FILED: NEW YORK COUNTY CLERK 02/22/2023 01:57 PM
`NYSCEF DOC. NO. 12
`SUPREMECOURT OF THE STATEOF NEW YORK
`
`INDEX NO. 150408/2023
`
`RECEIVED NYSCEF: 02/22/2023
`COUNTY OF NEW YORK
`
`Plaintiff
`/ Petitioner:
`PALISADES INSURANCE COMPANY,
`Defendant
`/ Respondent:
`INC., APTECHKA RX, INC., ASM
`ADVANCED MEDICAL SUPPLIES,
`INC., ATLANTIC MEDICAL & DIAGNOSTIC, P.C.,
`DIAGNOSTIC,
`BASIS MEDICAL, P.C., CARE EXPRESSPHARMACY,
`INC., et al
`
`AFFIDAVIT
`
`OF SERVICE
`
`Index No:
`150408/2023
`Date Filed:
`01/12/2023
`
`is over 18 years of age and resides in the State of
`The undersigned
`is not a party herein,
`being duly sworn, deposes and says; deponent
`served the within NOTICE
`NEW YORK. That on Mon, Feb 06 2023 at 11:15 AM at 99 WASHINGTON AVE, ALBANY, NEW YORK 12231 deponent
`OF ELECTONIC FILING, SUMMONS AND VERIFIED COMPLAINT FOR DECLARATORYJUDGMENT upon FIFTH AVENUE SURGERY CENTER, LLC
`
`Witness, personally;
`
`deponent
`
`knew the person so served
`
`a true copy of each to said Defendant/Non-Party
`Individual:
`by delivering
`to be the person described
`Witness therein.
`as said Defendant/Non-Party
`therein
`Corporation/Business/Gov.ernment
`Agency:
`a Defendant/Non-Party
`Witness,
`knew said corporation/business/government
`deponent
`true copy of each to
`personally,
`agency described, and knew said individual
`to be
`be the corporation/business/government
`thereat, a true copy of each to a person of suitable age and discretion
`Suitable Person: by delivering
`place or usual place of abode. a person of suitable age and discretion.
`dwelling
`at the actual place of business, dwelling
`a true copy of each to the door
`to Door: by affixing
`thereof,
`Affixing
`Witness, or a person of suitable
`abode, deponent was unable with due diligence to find Defendant/Non-Party
`at
`having called thereon;
`thereat,
`
`a
`
`named, by delivering
`agency so served to
`thereof.
`at the actual place of business,
`
`place or usual place of
`age or discretion
`
`X
`
`addressed to said Defendant/Non-Party
`sealed wrapper
`in a postpaid
`also enclosed a copy of same,
`Mailing: Deponent
`properly
`Place of business,
`, and depositing
`Witness's last known residence/Actual
`Witness at Defendant's/Non-Party
`in a post office, official depository
`the United States Post Office, department,
`said wrapper
`the exclusive care and custody of
`under
`within
`the state of New York. Mailed on
`two true
`therein
`of State:
`FIFTH AVENUE SURGERY CENTER, LLC a Defendant/Non-Party
`named, by delivering
`Witness,
`Secretary
`knew said Secretary of State so served to be the Secretary of State described,
`and
`copies of each to Sue Zouky personally,
`deponent
`knew said individual
`thereof. At the time of service a $40.00 fee was tendered.
`to be Document Specialist
`the United
`service of
`Witness was in active military
`Military Service:
`I asked the person spoken to whether Defendant/Non-Party
`Witness
`and received a negative reply. Defendant/Non-Party
`the state in which they reside in any capacity whatever
`States or within
`uniform. The source of my information
`of my belief are the
`wore ordinary
`civilian clothes and no military
`and the ground
`Witness is not
`and observations
`above narrated. Upon information
`and belief
`I aver that
`the Defendant/Non-Party
`conversations
`service of
`the United States as that
`term is defined
`in either
`the State or in the Federal statutes.
`the military
`
`in
`
`Description:
`Age:
`50
`Height:
`
`5'5"
`
`Other
`
`Service Details:
`
`Ethnicity:
`
`Caucasian
`Hair: Gray
`
`Gender:
`Brown
`
`Eyes:
`
`Female
`
`Weight:
`Relationship:
`
`120
`Document
`Specialist
`
`- our
`richard connolly
`Alliance Risk Group
`
`job #8310502
`
`Sworn to before me on
`
`Notary Public
`
`J LESCIN8KI
`TAl
`Notary Public - State of New York
`No. 01LE6428833
`Qualifted in Saratoga County
`My Commission Expires01/31/20
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