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Superior Court Civil Action Cover Sheet - Superior Court Civil Acti... / file:///C:/Users/Paula%20M/Downloads/Superior%20C ourt%20C\v...
A
DOCKET NUMBER Massachusetts Trial Court
CIVIL ACTION COVER SHEET Superior Court
AYBACILOIY [COUNTY Norfolk Superior Court ethan)
Plaintitt Granite City Electric Supply Company Defendant: Integrated Electric L.L.C.
ADDRESS: 19 Quincy Avenue ADDRESS: 344 John Dietsch Blvd North, Attleboro, MA 02760
Quincy, MA 02169. and
Plaintiff Attorney: Robert G. Cohen, Esq. Defendant, * ” Jeffrey M, Sloan
ADDRESS: Attornay at Law PC ADDRESS: 142 West Bacon Street, Plainville, MA 02762
35 Richmond Lane
Framingham, MA 01701
BEO: 090340 BBO:
Plaintiff Attorney: Defendant Attorney:
ADDRESS: |ADDRESS:
BEO: ‘REO:
TYPE OF ACTION AND TRACK DESIGNATION (see instructions section on next page}
CODE NO. TYPE OF ACTION (specify) TRACK HAS A JURY CLAIM BEEN MADE?
A02 goods sold & delivered F [KINo yes
“if "Other" please describe:
is there a claim under G.L. c, 33A7 Is there a class action under Mass. R. Civ. P. 237
O yes [J No Oves [No
STATEMENT OF DAMAGES REQUIRED BY G.L, c. 212, § 3A.
[The following Is a full, itemized and detailed statement of the facts on which the undersigned plaintiff or plaintiff's counsel relies to determine money damages.
|(Note to piainiiff: for this form, do not state double or treble damages; Indicate single damages only.)
TORT CLAIMS .
-
JA. Documentad medical expenses to date
4, Total hospital expenses
2. Total doctor expenses
3. Total chiropractic expenses
4. Total physical therapy expenses
5, Total other expenses (describe below)
‘Subtotal (1-5): $0.00
B, Documented lost wages and compensation to date
C, Documented property damages to date
D. Reasonably anticipated fulure medical and hospital expenses
E. Reasonably anticipated lost wages
F. Other documented items of damages (describe below)
[
TOTAL (AF): $0.00
G. Briefly describe plaintiffs injury, including the nature and extent of the injury:
|
SONTRAGT CLAIMS
Oo This action includes a claim involving collection of a debt incurred pursuant to a revolving credit agreement. Mass. R. Civ. P. 8.1{a).
Item# Detailed Description of Each Claim Amount
1 defendants purchased electrical goods & materials from plaintifi, on credit, for which they have failed, neglected &
Tefused to pay $138,751.95
Total $138,751.95
‘$C0001: 02/24 ‘uw.mass.govleaurts Date/Time Printed:02-23-2024 12:13:14
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Superior Court Civil Action Cover Sheet - Superior Court Civil Acti... file:///C:/Users/Paula%20M/Downloads/Superior%20Court%20Civ...
‘Signature of Attomey/Self-Represented Plaintiff: X VAP DX | { Date: February 23, 2024
RELATED ACTIONS: Please provide the case number, case name, and county of any related actions pending in the Superior Court.
CERTIFICATION UNDER S.J.C. RULE 1:18(5)
thereby certify that | have compliedwi rements of Rule 5 of Supreme Judicial Court Rule 1:18: Uniform Rules on Dispute Resolution, requiring that ! inform my dlients about
caurt-connected dispute resolution se s find discusgewit hem the advantages and disadvantages of the various methods of dispute resolution,
‘Signature of Attorney: X KUL Ee | [Date: February 23, 2024
Scouot: 02/24 www.mass.gow/courts: Date/Time Printed:02-23-2024 12:13:14
2of3 2/23/2024, 12:13 PM
Superior Court Civil Action Cover Sheet - Superior Court Civil Acti... file:///C:/Users/Paula%20M/Downloads/Superior%20Court%20Civ...
CIVIL ACTION COVER SHEET INSTRUCTIONS —
SELECT A CATEGORY THAT BEST DESCRIBES YOUR CASE*
AC Actions Involving the State/Munlclpalityt” ER Equitable Remedies BP Real Property
‘AA{ Contract Action Involving Commonwealth, (01 Specific Performance of a Contract, “a CO! Land Taking ©)
Municipality, MBTA, etc. 002 Reach and Apply ) G02 Zoning Appee!, G.L..c. 408 ©
AB1 Tortious Action involving Commonwealth, 1DO3 Injunction ) C03 Dispute Concoming Title ©)
Municipality, MBTA, etc. D4 Reform Cancel Instrument ) CO4 Foreclosure of a Mortgage
AC1 Real Property Action involvin DOS Equitable Reptevin ‘C05 Condominium Lien & Charges
Commonwealth, Municipality, MBTA etc. (A)
AD1 Equity Action involving Commonwealth,
06
DO7
Contribution or Indemnification
Imposition of a Trust
Fy
4F)
(a)
€99 Other Real Property Action a
Municipality, MBTA, etc. # DOB Minority Shareholder's Suit MC
Miscellaneous
Civil Actions
AE Administrative Action invotvit ‘DOS Interference in Contractual Relationship )
Commonwealth, Municipality, MBTA.et. (A) D10 Accounting E18 Foreign Discovery Proceeding ®
D11 Enforcement of Restrictive Covenant
CN
Contract/Business
Cases D12
D13
Dissolution of a Partnership
Declaratory Judgment, G.L.c. 231A
Fy
F)
(Ay
E97 Prisoner Habeas Corpus.
E22 Lottery Assignment, G.L. c. 10, § 28 &
AO1 Services, Labor, and Materials * D414 Dissolution of a Corporation AB Abuso/Harassment Prevention
‘AQ2 Goods Sold and Delivered (99 Other Equity Action )
‘A03 Commercial Paper (FY E15 Abuse Prevention Petition, G.L. ¢, 209A _(X)
‘A04 Employment Contract PA Civil Actions Involving Incarcerated
Party + E21 Protection from Harassment, G.L, ¢. 28E(X)
AOS Consumer Revolving Credit -macr.61 F)
‘AOS
A08
Insurance Contract
Sate or Lease of Real Estate
PAI Contract Action involving an
Incarcerated Party
-AA
Administrative
Civil Actions
A
‘A12Construction Dispute (A) PBI Tortious Action involving an E02 Appeal from Administrative Agency,
Al4 Inlerpleader #) Incarcerated P: “ GL.c.
BA1 Govemance, Conduet, lateral PC1 Real Property Action involving an E03 Certiorarl Action, G.L. c. 249, § 4 *)
Affairs of E tes @ Incarcerated P: ®) E05 Confirmation of Arbitration Awards
BAS Liability of Shareholders, Directors, PD1 Equity Action Involving an E06 Mass Antitrust Act, G.L. ¢, 93, § 9 A)
Officers, Partners, etc. Incarcerated Pé ) E07 Mass Antitrust Act, G.L.c. 93, § 8
BB1 Shareholder Derivative a) PE1 Administrative Action involving an E08 Appointment of a Receiver
BB2 Securities Transactions @) Incarcerated Party ©) E09 Construction Surely Bond, G.L, c. 149,
BC1 Mergers, Consolidations, Sates of §§ 29, 290 &
Assets, [ssuance of Debl, Equity, efc. a TR Torts, E10 Summary Process Appeal
BDt Inteltectuat Property E11 Worker's Compensation
BD2 Proprietary Information or Trade. B03 Motor Vehicle Negligence - Personal E16 Auto Surcharge Ap eal
Secrets @ InjuryiProperty Damage ©) E17 Givil Rights Act, GL. ¢.12, § 11H
Gt Financial InstituionsFunds @ B04 Other Negligence - Personal E24 Appeal from District Court
BHt Violalion of Antitrust or Trade Injury/Property Damage Commitment, G.L. c.123, § 8(b)
Regulation 8 B05 Products Liability a E94 Forfeiture, G.L. ¢. 265, § 56
‘A99 Other Contract/Business Action - Specify B06 Malpractice - Medical E95 Forfeiture, GL. c. 84C, §.47
807 Malpractice - Other A) E99 Other Administrative Action wo
* See Superior Court Standing Order 1-88 for an B08 Wrongful Death - Non-medical @) 201 Medical Malpractice - Tribunal only,
expianation of the tracking deadlines for each track B15 Defamation @) GL. c. 231, § 60B
designation: F, A, and X. On this page, the track B19 Asbestos @ ‘202 Appeal Bond Denial ”
designation for each case type is noted in 20 Personal Injury - Slip & Fall )
parentheses, B21 Environmental © ‘SO Sex Offender Review
B22 Emplayment Disorimination
t* Choose this case type if ANY party is the BE1 Fraud, Business Torts, etc, A £12 SDP Commitment, G.L. c. 123A, § 12 wo
‘Commonwealth, a municipality, the MBTA, or any B99 Other Tortious Action ®) E14 SDP Petition, G.L.c. 123A, § 9b) w
other governmental entity UNLESS your case is a
case type listed under Administrative Civil Actions: RP Summary Process (Real Property) RG
Restricted
Civil Actions
SOt Summary Process - Residential ) E19 Sex Offender Registry, G.L. c..6, § 178M (X)
3 Choose this case type if ANY party is an S02 Summary Process - Commercial £27 Minor Seeking Consent, G.L. 6.112, § 128(X)
incarcerated party, UNLESS your case Is a case Non-residential ©
type listed under Administrative Civil Actions (A)
or is a Prisoner Habeas Corpus case (E97), TRANSFER YOUR SELECTION TO THE FACE SHEET
EXAMPLE:
CODE NO, TYPE OF ACTION (specify) TRACK HAS A JURY CLAIM BEEN MADE?
Bo3 Motor Vehicle Negligence-Personal Injury. —£ YES [No
STATEMENT OF DAMAGES REQUIRED BY G.L. c. 212, § 3A
DUTY OF THE PLAINTIFF — On the face of the Civil Action Cover Sheet (or on attached additional sheets, if necessary), the plaintiff shall
state the facts on which the plaintiff relies to determine money damages. A copy of the completed Civil Action Cover Sheet, including the
statement concerning damages, shall be served with the complaint. A clerk-magistrate shall not accept for filing a complaint, except as
otherwise provided by taw, unless it is accompanied by such a statement signed by the attorney or self-represented litigant.
DUTY OF THE DEFENDANT — If the defendant believes that the statement of damages filed by the plaintiff is inadequate, the defendant may
file with the defendant's answer a statement specifying the potential damages which may result if the plaintiff prevails.
A CIVIL ACTION COVER SHEET MUST BE FILED WITH EACH COMPLAINT.
IF THIS COVER SHEET IS NOT FILLED OUT THOROUGHLY AND
ACCURATELY, THE CASE MAY BE DISMISSED.
$C 0001: 02/24 www.mass.govicourts Date/Time Printed:02-23-2024 12:13:14
3 of 3 2/23/2024, 12:13 PM
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Superior Court Civil Action Cover Sheet - Superior Court Civil Acti... / file:///C:/Users/Paula%20M/Downloads/Superior%20C ourt%20C\v... A DOCKET NUMBER Massachusetts Trial Court CIVIL ACTION COVER SHEET Superior Court AYBACILOIY [COUNTY Norfolk Superior Court ethan) Plaintitt Granite City Electric Supply Company Defendant: Integrated Electric L.L.C. ADDRESS: 19 Quincy Avenue ADDRESS: 344 John Dietsch Blvd North, Attleboro, MA 02760 Quincy, MA 02169. and Plaintiff Attorney: Robert G. Cohen, Esq. Defendant, * ” Jeffrey M, Sloan ADDRESS: Attornay at Law PC ADDRESS: 142 West Bacon Street, Plainville, MA 02762 35 Richmond Lane Framingham, MA 01701 BEO: 090340 BBO: Plaintiff Attorney: Defendant Attorney: ADDRESS: |ADDRESS: BEO: ‘REO: TYPE OF ACTION AND TRACK DESIGNATION (see instructions section on next page} CODE NO. TYPE OF ACTION (specify) TRACK HAS A JURY CLAIM BEEN MADE? A02 goods sold & delivered F [KINo yes “if "Other" please describe: is there a claim under G.L. c, 33A7 Is there a class action under Mass. R. Civ. P. 237 O yes [J No Oves [No STATEMENT OF DAMAGES REQUIRED BY G.L, c. 212, § 3A. [The following Is a full, itemized and detailed statement of the facts on which the undersigned plaintiff or plaintiff's counsel relies to determine money damages. |(Note to piainiiff: for this form, do not state double or treble damages; Indicate single damages only.) TORT CLAIMS . - JA. Documentad medical expenses to date 4, Total hospital expenses 2. Total doctor expenses 3. Total chiropractic expenses 4. Total physical therapy expenses 5, Total other expenses (describe below) ‘Subtotal (1-5): $0.00 B, Documented lost wages and compensation to date C, Documented property damages to date D. Reasonably anticipated fulure medical and hospital expenses E. Reasonably anticipated lost wages F. Other documented items of damages (describe below) [ TOTAL (AF): $0.00 G. Briefly describe plaintiffs injury, including the nature and extent of the injury: | SONTRAGT CLAIMS Oo This action includes a claim involving collection of a debt incurred pursuant to a revolving credit agreement. Mass. R. Civ. P. 8.1{a). Item# Detailed Description of Each Claim Amount 1 defendants purchased electrical goods & materials from plaintifi, on credit, for which they have failed, neglected & Tefused to pay $138,751.95 Total $138,751.95 ‘$C0001: 02/24 ‘uw.mass.govleaurts Date/Time Printed:02-23-2024 12:13:14 lof3 2/23/2024, 12:13 PM Superior Court Civil Action Cover Sheet - Superior Court Civil Acti... file:///C:/Users/Paula%20M/Downloads/Superior%20Court%20Civ... ‘Signature of Attomey/Self-Represented Plaintiff: X VAP DX | { Date: February 23, 2024 RELATED ACTIONS: Please provide the case number, case name, and county of any related actions pending in the Superior Court. CERTIFICATION UNDER S.J.C. RULE 1:18(5) thereby certify that | have compliedwi rements of Rule 5 of Supreme Judicial Court Rule 1:18: Uniform Rules on Dispute Resolution, requiring that ! inform my dlients about caurt-connected dispute resolution se s find discusgewit hem the advantages and disadvantages of the various methods of dispute resolution, ‘Signature of Attorney: X KUL Ee | [Date: February 23, 2024 Scouot: 02/24 www.mass.gow/courts: Date/Time Printed:02-23-2024 12:13:14 2of3 2/23/2024, 12:13 PM Superior Court Civil Action Cover Sheet - Superior Court Civil Acti... file:///C:/Users/Paula%20M/Downloads/Superior%20Court%20Civ... CIVIL ACTION COVER SHEET INSTRUCTIONS — SELECT A CATEGORY THAT BEST DESCRIBES YOUR CASE* AC Actions Involving the State/Munlclpalityt” ER Equitable Remedies BP Real Property ‘AA{ Contract Action Involving Commonwealth, (01 Specific Performance of a Contract, “a CO! Land Taking ©) Municipality, MBTA, etc. 002 Reach and Apply ) G02 Zoning Appee!, G.L..c. 408 © AB1 Tortious Action involving Commonwealth, 1DO3 Injunction ) C03 Dispute Concoming Title ©) Municipality, MBTA, etc. D4 Reform Cancel Instrument ) CO4 Foreclosure of a Mortgage AC1 Real Property Action involvin DOS Equitable Reptevin ‘C05 Condominium Lien & Charges Commonwealth, Municipality, MBTA etc. (A) AD1 Equity Action involving Commonwealth, 06 DO7 Contribution or Indemnification Imposition of a Trust Fy 4F) (a) €99 Other Real Property Action a Municipality, MBTA, etc. # DOB Minority Shareholder's Suit MC Miscellaneous Civil Actions AE Administrative Action invotvit ‘DOS Interference in Contractual Relationship ) Commonwealth, Municipality, MBTA.et. (A) D10 Accounting E18 Foreign Discovery Proceeding ® D11 Enforcement of Restrictive Covenant CN Contract/Business Cases D12 D13 Dissolution of a Partnership Declaratory Judgment, G.L.c. 231A Fy F) (Ay E97 Prisoner Habeas Corpus. E22 Lottery Assignment, G.L. c. 10, § 28 & AO1 Services, Labor, and Materials * D414 Dissolution of a Corporation AB Abuso/Harassment Prevention ‘AQ2 Goods Sold and Delivered (99 Other Equity Action ) ‘A03 Commercial Paper (FY E15 Abuse Prevention Petition, G.L. ¢, 209A _(X) ‘A04 Employment Contract PA Civil Actions Involving Incarcerated Party + E21 Protection from Harassment, G.L, ¢. 28E(X) AOS Consumer Revolving Credit -macr.61 F) ‘AOS A08 Insurance Contract Sate or Lease of Real Estate PAI Contract Action involving an Incarcerated Party -AA Administrative Civil Actions A ‘A12Construction Dispute (A) PBI Tortious Action involving an E02 Appeal from Administrative Agency, Al4 Inlerpleader #) Incarcerated P: “ GL.c. BA1 Govemance, Conduet, lateral PC1 Real Property Action involving an E03 Certiorarl Action, G.L. c. 249, § 4 *) Affairs of E tes @ Incarcerated P: ®) E05 Confirmation of Arbitration Awards BAS Liability of Shareholders, Directors, PD1 Equity Action Involving an E06 Mass Antitrust Act, G.L. ¢, 93, § 9 A) Officers, Partners, etc. Incarcerated Pé ) E07 Mass Antitrust Act, G.L.c. 93, § 8 BB1 Shareholder Derivative a) PE1 Administrative Action involving an E08 Appointment of a Receiver BB2 Securities Transactions @) Incarcerated Party ©) E09 Construction Surely Bond, G.L, c. 149, BC1 Mergers, Consolidations, Sates of §§ 29, 290 & Assets, [ssuance of Debl, Equity, efc. a TR Torts, E10 Summary Process Appeal BDt Inteltectuat Property E11 Worker's Compensation BD2 Proprietary Information or Trade. B03 Motor Vehicle Negligence - Personal E16 Auto Surcharge Ap eal Secrets @ InjuryiProperty Damage ©) E17 Givil Rights Act, GL. ¢.12, § 11H Gt Financial InstituionsFunds @ B04 Other Negligence - Personal E24 Appeal from District Court BHt Violalion of Antitrust or Trade Injury/Property Damage Commitment, G.L. c.123, § 8(b) Regulation 8 B05 Products Liability a E94 Forfeiture, G.L. ¢. 265, § 56 ‘A99 Other Contract/Business Action - Specify B06 Malpractice - Medical E95 Forfeiture, GL. c. 84C, §.47 807 Malpractice - Other A) E99 Other Administrative Action wo * See Superior Court Standing Order 1-88 for an B08 Wrongful Death - Non-medical @) 201 Medical Malpractice - Tribunal only, expianation of the tracking deadlines for each track B15 Defamation @) GL. c. 231, § 60B designation: F, A, and X. On this page, the track B19 Asbestos @ ‘202 Appeal Bond Denial ” designation for each case type is noted in 20 Personal Injury - Slip & Fall ) parentheses, B21 Environmental © ‘SO Sex Offender Review B22 Emplayment Disorimination t* Choose this case type if ANY party is the BE1 Fraud, Business Torts, etc, A £12 SDP Commitment, G.L. c. 123A, § 12 wo ‘Commonwealth, a municipality, the MBTA, or any B99 Other Tortious Action ®) E14 SDP Petition, G.L.c. 123A, § 9b) w other governmental entity UNLESS your case is a case type listed under Administrative Civil Actions: RP Summary Process (Real Property) RG Restricted Civil Actions SOt Summary Process - Residential ) E19 Sex Offender Registry, G.L. c..6, § 178M (X) 3 Choose this case type if ANY party is an S02 Summary Process - Commercial £27 Minor Seeking Consent, G.L. 6.112, § 128(X) incarcerated party, UNLESS your case Is a case Non-residential © type listed under Administrative Civil Actions (A) or is a Prisoner Habeas Corpus case (E97), TRANSFER YOUR SELECTION TO THE FACE SHEET EXAMPLE: CODE NO, TYPE OF ACTION (specify) TRACK HAS A JURY CLAIM BEEN MADE? Bo3 Motor Vehicle Negligence-Personal Injury. —£ YES [No STATEMENT OF DAMAGES REQUIRED BY G.L. c. 212, § 3A DUTY OF THE PLAINTIFF — On the face of the Civil Action Cover Sheet (or on attached additional sheets, if necessary), the plaintiff shall state the facts on which the plaintiff relies to determine money damages. A copy of the completed Civil Action Cover Sheet, including the statement concerning damages, shall be served with the complaint. A clerk-magistrate shall not accept for filing a complaint, except as otherwise provided by taw, unless it is accompanied by such a statement signed by the attorney or self-represented litigant. DUTY OF THE DEFENDANT — If the defendant believes that the statement of damages filed by the plaintiff is inadequate, the defendant may file with the defendant's answer a statement specifying the potential damages which may result if the plaintiff prevails. A CIVIL ACTION COVER SHEET MUST BE FILED WITH EACH COMPLAINT. IF THIS COVER SHEET IS NOT FILLED OUT THOROUGHLY AND ACCURATELY, THE CASE MAY BE DISMISSED. $C 0001: 02/24 www.mass.govicourts Date/Time Printed:02-23-2024 12:13:14 3 of 3 2/23/2024, 12:13 PM