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CLB Agenda 02/19/2014 CONTRACTORS LICENSING BOARD Agenda February 19 , 2014 Co e-- County COLLIER COUNTY CONTRACTORS' LICENSING BOARD AGENDA FEBRUARY 19, 2014 9:00 A.M. COLLIER COUNTY GOVERNMENT CENTER ADMINISTRATIVE BUILDING BOARD OF COUNTY COMMISSIONERS CHAMBERS ANY PERSON WHO DECIDES TO APPEAL A DECISION OF THIS BOARD WILL NEED A RECORD OF THE PROCEEDINGS PERTAINING THERETO, AND THEREFORE MAY NEED TO ENSURE THAT A VERBATIM RECORD OF THE PROCEEDINGS IS MADE, WHICH RECORD INCLUDES THAT TESTIMONY AND EVIDENCE UPON WHICH THE APPEAL IS TO BE BASED. I. ROLL CALL II. ADDITIONS OR DELETIONS: III. APPROVAL OF AGENDA: IV. APPROVAL OF MINUTES: DATE: January 15, 2014 V. DISCUSSION: VI. NEW BUSINESS: (A) Orders Of The Board (B) Jody A. Cabrera, Cabrera Electrical Service, Inc. —Verification of Construction Experience (C) Robert C. Marzzacco, Gulf Coast Construction and Design Corp—Review of Credit Report (D) Thomas G. Conroy, Better Breathing Limited Liability Company—Verification of Construction Experience (E) Joseph S. O'Malley—Verification of Construction Experience (F) Rodney W. Gatewood—Wavier of exams for a Reinstatement (G) Keith E. Morrison—Wavier of exams for a Reinstatement VII. OLD BUSINESS: (A) Dagoberto T Barcelo, Barcelo's Custom Cabinets & Mill work Inc-6 month Credit Review (B) Jimmy M. Dean, J.D. Design Construction Inc. —6 month Credit Review (C) Darleen Row, Dazzling Floors, Inc. —6 month Credit Review VIII. PUBLIC HEARINGS: (A) Case 2014-03—Deborah J. Plumber—Tiger Masonry Inc IX. REPORTS: X. NEXT MEETING DATE: WEDNESDAY, MARCH 19, 2014 COLLIER COUNTY GOVERNMENT CENTER ADMINISTRATIVE BUILDING THIRD FLOOR IN COMMISSI ONERS CHAMBERS 3299 E. TAMIAMI TRAIL NAPLES, FL 34112 January 15,2014 MINUTES OF THE MEETING OF THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD January 15, 2014 Naples, Florida LET IT BE REMEMBERED, that the Collier County Contractors' Licensing Board, having conducted business herein, met on this date at 9:00 AM in REGULAR SESSION in Administrative Building "F," 3rd Floor, Collier County Government Complex, Naples, Florida, with the following Members present: Chairman: Richard Joslin Vice Chair: Patrick White Members: Michael Boyd Ronald Donino Terry Jerulle Kyle Lantz Thomas Lykos Gary McNally Robert Meister ALSO PRESENT: Michael Ossorio — Supervisor, Contractors' Licensing Office Kevin Noell, Esq. —Assistant County Attorney James F. Morey, Esq. —Attorney for the Contractors' Licensing Board Reggie Smith —Licensing Compliance Officer Thomas Keegan—Licensing Compliance Officer 1 January 15,2014 Any person who decides to appeal a decision of this Board will need a record of the proceedings and may need to ensure that a verbatim record of the proceedings is made, which record includes the testimony and evidence upon which the Appeal is to be based. I. ROLL CALL: Chairman Richard Joslin called the meeting to order at 9:06 AM and read the procedures to be followed to appeal a decision. Roll call was taken and a quorum was established. Nine voting members were present. II. AGENDA—ADDITIONS,DELETIONS, OR CHANGES: Addition: • Under Item VI, "New Business" o A. Election of Chair and Vice Chair—2014 Term III. APPROVAL OF AGENDA: Corrections: • Vice Chairman White noted the order of"New Business" and"Old Business" had been reversed on the Agenda. • The correct date of the next meeting is February 19, 2014 Vice Chairman Patrick White moved to approve the Agenda as amended. Terry Jerulle offered a Second in support of the motion. Carried unanimously, 9—0. IV. APPROVAL OF MINUTES—NOVEMBER 20, 2013: Gary McNally moved to approve the Minutes of the November 20, 2013 meeting as submitted. Thomas Lykos offered a Second in support of the motion. Carried unanimously, 9—0. V. DISCUSSION (None) VI. NEW BUSINESS: A. Election of Chair and Vice Chair—2014 Term The Floor was opened to nominations for the Office of Chairman. Terry Jerulle nominated Patrick White to serve as Chairman. Robert Meister offered a Second in support of the nomination. There were no other nominations. Patrick White accepted the nomination. Motion carried, 8— "Yes"/1 — "Abstention." Mr. White abstained from voting. 2 January 15,2014 Chairman White thanked Mr. Joslin for his many years of service to the Board. Chairman White opened the Floor to nominations for the Office of Vice Chair. • Terry Jerulle nominated Thomas Lykos to serve as Vice Chair. • Thomas Lykos nominated Terry Jerulle to serve as Vice Chair. Kyle Lantz offered a second in support of the nominations. There were no other nominations. Vote to elect Thomas Lykos: 6— "Yes"/2— "Opposed"/1— "Abstention." Mr. Lykos abstained from voting. The Floor was closed. VII. OLD BUSINESS A. Orders of the Board Thomas Lykos moved to approve authorizing the Chairman to sign the Orders of the Board. Gary McNally offered a Second in support of the motion. Carried unanimously, 9—0. (Note: With reference to the cases heard under Section VII, the individuals who testified were first sworn in by the Attorney for the Board.) B. Victor Treissa—Six-Month Credit Review (d/b/a Kitchen Installations of SWFL,LLC) Victor Triessa stated: • He was able to stop the Bankruptcy proceedings and sold his home. • He confirmed the closing date was January 6, 2014. • Sale of home will increase his Credit Report score by approximately 40 points. • Although the Current Credit Report did not reflect sale of property, his score was still higher than the past Credit Report reviewed by the Board. Michael Ossorio stated: • Mr. Triessa has appeared before the Board on two occasions • Have not received any complaints • The Business Credit Report is in order • Business has been open for 12 months • Recommendation: terminate probation—Business Credit Report meets the MuniCode criteria Terry Jerulle asked Mr. Triessa how he would handle the remaining debt. Victor Triessa replied the medical bills would be paid in a lump sum since the hospital would not accept installments. 3 January 15,2014 Richard Joslin moved to approve accepting the Credit Report and terminating the probation. Ronald Donino offered a Second in support of the motion. Carried unanimously, 9—0. C. Nathan Hinz—Six-Month Credit Review (d/b/a Nathan Contracting Services, LLC) It was noted Mr. Hinz was not present. Michael Ossorio stated Mr. Hinz had been notified of the Hearing. He further stated Mr. Hinz was on probation. He no longer conducts business in Collier County. Mr. Hinz is in violation of the Board's Order to submit a current Credit Report. Recommendation: Suspend the license. Vice Chairman Thomas Lykos moved to approve suspending the license of Nathan Hinz. Second by Terry Jerulle. Carried unanimously, 9—0. D. Mico Ugrica,Jr.—Review of Verification of Construction Experience (d/b/a Zen Group,LLC) Mico "Mike" Ugrica and his wife,Alexandra,were sworn in. Michael Ossorio stated Mr. Ugrica took and passed the Building Contractor exam and the Business Procedures test, but there were questions concerning his experience. He further stated Mr. Ugrica applied for a Building Contractors license which requires 48 months' experience. James F. Morey, Esq., Counsel to the Contractors' Licensing Board, cited from Section 22-184, "Standards for the Issuance or Denial of a Certificate of Competency," as follows: (b) "Referral of application to Contractor's Licensing Board for decision. If it does not appear on the face of the application that the applicant has complied with the requirements of this Article so as to be eligible for a Certificate of Competency, then the Contractors' Licensing Supervisor shall refer the application to the Contractors' Licensing Board for a decision regarding approval or denial of the application." Mr. Morey listed the criteria necessary to assess the experience of an Applicant: • Affidavits from former employers indicating the years of service; • Copies of Certificates of Competency from other jurisdictions; • Affidavits of Building Supervisors from other jurisdictions; • Affidavits from a Union organization; • Affidavits from any other source within a particular Trade. 4 January 15,2014 The purpose is to gather information to substantiate the relevant experience. He further cited from Section 22-162, "Definitions and Contractor Qualifications," as follows: "Building Contractor requires 48 months experience with a passing grade on an approved test and a Business and Law test and means a contractor whose services are limited to construction of commercial buildings and single-dwelling or multiple-dwelling residential buildings, which commercial or residential buildings do not exceed three stories in height, and accessory use structures in connection therewith or a contractor whose services are limited to remodeling,repair, or improvement of any size building if the services do not affect the structural members of the building." Michael Ossorio stated a Commercial Building Contractor must show that he/she has done commercial work up to three stories but there are no height restrictions if working on a condominium doing non-structural work. Kyle Lantz noted the Applicant was required to provide four years of experience and asked if all four years was limited to commercial work. Michael Ossorio stated he would review a resume to determine if the Applicant had supervisory (foreman) experience of at least one year's duration. He further stated residential experience is also reviewed but a Commercial Building Contractor must prove that he/she has worked on commercial jobsites. Chairman White asked the Applicant if he could add anything further since Staff has determined the materials submitted did not adequately substantiate the required type of experience. Mico Ugrica stated: • He and his family moved to Collier County from Canada last year; • He has been a Contractor for the past 15 years • He contacted a few foinuer clients in Canada who sent letters and photographs of the work that he had performed on three and four-story buildings • He stated multi-family buildings are considered to be "commercial" construction in Canada (Note: The original documents were provided to the Board to review by the Applicant during the course of the Hearing.) Michael Ossorio cited from Section 22-184, "Standards for the Issuance or Denial of a Certificate of Competency," as follows: (c) "When an application is referred to the Contractors' Licensing Board, the Board shall take testimony from the Applicant and shall consider 5 January 15,2014 other relevant evidence regarding whether the application meets the requirements of this division. Upon the evidence presented by the applicant and the contractor licensing supervisor,the Contractors' Licensing Board shall determine whether the applicant is qualified or unqualified for the trade in which application has been made. Findings of Fact and Conclusions of Law regarding the approval or denial of the application shall be made by the Contractors' Licensing Board. The Board may consider the applicant's relevant recent experience in the specific trade and, based upon such experience, may waive testing requirements if convinced that the applicant is qualified by experience whereby such competency testing would be superfluous (1) If the Contractors' Licensing Board determines that an applicant is qualified for a particular type of Certificate of Competency, a competency card shall be issued by the Contractor Licensing Supervisor or his/her designee." Mr. Ossorio contacted the Toronto, Canada, and spoke with the Licensing Manager. In Toronto, if an applicant wishes to do work, he/she sits with the Building Marshall who asks a series of questions. If the applicant meets the criteria, he/she will be issued a license. Mr. Ossorio was informed that Mr. Ugrica had been licensed in Toronto for a period of one year. The Building Official in Toronto confirmed that a either a homeowner or a Contractor could pull an Owner/Builder Permit. Chairman White asked Mr. Ugrica to explain what else he had done in the past nine years in addition to the one year in Toronto. Mr. Ugrica responded that the majority of homes he worked on were "flipped." He pulled permits as an"owner" because it was his property. He stated the jobs from his clients varied from small renovations (adding an addition) to complete rebuilds where the original structure was demolished and rebuilt. He further stated he also did restorations of historic properties. He explained when he worked for a client, the homeowner or designer or architect would pull the permit and present him with approved plans for which he would provide a quote. If the quote was accepted, the job would proceed. Chairman White asked the Applicant to describe his experience from 2003 to 2013. Mr. Ugrica stated: • 2003 —he built a detached garage for a bungalow as an owner/builder ® 2004—he worked on a complete rebuild of a single-family home o There were water problems which necessitated waterproofing the exterior of the basement o Replaced rotten bench footers o Remodeled the kitchen and bathrooms 6 January 15,2014 • 2005 - A complete addition(foundation to third floor) was built onto a Victorian-style home in Toronto and dormer work was also completed • 2006/2007—began working on several four-story commercials buildings in downtown Toronto It was noted the documentation submitted covered the period from 2010 to 2012. Alexandra Ugrica stated the family emigrated from Canada in 2012 and the process took over a year. She explained her husband was not allowed to work while applying for a Visa. Chairman White requested information for the period from 2008 through 2012. Kyle Lantz stated that, after reviewing the documentation presented, while he was convinced the Applicant was qualified as a Residential Contractor, he did not see enough"commercial" experience. Mrs. Ugrica explained one of the clients was a Convention Center which was commercial. Terry Jerulle asked if"time was of the essence" concerning the Visa Application. Mrs. Ugrica replied that her husband was subject to stringent guidelines and, as a Contractor, he is required to employ U.S. citizens. They are required to file taxes but have no income to report. Mr. Jerulle suggested they return with copies of building permits, a resume, a timeline, and letters from an architect and/or structural engineer to satisfy the requirements. It was noted the Applicant's documentation included a letter from an engineering inspector confirming that the work done by Mr. Ugrica had passed inspection. Mico Ugrica stated it was very difficult to obtain copies of building permits due to the strict privacy laws in Canada. It took 60 days to obtain a copy of one permit where he was the owner/builder. Richard Joslin stated the permit was pulled by Mr. Ugrica as an owner/builder but not as the Building Contractor; it did not prove that he did the renovations himself Alexandra Ugrica explained the process: a Anyone may pull a permit—it is not limited to an owner/architect/Contractor; o with a letter of authorization, she could pull a permit for her neighbor • Work is approved by an inspector once it has been completed • An Inspector does not verify who completed the work—only that it had been done correctly and has met Code • Her husband preferred that either his clients or their architects or designers pulled the building permit • Even if permits for the commercial work could be obtain, Mr. Ugrica's name would not be listed on the document 7 January 15,2014 • Canadian law changed in 2011 and required a licensed architect submit drawings for approval. The Architect's license would be noted on the permit. Thomas Lykos explained that Collier County requires a licensed Contractor to pull a permit for a commercial job, unlike a residential construction where an owner-builder is allowed to obtain a permit. To obtain a Building Contractor's license, the Applicant must be familiar with the process because he will be responsible to pull the permits for his projects. The Contractor's name and his license number will appear on a permit. Chairman White explained the issue was to demonstrate relevant commercial construction experience. He stated there was more than adequate proof of Mr. Ugrica's residential construction experience. He asked for an explanation of any commercial-type construction projects that were completed during the required 48-month period of time. Mica Ugrica outlined additional commercial experience: • From 2010 to 2011 —the Convention Center project took 18 months • Address: 858 Davenport— 10 units—took 2 years—structural underpinning repairs—the property backed onto a ravine and was over 100 years old • 2006: 333 Harvard—built three 820-foot units—three-stories high which took 7 to 8-months to complete—the new units were additions to an existing building—each unit contained 3-bedrooms and 2-bathrooms (high end) Description of work completed: • Excavated from below the frost line and poured the foundation • Reinforced everything • 12-inch concrete block to above grade • First floor unit had a radiant hot-water flooring system • Because the building was located in a residential area, the new construction was required to mirror the historic style of construction (double-brick) and comply with Code • Building had a flat roof with metal coping Mico Ugrica stated as the General Contractor for the job, his responsibilities including: • hiring sub-contractors ("sub-Trades"), i.e., excavators, masons, Master electricians • supervising foundation pours and pushed wheelbarrows when necessary; • supervising installation of all windows/doors/balconies; • supervising installation of HVAC system for each unit (natural gas); • supervising installation of plumbing and electrical; • he did the accounting(client paid him and he paid the subs); • maintained contact with the client; • dealt with the Building Inspector when needed; 8 January 15,2014 • adhered to stringent Fire Code requirements—scheduled when wiring would be roughed-in, speaker systems throughout the units, pole stations, etc. (Fire Department's policy is to deal directly with building owners at inspection) • scheduled installation of insulation—spray and"pink"—dry walled, taped, plastered— • scheduled installation of finishes and trims, i.e., hardwood flooring (3/4-inch maple), marble in baths (countertops/floors) He stated he owned a small company and he was always on-site because he handled only one job at a time. His list of clients is small but they were all repeat customers. Gary McNally asked the Applicant to explain his formal training and educational background. Mico Ugrica stated his father was a builder and he grew up on construction sites; he began helping his father when he was seven years old. He further stated, "I don't know anything else." He did not have any"formal" education; his training was hands-on. Additional discussion ensued. Kyle Lantz stated he was more confident that the Applicant was qualified. Michael Ossorio stated he would not offer a recommendation. Terry Jerulle suggested that he, if it he was not required to obtain a Building Contractor's license for immigration purposes, Mr. Ugrica could apply for a Residential Contractor's License which could be issued immediately. Michael Ossorio confirmed if the Applicant could provide a list of residential construction job, the Board could issue a license. Mr. Ugrica could later re-apply for a Building Contractor's License when his documentation was complete. Chairman White explained if the Board issued a Building Contractor's license, it would be restricted to "residential only" until the Applicant was able to amend the original application and provide the additional documentation, i.e., sworn Affidavits demonstrating the degree of commercial experience, etc. Mr. Ossorio explained it would be simpler to issue a Residential Contractor's license which could be registered with the State. If he chose to upgrade it, he would re-apply to the Board, provide the documentation, and a Building Contractor's license could be issued which would also be registered with the State. He further explained there is a distinction between the two licenses and Mr. Ugrica should register accordingly to avoid confusion concerning his qualifications. Vice Chairman Lykos noted the Applicant used the correct terminology and based on the Applicant's vocabulary and description of the work performed, it sounded as if he had the proper experience. He stated he had enough confidence in the Applicant to approve issuing a license. Chairman White and Robert Meister agreed. Kyle Lantz moved to approve Mica Ugrica's application for a license as a Building Contractor. 9 January 15,2014 Discussion: Terry Jerulle stated part of the responsibilities of an Applicant is to provide documentation and data. The application was not complete because the correct data was not provided to prove that he had the commercial experience. He further stated he would only approve issuing a license as a Residential Contractor. Chairman White noted the standard allows the Board to hear testimony, under oath, as well as written documentation. He asked Mr. Ossorio if the Board could issue a license with a probationary period of six months. Michael Ossorio stated the Board has never issued a new license with probation. He was not sure how the State would react—it could delay the registration by weeks. Chairman White called for a vote on the motion made by Mr. Lantz to approve Mica Ugrica's application for a Building Contractor's license. Motion carried, 8— "Yes"/1 — "Opposed." Mr. Jerulle was opposed. E. Paul Bolcavage—Review of Credit Report (d/b/a Starfish Electric & Home Services,LLC) Paul Bolcavage stated his debts were personal caused by the downturn in the economy. Michael Ossorio stated because his business credit was less than 12 months, the personal credit must be considered. He further stated Mr. Bolcavage met the criteria as an Electrical Contractor. Kyle Lantz asked what score was required. Michael Ossorio stated he has been in contact with the Department of Business- Professional Relations. His target score is 660. The applicant has been licensed in Miami-Dade. He has been licensed for years in Pennsylvania. The Applicant's score is 626. Vice Chairman Lykos moved to approve Paul Bolcavage's application for a license as an Electrical Contractor. Kyle Lantz offered a Second in support of the motion. Carried unanimously, 9—1. BREAK: 10:20 AM RECONVENED: 10:31 AM VIII. PUBLIC HEARING: (Note: Regarding case heard under Section VIII, the individuals who testified were first sworn in by the Attorney for the Board.) 10 January 15,2014 A. Case#2014-01: BCC vs. Mario Rodriguez, d/b/a "K.C. Tiles & Marble, Inc." Chairman White briefly outlined the order of the proceedings to be followed: • Open the Public Hearing; • Swear the witnesses; • Accept any evidence from the parties; • The County will present its "Opening Statement;" • The Respondent will present his/her"Opening Statement;" • The County will present its "Case in Chief;" • The Respondent will present his/her defense; • The County may offer any rebuttal; • Each Party may present a"Closing Statement," • The Public Hearing will conclude. • The Board will close the Public Hearing and begin deliberations. • The Board's Attorney will give a"Charge"to the Board, similar to the Charge given to a Jury, setting out the parameters on which the decision will be based. • During deliberations,the Board can request additional information and clarification from the parties. • The Board will decide two different issues: o First, whether the Respondent is guilty of the offense as charged in the Administrative Complaint. o A vote will be taken on the issue. o Second, if the Respondent is found guilty, the Board will decide the sanctions to be imposed. • The Board's Attorney will advise the Board concerning the sanctions which may be imposed and the factors to be considered. • The Board will discuss the sanctions and vote. • The Chair will orally report the decision of the Board. • The Final Order will include the complete details as required under State laws and procedures. Reggie Smith,Licensing Compliance Officer,requested to enter into evidence the packet of information previously provided to the Board Members. Richard Joslin moved to open the Public Hearing in Case No. 2014-01: The Board of County Commissioners vs. Mario Rodriguez, d/b/a "K. C. Tiles & Marble, Inc.,"License No.: 19105 (Tile and Marble Contractor) and License No. 21273 (Masonry Contractor), and to enter the information packet into evidence as County's Exhibit "1." Vice Chairman Thomas Lykos offered a Second in support of the motion. Carried unanimously, 9—0. It was noted the Respondent, Mario Rodriguez, did not offer any documents to be admitted into evidence. 11 January 15,2014 Reggie Smith presented the County's "Opening Statement:" • The County is prepared to show that Mario Rodriguez violated Ordinance #90-105, as amended, Section 22-201(2) as follows: "Contracting to do any work outside the scope of his/her competency as listed on his/her competency card and as defined in the Ordinance or as restricted by the Contractors'Licensing Board." Address: 1365 47th Avenue NE,Naples, Florida • The County is also prepared to show that Mario Rodriguez violated Ordinance#90-105, as amended, Section 22-201(6) as follows: "Disregards or violates, in the performance of his/her contracting business in the County, any of the building, safety, health insurance, or Workers'Compensation laws of the State or Ordinances of the County"by failing to secure and maintain Workers' Compensation insurance for his employees working at 1365 47th Avenue NE, Naples, Florida. Respondent,Mario Rodriguez,presented his "Opening Statement:" • There was an on-going legal case. • The Corporation and Mr. Trujillo, President, are fighting the charge of a of Workers' Compensation violation in Court. • It is our position that Robert Wiley was not our employee and it was not our jobsite. • We disagree with the findings of the Workers' Compensation Board investigation. • He was not sure whether the case would be heard in Court or during an Administrative Hearing. Chairman White asked the Respondent if he had anything to add concerning the Scope of Work issue. The Respondent stated he was not aware that pouring and forming concrete was out of the scope of work of his license. He has a Masonry Contractor's license and thought pouring concrete was allowed under his license. He further stated he was not contesting the violation concerning Scope of Work. County's "Case in Chief:" • On June 27, 2013, Reggie Smith received a phone call concerning an accidental death of a worker at a construction site at 1365 47th Avenue NE in Naples. • The new home construction was being built by Ash-Ann Homes, Inc., qualified by Ariel Gonzalez, Certified General Contractor, License Number#GCG-1510731. • A lightning strike occurred at the jobsite approximately 1:00 PM on June 26, 2013. • During the site visit, he obtained information from Ariel Gonzalez, Mario Rodriguez, and Workers' Compensation Investigator Jack Gumph for the State of Florida. 12 January 15,2014 • The deceased and an injured employee appeared to be working for K. C. Tiles & Marble, Inc., which was qualified by Mario Rodriguez. • K. C. Tiles & Marble, Inc. had been hired to perform concrete forming and placing. • K. C. Tiles &Marble, Inc. held a Masonry Contractor license and a Tile and Marble Contractor license through Collier County. • At the jobsite, he observed and photographed equipment in place for concrete forming and placing. • Mr. Smith informed Investigator Gumph that the case would be reviewed by the Contractors' Licensing Office Supervisor, Michael Ossorio, for two violations, i.e, working outside the scope of a license and Workers' Compensation insurance violation. Ariel Gonzalez was called as a Witness for the County. Reggie Smith questioned Mr. Gonzalez: Q. Are you a State-certified General Contractor and holder of License Number #GCG-1510731, licensed since 2006? A. Yes. Q. Are you the Qualifier for Ash-Ann Homes, Inc.? A. Yes. Q. Are you familiar with the newly constructed home located at 1365 47th Avenue NE in Naples, Florida, built by Ash-Ann Homes, Inc.? A. Yes. Q. (Reference: Exhibit E-32) Is this the home construction site located at 1365 47th Avenue, NE? A. Yes. Q. Did you hire K. C. Tiles & Marble, Inc. to perform concrete forming and placing at this jobsite? A. Yes? Q. Whom did you contract with to arrange the concrete work? What person did you actually make a contract with to perform the concrete work? A. Filmon Cendejas. Q. Were you aware that K. C. Tiles & Marble, Inc. did not have the required licensing to perform this work? A. No. Q. If you had known that K. C. Tiles & Marble, Inc. was not licensed to perform the concrete work, would you have hired them? A. No. Thank you very much. Chairman White asked the Respondent if he had any questions for the witness and the response was, "No." Jack Gumph, Senior Compliance Investigator—Division of Workers' Compensation for the State of Florida was called as a Witness for the County. 13 January 15,2014 Reggie Smith questioned Mr. Gumph: Q. How many years have you held this title? A. Four years. Q. Did you or do you have an active Workers' Compensation investigation concerning the address of 1365 47th Avenue NE,Naples, Florida? A. Yes, I do. As the Board does have the information in its packet, as Mr. Rodriguez has stated, there are two forthcoming cases with the State. The first is the Division of Workers' Compensation civil action and there is a subsequent criminal action in the Twentieth Judicial District. Chairman White: "Those are both circuit court proceedings? A. (Gumph) The first is a civil action with the State of Florida Division of Worker's Compensation in Tallahassee. Chairman White: "That's an agency action, then? Administrative?" A. (Gumph) Yes, sir. The second is ... Chairman White: "A criminal which, of course, is ..." Reggie Smith resumed questioning Mr. Gumph: Q. Who does your investigation concern? A. The investigation concerns K. C. Tiles and Marble, Inc. Q. (Reference: Exhibits E-39 through E-69) Is this the State's Workers' Compensation Investigation Report#13-172-D7 that you and your co-worker, Investigator Aysia Snodgrass, compiled and submitted for review? A. It is. Q. Can you please advise the Board of your investigation and findings? A. I am aware the Board has a copy of the State's investigative file and narrative. It is quite exhaustive. The information contained was that, on June 27, 2013, I was contacted by my office to go to the address in Golden Gate Estates to assist Investigator Snodgrass with the investigation. I did go to the location. During the course of the investigation, I spoke to certain individuals at the job site which is in your narrative. Based on information provided at interviews, this case was provided to the Legal Division of the State of Florida Division of Workers' Compensation in Tallahassee which subsequently recommended the issuance of a"Stop Work" Order to K. C. Tiles and Marble, Inc. for the violation of failure to obtain Workers' Compensation insurance. Chairman White informed Mr. Rodriguez that he would have an opportunity to cross-examine the Witness. Reggie Smith resumed questioning Mr. Gumph: Q. While you were on site on June 27th, I met you and you had interviewed specific persons. Can you tell me who you interviewed? 14 January 15,2014 A. The interviews on site were conducted with Mario Rodriguez, Filemon Cendejas who was the Project Manager/Supervisor for K. C. Tiles, Jose Cruz who was an employee of K. C. Tiles & Marble who was on site, Arturo Vallejo who was an employee of K. C. Tiles & Marble who was on site, Ariel Gonzalez who was the General Contractor for Ash-Ann Homes who was on site. Q. In reference to your interview with Filemon Cendejas, can you tell the Board what questions you asked Filemon Cendejas and his answers pertaining to the employment of Jose Cruz and Robert Wiley? A. Specifically, to the question of Jose Cruz,that Jose Cruz had submitted an application at one point to K. C. Tiles and was turned down. He was provided a second application, filled it out, and provided it to Filemon Cendejas who inadvertently failed to take it to the office. Then the incident happened with the lightning strike, at which time he [Filemon Cendejas] subsequently submitted it to the office. As to Mr. Wiley, Filemon Cendejas stated to me that Mr. Wiley showed up on the jobsite on the previous Monday. He was told to go to the office of K. C. Tiles & Marble to fill out an application. Cendejas left the jobsite and went to another jobsite. When he came back, Mr. Wiley was working and he assumed Mr. Wiley had gone to the office, filled out the application, and was given the "okay"to come back. Mr. Wiley worked for the rest of that Monday, Tuesday, and Wednesday until the lightning strike caused his death. Q. At any point in time,were you made aware of any filings for Workers' Compensation insurance made for either Mr. Wiley or Mr. Cruz? A. Yes, I subsequently gained knowledge that, on the date of the lightning strike, Filemon Cendejas went to the office of K. C. Tiles &Marble and provide the completed application. Subsequently on that date, the application was submitted to the PEO/Leasing Company for Mr. Cruz. Q. Just to be clear—that was after the accident occurred? A. That was after the accident—correct. Q. Can you explain what is known as a"time stamp?" A. When an application is provided to a PEO/Leasing Company, it is usually done either by email or by fax. I require them to provide the time-stamps as to when this occurs. Q. And was there time stamp information with this application? A. There was a time stamp with this application. It was somewhere around 5:00 or 5:30 that afternoon which was the day after the incident with the lightning strike. Thank you, Mr. Gumph. Chairman White asked the Respondent if he had any questions to ask Mr. Gumph. The Respondent had none. 15 January 15,2014 Vice Chairman Lykos: "Mr. Gumph, to the best of your recollection, was there an existing umbrella-type Workers' Comp policy or were all the employees of K. C. Tiles and Marble insured through a PEO? A. All were insured through a PEO. The County's "Case in Chief'was concluded. Chairman White asked Mr. Rodriguez to present his defense. Mario Rodriguez stated: • As I stated, Robert Wiley was not our employee at the time and that was not our jobsite. • Mr. Cendejas brought Mr. Wiley there without our knowledge. • He was very aware of our ... how we use staff leasing ... that everybody is supposed to apply and be approved by the staff leasing before they are put to work. • I think ... he didn't follow procedures because maybe he had other intentions and we're trying to prove that in Court now. Chairman White questioned the Respondent: Q. You are trying to prove that in the civil action and in the criminal case? A. I believe so, yes. Q. When you say `court,' I believe the only thing I understand that is technically in court is the criminal matter. A. I'm sorry, yes. Q. And there's the civil action with the State agency. A. Yes, in both. Yes. Q. Is there anything else that you have relative to the defense of the Workers' Comp action? A. We did have Workers' Comp coverage through the staff leasing company at the time. We were trying to do the right thing. But it was never submitted ... the application was never submitted ... Mr. Wiley never came in to fill out an application. We didn't even know about Mr. Wiley until after the accident. Q. It's your standard and practice to require employees to fill out an application that is then submitted to staff leasing. Is there also a requirement that the form, once it is completed, is then brought back and turned in to the foreman/supervisor/ project manager? Is that your custom and practice? A. It could be ... or directly to the office. Either way, it needs to be submitted to the staff leasing and approved by them. Richard Joslin questioned the Respondent: Q. What kind of document verification do you have when you hire an employee that you are going to send to staff leasing that the man, if he shows up at a job, and you want him to go and fill out the paperwork? Who handles making sure that this happens? Is that your supervisor who is supposed to do that? Or do you put that responsibility upon the person who wants to work? 16 January 15,2014 A. Both, actually. Mr. Wiley was supposed to come in and fill out the application and it was supposed to be approved before starting to work. Chairman White questioned the Respondent: Q. You have indicated that you do not believe that Mr. Wiley was an employee. What about with respect to Mr. Cruz? A. Well, with Mr. Cruz—it was ongoing because he submitted the application once and it was declined—was something wrong with the date on it. And then he filled it [out] a second time ... where Mr. Cendejas said that he had the application and he was going to bring it back to the office but he never did or, I mean, ... or he did after the incident. Q. So you had the completed application from Mr. Cruz—Mr. Cendejas did—but had not turned it in to staff leasing prior to that? A. Yes, he said he forgot it in his truck. Terry Jerulle questioned the Respondent: Q. Just so I understand. Mr. Wiley and Mr. Cruz were on the job site that day ... A. Yes. Q. ... pouring the concrete beams? A. Forming them, yes. Q. Forming the concrete beams for K. C. Tiles &Marble? A. Well, we weren't even aware of that jobsite at that time. Until after the accident, we weren't aware of that jobsite. Q. I thought you admitted earlier that ... A. I admitted that we did form and pour concrete at Ash-Ann Homes' other job site at 18th Street. And we did pay a fine for that. Because I wasn't aware that it was not covered under my Masonry license. Q. So you are contending that you had workers on a job site that you were not aware of? A. Exactly, yes. Q And those workers were performing work— forming a tie-beam outside your license? A. Yes. Q. And you are the Qualifier of the company? A. I am. Vice Chairman Lykos questioned the Respondent: Q. Can you tell me, to the best of your recollection, how many days Mr. Wiley and Mr. Cruz were actually working on that jobsite before the accident? A. I think it was—in the statement, it was three days that there were there—since Monday. Monday through Wednesday of that week. Q. The accident occurred on a Wednesday? A. On a Wednesday, yes. Q. Do you acknowledge that Filemon Cendejas was your employee? A. Yes. 17 January 15,2014 Q. And it is your testimony today that Mr. Cendejas was responsible for hiring employees for your company? A. Not completely, not without full authorization and not without getting—going through the application process and being approved by the staff leasing company. He was aware of that procedure. Q. So your testimony is that Mr. Cendejas was your employee ... A. Yes. Q. ... and that he had some level of involvement in hiring new employees ... A. Yes. Q. ... but that process extended beyond his job description? A. Correct, yes. Chairman White noted the distinction was important because of the narrative on Exhibit E-42 provided by Mr. Gumph of the Workers' Compensation agency. It stated that Mr. Rodriguez said Filemon Candejas ran the masonry jobs and had the authority to hire and fire employees on behalf of K. C. Tiles and Marble, Inc. Mr. Rodriguez made the distinction that Mr. Candej as had the authority as long as he complied with their policy and procedures to ensure that an application was filed, approved, and Workers' Compensation insurance existed for that person as an employee. Q. Is that correct? A. Yes, it is, sir. Kyle Lantz questioned the Respondent: Q. You are saying you didn't know you had a job at this address? A. Right. Q. Including the block work or just the tiling? A. None of it. We didn't know about that jobsite. Chairman White: "His statement in regards to ... Will his admission for the Scope of Work count on a house at 18th Street ... where the Workers' Compensation issues are on a house that's on 47th Avenue." Kyle Lantz resumed questioning the Respondent: Q. You have admitted that you have done block work and tiling work? A. Yes. Q. How do you bill? Do you get money upfront? Do you get draws after the block before you begin the tiling? Do you just wait until the job is complete? How do you do that? A. It could change. Usually, an estimate upfront and payment when the job is complete. Q. An estimate? So you give them an estimate upfront and you don't get a dime until the job is complete? 18 January 15,2014 A. Yes .... or ... or sometimes, partially. I'm not completely sure. Q. Okay. So the other job that you did ... that you admitted doing ... how did you bill for that? Did you get a block draw and then a tiling draw or an upfront draw or you got a final payment? A. I can't recall those details. I don't remember. Q. And for this particular job, you never received any payment? A. No. Chairman White: "The one on 47th Avenue?" Respondent: "Right." Vice Chairman Lykos questioned the Respondent: Q. Did your company sign a contract with Ash-Ann Homes? Did your company have a written contract with Ash-Ann Homes for that project? For the project in question where the accident occurred. (47th Avenue) A. No, we don't. Q. You didn't have a contract for that project? A. No. Terry Jerulle questioned the Respondent: Q. Was Mr. Cruz paid that week by K. C. Tiles and Marble, Inc.? A. I'm not sure. I can't recall. I'd have to find out. Q. How about Mr. Cendejas—was he paid? A. That week? I'm not sure of the details, either. Q. You are the Qualifier of the company? A. Yes, Iam. Q. And you're responsible for those aspects of the company? A. Not on a daily basis. But I keep track of, you know, I stay informed. Q. But you don't know if those two people have been paid by K. C. Tiles and Marble for those dates—Monday, Tuesday, and Wednesday? A. Well, no, because we didn't know about that jobsite. We weren't aware of it. Q. I didn't ask if K. C. Tiles & Marble was paid—I asked if K. C. Tiles &Marble paid its employees that week. Chairman White asked if the two men were paid; did their pay include work for the house on 47th Avenue or if it was only for work that may have been performed on 18th Street for that week. A. I don't have those details. Kyle Lantz: "This job now has—I will assume—it's not stalled and the tie-beam has been poured and people have moved on? Am I correct?" Michael Ossorio: "The homeowner flew in from California and fired Ash-Aim Homes, Inc. He obtained an owner/builder permit and proceeded with the job." 19 January 15,2014 Kyle Lantz questioned the Respondent: Q. The blocks that were installed on the site and the rebar that was installed on the site—who paid for that? A. I don't know. Q. Can you say if it was K. C. Tiles & Marble? A. No, I know it wasn't. Q. So you did not pay for the block? You didn't pay for the rebar? A. No. Q. Typically when you do those jobs, do you supply materials or just the labor? A. It could be either way. The Masonry division that we were doing with Mr. Cendejas was fairly new. It had only been two or three months, I believe. So we didn't have a long, established procedure yet. We were starting to do some work but ... you know .... Q. So the other job you did—did you pay for the materials or just labor? A. I don't recall. I don't recall exactly on that. Q. Do you know much about your business? A. I do ... but ... Richard Joslin questioned the Respondent: Q. Was there a contract for the job on 18th Street? Did you have a contract for that job to do that work? A. There was an estimate accepted ... an estimate on that one, yes. Q. And it included the same basic things that you were performing at 18th ... and you don't know what was performed at 47th ... they were doing the same work? A. Yes. Q. But you had a contract for that job? A. Yes. Chairman White asked Mr. Rodriguez if he had any concluding comments on his defense and the response was, "No." Reggie Smith questioned the Respondent: Q. How long as Filemon Cendejas been working for K. C. Tiles and Marble? A. A few months, I can't recall exactly the ... it's only been a few months. I don't remember the date exactly ... Q. Maybe about the timeframe of April, 2013? A. It could be. Q. The incident took place in late June. Mr. Cendejas' payroll ... Is he paid on a weekly basis as a field supervisor or is he paid by piece work as per job? A. No, he's paid a salary. It's been according to the work flow. I don't believe it's been regular pay. We are trying to get the Masonry division going. We didn't have a steady work flow to be doing regular, weekly pay. Q. Would you estimate that he is working on a weekly basis and getting paid on a weekly or bi-weekly basis for his supervisory application? 20 January 15,2014 A. I'm not sure of the details. I just want to clarify something—I don't know some of these details because I haven't been there every day. My father is getting elderly and his health has gone down. For the past year, I have been working on the east coast, taking care of my parents and trying to help him with his business. So I have left those daily details to Mr. Trujillo. That's why I haven't been here every day, so I don't know all the little details. Another thing I want to mention is we're going to be moving, actually some time in the summer—because of the family health situation—to the east coast. It was my intention anyway to cancel these two licenses this year since I'm not directly involved with what's going on every day. That's the reason why I don't know all the details. Kyle Lantz questioned the Respondent: Q. Your project manager—Filemon Candejas—he started working in April and this incident happened in June. And you're saying you don't know how you got the job or if he was doing it as a side job or what the deal was? You just don't know about it? A. Right. Q. Is he—is he still employed by you? A. No. Q. When was his termination? A. Right after the incident. Richard Joslin questioned the Respondent: Q. Who actually hired him? A. Mr. Trujillo. Q. The owner of K. C. Tiles & Marble, Inc.? A. Yes. Michael Ossorio: "We have no more questions for Mr. Rodriguez." The Respondent's Defense was concluded. Ariel Gonzalez, Witness for the County, was recalled to testify. He was reminded that he was still under oath. Kyle Lantz questioned the Witness: Q. You hired K. C. Tiles & Marble, Inc. to do block work and tie-beam at a previous job. Correct? A. Yes. Q. How did you pay them? A. I paid—full pay. Just one pay at the end of the job. Q. At the end of the job? A. Yes. 21 January 15,2014 Q. Did they supply the materials and labor or just the labor? A. Just the labor. Q. And that was the same deal on this particular job—you were hiring them just for the labor? A. Yes. Chairman White: "So on both 18th Street and 47t1'Avenue—it was the same Arrangement—they provided the labor and you provided the materials, and they were paid at the end? A. Yes, correct. Kyle Lantz resumed questioning the Witness: Q. Who was it that you dealt with at K. C. Tiles &Marble, Inc.? A. Filemon Cendejas. Q. For everything? So for the first job, you handled the contract ... A. Okay. The clients—both are families—the 18th and the 47th. The family is a friend of mine. And when I talked to Filemon the first time, before I started the first job, I asked him about his company. I have known Filemon for about two or three years. He said he worked for K. C. Tiles &Marble. I talked to the office for K. C. Tiles & Marble before the first job and then we agreed about the prices—just for square feet—for the labor only. Vice Chairman Lykos questioned the Witness: Q. Do you have a written, executed contract with K. C. Tiles &Marble for the home at 1365 47th Avenue? A. No. I just do a verbal agreement. Q. So you don't have any written agreements on that house or ... what about the house on 18th Street? A. In writing? Q. Right. A. No, no, I don't have in writing. Chairman White: "What about the house on 18th Street? Do you have a written contract for the house on 18th Street?" A. Yes. Did you say—writing? Q. Yes. A. No, no, we don't have nothing in writing. Not on the first and not on the second one. Both are verbal. Terry Jerulle questioned the Witness: Q. On the house on 18th Street—was that started and completed first? A. Yes. Q. Can you just help me understand—you had foundation footings? A. Yes. Foundation, blocks, and footings. Q. And K. C. Tiles and Marble did all of that? A. All of that. 22 January 15,2014 Q. When they poured the foundation, did you pay them for it? A. No. Q. When they poured the slab, did you play them for the slab? A. No. Q. And they did the block work? A. Yes. Q. Did you pay them for the block work? A. No. Q. They did the tie-beams? A. Yes. Q. And did you pay them? A. All together. Q. You paid all of it at once? A. All together at once. Q. So, the house on 47th Avenue. A. Can I tell you something? Q. Yes, sir. A. When we finished the house on 18th Street,they sent to me invoices and on the invoices it said, "Any questions or anything in regard to the job,just contact our office to Filemon Cendejas." That's why I talked to Filemon Cendejas. Q. Okay. So when the house on 47th Avenue came available and you wanted to hire a subcontractor to do the work, you contacted Filemon? A. Yes. I said is it was the same price we talked about the first time, he said yes, and we started again. Q. They formed and poured the foundation? A. Yes. Q. They poured the slab? A. Yes. Q. They installed the block? A. Yes. Q. And they were forming the tie-beams when the accident happened? A. Yes. Q. And you were going to pay .... A. When they finished pouring the concrete, they sent me an invoice. Q. And you were going to pay K. C. Tiles and Marble? You were not going to pay Filemon Cendejas? A. I didn't pay to anybody. Q. Because he doesn't have a license? A. (nodded affirmatively) Vice Chairman Lykos questioned the Witness: Q. In your dealings, in your contractual relationship with K. C. Tiles &Marble, at any point did you ask K. C. Tiles & Marble for verification of their licenses? A. Yes. But, true, I never received the paperwork. Q. So you asked for license documentation but never received it? A. No. 23 January 15,2014 Q. Did you ask for copies of their Workers' Comp .... A. Yes, for everything. I asked for everything. Q. Did you receive copies of their Workers' Comp policy? A. No. No. I didn't have the papers on me. That's why Workers' Comp audited my company. And I paid. Q. Did your company have a Workers' Compensation insurance policy? A. No. Q. Are the owners exempt? A. I am the owner and exempt. I don't contract any workers. Q. How long as your company been in business? A. 2006. Q. And do you have an annual audit from Workers' Comp? A. No. Q. Because you don't have Workers' Comp? A. Because I don't have any workers. Terry Jerulle questioned the Witness: Q. You did not have a written contract with K. C. Tiles &Marble on the house on 18th Street, but you had an oral—or implied—contract? A verbal contract? A. A verbal contract, yes. Q. And it was your understand that you still had the same verbal contract—or implied contract—for the house on 47th Avenue? A. Yes. Kyle Lantz: "It's very late on this ... but after all this discussion, but I have had a relationship with Filemon Cendejas and K. C. Tiles & Marble. It was probably four years ago. I just wanted to disclose it. I didn't"put 2 +2 together"because it was one little, tiny job that I did." Chairman White: "They are not the Respondent. But, thank you for the disclosure. You don't have, today, any fiduciary interest in the outcome?" Kyle Lantz: "None at all. But I had hired Filemon Candejas through K. C. Tiles & Marble—three or four years ago. I didn't recognize the name until I looked it up on my cell phone—but I just wanted to disclose it. I never met any of these people before." Chairman White asked James Morey, Counsel to the Board, to outline the criteria concerning "conflict of interest." Attorney Morey explained: • "Form 8-B" is required by the County to be completed • It is to be used by anyone serving on a municipal board who must abstain from voting on a measure which inures to (i.e., benefits) his/her special, private gain(or loss) ... if you had a financial interest or an ongoing relationship. For example, if someone were to lose his/her license, it could impact your business. • In Mr. Lantz's situation,the contact was in the distant past and it was relatively minor. 24 January 15,2014 Mr. Morey concluding by stating it would not be necessary for Mr. Lantz to file a"Form 8-B." Vice Chairman Lykos questioned the Witness: Q. Is it your understanding that Filemon Cendejas was a representative of K. C. Tiles & Marble, Inc.? A. Yes. Q. Is it also your understanding that you were to negotiate and work directly with Mr. Cendejas in your relationship with K. C. Tiles & Marble, Inc.? A. Yes. Q. Is it also true that you received paperwork from the office of K. C. Tiles & Marble referring you to Mr. Cendejas with regard to your relationship with K. C. Tiles & Marble? A. Correct. Q. Is it also your testimony, sir, that in your relationship with K. C. Tiles & Marble, that you would negotiate with Mr. Cendejas, that you would have a verbal agreement with Mr. Cendejas which contracted you and K. C. Tiles & Marble. and at the end of the work, you would then pay for the work that was completed? A. Yes. Chairman White verifying there were no additional questions or witnesses to be heard. Michael Boyd asked if K. C. Tiles & Marble, Inc. had renewed its licenses with the County. Michael Ossorio responded that K. C. Tiles &Marble and the Qualifier, Mario Rodriguez, were in suspended status because the license had not been renewed. But Mr. Rodriguez could renew his license if he so chose. Vice Chairman Lykos verified the license would be considered"suspended" until the end of 2014. Mr. Rodriguez could renew his license at any point during the next 11 months. Mario Rodriguez stated he did not intend to renew either license because he will be moving. He did not cancel his licenses due to the current legal proceedings. Richard Joslin moved to approve closing the Public Hearing. Vice Chairman Lykos offered a Second in support of the motion. Carried unanimously, 9— 0. Chairman White asked the Board's Attorney to present the Charge. Attorney Morey outlined the Charge to the Board: • The Board shall ascertain in its deliberations that fundamental fairness and due process were accorded to the Respondent. • That, pursuant to Section 22-203(g) (5) of the Codified Ordinance, the formal Rules of Evidence set out in Florida Statutes shall not apply. • The Board shall consider solely the evidence presented at the Hearing in its deliberation of the matter. 25 January 15,2014 • The Board shall exclude from its deliberations irrelevant, immaterial, and cumulative testimony. • The Board shall admit and consider all other evidence of a type commonly relied upon by reasonably prudent persons in the conduct of their affairs, whether or not such evidence would be admissible in a Court of Law. • Hearsay evidence may be used to explain or supplement any other evidence but hearsay, by itself, is not be sufficient to support a Finding unless such hearsay would be admissible over objection in a civil action in Court. • The Standard of Proof in actions where a Respondent may lose his/her privileges to practice his/her profession is that the evidence presented by the Complainant must prove the Complainant's case in a clear and convincing manner. • The Burden of Proof on the Complainant is a larger burden than the "Preponderance of Evidence" standard set in civil cases. • The Standard of Evidence is to be weighed solely as to the charges set out in the Complaint. • The only charges the Board may decide upon are the ones to which the Respondent has had an opportunity to prepare a defense. • The damages awarded by the Board must be directly related to the charges. • The decisions made by the Board shall be stated orally at the Hearing and are effective upon being read, unless the Board orders otherwise. • The Respondent, if found guilty, has certain appeal rights to the Contractors' Licensing Board,the Courts, and the State's Construction Industry Licensing Board ("CILB"), if applicable. • The Board shall vote upon the evidence presented in all areas and if the Respondent is found in violation, shall adopt the Administrative Complaint. • The Board shall also make Findings of Fact and Conclusions of Law in support of the charges set out in the Complaint. Chairman White opened the floor to discussion. Chairman White stated: • Regarding Count I of the Administrative Complaint pertaining to contracting outside the Scope of Work, it seemed clear based both on the evidence and the admission of the Respondent, that a finding of guilty would be appropriate. • Regarding Count II, disregarding or violating the laws of the State pertaining to Workers' Compensation insurance. The Respondent stated as his defense that there was no contract, there were no employees. The County's case and the witness indicated that the pattern and practice of how business was conducted for K. C. Tiles and Marble allowed oral or verbal arrangements, payments were subsequently made at the completion of jobs. Barring the tragic accident, that is what would have happened for the residence at 47th Avenue. 26 January 15,2014 Richard Joslin agreed there was a verbal, implied contract for both jobs. There was no written contract but the men were on the jobsite. Someone knew those men were on the job and hired them. Mr. Gonzalez stated he paid K. C. Tiles & Marble for the first job (18th Street). Discussion ensued concerning whether or not the Board had jurisdiction to enter a judgment in lieu of the pending action in Criminal Court and the Administrative proceeding with the State's Worker's Compensation division. Attorney Morey confirmed the Board could make a determination based on the evidence presented and the testimony heard by the members. Vice Chairman Lykos moved to approve finding the Respondent guilty as to Count I of the County's Administrative Complaint. Richard Joslin offered a Second in support of the motion. Carried unanimously, 9-0. Vice Chairman Lykos moved to approve finding the Respondent guilty as to Count II of the County's Administrative Complaint. Kyle Lantz offered a Second in support of the motion. Carried unanimously, 9-0. Attorney Morey noted the Board found the Respondent to be guilty and the Respondent is a Collier County licensed Contractor. He holds two licenses: Tile and Marble Contractor(License#19105) and Masonry Contractor (License #21273.) He stated if the Respondent is the holder of Collier County Certificate of Competency and has been found to be guilty, the Contractors' Licensing Board may, but is not required to, impose any of the following Sanctions, either alone or in combination: (1) Revocation of a Collier County (or City) Certificate of Competency, (2) Suspension of a Collier County (or City) Certificate of Competency, (3) Denial of the issuance or renewal of a Collier County (or City) Certificate of Competency, (4) Imposition of a period of probation, not to exceed two years in length, during which time the Contractor's contracting activity shall be under the supervision of the Collier County Contractors' Licensing Board, (5) Imposition of a fine not to exceed $5,000, (6) Issuance of a public reprimand, (7) Requirement for re-examination or participation in a duly-accredited program of continuing education directly related to the Contractor's contracting activity, (8) Recovery of reasonable investigative costs incurred by the County for the prosecution of the violation, and (9) Denial of the issuance of Collier County or City building permits or requiring the issuance of such permits with specific conditions. 27 January 15,2014 Attorney Morey further advised the Board that, when imposing any of the possible Disciplinary Sanctions on a Contractor,the Contractors' Licensing Board may consider all the evidence presented during the Public Hearing as well as: (1) The gravity of the violation; (2) The impact of the violation on Public Health/Safety or Welfare; (3) Any actions taken by the violator to correct the violation(s); (4) Any previous violations committed by the violator, and (5) Any other evidence presented at the Hearing by the parties relevant to the Sanction which is appropriate for the case, given the nature of the violation(s) or the violator. Michael Ossorio stated the County had spent several weeks on the case and incurred administrative costs of$1,000. per Count for a total of$2,000. Recommendations: • Revocation of Mr. Rodriguez' Certificates of Competency (Tile and Marble; Masonry) • A fine of$5,000 per Count • Public Reprimand Richard Joslin moved to approve imposing the following Sanctions with regard to Mario Rodriguez, d/b/a K. C. Tiles and Marble,Inc.: • Payment of a fine in the amount of$10,000; • Payment of the Administrative Costs incurred by the County in the amount of$2,000; • Revocation of Mr. Rodriguez's Tile/Marble Contractor's License #19105 and his Masonry Contractor's License #21273; and • Issuance of a Public Reprimand. Vice Chairman Lykos offered a Second in support of the motion. Carried unanimously, 9—0. Chairman White outlined the Findings of Fact: • The Respondent, Mario Rodriguez, is the holder of record of two Collier County Certificates of Competency: #19105 (Tile/Marble Contractor) and #21273 (Masonry Contractor) • The Board of County Commissioners, Collier County, Florida, Contractors' Licensing Board is the Petitioner(Complainant) in this matter. • The Board has jurisdiction of the person of the Respondent. • Respondent, Mario Rodriguez, was present at the Public Hearing and was not represented by Counsel at the Hearing held on January 15, 2014. • All notices required by Collier County Ordinance 90-105, as amended, had been properly issued and were personally delivered. • Based on the evidence presented, the Respondent acted in a manner that is in violation of Collier County Ordinances and is the one who committed the act. 28 January 15,2014 • • The allegations of fact as set forth in Administrative Complaint as to: o Count 1, under Section 22-201(2) of Ordinance#90-105, as amended: "Contracting to do any work outside the scope of his/her competency as listed on his/her Competency Card and as defined in this Article or restricted by the Contractors' Licensing Board" and o Count II, under Section 22-201(6) of Ordinance #90-105, as amended: "Disregards or violates, in the performance of his/her contracting business in the County, any of the building, safety, health, insurance, or Workers' Compensation laws of the State or Ordinances of this County, " were found to be supported by the evidence presented at the Hearing. Conclusions of Law: • The Conclusions of Law alleged and set forth in the Administrative Complaint as to Count I and Count II were approved, adopted and incorporated herein, to wit: The Respondent violated Section 22-201(2) of Collier County Ordinance 90-105, as amended, regarding Scope of Work, and Section 22-201(6) regarding the Workers' Compensation violation. Order of the Board: • Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and in Collier County Ordinance 90-105, as amended, by a vote of nine (9) in favor and none (0) in opposition, a majority vote of the Board members present, the Respondent has been found in violations as set out above. • Further, it is hereby ordered by a vote of nine (9) in favor, and none (0) in opposition, a majority vote of the Board members present, that the following disciplinary Sanctions are hereby imposed upon Mario Rodriguez,the holder of Collier County Certificates of Competency#19105 (Tile/Marble Contractor) and#21273 (Masonry Contractor), to wit: o Payment of a fine in the total amount of$10,000; o Reimbursement of the Administrative Costs incurred by the County in the total amount of$2,000; o Revocation of Mr. Rodriguez's Tile/Marble Contractor's License #19105 and his Masonry Contractor's License#21273; and o Issuance of a Public Reprimand. Chairman White noted the case was closed. Chairman White advised the Respondent if he chose to appeal the Board's decision, he must obtain a verbatim record of the proceedings. (Terry Jerulle and Ronald Donino left @ 11:44 AM). (Quorum was maintained— 7 voting members) 29 January 15,2014 BREAK: 11:45 AM RECONVENED: 11:55 AM B. Case#2014-02: BCC vs. Seth B. Hollander, d/b/a "Hollander Construction Company,Inc." Chairman White noted Mr. Hollander had been present during the previous Hearing and heard the recitation of how the proceeding was to be conducted. He asked the County to place its information packet into evidence. Richard Joslin moved to open the Public Hearing in Case No. 2014-02: The Board of County Commissioners vs. Seth B. Hollander, d/b/a "Hollander Construction Company, Inc.,"License #201300000579, and to enter the information packet into evidence as County's Exhibit "1." Vice Chairman Thomas Lykos offered a Second in support of the motion. Carried unanimously, 7—0. Thomas Keegan,Licensing Compliance Officer,presented the County's "Opening Statement:" • The Respondent is Seth B. Hollander, d/b/a"Hollender Construction Company, Inc.," a suspended Excavation Contractor, Suspended License #210300000579. • Mr. Hollander was cited for violating Collier County Ordinance 90-105, as amended, Section 22-201(6): "Disregards or violates, in the performance of his/her contracting business in the County, any of the building, safety, health, insurance, or Workers' Compensation laws of the State or Ordinances of this County, " • On Friday, December 20, 2013, a complaint was received from Paleiiuo Pavers, Inc., regarding the installation of pavers at 12823 Valewood by Hollender Construction Company. • A site inspection was conducted and the excavation of a driveway was observed. • Two individuals identified themselves as Wayne Boswell and Hugh Campbell and stated they were employed by Hollender Construction Company, Inc. They began working for the company on Monday, December 16, 2013. • When asked, the men stated they had not completed any employment applications for the company. • Research conducted indicated the Workers' Compensation insurance policy for Hollender Construction had been cancelled on October 5, 2013. • Seth Hollander was contacted; he stated the two men were employed by Hollender Construction and that he had insurance coverage for them. He was advised that the Workers' Compensation policy had been cancelled, and was requested to come to the jobsite. 30 January 15,2014 • The homeowner was contacted; he verified that he hired The Construction Managers, Certified General Contractors. John Varsames was the Qualifer. • Mr. Varsames was contacted; he stated he subcontracted the excavation portion of the project to Hollender Construction. Mr. Varsames was advised that the subcontractor did not have Workers' Compensation coverage for his employees. • Jack Gumph, Senior Compliance Investigator—Division of Workers' Compensation, came to the jobsite and confirmed that Policy#10652685 had been cancelled for non-payment of the insurance premium. • Mr. Hollender arrived at the jobsite. He was advised he could no longer continue to work on the project due to the lack of Workers' Compensation coverage for his two employees. He was requested to meet Investigator Keegan at the Contractors' Licensing Office at a later time. • John Varsames and the homeowner were advised of the situation. • Mr. Hollender admitted that he knew the Workers Compensation policy had been cancelled and was served a Notice of Hearing to appear before the Contractors' Licensing Board on January 15, 2014 for violating the probation ordered by the Board on October 16, 2013. • Mr. Hollander's license as an Excavation Contractor was suspended by Michael Ossorio, Contractors' Licensing Office Supervisor. Seth Hollender presented his"Opening Statement:" • He admitted the County's complaint for failure to obtain Workers' Compensation coverage was true. • He claimed it was an administrative oversight on his part and as soon as he was aware of the cancellation in late November, he began the process to reinstate the policy. • He was audited by the State and it took approximately 2 V2 to obtain the results before the policy could be reinstated. • The Workers' Compensation policy was reinstated through Florida Citrus, Business and Industries Fund on Monday, December 23` . Thomas Keegan added Mr. Hollander was issued a"Stop Work" Order by the State of Florida on December 20, 2013 for failure to obtain Workers' Compensation coverage. The "Stop Work" Order remained active and had not been cleared. Chairman White clarified that prior to being notified of the alleged violation, the Respondent had begun the process correct the situation and reinstate the Workers' Compensation policy. Seth Hollender: "Yes, sir." He confirmed the State-issued "Stop Work" Order was still active based on the insurance audit. Vice Chairman Lykos questioned the Respondent: Q. You claim that ... When did you become aware that your policy had been cancelled? 31 January 15,2014 A. The end of November. Q. How were you notified? A. My insurance agent. Q. That appears to be more than thirty days after the policy was actually cancelled. The policy was cancelled on October 5, 2013 due to non-payment of premium. A. That's correct. Q. Were you aware that you hadn't paid the premium? A. It was an oversight on my part. Q. So, you didn't pay the premium --- you didn't know you hadn't paid the premium. So you didn't know that you policy had terminated on October 5th because you didn't know you hadn't paid the premium? A. That is correct. Q. And then you were finally notified at the end of November by your insurance agent that your policy was cancelled. A. That it may not have been cancelled but I needed to contact them immediately in order to either continue the policy or pay them what was still owed on the back payments to keep the policy active or to then go through the proceedings to re- instate the policy. Q. Let me restate my question. When did you become aware that your policy had been cancelled? A. It was the end of November—early December. Within the first few days of December. Q. According to the testimony provided to Mr. Keegan on site, the two employees— Mr. Boswell and Mr. Campbell—were both hired and started working for you on or about December 16th? A. That's correct. Q. You hired two new employees and put them on a job site, knowing that your policy had been cancelled? A. That was in the process of being reinstated. Q. It's a"yes" or"no" question, sir. A. Yes, sir. Q. Thank you. Richard Joslin questioned the Respondent: Q. Do you have an idea, sir, why Mr. Lykos asked his questions? Why, if you knew your policy was cancelled in November, did you put two new employees on the job in December? You just stated in your testimony that you knew your policy was cancelled. A. I did. Q. You began the process of putting it back together again but ... A. That's correct. Q. ... knowing that it wasn't, you still chose to put two men on the job. A. I did. Q. Okay. A. I don't have any excuses. 32 January 15,2014 Q. No excuse ... no answer. A. There isn't an excuse. Chairman White asked if the County had incurred any Administrative costs. Michael Ossorio replied the total amount was $525.00. It was noted if there was a finding of a violation and a decision to impose Sanctions, reimbursement of the costs would be included in the Board's Order. Vice Chairman Lykos moved to close the Public Hearing. Michael Boyd offered a Second in support of the motion. Carried unanimously, 7—0. Chairman White called for discussion on a finding of a violation. (No discussion.) Vice Chairman Lykos moved to approve finding the Respondent guilty as to Count I of the County's Administrative Complaint. Gary McNally offered a Second in support of the motion. Carried unanimously, 7—0. Attorney Morey reminded the Board of the existing Order which had been issued in October, 2013 which placed Mr. Hollender on probation. Attorney Morey noted the Board found the Respondent, Seth Hollander, to be guilty and he is a Collier County licensed Excavation Contractor, License#20130000057. He stated the Board may revisit the terms and conditions of the existing Order as well as impose any of the following Sanctions, either alone or in combination: (1) Revocation of a Collier County (or City) Certificate of Competency, (2) Suspension of a Collier County (or City) Certificate of Competency, (3) Denial of the issuance or renewal of a Collier County (or City) Certificate of Competency, (4) Imposition of a period of probation, not to exceed two years in length, during which time,the Contractor's contracting activity shall be under the supervision of the Collier County Contractors' Licensing Board, (5) Imposition of a fine not to exceed $5,000, (6) Issuance of a public reprimand, (7) Requirement for re-examination or participation in a duly-accredited program of continuing education directly related to the Contractor's contracting activity, (8) Denial of the issuance of Collier County or City building permits or requiring the issuance of such permits with specific conditions, and (9) Recovery of reasonable investigative costs incurred by the County for the prosecution of the violation. 33 January 15,2014 Attorney Morey further advised that, when imposing any of the possible Disciplinary Sanctions on a Contractor, the Contractors' Licensing Board may consider all the evidence presented during the Public Hearing as well as: • The gravity of the violation; • The impact of the violation on Public Health/Safety or Welfare; • Any actions taken by the violator to correct the violation; • Any previous violations committed by the violator, and • Any other evidence presented at the Hearing by the parties relevant to the Sanction(s) which is appropriate for the case, given the nature of the violation or the violator. Michael Ossorio noted Seth Hollender's license was suspended pursuant to the previous Order of the Board, issued on October 16, 2013. Mr. Hollender was ordered to pay a fine in the amount of$500/per month for the previous violation (total fine: $2,500). He has continued to make the installment payments and fulfill his obligations. Mr. Ossorio further stated the Stated Construction Industry Licensing Board ("CILB") will be notified of the proceedings and the Board's decision. He stressed notification to the State was important to prevent any Respondent from applying to become a State-Certified Contractor even though his/her license had been suspended locally. Recommendations: (1) Suspension/revocation of Mr. Hollender's Certificate of Competency for a period of one year; and (2) Mr. Hollender must continue to pay the previously imposed fine in the amount of$500 per month as well as any other fees and fines; It was noted the State's Workers' Compensation Division may assess a penalty because Mr. Hollender allowed his employees to work while the insurance coverage had lapsed. Mr. Hollender will be required to pay an additional premium for the reinstated policy. Vice Chairman Lykos: • By allowing the Workers' Compensation policy to lapse, Mr. Hollender put his employees and the property owner at risk; • It is the Contractor's responsibility to ensure that his/her employees are protected at all times; • Suggested imposing a second fine in the full amount of$5,000; • Agreed the revocation period should be one year. Chairman White asked the Board's Counsel if a revocation could be imposed with a time limit. He asked if it would be possible for the Board to state it would not entertain an application from Mr. Hollender for at least one year. 34 January 15,2014 Attorney Morey stated the Board had the authority to impose a reasonable condition on any Sanction. • "If it's revoked, it's revoked. The Board can certainly send a clear message concerning its expectations." Vice Chairman Lykos noted if the Board"suspended" Mr. Hollender's license, it would have the intended effect, i.e., he would have to re-apply to the Board at a future date and the suspension would be noted"on the record"for one year. But if the license was "revoked," it would be gone and Mr. Hollender could go to another jurisdiction and apply for a new license. Michael Ossorio confirmed after a period of one year, Mr. Hollender could choose to petition the Board for reinstatement of his license. If he did not, the license would become null and void. He further stated if the license is suspended for one year, Mr. Hollender must pay all imposed fines and penalties before he could submit a full application to the Board for a Hearing on the suspension. Chairman White noted: • Mr. Hollender is currently under a 24-month probation; • His permit-pulling privileges have been suspended; • He must continue to make the payments of the fines imposed under the prior Order of the Board; • He is to take and pass the Business Procedures Exam within six months of the issuance of the prior Order; and • If he violates any of the terms of the prior Order, he must appear before the Board at a Hearing. Michael Ossorio clarified Mr. Hollender does not have an active license and cannot work. He explained even if the State rescinded the "Stop Work" Order because the Workers' Compensation coverage was reinstated, Mr. Hollender still could not accept any jobs. He further stated if the Board chose to suspend his license,the suspension could run concurrently with the previous Order, i.e.,two years from October 16, 2013. Robert Meister asked what would happen if Mr. Hollender were "caught" working during the next year with a suspended license. Michael Ossorio stated he would be fined $1,000 for a first offense; $2,000 for a second offense, and if there were a third offense, the County Attorney's Office could pursue criminal charges. Attorney Morey stated Mr. Hollender could not work as a Contractor or subcontractor but he could work as an employee of a licensed, qualified company. Seth Hollender asked if he would be prevents from having someone else qualify his business. 35 January 15,2014 Michael Ossorio replied he could own a business but could not serve as the Qualifier of that business. The Qualifier would submit an application and appear before the Board for a full review. Chairman White stated, prior to making a decision, he tests whether the violation was inadvertent or intentional. In the prior case, the intention may have been inadvertent. In the current case before the Board, he is considering a severe fine. Vice Chairman Lykos moved to approve imposing the following disciplinary Sanctions: • Imposing a fine of$5,000 to be paid in full by December 31, 2014; • Suspending his license for a period of 21 months, ending on October 16, 2015; • Requiring reimbursement to the County for Administrative costs incurred in the amount of$525; • Continuation of the previous Order requiring payments to be made for three more months. Chairman White restated the Mr. Lykos'motion: • To suspend the Respondent's license until the end of the probationary period under the prior Order, i.e., October 16, 2015; • Imposing a fine of$5,000 to be paid by December 31, 2014; • Payment of the Administrative Costs incurred by the County in the amount of$525 within 90 days of the issuance of the Board's Order. • If reimbursement to the County is not made within the 90-day period, the Respondent must appear before the Board at a Hearing; • Issuance of a public reprimand. Michael Ossorio clarified if the Respondent complies with the terms of both Orders and all fees/fines are paid in full by January 1, 2015, Mr. Hollender may petition the Board for a Hearing on his suspension any time after October 16, 2015. Vice Chairman Lykos suggested that if Mr. Hollender chooses to petition the Board, that he present a complete plan detailing how he intends to manage his business in compliance with the Collier County's Ordinances. Chairman White asked the Respondent if he understood the Board's discussions and decision. Seth Hollender replied he fully understood. Chairman White offered a Second in support of the motion and called for a vote. Motion carried, 6— "Yes"/1 — "No." Richard Joslin was opposed. Chairman White outlined the Board's Order: • This Cause came on for Public Hearing before the Contractors' Licensing Board on January 15, 2014 for consideration of the Administrative 36 January 15,2014 Complaint in Case #2014-02 filed against the Respondent, Seth B. Hollander, d/b/a"Hollander Construction Company, Inc."the holder of record of Collier County Certificate of Competency Number 201300000579. • Service of the Complaint was consistent with the requirements of Collier County's Code of Laws and Ordinances. • The Board heard testimony under oath, received evidence, and heard arguments respective to all appropriate matters, and issued the following Findings of Facts and Conclusions of Law. Findings of Fact: • The Respondent, Seth B. Hollender, is the holder of record of Collier County Certificate of Competency: #201300000579 (Excavation Contractor). • The Board of County Commissioners, Collier County, Florida, Contractors' Licensing Board is the Petitioner(Complainant) in this matter. • The Board has jurisdiction of the person of the Respondent. • Respondent, Seth B. Hollender, was present at the Public Hearing and was not represented by Counsel at the Hearing held on January 15, 2014. • All Notices required by Collier County Ordinance 90-105, as amended, had been properly issued and were personally delivered. • Based on the evidence presented, the Respondent acted in a manner that is in violation of Collier County Ordinances and is the one who committed the act. • The allegations of fact as set forth in Administrative Complaint as to: o Count 1, under Section 22-201(6) of Ordinance #90-105, as amended: "Disregards or violates, in the performance of his/her contracting business in the County, any of the building, safety, health, insurance, or Workers' Compensation laws of the State or Ordinances of this County, " was found to be supported by the evidence presented at the Hearing in a clear and convincing manner. Conclusions of Law: • The Conclusions of Law alleged and set forth in the Administrative Complaint as to Count I were approved, adopted and incorporated herein, to wit: The Respondent violated the aforementioned Section of the County Code in the performance of his contracting business by action in violation of that Section, as set forth in the Complaint. Order of the Board: • Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and in Collier County Ordinance 90-105, as amended, by a vote of seven(7) in favor and none (0) in opposition, a majority vote of the Board members present, the Respondent has been found in violation as set out above. 37 January 15,2014 • Further, it is hereby ordered by a vote of six (6) in favor, and one (1) in opposition, a majority vote of the Board members present, that the following disciplinary Sanctions are hereby imposed upon the Respondent, Seth B. Hollender, to wit: o Suspension of the Respondent's license until the end of the Probationary period in the prior Order, i.e., October 16, 2015; o Imposition of a fine of$5,000 to be paid the end of Calendar Year 2014; o Payment of the Administrative Costs incurred by the County in the amount of$525 within 90 days of the issuance of the Board's Order. o If reimbursement to the County is not made within the 90-day period,the Respondent must appear before the Board at a Hearing; o Issuance of a public reprimand. Chairman White noted the case was closed. IX. REPORTS: • Michael Ossorio noted a new Citation process, effective January 1, 2014, will impose the following fines: o First Offense: $1,000 o Second Offense: $2,000 o Referred to the State's Attorney's Office • Several Citations have been written(1St Offense) • One Citation(2nd Offense) was issued and the $2,000 fine was paid • Feedback from Investigators in the field has been positive • If an application for a license is made within 45 days of the Citation, the fee will be reduced to $300 X. MEMBER COMMENTS: (None) XI. NEXT MEETING DATE: Wednesday, February 19, 2014 BCC Chambers, 3rd Floor—Administrative Building "F," Government Complex, 3301 E. Tamiami Trail,Naples, FL There being no further business for the good of the County, the meeting was adjourned by the order of the Chairman at 12:50 PM. 38 January 15,2014 COLLIER COUNTY CONTRACTORS LICENSING BOARD Patrick White, Chairman The Minutes were approved by the Chairman on , 2014, "as submitted" [ 1 OR "as amended" L]. 39 CDES Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104gPq APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO f j JAN - S FIRM INSTRUCTIONS: This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: Exact Corporate/Business Name: CA/5/LEJ I acu' ' -kJ i Fiction Name/DBA: (*ERA Qualifier Name: J 9 "L i do •'�"�' NO to FL T Physical Address: (Number ttl & Street) (City) (State) (Zip Code) Mailing Address: tdb� �� 3'ltoY e77-109(-1(Number & Street) (City) (State) (Zip Code) Telephone: d37- / E-Mail: V a 8y0e 6/17 /*/./ TYPE OF LICENSE: ❑ General $230.00 kr Electrician $230.00 ❑ Building $230.00 ❑ Plumber 230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 ❑ Specialty $205.00 Specialty trade: CHANGE OF STATUS: ( ) Reinstatement ( ) From One Business to Another ( ) Dormant License to Active Page 1 of 4 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. fl 1 c cfreAtazA ok.kwaz 93,- &?)-,o S V 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten years (ex. Held a license for or been a partner). Attach extra pages if needed. ( 1 ?fi c r1rc41 set v1Cc- 1n,c 3. List all debts you or any company(s)associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. AFFIDAVIT I,_ 3y A-. CAMERA certify that the foregoing is true and correct to the best of my knowledge. Authorized Officer of the Firm STATE OF FLORIDA, COUNTY OF LOUUVe The foregoing instrument as acknowledged before me this 6/0//3 `�, (Date) � i By "4 PY kOtA of £ z4 %i�eritie� -5 alt- (Name of officer, title/agent) (Name of Corporation) a �fo#f P4- Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced FL I? identification and did not take an oath. (Type of identification) NOTA ' ;5 av MARK SPEARS MY COMMISSION#EE 637273 % ._ .,P EXPIRES:December 3,2016 pfF;e;••. Bonded thru Notary PubhcUnderwriters (SIGNATURE OF NOTARY) Page 2 of 4 QUALIFIER INFORMATION: Name: 0O11 R. CA8(1E Address: 66 el .c(iV.A4- C► - 0-6a ✓ P 3wo S' (Number& Street) (City) (State) (Zip Code) Telephone: d32 (5)77-/o 9V Date of Birth: 5-d-7- 7V S.S.#: 000-00- DO— E-Mail: LI ofmjcesog Com01,57'• Nit Driver's License: e166 - '0 / -7 q -187-0 1. Type of Certificate of Competency for which application is made. ( E3ist titer rat 2 2. The names and telephone numbers of two persons who will know your whereabouts. �ES Si C CCU ?35- ga.6-00 a 1114 - 5PO4-5 9-3) -0153- 151 3. Have you ever been convicted of a crime related to Contracting? No (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? r3 , c litL i N o2oa / 8. List all debts you or any company(s) associated with you refused or failed to pay and reasons why. Nm�1E 9. List your business or work experience during the past ten years. _400..h101- 4,0e) Op`Jr Omer 4 10. Statement of any formal training you have had in the area for which the application is made. (Earn)l I A.4- Nikp(e3 V4-Tt-til t ti p Page 3 of 4 AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency. IG ATURE OF APPLICANT ciMi C(Tefnt41 `5 �►c E BUSINESS NAME DATE BEFORE ME this day personally appeared 'JOP y C451-82E,e,4 who affirms and says that he has less than one employee and does not require Workmen's Compensation and understands that at any time he employs one or more persons he must obtain said Workmen's Compensation Insurance. STATE OF FLOP COUNTY OF wAA2 The foregoing instrument was acknowledged before me this 8/4/7(1 (Date) by Nro 09 C11-844f-0-41, . • who has produced D L.. (name of person acknowledging) (Type of Identification) as identification and who did not take an oath. 4� P�y� ..+ MARK SPEARS SIG ATURE OF NOTARY NOTARY SEAL = *_ M COMMiSSIDN.#EE 837273 EXPIRES:December 3,2016 NOTARY PUBLIC '.F of Q;� Bonded Thru Notary PublicUnderwriters • STATEMENT OF OWNERSHIP This certifies that I, J0oy r' CAR" am a member or (APPLICANT'S NAME) Managing member of CAW E kc-tru,4f Se-v; (LIMITED LIABILITY COMPANY NAME) I own too % of the units issued by the Limited Liability Company listed above. Affidavit of Applicant: I certify that the information contained is a true and correct statement to the best of my knowledge. Jafl/ A. Ctt6 (PRINT NAME) i7L-- -- (APPLICANT'S SIGNATURE) 5- -/o`-. .._. (DATE) i �.�T1ra,�.3l i�i►�'�+�.�.-��a1F*��F.�,>i���z.T=���+�r.#ri.F=�i���� Test-Results Name Jody Cabrero Mailing Address United States Student # Title Master Electrician Started 4/23/2005 9:28 AM (GMT-5:00) Ended 4/23/2005 12:35 AM (GMT-5:00) Passing Score Not disclosed Your Score 75% Comments Take this notice to your sponsoring agency to continue with the process. Further information and Instructions GITS, LLC PO BOX 831127 Ocala, FL 34483-1127 (800)997-2129 This examination was administered at: Test Administrator—Jay E. Bowermeister River Park Community Center Proctor—Ginger C. Harber 301 N. 10th Street Naples, FL Content Section Review— Strength/Weakness Report Topic Items Possible Items Correct Licensee Information A Licensee Number Q20404 Description Type Property Alert Name JODY A.CABRERA Type ` Contractor Status Open View Master Project View All Activities for this Licensee Add a new person or business to Address Book Examination Results A Add Exam Result Link ExamJTest Type Date of acre Test City Score received "j ExarnrTest result b , BUSINESS AND LAW 03/02/2002 NAPLES 88.00 MASTER ELECTRICIAN 04/23/2005 NAPLES/GITS 75.00 GENERALSPECIALTY 09/11/1999 NAPLES 68.00 Show More Fields ( Hide or Clear Fields Charge Exam Fee n Exam Code Sponsoring County Sponsorship App Date 4 - Sponsorship Expiration Date Testing Facility t •Premier Profile-CABRERA ELECTRICAL SERVICE,INC r •• • • Subcode:970135 Ordered:01/03/2014 14:41:39 CST •T1:Experian- Transaction Number:C500242787 • Search Inquiry:CABRERA ELE/662 SQUIRE CIR/NAPLES/FL/34104/US/239-877-1090/739273060 A world of insight Model Description:Intelliscore Plus V2 Business Name V. F Business Identification Number CABRERA ELECTRICAL SERVICE, INC. 739273060 Primary Address: 662 SQUIRE CIR Phone: (239)877-1090 NAPLES,FL 34104-8354 Tax ID: 1111110101112437 TOP 0 Risk Dashboard 7'7742' ,'"--2 7.7:7? Risk Scores`and Credi Limit Recornmen•ation Days Beyond e s " ` =Derogatory °Fraud e k Intelliscore Plus Financial Stability Risk Company DBT Original Filings High Risk Alerts s�MEDIUM-HIGH s MEDIUM-HIGH 0 ,? RISK RISK Score range:1 -100 percentile Credit Limit Recommendation:$1,100 TOP 0 Business Facts Years on File: 11 (FILE ESTABLISHED 12/2003) SIC Code: SPECIAL TRADE CONTRACTORS,NEC-1799 State of Incorporation: FL NAICS Code: Specialty Trade Contractors-238000 Date of Incorporation: 02/12/2004 Business Type: Institutions-Profit Contacts: JODY A CABRERA-DIRECTOR TOP 0 Commercial Fraud Shield Evaluation for CABRERA ELECTRICAL SERVICE, INC,662 SQUIRE CIR, NAPLES, FL34104-8354 Pi t-`erfic.tionTrigge Active Business Indicator: Ole f Experian shows this business as active BUSINESS ADDRESS IDENTIFIED AS RESIDENTIAL Possible OFAC Match: • I No OFAC match found Business Victim Statement: No victim statement on file Credit Risk Score and Credit Limit Recommendation Current Intelliscore Plus Score: 16 Risk Class: 4 *' A-' ,. MEDIUM HIGH WSK' 3411,` _ M L The risk class groups scores by risk into ranges of similar Risk '.__..__. CISk ' performance.Range 5 is the highest risk,range 1 is the lowest risk. 0 10 25 50 75 100 This score predicts the likelihood of serious credit delinquencies for this business within the next 12 months.Payment history and public record along with other variables are used to predict future risk.Higher scores indicate lower risk. Premier Profile-CABRERA ELECTRICAL SERVICE,INC 1/3 9 • Factors lowering the score Industry Risk Comparison > NUMBER OF ACTIVE COMMERCIAL ACCOUNTS 15%of businesses indicate a higher likelihood of severe delinquency. > BALANCE OF ALL COMMERCIAL ACCOUNTS • BALANCE OF COMMERCIAL ACCOUNTS AT WORST DELINQUENCY • BALANCE OF DELINQUENT COMMERCIAL ACCOUNTS Action or risk based on your company's specific score thresholds:MEDIUM-HIGH RISK Quarter' Score Tren. , ,..rv,,f: f'. � � f� ;,s•., % 3�. ,ti .: Quarterly Score Trends 100 i 90 : i 80 ', 70 70 A -j The Quarterly Score Trends provide a view of the 60 " i likelihood of delinquency over the past 12 months for this 60 r 'r 1 business.The trends will indicate if the score improved, 40 i ,1 remained stable,fluctuated or declined over the last 12 months. 30 t' '' 20-i" ---.I 10-I Credit Risk Score:Financial Stability Risk Current Financial Stability Risk Score: 6 Risk Class: 4 {.. o, pTr-iv�u' P-k,s ta'+z't g? '-1"O l a ,�^;$ t'9 , mots u:' '?... ,,�,y y, �i�� h tax 5 ,h )�,�,� � IYISF� ::: High e, - k: 1 Ltw4 S The risk class groups scores by risk into ranges of similar Risk -- 3 . Risk ' performance.Range 5 is the highest risk,range 1 is the ` i lowest risk. 0 3 10 30 65 100 This score predicts the likelihood of financial stability risk within the next 12 months. The score uses tradeline and collections information,public filings as well as other variables to predict future risk.Higher scores indicate lower risk. Factors lowering the score Industry Risk Comparison NUMBER OF ACTIVE COMMERCIAL ACCOUNTS 5%of businesses indicate a higher likelihood of financial stability risk. > PERCENT OF COMMERCIAL ACCOUNTS DELINQUENT > PAST COMMERCIAL DEROGATORY BALANCE > RISK ASSOCIATED WITH THE COMPANY'S INDUSTRY SECTOR Credit Limit Recommendation Credit Lin-it Recommendation This recommendation compares this business against similar businesses in the Experian business credit database.It is based on trade information,industry,age of business and the Intelliscore $1,100 Plus.The recommendation is a guide.The final decision must be made based on your company's business policies. TOP 0 Payment and Legal Filings Summary ud mma'n ar y 5F 4 : ,,-,..k- n�r1v- ��.`. ,, ,;,.41,.6 ro 1 !'4 Ck{ .>: r E s �,% r , °k,_ ,. w>Grs, 1.— , ,„ e._ . •- ,. ,. •f Current DBT: 39 Total trade and collection(1): $200 Bankruptcy: No Predicted DBT: N/A All trades(1): $200 Tax Lien filings: 0 Judgment filings: 0 Monthly Average DBT: 0 All collections(0): $0 Sum of legal filings: $0 Highest DBT Previous 6 Months: 39 Continuous trade(1): $200 UCC filings: 0 Premier Profile-CABRERA ELECTRICAL SERVICE,INC 2/3 Highest DBT Previous 5 Quarters: 8 6 month average: N/A Cautionary UCC filings: No Payment Trend Indication: Highest credit amount extended: $600 Payment trend indicator not available Most frequent industry purchasing terms: Industry purchasing terms not available Industry Comparison ��' �� .3 '�^ � gm's r•�rd x��� .: f .. � �';, > t _ ._- ,. .... ,.. . .,E Industry DBT Range Comparison The current DBT of this business is 39.9%of businesses have a DBT range of 16+. DBT for this business: 39 4?0 of businesses 80% 11% 9% DBT Range 0-5 6-15 16+ TOP 0 Trade Payment Summary Trade Line Type Lines Reported DBT Recent High Credit Balance Current 01-30 31-60 61-90 91+ Continuous 1 39 $600 $200 21% 22% 22% 35% New 0 $0 r 4"i `jl1- $200 21%1, 22% 22% 35% Additional .-� 0 $0 Total Trade 1 $200 21% 22% 22% 35% TOP 0 Trade Payment-New and Continuously Reported Trade Details (Trade Lines with an(*)after the date are newly reported) Days Beyo,4s Business Date Last Payment Recent High Balance Cur 1-30 31-60 61-90 91+ Comments Cate.o Re•orted Sale Terms Credit FINCL SVCS 12/2013 09/2013 REVOLVE $600 $200 21% 22% 22% 35% TOP 0 Additional Business Facts THE FOLLOWING INFORMATION WAS PROVIDED BY THE STATE OF FLORIDA. State of Origin: FL Date of Incorporation: 02/12/2004 Current Status: Active Business Type: Institutions-Profit Charter Number: P040000321 Agent: CABRERA JODY A Agent Address: 662 SQUIRE CIRCLE 202 NAPLES,FL TOP i Experian prides itself on the depth and accuracy of the data maintained on our databases. Reporting your customer's payment behavior to Experian will further strengthen and enhance the power of the information available for making sound credit decisions. Give credit where credit is due. Call 1-800-520-1221,option#4 for more information. End of report 1 of 1 report The information herein is furnished in confidence for your exclusive use for legitimate business purposes and shall not be reproduced.Neither Experian information Solutions,Inc.,nor their sources or distributors warrant such information nor shall they be liable for your use or reliance upon it. ©Experian 2014.All rights reserved.Privacy policy. Experian and the Experian marks herein are service marks or registered trademarks of Experian. Premier Profile-CABRERA ELECTRICAL SERVICE,INC 3/3 UMW Merit Credit Fast, Accurate& Secure. MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS) , STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 0 SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1- 800-371-3348 OR 239-277-3202. COMPANY NAME: CABRERA ELECTRICAL SERVICE INC FEDERAL ID: 810642437 CURRENT STATUS: INACTIVE BUSINESS PRINCIPAL(S):JODY CABRERA TITLE: DIRECTOR DATE INCORPORATED: 02/12/2004 Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 7/93 01/03/14 14:40CT [SUBJECT] [SSN] [BIRTH DATE] CABRERA, JODY A. • [CURRENT ADDRESS] [DATE RPTD] 761 NW. 20TH AV. , NAPLES FL. 34120 7/12 [FORMER ADDRESS] 202662 SQUIRE CI. , #202. NAPLES FL. 34104 7/08 662 SQUIRE CI. , #262. NAPLES FL. 34104 [CURRENT EMPLOYER AND ADDRESS] [VERF] [RPTD] CABRERA ELECTRICAL SVC 1/12 1/12 M O D E L P R O F I L E ***FICO CLASSIC 04 SCORE +661 : 010, 018, 013, 014 *** C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=0 NEG=0 HSTNEG=2-2 TRD=18 RVL=13 INST=3 MTG=2 OPN=0 INQ=4 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $22.3K $26.5K $15.7K $0 $380 40% INSTALLMENT: $21.5K $ $14.4K $0 $390 MORTGAGE: $155K $ $114K $0 $706 TOTALS: $198K $26.5K $144K $0 $1476 T R A D E S SUBNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# VERFIED CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 WFHM B 72RP001 8/07 $155K 360M706 111111111111 MOl 12/13A $0 111111111111 I CONVENTIONAL REAL $114K 48 0/ 0/ 0 GECRB/FUNANC F 9992809 5/07 $11.8K 111111111111 ROl 12/13A $12.0K $0 111111111111 I CHARGE ACCOUNT 8/09C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 GECRB/APPDIR F 999200A 9/06 $1665 111111111111 ROl 12/13A $2000 $0 111111111111 I CHARGE ACCOUNT 11/08C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 SUNCST FCU Q 298Q007 4/09 $10.0K MIN194 121111111111 RO1 12/13A $10.0K $0 111111111111 I CREDIT CARD $9676 48 1/ 0/ 0 GECRB/CARECR F 999206T 7/10 $3925 111111111111 ROl 12/13A $4400 $0 111111111111 I CHARGE ACCOUNT 3/11P $0 40 0/ 0/ 0 GECRB/LOW L 235041J 7/12 $3925 MIN118 111111111111 RO1 12/13A $3900 $0 11111 I CHARGE ACCOUNT $3925 17 0/ 0/ 0 THD/CBNA B 26H3005 8/11 $1665 MIN50 111111111111 ROl 12/13A $2000 $0 111111111111 I CHARGE ACCOUNT $1665 28 0/ 0/ 0 BRCLYSBANKDE B 1ZZB001 1/07 $2064 MIN18 111111112111 RO1 12/13A $4700 $0 111111111111 I CREDIT CARD $533 48 1/ 0/ 0 US BANK B 23KW001 1/12 $21.5K 60M390 111111111111 I01 11/13A $0 1111111111 I AUTOMOBILE $14.4K 22 0/ 0/ 0 SUNCOAST CU Q 298Q001 5/09 $7343 60M151 111111111111 I01 7/13A $0 111111111111 I AUTOMOBILE 7/13C $0 CLOSED 48 0/ 0/ 0 MATTRESS FRM H 21GJ197 1/11 $3991 111111111111 RO1 6/13A $3900 $0 111111111111 I CHARGE ACCOUNT 2/13C $0 CLOSD BY CRDT GRANTOR 29 0/ 0/ 0 CAP ONE B 1DTV208 1/08 $2126 111111111111 RO1 7/12A $3000 $0 111111111111 I CREDIT CARD 10/11C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 CAP ONE B 1DTV001 12/07 $547 111111111111 RO1 8/10A $500 $0 11111111111 I BUSINESS CREDIT C 7/10C $0 ACCT CLSD BY CONSUMER 32 0/ 0/ 0 CAP ONE B 1DTV001 9/03 $436 111111111111 ROl 7/10A $500 $0 111111111111 I CREDIT CARD 7/10C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 SST/SYNOVUS F 1523037 6/05 $1144 111111111111 ROl 9/09A $1500 $0 111111111111 I CREDIT CARD 8/08C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 SST/JPMC F 1523055 6/06 $17.8K 63M378 X111111111X1 I01 6/09A $0 X11111111111 I AUTOMOBILE 6/09C $0 CLOSED 36 0/ 0/ 0 HM LN SERV F 1LYC001 7/05 $100K 360M926 111111111111 MO1 9/07A $0 111111111111 I CONVENTIONAL REAL 9/07C $0 CLOSED 24 0/ 0/ 0 CHASE B 701N134 6/05 $778 1111111 RO1 2/06A $1500 $0 I CREDIT CARD 2/06P $0 ACCT CLSD BY CONSUMER 7 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 1/03/14 ZNP6284423 (FLA) MERIT CREDIT 8/30/12 BUS5165714 (NTL) CHASE 7/03/12 NNY2120170 (EAS) GECRB/LOWES 1/03/12 BNC1619001 (FLA) US BANK C R E D I T R E P O R T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION WFHM BM72RP001 (800) 642-0257 LOAN SERVICE CREDI SAN ANTONIO TX. 78265 GECRB/FUNANC FZ9992809 (866) 396-8254 C/0 PO BOX 965036 ORLANDO FL. 32896 GECRB/APPDIR FZ999200A (866) 396-8254 C/O PO BOX 965036 ORLANDO FL. 32896 SUNCST FCU QC298Q007 (813) 621-7511 6801 HILLS AVE TAMPA FL. 33680 GECRB/CARECR FZ999206T (866) 396-8254 C/O PO BOX 965036 ORLANDO FL. 32896 GECRB/LOW LH235041J (800) 444-1408 PO BOX 956005 ORLANDO FL. 32896 THD/CBNA BZ26H3005 PO BOX 6497 SIOUX FALLS SD. 57117 BRCLYSBANKDE BZ1ZZB001 (866) 370-5931 P.O. BOX 8803 WILMINGTON DE. 19899 US BANK BB23KW001 (877) 457-3544 425 WALNUT STREET CINCINNATI OH. 45202 SUNCOAST CU QU298Q001 (813) 621-7511 PO BOX 11904 TAMPA FL. 33680 MATTRESS FRM HZ21GJ197 (800) 231-5089 CSCL DISPUTE TEAM DES MOINES IA. 50306 CAP ONE BC1DTV208 (800) 477-6000 PO BOX 30253 SALT LAKE CITY UT. 84130 CAP ONE BC1DTV001 (800) 955-7070 POB 30281 SALT LAKE CITY UT. 84130 SST/SYNOVUS FZ1S23037 (800) 789-8001 4315 PICKETT SAINT JOSEPH MO. 64503 SST/JPMC FZ1S23055 (800) 789-8001 4315 PICKETT ROAD SAINT JOSEPH MO. 64503 HM LN SERV FM1LYC001 (800) 346-6437 450 AMERICAN ST SIMI VALLEY CA. 93065 CHASE BC701N134 BANK ONE CARD SERV ELGIN IL. 60124 CHASE B 5165714 (800) 955-9900 PO BOX 15298 WILMINGTON DE. 19850 GECRB/LOWES N 2120170 (800) 444-1408 PO BOX 965005 ORLANDO FL. 32896 US BANK B 1619001 (877) 855-6680 1301 WESTWOOD LANE WILKESBORO NC. 28697 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED �/) SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR (239) 277-3202. State of Florida Department of State I certify from the records of this office that CABRERA ELECTRICAL SERVICE, INC. is a corporation organized under the laws of the State of Florida, filed on February 12, 2004. The document number of this corporation is P04000032199. I further certify that said corporation has paid all fees due this office through December 31, 2014, that its most recent annual report/uniform business report was filed on January 7,2014, and its status is active. I further certify that said corporation has not filed Articles of Dissolution. Given under my hand and the Great Seal of the State of Florida at Tallahassee,the Capital,this the Eighth day of January,2014 r � c VOA 0#61/A Secretary of State Authentication ID:CU7834123880 To authenticate this certificate,visit the following site,enter this ID,and then follow the instructions displayed. https://efile.sunbiz.org/certauthver.html %_-=\ /°-'./"4 --'\7---`4-. _ _ 3 - 7.-t-:-...;\/_---------\ Iq Y t°.•. r.Cr'"-�- w'.�r.__rF._ 'ti�N=:,p`° qC:. 7 -c"'e -.,.: q=r�^,�, •�� °"•" •,7•,`L"•.^- :--r ( F. .R'- i•.�' ^ti;C -.o: ., '^-. �4 fr ooyr! s .e. tiY° �i Jam' ,; 'o'./ >•,� d le{ )1'1"° `y`hn i ySn�i*y.,a -1°is s�° r ."titi?w �'r off ,'v♦♦ rs♦'f' y i � a i �� .y, � cam♦ '� �� it i� �4i 't ''A ♦ ii �� 0 (� h� ( ;Vii Vr �"'get, , r* °i ,,: N� V V ) i i it t, i Vii Ilii ' L��t F' f y a 1 t it F 'i'Ii 1 i r� � .� 11 ti a lil z.Y tVift }Y „i 11 (11 1Y Goa t A',Id y'" F+ t 1! ' I'7 . � �' ti ��ITa Ai , Ar �� �T"� . 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Licensee Information A Licensee Number 026411 Description Type I Property Alert Name CABRERA ELECTRICAL SERVICE, I Type Contractor Status Active View Master Project View All Activities for this Licensee Add a new person or business to Address Book Insurance Add Insurance Link Producer Type Policy Number Effective Date Expiration Date Limit LUTGERTINSURA.NCE- NAP General Liability 'MPG60290 02120/2013 02/207014 2000000 PAYCHEX INSURANCE AGE Worker's Compensatio 76 WEG LN5639 07/01/2012 07/01/2014 Address Address line 2 City/State/Zip Show More Fields [ Hide or Clear Fields Expiration Processed r Producer Phone Number 239-280-3212 ftp,_.,",, ••••••?4,..., r.,tes I' tt,t-et; _t* .,Jr,t,-..., ,.';:'..,„..':•°, .,. .;SWISITA I b : 'Yg--'g',.- .6,,'--•'-'11:-.,,,,,,-,„ 5,/ „,....., .,, At,W;IF•1. .tt■'''ti.jete..4111,30, -' ft'SF.'0'.,'"r .4..tt..4 i,,,‘.- Y.:, ,.4,1- .,...ft'''. 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"}'-‘,a7-.,kk,- aktvi ,a_-_,-,-"- .-., _.., • + , • ,',-;'-„," .„-•;;.'i,:artto .•;,.'AX-4"Z`'4,1'..'va:•:;',W, -ty, 1'.' 'V.* ' ,, ,.,'„--x, -ci.--,:k1 it'=1 , 1.4,...''' 'i ----- _,,, ,,,,,Aso.,,,L--- -4' ...' v--: -.,w Community Electric of Collier, Inc. 1045 Fifth Avenue,North •Naples,Florida 34102-5880•(239)262-3438•Fax#(239)262-6943 May 9,2012 Community Electric of Collier, Inc. 1045 Fifth Avenue North Naples, FL 34102 RE:Jody Anthony Cabrera To Whom It May Concern: Jody Anthony Cabrera was employed by Ci rrrmunity Electric of Collier, Inc. from 01-18-93 to 07-21-94. Community Electric of Collier", Inc. has been serving Collier and Lee Counties since 1972.Our work consists of both residential and commercial electrical installations.Our projects range from high rise condominiums,apartment complexes,office buildings,strip malls, hospitals and schools. During the time Cabrera was employed by Community Electric, he was involved in more than one of these types of projects. Sinc rel , Bret Groos President NOTARY: STATE OF: Florida County of:Collier SWORN TO(or Affirmed)AND SUBSCRIBED BEFORE ME THIS 9T"DAY OF May,2012. . 67,Ctsir NINA B.MASON W r it . . At aSe -• �•_ :r MYCOMbIISSION#DD979320 Print,Type or Stamp Name of Notary 4;fif,tiP• Bonded*WuRNotary Pubktifldetwvfters Personally Known X Or Produced Identification Seal Type of Identification Produced ▪ ODT. Q. t t9 0- JACKSON TOTAL SERVICE, INC• • JAc►�sON • AIR CONDITIONING • ELECTRIC • PLUMBING • SERVICE May 7,2012 TO WHO IT MAY CONCERN: Jody Cabrera was employed at Jackson Total Service,Inc.from July 25, 1994 to January 23, 1996. He worked as an electrician on a two story multi family commercial project in Lely Subdivision as well as an Assisted Living Commercial project in the Vineyards Subdivision. Jody was involved in both rough electric and trim electric on a single family home project in Crown Pointe. Jody also performed electrical service repairs. During his employment with Jackson Total Service Jody was found to be dependable and of good moral character. If you need any further information please do not hesitate to contact me. Sne , Adlipr i Paul Dean J, son President Electrical License#EC13002992 Sworn to and subscribed before me on this 7th day of May,2012 by Paul Dean Jackson who is personally known to me. NOTARY PUBLIC 1 ONi" : NEfLISA A.RINGO !..: f�, 'i,;=, Commission DD 800921 +!-w,;- x a= Expires July 10,2012 %.8. g ceded Thru ura Troy Fain Insnce 800.985.7019 3727 ENTERPRISE AVE. • NAPLES, FL 34104 PHONE (239) 643-0923 • FAX(239) 643-9872 P.O. BOX 9589 • NAPLES, FL 34101 EC13002992 • CAC014249 • CFC019073 p\QGDNDITIO�,�C JACKSON TOTAL SERVICE, INC. jiCK �a*^ScoN • AIR CONDITIONING • ELECTRIC • PLUMBING • SE"""E i 3727 ENTERPRISE AVE. • NAPLES, FL 33942 PHONE (813) 643-0923 • FAX (813) 643-9872 • . Q` P.O. BOX 9589 • NAPLES, FL 33941 March 09, 1995 Dear Jody A. Cabrera, This is to inform you that you attained a score of 80% on your final exam for the class "Basic Electrical Troubleshooting and Repair", and as such are certified and fully qualified to perform these duties. Yours was an excellent score. The fact that you are willing to devote your own time to continuing education to increase your job skills indicates that you are an exceptional employee that we are delighted and proud to have on our staff. Our efforts to improve the company and it's ability to profitably serve our customers with professionalism are made possible only by dedicated people such as you. Sincerely, pcLei, „ Ruben Pastian President 1 _ti �' ' ,- _ - __ E...„„,41 _ _ _ •_ ____ ___;:. •_::: .: -__ :___ , .. ••:.,.. ._27:: ____ __ ____ _ ::•,.• , ,,,:.„ ,, ..... ___:,__________7____ , , _ v _ - • • • • 1- &MI Electric May 1, 2003 Re: Jody Cabrera To Whom It May Concern: Mr. Cabrera was employed by my company from Feb. 16,1996 to Dec. 13, 1996. His position during this time was an electrician in the new construction and service department. Sincerely, t___,,F .. , , ,,, .. , ..„(,,e..., Andy Stocklein Former owner arc Anthony Inc. Residential Contractor Ph. (239) 293-8351 Date: 10/06/05 To: DBPR From: Marc A. De Nicola Re: Jody Cabrera To whom it may concern, I am writing this letter to state my knowledge of Jody Cabrera's employment in 1996. He was employed by A&M Electric (Andy Socklein) for what I remember to be about one year. At that time on Marco Island, business people all knew and dealt with one another. I worked with A&M frequently in the 90's and knew the employees. None of the employees or owners of A&M Electric can be located presently. The letter composed by Andy Stocklein dated May, 2003 is valid. I was present when it was signed. (I located Mr. Stocklein the first time For Mr. Cabrera) Since that time, Andy Stocklein cannot be located. Signed: /�/� Date: `4/7/�..�• Witnessed by: ' Date: (c, �� /vs- (Notary) os Y Pfr,,., JAIME BUITRAGO (�.Notary Public-State of Florida N �� /. yCommissicaapiesMar9,2008 Commission DO 298512 1 ° Bonded By National NotarYAssn. PREMIER ELECTRIC willini\W4 June 14, 2005 Re: Jody Cabrera To Whom It May Concern: The purpose of this letter is to confirm the employment of Jody Cabrera. Mr. Cabrera was employed with our company as an electrician from December 16, 1996 through December 19, 1997. If you have any further questions about the employment of Jody Cabrera, please do not hesitate to contact me. Sincerely, 41100- Aria Kulig Office Manager t c�� urk , 0bS t OLQ i 101 A i1bt,J1.Q.� ' (A ) `l hac �lln �� -� cv.Q . m Deborah DeMoss ' " '_ Commission#DD335904 Expires:Aug 27,2008 '��OF FLOP• onded Th AtlantiBc Bonding u Co.,Inc. "The Residential Wiring Specialists"TM 1443 Rail Head Boulevard • Naples, Florida 34110-8444 • (239)598-2000 • Fax(239)598-3603 eeaunwnt electric Co., jnc. February 11., 2003 To Whom It May Concern: Re: Jody A Cabrera Mr. Cabrera worked for Beaumont Electric Co., Inc. from December 29, 1997 to June 28, 1999. He was an apprentice electrician under a journeyman electrician for single and multi-family dwellings during that time period. If you have any further questions, please call our office. Respec u ► f 'ry R Beaumont resident STATE OF FLORIDA COUNTY OF COLLIER The foregoing instrument was acknowledged before me this 11th day of February, 2003 by Gary R. Beaumont, President of Beaumont Electric Co. Inc. , a Florida corporation, on behalf of the corporation. He is personally known to me and did not take an oath. NOTARY PUBLIC My commission expires: STATE OF FLORIDA O�P{iY PGeli SHARON GI�LApY 1^ * COMMISSION NUMBER � DD084637 9 ` .-'70F'f`Op`� MY COMMISSION EXPIRES JAN.15,2006 4584 MERCANTILE AVE.•SUITE E• NAPLES, FLORIDA 34104• (941) 643-4515• FAX (941) 643-1262 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, PGttn\ O eCt n u C`L C , am a resident of (C9 t) i e r County, (State) and have resided here for more than five (5) years. During the last five years I have known b 'cc( applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Signature) . . I"'!1 (Name) Pec c t Ile a -4 r) (Address) 3711 Cnierr;st A-V WLt()1 t'_5 F-L 39101 Telephone) 2.-.3q - G G 3 STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this 'St h D by 1)•(1 6)r∎ (Date) Pc?c A\ 0 per arc Y-Lcv-i who has produced (name of person acknowledging) (Type of identification) as identification and who did not take an oath. SIGNATURE-OF,-, • NEILISA A.RINGO :_ Commission#EE 207139 NOTARY'S SEAL (PRINT NAME_;0.411 f►�s+ ' In u .800-385-7019 NOTARY PUBLIC 8 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER . BC5 , am a resident of CP 14.1,112-T\ County, 'r C' (C (State)and have resided here for more than five(5)years. During the last five years I have known J a D 1 C I1 1 A applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Signature) A1117,114: (Name) 640-s (Address) /O 5 5 73 61-e tk i41 l 6,0? 3 Cc 36((C12-36((C12—_ Telephone)23'L� 34'5C? STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this 64 . 2S , QC)15 by (Date) .,�. u. .... A r'. 0. who has produced LI_ r i Ni- �4 0�3 a of p rson acknowledging) (Type of identii . ; as identification and who did not take an oath. eff N Notary Public State d Florida J •/a • Summer Szempruch +�, My Commission EE 195258 '?p�prJ Expirss 05/02/2016 >, Ellga NOTARY'S SEAL (PRINT . t;: OF NOT• ' NOTARY . >? C 8 COLLIER COUNTY BUSINESS TAX RECEIPT APPLICATION � = 0 ff, 2800 N.Horseshoe Drive,Naples,FL 34104 s�: ,�, b: Make Check Payable to Collier County Tax Collector Phone: 239-252-2477 Fax: 239-643-4788 Website:www.colliertax.com CHECKLIST Copy of Articles of Incorporation and/or Fictitious letter Yellow Fire Compliance(list of fire district phone number from the State stating that your business name is on file. enclosed) (850-245-6052 or 6058) www.sunbiz.org Copy of Marco Zoning Certificate.(239-389-5000) Copy of State license from Department of Business and Professional(850-487-1395)or Department of Health. Completed Zoning application with appropriate fee made payable (850-488-0595) to:Board of County Commissioners.(239-252-5603) Copy of City Business Tax Receipt.(239-213-1800) Completed Business Tax Receipt application with appropriate fee made payable to:Collier County Tax Collector.(239-252-2477) Copy of Motor Vehicle Repair Registration Certificate from Department of Agriculture.(800-435-7352) Other: Copy of Health inspection from Department of Hotels and Please contact the Property Appraiser's office at 239-252-8145 Restaurants(850-487-1395)or Department of Agriculture. regarding tangible tax. (800-435-7352) CHECK ONE: Date: V Original Application Classification Transfer of License# Code Number - - Renewal of License# License Amount 1) CORPORATE NAME- tek`tt EZ�ctr' .SI,�u c. la) DBA NAME- lb) BUSINESS OWNER OR QUALIFIER'S ,�NAME - .36o1 C e>k-9 2) PHYSICAL ADDRESS - Ito A-vi tk) Novk ; 3'(rae (No P.O.Box allowed) 2a) IS RESIDENCE USED AS AN OFFICE - Yes V No 3) BUSINESS MAILING ADDRESS - CR'• &t,a, A/i k t'{ 3((16,-/ Street City Zip 4) OWNER OR QUALIFIER'S RESIDENTIAL ADDRESS- -710I AVE J Nopk42 k 34/ 5) TELEPHONE-Business: 93,— 697`i09V Home: �--- 6) LEGAL FORM OF BUSINESS: Sole Proprietorship Partnership Corporation f LLC LLP 7) OPENING DATE OF BUSINESS OR DATE ASSUMED - d4' 8) OFFICE WITHIN CITY LIMITS OF NAPLES- Yes L.---No If Yes,City License No. 9) SOCIAL SECURITY NO. or FEDERAL EMPLOYER IDENTIFICATION NO. - R/ - 59 V37 *see back of application for explanation 9a) TYPE OF BUSINESS CONDUCTED: e~Z£c'fr,crx' 6.0.4A-rac4-02. 10) NUMBER OF EMPLOYEES -Including number of owners: / 11) FILL IN THE APPROPRIATE AREAS - a)Rental units(motel/hotel/apts.)Number of units: b)Seating Capacity(rest./cafes,etc)Number of seats: c)Number of coin-operated machines owned by business or individual: 45 12) STATE LICENSE OR CERTIFICATION NUMBER- Must have photo copy of state license if state licensed and certified UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE TO THE BEST OF MY KNOWLEDGE. xxxAPPLICANT'S SIGNATURE ��1C DATE: /`St- (Owner and/or representative of busin s)'1' TLE• fa!'ES` ****THIS LICENSE IS NON-REFUNDABLE FOR BUSINESS STATED ABOVE**** CorMr County COLLIER COUNTY GOVERNMENT DEPT. OF ZONING& LAND DEVELOPMENT REVIEW WWW.COLLIERGOV.NET (239)252-2400 FAX (239) 643-6968 LAND USE AND ZONING CERTIFICATE HOME OCCUPATION Please take the time to fill out this form as completely as possible. Remember that only someone actually living at the address given below may engage in the home occupation described. Customers or employees not living at this address are prohibited from traveling to and from the residence if visits are related to this home occupation. The applicant is the person in whose name the occupational license will be issued, and the applicant's signature must appear on this form. Verification as property owner or lessee in the form of a Valid Florida's Driver License or Florida Identification Card and/or copy of valid lease agreement is required. APPLICATION DATE /– 8–/ V ZONING CERTIFICATE#TC- APPLICANT'S NAME jC O( coat-0A PHONE: ?3c!– "(o ht APPLICANTS HOME ADDRESS 76/ do Ave- AJf ti Al C e5 rt 3 tili, TYPE OF BUSINESS TO BE CONDUCTED Z f C_*f i(44 Ceikik•CAcl-o r /''�� BUSINESS NAME(IF ANY) l�thex 7L4 E cip,,,A i s-f1`th c6 1, the undersigned, hereby affirm that l am the legal owner of the property at the above address or that l have the legal right to conduct the business described above at this address by virtue of my leasehold interest in this property, and that I have read, understood, and agree to abide by the provisions of LDC Section 5.02.00 Home Occupations"(see back of application). APPLICANT SIGNATURE e"- `—_ DATE /` 49-1 7 FEE: $50.00 CHECKS P ABLE TO: "COLLIER COUNTY TAX COLLECTOR" TO BE COMPLETED BY COUNTY STAFF ZONING: PROPERTY ID# DATE REVIEWED BY APPROVED HOLD DENIED COMMENTS/RESTRICTIONS: Must comply with Section 5.02.00 of the LDC (see back of application). Tax Collector Staff: Please forward a copy of issued certificate and receipt to Collier County Zoning Department. '! t .G ion iF �'�t�` 1Fr� �_ -.� 5lplF�[J77C rst/jjr, ,fin ''N.,DRIVERL1C .,VSE CLASS E y,„:1'ii.4,,,ii,j::t;:,i: t E i H , y ' I'. tom' .. eam�marry sob�ty test AV�bdLY M�ii. •,."`-e DBPR- CABRERA, JODY ANTHONY; Doing Business As: CABRERA ELECTRICA... Page 1 of 1 9:11:01 AM 1/9/2014 Licensee Details Licensee Information Name: CABRERA, JODY ANTHONY (Primary Name) CABRERA ELECTRICAL SERVICE INC (OBA Name) Main Address: 761 20TH AVE. NW NAPLES Florida 34120 County: COLLIER License Mailing: 761 20TH AVE. NW NAPLES FL 34120 County: COLLIER License Location: License Information License Type: Certified Specialty Contractor Rank: Cert Specialty License Number: ES12000235 Status: Current,Active Licensure Date: 08/25/2004 Expires: 08/31/2014 Special Qualifications Qualification Effective Residential Specialty 10/27/2003 View Related License Information View License Complaint 1940 North Monroe Street,Tallahassee Fl 32399 :: Email: Customer Contact Center:: Customer Contact Center: 850.487.1395 The State of Florida is an AA/EEO employer.Copyright 2007-2010 State of Florida.Privacy Statement Under Florida law,email addresses are public records.If you do not want your email address released in response to a public-records request,do not send electronic mail to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 850.487.1395.*Pursuant to Section 455.275(1),Florida Statutes,effective October 1,2012,licensees licensed under Chapter 455,F.S.must provide the Department with an email address if they have one.The emails provided may be used for official communication with the licensee. However email addresses are public record.If you do not wish to supply a personal address,please provide the Department with an email address which can be made available to the public.Please see our Chapter 455 page to determine if you are affected by this change. https://www.myfloridalicense.com/LicenseDetail.asp?SID=&id=4BF74B3A 14464292CC 10... 1/9/2014 CDES Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 1 Q 14-Z. LO APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUCTIONS:This application must be typewritten or legibly printed. The application fcc must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: Exact Corporate/Business Name: el)41 i1 i 1 i Fiction Name/DBA: Qualifier Name: a O . C., I i A __• , Physical Address: 1 210 31 uekivA Avg fflrwco (Number & Street) (City) S ( t3') (State) (Zi p Code) Mailing Address: A- y� �,q (Number & Street) (City) (State) (Zip.Code) Telephone: 2�1 `- 2C0-- agcl E-Mail:2, 7 ) j41^AY.CO TYPF LICENSE: General $230.00 CI Electrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 Cl Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 ❑ Specialty $205.00 43114§41-trade: G P.l1 Q r.G.,1 C 0 01Y iv-to r. A 6 2014 3 N CHANGE OF STATUS: ( ) Reinstatement ( ) From One Business to Another ( ) Dormant License to Active Page 1 of 4 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. q1dDOSA- rOACr4CCO IZIO131 ►r� NCO I ,�, .ft 34 J&f 23g - 2. List all businesses, firms,entities or contracting businesses you have been associated with during the last ten years (ex. Held a license for or been a partner). Attach extra pages if needed. No _ 3. List all debts you or any company(s)associated with you refused to pay and the reasons for the refusal to pay. Attach extra tr �� lIpages if needed. t L PC CA C� "V'eACCA- AFFIDAVIT I, ' c T (• a n certify that the foregoing g is true and correct to the best of my knowledge. Ara' Authorized Officer of I .j im, STATE OF FLORI A COUNTY OF ( J-' The foregoing instrument as acknowledged before me this 12 in 1 2013 By I �S� . inr;( p l (Date) of - �� Cuj\14)Cliol Si CO of (Name of officer, tiff t) (Name of Corporation) Sn a Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced ` identification a • di• not take an oath. (Type of identificatt Y `c a L 0/7//,„0 \\ ire NOTARY'S SEAL 0210112017 NOTARY PUBLIC Commission II C .'.—. /c!'>; EE866 �\\\\\ (SIGN• URE i F NOTARY) F'-'''' '' Page2of4 QUALIFIER INFORMATION: Name: 7-9\6 `— . 1 , 1 �O. Address: 210 ak1'Q 6(A, t1'Y0 Y lc co I Sf19f�� � 3`i )Lt s— (Number& Street) (City) (State) (Zip Code) Telephone: 2361 — 200 _%G,gi Date of Birth: S.S. #: 000-00- — — E-Mail: Driver's License: m( 1. Type of Certificate of Competency for which application is made. C- a »fIAG 2. The names and telephone numbers of two persons who will know your whereabouts. _ — 25- S32S" elk.. a .. 2 - ZL1 1 - 1321 3. Have you ever been convicted of a crime related to Contracting? (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? 110 8. List all debts you or any company(s)associated with you refused or failed to pay and reasons why. 9. List your business or work experience during the past ten ye.rs. • P' • i\ 1111.16. L.1r *iVO.N. i I _ • /�. I A 10. Statement of any formal training you have had in the area for which the application is made. kiti)(5 0--- COreirtWrNI Cç Page 3 of 4 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No. 2006-46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. -V- a. 11\Rmilepo APPLICANT(PLEASE PRINT) CONA pnywclion Ilinr1. -019 NAME OF C MPANY SIG -ATURE 0 APPL C STATE OF FLORIDA COUNTY OF C.,,a�1� J The foregoing instrument as acknowledged before me this 121)c11201-2 `_ � . (Date) By `ref' K rcCGO (Nam of person acknowledgin (Type of identification) as identification and did not take an oath. a\caLo '%,,� NOTARY'S SEAL / NOTARY PUBLIC . - Commis EE888389...' - ,`(SIGN•TURE OF NOTARY) Page 4 of 4 Licensee Information R Licensee Number LCC20120001594 Description Type Property Alert Name Marzzacca, Robert Type Contractor Status Pending View Master Proiect View All Activities for this Licensee Add a new person or business to Address Book Examination Results A Add Exam Result Link ExamiTest Type Date of Exam/Test City Score received Exam/Test result _ BUSINESS PROCEDURES 05/08/2012 Ocala 76% Pass GENERAL CONTRACTING 05/08/2012 Ocala 75% Pass Show More Fields ) Hide or Clear Fields Active ri Charge Exam Fee CI Exam Code ' Sponsoring County Sponsorship App Date 104/17/2012 Sponsorship Expiration Date Testing Facility JGITS (AAE2A) GITS, LLC Examination Operations Division Providing the services and products to assist Government Agencies to make informed educated decisions. Official Examination Score Report May 8, 2012 Official Score Report: Candidate Information: Name— Robert Marzzacco Candidate#: 63670670M Testing Site: Ocala, FL Final Score Result: General Contractor Score: 75% Business Procedures Score: 76% These results represent the grade that has been achieved on the General Contractor and Business Procedures examination(s) administered by Gainesville Independent Testing Service for Collier County, Florida on May 8, 2012. If you have any further questions, please do not hesitate to contact us. Sincerely, F• Pabl„..tettpi1/4.1A,N4,LQ- __ks),_) Jay E. Bowermeister President PO Box 831127 Ocala, Florida 34483-1127—Voice(352)369-GITS -Fax(352)387-2443 800 997 2129 AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency. SIGNATURE OF APPLIC �T .!o_. sr) SSCC��VL,O BUSINE AME U 12 - )C12013 DATE BEFORE ME this day personally appeared Y , 0, 164/33peCovho affirms and says that he has less than one employee and does not require Workmen's Compensation and understands that at anytime he employs one or more persons he must obtain said Workmen's Compensation Insurance. STATE OF FLORIDA, COUNTY OF `` The foregoing instrument was acknowledged before me this 12- IR L'� 1_`_ '_ ( ate) - .by 0 � • • Ofki) who has produced } _ (name of person a«. *wledgirrg) (Type of as identification and who did not take an oath. X0%1 "unn% 02/01/2017\ = ��.. NOTARY PUBLIC pm- 4A RE •F NOTARY NOTARY SEAL u,.Commission t ��,,9. EE866$ g .. ®TARY PUBLIC Of ,0 ‘•• 'i • f e 1 e �J1V MID Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: a- C. fi\ww Certificate Category Requested: CleiNS&. CO sJl2_ The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement.You should verify time of active experience working as an apprentice or a skilled worker(e.g.as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: lame,Title and license number of the person signing below and verifying Applicants relevant experience: Vame: 3644—t c �f9 p e Nile: Q(A t e r License Number(if applicable): PA p (OS 117 game of Business: a L k i e Oohs-4 r-L,c—t i 0, Business Address: c2 9 K(,A V ��� JerScr Silae TA l '7--)V CI Business Phone: 57O - 75 3- 33 "SV� `�( The Applicant's years of experience from /f i7 to/9 fir 'he applicant's scope of work(specific duties)included: /ea/nil/ / i-c 4.4 h Cc' Y/6d ^ 7.-2j C 1 1 .dditional Comments: alsifying any information provided heroin may subject your license to revocation. �p{ Print re `-� ` /d fate of Pleclda Print Name: C r �y ounty of 8elliere Lr\10 n he fuse wing insUwuent was acknowhdged before me on this Ill day of Slk`4 Tv- P.r c.. L.• K Q-+► who is personally known to me or produced_ :identification did who did note an oath. c‘...j n . r, '""+0..k.0 d. LOA it' COMMONWEALTH OF PENNSYLVANIA Signature of Notary Notarial Seal Cheri L.Aungst,Notary Public Avis Boro,Clinton County My Commission Expires Oct.17,2014 MEMBER,PENNSYLVANIA ASSOCIATION OF NOTARIES 6 JL KRAPE CONSTRUCTION, INC 29 KRAPE LANE JERSEY SHORE, PA 17740 July 12, 2012 Dear to whom it may concern; I have been asked to write a letter of recommendation on verifying Bob Marzzacco's experience when he worked for my company. He started working for me and my contracting business back in 1987 and stayed with us until 1991. Bob was fresh out of college and very eager to get working as he really is a go-getter kind of guy. I won't forget his work ethic or his positive attitude because these kinds of workers don't come around too often. Bob was able to hit the ground running and quickly moved up to a supervisor position with my business because he really did know the trade. He moved up to lead carpenter/foreman and eventually managed a 7 guy crew for me. My company built residential and commercial structures as well as single and multi story ones. Bob was able to do all facets of what the supervisor role entailed from supervising the guys on job sites to the laying of foundation, framing, interior petitions to the installation of the plumbing/ electrical to the installation of the windows and doors. His strong work ethic and his integrity about working are what remind me of how lucky I was to have him at J. L. Krape Construction. He was always on time and ready to work and get the guys moving. Bob was constantly focused on time frames and was readily able to assist myself in projecting them; whether it was a big or smaller job. He communicated with the guys well as well as myself, and he was able to be in control of entire projects if I needed him to be. He was able to read the blue prints when needed and never hesitated to keep me in the loop with what was going on day to day. He was attentive to budget constraints on all the jobs he supervised and Bob was good at giving suggestions or alternatives when a problem came up with a project or on the job site. He was extremely organized and had and still does have that leadership quality that a business owner appreciates. If I needed him to leave a job to help at another one unexpectedly, he was willing to work extended hours and help out as much as humanly possible. I was happy to write this letter for Mr. Marzzacco because as I said he is very knowledgeable and really was an asset to my company. I wish him all the best with his contracting business in Florida and if you have any questions or need anything else from me I would be happy to help. Sincerely, Jeff Krape/Owner LARRY D. BROOKS BUILDER • CONTRACTOR PA014069 68 LIME KILN RD LINDEN,PA 17744 570-398-7365 August 23, 2012 To Whom It May Concern: Bob Marzacco worked for me between 191' and Ma as arpenter. The last 3 years he worked as lead carpenter and job foreman. He possessed an unlimited amount of knowledge of carpentry skills and related trades such as electrical, plumbing, and heating. He was a hard worker, self motivated and able to lead others as well as take orders himself. He proved to be honest,trustworthy, and reliable while he worked for my company. Sincerely, Larry Brooks 4 • ',VERIFICATION OF CONSTRUCTION EXPERIENCE;, GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: , a_ Z Certificate Category Requested: G, . \f\ Ci:N\---Vic- t)c , The Applicant is seeking a Collier County Certificate of Competency pe cy iu the trade indicated above. As part of the application for this'certificate the Applicant must verify their experience within this trade.You are being requested to provide information that will aid the Applicant in meeting this requirement.You should verify time of active experience working as an apprentice or a skilled worker(e.g.as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: • lame,Title and license number of the person signing below and verifying Applicants relevant experience: game: Z.4E/2y (.Q':::1 kS rifle:(2('7/14/A9'�(.)L/ ()/A)4 JF,p License Number(if applicable): 7/1 •=:::5 / • c9 dame of Business: 4/9-,e t/ 2), Be-eon k/S -Su l L-J Epp - ( A.)' -j_tt} ..j--U 3usinessAddress: log Z (/Y2E (<itLN L_„if/j-A! P4 /77 iusiness Phone 5 77 3 7365 e Applicant's years of experience from,t1'6— to '' 9`Os• • - RIinIZ"4(J ' he applicant's scope of work(specific duties)inrluded:41c/00 l ,'"OA' ��?E-�S y O Vim. r� �,: /i et) g . _.. It-)A4-1-5/ / Roo r �5�f/,v�z_e S &)1 A- l xi ode 17Lil/ i4.)6- 4- 51„,5c 7--i2(c g-Lr #16�6 1)ao,�S, b..)Au,QOw/ / �-d 44- 7~y Y .dditional Comments: AWE) /7/N/S/ 'Tie 141, ,el-/4-5/r t`- S 4_/( //&7-/ )//517---ii), A Id/,lj f?L1 E 7-2) so L.v� ]Qa3 � ,mss, alsifying any information provided herein may subject your license to revocation '�/..� ir/ -"""-' q,. Print N4_,�,�y �ae°!�2'� its state of FIer t Names County of-Csliwr�4,a he funning ins wheat was acknowbdged before me on this J I day of T (Ili T who is personally known to me or produced ` Thi,.;vt.3 L f ec„ysc. . 15Q VI 7 y 0 :identificatiLn who did not take an oath. OAXk Signature of Notary g , COMMONWEALTH OF PENNSYLVANIA Notarial Seal Chen L.Aungst,Notary Public 6 Avis Boro,Clinton County My Commission Expires Oct.17,2014 , MEMBER,PENNSYLVANIA ASSOCIATION Of NOTARIES 4 Craftsman Design& Construction 185 Rosemont Garden Lexington, KY 40503 (859) 699-9428 July 13, 2012 To Board Members: I am writing this letter to verify employment and construction work for Robert. He worked for my company for several years here in Kentucky. From 2002 to 2007 he worked for me and he is first and foremost an upstanding quality guy and I am actually happy to write this letter for him. I have no doubt that he can get his own contracting business running and be successful at it. He is one of the most hardworking men I have ever hired on and like I said, he has a lot of integrity about his work and was very respectable to me, my family, the crews and my clients. It wasn't long before I put him in as the site foreman. My company mainly did residential properties and some commercial ones but with the market being what it was then and now it has been tougher getting a lot of bigger jobs. From the beginning, I used Rob to supervise and lead some of the smaller jobs that I had and he was a really good fit and within no time he was on the commercial projects. He was able supervise the men, 5 to 7 of them at a time, and he was hands on with all of the projects too. He was exceptionally good at supervising the jobs, many from beginning to end. Rob could start a project from the excavation or site preparation he could frame, install plumbing and electrical, roofing, siding, and he worked well with everyone when it came to getting these areas completed in the projects. I don't think there was one area that Rob couldn't handle when it came to building single or even multi story structures he was constantly helping out my company supervising multi jobs/projects at one time. When he came to Kentucky he impressed me because he brought all his own tools and was skilled at using all of them. We finished many projects on time and even earlier than anticipated in large part to Rob's willingness to work hard and long hours. His work ethic was above and beyond what I expected when I hired him. My company really stressed safety and Rob was very aware of the need to be conscientious with his crew members and I never had one issue with him and his crews follow safety standards. This is a quality guy with a lot of construction and supervising experience and I really hated to see him leave my company when he left Kentucky to go to Florida. Whatever I can do to help you folks with respect to Rob getting his contracting license I will do. If you have to call me for any reason feel free to. Like I said, I have no doubt that he will be successful in getting a construction company up and running. He genuinely has a substantial amount of construction knowledge and good character as a person and as a craftsman and he is one of those born leaders. Sincerel Michael Lathrem AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, _ k' V , am a resident of Ct� �-r— ;ounty, 1 o (State) and have resided here for more than five (5)years. During the last five years I have known t4,t ,-.* \crc z..2-ck - applicant). I have had he opportunity to observe his or her business and personal dealings and find him or her to be a person of Honesty, integrity and good character. (Signature) (Name) (Address) O r . -414,/ Wkc-r-co t° 34/4 Telephone) (4 �y _ �v��r — STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this _ �!- p (�� 'n � r _ kate-letkoll�.�C --c �-c �Z�ILZ 1 who has-produced— l� ►1�(name of person acknowledging) e of ideification) as identification and who did not take an oath. Am. • d • NATURE OF NOTARY e ce-L- NOTARY'S SEAL (PRINT NAME OF NOTARY) t NOTARY PUBLIC MADIGAN �` •S ;„9`. 0 ., 4 EE113228 ir EXPIRES July t;,'2015 (+p7jia.0 rv;ee.wm - - 159 F ,rys. 8 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, ROV-A N bD A L L A 7 , am a resident of e O L U E-e-- County, F LO i`IVt- (State) and have resided here for more than five (5) years. During the last five years I have known R010,2 2 T IA A(L 2 ZA CC... 0 (Applicant). I have had ;he opportunity to observe his or her business and personal dealings and find him or her to be a person of :ionesty, integrity and good character. (Signature) '47011/0—'^TPA►i t (Name) i20LA,J IJ O /I L,VAREZ. (Address) I X01- SuvisMI k al-U4 Apr c /vApl.Qs VL. Telephone) ".3. 0t - 5`3 S- 43 07 STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this ( '-t-k-AIVF)`(- Wad by ate) Kci a\‘\. 0 -A- who s-produced- rSo n Ct.1 -K n o(A)n 4-6 (name of person acknowledging) as identification and who did not take an oath. .s t_eom--)C,i C - NATURE OF NOTARY i1_,ZA___tz_.\1_9_z_i_a,___CialaszL n NOTARY'S SEAL (PRINT NAME OF NOTARY) cJ NOTARY PUBLIC ;i e'<. KATHLEEN C MADIGAN '' 'c MY COMMISSION#EE113228 *-W"' EXPIRES July 17,2015 (407)398.0153 fwraeNaery8ervice.com 9 Q fit V of trt V st art Volt go V tit go V st ft V 01► p la t ► � ∎,∎ f∎-�c► 4 �-Wit►,40∎ .�[• ��-' • /i• � • * 0 13, 4 41.- .(P. Alb, oruN MI A A 01; ■117`,# <it 4ct * 0 A 1,, 0 d 771 #11111)4:ti 410 04 A 40 V*" 1 2 ,ci) ° ,4 . 1 OD • V ft 4� 4 . w o .[►® a' o ,:=) -,.---,- 2 cd t E.' A 4;1 0 1)1 L4 .' c: (;) F C.)-V) '' 0 O Il OAS ., , . N 4 1%4 ♦ ' o U 6 = ..• m/ Ct.: 0/1(k ,L1 `-) ,(:). 1 c',7i rci !" .17ci c.-, ;,ls) 14Y0 4 41•41 01 0 (.7, cf, d ,4 rl oz t .e ° ° ' o � in ry i:-4 P s b k A N cd - ccd >1 w ---""‘ Ort( 4 {/l 0 v o •1I19% /� �v O t o '-d •� fit ' �rA� t 0 o U 0%V H rn H o 4 P. 03 ♦1* A # 4 * tt # 4 A 017217? ... ® 4Ahh1 •[►� bk � 144 i * 4��. `° • A. 1. 4. A a i �.� r •rr �A� t ∎ II ,. ��� ' Colf 40ee40 t/4r440 %Elee4y �I4''ey 4i/4%40 4 /e4411 • COLLIER COUNTY GOVERNMENT COMMUNITY DEVELOPMENT AND ENVIRONMENTAL SERVICES DIVISION 2800 N.Horseshoe Dr. • Naples.Florida 34104 • 239-403-2400 • FAX 239-403-2334 MEMORANDUM DATE: November 29, 2007 TO: Applicant's FROM: Michael Ossorio, Contractor Licensing Supervisor. CC: Robert Dunn, Collier County Building Director. Alamar Finnegan, Collier County Permitting Supervisor. Robert Zachary, County Attorneys Office. All Contractor Licensing personnel. SUBJECT: Collection of social security numbers. Pursuant to Chapter 119, Florida Statues and Collier County Contractor Licensing Ordinance 2006-46 Sec. 2.1.1, all applicants are required to submit their social security number(SSN) for the following purposes: a) Assess applicant's ability to satisfy creditors by reviewing their credit history. b) Verification of applicant's test scores and information. Our office will only use your SSN noted above for those reasons pursuant to Chapter 119, Florida Statues and as may otherwise be authorized by law. We are fully committed to safe-guarding and protecting your SSN and once collected, will be maintained as confidential and exempt under Chapter 119,Florida Statues. Equifax Thank you for your order! Equifax Secure Site Order Confirmation Your order confirmation number is: 1-27867374850 0 Important message about your order We're sorry. We were unable to complete your entire order. Please carefully review the order status below to see which products were not able to be delivered. You will not be charged for the undelivered products. You may contact our Customer Care department at 1-866-519-4800 Monday - Friday 8:00am- 8:00pm ET for further assistance. Product Status UnitsPrice Business Credit Report Unavailable 1 $99.95 GULF COAST CONSTRUCTION AND DESIGN1270 BLUEBIRD AVEMARCO ISLAND, FL 34145-2812 Subtotal: 1 $99.95 Tax: $0.00 Total: 1 $99.95 Member Center Having Trouble'? ` Contact us M Copyright Equifax 2014 I Privacy Policy I Terms of Use I Cancellation Policy https://sb.econsumer.equifax.com/bizdirect/compieteOrder.ehtml Page 1 of 1 1/5/14 Detail by Entity Name FLORIDA DEPARTMENT OF STATE DIVISION OF CORPORATIONS ° z�a�r�r �.. Detail by Entity Name Florida Profit Corporation GULF COAST CONSTRUCTION AND DESIGN CORP Filing Information Document Number P13000102041 FEI/EIN Number NONE Date Filed 12/30/2013 State FL Status ACTIVE Effective Date 12/28/2013 Principal Address 1270 BLUEBIRD AVE MARCO ISLAND, FL 34145 Mailing Address 1270 BLUEBIRD AVE MARCO ISLAND, FL 34145 Registered Agent Name & Address MARZZACCO, ROBERT C 1270 BLUEBIRD AVE MARCO ISLAND, FL 34145 Officer/Director Detail Name & Address Title P MARZZACCO, ROBERT C 1270 BLUEBIRD AVE MARCO ISLAND, FL 34145 Annual Reports No Annual Reports Filed Document Images search.sunbiz.org/Inq uirylCorporationSearch/SearchResultDetail/EntityName/dome-p13000102041-d21d9190-6f21-45e3-9556-25a3f5d6efeb/g ulf coast construc... 1/2 Electronic Articles of Incorporation F ED0102041 For December 30, 2013 Sec. Of State msolomon GULF COAST CONSTRUCTION AND DESIGN CORP The undersigned incorporator, for the purpose of forming a Florida profit corporation, hereby adopts the following Articles of Incorporation: Article I The name of the corporation is: GULF COAST CONSTRUCTION AND DESIGN CORP Article II The principal place of business address: 1270 BLUEBIRD AVE MARCO ISLAND, FL. 34145 The mailing address of the corporation is: 1270 BLUEBIRD AVE MARCO ISLAND, FL. 34145 Article III The purpose for which this corporation is organized is: ANY AND ALL LAWFUL BUSINESS. Article IV The number of shares the corporation is authorized to issue is: loo Article V The name and Florida street address of the registered agent is: ROBERT C MARZZACCO 1270 BLUEBIRD AVE MARCO ISLAND, FL. 34145 I certify that I am familiar with and accept the responsibilities of registered agent. Registered Agent Signature: ROBERT MARZZACCO P13000102041 FILED Article VI Sec. Of State' 2013 The name and address of the incorporator is: msolomon ROBERT MARZZACCO 1270 BLUEBIRD AVE MARCO ISLAND FL 34145 Electronic Signature of Incorporator: ROBERT MARZZACCO I am the incorporator submitting these Articles of Incorporation and affirm that the facts stated herein are true. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an annual report between January 1st and May 1st in the calendar year following formation of this corporation and every year thereafter to maintain "active" status. Article VII The initial officer(s) and/or director(s) of the corporation is/are: Title: P ROBERT C MARZZACCO 1270 BLUEBIRD AVE MARCO ISLAND, FL. 34145 Article VIII The effective date for this corporation shall be: 12/28/2013 Certificate of Status I certify from the records of this office that GULF COAST CONSTRUCTION AND DESIGN CORP is a corporation organized under the laws of the State of Florida,filed electronically on December 30,2013,effective December 28,2013. The document number of this corporation is P13000102041. I further certify that said corporation has paid all fees due this office through December 31, 2013,and its status is active. I further certify that said corporation has not filed Articles of Dissolution. I further certify that this is an electronically transmitted certificate authorized by section 15.16,Florida Statutes,and authenticated by the code noted below. Authentication Code: 131230115232-100255061051#1 Given under my hand and the Great Seal of the State of Florida at Tallahassee,the Capital,this the Thirtieth day of December,2013 Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 17 WP 8/85 01/09/14 08:57CT [SUBJECT] [SSN] [BIRTH DATE] MARZZACCO, ROBERT C. [ALSO KNOWN AS] MARZZACCO,CONTRACTING FULKROD,ROBERT RAINEY,ROBERT [CURRENT ADDRESS] [DATE RPTD] 361 BERTIN HT. , WILLIAMSPORT PA. 17702 6/06 [FORMER ADDRESS] 310 CULVERT ST. , JERSEY SHORE PA. 17740 10/05 1270 BLUEBIRD AV. , MARCO ISLAND FL. 34145 [POSITION] [CURRENT EMPLOYER AND ADDRESS] [VERF] [RPTD] SELF 3/08 3/08 [FORMER EMPLOYER AND ADDRESS] LONZA INC CHEMICAL OPERATOR 3/06 M O D E L P R O F I L E ***FICO CLASSIC 04 SCORE +571 : 038, 020, 016, 018 *** C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=3 COL=19 NEG=3 HSTNEG=1-26 TRD=8 RVL=1 INST=3 MTG=4 OPN=0 INQ=1 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE INSTALLMENT: $3024 $ $3024 $0 $120 MORTGAGE: $120K $ $ $ CLOSED W/BAL: $6200 $6200 $284 TOTALS: $123K $ $9224 $6200 $404 P U B L I C R E C O R D S SOURCE DATE LIAB ECOA COURT ASSETS DOCKET# TYPE PLAINTIFF/ATTORNEY Z 4780235 3/11R $11.2K C CI 201000449 CIVIL JUDGMENT MEDICAL Z 4780234 12/08R $4662 I CI 802805 CIVIL JUDGMENT DAVID NAU Z 4780230 5/07R $95.OK I CI 00700000342 CIVIL JUDGMENT CUT GROUP CONSUMER FIN C O L L E C T I O N S SUBNAME SUBCODE ECOA OPENED CLOSED $PLACED CREDITOR MOP ACCOUNT# VERIFIED BALANCE REMARKS UNITED REV Y 1JDZ002 I 8/08 $548 MEDICAL O9B 12/13A $548 PLACED FOR COLLECTIO MIDLAND FUND Y 36ET009 I 3/12 $1206 VERIZON WIRELESS 09B 12/13A $1206 PLACED FOR COLLECTIO KEYSTONE COL Y 1H85002 C 11/09 $128 01 COLIN R BRANTON 09B 12/13A $128 PLACED FOR COLLECTIO KEYSTONE COL Y 1H85002 I 12/08 $414 MEDICAL 09B 12/13A $414 PLACED FOR COLLECTIO LVNV FUNDING Y 21T9002 I 2/09 $565 12 HSBC BANK NEVAD 09B 12/13A $740 PLACED FOR COLLECTIO LO THMS REED Y 95UW001 I 11/08 $1156 MEDICAL 09B 12/13A $1156 PLACED FOR COLLECTIO REMIT CORP Y 1DBROO1 I 4/08 $56 MEDICAL 09B 9/13A $56 PLACED FOR COLLECTIO REMIT CORP Y 1DBROO1 I 12/07 $60 MEDICAL 09B 9/13A $60 PLACED FOR COLLECTIO CONVERGENT Y 57XU001 I 10/11 $263 DIRECTV 09B 8/13A $263 PLACED FOR COLLECTIO AMER AGNCIES Y 2DXM001 I 5/12 $332 MEDICAL 09B 4/13A $332 PLACED FOR COLLECTIO AMER AGNCIES Y 2DXM001 I 5/12 $417 MEDICAL 09B 4/13A $417 PLACED FOR COLLECTIO 2/11A $19.1K PLACED FOR COLLECTIO CREDITECH Y 1NEP001 I 3/09 $205 MEDICAL 09B 7/09A $205 PLACED FOR COLLECTIO CENTRAL CRED Y 53YC002 I 4/08 $1442 MEDICAL 09B 10/08A $1442 PLACED FOR COLLECTIO CENTRAL CRED Y 53YC002 I 4/08 $510 MEDICAL 09B 10/08A $510 PLACED FOR COLLECTIO CENTRAL CRED Y 53YC002 I 4/08 $1875 MEDICAL 09B 10/08A $1875 PLACED FOR COLLECTIO CENTRAL CRED Y 53YC002 I 4/08 $1030 MEDICAL 09B 10/08A $1030 PLACED FOR COLLECTIO CENTRAL CRED Y 53YC002 I 4/08 $3461 MEDICAL 09B 10/08A $3461 PLACED FOR COLLECTIO STERLING CRD Y 1JCY001 I 11/07 8/08F $5896 13 LONZA FEDERAL C 09P 12/10A $0 PAID COLLECTION T R A D E S SURNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# VERFIED CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 SANTANDER F 1R18003 12/04 $20.8K 72M284 I09 12/13A $6200 C AUTOMOBILE 1/10F $6200 UNPAID BLNC CHRGD OFF HSBC BANK B 2DQ1002 2/07 $523 R09 11/07A $0 $0 I CREDIT CARD 7/07F $0 PURCH BY OTHER LENDER CHASE B 1127001 4/06 $153K 360M1695 7/08 555555555543 M05 3/10A $0 $4490 05 2111XX55X132 I CONVENTIONAL REAL 3/10C $0 FORECLOSURE,CLTRL SLD 35 9/ 4/13 RACACCEPTNCE F 2E4W001 12/13 $3024 25M120 I01 12/13A $0 I RENTAL AGREEMENT $3024 RACACCEPTNCE F 2E4W001 7/13 $1799 18M99 11111 I01 12/13A $0 I RENTAL AGREEMENT 12/13C $0 CLOSED 5 0/ 0/ 0 ACCRED HOME B 22E1001 4/06 $153K 360M1123 1 MO1 11/06A $0 I CONVENTIONAL REAL 11/06C $0 PURCH BY OTHER LENDER 1 0/ 0/ 0 OCWEN LOAN B 813P004 8/05 $120K 360M667 1 MO1 10/05A I CONVENTIONAL REAL 1 0/ 0/ 0 OCWEN LOAN B 813P004 2/04 $77.6K 360M590 1111 MO1 6/04A $0 I CONVENTIONAL REAL 6/04C $0 TRNSFRD: OTHER LENDER 4 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 1/09/14 ZNP6284423 (FLA) MERIT CREDIT C R E D I T R E P O R T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE, P. 0. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION MONTOUR CO ZP4780235 (717) 271-3010 29 MILL STREET DANVILLE PA. 17821 LYCOMING CO ZP4780234 (717) 327-2200 48 WEST 3RD STREET WILLIAMSPORT PA. 17701 CLINTON CO ZP4780230 (570) 893-4007 230 E WATER ST LOCK HAVEN PA. 17745 UNITED REV YC1JDZ002 (215) 750-3202 PO BOX 1184 LANGHORNE PA. 19047 MIDLAND FUND YC36ET009 (800) 825-8131 8875 AERO DR SAN DIEGO CA. 92123 KEYSTONE COL YC1H85002 (570) 748-2981 124 E MAIN ST LOCK HAVEN PA. 17745 LVNV FUNDING YC21T9002 (866) 464-1183 625 PILOT ROAD LAS VEGAS NV. 89119 LO THMS REED YC95UW001 (607) 937-5597 88 TIOGAQ AVE CORNING NY. 14830 REMIT CORP YC1DBR001 (877) 736-4848 P 0 BOX 7 BLOOMSBURG PA. 17815 CONVERGENT YA57XU001 (800) 444-8485 PO BOX 9004 RENTON WA. 98057 AMER AGNCIES YC2DXM001 (717) 540-7636 2491 PAXTON ST HARRISBURG PA. 17111 STERLING CRD YC1JCY001 (215) 793-9144 716 BETHLEHEM PIKE AMBLER PA. 19002 CREDITECH YC1NEP001 (610) 588-0965 50 NORTH 7TH ST BANGOR PA. 18013 CENTRAL CRED YC53YC002 100 N THIRD ST SUNBURY PA. 17801 SANTANDER FA1R18003 (866) 923-9282 PO BOX 961245 FORT WORTH TX. 76161 HSBC BANK BC2DQ1002 (800) 695-6950 PO BOX 30253 SALT LAKE CITY UT. 84130 CHASE BM1127001 (800) 848-9136 PO BOX 24696 COLUMBUS OH. 43224 RACACCEPTNCE FZ2E4W001 (800) 275-2696 5501 HEADQUARTERS PLANO TX. 75024 ACCRED HOME BM22E1001 (877) 683-4466 16550 W BERNARDO D SAN DIEGO CA. 92127 OCWEN LOAN BM813P004 (561) 682-8000 1661 WORTHINGTON R WEST PALM BEAC FL. 33409 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED 3 SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR (239) 277-3202 . 1 From:Debb!e,Smith<smitd145aldelennins,coni> I Date:December 30,2013 at 12:06:18 EST To: '70051t-cZjahrto COM TcZaallaratLaal> Sul:firm:ft Revised Certificate of Insurance Hi Rob. Rer your request.the revised Certificate of Insurance Attached.Ha‘m a vtonderfut Holiday! Debbie ....----‘ Accpme CERTIFICATE OF LIABILITY INSURANCE I tan otoottrffn THIS CERTIFICATE IS ISSUED As A MATTER OF inromumose ow MIS CONFERS NO RIGHTS UPON THE CERTWICATE HOLOWL111111 CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,unto ON ALTER THE COVERAGE AFFORDED BY TEE POLICES BELOW. THIS OWITIFICATE OP INSURANCE 006$NOT CONSTITUTE A CONTRACT SETWININ THE PISMO INSURERIEL AUTHORIZE° RIPIRESID/TATIVE OR PRODUCER,AND THE CERITICATE HOUMA IMPORTANT:II his corIlkOs holder Is so ADDITIONAL NOSEBED,Iho poky.*moot be odorood.II SUEBOGATION 16 WAIVED,=IWO to his 101101011c0BETW/o/OI Bs POW.ootIois polldls my Nooks oi todonsomot.A otol0000t Go Oft ortEleato dos not corior rights To Ito cordIktoW holder Is his of suds todOssoitato1 MOMS '7'1-1'" =NM man AL MADE i ASSOCIATES. MI Th-r11111111VIMEMED F.'. ( .)is-m• 2014 LSI BLVD 1122 19 i.,---. 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Print legibly in each data entry field. If this application contains incomplete or inaccurate information or if the handwriting is not legible,it may cause a delay in the issuance of your exemption. SECTION 1: Applicant Name(please print): C P A. a. f\ I) Applicant's social security number: Applicant's E-mail address(optional): 200_5 I. 1 I'1; 7. c.ory\ SECTION 2: I am applying for exemption as a(You must check only one box in this section): CONSTRUCTION INDUSTRY($50 FEE REQUIRED)-The Division will accept a money order or a cashier's check made payable to the DFS WC ADMINISTRATION TRUST . 11 [Officer of a Corporation(Title): Oath— -OR- ❑ Member of a Limited Liability Company(LLC) NON-CONSTRUCTION INDUSTRY(NO FEE REQUIRED) ❑ Officer of a Corporation(Title): ) An officer electing an exemption under Chapter 440,Florida Statutes is not entitled to benefits under this chapter. SECTION 3. The corporation of which you are an officer or the limited liability company of which you are a member must be registered and in an active status with the Florida Division of Corporations.Applicants applying as an officer of a corporation must be listed as an officer of the Corporation with the Florida Division of Corporations. List the document number(document number s_h.Qwn on your Annual Report)on file with the Florida Division of Corporations. i (3c0 loz04 SECTION 4. This exemption application applies only to the person signing the application,the Corporation/LLC that is listed below,and the scope of business or trade listed:Name of Corporation or LLC: ( U, I (. O4- Qys' x4ctn c � t rl �f FEIN: S'Sjfjo 191 REGISTERED W WIT FLORIDA DIVISION OF CORPORA NS U Business Name: Phone: Q3q) zoo-0(4A. IF APPLICABLE-LIST FICTITIOUS NAME;DOING BUSINESS AS(DBA); ALSO KNOWN AS NAME(AKA) Applicant's Address of Record: 1 210 up\oi rA. INCLUDE APARTMENT OR SUITE NUMBER City: \A>t(en �1.'``f1Y�� State: Zip: 341 t{s County: I Con er Scope of Business or Trade: 1. GY 1ct Cpn-tfoc.V2. 3. 4. SECTION 5. List all certified or registered licenses issued pursuant to Chapter 489,F.S.held by the applicant,or the certified ur registered license numbers held by the qualifier for the corporation or LLC listed on this application of which the applicant is a corporate officer: SECTION 6. If you ha e submitted an electronic payment for this application,write the transaction confirmation number in the following space: f1[A- SECTION 7. Are you affiliated with any corporation(including LLC)other than the corporation(including LLC)to which this application applies? :Wes IF YES,PLEASE LIST THE NAME(s)AND FEIN(s)OF THE AFFILIATED CORPORATION(s)OR LLC(s): NAME: FEIN: SECTION 8. If your corporation or LLC is engaged in the construction industry,you must provide the required proof of ownership in the corporation or LLC. A. To be eligible for a construction industry exemption as an officer of a corporation,the applicant must be a shareholder, owning at least 10%of the stock of the corporation. A COPY OF A STOCK CERTIFICATE EVIDENCING THE REQUIRED OWNERSHIP MUST BE ATTACHED. B. To be eligible for a construction industry exemption as a member of a limited liability company,the applicant must confirm ownership of at least 10%of the company. THE REQUIRED OWNERSHIP MAY BE ESTABLISHED BY PRODUCTION OF DOCUMENTATION REFLECTING THE REQUIRED OWNERSHIP,OR BY SUBMITTING A STATEMENT ATTESTING TO THE REQUIRED OWNERSHIP. THIS APPLICATION IS CONTINUED ON PAGE 2 DWC 250,NOTICE OF ELECTION TO BE EXEMPT—REVISED 12/08;RULE 69L-8.009,F.A.C. NOTICE OF ELECTION TO BE EXEMPT—Page 2 SECTION 9. FRAUD NOTICE A. Any person who,knowingly and with intent to injure,defraud,or deceive the department or any employer or employee,insurance company or any other person,files a notice of election to be exempt containing any false or misleading information is guilty of a felony of the third degree. B. Attestation of applicant-By signing signing below,I attest that I have read,understand and acknowledge the foregoing notice. l� t5 " (./ SIG E OF APPLICANT SECTION 10.You must ident y the workers' compensation insurance carrier that covers any non-exempt employees of your business. Carrier Name: N IN AFFIDAVIT OF APPLICANT: I hereby certify that the information contained herein is true and correct to the best of my knowledge and belief;that this election does not exceed exemption limits for corporate officers,including any affiliated corporatio s as provided in§440.02 Florida Statutes. C Ii jq - IS APPLICANT'S TUBE DATE SIGNED NOTARY STATE OF FLORIDA,COUNTY OF e(her \��okumini#106„ Sworn to and subscribed before e is Iq 1 day of eC rr oV , 2)11, ,by '∎t r Personally Known •R P I du.e. - tification V.Type of Identification Pro NOTARY SIGNATURE I/".. My Commission Expires = �N���1�O. Please mail or submit your complete. appli,ation, application fee,and any required attachments ,, ,,� v; .,,, to The Division of Workers' Comp• sation at the district office nearest your place of business. ,t t - .t', 8=ILA. Effecti4hgf R all&." 2295 Victoria Avenue,Suite 163 921 North Davis Street 401 NW 2^d Avenue Ft.Myers,FL 33901 Building B,Suite#250 Suite #321,South Tower Telephone(239)461-4006 Jacksonville,FL 32209 Miami FL 33128 Expiration Date: Telephone(904)798-5806 Telephone(305)536-0306 610 E.Burgess Road Pensacola,FL 32504-6320 400 West Robinson Street TALLAHASSEE SUBMITTERS Control N wither: Telephone(850)453-7804 Room#512,North Tower Orlando FL 32801 Walk-in submissions 3111 S.Dixie Highway,Suite#123 Telephone(407)835-4406 or 2012 Capital Circle SE Postmark Date: West Palm Beach FL 33405 (407)245-0896 Suite#102,Hartman Bldg. Telephone(561)837-5716 Tallahassee FL 32399-2161 1313 N.Tampa Street,Suite#503 499 Northwest 70th Ave.,Suite#116 Telephone(850)413-1609 Payment Number: Tampa FL 33602 Plantation FL 33317 Telephone(813)221 6506 Telephone(954)321-2906 Mail in submissions p ( ) 200 East Gaines Street Received Date: Live Oak Business Center Tallahassee FL 32399-4228 1111 NE 25th Ave.,Suite#403 5969 Cattlemen Lane Telephone(850)413-1609 Ocala FL 34470 Sarasota FL 34232 Telephone(352)401-5350 Telephone(941)329-1120 "The collection of the social security number on this form is specifically authorized by Section 440.05(3), Florida Statutes. The social security number will be used as a unique identifier in Division of Workers' Compensation database systems for individuals who have applied for and/or been issued a certificate of election to be exempt. It will also be used to identify information and documents in those database systems regarding individuals who have applied for and/or been issued a certificate of election to be exempt for internal agency tracking purposes and for purposes of responding to both public records requests and subpoenas that require production of specified documents. The social security number may also be used for any other purpose specifically required or authorized by state or federal law." DWC 250,NOTICE OF ELECTION TO BE EXEMPT—REVISED 12/08;RULE 69L-6.009,F.A.C. r 'pc:DEPARTMENT OF THE TREASURY r J INTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023 Date of this notice: 06-15-2012 Employer Identification Number: 45-5504497 Form: SS-4 Number of this notice: CP 575 A GULF COAST CONSTRUCTION AND DESIGN CORP ROBERT C MARZZACCO For assistance you may call us at: 1270 BLUEBIRD AVE 1-800-829-4933 MARCO ISLAND, FL 34145 IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN) . We assigned you EIN 45-5504497. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. When filing tax documents, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear off stub and return it to us. Based on the information received from you or your representative, you must file the following form(s) by the date(s) shown. Form 1120 03/15/2013 If you have questions about the form(s) or the due date(s) shown, you can call us at the phone number or write to us at the address shown at the top of this notice. If you need help in determining your annual accounting period (tax year) , see Publication 538, Accounting Periods and Methods. We assigned you a tax classification based on information obtained from you or your representative. It is not a legal determination of your tax classification, and is not binding on the IRS. If you want a legal determination of your tax classification, you may request a private letter ruling from the IRS under the guidelines in Revenue Procedure 2004-1, 2004-1 I.R.B. 1 (or superseding Revenue Procedure for the year at issue) . Note: Certain tax classification elections can be requested by filing Form 8832, Entity Classification Election. See Form 8832 and its instructions for additional information. IMPORTANT INFORMATION FOR S CORPORATION ELECTION: If you intend to elect to file your return as a small business corporation, an election to file a Form 1120-S must be made within certain timeframes and the corporation must meet certain tests. All of this information is included in the instructions for Form 2553, Election by a Small Business Corporation. (IRS USE ONLY) 575A 06-15-2012 GULF B 9999999999 SS-4 If you are required to deposit for employment taxes (Forms 941, 943, 940, 944, 945, CT-1, or 1042) , excise taxes (Form 720) , or income taxes (Form 1120) , you will receive a Welcome Package shortly, which includes instructions for making your deposits electronically through the Electronic Federal Tax Payment System (EFTPS) . A Personal Identification Number (PIN) for EFTPS will also be sent to you under separate cover. Please activate the PIN once you receive it, even if you have requested the services of a tax professional or representative. For more information about EFTPS, refer to Publication 966, Electronic Choices to Pay All Your Federal Taxes. If you need to make a deposit immediately, you will need to make arrangements with your Financial Institution to complete a wire transfer. The IRS is committed to helping all taxpayers comply with their tax filing obligations. If you need help completing your returns or meeting your tax obligations, Authorized e-file Providers, such as Reporting Agents (payroll service providers) are available to assist you. Visit the IRS Web site at www.irs.gov for a list of companies that offer IRS e-file for business products and services. The list provides addresses, telephone numbers, and links to their Web sites. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not have access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax-related correspondence and documents. If you have questions about your EIN, you can call us at the phone number or write to us at the address shown at the top of this notice. If you write, please tear off the stub at the bottom of this notice and send it along with your letter. If you do not need to write us, do not complete and return the stub. Thank you for your cooperation. Keep this part for your records. CP 575 A (Rev. 7-2007) Return this part with any correspondence so we may identify your account. Please CP 575 A correct any errors in your name or address. 9999999999 Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 06-15-2012 ( ) - EMPLOYER IDENTIFICATION NUMBER: 45-5504497 FORM: SS-4 NOBOD INTERNAL REVENUE SERVICE GULF COAST CONSTRUCTION AND DESIGN CINCINNATI OH 45999-0023 CORP % ROBERT C MARZZACCO 1270 BLUEBIRD AVE MARCO ISLAND, FL 34145 City of Marco Island 440,1114, 50 Bald Eagle Drive h 'Aft ., ,J Marco Island, FL 34145 v. it%) out,ilfr (239)389-5000 C..d}, Home Occupation Fax (239)393-0266 Letter of Zoning Compliance Mailing Address: Robert Marzzacco Gulf Coast Construction 1270 Bluebird Ave Marco Island, FL 34145 Certificate Number HOC-13-004375 Issue Date 12/23/2013 Expiration Date 12/23/2014 Applicant Robert Marzzacco Phone 239-200-0689 Business Name Gulf Coast Construction and Design Type of Business Home Office Mailing Address 1270 Bluebird Ave Marco Island, FL 34145 Property Address 1270 Bluebird Ave Marco Island, FL 34145 Approval: 12/23/2013 Christop r Sp acino, CFM Date Planner/ Floodplain Coordinator Community Affairs Department City of Marco Island Notes / Restrictions Applicant must comply with City of Marco Island Ordinance Article III, Section 30-405. • COLLIER COUNTY BUSINESS TAX RECEIPT .,<<t'__.. ` °- APPLICATION '. . fity yT i 2800 N. Horseshoe Drive,Naples, FL 34104 x ':r ?` :=. .: Make Check Payable to: Collier County Tax Collector ..,�,��� Phone: 239-252-2477 Fax: 239-643-4788 Website: www.colliertax.com ' °�ut,"...••' CHECKLIST Copy of Articles of Incorporation and/or Fictitious letter Yellow Fire Compliance(list of fire district phone number from the State stating that your business name is on tile. encl --- (850-245-6052 or 6058) wwwsunbizorg Copy of Marco Zoning Certificate.(239-389-5000) Copy of State license from Department of Business and - Professional(850-487-1395)or Department of Health. _ Completed Zoning application with appropriate fee made payable (850-410-3359) to:Board Commissioners. _ Copy of City Business Tax Receipt.(239-213-1800) Completed Business Tax Receipt application with appropriate fee made payable to:Collier County Tax Collector.(239-252-2477) Copy of Motor Vehicle Repair Registration Certificate �� — 'F•y from Department of Agriculture.(800-435-7352) `� Utner: 6....4,,'"' n-1-ram- ,I-l,.,; C.e._S , Copy of Health inspection from Department of Hotels and Please contact the Property Appraiser's office at 239-252-8145 Restaurants(850-487-1395)or Department of Agriculture. regarding tangible tax. (800-435-7352) CHECK ONE: Date: Original Application Classification Transfer of License # Code Number - - Renewal of License # License Amount 1) CORPORATE NAME - 0We_'-"1 Ciyalu M a5;311 eforp la) DBA NAME -_ _ lb) BUSINESS OWNER OR QUALIFIF(R'S NAME - "V"Obef1- C. rnPrf 3-1116-7 2) PHYSICAL ADDRESS - 2.70 �11re.bi(tl Ave- flW o L kj� `J (No P.O. Box allowed) 2a) IS RESIDENCE USED AS AN OFFICE - X, Yes_ No 3) BUSINESS MAILING ADDRESS - . P _ vL Street City Zip 4) OWNER OR QUALIFIER'S RESIDENTIAL ADDRESS - SIM, 0,001._ 5) TELEPHONE - Business: 61 0 �D - S1 Home: 6) LEGAL FORM OF BUSINESS: 1, /Sole Proprietorship Partnership Corporation LLC LLP 7) OPENING DATE OF BUSINESS OR DATE ASSUMED - ©f(0 )2012. 8) OFFICE WITHIN CITY LIMITS OF NAPLES-_Yes o If Yes,City License No. 9) SOCIAL SECURITY NO. or FEDERAL EMPLOYER IDENTIFICATION NO. - - 45 - 55N 491 *see back of application for explanation 9a) TYPE OF BUSINESS CONDUCTED: ef t CQC -AC O 10) NUMBER OF EMPLOYEES- Including number of owners: 11) FILL IN THE APPROPRIATE AREAS- • a) Rental units(motel/hotel/apts.)Number of units: b)Seating Capacity(rest./cafes, etc)Number of seats: c)Number of coin-operated machines owned by business or individual: 12) STATE LICENSE OR CERTIFICATION NUMBER - Must have photo copy of state license if state licensed and certified UNDER PENALTIES OF PERJURY, I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN I ARE TRUE TO TILE BEST OF MY KNOWLEDG xxxAPPLICANT'S SIGNATURE: Z. DATE: • (Owner and/or representative of business)TITLE: O� ****TH1S LICENSE IS NON-REFUNDABLE FOR BUSINESS STATED ABOVE**** k f 4 " ,, to f `Y+ Z ' . / ? ' ' .■ ' , 1 °s Y,, . ,1 �i 1 1 ; 11/1" L.," e- c.,..Fcu- It , '� ,, ,i4A--GMD Operations & Regulatory Management/ i SIP' p Licensing Section 4' 2800 North Horseshoe Drive i. t 1011 Naples, FL 34104 - :Z APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUCTIONS: This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered; on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: ry 1A Exact Corporate/Business Name: .6a +e'+i" 8 re&i+ ;', �i tn.) t 4-(,-,C, L--u (,.-1)(. / t1 / Cc,pi t�-c.4.%t- I i Fiction Name/DBA: _a Qualifier Name: ar* : C.;C>►�re -- Physical Address: . i L �`` �" Q610 kes Ll ( I (Number 86 Street) (City) (State) (Zip Code) Mailing Address: 'RD , (Sax \ l 3 �.4 te> E __ 3`*lO tom, (Number 86 Street) (City) (State) (Zip Code) Telephone: .2,3°)- 35,Z-(,(0(.01-* E-Mail: I-046 b re'; h,)v, c 9 / �N C; �Y"L�'�i i` ( .,,ek , (co- TYPE OF LICENSE: ❑ General $230.00 ❑ Electrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $230.00 ilk Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 ❑ Specialty $205.00 Specialty trade: A.�i P—ComL_. C CHANGE OF STATUS: ( ) Reinstatement ( ) From One Business to Another ( ) Dormant License to Active Page 1 of 4 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. V D co y t or?? l PAil (S± k}rf kc/ FL_ 3'1/l a. 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten years (ex. Held a license for or been a partner). Attach extra pages if needed. l.�hl r-- a turd 1 t7 r.0 1).1— L La C 3. List all debts you or any company(s)associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. \ICJEL AFFIDAVIT I �--3 ,c-\(t certify that the foregoing is true and correct to the best of my knowledge. Authorized Officer of the Firm STATE OF FLORIDA COUNTY OF Cc--,\\l e (L The foregoing instrument as acknowledged before me this e 1\ 7—U ( C\t /� (Date) C, V1 C of �--0+r` bLyL cv ()n.l. (Name of officer, title/agent) (Name of Corporat' ) a o L.. Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced identification and did not take an oath. (Type of identification) NOTARY'S SEAL GINA NI DUKES �._ V / N Notary Public,State of Florida �(ISIGNATURE O • ARY) _ �''.; ° Commission#EE 109615 My comm. expires July 6, 2015 Page 2 of 4 QUALIFIER INFORMATION: Name: k 0 Cr1 o N ro --- Address: 2 « � i +--5"-J _t (mss � `� (Number& Street) (City) (State) (Zip Code) Telephone: . 3 9.-35 Q..°- (c(oL Date of Birth: S.S. #: 000-00- E-Mail:-T bnn e e ei-bre_o_41- tairrkoe-Gkto ,(1)r Driver's License: V 1. Type of Certificate of Competency for which application is made. 2. The names and telephone numbers of two persons who will know your whereabouts. S ,rte U c r A `- `l 3. Have you ever been convicted of a crime related to Contracting? 1\t(C) (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? NO 8. List all debts you or any company(s)associated with you refused or failed to pay and reasons why. 9. List your business or work experience during the past ten years. 0 CA-I r•re r o of ('O1 L 1\i C rei San'tr e ( J 0 r k-fe 1\ t"1":/,`,)-( r, 1M(G e.S 13'00 %-e L Ivrk Ys4,e% 5 k-{ C -5 /S-{-e,AA s- 10. Statement of any formal training you have had in the area for which the application is made. Page 3 of 4 Licensee c���� Infox� Information * — D�uh��n l�� Property Men Licensee Number Q28380 ________ __ . __ Name THOMAS G. CONROY i- - - -- - -- - - [] Type uCont�rmr �� - - -- - - - --- [] | Status Open. L�) | _______ - - -- View Master Project View All Activities for this Licensee Add a new person or business to Address Book Exa�������� ������ A Add Exam Result | ' ___ Score I ~| Uok| Eron�T�kTxpe Da�'�Em:n�o� City ^ / 1,.... BUSINESS 07/01/2006 NAPLES/GITS 32.00 pai|__________ �_ ----------------'---------------- -'---'-----` ' -'------BUSINESS PROCEDURES 10/07/2006 (GI TS) 76 v n0 TPass ���----'--------'------'--'------'---- — AIaCDND. SERVICE (C) 06/04/2013 Plantation,un, pL i78 . Pass '' L Show More T& nru eor Fields J Charge Exam Fee Li Exam Code �__ _ ~ ___'_~ _~- ____�_�_�___- __ _- spon�or,hip�pno�� Spnn,ohngcnumv \ . _ _______ Sponsorship Expiration Date�-'- ------ -- -------- Tasdng pad|i�� i AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No. 2006-46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. ( -(:). iVA C..)e_*)elkj re-j. APPLICANT(PLEASE PRINT) Ge_LA.e.c--- read. NAME OF COMPANY SIGNATURE OP APPLICANT STATE OF FLORIDA COUNTY OF co 11■e r- The foregoing instrument as acknowledged before me this �j c 6A r- ow1.1 (Date) By 1 n(Y`4t3 C0(\ who has produced clb44d 7rN&I 5\kili - (Name of persona knowledging (Type of identification) as identification and did not take an oath. NOTARY'S SEAL /zo, JOSEPH P.LA PORTE,JR. her i'3 Notary Public,State of Florida Commission*EE 96442 GNATURE OF NO RY) me, My comm.expires May 23,2015 Page 4 of 4 AFFIDAVIT IT IS understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency. I SIGNAF APPLICANT BUSINESS NAME A„.2 _" _- DATE CG';EFORE ME this day personally a ppeared ir\C Ac who affirms and says that he as less than one employee and does not require Workmen's Compensat' i understands that at any .me he employees one or more persons he must obtain said Workmen's Compensation Insurance. TATE OF FLORIDA OUNTY OF he foregoing instrument was acknowledged before me this -� Y 'u t-+1 2144-\ am 0 (Date) r t C �0c1 t\Th .- who has produced _,Leif + (name of person acknowledging) (Type of identification) identification and who did not take an oath. p� GINA M.DUKES 4, A, ' Notary Public,Slate of Florida _! ' Commission#EE 109615 I NATURE • •TARY My comm. expires July 6, 2015 OTC •Y. _ �� � .� . ..' '.:, a . : Ile _ . . i NOTARY PUBLIC GMD Operations & Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: ` 0 CO /0 ry 1 Certificate Category Requested: C' to S C, ki-- CO N 8.- 4- 1 D rJ i)i The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement.You should verify time of active experience working as an apprentice or a skilled worker(e.g.as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: Name, Title-aannddllicense number of the person signing below and verifying Applicants relevantexperience: Name: 1,(7_M CO r()`-'d— - Title: Ow €c n License Number(if applicable): C C C ( 3 L. o 3 Name of Business: C.�O C) lo l Coo L L I^,C Business Address: ?C) , (aX 9 c 3 f --16-f, tes` 1.- L 3`k. l 0 Cc Business Phone:-2-31'350Z`( C The Applicant's years of experience from k99.Z to ere5r' The applicant's scope of work(specific duties) included: PS 6 w t tie t i Co x;re,/ R o c c a --�- (,:.)0 rke�--{`Z`'-(1 c w 1(lA (+0 4-C CDCtitPawl ,c LpSf U r00 P - 0 Urv., -.5 dTe ' eeS c St 5.,, i_n1 HCt0 . b&,,,,-J ii 6r kit,-1_, 4.-c c k&& .-a,..(,)�,C r--C 4L,,3_,-leer op CC r„i„,,€rC LJ E-I-_v -c j(4.S- S 4 r,60,4,60,4,,..i Y/( O , ,91,.. 0 Er A s . .--,t.) f ( ar4.+J ,-1 J r 1 ` �v`�v�� t 0 S;� 5 `U`e /,av j Additional Comments: (�c -k)s-) n/�.. hem &-&Q -f - ('I .D CA se- i r &it s OQ- -/- 4Q( 5 h�,r.f ,er)( y�= �--. f C ex.v *e..10 v-C- �.,,.�. o?.,5-�i Q - a.. -i-v ee S i.P OVAL Scl5 'w-v4S c re •ek Jo(i e f r -for-c--4,41(0 Falsifying any information provided herein may subject your license to revocation. v.0 0-vAC r .4-4 ia>S Signature ,,----__ Print Name: l' a/''2 `sN r`3`-7_—.. State of Florida 2ounty of Collier the foregoing instru cn as acknowledged before me on this ay of 1„.. a.-3 Y"''. 20k ,y°� W s ( .�i \Z t.-. who is personally known to me or produced T t Cinc5.-O,_.-- 1 is identification and who did not take oath. • r ►. ` 1 Sign.ture of No GINA M.DUKES 'i ^pOt Notary Public,State of Florida Commission#EE 109615 6 ���� My comm. expires July 6, 2015 • `VERIFICATION OF CONSTRUCTION EXPERIENCE GMD Operations & Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: ((Wt. ©Nroy Certificate Category Requested: (Ird.SS C 4,i 60,0.1:116,-),‘c,3 The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement. You should verify time of active experience working as an apprentice or a skilled worker(e.g. as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: Name,Title and license number of the person signing below and verifying Applicants relevantexperience: Name: _17<(t( t'-)e.J7_. I Title: a-u, e p2, License Number(if applicable): c. C J C'. I S 01 o 1 I a Name of Business: • 0 I " oesa rr c '0,.✓ ;rv,; �-^ Business Address: 2-70 g`�'L, fkcf a3.i. myIe...s i`�I ;3t°fl, [ ,�} Business Phone:.?;5�} g;S- a .-, (, (+ The Applicant's years of experience from 9 C t C? to i� rf'_5-.-°`E` The applicant's scope of work (specific duties) included: kw,c___ wor Le a t,.:c -{.., `ka.ro,, (oar os.y 2P--- C o S it4-,S 4: C.12d�0�'inJC' c u-4 fs..,,. 3-eMs CV eu d�'A 1 r`€�vvve s J- k ux 11i t4 i c:'nvc s.e j r. a \-tf (t C a 04 vv.e L s L,A0 (, Ne.Q A 40 Iw ii c •4.0 Ad i ,),e..4 re-.s�a i4. ,, Additional Comments: Falsifying any information provided herein may subject your license to revocation. �- ,/ (----- , / yi Signature Print Name: b'Q11 1&02 State of Florida Thunty of Collier in r rr nt was acknowledged before me on this day of i�Q jam !/} / 8 The f re omg st e g y ,y (/�,l,(iQ . _ t. who is personally known to me or produced ,,_..!A G 1�� . _ , , i is identification and who di not take an oath. Va',- 0.-'[.0 Signature of Notary SANDRA LAVALLEY :': ■ •'c MY COMMISSION#EE188500 ``-t;r EXPIRES February 12,2016 -015l Fbridalloweaenics com , • "VERIFICATION OF CONSTRUCTION EXPERIENCES GMD Operations & Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: I o n/ Con f7 O L3 Certificate Category Requested: C I 6t,fS C A t v2 Condition I n The Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the application for this certificate the Applicant must verify their experience within this trade. You are being requested to provide information that will aid the Applicant in meeting this requirement. You should verify time of active experience working as an apprentice or a skilled worker(e.g. as a worker commanding the wage of mechanic or better in the trade). Time served solely in a supervisory or administrative role should be described, but may or may not be considered sufficient to demonstrate required trade experience. The person verifying trade experience must provide the following information: Name, Title and license number of the person signing below and verifying Applicants relevant experience: Name: 5iLve- C d(oWCAU\ Title: C.,• A• M . License Number(if applicable): Name of Business: 19M 2v.UFe./V i lino,c}eAml'if'ti Business Address: 5a00 1& 1 am 1 l 1611 I JJN arLe S I° 3-1 05 Business Phone: 23 1 `Z S54 Xa The Applicant's years of experience from 110133 to 'TVV e-Se%n"t The applicant's scope of work (specific duties) included: 10 in Co 9 Pn o o k Gl S t.,ot 4.\/ .C. SiftCi✓ ohmic- ? of /'onf-o g_ooriYlCi Inc has loo(-16?vt. • WM OW comfdin1 in conjunalorl vu)-111 .v. c- (orn;inn,6s 1115 G111ii�G� G� 1� I'G'��S Additional Comments: unit-s. Ir1CT S )Ckf'f i f 1& pvro✓V m S wi "h 0 u o uc s U st -S i 0 J NH-ICS on man L of our,p -o11-1-ies. 1; is an 6xficv-y on (I veer 5���6YY m(kifl1Cnonce,. Falsifying any informati provided herein may subject your license to rev.--at''.n. . Aug, _ _ AL. Signature �, Print Name: �� �' `_- Slate of Florida • County of Collier The foregoing instrument was cknowledged before me on this 0( day d of _C�if�_ �. 2c byaeNI bD X3 . who is personally known to me or .roduced 410r L as identification and o did not take an oath. rot. . GINA M.DUKES Notary Public,State of Florida Signature of Notary "—� Commission#EE 109615 u�+�r My comm. expires July 6, 2015 7 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, 5 -CC,-e.,( cckc-- , am a resident of Zee- County, rio (State) and have resided here for more than five (5) years. During the last five years I have known owt as o Lt (Applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Signature) /ifs (Name) (fit-C-Cv"f (- c� (Address) 2+4 t`( Telephone) ?f - ?o / /37/ STATE OF FLORIDA, COUNTY OF ( L0 l `� The foregoing instrument was acknowledged before me this U 06 by ' Ja_c 5Q,hac-4-€.__ who has produced ,'�'��' ��4 Roo lJu (name of per-Aon acknowledging) (Type of ide ification) as identification and who did not take an oath. �Y m JEANNIE M.SWARTOUT , Notary Public-State of Florida 4 (4 a _ ��� : .., 'e`I ri 4 •E My Comm.Expires Dec 1.5,2018 S+(� ATURE OF N�'TARY `` Commission N`EE 829902 r �" Bonded Through National Notary Assn. M Scp.341-*.04— NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC 10 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER ga/PI-LI-- L/3cC ��I, , • am a resident of County, (State) and have resided here for more than five (5) years. During the last five years I have known applicant). I have had the opportunity to observe his or her business and personal dealings and findtim or her to be a person of honesty, integrity and good character. (Signature) (Name) S1)' ( / (Address) r' to r y f 61 1../l Ft- 5 q//L/ Telephone)( ,R- 1) d 1 e% — ` STATE OF FLORIDA COUNTY OF L,.61iger The foregoing instrument was acknowledged before me this d # iv 24. by .te \SR Ivd(LB UrcE Q who has produced . +.1 AAA f _i Jtr (name of person acknowledging) (Type of ide ' I cation) as identification and who did not take an oath. 1 AT U RE OF •TARY _JE,AN_NIE MSWA_TD_ 940hF Notary Public-State of Florins/. T - n t 5 11 W q r fp I V c DE Q1S,2016 (PRINT NAME OF NOTARY) `s Bonded Through National Notary Assn. NOTARY PUBLIC STATEMENT OF OWNERSHIP This certifies that I, —1t15M � �r� am a member or (APPLICANTS NAME) Managing member of ee,-k--"- r 8 r` - --- (LIMITED LIABILITY COMPANY NAME) I own \ C)C' % of the units issued by the Limited Liability Company listed above. Affidavit of Applicant: I certify that the information contained is a true and correct statement to the best of my knowledge. -pwi 0 r) re, (PRINT NAME) •PPI.TCANT'S SIGNATURE) (DATE) Detail by Document Number Page 1 of 2 LQRIDA DEPARTMENT of STATE DIVISION OF CORPORATIONS : Detail by Document Number Florida Limited Liability Company BETTER BREATHING LIMITED LIABILITY COMPANY Filing Information Document Number L13000104178 FEI/EIN Number NONE Date Filed 07/23/2013 State FL Status ACTIVE Effective Date 07/19/2013 Last Event LC AMENDMENT Event Date Filed 10/08/2013 Event Effective Date NONE Principal Address 8101 XENIA LN NAPLES, FL 34114 Mailing Address P.O.BOX 913 NAPLES, FL 34106 Registered Agent Name & Address CONROY, TOM 8101 XENIA LN NAPLES, FL 34106 Manager/Member Detail Name &Address Title MGRM CONROY, TOM 8101 XENIA LN NAPLES, FL 34114 Annual Reports No Annual Reports Filed Document Images http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail/DocumentNumbe... 12/27/2013 tom.sry;. 1 COD WE z ' FLORIDA DEPARTMENT OF STATE Division of Corporations October 9, 2013 TOM CONROY P.O.BOX 913 NAPLES, FL 34106 Re: Document Number L13000104178 The Articles of Amendment to the Articles of Organization for BETTER BREATHING LIMITED LIABILITY COMPANY, a Florida limited liability company, were filed on October 8, 2013. The certification you requested is enclosed. Should you have any questions regarding this matter, please telephone (850) 245- 6051, the Registration Section. Tammy Hampton Regulatory Specialist lii Division of Corporations Letter Number: 413A00023710 www.sunbiz.org Division of Corporations - P.O. BOX 6327 -Tallahassee, Florida 32314 • �wOvCOOO O°OO> D'WoOOO°OOOdOa°O`GYC-= 0`�*O•®�O©C 7� &gi N W .anwnw i n I - A A w n N1-Win--fat a G- K(G aC t'C °f C' gil) Clrif hill g0 ' ' ' - ■ ■-■ otili . GOO WE(AJ 0 �c 3tpartmunt of 'tatr Qt . tp y I certify from the records of this office that BETTER BREATHING LIMITED rtO1 4 LIABILITY COMPANY, is a limited liability company organized under the laws of O .0. the State of Florida, filed on July 23, 2013, effective July 19, 2013. _�' gO kil The document number of this company is L13000104178. ' 4.1 43 Dv I further certify that said company has paid all fees due this office through n� December 31, 2013, and its status is active. D. , RO „)., c. V 6k2 Eq: '0'. i ,I). !,)0 D. .,, Given under my hand and the €1.4 �.� 11 Great Seal of the State of Florida 0 at Tallahassee, the Capital, this the -n=C- 4a Ninth day of October, 2013 VC 8 E='�`- `'iT f^.;,,,: � 1 � �. l RCS Ss rs#ttr r of s#tt#E 60 D. 0 ..,,,"VZ"---t". 7;:":•-;7,k. / V2A4° 04teMa i() 'CR2E022 (1-11) .0 • C vF�U-, Vr'wr�AV�� -V V .w/\vr,ww ri 7,',�v AVe�w wk-AV x + OY n� i non n'N n n. F ra n nfi rah �F-4,' n®nR n n n raven nR ,4 Electronic Articles of Organization 130008 0 AM For July 23 2013 Florida Limited Liability Company f. sec. Gestate thampton Article I The name of the Limited Liability Company is: BETTER BREATHING LIMITED LIABILITY COMPANY Article II The street address of the principal office of the Limited Liability Company is: 8101 XENIA LN NAPLES, FL. 34114 The mailing address of the Limited Liability Company is: P.O.BOX 913 NAPLES, FL. 34106 Article III The purpose for which this Limited Liability Company is organized is: ANY AND ALL LAWFUL BUSINESS. Article IV The name and Florida street address of the registered agent is: TOM CONROY 81 O1-XENIA LN NAPLES, FL. 34106 Having been named as registered agent and to accept service of process for the above stated limited liability company at the place designated in this certificate, I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes relating to the proper and complete performance of my duties, and I am familiar with and accept the obligations of my position as registered agent. Registered Agent Signature: TOM CONROY Article V The effective date for this Limited Liability Company shall be: 07/19/2013 Signature of member or an authorized representative of a member Electronic Signature: TOM CONROY I am the member or authorized representative submitting these Articles of Organization and affirm that the facts stated herein are true. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an annual report between January 1st and May 1st in the calendar year following formation of the LLC and every year thereafter to maintain"active" status. http.Thmages.sunba.org/COR%5C2013%5C0723%5C40940514.tif 7/30/13,8:11 PM Page 1of1 N V- 1 IRS DEPARTMENT OF THE TREASURY xa. INTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023 Date of notice: 09-18-2013 - Employer Identi ication Number: 001402.370033.0006.001 1 MB 0.405 530 30-0796536 ItltIn111111,rrlllllttrl,11111„111c1iu111111l111ltcciil111111i or-m: ss 4 Number of this notice: CP 575 G P. BETTER BREATHING LLC �;Z"c� THOMAS CONROY SOLE MBR For assistance you may call us at PO BOX 913 1-800-829-4933 NAPLES FL 34106 001402 IF YOU WRITE, ATTACH THE STUB OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICETION NUMBER Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 30-0796536. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. When filing tax documents, payments, and relates correspondence, it is very important that you use your EIN and complete name one address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than cne EIN. If the information is not correct as shown above, please make the correction using the attached tear-off stub and return it to us. A limited liability company (LLC) may file Form 8832, Entity Classification Election, and elect to be classified as an associaticn taxable as a corporation. If the LLC is eligible to be treated as a corporation ti at meets certain tests and it will be electing_ S. corporation status, it must time1 file Form 2553, Election by a Small Business Corporation. The LLC will be treated as a corporation as of the effective date of the S corporation election and does not need to file Form 8832. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not ha' e access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and IRS will not be able to gererate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax-related correspondence and documents. • * Provide future officers of your organization with a copy of this notice. Your name control associated with this EIN is BE:TT. You will need to provide this information, along with your EIN, if you file your returns electronically. If you have questions about your EIN, you can cz11 us at the phone number or write to us at the address shown at the top of this rotice. If you write, please tear off the stub at the bottom of this notice and send it along with your letter. If you do not need to write us, do not complete and return this stub. Thank you for your cooperation. Sep 03 13 12:02p 239-277-0167 2392770167 p.2 Prepared By: Merit Credi_ (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT (FOR: [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 5/85 09/03/13 10:57CT [SUBJECT] [SSN] [BIRTH DATE] CONROY, THOMAS - [ALSO KNOWN AS] CONROY,TOM [CURRENT ADDRESS] [DATE RPTD] 913 PO BOX 913, NAPLES FL. 34106 2/07 [FORMER ADDRESS: 10701 S. OCEAN DR., f615. JENSEN BEACH FL. 34957 1/07 1948 FREDERICK ST., NAPLES FL. 34112 [CURRENT EMPLOYER AND ADDRESS] [VERF] [RPTD] SELF 1/10V 1/10 M O D E L P R O F I L E * * * ALERT * * * ***FICO CLASSIC 04 ALERT: SCORE +694 : 039, 013, 010, 008 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON TEE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=O COL=O NEG=1 HSTNEG=0 TRD=10 RVL=9 INST=O MTG=1 OPN=0 INQ=1C HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $6138 $10.OK $4294 $0 $126 57% MORTGAGE: $37.4K _S_____ $35.5K - $0 $54C TOTALS: $43.5K $10.0K $39.8K $0 $666 T R A D E S SUBNAME SU3CODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT* VERFIED CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 HSEC BANK B 92WL014 8/93 $20.7K R09 4/11A $13.0K $0 A CREDIT CARD 4/10F $0 PORCH BY OTHER LENDER NEW MLNM BK B 2NY001 5/06 $481 111111111111 RO1 8/13A $500 $0 1111111111:1 I CREDIT CARD 6/13C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 CITI B 640B002 12/07 $4726 MIN30 1111111111_1 R01 8/13A $6500 $0 1111111111_1 I FLEXIBLE SPENDING $4223 48 0/ 0! 0 WELLS FARGO B 908N664 3/13 $605 MIN11 1111 RO1 8/13A $2500 $0 I CREDIT CARD $11 4 0/ 0/ 0 EST PREMIER B 41PF016 3/07 $394 MIN25 1111111111:1 RO1 8/13A $400 $0 1111111111"_1 Sep 03 1312:02p 239-277-0167 2392770167 p.3 I CREDIT CARD $60 DISP INV CMP-CNS DSGR 48 0/ 0/ 0 EVERHOME MTG F 704R001 2/13 $37.4K 24DM540 111 M01 8/13A $0 I CONVENTIONAL REAL $35.5K 3 0/ 0/ 0 CORTRUST BK B 27X0013 5/07 $413 111111111111 1101 8/13A $600 $0 111111111111 I CREDIT CARD 6/13P $0 48 0/ 0/ 0 NEW MLNM BK 3 21NY001 5/06 $481 111111111111 R01 2/10A $500 $0 11111'_1=1111 I CREDIT CARD 9/08C $0 CRDT CARD LOST/STOLEN 44 0/ 01 0 AAEX E 21WBOO1 11/07 $923 11111.111 RO1 9/08A $2000 $0 I CREDIT CARD 8/08C $0 CLOSD BY CRDT GRANTOR 9 0/ 0/ 0 NEW MLNM BK B 21NY001 1/07 $302 11111:111111 RO1 5/08A $300 $0 1111 I CREDIT CARD 11/07C $0 ACCT CLSD BY CONSUMER 16 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SURNAME TYPE AMOUNT 9/03/13 ZNP6284423(TLA) MERIT CREDIT 4/02/13 FC01207005(CAL) FA CREDCO 2/21/13 ZC06275032(CAL) FIRST AMERIC 1/28/13 ZC06275032(CAL) FIRST AMEBIC 1/15/13 ZC06275032(CAL) FIRST AMERIC 12/12/12 FC01207005(CAL) FA CREDCO 1/19/12 FC01207005(CAL) FA CREDCO 8/03/12 FDM0728002(ILM) CREDCO 4/23/12 ZLA4852358(CAL) BOFA/LANDSAF 4/17/12 ZLA4852358(CAL) BOFA/LANDSAF C R E D I T R E P O R T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION HSBC BANK BC92WL014 ROB 98706 LAS VEGAS NV. 89193 NEW MLNM BK BC21NY001 57 LIVINGSTON AVE. NEW BRUNSWICK NJ. 08903 CITI BC64DB002 POB 6241 SIOUX FALLS SD. 571:7 WELLS FARGO BC908N664 (800) 642-4720 CREDIT BUREAU DISP DES MOINES IA. 50306 FST PREMIER B2041PF018 3820 N LOUISE AVE SIOUX FALLS SD. 57104 EVERHOME MTG FM704R001 (800) 669-9721 301 WEST BAY STREE JACKSONVILLE FL. 32202 CORTRUST BK BC27XU013 (605) 782-3463 500 E 60TH ST N SIOUX FALLS SD. 57104 AMEX BC21rK13O01 (800) 874-2717 Sep 031312:02p 239-277-0167 2392770167 p.4 P.O. BOX 981537 EL PASO TX. 79998 FA CREDCO F 1207005 (800) 637-2422 12385 FIRST AMEBIC POWAY CA. 92064 FIRST AMERIC Z 6275032 (800) 523-0233 12395 FIRST AMERIC POWAY CA. 92064 CREDCO F 0728002 (877) 216-9150 1500 NW BETHANY BL BEAVERTON OR. 97006 BOFA/LANDSAF Z 4852338 {800) 447-1692 101 S MARENGO AVEN PASADENA CA. 91101 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-334.8 OR (239) 277-3202. CERTIFICATE OF LIABILITY INSURANCE rOAYE(ARA 12/30/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER.AND THE CERTIFICATE HOLDER. tM terms and If the I certificate of to holdcy Is certain ADDITIONAL may require=an endorsement.) A statement on this certificate does not onferlrights to the the forms and conditions of the policy,tettaln pollcles may certificate holder In lieu of such endorsement(s). PRODUCER R Nicholas Ott Insurance Agency CONTACT NICK OTT 10915 Bonita Beach Rd 41141 • PtioNE 239-408-0154 FAX CNC No Mid). Bonita Springs,FL 34136 "'' • wsunm BETTER BREATHING LIMITED LIABILITY COMPANY MEURER- PO BOX 913 nrs RERC: 1 . NAPLES,FL 34106 INSURER D: .- INSURER E: „-,,,^-, '-- IN&t1RER F COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: Tnis is TO CERTIFY THAT THE ANY REQUIREMENT.TERM RCONDITI N HAVE OFBANY CONTRACT OR OTHER DOCUMENT WIDTH RESPECT TO WHICH PERIOD WHICHTHIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN.THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. _ o e- A...A,;LIAR P• ICY EFF POLICY EXP O T lPE OF INSURANCE . , . POLICY NUMBER M .. M R!a ha A ril COMMERCIAL GENERAL LIABILITY I TSD 12(3012013 12/30/2014 EACH OCCURRENCE cH $300000 DANIA a E T.,' • 100000 ■CLAMS-MADE t�..l . III ust. OCCUR ..-,4 :...r.¢=rc= $ �— MED EXP pm•--• $5000 PERSONAL&ADV INJURY $300000 OEM_AGGREGATE LIMIT APPLIES PER' GENERA)..AGGREGATE i 600000 p,Q PRODUCTS-COMP/OP ADG $300000 IIII© FOLLY�JEC,T' �I LAC $ • ER: �K4 e 9�•.. MST AUTOMOBILE LIABILITY •'E ` r";;'d- - $ ANY AUTO BODILY INJURY(Per perm) $ is AaO(; ED I♦SCHEDULED BODILY INJURY(Perecddcm) $ AUTO 1MJE0 {PPROP Y DAMAGE $ III HIRED AUTOS �AUTOS f ffi 1 - -- -- • uMBRELLA UAB IIII OCCUR-._- - ®l III EACH CGCURRENCE-- - - $-._ -..__ Ill EXCESS LIAB IIII CLPJMS,MADE 1 AGGREGATE $ III DEd RETENTION $ WORKERS COMPENSATION STATUTE III Ma 111 AND EMPLOYERS'LIABIMTY Y I N ■ ANY PROPRIETORRsARTNF�EXECUTlVE ( I N I A L(. EACH ACCIDENT $ OFFICER/MEMBER EXCLUPEU7 J (Mandatory in NN) p.L DISEASE-EA EMPLOYE; $ If yes,dearnbe UWw E.L.DISEASE-PtkK Y MOT $ DESCRIPTION OF OPERATIONS below ill 0 pnscnlP1TON OF OPERATIONS(LOCATIONS I VEHICI-E$(ACORO 101,Additional RemENS SclMdule,may be attached If mote SOW ie required) JANITORIAL SERVICES CERTIFICATE HOLDER CANCELLATION COLLIER COUNTY CONTRACTOR LICENSING BOARD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES SE CANCELLED BEFORE 2800 N HORSESHOE DR THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN NAPLES,FL 34104 ACCORDANCE WITH THE POLICY PROVISIONS. AUTHORIZED REARESENTA1WE /L r. ,, _I .19$$-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Produced using Fame Boss Web software.w.vw.RIMMOM088.0111l s hrsressiva Publishing 800.208 1877 TO/TO 30Vd b00Z31766EZ WVb9:LO ETOZ/0E/ZT • Report Viewer Page 1 of 1 t* 4 1 !1 v. !,100% Lair NikrN JEFF ATWATER CHIEF FINANCIAL OFFICER STATE OF FLORIDA DEPARTMENT OF FINANCIAL SERVICES DIVISION OF WORKERS'COMPENSATION **CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA WORKERS'COMPENSATION LAW** CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 9/27/2013 EXPIRATION DATE: 9/27/2015 PERSON: CONROY THOMAS FEIN: 300796536 BUSINESS NAME AND ADDRESS: BETTER BREATHING LLC 8101 XENIA LN NAPLES FL 34113 SCOPES OF BUSINESS OR TRADE: HEATING,VENTILATION, AIR-COND Pursuant to Chapter 440 05(14),F.S.,an officer of a corporation who elects exemption from this chapter by filing a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certificates of election to be exempt...apply only within the scope of the business or trade listed on the notice of election to be exempt.Pursuant to Chapter 440 05(13),F.S.,Notices of election to be exempt and certificates of election to be exempt shall be subject to revocation if,at any time after the filing of the notice or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the certificate to meet the requirements of this section DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 https://apps8.fldfs.com/crreportviewer/reportV fewer.aspx?data=kdvpginc9D7Q3 gH6TER6... 10/7/2013 " COLLIER COUNTY BUSINESS TAX RECEIPT of so APPLICATION -!= �f, 2800 N.Horseshoe Drive,Naples,FL 34104 �� i' , :;o Make Check Payable to: Collier County Tax Collector ,ti., °`� ' Phone:239-252-2477 Fax: 239-643-4788 Website:www.colliertax.com SOD wEi" CHECKLIST Copy of Articles of Incorporation and/or Fictitious letter Yellow Fire Compliance(list of fire district phone number from the State stating that your business name is on file. enclosed) (850-245-6052 or 6058) www.sunbiz.org Copy of Marco Zoning Certificate.(239-389-5000) Copy of State license from Department of Business and Professional(850-487-1395)or Department of Health. Completed Zoning application with appropriate fee made payable (850-488-0595) to:Board of County Commissioners.(239-252-5603) Copy of City Business Tax Receipt.(239-213-1800) Completed Business Tax Receipt application with appropriate fee made payable to:Collier County Tax Collector.(239-252-2477) Copy of Motor Vehicle Repair Registration Certificate from Department of Agriculture.(800-435-7352) Other: Copy of Health inspection from Department of Hotels and Please contact the Property Appraiser's office at 239-252-8145 Restaurants(850-487-1395)or Department of Agriculture. regarding tangible tax. (800-435-7352) CHECK ONE: Date: v Original Application Classification Transfer of License # Code Number - - Renewal of License# License Amount 1) CORPORATE NAME - i3et-1'er 6ree.�44 N i—t-.C, ° A---;,-- '1)uc4-- C 1e0..'two. la) DBA NAME - Ib) BUSINESS OWNER OR QUALIFIER'S NAME - tom Co x)ro‘1-- 2) PHYSICAL ADDRESS - gib ) xep..)ie,L )--.rJ N Ws} F1— 31( ( )L{ (No P.O.Box allowed) 2a) IS RESIDENCE USED AS AN OFFICE - Yes No 3) BUSINESS MAILING ADDRESS - 4-O, ,e,,, . `i t 3 -- des ___3 C&1 � _ - - --- Street City Zip 4) OWNER OR QUALIFIER'S RESIDENTIAL ADDRESS - 1ci\l1 MukpsitJ St Niftes. fi3yt(--2, 5) TELEPHONE-Business: 0?,-31-35- --(G-2(.04 Home: 6) LEGAL FORM OF BUSINESS: Sole Proprietorship Partnership Corporation \LLC LLP 7) OPENING DATE OF BUSINESS OR DATE ASSUMED - ‘0— a 7 A O 13 8) OFFICE WITHIN CITY LIMITS OF NAPLES - Yes f No If Yes,City License No. 9) SOCIAL SECURITY NO. or FEDERAL EMPLOYER IDENTIFICATION NO. - _-_ 0 - 0.996.536, *see back of application for explanation 9a) TYPE OF BUSINESS CONDUCTED: ,A,,i r 0 v ck I e i)s`' -- 10) NUMBER OF EMPLOYEES-Including number of owners: --- 11) FILL IN THE APPROPRIATE AREAS - a)Rental units(motel/hotel/apts.)Number of units: b)Seating Capacity(rest./cafes,etc)Number of seats: c)Number of coin-operated machines owned by business or individual: 12) STATE LICENSE OR CERTIFICATION NUMBER- Must have photo copy of state license if state licensed and certified UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TRUE TO THE BEST OF MY KNOWLEDGE. xxxAPPLICANT'S SIGNATURE: " DATE: ACS" (Owner and/or representative of business)TITLE: ****THIS LICENSE IS NON-REFUNDABLE FOR BUSINESS STATED ABOVE**** • Coriffl-r County COLLIER COUNTY GOVERNMENT DEPT. OF ZONING& LAND DEVELOPMENT REVIEW WWVV.COLLIERGOV.NET (239) 252-2400 FAX (239)643-6968 LAND USE AND ZONING CERTIFICATE HOME OCCUPATION Please take the time to fill out this form as completely as possible. Remember that only someone actually living at the address given below may engage in the home occupation described. Customers or employees not living at this address are prohibited from traveling to and from the residence if visits are related to this home occupation. The applicant is the person in whose name the occupational license will be issued, and the applicant's signature must appear on this form. Verification as property owner or lessee in the form of a Valid Florida's Driver License or Florida Identification Card and/or copy of valid lease agreement is required. APPLICATION DATE 10-3- . ZONING CERTIFICATE#TC- APPLICANT'S NAME 0 Ch C O O PHONE: -2-3 9- l(o (0"-k APPLICANT'S HOME ADDRESS gl C ( K iJ% IA- L 6.01 (eS TYPE OF BUSINESS TO BE CONDUCTED 1-1-1V-- I� BUSINESS NAME(IF ANY) 1.J `� I, the undersigned, hereby affirm that I am the legal owner of the property at the above address or that I have the legal right to conduct the business described above at this address by virtue of my leasehold interest in this property, and that I have read, understood, and agree to abide by the provisions of LDC Section 5.02.00 Home Occupations"(see back of application). APPLICANT SIGNATURE DATE .✓1' -- FEE: $50.00 CHECKS PAYABLE TO: "COLLIER COUNTY TAX COLLECTOR" ONIMMINNEINIO TO BE COMPLETED BY COUNTY STAFF ZONING: PROPERTY ID# DATE REVIEWED BY APPROVED HOLD DENIED COMMENTS/RESTRICTIONS: Must comply with Section 5.02.00 of the LDC ('see back of application). Tax Collector Staff: Please forward a copy of issued certificate and receipt to Collier County Zoning Department. 71> ,(./ " 4,(1 Code,- County q/6 )(7 t GMD Operations & Regulatory Management z/rf Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 (__ 1 APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUCTIONS: This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: Exact Corporate/Business Name: Irish Electrical Service, Inc. Fiction Name/DBA: Qualifier Name: Joseph S. O'Malley Physical Address: 2257 Valencia Lakes Circle Naples FL 34120 (Number & Street) (City) (State) (Zip Code) Mailing Address: 2257 Valencia Lakes Circle Naples FL 34120 (Number 86 Street) (City) (State) (Zip Code) Telephone: (239) 633-5895 E-Mail: shawnomalley@comcast.net TYPE OF LICENSE:. ❑ General $230.00 El Electrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 ❑ Specialty $205.00 iV Specialty trade: AN CHANGE OF STATUS: ( ) Reinstatement ( ) From One Business to Another ( ) Dormant License to Active Page 1 of 4 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. Joseph S. O'Malley, President 2257 Valencia Lakes Cir Naples, FL 34120 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten years (ex, Held a license for or been a partner). Attach extra pages if needed. D.J. Gould Electric Co., Inc. 3. List all debts you or any company(s) associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. None AFFIDAVIT I, Joseph S. O'Malley certify that the foregoing is true and correct to the best of my knowledge. Authorized Off er of the Firm STATE OF FLORIDA COUNTY OF COU-1 E2- The foregoing instrument as acknowledged before me this 10£C-elvl&G1Z_Za L (Date) By Joseph S. O'Malley of Irish Electrical Service, Inc. (Name of officer, title/agent) (Name of Corporation) a Florida Corporation on behalf of the corporation. (State or Place of Corporation) He/ has produced FL. DLO 546 4 ii (oZ 424 0 identification and did not take an oath. (Type of identification) NOTARY'S SEAL , n ' V v iA/ ----- KIMBERLY PEARCEWI1.BER (SIGNATURE OF NOTARY) V u ;. MY COMMISSION I EE 103974 ft—,...-, 44,1 EXPIRES:June 28,2015 V r. Bonded T zu Not3y PubNc Underw here Page 2 of 4 QUALIFIER INFORMATION: Name: Joseph S. O'Malley Address: 2257 Valencia Lakes Circle Naples FL 34120 (Number& Street) (City) (State) (Zip Code) Telephone: (239) 633-5895 Date of Birth: S.S.#: E-Mail: shawnomalley @comcast.net Driver's License: 1. Type of Certificate of Competency for which application is made. Electrician 2. The names and telephone numbers of two persons who will know your whereabouts. Ivy O'Malley - (239) 633-5896 Robert Schmidt - (239) 777-4513 3. Have you ever been convicted of a crime related to Contracting? No (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? No 8. List all debts you or any company(s) associated with you refused or failed to pay and reasons why. None 9. List your business or work experience during the past ten years. I have been Director. General Manager. Project Manager, Hands-On Operator and have worked on projects associated with my company D.J. Gould Electric Co, Inc. since it's inception in 1992. 10. Statement of any formal training you have had in the area for which the application is made. Residential Network Installer Course - see certificate. I have also completed the CEUs that are required for the license holder to complete every two years in addition to him completing them. Page 3 of 4 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No. 2006-46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. Joseph S. O'Malley APPLICANT(PLEASE PRINT) Irish Electrical Service, Inc. NAME OF COMPANY /-__. ---____c , //'- i---- NATO E OF APPLICANT STATE OF FLORIDA COUNTY OF Cow �- The foregoing instrument as acknowledged before me this lib ->✓(�?M$CQ- 2._p1.3 (Date) By Joseph S. O'Malley who has produced FL, DI- (Name of person acknowledging) (Type of identification) as identification and did not take an oath. NOTARY'S SEAL IUM6ERI.Y PEARCE WILBER .., ,e, .`= MYCOMMISSIONfEEt03974 (SIGNATURE OF NOTARY)_ = MIRES:June 28,2015 ( ) Vt, y�d;;r Banded?Nu Notary Public Underwriters Page 4 of 4 PROMETRIC : . EXAMINATION RESULTS NOTIFICATION September 20, 2011 Joseph S OMalley 222-21-1740 2257 Valencia Lakes Cir Naples, FL 34120 Dear Candidate: We are pleased to inform you that you achieved a passing score on your recent Collier County examination. Your score(s) are as follows: 09/17/2011 Bonita Springs, FL Master Electrical 86 Pass Collier County requires a passing percentage of 75%. Please note that passage of the exam is no guarantee a certificate of qualification w ill be issued by the Licensing Board. To help you gain the recognition you deserve, Prometric has prepared a Certificate of Achievement, beautifully designed and very suitable for franing (8-1/2 x 11)for only $30.00 per category. Please fill out the order form below, cut along the dotted line,then send the completed form to Prometric . Payment options: check, money order, Visa or MasterCard. Credit card orders may be faxed to (800)813-6670. All others send to Prometric , 1260 Energy Lane, St. Paul, MN 55108. Allow 2-3 weeks for delivery. Certificate of Achievement Request Joseph S OMalley 222-21-1740 2257 Valencia Lakes Cir Naples, FL 34120 Quantity Collier County - Master Electrical- 09/17/2011 x $30.00 = For credit card payment, complete the following. Card Type: Visa Mastercard Card No. Exp. Date Signature F159-fl-bonsp-C PROMETRIC *1260 Energy Lane *St.Paul,MN 55108 Toll Free:800.280.3926 *Fax:800.813.6670*w w w.prometric.com PROMETRIC � k EXAMINATION RESULTS NOTIFICATION June 16, 2011 Joseph S OMalley 222-21-1740 2257 Valencia Lakes Cir Naples, FL 34120 Dear Candidate: We are pleased to inform you that you achieved a passing score on your recent Collier County examination. Your score(s) are as follows: 06/11/2011 Bonita Springs, FL Business and Law 90 Pass Collier County requires a passing percentage of 75%. Please note that passage of the exam is no guarantee a certificate of qualification w ill be issued by the Licensing Board. To help you gain the recognition you deserve, Prometric has prepared a Certificate of Achievement, beautifully designed and very suitable for framing (8-1/2 x 11)for only $30.00 per category. Please fill out the order form below, cut along the dotted line,then send the completed form to Prometric . Payment options: check, money order, Visa or MasterCard. Credit card orders may be faxed to (800)813-6670. All others send to Prometric , 1260 Energy Lane, St. Paul, MN 55108. Allow 2-3 weeks for delivery. Certificate of Achievement Request Joseph S OMalley 222-21-1740 2257 Valencia Lakes Cir Naples, FL 34120 Quantity Collier County - Business and Law -06/11/2011 x $30.00 = For credit card payment, complete the follow ing. Card Type: Visa Mastercard Card No. Exp. Date Signature F159-fl-bonsp-C PROMETRIC *1260 Energy Lane *St.Paul,MN 55108 Toll Free:800.280.3926 *Fax:800.813.6670*w w w.prometric.com AFFIDAVIT IT IS understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency. A LS di,/ �E OF APPLICANT I T Irish Electrical Service, Inc. BUSINESS NAME /;//ô/ o13 DATE EFORE ME this day personally appeared Joseph S. O'Malley who affirms and says that he as less than one employee and does not require Workmen's Compensation understands that at any me he employees one or more persons he must obtain said Workmen's Compensation Insurance. TATE OF FLORIDA OUNTY OF Cow►t._----:?--- lie foregoing instrument was acknowledged before me this to D.c.E AggQ 27)I (Date) Joseph S. O'Malley who has produced FL- ►-- 0- (name of person acknowledging) (Type of identification) identifirntinn nnrl who did not take an oath. IQI�ERLY"II EE WILBER 4Aiti'��. -,- MY COMMISSION A E 103974 � ='d : �� : �,-� E zo Underwriters SIGNATURE OF NOTARY Bonded Tin Notary Public 7'�'8f SLY•' I AA '[ Pe--4%-“E UJ1 L, NOTARY'S SEAL (PRINT NAME OF NOTARY PUBLIC) NOTARY PUBLIC 4 411) Winfield Companies, LC December 10,2013 To Whom It May Concern, Joseph Shawn O'Malley in his association with DJ Gould Electric had been performing electrical work for my Company since 1995. He has completed numerous Projects for us during this time span including single and multi-family buildings plus residential and commercial renovations of all sizes and price ranges. His contributions to these projects include: • Meeting with the owners and building managers prior to construction to help sort out possible conflicts and provide input or advice pertaining to products or design. • Load calculations and riser diagrams when needed. • Estimating and Contract administration. • Value engineering when needed to bring projects under budget or provide competitive advantage. • Scheduling of work and Inspections. • Supervision of work on site. • Invoicing. Throughout the eighteen years we have worked together with Mr.O'Malley has displayed character and integrity dealing with me, my staff and our clients. If you require any additional information please feel free to Contact me at 239-825-3944. Sincerely, • 1 • r. n R. infie d STATE OF 1" ioftc-`c•-- COUNTY OF C-o�wv� The foregoing instrument was acknowledged before me this trO day of c s2—.^-1 2013 by John Winfield,who is_personally known to me or have produced as identification. ;r WC9 A.D'AMICO s4 i. Noaty Public-SIMS of pa1N �comet. Aft 2.2017. Notary Public gemloloo•EE 1171042 OF nd���•"_ Bonded Through National Notary Atsn. 869 97TH AVENUE NORTH, SUITE A-2 • NAPLES, FLORIDA 34108 PHONE: 239.598.2133 • FAX: 239.597.9422 WINFIELDCOMPANIES.COM CGC1505960 eA A I I'Frt , To whom it may concern; December 6, 2013 I have known Joseph Shawn O'Malley since 2007. We first met when I was a Vice President of Construction for Premier Builders; Premier Builders is the builder of The Vineyards in Naples Florida. In his capacity of project manager for Vista Pointe which is located within The Vineyards, an eight story luxury condominium, he displayed the knowledge and experience necessary to make sure the project progressed to completion without delays or complication. He was responsible for the installation of the underground conduit and wiring to the building, all the unit feeders and wiring within the units as well as all the common area electrical systems including elevators and access control. Since that time, we have worked together on many projects including new construction of single and multi-family projects as well as renovation projects involving clubhouses, cabanas and pools. He has also performed as a service and maintenance electrician on many of the subdivisions in The Vineyards. We are currently working together on a 296 unit multi-family project in Cape Coral, Casa di Fiori. In addition to twelve and sixteen unit buildings, the project also consists of detached garages, Lake Fountain features, community pool and clubhouse with access control and a camera system. He also worked with our engineer to submit revisions to the original drawings so that the electrical services were code compliant. Through the year we have worked together, I have always found Mr. O'Malley to be honest, trustworthy, and dependable. S ,ould you have any question do not hesitate to contact me. ' cerely, ' s DINq Biarni Jons on � �� MyCOMMISS BROWN ' ;,F.� EXPIRES. liCN N EE 87 (is aedi IFiorinLLer &YdedThruNca5'P eu a� (:::::::D.te�,--- Co erj j , X10' liPage Casa di Fiori 1119 Winding Pines Circle , Cape Coral 33909 239 - 458 - 0114 ORANGETREE ASSOCIATES VIA USPS 02 December 2013 To Whom It May Concern: I have known Joseph Shawn O'Malley since 1998. Our relationship began when I was developing and building new homes within the Orangetree and Valencia Lakes at Orangetree Communities located in North East Collier County. Mr. O'Malley was responsible for the electrical construction on all the homes we built within the two communities. Mr. O'Malley was an extremely efficient, organized, and knowledgeable contractor. We were very pleased with the workmanship and effort Mr. O'Malley invested into each and every project we awarded him. Mr. O'Malley was awarded the new construction and restoration of services for our Water and Wastewater Treatment facility we have been operating since 1987. The scope of work for the Utility was greater than a new single family residence. It was challenging commercial service work that was completed with diligence and high degree of competency. The commercial service Mr. O'Malley performed can be summarized as follows, not limited to: • Wiring of new concrete block pump station • Installation of new motor controllers, blowers, pumps, and various service equipment for the 750,000 gallon a day wastewater treatment plant. • Installation of all underground wiring from the new pump station to the generator • Installation of conduit and feeders to all above ground structures • Installation of 600 amp / 480 volt service motor control center, transfer switch, and connection of 500 KVA generator • Mounting and wiring of transformers • Connection of new 480 volt equipment • New wiring for control panels for our water supply wells (3) Other service Mr. O'Malley directly oversaw was the renovation of our office located at 3000 Orange Grove Trail, Golf Course 1725 Double Eagle Trail (Pro Shop), 1705 Double Eagle Trail, (Maintenance Building), 1710 Double Eagle Trail 4500 Executive Drive Suite#110,Naples Florida 34119 Phone 239-596-4088,Fax 239-596-4091 rbollt@orangetreeassociates.com ORANGETREE ASSOCIATES (Cart Barn building), and our Administrative Center located at 4500 Executive Drive #110 Naples Florida 34119. Since establishing a professional relationship with Mr. O'Malley we quickly realized quality of workmanship and dependability was unlike many other trades we had onsite providing services for the various projects referenced above. We believe the results we experienced were due to the time and expertise Mr. O'Malley personally invested ensuring the projects were completed timely and without issue. Over the years Mr. O'Malley has become a trusted ally and I personally attest for his integrity, morals, and professionalism. Feel free to contact me regarding any of the above referenced information or if you have any further questions relating to Mr. O'Malley and the work he has performed for me. Sincerely, --WA,LIA-0`6)-Cel Roberto Bollt Trustee State of Florida) County of Collier ) Sworn to and subscribed before my by t- a—b 1:)'--4---r- this the Z''- day of Di , 2D12 on behalf of tj 6 T - cx- S , who is personally known kIentificat or My Commission expires: t1\ Notary Public ,�— q ERLY PEARCE WRIER ' MY COMMISSION#EE 103974 v1 EXPIRES:June 28,2015 '4,4 v Bonded MN Wm Public underwd►ers 4500 Executive Drive Suite#110,Naples Florida 34119 Phone 239-596-4088,Fax 239-596-4091 rbollt@orangetreeassociates.com AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER 1, Aker /4fTirD/ , am a resident of 6 c-Li i2 County, reeky 4- (State) and have resided here for more than five (5) years. During the last five years I have known Joseph S. O'Malley (Applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a person of honesty, integrity and good character. (Signature) . �/ i�_ , (Name) 'o ",r /• kArt (Address) %7 73- iT✓l ',6'/'i;` r4t�rcl ,e61, KA 'Z-Es .?7// 2e Telephone) ,2S 7-,5-70? STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this ( b pF ec. 2013 by (Date) �f P GI who has produced .POGO,ra(1 k.InOc.01 i (name of person acknowledging) (Type of identification) as identification and who did not take an oath. 4 s ROSERTO A.LANORON V , Notary Public-State of Florida ` T�� � My Comm.Expires Fob 24,2014 0 ���►I' •71�/%� �.. Commission#00 965262 TU' E OF NOTARY NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC 10 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I SG'o77 c=)7.--E , __, am a resident of 61oe...e—e e-,e _ County, __...___ °' -fO _ (State) and have resided here for more than five (5) years. During the last five years I have known Joseph S. O'Malley applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to e a person of honesty, integrity and good character, (Signature) (Name) "....:--- —'1,--o7 V (Address) SZp° fir �'JGf/� 40'e- Telephone) e79 - r-rf-- 7317 STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this 1d/41//_3 by (Date) E•SoeTI l 1 Oey Zvi,— a d (name of person adltnowledging) pi-aft..lly r<.ko0n (Type of identification) as identification and who did not take an oath. C ON `TRNn IARY Sa .cr, fii;/ �6 . NOTARY'S SEAL (PRINT NAkE OF NOTARY) NOTARY PUBLIC ". SANDRA MILTROKA 1 •'i MY COMMISSION I EE178267 . ,' � EXPIRES May 1,2010 (407)496.0153 9 }3„i Y C .--., �. o CU 7-4 Crl O cn 1-1"I: •-, a O cv r Vy x CIZ • O ate ' Cl.CCX Cl) `� h "� �r -� lia.FA r �E I ( EGG'' ��- =� q et{ $ new ftiS-1 m tx c O <, ' 0 �* tom:1 "t°' ,- •,�w ° (1 � CD .: ,x r, trfy Syr ,' ff „folk's% ortVe getiPot, 044'01 got's% "V•AD ,, b{� 41 1 144 * " • tOill xr A A 4 tioA 444 -+- ci, „, 0 -*- oft**, 0 ›, v•At . ,, cd * � ,# 4� 0 OA o A • ` O , V ,. .► o hr a ♦ � r° , g er.-4 0 \ a U0 U 0a ai 4 v . x t 4111■ is ` i o U] ►mil n H U _ 04 0 114 .� 1� 3 o A� '�vl 01 � 0 a N L 1,f/.A 9 o 14, .-5, 2 M cll I ■ X CCx '`�N N � $ -4 0 o Alp 40 eltV " 1) 4 e 2 V/l1 -ter . o -0 Cl).� o r# .,-, ;-4 v) tz) --. t A 40 `,V F-4 E- o ,9 V o= :P x •.c.: ■ - 1107(ettl°4 exT,IINTerfirtNTelit7ir4701wortkNollAtarzts•0 4•44i;4 {•0404 Cr4044 Cr 444 0y Cr ,t4 t,r 4■4 4t4 4) III) 886 110th Ave. N. Suite#6, Naples, FL 34108 Phone:239.777.1028 Fax: 877.275.3593 www.LicensesEtc.com BUSINESS CREDIT REPORT as of: 12 09 13 14:43 ET Irish Electrical Service, Inc. Fed Tax ID#46-4262572 Address: 2257 Valencia Lakes Or Key Personnel: President: O'Malley, Naples, FL 34120 Joseph S. United States Business Type: Unavailable Document Years in Business: Less than 1 Year P13000097050 No.: Filing Data Provided Florida Agent: O'Malley, Joseph S. by. Agent 2257 Valencia Lakes Cir Date of Incorporation: 12/04/2013 Address: Naples, FL Public Records PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS. Bankruptcies: 0 v Liens: 0 Judgments Filed: 0 Collections: 0 END OF REPORT Page 1 of 1 886 110th Ave. N.Suite#6, Naples, FL 34108 Phone:239.777.1028 Fax: 877.275.3593 www.LicensesEtc.com PERSONAL CREDIT REPORT(Compiled From National Records) <FOR> <SUB NAME> <MKT SUB> <INFILE> <DATE> <TIME> (I) P NP7771028 LICENSES ETC 16 NP 7/99 12/04/13 10:28CT <SUBJECT> <SSN> <BIRTH DATE> OMALLEY, JOSEPH S. <ALSO KNOWN AS> DMALLEY, JOSEPH, S <CURRENT ADDRESS> <DATE RPTD> 2257 VALENCIA LAKES CI . , NAPLES FL. 34120 7/04 <FORMER ADDRESS> 15804 BROTHERS CT. , #9. FORT MYERS FL. 33912 2/02 1861 NE. 16TH AV. , NAPLES FL. 34120 <POSITION> <CURRENT EMPLOYER AND ADDRESS> <VERF> <RPTD><HIRE> DJ GOULD ELECTRIC VP 8/13 8/13 8/90 M O D E L P R O F I L E ***FICO CLASSIC 08 SCORE +751 : PROPORTION OF BALANCES TO CREDIT LIMITS IS ***TOO HIGH ON BANK REVOLVING OR OTHER REVOLVING ACCOUNTS; PROPORTION OF ***LOAN BALANCES TO LOAN AMOUNTS IS TOO HIGH; TOO MANY ACCOUNTS WITH ***BALANCES; TOO MANY INQUIRIES LAST 12 MONTHS *** C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS PR=0 COL=0 NEG=0 HSTNEG=0 TRD=14 RVL=5 INST=7 MTG=2 OPN=0 INQ=3 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $22 . 0K $38 . 4K $13 . 3K $0 $267 65% INSTALLMENT: $15. 1K $ $15. 0K $0 $236 MORTGAGE: $144K $ $137K $0 $1335 TOTALS: $181K $38 . 4K $165K $0 $1838 T R A D E S SUBNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# VERFIED CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 DISCOVER FIN B 9616003 11/02 $13. 3K MIN267 111111111111 ROl 11/13A $15.2K $0 111111111111 I CREDIT CARD $13. 3K 48 0/ 0/ 0 CHASE B 1127001 4/12 $144K 240M1335 111111111111 M01 10/13A $0 1 C $137K 13 0/ 0/ 0 TD AUTO FIN F 624C382 8/13 $15. 1K 72M236 11 I01 10/13A $0 Page 1 of 2 C AUTOMOBILE $15. 0K 2 0/ 0/ 0 THD/CBNA B 26H3005 8/11 $535 111111111111 ROl 10/13A $1000 $0 111111111111 I CHARGE ACCOUNT 12/12P $0 25 0/ 0/ 0 CHASE B 1127001 11/01 $183K 360M1591 111111111111 MOl 4/12A $0 111111111111 C 4/12C $0 CLOSED 48 0/ 0/ 0 NISSAN MOTOR Q 507T073 11/05 $35. 9K 72M625 111111111111 I01 11/11A $0 111111111111 S AUTOMOBILE 11/11C $0 CLOSED 48 0/ 0/ 0 NISSAN MOTOR Q 507T073 6/04 $29. 6K 63M560 1111111111XX 101 12/08A $0 X1111111111 S AUTOMOBILE 12/08C $0 CLOSED 48 0/ 0/ 0 BK OF AMER B 1597029 4/02 $2596 XXXXXXX1XXXX ROl 9/06A $15. 4K $0 XXXXXX11 I CREDIT CARD 1/05P $0 ACCT CLSD BY CONSUMER 31 0/ 0/ 0 FIA CSNA B 1597185 9/83 $5576 111111111111 ROl 1/06A $6800 1 C CREDIT CARD 13 0/ 0/ 0 GMAC Q 2592672 1/02 $20 . 0K 36M558 111111111111 101 1/05A $0 111111111111 C AUTOMOBILE 1/05C $0 CLOSED 35 0/ 0/ 0 GMAC Q 2592672 12/01 $20 . 0K 36M558 111111111111 101 12/04A $0 111111111111 C AUTOMOBILE 12/04C $0 CLOSED 34 0/ 0/ 0 FRD MOTOR CR F 3796761 9/99 $23. 9K 60M462 111111111111 I01 10/04A $0 1111 C AUTOMOBILE 10/04C $0 CLOSED 16 0/ 0/ 0 FRD MOTOR CR F 3796761 9/99 $19. 4K 60M367 111111111111 101 9/04A $0 111111111111 C AUTOMOBILE 9/04C $0 CLOSED 48 0/ 0/ 0 FST USA BK B B 7519015 12/98 $4490 111111111111 RO1 8/04A $6000 $0 111111111111 I CREDIT CARD 4/04C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SURNAME TYPE AMOUNT 12/04/13 PNP7771028 (FLA) LICENSES ETC 8/21/13 FDT4113756 (MCH) TD AUTO FINA 3/07/12 BPH3256981 (EAS) JPMORGANBK END OF REPORT Page 2 of 2 Electronic Articles of Incorporation PILED 13 80097050 F For December 04, 2013 Sec. Of State sgilbert IRISH ELECTRICAL SERVICE, INC. The undersigned incorporator, for the purpose of forming a Florida profit corporation, hereby adopts the following Articles of Incorporation: Article I The name of the corporation is: IRISH ELECTRICAL SERVICE, INC. Article II The principal place of business address: 2257 VALENCIA LAKES CR NAPLES, FL. US 34120 The mailing address of the corporation is: 2257 VALENCIA LAKES CR NAPLES, FL. US 34120 Article III The purpose for which this corporation is organized is: ANY AND ALL LAWFUL BUSINESS. Article IV The number of shares the corporation is authorized to issue is: 1000 Article V The name and Florida street address of the registered agent is: JOSEPH S O'MALLEY 2257 VALENCIA LAKES CR NAPLES, FL. 34120 I certify that I am familiar with and accept the responsibilities of registered agent. Registered Agent Signature: JOSEPH S. O'MALLEY P13000097050 FILED Article VI December 04, 2013 Sec. Of State The name and address of the incorporator is: sgilbert JOSEPH S. O'MALLEY 2257 VALENCIA LAKES CR NAPLES, FL 34120 Electronic Signature of Incorporator: JOSEPH S. O'MALLEY I am the incorporator submitting these Articles of Incorporation and affirm that the facts stated herein are true. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an annual report between January 1st and May 1st in the calendar year following formation of this corporation and every year thereafter to maintain "active" status. Article VII The initial officer(s) and/or director(s) of the corporation is/are: Title: P JOSEPH S O'MALLEY 2257 VALENCIA LAKES CR NAPLES, FL. 34120 US To: 8772753593 From: Lynn Dowling 1-07-14 2:00pm p. 3 of 3 OP ID: RD ACl.JAO' DATE(MMIDDIYYW) klawr,. CERTIFICATE OF LIABILITY INSURANCE 01!07!2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Lynn Dowling Gulfstream Insurance Group Inc PHONE FAX P.O. Box 8908 (AIC,No,Ext):954-324-1726 (A/C,No):954537-0177 Fort Lauderdale,FL 33310-8908 ADDRESS:lynn @gulfstreaminsurance.net David Arch INSURER(S)AFFORDING COVERAGE NAIL# INSURER A:Covington Specialty INSURED Irish Electrical Service Inc. INSURERB: 2257 Valencia Lakes Circle Naples,FL 34120 INSURER C: INSURER D: INSURER E: _INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADDL SUER POLICY EFF POLICY EXP LIMITS LTR INSR WVD POLICY NUMBER (MMIDDIYYYY) (MMIDDIYYYY) GENERAL LIABILITY I EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY VBA271895 12/31/2013 12/31/2014 DAMAGE TO RENTED 50,000 PREMISES(Ea occu rence) $ CLAIMS-MADE X OCCUR j MED EXP(Any one person) $ 5,000 PERSONAL&ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENT.AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $ 2,000,000 X POLICY kT LOC $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) $ _ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _AUTOS NON-OWNED PROPERTY ACC ACCIDENT) $ HIRED AUTOS AUTOS JPER ) $ UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION CSTATU- ER AND EMPLOYERS'LIABILITY Y I N ANY PROPRILTOR/PARTNER/EXECUTI YE E .EACH ACCIDENT OFFICER/MEMBER EXCLUDED? N IA (Mandatory in NH) EL DISEASE-EA EMPLOYEE $ f Yes,describe under __- DESCRIPTION OFOPE RAT IONSbelow EL DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS 1 LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space Is required) Electrical contractor CERTIFICATE HOLDER CANCELLATION COLLIER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. Collier County Contractors Licensing Board 2800 North Horseshoe Drive AUTHORIZED REPRESENTATIVE Naples„FL 33942 a ©19888--2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD NOTICE OF ELECTION TO BE EXEMPT If this application contains incomplete or inaccurate information, it may cause a delay in the issuance of your exemption. An officer electing an exemption under Chapter 440, Florida Statutes, is not entitled to benefits under this chapter. Section 1: APPLICANT INFORMATION Name: Joseph S. O'Malley First Name M Last Name Suffix Driver's License Number: 0- or Identification Number: Florida Driver's License Number or ID: Yes X or No Social Security Number(last four digits): Date of Birth: Email Address: shawnomalleyt�comcast.net The Division's purpose in collecting an email address is to communicate with the applicant regarding exemption related issues. Section 2: CONSTRUCTION INDUSTRY APPLICANT($50 FEE REQUIRED): Please check the appropriate box to identify if you are an officer of a corporation or a member of a limited liability company. X Officer of a Corporation having at least 10%ownership(Title) President O Member of a Limited Liability Company(LLC)having at least 10%ownership 0 NON-CONSTRUCTION INDUSTRY APPLICANT(NO FEE REQUIRED): O Officer of a Corporation (Title) O Member of a Limited Liability Company(LLC)having at least 10%ownership Section 3: This section should be completed with information specific to your corporation or to the limited liability company in which you are a member. The name of the corporation or limited liability company listed on this application MUST match the name of the corporation or limited liability company as registered with the Florida Division of Corporations. Name of Corporation or LLC: Irish Electrical Service, Inc. FEIN 46 - 4262572 (To obtain a Federal Employer Identification Number contact IRS at 1-800-829-4933) Business Name(DBA): • PHONE: (239)633 -5895 Applicant's Address of Record: 2257 Valencia Lakes Cir City: Naples State: FL Zip: 34120 county: Collier Place the appropriate classification code for the Scope of Business or trade for the industry type chosen in Section 2. If you are unsure which classification code applies to your business, please contact your workers'compensation insurance carrier. If you do not have a workers' compensation insurance policy, please contact the National Council on Compensation Insurance(NCCI)at 1-800-622-4123,to obtain the proper classification code(s). Classification code(s): 1.00009 - Licensed Electrical Contractor2. DFS-F2-DWC-250, NOTICE OF ELECTION TO BE EXEMPT—REVISED 03/13/13 3. 4. NOTICE OF ELECTION TO BE EXEMPT-Page 2 Section 4: The corporation of which you are an officer or limited liability company of which you are a member must be registered and in ACTIVE status with the Florida Division of Corporations. Applicants applying as an officer of a corporation must be listed as an officer of the corporation with the Florida Division of Corporations. List the document number on file with the Florida Division of Corporations. P13000097050 Section 5: Pursuant to Chapter 489, F.S. (contractor licensing law), list certified or registered licenses related to the scope of business or trade listed in Section 3 held by the applicant, or the certified or registered license numbers held by the qualifier for the corporation or limited liability company listed on this application. The business name listed on the license MUST match the name of the corporation or limited liability company as registered with the Florida Division of Corporations and on this Notice of Election to be Exempt. DBPR License DBPR License 0 This section is not applicable to my business. Section 6: Confirmation Number(Online construction industry application submissions only) Section 7: Are you affiliated with any corporation or limited liability company other than the corporation or limited liability company to which this application r. applies? Yes No IF YES, PLEASE LIST THE NAME(S)AND FEIN(S)OF THE AFFILIATED CORPORATION(S)OR LLC(S): NAME: FEIN: NAME: FEIN: NAME: FEIN: Section 8: CONSTRUCTION INDUSTRY AND NON-CONSTRUCTION INDUSTRY LLC MEMBERS ONLY To be eligible for a construction industry exemption or non-construction limited liability company exemption, an applicant must have the required ownership of the corporation or limited liability company. I attest that I own at least ten percent(10%)of the corporation/limited liability company listed on this application. Section 9: I certify that: 1. any employees of the construction corporation or members of the limited liability company; or 2. four or more part or full-time employees of the non construction corporation listed in Section 3 are covered by workers'compensation insurance. Please identify the workers'compensation insurance carrier that covers any non-exempt employees. Carrier Name: Section 10: FRAUD NOTICE A. Any person who, knowingly and with intent to injure, defraud, or deceive the department or any employer or employee, insurance company or any other person,files a Notice of Election to be Exempt containing any false or misleading information is guilty of a felony of the third degree. B. Attestation of applicant-By providing my name below, I attest that I have read, understand and acknowledge the foregoing notice. C. I acknowledge that this Notice of Election to be Exempt does not exceed limits for corporate officers, including any affiliated corporations as provided in Section 440.02, Florida Statutes. DFS-F2-DWC-250, NOTICE OF ELECTION TO BE EXEMPT-REVISED 03/13/13 :.4rwr RE *Exemption information is reflected on the Proof of Coverage database the day following the issuance of the exemption. • DFS-F2-DWC-250, NOTICE OF ELECTION TO BE EXEMPT-REVISED 03/13/13 IRS IINTERNNALNREVENUEESERVI TREASURY CE CINCINNATI OH 45999-0023 Date of this notice: 12-09-2013 Employer Identification Number: 46-4262572 Form: SS-4 Number of this notice: CP 575 A IRISH ELECTRICAL SERVICE INC 2257 VALENCIA LAKES CIR NAPLES, FL 34120 For assistance you may call us at: 1-800-829-4933 IF YOU WRITE, ATTACH THE STUB AT THE END OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN) . We assigned you EIN 46-4262572. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. When filing tax documents, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear off stub and return it to us. Based on the information received from you or your representative, you must file the following form(s) by the date(s) shown. Form 1120 03/15/2014 If you have questions about the form(s) or the due date(s) shown, you can call us at the phone number or write to us at the address shown at the top of this notice. If you need help in determining your annual accounting period (tax year) , see Publication 538, Accounting Periods and Methods. We assigned you a tax classification based on information obtained from you or your representative. It is not a legal determination of your tax classification, and is not binding on the IRS. If you want a legal determination of your tax classification, you may request a private letter ruling from the IRS under the guidelines in Revenue Procedure 2004-1, 2004-1 I.R.B. 1 (or superseding Revenue Procedure for the year at issue) . Note: Certain tax classification elections can be requested by filing Form 8832, Entity Classification Election. See Form 8832 and its instructions for additional information. IMPORTANT INFORMATION FOR S CORPORATION ELECTION: If you intend to elect to file your return as a small business corporation, an election to file a Form 1120-S must be made within certain timeframes and the corporation must meet certain tests. All of this information is included in the instructions for Form 2553, Election by a Small Business Corporation. (IRS USE ONLY) 575A 12-09-2013 IRIS B 9999999999 SS-4 If you are required to deposit for employment taxes (Forms 941, 943, 940, 944, 945, CT-1, or 1042) , excise taxes (Form 720) , or income taxes (Form 1120) , you will receive a Welcome Package shortly, which includes instructions for making your deposits electronically through the Electronic Federal Tax Payment System (EFTPS) . A Personal Identification Number (PIN) for EFTPS will also be sent to you under separate cover. Please activate the PIN once you receive it, even if you have requested the services of a tax professional or representative. For more information about EFTPS, refer to Publication 966, Electronic Choices to Pay All Your Federal Taxes. If you need to make a deposit immediately, you will need to make arrangements with your Financial Institution to complete a wire transfer. The IRS is committed to helping all taxpayers comply with their tax filing obligations. If you need help completing your returns or meeting your tax obligations, Authorized e-file Providers, such as Reporting Agents (payroll service providers) are available to assist you. Visit the IRS Web site at www.irs.gov for a list of companies that offer IRS e-file for business products and services. The list provides addresses, telephone numbers, and links to their Web sites. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not have access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax-related correspondence and documents. If you have questions about your EIN, you can call us at the phone number or write to us at the address shown at the top of this notice. If you write, please tear off the stub at the bottom of this notice and send it along with your letter. If you do not need to write us, do not complete and return the stub. Your name control associated with this EIN is IRIS. You will need to provide this information, along with your EIN, if you file your returns electronically. Thank you for your cooperation. (IRS USE ONLY) 575A 12-09-2013 IRIS B 9999999999 SS-4 Keep this part for your records. CP 575 A (Rev. 7-2007) Return this part with any correspondence so we may identify your account. Please CP 575 A correct any errors in your name or address. 9999999999 Your Telephone Number Best Time to Call DATE OF THIS NOTICE: 12-09-2013 ( ) - EMPLOYER IDENTIFICATION NUMBER: 46-4262572 FORM: SS-4 NOBOD INTERNAL REVENUE SERVICE IRISH ELECTRICAL SERVICE INC CINCINNATI OH 45999-0023 2257 VALENCIA LAKES CIR n ul NAPLES, FL 34120 ' - ' ko-,-t4 rpr-t r-k-tri ilk -•-• :,--, ' ' - •-- r" Su/whine State-*::',•. •. , ... - -_ •". • ' ';:' At...., DRIVER JOSEPH SHAWN°MALLEY 2257 VALENCIA LAKES CIR • - '- . 4 14Araus,s.34120-7499 o0A. :Ex:M Hot 6.411 .. .-,,,,":: :;=•--, iir ---'' ''':::%:.. 1-2016 ,o6o81.2010244 .ic,•,t,,,a.a Motor vehicle cOnstakArts-nnsrral In MIN 50Ialely fkla terqi • GLASS , `i /, SINCE 1986 January 19, 2014 Collier County Licensing Board 2800 North Horseshoe drive Naples, FL 34104 I, Rodney Gatewood am petitioning the board to re-instate my license without retesting. 7 Thank you, Rodney Gatewood 4551 Cummins Court Fort Myers, FL 33905 Phone: 239.334.8002 Fax: 239.334.3444 Email: Info @GatewoodGlass.com 4 Ceoakty CDES Operations & Regulatory Management Licensing Section. 2800 North Horseshoe Drive Naples, FL 34104 APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUCTIONS:This application must be typewritten or legibly printed.The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: . . Exact Corporate/Business Name:,_ Gatewood Glass Inc. Fiction Name/DBA: Qualifier Name: Rodney W Gatewood Physical Address: 4551 Cummins Court Fort Myers FL 33905 (Number& Street) (City) (State) (Zip Code) Mailing Address: 4551 Cummins Court Fort Myers FL. 33905 (Number& Street) (City) . (State) (Zip Code) Telephone: 239-334-8002 E.Mail: rgatewood@gatewoodglass.com TYPE OF LICENSE: Q General $230.00 ❑ Electrician .$230.00 ❑ Building $230.00. U.Plumber $230.00 U. Residential $230.00 Ai $230 ❑ r Cond. .00. g O Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 0 0 Specialty $205.00 Specialty trade: Glass&Glazing Cntr RENSTATEMENT FEE $205.00 CHANGE OF STATUS: 3 BACK YEARS FEES $555.00 (x) Reinstatement ( )From One Business to Another NEW LICENSE FEE $205.00 TOTAL = $965.00 Page 1 of 4 A At • , 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. Rodeny W Gatewood-Owner/President 16900 N River Road Alva, FL 33920-3206 Angelisa Gatewood-Owner 16900 N River Road Alva, FL 33920-3206 2. List all businesses,firms,entities or contracting businesses you have been associated with during the last ten years(ex. Held a license for or been a partner). Attach extra pages if needed. None 3. List all debts you or any company(s)associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. None • • AFFIDAVIT I, Rodney W Gatewood certify that the foregoing is true and correct to the best of my knowledge. • . ;i'/"onzed Officer of the Firm STATE OF FLORIDA COUNTY OF'Lee • • • • The foregoing Instrument as acknowledged before me this 01/08/2014 (Date) • By Rodney W Gatewood-President of Gatewood Glass Inc. . (Name of officer,title/agent) (Name of Corporation) a Florida Corporation on behalf of the corporation. (State or Place of Corporation) He/She.has.produced. ..Personally Known identification and'did not take an oath. (Type of identification) NO S• . /0 wt Notary Public State of Florida /� /� `F 8rittan C McClure /�7 e //, i My Commission DC988989 (t/ l_X�t�lti{ y C. 'r o Expires 05/0512014 orf� (SIG URE OF NOTARY) is Page2of4 • QUALIFIER INFORMATION: Name: Rodney W Gatewood Address: 4551 Cummins Court Fort Myers FL 33905 (Number&Street) (City) (State) (Zip Code) Telephone: 239-334-8002 Date of Birth: S.S. #: E-Mail: rgatewood@gatewoodglass.com Driver's License: 1. Type of Certificate of Competency for which application is made. Glass&Glazing Contractor . 2. The names and telephone numbers of two persons who will know your whereabouts. Chris Gatewood-239-340-0017 Angie Gatewood-239-633-7761 3. Have you ever been convicted of a crime related to Contracting? No (If yes attach extra sheet with explanation) • 7. Have.you or any firms you have been associated with ever filed bankruptcy? No 8. List all debts you or any company(s)associated with you refused or failed to pay and reasons why. None 9. List your business or work experience during the past ten years. See Attached any training you have had in the area for which the application is made. 10. Statement of an formal trainin See Attached i Page 3 of 4 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No., 2006-46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. Rodney W Gatewood APPLICANT(PLEASE PRINT) Gatewood Glass Inc. • • • NAME OF COMPANY SIGNA IE OF APPLICANT • STATE OF FLORIDA COUNTY OF Lee • The foregoing Instrument as acknowledged before me this 01/08/2014 (Date) • • By Rodney W Gatewood who has produced Personally known (Name of person acknowledging) (Type of identification) • as identification and did not take an oath. • Jar Po Notary Public State of Florida • NitZ$ y C McClure < My Commission.00988889 ./� D� • m,,pc. Expires 05/05/2014 /� C. SIGN URE OF NRY Page 4 of 4 • • • • • AFFIDAVIT It is understood and acknowledged by the Collier County Contractors' Licensing • • Board and myself that if I fail to acquire, or maintain at all times effective • . Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency. SI 47,E OF APPLICANT • Gatewood Glass Inc. • BUSINESS NAME 01/08/2014 • DATE • • BEFORE ME this day personally appeared • who • affirms and says that he has less than one.employee and does not require • • Workmen's Compensation and understands that at any time he employs one or • more persons he must obtain said Workmen's Compensation Insurance. STATE OF FLORIDA COUNTY OF Lee The foregoing instrument was acknowledged,before me this 01/08/2014 • (Date) by .Rodney W Gatewood who has.produced personally known • (mime of person acknowledging) (Type of Identification) • as identification and who did not take an oath. • Mgr v� e. Notary Public State of Florida, srittany c Mcclure. SIGNATURE O NOTAR L°111•4114 NOTARY SEAL a My commission uosaeses i+of osp, Expires 05(0512014 • NOTARY PUBLIC • • RESOLUTION OF AUTHORIZATON WHEREAS proposes to (Name of Business Entity) engage ''`, ontracting as in (Type of legal entity:corp.,partnership,etc. Collier Coun ;Florida,according to Collier County Ordinance 2006-46,as amended;and W REAS proposes to (Name of Business Entity) qualify for a Certificate o h mpeten(cy with °?a, (Name of Individual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: We the undersigned of "30fficers,Owners,Partners) e eby resolve and represent to the Collier County (Name of Business Entity) ` Contractors'Licensing Board that the qualifyingint, ,is active (Name of Individual) in all matters connected with the contracting business o1 ,and (Name of Business Entity) We further resolve and represent that is ‘a,t‘nes of individual) legally empowered to act for in all matters connected with its (Name of Business Entity) contracting business,and has the authority to supervise construction idertaken by (Name of Business Entity) DULY PASSED AND ADOPTED THIS day o (Officers 'artners,Owners—with Design' n underneath) Witness • Witness Witness k Corporate Seal(if App able) Or Notary Public CerNicate Sworn to and subscribed before me this day of , by A Notary Public Name Printed Notary Public Signature Commission Number My Commission expires: ?Al; • AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER Malcolm Stewart , am a resident of Lee County, • Florida (State) and have resided here for more than five (5)years. )uring the last five years I have known Rodney W Gatewood (Applicant). I have had ae opportunity to observe his or her business and personal dealings and find him or her to be a person of onesty, integrity and good character. (Signature) (Name) Malcolm Stewart (Address) 4130 NW 32nd Lane Cape Coral, FL 33993 • Telephone) •239-633-7763 _ STATE OF FLORIDA COUNTY OF Lee The foregoing instrument was acknowledged before me this 01/27/2014 by (Date) Malcolm Stewart who has produced Personally Known • (name of person acknowledging) (Type of identification) as identification and who did not take an oath. . c ro`0°6 Notary Pudic State of Florida SIGNATURE O NOT Y Brittany C McClure t I My Commission 00988989 OF rt° Expires 05/05/2014 Brittany McClure NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC • 10 • AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER Chris Morgan , am a resident of Lee County, Florida (State) and have resided here for more than five (5)years. luring the last five years I have known Rodney W Gatewood (Applicant). I have had ae opportunity to observe his or her business and personal dealings and find him or her to be a person of onesty, integrity and good character. (Signatur (Name) Chris Morgan (Address) 41318 SW 9th Ave Cape Coral, FL 33914 • Telephone) .239-340-0985 STATE OF FLORIDA COUNTY OF Lee The foregoing instrument was acknowledged before me this 01/27/2014 by (Date) Chris Morgan who has produced Personally Known • (name of person acknowledging) (Type of identification) as identification and who did not take an oath. . C ,17!c& Ie. Notary Public State of Florida Brittany C McClu SIGNATURE NOT Y re fie My Commission DD988989 or '.O Expires 05/05/2014 Brittany McClure NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC 10 STATEMENT OF OWNERSHIP This certi '.es that I, am a member or (APPLICANT'S NAME) Managing me er of (LIMITED LIABILITY COMPANY NAME) I own 0/ of the units issued by the Limited Liability Company listed above. Affidavit of Applicant: I certify that" ie information contained is a true and correct statement to the best of Ty knowledge. } m (PRINT NAME) S 1 ,fit1 (APPLICANT'S SIGNATIIRE) (DATE) INT' 9 240 Marketplace Road p:239.768.1800 Suite 1 f:239.768.1271 CONSTRUCTION COMPANY,INC. Ft.Myers,FL 33912 wwwgpconstruction.com May 13, 2013 We certify that Rodney Gatewood of Gatewood Glass has been doing business with Gulfpoint Construction Company since February 1991. Rodney has subcontracted and performed work for Gulfpoint Construction Company in the Glass &Glazing Industry. Listed below are three major projects completed under the management of Rodney Gatewood. 1). Estero High School @ 21900 River Ranch Road, Estero, FL 33928 Started: May of 2012 Completed: October of 2012 2). Middle School"LL" @ 200 Schoolside Drive, Lehigh Acres, FL 33971 Started: August of 2011 Completed: April of 2012 3). Lehigh Acres Elementary @ 200 Schoolside Drive, Lehigh Acres, FL 33971 Started: October of 2008 Completed: April of 2009 Work completed by Subcontractor on time? ✓ Yes No Work completed satisfactory? ✓ Yes No / Are there any ongoing issues due to the fault of the subcontractor? Yes ✓ No If yes; please explain: SIGNATURE AND DATE: Gii<Y944"-C..-1 Q W), 67,: 113- A(L �. t6 CugeogAIL PRINT NAME AND TITLE: Ems'--YZ, STATE OF RI0 P COUNTY OF L The foregoing instrument was acknowledged before me this J�J day of M1 , 20 13 by \vv 2-who is personally known.to me or who has produced as identification. NOTARY PUBLIC: Signature Notary Public: Sul 14/0 442-- Commission Expiration Date: (Seal) r fey''' RENEE MARIE LAFEHR ;'c MY COMMISSION#DD899669 EXPIRES June 16,2013 (407)39e•0153 FlorldallolaryService.com Established 1985 • D. GARRETT • CONSTRUCTION, INC. GENERAL CONSTRUCTION-CONSTRUCTION MANAGEMENT "Building Relationships for Over 30 Years" We certify that Rodney Gatewood of Gatewood Glass has been doing business with D. Garrett Construction, Inc. since - I let$ . Rodney has subcontracted and performed work for D. Garrett Construction, Inc. in the Glass &Glazing Industry. Listed below are three major projects completed under the management of Rodney Gatewood. 1) Port Royal Fitness Center @ 2900 Gordon Drive, Naples, FL 34102 Started: May 2012 Completed: November 2012 2) Port Royal—North End Covered Terrace @ 2900 Gordon Drive, Naples, FL 34102 Started:June 2011 Completed:October 2011 3) Fabela Renovation @ 7401 Bay Colony, Naples, FL 34108 Started:April 2011 Completed: November 2011 Work completed by Subcontractor on time? K Yes _No Work completed satisfactory? >`v Yes _No Are there any ongoing issues due to the fault of the subcontractor? _Yes No If yes; please explain: SIGNATURE AND DATE: PRINT NAME AND TITLE: &Z./CG C• 6/Le.Q22r; P2cs 10 4.1"1! STATE OF FThridc(, COUNTY OF LiDU.If IH. The foregoing instrument was acknowledged before me this day of 016A/ , 20 13 by 2c_tCr.C.•rra i 110e-rtr ,who is personally known to me or who has produced as identification. NOTARY PUBLIC: Signature Notary Public: 1411..« Commission Expiration Date: t l ) • o, ,'�, COURTNEY ELIZABETH FELD �`;1� Commission k DD 920338 ix, „ y My Commission Expires .,,,,1,•„■�. November 21, 2013 w w w.dgarrettcons tract ion.com Address:4933 North Tamiami Trail,Suite 300•Naples,Florida 34103-3028•Phone:(239)643-2900 Faxes:Main(239)643-0898•Estimating(239)643-4309•Project Management(239)643-7783 orsoisou Owen aloha ortorsisO Owen-Ames-Kimball Company 11941 Fairway Lakes Drive,Fort Myers,FL 33913-8838 Voice 239-561-4141 • Fax 239-561-1996 We certify that Rodney Gatewood of Gatewood Glass has been doing business with Owen-Ames-Kimball since 1997. Rodney has subcontracted and performed work for Owen-Ames-Kimball in the Glass & Glazing Industry. Listed below are the three major projects completed under the management of Rodney Gatewood: 1) Chico's Childcare Center @ 11251 Metro Parkway, Fort Myers, FL 33966 Started: September 2013 Completed: December 2013 2) Lee Convenient Care @ 16230 Summerlin Road, Fort Myers, FL Started: December 2013 Completed: January 2014 3) Harold Park Concessions @ 23400 Harold Ave, Port Charlotte FL 33980 Started: June 2013 Completed:August 2013 Work Completed by Subcontractor on time? Yes No Work completed satisfactory? Yes No Are there any ongoing issues due to the fault of the subcontractor? Yes No Signature& Date: `�' f/ 1/28/14 Print Name&Title: David J. Dale,.President State of FL County of LEE The foregoing instrument was acknowledged before me this 28th day of January,2014. by: David J. Dale ,who is personally known to me or who has produced as identification and who did/did not take an oath. SHERRIE LENZI • Notary Public, State of FL �+ . Expires July 13 2017 Comm No FF 005511 Signature of Notary Public Bonded thru Notary Public Underwnters Sherrie Lenzi Notary Stamp Printed or Typed Name of Notary Public Building Since 1891 Jan 10 1411:23a 239-277-0167 2392770167 p.1 Merit Credit Fast, Accurate & Secure. Phone: 1-239-277-3202 or 1-800-371-3348 Fax Cover Sheet: Requested-Credit Report Attached-! Please call if you have any questions, CONFIDENTIALITY NOTICE:This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception,review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. Jan 10 14 11:24a 239-277-0167 2392770167 p.2 Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT (FOR] (SUB NAME] (MKT SUB) (INFILE] (DATE) [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 12/80 01/10/14 10 : 18CT (SUBJECT) [SSN] [BIRTH DATE] GATEWOOD, RODNEY W. [ALSO KNOWN AS] GATEWOOD,ROD,W [CURRENT ADDRESS] (DATE RPTD] 16900 N. RIVER RD. , ALVA FL. 33920 9/03 [FORMER ADDRESS) 4551 CUMMINS CT. , FORT MYERS FL. 33905 2743 BLUE CYPRESS LAKE CT. , CAPE CORAL FL. 33909 (POSITION] [CURRENT EMPLOYER AND ADDRESS] (VERF] [RPTD] GATEWOOD—GUASS=DIST—MANAGER 2/08 12/08 [FORMER EMPLOYER AND ADDRESS] GATEWOOD CUSTOM GLASS PRESIDENT 1/95 M O D E L P R O F I LE * * * A L E R T * * * ***FICO CLASSIC 04 ALERT: SCORE +796 : 030, 003, 010, 011 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=0 NEG=0 HSTNEG=0 TRD=27 RVL=15 INST=12 MTG=0 OPN=0 INQ=2 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $339K $607K $4227 $0 $85 99% INSTALLMENT: $74.4K $ $51.6K $0 $1468 TOTALS: $414K $607K $55. BK $0 $1553 T R A D E S SURNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# VERSIED CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 GECRB/LOW L 233041) 3/98 $966 111111111111 RO1 1/14A $424 $0 111111111111 T CHARGE ACCOUNT 10/080 $0 CLOSED 48 0/ 0/ 0 ALLY FINCL F 259237N 3/12 $43.0K 72M598 111111111111 I01 1/14A $0 11111111 C AUTOMOBILE $31.1K 20 0/ 0/ 0 ALLY FINCL F 259237N 2/13 $31.3K 36M870 1111111111 I01 1/14A $0 I AUTO LEASE $20. 5K 10 0/ 0/ 0 5TH 3RD BK B 9302020 2/09 $312K 111111111111 C01 12/13A $561K $0 111111111111 Jan 10 14 11:24a 239-277-0167 2392770167 p.3 C HOME EQUITY LOAN 9/13P $0 48 0/ 0/ 0 WELLS FARGO B 908N750 9/12 $10.7K MIN85 111111111111 RO1 12/13A $13.8K $0 11 A FLEXIBLE SPENDING $4227 14 0/ 0/ 0 WELLS FARGO B 908N756 3/11 $2373 111111111111 RO1 12/13A $7500 $0 111111111111 C CREDIT CARD 12/13P $0 33 0/ 0/ 0 US BANK B 23KW001 12/08 $51.0K 60M1000 111111111111 I01 12/13A $0 111111111111 P AUTOMOBILE 12/13C $0 CLOSED 48 0/ 0/ 0 ALLY FINCL F 259237L 1/10 $49.2K 39141263 111111111111 I01 2/13A $0 111111111111 I AUTO LEASE 2/13C $0 CLOSED 36 0/ 0/ 0 CITI-CITGO B 282E023 4/05 $2527 111111111111 RO1 2/13A $300 $0 111111111111 I CREDIT CARD 4/11C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 ._ AMEX B 21WBOO1 6/08 $8212 111111111111 RO1 10/12A $35.OK $0 X11111111111 T CREDIT CARD 9/12C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 REGIONS BANK B 3604047 12/07 $30.0K 37M 11111111.111 I01 1/10A $0 111111111111 I AUTOMOBILE 1/10C $0 CLOSED 24 0/ 0/ 0 WFDS/WDS F 839N077 6/08 $14.9K 36M452 11111_111111 I01 1/10A $0 111111 C AUTOMOBILE 1/10C $0 CLOSED 18 0/ 0/ 0 BK OF AMER B 1597029 1/07 $13.4K 111111111111 RO1 8/09A $9000 $0 11111111.111 I CREDIT CARD 5/09C $0 ACCT CLSD BY CONSUMER 31 0/ 0/ 0 CITI-CITGO B 282E023 1/05 $0 111111111111 RO1 7/09A $300 $0 111111111111 I CREDIT CARD 10/05C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 MSPBNA F 695S004 11/06 $261K 111111111111 CO1 3/09A $750K $0 XXX11111X11 C HOME EQUITY LOAN 3/09C $0 ACCT CLSD BY CONSUMER 27 0/ 0/ 0 GMACAB B 259237G 12/04 $39.1K 48M815 111111111111 I01 12/08A $0 111111111111 C AUTO LEASE 12/08C $0 CLOSED 47 0/ 0/ 0 AMEX B 21WB001 6/08 $0 RO1 7/08A $35.OK $0 I CREDIT CARD 6/08C $0 ACCT CLSD BY CONSUMER BK OF AMER B 1597029 8/02 $13.61( XXXXXXX11111 RO1 _ 4/08A $24.7K $0 111111111111 I CREDIT CARD 8/07P $0 ACC? CLSD BY CONSUMER 48 0/ 0/ 0 Jan 10 1411:24a 239-277-0167 2392770167 p.4 TDRC/CONGRS C 1427892 3/07 $49.2K 1111111111 R0. 2/08A $50.0K $0 I CHARGE ACCOUNT 2/08C $0 ACCT CLSD BY CONSUMER 10 0/ 0/ 0 CHASE B 26QK001 4/03 $13.6K 111111111111 RO1 7/07A $19.9K $0 111111111111 I CREDIT CARD 3/07C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 MSPBNA F 695S004 4/05 $100K 111111111111 CO1 11/06A $100K $0 1X1111 C CREDIT LINE SECUR 11/06C $0 CLOSED 18 0/ 0/ 0 GMAC Q 2592672 6/05 $14.5K 3614451 11111111 I01 3/06A $0 I AUTOMOBILE 3/06C $0 CLOSED 8 0/ 0/ 0 RBS CITIZENS B 7421059 4/01 $25.1X M519 11111 I01 4/05A $0 C AUTOMOBILE 4/05C $0 CLOSED 26 C/ 0/ 0 GMAC Q 2592672 3/C2 $40.8K 36M1134 111111111111 I01 2/05A $0 111111111111 I P.UTOMOBILE 2/05C $0 CLOSED 34 0/ 0/ 0 GMAC Q 2592672 11/01 $20.0K 36M556 111111111111 I01 12/04A $0 111111111111 I AUTOMOBILE 12/04C $0 CLOSED 35 0/ 0/ 0 RBS CITIZENS B 1ZD1001 4/01 $25.1K 60M519 11111111111X I01 10/04A $0 1111111111 C AUTOMOBILE 10/04C $0 TRNSFRD OTHER OFFICE 42 0/ 0/ 0 GECRB/JCP D 235058D 9/85 $1138 111111111111 RO:. 10/04A $800 $0 111111111111 C CHARGE ACCOUNT 10/04C $0 CLOSED DUE TO TRNSFR 48 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 1/10/14 ZNP6284423 (FLA) MERIT CREDIT 2/15/13 BNC1619001(FLA) US HANK C R E D I T R E P O R T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION GECRB/LOW LH235041J (800) 444-1408 PO BOX 936005 ORLANDO FL. 32896 ALLY FINCL FA259237N (800) 925-2559 P.O. BOX 380901 BLOOMINGTON MN. 55438 5TH 3RD BK BI9302020 (800) 972-3030 5050 KINGSLEY DR CINCINATTI OH. 45263 WELLS FARGO BC908N750 (800) 642-4720 CREDIT BUREAU DISP DES MOINES IA. 50306 Jan 10 14 1124a 239-277-0167 2392770167 p.5 WELLS FARGO BC908N756 (800) 642-4720 CREDIT BUREAU DISP DES MOINES IA. 50305 US BANK BB23KW001 (877) 457-3544 425 WALNUT STREET CINCINNATI OH. 45202 ALLY FINCL FA259237L (888) 925-2559 P.O. BOX 380901 BLOOMINGTON MN. 55438 CITI-CITGO BC282E023 (800) 950-5114 PO BOX 6497 SIOUX FALLS SD. 57117 AMEX BC21W8001 (800) 874-2717 P.O. BOX 981537 EL PASO TX. 79998 REGIONS BANK 813604047 720 NORTH 39TH STR BIRMINGHAM AL. 35222 WFDS/WDS FS839N077 P.O. BOX 1697 WINTERVILLE NC. 28590 BK or AMER BC1597029 PO BOX 982235 EL PASO TX. 79998 MSPBNA FZ695S004 PO BOX 5005 SIOUX FALLS SD. 57117 GMACAB BA259237G (800) 200-4622 P.O. BOX 38090: BLOOMINGTON MN. 55438 TDRC/CONGRS 021427892 (800) 808-6950 1000 MACARTHUR BV MAHWAH NJ. 07430 CHASE - BC26QK001 — (800-)-9s5-'-9900 P.O. BOX 15298 WILMINGTON DE. 19850 GMAC Q22592672 (800) 200-4622 P.O. BOX 380901 BLOOMINGTON MN. 55438 RBS CITIZENS 887421059 (800) 610-7300 480 JEFFERSON BLVD WARWICK RI . 02886 RBS CITIZENS BA1ZD1001 1 CITIZEN'S DRIVE RIVERSIDE RI. 02915 GECRB/JCP DC235058D (866) 227-5213 PO BOX 965007 ORLANDO FL. 32896 US BAN{ B 1619001 (877) 855-6680 1301 WESTW00D LANE WILKESBORO NC. 28697 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERI?IED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED _0_ SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR (239) 277-3202 . Jan 10 14 11:24a 239-277-0167 2392770167 p.6 Premier Profile-GATEWOOD GLASS,INC • •• • •= Subcode:970135 Ordered:01/10/2014 10:21:26 CST •: •• Experian Transaction Number:C500250553 ••'•• • Search Inquiry:RODNEY W GATEW000 DBA GATEW000 GLASS INC./4551 CUMMINS COL;RT/FORT A world of insight MYERS/FL/33905/800911378 Model Description:Intelliscore Phis V2 Business Name < � m Business Iden:ificahon Number GATEWOOD GLASS, INC '- '-,--L--4' 742383337 togs Doing Business As: GATEWOOD GLASS Website•gat-woodglass.com Primary Address: 4551 CUMMINS CT Phone: (239)334-8002 FORT MYERS,FL 33905-3709 This business is the ultimate parent. See the_corpplate hierarchy by clicking here TOP 0 Risk Dashboard _.:41A1$40..._R�. :7 .__a,,',.'"10.400 .at` i_....__: e-:; J.,. ..�_ `..i ' >.fir L ! r�T gYS",Y(.A f. Intelliscore Plus Financial Stability Risk Company DBT Original Filings High Risk Alerts 7 6= 'LOW-MEDIUM LOW RISK V RISK Score range:1-100 percentile Industry DBT:20 Credit Limit Recommendation:$181,800 TOP 0 Business Facts Years on File: 22(FILE ESTABLISHED 02/1992) SIC Code: PAINT,GLASS&WALLPAPER STORES-5231 State of incorporation: FL HARDWARE STORES-5251 Date of Incorporation: 03/2912013 GLASS&GLAZING WORK CONTRACTORS-1793 Business Type: Profit NAICS Code: Other Building Material Dealers•444190 Contacts: RODNEY WAYNE GATEWOOD•PRESIDENT Hardware Stores•444130 Glass and Glazing Contractors•238150 GATEW000 ANGELA-VICE PRESIDENT Number of Employees: 110 Sales: $11,711,000 TOP O Commercial Fraud Shield Evaluation for: GATEWOOD GLASS,INC,4551 CUMMINS CT,FORT MYERS,FL33905-3709 The primary Business Name,Address, and Active Business Indicator: I/I Experian shows this business as active Phone Number on Experian File were reviewed !— for High Risk indicators,no High Risk indicators were found. Possible OFAC Match: 1 No OFAC match found Business Victim Statement: i4 No victim statement on file Credit Risk Score and Credit Limit Recommendation 4104 ! 4tf1it, . I rk F i1 *,.' �' o it'(y s- l ,,1_, 1 r: Current Intelliscore Plus Score:65 Risk Class:2 The risk class groups scores by risk into ranges of similar Premier Profile-r;ATFWNrlrlfl(II ACC we-. ••- Jan 10 14 11:24a 239-277-0167 2392770167 p•7 performance. Range 5 is the highest risk,range 1 is the • 85 lowest risk. High Low Risk Risk 6 io 25 50 /5 100 This score predicts the likelihood of serious credit delinquencies for this business within the next 12 months.Payment history and public record along with other variables are used to predict future risk.Higher scores indicate lower risk. Factors lowering the score Industry Risk Comparison > BALANCE OF ALL COMMERCIAL ACCOUNTS 64%of businesses indicate a higher likelihood of severe > NUMBER OF COMMERCIAL ACCOUNTS WITH HIGH UTILIZATION delinquency. +BALANCE OF DELINQUENT COMMERCIAL ACCOUNTS >RATIO OF BALANCE TO HIGH CREDIT FOR COMMERCIAL ACCOUNTS Action or risk based on your company's specific score thresholds:LOW-MEDIUM RISK Quarterly Score Trends IVV- ----•------------`•--------------------- 100 • • so- 81 70 1-: fi5 t30�..'. . . -• • The Quarterly Score Trends provide a view of the• - likelihood of delinquency over the past 12 months for this 50 46 business.The trends will indicate if the score improved,• q0 `` ;•, ' f .n f ' , remained stable,fluctuated or declined over the last 12• 30 months. 20- 10 i N I>It P4 UA 3%A.-.50 QGt 0SC' CrOdil1ls 0404'01.081 aIS 0•XRI*i1 k• Current Financial Stability Risk Score: 98 Risk Class: 1 .98 ♦ -tOW RISK 1 High Risk _5 s.� 1 Low The risk class groups scores by risk into ranges of similar Risk performance.Range 5 is the highest risk,range 1 is the 6 3 10 30 65 100 lowest risk. This score predicts the likelihood of financial stability risk within the next 12 months. The score uses tradeline and collections information,public filings as well as other variables to predict future risk.Higher scores indicate lower risk. Factors lowering the score Industry Risk Comparison >RISK ASSOCIATED WITH THE COMPANY'S INDUSTRY SECTOR 97%of businesses indicate a higher likelihood of financial > RISK ASSOCIATED WITH THE BUSINESS TYPE stability risk. > BALANCE TO HIGH CREDIT RATIO FOR COMMERCIAL ACCOUNTS > PERCENT OF COMMERCIAL ACCOUNTS DELINQUENT Credit LAO RAcetiturkOtll+ltiwl Credit Limit Recommendation This recommendation compares this business against similar businesses in the Experian business credit database,It is based on trade information,industry,age of business and the Intelliscore $181,800 Plus.The recommendation is a guide.The final decision must be made based on your company's business policies. Premier Profile-GATEWOOD GLASS.INC - Jan 10 14 11:24a 239-277-0167 2392770167 p.8 • Top 0 Payment and Legal Filings Summary t , t ti+ r•Ph ti, - if151M 1164 014 td 3101 -- i 6, r r Current OBT: 0 Total trade and collection(23): $193,400 Bankruptcy: No Predicted 08T as 03/05/2014: 1 All trades(23): $193,400 Tax Lien filings: 0 Monthly Average DBT: 6 All collections(0): $0 Sum alingn: 0 y g ( ) Sum of legal filings: $0 Highest DBT Previous 6 Months: 11 Continuous trade(15): $138,400 UCC filings: 0 Highest OBT Previous 5 Quarters: 10 6 month average: $50,000-$190,700 Cautionary UCC filings: No Payment Trend Indication: Highest credit amount extended: $125,800 Payments are improving Most frequent industry purchasing terms: NET 30,REVOLVE,CREDIT •frli vstilr '(.130(pol42.11: -- Industry DBT Range Comparison DBT Norms The current DST of this business is 0.80%of businesses have a 08T range of 0-5 All industry: 8 DBT for this business:0 Same industry: 20 Industry Payment Comparison Has paid sooner than 50%of similar businesses • °%o of businesses .... ... - .90% 9% . DBT Range 0-5 .6-15 ' 16+ rap 0 Payment Trending MonlltyOUT Trends Quarterly DBT Trends 20.0 i 20.0I- 17.5 ^ � 17.5 ,' 15.0 15.0• . ........1�... 12.3 .. ". I 12.5 -... ..... ... i 1.; 10.0 I'. $Q.:. .la I •:... .......... , 10.0 73 • 7.5 5.0 5.O t 2.5% 2.5 I._ .. _. __ 1.00 030,,,x0,00, 00V1 C.,+e°; Ap s 1413 Zc13 9019 4.0.0•Win*N000ttniroilt.. 7.: Payment Trends Analysis Account Status PAINT,GLASS&WALLPAPER STORES_5231 Days Beyond Terms Date Reported Industry Business DBT Balance Cur 1-30 31-60 61-90 81+ Cur DBT CURRENT N/A N/A 0 $138,400 100% NOV13 -- -------70% 20 0 _...----------•— $139,600 100% ._._.--------- -- ________________ __ __ OCT13 69% 20 0-- ------ — $137,900 100% .-- -- - -— SEP 13 --_-- 69°0 20 5 $118,000 69% 31% — _- AUG13 — fig% 21 10 ----- $55,500 35% 65% - JUL13 69% 21 10 $53,100 31% 69% 'remier Profile-GATEVJCOn Si ASS IN r: - - Jan 10 14 11:25a 239-277-0167 2392770167 p.9 ' • JUN13 70% 20 11 _—_— $50,000 _ 28% fi�ttdr•��a��a�TwAtM► Payment History-Quarterly Averages Account Status Dayys:Bey Terms Quarter Months OBI Balance Cur 1-30 31-60 61-90 914 Q4-13 OCT-DEC 0 $138,600 100% Q3_13 JUL-SEP ------ 7 --$75,500 52% 48% — Q2 13 APR-JUN 10 $17,600 —A` 32% 68% 01 -13 __ JAN-MAR _ 0 $3,000 — 99% 1% 04-12 OCT-DEC 0 $6,600 100% TOP 0 Trade Payment Summary Trade Line Type Lines Reported DBT Recent High Credit Balance Current 01-30 31-60 61.00 91+ Continuous 15 S192,200 5138,400 100°k New 2 $52,400 $52,400 100% Combined Trade 17 $244,600 $190,800 100% Additional 6 $7,800 $2,600 100% Total Trade 23 $252,400 $193,400 100% ToP Cli—__. Trade Payment-New and Continuously Reported Trade Details {ddat' oq Y .:.;.,.,..,,,.z....-1..r ,t _.. { dRx. I AI 'At ee it tea► flog'gp ). __ _.... _..,.__ !1Ge :__�_._�.Y ar .—_...`- Business Date Last Payment Recent High Balance Cur 1-30 31-60 61.90 91+ Comments Category Reported Sale Terms Credit AIR TRANS 12/2013 12/2013 OTHER $400 $200 100% BLDG MATRL 10/2013 09/2013 VARIED $125,800 $125,800 100% BLDG MATRL 12/2013 04/2013 CREDIT $4,000 $0 ACCTCLOSED FINCL SVCS 12/2013' NET 30 $52,400 $52,400 100% SATSFTRY FINCL SVCS 01/2014 04/2013 NET 30 $2,200 $0 - ^— ACCTCLOSED FINCL SVCS 12/2013 12;2013 REVOLVE $7,800 $5,500 100% FREIGHT----.10/2013' 09/2013 VARIED $o ---- �-- -----• ---- FRGHT FWRD 09/2013 OTHER $700 3700 100% - — — -- INDUS MACH 10/2013 NET 30 $7,400 $1.300 100% METAL DIST 11/2013 10/2012 NET 30 $1,000 $0 — T -- METAL WORK 12/2013 ----- OTHER --, $0 •--_--_-._. -_•---------__.._ OFFC EQUIP 12/2013 11/2013 REVOLVE $500 $400 100% PACKAGING 12/2013 -— NET 30 SO CUST 3 YR PREC INSTR 01/2014 08/2011 CIA SO RENTALS 10/2013 NET 30 $900 $200 31% 68% 1% ROOF CONTR 12/2013 NET 30 $0 STON&GLASS 10/2013 NET 30 $41,500 $4,300 100% CUST 13 YR TOP p Trade Payment-Additional Trade Details ' V • a ` a td,ile4#1 q igt 0 ts 18 ( a f ' 4 Business Date Last Payment Recent High Balance Cur 1.30 31.60 61-90 914- Comments Category Reported Sale Terms Credit ALUMINUM 02/2011 01/2011 NET 30 $5,100 <$100 100% Premier Profile•GATEWOOD GLASS.INC 41 5 Jan 10 14 11:25a 239-277-0167 2392770167 p.10 INDUS SUPL 01/2011 0912010 NET 30 $300 <$100 100% CUST 15 YR LEASING 12/2013 CONTRCT $0 METL FNSHG 04/2013 NET 30 $2,400 $2,400 100% — PRNTG&PUBL 10/2012 VARJED $0 SAFTY PROD 07/2012 NET30 $0 CUST 4 YR lop Additional Business Facts ftri3t.ir0140WIT14*. 2• . THE FOLLOWING INFORMATION WAS PROVIDED BY THE STATE OF FLORIDA. State of Origin: FL Date of Incorporation:03/29/2013 Current Status: Active Business Type: Profit Charter Number: P130000289 Agent: GATEWOOD RODNEY Agent Address: 4551 CUMMINS CT FT MYERS,FL TOP 0 Corporate Linkage ---TWinquired upon business,GATEWOOD GLASS,INC,is the Ultimate Parent GATEWOOD GLASS,INC 4551 CUMMINS CT-FORT MYERS,FL 742383337 Branches of the inquired upon business: GATEWOOD GLASS,INC 4700 LAREDO AVE-FORT MYERS,FL 735816854 GATEWOOD GLASS,INC 926 SE 9TH LN UNIT A-CAPE CORAL,FL 736223740 GATEWOOD GLASS,INC 6200 METRO PLEX DR-FORT MYERS,FL 892942912 GATEWOOD GLASS,INC 3308 CANAL ST-FORT MYERS,FL 978699151 TOP 0 Inquiries ..Satii*igiff$0114: ' . : . . • I • •••. ".•;. Business JAN14 DEC13 NOV13 OCT13 SEP13 AUG13 JUL13 JUN13 MAY13 Category AIR TRANS 1 AUTOMOTIVE 1 BLDG MATRL 1 BUREAU 1 GENERAL 1 INSURANCE 1 1 TEXTILES 1 Totals 1 1 1 2 3 Experian prides itself on the depth and accuracy of the data maintained on our databases.Reporting your customer's payment behavior to Experian will further strengthen and enhance the power of the information available for making sound credit decisions.Give credit where credit is due. Call 1-800.520-1221,option#4 for more information. End of report 1 of 1 report The information herein Is furnished in confidence for your exclusive use for legitimate business purposes and shell not be reproduced.Neither&potion information Solutions,Inc.,nor their sources or distributors warrant such information not shall they be liable for your use or reliance upon it. 0 Experian 2014.All rights reserved.Privacy PolicY. Experian anc the Experian marks herein are service marks or registered Iracemarks of Experian. Premier Profile•GATEW000 GLASS.INC - Jan 10 14 11:25a 239-277-0167 2392770167 p.11 ET Merit Credit Fast,Accurate& Secure. MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS), STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 0 SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1- SOO--371 334a—OR 239../1/3202: — — COMPANY NAME: RODNEY W.GATEWOOD dba GATEWOOD GLASS INC FEDERAL ID:80-0911378 CURRENT STATUS: ACTIVE PRINCIPAL(S): RODNEY W. GATEWOOD TITLE:PRESIDENT ANGELA GATEWOOD TITLE:VICE PRESIDENT DATE INCORPORATED:04/22/2013 • vNvvNvNvNv vovo�ovov::vovovovovovovo vo�v�o�o�onovovoon0000�c npnnnnnF.f nR4nh0nRn,rrnR4nR.1n �n,,inR4n�.7nF,nv � S . • • ��c Q 40 f. 0 ..... .:, _ •.„ .. ., . a Of . .,.. .....• • ✓ J'�- �1 V 0 tiOf Pd ��) c Deportment of Otatr 0 etc 0 :70) . 0 I certify from the records of this office that GATEWOOD GLASS, INC is a iC .O corporation organized under the laws of the State of Florida, filed on ^�C 0 March 29, 2013, effective March 29, 2013. s �HC 4 C The document number of this corporation is P13000028937. ti0 y v ��C Of �'� I further certify that said corporation. has paid all fees due this office through(1)% December 31, 2013, and its status is active. GW C y0f S �C C �� 0tc I further certify that said corporation has not filed Articles of Dissolution. f y�f f Esc D 7Osc > CEc'* )f �.c tiff 4OC Given under my hand and the �OC Great Seal of the State of Florida (t) at Tallahassee, the Capital, this the 'Uf Df 1 sT Thirteenth day of May, 2013 .�.� - ' 1(: '''!1'''''..t1,3 7-0.i.v.,s-T4s kt ,p, ,01 ,8:,,,,,,y,-,,-ar.,.:: :g Vil't%Or !�0.0 1&4'4.`wE; 1n P tfz r ��� �.� - Trrfarg of,State 1mf O CR2E022 (1-11) x, " .�VN���w��wNvMV �NVMVOUOVOVOwOVO UO�/O�UOUOU�JOJ�JOJO�OJO�O,OJ��. 4n n�n�n r•� n n nh?n�nR4,cw,cF4nh�nR,n,-4nR,nR4nR0nRfrn �n�-4,c,4nR4n,,,,nF4nR,nR,nR,nh,,nRdnR X •y: ID DEPARTMENT OF THE TREASURY INTERNAL REVENUE SERVICE OGDEN UT 84201-0023 Date of this notice: 04-12-2013 Employer Identification Number: 001910.316376.0006.001 1 MB 0.405 850 80-0911378 11111111111111,1111111111111111111411111111111111111111119111 Form: SS-4 Number of this notice: CP 575 A We GATEWOOD GLASS INC For assistance you may call us at: 4551 CUMMINS CT 1-800-829-4933 FT MYERS FL 33905 001910 IF YOU WRITE, ATTACH THE STUB OF THIS NOTICE. WE ASSIGNED YOU AN EMPLOYER IDENTIFICATION NUMBER Thank you for applying for an Employer Identification Number (EIN). We assigned you EIN 80-0911378. This EIN will identify you, your business accounts, tax returns, and documents, even if you have no employees. Please keep this notice in your permanent records. When filing tax documents, payments, and related correspondence, it is very important that you use your EIN and complete name and address exactly as shown above. Any variation may cause a delay in processing, result in incorrect information in your account, or even cause you to be assigned more than one EIN. If the information is not correct as shown above, please make the correction using the attached tear-off stub and return it to us. Based on the information received from you or your representative, you must file the following form(s) by the date(s) shown. Form 941 07/31/2013 Form 1120 03/15/2014 Form 940 01/31/2014 If you have questions about the form(s) or the due dates(s) shown, you can call us at the phone number or write to us at the address shown at the top of this notice. If you need help in determining your annual accounting period (tax year), see Publication 538, Accounting Periods and Methods. We assigned you a tax classification based on information obtained from you or your representative. It is not a legal determination of your tax classification and is not binding on the IRS. If you want a legal determination of your tax classification, you may request a private letter ruling from the IRS under the guidelines in Revenue Procedure 2004-1, 2004-1 I.R.B. 1 (or superseding Revenue Procedure for the year at issue) . Note: Certain tax classification elections can be requested by filing Form 8832, Entity Classification Election. See Form 8832 and its instructions for additional information. i L Eil ou\T * LIC2012-00932 rgatewoodagatewoodqlass.corr License Holder RODNEY W GATEWOOD . Name: Firm Name: GATEWOOD GLASS INC Address: 4551 CUMMINS COURT FORT MYERS FL 33905 Thank you for assisting Lee County Contractor Licensing in their effort to"Go Green". Please keep this document/file in a safe place as you will not be receiving any additional copies of your license from this office. Be sure to keep your email address current with us at all times. Below please find your Lee County Certificate of Competency. This Certificate will need to be renewed yearly if you wish to perform work in Unincoprorated Lee County. Renewal will begin in the middle of August of each calendar year. If you choose to place your license on inactive status please notify this office as soon as possible. Please keep yourself up to date with our departments information by periodically reviewing our website at www.lee-county.com/dcd/contractorlicensing.htm In addition to this Certificate, it is your responsiblity to maintain your worker's compensation,general liability insurance and obtain a yearly business tax receipt from the Lee County Tax Collector while performing work in Unincorporated Lee County. You may email your certificates of insurance to ContractorLicensing @Leegov.com. Our phone number is 239-533-8895. Please send e-mail address and/or telephone changes to ContractorLicensing @Leegov.com IMPORTANT CHANGE PLEASE READ: In an effort to reduce costs and "go green" we will no longer be mailing renewal reminders. If you wish to receive a renewal reminder via email please provide us with your email address along with your case number LIC2012-00932 to ContractorLicensing @Leegov.com. Re: "renewal by email". Cut Here. Conditions of Certificate LEE COUNTY Conditions of Certificate CERTIFICATE OF COMPETENCY (239)533-8895 Shall maintain required insurances on active Renewal due for active and inactive certificates. certificate each year in September. NAME:RODNEY W GATEWOOD D/B/A GATEWOOD GLASS INC COMP.NO.shall appear on all LICENSED FOR Glass&Glazi Shall inform the Contractor Licensing Office of ng Cntr advertisements including vehicles reflecting any Address or telephone#change. a business name. Shall only contract in D/B/A name as it appears on certificate.Board of Approval COMP.NO.: GL12-00932 required on business name changes. NOT VALID • - :119/30/ r Si.-u • ic-'se Holder fcntrlocren2.rpt • • w • r"f f)r t(I( a.,t °RIVER LICENSE CLASS c' 1001001010111010111/1P0 _ ROO WAYNE GATEWE0 1E900 N RIVER RD AL VA.FL 3120-3246 SEX M 1-s3l:6-11 '09 ,v. 402090409 X+'• . consnn�tO W sobs twix;<rMm acd by;nw "7pw+010r•of i M.4{0 v • CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 01/27/14 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND,EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the poilcy(les)must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). CONTACT Gary Roth PRODUCER NAME: Olde Florida Insurance No.Ext): (239)333-0711 0711 FAX No): (239)274-3063 1901 Brantley Rd Unit 11 ADDRvss: lori@oldefloridainsurance.com Fort Myers,FL 33907 INSURER(S)AFFORDING COVERAGE NAIC# Phone (239)333-0711 Fax (239)274-3063 INSURER A: Ohio Security 24082 INSURED INSURER 8: Bridgefield Employers Ins Co 31267 Gatewood Glass,Inc. INSURER C: 4551 Cummins Court INSURER D: Fort Myers,FL 33905 239-334-8002 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE ADOLSUBR POLICY EFF POLICY EXP LIMITS LTR INSR W POLICY NUMBER (MM/DDIYYYY) (MMIDD/YYYY) GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000.00 � DAMAGE TO RENTED [u] COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ 300,000.00 J CLAIMS-MADE Ce OCCUR BKS55530418 MED EXP(Any one person $ 15,000.00 N A 04/17/2013 04/17/2014 PERSONAL&ADV INJURY $ 1,000,000.00 El GENERAL AGGREGATE $ 2,000,000.00 GENL AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000.00 Li POLICY i] j 7 Li LOC $ AUTOMOBILE LABILTY FEOa MaBcIcNdEDSINGLELIMIT $ 1,000,000.00 ANY AUTO BODILY INJURY(Per person) $ A AUTOS NED El SCHEDULED BAS55530418 04/17/2013 04/17/2014 BODILY INJURY(Per accident $ HIRED AUTOS �i AUT�WNED ((PRer acid d DAMAGE $ I0 ] $ UMBRELLA LIAB l_OCCUR EACH OCCURRENCE $ 5,000,000.00 EXCESS LIAB 1 US055530418 A r__ 1_J CLAIMS-MADE 04/17/2013 04/17/2014 AGGREGATE $ 5,000,000.00 BED CI RETENTION$ $ WORKERS COMPENSATION r WC STATU- ■ 0TH- AND EMPLOYERS'LIABILITY Y/N TORY UMITS L_�ER ANY PROPRIETORPARTNER/EXECUTIVE N/A 830-52823 07/15/2013 07/15/2014 E.L.EACH ACCIDENT $ 1,000,000.00 B (Mandatory NH) EXCLUDED? E.L.DISEASE-EA EMPLOYE $ 1,000,000.00 (Mandatory in NH) If yyes desmbe under E.L.DISEASE-POLICY LIMIT $ 1,000,000.00 DESCRIPTION OF OPERATIONS below DESCRPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,If more apace Is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Licensing Department THE EXPIRATION DATE THEREOF,NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2800 North Horseshoe Drive Naples FL 34104 AUTHORIZED REPRESENTATIVE 7 I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05)QF The ACORD name and logo are registered marks of ACORD . LEE COUNTY SOUTHWEST FLORIDA BOARD OF COUNTY COMMISSIONERS John E.Mannng District One Cecil L.Pendergrass District Two Larry K&er January 28,2014 District Three Brian Hammen District Four Frank Mann District Five Roger Desjadais County Manager Richard Wm.Wesch County Attorney Donna More Collins Hewing Examiner LETTER OF RECIPROCITY This letter is to verify that RODNEY W GATEWOOD took the Experior examination, sponsored by Lee County. Glass&Glazing Contractor-GL: 81.3% DATE: 12/06/1986 The appearance.arance. RODNEY W GATEWOOD hashadna the trade at the Licensing Glazing Contractor Board appearance. R in Lee County since 03/08/2013. If you have any questions or if I can be of further assistance,please contact Contractors Licensing at(239)533-8895. Sincerely, David Paschall Contractor Licensing flicltrrcp.rpt P.O.Box 398,Fort Myers,Florida 33902-0398 (239)533-2111 Internet address http:/Iwww.lee•county.com AN EQUAL OPPORTUNITY AFFIRMATIVE ACTION EMPLOYER • ' ,i ,. 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A,''''..,t, n,,,' . .,-", , ,,,t,,,,,,,,,,,,,,,,,,,,,t;',..;,/,,,t ',..,,,..,z„, _--lit,: ...."1!''',',,,,'„,../,,P'A' tt, ,,',,,` ,,,,,,,,,,,„_•,..,i,,,,,,f0",',''',4,,,..k,‘;;„k,_41.".Z.,,,,, ,ii,*.tif:4:4,,,,',ALA,,',,,:k2gti; ,1 it. ),1, ,',', ?"tiA,'•,'4',;' ,"'rk;;;;I 'f,,'1?-t;1,' ,2,-'4%,:•;t„A*,),,,,,,,,,' .!,, ,‘,' .....-..rf-i4 4,..,,, ,,,y i.,,,,,..41 L.LE • , A „,k,,,,,t,r...3$,, ,,,.a' . ,■,,.*,,,ti,,,',.r,s, ' -t'c, •„,„ 5..0 'tq,p;,6,,,,E,,,,c,.,, ,,.;ko;„,,,,,;,,,, • • , . 1 Morrison Aluminum Construction, Inc 1020 SE 12th Ave Cape Coral, Fl 33990 239-573-0549 January 1st, 2014 Collier County Division of Regulatory Management, Licensing section 2800 North Horseshoe Drive Naples,Fl 34101 To whom it may concern, I am writing this letter to clarify the reason that my license had lapsed in Collier County. As you are aware the challenges that we in the construction industry had faced during the last 6 years have been un-precedented. During that time I maintained my license, in good standing, in Lee County, Sarasota, Sanibel and Cape Coral; as the majority of the workload that my company had was there. Please consider this when reviewing my petition for re-instatement of my Collier county license. Sincerely, Keith ► orriso esident t �..EJ► +��" �,.o-pusi ty Growth Management Division Planning& Regulation Operations Department Licensing Section January 29, 2014 Keith E. Morrison 1020 SE 12Th Ave Cape Coral, FL 33990 RE: Reinstatement of license without re-testing Dear Mr. Morrison, You have been added to the agenda for the Contractor Licensing Board meeting on Wednesday, February 19, 2014. The meeting is held at 9:00am at the W. Harmon Turner Building (Bldg. F, Admin. Bldg.), 3299 Tamiami Trl. E., Naples, FL in the Commissioner's Meeting Room on the 3rd floor. If you have any questions or concerns, please call (239) 252-2431 / (239) 252-2909 Sincerely, ao.�„r time Joann Greenberg Customer Service Specialist Licensing/Operations ir....i, )1U.a emc:nt Divit;ion*Planning&S E, atior"_SLV Nurtr.1 of., hcw D, ,_D 239-252 21CJ':^.w...,.... „ .., s t GMD Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUCTIONS: This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: Exact Corporate/Business Name: Aidr n ,4b4 ln-4,1n r � Fiction Name/DBA: f►14 �( lY��oa<< �'�r�i t jern Qualifier Name: f kfi,diini /vim, .Y1 Physical Address: /Q g.0 'SE.Lz 4v�1t I 42e. t,ntl . 1- -min° (Number & Street) (State) (Zip Code) Mailing Address: (Number 86 Street) (City) (State) (Zip Code) Telephone:6239)5Z—4549 E-Mail: L .n TYPE OF LICENSE: ❑ General $230.00 ❑ Electrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 ❑ Roofing $230.00 ..Specialty $205.00 Specialty trade: 4)u1Niy on SpeejQWy LefiA eon CHANGE OF STATUS: (X, Reinstatement ( )From One Business to Anoth RENSTATEMENT FEE $205.00 Page 1 of 4 3 BACK YEARS FEES $555.00 TOTAL = $760.00 �' Z 1 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. KeAti E. ImSGY1nirr Son 1$11 P ialkv (.tr Pt-i lly 'oI 141%hia .br. crif cm-RA , i..mcfct , ..„‘ 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten years(ex. Held a license for or been a partner). Attach extra pages if needed. *Thal 469h;ri Wit) 6)}14-irtirliblrl d.b.as MAC- C./IA*6m Pk ^—A1 nti m 3. List all debts you or any company(s)associated with you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. AFFIDAVIT I, /(e.„41 4 Aldrnson certify that the foregoing is true and correct to the best of my knowledge. r Afrthorized Officer of the Firm STATE OF FLORIDA COUNTY OF The foregoing instrument as acknowledged before me this ,,=2, f �uriyt J'' 1 / (Date) By . .07"/"A /Vain'579 P7r, vie m-1- of Ala • 1s% ! .d �a_ " i / (Name of ficer, title/a'gent) (Na e of Corporation) a k1 - Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced / 2. 1 )-7,/eyS Lfee- S.f . identification and did not take an oath. (Type of identification) NOTARY'S SEAL`S • •��M's'c •9�i'2°d� *.aci ay 19 2 <<-to••�` 41_,A4( = v,• .• #EE000285 :;iti8dmN ••OQ1. 6jc,STATEGFoee Page 2 of 4 IfHHt0E1<< QUALIFIER INFORMATION: Name: 9Se/ � / rC2y� 'kn Address: /426 rSE � /7 (Number&Street) � (Ci ) (State) (Zip Code) Telephone: a V 573-0519 Date of Birth: //- s.s.#: 000-oo-_ -- E-Mail: A/, , ,,,jI,_ , i - Driver's License: /V4, 1. Type of Certificate of Competency for which application is made. Aluminum 6ifirf. 2. The names and telephone numbers of two persons who will know your whereabouts. / 1 • / i / i/'- 4/M11 ). -17710D Tin (230 1x33—8517 3. Have you ever been convicted of a crime related to Contracting? /(16' (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? do 8. List all debts you or any company(s)associated with you refused or failed to pay and reasons why. 9. List your business or work experience during the past ten years. 10. Statement of any formal training you have had in the area for which the application is made. Page 3 of 4 AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No. 2006-46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any information contained herein is grounds for disqualification. • APPLI ANT(PLEASE ( RINT) 4// 1_ ' / I . . // •I /I 7 [ r -Y)I.r)'1G• NA E OF COMPANY S)6NATU OF APPLICANT STATE OF FLORIDA COUNTY OF The foregoing instrument as acknowledged betore me this _ i� _ [� (Date) / By 1<e. 71h G. Qrn_iO» who has produced A �!714'A L.-ICC frc,- (Name of person acknowledging) (Type of identification) as identification and did not take an oath. 0i11t!!r!'Hi04` / "de NOTARY'S S\ o\y �'"AN Gq���,�� •c \y 19, 90.1%��'• �_ _./ • . / �'. * • �9N•, (. A iF NO A- ) • ®•® :* O• #EE 000285 :Q� °!ri#k!1!''• Page 4 of 4 AFFIDAVIT IT IS understood and acknowledged by the Collier County Contractors' Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result in the possible revocation of my Certificate of Competency_ S GNA 4 • OF APPLICANT 3 I Al radieniA6_... BUS NESS NAME _ 1L -/Z.--)3 DATE BEFORE ME this day personally appeared ! ' Ifl G. rTL5,l1/2 who affirms and says that he has less than one employee and does,not req a Workme s Compensation understands that at any time he employees one or more persons he must obtain said Workmen's Compensation Insurance. STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this (Date) by who has produced (name of person acknowledging) • (Type of identification) as identi ention send who did not take an oath SIGNATURE OF NOTARY NOTARY'S SEAL (PRINT NAME OF NOTARY PUBLIC) NOTARY PUBLIC 4 RESOLUTION OF AUTHOxIZATON WHEREAS Alienit,102Ainv MTh - 24.--i. proposes to (Name of Business Entity) engage in contracting as in - (Type bf legal entity:corp.,partnership,etc. Collier.County,Florida,according to Collier County Ordinance 2006-46,as amended;and WHEREAS Molrn S m CD --1.y proposes to (Name of Business Entity) qualify for a Certificate of Competency with jt E. tm5bn (Name of dividual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: _ We the undersigned_ rS of (Officers,Owners,Partners) • 4112:iibraimintiniS7. hereby resolve and represent to the Collier County (Name of Business Entity) Contractors'Licensing Board that the qualifying agent, ir x»"1.4 y), is active ' (Name o dividual) in all matters connected with the conducting business of ) r ela �Ulvp n.um /► - ,and We further re elve and represent that ofBusiness Entity)(. (Name Clfira50Yt is L11��� awes of dividual) legally empowered to act for.MOVV15 e1 111U sittiktm net in all matters connected with its (Name of Business Entity) conracting bu Ines ,nd has the authority to supervise construction undertaken by • (Name of Business Entity) • DULY PASSED AND ADOPTED THIS `1 day of A'L• , Zo/3 (Officers,Partners,Owners—with Des'u . on and rneath.Li4'_ _ • .� Afft 4 4 9 m_we, _ 400S i. .— Corporate Seal(if.ApplicabIc) . • Or NotaryPublic Certificate Sworn to and subscribed before me this O day of,7),.../.., ,,),,,,i...3 b ' f i i . ����a�it�ulllad��i �� . CT�tary ' •ticNom' 'ey ff \\`��'� 0THYq�N/r,•r No . ', . r a�. �' . nunissionNumbe ��` •joMMiss°• '-q/`/r. My Commission expires:.._ *:•N. JU1Y 1s, ;v''y°. 20' 2op p•1:- I I A 4 ,24 •* • • • AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, go-r apar am a resident of Counts, LO 6� GE, (State) and have resided here for more than five (5)years. During the last five years I have known fr-e/M / /' 4' applicant). I have had the opportunity to observe his or her business and personal dealings and find him o �,• .: a person of honesty, integrity and good character. �j (Signature).i (Name)_.$ 7—Ad( dress) /O �� /'b'W4 (41>-. X379/ Telephone)( ) 3'lQ -400 STATE OF FLORIDA COUNTY OF pp The foregoing instrument was acknowledged before me this n�( i . g.Qbr y 0-1O16, '9� ' who has produced �" ' 1�' /� 4'1 k I (name of person acknowl aging) (Type of ide 4 ,cation) as identification and who did not take an oath. 00111►H11111/// 0‘0\-V\A:...... A I JA, 0/1 .o pl'‘s 25 2 Ai.• % �. .TNAT_TRE OF NOTARY • e-4( M 1A)144—kt , NOTARY'S SEAL o:. CD 955440 :?Q (PRINT NAME OF NOTARY) 9 '• r4 re.11.0°'. ( t��°�` NOTARY PUBLIC ///� �re�eiiii� �o�\\\ 9 LULLItK LUUNV I Y UU VhKINMVMLIN I COMMUNITY DEVELOPMENT AND ENVIRONMENTAL SER VICES DIVISION • 2800 N.Horseshoe Dr. • Naples..Florida34104 ® 239-403-2400 e FAX 239-403-2334 • • MEMORANDUM DATE: November 29, 2007 • TO: Applicant's FROM: Michael Ossorio,-Contractor Licensing Supervisor. • CC: Robert Dunn, Collier County Building Director. AIamzr Finnegan, Collier County Permitting Supervisor. • Robert Zachary, County Attorneys Office. All Contractor Licensing personnel SUBJECT: Collection of social security numbers. • • Pursuant to Chapter 119, •Florida Statues and Collier County Contractor Licensing Ordinance 2006-46 Sec, ?.1.1, all applicants are required to submit their social security number (SSN) for the following purposes: a) Assess applivaut's chili ly to satisfy etedituIs by reviewing their credit history. b;1 Vel f cal on o f applicant's test scpres and information,. • Our office will only use your SSN noted.above forthose reasons pursuant to Chapter 119, Florida Statues and as may otherwise he authorized by law. We are fully committed to safe-guarding and protecting your SSN and once collected, will he maintained as confidential and exempt under Chapter 11.9,Florida Statues. • • • • Ott LEE11t_I\nT\ LIC2007 01259 keith @macpools.net Kathy @macpools.net Lynn @macpools.net Kathy @macpools.net renewa License Holder KEITH MORRISON Name: Firm Name: MORRISON ALUMINUM CONSTRUCTION I Address: 1020 SE 12TH AVENUE CAPE CORAL FL 33990 Thank you for assisting Lee County Contractor Licensing in their effort to"Go Green". Please keep this document/file in a safe place as you will not be receiving any additional copies of your license from this office. Be sure to keep your email address current with us at all times. Below please find your Lee County Certificate of Competency. This Certificate will need to be renewed yearly if you wish to perform work in Unincoprorated Lee County. Renewal will begin in the middle of August of each calendar year. If you choose to place your license on inactive status please notify this office as soon as possible. Please keep yourself up to date with our departments information by periodically reviewing our website at www.lee-county.com/dcd/contractorlicensing.htm in addition to this Certificate, it is yourresponsiblity-to maintain your worker's compensation, general liability insurance and obtain a yearly business tax receipt from the Lee County Tax Collector while performing work in Unincorporated Lee County. You may email your certificates of insurance.to ContractorLicensing @Leegov.com. Our.phone.number.is. 239-533-8895. Please send e-mail address and/or telephone changes to ContractorLicensing @Leegov.com IMPORTANT CHANGE PLEASE READ: In an effort to reduce costs and "go green" we will no longer be mailing renewal reminders. If you wish to receive a renewal reminder via email please provide us with your email address along with your case number LIC2007-k1259 to ContractorLicensing @Leegov.com. Re: "renewal by email". • Calere- - --- ---- - ----- -- --- --- • Conditions of Certificate LEE COUNTY Conditions'of Certificate • CERTIFICATE OF COMPETENCY • • - • (239);533-8895. Shall•maintain required insurances on active Renewal due for active and inactive certificates. certificate each year in September. NAME:KEITH MORRISON D/B/A MORRISON ALUMINUM CONSTRUCTION INC COMP.NO.shall appear on all Shall inform the Contractor Licensing Office of LICENSED FOR: Aluminum Specialty Structure any Address or telephone#change. advertisements including vehicles reflecting a business name. Shall only contract in D/B/A name as it • appears on certificate.Board of Approval COMP.NO AL 000111 required on business name changes. NOT VALI AFTE •09/30/2014 ( Sig. ure of License Hodder fcntrlocren2.rpt t • --„,,. ,, LEE C f LIC2007-01259 • keithmacpools.nei Kathy) macpools.nei Lynnamacpools.nei Kathyamacpools.net renewa License Holder KEITH MORRISON Name: Firm Name: MORRISON ALUMINUM CONSTRUCTION I Address: 1020 SE 12TH AVENUE CAPE CORAL FL 33990 Thank you for assisting Lee County Contractor Licensing In their effort to"Go Green''. Please keep this document/file in a safe place as you will not be receiving any additional copies of your license from this office. Be sure to keep your email address current with us at all times. Below please find your Lee County Certificate of Competency, This Certificate will need to be renewed yearly if you wish to perform work in Unincoprorated Lee County. Renewal will begin in the middle of August of each calendar year. If you choose to place your license on inactive status please notify this office as soon as possible. Please keep yourself up to date with our departments information by periodically reviewing our website at www.lee-county.com/dcd/contractorlicensing.htm In addition to this.Certificate, it is your responsiblity to maintain your worker's compensation,general liability insurance and obtain a yearly business tax receipt from the Lee County Tax Collector while performing work in Unincorporated Lee County. You may email your certificates of insurance to ContractorLicensing @Leegov.com. Our phone number is 239-533-8895. Please send e-mail address and/or telephone changes to ContractorLicensing @Leegov.com IMPORTANT CHANGE PLEASE READ: In an effort to reduce costs and "go green" we will no longer be mailing renewal reminders. If you wish to receive a renewal reminder via email please provide us with your email address along with your case number LIC2007-01259 to ContractorLicensing@Leegov.com. Re: "renewal by email". CutHere Conditions of Certificate LEE COUNTY Conditions of Certificate CERTIFICATE OF COMPETENCY (239)533-8895 - Shall maintain required insurances on active• Renewal due for active and inactive certificates. certificate each year in September. NAME:KEITH MORRISON D/B/A MORRISON ALUMINUM CONSTRUCTION INC Shall inform the Contractor Licensing Office of COMP.NO.shall appear on all LICENSED FOR: Aluminum Specialty Structure any Address or telephone#change. advertisements including vehicles reflecting a business name. Shall only contract in D/B/A name as it COMP.NO.: AL 000111 appears on certificate.Board of Approval required on business name changes. NOT VALID AFTER:09/30/2013 Signature of License Holder • fcntrlocren2.rpt ° LEE COUNTY LIC2007-01259 License Holder KEITH MORRISON Name: Firm Name: MORRISON ALUMINUM CONSTRUCTION I Address: 1020 SE 12TH AVENUE CAPE CORAL FL 33990 Below please find your Lee County Certificate of Competency. This Certificate will need to be renewed yearly if you wish to perform work in Unincoprorated Lee County. Renewal will begin in the middle of August of each calendar year. If you choose to place your license on inactive status please notify this office as soon as possible. Please keep yourself up to date with our departments information by periodically reviewing our website at www.lee-county.com/dcd/contractorlicensing.htm In addition to this Certificate, it is your responsiblity to maintain your worker's compensation, general liability insurance and•obtain a-yearly business tax.receipt_from.the.Lee.County Tax Collector while performing work in Unincorporated Lee County. You may do so by emailing your certificates to ContractorLicensing©Leegov.com. Our phone number is 239-533-8895 Please e-mail address and/or telephone changes to ContractorLicensing @Leegov.com IMPORTANT CHANGE PLEASE READ: In an effort to reduce costs and "go green" we will no longer be mailing renewal reminders. If you wish to receive a renewal reminder via email please provide us with your email address along with your case number LIC2007-01259 to ContractorLicensing@Leegov.com. Re: "renewal by email". _ • • • • Cut Here. Conditions of Certificate LEE COUNTY Conditions of Certificate CERTIFICATE OF COMPETENCY (239)533-8895 Shall maintain required insurances on active Renewal due for active and inactive . certificates. certificate each year in September. NAME: KEITH MORRISON D/B/A MORRISON ALUMINUM CONSTRUCTION INC COMP. NO.shall appear on all LICENSED FOR: Aluminum Specialty Shall inform the Contractor Licensing Office of Structure advertisements including vehicles reflecting any Address or telephone#change. a business name. Shall only contract in D/B/A name as it COMP. NO.: AL 000111 appears on certificate. Board of Approval required on business name changes. NOT V•'L ' AFTER:'09130/2012 - Sign re of Lice -- older fcntrlocren2.rpt 01', 11 A , " .I LEE COUNTY LIC2007-01259 • License Holder KEITH MORRISON Name: Firm Name: MORRISON ALUMINUM CONSTRUCTION I Address: 1020 SE 12TH AVENUE CAPE CORAL FL 33990 Below please find your Lee County Certificate of Competency. This Certificate will need to be renewed yearly if you wish to perform work in Unincoprorated Lee County. Renewal will begin in the middle of August of each calendar year. If you choose to place your license on inactive status please notify this office as soon as possible. Please keep yourself up to date with our departments information by periodically reviewing our website at vvww.lee-county.com/dcd/contractorlicensing.htm In addition to this Certificate, it is your responsiblity to maintain your worker's compensation, general liability insurance and obtain a yearly business tax receipt from the Lee County Tax Collector while performing work in Unincorporated Lee County. You may do so by emailing your certificates to ContractorLicensing©Leegov.com. Our phone number is 239-533-8895 Please e-mail address and/or telephone changes to ContractorLicensing©Leegov.com Cut Hera Conditions of Certificate LEE COUNTY 1 CERTIFICATE OF COMPETENCY Conditions of Certificate Renewal due for active and inactive _ • ,(239)533-8895 , certificate each year in September. NAME:KEITH MORRISON :Shall maintain required insurances on active D/B/A 'MORRISON ALUMINUM CONSTRUCTION iNC certificates. COMP.NO.shall appear on all advertisements including vehicles reflecting LICENSED FOR: Aluminum Specialty Structure a business name.. Shall inform the Contractor Licensing Office of Shall only contracf in'D/B/A name as it COMP. NO.:"AL 00011f - any Address or telephone#change. appears on certifcate:.Board of Approval : _ T, '' + r required on business name changes. , N©,T,VALID . R:09/3Q/20g t •. Siwatt.._of License Ho' e rcntrlocren2.rpt • i' yak'{{� ST Aj LEE COUNTY • License Holder KEITH MORRISON Name: Firm Name: MORRISON ALUMINUM CONSTRUCTION Address: 1020 SE 12TH AVENUE CAPE CORAL FL 33990 Cut:Hera LEE COUNTY MAIL ADDRESS AND/OR CERTIFICATE OF COMPETENCY Conditions of Certificatg TELEPHONE#CHANGE TO: (239)533-5895 LEE COUNTY - Renewal due for active and inactive certificate each year in September. DEVELOPMENT SERVICES NAME: KEITH MORRISON P.O.BOX 398 FORT MYERS,FLORIDA 33902 D/B/A MORRISON ALUMINUM CONSTRUCTION COMP.NO.shall appear on all advertisements including vehicles reflecting a ATTENTION:CONTRACTOR LICENSING business name. LICENSED FOR: Aluminum Specialty Structure Shall only contract in D/B/A name as It appears on certificate.Board of Approval required on business name changes. COMP. NO.: AL 000111 ��A nnn Shall maintain required insurances on active certificates. NO a ID AFTE''.0.9/30/2O ry Shall Inform the Contractor Licensing Office of any Address or telephone# J change. I•'-` re o Icense'o•er fcntrlocren2.rpt • COUNTY TRADES „ License Holder ,r l,, r r KEITH MORRISON �:''s- Name: 78 Firm Name: MORRISON ALUMINUM CONSTRUCTION Address: 1020 SE 12TH AVENUE CAPE CORAL FL 33990 aut LEE COUNTY MAIL ADDRESS AND/OR CERTIFICATE OF COMPETENCY conditions of certificate TELEPHONE#CHANGE TO: (239)533-5895 LEE COUNTY Renewal due for active and inactive certificate each year in September. DEVELOPMENT SERVICES NAME:KEITH MORRISON P.O.BOX 398 FORT MYERS,FLORIDA 33902 D/B/A MORRISON ALUMINUM CONSTRUCTION COMP NO.shall appear on all advertisements including vehicles reflecting a business name. ATTENTION:CONTRACTOR LICENSING LICENSED FOR: Aluminum Specialty Structure Shall only contract in O/B/A name as it appears on certificate.Board of Approval required on business name changes. COMP.NO.: AL 000111 Shall maintain required insurances on active certificates. NOT V'LI► AFTER: 0' e " • Shall inform the Contractor Licensing Office of any Address or telephone it change. gn• re o!cense fcntrlocren2.rpt b , LEE COUN y , . . , . . License Holder KEITH MORRISON Name: Firm Name: MORRISON ALUMINUM CONSTRUCTION Address: 1020 SE 12TH AVENUE CAPE CORAL FL 33990 • • • Cut Here LEE COUNTY MAIL ADDRESS AND/OR CERTIFICATE OF COMPETENCY Conditions of Certificate TELEPHONE#CHANGE TO: (239)533-5895 LEE COUNTY Renewal due for active and inactive certificate each year in September. DEVELOPMENT SERVICES NAME: KEITH MORRISON P.O.BOX 398 FORT MYERS,FLORIDA 33902 D/B/A MORRISON ALUMINUM CONSTRUCTION COMP.NO.shall appear on all advertisements including vehicles reflecting a ATTENTION:CONTRACTOR LICENSING business name. LICENSED FOR: Aluminum Specialty Structure Shall only contract in D/B/A name ash appears on certificate.Board of Approval required on business name changes. COMP.NO.: AL 000111 Shall maintain required insurances on active certificates. NOT VALID AFTER: 09/30/2008 Shall inform the Contractor Licensing Office of any Address or telephone ti change. Signature o Icense o er fcntrlocren2.rpt BUILDING DEPARTMENT • CITY OF PUNTA GORDA, FLORIDA BUILDING DEPARTMENT CERTIFICATE OF COMPETENCY CITY OF PUNTA GORDA, FLORIDA (941)575-3324,ext. 1 CERTIFICATE OF COMPETENCY (941) 575-3324, ext. I ALUMINUM CONST `T, ;^ KEITH EDWARD MORRISON of rLL MORRISON ALUMINUM CONST INC 1817 PICCADILLY CIR CAPE CORAL , FL 33991 L RT. # i 1::2f1^, 1 i r TYPE: sPF,i TALTY r ;TURF . C CEr'-.T.# . 07-000119'7 5 REGISTERED _ ,a�PE: ALUMINUM/:CONCRETE NOT VALID AFTER. P / ;c' ' a CONTRACTOR 40'VALID AFTER- 9/3 0/0 7 BUILDING DEPARTMENT BUILDING DEPARTMENT CITY OF PUNTA GORDA,FLORIDA CITY OF PUNTA GORDA, FLORIDA CERTIFICATE OF COMPETENCY CERTIFICATE OF COMPETENCY (941)575-3324,ext. 1 941-575-3324,ext 1 KEITH EDWARD MORRISON MORRISON ALUMINUM CONST INC 1817 PICCADILLY CIR CAPE CORAL FL 33991 CERT.#10-00011975 CERT.# TYPE:SPECIALTY STRUCTURE CONT-REGISTERED TYPE: NOT VALID AFTER: September 30,2010 ^r, NOT VALID AFTER: BUILDING DEPARTMENT BUILDING DEPARTMENT CITY OF PUNTA GORDA,FLORIDA CITY OF PUNTA GORDA,FLORIDA CERTIFICATE OF COMPETENCY CERTIFICATE OF COMPETENCY 941-575-3324;ext 1 941-575-3324,ext 1 KEITH EDWARD MORRISON KEITH EDWARD MN MORRISON ALUMINUM CONST INC MORRISON ALUMINUM INUM CONST INC 1817 PICCADILLY CIR 1817 PICCADILLY CIR CAPE CORAL FL 33991 - CAPE CORAL FL 33991 CERT.#11-00011975 CERT.#12-00011975 TYPE:SPECIALTY STRUCTURE CONT-REGISTERED TYPE:SPECIALTY STRUCTURE CONT-REGISTERED NOT VALID AFTER: September 30,2011 NOT VALID AFTER: September 30,2012 e p • BUILDING DEPARTMENT BUILDING DEPARTMENT CITY OF PUNTA GORDA, FLORIDA CITY OF PUNTA GORDA,FLORIDA CERTIFICATE OF COMPETENCY CERTIFICATE OF COMPETENCY 941-575-3324,ext 1 941-575-3324,ext 1 KEITH EDWARD MORRISON KEITH EDWARD MORRISON MORRISON ALUMINUM CONST INC MORRISON ALUMINUM CONST INC 1817 PICCADILLY CIR 1817 PICCADILLY CIR CAPE CORAL Fl 33991 CAPE CORAL FL33991 CERT.#13-00011975 CERT.#14-00011975 TYPE:SPECIALTY STRUCTURE CONT-REGISTERED TYPE SPECIALTY STRUCTURE CONT-REGISTERED NOT VALID AFTER: September 30,2013 NOT VALID AFTER: September 30,2014 CITY OF 9A O {ORto g c�Tr or w City of Cape Coral Certificate of Competency 41840 Date Issued: 09/04/2013 ALUMINUM/CONCRETE MORRISON KEITH MORRISON ALUMINUM CONST INC Expiration Date: 09/30/2014 L J Detach and post bottom portion CITY OF CAPE CORAL CERTIFICATE OF COMPETENCY City of Cape Coral -- 1015 Cultural Park Blvd-- Cape Coral Florida 33990 -- (239) 574-0430 This Certificate expires September 30, 2014 Visit Our Website at www.capecoral.net Certificate #: 41840 Location: 1020 SE 12TH AV CITY OF Classification: Business Phone: (239) 573-0549 SPECIALTY State License: RX0066476 0 q"41. ALUMINUM/C ON CRETE 9A V O MORRISON KEITH <alto MORRISON ALUMINUM CONST INC Date Issued: 09/04/2013 1020 SE 12TH AV Amount: $ 75.00 CAPE CORAL.FL 33990-3015 CITY O F "%.p.:41111111:_4*: A<OR\OP V„itY City of Cape Coral Certificate of Competency -j 41840 ALUTvIINU Date Issued:08/09/2012 1VtJCONCRETE MORRISON KEITH MORRISON ALUMINUM CONST INC Expiration Date: 09/30/2013 Detach and post bottom portion CITY OF CAPE CORAL CERTIFICATE OF COMPETENCY City of Cape Coral -- 1015 Cultural Park Blvd -- Cape Coral Florida 33990 -- (239) 574-0430 This Certificate expires September 30, 2013 Visit Our Website at www.capecoral.net Certificate #: 418.40 CITY OF Location: 1020 SE 12TH AV Classification: Business Phone: (239) 573-0549 SPECIALTY State License: RX0066476 9 4- ALUMINUM/CONCRETE A<ORIOP MORRISON KEITH Date Issued: 08/09/2012 MORRISON ALUMINUM CONST INC 1020 SE 12TH AV Amount: 75.00 CAPE CORAL. FL 33990-3015 Ay A CITY OF City of Cape Coral .. 1015 Cultural Park Blvd. 4� 4�� V Cape Coral, Florida 33990 CITY t7F g Ar 1 0 9 493-1-1****AUTO**SCH 3-DIGIT 339 II,IIIIIIIIIIIIIIIhIIIIII'IIIIIIIuIIII■11111I'II'II"11ililI'I'I1 MORRISON KEITH ALUM �4ORO 1020 SE 12TH AVE CAPE CORAL, FL 33990-301 5 CITY °`v., City of Cape Coral 4��� Certificate of Competency 41840 Date Issued: 09/01/2010 ALUMINUM/CONCRETE Owner Name: MORRISON KEITH ALUM DBA: MORRISON ALUMINUM CONST INC Expiration Date: 09/30/2011 Detach and post bottom portion I CITY OF CAPE CORAL CERTIFICATE OF COMPETENCY City of Cape Coral-- 1015 Cultural Park Blvd--Cape Coral Florida 33990 -- (239) 574-0430 This Certificate expires September 30, 2011 Visit Our Website at www.capecoral.net Certificate #: 41840 CITY OF Location: 1020 SE 12TH AV Phone: (239) 573-0549 State License: RX0066476 17).N1 °, tooto „, Classification: ALUMINUM/CONCRETE MORRISON KEITH ALUM 1020 SE 12TH AVE Date Issued: 09/01/2010 CAPE CORAL, FL 33990-301 5 Amount: $75 (`t'(' IAA CITY OF 41, lhi. cap° 4ORto °"r °` City of Cape Coral � �� Certificate of Competency 41840 Date Issued: 07/30/2009 ALUMINUM/CONCRETE MORRISON KEITH ALUM MORRISON ALUMINUM CONST INC Expiration Date: 09/30/2011 Detach and post bottom portion CITY OF CAPE CORAL CERTIFICATE OF COMPETENCY City of Cape Coral -- 1015 Cultural Park Blvd -- Cape Coral Florida 33990 -- (239) 574-0430 This Certificate expires September 30, 2011 Visit Our Website at www.capecoral.net Certificate #: 41840 Location: 1020 SE 12TH AV CITY OF Business Phone: (239) 573-0549 State License: RX0066476 Q► • Classification: ALUMINUM/CONCRETE A<OR\OP MORRISON KEITH ALUM Date Issued: 07/30/2009 MORRISON ALUMINUM CONST INC Amount:SE 12TH AV mount: $ 75.00 CAPE CORAL, FL 33990-3015 CITY OF CAPE CORAL CaFfOral FLORIDA COMPETENCY LICENSE MORRISON KEITH I LOCATION ADDRESS: 1020 SE 12TH AV CONTROL NUMBER ISSUE DATE EXPIRATION DATE'LiciKiltNUMBeii 0024369 September 27, 2007 September 30, 2008 08-00041840 CLASS: CONTRACTOR ALUMINUM/CONCRETE License Fee: 75.00 MORRISON KEITH MORRISON ALUM CONST INC 1020 SE 12TH AV CAPE CORAL FL 33990-3015 THIS IS NOT A BILL Comments: Post In Conspicuous Place MORRISON KEITH MORRISON ALUM CONST INC 1020 SE 12TH AV CAPE CORAL FL 33990-3015 t:-'7==---At CITY OF CAPE CORAL C* DA COMPETENCY LICENSE , ,, ,,,, _ MORRISON KEITH LOCATION ADDRESS: 1020 SE 12TH AV CONTROL NUMBER ISSUE DATE EXPIRATION DATE t ,13,i--:- ,1 ," 0024369 August 21, 2006 September 30, 2007 07-00041840 CLASS: CONTRACTOR ALUMINUM/CONCRETE r - License ee:'755:00 a4 MORRISON EITH t M IT, I .O.N ALUM CONST , _ 1 ti 1 20 E 12TH.AV7 , ,�; IS • BILL '''''', i C j ,:!: r ' 1 FLORIDA Comments: Post In Conspicuous Place MORRISON KEITH MORRISON ALUM CONST INC 1020 SE 12TH AV CAPE CORAL FL 33990-3015 Jan 14 14 01:57p 239-277-0167 I 2392770167 p.2 Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TPA.NSLNICN CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] ((I; Z NP6284423 MERIT CREDIT 16 NP 6/83 12/05/13 12 :33CT [SUBJECT] ISSN1 [BIRTH DATE] MORRISON, KEITH E. :CURRENT ADDRESS] R,.- [DATE RPTD] 1817 PICCADILLY CI. , CAPE CORAL FL. 33991 L �,F 14 2014 10/01 [FORMER ADDRESS] c! !�E 1020 SE. 12TH AV. , CAPE CORAL FL. 33990 1817 PICADILLY CI, CAPE CORAL FL. 33991 `-_..,,._,................ [CURRENT EMPLOYER AND ADDRESS] [RPTD] MORRISON ALUM CONSTRUCTION 9/94 M O D E L P R O F I L E * * * A L E R T * * * ***FICO CLASSIC 04 ALERT: SCORE +749 : 039, 005, 010, 008 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=C COL=0 NEG=O HSTNEG=1-3 TRD=22 RVL=11 INST=9 MTG=2 OPN=O INQ=3 HIGH CRED TEED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $243K $267K $231K $0 $715 13% INSTALLMENT: $23. 6K $ $ $ MORTGAGE: " $149K $ $149K $0 $767 TOTALS: $416K $267K $381K $0 $1462 T R A D E S SUBNAME SUECODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# VERFIED CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 GECRB/JCP D 235058D 6/92 $1147 11111=111111 R31 11/13A $700 $0 111111111111 C CHARGE ACCOUNT 1/12P $0 48 0/ 0/ 0 GECRB/SCUNDA H 9992631 8/03 $0 1111111:1111 RO1 11/13A $1500 $0 111-11111111 C CHARGE ACCOUNT 11/07C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 11/13A $9000 $0 I CREDIT CARD $4650 5 0/ 0/ 0 GECRB/LOW L 235041) 4/01 $2555 111111111111 RO1 11/13A $424 $0 111111111111 I CHARGE ACCOUNT 10/08C $0 CLOSED 48 0/ 0/ 0 3K OF AMER B 6331213 5/05 $230K M1N622 111111111111 C01 10/13A $231K $0 C HOME EQUITY LOAN $226K 46 0/ C/ 0 Jan 14 14 01:57p 239-277-0167 2392770167 p.3 FIFTH THIRD 3 9925002 9/13 $149K 360M767 1 M01 13/13A $0 C CONVENTIONAL REAL $149K 1 0/ 0/ 0 BK OF AMER B 4275002 5/31 $175K 360M 111111111111 MO1 9/13A $0 111111111111 C CONVENTIONAL REAL 9/13C $0 CLOSED 48 0/ 0/ 0 KIA MTR FIN F 29M2002 11/10 $21.8K 36M280 111111111111 101 5/13A $0 111111111111 S AUTO LEASE 5/13C $0 CLOSED 29 0/ 0/ 0 BK OF AMER B 6331213 1/99 $7000 111111111111 C01 6/12A $7000 $0 111111111111 I LINE CF CREDIT 6/12C $0 CLOSED 48 0/ 0! 0 CHASE B 26QK001 6/06 $1018 111111111111 RO1 4/12A $5000 $0 111111111111 A FLEXIBLE SPENDING 1/12C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 SUNTRUS: BK B 423A022 11/05 $45. 5K 72M1270 111111111111 I01 c 2/12A $0 111111111111 48 0/ 0/ 0 AUTOMOBILE 2/12C $0 CLOSED TD AUTO FIN F 624C382 11/06 $20.OK 48M477 X'XX111111111 -01 11/10A $0 111111111111 AUTOMOBILE 11/10C $0 CLOSED' 48- 0/ 31 0. HSBC/BSTBY B 2DQ1071 5/03 $1839 11111111111= R01 7/09A $3600 $0 11111111111 I CHARGE ACCOUNT 3/05C SO CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 G:4A0 Q 2592669 5/03 $12.8K 60M267 1111111:1111 101 6/08A $0 111111111111 C AUTOMOBILE 6/080 $0 CLOSED 48 0/ 3/ 0 BK OF AMER B 6331059 6/01 $6604 XXX11I 111111 RO1 4/08A $13.31K $0 111111111111 C CREDIT CARD 4/07P $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 HNTINGTN NTL B 8140018 6/05 $21.6K 48M521 1111111-1X11 201 2/08A $0 X11X11X1X111 C ACTOMOBILE 2/08C $0 CLOSED 31 0/ 0/ 0 GMAC Q 2592669 5/03 $12. EK 60M267 111111111111 I01 2/08A $0 111111111111 C AUTOMOBILE 2/080 $0 CLOSED 48 0/ 0/ 0 BI{ OF AMER 3 1597029 9/06 $92 4/07 543 ROI . 5/07A $12.5K $0 $76 05 1 CREDIT CARD 5/07P $0 CLOSD BY CRDT GRANTOR 3 0/ 1/ 2 SUNTRUST BK B 423A022 5/05 $28 . 9K 60M584 111111111 101 2/06A $0 S BUSINESS 2/06C $0 CLOSED 9 0/ 0/ 0 Jan 14 14 01:57p 239-277-0167 I 2392770167 p.4 Br{ OF AMER B 6331213 4/03 $149K 111111111111 CO1 5/05C $0 CLOSED 24 0/ 0/ 0 1ST NATBK FL 3 1Y4F001 8101 $23.6K 60M482 1=1111111111 I01 1/C5A 111111111111 C AUTOMOBILE 37 0/ 0/ 0 FRD MOTOR CR F 3796761 8/00 $22.2K 60x469 11111111111 I01 12/04A $0 1111111 C AUTOMOBILE .2/04C $0 CLOSED 19 0/ 0/ 0 I N Q U I R I E S DATE SU3CODE SUBNAI4E TYPE AMOUNT 12/05/13 ZNP6284423 (FLA) MERIT CREDIT 7/03/13 BCI5512716 (DAY) FIFTH THIRD 3/12/12 BNC5085458 (FLA) BK OF AMER C R E D I T R E P O R T S E R V I C E D BY : TRANSJNION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consu:ter disclosures can be obtained online through TransUnion at: http: //www.transanicn.com CREDITOR CONTACT INFORMATION GECRB/JOP DC235058D (866) 227-5213 PO BOX 965007 ORLANDO FL. 32896 3ECRB/SOUNDA HM9992631 (266) 396-8254' C/O PO BOX 965036 ORLANDO FL. 32896 (800) 972-3C30 5/3 BANK CC BC2IAV061 ( 5050 KINGSLEY DP. CINCINATTI OH. 45263 GECRB/LOW LH2350411 (300) 444-1408 PO BOX 956005 ORLANDO FL. 32896 BK OF AMER BB6331213 (800) 451-6362 4161 PIEDMONT PKWY GREENSBORO NC. 27410 FIFTH THIRD BM992S002 (513) 358-4801 5050 KINGSLEY DR CINCINATTI OH. 45263 BK OF AMER BM427S002 (800) 451-6362 4161 PIEDMONT PKWY GREENSBORO NC. 27410 KIA MTR FIN FA29M2002 10550 TALBERT AVE FOUNTAIN VALLE CA. 92708 CASE BC26Qzc001 (800) 955-9900 P.O. BOX 15298 WILMINGTON DE. 19850 (877) 596-5407 SUNTRUST BK BY423A022 PO BOX 85526 RICHMOND VA. 23285 TD AUTO FIN FA624C382 ;800) 556-8172 PO BOX 9223 FARMINGTON MI. 48333 HSBC/BSTBY BC2DQ1C71 (800) 695-6950 PO BOX 30253 SALT LAKE CITY UT. 84130 GMAC QZ2592669 ,800; 200-4622 P.U. BOX 383901 BLOOMINGTON MN. 55432 BK OF AMER BC6331059 PO BOX 982235 EL PASO TX. 79998 BNTINGTN NTL BZ814D018 PO BOX 1558 COLUMBUS OH. 43216 BK OF AMER BC1 597029 PO BOX 982235 EL PASO TX. 79998 Jan 1414 01:57p 239-277-0167 2392770167 i p.5 1ST NATBK FL BZ1Y4F001 1150 CLEVELAND SI'R CLEARWATER FL. 33755 PRD MOTOR CR FA3796761 (8C0) 727-7000 POB 542000 OMAHA NE. 65154 FIFTH THIRD B 5512716 (513; 379-5353 38 FOUNTAIN SQUARE CINCINNATI OH. 45263 BK OF AMER B 5085458 MAIL CODE: IL4-135 CHICAGO IL. 60603 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED A7 THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUEST IONSREGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 CR (239) 277-3202'. Jan 14 14 01:57p 239-277-0167 2392770167 p.1 U ' T Merit Credit : Fast, Accurate & Secure. To:Collier County Contractor Licensing Office JAN 14 2014 Attn:Joanne,Jennifer,Connie BY Please accept these reports for the individual Keith Morrison and his company.Their reports were pulled and mailed on December 5, 2013 but never seemed to have been delivered to them. Due to the holidays we have had countless issues with the US Postal Service. Thank you /141 Pt4L-- Ashley Paulus Administrator Merit Credit Inc. Jan 14 14 01:58p 239-277-0167 I 2392770167 p.6 Premier Profile -MORRISON ALUMINUM CONSTRUCTION, INC ■� • •• Ordered: 12/05/2013 12:34:49 CST `:.air Experian Subcede:970135 . - Transaction Number: C5002'2527 A. ncrl�of in sight Search inquiry: MORRISON ALUMINUM CONSTRUCTION. INC11020 SE 12TI- AVE%C,4PE CORAL/F L133990FUSt239-573-0549;735986268 Model Description: Inteliiscore Pius V2 Business Name - Business Identificatronf3umb r Y�,ORRISON'ALUMINUM CONSTRUCTION„ 2 � ¢': ' :: :' ; , LUebsiYe: mac�lUtninum.net Going Business MORRISON ALUMINUM CONSTRUCTION, Phone: (2391 uininum. As: INC 1 Primary Address: 1020 SE 12TH AVE Tax ID: 65-0769790 CAPE CORAL,FL 3399C-3015 sK DashbUar>t w .. , s; Risk Scores and Credit Limit Recommendation Days Beyond Terms Derogatory Legal Fraud Alerts Financial Stability Risk Company DST Original Filings High Risk Alerts lnt�llisccre Pius ----1 i � LOW-MEDIUM /i 9 LOW-MEDIUM ?'. F; '1041Txmli 1`-i RISK `J RISK A Industry DST: 11 Score range: 1 -100 percentile Credit Limi:Recommendation:555,100 oP 0 Years rs s on .a......, . . ; SPECIAL TRADE CONTRACTORS.NEC 1799 a on File: 1 18(FILE ESTABLISHED 10 1935) SIC Code: ALUMINUM FOL VDR.ES 3365 Date of ncorp ra iOn FL Date of!ncerporation: 66;30:1997 LEAD &ZINC ORES- ':031 Business Type: institutions-Profit NAILS Code: VIN RAY MORRISON-DIRECTOR Commercial and Institutional Building Construction-235220 Contacts: KEVIN Aluminum Foundries(except Die-Casting;-331524 KEITH EDWARD f•,IORRISOPd- DIRECTOR Lead Ore and Zinc Ore r4ininc-212231 12 1 LYNN M MORRISON-DIRECTOR Number of Employees: 53,308,012 Sales: i.;:•'r r Commercial Fraud Shield .Evaluation for-MOI SON:_ALUMINUM CoNSTRUOT1oN13Nc 1 2fl V--10t4 AVE t 1CAP.)T COFRA4 FL3399ft 3815 B. Verification Triggers Business Alerts - . The primary Business Name.Address.and Active Business Indicator: . .-‘'' Expenan shows this business as active Phone Number cn Experian File were reviewed • for High Risk.ndicators no Hich Risk indicators were found. Possible OFAC Match: No OFAC match found Business Victim Statement: No victim statement on file c1 cL t Risk Seale and Credit 3.,ti94.-- ccrtr#,me c#a0,0r!., .., . •: ,. ,..., ;F. Z. ,.. , ..,t•: , .s'M,'� •M,�a•LR,e i55.3�,. Credit Risk Score:Intetliscore Plus Class:2 Current lntetiiscare Plus Score: 59 Risk _... _.. ...... ...... ... The risk class croons scores by rsk into ranges of sim's'ar performance,Range 5 is the hiohest risk,range 1 is the 1'S Premier Pro`de-MORRISON ALUMINUM CONSTRUCTION,INC Jan 14 14 01:59p 239-277-0167 I , 2392770167 p.7 • ' ' • , ' lowest.risk. . 59 , --7,,--,-..------iolmwormil I,. Q., :,L P.i5;,. I ; r-----1 0 10 25 50 75 100 I ,, . ,..... ... .. . .. This score predicts the likelihood cf serious credit delinquencles for this business ! within the next 12 months.Payment history and public record along with other valables are used to predict future risk.Higher scores indicate Lower risk. Factors lowerinc the score Industry Risk Comparison > NUMBER OF COMMERCIAL ACCOUNTS WITH NET 1-30 DAYS TERM 58%of businesses indicate a higher likelihood of severe delinquency. Y NUMBER OF COMMERCIAL COLLECTION ACCOUNTS ?- NUMBER OF RECENTLY ACTIVE COMMERCIAL ACCOUNTS > NUMBER OF COMMERCIAL ACCOUNTS WITH HIGH UTILIZATION Action or risk based on your company's specific score thresholds: LOW-MEDIUM RISK Quarterly Score Trends Quarterly Score Trends , . . . . . . . . . • • 100 - t•lo - so - 70 - • • The Quarterly Score Trends provide a view of the GO - likelihood of delinquency over the past 12 months for this 50 - -10 30 20 - • • 29 business.The trends will indicate if the score mprcved, - remained stable,fluctuated or deciined'over the lash.1- - 7' months, . 12 12 8 0 • . i . .. . • ' • ,i S. 6 1„P.71 Si ic., I V .C''. ,-.4'''''' .:,l•-,' s 'C''. Credit Risk Score:Financial Stability Risk Current Financial Stability Risk Score: 49 Risk Class: 2 - , .-- • • 49 • .•-• -- '• . •• - --- - -• High f"--- .. ailiginalanna, Rls' The risk class groups scores by,isk info ranges of similar performance.Range 5 is the highest risk, range 1 is the lovvest risk. 0 '.; in 1:-:0 E...: 1C 0 . This score predicts the likelihood o5 financial stabihty risk within the next 12 months. The score uses tradeline and collections information,public flings as well as other variables to predict future risk.Higher scores indicate lower risk. Factors lowering the score Industry Risk Comparison > NUMBER OF COMMERCIAL COLLECTION ACCOUNTS 48%of businesses indicate a higher likelihood of financial stability.risk. , > RISK ASSOCIATED WITH THE COMPANY'S INDUSTRY SECTOR i > NUMBER OF ACTIVE C.:0IMMERCiAL ACCOUNTS ) RISK ASSOCIATED WITH THE BUSINESS TYPE Credit Limit Recommendation • Credit Limit Recommendation Tnis recommendation compares this business against simiar businesses in the Experiar business credit database. It is based on trace irformation,industry,age of business and the Intelliscore 565,100 Pius.The recommendation is a guide.The final decision must be made based on your compar ys I business policies. i Premier Profile-MORRISON ALUMINUM CONSTRUCTION,INC 2:'5 Jan 14 14 02:00p 239-277-0167 2392770167 p.8 Tv,, 0 tee alnd 1. 1 Frbn STS►. , t. _:,o . . ,:<< ,;.'r:u� Payment Performance Trade and Collection Balance Legal Filings 0 Total trade and collection(10): S255,200 Bankruptcy: No Current DBT: 0 $237 2,30 Tax Lien filings:1 Ail trades 9: 0 Predicted DST as 01/2912014: ) j Judgment filings: Monthly Average DST: 0 All collections(1): $18,0'00 Sum of legal filings: SO Y 9 2 5237,'00 UCC filings: Highest DBT Previous 6 Vianths: 0 Continuous trade(7): Cautionary UCC filings: Yes . Highest DST Previous 5 Quarters: Q 6 month average: 5234,500-$247,000 Payment Trend Indication: Highest credit amount extended. $2.35,90'0 Payments are stable Most frequent industry purchasing terms: NET 30,REVOLVE,CREDIT Industry Comparison Industry DST Range Comparison DDT Norms ' The mime-008T of this business is 0.80%of businesses nave a DBT-ange of 0.5. All industry: 9 ----- Sa�-�c industry: 11 �P y this business: 0 Industry Payment Comparison 1 Has paid sooner than 50%of similar businesses DST Range 0-., 6-15 16" .._.......I T tV .� �. ew-..)n- ,.....i#+*+.ti AL.:. ..�....0+, 3f,S.. ,. 9: '+. -I n ,:1 ,'+a.-:: DBT Trends Monthly DBT Trends Quarterly DBT Trends -I0 10 r. S - S - 3- 5 4 -4- 4- 3 3 - t I 0- 0 0 © 0_1 LI U y 0 0. Monthly Payment Trends Payment Trends Analysis Account Status SPECIAL TRADE CONTRACTORS,NEC-1799 Days Beyond Terms Industry Business DST Balance Cur 1-30 31-60 61-90 91+ Date Reported Cur DBT CURRENT N/A N/A 0 $237,100 100% OCT13 81% 11 0 $238,700 98% 2% SEP13 82% '0 0 $236.900 100% AUG13 83% 9 0 $247,000 100% JUL13 83% 10 0 ii235,000 100% , JUN13 83% 10 0 $241,100 103% Premier Profile-M0RRISOI•:ALUMINUM CONSTRUCTION,!NC Jan 14 14 02:00p 239-277-0167 2392770167 p.9 mrY13 645 10 0 9234,500 100% i Quarterly Payment Trends Account Status Payment History-Quarterly Averages Days Beyond Terms DST Balance Cur 1-30 31-60 61-90 91+ Months _ .. __-__ Quarter --.. ------- _ .-.__ -- - -- _ - - - - - - -- _ ----------------------------._- 0 -- S239,600 100% Q3- 13 JUL-SEP 02 13 APR-JUN 2 $2 38,500 93% % 10.E Qi - 13 JAN-MAR 4 5246,100 94% 1% 2% 2% 1% 04- 12 OCT- DEC 1 5258,100 95% 4% 1% 03 12 JUL-SEP 0 $256,700 97% 3% Top 4)•Collection Experiences. - . . .. , 1, -c.:.:'.... . •- ,.. ,f=: 1, Date Placed Status Original Balance Outstanding Balance Date Closed Agency __- _ -Agency Phone 0612009 Unco lected --$18,000 --- $18,000 - 0712009 ETHAN&ASSOCIATES (985)875-2294 py 7CP0•Txad+;pays enf SytntnarY< , . . , uiZS,mA! Trade Line Tyne Lines Reported -DST Recent High Credit Balance __-Curren- 01-30 31-60 0 61-90 91+ Continuous -- 7 — -_ - $283,000 5237,100 100% New 0 50 Combined Trade 7 5283.000 $237,100 100% Additional 2 $5,300 $100 100% Total Trade 9 $238,300 5237,200 100% 70P0 .TR f ilYnu8 :Hel a d i'2 ti 9° ' N4249d T0 , ,.!.0..:4,;.; .,.:,k.,x> .,,-. c- : , : ..,- , .i>., .S: - .:. 4 Payment Experiences Account Status (Trade Lines with an(*)after the date are newly reported) Days Beyond Terms Business Date Last Payment Recent High Balance Cur 1-30 31-60 61-90 91+ Comments Cate ory Reported Sale Terms Credit BANK 10/2013 CONTRCT 9235.900 6220,900 100% BLDG MATRL 11/2013 10/2013 CREDIT $900 $200 `:C0% CON STRUCTN 11/2013 NET 33 So FINC!SVCS 11/2013 10'2013 VARIED $12,800 $1,900 100% SATSFTRY CFTC SUPPL 10/2013 06(2009 CREDIT $0 ACCTCLOSED , PRNTG&P'JBL 1112013 `JA=DED $700 90 LROOFF CONTR 11/2013 NET 30 $32,700 $14,100 100% 'ttOt.F• frlll2,rSt ,AdAi 0111al Trade Detail$ .. _ . .. . _.. ,, L . „..,t r a.: . -+l -' .A:4S}5'. Payment Experiences Account Status (Trade Lines with an(*)after the date are newly reported) Days Beyond Terms Business Date Last Payment Recent High Balance Cur 1-30 31-$0 61-90 91+ Comments _Categc + Reported_ Sale ._...__Terms ---Credit .-----__-._-. --.-._._...._._._-.---•----.__-._...-----__.-...__._....__._..--_-- ALUMINUM 04/2013 03/2013 VARIOUS $5,300 <$100 100% OUST 22 YR FINCL SVCS 03/2011 REVOLVE SC --'P M1aI ,unifo m Commercial bode.WPC)Ftlipos ., - t . .. - UCC Filing Summary Cautionary Total Released I Amended. 4i 5 Premier Profile-MORRISON ALUMINUM CONSTRUCTION.INC Jan 1414 02:01p 239-277-0167 2392770167 p.10 i Date Range Year UCC_s.. Filed Termination Continuous Assigned i --- JUL-PRESENT --- 2013 � 1 ---� JAN-JUN 2013 JUL-DEC 2012 JAN-JUN 2012 1 JUL- DEC 2011 PRIOR TO JUL 2011 Total 1 2 0 0 0 -"Cautionary UCC FiFngs incluoe one or more of the following collateral: Accounts.Accounts Receivables,Cora Rights,Hereafter Acquired Property,Inventory.Leases,Notes Receivable or Proceeds. • UGC Details UCC FILED Date:02106;2012 UCC FILED Date: 113 Filing Number: 2012006133374 FJurisdiction:ing Number: 201309969112, Jurisdiction: SEC OF STATE FL Secured r SEC OF STATE FL Secured Party:TEREX FINANCIAL SERVICES, INC.CT!rJESTPORT Secured 59107 PC BOX 35701 CAPITAL COMMERCIAL INC.MT BILLINGS 06 880 200 NYALA F Collateral: EQUIP, AFTER ACQUIRED PROP, UNDEFINED top 4:1 dtttonak BU lneSS Facts is Corporate Registration THE FOLLOWING INFORMATION WAS PROVIDED BY THE STATE OF FLORIDA. State of Origin: FL . Date of Incorporation: 06'30/1997 Current Status: Active Business Type: Institutions-Profit Charter Number. P970000578 Agent: MORRISON'KEiTI E Agent Address: 1020 SE 12TH AVENUE CAPE CORAL, FLT ToP InuneS. Summary of Inquiries Business NOV13 OCT13 SEP13 AUG13 JUL13 JUN13 MAY13 APR13 MAR13 Category — —_-- -- --°--- — — — --- --- —_. -- — — ._1.... BANK GENERAL 1 • 1 Totals 1 Expenan prides itself on the depth and accuracy of the data maintained on our databases.Reporting your customer's payment behavior to Experian will further strengthen and enhance the power of the information available for making sound credit decisions. Give credit where credit is due. Call 7-800-520-1221,option#4 for more information. 1 oft report End of repair The irtiorrnatiorr hoick,is furnished,in coniitence for your exclusive use ivr legitimate business purposes and shall not be reproduced."Jeit!rer E.rporian infurmatiori Solutions.Inc..nor their sources or distributors warrant such information ner shall they be liabiet for your use or(51151700 upon it. r Expenan 2013.All rights reseried,Er acy policy. Experian and the Experiar marks herein are service marks or reg stered trademarks of Expenan. 515 P-ernier Profile-MORRISON ALUMINUM CONSTRUCTION,INC Jan 14 14 02:02p 239-277-0167 2392770167 p.11 want Merit Credit past, Accurate & Secure. MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS REQUESTED BY TEE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS) , STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: `2_ SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1- 800-371-3348 OR 239-277-3202. COMPANY NAME:MORRISON ALUMINUM CONSTRUCTION, INC FEDERAL ID:65-0769790 CURRENT STATUS:ACTIVE PRINCIPAL(S): KEITH E. MORRISON TITLE: PRESIDENT LYNN M.MORRISON TITLE:VICE PRESIDENT KEVIN R.MORRISON TITLE: CFO DATE INCORPORATED:06/30/1997 Detail by Entity Name Page 1 of 2 • 8 '` B 7 FLORIDA DEPARTMENT OP STATE •1, DIVISION CORPORATIONS f t Detail by Entity Name Florida Profit Corporation MORRISON ALUMINUM CONSTRUCTION, INC. Filing Information Document Number P97000057884 FEI/EIN Number 650769790 Date Filed 06/30/1997 State FL Status ACTIVE Last Event CANCEL ADM DISS/REV Event Date Filed 02/02/2005 Event Effective Date NONE Principal Address 1020 SE 12TH AVENUE CAPE CORAL, FL 33990 UN Changed: 03/21/2012 Mailin• Address 1020 SE 12TH AVENUE CAPE CORAL, FL 33990 Changed: 05/15/2001 Re•istered A•ent Name &Address MORRISON, KEITH E 1020 SE 12TH AVENUE CAPE CORAL, FL 33990 address Changed: 05/15/2001 Officer/Director Detail Name &Address Title P MORRISON, KEITH E 1817 PICADILLY CIRCLE CAPE CORAL, FL 33991 tie VP http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail/EntityName/dome-... 1/29/2014 Detail by Entity Name Page 2 of 2 5 MORRISON, LYNN M 1817 PICCADILLY CIRCLE CAPE CORAL, FL 33991 TitlerGFO Contact Us E-Filing Services Document Searches Forms Help MORRISON, KEVIN R 7045 WESTWOOD DRIVE SARASOTA, FL 34241 Annual Reports Report Year Filed Date 2011 03/16/2011 2012 03/21/2012 2013 04/15/2013 Document Images 04/15/2013 -- ANNUAL REPORT View image in PDF format 03/21/2012 --ANNUAL REPORT View image in PDF format 08/23/2011 --ANNUAL REPORT View image in PDF format 03/16/2011 --ANNUAL REPORT View image in PDF format 04/13/2010 --ANNUAL REPORT View image in PDF format 03/24/2009 --ANNUAL REPO.RT View image in PDF format 01/22/2008 --ANNUAL REPORT View image in PDF format 01/09/2007 -- ANNUAL REPORT View image in PDF format 01/31/2006 --ANNUAL REPORT View image in PDF format 02/02/2005 -- REINSTATEMENT View image in PDF format 08/25/2003 --ANNUAL REPORT View image in PDF format 03/18/2002 --ANNUAL REPORT View image in PDF format 05/15/2001 --ANNUAL REPORT View image in PDF format 03/27/2000 --ANNUAL REPORT View image in PDF format 02/19/1999 --ANNUAL REPORT View image in PDF format 02/26/1998 --ANNUAL REPORT View image in PDF format 06/30/1997 -- Domestic Profit Articles View image in PDF format Copvripht( and Privacy Policies State of Honda,Department of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail/EntityName/domp-... 1/29/2014 1 t Of irt . 04 [ ebb I ,,„..t_ Or f , ..- ..: . -,.`r_ - ...,?....____,Iba ,• 1,,,, 44____. ,, ,. 1). 01 0): 01 401 _„4.,Attt.ui %. . .11,--_- - tol ;If gol oi • Brpartinrnt of #tate )- A go). ..- 0 I certify from the records of this office that MORRISON ALUMINUM ig01 ilCONSTRUCTION, INC. is a corporation organized under the laws of the State of icT. Florida, filed on June 80, 1997. . IV kl0 The document number(If This corporation is P97000057884. 4 tO1 I further certify:that eaid con5Oration has paid all fees and penalties due this office -€. 4.41: througn December,31,:1997;and its status is active. - r-',.,, -'. I further certify that said corporaticin has not filed Articles of Dissolution. 0 tol 0 -. . g() , POI POI ti pi „.-o*:#14-4.4•. .01 ,t- l'-'•:,1, _ . \-..O,e, , . tO°1 r!V i l' 0 '. ,,T..'.;:'''; -ri,,z2.,--1--mgi a,6r'r27,94.4e.c.) 01 51 it%-_ . 0 ^ !ol • • 2013 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT# P97000057884 Apr 15, 2013 Entity Name: MORRISON ALUMINUM CONSTRUCTION, INC. Secretary of State • Current Principal Place of Business: • 1020 SE 12TH AVENUE CAPE CORAL, FL 33990 Current Mailing Address: 1020 SE 12TH AVENUE CAPE CORAL, FL 33990 FEI Number: 65-0769790 Certificate of Status Desired: No Name and Address of Current Registered Agent: MORRISON,KEITH E 1020 SE 12TH AVENUE CAPE CORAL,FL 33990 US • The above named entity submits this statement for the purpose of changing Its registered office or registered agent,or both,in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent _ Date Officer/Director Detail Detail : Title P Title VP Name MORRISON,KEITH E Name MORRISON,LYNN M Address 1817 PICADILLY CIRCLE Address 1817 PICCADILLY CIRCLE City-State-Zip: CAPE CORAL FL 33991 City-State-Zip: CAPE CORAL FL 33991 Title CFO Name MORRISON,KEVIN R Address 7045 WESTWOOD DRIVE. City-State-Zip: SARASOTA FL 34241 1 hereby certify that the information indicated on this report or supplemental report is five and accurate and that my electronic signature shall have the same legal effect as if made under oath;that lam an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607,Florida Statutes;and that my name appears above,or on an attachment with all other like empowered. SIGNATURE:KEVIN MORRISON CFO 04/15/2013 Electronic Signature of Signing Officer/Director Detail Date FILED APPLICATION FOR RENEWAL OF FICTITIOUS NAME Aug 14, 2013 Secretary of State REGISTRATION# G08030900414 G13000081145 Fictitious Name: MAC CUSTOM POOLS-ALUMINUM Current Mailing Address: New Mailing Address: 1020 S.E. 12TH AVE. CAPE CORAL, FL 33990 Current County of Principal Place of Business: New County of Principal Place of Business: LEE Current FEI Number: New FEI Number: 65-0769790 Current Owner(s): Additions/Changes to Owner(s): Document#:P97000057884 ( )Delete Document#: ( )Change ( )Addition FEI#: 65-0769790 FEI#: Name: MORRISON ALUMINUM CONSTRUCTION,INC. Name: Address: 1020 S.E. 12TH AVE. Address: City-St-Zip: CAPE CORAL,FL 33990 City-St-Zip: I the undersigned, being an owner in the above fictitious name, certify that the information indicated on this form is true and accurate. I understand that the electronic signature below shall have the same legal effect as if made under oath. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s. 817.155, Florida Statutes. KEVIN MORRISON 08/14/2013 Electronic Signature(s) Date Certificate of Status Requested(X) Certified Copy Requested( ) , 1 . APPLICATION FOR REGISTRATION OF FICTITIOUS NAME DOCUMENT# G08030900414 Fictitious Name to be Registered: MAC CUSTOM POOLS-ALUMINUM Mailing Address of Business: 1020 S.E. 12TH AVE. CAPE CORAL, FL 33990 Florida County of principal place of business: LEE FILED FEI Number. Jan 30, 2008 Secretary of State Owner(s)of Fictitious Name: MORRISON ALUMINUM CONSTRUCTION, INC. 1020 S.E. 12TH AVE. CAPE CORAL, FL 33990 US Florida Registration Number: P97000057884 FEI Number: 65-0769790 • I (we)the undersigned, being the sole(all the) party(ies)owning interest in the above fictitious name, certify that the information indicated on this form is true and accurate. I (we) understand that the electronic signature(s) below shall have the same legal effect as if made under oath. KEVIN MORRISON 01/30/2008 Electronic Signature(s) Date Certificate of Status Requested ( ) Certified Copy Requested( ) 1 . Form W-9 Request for Taxpayer Give Form to the (Rev.January 2011) Identification Number and Certification requester.Do not Department of the Treasury send to the IRS. Internal Revenue Service Name(as shown on your income tax return) MORRISON ALUMINUM CONSTRUCTION INC. N Business name/disregarded entity name,if different from above & MAC CUSTOM POOLS&ALUMINUM a a Check appropriate box for federal tax o classification(required): ❑ Individual/sole proprietor ❑ C Corporation 51 S Corporation ❑ Partnership ❑ Trust/estate Ll. O ❑ Limited liability company.Enter the tax classification(C=C corporation,S=S corporation,P=partnership)► 0 Exempt payee O 2 ♦+ N a ❑ Other(see instructions)► F.- Address(number,street,and apt.or suite no.) Requester's name and address(optional) O a 1020 S.E. 12th Avenue City,state,and ZIP code in Cape Coral, Florida 33990 List account number(s)here(optional) Part I Taxpayer Identification Number(TIN) . Enter your TIN in the appropriate box.The TIN provided must match the name given on the"Name"line I Social security number to avoid backup withholding.For individuals,this is your social security number(SSN).However,for resident alien,sole proprietor,or disregarded entity,see the Part I instructions on page 3.For other - - entities,it is your employer identification number(EIN).If you do not have a number,see How to get a TIN on page 3. Note.If the account is in more than one name,see the chart on page 4 for guidelines on whose I Employer identification number number to enter. 6 5 - 0 7 6 9 7 9 0 Part II Certification Under penalties of perjury;I certify-that:- 1. The number shown on this form is my correct taxpayer identification number(or I am waiting for a number to be issued to me),and 2. I am not subject to backup withholding because:(a)I am exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Serbice(IRS)that I am subject to backup withholding as a result of a failure to report all interest or dividends,or(c)the IRS has notified me that I am no longer subject to backup withholding,and 3. I am a U.S.citizen or other U.S.person(defined below). Certification instructions.You must cross out item 2 above if you have been notified by the IRS that you are currently subject to backup withholding because you have failed to report all interest and dividends on your tax return.For real estate transactions,item 2 does not apply.For mortgage interest paid,acquisition or abandonment of secured property,cancellation of debt,contributions to an individual retirement arrangement(IRA),and generally,payments other than interest and dividends,you are r uired to sign the certification,but you must provide your correct TIN.See the instructions on page 4. Sign Here of /�/� Here U.S.pers• Date). General Ins ••`OnS Note.If a requester gives you a for other than Form W-9 to request your TIN,you must use the requester's form if it is substantially similar Section references are to the I. `evenue Code unless otherwise to this Form W-9. noted. Definition of a U.S.person:For federal tax purposes,you are Purpose of Form considered a U.S.person if you are: A person who is required to file an information return with the IRS must •An individual who is a U.S.citizen or U.S.resident alien, obtain your correct taxpayer identification number(TIN)to report,for - •A partnership,corporation,company,or association created or example,income paid to you,real estate transactions,mortgage interest organized in the United States or under the laws of the United States, you paid,acquisition or abandonment of secured property,cancellation •An estate(other than a foreign estate),or of debt,or contributions you made to an IRA. •A domestic trust(as defined in Regulations section 301.7701-7). Use Form W-9 only if you are a U.S.person(including a resident Special rules for partnerships.Partnerships that conduct a trade or requester)to provide your correct TIN to the person requesting it(the business in the United States are generally required to pay a withholding requee ster)and,when applicable,to: • tax on any foreign partners'share of income from such business. 1.Certify that the TIN you are giving is correct(or you are waiting for a Further,in certain cases where a Form W-9 has not been received,a number to be issued), partnership is required to presume that a partner is a foreign person, 2.Certify that you are not subject to backup withholding,or and pay the withholding tax.Therefore,if you are a U.S.person that is a 3.Claim exemption from backup withholding if you are a U.S.exempt partner in a partnership,conducting a trade or business in the United payee.If applicable,you are also certifying that as a U.S.person,your States,provide Form W-9 to the partnership to establish your U.S. allocable share of any partnership income from a U.S.trade or business status and avoid withholding on your share of partnership income. is not subject to the withholding tax on foreign partners'share of effectively connected income. Cat.No.10231X Form W-9(Rev.1-2011) MORRI-2 OP ID:TF `AWRO' CERTIFICATE OF LIABILITY INSURANCE I DATE(MM/DD/YYYY) 08/29/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER Phone:321-397-3870 CONTACT Insurance By Ken Brown,Inc. NAME` PO Box 948117 Fax:321-397-3888 IAHONN ,Extl: FAX No): Maitland,FL 32794-8117 ADDRESS: David R.Griffiths INSURER(S)AFFORDING COVERAGE NAIC# INSURER A:Amerisure Ins Company 19488 INSURED Morrison Aluminum Construction INSURER B: Inc. 1020 SE 12th Avenue INSURER C: Cape Coral,FL 33990 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER: • REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES..LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDLISUBRI • - POLICYEFF POLICYEXP LTR TYPE OF INSURANCE INSR IWVD POLICY NUMBER JMM/DD (MM/DD/YYYYL LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 A X COMMERCIAL GENERAL LIABILITY GL20479920503 09/01/2013�09/01/2014 PRMMGE 10 RENTED PREMISES(Ea occurrence) $ 100,000 i CLAIMS-MADE X OCCUR MED EXP(Any one person) L$ 5,000 . PERSONAL&ADV INJURY -$ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ 2,000,000 POLICY X I jT LOC 1 $ •AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea acddent) $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acddent) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per acddent) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION T WC STATU- OTH- AND EMPLOYERS'LIABILITY Y/N TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE - N/A - E.L.EACH ACCIDENT $ /M OFFICEREMBER EXCLUDED? (Mandatory In NH) .E.L DISEASE-EA EMPLOYEE $ If yes,describe under - '- DESCRIPTION OF OPERATIONS below • - E.L.DISEASE-POLICY LIMIT $ I . DESCRIPTION OF OPERATIONS/LOCATIONS I VEHICLES(Attach ACORD 10i,Additional Remarks Schedule,if more space is required) fax 239-252-2469 CERTIFICATE HOLDER CANCELLATION COLLIER SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Collier County Contractor THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ty ACCORDANCE WITH THE POLICY PROVISIONS. Licensing Board 2800 N. Horseshoe Drive AUTHORIZED REPRESENTATIVE Naples, FL 34104 , I ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD • DATE(MM/DD/YYYY) ACORD) CERTIFICATE OF LIABILITY INSURANCE 12/19/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies) must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). PRODUCER CONTACT NAME: Bouchard Insurance for WBS PHONE o Eat): (866)866 293-3600 ext.623 FAx P.O.Box 6090 E-MAIL (AIC,No): Clearwater,FL 33758-6090 ADDRESS: INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: American Zurich Insurance Company 40142 INSURED INSURER B: Workforce Business Services,Inc Alt.Emp:Morrison Aluminum Construc Inc INSURER C: 1401 Manatee Ave.West Ste 600 Bradenton,FL 34205-6708 INSURER D: INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:13FL079807722 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADDL SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVD POLICY NUMBER `fM M/DD/YYYYLIM M/DD/YYYYL LIMITS GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ CLAIMS-MADE OCCUR MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GENERAL AGGREGATE $ GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ POLICY PRO- LOC $ AUTOMOBILE LIABILITY UUMHINEU SINGLE LIMIT (Ea accident)" $' ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION X WC STATU- 0TH- AND EMPLOYERS'LIABILITY TORY LIMITS ER A OFFICER/MEMBER EXCLUDED?PROPRIETOR/PARTNER/EXECUTIVE Y/N N/A WC 90-00-818-03 12/31/2013 12/31/2014 E.L.EACH ACCIDENT $ 1,000,000 (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ 1,000,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ 1,000,000 Location Coverage Period: 12/31/2013 12/31/2014 Client# 001574 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) Morrison Aluminum Construc Inc Coverage is provided for 1020 SE 12th Ave only those employees leased to but not Cape Coral,FL 33990 subcontractors of: CERTIFICATE HOLDER CANCELLATION Collier County Contractor Licensing Board SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE Development Service Center THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2800 North Horseshoe Drive ACCORDANCE WITH THE POLICY PROVISIONS. Naples,FL 34104 AUTHORIZED REPRESENTATIVE ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD CITY OF SANIBEL BUSINESS REGISTRATION NO. - - - -=0 0 L 0 r CODE 0:30'2E NO' EXPIRES SEPTEMBER 30, 2013 APPLICANTS NAME BUSINESS NAME MORRISON AL_UM1NUM CONST INC NOR F•,:I SON KEITH BUSINESS LOCATION - - ��, `•� O-• r -v-�� LOCATION REGISTRATION FEE i TO TRANSACT THE BUSINESS OF fl yt€� c t ' - r I; f I� . 00 City Of Sanibel Ordinance No.04-005 requires construction contractor licensing in addition TOTAL $ to the Registration Fee. M A DATE ISSUED r A D MORRISON ALUMINUM CONST INC - �/�"!7 I D 1020 SE 12TH AVENUE E CAPE iw i'P iN. FL ;33990 $ i L l.."} • AMOUNT PAID N G S This registration must be conspicuously posted on the premises at all times or, if there are no premises, carried by the applicant. Application must be made to the City Manager immediately if license is lost, business is moved to a new location or business is acquired by a new owner,otherwise,this registration becomes VOID. CONTRACTOR'S OPERATING CERTIFICATE NAME, ADDRESS OR STATUS CHANGE MUST SARASOTA COUNTY BE SENT TO THIS OFFICE WITHIN 30 DAYS REGISTERED ALUMINUM/CONCRETE CONTRACTOR MAIL TO:PLANNING & DEVELOPMENT SERVICES EXPIRES: 09/30/2014 BUSINESS CENTER 1001 SARASOTA CENTER BLVD LICENSE# RGALCO-SAC- 10 SARASOTA, FLORIDA 34240 MORRISON, KEITH E (941) 861-6126 MORRISON ALUMINUM CONSTRUCTION INC 1817 PICCADILLY CIRCLE CAPE CORAL FL 33991 • Signature:• WALLET CARD -TEAR HERE Folder Her Cut Off Here IMPORT.ANT 172 NTINT1FA BUILDING DEPARTMENT • . CITY OF PUNTA GORDA, FLORIDA . .. CERTIFICATE OF COMPETENCY 941-575-3324,ext 1 KEITH EDWARD MORRISON • MORRISON ALUMINUM CONST INC 1817 PICCADILLY CIR • CAPE CORAL FL 33991 CERT.#13-00011975 - TYPE:SPECIALTY STRUCTURE CONT-REGISTERED NOT VALID AFTER: September 30,2013 a "m - i* i fl 19/4• 800 Dunlop Road Sanibel,FL 33957 LIC HOLDER Keith Morrison FIRM NAME Morrison Aluminum Construction,Inc. 1020 SE 12th Ave. Cape Coral,FL 33990 • CITY OF SANIBEL -BUSINESS REGISTRATION NO. 08-00013600 CODE 0302R Na EXPIRES SEPTEMBER 30, 2008 BUSINESS NAME APPLICANT'S NAME MORRISON ALUMINUM CONST INC MORRISON KEITH BUSINESS LOCATION REGISTRATION FEE $ M0.00 OUT OF CITY LOCATION ' TO TRANSACTTHE BUSINESS OF = ' .00 ALUMINUM ERECTION CONTR . "".+ R .00 City Of Sanibel Ordinance No.04-005 requires construction contractor licensing in addition TOTAL $ 50.00 to the Registration Fee. M A DATE ISSUED 9/44/07 A D MORRISON ALUMINUM CONST INC I D 1.020 SE 12TH' AVNEUE • E CAPE CORAL FL 33 0 AMOUNT PAID $ I E 9 50.O0 N S G S -• This registration must be conspicuously posted on the premises at all times or,if there are no premises,carried by the applicant.Application must be made to the City Manager immediately if license is lost, business is moved to a new location or business is acquired by a new owner,otherwise,this registration becomes VOID. Certificate of Competency Conditions of Certificate NAME: Keith Morrison Renewal due for active&inactive certificate each D/B/A: Morrison Aluminum Construction Inc. year in September. 1020 SE 12th Ave. Cape Coral,FL 33990 COMP.NO.shall appear on all advertisements including vehicles reflecting a business naive. li. r�`r ��_ ' a LICENSED FOR: Aluminum Erection Contractor Shall only contract in D/B/A name as it appears on � ' , $.> certificate. Board Approval required on business '� COMP.NO S2-13530 name changes. .1974 NOT VALID ': 09/30/08 Shall maintain required insurance's on active ti certificate. Shall inform the Contractor Licensing Office of any Signature of License Holder Address or Telephone#change. °, ,y Lee County Tax Collector Pl Tax col�lEk!tor 2480 Thompson Street Fort Myers, Florida 33901 sr°re of r`O`,JA www.leetc.com Tel: 239.533.6000 Local Business Tax Account: 9302893 Dear Business Owner: Your 2013-2014 Lee County Local Business Tax Receipt is attached below. The receipt is non- regulatory and is issued using the information currently on file with our office. It does not signify compliance with zoning, health or other regulatory requirements nor is it an endorsement of work quality. Annual account renewal notices are mailed in August to the address of record at that time; to ensure delivery of your annual notice, mailing addresses may be updated online at www.leetc.com. If there is a change in the business name, ownership, physical location or if the business is being closed, please follow the instructions on the back of this letter to transfer or to close the account. I hope you have a successful year. .14j— Lee County Tax Collector Detach and display bottom portion and keep upper portion for your records �Ce COL76, LEE COUNTY LOCAL BUSINESS TAX RECEIPT 2013 - 2014 Tax ColW ctor- ACCOUNT NUMBER: 9302893 ACCOUNT EXPIRES SEPTEMBER 30, 2014 a2 sf%°r F\°{� May engage in the business of: ALUMINUM CONTRACTOR Location 1020 SE 12TH AVE CAPE CORAL FL 33990 THIS LOCAL BUSINESS TAX RECEIPT IS NON REGULATORY MORRISON ALUMINUM CONSTRUCTION INC MORRISON KEITH EDWARD THIS IS NOT A BILL-DO NOT PAY 1020 SE 12TH AVE CAPE CORAL FL 33990 PAID 334953-5-1 09/04113 01:44:27 CCM1 $50.00 4L CITY O■ffi >� I T Y O F - City of Cape Coral Business Tax Receipt Q BT14-39589 Issue Date:09/04/2013 ,0 1 DBA: MORRISON ALUMINUM CONST INC C? Owner Name: MORRISON KEITII <oatioP Expiration Date: 09/30/2014 THIS RECEIPT IS FURNISHED PURSUANT TO FLORIDA STATE STATUTES, CHAPTER 205 AND CITY OF CAPE CORAL ORDINANCE 9-72 AS AMENDED The law requires this receipt to be displayed conspicuously at the place of business so that it is open to the view of the pubic and available for inspection. Payment is due each year by September 30th. Payment after September 30th is delinquent and subject to a penalty of 10%for the month of October, plus an additional 5%for each month thereafter. The total delinquency penalty shall not exceed 25% of the tax. A 25%penalty is imposed on any person engaged in any new business, occupation or profession without first paying a Cape Coral Business Tax. This receipt is for a business tax only. It does not permit the person/business to violate any existing regulatory or zoning laws of the state, county, or cities, nor does it exempt the business from licenses or permits that may be required by law. This receipt does not assure quality of work. Annual renewal notices are mailed on July 1st to the address of record at that time. If you need to transfer your Business Tax due to a change in business name, ownership, location or are closing the business,please.come.to our.office to have the. records updated. Detach and post bottom portion CITY OF CAPE CORAL BUSINESS TAX RECEIPT RECEIPT#:BTI4-39589 City of Cape Coral -- 1015 Cultural Park Blvd —Cape Coral Florida 33990—(239) 574-0430 This receipt expires September 30, 2014. Visit our website at: www.capecoral.net DISPLAY AT PLACE OF BUSINESS FOR PUBLIC INSPECTION FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS. -THIS TAX IS NON REFUNDABLE - CITY O F Number of Employees: Location: 1020 SE 12TH AV Classification: Business Phone: (239) 573-0549 Q CONTRACTOR/SPECIALTY CONT F C? ooRio MORRISON ALUMINUM CONST INC MORRISON KEITH Classification Code: 140A 1020 SE 12TH AVE Issued Date: 09/04/2013 CAPE CORAL, FL 33990 Amount: $ 88.00 This document is a business tax only. This is not certification that licensee is qualified. It does not permit the licensee to violate any existing regulatory zoning laws of the state,county or cities nor does it exempt the licensee from other taxes or permits that may be required by law. ' . , . tA.7, • ,11:‘ toff t. . _ Aft: - - • , - ...... . . „, 2 • .■ ' -•-' s' -- -rt A r,.`;"14.4..s.NZifqk • •••• of a 7/. • • • Co e r •H-i-ity Growth Management Division Planning & Regulation Operations Department Licensing Section January 16, 2014 Barcelo's Custom Cabinets & Mill work Inc • Barcelo, Dagoberto T 3425 Westview Drive Unit 1 Naples, FL 34104 RE: Review of Credit Report Dear Mr. Barcelo, You have been added to the agenda for the Contractor Licensing Board meeting on Wednesday, February 19, 2014. The meeting is held at 9:00am at the W. Harmon Turner Building (Bldg. F, Admin. Bldg.), 3299 Tamiami Trl. E., Naples, FL in the Commissioner's Meeting Room on the 3rd floor. If you have any questions or concerns, please call (239) 252-2431 Sincerely, • t • . s ela Thomas Administrative Supervisor Licensing/Operations Growth Management Division*Planning&Regulation*2800 North Horseshoe Drive*Naples,Florida 34104*239-252-2400*www.colliergov.net Premier Profile-BARCELO'S CUSTOM CABINETS&MILL WORK • .,. • Subcode:970135 Ordered:01/03/2014 09:08:27 CST •; • EXpeI';an' Transaction Number:C500242045 • • Search Inquiry:BARCELO'S CUSTOM/3425 WESTVIEW DR STE A world trf insight 1/NAPLES/FL/34104/US/239-682-6522/954417665 Model Description:Intelliscore Plus V2 Business Name BARCELO'S CUSTOM CABINETS & MILL e Business Identification Number ,° 954417665 WORK INC Lena` Primary Address: 3425 WESTVIEW DR STE 1 Phone: (239)682-6522 NAPLES,FL 34104-4063 TOP 0 Risk Dashboard Risk Scores and Credit Limit Recommendation Days Beyond Terms Derogatory Legal Fraud Alerts' Intelliscore Plus Financial Stability Risk Company DBT Original Filings High Risk Alerts 36 MEDIUM [ , MEDIUM-HIGH DBT RISK RISK Unavailable Score range:1 -100 percentile Credit Limit Recommendation:$1,400 TOP 0 Business Facts Years on File: 3(FILE ESTABLISHED 12/2011) SIC Code: WOOD PRODUCTS,NEC-2499 State of Incorporation: FL NAICS Code: Date of Incorporation: 06/20/2012 All Other Miscellaneous Wood Product Manufacturing-321999 Business Type: Profit Contacts: DAGOBERTO BARCELO TOP 0 Commercial Fraud Shield Evaluation for: BARCELO'S CUSTOM CABINETS&MILL WORK, 3425 WESTVIEW DR STE 1, NAPLES,FL34104-4063 Business Alerts Verification Triggers ( The primary Business Name,Address,and l Active Business Indicator: 1 Experian shows this business as active Phone Number on Experian File were reviewed for High Risk indicators,no High Risk indicators • were found. Possible OFAC Match: • No OFAC match found Business Victim Statement: I N8 No victim statement on file Credit Risk Score: Intelliscore Plus Current intelliscore iglus Score: 36 Risk Class: 3 36 f.(BII ivi R6an High ,x Lo bv The risk class groups scores by risk into ranges of similar Risk 'r � Risk performance.Range 5 is the highest risk,range 1 is the ' lowest risk. 1.1-1 10 25 50 75 100 This score predicts the likelihood of serious credit delinquencies for this business within the next 12 months.Payment history and public record along with other Premier Profile-BARCELO'S CUSTOM CABINETS&MILL WORK 1/3 variables are used to predict future risk.Higher scores indicate lower risk. Factors lowering the score Industry Risk Comparison 35%of businesses indicate a higher likelihood of severe : COMPANY'S BUSINESS TYPE delinquency. > RISK ASSOCIATED WITH THE COMPANY'S INDUSTRY Quarterly Score Trends Quarterly Score Trends 100- 90- sa- 70 50 The Quarterly Score Trends provide a view of the likelihood of delinquency over the past 12 months for this 50 - business.The trends will indicate if the score improved, 40_ remained stable,fluctuated or declined over the last 12 30- months. 20 10 0 *No score average available for this quarter Credit Risk Score:Financial Stability Risk Current Financial Stability Risk Score: 6 ` .ti.. ._gig. 6 High `, LOW The risk class groups scores by risk into ranges of similar Risk = 3 1 - R bk performance.Range 5 is the highest risk,range 1 is the lowest risk. 0 3 10 3n 65 100 This score predicts the likelihood of financial stability risk within the next 12 months. The score uses tradeline and collections information,public filings as well as other variables to predict future risk.Higher scores indicate lower risk. Factors lowering the score Industry Risk Comparison 5%of businesses indicate a higher likelihood of financial > LACK OF ACTIVE TRADES stability risk. > RISK ASSOCIATED WITH THE BUSINESS TYPE > EMPLOYEE SIZE OF BUSINESS > RISK ASSOCIATED WITH THE COMPANY'S INDUSTRY SECTOR Credit Limit Recommendation Credit Limit Recommendation This recommendation compares this business against similar businesses in the Experian business credit database.It is based on trade information,industry,age of business and the Intelliscore $1,400 Plus.The recommendation is a guide.The final decision must be made based on your company's business policies. TOP 0 Payment and Legal Filings Summary Payment Performance Trade and Collection Balance Legal Filings Current DBT: Not Available Total trade and collection(0): $0 Bankruptcy: No N/A All trades(0): $0 Tax Lien filings: 0 Predicted DBT: ( ) Judgment filings: 0 Monthly Average DBT: 0 All collections(0): $0 Sum of legal filings: $0 Highest DBT Previous 6 Months: 0 Continuous trade(0): $0 UCC filings: 0 Cautionary UCC filings: No Highest DBT Previous 5 Quarters: 0 6 month average: N/A Payment Trend Indication: Highest credit amount extended: N/A Payment trend indicator not available Most frequent industry purchasing terms: Premier Profile-BARCELO'S CUSTOM CABINETS&MILL WORK 2/3 X11 Merit Credit Fast, Accurate&Secure. MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS) , STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 0 SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1- 800-371-3348 OR 239-277-3202. COMPANY NAME: BARCELO'S CUSTOM CABINETS&MILL WORK INC FEDERAL ID: 45-5533861 CURRENT STATUS:ACTIVE BUSINESS PRINCIPAL(S): DOGOBERTO BARCELO TITLE: PRESIDENT DATE INCORPORATED:06/20/2012 Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 7/97 01/03/14 09:06CT [SUBJECT] [SSN] [BIRTH DATE] BARCELO, DAGOBERTO T. - [CURRENT ADDRESS] [DATE RPTD] 3345 SE. 10TH AV. , NAPLES FL. 34117 [FORMER ADDRESS] 13260 IMMOKALEE RD., #6. NAPLES FL. 34120 1/07 481 S. EVERGLADES BV. , NAPLES FL. 34117 [POSITION] [CURRENT EMPLOYER AND ADDRESS] [RPTD] EXCEPTIONAL WOODWORKING & DESI CABINET MAKER 7/07 [FORMER EMPLOYER AND ADDRESS] EXCEP GROUP 3/06 M O D E L P R O F I L E ***FICO CLASSIC 04 SCORE +550 : 038, 010, 013, 018 *** C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=4 NEG=8 HSTNEG=2-18 TRD=22 RVL=15 INST=4 MTG=2 OPN=1 INQ=2 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $465 $500 $12 $0 $6 98% CLOSED W/BAL: $20.5K $13.5K $257 TOTALS: $465 $500 $20.5K $13.5K $263 C O L L E C T I O N S SUBNAME SUBCODE ECOA OPENED CLOSED $PLACED CREDITOR MOP ACCOUNT# VERIFIED BALANCE REMARKS MIDLAND FUND Y 36ET009 I 12/10 $3376 CITIFINANCIAL O9B 8538036147 12/13A $4599 PLACED FOR COLLECTIO MIDLAND FUND Y 36ET009 I 9/13 $11.5K CITIBANK N A O9B 8560602703 12/13A $11.5K PLACED FOR COLLECTIO CAVALRY PORT Y lYNA008 I 9/11 $18.0K 08 BANK OF AMERICA O9B 16859063 12/13A $27.3K PLACED FOR COLLECTIO ENHANCRCVRCO Y 26MT002 I 10/11 $250 11 SPRINT O9B 56446942 12/11A $250 PLACED FOR COLLECTIO T R A D E S SUBNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT# VERFIED CREDLIM PASTDUE AMT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 DFS/WEBBANK F 22ZE001 10/07 $2624 R09 87945012905842 12/13A $5000 $1180 I CHARGE ACCOUNT 12/09F $1180 UNPAID BLNC CHRGD OFF CHASE B 26QK004 4/99 $11.7K R09 11/13A $10.6K $11.3K I CREDIT CARD 10/09F $11.3K CLOSD BY CRDT GRANTOR THD/CBNA B 26H3005 8/00 $11.2K R09 11/12A $9900 $0 I CHARGE ACCOUNT 11/11F $0 PURCH BY OTHER LENDER BK OF AMER B 6331059 9/06 $18.0K R09 9/11A $15.4K $0 I CREDIT CARD 6/09F $0 PURCH BY OTHER LENDER CITIFINANCIA F 7212001 12/06 $3375 R09 12/10A $3100 $0 I CHARGE ACCOUNT 3/10F $0 PURCH BY OTHER LENDER CITIFINANCIA F 7212001 4/07 $3712 R09 6/10A $3100 $0 C CHARGE ACCOUNT 9/09F $0 PURCH BY OTHER LENDER BK OF AMER B 1597186 10/07 $1781 R9P 3/12A $2600 $0 I BUSINESS CREDIT C 6/10F $0 PURCH BY OTHER LENDER AMER HONDA Q 3946010 7/07 $10.3K 60M257 108 1/10A $1031 C AUTOMOBILE 1/10F $7998 REPOSSESSION SEARS/CBNA D 6256443 5/98 $1862 111111111111 ROl 12/13A $1520 $0 111111111111 I CHARGE ACCOUNT 4/09C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 5/3 BANK CC B 21AV061 4/13 $465 MINE 11111111 RO1 $12 8 0/ 0/ 0 BK OF AMER B 6331059 8/05 $0 RO1 2/11A $6900 $0 I CREDIT CARD 9/06C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 WFDS/WDS B 11YD054 10/06 $15.2K 60M 3/10 132221111111 101 5/10A $0 $625 03 111111111111 I AUTOMOBILE 5/1OC $0 CLOSED 43 3/ 1/ 0 BK OF AMER B 4275002 11/06 $328K 360M2046 2/09 5X5555555555 MO1 2/10A $0 $8185 05 432111111111 I CONVENTIONAL REAL 2/1OC $0 FORECLOSURE,CLTRL SLD 38 1/ 1/12 TARGET N.B. D 1ZX5001 9/99 $134 111111111111 RO1 2/10A $5000 $0 111111111111 I CREDIT CARD 12/07C $0 CLOSED 48 0/ 0/ 0 HSBC/POLARS B 2DQ1130 8/06 $11.OK 111111111111 ROl 9/09A $300 $0 111111111111 I CHARGE ACCOUNT 9/09C $0 CLOSED 36 0/ 0/ 0 DISCOVER FIN B 9616003 12/04 $6408 111111111111 ROl 5/09A $7500 $0 111111111111 A CREDIT CARD 5/09C $0 CLOSED 48 0/ 0/ 0 AMEX B 21WB001 7/97 $76 111111111111 RO1 8/08A $1500 $0 111111111111 I CREDIT CARD 7/08C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 BK OF AMER B 6331213 8/05 $141K 111111111111 COl 7/08A $27.5K $0 111111111111 C HOME EQUITY LOAN 7/08C $0 ACCT CLSD BY CONSUMER 34 0/ 0/ 0 AMEX B 21WB001 10/97 $84 111111111111 001 11/07A $0 111111111111 I CREDIT CARD 11/07C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 CHASE MORT B 722T001 8/03 $152K 360M 111111111111 MO1 11/06A $0 111111111111 C FRD722688730 11/06C $0 CLOSED 37 0/ 0/ 0 5TH 3RD BK B 9302020 9/03 $39.2K 84M608 I01 5/06C $0 ACCT CLSD BY CONSUMER SPRINGLF FIN F 654N1HG 9/05 $11.3K 60M189 11 I01 1/06A $0 C SECURED BY HOUSEH 1/06C $0 CLOSED 2 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 1/03/14 ZNP6284423(FLA) MERIT CREDIT 11/30/12 ZMI0631354 (FLA) CBS C R E D I T R E P O R T S E R V I C E D BY : TRANSUNION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION MIDLAND FUND YC36ET009 (800) 825-8131 8875 AERO DR SAN DIEGO CA. 92123 CAVALRY PORT YCIYNA008 (800) 501-0909 500 SUMMIT LAKE DR VALHALLA NY. 10595 ENHANCRCVRCO YC26MT002 (904) 680-2591 8014 BAYBERRY RD JACKSONVILLE FL. 32256 DFS/WEBBANK FZ22ZE001 (800) 283-2210 PO BOX 81607 AUSTIN TX. 78708 CHASE BC26QK004 (800) 955-9900 P.O. BOX 15298 WILMINGTON DE. 19850 THD/CBNA BZ26H3005 PO BOX 6497 SIOUX FALLS SD. 57117 BK OF AMER BC6331059 PO BOX 982235 EL PASO TX. 79998 CITIFINANCIA FZ7212001 (800) 922-6235 605 MUNN ROAD FORT MILL SC. 29715 BK OF AMER BC1597186 PO BOX 982235 EL PASO TX. 79998 AMER HONDA QA3946010 (404) 475-2121 1030 CAMBRIDGE SQU ALPHARETTA GA. 30201 SEARS/CBNA DC6256443 PO BOX 6282 SIOUX FALLS SD. 57117 5/3 BANK CC BC21AV061 (800) 972-3030 5050 KINGSLEY DR CINCINATTI OH. 45263 WFDS/WDS BB11YD054 (800) 289-8004 CREDIT BUREAU DISP WINTERVILLE NC. 28590 BK OF AMER BM427S002 (800) 451-6362 4161 PIEDMONT PKWY GREENSBORO NC. 27410 TARGET N.B. DZ1ZX5001 PO BOX 673 MINNEAPOLIS MN. 55440 HSBC/POLARS BZ2DQ1130 (800) 695-6950 PO BOX 30253 SALT LAKE CITY UT. 84130 DISCOVER FIN BC9616003 POB 15316 WILMINGTON DE. 19850 AMEX BC21WBOO1 (800) 874-2717 P.O. BOX 981537 EL PASO TX. 79998 BK OF AMER BB6331213 (800) 451-6362 4161 PIEDMONT PKWY GREENSBORO NC. 27410 CHASE MORT BM722T001 (614) 422-7001 3415 VISION DR COLUMBUS OH. 43219 5TH 3RD BK BI9302020 (800) 972-3030 5050 KINGSLEY DR CINCINATTI OH. 45263 SPRINGLF FIN FP654N1HG (941) 262-7671 STONEY'S PLAZA NAPLES FL. 34105 CBS Z 0631354 (954) 561-1400 3503 NORTH DIXIE H OAKLAND PARK FL. 33334 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR (239) 277-3202. J. 1) . 1)I :SIG COINSTRi_TCTIC)N INC. LIC. # LCC201300002248 Cell Phone:239-595-8769 Telephone:239-304-9466 Fax:239-304-9466 2036 50TH Terrace S.W. Naples, FL. 34116 February 5,2014 To: Collier County Licensing Board This is to inform you that I have taken care of things that have not been removed from my credit report that I have provided.At this time I have taken care of the ones listed below. l) Amerassist in the amount of$310.00 was paid. 2) Capital One in the amount of$973.00 was paid. 3) Design Rec. in the amount of$158.00 was paid,but not removed off of the report yet. 4) Enhancrcvrco in the amount of$981.00 was paid but not removed off of the report yet. 5) FFCC Cleveland in the amount of$160.00 was paid. 6) FST Premier in the amount of$375.00,this one I could not find they couldn't locate it in the system. Still looking it to this one. 7) FST Premier in the amount of$714.00 was paid but not removed off of the report yet. 8) Gulf CST Col in the amount of$150.00 was paid._ 9) Jeffcapsys in the amount of$767.00 was paid bit not,removed off of the report yet. 10) Wed Bus Bur in the amount of$118.00 was pai but,hot removed off of the report yet. 1 1) Midland Fund in the amount of$2,481'.00we are working on a settlement for this one 12) Midland Fund in the amount of$1,267.00 we are working on a settlement for this one 13) Midland Fund in the amount of$1,043.00 was paid., The case of Capital One for the amount of$9,947.00 we are negotiating with them. The statues of the judgment for Suncoast Credit we are working out a payment plan.The statues of the judgment for SLM Financial we are working out a pay off amount. The only reason they where not done sooner is that my new born son was in and out of the hospital with breathing issues this set me back on the time line and financially for I'm a self pay. Thank You! J. D. Design Construction Inc. 2036 50th Terrace S.W. Naples, Florida 34116 Office: (231)353-4121 Fax: (231)353-1044 Cell: (231) 595-6169 President: Jimmy Dean Page 1 of 1 CREDIT CHECKTM CONFIDENTIAL Individual Credit Report Name . DEAN, JIMMY M. Ordered By: Address : 2036 50TH TERRACE SW Customer : 9999 Received : 02/05/14 NAPLES, FL 34116 Completed : 02/05/14 Social #: Applicant: - Bill Amt : $50. 00 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid Past Pay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA 5TH 3RD BK SETTLED 07/09 01/04 27468 CLOSED 0 0 0605 02 I1-* 27 A DLA=07/09 06/06 05/05 218400 CLOSED 0 0 00 00 00 M1 12 A DLA=06/06 CAPITAL 1 FA COLLECTION CITIRL PD WAS 120 03/09 05/06 340000 0 0 0 07 06 07 M5-* 23 C DLA=06/08 CREDITACPT DESGN REC HLT2HMA1432695912 01/14 06/12 157 158 158 COLL -- -- -- 09-*COLLECTION 01A ORIGINAL CREDITOR: MEDICAL ENHANCRCVRCO 05/11 04/11 981 981 981 COLL - 09L*ECTION - -- -- 00 A 09- ORIGINAL CREDITOR: SPRINT FREMONT INV AS 06/04 12/03 136000 CLOSED 0 0 00 00 00 M1 AG 06 P DLA=04/04 FST PREMIER 03/13 12/12 375 375 375 11 - COLL ECTION DLA=03/13 - -- -- 00 A Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. - 3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 SM CREDIT CHECK CONFIDENTIAL Name . DEAN, JIMMY M. Customer: 9999 Page: 2 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date . ) Creditor Date Date High Unpaid Past Pay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA FST PREMIER COLLECTION GULF CST COL PD COLLECT 01/14 10/07 150 0 0 0 -- -- -- 09-* 07 A ORIGINAL CREDITOR: MEDICAL HOMEWARDRES PD WAS 30 HSBC BANK AS AGREED 09/05 01/04 530 PAID 0 REV 00 00 00 R1 20 A DLA=09/05 JEFFCAPSYS COLLECTION CREDITOR: WACHOVIA BNK CHK ACCT LITTON LOAN AS AGREED 05/05 12/03 34000 CLOSED 0 0 00 00 00 M1 09 P DLA=05/05 MED BUSI BUR COLLECTION 01/14 11/07 118 118 118 COLL -- -- -- 09-* 07 A ORIGINAL CREDITOR: MEDICAL MIDLAND FUND COLLECTION 01/14 09/10 1267 1267 1267 COLL -- -- -- 09-* 04 A ORIGINAL CREDITOR: VERIZON WIRELESS MIDLAND FUND COLLECTION 12/13 10/11 2481 2481 2481 COLL -- -- -- 09-* 02 A ORIGINAL CREDITOR: T MOBILE OCWEN LOAN CUR WAS 30 12/13 05/06 340000 232994 0 1076 0400 00 M1-* 08 C DLA=12/13 ONYX ACCEP AS AGREED 10/05 08/05 34531 CLOSED 0 0 0000 00 I1 01 A DLA=09/05 Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 sM CREDIT CHECK CONFIDENTIAL Name • DEAN, JIMMY M. Customer: 9999 Page: 3 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid Past Pay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA SEARS/CBNA PD COLLECT SLM FINC CO COLLECTION 01/14 04/03 19010 8290 8290 310 -- -- -- I9-* 12 A DLA=02/08 SUNCOAST CU AS AGREED 08/05 09/04 27756 CLOSED 0 0 0000 00 I1 11 A DLA=08/05 TOYOTA TOYOTA MTR AS AGREED 03/06 07/05 24680 CLOSED 0 0 0000 00 I1 07 S DLA=03/06 WILSHIRE CRD AS AGREED 05/05 12/03 136000 CLOSED 0 0 00 00 00 M1 08 C DLA=05/05 Total trade lines on this report: 26 PUBLIC RECORDS: PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS WITH THE FOLLOWING RESULTS AS OF 02/05/14 : SEE BELOW. --- TRANSUNION PUBLIC RECORD --- SOURCE DATE LIAB ECOA DOCKET# TYPE COURT LOC PLAINTIFF/ATTORNEY Z 05064186 11/09/07 $15, 426 I 73250CA CIVIL JUDGMENT COLLIER COUNTY COURT SUNCOAST SCHOOLS FEDER Z 05064207 02/03/09 $8, 290 I 8CC006249 CIVIL JUDGMENT LEE COUNTY COURT SLM FINANCIAL CORPORATON SOURCE (S) : EQUIFAX TRANSUNION INQUIRIES: 02/05/14 by CREDIT CHECK (TU) #00630273 Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 ` snn CREDIT CHECK CONFIDENTIAL Name - DEAN, JIMMY M. Customer: 9999 Page: 4 INQUIRIES: 11/11/13 by EXETER FIN (TU) #03204338 COMMENTS: FRAUD RECORDS HAVE BEEN SYSTEMATICALLY CHECKED BY THE ABOVE ACCESSED BUREAUS . SAFESCAN/EQUIFAX, HAWK ALERT/TRANSUNION CHECKED FOR FRAUD. REPORT WORKED BY RENEE CREDIT SCORE: APPLICANT FICO SCORE: 541 (scores range from 300 to 850) *** END OF REPORT *** This information is confidential and is not to be civulged except as required by the Fair Credit Reporting Act This Tperssonal report is furnished simply as an aid in determining the seek desirability of the applicant(s). It is based upon information obtained in good faith by this agency from sources deemed reliable. accuracy of same,however,is in no way guaranteed. By your acceptance and use of this report,you specifically agree to told Credit Check,Inc.harmless from any liability whatsoever. Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 • Co c-r Co-ri.-r�ty Growth Management Division Planning& Regulation Operations Department Licensing Section January 28, 2014 Jimmy Dean J.D. Design Construction Inc. 2036 50th Ter SW Naples, FL 34116 RE: Review of Credit Report Dear Mr. Dean, You have been added to the agenda for the Contractor Licensing Board meeting on Wednesday, February 19, 2014. The meeting is held at 9:00am at the W. Harmon Turner Building (Bldg. F, Admin. Bldg.), 3299 Tamiami Trl. E., Naples, FL in the Commissioner's Meeting Room on the VI floor. - If you have any questions or concerns, please call (239) 252-2431 Sincerely, • 1 I Consuewa Thomas Administrative Supervisor Licensing/Operations Growth Management Division*Planning&Regulation*2800 North Horseshoe Drive*Naples,Florida 34104*239-252-2400*www.colliergov.net Findings of Fact, Conclusions of Law and Decision of the Board Collier County Contractors' Licensing Board For Applications Submitted to the Board for Review Type of Application: X Credit Report Review Waiver of Testing Requirements Reinstatement of License Request to Qualify Second Entity Other (specify) THIS CAUSE came on for public hearing before the Contractors' Licensing Board (hereafter Board) on August 21, 2013, for consideration of the application submitted to the Board for review. The type of application is set out above. The Board having heard testimony under oath, received evidence, and heard arguments relative to all appropriate matters, thereupon issues its Findings of Fact, Conclusions of Law and Order of the Board as follows: FINDINGS OF FACT 1. That Jimmy M. Dean d/b/a J.D. Design Construction, Inc. (the "Applicant") has submitted an application to the Collier County Contractor Licensing Supervisor or his designee for a Certificate of Competency as a General Contractor and based on the credit reports supplied by the Applicant the Licensing Superviser determined a review of the credit by the Board is necessary. 2. That pursuant to Section 22-184(b) of the Collier County Contractors' Licensing Ordinance (Ordinance 90-105, as amended) applications which do not appear on their face to be sufficient require referral to the Board for a decision regarding approval or denial of said application. 1 314351.1 9!13/2013 3. That the Board has jurisdiction over this matter and that Jimmy M. Dean d/b/a J.D. Design Construction, Inc. and Jimmy M. Dean was present at the public hearing on August 21, 2013, and was not represented by counsel. 4. All notices required by Collier County Ordinance No. 90-105, as amended, have been properly issued. 5. The facts in this case are found to be: a. Applicant has adequately demonstrated through testimony and evidence presented at this hearing that his licensure will not result in risk of economic loss resulting from the Applicant's ability to pay lawful contractual obligations, subject to his satisfaction of the terms set out herein. b. Credit report does not meet the standards of Florida Rule 61 G4-15.006 for Financial Responsibility. c. It is appropriate for the Applicant to be issued a probationary license and subject to further credit review. CONCLUSIONS OF LAW 1. Based upon the foregoing facts, the Board concludes that the applicant has met the standard set out in Ordinance 90-105, as amended, subject to the restrictions and stipulations set out herein. ORDER OF THE BOARD 1. Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and Collier County Ordinance No. 90-105, as amended, by a vote of 8 in favor and 0 opposed, a 2 314351.1 9/13/2013 unanimous vote of the Board present, the Applicant's credit report is approved so that a license may be granted subject to the following conditions: a. Six (6) month probationary license shall be issued; b. Applicant is to provide updated business and personal credit reports to the Contractor Licensing Supervisor six (6) months from the date of the hearing held August 21, 2013 and shall appear before the Board for a review of the credit reports at the next regularly scheduled Board meeting after submitting the reports; c. Applicant is to demonstrate compliance with the application process with the State of Florida Contracting Licensing Board for a General Contractor's License including financial bonding requirements, if any; d. Applicant is to pay designated outstanding credit accounts reflected on the credit report submitted to the Board within six (6) months as follows: i. Amerassist in the amount of$310; ii. Capital One in the amount of$973; iii. Desgn Rec in the amount of$158; iv. Enhancrcvrco in the amount of$981; v. FFCC Cleveland in the amount of$160; vi. Fst Premier in the amount of$375; vii. Fst Premier in the amount of$714; viii. Gulf Cst Col in the amount of$150; ix. Jeffcapsys in the amount of$767; x. Med Bus Bur in the amount of$118; 3 314351.1 9/13/2013 xi. Midland Fund in the amount of$2,481; xii. Midland Fund in the amount of$1,267; xiii. Midland Fund in the amount of$1,043; e. Improvement and reduction in the outstanding balance of the Capital One account in the amount of$9,947; and f. Status and explanatory statements with regard to Suncoast Credit Civil Judgment and SLM Financial Civil Judgment. ORDERED by the Contractors Licensing Board effective the 21st day of August, 2013. CONTRACTOR'S LICENSING BOARD COLL R COUNTY, FLORIDA ,/ .(9,'Xil4,,-/------ ( , , By: Richard Joslin, Chairman I HEREBY CERTIFY that a true and correct copy of the above and foregoing Findings of Fact, Conclusions of Law, and Order of the Board has been furnished the Applicant, and Michael Ossorio, Licensin Compliance p isor! 2800 North Horseshoe Drive, Naples, FL 34103 on this k, th day of , 2013, -!! Secr- ary tractor's Licensing Board 4 314351.1 9/1312013 • cRED1T CHECK CONFIDENTIAL Individual Credit Report Name • DEAN, JIMMY MICHAEL Ordered By: Customer : 9999 Address : 2036 50TH TERRACE SW Received : 06/27113 NAPLES, FL 34116 Completed : 06/27/13 Social #: Applicant: .- Bill Amt : $60.00 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid Past ?ay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA SETTLED 5TH 3RD BK 07/09 01/04 27468 CLOSED 0 0 0905 02 I1-* 34 A DLA=07/09 COLLECTION A130628IST - -- - 11/10 03/10 300 /410 X10 COLL - - 09- 00 A ORIGINAL CREDITOR: TRULY NOLEN OF AMERICAlINC / AS AGREED BK OF AMER 06/06 05/05 218400 CLOSED 0 0 0000 00 Ml 12 A DLA=06/06 PASTDUE 60 CAP ONE 06/13 01/11 973 7413; —'", 34 30 0100 00 R3-* 28 A DLA=02/13 L_ r 7 _ COLLECTION CAPITAL 1 FA � 674 __ __ __ I9-� 09 A 05/13 08/05 34531 9947 9 DLA=09/09 PD WAS 120 CITIRL 03/09 05/06 340000 0 0 0 1207 07 115-* 33 C DLA=06/08 r i�.h LI i i tai PT rr r.-'' \\ A3 AGRDDD 06/13 08/12 29268( 24672/)0 513 UUUU 00 II 09 C DLA=05/13 ---, COLD '1`1UN DESGN REC _ __ _- 09-* 01 A HLT2HMA1432695912 06/13 06/12 157 158 158 COLL - ORIGINAL CREDITOR: MEDICAL COLLECTION ENI ANCRCVRCO _ __ __ pg. 00 A 05/11 04/11 981 981 9 1 COIL - ORIGINAL CREDITOR: SPRINT Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561)676-5556 • sm CREDIT CHECK CONFIDENTIAL Name • DEAN, JI_MMY MICHAEL Customer: 9999 Page: 2 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid east Pay Eistoric Stet Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA FFCC-CLVLAND i' COLLECTION 05/13 02/11 160 10 / 6O COLL -- -- -- 09-* 02 A ORIGINAL CREDITOR: MEDICAL FRD MOTOR CR AS AGREED 08/03 07/00 22466 CLOSED 0 0 0000 00 II 01 A DLA=08/03 FREMONT INV AS AGREED 06/04 12/03 136000 CLOSED 0 0 0000 00 M1 06 P DLA=04/04 FST PREMIER /'---`1 COLLECTION 03/13 12/12 375 ( 375 y175 11 -- -- -- R9-* 00 A DLA=03/13 FST PREMIER COLLECTION 12/10 06/09 714 714 ,x714 21 -- -- -- R9-* 01 A DLP_=07/09 GULF CST COL �0, COLLECTION 06/13 10/07 150 .' 15 150 COLL -- -- -- 09-* 06 A ORIGINAL CREDITOR: MEDICAL HOMEWARDRES PD WAS 30 03/13 05/06 540000 0 0 0 1802 06 M2-* 39 C DLA=02/13 HSBC BANK AS AGREED 09/05 01/04 530 PAID 0 REV 0000 00 RI 20 A DLA=09/05 JEFFCAPSYS / COLLECTION n6/11 n6/11 7617 / 7f7 67 COLL -- -- -- 09-* 02 A ORIGINAL CREDITOR: WACHOVIA BNK CHK ACCT t, LITTON LOAN AS AGREED 05/05 12/03 34000 CLOSED 0 0 00 00 00 MI 09 P DLA=05/05 MED BUSI BUR COLLECTION 06/13 11/07 118 118/ 118 LOLL -- -- -- 09-* 06 A ORIGINAL, CREDITOR: MEDICAL Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc.-3017 Exchange Court, Suite H,West Palm Beach, FL 55409 . (561)616-5556 ' _ - 0CREDIT CHECK CONFIDENTIAL Name - DEAN, JIMMY MICHAEL Customer: 9999 Page: 3 CREDIT RECORD (Credit histor has been checked for a •eriod of seven ears or from o•en date.) r_i4h Unpaid Past Pay historic Stet Current Mos Date Date 90 Status Rev ECOP. Account Reported opened Credit Balance Due Terns 30 60 ACCOnnt Number , --�, COLLECTION MIDLAND FUND -- -- -- 09-* 01 A T MOBILE COLLECTION MIDLAND FUND 1 - -- -- 09-* 03 A 05/13 09/10 1267 12267 COLL - ORIGINAL CREDITOR: VERIZON WIRELESS COLLECTION MIDLAND MCM _ -- -- 09-* 01 A 07/10 04/09 765 , 1043 43 LOLL ORIGINAL CREDITOR: HSBC BANK NEVADA AS AGREED ONYX DLA 09/05 PD COLLECT SEARS/GBNA _ -- -- R9-* 0 2 A 02/08 04/06 8238 PAID 0 REV DLA=02/08 PD COLLECT SEARS/CSNA 1 283 PAID 0 REV -- -- -- R9-* 02 A 06/07 09/05 DLA=04/07 COLLECTION SLM FINC CO - -- -- I9-* 12 A 06/13 04/03 19010 8290 8290 310 - DLA=02/08 AS AGREED SLM FINC CO 02/04 06/03 20105 CLOSED 0 0 0000 00 I1 07 A DLA=02/04 COLLECTION DLA=U 1/07 AS AGREED DLA=08/05 PD WAS 90 TOYOTA M 01/07 02/06 28724 CLOSED 0 0 02 01 01 Il-* 10 S DLA=01/07 Ordered by: APPLICANT - SEE NAME ABOVE s1s-ssss Reporting Agency: Credit Chec)c, Inc.-3017 Exchange Court, suite H,West Palm Beach,FL 3340e . (561? . _ sm •: CREDIT C CONFIDENTIAL Name - DEAN, JIMMY MICHAEL, Customer: 9999 Page: 4 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid at Bay Historic Stat Current '.'Los Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA AS AGREED TOYOTA MTR PD COLLECT WELLSFARGO _ __ __ 09-* 01 C 04/09 05/08 0 PAID 0 0 - DLA=04/09 AS AGREED WILSHIRE CRD Total trade lines on this report: 34 PUBLIC RECORDS: PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS WITH THE FOLLOWING RESULTS AS OF 06/27/13: SEE BELOW. - TRANSUNION PUBLIC RECORD --- DOCKET# SOURCE DATE LIAB ECOA TYPE COURT LOC PLAINTIFF/ATTORNEY Z 05064186 11/09/07 $15,426 I 732500A CIVIL JUDGMENT COLLIER COUNTY COURT SUNCOAST SCHOOLS FEDER z 05064207 02/03/09 $8,290 I 8CC006249 CIVIL JUDGMENT LEE COUNTY COURT SLM FINANCIAL CORPORATON SOURCE (S) : EQUIFAX TRANSUNION INQUIRIES: 06/27/13 by CREDIT CHECK (TU) #00630273 05/06/13 by CAP ONE (TU) #02699824 COMMENTS: FRAUD BY ACCESSED BUREAUS. REPORT WORKED BY RENEE CREDIT SCORE: APPLICANT FICO SCORE: 49i (scorcc range from 300 to 850) • Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc.-3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561)616-5556 SM CONFIDENTIAL Name - DEAN, JIMMY MICHAEL Customer: 9999 Page: 5 *** END OF REPORT *** Tits cdmmatanism aeniataaamttobe&skied except es required tri the Pak m paling ten tycnsa�CYVOmsas aeeneard�e perSTEd eyour ae�r ) you r tohdri u. Inc. arriassuornalY t,ubetsoewer- The a same.h t a v s v e c,is in r wag 9t'7 `and we ci els report, Ordered by: APPLICANT — SEE NAME ABOVE 516-5556 Reporting Agency: Credit Check. [nc_-3017 Exchange Court, Suite H, West Palm Beach, FL 33409 (551) Co er C •u-►tty Growth Management Division Planning & Regulation Operations Department Licensing Section January 28, 2014 Darleen Rowe Dazzling Floors, Inc. 7935 Airport Pulling Rd. #4-111 Naples, FL 34109 RE: Review of Credit Report Dear Mrs. Rowe, You have been added to the agenda for the Contractor Licensing Board meeting on Wednesday, February 19, 2014. The meeting is held at 9:00am at the W. Harmon Turner Building (Bldg. F, Admin. Bldg.), 3299 Tamiami Trl. E., Naples, FL in the Commissioner's Meeting Room on the 3rd floor. If you have any questions or concerns, please call (239) 252-2431 Sincerely, • uela Thomas Administrative Supervisor Licensing/Operations Growth Management Division*Planning&Regulation*2300 North Horseshoe Drive*Naptes,Florida 34104239-252-2400*www.colliergov.net Findings of Fact, Conclusions of Law and Decision of the Board Collier County Contractors' Licensing Board For Applications Submitted to the Board for Review Type of Application: X Credit Report Review Waiver of Testing Requirements Reinstatement of License Request to Qualify Second Entity Other (specify) THIS CAUSE came on for public hearing before the Contractors' Licensing Board (hereafter Board) on February 20, 2013, for consideration of the application submitted to the Board for review. The type of application is set out above. The Board having heard testimony under oath, received evidence, and heard arguments relative to all appropriate matters, thereupon issues its Findings of Fact, Conclusions of Law and Order of the Board as follows: FINDINGS OF FACT 1. That Darleen Rowe d/b/a Dazzling Floors, Inc. (the "Applicant") had previously submitted an application to the Collier County Contractor Licensing Supervisor or his designee for a Certificate of Competency as a Floor Covering Installation Contractor and based on the credit reports supplied by the Applicant the Licensing Superviser determined a review of the credit by the Board was necessary. 2. The Board previously issued the requested license subject to a probationary period and a six (6) month review period. 3. That pursuant to Section 22-184(b) of the Collier County Contractors' Licensing Ordinance (Ordinance 90-105, as amended) applications which do not appear on their 1 307375.1 3/612013 face to be sufficient require referral to the Board for a decision regarding approval or denial of said application. 4. That the Board has jurisdiction over this matter and that Darlene Rowe d/b/a Dazzling Floors, Inc. was present at the public hearing on February 20, 2013, and was not represented by counsel. 5. All notices required by Collier County Ordinance No. 90-105, as amended, have been properly issued. 6. The facts in this case are found to be: a. Applicant has adequately demonstrated through testimony and evidence presented at this hearing that her licensure will not result in risk of economic loss resulting from the Applicant's ability to pay _ lawful contractual obligations, subject to her satisfaction of the terms set out herein. b. Credit report does not meet the standards of Florida Rule 61G4-15.006 for Financial Responsibility. c. It is appropriate for the Applicant to be issued a probationary license and subject to further credit review. CONCLUSIONS OF LAW 1. Based upon the foregoing facts, the Board concludes that the applicant has met the standard set out in Ordinance 90-105, as amended, subject to the restrictions and stipulations set out herein. ORDER OF THE BOARD 2 307375.1 3/6/2013 1. Based upon the foregoing Findings of Fact and Conclusions of Law, and pursuant to the authority granted in Chapter 489, Florida Statutes, and Collier County Ordinance No. 90-105, as amended, by a vote of 6 in favor and 0 opposed, a unanimous vote of the Board present, the Applicant's credit report is approved so that a license may be granted subject to the following conditions: a. One year probationary license shall be issued; b. Applicant is to provide updated business and personal credit reports to the Contractor Licensing Supervisor six (6) months from the date of the hearing held February 20, 2013 and one (1) year from the date of the hearing held on February 20, 2013 and shall appear before the Board for a review of the credit reports at the next regularly scheduled Board meeting after submitting the reports. ORDERED by the Contractors Licensing Board effective the 20th day of Feburary, 2013. CONTRACTOR'S LICENSING BOARD COLLIER COUNTY, FLORIDA I ! HEREBY CERTIFY that a true and correct copy of the above and foregoing Findings of Fact, Conclusions of Law, and Order of the Board has been furnished the Applicant, and Michael Ossorio, Licensi .g ral:Zan e Supervisor, 2800 North Horseshoe Drive, Naples, FL 34103 on this`.gth day of 'ebruary, 2013. Secretary/Contractor's Licensing Board 3 307375.1 3/6/2013 . . • • . . , M r,cagio G vf 10 0sz0e/201 s 1-4:54:-.as eor 123,023,50270 r1,7111. •.5I115)/V't,LAUS . . '.., WrIf tr. <•'- ....,41Zait 12 rk 1. ■ . =',0,- Prepared By: r AUG 0 5 2013 q Merit Credit i,239) 277-3202 (800 371-3346 BY:.... .toO■POecoftwe.e•eor. TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 12/84 08/05/13 13:3ECT [SUBJECT] fsSN1 [BIRTH DATE] DOME, DARLEEN MACKLIN - [ALSO KNOWN AS] MACKLIN, DARLEEN,MACKLIN MACKLIN,DARLENE [CURRENT ADDRESS] [DATE RPTD[ 3327 SANDPIPER WY., NAPLES FL. 34109 8/1.2 [FORMER ADDRESS] 5835 PO BOX 5833, DESTIN FL. 32540 4/08 337 TEQUESTA DR., DESTIN FL. 32541 [CURRENT EMPLOYER AND ADDRESS] [RPTD] DAZZLING FLOORS 5/04 [FORMER EMPLOYER AND ADDRESS] TAM OFFICE OF GATONO nuNA 12/96 SPECIAL MESSAGES ***ADDRESS ALERT: CURRENT INPUT ADDRESS DOES NOT MATCH FTLE ADBRESS(HS) ' MODEL PROFILE * * * ALERT * * * ***FTC° CLASSIC 04 ALERT: SCORE +519 : 038, 010, 013, 020 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMED'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. CREDIT SUMMARY ie 4; * TOTAL FILE HISTORY PR=0 COL=12 NEG-11 HSTNEG=2-4 TRD=18 RVL-8 INST=6 MTG=3 OPN-1 I53=8 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $336 $300 $131. $0 $25 INSTALLMENT: $12.0K $9517 $0 -5436 OPEN: $1790 $ $3285 $3285 $ Wi, CLOSED W/BAL: $5672 $1450 $ TOTALS: $14.2K $300 $18.7K $4735 $461 C O L L E C T I O N S SURNAME SUBCODE ECOA OPENED CLOSED $PLACED CREDITOR. MOP ACCOUNTS VERIFIED BALANCE REMARKS MIDLAND FUND Y S6ETOOS I 611.1 $ 51.6 CHASE 0511K USA N A 056 7/13A $5623 ACCT INFO DSP BY CSM A651 ALL.M-'1 1 iFdJUU1 i. b/1.1 P1643 UI :,E CAPITAL CARE 095. 7/13A $8799 ACCT INFO DSP BY CSM ASSET ACCEPT Y 1FJ3001 I 8/11 56027 01 BANK OF AMERICA 096 7/13A $6683 PLACED FOR COLLECTIO SW CRDT 0Y8 Y 9'785i001 I 6/13 -237 11 CINGULAR WIRELE 09R • , . To ■=mo.7 of 10 05/0512013 1.4:5 ,29 ' OT 12392350270 Frc,r-n• Ashley Pmuluu. 7/13A $237 ACCT INFO DSP BY CSM CSI Y 2667001 I 12/12 $380 10 GULF POWER CO 090 7/13A $380 PLACED FOR COLLECTIO RON ACQ LLC Y 1M7S003 I 12/11 $376 OS BANK OF AMERICA 093 6/13A $376 ACCT INFO DSP BY CSM CSI Y 2667001 I 2/12 $381 MEDICAL 098 2/13A $411 DISP INV CMP—CNS DEC CSI Y 2667001 I 9/12 $172 11 COX COMMUNICATT 098 2/13A $177 DISP INV- CMP—CNS DEG CST Y 2667001 1 8/11 $201 MEDICAL USE 2/13A $201 DISP INV CMP—CNS DSG CST Y 2667001 I 7/11 $4118 MEDICAL USE 2/13A $4113 DISP INV CHP—CNS PSG CSI Y 2667001 I 9/1 $1494 MEDICAL 098 2/13A $1494 DISP INV CMP—CNS PSG CSI Y. 2667001 I 9/11 $230 MEDICAL 05% 2/13A $230 DISP TNT CMP CND DOG TRADES SURNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNTS VERFIED CREDLIM PASTDUE ANT—MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 BK OF AMER B 6331.059 9/05 $5672 RO9 1651 1/13A $4500 $1450 I CREDIT CARD 2/09F $5672 CLOSD BY CRDT GRANTOR BK OF AMER 8 1597029 2/07 $6027 R09 319 8/11A $5000 $0 I CREDIT CARD 2/09F $0 PORCH BY OTHER LENDER LvNv FUNDING F 21T9002 3/09 31790 000 517805731314 7/13A $3285 I 12 CAPITAL ONE BA $3285 ACCT INFO DSP BY CSMR CHASE B 26QK001 1.1./06 $3915 R9P 418586800986 2/13M $3000 SO I CREDIT CARD 1/09F $0 PORCH BY OTHER LENDER CHASE R 2601001 5/06 :145?4 p9D 540168303099 1/11M ”500 $0 I CREDIT CARD 1/093' $0 PORCH BY OTHER LENDER CD/NPRTNWS C 1NZ8090 9/06 $508 R97 585637338841 7/0951 $450 $0 I CHARGE ACCOUNT 7/09F $0 PORCH BY OTHER LENDER 08/jUSTICE C 122P002 1.1/06 $457 89P Q030 7109M 2c,0 SO .1 CHARGE ACCOUNT 7/09F $0 PORCH 13Y OTHER LENDER . _ . To 1=o0o 3 of 10 05/03/2013 14-.542.5 EMT 12352350270 Frort, AS.1-0.1'3osJ1,4o CAP ONE B 1DTv001 6/07 $1758 R92 3/09M $1000 $0 C SLDTO SHERMAN ORE 2/09F $0 PORCH BY OTHER LENDER HOBO/MS F 235197C 4/06 $360K 30M 19P 2/09E $0 FORECLOSURE,CLTRL OLD HOmEWARDRES F 1946001 1/06 $474K 480M2387 4/08 432111111x1x M05 4/08M $0 05 11X11x11111 CONVENTIONAL REAL 4/080 $0 FORECLOSuRE,CLTRL SLD 23 1/ 1/ 1 CAPITAL 1. FA F 1.W2K001 10/06 $32.2K 7201578 111111111111 102 11/12v $0 111111111111 1 AUTOMOBILE 11/12C $0 CLOSED 48 1/ 0/ 0 HELLS FARGO B 908N664 7/12 $336 MIN25 11111111111 F.01 CREDIT CA $131 F 0/ 13/ 0 AUTOPRTFLSRV F 2097001 7/12 $12.0K 39M436 1111111 101 7/13A $0 I AUTOMOBILE $9617 7 0/ 0/ 0 BK op AMER B 6331205 12/05 $37.7K 6001792 11.11111111 101 10/06A $0 ,-, AUTOMOBILE 10/060 $0 CLOSED 10 0/ 0/ 0 HOBO AUTO F 1B6A001 5/04 $25. 1K 6004595 111111121111 r01 2/06A 30 1111111 I AUTOMOBILE 2/06c $0 CLOSED 19 0/ 0/ 0 B HILL AUTO A 10A5001 7/04 $7835 4001259 111111111111 101 2/06A $0 111111 1 AUTOMOBILE 2/06C $0 CLOSED 18 Cl 0/ 0 HOME() F 1B6F123 9/03 3206K 360M1538 111111111111 ND] 1/06A 111111.111 I SECURED I/06C $0 CLOSED 21 0/ 0/ 0 NEW CNTY BIG F 1YP6002 9/03 $206K 360011335 11 0101 12/03A $0 I CONVENTIONAL REAL 12/030 $0 TRNSFRD: OTHER LENDER 2 0/ 0/ 0 INQUIRIES DATF1 suBCODE SURNAME TYPE. AMOUNT 8105/13 '1,NPID2U4423(FLA) MERIT CREDIT 5/24/13 ZNv0005620 (EA3) SAFCRENT 2/02/13 ZUT6303148 (MwB) RENTING AUTH I/29/13 NI,,t52814.423ctLA) pivil- LRLD_CI 10/02/12 IPE5855636(IND) CSI 7/10/12 ?,c08256078 (CAL) CREOCO INS 9/11/12 ZN36204423(FLA) MERIT CREDIT 10/06/11 YDT4587653(MCM ASSET ACCEPT CREnTT REPORT SERVICED BY : . ' rc, Pop -9 of 10 05/013/2013 14.5425 sr 12592550270 Frorn: aatshl.y Pastalus TRANsONION 800-888-4213 2 BALDWIN PLACE P.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION MIDLAND FUND YC36ET009 (800) 925-8131 8875 AFRO DR SAN DIEGO CA. 92123 ASSET ACCEPT YC1Fj3001 (800) 614-4730 POP 1630 WARREN MI. 48090 SW CRDT SYS YC978M001 (972) 246-1906 591.0 N PLANO PKWY PLANO TX. 75093 051 YC2667001 (850) 434-0283 FOB 1431 PENSACOLA FL. 32596 R311 ACQ LLC YC1M7S003 (800) 268-0623 575 UNDERHILL BLVD SYOSSET NY. 11791 BE OF AMER BC6331059 PO BOX 982235 EL PASO TX. 79998 BK OF AMER BC1597029 PO BOX 982235 EL PASO TX. 79998 LVNV FUNDING FY21T9002 (869) 464-1183 625 PILOT ROAD LAS VEGAS NV. 89119 CHASE BC26QK001 800) 955-9900 P.U. BOX 1:,298 WILMINGTON DE. 19830 CB/NPRTNWS CW1NZ8090 PO BOX 182789 COLUMBUS OH. 43218 OP/JUSTICE CS122POU2 PO BOX 182789 COLUMBUS OH. 43218 CAP ONE BC1DTV001 (800) 955-7070 POP 30281 SALT LAKE CITY UT. 84130 HSBC/MS Fm2351970 PO BOX 9068 BRANDON FL. 33509 HOMEWARDRES FM1946001 (877) 304-3100 1525 S BELTLINE COPPELL TX. 75019 CAPITAL 1 FA FA1W2K001 (800) 946-0332 ATTN- CREDIT BUREA PLANO TX. 75093 WELLS FARGO BC909N664 (800) 642-4720 CREDIT BUREAU DISP DES MOINES TA. 50306 AUTOPRTFLSRV FA2D87001 (873) 781-3111 20 BOX 4097 ENGLEWOOD CO. 60111 BK OF AMER BI6331205 (800) 215-61.93 9000 SOUTHSIDE BIN JACKSONVILLE FL. 32256 9230 AUTO PA186A001 (214 ) 237-3430 PO BOX 961245 FORT WORTH TX. 76161 B HILL AUTO AZ1UAZDO1 (850) 763-9005 13:13 W. 23R1 92 rT,NAp: CITY CL, 32405 HOME° FM1DGF123 (077) 007 7370 P.O. BOX 13716 SACRAMENTO CA. 95853 HETiq CisiTY. MV; rmirpc-mn? 210 COMMERCE IRVINE CA. 92602 SAFERSNT Z 0005628 (800) 999-0350 7300 WESTMORE RD ROCKVILLE MD. 20850 RENTING AUTH Z 6303148 (888) 674-91.81. 230 3 700 11 PROVO UT. 04600 031 Y 5855036 • PaSO 10 Of 10 05/05/2013 14:54:29 EDT 12:750270 IV IOuIo 4 180 E. BURGESS ROAD PENSACOLA FL. 32503 CREDCO INS 2, 8256078 (800) 607-2122 12395 FIRST AMERIC POWAY CA. 92054 ASSET ACCEPT Y 4887653 28405 VAN DYKE WARREN MI . 48090 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY, STATE AND FEDERAL, LEVELS. PUBLIC RECORDS HAVE ALSO BEEN VERIFIED FOR PINELLAS COUNTY. PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR (239) 277-3202. • for Pasaev 1 0'/ '10 05/08/2013 14:54:24 EOT 1a36,2BSO2VOO From: Aahloy Peaulua Prefilter Her Profile-DAZZLING FLOORS,INC J S WM P i@ 6 Subcodre: 970135 Ordered:08/ E;::01' 8 9 S ys!Ex r r Transaction Number:C500048467 h' ' � �� ''asp_ Search Inquiry:dazzling floorsiPO BOX 58:351DESTIN f'FL73254OIUS/lti/A/7 3939 7 657 A v1671��c:Yairai i Model Description:inteiliscore Plus V2 T.'. e7k,,,,,,7 ,��a;:7,t7,,,,?,,..!,-, ,,x .•}s ,1 7*:, '3 1 '4'' ; ,,-y,.. -.� '- ,7',•w/b F V:i 2 T ,r 7 l ' 1.. ,K ter.it s.$ ^� 5,149M ' r r z` f, 1 a G 'r�s�tr- +,,,S1Ft.'q.5i f-84 .. 911,7 ,,9.'. . > i3 s"k L{s,, E t r ,P. F, si Y r , i t -` C$9$4•YV f.:;.--:%.,, 5` r/ ,4--,,l'pp ,1'.4.\'r " ,,� `,:X- cc1.3 : If _.. a t } } .' o� wk...z.:, < a 'r s$x a;'1 a 4. 7 1 ,i''''-'1-",c," ` c.���, �,w s w x f? ;� .� � � s Y 5.�x a$i3�i •_ +z 4'.`; �a;t L;,r b-_�...� :.� ��« +-_ e.^. I Doing Business As: DAZZLING FLOORS,INC Tax ID: XX-XXX5049 Primary Address: P.O.BOX 5635 DESTIN,FL 32540-5835 _---� - This business is the ultimate parent. 1 v y B e_tbe.P_r?-o..r>atf<_hi. carc:1y by-chcattig..stere. .r c r -:t a 1- - p :,-, ? fi Ri;s ,,, r T/F1't u,i'tj...x ,-5 t ,4 ` :`'l""' x ,/.,",- .,:J F l t 45 0 (.: t `:}-ti g .ry t s" ti'i + �, J 1>t i'i -.' a`Y ".+ §i,''" J 4 1S U' t' k 4`'. I ft 1 - f b �. dd n G c P - ' 4d XYj1.fr Fit {� � �� ,,a;�, �; nr;�," rat�'�a. x �,,ah�lia"'" '�ti '�,� a a y "r; , C x+i Y, tiRt`s �rsi salty ti eta Oild0.11* + r try ° y?.A•Z ,, a..1 ..size-A.4 ,::..71:`_-241-:a...s-. '-.9B ,.kw-.er...41.,mtA. k i'.. '.'t s'Yz'M-ill'�'Z' du,..::.. c.. s'a' 4.,. .,.3«, .t�ra..1.4. S,.•t s' 1,..sR3.,^C_.''.,rm u's,tt•148 Intet(iscrare Pius Financial Stability Risk Company DST Original Filings High Risk Ale is • r r HIGH RISKr c HIGH RISK Dt3T ,' I : i f'''' "-. ' unavailable i l . r. i Score range:1 -100 percentile Credit Limit Recommendation:$1,100 --_--._ --___—.--.--.-- - Ter: . ` � g l , 'ti-v ti,$:., Cp ,f r« k 4.-2.-. s}._.a V ai' L> i t - -` u`n d f.. x `ri '�r i �:i A 1 { �'t 4s .an , , d- ,. '��..�`'�- ,s..i-�.,,,��,,. , .�_�� .1✓�'. _.a� . :1�� ..» 3'.a,.;s ..�,. ._:.r a. . R.# �` r-r-... +�_�ra�t��� Years on File: 10(FILE ESTABLISHED. 07/2003) SIC Code: FLOOR COVERING STORES-5713 I State of incorporation: FL LEGISLATIVE BODIES-9121 I Date of Incorporation: 01/14/2002 FLOOR LAYING 13 OTHER FLOOR WORK. NEC;-1752 Business Type: Institutions-Profit NAICS Code: Floor Covering Storrs-442210 DARLEEN DA77LING Legislative.Bodice..-921120 Contacts: Flooring Contractors-238330 Number of Employees: 2 Sales: 5566 000 �......... .......__.. .. _._......___ _ _ Tea r,_ F4.1 ii' t ..�..,y j',"' -11-',.-7; "f. _7, 7,.., r > �{ ., fir•s J.r rrs'�4 y'y S , r;" t , -viC1t vr.Went�'"i-ltit �lltild.7.',,-., 5 7 ¢/ n ,7 Y {o .0.44,,,,:;.%,...,:i { ,L. k '4,,',4]..,,,t, r•i -;.�' t i. 1 UrO "'7 Lk Qt4. 't1N a E} 1LiOT V,i� J.„� 3 tr { z1V d6., 7 ,' t i / r l t l 1"a f''' Fk•r�t�w, t' ,u.� � �n a ,, i 1 4s:` � ,,-, a +:,�I'' ', J .� '� f C4,• 5 � t fiy.+ t°, ".,,,t4r,i,'# ` ` ,7 ;4"� ,v,-.�. ray t. r + "�+u ny t m 9 h ,,'�'? ,r ti i,fi.thin r�*^r, a r �t 4 ,, x• eag, e4i -.4 r iv: -.; `�"' '':y'tic f I 4 a.c �yt:v''' , A+�. • a 4 ,y v r �`r,�,.a s.o• .-._.�:4rat'§t 1 .fit �ta`Y. ..t. � .kid a,.,..ky.« TR..., Y_.�..1+..�.�'a voY�:;'. ..�7 :�tiih,.,.r�..:_Ab �, The primary Business Name,Address.and Active Business Indicator: ( Experiart shows this business as active Phone Number on Experion File wore reviewed , ? for High Risk indicators,no High Risk indicators I �� were found. Pne ihle QFAC Match: (€',of No QFAC match fnt.lnd Business Victim Statement: °`+i No victim otatemont on filo — rot0 d. � 17147' r �'',C)� s6 r.. r� u t a �5J '`rJ J. r T 6�F' r�'y�'� 3 r*.��(�.+�tk�t� �/ .t� ,, p . r h *VT:.ari I '� '� 7 m��D�I :/, , air y ataS . y,y`S`? p' k 1_ M.4r �r A y,., * ri 1 ik t..:...t rc.;'' ''; '-li r.. ya „.rF'*.4 1%,„,P ,<,i,:n '.'rr 1.�,xx,. -F r r.'1 /t .- r ',"4Ti 5 -,.4.2 4"J *:, 4 i'1,W D ., 1;;;, 7„. ' t�'d2,f-,1 Ye {•4 s t a .1. { , t r ,t,,Av.<;;;{.0 Tea a,1q-,:t'..,,1;‘,.. 3 s �Gr£{1Si l tS L �B,f 1nF9�C S.1'OVl r� 1 SA.;T"rs,rk i' 4f:Tyy. ) ci sY .. tit/.�t$.,,i'.�. . ,,,,,,,i.n.'t.?, t.. -§.'',.A i.... ;.. a..,.gx e-r.:k;..,, .,4,.....•..r .. Current intolliscoro Pith Score; 7 Risk Class; 5 1177. �—arc .s�rc.,ee".71. 77.1:7,:j e.;°'^r ,74,.'°' t �r t � t`. 3 �jt+�,� r�;A � ,�'� t r .r�.;,rr.w.,.t brX`�i,` typ kj� `.r.. ..i414.-0.)-..-i r r x "r rep f> 5y� ,''`Fm' The risk class croups scores by risk into tangos of stabler F..11,,..i .a . �.x .. .:.... :',. A`2:i2si 'Y''. �`, :a'r'u < s:i?I11±. Premier Prork.-DAZZLING FLOORS,INC 114 ._ . To Pooe Z of 10 05/os/201 a"I 4:54:2W or 12392360270 Front: Ash Icy r�E,ulus { 17� ; �, i performance.Range 5 is the highest risk.range 1 is the .a lU E.5 50 a 7S ;; fl. lowest risk. I This score predicts the likelihood of serious credit delinquencies for this business i within the next 12 months.Payment history and public record along with other i variables are used to predictfuture-risk:Higherscores indicate-lower-risk:- — . i Factors lowering the score Industry Risk Comparison > NUMBER OF RECENTLY ACTIVE COMMERCIAL ACCOUNTS 6%of businesses indicate a higher likelihood of severe delinquency. . NUMBER OF COMMERCIAL ACCOUNTS WITH NET 1-3O DAYS TERM I ? NUMBER OF COMMERCIAL COLLECTION ACCOUNTS AGE OF MOST RECENTLY OPENED COMMERCIAL COLLECTION ACCOUNT I pp yr� y,�.> 1 y u A x Y�. f '�, s i�c�' 4 f,c' 4 J d<. ',� i V: i'� :r i r} • ! ! 1 f: r Y o e .r, 6 y ,fir,.A. n ��, ,• r C t� �:�#�!"xr..-s._.._n�''.. d"r� .Y...nr.:..�'�_:� r .�a.. ;�`s.C.a(`�isLe�1 u�5 L..s!-r�.,I_a -a� ..r11', t-. t.Eal e,t... i.$5.,. ..- k >':..�......,.,}rte..:.-. Quarterly Score Trends• 1007 _.� . --, ~ ._......-.._....._..___-_.__._.-'l la ,'t CD 1 70 . ..........; The Quarterly Score Trends provide a view of the SD - likelihood of delinquency over the past 12 months for this business The trends will indicate if the score improved. 60 -- remained stable,fluctuated or declined over the last 12 40 ,':; „•,_.1 months. 30 - 20 v F': .. .C f- r1 r t r^n .1 r :f'r xt t'"3 Yr1[�'�J tin «• ye^�"',�`,''That-X+N» s » �"fs '' ,- ''ila.'gr'IFtr iSF,', �"rt `. ,4 r t ,r / x �di ..}. � 3a 4 -AI l p 4f�1 J � ` k';•i r k.-. ;.. 'iW•'1:! °. -it ,: Sa;-' 11 .W,Si"lg-eV. '^"t+, ,f. t r .11. tYt.rt. ., r. s k � zat�4� s .�`�{qr,. ��.� u e.�'�,xrr,.,.. ?3_��...fff'.�..`t.., ,�.3.st_,.,�..s._�.• Current Financial Stability Risk Score:2�y'VA.' Risk Class: 5 ;401.�* " 4 a s sY. 11k� A t"5 l. i ir,4 a y 1. is ^1;. ,,,,, I -ti r M w . u '.3.' 1s. u tt x f f 'z The risk class groups scores by risk into ranges of similar fk tg€vr Y * Y performance.Range 5 is the.highest risk.range 1 is the r, 1 .- . t lowest risk. o91iii �L f € : 1oc r This score predicts the likelihood of financial stability risk within the next 12 months, The score uses tradellne and collections information,public filings as well as other variables to predict future risk.Higher scores Indicate lower risk. Factors lowering the score Industry Risk Comparison i > NUMBER OF ACTIVE COMMERCIAL ACCOUNTS 1%of businesses indicate a higher likelihood of financial stability risk. l > NUMBER OF COMMERCIAL COLLECTION ACCOUNTS il > RISK ASSOCIATED WITH THE COMPANY'S INDUSTRY SECTOR > NUMBER OF COMMERCIAL ACCOUNTS .y>?'n;,�F '�$`. 'Y x•3 k`;f, }'*ge£ `�ii� q !- a t{, 4,41. rr. '` 4s 'im�y`(d .EK 1i y tl�l,rt� E a t .. � irtf.f Y� t #` t;•„%�ir�i, �,r'L..�dr^,iii q. .l .0 r i. i'... +,. �4x -•n .'h.,rilII' 1 T S22 k i n''s�J = -, 4\•. . �t, ` 1, :_S 'fr:°i 1E. `�itN:1 .6. M L�:lign n..oii.: fa w._.,. 1a fiw i Credit Limit Recommendation This recommendation compares this business against similar businesses in the Experian business rrixiil delahrtce It is hasnri en frerfe ir,fnrm:>finn,inrirlrtry,ego of bueinecc and the lnloiliceero S1,100 Plus.The recommendation is a guide.The-limit decision must be made based on your company's business policies. roP Co .,� s 1 v4. 1a �°4 b"�i fr TY 2'.1•• '`�py�� . 1.a}/„,�j�',j}.5 .. ' '+1',7 l t 'r 'r'r' t 9. �' . qe,.f.• ,:e ).A1.:1 ...}• . '-,Y. :,..., �Lf K.e.• 1 :f 4,„;1.%''i t ,,4� '�7 f J ' Lk i�b Sri 1 0,•'4,, y. 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Current OBT: Not Available Total trade and collection(1): S12,051 Bankruptcy: No 1 so Tax Lien filings: 0 t Predicted 1Jf?,T: NIA All trades(0): Judgment filings: 0 I Premier Profile-DAZZLING FLOORS.INC :u To f ago 3 of 10 05/08/2013 1.4:54:29 EOT 2392303027'0 From: Axnh,cy Paulus Monthty Average DST: 0 All collections(1): $12.051 Sum of Legal filings: $0 Highest DBT Previous 6 Months: 0 Continuous trade(0): $0 UCC filings: 0 Hi43hest DBT Previous 5 Quarters: 0 6 month average: N/A Cautionary LICC filings: No Payment Trend Indication: Highest credit amount extended: N/A Naymuril trend indicator not available Most frequent industry purchasing terms: Industry purchasing terms not available -• -,• !<� l y,W�+: t c NA-K1-1411,:: W 1�rf¢�t t"� I`6•T-zC.z°£r, +:.i tti ti 1" .� w,r.;,t F }. e j8.'4h j� IS (Y�ni 9�ye���Hr� ' y,v �t ;';; lxy � J! s,� is.. j &* a �.4 . ' a��=tE�a3 d _K c5. t�..r.rs�t. _?5:.fiT�z'ryv r..,a. t.�t�? z•� w,4.,:{3' >,' Industry DBT Range Comparison The current DBT of this business is Not Available. DBT for this business: Not Available � l�A11'Nt 11I ''f.t—'& L r .e?1. rtl i,, y © T.Stan 9 ; TOP 0 �k}5. 4 f e Ff. 1� ,Yy/xz ''f $ b S Date Piaced Status Original Balance Outstanding Balance Date Closed Agency Agency Phone 10/2009 Open Account $12,051 $12:051 STERLING AND KING (407)339,-9033 TOP • j•-• ‘11134114,i1ctrtP t; a 4 ((l � . .%`1 s lye x },�j.r s1 r ,fin ,,r �;' +y' L i t o 041eRtolOr da R!ZI U# � � 4az G e Z °` ijy ita�..a3. r_rx. ndr. ��. . 9;o'.$: nWit$. .. r_. THE FOLLOWING INFORMATION WAS PROVIDED BY THE STATE OF FLORIDA. State of Origin: FL I Date of incorporation: 01/14/2002 I. Current Status: Active Business Type: Institutions-Profit Charter Number: F020000047 Acton': DARLEON ROWE Agent Address: 337 TEQUES T A DRIVE DESTIN,FL TOP f r ` .. E`r §�ti.y f? • • To F.sts 4 of 10 OS/0a/3013 14:3429 EDT 123323a0270 Fro11. Ofk credit decisions.Give credit where credit is due. Call I-800-520-1221,option#4 for more information. .E.v.:1 of report 1 of 1 repOrt -rho infOrlrat10,1 herein is furnished in confidence for your exclusive use for logilimate bunt-ices porposas one shell not.be yeplz>due;od.Nothor EXIX:ii;117 Inc..!XV their sources or ChSiaLtiOIS 14031M11:3ZICil inionnation r30111,11!thOy bO/7/10/0 10;yOUf 050 or reirianco E;pori IL Experia,,2013.Ail rights reserved. Lxperirn and Ile Experian marks heroin are service marks or registered trademarks of aperian. Promicr I,iiraf DAZZLING FLOORS.INC • Licensee Information Licensee Number LCC20120003359 Description —_ Type Property Alert Name 'Dazzling Floors, Inc. Type Contractor Status Inactive View Master Project View All Activities for this Licensee Add a new person or business to Address Book Classifications h Generate Defaults Add a Classification To add a classification to this Licensee,enter text below. CityView will suggest possible matches as you type: FLOOR COVERING CONTR. Link Type _ Date Entered ( Status I Status Date FLOOR COVERING CONTR. 08/15/2012 Inactive 01/28/2014 Show More Fields [ Hide or Clear Fields Unique Identifier ILCC2114 Contractor Licensing A Renewable? { License Category Local - Specialty License Issuances Attach Driver License Photo) Add Issuance Link Type Status Date Issued I Issuance Number Expiration Date FLOOR COVERING CONTR. Suspended 08/15/2012 201200001482 09/30/2013 Comments 8/15/12 qualifier attended and placed on probation per clb for one year.mgo 2/20/2013 CLB extended probation period for 6 more months. I Show More Fields j ( Hide or Clear Fields 1 License Category Local - Specialty L-1 Renewable? Unique Identifier!LCC2114 BEFORE THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY, FLORIDA, CONTRACTORS' LICENSING BOARD Petitioner, V. Case Number: 2014-03 License Number(s)#18458/201300000372 Deborah Plummer D/B/A— Tiger Masonry Inc. Respondent. ADMINISTRATIVE COMPLAINT Collier County(County)files the Administrative Complaint against Deborah Plummer( Respondent),a Collier County licensed Masonry,and Concrete Forming and Placing Contractor( license(s)#18458 and #201300000372), and states the following facts and allegations in support of the cited violations below: 1. The Respondent is currently licensed by Collier County as a Masonry and Concrete Forming and Placing Contractor with License number(s)#18458 and#201300000372. 2. Under the provisions of Collier County Ordinance 90-105,as amended,Section 22-201,the following actions by a holder of a Masonry, and Concrete Forming and Placing contractors license shall constitute misconduct and grounds for discipline pursuant to Section 22-202. a. In January of 2014, employees of Tiger Masonry Inc. were discovered working and/or subcontracting outside the scope of their Masonry,and Concrete Forming and Placing Iicensures at 1461 Caxambas Ct. Marco Island, FL. 34145 b. Work performed and/or subcontracted at this jobsite was determined to require building permits by the City of Marco Island Building Official. c. No building permits were applied for,or in issuance at the time the work was performed and/or subcontracted by the Respondent. 3. Thereafter, pursuant to Collier County Ordinance 90-105, as amended,Section 22-202(b) and Section 22-202(c),the complaint was investigated and found sufficient cause to file formal charges. 4. Collier County brings the following charge(s) in this formal complaint against the Respondent COUNT I 5. Collier County Ordinance 90-105, as amended,Section 22-201(2) states : "Contracting to do any work outside the scope of his/her competency as listed on his/her competency card and as defined in this article or as restricted by the Contractors' Licensing Board." COUNT II 6. Collier County Ordinance 90-105, as amended,Section 22-210(18)states : " Proceeding on any job without obtaining applicable permits or inspections from the City Building and Zoning Division or the County Building Review and Permitting Department." WHEREFORE, the Petitioner asserts the above facts and charges are grounds for disciplinary action under Section 22-201 of Collier County Ordinance 90-105,as amended,and WHEREFORE, in consideration of the foregoing,the Petitioner respectfully requests the Collier County Contractors' Licensing Board to find the Respondent guilty of the violations charged. Dated:January 30th, 2014 Signed: A Rob Gangul. License Compliance Officer Collier County Contractors' Licensing SUMMARY On January 3rd, 2014 I received a complaint regarding possible unlicensed/unpermitted activity at 1461 Caxambas Ct. Marco Island, FL. 34145 being performed by the Collier County licensed Masonry, and Concrete Forming and Placing contractor Tiger Masonry Inc./ Collier County certificate(s) #18458 and #201300000372. A site visit was made to the property with Marco Island Inspector, Gary Konicek, where a corporate officer for Tiger Masonry Inc., Roger Call, was discovered on site. Mr. Call explained that he was there to provide an estimate for a small concrete repair on a retaining wall, and nothing more. At this time, additional work was discovered on the boat lift/dock at that location which Mr. Call claimed to know nothing about. I made contact was made with the property owner, Ronald Hodge, and when questioned about Tiger Masonry Inc. working on his home, Mr. Hodge advised that he had paid them a deposit of$50,000.00 to perform and "oversee" a various scope of work inclusive of a kitchen remodel, electrical and plumbing, as well as the boat lift/dock renovation. Mr. Hodge was informed of possible permitting requirements for work observed and described by him, as well as the STOP WORK order issued by the City of Marco Island Building Services until an investigation had been conducted into this matter. On January 10th, 2014, a meeting was conducted with the qualifier of Tiger Masonry Inc., Deborah Plummer, who initially claimed to have no knowledge of the $50,000.00 deposit received or any work at that location other than the concrete repair on the retaining wall. A subsequent meeting was conducted with Contractors' Licensing Supervisor Michael Ossorio on January 16th, 2014 with the requirement that Ms. Plummer bring forth her most recent bank deposit statements for inspection. This inspection revealed a deposit in the amount of$50,000.00 in a Tiger Masonry Inc. corporate account. In this meeting, Ms. Plummer admitted to Supervisor Ossorio of having accepted the $50,000.00 deposit on a total contract of$120,000.00 for kitchen remodeling, electrical, plumbing, and the boat dock/lift work which she was aware was beyond the scope of her Masonry, and Concrete Forming and Placing licensure. Ms. Plummer further advised that she had arranged for Stagecoach Restorations L.L.C./CGC1511821 to take over the jobsite and complete the project for the home owner. On June 18th, 2013, a previous infraction was discovered by myself and City of Marco Island Inspector, Kim Ferris, at a jobsite located at 861 S. Collier Blvd where Ms. Plummer received two citations for unlicensed general contracting and for commencing work requiring a building permit. Based upon this repeat violation, a Notice to Appear in front of the Contractors' Licensing Board on February 19th, 2014 was sent via Certified Mail and was received by the respondent. As part of the permit application process submitted by Stagecoach Restorations L.L.C., the City of Marco Island Building Official required a complete inspection of the jobsite to determine the exact scope of work that had been performed. This inspection was conducted on January 30th, 2014, and a determination was made by the Building Official of work performed without a building permit in issuance. My investigation into this matter also revealed invoices for subcontracted electrical and plumbing work to Tiger Masonry Inc. for this jobsite. These activities conducted by Tiger Masonry Inc. construe violations of Collier County Ordinance 90-105, as amended, Section(s) 22-201(2) which states : "Contracting to do any work outside the scope of his/her competency as listed on his/her competency card and as defined in this article or as restricted by the Contractors' Licensing Board", as well as Section 22-201(18) which states : Proceeding on any job without obtaining applicable permits or inspections from the City Building and Zoning Division or the County Building Review and Permitting Department." C.L.B. Case #2014-03 Deborah Plummer D/B/A - Tiger Masonry Inc. Table of Contents E1/E3 — Formal Complaint. E4 — Collier County Certificate Detail Report. E5 — Notice of Hearing sent via Certified Mail/Return Receipt. E6 — Signed Return Receipt for accepted Certified Mail. E7 — Letter from City of Marco Island Building Official determining Permitting Violations. E8/E10 — Photographs of Unpermitted Installations from Building Official. E11/E12 — Tiger Masonry Inc. Bank Statement depicting $50,000.00 deposit made December 13th, 2013. E13/E15 - Subcontracts from Tiger Masonry Inc. for Electrical and Plumbing. E16/E19 — Case Detail Report for Current Misconduct Violation. E20/E23 — Case Detail Reports for Previous Unlicensed/Permitting Violations. E24 — Florida Building Code Section 105.1 outlining Permitting Requirements. Table of Contents (continued) E25/E27— Collier County Ordinance 90-105, as amended, Section(s) 22- 201(2) and 22-201(18) outlining Violations of Working Outside the Scope of Licensure, and Commencing Work without Permits. Contractors' Licensing Board 2800 North Horseshoe Dr. Naples, Fl. 34104 Complaint Number-2014-03 Complainant:Any person who believes that a Contractor holding a State Certification or Certificate of competency has violated Collier County Ordinance 90-105,as amended, may submit a sworn complaint to the Contractor Licensing supervisor, or his/her designee.The complaint shall be in substantially the form prescribed by the Contractor Licensing Supervisor.The complainant shall pay a fee of$50.00 to defray the costs of administering the complaint,at the time of filing the complaint.The complaining party shall state with particularity which section(s)of this Ordinance he or she believes has been violated by the contractor and the essential facts in support thereof. Complaint: Please print or type and return signed copies of the complaint. Date:January 30th, 2014 Against: Contractor's Name: Deborah Plummer Phone: (239) 348-2411 Business Name:Tiger Masonry Inc. License Number if known:#18458(Masonry) and#201300000372 (Concrete Forming and Placing) Collier County Competency Number: Same Contractor's Business Address: 3271 17th Ave S.W. Naples, FL. 34117 Filed By: E- 1 Name: Collier County Contractors' Licensing Office Address: 2800 N. Horseshoe Dr. Naples, FL. 34104 Business Phone: (239) 252-2914 Address where work done: 1461 Caxambas Ct. City: Marco Island County: Collier Date of contract: Unknown . Date job started: Unknown Date job completed or new home occupied: Incomplete Were there plans and specifications? Unknown Is there a written contract? NO . If yes, amount of Contract: $120,000.00 Has Contractor been paid in full ? NO . If not, what amount?$50,000.00 Was a Building Permit obtained ? NO Building Permit number if known: N/A Have you communicated by letter with the licensee ?YES Date:January 17th, 2014. Do you have a reply?YES Please attach to this form all copies of the purchase agreement, building contract, home improvement contract,copies of receipts and/or cancelled checks available and any additional evidence to substantiate your allegations. List any subsections of Section 4 of Collier County Ordinance number 90- 105,as amended,which, in your opinion, have been violated by the contractor which is the subject of this complaint, (list subsection number): Collier County Ordinance 90-105,as amended,Section#22-201(2)states : "Contracting to do any work outside the scope of his/her competency as listed on his/her competency card and as defined in this article or as restricted by the Contractors' Licensing Board." Collier County Ordinance 90-105,as amended,Section#22-201(18)states: "Proceeding on any job without obtaining applicable permits or inspections from the City Building and Zoning Division or the County Building Review and Permitting Department." —a Please state the facts which you believe substantiate your charge of misconduct against the subject contractor. List facts separately for each subsection number above: Performing replacement of master bath sunken tub and kitchen countertops along with disconnect and reconnection of plumbing fixtures and appliances without required building permits as determined by the City of Marco Island Building Official. ( Complainant's signature) State of: Florida County of: Collier Sworn to (or affirmed) and subscribed before me this 30th day of January, 2014, by ! V4 C cJ j (signature of person making statement). t/ 20.....�•o SAMANTHA LYNN ROE * ' ')- * MY COMMISSION•EE 875239 4/j . ---mot' 1 (signature of Notary Public) ,,,. 7 i.„ EXPIRES:Febma 17,2017 -4rFOC FvOn\o Bonded Nu Budget Notary Services P ',t,type or stamp commissioned name of Notary Public: Personal) known or produced identification Y� p Business License Application Status - CityView Portal Page 1 of 2 GMD License Application Status — License Application Summary Application Number: C18458 Business Name: Tiger Masonry, Inc. License Type: Contractor Application Status: Active Description of Business: All Certificates from CDPlus: 18458 Mailing Address: 3271 17 Ave SWNaples FL 34117- United States Locations: — Issuances Type Date Issued Date Expires Status Number CONCRETE FORMING AND 02/26/2013 09/30/2014 Active 201300000 PLACING MASONRY CONTR. 05/29/1998 09/30/2014 Active 18458 — Reviews There are no reviews for this license application. — Insurance Producer Type Policy Effective Date Expiry Date 1 INSURANCE & RISK 2063505512 05/29/20 11 05/29/2014 I $2,000,( MANAGEMENT SERVICES, INC. f Expiration Processed: No Producer Phone Number: 2396491444 INSURANCE & RISK 083030192 I 05/29/2010 05/29/2014 $500,( MANAGEMENT SERVICES, INC. r—_--- --_-- I _ Expiration Processed: No Producer Phone Number: 2396491444 DEBORAH 3. 1 06/20/2012 06/19/2014 1 PLUMMER j t Expiration Processed: No e-- U 1lttrr//nxmnrtal enllipranv not/('itvViaxxrWah/T in •ncragfatnc9lincnocar1-00Q77 1 /21 /'ln1 A Collier County Growth Management Division / Planning and Regulation Operations Department/ Licensing Section CERTIFIED MAIL#7007 2560 0001 1485 5606 Deborah Plummer DB/A/-Tiger Masonry Inc. 3271 17`h Ave S.W. Naples,FL. 34117 Date: 1/17/14 RE: Complaint filed against you by Collier County Contractors' Licensing regarding a violation of Ordinance 90-105, as amended, Section 22-201 in(date of violation)January of 2014 Dear : Deborah Plummer A complaint has been filed against you by the above referenced individual. A hearing of this complaint will be held by the Contractors' Licensing Board on at 9:00 AM on February 19`h, 2014 in the Board of County Commissioner's Room,Third Floor,Administration Building(W. Harmon Turner Bldg.),at 3301 East Tamiami Trail,Naples, Florida. Your presence before the Contractors' Licensing Board is required at this time. The packet you will receive marked composite exhibit"A"will be delivered to the members of the Contractors' Licensing Board one week prior to the hearing. If you wish to prepare a defense packet and have it delivered in conjunction with composite exhibit"A",you must make fifteen copies and have them in our office by 8:00 AM on Wednesday, one week prior to the hearing. In your packet,you may give a summary of events. At this meeting,you may present evidence and be represented by an attorney of your choice. In the event the Contractors' Licensing Board finds you in violation of Section number(s)22-201(2)and 22-201(18)of Ordinance#90-105, as amended,the range of disciplinary sanctions which may be imposed are from an oral reprimand to a suspension or revocation of your Collier County Certificate#18458 and #201300000372, and/or suspension or revocation of your permit privileges against your state licenses #(not applicable). Sincerely, Rob Gan_uli Licensing ompliance Officer Collier Co+nty Contractors' Licensing U.S. Postal Service, CERTIFIED MAILTr., RECEIPT • (Domestic Mail Only;No Insurance Coverage Provided) I= For delivery information visit our website at wvnw.usps.com�F tl7 ul [ Postage $ Certmed Fee rg ,1 R 0 Endo etu Receipt Rel ed Postmark Here Restricted D (Endo seinent Required) L11 Total�Postage 8 Fees $ p Sent 1 __� � �t,Ulkft'� :4: -°-..__ D __66;6,,-;C No.; [�- or PO Banc No. 3)�t1J F S < City;State.ZIP+4` �'�-'C�'---�'"S t c___:: � .t "y++ PS Form 3800.August 2006 - S Reverse for Instructions SENDER: COMPLETE THIS SECTION 2006 COMPLETE THIS SECTION ON DELIVERY ' �c ta,�� € ,� 1 Ip"e) cr.e �tir�i°'d' �`�.- -T k °' , ' R E,k t tl�:���^44..��-- s� e'E '..r m.a�',;gyp' e,,_ `" ,, �' :' ‘..-!;;;/21;' E,tr�* . • vY. � .,.� s `,a4 �a s a�°'� icE� f l °i t l"i; a 3e. _F ..� lF6.t4''`,f " • 3 D�°t ''N �q'`,�.,+ r��� v� '.�1 t `"�" -}{ X5 3'1, d. .� xt(k`h` 7 k,4'�. P� M ' s `'' 2 34 ,4 r ' ,.,7`.1 a �°' as 's- .= � � tea, t a � '. f �� is"' `-- F' +{ .s ,x � i s .`5v i� �k ,ur 1. '`N 4 -<V �.sP.y'. �,�. },s�g�d� ,:,���c�i, � '*-�,. � ;'�, 4� '_° r�aA° ��^a, Fy'� 16 �A� ,'� `�{`,�W' f .. %; 7007 2560 0,021 1485 5605 , 'S $1 ebruary 2...004 omestic eturn iec pf to s5-02 i ' �. c3 _ 71 y of Marco bland c*oE January 29,2014 Hodge Residence 1461 Caxambas Ct. Marco Island, Fl. 34145 The Marco Island Building Department performed a site visit on the above address and found that the following work was done without the required permit: 1. Replacement of master bath sunken tub. 2. Replacement of kitchen counter tops. 3. Required electrical upgrades in kitchen. 4. Disconnect and reconnect of plumbing fixtures and appliances. Any questions please contact: Jack McStravic Build Official Marco Island Building Services 50 Bald.Eagle Drive, Marco Island,Florida 34145 (239)389-5000 <> Fax(239) 389-4359 .rt .. 14 M , tp 410 ... • • 0 g •...! „ • : x t xr 'S is P !'. . , / - ": • .001)11 e X, • T . . • .:. ., .. , 0001001111;1, l'r 1. • ' ',''..".:,,-:...l..„''''''':..''..4'it,'...•r...t.,:.'•...:Est MCc • 0.---11- t M yy K".: T .iOP• \.at"'E f ; rt "� jam. 0 0 0 ;. app 1. ' 'I r..> ' �.' t .y k �''""j.. «i • 3 �e _ " 4•'. 4.d b' it.i. .'' �j)n._ TM3� rf t k;;,:4''.rvwf•P^ .4 y /"..:;!..$.4.","'a s , - - . '- __,,,,......,.,-.:."-";7 ::'''1' ,,,,,t r.„..,:„ .7.....14, ..' . ,..„,...,,.....38......,;ic......,,s,,,,,, ,..,,:..,„,„,,,,,.„.,,,,,.:.......44. 1. '. l ,„ . . .....„.",..i..:,,,,'r',$'''",."':' ".$"',$$$/$,./' .'$"'-"-,$- a m., ..... , : ....., , -r. fi �d mar -c �Q . a a E " �" °$ . f,:. a�`tc a AA zt ma - yS a 'CS a+ a . # a . .4h 9,' a 0 ,:mow ij 4 • h.a ry • g3 m =§-n as y � s Ll% 2 yy k s a'C - ar � . 3x8 '�` V ✓' �i 5 IT 4. ry LI Jlt If �„�,.,.�..�.... P .' a Or 0 d A.• • • - ir, .111/1b/LF714 tl'i:41 •Ljy5yl14bb U5 IAX ACCOUNTING_ PAGE 01/03 • • FLORIDA COMMUNITY RANK • • www,floridacommunitybonk.net • • • .• • Lest statement: November 30, 2013 Page 1 of 3 001687 ��, This statement December 31, 2013 1 1W' •• Total.days in statement period: 31 (.7,3) A6l'S `' a� Direct.inquiries to: . . Local Branch, 239 348-0186 TIGER MASONRY INC . . 3271 17TH AVE.5W Florida Community Bank, N.A. . NAPLES FL 34117.6117 5240 Golden Gate Pkwy • Naples, FL 34116 • Small Business Checl ig• . . • .Accatint.number . . . , Beginning balance 826,514.13 Enclosures 73 Total additions 96,937.38 . Total subtractions 86,460.25 Ending balance $36,991.26 CHECKS ' Number . . . Date.. • Amount Number Date Amount 5102 - . .. 12-02.._. • 1,715:58 "51-50- - __ .. .---12-16 1,238.07 5123 * • • 12-03 512 ___ _,425.44 5151- 12.16 .1,791:67 4 12-03 222.35 5152 12-17 5,068.66 • 5125 • 1.2-04 543.03 5153 12-16 349.81 5126 12-02 132.69 5154 12-16 364.16 • 5127 _ ' 12-03 4.99 5155 . 2-16� 555.68 5128 12-04 1,005.00 5156 12-16 549.48 5129'. • 12,-03 2,180.00 • 5157 , .12-19 549.48 5130 12-03 273.92 5158 12-16 5,250.60 .5131_ 12-02 555.68 5159 12-'18 4,480.00 ' 5132 12-03 •• 549.48 5160x_ .. 12=23 63.12 . 5134 ` 12-02 . 422.33 5161�"--� 12-24 "-' 235.15 • •• 5135. 1.2,02 . • 441.37 5162 1.2-24 543.03 5136 12-05 5,756.86' 5163• 12-23 1,860.00 • 5.1.37 . ,: . • 12-10 209•.88 514 12-23 420.00 5138 12-09 8,988.16 5165 • _ • 12-20 4,480:00 5139' __ 12.09. 4,760.00 51.66.- ,_._,._�12-30 _ _ 1.,00 000 • 5140 12-10 850.00 ' 5167 12-23 89.75 5141 . . 1.2-09 285.91 5168 12-23 422.33 5142 12-09 • ' 297.26 5169 • 12-23 441.37 5143 12-09 555.68 -61/0 12-23 555.68 • 5144 • • 12-09 . . 549.48 5171 .12-23 549.48 5145 - -...--` 12.06._ 549.4$ ST72 „ 12-19 . 5.49.48 5146„ • , 12-09 . 847.04 5173 12-26 427.3) 5147 12-16 3,389.93 5154"_..__...,_ .__1.2-23 - 870.23• . 5.148 12-13 417.31 5175 12-27 _225 O0 5149 12-17 -._� 2,265.00 5176 • 12-30 4.99 • MK PLEASE SEE SIDE FOP.IMPORTANT FDa FLORIDA COMMUNITY el • 12.55 TAM1AMt TRAIL;PORT CHARLOTTE.FL 33953 • TELEPHONE: 1 (8O&1 764-0006 Mom-, E -- R 171/1 b/Lk714 277:4z L j75 i//gb47 U5 I AX AC;UUUN I ING PAGE 02/03 t,r♦rt`,r r • kt .f. F FLORIDA C•MM(INLT,Y BANK ' www.Roridocammun•itybank.net • ••• • eelesr 2 • • • • '14t3ER MASONRY INC . Page 2 of 3 December 31, 2013 . 0003107833 •• Number Date Amount Number Date • Amount • . 5177 • _12-30 • 262.68 5131 ... . 12-31 549.48 51.73. •12430 275.61 5182 • 12-27 549.48 5179 17-30 .. 286.96 5133 . . 12-31 377.68 • . : 5'180 12-30 ' 555.68 • "Skip;in'.check sequence• .oE81TS • , . ' Date :Description . Subtractions • ••• •. 12-04 ' Preauthorized Wd 818.81 IRS USATAXPYMT•131.204 • . • • • . • • 12-11 ' Preautlto.rized•Wd . • . 722.56 • , , IRS USATAXIyYMT 131211 • . ' ---w�• 766.70 •.IRS USATAXPYMT 131218 - • • 8,263.18 CAPITAL ONE ONLINE PMT 131219 • 12-20 ' Preauthorized Wd • .•, 818.81 .IRS USATAXPY1911 1.312'20 . • • ' . 280.00 • IRS USA'TAXPYMT 131230 • • 12-30 Preauthorized Wd 716.26 • IRS USATAXPYNIT'131230 ' . . CREDITS. . , Date. . .•Description • . Additions • • • • 12-03 De posit: - 7,768.25 • '12.05 . Deposit . . .3,037.63 12-06 Deposit 7.318. 12-09 Deposit • — _ -`" 5,698.00 • . 12-11 'Deposit 2,375:00 • 12-1,2• Deposit . . _ , , • • 195.00 • - 12-13 Deposit . . . _ . 50,000.00 .- •12-16, Deposit • _ . • 1,425.00 • , 12718 •Deposit . . 6,750.00•. '1 -19,,,, Deposit• .,_ ,• 4,162.00 12-23' ,posit ' . '.. . . 7,318.25 _ _......_,... .12-27 Deposit.. 896• M r..o h r. PLEASE SEE_REVEPSE 3IDF FOR IMr�i7RTAt.:I.INtORMATION. • el FDIC FLORIDA COMMUNITY BANK 1253 TAMIAMI TRAIL, PORT CHARLOTTE,FL 33953 •TEI•EPHONE: 1 (856)764-0006 mum - Cg• 1 [El Guzzo Electric, LLC 799 E. Elkcam Circle Invoice Marco Island,FL 34145 Date ✓ • i Invoice# 'x/2014 , 5201 Bill To Tiger Masonry 3271 17th Ave SW Naples,FL 34117 E-mail susan@guzzoelectric.com Web Site www.guzz elecnic.com Terms Project/Service Phone# 239-642-6625 Due upon receipt • Hodge Res. Qty Description Furnish labor and material to complete the following electrical service Amount time period;12-17-13,12-18-13,12-19-13,12-20-13, 0.00 0.00 12-21-13,12-23-13,12-24-13,12-27-13,12-30-13,12-31-13,1-2-14,1-3 -14,1-6-14. Work completed during this time period represents rough wiring and or trim of the following items,including but not limited to: *Perform miscellaneous electrical repairs and installations as directed. Job Location: Hodge Residence 1461 Caxambus Ct. Marco Island,FL 77.5 Electrical Technician Hours: 71 Electrical Technician Hours: 75.00 5,812.50 Material Total: 35.00 2,485.00 3,359.54 3,359.54 Thank You for Choosing Guzzo Electric ! Total $11,657.04 E - t� 1 CUSTOMER#: 15663 =f Prout's PLUMBING, Inc. =. . „ - INVOICE#: 64902-5243 `�, •` - 881 Eatt Elkcam Circle Marco'lslnd;;Florida 34145 INVOICE DATE: 12/31/13 ':.�•�" 394-1668 • Fax:394-3908 DUE DATE: 01/20/14 I BILL TO: : LOCATION: TIGER MASONERY 1461 CAXAMBAS COURT 1461 CAXAMBAS COURT MARCO ISLAND, FL 34145 WORK ORDER NUMBER: 205243 YOUR REFERENCE NUMBER: { I 1 • DESCRIPTION QUANTITY PRICE AMOUNT REQUEST: 12/30-CHECK FARM INK IN :KITCHEN HOT AND COLD REVERSED. : CHECK DISHWASHER AND STOPS (STOPS DONT SEEM TO SHIT OFF). ANDI.IT IS ONLY .LUKE WARM. UPSTAIRS KITCHEN SUITE--FAUCET LEAKS. SHOWER GETS NO HOT WATER AND HOT SIDE StrOP ON VANITY NEEDS TO BE RELACED. 12/19: 1=REPAIR UPSTAIRS TOILET 1 2-F 8I MOEN S71708CSL KIT FPfUET:ONPREP SINK WITH MOEN 3942CSL AND SS AIR SCWITHC, ISE PRO DISPOSAL AND JBX128 BASKET STRAINERS:FOR.DISPOSAL FLANGE. 3-F&I (2) MOEN VOSS CHROME PATHROOM FAUCETS (BRING 1-K-2269-8-96 WITH FOR TIGER TO CUT OUT UINLESS HE PICKS UP FRIDAY) ! 4-F 8I MOEN CHROME BIDET FTC; T5269/9200 12/16-DISCONNECT 2 KITCHN SINKS.AND 1: MB LAV SINK FOR GRANITE (NEW IN KITCHN AND POSSIBLE SUT OUT FOR NEW STYLE SINK IN MB). ( DISCONNECT TUB TO SEE IF ATTACHED TUB WILL FIT. GOLD TO BRUSHED;NICKEL. 12/16/13 REED, DANIEL P { 2.50 hrs 88.0000 220.00 12/16/13 BIS 30 X:22 MEMOIRS SINK 2.00 937.8000 1.875.60 I 12/16/13 96 BIS IRON/TONES S 1.00 843.7000 843.70 12/16/13 CSL LF 1 HDL KTN FCT 2.00 677.2500 1,354,50 { ALL BALANCES OVER 30 DAYS.SUBJET TO FINANCE CHARGES AT A RATE OF 1.5% MONTHLY. I. f CUSTOMER#: 15663 ° !'rout's P UMBING, Inc. ,/,..!! _ 881 E Elkcarri Circle INVOICE#: 64902 5243 Marco Island, Florid a;34145: INVOICE DATE: 12/31/13 ;,.#9 _ ,3,64...„,66 • Fax'394-3908 DUE DATE: 01/20/14 BILL TO: LOCATION: 00026 TIGER MASONERY 9461 CAX,4MBAS COURT x461 CAXAMBAS COURT MARCO ISLAND, FL 34145 WORK ORDER NUMBER. 205243, YOUR REFERENCE NUMBER: I�ESC`RIPTIO QUANTITY PRIG AMOUNT 12/16/13 BR SHANK FLUIDM .STER E 1.00 25.0000 25.00 12/16/13'BLK AS DISC 1.00 6.1900 6.19 12/16/13 CHR ANG STOP 1.00 13.1800 13.18 12/16/13 BRNUT 1.00 2.0000 2.00 12/16/13-3/8"X 12 RIGID W/C SUPPLY 1.00 5.8000 5.80 12/19/13 AGUILERA, LUIS J 4.00 his 88.0000 352.00 12/19/13 JENSEN, CODY 4.00 58.0000 232.00 PRO 880 3 EA BAGS DISPOSAL ' 2.00 245.00©0 490.00 2IN ADMITTANCE VALVE 1.00 28.5400 28.54 1 1/2"P-TRAP W/TRAP ADAI T , 2.00 5.5000 11.00 2"PVC DWV COUPLING. I: 1.00 1.9650 1.97' 2"X11/2OWVSAN TEE 1.00 5:3058 5.31 2"'PVC SCH 40 RIPE 1.00 2.3833 2.38 DISP FL IN STAINLESS FIMSH 2.00 58.0000 116.00 ELEC CORD FOR DISPOSAL! 2.00 6.9500 13.90 RUBBER BOOT 1.00 3.2500 3.25 12/23/13 AGUILERA, LUIS J 5.00 his 88.0000 440.00 1 4' I 1 ALL BALANCES OVER 30 DAYS SUBJET TO FINANCE CHARGES AT A RATE OF,1.5% MONTHLY. • Ciaialrergov.net Report Title: Code Case Details Date: 1/31/2014 9:13:05 AM Case Number: cemis20140001202 Case Number: CEMIS20140001202 Status: Preliminary Review Case Type: Misconduct Date&Time Entered: 1/17/2014 6:46:22 AM Priority: Normal Entered By: RobinGanguli Inspector: robinganguli Case Disposition: Case Pending Jurisdiction: City of Marco Origin:Complaint Detail Description: Complaint regarding possible unlicensed/unpermitted activity being performed by Tiger Masonry Inc. Location Comments: 1461 Caxambas Ct. Marco Island, FL. 34145 .t 4 rit W4 P Y Qx *u..r . -+« �+�w� Mss .e '� ;� " ��- "P.�°"'i'.,.�� a-����:• � aa>� . G...,F V* ,.rttr«,C.A 01-.,.b.�L:6'%fa:1«&t 2T..r.-_.._ zorkEZIt ry Property 58113720009 J k .c _.�.ax., ..n x$'._ `.v., 3..✓ ... ...... s ......:.�.,a ..._.._.. ..s..._'a\ Contractor Tiger Masonry, Inc. Property Owner Hodge, Ronald C. Business Management&Budget Office 1 IG Code Case Details Execution Date 1/31/2014 9:13:05 AM �, ,.�..�.Ne<__�� �u.�.a.+.�t� ��?���.�` �asacw.,x.�,€�. f.._ _ .e. .,.;3.. ..s�...x�w.�t�✓e>.zs..s �:m:-.M.��•an"�- �._�,,a� � Desc Assigned Required " Completed Outcome Comments Preliminary Investigation robinganguli 1/3/2014 1/3/2014 Needs 1/3/14.Complaint received regarding possible Investigatio unlicensed/unpermitted activity at 1461 n Caxambas Ct.Marco Island, FL.34145.On site with Marco Island Inspector Gary Konicek observed Roger L.Call of Tiger Masonry Inc. on the property. Inspector Konicek and I observed extensive work on a boat lift/dock in the rear of the property where Mr.Call was observed returning from.When asked what he was doing on the property,Mr.call responded that he was giving an estimate to repair a hole in a concrete retaining wall.Unable to contact the property owner at the time.A STOP WORK order was posted by Inspector Konicek at this time for the bost IifUdock work for no permitting on file.Retumed to the property later in the day and met with the new owner,Ronald C.Hodge,who advised that he had recently purchased in December,2013. When asked about his hiring of Tiger Masonry Inc.,Mr.Hodge advised that he had paid a deposit of$50,000.00 to them to perform a various scope of work to be performed including a kitchen remodel with new countertops,electrical and plumbing work,as well as the boat lift/dock.Mr. Hodge advised that he had not directly paid other companies that had worked on his property and that Tiger masonry Inc.was"overseeing"these payments for him.When I inquired if a copy of a contract existed,Mr.Hodge advised that everything was done verbally. Mr.Hodge informed me that he was a business man from Maine,and was not aware of the protocol of how construction projects were handled in Florida.I advised Mr.Hodge of specific the licensure and permitting requirements for what he had described and which Tiger Masonry Inc.did not possess.Mr.Hodge was informed of the STOP WORK order in place until my investigation was conducted and he stated that he would obtain a copy of the cancelled$50,000.00 check paid to the contractor.for my usage. Cont.Investigation RobinGanguli 1/8/2014 1/8/2014 Complete 1/8/14.Phone call to Mr.Hodge seeking the copy of the cancelled$50,000.00 check paid to Tiger Masonry Inc. Mr.Hodge advised me that he wanted to seek legal counsel prior to any further activity.Advised Supervisor Ossorio of this development.Directive given to schedule a meeting with Tiger Masonry Inc. qualifier,Deborah Plummer. Business Management&Budget Office 2 Code Case Details Execution Date 1/31/2014 9:13:05 AM Desc Assigned Required Completed Outcome Comments Cont. Investigation RobinGanguli 1/8/2014 1/8/2014 Complete 1/8/14. Phone message received by Tiger Masonry Inc.corporate officer,Patrick Lagemann who advised that he was the president of the company and was inquiring what was being investigated.After initially claiming that they were onsite to provide an estimate for a small concrete repair,Mr. Lagemann now claimed that that the contract for work was with Stagecoach Restorations L.L.C./CGC1511821.Previous violations against Tiger Masonry Inc.on 6/18/13,cases #CEUL20130008693 and #CECV20130008704 where citations were issued for license and permitting violations resulted in the same explaination involving Stagecoach Restorations L.L.C.Investigation into these violations resulted in no involvement of Stagecoach other than to take over the jobsite and obtain required permitting after the fact. Phone messsage left for qualifier of Stagecoach,Randall Shannon,but no response received. Cont. Investigation RobinGanguli 1/10/2014 1/10/2014 Complete 1/10/14. Meeting with Deborah Plummer. Advised her of jobsite encounter with Mr.Call, $50,000.00 check made payable to Tiger Masonry,and my investigation into the scope of work performed.Ms. Plummer claimed that she had no knowledge of the funds paid and that she and corporate officers,Roger Call and Patrick Lagemann were"friends"of the property owner.When I inquired about the name of the property owner,Ms.Plummer was initially unable to produce Mr.Hodge's name. Ms.Plummer then informed me that all field operations for Tiger Masonry Inc.were conducted by Mr.Lagemann and Mr.Call.I advised her that as qualifier,she was ultimately the responsible party.A directive was given to research her records for evidence of the$50,000.00 deposit and to contact me after the weekend. Cont. Investigation robinganguli 1/14/2014 1/14/2014 Complete 1/14/14. Phone call received from Ms. Plummer who stated that she was unable to find any evidence of payment of the $50,000.00 deposit to Tiger Masonry Inc.from Mr.Hodge. Informed Supervisor Ossorio who directed that I schedule a second meeting with Ms. Plummer to provide the past two months of the bank statements for Tiger Masonry Inc. Business Management&Budget Office 3 Code Case Details Execution Date 1/31/2014 9:13:05 AM Desc Assigned Required Completed Outcome Comments Cont.Investigation RobinGanguli 1/16/2014 1/16/2014 Complete 1/16/14.Meeting with Superisor Ossorio and Ms. Plummer who admitted that Tiger Masonry had accepted a$50,000.00 deposit out of a total$120,000.00 bid for general contracting work beyond the scope of their masonry and concrete forming licensures.Ms. Plummer stated that"her brother had gone rogue"with her license and that she had contacted Stagecoach Restorations L.L.C. again to take over the jobsite and obtain any permitting required.Ms.Plummer advised by Supervisor Ossorio that she would be receiving a Notice to Appear in front of the Contractors'Licensing Board for the misconduct of having worked beyong the scope of their licensure and without a building permit for the second time. Cont. Investigation RobinGanguli 1/17/2014 1/17/2014 Complete 1/17/13.Contacted City of Marco Island Building Official Jack McStravic to advise of undocumented and unpermitted work admitted to by Tiger Masonry Inc.as well as Stagecoach Restorations L.L.C.takeover of the jobsite.Mr.McStravic advised that he would require inspections of the jobsite before approving any permit application submitted to verify all work had been accounted for. Contacted,qualifier of Stagecoach, Randy Shannon,to inform him of Building Official's directive and advised him to contact Mr. McStravic for specifics. Cont. Investigation RobinGanguli 1/30/2014 1/31/2014 Complete 1/30/14.Inspection conducted by City of Marco Island Building Official,Jack McStravic, and determination of permitting requirements for scope of work performed,inclusive of plumbing and electrical,made by him. Photos of completed work taken.Subcontracts to other companies from Tiger Masonry Inc. obtained.Case scheduled for February 19th, 2014 Contractors'Licensing Board Hearing. Investigation robinganguli 2/19/2014 Pending _'" a �4,na=='(�€.. � 2 .rte � `V�; Violation Description Status Entered Corrected Amount Comments 4.1 Misconduct-County/City Open 1/17/2014 $0 Certificate of Competency tee a _rte o ... teh»� a t'�.,f c..._ <r' .. .�.�� -- ..����y ae� � �.. y re..�k : __��"r k_<e: Title Reason I Result Compliance j Fine/Day Condition Business Management&Budget Office 4 t • tergovitet Report Title: Code Case Details Date: 1/16/2014 8:20:02 AM Case Number: ceu120130008693 Case Number: CEUL20130008693 Status: Closed Case Type: Unlicensed Date&Time Entered: 6/19/2013 7:35:28 AM Priority: Normal Entered Sy: RobinGanguli inspector: robinganguli Case Disposition: Paid Jurisdiction: City of Marco Origin: Complaint Detail Description: Plummer, Deborah J. $300 citation#7733 issued for unlicensed general contracting. Location Comments: 861 S. Collier Blvd.#406 Marco Island, FL.34145. rr M O a. s^ .g,... x e .x .,. ,t�,.:-..,�°:. . 'fan ;", WIdtZ .,..F _,. Propertyl31330001065 J �` d i? E gigla t x �� - rz `��, m "R�r;. -ui" x ''3 a t € .,... ;�e,c:,>;.t?�, .._... sue.. , ._..��.xs ..,ate.,�,....k'��._. �,�...r�..w .._..�.�.��. ,..,..... . .. ...... ..�.�.> ,.� i�; at-=�...�..�....x..�� x ?�� .::. ......� ContractorlTiger Masonry, Inc. Business Management&Budget Office 1 a--O Code Case Details Execution Date 1/16/2014 8:20:02 AM Desc ! • Assigned Required! Completed Outcome Comments • Preliminary Investigation robinganguli 6/18/2013 6/18/2013 Citation 6/18/13.Complaint received regarding Tiger Required Masonry Inc.C.C.certificate#18458/concrete -masonry contractor performing unpermitted renovation in condominium unit located at 861 S.Collier Blvd.#406 Marco Island, FL.34145. On site with Inspector Kim Ferns observed Tiger Masonry employee Roger Call performing a bathroom renovation to include drywall,cabinet installation and removal of plumbing fixtures for replacement. No permits on file.STOP WORK order posted. Mr.Call put Inspector Ferris in contact with qualifier Randy Shannon of Stagecoach Restorations L.L.C./CGC1511821 for fulfillment permitting requirements.Mr.Shannon informed Inspector Ferris that he would take over the jobsite. Issue Citation(Licensing) robinganguli 6/18/2013 6/18/2013 Complete 6/18/13.$300 citation#7733 issued to qualifier for Tiger Masonry Inc.Deborah Plummer for unlicensed general contracting and signed for by Roger Call as her onsite agent. Citation Paid/Contested clements_k 7/3/2013 6/21/2013 Payment Received '+, s-h "...Yr .�,+, - �t5 ... wag . - '` y,E A '' +r•. �, r, y .,. � ti bra'" xi __ •.� ,. ., �.�, .�.�.����.�...�x,.-. s'•-- -,-r:.,�„�+,. <..s. N..< ,�k.., � +e. �3-a ` o_.���.�'e »..,, .��' Violation Description • Status Entered Corrected + Amount Comments Unlicensed General Contracting Open 6/19/2013 $300 Title I Reason I Result Compliance Fine/Day I Condition Business Management&Budget Office 2 teirgo z Report Title: Code Case Details Date: 1/16/2014 8:20:56 AM Case Number: cecv20130008704 ..a.. ...� ..-ti,.. i.-.ix:'m-.. -,b' ..,-k.�A$f'.h.�"•..,d..�C.a«.a..--. fi..;�: Case Number: CECV20130008704 Status: Closed Case Type: Code Violation Date&Time Entered: 6/19/2013 8:19:37 AM Priority: Normal Entered By: RobinGanguli Inspector. robinganguli Case Disposition: Paid Jurisdiction: City of Marco Origin: Complaint Detail Description: Plummer, Deborah J. $300 citation#7734 issued for commencing work without a permit. Location Comments: 861 S.Collier Blvd.#406 Marco Island, FL. 34145 s xa,.-. _<....< mu „.ate, «t.�,...,�,w.:,,vc .,k Ag.a ...«<r ..w:stdf .^ ,._. . ..x.m.«, . ., »av, >.°,'., , n`` ..gt ,.bxi«a.i..«,aaa � x Property j 31330001065 PetWOMESMWRIPORManagniMPUTIVIIMMUNSIFIMPlatirai ireaniew fig` Contractor'Tiger Masonry, Inc. Business Management& Budget Office 1 Code Case Details Execution Date 1/16/2014 8:20:56 AM ,AgN : ......,...� .wm • Desc Assigned Required ' Completed Outcome Comments Preliminary Investigation robinganguli 6/18/2013 6/18/2013 Citation 6/18/13.Complaint received regarding Tiger Required Masonry Inc.C.C.certificate#18458/concrete -masonry contractor performing unpermitted renovation in condominium unit located at 861 S.Collier Blvd.#406 Marco Island, FL.34145. On site with Inspector Kim Ferris observed Tiger Masonry employee Roger Call performing a bathroom renovation to include drywall,cabinet installation and removal of plumbing fixtures for replacement.No permits on file.STOP WORK order posted.Mr.Call put Inspector Ferris in contact with qualifier Randy Shannon of Stagecoach Restorations L.L.C./CGC1511821 for fulfillment permitting requirements. Mr.Shannon informed Inspector Ferris that he would take over the jobsite. Issue Citation(Licensing) robinganguli 6/18/2013 6/18/2013 Complete 6/18/13.$300 citation#7734 issued to Tiger Masonry Inc.qualifier Deborah Plummer for commencing work requiring a building permit and signed for by employee Roger Call as her on site agent. Citation Paid/Contested clements_k 7/3/2013 6/21/2013 Payment Received Violation Description Status Entered Corrected Amount Comments Commencing Work Without A Permit Open 6/19/2013 $300 Title Reason Result Compliance Fine/Day 1 Condition Business Management& Budget Office 2 SECTION 105 PERMITS Page 1 of 7 105 SECTION 105 PERMITS 105.1 Required. Any owner or authorized agent who intends to construct, enlarge, alter, repair, move, demolish, or change the occupancy of a building or structure, or to erect, install, enlarge, alter, repair, remove, convert or replace any electrical, gas, mechanical or plumbing system, the installation of which is regulated by this code, or to cause any such work to be done, shall first make application to the building official and obtain the required permit. 105.1.1 Annual facility permit. In lieu of an individual permit for each alteration to an existing electrical, gas, mechanical, plumbing or interior nonstructural office system(s), the building official is authorized to issue an annual permit for any occupancy to facilitate routine or emergency service, repair, refurbishing, minor renovations of service systems or manufacturing equipment installations/relocations. The building official shall be notified of major changes and shall retain the right to make inspections at the facility site as deemed necessary. An annual facility permit shall be assessed with an annual fee and shall be valid for one year from date of issuance. A separate permit shall be obtained for each facility and for each construction trade, as applicable. The permit application shall contain a general description of the parameters of work intended to be performed during the year. 105.1.2 Annual permit records. The person to whom an annual permit is issued shall keep a detailed record of alterations made under such annual permit. The building official shall have access to such records at all times or such records shall be filed with the building official as designated. 105.1.3 Food permit. As per Section 500.12, Florida Statutes, a food permit from the Department of Agriculture and Consumer Services is required of any person who operates a food establishment or retail store. 105.2 Work exempt from permit. Exemptions from permit requirements of this code shall not be deemed to grant authorization for any work to be done in any manner in violation of the provisions of this code. Permits shall not be required for the following: Gas: 1. Portable heating appliance. 2. Replacement of any minor part that does not alter approval of equipment or make such equipment unsafe. Mechanical: 1. Portable heating appliance. 2. Portable ventilation equipment. .111/x1.,,«.1.,0/1/10 ,., . ..,/T7/,.:lannnn 'CT // n/c/nnno ARTICLE V.BUILDING TRADES* Page 27 of 36 (i) Any individual who fails to renew his/her certificate of competency prior to December 31 of the year following its expiration shall thereby automatically have a certificate of competency that is null and void. To acquire a valid certificate from the county the individual must pay the then applicable full application fee in accordance with the schedule of fees and charges adopted by resolution pursuant to section 22-182(a)(4) herein, and must submit an entire new application. If, as of the date of receipt by the county of said new application, three years have passed since the date of his/her most recent examination that the individual passed to acquire the former certificate, that individual must pass all then applicable testing requirements. If the request is to reactivate a dormant certificate, the re-testing requirement can be waived by staff if the applicant proves that he/she has been active in the trade in another jurisdiction, or has been active as an inspector or investigator in the trade; or for other valid reason that would render such re-testing superfluous. (Ord. No. 90-105, § 1.4; Ord. No. 92-61, § 1; Ord. No. 94-34, § 1; Ord. No. 97-68, § 1, 10-28-97; Ord. No. 99-45, § 1.4--1.4.9, 6-8-99) Secs. 22-192--22-200. Reserved. DIVISION 3. STANDARDS OF CONDUCT AND DISCIPLINE* *State law references: Discipline of contractors, F.S. §§489.129, 489.533. Sec. 22-201. Misconduct--Collier County/city certificate of competency. The following actions by a holder of a Collier County/city certificate of competency shall constitute misconduct and grounds for discipline pursuant to section 22-202: (1) Knowingly combining or conspiring with an unlicensed contractor by allowing one's certificate of competency to be used by an unlicensed contractor with intent to evade the provisions of this article. When a licensed contractor acts as the qualifying agent for any firm without first making application under this article to represent said firm, such act shall constitute prima facie evidence of intent to evade the provisions of this article. When a certificate holder allows his certificate to be used by one or more companies without having any active participation in the operations, management, and control of such companies, such act constitutes prima fade evidence of an intent to evade the provisions of this article. Active participation requires job site supervision, knowledge of and participation in the business operations of the company, including all contractual matters. a. If any individual qualifying any business organization ceases to be affiliated with such business organization, he shall so inform the board. In addition if such individual is the only certified individual affiliated with the business organization, the business organization shall notify the board of the individual's termination and shall have no more than 60 days from the date of termination of the individual's affiliation with the business organization in which to affiliate with another person certified under the provisions of this article. In any event, the business organization shall not enter into any new contracts and may not engage in any new contracting until such time as a qualifying agent is employed. (2) Contracting to do any work outside of the scope of his competency as listed on his ARTICLE V. BUILDING TRADES* Page 28 of 36 competency card and as defined in this article or as restricted by the contractors' licensing board. (3) Abandoning a construction project in which he is engaged or under contract as a contractor. A project may be presumed abandoned if the contractor terminates the project without just cause, or fails to notify the owner in writing of termination of the contract and basis for same, or fails to perform work for 90 consecutive days without just cause and no said notice to the owner. (4) Diverting funds or property received for execution of a specific contract project or operation or diverting funds earmarked for a specified purpose to any other use whatsoever. (5) Departing from or disregarding in any material respect the plans or specifications of a construction job without the consent of the owner or his duly authorized representative. (6) Disregards or violates, in the performance of his contracting business in the county, any of the building, safety, health, insurance or workers' compensation laws of the state or ordinances of this county. (7) Falsifying or misrepresenting any material fact in his application and supporting papers for the purpose of obtaining a certificate of competency under this article. (8) Committing mismanagement or misconduct in the practice of contracting that causes financial harm to a customer. Financial mismanagement or misconduct includes, but is not limited to, any of the following: a. The contractor fails to fulfill his contractual obligations to a customer because of inability, refusal or neglect to pay all creditors for material furnished or work or services performed in the operation of the business for which he is licensed, under any of the following circumstances: 1. Valid liens have been recorded against the property of a contractor's customer for supplies or services ordered by the contractor for the customer's job; the contractor has received funds from the customer to pay for the supplies or services; and the contractor has not had the liens removed from the property, by payment or by bond, within 30 days after the date of such liens; 2. The contractor has abandoned a customer's job and the percentage of completion is less than the percentage of the total contract price paid to the contractor as of the time of abandonment, unless the contractor is entitled to retain such funds under the terms of the contract or refunds the excess funds within 30 days after the date the job is abandoned; 3. The contractor's job has been completed, and it is shown that the customer has had to pay more for the contracted job than the original contract price, as adjusted for subsequent change orders, unless such increase in cost was the result of circumstances beyond the control of the contractor, was the result of circumstances caused by the customer, or was otherwise permitted by the terms of the contract between the contractor and the customer. b. The contractor's job been completed, and it is shown that the customer has incurred financial harm by having to seek a variance or other administrative remedy because of actions by the contractor. (9) Performing any act which assists a person or entity in engaging in the prohibited unlicensed practice of contracting, if the licensed contractor knows or should have known that the person or entity was unlicensed. ARTICLE V. BUILDING TRADES* Page 29 of 36 (10) Failing to promptly correct faulty workmanship or promptly replace faulty materials installed contrary to the provisions of the construction contract. Faulty workmanship means work that is not commenced, not continued, or not completed in accordance with all specifications of the applicable written agreement. Faulty workmanship includes any material flaw(s) in the quality and/or quantity of the unfinished work product, including any item that does not function properly as a part of the entire project. If there is no written agreement provision regarding the specific faulty workmanship issue, faulty workmanship exists if the work, process, product or part thereof does not meet generally accepted standards in Collier County in relation to the entire project. Faulty workmanship does not include matters of aesthetics unless the aesthetically related item clearly violates a written contract specification directly related thereto. (11) Failure to maintain at all times, with an insurance company authorized to do business in the state, the limits of liability and other categories of insurance as required by this article. (12) Failing to claim or refusing to accept certified mail directed to the contractor by the contractors' licensing board, or its designee. (13) Failing to maintain a current mailing address. (14) Failing to appear in person or through a duly authorized representative at any scheduled hearing on a complaint filed against the contractor. (15) Being convicted or found guilty, regardless of adjudication, of a crime in the county which directly relates to the practice of contracting or the ability to practice contracting. (16) Allowing another to take a qualifying examination on the applicant's behalf. (17) Engaging in contracting business in the county or the city when prohibited from doing so by the contractors' licensing board. (18) Proceeding on any job without obtaining applicable permits or inspections from the city building and zoning division or the county building review and permitting department.. (19) Failing in any material respect to comply with the provisions of this article as a contractor or as a qualifying agent for a business entity engaging in contracting. (20) Signing a statement with respect to a project or contract falsely indicating that the work is bonded; falsely indicating that payment has been made for subcontracted work, labor, or materials which results in a financial loss to the owner, purchaser, or contractor; or falsely indicating that workers' compensation and public liability insurance are provided. (21) Failure of a qualifying agent for a firm/legal business entity to comply with the requirements set forth in F.S. §§489.119 and 489.1195. (22) Falsifying or misrepresenting any material fact to another person with the intent or for the purpose of engaging in the contracting business, providing materials or services, or soliciting business for an employer, as a contractor, or as an employee, regardless of any financial consideration. (23) Failing or refusing to provide proof of public liability and property damage insurance coverage and workers compensation insurance coverage. (24) Misconduct in the practice of contracting (see section 22-201.1 below). (Ord. No. 90-105, § 4.1; Ord. No. 92-61, § 4; Ord. No. 94-34, § 4; Ord. No. 97-68, § 1, 10-28-97; Ord. No. 99-45, §4.1--4.1.24, 6-8-99)