
BRANCH NAME: Bakersfield Court
Plaintiff/Petitioner: Justin Carino
Defendant/Respondent: Adventist Health Delano dba Delano Regional Medical Center
NOTICE AND ACKNOWLEDGMENT OF RECEIPT—CIVIL |Bev20-0zere
%
TO (insert name of party weka sored Adventist Health Delano dba Delano Regional Medical Center
_>
NOTICE
The summons and other documents identified below are being served pursuai of the | ifornia Code of Civil
Procedure. Your failure to complete this form and return it within 20 days from the date of mailing shown below may subject you
(or the party on whose behalf you are being served) to liability for the payment of any expenses incurred in serving a summons
‘on you in any other manner permitted by law.
If you are being served on behalf of a corporation, an unincorporated association (including a partnership), or other entity, this
form must be signed by you in the name of such entity or by a person authorized to receive service of process on behalf of such
entity. In all other cases, this form must be signed by you personally or by a person authorized by you to acknowledge receipt of
iummons. If you return this form to the sender, service of a summons is deemed complete on the day you sign the
acknowledgment of receipt below.
Keeble
Date of mailing: December 24, 2020
Lea Garbe
(TYPE OR PRINT NAME)
> (SIGNATURE OF SENDER—MUST NOT BE A PARTY IN THIS CASE)
ACKNOWLEDGMENT OF RECEIPT
This acknowledges receipt of (to be completed by sender before mailing):
1. [3€] A copy of the summons and of the complaint.
2. [Ge] Other (specify):
Civil Case Cover Sheet, Notice of Case Assignment, Order to Show Cause and Case Management
Conference; First Amended Complaint
(To be completed by recipient):
—_—
Date this form is signed: January 15, 2021
(TYPE OR PRINT YOUR NAME AND NAME OF ENTITY, IF ANY,
» = ate
(SIGNATURE OF PERSON ACKNOWLEDGING RECEIPT, WITH TITLE IF
‘ON WHOSE BEHALF THIS FORM IS SIGNED) ACKNOWLEDGMENT IS MADE ON BEHALF OF ANOTHER PERSON OR ENTITY)
Page
1 of 1
Form Adopted for Mandatory Use NOTICE AND ACKNOWLEDGMENT OF RECEIPT — CIVIL Code of Civil Procedure,
Judicial Council of California §§ 415.30, 417.10
POS-015 (Rev. January 1, 2005] www courtinfo.ca.gov
Envelope Details Page 1 of 2
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Case # BCV-20-102879 - CARINO VS ADVENTIST HEALTH
DELANO (Clark, Thomas S.)
Case Information
Location Kern - Bakersfield-Civil
Date Filed 3/17/2021 10:23 AM
Case Number BCV-20-102879
Case Description CARINO VS ADVENTIST HEALTH DELANO
Assigned to Judge Clark, Thomas S.
Attorney Jeremy Bollinger
Firm Name Moss Bollinger LLP
Filed By Lea Garbe
Fees
Convenience Fee $0.10
Total Court Case Fees $0.00
Total Court Party Fees $0.00
Total Court Filing Fees $0.00
Total Court Service Fees $0.00
Total Filing & Service Fees $3.50
Total Provider Service Fees $0.00
Total Provider Tax Fees $0.00
Total Taxes (for non-court
$0.00
fees)
Grand Total $3.60
Payment
Account Name BR Card
Transaction Amount $3.60
Transaction Response
Transaction ID 9457017
Order # 006048938-0
Proof of Service of Summons/Complaint
Filing Type EFile
Filing Code Proof of Service of Summons/Complaint
Motion Code
Filing Description
Reference Number
Comments
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Envelope Details Page 2 of 2
Status Rejected
Fees
Court Fee $0.00
Service Fee $0.00
Rejection Information
Reason Time Comment
Second Rejection. No changes made. Party does not conform to the
14- 3/17/2021
Complaint. Party must match word for word. Please review the
Rejected 1:36 PM
Complaint.
Documents
Lead Document POS DRMC.pdf Original
Associated Parties
Party/Business Name
JUSTIN CARINO, INDIVIDUALLY AND ON BEHALF OF OTHER PERSONS SIMILARLY
SITUATED
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