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CLB Agenda 08/19/2015 Co er County COLLIER COUNTY CONTRACTORS' LICENSING BOARD AGENDA AUGUST 19, 2015 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: July 15, 2015 V. DISCUSSION: VI. NEW BUSINESS: (A) Orders Of The Board (B) David M Jones, Love Landscape Inc.-Waiver of Exam(s) (C) Octavio E. Calderon, All in 1 Drywall & Painting, Inc.-Verification of Experience (D) William Orr-Contesting Citation 09365 (E) Cesar Franco, Finishing By Franco, Inc.- Review of Credit (F) Bradley G. Johnson, Just Fix It of SWFL, Inc.- Review of Credit (G) Locke,Thomas, L.C. Stoneworks- Reinstatement of license C30407 VII. OLD BUSINESS: (A) Teodor Danilov, Custom Flooring Design Inc—6 Month Review Of Credit (B) Abel Arredondo, Superior Woodworking, Inc.- Review of Probation VIII. PUBLIC HEARINGS: (A) Case 2015-04-Joseph Brown-DBA Anything in Doors,/LLC-C31217 (B) Case 2015-05-Michael Paul Taillefer-DBA Imperial Homes Inc.,/CBC1257228 IX. REPORTS: X. NEXT MEETING DATE: WEDNESDAY, SEPTEMBER 16, 2015 COLLIER COUNTY GOVERNMENT CENTER ADMINISTRATIVE BUILDING THIRD FLOOR IN COMMISSIONER'S CHAMBERS 3299 E.TAMIAMI TRAIL NAPLES, FL 34112 July 15, 2015 MINUTES OF THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD MEETING July 15, 2015 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: Patrick White Vice Chair: Thomas Lykos Members: Terry Jerulle Richard Joslin Kyle Lantz Gary McNally Excused: Michael Boyd 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 Rob Ganguli — Collier County Licensing Compliance Officer 1 July 15, 2015 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 said proceedings is made, which record includes the testimony and evidence upon which any Appeal is to be based. I. ROLL CALL: Chairman Patrick White called the meeting to order at 9:00 AM and read the procedures to be followed to appeal a decision of the Board. Roll call was taken and a quorum was established; six (6)voting members were present. Michael Ossorio noted Ronald Donino had resigned from the Contractors' Licensing Board to serve on the Code Enforcement Board. II. AGENDA—ADDITIONS OR DELETIONS: (None) III. APPROVAL OF AGENDA: Vice Chairman Thomas Lykos moved to approve the Agenda as submitted. Richard Joslin offered a Second in support of the motion. Carried unanimously, 6—0. IV. APPROVAL OF MINUTES—MAY 20, 2015: Gary McNally moved to approve the April 15, 2015 minutes as presented. Terry Jerulle offered a Second in support of the motion. Carried unanimously, 6— 0. V. DISCUSSION: • Michael Ossorio requested the Board hear Item VII-A("Old Business") first, followed by Item VIII-A("Public Hearings"), and then resume following the Agenda as previously approved. Chairman White polled the Board; there were no objections to changing the order of the Agenda. VII. OLD BUSINESS: A. Mikel G. Diehl—Review of Credit(3 Month) (d/b/a: "Florida Hardscapes &Paver Maintenance, Inc.") Chairman White noted Mr. Diehl's Attorney delivered a Memorandum to the Board concerning the Agenda item prior to the Hearing. William Hazard,Esq., of Coleman, Hazard and Taylor, represented Mr. Diehl. He explained Mr. Diehl uses his middle name, Garrett,to distinguish himself from his father, also named Mikel Diehl. 2 July 15,2015 Attorney Hazard stated: • There has been a great deal of confusion regarding his client's credit report since both he and his father are "Mikel" Diehl. • His firm was hired by Garrett Diehl to help correct several errors on his credit report. • His firm will consult the three credit reporting agency to discuss how to remove the items from Garrett Diehl's and his company's credit reports. • Some of the areas of confusion: o Garrett Diehl's company is Florida Hardscapes &Paver Maintenance, Inc. o Mikel Diehl's former company was M&C Florida Pavers, Inc. o Mikel Diehl's company was dissolved in 2011. o Garrett Diehl had previously worked for his father. o Garrett Diehl opened his company prior to the dissolution of his father's company. • The two items on the credit report of concern to the Board: the tax liens and the judgment. Mr. Hazard stated both items were related to Mikel Diehl's company,M&C Florida Pavers, Inc. • He noted the tax liens (See: Tabs 8, 9, and 10 of the Memorandum) recorded by the Florida Department of Revenue referenced Mikel Diehl's company, not Florida Hardscapes & Paver Maintenance, Inc. • Relationship between the two companies: Mikel Diehl currently works for Garrett Diehl. • Attorney Hazard referenced Tab 11, stating the judgment was initially entered in Lee County's Circuit Court (Case #12-CC-1727—May, 2012). o Parties to the action: Tri-Circle Pavers, Inc. (Plaintiff) vs. M&C Florida Pavers, Inc. and Mikel Diehl (Defendants). o Amount of the judgment was $6,744.49. • He further noted similarly named companies located in Margate and Coconut Creek, Florida, were not affiliated with Garrett Diehl's company. (See: "Corporate Linkage"—last page of Experian's Credit Report) Chairman White asked who had been the Qualifier for M&C Florida Pavers,Inc. Attorney Hazard answered Garrett Diehl was the Qualified until he left his father's employment to form his own company (documents were filed with the Secretary of State on 02/16/2010; effective 03/01/2010). • It was noted the tax liens were recorded in 2011 and November, 2012. Chairman White questioned whether Garrett Diehl had been an officer in M&C Florida Pavers, Inc.; if he had been the Qualifier while serving as an officer of his father's company, and if he continued to be an officer after he was no longer the Qualifier. Attorney Hazard referenced Tab 4 of the Memorandum. He stated when Mikel Diehl filed ("Detail by Entity Name")with the Secretary of State's Divisions of Corporations in February, 2010 he was the only Officer and Director listed for M&C Florida Pavers, Inc. He further stated Garrett Diehl removed "d/b/a Florida Pavers" when he removed himself as the Qualifier for his father's company and formed his own business. 3 July 15,2015 Garrett Diehl stated when he switched his license to apply it to his company, Florida Hardscapes &Paver Maintenance,Inc., he requested that the Division of Corporations drop the d/b/a because he did not want his company to be associated with Florida Pavers. Michael Ossorio noted in March, 2014, Garrett Diehl paid a re-instatement fee, a new license fee, and back year fees (2011 —2013)to obtain his license. Chairman White requested clarification concerning when the "d/b/a"was changed and Garrett Diehl was no longer the Qualifier and Officer for his father's company. Attorney Hazard referenced Tabs 2 through 5 of the Memorandum which traced the dissolution of Mikel Diehl's company and the creation of Garrett Diehl's company. Vice Chairman Lykos directed his questions to Attorney Hazard and Mr. Diehl: Q. When was M&C dissolved? A. In 2011 (see Tab 2)—specifically September 23, 2011. The entity stopped filing its Annual Reports in 2010. Q. When did Garrett stop acting as the Qualifier for M&C? A. Florida Hardscapes &Paver Maintenance,Inc. was formed in 2010. Q. His company was established in 2010. But when did he stop acting as the Qualifier for M&C? A. (GD) Once the company was dissolved, I did not renew my license. Q. You let your license become suspended and then void? You didn't formally terminate your qualification of that company—you just let your license lapse? A. (GD) Yes. Q. When did that occur? Do we have that date? Michael Ossorio stated it was sometime in 2011 —the license was suspended and then was null and void. He did not renew in 2010. In September, 2010, his license became delinquent for three months. In 2011, it was suspended and null/void in 2012. He appeared before the Board in 2014 to request to have his license reinstated without taking any exams and because of the credit issues. Chairman White noted because Garrett Diehl's license did not become null and void until January 1, 2012, liability could attach to him as the Qualifier of M&C up to that point. He had not formally or affirmatively acted to end his role as Qualifier of his father's company. Attorney Hazard agreed it was possible. Chairman White continued the only thing he saw was the Administrative Dissolution of M&C—there was no formal termination of M&C as a corporate entity. If there had been, it might have resolved the issues pertaining to the tax liens and other matters. Attorney Hazard stated while he did not represent Mikel Diehl, he understood that Mr. Diehl went through a personal bankruptcy. He was not aware of whether the judgment had been discharged as a result of the bankruptcy. Chairman White stated he was not convinced that Garrett Diehl did not have any financial exposure or responsibility up to January 1, 2012. He noted the Board was being asked to evaluate Garrett Diehl's credit-worthiness to go forward without any 4 July 15,2015 probationary period. He further stated he was not comfortable to do so, based on the information that was only recently presented to the Board. Chairman White asked Attorney Hazard if he and his client would like additional time to resolve the matter. Attorney Hazard suggested six months should be sufficient. Chairman White suggested that the Board should be presented with a parallel tracking of what happened with M&C's business dealings and a parallel track showing the points in time when Garret's believed the negative credit reporting events took place. Vice Chairman Lykos noted his other issue was that a Qualifier of a company carried the responsibility and liability of the company—not until a credit report states that he/she was finished—but when Collier County acknowledged that he/she no longer had that responsibility. He stated Garrett Diehl was the qualifying agent for his father's company up to the end of 2011; tax liens were filed during that reporting period. His responsibility as a qualifying agent extended to the end of 2011. Chairman White noted a mechanism existed to allow a qualifying agent to resign as the Qualifier of a company. He stated nothing had been produced confirming that Mr. Diehl had resigned. The only thing the Board was relying on was the status of his license. Kyle Lantz stated that, in his opinion, since Garrett Diehl was the qualifying agent for his father's company until it was dissolved, he is responsible for the tax liens and the judgment. He further stated he hoped Mr. Diehl could provide clarification of when his association with his father's company actually ended when returned in six months. Richard Joslin stated because a license was not renewed did not necessarily remove a qualifying agent from his/her responsibility as a Qualifier for a company. Michael Ossorio confirmed that a Qualifier of a company could submit a letter to Collier County, as well as to the company, stating he/she no longer wanted to remain as the qualifying agent for the company. If the Qualifier did not have any ownership in the company, his/her license would have been put into dormant status. Gary McNally moved to approve requesting Garret Diehl produce a current credit report when he appeared before the Board in six months. Chairman White clarified the form of the motion was the Board would grant a six- month extension of the probationary license issued to Garrett Diehl and he was required to produce updated personal and business credit reports for the Board at the end of the probationary period. Richard Joslin offered a Second in support of the motion. Carried unanimously, 6—0. VIII. PUBLIC HEARINGS: A. Case 2015-03: Louis Bruno, IV, d/b/a "Bruno Air Conditioning of SW FL" Michael Ossorio stated Attorney Patrick Neale had asked to address the Board prior to opening the Public Hearing. 5 July 15,2015 Attorney Neal stated a Request for a Continuance had been filed with the Board on Monday, July 13, 2015, because he had only recently been retained by Mr. Bruno to represent him. He further stated he was in discussion with Collier County to try to resolve the matter without the necessity of requiring a Public Hearing. He requested a two-month continuance of the matter. Michael Ossorio stated the County would not object if the Board granted a two- month continuance to the Respondent. Richard Joslin moved to approve granting Respondent Louis Bruno's Request for a Continuance for a period of two months in Case#2015-03. Attorney Neale stipulated the motion would serve\as legally sufficient notice and the Respondent must resolve the credit issues prior to September or appear before the Board at the September hearing. Gary McNally acknowledged he had a relationship with Bruno Air and would not vote on the motion. He stated he intended to disclose this information at the Public Hearing. Chairman White clarified the motion to grant the requested Continuance was procedural and would not be affected by Mr. McNally's relationship to Bruno Air. He suggested Mr. McNally discuss the issue with the Board's Attorney after the meeting and prepare the appropriate paperwork for the September meeting. Attorney James Morey, Attorney for the Board, confirmed there were no issues preventing Mr. McNally from voting on the Continuance since substantive matters were not addressed. Chairman White called for a vote on the motion, asking if there were any objections from the Board. There were none. Carried unanimously, 6— 0. VI. NEW BUSINESS: (Note: With reference to the cases heard under Section VI, the individuals who testified were first sworn in by the Attorney for the Board.) A. Orders of the Board Gary McNally moved to approve authorizing the Chairman to sign the Orders of the Board. Vice Chairman Lykos offered a Second in support of the motion. Carried unanimously, 6—0. B. Samuel Compere—Contesting Citation #09411 Citation: #09411 ("Working without a Building Permit") Date Issued: June 2, 2015 Fine: $1,000.00 6 July 15,2015 Description of Violation: Commence or perform work for which a Building Permit is required pursuant to an adopted State minimum Building Code or without such permit being in effect. C. Samuel Compere—Contesting Citation #09412 Citation: #09412 ("Unlicensed Contracting—Fence Installation") Date Issued: June 2, 2015 Fine: $1,000.00 Description of Violation: Engage in the business or act in the capacity of a Contractor, or advertise self or business organization as available to engage in the business of or act in the capacity of a Contractor, without being duly registered or certified. Chairman White stated the Board would hear the cases concomitantly. Reverend Jim Yun Israel, who was Samuel Compere's Pastor, served as the translator for him. Attorney Morey advised Rev. Israel of the necessity to relay exactly what was being said truthfully and accurately. Rev. Israel responded, "Yes." Joseph De Rival, the owner of 2571 47th Terrace SW,Naples, FL, was also present. Chairman White asked Samuel Compere how he would like to proceed. (Rev. Israel responded for Mr. Compere.) A. The reason is because he did not know that he needed a permit or license—that's why he did it—he does not like to have any problems. He said, "I was given two tickets." Q. Yes—we call them Citations or tickets. Richard Joslin: Q. What type of fence was installed? A. (Joseph De Rival) A chain fence. Q. A chain link fence? A. Yes. Q. Like the one in the picture? Joseph DeRival: If you allow me to talk to you—we did not know if we need to have a permit and license to do so. Then as soon as we know, we did stop doing the fence. And me,personally, I go to the Building Office to get an application permit— two days or three days after I'd been to 2571 47th Terrace SW. Someone meet me there—Brother Samuel was not there—and he asked me, "Who is doing the job?" Then I show him the permit application and he said I need to see Brother Samuel. When I went to his office with Brother Samuel, he said to Brother Samuel that he 7 July 15,2015 needs to have a license to do so. Then he said, "I'm going to give you two Citations." I said we did stop doing the job until we get the permit. He said, "Somebody called me and talked to me about it, then I have to give you the Citation." I said, "Instead of give the Citation—why you no give a warning because we don't do the job." Then as soon as I know, I take away everything in my property. And I call someone else who has a license to do my fence. Q. Has the permit been pulled and the fence installed? A. (Joseph De Rival) No. Q. Has a permit been applied for? A. No—I get a new licensed guy to do my fence. He said he will do —start to do my fence by the 27th of this month. Chairman White: Here is the Board's problem—the County's problem. We are not in a position to be able to waive the Citation or act as if it wasn't issued unless the violation has been abated ...meaning, the work was done before the Hearing. No one has said they shouldn't have gotten a permit; no one has said they shouldn't have had a license to install the fence. We are really—at this point, our hands are pretty much tied. I appreciate the fact that an effort was made to abate the violation by talking to a licensed fence contractor and trying to obtain a permit, but those things haven't been done yet. Terry Jerulle questioned Mr. De Rival: Q. Did you pull an owner/builder permit? A. It does have a permit license. Michael Ossorio stated a building permit had been issued. Rob Ganguli, Collier County Licensing Compliance Officer, confirmed while a permit had been pulled, the work had not been completed. Chairman White asked if a contract had been entered into and Mr. De Rival responded, "Yes." Kyle Lantz questioned Mr. De Rival: Q. You had said you hadn't done any work on the fence yet—you hadn't started installation yet? A. No—on the 27th. Q. But the pictures we are showing have all the fence poles in. Did you put those fence poles in? A. We did start to do it but as soon as we know—I been to Building Office to make an application but they said because I am not living in the property, then they cannot give me a permit and I have to get a licensed guy to do so. For that reason I call a Carter Fence to do it. And he make the application and the permit is there —and the permit number is [on] my paper—and he said he will get my fence installed on the 27th of this month. Chairman White asked Mr. De Rival if he had paid the Contractor; he replied he paid half to the Contractor. 8 July 15,2015 Q. When did you pay? A. Three weeks ago. Reverend Israel stated: • Both men were members of his church. • Samuel Compere had just lost his job. • Mr. De Rival was trying to give him something to do. • They were actually doing the job together, not realizing that they needed a permit. Reverend Israel stated he was not aware of the problem until after they received the Citations. He understood they had agreed on a price while they were working on the project together. Mr. De Rival gave Mr. Compere $300 which he returned once they found out that this was not going to work. Those fences that you see have been pulled up and a contract has been entered into with a Contractor to do the job. Chairman White explained to Rev. Israel that Mr. Compere had offered to do work as a Contractor ... a fence installer ... for compensation—for money—without having either the permit that was required or a license. Reverend Israel stated he understood and they both realized they were wrong but they were not aware of it. He clarified that Mr. Compere did not offer to do the work. Mr. De Rival knew Mr. Compere had been previously employed as a carpenter in Haiti and had the ability to do those things. Mr. De Rival asked Mr. Compere and they were both working together as brothers of the church. He continued they had no idea but once they found out ... Chairman White: Sometimes people come before the Board in this type of a situation. They claim they were not doing it for compensation—"I was helping a friend." And that is a valid defense. It is a valid defense—it's just usually not true. Rev. Israel: I taught my members not to lie. Chairman White: We appreciate that and if there's any way we can help get to a place where the financial impact of paying the Citations is ... it doesn't seem to be helping the community ... at least in my opinion. I don't know that a consumer was harmed ... the gentleman is here ... he's trying to do the right thing ... he's pulled a permit ... he's entered into a contract to have the work done—it just hasn't been done yet. I would be interested in the other Board members' comments and perspectives and also hearing from the County as to its position. Rob Ganguli, Licensed Compliance Officer, stated: • It was a complaint-driven investigation. • He had the two components he needed to issue the Citations—he had proof of compensation and work that required a building permit. • He met with Mr. Compere and Mr. De Rival, there was never any denial of having done the work. • There was a request for some latitude in how he addressed the situation. • The violations were addressed. 9 July 15, 2015 Richard Joslin asked Mr. Ganguli if he took the pictures and saw the fence posts that were in place which indicated that someone was doing the job. Rob Ganguli responded, "Yes." Mr. Joslin noted the paperwork that Mr. De Rival provided to the Board did not constitute a contract—it was only an estimate, it was not signed and there was no amount specified. Joseph De Rival replied that he did have a contract but did not have a copy with him to produce. Chairman White pointed out Mr. De Rival testified he had paid the Contractor money three weeks earlier. Rob Ganguli requested to have the document(email) provided to the Board by Mr. De Rival entered into evidence. Chairman White asked Mr. De Rival if he wanted to enter the document into evidence as "Respondent's Exhibit 1" and the reply was affirmative. Kyle Lantz moved to approve entering the two page email entitled "Estimate for 1571 47th Terrace SW"from Jaimie Myers (Carter-fence.corn) to Joseph De Rival into evidence as Respondent's Exhibit 1. Vice Chairman Lykos offered a Second in support of the motion. Carried unanimously, 6—0. Kyle Lantz asked Attorney Morey to explain the Board's options. Attorney Morey cited from Florida Statute 489, Section 127, entitled "Prohibitions and Penalties" as follows: "3. If the person who was issued the Citation, or his/her designated representative, shows that the Citation is invalid or that the violation has been corrected prior to appearing before the enforcement or Licensing Board or designated Special Magistrate, the enforcement or Licensing Board or designated Special Magistrate may dismiss the citation unless the violation is irreparable or irreversible." Kyle Lantz noted the language covered Citation for not obtaining a permit but did not cover the Citation for contracting without a license. Attorney Morey stated the Statute was applicable for anyone who was contesting an issued Citation. Vice Chairman Lykos moved to approve dismissing both Citations. Chairman White offered a Second in support of the motion only as it applied to Citation #9411 (commencing work without obtaining a Building Permit). Terry Jerulle agreed, stating that by hiring a Contractor to obtain a permit and install the fence, the Citation had been abated. Richard Joslin reiterated the Citation for unlicensed contracting should be upheld. 10 July 15,2015 Terry Jerulle noted a complaint had been made and it was investigated by Officer Ganguli. He stated that, given the nature of the situation, he was not happy about upholding the Citation for unlicensed contracting but there were rules in place. He further stated he would not support the Vice Chairman's motion. Vice Chairman Lykos cited the example of a previous action of the Board when he and Mr. Jerulle had disagreed. He stated Mr. Jerulle had commented that the reason why the Board existed was to review each case individually and make a decision based on the merits of the case and not just follow the rules. He noted their positions concerning the current care were reversed. He further stated he stood by his motion. Terry Jerulle stated he understood and agreed with the Vice Chairman concerning the permit Citation but stated he still needed convincing with regard to dismissing the Citation for unlicensed contracting. Vice Chairman Lykos replied the intent was not to avoid the Ordinances of Collier County nor the intent was not to avoid paying a higher price by hiring a licensed Contractor—the intent was between a gentleman who owned a piece of property who reached out to a fellow member of his community to help him get through a hard time. They worked on the project together based on their testimony. The intent was not to avoid the law or to avoid the legitimate process. He continued the reason why the Board was established was to take the intent into consideration, under certain circumstances. Chairman White noted Mr. Compere willingly returned the money he had been given to Mr. De Rival. Vice Chairman Lykos agreed stating a licensed Contractor had been hired, a permit had been obtained, and the work would proceed when the Contractor's schedule allowed. He stated both Mr. Compere and Mr. De Rival had been honest with the Board and he did not think anything else could have been done to mitigate the circumstances. Kyle Lantz,while expressing sympathy for the parties involved, stated his concern was for the Board. He asked if the Board could be violating Collier County's Ordinances by negating the Citation for unlicensed contracting. He did not want the Board to set precedence. Chairman White stated, in his opinion, the question was whether or not the Board had the authority or jurisdiction to do equity. He did not think the Board would be establishing a precedent if a certain action were to be taken. Vice Chairman Lykos noted anyone who had been served with a Citation had the right to come before the Board to challenge it and to provide testimony to contest it. Chairman White asked Michael Ossorio if the County had a position concerning the dismissal of both or either Citations. Michael Ossorio replied the County was indifferent—the Citations were issued but the decision was the Board's to make. Chairman White announced he was prepared to second the motion in its entirety based upon the clearly demonstrated lack of intent. He stated the unlicensed contracting case was tied into the permitting case. The efforts that were made to 11 July 15, 2015 abate the violation were sufficient and in combination with the absence of intent as evidenced by the return of the funds. He determined the more appropriate thing to do under the circumstances —especially since no one was harmed—was to support the motion. Chairman White offered a Second in support of the motion in its entirety. Richard Joslin again noted proof of a signed contract had not been submitted to the Board. Joseph De Rival reiterated a contract had been signed and he had a copy of it in his car—just not with him. Vice Chairman Lykos stated the Carter Fence Company had applied for and obtained a permit from the County. Chairman White called for a vote on the motion to dismiss both Citations. Motion carried, 5— "Yes"/1 — "No." Richard Joslin was opposed. D. Beker L. Escalante—Qualifying Second Entity ("MKA Finishing,Inc., d/b/a Tarpon Tile &Marble") (Second Entity: "Marble.com, Inc." Beker Escalante stated he was appearing before the Board to request approval to qualify a second entity. Michael Ossorio stated the Applicant currently qualified MKA Finishing, Inc. and had applied to qualify Marble.corn, Inc. for both tile &marble and for cabinet installation. Gary McNally referenced a State tax lien filed in October, 2011 in the amount of $1,022 against Marble.com, Inc. He requested an explanation. Beker Escalante stated he was not aware of an open lien against Marble.com, Inc. Gary McNally explained it appeared that the lien had not been released and no documentation had been provided to verify that it had been released. He stated it was cited on the Experian Credit Report under"Legal Filings." Beker Escalante stated he would look into the matter and see that the lien was released. He reiterated he would fix it. It was noted Mr. Escalante is a 51%owner of Marble.com, Inc. and has the authority to sign checks. Mr. Escalante confirmed he is the President of Marble.com, Inc. Michael Ossorio asked Mr. Escalante if the Second Entity was Marble.corn, Inc. and not a d/b/a as it appeared in other documents. Beker Escalante reiterated the Second Entity was Marble.corn, Inc. Terry Jerulle: A. Who is the current Qualifier of Marble.com, Inc. 12 July 15,2015 Q. The Qualifier was Juan Mendoza—Paul Mendoza. But he is not interested in the marble business at all. Mr. Escalante stated since he was the Qualifier for Tarpon Tile & Marble, he felt it would be beneficial to buy Marble.com, Inc. because of the clients list and because Tarpon Tile & Marble had successfully worked with Marble.com, Inc. in the past. Terry Jerulle: Q. You said Mr. Mendoza was the Qualifier. Is he no longer qualifying Marble.com, Inc.? A. It is my understanding he would still qualify the company until the end of this month or until I can become the Qualifier. Q. Why did you purchase Marble.com, Inc.? A. I had done business with them before—their clientele is really great—they do a lot of jobs with BCB Homes which is a very big company. Tarpon has also worked with BCB but Marble.com has a bigger share of the market. I would buy their assets and get a good share of the market. Q. One of the concerns that I have is that Marble.com does flooring and your current business also does flooring. A. Yes, sir. What I was looking to do is have one company focus more on tile and marble—doing floors and showers, and the other one focus more on just marble ... maybe pool decks and granite. That's what I want—have one focus on one thing and one focus on another thing. So I would have two corporations doing similar things but not exactly. They already have an established name in the market which I believe would benefit me in the long run. Q. I was on the Marble.com website this morning and it shows that they do flooring just like your other company. A. In order to clarify that, did you go to Marble.com or the website itself because a lot of people get confused with that because the name is Marble.com—that we own the website, which we do not. Q. No, it was the website listing you as the president. A. Okay. Q. They do marble and tile flooring just like MKA does. A. Yes, sir. Well, also, they've done it in the past before—Juan is a General Contractor so he would do pretty much anything that comes to the field—so I know at one point, he was doing it but then for the majority of the time, he would tell us or hand out clients to us and rather us do it because we are rather more experienced in that market than he was. So, that's the only explanation I have for that. Kyle Lantz: Q. Can you tell me about the ownership of your existing company, MKA Tile? A. MIA Finishing. Q. And Marble.com ... who owns MKA Finishing? A. I own 50% of MKA Finishing. Q. And who owns the other 50%? 13 July 15, 2015 A. We have two other officers—I don't remember the numbers exactly—they each own less than 50%—but I'm the majority shareholder for MKA as well as for Marble.com. (51%) Q. As so for Marble.com—who owns Marble.com? A. There are two of us—there's me and Lisette. Q. And the other owner of Marble.com—is that also an owner of MKA Finishing? A. No, sir. It's totally separate. Q. So you're the only bond between the two? A. Yes, sir. Q. So is it safe to say you wanted a separate company because there are different owners involved and you didn't want to give ownership of Marble.com to the people who own the minority stake in MKA Finishing? A. In a way—it could be said that way. I mean, that's not the main reason. But that's one of the things that could help me out ... benefit me, I guess. Richard Joslin: Q. On the credit report, I'm confused about the principals —on one page from Experian, for MKA Finishing, I have three directors: Mario Osorio who is the President ... A. Vice President ... Q. It says President ... and Beker, which is you, as the Vice President and then it says Alex Delgado as Secretary. Then on the Merit credit report for MKA Finishing, it has another person listed: Mario Osorio as the Vice President, and Beker Escalante as the President, and then it has a Ronald Segura as a Director. A. Yes, sir. I believe there is one more current than the other because I know Alex was a Director before but then we switched it to Segura. Q. Okay—so which one is—they both are in 2006—they both were listed on 11/10/2006. It's two different credit reporting agencies and I'm wondering who is ... as Vice President and then we have Segura as the other Director also. Q. Delgado ... ? A. Yes, while I'll be able to tell you myself that right now it's me as President, Mario A. No, he is not a Director any longer, so that must have been—I don't know how they got that. Q. It says 06/23/2015 —you might want to check that out. A. Yes, I definitely will. Attorney Morey noted the Secretary of State's printout, dated in June, coincided with what Mr. Escalante said in terms of the current Officers. There was a disconnect between the credit reports and the filing ... Beker Escalante apologized for the confusion, stating he was unaware. Chairman White stepped down from the dais and turned the gavel over to Vice Chairman Lykos to chair the meeting. (Chairman White left at 10:25 AM;five voting members remained.) Vice Chairman White referenced Mr. Escalante's signed Affidavit. Q. As the Qualifier for MKA, you are responsible for the operations of the company? 14 July 15,2015 A. Yes, sir. Q. Does that include the financial operations of the company? A. Yes, sir. Q. You have the same packet that we have — is that correct? A. Yes, I believe so, sir. Q. Okay. If you'll go the section with the MKA bank statements. There are some electronic transactions for which we don't have a copy—the statement just lists that it was either put into or taken out of your account. On the first month for May 1 through May 31, there is an item on May 5th which says, "Customer withdrawal image"—under withdrawals and other debits -- A. Yes, sir. Q. We don't know who the payee was or who that money went to. I found several checks in your statement—for$300, $500, $800—I can't read who the payee is on those ... can you tell me who the payee is on Check#2899 for $300? A. Yes, sir. The first one would be for Mario Peres for$300—he was the one giving that check. Q. Who is Mario Peres? A. I believe at the time, he might have been an employee. Jesus Sarrat and then you've got Turquoise Trading, LLC. Q. The first check is for Mario Peres and he was an employee? A. I believe so. Q. And what would that check be for? A. Like I said, that is not my signature—so I wouldn't have known exactly. Q. The first question I asked you was whether or not you were financially responsible for the company. A. Yes, sir. Q. And you want me to authorize you to be financially responsible for another company? So when you come before me, I expect you to know the answer to the answers to these questions, okay? A. Yes, sir. Q. The next check—who is that made out to? A. Jesus Sarrat. Q. And who is he? A. Also an employee. Q. And can you tell me what that check was made out for? What the purpose of that $500 was? A. What the purpose was ...? Q. Yes. A. I'm pretty sure it must have been a job—I mean that's the only reasonable explanation that I have. Q, Okay—if you skip the "Turquoise" check, there's another check. Can you tell me who that's made out to? A. Also another employee, sir. Q. Okay. Then you have another check—Check#2399 for $500. A. Yes, sir. Q. And is that ... A. Santiago Sarrat. Q. That's one of the names you had from before—correct? 15 July 15,2015 A. I believe this was his brother actually. Q. Okay—so it's another employee? A. Yes, sir. Q. So, what I'm seeing is—going through your bank statements for May and March and April, I saw a lot of these checks that were written to what appear to be an employee for an exact dollar amount. A. Yes, sir. Q. What I didn't see were any transactions for payroll taxes, Workers' Compensation insurance—so my question to you is: how are these employees being paid, and how are you paying all of your payroll taxes for the company? A. Yes, sir. We are—we have everybody under our Workers' Comp and on our payroll and general liability. I don't believe I have any of that information here but our payroll is First Payroll. We have our checks and General Liability and Workers' Comp through them. Q. You have your Workers' Comp through who? A. I don't believe—they offer the Workers' Comp... Q. Who? A. The First Payroll Choice, I believe, is the company that we get it from. Q. You have a company that processes your payroll? A. Yes, sir. Q. Then why do you write individual checks to individual employees? A. That's what I'm ... I want to be able to answer you, sir. Q. I want you to give me the right answer. Richard Joslin asked who signed the checks and the response was, "Mario Osorio." A. And I actually had a couple of situations with that before ... and then with me being able to transfer and leaving him not—with him as much anymore. But ... all the signatures are Mario's. Q. I understand but you're the ... A. Yes, I know. I understand that, sir. Q. Qualifier. A. Yes, sir. Q. Okay. So there are several checks—not only in the month of May but also in the months of March and April where it looks like checks were written directly to employees. Because you have electronic transactions I don't know what these other withdrawals were for—I'm not accusing you of anything but what I do expect you to is to be able to explain to me when I ask about the payroll, and how the employees are being paid; how the taxes and Workers' Comp are being paid—I can't find that within your bank statements so I need you to be able to tell me that. A. Like I said before, everybody is on the payroll. We have everybody under Workers' Comp and general liability but some of these checks that aren't signed by me ... I know—I understand that I have a financial responsibility. Q. If you look at the bank statements from Marble.com—the company that you want to qualify—if you look through their bank statements, you'll see that every month there is a check written to the IRS. Their bank statements show a paper trail of taxes being paid on a monthly basis. 16 July 15, 2015 A. Yes, sir. Q. I don't see that paper trail for your current company. A. Okay. Q. That raises a red flag for me. So if you don't understand your company's finances, if you can't explain to me how people are being paid; how the taxes are being paid, and now you ask me to let you qualify a second company? The second company looks like they are already paying their taxes—I'm going to give you the authority to run a second company when you can't prove to me that you're running the first company correctly? A. I understand, sir. Like I said, I mean, I would honestly still want you to consider me being able to qualify this. I know the people I'm getting into have done that for a while,too, and they know exactly what they're doing. Here with MKA, I still feel like I am responsible for everything that goes on, so I have to do a better job with that. But anything that has to do with the IRS or taxes I could have my accountant pull all the information and I could present it to you as well because we do pay for that every year and it's a good amount. Vice Chairman Lykos stated he would not support the application to qualify a second entity because the Applicant was not able to explain how the taxes and Workers' Comp were paid, as well as the payroll for his employees. He suggested the Applicant consider rescinding his application and returning at the next Board hearing—if he were able to answer the questions and provide detailed documentation at that time proving that the company was being properly managed. Beker Escalante agreed, stating he was willing to return. He stated he would contact his accountant to provide the necessary documentation to the Board. He understood the Vice Chairman's position and apologized for not bringing the required paperwork. He stated he would wait until the following month for the Board to reconsider his request and asked if there were anything that he could do to keep Marble.com running and not lose its clientele. Vice Chairman Lykos reiterated he was not accusing Mr. Escalante of anything other than not being able to answer his questions. He stated he had additional questions to be addressed by Mr. Escalante when he returned. Q. On the "Questionnaire for Qualifying a Second Entity," your answers to Questions 9, 10, and 11 did not contain the level of detail I would like to see. If you are already working at the company, what is your salary? Don't tell me what it is going to be a"reasonable salary"—this is asking about the company you already own and work with. As for the new company, if you have a financial plan for that company, how much money are you going to take out of it? I want to know that you have reasonable expectations and a reasonable plan for running the second company or I can't support you to run a second company. A. So you want a dollar amount or ...? Q. If you say, "10%of the profits," or my salary will be $1,000 per week plus a percentage of the profit ... but I want you to prove to me that you have a handle on the financials of the company and that you know how you're going to run it and how you're going to be compensated for that liability and that responsibility. A. Understood, sir. 17 July 15,2015 Q. Also, Questionl3 asks you to list all partners and owners of the second entity and their positions. You list yourself and Lisette but it is important to have the application filled out completely. A. So I should say who is President and Vice President? Q. Right. It's important that this portion of the application be complete. A. Okay, understood, sir. Q. It might be a good idea for you to clear up that tax lien before you return. A. Okay. Michael Ossorio confirmed Marble.com was currently qualified as a tile and marble Company. Vice Chairman Lykos explained several options to Mr. Escalante, i.e., the Board could vote to approve or deny his request to qualify a Second Entity, or he could request to rescind his application to return at another time. He asked the Applicant what he would like to do and the response was, "I'd like to rescind my application." Vice Chairman Lykos reiterated the Board's areas of concern to be answered by the Applicant: • Status of the tax lien filed against Marble.com; • How are the employees of MKA being paid; how the payroll taxes are being paid, and how is the Workers' Comp insurance being paid. • The name of the payroll company. • A letter from the payroll company explaining how the payroll is processed. We are seeing a number of checks to individuals but we're not seeing any checks to the payroll company. E. James R. Blackburn—Waiver of Examination (d/b/a "Design Custom Millwork, Inc.") Vice Chairman Lykos asked Mr. Blackburn to provide his background information and why the Board should consider his request to waive the examination. James Blackburn: • His company was formed in 1999; • We have done architectural millwork across the U.S. —from New York to California. • He previously had a license in Collier County to install his company's products which were manufactured in Sanford. • He sold his company and its assets to Ruth's Chris' Steakhouse and went to work for them as Director of Millwork. They purchased his facility and upgraded it. But then everything crashed in 2007 and all development stopped. • He then worked for Alleghany Millwork, Lawrence, PA. He managed the installations and 60 to 70 installers. He ran the safety program,processed the payroll, doing a "cost plus"under DCM. 18 July 15,2015 o His first job was an Indian Reservation Casino in Oklahoma ... it was a $20M casino with a large hotel. He supervised the millwork installation—running trim, etc. o He also supervised installation at the Green Briar in West Virginia which was an 80,000 square foot bunker with nine miles of running trim. o He went to NY City and worked in Manhattan on a Medical Center and a restaurant. • He has also worked in restaurants and country clubs in Naples in 2007 and before. • When he returned to Naples, he purchased a building to begin manufacturing architectural millwork. He always has a contract to manufacture for a construction company. • He would like to perform the installation work and has applied to reinstate his license. • He has continued to remain active in the business. • He has retained a payroll company to handle payroll, insurance, and file taxes on a quarterly basis. He has also retained the services of a CPA in Orlando. Vice Chairman Lykos requested information on Mr. Blackburn's previous license. Michael Ossorio: • It is a cabinet/millwork installation license. • He passed the Business Procedures test. • The County has no objection to renewing his license without requiring further examination which would be superfluous to his work. Mr. Blackburn stated he was prepared to pay the required fees of$760 to obtain his license. Vice Chairman Lykos asked the Applicant to confirm that during the time his license was expired that he stayed active in his industry. A. Yes, sir,that is correct. Kyle Lantz asked why the Applicant did not want to take the test. A. I didn't think it would be necessary. I did have a license here. I'm very qualified to do what I do at a high level. I have million dollar contracts and I have a lot of happy clients. I have a wonderful reputation from Boston to California, including the State of Florida. My business is in Seminole County, north of Orlando, and I have worked in every theme park over there. Richard Joslin: Q. Are you planning on working in other counties, besides Collier County? A. Yes. Q. You know this is just a County license—correct? A. I have licenses in other counties, i.e., Seminole County, and I will be applying for a license in Orange County. It will be based upon what jobs I have going on. 19 July 15,2015 Richard Blackburn stated he was also licensed by the City of Sanford in Seminole County. Vice Chairman Lykos noted the only test required was the Business & Law exam; a trades test was not required. He also noted the credit report reflected that the Applicant was capable of managing his business. Richard Joslin moved to approve granting the Applicant's request for a Waiver of Examination and to reinstate his license. Gary McNally offered a Second in support of the motion. Carried unanimously, 5—0. IX. REPORTS: (None) X. NEXT MEETING DATE: Wednesday, August 19, 2015 BCC Chambers, 3' 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 Vice Chairman at 11:30 AM. COLLIER COUNTY CONTRACTORS' LICENSING BOARD THOMAS LYKOS, Vice Chairman The Minutes were approved by the Committee Chair/Vice Chair on , 2015, "as submitted" [ 1 OR "as amended" [ 1. 20 OCTAVIO ELIAS CALDERON 12825 COLLIER BLVD NAPLES.FL.34116 PH:239-398-6850 JULY 1'.2015 TO THE COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS/ CONTRACTOR LICENSING BOARD: Since I came to this country in 1999, I developed interest in becoming an experienced professional in the Construction business. As it is written in the Work Experience Letters that I provided as evidence you will find that I been working in a stable and professional way throughout all these years to improve and to learn day by day to become a progressive skilled worker. My extended and professional experience of over 15 years includes knowledge in: - Drywall - Painting - Framing - Stucco - Trusses - Tile Installation - Demolition - Remodeling (able to recognize when a permit is needed, involved in the process but not allow to pull a permit for a lack of a license) - In New Construction, Existing Houses and Commercial - Interior and Exterior LICENSES EARNED: - DRYWALL#20130000774 - PAINTING#20130000774 MY PHYLOSOPHY: - Because I believe in myself and in my continuing education, I took the General Contractor Exam which I am proud to have recently passed on June 13th 2015 to add to the licenses I have and to continue learning as much as I can about this career understanding that never ends with the new codes, laws and trends we face each day. - With all the years of experience on my shoulder, the good reputation from my previous employers/co-workers and specially my clients that I have, I know I possess what I need to become a General Contractor Licensed for Collier County as I dreamed. - I understand that being a GC is a big challenge and a huge responsibility that I am willing to face starting for baby steps and continuing growing as the time goes by. - I truly hope you have confidence in me as I do have for myself and trust in me to have my license approved for the good of our beautiful community and the citizens in Collier County. Warm 'egar 400 /' e OCTAVIO CALDERON 239-398-6850 OCTAVIO ELIAS CALDERON 12$25 COWER BLVD NAPLES.FL.34116 PH:239-396-6$50 JULY 1 s`.2015 TO THE COWER COUNTY BOARD OF COUNTY COMMISSIONERS/ CONTRACTOR LICENSING BOARD: Since I came to this country in 1999, I developed interest in becoming an experienced professional in the Construction business. As it is written in the Work Experience Letters that I provided as evidence you will find that I been working in a stable and professional way throughout all these years to improve and to learn day by day to become a progressive skilled worker. My extended and professional experience of over 15 years includes knowledge in: - Drywall - Painting - Framing - Stucco - Trusses - Tile Installation - Demolition - Remodeling (able to recognize when a permit is needed, involved in the process but not allow to pull a permit for a lack of a license) - In New Construction, Existing Houses and Commercial - Interior and Exterior LICENSES EARNED: - DRYWALL#20130000774 - PAINTING#20130000774 MY PHYLOSOPHY: - Because I believe in myself and in my continuing education, I took the General Contractor Exam which I am proud to have recently passed on June 13th 2015 to add to the licenses I have and to continue learning as much as I can about this career understanding that never ends with the new codes, laws and trends we face each day. - With all the years of experience on my shoulder, the good reputation from my previous employers/co-workers and specially my clients that I have, I know I possess what I need to become a General Contractor Licensed for Collier County as I dreamed. - I understand that being a GC is a big challenge and a huge responsibility that I am willing to face starting for baby steps and continuing growing as the time goes by. - I truly hope you have confidence in me as I do have for myself and trust in me to have my license approved for the good of our beautiful community and the citizens in Collier County. Warm Regards,, A-7 cr2-4' ek OCTAVIO CALDERON 239-398-6850 i _,,d, ir , . , . rui, 90A..., . er Couvsty pGMD Operations & Regulatory Management {)3---- Licensing Section 2800 North Horseshoe Drive 0 2012-z(4) Naples, FL 34104 C��I j- 07 A APPLICATION FOR COLLiKR COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUTIONS: This application must be typewritten or legibly printed. The application fee must be paid upon approval and is not refundable. All checks should be made payable to: Collier County Board of County Commissioners. For further infoumation, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: _ Exact Corporate/Business Name: kl\ �,� A A . ct\l pci(n cA� 4 sc■C - Fiction Name/DBA: I Qualifier Name: 0 C NicZ 0_ C c\t&evC( , Physical Address: ,,a r . Cir-s, \',cz - `yC� �(aR\{?S , L �y\,,�j (Number& Street) (City) �` (State) (Zip Code) Mailing Address: �a�a Ca V,.(2.-,- \i&„ Svc c\ems L„ �Wcz (Number& Street) (City) (Sta e) (Zip Code) Telephone: �a \ g-Loce,� E-mail: G\\`{Yi_ cyWc& ,.V(d,Qc\V(\%�.c.cs`nccs TY E OF LICENSE: General $230.00 Electrician $230.00 Building $230.00 Plumber $230.00 Residential $230.00 Air Conditioner $230.00 Mechanical $230.00 Swimming Pool $230.00 Roofing $230.00 Specialty $205.00 S r e c 'Trade: ( r r rt. ( ('O On t . __ f j i i-f r t• r I CHANGE OF STATUS: ( )Reinstatement ( ) From One Business to Another ( )Dormant License to Active Page 1 of4 ygcrgEwgh iii! JUN 302115 BY: 1. The names, titles,home address and phone numbers of all Officers/Managing,�M^�empp Members of the Firm. \\e cG�'1 'WCl GL Ck. 3. C-U( k.rO n CCTV l© Q Li I.-70 1'1/4,0LSi'1in9-U1'1 Lf\ # )Qa , H IQ's Pi 34H6 2. List all businesses,firms, entities or contracting businesses you have been associated with during the last ten years(i.e. held a license for or been a partner). Attach extra pages if needed. CQ\ez\-8C-Cs'C\ o`C15 \ , 3. List all debts you or any company(s) associated with you that you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. - i ,r� AFFIDAVIT Under the penalties of perjury I declare that I have read the foregoing application and that the facts stated in it are true. Odd Authorized Officer of the Firm The foregoing instrument as acknowledged before me this 0(0- DA- aO\S (Date) by _c c1�i�9 C o\Ac c\ of •\- u'1 �c� c;�c� n� CNC'. (Name of Officer, Title/Agent) (Name of Corporation) a �e , -°`e�O Corporation on behalf of the corporation. (State or Place of Corporation) He/ has produced identification and did not take an oath. (Type of identification) NOTARY'S SEAL myna V 4 c ANA GISSELA PATINO „'+"11•,"4: Notary Public-State of Florida Page 2 of 4 My Comm.Expires Jun 30,2017 Commission N FF 032292 I , QUALIFIER INFORMATION: Name: ,,c,\ Address: ,�� CsoVV■Qc (Number&Street) (City) (State) (Zip Code) Telephone: �a �-(0C:4)c Date of Birth: SS#: (�� E-mail: 0,\\a‘-\'1..N.c-yaocA Qc .cc• ..c\c CLCIiNrN QA Driver's License #: 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. yl 1i 0 L d r 7 _6--C,5 _2 /-63/ fi YCA (-)C7r)' -0R cy, 9e-/--c7Zjr 3. Have you ever been convicted of a crime related to Contracting? ,V (If yes, attach extra sheet with explanation.) 4. Have you or any firms you have been associated with ever filed bankruptcy? Vs. f ' _ 5. List all debts you or any company(s) associated with you that you refused to pay and the reasons for the refusal to pay and reasons why. 6. List your business or work experience during the last ten years. 7. Statement of any foiival training you have had in the area for which the application is made. -i)r )O L) Fro 01 ,'7t ) pc) J 7 'T 1 Co • Pc f , r p e )7). y • c-9 3 of 4 Licensee Information Licensee Number LCC20120002901 Description Type Property Alert Name CALDERON, OCTAVIO E. Type Contractor Status Open 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 ExanTest Type Date of ExarrtiTest City Score received ExanTest res PAINTING 08/29/2012 Plantation 80.0% Pass BUSINESS PROCEDURES 11/13/2012 Plantation 80.0% Pass ..... DRYWALL CONTR. 02/09/2013 PLANTATION 82.0% Pass GENERAL CONTRACTING 06/13/2015 NAPLES, FL 75.0% Pass IShow More Fields Hide or Clear Fields Active': Charge Exam Fee 19 Exam Code BPE1A Sponsoring County Collier Sponsorship App Date 07/12/2012 Sponsorship Expiration Date Testing Facility rometr c i AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County No. 2006-46, as amended, and under penalties of perjury. I declare that I have read the foregoing qualifier information and that the facts stated in it are true. 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/she 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. Q\(t\R© Applicant (please print) Pig Name of Company Signature of Applicant State of Florida County of eiz:;\\',Q� The foregoing instrument as acknowledged before me this (Date) by c\-(2_v�c-\. who has produced ` cc�n� (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL y cj-( G6.J . s• ''- ANA GISSELA PATINO Notary Public-State of Florida 4 of 4 Dili My Comm. Expires Jun 30,2017 •• Con mission 11 FF 032292 „�-�r,,..«,�.,,-,.�,,,...a,�w.:Q,m-..,,,«4...,�.....,A-.,ate-•�:�- . AFFIDAVIT It is understood and acknowledged by the Collier County Contractor's 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. 94 di ad Signature of Applicant Business Name CYci Date BEFORE ME this day personally appeared Qc' ,vac, E c4\--1 who affirms and says that he/she has less than one employee and does not require Workmen's Compensation and understands that at any time he/she employs one or more persons he/she must obtain said Workmen's Compensation Insurance. State of Florida "� County of C c\\ . The foregoing instrument as acknowledged before me this Q(© (Date) by ® VRp G �Cp2c��1 who has pro duced , A (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL ‘\•, 1 @i.,.� C`R „'-, ANA GISSELA PATINO ``«' '.` Notary Public State of Florida ,,( 1 0;lt�," ANA GISSELA PATINO ry ,,, zn 9n17Si ( Notary Public-State of Florida 4 y* ii My Comm.Expires Jun 30,2017 1 '; r Os" Commission# FF 032292 COLLIER COUNTY • CERTIFICATE OF COMPETENCY CERTIFICATION INFORMATION LCC20130000774 Certification Information Collier County Board of County Commissioners Date: July 10, 2015 DBA: ALL IN 1 DRYWALL & PAINTING INC ADDRESS: 12825 COLLIER BLVD NAPLES, FL 34116 PHONE: 2393986850 CELL: FAX: LICENSEE NBR: QUALIFIER: CALDERON, OCTAVIO E. LCC20130000774 TYPE: DRYWALL CONTR. CLASS CODE: 4110 ISSUANCE NBR: 201300000458 INSURANCE: ORIG ISSD: EXPIRATION: General Liability March 06, 2013 September 30, 2015 April 24, 2016 Worker's Comp Exemption February 21, 2017 Worker's Compensation June 01, 2016 NOTE: It is the Qualifier's responsibility to keep all business, licensing and requirements current and to provide up to date copies for Collier county files. This includes all insurance certificates and any change of address information. Collier County * City of Marco * City of Naples Contractor Licensing DRYWALL CONTR. Cert Nbr: Exp: Status: LCC20130000774 09/30/2015 Active ALL IN 1 DRYWALL & PAINTING INC CALDERON, OCTAVIO E. 12825 COLLIER BLVD NAPLES, FL 34116 Signed: COLLIER COUNTY • CERTIFICATE OF COMPETENCY CERTIFICATION INFORMATION LCC20130000774 Certification Information Collier County Board of County Commissioners Date: July 10, 2015 DBA: ALL IN 1 DRYWALL & PAINTING INC ADDRESS: 12825 COLLIER BLVD NAPLES, FL 34116 PHONE: 2393986850 CELL: FAX: LICENSEE NBR: QUALIFIER: CALDERON, OCTAVIO E. LCC20130000774 TYPE: PAINTING CONTR. CLASS CODE: 4270 ISSUANCE NBR: 201300000457 INSURANCE: ORIG ISSD: EXPIRATION: General Liability March 06, 2013 September 30, 2015 April 24, 2016 Worker's Comp Exemption February 21, 2017 Worker's Compensation June 01, 2016 NOTE: It is the Qualifier's responsibility to keep all business, licensing and requirements current and to provide up to date copies for Collier county files. This includes all insurance certificates and any change of address information. Collier County * City of Marco * City of Naples Contractor Licensing PAINTING CONTR. Cert Nbr: Exp: Status: LCC20130000774 09/30/2015 Active ALL IN 1 DRYWALL & PAINTING INC CALDERON, OCTAVIO E. 12825 COLLIER BLVD NAPLES, FL 34116 Signed: ANCHOR BUILDERS CORP. 5651 Lago Villaggio Way, Naples-Florida 34104 Phone: (239)389-9495/Fax: (239)732-9495 qaryqionethotmail.com July 13,2015 To Whom It May Concern: This letter is to verify the employment of OCTAVIO CALDERON, who has been working for ANCHOR BUILDERS CORP. since 2004 to present. Mr. Calderon is a skilled and experienced worker with over 15 years of experience. He has demonstrated full knowledge on: • Kitchen and bathroom remodeling • Framing • Drywall • Painting • Fine carpentry • Tile • Finish • Stucco • Supervision Please contact me at 239- 389-9495 if you have any questions or need more information. Sincerely, Ar GA-Y ION T PRE ENT STATE OF FLORIDA COLLIER COUNTY The foregoing instrument was acknowledge before me on this (5"4a' day of ..,J kit%) 26 f 5 By 672 ax G I bne-) whoi pro cad o� '� �b,2■ �} PpLa_rLS¶� m _ as identification and who did not take an oath, _ % e of Notary 04�Y'4� Willem J O'Brien State of Florida ' g My Commission Expires O8/1812018 1,0R re Commission No.FF 152130 TRUSSES & METAL FRAMING, PLASTERING DRYWALL & PAINTING 4755 MERCANTILE AVENUE, SUITE #2 NAPLES, FLORIDA 34104 PH: (239)649-7909 FAX: (239)649-7971 Website: www.vasquezcarson.com Email: vasquezcarson @yahoo.com June 29th2015 To Whom It May Concern: This letter is to verify the employment of OCTAVIO CALDERON who is personally known by me and worked for my company for 4 years from 1999 to 2003. During that time Mr. Calderon performed the Supervisor duty and gained experience in remodeling as: D Trusses D Metal Framing D Plastering • Drywall D Painting If you have any questions or need more information about his letter, please contact me at(239)649-7909 :incerel , 4:- CHRIS CARSON VICE PRESIDENT VASQUEZ-CARSON CONSTRUCTION, INC. STATE OF FLORIDA COLLIER COUNTY The foregoing instrument was acknowledged before me on this 1 , Af:\ ( sA 0,\ By CHRIS CARSON who is personally known to me. My commission expires: ) ■ S.RUCKER r Y``.� MY COMMISSION#Ffi96957 Notary Public Signature EXPIRES:FEB 08,2019 Bonded through 1st State insurance VERIFICATION OF CONSTRUCTION EXPERIENCE' GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,EL 34104 0C-1--Ow i 0 E . CP(L i C I'J Applicant's Name: r (� —� rt- Certificate Category Requested: GE N e W 0 l3 ' t`—`-GTO R. 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: (-1-7662"'Y i O t Title: �12 t�J License Number(if applicable): (:-.-13 C. S`''`39 Name of Business: X11 C \) 11 > c` v2.,s C_o -p Business Address: L 1Q J? LLi 1 C C ( \i16 ' f"Y i V �'iL � � C) (o�,{ o 0 to 15 Business Phone `C � L �5 TI�e Applicant's years of experience from The applicant's scope of work(specific duties)included: T-1! N - VJ A-(.._t,_._. INflNG_ CA-2P-EN tVvy _ T�L� _ Additional Comments: Falsifying any information provided herein may subject your license to revoc,'ite. e Signa i.e Print Nan : `( L-\ (o fJ�� State of Florida County of Collier The foregoing instim neat was acknowledged before me on this 2g day of �V 4 ■6 n)Z.).c who is personally known to me or pre• ed 'C 4 ( as identification and who did not take an oath. /fl c`■ ►�., Pamela Johnston* Signature of Notary Notary Public State of Florida My Commission#EE 207749 Expires:June 13,2016 • 1 . • • of • • � • i � \ o. • • t, GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: 0CMV c 0 G . CA t.€ 1R"0 Certificate Category Requested: Gt o e Rfia__ C,omTv--A-c;ro R. 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: WI0S-tO V'i U/SQUez.-. . Title: au I L 2,1e-a-- License Number(if applicable): C GG °" Name of Business: L PI ry n S '" " C ( G Business Address: /CI I .r i 9 Ave- O I c-_-s 341061 Business Phone:(2-361),2-00 - 5-x-14P The Applicant's years of experience from 900 Li to O 15 The applicant's scope of work(specific duties)included: - 12- z l\) "'7 VL) pA-I N`T1 N G T C Additional Comments: Falsifying any information provided herein may subject your license-t�revo atio . Prins �� S 'L'- Print Name: � '1�(� � State of Florida County of Collier The foregoing instrument was acknowledged b,efore_me-on_this day of who is personally known to or produced , 1- S G by u) t6 � (1t,2uc C p Y p as identification and who did not take an oath. -- -- J Sig i.t-teofNota Y ogfiji B`i OSCAR J.PINEDA �� __ Notary Public-State of Florida My Comm.Expires Nov 9,2016 kt e Commission#EE 221531 • ANCHOR BUILDERS CORP. 5651 Lago Villaggio way, Naples—FL 34104 Phone(239)389-9495/FAX(239)732-9495 garygionet @hotmail.com To whom this may concern: Applicant's name: Mr. Octavio E. Calderon Certificate Category Requested: General Contractor I verify that the Applicant mentioned above seeking a Collier County Certificate of Competency in the trade indicated previously has worked as a skilled and experienced worker for my company from 2004 to 2015 in the trades as follow: - Framing - Carpentry - Stucco - Drywall - Tile - Painting - Finish Mr. Calderon has over 15 years of experience on those trades. He has demonstrated an excellent work ethics, responsibility, trustworthy and fairness during the time worked at my company. If you need further information on his qualifications, do not hesitate to contact me. Sincerely, Gary Gionet (Presii-nt) ` U State of Florida Collier County The foregoing instrument was acknowledged before me on this 02q day of by 0,ATNN L C k J -Q who is personally known to me or produced as identification and who did not take an oath. (-7Th Pamela Johnstone Notary Public State of Florida Signature of Notary) My Commission#EE 207749 Expires:June 13,2016 „,„ LAPLAYA CONSTRUCTION OF SWFL 2) La Playa Construction of SW FL, Inc. License #CGC151753 1941 Curling Ave Naples, FL 34109 Phone: (239) 200-5276 Fax: (239) 591-2089 To Whom it may concern This Letter is to state the Octavio E Calderon, is been exercising construction for at lest 10 years and that i personally know that he is capable of performing, Framing ,Drywall,< carpentry, Painting and tile. He is a good and honest worker, whit good working ethics.. Winston Vasquez President and owner of la playa construction Lic# CGC 151753 Signature: jJ.,_� Print: q SC'CAM \ _Sa U P g ' Theforego—instrument--was acknowledge before me on this day of- by Who is personally know to mew produce as identification. V2o - f16- �&- lam-o � A,N,„ pSCA. J.PINEDA K ,� : Notary Pub,c-State of Florida 1 Al My Comm/Expires Nov 9,2016 Afig re Commission#EE 221531 Pmosiwosiwilergr WNW To whom this may concern: June, 29th 2015 I, GABRIELA ALGRANATI authorize ALL IN 1 DRYWALL& PAINTING, INC. to use the following address: 12825 COLLIER BLVD NAPLES FL. 34116 as the company residence, billing address and for any other matter needed. @pp GABRIELA ALGRANATI 4$;0144;;,,,,, • CAR J. •INEDA fr.% Nota, Public-State of Florida 0 am My omm.Expires Nov 9,2016 I 4 '•.'{ofn �•'` Commission#EE 221531 06/18/2015 02:33 2399198333 ASAP ACCOUNTING #3341 P. 001/001 'VERIFICATION OF CONSTRUCTION • • GMD Operations &Regulatory Management Department • Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 • Applicant's Name: V C..-1-Pc. p CAL"p 4 . • Certificate Category Requested: CO•QPL-wltt�.'i .�'��?�✓ � i �A+tart#.16, t-Loo 43 4G.(G. Cr) • i The applicants seelang a Collier County Certificate of Competency in the tracle 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 dcmonstaate required trade experience. The person verifying trade experience must provide the following information: Name: (-e-1 g-t _ Title: i JAc1^.°(- t.e. License Number(if applicable): 66)bA18 Name of Business. VASCv ft J,- r G. , Business Address: �� l t ?Ol'L-'C Z A-3, b(Z'(-,-4 1� Business Phone: Z. ( C-44-19 DQThe applicant's years of experience from tqq 1 to Se>L ' The plUeant's scope of work(secific duties)included: a o.-e t::f1Tiz.'-e , t2 a�a- at to Lp tZk Additional comments; Falsifying any information provided herein may subject yo, ttense t• evocatio . Under the penalties of perjury I declare that I have read t -_oin• applicati• . ,. that the facts stated in it are true. iscpure Print Name State of Florida • County ofd 1,2 The foregoing instrument as acknowledged before me this by CA�V t ,, (Date) 1 S C(�.(3?- who has produced (name of person acknowledging) (type of identification) • • • as identification and did not take an oath. • NOTARY'S SEAL .41 • S'1y `� JENNIFER VASQUEZ ` ( "ATURE OF NOTARY) 4 -4 Notary Public•State of Florida .f • i , �e My Comm Expires Apr 21,2017 F o Commission# FF 10610 4 °' t�` Bonded Through National Notary Assn. Ilmengeowerelougeselpeupoweepoieneeemery 1 . , V , { eCao s C s ns co kc . . TRUSSES& METAL FRAMING, PLASTERING DRYWALL& PAINTING 4755 MERCANTILE AVENUE, SUITE#2 NAPLES, FLORIDA 34104 PH :( 239)649-7909 FAX :( 239)649-7971 Website: www.vasquezcarson.com Email: vasquezcarson @yahoo.com 06-25-2015 To Whom It May Concern I am writing this letter to confirm that Octavio Calderon is personally known by me. Octavio was at one time employed by my company for 3 %years, as a painter, drywall and carpentry laborer. We have a good relationship. I attest that the information provided above is accurate and truthful. H t of ks A.Aci'"' ,. CHRIS CARSON VICE PRESIDENT VASQUEZ-CARSON CONSTRUCTION, INC. STATE OF FLORIDA COLLIER COUNTY The foregoing instrument was acknowledged before me on June 25th 2015, by CHRIS CARSON who is personally known to me. My commission expires: _ : , NOTARY PUBLIC- S.RUCKER Ot+�'�*`Y P`�G :f MY COMMISSION#FF196957 t EXPIRES:FEB 08,2019 % . "- Bonded through 1st State Insurance AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF'rt,= • • .4-K d _d�eat,._�� 0.k Y WYE _ si v . ,. . R i ai�asation 0f ,. f '44,;4:-:.'-',,,,.:',:;4.41,-1`,4e,'"'"�r� Y wY k &S �v !} r i • A . • AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF COUNTY OF Cc\\ Qc- ` 1 C'� 1 I, P\'Vp(1 ` �v M�� , having been first duly sworn, state and afflin: 1 am a resident of p �p� ; County, C zteWe Q2c. (State) and have resided here for more than five (5) years. During the last five years I have known ©C ��"gyp E esz, XiQvopplicant). I have had the opportunity to observe his or her business and pers dealings and find him or her to be a person of honesty, integrity and good charact- -�`%I� / � Signature Co -ty---v-764fi at e 2$ s l P i� Addres C� 0 Z3C7 Telephone The foregoing instrument as acknowledged before me this Oo (Date) CC\ `� by �UL C©\et�r who has produced `vtc (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL AISA PATIN0 y PublicNA GSEL Stale of Florida Notar My Comm. Expires Jun 30,2017 Commission 11 FF 032292 1 ` L f' /! ... Seim: lithe'6laaI4 . Y @` qua a ' IN • I � E w 4t Operation of a motor ! ssMtery test rxxquiia�[ w. • AFFIDAVIT OF I"ZTEORITY AND GOOD CHARACTER • STALE OF \_o q, COUNTY OF C - I,�c�ho c�cr�z Mcac°k:�ne , having been first duly sworn, state and affiilli: I am a resident of \P� '�\ County, ecm\V".QC (State) and have resided here for more than five (5) years. \ During the last five years I have known (c V`\G ��\c.mNiapplicant). 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. Aw gl ��/� Si: ature /0;9 00 /4A1 ,0/ AI t Name 3000 L-13 gD s T 5L0 ()(, Address 239- J 61 sc Telephone The foregoing instrument as acknowledged before me this GL � (Date) by \skQC=ic>. elatvho has produce �,. S (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL - - - - - - - - - _ ---- -L e ARYL ANA GISSELA PATINO ? Notary Public-State of Florida ' nu c My Comm. Expires Jun 30,2017 0 '�`'' Commission # FF 032292 � � g� .1 S _ � r a x �7- ^Fg f Aa Rt Yom.% i +l 1 r3c7a,, .�.. 'St �LC ,.wrt.^jam;: , I _ • ler • • RESOLUTION OF AUTHORIZATION \\ � Q Est WHEREAS N\\ '�� c v�t: c � poses to engage (Name of business Entity) in contracting as . in (Type of legal entity: corp.,partnership, etc.) Collier County,Florida, according to Collier County Ordinance 2006-46,as amended: and WHEREAS t A',n ��r�Wc\ g \'cxy(\\3k:e c proposes to qualify (Name of Business Entity) for a Certificate of Competency with C\0....- Na (Name of Individual) NOW,THEREFORE, BE IT HEREBY RESOLVED THAT: We the undersigned L k.\\0��O F Q\&(42x.-'Z c\ of ll (Officers, Owners,Partners) \\\`� � y�� Q �'� C hereby resolve and represent to the Collier County (Name of Business Entity) Contractor's Licensing Board that the qualifying agent, A0.i,c3 .Cee\Ar,--atlis active (Name of Individual) \' \ ° in all matters connected with the contracting business of•Q\\ c\ \� , am (Name of Business Entity) We further resolve and represent that Qti,,o is (Name of Individual) Legally empowered to act for NAon 1:0 twat `� �� in all matters connected with its (Name of Business Entity) contracting business, and has the authority to supervise construction undertaken by (Name of Business Entity) DULY PASSED AND ADOPTED THIS c� \ DAY OF �c a , �S. AMP (Officers,Partners,Owners-with designation\ , gnation underneath) ifre. ))041CC,Id Ca- Witness Witness Corporate Seal(if applicable)or Notary Public Certificate Sworn to and subscribed before me this 7C\ day of ,\3•4 by (*)c s■,;-,c, The foregoing instrument as acknowledged before me this 0(c) (Dat by CQ___ cp.si°i3 C10._ e who has produced (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL T ANA GISSELA PATINO TURF OF—NOTAR 7l Notary Public-State of Florida sat J.• My Comm. Expires Jun 30,2017 '��' Commission N FF 032292 (Jo Lies 0 -rnty GMD Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 MEMORANDUM Date: February 17, 2015 - To: Applicant's for Certificate of Competency From: Michael Ossorio, Contracting Licensing Supervisor Subject: Collection of social security numbers. Pursuant to Chapter I-19, Florida Statutes and Collier County Contractor Licensing Ordinance 2006-46 Section 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 I-19, Florida Statutes, 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 I-19, Florida Statutes. . , . CISEI r a Credit Reporting 8 Collections ... . . N. 8546 W Homosassa Trl Ste 4, Homosassa FL 34448 Phone 352-628-2580 • 888-474-2270 • Fax 866-588-3604 CONTRACTOR CREDIT REPORT JUNE 30, 2015 BUSINESS CREDIT REPORT ALL IN 1 DRYWALL & PAINTING INC FED TAX ID#: 46-2047626 FILED: 2-15-2013 12825 COLLIER BLVD, NAPLES FL 34116 CORPORATE OFFICERS OFFICE SSN OCTAVIO CALDERON P - - DONALD CALDERON VP NONE PROVIDED FINANCIAL RECORDS CREDITOR/BANK TYPE OF HIGH RET PAST ACCOUNT NUMBER ACCOUNT OPENED BALANCE LIMIT CHECKS DUE NOT APPLICABLE BANKRUPTCY/JUDGMENT/LIEN SEARCH PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS ANY RECORDS FOUND MATCH ONE OF THE ELEMENTS SEARCHED AND MAY OR MAY NOT PERTAIN TO THIS SITUATION: NO RECORDS FOUND ELEMENTS SEARCHED: ALL IN 1 DRYWALL & PAINTING INC FED TAX ID#: 46-2047626 12825 COLLIER BLVD, NAPLES FL 34116 IN THE PREPERATION OF THE CONTRACTOR LICENSE REPORT, USA CREDIT BUREAU HAS USED CREDIT AND PUBLIC RECORD INFORMATION FROM ONE OR MORE OF THE NATIONALLY RECOGNIZED CREDIT AND PUBLIC RECORD INFORMATION REPOSITORIES. EACH OF THESE REPOSITORIES CERTIFIES THAT PUBLIC RECORD INFORMATION IS SYSTEMATICALLY COLLECTED AND ENTERED INTO THEIR DATA BASES. USA CREDIT BUREAU • • • PAGE 1 OF BUSINESS CREDIT REPORT USA Credit I3urQciu Credit Reporting Fi Collections 8546 W Homosassa Trl Ste 4, Homosassa FL 34448 Phone 352-628-2580 • 888-474-2270 • Fax 866-588-3604 JUNE 30, 2015 PERSONAL CREDIT REPORT(COMPILED FROM NATIONAL RECORDS) [SUBJECT] [SSN] [BIRTH DATE] CALDERON, OCTAVIO E. - ,- [ALSO KNOWN AS] CALDERON,OCTOVIO [CURRENT ADDRESS] [DATE RPTD] 4170 WASHINGTON LN. , #102. NAPLES FL. 34116 10/08 [FORMER ADDRESS] 875 QUAIL RN. , FORT DENAUD FL. 33935 12/09 8047 ROLLING CI. , LABELLE FL. 33935 M O D E L P R O F I L E * * * A L E R T * * * ***FICO CLASSIC 04 ALERT: SCORE +695 : 038, 018, 013, 024 *** 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=1 COL=0 NEG=3 HSTNEG=0 TRD=10 RVL=7 INST=1 MTG=1 OPN=1 INQ=5 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $743 $1500 $0 $0 100% TOTALS: $743 $1500 $0 $0 $ P U B L I C R E C O R D S SOURCE DATE LIAB ECOA COURT ASSETS PAID DOCKET# TYPE PLAINTIFF/ATTORNEY Z 5064304 5/11R C FE 11/11 1109905 CHAPTER 7 BANKRUPTCY DISCHARGED HENRY HERNANDEZ 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 THD/CBNA B 26H3005 1/06 $1584 R09 9/10A $1584 $0 I CHARGE ACCOUNT 9/09F $0 PURCH BY OTHER LENDER 5/3 BANK CC B 21AV061 4/13 $234 111111111111 R01 6/15A $300 $0 111111111111 I CREDIT CARD 5/15P $0 25 0/ 0/ 0 SYNCB/CARECR F 999206T 12/12 $0 111111111111 RO1 6/15A $1800 $0 111111111111 I CHARGE ACCOUNT 1/14C $0 CLOSD BY CRDT GRANTOR 29 0/ 0/ 0 SYNCB/CHEVRO 0 235064X 4/04 $0 111111111111 RO1 6/15A $300 $0 111111111111 USA CREDIT BUREAU • • • PAGE 1 OF PERSONAL CREDIT REPORT I CHARGE ACCOUNT 3/08C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 WELLS FARGO B 908N664 11/12 $509 111111111111 RO1 5/15A $1200 $0 111111111111 I CREDIT CARD 5/15P $0 29 0/ 0/ 0 SCU/SETF F 2CC4002 11/07 $31.5K 75M554 1111XXXXX111 I01 3/12A $0 111111111111 C AUTOMOBILE 3/12C $0 REAFFIRMATION OF DEBT 48 0/ 0/ 0 BK OF AMER B 6331059 12/04 $0 ROl 6/09A $2500 $0 I CREDIT CARD 7/08C $0 CLOSD BY CRDT GRANTOR 48 0/ 0/ 0 CHASE B 1127001 6/05 $309K 360M3176 111111111111 MOl 7/07A $0 111111111111 I CONVENTIONAL REAL 7/07C $0 CLOSED 25 0/ 0/ 0 SUNCOAST CU Q 298Q001 9/05 $919 OUR 3/15A $0 C DEPOSIT ACCT OVRD 5/11C $0 CHAPTER 7 BANKRUPTCY BK OF AMER B 6331059 8/04 $6276 RUR 11/11A $5000 $0 I CREDIT CARD 10/09C $0 CHAPTER 7 BANKRUPTCY I N Q U I R I E S DATE SUBCODE SURNAME TYPE AMOUNT 6/30/15 ZNF1034779 (FLA) COLLIERCOUNT 6/18/15 ZDT0200064 (MCH) THEAMERICANE 6/02/15 BDM5950954 (ILM) CREDCO 1/30/15 ZNP2083942 (FLA) MERIT CREDIT 7/18/14 BCI5512716 (DAY) FIFTH THIRD BANKRUPTCY/JUDGMENT/LIEN SEARCH PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS ANY RECORDS FOUND MATCH ONE OF THE ELEMENTS SEARCHED AND MAY OR MAY NOT PERTAIN TO THIS SITUATION: BANKRUPTCY DEBTOR - OCTAVIO ELIAS CALDERON ADDRESS - 4170 WASHINGTON LN, NAPLES FL 34116-3001 SSN - XXX-XX- POTENTIAL SSN - - LEXID - 348854570 ADDITIONAL DEBTOR - BOBBIE LYNN SEAY ADDRESS - 2007 MUSE RD, LABELLE FL 33935-7492 SSN - XXX-XX- POTENTIAL SSN - XXX-XX- LEXID - 1124930985 CASE NUMBER - 1109905 COURT LOCATION - FLORIDA MIDDLE - FT MYERS DATE FILED - 05/24/2011 FILING STATUS - JOINT ELEMENTS SEARCHED: USA CREDIT BUREAU • • • PAGE 2 OF PERSONAL CREDIT REPORT OCTAVIO CALDERON 4170 WASHINGTON LN APT 102, NAPLES FL 34116 SSN: - IN THE PREPERATION OF THE CONTRACTOR LICENSE REPORT, USA CREDIT BUREAU HAS USED CREDIT AND PUBLIC RECORD INFORMATION FROM ONE OR MORE OF THE NATIONALLY RECOGNIZED CREDIT AND PUBLIC RECORD INFORMATION REPOSITORIES. EACH OF THESE REPOSITORIES CERTIFIES THAT PUBLIC RECORD INFORMATION IS SYSTEMATICALLY COLLECTED AND ENTERED INTO THEIR DATA BASES. USA CREDIT BUREAU • • • PAGE 3 OF PERSONAL CREDIT REPORT Detail by Entity Name Page 1 of 2 FLORIDA DEPARTMENT OF STATE DIVISION OF CORPOR ATIONS .-kn 1 Detail by Entity Name Florida Profit Corporation ALL IN 1 DRYWALL & PAINTING INC Filing Information Document Number P13000016325 FEI/EIN Number 46-2047626 Date Filed 02/19/2013 Effective Date 02/15/2013 State FL Status ACTIVE Last Event AMENDMENT AND NAME CHANGE Event Date Filed 02/28/2013 Event Effective Date NONE Principal Address 12825 Collier Boulevard NAPLES, FL 34116 Changed: 03/07/2014 Mailing Address 12825 Collier Boulevard NAPLES, FL 34116 Changed: 03/07/2014 Registered Agent Name &Address Octavio, Calderon 12825 Collier Blvd NAPLES, FL 34116 Name Changed: 02/23/2015 Address Changed: 03/07/2014 Officer/Director Detail Name &Address Title P CALDERON, OCTAVIO E http://search.sunbiz.org/Inquiry/Corporate onSearch/SearchResultDetail?inquirytype=Entity... 6/30/2015 Detail by Entity Name Page 2 of 2 12825 Collier Blvd NAPLES, FL 34116 Title VP CALDERON, DONALD 4170 WASHINGTON LN APT 102 NAPLES, FL 34116 Annual Reports Report Year Filed Date 2014 03/07/2014 2015 02/23/2015 Document Images 02/23/2015 --ANNUAL REPORT View image in PDF format 03/07/2014 --ANNUAL REPORT View image in PDF format 02/28/2013 --Amendment and Name Change View image in PDF format 02/19/2013 -- Domestic Profit View image in PDF format Copvrighk and Privacy Policies State of Florida,Department of State http://s e arch.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 6/30/2015 . . State of i Fl r o da Department of State I certify from the records of this office that ALL IN 1 DRYWALL & PAINTING INC is a corporation organized under the laws of the State of Florida, filed on February 19, 2013, effective February 15, 2013. The document number of this corporation is P 13000016325. I further certify that said corporation has paid all fees due this office through December 31, 2015, that its most recent annual reportluniform business report was filed on February 23, 2015, 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 Twenty-third day of February, 2015 --iiii.._,_.,::-%...., ..„ -g,` �' //. . _ - .... Secretary of State Authentication ID:CC3707571307 To authenticate this certificate,visit the following site,enter this ID,and then follow the instructions displayed. https://efile.sunbiz.orgicertauthver.html Ea gii j olt- go"OA C") rift 4 Vi C '" a iii- 414,04 -.:4-104144 ; tiktaik■Itt,04.14A- ; t1,0 °4 ;"14Y0:7400"..: 4 tr 111- * # ) 11 # .141K t11 � #_ _. O� ►mss * OA)7, r9.1 -. cl. )-n 2, 4 0 OA b, : Ar 0 0 0 n arc?t./A ♦((4 -s", P. o a - N. f/®,,T $19"'"L 0 4- Ilk c4 e-t-. e--t cam+ C- ® N Q+ . i V ill it� ' o C 0 En 4/1111.. 5, 0 0-1 F, -.' ,-,.- 0 0 ,__,(1) k101 kt20, 4' oAts, co° W (--+- F, _ .) ,-- ;.i :4 ,r, (-)" pp 000 04, ar ♦ a iii! . Po 0 c) • g'' (-+ 0 — c) g. E ,-, 1%.*-1-411 'Ilk CD CD e+ C' ,.y n ,-+. filii r * ttf,t3( -si i P (9-' 71' r:2-, r- t lift 4: ? vi. 0-, Rq (1) °11711ib, g.r. 0 0 cn -6 it ta 0 r--)i a --i kc; 0 c ) E -- --b 4; oil: bkyo e'rlAtI, ay 0 2N v) __G 0 Ark „,4 0 CD .0-1 LI rcq"- H A WO .g iro P o O ink 0 � �• o .. )61)4 : ay 0[t 04 Lc CD o L+*••• la' II,0 :p trIwog'...4+ # 4 . 11, 0 .4414 0 4 ■ A )14 ■, 11 0411■ 4r(Alk: e ‘,44 410�r �► :fir � �r �.A� r�, ..°17.irkt°71A111--'4. ., � r �r� � r 2015 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT# P13000016325 Feb 23, 2015 Entity Name: ALL IN 1 DRYWALL& PAINTING INC Secretary of State CC3707571307 Current Principal Place of Business: 12825 COLLIER BOULEVARD NAPLES, FL 34116 Current Mailing Address: 12825 COLLIER BOULEVARD NAPLES, FL 34116 US FEI Number:46-2047626 Certificate of Status Desired: Yes Name and Address of Current Registered Agent: OCTAVIO,CALDERON 12825 COLLIER BLVD NAPLES,FL 34116 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: OCTAVIO CALDERON 02/23/2015 Electronic Signature of Registered Agent Date Officer/Director Detail : Title P Title VP Name CALDERON,OCTAVIO E Name CALDERON,DONALD Address 12825 COLLIER BLVD Address 4170 WASHINGTON LN APT 102 City-State-Zip: NAPLES FL 34116 City-State-Zip: NAPLES FL 34116 hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am 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:OCTAVIO CALDERON P 02/23/2015 Electronic Signature of Signing Officer/Director Detail Date • v IRSDEPARTMENT OF THE TREASURY 1 "INTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023 Date of this notice: 02-15-2013 Employer Identification Number: 46-2047626 Form: SS-4 Number of this notice: CP 575 A ALL IN 1 DRYWALL & PAINTING INC 2160 43RD TER SW APT 51 NAPLES, FL 34116 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 46-2047626. 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. it , , FT I 02/19/2013 erecrmnic Federal Tax Payment System P:17 T6 10004247 PP1 B-012469 TIN/EIN ALL IN 1 DRYWALL&PAINTING INC 2160 43RD TER SW (Taxpayer Identification Number/Employee Identification Number) 51 APT NAPLES FL 34116-6424 **-*** ll„lll,,,l,,.i.hlllllll„lun,niui!IuilhIhIIhllli iill,.til,I PIN (EFTPS Personal Identification Number) Dear All In 1 Drywall & Painting Inc, As a new business with a likely federal tax deposit obligation, you were enrolled in the Electronic Federal Tax Payment System (EFTPS), a free service of the U.S. Department of the Treasury. To start making payments via EFTPS, follow these steps: 1. Call 1.800.555.3453. Enter your EIN and the four-digit PIN that appears in the box above. If you're calling from outside the U.S., please call 1.303.967.5916. 2. Enter your financial institution information, including account number, bank routing number, and account type (savings or checking) when instructed. The voice response system will repeat the number you entered so you can either confirm or correct the number. 3. Re-enter your PIN. 4. Enter the phone number of the person to contact if we have questions about your EFTPS enrollment. This could be you or a member of your staff. 5. Record the enrollment number and keep for future reference. After you've completed your enrollment, you can make payments at EFTPS.gov or via the phone by following the steps listed on reverse side of this letter. Please note;While-you can schedule a-payment as soon as you activate your~enrollment, payments must be scheduled by 8 p.m. ET the day before the due date to be timely.The funds will move out of your bank account on the payment settlement date you select. Payments can be scheduled up to 120 days in advance. If a payroll company, accountant, or other third party makes any federal tax payments for you, be sure to review this information with that entity. If you need further assistance, please call customer service 24 hours a day, 7 days a week at 1.800.555.4477. If you are calling from outside the U.S., call 1.303.967.5916. Prkil PP1 12-12 •ACCORD CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDDIYYYY) 06/23/2015 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: CUSTOMER SERVICE INTEGRAL UNDERWRITERS CORP (A/C.No,Est): (239)304-3200 FAX No): (877)745-5560 PO BOX 990337 E-MAIL ADDRESS: infogintegralund.com NAPLES FL 34116 INSURER(S)AFFORDING COVERAGE NAIC# INSURER A: UNITED STATES LI ABILITY INSURANCE CO 25895 INSURED INSURER B: ALL IN 1 DRYWALL&PAINTING INC 12825 COLLIER BLVD INSURER C NAPLES,FL 34116 INSURERD: 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 ADDL SUBR POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR WVn POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000 X COMMERCIAL GENERAL LIABILITY DAMAGE TO RENTED r PREMISES(Ea occurrence) $ 100,000 X CLAIMS-MADE X OCCUR - N i MED EXP(Any one person) $ 5,000 X Deductible$500 CL1649016 04/24/2015 04/24/2016 PERSONAL E.ADV INJURY $ 1,000,000 GENERAL AGGREGATE $2,000,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS-COMP/OP AGG $ INCLUDED —X-1 POLICY PRO LOC $ JECT AUTOMOBILE LIABILITY 5-IW„ COMBINED SINGLE LIMIT J �� (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE AUTOS $ (Per accident) PIP$10,000 $ UMBRELLA LIAB OCCUR 1 " ' EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED RETENTION$ I $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICE/MEMBER EXCLUDED? N/A I N (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ FN— DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) CONSTRUCTION CONTRACTOR CERTIFICATE HOLDER CANCELLATION COLLIER COUNTY CONTRACTORS LICENSING BOARD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2800 N HORSESHOE DR ACCORDANCE WITH THE POLICY PROVISIONS. NAPLES,FL 34104 AUTHORIZED REPRESENTATIVE • FAX:2392522469 0 A, /c3 . JULIO HERNANDEZ o ©1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010/05) The ACORD name and logo are registered marks of ACORD • PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE r�. IMPORTANT STATE OF FLORIDA E�w Pursuant to Chapter 440.05(14),F.S.,an officer of a corporation DEPARTMENT OF FINANCIAL SERVICES "9� who elects exemption from this chapter by filing a certificate of DIVISION OF WORKERS'COMPENSATION r ` election under this section ma not recover benefits or �.: may •*i„s F compensation under this chapter. CONSTRUCTION INDUSTRY EXEMPTION (J CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA L Pursuant to Chapter 440.05(12},F.S.,Certificates of election to WORKERS'COMPENSATION LAW D be exempt..,apply only within the scope of the business or trade EFFECTIVE DATE; 3/14/2015 EXPIRATION DATE: 3/13/2017 listed on the notice of election to be exempt. PERSON: CALDERON DONALD FEIN: 462047626 H Pursuant to Chapter 440.05(13),F.S..Notices of election to be E exempt and certificates of election to be exempt shall be BUSINESS NAME AND ADDRESS: R subject to revocation if,at any time after the filing of the notice ALL IN 1 DRYWALL&PAINTING INC E or the issuance of the certificate,the person named on the notice or certificate no longer meets the requirements of this 12825 COLLIER BLVD section for issuance of a certificate.The department shall revoke a certificate at any time for failure of the person named on the NAPLES FL 34116 certificate to meet the requirements of this section. SCOPES OF BUSINESS OR TRA WALLBOARD,SHEETROC PAINTING NOC&SHOP K,DRYWALL. P OPERATIONS• DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 c r'DD WS 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: 2/22/2015 EXPIRATION DATE: 2/21/2017 PERSON: CALDERON OCTAVIO FEIN: 462047626 BUSINESS NAME AND ADDRESS: ALL IN 1 DRYWALL&PAINTING INC 12825 COLLIER BLVD NAPLES FL 34116 SCOPES OF BUSINESS OR TRADE: WALLBOARD,SHEETROC PAINTING NOC&SHOP K,DRYWALL, P OPERATIONS 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 DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 • PLEASE CUT OUT CARD BELOW AND RETAIN FOR FUTURE REFERENCE T STATE OF FLORIDA y� Pursuant to Chapter 440.05(1gMPORTofficerofacorporation DEPARTMENT OF FINANCIAL SERVICESr who elects exemption from this chapter by filing a certificate of v, 'z� election under this section may not recover benefits or DIVISION OF WORKERS'COMPENSATION "'� F �`��f„fi compensation under this chapter. CONSTRUCTION INDUSTRY EXEMPTION 10 CERTIFICATE OF ELECTION TO BE EXEMPT FROM FLORIDA I L Pursuant to Chapter 440.05(12),F.S.,Certificates of election to WORKERS'COMPENSATION LAW D be exempt...apply only within the scope of the business or trade EFFECTIVE DATE: 2/22/2015 EXPIRATION DATE: 2/21/2017 listed on the notice of election to be exempt. PERSON: CALDERON OCTAVIO f'I Pursuant to Chapter 440.05(13),F.S.,Notices of election to be FEIN: 462047626 E exempt and certificates of election to be exempt shall be BUSINESS NAME AND ADDRESS: R subject to revocation if,at any time after the fling of the notice ALL IN 1 DRYWALL&PAINTING INC E 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 12825 COLLIER BLVD a certificate at any time for failure of the person named on the NAPLES FL 34116 certificate to meet the requirements of this section. I ' SCOPES OF BUSINESS OR TRA WALLBOARD,SHEETROC PAINTING NOC&SHOP K,DRYWALL, P OPERATIONS DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 • SLR �� '_ - ! •OPera a �i.:,4G �aa ± "F"aR01 i Wes. tbn of Q w !YC,7� Con8�7u7as cnnsant to any °Otx11'fas"4""a COLLIER COUNTY BUSINESS TAX RECEIPT eFTr:SF APPLICATION `,`-'-== -- _-_� y s pp �� r 7d r A&' 2800 N.Horseshoe Drive,Naples,FL 34104 4`, :f it `y.--.1-; 4 l Make Check Payable to: Collier County Tax Collector ;ti ,,, ' Phone: 239-252-2477 Fax:239-643-4788 Website:www.colliertax.com °OD �� 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) CIECK ONE: Date: Original Application Classification Transfer of License# Code Number - - Renewal of License # License Amount 1) CORPORATE NAME - ALL IN I ) UJLL-1- eA I Km- i N G ,sN G la) DBA NAME - lb) BUSINESS OWNER OR QUALIFIER'S NAME- OCTAV 10 e. c_A-LJ1Wry 2) PHYSICAL ADDRESS- I a V 2S C01 ii e r i' k'c- Qat I(LS _ T-1 341 1(9 (No P.O.Box allowed) 2a) IS RESIDENCE USED AS AN OFFICE- ✓ Yes No 3) BUSINESS MAILING ADDRESS- I<9S 2-S C")111 CC 61t/CA IJq Icy Ft 3 411(0 Street City 1 �'- ,`_ ]�, Zip ,�p, 4) OWNER OR QUALIFIER'S RESIDENTIAL ADDRESS - 4 I-10 �1Jo-1■ng I v r �*-102,13' I P I 5) TELEPHONE -Business:CAN)361S" (08.50 Home: / 6) LEGAL FORM OF BUSINESS: Sole Proprietorship Partnership ,/ Corporation LLC LLP 7) OPENING DATE OF BUSINESS OR DATE ASSUMED- v.I 1 c I 13 ■ 8) OFFICE WITHIN CITY LIMITS OF NAPLES - I Yes No If Yes,City License No. 9) SOCIAL SECURITY NO. or FEDERAL EMPLOYER IDENTIFICATION NO. - - 4(Q - 2014-1 (0 26? *see back of application for explanation 9a) TYPE OF BUSINESS CONDUCTED: ( 2n . . COnkc 10) NUMBER OF EMPLOYEES -Including number of owners: 2.. 11) FILL IN THE APPROPRIATE AREAS- II a)Rental units(motel/hotel/apts.)Number of units: N lA b)Seating Capacity(rest./cafes, etc)Number of seats: 1\)/A c)Number of coin-operated machines owned by business or individual: NI A 12) STATE LICENSE OR CERTIFICATION NUMBER- 7' 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 TH BEST OF MY KNOWLEDGE. xxxAPPLICANT'S SIGNATURE: �OaQ-r DATE: (pi c2c'l) is (Owner and/or representative of business) ITLE: ****THIS LICENSE IS NON-REFUNDABLE FOR BUSINESS STATED ABOVE**** SECTION A, B,AND C FOR OFFICE USE ONLY THIS SECTION TO BE FILLED OUT BY CONTRACTORS/BCC LICENSING BOARD SECTION A Classification of Contractor: County Certification Number: Department Supervisor Date: THIS SECTION TO BE COMPLETED BY PLANNING SERVICES SECTION B Business is an in-home occupation and the applicant has agreed to adhere to the requirements as set forth in the Collier County Zoning Ordinance. PROPERTY Business DOES COMPLY with the Collier County Zoning Ordinance. ZONED Signed: Title: Date: Comments: THIS SECTION TO BE COMPLETED BY THE HEALTH DEPARTMENT SECTION C Business DOES COMPLY with the local and/or State requirements. Signed: Title: Date: * In accordance with Florida Statute 205.0535(5), we require you to provide us with either a Federal Employer Identification Number (FEIN) or a Social Security number. co er CoH v,ty Growth Management Department Planning & Regulation Operations Division Licensing Section July 16, 2015 William Orr 8578 Julia Ln. Naples, FL 34114 RE: Contesting Citation #09365 Mr. Orr, You have been added to the agenda for the Contractor Licensing Board meeting on Wednesday, August 19, 2015. 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) 252-5572. Sincerely, chI" i /7, (,(171-A- Samantha Roe Customer Service Specialist Licensing/Operations 2800 North Horseshoe Drive Naples, FL 34104 Growth Management Division*Planning&Regulation*2800 North Horseshoe Drive*Naples,Florida 34104*239-252-2400*www.colliergov.net To: Collier County Licensing Board, Contractor's Licensing Supervisor 2800 N. Horseshoe Drive, Naples, FL 34104 From: William Orr Date: July 16, 2015 Subject: Request for an Administrative Hearing on Citation#09365 I am hearb equesting an Administrative Hearing re the above Citation. Very ul yo rs, ifIger44 Willia f S rr 857: ulia Lane N- . es, FL 34114 813-777-1402 Deliver by Hand COLLIER.GOUN.TY_. ° . 17, - : GROWTH MANAGEMENT DIVISION 4: - CITATION Pursuant t¢-section 489.127_( Florida Statutes,the-undersigned hereby certifies that upon .' aeisen investigatioa>fieiSl=liasrtias nable}aerdgobable-gsoundstobelievethatthe,peson:whose --name appears below as issuedto,didviolate subsection 489.127.(1),Florida Statutes,and the Collier County Contractor's Licensing Ordinance No.2006-46(as may be amended)by committing the violation stated below. Month Day Year —HTime 1AM7PM Issued To - - Address — ' ` � — City 1.174 f✓'J State /- Zip Telephone No_ I.D. Date of Birth Race Sex Height Vehicle Make/Type(if applicable). Color Tag No. - Location of Violation _ - 1:::,-,-_, OPTIONS I have-been informed,of the violationfor which I-havebeencharged.and.elect the following option(Check one) 1) ❑ I choose to pay_the penalty of$ sr„i.`---t:;-' ,'-'` -' ''` - 2) ❑ I choose not to pay-the penalty,and will request in writing by certified mail or hand delivery an Administrative Hearing before:the Contractor's Licensing Board. Description of Violation Date Violation Observed :-11`- -'. a) ❑ Falsely hold self or business organization-out as a licensee,certificate holderor registrant; b) ❑-Falsely impersonate a-certificate holder or registrant; c) ❑ Present as his/her own the certificate or registration of another; - d) ❑ Knowingly give false or.forged evidence to the.Board or a member thereof; e)-❑ Use or attempt_to use a-certificate or registration which has been suspended or revoked y C . , r >s 2 ,.— .f) (,Engage in the_business or actin the capgcity_pf a contractor-or advertise self_ or business organization as available to engage in the business or act in the capacity of a contractor-without:being duly-registered or certified, g) ❑ Operate a business organization engaged.rn_contracting after(60)days; h)-.0.Commence oLperform work for-which a'6uilding permit is required pursuant to an.adopted state minimum building code orwithoutsuchpermit being ineffect; i) ❑ Willfully or deliberately disregard or violate any Collier County ordinance - - relating to uncertified or unregistered contractors.- - A person or businessorgani7ation operating on an inactive or suspended certificate,. -or registration,or operating beyond the scope of work or geographical scope ofthe registration, not duly e�ertified.or registered. : . -I I ixf_---..:14V----1,- - - --'5..$--'->-,5,,ey-'1 SIGNJATURE(RECIPIENT) :-. - - SIGNATURE(INVESTIGATOR) PRINT(RECIPIENTS NAME) • PRINT(INVESTIGATOR'S NAME) Pursuant to 489.127, Florida Statutes, willful refusaLto.sign and accept--this citation constitutes a misdemeanor of the sec_and degree, punishable as provided in section 775.082 or 775.083 Florida Statutes. j (SEE-REVERSE-FOR INSTRUCTIONS) Jr s I"(✓ ,�'"r' ✓_ T ,r J ” 4=.� - C.. T -/ 4✓ vi !f - R' C1-Fn1Efl COPY- - www.sunbiz.org - Department of State Page 1 of 1 FLORIDA DEPARTMENT OF STATE IVISION OF CORPORATIONS Home m..... - Contact Us E-Filing Services Document Searches Forms Help Previous on List Next on List Return to List Fictitious Name Search No Filing History Submit J Fictitious Name Detail Fictitious Name ECO FRIENDLY ELECTRIC Filing Information Registration Number G14000047509 Status ACTIVE Filed Date 05/14/2014 Expiration Date 12/31/2019 Current Owners 1 County COLLIER Total Pages 1 Events Filed NONE FEI/EIN Number NONE Mailing Address 8578 JULIA LANE NAPLES, FL 341142736 Owner Information ORR, WILLIAM J. 8578 JULIA LANE NAPLES, FL 341142736 FEI/EIN Number: NONE Document Number: NONE Document Images 05/14/2014 -- REGISTRATION View image in PDF format If<. Previous on List Next on List Return to List Fictitious Name Search No Filing History [ Submit 1 i Home I Contact us I Document Searches I E-Filing Services I Forms I Help Copyright©and Privacy Policies State of Florida, Department of State httn://www.sunbiz.org/scripts/ficidet.exe?action=DETREG&docnum=G 14000047509&rdocnum=G 140... 7/15/2015 DBPR- ORR, WILLIAM JAY, Certified Electrical Contractor Page 1 of 1 9:19:25 AM 7/15/2015 Licensee Details Licensee Information Name: ORR, WILLIAM JAY (Primary Name) Main Address: 8578 JULIA LANE NAPLES Florida 34114-3627 County: COLLIER License Mailing: LicenseLocation: License Information License Type: Certified Electrical Contractor Rank: License Number: Status: Application in Progress Licensure Date: Expires: Special Qualifications Qualification Effective Alternate Names 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 he 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=F9E36E3EC 1 E6AE89BB57F7ED615B... 7/15/2015 Ls (i VERONAWALK SERVICES FOR VERONAWALK RESIDENTS /11`;"-- Business Name* Fc d FA'/ / y tL G lc, Resident Name* l%1 i MA A �q. y0 4 Category LL E(TA!CPL.,( iii k"� kw S iziiabwogI.9, .4 lJ Contact Name* B/ c 4, 02 k Contact Title* av K. Email Address* i ji-3—//0�O 7i4lttOOJ VeronaWalk Address* gsC 7§ COL/q x 4',41 6 Business Phone* 739- 43 I -SJ?j j Cell Phone 03'777 - i602 44* Home Phone 23-9— C / --s''j / 3 Website URL (if applicable) t it.14) �.�'O�'�Ic,�f/�L fI-E -7. Lis D£Sl6t,/>r,fLL 4'//'f5i"RLc %.otJ !/4Lr'A6 Th - sy rcM Short Description* ,Ql.c,�rve-ZLIi rN article tc)/RiN&-416E275W S INO7C -� S Ccrv7'7r4CiS cd�/4_ABL J �• .r:1) f,,�IA�C�- Please note: items with an asterisk MUST be filled in and will be included in the Services Directory for t- /dents to view. Other items are optional,but if filled in, WILL be included and visible to residents. �ti Mail India z-e-ao, C //avallII.A Date ; ature ECO FRIENDLY ELECTRIC Green Energy Electrical Products Landscape Lighting and Lake Fountains our Specialty www.ecofriendlyelectric.us Bill Orr,Owner wijaor@yahoo.com 4 '� S 813-777-1402/239-631-5313 Naples,Tampa,Miami,Florida Maintenance Contracts Available Suppliers of Fixtures, Landscape LL. ,iv Wire&Accessories Lake Fountai* , Green Energy Electrical Products, Landscape Lighlippg and Lake Fountains o S m ecialty www.ecofriendlyelectric.us Ctflflergov.net f�Cf.JVI l I ILIC. L UUC Vc1JC VCLAIIJ Date: 7/20/2015 3:34:45 PM Case Number: CEUL20150014029 Case Number CEUL20150014029 Status: Citation Case Type: Unlicensed Date & Time Entered: 7/13/2015 3:50:22 PM Priority:I Normal Entered By: I JosephNourse Inspector: r JosephNourse Case Disposition: 'Case Pending Jurisdiction: Contractor's Licensing Origin: Complaint Detail Description: 7/13/15 Orr, William (DBA) ECO Friendly Electric, Unlicensed Advertisement, Citation # 09365 Location Comments: Verona Walk 8578 Julia Lane Naples Fl 34114 Folio 79904164426 Property 79904164426 Violator WILLIAM ORR Cddditergov.net r\epUI I. I ILIC. VUUC Lecl a UCIQIIJ Date 7/20/2015 3:34:45 PM Case Number: CEUL20150014029 Desc Assigned Required Completed Outcome Comments Preliminary Investigation JosephNourse 7/13/2015 7/15/2015 Citation 7/13/15 Received complaint of an unlicensed Required electrician advertising for work in the Verona Walk community. Investigation in to the complaint reviled that William Orr(DBA) Eco Friendly Electric is advertising for work as an electrician and is not licensed as such. Mr. Orr has been citied in the past CEUL20120014852 for unlicensed electrical contracting. Cont. Investigation JosephNourse 7/14/2015 7/15/2015 Complete 7/14/15 Site visit to 8578 Julia Lane Naples Fl. owner William Orr was not home his wife said that he was in Tampa and would be back in town next Monday. Left my card with contact information for Mr. Orr requested he contact me when he returns. Cont. Investigation JosephNourse 7/15/2015 7/15/2015 Complete 7/15/15 Meet with Mr. William Orr Licensing Compliance Officer R. Smith and my self J. Nourse here in office. Explained violation to Mr. Orr and issued citation 09365. Cont. Investigation JosephNourse 7/15/2015 7/15/2015 Complete 7/15/15 Contacted Maureen Hibbard the Assistant Town Manager, in Verona Walk to request information as to how the add for ECO Friendly Electric was posted to the community electronic bulletin board. Mrs. Hibbard provided the request form signed by William Orr(see attached)Verona Walk Services for Verona Walk Residents. Issue Citation (Licensing) ReggieSmith 7/15/2015 7/15/2015 Complete 7/15/15 Issued citation#09365 to William Orr (DBA) Eco Friendly Electric for Unlicensed Advertisement. $2,000.00 2nd offence with all reverse side information explained. Citation Paid/Contested clements k 7/29/2015 Pending Violation Description Status Entered Corrected Amount Comments Unlicensed Advertisement Open 7/13/2015 $0 Title Reason Result Compliance Fine/Day Condition View Listing VeronaWalk Page 1 of 1 81.0°F RESi DENT iNFO COMMITTEES EVENTS HCA L G UT ECC) FRIENDLY ELECTRIC Print Listing Return To Report Click here for Bill's business card Bill Orr,Owner Member Name: William Orr 8578 Julia Lane Category: Electrician Naples,FL 34114 Keyword: Electrical Business Phone: 239-631-5313 Cell Phone:813-777-1402 Home Phone:239-631-5313 Email Address:wijaorruyahoo.com,bill @ceofriendlyelectric.us Link URL:www.ecofriendlyelectric.us Boasiness Description Outdoor lighting &wiring, specialty low voltage; design, sell and install low voltage landscape lighting systems along with other wiring needs and projects. Maintenance contracts available. All work guaranteed. VERONAWALK 8090 Sorrento Lane Naples,FL 34114 T.239.774.0026 (0 2014 Copyright. All Rights Reserved. Site by Clubessential Terms and Conditions Privacy Policy https://www.veronawalknaples.com/default.aspx?p=.NETBizDBListing&id=5&ss=1% 7/10/2015 • ECO FRIENDLY ELECTRIC, LLC Page 1 of 1 It ALIL_Fg L L -- ''' ' - 7A. - 4- IT '--°_*- , r-- „ __,. ,, , * , - F, L.*1 ,j__; „ , g. :, .._ ,_ _,., I - - • . '-- Li - ' 4 , - --•-'''., . , ._,.. • CTRir , L-..,, ,,--'f'-..T..:7--"' ' '''-'. '— - • '• ..., . . , . . . c --- c.r if,. ,,,,..:Lis ? .,--,1-;--.-._. •=1:7= is a USA based Energy Efficient, one -ouloc 4 ..,.._..,. ,,, , ., .,. - . ,„. the most advance(1 arid effrcrent pro , ...:, ..--.5L,.._;,,„;,,,,,i.i.,i",:c_it,„:,-?,..,.„::.--:-1'..7::-.:1:1:-.,,-.4, ::.,..,.-,-,.,,-.,„;i,-,,ii.,,,,i- : Line &'7::-,_._„,„:„-. ..- Lci-,v„, V -, -.... ,i.:.,,,A,,.-i-, .r,,,ui.-.;,.Ftal-itili.T.:..13-i7,-.7.-,--::-.,:i- 2.iilt`1_-:1:-.,:sdi.';:,:,.'=,::::,r',1-:',,, /=i:.!=, r; 4 athways, . .. -iii• i_i• '— ''..-1-'-tY_, ' -''''''' -1-..,-: " -.--'1'.rie ''''''- tirStallation B LfibS: 4'.4 Y.,•'-ii '''''."''' , „ • r. • ••, , '-i,•_-,,z,irri-5:-,1.,-.::;f:f::-.-.iiiri ,',:i.r„--_iii'-riii-ii,iii-i-_-_::.zirt....:,i4Gti,f.--ii-.1.p,g-ii,-„-'•-i-'''.-V C .0 esign, Install (licensed elecinciai„,,,,-J, . . y,-1 ri f e ria nc..,,e (PesC1rn.,,77.,.., ir1d..,„)..:C a.117 : I1.7 (jrer.1::.;,'_::2,,:'' info( eic.d, ieiiiiii-r--:•„-rvi.i.7ririiiJi.--iii t•C:,-11G-•-',.•-,'_: _'-'_.,--."•,:, - ••- - ' ' ,,.,-;- - - ' - gagnie—''''-''''' .ri•L:'-'-•'-=;'-;.-:-'-, '-:-,,ri•:-••"---,-4-1'-",..-;-----ic--;•,- ..--:•-•••;..,:=;,..1.:-.-'•,J.- , ,,,,._:,. •:_,-:- ' - -',v-•:7„.,....:.,1,7,-;t:45,7:',--=,-----=',7,4•'-',-„2.-....-.....,-; 1•=z-_-,•-_-:- - - -..1,:• !I- 'i; ' '4iP w , ,..- . 7/13/2015 http://w-vvw.ecofriendlyelectnc.us/ Details Page 1 of 1 Collier County Tax Collector 2800 N. Horseshoe Drive Naples, FL 34104 Collier County Business Tax Receipt Tax Year Info: 2015 Prey Record Next Record BUSINESS INFORMATION OWNER INFORMATION License # 132684 Name 1: ORR, WILLIAM Name: ECO FRIENDLY ELECTRIC Name 2: Address 1: 8578 JULIA LN DBAIII _ Location: 8578 JULIA LN Address 2: Zoned) HOME OCCUPATION City, State, Zip: NAPLES FL 34114 Mail 1: 8578 JULIA LN L Phone:1 813-777-1402 Mail 2: City, State,I NAPLES , FL 34114 Zip: Phone: 1632 5313 Open Date: 05-19-14 TANGIBLE Code: 04200001 Description: PERS PROP L Changed Date: 00-00-00 DEALER OF II Paid Date: 00-00-00 TANGIBLE I _ Closed Dat� 00-00-00 State Lic: Class: — PERSONAL PROPERTY Amount Due: 30,00 County Lic: I Category: 1 L` City Lic: Preq:Il T— ** License is: Unpaid ** ** License is: Open ** You may be able to pay your business tax online. More details Prey Record New Search Next Record Back To Lis—t- 2013 Tax Ii ftrmation 2014 Tax Information http://www.colliertax,com/search/o1s_details:php?ID=61327023&page=&year=2015 7/13/2015 Detail by Entity Name Page 1 of 2 -- FLORIDA DEPAwith ENT OP STATE r x " zr •" DIVISION or CORPORATIONS Detail by Entity Name Florida Limited Liability Company ECO FRIENDLY ELECTRIC, LLC Filing Information Document Number L12000039445 FEI/EIN Number NONE Date Filed 03/21/2012 Effective Date 03/19/2012 State FL Status INACTIVE Last Event VOLUNTARY DISSOLUTION Event Date Filed 04/30/2013 Event Effective Date NONE Principal Address 16301 AVILA BLVD TAMPA, FL 33613 Mailing Address 16301 AVILA BLVD TAMPA, FL 33613 Registered Agent Name & Address ORR, WILLIAM 16301 AVILA BLVD TAMPA, FL 33613 Authorized Person(s) Detail Name & Address Title MGRM ORR, WILLIAM 16301 AVILA BLVD TAMPA, FL 33613 Annual Reports No Annual Reports Filed Document Images http://search,sunbiz.org/Inquiry/CorporationSearch/SearchResu hDetail?inquirytype—Entity.„ 7/13/2015 • Detail by Entity Name Page 2 of 2 04/30/2013 -- VOLUNTARY DISSOLUTION View image in PDF format 03/21/2012 Florida Limited Liability_ View image in PDF format r,s1p.,021,2i drici slati-0,FloHaD,DePa■lime,o.ot slate http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype—Entity... 7/13/2015 C.e lJ� ),,,e3-00./. 0 coiLl>=R COUNTY C 9 3 6 5 GROWTH MANAGEMENT DIVISION Pursuant to section X59.127, __CITATION personal investigation,o sect section 4 he/she.127 has lsonorid and probable undersigned hereby name personal e ow as issued ha did reasonable and r ble grounds to believe y�reper that upon County Contractor's ssthat the person whose violation stated below.Licensing Ordinance No.2006 46 Floe da Statutes,and the Collier (as may be amended)by committing the Month ✓ Day /4S' MTirne/O_'Ce ,fir•M ` Issued To Z/ a Address , City � .-r. _ State d` Telephone No. ID. Zip �f,!t' 277_/5.0 Date of": ®Color Tag No Location of Violation V s t/-/..l' x-78- i,.5_ Z I have been informed of OpT ONS I have o the violation for which I have been charged following option(Check one) g and elect the 1) ❑ I choose to pay the penalty of$ ,63O0,0-=.' 2) ❑ I choose not to pay the end .),�c/ 64,(2.e delivery not t Administrative pay the en Hearing n will request in writing by certified mail g before the Contractor's Licensing Board.hand Description of Violation •'' Date Violation Observed a) ❑ Falsely hold self or business organ ization out as a /ldr licensee,certificate holder or b) ❑ Falsely impersonate a certificate holder or registrant; c) ❑ Present as his/her own the certificate or registration of another; d) ❑ Knowingly give false or forged evidence to the Board or a member e) ❑ Use or attempt to use a certificate or registration which revoked thereof; �/ylJG ys�p �1t has been suspended or fl Engage in the business or act in the c pac i of a won actor advertise dve or business organization as available to e .;r capacity of a contractor without ngage in the business or actin the g) ❑ Operate a business organization out being duly registered or certified; fi)g) ❑ Co gani engaged in contracting after(60)days; Commence or perform work for which a building an adopted state m' g Permit is required pursuant to minimum building code or without such permit being i) ❑ Willfully or deliberately disregard or violate any Collier Coun ty ordinance relating to uncertified or unregistered contractors. in effect A person or business orga.'zatlon operating on an inactive or suspended certificate, or registration,or or t' g beyond the scope of work or geographical scope o'the tegistr'a'on,is not. ;rtified or registered, iIEgp 'S • NNA (' CIPIENT) SIGNATURE M ATII') • 1 01. e''` / PRINT(RECIPIENTS NAME) F Pursuant to 489.127 PRINT(INVESTIGATOR'S NA ME) Florida Statutes, willful refusal to sign and accept e as provided in section 775.082 or 775.083 Florida Statutes. P this citation constitutes a misdemeanor of the second degree, punishable 4(-‘2 ��j REVERSE FOR INSTRUCTIONS) //t t4 f lQe'7-4/)lG COLLIER COUNTY CONTRACTORS LICENSE ECO FRIENDLY ELECTRIC Green Energy Electrical Products Landscape Lighting and Lake Fountains our Specialty www.ecofriendlyelectrlc.us Bill Orr,Owner wijaor@yahoo.com '` 11 313-777-1402/239-631-5313 Naples,Tampa,Mianu,Florida Maintenance Contracts Available r F Suppliers of Fixtures, Landscape L1 li it Wire&Accessories Lake Founta�Y ". Green Energy Electrical.Products, Landscape La and Lake Fountains our S e eeialty www.ecofriendlyelectric.us . /r . 7 / L'411/1 G//� "77. cir JUL 1 0 2015 Go C,oun.y GMD Opera a: . ,'/• ��,1i o a 1..gement C). a---s-9 ca 28 fr'■.:, . a: , ,- .6,ve w � ,,„ ,�U., APPLICA; 4:OR COLLIER c TY/CIT )F /'LES/CITY OF MARCO h� v maw l• INSTRUTIONS: This application mibe ewritten or legibly printed. The application fee must be paid upon approval and is not refu able. All checks should be made payable to: Collier County Board of County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: .` Exact Corporate/Business Name: N ')AG tkl 7NvCA 1 114C Fiction Name/DBA: Qualifier Name: C5i6gla 74. -- C /4 C )Q Physical Address: 2420 'SVEg t•N-1 5 1-YP- Uks i - `)4)2.0 �j(Number&Street) (City) (State) (Zip Code) Mailing Address:24 7,0 ?' Eg 4L s • N4is 4) ✓4`lc (Number&Street) (City) (State) (Zip Code) Telephone: q(37^of B5 E-mail: P / c)cJO li,o roes a J.& TYPE OF LICENSE: General $230.00 Electrician $230.00 Building $230.00 Plumber $230.00 Residential $230.00 Air Conditioner $230.00 Mechanical $230.00 Swimming Pool $230.00 Roofing $230.00 1. Specialty $205.00 Specialty Trade: C l A .(p.,,,7 CHANGE OF STATUS: ( )Reinstatement ( )From One Business to Another ( )Dormant License to Active Page 1 of 4 • QUALIFIER INFORMATION: Name: • -F 1 CO Address: 2 f��'ai�,t„/, ^S „ Vel - NAf tz5J 1 '' • 120 (Number&Street) (City) (State) (Zip Code) Telephone( 6) q(0-7.01 65 Date of Birth: SS#: E-mail: Frilna� hay (1441 •cctm Driver's License#:. 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. c2A 1 co C7e ) 7.GC4,41 ( c ) 3. Have you ever been convicted of a crime related to Contracting? tic (If yes,attach extra sheet with explanation.) 4. Have you or any firms you have been associated with ever filed bankruptcy? 114 0 5. List all debts you or any company(s) associated with you that you refused to pay and the reasons for the refusal to pay and reasons why. °tai C 6. List your business or work experience during the last ten years. 7. Statement of any formal training you have had in the area for which the application is made. 3 of 4 Work Experience Cesar Franco John Rousseau Inc. From Jan. 2005 to Mar. 2008 6921 Burnt Sienna Circle Naples, FL 34109 Supervisor-John Rousseau (239) 253-3679 Kurtz Homes From Feb. 2003 to Dec. 2004 1055 Cross Point Drive From Apr. 2008 to Aug. 2010 Naples, FL 34110 Supervisor- Joey Broseau (239) 565-6420 Park Shore Kitchen and Interiors From Dec. 2010 to Dec. 2013 3860 Tamiami Trail N. Naples, FL 34103 Supervisor- Richard Marotta (239) 560-1742 Williams Finish Carpentry Inc. From Feb. 2014 to Jul. 2015 220 Magellan Street Fort Myers, FL 33913 Supervisor-Jason Williams (239) 777-6464 1. The names, titles,home address and phone numbers of all Officers/Managing Members of the Firm. Cz�.x•A*TgoCV4 CO t'4 CO + CO TfiaLr-5s06-14-r. —T" 5.uw 020 ENezroc./*E s lA- l ,64ke . zefrzo '•,16f-Tot1»eS two. 1,J/ 'cE, C. - --- , +rzo 4 120 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten years(i.e. held a license for or been a partner). Attach extra pages if needed. IQOi4L 3. List all debts you or any company(s) associated with you that you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. - i,(oJ AFFIDAVIT Under the penalties of perjury I declare that I have read the foregoing ap•li'.tion and that the facts stated in it are true. Autho ' ed 1'7 cer of the Firm/4 The foregoing instrument as acknowledged before me this �!G7o(1 8 /6 mate) by e r/ /GWC0 %r:'i bt %lliggiii In / ar/WC® (Name of Officer, Title/Agent) (Name o a orp• ation) • a /6.66∎ �"— Corporation on behalf of the corporation. ,, (State or Place of Corporation) The has produced : -ij i iii .,/ ; A //�A h-n�ification and did not take an oath. ( ype of identific. en) NOTARY'S SEAL /IglOP '1' (SIG 7 f v� OF NOl .RY) ,�t ,"'y LAURIE A tJl� Page 2 of 4 A.�2� 4 Z _* ,.■ ;Y MY COMMISSION#EE 132913 ... , EXPIRES:November 2,2015 '0'..cr Bonded Thru Notary Pubic Underwriters AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County No. 2006-46, as amended, and under penalties of perjury. I declare that I have read the foregoing qualifier information and that the facts stated in it are true. 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/she 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. Applicant(please print) -Fi M PSI-VI)4.6 T3`f-F0-44,1 co Name of Company Signature of •ID', i' t State of Florida County of ("4 7—1 ... G The foregoing instrument as acknowledged before me this 40 =''''- . /../o % (Date) by , I' !"/L / who has prociuc d .?.1 4--} �• ¢ .,x,,,,i ame�erson acknowledging) \ 111 (type of identifp‘ation) as identification and did not take an oath. i ......"NOTARY'S SEAL r `.� Ji L------- � Or SIN• TURE OF NOTAR •� % LAURIE A.LINO r! MY COMMISSION#Er 1 12913 ■ EXPIRES:November% ':'15 ! W..,,,;,,,..: 4 of 4 ,;i �' Bonded Tin Notary Public item i °t""• LAURIE ALMID rig :.% MY COMMISSION 11 EE 132913 ~ EXPIRES: 1it? ae Bo Thu Notary � r witu s ii\ Z`eL 5/7/2015 Detail by Entity Name Detail by Entity Name Florida Profit Corporation FINISHING BY FRANCO, INC, Filing Information Document Number P10000076673 FEI/EIN Number 273518359 Date Filed 09/20/2010 Effective Date 09/20/2010 State FL Status ACTIVE Principal Address 2420 Everglades Blvd N - NAPLES, FL 34120 Changed: 04/18/2015 Mailing Address 2420 Everglades Blvd N NAPLES, FL 34120 Changed: 04/18/2015 Registered Agent Name & Address FRANCO, CESAR A 2420 EVERGLADES BLVD N NAPLES, FL 34120 Name Changed: 04/23/2013 Address Changed: 04/23/2013 Officer/Director Detail Name&Address Title P FRANCO, CESAR A 2420 EVERGLADES BLVD N NAPLES, FL 34120 Title T FRANCO, MARILE A 2420 EVERGLADES BLVD N. NAPLES, FL 34120 Annual Reports Report Year Filed Date 2013 04/23/2013 2014 01/10/2014 2015 04/18/2015 data:text h tml:charset=utf-8,%3Ch2%20style%3D%22text-align%3A%201eft%3B%20color%3A%20rgb(153%2C%2032%2C%200)%3B%20font-family%3A%2... 1/2 2015 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT#P10000076673 Apr 18, 2015 Entity Name: FINISHING BY FRANCO, INC, Secretary of State CC6936581744 Current Principal Place of Business: 2420 EVERGLADES BLVD N NAPLES, FL 34120 Current Mailing Address: 2420 EVERGLADES BLVD N NAPLES, FL 34120 US FEI Number: 27-3518359 Certificate of Status Desired: No Name and Address of Current Registered Agent: FRANCO,CESAR A 2420 EVERGLADES BLVD N NAPLES,FL 34120 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: CESAR A. FRANCO 04/18/2015 Electronic Signature of Registered Agent Date Officer/Director Detail : Title P Title T Name FRANCO,CESAR A Name FRANCO,MARILE A Address 2420 EVERGLADES BLVD N Address 2420 EVERGLADES BLVD N. City-State-Zip: NAPLES FL 34120 City-State-Zip: NAPLES FL 34120 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that tam 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 wilh all other like empowered. SIGNATURE:MARILE FRANCO TREASURER 04/18/2015 Electronic Signature of Signing Officer/Director Detail Date 2014 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT#P10000076673 Jan 10, 2014 Entity Name:FINISHING BY FRANCO, INC, Secretary of State CC8103240008 Current Principal Place of Business: 1241 18TH AVE NE NAPLES, FL 34120 Current Mailing Address: 1241 18TH AVE NE NAPLES, FL 34120 US FEI Number:27-3518359 Certificate of Status Desired: No Name and Address of Current Registered Agent: FRANCO,CESAR A 2420 EVERGLADES BLVD N NAPLES,FL 34120 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: CESAR A.FRANCO 01/10/2014 Electronic Signature of Registered Agent Date Officer/Director Detail : Title P Title T Name FRANCO,CESAR A Name FRANCO,MARILE A Address 2420 EVERGLADES BLVD N Address 2420 EVERGLADES BLVD N. City-State-Zip: NAPLES FL 34120 City-State-ZIip: NAPLES FL 34120 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shag have the same legal effect as if made under oath;that t am 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 at other Re empowered. SIGNATURE:CESAR FRANCO PRESIDENT 01/10/2014 Electronic Signature of Signing Officer/Director Detail Date 2013 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT#P10000076673 Apr 23, 2013 Entity Name: FINISHING BY FRANCO, INC, Secretary of State CC6370247829 Current Principal Place of Business: 1241 18TH AVE NE NAPLES, FL 34120 Current Mailing Address: 1241 18TH AVE NE NAPLES, FL 34120 US FEI Number: 27-3518359 Certificate of Status Desired: No Name and Address of Current Registered Agent: FRANCO,CESAR A 2420 EVERGLADES BLVD N NAPLES,FL 34120 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: CESAR A. FRANCO 04/23/2013 Electronic Signature of Registered Agent Date Officer/Director Detail : Title P Title T Name FRANCO,CESAR A Name FRANCO,MARILE A Address 2420 EVERGLADES BLVD N Address 2420 EVERGLADES BLVD N. City-State-Zip: NAPLES FL 34120 City-State-Zip: NAPLES FL 34120 I hereby certify that the information indicated on this report or supplemental report is true and accurate and that my electronic signature shall have the same legal effect as if made under oath;that I am 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:CESAR FRANCO PRESIDENT 04/23/2013 Electronic Signature of Signing Officer/Director Detail Date State of Florida Department of State I certify from the records of this office that FINISHING BY FRANCO, INC, is a corporation organized under the laws of the State of Florida, filed on September 20, 2010, effective September 20, 2010. The document number of this corporation is P 10000076673. I further certify that said corporation has paid all fees due this office through December 31, 2015, that its most recent annual report/uniform business report was filed on April 18, 2015, and that 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 Eighteenth day of May,2015 -w._ K. J x � .. Secretary of State Tracking Number:CU4947358252 To authenticate this certificate,visit the following site,enter this number,and then follow the instructions displayed. https://services.sunbiz.org/Filings/CertificateofStatus/Certifica teAuthentication Electronic Articles of Incorporation FPILE1000D 0076673 For September 20, 2010 Sec. Of State cgolden FINISHING BY FRANCO, 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: FINISHING BY FRANCO, INC, Article II The principal place of business address: 1241 18TH AVE NE NAPLES, FL. US 34120 The mailing address of the corporation is: 1241 18TH AVE NE 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: 1,000.00 Article V The name and Florida street address of the registered agent is: PAULA L FRANCO 1241 18TH AVE NE NAPLES, FL. 34120 I certify that I am familiar with and accept the responsibilities of P10000076673 registered agent. FILED September 20, 2010 Sec. Of State Registered Agent Signature: PAULA FRANCO cgolden Article VI The name and address of the incorporator is: PAULA FRANCO 1241 18TH AVE NE NAPLES, FL 34120 Incorporator Signature: PAULA FRANCO Article VII The initial officer(s) and/or director(s) of the corporation is/are: Title: P PAULA L FRANCO 1241 18TH AVE NE NAPLES, FL. 34120 US Title: VP CESAR A FRANCO 1241 18TH AVE NE NAPLES, FL. 34120 US Article VIII The effective date for this corporation shall be: 09/20/2010 886 110th Ave.N.Suite#6,Naples,FL 34108 :'', 1?-if,;;--- i::'' 4;*.r .i' io -''- ',:- .4"' t V # % Phone:239.777.1028 k. 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 9/94 06/08/15 08:36CT <SUBJECT> <SSN> <BIRTH DATE> FRANCO, CESAR A. : <CURRENT ADDRESS> <DATE RPTD> 230 SW. 29TH ST., NAPLES FL. 34117 11/06 <FORMER ADDRESS> 2420 N. EVERGLADES By. , NAPLES FL. 34120 8/05 3231 CALUSA AV., NAPLES FL. 34112 M O D E L P R O F I L E ***FICO CLASSIC 08 SCORE +520 : SERIOUS DELINQUENCY, AND PUBLIC RECORD OR ***COLLECTION FILED; TOO FEW ACCOUNTS CURRENTLY PAID AS AGREED; NO RECENT ***NON-MORTGAGE BALANCE INFORMATION; NUMBER OF ACCOUNTS WITH DELINQUENCY *** 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=5 NEG=5 HSTNEG=2-63 TRD=7 RVL=5 INST=0 MTG=2 OPN=0 INQ=2 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE CLOSED W/BAL: $273K $65.OK $938 TOTALS: $ $ $273K $65.OK $938 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 5/10 $1522 CITIBANK 09B 5/15A $2332 PLACED FOR COLLECTIO PORTFOLIO RC Y 1KSE003 C 6/11 $1236 WELLS FARGO BANK N 09B 5/15A $1236 PLACED FOR COLLECTIO LTD FINC SVC Y 1SQC001 I 1/10 $1258 CITIBANK SOUTH DAK 09B 5/15A $1258 PLACED FOR COLLECTIO STELLAR REC Y 2CPY001 I 6/14 $74 01 COMCAST 09B 4/15A $74 PLACED FOR COLLECTIO CRD PRT ASSO Y 4326001 I 9/08 $74 11 COMCAST FORMERL 09B 1/09A $74 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 WELLS FARGO B 908N664 1/95 $2758 R09 Page l of 2 6/11A $1150 $0 C CREDIT CARD 6/10F $0 PURCH BY OTHER LENDER CITI-SHELL B 282E022 10/96 $752 R09 6/10A $1025 $0 I CREDIT CARD 11/08F $0 PURCH BY OTHER LENDER THD/CBNA B 26H3005 9/07 $1258 R09 2/10A $1258 $0 I CHARGE ACCOUNT 11/08F $0 PURCH BY OTHER LENDER CITIFINANCIA F 7212001 3/07 $8051 R09 11/09A $7500 $0 I CHARGE ACCOUNT 2/09F $0 PURCH BY OTHER LENDER GREEN TREE F 1190001 7/05 $273K 360M938 12/13 555555555555 M05 4/15A $65.0K $58.6 05 5555 I CONVENTIONAL REAL 3/14C $273K FORECLOSURE INITIATED 23 0/ 0/16 BK OF AMER B 427S002 7/05 $247K 360M1546 8/08 555555555555 MOl 3/13A $0 $25.9 05 555555555555 I CONVENTIONAL REAL 3/13C $0 TRNSFRD: OTHER LENDER 48 1/ 1/45 SYNCB/SAMS D 235046S 3/06 $283 111111111111 RO1 12/09A $300 $0 111111111111 A CHARGE ACCOUNT 2/07C $0 CRDT CARD LOST/STOLEN 44 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 6/08/15 PNP7771028 (FLA) LICENSES ETC 5/09/15 ZSM0049997 (WIL) CREDIT PLUS END OF REPORT Page 2 of 2 886 110th Ave.N.Suite#6,Naples,FL 34108 '''''' .4 ':''I-:''',:r: -:.5x;-‘. - I - :1-1'" -4: ,,,o4 o- Phone:239.777.1028 Fax: 877.275.3593 www.LicensesEtc.com BUSINESS CREDIT REPORT as of: 06/08/15 09:40 ET Finishing by Franco, Inc. Fed Tax ID# 27-3518359 Address: 1241 18th Ave NE Key Personnel: Cesar Franco Naples, FL 34120-3406 Paula L Franco United States Marile Franco Phone: 239-821-1008 SIC Code: 7641-Reupholstery& Furniture Repair Experian BIN: 937469751 NAICS Code: 811420-Reupholstery And Furniture Repair Agent: Franco Cesar A Business Type: Corporation Agent 2420 Everglades BLVD N Address: Naples, FL Experian File September 2010 Established: Also is (or has been) operating as: Experian Years on File: 5 Years Finishing By Franco Inc Years in Business: More than 5 Years Filing Data Provided Florida by: Date of Incorporation: 09/20/2010 Public Records PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS. V Bankruptcies: 0 Page 1of2 V Liens: 0 V Judgments Filed: 0 3t Collections: 0 END OF REPORT Page 2 of 2 Ac°R CERTIFICATE OF LIABILITY INSURANCE DATE(MM/DD/YYI Y) 1/4...-- - 7/6/2015 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 N(2ME:CT CHRISTINE OLSON OLSON & DINUNZIO INSURANCE AGENCY INC (PHC Nq Ext)_ I A/C,No): 2536 NORTHBROOKE PLAZA DRIVE E-MAIL ADDRESS: CHRIS @OLSONDINUNZIO.COM NAPLES FL 34119 INSURER(S)AFFORDING COVERAGE I _NAIC# — (239)596-6226 (239)596-1620 INSURER A: FEDERATED NATIONAL 1-- 10790 ■ INSURED INSURER 8: ! FINISHING BY FRANCO INC INSURER C: INSURER D: 2420 EVERGLADES BLVD N INSURERS: NAPLES, FL 34120 � — 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 ADDL1SUER POLICY EFF POLICY EXP LTR TYPE OF INSURANCE INSR I WVD POLICY NUMBER (MM/DD/YYYY) (MM/DDIYYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $$100,000 FA COMMERCIAL GENERAL LIABILITY DAMAGE SESO(EaEo RENTED $$100,000 _ CLAIMS-MADE 1151 OCCUR GL-0000029272-00 07/07/2015 07/07/2016 MED EXP(Any one person) s$5,000 PERSONAL 8,ADV INJURY _ $$100,000 1I_ _ _ GENERAL AGGREGATE $$100,000 !GEN'L AGGREGATE UMIT APPLIES PER: PRODUCTS-COMP/OP AGG $$100,000 MI POLICY I MT LOC $ JEC AUTOMOBILE LIABILITY I COMBINED SINGLE UMIT 1-- ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS HIRED AUTOS NON-OWNED PROPERTY DAMAGE $ AUTOS (Per accident) I $ UMBRELLA LIAB OCCUR EACH OCCURRENCE S____ EXCESS LIAB 1 CLAIMS-MADE AGGREGATE $ DED i RETENTION S I $ WORKERS COMPENSATION TORY LIMITS OTH- AND EMPLOYERS'LIABILITY Y/N ANY PROPRIETOR/PARTNER/EXECUTIVE _E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? I N/A --- (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE $ If yes,describe under DESCRIPTION OF OPERATIONS below l E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,if more space is required) INSTALLING WOOD CABINETS AND TRIMS CERTIFICATE HOLDER CANCELLATION COLLIER COUNTY LICENSING DEPARTMENT SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS. 2800 NORTH HORSESHOE DRIVE 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 RESOLUTION OF AUTHORIZATION WHEREAS 'r")M !v 6 3y --FIZAA CO 1 N proposes to engage (Name of Business Entity) in contracting as zRoZ J T'l 04 in (Type of legal entity: corp.,partnership, etc.) Collier County,Florida,according to Collier County Ordinance 2006-46,as amended:and WHEREAS)J4 ksw46i3 {f¢,tvlCo, MG proposes to qualify (Name of Business Entity)) for a Certificate of Competency with C.1± —�'�- t - >4 CO (Name of Individual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: We the undersigned N c O la-e. of (Officers,Owners,Partners) SPA14015 Co, - hereby resolve and represent to the Collier County (Name of Business Entity) Contractor's Licensing Board that the qualifying agent, ( yam_ A NCO,is active (Name of Individual) in all matters connected with the contracting business off J Ja is-WAG T,I (Name of Business Entity) We further resolve and represent that C. .5.15.12— CO is (Name of Individual) Legally empowered to act for '1 J.)lS141,4 CVI ft,%N C- in all matters connected with its (Name of Business Entity) contracting business,and has the authority to supervise construction undertaken by )1M5v1'1 J4� 134 0,-41c1-) 1 (Name of Business Entity) DULY PASSED AND ADOPTED THIS C DAY OF (Officers,Partners,Owner/ /.esignation underneath) La! i1 ��2 iii Witness ej Wi s Corporate Seal(if applicable)or Notary Public Certificate Sworn to and subscribed before me thisMay o .1 0/ 1.3,y The foregoing instrument as acknowledged before me thi (Date) by '� 5 I,_ .4 i_ ,/.f''• produced (n.sue of person acknowl-dging) (type of identification) as identification-and did not take an oath. NOTARY'S SEAL '4111111111°41411 ,4 -41"--411% (SI NATURE O N•TARY) " - -- �.•,,,",.,, LAURIE AtINQ S.• ry�F` MY COMMISSION EE 132913 AaA41./e'�� * bef 2 2015 XPIRES:Novem t l d Bonded T "Natat?pubric Undermiters AFFIDAVIT It is understood and acknowledged by the Collier County Contractor's 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 C. %-/cy. Signature of pp is. t �il� sri�t,;v�6 131 T1216.-Nc0 Business Name E e5f 20 15 Date BEFORE ME this day personally appeared who affirms and says that he/she has less than one employee and does not require Workmen's Compensation and understands that at any time he/she employs one or more persons he/she must obtain said Workmen's Compensation Insurance. State of Florida County of Caj The foregoing instrument as acknowledged before me thisC G� ate) by ( +1 ej4-`Z (name of person acknowledging) (type of identificati n) as identification and did not take an oath. NOTARY'S SEAL 4114 6- _ (SIGNAT • OF NOTARY) LAURIE AUND MY COMMISSION#EE 132913 EXPIRES'November 2,201 3 BondedI NotaryPublicu2sda rrs, %nay 1,VERIFICATION OF CONSTRUCTION EXPERIENCE GMD Operations & Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: -- -�-- J C 0 Certificate Category Requested: 1 ' 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: R t C.H A P-..? I`'n.A. R.c2 T-CAr Title: 641!`1 E CL License Number(if applicable): C 6--c-- 15394330 Name of Business: &,1--"rONO%e7—. e-( -O`,c=L.. rk-,e— C Business Address: 17 ai is- R it G" \t>Cz iV 0�P t(?...5 Pt" act 12-v Business Phone: g 39- St 0--i'7 9 •- The Applicant's years of experience from 7o to to ea C. 13 The applicant's scope of work(specific duties)included: 1nTC-:2/cj,z i Q/"1 "`ZS rt-At ,1€ i . --7<f:fir'//r9-7-?0", c I t 4 5: is r..S ` >)f77 1.-M-1/ Additional Comments: CC5.4,2 S l 7�G /,7`.G �U �t-- 74 lL, 4-N i N/...S at),//in I./GSS 71-v 1,c1tatI< £ H hod es Falsifyinany information provided herein may subject your license to re : . '+n. ' / /" Signa e /}� Prin ame: 8/c,-i4 /,9gO i 74 State of Florida County of Collier S The regoing instrument was acknowledged before me on this ' day of M ki a-D 1 by -‘cy-y A �-t(rr� who is personally known to me or produced as identification and who did not take an oath. r .o. �......, , GINA BOVE Signature of\Notary �,+' \:.,, Notary Public-State of Florida 9 n I s;., T �J.:My Comm.Expires Apr 29.2018 1 •.,,ki Commission#FF 099163 0 VERIFICATION OF CONSTRUCTION EXPERIENCE.;• GMD Operations & Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: Cc_,.442... p CE) — Certificate-CategoryRequested: a — `1# 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: j4.1.114 Title: VP are- 14 fY1,es License Number(if applicable): C[.G l 5-0 9 57? Name of Business: ' utz.� 1-4-• i E_-s Business Address: jQ S's C`E2.pSS p01 t�l s� Fl-• 31110 Business Phone:z_343-5,4- LSO( The applicant's years of experience from 2.0O3to 20:0/0 The applicant's scope of work(specific duties) included: ' ,—ir y TRIrn Additional comments: C.� . tS .4 Gs�'a01�,�O 1SG1 1r 4-T( DIES a-M LC)'<E.E- Falsifying any information provided herein may subject your license to revocation. Under the penalties of perjury I declare that I have read the foregoing ape ication and that the facts stated in it are true. _ Signa re Print Name State of Florida p� County of The f. egoing instrument as acknowledged before me this ( ) �l _ ate) by a �� , who has produced 41/ , A-J/. // / / name of person . knowled'_ing) pe of is entification1 as identification and did not take an oath. NOTARY'S SEAL LAURIE A.UND , (Si,�c'TURE O NOTAR') MY COMMISSION#EE 13291 V:, ', . EXPIRES:November 2,2015 ";gi g Bonded Thtu Notary Public Undeiwdtets VERIFICATION OF CONSTRUCTION EXPERIENCEL GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,C FL34104 Applicant's Name: �= - ". --17-5.6.4,i Co Certificate Category Requested: ZJ Z� 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 informatigy-, Name: 3Q ` K(.D Uss EA C) Title: 12ZSI1D'f.A?• + License Number(if applicable): 12 6 - t 1 03615 Name of Business: O\4' (Roo ss c) 1 1 M C Business Address: (/Z 1 a 1 <1 e---N,A1 is CIi. _ , 1,1m4r. 1 r 4'° J Business Phone�2. )2 ')'3•371'The applicant's years of experience from 000 to fi�e The applicant's scope of work(specific duties) included:`J + O(... )no/..5 I RDU.Z1k o-fc 1>—)1 LVa(- ' 12A v4 ( '1if, C4130J6 r' 1 i iXJ- -r'��I Additional comments: Falsifying any information provided herein may subject your license to'revocatier. Under the penalties of perjury I declare that I have read the fo Drug applic4tion and that the facts stated in it are true. - L__________----Si- gnaturg ---;"h r ,a 1t/ f t 2 '.- Print Name State of Floyd`a County of )LLI -- The foregoing instrument as acknowledged before me this 0 1 6015 ` (Date) by Otk-k (12._(1\SS.E A U who has produced ►v/A L KI.lCZUt,,) (name of person acknowledging) ,(type of identification) as identification and did not take an oath. r_.—"__ NOTARY'S SEAL 1 [ r 1 `' y - OF N ARY) ,. eii;, . oi�Y°°a, LOU LOU NEACE • Y• Notary Public State of Florida. I Nr Ti ',013i Gomm'Expires'Ngv.17 2018 i I ?4,o c ;Commission!PIE 145794 _ 0 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STA'I'l; OF /--e)/2/P/9 COUNTY OF Le t/ / ,having beeirfrrst du-Iy sworn,-state and-affirrn. I--— am a resident of GL./ County, ,AGO, /)>9 (State) and have resided here for more than five (5) years. Durin g the last five years I have known C2e----52 %Wiled/r (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 *Of/e6 Name _6_6 U /6 6/5:TT/ Af /1 ,Z S" c 6,ei 9 3V/3 Address Telephone The foregoing instrument as acknowledged before me this D� 191,90lb (Date) by ANN tiop...E.L1 who has produced-FLDL 141 64 d b c 3Z5g9O (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL / (' • • • OF NOTARY) FREDDY E MANTILLA Notary Public,State of Florida I Commission#FF 151457 -9 O,0 t/f f _ F4,1 A My comm.expires Aug.14,2018 I `V I, AFFIDAVIT OF INTEGRITY AN ) GOOD CH.ARACTER STATE OF �j�m'41 274 COUNTY OF C U—)eg. I, --T. 4 VAN t 17? , having been first duly sworn, state and affirm: 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 CE-5, ijZL* Co (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. ignature y�� 1,64-0-{y IZAPP Name SZ•S g . i.10647 s 1 .34.‘ o Address 2-S C;) Z C4'3 Telephone The foregoing instrument as acknowledged before me this 91,6-// 5 (Date) by U a m rn ,}p who has produced (name ofierson acknowledging) (type of identification) R/u-&La as identification and did not take an oath. NOTARY'S SEAL / sue, HY K.CHESSER ( GNAT 4 O NOTARY) ;viMlssl ON Si FF088229 - y. "',rs:Apra 12,201E P""Kt+KATHY K.CHESSER MY COMMISSION 8 1,15T EXP .Apt0 12.2018 • .-- -;4- O O Z CO N r- 0 z o I o co 0 E rn > CD 0 CO CO m M P -4 , cncD z0 .• , ' 9 5 5 1 >ii° ''' I 3 —Woo -5 0- •- 13 rg 10 7 CD fn 0 • 0 0 -0 < CD ID M to g) 0 > M C° -I Z -4.0 0 M 3 < %,33 0 t 3 Er•...:z 0. a -. 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DRIVER LICENSE CLASS E ;, -ALBE2�:• co 6 20 EVERGLADES BLVD N FL 341204539 •- SEX: SksiORNER Cff2OAt.OC7K OperNgn Of 2 sat Y,4iidt Cot u [ORSISK to ON SOM4elp 4Ott ImItWOd @y t w I■cpu1 L viewer Page 1 of 1 ..s 4 i Fl . =,i00% , \\\ \ \ \ i '',t '\,,,,,,,ta.," \\*\ • • • P.• .`�'s ...acs r.:\. N� .•.,,.,. `\\\,\\\\\ \\\\\\\\\ • • • • \\ �\\�\ N.• , \\ \\Z\\ `Ni;i ∎i•N \\:\C\\.. ........:...;+.:1:k. : �\.-\>:\�'abin::5rit...0",,ii• k,1�CC\,,., .\\\Q\\\'S< \0.,�`.\ \��y,�.. \\*��. .*2•\,a v4.. \ \�..'*" .��.e\`\a\\,. \.\\• \`\``�\\\\ \\\\\\\, \\... \ \ \ \ \`. \ \ \ \ \ \k \ \ \ \ \ \ \ hops://apps8.fldfs.com/crreportviewer/reportViewer.aspx?data=kdvpgine9D7Q3gH6'1'ER6... 7/1 0/201 5 Co Tier County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION NAPLES, FLORIDA 34104 www.colliergov.net (239) 252-2400 FAX (239) 252-5355 LAND USE AND ZONING CERTIFICATE: HOME OCCUPATION LDC section 5.02.00 & subsection 10.02.05 B.1.f Chapter 4 K. of the Administrative Code Please take the time to fill out this form as completely as possible. 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 Business Tax Receipt 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. APPLICANT CONTACT INFORMATION Name of Applicant(s): Telephone: Cell: Fax: E-Mail Address: BUSINESS& USE INFORMATION Business Name(If any): Phone Number: Address: City: State: ZIP: Description of the type of business or use: Collier County Land Development Code Section 5.02.00-Home Occupations 5.02.01-Applicability Home occupations shall be allowed in any zoning district which permits residential dwellings as a permitted use. 5.02.02-Allowable Home Occupation Uses There shall be no retail sale of materials, goods,or products from the premises. 5.02.03-Standards The home occupation shall be clearly incidental to the use of the dwelling for dwelling purposes. The existence of the home occu_pation shall not chafe the character of the dwelling. A. An allowable home occupation shall be conducted by an occupant of the dwelling. B. There shall be no on-site or off-site advertising signs. C. The use shall not generate more traffic than would be associated with the allowable residential use. To that end, traveling to and from as well as meeting or parking at the residence by either employees of the business operated there from who are not residing at the subject address or by customers or clients of the home occupations is prohibited. 1/14/2014 Page 1 of 2 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 18, 2015, 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 Teodor Danilov dba Custom Flooring Design, Inc. (the "Applicant") has submitted an application to the Collier County Contractor Licensing Supervisor or his designee for a Certificate of Competency as a floor covering and tile and marble 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 Code of Laws and Ordinances of Collier County, Florida, 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. Page 1 of 3 360227.1 3/11/2015 3. That the Board has jurisdiction over this matter and that Teodor Daniiov was present at the public hearing on February 18, 2015, and was not represented by counsel. 4. All notices required by the Code of Laws and Ordinances of Collier County, Florida, 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. It is appropriate for the Applicant to be issued a license as requested. CONCLUSIONS OF LAW 1. Based upon the foregoing facts, the Board concludes that the applicant has met the standard set out in Section 22-184 of the Code of Laws and Ordinances of Collier County, Florida. 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 the Code of Laws and Ordinances of Collier County, Florida, by a vote of 9 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 a six month probationary period and review of a newly issued credit report in six months. Page 2 of 3 360227.1 3/11/2015 ORDERED by the Contractors Licensing Board effective the 18th day of February, 2015. CONTRACTOR'S LICENSING BOARD € LIE COUNTY, FLORIDA 1,i,c,17 ,,.. ,c:. ,By Patrick White, 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 Mr. Michael Ossorio, Licensing Compliance Supervisor, 2800 North Horseshoe Drive, Naples, FL 34103 on this 18th day of February, 2015. Secretary/Contractor's Licensing Board Page 3 of 3 360227.1 3/11/2015 John C.Heath,Directing Attorney :' Lexington Law:. Admitted in Utah,Washington D.C.,New York,Colorado,Georgia,and Texas. The Law Offices ofJohn C.Heath 360 North Cutler Dr.//North Sa It Lake,Utah 84054//p(800)341-8441//john@lexingtonlaw.com//www.lexIngtonlaw.com Date: 07/31/2015 To Whom It May Concern: Re: Teodor Danilov P.O. Box 368125 Bonita Springs, FL 34136 It is the purpose of this communication to inform you that the above named client has retained this firm for the purpose of working with the credit bureaus to audit and verify the status of his credit reports. According to our client, there is reason to believe that various accounts appearing on the consumer credit reports are inaccurate, invalid, and/or unverifiable. We are requesting the appropriate investigative procedures from all three credit bureaus at this time. Please note that according to our client's most recent Equifax and Trans Union credit reports that we have on file, the following items have been removed: - Capital One Bank Usa Na(removed from TU, EQ) - Best Buy/CBNA (removed from TU, not appearing on EQ) - Captial One/Best Buy(removed from TU, EQ) During this time we ask that you please take our client's good faith efforts to correct these notations into consideration while making your decision concerning the approval of his credit privileges. Sincerely, /7,7 yohn C e ath`\v /I� 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 10/07 07/30/15 08:15CT [SUBJECT] [SSN] [BIRTH DATE] DANILOV, TEODOR [CURRENT ADDRESS] [DATE RPTD] 368125 PO BOX 368125, BONITA SPRINGS FL. 34136 2/15 [FORMER ADDRESS] 1014 PO BOX 1014, ESTERO FL. 33929 1/13 5223 CEDARBEND DR. , #4. FORT MYERS FL. 33919 [POSITION] [CURRENT EMPLOYER AND ADDRESS] [VERF] [RPTD] SARMIS MARBLE TILE OWNER 7/11 7/11 S P E C I A L M E S S A G E S ***ADDRESS ALERT: CURRENT INPUT ADDRESS DOES NOT MATCH FILE ADDRESS (ES) *** M O D E L P R O F I L E * * * A L E R T * * * ***FICO CLASSIC 04 ALERT: SCORE +539 : 039, 018, 010, 013 *** 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 SUMMARY * * * T O T A L F I L E H I S T O R Y PR=0 COL=0 NEG=1 HSTNEG=0 TRD=1 RVL=1 INST=0 MTG=0 OPN=0 INQ=5 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE CLOSED W/BAL: $2368 $559 $ TOTALS: $ $ $2368 $559 $ 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 BK OF AMER B 1597029 10/07 $2368 R09 7/15A $2000 $559 I CREDIT CARD 5/14F $2368 ACCT CLSD BY CONSUMER I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 7/30/15 ZNP6284423 (FLA) MERIT CREDIT 2/03/15 QLA6410610 (CAL) I R ANAHEIM 1/30/15 PNP7771028 (FLA) LICENSES ETC 12/19/14 PNP7771028 (FLA) LICENSES ETC 11/17/14 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.O. BOX 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION BK OF AMER BC1597029 PC BOX 982235 EL PASO TX. 79998 I R ANAHEIM Q 6410610 (800) 473-4633 13030 EUCLID ST GARDEN GROVE CA. 92843 LICENSES ETC P 7771028 (239) 777-1028 886 110TH AVE STE NAPLES FL. 34108 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. L -- Co 'tier Cou- -ty r GMD Operations & Regulatory Management . ate// Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 AP ' . Si ON FOR COLLIER COUN OF NAPLEWS01 MARCO' „I* INSTRUCTIONS: This application must be nee ritte r-1 ri�4t .: h'a .t3'l. 1. �v � � �� e'application fee must accompany this application. The _fee<ji�kY �t refundable_...afiei t iL application has been accepted and entered on the records. All checks_shatiild be made payable to the Board of Collier County Comm issionersViFoffurther information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: Exact Corporate/Business Name: i<C,):7 i C. --1 --LCC P i 1,'6 6E2-F)/ Fiction Name/DBA: Qualifier Name: r t060,g, N t Lei � O4-+'+'A Ci NAB' Physical Address: t-�`.� ) f G - C"o oc (Number & Street) (City) (State) (Zip Code) Mailing Address: ` fr,D -O i'i i ? l rL 34, 1 (> (Number & Street) (City) (State) (Zip Code) Telephone: 23P--, 770 `';tJ', 1 r— E-Mail: 7 O6vE N1<< 1.i 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 e- $230.00 U Specialty ;$205.00 Specialty trade: 4-L O L?e ( V C'C'n.,i,2 A CT CZ • 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. 7.-: 06 i74::: i A),,1 't_«'.f /JI'L ix1r_A Ci 1 ,r-. c 7:-K..!-4; f i C rt✓L 9 3(---1 l_% 2 5 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. A 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. v i.:) AFFIDAVIT I, I E CEO 1-Z; 1W),J i LC`/ certify that the foregoing is true an cor ec to the best of my knowledge. Authorized Officer of the Firm STATE OF FLORIDA COUNTY OF The foregoing instrument as acknowledged before me this yC 2Q�Y � Date) By l )a n,41 /./Z41/2/1 of a.3�� 1/09/1'1Y .-1 4 (Name of officer, title/ gent) (Name of Corporation) `� ' a -0 P f7 CLi Corporation on behalf of the corporation. (Sta e or Place of Corporation) He/She has produced --- ---G-or/ *D( ,- identification and did not take an oath. (Type of identification) NOTARY'S. . GEOHOiNAaARCIA r% / p` s Notary public),Slate of Florida I 7 -,-Y, — Commission#EE 933595 "^' My mom.oxpiros Sept.9,2016 (SIGNATURE OF NOTARY) Page 2 of 4 QUALIFIER INFORMATION: Name: ! EC iY0 L_1)1(/ Address: !CI I `<02 i CT M)?L 5 ( Q - 0 (Number& Street) (City) (State) (Zip Code) Telephone: 3t7 ) 7 Date of Birth: S.S. f#: 000-00 E Mail:�E o M L�-� yiA N(7= C Driver's License: - ' ° - ` 1. Type of Certificate of Competency for which application is made. [1."�(,' 'C cA E 6 2. The names and telephone numbers of two persons who will know your whereabouts. --Y,Gziau .2 - a - q I 3, Have you ever been convicted of a crime related to Contracting? A/ (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? 7\1 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. 2T j 00;2 C3 ' \I C 10. Statement of any formal training you have had in the area for which the application is made. A 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. • j APPLICANT(PLEASE PRINT) NAME OF COMPANY SIGNATURE OF APPLICANT` STATE OF FLORIDA e COUNTY OF The foregoing instrument as acknowledged betore me this Q. ,2dry / ,, � /� (Date) By 1�(/iDG�(J C/Gl"»/ 1/ who has produced (Name of person acknowledging) (Type of identification) as identification and did not take an oath. NOTARY'S SEAL 9111°F (SIGNATURE OF NOTARY) ®KORGINA GARRCIA Notary Public,State of Florida ;17•111 Commission#EE 033505 f,y corm,expires Sept,0,2010 =ate Page4of4 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 APPLI6.NT U i(:C 1-1 L sc--, G 0 9 BUSINESS NAME , DATE '/ BEFORE ME this day personally appeared e%LS�f! patl/U c/ who affirms and says that he has less than one employee and does not require Workmen'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 �/ �% �U�y b4r 0G'/(U ate) J jl by who has produced � ,�C_---- , (name of person acknowledging) (Type of identification) as identification and who did not take an oath. A, , 14, ��.n., ; GEORGINA GARCIA ''IGNAT E OF NOTAR 2 r k : Notary Public,State of Florida t 0 0 Commission#EE 833595 / 7d/ _ Idy comm.expires Sopt,9,2018 f Nb'fli7RTP e-- (PRINT WIE OF NOTARY PUBLIC) NOTARY PUBLIC 4 Q . 0� , �� ' 4,41!0 rr e O in 0, I*► , : 'j'" :fit t t iik• X . - 1 •--ii •- [r a •-•�[e49 - -. ► 4 40- -dam-. 11- *� 4 - % .t O t- x. 7 1.( � t Vie* : it tiv v 140 4. ,► . ,,;"tiorg �, 4,4051 'Oki," 2 ,., , a-, _4,-5 . ,A) �r ►� � ' ',� ® 1: ,r0. j,14:. : O Q V: q�� cd as o ¢"Q? ,,,. IV i, -4-4 - , ..fi ,,,,,ow . 4_,...., -.:.,_.7 ci 4 a). (73 i u ! . ., .2 Aft-.1 Ati. ! 'F-- R ' ® -7 ® M • J p• ! r C� o F U �ll N 1 v� U _, o 'iller!o► ), . . \} '� - ° ,,,,,74. ,-,, , . ,._ ) ..+_, , ,_ • c, . c,„ ,, „ �� o O N o 1440' .--*k tkyo 41,-4.10., - : . . c t 8 (4-+ rd ' Pl•-• 0 .140-414-:: :41:,1-.4091. c_‘) cn 0 ci• 0 '1) . OA 1:( gzi 1-c) g c+-6( 4 ci - • le ink ' {*—)31-10`4•'-'0 . :&.- - A ' )144:: t-s-itt..44)*--.)4 .; 04-4:A,' J.0.4 4. AO va, ,,. ' s'it it 0—. itgor4i71-1-44N: t0' T, k i � ®^ 410# P �� ®tI`{ f- �� `' , y, b 7 . I. f w. � d'Y [ !� t 4! pW�F' • GITS, LLC Examination Operations Division Providing the services and products to assist Government Agencies to make informed educated decisions. Official Examination Score Report October 31, 2014 Official Score Report: Candidate Information: Name—Teodor DaniIov Candidate it 00670980D Testing Site: Ocala, FL Final Score Result: f Tile and Marble Contractor Score: 76% (10/28/2014)/ Business Procedures Score: 78% These results represent the grade that has been achieved on the Tile and Marble Contractor and the Business Procedures examination(s) 'administered by Gainesville Independent Testing Service for Collier County, Florida on October 31, 2014. If you have any further questions, please do not hesitate to contact us.; Sincerely, J y E. Bowerrneister (g. - President PO Box 831127 Ocala,Florida 34483-1127—Voice(352)369-GETS –Fax(352)387-2443 800 997 2129 ti I,VERIFICATION OF CONSTRUCTION EXPERIENCE I GM1'ID Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples, FL 34104 Applicant's Name: \ f_._ d 4 0 .\ U\` 2ertificate Category Requested: Fite Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the rpplication for this certificate the Applicant must verify their experience within this trade. You are being requested to )rovide 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). lime served solely in a supervisory or administrative role should be described, but may or may not be considered :efficient to demonstrate required trade experience. The person verifying trade experience must provide the following nformation: flame, Title and license number of the person signing below and\erifying Applicants relevant experience: Jame: tp\ Ci'c• i1 C C Cdl t1im e. 'itle: Jh...)i`. 1 License Number(if applicable): I r� C 5 L `:�1 lame of Business: SL._ \' C.._C(\ j - v( '' \0Y\ LL-C-. � � �!. + q %L L 5 ;usiness Address: a SLi V O v \ K i Ot\�'r SC C�.q j usiness Phone: a,39 9 y IS- l s aO The Applicant's years of experience from OS « j J is to a, I a G I`-{ 'he applicant's scope of work (specific duties) included: \" QCC‘^,c-\ t C\SS A\\c■•11' t c„.)n d-` � ,\2 \nCc (3\.-e_ Sic �� WoCC G CQCQ . J v c ■5. J s a.00- cC S 1 s��e8�\-e�• - ocgc zec4 tt,.\sk-Q\\a i0 , dditional Comments: co A-\1 all a q t d i3 Q■ C17- ' - 'r`n S C ` "C'c) C U4r \C (or) J A aC\d gSSu(ta e(... 1\--o1)(1eC 5 C._3,.,,e\ \tk--e\ S0.\--∎SC-\ r d alsifying any information provided herein may subject your license to revocation. Signature Print Name: 0‘0.-C Ue 00,00C. ate of Florida Runty of Collier ne re foregoing instrument was acknowledged bef e me on rhic o� day of Qec._ r a Ui`( 0\,,-c-- K u e m m e\ who is personally known to me'or-pradeect lueiTtificafio'n and who did not take an oath. \`-C �.�+, h.-N . •-.(w) c Yl Signature ofNotary �1�i � MY CO SSON f4TN9 ' ?d So 4,2018 I h`' Bmded iru Notary y d$1Rrie • n 8 i GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples, FL 34104 Applicant's Name: t i,, 4?`l IL. [ Li/ Certificate Category Requested: �� a �; i L�� t� r fr `�,;k�L %t c A it, �"r-, the Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the rpplication for this certificate the Applicant must verify their experience within this trade. You are being requested to )rovide information that will aid the Applicant in meeting this requirement. You should verify time of active experience vorking as an apprentice or a skilled worker(e.g. as a worker commanding the wage of mechanic or better in the trade). rime served solely in a supervisory or administrative role should be described, but may or may not be considered ,ufficient to demonstrate required trade experience. The person verifying trade experience must provide the following nformation: lame, Title and license number of the person signing below and\erifying Applicants relevant experience: dame: (}-41‘.( Mt c-N (' Ch a i" 'isle: ;gip-z; fir' t)r.--tv I License Number(if applicable): r;`f I-c.1 lame of Business: j(l)c - l�f.`_E' : r��i ;usiness Address: 3C-3 �_�(.tee / cf/( ,usiness Phone: 2? t-(C 'U r )L' The Applicant's years of experience from to he applicant's scope of work(specific duties)included: i N• lit <<At7.; dditional Comments: t'(2.; Xl alsifying any information provided herein may subject your license to revocation. Signature Print Name: fYl lvti CZV /7 ate of Florida Aunty of Collier i foregoine instn e�1t was cknowledged before me on this day of "�L, 46/4" —VA 014/ U who is personally known to me or produced U,134-/i3 (r�- ✓��. identification and who did not take an oath. -(4 --_-_ Signature of Notary aY DENISE K MORRIS �� :=Notary Public•State of Florida �;• 4. 47s Commission#FF 92047 74'o0∎?:` My Comm,Exp.February 11,2018 8 1 . [VERIFICATION OF CONSTRUCTION EXPERIENCE j'.• GMD Operations & Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 ©J0 Lam lo Y Applicant's Name:. //'� /' Certificate Category Requested: 7 7l-e , /a(I/e • 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: i170/10'4 J1 /Q 0 - Title: OW n<'/' License Number(if applicable): L C &1 3000/S70 Name f Busin /' /C S ao C es 4C Business Address: 7 7 /a Y/ 4'' N17 P_., fi� / 3 / D Business Phone 67) (26'2- 7 .2/, The Applicant's years of e .�J ( ± �s- a -e id--e hf5 in 640 P/o�ecf r�a�iz° P /fi Additional Comments: CX C.e)!e d NY1CM ` ` c-1 i C„, yCL lue J 0/2c1 co o w er i (4-4 0 i Falsifying any information provided herein may subject your license to revocation. 4).41 Signature f14 Print Name: /'AAi1 k —JI /ai State of Florida County of Collier ( (�,�,, The foregoing instrument\Y as acknowledged before me on this Z day o 1/°Al C/Ol' by '' 1ar1ou,/ 1410,13 who is personally known to me • educed I '/./. "A LAVA& '../ as identification and who id not take an oath. ■‘‘ \P+ 1 Q /,i i%�..J.ma� ;• NOTARP.'.;9 ature of N . S omm.Expires'; June 9,2018 I No.FF 130823 1 Bonded through J Cn�: Wells Fargry 0 A • f ':��OF F100 .` AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, �:', �v i'{��i"��,° , am a resident of U �•`i ICC County, 7-- (State) and have resided here for more than five (5) years. During the last five years I have known e Udoc oA) 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) C(Name) C)\ c K,ve1Y∎1h�\ (Address) 5 aim \ \ems t4.)c t o Telephone) - ,.- STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this l g «• a Ce) 1 by (Date) G\ who has produced L;ctos� (name of person acknowledging) (Type of identification) as identification and who did not take an oath. SIGNATURE OF NOTARY NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC .ncR PATRICIA A.'SON x1.4.`. MY COMMISSION i ff 147709 ,.a; EXPIRES:August 4,2016 `,;r S•M_; 19)r6ed ThN t o acy Put( Uodera en AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, P k\((a 1 /a v , am a resident of CO (/P ��U0 y _ / County, / /br/ Q (State) and have resided here for more than five (5) years. During the last five years I have known --ree,C 0f q 4( •,1 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) �/� r (Name) /7 ' L l v (Address) %;))7 ID 7W Y/C9V-7r Nov it (3///O Telephone(4-1 ) STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this ICI Nov 201I-by ln J -q (Date) , Y \c ‘ 1CkA) who has produced orici a VQ Vs t IC€ 5 , (name of person acknowledging) (Type of identification) as identification and who� pj i f) e an oath. \-‘ \ ■••/,9 .0/ _1111" ,e01"-.1111IN \40 TA AA‘ielthr.OW ,•'My Comm.Expires; TATURE iirr'Y June 9,2018 • No.FF 130823 I( nU :• Bonded through 1 I t,t i NOTARY'S S 'A, Wells Fargo' ? Q' (PRINT NAME OF NOTARY) ;;•.'°U1309. ' \�� NOTARY PUBLIC '�F F�-oQ�$, :otrlittO` 41 COLLIER COUNTY GOVERNMENT COMMUNITY DEVELOPMENT AND ENVIRONMENTAL SERVICES DIVISION 2300 N.Horseshoe Dr. • Naples,Florida 34104 s 239-403-2400 • FAX 239-403-2334 1 t fR -4' . . 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. /3 t` /A )(v-z( January 30, 2015 �Y (V`V To whom it may concern: I Teodor Danilov have attached documentation for my tile and marble contractor and floor covering license. You will see a credit report indicating a score of 509. I am currently working with a company called Lexington Law to clean up my credit report. I was able to increase my credit score to 543. I expect to have a significant increase within the next 2 to 4 months. I don't have any bankruptcy or have any collection agencies trying to collect. I only had some late payments and an error with a finance company that I have been working on fixing. In 12 years I have never been arrested or have had any traffic tickets. Thank you very much for your consideration. Sincerely, Teodor Danilov ti -9 ic)) - I- ___ ___ - - --L. -_:-__ COLLIER COUNTY BUSINESS TAX BUSINESS TAX_NUMBER: 141935 _ COLLIER COUNTYTAX-COLLECTOR-2800 N.HORSESHOE DRIVE-NAPLES FLORIDA 34104-(239)252-2477 , _-- --_- ----- ---_- - ----= - VISIT OUR VVEBSITE AT:www.colliertax.com THIS RECEIPT EXPIRES SEPTEMBER 30, 2015 - - - : ‘, 7 t17- r-,,_-'7,--, DISPLAY AT PLACE OF BUSINESS FOR PUBLIC INSPECTION LOCATION: 1015 IXORA CT , N --- FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS. ZONED: HOME OCCUPATION -12EGAL-FORM-- -_ y" -- -,,./ „. , ^ - THIS TAX IS NON-REFUNDABLE - BUSINESS PHONE: 770-3585 - - - -_ -- ., , ,, - , .% --.- CUSTOM FLOORING DESIGN INC - _ _ _, = ,---- S DANILOV TEGDOR -- COUNTY LIC: 2014-4289 PO BOX 368125 • , i _ -)-,-,-:--,-- ' - - = --_--..- BONITA SPRINGS FL 34136-0000• s 3--• \ '',--_.- --'7,-,,;-#- -1 ,,,, .., 0, NUMBER OF EMPLOYEES: 1-10 EMPLOYEES _.._ 1 'A,..,4,.." 4,., CLASSIFICATION:TILE 8.MARBLE----CONTRA-L,TOR --------- f ---_=- t'''N f-s. c" y, ----- - ==----- ----_- :-DATE ---- 02/19/2015 CLASSIFICATION CODE 02101901-= ----=, -- - t _ AMOUNT 9.00 - - --- = This document is a business tax only This is no- t-certification that licensee is qualified. RECEIPT 6572.41 L-__. It does_notpermit the_licensee to violate any existing regulatory zoning laws of the statecounty-_or cities 7.-- nor does it exempt the licensee from any other taxes or permits that may be required by law. -- -- - - • - -- - • ------- _ - _ --- -_--_ -1 COLLIER COUNTY BUSINESS TAX l---BUSINESS TAX NUMBER: 141934' COLLIER COUNT -TAX COLLECTOR-2800 N.HORSESHOE DRIVE-NAPLES FLORIDA34104-(239)252-2477 _ ---- --=---- --,_ ----- VISIT OUR WEBSITE AT:mw.colliertax ..com --- --- -- --_ THIS RECEIPT EXPIRES SEPTEMBER 30, 2015 • f__._ ‘s■:..'ir'_: .((--,:j i. -t- "-_DISPLAY AT--PLACE OF BUSINESS FOR PUBLIC INSPECTION ----LOCATION:1015 IXORA CT '. \ ' -----: ---I -r: 4 A-- --FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS. ,,,:,,,. "-LEGALFORM - • ZONED: HOME OCCUPATION ,- i. . • THIS TAX IS NON-REFUNDABLE - ' ) ., CORPORATION ‘, *" i . BUSINESS PHONE: 770-3585 -- -- - -- - ,------- -, -- -- -1 -;-- ---= ----- -.- ------ r--:-- f_-.-1 ; '--, `--..-7,'• -. N• CUSTOM FLOORING DESIGN INC - ___--- --- -_ -- _. - -r- - COUNTY LIC: 2014-4289 1 DANILOV,-TEODOR - - - 1-i X $ ; PO BOX 368125 , .---.s-,,f-,;---:-'4--- --;--_--:- f-..==-_ --7-:_-_1 : BONITA SPRINGS FL 34136-0000 ,_-? ;i_._ __-_, -_ 4-..- , _-_--___ -,- (--.., NUMBER OF EMPLOYEES: 1-10 EMPLOYEES _ -1 i . -1, ..---' .,'\---.'- CLASSIFICATION:FLOOR COVERING CONTRACTOR -----1 n _ , 1 ,-.. \.., - _ _ DATE 02/19/2015 CLASSIFICATION CODE: 02104301- - --- •----- -- - -- L:::: 1_-_---±:.- - AMOUNT 9.00 _ . - _ __ This document is a business lax only This is not certification that licensee is qualified. - RECEIPT 6573.41 - It does not permit the licensee to violate any existing regulatory zoning laws of the state,county or cities ''7,. ' -= nor does it exemPt the licensee from any other taxes or permits that may be-required by laW. -- -- ..-<--,a-'''',f4- :-/-7-•.. .-''...(,-.‹.-e,,," X ' ---,-- 886 110`h 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 10/07 01/30/15 08 :28CT <SUBJECT> <SSN> <BIRTH DATE> DANILOV, TEODOR - <CURRENT ADDRESS> <DATE RPTD> 1014 PO BOX 1014, ESTERO FL. 33929 1/13 <FORMER ADDRESS> 5223 CEDARBEND DR. , #4 . FORT MYERS FL. 33919 12/11 7621 WINGED FOOT DR. , FORT MYERS FL. 33967 <POSITION> <CURRENT EMPLOYER AND ADDRESS> <VERF> <RPTD> • SARMIS MARBLE TILE OWNER 7/11 7/11 S P E C I A L M E S S A G E S ***ID MISMATCH ALERT: CURRENT INPUT ADDRESS DOES NOT MATCH FILE ADDRESS (ES) M O D E L P R O F I L E * * * ALERT * * * ***FICO CLASSIC 08 ALERT: SCORE +543 : SERIOUS DELINQUENCY; TOO FEW ***ACCOUNTS CURRENTLY PAID AS AGREED; PROPORTION OF BALANCES TO CREDIT ***LIMITS IS TOO HIGH ON BANK REVOLVING OR OTHER REVOLVING ACCOUNTS; NUMBER ***OF ACCOUNTS WITH DELINQUENCY *** 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 PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY,STATE AND FEDERAL LEVELS PR=0 COL=0 NEG=2 HSTNEG=1-1 TRD=3 RVL=3 INST=0 MTG=0 OPN=0 INQ=4 I HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE CLOSED W/BAL: $4682 $2873 $ TOTALS : $ $ $4682 $2873 $ 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 BK OF AMER B 1597029 10/07 $2368 R09 1/15A $2000 $559 I CREDIT CARD 5/14F $2368 UNPAID BLNC CHRGD OFF BBY/CBNA H 292F021 5/08 $2314 R09 1/15A $1400 $2314 I CHARGE ACCOUNT 11/12F $2314 ACCT INFO DSP BY CSMR CAP1/BSTBY D 1DTV057 5/08 $2229 XXXXXXXX2111 ROl Pagelof2 r I /I 9/13A $1400 $0 111111111111 I SLDTO CITI 11/12C $0 ACCT INFO DSP BY CSMR 48 1/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 1/30/15 PNP7771028 (FLA) LICENSES ETC 12/19/14 PNP7771028 (FLA) LICENSES ETC 11/17/14 ZNP6284423 (FLA) MERIT CREDIT 3/24/13 NDY1263431 (DAY) SYNCB END OF REPORT Page 2 of 2 E 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 10/07 12/19/14 14 : 28CT <SUBJECT> <SSN> <BIRTH DATE> DANILOV, TEODOR - <CURRENT ADDRESS> <DATE RPTD> 1014 PO BOX 1014, ESTERO FL. 33929 1/13 <FORMER ADDRESS> 5223 CEDARBEND DR. , #4 . FORT MYERS FL. 33919 12/11 7621 WINGED FOOT DR. , FORT MYERS FL. 33967 <POSITION> <CURRENT EMPLOYER AND ADDRESS> <VERF> <RPTD> SARMIS MARBLE TILE OWNER 7/11 7/11 S P E C I A L M E S S A G E S ***ID MISMATCH ALERT: CURRENT INPUT ADDRESS DOES NOT MATCH FILE ADDRESS (ES) M O D E L P R O F I L E * * * A L E R T * * * ***FICO CLASSIC 08 ALERT: SCORE +509 : SERIOUS DELINQUENCY; TOO FEW ***ACCOUNTS CURRENTLY PAID AS AGREED; PROPORTION OF BALANCES TO CREDIT ***LIMITS IS TOO HIGH ON BANK REVOLVING OR OTHER REVOLVING ACCOUNTS; NUMBER ***OF ACCOUNTS WITH DELINQUENCY *** 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 PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS PR=0 COL=0 NEG=4 HSTNEG=1-6 TRD=4 RVL=4 INST=0 MTG=0 OPN=0 INQ=3 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE CLOSED W/BAL: $5436 $3627 $ TOTALS : $ $ $5436 $3627 $ 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 CAP ONE B 1DTV001 4/08 $818 R09 12/14A $750 $754 I CREDIT CARD 10/14F $754 CLOSD BY CRDT GRANTOR BBY/CBNA H 292F021 5/08 $2314 R09 11/14A $1400 $2314 I CHARGE ACCOUNT 11/12F $2314 UNPAID BLNC CHRGD OFF Pagelof2 , BK OF AMER B 1597029 10/07 $2368 R09 9/14A $2000 $559 I CREDIT CARD 5/14F $2368 CLOSD BY CRDT GRANTOR CAP1/BSTBY D 1DTV057 5/08 $2229 8/13 543211113211 R05 9/13A $1400 $0 $105 05 111111111111 I CHARGE ACCOUNT 11/12C $0 PORCH BY OTHER LENDER 48 2/ 2/ 2 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 12/19/14 PNP7771028 (FLA) LICENSES ETC 11/17/14 ZNP6284423 (FLA) MERIT CREDIT 3/24/13 NDY1263431 (DAY) SYNCB END OF REPORT Page 2 of 2 • Paae 2 of 13na. I,co ,11 14 3 31. Zr',,., 'i4 rra ore Oa .3.4 3-, 1 c ICON E REPORTED CAP11113.STAY Inre About Pins Tramillnion E.',,f1,1(11■1 Equifax Account 4: 7E011670—• 70D1137,01,-:176 16g601-7016W- Coed-dice.: Trans:eared C.csed Transferred Elatance, 112 LI 50 Type: Charge aix...osrt Cnarste Charge account Pay Stata.a, Z2.ris 1...a* 120 01,5 TM-Year partner-A history Tr"Sur''''5,,J J f;,4 s,tj J J 4 LI L.;1 i;;J Li i0'ifi mr,in '12 in .="Ts rat '13 rte.Ira txsa Ivy E.P"',11 JLJLiLiLiLiLiLiLiLLJLi LiLALJL.J Cr,1,1(Zr .12 in ruo ta. ss. tacO-7,1<>5 .41 CR .13 ma rita 144 in ,11 at ital 1. Equ"10, T.E. 1. '12/1,8 `Va.. CO 441 1,4'CR '13 OE Ca“It ,1,1,I. wa DIX OF A!ttER "Ante about this,c.coont Zr TransOnion Exprrian Equifax Acco_ra 45 • Condition: Derogatory OetYcLtuTCry Derogatory Balance, 5751-5 52753 52753 Type: Credit Card Credit Czrd Pay Status, CoCsrr,1 Cri'ectcr:Chei-g.-41 CoVectontriargeol Two-Year payment history Limontt TransUniOn 1:.‘i t—I L-11...J L-4 L.,1 L.1 Lij , c+.7 n,tit '13 in 11414 try vs >5>5 r.CO 101 CR '14 I.we Asi%12.1V 0.13 sr, •13 r. ..}1 CFC '111 11111 I Ocl GC.I,/:WI JO COI Ins lattment Accounts:Accounts comprised of fixed terms v;:th regular payments 11101 CIt qon,ohont 1;1 5,,,nrunt iv TransUnion Exp2rian Equifax Account I 209" • Condition: Paid Balance: Type: Auto Loan Pay Status: Current Two-Ye T!pal/pent history s53errcl>5 TransUnion ROUE REPORTED Elpetian NONE REPORTED Eqvtfax '12/13 1=42 14-4/WI Y...1?J. ? 13 On 1,4, CI,114 Public Information NONE REPORTED • !Inquiries Creditor Name Dale of-ftioastry Credit Bureau LEXIStISOS ES,afax AT&T SRVS TOY,'CR EC iT 24,15n2 as..,/fax SYNCB f5.5 24507,3 Tra,S17-^"-cri TD CARD SER-:CE BOFAti.:DSE EOFAII:DS-F 22:2 E.pe,-•an 60F,1,21_NDSF 120552<2 ',Creditor Contacts !Creditor Name Address Phone Number I TO RETAIL CARD SER tfiCE 1C.00 LLSCARTHUR BLVD 201-818-4000 MANA'AtiNJ 07420 CAP lifISTBY 25525 N RIVER?i0ODS BLVD C00-6950950 L'ETTA'NA1L 60345 CAP ONE PO BOX 65520 BYV-AlliONLY FLCC,ZOI■DVA 23255 130FAINDF.F 35 U LAKE AVE E00-447-1652 PASADENACA 91101 EKOFAMEIT PO SOX Ekitea5 EL PAS-0TX 79033 BBY428:1A 50 tiORTI-PAEST POINT ROAD ELK GROVE VILLAGEIL 60007 • Ilttps://ttli..scoresense.colia/01-Produei\VehIlt:4:...epredticiDisplavCenterbet!fari_do?wbTol;e.... I .1111V",()14 , . I TI 3 it-_ Credit Reports :- E o,v ICJ 2314) inatioo Tr,:nsDn on E'rpun Equifax CREDIT FtErrIT DATE: 'r24 ;C2-014 NAME: ECCEFR t.a R C' 4 2C-3 C ISISO FC:0474 AS: CATE CE xr-1?...EYT P.C.I.RESS_ 7 r: E E03: -4 FEL 5133.1E PROV:C4SS ADORESS: E7224 5223 Ca3AREEND CR E3,E F"_. 'P14 FORT MYERS FL ER 33E"3,-36C 51,2,3 2'522'2 E"..r.PLOYE3R. TILE. 5 TIE irConsumer Statement 1 Trans unto it: t;CE PEECPTE.-D Ex p c ri a n: RErC.RTE7. Equitox: REECRTED tirttittarj 17.J17,1-!"' I cz.--L fransUfflon Experian Equifax TOTAL ACC-VW:TS: 4 4 OPEN ACCOUNTS: 0 0 1 CIL -OSED ACCOVITS: 4 4 3 DELING :T: 1 1 2 DEROGATORY: 3 3 1 BALPACES: $545603 6543203 03003743 PAYVENTS%- SD GO SO 03 00-0 00 PUBUIC RECORDS" G 0 0 MOIPITESi21.,s3ars 2 2 4 lAccount Histori 3 1e Teo t-a-Varsce cf .$pnjOxe-at#567451 CI CO., c'"'" P%;tic-, Revolving Ace°L.1115.: CAP ONE More ahout this account s›. FroosUnion Expertan Equifax Accou-A 4. Condition: Cierrcst Ope, Balance: Type: 0-,51t Carl Cs-cl 0,51 CAM Pay StAG.A: 67 1Z,, Too-Year pernax-it S Lcquorf Trantl.M.ott El Peri.° t...t dj ra ea! '13,n 1-.=1 4,7 te: '14 1E2 ,..14 El> 0^1. 1•7! Litt ICr pt...s ED m7 art '13 Fes rosa non rir,144 14 IL/ 10:0 BOY:CERA rIc x hout 11)15 e 1711i>> TransUnion Enperino Equifax Account I: 70011670-- 7001 1670105o Conditton: Derogatory Derogatory Datartoo: S2314 $2314 Type: Charge account Charge account Pay Status: CckectortChzfgeol CoZec.t.:onthaqq-o7 Two-Year payment history L.1...q.end>5 TransUnion I Etp,i2n tZt fal LIN trA B1:1 tO IA la ttfail t ps://tui.seores..! se.coliCOTProduclWellit-le_N:7;rxe,ductDisplayC.'enter.17-e,3ia.do?webTeke.._. 11'101.2014 Nlernti-er Ilorge -Sc cjigi l'atte I of • ifrgne AI,Ps C(cd11. :,ly Account 1.c....roling Ccn Icr my Credit 0 s- • ( View Rcpori Latest Credit Scores HowTo:Top 5 Your Credit Rating: 1. l_ea;ri the Das 593 2. I P los 605 ::;• :•) 350 4,1'51 .1_5-7 5:25,' 5750 603 550 700 750 50 850 3. Pro,--xt Your kfer,t 541,9 You are un!00 to quo' 'far a loan vaTh an attractive interest rate. 4. KE:p Ye's Fr.;11,:y SiOik.'Itadr core( Center 5. (.1,3-:.= Crr.'.2•:t Us FAO 5C711.3 C Ccf7d cr, )2014 Scc:eSc,:-...corn A! hlips://nlemberS1..scoresense.comidwIthoard I IA 0/2014 Detail by Entity Name Page 1 of 2 FLORIDA' DEPARTMENT ,QF STATE . D°I. ISION OIL C ORPOR 1'I`I011S 1t1h r Detail by Entity Name Florida Profit Corporation CUSTOM FLOORING DESIGN INC Filing Information Document Number P14000090809 FEI/EIN Number NONE Date Filed 11/06/2014 State FL Status ACTIVE Effective Date 11/03/2014 Principal Address 1015 IXORA CT NAPLES, FL 34110 Mailing Address P.O. BOX 368125 BONITA SPRINGS, FL 34136 Registered Agent Name & Address DANILOV, TEODOR 1015 IXORA CT. NAPLES, FL 34110 Officer/Director Detail Name &Address Title P DANILOV, TEODOR 1015 IXORA CT NAPLES, FL 34110 Annual Reports No Annual Reports Filed Document Images 11/06/2014 -- Domestic Profit View image in PDF format http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResUltDetait?inquirytype=Entity... 1/30/2015 Z Detail by Entity Name Page 2 of 2 Cooyrl__ ,)and Privacy Policies Slate of Honda,Department of State l ttp://search,sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 1/30/2015 2 ?, P14000090809 Electronic Articles of Incorporation FILED For November 06, 2014 m ,Of State CUSTOM FLOORING DESIGN WC 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: CUSTOM FLOORING DESIGN INC Article II The principal place of business address: 1015 IYORA CT NAPLES, FL. 34110 The mailing address of the corporation is: P.O. BOX 368125 BONITA SPRINGS, FL. 34136 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: 1 Article V Thename and Florida street address of the registered agent is: TEODOR DA,NTILOV 1015 FORA CT. NAPLES, FL. 34110 I certify that I am familiar with and accept the responsibilities of registered agent. Registered Agent Signature: TEODOR DANILOV Z. ) • P14000090809 FILED Article VI November 06, 2014 Sec. Of State The name and address of the incorporator is: msolomon TEODOR DANILOV 1015 LXORA CT NAPLES, FL. 34110 Electronic Signature of Incorporator: TEODOR DA 1LOV 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 TEODOR DANILOV 1015 IXORA CT NAPLES, FL. 34110 US Article VIII The effective date for this corporation shall be: 11/03/2014 26 Certified Copy 1 certiI the attached is a true and correct copy of the Articles of Incorporation of CUSTOM FLOORING DESIGN INC,a Florida corporation, filed electronically on November 06.2014 effective November 03, 2014, as shown by the records of this office. I further certify that this is an electronically transmitted certificate authorized by section 15.16. Florida Statutes, and authenticated by the code noted below. The document number of this corporation is P14000090809. Authentication Code: 141107122511-200266114732#1 Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Seventh day of November,2014 '''''."\ 4,:, ,''.•,',7=.,-.12:„_-_,,,. 4 6:4ft: r". 7) -',",,,V.,-.11C--r-'P Vibik, aititittm. c-l; , _i en Metrner 6eiretrp of a** 26 _-- _! 1 Application for Employer Identification Number f=Ar5 7.r ---___ kF.t-v_,s'artory 23t74 (For use by ors,corporations,partnerships,trusts,estates,churches, 1134 gcrerrrr errt agenfi'es,foci an tribal entities,certain nth duals,and others.) 47.2280498 -� _,Si,--.: > See sate instructors for each line. fo Keep a copy for your records. i '1 1 etii_ ^r-e cs entity, .:'cu: - ..,:C7 tri E:C s s -,a requested Custom Flooring Design Inc 2 ?^" s l different. 3 • 2a, 13'43 `-iafi g eifirtress; .act.st.nite _ s-v __ ,. PC' b.:s 5a Street a- c P.Q. box 368125 i 10'15 Ixora ct 0_! C;ty.,s'-='=and ZIP coth Ff tc a ,, ,C-_ Sb City,stale,and LP c d -s < sr _) j 1 Bonita Springs,Florida,34136 1 Naples, Florida,34110 0 6 Cct,,ty and state :hare .cwt.ai_,. r . `._. 3 ITi county, Florida 7 a `.a.: cf: pars 'e pant !lb SEN.MN .` rte, i leader Danilov I 769 ^ca _�si c �.`'rzn'cx a ni77,.itaiti Yatifiltir-_ ,.-"z.L-U)for ;(Eh If ca is"Yes."enter the i �^ ci a fcregrt egucaentj? ❑ Yes 0 No LLC members tr 8c ff 8a is Yes,"was the t a C cr°ta•-. el;,ei the L'r:'_ed Snags? 1 Yes ❑ No 93 Type of entity(check cr.:y one tax;_Car ton.If Ea is`Yes,'see the instructons for the correct box to check, ❑ Sn'e pTpr' to(SS") . Estate(SSN Cl decedent) ❑ Part arsk p ❑ Ran adnln:stratcr(TIN) 0 Corer_`co r-.__. rem.r--ter.o�_. _d)r Form 1120 ❑ Trust(T R:of granter) ❑ Pr-sanal science corporation ❑ National Guard ❑ Statellocal government i t Church or churcr oentrollad organization ❑ Fanners'cooperative Federal ec.;err- m'ttarf ❑ Other nonprofit organization(specify) D ❑ RE41IC ❑ tncPe i tr:bai go:rmments'enterprises L{ Other(specify) ' Group Exemption Number(GEN)if any S. • 9b If a corporation, name the state or foreign country I State 1Foreign country (if appEcabte)where incorporated Florida 10 Reason for applying(check only one box) ❑ Banking purpose(specify purpose) 0 Started new business(specify type) I. ❑ Changed type of organization(specify new type)t.- Construction ❑ Purchased going business ❑ Hsed employees(Check the box and see fine 13.) ❑ Created a trust(specify type) D. ❑ Compliance with IRS withholding regulations ❑ Created a pension plan(specify type) Si* ❑ Other(specify) I> 11 Date business started or acquired(month,day,year)_ See instructions. 12 C`os:,a month of accounting year December 11/07/2014 k 14 If you c oped you errpfoyrnent tax s y 10 be 51,000 13 Highest number of employees expected in the next 12 months(enter-0-if rone.. ( or!ess in a full calenda'year and ward to fie Form 344 If no crnpioyec-s expected,skip fine 14. 1 a nu .y instead of Forms 941 Guarterty,check hue- !. (Your ernpa?tnent taxt.;abLly genraSy w:3 be$1,000 I 1 crews f you expo to pay cr-'.-,000 or Less in total Agricultural I Potser•okt ! Other wages.)ti you do not ched<this box,you must fi e t Fcfm 941 to(every cruarter. ❑ 15 Fort date wages or sruft"es is pad(month,thy,yam;.r).Note.If a p'ceart is a .v.u't, ff:Eng agent,enter date income will first be paid to nonreader;stem(month,thy,yam) 16 Check one brx t-,=„t; e •v ` p.: c_i a:r� y of,Cur business. ❑ P,efilfh care&social assistance ❑ 4r7-cesite-agenllbroker 0' Cr ,,grin in Pic-'i&tw_,g ❑ Transportation s ..eretre..;satg ❑ A owned,:cn e food semico ❑ 4y7•,c,=x'a-other ❑ Retell Li Real estate ❑ ii,arutctunn ❑ Finance&insurance g ❑ Other(specify) 17 t i`c`e pr_rcdd,..ri_a-e of merchandise sold,specific construction work done,products produced,or services provided_ Construction Work 18 Has the applicant er-ttl shown on lie 1 ever applied ter and received an EIN? ❑ Yes 0 No If"Yes,"write previous EIN here Corr)? `e the:-._^n ceit'f 7 rood,..'et to autthoa ze d-o roust.,. .._:.ti_i to re,,,-',a tf?rr:i/S Ei.'l zA c 5.,:-f' 5'CZS ateut r �, -� r de mire,-yen G.tills turn. Third Designee's name e ffes s tet=ptxtxx ambe(metric area code) Party Nicole Ramirez(93012413) ( 888 ) 629-9001 Designee Address and ZIP code Designee's fax number(include area code) 2800 Biscayne Blvd STE 200, Miami, FL 33139 ( 888 ) 593-2328 Under penalties of perjury,I declare that I have exzrriThod this app`cal:on,and to the best of my kno•Medge and het 1,it is Icua,correct,and complete. Appfcant's teixphone number(include area code) Name and title(type or print clearly) Is Teodor Danilov,Principal Officer ( 239 ) 770-3585 Appicant's fax number(include area code) Signature - Date tJ ( ) For Privacy Act and Paperwork Reduction Act Notice,see separate instructions. Cat.No. lErr5Al Form SS-4 (Rev. 1-2010) L. f I CERTIFICATE OF LIABILITY INSURANCE DATE(MIWODIYYYY) 07/24/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVFI Y AMFNO, FXTFNn OR Al TFR Ti-IF nfVFRA(F eEFnPnFn RY 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. !!`.1POPTANT: If the cnrtifirat"M^I,'"e .., r tf CI IFARnnATION IS WAIVED,subject to th,.;.,..�:_- ;; -:.. :-' - --- . - -_ --- '�� -' - ,, .... •in htc to!It: certificate holder in lieu of such endorsement(s). I PRODUCER CONTACT _NAME:_._ Weems Insurance of Naples,Inc PHONE n p(239)775-8705 I(aC,No):(239)775.8570 2661 South Airpori rcoau Suite o IUS ADDRESS: Susan@weeufaurau,anoc.wu,uoawl[.nei Naples FL 34112 .............__.. INSURER(S)AFFORDING COVERAGE NAIC INSURER A: CYPRESS PROPERTY&CASUALTY INSURANC INSURED INSURER B: _ Custom Flooring Design Inc INSURER C_ PO Box 368125 INSURER D: Bonita Springs,FL 34136 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 of !oc,i'"OP.„,^Y r,E.,7-"i., T, _ _...._ . __7 .. TO."11.7!IE TEP.MS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ADOLISUBR POLICYEFF POLICY EXP LTR TYPE OF INSURANCE INS° WVD POLICY NUMBER 1MMIDDIYYYYI (MMJDDIYYYY) LIMITS X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE 000,000 A CLAIMS-MADE X OCCUR DAMAGE TO RENTED 100 000 20P0071072-0 07/24/2014 07/24/2015 PRFRSISFS(Fa occurrence) S ,t,SED EXP(Any one person) $6,00.0„ PERSONAL&ACV INJURY $100,000 GE(N'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $200,000 X I POLICY j c9 LOC PRODUCTS-COMP/OP AGG $200,000 OTHER: S AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT $ (Ea accident) ANY AUTO BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS _ AUTOS NON-OWNED PROPERTY DAMAGE HIRED AUTOS AUTOS _IRer_aaisten1,1 S UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE S DED 1 1 RETENTION$ $ WORKERS COMPENSATION PERnITE_L—L0R— AND EMPLOYERS'LIABILITY YI N TH- ANY PROPRIETOR/PARTNER/EXECUTIVE EL EACH ACCIDENT S OFFICER/MEMBER EXCLUDED? N f A -- -- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If yes.describe under DESCRIPTION OF OPERATIONS be n E.L.DISEASE-POLICY LIMIT S DESCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES (ACORD 101,Additional Remarks Schedule,may be attached if more space is required) FAX: 252-2469 CERTIFICATE HOLDER CANCELLATION COLLIER COUNTY CONTRACTORS LICENSING BOARD SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 2800 N HORSESHOE DRIVE ACCORDANCE WITH THE POLICY PROVISIONS. NAPLES,FL 34104 AUTH IZED REPRES NTATIVE ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are gistered marks of ACORD 22 >E • 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: 11/17/2014 EXPIRATION DATE: 11/16/2016 PERSON: DANILOV TEODOR FEIN: 472280498 BUSINESS NAME AND ADDRESS: CUSTOM FLOORING DESIGN 1015 IXORA CT. NAPLES FL 34110 SCOPES OF BUSINESS OR TRADE: CERAMIC TILE, INDOOR STONE, MA 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 Fated 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 shag be subject to revocation if,at any lime after the filing of the notice or the issuance of the certificate. the person named on the notice or certigra..+a no longer meets the requirements of this section for issuance of a certificate.The department shat revoke a DFS-F2-DWC-252 CERTIFICATE OF ELECTION TO DE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 G G] • • t 1.01$`X+' ." sd7r. {•g sg co er CovrKty Growth Management Department Planning & Regulation Operations Division Licensing Section August 5, 2015 Abel Arrendondo Superior Woodworking, Inc. 1405 SE 23rd PI. Cape Coral, FL 33990 RE: Review of Credit Mr. Arrendondo, You have been added to the agenda for the Contractor Licensing Board meeting on Wednesday, August 19, 2015. 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) 252-2930. Sincerely, Jason Bridwell Administrative Supervisor Licensing/Operations 2800 North Horseshoe Drive Naples, FL 34104 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: Credit Report Review X 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 18, 2015, 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 Abel Arrendondo dba Superior Woodworking, Inc.. has submitted an application to the Collier County Contractor Licensing Supervisor or his designee for waiver of testing requirements for reinstatement of a Certificate of Competency as a cabinet installation contractor. 2. That pursuant to Section 22-184(b) of the Code of Laws and Ordinances of Collier County, Florida, 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 3. That the Board has jurisdiction over this matter and that Abel Arrendondo was present at the public hearing on February 18, 2015, and was not represented by counsel. 4. All notices required by the Code of Laws and Ordinances of Collier County, Florida, have been properly issued. 5. The facts in this case are found to be: a. Applicant has demonstrated through testimony and evidence presented at this hearing that he has been active in the trade in another jurisdiction and has adequate knowledge of the contracting specialty to make re-testing in the trade superfluous. b. His knowledge of the contracting business is adequate, when combined with a full application to protect the public health and safety of the citizens of Collier County. CONCLUSIONS OF LAW Based upon the foregoing facts, the Board concludes that the applicant has met the standard set out in the Code of Laws and Ordinances of Collier County, Florida, and that the testing requirement may be waived. 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 Section 22-184(b) of the Code of Laws and Ordinances of Collier County, Florida, by a vote of 9 in favor and 0 opposed, a unanimous vote of the Board members present, the applicant's request to waive testing in the trade for reinstatement of his license is granted, subject to his payment of 2 all back fees due and owing as set out in Code of Laws and Ordinances of Collier County, Florida, and further subject to a six month probationary license and credit review in six months. ORDERED by the Contractors Licensing Board effective the 18th day of February, 2015. CONTRACTOR'S LICENSING BOARD LLIER COUNTY, FLORIDA VA I R A k , 46 .. By: Patric White, 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, Licensing Compliance Supervisor, 2800 North Horseshoe Drive, Naples, FL 34103 on this 18th day,of-February, 2015. (-- Secretary/Contractor's Licensing Board 3 886 110th Ave. N.Suite#6, Naples, FL 34108 Libee -... - . Phone: 239.777.1028 = Fax: 877.275.3593 www.LicensesEtc.com BUSINESS CREDIT REPORT as of: 08/05/15 8:08 ET Superior Woodworking, Inc. Fed Tax ID# 47-2902842 Address: 1405 SE 23rd PL Key Personnel: Arredondo Abel Cape Coral, FL 33990-1906 United States Business Type: Corporation Experian File Established: February 2015 Experian BIN: 996109002 Experian Years on File: Less than 1 Year Agent: Arredondo Abel Jr. Filing Data Provided by: Florida Agent 1405 S E 23RD Place Address: Cape Coral, FL Date of Incorporation: 01/20/2015 Public Records PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS. yr Bankruptcies: 0 +/Liens: 0 'Judgments Filed: 0 VCollections: 0 END OF REPORT Page 1 of 1 � F Full Credit Report I Credit Karma Page 1 of 9 V 4 edit()Karma Reported an;;r Jul 28,2015 abet arredondo's Credit Report Overview Your Credit Score Account Mix Credit Cards Real Estate 633 Auto Poor " Other Loans -,.ra4 vc:ou-ts Personal Information Names Reported ABEL M ARREDONDO See something wrong? MARTiNEZ,ABELA Frd out how to update personal information. Addresses Reported Employer Reported Date Reported 1205 NE 7TH PL CAPE CORAL,FL DESIGNER ABEL ARREDO Nov 3,2011 33909 SUPERIOR CUSTOM CABINET Mar 31,2005 1622 SE 21ST TE CAPE CORAL,FL 33990 475 E GOLDEN GATE BV NAPLES,FL 34120 Accounts Account Name Account Type Open Date Status Balance https://www.creditkarma.com/myfinances/creditreport/transunion/view/print 8/2/2015 Full Credit Report I Credit Karma Page 2 of 9 DISCOVERBANK S Credit Card Jun 29,2003 Closed $5,101 Account Details Payment History Last Reported Jul 15,2015 No par-rant history has been reported by this creditor. Creditor Name DISCOVERBANK Credit Utilization* 134.24: Account Type Credit Card Account Status Closed-Derogatory Creditor Contact Details Ope^.ed Date Jun 29,2003 Closed Date Nov 30,2009 DISCOVER FINANCIAL SERVI PO BOX 15316 Lirrat $3,800 WILMINGTON,DE Term 15850 (KO)347-2683 Monthly Payment $0 Responsibility Individual See something wrong? Balance $5,101 Learn more about how to dispute items on your credit report, Hignest Balance $5,101 Payment Status Collection;Charge-Off Worst Payment Status Unknown Date of Last Payment Jul 12,2009 Amount Past Due $5,101 Times 30160/9C.Days Lan 0:010 Remarks Charged off as bad debt Profit and loss write- off BK WEST g Other Mar 31,2006 Closed $13516 Account Details Payment History Last Reported May 30,2014 tic pa"^e.st',iatoty has been reported by tries creditor Creditor Name BK WEST Creditor Contact Details ACCOUrit Type Recreational Merchandise BANK OF THE WEST PO BOX 2078 Account Status Closed-Derogatory OMAHA,NE Opened Date Mar 31,2006 68154 (800}827-7500 Closed Date Mar 25,2009 Limit See something wrong? Term 144 Months Learn more about haw to dispute sterns on your credit report Mont iiy Payment $o Responsibility Individual Balance $13,516 Higneat Balance $17,413 Payment Status Collection/Charge-Off NJcrs*Pay-rent Status Unknown Date of Last Payment Aug 16,2010 Amount Past Due $0 Times 30/60/90 Days Late 0/0/0 Remarks Charged off as bad debt Profit and loss write- off https://www.creditkarma.com/myfinances/creditreport/transunion/view/print 8/2/2015 Full Credit Report I Credit Karma Page 3 of 9 CHASE 'O Credit Card Jun 30,2005 Closed $5,030 Account Details Payment History Last Reported Oct 29,2013 caymeht`sutory las bees reported by this creditor Creditor l+rame CHASE Credit Utilization* 109,35`"; Account Type Credit Card Account Status Closed-Derogatory Creditor Contact Details Opened Date Jun 30,2005 Cored Date Jul 29,2009 CHASE SANK USA NA PC BOX 15295 Limit $4;600 WILMINGTON,DE Teri 19850 (8001 432-3117 Monthly Payment $0 Responsibility Individual See something wrong? Balance $5,030 Learn more about how to dispute items on your credit report. Hig'•rest Bai:1-ce $7,114 Payment Status. Collection/Charge-Off Worst Payment Status Unknown ■ Date of Last Payment Nov 25,2008 Amount Past Due $5,030 Times 30/5090 Days Late 010;0 Rerrrarics Charged off as bad debt Canceled by credit grantor CHASE ft, Mortgage Mar 01,2004 Closed SO C.U.sues Payments Account Details Payment History Last Reposed Dec 15.2009 z.:09 ,9 u s v : 1. ._.:m,�,, 'v.^,x Creditor Marie CHASE 22047 cx it''ix:N q{ ,w. OK..h OK OK ON ;)K • Account Type Conventional Real 38pe c.x;OK OK OK ox a:cx cx ,r:a,;ix Estate Mortgage 20 OK Account Status Closed-Derogatory F :a a u A Opened Date Mar 01,20044 rt. 30-$9 Days Late Closed Cate . 60-89 Days Late Dec 15,2909 ,c 90-119 Days Late Limit I -- 120-149 Days Late Unknown Term 360 Months • Monthly Payne:t $1,517 Creditor Contact Details Responsibility Join CHASE Balance $0 PO BOX 24696 COLUMBUS,OH Highest 5aiana $169,750 43224 Pay--cent Status 120-149 Days Late 00)848-9136 Worst Payment Slat:s 120-149 Days Late See something wrong? Date of Last Panne-- Nov 01,2008 A,mcc:nt Past D,,F Learn more about how to dispute items on your cred report o repo . Tires 3r/6 n^,ayes La- 111;8 Foreclosure redeemed https://www.creditkarma.com/myfinances/creditreport/transunion/view/print 8/2/2015 Full Credit Report I Credit Karma Page 4 of 9 SYNCBICHEVRO S Credit Card Oct 13,2003 closed $0 Account Details Payment History Last Reported Jul 14,2015 2015 m OK°'K OK OK OK 2014 ac OK OK OK ac ac ccc OK a:OK tic ccc Creditor"tame SYNCB;'CHEVRO 2013 UK ac cx ac ac OK OK ac c cac OK OK Account Type Charge Account 2012 eK cc cc-OK 0,ac OK we OK ac ac ON Account States Closed " ° OK OK OK M. 4 44 c c A a C rc Opened Date Oct 18,2003 Closed Date Mar 29,2008 Credit Utilization. 0 0D1) Limit $800 Terra Creditor Contact Details Mcitt^ly;Payment $0 SYNCBrCHEVRON PLCC Respcnsibi i;., individual PO BOX 965015 Balance $0 ORLANDO,FL Highest.Baia.ce $0 32896 (BOO 243-8766 Payment Status Current See something wrong? Worst Payment Stars Current Date of Last Payment — Learn more about how to dispute items on your credit report. Arno -µPast Due $0 Times 30)6390 Days Late 0.•'0/0 Remarks Closed CAP1/BSTBY 8 Credit Card Jul 25,2004 Closed $Q liv'.lased Payments Account Details Payment History Last Reported Jul 28,2009 2006 .c ..,..,......w 3x: CK".K CM DX ccc J/.04,Cc CK:y(0x tx Creditor Nacre CAP1/BSTBY 2 4 0 7 _ 0.. c. 0. ficoau.ct Type Charge Account 2006 C c c=;,K cc^r.;n.:OK OK ac 3x c Account Status Closed-Paid F M A M } 1 A S c s it Opened Date Jui 25,2004 Unknown Closed Date Feb 21,2009 Limit $1,400 Credit Utilization* Term Monthly Payment $0 Creditor Contact Details -Responsibility Joint CAPtTAL ONE(BEST BUY b20artce 50 PO BOX 30253 SALT LAKE CITY,UT Hignest Balance $1,403 54130 Payment Status. Current (800)695-6950 rat Oav'nent Status. Current See something wrong? Date of Last Payment Mar 27,2006 Amount Past Due Learn more about Sow to dispute items art your credit report. Times 30r64'90 Days Late 000/0 Remarks Closed https://www.creditkarma.com/myfinancesi ereditrepordtransunion/view/print 8/2/2015 Full Credit Report 1 Credit Karma Page 5 of 9 CITI D Credit Card NOV 14,1999 Closed SO Account Details Payment History Last Reported Aug 08,2007 2007 x .ox 33 13 2008 C, Creditor Name CITI 2005 .714:A,_. Acocunt Type Credit Card 8,104 13- 33..33 3... �: Account Status Closed-Paid 2an ....,. .....'" K At A At .. . a _ r: Opened Date Nov 14,1999 Closed Date Apr 18,2007 Credit Utilization' .CT LI Mit $3,410 Term Creditor Contact Details Mo'ti ly Pa.m em $0 CITICARDS CBNA Responsibility Individual PC BOX 6497 Balance $0 SIOUX FALLS,SD Hig":est Balance $0 57117 (800)533-5600 Payment Status Current Worst Payment Status Current See something wrong? Date of Last Payment May 24,2007 Learn more about how to dispute items on your credit report. Amount cunt Past Due $0 Times 3C/60.130 Days Late 0/0/0 Remarks Account dosed by consumer FRD MOTOR CR 44 Auto Aug 20:2005 Closed SO Account Details Payment History Last Reported May 12,2007 ,T;reditor Name FRD MOTOR CR Account Type Automobile = is r. , Account Status Closed Opened Date Aug 20,2005 Creditor Contact Details Closed Date May 12,2007 FORD MOTOR CREDIT Limit __ PO BOX 542000 OMAHA,NE Tern 50 Months 68154 t unt u',,Pa me".t $609 t80O)727-7000 Res.onsib iity Individual See something wrong? Balance $0 Learn more about how to dispute items on your credit report. Fignest Balance $29,330 Payment Status Current • Worst Payment Status Current Date of Last Payment May 12,2007 Amount Past Due SO Vries 30/60/B0`gays Late 040 Remarks Closed https://www.creditkarma.com/myfinances/creditreport/transunion/view/print 8/2/2015 Full Credit Report I Credit Karma Page 6 of 9 CAPITAL ONE 'O Credit Card Nov 28,2001 Closed $0 Account Details Payment History Last Reported Apr 20,2007 Creditor Name CAPITAL ONE Accovrt Type Credit Card a. n 3 ; S AccoLnit Status Closed-Paid Opened Date Nov 28 2001 Credit Utilization* ^t-�. Closed Date Apr 20,2007 M Limit Creditor Contact Details Term -- Mott"3y Payment $0 CAPITAL ONE BANK USA NA PO BOX 330281 Responsibility individual SALT LAKE CITY,UT Balance $1) 84130 (800)955-7070 Highest Balance $530 Payment Status Current See something wrong? Worst Payment Status Current Learn more about how to dispute items on your credit report. Date of Last Payment Jan 08,2007 Amount Past Etue $0 Times 30/50/90 Days Late 0/0/0 Remarks Account closed by consumer *Calculated::sing,reported oalar.e and credit limit on account. Credit Inquiries Creditor Name ingairy Date Removed By* Type MIAMI CAR CR May 5,2014 Jun 2016 Automotive Creditor Contact Details See something wrong? MIAMICARCREQii MIAMiCARCR MIAMI,FL 33159 Find out now to dispute a hard inquiry (440)317-0010 MIAMI CAR CR May 4,2014 Jun 2016 Automotive • Creditor Contact Details See something wrong? MiAMICARCREDifMLAMICARCR MIAMI,FL 33163 Find out how 10 dispute a hard inquiry (440)317-0010 *Estimated used on the date of your inquiry and an assumed 2 year expiration period https://www.creditkarma.com/myfinances/creditreport/transunion/view/print 8/2/2015 Full Credit Report I Credit Karma Page 7 of 9 g Collections A gency Original s.Credror Open Date Status Balance ce CAVALRY PORT 08 GE MONEY BANK Feb 20,2013 Closed $0 Account Details See something wrong? Last Redone:: Jul 22,2015 Learn more about how to dispute items on your credit report. Collection Agency CAVALRY PORT Original Creditor 08 GE MONEY BANK Status Closed Coated Date Feb 20,2013 Closet Date - Resocnsib,ity Individual Balance $0 Flrgt Balance $268 Remarks Account information disputed by consumer, meets FCRA requirements AFNI 10 VERIZON Nov 29,2011 Closed $0 WIRELESS Account Details See something wrong? Last Reported Jul 15,2015 Learn more about now to dispute items on your credit report. Collection,Agency AFNI Original Creditor 10 VERIZON WIRELESS Status Closed Licence'Date Nov 29,2011 Closed Date - Reseo^shinty Individual Balance $0 t-kgh Balance 5661 Remarks Paid collection https://www.creditkarma.com/myfinances/creditrepordtransunion/view/print 8/2/2015 Full Credit Report I Credit Karma Page 8 of 9 MIDLAND FUND CITIBANK SOUTH Dec 27,2012 Closed $p DAKOTA N A • Account Details See something wrong? Last Reported Jul 14,2015 Learn more about now to dispute items on your credit report. Colictior Agency MIDLAND FUND Original Creditor CITIBANK SOUTH DAKOTA N A tats Closed Opened Date Dec 27,2012 Closed Date — Responsibil.ty Individual Balance $0 Hign Balance $2,639 • Remarks Account information disputed by consumer, meets FCRA requirements Public Records 0 As of Jut 28,2015,you had no public records on your credit report. How to Read Your Credit Report Your full credit report is divided into five Irripartxtt sections: Personal and Employment information This section contains names,addresses and employers included on your credit report.This sort of information,is added to your report after s been iced on credit applications Review this section for any information you don't recognize Accounts This to ns detaris Cr,each credit account on your credit report,including born open and closed accounts.Details include,.ayrr:ent nisi ri i..err stat:,s and reported balances Rev ew this section to ensure that your fenders nave been properly reporting your activity,and t0 look for any accounts that you dicn'topen, https://www.creditkarma.com/myfinances/creditrepordtransunionly iew/print 8/2/2015 4 Full Credit Report I Credit Karma Page 9 of 9 Credit Inquiries This section contains details on earn hard credit inquiry on your credit report Hard inquiries are typically added to your report,wren you apply for new lines of credit.Review this section to verify that eac1 inquiry is correct and authozed by you,and to find our approximation of when each inquiry will be removed from your report This section contains information about any accounts reported as in collections.If you've fallen behind on payments and nave outstanding debts,a lender could send your account to collections Review this section to check the accuracy of information about each collections account and to find contact information for your collections agencies Public Records This section contains details on any public record information included in your credit report.Public records include bankruptcies,civil judgments and tax liens.Review this section to ensure that each item is reported accurately If there is incorrect information,you could file a dispute directly with the credit bureaus. If you anticipate changes to your report over time,you can get an update to your credit report once a week through Credit Karma to check if new information has been added and oki information has been updated.Because lenders typically only report information to the bureau once a month,rt may take time for these updates to appear.View your report online to find highlights of information that could be important to your credit health. https://www.creditkarma.com/myfinances/creditreport/transunion/view/print 8/2/2015 Cover Letter for Superior Woodworking, Inc. By Abel Arredondo At the end of 2007 when the economy took a down fall and new construction nearly died, I was forced to take a salary job as a service/progect manager for Palm Bay Kitchens. A few months later they let the remaining licensed installers go and I found myself doing all the installations and service for the company as an employee. Unfortunately, I was not aware that I could pay to have my licence inactive. I simply thought I could renew my licence any time I needed it. Three years later I tried to renew my licence and was told that I needed to retest. This discouraged me and I did not to try to reinstate my licence. Since I have let my licence go I have worked for : Palm Bay Kitchens which later bought Naples Custom Cabinets and Designer Closets. I worked for this company for 3 years, the company shut down in January 2012. After that I worked for Grand Woodworking,LLC. I was their sole installer and service man for them from July 2012 to January 26, 2015. Due to a business dispute between partners the company is being dismantled. Now I would like to reinstate my installation licence for operating my own business, since I have work offers from the most prestigious cabinet shops in town, Artisan and Guild, AlliKriste, Rufino and others. Having my licence reinstated will give me the opportunity to serve these business with my expertise in cabinet installation. frh:* CDES Operations & Regulatory Management Licensing Section. 2800 North Horseshoe Drive (;5 47 j( Naples, FL 34104 (26/S-- G'67 7 APPLICATION FOR COLLIER COUNTY/CITY O 7 OF MARCO Ntr 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 Conunissi.oners, For further information, consult Collier County Ordinance No. 90405, as amended. NAME OF COMPANY: Exact Corporate/Business Nae: S U Q,t�l { m "Lx—t) 03340-1 A[, • Fiction Name/DBA: Qualifier Name: i`.}^r> ; ;~t r" rA'i IRY. n � nn Physical Address: 1 `3 D SE 23rd "PL. . @& COX. L 33qci 3 . (Number & Street) (City) (State) (Zip Code) Li Mailing Address: i `1 0 5 SE. Z�trd ?L• CxL Q eta "FL ?j f (Number & Street) (pity) (State) (Zip Code) Telephone:(23q) (.0 03— 5 6 `[ E=Mail: r'1 bQ.{ F X- a .r jrM11-'C TYPE OF LICENSE: U General $230.00 ❑ Electrician .$230.00 ❑ Building $2.30.00. ❑ pi,,.„Hor 5230.00 0. Residential $230.00 .. .. _ 1/13/2015 Reinstatement Fee=$205.00 ❑ Mechanical $230.00 ❑ New License Fee=$205.00 Roofing $230.00 3 Year Fees=$555.00 'Different fees may apply` Total=$965.00 Specialty trade: CCL b l Q± f!s. Qt Cont !` C GE OF STATUS6� Pr . ',< ��(ow j ) Reinstatement ((J) 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. -A Qd r ._.?)61) 1003 667,1 i 05 SE ;`d ar-Coroll) F(. 3cicto 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. v �cst- Cu-4 on' C` .b inoS ;i:n t✓. 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. • I .1 r 0C11 PQX561lik: cxodi�- e&,rds , r .dtcaV.al . fth) , s . Re k5Gns: -iv() d cV aC cstD , Can 0rt 1i Q,o 1 t0. I t N 010( N.S tie r41)139 t( r\4- . ( fv 1 AFFIDAVIT I, P■bQ 1 Y-(kaan61,D {• certify that the foregoing is true and correct to the best of my knowledge. ter/ • • Authorized Officer of the Firm STATE OF FLORIDA COUNTY OF Gc,/ +� The foregoing instrument as acknowledged before me this ( ./r? `` J ,30 o/5 V (Date) By *4e,-/ kre Gf a of 5(A-1,a4- <G r !,0©a L.vv r l _ ___.t I (Name of officer, title/agent) f (Name of Corporation) U a Q , c- x --- Corporation on behalf of the corporation. (State or Place of Corporation) He/She bas-produced - r ✓. La t 4--Z—Identification and did not take an oath. (Type of identification) NOTARY'S SE4 ,a.....,,, RUDINA Q.RUCI ro Notary Public•Stale of florlda ` I. 44 = My Comm.Expires Feb 5,2016 t 4 Commission N fF 089485 ( (SIG/NATURE OF NOTAR 1 ' ","•` Bonded Tluough RatIonsl Wary • Page 2 of 4 1 QUALIFIER INFORMATION: Name: �hel Art(camia Address: )(-I o5 s 23 rd -FL . Oa eQeofc& t'L 3 3` q o (Number& Street) (City) (State) (Zip Code) Telephone: 2 (,1 - d - 563 `t Date of Birth: t S.S. #: 000-00 - E-Mail: A ,�F X-4-coifL(@3mat .C-ai Driver's License: 1, Type of Certificate of Competency for which application is made. l}_ d1 t.YISLA- t 15-�G� V t A-b.(31) k 111 i 1( W o C�L.. 2. The names and telephone numbers of two persons who will know your whereabouts. x-05 i Q/' 2.3q - Lrr a - g7 y 1m P{r-QcimID 2s - Uo3 - 55Vs 3. Have you ever been convicted of a crime related to Contracting? 0 (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? 1' 8. List all debts you or any company(s) associated with you refused or failed to pay and reasons why. .rn a.11 : o Q ?f5G \aQ; C,(Cd;4- Canis friedtca kie• )k C i 14-�+) 4 5. wo ol.i v o(C.Qd aC an orn Co\ • Q onokS Lai I b h VAN.c - i 9. List your business or work experience during the past ten years. "Palm . .Ki-A-cken 4 .1 E •lb pc Mgr?-200,3 a.ts rt _ • r Su' A.ertareciS Cabin Sd0o3 l?alm Ki b2.431 0110 1)32k 2UA- Zb121 (3-rat W04,0.)odiinc,Inc. 2012- 2U Is- 2005 10. Statement of any formal training you have had in the area for which the application is made. ha. e rb0,�tafoi( Tr AccUQd CuS4om&6v��{ 'Su(11 t)( - ovQ.(o.} .All Klnd 1,�e • .+ • S S\nca \ ' had m o rno c�,� w. �. � � Q z ho.ue. � � '. b■Lsk3- 2ob`A 3(a-cc\ 200 • • Page3of4 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. Al ,\ 1(IQ61(maoY. APPLICANT(PLEASE PRINT) W ()44U)0"6.113' Vle■ , NAME OF COMPANY Aey SIGNATU`E OF APPLICANT STATE OF FLORIDA COUNTY OF 01/i The foregoing Instrument as acknowledged before me this !ar- n c-c c 0 0/5 ' I (Date) f ! By L1 �, / � /'ice j- L— ce P s B , t �i( �_d C-�._C;60 •�1 who has produced (Name of person acknowledging) _ (Type of identification) as identification and did not take an oath. ocA RUDINA G.RUCI / r �UYar�rPubllo State of Florida ;., •• My Comm.Expires Feb 5,2016 .1„."..,"„i4 Commission I FF 089465 Bonded'through National Notary Assn. (SIGNATURE OF NOTARY) • 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. • SIGNATU'E OF APPLICANT S� ttr Wobawcut , t • BUSINESS NAME ( I f ///D//✓`- DATE • •BEFORE ME this day personally appeared/IL{ /tr-�a,J0o.J who - affirms and says that he has less than one employee and does not require • Workmeh's Compensation and understands that at anytime he employs one or more persons he must obtain said Workmen's Compensation Insurance. • STATE OF FLORIDAI COUNTY OF o`/i The foregoing instrument was acknowledged.before me this //1 36' :o/S (Date) - -by/4-h f(e''P D Gt'o. who has produced L— ,t_ (name �- (name of person acknowledging) - (Type of Identification) as identification and who did not take an oath. . ""44 RUOINA G.RUCI ` •:�. .i'IA -Notary Public•State at Florida SIG NATURE OF NOTARY ' NOTARY SEAL My Comm:Expires Feb S 2018 ,; �•µF.•' Commission•N FF 089465 NOTA7 PUBLIC • 5nnded Through NaUOnat Notary Alin. • AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, cu.. ASigiii , am a resident of C1 ��(( County, D I�CG�k (State) and have resided here for more than five (5)years. During the last five years I have known a.biQ,C 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. Y65(Signature) a- (Name) U � Lo I Q. (Address) '1 25— 3(e 121(ra.cQ Telephone) a39) (ee 1S7 `I STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this -JO.nu CltA, a �u 'ty (Datd) who has produced (na of person acknowled ' g) (Type of identification) as identification and who did not take an oath. - ATUR.E OF NOTARY `rI Jr) Cn � C� NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC JANET KINCAID Notary Public•Slate of Florida !y`l My Comm.Expires Apr 30,2017 ` CommIssian 0 EE 863651 Bonded Through National Notary As« • 9 VERIFI CATION OF CONSTRUCTION EXPERIENCE GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples,FL 34104 Applicant's Name: el_ Ai /z26.4,O/\\.P0 Certificate Category Requested: 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: (2.F7 i-- Fi;t Title: /e2/4-1er7■/FA/2=?nriA4) 4• 'P License Number(if applicable): Al/71---e ,,4/1VVi /J' G(.2 re) • Name of Business: Ph LM, g-LTtbiZ / 191K-674' Business Address: / ./a "7-14-04--D-1: " �+r 1/44#y A1/24-/l FL-- 2V a9 Business Phone: 69.3c )- O 0 1-9'2- The Applicant's years of experience from o2OOJ to co/c,1- The applicant's scope of work(specific duties)included: FRar-t 3 Zo a-ao 2- 4'z3,E L 1.✓O.L�.E'� N f}- J',/45-co 7-"Ad4 d-rv/z L/�.,l1f� /.v'VTA-4',2 ,� �/ v,1 A �ZO 0 —21-0 u/�i v° r/'s4,J�e ' rrvA A/i4C-E R- Fia J2 )44,6,41-r!�}.�/, 71-14-H�✓ Tdd Fi.✓�(. 3'�n__: /�✓' /n/✓'�,ali '.b i ?4 r L€.3 c th'ow lnGu,t va mac r cef�.f x-16 rf �-1�3� �! -2 y �di r�T i C-Roo min) z9:4-VI de/teraevl.1 7-142 Additional Comments: ft-I3 th U /e 7-41-4. P�L0_0� a✓4L-, j E� t k!", ��N �A ✓�d 72- *Al -✓f/2, fo(Ai <fi v0-10yV r74 FL I t/ rl i nca✓v )44/p Ar Falsifying any information provided herein may subject your license to revocation. G�-EST- �✓� Gii� Si atur (/ Print Name: Z2774--?-_,,-- /Al, State of Florida County of Collier The foreg.ojng ins ment-was acknowledged before me on this / day of J� r c�( Q 7 y --t`) i - by f i k who is personally known to me or produced LLD 1. P 2'J O b 7-j S-Z DO2 as identification and who did not take an oath. ..�/ I Signature of No ►si-•�._. • ,'."'',,a',., YURIMA MEJIAS `.' ', ` Notary Public •State of Florida -. s,r. . ; My Comm.Expires Jun 7,2015 ,,, Commission# EE 875377 'VERIFICATION OF CONSTRUCTION EX- XPERIENCE GRAD Operations & Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: 47 7 MT/i'E-c‘vr'!'e) Certificate Category Requested: 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: /UPI Title: License Number(if applicable): Name of Business: �f. Business Address: J Vic• . Pc, Business Phone:a5 1 ` ! 3 3 The Applicant's years of experience from t.c.,r,L�,.,i 9i to f-N/ The applicant's scope of work (specific duties)included: }() r {V 1 , 1 1 ��t 1,,e")/ t.)V - i.J/�1.d'� ti\ f�' ��1-2r, cf:r JJ�/,�� i� i tf Olin 'z C ,--), Additional Comments: J V a mot/ �c�S �,�• ■ e:t-y x-b1. e.i - Falsifying any information provided herein may subject your license to revocation. Signature r Print Name: 4 1 State of Florida County of Collier The foregoing instrument was acknowledged before me e• • day of —` •`��= by i i t2 l L N ✓ ='2 who is p-rsonally known to e or produced as identification and who did not take an oath. Sig a tie of Notary Notary Public State of Florida James Skowronski ,p My Commission EE 177586 4ay6• Expires 03/08/2016 • COLLIER COUNTY GOV RNMENT 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, CoIIier County Building Director. Alainar Finnegan, Collier County Permitting Supervisor. Robert Zachary, County Attorneys Office. All Contractor Licensing personnel. • SUBJECT: Collection of social security numbers. Pursuant.to Cliapter 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 Ind as may otherwise be authorized by law. Ve are fully committed to safe-guarding and protecting your SSN and once collected, will be maintained as, ;onfidential and exempt under Chapter 119,-Florida Statues. • • • STATEMENT OF OWNERSHIP This certifies that I, Ak -r( n am a member or (APPLICANT'S NAME) Managing member of Jow(CC' orolcoudstk . (LIMITED LIABILITY COMPANY NAME) I own I 00 % 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. -A62l pra.0,14 i�. (PRINT NAME) (APPI.ICANT'S SICNATIIRE) l/3o/is (DATE) 1/28/15 Full Credit Report(Credit Karma Cred i i.C Marna Reported as of Jan 22,2015 abe! arredondo's Credit Report Provided by Overview Your Credrt Score Account Mix et Credit Cards 13 594 . Reai Estate I Credit Rating:Poor C`' Auto 2 0 Other Loans 1 Total Accounts 17 Personal Information Names Reported Dispute Details ABEL Ai ARREDONDO Found sornettsng incorrect on your report? t/ARTINEZ,ABELA Learn more about how to dispute items on your credit report. Addresses Reported 4i 1205NE7TH PL rt yers 8e e GAPE CORAL,FL. ,ti 3 _ of s 33909 Cape Coral p 1622SE21STTE n- itaSpriogs , CAPE CORAL,FL I{onl ;p!es 33990 Naples y 475 E GOLDEN GATE By tvr9rades t,h NAPLES,FL mat;.1 Report a map enor 34120 Employment Information Employer Reported Date Reported DESIGNER ABEL ARREDO Nov B,2011 SUPERIOR CUSTOM CABINET Mar 31,2006 tThese Approval Odds represent Credit Karma's estimation of how likely you are to be approved for a product based on a comparison of your profile with data about Credit Karma members who havebeenn approved for the product in the past Of avatable).There is no guarantee that you will be approved by the lender or that credit will be extended to you. Accounts Account Name Account Type Open Dale Status Balance 1/2W15 Full Credt Report I Credit Karma BK OF.AMEF1 -1— Credit Card May 21,2003 Closed $2,217 Ito F.!:ssca Patmcnts Account Details Payment History Last Reported Apr 30,2009 No}lament history has been reported by thts creditor. Creditor Name 8K OF AMER Credit Utilization' •147.80% Accotml Type Credit Card Account Status Closed-Derogatory Creditor Contact Details Opened Date May 21,2003 BANK OF AMERICA Closed Date Dec 22,2008 PO 130X 982239 982238 Limit $1,500 EL PASO,TX 79998 Term – (800)421-2110 Monthly Payment $0 Dispute Details Responsibility Individual Balance $2,217 Found something incorrect on your report? Learn more about how to dispute items on your credit report Highest Balance $2,217 Payment Status Collection/Charge-Off Worst Payment Status Unknown Date of Last Payment Jan 24,2009 Amount Past Due $578 Times 30/00/90 Days I ate 0/0/0 Remarks Charged off as bad debt Canceled by credit grantor 1128/15 Full Credit Report I Credit Karma DISCOVERBANK �`— Credit Card Jun 29,2003 Closed $5,1 01 No t t,ssed Payments Account Details Payment History Last Reported Dec 15,2014 No payment historybas been teported by this creditor. Creditor Name DISCOVERBANK Credit Utilization •134.245L Axount Type Credit Card Account Status Closed-Derogatory Creditor Contact Details Opened Date Jun 29,2003 DISCOVER FINANCIAL SERVI Closed Date Nov 30,2009 PO BOX 15316 1 531b WILMINGTON,DE Limit $3,800 19850 Tenn (B0O)347-2653 — Monthly Payment $0 Dispute Details Responsibility Individual Found something incorrect on your report? Balance $5,101 Learn more about how to dispute items on your credit report. Highest Balance $5,101 Payment Status Collection/Charge-Off Worst Unknown Date of Last Payment Jul 12,2009 Amount Past Due $5,101 Tunes 30/60/93 Days Late 0/0/0 Remarks Charged off as bad debt Profit and loss write- off 1/28/15 Frill Credit Report I Credit Karma BK WEST Ire! Other Mar 31,2006 closed $13,516 No Lrss_-o Payments Account Details Payment History Last Reported May 30,2014 Noopayment history has been reported by this creditor. Creditor Name 8K WEST Creditor Contact Details Account Type Recreational Merchandise BANK OF THE WEST 1450 TREAT IN Account Status Closed-Derogatory WALNU1 CREEP CA Opened Date Mar 31,2006 94596 (800)827-7500 Closed Date Mar 25,2009 Limit _ Dispute Details Term 144 Months I ound something incorrect on your report? Monthly Pay)rent $0 Learn moe about how to dispute items on your credit report Responsibility Individual Balance $13,516 Highest Balance $17,413 Payment Status Collection/Charge-Of I Worst Payment Status Unknown Date of Last Payment Aug 16,2010 Amount Past Due So Times 30/60/90 Bays Late 0/0/0 Remarks Charged off as bad debt Profit and loss write- off • 1/28/15 Full Credit Report I Credit Karma CHASE Sy Credit Card Sep O5,2001 Closed $4,629 No r.tsv_d Payments Aecount'Details Payment History Last Reported Nov 03,2013 No payment histuy has been reported by this creditor. Creditor Name CHASE Credit Utilization' 115.73': Account 1ype Credit Card Account Status Closed-Derogatory Creditor Contact Details Opened Date Sep 05,2001 CHASE BANK USA NA Closed Date Aug 03,2009 PD BOX 15298 15298 Limit $4,000 WILMINGTON,DE 19850 Term (800)432-3117 Monthly Payment $0 Dispute Details Responsibility Individual Balance $4,629 Found something incorrect on your report? Learn more about to dispute Items on your cre.dd report. Highest Balance $7,480 Payment Status Collection/Charge-Off Worst Payment Status Unknown Date of Last Payment Nov 06,2008 Amount Past Due $4,629 Times 30/60/90 Days Late 0/0/0 Remarks Charged off as bad debt Canceled by credit grantor ( 1/28/15 Full Credit Report I Credit Karma CHASE S Credit Card Jun30,2005 dosed 55,030 No Massed Payments Account Details Payment History Last Reported Oct 29,2013 No payment histoiyhas been reported by this creditor. Creditor Name CHASE Credit Utilization' 109.35% Account Type Credit Card Account Status Closed-Derogatory Creditor Contact 0etails Opened Date Jun 30,2005 CHASE BANK USA NA Closed Date Jul 29,2009 PO BOX 15298 15298 Limit $4,500 WILMINGTON,DE 19850 Term (800)432-3117 Monthly Payment $0 Dispute Details Responsibility Individual Balance $5,030 Found something incorrect on your report? Learn more about how to dispute items on your credit report Highest Balance $7,114 Payment Status Collection/Charge-Of f Worst Payment Status Unknown Date of Last Payment Nov 25,2008 Amount Past Due $5,030 Times 30/60/90 Days Late 0/0/0 Remarks Charged off as bad debt Canceled by credit grantor 112W15 Full Credit Report I Credit Karma Tt40/CBNA tin Credit Card Jan 26,2004 Closed $0 No Missed Payments Account Details Payment History Last Repoled Jan 07,2013 No payment history has been reported by this creditor. Creditor Name THD/CONA Credit Utilization. 0.00` Account Type Charge Account Account Status Closed-Derogatory Creditor Contact Details Opened Date Jan 26,2004 THE HOME DEPOT/COMA Closed Date Oct 05,2009 PO BOX 6497 6497 Limit $2,200 SIOUX FALLS,SD 57117 Term Monthly Payment $0 Dispute Details Responsibility Individual Found something incorrect on your report? Balance $0 Learn snore about how to dispute items on your credit report. Highest Balance $2,639 • Payment Status Collection/Charge-Oft Worst Payment Status Unknown Date of Last Payment Jun 22,2009 Amount Past Due SO Times 30/60/90 Days Late 0/0/0 Remarks Charged off as bad debt Purchased by another lender I 1/28/15 Full Credit Report I Credit Karma CITIFINANCIA C a Credit Card Feb 01,2007 Closed $0 No t:,;ssed Payments Account Derails Payment History Last Reported Mar 24,2010 No payment h stoyhas been wonted by this creditor. Cred la,Name CITIFINANCIA Credit lriiltzatiori WA Account Type Charge Account No credit limit reported Account Status Closed-Derogatory Opened Date Feb 01,2007 Creditor Contact Details Closed Date Jul 31.2009 CITIFINANCIAL Limit — 605 MUNN ROAD C/S CARE DEPT FORT MILL,SC Tenn — 29715 Monthly Payment $0 (800)922-6235 Responsibility Individual Dispute Details Balance $0 II Found something incorrect on your report? Highest Balance $5'782 team more about how to dispute items on your credit report Payment Status Collection/Charge-Of f Worst Payment Status Unknown Date of Last Payment — Amount Past Due $0 Times 30/60/93 Days Late 0/0/0 Remarks Charged off as bad debt Purchased by another lender 1/28/15 Full Credit Report I Credit Kartrts CHASE ft, Mortgage Mar 01,2004 Closed $0 10 td:ssed Payments Account Details Payment History Last Reported Dec 15,2009 2009L-'ElEMU 111111111111111111 2008 1101111111111111111111111111E111111111 Creditor Name CHASE 2007®®®®®®®i®®®SI Account Type Conventional Real 2006®®®®®®®®®®1EM Estate Mortgage 2005 ea Account Status Closed-Derogatory J r rJ n tJ J J n SO u n Opened Date Mar 01,2004 ' 30-59 Days Late • el 60-89 Days Late Closed Date Dec 15,2009 0 90-119 Days Late • • Limit — ® 120-149 Days Late Unknown Term 360 Months Moodily Payment $1,517 Creditor Contact Details Responsibility Joint CHASE Balance $0 PO BOX 24696 24696 COLUIABUS,OH Highest Balance $169,750 43224 Payment Status 120-149 Days Late (800)848-9136 Worst Payment Status 120.149 Days Late Dispute Details • Date dint Payment Nov 01,2008 Found something incorrect on your report? Amount Past Due SO Learn more about how to dispute items on your credit report Times 30/60/90 Days Late 1/1/8 Remarks Foreclosure redeemed SYNCB/CHEVRO S Credit Card Oct 18,2003 Closed $0 • No Missed Payments Account Details Payment History Last Reported Jan 14,2015 2014®®®e ®®®®im®®® 2053®®®®®®®®EM®®® Creditor Name SYNCB/CHEVRO 2012®®®®®®®®®®10® Account Type Charge Account 2011 Ora®C®®®ECI®®®EZI J r rJ A r a J J A S O u 0 Account Status Closed Opened Date Oct 18,2003 Credit Utilization' 0.00. Closed Date Mar 29,2008 Limit $600 Creditor Contact Details Terns — Monthly Payment SO SYNCB/CHEVRON PLCC PO BOX 9 6501 5 965015 Responsibility Individual ORLANDO,FL Balance SO 32896 (800)243-8766 Highest Balance $0 Payment Status Current DispuieDetails Worst Payment Status Current Found something incorrect on your repot? Date of Last Payment — Learn more about how to dispute items on your credit report. Amount Past Due $0 Tunes 30/60/90 Days Late 0/0/0 • Remarks Closed 1/28/15 Full Credit Report I Credit Karma • SEARS/CBNA Credit Card Oct 29,2000 Closed $0 No tfcssed Payments Account Details Payment History Last Reported Jan 06,2015 2014 00100000.10000 2513 Credrta Name sEARSTCBNn 2012 000®0000000 Account Type Charge Account 2011 00®0®000®OOm Account Status Closed-Paid r to t1 d A s 0 11 D Opened Date Oct 29,2000 Credit Utilization' 0.005 Closed Date May 12,2008 Limit 5250 Creditor Contact Details Term — Monthly Payment SO SEARS/CBNA PO BOX 6282 6282 Responsibility Individual SIOUX FALLS,SD Balance $0 57i17 Highest Balance $445 Dispute Details Payment Status Current Found something incorrect on yvur report? Worst Payment Status Current (.,earn more about how to dispute items on your credit report. Date of Last Payment Jun 02,2005 /vnount Past Due $0 Times 30/60/90 Days Late 0/0/0 Remarks Canceled by credit grantor • i 1/28/15 Full Credit Report I Credit Karma SST/SYNOVUS S Credit Card Dec 03,2004 Closed $0 No thsce i Payments Account Details Payment History Last fleported Sep 21,2009 2000®®0®0000 2009®®83®®83■83®®®® Cred,tcf(Jame SST/SYNOWS 2007 110.11111111111111111111111111111111 Account lype Credit Card 2008®®0®®®®®®®110® Account Status Closed-Paid 2005 2222®® J F r d A rA J J A S O N D Opened Date Dec 03,2004 Closed Date Nov 16,2006 Credit Utilization' 0.00% Limit $2,530 Term Creditor Contact Details Monthly Payment $0 SST/SYNOVUS Responsibility Individual 4315 PICKETT Balance $0 SAINT JOSEPH,MO 64503 Highest Balance $3,090 (800)789-8001 Payment Status Current Dispute Details Worst Payment Status Current Date of Last Payment Aug 31,2005 Found something incorrect on your report? Learn more about how to dispute items on your credit report Amount Past Due so Times 30/60/90 Days Late 0/0/0 Remarks Account closed by consumer CAP1/BSTBY g Credit Card Jul 25,2004 Closed $0 No Missed Payments Account Details Payment History Last Reported Jul 28,2009 2009®®®®E2E2 2008 22®®®®®®22®83®m Creditor Name CAPI/BSTBY 2007 ®®®®rea®IDO®® Account Type Charge Account 2009®®2222®Pi{®®®®®® Account Status Closed-Paid 2005 2222®®®® J F 1.1 A IJ J J A S O N O Opened Date Jul 25,2004 Unknown Closed Date Feb 21,2009 Limit $1,400 Credit Utilization` 0.00`x Term — Monthly Payment $0 Creditor Contact Details Responsibility Joint CAPITAL Ot4E/BEST BUY Balance $0 PO BOX 30253 30253 SALT LANE CITY,UT Highest Balance $1,403 84130 Payment Status Current (800)695-6950 Worst Payment Status Current Dispute Details Date of Last Payment Mar 27,2006 Found something incorrect on your report? Amount Past Due $0 Learn more about how to dispute items on your credit report Times 30/60/90 Days Late 0/0/0 Remarks Closed 1/28/15 Full Credit Report Credit Karma CITI S Credit Card Nov 14,1999 Closed $0 NO I,'s5,=d Paymcnls Account Details Payment History Lest Reported Aug 08,2007 2002®0®E1111W1 2006®®®®®ln®®®®®® Credit&Name CITI 2005®®®®®®®®®®131® Account type Credit Card 2002®®L'{a®®®om®s®m Account Status Closed•Paid 2003 113111:10211112 J r rd A td J J A S O N D Opened Date Nov 14,1999 Closed Date Apr 18,2007 Credit Utilization' 0,00% Limit $3,410 Term Creditor Contact Details Monthly Payment $0 CITICARDS CBNA Responsibility Individual PO BOX 6497 6497 CREDIT BUREAU DISP Balance SO SIOUX FALLS.SD 57117 Highest Balance $0 (800)533.5500 Payment Status Current Dispute Details Worst Payment Status Current Date of Last Payment May 24,2007 Found something incorrect on your report? Learn more about how to dispute items on your credit report. Amount Past Due $0 Times 30/60/90 Days Late 0/0/0 Remarks Account closed by consumer FRD MOTOR CR Auto Aug20,2005 Closed $0 No Missed Payments Account Details Payment History Last Reported May 12,2007 2007®®®® 2006®®ME®®MI®MI®® Creditaa Name FRO MOTOR CR 2005 ®®re®® Account Type Automobile J F L I A M J J A S O N D Account Status Closed Opened Dale Aug 20,2005 Creditor Contact Details Closed Date May 12,2007 FORD MOTOR CREDIT Limit _ PO BOX 542000 542000 OMAHA,NE Terri 60 Months 58154 Monthly Payment $609 (II00)727-7000 Responsibility Individual Dispute Details Balance S0 Found something incorrect on your report? Highest Balance $29,330 Learn more about how to dispute items on your credit report_ Payment Status Current Worst Payment Status Current Date of Last Payment May 12,2007 Amount Past Due $0 Times 30/60/90 Days Late 0/0/0 Remarks Closed • Report I Full Credt R Credit Karma 1/2&15 CAP ONE S Credit Card Nov 28,2001 Closed $0 No t.4ssed Po ments Account Details Payment 1-listory Last Reported Apr 20,2007 2007■E® 2006®®®®®®611®®®1111® Creditor(dame CAP ONE 2005 ®®®Q Account Type Credit Card J r rJ A 1.1 u J A S o N o Account Status Closed-Paid Opened Date Nov 28,2001 Credit Utilization* N/A Closed Date Apr 20,2007 No credit limit reported • Limit Creditor Contact Details • • Term •- Monthly Payment SO CAPITAL ONE BANK USA NA PO BOX 30281 30281 Responsibility Individual SALT LAKE CITY,UT Balance SO 84130 (800)955-7070 Highest Balance $530 Payment Status Current Dispute Details Worst Payment Status Current Found something incorrect on your report? Date of Last Payment Jan 08,2007 Learn more about how to dispute items on your credit report, Amount Past Due SO Times 30/60/90 Days I_ate 0/0/0 Remarks Account closed by consumer II � I 1/28!15 Full Credit Report I Credit Karma CHASE 'J Credit Card Dec 03,2004 Closed $0 No Mooed Payments Account Details Payment History Last Reported Feb 21,2006 2006 III 2005®®®®®®Z®®®®® Creditor Name CHASE 2005 Account Type Credit Card J F M A U J J A 5 0 0 0 Account Status Closed Opened Date Dec 03,2004 Credit Utilization' 0.00% Closed Date — Limit $2,500 Creditor Contact Details Term — CHASE BNK-FRMLYPRVD/VJAM Monthly Payment $0 0 BANK ONE CARD SERV 2500 WESTFIELD DRI ELGIN,IL Responsibility Individual 60124 Balance $0 Dispute Details H!ghe sl Balance $3,090 Payment Status Current Found something incorrect on your report? Learn more about how to dispute items on your credit report. Worst Payment Status Current Date of Last Payment Aug 31,2005 Amount Past Due $0 Times 30/60/90 Days Late 0/0/0 Remarks Account closed by consumer FRO MOTOR CR (4 Auto Jun 16.2001 Closed SO No Missed Payments Account Details Payment History Last Reported Aug 25,2005 2005®®®®®®® 2004®®®®®ZI®®®®®® Creditor Name FRD MOTOR CR 2003 Mira®®rain®®®MEMO Account Type Automobile 2002®®I] ®®®M3®®®® Account Status Closed N101 01111113113 J F Li A r.l J J A S O N D Opened Date Jun 16,2001 Unknown Closed Date Aug 25,2005 Limit — Creditor Contact Details Term 72 Months FORD MOTOR CREDIT Monthly Payment $519 PO BOX 542000 542000 OMAHA,NE Responsibility Joint 68154 Balance $0 (800)727-7000 Highest Balance $25,248 Dispute Details Payment Status Current Found something incorrect on your report? Worst Payment Status Current Learn more about how to dispute items on your credit report Date of Last Payment Aug 25,2005 Amount Past Due $0 Times 30/60/90 Days Late 0/0/0 Remarks Closed 1/28/15 Full Credit Report I Credit Karma i MIDLAND FUND CITIBANK SOUTH Dec 27,2012 Open $3,258 DAKOTA N A Account Details Creditor Contact Details • Last Reported Jan 12,2015 MIDLAND FUNDING t LC 13975 AFRO DR 200 Collection Agency MIDLAND FUND SAN DIEGO,CA Original Creditor CITIBANK SOUTH 92123 DAKOTA N A (844)236-1959 Status Open Dispute Details Opened Date Dec 27,2012 Found something incorrect on your report? Closed Date — Learn more about how to dispute items on your credit report • Responsibility Individual Balance $3,258 High Balance $2,639 Remarks Placed for collection PORTFOLIO RC CITIFINANCIAL INC Mar 30,2010 Open $6,317 Account Details Creditor Contact Details Last Reported Jan 08,2015 PORTFOLIO RECOVERY 287INDEPENDMCE Collection Agency PORTFOLIO RC VIRGINIA BEACH,VA Original Creditor CITIFINANCIAL INC 23462 (800)772-1413 Status Open Opened Date Mar 30,2010 Dispute Details Closed Dale — round something incorrect on your report? Responsibility Individual Learn now about how to dispute items on your credit report. Balance $6,317 High Balance $5,783 Remarks Placed for collection PORTFOLIO RC HSBC BANK NEVADA Nov 20,2009 Open $7,396 NA Account Details Creditor Contact Details Last Reported Jan 08,2015 PORTFOLIO RECOVERY 287 INDEPENDENCE Collection Agency PORTFOLIO RC VIRGINIA BEACH,VA Original Creditor HSBC BANK NEVADA N 23462 A (800)772-1413 Status Open Dispute Details Opened Date Nov 20,2009 Found something incorrect on your report? Closed Dale — Leam more about how to dispute items an your credit report. Responsibility Individual Balance $7,396 High Balance S6,574 Remarks Placed for collection 1/28/15 Full Credit Report I Credit I<arrna AFNI 10 VERIZON Nov 29,2011 Open $661 WIRELESS Account Details Creditor Contact Details Last Reported Apr 22,2012 AFNI PO BOY.3097 3097 Collection Agency AFNI BLOOMINGTON,IL Original Creditor 10 VERIZON 61702 WIRELESS (GOO)371-35,15 Status Open Dispute Details Opened Date Nov 29,2011 Found something incorrect on your report? Closed Date — Learn more about how to dispute items on your credit report, Responsibility Individual • Balance $661 • High Balance $661 Remarks Placed for collection Public Records 0 As of Jan 22,2015.you had no public records on your credit report. How to Read Your Credit Report Your full credit report is divided into five important sections: ail Personal and Employment Information 1 his section contains names,addresses and employers included on your credit report This sort of information is added to your report after it's been used on credit applications.Review this section for any information you don't recognize. Accounts This section contains details on each credit account on your credit report,including truth open and closed accounts.Details include payment history,current status and reported balances.Review this section to ensure that your lenders have been properly reporting your activity,and to look for any accounts that you didn't open. p Credit Inquiries 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: 02/02/15 09:19 ET Superior Custom Cabinet,Inc. Fed Tax ID#52-2407694 Address: 1622 SE 21st Ter Business Type: Corporation Cape Coral, FL 33990-4715 United States Experian File April 2010 Established: Experian BIN: 930565402 Experian Years on File: 5 Years Agent: Arredondo Abel J Years in Business: More than 5 Years Agent 1622 SE 21ST Terr Filing Data Provided Address: Cape Coral, FL b Florida Y� Date of Incorporation: 10/31/2003 Public Records PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS. /Bankruptcies: 0 /Liens: 0 /Judgments Filed: 0 /Collections: 0 END OF REPORT Page 1of1 x Iii 4,0 ink Ott Pjt OA $r t t+1$A OtI OA 0ft 41,"OA Oft V/A x II "AuV# t( 9 # 11 ♦ ` # ) 4 * # * # 14 � � # ` to ♦ ter " 1� o j %A` 4 0 Ort t o v 1111 " r a 41* u ,_+ I �`I p w O � • o. tc L 2 Q, y Q Q :111 1) -tc,, e _ 0 40 i 10 Ili? la A.4 (4-04 `s 0 (4--( ,..s t'a) A 11; 0 1 «�� , o u U1 F"' t`*/A g N._ 1, c/D . . 2 ° i NsV OAtk : 401 Of €(45 z'. , ,4 0 -,_ l' (41 t s•fx, Ali + •� = o b ` b♦ 12 p \ NI �-4 a OU a) (5, \ V s It> 0 cn TEA \' ''; tl#A4r, ' 4:14 0 c.'7 .6. ct Al rk 4 ' E a �� o i o — o � ' *rte - -4111■*4 4t U � b )zw. v, 0 o �A� � y:-. '2t f+1 H H o cn 4 g tit/A erg f 40 O t/ 11!•.11 1��t► �)•►�t► �1►•�1 41•� A , ,,, X(Al 04 /1k 14P ' O NTH; S . - PTO :+► .*40. .F:.._ 'Ate. . 0 ti :- ll 0 A11 #A� e �t 14*2 1[`; �� op toe*0 '1[O A®2 1[� �`0.0 't<w�� 02 �. L_ ciai b} Entity Name Page 1 of 2 y t� f FI►{�RTT}A' DEPARTM;&Nfi dF �iTAT$ DIVISION op &o�pox� ,._, Y _ � . 7-,,,,p 3 } R -' tijG 44 4 .< Al^ Detail by Entity Name Florida Profit Corporation SUPERIOR WOODWORKING,INC. Fil c Information Document Number P15000006424 FEI/EIN Number NONE Date Filed 01/20/2015 State FL Status ACTIVE Effective Date 01/20/2015 Principal Address 1405 S.E. 23RD PLACE CAPE CORAL, FL 33990 Mailing Address 1405 S.E. 23RD PLACE CAPE CORAL, FL 33990 Red istered Ac ent Name 8 Address ARREDONDO, ABEL, JR. 1405 S.E. 23RD PLACE CAPE CORAL, FL 33990 Officer/Director Detail Name & Address Title P ARREDONDO, ABEL, JR. 1405 S.E. 23RD PLACE CAPE CORAL, FL 33990 Annual Reports No Annual Reports Filed Document Images 01/20/2015 -- Domestic Profit[ View image in PDF format Electronic Articles of Incorporation F1 5000006424 For January 20, 2015 Sec. Of State msolomen SUPERIOR\ OODWORKING,INC. The undersigned incorporator, for the purpose of foaming a Florida profit corporation, hereby adopts the following Articles of Incorporation: Article I The name of the corporation is: SUPERIOR WOODWORKING,IN C. Article II The principal place of business address: 1405 S.E. 23RD PLACE CAPE CORAL, FL. US 33990 The mailing address of the corporation is: 1405 S.E. 23RD PLACE CAPE CORAL, FL. US 33990 Article HI The purpose for which this corporation is organized is: ANY AND ALL LAWFUL BUSINESS. Article I'V The number of shares the corporation is authorized to issue is: 100 Article V The name and Florida street address of the registered agent is: ABEL ARREDONDO JR. 1405 S.E. 23RD PLACE CAPE CORAL, FL. 33990 I certify that I am familiar with and accept the responsibilities of registered agent, Registered Agent Signature: ABEL ARREDONDO JR. Forth W.9 Request for Taxpayer Give form to the (Rev.October 2007) Identification Number and Certification requester.Do not Deparlrnant of the Treasury send to the iRS. Internal Raarue service Name(as shown on your income tax return)/ cNi a Business name,If different from above j; SUPe�ia CUDa�VDX/C/,vq, Gve• n 2 Check appropriate box:❑ In fetduaVSote,proprietor C•rporatan ❑ Partnership Exempt Z'i ❑ Limited liability company Enter the tax dassfication(O=disregarded entity.C.-corporation,P-partnship)• ❑ Mee `o E ❑ Other(see trsrnxtions)• Address(number,street,and ppt.or suite no.) Requester's name and address(optional) do /( j 5 c2_3'I' 1'41 City,state,and ZiP code N CA/�je ep R� ,C/ .'33`30 g List account number(s)here(optional) re Part I Taxpayer Identification Number(TIN) Enter your TIN in the appropriate box.The TIN provided must match the name given on Line 1 to avoid Social security number backup withholding.For individuals,this is your social security number(SSN).However,for a resident , alien,sole proprietor,or disregarded entity,see the Part I Instructions on page 3.For other entitles,It is your employer identification number(EIN).If you do not have a number,see How to get a TIN on page 3. or Note,If the account is in more than one name,see the chart on page 4 for guidelines on whose Employer Identification number number to enter. 97; .g'7'0,V y7 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 are exempt from backup withholding,or(b)I have not been notified by the Internal Revenue Service(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 em 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 not required to sign the Certification,but you must provide your correct 1114.See the Instructions on page 4. Sign Signature of l Here u.s.person• ///'� / /- Data O. /,,Z/�5- i General Instructions Definition of a U.B. person.For federal tax purposes, you are considered a U.S.person if you are: Section references are to the Internal Revenue Code unless • An individual who Is a U.S.citizen or U.S.resident alien, otherwise noted. • A partnership,corporation,company,or association created or Purpose of Form organized in the United States or under the laws of the United A person who is required to file an information return with the States, IRS must obtain your correct taxpayer identification number(11N) • An estate(other than a foreign estate),or to report,for example,Income paid to you,real estate • A domestic trust(as defined in Regulations section transactions,mortgage Interest you paid,acquisition or 301.7701-7). abandonment of secured property,cancellation of debt,or Special rules for partnerships.Partnerships that conduct a contributions you made to an IRA. trade or business In the United States are generally required to Use Form W-9 only if you are a U.S.person(Including a pay a withholding tax on any foreign partners'share of income resident alien),to provide your correct TIN to the person from such business.Further,in certain cases where a Form W-9 requesting it(the requester)and,when applicable,to: has not been received,a partnership is required to presume that 1.Certify that the TIN you are giving Is correct(or you are a partner Is a foreign person,and pay the withholding tax. waiting for a number to be issued), Therefore,if you are a U.S.person that Is a partner In a 2 Certify that you are not subject to backup withholding,or partnership conducting a trade or business In the United States, provide Form W-9 to the partnership to establish your U.S. 3.Claim exemption from backup withholding if you are a U.S. status and avoid withholding on your share of partnership exempt payee.If applicable,you are also certifying that as a Income. . U.S.person,your allocable share of any partnership income from The person who gives Form W-9 to the partnership for a U.S.trade or business Is not subject to the withholding tax on purposes of establishing Its U.S.status and avoiding withholding foreign partners'share of effectively connected income. on its allocable share of net income from the partnership Note.if a requester gives you a form other than Form W-9 to conducting a trade or business in the United States Is In the request your TIN,you must use the requester's form if it Is following cases: substantially similar to this Form W-9. •The U.S.owner of a disregarded entity and not the entity, Cat No.10231x Form W-9 (Rev.10-2007) --!4) o DATE(uuDOrvvrv) ACOR® CERTIFICATE OF LIABILITY INSURANCE 1/30/2015 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(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). CT PRODUCER NAME Customer Service Department Gaslamp Insurance Services, Inc. HONE aR, (619)229-3854 I(nc.11n). 3234 Grey Hawk Ct. ADDRESS;Certif icate @premieragencyservices.com INSURER(S)AFFORDING COVERAGE NAM 0 Carlsbad CA 92010 INSURERA:United Specialty Ins Co. 12537. INSURED INSURER B: Superior Woodworking Inc INSURER C: 1405 SE 23rd IHSURERD: INSURER E: Cape Coral FL 33990 INSURER F: COVERAGES CERTIFICATE NUMBER;GL Master 14-15 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 SLUM SU POUCY EFF POLICY EXP TYPE OF INSURANCE WETS LTR [NSA WVO, POLICY NUMBER RJIJ'D/YYYYI RJN/DD/YYYYI GENERAL LIABILITY EACH OCCURRENCE S 1,000,000 , DAMAGE TO RENTED 50,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrence) $ A X CLAIMS-MADE I I OCCUR SI/1008002715 1/27/2015 1/27/2016 MED EXP(My one peaon) 5 5,000 PERSONAL E ADV INJURY $ 1,000,000 GENERAL AGGREGATE $ 2,000,000 GENL AGGREGATE LIMIT APPUES PER: PRODUCTS-COMP/OP AGG S 1,000,000 )—(1 POLICY I—I PECT fl LOC $ AUTOMOBILE UABtLnY COMBINED SINGLE LIMIT (Ea accident) .$_ ANY AUTO _ BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per acddc-nt) $ - AUTOS — AUTOS PROPERTY DAMAGE NON-OWNED MED (Per PERT Yl $ HIRED AUTOS AUTOS --- UMBRELLA LIAR OCCUR EACH OCCURRENCE $ EXCESS UAB CLAIMS-MADE AGGREGATE S DEO I I RETENTION$ $ WORKERS COMPENSATION WC STATU- OTH- AII)EMPLOYERS'LIABILITY TORY LIMITS I FR ANY PROPRIETOR/PARTNER/EXECUTIVE IY!1 N/A EL EACH ACCIDENT S OFFICEFVMEMBER EXCLUDED' (Mandatory In NH) EL DISEASE-EA EMPLOYEE$ If yes,desube under DESCRIPTION OF OPERATIONS below EL DISEASE-POUCY LIMIT S DESCRIPTION OF OPERATIONS/LOCATIONS!VEHICLES (Attach ACORD 101,Addlllonal Remarks Schedule,II mote space Is required) Verification of Coverage *Subject to all policy terms, exclusions and conditions* CERTIFICATE HOLDER CANCELLATION (239)252-2469 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 Licensing Department 2800 N. Horseshoe Drive AUTHORIZED REPRESENTATIVE Naples, FL 34104 lam_.-s,.....7"..e.. ,S A-t om P Salvagio/KATIE ACORD 25(2010/05) ©1988-2010 ACORD CORPORATION. All rights reserved. INS025(201005)01 The ACORD name and logo are registered marks of ACORD • JEFF ATWATER -- cmsrpmxwoALornccn srxrsnrp�omn� 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 listeo below has elec!el to be exempt from F:or■cla Workers'Compensation law EFFECTIVE DATE: 1o8'2010 EXPIRATION DATE: 1/27/2017 PERSON: ARREDONDO ABEL FEIN: 4720028w2 BUSINESS NAME AND ADDRESS; SLIPERIOR WOODWORKING INC 1405 SE 23Ro PLACE CAPE CORAL FL 33990 SCOPES OF BUSINESS OR TRADE: CARPENTRY NOC r"==°mwu°^'u*x.4` n s ""off°,*^~"==cn^17:^^tu^`nn."=,"mm.m",,° ce"�"°.`°,="`,=^,,==~ receve:be°x ,,.?mpe=""`un^~10^.=*=r o.ar?=+um,z, p" ^== an?'y"v "w"Ike mope r."°y~,^ES"Va°,.x,"`,.",,/"."/ p'°,^'/*c^°�::,*"v,:``, ,o ^m°,,,°�.�u� .°^ =nd.^^"=;e.u,��:n..;;;C^°" : '= .a===1:a,, F.: ":"^.^w0'^,= uI", zzle "`=`"arr^ =~..="n• "a` , ""= Ina��rc,= ,"~,`~�^ `aa..="0'°""/°^ The"ea"~*��,.=.^°^ [IFS 2f.)7cc*1-IrIC^7coveF,cr1c,, ec�x�m' nro�s��'� uucor/uw» tF;a=./3-,ma I • Florida Sortsfiltre sr�. CD CLSSA tEi0 'J a M t ABEL }' ARftEDONDO Ja 1406 SE 231tD PL CAPE CORAL,FL 3. 90;190f, sic � 2012H((� � 2020 a .*." °pPK r 'S` � _ ,.�... - „�. ...-.....-qty .+F.. q..riVn al a molar•diAr[vst1V es consent 10 rry sduicj 1�Y r. ad try l.r I s I!t BEFORE THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY, FLORIDA, CONTRACTORS' LICENSING BOARD Petitioner, V. Case#2015-04 License #31217 Joseph Brown D/B/A—Anything in Doors L.L.0 Respondent. / ADMINISTRATIVE COMPLAINT Collier County (County) files the Administrative Complaint against Joseph Brown ( Respondent), a Collier County licensed Glass& Glazing Contractor( license #31217), 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 Glass &Glazing Contractor with License number#31217. 2. Under the provisions of Collier County Ordinance 90-105, as amended, Section 22-201,the following actions by a holder of a Collier County issued Glass &Glazing Contractor's license shall constitute misconduct and grounds for discipline pursuant to Section 22-202. a. In July, 2015 a complaint involving an unpermitted human access door installation in a garage structure located at 1400 Misty Pines Circle#202 Naples, FL. 34105 was investigated by the Collier County Contractors' Licensing Office. b. The investigation revealed on or about May, 2014 the door installation was contracted by the Collier County licensed Glass &Glazing Contractor,Anything in Doors L.L.C. c. The work contracted by Anything in Doors L.L.C. is outside the scope of Glass &Glazing licensure. d. The work contracted for by Anything in Doors L.L.C. requires a building permit. e. Anything in Doors L.L.C. completed the door installation without a building permit in issuance and was paid in full for the work. f. 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. 3. Collier County brings the following charge in this formal complaint against the Respondent. COUNT I Collier County Ordinance 90-105, as amended,Section 22-201(2) states, "Contracting to do any work outside of the scope of his competency as listed on his competency card and as defined in this article or as restricted by the Contractors' Licensing Board." COUNT II 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 Divisions 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 : August 5th, 2015 Signed: Collier Coun y Contractors' Licensing Supervisor or Designee C.L.B. Case #2015-04 Joseph Brown D/B/A — Anything in Doors L.L.C. Table of Contents E1/E3 — Formal Complaint. E4 — Collier County Certificate Detail Report. E5 — Notice of Hearing hand delivered to agent for qualifier. E6 — U.S.P.S. Return Receipt for Notice of Hearing sent via Certified Mail. E7 — Preliminary Complaint Form submitted against Anything in Doors L.L.C. E8 — Contract for door installation with Anything in Doors L.L.C. E9 — Permit application #PRBD20140617136 submitted for door installation. E10/E11 — Database notations of HOLD dated August 20th, 2014 placed on permit #PRBD20140617136 for insufficient licensure. E12/E13 — Checks made payable to contractor with final installment dated October 2nd, 2014 after completion of work. E14/E15 — Collier County Ordinance #90-105, as amended, Section 22-162(22) outlining scope of accepted work for Glass & Glazing Contractor. E16/E17 — Collier County Ordinance #90-105, as amended, Section 22-201(2) outlining violation of working outside the scope of licensure. E18 — Collier County Ordinance #90-105, as amended, Section 22-201(18) outlining violation of working without obtaining applicable permitting. E19 — 2010 Florida Building Code, Section 105.1 outlining permitting requirements. E20/E22 — Case Detail Report. E23 — Photograph of door installation. Contractors' Licensing Board 2800 North Horseshoe Dr. Naples, Fl. 34104 Complaint Number-2015-04 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: August 5th, 2015 Against: Contractor's Name:Joseph Brown Phone: (239) 479-7887 Business Name:Anything in Doors L.L.C. License Number if known:#31217 Collier County Competency number: Same Contractor's Business Address: 1421 S.E. 43rd St. Cape Coral, FL. 33904 Filed By: Name: Collier County Contractors' Licensing Office Address: 2800 N. Horseshoe Dr. Naples, FL. 34104 Business Phone: (239) 252-2431 Address where work done: 1400 Misty Pines Circle#202 City: Naples, FL. County: Collier Date of contract: N/A. Date job started: Unknown Date job completed or new home occupied: On or about October, 2014 Were there plans and specifications ? : Yes Is there a written contract ? : Yes. If yes, amount of Contract: $640.00 Has Contractor been paid in full ? :Yes. If not, what amount? : N/A Was a Building Permit obtained ? : No Building Permit number if known: application #PRBD20140617136 (HOLD) Have you communicated by letter with the licensee ? : Yes Date:July 16`h,. 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)which states, "Contracting to do any work outside of the scope of his competency as listed on his competency card and as defined in this article, or as restricted by the Contractors' Licensing Board," and Section 22-201(18) which states, "Proceeding on any job without obtaining applicable permits or inspections from the City Building and Zoning Divisions or the County Building Review and Permitting Department." Please state the facts which you believe substantiate your charge of misconduct against the subject contractor. List facts separately for each subsection number above: On or about May, 2014 a contract for the installation of a human access door in a garage structure located at 1400 Misty Pines Circle Naples, FL. 34105 was taken by the Collier County licensed Glass & Glazing Contractor(#31217), Anything in Doors L.L.C.The contractor submitted for a permit application (#PRBD20140617136) which was placed on HOLD after a review of the scope of work outlined was determined to be outside of glass & glazing licensure by the Contractors' Licensing Supervisor. Despite a HOLD on the permit issuance for insufficient licensure, the door installation was completed and the contractor paid in full without the permit having ever been in ISSUANCE. Complainant's signature 1 State of: Florida County of: Collier Sworn to (or affirmed) and subscribed before me this 5th day of August, 2015 by Collier County License Compliance Officer, Rob Ganguli, (signature of person making statement) / 2ISi nature of Notary) Y) Print,type or stamp commissioned name of Notary Public /,r-,,a7 7 E. (/n r''77t Personally known ,% Produced identification gipti'"':'rS}; KAREN E.CLEMENTS ;t: : :+z MY COMMISSION#EE 882321 'W.—=' .1g, EXPIRES:March 27,2017 4,Rf,.ih ' Bonded Thai Notary Public Underwriters -3 License Application Status - CityView Portal Page 1 of 2 GMD Public Portal License Application Status — License Application Summary Application Number: C31217 Business Name: ANYTHING IN DOORS,LLC License Type: Contractor Application Status: Inactive Description of Business: All Certificates from CDPIu5: 31217 Mailing Address: 1421 S.E.43RD ST.CAPE CORAL FL 33904- Locations: — Issuances Type Date Issued Date Expires Status Number GLASS&GLAZING CONTR. 10/02/2014 09/30/2015 Active 31217 — Reviews There are no reviews for this license application. _ Insurance Producer Type Policy Effective Date Expiry Date Limit SHORES INSURANCE, General Liability GL-0504007521 06/04/2012 06/04/2015 $2,000,000.00 'INC. Expiration Processed: Yes Producer Phone Number: 9544938240 JOSEPH BROWN Worker's Comp 03/06/2015 03/06/2017 Exemption Expiration Processed: No http://cvportal.colliergov.netlCityViewWeb/License/Status?licenseld=100530 7/14/2015 —(-{ Collier County Growth Management Division / Planning and Regulation Operations Department/ Licensing Section • Delivery /__. /i/7----- -` �%(// rx_ ( A-'mil �//�� Hand ry Date: July16th, 2015 7-/6- o '(9// Joseph Brown d/b/a—Anything in Doors L.L.C. • 1421 S.E. 43rd St. Cape Coral,FL. 33904 RE: Complaint filed against you by the Collier County Contractors' Licensing Office. Dear : Joseph Brown 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 Wednesday August 19th, 2015 at 9:00 AM 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(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 issuance #31217, and/or suspension or revocation of your permit privileges against your state license(N/A). Sincerely R • G.•: li Licensi g Compliance Officer • Collier lounty Contractors' Licensing (239) 252-2914 —S SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • Complete items 1,2,and 3.Also complete ignatu ' - item 4 if Restricted Delivery is desired. /- 0 Agent II Print your name and address on the reverse / - 0 Addressee so that we can return the card to you. B. _.-.- by e) C. to of Delivery • Attach this card to the back of the mailpiece, /lam 2LA1 7, or on the front if space permits. U /s D. Is delivery address different from item 1? 0 Yes 1. Article Addressed to: If YES,enter delivery address below: 0 No R 1 -lo?-t S- E 0 51- Pe 3. Service Type Certified Mall 0 Express Mail q 0 Registered 0 Return Receipt for Merchandise 33 °L\ ❑Insured Mail . ❑ C.O.D. 4. Restricted Delivery?(Extra Fee) 0 Yes 2. 7007 2560 0001 1485 6626 c^rm 3811,February 2004 Domestic Return Receipt 102595-02-M-15401 �•S z-oi soar 5ct COLLIER COUNTY BUILDING REVIEW & PERMITTING CONTRACTORS LICENSING 1111112800 N. Horseshoe Drive • Naples, Florida 34104 • (239) 252-2432 • Fax (239) 252-2469 PRELIMINARY COMPLAINT FORM Your Name: ill C-Pc K,CTE W 'J ER. Date: -71q(1)--- c ec -E Address: f f-d'o ;(4111 �,��-� ?o.City: Vpr1- t-e5 State: Et - Zip: 3 icr Home Phone: 'J 4- -7 2 3.31- Business Phone: THIS COMPLAINT IS AGAINST: Company Name: Fa ( 1 -F(c i7/c 1 N./ 0 Oq icense # 3 Contractor or Person in Charge: (If Known) Address: 2 is COeff1-1 L 334VX Phone:(3 g—� I -G d 6' Date of Contract: THE SPECIFIC COMPLAINT IS: (Attach additional sheets as necessary) )4- ILL rte- ex- 9,v2tA,:t- Attach Copies of All Appropriate Documents: Contracts, Checks, Liens, Permits, Etc. Contractor Licensing Officers: Michael Ossorio (Supervisor) - (239) 252-5706 Ian Jackson- (239) 252-2451 Allen Kennette- (239) 252-2468 Robin Ganguli- (239) 252-2914 Karen Clements- (239) 252-2450 Signature: I1Q , d�., C o Li e r C a x x t y ANYTHING IN Office (239) 479-7887 Fax (239) 542-6828 1421. SE 43R`' ST. Cape Cora?, Fla. 33904 RESIDENTIAL - COMMERCIAL SALES & INSTALLATION WOOD— STEEL,—HOLLOW METAL DOORS —FIRE RATED DOORS CUSTOM MAHOGANY DOORS —FIBERGLASS DOORS—IMPACT WINDOWS—STOREFRONT DOORS —GLAZING& HARDWARE NAME: DATE: ADDRESS: Unit No-F-202 Garage No-12 PHONE: - WE HERE BY SUMBIT SPECIFICATIONS AND ESTIMATES FOR: 1 2Ft.8in,X 6ft.8in Fiberglass Door, 6 panel smooth High velocity hurricane Florida building code. Fiberglass Frames with weather stripping,mill threshold, stainless steel hinges Fiberglass brick molding outside and clam shell casing inside frame Price is based on 10 or more units All doors to retro fit in same openings Supplied and installed Permits included rod;ict Plastpro Builders Hardware Total$ 625.00 Check No- Deposit$300.00 t°` Balance after inspection$325.00 1 c� 30.00 1 ( Signature Proposal #-20 Weber, Margarete COLLIER COUNTY BUILDING PERMIT APPLICATION Growth Management Division, Planning and Regulation 2800 N.Horseshoe Drive, Naples, Florida 34104 TEL: 239-252-2400 Please fold plans with the plain side out. Ensure documents are stapled inside each s t of plans. El Residential 1 on 2 Units(Single F-s - y/Duplex =Residential 3 or more Units(Multi-family)each Permit No. p (1 r-!.0 1 t f Master Permit No. ,/ Parcel/Folic: 2 3e5 Q 0//‘C ra Contractor DDesign Professional Downer Builder Z Job Address:/SW jy11j/). A,,,of C`r is 7--°"Z-- O License#State Cert/R.eg-Prefix: #: 3/2.17 - Owner's Phone No.: Company Name: '(-h tkis -t, b-,er c z JJ / Owner's Name:f'1a(cie/k A" W f{(r tR O Quslifer/ProfessionalName: jc{efl Q�,r„t, ULot Bloch Unit r Contact Name: JQSr'l, /T 53'Jl../m'l 3 Subdivision: 6 e-GL C t--a-'r-c-- P-- C--' ' t Address:/YD./ S4 `1 ) c4. Op Township: t3-ci Range:?. Section: 1 U C' G, P Cara/ State: City: � pi Zip: 3j�c'ii FEMA. BFE: Flood Zone: g Phone(Z?') $/71-Xs7 Fax:(2.3rI)5-172-6fi SDP/PL: O E:*nA;i Address: cA,},.{1.),.j,'„,iCI,r e ad. Code Case: COA: nAlteration 77Mechanical Clean Agent System =L2 Gas z =Convenience Book nMobile Home i=7 (Mire AIarm =Pre-Engineered Fire q =Demo New Construction U Lire Alarm Monitoring =Suppression =boor/Window C]Plumbing C]Fhe Pumps r iStandpipes g =Electric/Low Voltage l jPool ��-, j_Thire Sprinkler System FISpray Booths O �l fElectric from House =Re-roof - F."-,- [Fossil Fuel Storage System =Tents ' J—IFence • f Screen Enclosure K =Hoods fiUndcrground Fire Lines ate. =Gas =Shutter H =Marine (lSign/Flagpole OTHER =Solar rq =Private Provider =Plumbing z I =Non-sprinkled (Sprinkled 0 0 =Roofing fi Electrical x U ®Septic =Low Voltage CPA _� C=IA 0� `n (,Shutters =Mechanical [�1 0 n� 1-11-VA _W O =Permit by Affidavit 0= VA FIVE (.) C.) Occupancy Classification(s): Description of Work: Rep/4 Oe:,1 4,J Ai m.e cite 7 s,lC z 0 Project Name: /9e0 h'1.�i.5., p'r 5- 6'•r =r ?OZ - Declared Value$: C25 ' NEW CONSTRUCTION/ADDITION AREA ALTERATION WORK AREA-SO.FT. to If applicable: #Stories/Floors:_ #Units: #Tons: U RESIDENTIAL; GZ #Bedrooms: #Baths: ti Living. Non-living: O RESIDENTIAL: Living: Non-living: Total sq.ft.: TOTAL SQ.FT P" C0 MMER CIAL: COMMERCIAL: Interior. Exterior. Z< #Fixtures: Interior: Exterior: Total: TOTAL SQ.FT.: Z l U, SEWAGE: 0 Septic=Ave Maria (]City of Naples 0 Collier County D Golden Gate City ED Immokalee =Orange Tree =Other .-c WATER SUPPLY: Hf Well []Ave Maria =City of Naples 0 Collier County =Golden Gate City =Immokalee D Orange Tree 0 Other • Application/Plans Discrepancies-Customer Acknowledgement of possible rejection for the following missed information: 1. Square footage does not match 2.Occupancy Classification not provided . 3. Construction type not provided 4.No Certified site plans JUNE 2,2014 ddp-PMR Date: Days Review: # Set of Plans: -- l i,elp ! 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CityView will suggest possible matches as you type; Permit Application !Miscellaneous Conditions 1 Permit Details/Fees Link I Number I Condition Code I Status I Department Permit Inspections 1 Fire Certificate Open I Building Review and Permitting aI Plan Permit PI Check i. . 2 - ,Miscellaneous Condition --- Open - 11 Permit Reports Jesday,Jul 14,2015 08:11 AM E__— (0 permit hold per mike o, cant do job under this license Collier County Payment Slip - Permits Date: August 20, 2014 Contact: ANYTHING IN DOORS, LLC 1421 S.E. 43RD ST. CAPE CORAL, FL 33904-- Owner: WEBER TR, MARGARETE K UTD 8-1-97 Permit Location: 1400 Misty Pines CIR, Unit:202 FEES: Description Application Number Permit Number Fee Paid Fee FIRE Inspection Minimum Fee- (not PRBD20140617136 $100.00 $0.00 otherwise noted) PRBD20140617136 PRBD2014061713601 $55.00 $0.00 Inspection Fee PRBD20140617136 PRBD2014061713601 $2.00 $0.00 BCAI PRBD20140617136 PRBD2014061713601 $2.00 $0.00 DCA Total: $159.00 $0.00 Bonds: Item Type Balance Job Description: REPLACE DOOR AND FRAME SIZE TO SIZE 1400 MISTY PINES CIR #202 ( -C) ()JS f ?e_,? � LA) Page l of l MARGARETE WEBER 134 1400 Misty Pines Cir Apt 202 63-466/631 Naples,FL 34105 - — �l UU e 1,9 j DATE FORD TEO TO HNc� I V C 1 $ 3OO'e v +WYI R.Ci " ti22r.L4,6 1ape, DOLLARS t �L A . A REGIONS Zap - /` is FOR 112 ithyl,c.rim eS ra. .rii!L r 4 iJ '""f!_(1 RV s Posting Date May 06 2014 DB/CR D Amount $300.00 Item Bank 92 Account Check No 134 Posting Seq No 9200417871 Teller Seq No 0000000000 http://iaprocwv2.corpsgbk.com/inquiry/page/itemprintj sp?BEANNAME=ArchiveltemLis... 7/15/2015 Page 1 of 1 • MARGARETE WEBER 141 1400 Misty Pines Cir Apt 202 63-+ st Naples,FL 34105 j or Qi c4 DATE PAY TO THE pp ORDER OF 1f� � 44/916 1 $ cO- PJ r) (2D/`a.p q � DOLLARS in A. REGIONS:-- Ca FOR i/ 'i ei Q -- sr Harland Clerks _ vO romg Posting Date Oct 06 2014 DB/CR D Amount $340.00 Item Bank 92 Account Check No 141 Posting Seq No 9000093522 Teller Seq No 0000000000 http://iaprocwv2.corp.rgbk.com/inquiry/page/itemprint jsp?BEANNAME=ArchiveItemLis... 7/15/2015 ARTICLE V. BUILDING TRADES* Page 5 of 36 material by pump and which deposits the pumped material at a fill location in one operation. (15) Drywall contractor requires 36 months experience with a passing grade on an approved test and a passing grade on a business and law test and means those who are qualified to install gypsum drywall products to wood and metal studs, wood and steel joists, and metal runners in buildings of unlimited area and height. The scope of work shall include the preparation of the surface over which the drywall product is to be applied, including the placing of metal studs and runners and all necessary drywall preparation trim and shall include the placement of fire safing and fire stopping materials as part of the overall drywall contract. (16) Hurricane shutter/awning contractor requires 24 months experience with a passing grade on an approved hurricane shutter installer test and a passing grade on a business and law test, and means, those who are qualified to install, maintain, repair or replace shutters and awnings that are designed to protect residential and commercial buildings from hurricane and storm force winds and windbome debris all in accordance with Collier County amendments to the Applicable Building Code, as amended from time to time. Any electrical work connected with the installation of the shutters or awnings must be done by a licensed electrical contractor. Only nonstructural adjustments to existing openings may be performed as part of the work. Contractors who hold current Collier County Aluminum Contractor Including Concrete or Aluminum license on the effective date of this amendment are not required to pass this test, but must apply for this Certificate not later than one year from the effective date of this amendment. (17) Epoxy stone contractor requires 24 months experience with a passing grade on a business and law test and means those who are qualified to batch and mix aggregates, epoxy, hardener, and gravel to specifications, or to construct forms and framework for the casting and shaping of epoxy and aggregate, or to pour, place and finish over concrete base. (18) Excavation contractor requires 36 months experience and a passing grade on an approved test and a passing grade on a business and law test and means any person who is qualified to excavate to obtain or remove materials such as rock, gravel and sand; to construct or excavate canals, lakes and levees, including the cleaning of land of surface debris and vegetation as well as the grubbing of roots; and to remove debris and level surface land incidental and necessary thereto in compliance with all environmental laws, the building code, and other applicable codes and regulations. Minor excavations, such as footings, backfill without compaction, and similar activities are exempt hereunder. The use of explosives is not included in this category. (19) Fence erection contractor requires 24 months experience and a passing grade on a business and law test and means any person who is qualified to install, maintain or repair fencing or decorative prefabricated walls on grade. (20) Floor coverings installation contractor requires 24 months experience installing the specific product and a passing grade on an approved business and law test and means any person who is qualified to install carpet, sheet vinyl and/or all types of wood. (21) Gasoline tank and pump contractor requires 48 months experience and a passing grade on an approved test and a passing grade on a business and law test and means those who are qualified to install, maintain, repair, alter, or extend any aboveground system used for the storing and dispensing of gasoline, kerosene, diesel oils and similar liquid hydrocarbon fuels or mixtures (not to include pollutant storage). (22) Glass and glazing contractor requires 24 months experience, a passing grade on an approved test and a passing grade on a business and law test, and means those who are qualified to select, cut, assemble, and install all makes and kinds of glass and glass work, and execute the glazing frames, panels, sash and door and holding metal frames, ARTICLE V. BUILDING TRADES* Page 6 of 36 ornamental decorations, mirrors, tub, shower enclosures, and portable partitions. The scope of work shall include the installation of hurricane shutters or devices that are integral with the window system. (23) Insulation contractor. a. All types, except buildings, requires 36 months experience, a passing grade on an approved test and a passing grade on a business and law test, and means those who are qualified to install, maintain, repair, alter, or extend any insulation primarily installed to prevent loss or gain of heat, from internal or external sources on pipes, vessels, ducts, fire stopping materials, sprayed-on fire resistive materials, or built-up refrigerated boxes or rooms, and acoustical materials. b. Buildings, requires 24 months experience, a passing grade on an approved test and a passing grade on a business and law test, and means those who are qualified to install, maintain, repair, alter, or extend any insulation primarily installed to prevent loss or gain of heat from rooms or buildings. (24) Irrigation sprinkler contractor requires 24 months experience and a passing grade on an approved test and a passing grade on a business and law test and means any person who is qualified to install, maintain, repair, alter or extend all piping and sprinkler heads used for irrigation, including any required connections to a water pump; however, such work does not include direct connection to potable water lines. (25) Landscaping contractor requires 12 months experience and a passing grade on a business and law test and means any person who is qualified to install and/or remove trees, shrubs, sod, decorative stone and/or rocks, timber and plant materials, and concrete paving units for sidewalks, patios and decks only, whether or not incidental to landscaping, prepackaged fountains, or waterfalls, provided same does not include connection to a sanitary sewer system, portable water line, or to any electrical installation, which tasks must be performed by tradesmen licensed in the relevant trade. Landscape contractors may contract for only removal and/or trimming of trees and/or other combination of the authorized services. All new applicants applying for landscaping license are required to obtain a passing grade on an approved exam pertaining to pruning and safety, in addition to the business and law exam. (26) Liquefied petroleum gas installation contractor means any person qualified and licensed pursuant to F.S. ch. 527 to install apparatus, piping and tubing, and appliances and equipment necessary for storing and converting liquefied petroleum gas into flame for light, heat, and power. Placement of fire safing and fire stopping materials shall be permitted on wall, ceiling and floor penetrations created within the scope of the work allowed by this section. (27) Marine, seawall, and dock construction contractor requires 36 months experience, a passing grade on an approved test and a passing grade on a business and law test, and means those who are qualified to build and install bulkheads, revetments, docks, piers, wharves, groins, boathouses, lifts and davits, and to do pile driving. Electrical service and wiring must be provided by a licensed electrical contractor. (28) Masonry contractor requires 36 months experience, a passing grade on an approved test and a passing grade on a business and law test and means those who are qualified to select, cut, and lay brick and concrete block or any other unit masonry products, lay other baked clay products, rough cut and dress stone, artificial stone and precast blocks, glass brick or block, but who shall not pour or finish concrete. (29) Paving blocks contractor requires 24 months experience in the respective construction plus a passing grade on an approved test and a passing grade on a business and law test, and means those persons who are qualified to construct ��rs 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; O-rd. 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 rOking 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 • (fO • ARTICLE V. BUILDING TRADES* Page 28 of36 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 the 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 pOrformance 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 terns 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. • �—ice 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) 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, shell 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 a ll 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. ;,.noofv nrn/;n •ra/.ro+c+cvw,111TT1, 1 of/nr„c+r,,,/u,,;1rOnna PT./1/R9f=tPmnlat 9/5/90OR E` I`1 C tergovmet Report Title: Code Case Details Date: 8/5/2015 12:31:22 PM Case Number: cemis20150013931 Case Number: CEMIS20150013931 Status: Refer to CLB Case Type: Misconduct Date&Time Entered: 7/13/2015 8:02:16 AM Priority: Normal Entered By: RobinGanguli Inspector: robinganguli Case Disposition: Case Pending Jurisdiction: Contractor's Licensing Origin: Complaint Detail Description: Complaint received regarding a door installation performed prior to contractors request to cancel permit(#PRBD2014061713601)for work. Location Comments: 1400 Misty Pines Circle#202 Naples, FL. 34105 Property 23895001165 Complainant Weber, Margarete Contractor Anything in Doors LLC/Brown, Joseph Business Management& Budget Office 1 Code Case Details Execution Date 8/5/2015 12:31:22 PM Desc Assigned Required Completed Outcome Comments Preliminary Investigation robinganguli 7/10/2015 7/13/2015 Needs 7/10/15.Complaint received from property Investigatio owner of 1400 Misty Pines Circle#202 n Naples, FL.34105 regarding an installation of a human access door with the issued permit (#PRBD2014061713501)never closed out and subsequently cancelled by the contractor. Contacted qualifier of Anything in Doors, Joseph Brown,who claimed he never performed the work due to cost effectivness. On site met with complainant, Margarete Weber,who produced checks made payable to Anything in Doors for the entire amount of the contract. Photos taken of the door installed.Second phone call made to Mr. Brown and message left requesting a meeting. Cont. Investigation RobinGanguli 7/13/2015 7/14/2015 Complete 7/13/15 Consulted with permitting technician, Theresa Potter,who advised that database research revealed a HOLD was placed on permit#PRBD20140617136 prior to issuance on August 20th,2015 by M.G.O.for inadequate licensure to obtain a door installation permit with glass &glazing licensure. Final check from customer made payable to Anything in Doors dated October 6th, 2015 with customer advising all work completed. Further database research reveals request for permit application cancellation dated October 27th,2014 with permit having never been issued. Meeting scheduled with qualifier,Joseph Brown,for Thursday 7/16/15 Investigation robinganguli 7/16/2015 7/17/2015 Refer to 7/16/15. Meeting with Father of qualifier,Tom CLB Brown,in Joseph Brown's absence.Violations of working outside the scope of licensure as well as commencing work requiring a building permit explained. Directives from M.G.O.for Contractors'Licensing Board appearance for violations. Notice of Hearing for August 19th, 2015 C.L.B. hearing served to Mr. Brown and also sent via Certified Mail#7007 2560 0001 1485 6626. Not Applicable RobinGanguli 7/17/2015 7/17/2015 Not Required Schedule for CLB samantharoe 7/17/2015 7/17/2015 Complete Generate CLB Notice of Hearing samantharoe 7/17/2015 7/17/2015 Complete Enter Hearing Results michaelossori 7/17/2015 Pending 0 Cont. Investigation RobinGanguli 7/23/2015 7/23/2015 Complete 7/23/15. Return receipt for Notice of Hearing sent via Certified Mail#7007 2560 0001 1485 6626 recieved,signed for,and returned. Enter Hearing Results 8/19/2015 Pending Business Management& Budget Office 2 Code Case Details Execution Date 8/5/2015 12:31:22 PM Violation Description Status Entered Corrected Amount Comments 4.1 Misconduct-County/City Open 7/13/2015 $0 Certificate of Competency n7" Title Reason Result Compliance Fine/Day Condition 3 Business Management& Budget Office r x.a xA, ce. 1 ' l :,.,,,,,44...;!_f.4 ,s S may. '4'.5:-..21.-- Y . K• 1- 1' ' ,» i 'va „n : b .X F y 1..:42"A''-' ' + n 1; . � 'h °f S? F i { �Ce r � ,: � Y s ;' M iyy'R y #a M _ � 7 - , ?it }S v+ e - E yJ ` .% eK. k., --,-.,;-,i...,:0-- ..i,.nY Y A� r't S k -. 4....7,,..........-.,,,, ° * 4,'"f. x.'.. ,ya T,�4„r'jy� 4,'•S ''L _r, "c: i ' 4,--.4..--,=1.4 -'-tom Pik ` . ,, �,2r. i .d r �r • 0 6 f i S it -file • .y . • ''" > xi{ f ; 4t d d is r 1.,,-,t4.!.;':,-- s#+ fi 1 6 t '� , t, 1,-,,,:::.-,,,.-.,-A 5 x c i x $ 1 7 i 1 8 -F„,;,1'; . 9 r 1 ----__- — .a rr -tea BEFORE THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY, FLORIDA, CONTRACTORS' LICENSING BOARD Petitioner, V. Case#2015-05 License#CBC1257228/Collier County#33986 Michael Paul Taillefer D/B/A—Imperial Homes Inc. Respondent. ADMINISTRATIVE COMPLAINT Collier County (County) files the Administrative Complaint against Michael Paul Taillefer( Respondent), a State licensed Certified Building Contractor( license #CBC1257228), and states the following facts and allegations in support of the cited violations below: 1. The Respondent is currently licensed by the State of Florida as a Certified Building Contractor with License#CBC1257228. 2. Under the provisions of Collier County Ordinance 90-105, as amended, Section 22-201.1,the following actions by a holder of a Certified Building Contractor's license shall constitute misconduct and grounds for discipline pursuant to Section 22-202. a. In April, 2015 a case (#CESD20150006859) was forwarded by the Collier County Code Enforcement Department for review by Collier County Contractors' Licensing regarding an unpermitted remodel of a condominium unit located at 142 Palm Dr. #3 Naples, FL. 34112. b. An Investigation conducted by Collier County Contractors' Licensing revealed that the remodel had been performed by Imperial Homes Inc./CBC1257228. c. Database research revealed no permits applied for or in issuance for the jobsite. d. Directives to abate the violation were given to the qualifier, Michael Paul Taillefer who submitted permit application #PRBD20150722767 which was REJECTED by the Plans Review Department for discrepancies. e. Upon receiving outstanding corrections required for re-submittal of the permit application, Mr.Taillefer advised of his disagreement with the requirements further advising that he intended on presenting his case in front on the Contractors' Licensing Board. f. 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. 3. Collier County brings the following charge in this formal complaint against the Respondent. COUNT I 4. Collier County Ordinance 90-105, as amended, Section 22-201.1(2) states "Willfully violating the applicable building codes or laws of the State, City, or Collier County." 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: August 6th, 2015 Signed: Col er County Contractors' Licensing Supervisor or Designee Martha S. Vergara From: Clements, Karen Sent: Friday, September 04, 2015 3:02 PM To: Martha S. Vergara Subject: Order to be filed Attachments: 201509041447.pdf Good Afternoon Martha, Please find the attached Case No. 2015-04, from the Contractors Licensing Board meeting of August 19th, 2015. Mike Ossorio, Supervisor of Contractor Licensing, asked that I send this to you to be filed, not recorded, with the other exhibits from the contractor licensing board from last month (August 19th, 2015). If you have any questions you can call me at 252-2450 or Mike Ossorio at 252-5706.Thank you. Karen Clements Contractor License Compliance Officer Operations Department/Licensing Section Growth Management Division 239-252-2450 office 239-252-2469 fax Under Florida Law,e-mail addresses are public records.If you do not want your e-mail address released in response to a public records request,do not send electronic mail to this entity.Instead,contact this office by telephone or in writing. 1 CONTRACTORS LICENSING BOARD COLLIER COUNTY, FLORIDA BOARD OF COUNTY COMMISSIONERS ) COLLIER COUNTY, FLORIDA ) Petitioner, ) ) Case No: 2015-04 vs. ) License No. 31217 ) Joseph Brown ) d/b/a Anything in Doors, L.L.C. ) ) Respondent(s) ) ) ORDER THIS CAUSE came on for public hearing before the Contractors' Licensing Board (hereafter Board) on August 19, 2015, for consideration of the Administrative Complaint filed against Joseph Brown d/bla Anything in Doors, L.L.C., the "Respondent". Service of the Complaint was made in accordance with Section 22-202 of the Code of Laws and Ordinances of Collier County, Florida. The Board made a finding of fact that the service conformed with the requirements of-the Coeur Laws and-Ordinances-ofeollier County, Florida. The Board having at said hearing heard testimony under oath, received evidence, and heard arguments respective to all appropriate matters, thereupon issues its Findings of Fact, Conclusions of Law, and Order of the Board as follows: Page 1 of 8 395045.1 8/2512015 FINDINGS OF FACT 1. That Joseph Brown is the holder of record of Collier County License Number 31217, as a Glass & Glazing Contractor. 2. That the Board of County Commissioners of Collier County, Florida,. is the complainant in this matter. 3. That the Board has jurisdiction of the person of the Respondent and that Joseph Brown was present at the public hearing and was not represented by counsel at the hearing on August 19, 2015. 4. All notices required by the Code of Laws and Ordinances of Collier County, Florida, have been properly issued, hand delivered and delivered by certified mail In accordance with Section 22-202 of the Code of Laws and Ordinances of Collier County, Florida. 5. The evidence presented and testimony given established that the Respondent acted in a manner that is in violation of the Code of Laws and Ordinances of Collier County—Florida,-as-follows-as_to_Caunt_l_ontracted to do work outside of the scope of his license pursuant to Section 22-201(2) of the Code of Laws and Ordinances of Collier County, Florida, and as to Count II proceeded on a job without obtaining applicable permits or inspections pursuant to Section 22-201(18) and is the one who committed the acts. 6. That the Contractors' Licensing Supervisor and Staff presented sworn testimony, and the administrative complaint and exhibits thereto were admitted into evidence. The Page 2 of 8 395045.1 812512015 Respondent was afforded an opportunity to present sworn testimony, exhibits, and to cross examine the Contractors' Licensing Supervisor and witness. The Board was afforded an opportunity to ask questions of the Respondent and witness. The Board determined that the allegations of fact as set forth in the Administrative Complaint, as to Count I, Code of Laws and Ordinances of Collier County, Florida, Section 22201(2) and as to Count II, Code of Laws and Ordinances of Collier County, Florida, section 22- 201(2) are true and therefore such facts are hereby found to be supported by the evidence presented at the hearing. CONCLUSIONS OF LAW 1. The Conclusions of Law alleged and set forth in the Administrative Complaint as to Count 1 and Count II were supported by the clear and convincing evidence presented at the hearing on August 19, 2015, and said conclusions of law are hereby approved, adopted, and incorporated herein, to wit, the Respondent violated Code of Laws and Ordinances of Collier County, Florida, Section 22-201(2) and Section 22-201(18) in the performance of his contracting business in Collier County by acting in violation of the sections set out above with particularity. 2. Collier County has jurisdiction over this contractor. 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 the Code of Laws and Ordinances of Collier County, Florida, by a vote of 7 in favor and 0 opposed, Page 3 of 8 395045,1 8/25/2015 I dIr a unanimous vote of the Board members present, the Respondent has been found in violation as set out above. Further, it is hereby ORDERED, by a vote of 7 in favor and 0 opposed, a unanimous vote of the Board members present, that the following disciplinary sanction(s) and related order are hereby imposed upon the Respondent as holder of Contractor's License Numbers 31217: 1. The Respondent shall be placed on probation for a period of one year under the supervision of the Collier County Contractor's Licensing Supervisor's office. 2. Respondent is ordered to pay a fine in the amount of two thousand five hundred dollars ($2,500.00) to be paid within 30 days as to Count I. 3. Respondent is ordered to pay $250.00 in administrative and investigative costs to the County within 30 days as to Count I. 4. Respondent is ordered to pay a fine in the amount of one thousand dollars ($1,000.00) to be paid within 30 days as to Count Il. 5. Respondent is ordered to pay $250.00 in administrative and investtgative-custs-to the County within 30 days as to Count II. 6. Respondent shall take the Glass & Glazing trades test and demonstrate a passing score within 90 days. 7. Failure to pay the fine or administrative costs as set forth above shall result in the revocation of the Respondent's license. Page 4 of 8 395045.1 8/25/2015 8. If the Respondent fails to take the test or report the passing grade as set forth above the Respondent shall appear before the Board at its then next scheduled hearing. The Respondent, any other party, the chairman of the Contractors' Licensing Board, the Contractors' Licensing Board as a body, or the assistant county attorney who tried the case may request a rehearing of any decision of the Contractors' Licensing Board, A request for rehearing shall be in writing and shall be filed with staff and a copy thereof should be delivered to all other parties within twenty (20) days from the date of mailing or other method of delivery to the Respondent(s) of the Board's written decision. A request for rehearing must be based only on the ground that the decision was contrary to the evidence or that the hearing involved an error on a ruling of law that was fundamental to the decision of the Board. The written request for rehearing must specify the precise reasons therefore. The decision of the Board that is the subject of the rehearing request will remain in effect throughout the rehearing procedure unless the Board orders otherwise. The Board wili_make a—dete[mitlation as to whether or not to rehear the matter and its decision shall be made at a public meeting, which will be reduced to writing and mailed to the interested parties within 21 days after the determination is made. If the Contractors' Licensing Board determines it will grant a rehearing, it may: a. Schedule a hearing where the parties will be given the opportunity of presenting evidence or argument limited by the Board to the specific reasons for which the rehearing was granted; or Page 5 of 8 395045.1 8/25/2015 I y b. Modify or reverse its prior decision, without receiving further evidence, providing that the change is based on a finding that the prior decision of the Board resulted from a ruling on a question of law that the Board had been informed by its counsel was an erroneous ruling and which ruling could affect the substantive decision. The parties are further notified that upon the timely filing of a Notice of Appeal within thirty (30) days you may have the decision of the Board reviewed pursuant to the procedure set out herein. The Respondent may appeal a decision of the Board to the Collier County Circuit Court. Such an appeal shall not be a hearing de novo but shall be limited to appellate review of the record created before the Board. Any appeal shall be filed with the Circuit Court and served on the parties within thirty (30) days of the mailing of the decision of the Board under the Code of Laws and Ordinances of Collier County, Florida, Section 22-202(g)(9). if there has been a re-hearing request granted, the appeal shall be filed with the Circuit Court and served on the parties within thirty (30) days of the mailing of the re-hearing decision under Code of Laws and Ordinances of Collier County, Florida, Section 22-205. In the event that the Respondent elects to appeal, a verbatim record and transcript of the proceedings will be necessary. It shall be the sole responsibility of said party to ensure that a record is made from which a transcript may be prepared which includes the testimony upon which an appeal may be taken. Neither Collier County nor the Board has any responsibility to provide a verbatim record transcript of the proceedings. Page 6 of 8 395045.1 8/25/2015 In accordance with Section 489.131(7) (c) and (d), Florida Statutes, the disciplined contractor, the complainant, or the Department of Business and Professional Regulation may challenge the Board's recommended penalty to the State Construction Industry Licensing Board. Such challenge must be filed within sixty (60) days of the issuance of the recommended penalty to the State Construction Industry Licensing Board in Tallahassee, Florida. If challenged, there is a presumptive finding of probable cause and the case may proceed before the State Board without the need for a probable cause hearing. Failure of the disciplined contractor, the complainant, or the Department of Business and Professional Regulation to challenge the Board's recommended penalty within the time period set forth herein will constitute a waiver of the right to a hearing before the State Construction Industry Licensing Board and be deemed as an admission of the violation such that the penalty recommended will become a final order according to the procedures developed by State Board rule without further State Board action. Pursuant to Section 120.59, Florida Statutes, the parties are hereby notified that they may thereafter appeal the Final Order of the State Board by filing one copy of a Notice of Appeal with the Clerk of the Department of Business and Professional • Regulation, Northwood Centre, 1940 Monroe Street, Tallahassee, Florida 32399-0792, and by filing the filing fee and one copy of the Notice of Appeal with the appropriate District Court of Appeal within thirty (30) days of the effective date of said State Board Order. Page 7 of 8 395045.1 8/25/2015 ORDERED by the Contractors' Licensing Board effective the 19th day of August, X15. Patrick White, Chairman Contractors' Licensing Board 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 to the • Respondent; and Mr. Michael Ossorio, Licensing Compliance Supervi or, 2800 North Horseshoe Drive, Naples, FL 34103, on thi ? day of r- , 2015. aecreta /Contractors' Licensing Board Page 8 of 8 395045.1 8/25/2015 C.L.B. Case #2015-05 Michael Paul Taillefer D/B/A — Imperial Homes Inc. Table of Contents E1/E3 — Formal Complaint. E4 — D.B.P.R. State Licensing Information. E5 — Collier County Certificate Detail Report. E6 — Notice of Hearing sent via U.S.P.S Certified Mail. E7 — U.S.P.S. Return receipt received upon delivery. E8 — Signed Notice of Noncompliance acknowledging performance of unpermitted work. E9 — E-mail sent from Son of property owner verifying form of payment to qualifier for work performed. E10/E11 — Permit application submitted on 7/10/15 for kitchen cabinet replacement only. E12/E13 — Outstanding Corrections letter sent to qualifier outlining discrepancies with permit application. E14/E16 — Code Enforcement Case Detail Report outlining unpermitted kitchen countertops, cabinetry and sink replacement verified by property owner. E17/E19 — Contractors' Licensing Case Detail Report resulting from Code Enforcement investigation. E20 — 2010 Florida Building Code Section 105.1 outlining permitting requirements. E21 — Collier County Ordinance #90-105, as amended, Section 22-201.1(2) outlining violation of "Willfully violating the applicable building codes or laws of the State, City, or Collier County." E22 — Photograph of unpermitted kitchen remodel. Contractors' Licensing Board 2800 North Horseshoe Dr. Naples, Fl. 34104 Complaint Number-2015-05 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: August 6`h, 2015 Against: Contractor's Name: Michael Paul Taillefer Phone: (239) 784-8747 Business Name: Imperial Homes Inc. License Number if known: #CBC1257228 Collier County Competency number:#33986 Contractor's Business Address:4600 Summerlin Rd. #C2-300 Ft. Myers, FL. 33919 Filed By: Name: Collier County Contractors' Licensing Address: 2800 N. Horseshoe Dr. Naples, FL. 34104 Business Phone: (239) 252-2431 Address where work done: 142 Palm Dr.#3 City: Naples, FL. County: Collier Date of contract: N/A Date job started: Unknown Date job completed or new home occupied: Unknown Were there plans and specifications? : Unknown Is there a written contract ? : No. If yes, amount of Contract: N/A Has Contractor been paid in full ? : Yes. If not, what amount? : N/A Was a Building Permit obtained ? : No Building Permit number if known : N/A Have you communicated by letter with the licensee? : Yes Date ? : July 1st, 2015. 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 22-201.1(2) which states : "Willfully violating the applicable building codes or laws of the State, City, or Collier County." Please state the facts which you believe substantiate your charge of misconduct against the subject contractor. List facts separately for each subsection number above: In April of 2015, a case was forwarded by the Collier County Code Enforcement Department for review by Contractors' Licensing involving an unpermitted remodel of a condominium unit located at 142 Palm Dr. #3 Naples, FL. 34112. An investigation into this matter revealed the work had been performed by Imperial Homes Inc./CBC1257228. Contact was made with the qualifier, Michael Paul Taillefer, advising of the violation and with directives given to obtain permitting for violation abatement. In July, 2015 a permit application was submitted and REJECTED by the Collier County Plans Review Department for discrepancies. Outstanding corrections required for re-submittal were provided to Mr.Taillefer but none were received. When contacted for an update, Mr.Taillefer voiced his disagreement with the required corrections and advised he would retain legal counsel for a hearing in front of the Contractors' Licensing Board. P 111!„"/ ( Complainant's signature) State of: Florida County of: Collier Sworn to (or affirmed) and subscribed before me this 6th day of August, 201R, By Collier County License Compliance Officer, Rob Ganguli, (signature of person making statement). /� /117.. (signature of Notary Public) Print, type or stamp commissioned name of Notary Public: la"— f(1/2{ e:7/J' Personally known ✓ or produced identification 'M" KAREN E CLEMENTS �� MY COMMISSION#EE 882321 , EXPIRES:March 27,2017 Af,ty ` Bonded Thru Notary Public Undenvr8ers fr° DBPR- TAILLEFER, MICHAEL PAUL; Doing Business As: IMPERIAL HOMES INC,... Page 1 of 1 1:14:16 PM 8/5/2015 Licensee Details Licensee Information Name: TAILLEFER, MICHAEL PAUL (Primary Name) IMPERIAL HOMES INC (DBA Name) Main Address: 5251 BENTON STREET LEHIGH ACRES Florida 33971 County: LEE License Mailing: LicenseLocation: 4600 UMMERLING RD SUITE C2-300 FORT MYERS FL 33919 County: LEE License Information License Type: Certified Building Contractor Rank: Cert Building License Number: CBC1257228 Status: Current,Active Licensure Date: 02/02/2009 Expires: 08/31/2016 Special Qualifications Qualification Effective Construction Business 02/02/2009 Alternate Names View Related License Information View License Complaint 1940 North Monroe Street,Tallahassee FL 32399 :: Email: Customer Contact Center :: Customer Contact Center: 850.487.1395V The State of Florida is an AA/EE0 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 mall to this entity.Instead,contact the office by phone or by traditional mail.If you have any questions,please contact 859.487.1395 1. '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. httns://www.mvfloridalicense.com/LicenseDetail.asp?SID=&id=DB7A447D6CB055CD95... 8/5/2015 License Application Status - CityView Portal Page 1 of 2 . GMD Public Portal License Application Status — License Application Summary Application Number: C33986 Business Name: IMPERIAL HOMES INC License Type: Contractor Application Status: Active Description of Business: All Certificates from CDPlus:33986(9/5/14:Name Change from EXACT CONTRACTORS INC-Same EIN) Mailing Address: 4600 SUMMERLIN RD SUITE C2-300 FT MYERS FL 33905- Info@imperialhomes.com Locations: — Issuances 1 Type Date Issued Date Expires Status Number 1 BUILDING CONTR.-CERTIFIED 09/05/2014 08/31/2016 i Active 33986 — Reviews There are no reviews for this license application. — Insurance Producer Type Policy Effective Date Expiry Date Limit Daw n aflFlorida General Liability --i 2070645014 i 01/09/2015 01/06/2016 $2,000,000.00_ Expiration Processed: No I Producer Phone Number: 239-542-1533V i Michael Taillefer ;Worker's Comp 12/31/2013 12/31/2015 j Exemption j Expiration Processed: No ' I I 1 Negip,Justin Worker's Comp i 12/17/2013 12/17/2015 Exemption I I i 1 _ —i Expiration Processed: No g" — S 1,ttr,•//cvnnrta1_celliergov.net/CitvViewWeb/License/Status?licenseId=101888 8/5/2015 Collier County Growth Management Division / Planning and Regulation Operations Department/ Licensing Section Hand Delivery Certified Mail#7007 2560 0001 1485 5506 Date: July l st, 2015 Michael Paul Taillefer d/b/a—Imperial Homes Inc./CBC 1257228 4600 Summerlin Rd. Suite#C2-300 Ft.Myers,FL. 33919 RE: Complaint filed against you by the Collier County Contractors' Licensing Office. Dear: Michael Paul Taillefer 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 Wednesday August 19th, 2015 at 9:00 AM 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 fords you in violation of Section#22-201.1(2)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 issuance,and/or suspension or revocation of your permit privileges against your state license#CBC1257228. Sincerel 1.7• i-1-3.G gulf Licensin Compliance Officer Collier County Contractors' Licensing (239)252-2914 • • • SENDER:COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY • Completetems 1,2, 3.Also complete item 4if Restri ted Delivery is desired. 9, �� G Agent Print ournarrre and address on the reverse. F -41.■ a Addressee so that we can return the card to ou. �' Y �'- - �-•�-� ed Name) • C. Date of Delive - q Attach this card to the back of the mailpiece, or on the front if space permits. B. Is delivery address different from item 1? ❑Yes 1. Article Addressed to: If YES,enter delivery address below: ❑ No A d L t LL,E_ : �Lt - 46a) Su eb C 3 3 C`- — 3 C3 O 3. Service Type �Certified Mall 0 Express Mail 1 �r– / E• ❑Registered ❑Retum Receipt for Merchandise C ' W� 2 Q ❑Insured Mail ❑ C.O.D. '3 7'1 1 -1 4. Restricted Delivery?(Extra Fee) ❑yes 2. 7007 2560 0001 1485 5506 • h PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540 • • so t c-ta jL ()AV L Ct C�E F PLA P 4 -t+U C. . / cBSc- l�5--4.p_7.8 • Notice of Noncompliance BE.rr KNOWN THAT i,the person whose signature appears below,do hereby formally acknowledge, agree and consent as follows: - THAT a certain case,case# C_. t S P-01 C. oOO jage, involving me has recently been investigated by the Collier County Contractor Licensing Department. THAT the said Department had made it known to me that,in the Department's view,i violated State (Florida Building Code section 105.1)and County(Ordinance 2006-46,asamended, 4.1.6&4.1.18) licensing laws in said case by commencing work without first obtaining a Building Permit. Type of Work: i e-f'FEM o b E_L ( C olu 0 b Mil t N 10 p, u�•y t Location of work: /4,c- PA-- - i-. t'LS) FL. 3`tti2. • Date of work: THAT the said Department has explained to'me that all contracting work,including BUT NOT LIMITED TO, home or business improvement, remodeling,renovation,addition,repair,.plumbing,electrical, roofing,pool building,air conditioning,sheet metal,aluminum and alarm contractor work all require the issuance of a Building Permit prior to cummencemerrt. THEREFORE,BEING FULLY ADVISED,I DO AGREE that I will obtain all Building Permits required by Statutes and fully understand that if I.commence work without obtaining necessary Building Permits in the future the Contractor Licensing Department will consider that a willful code violation,where penalties and restrictions to Building Permit privi -•- r.c • • Witness my signature(Contractor): j • State of. T LCe A . . • ' County of CO I fart • was acknowledged before me this 061!9 i t 5 • (date)by The foregol g instrument g (Y l(II Die P. Tq if ie cer who has produced FL (r;rrefs /;T'ISe as identification and who did not take an oath. c +liaadhollidordirdwdbmallmeraillawr ... - . MIEN OLSEN 1 L rNotary ruble- of Florida Commission/FF 213Y11! 4 y�'�,I;fN My Comm.F.opirs Mar 25,2019) � Signature of Notary kJ )4 . - Licensing Investigator,in lieu of Notary.Date GanguliRobin From: Jim Kreider[Jim @krossinspectors.com] Sent: Tuesday, June 30, 2015 8:41 PM To: GanguliRobin Subject: RE: RE : cancelled checks Hi Rob, I apologize for the delay. In reviewing my records, I did not issue checks to Michael. I paid him two installments in cash when he came by the office for Mom's project. First was$1,200. The final was$1,100. I assumed when I sent him a floor plan for Mom's condo, he had completed the permit application. I have not spoken with him for a while as I have been on remote assignments for the past 6 weeks. What else can I do to help with this process? I am back in town until July 9th and am willing to assist in any way I can. Thank you. Sincerely, Jim Kreider President Kross Inspectors 12155 Metro Parkway Unit 4 Fort Myers, FL 33966 (239) 677-4403 Toll Free (877) 496-4662 Fax (239) 214-2684 www.krossinspectors.corn Click below to subscribe to our weekly news letter for a chance to win a $25 gift card weekly. Sign Up This e-mail may contain data that is confidential,proprietary or"non-public personal information",as that term is defined in the Gramm-Leach-Bliley Act (collectively, "Confidential Information").The confidential Information is disclosed conditioned upon your agreement that you will treat it confidentially and in accordance with applicable law,ensure that such data isn't used or disclosed except for the limited purpose for which it's being provided and will notify and cooperate with us regarding any requested or unauthorized disclosure or use of any Confidential Information. By accepting and reviewing the Confidential Information you agree to indemnify us against any losses or expenses, including attorney's fees that we may incur as a result of any unauthorized use or disclosure of this data due to your acts or omissions.If a party other than the intended recipient receives this e-mail,you are requested to instantly notify us of the erroneous delivery and return to us all data so delivered. From: GanguliRobin [mailto:RobinGanguli @colliergov.net] Sent:Tuesday,June 30, 2015 6:46 AM To: iim@krossinspectors.com Subject: FW: RE : cancelled checks Jim, 1 COLLIER COUNTY BUILDING PERMIT APPLICATION Growth Management Division f 2800 N.Horseshoe Drive,Naples,Florida 34104 TEL: 239-252-2400 Please fold plans with the plain side out Ensure documents are stapled inside each set of plans. 0 Residential 1 or 2 Units(Single Family/Duplex)'Residential 3 or more Units(Multi-family)[]Commercial Permit No. _ Master Permit No. /,Parcel/Folio: 6 3�(.,)/‘'<i )(761.51 j[ Contractor ['Design Professional ['Owner Builder z /� f Job Address: /92 'AL 1 D,Q • #3 �O License State Cert/Reg.-Prefix:63 G #:I 2-5 721-3 /j'/ Owner's Phone No.: Company Name: T�p�1Lty-e 7 ,tfe5 /pig Owner's NAM.: To 4,v,v &c i d e r cl H Qnalifier/Professional Name: till '1q TACl E � AXi� _ U -Lot B cic Unit:• X 3 / -g Contact Name: /t'i'e/{A[G %A!cta�,L Oa Subdivision: /L1 t1,45 cl(n i4-"V g Address: 9 oa $r/ •,*101.4In• Jed• 2 -3 o Township: , Range: Section: /2 t City: 41,04::411-1d .- State: `L• zip:3 9 f 1 FEMA: BFE: Flood Zone: H Phone :51 - )f 4-97¢ 7 Fax: SDP/PL: p E-mail Address: /t1/6Ngc-4&,I.(774.6e 64G/43.4E- Co,y Code Case: COA: Cg Alteration =Mechanical =Clean Agent System QLP Gas ['Convenience Book =Mobile Home =Fire Alarm =Pre-Engineered Fire a ['Demo =New Construction =Fire Alarm Monitoring (Suppression t =Door/Window UPlumbing G-. =Fire Pumps (Standpipes p `� =Electric Low Voltage ['Pool G-. (Fire Sprinkler System (Spray Booths ['Electric from House =Re-roof O C ['Fossil Fuel Storage System (Tents UO : _Fence —Screen Enclosure =Hoods =Underground Fire Lines e, Gas Shutter r. =Marine ED Sign/Flagpole OTHER =Solar aQ Private Provider Q Plumbing Z =Non-sprinkled riSprinkled O Q Roofing 0 Electrical 2 az a Q Septic Q Low Voltage N _�' �� L7�� Q� r H, Q Shutters Q Mechanical H, F =nUa =� DIVA =IVs O Q Permit by Affidavit Zp =�'A =� U U / Occupancy Classification(s): Description of Wort: ,1/‹. :41.6.'Z. 4 `-c l-�C,4C:c k", -Cr'/5/:.. L."-4,-57.- e Z O g 8 Project Name: Declared Value$: , , '._7 O YEW CONSTRUCTION/ADDITION AREA, ALTERATION WORK AREA- SO.FT. H, If applicable: #Stories/Floors: #Units: #Tons: y #Bedrooms:_#Baths: RESIDENTIAL: ., Living, Non-living: O RESIDENTIAL: Living; Non-living: Total sq.ft: TOTAL SQ.FT.: r COMMERCIAL: COMMERCIAL: Interior. Exterior: #Fixtures: Interior: Exterior. Total: TOTAL SQ.FT.: SEWAGE: . Q Septic Q Ave Maria['City ofNaples 2]Collier County Q Golden Gate City Q Immokalee []Orange Tree Q Other H WATER SUPPLY: d Q Well Q Ave Maria =City ofNaples n Collier County Q Golden Gate City Immokalee ty (� Q Orange Tree 0 Other a Application/Plans Discrepancies—Customer Acknowledgement of possible rejection for the following missed information: 1.Square footage discrepancies 2.Occupancy Classification/Construction type not provided 3.Required documents not certified 4.Incomplete Plan Sets or Drawings 5.Sets not identical e_,---Nov.I,2014-PMR Date: Days Review: # Set of Plans: e_,---i U QUALIFIERS PAGE ACKNOWLEDGEMENT OF COLLIER COUNTY REGULATIONS Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating construction in this jurisdiction. The permit or application fee may have additional fees imposed for failing to obtain permits prior to commencement of construction. The approved permit and/or permit application expires if not commenced within 180 days from the date of issuance. The permittee further understands that only licensed contractors may be employed and that the structure will not be used or occupied until a certificate of occupancy is issued. By signing this permit application, I agree that I have been retained by the owner/permittee to provide contracting services for the trade for which I am listed. Furthermore, it is my responsibility to notify the Building Review and Permitting De partrnent should I no longer be the contractor responsible for providing said contracting services. I further agree that I understand that the review and issuing of this permit does not exempt me from complying with all County Codes and Ordinances. It is further understood that the property owner/permittee is the owner of the permit Note: if change of contractor, please provide the following: Permit Number: E-mail Address: Tel: • • COMPANY NAME: /4/r'/1 9 vet �ti STATE LICENSE NO: C C_ 7 `C QUALIFIER'S NAME (PRINT) : QUALIFIER'S SIGNATURE: ��- STATE OF: •. TY 0 : a ISM SWORN TO (OR AFFIRMED)AND SUBSCRIBED BEFORE ME THIS / / ` EDWARD C,BOIIZA N * =tom * Ml'COMMISSIONtFF087?l WHO IS PERSONALLY KNOWN: OR AS PRODUCED ID: �! EXPIRES January 28,2U18 'r or r�ri�e lonhdTntu 611d)et No'ary Services TYPE OF ID: F P t- NOTARY PUBLIC SIGNATURE: (SEAL) NOTICE IN ADDITION TO THE REQUIREMENTS OF THIS PERMIT, THERE MAY BE ADDITIONAL RESTRICTIONS APPLICABLE TO THIS PROPERTY THAT MAY BE FOUND IN THE PUBLIC RECORDS OF THIS COUNTY, AND THERE MAY BE ADDITIONAL PERMITS REQUIRED FROM OTHER GOVERNMENTAL ENTITIES SUCH AS WATER MANAGEMENT DISTRICT,STATE AGENCIES,OR FEDERAL AGENCIES. WARNING OF POSSIBLE DEED RESTRICTIONS THE LAND SUBJECT TO THIS PERMIT MAY BE SUBJECT TO DEED, AND OTHER RESTRICTIONS THAT MAY LIMIT OR IMPAIR THE LANDOW NER'S RIGHTS. COLDER COUNTY IS NOT RESPONSIBLE FOR THE ENFORCEMENT OF THESE RESTRICTIONS, NOR PRE COLLIER COUNTY EMPLOYEES AUTHORIZED TO PROVIDE LEGAL OR BUSINESS ADVICE TO THE PUBLIC RELATIVE TO THESE RESTRICTIONS. THE LANDOWNER OR ANY APPLICANT ACTING ON BEHALF OF THE LANDOWNER IS CAUTIONED TO SEE K PROFESSIONAL ADVICE. WARNING ON WORK IN COUNTY RIGHT-OF-WAYS THIS PERMIT DOES NOT AUTHORIZE CONSTRUCTION OR INSTALL AT1ON OF ANY STRUCTURE OR UTILITY, ABOVE OR BELOW GROUND, WITHIN ANY RIGHT-OF-W AY OR EASEMENT RESERVED FOR ACCESS, DRAINAGE OR UTILITY PURPOSES. THIS RESTRICTION SPECIFICALLY PROHIBITS FENCING, SPRINKLER SYSTEMS, LANDSCAPING OTHER TH AN SOD, SIGNS, W ATER, SEWER, CABLE AND DRAINAGE WORK THEREIN. IF SUCH IMPROVEMENTS ARE NECESSARY, A SEPARATE PERMIT FOR THAT PURPOSE MUST BE OBTAINED FROM TRANSPORTATION/ROW PERMITS AND INSPECTIONS(239)252-8192 WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY pEFORE RECORDING YOUR NOTICE OF COMMENCEMENT. Per Florida Statutes 711135a Notice of Commencement(NOC)Is i-equired for construction of improvements totaling more than$2,500,with certain exceptions. For A/C Repairs or Replacements a notice of commencement is required for improvements more than$7,500. The applicantshall file with the issuing authority prior to the first inspection eithera certified copy of the recorded NCO ore notarized statement thatthe NOG has been filed for recording,along with a copy thereof.In orderto complywith the state requirem en t,permits will be placed In inspection hold until proof of the NOC is flied with the building permitting and inspection department The issuing authority shall not perform or approve subsequent inspections until the applicant files by mall,facsimile,hand delivery,email or any other means such certified copy with the issuing authority_ COLLIER COUNTY GOVERNMENT GROWTH MANAGEMENT DIVISION / PLANNING AND REGULATION 2800 N. Horseshoe Drive, Naples FL 34104 * Phone (239) 252-2400 Outstanding Corrections Date: July 17, 2015 PERMIT NO: PRBD2015072276701 Contact Name: Imperial Homes Inc APPLICATION NO: PRBD20150722767 Address: 4600 Summerlin Rd Suite C2-300 JOB SITE ADDRESS: 142 Palm DR, Unit:3 City, State Zip: FT MYERS, FL 33905-- Fax: (866)274-3303 Email:info @imperialhomes.com Dear Applicant: Plans submitted with the referenced permit have been reviewed. We are unable to approve your permit application for the reason(s) indicated below. Submit 5 sets of revised sheets along with 5 letters of response addressing each item. All corrections must be clouded. Corrections must be submitted in person, the GMD office receiving corrections is open until 4:00 pm. (NOTE: SIRE permit corrections must be resubmitted through SIRE) JOB DESCRIPTION: REMOVE & REPLACE KITCHEN CABINETS. CODE CASE REFERENCE CEMIS20150008426. 142 PALM DR#3 Rejected Review: Structural Review Reviewed By: Tom Williams Phone:239-252-2369 Emaii:thomaswilliams @colliergov.net Correction Comment 1: No existing floor plan provided. Rejected Review: Fire Review Reviewed By: Ame Davis Phone:239-252-7517 Email:AmeDavis @colliergov.net Correction Comment 1: Provide a detailed scope of work on the plan submittal. What floor is this unit located on? Show on plans location of tenant separation walls. Correction Comment 2: Provide the wall detail including the fire rating of the tenant separation walls and include the UL Cut sheets of the wall. ALL penetrations including existing and new must be fire stopped. Provide detailed system designs (such as UL design details) for all fire stopping repairs to all tenant separation walls &floor/ceiling assemblies. Make sure the repair materials match the listing in accordance to the listed assembly repair requirements. If utilizing a fire Stop Company provide the fire stop submittal package that was provided to you. FFPC 5th ed 101:8.4.3 Rejected Review: Plumbing and Handicap Review Reviewed By: Bob Garee Phone:239-252-4282 Email:robertgaree @colliergov.net Correction Comment 1: No existing floor plan provided. Is the sink and refrigerator being reinstalled at same location. Rejected Review: Mechanical Review Reviewed By: Bob Garee Phone:239-252-4282 Email:robertgaree@colliergov.net Correction Comment 1: Is a ducted kitchen hood or microwave being installed. Rejected Review: Electrical Review Reviewed By: Daniel Cortez Phone:239-252-2415 Email:danielcortez @colliergov.net Correction Comment 1: No drawings were submitted. Per Florida Building Code 107.2.1 Construction documents shall be of sufficient clarity to indicate the location, nature and extent of the work proposed. ATTENTION: Collier County Plan Review and Inspections routinely reviews all outstanding permit applications in order to determine their status. The review process includes appropriate responses from the permit applicant when the permit cannot be approved. When the applicant is advised of deficiencies and does not respond within 180 days with corrected plans or an appeal to the Code Enforcement Board, the permit application will be canceled as per Collier County Ordinance 2002-01, Section, 104.5.1.1 to 104.5.1.4. IMPORTANT: The new Digital Flood Insurance Rate Map (DFIRM) will be effective on March 30, 2012. All development and building permit must be in compliance with the DFIRM flood zone and flood elevation requirements beginning on March 30, 2012. Please note that applications submitted prior to March 30, 2012, but issued after March 29, 2012, must be in compliance with the DFIRM requirements. �-� 3 Cd iergov.net Report Title: Code Case Details Date: 8/5/2015 1:08:55 PM Case Number: CESD20150006859 Case Number: CESD20150006859 Status: Open Case Type: Site Development Date &Time Entered: 4/3/2015 11:47:01 AM Priority: Normal Entered By: webAnonymousUser Inspector: ArthurFord Case Disposition: Case Pending Jurisdiction: Collier County Code Enforcement Origin: Public Portal Detail Description: A unit in our condo association had extensive remodeling work done (inc. plumbing and electrical)with no permits posted. It is unclear if the work was done by a licensed contractor. Location Comments: 142 Palm Dr.,#3, Naples FL 34112 Naples Sunrise III Condo Association Address 142 Palm DR, Unit:3 Property 63301640009 Complainant Naples Sunrise III c/o Sandcastle Community Management Property Owner KREIDER, JO ANN Business Management&Budget Office 1 Code Case Details Execution Date 8/5/2015 1:08:55 PM Desc Assigned Required Completed Outcome Comments Enter Initial Case Information webAnonymo 4/3/2015 4/3/2015 Complete usUser Addressing Review webAnonymo 4/3/2015 4/3/2015 Complete usUser Initial Inspection ArthurFord 4/3/2015 4/3/2015 Incomplete 4/3/15, message left on complainants voicemail and an e-mail was sent with follow up questions and a request for her to report this to contractor Licensing as work may have been performed by an unlicensed contractor. AF-56 Attach Picture(s) ArthurFord 4/9/2015 4/9/2015 Complete Initial Inspection Follow-up ArthurFord 4/9/2015 4/9/2015 Incomplete 4/9/15,on site spoke to the homeowner who stated that she recently had her kitchen cabinebts, counter top and sink replaced by "Imperial Homes"without permits.she stated that there was no invoice and she paid a"flat rate"for the work that was done.She allowed me into the residence to photograph the work that was done see photos. I informed her that the case will be forwarded to Contractor Licensing for follow up and that an investigator would be contacting her in the near future.The case was turned over to Contactor Licensing supervisor for assignment to area investigator.Will monitor. AF-56 Initial Inspection Follow-up ArthurFord 5/1/2015 5/1/2015 Incomplete 5/1/15,C. L investigator Ganguli has an open case(CEMIS20150008426)contractor was due to apply for permit on 4/29/15,will continue to monitor.AF-56 Initial Inspection Follow-up ArthurFord 5/19/2015 5/19/2015 Incomplete 5/19/15, monitoring C. L. case #CEMIS20150008426, Contractor due to file for permit this week.Will continue to monitor. AF-56 Initial Inspection Follow-up ArthurFord 5/26/2015 5/26/2015 Incomplete 5/26/15, monitoring CL case CEMIS20150008426, awaiting for contractor to submit permit application.AF-56 Initial Inspection Follow-up ArthurFord 6/9/2015 6/9/2015 Incomplete 6/9/15,e-mail sent to C. L. Investigator R. Ganguli regarding contractor permitting(see case CEMIS20150008426)awaiting follow up. AF-56 Initial Inspection Follow-up ArthurFord 7/2/2015 7/2/2015 Violation(s) 7/2/15, per C.L. Investigator Ganguli, Found Contractor is not/has not applied for a permit. He will be brought before the licensing board for misconduct. NOV to be issued to the property owner.AF-56 Record Violations ArthurFord 7/2/2015 7/2/2015 Complete Attach Picture(s) ArthurFord 7/2/2015 7/2/2015 Complete Generate Notice of Violation ArthurFord 7/2/2015 7/2/2015 Complete Personal Service Attempt ArthurFord 7/2/2015 7/2/2015 Complete 7/2/15,served the NOV to J. Krieder at 12:50pm,see AOS.AF-56 Business Management & Budget Office 2 E _ t5 Code Case Details Execution Date 8/5/2015 1:08:55 PM Desc Assigned Required Completed Outcome Comments CE Staff Review rajahindira 7/2/2015 7/6/2015 Complete Scan NOV and AOS into the case Done-7/6/2015-ir CE Staff Review rajahindira 7/6/2015 7/6/2015 Complete Scanned and attached signed NOV to case-ir CE Staff Review rajahindira 7/6/2015 7/6/2015 Complete Scanned and attached AOS to case-ir Re-Inspection ArthurFord 8/3/2015 8/3/2015 Non- 8/3/15,according to C.L.Ganguli,the Compliant contractor is refusing to move forward with the permitting process.The contractor will be brought before the C. L Board at the next hearing date. I will contact the property owner and inform her that she must make arrangements to have another contractor continue with the permitting process.AF-56 Lien Search/Payoff Request DailyNavarro 8/5/2015 8/5/2015 Complete LIEN SEARCH COMPLETED FOR PARADISE COAST TITLE& ESCROW, LLC Re-Inspection ArthurFord 8/18/2015 Pending check permit status, new contractor? Violation Description Status Entered Corrected Amount Comments Building Permit LDC NOV Issued 7/2/2015 $0 Installation of kitchen countertops, sink and cabinets without required Collier County permits, inspections and Certificate of Completion/Occupancy. Title Reason Result Compliance Fine/Day Condition Business Management& Budget Office 3 le CArgov.net Report Title: Code Case Details r Date: 8/5/2015 1:10:42 PM Case Number: cemis20150008426 Case Number: CEMIS20150008426 Status: Refer to CLB Case Type: Misconduct Date& Time Entered: 4/27/2015 7:57:22 AM Priority: Normal Entered By: RobinGanguli Inspector: robinganguli Case Disposition: Case Pending Jurisdiction: Contractor's Licensing Origin: Complaint Detail Description: Complaint forwarded from code enforcement for licensing review (ref. case CESD20150006859) regarding a possible unlicensed/unpermitted kitchen renovation. Location Comments: 142 Palm Dr. #3 Naples, FL. 34112. Property 63301640009 Contractor Taillefer, Michael Paul Property Owner KREIDER, JO ANN Property Owner KREIDER, JO ANN Business Management& Budget Office 1 - lam Code Case Details Execution Date 8/5/2015 1:10:42 PM Desc Assigned Required Completed Outcome Comments Preliminary Investigation robinganguli 4/24/2015 4/27/2015 Needs 4/24/15. Complaint forwarded from code Investigatio enforcement(ref. case#CESD20150006859) n regarding a possible unlicensed/unpermitted kitchen remodel at commercial condominium unit located at 142 Palm Dr.#3 Naples, FL. 34112.On site met with property owner, Jo Ann Kreider who informed us of remodel inclusive of cabinetry, countertop and sink replacement performed by"Imperial Homes". Ms. Kreider advised that no hardcopy contract for work existed and payment checks made out to an individual named "Michael"who was referred to her by her Son, James Kreider. Contacted Mr. Kredier who advised that work was performed by Michael Taillefer, qualifier of Imperial Homes Inc./CBC1257728. Contacted Mr.Taillefer to advise of violation and remedial action. Notice of Noncompliance issued to him and A.T.F.fees applied. Mr. Taillefer advise he would be in for permit application on 4/29/15. Not Applicable RobinGanguli 4/27/2015 4/27/2015 Not Required Cont. Investigation RobinGanguli 5/11/2015 5/11/2015 Complete 5/11/15.Contacted qualifier, Michael Taillefer, regarding permit application submitted and no Notice of Noncompliance received. He advised he had issues that prevemted a trip to Naples but would be in the following week for submittal. Cont. Investigation RobinGanguli 5/27/2015 5/27/2015 Complete 5/27/15. No permit application submittal or Notice of Noncompliance received from qualifier. Cont. Investigation RobinGanguli 7/1/2015 7/20/2015 Complete 7/1/15. Notice of Hearing sent via Certified Mail#7007 2560 0001 1485 5506 to appear at August 19th, 2015 C.L.B. hearing per M.G.O. Cont. Investigation RobinGanguli 7/1/2015 7/6/2015 Complete 7/1/15.Advised by qualifier, Michael Taillefer, that he has obtained a floor plan for the unit in which work was performed and would be submitting for permitting by the end of last week. Database research reveals no such submittal. Received an e-mail from Son of property owner, Jim Kreider, who previously informed he he would be sending copies of checks made payable to Mr.Taillefer for work performed in the absence of a hardcopy contract of work. Mr. Kreider's e-mail states that a search of his records indicated that no checks were made payable to Mr.Taillefer, but rather two (2)cash installment payments of$1,200 and $1,100 for his services. Cont. Investigation RobinGanguli 7/13/2015 7/13/2015 Complete 7/13/15. Permit application #PRBD20150722767 applied for and UNDER REVIEW. Business Management & Budget Office 2 - 1S Code Case Details Execution Date 8/5/2015 1:10:42 PM Desc Assigned Required Completed Outcome Comments Cont. Investigation RobinGanguli 7/20/2015 7/20/2015 Complete 7/20/15. Permit application #PRBD2015072276701 REJECTED for discrepancies. Outstanding Corrections letter forwarded to contractor for review. Schedule for CLB samantharoe 7/31/2015 Pending Investigation robinganguli 7/31/2015 7/31/2015 Refer to 7/31/15.Contacted qualifier who advises CLB requirements for obtaining permit for job are "bullshit"and he will be retaining counsel for C.L.B. hearing. Violation Description Status Entered Corrected Amount Comments 4.2 Misconduct State Certified Open 4/27/2015 $0 Contractors Title Reason Result Compliance Fine/Day Condition Business Management& Budget Office 3 • 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. • ARTICLE V. BUILDING TRADES* Page 30 of 36 Sec. 22-201.1 Misconduct—State certified contractors. The following actions by state certified contractors shall constitute misconduct and grounds for discipline pursuant to section 22-202 of this article. (1) Failing or refusing to provide proof of public liability and property damage insurance coverage and workers compensation insurance coverage as required by .Florida Statutes. (2) Willfully violating the applicable building codes or laws of the state, city or Collier County. (3) if the CLB finds through its public hearing process that the contractor was found by another county or municipality within the past 12 months, to have committed fraud or a willful building code violation and the CLB finds that such fraud or other willful violation would have been fraud or a willful violation if committed in Collier County or within the respective city. (4) Fraud. (Ord. No. 94-34, §4; Ord. No. 99-45, § 4.2-4.2.3, 6-8-99; Ord. No. 06-46, § 1(4.1.8.2)) Sec. 22-202. Disciplinary proceedings, including minor violations. • (a) There are three categories of violations: (i) violations of subsection 489.127(1), F.S.;' (ii) violations of subsection 489.132(1), F.S.; and (iii) other violations within the jurisdiction of the contractor's licensing board. (1) Subsection 489.127(1), F.S., is incorporated herein. (Lack of required license, certificate, or registration). The following are designated to enforce subsection 487.127 (1), ES.: Collier County Building Official,' all license "compliance officers, the-chief building inspector, chief electrical inspector, chief plumbing/mechanical inspector, and/or other inspectors authorized from •time=to-time by the building official: Procedures specified in this section shall apply except to the extent, if any, that Section 489.127 or Section 489.132, may require different procedure(s). The penalties for each uncontested violation of subsection 489:127(1) and/or 489.132(1), F.S., are $300.00 for the first uncontested violation and $500:00 for each subsequent uncontested violation by the same individual or entity. Penalties for contested Violations of subsection 489.127(1), F.S., are as now or hereafter specified in Section 489.127, F.S. Penalties for contested violations of subsection 489.132(1), F.S., . Te as now or hereafter specified in Section 489.132, F.S. The citation form attached hereto as Exhibit "A" is-approved, which form may be amended from time-to-time by resolution of the board of county commissioners. (2) Minor violations: The contractor licensing supervisor or designee shall issue. a "notice of noncompliance" as the county's first response to a minor violation of any provision of any regulatory law, including this section, when (i) it is reasonable for staff to assume that the violator, at the time of violation,was not aware of the provision that was violated or it can be assumed that it was not clear to the violator how:to.comply with the violated provision; and (ii) that violation has not then resulted in economic. harm or physical harm to any person; and :(iii) the violation has neither adversely affected the public health, safety, or welfare, nor created any significant threat of any such adverse affect. The notice of noncompliance should identify the specific provision that was violated, should provide information on how to comply with that provision and should specify a reasonably time for full compliance. The notice of noncompliance shall not be accompanied with any immediate threat of any monetary fine or any other disciplinary penalty, but may specify that failure of the violator to correct the violation within the time specified in the notice for compliance may result in disciplinary proceedings. Each i1. , ,�"` -,-410-,„'N.,,,-;..,! $ !' � ° . t at c ''.."...4..,:'......7c2?:' t4- a � may 4 ' ''may, "I..- ,yam o ,J F�• _ t _----- . ,r. ,,:.;;.:..-.."'',,,.:.;'r t � • «,'' 1,+ h4 s� _ a P4s 3 __ ■ 1 °-- s 3 a. INN k■ vrawirk t ' . _- 7-14\\ i . � v { a 4-,,,=4'..,,:,".,.,,-....„,.:.--,,,-....-, 'j'+c, ?'.r. ,+:l , 1, • 7. ;4 .71Ca s4 fir'^ ' 't - , , v -,yam s a'-` s ....,o r COT-i vtty GMD Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUTIONS: This application must be typewritten or legibly printed. The application fee must be paid upon approval and is not refundable. All checks should be made payable to: Collier County Board of County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: j� Exact Corporate/Business Name: L. C , 610(1('wc'VkS } L LC Fiction Name/DBA: ,. — • ' p Qualifier Name: T h0 on u`� G r-N L b c V. €.' T r , Physical Address: 1bOt) 4rbuc,v;eu g Ilid 4 14 1 1 Al ti pies FL, 31IiO (Number& Street) (City) (State) (Zip Code) Mailing Address: .01 e- a`) et 0 U (Number&Street) (City) (State) (Zip Code) Telephone:0-3 q) g I _ 1613 G E-mail: -41,1e5 r-ow,j.}- et,4,kn; std-rs,a(-C, ycA)oc .0 TYPE OF LICENSE: General $230.00 Electrician $230.00 Building $230.00 Plumber $230.00 Residential $230.00 Air Conditioner $230.00 Mechanical $230.00 Swimming Pool $230.00 Roofing $230.00 K. Specialty $205.00 122,1•44Wilto PO X C6 Specialty Trade: C PAbt loin' 1 NIA,—ANACO eeNtAm ixt"x3 PS I- 5 1Q,C CHANGE OF STATUS: Reinstatement ( ) From One Business to Another ( ) Dormant License to Active l %,(9. Page 1 of 4 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. I kit.)f a J c, '[1 V) Lc r f( 1-4- C) V-;It?r/op e-0-67 4-6u^ 1 t G LCam_ A r b y-e V F'<-'(,) 2 l Ufa' 1 -7 ./epic , FL ,3 41io 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten years(i.e. held a license for or been a partner). Attach extra pages if needed. f ' CAA ( (� fi \!/'i �lRl'.� y �jfG'el�' e).-n1(2.- Cf1Gt�l4�l" V�(.1) Li '.. c\c e oil) c._ ---celez---)-- 5-1-one, - ,i i ) 3. List all debts you or any company(s) associated with you that you refused to pay and the reasons for the refusal to pay. Attach extra pages if needed. AFFIDAVIT Under the penalties of perjury I declare that I have read the foregoing application and that the facts stated in it are true. i f _J.1,,o,ntt) ' -(4, , ,-- -0-0-,)/, 4 " . ' 1 i'/ il Authorized Officer •''t - Firm t (? '^ The foregoing instrument as acknowledged before me this ' 7/` ) / 7 �' /-S' (Date) j c�� of C�' by ! 1'c.le{3 L. , _1 , c._�7 rie k. c �_ t.., (Name of Officer, Title/Agent) (Name of Corporation) a A2 L>A -/-' Corporation on behalf of the corporation. (State or Place of Corporation) HeOlf#uriyil ced /-7:-/--4 <> '<< r^'-=+f :,, ./._/ '-4'L/r Z-7( iyY identification and did not take an oath. .0,,G M. iy!1I (Type of identification) i Z 1/662RY' • �.zo1e .Z G - . F. ( V• so.FF 135053 i (SIGi4-ATURE ON IOTAR I- i t F .: ' Page 2 of 4 QUALIFIER INFORMATION: Name: / /1omq_s l-2 s L. oc/4 3 .4 r i/ 3 �/i3 Li I? !tla I s FL 3 //Z Address: � (� C�✓ � r � r ' �' w (Number& Street) (City) (State) (tip Code) Telephone:( 3 9) 1 1 613 Date of Birth: SS#: 11111 �` E-mail: 6,5 Y bpi ‹_ w17) ,5perer. €., Driver's License #: .. < � — 1. Type of Certificate of Competency for which application is made. C CI b 111 2. The names and telephone numbers of two persons who will know your whereabouts. Duntilo C.2.3 q) -- a3-0 D l• -511 o ( 3'0 2 - 3 7 ; 0 3. Have you ever been convicted of a crime related to Contracting? n 0 (If yes, attach extra sheet with explanation.) 4. Have you or any firms you have been associated with ever filed bankruptcy? V' 0 5. List all debts you or any company(s) associated with you that you refused to pay and the reasons for the refusal to pay and reasons why. f(iv 6. List your business or work experience during the last ten years. I L ^AUe L1C�P51 (,bl_S i:5'�°�� t! 1�17i1T)EGA v) 4'�1- 1�1C.c�u,a t S+o� i r 1� �S y �o' -} 1G ) r5' 7. Statement of any formal training you have had in the area for which the application is made. a e. ec C r� <�; °�� b C�C,te'S�ti�5: j01 (n_A(0•'1 ) s rain -r'1Llc!�C 1.LGr r� q- rec.,S,�to 0,1 k Z (� �'G C (�'C 3 3 of 4 p AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County No. 2006-46, as amended, and under penalties of perjury. I declare that I have read the foregoing qualifier information and that the facts stated in it are true. 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/she 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. Applicant (please print) L . C : S�c..›0e 6) 51 `t C Name of Company f i-? 1/ /7-- , 1 '- -''..-,1 4,',s ,,,, ,&—. ,,,,k,/-7,,,, . ../,"/ i 1 77,1e4 ,,,, p, / ,,,,, ___,J12%,. -ineo •Ar--1 __//7, ‘,.._// i,6 , J/,, / /79-1 t - Signature of Applicant State of Florida County of e."1 L 7l /Z The foregoing instrument as acknowledged before me this tit C 1 2 is 5 (mate) by----`7 .w< ,, .,,'.,L.0 t .. -..... Se' who has produced it.k./.. A _"f v4 L a c°e.0 ,. (name of person acknowledging) (type of identification) as identification and did not��elpth, ieb 'w I • j > ' NOTARY'S SEAL • + f�OTAR� �„\ y �° C3 • Of NOTAK •W; VOU MD': IN �0Zo.f4 1111110 AFFIDAVIT It is understood and acknowledged by the Collier County Contractor's Licensing Board and myself that if I fail to acquire, or maintain at all times effective Workmen's Compensation Insurance it will result the possible revocation of my Certificate of Competency. J/2?ice} i� / /11✓� . Signature of Applicant L . C , 'TG in e ,.:,i0 Y` �, L c Business Name rJ/2/ f/// l _ Date ---7 L'I J `.G t-.1 Lc c_ ✓: who BEFORE ME this day personally appeared G, l<_S t/ affirms and says that he/she has less than one employee and does not require Workmen's Compensation and understands that at any time he/she employs one or more persons he/she must obtain said Workmen's Compensation Insurance. State of Florida County of L.._ C L /-1/1/f. ' 1 The foregoing instrument as acknowledged before me this • / t� ((Date) / _ who has produced /��.2 f'�e r v,<. 7 r yF ii 1)81 by � La�, , � ,��r �t,� � �•� �� ----:, s pr (name of person acknowledging) (type of identification) • 1111111 as identification and did p►t a4/i,�i i ,;. .e. •OTAR y•ii �•� 7 /2 1 / /1 NOTARY'S SEAL t Z 'My Comm.Expires ' , () : .tune 24,2018 s/__________, C . % No. ? 1(SIGNATUREOF NOTARY) N:• Weis Farms 1,7" L____-_) '_' /f *•.$M•••• •••.N.••• ` ",�� OF f\-C)4 o C ear GMD Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 MEMORANDUM Date: February 17, 2015 To: Applicant's for Certificate of Competency From: Michael Ossorio, Contracting Licensing Supervisor Subject: Collection of social security numbers. Pursuant to Chapter I-19, Florida Statutes and Collier County Contractor Licensing Ordinance 2006-46 Section 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 I-19, Florida Statutes, 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 I-19, Florida Statutes. To whom it may concern, Thr-nas Locke was employed with Classic Stone as a natural stone/quartz templater, installer and restoration technician from 2012 through 2015. Please feel free to contact us if you have any questions. Sincerely„.., Li14%!Z`/5 &ON''S e; Kris Banski (239)366-8040 Classic Stone Marble&Granite Fabrication 6235 Shirley Street Naples,FL 34109 MARBLE Fax(239)566-9020 INSTITUTE banskiinc@aoLcom +w^ll imam& AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF F101404, COUNTY OF Cb b i e r I, -'22%S2 •t. T)-f> , having been first duly sworn, state and affirm: I am a resident of C c 11.1 er County, F lo t` iGll (State) and have resided here for more than five (5) years. L During the last five years I have known TliAzi,'1)4- L L( L.(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 sic Name 11 ( L C 1456. on 6,9 A) des FL 3 yID41 Addres 93q 5-6.6 --90dD Telephone The foregoing instrument as acknowledged before me this �; _) , (Date) by �� i� (\_ !�� :�. � 1 who has produced - (name of person acknowledging) (type'of identification) as identification an�. 1301 ¢ ic�atP�/i NOTARY'S SEAL; ; My Comm. Expires: May 28,2019 (SIGNATURE OF NOTARY) + No.FF 235507 : • u• ), •: Q- '"'f'� ('F F`O,%%•% =fill AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF i C r C�CI COUNTY OF Collier I, 144-k; , having been first duly sworn, state and affirm: I am a resident of t'(� County, lc:r (State) and have resided here for more than five (5) years. During the last five years I have known 71'1011 4,5 -c)C k .. (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. t v�e, Signature Name CW 843c-0'3121 '2._ BP 7y/1Lf Address 13 ! - 272 - 1756 Telephone The foregoing instrument as acknowledged before me this t �� (Date) 1 by \U �1C S ��' ° who has produced (name of p`e�r�q c owledging) (type of identification) ∎%% ,\AHE- as identifica�oQ,p.clhd�.not,take all oath. NOTARY SE, � •• YCo m. Expires: Mm ay 28, 2019 •Np No. FF 235507 (SIGNATURE OF NOTARY)S. "9j•'•:°U C•.:' <7. ,,,i 0�tFet©¢N," Certificate of Status I certify from the records of this office that L.C. STONEWORKS LLC, is a limited liability company organized under the laws of the State of Florida, filed electronically on July 31, 2015, effective July 31, 2015. The document number of this company is L15000131430. I further certify that said company has paid all fees due this office through December 31. 2015, and its status is active. I further certify that this is an electronically transmitted certificate authorized by section 15.16. Florida Statutes. and authenticated by the code noted below. Au hentication Code: 150804171234-70027562563741 Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Fourth day of August, 2015 1 � 0.404„ ifOti )111e0ner cry 141- 6erret Sri' of *talc Gmail - Liability Insurance Page 1 of 1 4-Cri Tom Locke<tiocke72 @gmail.com> Liability Insurance 1 message Olin Hill Ill<olin3 @olinhill.com> Wed, Aug 5, 2015 at 11:28 AM To: "tlocke72 @gmail.com" <tlocke72 @gmail.com> Good morning Thomas. The only quote I was able to secure was from Scottsdale Insurance Company. Their premium is$1000 per year. This would give you a $500,00 limit. Also, if you need any additional insured endorsements made to the policy during the year, that premium can rage from $50 to$500 depending on they type of endorsement. Typically those endorsements are requested by the larger general contractors. Let me know if this is something you would like to pursue as I need to get an application filled out. Olin https://mail.google.com/mail/u/0/?ui=2&ik=15dcec58d6&view=pt&search=inbox&th=14ef... 8/6/2015 �G-, Cott e'r County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION NAPLES, FLORIDA 34104 www.colliergov.net (229) 252-2400 FAX ;2�9) 252-5258 LAND USE AND ZONING CERTIFICATE: HOME OCCUPATION LDC section 5.02.00 & subsection 10.02.06 B.1.f Chapter 4 K. of the Administrative Code Please take the time to fill out this form as completely as possible. 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 Business Tax Receipt 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. APPLICANT CONTACT INFORMATION Name of Applicant(s): 1 h1L'r =t n Lc( € 3 ( Telephone:(3 1) � `t!✓ -c=" :3 1 Ceii( 0-3 ) ` j 3 t, Fax: n E-Mail Address: .CA i" ,r)., L' w`1‘Sp P r e y' a ' Gt k G p y ti'i BUSINESS& USE INFORMATION Business Name(If any): L , C, "fin ll wcr� S, LLL Phone Number: ( 2.3 ) � I_ /�-37 t ,-fie" V;�' i?Iui) t 7 ALtp r_C State: f= Z ZIP: 311/3 Address: (c;(:�G`,,� ,� City: Description of the type of business or use: O c4' ` L ' C Collier County Land Development Code Section 5.02.00- Horne Occupations 5.02.01-Applicability Home occupations shall be allowed in any zoning district which permits residential dwellings as a permitted use. 5.02.02-Allowable Home Occupation Uses There shall be no retail sale of materials, goods, or products from the premises. 5.02.03-Standards The home occupation shall be clearly incidental to the use of the dwelling for dwelling purposes. The existence of ____the home_occupation shall not change the character of the dwelling____ ______ A. An allowable home occupation shall be conducted by an occupant of the dwelling. B. There shall be no on-site or off-site advertising signs. C. The use shall not generate more traffic than would be associated with the allowable residential use. To that end, traveling to and from as well as meeting or parking at the residence by either employees of the business operated there from who are not residing at the subject address or by customers or clients of the home occupations is prohibited. 1/14/2014 Page 1 of 2 COLLIER COUNTY BUSINESS TAX RECEIPT _F-0,--.:.E S �z APPLICATION _ _t_t =, -!t l J 2800 N.Horseshoe Drive,Naples,FL 34104 !. 1- Make Check Payable to Collier County Tax Collector Phone: 239-252-2477 Fax: 239-643-4788 Website: www.colliertax.com ,: -°oD wE 06:-.0° .4 F 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 ofAgriculture. 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 - — , C , S-!'e17e worKS L LC la) DBA NAME - ib) BUSINESS OWNER OR QUALIFIER'S NAME - T l") 0(1111,s L1 t:/L - 3 r- 2) PHYSICAL ADDRESS - f F-. CA)S ArKb1:1: Ii;.e tk) i V D It 'I 1 ? gp/p.5 FL 3///it (No P.O.Box allowed) 2a) IS RESIDENCE USED AS AN OFFICE- Yes No 3) BUSINESS MAILING ADDRESS - \ 6 CE:_„."-- -E: 4 i- ` r L ,.. L t 1) 41) 7 ,,410r ,rL A Street City Zip :5'///a 4) OWNER OR QUALIFIER'S RESIDENTIAL ADDRESS -/'.0 44, 4" :-:= Si i-'1-'= /r 7 5) TELEPHONE -Business:L:9 ri —/ l S Homer > ,! i-i ;3� 6) LEGAL FORM OF BUSINESS: Sole Proprietorship Partnership Corporation tr. 4-1-7 LLC LLP 7) OPENING DATE OF BUSINESS OR DATE ASSUMED - 4r.!l� _2.G 4- _ i 8) OFFICE WITHIN CITY LIMITS OF NAPLES - Yes No If Yes,City License No. 9) SOCIAL SECURITY NO. or FEDERAL EMPLOYER 1 OVER IDE TIFICATIO ti' NO. - — "see back of application for explanation 9a) TYPE OF BUSINESS CONDUCTED: C. 0 b,D e4:s 1 co,_A vv C A- c p 1,h5}u (I(-t 1--i G t'1 0) 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- i\Iust have photo copy of state license if state licensed and certified UN D ER 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. r , / /Li xxNAPPLICANT'S SIGNATURE: °^�� 77!) /12',L2--/,' , DATE: % % ' ! - (O«ner and/or representative of business)TITLE: : ✓l' .i ***`THIS LICENSE IS NON-REFUNDABLE FOR BUSINESS STATED ABOVE'"'"" _____----- . . . ''''''■-.,:lri-',,it,, , ' iLle,LoOKE JR .,...:•—.,'' i,Z4'.! 770 sem AtVE N Ir ..,,......_ . ,,,,,,,,,,,,,..,,,,,,,,,,,,,4,,.,,,,, i4 • ''' ' '' " ''''',:'''":4'-', *.1 I' - , ':"-iltfl.:,',,,' ,;';...'"...31' ■J it ,;:,.--,, -7 ' fel% , • . ,,,,,,,__'_":":%-iilti!,. ..,t,„,,.;---•,,,,,,i,,;:`,',"',7"7",'.---.4,';',-...„..,4-..,„64, ,,,,-4-f-.,,., . OfiGAN--,•”'"i''''-'-' ' ,k.twit.,;',,,,....4‘, ,‘" ' ' ' -,by,,,, , oimoi '..hics.eotewoi"vi ene.....- _......,,, OPowagion trf,41 1.7:14111 --------------- • Credit Bureau Services, Inc. 3503 N. Dixie Hwy Oakland Park, FL 33334 954-561-1400 FAX: 954-567-1441 or email to: info @credit1400.com www.credit1400.com APPLICATION FOR BUSINESS CREDIT REPORT FOR LICENSE Collier County Licensing Board 2800 Horseshoe Drive Naples, FL 34104 Name and address of Licensing Board Application Number (if known): L. C. Stoneworks LLC Name of Company to prepare report on n/a If your company operates as a D/B/A, please state the name of the D/B/A here 16005 Arbor View Blvd#417 Naples FL 34110 Address: Please enter full address. We MUST have a zip code. Thomas Locke Jr Name of Qualifying Contractor on Business Application TeAcphone: 239 821 1936 Cell: same Email: thegranitewhisperer@yahoo.com Names of President or Owner name: Thomas Locke Jr Check one: Corporation; _X LLC; Sole Proprietorship Partnership Federal Tax ID #: 342063983 Report Charge: '.47 in Florida + $2.35 credit card transaction charge or = yq 3'� 1 $56 out o lorida .80 credit card transaction ee. Fax Number: 0`36i) 1431 S o` S Credit Card Number: Expiration Date:NIP Three digit security # on back or 4 digit number on front for AMEX I. Billing Name of Credit Card: Thomas John Locke Jr. Billing Address of Credit Card: 16005 Arbor View Blvd#417 Naples FL 34110 Street de dress, City, State and zip Signature: L I Full Credit Report Credit Karma Page 1 of 5 Thomas ■ Home My Recommendations 2 Credit Cards Loans Insurance Debt Solutions R Jul 30, latest n Overview View Report From 20 7 5(latest) E Credit Factors Print this Report 2 Credit Reports Credit Report k4, Recommendations Provided by Collections Items For Your Review ()Advertiser Disclosure p Track Spending ; Credit Score Simulator Full Credit Report Open Collections Accounts(14) Credit 14 Collectlibn Public Overview 2 Accounts Inquiriestecords Find basic information from your credit report on this page,including an overview of your credit score and credit accounts.You can also find personal information,such as your reported names and addresses,here. https://www.creditkarma.com/myfinances/creditreport/equifax 7/31/2015 Full Credit Report I Credit Karma Page 2 of 5 Your Credit Score Account Mix 0 0 Credit 1 Cards 640 Pa, 300 Fair 850 Estate 1 Auto 0 Student Other 0 Loans Total 2 Accounts: 4 Congratulations! We found a great offer for you based on your credit profile! Credit One Bank® Credit Card with Gas Rewards cmrcJr �' ""«"" earn More 4000 12 &I* a010 CV1;;,.,,r, VISA PLY NOW Approval Oddst https://www.creditkarma.com/myfinances/creditreport/equifax 7/31/2015 Full Credit Report I Credit Karma Page 3 of 5 Good i%s S 365 Reviews • Unlimited 1%cash back gas rewards • Get Pre-Qualified without affecting your credit score • Keep an eye on your credit information with fmminiVinftnionthly credit score tracking • Learn More APPLY NOW Personal Information Names Reported See something wrong? THOMAS JOHN LOCKE Find out how to update personal information. Addresses Reported Employer Date Reported Reported 4479 LAKEWOOD BLVD NAPLES,FL FRANKLIN -- 34112 MINT 770 98TH AVE N NAPLES,FL 34108 710 98TH AVE N NAPLES,FL 34108 https://www.creditkarma.coral/myfinances/creditreport/equifaY 7/31/2015 Full Credit Report I Credit Karma Page 4 of 5 View Overview on your credit report Advertiser Disclosure:The offers that appear on this site are from third party advertisers from which Credit Karma receives compensation.This compensation may impact how and where products appear on this site(including,for example,the order in which they appear). It is this compensation that enables Credit Karma to provide you with services like free access to your credit scores and free monitoring of your credit and financial accounts at no charge.Credit Karma strives to provide a wide array of offers for our members,but our offers do not represent all financial services companies or products. 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Android is a trademark of Googie Inc. The Equifax logo is a registered trademark owned by Equifax in the United States and other countries. https://www.creditkarma.com/myfinances/creditreport/equifax 7/31/2015 Full Credit Report I Credit Karma Page 1 of 9 4,4 t it t Reported as of Jul 30,2015 Thomas Locke's Credit Report Provided by Overview Your Credit Score Account Mix Credit Cards 1 Real Estate 0 ar 640 Student 0 300 Fair 850 other Loans 0 Total Accounts: 2 Personal Information Names Reported See something wrongu THOMAS JOHN LOCKE Find out how to update personal information. Addresses Reported Employer Reported Date Reported 4479 LAKEWOOD BLVD NAPLES,FL FRANKLIN MINT 34112 770 98TH AVE N NAPLES,FL 34108 710 98TH AVE N NAPLES,FL 34108 Accounts Account Name Account Type Open Date Status Balance https://www.creditkarma.com/mylinances/creditreport/equifax/view/print 7/31/2015 tl Full Credit Report I Credit Karma Page 2 of 9 WELLS FARGO BANK 8 Credit Card Jul 24,2015 Open-Current $0 CAR No Missed Payments 5%of Creri Account Details Payment History Last Reported Jul 24,2015 No payment history has been reported by this creditor Creditor Name WELLS FARGO BANK Credit Utilization' 0.00% CAR Account Type Secured Credit Card See something wrong? Account Status Open Opened Date Jul 24,2015 You could dispute an error with Equifax. Closed Date — Limit $300 Term — Monthly Payment -- Responsibility Individual Account. Balance $0 Highest Balance SO Payment Status Current Worst Payment Status -- Date of Last Payment -- Amount Past Due — Times 30/60/90 Days Late 0/0/0 Remarks -- TD AUTO FINANCE Auto Jul 03,2001 Closed $0 Account Details Payment History Last Reported Oct 03,2007 No payment history has been reported by this creditor. Creditor Name TD AUTO FINANCE See something wrong? Account Type Auto You could dispute an error with Equifax. Account Status Closed-Paid and Closed Opened Date Jul 03,2001 Closed Date -- limit -- Term 60 Months Monthly Payment Responsibility Joint Account Balance SO Highest Balance $17,743 Payment Status Current Worst Payment Status Date of Last Payment Jun 01,2007 Amount Past Due Times 30/60/90 Days Late 0/0/0 Remarks — "Calculated using reported balance and credit limit on account. https://www,creditkarma.com/myfinances/creditreport/equifax/view/print 7/31/2015 Full Credit Report I Credit Karma Page 3 of 9 Credit Inquiries Creditor Name Inquiry Date Removed By. Type WF CRD SVC Jul 23,2015 Aug 2017 National Credit Card Cos. I,l REALPAGE INC Jun 1,2015 Jul 2017 Miscellaneous Reptg.Agencies WF CRD SVC Jan 9,2015 Feb 2017 National Credit Card Cos. AMERICREDIT FINANCIA Sep 1,2014 Oct2016 Auto Financing NAPLES DODGE,INC. Sep 1,2014 Oct 2016 Automobile Dealers,New DIRECTV Sep 12,2013 Oct 2015 Miscellaneous Utilities DIRECTV Aug 8,2013 Sep 2015 Miscellaneous Utilities "Estimated based on the date of your inquiry and an assumed 2 year expiration period. See something wrong? You could dispute an error with Equifax_ Collections Agency Original Creditor Open Date Status Balance https://www.creditkarma.com/m}rfinances/creditreport/equifax/view/print 7/31/2015 Full Credit Report I Credit Karma Page 4 of 9 GULFCSTCOL DAVID LAWRENCE Ju130,2011 Open $60 CENTER Account Details See something wrong? Last Reported Jul 25,2015 You could dispute an error with Equifax. Collection Agency GULFCSTCOL Original Creditor DAVID LAWRENCE CENTER Status Open Opened Date Jul 30,2011 Closed Date Responsibility Individual Account. Balance $60 High Balance S60 Remarks Medical GULFCSTCOL DAVID LAWRENCE Apr 28,2011 Open $55 CENTER Account Details See something wrong? Last Reported Jul 25,2015 you could dispute an error with Equifax. Collection Agency GULFCSTCOL Original Creditor DAVID LAWRENCE CENTER Status Open Opened Date Apr 28,2011 Closed Date -- Responsibility Individual Account. Balance $55 High Balance $55 Remarks Medical GULFCSTCOL DAVID LAWRENCE Feb 24,2011 Open $55 CENTER Account Details See something wrong? Last Reported Jul 25,2015 You could dispute an error with Equifax. Collection Agency GULFCSTCOL Original Creditor DAVID LAWRENCE CENTER Status Open Opened Date Feb 24,2011 Closed Date Responsibility Individual Account. Balance $55 High Balance S55 Remarks Medical https://www.creditkarma.com/mytinances/creditreport/equifaxhriew/print 7/31/2015 Full Credit Report ( Credit Karma Page 5 of 9 PROFADJ NAPLES Apr 29,2O11 Open $324 RADIOLOGISTS Account Details See something wrong? Last Reported Jul 15,2015 You could dispute an error with Equifax. Collection Agency PROFADJ Original Creditor NAPLES RADIOLOGISTS Status Open Opened Date Apr 29,2011 Closed Date -- Responsibility Individual Account. Balance $324 High Balance $324 Remarks Medical PROFADJ NAPLES Mar 31,2O11 Open $200 RADIOLOGISTS Account Details See something wrong? • Last Reported Jul 15,2015 You could dispute an error with Equifax. Collection Agency PROFADJ Original Creditor NAPLES RADIOLOGISTS Status Open Opened Date Mar 31,2011 Closed Date Responsibility Individual Account. Balance $200 High Balance $200 Remarks Medical PROFADJ NAPLES Dec 30,2010 Open $82 RADIOLOGISTS Account Details See something wrong? Last Reported Jul 15,2015 You could dispute an error with Equifax, Collection Agency PROFADJ Original Creditor NAPLES RADIOLOGISTS States Open Opened Date Dec 30,2010 Closed Date Responsibility Individual Account. Balance $B2 High Balance $82 Remarks Medical https://www.creditkarma.com/myfinances/creditreport/equifax/view/print 7/31/2015 Full Credit Report ' Credit Karma Page 6 of 9 AM CRED RD DR MICHAEL HAVIG Jul 28,2010 Open $79 MD Account Details See something wrong? Last Reported Jul 02,2015 You could dispute an error with Equifax. Collection Agency AM CRED BU Original Creditor DR MICHAEL HAVIG M D Status Open Opened Date Jul 28,201O Closed Date -- Responsibility Individual Account. Balance $79 Hign Balance $79 Remarks Medical ARS SOUTHWEST Feb 27,2012 Open $1,380 FLORIDA EMERGENCY MA Account Details See something wrong? Last Reported May 30,2015 You could dispute an error with Equifax. Collection Agency ARS Original Creditor SOUTHWEST FLORIDA EMERGENCY MA Status Open Opened Date Feb 27,2012 Closed Date -- Responsibility Individual Account. Balance $1,380 High Balance $1,380 Remarks Medical ARS SOUTHWEST Dec 27,2011 Open $1,140 FLORIDA EMERGENCY MA Account Details See something wrong? Last Reported May 30,2015 You could dispute art error with Equifax. Collection Agency ARS Original Creditor SOUTHWEST FLORIDA EMERGENCY MA Status Open Opened Date Dec 27,2011 Closed Date Responsibility Individual Account. Balance $1,140 High Balance $1,140 Remarks Medical https://www.creditkarma.com/myfinances/creditreport/equifax/view/print 7/31/2015 Full Credit Report I Credit Karma Page 7 of 9 ARS SOUTHWEST Sep 26,2011 Open $760 FLORIDA EMERGENCY MA Account Details See something wrong? Last Reported May 30,2015 You could dispute an error with Equifax. Collection Agency ARS Original Creditor SOUTHWEST FLORIDA EMERGENCY MA Status Open Opened Date Sep 26,2011 Closed Date Responsibility Individual Account. Balance $760 High Balance $760 Remarks Medical PARAGON PHYSICIANS Jul 01,2014 Open $278 REGIONALCOLLIER Account Details See something wrong? Last Reported Aug 11,2014 You could dispute an error with Equifax. Collection Agency PARAGON Original Creditor PHYSICIANS REGIONALCOLLIER Status Open Opened Date Jul 01,2014 Closed Date -- Responsibility Individual Account. Balance 3278 High Balance $278 Remarks Medical FINANCIAL NORTH COLLIER Jun 10,2011 Open $4,025 HOSPITAL Account Details See something wrong? Last Reported Aug 01,2011 You could dispute an error with Equifax. Collection Agency FINANCIAL Original Creditor NORTH COLLIER HOSPITAL Status Open Opened Date Jun 10,2011 Closed Date Responsibility Individual Account. Balance $4,025 High Balance $4,025 Remarks Medical https://www.creditkarma.com/myfinances/creditreport/equifax/view/print 7/31/2015 Full Credit Report I Credit Karma Page 8 of 9 FINANCIAL NORTH COLLIER May 27,2011 Open $13,708 HOSPITAL Account Details See something wrong? Last Reported Aug 01,2011 You could dispute an error with Equifax. Collection Agency FINANCIAL Original Creditor NORTH COLLIER HOSPITAL Status Open Opened Date May 27,2011 Closed Date — Responsibility Individual Account. Balance $13,708 H gn Balance S13,7O8 Remarks Medical FINANCIAL NORTH COLLIER Apr 11,2011 Open $4,800 HOSPITAL Account Details See something wrong? Last Reported Jun 01,2011 You could dispute an error with Equifax. Collection Agency FINANCIAL Original Creditor NORTH COLLIER HOSPITAL Status Open Opened Date Apr 11,2011 Closed Date -- Responsibility Individual Account. Balance $4,800 High Balance $4,800 Remarks Medical Public Records 0 As of Jul 30,2015,you had no public records on your credit report. How to Read Your Credit Report Your full credit report is divided into five important sections. https://www.creditkarma.com/myfinances/creditreport/equifaxiview/print 7/31/2015 Full Credit Report I Credit Karma Page 9 of 9 Personal and Employment Information This section contains names,addresses and employers included on your credit report.This sort of information is added to your report after its been used on credit applications.Review this section for any information you dont recognize. Accounts This section contains details on each credit account on your credit report,Including both open and closed accounts.Details include payment history,current status and reported balances.Review this section to ensure that your lenders have been properly reporting yecr activity,and to look for any accounts that you didn't open Credit Inquiries T his section contains details on each hard credit inquiry on your credit report Hard inquiries are typically added to your report when you apply for new lines of credit.Review this section to verify that each inquiry is correct and authorized by you.and to find our approximation of when each inquiry will he removed from your report. Collections This section contains information about any accounts reported as in collections.If you've fallen behind on payments and have outstanding debts,a lender could send your account to collections.Review this section to check the accuracy of information about each collections account and to find contact information for your collections agencies. Public Records This section contains details on any public record information included in your credit report.Public records include bankruptcies,civil judgments and tax liens.Review this section to ensure that each item is reported accurately.If there is incorrect information,you could file a dispute directly with the credit bureaus If you anticipate changes to your report over time,you cart get an update to your credit report once a week through Credit Karma to check if new information has been added and old information has been updated.Because lenders typically only report information to the bureau once a month,it may take time for these updates to appear.View your report online to find highlights of Information that could be important to your credit health. https://www.creditkarma.com/mytinances/creditreport/equifax/view/print 7/31/2015