Request DismissalCal. Super. - 6th Dist.January 4, 2021j ATTORNEY OR PARTY WITHOUT ATTORNEY (Name, stele Bar number, end eddiesvi. Barbara V. Lam, Esq./S.B.N. 231073 Law Offices of Stephenson, Acquisto & Colman, Inc303 N. Glenoaks Blvd., Suite 700 FOR COURT USE 0NL Y CIV-110 Burbank, CA 91502 TELEPHONENO. 818-559-4477 Fnxno iopiamasi 818-559 - 5484 E MAIL ADDRESB/opt~i) blamg sacf irm. corn ATTQRNEY FQR(Nemei. Pl aint i f f SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA srREOADDREss 191 N. 1st Street MAILING ADDRESS cITYANDzIPcoDE. San Jose, CA 95113 BRANCH NAME. PLAINTIFF/PETITIONER: STANFORD HEALTH CARE DEFENDANT/RESPONDENT: ORANGE COUNTY HEALTH AUTHORITY REQUEST FOR DISMISSAL CASE NUMBER'1CV375310 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 aclass action. (Cal. Rules of Court, rules 3.760 and 3.770.) 1. TO THE CLERK: Please dismiss this action as follows: a. (1) ~x With prejudice (2) CJ Without prejudice b. (1) M Complaint (2) ~ Petition (3) ~ Cross-complaint filed by (name): on (date): (4) ~ Cross-complaint filed by (name): on (date): (5) ~x Entire action of all parties and all causes of action (6) ~ Other (specify):* 2. (Comp/ete in a/i cases excepl family law cases.) The court M did Mx did not waive court fees and costs for a party in this case. (This information may be obtained fromthe clerk. /f court fees and costs were waived, the declaration on the back of (his form must b ed). Date; May 27, 2021 Barbara V. Lam, Esq./S.B.N. 231073 I / P(S RE)(TYPE OR PRINT NAME OF ~X ATTORNEY j P~Y WRHOUT AnORNEY) A(torney or party w~j~p to ey for. $ TA'NF'oRD HFALTH'lf dismissal requested ia of specaed parties only of Bpealied causes of action CARE only,orofapeaffed cross-complaints only, ao slate and idenbfythepartiee. ~X Plaintiff/PetitiOner ~ Defendant/ReSpandentcauses of action, or cross-complaints to be diemieeed. ) Cross-Complainant 3. TO THE CLERK: Consent to the above dismissal is hereby given.** Date: (TYPE OR PRINT NAME OF I I ATTORNEY M PARTY WITHOUT ATTORNEY) ** If e croaa-complaint-or Response (Family Law) seeking effirmative relief - is on file, Ihe attorney for cioae-complainant (reapondent) must sign this consent if required by Code of Civil Procedure eecbon 551 (i)oi 4) (To be completed by clerk) 4. ~ Dismissal entered as requested on (date): 5. ~ Dismissal entered on (dele): 6. j I Dismissal not entered as requested for the following (SIGNATURE) Attorney or party without attorney for: ~ Plaintiff/Petitioner ~ Defendant/Respondent~ Cross-Complainant as to only (name): reasons (specify): 7. a. L Attorney or parly without attorney notified on (dsfe): b. ~ Attorney or party without attorney not notified. Filing party failed to provide~ a copy to be conformed H means to return conformed copy Date: Clerk, by , Deputy Form Adopted for Mandatmy Uee Judiaal Council of California clv-110 [Rev Jan 1. 2013( REQUEST FOR DISMISSAL ~4Pius PeaeI ofa Code ofC IPimmluie I 5SI et eq Gov.code sess31(c),cai Ruleeofco n, uie31330 Electronically Filed by Superior Court of CA, County of Santa Clara, on 6/1/2021 1:51 PM Reviewed By: R. Nguyen Case #21CV375310 Envelope: 6554748 21CV375310 Santa Clara - Civil R. Nguyen 6/1/2021 1:51 PM 6/1/2021 1:51 PM X 6/1/2021 1:51 PM R. Nguyen X PLAINTIFF/PETITIONER; STANFORD HEALTH CARE DEFENDANT/RESPONDENT: ORANGE COUNTY HEALTH AUTHORITY CASE NUMBER: 21CV375310 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, 5 6863L) 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. M recovering less than $ 10,000 in value by this action. c. M recovering $10,000 or more in value by this action. (Ifitem 2c is checked, item 3 must be completed.) 3. ~ All courtfees andcourtcoststhatwere waived inthisactionhave been paid to the court(checkone): I Yes H No I declare under penalty of perjury under the laws of the State of California that the information above is true and correct. Date: (TYPE OR PRINT NAME OF ~ ATTORNEY ~ PARTY MAKING DECLARATION) (SIGNATURE( CIV-110 (RSY January I, 2013( REQUEST FOR DISMISSAL PS0$ 2 s12 PROOF OF SERVICE I am employed in the county ofLos Angeles, State of California. I am overthe age of 18 and not a party to the within action; my business address is 303 NorthGlenoaks Boulevard, Suite 700, Burbank, California 91502-3226. On I June 2021,I served the foregoing document(s) entitled: 9 10 12 13 14 15 16 17 REQUEST FOR DISMISSAL by placing a true copy thereof enclosed in a sealed envelope addressed per theattached Service List. BY U.S. MAIL: I am "readily familiar" with the firm's practice of collectioand processing correspondence for mailing. Under that practice it would bedeposited with the United States Postal Service on that same day with postage thereon fully prepaid at Burbank, California in the ordinary courseof business. I am aware that on motion of the party served, service is presumed invalid ifpostal cancellation date or postage meter date is morethan 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 overnightFederal Express Delivery Charges to be paid by this firm, to be depositedwith the Federal Express Corporation at a regularly maintained facility onthe aforementioned date. [C.C.P. 1013(c) 1013(d)] 18 19 20 21 22 23 24 25 26 27 28 I BY PERSONAL SERVICE: I caused the above-stated document(s) to beserved 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 thereonfully prepaid and addressed to the party(s) shown above, to be deposited ina'acilityoperated by the U.S. Postal Service and regularly maintained for thereceipt ofExpress 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 facsimilemachine (818/559-4477) to the facsimile machine number(s) shown above.Transmission to said numbers was successful as evidenced by aTransmission 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 1 June 2021 in Burbank, California. 10 AIDA GRIGORIAN 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 SERVICE LIST Diane M. Racicot, Esq. PROCOPIO 525 B. Street, Suite 2200 San Diego, CA 92101 Email: d ' 10 12 13 14 15 16 17 19 20 21 22 23 24 25 26 27 \OOOQOKUI-hUJNp-n NNNNNNNNNr-ar-Ar-dr-‘r-dr-Av-ar-tr-An-A OOQQU‘AUJNHCOWNQMAWNHO i . acicot, s . P . t et ui i , mail: iane.racicot@procopio.com