On April 12, 2024 a
Miscellaneous
was filed
involving a dispute between
Mortimer Holding Company, Llc,
and
American Integrity Insurance Company Of Florida,
for Insurance Claim
in the District Court of Charlotte County.
Preview
Filing # 196077282 E-Filed 04/12/2024 11:53:16 AM
FORM 1.997. CIVIL COVER SHEET
The civil cover sheet and the information contained in it neither replace nor supplement the filing
and service of pleadings or other documents as required by law. This form must be filed by the
plaintiff or petitioner with the Clerk of Court for the purpose of reporting uniform data pursuant
to section 25.075, Florida Statutes. (See instructions for completion.)
I CASE STYLE
IN THE CIRCUIT/COUNTY COURT OF THE TWENTIETH JUDICIAL CIRCUIT,
IN AND FOR CHARLOTTE COUNTY, FLORIDA
Mortimer Holding Company, LLC
Plaintiff Case # 24000910CA
Judge
vs.
American Integrity Insurance Company of Florida
Defendant
I. AMOUNT OF CLAIM
Please indicate the estimated amount of the claim, rounded to the nearest dollar. The estimated amount of
the claim is requested for data collection and clerical processing purposes only. The amount of the claim
shall not be used for any other purpose.
O $8,000 or less
C $8,001 - $30,000
OD $30,001- $50,000
D $50,001- $75,000
OZ $75,001 - $100,000
&X] over $100,000.00
Til. TYPE OF CASE (If the case fits more than one type of case, select the most
definitive category.) If the most descriptive label is a subcategory (is indented under a broader
category), place an x on both the main category and subcategory lines.
-1l-
FILED: 04/12/2024 11:53 AM: Roger D. Eaton, Clerk of the Circuit Court, Charlotte County, FL DIN 2
CIRCUIT CIVIL
O Condominium
CO Contracts and indebtedness
O Eminent domain
O Auto negligence
O Negligence—other
CO Business governance
CO Business torts
O Environmental/Toxic tort
O Third party indemnification
CO Construction defect
C Mass tort
C Negligent security
O Nursing home negligence
O Premises liability—commercial
O Premises liability—residential
O Products liability
OC Real Property/Mortgage foreclosure
O Commercial foreclosure
C Homestead residential foreclosure
O Non-homestead residential foreclosure
O Other real property actions
OProfessional malpractice
O Malpractice—business
0 Malpractice—medical
0 Malpractice—other professional
Other
O Antitrust/Trade regulation
C Business transactions
0 Constitutional challenge—statute or ordinance
O Constitutional challenge—proposed amendment
O Corporate trusts
O Discrimination—employment or other
Insurance claims
C Intellectual property
O Libel/Slander
O Shareholder derivative action
O Securities litigation
O Trade secrets
O Trust litigation
COUNTY CIVIL
O Small Claims up to $8,000
O Civil
O Real property/Mortgage foreclosure
-2-
O Replevins
O Evictions
O Residential Evictions
O Non-residential Evictions
O Other civil (non-monetary)
COMPLEX BUSINESS COURT
This action is appropriate for assignment to Complex Business Court as delineated and mandated by the
Administrative Order. Yes D1) No
IV. REMEDIES SOUGHT (check all that apply):
Monetary;
O Nonmonetary declaratory or injunctive relief;
O Punitive
Vv. NUMBER OF CAUSES OF ACTION: [ ]
(Specify)
i1
VI. IS THIS CASE A CLASS ACTION LAWSUIT?
0 yes
& no
Vil. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
& no
O yes If “yes,” list all related cases by name, case number, and court.
Vil. IS JURY TRIAL DEMANDED IN COMPLAINT?
yes
Ono
IX. DOES THIS CASE INVOLVE ALLEGATIONS OF SEXUAL ABUSE?
0 yes
& no
I CERTIFY that the information I have provided in this cover sheet is accurate to the best of
my knowledge and belief, and that I have read and will comply with the requirements of
Florida Rule of Judicial Administration 2.425.
Signature: s/ Gabriel Manuel de las Salas Fla. Bar # 85691
Attorney or party (Bar # if attorney)
Gabriel Manuel de las Salas 04/12/2024
(type or print name) Date
-3-
Document Filed Date
April 12, 2024
Case Filing Date
April 12, 2024
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