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CLB Agenda 10/21/2015 Co er County COLLIER COUNTY CONTRACTORS' LICENSING BOARD AGENDA OCTOBER 21, 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: September 16, 2015 V. DISCUSSION: VI. NEW BUSINESS: (A) Orders Of The Board (B) Neftali Triana- Contesting Citation 09936 (C) Tom Frechette-Contesting Citation 09602 (D) Antonio Galindez-d/b/a High Wind Aluminum Corp.- Review of Application (E) Marina Reyes- Reyes Tile Service-Waiver of Exams/Review of Credit (F) Garon Skender-Marco Pool Service-Review of Credit (G) Brian Kirwan-Kirwan Painting Inc.- Review of Credit/Waiver of Exams VII. OLD BUSINESS: (A) Matthew R. Rambo, Neapolitan Tree Service, Inc—6 mos. Review of Credit (B) Teodor Danilov, Custom Flooring Design Inc—Reinstatement-Review Of Credit VIII. PUBLIC HEARINGS: (A) Case 2015-07-Tiffinay Fronimakis-D/B/A Statewide Florida Glass LLC/ LCC20130001831 IX. REPORTS: X. NEXT MEETING DATE: WEDNESDAY, DECEMBER 16, 2015 COLLIER COUNTY GOVERNMENT CENTER ADMINISTRATIVE BUILDING THIRD FLOOR IN COMMISSIONER'S CHAMBERS 3299 E. TAMIAMI TRAIL NAPLES, FL 34112 September 16,2015 MINUTES OF THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD MEETING September 16, 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 Members: Richard Joslin Kyle Lantz Gary McNally Robert Meister Excused: Thomas Lykos, Vice Chair Michael Boyd Terry Jerulle ALSO PRESENT: Michael Ossorio — Supervisor, Contractors' Licensing Office Kevin Noell, Esq. —Assistant County Attorney James F. Morey, Esq. — Attorney for the Contractors' Licensing Board Ian Jackson— Collier County Licensing Compliance Officer 1 September 16,2015 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; five (5)voting members were present. Michael Ossorio noted that Vice Chairman Thomas Lykos, Michael Boyd and Terry Jerulle had been excused. He also noted the Board of County Commissioners was in the process of approving a new applicant to the Board who will represent the category of"Consumers." II. AGENDA—ADDITIONS OR DELETIONS: Changes: • Under Item VIII—(A), "Public Hearings," the following case will be heard following Item V on the Agenda. o Case#2015-03: Board of County Commissioners vs. Louis Bruno, Louis Bruno, LLC, d/b/a "Bruno Air Conditioning of SWFL" (CAC 1817131) III. APPROVAL OF AGENDA: Gary McNally moved to approve the Agenda as amended. Richard Joslin offered a Second in support of the motion. Carried unanimously, 5— 0. IV. APPROVAL OF MINUTES—AUGUST 19,2015: Correction: • Page 17 — 5th Paragraph (2nd comment by Chairman White): The word "need" was inserted following the word"will" in the second sentence. Gary McNally to approve the August 19, 2015 minutes as amended. Richard Joslin offered a Second in support of the motion. Carried unanimously, 5— 0. V. DISCUSSION: (NONE) 2 September 16, 2015 VIII. PUBLIC HEARINGS: (Note: With reference to the cases heard under Section VIII, the individuals who testified were first sworn in by the Attorney for the Board.) A. Case #2015-03: Board of County Commissioners vs. Louis Bruno, Louis Bruno, LLC, d/b/a "Bruno Air Conditioning of SWFL" (CAC 1817131) Michael Ossorio noted Louis Bruno, the Respondent, was present and was represented by his attorney, Patrick Neale, Esq. He stated the County had entered into a Stipulation with Mr. Bruno which his attorney would enter into the record. Chairman White explained the process to be followed during the proceeding: • The Witnesses are sworn in; • The County presents a summary of its Case; • The Respondent presents a summary of his/her Case; • Each party presents their"Case in Chief;" • The County is allowed an opportunity to rebut. • The Public Hearing is then closed; • The Board will deliberate any findings of violation or guilt concerning the matters that were charged; • The Board will vote regarding the imposition of any Sanctions based upon advice from the Board's attorney concerning the factors to be weighed when considering evidence. • The Chairman will orally report the Order that will subsequently be rendered to become the official decision of the Board. Attorney Patrick Neale stated a Stipulated Settlement Agreement had been entered into by the County and his client which addressed the issues contained in the Administrative Complaint. He requested the Board approve the Agreement. Mr. Neal outlined the teHus of the Agreement: • The Respondent will be placed on probation for-a period of six months; • If a violation occurs after the date of the Settlement Agreement and Order, the Respondent will be notified of the violation and validated by the Contractors' Licensing Office Supervisor; • If warranted, the Respondent's permit pulling privileges will be immediately suspended, pending a full hearing before the Contractors' Licensing Board' • Pursuant to the State's Building Code, the Respondent has the right to make emergency repairs "where equipment replacement and repairs must be performed in an emergency situation." The permit application will be submitted during the next working ("business") day to the Building Official. 3 September 16,2015 • The Respondent will pay the investigative and operational costs incurred by the County in the sum of$1,500 within thirty (30) days from the date of the Stipulated Settlement Agreement and Agreed Order. • The Stipulation and Order shall be forwarded to the State's Construction Industry Licensing Board ("CILB") with a recommendation that no further action is necessary. Attorney Neale questioned the Respondent, Louis Bruno: Q. Have you read the Stipulation as entered into the record? A. Yes, I read it. Q. Do you accept the terms of the Stipulation as entered into the record? A. I accept the terms. Q. Do you have any questions about the Stipulation? A. No. Chairman White stated he was satisfied. Kyle Lantz commented he did not think the Board had the authority to place a State- certified Contractor on probation, but agreed the Board could restrict a Contractor's permit pulling privileges. As he had done previously, he stated he would not approve the Stipulation. Chairman White noted the impact of the probationary period was nothing more than requiring the Respondent to "... comply with the laws and ordinances governing Contractors within the State of Florida and Collier County." The laws are already in effect at the State and local level. No other additional Sanctions were imposed. The Licensing Board Supervisor had the jurisdiction to immediately suspend Mr. Bruno's permit-pulling privileges if a determination was made that a potential further violation had occurred. Richard Joslin requested an explanation from the Board's Attorney of what the Board was permitted to do regarding a State-certified Contractor. Attorney James Morey replied the Board was limited but could impose restrictions on permit-pulling privileges within Collier County, as well as making referrals to the State's Construction Industry Licensing Board ("CILB"). He stated the Board had the authority under Collier County's Code of Laws and Ordinances. Chairman White concurred, noting the Stipulation was agreed to by the Respondent as a way of addressing the asserted violations contained in the County's Administrative Complaint. When asked about the amount of fees paid by the Respondent to obtain after-the-fact permits, Michael Ossorio explained the County and the Florida Building Code assessed a fee that was twice the amount of the permit. Chairman White explained the amount paid was not a"fine" but an additional permit fee as required by law. 4 September 16,2015 Richard Joslin asked if the permits had been pulled and the work has been inspected. Michael Ossorio replied, "Yes." He further explained that Mr. Bruno had come into compliance —there were no Code issues or violations—which is why the County had agreed to the teiiiis of the Stipulation. Kyle Lantz asked if the Respondent had steps in place to ensure the same violations would not occur again and Mr. Ossorio's response was, "He does." Chairman White commented: "One of the benefits of a Stipulated Settlement Agreement was that it resolved not only the issues that were before the Board but also addressed the potential concern about an Appeal and the additional expense that it would entail." He further noted for the record the Respondent had agreed to reimburse the County for investigative and operational costs incurred during the prosecution of the matter. Richard Joslin moved to approve the Stipulated Settlement Agreement reached in Case #201 5-03. Gary McNally offered a Second in support of the motion. Motion carried, 4— "Yes"/1 — "No." Kyle Lantz was opposed. VI. NEW BUSINESS: A. Orders of the Board Richard Joslin moved to approve authorizing the Chairman to sign the Orders of the Board. Gary McNally offered a Second in support of the motion. Carried unanimously, 5— 0. (Note: With reference to the cases heard under Section VI, the individuals who testified were first sworn in by the Attorney for the Board.) B. Charles K. Singletary Jr. —Waiver of Exam(s) (d/b/a "Hardcore Concrete, Inc.") Charles Singletary stated he was appearing before the Board to request a Waiver of Exam for the Masonry Contractor's license because he had continued working within his trade and was currently employed doing concrete and masonry work. Kyle Lantz referred to the Applicant's "Verification of Construction Experience" form and questioned the applicant as follows: Q. You are currently working for LJ Hayes Construction. Is this a licensed Contractor? A. Correct. Q. What are they licensed for? A. He is a masonry contractor. Mr. Lantz pointed out an error in the Jurat and asked who signed the Verification— Timothy Hayes or Charles Singletary. A. Timothy Hayes signed it. 5 September 16,2015 [Note: The Notary inserted the wrong name, indicating Charles Singletary had signed the document instead of Timothy Hayes.] Q. What kind of work have you done since 2007? A. I've done remodels on Wal-Mart for Ogden Brothers Construction, schools, houses, and a little bit of commercial work. Q. All block work? A. I've done block, pre-cast, cultured stone, concrete, ty-beam. Q. Have you been doing that pretty consistently since 2007? A. Since I graduated from high school, yes. Q. Can you make me comfortable that you have kept up on the business side of things? A. It pretty much has stayed the same. Q. If definitely has not stayed the same. Chairman White: Q. What have you been doing relative to the management or supervision of the jobs you have been on and the business management or administration of those jobs? A. I'm a superintendent. I don't do the payroll right now but I plan to use a payroll company when I get my own company set up. Kyle Lantz: Q. Are you familiar with the Workers' Compensation laws, the different payroll laws, the laws pertaining to what you can and cannot do, insurance—that's the stuff people get in trouble for. A. Absolutely. I know I have to carry Workers' Comp and general liability. I've done it before—there might be a couple of things that I need to catch up on. Richard Joslin asked Mr. Singletary if he would be adverse to taking a Business and Law class. A. No, I'll do it. Mr. Joslin noted the Applicant had passed a test in 2000; Score was 79. He stated the laws had changed a great deal since then. Kyle Lantz agreed, stating he would not have a problem waiving the trades test for the Applicant but was not comfortable waiving the business and law exam. Michael Ossorio confirmed Mr. Singletary had taken the Business and Law exam in 2000 and the Masonry trades test in 2002. Both scores were 79.6%. He noted under the County's Code of Law and Ordinances,that Staff could waive the re-testing requirement if an Applicant could prove that he/she had been active in the trade in other jurisdictions or had been active as an inspector or investigator in the trade, or for any valid reason that would render such re-testing superfluous to do the job. 6 September 16,2015 Chairman White asked the Applicant approximately how much time he would need to prepare for and taking the exam. A. Ninety days. Kyle Lantz moved to approve to waive requiring the Applicant to take the Masonry Trades test. He is required to take and pass the Business and Law exam. His applicant for a Masonry Contractors'License would be effective upon passing the exam. Richard Joslin offered a Second in support of the motion. Discussion: Gary McNally noted there were two items on the Experian credit report that had been placed in collections. The two items, totally approximately $3,000, were owed to Home Depot. He asked if the situation had been resolved. A. They have been paid. I don't have any documentation with me today, but I can get it for you. It was suggested that Mr. Lantz amend his motion to include providing proof of payment to the Contractors'Licensing Office Supervisor before a license could be issued to Charles Singletary. Kyle Lantz amended his motion to include the above-referenced language, and Richard Joslin offered a Second in support of the amended motion. The Amended Motion was carried unanimously, 5—0. C. David M. Jones—Waiver of Exam(s) (d/b/a "Love Landscape,Inc.") David Michael Jones stated he was appearing before the Board to request a Waiver of Exam based upon his 30+years of experience in his field. He further stated he had taken and passed the exam previously but had been recruited to work in a large corporation. He also worked for the City of Naples as a Landscape Manager. Neither employer required him to obtain his Contractors' License. He had applied to obtain a Restricted Landscaping License. Chairman White asked the Applicant if was familiar with the Scope of Work that pertained to the License. A. Absolutely. Q. Have you had the relevant experience throughout your work history consistent with the same requirements? A. Yes, sir, very much so. Michael Ossorio explained to the Board that re-testing requirements can be waived. He stated Mr. Jones had taken the "Business Procedures"test in 1995. Since then, the requirements have been revised to include taking a trade exam. He reminded the Board in similar situations in the past, it did require Applicants to take a Trades exam when applicable. He stated he thought the Applicant was licensed in other jurisdictions and has kept his business in those areas. 7 September 16, 2015 Chairman White requested the Applicant to explain where he was licensed in Florida and what licenses he held. A. I am a Florida-certified Horticultural Professional [designation]; I have an Associates' Degree; I have sat on Advisory Boards for the University of Florida's Institute of Food and Agricultural Sciences. I am constantly trying to expand my knowledge in the field. This is all I have ever done. Kyle Lantz: Q. Are you licensed as a Landscape Contractor or something of that sort in any other county, city or municipality? A. Not licensed as a Contractor. I do have a state license as a Florida certified Horticulturalist. Q. Can you explain what the difference is? A. After a certain amount of schooling—pretty extensive amount of schooling—I was able to obtain the Florida-certified Horticultural Professional [designation]. In our industry, there are not a lot of people who have it. It includes knowledge of environmental practices, the right plants in the right place, and sustainable landscape design. Richard Joslin: Q. Was this a college-type degree or ...? A. It was from the University of Florida in 2000; my Associates' Degree of Agricultural was from Cuyahoga Valley in Ohio in 1985. For the last thirty years, I have been working in Florida. Michael Ossorio noted the application packet included a letter from the City of Naples verifying that Mr. Jones had been employed from 2007 through 2011 in the Community Services Department as a Landscape Tech-2, Landscape Tech-3, Senior Landscape Tech, and Facilities Management Supervisor. Chairman White asked Mr. Ossorio for the County's recommendation. Mr. Ossorio stated: • Approve the application for a period of six months to allow Mr. Jones to prepare for and take the Trade exam (Tree exam). • After he has passed the exam, his conditional license will become active and current. David Jones stated he was "very comfortable" with the County's recommendation. Kyle Lantz stated he recognized the Applicant had taken the business test approximately twenty years earlier. He stated he was not concerned about the Applicant passing the Trades test but reservations concerning his business knowledge. He asked the Applicant to explain his business knowledge. A. It may not be my strong suit but I have the people in place to assist me. I have an insurance company and a payroll company. I have someone who has a degree in finance and also ran two large local companies. I have the right people in place for that. At the City of Naples, I was in charge of a$2.2M budget. I am familiar 8 September 16,2015 with setting a budget and sticking to it but, as far as the legalities, I have the right people in place for that. Chairman White stated the Board's concern was the Applicant's over-arching management umbrella and his overview of those operations. He asked if one of the skilled professionals was not doing his/her job, did the Applicant understand that he was responsible and what he had to do to fix things. That was the basis of the Board's concern and support for requiring the Applicant to also take the Business and Law exam in addition to the Trades test as recommended by the County. Chairman White asked Mr. Jones if he would be comfortable taking and passing the Business and Law exam within the next six months. He explained his license would be effective immediately and would become a full, unconditional license upon passing both tests. A. I would be happy to do that. Kyle Lantz moved to approve granting a temporary waiver of the license testing requirement for a period of six months, and issuing a provisional license to David M. Jones. At the end of the six-month period, if he has not passed both the Business and Law exam and Trades (Tree) exam, his license will become inactive until both exams are passed. Richard Joslin offered a Second in support of the motion. Carried unanimously, 5— 0. D. Victor Rodriguez—Credit Review (d/b/a "Vic& C Painting,Inc.") Victor Rodriguez and his wife, Maria Carmen, were sworn in, with Maria Carmen serving as her husband's translator. Maria Carmen stated she and her husband were both involved in the company and she wanted to make sure that her husband understood the discussion. Chairman White confirmed Maria Carmen's intention was to translate whatever the Board said to her husband and to translate his responses to Board. He asked Maria Carmen if she could translate accurately and completely; her response was "Yes." Chairman White stated the Board was concerned about Mr. Rodriguez's FICO score which was 627. He noted the credit report contained a civil judgment in the amount of approximately $3,400 and outstanding collections of approximately $10,000. He asked what was being done to pay these debts. Maria Carmen: • Most of the accounts were from 2008 through 2010 when the jobs were down and the economy was down. Chairman White asked what was being done to take care of the debts. 9 September 16,2015 Maria Carmen: • In the last two weeks, we started paying one of the accounts with AT&T and we want to pay the accounts — it's only that he hasn't been working. We have two kids—we have been trying to survive. That's why we want to get a license so he can work and then start to pay our debts. We don't want to have debts. Chairman White asked if a payment had been made on the AT&T account in the amount of$921. A. I think it was $1,049 or something ... Q. That's a medical bill with Paragon. If you look on the credit report supplied by Licenses, Etc. on Page 2. A. It's not that one ... we paid another one for one thousand ... Q. Is that the one you are talking about that you made payments on ... with AT&T Mobility? A. We paid already—we paid that off They didn't send me the letter yet. I asked them a few times but they only sent me an email from AT&T saying that we paid. Q. Do you have a copy of the email with you? A. No, I didn't make a copy. Q. Is your service provider currently AT&T? A. No, it's Verizon. Q. What about the others? There are more than a few of them for some substantial amounts. A. Yes, we understand that and we definitely want to pay them. You know, we only need a job. My husband has been sick—he hasn't been able to be hired for a company but we want to work. I do house cleaning and been trying to survive with that. We want a chance to prove that. Q. I admire that and respect that—we would like to be able to work something out if we could. But what we would like you to do is to demonstrate how these things that have affected the credit score are being taken care of. If you have approached one of the creditors—there are some substantial amounts that Citibank has placed for collection and those were verified as being owned all the way up until July of this year. You've got $6,000 .... $7,300 ... $18,000 -- those are substantial obligations out there that ... if you're going to run your business the way you run your finances, regardless of what the causes are, because you could always say, "Well, what if he gets sick and the business can't operate." The business will have expenses and you will have customers who will be left without their jobs getting done ... you will have suppliers who will not get paid. What we are trying to do is to say, "Show us a level of fiscal responsibility—fmancial management— budgeting—paying the debts that are owed." What you have done up until today, isn't quite enough. So this is your chance to tell us what you're doing or going to do." A. Yes, before this, we were about fifteen years with excellent credit, before 2010 or 2008. We always paid our debts. We've been—like I said—we haven't done much this last year because my husband has been sick and we've been trying— having a hard time trying to pay our bills and all that. But, of course, it's not going to happen—you know, we are responsible to try to solve this problem. 10 September 16,2015 With Chase, we went to the Court for one citation and we told them we can start paying $50 a month and they said, "No—we want $300." The Judge said to wait for another hearing but they never called again. We were trying. Q. A judgment has been entered in the amount of$3,429. The judgment was entered since 2010. Have you contacted Chase to try to pay the civil judgment? A. No. We didn't hear anything else from them after that. Q. Well, in the public record, there is a judgment that says Victor owes $3,429. The point is if you have not contacted Chase about something that has already gone to a judgment and you have not contacted the other creditors you have ... Citibank, the medical bills ... the only one you've talked to and made payment on is the phone company. Then help me to understand why we should grant you a license. A. Well, if you can give us a chance, we can prove that ... we can always contact them and start doing something. Q. But the point is—we would like to have seen that before you came here. It is not our job to help you to understand what your financial responsibilities are and to properly manage them in a way that demonstrates when you come here ... your FICO score isn't horrible, but it needs to be better. We're trying to help you to get there ... A. Yes, I know .... Q. ... but it's not our job to get you there. A. No ... no ... I understand that. And, well, we didn't have the money, that's all ... if we had the money, of course ... it's embarrassing ... every time you want to buy something and they say, "Let me check your credit" ... we don't want to hear that all the time. That's why we're taking this step—trying to work ... Richard Joslin: Q. Is he working for a painting company at all now? In the field that he wants to get the license for—is he working now? A. No, no—not right now. Q. Why? A. Because, like I said, he was having trouble with his back. He tried to work a few months with a company lately but he couldn't make it because it was only an exterior job. Q. If we give you a license, who is going to do the painting? A. I do painting—I learned already. And we both do it. And we can always get an employee. Q. Then you're going to need insurance and it takes money to get insurance. A. Yes. We'll do it. Kyle Lantz: Q. Here is my concern—you're asking us to grant you a license ...so, if you haven't paid your bills in the past ... if someone hires you, what's to say that you're not going to take the money and use that money to pay for something else instead of buying materials for his job. You're asking for a chance—how about I call the Midland Fund and ask them if we should give you a chance ... or Paragon or Chase and ask them. They've already give you a chance. And what you've shown them is that you don't deserve a second chance because you've not done 11 September 16,2015 what you were supposed to do. I understand—people get sick and times gets tough ... some of these debts are from 2010 and 2011 —your husband got sick in the last year and the market was down, but ... I had a business in 2007 when the market tanked but I had some steps in place to make sure that I paid my bills. What we want to know is that you have steps in place and what you have shown us from your past performance is that you didn't have any steps in place to pay your bills. Now it is five years later and you still haven't paid those bills. I would hate to be the one issuing you credit knowing that your past performance doesn't do it. You haven't convinced me that you are in control of your finances at all. That's not only going to affect you but now you are asking us to allow your lack of responsibility to affect other residents of Collier County. It's tough for me to approve getting your license—you have to be in control—to drive a ship, you have to have a firm plan on where you're going. That's what we want to see. You can do that—you can get your finances in order—you can get a payment plan. You can contact all of these creditors—you can talk to them and set up a payment plan, then come back to us and say, "Now I'm in control. Now I see where I was—now I'm taking charge of my past." At least you would have something. As far as I am concerned, you are going to take a deposit from a customer and use that money to pay one of these past-due bills because there will be a debt collector knocking on your door. I need to know that you have a plan for these past bills before I allow you to take a deposit from a customer. A. Well, that's why my husband said ... well, it's up to you if you give us a chance ... but my husband said we know we have to prove that we're working on it. And he said as soon as we get it, we'll start contacting the people to pay them little by little. One account and then the next one—that was our plan. Q. So you're asking us to make the first step rather than you making the first step. A. Well, we can do it. The first thing we did was start with AT&T and that counts ... from the little to the big one. That was our plan. Chairman White: Q. Other folks have come before us with that as their plan. We haven't always been comfortable with that. What we have asked them to do is to go back and get a better plan ... a more detailed plan. Something other than, "Well, this is what we think we'll do." But to actually reach out to these creditors, even if you don't have the present ability or means to pay them—to at least have contacted them. Even though they may say to come back when you have money, there are laws that they operate under—the"Fair Debt Collection Act"=and they do have to talk to you. They do not necessarily have to agree, but if you make an offer to them— and you come back and tell us or show us the letter or the email—that shows us something. The thing that, to me, is the big hurdle that I'm not over yet is the civil judgment. That's out there. If you go to a supplier to buy paint and they do the most minimal check, they will see that judgement is out there—that nothing has been done about it. To me, to contact Chase and figure out how you can get that out of the public record—that's a big hurdle to clear. 12 September 16,2015 Richard Joslin: Q. The other question that I have—everything in the packet indicates Victor is the license holder but what you're telling us is that Victor can't work and hasn't worked in the industry because he's hurt. It means that you are going to be doing the work or someone you will hire will do the work. A. No, he is able to work but, like I said, he was trying to work with a company that —they were doing an exterior job— 3rd floor—but he is able to work—he is able to paint. Yes. And I do, too. We paint our house all the time and I have learned. We have in our minds to pay those debts but if you want to see more, of course, we'll put ... Q. I think Mr. White has the idea ... come back ... maybe come back before us with a better plan. Contact some of these people that you do owe—especially the civil judgment and try to get something started. Whether they accept or deny—at least you've started working rather than coming in here cold and telling us you're going to do it. Chairman White referenced the official exam score report in the packet: • Business Procedures exam—82% • Painting Contractor exam—79% Chairman White advised the couple they could ask the Board to withdraw their request and come back again at a later date. He did not think the Board would support their application for a Painting Contractor's license. He suggested before returning, they obtain evidence that they tried to establish a payment play with Chase and some of the other creditors. Maria Carmen: We are going to come back another day. Michael Ossorio suggested that Mrs. Rodriguez stop by his office to review the credit report and to devise a business plan. Mrs. Rodriguez agreed. Chairman White confirmed the application had been withdrawn. E. Joong J. Kim—Credit Review (d/b/a "Lhop Contractors, Inc.") Joong Kim stated he recently moved from Louisiana to help his uncle. From 2006 to 2008, he had worked with his uncle installing wood floors. He moved to Louisiana in 2012 for a job. But he worked multiple jobs and his wife had to work because of the lower wages in Louisiana. His uncle has a business in Lee County doing wood floor installation and he will retire in 2015. He wants his nephew to take over his accounts and obtain his license. Mr. Kim further stated his intention was to which he had been unable to do previously because his first priority was to support his wife and three children. His uncle said that he would help Mr. Kim establish himself. His uncle has been in Florida for the past 17 years and was very successful in his business. He stated he felt that obtaining his license was his "last chance for my life and for my family." 13 September 16, 2015 Chairman White stated Mr. Kim's FICO score was approximately 100 points lower than the accepted minimum. He noted two specific items from the credit report: (1) a civil judgment from Discover Bank dated 2012, and (2) a Federal tax lien dated 2010. He continued there were smaller matters that had been placed for collection including $1,000 placed into collection by Verizon, and asked Mr. Kim what had been done to address those items. Mr. Kim stated he had been trying to pay off the car loan through Capital One—he had been concentrating on paying off the car loan. Chairman White again referenced the debt to Verizon in the amount of$1,087as well as the debts to Esurance ($84) and Bright House ($269). He also referenced debts to Capital One ($597) and Progress Energy ($71) which had been placed in collection. He again asked Mr. Kim to state what had been done about paying the five items or what he planned to do about them, as well as the civil judgment ($4,631) and the tax lien($1,017). Mr. Kim stated if he was granted a license and could start working immediately, he could pay off all the items within the next six months. He again stated obtaining a license was "his last chance." He stated he promised God and his family—"I can take care of this in the next six months." He further stated his uncle was willing to help him build his business. Chairman White stated the total amount that Mr. Kim owed and that the Board considered to be an issue was $7,756 —if he was able to get them all wiped off his credit report, he could begin to establish his credit. He asked Mr. Kim if it were possible to pay the creditors within the next six months. Mr. Kim stated he was currently working on at night. His wife is also trying to find a job. He and his family are staying with his Pastor until they can move out. He again stated he needed to start working which is why he has applied to obtain his license. He stated his uncle has a job waiting for him as soon as he is licensed. Richard Joslin asked if Mr. Kim's uncle could hire him as an employee. He also asked where Mr. Kim was currently employed. Mr. Kim replied he was working at a restaurant. He stated his uncle had a remodeling business from 2006 through 2014. His uncle had retired but still had contacts with"Taylor Flooring One." His uncle is not licensed but planned to work with Mr. Kim as an employee after he obtained his license. Michael Ossorio noted the Verification of Construction Experience forms signed by Bob Murphy and Donald Pribanic, as well as the Affidavits of Good Character signed by each,were not properly notarized because the Notary had inserted Mr. Kim's name instead of the names of the actual signers. Mr. Ossorio asked Mr. Kim if he had ever worked for Taylor One Flooring as an employee. A. Not as an employee. My uncle's company, I J Remodeling, worked for Taylor One and I worked for him. But they knew I worked for him. Michael Ossorio explained Taylor One was in Fort Myers. Lee County did not require a license to install wood flooring— only a Business Tax Receipt. He stated the Affidavits were not complete and were not valid. He recommended denying the application. He further stated Mr. Kim could come to the Licensing Board Office 14 September 16, 2015 where he would explain the application in detail. Mr. Kim could return before the Board on another date. Chairman White concurred, noting corrections needed to be made on the Verifications of Construction Experience forms and Mr. Kim needed to form a plan concerning payment of the credit items. He suggested Mr. Kim ask to borrow some money from his uncle to pay the debts which would eliminate one issue. The other issue concerning the Board was Mr. Kim's experience and his lack of documentation of his actual work experience. Chairman White asked Mr. Kim if he wished to withdraw his application. Joong Kim asked if he could be granted a probationary license. Chairman White stated he would not support a motion if it were made. He further stated the Board might be willing to do that if Mr. Kim returned with a properly completed application and documentation of his work experience. Mr. Kim agreed to withdraw his application. Richard Joslin urged Mr. Kim to contact Michael Ossorio for help concerning how to properly prepare the application packet. Chairman White confirmed that Mr. Kim had withdrawn his application. F. Benjamin T. Mading—Waver of Exam(s) / Credit Review (d/b/a "Adria Group, Inc.") Benjamin Mading outlined his educational and work experience: • Attended the James Lorenzo Vocational Training Program in high school; • Has been in the trade since he was 18 —approximately 24 years; • In 1999, he started working with AFC Electric and became Vice President in 2000; and President in 2012. o He prepared the permit applications; o Went over the load calculations; o Did the payroll; o Did all the estimating; • He stepped down as President in 2013 due to the death of his daughter and also went through a divorce; • Concerning the credit report: He contacted each creditor and has either set up a payment plan or paid the debt in full. o He noted most of the bills (Target and Pier One, etc.) had been incurred by his former wife o He had been unaware of the debts until he pulled his credit report to complete his application o None of the debts incurred were business-related • The Adria Group has $10,000 in its bank account; the funds will be used to start the company, 15 September 16,2015 Michael Ossorio stated: • Mr. Mading applied to reinstate his Electrical Contractor's license which expired; • He was registered with the State as a Registered Electrical Contractor but his license became delinquent in August, 2014; • He took the Trade test in 2000; he took the Business Procedures test in 2002 • He must also petition the Department of Business and Professional Regulation to reinstate his State license—he may be required to post a Bond due to his low credit score and could be issued a provisional license. Benjamin Mading stated he had recently completed 14 hours of Continuing Education. Chairman White stated the Board was more concerned with Mr. Mading's credit issues than his work experience. Mr. Mading further stated he felt confident he could have his debts paid in full within the next six months. Chairman White pointed out the Applicant's FICO was well below the accepted minimum of 660. He conceded it could improve drastically within the next 30— 60—90 days but the timing would be up to the Applicant and dependent upon what he was able to do. He suggested the Board consider granting a probationary license; Mr. Mading would return at the end of the six-month period and present a revised credit report for the Board to review. Benjamin Mading asked if the probationary license would still allow him to obtain permits on behalf of his new company, Adria Group, Inc. Michael Ossorio confirmed once Mr. Mading received his Competency card from the Board, he would be able to apply to the State for reinstatement. After he had been reinstated, he would be allowed to pull permits. But due to his credit score, the State might require that he furnish a Bond before he could be reinstated. Michael Ossorio explained that even if the Board were to grant a probationary license, Mr. Mading would not be allowed to work as an Electrician until his registration with the State of Florida became "current"which could take up to four additional weeks. Mr. Mading stated he had paid $1,100 which he thought covered the fees owed to the State. Mr. Ossorio stated he would contact Lisa at Licenses, Etc. to coordinate their efforts. Kyle Lantz moved to approve granting the application of Benjamin Mading for an Electrical Contractor's License on a probationary basis. The probationary period will not commence until Mr. Mading's license with the State becomes current. Mr. Mading is to return to the Board at the end of the six-month probationary period to present a revised credit report for review. Richard Joslin offered a Second in support of the motion. 16 September 16,2015 Discussion: Gary McNally asked what Mr. Mading had been doing since he stepped down as President of AFC Electric, Inc. A. In 2014, I started with Metro Electric. I helped with estimating and service work. Q. Are you currently working for that company? A. Yes. Richard Joslin asked whether or not Mr. Mading's new company, Adria Group, Inc., could perform electrical work if he was not allowed to serve as its Qualifier. Michael Ossorio confirmed the company could find another Qualifier or could wait until Mr. Mading was reinstated by the State of Florida. Chairman White called for a vote on the motion. Carried unanimously, S—0. RECESS: 10:35 AM RECONVENED: 10:50 AM VII. OLD BUSINESS: (Note: With reference to the cases heard under Section VII, the individuals who testified were first sworn in by the Attorney for the Board.) A. Janet Ramirez— Credit Review (d/b/a "Castaway Flooring Service,Inc.") Janet Ramirez presented copies an updated credit report, dated September 15, 2015, to the Board to review. Janet Ramirez apologized for the late presentation of her newest credit report. She stated she had difficulty making the payment to Licenses, Etc. —she lost her wallet two weeks ago and had to set up new accounts, in addition to moving. Richard Joslin noted her credit score had improved a bit and Chairman White agreed. Ms. Ramirez stated she tried to remain with the company she had been working for but they didn't have enough work to keep her busy—working one day a week was not enough. She moved to Collier County and began applying at several flooring installation companies (approximately 6); she also began networking with friends and also contacting realtors. She stated her first priority is to pay off her old debts. She said she is "getting there" and needs a little more time. She continues to look for work with other Contractors and says she is moving forward "slowly but steady." Chairman White noted six items from the previous credit report still remained on the new report. The FICO score did increase by seven points. It is approximately 80 17 September 16,2015 points below the minimum accepted threshold. He asked Ms. Ramirez to explain why the six items had not been paid. Janet Ramirez stated she had contacted each of the creditors since her previous appearance before the Board in March. She attempted to establish a payment plan but her projected income was reduced by half due to lack of work. She makes payments whenever she has the funds to do so. Chairman White noted some of the medical bills had been addressed. A. I contacted Physicians Regional about the bills but I have not been able to pay them in full. Ms. Ramirez stated she started by paying the smaller bills first. She will move up to paying the larger bills as her funds increase. Chairman White stated one medical bill ($813) had been place in collection by ARS in May, 2015. He acknowledged there had been some improvement, and understood her request to continue her probation in order to chip away at the debts. Kyle Lantz noted additions to the credit report, i.e., Verizon Wireless ($1,235) which was new. He requested an explanation. A. There was an issue with a phone that had been returned late—past the deadline. They are still my current provider. I have kept in touch with most of my creditors. My plan is pay the bills in portions. I am hoping that once "Season" starts, I will be busier again as I was last year. Since I am in Collier County now, I will have the opportunity to be here—instead of in Fort Myers—I will see a big difference and hopefully that bill will be cleared up as soon as possible. I don't want any of this to keep affecting that I can't work and not pay my bills because I am very capable of doing it. Q. Can you tell me how much you have paid toward reducing your debt during the past six months? A. Probably about $500 to Bank of America, SunTrust—I had a small debt with Chase and I took care of that. I set up payment options with some of them. As I said, it's slow moving. Richard Joslin stated since she had made some improvement and some of the items had been removed from her credit report, he was included to support extending the probation for an additional six months. Michael Ossorio noted that the County had not received any complaints concerning the Applicant. Richard Joslin moved to approve extending the probation period of Janet Ramirez for an additional six months, at which time she is to return to the Board and provide an updated credit report. If the improvement has not been sufficient, the Board will make a determination at that time. Gary McNally offered a Second in support of the motion. Carried unanimously, S—0. 18 September 16,2015 B. Jim E. Skelton —Review of Probation //Waiver of Exam(s) (d/b/a "Skelton's Construction, Inc.") Jim Skelton stated he had appeared before the Board to request an extension of his probationary period for another six months due to health issues—his cancer had returned. He attempted to take the Business and Law test but he was unable to concentrate due to the chemotherapy. Chairman White asked Mr. Skelton how much time he would need. A. I have three months of chemo left. Chemo makes it difficult to concentrate. I would like a little more time so I can try to take the test again. That's all I'm asking. When asked what type of work he did, Mr. Skelton replied that he has a framing business, doing trim work and custom framing. He stated his business was still in operation because his brother works for him and was running it in his absence. He does go to his office occasionally but his brother has "pretty much been the workhorse."All he wants to do is to keep his business going. Kyle Lantz: Q. You pretty much, personally, haven't been doing much work. A. No, physically, I cannot. But I can do certain things—like run after payroll and get supplies ... stuff like that. Q. Do you have employees? A. Yes—all run through a leasing company. Chairman White: Q. Who is supervising them? A. My brother. Kyle Lantz: Q. Is he an owner or an officer or just an employee? A. He is just an employee. But if this continues, then I'm going to try to make him an officer—incorporating him in my "S" Corp. Michael Ossorio stated the County would not object if the Board chose to grant the Applicant another six months to take and pass the test. Chairman White stated one of the things the Board expects a Qualifier to do is to be able to supervise jobs. A. I do go in but not all the time, especially if I'm doing my chemo rounds. Q. I understand it's very challenging. I am assuming the level of communication that you have with your brother is one that, if there are any issues or problems, you are aware of them. A. Oh, yeah. Q. You guys work together to figure out how to fix it? A. I talk to him every day. 19 September 16, 2015 Kyle Lantz: Q. What is your brother's experience? A. His is right along with mine—we grew up in the construction industry and worked together for 30+ years. Q. So he's someone you feel is pretty competent to run ... A. Absolutely, absolutely. Richard Joslin: Q. One last item. You do understand, now, that if the Board grants you another six months—you know what has to be done, right? You have to take and pass this test. A. Oh, yeah. I'm going to pass it—you'll see. Q. Okay—just so you are aware of that. A. Yes, I know. Richard Joslin moved to approve granting Jim E. Skelton another six-month probationary Waiver of Exam to take and pass the Business and Law exam. He will be granted a full license upon passing the exam. Gary McNally offered a Second in support of the motion. Carried unanimously, 5— 0. VIII. PUBLIC HEARINGS: (Note: With reference to the cases heard under Section VIII, the individuals who testified were first sworn in by the Attorney for the Board.) 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. B. Case #2015-06: Board of County Commissioners vs. Antonio Galindez, d/b/a "High Wind Aluminum Corp." (License #33352) Chairman White outlined the order of the proceedings: • The Public Hearing will be opened;witnesses will be sworn in, and accept any evidence from the parties; • The County will present its "Opening Statement," followed by the Respondent's "Opening Statement;" • The County will present its "Case in Chief," followed by the Respondent's defense; • The County may offer any rebuttal; • The Public Hearing process is then concluded. • After closing the Public Hearing, the Board will receive instruction from its Attorney, similar to a"Charge to a Jury" in a civil trial, which sets out the parameters upon which the Board members will base their decision. 20 September 16, 2015 • During deliberations, the Board members may ask for additional infolination and clarification from either of the parties. • The Board will decide two different issues: o Whether the Respondent is guilty of the offense(s) as charged in the Administrative Complaint. A vote will be taken. o If the Respondent is found guilty, the Board will decide the Sanctions to be imposed. • The Board's Attorney will advise the Board concerning the Sanctions that may be imposed and the factors to be considered. • The Board will discuss the Sanctions and vote. • The Chair will orally report the decision of the Board. Kyle Lantz moved to approve opening the Public Hearing. Gary McNally offered a Second in support of the motion. Motion carried, 5— 0. Ian Jackson, Licensing Compliance Officer, requested to enter the County's information packet in Case #2015-06 into evidence. Richard Joslin moved to approve accepting Case #2015-06:Board of Collier County Commissioners vs.Antonio Galindez, d/b/a "High Wind Aluminum Corp." (License #33352) into evidence as County's Exhibit#1. Gary McNally offered a Second in support of the motion. Carried unanimously, 5— 0. Ian Jackson presented the County's "Opening Statement:" • The County is prepared to show through documented facts and sworn testimony that the Respondent, Antonio Galindez, violated: o Collier County Ordinance 90-105, as amended, Section 22-201(2) by contracting outside 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 o Collier County Ordinance 90-105, as amended, Section 22-201(18) by proceeding on this job without obtaining applicable permits or inspections from the City of Naples Building and Zoning Division. James Morey, Attorney for the Board, noted for the record, the original Affidavit ("E-5") contained in the Administrative Complaint had been notarized and filed with the Clerk of Courts. The information packet contained an unsigned copy. Chairman White asked the Respondent if he had any questions concerning the County's "Opening Statement" and the response was, "No." The Chairman then asked the Respondent if he had an"Opening Statement." A. No, we were doing a job without a permit. It was not our intention. We weren't hiding it. Our truck was parked in front of the house. Our office staff failed or I failed to have a permit on the job site. I take full responsibility for my action. Chairman White: While I appreciate, Mr. Galindez, can you tell us about the charge of"work outside the scope?" 21 September 16,2015 • A. Yes, I currently have a Hurricane Shutter License. We did contract for some glass on this particular job. One of my employees has a GC license—he's under our payroll under the Workers' Comp and that's how we were getting the permits through. But it wasn't— our contract wasn't under his company name—it was under our company name. It was on the bottom, in the notes, we would put "Installation provided by Nolen Construction." But it's not a legal way of doing it. I mean—he's been advising me and telling me stuff that I need to do to do it on a legal way. I can sell the job but I will have to do a separate contract for the labor part if I don't have a current license to contract that job. Chairman White: That would be correct. So, you are admitting the violations for each Count? A. Yes. Q. I understand that you've taken the steps that seem to be necessary and appropriate to ensure that it won't happen again ... A. Yeah, I want to do the right thing and he guide me and told me why you don't take ... I told him I'm going to get my employee to qualify my business through the State of Florida. He said, "Why don't you do it yourself and go and take your Glass and Glazing license?" So I went and got sponsored by Collier County the day after I spoke to him in his office. Yesterday I went and took my Glass and Glazing license test. Q. How did you do? A. I just got an email and I failed—62%. I answered 31 —I needed at least 38 to answer correct and I got 31. But I know I'm going to achieve the test. I was nervous—I didn't prepare enough. I had a couple of weeks to do it ... Q. You are going to retake the exam and you hope to pass? A. Yes. I will pass. Q. I admire your confidence. A. As far as my knowledge in the business, since I graduated from high school in 1993, and I have been doing shutters and windows. I worked for several companies so I got my background—experience—doing it. Q. Here's the problem I have—there's a pattern here of work done without permits for windows and condos—what I'm saying is ... A. This is like the second violation—I think we got caught on Marco one time ... we had a permit for shutters but we didn't have a permit for the window part. Q. This would be `Strike Two' and I think our Board applies what I call the `baseball' approach—and you know what happens on the third strike. Is there anything that you would like to add at this time? A. Yes, I just want to ask for one more chance—to not suspend my license. I'm running my business and trying to make a living. Give me a chance—I can just complete my Glazing license. I just don't know if it's going to suspend m other business—to allow me to keep working in Collier County pulling permits for my shutter business. I want to have an opportunity to prove and do what I `gotta' do to prove to you that I'm going to be ... and follow all the rules and not commit these type of violations again. Q. Appreciate that, thank you. I think we're into the "Case in Chief' with the Respondent. Board members, do you have any other questions? 22 September 16,2015 • Richard Joslin: Q. I don't think your hurricane license has anything to do with the problem. I think the problem is that you did the windows with no peimit. A. Yes, I understand. I did it with no permit. Q. Correct. A. Which we—we went and got a permit for it. Chairman White asked if the County had any questions to ask the Respondent. Ian Jackson: No. Chairman White noted the Respondent had admitted he was guilty of the violations. He asked Ian Jackson if the County had anything further to add. Ian Jackson: With the Respondent's admission of guilt to both counts, the County has nothing to add. Chairman White asked the Board members if they had any questions for the County. Kyle Lantz inquired if the County was concerned about pulling permits for another contractor. Chairman White stated Nolen Construction was not the issue before the Board. Kyle Lantz stated if a contractor was pulling permits for another contractor's job, the contractor should"get in trouble." He wanted to know the issue would be addressed by the County at some point. Chairman White asked if Mr. Nolen was an employee of the Respondent. Ian Jackson stated he was given payroll records which indicated Mr. Nolen was an employee of Mr. Galindez. Richard Joslin stated the contract for the windows could have been written under the GC's name. Chairman White: I think Mr. Galindez understands what is necessary to go forward and be in compliance. A. Yes, I do. Chairman White asked Mr. Lantz if his concerns were addressed given the work relationship between Nolen Construction and the Respondent, and the response was "Yes." Chairman White asked if the County had anything further to put on the record in terms of the Public Hearing, the costs of prosecution, or whatever else the Board should know. Michael Ossorio stated the County incurred $250 to investigate each Count, for a total of$500 in costs. Richard Joslin moved to approve closing the Public Hearing. Gary McNally offered a Second in support of the motion. Carried unanimously, 5—0. 23 September 16,2015 Chairman White declared the Public Hearing was closed. Kyle Lantz moved to approve finding the Respondent in violation of Counts I and II of the Administrative Complaint. Richard Joslin offered a Second in support of the motion. Carried unanimously, S—0. Attorney Morey noted the Respondent is the holder of a Collier County Certificate of Competency (#33352). If after the Hearing, the Contractors' Licensing Board fmds that there has been misconduct, the Board may, but is not required to, impose any of the following Sanctions, either alone or in combination: 1) Revocation of a Collier County (or City) Certificate of Competency, 2) Suspension of a Collier County (or City) Certificate of Competency, 3) Denial of the issuance or renewal of a Collier County (or City) Certificate of Competency, 4) Imposition of a period of probation, not to exceed two years in length, during which time the Contractor's contracting activity shall be under the supervision of the Collier County Contractors' Licensing Board, and may be revoked for cause; 5) Restitution; 6) Imposition of a fine not to exceed $5,000, 7) Issuance of a public reprimand, 8) Requirement for re-examination or participation in a duly-accredited program of continuing education directly related to the Contractor's contracting activity, 9) Denial of the issuance of Collier County or City building permits or requiring the issuance of such permits with specific conditions, and 10) Recovery of reasonable investigative costs incurred by the County for the prosecution of the violation. Attorney Morey further advised the Board that, when imposing any of the possible Disciplinary Sanctions on a Contractor, the Contractors' Licensing Board may consider all the evidence presented during the Public Hearing as well as: 1) The gravity of the violation; 2) The impact of the violation on Public Health/Safety or Welfare; 3) Any actions taken by the violator to correct the violation(s); 4) Any previous violations committed by the violator, and 5) Any other evidence presented at the Hearing by the parties relevant to the Sanction which is appropriate for the case, given the nature of the violation(s) or the violator. Chairman White asked if the County had any recommendations concerning the imposition of Sanctions. Michael Ossorio referenced Page 2 of the Code Case Details Report ("E-7"): • 26 permits were obtained; the permit fees were paid by High Wind Shutters; • Total declared value: $153,783.00 24 September 16, 2015 Michael Ossorio recommended imposition of the following Sanctions: • a fine of$5,000 for Count I, to be paid within sixty days; • a fine of$5,000 for Count II, to be paid within sixty days; and • reimbursement to the County in the total amount of$500 for expenses incurred in the prosecution of this matter. He also recommended suspending the Respondent's license for a period of six months and placing him on probation for a period of two years. Chairman White reiterated the County's recommendations: • Imposition of a fine of$5,000 for Count I, to be paid within sixty days; • Imposition of a fine of$5,000 for Count II, to be paid within sixty days; and • Reimbursement to the County in the total amount of$500 for expenses incurred in the prosecution of this matter, to be paid within sixty days. • If the fines and reimbursement are not paid within 60 days, the Respondent's license will become null and void. • The Respondent's license will be suspended for a period of six months. • The Respondent will be placed on probation for a period of two years following the suspension. • During the two-year period, the Respondent must report all business activity to the Contractors' Licensing Board Office on a weekly basis. Chairman White expressed his concern regarding suspending the Respondent's license. He stated the Respondent had attempted to obtain his Glass and Glazing license, and asked if the Respondent passed his test, would the County consider lifting the suspension at that time. Michael Ossorio stated if the Respondent passes his test, he will then complete a full application and petition the Board to obtain his license. The Board may decide at that time whether or not to lift his suspension. Kyle Lantz: Q. Mr. Galindez, do you understand what the County is recommending for your punishment? A. Not completely understanding if my license going to get suspended or if I'm just going to get a fine, or if I don't pay the fine, is my license going to get suspended? Q. What they're recommending is a total of a $10,000 fine ($5,000 for each), plus your license would be suspended for six months. After six months, you would be on probation for two years. A. So for six months, I cannot do any work in Collier County? Q. According to their recommendations. Q. How about pending jobs that we have permitted—I got jobs that need to be addressed—I pulled permits and are not even done ... and I obtained the permit. I mean ... because we have work—pending to do in Collier County—jobs that we got contracts so the consumers—these customers `gotta' be addressed. 25 September 16,2015 Chairman White: I understand your point. A. You know, I'm willing to sacrifice and come up with the money and pay the fine. Give me the probation and I will complete my license, and I will bring my results from my test and I will pass it. But not completely suspend my privileges to work in Collier County completely. You can give me the chance of— give me a probation longer than you guys are willing to give to me. I don't care if it's two or five years. But I need to be able to do work. I know I made a mistake—I failed and I take full responsibility for my actions and I'm going to pay whatever fine. But I just need to be able to have the privilege of working in Collier County and to pull peiniits—I can't be without action—I've got twelve guys who work under me—I'd be stopping twelve families ... it's like the whole operation ... Q. I understand what you are saying. Kyle Lantz: Q. Do you do work outside of Collier County as well? A. Yes. Q. Yes. A. Most of our work—most of it is more in Collier. We do Lee and Collier. Q. The jobs that you have done that you've sold windows in the past ... for the most part, did Nolen pull the permits for all those jobs? A. Yes. Q. Would it be safe for us to assume that the 26 permits that the County talked about for windows are all through you? A. I'm sure some of them, they are—without looking at them .... I would say ... you know he has done work on his own as well. But I would say, "Yes." Q. A decent amount of them. When I consider the gravity of this --to have the maximum fine, I don't consider this at the highest gravity. The permits were being pulled—yes—and the contract was not in the right name. He's contracting for work that's not being done. However, he's not just contracting for work that's not being done in general. Obviously, he's contracted for work that he's not licensed for in this particular job and on one other job on Marco but, in general, he's getting permits pulled and they are getting inspected. I don't find the gravity —on a scale of one to ten—I don't find the gravity at a ten. Same thing on the impact for the consumer—it doesn't seem like we've gotten any complaints from consumers. I don't consider the impact at a ten either. His actions that he's taken —well, he's slowly working on—I don't know how much_he's actually studied and worked for the test. Previous violations—I mean, there's a lot of them. Kyle Lantz summarized his personal opinion: the County's recommendations were pretty severe and he would like the amounts of both fines cut by half; opposed to the six-month suspension—or any suspension—but supported the two-year probation. He felt this case was "nowhere near the extreme." Michael Ossorio noted if the Respondent had not been licensed, he would have been fined $2,000 for each Count because it was a second offense for each—but he was licensed and knew since 2012 that he couldn't do what he was doing. 26 September 16,2015 Kyle Lantz again stated he thought the recommendations were extreme. He cited the difference in penalties when compared to an earlier case where that Respondent had been represented by an attorney and received a much lighter reprimand. Four offences were involved in the previous case. Chairman White stated he agreed the County's recommendations were stricter than were warranted and he would support a reduction of the amount of the fines. He suggested modifying the six-month suspension to a denial of permit-pulling privileges until the Respondent obtained the Glass and Glazing license. He stated the lack of the Glass and Glazing license was a contributing factor or basis for the Respondent's issues—having the Glass and Glazing license would effectively prevent a repeat of the same issues in the future. Chairman White further stated he felt the Respondent had made an effort with respect to the corrective actions. He also understood the County's intent—imposing such a large fine would reinforce the importance of complying with the law. He confimned imposing the two-year probation would ensure the County's ability to revoke the Respondent's license should there be an issue in the future. Richard Joslin agreed with the Chaiiuian, stating once the Respondent obtains his Glass and Glazing license "this will all go away because he will have the credentials to do it all." Chairman White reiterated by suspending the Respondent's permit-pulling privileges instead of his license, he will still be able to complete the jobs currently under contract and for which he did obtain permits. The Respondent would not be able to pull permits for future jobs until he passed the test and was granted his Glass and Glazing license by the Board. Richard Joslin asked if any of the jobs the Respondent currently had under contract involved glass or glazing work, and the response was, "No—only hurricane shutters." Mr. Joslin again asked if any glass work was required to complete the jobs that were active and permitted by the Respondent. Antonio Galindez assured Mr. Joslin he would not touch another piece of glass until he had his Glass and Glazing license. Kyle Lantz asked the Respondent if he had other jobs under contract in Collier County for which he had not obtained a permit. A. For hurricane shutters—yes. Kyle Lantz suggested the Respondent be allowed a period of one week to apply for the permits necessary to complete the jobs under contract in Collier County. Michael Ossorio acknowledged the Respondent was scheduled to appear before the Board in October due to his probation and, at that time, could submit a list of current and pending jobs. He stated every effort would be made "within reason"to ensure those jobs received permits. The Respondent will be required to submit copies of the contracts for each job which would then be matched to the permit applications. He confiuued the County modeled its process upon the one established by the State. He further stated the County would work with the Respondent on this issue. 27 September 16,2015 Michael Ossorio explained the County's position concerning the penalty: the Respondent chose to accept contracts from Collier County homeowners valued at over $150,000 knowing he was not licensed to do the work and that was just in the County—not including the City of Naples or the City of Marco Island. The home owners could have hired a licensed Glass and Glazing contractor but didn't because the Respondent submitted the lowest bid. The purpose of the penalty was to deter others from not complying with the law. The gravity of the violation was that the Respondent was unlicensed and prevented a legitimately licensed contractor from getting the job. Chairman White concurred the penalty could be viewed as a cost of doing business. Chairman White stated he understood the County's rationale concerning the recommended penalty but it was only in the most egregious of circumstances that the Board had imposed the maximum penalties. He continued, in the case before the Board, there was a ready admission of guilt to both Counts by the Respondent and a complete understanding on the Respondent's part of how things could go over the next two years. He further stated he would support imposing a fine of$3,000 for each Count. Richard Joslin moved to approve imposing the following Sanctions in view of the Respondent's admission of guilt to Counts I and II of the County's Administrative Complaint in Case #2015-06: • Imposition of a fine of$5,000 for Count I, to be paid within sixty days; • Imposition of a fine of$5,000 for Count II, to be paid within sixty days; and • Reimbursement to the County in the total amount of$500 for expenses incurred in the prosecution of this matter, to be paid within sixty days. • If the fines and reimbursement are not paid within 60 days, the Respondent's license will become null and void. • The Respondent's permit pulling privileges will be suspended for a period of ninety days or until he takes and passes the Glass and Glazing exam. • The Respondent will be placed on probation for a period of two years following the suspension. • During the two-year period, the Respondent must report all business activity to the Contractors'Licensing Board Office on a weekly basis. The motion did not receive a Second. Kyle Lantz moved to approve imposing the following Sanctions in view of the Respondent's admission of guilt to Counts I and II of the County's Administrative Complaint in Case #2015-06: • Imposition of a fine of$2,500 for Count I, to be paid within sixty days; • Imposition of a fine of$2,500 for Count II, to be paid within sixty days; and • Reimbursement to the County in the total amount of$500 for expenses incurred in the prosecution of this matter, to be paid within sixty days. • If the fines and reimbursement are not paid within 60 days, the Respondent's license will become null and void. 28 September 16, 2015 • The Respondent's permit pulling privileges for all new jobs will be suspended until he is issued a Glass and Glazing Contractor's License. • The Respondent will be placed on probation for a period of two years following the suspension. • During the two-year period, the Respondent must report all business activity to the Contractors'Licensing Board Office on a weekly basis. Gary McNally offered a Second in support of the motion. Michael Ossorio requested to amend the motion to require payment of all fines within thirty (30) days and not sixty days. Kyle Lantz and Gary McNally agreed to and accepted the proposed amendment to the motion. Motion carried, 4— "Yes"/1 — "No." Richard Joslin was opposed. Chairman White recited the terms of the Board's Order: • In Case#2015-06, The Board of County Commissioners vs. Antonio Galindez, d/b/a "High Wind Aluminum Corp." (License #33352), the Contractors' Licensing Board has found the Respondent, Antonio Galindez, guilty on both Counts as stated in the Administrative Complaint and has imposed the following Sanctions: o Imposition of a fine of$2,500 for Count I, to be paid within thirty days; o Imposition of a fine of$2,500 for Count II, to be paid within thirty days; and o Reimbursement to the County in the total amount of$500 for expenses incurred, to be paid within thirty days. o If the fines and reimbursement are not paid within thirty days, the Respondent's license will become null and void. o The Respondent's permit pulling privileges will be restricted; the Respondent cannot pull permits for any new jobs until he is issued a Glass and Glazing Contractor's License by the Contractors' Licensing Board. o The Respondent will be placed on probation for a period of two years, to be effective immediately. o During the two-year period, the Respondent must report all business activity to the Contractors'Licensing Board Office on a weekly basis. Chairman White stated the Board's Order would be put into written foim and he would sign it as soon as it was available. Chairman White asked the Respondent if he had any questions. A. Yes. When I provide a list of my jobs dated prior to today, I will be able to pull those permits? Q. That is correct, but for hurricane shutters only. 29 September 16,2015 A. Right. Any job from today over, I won't be able to get the permit until I pass my test, submit it to the Board, and my license gets approved? Q. Yes. Even if it's just for hurricane shutters. A. Okay. Q. Okay? But if it's approved, it will include glass and you'd be good to go— assuming that we approve your application. IX. REPORTS: • Michael Ossorio noted an Operations Manager, Stephanie Amans, has been appointed to oversee the Licensing Department. • Chairman White welcomed Ms. Amans on behalf of the Board. X. NEXT MEETING DATE: Wednesday, October 21, 2015 BCC Chambers, 3`d Floor—Administrative Building "F," Government Complex, 3301 E. Tamiami Trail, Naples, FL There being no further business for the good of the County, the meeting was adjourned by the order of the Chairman at 12:30 PM. COLLIER COUNTY CONTRACTORS' LICENSING BOARD PATRICK WHITE, Chairman The Minutes were approved by the Committee Chair/Vice Chair on , 2015, "as submitted" ( 1 OR "as amended" ( 1. 30 . Coilfiergota.net Report Title: Code Case Details Date: 10/12/2015 10:31:31 AM Case Number: ceuI20150014965 Case Number: CEUL20150014965 Status: Citation Case Type: Unlicensed Date & Time Entered: 7/24/2015 2:29:25 PM Priority: Normal Entered By: ReggieSmith Inspector: ReggieSmith Case Disposition: Unpaid Jurisdiction: Contractor's Licensing Origin: Complaint Detail Description: UNLICENSED CARPENTRY, TRIANA, NEFTALI, CITATION 09936, $2000.00, 2ND OFFENSE MICHAEL'S CLEANING & HANDYMAN SERVICES BTR#072233 Location Comments: 8020 TIGER COVE Property 179890002359 ViolatorITRIANA, NEFTALI Business Management& Budget Office 1 • Code Case Details Execution Date 10/12/2015 10:31:31 AM Desc Assigned Required Completed Outcome Comments Preliminary Investigation ReggieSmith 7/24/2015 7/24/2015 Citation 07-23-15 RECEIVED COMPLAINT VIA Required EMAIL AND SITE VISITED. NO WORK ON THE WOODEN STRUCTURE DESCRIBED AS TWO BOARDWALKS/BRIDGES, LOCATED IN THE CENTER OF MULTIFAMILY HOUSING, LEADING TO THE POOL. CALLED THE COMPLAINANT, JOHN LUIS, 775-1025 TO ADVISE SAME. RS 07-24-15 RECEIVED A CALL FROM THE COMPLAINANT,WHO ADVISED THE CONTRACTOR WAS BACK WORKING ON THE BOARDWALK. I ARRIVED SHORTLY AFTER TO WITNESS, EMPLOYEE,ARIEL, FOR MICHAEL'S CLEANING&HANDYMAN SERVICES, COLLIER COUNTY BUSINESS TAX RECEIPT 0722333, ON SITE ACTIVELY REPLACING WOOD MATERIAL(BOARDS) FOR THE WEATHERED/DILAPIDATED BOARDWALK. WHEN ASKED,ARIEL, ADVISED HIS EMPLOYER WAS NEFTALI TRIANA,WHO WILL ARRIVE SHORTLY. ARIEL ADVISED THE WORK AS A REPAIR BY REPLACING DAMAGED BOARDS AND SUPPORTS UNDERNEATH. I PHOTOGRAPHED THE WORK ON BOTH BOARDWALKS FOR PERMIT REVIEW. N. TRIANA ARRIVED AND ADVISED THE SAME. I ADVISED MY LICENSING CHECK WITH INTERIM SUPERVISOR, IAN JACKSON, WHO ADVISED THE AMOUNT AND SCOPE OF WORK REQUIRED A CARPENTER'S LICENSE. I REMINDED MR. TRIANA OF HIS PREVIOUS CITATION ISSUANCE/OFFENSE AND ADVISED ANOTHER CITATION ISSUANCE OF A 2ND OFFENSE. HE STATED HE UNDERSTOOD, BUT WAS UNSURE IF HE COULD PERFORM THE WORK WITHOUT A LICENSE. I ADVISED A PERMITTING REVIEW. WHILE ON SITE, I SPOKE TO SOME BOARDMEMBERS, ONE OF WHICH WAS NAMED, BILL METRIE, 530-0719, WHO CONFIRMED THE BOARD'S DECISION TO HAVE SANDCASTLE MANAGEMENT HIRE MR.TRIANA TO REPAIR THE BOARDWALKS FOR JUST OVER$1000.00. I ISSUED CITATION 09936; SIGNED FOR AND ACCEPTED BY MR.TRIANA. I ADVISED ALL REVERSE SIDE APPLICABLE INFORMATION, EXCLUDING THE PENALTY ABATEMENT/REDUCTION IN CITATION AMOUNT. PHOTO X 10. RS Business Management& Budget Office 2 Code Case Details Execution Date 10/12/2015 10:31:31 AM Desc Assigned Required Completed Outcome Comments Issue Citation (Licensing) ReggieSmith 7/24/2015 7/24/2015 Complete ISSUED CITATION 09936; SIGNED FOR AND ACCEPTED BY MR. TRIANA. I ADVISED ALL REVERSE SIDE APPLICABLE INFORMATION, EXCLUDING THE PENALTY ABATEMENT/REDUCTION IN CITATION AMOUNT. RS Attach Picture(s) ReggieSmith 7/24/2015 7/24/2015 Complete ATTACHED PHOTO X 10, SCANNED CITATION,AND OTHER SUPPORTING DOCUMENTS. RS Cont. Investigation ReggieSmith 7/24/2015 7/24/2015 Complete 07-24-15 RESEARCHED PERMITTING REQUIREMENTS WITH MYRON JACOBS, WHO ADVISED THE BOARD REPLACEMENTS ARE CONSIDERED A "REPAIR"AT THIS TIME NOT REQUIRING A PERMIT; HOWEVER IF ADDITIONAL WORK IS TO BE PERFORMED ON THE RAILINGS, INSPECTIONS MAY BE REQUIRED. CALLED MR. METRIE, 530-0719, AND ADVISED THE SAME ON A VOICE MESSAGE. ADVISED MR.TRIANA,WHILE ON SITE, THAT HIS WORK VAN ADVERTISES"PAINTING",AND SHOULD BE REMOVED AS IT IS IN VIOLATION; HE STATED HE UNDERSTOOD. RS Citation Paid/Contested clements k 10/22/2015 Pending Violation Description Status Entered Corrected Amount Comments Unlicensed Carpentry Open 7/24/2015 $0 Title Reason I Result I Compliance Fine/Day I Condition Business Management& Budget Office 3 COLLIER COUNTY 0 9 9 3 6 _ GROWTH MANAGEMENT DIVISION C UI-4)2C)S.CG 1`t(76 TATION s s Pursuant to section 489.t ?—a er},Florida Statutes,the undersigned hereby reni8es that upon r personal investigation,he/she has reasonable and probable grounds to believe that the person whose name appears below as issued to,did violate subsection 489.127.(1),FloridaStatut i es,o and — — — CountyConfractb7'Zcasing Ordnance No.2006-4b(as may be amended)by committing the violation stated below, Month 181 Da Issued To / ' ('1 Address �c ( t 7 LJ" -" b r /V City S. State Zip '3 9/ p3 Telephone No. , / I.D. fro 7,4)clg Jlake(Ipe pplica S Year CQrA � / - A.,..) bl Location of violation OPTION I have been informed of the violation for which I have been charged and elect the following option(Check one) ,ri ,t f �[i's/� 1) ❑ 1 choose to pay the penalty of S 2a'c .C��� "`� C^(I�'.1L� 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 Volation Observed 0 2-9 t// ' a) ❑ Falsely hold self or business organization out as a licensee,certificate holder or 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 jo use certificate or regi tratigggppp which has n suspended or yoked; ��e2 i t in t e c _ac, i 1"))41- ,revoked; in the basin slot act m t e capacity •o a o racfo r a ertise self or business organization as available to engage in the business or act in rise capacity of a contractor without being duly registered or certified; g) m❑ Operate a business organization engaged in contracting afer(60)days; h)❑ Commence or perfor work for which a bud pursuant to an adopted state minimum building code or without such permit being in effect; i) ❑ Willfully or deliberately disregard or violate any Collier County ordinance relating to uncertified or unregistered contractors. A person or business organization operating on an inactive or suspended certificate, or registration,or operating beyond the scope of work or geographical scope o he registration,is not duly certified or registered. ,..0iiimppr .,. °9,,, :,,, • 5[Gi`IA ••.�hT SIGNAT :. (NV TIGATOR) ,<l Q r7,4 1 (Y 7,:t--1 y * e �[iAi PRINT(RE IENTS NAME) PRINT' t' TIGATOR'S NAME) • Pursuant to 489.127, Florida Statutes, willful refusal to sign and accept this citation constitutes a misdemeanor of the second degree, punishable as provided in section 775.082 or 775.083 Florida Statutes. (SEE REVERSE FOR INSTRUCTIONS) COLLIER COUNTY CONTRACTORS LICENSE SmithReggie From: Jacksonian Sent: Wednesday, July 22, 2015 2:10 PM To: SmithReggie Subject: FW: Unlicensed Carpentry Importance: High Follow Up Flag: Follow up Flag Status: Flagged Ian Jackson Collier County License Compliance Officer Operations and Regulatory Management Growth Management Department 2800 North Horseshoe Drive Naples, Fl 34104 239-252-2451 ianjackson@colliergov.net From: RoeSamantha Sent: Wednesday, July 22, 2015 2:01 PM To: RoeSamantha; OssorloMichael Cc: Jacksonlan Subject: RE: Unlicensed Carpentry Importance: High The Complainant called hack. He said the person left the jobsite but may be back tomorrow to repair the bridge. From: RoeSamantha Sent: Wednesday, July 22, 2015 1:53 PM To: OssorioMichael Cc: Jacksonlan Subject: Unlicensed Carpentry Importance: High 8025 Tiger Cove Naples, FL 34113 -In Verandas 2, Lely Reserve -In common area by pool -building a walkway wooden bridge -Michaels Cleaning and Handyman Service-072233 Please call complainant for feedback on the case:.775-1025 John Luis `Zi llr.71,k -p�y�.jam ' s r�'' .:,r•• � - 1.a nIR: — ••,11 te a :�:i. t 1 •••• F ! •N \ • V� AR.Wfv q.y� A 4'( ;. -ll 1 ‘-'•••••., ,�,• • �' -q i. w. ` ; _ '' . 0.1\ ,.. r .4:' A„..• • , .t...-!.3,4(t. : ; __ I. r ti '!•sue 1 :•:, -�4 Ai,r'�j - fl'„, , . , , •, •„•,..,,.., :. _=:„....:....„..._.,,.. • :, 1 1 1: i -- .1 ' .. � R 1 , :a - ' f , A4ie: I' r ' ', ,l a -c �-” _ _ j 1 ,f_ - •- qqq ~ l4 f ,.,. .4 .. .• •••.; . i i. 1 ,.... _ r- • : ' ;--..;.-••s ' 1.4.,Vr.".•••• - T ' 4 � N. • r1= e _ fy • .. ...•. 4 ‘ ,•_ . . 1. .. ..L. ....., . . _ . , . „,:„ , , . .. . . , . ii. •., :,,, •, ,.... . _‘" 1 ...., • ....-• t.. 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C6111ergonnet Report Title: Code Case Details Date: 10/12/2015 10:30:02 AM Case Number: ceu120130018572 Case Number: CEUL20130018572 Status: Closed Case Type: Unlicensed Date & Time Entered: 12/10/2013 3:26:35 PM Priority: Normal Entered By: RobinGanguli Inspector: robinganguli Case Disposition: Paid Jurisdiction: Contractor's Licensing Origin: Complaint Detail Description: Triana, Neftali. $300 citation #8288 issued for unlicensed electrical contracting. Location Comments: 8020 Tiger Cove Naples, FL. 34113 Property 79890002359 Violator Triana, Neftali Business Management& Budget Office 1 Code Case Details Execution Date 10/12/2015 10:30:02 AM Desc Assigned Required Completed Outcome Comments Preliminary Investigation robinganguli 12/10/2013 12/10/2013 Citation 12/10/13. Complaint received regarding Required possible unlicensed electrical work in common areas of Veranda Condominium located at Tiger Cove Naples, FL.34113. On site observed employees of Michael's Cleaning& Handyman Services Inc./Collier County business tax receipt#072233 for maintenance service, Ezequiel Leon and Yerlen Galvez Gomez changing out electrical fixtures and ceiling fans.Contacted business owner, Neftali Triana to advise of electrical contractor's license requirements for work observed. No permitting requirements for like for like changeout. STOP WORK order issued. Issue Citation (Licensing) robinganguli 12/10/2013 12/10/2013 Complete 12/10/13. $300 citation#8288 issued to Mr. Triana for unlicensed electrical contracting and signed for by worker Ezequiel Leon as his on site agent. Citation Paid/Contested clements_k 12/26/2013 12/27/2013 Payment Not Received Generate Follow Up Letter clements_k 12/27/2013 12/27/2013 Complete Citation Paid Clements k 1/13/2014 12/27/2013 Paid Violation Description Status Entered Corrected Amount Comments • • Unlicensed Electrical Open 12/10/2013 $300 Title Reason I Result I Compliance Fine/Day Condition Business Management& Budget Office 2 c-L- f'•5 r Fs-l- ___-. o8288 COLLIER COUNTY BUILDING REVIEW& PERMITTING . C.-c..- ( CITATION ; '4-• Pursuant to section 489,127.(3)(a),Florida Statues,the undersigned hereby certifies that upon . personal investigation,he/she has reasonable and probable grounds to believe thatthe person whose name appears below,as Issued To,'did violate Subsection 489 127(1),Florida Statutes, and Collier county Contractor's Licensing Ordinance No.97-68(as may be amended from time to time)by committing the violation stated below. •z< 1 ���� Month D�t� _Day I d•.; • YeiirJ . Titnad�' c.J M Issued To: L I T' -1')i�� •J Address -,7- t 6 7- r�-P--.1"v R. City 1!\Ili-.0 State �t = Zip ,47/(--2-i Thief hone,Nn. I.D. ' Date of Birth Race Sex Height Vehicle Mt keiType. if ap icable) Year Cofor I Tag No. �: a 4.1-1g14, uG•it_�ot� it on \ OPTIONS ( 114';('3 I have been informed of the violation of which I have been charged and elect the following option(Check one) ` 1) El I choose to pay the penalties of$, ✓b O 'i on the Citation. • 2) ❑.1 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[Sound.;:•. Description of t lgp on g Date.Vio�l^ation Observed •fi f I ' r� a) ❑ falsely hold self or business org ft tzanon o cat nee certtficatc of cr or • registrant; ; b) ❑ Falsely impersonate a certificate ladder or registrant: 1 c) 0:'Present as his own'the certificate or registration of another, d) 0 Knowingly give false or forged evidence to the Board of a member thereof; 1 . e) D Use or to use a certificate or registration'which has been suspended or revoked; t) iiiir 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 or act in a capacity of a contractor Without being duly registered or certified;" g) El Operate a business organization engaged in contracting after(60)days following the termination of its only qualifying agent without designating another primary qualifying agent,except as provided in ss 489.119 and 489.1195 Florida Statues; h) ❑`Commence or perform work for which a building permit is required pursuant to an adopted state Minimum building code;without such Permit tbeing in effect or ': i) ❑ Willfully or deliberately disregard or violate any Collter'County ordinance'relating to uncertified'or unregistered'oontraetors1 A person or business organization operating on an inactive or suspended certificate or registration,or operating beyond the scope of work or geographical scope of the registration,is not duly certified or registered. A • edir S GNAU: . b. GATOR) SIGNA.. ( CIPIENT) 'I' / t PRINT(R• IPIENT'S NAME) PRINT(INVESTIGATOR'S NAME) Pursuant to 489.127,Flori a Statues,willful refusal to sign and accept this citation constitutes a misdemeanor of the second degree,punishable as provided in section 775.082 or 775.083 Florida Statutes. (SEE REVERSE FOR INSTRUCTIONS) COLLIER COUNTY CONTRACTORS LICENSE DEPARTMENT Details Page 1 of 1 Collier County Tax Collector 2800 N. Horseshoe Drive Naples, FL 34104 Collier County Business Tax Receipt Tax Year Info: 2013 Prey.'Record Next Record BUSINESS INFORMATION OWNER INFORMATION License # 072233 Name 1: ITRIANA, NEFTALI Name: MICHAEL'S CLEANING & I Name 2: HANDYMAN SERVICES Address 1: 2167 GROVE DR DBA:I Address 2: Location: 2167 GROVE DR City, State, Zip: NAPLES, FL 34120 Zoned: HOME OCCUPATION Phone: 455-3240 Mail 1: 2167 GROVE DR Mail 2: City,State, NAPLES , FL. 34120 Zip: Open Date: 01-23-08 Phone: 572-221.4 -- PUl11 T( Changed Date: 05-21-12 Code: 03703301 uesulption: SERVICES Paid Date: 00-00-00 MAINT. Closed Date:1100-00-00 State Lic: Class: SERVICE/ NO CONTRACTOR WORK Amount Due: 26.40 County Lic: Category: EMPLOYEES ** License is: Unpaid ** City Lic: Preq: I ** License is: Open ** You may be able to pay your business tax online. More details Prey Record ( New.Search: Next Record I Baek To_Llst; 2007 Tax 2008 Tax 2009 Tax 2010 Tax 2011 Tax 2012 Tax Information Information Information Information Information information I1j tUS ) çs G� torn FREcIWETrE C.'4' e 'r$P,c G 1tNN • 014 04 CO Movto TO DECM €ER Goal lex-Coz-�n�y GMID Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 APPLICATION FOR COLLTF.R 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: r , Exact Corporate/Business Name: U l k)i i-lO 41uY►'1-butn C.c'rp Fiction Name/DBA: • Qualifier Name: 44T01V; O 4A-I ,-ti �Z-- Physical Address: t eA/1�� � � ;,1. 11-trE3 (Number& Street) (City) (State) VV (Zip Code) Mailing Address: (Number& Street) (City) (State) (Zip Code) Telephone: 9-3°() l/0— °/14 E-mail: Phony q d2) )Gh 6,41-14)sA a, S awl V 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 ) Specialty $205.00 Specialty Trade: 4/05 r t) a/ CHANGE OF STATUS: ( )Reinstatement ( ) From One Business to Another ( )Doimant License to Active Page 1 of 4 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. 4/47-0K6 0 Ontti N-a (435) . q 2R1_ I CAA utilr- E"�. LLTI 14-e/A5 F( " )3W 2. List all businesses, firms, entities or contracting businesses you have been associated with during the last ten ye s (i.e. held a license for or been a partner). Attach extra pages if needed. 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. - 1"lk k..._ AFFIDAVIT Under the penalties of perjury I declare that I have re.. the foregoing ap.lication and that the facts stated in it are true. l 7-M .tieri/ Authorizes Offic- of the■ irm The foregoing instrument as acknowledged before me this /0 /1 1/5 (Date) n by c4Ov' ; O �k n �e.Z of H;9k otv 4(uv ; ,�0wt C2 C) (Name of Officer, Title/Agent) `J (Name of Corporation) a r!0 r ,,O16} Corporation on behalf of the corporation. - ------(State-or-Place of-Corporation) ( 7-p- - - )------------ - -- --- - ---— He/She has produced e J et s L c . identification and did not take an oath. (Type of identification) NOTA°a114/°°41PA " ■ " — • — — • j,,-a2w• MAGDALENAPACHECO 0 4/l--- ----"'" - Notary Puente•Bute of florbs Commission.R 91110 (SIGNATURE OF NOTARY) ( *r_ My Comm.Expires Sop 21,2019 4 '••m arriNu 1 fach National Notary Aim i Page 2 of 4 QUALIFIER L FORIVLATION: Name: CPT hi C5 G C7-- Address: 9 u t L4 A 4r&-3 El '3397/ (Number&Street) (City) (Stile) (Zip Code) Telephone �3 yd. gtf }'I Date of Birth: SS#: E-mail: 44 10NY s, as%-b_RS- Driver's License#: 1. Type of Certificate of Competency for which application is made. 6456 0-4,O /,1-7; 2. The names and telephone numbers of two persons who will know your whereabouts. AM PA-th iC v ( 3 ) 'e7 996 3 aietv 0 a-(iwo z___ ���j) ?3 q 3. Have you ever been convicted of a crime related to Contracting? (If yes,attach extra sheet with explanation.) 4. Have you or any firms you have been associated with ever filed bankruptcy? 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. j a-001 eV01aui+4 Hjw►E W W.00‘0.5 (11 — 4,06 J W)VOdie.5 v ivy �l wi1ory S 2-450,-- COI/ icl>/c)-f75 Cdwe "I'd ) ab11 — 2-a 13 7. Statement of any formal training you have had in the area for which the application is made. k4c 8E1 IL.io w�►-l� Dorty -Fit( ,-f(, 4p s e,r gfrAD o WS F 1-'1,t -pa Sr PB yearr5 3 of 4 • 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 infoituation 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. 4149-01v 6,41.el-- Applicant (please print) 1,11- It VjT}v0 41(4kw uyl Nameof Company 1..i� Signature of • t State of Florida County of L e.2. The foregoing instrument as acknowledged before me this /D /i /ir 11 (Date) by 1%n+o v1, i c e Z who has produced e c‘* L (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SE ,r MAGDALENA PACHECO � Notary Public-State of Florida _ Commission 914054 SIGNATURE OF NOTARY) My COMM.Wins Sep 21,2019 - - 4 ofa" • 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 Ce 'ficate of Combete cy. Signature of Appl'can-,, Busines ame b\ t \ 15 Date BEFORE ME this day personally appeared P047-0 t,ft 0 (.2.:y14\,`tt.- 0 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 Le 2 The foregoing instrument as acknowledged before me this / �i /5- (Date) by 'AY1 %O Cam\ A, z Z who has produced "bt s L c . (name-of-person (type-of identification- ---- __ --- —--- as identification and did not take an oath. ibrosilibrribidwarandearbsdhoor NOTARY'S SEAL) ,w; MAODALENA PACHECO Notary Public-State of Florida IT 914054 (SIGNATURE OF NOTARY) .2 My Comm.Expires Sep 21.2019 �•a� Osxdolthmash Moroi Notary Assa • VERIFICATION OF CONSTRUCTION EXPERIENCE:. GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: rOh 0 Certificate Category Requested: 6155 fvr) 64' l%/ The applicant is seeking a Collier County Certificate of Competency in the trade i ated 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: ,TG.r S [- NA IQ/ 'r Title: i�`t 5 d F n 4 C C°r( i License Number(if applicable): -k S2 0 , C, Name of Business: S crr\ \�,c - ,, Business Address: 3��{j {�P ` �12-,�o Q\ ) i I Q S -7 ape Cowl L J l 0 Business Phon .,23') 7 0-7-4,O$ & The applicant's years of experience fromo?O0 to 020 1 The applicant's scope of work(specific duties) included: T rvs \\ n1oL, okr1) C\op ‘(\C •-tS c�i"i;� j••.,,,G, Q k-k • Additional comments: Falsifying any information provided herein may subject your license to revocation. Under the penalties of perjury I declare that I have read the fo going applic- '. - • a facts stated in it are trues • -tt�r�— —� _ one hi,o Print Name State of Florida County of L cz The foregoing instrument as acknowledged before me this q /,2 9 //5— — — (Date) by Jct v+A-e 5 it) y who has produced o r L c (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S — — — — — — — /J,r 1 rw MAGDALENA PACHECO 4 /�G firvA Notary Public-State of Florida (SIGNATURE OF NOTARY) Commission FF 914054 r �..�x My Comm,Expires Sep 21,2019 4 _ _ _ 9ondedthmugh twang Notary Ann. -VfR 1_ II. . • b ' �t • ay GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: 4-141-0 v i 0 40,-(1),, et-- Certificate Category Requested: e71i46fi a° viD 6/42;1w The applicant is seeking a Collier County Certificate of Competency in the trade�jdicated 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: .5`v _.4. / A/ fr7 6rL- Title: b`W tom S.l 4,6 /rArs�,o4 ,ad License Number(if applicable): Name of Business: «—A 1.6.1.4/ /1",Z °7 tU/N.�C Business Address: relic 14-7-64-s CI c 33 7/ e Business Phone:oZ37 LC 9/ 3 /t 3 The applicant's years of experience from 17?7 to �i>C The applicant's scope of work(specific duties) included: :2745"44)--,741.-c-9-7./0", - �'c'�d Jc.c_S .• ; mac-J fs` c v�` ' 1--,1-/-7— eNi A p "ie Additional comments: 11 /) (trAL/77 e00 C- — �/( i/ l'4'r ('��7`7 Falsifying any information provided herein may subject your license to revocation. Under the penalties of perjury I declare that I have read the f6 e_o' g application and t the s stated in it are true. Signature Print Name State of Florida County of The foregoing instrument as acknowledged before me this (/�//5- --(Date)------ —by ,Ri E 5 0:2A who has produced -t`tit,n(name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S H MAGOALENA PACHECO` •• •. Notary Public-State of Flortde • • Commission#FF 914054 (SIGNATURE OF NOTARY)it My Comm.EXPlrs Sep 21,2019 1 lsbedttroKAIII lour Nosy VERIFICATION OF CONSTRUCTION EXPERIENCE`; GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: 11-/-rrolv y 0 G411 Jv ID EZ Certificate Category Requested: (g}-5 j P-1,1) 447 I' ^' - The applicant is seeking a Collier County Certificate of Competency in the trade i,�d ated 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: \At 614\ N t)I G I4 Title: 0 V"( M C k License Number(if applicable): C C-�(. 15 1 4� 5 3 Name of Business: 1\1 I ii d I i1 S G 0/4 5-1" . o Business Address: b 3 C-0 tz /► i 13 is - D '•r,7 113014 ` F! -34 21 Business Phone: 5 b' 7. ( b b 11 The applicant's years of experience from 'Zo f 1 to Zvi' The applicant's scope of work(specific duties) included: NA EA 5 r-M Ekj r ! Ddrizi 1,19 Additional comments: Falsifying any information provided herein may subject your license to revocation. Under the penalties of perjury I declare that I have read the foregoin ap 1 ation .rd that the facts stated in it are true. / Signature i W iA �0 � Print Name State of Florida / County of L P_�. The foregoing instrument as acknowledged before me this /d /: 11 -----a a --- — -by (1-),\� . y1,.e n who has produced ∎ve L;-c__. - (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S -" MAGDALENA PACHECO Notary Public-Stag of Florida -- - �nan ssioa•FF 91+054 (SIGNATURE OF NOTARY) y My Opp,E> =Sp 21.2019 ?.3 so,aiearouON NUY Assn. AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STA I'E OF 11 0 d't,ll9ti COUNTY OF 1,4-C._ I,lit afrt44 V it-z n,/yr , having been first duly sworn, state and affirm: I am a resident of 1-,-r-C County, F.1 01- J& (State) and have resided here for more than five (5) years. During the last five years I have known A j40 n t 6 Cw ii nottZ(applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her jeisiAA to be a person of honesty, integrity and good character. ignaturre A0N9.ArS,__ O(F Name 3d' Brd ad 4v- 4-ceks i f Jcs �J q, 33' 3 Address I23R 0'-r1 -e c Telep The foregoing instrument as acknowledged before me this JO /i "ii to by 40o .Q S 9Z.n0O - who has produced (name of person acknowledging) (type of ide tification) as identification and did not take an oath. NOTAR MA60ALENA pACHECO Notary public-State of Florida (SIGNATURE OF NOTARY) MOW 4411 Commission.Expires#FF 914054 Comm Sep 2019 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER • STATE OF -1OY l COUNTY OF (fr. I, 3ennt-ca LJlav-h0 , having been first duly sworn, state and affinii: I am a resident of (eC, County, -Rov da (State) and have resided here for more than five (5) years. During the last five years I have known an-boo BOilhC1Cz (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. )Uat*--- Signature J exnfev Ltavhv Name 3031 20 It' W (vil\ 3eS• PC • 336/71 Address 6141 3F0 42 Telephone The foregoing instrument as acknowledged before me this /0 / J 1,S — — ate by-e,ntl,',0eC scA-t ,r1 who has produced (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S VAL,_ _ _ _ _ _ _— _ _ � I , MAGDALENA PACHECO (less) Notary PupNc•8hte of Fbrfd, (SIGNATURE OF NOTARY) Commhuion#F FF 914054 My Cow.Expires Mem!Sep Notary 19 Assn. ' RESOLUTION OF AUTHORIZATION WHEREAS -W , w� W 4,t'�t dA proposes to engage- _ (Name of Business Entity) in contracting as 44-edit_. 1411410 &IM Cot-p ` in VV (Type of legal entity: corp.,partnership, etc.) Collier County,Florida,according to Collier County Ordinance 2006-46,as amended: and WHEREAS I1 7 Pt W 1�6 Kg 1)W1 I proposes to qualify (Name of Business Entity) for a Certificate of Competency with 4#- f viv:a 641i-ivy 62-- . (Name of Individual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: We the undersigned 4/47 /) 7 jh/ of (Officers,Owners,Partners) U1/0 -t/,y'/4Vi!✓\ hereby resolve and represent to the Collier County (Name of Business Entity) Contractor's Licensing Board that the qualifying agent, 4IEt1731liO 64,6vDEZ,is active (Name of Individual) in all matters connected with the contracting business of gi,q It r,(JA.i 4- )vS'✓,1and V (Name of Business Entity) We further resolve and represent that 147Vrish,ro 644,v•L2 is r q� ,� I (Name of Individual) Legally empowered to act for I klJtvO lddkv;i$7 in all matters connected with its gq�1 (Name of Business Entity) contracting business,and has the authority to supervise construction undertaken by %: I , 1 �'(UWti)ivi s 6or- . fe�:fBusiness Entity) D / Y PASS ! AND ADOP 1'ED THIS I DAY OF 0 C., i , x-015 � / (Officers,Partners,Owners-with designation underneath) i %: 4lu`taNTp 6 iryfZ sitn,s / W . ess Corporate Seal(if applicable) or Notary Public Certificate Sworn to and subscribed before me this I day of bG - by The foregoing instrument as acknowledged before me this "/. /,, ,Qf (Date) by N,1 k-o rL;77 G`‘vt..--�...C___ who has produced s�, ,s L,-c. (name of person acknowledging) (type of identific 'o - as identification-and did not take an oath. NOTARY'S SE Al —— —--— — — — — — — MAGDALENA PACHECO .tiii Notary Public•State of Raids 1 r IGNATURE OF NOTARY) Commission 0 FP 91405 *. • My Comm.Expires Sep 21,2019 0ondsd through Naomi NotaryAssn. 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. ----- -_r._. Page 1 of 1 Score Report IPrint 4, i fig*:- rro -. Galindez,Antonio Name: Antonio Galindez Test: Glass&Glazing-(FL08114) Sponsor Collier County Date' 09/24/2015 ID* Test ID. 661326730 Score: 78 Resin, Pass #Unanswered Questions 0 Module Subject Area Status LOW FLPRE Plan Reading&Estimating F Cut Score HIGH FLG&G 1 Glass&Glazing P INN FLP&G V Plastic&Glazing FLSEAL� Sealants P FLOW Curtain Walls P F FLSGS Structural Glazing Systems FLBE&M Bath Enclosures&Mirrors F FLSAFE b Safety ------------ P - • :\Users1bbrawley\APPData\LocallMicrosoftl WindowslTem porary TntP, r. I � • • I l iB::1il7ii' .. LICENSE R --111We • • i ,,eeCo4,, Lee County Tax Collector SU000109 Tax Co for 2480 Thompson Street Fort Myers, Florida 33901 %ofF101‘am www.leetc.com Tel: 239.533.6000 Local Business Tax Account: 0806162 Dear Business Owner: Your 2015-2016 Lee County Local Business Tax Receipt is attached below. The receipt is non- regulatory and is issued using the information currently on file with our office. It does not signify compliance with zoning, health or other regulatory requirements nor is it an endorsement of work quality. Annual account renewal notices are mailed in August to the address of record at that time; to ensure delivery of your annual notice, mailing addresses may be updated online at www.leetc.com. If there is a change in the business name, ownership, physical location or if the business is being closed, please follow the instructions on the back of this letter to transfer or to close the account. I hope you have a successful year. Lee County Tax Collector Detach and display bottom portion and keep upper portion for your records sieeec°uny LEE COUNTY LOCAL BUSINESS TAX RECEIPT 2015 - 2016 ix Co for ACCOUNT NUMBER: 0806162 ACCOUNT EXPIRES SEPTEMBER 30, 2016 efe of F\o�aa May engage in the business of: HURRICANE SHUTTER CONTRACTOR Location 819 CALVERT AVE LEHIGH ACRES FL 33971 THIS LOCAL BUSINESS TAX RECEIPT IS NON REGULATORY HIGH WIND ALUMINUM CORP GALINDEZ ANTONIO THIS IS NOT A BILL-DO NOT PAY 819 CALVERT AVE LEHIGH ACRES FL 33971 PAID 390588-73-1 09/01/2015 09:42 WEB $50.00 • ACtaRCP CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 7/13/2015 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). PRODUCER CONTACT NAME: FED*USA 01648/ROSSMAN INSURANCE SERVICES PHONE, , I wc,l,,,k 4922 LEE BLVD E-MAL ADDRESS: LEHIGH ACRES FL 33936 INSURER(S)AFFORDING COVERAGE NAIC11 (239)303-1224 (239)303-1247 INSURER A: FEDERATED NATIONAL 10790 INSURED INSURER B HIGH WIND ALUMINUM CORPORATION INSURERC: HIGH WIND SHUTTERS INSURER D: 819 CALVERT AVE INSURER E: • LEHIGH ACRES,FL 33971 INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT,TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN,THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES_LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR TYPE OF INSURANCE R qwD POLICY NUMBER JMMIDCDIYYYYI 1MMIDD!Y SCP LIMITS GENERAL LIABILITY EACH OCCURRENCE $$1,000,000 ✓I COMMERCIAL GENERAL LIABILITY EMISESS((Ea ooeurencel S$100,000 CLAIMS-MADE 1151 OCCUR GL-0000023262-01 7/1712015 7/17/2016 MEDEXP(Any one paten) $$5,000 PERSONALS Am/INWRY $$1,000,000 GENERAL AGGREGATE $$2,000,000 GEN'L AGGREGATE UTAITAPPLIES PER PRODUCTS-COMP/OP AGG $$2,000,000 POLICY JPECT P1 LOC S AUTOMOBILEUABILITY COMBINED tSINGLEUMIT • ANY AUTO BODILY INJURY(Per person) S . —ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS ED I PROPERTY DAMAGE HIRED AUTOS —AUTOS — S UMBRELLA LIAR OCCUR EACH OCCURRENCE S EXCESS IIAB CLAIMS-MADE AGGREGATE _ S DED RETENTIONS $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YI N TORY LIMITS ER ANY PROPRIETOR/PARTNER/DO=CUT1VEI N!A (Mandatory In NH) EL EACH ACCIDENT S EXCLUDED? 3 r1fyya�., E.L DISEASE-EAT:MPLOYEE$ DESCRIPTION OF OPERATIONS below EL DISEASE-POLICY LIMIT S , DESCRIPTION OF OPERATIONS!LOCATIONS I VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) INSTALLATION OF HURRICANE SHUTTERS 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 AUTHORIZED REPRESENTATIVE 1988-2010 ACORD CORPORATION. All rights reserved. ACORD 25(2010105) The ACORD name and logo are registered marks of ACORD ACOREP® CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY) 11/20/2014 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER.THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder Is an ADDITIONAL INSURED,the policy(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). PRODUCER CONTACT Lutgert Insurance-Ft Myers PRONE Mildred Kraujalis 12660 World Plaza Ln Bldg 73 (A/C_A►o,Fat).239- FAX No):239-936-8288 Fort M ers FL 33907 ADDRE mkrau'alislut ertinsurance,com y ADDRESS: @ g INSURER(S)AFFORDING COVERAGE NAIC S INSURER A:FUBA INSURED HIGHW-1 INSURER B: High Wind Aluminum Corp.dba INSURER C: High Wind Shutters 5582 Lee St,#2 INSURER D: Lehigh Acres FL 33971 INSURER E: INSURER F: COVERAGES CERTIFICATE NUMBER:159283840 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POUCIES 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. LTR TYPE OF INSURANCE I�NSD SWVD POLICY NUMBER (MMMIDCYD/YYYY) (MMIDD/YYYPY) LIMITS COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ CLAIMS-MADE OCCUR DAMAGE (Ea occurrence) $ MED EXP(Any one person) $ PERSONAL 8 ADV INJURY $ GENt AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY JECT LOC PRODUCTS-COMP/OP AGG $ OTHER: $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT - $ (Ea accident) ANY AUTO BODILY INJURY(Per person) $ ALL SCHEDULED BODILY INJURY(Per accident) $ HIRED AUTOS AUTOED PROPERTY DAMAGE (Per accident) $ UMBRELLA UAB — OCCUR EACH OCCURRENCE _ $ EXCESS UAB CLAIMS-MADE AGGREGATE $ DED I RETENTION$ $ A WORKERS COMPENSATION 10655793 11/17/2014 11/17/2015 AND EMPLOYERS'LIABILITY YIN X STATUTE ER ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? N/A E.L EACH ACCIDENT $1,000,000 (Mandatory in NH) If yes,describe under EL DISEASE-EA EMPLOYEE $1,000,000 DESCRIPTION OF OPERATIONS below E.L DISEASE-POLICY UNIT $1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached If more space Is required) Qualifier.Antonio Galindez is Included Fax:239-252-2469 CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Collier County Board of County Comissioners Contractors ACCORDANCE WITH THE POLICY PROVISIONS. Licensing 2800 North Horseshoe Drive AUTHORIZED REPRESENTATIVE Naples FL 34104 V .v(. ©1988-2014 ACORD CORPORATION. All rights reserved. (CORD 25(2014/01) The ACORD name and logo are registered marks of ACORD Detail by Entity Name Page 1 of 2 FLORIDA DEPARTMENT OF STATE DIVISION of C ORPORATIoy s sk . Detail by Entity Name Florida Profit Corporation HIGH WIND ALUMINUM CORP. Filing Information Document Number P08000067664 FEI/EIN Number 90-0401260 Date Filed 07/17/2008 Effective Date 07/16/2008 State FL Status ACTIVE Principal Address 5582 LEE ST 2 LEHIGH ACRES, FL 33971 Changed: 02/28/2013 Mailing Address 819 CALVERT AVE. LEHIGH ACRES, FL 33971 Registered Agent Name &Address GALINDEZ, ANTONIO 819 CALVERT AVE LEHIG ACRES FLORIDA, FL 33971 Officer/Director Detail Name&Address Title P GALINDEZ, ANTONIO 819 CALVERT AVE LEHIGH ACRES, FL 33971 Annual Reports Report Year Filed Date 2013 02/28/2013 2014 02/01/2014 2015 02/21/2015 http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultDetail?inquirytype=Entity... 9/29/2015 Detail by Entity Name Page 2 of 2 Document Images 02/21/2015--ANNUAL REPORT View image in PDF format 02/01/2014--ANNUAL REPORT View image in PDF format 02/28/2013--ANNUAL REPORT View image in PDF format 04/30/2012--ANNUAL REPORT View image in PDF format 04/28/2011 --ANNUAL REPORT View image in PDF format 04/26/2010 --ANNUAL REPORT View image in PDF format 08/26/2009 --ANNUAL REPORT View image in PDF format 02/28/2009--ANNUAL REPORT View image in PDF format 07/17/2008 — Domestic Profit View image in PDF format Covvrioht©and Privacy Policies State of Florida,Department of State ban://search.sunbiz.org/Inquiry/CorporationSearch/S earchRe sultDetail?inquirytype=Entity... 9/29/2015 Sep 2E) 1510:24a 2392770167 p.1 WNW • TIT Merit Credit ....cast, A ccurate & Secure. Phone: 1-239-277-3202 or 1-800-371-3348 Fax Cover Sheet: Requested Credit Report Attached! Please call if you have any questions. CONFIDENTIALITY NOTICE:This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception, review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. Sep 29 1510:24a 2392770167 p.7 Premier Profile-HIGH WIND ALUMINUM CORP • •. • Subcode:970135 Ordered:09/29/2015 08:34:52 CST .: OM i:Experian- Transaction Number.0501019548 •�+��• Search Inquiry:HIGH WIND ALUMINUM/5582 LEE ST STE 2/LEHIGH A world ofinsiglit ACRES/FL/33971/US/239-590-9463/884548659 Model Description: Intelliscore Plus V2 ' Business Nare < c Business Ideniticaticn Number HIGH WIND ALUMINUM CORP. -`• =--=.4" 884548659 °s'i-tip• Doing Business As: HIGH WIND SHUTTERS Website: htto://www.downtownbedford.conl Primary Address: 5582 LEE ST STE 2 Phone: (239)590-9463 LEHIGH ACRES,FL 33971-1560 Tax ID: 90-0401260 41 This business is the ultimate parent. See the corporate hierarchy by clicking here TOP 0 Risk Dashboard •'Risk Scores and Credit,Ll Mit:Recommendafiori: `.:: :_Da s:.Se. and Tersns,. .:. .:. ..... :, .. � .:.,.Y ,:..•.........:._:. Derogatory'ke�jat^'; ,,:�:: �: >,�Fra��i°idle Intelliscore Plus Financial Stability Risk Company DBT Original Filings High Risk Alerts 7` 4"'. MEDIUM 4M.`': LOW RISK .•�q LL.:) RISK Score range: 1 -100 percentile Industry DBT:4 Credit Limit Recommencation:$17,800 TOP 0 Business Facts Years on File: 7(FILE ESTABLISHED 04/2008) SIC Code: State of Incorporation: FL LUMBER; PLYWOOD,MILLWORK&WOOD PANELS-5031 Date of Incorporation: 07/17/2008 LUMBER&BUILDING MATERIALS DEALERS-5211 Business Type: Profit NAICS Code: Contacts: ANTONIO GALINDEZ-PRESIDENT Lumber,Plywood,Millwork,and Wood Panel Merchant Wholesal ers- GALINDEZ DAVID-VICE PRESIDENT 423310 Other Building Material Dealers-444190 RAZNOFF THOMAS-OFFICER Number of Employees: 3 Sales: $4.385,000 TOP 0 Commercial Fraud Shield Evaluation for: HIGH WIND ALUMINUM CORP, 5582 LEE ST STE 2,LEHIGH ACRES, FL33971-1560 Business Alerts' .:.: ._._ .. ..... . .........._._ .. _ ._._,... ._ -_....__. .. ..._ ._.____. .._.... .._VerificittinttTriggers.....___._. ..__.__. Active Business Indicator: 1 Experian shows this business as active BUSINESS ADDRESS IDENTIFIED AS —~-� RESIDENTIAL Possible OFAC Match: Ii No OFAC match found Business Victim Statement: W• I No victim statement an file TOP 0 Credit Risk Score and Credit Limit Recommendation 'Credit RiskScore'1ntefllscore'041i' = Current Intelliscore Plus Score:74 Risk Class:2 Premier Profile-HIGH WIND ALUMINUM CORP i/c Sep 29 1510:25a . 2392770167 p.8 • . . . . . . ... . .. . . 74 • Hi g h • ,.,,.., IIIDI *N ,,,,,,,j,_ ,.„. ,.._ Low Risk ,.,_.'" • ''. . - —- ; Risk _ . . . 0 10 25 50 75 100 ....----- —""""...."------"----"-"*".."..."--.-----"----1 :Fmmt7r7e.-77,Tc75.717,77.7111 .—.---„...—......• The risk class groups scores by risk into ranges of similar performance.Range S is the highest risk,range 1 is the lowest risk. This score predicts the likelihood of serious credit delinquencies for this business within the next 12 months.Payment history and public record along with other variables are used to predict future risk. Higher scores indicate lower risk. Factors lowering the score Industry Risk Comparison > NUMBER OF RECENTLY ACTIVE COMMERCIAL ACCOUNTS 73%of businesses indicate a higher likelihood of severe delinquency. > COMMERCIAL ACCOUNT DELINQUENCY IN LAST 12 MONTHS > LENGTH OF TIME ON EXPERIAN'S FILE > RATIO OF TOTAL BAL TO TOTAL HIGH BAL ACROSS ALL COMM ACCTS Quarterly Score Trends Quarterly Score Trends .-. . loaf go i •: • 80 i• 72 ... 704 ' -',- : . • 63 63 . .. ! : ! • : The Quarterly Score Trends provide a view of the 50-i• : . . . likelihood of delinquency over the past 12 months for this .:.•...,, ...;. .:- .• . ... . .,.- . 50 i' ! business.The trends will indicate if the score improved, Art I .,%.-74.911,,S,.:-' 1.'•-••-:',':' 1,:,,'.*::::''f.1,f, :.:p.,''t.;.,i'..tr,:-;,:.':.., .'..!:7.::::;:j.,;:.:,.•.;!',.,.: .: remained stable,fluctuated or declined over the last 12 -", 1 iz•-•7,4r;:.;:::,,,,a--_•:;.•-,:;!- :-,-...--:,...,: :‘::::i... .,;r.,.. ::::.„,.;ii.,•,-,:i-i:f;:,,t3.:. ., t.,-,;:,.,,,,•::;:;.,,,..::::„... ..,: : :..,-f•;:,s,3;; ;;,?,.ii:,.:• ,!:. 1.?_ .'.: 1-;i• ,.:,:k3:;"::*-V-t:•4!V•!': ....:-t-it', •-:.•:; t,...,•.::!- • months. 3D-; .!:;1:,:.;t---,,•=.,::-'•':,i.: 4.:.,13.tt.ltviefip. .-:,4::1:44.;:,,.-..: :-.7•.-,,,:-.N4,,.-4v. _...•.,•:-.„.;'•--",: ' ">•'''•:,,,,•I'... ..-,::•4, ?..,:: ,';',•:..!,4:k.••Ai.:,;.ricA .. 20 1. .,••::—. ?' .:.,2:*-..,' !.-:. '.--..1-:.:41,,_ L --•_":-.•:-41::. - .:•••`) ,-:, ,,,,_ , • ,. 0 4:'•• .___. ........ DSZ' SIXt. 1\114 SS? Credit giikSaAinfinanoal.$tab!lity:;Risk': :::.:• '..," .:•• . ..•... .•• - . .::':. ::,.:•:::.:.:.- -..'•':: .•:1 ,...:,..'. --•. :: ..•..,:.--:!,,,:'...i:•;.:c.=:-:- :::•, -':'• Current Financial Stability Risk Score: 96 Risk Class: 1 . „ . . 06 - --LOW-RISK—' .• High ,vlltllIlmmw- ' Low The risk class groups scores by risk into ranges of similar Risk .,=" . -- - " _. Risk performance.Range 5 Is the highest risk.range 1 is the lowest risk. 0 ,J 10 30 65 100 This score predicts the likelihood of financial stability risk within the next 12 months. The score uses tradeline and collections information,public filings as well as other variables to predict future risk.Higher scores irdicate lower risk. Factors lowering the score Industry Risk Comparison > NUMBER OF ACTIVE COMMERCIAL ACCOUNTS 95%of businesses indicate a higher likelihood of financial stability risk. >RISK ASSOCIATED WITH THE BUSINESS TYPE ). RISK ASSOCIATED WITH THE COMPANY'S INDUSTRY SECTOR > EMPLOYEE SIZE OF BUSINESS Credit Limit Recommendation This recommendation compares this business against similar businesses in the Experian business credit database.It is based on trade information,industry,age of business and the Intelliscore $17,800 Plus.The recommendation is a guide.The final decision must be made based on your company's business policies. lop a . . . . . Payment and Legal Filings Summary Premier Profile-HIGH WIND ALUMINUM CORP Sep 29 1510:25a . 2392770167 p.9 . Payment Parforrnance 1. - :'' ; ' . ' '.Trade and Collection Balance ::- -,: !' .;: •- :. . LegatFilings:::::,:-.',::,',i:!:: .-,:.--,f.;....-.....--; -S.",:---r• Current DBT: 0 Total trade and collection(7): $2,500 Bankruptcy: No Predicted DBT as 1112512015: 1 All trades(7): $2,500 Tax Lien filings: 0 Judgment filings: 0 Monthly Average DBT: 0 All collections(0): SCI Sum of legal filings: $0 Highest DBT Previous 6 Months: 0 Continuous trade(4): $1,500 UCC filings: 0 Highest DBT Previous 5 Quarters: 14 6 month average: $700-$2,400 Cautionary UCC filings: No Payment Trend Indication: Highest credit amount extended: $4,900 Payments are stable Most frequent industry purchasing terms: NET 30,REVOLVE.CONTRCT lndcstryComparlsori Industry DBT Range Comparison DBT Norms The current DBT of this business is 0.80%of businesses have a DB7 range of 0-5. All industry 5 DBT for this business: 0 Same industry: 4 Industry Payment Comparison • Has paid sooner than 50%of similar businesses v •--4t4i-bof-bi3sterttt-e-V-''''"`'-'''''''''''''=11111V:f, ■ . , , ■.,.: D BT 1,---...,.La2..,t--...—:—„,---2L62'...52‘2-jj---j TOP CI Payment Trending DBTTrends Monthly DST Trends Quarterly DBT Trends 20.0 7''' ' 20.0 -. 17.5-' : 17.5- . . 15.0 i- 15.0 .1 • 14 12 5-* .- - - - - : 12 5 i . : ! 10 0 -; ' ' " - I --`• -,: .- . - - I i .. . . . . 7.5 -, ' 7.5 60- . 5Z : 1 1 ' ; ;*; 2.54 i 2.5 ;- 7- 0.0— :41111rAIPSAar-AlittalMr., 11PtfAllIr2 —— ' 40%1111V-41111."--- 0.0 vossr.,‘s itvicesori AS sips siotoo-N5c,vtiar.. '3CI-4'°' 3e4 AC114 AC116 Payment Trends Analysis Account Status LUMBER,PLYWOOD,MILLWORK&WOOD PANELS-5031 Days Beyond Terms Business Date Reported Cur Industry Balance Cur 1-30 31-60 61-90 91+ DBT DBT CURRENT 90% 4 0 $1,500 100% AUG15 90% 4 0 $1,100 100% JUL15 90% 4 0 $700 100% JUN15 90% 4 0 $700 100% MAY15 91% 3 0 $',100 100% AR15 91% 4 0 $2,400 100% MAR15 90% 4 0 $1,000 100% Quarterly Payment Trends Premier Pratte-HIGH WIND ALUMINUM CORP 315 Sep 29 1510:26a 2392770167 p.10 Payment History-Quarterly Averages Account Status Days Beyond Terris Quarter Months DBT Balance Cur 1-30 31-60 61-90 91+ Q2-15 APR-JUN 0 51,400 100% al-is JAN-MAR 0 $1,300 100% Q4-14 OCT-DEC 1 $1,500 91% 9% 03-14 JUL-SEP 3 $1,900 79% 21% 02-14 APR-JUN 14 $3,300 67% 13% 10% 10% TOP 0 Trade Payment Summary Trade Line Type Lines Reported DBT Recent High Balance Current 01-30 31-60 61-90 91+ Credit Continuous 4 $7.400 $1,500 100% New 0 $0 Combined Trade 4 $7,400 $1,500 100% Additional 3 $5,400 $1,000 100% Total Trade 7 $12,800 $2,500 100% TOP 0 Trade Payment-New and Continuously Reported Trade Details • Payment Experiences •. • • , . :;Acebitet Stus : :(TradeilititS,Witit an.{")after the data are newly reported) ' -"' Days Beyond Terms Business Date Last Payment Recent High Balance Cur 1-30 31-60 61-90 91+ Comments Category Reported Sale Terms Credit FINCL SVCS 09)2015 0812015 REVOLVE $1,100 $600 100% PACKAGING 08/2015 NET 30 $1,400 $200 100% GUST 4 YR PRNTG&PUBL 09/2015 VARIED $4,900 S700 100% ROOF CONTR 09/2015 NET 30 $0 top 0 Trade Payment-Additional Trade Details Payment Experiences Account Status - - • • - • - • • - ....(Trade Lines with an(1 rafter the date newly reported4 z-•• - •Days Eleyond,Terthi- '• Business Date Last Payment Recent High Balance Cu' 1-30 3140 61-90 91+ Comments Category Reported Sale Terms Credit ALUMINUM 06/2013 02(2013 VARIOUS $700 $0 CUST 1 YR AUTO RENTL 09;2015 NET 30 $0 CRED CARD 09;2015 0912015 CREDIT S4.700 $1.000 100% TOP 0 Additional Business Facts Corporate Registration : : • THE FOLLOWING INFORMATION WAS PROVIDED BY THE STATE OF FLORIDA. THE DATA IS CURRENT AS OF 09/29/2016: State of Origin: FL Date of Incorporation: 07/17/2008 Current Status: Active Business Type: Profit Charter Number: P080000876 Agent GALIN DEZ ANTONIO Agent Address: 819 CALVERT AVE LEHIG ACRES FLORIDA,FL TOP Corporate Linkage : 11. 1 ,.•' •-•'; 1;- Premier Profile-HIGH WIND ALUMINUM CORP 4/5 Sep 29 1510:26a 2392770167 p.11 ,:;:".=;.BIN :. :.;:<•,;::: _;:. The Inquired upon business,HIGH WIND ALUMINUM CORP,is the Ultimate Parent HIGH WIND ALUMINUM CORP 5582 LEE ST STE 2-LEHIGH ACRES,FL 884548659 Branches of the Inquired upon business: HIGH WIND ALUMINUM CORP 5582 LEE ST STE 2-LEHIGH ACRES,FL 967821792 TOP 0 Experian prides itself on the depth and accuracy of the data maintained on our databases. Reporting your customer's payment behavior to Experian will further strengthen and enhance the power of the information available for making sound credit decisions. Give credit where credit is due. Call 1-800-520-9221, option#4 for more information. End of report 1 of 1 report The information herein is furnished in confidence for your exclusive use for legitimate business purposes and shall not be reproduced.Neither Experian Information Solutions, inc.,nor their sources ordistrIbutors warrant such information nor shall they be liable for your use or reliance upon it. ©Experian 2915_All rights reserved.Privacy policy. Experian and the Experian marks herein are service marks of registered trademarks of Experian. Premier Profile-H GH WIND ALUMINUM CORP 5i 5 Sep 29 1510:27a 2392770167 p.12 T1► Merit Credit -- Fast, Accurate& Secure. MERIT CREDIT HAS RETRIEVED THE ABOVE BUSINESS REPORT FOR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OWNER/PROPRIETOR. PUBLIC RECORDS FOR THIS REPORT HAVE BEEN CHECKED AND VERIFIED AT THE COUNTY (INCLUDING PINELLAS), STATE AND FEDERAL LEVELS. PUBLIC RECORDS LEARNED: 0 SOURCES OF INFORMATION: EXPERIAN BUSINESS INFORMATION SERVICES IRS LIEN SECTION COUNTY COURTHOUSE RECORDS IF YOU RAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1- 300-371-3348 OR 239-277-3202. COMPANY NAME: HIGH WIND ALUMINUM CORP FEDERAL ID:90-0401260 CURRENT STATUS:ACTIVE PRINCIPAL(S):ANTONIO GALINDEZ TITLE: PRESIDENT DATE INCORPORATED;JULY 17. 2008 Sep 29 15 10:24a 2392770167 p.2 Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILE] [DATE] [TIME] (I) , Z NPE284423 MERIT CREDIT 16 NP 7/94 09/29/15 08:32CT [SUBJECT] [SSN] [BIRTH DATE] GALINDEZ, ANTHONY [ALSO KNOWN AS] GALINDEZ,ANTONIO [CURRENT ADDRESS] [DATE RPTD] 819 CALVERT AV. , #17. LEHIGH ACRES FL. 33971 1/03 [FORMER ADDRESS] 5221 DIXIE DR. , NAPLES FL. 34113 9/10 17819 CALVERT AV. , LEHIGH ACRES FL. 33971 [POSITION] ;CURRENT EMPLOYER AND ADDRESS] [RPTD] ROLLSECURE SHUTTERS INSTALLER 3/C4 M O D E L P R O F I L E * * * ALERT * ***FICO CLASSIC 04 ALERT: SCORE +632 : 039, 010, 013, 018 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=0 NEG=1 HSTNEG=5-23 TRD=31 RVL=22 INST=6 MTG=3 OPN=0 INQ=9 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $32.OK $32.BK $23. 8K $0 $418 27% INSTALLMENT: $46.OK $ $36.2K $0 $911 MORTGAGE: $202K $ $185K $0 $1014 TOTALS: $280K $32.8K $245K $0 $2343 T R A D E S SUBNAME SUBCODE OPENED HIGHCRED TERMS MAXDELQ PAYPAT 1-12 MOP ACCOUNT## VERFIED CREDLIM PASTDUE ANT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/PD BALANCE REMARKS MO 30/60/90 SYNCB/YAMAHA F 235059T 7/05 $26.2K 18014 109 3/11A $0 C SLDTO CHARGEDOFF 3/11F $0 CONTACT SUBSCRIBER TARGET/TD D 6476007 8/14 $426 M1N25 111111111111 RO1 47402 9/15A $500 $0 I CREDIT CARD $234 12 0/ 0/ 0 DISCOVERBANK B 9616003 9/07 $9291 MIN183 111111111111 ROl 9/15A $9200 $0 111111111111 I CREDIT CARD $9118 48 1/ D/ 0 SYNCB/LOW L 235041J 6/14 $1817 MIN25 111111111111 R01 9/15A $2000 $0 111 I CHARGE ACCOUNT $1018 15 0/ 0/ 0 Sep 29 1510:24a 2392770167 p.3 DISCOVERBANK B 9616003 12/08 $1543 MIN32 111111111111 RO1 old 9/15A $2000 Sc 111111111111 I CREDIT CARD $1033 28 0/ 0/ 0 JARED J 722D64G 3/15 $852 111111 RO1 401076 9/15A $6000 $0 I CHARGE ACCOUNT 8/15P $0 6 0/ 0/ 0 SYNCB/WALMAR D 235057X 11/14 $2L3 111111/111 RO1 diMiliMMIIMMIM 9/15A $1000 $0 I CHARGE ACCOUNT 6/15C $0 CRDT CARD LOST/STOLEN 10 0/ 0/ 0 SYNCB/WALMAR D 235057K 11/14 $366 MIN35 111111111 R01 9/15A $1400 $0 I CHARGE ACCOUNT $272 9 0/ 0/ 0 SYNCB/AMAZON D 235064K 9/15 $1161 MIN25 RO1 Wimmoussilk 9/15A $1500 $0 I CHARGE ACCOUNT $1158 CAPITAL ONE B 1DTV001 7/15 $994 MIN25 1 ROI arimiumpown 9/15A $1000 $0 I CREDIT CARD $994 1 0/ 0/ 0 BK OF AMER B 427S002 8/06 $202K 360M1014 3/11 1=11 MO1 - 9/15A $0 $5606 05 C BALLOON 09012036 $185K LOAN MOD/FED GOVT PLN 48 4/ 4/ 0 SYNCB/SAMS D 2350465 3/15 $0 111111 RO1 dimmemillt 9/15A $437 $0 I CHARGE ACCOUNT $0 6 0/ 0/ 0 SYNCB/SANS D 235046S 9/06 $156 111111111111 R01 INIMMIONSIONNO 9/15A $124 $0 111111111111 I CHARGE ACCOUNT 11/10C $0 CLOSED 48 0/ 0/ 0 BK OF AMER B 1597029 5/07 $8060 111111111111 RO1 IMO 9/15A $4500 $0 111111111111 I CREDIT CARD 6/13C $0 CLOSD BY CRDT GRANTOR 48 2/ 0/ 0 KOHLS/CAPONE D 12EN005 12/14 $399 11111111 RO1 AMMOMPIPPOMB 9/15A $400 $0 I CHARGE ACCOUNT 4/15P $0 8 0/ 0/ 0 CHRYSLERCAP F 2E3D001 7/14 $35.4K 72M617 111111111121 I01 MMOMMOOMMOOMMNO00 8/15A $0 I AUTOMOBILE $30.3{ 12 C/ 0/ 0 SYNCB/AMEAGL C 235051N 2/14 $214 111111111111 RO1 8/15A $400 $0 111111 I CHARGE ACCOUNT 8/15P $0 18 0/ 0/ 0 AMEX 3 21WB001 11/07 $9746 111111111111 RO1 ONIMMWMAWAMOMOS 8/15A $4900 $0 111111111111 I CREDIT CARD $8059 48 0/ 0/ 0 BBY/CBNA H 292F014 11/14 $1177 MIN25 11111111 RO1 Sep 29 1510:24a 2392770167 p.4 8/15A $2000 SC „I CHARGE ACCOUNT $1088 8 0/ 0/ 0 THD/CBNA B 26H3005 1/07 $3414 MIN43 111111111111 R01 8/15A $500 $0 111111111111 I CHARGE ACCOUNT $872 48 0/ 0/ 0 KIA MTR FIN F 29M2002 3/14 $10.5K 36M294 111111111111 I01 5 7/15A $0 111 S AUTO LEASE $5909 15 0/ 0/ 0 DSNB MACYS D 2A5T001 11/11 $462 111111111111 1201 7/15A $100 $0 111111111111 I CHARGE ACCOUNT 3/13P $0 43 0/ 0/ 0 BAYVIEW LOAN F 27DB001 8/06 5185K 276M153 3/13 111111111111 MO1 INIUMMIONOPOR 4/15A $0 $8647 05 115555555555 C CONVENTIONAL REAL 4/15C $0 TRNSFRD: OTHER LENDER 25 0/ 0/11 SANTANDER F 1R18003 1/11 $29.6K 72M588 X11111111111 I01 8/14A $0 111111111111 I AUTOMOBILE 8/14C $0 CLOSED 43 0/ 0/ 0 5TH 3RD BK B 9302020 7/08 $10.1K 60M 111111111111 I01 8/13A $0 111111111111 AUTOMOBILE 8/13C $0 CLOSED 48 0/ 0/ 0 BK OF AMER B 6331205 3/C8 $17,6K 75'M287 111111111111 I01 4/13A $0 111121111111 C AUTOMOBILE 4/13C $0 CLOSED 48 1/ 0/ 0 PRSM/CBNA B 292F001 5/08 $0 11111111_111 RO1 aigglingifinill 10/09A $4000 $0 1111 I CREDIT CARD 8/08C $0 ACCT CLSD BY CONSUMER 16 0/ 0/ 0 CHASE B 26QK001 7/00 $1386 111111111111 R01 diailiiimillft 6/09A $897 $0 111111111111 I CREDIT CARD 8/08C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ 0 CAPITAL ONE B 1DTV001 7/99 $619 111111111111 RO1 10/08A $500 $0 111111111111 I CREDIT CARD 9/08C $0 ACCT CLSD BY CONSUMER 48 0/ C/ 0 BK OF AMER B 427S002 5/04 $136K 36CM1052 111111111111 M01 26 9/06A $0 111111111 C CONVENTIONAL REAL 9/06C $0 CLOSED 27 0/ 0/ 0 CB/VICSCRT C 16US001 2/06 $194 11 RO1 4/06A $400 $0 CHARGE ACCOUNT 4/06P $0 2 0/ 0/ 0 I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 9/29/15 ZNP6284423 (FLA) MERIT CREDIT 9/05/15 BNY5371284 (EAS) SYNCE/AMAZON 7/14/15 BPC2699824 (NTL) CAP ONE 7/12/1s BPC2699824(NTL) CAP ONE , Sep 29 1510:24a 2392770167 p.5 3/29/15 NNY4215612 (EAS) SYNCB/SAMS 11/15/14 NNY1212732 (EAS) SYNCB/WALMRT 9/15/14 FLA2902956(CAL) QUICKEN LOAN 3/10/14 FLA1C18264 (CAL) KMF 3/09/14 ZCO8256078 (C_AL) CREDCO 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. 30X 1000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at http://www.transunion.com CREDITOR CONTACT INFORMATION SINCE/YAMAHA F2235059T (877) 314-1507 C/O PO BOX 6153 RAPID CITY SD. 57709 TARGET/TD DC6476007 PO 3CX 673 MINNEAPOLIS MN. 55440 DISCOVERBANK BC9616003 (800) 347-2683 POB 15316 WILMINGTON DE. 19850 SYNCB/LOW LH235C41J (800) 444-1408 PO BOX 956005 ORLANDO FL. 32896 JARED JA722D64G 375 GHENT RD AKRON OH. 44333 SYNCB/WALMAR DC235057X (877) 294-7880 PO BOX 965024 EL PASO TX. 79998 SYNCB/AMAZON DZ235054K (866) 634-8379 PO BOX 965015 ORLANDO FL. 32896 CAPITAL ONE BC1DTV001 (800) 955-7070 POB 30281 SALT LAKE CITY UT. 84130 BK OF AMER BM427S002 (800) 451-6362 1800 TAPO CANYON SIMI VALLEY CA. 93063 SYNCB/SAMS DV235046S (800) 964-1917 PO BOX 965005 ORLANDO FL. 32896 BK OF AMER BC1597029 PO BOX 982235 EL PASO TX. 79998 KCHLS/CAPONE DC12EN005 (800) 564-5740 PO BOX 3115 MILWAUKEE WI. 53201 CHRYSLERCAP • FA2E3D001 (800) 423-7712 PO BOX 961275 FORT WORTH TX. 76161 SYNCB/AI4EAGL CZ235051N (800) 943-0875 PO BOX 965005 ORLANDO FL. 32896 AMEX BC21W13001 (800) 874-2717 P.O. 30X 981537 EL PASO TX. 79998 BBY/CBNA HE292F014 PO BOX 6497 SIOUX FALLS SD. 57117 THD/CBNA BZ26H3005 PO BOX 6497 SIOUX FALLS SD. 57117 KIA MTR FIN FA29M2002 1055D TALBERT AVE FOUNTAIN VALLE CA. 92708 DSNB MACYS DC2A5T001 PO BOX 8218 MASON OH. 45040 BAYVIEW LOAN FZ27DB001 (800) 457-5105 4425 PONCE DE LEON CORAL GABLES FL. 33146 SANTANDER FA1R18003 (866) 923-9282 PO BOX 961245 FORT WORTH TX. 76161 5TH 3RD BK BI9302020 (800) 972-3030 5050 KINGSLEY DR CINCINATTI OH. 45263 Sep 29 1510:24a 2392770167 p.6 3K OF AMER BI6331205 (800) 215-6195 9000 SOUTHSIDE BLV JACKSONVILLE FL. 32256 PRSM/CBNA BC292F001 PO BOX 6497 SIOUX FALLS SD. 57117 CHASE BC26QK001 (800) 432-3117 P.O. BOX 15296 WILMINGTON DE. 19850 CB/VICSCRT CZ16US001 PO BOX 182789 COLUMBUS OH. 43218 SYNCB/AMAZON E 5371284 (866) 634-6379 PO BOX 965015 ORLANDO FL. 32896 CAP ONE B 2699824 (800) 955-7070 PO BOX 3028: SALT LAKE CITY UT. 64130 SYNCB/SAMS N 425612 (600) 964-1917 PO BOX 965005 ORLANDO FL. 32895 SYNCB/WALMRT N 1212732 (877) 294-7880 PO BOX 965024 ORLANDO FL. 32896 QUICKEN LOAN F 2902956 (800) 523-0233 PO BOX 509124 SAN DIEGO CA. 92150 KMF F 1018264 (866) 331-5632 HYUNDAI MOTOR FIND_ FOUNTAIN VALLE CA. 92728 CREDCO Z 8256078 (800) 523-0233 PO BOX 509124 SAN DIEGO CA. 92150 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. September 30`h, 2015 Collier County GMD Operations& Regulatory Management Licensing Section 2800 North Horshoe Drive Naples, Fla. 34104 Re: C 21466 Sirs; I was licensed in Collier since 2000, unfortunately when the economy crashed, I was unable to pay my yearly corporate fee and my Corporation became inactive in Tallahassee.The fee to become active was $1000 and I could not afford it. It was a requirement that the Corporation be active for Collier County to renew my contractor license,therefore I was not able to renew it. I have maintained active in Lee County, Port Charlotte and Cape Coral although due to the lack of work I relocated back to Miami-Dade for two years.As the economy became better I came back to Lee County and have been working here steadily and I see the opportunity to work in Collier County so I decided to reapply for the license and I am requesting that you give me the opportunity to do so. I am also a licensed real estate sales person since 1979. My credit is currently poor, but I have no foreclosures or car repossessions, I still have a mortgage and I am paying for two vehicles. In this process I uncovered that I have a lien for documentary stamps from the State of Florida.This came about because I subdivided a lot in Hialeah and in 1994 the City had through Ordinance issued half of the adjacent alley to the owners of the property. When I closed on the house,the title company did not pick up on this and the alley was not transferred to me.Therefore my attorney located the previous owners and had them sign a Quit Claim Deed for this alley to me and he recorded the same.The Revenue Department decided to charge me Doc Stamps although the alley was not encumbered by the mortgage nor was there any consideration paid. I have entered into a payment plan for these taxes due so that it is taken care of for the purpose of this application, and I have also requested a review to see if this can be exempt. Reyes Tile is also showing a collection in the amount of $654 from Receivable Management Services, I have contacted them and they cannot find us in the system. 9/30/2015 Collier County Licensing Board Page 2 I hereby humbly request that you consider my license reinstatement taking into account my years of experience in the field, my record with other Counties and give me the opportunity to benefit from the economic comeback which in turn will allow me to take care of any pending financial matters. Respectfully, Marina Reyes 890 E 23 St. Hialeah, Fl. 33013 Cell: 239-560-8243 VA* ct) CL Aykoi4 tie r cU �t GMD Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive Naples, FL 34104 e r)/4/57(. kl 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: Exact Corporate/Business Name: ")eyes /" /e sc r v i c e L. O Fiction Name/ DBA: Qualifier Name: '72,9 /- 7e S Physical Address: `3 4.4 4,1 U ig2e-gre i C Z /e) /1-2 K s* ,—91 (Number& Street) (City) (State) (Zip Code) 3 3 9 a �- Mailing Address: (Number& Street) (City) (State) (Zip Code) Telephone: Z.3 9-....3-60-g .Z�,j E-mail: /d)f fiA.4.9/O RepS .4 a1-1"I'"9-17' 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 l/ Specialty $205.00 Specialty Trade: � -�- M a vt loI CHANGE OF STATUS: (V) Reinstatement ( ) From One Business to Another ( ) Dormant License to Active Page 1 of 4 119/16/201' Reinstatement of Delinquent License Lee=1,205 00 Renm‘al License Pee=I25.1)U 3 Rick vcar lees=S555.00 Total=S88S.00 Does not included penalty fees after 9/30/2015 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. /N-)e v-e-S X34 a - V� 89C —13 a� / y h "9-4, • ,3,3e d /-/Yr-t/e 9—? -9-f 3 / 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. Ryecy-e5 ✓. /-e SCry ce £ . 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. v ;774-P ,.� /ice C , i G i e �i e J �- `)'3-r-4 s A , h i-/.e 7 Z) @ c-c cN r.-2 73 42-/ 5 c-) ..S B -ti/-4 / - d c l t...e--)/2‘-7 c 1 c> / -2#v r/7 1)",--f/ 'ns 2 /?) v . AFFIDAVIT Under the penalties of perjury I declare that I have read the foregoing application and that the facts stated in it are true. Authorized Officer of the Firm The foregoing instrument as acknowledged before me this 9 -_.18 -/s- (Date) by /))r- ,d , /-? e y- J / / reS of /L e,y..e s 7: % (Name of Officer, Title/Agent) (Name of Corporation) a 7'c-s 143 /�- Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced /Dr�`v i /`C• • identification and did not take an oath. (Type of identification) NOTARY'S SEAL (SIGNATURE OF NOTARY) y,,, ALE :1A PADRO Page 2 of 4 L1' `�= Notary Public -Stats of Florida: •I My Comm.Expires Mar 15,20111 r. ,P`,• 'ommission#EE 179725 4 Through National Notary Assn. QUALIFIER INFORMATION: Name: /2)69 9 /1)6 Address: S7 te) 3 ,5 c i,g (Number&Street) (City) (State) (Zip Code) Telephone: -23 9 -.S d,G - ca c./ 5 Date of Birth: All.1111111.W SS#: E-mail: R e t��S hO% ,py� Driver's License #: I. Type of Certificate of Competency for which application is made. j•. 2. The names and telephone numbers of two persons who will know your whereabouts. / "-9 c . e---y 675 '� /�-�l0 7e 7411- x %)6) /9 eY -72 -3788 7-''`7 , .e, y-e-5 ���- 3, , - 1 2- 3. Have you ever been convicted of a crime related to Contracting? /v o (If yes, attach extra sheet with explanation.) 4. Have you or any firms you have been associated with ever tiled bankruptcy? 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. / `o^9--2 .v o 7 r Cu S t.J /-4) , c''��t1Y Tv oc..-�j (/yr� V T?j Ne ecv .✓v� y o e_. J ," -"�i � �7 / I✓ r`�3Sl1//" G= yS� v a-� e ,7-2> 6 c �c:/ �.' dL� C �/�! Q iGCG c, "''�S � GCJII/�Gl�1 7j� f� f` r Ly ✓� ' -`J',``4� 6. List your business or work experience during the last ten years. /4 mss. Wo e-s ///e- o.csc 4 f)j L e e Go . / G'C''9 e r,:tay, [�°Si9/✓Q S'i c- -C.'t5 9 v7 G29-/J e , ,t) ,44) (..J crib u 7. Statement of any formal training you have had in the area for which the application is made. 5 , '9-T e rig H �- (� %, 5L).d-C U 3 of4 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 infoumation contained herein is grounds for disqualification. 7-17.9 2,;U,q 61Re y e s Applicant (please print) 'Qe S / e se r V C e Name of Company Signature of Applicant State of Florida County of - c The foregoing instrument as acknowledged before me this 57 -/S- (Date) by /4 /c,?-e who has produced s c - (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL (SI NATURE OF NOTARY) �oerfi""'M.,, ALEJITA PADRO A Notary Public•State of Florida 4 of 4 • My Comm.Expires Mar 15,2016 r.= Commission #EE 179725 '4,of o BO^rl,., Vofar 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. �D I G�--L..�-� d /G)-e----e---7.. Signature of Applicant ,f&y-€5 / ,, /.0 sc tr-4-:).-c.c Co . Business Name Date BEFORE ME this day personally appeared //).••},r-�",�,9- 'e—c-74--e- S 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 The foregoing instrument as acknowledged before me this 9 -a 'is (Date) by /i),-3-7-7‘‘',i /�'e c--7--e S who has produced f'�!1` E)--//t... �iS �i C (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL ��/,v 1 ;o��a+'�-�5,, AIE c- tate of (SIGH ATURE OF NOTARY) 1 :?tik Notary Public-State of Florida •e My Comm.Expires Mar 15.201E r Commission#r EE 179725 + ,' �ni� Bonded Through National Notary Assn 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 1-19, 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. • rz<, !r>t.iCWIr`o40,?±•h ,III.Jr=t� ^.1l!i«./N k��11 11NieINl1 'e' lc Li J J ,o V�j .r n�1s>1�<>,/��>i 1 i<>i 1■ii,!,■r s.1 Kill 1<rl!i�c>a!t<ri!IN ri 1�s>f!N 1�e>i!ioa(!iti>t•iS>ii IN el!<<r(*�s>i!�sri•'ti>.1■•c fi 1�<a�1,rFc I Cc->.!■irr!!'t�a(!�s••i:t s•r C (if 1 1 0 s ti LI alb. t lilt r ,i, „,,.... A=K F �9 GOD wE i'li • jd Dp arlmpnt of Late • Q t ,I. �.C. I certify the attached is a true and correct copy of the Articles of Incorporation of k: REYES TILE SERVICE CO., a corporation organized under the laws of the State 4, of Florida, filed on July 3, 2000, as shown by the records of this office. _ sOs- =C The document number of this corporation is P00000064354. •.• lir �Y ii kl_ .•. co; sty X105 .. • t_e 0 ice••yllll •���. - • V) . Given under my hand and the ,Q.> Great Seal of the State of Florida .'• at Tallahassee, the Capitol, this the '107 Twentieth day of October, 2000 ` :S dF. sue' .4 aiu $ 6�E G w 1, 1 't.11)` ' :144,..12,7 - —V 9(...-7144' If*erril: 41k)A1h. 41A)1 lb tislfl?Crfllt` !1"tl't`t fix. °'n=._, E rr:fZrrta of �t,tfr ,V ,0 '.;R2F022 1 99; , f[`a ,�'`•l�� !.4.4 !✓1}` it # 1'<f �7� ~!p!My Pal • at t,*ra, iron,mot!is.l r l�i t fS # S P 'r, • ., . rrti�tls�rT V�!�?I!`�srN����.l,�:r!,�-ec"No lr�rt�l! cSt+sa.! 07/03/2000 15:50 305-264-377@ ed R3S GONSALEZ. PAGE 04 __ CERTIFICATE OF DESIGNATION OF REGISTERED AGENT/REGISTERED OFFICE PURSUANT TO THE PROVISIONS OF SECTION 617.0501,FLORIDA STATUTES,THE UNDERSIGNED CORPORATION,ORGANIZED UNDER THE LAWS OF THE STATE OF FLORIDA,SUBMITS TIDE FOLLOWING STATEMENT IN DESIGNATING THE REGISTERED OFFICE/REGISTERED AGENT,IN THE STATE OF FLORIDA. I.The name of the corporation is: REYES TILE SERVICE CO. • � c" a 2.The name and address of the registered agent and office is: `+ r �-4 -0 CC/ MARINA REYES '' 552 E. 10 ST oN` - - HIALEAH,FL.33010' ^ • Having been named as registered agent and to accept service of process for the above stated corporation at the place designated in this certificate, I hereby accept the appointment as registered agent and agree to act in this capacity. Xfiirther agree to comply with the provisions ofall statutes relating to the proper and complete performance of my duties, and I am familiar with and accept the obligations of my position as registered agent. • (SIGNATURE) - . — (DATE) '7 ` ° ° danlin eVnn3671:3 3 07/03/2800 15:50 305-254-3770 vv vv — GEORGE GONSALEZ PAGE 03 r-T ARTICLE V INCORPORATOR(S) The naaxe(s)and street address(es)of the incorporator(s)to these Articles of Incorporation is(are): MARINA REYES DIRECTOR at PRESIDENT 552 E. 10 ST HIALEAH,FL.33010 WILMER REYES VICE PRESIDENT 552 E. 10 ST HI LEAH,FL.33010 • The undersigned incoxporator(s)bas(have)executed these Articles of Incorporation this day of ) _,20 Signature Signature • Signature NOTE:Affixing an officer title after a signature of an incorporator does not constitute the designation of officers. aoa 0tx'.9578_-3 07/03/2000 15:50 305-264-3770 GEORGE GONSALEZ PACE 02 fl46.6)00Q067 ea • • • ARTICLES OF INCORPORATION The undersigned incorporator(s),for the purpose offorming a corporation under the Florida Business Act,hereby adopt(s)the following Articles of Incorporation. ARTICLE I NAME The name of the corporation shall be:REYES TILE SERVICE CO. ARTICLE II PRINCIPAL.OFFICE The principal place of business and mailing address of this corporation shall be: 552E. 10ST HIALEAH,FL.33010 ARTICLE III SHARES The number of shares of stock that this corporation is authorized to have outstanding at any one time is:One Thousand(1,000)shares of One Dollar($I.00)par value common stock,which shall be designated 4COMMON SIIARES_m ARTICLE IV INITIAL REGISTERED AGENT AND STREET ADDRESS The name and address of the initial registered agent is: MARINA REYES 552 E. 10 ST -.4 FIIALEAH,EL.33010 r°) r- cr. Prepared by:MARINA REYES s c.') 552)E_ 10 ST m a iT� HIALEA11,FL. 33010 -c' T 305 8876350 - c>" w corn ii.e2frr20e;ea3 5 03 v .. 07103/2000 15:50 305-264--3770 GEORGE GONSALEZ PAGE 01 Division o rations Page 1 of 2 ocoom6 q 35q Florida Department of State ' Division of Corporations . Public Access System Katherine Harris,Secretary of State Electronic Filing_Cover Sheet Note:Please print this page and use it as a cover sheet.Type the fax audit number(shown below)on the top and bottom of all pages of the document (((H00000035183 3))) Note:DO NOT hit the REFRESH/RELOAD button on your browser from this page.Doing so will generate another cover sheet. Division of Corporations sue-' "7 Fax Number : (850)922-4001 Front: ,-1 _ Account Name : BUSINESS WORLD TRANSACTIONS. INC. ';`i r j Account Number : 104512000707 --1 _ Phone : (305)867-8448 r F o ax Number _ - : (305)264-0232 ri c .___....—_._._ .M=_.—._ _—_..�_:._ _,.. .._. . _ 1 _ - - FLORIDA PROFIT CORPORATION OR P.A. REYES'TILE SERVICE CO...... Certificate of Status 0 'Certified Copy �� 0 Page Count 1i 05 'Estimated Charge Il $70.00 N Culligan jjji w https://ccfssl.dos.state.fi.us/scripts/efllcovr.exe 7/3/00 2015 FLORIDA PROFIT CORPORATION ANNUAL REPORT FILED DOCUMENT#P00000064354 May 02, 2015 Entity Name: REYES TILE SERVICE CO. Secretary of State CC9431557848 Current Principal Place of Business: 3444 MARINATOWN LANE 10A NORTH FORT MYERS, FL 33903 Current Mailing Address: P. O. BOX 151701 CAPE CORAL, FL 33915 FEI Number:65-1020720 Certificate of Status Desired: No Name and Address of Current Registered Agent: REYES,ANGEL 1485W5LANE HIALEAH,FL 33010 US The above named entity submits this statement for the purpose of changing its registered office or registered agent,or both,in the State of Florida. SIGNATURE: Electronic Signature of Registered Agent Date Officer/Director Detail : Title DP Title EXECUTIVE SECRETARY Name REYES,MARINA Name REYES,ANGEL Address 890 E 23 ST Address 1485 W 5 LN City-State-Zip: HIALEAH FL 33013 City-State-Zip: HIALEAH FL 33010 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 lam an officer or director of the corporation or the receiver or trustee empowered to execute this report as required by Chapter 607,Florida Statutes;and that my name appears above,or on an attachment with all other like empowered. SIGNATURE:MARINA REYES PRES. 05/02/2015 Electronic Signature of Signing Officer/Director Detail Date Reyes,Marina-Personal Report.pdf 886 110"Ave N Suite 66,Naples,FE 34108 , I Phone:239 777 1028 Fax.877.275.3593 wore(I■censpr,ILte corn PERSONAL CREDIT REP(F lCompiled From National Records) 'J II I ,r, LI III I r II 0 o I 01 V [1,1,11ip, F. LJ LIEL :NA cf,E I(,,, CI'1, I •i h,111 FE 1,1 L 1,141'1, - ELLI (I F • FIE, L II IV E E I II IL I I IL,,IELILP I''II'I 1•• '-1 E... , LE 1,F !.11,! L (, I LL I I E. ***5 CLASSIC 08 SCORE +491 . I-I ' 11;,;‘,41,"L: I'LlIEI 'FE L -A All ILL 'AEI%vE.11, L; 1E I LE 1-..1.1411 E: I. .L(.E(I c ,m14 I L I 1 . I, V A P L I ! -, L 1111 I ' . III I. I • .LL,, 14, H.,14,1,, -',(` '11E1, ILI EL 4 141,. . I'I If; PI 1 ,.1L1 I A IL i I I EL,J I; BALL. .1 rE 1E I. I E PURUC RECORDS HAVE BEEN SEARCHED AT THE COUNTY,STATE AND FEDERAL LEVELS 41,4 ur..L H.!, f:I i t. 1.1,11 '•,1111EE ,,, 11- 1'140 Pfp I L ''A LE LI AY, I,I F.J I. LIII L, 'loll III. 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F ,!L1F+*I1111 It r I3,1"iu01 . r.1 I 1,1111 I`.)i-:1 Ir; I/P I I:A 1'1.A11I1., 1-,n •HI It II, I: /e .t 'I!KMAMI: It I I VIII It 111,1!1"P1 I-:FMS Fit_tItE'.I,4, {'Sr PI`T I-I.' r)F A,'''111111'11 tNF_1:1, -3FI,P1,l:t X14 liIrE AF1-Mrrp 13/31F,T I'-._4 I.I/.IA I,/t L/),:11 rI F '1.II I L F,r..LIA4'F, )-,.i,,`+1 4'H 1'.1AT, ''NE ? 1 97`4t'.(IIL 1.';0, ;11:1 F19 I;It °,1-IN6l: .,:II1 ■-• ''I.1':I )1 111E 1/1A01 I.Jt I,:"V11P', I' "'F,t'Il /1'0'7 `1'.IF iM'i,`, II' 4A :p i[-:`_II LL."!r HHr,U III I"; ,1', "OA 4'r tir7„ 4/I ,_sou I:r KF.I I._ .!;)CIF :426 ;-t..,',.II Al llt' IiP',1, .,11- 11 IA,I FIUItII1 ,I IMP I ' 11 II 11131 t) .n tno9 "1. or =,1, Tr:, INT IF' :T1 1 I I PLM(' 'Ilti II .1F "t11 I) IIFT'.N t, 130 1;[i 1 Y'Ii 1'(,) Page 2 of 3 tic Reyes,Marina-Personal Report.pdf �F 11 ul.r uu�l�t I I' ■ !II:I' !1.1.! A wt. I.." I',A1-•'1 'IfiI I - rlr I '.IP: ! { I I 1 1 A on-1 I.I:I.i- 'IF: ':.� I'A ti_I'I: I II rc-wrnl I f_Il 'ul �. I �.1 , 1 I I.I t u. , I.. L_1111 .II\'f�NPi 4N AL I,FA. ':II -t; . '1 NIA 1'11' '.'1'1 11.`I 1 I 1 z I1 7'J I I.'!�,A .- AII'I'n'.i WI! 11111...111111 IIY'. A;=`aA -- 1111 A11'Pt1'.1:!HI 1.: s;'■,IL 1,1 CH. 1-'1' If I ' '] I'IIA?£ ,-1 ILA _ ., ,till Ill!!! Nil -I I A :HA!!! (A!!! ',Li.'I I' A'J ';'Ulf ._ ''1.f I J I I I" '7 11 tl II L I- I IUA'IS .'•.AL'.)JG "IPNAMI' r'I -:NI,IiN" 11! 1'111';!;1'.. 1' I, ! l" .'1.4 III' h.* -,.A 1L I. •'AI' 'III! Page 3of3 09/24/2015 THU 11: 02 FAX X001/009 STATE OF FLORIDA -. � DEPARTMENT OF REVENUE f ' , r iz � TALLAHASSEE, FLORIDA 32399-0100 Stipulation Agreement DR-68(8.8/07) n. ■' t;1 i` '10,le l,', .5U;,-t"1501 ,.■t f•{:?i;,, 1.The Florida Department of Revenue, MARINA P. REYES the taxpayer,Tax Identification No. and(the guarantor) hereby agree that$1,699.62 (hereinafter referred to as the"liability")is owed by the taxpayer to the State of Florida for Documentary Stamp Tax for the period(s): 11/09. The amount due is comprised of: Tax: $1,301.40 Penalty: $0.00 Interest: 1139.36 Fees: 1158.66 Total: 11,599.62 2. The parties agree that upon the execution of this document, the amount due will be paid according to the amortization schedule attached. The parties further agree that the taxpayer shall meet each payment term which is detailed on the Stipulation payment coupon provided by the Department of Revenue. MIAMI SERVICE CENTER 8176 NW 12TH ST STE 119 DORAL FL 33126-1828 3. The parties agree that the t xpayer shall accuratei complete and timely file all required returns for the next 12 months beginning with the period /0 K5' through I O//(e •and timely remit all tax collections due for the next 12 months. 4. The parties agree that the taxpayer shall comply with all other provisions within Chapter 212, Florida Statutes. 5. The taxpayer is in compliance with all of the terms of this agreement the Department agrees not to commence any additional collection activities for the liability. THE PARTIES FURTHER AGREE THAT: A. They have executed this agreement freely and voluntarily, and for the consideration set forth herein. B. They have had the opportunity to consult with counsel of their choice prior to executing this agreement. C. There are no promises or conditions other than those set forth in writing in this document, and there shall be no modification of the terms of this agreement other than In wilting and signed by both parties. D. The.amount of the liability is subject to increase if the Department discovers, through audit or otherwise, that such liability has been understated. However, If any additional liability is discovered, the taxpayer will have the benefit of the Department's normal protest procedures to protest the additional liability. E. The waiver by the Department of any breach of this agreement by the taxpayer or the guarantor shall not constitute a waiver of any other breach. F. If the taxpayer fails to timely perform any of the obligations under agreement, including the timely filing of returns and timely payment of all taxes, penalties and interest as they become due, all amounts of the interest and penalty settled under this agreement and any unpaid balance shall be Immediately due and payable and collectible by all legal means without further notice including but not limited to the filing of a lien pursuant to s. 213.89,F.S., the commencement of revocation procedures pursuant to s. 212.18,F.S., and the garnishment of bank accounts pursuant to a.213.67,F.S. Page 1of3 09/24/2015 THU 11: 03 FAx U002/009 G. Pursuant to this agreement, the taxpayer and the guarantor agree to waive any and all rights, or purported rights, to institute any judicial or administrative proceeding to recover, compromise, defer, restructure, avoid, challenge or reduce any tax, penalty or interest paid or payable pursuant to this agreement. H. The guarantor Is signing this agreement in hislher individual capacity,whether or not also doing so on behalf of another person, and whether or not affixing to his/her signature an indication of corporate office,for the following limited purpose. The guarantor hereby personally guarantees that all subsequent returns for the twelve months immediately following the date of this agreement are accurate and timely and that all tax shown due, or otherwise collected, Is timely remitted to the Department. The guarantor further states that he/she la jointly and severally liable for tax, Interest and penalty finally determined due and unpaid for this period and will pay same within 10 days of the Department's demand for payment. If the guarantor falls to pay the debt owed within 10 days of demand, the Department may take any and all collection actions against the guarantor that it could take against a delinquent taxpayer Including but not limited to the filing of a lien pursuant to s.213.69,F.S.and the garnishment of bank accounts pursuant to s.213.67,F.S. I. The taxpayer and the guarantor fully understand and accept the terms of this agreement. J. If the taxpayer or the guarantor falls to comply with the terms of this agreement, the Department shall be entitled to recover, in additltion to all tax, penalty, interest and costs owed, all costs of collection incurred in this matter, including a reasonable attorney's fee. • Page 2 of 3 09/24/2015 THU 11: 03 FAX X003/009 • Y.,4•F r ry-r - . -•-- -.... muiimmmiummamiumm Payment Sotteduleq;4400,00 Number of PaYmenla;4 Interest Rate:7,0000 % Next Payment Data:10f01SA010 Need Payment M oUnt: D'"o" Payment,i0A0• Pint Payment Amount:$200.00 as a❑balloons payment or l.�new payment schedule ppn,.nt Means repo* Pwrnire lrlMrwt iM� Mb MeadNOW *Pl Inlwss% Fade TUN Ban=s WW1. 11111.11.1PMEMINIMMIll riirmlimPritirripurumortmorporirrynowriumrPrrisiorsti • This agreement if Eby Map*for and an the behalf of the tower an tNt day at______af —t+ s t nature of TaxP a.4--".L.'-ze_ a t1) `ty the Ouerantar n ir (d ) I wnderrtand that by etgallld MN armament I am personally liable for tax,penalty and Interest that mil Wow due far the twelve menthe foIttoWSt f f the data at on aXaCulfon Wilds s yeentem. THIS ACME ENT IS ERREY ACCEPTED FOR AND ON THE BHHALI OP THE FLORIDA DEPARTMENT OF REVENUE', OR • UNDER a.210.21(4 F.S. iv AI DOS 0/1/6-- *. / Page 3 of tE September 25, 2015 FLORIDA DEPARTENT OF REVENUE Attn.Jack Scott Via fax: 850-922-9252 Re: Business Partner No. 3352570 Documentary Stamp Warrant Sir; When I purchased my home is 2002 the sale was for the actual Lot 14 and 15 as stipulated in the deed Transferred form the Velazquez to me. It turns out that the City of Hialeah had issued an ordinance Transferring ownership of%the alley to each of the adjacent owners. Since I was in the process of subdividing my lot, it was noticed by the City that ownership of the Alley Had not been included in the original deed,thus we were required to locate the previous owners and Have them deed the portion of the alley to me. My attorney did the deed, it was signed and recorded. The alley was not encumbered by the original mortgage and there was no consideration paid for the Transfer. I am hereby requesting a further review of my documentary stamp assessment. Respectfully, /s Marina Reyes 890 E 23 St., Hialeah, Fl. 33013 Tel. 239-560-8243 Back mom Kecard Search ,Group:1 Page 1 dhttp 1111111111111111111111111111111111111 11111111 CFN 2OO9RO81968 �4aorswis4sswrrellp iIbllun'4i OR Bk 27097 Ps 1567; (las) 77 j• p RECORDED 11/30/2009 12:15:20 FL 33157 DEED DOC TAX 0.60 SURTAX 0.45 HARVEY RUVIHr CLERK OF COURT MIAMI-DADE COUNTY, FLORIDA LAST PAGE Peal orawbors 04-3104-002-3390 (hdtelidin Deed 7bhQabiehaDseai, Itdsirih 1 dqd W.vsaber ,2009 wa. =sibs NQ.q VIL01011I and P9 1= A. WW 10022, his rife der Ooai of 3313ai-Gads , see of Florida ,ignatsr, MEM P. $•119, a single moms sh4w slims e; 400 1. 23rd Street, 5ia1eah, Pi 33013 albs amok d U1.INIA■Oed• srr d Florida r WYaasedh kiks•RAM10R,sterik:oroM44 adfrw4d 441 oar kW Hid..wb.WM. t�Atft 0022.204 010)-010) ---------- - 1r amen.b own.east•/oar alassoders4 beg esuKbodrirM7iUSWSfrsNOlA1a♦ukORA P$1i elemosSwWssipslewRO.M_____ Kii, b4ssliness as°m.b st IILsteL-Oads lead Florida ewe The North 1/2 of that portion of the 11 Psot allay Ipiag Booth and adiaoent to Lets 14 and 33, 1110014 103-0, of TIM 3111111191103 nay 04 i's. 201110749D PLAT OW T!= T1032311111911 100210001 TO 1IaLNA1, according to the Plat thereof, as recorded in plat look 34, rage 26 of the Publio aeoords of nisei-Dade County, riarids closed per Ordiaanoe l0 94-07, passed and adopted on January 23,1094 r: To Have and N BW b sr soke.r .la bba W mbphs b •A.,r,ns ehrW4 61101 K r Web' sesieio W 4l b pe• skik WOO. w agar sbl shim .b44s44r d prom der Y e. or 404 At R hs4a W prat of b sM moan Ass. la Mean WlwsuR,sr woo le ammo as emi W mil b / per Amt bibs. 8rpni,maul aid 4eswhJ to eta,imam • tJJ/ ted Nana: efrajleP, V112101111 �/� *r " 5. Pria-V Mss: 1 L,t r.t, "i4b0 o PANIC= K. ViLL$QOi3 Witness iQ Mims lMl$we st,ab44,s1.sp MTh OF Florida earn, or!beet:-Dada a. °`Ab41M+t. mbs.4._:bruitd ta s s.k E)•71.if NoIanber ,2009 y 1121$Ol V'MLLIgO:= sad PAT*XCla It. v1L><spo3I, his rite woo 84944440 Woos eOMAm boomer eittlo driver's Hoppe' Yil3l-`2•s.•T2-//�•O �V V1:`t�•J 6 fse-0 lr' s .414./ peen Notary Public CFN: 20110401061 BOOK 27726 PAGE 4438 DATE 06/20/2011 11:06:01 AM HARVEY RUVIN,CLERK OF COURT,MIA-DADE CTY Florida Department of Revenue WARRANT ■! tWEPARTMENT OF REVENUE MARINA REYES Tax :Documentary Stamp Tax 890 E 23RD ST Business Partner# :3352570 HIALEAH,FL 33013-4227 Contract Object# • FEIN . Warrant# :1000000220653 Re:Warrant issued under Chapter 201 ,Florida Statutes THE STATE OF FLORIDA TO ALL AND SINGULAR,THE CLERKS OF THE CIRCUIT COURTS AND ALL AND SINGULAR,THE SHERIFFS OF THE STATE OF FLORIDA WARRANT FOR COLLECTION OF DELINQUENT Documentary Stamp Tax TAX(ES). The taxpayer named above in the County of Miami-lode is indebted to the Department of Revenue, State of Florida,in the following amounts: TAX $ 1301.40 PENALTY $ 0.00 INTEREST $ 139.36 TOTAL $ 1440.76 FEE(S) $ 20.00 GRAND TOTAL $ 1460.76 For returns due on or before December 31, 1999,interest is due at the rate of 12%per annum. For returns due on or after January 1,2000,a floating rate of interest applies in accordance with section 213.235,Florida Statutes. WITNESS my hand and official seal in this City of Miami Miami-dade County,Florida,this 17th _ day of June 2011 ;53 { '. ♦-. .. lit t. ,. .t> Department of Revenue, State of Florida dot 'itiii•. Thi instrument prepared by: 5, Q,., 714130°°. :s m E E.,- Authorized Agent Please bill to: State of Florida, Department of Revenue MIAMI NORTH SERVICE CENTER 8175 NW 12TH ST STE 119 DR-78 Miami,FL 33126-1828 R.08/09 Having issues viewing this image?(GetBin.aspx? 886 110th Ave.N.Suite#6, Naples,FL 34108 - x o Phone:239.777.1028 '-ideirt- 40- . Fax: 877.275.3593 ` www.LicensesEtc.com BUSINESS CREDIT REPORT as of: 09/23/15 08:54 ET Reyes Tile Service Co. Fed Tax ID# 65-1020720 Address: 3444 Marinatown Ln Ste 10a Key Personnel: Reyes Angel N FT Myers, FL 33903-7010 Reyes Marina United States SIC Code: 1743-Terrazzo, Tile, Marble &Mosaic Experian SIN: 744961150 Work Agent: Reyes Angel NAICS Code: 238340-Tile And Terrazzo . Contractors Agent 1485 W 5 Lane Address: Hialeah, FL Business Type: Corporation Experian File May 2002 Family Linkage: Established: Ultimate Reyes Tile Service Co Experian Years on File: 13 Years Parent 3444 Marinatown Ln Ste 10a N FT Myers, FL Years in Business: More than 13 Years Total Employees: 5 Branches/ Reyes Tile Service Co Alternative 151 Fairway Dr Apt 2308 Locations Miami Springs, FL United States Sales: $351,000 Reyes Tile Service Co Filing Data Provided Florida 1501 Ortiz Ave by: Fort Myers, FL United States Date of Incorporation: 07/03/2000 Reyes Tile Service Co Page 1 of 2 151 Fairway Dr Apt 2306 Miami Springs, FL United States Public Records PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS. V Bankruptcies: 0 V Liens: 0 V Judgments Filed: 0 X Collections: 1 Collection Filings Date Agency gency Phone Status Closed Amt Amt Comments Date Disputed Collected Receivable Open 09/11 Management 484-242-4000 $654 $0 Account Services Collections Summary Status Number of Items Amt Disputed Amt Collected Open Account 1 $654 "0 END OF REPORT Page 2 of 2 Client#: 1448888 132REYESTIL ACORDr. CERTIFICATE OF LIABILITY INSURANCE DATE(MMIDD/YYYY)9/24/2015 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 Pam Giilmore NAME: BB&T-Oswald Trappe and Company PHONE 239 433-7197 FP'X 866 802-8680 13515 Bell Tower Drive E-MAIL°Ert): (ac,No): ADDRESS: pgillmore©b andt.com Fort Myers,FL 33907 _ INSURER(S)AFFORDING COVERAGE NAIC# 239 433-4535 INSURER A:Old Dominion Insurance Company 40231 --------- ------------ INSURED INSURER B: ----- --------_-----------_---- Reyes Tile Service Company -- —--INSURER C: Marina Reyes - — ` INSURER D 890 E.23rd Street INSURER E: Hialeah,FL 33013 — — --- — 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 WVD POLICY NUMBER 1MM/DD/YYYY) (MMIDDIYYYY) LIMITS. - A GENERAL LIABILITY MPG8531 F 07/15/2015 07115/2018 EACH OCCURRENCE $1,000,000 ppaqMlq�E 77 RENTED X COMMERCIAL GENERAL LIABILITY PREMISES�Ea occurrence) $500,0()0 CLAIMS-MADE l X OCCUR MED EXP(Any one person) $10,000 PERSONAL&ADV INJURY $1,000,000-_ GENERAL AGGREGATE $2,000,000 GENT AGGREGATE LIMIT APPLIES PER PRODUCTS-COMP/OP AGG $2,000,000 X1 POLICY P 1 ECT LOC — -- -- - -- - - $ --------_- A AUTOMOBILE LIABILITY MPG8531 F 07/15/2015 07/15/2016 COMBINED SINGLE LIMIT 1 000,000 IEa accident) r ANY AUTO BODILY INJURY(Per person) $ ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE c $ X HIRED AUTOS X AUTOS (Per acident UMBRELLA LIAB OCCUR EACH OCCURRENCE__ EXCESS LIAB CLAIMS-MADE AGGREGATE DED LRETENTION$ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABIUTY Y/N _TORY LIMITS _.ANY PROPRIETOR/PARTNER/EXECUTIVE E.L.EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? L_ N/A ---- ----------- - --- (Mandatory in NH) E.L.DISEASE-EA EMPLOYEE $ If DESCRIPTION OF E.L.DISEASE-POLICY LIMIT $ DESCRIPTION OF OPERATIONS below DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space is required) tile installation CERTIFICATE HOLDER CANCELLATION Collier County SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ty THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN GMD Operations&Regulatory Mgmt. ACCORDANCE WITH THE POLICY PROVISIONS. Licensing Section 2800 N Horseshoe Drive AUTHORIZED REPRESENTATIVE Naples, FL 34104 ©1988-2010 ACORD CORPORATION.All rights reserved. ACORD 25(2010/05) 1 of 1 The ACORD name and logo are registered marks of ACORD #S148393971M14474695 PAGI DATE(MWDD/YVYY) ACRD® CERTIFICATE OF LIABILITY INSURANCE 9/23/2015 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 NAME CT Yenitza Guzman __ ___ Lykes Insurance, Inc. " 239-931-3024 1 FA Ne): P.O. Box 60043 239-931-5604 Fort Myers FL 33906-6043 E-MAIL yguzman @lykesinsurance.com INSURER(S)AFFORDING COVERAGE NAIC• INSURER Technology Insurance Company 42376 INSURED REYES-2 INSURER B: Reyes Tile Service Company INSURER C P.O. Box 151701 Cape Coral FL 33915 INSURER D; INSURER E INSURER F: COVERAGES CERTIFICATE NUMBER: 1686721919 REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR ----- __ --ADDL-SUER T POLICY EFF POLICY EXP LIMITS LTR TYPE OF INSURANCE INSD WVD POLICY NUMBER (MM/DD/YYYY) (MM/DD/YYYY) COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ DAMAGE TO RENTED 1 CLAIMS-MADE OCCUR PREMISES(Ea occurrence) $ MED EXP(Any one person) $ PERSONAL&ADV INJURY $ GEN'L AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ POLICY I----1 PRO- 1 LOC PRODUCTS COMP/OP AGG $ JECT OTHER: - ---.— __._ ---$ ---- ------ AUTOMOBILE LIABILITY (EOa aBc EIJ SINGLE LIMIT $ ANY AUTO BODILY INJURY(Per person) $ ALL OWNED -_- SCHEDULED BODILY INJURY(Per accident) $ AUTOS AUTOS NON-OWNED PROPERTY DAMAGE- HIRED AUTOS AUTOS (Per accident) $ UMBRELLA LIAB OCCUR EACH OCCURRENCE $ EXCESS LIAB CLAIMS-MADE AGGREGATE $ DED I I RETENTION$ - -- -- - --$ - -_ -__ A WORKERS COMPENSATION N TWC3491674 8/31/2015 8/31/2016 I STATUTE uTE J ER AND EMPLOYERS'LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE Y/N1 N/A _E L EACH ACCIDENT $500,000 OFFICER/MEMBER EXCLUDED? -- (Mandatory in NH) E.L.DISEASE EA EMPLOYEE $500,000 If yes,describe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $500,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(ACORD 101,Additional Remarks Schedule,may be attached H more space is required) CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN Collier County GMD Operations&Regulatory ACCORDANCE WITH THE POLICY PROVISIONS. Management Licensing Section 2800 N Horseshoe Drive AUTHORIZED REPRESENTATIVE Naples FL 34104 / "�f/�(� �A ((()G/- 11/ ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and logo are registered marks of ACORD 200117 R10325 - /� Department of the Treasury Date of this notice: MA1� 7, 20 01 4 ) Internal Revenue Service Taxpayer Identifying Number 65-1020720 ATLANTA GA 39901 Form: Ta Period: For nce you may / call us at: _ -- 1-800-829-1040 IIrrIIrJlrrlirlllrrLJL11 I null I I i Or you may write to us at the address shown at the left.If you write,be REYES TILE SERVICE CO sure to attach the bottom 552 E 10TH ST part of this notice. HIALEAH FL 33010-3634520 NOTICE OF ACCEPTANCE AS AN S-CORPORATION YOUR ELECTION TO BE TREATED AS AN S-CORPORATION WITH AN ACCOUNTING PERIOD OF DECEMBER IS ACCEPTED. THE ELECTION IS EFFECTIVE BEGINNING JAN. 1, 2001, SUBJECT TO VERIFICATION IF WE EXAMINE YOUR RETURN. IF YOUR EFFECTIVE DATE IS NOT AS REQUESTED, IT WILL HAVE BEEN CHANGED FOR ONE OF TWO REASONS. EITHER YOUR ELECTION WAS MADE AFTER THE 15TH DAY OF THE THIRD MONTH OF THE TAX YEAR TO WHICH IT APPLIES, BUT BEFORE THE END OF THAT TAX YEAR, OR THE ELECTION WHEN SUBMITTED WAS INCOMPLETE, AND REQUESTED INFORMATION WAS RECEIVED AFTER THE FILING PERIOD. IN EITHER CASE, YOUR ELECTION IS INVALID FOR THE TAX YEAR REQUESTED AND HAS THEREFORE, BEEN TREATED AS THOUGH IT WERE MADE FOR THE NEXT TAX YEAR. PLEASE KEEP THIS NOTICE IN YOUR PERMANENT RECORDS AS VERIFICATION OF YOUR ACCEPTANCE AS AN S-CORPORATION. IF YOU HAVE ANY QUESTIONS ABOUT THIS NOTICE OR THE ACTIONS WE HAVE TAKEN, PLEASE WRITE TO US AT THE ADDRESS SHOWN ABOVE. IF YOU PREFER, YOU MAY CALL US AT THE IRS TELEPHONE NUMBER LISTED IN YOUR LOCAL DIRECTORY. AN EMPLOYEE THERE MAY BE ABLE TO HELP YOU HOWEVER, THE OFFICE AT THE ADDRESS SHOWN ON THIS NOTICE IS MOST FAMILIAR WITH YOUR CASE. IF YOU WRITE TO US, PLEASE PROVIDE YOUR TELEPHONE NUMBER AND THE MOST CONVENIENT TIME FOR US TO CALL SO WE CAN CONTACT YOU TO RESOLVE YOUR INQUIRY. PLEASE RETURN THE BOTTOM PART OF THIS NOTICE TO HELP US IDENTIFY YOUR CASE. THANK YOU FOR YOUR COOPERATION. To make sure that IRS employees give courteous responses and correct information to taxpayers,a second IRS employee sometimes listens in on telephone calls. Overlay 5 Form 8489(Rev,8-91) Keep this part for your records ---------------------------_____---- --------------------------------------- ---- ---- -- Return this part to us with your check or inquiry / Your telephone number Best time to call ( ) 200117 07953-503-01577-1 -- INTERNAL REVENUE SERVICE ATLANTA GA 39901 REYES TILE SERVICE CO 552 E 10TH ST HIALEAH FL 33010-3634520 651020720 WH 00 000000 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF tqog 1 r COUNTY OF 1-ir E- I, PArz hge a F15/I , having been first duly sworn, state and affirm: I am a resident of .2 € e County, 4-10/2 / ? (State) and have resided here for more than five (5) years. During the last five years I have known M 4E/Alo /Rgye---s (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. CIO tf44-78/' S ignat�ire IMPieCigIZET -(11--13 Name 9.-2 7 Scc.) G 5,- C o7..�- L o Address Telephone The foregoing instrument as acknowledged before me this Z kG4- „c ' Z o/S � �. i A� (Date) by � X 9 � who has produced !0. "'S`''`" 4//`/ �A.Jd 0.J-c) (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL ' '. .---ec.:- ,Wee-4e; (SIGN URE OF NOTARY) �",,t, ALEJITA PADRO rU`�{tY P��,�S ' �� Notary Public-State of Florida N ,'; •=My Comm.Expires Mar 15,2016 =�F�∎�a°r' Commission#EE 179725 Bonded Through National Notary Assn. AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER S'FATE OF r10 40---- COUNTY OF ,Z g E I, , having been first duly sworn, state and affirm: I am a resident of 2 ze-- County. F/o�'d 4 (State) and have resided here for more than five (5) years. During the last five years I have known PN 2i/va 2E y (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 Chr).'lline ( cbre[e Name 3/2 L / zzd-Gc% Rwy L eape Ora / L/ 33904,/ Address a 3q- 40/ - 73 7 Telephone The foregoing instrument as acknowledged before me this 2 S' I U'S (Date) by C if) Y I Sf A -0- C A.bti--ab- a-- who has produced ) (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL ? ' (SIGNA URE OF NOTARY) j�1rV■N4e�;- ALEJITA PADRO -_ Notary Public-State of Florida �� r jii My Comm. Expires Mar 15, o,•: 2016 ',48,, ps Commission #EE 179725 """ ,.,.Bonded Through Nafinni kJ^. VERIFICATION OF CONSTRUCTION EXPERIENCE'i GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: ( it.1 L s 1i 1--( 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 fo s�wwing information: --_� Name: e 1e< <'`X' /ce e'.:_1/ Z 7.— -" Title: / ,-/2-- t/27//7/c.:- e : 7 License Number(if applicable): A Cam, irk„,;,.,:3 f yco Name of Business: di„<., A..-„Y...,1 V > Qrr, (,..,14y1.r Business Address: // ' /6:i.. f kw,y A c/ m'y c, 3 ” 4. Business Phone: 0.11 32 7-7,2 i1 The applicant's years of experience from , OOO to 'C r`I yl'ti�' The applicant's scope of work(specific duties) included: /,, t : .f -� Additional comments: Falsifying any information provided herein may subject your license to revocation. Under the penalties of perjury I declare that I have read the fo going application and that be facts stated in it are true. �.... Siratyre _-- �t t.. C77— [1,_c 2_L.i, j..... . Print Name I State of Florida County of �'t t The foregoing instrument as acknowledged before me this ?I,l, i" j y�1.,�- -� 2./.5�� . (Date) by C. ,,.n<r /{(-/�y who has produced A7.4 , ,f..,.f% K.,,,,,,, (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL NICHOLAS GABRIELSEN / �t NOTARY PUBLIC SIGNATURN NOTARY) U. `__STATE OF FLORIDA ( ) , �,,,�'a Comm#EE203633 CE l0V Expires 5/30/2016 TILE CONCEPTS OF LEE COUNTY] INC, 720 NE 25th Ave, Ste 1, Cape Coral, FL 33909 (239)673-9728 September 28, 2015 To Whom It May Concern„ We have been doing business with Reyes Tile Service Co. for over 10 years. They are a very competent from layout to punch out. Their installations have been very good and timely. Reyes Tile Service Co. is an easy company to work with If you have any questions, please do not hesitate to call. Sinc Frank Rowan, President State of ioruia County of Lee Sworn to and Subscribed bei:r. 9,e day o2 +60,.....<1, DALE C.NOLFF V * * MY COMMISSION#EE 8401'? EXPIRES:October 19,20 i Notary Public 'reoF�oF`Oe BonedThruBudgetNotary Sery Personally known ✓ or produced identification Identification pro duc;d: Designers Showcase of Cape Coral, Inc. 940 Country Club Boulevard Cape Coral, Florida 33990 Phone 239-574-3602 Fax 239-574-3884 September 24, 2015 To Whom It May Concern: This letter is to verify that Marina Reyes of the Reyes Tile Service Co. has worked for us as a tile installation subcontractor since July of 2005. The company has provided us with quality workmanship for the past 10 years. It is our recommendation that you grant her a Collier County license. Sincerely, _1 61�-_ Julie Pescatrice,Sec. r�5 r���� LT \ 11 4a+- % LLINIT HERNANDEZ .;� Notary Public,State of Florida ;;;;; Commission#EE 843408 My comm.expires Oct.14,2016 _O l� t r 9 t4 ')-o S °°°"„. Lee County Tax Collector Tax Co tor 2480 Thompson Street Fort Myers, Florida 33901 ele°f °<`am www.leetc.com Tel: 239.533.6000 Local Business Tax Account: 0100601 Dear Business Owner: Your 2015-2016 Lee County Local Business Tax Receipt is attached below. The receipt is non- regulatory and is issued using the information currently on file with our office. It does not signify compliance with zoning, health or other regulatory requirements nor is it an endorsement of work quality. Annual account renewal notices are mailed in August to the address of record at that time; to ensure delivery of your annual notice, mailing addresses may be updated online at www.leetc.com. If there is a change in the business name, ownership, physical location or if the business is being closed, please follow the instructions on the back of this letter to transfer or to close the account. I hope you have a successful year. Lee County Tax Collector Detach and display bottom portion and keep upper portion for your records ‘sieCou LEE COUNTY LOCAL BUSINESS TAX RECEIPT 2015 - 2016 Tax Co ' tor s, ACCOUNT NUMBER: 0100601 ACCOUNT EXPIRES SEPTEMBER 30, 2016 d'relle of P.0' May engage in the business of: MARBLE/TILE/TERRAZZO CONTRACTOR Location 3444 MARINATOWN LN 10A N FT MYERS FL 33903 THIS LOCAL BUSINESS TAX RECEIPT IS NON REGULATORY REYES TILE SERVICE COMPANY REYES MARINA P THIS IS NOT A BILL-DO NOT PAY PO BOX 151701 CAPE CORAL FL 33915 PAID 392518-13-1 09/24/15 01:16:30 MBM1 $50.00 iLée C \Souti west rF60r'ida LIC2000-00437 marinapreves(a�hotmail.com License Holder MARINA REYES Name: Firm Name: REYES TILE SERVICE COMPANY Address: P 0 BOX 151701 CAPE CORAL FL 33915 Thank you for assisting Lee County Contractor Licensing in their effort to "Go Green". Please keep this document/file in a safe place as you will not be receiving any additional copies of your license from this office. Be sure to keep your email address current with us at all times. Below please find your Lee County Certificate of Competency. This Certificate will need to be renewed yearly if you wish to perform work in Unincorporated Lee County. Renewal will begin in the middle of August of each calendar year. If you choose to place your license on inactive status please notify this office as soon as possible. Please keep yourself up to date with our departments information by periodically reviewing our website at www.lee-county.com/dcd/contractorlicensing.htm In addition to this Certificate, it is your responsiblity to maintain your worker's compensation, general liability insurance and obtain a yearly business tax receipt from the Lee County Tax Collector while performing work in Unincorporated Lee County. You may email your certificates of insurance to ContractorLicensing @Leegov.com. Our phone number is 239-533-8895. Please send e-mail address and/or telephone changes to ContractorLicensing @Leegov.com IMPORTANT CHANGE PLEASE READ: In an effort to reduce costs and "go green" we will no longer be mailing renewal reminders. If you wish to receive a renewal reminder via email please provide us with your email address along with your case number LIC2000-00437 to ContractorLicensing @Leegov.com. Re: "renewal by email". Cut Here Conditions of Certificate LEE COUNTY Conditions of Certificate CERTIFICATE OF COMPETENCY (239)533-8895 Shall maintain required insurances on active Renewal due for active and inactive certificates. certificate each year in September. NAME: MARINA REYES D/B/A REYES TILE SERVICE COMPANY COMP. NO. shall appear on all Shall inform the Contractor Licensing Office of LICENSED FOR: Tile and Marble any Address or telephone#change. advertisements including vehicles reflecting a business name. Shall only contract in D/B/A name as it appears on certificate. Board of Approval COMP. NO.: TM00 00437 required on business name changes. NOT VALID AFTER: 09/30/2016 Signature of License Holder fcntrlocren2.rpt CITY OF 17t '<OR\OP City of Cape Coral ir F Certificate of Competency 10314 Date Issued: 09/29/2014 TILE/TERAZZO/MARBLE REYES MARINA P REYES TILE SERVICE CO Expiration Date: 09/30/2016 Detach and post bottom portion CITY OF CAPE CORAL CERTIFICATE OF COMPETENCY City of Cape Coral -- 1015 Cultural Park Blvd -- Cape Coral Florida 33990 -- (239) 574-0430 This Certificate expires September 30, 2016 Visit Our Website at www.capecoral.net Certificate #: 10314 Location: P O BOX 151701 CITY OF Classification: Business Phone: (239) 458-7883 SPECIAL'T'Y State License: N17.1 "PILE/TF,RAZLO/MARBLE REYES MARINA P TILE SERVICE CO Date Issued: 09/29/2014 P O BOX 151701 Amount: $ 150.00 CAPE CORAL. FL 33915 2015/ 2016 CHARLOTTE COUNTY LOCAL BUSINESS TAX RECEIPT ACCOUNT 8803 MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES SEPTEMBER 30 2016 TYPE OF 2126 TILE, MARBLE,TERRAZZO,AND MOSAIC RENEWAL BUSINESS BUSINESS VARIOUS LOCATIONS ADDRESS CHARLOTTE, FL 00000 BUSINESS REYES TILE SERVICE CO NAME AMOUNT 00 PENALTY ()00 OWNER MARINA P REYES TOTAL 35 00 MAILING PO BOX 151701 ADDRESS CAPE CORAL, FL 33915 • TI IIS I ORM BECOMES A RECEIPT ONLY WHEN VAL II)ATED Paid 09/25/2015 Receipt # 777-00005171 35.00 2015/ 2016 CHARLOTTE COUNTY LOCAL BUSINESS TAX RECEIPT ACCOUNT 8803 MUST BE DISPLAYED IN A CONSPICUOUS PLACE EXPIRES SEPTEMBER 30 2016 TYPE OF 2126 TILE,MARBLE,TERRAZZO,AND MOSAIC RENEWAL BUSINESS BUSINESS VARIOUS LOCATIONS ADDRESS CHARLOTTE,FL 00000 BUSINESS REYES TILE SERVICE CO NAME AMOUNT 35 00 PENALTY ;,00 OWNER MARINA P REYES TOTAL 35 00 MAILING PO BOX 151701 ADDRESS CAPE CORAL, FL 33915 THIS FORM BECOMESA RECEIPT ONLY WHEN VALIDATED Paid 09/25/2015 Receipt # 777-00005171 35.00 Dear Business Owner. Your 2015- 2016 Charlotte County Local Business Tax Receipt is attached above Please detach the receipt and display it in a place that Is visible to the public and available for inspection The Charlotte County Local Business Tax Receipt is in addition to any other license or certificate that may be required by law and does not signify compliance with zoning,health, or regulatory requirements The Charlotte County Local Business Tax Receipt is non-regulatory and is not an endorsement of work quality. Your 2015 - 2016 Local Business Tax Receipt is valid from September 01. 2015 through September 30. Annual account notices r,• mailed in June to the address of record at that time Any Changes to your Local Business Tax Account due to change of Business Name. Ownership. Physical Address or you are Closing your Business please contact our office at 941-743-1350 VICKIE L. POTTS Charlotte County Tax Collector CHARLOTTE COUNTY LICENSING CERTIFICATE OF COMPETENCY �j NOT VALID AFTER 09/30/2017 X92 Lic Type: L CERAMIC TILE DBA REYES TILE SERVICE CO Nb• AAA0010801 MARINA REYES 890E 23RD STREET 71% HIALEAH FL 33013 z — C11 k _ } \ / U uJ 0 0 E g CO c • $ _ E z k m » c 3 2 2 m = i ] e / 2 $ 'd " §2 m # 2 @ • re J Q � 9 m CC.... R $ @ _ re , q z k / -73 \ m D •§ a g Z e _ o [ CI5 . a 6 ) Li - b � § ) - § $ 2 0 + c:L. ou ;1 o ,D ± 0 . 2 ] § Z � \ m # § a. U ,, ® o6 § j 0-3 1 .0 E Uj 0 2 \ NI ƒ \ .. j » IN La ( cew - �tol re < Ee zm0_ 24 \ k Iwo U4 eme § ( / } / � 2 R D :- cam!4T s- E�,f Ittrif-0;13' 2 —+ m C) Dtn o o c C) 70 1 xi 0 O m Z o D —I < (1 V) D 0 ul �' N X = 0 -, -,, :m o . DJ 3' a W �_�, ' . (fi r s Ei m vz � m n1 v CD GI Fi O� to O G`S D IX�•3 tvn° fiT1 cOn o � ,� -.� O - m CD N J> Z z �, O cr fD rt _ z ? m m fl" C m O > n D O 3 -c C —h—• ° •U,.� '.. t STATE OF FLORIDA } DEPARTMENT OF BUSINESS AND PROFESSIONAL REGULATION DIVISION OF REAL ESTATE 850-487-1395 1 1940 N. MONROE ST. 4 TALLAHASSEE FL 32399-0783 coo Congratulations! With this license you become one of the nearly one million Floridians licensed by the Department of Business and Professional Regulation. Our professionals and businesses range from architects to yacht brokers,from boxers to barbeque restaurants, and they keep Florida's economy strong. Every day we work to improve the way we do business in order to serve you better. For information about our services, please log onto www.myfloridalicense.com.There you can find more information about our divisions and the regulations that impact you, subscribe to department newsletters and learn more about the Department's initiatives. Our mission at the Department is: License Efficiently, Regulate Fairly. We constantly strive to serve you better so that you can serve your customers.Thank you for doing business in Florida, and congratulations on your new license! STATE OF FLORIDA DEPARTMENT BUSiness/c OF BUSINESS AND PROFESSIONAL Professional REGULATION SL607553 ISSUED:09/27/2015 SALES ASSOCIATE REYES, MARINA PADRO Signature PROVISIONS OF CHAPTER 475,FLORIDA STATUTES EXPIRATION DATE: SEPTEMBER 30,2017 .- $ *S'4..6. ,ti1i M/jt` SI'lYb�.e DRIVER LICENSE C E 1ARINA PADRO REYES 880 E 23 ST HI H.FL 3309341300 e. ._ SEX:f SAFEiIRWER Opera/ion of a Mean whiohe a gnsliteMes tenser*m any sca»teq test regsured by Eau +Co1 >rr Caunty GMO-Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive ,'a Naples, FL 34104 )..D15 _340 l APPLICATION FOR COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO INDIVIDUAL INSTRUCTIONS: This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. QUALIFIER INFORMATION: Name: t/I,fp Al A- S,t ia, Address: r �� �y4r CSie / /Ic 3Y//5 (Number&Street) r (City) (State) (Zip Code) Telephone: j3 5?. �P V( Date of Birth: S.S. #: 000-00- _ _ E-Mail: 6149A/ /0010 e 6P'.4r L. cop4. Driver's License: FICTITIOUS NAME(IF APPLICABLE): ,4(4' c0 r t t Address: 196 60A 537 A44 ( T S4A tiD Ft 3Y/ (Number&Street) 44'6 (City) (State) (Zip Code) Telephone: j-3 t 575 5- E-Mail: Jif AI-, / 6 e 6,14 i i.. TYPE OF LICENSE ❑ General $230.00 ❑ Electrician $230.00 ❑ Building $230.00 U Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 Ca/Swimming Pool $230.00 ❑ Roofing $230.00 lrl Specialty $205.00 Specialty trade: Pt ' I C1wnln9 On 19 IF PART SHIP: Name: Address: (Number& eet) (City) (State) (Zip Code) Telephone: 1. List all businesses, firms, entities or contracting businesses you have been associated.(ex: held a license or was a partner) with during the past ten (10) years.Attach extra pages if needed. 2. License No. of ANY CURRENT OR PREVIOUS CERTIFICATE OF COMPETENCY held.by Applicant. Licens o. License No. License No. H License No. 3. Name ap d telephone ig.umbrs of two persons who alwa s know the hereabouts of the contractor. ,LIANA M4i AAN 23i -J3c 7w1 'y GAS ffiG4 iA ./ 23 Fri ZY.3 ' 4. Statement of business or work experience during past ten (10) years. Fr,e r".,Gd 6A-/E-fri 417-41,151— 5-6,,ArC Al/A C 6600 •/"' 4cNoitlee r e- s-c 0 t 1a1 5. Statement of any formal training of the qualifying agent in area for which application is being made. 6. List all debts you or any company(s) associated with you refused or fail to pay and reasons for its refusal to pay. NaNe 7. Have you ever been convicted of a crime related to Contracting? ❑ Yes (If yes attach explanation). l' No 8. Have you or any firms you have been associated with ever filed bankruptcy? ❑ Yes No 2 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 Certific of Competency. Signature of Applicant /1/41 O root c6. Business Name ?b//5. Date BEFORE ME this day personally appeared Z4/0 N 3-164/4 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 CO LLt E t. The foregoing instrument as acknowledged before me this SEPrEAZER' 3 Za LS' (Date) by (A@r0►J Skr-car-2- who has produced all tJe .S (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL 141« /`t )1(• , Vi (SIGNATURE OF NOTARY) Notary Public State of Florida Brenda M Hartman +� d' My Commission EE 830358 �7i_._dam c ml.a nN2cd2nt8 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. &4RoN S{KENom Applicant(please print) /Vilfco fôL EMI/scE Name of Company //L fr Signature of Applicant State of Florida County of C,oU_1 ER The foregoing instrument as acknowledged before me this 5f 9 EM$Ea. 3 2.0 is ` (Date) by QA?a{ S EA who has produced d�0v ee-S lie-Vase, (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL Zadeic`-ht, •Vt1 (SIGNATURE OF NOTARY) MOW 11o►oarozmo•+nd 31 uass!wWO3 Ap ii N 4 of 4 ueu ueH{ry epueog BPPWj Jo MIS*!IQnd ti@tANI Nat, GITS, LLC Examination Operations Division Providing the services and products to assist Government Agencies to make informed educated decisions. Official Examination Score Report August 3,2015 Official Score Rel t: Candidate Information: Name—GaronSk . Candidate.#818018705 Testing Site: Ft.Myers,FL = _ Final Score Result: g Business Procedures Score: 84% These results represent r�de that has been achieved on the Business procedures exmination(s) administered by Gainesville Independent Testing Service for Collier County, Florida on August 3,2015. If you have any further questions,pleasexIo not hesitate to contact us. Sincerely, q;. (ii;) ♦ Jay . :owermeister President Viz.. PO Box 831127 Ocala,Florida 34483-1127—Voice(352)369-GITS –Fax(352)387-2443 800 997 2129 REGISTRATION#G15000081539 Fictitious Name to be Registered: MARCO POOL SERVICE Mailing Address of Business: PO BOX 537 MARCO ISLAND.FL 34146 Florida County of Principal Place of Business: COLUER FILED FEI Number: AV 06,2015 secretary of State Owner(s)of Fictitious Name: SKENDER,GARON A PO BOX 537 MARCO ISLAND,FL 34146 I the undersigned,being an owner in the above fictitious nano certify that the information indicated on this form is true and accurate.I further certify that the fictitious name to be registered has been advertised at least once in a newspaper as defined in Chapter 50,Florida Statutes,in the county where the principal place of business is located. I understand that the electronic signature below shall have the same legal erect as if made under oath and I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155,Florida Statutes. GARON SKENDER 08106/2015 Electronic Signatures) Date Certificate of Status Requested(X) Certified Copy Requested( ) A CERTIFICATE OF LIABILITY INSURANCE 090 01'5°°"""' 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: ANEW INSURANCE!ALLSTATE INSURANCE INC.PHONE E >n)239-793-8500 {ac,N 39 793 8524 EMAIL 3940 Radio Rd Suite 108 ADDRESS: Naples,FL 34104 PRODUCER CUSTOMER ID T. INSURER(S)AFFORDING COVERAGE NAIC S INSURED INSURER A: Cypress Insurance Company 10953 GARON SKENDER INSURER B: MARCO POOL SERVICE INSURER C: 470 ELK CIRLCLE INSURER D: MARCO ISLAND FL 34145 INSURERE: 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. _—- ADDLISUBR POLICY EFF POLICY EXP ILTRR TYPE OF INSURANCE INSR WVD POLICY NUMBER (MMIDDIVYYY) (MMIDDVYYYY): LIMITS GENERAL LIABILITY ,EACH OCCURRENCE $1 00,000 FGL 5003006 00 09/0312015 09/03/2016 DAMAGE TO RENTED X COMMERCIAL GENERAL LIABILITY I PREMISES(Ea occurrence) $100,000 CLAIMS-MADE X OCCUR MED EXP(Any one person) $5,000 PERSONAL 8 ADV INJURY $100+000 A i GENERAL AGGREGATE $100+000 GEN'L AGGREGATE LIMIT APPLIES PER: I PRODUCTS-COMP/OP AGG $ Induded lit POLICY 3 C- LOC - $ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT (Ea accident) ANY AUTO I BODILY INJURY(Per person) $ ALL OWNED AUTOS '.~BODILY INJURY(Per accident) $ SCHEDULED AUTOS I PROPERTY DAMAGE HIRED AUTOS (Per accident) NON-OWNED AUTOS $ UMBRELLA LIAR OCCUR I EACH OCCURRENCE $ —EXCESS LIAB CLAIMS-MADE AGGREGATE $ DEDUCTIBLE �[ $ RETENTION $ WORKERS COMPENSATION WC STATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETORIPARTNERIEXECUTIVE E.L.EACH ACCIDENT $ OFFICERIMEMBER EXCLUDED? N/A (Mandatory In NH) E.L.DISEASE-EA EMPLOYEE$ If yes,describe under DESCRIPTION OF OPERATIONS below I E.L.DISEASE-POLICY LIMIT $ I i 0 111 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES(Attach ACORD 101,Additional Remarks Schedule,If more space Is required) CERTIFICATE HOLDER CANCELLATION COLLIER COUNTY LICENSING DEPAR SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE 2800 NORTH HORSESHOE DRIVE THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN ACCORDANCE WITH THE POLICY PROVISIONS NAPLES FL 34104 AUTHORIZED REPRESENTATIVE Denise Thoman ©1988-2009 ACORD CORPORATION. All rights reserved. ACORD 25(2009109) The ACORD name and logo are registered marks of ACORD snn CREDIT CHECK CONFIDENTIAL Individual Credit Report Name • SKENDER, GARON ANDREW Ordered By: 1186 Address : 387 EDGEWATER COURT Customer : 9999 Received : 08/25/15 MARCO ISLAND, FL 34145 Completed : 08/25/15 Social #: Applicant j Bill Amt : $60. 00 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid Past Pay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA ACS/WELLS PD COLLECT 03/10 01/08 66175 CLOSED 0 0 -- -- -- 19-* 02 A DLA=10/09 BK OF AMER PD COLLECT 08/12 07/06 12548 PAID 0 REV -- R9-* 07 A DLA=11/09 CAPITAL ONE PD COLLECT 10/12 01/02 5126 PAID 0 REV -- -- -- R9-* 12 A DLA=12/09 CAPITAL ONE AS AGREED 08/15 06/15 333 333 0 25 00 00 00 R1 01 A DLA=08/15 CAPITAL ONE AS AGREED 08/15 05/15 60 20 0 20 0000 00 R1 02 A DLA=08/15 CAPITAL ONE AS AGREED 10/08 11/03 799 PAID 0 REV 0000 00 R1 48 A DLA=01/08 CHASE PD COLLECT 03/12 02/03 2065 PAID 0 REV -- -- -- R9-* 10 A DLA=12/09 CNVRGT HTHCR COLLECTION 07/15 05/15 1809 1809 1809 COLL -- -- -- 09-* 00 A ORIGINAL CREDITOR: MEDICAL CREDITACPT COLLECTION 08/15 02/13 8991 6552 6552 357 -- -- -- I1 03 A DLA=06/15 Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 CREDIT CHECK CONFIDENTIAL Name • SKENDER, GARON ANDREW Customer: 9999 Page: 2 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid Past Pay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA E LOAN/SST AS AGREED 05/06 10/03 10827 CLOSED 0 0 0000 00 I1 29 A DLA=05/06 FIA CS AS AGREED 02/10 12/04 1872 PAID 0 REV 0000 00 R1 48 A DLA=05/06 FRD MOTOR CR AS AGREED 05/06 10/05 14503 CLOSED 0 0 0000 00 I1 07 A DLA=04/06 HWARFIELD COLLECTION 06/15 08/10 1770 2615 2615 COLL -- -- -- 09-* 05 A ORIGINAL CREDITOR: CAMDEN ASHBURN FARMS MERCHANTSCOL COLLECTION 01/15 02/14 125 125 125 COLL -- -- -- 09-* 01 A ORIGINAL CREDITOR: MEDICAL MERCHANTSCOL COLLECTION 01/15 02/14 125 125 125 COLL -- -- -- 09-* 01 A ORIGINAL CREDITOR: MEDICAL MIDLAND FUND COLLECTION 08/15 09/13 5315 5315 5315 COLL -- -- -- 09-* 02 A ORIGINAL CREDITOR: CAPITAL ONE BANK USA N A MIDLAND FUND COLLECTION 08/15 10/12 127 127 127 COLL -- 09-* 03 A ORIGINAL CREDITOR: VERIZON VIRGINIA INC MIDLAND FUND COLLECTION 08/15 02/12 2065 2339 2339 COLL -- -- -- 09-* 04 A ORIGINAL CREDITOR: CHASE BANK USA N A SALLIE MAE AS AGREED 06/06 12/02 3770 CLOSED 0 0 0000 00 I1 40 A DLA=05/06 SNAP ON CRDT AS AGREED 09/13 09/10 4887 CLOSED 0 0 0000 00 I1 35 A DLA=09/13 Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 CREDIT CHECK CONFIDENTIAL Name • SKENDER, GARON ANDREW Customer: 9999 Page: 3 CREDIT RECORD (Credit history has been checked for a period of seven years or from open date. ) Creditor Date Date High Unpaid Past Pay Historic Stat Current Mos Account Number Reported Opened Credit Balance Due Terms 30 60 90 Status Rev ECOA SST/FRFT2005 AS AGREED 08/06 02/01 9058 CLOSED 0 0 0000 00 I1 13 A DLA=08/06 SST/JPMC PD WAS 90 12/12 05/06 23133 0 0 0 1205 00 I4* 48 A DLA=12/12 SUNTRUST MTG FORECLOSURE 06/10 03/07 300000 0 0 0 0102 12 M5-* 38 C DLA=04/09 SYNCB/CHEVRO AS AGREED 07/15 09/04 0 CLOSED 0 REV 0000 00 R1 48 A DLA=07/15 UNVL/CITI AS AGREED 12/08 12/03 0 PAID 0 REV 0000 00 R1 48 A DLA=04/07 USAA SVG BK COLLECTION 08/15 09/00 8315 8315 8315 249 -- -- -- R9`* 17 A DLA=12/09 USAA SVG BK AS AGREED 09/08 09/00 2039 PAID 0 REV 0000 00 R1 48 A DLA=01/07 WE EFS COLLECTION 07/15 03/08 62000 675336753365195 I9-* 08 A DLA=02/11 Total trade lines on this report: 28 PUBLIC RECORDS: PUBLIC RECORDS HAVE BEEN CHECKED AT THE COUNTY, STATE AND FEDERAL LEVELS WITH THE FOLLOWING RESULTS: CLEAR AS OF 08/25/15. SOURCE (S) : EQUIFAX TRANSUNION INQUIRIES: 08/25/15 by CREDIT CHECK (TU) #00630273 06/14/15 by CAP ONE (TU) #02699824 Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 sm CREDIT CHECK CONFIDENTIAL Name • SKENDER, GARON ANDREW Customer: 9999 Page: 4 INQUIRIES: COMMENTS: FRAUD RECORDS HAVE BEEN SYSTEMATICALLY CHECKED BY THE ABOVE ACCESSED BUREAUS. SAFESCAN/EQUIFAX, HAWK ALERT/TRANSUNION CHECKED FOR FRAUD. REPORT WORKED BY RENEE CREDIT SCORE: APPLICANT FICO SCORE: 579 (scores range from 300 to 850) *** END OF REPORT *** This information is confidential and is not to be divulged except as required by the Fair Credit Reporting Act. This personal report is furnished simply as an aid in determining the credit desirability of the applicant(s). It is based upon ii damation obtained in good faith by this agency from sources deemed reliable. The accuracy of same,however,is in no way guaranteed. By your acceptance and use of this report,you specifically agree to hold Credit Check,Inc.harmless from any liability whatsoever. Ordered by: APPLICANT - SEE NAME ABOVE Reporting Agency: Credit Check, Inc. -3017 Exchange Court, Suite H, West Palm Beach, FL 33409 . (561) 616-5556 GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: beAr0/ - S Certificate Category Requested: Swim✓.i t (oo■ C)eb.,n V °A)t-�1 The applicant is seeking a Collier County Certificate o f Competency in the trade indicted 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 tme 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: Na-t- - Std i i,er Title: (?wv.t r License Number(if applicable): C.a`17 73 Name of Business: Ca 1Lt544. Poo 1 5e T✓ l c Business Address: ?b X Soy 0,1 c 6 --/-1/4/10( f R 3 ix& Business Phone: 0171-8-01-S-°70 6 The applicant's years of experience from SIP. to b'I /.5 The applicant's scope of work(specific duties)included: des c.‘ S w N m rh A2oa Sec-, L 2cicl to Additional comments: J Falsifying any information provided herein may subject your license to revocation. Under the penalties of perjury I declare that I have read the foregoing� ok applicati.n i •• that the facts stated in it are true. 1�,J�iZzt plz/ Signature atj- l el Print Name State of Florida County of e...OL1 J E/� The foregoing instrument as acknowledged before me this 21 sr A4,4 of Set ichtip .R 2016 by MAA� ,,�j L Mate) SToIIE R who has produced dam/ Lite/►ge.•,0jhh (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL dAi4atit. 4 � p e c state of Florida (SIGNATURE OF NOTARY) Brenda M Hagman II My Commission EE 830358 \wog' Expires 0812612016 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STA l'E OF FL u,Z LM COUNTY OF GOLtyat CNYyk., Arran , having been first duly sworn, state and affirm: I am a resident of ('} . 1 f'ti' Lourilj County, _ \6y l f X (State) and have resided here for more than five (5) years. f� During the last five years I have known (/4RoN 5)G�n'�12 (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`4 Signature _ .V - 1/` Name C)AP C* . � Imo%. ~) I Address z,31\ "R7*\-94 Telephone The foregoing instrument as acknowledged before me this O( 13( 1 5 (Date) by 1b., p,n(_ \A {mat\ who has produced (j( \ l c-e ' e (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL .....�.+� (SIGNATURE OF N►TARY) 4s•TL:•,•,, ROBIN G. ROZANKOWSKI Commission 4 FF 4803 My Commission Expires �:4 3,,,a�;,. April 03. 2017 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF rt `pit COUNTY OF Coq i-e� I,Q) \e\&O C oQ\ , having been first duly sworn, state and affirm: I am a resident of C)N\\{,,V County, -- (State) and have resided here for more than five (5) years. During the last five years I have known etalO\ eii ' ,Q r (applicant) I have had the opportunity to observe his or her business and personal dealings and fmd him or her to be a person of honesty, integrity and good charac . 4 1 (1V Alt__�.!�At. iar' ignature ein6ea Co - Name Eck Masco .emla M14s Address a 39 - 5-1 cxocie Telephone The foregoing instrument as acknowledged before me this c1\R .\v5- Ckn�\S�a ep�� (Date) . by who has produced dot«f s t c e.if)5C- (name of person acknowledging) (type of identification) as identification and did not take an oath. NOTARY'S SEAL (SIGNATURE OF NOT Y) IIININ� i o``N,.�r►de. ROBIN G. ROIANKOWSKI ;` *__ Commission#FF 4803 :$9,:,r„= My Commission Expires COLLIER COUNTY BUSINESS TAX RECEIPT , APPLICATION Az'It 2800 N.Horseshoe Drive,Naples,FL 34104 k;4 Wig° Make Check Payable to Collier County Tax Collector ° •` �'; Phone:239-252-2477 Fax:239-643-4788 Website:www colliertax.com �Z::;p0 CHECKLIST Co py 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.(239-252-24M Copy of Motor Vehicle Repair Registration Certificate $IOC 0 from Department of Agriculture.(800-435-7352) Confir *z c LrG SiS,- a Copy of Health inspection from Department of Hotels and Please contact the Property Appraiser's office at 239-25Z-8145 Restaurants(850-487-1395)or Department of Agriculture. regarding tangible tax. (800-435-7352) CHECK ONE: Date: q/A X Original Application Classification O p( "C ) vt � Transfer of License# Code Number OA/ - /0/ ` Renewal of License# License Amount 1) CORPORATE N la) DBA NAME- P1ARC o Pod L SLgv=C lb) BUSINESS OWNER OR QUALIFIER'S NAME- &4/?Ii I SKKNQEi 2) PHYSICAL ADDRESS- 2111141 - MARCO x/93 (No P.O.Box allowed) 970 ELK C 41-4- 2a) IS RESIDENCE USED AS AN OFFICE- X Yes No 3) BUSINESS MAILING ADDRESS- fa Bak 537 PlAfe6 SLAV,' iL• 1% Street City qv e • cu. Zip 4) OWNER OR QUALIFIER'S RESIDENTIAL ADDRESS- P1 ARGo FL rift 5) TELEPHONE-Business: 231 59 05 Home: Z39 5q5 6y05 6) LEGAL FORM OF BUSINESS: -)C Sole Proprietorship Partnershi Corporation LLC LLP 7) OPENING DATE OF BUSINESS OR DATE ASSUMED- (Q/Ir 8) OFFICE WITHIN CITY LIMITS OF NAPLES- Yes X No If Yes,City License No. 9) SOCIAL SECURITY NO. or FEDERAL EMPLOYER IDENTIFICATION NO. — W6 /25 *see back of application for explanation 9a) TYPE OF BUSINESS CONDUCTED: oalCLEAN 106 10) NUMBER OF EMPLOYEES-Including number of owners: I 11) FILL IN THE APPROPRIATE AREAS- a)Rental units(motel/hotel/apts.)Number of units: b)Seating Capacity(rest./cafes,etc)Number of seats: c)Number of coin-operated machines owned by business or individual: 12) STATE LICENSE OR CERTIFICATION NUMBER- Must have photo copy of state license if state licensed and certified UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN IT ARE TO THE BEST OF MY KNOWLEDGE. vvvAPPI.ICANT'@C36:'NATITR3+• � itATP! i/Iv//5. City of Marco Island 50 Bald Eagle Drive 4 . �, Marco Island, FL 34145 (239)393-0200 Home Occupation Fax (239)393-0266 Letter of Zoning Compliance Mailing Address: GARON SKENDER 470 Elk Cir Marco Island, FL 34145 Certificate Number HOC-15-003734 Issue Date 08/25/2015 Expiration Date 08/24/2016 Applicant GARON SKENDER Phone 2395956405 Business Name Type of Business Mailing Address 470 Elk Cir Marco Island, FL 34145 Property Address 470 Elk Cir Marco Island, FL 34145 Approval: 8/26/2015 Da Martinez Date Notes/Restrictions Applicant must comply with City of Marco Island Ordinance Article Ill, Section 30-405. coffre r County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION NAPLES, FLORIDA 34104 www.colliergov.net (239) 252-2400 FAX (239)252-6358 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): big SKENG ER- Telephone: 2:31 ' 51 5 -611°5 Cell: Fax: E-Mail Address: bOaA/ /0OOt7M,4 Lt, • Cam. BUSINESS& USE INFORMATION Business Name(If any): I'►ARGo 113L S ;CE Phone Number: 237 — 5”— —(pI/05 Address: 1 0 [ `'c 537 City: #14RCO t''1 State: f G ZIP: 3,1 1 116 Description of the type of business or use: POOL ANO Sfri GG iI N LNG l 5t v c SN c OPT Of rice 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 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 . . . . :•••,•• � ..... : %« ?y� ©« : . . . � «a d� : ». 2� \ \ < \ . \! y \.:• y •,,. < » \ \ • \ \ <%. - »\\ . . 2 . . } \����\\ © £ y% } - &1m ƒ ƒ {��� �«�+e . \ /. < �?�d <f w w�� °d d \\-- : . . 2f 2 - : . .&��S` : \ ' . . October 2,2015 Brian Kirwan for: Brian Kirwan Painting Inc, 101 Willoughby Dr. Naples, FL 34110 239-777-6051 GMD Operations&Regulatory Management Licensing Section 2800 North Horseshoe Dr. Naples, FL 34104 Michael Ossorio: Brian Kirwan requests a meeting before the Collier County Board of Commissioners in the month of October, 2015 for the reinstatement of his painting contracting license. Enclosed is all the d•-• -ntation requested. Sincerely; G% Brian Kirwan Co i e-r C431.4.1-ity 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: P � Exact Corporate/Business Name: /'it a,YI /rl/" GW c ,7 � -j` A7.-/-,4/l /t ?i !rte 1720 Fiction Name/DBA: fit/i?? Qualifier Name: /177/a YI )7/ /r, 7? Physical Address: /a/ ez, //ate A ,V, ;4,44 /-1 39//a (Number&Street) / (City) (State) (Zip Code) Mailing Address: 0?3YI ,137 de,lee iii fE0Z? Pyle 5 17 JV//# (Number&Street) (City) (State) (Zip Code) Telephone: 42 7y'- 777 6,i7 / E-mail: 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 Specialty $205.00 Trade: PeLi 11+i 0- i 1t-cs , 3 i`5� Specialty lab �cj C� CGE OF STATUS' (=statement ( ✓) From One Business to Another) ( 1 i�nrmant License to Active r� Ciao 8/31/2015 Reinstatement Fee=$205.00 Page 1 of 4 3 Year Fees=$555.00 New License fee—$205.00 *Different fees may annly* Total=$965.00 • 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. /6c p 1 e ms - eyrie;//ff/ i/% p4 , t/q4 2391.- 777 W5/ 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. 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. ,fryie../.. Authorized Office of the Firm The foregoing instrument as acknowledged before me this // I `J- by f' :et, h of A✓' (Name of Offic , Title/Agent) (Name of Corporation) a fki Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced Fbi1`cf a Of L' r Li?'P.f?i€- identification and did not take an oath. Ou w 4yse of identification) NOTARY'S SEA %,,z7;4,061041,,�per 2� ;.. s �► / p7/`%11 (SIGNATURE O OTARY) • #FF 144316 :a Page 2 of 4 QUALIFIER INFORMATION: Name: 41e/n/a 21h, /17/14,7a7-7 Address: /0/ t//'G� /A �� -/; (Number&Street) (City) (State) (Zip Code) Telephone: I- 777' ‘'act Date of Birth: SS#: E-mail: Driver's License #: 1. Type of Certificate of Competency for which application is made. Ai-, /7, 2. The names and telephone numbers oft two persons who will know your whereabouts. gA a n n on i/ 7c//-5 1 t - a7W-- ‘o/O 6/1a77/' 7e .7 ?r5/ )39-799 -. 939 3. Have you ever been convicted of a crime related to Contracting? all (If yes, attach extra sheet with explanation.) 4. Have you or any firms you have been associated with ever filed bankruptcy? 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. ��< h� Oft,c�4J( eGf CC 4;h1,-17 �t�!,;v2 � h`Gt -t_ 5' /57/ 7. Statement of any formal training you have(ad in the area for which the application is made. 6,0 Tyr ∎ 22,y 5 C./ */ite'd 344 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 sr 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. , 7/Cc;h /JJi' Ge eZ77 Applicant (please print) am- • Company •nature of Appl.c. State of Florida County of Cof h`er The foregoing instrument as acknowledged before me this CtfebEir / o2C1l5- (Date) by grjah /n Kir&yyi who has produced j—bokdo L tr s CrpC4.125-'- (name of person acknowledging) (type of identification) as identification and did not take an oath. s..1\�•, o,��NOTARY'S SEAL 09`P`' 6' 7 4),* s1oN t 2 .4*a ?, (SIGNATURE OF NOT Y) •gz •�• �• a= 144316 • p+ r #FF •OQS 4of4 %91.••'��'•Rlbfw•••• 0���\ /fi/ii��f{1111 P%��\� 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 m _.-rt�to of Compete lc ignature of ApplicAlli 413/7/I ir/ilt/R.,-7-r Li? C Business Name Date BEFORE ME this day personally appeared Ong y) rn /- i( (i,/4Y► 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"If 1/rr The foregoing instrument as acknowledged before me this Orly/9er- // /,— /� '` (Date)/ by 6 is yt /► ! l<ir(.WJc(f who has produced Rei17aa /Jn /S LP11 (name of person acknowledging) (type of identification) as identification and did not take an oath. ��0�p‘p 1WR AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER STATE OF rlOi'ij edi COUNTY OF f e I, e, T)tiANe ' ) 4 L) , having been first duly sworn, state and affirm: I am a resident of Ca/hPrt County, RP t'Li (State) and have resided here for more than five (5) years. During the last five years I have known B• r f A" t P (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. eSi Signature e Dtvifre_ gYy/4", Name 1007 1cZi L 1& rc 11 Ie1 P/ 3 '`/a5 Addres 4)39- 815- /i't Telephone The foregoing instrument as acknowledged before me this -f?iicer 11 a©tS- (Date) by C Dwoe igiy an who has produced F(ekci ,iQq FS 1-cons€ (name of person acknowledging) (type of identification) �„►uuir my as identification and` 4� tla 12Ly,gath. NOTARY'S SEAL. :G9,0°121 oao9 / • (SIGNATURE OF N RY) :o #FF 1443 16 of n rad� �o:;(<, •. RESOLUTION OF AUTHORIZATION WHEREAS 4/7/60-7 A/�tint/a,y /-7 GGf7//p7 fproposes to engage /` e of Business Entity) in contracting as Cam e/i7 X-, in (Type of legal entity: corp.,partnership,etc.) Collier County,Florida, according to Collier County Ordin, tce 2006-46, as amended: and WHEREAS �3P/lL?7 X//,Ge/'2?t //et-ih/!?c Jh9roposes to qualify (Name of Business Entity) 7 for a Certificate of Competency with e///Q.7�r' 2 /!//'ctva- 77 (Name of Individual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: We the undersigned /9/'/(,t, 2 ,2Z /�/f�l�J'f,�yr of ,[[�� (Officers, Owners,Partners) t/'/.?? / //'l!/4 7-, /a/7/jc ,2 C hereby resolve and represent to the Collier County (Name of Business Entity) Contractor's Licensing Board that the qualifying agent, /✓/'/CG77 /f'f�lG�r, is active (Name of Individual) ,aihf ,4 c in all matters connected with the contracting business of, jam/ ,and (N e of Business Entity) We further resolve and represent that 67,/k/..,77 //rGf/t7i is (Name of Individual)' Legally empowered to act for V//'/C(,?z //%,wall �/'1�Vali matters connected with its (Name of Business Entity) contracting business, and has the authority o supervise construction undertaken by tgritG�r /t/%°u/wry/ U�ffiT` 19iC (Name of Business Entity) f DULY PASSED AND ADOPTED THIS / DAY OF UCI , /9 (Officers,P ers,Owners-with designation underneath) e2tnes fitness Witness Corporate Seal (if applicable)or Notary Public Certificate Sworn to and subscribed before me this [ day of Cr.-r- , ,2O/5 by 6 r qt /71 1<ir(, i The foregoing instrument as acknowledged before me this C ' -eber 1 /5- Date) by eriOyl in 1 j/�,igo who has produced ROn:o(ct Pc3/S C{Ce/tse. (name of person acknowledging) (type of identification) as identification and did oa 11 et 1 p22N NOTARY'S SEAL \$01,5 , T / ` 9 „ 2 cep On•*? (SIGNATURE OF N.%ARY) 22 tFFF vos :t o¢ - t 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. COLLIER COUNTY BUSINESS TAX RECEIPT oFE_s � APPLICATION •fir, 2800 N.Horseshoe Drive,Naples,FL 34104 k .;irt ; =_ ;o Make Check Payable to: Collier County Tax Collector °' , �=:;'� Phone:239-252-2477 Fax:239-643-4788 Website:www.colliertax.com �N0 w:vs% CHECKLIST Copy of Articles of Incorporation and/or Fictitious letter Yellow Fire Compliance(list of fire district phone number from the State stating that your business name is on file. enclosed) (850-245-6052 or 6058) www.sunbiz.org Copy of Marco Zoning Certificate.(239-389-5000) Copy of State license from Department of Business and Professional(850-487-1395)or Department of Health. Completed Zoning application with appropriate fee made payable (850-488-0595) to:Board of County Commissioners.(239-252-5603) Copy of City Business Tax Receipt.(239-213-1800) Completed Business Tax Receipt application with appropriate fee made payable to:Collier County Tax Collector.(239-252-2477) Copy of Motor Vehicle Repair Registration Certificate from Department of Agriculture.(800-435-7352) Other: Copy of Health inspection from Department of Hotels and Please contact the Property Appraiser's office at 239-252-8145 Restaurants(850-487-1395)or Department of Agriculture. regarding tangible tax. (800-435-7352) CHECK ONE: Date: Original Application Classification Transfer of License# Code Number - - Renewal of License# License Amount 1) CORPORATE NAME - /JPi'I,n kip',r/girt Pit 177 71/71 q ' 4, la) DBA NAME / lb) BUSINESS OWNER OR QUALIFIER'S NAME - /3/i n 7 X," 4€s4,7.7 2) PHYSICAL ADDRESS- 4/ 144//0 7/,,i d Jis 77yl 4 N .19//, (No P.O.Box allowed) 2a) IS RESIDENCE USED AS AN OFFICE- /j Yes � No / , zt 3) BUSINESS MAILING ADDRESS- 23)g i *7 t7/I ct l€c fly/ /,g /7 J//�� Street City Zip 4) OWNER OR QUALIFIER'S RESIDENTIAL ADDRESS- /O/ /1.4//ice 4%ih2 feII/ 5) TELEPHONE -Business:aZ3%° 777 1O / Home: 6) LEGAL FORM OF BUSINESS: Sole Proprietorship Partnership K Corporation ^ LLC LLP 7) OPENING DATE OF BUSINESS OR DATE ASSUMED - /777 8) OFFICE WITHIN CITY LIMITS OF NAPLES- Yes VNo If Yes,City License No. 9) SOCIAL SECURITY NO. or FEDERAL EMPLOYER"/{PLOY�ER IDENTIFICATION NO. 1-1 :/ 7 - /j a it *see back of application for explanation 9a) TYPE OF BUSINESS CONDUCTED: /4t/h T J . 10) NUMBER OF EMPLOYEES -Including number of owner / 11) FILL IN THE APPROPRIATE AREAS- a)Rental units(motel/hotel/apts.)Number of units: b)Seating Capacity(rest./cafes,etc)Number of seats: c)Number of coin-operated machines owned by business or individual: 12) STATE LICENSE OR CERTIFICATION NUMBER- Must have photo copy of state license if state licensed and certified UNDER PENALTIES OF PERJURY,I DECLARE THAT I HAVE READ THE FOREGOING DOCUMENT AND THAT THE FACTS STATED IN ' • ' TRUE TO T- .. ' - T OF MY KNOWLEDGE. xxxAPPLICANT'S SIGNATURE: - DATE: `O //.5 ✓ ✓ (Owner and/or representative of business)TIT LE: /'e S f e2. ****THIS LICENSE IS NON-REFUNDABLE FOR BUSINESS STATED ABOVE**** cotter County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION NAPLES, FLORIDA 34104 www.coilierclov.net (239) 252-2400 FAX (239) 252-6358 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): 16/114?-777 Telephone: ..239'` 777 -I 0.57 Cell: S'oc..-pz."— Fax: E-Mail Address: BUSINESS& USE INFORMATION Org Business Name(If any): /✓f'J4 7 / `//` &zr /`�h/"ho n6Number: Z79}-77 �6 / Address: ,4/ i/c//OGc�.6/,7 a City: /IiO.T State: / / ZIP: type Description of the t e ofbusineess or use: 2' 7z /1.7 P 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 Occupatiop 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 Co er County COLLIER COUNTY GOVERNMENT 2800 NORTH HORSESHOE DRIVE GROWTH MANAGEMENT DIVISION NAPLES, FLORIDA 34104 www.colliergov.net (239) 252-2400 FAX (239) 252-6358 D. There shall be no receiving of goods or materials other than normal delivery by the U.S. Postal Service or similar carrier. E. Parking or storage of commercial vehicles or equipment shall be allowable only in compliance with the requirements for commercial vehicles in the County Code. F. The on-site use of any equipment or materials shall not create or produce excessive noise, obnoxious fumes, dust, or smoke. G. The on-site use of any equipment or tools shall not create any amount of vibration or electrical disturbance. H. No on-site use or storage of any hazardous material shall be kept in such an amount as to be potentially dangerous to persons or property outside the confines of the home occupation. I. There shall be no outside storage of goods or products, except plants. Where plants are stored, no more than fifty(50) percent of the total square footage of the lot may be used for plant storage. J. A home occupation shall be subject to all applicable County occupational licenses and other business taxes. I, the undersigned, hereby affirm that I am the legal owner of the property at the above address or that I have the legal right to conduct the business described above at this address by virtue of my leasehold interest in this property, and that / have read, understood, and agree to abide by the provisions of LDC Section 5.02.00 "Home Occupations". /! __ . is •plicant Signature Da The following to be completed by County Staff: Zoning: Property ID#: Date: ❑ Approved n Hold ❑ Denied Comments/Restrictions: Staff Reviewer Date Tax Collector Staff: Clerks Initials: Horseshoe ❑Greentree Business Tax License#: 1/14/2014 Page 2 of 2 886 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 6/88 09/29/15 15: 33CT <SUBJECT> <SSN> <BIRTH DATE> KIRWAN, BRIAN M. <CURRENT ADDRESS> <DATE RPTD> 248 MADISON DR. , NAPLES FL. 34110 6/05 <FORMER ADDRESS> 11870 MCGREGOR BV. , FORT MYERS FL. 33919 9/96 784 N. 94TH N AV. , NAPLES FL. 34108 <POSITION> <CURRENT EMPLOYER AND ADDRESS> <VERF> <RPTD> SELFEMPLOYED PAINTING CONTRACTER 4/08 4/08 <FORMER EMPLOYER AND ADDRESS> BMK PAINTING INC 2/04 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 ***FICO CLASSIC 08 SCORE +547 : SERIOUS DELINQUENCY, AND PUBLIC RECORD OR ***COLLECTION FILED; TOO FEW ACCOUNTS CURRENTLY PAID AS AGREED; LACK OF ***RECENT BANK REVOLVING INFORMATION; NO RECENT NON-MORTGAGE BALANCE ***INFORMATION *** 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=2 HSTNEG=0 TRD=8 RVL=5 INST=1 MTG=2 OPN=0 INQ=1 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $9203 $13.3K $0 $0 100% TOTALS: $9203 $13. 3K $0 $0 $ P U B L I C R E C O R D S PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY,STATE AND FEDERAL LEVELS SOURCE DATE LIAB ECOA COURT ASSETS PAID DOCKET# TYPE PLAINTIFF/ATTORNEY Z 5064304 5/13R I FE 8/14 1306537 CHAPTER 7 BANKRUPTCY DISCHARGED LINDA KAY YERGER 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 SYNCB/LOW L 235041J 4/04 $2480 111111111111 ROl 11/09A $4500 $0 111111111111 Page 1 of 2 I CHARGE ACCOUNT 5/07C $0 CRDT CARD LOST/STOLEN 48 0/ 0/ 0 SYNCB/LOW L 235041J 4/04 $5842 111111111111 ROl 11/09A $5900 $0 111111111111 I CHARGE ACCOUNT 9/08C $0 CRDT CARD LOST/STOLEN 48 0/ 0/ 0 BK OF AMER B 6331059 5/04 $9203 XXXXXXXXXXXX RO1 4/08A $13.3K $0 XXXXX1111111 I CREDIT CARD 10/06P $0 ACCT CLSD BY CONSUMER 47 0/ 0/ 0 CHASE B 26QK001 2/05 $0 111111111111 ROl 1/08A $3500 $0 111111111111 A CREDIT CARD 10/07C $0 CLOSD BY CRDT GRANTOR 34 0/ 0/ 0 BK OF AMER B 6331213 4/05 $56.7K 111111111111 C01 9/06A $56.7K $0 1111 I HOME EQUITY LOAN 8/06C $0 ACCT CLSD BY CONSUMER 16 0/ 0/ 0 WELLSFARGO F 1BR6001 6/04 $1059 36M39 1X1111111111 I01 11/05A $0 11111 I NOTE LOAN 11/05C $0 CLOSED 17 0/ 0/ 0 CALIBER F 2CLH001 7/03 $156K MUR 3/15A $0 I CONVENTIONAL REAL 5/13C $0 CHAPTER 7 BANKRUPTCY BK OF AMER B 4275002 7/03 $156K MUR 4/13A $0 I CONVENTIONAL REAL 4/13C $0 CHAPTER 7 BANKRUPTCY I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 9/29/15 PNP7771028 (FLA) LICENSES ETC END OF REPORT Page 2 of 2 886 110th Ave. N. Suite#6, Naples, FL 34108 Phone:239.777.1028 Fax: 877.275.3593 www.LicensesEtc.com BUSINESS CREDIT REPORT as of: 09/29/15 16:34 ET BMK Painting, Inc. Fed Tax ID# 65-0336486 Address: 248 Madison Dr SIC Code: 1721-Painting & Paper Naples, FL 34110-1326 Hanging United States Contractors Phone: 239-598-1594 NAICS Code: 238320-Painting And Wall Covering Experian BIN: 740085505 Contractor Business Type: Corporation Agent: Kirwan Brain M Experian File Agent 248 Madison Drive Established: October 1993 Address: Naples, FL Experian Years on File: 22 Years Years in Business: 22 Years Total Employees: 2 Sales: $148,000 Filing Data Provided Florida by: Date of Incorporation: 12/30/1992 Public Records PUBLIC RECORDS HAVE BEEN SEARCHED AT THE COUNTY, STATE AND FEDERAL LEVELS. Page 1 of 3 Bankruptcies: 2 Liens: 2 /Judgments Filed: 0 /Collections: 0 Bankruptcies File Date: 08/05/2014 Filing Location: Us- Bankruptcy Court-Middle Tampa Legal Type: Bankruptcy Legal Action: Chaper 7 Discharged Document Number: 1306537 File Date: 05/17/2013 Filing Location: Us- Bankruptcy Court-Middle Tampa Legal Type: Bankruptcy Legal Action: Chapter 7 Document Number: 1306537 Tax Lien Filings Date: 01/30/2013 Owner: State Of Florida Filing Location: Collier County Circuit Court Legal Type: State Tax Legal Action: Lien Document Number: 4792903 Liability Amount: $914 Description: Other Tax Date: 12/21/2010 Owner: State Of Florida Filing Location: Collier County Circuit Court Legal Type: State Tax Legal Action: Lien Document Number: 4507999 Liability Amount: $120 Page 2 of 3 Description: Other Tax END OF REPORT Page 3 of 3 Case 9:13-bk-06537-FMD Doc 60 Filed 08/05/14 Page 1 of 2 Form B18(Official Form 18)(12/07) United States Bankruptcy Court Middle District of Florida Case No. 9:13—bk-06537—FMD Chapter 7 In re: Debtor(s) (name(s)used by the debtor(s)in the last 8 years, including married,maiden,trade,and address): Brian M Kirwan dba Brian Kirwan Painting 248 Madison Drive Naples,FL 34110 Social Security No.: xxx—xx-8370 Employer's Tax I.D.No.: DISCHARGE OF DEBTOR It appearing that the debtor is entitled to a discharge, IT IS ORDERED: The debtor is granted a discharge under section 727 of title 11,United States Code, (the Bankruptcy Code). BY THE COURT ea4,11_, 4-11.40,104' Dated: August 5,2014 Caryl E. Delano United States Bankruptcy Judge SEE THE BACK OF THIS ORDER FOR IMPORTANT INFORMATION. Case 9:13-bk-06537-FMD Doc 60 Filed 08/05/14 Page 2 of 2 FORM B18 continued(12/07) EXPLANATION OF BANKRUPTCY DISCHARGE IN A CHAPTER 7 CASE This court order grants a discharge to the person named as the debtor. It is not a dismissal of the case and it does not determine how much money,if any,the trustee will pay to creditors. Collection of Discharged Debts Prohibited The discharge prohibits any attempt to collect from the debtor a debt that has been discharged. For example,a creditor is not permitted to contact a debtor by mail,phone,or otherwise,to file or continue a lawsuit,to attach wages or other property, or to take any other action to collect a discharged debt from the debtor.[In a case involving community property: There are also special rules that protect certain community property owned by the debtor's spouse,even if that spouse did not file a bankruptcy case.] A creditor who violates this order can be required to pay damages and attorney's fees to the debtor. However, a creditor may have the right to enforce a valid lien, such as a mortgage or security interest,against the debtor's property after the bankruptcy, if that lien was not avoided or eliminated in the bankruptcy case. Also,a debtor may voluntarily pay any debt that has been discharged. Debts That are Discharged The chapter 7 discharge order eliminates a debtor's legal obligation to pay a debt that is discharged.Most,but not all,types of debts are discharged if the debt existed on the date the bankruptcy case was filed. (If this case was begun under a different chapter of the Bankruptcy Code and converted to chapter 7,the discharge applies to debts owed when the bani rtaptcy case was converted.) Debts that are Not Discharged. Some of the conrr r,n types of debts which areggf discharged in a chapter 7 bankruptcy case are: a.Debts; r most taxes; b.Debts incurred to pay nondischargeable taxes; c.Debts that are domestic support obligations; d.Debts for most student loans; e.Debts for most fines,penalties,forfeitures,or criminal restitution obligations; f.Debts for pet Bona:injuries or death caused by the debtor's operation of a motor vehicle,vessel,or aircraft while intoxicated; g.Some dents w hich were not properly listed by the debtor; h.Debts that the bankruptcy court specifically has decided or will decide in this bankruptcy case are not discharged; i.Debts for which the debtor has given up the discharge protections by signing a reaffirmation agreement in compliance with the Bankruptcy Code requirements for reaffirmation of debts;and j.Debts owed to certain pension,profit sharing,stock bonus,other retirement plans,or to the Thrift Savings Plan for federal employees for certain types of loans from these plans. This information is only a general summary of the bankruptcy discharge.There are exceptions to these general rules. Because the law is complicated,you may want to consult an attorney to determine the exact effect of the discharge in this case. Electronic Articles of Incorporation P15000078637 FILED For September 22, 2015 Sec. Of State tdcannon BRIAN KIRWAN PAINTING, 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: BRIAN KIRWAN PAINTING, INC. Article II The principal place of business address: 101 WILLOUGHBY DR NAPLES, FL. 34110 The mailing address of the corporation is: 2338 IMMOKALEE RD PMB 202 NAPLES, FL. 34110 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: 100 Article V The name and Florida street address of the registered agent is: BRIAN M KIRWAN 101 WILLOUGHBY DR NAPLES, FL. 34110 I certify that I am familiar with and accept the responsibilities of registered agent. Registered Agent Signature: BRIAN KIRWAN P15000078637 FILED Article VI September 22, 2015 Sec. Of State The name and address of the incorporator is: tdcannon BRIAN KIRWAN 101 WILLOUGHBY DR NAPLES, FL 34110 Electronic Signature of Incorporator: BRIAN KIRWAN 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 BRIAN KIRWAN 101 WILLOUGHBY DR NAPLES, FL. 34110 Article VIII The effective date for this corporation shall be: 09/15/2015 10/3/2015 ,www.sunbiz.erg-Department of State FLORIDA DEPARTMENT OP STATE r 11,4 IVISION OF CORPORATIONS As- Home Contact Us E-Filing Services Document Searches Forms Help Fictitious Name Registration Payment Thank you for filing your Fictitious Name Registration online. Your confirmation number is 400277655994. Your charge amount is$50.00. File another document https://efilesunbiz.org/scripts/ficrfs.eze 1/1 - IVU.1 11,C. Ur CI-CA...Ill./IN I U DC cAcivir I If this application contains incomplete or inaccurate information, it may cause a delay in the issuance of your exemption. An officer electing an exemption under Chapter 440, Florida Statutes, is not entitled to benefits under this chapter. Section 1: APPLICANT INFORMATION First& Last Name: Brian M Kirwan State Driver's License Number: State ID Number: State: FL Date of Birth: 4/3/1959 Social Security Number(last four digits): 8370 Email Address: nkdrafting @aol.com Section 2: CONSTRUCTION INDUSTRY APPLICANT ($50 FEE REQUIRED) Officer of a Corporation (Construction) Corporate Title: PRESIDENT Section 3: This section should be completed with information specific to your corporation or to the limited liability company in which you are a member. The name of the corporation or limited liability company listed on this application MUST match the name of the corporation or limited liability company as registered with the Florida Division of Corporations. Name of Corporation or LLC: Brian Kirwan Painting Inc, FEIN: 47-5141644 IF YOU NEED TO APPLY FOR A FEIN,CLICK HERE Business Name (DBA): Brian Kirwan Painting Inc, Phone: (239)777-6051 Applicant's Address of Record: 101 Willoughby Drive City Naples State: FL Zip 34110 County: Collier Click on the arrow(s) next to the text box(s)to view a list of available Scope classifications/trades for the form type chosen in Section 2. Click on the appropriate scope to select. If you are unsure as to which classification/trade to choose, please contact your workers' compensation insurance carrier. If you do not have a workers' compensation insurance policy, contact the National Council on Compensation Insurance (NCCI) at 1-800-622-4123 option 5 to obtain a classification code. Scope 1: 05474 Painting NOC& Scope 2: Scope 3: Scope 4: Shop Operations, Drivers Section 4: The corporation of which you are an officer or limited liability company of which you are a member must be registered and in ACTIVE status with the Florida Division of Corporations.Applicants applying as an officer of a corporation must be listed as an officer of the Corporation with the Florida Division of Corporations. List the document number on file with the Florida Division of Corporations. P15000078637 Section 5: Pursuant to Chapter 489, F.S. (contractor licensing law), list certified or registered licenses related to the scope of business or trade listed in Section 3 held by the applicant, or the certified or registered license numbers held by the qualifier for the corporation or limited liability company listed on this application. The business name listed on the license MUST match the name of the corporation or limited liability company as registered with the Florida Division of Corporations and on this Notice of Election to be Exempt. No DBPR License Listed This section is not applicable to my business Section 6: If you have submitted an electronic payment for this application, the transaction confirmation number is listed in the following space: Confirmation Number: 262133147 Application Number: E00393879 Section 7: N/A Are you affiliated with any corporation or limited liability company other than the corporation or limited liability company to which this application applies? Name: FEIN Name: FEIN Name: FEIN Section 8: CONSTRUCTION INDUSTRY AND NON-CONSTRUCTION INDUSTRY LLC MEMBERS ONLY To be eligible for a construction industry exemption or a non-construction limited liability company exemption, an applicant must have the required ownership of the corporation or limited liability company. I am a shareholder owning at least ten percent(10%)of stock of the corporation listed on this application. Section 9: I certify that any employees of the corporation or members of the limited liability company listed in Section 3 are covered by workers' compensation insurance. Please identify the workers'compensation insurance carrier that covers any non-exempt employees. Carrier Name: My business does not have any non-exempt employees Section 10: FRAUD NOTICE A. Any person who, knowingly and with intent to injure, defraud, or deceive the department or any employer or employee, insurance company or any other person, files a Notice of Election to be Exempt containing any false or misleading information is guilty of a felony of the third degree. B. Attestation of applicant—By providing my name below, I attest that I have read, understand and acknowledge the foregoing notice. C. Acknowledge that this Notice of Election to be Exempt does not exceed limits for corporate officers, including any affiliated corporations as provided in Section 440.02, Florida Statutes. First Name: Brian Last Name: Kirwan Note: The Division has 30 days to review your application to determine if it meets the eligibility requirements for the issuance of an exemption. The Division will either issue a Certificate of Election to be Exempt or notify you that your application is incomplete. The Division reviews and processes exemption applications in the order they are received. Exemption information is reflected on the Proof of Coverage database the day following the issuance of the exemption. Visit the Division's website at http://www.myfloridacfo.com/wc to print your certificate. 1Gi22015 NOTICE OF ELECTION O BE EAEN,IT NOTICE OF ELECTION TO BE EXEMPT Thank you for submitting your application to the Division of Workers'Compensation. The Division has 30 days to review your application to determine if it meets the eligibility requirements for the issuance of an exemption.The Division will either issue a Certificate of Election to be Exempt or notify you that your application is incomplete.The Division reviews and processes exemption applications in the order they are received. Exemption information is reflected on the Proof of Coverage database the day following the-issuance of the exemption..The Proof of Coverage database can be accessed from the Division's homepage at http://www.myfloridacfo.com/wc. Certificate holders are required to print their Certificate of Election to be Exempt.Certificates are available for printing immediately after the exemption is issued by the Division.To print your Certificate,visit https://apps.fldfs.com/bocexempt/.Click on the gray"Print your Certificate of Election to be Exempt"button. Enter your Drivers License Number(or FL ID)and Last Name.Click on your application number.Scroll down and click on the click the"Print Exemption Certificate"button for a full size Certificate or"Print Exemption Certificate Wallet"button for a wallet size Certificate. If you are unable to print your Certificate,please contact the Division's Customer Service Office at 850-413-1609. Print Application For Your Records 1 Return to Notice of Election To Be Exempt Your Confirmation number is: 262133147 Copyright 2010 Florida Department of Financial Services Privacy Accessibility https://apps.fldfs.com'boce empt/Final_Instructions.asp41b _ 1/1 1 • COLLIER COUNTY - GROWTH MANAGEMENT DIVISION CITATION 1)-.b fi € " Pursuant to section 489.127. .:Florida Statutes,the undersigned here y certifies that upon- _ personal investigation,he/she has:reasonable and probable grounds to believe that the person.whose name appears below as issued to;di¢violate 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 SU fl; Dav Near (Tune I - Issued To i✓(--t CAA I.=1-11:E L PZ412. ; Address c`-'4 Sd #-bit6x -. - City `.5 State • -- .. 'Zip 9 t 710' Telephone No. I.D t.. .. -----Date o Birth Sex H�eigl Vehicle ake(F a(if applicable) Year... I Color Tag No Location of Violation ,; ,�, > ,. 1 -„ OPTIONS i; -` - Ihave been informedof the violation foi=whichThave beetrefiarged and"elect the following option(Check one) 1) ❑ I choose to pay the penalty of$ t 0 LO s 2) ❑ I choose not to pay the penalty,and will request in writing by certified mail or,hand delivery an Administrative Hearing before the'Contraq(or s Licensing Board. Description of Violation . --Date Violation Observed ,g f.2 9./E a).0.Falsely.hold self_or business organization out as.a licensee,certificate holder or registrant b) ❑ Falsely impersonate-a certificate"holder or registrant; c) ❑ Present as his/het-Own the certificate or registration of another; .d)"❑ Knowingly give-false or forged evidence to the-Board of a member thereof; e).(] FJse:or attem ptto use a certificate or registration which has been suspended or revoked t) I"Engage in the business or act in the capacity of a contractor or advertise self or business organization as available to engage m the business or act in the capacity of a contractor without being duly registered or certified; g) ❑ Operate a business organization engaged in contracting after(60)days; h) 0. Commence or perform work for which a bnilding permit is required pursuant.to . j an adopted state minimum building code:or-without Such permit being in effect; i) ❑ Willfully or deliberately disregard or violate any Collier County ordinance relating to uncertified or unregistered contractors. _.. A person or business organization operating on an inactive-or suspended certificate, or registration,or operating beyond the scope of work or geographical scope of the registration,is not duly certified regist d. 't ►•1' \e-1_- -�. 0Jfl&}4.r- F , ` {f�4- paq,ATURE(I CIPIENa') SIGNAT ` 1, 'a IGATOR) - JJr q PRINT(RECIPIENTS NAME) PRINT(INVESTIGATOR'S NAME) _ Pursuant to 489.127, Florida Statutes, willful refusal to sign and accept this citation constitutes a misdemeanor of the second.degree, punishable as provided in section 775.082 or 775.083 Florida Statutes. (SEE REVERSE FOR INSTRUCTIONS) AEC P EN COPY. 3. That the Board has jurisdiction over this matter and that Matthew R. Rambo was present at the public hearing on April 15, 2015, and was not represented by counsel. 4. All notices required by the Code of Laws and Ordinances of Collier County, as amended, have been properly issued. 5. The facts in this case are found to be: a. Applicant has some credit issues which were of concern to the Board. b. It is appropriate for the Applicant to be subject to a probationary license and further credit review. CONCLUSIONS OF LAW 1. Based upon the foregoing facts, the Board concludes that the applicant has not met the standard set out in Code of Laws and Ordinances of Collier County, as amended. 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 Code of Laws • and Ordinances of Collier County, as amended, by a vote of 8 in favor and 0 opposed, a unanimous vote of the Board present, the Applicant's credit report is not approved and he shall be issued a probationary license as follows: a. Twelve month probationary license with a credit review in six months at which time the Applicant shall appear before the Board and provide an updated credit report. ORDERED by the Contractors Licensing Board effective the 15th day of April, 2015. 2 370094.1 5/5/2016 1,, ( 05/ 6" CU31) i>P13Y �� l ". E4 11 'U o ,nty � � y III Orr 0 b 2I115 (7 GM perations & Regulatory Management , -^-- Licens. r 1 li i n (' (�, N--i On-th ='` ...,.. •. nootm Drive 7 6h t r - �J I I\ 50 s, Ft 34104 2015 4 1 Y � 6s� w� . Nio . C r.ec:i APPLICATION FOR rw; COLLIER COUNTY/CITY OF NAPLES/CITY OF MARCO FIRM INSTRUCTIONS:This application must be typewritten or legibly printed. The application fee must accompany this application. The fee is not refundable after the application has been accepted and entered on the records. All checks should be made payable to the Board of Collier County Commissioners. For further information, consult Collier County Ordinance No. 90-105, as amended. NAME OF COMPANY: Exact Corporate/Business Name: NL° Apo l/7LG1 t Irfe, SCrvt e , U_-L Fiction Name/DBA: Qualifier Name: itileAC.4 •f ?4L 0 Physical Address: 13(15 dm e) c, t)1". (/ 1 . e,2 �Jeples, (Number & Street) r (City) (State) (Zip Code) Mailing Address: /3'(S C S+e jvlC n (be (f n 14. ago. Napl6, rt.. 3Li 11 (Number& Street) (City) (State) (Zip Code) Telephone: 1i'1) [6,( I Di.i E-Mail: fhChvM6/Ge05eorig/itot/ 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 ❑ ,�,�wimming Pool $230.00 ❑ Roofing $230.00 Gl Specialty $205.00 Specialty trade: l f 2L CD^.4rg .+6✓' CHANGE OF STATUS: ( ) Reinstatement ( )From One Business to Another ( )Dormant License to Active Page 1 of 4 - I 1. The names, titles, home address and phone numbers of all Officers/Managing Members of the Firm. Mat+hei) RQMbb 1445 Cha,./PS.n 51.()x. Lint+ 26 OaPkt, FL 3,f( to Casl)9Gl-!oa 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. 140ne 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. fe_e a 44-ace , AFFIDAVIT I, Ma14/►CkJ RAMS b certify that the foregoing is true and correct to t -1:f Umy knowledge. Authorized Officer of the Firm STATE OF FLORIDA COUNTY OF G-s-IL-tie-/Z The foregoing instrument as acknowledged before me this 27 2 6// • (Date) By / Z ('`' .A'-8O of p)e�,Fo l l- dY, I r{( ..Se,-\(/cc L. L. C_, (Name of officer, title/agent) (Name of Corporation) a JAL rt.I A Corporation on behalf of the corporation. (State or Place of Corporation) He/She has produced ]v.-t a•.�111-, k,nvwr, identification and did not take an oath. (Type of identification) NOTARY'S SEAL • J.GARY SHIRK 41110 wilibleo 4, 4 li)„ �o`�:: Notary Public•State of Florida ( IGNATU:iO 0 ARY) So ` •, My Comm.Expires Oct 27,2015 ;f �a•' Commission#EE 142041 "'°11,' Bonded Through National Notary Assn. 0 page 2 of 4 • . II QUALIFIER INFORMATION: Name: MAI-41 RA/446o Address: /3115 (170teltS4'or► '. P' 11^(4 202 14M-I FL. 5t(114 (Number& Street) (City) (State) (Zip Code) Telephone: (0.'51') q w/- !O ( Date of Birth: dam. E-Mail: -1-Ae-hvitib jer O5 AD roil caM Driver's License: galINIMMINWAIMIND 1. Type of Certificate of Competency for which application is made. rte., Go 4rIic—+-or 2. The names and telephone numbers of two persons who will know your whereabouts. Nltice. RaAh o - a q , '6 o- srglrl Ra-F RaMbP — 451- 7.76- .23a i 3. Have you ever been convicted of a crime related to Contracting? /Vb (If yes attach extra sheet with explanation) ,, l 7. Have you or any firms you have been associated with ever filed bankruptcy? /V 0 8. List all debts you or any company(s)associated with you refused or failed to pay and reasons why. S cc.. Gti-t4 L e) 9. List your business or work experience during the past ten years. •P or Fl.nD/abI/ otls(.hite�.td -Fro NI .ML �Ayvv 1r, ,2 Po q, h1orkd 4or Nth #..hlrs io^a� tf— c .Mn•^ 1�'sM ,�►ey +° ,2°82' — 1.1 6,t,c� f.l� Clt of dAeks, 6e.4.4 d. l .4ev s fei -2009" 2°11/ 10. Statement of any formal training you have had in the area for which the application is made. Ail hsviols 0r1 PXPer!/t^GL. Work-e) •coe M C,44.114•2!. (41,1V-wipe MA in*n(n(G GoNtp#•-, .f4i h�►s katf, opt,�'�-�►., i G.the' Co4r, -kt, S1rtL (1 O . Wer•k.ed .ebe Gt�Y1v� NGple i .eoe 5't .jeArt. .t hlas Seller lAr%). tApe. -(+cc,t, . W14 +4G L 14-1 . �M{�vjs -fre .Ir,"IA► n Aeti, 4rt . rGMal, )64c W 11.k {-LG Ct+y. V{ Page 3 of 4 ' s GITS, LLC Examination Operations Division Providing the services and products to assist Government Agencies to make informed educated decisions. Official Examination Score Report February 2, 2015 Official Score Report: Candidate Information: Name—Matthew Rambo Candidate# 5681.4110R Testing Site: Ft. Myers, FL Final Score Result: Business Procedures Score: 84% These results represent the grade that has been achieved on the Business Procedures examination(s) administered by Gainesville Independent Testing Service for Collier County, Florida on January 31,2015. If you have any further questions,please do not hesitate to contact us. Sincerely, Jay E. Bowermeister President PO Box 831127 Ocala,Florida 34483-1127—Voice(352)369-GITS –Fax(352)387-2443 800 997 2129 GITS, LLC Examination Operations Division Providing the services and products to assist Government Agencies to make informed educated decisions. Official Examination Score Report February 6, 2015 Official Score Report: Candidate Information: Name—Matthew Rambo Candidate # 56814110R Testing Site: Ft. Myers, FL Final Score Result: Tree Contractor Score: 82% These results represent the,grade that has been achieved on the Tree Contractor examination(s) administered by Gainesville Independent Testing Service for Collier County, Florida on February 6,2015. If you have any further questions, please do not hesitate to contact us. Sincerely, Jay E. Bowermeister President • PO Box 831127 Ocala,Florida 34483-1127—Voice(352)369-GITS –Fax(352)387-2443 800 997 2129 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. Mat fkeb./ R4N,bo APPLICANT(PLEASE PRINT) r\) Apot/l irct Gruf Le., L�.L NAME OF COMPANY SIGNATURE OF APPLICA T STATE OF FLORIDA COUNTY OF IOLG(csx The foregoing instrument as acknowledged betore me this 2 2 C:/5 (Date) By /-1-,0 cfc Q/€A/6 0 who has produced per5 '4' w (Name of person acknowledging) (Type of identification) as identification and did not take an oath. NOTARY'S SEAL y ( ,.:;xr a, J.GARY SHIRK Nei -A� IGNATURE �J' N�A'Y) ( ?°,'1•`�c Notary Public•Slate of Florida ,/ ( r��, •: My Comm.Expires Oct 27,2015 r -;.��� �'.� Commission#EE 142041 'hfC�F fl��� "' Bonded Through National Notary Assn. 1 Page 4 of 4 I � 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. 77:0' SIGNATURE OF APPLICANT lV eo∎pa l{o.., T-. e iii_ BUSINESS NAME //51-ee DATE BEFORE ME this day personally appeared /1 f-the R4Mbp 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 G DLL 'LSL The foregoing instrument was acknowledged before me this 212 v �6.v (Date) by f`L who has produced /P>�r?on��f (name of person acknowledging) (Type of identification) is identifirnticn and who did not take an oath. SIG TUBE OF y• �{ J.GARY SHIRK "==�,,,,, Notary Public Stale of Florida f i1 C_ c fia',e `1?e _ �WISE"s ac127.2015 1 ` _ R '� Commission M EE tg2041 (PRINT NAME OF NOTARY PUBLIC) • °, ;i :P, Bonded through National Notary Assn. NOTARY PUBLIC 4 •VERIFICATION OF CONSTRUCTION EXPERIENCE GMD Operations &Regulatory Management Department Licensing Section 2800 N.Horseshoe Drive Naples,FL 34104 Applicant's Name: / IG� i Ra t"1 k (Or rq Certificate Category Requested: �1frCt C410(' 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 amend` license number of the person sign ig below and verifying Applicants relevant experience: Name: (� l ala S Ar' Title: P SidAffr :/, 5 L ti 4SQficile ense Number(if applicable): (t//4 Name of Business: L d` Business Address: a 70 teivg,s-ze a pits FL 3(//Oc Business Phone: d37- c)C3 ^ 7/3 tT ie Applicant's years of experience from 3/4062 to (Lola 0! The applicant's scope of work (specific duties)included: Tee 7 (44 t. e tr{ ' 11.42,40e%, l� ©Y .w,�J�( t Mv4 ( ` / 'atr,. of JY P a he S c/L Additional Comments: Falsifying any information provided herein may subject your license to revoc, Signnture Print Name: /mow/< Deic S4Me-f State of Florida County of Collier /� e,�__/� The fore ouig instrument was acknavledged before me on this 267(day of � �V�sT"Y 2C)/ by Vt g Art AsiOnwr who is personally known to me or produced as identification and who did not take an oath. — — — - Sig/ tire o 'otary "" n J.GARY SHIRK / ':° `o. Notary Public•State of Florida T My Comm.Expires Oct 27,2015 .,, .� Pr Commission#EE 142041 7 ............ Bonded Through National Notary Assn. 0 ' VERIFICATION OF CONSTRUCTION EXPERIENCE GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples,FL 34104 Applicant's Name: 1 -IQ+h 4) (4Mb�O • , . Certificate Category Requested: �`C C CoA-frA C�"DC 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%erifying Applicants relevant experience: Name: 4e-G-fher 4h te-0 Title: Cpe 4frcf MAnmer Orb ortS O License Number(if applicable): 414 Name of Business: C.1 k1 Of fv yk6 Business Address: °�`7 6 n p t%/ee-s(le CI✓"Gl _ N)Apie Si EL gil(O a Business Phone: a23i- .21 3 — 1 (' 7 The Applicant's years of experience from 5'2o.1 to 419.., i q The applicant's scope of work(specific duties)included: 17t e... 4'3"Impt t0ne, oSn fe/-j I , 1 IGnd*tn�S 0-e -trees anr( Siirobs . (�t- td-t -trtmkttnct- Additional Comments: Falsifying any information provided herein may subject your license to revocation. G42,0_161 , a-ak-43 Signature Print Name: H e c t T1 'h e r S h , etas s State of Florida County of Collier The foregoing instrument was acknowledged before me on this �O' d of E ��i"/ 2 O/s by who is personally known to me or produced as identification and who did not take an oath. I !+ AI Signa'ofNotary jo/ ,`�,,,,�,, J.GARY SHIRK I 41 r° '`�: Notary Public-Slate of Florida My Comm.Expires Oct 27.2015 ' ( %,4 -%r�� A:' Commission # EE 142041 F,%'.�Zd', Bonded Through National Notary Assn. r 8 R . e VERIFICATION OF CONSTRUCTION EXPERIENCE' GMD Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples,FL 34104 Applicant's Name: Ma t ik) Rat4 b o Certificate Category Requested: r n'4'CA C415 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 rclevantexperience: Name: )o e ph 6as64 ,/11. (Arbor Arbo r iL#.) Title: iciei fa.tu.r/ r ��'f�°rrnfC nett nr icense Number(if applicable): A114 Name of Business: C Mflt of Ak t .I Business Address: c 2-)O R, r'S l cte C.t' c.J( Nip rec � t'L 3q i D a. Business Phone:.131-oZ)3 7 t S 3 The Applicant's years of experience from 5(2 to G/2 a 1171 The applicant's scope of work(specific duties)included: free 'f'r p'-11 t r►c/ Gf rI re,a vet • Orn.cNf^-t / 4-rtHMt .1a- Pia nfr elf S 0-h -free-S Q^de S1tru6- Additional Comments: �I alsl In any Information provided herein may'subject your lie s iu re►u Jun. Si ire P J' Name: -V ter--- lErde / State of Florida County of Collier ,l A The foregoing instrument was acknowledged before me on this _ day of far 44 r k ZQ 15 by who is personally know roduced as identification and who did not take an oath. I 440 -41/ J.GARY SHIRK Suture of Notary €" Notary Public-State of Florida My Comm.Expires Oct 27.2015 ' 1"'"' ��` a;= Commission#EE 142041 6 Bonded Through National Notary Assn. AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER `'— s'f"44 , am a resident of t County, (State) and have resided here for more than five (5)years. During the last five years I have known MAR + O (Applicant). I have had the opportunity to observe his or her business and personal dealings and find him or h= to be a person of honesty, integrity and good character. 41111r--/ (Signature) (Name) !:A 0.60 14 ��©© /� s / (Address) 290 AdefS/d ? i Telephone) 23 -2/3^71 STATE OF FLORIDA COUNTY OF •(' The foregoing instrument was acknowledged before me this 2 2- by ,, (.1 at ) JQ�b ' l3/� f1/14 who has produced A tsoe-4 (name of person acknowledging) (Type of identification) as identification and who did not take an oath. ariff SIG/✓'TURE OF NO`/'-f tY NOTARY'S SEAL (PRINT NAME OF NOTARY) — — — NOTARY PUBLIC +�,+,Y�,,,' J.GARY SHIRK U �z�`� e`o Notary Public•Stale of Florida a My Comm.Expires Oct 27,2015 Commission#EE 142041 4 '''f,,∎V Banded Through National Notary Assn. ■ 10 f r t AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER 4/o 4 I, f hAt/fS S ' , am a resident of &11frC fr. County, Poe aof (State) and have resided here for more than five (5) years. During the last five years I have known M Rclft621 applicant). I have had the opportunity to observe his or her business and personal dealings and find him or her to be a pe• on of honesty, integrity and good character. l t 11/4(Signature) (Name) /rav( 5 Alq 5 (Address) ' 21/ 3 4 /h2 ''efE /14,X1s 7C Telephone) 0 .31 ' 3'Y'6?Q7 STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this 2 l� by ( ate) 7744//5 A/bR241/PD' 7 who has produced gam+-''' (name of person acknowledging) (Type of identification) as identification and who did not take an oath. / i . I .STCe ATUR.I OF NOT" 1 ,;dilim . �. HlBK 0 (PRINT NAME OF NOTARY) � °, :14::',,-1, Notary Public-State of Florida NOTARY PUBLIC f. n>i . .5 My Comm.Expires Oct 27, 2015 -,',1" stfo Commission ri EE 142041 Bonded Through National Notary Assn. 9 RESOi.UTTON OF AUTIIORIZATON WHEREAS NeApai 1{A A Tete Se'- 'i ct, Li-4--proposes ses to r (Name of Business Entity) engage in contracting as L.L.-L (Type of legal entity:co in .Collier.County,Florida,according to Collier County Ordinanc partnership,006-46,as amended;and WHEREAS—Nti+oer'r4w-. �h,e Strvrc «e- proposes to i(Name of Business Entity) qualify-for a Certificate of Competency with I'1 tt'k4'W R4H60 (Name of Individual) NOW,THEREFORE,BE IT HEREBY RESOLVED THAT: • We the undersigned__ ArP. 0 6�,. (Officers,Owners,Partners) • of N61%rpl 14-4 ti Tare Sty r Gt.) t.c- ' hereby resolve and represent to the Collier County (Name ofBusiness Entity) Contractors'Licensing Board that the qualifying agent,_PI Ffh � is active ' in all matters connected with the contracting business of Al R as f^f Individual)stet,tr'lrrc Lam and We further resolve and represent that M (Name B R css Entity) \ s Mbo is legally empowered to act for IIkw po(1 140 r•(cc L Sc . (Names of Individual) ^/ C in all matters connected with its tifj (Name ofBusiness Entity) contracting business,and has the authority to supervise construction undertaken by ?de•-,ei/tot� 7e,. CePVitX LI.4, (Name ofBusiness Entity) v • DULY PASSED AND ADOPTED THIS G f 4 day of 1CG a e/S' . fi - -'(Officers,Partners,Own -with D5rT no thy ' A ifWitness A/ . ' _ Witness • Corporate Seal(ifApplicablc) • Or Notary Public Certificate • Sword to and subscribed before me this -n 6-4R. 76 lay of 15_& ,26/5 by w`/}- te4r�` -f Notary Public Nathe Printed i Public Conunission Number `.time My Commission expires:_ "14.',!" .J.GARY SHIRK • ���pM1Y YVB,� • i.---1�.`F% Notary Public-Slate of Florida • ?v 3 My Comm.Expires Oct 27,2015 ■ ';F"' - ,y Commission M EE 142041 Bonded Through National Notary Assn. COLLIER COUNTY GOVERNME T COMMUNITY DEVELOPMENT AND ENVIRONMENTAL SERVICES DIVISION 2800 N.Horseshoe Dr. • Naples.Florida 34104 • 239-403-2400 • FAX 239-403-2334 MEMORANDUM DATE: November 29,2007 • TO: Applicant's • FROM: Michael Ossorio, Contractor Licensing Supervisor. CC: Robert Dunn, Collier County Building Director. • Alainar 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 nid 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 ;onfidential and exempt under Chapter 119,Florida Statues. • • • STATEMENT OF OWNERSHIP • This certifies that I, Ma h w g4,4b, am a member or (APPLICANT'S NAME) • r Managing member of N (LIMITED L BILITYCOMPANYNAME) I own 100 %of the units issued by the Limited Liability Company listed above. • Affidavit ofApplicant:.I certify that the information contained is a true and correct statement to the best of my knowledge. . • • 1,44,4hehJ Rakth.D (PRINT NAME) • • (APPLICANT'S SIGNATURE) • • 2/a6 (,s . . ..... (DATE) • • • I - i From June, 1994(Sears revolving credit card),June 2004(SunTrust Bank auto loan),January, 2005(Navy Federal Credit Union consolidation loan),March,2005(NY Community Bank real estate loan),September,2005(Chase credit card)and May,2007 (Discover Bank credit card)all credit was paid as agreed. January 15,2002 I was married and my wife did not have good credit. She began using my credit to obtain other cards without my knowledge. She also had control of the checkbook and record keeping. I had no knowledge of what bills were paid and to whom. We did get approved for a real estate loan in August of 2005 and had two children while in the home. Then the recession dramatically reduced the value of our property which was eventually foreclosed on. The furniture loan (Citi Financial) unbeknownst to me was not being paid. Below is a listing of debts that,other than the CitiFinancial furniture loan,was not approved by me. Citi Financial: Opened 3/7(furniture) Capital One: Opened 10/10 World Financial: Opened 3/12 Midland Fund: Opened 10/13 Verizon: Opened 11/13 Progressive Insurance: Opened 2/14 ARS (medical): Opened 9/14 We separated in December, 2013 and still accounts were opened and charged off in my name without my knowledge or approval. Our divorce became final in July,2014. • Feb 11 15 11:25a 2392770167 p.1 TOT Merit Credit - - Fast, Accurate & Secure. Phone: 1-239-277-3202 or 1-800-371-3348 Fax Cover Sheet: Requested Credit Report Attached! Please call if you have any questions. CONFIDENTIALITY NOTICE:This communication with its contents may contain confidential and/or legally privileged information. It is solely for the use of the intended recipient(s). Unauthorized interception,review, use or disclosure is prohibited and may violate applicable laws including the Electronic Communications Privacy Act. If you are not the intended recipient, please contact the sender and destroy all copies of the communication. ( Feb 11 15 11:25a 2392770167 p.2 • Prepared By: Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] [SUB NAME] [MKT SUB] [INFILEJ [DATE] :TIME] (I) Z NP66284423 MERIT CREDIT 16 NP 1/01 02/11/15 10:2:CT [SUBJECT] ISSN] [BIRTH DATE) RAMBO, MATTHEW R. [CURRENT ADDRESS] 'DrTE•RPTD] 774 N. 107TH AV., NAPLES FL. 34108 1/10 [FORMER ADDRESS] 175 LEAWOOD CI., NAPLES FL. 34104 4/05 FRANKLIN RD., CEIBA PR. 00735 [CURRENT EMPLOYER ANC ADDRESS] [RPTD] 3NITED STATES NAVY 3/04 M O D E L P R O F I E ***FICO CLASSIC 04 SCOrE +575 : 038, 013, 010, 020 *** C R E D I T S U Al M • . w * * T O T A L F I L E H I S T O R Y PR=0 COL=7 NEG=8 HSTNEG=2-25 TRD=14 RVL=6 INST=2 MTG=3 OPN=3 INQ=1 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: S4624 $5900 S4248 $0 $85 28% MORTGAGE: $163K $ $ $ CLOSED 47/BAL: $279 $279 $ TOTALS: $168K S5900 $4527 $279 $85 C O L L E C T I O N S SURNAME SUBCODE ECOA OPENED CLOSED SPLACED CREDITOR MOP ACCOUNT VERIFIED BALANCE REMARKS MIDLAND FUND Y 361T009 I 10/13 $950 WORLD FINANCIAL NE 098 1/15A $950 PLACED FOR COLLECTIO PORTFOLIO RC Y 1KSE003 I 3/14 $545 CAPITAL ONE BANK U 09B 1/15A $545 PLACED FOR COLLECTI0 i PORTFCLIO RC Y 1KSE003 I 3/:2 $275 WORLD FINANCIAL NE 091 1/15A $275 PLACED FOR COLLECT:0 PORTFOLIO RC Y 1KSE003 I 5/10 $3458 CITIFINANCIAL INC 09B 1/15A $3458 PLACED FOR COLLECTIO ASSET ACCEPT Y 1E03001 I 5/12 $3086 01 NAVY FEDERAL CR 098 1/15A $3425 PLACED FOR COLLECTIO ARS Y 28Q4002 I 9/14 $601 MEDICAL 09B 12/14A $601 PLACED FOR COLLECTIO CREDIT COLL Y 1GZD005 1 2/14 $276 06 PROGRESSIVE INS 09B 7/14A $276 PLACED FOR COLLECTIO T R A D E S . Feb 11 15 11:25a 2392770167 p.3 i ■ SURNAME SUBCODE OPENED HLG11CRED TERMS MAX0ELQ PAYPAT 1-12 MOP ACC'OUNT1 VERF_ED CREDLIM PAST2LE WT-MOP PAYPAT 13-24 ECOA COLLATRL/LOANTYPE CLSD/9D BALANCE REMARKS MO 30/60/90 CAP ONE B 1DTV001 10/10 $507 R09 4/14A $300 $0 SLDTO PORTFOLIO R 9/111 $0 PORCH BY OTHER LENDER NAVY FCU Q 692N001 4/02 $3300 R09 5/12A $3200 $0 I CREDIT CARD 6/08F $0 PORCH BY OTHER LENDER CITIFINANCIA F 7212001 3/07 $3457 R09 0. 5/10A $29C0 $0 I CHARGE ACCOUNT 8/09F $0 PORCH BY OTHER ENDER VERIZON U 1R2W002 11/13 $279 09B 1/15A $279 I TELECOMMMUNICATION 4/14F $279 PLACED FOR COLLECTION US DEPT VETS V 9181051 6/12 $353 09P 4/13A $0 I GOVERNMENT OVERPA 10/12F $0 PAID COLLECTION US DEPT VETS V 9181001 6/12 $5184 09P 4/13A SC I GOVERNMENT OVERPA 11/12F $0 PAID COLLECTION RCS MTG F 2133K301 8/05 $208K 396N1171 11/10 55555 MO5 4/11A $0 $31.6 05 C CONVENTIONAL REAL 4/11C SO FORECLOSURE,CLTRL SLD 8 0/ 0/ 5 NY COMM BANK B 543T014 8/05 $208K 360t1171 4/09 55555555555X M05 8/10A $0 $5031 05 XX5543332111 C CONVENTIONAL REAL 8/1OC $0 TRNSFRD; OTHER LENDER 27 3/ 3/14 SEARS/CBNA B 6256458 6/94 $14.2K 111111111111 ROI 1/15A $15.0K $0 111111111111 A CREDIT CARD 5/05C $0 ACCT CLSD BY CONSUMER 48 0/ 0/ C DISCOVERBAhK B 9616003 5/07 54624 MIN85 111111:11111 RO1 1/15A $5900 $0 111111111111 A CREDIT CARD $4248 29 0/ 0/ 0 NAVY ECU Q 692N002 1/05 $5928 60?i134 X11111 IO_ 8/05A $0 >1 CONSOLIDATION 8/05C $0 ACCT CLSD BY CCNSUN_ER 6 0/ 0/ 0 SUNTRUST BK B 423A022 6/04 $37.9K 721705 111111111111 I01 8/05A $0 11 C AUTOMOBILE 8/05C $0 CLOSED 14 0/ C/ 0 NY COMM BANK B 543T014 3/05 $163K 360M1358 111 MO1 6/05A C CONVENTIONAL REAL 3 0/ 0/ 0 CHASE - CC H 247V018 9/05 $0 111111111111 RUR 1/07A $1500 $0 1111 1 Feb 11 15.11:25a 2392770167 p.4 c CREDIT CARD 9/050 $0 ACCT CLSD BY CONSUMER 16 0/ C/ 0 I N Q U I R I E S DATE SUBCODE SURNAME TYPE AMOUNT 2/11/15 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 : TRANSUNION4 800-888-9213 2 BALDWIN PLACE P.O. BOX .000,CHESTER, PA. 19022 Consumer disclosures can be obtained online through TransUnion at: http://www.transunion.com CREDITOR CONTACT INFORMATION MIDLAND FUND YC36ET009 (844) 236-1959 8875 AERO DR SAN DIEGO CA. 92123 PORTFOLIO RC YCIKSE003 (800) 772-1413 287 INDEPENDENCE VIRGINIA BEACH VA. 23462 ASSET ACCEPT YC1FJ3001 (800) 614-4730 FOB 1630 WARREN MI. 48090 ARS YC2BQ4002 (954) 321-5957 1801 NW 66TH AVE FORT LAUDERDAL FL. 33313 CREDIT COLL YC1GZD005 (603) 570-4784 PO BOX 9134 NEEDHAM MA. 02494 CAP ONE BC1D_V001 (E00) 955-7070 POB 30281 SALT LAKE CITY CT. 84130 NAVY FCU QU692N001 (800) 336-3333 820 FOLLIN LANE VIENNA VA. 22180 CITLFINANCIA FZ7212001 (800) 922-6235 605 MUNN ROAD FORT MILL SC. 29715 VERIZON CR1R2W002 (800) 852-1922 NATIONAL RECOVERY MINNEAPOLIS MN. 55426 US DEPT VETS VZ9181001 POB 11930 ST PAUL MN. 55111 RCS MTG FM2BJK001 350 S. GRAND AVENU LOS ANGELES CA. 90071 NY COMM BANK BB543T014 (216) 696-2222 1801 E 9TH ST CLEVELAND OH. 44114 SEARS/CBNA BC6256453 PO BOX 6282 SIOUX FALLS SD. 57117 DISCOVERBANK BC9615003 (800) 347-2683 POB 15316 WILMINGTON DE. 19850 NAVY ECU QU692N002 (800) 914-9494 1 SECURITY PLACE MERRIFIELD VA. 22116 SUNTRCST BK BY423A022 (877) 596-5407 PO BOX 85526 RICHMOND VA. 23285 CHASE - CC iE247VC18 (800) 432-3117 P.O. BOX 15298 WILMINGTON DE. 19E50 END OF TRANSUNION REPORT MERIT CREDIT HAS RETRIEVED THE ABOVE PERSONAL CREDIT REPORT FCR LICENSING PURPOSES AS REQUESTED BY THE BUSINESS OcNER/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. Feb 11 15'11:25a 2392770167 .5 P PUBLIC RECORDS LEARNED 0 SOURCES OF INFORMATION: TRANS UNION LLC IRS LIEK SECTION • COUNTY COURTEOUSE RECORDS IF YOJ HAVE ANY QUESTIONS REGARDING THIS REPORT, PLEASE CONTACT MERIT CREDIT AT: 1-800-371-3348 OR (239) 277-3202. Detail by Entity Name Page 1 of 2 f FLORIDA DEPARTMENT Or STATE _ w �y DIVISION OF CORPORivrIONS X61. z Y- Detail by Entity Name Florida Limited Liability Company NEAPOLITAN TREE SERVICE, LLC Filing Information Document Number L15000025197 FEI/EIN Number NONE Date Filed 02/10/2015 Effective Date 02/10/2015 State FL Status ACTIVE Principal Address 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL 34110 Mailing Address 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL 34110 Registered Agent Name & Address RAMBO, MATTHEW 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL 34110 Authorized Person(s) Detail Name & Address Title MGRM RAMBO, MATTHEW 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL 34110 Annual Reports No Annual Reports Filed Document Images 02/10/2015-- Florida Limited Liability View image in PDF format http://search.sunbiz.org/Inquiry/CorporationSearch/SearchKesultlletailYntquuytype=l J ntity.., 3/I.5/2U I o Detail by Entity Name Page 2 of 2 Coovrjghk i?and Privacy Pollcie5 State of Florida,Department of State http://search.sunbiz.org/Inquiry/CorporationSearch/SearchResultlletaiI7inquuytype=Entity... 3/1 3/2U I Electronic Articles of an Or ization L15000025197 For g FILED 8:00 AM Florida Limited Liability Company Sec.Of State syoung Article I The name of the Limited Liability Company is: NEAPOLITAN TREE SERVICE, LLC Article II The street address of the principal office of the Limited Liability Company is: 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL. US 34110 The mailing address of the Limited Liability Company is: 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL. US 34110 Article III Other provisions, if any: TREE TRIMMING, TREE REMOVAL, STUMP GRINDING Article IV The name and Florida street address of the registered agent is: MATTHEW RAIv1BO 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL. 34110 I-Iaving been named as registered agent and to accept service of process for the above stated limited liability company at the place designated in this certificate, I hereby accept the appointment as registered agent and agree to act in this capacity. I further agree to comply with the provisions of all statutes relating to the proper and complete performance of my duties, and I am familiar with and accept the obligations of my position as registered agent. Registered Agent Signature: MATTHEW RAMBO Article V L15000025197 The name and address of person(s) authorized to manage LLC: FILED ry 1 , 2 p � ) � February 10, 2015 Title: MGRM Sec. Of State MATTHEW RAMBO syoung i ± 1345 CHARLESTON SQUARE DRIVE UNIT 202 NAPLES, FL. 34110 US Article VI The effective date for this Limited Liability Company shall be: 02/10/2015 Signature of member or an authorized representative Electronic Signature: MATTHEW RAMBO I am the member or authorized representative submitting these Articles of Organization and affirm that the facts stated herein are true. I am aware that false information submitted in a document to the Department of State constitutes a third degree felony as provided for in s.817.155, F.S. I understand the requirement to file an animal report between January 1st and May 1st in the calendar year following formation of the LLC and every year thereafter to maintain "active" status. T 1RS INTERNAL REVENUE SERVICE CINCINNATI OH 45999-0023 Date of this notice: 02-11-2015 Employer Identification Number: 47-3089452 Form: SS-4 Number of this notice: CP 575 G NEAPOLITAN TREE SERVICE LLC MATTHEW RAMBO SOLE MBR 1345 CHARLESTON SQUARE DR APT 202 For assistance you may call us at: NAPLES, FL 34110 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 47-3089452. 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. • A limited liability company (LLC) may file Form 8832, Entity Classification Election, and elect to be classified as an association taxable as a corporation. If the LLC is eligible to be treated as a corporation that meets certain tests and it will be electing S corporation status, it must timely file Form 2553, Election by a Small Business Corporation. The LLC will be treated as a corporation as of the effective date of the S corporation election and does not need to file Form 8832. To obtain tax forms and publications, including those referenced in this notice, visit our Web site at www.irs.gov. If you do not have access to the Internet, call 1-800-829-3676 (TTY/TDD 1-800-829-4059) or visit your local IRS office. IMPORTANT REMINDERS: * Keep a copy of this notice in your permanent records. This notice is issued only one time and the IRS will not be able to generate a duplicate copy for you. You may give a copy of this document to anyone asking for proof of your EIN. * Use this EIN and your name exactly as they appear at the top of this notice on all your federal tax forms. * Refer to this EIN on your tax-related correspondence and documents. If you have questions about your BIN, you can call us at the phone number or write to us at the address shown at the top of this notice. If you write, please tear off the stub at the bottom of this notice and send it along with your letter. If you do not need to write us, do not complete and return the stub. Your name control associated with this EIN is NEAP. You will need to provide this information, along with your EIN, if you file your returns electronically. Thank you for your cooperation. JC 1) From: Matthew Rambo an)p )IandscapeC,�n)<�Lco r 8 Sut>ject: Date: March 5,2015 at 6:59 PM To: Matt Rambo IivauRnblef'05' (small corn /117"R'' CERTIFICATE OF LIABILITY INSURANCE WE 3/5/2015 ■ 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 7HE CERTIFICATE HOLDER, IMPORTANT: H the certificate holder Is an ADDITIONAL INSURED,the pollcytles)must be endorsed. tt 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), certificate .. ..... �i "9"‘""9"‘" PROCAKFa Jnszica Hornoault PrimeOroup Insurance Services, Inc. PuH■O"E 813 288.6270 Il e;tN,: 5402 H. Laurel St. PF55jnorneault0primegroupins,con Suite 220 ---'---. IAiI?1t!IL51 Rt1URDfI6 C9YLMOL NAM r__. Tampa FL 33607-1726 Nsu/v-AANorthfield Insurance Company 04869 IV6UP40 Mt/MAO Neapolitan Tree Service, LLC tysuwlc;_ 1345 Charleston Square Drive, Unit 202 Ivsuta/lo: W SUra:n E: i Naples FL 34110 IVSOnIJI I: • COVERAGES CERTIFICATE NUMBERCL153513993 REVISION NUMBER: THIS Is TO CERTIFY THAT 1I-_POLICIES OF 4•1SUFtAILCE LIF;f€l)BELLY\'HAVE BEEN■:SS+1:Ef)TO THE_ITISUREO NWIEO mum:FOR IMF.POLICY PERIOD Itn1CAIEU. NUT't\'1IIISTANUINU,\7f,•REQUIREMENT. IEHJA OR CORM 1ON OF ANI CONIFLAC.1 OR OTHER DOCUVENT WITH REV5C1 TO'AH,_'11 THIS CERTII'r=.ATE MAY FIE f)''itTEU OR MAY PEHTAN. IHE INSURANCE AFFORDED BY THE POLICIES OESCRIBEU F:_REN IS SIAJECT TO ALL THE TEHJAS, F.XCLIJsu lIS Alsn COra71TlON$or suC>I c xit;Fs UViTS SFIIYAN MAY NA4[BEEN REBIXEO FTY PAIOCLAIAIS --------- ..- -------------------'[D�F><TOEia�------ roucY eh' �. rtt,cY tar' Ix•.n IYre-Cr►lsuaAACt roar Y rrUUatn INIAG(WeIVY1`110WOONYY VI Lun. Its: enn MOD GENERAL IlialITY LL(.n Orr.oFF/;!i'E s_ 1,000,000 )( ,a.a1R-v:-M1_!.(1(11 I1 III PFLul1 F).. n, c 1 s— .. 100,000 A • _](I NU9Var'- lx]P::L4 R5)15051 7/l/7019 )/1/7016 1120t I , f2,.l I,• T 5000 PEA,SCooLAA4,!JDL1ir_ I 11000,-000 Mi ERAt Nira Tpq:E I 2000,000 Gallmr,,grr•.r,,ctor,TAFtt,ESPEr 1'41,['.1!;1: Ciur•<-rnr.;, S ;1000,000 Par, xl1, f IJ_f:I I-..1 ,; ,, it,•nnI.O T 5,000 ,WTONOBI F(MOUT( Luildr/eLl Keiu_L ulltl ,95,',.111.1 11i01_4 nfJ,et;Plr u;al0 I - _�Ali IU1: A-11!» O q1,Y 1)!J6,,Plrl<f T it - • — —_ ',.I'.V:�rILL'• IMUI•L IIIY❑ )!a,,. I urao al!Iui r AJI:r: IC11.11i J;c!, • 11UaPFlLA IIAR 1 Ct!:L<t E)IIiOff;lSli_VCE T rACC651.1AR _ c[,VUS W,FE Ar,iFE,iaif F .__......_.._ WORELII ICOUPLI,YAII0H 1, 161u VI11 My 1.9riOYLe6'LRlILJIY ._.. IL.17'I.lII I_. 1111. :x•41,1+.:lrrh_I1r41`rulrA:l,.1 e.1'.IIII\'t Yf1 NfA , EL EAr11 W. ICC/T I !x1111 111 AI,)!IIIN1:!,'lI4'-li, I ., ---- IU.ne.ler)H)HI ..t EL Or:U.1E EA EUPLLnEF I 1. ° . .:Il_lrOUre u.ul2461 u:'5 I.,u ..._.. CL r E"SE "St,..41.11.17 T j • Tf SCACIICrI OF OPFPATTOVS 11CCAT,ONS!'eFHCkFA MHO acTeD in FOFFtha,I 51rnr.AS S:t.IOAF.IF no,e Iqe.:r N'Mawr) CERTIFICATE HOLDER CANCELLATION (239)252-2469 SHIOW.°ANY OF THE ABOVE OESCf110E-D PO(IClf•S BE CANCTI.LED OEFOIIE THE f.>tPIHATIOII DATE THEREOF. NOTICE IMt.L IJE OFLIYEFIE0 IN GHD Operation 6 Regulatory Hangement ACCORDANCE WRIT THE POLICY PROVISIONS. Licensing Section 2800 North Horseshoe Drive AIR FF.PPEFFIrTAnVF Naples, FL 14104 e ellaassor IA077187/ = ,S.--.r-er:;TT`'G ••�i.v-0-• I Report Viewer 2/18/15,9:24 PM 4 1�.7dpa r+b s a; 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•* NON-CONSTRUCTION INDUSTRY EXEMPTION This certifies that the individual listed below has elected to be exempt from Florida Workers'Compensation law. EFFECTIVE DATE: 2/18/2015 EXPIRATION DATE: 2/17/2017 PERSON: RAMBO MATTHEW R FEIN: 473089452 BUSINESS NAME AND ADDRESS: NEAPOLITAN TREE SERVICE LLC 1345 CHARLESTON SQUARE NAPLES FL 34110 SCOPES OF BUSINESS OR TRADE: TREE PRUNING, SPRAYING,REPAIR Pursuant to Chapter 440.05(141,F.S.,an otecer of a corporation Hfo ejects exemption from Qris chapter by fdny a cereecate of election under this section may notrecoser benefds or compensation under this chapter.Pursuant to Chapter440.05(12),F.S.,Certificates of election to be exenvL..a axthn the snipe of the business or trade fisted on the nobs of ejection to be exenp1 Pursuant to Cho er 440.05(13),F.S.,Notices of electioonl be exempt and cerefirates of election to be exempt shat be subject to on it,at any erne after she of 0ae notice or the rssuanae of the certificate, the person named on the notice or cenYlcale no longer meets the requirements of Uds section for issuance of a cerlfcate.The department sisal revoke a OFS-F2-DVVG252 CERTIFICATE OF ELECTION TO BE EXEMPT REVISED 08-13 QUESTIONS?(850)413-1609 hops://apps8.Odfs.com/crreportvlewer/reportVlewer.aspx?data=kdv...ZxVwgiMs8KTGmMr2wzOK%2fmfGPpbrLIyENG%2fimvdxGT9o1114%2fivcA%3d%3d Page 1 of 2 r I l F f f 1 V i i b i t. . 4 mprii ry O pr m; t taizp'bx 2 D g;' k � v N rn ca ti 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 1/01 09/17/15 10:55CT [SUBJECT] fRSNi [BIRTH pATE] RAMBO, MATTHEW R. [CURRENT ADDRESS] [DATE RPTD] 774 N. 107TH AV. , NAPLES FL. 34108 1/10 [FORMER ADDRESS] 175 LEAWOOD CI. , NAPLES FL. 34104 4/05 FRANKLIN RD. , CEIBA PR. 00735 [CURRENT EMPLOYER AND ADDRESS] [RPTD] UNITED STATES NAVY 3/04 M O D E L P R O F I L E * * * A L E R T * * * ***FICO CLASSIC 04 ALERT: SCORE +574 : 038, 018, 013, 010 *** IN ADDITION ***TO THE FACTORS LISTED ABOVE, THE NUMBER OF INQUIRIES ON THE CONSUMER'S ***CREDIT FILE HAS ADVERSELY AFFECTED THE CREDIT SCORE. C R E D I T S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=6 NEG=8 HSTNEG=2-22 TRD=9 RVL=4 INST=O MTG=2 OPN=3 INQ=2 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE REVOLVING: $4624 $5900 $3943 $0 $79 33%. CLOSED W/BAL: $279 $279 $ TOTALS: $4624 $5900 $4222 $279 $79 C O L L E C T I O N S SUBNAME SUBCODE ECOA OPENED CLOSED $PLACED CREDITOR ACCOUNT# MOP VERIFIED BALANCE REMARKS PORTFOLIO RC Y 1KSE003 I 3/14 $545 CAPITAL ONE BANK U O9B 9/15A $150 PLACED FOR COLLECTIO PORTFOLIO RC Y 1KSE003 I 3/12 $275 WORLD FINANCIAL NE O9B 9/15A $275 PLACED FOR COLLECTIO MIDLAND FUND Y 36ET009 I 10/13 $950 WORLD FINANCIAL NE O9B 8/15A $950 PLACED FOR COLLECTIO ARS Y 2BQ4002 I 9/14 $601 MEDICAL O9B 5/15A $601 PLACED FOR COLLECTIO AVANTE Y 2C43001 I 1/15 $118 MEDICAL O9B 3/15A $118 PLACED FOR COLLECTIO CREDIT COLL Y 1GZD005 I 2/14 $276 06 PROGRESSIVE INS O9B 7/14A $276 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 Comp cry►-z0 (14+'hats-) Pie 6t13-9.0 oat f ii-t,K AVA►* A-f L u h + tiv/ t1 P0.0460 " 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 300227.1 3111/2015 3. That the Board has jurisdiction over this matter and that Teodor Danilov 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 181" day of February, 2015.. CONTRACTOR'S LICENSING BOARD 4 LIE' COUNTY, FLORIDA c)\' W6 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 3/1112016 John C.Heath,Directing Attorney �y Le xi 1 1 g l O I 1 Law Admitted in Utah,Washington D.C.,New York,Colorado,Georgia,and Texas. tom" Theta W Officesotionn C.Heath 360 North Cutler Dr.//North Salt Lake,Utah 84054//p(8001341-8441//john @!exingtonlaw.com//www.!exingtonlaw._om 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, i Jiohn C'.� eath�✓ 886 110th Ave. N.Suite#6, Naples, FL 34108 Phone: 239.777.1028 . Fax: 877.275.3593 www.LicensesEtc.com PERSONAL CREDIT REPCRT(Compiled From National Records) <FOR> <SUB NAME> <MKT SUB> <INFILE> <DATE> <TIME> (I) P NP7771028 LICENSES ETC 16 NP 10/07 09/28/15 09: 10CT <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 ***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+507 : 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 FEDER AL LEVELS PR=0 COL=0 NEG=1 HSTNEG=0 TRD=1 RVL=1 INST=0 MTG=O OPN=0 INQ=7 HIGH CRED CRED LIM BALANCE PAST DUE MNTHLY PAY AVAILABLE CLOSED W/BAL: $2368 $2368 $ TOTALS: $ $ $2368 $2368 $ 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 9/15V $2000 $2368 I CREDIT CARD 5/14F $2368 ACCT CLSD BY CONSUMER I N Q U I R I E S DATE SUBCODE SUBNAME TYPE AMOUNT 9/28/15 PNP7771028 (FLA) LICENSES ETC 7/30/15 PNP7771028 (FLA) LICENSES ETC 7/30/15 ZNP6284423 (FLA) MERIT CREDIT Page 1 of 2 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 END OF REPORT Page 2 of 2 Prepared By; Merit Credit (239) 277-3202 (800) 371-3348 TRANSUNION CREDIT REPORT [FOR] (SUB NAME] (MKT SUB) (INFILE] (DATE) (TIME] (I) Z NP6284423 MERIT CREDIT 16 NP 10/07 07/30/16 08:15CT (SUBJECT] (SSN] (BIRTH DATE) DANILOV, TEODOR (CURRENT ADDRESS) (DATE RPTDI 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 MESSAGES ***ADDRESS 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 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 S U M M A R Y * * * T O T A L F I L E H I S T O R Y PR=0 COL=0 NEG=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 $ TRADE 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 SUBNA24C 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 PO 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 4 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 . • /.._„,...---0 ft,,,t,,,i--",t,E. ( o` 1iev o --nty 11,i, GO r// e.,/ .4_,:)GMD Operations & Regulatory Management Licensing Section 2800 North Horseshoe Drive a... .- Ij l Naples, FL 34104 ,D.90- -`1 ,1\ ' l AP 41. ON FOR COLLIER COUN N' OF NAPLES/ 73'O'MARCO-' r INSTRUCTIONS: This applicatiou,inust J2e,tyl,e`yr`t.�te `isi-legs)yrprillit, °he application fee must accompany this application. The i e1' 'k�'b refundabl of ei tip application has been accepted and entered on the record. All check hotild be made payable to the Board of Collier County Cointnissionetr1sO-Fo further information, consult Collier County Ordinance No. 90-106, as amended. NAME OF COMPANY: Exact Corporate/Business Name: CU 5 T O i ;" CO R.: 1\16) 6E I ant pvc. Fiction Name/DBA: • Qualifier Name: .T Ca60R, CA I I Ldp/ Physical Addis s:1/i O R CT N fa l�Lt-`J -t`L. 11 0 - O-0O0 (Number & Street) (City) (State) (Zip Code) Mailing Address: P 1 ( ?Q R∎ 2 5 O N 1 1 A `5 PR I N G S +-L. 3z, l'3 _, (Number & Street) (City) (State) (Zip Code) Telephone: 23°1 `170 J R ItT E-Mail: ? (me. _ At\lf40,i0 rilcx--',e TYPE OF LICENSE: ❑ General- $230.00 ❑ (=lectrician $230.00 ❑ Building $230.00 ❑ Plumber $230.00 ❑ Residential $230.00 ❑ Air Cond. $230.00 ❑ Mechanical $230.00 ❑ Swimming Pool $230.00 1 ❑ Roofing $230.00 LI Specialty /'$205.00 ) 62.--.) i Specialty trade: f't 00Q., CC'7V&-c2.11\1 & CO i e f\QT 02. i) 4.1 0. (.) D 'J 11 ( r_ He ' , 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. lL.'D"J /0/'I /xrOQA ci NA Pi_ t� 3110 239 710 2. List all businesses, firms, entitles 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. 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. 1v/ • AFFIDAVIT I, /1 0601. 1� J I I LO-/ 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 P2 Date) By 7,t0GtO r7cDa ni </ezdiv7 of 13 avd (Name of officer, title/ gent) (Name of Core ration) • a Corporation on behalf of the corporation. (St71--/or?or Place of Corporation) He/She has produced Identification and did not take an oath. (Type of identification) NOTARY', aitaNptNhtion, �� • m moSEEo af 3 °3 P9 l My Comm.oxplros UPI.J,2016 (SIGNATURE OF NOTARY) Page 2 of 4 ,l QUALIFIER INFORMATION: Name: -FE CC\) Address: l0J`� i xORA CT T(_. 34 I ( 0 - 0°"0 (Number Sc Street) (City) (State) (Zip Code) Telephone: 2aq —1110 3hS'b Date of Birth: S.S. #: 000-00- AIM 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. Ns �'c t�io�1 COVU T 2 o4 -0a10 1,-) Q::Afai.3 -3\ GZAU - a - ARn 3, Have you ever been convicted of a crime related to Contracting? /V / 4 (If yes attach extra sheet with explanation) 7. Have you or any firms you have been associated with ever filed bankruptcy? 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. Z-7QOr CovEX21 t\lG 10. Statement of any formal training you have had in the area for which the application is made. Page 3 of 4 ., AFFIDAVIT The undersigned hereby makes application for Certificate of Competency under the provisions of Collier County Ordinance No. 2006-46, as amended, and vouches for the truth and accuracy of all statements and answers herein contained. The undersigned hereby certifies that he is legally qualified to act on behalf of the business organization sought to be licensed in all matters connected with its contracting business and that he has full authority to supervise construction undertaken by himself or such business or organization and that he will continue during this registration to be able to so bind said business organization. The qualified license holder understands that in all contracting matters, he will be held strictly accountable for any and all activities involving his license. Any willful falsification of any Information contained herein is grounds for disqualification. i-EEl O t Lc./ APPLICANT(PLEASE PRINT) CL)5 7-GM 1-1-O01l1V Li SciC� ( 1.\C' NAME OF COMPANY SIGNATURE OF APPLICANT STATE OF FLORIDA COUNTY OF /, The foregoing Instrument as acknowledged before me this " / ,,2d/ � � JJ (Date) By GG{={7 C/ 7fr)i/DL/ who has produced / 2)C (Name of person acknowledging) (Type of identification) as identification and did not take an oath. NOTARY'S SEAL .Aucyta=Cbe (SIGNATURE OF NOTARY) �{ n tlttoroNA GARCIA i i � notary CCom mission 4 EE 0335 5 � My comm.oxp ros IIcpl,0,2918 Page 4 of 4 j_ 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. eel SIGNATURE OF APPL'6ANT C U " TO 1\9 BUSINESS NAME 12 o2 ) o I4 DATE • BEFORE ME this day personally appeared A%%/75)0/U4 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 D/�% p2 by 04> elm f ate) l� y p�9� 0 who has produced (name of person acknowledging) (Type of identification) as identification and who did not take an oath. 4 OEORO(NA GARCIA �IGNA E OF NOTAR ` , Notary Public,Sfalo o! 595 , � 3 �� rl commission B FE pl.9,2 My Comm,oxplros Sopl.9,20f NO'1' "S• `w °' - - (PRINT IE OF NOTARY PUBLIC) NOTARY PUBLIC 4 §:s.:( '00 a*if ig®:V it-iat/h, ont0f Oit a,,it OA ' ,00.404,P� ai T� f""4 _A VP r P� � ,. iNk pit.A ..r._!iwt„..„,...000,_04104„trgoo .-161041;x"/00 4f )A� t/ 4 *� 4 4 tt, .tea-,-.,,,--;7%. ._t1/4 , A s. N ` 4,4.7 ° y4 4 to, 0 + tee,'-II:ikkiy,it..., , _- ♦-F � , mil®�`at xy :• o cd o ::: .l i fs- �.tot. 'A,, F �.® c+-4 AO 0 j s NMI a-) ® fJ! U ,�V • � 7 .J ,4 d o At DC-:;,',: ..,/,..:-."_* .1 -13-1‘ 1( 1 i :15 )::(r 1 4 4 41411:k";#1' 411 e\ / '-' (CI) S - d ,--ci M 0 .8 i.,1411 ) - 1--4 Z 4 - 0 a, <1.) .C.,) ,i...„ v .,..c1 :ticc.. - sd,y.'tie Ar = } _, -,-.4 ` c:� - N •I a ®���3 0.0 ��014} -� 4 ® a 1 v3 , ,..,,_iegorp---,- tir.PIAA C..) Ch CU C-) CU '3) ‘- . \'■i. 4 - 111411 ,..` ��� � o � c i �� •AV , � !� ,.. - ;‘, ... ....„- „,..-, * 1 ta�� . F 11 l � f i Y f', Y .. m- i ��� . � f J *, j J ` .444A -- a _. . . - . •-- F.' . - d. : .- " f - .),, ,}_ ._:A •: ` A _. - "_:. _.A Y^� _a n• R.•%s\- c I GUTS, 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: ,. Narne—Teodor Danilov 1 . Candidate#006.70980D ' Testing Site: Ocala, FL . . • Final Score Result: • 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, . c /-'cucuyUtZ c_ (0...q1 . J y B. Bowermeister President PO Box 831127 Ocala,Florida 34483-i 127—Voice(352)389-G(TS —Fax(352)387-2443 800 997 2129 �. VERIFICATION OF CONSTRUCTION EXPERIENCE 1 G Operations & Regulatory iVianagcment Department Licensing'Section 2800 N. Horseshoe Drive Naples, FL 34104 Applicant's Name: ' e---O Q O C L'ertificate Category Requested: I'he 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 he described, but may or may not he considered :efficient to demonstrate required trade experience. The person verifying trade experience must provide the following n formation: Jane,Title and license number of the person signing below and Nerifyiug Applicants relevant experience: tarn e: Q\ Q Kuernr`ne\ 'itle: U wt1 E C License Number(if applicable): C C>C l so H9(1 S lame of Business: SW F Qoc\ S k--C v C.-IC o Y\ :usiness Address: a g y ki O 0\8 � \ �� �` y c-6 on,17-q r(4 S fi L 3 •usiness Phone: a,39 `I`f f$• IS a,p The Applicant's years of experience from Oa, 1a01a to a PasoiL-- The applicant's scope of work(specific duties)included: `000.‘(1 inS-NS \c�tr\ off` \� 4`C\ c � sksoce, wood G(16 ca . SL)pre_c� �sPC1 oSesS S edv\-e8 0 cclgt\'17._ S \- , dditional Comments: \ . . • r a (01 ecc- s • "s-- ti C \e icon A-d gsSucrd CUS'\--ame \ o,��s�� e d • alsifying any information provided herein may subject your license to revocation. Signature Print Name: O�.a-C 11\ mme ate of Florida Junty of Collier R� le foregoing instrument was acknowledged bef a- • da of Qe_t , a o►`I O\a f �uemcn.Q` who is personally known to n or-predueed iteigtIMM and who did not take an oath. Signature ofNotary PATFIMA.l804 - .1,I ?■1Y COVISSION#Ff 147709 i EXPIRES:Aovst 4,2018 806144 aw tianf At&ee14orct a 8 •., • VERIFICATION OF CONSTRUCTION EXPERIENCE F" 1.�. ._,...-.:. ., iasv_�EhF�.�7t ,3..�t�^.-6 zr r,:.=s._�c n,._�x•-».>s-..,._ a.c;J•,2..�.1.,:fat.3- GA'ID Operations & Regulatory Management Department Licensing Section 2800 N. Horseshoe Drive Naples,ILL, 34104• Applicant's Name: , G � ,` 1)474 IL T)(./ certificate Category Requested: - _ % ,l` c - %Lvc' •,i t- fhe Applicant is seeking a Collier County Certificate of Competency in the trade indicated above. As part of the triplication 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 n'orking 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 ;ufficicnt to demonstrate required trade experience. The person verifying trade experience must provide the following nfonnation: dame, Title and license number of the person signing below and terifyitig Applicants relevant experience: dame: j>,4/1,( 4 (Jt QH (Ob i(1 [tie: 17(2-, Si fit=lN(! License Number(if applicable): 2.�( 2-�� - lame of Business: O(%N !<Zc t',1,4-12.01Lw /4e. ;usiness Address: 35-5 RR_0(,4A 4u N,+-pLr=3 -( , 3 £1// ,usincss Phone: 231 1-10t( _o g 30 The Applicant's years of experience from to he applicant's scope of work(specific duties)included: /11 / t(--‘7-1 (1/f'2(V-6'( rGc%o2 eet/(: (m-6.. dditional Comments: 40C(1 i'6 0-7Or( alsifying any information provided herein may subject your license to revocation. ) pu Print Siga Nam tre /l'0 ate of Florida aunty of Collier ) J �t -fore Ding instrtytte�tj�as�acknowwledged before me on this o� day of ` "Q � �� �J who is personally known to me or produced !/.C'JL/J- /(_ ✓�_, identification and who did not take an oath. ` Signature of Notary • ,s;AVota4; DENISE K MORRIS Notary Public State of Florida Commission#FF 92047 'oicr* My Comm.Exp,February t 1,2018 8 • • VERIFICATION OF CONSTRUCTION EXPERIENCE I GMD Operations & Regulatory Management Department Licensing Section 2800 N,Horseshoe Drive Naples,FL 34104 Applicant's Name: e0�0 7' 6 ApP I Certificate Category Requested: Tile 04r1 Ka( 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 ill—al-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 rote 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: NQlrf a ..J f Vac/ t Title: tDVJ/�./' License Number(if applicable): L `--i, 0'! 3a n947,0 /0 Name of Business: 1 ;G irl c es 4C _ 727 --talf�I C'�' At `gill )e -L //Q Business Address: Y/ r Business Phone 7) (267` 1 `2(/ The Applicant's years of experience from ,72°)M to 0/7. The applicant's scope of wor (specific duties)included: �/J o f e L'� �s / Q -ie -e //45' a ///),- 40/1 -�JO er l is r2aotoole -t_ \ Additional Comments: te ' r k ,' Cv,3.10 wer / ca 7o, 5 . Falsifying any information provided herein may subject your license to revocation. Print Name: 611 k 0 rJ/7 aU State of Florida County of Collier 'j �/ �j,� The foregoing instrument ti as acknowledged before me on this Zday o V Ai ve'► by attain 1 f who is personally known to me a educed 11 I '/ )..AU ..J ° as identification and who id not take an oath. �\\ \A e) '/i NNW�..J .1 .� ' oTARi:.%9 attire ofN.��„ t Ju mm.Expires' ne9,2018 No.FF 130823 Bonded throu Cn• We11s Farga h ; 9>� Ug u�. ��O��i CI '•N O F'\,p```\. AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I, (-)lQ �iJ�i tlftilt' 1 , am a resident of C o 1 e c County, F oc i d a (State) and have resided here for more than five (5)years. During the last five years I have known fie?odoc Cat11 oU 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) (Name) 0\a c 1�ue tY u (Address) ?)3-.1 c■`m L} e■ 0)c. l'\c,ees (2- 3`{ X 10 Telephone) a 3\• 3y O say 6 STATE OF FLORIDA COUNTY OF The foregoing instrument was acknowledged before me this l al a• an by (Date) - c \a-c \(„uernso-e_1 who has produced F. S L;ctp S (name of person acknowledging) (Type of identification) as identification and who did not take an oath. STGNATURE OF NOTARY JG� 6'■c1Q _Soc. NOTARY'S SEAL (PRINT NAME OF NOTARY) NOTARY PUBLIC f ham'" r M PA;RICUA ISM' ,,.t• },1Y CO3�4USSICN I ff 147703 e' y?d� EXPIRES;August 4 2018 Ek44rd WI Wavy Rita[kik mite!" • I (7 AFFIDAVIT OF INTEGRITY AND GOOD CHARACTER I ifinricto , am a resident of a /ma i C`0M County, / /bo Ja (State) and have resided here for more than five (5) years.' During the last five years I have known 1 eeG D/ t4(/OY 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) ► (Name) A/ (Address) /U 17 /D67 Y 6 r <Of ILeS 111 311/0 TelephoneA5 /1 c)2._‘ STATE OF FLORIDA COUNTY OF r,,,,'y'- The foregoing instrument was acknowledged before me this 261 Novemb 0)t'"by (Date) MO\Y who has produced 'nOr-ida vrweys 1Ce,n5e, (name of person acknowledging) (Type of identification) as identification and who Kitt )e an oath. ��, NA BO /i�i ...... 4160 ►• : ll7�T� My Comm,Expires�, IFTTATURE • 3i • _• 'Y ! June 9,2018 1. { 130023 •• � Bonded Through ! Z 1• t�l NOTARY'S,S ' Wells Fargcf ;• q- (PRINT NAME OF NOTARY) y, ptJ81.�C:•''�\��``� NOTARY PUBLIC . OF F - \‘‘\\ I1 • • COLLIER COUNTY GOVERNMENT COW-UNITY DEVELOPMENT AND ENVIRONMENTAL SERVICES DIVISION 2300 N.Horseshoe Dr. a Naples,Florida 34104 a 239-403-2400 a FAX 239-403-2334 MEMORA.NDUM DATE: November 29,2007 • • • . TO; Applicant's FROM; Michael Ossorio, Contractor Licensing Supervisor. CC: Robert Dunn, Collier County Building Director. • Alannar Finnegan, Collier County Permitting Supervisor, Robert Zachary, County Attorneys Office, • All Contractor Licensing personnel. • STJBJECT: 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 , '''''' r Akz...„..) r,nal\ I,\ ' A '' ' j7--------- ---7717-:A..,..) Vjjz-Y v k' ' d'-'-.>)'("7( t > January 30,2015 `1 Y 6c71( /'`-a mAr ..,,, 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 i 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. 1* Sincerely, el,,,c) „..,.....---- ,,, Teodor Oanilov >G9 4 k k_ i D ,,,;,0„., A, (:),,i � rrw ■0011Millr"Q 4V X4)4 ` — -------.-7---:---- __ — , 1 - - -- --•'--- -:-- --:--- COWER COUNTY BUSINESS TAX .- BUSINESS,TAX;NUMBER: 141935 _ _ , . ._ COLCIEk CaiNTYATAtolLgOTOR-2800 N,HORSESHOE DRIVE-NAPLES rom0Ai-34104-C230252:2477 , VISIT OUR WEBSITE AT:www.colllertax.com THIS RECEIPT EXPIRES SEPTEMBER 30, 2016 -.5-7::._ -:zi. ,-:;,:•,-.-1;:t.. = ;,-;,::-.-:- - , • 1 oispLAy- AT PLACE OF BUSINESS FOR PUBLIC INSPECTION -.-:,LOCATIONL:1015:1XCRA CT FAILURE TO DO SO IS CONTRARY TO LOCAL LAWS. ' \/ -''' 2'.-11R1-Cri-"L':!--/-`: , i tEGAL.F0 \ -''- -20NEO: HOME OCCUPATION '' . -:- - . THIS TAX IS NON-REFUNDABLE • (..) ,r- CORPORATIOO\ ' L• BUSINESS PHONE: 770-3585 --::: =-7 -'',f-- .' -- :1-j::''I.: CUSTOM-FLOORING DESIGN INC COUNTY LIC:2014-4289 s DANILOWTEODOR 2--.-- •-,--- .-::':' ' i 'i,-- i PO BOX 368125 1 ' --I' /-,--4' c ('--- ---'-- BONITA SPRINGS FL 34136.0000 ";Lk=,1 'IT- .--ff5 ..-.:=-.- -,•:= .1,-- 7. '-f; 1 I ;=. ,:i=f• ili?-:,:"-.:-: N -,.--,.=,:y:. --=- ,.1- zU A.7-:-.:-,:•..-i,-- NUMBER OF EMPLOYEES: 1---10 EMPLOYEES__ ,.,_ , 4...., .0 ,<, -_- --- t-.-----,- .:1'.--, ;:fix . CLASSIFICATION:TILE&MAIRBLE,,.COa-TF9N,OT9R "-. .: i:):: -1.:-_-, C\r\ 1 • e_,C,-' ::-_ -_-=-,-.- =f-t.... ---;-_,• -•:-.:DATE-f-..-..---:.: 02119/2015 z-.:.,t1-, =1.7- -:-.,: .--7:-±,- ---= J-•:--r----:.' \_./ ‘_,, _,.,,...- CLASSIFICATION CODE: 02-101904-. .;',■_ _Z-,-3 t:Lf., i"-I,V_ --2-4" -----..k_s_'_.---- --.--: '' -,- 11AlvICAMI.1:-.7 9.00 -----:--- ----=:'--- -:- This document is a business lax only.This is ni:If"Cir-tific:alionlig licensee Is qualified. ECELPY 6672.41 It does not_permthelfcensee to violate any existing regulatory zoning fam:of the,stalq,countyor cities,: // - =.7 c-/. 1//, 7'7, i<riPV -does it exempt ttierircensee from any other taxes or permits that may bairequiteci'M lAW. :--f'; ,=:`-f: '---=:- % 7.-e. '-- ---- ..-Z:. COLLIER COUNTY BUSINESS TAX ' ';BUSINESS TAX NUMBER 141934 COLLIER 000N171:7,-TWICoLi_ECTOR-2800 N.HORSESHOE DRIVE-NAPLES-FLOOiok34iO4-(29i-2.5.2477 I 1 VISIT OUR WE BSITE AT:wvivi.e,olltertax.com--:--7 1 , -- - -.;„ THIS RECEIPT EXPIRES SEPTEMBER 30, 2015 -4;,?. _:.. s_43(-i ).,_=,,i 0_,..1SJIL:#_.AtpLACE OF BUSINESS FOR PUBLIC INSPECTION LOCATIONI;-10151X0KuT ' \ ----'.:-:-' --2z,:- '.--' L.'TFAlLURE TO DO SO IS CONTRARY TO LOCAL LAWS, ----_-i,-,-._. ,- = HOME OCCUPATION THIS TAX IS NON-REFUNDABLE -f•t:EGAL--,FORAC*== ../ , ,----. ZONED:- IC)-... CORPORATION\ "/\ I - --- BUSINESS PHONE: 770-3585 ?,-5;._ :::;? -,..="-__ =-_:- --. -;-- 1:ff I . 71 9'1', ', i ', CUSTOM FLOORING DESIGN -, - :--..Si:" ;---ge -f:';.r,." ' ■ i COUNTY LIC:2014-4289 1 , I '. OANILA:fgoboR,.: _ . m yr- . - I j PO BOX 3.6-8126 b ■ •! --_-_-`,.. ,i. _.. ,t:V.;•• -5 ----_. (-:=-.i, :=;-:-f-:: BONITA SPRINGS FL 34136-0000 -.-- -- ' ;-:-Z.:c.:- :.-::": '=7' r';- ':::--7 "5. ' ' '?• ..':-., --W--2 A-1-;1 t_ri .i !,-.1,-.:.; '.-•=f i2./ :... . 1 - ,_ NUMBER OF EMPLOYEES: 1;10 EMPLOYEES ___ ._,_:_.__ i__ '-4.., ----- ---1/4‘ ..' - _ -- CLASSIFICATION:FLOOR COVERING.00NT_RADTOR= ;:-: :-- ,fs:-. •-:-.----.-{ C n..‘I \.h'-t`•C' ' ,:-,---- -:-_-- --"': 1,--- .:_,o..,kT.E'- 02/19/2015 CLASSIFICATION CODE 021043d1F : -- -_ - AMOUNT 900 This document Is a business lax only.This Is not'c:artificationitfat licensee is qualified. -'--REctiPt 6573.41 -:,.- It•does not pemiitthe.lfeensee to violate any existing regulatory zoning laws:of the,stetecsounttor cities /1 *2c' i,;_,_) -„„ - ..-nPr does it exempt ttie]lansee from any other taxes or permits that may lie4requirbd by laA 3-4-i• •f:. •:'.-- ..•‘ ClAn9 7-7', , ,r-11--‘,•4 • I 886 11O`h Ave. N.Suite 116, Naples, FL 34108 V - -,7-4M 64-N ii-"- -1 ---',, j.; z, ic .=. _„ , . _. f----'-,;4. t- - IT 1..-• .. ct _ - , -4, or,- 1. . ,,, . i t Phone:239.777.1028 Fax: 877.275.3593 =s `°' www.LlcensesEtc.com PERSONAL CREDIT REPCRT (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 WilWAIIIMINIMIN <CURRENT ADDRESS> <DATE RPTD> 1014 PO BOX 1014, ESTERO FL. 33929 1/13 <FORMER ADDRESS> 5223 CEDARBEND DR. , 1#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 * * * ALE R T * * * ***FTCO CLASSIC 08 ALERT: SCORE +5.43 : 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 SEEN SEARCHED AT THE COUNTY,STATE AND FEDERAL LEVELS PR=0 COL=0 NEG=2 HSTNEG=1-1 TRD=3 RVL=3 INST=0 MTG=O OPN=0 INQ=4 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-1k 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 RO1 Pagelof2 /L 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) SYNCH END OF REPORT Page2of2 886 110th Ave. N.Suite 116, Naples, FL 34108 Ns oe fi 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 eggiggORIMOMO <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 * * * "'TICO 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,STATEAND FEDERAL LEVELS PR=O COL=0 NEG=4 HSTNEG=1-6 TRD=4 RVL=4 INST=0 MTG=O OPN=O 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 Page 1 of 2 / ,c�' • 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 PURCH BY OTHER LENDER 48 2/ 2/ 2 I N Q U I R I E S DATE SUBCODE SURNAME 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 Priee 2 o12 EA. •i3A0(r-,2 in in AC la in cin st n 1.0 EL22.L_ NONE RS'ORTRI CAP1MSTOY Trans linien E.304(13r1 Equifax A ccc,rrit 70011670''" 101110713 lf.46-'' 16903 1-7016,53 Conditioen Tral.U'Efft<1 Cosel Transferred 30 113 20 Oztascia: TYPec Mama einootaM C2tare account Charge accound Pan Status._ /2•0 Day; lot?a2304,s 1.sla 120 aain Tem-Year payment lister, Lenard>a rte Ca '12 as as rial em (411 WC'fa 13 III tan ne ion .. 4&JILHJkJ• (1:1 Co ad (EC .1 2 113 11.2 LAI Ins,Ca'cc EEC 330.(04 A./:A.74 an 1. fault S.CA 15/ICC '12 so (...! XI.C.,13,CO PC./CA II Al 1.7 LLA ftlf-Mt OK OF AMER More about his account a, ToansUnlon Experian Equifax Ac-cv_rA e 45- 426422794632' Condition: Defogatory Cnnegatery Derogatory Balance: 522E8 52373 .ra-53 Type: CarecEt Cant Caeca Cad Pay Status: Co'o•C;xaCtien2:,..nY ColecZotiChnge.olf Two-Year payment hhtOry TransUnIon E,F.Man iii JLl4i2JLj3c.itJLJ% I0J3ii i1I61 : rce '13 in Ira 1-441 AA An Ai CA KV CA '14 701 eta CIA 1141 4.1%!.4. 0/1 na. Equaax . 1E.(CI C.:.0 in '13 rui isx%IS'(1111 4/1.51 Ft.CA ft)/(IC '14 In(CO(CO rex/An At on . . _ • Installment Accounts:Accounts=Trisect of fixed(emit WTh regular payments 11101 C11 t1oro about ibis account sa DansUnion Exparian Equifax Accoard 9: 203" CondIllon: Paid Balance: :0 Type: AM*Loan P.ySt2fus: Covent • Ttro-Yeu payment istory Learnd>= Tran%Union NONE REPORTED Expecian SONE REPORTED EVIZ.1.c 'IS la r.15(41 tee is XI,0::In to(4?la '13 na roe re ISM Al(cl an.101.CA K,ICC PUblIc Information NONE REPORTED Ifriqu1(169 Creditor Nome Date of Credit Doreau LEGS/1003 11,0B2013 Egieu AT&TSRVS 03(3,2703 Eia.ttaic TOY/CREDIT 051 /3 Einitax SYUCB 05•243011 Tarattrfc. 1D RETAIL CARA]SERV.CE 02a23.:33:13 ROFAL/113SF 12050312 Eaz..Va.c EOFA.IRDSF 3z.a37022 1307M.2.23.SF 22031:7.2 • • - 1Crecclor Cortlacls !Creditor Hanle Address Phone/lumber TO RETAIL CARD SERV.CE ICOO MCARTHUR BLVD 701-8113-4C*3 LIAHAVailil 07420 CAS 2e52511111VER'ACOOS DOD 300-015-6950 LIETTAYpp.6:045 CAP ONE PO SOX 65520 FEORVOM/VA 23265 DOFAIJIOSF 35 Ft tAxe AVE 6W-447-1692 PASCO-LACA 91101 82(00 AMER poem(532235 EL PASOTX79`.M3 EIRMBRA 50 ItORTHVSES r PU/11 ROAO aK GROVE VILLAGER_60)37 Iltips://tui.scorestase.cou2/01T-rodu.ct\A'ehillexproductDispiayCenterlxein.do?webToke.... . 11/1012014 • 3'atar 1 of 2 Credit Reports Prim Ri po it pon3OnaI Information C c U-Js FZncara'r,'nc,li9cnI o,n:r11.1anunt 5stor, Trans-Union Expenrn Equifax CREIXTREPCIRT DATE_1+..til tt tt•10.Gt4 IV10201a riATE TEC1C t 'U d =C3 CL'FLGY TECCC.?Q;::tC'/ A1SO K CTZPi AS: DATE GE E3RT-h :s,E7 • CU7PStT ACUR'FSS :�,rYO EST.71,4. l-vE IXr:r4 PO50:<1014 FS:c-n:i SEF..O FL s13 ?a Fi�YAl1SAL'DRESS: .E.2nC52i5I ' '!'.i 52e23 CMARDSNEI CFI FLIT 1_'lcySPL AFT4 FORT MYERS F. • OR 225 Y0F 3.E.31-9 FORT 3i-5 Fv 3511• �iT73 � E./PLOVER: PA—11-3' •=;;<GTee /A sE?f-0 07.:•51$ -1e uizza Consumer Statement Tra!satin long 1:C11C FIE-Peat ciJ Exporter!! NONEAET-CRTEO Equifax: r:Ot,ERERC5 T£O Summary/ zc!t la(Sc iransUnion Ezparian Equifax TOTAL ACCOUNTS: 4 4 4 OPEN ACCOWITS: 0 0 CLOSED ACCOUNTS: 4 4 3 OE11.12t i1_ 1 I 2 DEROGATORY: 3 3 1 BALANCES: 55.5,5!03 5542203 mea.A PAY'.KEYTS: S3C0 50 CO 5&9.00 PUBLIC REDS 0 0 0 O:OIT Sr2)�rs. 2 2 4 Account History a{:x to Tog rat-t-0'Jriceyiei nsicr'a0.Tsorne,tliee. L7 • • ,.1 (:1 L7 02 61 Ittt \�r"s" la fftt fa rltr C04.1r 1.1at,l 1:a.ltlt D.,.l,t 111'fltrrnt, Clnraur. Sits ` '"` I..4 pn cow rill he gars r..1du.,r Cavur.T Revolving Acco alts_Act o:etsuD301cc idt-n CAP ONE Mote about 414l0 sScoun1>D TlansUnfoo Eoperfan Equifax Acc«r3�: 57!0.91 5-01:0572— 51tcT�/c"- COttaltfon: bxrtery Ocecga,Sxy Oyu+ Ualaoee: Sr_3 .sr-4 5c2 Types CCsso tCar! CreSt Card CRdi Card Pry Ste: W'�rn Ofi.Jtf U_:stn Gc;cr1 laa vC:-ys Tno-Yeti prsxze t history 1-"'4cnd'> TrenfUnion E,P.n... W t;3 l i t 1.i:t T s 9 t i;t r:.:1 r:►LAW c LA i l' • • �.-,<.3_:.+C�i t�t�l rr. 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Aso:el Croon Pitfatts 605 ) tool) a 0 fj d 350 4 Z0 4.50 O 5=0 6(0 6S0 700 7.f,0 8f.0 Pe...tate 0,e,,ecocurencredt roQt.aos 3. Protect Your Wen:ty 49 You one unt-X0 qua!:ty for a"oan vnth an attroalve interest rale. Learn mcre t-tc.4 tc.r.coi a.r 4. Keep Your Foniny Site SeureTtacko ScoreCact Dispute Cotta . Una ereSenyo Features Get en rr..)$t Scos•,e,nrrt:netO • .1tcs11 Cen,_sct Ifs FAO Terms t.CCGOcot PheactrPecq 0 2014 SchreSenfe mat.A4 r:ohts ref Freed b tip s://m enthers1 sc ore se Ilse.cornkiiish b oard 11110/2014 Detail by Entity Name Page 1 of 2 F)E,Olt1t➢71 DEP1lRTMEIT 4F STATE r 5 JV �D171.0102.! O}CORi!ORA lQ S 6 . J r s` - > •- f-°i 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/SearehResultDetaiPinquirytype=Entity,,. 1/30/2015 Z 2 ' Articles of Incorporation F14000090809 Electronic Art 1 FILED For November 06, 2014 m Sec.nm nS to CUSTOM FLOORING DESIGN LAIC 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 TXORA CT NAPLES,FL. 34110 The mailing address of the corporation is: P.O.BOX 368.125 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 The•name and Florida street address of the registered agent is: TEODOR DA.NILOV 1015 IXORA CT. NAPLES, FL. 34110 I certify that I am frrmliar with and accept the responsibilities of registered agent. Registered Agent Signature: TEODOR DANILOV P14000090809 FILED Article DTI November 06, 2014 Sec. Of State The name and address of the incorporator is: msotomon I'EODOR DANILOV 1015 LX.ORA CT NAPLES, FL. 34110 Electronic Signature of Incorporator: TEODOR DANr1LOV I am the incorporator submitting these Articles of Incorporation and affirm that the facts stated herein are true. I run 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: 11103/2014 26 Cep I Copy 1 1 certify 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: 1.41107122511-200266114732#l Given under my hand and the Great Seal of the State of Florida at Tallahassee, the Capital, this the Seventh day ofNovember,2014 4.Y"; 4:;-' ..2:7,t ;: ca. „,,,.r � : K tern tet n r ape tret p at gz,tate 2.6 1 I SS-4 Application for Employer identification Number (pee 271 (For use by empkrrfers,corporations,parinersfaps,trusts,estates,churches, EIN government agencies,Indian tribal entities,certain individuals,and others.) 47.2 230490 See separate inslnrctions for each line. > Keep a copy for your records. j 1 Leta narro cf ee ty)or`.ct;!L a}ter..;cm the Eh`d s be2ng requested Custom Flooring Design Inc `;2 Traxle race of ttsresa(4 different.`_*r_,-m r•ea o, 1) 3 Eye-cuter,2dm;na=.?2'or.tustee,'ore et'rare mf o(•la �C irg c=�res�,;:corn.ect,szr'.e no.&d e et P.O. tsar) (5e Steel.agrees(if cf.'; e-±1 Po rot enaes a P_O.t;nx1 C P.O.box 368125 1015 Ixora ct `4 E..4b at!,stale and ZIP code ff!co act s •s) Sb City,state;and ZIP cods 1 for& �see • Bonita Springs,Florida,34136 Naples,Florida,34110 O 6 Corxty and state be--e fc a • county,Florida 7a None of ri aportva7 e pa-17 7b SSN,MU,or Gtl Teodor Danilov 769 8a laths 2 %a_lton for a 5-71ed Fze/z y,X z•ar f(h G)fcr Eh If 8a is-Yes,'enter the rarna-r c3 a foreign equivalent)? (11 Yes ❑✓ No LC members . . . . la 8c tf 8a is-Yes,'v2s the LG o2ar^^4d::r16..e Veiled States? El Yes ❑ No 3a Type of entity(check enby ore box)_C.-ution_If Ea is-Yes,'see the insbucbons for the correct box to check. ❑ Sole prcpr'e cr ISSN) ❑ Estate(SSA f of decedent) ❑ PartnershIp ❑ Ran administrator(TIN) 21 Corpora- (ceder'arm ra_mb=r to be Gao)D-Form 1120 ❑ Trust(tiN of grantor) ❑ Personal sonic?corporation ❑ Notional Guard ❑ Staterlocal government ❑ Church or church-cc-ttro ed organization ❑ Farmers'cceperali e ❑ Federal government/ornery ❑ Other nonprofit organization(specify)D ❑ HE,MIC ❑ Indian trbd go,:emments/entettr'ses ❑ Other(specify)D Group Exemption Number(BEN)if any D 9b If a corporation,name the state or foreign country State • Foreign country (if appficab!e)where incorporated Florida 10 Reason for applying(check only one box) ❑ Banking purpose(specify purpose) ❑ Started new business(specify type) b ❑ Changed type of organization(specify now type)I:- Construction ❑ Purchased going business ❑ Hired employees(Check the box and see fine 13.) ❑ Created a trust(specify type) D ❑ Compliance with IRS withf•.okling regulations ❑ Created a pension plan(specify type)1 ❑ Other(specify)P- 11 Date business started or acquired(month,day,year).See instructions. 12 Closr,g month of accounting year December 11/0712014 14 It you expect your emp:oynueni tax tiabfty to be$1,000 13 Highest number of emp.'oyees expected in the next 12 months(enter-0-if none). or fess in a MI calendar year and want to file Form 944 If no em io expected,ski fine 14. annual y instead of Forms 941 quarterly,check here. p yee >�t P ' Clot.employment tax 1iabMy generally ssii be$1,000 or foss if you expect to pay SA,COO or less in total Agncatturei J House]old Other wages.)f1 you do not check this box,you most file Farm'941 for every quarter_ ❑ 15 First date wages or a mites were pad(north,day,year).Efate.If applicant is a vnthito!dng agent,enter data income Wn first be paid to nonresident aten(recr-•ttti day,year) P 16 Check one box that b sit d Th s the peccipaJ actrrhy of y-ctrr tlus:n , ❑ YezRh cue t soda]assis1arree ❑ Wl olesafe-egentibroker Ccr--t uatan ❑ Pert-•Ziess.g ❑ Trerspertaton&tin o:sing ❑ Aaxrodstir.+n&(cod seiVca ❑ 4r'Cci e-other ❑ Reta3 ❑ Red ❑ 0.ta,,uf m,twfng ❑ FL,a„ce ti i„s,rrance ❑ Ocher(woolly) 17 Ind--e pre cp i fne of merchandise sold,specific construction work done,products produced,or services provided_ Construction Work 18 Has the apt}writ entity sham on tine 1 ever app led for and received an RN? ❑ Yes 0 No If'Yes,'write prericus RN here I> Corup&tta 114 sit Son yelp U wo vast to arrilnr¢e tea rural;ref:env to«onra the alit/s Eat and 2rsear q tstions hart tie rrnrairdon of tfis foam. Third Designee's wane 0.3 ,ms's tdep xne rrmbff()Axle area cede) Party Nicole Ramirez(93012413) ( 808 ) 629-9001 Designee Address and ZIP code Designee's fax number(eciude sea code) 2800 Biscayne Blvd STE 200,Miami, FL 33139 ( 888 ) 593-2328 Under panaltias of perjury,I endue ant I tuw examined this rcg calm,aid to the test of my tmaiedga sob tN Oel,it is btu,cared,and coo,pite. ?ypFrare's tgepl-,ene renter include sea cad.) Name and tine(type or print dearly) 1. Teodor Danilov,Principal Officer ( 239 ) 770-3585 Appfcant's fax number(Include area code) Signature D Date P ( ) For Privacy Act and Paperwork Reduction Act Notice,see separate Instructions. Cat No.16055N Form SS-4 (Rev.1-2010) } l CERTIFICATE OF LIABILITY INSURANCE DATE IMMIODIYYYY) I 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 AMFND, FXTFNI)nR Al TFR THE RfUFRAr;F AFFORRFf RY THE POI.ICIFS BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S),AUTHORIZED REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER. i IMPORTANT: It thn rprtllh?h h l i'r h ^r. n nnrnn1■:nr [MCI iocn Ihn I: ,,I ..), ,et hn +',rand. IF SI_IRR.nGATION IS WAIVED,subject to certificate holder in lieu of such endorsemen((s). CONTACT PRODUCER .NAfAE;.. Weems Insurance of Naples,Inc PHONE N , p(239)775.8705 I�> ,.t0J:(239)775.8570 _ E1 2081 South Airport ruai Suite c ivu AODRFS S: SUSd1 w eeutb i n.o w dn t.C.t.uni,dbiule.Het Naples FL 34112 ,. _RISURERISI AFFORDING COVERAGE NAIC4 INSURER A: CYPRESS PROPERTY&CASUALTY INSURANC INSURED INSURER B: —.—. ... Custom Flooring Design Inc IN.ORER.g.: _- PO Box 368125 INSURER D: Bonita Springs,FL 34136 INSURER E: — .._.,—_ INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THATTHE 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 EE i' I rr,^^"AV nr I..!x1 -,-1 lr 1.,,or,A nor,- Arrnnnrn MI Y,lr nn.inirn nrnn H,Mrn 1,rnr,u In r,' : r 'AI 1 T,IC TE ?.1S EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE SEEN REDUCED BY PAID CLAIMS. INS/ ADEN_SUER POLICY EFF POLICY EXP SYV LUSTS LTR TYPE OF INSURANCE RIRn O POLICY NUMBER IMMODIYYYY) DJ NAMIOYYYYI X I COMMERCIAL GENERAL LIABIUTY EACH OCCURRENCE $100,000 A CLA1MS t.1ADE I X I OCCUR DAMAGE E TO RENTED g 100 000 PREMISES(Fe ocaKrenca) , 20P0071072-0 07/24/2014 07/24/2015 NEDEXP(Any w,eperson). 56,000 ___. . -. PERSONAL&AOV INJURY 3100,006 OWL AGGREGATE LMtITAPPLIESPER: GENERAL AGGREGATE 5200,000 X POLICY PRO T _LOC PRODUCTS-COMP/OP AGG $200,000 JEC OTHER: $ AUTOMOBILE LWUILITY (Oe IBIN D SINGLE LUST S ANY AMID BODILY INJURY(Per person) S ALL OWNED SCHEDULED BODILY INJURY(Per accident) S AUTOS — [ION-OWNED PPROPPCEtR�TY DAMAGE $ HIRED AUTOS AUTOS $ UMBRELLA LIAR _ OCCUR EACH OCCURRENCE EXCESS LIAR CLAIMS-MACE AGGREGATE S DED I I RETENTIONS S WORKERS COMPENSATION STN TE OTH- _.—.__ ANDEMPLOYERS'LIABILITY ER.. ANY PROPRIETOR/PARTNERIEXECUTVEy 2 ELEAC-jACCIDENT $ OFFICERIEMBER EXCLUDE07 11/A (Mandatory in NH) EL.DISEASE-EA EMPLOYEE $ W yes,describe under DESCRIPTION OF OPERATIONSbeott E.L.OISEASE-POLICY I-IMrr 5 DESCRIPTION OF OPERATIONS I LOCATIONS/VEHICLES (ACORD 101,Addlllonai Remarks Sohodule,may bo attached If more space Is required) FAX:262-2469 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 ED REPRES ITATIVE I ©1988-2014 ACORD CORPORATION. All rights reserved. ACORD 25(2014/01) The ACORD name and Logo are glstered marks of ACORD 2- • JEFF ATWATER CHEF 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 FEfN: 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 Ktio elects exemption from this chapter by fifarg a certificate of election under this section may not recover benefits or compensation under this chapter.Pursuant to Chapter 440.05(12),F.S.,Certffieates of eledlon to be exempt...apply only s5lhin the scope of the business or trade F a t e d on the notice of eted$on to be exempt Pursuant to Chapter 440.05(13).F.S.,Notices of election to be exempt and certificates of elecion to be exempt shag be sub)ect to revocahcil if,at any tine alter the lithe of the notice or the Issuance of the certificate, the persen earned on the notice or cmlf 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 BE EXEMPT REVISED 07-12 QUESTIONS?(850)413-1609 • 1 Cl • F' ,trel.�ei �) ,{ yr • r-r' BEFORE THE COLLIER COUNTY CONTRACTORS' LICENSING BOARD BOARD OF COUNTY COMMISSIONERS, COLLIER COUNTY, FLORIDA, CONTRACTORS' LICENSING BOARD Petitioner, V. Case Number: 2015-07 License Number: 201300001831 Tiffany M. Fronimakis D/B/A—Statewide Florida Glass LLC Respondent. ADMINISTRATIVE COMPLAINT Collier County (County) files the Administrative Complaint against Tiffany M. Fronimakis ( Respondent), a Collier County licensed Glass &Glazing Contractor( license#201300001831), 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 201300001831. 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 Glass & Glazing Certificate of Competency shall constitute misconduct and grounds for discipline pursuant to Section 22-202. a. On 3/5/15 the respondent contracted with Gary Hains for window/door replacement at 2777 12th St North with a contract amount of$19,748.47. On 3/13/15 a $9,000.00 deposit was given (46%). On 3/24/15 the contract changed from the original "EMS 2661" and "EMS 5000" products to "PGT 740" and "PGT 101" products.The new contract price being$13,168.66.The original $9,000.00 deposit was retained, resulting in a 68%deposit. On 4/22/15 a permit was applied for by the respondent through The City of Naples. Said application shows "work being performed" as change out 10 EMS 2661 and change out 2 EMS 5000, which was the original product contracted for, not for what was subsequently contracted for on 3/24/15 ( PGT products). On 5/1/15, said permit application was approved and was ready for issuance.To date, the permit has not been issued. The respondent's failure to perform work from 5/1/15 to 10/5/15 (157 days) without just cause and no notice to the owner constitutes a violation of Collier County Ordinance 90-105, as amended, Section 22-201(3). b.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(3) states "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 owner". 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. i l Dated: October 5, 2015 Signed: C� Collier County Contractors' Licensing Supervisor or Designee Tiffany M. Fronimakis D/B/A Statewide Florida Glass LLC C.L.B. Case 2015-07 Table of Contents El through E3 — Formal Complaint E4— Collier Ordinance 90-105, as amended, Sec. 22-201. Misconduct E5 — Collier Ordinance 90-105, as amended, Sec. 22-201(3) E6 & E7— Complaint E8 & E9— Collier County Licensee Information E10— Notice of Hearing certified Mail Return Receipt E11 & E12 — Returned Certified Mail Return Receipt E13 & E14— United States Postal Service Certified Mail Tracking E15 & E16— 3/5/15 Estimate / Contract E17 - $9,000.00 Deposit E18— 3/24/15 Revised Contract E19 — Correspondence Involving Revised Contract E20 through E22 — City of Naples Permit Application E23 through E26 —Text Message Correspondence E27 through E35 — Email Correspondence E36 through E74 — Statewide Florida Glass LLC Ch. 7 Bankruptcy Filing Contractors' Licensing Board 2800 North Horseshoe Drive Naples, Fl. 34014 Complaint Number: 2015-07 Complainant: Any person that 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 copied of the complaint. Date: October 5, 2015 Against: Contractor's name:Tiffany M. Fronimakis Phone: 239-431-7904 Business name: Statewide Florida Glass LLC License number if known: 201300001831 Collier County Competency number: 201300001831 Contractor's business address: 1447 Railhead Blvd Suite 11 Naples, Fl. 34110 Filed By: Name: Collier County Contractor Licensing/ Ian Jackson Address: 2800 North Horseshoe Drive Naples, Fl. 34104 Business phone: 239-252-2451 Address where work done: 1227 12th St North City: Naples County: Collier Date of contract: 3/5/15 CI Date job started:4/22/15 Date job completed or new home occupied: Not Appliable Were there plans and specifications? Yes Is there a written contract?Yes If yes, amount of Contract?$13,168.66 Has Contractor been paid in full? No If Contractor has NOT been paid in full, what amount is paid? $9,000.00 Was a Building Permit obtained? No Building Permit number if known: City of Naples 152073 Have you communicated by letter with the licensee? Yes Date: 9/18/2015 Do you have a reply? No 1. 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): Collier County Ordinance 90- 105, as amended, Section 22-201(3) states "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 owner". 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 3/5/15 the respondent contracted with Gary Hains for window/door replacement at 2777 12th St North with a contract amount of$19,748.47. On 3/13/15 a $9,000.00 deposit was given (46%). On 3/24/15 the contract changed from the original "EMS 2661"and "EMS 5000" products to "PGT 740" and "PGT 101" products. The new contract price being$13,168.66. The original $9,000.00 deposit was retained, resulting in a 68 %deposit. On 4/22/15 a permit was applied for by the respondent through The City of Naples. Said application shows "work being performed" as change out 10 EMS 2661 and change out 2 EMS 5000, which was the original product contracted for, not for what was subsequently contracted for on 3/24/15 ( PGT products). On 5/1/15, said permit application was approved and was ready for issuance. To date, the permit has not been issued. The respondent's failure to perform work from 5/1/15 to 10/5/15 (157 days) without just cause and no notice to the owner constitutes a violation of Collier County Ordinance 90-105, as amended, Section 22-201(3). (complainant's nature) o f State of: A 4.( `fe... County of: C� f Sworn to(or affirmed) and subscribed before me this CQ day of (..)c-I -,b , 2015. By ' %' (signature of person making statement). r ' ,,o,, ,...6.___. ' ,,,.,-------- (signature of Notary Public) sr:;\ ANGELA K SU ` , ui MY COMMISSION#FF161686 c' >� G1.-,,:,,:: y Print, type or stamp name of Notary Public: G EXPIRES September 21,2018 (407)398-0153 FloridallotaryService.com Pers ' or produced identification. ARTICLE V. BUILDING TRADES* Page 27 of 36 (i) Any individual who fails to renew his/her certificate of competency prior to December 31 of the year following its expiration shall thereby automatically have a certificate of competency that is null and void. To acquire a valid certificate from the county the individual must pay the then applicable full application fee in accordance with the schedule of fees and charges adopted by resolution pursuant to section 22-182(a)(4) herein, and must submit an entire new application. If, as of the date of receipt by the county of said new application, three years have passed since the date of his/her most recent examination that the individual passed to acquire the former certificate, that individual must pass all then applicable testing requirements. If the request is to reactivate a dormant certificate, the re-testing requirement can be waived by staff if the applicant proves that he/she has been active in the trade in another jurisdiction, or has been active as an inspector or investigator in the trade; or for other valid reason that would render such re-testing superfluous. (Ord. No. 90-105, § 1.4; Ord. No. 92-61, § 1; Ord. No. 94-34, § 1; Ord. No. 97-68, § 1, 10-28-97; Ord. No. 99-45, § 1.4--1.4.9, 6-8-99) Secs. 22-192-22-200. Reserved. DIVISION 3. STANDARDS OF CONDUCT AND DISCIPLINE* *State law references: Discipline of contractors, F.S. §§489.129, 489.533. Sec. 22-201. Misconduct--Collier County/city certificate of competency. The following actions by a holder of a Collier County/city certificate of competency shall constitute misconduct and grounds for discipline pursuant to section 22-202: (1) Knowingly combining or conspiring with an unlicensed contractor by allowing one's certificate of competency to be used by an unlicensed contractor with intent to evade the provisions of this article. When a licensed contractor acts as the qualifying agent for any firm without first making application under this article to represent said firm, such act shall constitute prima facie evidence of intent to evade the provisions of this article. When a certificate holder allows his certificate to be used by one or more companies without having any active participation in the operations, management, and control of such companies, such act constitutes prima facie evidence of an Intent to evade the provisions of this article. Actives 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 http://library2.municode.com/default/DocView/10578/1/36/41?hilite=2006 46; 1/16/2009 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 performance of his contracting business in the county, any of the building, safety, health, insurance or workers' compensation laws of the state or ordinances of this county. (7) Falsifying or misrepresenting any material fact in his application and supporting papers for the purpose of obtaining a certificate of competency under this article. (8) Committing mismanagement or misconduct in the practice of contracting that causes financial harm to a customer. Financial mismanagement or misconduct includes, but is not limited to, any of the following: a. The contractor fails to fulfill his contractual obligations to a customer because of inability, refusal or neglect to pay all creditors for material furnished or work or services performed in the operation of the business for which he is licensed, under any of the following circumstances: 1. Valid liens have been recorded against the property of a contractor's customer for supplies or services ordered by the contractor for the customer's job; the contractor has received funds from the customer to pay for the supplies or services; and the contractor has not had the liens removed from the property, by payment or by bond, within 30 days after the date of such liens; 2. The contractor has abandoned a customer's job and the percentage of completion is less than the percentage of the total contract price paid to the contractor as of the time of abandonment, unless the contractor is entitled to retain such funds under the terms of the contract or refunds the excess funds within 30 days after the date the job is abandoned; 3. The contractor's job has been completed, and it is shown that the customer has had to pay more for the contracted job than the original contract price, as adjusted for subsequent change orders, unless such increase in cost was the result of circumstances beyond the control of the contractor, was the result of circumstances caused by the customer, or was otherwise permitted by the terms of the contract between the contractor and the customer. b. The contractor's job been completed, and it is shown that the customer has incurred financial harm by having to seek a variance or other administrative remedy because of actions by the contractor. (9) Performing any act which assists a person or entity in engaging in the prohibited unlicensed practice of contracting, if the licensed contractor knows or should have known that the person or entity was unlicensed. t /t ls,•//lil,rQr r') mttninnrlc nnw./rl.afn..14/Tl....�/:,..../�nc'70/1 MG/n i /t " AAA nnn Jacksonian From: Gary Hains <hains.gary@gmail.com> Sent: Wednesday, September 09, 2015 1:57 PM To: Jacksonian Cc: Carlo Zampogna Subject: Statewide Florida Glass Attachments: Statewide_1.pdf; Statewide_Emails.pdf; Statewide_Texts.pdf; Entity Name.pdf; Tampa_Address.pdf Ian, As discussed, please see attached documents relating to Statewide Florida Glass and the $9000 deposit I gave them. 1. File "Statewide 1" Contains: a. initial email from February 25, 2015 giving Statewide permission to begin the order. b. Estimate from March 5, 2015 for $19,748.47. This invoice has the owner's signature at the bottom that I gave him check# 2174 for $9000. c. Copy of check 2174 that was deposited. d. New proposal for windows after 1st order was not fulfilled. I kept the $9000 deposit with them for the new PGT order. e. Email to Tiffany Fronimakis (owner's wife), giving permission to place the PGT order on July 7, 2015. 2. File "Statewide Emails" - various emails with Tiffany regarding status and updates to my order. You will see that she was not the best as responding, and when she did, would just say that there was a delay with the manufacturer. Have since found out through conversations with PGT that Statewide Florida Glass never had an account with PGT, nor was an order ever placed for my address. 3. File "Statewide Texts - various texts with the owner, Erikk Fronimakis. 4. File "Entity Name" - you will see that the registered agent is Antonios Fronimakis, who I believe is Erikk's father. The address was Erikk's primary residence, which he has already vacated. 5. File "Tampa Address" - He opened another company in the Tampa area on July 6, 2015. He did reside in the Tampa area before moving to SW Florida. May be his location. Appears to have filed Chapter 7 on September 5, 7015 https://www.inforuptcy.com/filings/flmbke 1189438-9-15-bk-09115-statewi de-fl orida-"lass-Ilc-bankruptcy Attorney as: Robert S. Cohen Cohen& Kendziorra, PA 3049 Cleveland Ave, Suite 259 Fort Myers, FL 33901 T: 239.931.1111 E: cokenpa2 @yahoo.com 1 �� At the minimum we have a contact that can get to him. My feelings are that Statewide Florida Glass knew that they were not going to supply the windows for my home. This should not be a protection under Bankruptcy since they never even ordered the material. Up until the day I found Erikk at his office on Saturday, August 29, 2015, he was still telling me that it was a manufacturer issue, and the reason for his office being empty was that he was moving to a Naples location. I was aware that he was not being truthful. There is also a possibility that he went back to the New York area, but I am less confident of that. Please let me know if you need any additional information. Gary Hains 239.821.8815 2 �� View Master Project View All Activities for this Licensee Add new person or business to Address Boo: Licensee Information New Licensee (current project) j f New Licensee (no project) Licensee NumberLCG2Qi3GQr03573 Status Inactive Name/ Description !STATEWIDE FLORIDA GLASS, LLC Start Date 110/22/2013 • Type Contractor End Date 110/22/2014 • Inspector Submitted On 11 22:'2013 Jurisdiction Collier County 1' Department Operations Activity Description Suggest Mailing Address l Exclude from Auto-Suggest? (' Add this Mailing Address as a Location Add Contact Number • Mailing Address 11447 RAIL HEAD BLVD SUITE 11 Type Contact Number Ext. Primary (239) 431-7904 Address Line 2 Address Line 3 City,JStatet'Zip :NAPLES FL (�1r 34110 Country Email ... _ _.w_ ... . . . ..r Preferred Contact Method l Show More Fields Hide or Clear Fields Contractor Attributes Contractor Type Business H DOB 1 Drivers License Number I Sponsorship Appliction Date < Workers Compensation < Business Tax Receipt? Yes `; Expiration Date Location Add Related Parcels and Addresses ( Add a Location To link a location to this Licensee,enter location information below. C.ityViewwill suggest possible matches as you type: 1 Description Type Property Alert Primary? Display? contacts Add new person or business to Address Book Go to Alerts Add a Contact To link a contact to this Licensee,enter contact information below. C:ityView will suggest possible matches as you type: ITIFFANY M. FRONIMAKIS,Address:331 104TH AVE. N., Phone (239) 2.50-3100 Go Link Type Description Contact Alert End Date Primary? Display? =Qualifier TIFFANY M FRONIMAKI Address,831 104TH AVE.N. Pho ' Applicant STATEWIDE FLORIDA GLASS,LLC,Address:1447 RAIL HEA i Licensee Information .0; Licensee Number L0020130003573 Description Type Property Alert Name STATEWIDE FLORIDA GLASS, LLC Type Contractor Status Inactive View Master Project View All Activities for-this Licensee Add a new Der-son or business to Address Book Classifications Generate Defaults I Add a Classification To add a classification to this Licensee, enter text below. CityView will suggest possible matches as you type: IGLASS & GLAZING CONTR.. Link Type _ Date Entered Status Status Date ..... GLASS&GLAZING CONTR. 10/22/2013 Active 10/22/2013 Show More Fields j Hide or Clear Fields 1 Unique Identifier1LCC3810 Contractor Licensing A Renewable?12Le: License Category Local - Specialty El License Issuances 1 Attach Driver License Photo j Add Issuance Link Type Status _ Date Issued Issuance Number Expiration Date GLASS&GLAZING CONTR. Delinquent " 03/04/2014 1201300001831 109/30/2015 .... Comments . . Show More Fieldc I Hide or Clear Fields 1.1 License Category Local - Specialty Renewable? Unique Identifier ILCC3810 Collier County Growth Management Division / Planning and Regulation Operations Department/ Licensing Section CERTIFIED MAIL RETURN RECEIPT: 7007 2560 0001 1485 6718 Tiffany Fronimakis D/B/A Statewide Florida Glass LLC 1447 Railhead Blvd Suite#111 Naples,Fl. 34110 Date: 9/18/2015 RE: Complaint filed against you by Gary Haim regarding a violation of Collier County Ordinance 90- 105, as amended, Section 22-201(3). Dear Ms. Fronimakis, 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 October 21, 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 number(s) 22-201(3) of Collier County 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# 201300001831 and/or suspension or revuealiuu of your permit privileges against your state license #N/A I nn l Si eti:1 eh/, Ian J.t kson 'Licensing Compliance Officer Phone#239-252-2451 /m E .....L.._,._,.„„a.,.......,,,aaa....., , , .,..j .4,•-f'1 ,.."- !,..‘ , g- ..c,- i it ,. i „.--- „..- i f v- t t ' i 1 I , - ‘ - t ',. i 1- g.' I-4 -- / _'--- Cr .- i t ..t .'..1, ('r,„,,.. .4. 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Search or Enter a Tracking Number ILI https://tools.usps.com/go/TrackConfirmAction.action?tRef=fullpage&tLc=1&text28777=&tLabels=700... 10/5/2015 Statewide Florida Glass LLC Estimate 27925 Industrial St Bonita Springs, FL 34135 Date Estimate No. Phone# 239-431-7904 3/5/2015 544 E-mail info(astatewidelloridaglass.com Name/Address Ship To Gary Rains House#2 750 11th St S Personal House Naples, FL P.O. Name EMS vinyl r - - Description Qty Rate Total WiNDOW-EMS 2661 Series-impact casement XX- 2 1,164.21 2,328.42 +/-50 design pressure-5/16"clear ann (1/8"-.090- .,n 1/8")/white frame-(2) 35 3/4"x 70 3/4" INSTALLATION-of casement 2 400.00 800.00 WINDOW-EMS 2661 Series-impact casement X- 2 543.78 1,087.56 +/-50 design pressure-5/16"clear ann (1/8"-.090- 1/8")/white frame-35 1/8"x 71 1/2" INSTALLATION-of casement 2 200.00 400.00 WINDOW-EMS 2661 Series-impact casement XX- 1 1,013.47 1,013.47 +/-50 design pressure-5/16"clear ann (1/8"-.090- 1/8")/white frame-(2) 21 1/2"x 58 1/2" INSTALLATION-of casement 1 400.00 400.00 WINDOW-EMS 2661 Series-impact casement XOX 2 1,397.92 2,795.84 -+/-50 design pressure -5/16"clear ann (1/8"-.090- 1/8")/white frame-(3) 27 5/16'x 45" INSTALLATION-of casement/picture 2 600.00 1,200.00 window/casement FRENCH DOOR-EMS 5000 Series-impact 7/16" 1 3,113.71 3,113.71 clear lami hs/white frame-+/- 75 design pressure- 72"x 79 1/4"-w/(2)sidelite EMS 2000 Series- 1/2" clear lami(hs-.10 hp-hs)/white frame- +/-90 design pressure-24 1/2"x 79 1/4" INSTALLATION-of fd w/two sidelites 1 1,000.00 1,000.00 FRENCH DOOR-EMS 5000 Scrics impact 7/16" 1 ?,173 71 3,173 71 clear lami hs/white frame -+/- 75 design pressure- 72"x 79"-w/(2)sidelite EMS 2000 Series- 1/2"clear lami(hs-.10 hp-hs)/white frame-+/-90 design pressure-27 1/2"x 79" Total t n L Page 1 `1 (-7 I C1.7) Statewide Florida Glass LLC Estimate 27925 Industrial St Bonita Springs, FL 34135 ( Date Estimate No. Phone# 239-431-7904 I 3/5/2015 544 J E-mail info Jstatewidefloridaglass.corn Name/Address Ship To Gary Hains House#2 750 11th St S Personal House Naples, FL P.O.Name EMS vinyl Description 1 Qty Rate Total INSTALLATION-of fd w/two sidelites 1 1,000.00 1,000.00 sales tax 1 810.76 810.76 Permit Fees(not including engingeering) 1 375.00 375.00 ENGINEERING- 1 250.00 250.00 I Total $19,748.47 J F ;a r�i 8 - 'S-- C k :u L) ° n .,`ez Page 2 ay TT (No' Wells Fargo Business Online`^' View Check Copy Check Number Date Posted Check Amount Account Number - .-... P11 0 74 03/13/15 ,$9,000.00 GARY P.A. GARY MAINS PA 2174 2777 12TH ST N - 1 136103817 14APLSS,FL 34103-4523 -� r1 �� /J _ ( ./, !. / Pep to me �' c t C G� r� _ I s � ,Oct Order o�. �- qq f I.-J 2' yjOt cS- / �pll�rs W tLF.I.(.y Y;; u.94,=.I. .A Far !— — -----.—' a Regions Bank>062000019‹ Regions Bank>0620O0D19< 'Ea Equal Housing Lender 0 1995-2015 Wells Fargo.All rights reserved. jll ti Statewide Florida Glass, LLC ` ,i Invoice a 27925 Industrial St , t Date Invoice 4 Bonita Springs,FL 34135 \\.. ;' 3/24/2015 854 Bill To Ship To Gary Hains House#2 750 11th St S Personal House Naples,FL P.O. No. Terms Project EMS vinyl Item Quantity Description Rate Amount window 2 WINDOW-PGT 740 CA-impact casement XX-+/-50 1,902.21 3,804.42 design pressure-5/16"clear ann(1/8"-.090-1/8")/white frame-(2)35 3/4"x 70 3/4" INSTALL 2 INSTALLATION-of casement 400.00 800.00 window 2 WINDOW-PGT 740 CA-impact casement X-+/-50 912.78 1,825.56 design pressure-5/16"clear ann(1/8"-.090-1/8")/white frame-35 1/8"x 71 1/2" INSTALL 2 INSTALLATION-of casement 200.00 400.00 window 1 WINDOW-PGT 740 CA-impact casement XX-+/-50 1,147.54 1,147.54 design pressure-5/16"clear ann(1/8"-.090-1/8")/white frame-(2)21 1/2"x 58 1/2" INSTALL 1 INSTALLATION-of casement 400.00 400.00 window I WINDOW-PGT 740 CA-impact casement XOX-+/-50 2,504.92 2,504.92 design pressure-5/16"clear ann(1/8"-.090- 1/8")/white frame-(3)27 5/16"x 45" INSTALL 1 INSTALLATION-of casement/picture window/casement 600.00 600.00 French Door 0 FRENCH DOOR-PGT 101H-impact 7/16"clear lami hs/ 4,589.71 0.00 white frame-+/-75 design pressure-72"x 79 1/4"-w/(2) sidelite EMS 2000 Series- 1/2"clear lami(hs-.10 hp-hs)/ white frame-+/-90 design pressure-24 1/2"x 79 1/4" 0.00 INSTALL 0 INSTALLATION-of fd w/two sidelites 1,000.00 French Door 0 FRENCH DOOR-PGT 10114-impact 7/16"clear lami hs/ 4,649.71 0.00 white frame-+/-75 design pressure-72"x 79"-w/(2) v Aelitr FMS')000 Series- 1/2"clear lami(he-.10 hp-hs)/ white frame-+1-90 design pressure-27 1/2"x 79" INSTALL 0 INSTALLATION-of fd w/two sidelites 1,000.00 0.00 tax l sales tax 1,061.22 1,061.22 Permit l Permit Fees(not including engingeering) 375.00 375.00 250.00 ENGINEERING 1 ENGINEERING- Total L__ $13,168.66 Payments/Credits $0.00 Pay' online at:https://ipn.intuit.coln/1-mn2nk58 Balance Due $13,168.66 9/9/2015 Gmail Re:Inv . . 1411� � Gary Hane <hoins'gorn@@madiomnn> Re: inv 1 message ---- ---------------------------------------------------------------'------------------ Gary Haina <hains.gary@gmail.com> Tue. Jul 7, 2015 at 4:42 PM To: Tiffany Fnonimakia <info@etatewidef|ohdog|aua.00m> OK to order, but I believe your sales tax number is off. It did not recalculate lower when you adjusted. Can you please take a look and resend. Thanks. On Tue, Jul 7, 2015 at 11:43 AM, <info@statewidefloridaglass.com> wrote: Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel Fam(239)405-832 wvvw.stgtexvdefohd000ss.00m _ Gary Haino 239.821.8815 mtpo://mai|.googlo.comhnaiVu0/?ui=2&ik~no19fc18anaview~pt&os_to~inm%4ostaxewxdeflcmuuoass.00maas_sizaoperuto=r_s|aas sxzmm=s smuaas_su ' 1/1 City of Naples - Building Department .,.: 295 Riverside Circle;Naples, Florida 34102 11• iW :.*\.'n Phone. (239) 213-5020 Fax' (239) 213-5025 ii _ ; WINDOW I DOOR REPLACEMENT ` q ,�� PERMIT APPLICATION-= <r SIZE FOR SIZE ONLY FLORIDA BUILDING CODE 2010 Job information: Permit#:1 5 Tax/Folio#: 13800520007 Legal Description: N I C L F Comm NW Cor Of Lot 86, (see Attached) Job Address: 2777 12th St N, Naples, FL 34103 _ Property Owner: Gary & Elizabeth Hains Tenant Name: _ Mailing Address: 2777 12th St N, Naples, FL 34103 Est.Cost:$ 20,000 Permit Expiration Date: 10/01/2015 Number of condo units: Number of floors: 1 Square footage: 310.68 - {Sq.Ft of Window/Door opening only) Are these impact rated? yes Current Flood Zone: 'Work Being Performed: 0 Garage Doors #to be changed out: Model: Series. — *Windows #to be changed out: 10 Model: EMS Series: 2661 0 Doors #to be changed out: 2 Model: EMS Series. 5000 ❑ Slider #to be changed out: Model: Series: ❑Other # to be changed out: Model: Series: Description of Work: change out 14 windows in 7 window openings, 2 door openings with double french doors w/ 2 equal sidelites, from regular to hurricane impact. -'Contractor Information: Contractor: Statewide Florida Glass, LLC State Cert/CC Comp Card #: LCC20130003573 Qualifier's Name: Tiffany M Fronimakis Phone#: 239-431-7904 Fax#: 239-405-8432 FL 34135 _ Y Address: 27925 Industrial St __..._.-._—cit Bonita Springs State Zip Must be provided with permit package: Two copies of a Complete Floor Plan, showing all rooms,,depicting openings to be changed out. ..___, Required plan size is 24" x 36" maximum. Plans must be to scale with a minimum of 3/16"=1' — Two copies of FL State Dept. of Community Affairs Product Approval or Miami-Dade Notice of Acceptance for the proposed windows/doors. Two copies of design pressures for all openings, based upon ASCE, Or FBC Tables (if applicable to specific exposure category and building design) — Opening pressure calculations for buildings greater than 60 feet in height must be signed and sealed by a Florida Registered Engineer or Architect. Window/Door Replacement Permit Application 07/2014 1 of 2 i �l C,OO Regulations and.information:::',' 1. Exterior window and door replacement shall comply with Florida Building Code 2010 Existing Building. Florida Building Code Building, and if applicable, Florida Building Code 2010 Residential. 2. Please highlight the applicable model of the window-door to be installed for quick reference. 3. Windows within sight of the beach will comply with Section 52-61(6) of the Code of Ordinances (turtle glass) 4. Required plan size is 24' x 36" maximum. Plans must be to scale with a minimum of 3116"=1' 5. Manufacturer and model of all exterior windows and doors. including sliders and garage door, must be included on plans. 6. Owner-builders must sign an affidavit. 7. Check with prospective property owners association for deed restrictions. 8. Fee for this permit is $0.50 per square foot of the gross square footage of the structure for the building permit. The minimum fee shall be $150.00. A plan check fee of 15%of the building permit fee will be charged at the time of application. This fee is not refundable nor is it credited to any other fee. FLOODS:• 1. If this site is located in an AE, AH, or VE Zone, additional information may be required on a FEMA Form (Additions/ Alterations form for structures located below the Base Flood Elevation). Recorded Notice of Commencement must be posted if the project valuation exceeds $2,500.00 WARNING TO OWNER: YOUR FAILURE TORECORD A TWICE NOTICE OF F COMMENCEMENT MAY RESULT IN YOUR IMPROVEMENTS TO YOUR PROPERTY. INTEND ATTORNEY BEFORE OBTAIN ORE FINANCING, CONSULT WITH YOUR LENDER OR AN RECORDING YOUR NOTICE OF COMMENCEMENT. Contractors Affidavit: I certify that all the foregoing information is accurate and that all work must be done in compliance with all applicable laws regulating construction and zoning. I understand THERE WILL BE A FINAL INSPECTION of the work permitted herein. Compliance will be strictly enforced. No work whatsoever will commence until the building permit has been issued. • The permit fee will be doubled if work is started without an approved permit, • Windows within sight of the beach will comply with section 52-16 (6) of the Code of Ordinances (turtle glass) • Additional info ••- �•n •-n be found on our websit0 www neple gov.,corn r~" 6/. O k1 Signature of Q iffier Prin Name of Qualifier State of Florida County of C. 14:`Yts-- The foregoing instrument was acknowledged before me this a a- day of— r , 20IS..... by r... J 1; wept4`5 who is pers2ls: •• ,a • IV- • • _produced am as identification. --- � (Seal) ., of ature, Notary Public- State of Florida t lj 45 i!S en Printed, Typed, or Stamped Name of Notary r Window/Door Replacement Permit Application .t • 0x2014• 2of2 , ii: Statewcie. Florida Gass, LLC 2..F.333 !F",ernwood Dr '43 •ings, FL 34135 239-431-7904, 2h 239-405-8432 Fx Window& Doc:. A-Casemeri': 2 . 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Thanks. , ",-:`,1:::11.::''' Aa D i Br M . 73 =RmeND a ri3Ohn Ea7u mall-m- .. li1c9 In-en ticUisik=g /iscsini a"-sta le.com- s://mail.g°°9 httP Jc-UGHK,_ 9/9/2015 Gmail-RE:Update LI Q„ a Gary Hains <hains.gary@gmail.corn> RE: Update 1 message info @statewidefloridaglass.com <info @statewidefloridaglass.com> Tue, Mar 10, 2015 at 8:36 AM To: Gary Hains <hains.gary@gmail.com> I will call the manufacture to see for updates this morning waiting on them to send me corrected quote to sign off and for the new quote she emailed me yesterday to tell me she was a little behind so I will call her this am Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel(239)431 7904 ` Fax(239)405-8432 ,,, www.statewidefloridaglass.com `'ems ,,' . 0, , Original Message ' Subject: Update From: Gary Hains <hains.gary rx gmail.com> `\ Date: Tue, March 10, 2015 6:47 am To: "<info@ statewidefloridaglass.com>" <info @statewidefloridagiass.com> ,` i t Hi Tiffany, Couple items. j` 1 Are..yetrall-set with the new windows-For-5681-P.ogwood? Can we order? q. Have you received updated pricing for my home? -'°° ~fThanks your help;_ —.........._.....__.._ - __— Gary hops://mail.google.com/mail/u/0nui=2&ik=69191c18a6&view=pt&as_from=info%40statewidefloridaglass.corn&as_sizeoperator=s_sl&as_sizeunit=s_smb&es=.. 1/1 9/9/2015 Gmail-RE:Windows for Crayton Office Gary Hains<hains.gary@gmail.com> RE: Windows for Crayton Office 1 message info @statewidefloridagtass.com<info @statewidefloridaglass.com> Wed,Apr 8,2015 at 10:38 AM To: Gary Heins<hains.gary@gmail.com> i sent her an email this morning waiting on a response then ill email you Tiffany F. Statewide Florida Glass,LLC 27925 Industrial St 1 Bonita Springs,FL 34135 / z Tel(239)431-7904 Fax(239)405-8432 Www.statewiderloridaglass.com —Original Message— Subject:Re:Windows for Crayton Office From:Gary Heins<hains,gary@gmail.com> Date:Wed,April 08,2015 9:39 am To:Tiffany Fronimakis<info @statewidefioridaglass.ccm> Got them. Thanks. - When are you estimating windows for Dogwoo and my personal home? Also, I need the specs for the permits for the Arrowhe jeet— Gary On Wed,Apr 8,2015 at 9:38 AM,<info@statewidefloridagiass.com>wrote: just sent them Tiffany F. Statewide Florida Glass,LLC 27925 Industrial St Bonita Springs,FL 34135 Tel(239)431-7904 Fax(239)405-8432 LV\:W.staitewidefloridaglass.com —Original Message— Subject:Re:Windows for Crayton Office From:Gary<hains.gary @gmaiLcorn> Date:Wed,April 08,2015 9:13 am To:"<info(istatewidefloridaglass.com>"<info@ state idefloridaglass.com> Do you have the MOs for Dogwood? On Apr 8,2015,at 9:09 AM,<info @statewidefioridaglass.corn><info(e statewidefiorideglass.com>wrote: We can do this wednesday 4/15 Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel(239)431-7904 Fax(239)405-8432 www.statewidefloridagiass.com —Original Message— Subject:Re:Windows for Crayton Office From:Gary Heins<hains.gary@gmail.com> Date:Wed,April 01,2015 12:06 pm To:Tiffany Fronimakis<info@statewidefloridaglass.corn> And begin install? Also,can you quote a non-fire rated front door for the office. Eric knows the dimension. hops:Ilmail.google.comlmaillu101?ul_2&tk= 919fc18a6&view=P t&as from=info%40statewidelioridaglass.com&as sizeoperator=s_sl&as sizeunit=s smb&as_... 1/4 6 9/9/2015 Gmail-RE:Lawyers Office Gary Hains <hains.gary@gmail.com> RE: Lawyers Office 1 message info @statewidefloridaglass.com <info @statewidefloridaglass.com> Thu, Aug 13, 2015 at 9:13 AM To: Gary <hains.gary @gmail.com> let me speak to erik Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel Fax(239)405-8432 www.statewidefloridaglass,com I Original Message Subject: Re: Lawyers Office From: Gary <hains.gary@gmail.com> Date: Thu, August 13, 2015 7:58 am To: "<info @statewidefloridagiass.corn>" <info@statewidefloridaglass.com> Also on the front door, they would like to add another deadbolt in the center of the door. Thanks. On Aug 12, 2015, at 12:52 PM, <info@statewidefloridaglass.com> <i ion:bstatewidefloridaglass,corn> wrote: We would be 2 weeks out on the powder coating. The guys installed the extention bracket today for the handle. Let me know when a checkis ready for the two open invoices. --9 for your house there was a back order on a few of the openings so once they check those in will let you know -- Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel Fax(239)405-8432 www.statewidefloridaglass.com <hains-storefront door.pdf> <hains-hardware.pdf> httpsa/mail.googie.comlmail/WO/?ui=2&ik=6919fc18a6&view=pt&as from=info%40statewidefloridagiass.com&as sizeoperator=s si&as sizeunit=s_smb&as_.. 1/1 9/9/2015 Gmail-RE:Dogwood rtA Gary Hains <hains.gary@gmail.com> RE: Dogwood 1 message info @statewidefloridaglass.com <info @statewidefloridaglass.com> Thu, Aug 20, 2015 at 2:49 PM To: Gary Haim <hains.gary@•mail.com> IWe did not get it on wed waiting on email from manufacture on whats going onJ Tiffany F. Fa w r Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel(239)431-7904 Fax(239)405-8432 www.statewidefloridagiass.corn Original Message Subject: Re: Dogwood From: Gary Haim <hains.gary c x7gmail.com> Date: Thu, August 20, 2015 2:39 pm To: Tiffany Fronimakis <info @statewidefloridaglass.com> You still have not responded to me on my home. Is there an issue? On Thu, Aug 20, 2015 at 2:38 PM, <info @statewideflorida glass.com> wrote: Everything will be completed but the painting. And I was told Erik we need to be paid in order to come out there. Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel(239)431-7904 Fax(239)405-8432 www.statewidefioridaglass.ccm Original Message ---- Subject: Re: Dogwood From: Gary <hains.gary@gmaii.com> Date: Thu, August 20, 2015 10:20 am To: "<info @statewidefloridaglass.com>" <info@statewidefloridaglass.com> What is the status of my home? As for dogwood, they need to finish everything...parts still missing, frame needs to be painted, front door painted, locks not working. These are not new items. I have requested for quite some time. Gary P7C) https://mail.google.com/mail/ul0/?ui=2&ik=6919fc1866&view=pt&as from=info%40statewidefloridaglass.com&as_sizeoperator=s sl&as_sizeunit=s_smb&as_... 1/2 9/9/2015 Gmail-RE:Dogwood On Aug 20, 2015, at 10:12 AM, <infu@sta i ,iuu"io d2g!a s.c:ci, °,> <info @statewidefloridaglass.cornn> wrote: yes we can do friday... If you can have a check for the$1000 to give to the guys since erik is out of town till wendesday �J Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel(239)431-7904 Fax(239)405-8432 www.statewidef ioridaglass.coin Original Message Subject: Fwd: Dogwood From: Gary <hains.gary@gmaii.com> Date: Wed, August 19, 2015 2:37 pm To: "<info @statewidefiolidaglass.com>" <info@ statewidefloridaglass.com> > Erik mentioned to me Friday that all the glass is in. Can you let me know when you can install and complete the other outstanding items. Also, any update on my house to report? > Thanks. Gary Hains 239.821.8815 L3� Mips://mail.google.com/mail/u/0/?ui=2&ik=6919fc18a6&view=pt&as from=info%40statewidefloridaglass_com&as_sizeoperator=s_sl&as_sizeunit=s_smb&as_.. 2/2 9/9/2015 Gmail-Re:Dogwood Gary Hains <hains.gary @gmail.com> Re: Dogwood 1 message Gary <hains.gary@gmail.com> Thu, Aug 20, 2015 at 10:20 AM To: "<info @statewidefloridaglass.corn>" <info @statewidefloridaglass.corn> What is the status of my home? As for dogwood, they need to finish everything...parts still missing, frame needs to be painted, front door painted, locks not working. These are not new items. I have requested for quite some time. Gary On Aug 20, 2015, at 10:12 AM, <info @statewidefioridaglass.c.om> <info @statewidefio€idaglass.com> wrote: yes we can do friday... If you can have a check for the $1000 to give to the guys since erik is out of town till wendesday Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel(239)431-7904 Fax(239)405-8432 www.statewidefloridaglass.cornn Original Message Subject: Fwd: Dogwood From: Gary <hains.gary @gmail,com> Date: Wed, August 19, 2015 2:37 pm To: "<info @statewidefloridaglass.com>" <info @statewidefloridagiass.com> > Erik mentioned to me Friday that all the glass is in. Can you let me know when you can install and complete the other outstanding items. Also, any update on my house to report? > Thanks. :3q hops://mail.google.com/mail/u/0/?ui=2&ik=6919fc18a6&view=pt&as_to=info%4ostatewidefl oridag lass.com&as_sizeoperator=s sl&as_sizeunit=s_smb&as_su... 1/1 9/9/2015 Gmail-Fwd:Dogwood Gary Heins <hains.gary@gmail.com> Fwd: Dogwood 1 message Gary <hains.gary @gmail.com> Thu, Aug 27, 2015 at 12:17 PM To: "<info @statewidefloridaglass.com>" <info@statewidefloridaglass.corn> Tiffan //''''See below. Can you please respond. It has been another week. `\ Thanks. Begin forwarded message: From: Gary <hains.gary @gmaii.com> Date: August 25, 2015 at 8:46:58 AM EDT To: "<info @statewidefloridaglass.cot�m>" <info @statewideflorideglass.com> Subject: Re: Dogwood Hi Tiffany, Left you a message in the office today. Can you please let me know the status of the following. 1. Dogwood. No one came on Friday and I have not heard back from you on when they will be ere. 2. Windows for my home. Thanks. On Aug 20, 2015, at 2:49 PM, <info as' statewidefloridaglass.com> <infor, statewidefloridagglass. corn> wrote: ._ _ We did not get it on wed waiting on email from manufacture on whats going on Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel{239}431-7904 Fax(239)405-8432 www.statewidefloridaglass.corn Original Message Subject: Re: Dogwood From: Gary Hains <hains.gary@gmail.corn> e-55 https://mail.google.com/mail/ul0/?ui=2&ik=6919rc18a6&view=pt&as_to=info%40statewidefloridaglass.com&as sizeoperator=s_sl&as_sizeunit=s_smb&as_su... 1/3 9/9/2015 Gmail-Fwd:Dogwood Date: Thu, August 20, 2015 2:39 pm To: Tiffany Fronimakis <inf� ststatevvidefioriaag'a=s corri> ove not responded to me on my home. Is there an issue? - On Thu, Aug 20, 2015 at 2:38 PM, <i=ro r�_;staeY,,ideficridag;ass.com> wrote: Everything will be completed but the painting. And I was told Erik we need to be paid in order to come out there. Tiffany F. Statewide Florida Glass, LLC E " 27925 Industrial St '_.. Bonita Springs, FL 34135 TeI(239)431-7904 /7C Fax(239)405-8432 www.statewidefloridaglass.com Original Message Subject: Re: Dogwood From: Gary <hains.gary(t gmail.coni> Date: Thu, August 20, 2015 10:20 am To: "<info @statewidefloridaglass.com>" f info states efi-eridaglas`::dorn> What is the status of my home? As for dogwood, they need to finish everything...parts still missing, frame needs to be painted, front door painted, locks not working. These are not new items. I have requested for • quite some time. Gary On Aug 20, 2015, at 10:12 AM, <info rest:tewidefloridagiass. corn> <info@statewidefloridagiass.com> wrote: yes we can do friday... If you can have a check for the $1000 to give to the guys since erik is out of town till wendesday Tiffany F. Statewide Florida Glass, LLC 27925 Industrial St Bonita Springs, FL 34135 Tel Fax(239)405-8432 www.statew idefl oridagl ass.corn Original Message Subject: Fwd: Dogwood From: Gary <hains.gary@gmail.com> Date: Wed, August 19, 2015 2:37 pm L 3� To: "<info @statewidefloridag.lass.com>" https•J/mail.google.com/mail/u/0/?ui=2&ik=6919fc18a6&view=pt&as_to=info%40statewidefloridaglass.com&as sizeoperator=s_sl&as sizeunit=s_smb&as_su... 2/3 9/9/2015 Gmail-Fwd:Dogwood <info @statewide€oridaag`as's.corn> > Erik mentioned to me Friday that all the glass is in. Can you let me know when you can install and complete the other outstanding items. Also, any update on my house to report? > Thanks. Gary Hains 239.821.8815 https://mail.google.com/mail/u/0/?ui=2&ik=6919fc18a6&view=pt&as_to=info%40statewidefloridaglass.com&as sizeoperator=s sl&as sizeunit=s smb&as_su... 3/3 Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 1 of 39 B1(Official Form 1) (04/13) United States Bankruptcy Court Middle District of Florida Voluntary Petition Name of Debtor(if individual,enter Last,First,Middle): Name of Joint Debtor(Spouse)(Last,First,Middle): Statewide Florida Glass, LLC All Other Names used by the Debtor in the last 8 years All Other Names used by the Joint Debtor in the last 8 years (include married,maiden,and trade names): (include married,maiden,and trade names): Statewide Windows Door&Glass Last four digits of Soc.Sec.or Individual-Taxpayer I.D.(ITIN)/Complete EIN Last four digits of Soc.Sec.or Individual-Taxpayer I.D.(ITIN)/Complete EIN (if more than one,state all): 45-5289334 (if more than one,state all): Street Address of Debtor(No.&Street,City,State&Zip Code): Street Address of Joint Debtor(No.&Street,City,State&Zip Code): 27925 Industrial Street Bonita Springs,FL ZIPCODE 34135 ZIPCODE County of Residence or of the Principal Place of Business: County of Residence or of the Principal Place of Business: Lee Mailing Address of Debtor(if different from street address) Mailing Address of Joint Debtor(if different from street address): ZIPCODE ZIPCODE Location of Principal Assets of Business Debtor(if different from street address above): 27925 Industrial Street,Bonita Springs, FL ZIPCODE 34135 8 Type of Debtor Nature of Business Chapter of Bankruptcy Code Under Which (Check one box. (Form of Organization) ( ) the Petition is Filed(Check one box.) (Check one box.) ❑Health Care Business [/7 Chapter 7 ❑ Chapter 15 Petition for E ❑Individual(includes Joint Debtors) ❑Single Asset Real Estate as defined in I I ❑ Chapter 9 Recognition of a Foreign is See Exhibit D on page 2 of this form. U.S.C.§ 101(51 B) ❑ Chapter 11 Main Proceeding Corporation(includes LLC and LLP) ❑Railroad ❑ Chapter 12 ❑ Chapter 15 Petition for ° V ❑Partnership ❑Stockbroker ❑ Chapter 13 Recognition of a Foreign m ❑Other(If debtor is not one of the above entities, ❑Commodity Broker Nonmain Proceeding o check this box and state type of entity below.) ❑Clearing Bank Nature of Debts m "Other (Check one box.) Chapter 15 Debtor ❑ Debts are primarily consumer [Debts are primarily c Country of debtor's center of main interests: Tax-Exempt Entity debts,defined in 11 U.S.C. business debts. m (Check box,if applicable.) § 101(8)as"incurred by an i Each country in which a foreign proceeding by, ❑Debtor is a tax-exempt organization under individual primarily for a w regarding,or against debtor is pending: Title 26 of the United States Code(the personal,family,or house- d Internal Revenue Code). hold purpose." m Filing Fee(Check one box) Chapter 11 Debtors — Check one box: © RtFull Filing Fee attached ❑Debtor is a small business debtor as defined in 11 U.S.C.§ 101(51D). ❑Debtor is not a small business debtor as defined in 11 U.S.C.§ 101(51D). ❑Filing Fee to be paid in installments(Applicable to individuals only).Must attach signed application for the court's Check if: consideration certifying that the debtor is unable to pay fee ❑Debtor's aggregate noncontingent liquidated debts(excluding debts owed to insiders or affiliates)are less except in installments.Rule 1006(b).See Official Form 3A. than$2,490,925(amount subject in adjustment on-1/01/16 and every three years thereafter). ❑Filing Fee waiver requested(Applicable to chapter 7 individuals Check all applicable boxes: only).Must attach signed application for the court's ❑A plan is being filed with this petition consideration.See Official Form 3B. ❑Acceptances of the plan were solicited prepetition from one or more classes of creditors,in accordance with II U.S.C.§ I126(b). Statistical/Administrative Information THIS SPACE IS FOR ❑Debtor estimates that funds will be available for distribution to unsecured creditors. COURT USE ONLY ('Debtor estimates that,after any exempt property is excluded and administrative expenses paid,there will be no funds available for distribution to unsecured creditors. Estimated Number of Creditors ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ ❑ 1-49 50-99 100-199 200-999 1,000- 5,001- 10,001- 25,001- 50,001- Over 5,000 10,000 25,000 50,000 100,000 100,000 Estimated Assets ❑ ❑ ❑ ❑ ❑ W' ❑ ❑ ❑ ❑ $0 to $50,001 to $100,001 to $500,001 to $1,000,001 to $10,000,001 $50,000,001 to $100,000,001 $500,000,001 More than $50,000 $100,000 $500,000 $1 million $10 million to$50 million $100 million to$500 million to$1 billion $1 billion Estimated Liabilities ❑ ❑ l ' ❑ ❑ ❑ ❑ ❑ ❑ ❑ $0 to $50,001 to $100,001 to $500,001 to $1,000,001 to $10,000,001 $50,000,001 to $100,000,001 $500,000,001 More than $50,000 $100,000 $500,000 $1 million $10 million to$50 million $100 million to$500 million to$1 billion $1 billion Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 2 of 39 B1 (Official Form 1) (04/13) Page 2 Voluntary Petition Name of Debtor(s): (This page must be completed and fled in every case) Statewide Florida Glass, LLC All Prior Bankruptcy Case Filed Within Last 8 Years(If more than two,attach additional sheet) Location Case Number: Date Filed: Where Filed:None Location Case Number: Date Filed: Where Filed: Pending Bankruptcy Case Filed by any Spouse, Partner or Affiliate of this Debtor(If more than one,attach additional sheet) Name of Debtor: Case Number: Date Filed: None District: Relationship: Judge: Exhibit A Exhibit B (To be completed if debtor is required to file periodic reports(e.g.,forms (To be completed if debtor is an individual 10K and 10Q)with the Securities and Exchange Commission pursuant to whose debts are primarily consumer debts.) Section 13 or 15(d) of the Securities Exchange Act of 1934 and is I,the attorney for the petitioner named in the foregoing petition,declare requesting relief under chapter 11.) that I have informed the petitioner that[he or she] may proceed under chapter 7, 11, 12, or 13 of title 11, United States Code, and have ❑ Exhibit A is attached and made a part of this petition. explained the relief available under each such chapter.I further certify that I delivered to the debtor the notice required by 11 U.S.C. §342(b). 0 X Signature of Attorney for Debtor(s) Date E Exhibit C • Does the debtor own or have possession of any property that poses or is alleged to pose a threat of imminent and identifiable harm to public health N or safety? • p Yes,and Exhibit C is attached and made a part of this petition. Mr No Exhibit D LL (To be completed by every individual debtor.If a joint petition is filed,each spouse must complete and attach a separate Exhibit D.) p Exhibit D completed and signed by the debtor is attached and made a part of this petition. If this is a joint petition: ❑ Exhibit D also completed and signed by the joint debtor is attached a made a part of this petition. Information Regarding the Debtor-Venue (Check any applicable box.) Fr Debtor has been domiciled or has had a residence,principal place of business,or principal assets in this District for 180 days immediately preceding the date of this petition or for a longer part of such 180 days than in any other District. ❑ There is a bankruptcy case concerning debtor's affiliate,general partner,or partnership pending in this District. ❑ Debtor is a debtor in a foreign proceeding and has its principal place of business or principal assets in the United States in this District, or has no principal place of business or assets in the United States but is a defendant in an action or proceeding[in a federal or state court] in this District,or the interests of the parties will be served in regard to the relief sought in this District. Certification by a Debtor Who Resides as a Tenant of Residential Property (Check all applicable boxes.) ❑ Landlord has a judgment against the debtor for possession of debtor's residence.(If box checked,complete the following.) (Name of landlord that obtained judgment) (Address of landlord) ❑ Debtor claims that under applicable nonbankruptcy law,there are circumstances under which the debtor would be permitted to cure the entire monetary default that gave rise to the judgment for possession,after the judgment for possession was entered,and ❑ Debtor has included in this petition the deposit with the court of any rent that would become due during the 30-day period after the filing of the petition. ❑ Debtor certifies that he/she has served the Landlord with this certification.(11 U.S.C. §362(1)). �3� Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 3 of 39 Page 3 'B1 (Offibial Form 1) (04/13) Voluntary Petition Name of Debtor(s): (This page must be completed and filed in every case) Statewide Florida Glass,LLC Signatures Signature(s)of Debtor(s) Signature of a Foreign s)(Individual/Joint) g g Representative I declare under penalty of perjury that the information provided in this 1 declare under penalty of perjury that the information provided in this petition is true and correct. petition is true and correct,that I am the foreign representative of a debtor [If petitioner is an individual whose debts are primarily consumer debts in a foreign proceeding,and that I am authorized to file this petition. and has chosen to file under Chapter 7]1 am aware that I may proceed (Check only one box.) under chapter 7, 11, 12 or 13 of title 11,United States Code,understand ❑ I request relief in accordance with chapter 15 of title 11, United the relief available under each such chapter,and choose to proceed under States Code.Certified copies ofthe documents required by 11 U.S.C. chapter 7. § 1515 are attached. [If no attorney represents me and no bankruptcy petition preparer signs Pursuant to 11 U.S.C.§ 1511,I request relief in accordance with the the petition]I have obtained and read the notice required by 11 U.S.C.§ chapter of title 11 specified in this petition.A certified copy of the I request relief in accordance with the chapter of title 11,United States). order granting recognition of the foreign main proceeding is attached. req Code,specified in this petition. X XSignature of Foreign Representative Signature of Debtor _,__ —.—_--._ XPrinted Name of Foreign Representative Signature of Joint Debtor _ Date Telephone Number(If not represented by attorney) C O m Date — En Signature of Attorney* Signature nature of Non-Attorney Petition Preparer E I declare under penalty of perjury that: 1)1 am a bankruptcy petition ' X /s/Robert S. Cohen preparer as defined in 11 U.S.C. § 110;2)I prepared this document for v Signature of Attorney for Debtor(s) compensation and have provided the debtor with a copy of this document w and the notices and information required under 11 U.S.C. §§ 110(b), A9 Robert S.Cohen 564079 110(h)and 342(b);and 3)if rules or guidelines have been promulgated 4 Cohen&Kendziorra, P.A. pursuant to 11 U.S.C. § 110(h) setting a maximum fee for services 3049 Cleveland Avenue,Ste 259 chargeable by bankruptcy petition preparers, I have given the debtor Fort Myers,FL 33901-7047 notice of the maximum amount before preparing any document for filing (239)931-1111 Fax:(239)656-4022 for a debtor or accepting any fee from the debtor, as required in that LL section.Official Form 19 is attached. W cokenpa2 @yahoo.com M ° M Printed Name and title,if any, of Bankruptcy Petition Preparer m tP ® Social Security Number(If the bankruptcy petition preparer is not an individual,state the Social Security number of the officer,principal,responsible person or partner of the bankruptcy petition preparer.)(Required by 11 U.S.C.§110.) September 4,2015_ _____. ._._.___._.._.-_-..__.....—_..._.._. Date — ----- — In a case in which§707(b)(4)(D)applies,this signature also constitutes a Address certification that the attorney has no knowledge after an inquiry that the information in the schedules is incorrect. Signature of Debtor(Corporation/Partnership) X I declare under penalty of perjury that the information piovidcd ill tliia - Signature petition is true and correct, and that I have been authorized to file this petition on behalf of the debtor. Date The debtor requests relief in accordance with the chapter of title 1 1, Signature of Bankruptcy Petition Preparer or officer,principal,responsible United States Code,specified in this petition. person,or partner whose social security number is provided above. Names and Social-Security numbers of all other individuals who prepared or X /s/Antonios Fronimakis assisted in preparing this document unless the bankruptcy petition preparer is not an individual: Signature of Authorized Individual Antonios Fronimakis If more than one person prepared this document,attach additional sheets Printed Name of Authorized Individual conforming to the appropriate official form for each person. Registered Agent/Managing Partner .— A bankruptcy petition preparer's failure to comply with the provisions of title 11 Title of Authorized Individual and the Federal Rules of Bankruptcy Procedure may result in fines or September 4,2015 _ _— imprisonment or both II U.S.C.§110: 18 U.S.C.§156. Date C3 , Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 4 of 39 FB 201A(Form 201A)(06/14) UNITED STATES BANKRUPTCY COURT NOTICE TO CONSUMER DEBTOR(S)UNDER §342(b) OF THE BANKRUPTCY CODE In accordance with § 342(b) of the Bankruptcy Code,this notice to individuals with primarily consumer debts: (1) Describes briefly the services available from credit counseling services;(2)Describes briefly the purposes, benefits and costs of the four types of bankruptcy proceedings you may commence; and(3)Informs you about bankruptcy crimes and notifies you that the Attorney General may examine all information you supply in connection with a bankruptcy case. You are cautioned that bankruptcy law is complicated and not easily described. Thus,you may wish to seek the advice of an attorney to learn of your rights and responsibilities should you decide to file a petition. Court employees cannot give you legal advice. Notices from the bankruptcy court are sent to the mailing address you list on your bankruptcy petition. In order to ensure that you receive information about events concerning your case,Bankruptcy Rule 4002 requires that you notify the court of any changes in your address. If you are filing a joint case(a single bankruptcy case for two individuals married to each other), and each spouse lists the same mailing address on the bankruptcy petition,you and your spouse will generally receive a single copy of each notice mailed from the bankruptcy court in a jointly-addressed envelope, unless you file a 0 statement with the court requesting that each spouse receive a separate copy of all notices. 1. Services Available from Credit Counseling Agencies E With limited exceptions, § 109(h) of the Bankruptcy Code requires that all individual debtors who file for bankruptcy relief on or after October 17, 2005,receive a briefing that outlines the available opportunities for credit counseling and provides assistance in performing a budget analysis. The briefing must be given within 180 days before the bankruptcy filing. The briefing may be provided individually or in a group(including briefings conducted by telephone or on the Internet)and must be provided by a nonprofit budget and credit counseling agency approved by the United States trustee or bankruptcy administrator. The clerk of the bankruptcy court has a list that you may consult of the N approved budget and credit counseling agencies. Each debtor in a joint case must complete the briefing. In addition, after filing a bankruptcy case,an individual debtor generally must complete a financial management instructional course before he or she can receive a discharge. The clerk also has a list of approved financial management instructional courses. Each debtor in a joint case must complete the course. 2. The_Your Chaptersof_the Bankruptcy_Code Available.__to Individual Consumer Debtors Chapter 7: Liquidation ($245 filing fee,$75 administrative fee,$15 trustee surcharge: Total fee$335) Chapter 7 is designed for debtors in financial difficulty who do not have the ability to pay their existing debts. Debtors whose debts are primarily consumer debts are subject to a"means test"designed to determine whether the case should be permitted to proceed under chapter 7. It your income is greater than the median inc vine fo,year state of residence and family size, in some cases,the United States trustee(or bankruptcy administrator),the trustee, or creditors have the right to file a motion requesting that the court dismiss your case under § 707(b) of the Code. It is up to the court to decide whether the case should be dismissed. Under chapter 7, you may claim certain of your property as exempt under governing law. A trustee may have the right to take possession of and sell the remaining property that is not exempt and use the sale proceeds to pay your creditors. The purpose of filing a chapter 7 case is to obtain a discharge of your existing debts. If,however,you are found to have committed certain kinds of improper conduct described in the Bankruptcy Code,the court may deny your 639 Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 5 of 39 Form B 201 A,Notice to Consumer Debtor(s) Page 2 discharge and, if it does,the purpose for which you filed the bankruptcy petition will be defeated. Even if you receive a general discharge, some particular debts are not discharged under the law. Therefore,you may still be responsible for most taxes and student loans;debts incurred to pay nondischargeable taxes;domestic support and property settlement obligations; most fines,penalties, forfeitures, and criminal restitution obligations;certain debts which are not properly listed in your bankruptcy papers; and debts for death or personal injury caused by operating a motor vehicle,vessel, or aircraft while intoxicated from alcohol or drugs. Also, if a creditor can prove that a debt arose from fraud,breach of fiduciary duty, or theft, or from a willful and malicious injury,the bankruptcy court may determine that the debt is not discharged. Chapter 13: Repayment of All or Part of the Debts of an Individual with Regular Income($235 filing fee, $75 administrative fee: Total fee$310) Chapter 13 is designed for individuals with regular income who would like to pay all or part of their debts in installments over a period of time. You are only eligible for chapter 13 if your debts do not exceed certain dollar amounts set forth in the Bankruptcy Code. Under chapter 13,you must file with the court a plan to repay your creditors all or part of the money that you owe them,using your future earnings. The period allowed by the court to repay your debts may be three years or five years, depending upon your income and other factors. The court must approve your plan before it can take effect. After completing the payments under your plan, your debts are generally discharged except for domestic support obligations; most student loans; certain taxes; most criminal fines and restitution obligations; certain debts which are not o properly listed in your bankruptcy papers; certain debts for acts that caused death or personal injury; and certain long term secured obligations. Chapter 11: Reorganization ($1167 filing fee,$550 administrative fee: Total fee$1717) Chapter 11 is designed for the reorganization of a business but is also available to consumer debtors. Its provisions are quite complicated, and any decision by an individual to file a chapter 11 petition should be reviewed with an attorney. Chapter 12: Family Farmer or Fisherman ($200 filing fee,$75 administrative fee: Total fee$275) Chapter 12 is designed to permit family farmers and fishermen to repay their debts over a period of time from future earnings and is similar to chapter 13. The eligibility requirements are restrictive, limiting its use to those whose W income arises primarily from a family-owned farm or commercial fishing operation. 3. Bankruptcy Crimes and Availability of Bankruptcy Papers to Law Enforcement Officials A person who knowingly and fraudulently conceals assets or makes a false oath or statement under penalty of perjury,either orally or in writing, in connection with a bankruptcy case is subject to a fine, imprisonment, or both. All information supplied by a debtor in connection with a bankruptcy case is subject to examination by the Attorney General acting through the Office of the United States Trustee,the Office of the United States Attorney, and other components and employees of the Department of Justice. WARNINC: Section 521(a)(1)of the Bankruptcy Code requires that you promptly file detailed information regarding your creditors,assets, liabilities, income,expenses and general financial condition. Your bankruptcy case may be dismissed if this information is not filed with the court within the time deadlines set by the Bankruptcy Code,the Bankruptcy Rules, and the local rules of the court. The documents and the deadlines for filing them are listed on Form B200,which is posted at http://www.uscourts.gov/bkforms/bankruptcy forms.html#procedure. Eqc) • s2o1s(Form 2o1s)(1z/o9)Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 6 of 39 United States Bankruptcy Court Middle District of Florida IN RE: Case No. Statewide Florida Glass, LLC Chapter 7 Debtor(s) CERTIFICATION OF NOTICE TO CONSUMER DEBTOR(S) UNDER§ 342(b)OF THE BANKRUPTCY CODE Certificate of[Non-Attorney] Bankruptcy Petition Preparer I,the[non-attorney]bankruptcy petition preparer signing the debtor's petition,hereby certify that I delivered to the debtor the attached notice,as required by §342(b)of the Bankruptcy Code. Printed Name and title,if any,of Bankruptcy Petition Preparer Social Security number(If the bankruptcy Address: petition preparer is not an individual,state the Social Security number of the officer, principal,responsible person,or partner of the bankruptcy petition preparer.) (Required by 11 U.S.C. § 110.) X ° Signature of Bankruptcy Petition Preparer of officer,principal,responsible person,or partner whose Social Security number is provided above. ,) Certificate of the Debtor LL I(We),the debtor(s),affirm that I (we)have received and read the attached notice,as required by §342(b)of the Bankruptcy Code. 0 0 Statewide Florida Glass, LLC X/s/Antonios Fronimakis 9/04/2015 Printed Name(s)of Debtor(s) Signature of Debtor Date LL Case No.(if known) X Signature of Joint Debtor(if any) Date Instructions: Attach a copy of Form B 201A,Notice to Consumer Debtor(s)Under§ 342(b)of the Bankruptcy Code. Use this form to certify that the debtor has received the notice required by 11 U.S.C. § 342(b)only if the certification has NOT been made on the Voluntary Petition,Official Form B 1.Exhibit B on page 2 of Form B1 contains a certification by the debtor's attorney that the attorney has given the notice to the debtor.The Declarations made by debtors and bankruptcy petition preparers on page 3 of Form B1 also include this certification. 9 ,B6 Summary(Official Formc6?s3%1%tlykili)i 1)09115-FMD Doc 1 Filed 09/04/15 Page 7 of 39 United States Bankruptcy Court Middle District of Florida IN RE: Case No. Statewide Florida Glass,LLC Chapter 7 Debtor(s) SUMMARY OF SCHEDULES Indicate as to each schedule whether that schedule is attached and state the number of pages in each.Report the totals from Schedules A,B,D,E,F,I,and J m the boxes provided.Add the amounts from Schedules A and B to determine the total amount of the debtor's assets. Add the amounts of all claims from Schedules D,E,and F to determine the total amount of the debtor's liabilities. Individual debtors also must complete the"Statistical Summary of Certain Liabilities and Related Data"if they file a case under chapter 7,l 1,or 13. ATTACHED NO.OF NAME OF SCHEDULE (YES/NO) SHEETS ASSETS LIABILITIES OTHER A- Real Property Yes 1 $ 0.00 B - Personal Property Yes 3 $ 128,089.54 C- Property Claimed as Exempt Yes 1 0 a D -Creditors Holding Secured Claims Yes 1 $ 0.00 LL N E- Creditors Holding Unsecured Priority Yes 1 $ 0.00 Claims(Total of Claims on Schedule E) 0 rn F- Creditors Holding Unsecured Yes 11 $ 152,437.83 Nonpriority Claims G-Executory Contracts and Unexpired Yes 1 Leases (�l H -Codebtors Yes 1 I- Current Income of Individual No $ Debtor(s) J- Current Expenditures of Individual No $ Debtor(s) TOTAL 20 $ 128,089.54 $ 152,437.83 Li to B6A(Official Form 6A)(12Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 8 of 39 IN RE Statewide Florida Glass,LLC __ Case No. Debtor(s) (If known) SCHEDULE A-REAL PROPERTY Except as directed below, list all real property in which the debtor has any legal,equitable,or future interest, including all property owned as a cotenant,community property,or in which the debtor has a life estate.Include any property in which the debtor holds rights and powers exercisable for the debtor's own benefit.If the debtor is married,state whether the husband,wife,both,or the marital community own the property by placing an"H,""W,""J,"or"C"in the column labeled"Husband,Wife,Joint, or Community."If the debtor holds no interest in real property,write"None"under"Description and Location of Property." Do not include interests in executory contracts and unexpired leases on this schedule.List them in Schedule G-Executory Contracts and Unexpired Leases. If an entity claims to have a lien or hold a secured interest in any property,state the amount of the secured claim. See Schedule D.If no entity claims to hold a secured interest in the property,write"None"in the column labeled"Amount of Secured Claim." If the debtor is an individual or if a joint petition is filed,state the amount of any exemption claimed in the property only in Schedule C-Property Claimed as Exempt. :9-: CURRENT VALUE OF w DEBTOR'S INTEREST IN NATURE OF DEBTOR'S 5 PROPERTY WITHOUT AMOUNT OF SECURED DESCRIPTION AND LOCATION OF PROPERTY INTEREST IN PROPERTY O 0 DEDUCTING ANY CLAIM v SECURED CLAIM OR w p EXEMPTION n x None 0 a II CO 0, d 0 C? U C m C N W M 0 N ah rn ' TOTAL 0.00 (Report also on Summary of Schedules) Eq3 B6B(Officia1Form6B)(12�T_se 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 9 of 39 IN RE Statewide Florida Glass, LLC Case No. Debtor(s) (If known) SCHEDULE B-PERSONAL PROPERTY Except as directed below,list all personal property of the debtor of whatever kind.If the debtor has no property in one or more of the categories,place an"x"in the appropriate position in the column labeled"None."If additional space is needed in any category,attach a separate sheet properly identified with the case name,case number, and the number of the category.If the debtor is married,state whether the husband,wife,both,or the marital community own the property by placing an"H,""W,""J,"or "C"in the column labeled"Husband,Wife,Joint,or Community."If the debtor is an individual or a joint petition is filed,state the amount of any exemptions claimed only in Schedule C-Property Claimed as Exempt. Do not list interests in executory contracts and unexpired leases on this schedule.List them in Schedule G-Executory Contracts and Unexpired Leases. If the property is being held for the debtor by someone else,state that person's name and address under"Description and Location of Property."If the property is being held for a minor child,simply state the child's initials and the name and address of the child's parent or guardian,such as"A.B.,a minor child,by John Doe,guardian."Do not disclose the child's name.See, 11 U.S.C.§112 and Fed.R.Bankr.P. 1007(m). CURRENT VALUE OF N w DEBTOR'S INTEREST IN O PROPERTY WITHOUT TYPE OF PROPERTY DESCRIPTION AND LOCATION OF PROPERTY DEDUCTING ANY N O 0 SECURED CLAIM OR E p EXEMPTION m 1. Cash on hand. X 1,064.54 2. Checking,savings or other financial Regions Bank accounts,certificates of deposit or pending garnishment shares in banks,savings and loan, tv thrift,building and loan,and homestead associations,or credit unions,brokerage houses,or cooperatives. u_ 3. Security deposits with public utilities, X Ntelephone companies,landlords,and others. 4. Household goods and furnishings, X include audio,video,and computer equipment. 5. Books,pictures and other art objects, X antiques,stamp,coin,record,tape, LL compact disc,and other collections or collectibles. 6. Wearing apparel. X • 7. Furs and jewelry. X ® 8. Firearms and sports,photographic, X and other hobby equipment. 9. Interest in insurance policies.Name X insurance company of each policy and itemize surrender or refund value of each. 10. Annuities.Itemize and name each X issue. 11. 6.n.r sc,:.i an education IRA ac X defined in 26 U.S.C.§530(b)(1)or under a qualified State tuition plan as defined in 26 U.S.C.§529(b)(1). Give particulars.(File separately the record(s)of any such interest(s).11 U.S.C.§521(c).) 12. Interests in IRA,ERISA,Keogh,or X other pension or profit sharing plans. Give particulars. 13. Stock and interests in incorporated X and unincorporated businesses. Itemize. 14. Interests in partnerships or joint X ventures.Itemize. ELI B6B •(Official Form 6B)(lgiaspoft:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 10 of 39 IN RE Statewide Florida Glass, LLC __..._._..__._._.____..._.__._.__._._.._.._..__.._....._.____—_._.._ Case No. _. Debtor(s) (If known) SCHEDULE B-PERSONAL PROPERTY (Continuation Sheet) _ CURRENT VALUE OF N E DEBTOR'S INTEREST IN O DESCRIPTION AND LOCATION OF PROPERTY PROPERTY WITHOUT TYPE OF PROPERTY N 01 DEDUCTING ANY E �d V SECURED CLAIM OR 0 EXEMPTION 15. Government and corporate bonds and X other negotiable and non-negotiable instruments. 16. Accounts receivable. X 17. Alimony,maintenance,support,and X property settlements in which the debtor is or may be entitled.Give particulars. 18. Other liquidated debts owed to debtor X including tax refunds.Give particulars. • 19. Equitable or future interest,life X estates,and rights or powers exercisable for the benefit of the debtor other than those listed in Schedule A-Real Property. `o 20. Contingent and noncontingent X " interests in estate of a decedent,death benefit plan,life insurance policy,or v trust. 0 21. Other contingent and unliquidated X claims of every nature,including tax refunds,counterclaims of the debtor, and rights to setoff claims.Give estimated value of each. N 22. Patents,copyrights,and other X intellectual property.Give particulars. 23. Licenses,franchises,and other X o general intangibles.Give particulars. 24. Customer lists or other compilations X containing personally identifiable information(as defined in 11 U.S.C.§ 101(4IA))provided to the debtor by individuals in connection with obtaining a product or service from the debtor primarily for personal, family,or household purposes. 25. Automobiles,trucks,trailers,and 2001 Ford van 4,000.00 other vehicles and accessori". over 150006 miles 26. Boats,motors,and accessories. X 27. Aircraft and accessories. X 28. Office equipment,fumishings,and X supplies. 29. Machinery,fixtures,equipment,and blown glass„2 large 4 drawer filing cabinets,2 laminated glass 123,025.00 supplies used in business. tables,computer, phone,desk,2 shower displays,glass display rack,assorted sheets of glass-1/8,1/4",3/8",assorted stock lengths of metal,assorted glass hardware,polishing machine 30. Inventory. X 31. Animals. X 32. Crops-rowing or harvested.Give X particulars. i B6B(Official Form 6B)(12g, s @opt:15-bk-09115-FM D Doc 1 Filed 09/04/15 Page 11 of 39 IN RE Statewide Florida Glass, LLC Case No. Debtor(s) (If known) SCHEDULE B-PERSONAL PROPERTY (Continuation Sheet) CURRENT VALUE OF N DEBTORS INTEREST IN O TYPE OF PROPERTY DESCRIPTION AND LOCATION OF PROPERTY PROPERTY DEDUCTW WITHG OUT N L1 ANY E Z u SECURED CLAIM OR m p4 EXEMPTION ti 33. Farming equipment and implements. X 34. Farm supplies,chemicals,and feed. X 35. Other personal property of any kind X not already listed.Itemize. FT t0 (7) E `o LL m m O O C C 6 C LL N W r) O O) O TOTAL 128,089.54 (Include amounts from any continuation sheets attached. 0 continuation sheets attached Report total also on Summary of Schedules.) , B6C(Official Form 6C)(Odfl�se 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 12 of 39 IN RE Statewide Florida Glass, LLC _____ __ Case No. Debtor(s) (If known) SCHEDULE C-PROPERTY CLAIMED AS EXEMPT Debtor elects the exemptions to which debtor is entitled under: ❑Check if debtor claims a homestead exemption that exceeds$155,675.* (Check one box) I 1 U.S.C.§522(bX2) ❑11 U.S.C.§522(bX3) CURRENT VALUE VALUE OF CLAIMED OF PROPERTY DESCRIPTION OF PROPERTY SPECIFY LAW PROVIDING EACH EXEMPTION EXEMPTION WITHOUT DEDUCTING EXEMPTIONS Not Applicable El 0 I) `o LL N 01 O O LL N W 0 N) cn O) *Amount subject to adjustment on 4/1/16 and every three years thereafter with respect to cases commenced on or after the date of adjustment. B6D(Official Form 6D)(1gAse 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 13 of 39 IN RE Statewide Florida Glass, LLC ___.__. _. Case No. _ -- -- _ __...__._.._----___.__----------- Debtor(s) (If known) SCHEDULE D-CREDITORS HOLDING SECURED CLAIMS State the name,mailing address,including zip code,and last four digits of any account number of all entities holding claims secured by property of the debtor as of the date of filing of the petition.The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so.List creditors holding all types of secured interests such as judgment liens,garnishments,statutory liens,mortgages,deeds of trust,and other security interests. List creditors in alphabetical order to the extent practicable.If a minor child is the creditor,state the child's initials and the name and address of the child's parent or guardian,such as"A.B.,a minor child,by John Doe,guardian."Do not disclose the child's name.See,11 U.S.C.§112 and Fed.R.Bankr.P. 1007(m).If all secured creditors will not fit on this page,use the continuation sheet provided. If any entity other than a spouse in a joint case may be jointly liable on a claim,place an"X"in the column labeled"Codebtor,"include the entity on the appropriate schedule of creditors,and complete Schedule H—Codebtors.If a joint petition is filed,state whether the husband,wife,both of them,or the marital community may be liable on each claim by placing an"H,""W,""J,"or"C"in the column labeled"Husband,Wife,Joint,or Community." If the claim is contingent,place an"X"in the column labeled"Contingent."If the claim is unliquidated,place an"X"in the column labeled"Unliquidated."If the claim is disputed,place an"X"in the column labeled"Disputed."(You may need to place an"X"in more than one of these three columns.) Total the columns labeled"Amount of Claim Without Deducting Value of Collateral"and"Unsecured Portion,if Any"in the boxes labeled"Total(s)"on the last sheet of the completed schedule.Report the total from the column labeled"Amount of Claim Without Deducting Value of Collateral"also on the Summary of Schedules and, if the debtor is an individual with primarily consumer debts,report the total from the column labeled"Unsecured Portion,if Any"on the Statistical Summary of Certain Liabilities and Related Data. Check this box if debtor has no creditors holding secured claims to report on this Schedule D. °2 � Ero AMOUNT OF c w < w CLAIM WITHOUT CREDITOR'S NAME AND MAILING ADDRESS �'' DATE CLAIM WAS INCURRED, C7 p UNSECURED �3 NATURE OF LIEN,AND DESCRIPTION AND VALUE OF Z S DEDUCTING INCLUDING ZIP CODE AND ACCOUNT NUMBER µt S e, PORTION,IF ANY O z O PROPERTY SUBJECT TO LIEN O' v, VALUE OF (See Insrnraions Abm�e.J 4 O �r' O COLLATERAL v u ec 0 u 0 E LL `Q ACCOUNT NO. N O Value$ LL ACCOUNT NO. 0 N so Oi O' Value$ ACCOUNT NO. VraluP$ ACCOUNT NO. Value$ Subtotal (Total of this page) $ $ 0 continuation sheets attached Total (Use only on last page) $ $ (Report also on (If applicable,report Summary of also on Statistical Schedules.) Summary of Certain Liabilities and Related Data.) C�I�I B6E(Official Form 6E)(O,p se 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 14 of 39 IN RE Statewide Florida Glass, LLC Case No. —. Debtor(s) (If known) SCHEDULE E- CREDITORS HOLDING UNSECURED PRIORITY CLAIMS A complete list of claims entitled to priority,listed separately by type of priority,is to be set forth on the sheets provided.Only holders of unsecured claims entitled to priority should be listed in this schedule.In the boxes provided on the attached sheets,state the name,mailing address,including zip code,and last four digits of the account number,if any,of all entities holding priority claims against the debtor or the property of the debtor.as of the date of the filing of the petition.Use a separate continuation sheet for each type of priority and label each with the type of priority. The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so. If a minor child is a creditor,state the child's initials and the name and address of the child's parent or guardian,such as"A.B.,a minor child,by John Doe,guardian."Do not disclose the child's name.See,11 U.S.C.§112 and Fed.R.Bankr.P. 1007(m). If any entity other than a spouse in a joint case may be jointly liable on a claim,place an"X" in the column labeled"Codebtor," include the entity on the appropriate schedule of creditors,and complete Schedule H-Codebtors.If a joint petition is filed,state whether the husband,wife,both of them,or the marital community may be liable on each claim by placing an"H,""W,""J,"or"C"in the column labeled"Husband,Wife,Joint,or Community."If the claim is contingent,place an"X"in the column labeled "Contingent"If the claim is unliquidated,place an"X"in the column labeled"Unliquidated."If the claim is disputed,place an"X"in the column labeled"Disputed."(You may need to place an"X"in more than one of these three columns.) Report the total of claims listed on each sheet in the box labeled"Subtotals"on each sheet.Report the total of all claims listed on this Schedule E in the box labeled"Total" on the last sheet of the completed schedule.Report this total also on the Summary of Schedules. Report the total of amounts entitled to priority listed on each sheet in the box labeled"Subtotals"on each sheet.Report the total of all amounts entitled to priority listed on this Schedule E in the box labeled"Totals"on the last sheet of the completed schedule.Individual debtors with primarily consumer debts report this total also on the Statistical Summary of Certain Liabilities and Related Data. Report the total of amounts not entitled to priority listed on each sheet in the box labeled"Subtotals"on each sheet Report the total of all amounts not entitled to priority listed on this Schedule E in the box labeled"Totals"on the last sheet of the completed schedule.Individual debtors with primarily consumer debts report this total also on 8 the Statistical Summary of Certain Liabilities and Related Data. 0 [ Check this box if debtor has no creditors holding unsecured priority claims to report on this Schedule E. € TYPES OF PRIORITY CLAIMS(Check the appropriate box(es)below if claims in that category are listed on the attached sheets) 0 LL ❑ Domestic Support Obligations Claims for domestic support that are owed to or recoverable by a spouse,former spouse,or child of the debtor,or the parent,legal guardian,or responsible relative of such a child,or a governmental unit to whom such a domestic support claim has been assigned to the extent provided in 11 o U.S.C. §507(a)(1). ❑ Extensions of credit in an involuntary case • Claims arising in the ordinary course of the debtor's business or financial affairs after the commencement of the case but before the earlier of the LL appointment of a trustee or the order for relief. 11 U.S.C. §507(a)(3). • ❑ Wages,salaries,and commissions N Wages,salaries,and commissions,including vacation, severance,and sick leave pay owing to employees and commissions owing to qualifying independent sales representatives up to$12,475*per person earned within 180 days immediately preceding the filing of the original petition,or the cessation of business,whichever occurred first,to the extent provided in 11 U.S.C. §507(a)(4). ❑ Contributions to employee benefit plans Money owed to employee benefit plans for services rendered within 180 days immediately preceding the filing of the original petition, or the cessation of business,whichever occurred first,to the extent provided in 11 U.S.C.§507(a)(5). ❑ Certain farmers and fishermen Claims of certain farmers and fishermen,up to$6,150*per farmer or fisherman,against the debtor,as provided in 11 U.S.C.§507(a)(6). ❑ Deposits by individuals Claims of individuals up to S2,1754 far deposits foi the pmchasc,lcaac,or rental of property or cervirec for personal,family,or household use,that were not delivered or provided. 11 U.S.C. §507(a)(7). ❑ Taxes and Certain Other Debts Owed to Governmental Units Taxes,customs duties,and penalties owing to federal,state,and local governmental units as set forth in 11 U.S.C. §507(a)(8). ❑ Commitments to Maintain the Capital of an Insured Depository Institution Claims based on commitments to the FDIC,RTC,Director of the Office of Thrift Supervision,Comptroller of the Currency,or Board of Governors of the Federal Reserve System,or their predecessors or successors,to maintain the capital of an insured depository institution.11 U.S.C.§507(a)(9). ❑ Claims for Death or Personal Injury While Debtor Was Intoxicated Claims for death or personal injury resulting from the operation of a motor vehicle or vessel while the debtor was intoxicated from using alcohol, a drug,or another substance. 11 U.S.C.§507(a)(10). *Amounts are subject to adjustment on 4/01/16,and every three years thereafter with respect to cases commenced on or after the date of adjustment. 0 continuation sheets attached 15. �} B6F(Official Form 6F)(12Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 15 of 39 IN RE Statewide Florida Glass, LLC _ Case No. — Debtor(s) (If known) SCHEDULE F-CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS State the name,mailing address,including zip code,and last four digits of any account number,of all entities holding unsecured claims without priority against the debtor or the property of the debtor,as of the date of filing of the petition.The complete account number of any account the debtor has with the creditor is useful to the trustee and the creditor and may be provided if the debtor chooses to do so.If a minor child is a creditor, state the child's initials and the name and address of the child's parent or guardian,such as"A.B.,a minor child,by John Doe,guardian."Do not disclose the child's name.See,11 U.S.C.§112 and Fed.R.Bankr.P. 1007(m).Do not include claims listed in Schedules D and E.If all creditors will not fit on this page,use the continuation sheet provided. If any entity other than a spouse in a joint case may be jointly liable on a claim,place an"X"in the column labeled"Codebtor,"include the entity on the appropriate schedule of creditors,and complete Schedule H-Codebtors.If a joint petition is filed,state whether the husband,wife,both of them,or the marital community may be liable on each claim by placing an"H,""W,""J,"or"C"in the column labeled"Husband,Wife,Joint,or Community." If the claim is contingent,place an"X"in the column labeled"Contingent."If the claim is unliquidated,place an"X"in the column labeled"Unliquidated."If the claim is disputed,place an"X"in the column labeled"Disputed."(You may need to place an"X"in more than one of these three columns.) Report the total of all claims listed on this schedule in the box labeled"Total"on the last sheet of the completed schedule. Report this total also on the Summary of Schedules and,if the debtor is an individual with primarily consumer debts,report this total also on the Statistical Summary of Certain Liabilities and Related Data. Ei Check this box if debtor has no creditors holding unsecured nonpriority claims to report on this Schedule F. °: W < W AMOUNT CREDITOR'S NAME,MAILING ADDRESS DATE CLAIM WAS INCURRED AND V 5 OF INCLUDING ZIP CODE,AND ACCOUNT NUMBER W CONSIDERATION FOR CLAIM.IF CLAIM IS q 'O SUBJECT TO SETOFF,SO STATE O' ' CLAIM (See Instructions Above.) O p U 8 g e 8 v o o ACCOUNT NO.4700 't Supply Co 1100 Sun Century Road • Naples,FL 34110 a 4,248.32 2 ACCOUNT NO.XXXX • Advanced Disposal Solid Waste Southeast N 17101 Pine Ridge Road Fort Myers Beach, FL 33931 132.72 ACCOUNT NO.XXXX Aldora Aluminum and Glass Products, Inc 11500 Miramar Pkwy,#300 Miramar,FL 33025 12,589.62 ACCOUNT NO Assignee or other notification for: Kailas,SG Aldora Aluminum and Glass Products, Inc Kohner Mann& 4650 N Port Washington Road Milwaukee,WI 53212-5110 Subtotal (Total of this page) $ 16,970.66 10 continuation sheets attached Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules and,if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ 0 B6F(Official Form 6F)(12707jSCo�tf.15-bk-09115-F M D Doc 1 Filed 09/04/15 Page 16 of 39 IN RE Statewide Florida Glass,LLC Case No. --...--------._..._.._..------ Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) r o o CREDITORS NAME,MAILING ADDRESS DATE CLAIM WAS INCURRED AND p w AMOUNT �3 CONSIDERATION FOR CLAIM.IF CLAIM IS 5 S OF INCLUDING ZIP CODE,AND ACCOUNT NUMBER p ti (See Jnstrocoons Above) p O SUBJECT TO SETOFF,SO STATE 0' CLAIM O r� " Cj No ACCOUNT NO 01XX attorneys fees--Bass Law Office,P.A>vs. Statewide Florida Glass LLC,et al Bass Law Office 2335 Tamiami Trail N,Ste 409 Naples,FL 34103 2,500.00 ACCOUNT NO XXXX C R Laurence 2503 E Vernon Avenue Los Angeles,CA 90058-1826 unknown 0 ACCOUNT NO.XXXX E Carol Ostrange LL 5051 Pelican Colony Blvd a Bonita Springs,FL 34134 1,475.52 ACCOUNT NO.XXXX Chase Cardmember Service 4 P.O.Box 15298 W Wilmington, DE 19850 2,021.00 Ell ACCOUNT NO.XXXX © City Mattress Attn: Nick 4296 Tamiami Trail N Naples,FL 34103 613.50 ACCOUNT NO.XXXX Cole,Scott&Kissane,P.A. Bonita Srpings,FL 34134 unknown ACCOUNT NO.XXXX Comcast P.O.Box 105184 Atlanta,GA 30348-5184 700.84 tt h 1 of 10 continuation sheets attached to Subtotal Sheet no. (Total of this page) $ 7,310.86 Schedule of Creditors Holding Unsecured Nonpriority Claims Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ C�� B6F(Official Form 6F)(12eo :15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 17 of 39 IN RE Statewide Florida Glass, LLC Case No. Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) CREDITOR'S NAME,MAILING ADDRESS C DATE CLAIM WAS INCURRED AND 5 AMOUNT INCLUDING INCLUDING ZIP CODE,AND ACCOUNT NUMBER w CONSIDERATION FOR CLAIM.IF CLAIM IS a CLAIM 8 (See Insmm�ions Above.) QO O SUBJECT TO SETOFF,SO STATE 0 U 0 C S ACCOUNT NO.XXXX Countryside Golf&Country Club Attn: Ken Williams 600 Countryside Drive Naples,FL 34104 585.50 ACCOUNT NO.XXXX Dennis Guay 1012 Eastham Court Naples, FL 34104 unknown ACCOUNT NO.XXXX Dr.Ralph Ryback LL 9148 The Lane Naples,FL 34109 1,000.00 ACCOUNT NO XXMB pending lawsuit Eastern Metal Supply Inc si CIO William Joel Marell, Esquire LL 1601 Forum Place,Ste 1101 W West Palm Beach, FL 33401 8,801.00 s _ Si ACCOUNT NO.XXXX EyeMD EMR Healthcare Systems 27300 Riverview Center Blvd,Ste 100 Bonita Springs, FL 34134 10,208.81 ACCOUNT NO.XXXX FPL 26301 Cutting Horse Lane Bonita Spring,FL 34135 unknown ACCOUNT NO XXXX breach of business lease Frank LaCava 27925 Industrial Street Bonita Springs,FL 34135 • unknown Sheet no. 2 of 10 continuation sheets attached to Subtotal Schedule of Creditors Holding Unsecured Nonpriority Claims (Total of this page) $ 20,595.31 Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ B6F(Official Form 6F)(124P og:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 18 of 39 IN RE Statewide Florida Glass, LLC _._._______��___ Case No. Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) o CREDITORS NAME,MAILING ADDRESS 9 DATE CLAIM WAS INCURRED AND Ej AMOUNT OF ZIP CODE,AND ACCOUNT NUMBER CONSIDERATION FOR CLAIM.IF CLAIM IS S SUBJECT TO SETOFF,SO STATE d ti CLAIM (See Instructions Above.) 9 E, p m O 0 7ti ACCOUNT NO.XXXX Gary Brecka 3368 Atlantic Circle Naples,FL 34119 1,272.00 ACCOUNT NO.XXXX Gary Heins 2777 12th Street Naples,FL 34103 10,000.00 g ACCOUNT NO.XXXX `o E George&Be McArdle LL 6700 Huntington Lakes Circle,#101 a Naples,FL 34119 unknown m 0 • ACCOUNT NO.XXXX George Fellows 927 Bercarmil Way Naples,FL 34110 W unknown o°, ACCOUNT NO.XXXX o GF Holdings Naples CIO Heidemarie Klimt 71 18th Avenue S Naples,FL 34102 11,000.00 ACCOUNT NO.XXXX Hastings Investments,LLC CIO Cohen&Crigeby,PC 9110 Strada Place,Ste 6200 Naples,FL 34108 unknown ACCOUNT NO.XXXX Herbert Bergman 2636 Sommerville Lopp,#1601 Cape Coral,FL 33991 3,000.00 3 of 10 continuation sheets attached to Subtotal Sheet no. (Total of this page) $ 25,272.00 Schedule of Creditors Holding Unsecured Nonpriority Claims Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ E-573-53 B6F(Official Form 6F)(127� SCollt:15-bk-09115-FM D Doc 1 Filed 09/04/15 Page 19 of 39 IN RE Statewide Florida Glass, LLC Case No. _._ .__ —. �__.__.----..—__....._....._..._...._.___._. (If known) Debtor(s) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) DATE CLAIM WAS INCURRED AND p AMOUNT CREDITOR'S NAME,MAILING ADDRESS m CONSIDERATION FOR CLAIM.IF CLAIM IS z r) S OF INCLUDING ZIP CODE,AND ACCOUNT NUMBER w SUBJECT TO SETOFF,SO STATE eG d CLAIM (See Insmrcfians Above.) OV V O V y0 ACCOUNT NO.XXXX (Mark Development 2205 SE 32nd Terrace Cape Coral,FL 33904 unknown ACCOUNT NO.XXXX Jack Clark 21550 Madera Road Fort Myers Beach, FL 33931 unknown t ACCOUNT NO.XXXX E Jill Frye LL 24547 Redfish Street a Bonita Springs,FL 34134 1,400.00 q ACCOUNT NO reek Joe Hieronimus 13402 Rosewood Lane LL Naples,FL 34119 m 3,064.86 cJ S ACCOUNT NO XXXX John&Fran Kazmerski 3006 Cinnamon Bay Circle Naples,FL 34119 unknown ACCOUNT NO. John Largura 27251 Ibis Cove Bonita Springs,FL 00000 350.00 ACCOUNT NO.XXXX Kenneth Van DeMark 8165 Saratoga Drive,#1302 Naples,FL 00000 350.00 t h i 4 of 10 continuation sheets attached to Subtotal Sheet no. (Total of this page) $ 5,164.86 Schedule of Creditors Holding Unsecured Nonpriority Claims Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ B6F(Official Form 6F)(I2Se oP:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 20 of 39 IN RE Statewide Florida Glass,LLC Case No. ._______._._ — Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) a p CREDITORS NAME,MAILING ADDRESS E_ DATE CLAIM WAS INCURRED AND m AMOUNT Ej OF INCLUDING ZIP CODE,AND ACCOUNT NUMBER u� 3 CONSIDERATION FOR CLAIM.IF CLAIM IS Z 7 pO p 8 SUBJECT TO SETOFF,SO STATE d v, CLAIM (See lnsin�ciions Above.) Z 0 r� v Q a �j y0 5 ACCOUNT NO.XXXX KTS Group 2430 Vanderbilt Beach Road,#260 Naples,FL 34109 unknown ACCOUNT NO.XXXX Lisa Rydberg 26463 Doverstone Street Bonita Springs,FL 34135 unknown ACCOUNT NO.XXXX E Living Styles FHD LL Marion Smith a 561 S Collier Blvd N Marco Island,FL 34145 3,050.00 th ACCOUNT NO.XXXX Li Luminous Glass Supply 1140 BW 159th Drive T Miami,FL 33169 w unknown 0) S ACCOUNT NO.XXXX Marion VanHorn 5320 SW 11th Place Cape Coral,FL 00000 1,272.00 ACCOUNT NO.XXXX Matt 271 South Bay nrive,#133 Naples,FL 34108 unknown ACCOUNT NO.XXXX Mike Percorio 803 Slash Pine Court Naples,FL 34108 unknown 5 of 10 continuation sheets attached to Subtotal Sheet no. (Total of this page) $ 4,322.00 Schedule of Creditors Holding Unsecured Nonpriority Claims Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ B6F(Official Form 6F)(12 Sao :15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 21 of 39 IN RE Statewide Florida Glass, LLC Case No. — Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) • < ++ AMOUNT CREDITORS NAME,MAILING ADDRESS DATE CLAIM WAS CLAIM IF AND F- O OF INCLUDING ZIP CODE,AND ACCOUNT NUMBER iy 3 CONSIDERATION FOR CLAIM.IF CLAIM IS d ti CLAIM q (See JtlSInICIlOnS Above.) p Z SUBJECT TO SETOFF,SO STATE O v MIN O a ACCOUNT NO.XXXX Naples Zoo Caribbean Gardens 1590 Goodlette Road Naples,FL 34102 1,962.50 ACCOUNT NO.XXXX Nolen's Permitting 90 24th Avenue NE Naples,FL 34120 unknown fu g ACCOUNT NO.XXXX E PNC Bank LL P.O.Box 3180 r Pittsburgh,PA 15253-3180 1,824.30 ACCOUNT NO.XXXX g Professional Conractors Group Lee Hershey 9201 Brookwood Court,#6 W Bonita Springs,FL 00000 3,800.00 S ACCOUNT NO.XXXX ® Protection One 800 E Waterman Wichita,KS 67202 894.24 ACCOUNT NO.4135 R&L Carriers P.O. BoY lOnva Port William,OH 45164-2000 337.94 ACCOUNT NO Assignee or other notification for: R&L Carriers Precision Glass Bending 3811 W Highway 10 Greenwood,AR 72936 6 of 10 continuation sheets attached to Subtotal Sheet no. Schedule of Creditors Holding Unsecured Nonpriority Claims (Total of this page) $ 8,818.98 Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ B6F(Official Form 6F)(12seo :15-bk-09115-FM D Doc 1 Filed 09/04/15 Page 22 of 39 IN RE Statewide Florida Glass, LLC _._.......___.__.._..__.__.____.._._......__._....__._...._.__ Case No. Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) gr CREDITOR'S NAME,MAILING ADDRESS DATE CLAIM WAS INCURRED AND U ^ O AMOUNT INCLUDING ZIP CODE,AND ACCOUNT NUMBER FH19 CONSIDERATION FOR CLAIM IF CLAIM IS Z E OF (See Instructions Above) 0 O O SUBJECT TO SETOFF,SO STATE ,,..0 N_ CLAIM U U O m C U v,O ACCOUNT NO.9699 Radio America P.O.Box 3307 Oak Park,IL 60303-3307 267.00 ACCOUNT NO.XXXX Raymond Bass 2800 Gulf Shore Blvd N,#107 Naples,FL 34103 unknown t ACCOUNT NO.XXXX Rayond Building Supply 7751 Bayshore Road North Fort Myers,FL 33917 unknown c ACCOUNT NO 0361 defaul final judgment Richard And Nancy Klass si 3377 Gulf Shore Boulevard North,#8C E Naples,FL 34103 N O 8 p ,000.00 Si ACCOUNT NO Assignee or other notification for: ® Shaun M.Garry, Esquire Richard And Nancy Klass 9115 Corsea Del Fontana Way,Ste 100 Naples, FL 34109 ACCOUNT NO.East Silvico 1010 Manatee Road, Unit 205-B Naples, FL 34114 1,875.00 ACCOUNT NO.XXXX South Street Grill Attn: Michelle 1410 Pine Ridge Road Naples, FL 34108 1,140.00 Sheet no. 7 of 10 continuation sheets attached to Subtotal Schedule of Creditors Holding Unsecured Nonpriority Claims (Total of this page) $ 11,282.00 Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ Li- s6F(Official Form 6F)(12/o.aseo itt:15-bk-09115-FM D Doc 1 Filed 09/04/15 Page 23 of 39 IN RE Statewide Florida Glass, LLC _ No. _ Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) 9� CREDITOR'S NAME,MAILING ADDRESS m DATE CLAIM WAS INCURRED AND wV p "' AMOUNT INCLUDING ZIP CODE,AND ACCOUNT NUMBER CONSIDERATION FOR CLAIM.IF CLAIM IS Z OF (See Insmictions Above.) 0 QO g SUBJECT TO SETOFF,SO STATE d CLAIM e z V O <m a rj 0 ACCOUNT NO.XXXX Steve Pursley 6520 Valen Way,#C204 Naples,FL 34106 unknown ACCOUNT NO.XXXX Terry Gilcrest 1139 Imperial Drive Naples, FL 34110 0 750.00 ACCOUNT NO.XXXX E The Swiss Colony ,;5_ 1112 7th Avenue a Monroe,WI 53566-1364 N 2,000.00 "2,1;7 m ACCOUNT NO.XXXX The Hartford P.O. Box 7247 LL Philadelphia,PA 19170 unknown N - ir ACCOUNT NO XXXX ® The Home Mag 1732 SE 47th Terrace Cape Coral,FL 33904 2,000.00 ACCOUNT NO.XXXX The Yellow Book 2201 Renaissun'e-Rlytl King Of Prussia,PA 19406 unknown ACCOUNT NO 1669 default final judgment--4-22-15 Thomas E.Boyle 26170 Mira Way Bonita Springs,FL 34134 1,700.00 Sheet no. 8 of 10 continuation sheets attached to Subtotal Schedule of Creditors Holding Unsecured Nonpriority Claims (Total of this page) $ 6,450.00 Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ Eq)' B6F(Official Form 6F)(]2SF og:15-bk-09115-FM D Doc 1 Filed 09/04/15 Page 24 of 39 IN RE Statewide Florida Glass, LLC Case No. Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) CREDITORS NAME,MAILING ADDRESS DATE CLAIM WAS INCURRED AND / F AMOUNT INCLUDING ZIP CODE,AND ACCOUNT NUMBER mw CONSIDERATION FOR CLAIM.IF CLAIM IS Z 5 OF (See/nsinicnons Above.) DO D 0 SUBJECT TO SETOFF,SO STATE V Z U O m y O 0 V ej �O ACCOUNT NO Assignee or other notification for: John D Agnew, Esquire Thomas E. Boyle Henderson,Franklin,Starnes&Holt, P.A P.O. Box 280 Fort Myers,FL 33902 ACCOUNT NO.A542 pending lawsuit TM Windows,LLC CIO Malka&Kravitz, P.A. 1300 Sawgrass Corporate Pkwy, Ste 100 Fort Lauderdale,FL 33323 17,274.00 iu ACCOUNT NO Assignee or other notification for: E Cole,Scott&Kissane,P.A. TM Windows, LLC LL 27300 Riverview Center Blvd,Ste 200 a Bonita Srpings,FL 34134 N OD c? ACCOUNT NO Assignee or other notification for: Ls Cohen&Grigsby,P.C. TM Windows,LLC 9110 Strada Place,Ste 6200 Naples,FL 34108 N W C,) O Si ACCOUNT NO.XXXX ® Tom Ecker 1036 Port Orange Court Naples, FL 34120 609.50 ACCOUNT NO.XXXX Tracy L Juels 860 Willow Court Marco Island, FL 34145 11,707.66 ACCOUNT NO Assignee or other notification for: Roberts Bay Custom Homes Inc Tracy L Juels Hayden Warren 840 Newell Terrace Marco Island, FL 34145 Sheet no. 9 of 10 continuation sheets attached to Subtotal Schedule of Creditors Holding Unsecured Nonpriority Claims (Total of this page) $ 29,591.16 Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ Ls1 B6F(Official Form 6F)(12 Sao :15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 25 of 39 IN RE Statewide Florida Glass,LLC Case No. Debtor(s) (If known) SCHEDULE F- CREDITORS HOLDING UNSECURED NONPRIORITY CLAIMS (Continuation Sheet) P} r � � o CREDITOR'S NAME,MAILING ADDRESS DATE CLAIM WAS INCURRED AND m AMOUNT INCLUDING ZIP CODE,AND ACCOUNT NUMBER „m-, CONSIDERATION FOR CLAIM.IF CLAIM IS Z S S OF (See Instructions Above.) o 9 p7 O SUBJECT TO SETOFF,SO STATE d_ Q CLAIM u o .p ACCOUNT NO.XXXX Trulite P.O.Box 935480 Atlanta,GA 31193-5480 7,360.00 ACCOUNT NO.XXXX Wayne Weigard 3594 Beaufort Court Naples,FL 34119 0 9,300.00 g ACCOUNT NO Assignee or other notification for: Wayne Weigard Cary J.Goggin,Esquire LL Goede,Adamczyk,DeBoest&Cross, PLLC 8950 Fontana Del Sol Way,1st Floor Naples, FL 34109 m ACCOUNT NO. a C LL W M 0 (I1 Si ACCOUNT NO. 0 ACCOUNT NO. ACCOUNT NO. Sheet no. 10 of 10 continuation sheets attached to Subtotal Schedule of Creditors Holding Unsecured Nonpriority Claims (Total of this page) $ 16,660.00 Total (Use only on last page of the completed Schedule F.Report also on the Summary of Schedules,and if applicable,on the Statistical Summary of Certain Liabilities and Related Data.) $ 152,437.83 B6G(Official Form 6G)(lse 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 26 of 39 IN RE Statewide Florida Glass, LLC Case No. Debtor(s) (If known) SCHEDULE G - EXECUTORY CONTRACTS AND UNEXPIRED LEASES Describe all executory contracts of any nature and all unexpired leases of real or personal property. Include any timeshare interests. State nature of debtor's interest in contract,i.e.,"Purchaser,""Agent,"etc.State whether debtor is the lessor or lessee of a lease.Provide the names and complete mailing addresses of all other parties to each lease or contract described.If a minor child is a party to one of the leases or contracts,state the child's initials and the name and address of the child's parent or guardian, such as"A.B.,a minor child,by John Doe,guardian."Do not disclose the child's name.See,11 U.S.C.§1I2 and Fed.R.Bankr.P. 1007(m). ❑Check this box if debtor has no executory contracts or unexpired leases. DESCRIPTION OF CONTRACT OR LEASE AND NATURE OF DEBTOR'S INTEREST. NAME AND MAILING ADDRESS,INCLUDING ZIP CODE STATE WHETHER LEASE IS FOR NONRESIDENTIAL REAL PROPERTY. OF OTHER PARTIES TO LEASE OR CONTRACT STATE CONTRACT NUMBER OF ANY GOVERNMENT CONTRACT. Frank LaCava commercial lease P.O. Box 398 Goodland,FL 34140 0 `o W a N N m m m 0 0 N W C) M 0) m v T I B6H(Official Form 6H)(1 se 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 27 of 39 IN RE Statewide Florida Glass,LLC Case No. Debtor(s)��—. ------------..._----------- (If known) SCHEDULE H - CODEBTORS Provide the information requested concerning any person or entity,other than a spouse in a joint case,that is also liable on any debts listed by the debtor in the schedules of creditors.Include all guarantors and co-signers.If the debtor resides or resided in a community property state,commonwealth,or territory(including Alaska,Arizona, California,Idaho,Louisiana,Nevada,New Mexico,Puerto Rico,Texas,Washington,or Wisconsin)within the eight-year period immediately preceding the commencement of the case,identify the name of the debtor's spouse and of any former spouse who resides or resided with the debtor in the community property state,commonwealth,or territory.Include all names used by the nondebtor spouse during the eight years immediately preceding the commencement of this case.If a minor child is a codebtor or a creditor,state the child's initials and the name and address of the child's parent or guardian,such as"A.B..a minor child,by John Doe,guardian."Do not disclose the child's name.See,11 U.S.C.§112 and Fed.R.Bankr.P. 1007(m). [Check this box if debtor has no codebtors. NAME AND ADDRESS OF CODEBTOR NAME AND ADDRESS OF CREDITOR O d m` 0 0 E LL N 0'01 O O C C C LL N W m 0 0) O1 L(9. B6 Declaration(Official Focfli165-`DaratAo (aWJ15-FMD Doc 1 Filed 09/04/15 Page 28 of 39 IN RE Statewide Florida Glass, LLC Case No. Debtor(s) (If known) DECLARATION CONCERNING DEBTOR'S SCHEDULES DECLARATION UNDER PENALTY OF PERJURY BY INDIVIDUAL DEBTOR I declare under penalty of perjury that I have read the foregoing summary and schedules,consisting of sheets,and that they are true and correct to the best of my knowledge, information,and belief. Date: Signature: —................... — Debtor Date: Signature: (Joint Debtor,if any) [If joint case,both spouses must sign.] DECLARATION AND SIGNATURE OF NON-ATTORNEY BANKRUPTCY PETITION PREPARER(See 11 U.S.C. § 110) I declare under penalty of perjury that: (1) I am a bankruptcy petition preparer as defined in 11 U.S.C. § 110; (2) I prepared this document for compensation and have provided the debtor with a copy of this document and the notices and information required under 11 U.S.C.§§ 110(b), 110(h), and 342(b);and,(3) if rules or guidelines have been promulgated pursuant to 11 U.S.C. § 110(h)setting a maximum fee for services chargeable by bankruptcy petition preparers,I have given the debtor notice of the maximum amount before preparing any document for filing for a debtor or accepting any fee from the debtor,as required by that section. C t] Printed or Typed Name and Title,if any,of Bankruptcy Petition Preparer Social Security No.(Required by 11 U.S.C.§110.) , If the bankruptcy petition preparer is not an individual, state the name, title (if any), address, and social security number of the officer,principal, E responsible person,or partner who signs the document. _LL • • N op• Address rn c Signature of Bankruptcy Petition Preparer Date Names and Social Security numbers of all other individuals who prepared or assisted in preparing this document,unless the bankruptcy petition preparer is not an individual: • If more than one person prepared this document,attach additional signed sheets conforming to the appropriate Official Form for each person. A bankruptcy petition preparer's failure to comply with the provision of title 11 and the Federal Rules of Bankruptcy Procedure may result in fines or imprisonment or both. I1 U.S.C.§110; 18 U.S.C.§156. DECLARATION UNDER PENALTY OF PERJURY ON BEHALF OF CORPORATION OR PARTNERSHIP magic+ororl Anon+lMananinn Partner (the president or otl ecofficer or an authorized agent of the corporation or a member or an authorized agent of the partnership)of the Statewide_Florida Glass,_LLC (corporation or partnership) named as debtor in this case, declare under penalty of perjury that I have read the foregoing summary and schedules, consisting of 21 sheets (total shown on summary page plus 1), and that they are true and correct to the best of my knowledge, information,and belief. Date:September 4,2015 Signature:/s/Antonios Fronimakis Antonios Fronimakis (Print or type name of individual signing on behalf of debtor) [An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor.] Penalty for making a false statement or concealing property:Fine of up to$500,000 or imprisonment for up to 5 years or both. 18 U.S.C.§§152 and 3571. 3 B7(Official Form 7)(04/1 Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 29 of 39 United States Bankruptcy Court Middle District of Florida IN RE: Case No. Statewide Florida Glass, LLC Chapter 7 Debtor(s) STATEMENT OF FINANCIAL AFFAIRS This statement is to be completed by every debtor. Spouses filing a joint petition may file a single statement on which the information for both spouses is combined. Ifthe case is filed under chapter 12 or chapter 13,a married debtor must furnish information for both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.An individual debtor engaged in business as a sole proprietor,partner,family farmer,or self-employed professional,should provide the information requested on this statement concerning all such activities as well as the individual's personal affairs.To indicate payments,transfers and the like to minor children,state the child's initials and the name and address of the child's parent or guardian,such as"A.B.,a minor child,by John Doe,guardian."Do not disclose the child's name.See,11 U.S.C. §112 and Fed.R.Bankr.P. 1007(m). Questions I - 18 are to be completed by all debtors.Debtors that are or have been in business,as defined below,also must complete Questions 19- 25.If the answer to an applicable question is"None," mark the box labeled "None."If additional space is needed for the answer to any question, use and attach a separate sheet properly identified with the case name,case number(if known),and the number of the question. DEFINITIONS "In business."A debtor is"in business"for the purpose of this form if the debtor is a corporation or partnership.An individual debtor is"in business" for the purpose of this form if the debtor is or has been,within six years immediately preceding the filing of this bankruptcy case,any of the following: an officer,director,managing executive,or owner of 5 percent or more of the voting or equity securities of a corporation;a partner,other than a limited ° partner,of a partnership;a sole proprietor or self-employed full-time or part-time.An individual debtor also may be"in business"for the purpose of this form if the debtor engages in a trade,business,or other activity,other than as an employee,to supplement income from the debtor's primary employment. • "Insider."The term"insider"includes but is not limited to:relatives of the debtor;general partners of the debtor and their relatives;corporations of ' which the debtor is an officer,director,or person in control;officers,directors, and any persons in control of a corporate debtor and their relatives; affiliates of the debtor and insiders of such affiliates;any managing agent of the debtor. 11 U.S.C. § 101(2),(31). r m Cg 1.Income from employment or operation of business 0 • None State the gross amount of income the debtor has received from employment, trade, or profession,or from operation of the debtor's business, including part-time activities either as an employee or in independent trade or business,from the beginning of this calendar year to the date this case was commenced. State also the gross amounts received during the two years immediately preceding this calendar year. (A debtor that maintains,or has maintained, financial records on the basis of a fiscal rather than a calendar year may report fiscal year income. Identify the beginning and ending dates of the debtor's fiscal year.)If a joint petition is filed,state income for each spouse separately.(Married debtors filing under chapter 12 or chapter 13 must state income of both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) ® AMOUNT SOURCE 398,003.00 2013--gross receipts 550,000.00 2014--gross receipts 247,294.00 2015 to date--gross receipts 2.Income other than from employment or operation of business None State the amount of income received by the debtor other than from employment,trade,profession,operation of the debtor's business during the two years immediately preceding the commencement of this case. Give particulars. If a joint petition is filed, state income for each spouse separately.(Married debtors filing under chapter 12 or chapter 13 must state income for each spouse whether or not a joint petition is tiled,unless the spouses are separated and a joint petition is not filed.) 3.Payments to creditors Complete m or b.,as appropriate,and c. None a.Individual or joint debtor(s)with primarily consumer debts:List all payments on loans,installment purchases of goods or services,and other debts to any creditor made within 90 days immediately preceding the commencement of this case unless the aggregate value of all property that constitutes or is affected by such transfer is less than$600.Indicate with an asterisk(*)any payments that were made to a creditor on account of a domestic support obligation or as part of an alternative repayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency.(Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 30 of 39 None b.Debtor whose debts are not primarily consumer debts:List each payment or other transfer to any creditor made within 90 days immediately preceding the commencement of the case unless the aggregate value of all property that constitutes or is affected by such transfer is less than $6,255.*If the debtor is an individual,indicate with an asterisk(*)any payments that were made to a creditor on account of a domestic support obligation or as part of an alternative repayment schedule under a plan by an approved nonprofit budgeting and credit counseling agency.(Married debtors filing under chapter 12 or chapter 13 must include payments and other transfers by either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) *Amount subject to adjustment on 4/01/16,and every three years thereafter with respect to cases commenced on or after the date of adjustment. None c.All debtors:List all payments made within one year immediately preceding the commencement of this case to or for the benefit of creditors who are or were insiders.(Married debtors filing under chapter 12 or chapter 13 must include payments by either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) 4.Suits and administrative proceedings,executions,garnishments and attachments None a.List all suits and administrative proceedings to which the debtor is or was a party within one year immediately preceding the filing of this ❑ bankruptcy case.(Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) CAPTION OF SUIT COURT OR AGENCY STATUS OR AND CASE NUMBER NATURE OF PROCEEDING AND LOCATION DISPOSITION Eastern Metal Supply Inc.vs civil County Court pending Statewide Florida Glass,LLC,et Palm Beach County, FL al Case No. 502015CC006984XXXXM B o TM Windows,LLC vs Statewide civil Circuit Court pending Florida Glass LLC,et al Lee County, FL t Case No.14-CA-000542 Thomas E Boyle vs.Statewide civil County Court default final u_ Florida Glass LLC Lee County FL judgment/garnishment Case No.15-SC-001669 • Richard L Klass and Nancy Klass civil Small Claims default final judgment vs.Statewide Florida Glass, LLC Collier County, FL E Case No.15-000361-SC Li Bass Law Office PA vs. civil Small Claims pending Statewide Florida Glass LLC Collier County FL LL Case No. • 112015SC0011710001XX n None b.Describe all property that has been attached,garnished or seized under any legal or equitable process within one year immediately preceding the commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) 5.Repossessions,foreclosures and returns None List all property that has been repossessed by a creditor,sold at a foreclosure sale,transferred through a deed in lieu of foreclosure or returned to ikr the seller,within one year immediately preceding the commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) 6.Assignments and receiverships None a.Describe any assignment of property for the benefit of creditors made within 120 days immediately preceding the commencement of this case. • (Married debtors filing under chapter 12 or chapter 13 must include any assignment by either or both spouses whether or not a joint petition is filed, unless the spouses are separated and joint petition is not filed.) None b.List all property which has been in the hands of a custodian,receiver,or court-appointed official within one year immediately preceding the • commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include information concerning property of either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 31 of 39 7.Gifts None List all gifts or charitable contributions made within one year immediately preceding the commencement of this case except ordinary and usual 12- gifts to family members aggregating less than$200 in value per individual family member and charitable contributions aggregating less than$100 per recipient.(Married debtors filing under chapter 12 or chapter 13 must include gifts or contributions by either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) 8.Losses None List all losses from fire,theft,other casualty or gambling within one year immediately preceding the commencement of this case or since the jig commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include losses by either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) 9.Payments related to debt counseling or bankruptcy None List all payments made or property transferred by or on behalf of the debtor to any persons,including attorneys,for consultation concerning debt ❑ consolidation,relief under the bankruptcy law or preparation of a petition in bankruptcy within one year immediately preceding the commencement of this case. DATE OF PAYMENT,NAME OF AMOUNT OF MONEY OR DESCRIPTION NAME AND ADDRESS OF PAYEE PAYOR IF OTHER THAN DEBTOR AND VALUE OF PROPERTY Cohen&Kendziorra,P.A. 8-13-15 1,800.00 3049 Cleveland Avenue,Ste 259 Fort Myers,FL 33901-0000 10.Other transfers None a.List all other property,other than property transferred in the ordinary course of the business or financial affairs of the debtor,transferred either absolutely or as security within two years immediately preceding the commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include transfers by either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) E LL None b.List all property transferred by the debtor within ten years immediately preceding the commencement of this case to a self-settled trust or similar device of which the debtor is a beneficiary. N eb O� • 11.Closed financial accounts • None List all financial accounts and instruments held in the name of the debtor or for the benefit of the debtor which were closed,sold,or otherwise gg transferred within one year immediately preceding the commencement of this case. Include checking, savings, or other financial accounts, certificates of deposit,or other instruments; shares and share accounts held in banks,credit unions,pension funds,cooperatives,associations, brokerage houses and other financial institutions. (Married debtors filing under chapter 12 or chapter 13 must include information concerning accounts or instruments held by or for either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) © 12.Safe deposit boxes None List each safe deposit or other box or depository in which the debtor has or had securities,cash,or other valuables within one year immediately • preceding the commencement of this case.(Married debtors filing under chapter 12 or chapter 13 must include boxes or depositories of either or both spouses whether or not a joint petition is filed,unless the spouses are separated and a joint petition is not filed.) 13.Setoffs None List all setoffs made by any creditor,including a bank,against a debt or deposit of the debtor within 90 days preceding the commencement of this • case.(Married debtors filing under chapter 12 or chapter 13 must include information concerning either or both spouses whether or not a joint petition is filed,unless the spouses are separated and anoint petition is not filed.) 14.Property held for another person None List all property owned by another person that the debtor holds or controls. 15.Prior address of debtor None If debtor has moved within three years immediately preceding the commencement of this case,list all premises which the debtor occupied during • that period and vacated prior to the commencement of this case.If a joint petition is filed,report also any separate address of either spouse. Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 32 of 39 16.Spouses and Former Spouses None If the debtor resides or resided in a community property state,commonwealth,or territory(including Alaska,Arizona,California,Idaho,Louisiana, Nevada,New Mexico,Puerto Rico,Texas,Washington,or Wisconsin)within eight years immediately preceding the commencement of the case, identify the name of the debtor's spouse and of any former spouse who resides or resided with the debtor in the community property state. 17.Environmental Information For the purpose of this question,the following definitions apply: "Environmental Law"means any federal,state,or local statute or regulation regulating pollution,contamination,releases of hazardous or toxic substances, wastes or material into the air,land,soil,surface water,groundwater,or other medium,including,but not limited to,statutes or regulations regulating the cleanup of these substances,wastes or material. "Site"means any location,facility,or property as defined under any Environmental Law,whether or not presently or formerly owned or operated by the debtor,including,but not limited to,disposal sites. "Hazardous Material"means anything defined as a hazardous waste,hazardous substance,toxic substance,hazardous material,pollutant,or contaminant or similar term under an Environmental Law. None a.List the name and address of every site for which the debtor has received notice in writing by a governmental unit that it may be liable or WI* potentially liable under or in violation of an Environmental Law. Indicate the governmental unit, the date of the notice, and, if known, the Environmental Law. None b.List the name and address of every site for which the debtor provided notice to a governmental unit of a release of Hazardous Material.Indicate IZ the governmental unit to which the notice was sent and the date of the notice. None c.List all judicial or administrative proceedings,including settlements or orders,under any Environmental Law with respect to which the debtor Wer is or was a party.Indicate the name and address of the governmental unit that is or was a party to the proceeding,and the docket number. E 18.Nature,location and name of business ENone a.Ifthe debtor is an individual,list the names,addresses,taxpayer-identification numbers,nature of the businesses,and beginning and ending dates ❑ of all businesses in which the debtor was an officer, director, partner,or managing executive of a corporation,partner in a partnership, sole proprietor, or was self-employed in a trade, profession,or other activity either full-or part-time within six years immediately preceding the N commencement of this case,or in which the debtor owned 5 percent or more of the voting or equity securities within six years immediately preceding the commencement of this case. If the debtor is a partnership,list the names,addresses,taxpayer identification numbers,nature of the businesses,and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities,within six years immediately preceding the commencement of this case. N If the debtor is a corporation,list the names,addresses,taxpayer identification numbers,nature of the businesses,and beginning and ending dates of all businesses in which the debtor was a partner or owned 5 percent or more of the voting or equity securities within six years immediately preceding the commencement of this case. LAST FOUR DIGITS ® OF SOCIAL- SECURITY OR OTHER INDIVIDUAL TAXPAYER-I.D.NO. NATURE OF BEGINNING AND NAME (ITIN)/COMPLETE EIN ADDRESS BUSINESS ENDING DATES Statewide Florida Glass, LLC 45-5289334 27925 Industrial Street glass 5-11-2012 to Bonita Springs, FL 34135-0000 installation and present repair b.Identify any business listed in response to subdivision-a.,above hat is"single asset real estate"as defined in 11 U.S.C.■ 101. L (C7 Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 33 of 39 • The following questions are to be completed by every debtor that is a corporation or partnership and by any individual debtor who is or has been,within six years immediately preceding the commencement of this case,any of the following: an officer,director,managing executive,or owner of more than 5 percent of the voting or equity securities of a corporation;a partner,other than a limited partner,of a partnership,a sole proprietor,or self-employed in a trade,profession,or other activity,either full-or part-time. (An individual or joint debtor should complete this portion of the statement only if the debtor is or has been in business,as defined above,within the six years immediately preceding the commencement of this case.A debtor who has not been in business within those six years should go directly to the signature page.) 19.Books,records and financial statements None a.List all bookkeepers and accountants who within the two years immediately preceding the filing of this bankruptcy case kept or supervised the wr keeping of books of account and records of the debtor. None b.List all firms or individuals who within the two years immediately preceding the filing of this bankruptcy case have audited the books of account • and records,or prepared a financial statement of the debtor. None c.List all firms or individuals who at the time of the commencement of this case were in possession of the books of account and records of the Ikr debtor.If any of the books of account and records are not available,explain. None d.List all financial institutions,creditors,and other parties,including mercantile and trade agencies,to whom a financial statement was issued by • the debtor within the two years immediately preceding the commencement of this case. 20.Inventories None a.List the dates of the last two inventories taken of your property,the name of the person who supervised the taking of each inventory,and the o ❑ dollar amount and basis of each inventory. DOLLAR AMOUNT OF INVENTORY N DATE OF INVENTORY INVENTORY SUPERVISOR (Specify cost,market,or other basis) E 8-13-15 Tiffany Fronimakis $124025.00--cost c None b.List the name and address of the person having possession of the records of each of the two inventories reported in a.,above. N ❑ DATE OF INVENTORY NAME AND ADDRESS OF CUSTODIAN OF INVENTORY RECORDS 8-13-15 Tiffany Fronimakis 27925 Industrial Street Bonita Springs,FL 34135-0000 w 21.Current Partners,Officers,Directors and Shareholders N None a.If the debtor is a partnership,list the nature and percentage of partnership interest of each member of the partnership. Ikr None b.If the debtor is a corporation,list all officers and directors of the corporation,and each stockholder who directly or indirectly owns,controls, ❑ or holds 5 percent or more of the voting or equity securities of the corporation. NATURE AND PERCENTAGE NAME AND ADDRESS TITLE OF STOCK OWNERSHIP Antonios Fronimakis manager 100% 24700 Carnoustie Court Bonita Springs,FL 34135 22.Former partners,officers,directors and shareholders None a.If the debtor is a partnership,list each member who withdrew from the partnership within one year immediately preceding the commencement • of this case. None b.If the debtor is a corporation,list all officers,or directors whose relationship with the corporation terminated within one year immediately ❑ preceding the commencement of this case. NAME AND ADDRESS TITLE DATE OF TERMINATION Erik Fronimkais Manager 7-7-15 24700 Carnoustie Court Bonita Springs,FL 34135 Tiffany Fronimakis Manager 7-7-15 24700 Carnoustie Court ((// Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 34 of 39 Bonita Springs,FL 34135 23.Withdrawals from a partnership or distributions by a corporation None If the debtor is a partnership or corporation,list all withdrawals or distributions credited or given to an insider,including compensation in any form, • bonuses,loans,stock redemptions,options exercised and any other perquisite during one year immediately preceding the commencement of this case. 24.Tax Consolidation Group None If the debtor is a corporation,list the name and federal taxpayer identification number of the parent corporation of any consolidated group for tax • purposes of which the debtor has been a member at any time within six years immediately preceding the commencement of the case. 25.Pension Funds. None If the debtor is not an individual,list the name and federal taxpayer identification number of any pension fund to which the debtor,as an employer, g has been responsible for contributing at any time within six years immediately preceding the commencement of the case. [If completed on behalf of a partnership or corporation] I declare under penalty of perjury that I have read the answers contained in the foregoing statement of financial affairs and any attachments thereto and that they are true and correct to the best of my knowledge,information,and belief. Date: September 4,2015 Signature:/s/Antonios Fronimakis C 0 Antonios Fronimakis,Registered Agent/Managing Partner Pont Name and Title 0 rn LL [An individual signing on behalf of a partnership or corporation must indicate position or relationship to debtor.] sr co 0 continuation pages attached a Penalty for making a false statement: Fine of up to$500,000 or imprisonment for up to 5 years or both. 18 U.S.C. §152 and 3571. LL lL m 0 M a O) L L Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 35 of 39 United States Bankruptcy Court Middle District of Florida IN RE: Case No. Statewide Florida Glass, LLC Chapter 7 Debtor(s) VERIFICATION OF CREDITOR MATRIX The above named debtor(s)hereby verify(ies)that the attached matrix listing creditors is true to the best of my(our)knowledge. Date: September 4,2015 Signature: /s/Antonios Fronimakis Antonios Fronimakis,Registered Agent/Managing Partner Debtor Date: Signature: Joint Debtor,if any C 0 a, 0 LL NN N N m O O aD C C m C LL N W C) O W C7o Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 36 of 39 Statewide Florida Glass, LLC City Mattress Frank LaCava 27925 Industrial Street Attn: Nick P.O. Box 398 Bonita Springs,FL 34135 4296 Tamiami Trail N Goodland, FL 34140 Naples,FL 34103 Cohen&Kendziorra,P.A. Cohen&Grigsby, P.C. Frank LaCava 3049 Cleveland Avenue,Ste 259 9110 Strada Place,Ste 6200 27925 Industrial Street Fort Myers,FL 33901-7047 Naples, FL 34108 Bonita Springs,FL 34135 ABC Supply Co Cole,Scott&Kissane, P.A. Gary Brecka 1100 Sun Century Road 27300 Riverview Center Blvd,Ste 200 3368 Atlantic Circle Naples, FL 34110 Bonita Srpings,FL 34134 Naples,FL 34119 Advanced Disposal Solid Waste Southeast Comcast Gary Hains 17101 Pine Ridge Road P.O.Box 105184 2777 12th Street Fort Myers Beach, FL 33931 Atlanta,GA 30348-5184 Naples, FL 34103 Aldora Aluminum and Glass Products, Inc Countryside Golf&Country Club George&Be McArdle 11500 Miramar Pkwy,#300 Attn: Ken Williams 6700 Huntington Lakes Circle,#101 Miramar,FL 33025 600 Countryside Drive Naples, FL 34119 Naples, FL 34104 Bass Law Office Dennis Guay George Fellows 2335 Tamiami Trail N,Ste 409 1012 Eastham Court 927 Bercarmil Way Naples,FL 34103 Naples, FL 34104 Naples, FL 34110 C R Laurence Dr.Ralph Ryback GF Holdings Naples 2503 E Vernon Avenue 9148 The Lane CIO Heidemarie Klimt Los Angeles,CA 90058-1826 Naples, FL 34109 71 18th Avenue S Naples, FL 34102 Carol Ostrange Eastern Metal Supply Inc Hastings Investments,LLC 5051 Pelican Colony Blvd C/O William Joel Marell,Esquire C/O Cohen&Grigsby,PC Bonita Springs,FL 34134 1601 Forum Place,Ste 1101 9110 Strada Place,Ste 6200 West Palm Beach, FL 33401 Naples, FL 34108 Cary J.Goggin,Esquire EyeMD EMR Healthcare Systems Herbert Bergman Goede,Adamczyk,DeBoest&Cross,PLLC 27300 Riverview Center Blvd,Ste 100 2636 Sommerville Lopp,#1601 8950 Fontana Del Sol Way, 1st Floor Bonita Springs, FL 34134 Cape Coral, FL 33991 Naples,FL 34109 Chase FPL (Mark Development Cardmember Service 26301 Cutting Horse Lane 2205 SE 32nd Terrace P.O. Box 15298 Bonita Spring,FL 34135 Cape Coral, FL 33904 Wilmington, DE 19850 t.: -7 1 Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 37 of 39 Jack Clark Living Styles FHD Protection One 21550 Madera Road Marion Smith 800 E Waterman Fort Myers Beach,FL 33931 561 S Collier Blvd Wichita, KS 67202 Marco Island, FL 34145 Jill Frye Luminous Glass Supply R&L Carriers 24547 Redfish Street 1140 BW 159th Drive P.O. Box 10020 Bonita Springs,FL 34134 Miami, FL 33169 Port William,OH 45164-2000 Joe Hieronimus Marion VanHorn Radio America 13402 Rosewood Lane 5320 SW 11th Place P.O. Box 3307 Naples,FL 34119 Cape Coral,FL 00000 Oak Park,IL 60303-3307 John&Fran Kazmerski Matt Raymond Bass 3006 Cinnamon Bay Circle 271 South Bay Drive,#133 2800 Gulf Shore Blvd N,#107 Naples,FL 34119 Naples, FL 34108 Naples, FL 34103 John D Agnew,Esquire Mike Percorio Rayond Building Supply Henderson,Franklin,Starnes&Holt, P.A 803 Slash Pine Court 7751 Bayshore Road P.O. Box 280 Naples,FL 34108 North Fort Myers,FL 33917 Fort Myers,FL 33902 John Largura Naples Zoo Richard And Nancy Klass 27251 Ibis Cove Caribbean Gardens 3377 Gulf Shore Boulevard North,#8C Bonita Springs,FL 00000 1590 Goodlette Road Naples, FL 34103 Naples,FL 34102 Kenneth Van DeMark Nolen's Permitting Roberts Bay Custom Homes Inc 8165 Saratoga Drive,#1302 90 24th Avenue NE Hayden Warren Naples, FL 00000 Naples,FL 34120 840 Newell Terrace Marco Island,FL 34145 Kohner Mann&Kailas,SC PNC Bank Shaun M.Garry,Esquire 4650 N Port Washington Road P.O.Box 3180 9115 Corsea Del Fontana Way,Ste 100 Milwaukee,WI 53212-5110 Pittsburgh, PA 15253-3180 Naples,FL 34109 KTS Group Precision Glass Bending Silvico 2430 Vanderbilt Beach Road,#260 3811 W Highway 10 1010 Manatee Road, Unit 205-B Naples,FL 34109 Greenwood,AR 72936 Naples,FL 34114 Lisa Rydberg Professional Conractors Group South Street Grill 26463 Doverstone Street Lee Hershey Attn: Michelle Bonita Springs,FL 34135 9201 Brookwood Court,#6 1410 Pine Ridge Road Bonita Springs,FL 00000 Naples, FL 34108 E--7; Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 38 of 39 • Steve Pursley Trulite 6520 Valen Way,#C204 P.O. Box 935480 Naples,FL 34106 Atlanta, GA 31193-5480 Terry Gilcrest Wayne Weigard 1139 Imperial Drive 3594 Beaufort Court Naples,FL 34110 Naples, FL 34119 The Swiss Colony 1112 7th Avenue Monroe,WI 53566-1364 The Hartford P.O. Box 7247 Philadelphia,PA 19170 The Home Mag 1732 SE 47th Terrace Cape Coral,FL 33904 The Yellow Book 2201 Renaissance Blvd King Of Prussia, PA 19406 Thomas E.Boyle 26170 Mira Way Bonita Springs,FL 34134 TM Windows,LLC CIO Malka&Kravitz,P.A. 1300 Sawgrass Corporate Pkwy,Ste 100 Fort Lauderdale,FL 33323 Tom Ecker 1036 Port Orange Court Naples,FL 34120 Tracy L Juels 860 Willow Court Marco Island,FL 34145 7.3 Case 9:15-bk-09115-FMD Doc 1 Filed 09/04/15 Page 39 of 39 United States Bankruptcy Court Middle District of Florida IN RE: Case No. Statewide Florida Glass, LLC Chapter 7 Debtor(s) DISCLOSURE OF COMPENSATION OF ATTORNEY FOR DEBTOR 1. Pursuant to 11 U.S.C. §329(a)and Bankruptcy Rule 2016(b),I certify that l am the attorney for the above-named debtor(s)and that compensation paid to me within one year before the filing of the petition in bankruptcy,or agreed to be paid to me,for services rendered or to be rendered on behalf of the debtor(s)in contemplation of or in connection with the bankruptcy case is as follows: For legal services,I have agreed to accept $ 1,800.00 Prior to the filing of this statement I have received $ 1,800.00 Balance Due �( 2. The source of the compensation paid to me was: LJ Debtor ❑Other(specify): 3. The source of compensation to be paid to me is: ❑Debtor El Other(specify): 4. V( I have not agreed to share the above-disclosed compensation with any other person unless they are members and associates of my law firm. ❑ I have agreed to share the above-disclosed compensation with a person or persons who are not members or associates of my law firm.A copy of the agreement, together with a list of the names of the people sharing in the compensation,is attached. E• 5. In return for the above-disclosed fee,I have agreed to render legal service for all aspects of the bankruptcy case,including: a. Analysis of the debtor's financial situation,and rendering advice to the debtor in determining whether to file a petition in bankruptcy; co b. Preparation and filing of any petition,schedules,statement of affairs and plan which may be required; • c. Representation of the debtor at the meeting of creditors and confirmation hearing,and any adjoumed hearings thereof; e. [Other provisions as needed] Filing of suggestion of bankruptcy in state court cases 0) C LL N W CnC) 0 m 6. By agreement with the debtor(s),the above disclosed fee does not include the following services: CERTIFICATION I certify that the foregoing is a complete statement of any agreement or arrangement for payment to me for representation of the debtor(s)in this bankruptcy proceeding. September 4,2015 /s/Robert S. Cohen Date Robert S.Cohen 564079 Cohen&Kendziorra,P.A. 3049 Cleveland Avenue,Ste 259 Fort Myers,FL 33901-7047 (239)931-1111 Fax:(239)656-4022 cokenpa2@yahoo.com