On January 15, 2021 a
Party Statement
was filed
involving a dispute between
Johnson, Harriet S,
The Estate Of Harry Johnson Jr,
and
Alvarez, Norma,
Florida Facilities Llc,
Gulf Coast Health Care Holdings Llc,
Hc Navigator Llc,
Mf Flagler Llc,
Pensacola Administrative Services Llc,
Petretti, Charlene,
for OTHER NEGLIGENCE NURSING HOME
in the District Court of Flagler County.
Preview
Filing # 123939458 E-Filed 03/29/2021 02:45:59 PM
AFFIDAVIT OF SERVICE
State of Florida County of Flagler Circuit Court
Case Number: 21-CA-23
Plaintiff: | l| | ll (OMI IM l
SLK20210011
The Estate of Harry Johnson, Jr. by and through Harriet S Johnson, 80
Personal Representative
vs.
Defendant:
MF Flagler, LLC; Florida Facilities, LLC; Pensacola Administrative Services,
LLC; HC Navigator, LLC; Guld Coast Health Care Holdings, LLC; Norma
Alvarez and Charlene Petretti (as to Flagler Health and Rehabilitation
Center)
For:
Carl R. Wilander
Mendes, Reins & Wilander, PLLC
4401 W. Kennedy Blvd
Ste. 250
Tampa, FL 33609
Received by SLK INVESTIGATIONS on the 5th day of March, 2021 at 8:42 am to be served on Norma Alvarez, 580
Morning Sun Dr, Apt 1027, Ormond Beach, FL 32174.
|, Holly Graham, being duly sworn, depose and say that on the 23rd day of March, 2021 at 12:23 pm, I:
INDIVIDUALLY/PERSONALLY served by delivering a true copy of the SUMMONS and COMPLAINT and EXHIBIT
A and DESIGNATION OF EMAIL ADDRESSES PURSUANT TO RULE OF JUDICIAL ADMINISTRATION 2.516
with the date and hour of service endorsed thereon by me, to: Norma Alvarez at the address of: 1010 Winderley
Place, Unit 102, Maitland, FL 32751, and informed said person of the contents therein, in compliance with state
statutes.
Military Status: Based upon inquiry of party served, Defendant is not in the military service of the United States of
America.
Marital Status: Based upon inquiry of party served, Defendant is not married.
Description of Person Served: Age: 43, Sex: F, Race/Skin Color: Hispanic, Height: 5'3", Weight: 150, Hair: Black,
Glasses: N
Electronically Received in the Office of the Clerk of the Circuit Court - Flagler County, Florida - 03/30/2021 09:29 AMAFFIDAVIT OF SERVICE For 21-CA-23
| do hereby certify that | have no interest in the above action, that | am over the age of eighteen, and that | ama
Certified Process Server in the Judicial Circuit in which it was served. Under penalties of perjury, | declare that | have
read the forgoing affidavit and that the facts stated in it are true. No Notary required Pursuant to F.S. 92.525 (2)
Lips nygiv en fi
. tua i te
Subscribed and sworn to before me on this the 23rd day NA LVM u (i
—
of March, 2021 by the affiant who is personally known Holly Graham 7;
tome," + / 0154
G- /,
SLK INVESTIGATIONS
2212 East 5th Ave
Tampa, FL 33605
(813) 247-6250
: Our Job Serial Number: SLK-2021001180
T ORIDA Ref: 19-0117
Gornmit GG100431
Expires 5/2/2021 Copyright © 1992-2021 Database Services, Inc. - Process Server's Toolbox V8.1u
Document Filed Date
March 29, 2021
Case Filing Date
January 15, 2021
Category
OTHER NEGLIGENCE NURSING HOME
For full print and download access, please subscribe at https://www.trellis.law/.
Preview
Filing # 123939458 E-Filed 03/29/2021 02:45:59 PM AFFIDAVIT OF SERVICE State of Florida County of Flagler Circuit Court Case Number: 21-CA-23 Plaintiff: | l| | ll (OMI IM l SLK20210011 The Estate of Harry Johnson, Jr. by and through Harriet S Johnson, 80 Personal Representative vs. Defendant: MF Flagler, LLC; Florida Facilities, LLC; Pensacola Administrative Services, LLC; HC Navigator, LLC; Guld Coast Health Care Holdings, LLC; Norma Alvarez and Charlene Petretti (as to Flagler Health and Rehabilitation Center) For: Carl R. Wilander Mendes, Reins & Wilander, PLLC 4401 W. Kennedy Blvd Ste. 250 Tampa, FL 33609 Received by SLK INVESTIGATIONS on the 5th day of March, 2021 at 8:42 am to be served on Norma Alvarez, 580 Morning Sun Dr, Apt 1027, Ormond Beach, FL 32174. |, Holly Graham, being duly sworn, depose and say that on the 23rd day of March, 2021 at 12:23 pm, I: INDIVIDUALLY/PERSONALLY served by delivering a true copy of the SUMMONS and COMPLAINT and EXHIBIT A and DESIGNATION OF EMAIL ADDRESSES PURSUANT TO RULE OF JUDICIAL ADMINISTRATION 2.516 with the date and hour of service endorsed thereon by me, to: Norma Alvarez at the address of: 1010 Winderley Place, Unit 102, Maitland, FL 32751, and informed said person of the contents therein, in compliance with state statutes. Military Status: Based upon inquiry of party served, Defendant is not in the military service of the United States of America. Marital Status: Based upon inquiry of party served, Defendant is not married. Description of Person Served: Age: 43, Sex: F, Race/Skin Color: Hispanic, Height: 5'3", Weight: 150, Hair: Black, Glasses: N Electronically Received in the Office of the Clerk of the Circuit Court - Flagler County, Florida - 03/30/2021 09:29 AMAFFIDAVIT OF SERVICE For 21-CA-23 | do hereby certify that | have no interest in the above action, that | am over the age of eighteen, and that | ama Certified Process Server in the Judicial Circuit in which it was served. Under penalties of perjury, | declare that | have read the forgoing affidavit and that the facts stated in it are true. No Notary required Pursuant to F.S. 92.525 (2) Lips nygiv en fi . tua i te Subscribed and sworn to before me on this the 23rd day NA LVM u (i — of March, 2021 by the affiant who is personally known Holly Graham 7; tome," + / 0154 G- /, SLK INVESTIGATIONS 2212 East 5th Ave Tampa, FL 33605 (813) 247-6250 : Our Job Serial Number: SLK-2021001180 T ORIDA Ref: 19-0117 Gornmit GG100431 Expires 5/2/2021 Copyright © 1992-2021 Database Services, Inc. - Process Server's Toolbox V8.1u