Miscellaneous: CALIFORNIA CASUALTY INDEMNITY EXCHANGE, aso Childers, Ashley Plaintiff vs Garcia, Evelyn Rosa Defendant

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                                Filing # 50495148 E-Filed 12/27/2016 10:12:34 AM

FORM 1.997. CIVIL COVER SHEET

The civil cover sheet and the information contained herein neither replace nor supplement the filing and service of
pleadings or other papers as required by law. This form shall be filed by the plaintiff or petitioner for the use of the Clerk
of the Court for the purpose of reporting judicial workload data pursuant to Florida Statutes section 25.075.

I. CASE STYLE

IN THE CIRCUIT COURT OF THE TWENTIETH JUDICIAL CIRCUIT,
IN AND FOR LEE COUNTY, FLORIDA

Case No..:
Judge:
CALIFORNIA CASUALTY INDEMNITY EXCHANGE
Plaintiff
vs.
Evelyn Rosa Garcia
Defendant
I. TYPE OF CASE
G Other real property actions $0 - $50,000
O Condominium Other real property actions $50,001 - $249,999
O Contracts and indebtedness O Other real property actions $250,000 or more
O Eminent domain
O Professional malpractice

& Auto negligence

OD Negligence — other

Business governance

Business torts

Environmental/Toxic tort

Third party indemnification

Construction defect

Mass tort

Negligent security

Nursing home negligence

Premises liability - commercial

O _sPremises liability — residential

O Products liability

OD Real Property/Mortgage foreclosure

Commercial foreclosure $0 - $50,000
Commercial foreclosure $50,001 - $249,999
Commercial foreclosure $250,000 or more
Homestead residential foreclosure $0 — 50,000
Homestead residential foreclosure $50,001 -
$249,999

Homestead residential foreclosure $250,000 or
more

Non-homestead residential foreclosure $0 -
$50,000

Non-homestead residential foreclosure
$50,001 - $249,999

Non-homestead residential foreclosure
$250,00 or more

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Malpractice — business
Malpractice — medical
Malpractice — other professional

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Antitrust/Trade Regulation
Business Transaction
Circuit Civil - Not Applicable

Constitutional challenge-statute or
ordinance

Constitutional challenge-proposed
amendment

Corporate Trusts
Discrimination-employment or other
Insurance claims

Intellectual property

Libel/Slander

Shareholder derivative action
Securities litigation

Trade secrets

Trust litigation

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eFiled Lee County Clerk of Courts Page 1COMPLEX BUSINESS COURT

This action is appropriate for assignment to Complex Business Court as delineated and mandated by the
Administrative Order. Yes (1 No

mM. REMEDIES SOUGHT (check all that apply):
Monetary;
OQ Non-monetary
© Non-monetary declaratory or injunctive relief;
O Punitive

Iv. NUMBER OF CAUSES OF ACTION:(__)
(Specify)

1

Vv. IS THIS CASE A CLASS ACTION LAWSUIT?
O Yes
No

Vi. 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?
D Yes
& No

| CERTIFY that the information | have provided in this cover sheet is accurate to the best of my knowledge and belief.

Signature s/ Flynn Lavrar FL Bar No.: 91596
Attorney or party (Bar number, if attorney)

Flynn Lavrar 12/27/2016
(Type or print name) Date

eFiled Lee County Clerk of Courts Page 2