Request DismissalCal. Super. - 6th Dist.October 1, 2020ATTORNEY OR PARTY WITHOUT ATTORNEY (Na e. Stares ae, cdaddmss) Barbara V. Lam, Esq./S.B.N. 231073 Law Offices of Stepitenson, Acquisto & Colman, Inc 303 N. Glenoaks Blvd., Suite 700 FOR COURT USE ONL Y CIV-110 Burbank, CA 91502 TELEPHONENO (818) 559 4477 FAxno (opiunai) (818) 559 5484 EMAILADDRESSIOPIrcrrag blamgaaCfirm. COm ATTORNEY FOR(Name) Plaintif f SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA STREET ADDRESS 1 91 N. 1 st St . MAILING ADDRESS clTY AND zIP CGDE San Jose, CA 9 5 1 1 3 BRANCII NAME PLAINTIFF/PETITIONER: STANFORD HEALTH CARE DEFENDANT/RESPONDENT: BLUE CROSS OF CALIFORNIA REQUEST FOR DISMISSAL CASE NUMBER 20CV371639 A conformed copy will not be returned by the clerk unless a method of return Is provided with the document. This form may not be used for dismissal of a derivative action or a class action or of any party or cause of action in a class action. (Cal. Rules of Court, rules 3.760 and 3.770.) 1. TO THE CLERK: Please dismiss this action as follows: a. (1) I x I With prejudice (2) C Without prejudice b. (1) ~ Complaint (2) ( Petition (3) ~) Cross-complaint filed by (name): on (date); (4) j Cross-complaint filed by (name): on (date) (5) ~x Entire action of all parties and all causes of action (6) j Other (specify) 2. (Comp/e/e in a// cases except family law cases.) The court j did x 'id not waive court fees and costs for a party in this case. (This /nf ation msy be obtained from the clerk. /f court lees and costs were waived, the declaration on the back ofthrs form st 0 ap/eted). Date: September 9, 2021 3 c v I,, q rs 231073 F / (SIGNATURE) Afforney or Pa y)s/III)out at(of'ney fof" STANFORD HEALTH If dismissal requested is of speofied parties only of specified causes of action CARE only,orofspeofied crossmomplaints only, so stale and idenlifythe parties, ~x plaintiff/petitioner, j Defendant/Respondent causes of action, or cross-complaints to be dismissed. ~ Cross-Complainant 3. TO THE CLERK: Consent to the above dismissal is hereby given.** Date: (TYPE OR PRINT NAME OF ~ ATTORNEY ~ PARTY WITHOUT ATTORNEY) If a cross-complaint - or Response (Family Law) seeking affirmative relief- is on file, the attorney for cross-complainant (respondent) must sign this consent if required by Code of Civil Procedure sectmn BS1 (i) or 4) (To be completed by clerk) 4. I Dismissal entered as requested on (dale): 5 I Dismissal entered on (dale): 6. Dismissal not entered as requested for the following (SIGNATURE) Attorney or party without attorney for: M Plaintiff/Petitioner M Defendant/Respondent~ Cross-Complainant as to only (name): reasons (specify): 7. a, ~ Attorney or party without attorney notified on (date): b. ~ Attorney or party without attorney not notified Filing party failed to provide ' copy to be conformed M means to return conformed copy Date: Clerk, by , Deputy Form Adopted fo Mandatory Uss Judical Counol of Csl fomis CIY-110 IRev Jan I, 2013) REQUEST FOR DISMISSAL LeRal SotutIons. Page I of 2 Cod of Civil Pmcsdure. 3 331 etseq: Gov code, g sas3T(ch cal. Rules of court, rule 3.1390 Electronically Filed by Superior Court of CA, County of Santa Clara, on 9/9/2021 1:59 PM Reviewed By: M. Sorum Case #20CV371639 Envelope: 7233602 20CV371639 Santa Clara - Civil M. Sorum 9/9/2021 1:59 PM 9/9/2021 1:59 PM X 9/9/2021 1:59 PM M. Sorum X PLAINTIFF/PETITIONER; STANFORD HEALTH CARE DEFENDANT/RESPONDENT: BLUE CROSS OF CALIFORNIA CASE NUMBER: 20CV371639 CIV-110 COURT'S RECOVERY OF WAIVED COURT FEES AND COSTS If a party whose court fees and costs were initially waived has recovered or will recover $10,000 or more in value by way of settlement, compromise, arbitration award, mediation settlement, or other means, the court has a statutory lien on that recovery. The court may refuse to dismiss the case until the lien is satisfied. (Gov. Code, $ 68637.) Declaration Concerning Waived Court Fees 1. The court waived court fees and costs in this action for (name): 2. The person named in item 1 is (check one below): a. ~ not recovering anything of value by this action. b. A recovering less than $ 10,000 in value by this action. c. recovering $ 10,000 or more in value by this action (if item 2cis checked, item 3 must be completed,) 3. ~~ All courtfees and courtcosts thatwerewaivedin thisactionhave been paid tothe court(checkone): ~ Yes M No I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: (TTPE GR PRINT NAME or 2 1 ATTGRNET u PARN MAKING DEGLARATIQN) (SIGNATURE) CIV-11D IRe January 1 2D13] REQUEST FOR DISMISSAL Page 2 ai 2 PROOF OF SERVICE I am employed in the county of Los Angeles, State of California. I am over the age of 18 and not a party to the within action; my business address is 303 North Glenoaks Boulevard, Suite 700, Burbank, California 91502-3226. On 9 September 2021, I served the foregoing document(s) entitled: REQUEST FOR DISMISSAL by placing a true copy thereof enclosed in a sealed envelope addressed per the attached Service List. 9 10 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 BY U.S. MAIL: I am "readily familiar" with the firm's practice of collection and processing correspondence for mailing. Under that practice it would be deposited with the United States Postal Service on that same day with postage thereon fully prepaid at Burbank, California in the ordinary course of business. I am aware that on motion of the party served, service is presumed invalid if postal cancellation date or postage meter date is more than one day after date of deposit for mailing in affidavit. [C.C.P. 1013a(3); F.R.C.P. 5(b)] BY FEDERAL EXPRESS: I caused such envelope(s), with overnight Federal Express Delivery Charges to be paid by this firm, to be deposited with the Federal Express Corporation at a regularly maintained facility on the aforementioned date. [C.C.P. 1013(c) 1013(d)] BY PERSONAL SERVICE: I caused the above-stated document(s) to be served by personally delivering a true copy thereof to the individuals identified above. [C.C.P. 1011(a); F.R.C.P. 5(b)] BY EXPRESS MAIL: I caused such envelope(s), with postage thereon fully prepaid and addressed to the party(s) shown above, to be deposited in a facility operated by the U.S. Postal Service and regularly maintained for the receipt of Express Mail on the aforementioned date. [C.C.P. 1013(c)] BY TELECOPIER: Service was effected on all parties at approximately am/pm by transmitting said document(s) from this firm's facsimile machine (818/559-4477) to the facsimile machine number(s) shown above. Transmission to said numbers was successful as evidenced by a Transmission Report produced by the machine indicating the documents had been transmitted completely and without error. C.R.C. 2008(e), Cal. Civ. Proc. Code $ 1013(e). [ X ] BY ELECTRONIC SERVICE: By emailing true and correct copies to the persons at the electronic notification address(es) shown on the accompanying service list. The document(s) was/were served electronically and the transmission was reported as complete and without error. [ X ] State: I declare under penalty ofperjury under the laws of the State of California that the above is true and correct. Executed on 9 September 2021 in Burbank, California. 10 AIDA GRIGORIAN 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 SERVICE LIST Chad R. Fuller, Esq. TROUTMAN PEPPER HAMILTON SANDERS LLP 11682 El Camino Real, Suite 400 San Diego, CA 92130 Email: chad.tuiler@troutman.corn 10 Jenna Uyen Nguyen, Esq. 5 Park Plaza, Suite 1400 Irvine, CA 92614 Email: ienna.nomen troutman.corn 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27