Party Statement: Hereford Insurance Company v. 21 Century Chiropractic Care, Arte Medical Primary Care, P.C., Arthur Avenue Medical Office, P.C., Azcare Inc., Bridges Psychological Services P.C., City Pain Docs Pc, Coney Island Psychology P.C., Englewood Orthopedics Group Pc, Englinton Medical, P.C., Fairpoint Acupuncture P.C., Future Chiropractic Care, P.C., Joseph A. Raia, M.D., P.C., Joseph A Rossello Dc, Kv Medical Of Ny P.C., Lenco Diagnostic Laboratories, Inc., Manalapan Surgery Center, Metropolitan Medical & Surgical P.C., Nile Rehab Physical Therapy, P.C., Pain Medicine Of Ny P.C., Perloff Physical Therapy, P.C., Precision Anesthesia Associate, Rapid Imaging Corp., Smk Pharmacy, Corp., Stephens Acupuncture P.C., Westchester Radiology & Imaging, P.C., Wjw Medical Products (Dme), Kelvin Brioso, Lionel Hughes, Phil Nelson, Quinn Oliver

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                                FILED:         NEW     YORK       COUNTY        CLERK        05/07/2020             12:15        PM                 INDEX    NO.   651472/2020
   NYSCEF     DOC.   NO.   20                                                                                 RECEIVED      NYSCEF:     05/07/2020




                  SUPREME          COURT        O         E  STATE      OF   NEW      YORK
                                                    f'
                  COUNTY         OF      U ty     I



                                              STATEMENT            OF   AUTHORIZATION                 FOR
                                                            ELECTRONIC             FILING
                                    (Single    Attorney       Authorizing        Individual        Filing   Agent)


                           I,.                                           , Esq., ( Attorney   Registration    No.

                                           ) am   an a  thorized    user  of the New    York  State  Courts   Electronic   Filing
                  Sy  tem   ("1      EF")  (User   ID     R5ch     VP        ).I hereby   authorize
                                              M  hn         5
                                                              †f-                         ("the  filing agent")   to utilize his/her
                  NYSCEF     filing agent   ID  to file documents     on  my  behalf   and  at my   direction  in any  e-filed matter
                  in which   I am  counsel    of record  through    the  NYSCEF     system,   as  provided   in Section   202.5-b   of
                  the  Uniform    Rules  for  the Trial  Courts.


                           This  authorization     extends   to any  consensual    matter   in which   I have  previously
                  consented    to e-filing, to  any  mandatory     matter   in which   I have  recorded    my   representation,    and
                  to any  matter   in which   I may   authorize   the  filing agent  to record   my   consent   or representation
                  in the  NYSCEF     system.


                           This  authorization    extends    to any  and  all documents     I generate   and  submit    to the filing
                  agent  for filing in any   such  matter.   This  authorization,    posted   once  on  the  NYSCEF     website   as to
                  each  matter   in which   I am   counsel   of record,  shall  be  deemed   to  accompany     any  document     filed
                  in that  matter  by  the  filing agent.


                           This  authorization    also  extends   to matters   of payment,     which   the  filingagent   may  make
                  either  by debiting   an  account   the  filing agent  maintains    with  the  County    Clerk  of any  authorized
                                    or                an  account   I maintain    with  the           Clerk  of      authorized    e-
                  e-filing county      by  debiting                                         County              any
                  filing county.


                           This  authorization    regarding    this filing agent   shall continue    until  I revoke  itin writing
                  on  a prescrib   d form   delivered   to the  E-Filing   Resource    Center.


                  Dated:




                  Signature                                                      City,  State  and  Zip  Code




                  Print Name                                                     Phone




                  Firm/Department                                                E-Mail   Address




                  Street Address
                                           b                                                                          (6/6/13)




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