Civil Case Cover SheetCal. Super. - 6th Dist.April 1, 2021Electronically Filed by Superior Court of CA, County of Santa Clara, on 4/1/2021 12:00 AM Reviewed By: D Harris Case #21CV381456 Envelope: 6149137 21CV381456 ATTORNEY OR PARTY WITHOUT ATTORNEY (Name and Address): Mark R. Nivinskus State Bar No.: 195335 ‘ NIVINSKUS LAW GROUP, A LAW CORPORATION 1 134 W, WELSHERE AVE. ‘ FULLERTON, CA 92832 ATTORNEY FOR (NAME): PLAINTIFF 21000432 (714) 533-81 10 Telephone ND: FOR. COURT USE ONLY SUPERIOR COURT OF CALEFORNiA, COUNTY OF SANTA CLARA STREET ADDRESS: 191 North First St. MAILING ADDRESS: ClTY AND ZIP CODE: San Jose. CA 951 13 BRANCH NAME: SANTA CLARA FACILETY Case Name: ProgreSSive West insurance v. Gregory S. Powers 77777 _ CEVEL CASE COVER SHEET Complex Case Designation CASE NUMBER:D Unlimited Limited E Counter D Jaimie: (Amount (Amount Filed with first appearance by defendant JUDGE: demanded demanded is (Cal. Rules of Court, rule 3.402) exceeds $25,000) $25,000 or Hess) DEPT: ' Items 1-6 beiow must be mtnpmfadfsee instructions on gage.» 2x 1. Check one box beiow for the case type that best describes this case: ContractAuto Tortm Auto (22) SD Uninsured motorist (46) Other PIIPDIWD (Personal InjurylProperty Damagmrmgmi Death) Tort Asbestos (D4) Product liability (24)j Medica! maipractice(45)D Other PUPDIWD (23) Non-PIIPDIWD (Other) Tort Business tom'unfair business practice (07)a Civii rights (08) Defamation (1 3) E] Fraud (16)D Inteilectual property (19) Professiona! negiigence (25)D Other non-PIIPD/WD tort (35) finmaymem 777777 _Wrongful termination (36) Other empioyment (1 5) Coliections (09) D Other contract (37) Real Property condemnation (14) E3 Wrongfu! eviction (33) Unlawful Detainer E] Commercial (31) E3 Residential (32)E Drugs (38) Judiciai Review Asset forfeiture (05) Writ of mandate (02) E: Breach of contract/warranty (06) Insurance coverage (1 8) D Eminent domainiinverse D Other rea! property (26) Petition re: arbitration award (1 1) Provisionally Complex Civi! Litigatian Rules of Court, ruies 34109-3403) AntitrustlTrade regulation (03) Construction defect (10) Mass tort (40) Securities litigation (28) Environmentall'l'oxic Ton (30) insurance coverage claims arising from the above listed provisionaily complex case types (41) Enforcema'mgf Judgment Enfomfsmant ofjudgment (20) Miscelianecus Civil Complaint ' Rico (27) Other complaint (not specified above) (42) Misceiianeous Civil Petiticn Partnership and corporate governance {21) Other petition (not specified above) (43) Otherjudicia! review (39) 2. This case {”3 is m is not compiex under rule 3.460 of the Caiifornia Ruies of Court. If case is compiex, mark the factors requiring exceptional judicial management: a. Large number of separately represented parties ti b. . Extensive motion practice raising difficult 0r novel =3. igsues that wiII be time-consuming to resolve c.D Substantiai amount of documentary evidence f. Large number of witnesses Coordination and reiated actions pending in one or more courts in other counties, states or countries, or in a federaI court Substantial postjudgment judicial disposition 3. Remedies soughucheck allthatapply): a m Monetary b.m Nonmonetary:declarat0ry orinjunctiverelief c E: Punitive 4 Number of causes 0f action (specify): One 5. This case [:3 is is not a ciass action suit. 6f If there are any known related cases, fiie and serve a notice of related: (Yau may use form CM-01‘ .= Date: March 29, 2021 Mark R. Nivinskus t. e ‘cu e‘pc o. m4 o- ¢ (z we ‘a'saim'fir 34mg: .i..v5.._...v.v..o a -a' Hp”e ”a e 7 NoTaCE ' Plaintiff must fiie this cover sheet with the firstgaper.$23} m éhe action or roceeding {agent smafi claims cases or cases filed under the Probate Family, curt {mei-£28) Failure ofile may rescitm sanciions 1 or Welfare and Institutions Code). (Cal. Ruies of I ‘ File this cover sheet in addition to any cever sheet required by local court rules ° if ENS; case is complex under rule 3.400 et seq of the California Rules cf Court you must serve a copy of this cover sheet on all other parties to the action or 'preweding. § Unless this'is a coiiections case under ruie 3.740 or a complex case, this cover sheet shall be used for statistical purposes only. Fism £35233 m? ’v‘iardatn y Use Busy: “ii'of Cal.fornia CM..6[Re'v Juan 290'. File By Fax 1003-033010246 021033010. 12 Lea & Nivinskus (714) 533-8828 Page 3 of 13 CIVIL CASE COVER SHEET 3of13 stTRUCTEQNS QM How Ta QQMPLETE THE CGVER SHEET WWW Ta Piaintiffs mac! whats Fiiifing First 93mm. 1f yen am" fiiihg a firm gape: (mi? axampie‘, a aomxsi'aiat) in g cm wee 33m; mug: mmpie‘te 23nd fiig.‘ a§0r1g,wiih 33mm fag: statisfic:§ 23mm the: types: and numfo‘em a cm: 10:3): far ma case tygaiathat bras? de shack the name agaa‘ifia (ma. if ihe‘casvfi hag Tc assist yam in mmgfisesting mes :5th examinigs afiaetmusibe flied gniy with. yaw Iin‘iiiizai pangs; Fai ‘ (seamen Br 230th {a Sahati‘cna uridgwuies‘ 123$) mid 3.228 mhe vfiaiifomia Rules 0f Cami. ‘75:: Fatima; in Rifle fsfidlfl Caifiettim'ss {233635. A ““mi-isg ah a sum stated 1's be cattiéain th'ai ‘iés hm. murs- Efian $25K} prémsiy; Servicefi. m mmey was acquired 0:1 vcr'edii. fisma‘gesi {2} mmiiizva fiamagea {3} rmséuaw m” (4&3? pmperiga papa: the QM? £2 agribgsa Ema mesa i 389 Smearszaai'cimiained an psgga This infmmaéim: win be um} its mmpiia fca‘ses fiiea Van must tampiefi iréasms‘ 1 thmmgh E m ma sheaf. m firem ii. you {him 548$ :f ma. Cass: fii'se Emir: a genera: arm as mom‘s swam {vise 9f casa- l‘égflggfi in itam '3; muitipie (images: 0f actiiam diacfi. {ha hm: ihai beai indiaaifizs 3' c"? the gasses: mat beiang .umis-zsr gash mase type in item 1 are prqvided mam: A cover tuna ta 'fitea ezmres‘ sheet mth 2m: firs: papar flied in a civil case may subjessi a party, its 51-3: prfimaw aaas-zr {sf swan. Nam cam" under ruia 3740 i3 defined as an action fer {ecovery m" money awed GD, exmuséve of in‘barest and attorney's fees, arising from a transaction En which A :fiefiecéigns case does n0: include an acfiion seeking the foiiewing: {1) ton: (4} recovery 9f persoraai grepefiy. 0r {5) a prejudgméfii writ Q? atkaahmem The idenfifimmn QM: case as-a M33348cofieatiiyns case an thisvform means that it wiii be exempt from the ganérai timaas-farvsewiice {muike-mem's anti Cam management mile t0 the requiramsnts tor samiae and mlbiammg a §udgrnersi: m mia EMS. Tc: ?artias in Cwmiéx S‘ases“, En sempiax,‘ c 1:523:23 is. mmpiexz {f 5‘s mainfiifi‘befiwes {fie {:mrapiefimg the aggropriate hams in Etemas 1 a:anmkaim 0n fl parii'e'g w 151%: a‘atim. A d‘e mamfiffis éfisigfi‘afian. a wun‘t'erndesignatéon (ha? the case is compiex. Auto Tart Auto (22)»--»Perscnai fnjLzry/‘Prcperty Damage/Wmngfu! Death Uninsured. Motorist (4&3) (ifthe case invoives an unimured motorist ciaim subject to arbitration, check this item instead ofAL/m) QEher PilPDlWfl (Perscnai injury! Pmpea’ty Damagemrongfui Death) Tort Asbestos; (O4) Asbestcs Property Damage Asbestos Persona! injury/ Wrongfui Death Product Liabéiity (not asbestos or toxicmnvironmental) (24) Medicai Malpractice (45) Medicai Maipracticem Physicians & Surgeons Other Prefesséonai Health Care Maipr stifle Other PUPB/WD (23) Premises Liabiiity (e‘gw siip and fail) intentionai deily injury/PD/WD (6‘9” assauit, vandaiism) £ntentional infliction 0f Emotionai Distress Negiigent infliction of Emotionai Distress Other PEIPD/WD NumPHPDNVB (Other) Tort Business Tert/Unfair Business Practice (07) Civi! Rights (99., discrimination, faise arrest) (nor civii harassment) (08) Defamation (e.gw siander, Eibei) (13) Fraud (16) inteiiectuai Property (19) meessi-snai Negiigence (25) Legal Maipractise Other Prafessic-na! Maipractice (not medicai 0r iegai) Other Non-PEIPDNVD Tort (3,5) Employment Wrongfu! Termination ( _ Other Emp‘éoyment (1 55% I le B '(SM-GW L": [Rem Jwy 1, ?GL‘L-Ti cage is wmfiiiek Um ?en'dang may file and aarve CASE TYPES AND EXAMPLES Contract Breach 0f CentracfiWarranty (06) Breach of Reniai/Lease Contract (no? unlawful defame! or wrongfui eviction) Contracb’Warranty Braactheiier Plaintiff (not fraud or negfigence} Negligent Breach of Contrast! Warraniy Other Breach of ComraCWVarranty CoHections (eg, maney owed, open book accounts) (£39) Coiiection Cassen-Seiier Piamtiff Other Promissory Note/Coiiections Case Insurance. Coverage (m)! provisionafly compiex} (1 8) Auto Submgatisn Other Coverage Other Contract (37) Centractuai Fraud Gther Contract Dispute Real Pmperfiy Eminent Domain/inverse Condemnaiian (14) WrQa-gm! Evinfsfion (33) Oii‘er Ram Pmperty (8.9.. quiet title) (26} Writ of Pcssession of Reai Prcpeny Mortgage Forec’aosure Quiet Tifle Other Real Praperty (no: eminent damaim Iandiord/tenant, or forec/osure) Uniawfui fletainer Commercial (31) Residentiai (3‘2) Drugs (38') (if the case invoives iiiegai drugs, check this item; Otherwise, report as Commeiciai 0r Residgntiai} Judicial Review Asset Forfeiture {05) Petition Re: Armtration Award (1 1) Writ of Mandate (02) Writ-Admimstmtive Mandamus Writ-Mandamus or: Limited Court Case Matter Writuffither Limited Court Case Review Oiher Judiciai Review (39) Review of Health Officer Order Notice cf Appeai-Labor ~33, mieas a degendam: flies a responsive pieadmg. A ruie 3740 caiiecfions case wiii be: gubjeci Sizes: um? garfies must aiso use the Civil Case Ccver Sheet to designate whether the ‘ ermie 3400 of the Caiifomia Ruias of Court this mus? be indicated by Ema? 3‘ if 5i mamtiffvdggSEgs‘aatea a case as compiexi the cover sham mug: be served with the n0 iater than the time 0f its first amearanca a joinder in the {he Ease is not mmpéex, or, if the plaintiff has made no designaticn‘ a de ignation that Pravisicnaiiy Comma): Civii Litigation (Caiv, Ruies of {Smut Ruies 3.400m3.433) AntitrustlTrade Reguiat’aon (03) Canstruction Defect {1 O) Ciaims anoiving Masses Tort (40)- Securities Litigation (28) EnvimnmentaE/TQXEC: Ton (39) insurance Coverage Ciaims (arising from provisianally compiex case type iistea‘ above} (41) Enhancement of Judgment Enfarcement of Judgment (20) Abstract of Judgment (Out 0f Gaunty) Confession 0f Judgment {non- domesz‘c reiaflons) Sister State Judgment Ad ministrative Agency Award (not unpaid taxes) Petition/Cefiéfication of Entry 0f Judgment on Unpaid Taxes: Other Enforcement of Judgment Case Misceflaneaus CM? Compiaint RICO {27) Other Compiaint {riot specified above) (42) Deciaratery Relief Omy injunctive Reiief Only (non- harassment) Mechanics Lien Other Commerciai Compiaint Case {non-fort/r:on~compiex) Other Civii Ccmplaint (norz-toz'b/rron-comp!e>:) Misceiianeoua CM! Fetiticm Partnership and Corpurate Governance (2.1) Other Petition ("not specified above) (43) Civi! Harassment Workpiace Vioience Ekder/Dependent Admit Abuse Eéection Contest Petition for Name Change Petition for Reiief from Late Claim Other CM! Petition ax Commissioner Appeais 1003-033010246 02105301012 LeaflWflsMfiEfiMflfimfifiT Page 2 0:24of13
