Appendix XII-B1 FOR USE BY OFFICE ONLY CIVIL CASE INFORMATION STATEMENT EICK DOA (C S) No. Use for initial Law Division Civil Part pleadings (not motions) under Rule 4:5?1 Pleading will be rejected for filing, under Rule OVERPAYMENT: if information above the black bar is not completed or attorney?s signature is not affixed BATCH NUMBER: 1 . ATTORNEY PRO SE NAME 2. TELEPHONE NUMBER 3. COUNTY OF VENUE Philip A. Machlin, Esq. (732) 669-3007 Union 4. FIRM NAME (if applicable) av?ailable) 6: Philip A. Machlin, PC AIR 6. OFFICE ADDRESS 7. DOCUMENT TYPE 28 Gibson Boulevard Complaint Clark, NJ 07066 8.JURY DEMAND I YES No 9. NAME OF PARTY (3.9.. John Doe. PIaintiI?f) 10. CAPTION 430 West?eId Ave., LLC 430 WESTFIELD AVE., LLC VS. ROSELLE PARK BOARD OF EDUCATION 11.CASE TYPE NUMBER 12_ HURRICANE (See reverse side for listing) SANDY 13. IS THIS A PROFESSIONAL MALPRACTICE YES YOU HAVE CHECKED N.J.S.A. A -27 AND APPLICABLE CASE LAW REGARDING YOUR OBLIGATION TO FILE AN AFFIDAVIT OF MERIT. 14. RELATED CASES 15. IF YES, LIST DOCKET NUMBERS YES I No 16. DO YOU ANTICIPATE ADDING ANY PARTIES 17. NAME OF PRIMARY INSURANCE COMPANY (If known) (arising out of same transaction or occurrence)? NONE YES No I UNKNOWN THE INFORMATION PROVIDED ON THIS FORM CANNOT BE INTRODUCED INTO EVIDENCE. CASE CHARACTERISTICS FOR PURPOSES OF DETERMINING IF CASE IS APPROPRIATE FOR MEDIATION 18. DO PARTIES HAVE A CURRENT, PAST OR IF YES, IS THAT RELATIONSHIP: RECURRENT El El OTHER (explain) YES No FAMILIAL BUSINESS 19. DOES THE STATUTE GOVERNING THIS CASE PROVIDE FOR PAYMENT OF FEES BY THE LOSING YES I NO 20. USE THIS SPACE TO ALERT THE COURT TO ANY SPECIAL CASE CHARACTERISTICS THAT MAY WARRANT INDIVIDUAL MANAGEMENT OR ACCELERATED DISPOSITION - 21. DO YOU OR YOUR CLIENT NEED ANY DISABILITY IF YES, PLEASE IDENTIFY THE REQUESTED ACCOMMODATION YES i No 22. WILL AN INTERPRETER BE IF YES, FOR WHAT YES i No 23. I certify that con?dential personal identifiers have been redacted from documents now submitted to the court, and will be redacted from all documents submitted in the future in accordance with Rule 24. ATTORNEY SIGNATURE: 9. ?/qI/l Ll CN 10517_ps - English, Effective 08-19-2013 Page 4 0f 5 CIVIL CASE INFORMATION STATEMENT (CIS) Use for initial pleadings (not motions) under Rule 425-1 CASE TYPES (Choose one and enter number of case type in appropriate space on the reverse side.) Track - 150 days' discovery 151 NAME CHANGE 175 FORFEITURE 302 TENANCY 399 REAL PROPERTY (other than Tenancy. Contract, Condemnation, Complex Commercial or Construction) 502 BOOK ACCOUNT (debt collection matters only) 505 OTHER INSURANCE CLAIM (including declaratoryjudgment actions) 506 PIP COVERAGE 510 UM or UIM CLAIM (coverage issues only) 511 ACTION ON NEGOTIABLE INSTRUMENT 512 LEMON LAW 801 SUMMARY ACTION 802 OPEN PUBLIC RECORDS ACT (summary action) .999 OTHER (brie?y describe nature of action) Track II - 300 days' discovery 305 CONSTRUCTION 509 EMPLOYMENT (other than CEPA or LAD) 599 TRANSACTION 603N AUTO NEGLIGENCE PERSONAL INJURY (non-verbal threshold) 603Y AUTO NEGLIGENCE PERSONAL INJURY (verbal threshold) 605 PERSONAL INJURY 610 AUTO NEGLIGENCE PROPERTY DAMAGE 621 UM or UIM CLAIM (includes bodily injury) 699 TORT OTHER Track - 450 days' discovery 005 CIVIL RIGHTS 301 CONDEMNATION 602 ASSAULT AND BATTERY 604 MEDICAL MALPRACTICE 606 PRODUCT LIABILITY 607 PROFESSIONAL MALPRACTICE 608 TOXIC TORT 609 DEFAMATION 616 WHISTLEBLOWER CONSCIENTIOUS EMPLOYEE PROTECTION ACT (CEPA) CASES 617 INVERSE CONDEMNATION 618 LAW AGAINST DISCRIMINATION (LAD) CASES Track IV - Active Case Management by Individual Judge I 450 days' discovery 156 ENVIRONMENTAUENVIRONMENTAL COVERAGE LITIGATION 303 MT. LAUREL 508 COMPLEX COMMERCIAL 513 COMPLEX CONSTRUCTION 514 INSURANCE FRAUD 620 FALSE CLAIMS ACT 701 ACTIONS IN LIEU OF PREROGATIVE WRITS Multicounty Litigation (Track IV) 266 HORMONE REPLACEMENT THERAPY (HRT) 288 PRUDENTIAL TORT LITIGATION 271 ACCUTANEIISOTRETINOIN 289 REGLAN 274 290 POMPTON LAKES ENVIRONMENTAL LITIGATION 27B 291 PELVIC 279 GADOLINIUM 292 PELVIC 281 BRISTOL-MYERS SQUIBB ENVIRONMENTAL 293 DEPUY ASR HIP IMPLANT LITIGATION 282 FOSAMAX 295 ALLODERM REGENERATIVE TISSUE MATRIX 284 NUVARING 296 REJUVENATEIABG II MODULAR HIP STEM COMPONENTS 285 TRIDENT HIP IMPLANTS 297 MIRENA CONTRACEPTIVE DEVICE 286 LEVAQUIN 601 ASBESTOS 287 623 PROPECIA If you believe this case requires a track other than that provided above, please indicate the reason on Side 1, in the space under "Case Characteristics. Please check off each applicable category Putative Class Action Title 59 CN 10517_ps - English, Effective 08-19-2013 Page 5 of5 COURT 2 BEGAN STREET ELIKRHETH H3 0?20? COURT TELEPHGNE NO. 659-481? TRACK RSSIGHKENT NOTICE COURT HOURS 8:30 AM - 4:30 PE DETE: JUNE 05, 2014 RE: 430 WESTFIELU AVE LLC VS ROSELLE PARK BOARD ROCK ET L. THE ABOVE CASE HAS BEEN ASSIGNED DISCOVERY IS -001991 14 TRACK Z- 300 DAYS AND RUNS FROM THE FIRST ANSWER OR 90 DAYS FROM SERVICE QM THE FIRST DEFENDANT, EHICHEVER COMES FIRST. THE PRETRIAL JUDGE ASSIGNED IS: HON MRRK P- CIARROCCA IF YOU HAVE ANY CONTACT TEAM 0,01 AT: 659?4826- a IF YOU BELIEVE THAT THE TRACK IS INAPPROPRIATE YOU MUST FILE A CERTIFICATION OF GOOD CAHSE WITHIN 30 DAYS OF THE FILING OF YOUR PLEADING- PLAINTIFF MUST SERVE COPIES OF THIS HIWWI ATTENTION: JUVADEO FORM ON ALL OTHER PARTIES IN ACCORDANC ATT: PHILIP A. HACHLIN ESQ PC PHILIP A 28 GIBSON BLVD CLARK NJ 0?066: Conf/ (cram . A '57 42 Rec was?? FEE ATTACHED Supe?OI 00 Wk BATCH NO. 6&5 Nil ?1 New CASH 0 cc. CASEM M6: can PHILIP A MACHLIN PQNLU NON do 28 Gibson Blvd. AMOUNT 91,5 Clark, New Jersey 07066 (732) 669?3007 . . Attorney for Plaintiff 430 AVE, LLC, SUPERIOR COURT OF NEW JERSEY - LAW DIVISION Plaintiff, UNION COUNTY vs. Docket No. is ll?yllx :51 9 9 1-, 4 ROSELLE PARK BOARD Civil Action OF EDUCATION, VERIFIED COMPLAINT Defendant. Plaintiff, 430 WESTFIELD AVE, LLC, having an address of 28 Gibson Boulevard, Clark, New Jersey, by way of Complaint against the Defendant, ROSELLE PARK BOARD OF EDUCATION, says: FIRST COUNT (Breach of Contract) 1. At all times mentioned herein, Plaintiff, 430 Westfield Ave, LLC, (hereafter the ?Plaintiff?) was and is a New Jersey Limited liability Company with a place of business located at 28 Gibson Boulevard, Clark, New Jersey. 2. At all times mentioned herein, Defendant Roselle Park Board of Education (hereafter the ??Defendant?), was and is a municipal school district with offices located at 510 Chestnut Street, Roselle Park, New Jersey. 3. On or about February 13, 2007, the Plaintiff entered into a Lease Agreement (the ?Lease? or ?Lease Agreement?) with the Defendant with regard to a commercial building owned by the Plaintiff and located at 430 West?eld Avenue East, Roselle Park, New Jersey (the ?Building?). 4. Speci?cally, the Defendant agreed to lease 6,175 square feet of of?ce space in the Building (hereafter the ?Leased Premises?) for a term of ?ve (5) years commencing July 1, 2007, with an option to renew the lease for two additional terms of ?ve (5) years each. 5. The Lease Agreement provided for the payment of base rent at the initial rate of $20.00 per square foot, or $123,500.00 per year, which rate would be increased by 2.5% per year A during the initial term of the Lease. The Lease also provided for the payment of CAM charges as additional rent. 6. The Lease Agreement further provided that Plaintiff would perform various agreed upon construction work in and to the Leased Premises, and that Defendant would pay for same as additional rent pursuant to a formula set forth in the Lease. 7. Paragraph 5.1 of the Lease Agreement provided that Plaintiff would complete all construction "in accordance with the plans prepared by Tenant?s [Defendant?s] engineer." 8. The Lease contemplated that Defendant would provide construction plans to Plaintiff in a timely manner so as to enable the Plaintiff to complete the construction by the lease commencement date of July 1, 2007. 9. The Defendant failed to provide the plans to Plaintiff in a timely manner so as to enable the Plaintiff to complete the construction by the intended lease commencement date. 10. In fact, the Plaintiff did not receive the ?nal set of construction plans ?om the Defendant until sometime in December 2007. 11. Immediately thereafter, Plaintiff commenced the ?rst phase of the required construction work which included the construction of a handicapped ramp as required by the plans. 12. In or about January 2008, Defendant advised Plaintiff that the borough engineer was requiring the parties to obtain planning board approval for the construction work and the Defendant advised the Plaintiff that its attorney would be responsible for preparing and ?ling the required land use application. 13. The Defendant ?led the required land use application on or about April 16, 2008 and a hearing before the borough planning board was scheduled for June 16, 2008. 14. By letter dated June 6, 2008, the Defendant, through their attorney, noti?ed the Plaintiff that it was no longer interested in occupying the Leased Premises and would be withdrawing the pending land use application. 15. Said letter constituted a breach of the Lease Agreement by the Defendant. 16. Defendant?s failure to supply Plaintiff with the construction plans in a timely manner also constituted a breach of the Lease Agreement. 17. As a result of Defendant?s breach of the Lease Agreement, Plaintiff suffered damages, including, but not limited to the loss of rental income and the expenditure of construction costs in an amount to be determined by the Court. 18. The Plaintiff provided Defendant with several opportunities to cure the breach of contract and to honor its obligations pursuant to the Lease Agreement, but the Defendant declined and refused to cure the breach. 19. Plaintiff attempted to mitigate its damages by ?nding a replacement tenant, but was unable to do so. WHEREFORE, Plaintiff, 430 WESTFIELD AVE., LLC, demands judgment against Defendant, ROSELLE PARK BOARD OF EDUCATION, for damages, interest, costs of suit, legal fees, and such other relief as this Court may deem equitable and just. SECOND COUNT (Detrimental Reliance) 1. Plaintiff repeats and realleges each and every allegation contained in the First Count of the Complaint as though set forth at length herein. 2. By executing the Lease Agreement, Defendant obligated itself to provide Plaintiff with the construction plans in a timely manner and to occupy the Leased Premises upon the completion of the construction. 3. The Plaintiff detrimentally relied upon the explicit and implicit promises made by the Defendant in the Lease Agreement. 4. The Plaintiff suffered damages as a result of Defendant?s breach of the Lease Agreement. A WHEREFORE, Plaintiff, 430 WESTFIELD AVE., LLC, demands judgment against Defendant, ROSELLE PARK BOARD OF EDUCATION, for damages, punitive damages, interest, costs of suit, legal fees, and such other relief as this Court may deem equitable and just. PHILIP A. MACHLIN, PC Attorney for Plaintiff, D. Philip A. Machlin, Esq. Dated: June 4, 2014 JURY DEMAND Plaintiff 430 West?eld Ave, LLC hereby demands a trial by jury on all issues so triable. DESIGNATION OF TRIAL COUNSEL Pursuant to R. 4225?4, Philip A. Machlin, Esq., is hereby designated as trial counsel for Plaintiff in the above matter. PHILIP A. MACHLIN, PC Attorney for Plaintiff, By: WWQL Philip A. Machlin, Esq. Dated: June 4, 2014 CERTIFICATION PURSUANT TO RULE 4:5-1 I hereby certify that the matter in controversy is not the subject of any other action pending in any other Court or of a pending arbitration proceeding, and that no other action or arbitration proceeding is presently contemplated. I hereby further certify that no other parties are presently known that should be joined in this action. I hereby certify that the foregoing statements made by me are true. I am aware that if any of the foregoing statements made by me are willfully false, I I am subject to punishment. PHILIP A. MACHLIN, PC Attorney for Plaintiff, 'By: Philip A. Machlin, Esq. Dated: June 4, 2014 VERIFICATION I hereby certify that the allegations set forth in the annexed Veri?ed Complaint are true to the best of my knowledge and belief. I am aware that if any of the foregoing statements made by 430 WESTFIELD AVE, LLC . quu? Gioyal/ano, Managing Member me are willfully false, I am subject to punishment. Dated: June 4, 2014 LAW OFFICES PHILIP A. MACHLIN, PC 28 GIBSON BOULEVARD CLARK, NEW JERSEY 07066 (732) 669-3007 pmochlin@moohiinlow.com Fox: (732) 882?0404 une 4 superior Court of New Jersev Via Hand Delivery ?iN Clerk, Superior Court of New Jersey 3 *5 Law Division CIVIL CASE Mme; . I . Lutiull'EEF?L'l?Fh Umon County Courthouse UNION on: ft-iT?r" 2 Broad Street, Room 107 Elizabeth, NJ 07207 Re: 430 Westfield Ave., LLC vs. Roselle Park Board of Education Docket No. Dear Sir or Madam: I represent 430 West?eld Ave, LLC, the Plaintiff in the above captioned matter. Enclosed please ?nd for ?ling an original and two (2) copies of a Veri?ed Complaint and Case Information Statement, along With a check for the ?ling fee of $200.00. Please ?le the enclosed and return to me a copy of the Complaint stamped ??led? in the self-addressed, stamped envelope enclosed herewith. Thank you for your kind attention to this matter. Very truly yours, PW Philip A. Machlin, Esq. Enclosures cc: 430 West?eld Ave, LLC Ltr.Clerk.01