FILED: KINGS COUNTY CLERK 10/02/2017 12:17 PM
`RECEIVED NYSCEF: 10/02/2017
`NYSCEF DOC. NO. 10
`Request for Judicial Intervention Addendum
`UCS-840A (7/2012)
`Index No:
`Kings Supreme COURT, COUNTY OF Kings
`For use when additional space is needed to provide party or related case information.
`
`INDEX NO. 518942/2017
`
`PARTIES:
`For parties without an attorney, check "Un-Rep" box AND enter party address, phone number and e-mail address in "Attorneys" space.
`Parties:
`Attorneys and/or Unrepresented Litigants:
`
`Un-
`Rep
`
`List parties in caption order and indicate
`party role(s) (e.g., defendant; 3rd-party
`plaintiff).
`
`Provide attorney name, firm name, business address, phone number and e-
`mail address of all attorneys that have appeared in the case. For
`unrepresented litigants, provide address, phone number and e-mail address.
`
`Issue
`Joined
`(Y/N):
`
`Insurance Carrier(s):
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`☐
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`☒
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`☒
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`☒
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`Name: IN THE MATTER OF THE
`APPLICATION OF STATE FARM MUTUAL
`AUTOMOBILE INSURANCE COMPANY
`Role(s): Plaintiff/Petitioner
`
`ARTHUR WADE III, DeSena & Sweeney, LLP, 1500 Lakeland Ave , Bohemia,
`NY 11716, 6313607333, atwesq@dslawny.com
`
`Name: PROVINCE, JERRY
`
`921 East 101st Street, Brooklyn, NY 11236
`
`Role(s): Defendant/Respondent
`
`Name: PROVINCE, CLAUDETTE
`
`921 East 101st Street, Brooklyn, NY 11236
`
`Role(s): Defendant/Respondent
`
`Name: ALLSTATE PROPERTY &
`CASUALTY INSURANCE COMPANY
`
`Role(s): Defendant/Respondent
`
`1125 RXR Plaza, Suite 1100E, Uniondale, NY 11556
`
`Name: PASCALL, CRAIG C.
`
`71-05 Sutton Place Apt. 1, Fresh Meadows, NY 11365
`
`Role(s): Defendant/Respondent
`
`Name: PROGRESSIVE MAX INSURANCE
`COMPANY
`
`6300 Wilson Mills Road, Mayfield Village, OH 44143
`
`Role(s): Defendant/Respondent
`
`Name: ROSARIO, JUAN M.
`
`192 Pine Street, Brooklyn, NY 11208
`
`Role(s): Defendant/Respondent
`
`Name: ESPERANZA MANAGEMENT CORP.
`
`Peter Bartfeld, Salon Marrow Dyckman Newman & Broudy, LLP, 292 Madison
`Ave., 6th FL., New York, NY 10017
`
`Role(s): Defendant/Respondent
`
`Name: AMERICAN TRANSIT INSURANCE
`COMPANY
`
`One Metro-Tech Center, Brooklyn, NY 11201
`
`Role(s): Defendant/Respondent
`
`Name: STEVENSON, SIMUEL
`
`872 Hegeman Avenue Apt. 1, Brooklyn, NY 11208
`
`Role(s): Defendant/Respondent
`
`Name: STEVENSON, DEBORAH
`
`872 Hegeman Avenue Apt. 1, Brooklyn, NY 11208
`
`Role(s): Defendant/Respondent
`
`1 of 2
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`

`

`FILED: KINGS COUNTY CLERK 10/02/2017 12:17 PM
`NYSCEF DOC. NO. 10
`Parties:
`Attorneys and/or Unrepresented Litigants:
`
`Un-
`Rep
`
`List parties in caption order and indicate
`party role(s) (e.g., defendant; 3rd-party
`plaintiff).
`
`Provide attorney name, firm name, business address, phone number and e-
`mail address of all attorneys that have appeared in the case. For
`unrepresented litigants, provide address, phone number and e-mail address.
`
`INDEX NO. 518942/2017
`
`RECEIVED NYSCEF: 10/02/2017
`Issue
`Joined
`(Y/N):
`
`Insurance Carrier(s):
`
`☒
`
`☒
`
`☒
`
`☒
`
`☒
`
`☒
`
`☒
`
`☒
`
`☒
`
`☒
`
`☒
`
`Name: GEICO INDEMNITY COMPANY
`
`750 Woodbury Road, Woodbury, NY 11797, (800) 841-3000
`
`Role(s): Defendant/Respondent
`
`Name: TURNER, JOSHUA M.
`
`322 Decatur Street 1st Floor, Brooklyn, NY 11233
`
`Role(s): Defendant/Respondent
`
`Name: METROPOLITAN PROPERTY AND
`CASUALTY INSURANCE COMPANY
`
`Role(s): Defendant/Respondent
`
`700 Quaker Lane P.O. Box 350, Warwick, RI 02818, (800) 422-4272
`
`Name: HUGHES, ALICIA D.
`
`146-16 106th Avenue, Jamaica, NY 11435
`
`Role(s): Defendant/Respondent
`
`Name: GEICO INDEMNITY COMPANY
`
`750 Woodbury Road, Woodbury, NY 11797, (800) 841-3000
`
`Role(s): Defendant/Respondent
`
`Name: JERVISE, AUGUSTUS
`
`1275 East 72nd Street, Brooklyn, NY 11234
`
`Role(s): Defendant/Respondent
`
`Name: ALLSTATE INSURANCE COMPANY
`
`1125 RXR Plaza, Suite 1100E, Uniondale, NY 11556
`
`Role(s): Defendant/Respondent
`
`Name: BROWN, ALICIA D.
`
`724 East 53rd Street 2nd Floor Apt., Brooklyn, NY 11203
`
`Role(s): Defendant/Respondent
`
`Name: STATE FARM INSURANCE
`COMPANY
`
`Role(s): Defendant/Respondent
`
`P.O. Box 8000, Ballston Spa, NY 12020
`
`Name: TRAORE, IBRAHIMA
`
`340 Williams Avenue , Brooklyn, NY 11207
`
`Role(s): Defendant/Respondent
`
`Name: PROGRESSIVE SOUTHEASTERN
`INSURANCE COMPANY
`
`P.O. Box 89490 , Cleveland, OH 44101
`
`Role(s): Defendant/Respondent
`
`RELATED CASES:
`
`List any related actions. For Matrimonial actions, include any related criminal and/or Famiy Court cases.
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`NO
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`This form was generated by NYSCEF
`2 of 2
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