Preview
Filing # 141153808 E-Filed 12/30/2021 03:35:19 PM
RETURN OF SERVICE
State of Florida County of Palm Beach Circuit Court
Case Number: 50-2021-CA-010108
Plaintiff:
MARION J. YOUNG BUTERA and THOMAS BUTERA, her spouse
vs.
Defendants,:
EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA and THE
BRIGHT VIEW LANDSCAPES, LLC
For:
David J. Majcak, Esq.
Goldberg Segalla, LLP
222 Lakeview Avenue
Suite 800
West Palm Beach, FL 33401
Received by WILLIAMS PROCESS SERVICE, INC. on the 16th day of December, 2021 at 11:54 am to be served on
Records Custodian: Geico General Insurance Company c/o Chief Financial Officer, as Reg. Ag. (Re: Marion
Butera), 200 E. Gaines Street, Tallahassee, FL 32399. 7
|, MICHAEL C. NOLAN, do hereby affirm that on the 17th day of December, 2021 at 9:15 am, I:
CORPORATE: served by delivering a true copy of the Subpoena Duces Tecum Without Deposition and Notice
of Production from Non-Party; CFO check no, 31957 dated: 12/16/2021 in the amount of $15.00 with the date
and hour of service endorsed thereon by me, to: JONATHAN DOSTER as OPS CLERK for the Registered Agent of
Records Custodian: Geico General Insurance Company c/o Chief Financial Officer, as Reg. Ag. (Re: Marion Butera)
at the address of: 200 EAST GAINES STREET, TALLAHASSEE, FL 32399, and informed said person of the
contents therein, in compliance with state statutes.
Description of Person Served: Age: 28, Sex: M, Race/Skin Color: WHITE, Height: 5'9", Weight: 180, Hair: BLONDE,
Glasses: Y
| certify that | am over the age of 18, have no interest in the above action, and am a Certified Process Server, in
good standing, in the judicial circuit in which the process was served. Under penalty of perjury | declare that the
facts contained herein are true to the best of my knowledge.NO NOTARY REQUIRED PURSUANT TO F.S. 92.525
Q).
WILLIAMS PROCESS SERVICE, INC.
721 U.S, HIGHWAY 1
SUITE 121
NORTH PALM BEACH, FL 33408
(561) 881-1442
Our Job Serial Number: WPS-2021023364
Ref: 16214.0040
Copytight © 1992-2071 Database Services, ine. - Process Server's Toattox V8.2b
KYA A
*** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 12/30/2021 03:35:19 PM ***723ey
IN THE CIRCUIT COURT OF THE 15th
JUDICIAL CIRCUIT IN AND FOR PALM
BEACH COUNTY, FLORIDA
MARION J. YOUNG BUTERA
AND THOMAS BUTERA, her spouse,
Plaintiffs, CASE NO: 50-2021-CA-O010108
ve
EDENS LIMITED PARTNERSHIP d/b/a
SUNSHINE SQUARE PLAZA and THE
BRIGHTVIEW LANDSCAPES, LLC,
Defendants,
EDENS LIMITED PARTNERSHIP d/b/a
SUNSHINE SQUARE PLAZA,
Cross-Plaintift,
v
THE BRIGHTVIEW LANDSCAPES, LLC,
Cross-Defendants,
SUBPOENA DUCES TECUM WITHOUT DEPOSITION
To: Records Custodian:
GEICO GENERAL INSURANCE COMPANY
C/O Florida’s Chief Financial Officer
200 E. Gaines Street
Tallahassee, Florida 32399
TICE: In accordance with the provisions of 45 C.F.R. 164.512(3)(1), we have previously
notified PlaintifP's counsel of our request for the above-referenced information pursuant to a Notice of Production
from Non-Party dated the 2nd day of December, 2021. This Notice included sufficient information about the above
captioned matter to provide an opportunity for the Plaintiff to raise an objection with the Court. The time for the
Plaintiff to raise objections has lapsed and no objections were filed or all objections filed have been resolved by this
Court.
YOU ARE COMMANDED TO EMAIL TO THE BELOW EMAIL ADDRESSES or MAIL
TO: David Majeak, Esquire, Goldberg Segalla, LLP, at our central mail address: P.O. Box 787, Buffalo, NY 14201,
within ten (10) days of service hereof, the following:
Any and all records of the entire claim file, for any and all claims, including but not limited to
correspondence, pay-out sheets, medical bills submitted, wage loss claims submitted, drafts indicating
payment of medical bills and wage loss claims, expert reports pertaining to medical review, IME reports,
and subrogation/lien letters and documentation, insurance policies, applications, insurance records, claim
31234993.v1forms, pay out sheets, accident reports, crash reports, medical records with respect to any injury or illness,
medical history, consultations, treatment, patient questionnaires, progress notes, laboratory reports, nurses
notes, bills on accounts, hospital records, reports of diagnostic and surgical procedures, x-rays and x-ray
reports, narrative reports, office notes and any and all reports or correspondence of other physicians or
hospitals, correspondence or any other record of any kind or nature that you have in your possession
regarding any injury, accident, or treatment from the first date of coverage to the present, Please note this
request is not limited to only one (1) incident, and your response should include your complete file for the
below-stated individual:
NAME OF PATIENT : M. J. YOUNG BUTERA
DATE OF BIRTH :
SOCIAL SECURITY NO
POLICY NUMBER
CLAIM NUMBER
IN AN EFFORT TO AVOID ANY DISCREPANCIES AND DUPLICATION OF RECORDS,
IT IS HEREBY REQUESTED THAT A COPY OF THIS SUBPOENA BE ATTACHED TO
YOUR RECORDS.
You must produce each and every piece of paper contained in your files regarding the patient, whether or not
prepared by you (i.c., including letters or records sent to you from other healthcare providers).
Pursuant to Florida Statutes 456.057(17) and Florida Administrative Code § 64-B8-10.003, a fec of
$1.00 per page for the first twenty-five (25) pages and $0.25 conts per page for each additional page will be paid
for the photocopying of said records. IF THE FEE FOR PHOTOCOPYING EXCEEDS FIFTY ($50.00)
DOLLARS, PLEASE CONTACT THE UNDERSIGNED IN ADVANCE OF THE COPYING FOR
AUTHORIZATION TO DO SO. If it is necessary to have the fee paid in advance or if the records cannot be
gathered by the appointed date, please contact the undersigned on or before the date on the Subpoena and
_ arrangements will be made.
You have the right to object to the production pursuant to this Subpoena at any time before production by
giving written notice to the attorney whose name appears on this Subpocna, THIS WILL NOT BE A DEPOSITION,
NO TESTIMONY WILL BE TAKEN.
If you fail to: (1) furnish the records; ar (2) object to this Subpoena, you may be in contempt of Court. You
are subpoenaed by the allorney whose name appears on this Subpoena and unless excused from this Subpoena by the
attorney whose name appears on this Subpoena or the court, you shall respond to this subpocna as directed.
DATED this 12th day of December, 2021
DAVID MAJCAK
For the Court
fs! David Maicak
GOLDBERG SEGALLA, LLP
David J. Majeak, Esquire
Florida Bar No. 0073883
222 Lakeview Avenue, Suite 800
West Palm Beach, FL 33401
(561) 618-4469 Office
(561) 618-4549 Fax
entail designations:
duagicak@goldbergsegalla.com
31234993.vi
Preview
Filing # 141153808 E-Filed 12/30/2021 03:35:19 PM RETURN OF SERVICE State of Florida County of Palm Beach Circuit Court Case Number: 50-2021-CA-010108 Plaintiff: MARION J. YOUNG BUTERA and THOMAS BUTERA, her spouse vs. Defendants,: EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA and THE BRIGHT VIEW LANDSCAPES, LLC For: David J. Majcak, Esq. Goldberg Segalla, LLP 222 Lakeview Avenue Suite 800 West Palm Beach, FL 33401 Received by WILLIAMS PROCESS SERVICE, INC. on the 16th day of December, 2021 at 11:54 am to be served on Records Custodian: Geico General Insurance Company c/o Chief Financial Officer, as Reg. Ag. (Re: Marion Butera), 200 E. Gaines Street, Tallahassee, FL 32399. 7 |, MICHAEL C. NOLAN, do hereby affirm that on the 17th day of December, 2021 at 9:15 am, I: CORPORATE: served by delivering a true copy of the Subpoena Duces Tecum Without Deposition and Notice of Production from Non-Party; CFO check no, 31957 dated: 12/16/2021 in the amount of $15.00 with the date and hour of service endorsed thereon by me, to: JONATHAN DOSTER as OPS CLERK for the Registered Agent of Records Custodian: Geico General Insurance Company c/o Chief Financial Officer, as Reg. Ag. (Re: Marion Butera) at the address of: 200 EAST GAINES STREET, TALLAHASSEE, FL 32399, and informed said person of the contents therein, in compliance with state statutes. Description of Person Served: Age: 28, Sex: M, Race/Skin Color: WHITE, Height: 5'9", Weight: 180, Hair: BLONDE, Glasses: Y | certify that | am over the age of 18, have no interest in the above action, and am a Certified Process Server, in good standing, in the judicial circuit in which the process was served. Under penalty of perjury | declare that the facts contained herein are true to the best of my knowledge.NO NOTARY REQUIRED PURSUANT TO F.S. 92.525 Q). WILLIAMS PROCESS SERVICE, INC. 721 U.S, HIGHWAY 1 SUITE 121 NORTH PALM BEACH, FL 33408 (561) 881-1442 Our Job Serial Number: WPS-2021023364 Ref: 16214.0040 Copytight © 1992-2071 Database Services, ine. - Process Server's Toattox V8.2b KYA A *** FILED: PALM BEACH COUNTY, FL JOSEPH ABRUZZO, CLERK. 12/30/2021 03:35:19 PM ***723ey IN THE CIRCUIT COURT OF THE 15th JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA MARION J. YOUNG BUTERA AND THOMAS BUTERA, her spouse, Plaintiffs, CASE NO: 50-2021-CA-O010108 ve EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA and THE BRIGHTVIEW LANDSCAPES, LLC, Defendants, EDENS LIMITED PARTNERSHIP d/b/a SUNSHINE SQUARE PLAZA, Cross-Plaintift, v THE BRIGHTVIEW LANDSCAPES, LLC, Cross-Defendants, SUBPOENA DUCES TECUM WITHOUT DEPOSITION To: Records Custodian: GEICO GENERAL INSURANCE COMPANY C/O Florida’s Chief Financial Officer 200 E. Gaines Street Tallahassee, Florida 32399 TICE: In accordance with the provisions of 45 C.F.R. 164.512(3)(1), we have previously notified PlaintifP's counsel of our request for the above-referenced information pursuant to a Notice of Production from Non-Party dated the 2nd day of December, 2021. This Notice included sufficient information about the above captioned matter to provide an opportunity for the Plaintiff to raise an objection with the Court. The time for the Plaintiff to raise objections has lapsed and no objections were filed or all objections filed have been resolved by this Court. YOU ARE COMMANDED TO EMAIL TO THE BELOW EMAIL ADDRESSES or MAIL TO: David Majeak, Esquire, Goldberg Segalla, LLP, at our central mail address: P.O. Box 787, Buffalo, NY 14201, within ten (10) days of service hereof, the following: Any and all records of the entire claim file, for any and all claims, including but not limited to correspondence, pay-out sheets, medical bills submitted, wage loss claims submitted, drafts indicating payment of medical bills and wage loss claims, expert reports pertaining to medical review, IME reports, and subrogation/lien letters and documentation, insurance policies, applications, insurance records, claim 31234993.v1forms, pay out sheets, accident reports, crash reports, medical records with respect to any injury or illness, medical history, consultations, treatment, patient questionnaires, progress notes, laboratory reports, nurses notes, bills on accounts, hospital records, reports of diagnostic and surgical procedures, x-rays and x-ray reports, narrative reports, office notes and any and all reports or correspondence of other physicians or hospitals, correspondence or any other record of any kind or nature that you have in your possession regarding any injury, accident, or treatment from the first date of coverage to the present, Please note this request is not limited to only one (1) incident, and your response should include your complete file for the below-stated individual: NAME OF PATIENT : M. J. YOUNG BUTERA DATE OF BIRTH : SOCIAL SECURITY NO POLICY NUMBER CLAIM NUMBER IN AN EFFORT TO AVOID ANY DISCREPANCIES AND DUPLICATION OF RECORDS, IT IS HEREBY REQUESTED THAT A COPY OF THIS SUBPOENA BE ATTACHED TO YOUR RECORDS. You must produce each and every piece of paper contained in your files regarding the patient, whether or not prepared by you (i.c., including letters or records sent to you from other healthcare providers). Pursuant to Florida Statutes 456.057(17) and Florida Administrative Code § 64-B8-10.003, a fec of $1.00 per page for the first twenty-five (25) pages and $0.25 conts per page for each additional page will be paid for the photocopying of said records. IF THE FEE FOR PHOTOCOPYING EXCEEDS FIFTY ($50.00) DOLLARS, PLEASE CONTACT THE UNDERSIGNED IN ADVANCE OF THE COPYING FOR AUTHORIZATION TO DO SO. If it is necessary to have the fee paid in advance or if the records cannot be gathered by the appointed date, please contact the undersigned on or before the date on the Subpoena and _ arrangements will be made. You have the right to object to the production pursuant to this Subpoena at any time before production by giving written notice to the attorney whose name appears on this Subpocna, THIS WILL NOT BE A DEPOSITION, NO TESTIMONY WILL BE TAKEN. If you fail to: (1) furnish the records; ar (2) object to this Subpoena, you may be in contempt of Court. You are subpoenaed by the allorney whose name appears on this Subpoena and unless excused from this Subpoena by the attorney whose name appears on this Subpoena or the court, you shall respond to this subpocna as directed. DATED this 12th day of December, 2021 DAVID MAJCAK For the Court fs! David Maicak GOLDBERG SEGALLA, LLP David J. Majeak, Esquire Florida Bar No. 0073883 222 Lakeview Avenue, Suite 800 West Palm Beach, FL 33401 (561) 618-4469 Office (561) 618-4549 Fax entail designations: duagicak@goldbergsegalla.com 31234993.vi