Notice Lien ClaimantCal. Super. - 6th Dist.March 29, 2021Electronically Filed by Superior Court of CA, County of Santa Clara, on 12/20/2021 9:12 AM Reviewed By: R. Tien Case #21CV381433 Envelope: 7897285 10. 11 12 13 14 15. 16 1-7 18 1'9 20 21 22 23 24 25 26 27' 2-8 JAMES R. WILLIAMS, County Counsel (S.B. #271253) SARA J. PONZIO, Deputy County Counsel (S.B. #206774) OFFICE OF THE COUNTY COUNSEL 70 West Hedding Street, East Wing, 9th Floor San Jose', California 951 10-1770 Telephone: (408) 299-5900 Facsimile: (408) 292-7240 Email: sara.ponzio@cco.sccgov.org Attorneys for Lienholder COUNTY OF SANTA CLARA SUPERIOR COURT OF CALIFORNIA, COUNTY OF SANTA CLARA CESAR FERNANDEZ-GOMEZ, et a1., Case No. 21CV3 81433 Plaintiffs, NOTICE 0F LIEN [Civil Code §2881 et seq., v. Civil Code §3040 et seq. Civil Code §3045.1 et seq., and MIRAGE HOSPITALITY, INC., et a1., Government Code §23004.1 et seq.] Defendants. [Exempt from Filing Fees pursuant to Government Code §6103] To Plaintiffs, Defendants, and their attorneys of record: Notice is hereby given that the Santa Clara County Valley Medical Center furnished emergency medical and ongoing medical or other services t0 Monica Roman, aka Monica Alejandra Roman Ortega, from October 18, 2019 through October 20, 2019. The amount 0f the reasonable and necessary charges incurred to date in treating Monica Roman, aka Monica Alejandra Roman Ortega is $23,557.47. Pursuant to California Civil Code section 2881 et seq., the County of Santa Clara gives notice of its lien against any settlement orjudgment awarded to Monica Roman, aka Monica Alejandra Roman Ortega, his or her guardian, personal representative, estate, or survivors. Pursuant to California Civil Code section 3040 et seq., in the case oftreatment provided outside of County networks or facilities but paid for by the County, County of Santa Clara gives notice of its lien on any final judgment, compromise, or settlement agreement awarded to 1 Notice of Lien 2 1CV3 8 1433 10 11 12 13 14 15 16 17 13 19 20 2'1 22 23 24 25 26 27 28 Monica Roman, aka Monica Alejandra Roman Ortega, or his or her heirs or personal representative. Any person, firm, or corporation, including but not limited to the insurance carrier, making any payment to the injured person, without paying the County lien first, or as much as can be satisfied under the provisions of Civil Code section 3040 er seq. due under any final judgment, compromise, or settlement agreement after paying any prior liens, shall be liable to the County for the amount owed under the lien. Pursuant t0 California Civil Code section 3045.1 et seq. in the case of emergency and ongoing treatment provided at County hospitals or facilities, County of Santa Clara gives notice of its lien on any final judgment, compromise or settlement agreement award to Monica Roman, aka Monica Alejandra Roman Ortega, or his or her heirs or personal representative. Any person, firm 0r corporation, including, but not limited to an insurance carrier, making any payment to the injured person, without paying the hospital lien first, or as much as can be satisfied out of 50 percent of the moneys due under any final judgment, compromise, or settlement agreement after paying any prior liens, shall be liable to the hospital for the amount owed to the hospital under the lien. Pursuant to California Government Code section 23004.1 et seq., the County of Santa Clara gives notice of its lien against any judgment awarded to Monica Roman, aka Monica Alejandra Roman Ortega, his or her guardian, personal representative, estate, or survivors. The following information is provided to you in accordance with the provisions of Civil Code section 2881 et seq., Civil Code section 3040 et seq., Civil Code section 3045.1 et seq., and Government Code section 23004.1 et seq.: 1. Name and address of injured person: Monica Roman, aka Monica Alejandra Roman Ortega, c/o Owili K. Eison, BD&J, PC, 9701 Wilshire Blvd., 12th Floor, Beverly Hills, California 90212. 2. Date of accident: on or about October 18, 2019. 3. Name and location of hospital: Santa Clara Valley Medical Center, 751 South Bascom Avenue, San Jose’, California, 95128. 4. Amount of reasonable and necessary charges claimed to date: $23,557.47. /// Notice of Lien 2 1CV3 8 1 433 10 11 12 13 14 15 16 17 1-8 19 2.0 21 23 24 25 26 27 28 J 5. To the best knowledge of the undersigned, the names and addresses of all persons, firms, and insurers claimed to be liable for damages arising out of the injuries sustained in the accident are as follows: Name: Elite Rooter Inc. Address: c/o Michael D. McLean Adelson McLean, APC 4100 Newport Place Drive, Suite 200 Newport Beach, California 92660-2400 /// Name: Brian Ray Saabedra Address: c/o Elizabeth G. Sutlian-Mardikian Adelson McLean, APC 4100 Newport Place Drive, Suite 200 Newport Beach, California 92660-2400. Dated: DEC 2 0 2021 Respectfillly submitted, I R. WILLIAMS Co s By: s MOMO De u County Counsel Attorneys for Lienholder COUNTY OF SANTA CLARA 3 Notice of Lien 2 1CV3 8 143 3 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 PROOF OF SERVICE BY MAIL Cesar Fernandez-Gomez, et a1. vs Mirage Hospitality Inc., et al. Superior Court Case No. 2 1CV3 8 1 433 I, Chenny Tracey, declare that: I am employed in the County of Santa Clara; I am over the age 0f eighteen years and not a party to the within entitled action, and my business address is 9th Floor, East Wing, 70 West Hedding Street, San José, California 951 10-1770. I served a true copy of the attached document 0n the persons listed below by placing the envelope for collection and mailing by certified mail with return receipt requested and postage prepaid on the date and at the place shown below following our ordinary business practices. I am readily familiar With this business practice for collecting and processing correspondence for mailing. On the same day that correspondence is placed for collection and mailing, it is deposited in the ordinary course 0f business with the United States Postal Service. Date of Deposit: _DEE_2_0_2021 Exact title of document served: NOTICE OF LIEN Addressed as follows: Plaintiff: Monica Roman, aka Monica Alejandra Roman Ortega 2390 Lucretia Avenue, Apt. 608 San José, California 95122 Attorney for Defendant: Elite Rooter, Inc. Michael D. McLean ADELSON MCLEAN, APC 4100 Newport Place Drive, Suite 200 Newport Beach, California 92660-2400 Attornev for Plaintiffs: Monica Roman aka Monica Aleiandra Roman Ortega Owili K. Eison BANAFSHEH DANESH & JAVID, PC 9701 Wilshire Boulevard, 12th Floor Beverly Hills, California 90212 Attorney for Defendant: Brian R. Saabedra Elizabeth G. Sutlian-Mardikian ADELSON MCLEAN, APC 4100 Newport Place Drive, Suite 200 Newport Beach, California 92660-2400. I declare under penalty of perjury under the laws of the State 0f California that the foregoing is true and correct. Executed on DEC 2Q 2021 , at San José, Cali ornia. ESA N0. 040536 2539995 Ce Trac. Proof of Service 21CV381433
