UNITED STATES DISTRICT COURT

SOUTHERN DISTRICT OF FLORIDA

CASE NO. __________________

15 OZ FRESH & HEALTHY FOOD LLC,

individually and on behalf of all others 

similarly situated,

Plaintiff,

v. CLASS ACTION

UNDERWRITERS AT LLOYD’S, LONDON

KNOWN AS SYNDICATES AML 2001, 

WBC 5886, MMX 2010, and SKD 1897,

JURY TRIAL DEMANDED

Defendants.

_______________________________________/

CLASS ACTION COMPLAINT

Plaintiff 15 Oz Fresh and Healthy Food LLC (“Fresh & Healthy Food”), individually and 

on behalf of all others similarly situated, files this class action against Underwriters at Lloyd’s,

London known as Syndicates AML 2001, WBC 5886, MMX 2010, and SKD 1897 (collectively 

“Defendants”), and in support states the following:

INTRODUCTION

1. Plaintiff, 15 Oz Fresh & Healthy Food, is the operator of a restaurant, Lokum 

Mediterranean Grill, located at 1629 Alton Road in Miami Beach, Florida. 

2. To protect the restaurant and the income from operation of the restaurant, Plaintiff

purchased a property insurance policy with policy number B1180D190825/11941SP (the 

“Policy”). 

3. The Policy was issued and underwritten by the Defendants.

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4. The Policy is a bilateral contract: Plaintiff agreed to pay monthly premiums to 

Defendants, in exchange for Defendants’ promises of coverage for certain losses.

5. Among other types of coverage, the Policy protects Plaintiff against a loss of 

business income due to a suspension of the restaurant’s operations. This type of coverage is often 

referred to as business interruption coverage. 

6. The Policy also provides “Extra Expense” coverage, under which Defendants 

promised to pay expenses incurred to minimize the suspension of business. Additionally, the 

Policy provides “Civil Authority” coverage, under which Defendants promised to pay for loss of 

business income caused by the action of a civil authority prohibiting access to the restaurant. 

7. Plaintiff duly complied with its obligations under the Policy and paid the requisite 

premiums. 

8. Beginning in March 2020, Plaintiff was forced to suspend business operations at 

the restaurant, as a result of COVID-19. Related actions of civil authorities also prohibited access 

to and occupancy of the restaurant. This suspension, which is ongoing, has caused Plaintiff to

suffer significant losses and incur significant expenses.

9. Under the Policy, Defendants promised to cover these losses and expenses, and are 

obligated to pay for them. But in blatant breach of their contractual obligations, Defendants have 

failed to pay for these losses and expenses. 

10. Upon information and belief, Defendants have failed to pay for similar losses and 

expenses by at least thousands of other insureds holding policies that are, in all material respects, 

identical. 

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THE PARTIES

11. Plaintiff, 15 Oz Fresh & Healthy Food LLC, is a Florida corporation organized to 

do business and doing business at 1629 Alton Road, Miami Beach, Florida 33139.

12. Defendants Underwriters at Lloyd’s, London known as Syndicates AML 2001, 

WBC 5886, MMX 2010, and SKD 1897 are insurance underwriters that participate in the 

insurance market known as Lloyd’s of London. At Lloyd’s of London, insurance underwriters 

form syndicates to jointly price and underwrite risk. These syndicates enter into insurance 

contracts on behalf of their members, and the members share the premiums, risk, and liability on 

these contracts. Each Lloyd’s syndicate is identified by its syndicate number. 

13. The Defendants are insurance underwriters who contracted—by and through the 

syndicates of which they are members—to insure Lokum Mediterranean Grill. As indicated in

Fresh & Healthy Food’s Policy, the underwriters of the Policy include the members of the Lloyd’s 

syndicates identified by the numbers AML 2001, WBC 5886, MMX 2010, SKD 1897.

14. At all times material, Defendants engaged in substantial and not isolated activity 

on a continuous and systematic basis in the state of Florida, namely by issuing and selling 

insurance policies in Florida and by contracting to insure property located in Florida. 

15. Under the applicable law and in accordance with the Policy’s Service of Suit Clause

(U.S.A.), service of process on Defendants may be effectuated by serving Lloyd’s America, Inc.

at 280 Park Avenue, East Tower, 25th Floor, New York, NY 10017.

JURISDICTION AND VENUE

16. This Court has subject matter jurisdiction under 28 U.S.C. § 1332 because there is 

diversity between Defendants and at least one member of each class; there are more than one 

hundred members of each class; and the amount in controversy exceeds $5,000,000 exclusive of 

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interest and costs. This Court also has subject matter jurisdiction under 28 U.S.C. §§ 2201 and 

2202 and is authorized to grant declaratory relief under these statutes.

17. Venue is proper in this district pursuant to 28 U.S.C. § 1391(b)(2) because a 

substantial part of the events and/or omissions giving rise to the claims occurred within the 

Southern District of Florida, and a substantial part of property that is subject of the action is situated 

in this district.

18. This Court has personal jurisdiction over Defendants pursuant to Fla. Stat. § 

48.193(1)(a) because Plaintiff’s claims arise out of, among other things, Defendants conducting, 

engaging in, and/or carrying on business in Florida; Defendants breaching a contract in this state 

by failing to perform acts required by contract to be performed in this state; and Defendants 

contracting to insure property in Florida, including but not limited to the premises insured under 

the Policy. Defendants also purposefully availed themselves of the opportunity of conducting 

activities in the state of Florida by marketing their insurance policies and services within the state, 

and intentionally developing relationships with brokers, agents, and customers within the state to 

insure property within the state, all of which resulted in the policy at issue in this action.

FACTUAL BACKGROUND

The Policy

19. Plaintiff and Defendants entered into a property insurance contract, the Policy, 

which was issued and underwritten by Defendants. The Policy has a policy period of February 7, 

2020 to February 7, 2021. The insured property under the Policy is 1629 Alton Road, in Miami 

Beach, Florida, the location of the Lokum Mediterranean Grill restaurant.

1

1 The Policy is attached to this complaint as Exhibit “A.” 

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20. The Policy is an all-risk insurance policy. In an all-risk insurance policy, all risks 

of loss are covered unless they are specifically excluded. 

21. Consistent with the all-risk nature of the Policy, Defendants specifically agreed to 

pay for all losses caused by “Covered Causes of Loss,” defined as “direct physical loss” unless the 

loss is excluded under the Policy. 

22. One type of coverage provided by the Policy is for loss of business income, often 

called business interruption insurance. This coverage is specifically provided for in a section of 

the Policy titled “Business Income (and Extra Expense) Coverage Form.”

23. Pursuant to this Form, Defendants promised to pay for “loss of Business Income” 

caused by a Covered Cause of Loss. Specifically, Defendants promised to pay for the loss of 

Business Income sustained due to the necessary “suspension” of the insured’s “operations” during 

the “period of restoration.” 

24. Each of the operative terms of this coverage provision is defined as follows.

25. Business Income means the net profit that the business would have earned absent 

the suspension of operations, plus any continuing normal operating expenses, including payroll. 

26. Suspension means, among other things, a slowdown or cessation of the insured’s 

business activities.

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27. Period of Restoration means the period of time beginning 72 hours after physical 

loss or damage to the property and ending on the date when the property is repaired or the date 

when business is resumed at a new location, whichever is earlier. 

28. Additionally, under the Policy, Defendants also promised to cover “Extended 

Business Income.” This coverage requires Defendants to pay for loss of Business Income beyond

the Period of Restoration under certain conditions. 

29. Specifically, Defendants promised to pay for the actual loss of Business Income 

during the period that begins on the date that the insured property is repaired, and ends either 60 

days thereafter or on the date when operations are restored to the level which would generate 

business income at normal levels, whichever is earlier. 

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30. In addition to promising to pay for loss of Business Income, under the Policy,

Defendants also promised to pay for certain necessary “Extra Expense[s].” Extra Expenses mean 

expenses that the policyholder incurs to, for example, minimize the suspension of business. 

31. The Policy also provides “Civil Authority” coverage. Under this type of coverage, 

Defendants promised to pay for the loss of Business Income and Extra Expense that the Plaintiff 

sustained as a result of “action of civil authority that prohibits access to the described premises

[Lokum Mediterranean Grill].”

32. This Civil Authority provision is an independent basis for business interruption

coverage. That is, it can be triggered even when the standard business interruption coverage is 

not.

33. Parts of the Policy, including the “Business Income (and Extra Expense) Coverage 

Form,” are standardized forms drafted by the Insurance Services Office (ISO). The ISO is a 

company that drafts standard policy language for use in insurance contracts. 

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34. In 2006, the ISO drafted a new endorsement, CP 01 40 07 06, acknowledging that 

claims for business interruption losses would be filed under existing policy language for losses 

resulting from the presence of viruses and other disease-causing agents. Endorsement CP 01 40 

07 06, which other insurers have since incorporated in policies, provides that the insurer “will not 

pay for loss or damage caused by or resulting from any virus, bacterium or other microorganism 

that induces or is capable of inducing physical distress, illness or disease.” Significantly, 

Defendants chose to not include this endorsement in Plaintiff’s Policy. 

35. Plaintiff’s Policy does not contain any exclusion which would apply to allow 

Defendants to deny coverage for losses caused by COVID-19 and related actions of civil 

authorities taken in response to COVID-19.

36. Accordingly, because the Policy is an all-risk policy and does not specifically 

exclude the losses that Plaintiff has suffered, those losses are covered. 

Plaintiff’s covered losses

37. As of August 14, 2020, according to the Florida Department of Health, COVID-19

is present in all of Florida’s 67 counties, with Miami-Dade County being the most affected county. 

As of August 14, Miami-Dade County, where Miami Beach is located, has had over 141,000

confirmed cases of COVID-19, and at least 1,954 deaths. 

38. The presence of COVID-19 and the public health emergency it has created have 

prompted actions by civil authorities throughout the United States (“Civil Authority Actions”), 

including but not limited to civil authorities with jurisdiction over Lokum Mediterranean Grill: the 

City of Miami Beach, Miami-Dade County, and the State of Florida. These Civil Authority 

Actions have restricted and prohibited access to the insured property. 

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39. On March 12, 2020, the City of Miami Beach declared a State of Emergency in 

response to COVID-19. The city has repeatedly extended this the State of Emergency, with the

most recent extension issued on August 12 and extending through August 19. 

40. On March 17, 2020, the Governor of Florida signed Executive Order 20-68 limiting 

all restaurants to 50% Capacity. 

41. On March 20, 2020, the Governor of Florida signed Executive Order 20-71 closing 

all commercial food/beverage establishments for on-site consumption, including but not limited to 

all restaurants in Miami-Dade County. 

42. On March 30, 2020, the Governor of Florida signed Executive Order 20-89, 

ordering Miami-Dade County, among other counties, “to restrict public access” to non-essential 

businesses.

43. On May 15, 2020, the Miami-Dade County issued Executive Order 23-20, allowing

restaurants to open for outdoor dining only. This Order became effective May 18, 2020.

44. On July 7, 2020, Miami-Dade County issued Executive Order 26-20, prohibiting 

restaurants from serving food and alcohol for on-site consumption between the hours of 10:00 p.m. 

and 6:00 a.m. 

45. On August 5, 2020, Miami-Dade County issued Amendment No. 3 to Executive 

Order 26-20, prohibiting more than four persons per table at restaurants and reaffirming that only 

outdoor dining is permitted. 

46. These and other Civil Authority Actions have required Lokum Mediterranean Grill 

to, at various times, restrict or forbid access to the restaurant, physically alter or restrict operations 

at the restaurant, and cease or restrict its functional use of the restaurant.

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47. In Florida, violations of an executive order issued by the Governor pursuant to the 

State Emergency Management Act are second-degree misdemeanors punishable by imprisonment. 

48. COVID-19, the public health emergency it has created, and the Civil Authority 

Actions have caused direct physical loss of and/or damage to the covered premises under the Policy 

by, among other things, damaging the property, denying access to the property, preventing 

customers from physically occupying the property, causing the property to be physically 

uninhabitable by customers, causing its function to be nearly eliminated or destroyed, and/or

causing a suspension of business operations on the premises. 

49. The Civil Authority Actions prohibiting public access to the covered premises and 

the surrounding area were issued in response to dangerous physical conditions and caused a 

suspension of business operations on the covered premises. 

50. As a result of the presence of COVID-19, Fresh & Healthy Food has suffered a 

suspension of business operations, sustained losses of business income, and incurred extra 

expenses.

51. As a result of the Civil Authority Actions, Fresh & Healthy Food has suffered a 

suspension of business operations, sustained losses of business income, and incurred extra 

expenses. 

52. These losses and expenses have continued through the date of filing of this action. 

Indeed, as of the date of filing, the restaurant remains at reduced occupancy, and subject to 

significant restrictions, alterations, and impairments of the restaurant’s business operations. 

53. These losses and expenses are not excluded from coverage under the Policy. And 

because the Policy is an all-risk policy, and Plaintiff has complied with its contractual obligations, 

Plaintiff is entitled to payment for these losses and expenses. 

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54. Accordingly, Plaintiff provided notice of its losses and expenses to Defendants, 

consistent with the terms and procedures of the Policy.

55. But contrary to the plain language of the Policy, and to Defendants’ corresponding 

promises and contractual obligations, Defendants have refused to pay for Plaintiff’s losses and 

expenses.

CLASS ACTION ALLEGATIONS

56. The class claims all derive directly from a single course of conduct by Defendants: 

their systematic and uniform refusal to pay insureds for losses suffered due to the COVID-19 

pandemic and the related actions taken by civil authorities to suspend business operations. 

57. Plaintiff brings this action pursuant to Rules 23(a), 23(b)(1), 23(b)(2), and/or 

23(b)(3), as well as 23(c)(4), of the Federal Rules of Civil Procedure, individually and on behalf 

of all others similarly situated. This action satisfies the numerosity, commonality, typicality, 

adequacy, predominance, and superiority requirements of those provisions.

58. Plaintiff seeks to represent nationwide classes defined as:

a) All persons and entities with Business Income coverage under a property 

insurance policy issued by any of the Defendants, which suffered a suspension of business 

due to COVID-19, and for which Defendants have denied a claim for the losses or have 

otherwise failed to acknowledge, accept as a covered loss, or pay for the covered 

losses (“the Business Income Coverage Class”).

b) All persons and entities with Civil Authority coverage under a property 

insurance policy issued by any of the Defendants, which suffered loss of Business Income 

and/or Extra Expense caused by an action of a civil authority, and for which Defendants 

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have denied a claim for the losses or have otherwise failed to acknowledge, accept as a 

covered loss, or pay for the covered losses (“the Civil Authority Coverage Class”).

c) All persons and entities with Extra Expense coverage under a property 

insurance policy issued by any of the Defendants, which sought to avoid or minimize the 

suspension of business caused by COVID-19 and/or the actions of civil authorities in 

response to COVID-19, and for which Defendants have denied a claim for the expenses or 

have otherwise failed to acknowledge, accept as a covered expense, or pay for the covered 

expenses (“the Extra Expense Coverage Class”).

59. Excluded from each defined proposed Class are Defendants and any of their 

members, affiliates, parents, subsidiaries, officers, directors, employees, successors, or assigns; 

governmental entities; Class Counsel and their employees; and the judicial officers and Court staff 

assigned to this case and their immediate family members.

60. Plaintiff reserves the right to modify, expand, or amend the definitions of the 

proposed Classes, as appropriate, during the course of this litigation.

61. This action has been brought and may properly be maintained on behalf of each 

Class proposed herein under the criteria of Rule 23 of the Federal Rules of Civil Procedure.

Numerosity and Ascertainability

62. This action satisfies the requirements of Fed. R. Civ. P. 23(a)(1). The members of 

each proposed Class are so numerous that individual joinder of all Class members is impracticable. 

There are, at a minimum, thousands of members of each proposed Class, and these individuals and 

entities are spread out across the country.

63. The identity of Class members is ascertainable, as the names and addresses of all 

Class members can be identified in Defendants’ or their agents’ books and records. Class members 

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may be notified of the pendency of this action by recognized, Court-approved notice dissemination 

methods, which may include U.S. mail, electronic mail, internet postings, and/or published notice.

Predominance of Common Issues

64. This action satisfies the requirements of Fed. R. Civ. P. 23(a)(2) and 23(b)(3) 

because this action involves common questions of law and fact which predominate over any 

questions affecting only individual Class members. Defendants issued all-risk policies to all the 

members of each proposed Class in exchange for payment of premiums by the Class members. 

The questions of law and fact affecting all Class members include, without limitation, the 

following: 

a) Whether Plaintiff and the Class members suffered a covered loss under the 

common policies issued to members of the Class;

b) Whether Defendants wrongfully denied all claims based on COVID-19;

c) Whether Defendants’ Business Income coverage applies to a suspension of 

business caused by COVID-19 and/or related actions of civil authorities 

taken in response to the presence or threat of COVID-19;

d) Whether Defendants’ Civil Authority coverage applies to a loss of Business 

Income caused by the orders of local, municipal, city, county, and/or state 

governmental entities requiring the suspension of business during the 

outbreak of COVID-19 in the United States;

e) Whether Defendants’ Extra Expense coverage applies to efforts to avoid or 

minimize a loss caused by COVID-19;

f) Whether Defendants have breached their contracts of insurance through a 

uniform and blanket denial of all claims for business losses related to 

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COVID-19 and/or the related actions of civil authorities taken in response 

to the presence or threat of COVID-19; 

g) Whether Plaintiff and the Class members suffered damages as a result of 

Defendants’ actions; and

h) Whether Plaintiff and the Class members are entitled to an award of 

reasonable attorneys’ fees, interest, and costs.

Typicality

65. This action satisfies the requirements of Fed. R. Civ. P. 23(a)(3) because Plaintiff’s 

claims are typical of the claims of the Class members and arise from the same course of conduct 

by Defendants. Plaintiff and the other Class members are all similarly affected by Defendants’ 

refusal to pay under their property insurance policies. Plaintiff’s claims are based upon the same 

legal theories as those of the other Class members. Plaintiff and the other Class members sustained 

damages as a direct and proximate result of the same wrongful practices in which Defendants 

engaged. The relief Plaintiff seeks is typical of the relief sought for the absent Class members.

Adequacy of Representation

66. This action satisfies the requirements of Fed. R. Civ. P. 23(a)(4) because Plaintiff 

will fairly and adequately represent and protect the interests of Class members. Plaintiff has 

retained counsel with substantial experience in prosecuting complex class action litigation.

67. Plaintiff and its counsel are committed to vigorously prosecuting this action on 

behalf of the Class members and have the financial resources to do so. Neither Plaintiff nor its 

counsel has interests adverse to those of the Class members.

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Inconsistent or Varying Adjudications and the Risk of Impediments to Other Class 

Members’ Interests

68. This action satisfies the requirements of Fed. R. Civ. P. 23(b)(1). Plaintiff seeks 

class-wide adjudication as to the interpretation and scope of Defendants’ property insurance 

policies. The prosecution of separate actions by individual members of the proposed Classes 

would create an imminent risk of inconsistent or varying adjudications that would establish 

incompatible standards of conduct for Defendants. 

Final Injunctive and/or Corresponding Declaratory Relief with respect to the Class is 

Appropriate

69. This action satisfies the requirements of Fed. R. Civ. P. 23(b)(2) because 

Defendants acted or refused to act on grounds generally applicable to Plaintiff and the other Class 

members, thereby making appropriate final injunctive and/or corresponding declaratory relief with 

respect to the Class members. The class claims all derive directly from Defendants’ systematic 

and uniform refusal to pay insureds for losses suffered due to the COVID-19 pandemic and the 

related actions taken by civil authorities to suspend business operations. Defendants’ actions or 

refusal to act are grounded upon the same generally applicable legal theories. 

Superiority

70. This action satisfies the requirements of Fed. R. Civ. P. 23(b)(3) because a class 

action is superior to other available methods for the fair and efficient adjudication of this 

controversy. The common questions of law and of fact regarding Defendants’ conduct and the 

interpretation of the common language in their property insurance policies predominate over any 

questions affecting only individual Class members. 

71. Because the damages suffered by certain individual Class members may be 

relatively small, the expense and burden of individual litigation would make it very difficult or 

impossible for all individual Class members to redress the wrongs done to each of them 

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individually, such that many Class members would have no rational economic interest in 

individually controlling the prosecution of specific actions, and the burden imposed on the judicial 

system by individual litigation by even a small fraction of the Class would be enormous, making 

class adjudication the superior alternative under Fed. R. Civ. P. 23(b)(3)(A).

72. The conduct of this action as a class action presents far fewer management 

difficulties, far better conserves judicial resources and the parties’ resources, and far more 

effectively protects the rights of each Class member than would piecemeal litigation. Compared 

to the expense, burdens, inconsistencies, economic infeasibility, and inefficiencies of 

individualized litigation, the challenges of managing this action as a class action are substantially 

outweighed by the benefits to the legitimate interests of the parties, the Court, and the public of 

class treatment in this Court, making class adjudication superior to other alternatives, under Fed. 

R. Civ. P. 23(b)(3)(D).

73. Plaintiff is not aware of any obstacles likely to be encountered in the management 

of this action that would preclude its maintenance as a class action. Rule 23 provides the Court 

with authority and flexibility to maximize the efficiencies and benefits of the class mechanism and 

reduce management challenges. The Court may, on motion of Plaintiff or on its own 

determination, certify nationwide, statewide and/or multistate classes for claims sharing common 

legal questions; utilize the provisions of Rule 23(c)(4) to certify any particular claims, issues, or 

common questions of fact or law for class-wide adjudication; certify and adjudicate bellwether 

class claims; and utilize Rule 23(c)(5) to divide any Class into subclasses.

CAUSES OF ACTION

COUNT I: DECLARATORY JUDGMENT

(On behalf of the Business Income Coverage Class)

74. Plaintiff re-adopts and re-alleges paragraphs 1 through 73 above.

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75. Plaintiff brings this Count individually and on behalf of the other members of the 

Business Income Coverage Class.

76. Under 28 U.S.C. §§ 2201 and 2202, this Court has jurisdiction to declare the rights 

and other legal relations of the parties in dispute.

77. Plaintiff’s Policy, as well as the policies of other Business Income Coverage Class

members, are insurance contracts under which Defendants were paid premiums in exchange for 

promises to pay Class members’ losses for claims covered by the Policy.

78. In the Policy, Defendants promised to pay for losses of business income sustained

as a result of perils not excluded under the Policy. Specifically, Defendants promised to pay for 

losses of business income sustained as a result of a suspension of business operations during the 

Period of Restoration. 

79. COVID-19 caused direct physical loss of and damage to Fresh & Healthy Food and 

other Class members’ insured premises, resulting in suspensions of business operations at these 

premises. These suspensions have caused Plaintiff and Class members to suffer losses of business 

income. 

80. These suspensions and losses triggered business income coverage under the Policy 

and other Class members’ policies. 

81. Plaintiff and the other Class members have complied with all applicable provisions 

of their respective policies, including payment of premiums.

82. Defendants, without justification, dispute that the Policy and other Class members’ 

policies provide coverage for these losses.

83. Plaintiff seeks a Declaratory Judgment that its Policy and other Class members’ 

policies provide coverage for the losses of business income.

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84. An actual case or controversy exists regarding Plaintiff’s and other Class members’

rights and Defendants’ obligations to reimburse Plaintiff and other Class members for the full 

amount of these losses. Accordingly, the Declaratory Judgment sought is justiciable.

WHEREFORE, Plaintiff requests that this Court enter a Declaratory Judgment declaring 

that the Policy and other Class members’ policies provide coverage for Class members’ losses of 

business income.

COUNT II: BREACH OF CONTRACT

(On behalf of the Business Income Coverage Class)

85. Plaintiff re-adopts and re-alleges paragraphs 1 through 73 above.

86. Plaintiff brings this Count individually and on behalf of the other members of the 

Business Income Coverage Class.

87. Plaintiff’s Policy, as well as the policies of other Business Income Coverage Class

members, are insurance contracts under which Defendants were paid premiums in exchange for 

promises to pay Class members’ losses for claims covered by the Policy.

88. In the Policy, Defendants promised to pay for losses of business income sustained

as a result of perils not excluded under the Policy. Specifically, Defendants promised to pay for 

losses of business income sustained as a result of a suspension of business operations during the 

Period of Restoration. 

89. COVID-19 caused direct physical loss of and damage to Fresh & Healthy Food and 

other Class members’ insured premises, resulting in suspensions of business operations at these 

premises. These suspensions have caused Class members to suffer losses of business income. 

90. These suspensions and losses triggered business income coverage under the Policy 

and other Class members’ policies. 

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91. Plaintiff and the other Class members have complied with all applicable provisions 

of their respective policies, including payment of premiums.

92. Defendants, without justification, have refused performance under the Policy and 

other Class members’ policies by denying coverage for these losses and expenses. Accordingly, 

Defendants are in breach of the Policy and other Class members’ policies. 

93. As a result of Defendants’ breaches of the Policy and other Class members’ 

policies, Plaintiff and other Class members have suffered actual and substantial damages for which 

Defendants are liable. 

WHEREFORE, Plaintiff, individually and on behalf of other Class members, seeks 

compensatory damages resulting from Defendants’ breaches of the Policy and other Class 

Members’ policies and seek all other relief deemed appropriate by this Court, including attorneys’ 

fees and costs.

COUNT III: DECLARATORY JUDGMENT

(On behalf of the Extra Expense Coverage Class)

94. Plaintiff re-adopts and re-alleges paragraphs 1 through 73 above.

95. Plaintiff brings this Count individually and on behalf of the other members of the 

Extra Expense Coverage Class.

96. Under 28 U.S.C. §§ 2201 and 2202, this Court has jurisdiction to declare the rights 

and other legal relations of the parties in dispute.

97. Plaintiff’s Policy, as well as the policies of other Extra Expense Coverage Class

members, are insurance contracts under which Defendants were paid premiums in exchange for 

promises to pay Class members’ losses for claims covered by the Policy.

98. Specifically, Defendants promised to pay for Extra Expenses incurred by Plaintiff 

and other Class members during the Period of Restoration that the insureds would not have 

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incurred if there had been no loss or damage to the insured premises. These Extra Expenses include 

expenses to avoid or minimize the suspension of business, continue operations, and to repair or 

replace property. 

99. COVID-19 caused direct physical loss of and damage to Fresh & Healthy Food and 

other Class members’ insured premises, resulting in suspensions of business operations at these 

premises. As a result, Plaintiff and other Class members have incurred Extra Expenses. 

100. These Expenses triggered Extra Expense coverage under the Policy and other Class 

members’ policies. 

101. Plaintiff and the other Class members have complied with all applicable provisions 

of their respective policies, including payment of premiums.

102. Defendants, without justification, dispute that the Policy and other Class members’ 

policies provide coverage for these Extra Expenses.

103. Plaintiff, individually and on behalf of the other members of the Extra Expense 

Coverage Class, seeks a Declaratory Judgment that its Policy, and those of other members of the 

Extra Expense Coverage Class, provides coverage for these Extra Expenses.

104. An actual case or controversy exists regarding Class members’ rights and 

Defendants’ obligations under Class members’ policies to reimburse Class members for these 

Extra Expenses. Accordingly, the Declaratory Judgment sought is justiciable.

WHEREFORE, Plaintiff requests that this Court enter a Declaratory Judgment declaring 

that the Policy and other Class members’ policies provide coverage for Class members’ Extra 

Expenses.

COUNT IV: BREACH OF CONTRACT

(On behalf of the Extra Expense Coverage Class)

105. Plaintiff re-adopts and re-alleges paragraphs 1 through 73 above.

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106. Plaintiff brings this Count individually and on behalf of the other members of the 

Extra Expense Coverage Class.

107. Plaintiff’s Policy, as well as the policies of other Extra Expense Coverage Class

members, are insurance contracts under which Defendants were paid premiums in exchange for 

promises to pay Class members’ losses for claims covered by the Policy.

108. Specifically, Defendants promised to pay for Extra Expenses incurred by Plaintiff 

and other Class members during the Period of Restoration that the insureds would not have 

incurred if there had been no loss or damage to the insured premises. These Extra Expenses include 

expenses to avoid or minimize the suspension of business, continue operations, and to repair or 

replace property. 

109. COVID-19 caused direct physical loss of and damage to Fresh & Healthy Food and 

other Class members’ insured premises, resulting in suspensions of business operations at these 

premises. These suspensions have caused Class members to incur Extra Expenses. 

110. These Expenses triggered Extra Expense coverage under the Policy and other Class 

members’ policies. 

111. Plaintiff and the other Class members have complied with all applicable provisions 

of the Policy, including payment of premiums.

112. Defendants, without justification, have refused performance under the Policy and 

other Class members’ policies by denying coverage for these Extra Expenses. Accordingly, 

Defendants are in breach of the Policy and other Class members’ policies. 

113. As a result of Defendants’ breaches of the Policy and other Class members’ 

policies, Plaintiff and other Class members have suffered actual and substantial damages for which 

Defendants are liable. 

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 21 of 30
22

WHEREFORE, Plaintiff, individually and on behalf of other Class members, seeks

compensatory damages resulting from Defendants’ breaches of the Policy and other Class 

Members’ policies and seek all other relief deemed appropriate by this Court, including attorneys’ 

fees and costs.

COUNT V: DECLARATORY JUDGMENT

(On behalf of the Civil Authority Coverage Class)

114. Plaintiff re-adopts and re-alleges paragraphs 1 through 73 above.

115. Plaintiff brings this Count individually and on behalf of the other members of the 

Civil Authority Coverage Class.

116. Under 28 U.S.C. §§ 2201 and 2202, this Court has jurisdiction to declare the rights 

and other legal relations of the parties in dispute.

117. Plaintiff’s Policy, as well as the policies of other Civil Authority Coverage Class

members, are insurance contracts under which Defendants were paid premiums in exchange for 

promises to pay Class members’ losses for claims covered by the policies.

118. In the Policy and other Class members’ policies, Defendants promised to pay for 

losses of business income sustained and extra expenses incurred when, among other things, a 

Covered Cause of Loss causes damage to property near the insured premises, the civil authority 

prohibits access to property near the insured premises, and the civil authority action is taken in 

response to dangerous physical conditions. 

119. Plaintiff and other Class members have suffered losses and incurred expenses as a 

result of actions of civil authorities that prohibited access to insured premises under the Policy and 

Class members’ policies. 

120. These losses satisfied all requirements to trigger Civil Authority coverage under the 

Policy and other Class members’ policies. 

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 22 of 30
23

121. Plaintiff and the other Class members have complied with all applicable provisions 

of the Policy, including payment of premiums.

122. Defendants, without justification, dispute that the Policy provides coverage for 

these losses.

123. Plaintiff seeks a Declaratory Judgment that its Policy and other Class members’ 

policies provide coverage for the losses that Class members have sustained and extra expenses 

they have incurred caused by actions of civil authorities. 

124. An actual case or controversy exists regarding Class members’ rights and 

Defendants’ obligations under Class members’ policies to reimburse Class members for these 

losses and extra expenses. Accordingly, the Declaratory Judgment sought is justiciable.

WHEREFORE, Plaintiff, individually and on behalf of other Class members, requests that 

this Court enter a Declaratory Judgment declaring that the Policy provides Civil Authority 

coverage for the losses and extra expenses incurred by Plaintiff and the other Class members.

COUNT VI: BREACH OF CONTRACT

(On behalf of the Civil Authority Coverage Class)

125. Plaintiff re-adopts and re-alleges paragraphs 1 through 73 above.

126. Plaintiff brings this Count individually and on behalf of the other members of the 

Civil Authority Coverage Class. 

127. Plaintiff’s Policy, as well as the policies of other Civil Authority Coverage Class

members, are insurance contracts under which Defendants were paid premiums in exchange for 

promises to pay Class members’ losses and expenses covered by the Policy.

128. In the Policy and other Class members’ policies, Defendants promised to pay for 

losses of business income sustained and extra expenses incurred when a Covered Cause of Loss 

causes damage to property near the insured premises, the civil authority prohibits access to 

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 23 of 30
24

property near the insured premises, and the civil authority action is taken in response to dangerous 

physical conditions. 

129. Plaintiff and other Class members have suffered losses and incurred expenses as a 

result of actions of civil authorities that prohibited access to insured premises under the Policy and 

Class members’ policies. 

130. These losses satisfied all requirements to trigger Civil Authority coverage under the 

Policy and other Class members’ policies. 

131. Plaintiff and the other Class members have complied with all applicable provisions 

of the Policy, including payment of premiums.

132. Defendants, without justification, have refused performance under the Policy and 

other Class members’ policies by denying coverage for these losses and expenses. Accordingly, 

Defendants are in breach of the Policy and other Class members’ policies. 

133. As a result of Defendants’ breaches of the Policy and other Class members’ 

policies, Plaintiff and other Class members have suffered actual and substantial damages for which 

Defendants are liable. 

WHEREFORE, Plaintiff seeks compensatory damages resulting from Defendants’ 

breaches of the Policy and other Class members’ policies. and seek all other relief deemed 

appropriate by this Court, including attorneys’ fees and costs.

PRAYER FOR RELIEF

WHEREFORE, Plaintiff respectfully requests that the Court enter judgment in its favor 

and against Defendants, as follows:

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 24 of 30
25

A. Entering an order certifying the proposed nationwide Classes, designating Plaintiff 

as Class representative, and appointing Plaintiff’s undersigned attorneys as Counsel 

for the classes;

B. Entering declaratory judgments on Counts I, III, and V in favor of Plaintiff and the 

members of the Business Income Coverage Class, Civil Authority Coverage Class, 

and Extra Expense Coverage Class as follows:

i. Business Income, Civil Authority and Extra Expense losses and expenses 

incurred and sustained as a result of COVID-19 and related civil authority 

actions are insured and covered losses and expenses under Plaintiff’s and 

Class members’ policies; and

ii. Defendants are obligated to pay for the full amount of the Business Income, 

Civil Authority and Extra Expense losses and expenses sustained and 

incurred, and to be sustained and incurred, as a result of COVID-19 and 

related civil authority actions are insured and covered losses and expenses 

under Plaintiff and Class members’ policies;

C. Entering judgments on counts II, IV, and VI in favor of Plaintiff and the members 

of the Business Income Coverage Class, Civil Authority Coverage Class, and Extra 

Expense Coverage Class; and awarding damages for breach of contract in an 

amount to be determined at trial;

D. An order requiring Defendants to pay both pre- and post-judgment interest on any 

amounts awarded;

E. An award of costs and attorneys’ fees; and

F. Such other or further relief as may be appropriate.

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 25 of 30
26

DEMAND FOR JURY TRIAL

The undersigned hereby demands a trial by jury as to all issues so triable.

Dated: August 17, 2020

PODHURST ORSECK, P.A.

/s/ Steven C. Marks

Steven C. Marks (Fla. Bar. No. 516414)

Aaron S. Podhurst (Fla. Bar. No. 63606)

Lea P. Bucciero (Fla. Bar. No. 84763) 

Matthew P. Weinshall (Fla. Bar. No. 84783)

Kristina M. Infante (Fla. Bar. No. 112557)

Pablo Rojas (Fla. Bar No. 1022427)

SunTrust International Center

One Southeast 3rd Ave, Suite 2300

Miami, Florida 33131

Phone: (305) 358-2800

Fax: (305) 358-2382

smarks@podhurst.com

apodhurst@podhurst.com

lbucciero@podhurst.com

mweinshall@podhurst.com

kinfante@podhurst.com

projas@podhurst.com

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 26 of 30
JS 44 (Rev. 06/17) FLSD Revised 06/01/2017 CIVIL COVER SHEET

The JS 44 civil cover sheet and the information contained herein neither replace nor supplement the filing and service of pleadings or other papers as required by law, except as

provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is required for the use of the Clerk of Court for the purpose

of initiating the civil docket sheet. (SEE INSTRUCTIONS ON NEXT PAGE OF THIS FORM.) NOTICE: Attorneys MUST Indicate All Re-filed Cases Below.

I. (a) PLAINTIFFS DEFENDANTS

(b) County of Residence of First Listed Plaintiff County of Residence of First Listed Defendant

(EXCEPT IN U.S. PLAINTIFF CASES) (IN U.S. PLAINTIFF CASES ONLY)

NOTE: IN LAND CONDEMNATION CASES, USE THE LOCATION OF

THE TRACT OF LAND INVOLVED.

(c) Attorneys (Firm Name, Address, and Telephone Number) Attorneys (If Known)

(d)Check County Where Action Arose: MIAMI- DADE MONROE BROWARD PALM BEACH MARTIN ST. LUCIE INDIAN RIVER OKEECHOBEE HIGHLANDS

II. BASIS OF JURISDICTION (Place an “X” in One Box Only) III. CITIZENSHIP OF PRINCIPAL PARTIES (Place an “X” in One Box for Plaintiff)

(For Diversity Cases Only) and One Box for Defendant)

1 U.S. Government 3 Federal Question PTF DEF PTF DEF

Plaintiff (U.S. Government Not a Party) Citizen of This State 1 1 Incorporated or Principal Place 4 4

of Business In This State

2 U.S. Government 4 Diversity Citizen of Another State 2 2 Incorporated and Principal Place 5 5

Defendant (Indicate Citizenship of Parties in Item III) of Business In Another State

Citizen or Subject of a 3 3 Foreign Nation 6 6

Foreign Country

IV. NATURE OF SUIT (Place an “X” in One Box Only) Click here for: Nature of Suit Code Descriptions

CONTRACT TORTS FORFEITURE/PENALTY BANKRUPTCY OTHER STATUTES

110 Insurance PERSONAL INJURY PERSONAL INJURY 625 Drug Related Seizure 422 Appeal 28 USC 158 375 False Claims Act

120 Marine 310 Airplane 365 Personal Injury - of Property 21 USC 881 423 Withdrawal 376 Qui Tam (31 USC

130 Miller Act 315 Airplane Product Product Liability 690 Other 28 USC 157 3729 (a))

140 Negotiable Instrument Liability 367 Health Care/ 400 State Reapportionment

150 Recovery of Overpayment 320 Assault, Libel & Pharmaceutical PROPERTY RIGHTS 410 Antitrust

& Enforcement of Judgment Slander Personal Injury 820 Copyrights 430 Banks and Banking

151 Medicare Act 330 Federal Employers’ Product Liability 830 Patent 450 Commerce

152 Recovery of Defaulted Liability 368 Asbestos Personal 835 Patent – Abbreviated

New Drug Application 460 Deportation

Student Loans 340 Marine Injury Product 840 Trademark 470 Racketeer Influenced and

(Excl. Veterans) 345 Marine Product Liability LABOR SOCIAL SECURITY Corrupt Organizations

153 Recovery of Overpayment Liability PERSONAL PROPERTY 710 Fair Labor Standards 861 HIA (1395ff) 480 Consumer Credit

of Veteran’s Benefits 350 Motor Vehicle 370 Other Fraud Act 862 Black Lung (923) 490 Cable/Sat TV

160 Stockholders’ Suits 355 Motor Vehicle 371 Truth in Lending 720 Labor/Mgmt. Relations 863 DIWC/DIWW (405(g)) 850 Securities/Commodities/

190 Other Contract Product Liability 380 Other Personal 740 Railway Labor Act 864 SSID Title XVI Exchange

195 Contract Product Liability 360 Other Personal Property Damage 751 Family and Medical 865 RSI (405(g)) 890 Other Statutory Actions

196 Franchise Injury 385 Property Damage Leave Act 891 Agricultural Acts

362 Personal Injury - Product Liability 790 Other Labor Litigation 893 Environmental Matters

Med. Malpractice 791 Empl. Ret. Inc. 895 Freedom of Information

REAL PROPERTY CIVIL RIGHTS PRISONER PETITIONS Security Act FEDERAL TAX SUITS Act

210 Land Condemnation 440 Other Civil Rights Habeas Corpus: 870 Taxes (U.S. Plaintiff 896 Arbitration

220 Foreclosure 441 Voting 463 Alien Detainee or Defendant) 899 Administrative Procedure

230 Rent Lease & Ejectment 442 Employment 510 Motions to Vacate

Sentence

871 IRS—Third Party 26

USC 7609 Act/Review or Appeal of

240 Torts to Land 443 Housing/

Accommodations Other: Agency Decision

245 Tort Product Liability 445 Amer. w/Disabilities - 530 General IMMIGRATION 950 Constitutionality of State

Statutes

290 All Other Real Property Employment 535 Death Penalty 462 Naturalization Application

446 Amer. w/Disabilities - 540 Mandamus & Other 465 Other Immigration

Other 550 Civil Rights Actions

448 Education 555 Prison Condition

560 Civil Detainee –

Conditions of

Confinement

V. ORIGIN (Place an “X” in One Box Only)

Transferred from

another district

(specify)

6 Multidistrict

Litigation

Transfer

8 Multidistrict

Litigation

– Direct

File

9

Remanded from

Appellate Court

1 Original

Proceeding

2 Removed

from State

Court

3 Re-filed

(See VI

below)

4 Reinstated

or

Reopened

5 7 Appeal to

District Judge

from Magistrate

Judgment

VI. RELATED/

RE-FILED CASE(S)

(See instructions): a) Re-filed Case YES NO b) Related Cases YES NO

JUDGE: DOCKET NUMBER:

VII. CAUSE OF ACTION

Cite the U.S. Civil Statute under which you are filing and Write a Brief Statement of Cause (Do not cite jurisdictional statutes unless diversity):

LENGTH OF TRIAL via days estimated (for both sides to try entire case)

VIII. REQUESTED IN

COMPLAINT:

CHECK IF THIS IS A CLASS ACTION

UNDER F.R.C.P. 23 DEMAND $ CHECK YES only if demanded in complaint:

JURY DEMAND: Yes No

ABOVE INFORMATION IS TRUE & CORRECT TO THE BEST OF MY KNOWLEDGE

DATE SIGNATURE OF ATTORNEY OF RECORD

FOR OFFICE USE ONLY

RECEIPT # AMOUNT IFP JUDGE MAG JUDGE

x

15 OZ FRESH & HEALTHY FOOD LLC,

individually and on behalf of all others

similarly situated

UNDERWRITERS AT LLOYD'S LONDON

KNOWN AS SYNDICATES AML 2001, WBC

5886, MMX 2010 and SKD 1897

Miami-Dade County Out of State

Steven C. Marks, Esq., Podhurst Orseck P.A., One S.E. 3rd Avenue

Suite 2300, Miami, FL 33130 - Tel: 305-358-2800

4

4

4

4

8

4

4 4

Declaratory Judgment / Breach of Contract

4

August 17, 2020

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 27 of 30
JS 44 (Rev. 06/17) FLSD Revised 06/01/2017

INSTRUCTIONS FOR ATTORNEYS COMPLETING CIVIL COVER SHEET FORM JS 44

Authority For Civil Cover Sheet

The JS 44 civil cover sheet and the information contained herein neither replaces nor supplements the filings and service of pleading or other papers as

required by law, except as provided by local rules of court. This form, approved by the Judicial Conference of the United States in September 1974, is

required for the use of the Clerk of Court for the purpose of initiating the civil docket sheet. Consequently, a civil cover sheet is submitted to the Clerk of

Court for each civil complaint filed. The attorney filing a case should complete the form as follows:

I. (a) Plaintiffs-Defendants. Enter names (last, first, middle initial) of plaintiff and defendant. If the plaintiff or defendant is a government agency, use

only the full name or standard abbreviations. If the plaintiff or defendant is an official within a government agency, identify first the agency and then the

official, giving both name and title.

(b) County of Residence. For each civil case filed, except U.S. plaintiff cases, enter the name of the county where the first listed plaintiff resides at the

time of filing. In U.S. plaintiff cases, enter the name of the county in which the first listed defendant resides at the time of filing. (NOTE: In land

condemnation cases, the county of residence of the “defendant” is the location of the tract of land involved.)

(c) Attorneys. Enter the firm name, address, telephone number, and attorney of record. If there are several attorneys, list them on an attachment,

noting in this section “(see attachment)”.

II. Jurisdiction. The basis of jurisdiction is set forth under Rule 8(a), F.R.C.P., which requires that jurisdictions be shown in pleadings. Place an “X” in

one of the boxes. If there is more than one basis of jurisdiction, precedence is given in the order shown below.

United States plaintiff. (1) Jurisdiction based on 28 U.S.C. 1345 and 1348. Suits by agencies and officers of the United States are included here.

United States defendant. (2) When the plaintiff is suing the United States, its officers or agencies, place an “X” in this box.

Federal question. (3) This refers to suits under 28 U.S.C. 1331, where jurisdiction arises under the Constitution of the United States, an amendment to the

Constitution, an act of Congress or a treaty of the United States. In cases where the U.S. is a party, the U.S. plaintiff or defendant code takes precedence, and

box 1 or 2 should be marked. Diversity of citizenship. (4) This refers to suits under 28 U.S.C. 1332, where parties are citizens of different states. When Box 4

is checked, the citizenship of the different parties must be checked. (See Section III below; federal question actions take precedence over diversity cases.)

III. Residence (citizenship) of Principal Parties. This section of the JS 44 is to be completed if diversity of citizenship was indicated above. Mark this

section for each principal party.

IV. Nature of Suit. Nature of Suit. Place an "X" in the appropriate box. If there are multiple nature of suit codes associated with the case, pick the nature

of suit code that is most applicable. Click here for: Nature of Suit Code Descriptions.

V. Origin. Place an “X” in one of the seven boxes.

Original Proceedings. (1) Cases which originate in the United States district courts.

Removed from State Court. (2) Proceedings initiated in state courts may be removed to the district courts under Title 28 U.S.C., Section 1441. When the

petition for removal is granted, check this box.

Refiled (3) Attach copy of Order for Dismissal of Previous case. Also complete VI.

Reinstated or Reopened. (4) Check this box for cases reinstated or reopened in the district court. Use the reopening date as the filing date.

Transferred from Another District. (5) For cases transferred under Title 28 U.S.C. Section 1404(a). Do not use this for within district transfers or multidistrict

litigation transfers.

Multidistrict Litigation. (6) Check this box when a multidistrict case is transferred into the district under authority of Title 28 U.S.C. Section 1407. When this

box is checked, do not check (5) above.

Appeal to District Judge from Magistrate Judgment. (7) Check this box for an appeal from a magistrate judge’s decision.

Remanded from Appellate Court. (8) Check this box if remanded from Appellate Court.

VI. Related/Refiled Cases. This section of the JS 44 is used to reference related pending cases or re-filed cases. Insert the docket numbers and the

corresponding judges name for such cases.

VII. Cause of Action. Report the civil statute directly related to the cause of action and give a brief description of the cause. Do not cite jurisdictional

statutes unless diversity. Example: U.S. Civil Statute: 47 USC 553

Brief Description: Unauthorized reception of cable service

VIII. Requested in Complaint. Class Action. Place an “X” in this box if you are filing a class action under Rule 23, F.R.Cv.P.

Demand. In this space enter the dollar amount (in thousands of dollars) being demanded or indicate other demand such as a preliminary injunction.

Jury Demand. Check the appropriate box to indicate whether or not a jury is being demanded.

Date and Attorney Signature. Date and sign the civil cover sheet.

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 28 of 30
AO 440 (Rev. 06/12) Summons in a Civil Action

UNITED STATES DISTRICT COURT

for the

__________ District of __________

)

)

)

)

)

)

)

)

)

)

)

)

Plaintiff(s)

v. Civil Action No.

Defendant(s)

SUMMONS IN A CIVIL ACTION

To: (Defendant’s name and address)

A lawsuit has been filed against you.

Within 21 days after service of this summons on you (not counting the day you received it) — or 60 days if you

are the United States or a United States agency, or an officer or employee of the United States described in Fed. R. Civ.

P. 12 (a)(2) or (3) — you must serve on the plaintiff an answer to the attached complaint or a motion under Rule 12 of

the Federal Rules of Civil Procedure. The answer or motion must be served on the plaintiff or plaintiff’s attorney,

whose name and address are:

If you fail to respond, judgment by default will be entered against you for the relief demanded in the complaint.

You also must file your answer or motion with the court.

CLERK OF COURT

Date:

Signature of Clerk or Deputy Clerk

Southern District of Florida

15 OZ FRESH & HEALTHY FOOD LLC,

Individually and on behalf of all others

similarly situated

UNDERWRITERS AT LLOYD'S LONDON KNOWN AS

SYNDICATES AML 2001, WBC 5886, MMX 2010 and SKD 1897

UNDERWRITERS AT LLOYD'S LONDON KNOWN AS

SYNDICATES AML 2001, WBC 5886, MMX 2010 and SKD 1897

By Serving:

Lloyd's America, Inc.

280 Park Avenue - East Tower - 25th Floor, New York, NY 10017

Steven C. Marks, Esq.

Podhurst Orseck, P.A.

One S.E. 3rd Avenue - Suite 2300

Miami, FL 33130

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 29 of 30
AO 440 (Rev. 06/12) Summons in a Civil Action (Page 2)

Civil Action No.

PROOF OF SERVICE

(This section should not be filed with the court unless required by Fed. R. Civ. P. 4 (l))

This summons for (name of individual and title, if any)

was received by me on (date) .

" I personally served the summons on the individual at (place)

on (date) ; or

" I left the summons at the individual’s residence or usual place of abode with (name)

, a person of suitable age and discretion who resides there,

on (date) , and mailed a copy to the individual’s last known address; or

" I served the summons on (name of individual) , who is

designated by law to accept service of process on behalf of (name of organization)

on (date) ; or

" I returned the summons unexecuted because ; or

" Other (specify):

.

My fees are $ for travel and $ for services, for a total of $ .

I declare under penalty of perjury that this information is true.

Date:

Server’s signature

Printed name and title

Server’s address

Additional information regarding attempted service, etc:

0.00

Case 1:20-cv-23407-AHS Document 1 Entered on FLSD Docket 08/17/2020 Page 30 of 30