On June 10, 2021 a
Miscellaneous
was filed
involving a dispute between
Pardo, Yasel Perez,
Riveron Estrada, Betsys Y,
and
American Integrity Insurance Company Of Florida,
in the District Court of Sarasota County.
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Filing # 128478858 E-Filed 06/10/2021 10:41:28 AM
FORM 1.997. CIVIL COVER SHEET
The civil cover sheet and the information contained tn 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 COURT OF THE TWELFTH JUDICIAL CIRCUIT,
IN AND FOR SARASOTA COUNTY, FLORIDA
BETSYS Y RIVERON ESTRADA, YASEL PEREZ PARDO
Plaintiff Case #
Judge
VS.
AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA
Defendant
II. 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.
$8,000 or less
$8,001 - $30,000
C1 $30,001- $50,000
1 $50,001- $75,000
$75,001 - $100,000
X] over $100,000.00
WI. TYPE OF CASE (if the case fits more than one type of case, select the most
definitive category.) If the most descriptive label 1s a subcategory (is indented under a broader
category), place an x on both the main category and subcategory lines.
Filed 06/10/2021 10:51 AM - Karen E. Rushing, Clerk of the Circuit Court, Sarasota County, FLCIRCUIT CIVIL
—
L
1] Other
Condominium
xX} Contracts and indebtedness
Eminent domain
1 Auto negligence
Negligence—other
Business governance
Business torts
Environmental/Toxic tort
Third party indemnification
Construction defect
Mass tort
Negligent security
Nursing home negligence
Premises liability—commercial
Premises liability—tresidential
O Products liability
[1 Real Property/Mortgage foreclosure
Commercial foreclosure
[1 Homestead residential foreclosure
Non-homestead residential foreclosure
Other real property actions
Professional malpractice
Malpractice—business
Malpractice—medical
Malpractice—other professional
Antitrust/Trade regulation
Business transactions
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
COUNTY CIVIL
Civil
Small Claims up to $8,000
|] Real property/Mortgage foreclosureReplevins
Evictions
Residential Evictions
||] Non-residential Evictions
Other civil (non-monetary)
COMPLEX BUSINESS COURT
This action 1s appropriate for assignment to Complex Business Court as delineated and mandated by the
Administrative Order. Yes LJ No XK
IV. REMEDIES SOUGHT (check all that apply):
| Monetary;
x] Nonmonetary declaratory or injunctive relief;
Punitive
V. NUMBER OF CAUSES OF ACTION: [|]
(Specify)
1
VI. IS THIS CASE A CLASS ACTION LAWSUIT?
yes
x] no
VII. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED?
x] no
yes If “yes,” list all related cases by name, case number, and court.
VII. IS JURY TRIAL DEMANDED IN COMPLAINT?
xX
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/ David F Garcia Fla. Bar # 87055
Attorney or party (Bar # if attorney)
David F Garcia 06/10/2021
(type or print name) Date
Document Filed Date
June 10, 2021
Case Filing Date
June 10, 2021
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Filing # 128478858 E-Filed 06/10/2021 10:41:28 AM FORM 1.997. CIVIL COVER SHEET The civil cover sheet and the information contained tn 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 COURT OF THE TWELFTH JUDICIAL CIRCUIT, IN AND FOR SARASOTA COUNTY, FLORIDA BETSYS Y RIVERON ESTRADA, YASEL PEREZ PARDO Plaintiff Case # Judge VS. AMERICAN INTEGRITY INSURANCE COMPANY OF FLORIDA Defendant II. 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. $8,000 or less $8,001 - $30,000 C1 $30,001- $50,000 1 $50,001- $75,000 $75,001 - $100,000 X] over $100,000.00 WI. TYPE OF CASE (if the case fits more than one type of case, select the most definitive category.) If the most descriptive label 1s a subcategory (is indented under a broader category), place an x on both the main category and subcategory lines. Filed 06/10/2021 10:51 AM - Karen E. Rushing, Clerk of the Circuit Court, Sarasota County, FLCIRCUIT CIVIL — L 1] Other Condominium xX} Contracts and indebtedness Eminent domain 1 Auto negligence Negligence—other Business governance Business torts Environmental/Toxic tort Third party indemnification Construction defect Mass tort Negligent security Nursing home negligence Premises liability—commercial Premises liability—tresidential O Products liability [1 Real Property/Mortgage foreclosure Commercial foreclosure [1 Homestead residential foreclosure Non-homestead residential foreclosure Other real property actions Professional malpractice Malpractice—business Malpractice—medical Malpractice—other professional Antitrust/Trade regulation Business transactions 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 COUNTY CIVIL Civil Small Claims up to $8,000 |] Real property/Mortgage foreclosureReplevins Evictions Residential Evictions ||] Non-residential Evictions Other civil (non-monetary) COMPLEX BUSINESS COURT This action 1s appropriate for assignment to Complex Business Court as delineated and mandated by the Administrative Order. Yes LJ No XK IV. REMEDIES SOUGHT (check all that apply): | Monetary; x] Nonmonetary declaratory or injunctive relief; Punitive V. NUMBER OF CAUSES OF ACTION: [|] (Specify) 1 VI. IS THIS CASE A CLASS ACTION LAWSUIT? yes x] no VII. HAS NOTICE OF ANY KNOWN RELATED CASE BEEN FILED? x] no yes If “yes,” list all related cases by name, case number, and court. VII. IS JURY TRIAL DEMANDED IN COMPLAINT? xX 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/ David F Garcia Fla. Bar # 87055 Attorney or party (Bar # if attorney) David F Garcia 06/10/2021 (type or print name) Date